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THE MEDICAL INSPECTION OF SCHOOL CHILDREN.
1642 What I wished to convey was that the remarks in the annual report that the Members if elected on the Council would turn it into a socio-political affair were untrue and a libel on the Members of the College. The Members have as much desire to sustain the honour and dignity of the College as the Council. I am, Sirs, yours faithfully, JOSEPH SMITH, M.R.C.S. Eng. & D.P.H. Camb., J.P. Wellesley-road, Gunnersbury, W., Dec. 3rd, 1907.
stated at the meeting.
least hour ; and Section 13 says in Sub. occupy I would section (a) :"The examination of each child need Sections rule than few minutes." These at
an
not
as a
two a occupy more the Board of me to be to On the whole appear incompatible. Education seems to have honestly tried to deal, in part, with a most important and difficult matter in a thorough manner, although two cardinal matters are, as you stated, dealt with very delicately. The one is the question of following up cases of illness or defect and the other is the question of treatment. As to the success of the movement, so far as it goes, everything depends upon how the local THE MEDICAL INSPECTION OF SCHOOL authorities discharge the task which it is wished that they should carry out. Moreover, no provision is apparently made CHILDREN. for any payments to the medical men and the matter of To the Editors of THE LANCET. expense will probably be the rock upon which many local SIRS,-The recent circular from the Board of Education authorities will go to pieces, for the question of hygiene is deals with matters of so great importance that I shall be in many cases the very one upon which local authorities are grateful if you will allow me space to call attention to one unable or unwilling to see the necessity of spending money. or two points which you did not touch upon in your leading I am, Sirs, yours faithfully, article. It may be as well to recall the inception of the M.D. Dec. 2nd, 1907. 1907. circular before dealing with the points in question. Last summer there passed through Parliament a Bill now To the Editors of THE LANCET. known as the Education (Administrative Provisions) Act, ’ SIRS,-Some expression of opinion in the columns of 1907. Section 13 of this Act deals with the question of THE LANCET as to the proper remuneration for this work medical inspection, and its provisions were published at would be of great assistance to many a medical officer of of in the the abstract of Nov. 30th p. 1555 of your issue health in small districts, where the local authority is as a More or less coincidently circular referred to below. with the passage of this Act the Board of Education rule only too ready to impose additional duties upon its determined upon the creation of a medical department officers without any commensurate payment. I am, Sirs, yours faithfully, and in THE LANCET of Sept. 21st a circular from the AN ILL-PAID M.O.H. Nov. 1907. 30th, Board was published notifying the appointment of a The raised in this letter has been Board and that in the President for this ** stating important question autumn the Board would issue a circular to local edu- present to our minds ever since we read the memorandum of cation authorities "regarding their new duties in the the Board of Education. The action of the Board of matter of the medical inspection of school children." Education will probably lead either to the appointment of The section of the Act with which the circular in question deals comes into force on Jan. lst, 1908, so that between the assistant medical officers of health or to the engagement of date of the circular, Nov. 22nd, and the beginning of next practitioners as inspectors on a part-time basis according year there remain nearly six weeks during which its pro- to the population of the area. In the case of the medical visions may be considered-a period none too long when the officer of health there will be remuneration independent importance of the duties laid upon education authorities from the salary as medical officer of health, a principle and the wide-reaching nature of the same be considered. It is all very well to make regulations and to express which has already been recognised. We are not in a position aspirations, but the carrying out of regulations is a different to say anything more definite as yet, but we believe that matter from their formulation, and by far the most both the Board of Education and the Local Government important portion of the circular is that which deals with Board are fully aware that a payment scheme will have to the administration of the clauses of the Act in question. be arranged and are prepared to act fairly towards the The function of the Board of Education is to advise local medical profession in the matter. We must trust to practieducation authorities as to the manner in which they should to tioners out the of the and the give us their help when we seek it if the question circular Act, carry provisions lays down that the work of medical inspection should be is not satisfactorily dealt with.