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needed only when the child is ill. The discovering
of major defects at school inspection is perhaps a reflection
on the parental care of the child, or it may be that
parents wait for the routine medical inspection, or use
the School Clinic as a hospital out-patient department;
but the fact that major defects in the child are discovered
at the medical inspection indicates a failure
somewhere in our method of prevention. The present
economic conditions play a part in this; medical
expenses in the household are seldom provided for in
the allocation of the weekly wage. Bromley lacks an
Out-patient Service, so that the School Clinic is bound
to be used as a consultation clinic for the children
attending elementary schools. It must not be forgotten
that the School Medical Service forms no part in the
domiciliary treatment of the sick child.
Treatment.
It is in the correction of these defects that the
various special clinics are established. I am convinced
from my own experience that if the special clinics were
not provided by the Local Authority, few of these
children would receive the necessary treatment in the
early stages and that much impairment of the child
would result from the delay. In this respect we ourselves
are not blameless, for there is delay on part of
the Clinic in the correction of the eye defects. The
Board of Education was approached on this matter, hut
would not allow the provision of staffing additional eye
clinics, and suggested a lowering of the standard of
reference, which is at present 6/9 in both eyes.
Eye Clinic.
Table IV., Group II., gives details of the work
carried out at the Clinic during the year. If one refers
to the medical inspection it will be found that approximately
5 per cent. of the children examined were found
to have defective vision. This means that 190 children
should come under periodical examination for refraction
each year. Unfortunately, in 1932, we were able to
refract only 123 cases, so that at the end of the year
we are left with a waiting list of some 70 cases. With
increasing school population of the Borough, and the