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This service now has, by the nature of its organisation, a complete
integration with the child psychiatric hospital and general medical practitioner
services of the Borough.
School Ophthalmic Service
The provision of occluders and alternative vision testing charts has
improved standards of accurate vision testing in schools. The Stycar testing of
under 5 year olds at the Child Health Clinics provides an earlier screening.
Routine eye tests are carried out at 5 years, 8 years 10 years and 14
years examinations and at special examinations when indicated. There is no delay
in follow up and re-examinations, but clearly the ideal service should provide
annual tests. Squint and amblyopia due to binocular vision or suppression of
visual images can develop quickly after many childhood illnesses and for other
reasons and produce permanent defects of sight. A great responsibility rests on
those officers who carry out these tests but a further safeguard lies in the fact
that the services of four consultant ophthalmologists are available under the
supplementary ophthalmic service to examine all referrals from school or clinic.
Orthopaedic Service
The number of children at school medical examinations noted as needing or
reoeiving treatment for defects of posture or minor deformities of feet decreased
by 53• The number of attendances for remedial exercises decreased by 103. This
improvement is an extension of that noted in previous reports and has raised the
question of whether this service might more efficiently be provided entirely from
hospital out-patients. To some extent this already happens when the hospital
orthopaedic clinics receive patients referred directly from the general medical
practitioner service. Diagnostic facilities are more easily available in hospital
but treatment services at clinics may save valuable school time for the children
and are often more convenient and acceptable to parents.
Health Education
The comprehensive report shows that we can never become complacent on this
important subject. After rejoicing for several years on the progressive reduction
in home accident figures, this year an increase of 1,379 casualties, shared between
915 adults and 464 children, has come as a shock. The local campaigns for 1970
are all directed towards the various identifiable causes but clearly the continuing
and main effort must come from the home.
Last year the new Health Education Council took over the functions of the
Central Council for Health Education. It has set up a Working Party to consider
in particular problems of sex health education, and in due course Authorities will
receive recommendations. This difficult problem is mentioned later in this report
under the heading of "The School and the Future Parent".
In concluding this report, I wish to refer to the resignations of three
Medical Officers, Dr. Maxwell in March, Dr. Hilton in July and Dr. Swistak in
December. Dr. Maxwell had served the former Borough of Bromley for eleven years
before transfer to the London Borough of Bromley and was an efficient and very
popular Medical Officer. At the same time, we welcomed Dr. Menon in April,
Dr. Lyttle in November and Dr. Parkinson in December, to the School Health Service.
Finally, may I sincerely thank the Chairman and Members of the Committee
for their sympathetic support throughout the year. Mr. Barraclough, the Chief
Education Officer, his staff with special responsibilities, and the Heads of
Schools, have continued to receive the advice and recommendations of the medical
staff with extreme courtesy, and to encourage wholeheartedly the development of
any worthwhile support service. My own staff, and in particular Dr. Currie,
Senior Medical Officer, have worked diligently to introduce new ideas to improve
the service for the handicapped child, and to work in unison with the Hospital
and General Medical Services, and I am grateful to them for their efforts throughout
the year.
L.R.L. EDWARDS
Principal School Medical Officer
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