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tinues but failure to date is no reason for ceasing efforts to reduce other atmospheric
pollutants. In smoke control areas, problems are arising in regard to the disposal
of garden refuse, afterbirths, dressings, etc. which cannot be placed in dustbins
and local authorities may yet have to consider ways of dealing with these difficulties.
The proximity of the Borough to London Airport has focussed attention on noise
especially that of aircraft. The ability of the average person to exclude some noises
while attending to others is a matter of everyday experience, but there is no doubt
that aircraft noise can be very disturbing in schools, offices and in any other work
where relative quiet is essential. The type of construction of houses, offices, etc.
seem to have a bearing on the intensity and reverberation of noise from aircraft and
as there seems as yet to be little prospect of reducing the noise of aeroplane
engines, this point might be worthy of consideration by architects. In the disturbance
caused by aircraft noise there may be a subconscious element of fear. Road or
rail traffic noise does not conjure up the idea of being personally involved if an
accident occurs but the same cannot be said of aircraft passing overhead and to some,
at night aircraft noise may recall war memories. Reaction to sound is individual and
personal and what disturbs one person may be relatively unnoticed by another. All will
agree that efforts should be made to reduce noise of all kinds but one wonders if any
noise will ever disturb the present youth who seem to be happy only when television
radio, tape-recorders and gramophones are at full volume or even further amplified.
Ante natal clinics provide medical supervision for mothers during pregnancy and
in recent years increasing attention has been given to mothercraft teaching and relaxation
classes, There are now 4 weekly sessions as compared with 6 in 1939 and the
average annual attendance has fallen from 4,645 in 1939-43 to 3,287 in 1959-63.
The work of infant welfare clinics is largely advisory in regard to the diet
nurture and welfare of babies and young children. In recent years so much has been said
and written about child psychology and the importance of the relationship between
parents and children that parents are almost made to feel guilty. The association
between emotional and behaviour problems in children and broken or disturbed homes
is undoubted, but most parents are genuinely interested in the Welfare of their children,
and it is to be hoped that infant welfare clinics will continue to provide support
and encouragement. At each session welfare foods (National dried milk, orange juice,
etc.) are available to all eligible persons and other proprietory brands of infant
foods, vitamins etc. are on sale to mothers attending the clinics. The number of items
stocked is such as to meet the needs of most children and attempts to look upon these
clinics as shops which should stock everything must be resisted. Ten sessions are
now held each week and the average annual attendance has fallen from 28,272 in 193943
to 18 750 in 1959-63.
The general arrangement of the school health service has not changed. Periodic
medical examinations of "entrants" "intermediates" and "leavers''' are carried out
in the schools and minor ailment consultation orthopaedic eye clinics and speech
therapy continue. In some districts periodic medical examinations of all intermediates"
and "leavers" has been replaced by selective examination of pupils considered
by head teachers school nurses and others to be in need of medical examination.
Here when a school is to be visited for periodic medical examination, the head
teacher is asked to submit the names of any other pupils in whose case a medical
examination is thought to be advisable. Further, at any time a head teacher or school
nurse may refer or a parent may bring, a pupil to the school consultation clinic, so
it might be said that we combine the periodic and selective systems. Due to the reduction
in the incidence of malnutrition skin infections, running ears, inflamed
eyes etc. the numbers attending the minor ailment and consultation clinics have fallen.
Emotional disturbances social maladjustment school phobia and failure to progress
in school now take up much of the school medical officer's time. The solution
of these problems is complicated as in many cases they seem to be associated with some
unstabilizing factor in the home.
The Child Guidance Clinic, under the administrative control of the School Medical
Officer was started in 1943. Later control passed to the Education Officer and there
it remains despite the recommendation of the Ministry of Education that such clinics
should be an integral part of the school health service. School medical officers endeavour
to maintain a link with this clinic and to secure exchange of information. The
volume of work at this clinic is heavy and treatment is lengthy even when adequate and
suitable trained staff can be recruited.
A primary responsibility of the school health service is to find children suffering
from handicaps and to make recommendations as to special education for such
children. Early diagnosis is essential if handicapped children are to get the maximum
benefit from treatment and special education and therefore school medical officers
participate in the maternity and child welfare services. The Education Department has
responsibilities for handicapped children from the age of 2 years and now there is a nursery
section in many special schools. The handicapped children for whom special provision
may have to be made are usually grouped in the following categories:- (a) blind, (b)
partially sighted, (c) deaf (d) partial hearing (e) delicate (f) diabetic, (g)
educationally sub normal (h) epileptic (i) maladjusted (j) physically handicapped
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