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to the fact that the necessity for each main branch of preventive
medicine was not conceived at one and the same time, that they
arose piecemeal, as it were, and it was not deemed advisable to
jeopardise the working of the young growing services by repeated
experimental reorganisations: Moreover, the accommodation for
our Medical Services—in old store rooms, dwelling houses, church
halls and what not—has been pure improvisation. As a result,
complete co-ordination, although one of the foremost aims throughout,
has not been achieved entirely, and one looks forward to the
time when the economic conditions will allow of the residents of
each of the four quarters of the Borough being served by one
Medical Officer, a team of two or three trained nurses and its own
satisfactorily equipped clinic building, where the parents, the
infant, and the school child may receive the necessary advice and
treatment on all those matters which are undertaken by the medical
services of the Public Health Department, the most central of
these clinics being equipped for the carrying out of specialised
work, e.g., Ophthalmic treatment, Aural treatment, X-ray and
Light treatment, etc. Such an arrangement would simplify central
administration, increase that very important interest and personal
contact between the staff and the inhabitants of East Ham, prove
of great convenience to the latter (it is not uncommon for members
of one family to be visiting three or four different clinics nor for
the home to be visited by two or three different members of the
nursing staff), and, apart from the initial outlay, for buildings and
equipment, should result in a considerable reduction in expenditure.
3. THE SCHOOL MEDICAL SERVICE IN
RELATION TO PUBLIC ELEMENTARY SCHOOLS.
School Hygiene.
During the year 1928 a complete survey of the sanitary
and hygienic conditions pertaining to all the schools of the
Authority has been carried out. Reports upon matters requiring
attention have been submitted month by month to the Committee.
In most instances my recommendations have received careful con
sideration, and an endeavour has been made to remedy defects
where possible, but a good deal remains to be done in connection
with improvements in the lighting and heating of. school premises.