-ED. L. carried out in intimate conjunction with "the public health authorities and under the direct supervision of the medical THE ARMY AND NAVY MALE NURSES’ officer of health." Reference to your abstract of the provisions of the circular will show that the administration of the Act is to be in the hands of county councils, town To the Editors of THE LANCET. councils, and urban and rural district councils which are local authorities for elementary education ; the last named one who has frequent occasion for the employSIRS,-As are advised to make arrangements for the purpose either ment of male nurses may I ask the reason for the continued separately or in combination. These bodies should be delay in the establishment of this much-needed institution? capable of doing the work which is set before them There are hundreds of former R.A.M.C. men walking about if they are willing to carry out the task. But there the streets who might get employment easily, as they are does not appear to be any provision for compelling local willing to take lower fees than those charged at the existing health authorities to do their duty, and recent events institutions. Why should the proposed cooperation be placed have shown that there are health authorities who are by no upon an eleemosynary basis at all ? What do Sir Frederick means willing to carry out their duties as guardians of the Treves and Dr. Howard Tooth want £2000 for? I will health of the community which has elected them. Your undertake to say that not one of the associations which can readers will have no difficulty in calling to mind instances now afford to advertise themselves so liberally started with a of neglect, examples of which are constantly made public in capital of £2000 or even £200. Surely there is credit enough the reports of the medical inspectors of the Local Govern- behind the scheme to take and furnish a small house in a ment Board, but although the British nation as a whole central position ; nothing more is required, the cooperation agrees with the Sussex motto, "Wunt be druv," when the would pay from the first, as no doubt official patronage national health is in question it is as well to have a little could be obtained. I am, Sirs, Jours faithfully, driving power behind the recommendations and opinions of a Nov. 29th, 1907. W. G. D. Government departmental circular, and it may be that at some -
’
’
COÖPERATION.
future time the control of matters dealing with the public health will have to be taken out of the hands of popularly elected bodies. Another point to which I desire to draw attention are the directions contained in Sections 10 to 13 inclusive of the Section 10 states that the directions given in the circular as to the degree and frequency of inspection refer only to the minimum medical inspection. Section 11 sets forth a schedule for examination which to carry out properly
circular.
LONG SERVICE OF A POOR-LAW MEDICAL OFFICER. -At the meeting of the Thornbury (Gloucestershire) board of guardians held on Nov. 29th the resignation of Mr. Edward Mills Grace, M.R.C.S. Eng., L.R.C.P. Edin., the well-known cricketer, as district medical officer and medical officer to the workhouse was accepted with regret. Mr. Grace has held the appointment for 40 years and will be granted a superannuation allowance.
stated at the meeting.
least hour ; and Section 13 says in Sub. occupy I would section (a) :"The examination of each child need Sections rule than few minutes." These at
an
not
as a
two a occupy more the Board of me to be to On the whole appear incompatible. Education seems to have honestly tried to deal, in part, with a most important and difficult matter in a thorough manner, although two cardinal matters are, as you stated, dealt with very delicately. The one is the question of following up cases of illness or defect and the other is the question of treatment. As to the success of the movement, so far as it goes, everything depends upon how the local THE MEDICAL INSPECTION OF SCHOOL authorities discharge the task which it is wished that they should carry out. Moreover, no provision is apparently made CHILDREN. for any payments to the medical men and the matter of To the Editors of THE LANCET. expense will probably be the rock upon which many local SIRS,-The recent circular from the Board of Education authorities will go to pieces, for the question of hygiene is deals with matters of so great importance that I shall be in many cases the very one upon which local authorities are grateful if you will allow me space to call attention to one unable or unwilling to see the necessity of spending money. or two points which you did not touch upon in your leading I am, Sirs, yours faithfully, article. It may be as well to recall the inception of the M.D. Dec. 2nd, 1907. 1907. circular before dealing with the points in question. Last summer there passed through Parliament a Bill now To the Editors of THE LANCET. known as the Education (Administrative Provisions) Act, ’ SIRS,-Some expression of opinion in the columns of 1907. Section 13 of this Act deals with the question of THE LANCET as to the proper remuneration for this work medical inspection, and its provisions were published at would be of great assistance to many a medical officer of of in the the abstract of Nov. 30th p. 1555 of your issue health in small districts, where the local authority is as a More or less coincidently circular referred to below. with the passage of this Act the Board of Education rule only too ready to impose additional duties upon its determined upon the creation of a medical department officers without any commensurate payment. I am, Sirs, yours faithfully, and in THE LANCET of Sept. 21st a circular from the AN ILL-PAID M.O.H. Nov. 1907. 