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No children are re-admitted to school until they have had two negative examinations at an
interval of one week. After re-admission they are kept under observation and re-examined under
the Wood Glass filter until the Medical Officer is satisfied that there is no return of the infection.
(d). Visual Defects and External Eye Disease.
Later in this report will be found Dr. Roberts' Report which I specially asked her to make
on the present position with regard to the eye service.
I found, on taking up duty here, that parents were being pressed by the optician appointed
by the Committee to spend more than their means warranted and also that derogatory remarks
were made with regard to the frames which were on sale at a lower price. In going into the
matter I found that around London some of the districts were very definitely crippling their
service by reason of the prices demanded for the spectacles prescribed by the Ophthalmic Surgeon.
Twenty-five shillings was a common price I found in certain areas for extravagant frames
and also for astigmatic glasses with high diopter value. This meant when one came to look
into it that in many cases the parents could not afford the prices demanded and in the case of
the progressive myope whose glasses had to be altered fairly frequently the expense was one the
parents could not face, and, moreover, did not face. It was brought home to me that if our
ophthalmic service was to be of any value to the chiM the prices paid for the glasses must be
within the capacity of the parents to pay. Moreover, there must be, when the parents were
faced with the necessity of providing their children with glasses, some certainty of the limitations
of the expense they were asked to incur.
It was exactly as one found when one was in practice. Many and many a time one found
humble people not coming to consult one because of the dread, that is the only word that can be
used, the dread of the unknown doctor's bill. Amongst the poor who live so close to the
poverty line, it is not the question of shillings but a question of pence that matters and those
who had heard that so and so's child had to have spectacles costing 25/- were appalled at the
prospect of having to pay what was almost half-a-week's wages for something they could not see
the real value of. When I say could not see the value of, the fact that they will try grandpa's
glasses on the child, or as I have often heard, the glasses grandma wore before she died, in their
abysmal ignorance of what glasses are or are intended to do, it is small wonder that they cavil
at the prospect of paying, as I have said, almost half-a-week's wages.
There is another factor which makes for difficulty, and that is the vanity of the girls who
object to wearing the plain nickel frames, and the fact that other children in the class are wearing
the imitation tortoisehell frame is gall and wormwood to them if they are only offered steel or
nickel. This one has to face and one finds, as a matter of fact, that the " Windsor " frame, that
is rolled gold with a film of imitation tortoiseshell around the eye piece, is the most satisfactory
in that it appeals to the vanity of the children and they in turn do take much more care than they
do with the nickel ones.
In order to counter this difficulty I insisted, first of all, on a flat rate payment so that
there was no anxiety as to what payment would be demanded. I started with 4/- which
covered a good nickel frame and,, the most important part, lenses of any magnitude. The previous
system I found in existence in so many areas was that the child who was most affected was
the one whose parents were penalised by the heavy cost of glasses. The response to the new
idea was excellent and the number of cases who turned up to be refracted increased steadily.
One found, however, that it was desirable to improve slightly the quality of the frames and the
contract was ultimately entered into at 4/6d. instead of 4/-.
As the news percolated through the district that the payment was a fixed one of comparatively
small amount the improvement in the acceptances of treatment steadily rose with it. A
still further important point in getting the sympathy of the parents was that one had a contract
price for every kind of repair and this was posted up so that they knew exactly what their
commitment was, and again the unknown had lost its terrors. The result has been a steady
improvement in that we were able last year to say that every child who required spectacles got
them. This of course was assisted very materially by the fact that on a wage scale the parents
were assessed to pay a reduced amount or even nothing.
It is joy to look back on the changes that fifteen years have made, due to the alteration
in the policy and the help of an enlightened Education Committee.
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