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83
the vision of children could be tested by a nurse, a hearing defect
revealed by an audiogram, while mass X-rays would show early lung
changes that are imperceptible on stethescopic examination. Unfortunately
there are still many complaints (some very minor admittedly)
which pass unnoticed by the lay eye. In fact, 1 had almost reached
the conclusion that 1 was wasting a lot of time in these examinations,
when I found a very anaemic boy actually at school. (In 1910-14 the
yearly average was 23%). This child was accepted by all as being quite
well, but his real state of " good health " was only evident on his
return from hospital. Of course, if his condition had deteriorated, he
would have eventually been taken to his own general practitioner, but
I was happy that this loss of time had been avoided.
These early and often borderline cases are the particular province
of the school medical officer; not only physical, but conditions
founded on mental instability or emotional upset, can and should be
found, but only if the inspection ceases to be formally routine and
becomes, as anticipated by the Medical Officer of Health in one of
his earlier reports, an opportunity to discuss with the parents any particular
problems. Often these are the very ones which cause so much
anxiety, but for which no advice is sought because of the overcrowded
surgeries of to-day. I am aware that it is fashionable nowadays to
consult a psychiatrist on the least provocation, but it is perhaps because
of the great amelioration in the physical condition of the child that
more attention is being paid to psychological effects.
The general state of health is, without doubt, good, but this can
only be maintained by vigilance, education and the closest co-operation
of all concerned, and the National Health Service Act has, I think,
brought the general practitioner and the school medical officer closer
together in their mutual tasks and aims."
1 have again included a report by Miss Bentley on physical
education, and this will be found at the end of the Report.
Mr. King, the dental officer, has continued to work with his usual
enthusiasm and efficiency in spite of dental staff shortage, and his
report will be found in the text of the Report. The reports of Dr.
Lyle, Ophthalmic Surgeon, and Mr. Hulbert, Orthopaedic Surgeon,
are also embodied in this Report.
I could not end this introductory letter without expressing appreciation
of the help I have always received from the members of the
Welfare Committee and from the Borough Education Officer, Mr.
Smith, nor could I carry out my duties without the tireless efforts of
the professional staff and of Mr. Judd, the Chief Clerk and the clerical
staff who work under him.
K. E. TAPPER,
Medical Officer of Health.