30th, Board was published notifying the appointment of a The raised in this letter has been Board and that in the President for this ** stating important question autumn the Board would issue a circular to local edu- present to our minds ever since we read the memorandum of cation authorities "regarding their new duties in the the Board of Education. The action of the Board of matter of the medical inspection of school children." Education will probably lead either to the appointment of The section of the Act with which the circular in question deals comes into force on Jan. lst, 1908, so that between the assistant medical officers of health or to the engagement of date of the circular, Nov. 22nd, and the beginning of next practitioners as inspectors on a part-time basis according year there remain nearly six weeks during which its pro- to the population of the area. In the case of the medical visions may be considered-a period none too long when the officer of health there will be remuneration independent importance of the duties laid upon education authorities from the salary as medical officer of health, a principle and the wide-reaching nature of the same be considered. It is all very well to make regulations and to express which has already been recognised. We are not in a position aspirations, but the carrying out of regulations is a different to say anything more definite as yet, but we believe that matter from their formulation, and by far the most both the Board of Education and the Local Government important portion of the circular is that which deals with Board are fully aware that a payment scheme will have to the administration of the clauses of the Act in question. be arranged and are prepared to act fairly towards the The function of the Board of Education is to advise local medical profession in the matter. We must trust to practieducation authorities as to the manner in which they should to tioners out the of the and the give us their help when we seek it if the question circular Act, carry provisions lays down that the work of medical inspection should be is not satisfactorily dealt with.-ED. L. carried out in intimate conjunction with "the public health authorities and under the direct supervision of the medical THE ARMY AND NAVY MALE NURSES’ officer of health." Reference to your abstract of the provisions of the circular will show that the administration of the Act is to be in the hands of county councils, town To the Editors of THE LANCET. councils, and urban and rural district councils which are local authorities for elementary education ; the last named one who has frequent occasion for the employSIRS,-As are advised to make arrangements for the purpose either ment of male nurses may I ask the reason for the continued separately or in combination. These bodies should be delay in the establishment of this much-needed institution? capable of doing the work which is set before them There are hundreds of former R.A.M.C. men walking about if they are willing to carry out the task. But there the streets who might get employment easily, as they are does not appear to be any provision for compelling local willing to take lower fees than those charged at the existing health authorities to do their duty, and recent events institutions. Why should the proposed cooperation be placed have shown that there are health authorities who are by no upon an eleemosynary basis at all ? What do Sir Frederick means willing to carry out their duties as guardians of the Treves and Dr. Howard Tooth want £2000 for? I will health of the community which has elected them. Your undertake to say that not one of the associations which can readers will have no difficulty in calling to mind instances now afford to advertise themselves so liberally started with a of neglect, examples of which are constantly made public in capital of £2000 or even £200. Surely there is credit enough the reports of the medical inspectors of the Local Govern- behind the scheme to take and furnish a small house in a ment Board, but although the British nation as a whole central position ; nothing more is required, the cooperation agrees with the Sussex motto, "Wunt be druv," when the would pay from the first, as no doubt official patronage national health is in question it is as well to have a little could be obtained. I am, Sirs, Jours faithfully, driving power behind the recommendations and opinions of a Nov. 29th, 1907. W. G. D. Government departmental circular, and it may be that at some -
’
’
COÖPERATION.
future time the control of matters dealing with the public health will have to be taken out of the hands of popularly elected bodies. Another point to which I desire to draw attention are the directions contained in Sections 10 to 13 inclusive of the Section 10 states that the directions given in the circular as to the degree and frequency of inspection refer only to the minimum medical inspection. Section 11 sets forth a schedule for examination which to carry out properly
circular.
LONG SERVICE OF A POOR-LAW MEDICAL OFFICER. -At the meeting of the Thornbury (Gloucestershire) board of guardians held on Nov. 29th the resignation of Mr. Edward Mills Grace, M.R.C.S. Eng., L.R.C.P. Edin., the well-known cricketer, as district medical officer and medical officer to the workhouse was accepted with regret. Mr. Grace has held the appointment for 40 years and will be granted a superannuation allowance.