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86
pathic child of the younger age groups. The matter is,
however, not easily remedied, especially as the grant in
aid is dependent fundamentally on the attendance figure.
I am again pleased to record the fact that parents
attend medical inspections at school in 89 per cent. of
children examined, and it is of special interest, now that
the Maternity and Child Welfare service is so closely
associated with the School Medical service, to examine
children who have been seen by the medical inspector
at the welfare centres. That this co-operation between
public health services should cease at 14 years of age
and not continue into the secondary schools is obviously
regrettable.
Main Defects discovered at Medical Inspection.
A reference to the Appendix Table II. will show the
result of medical inspection of the children at school,
routine inspection, and of children attending the clinic
special inspections. The defects are sub-divided into those
requiring treatment and those requiring observation.
Malnutrition.
No standard of physical fitness has been laid down,
nor would it be possible to do so. It is thus left to the
medical examiner to fix the normal, and to record the
departure from the normal. Thus does one get varied
results in various areas. In Bromley, unless there is
some family constitutional element, all cases of malnutrition
are referred to the School Clinic for observation,
and where the case is necessitous referred to the Care
Committee for convalescence, or for free milk in school.
Four per cent. of children examined showed this condition
of low physique, 40 of these children were sent
to convalescent homes, and 116 were provided with free
milk and other nourishment. The net cost to the Children's
Care Committee was £46. This cost is an exceedingly
small one mainly because of the convalescent home
letters granted by the Queen's Reign Commemoration
Fund. Many of these children do not respond to treatment,
but if we can but stop progression of the defect,
we have achieved much.