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THE DOCTOR IN THE DAY-SCHOOL.I

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THE DOCTOR IN THE DAY-SCHOOL. I WHAT IS BEING DONE IN CARXARYO X SHIRK. [SPECIAL TO THE Weekly News.] When I remember the great outcry that was raised in certain quarters against the present Government's legislation for the medical inspec- tion of school children, and when I compare the actual wonkirng of that measure with the ter- rible things predicted by those who opposed n, I am filled with surprise at the lack of foresight displayed by those people who objected to placing the doctor on the rates." The proposal was in itself so reasonable, and so full of potentialities for good:, that the na- tion ought to be unanimous in its favour. True, it meant increased expenditure; but how can one compare mere money with the health of the community? Besides, if one regard's the matter from the purely financial point of view—: admittedly a very low plane—it is obvious that it is cheaper to run a healthy country than an unhealthy one. And if we are to have a healthy race, it is plain for all to see that we must start with the children and nip their incipient ailments in the bud. Thus may we hope to stem the tide of pauperism due to unhealthy habits and to life in unhealthy surroundings, and thus, as a matter of course, may we hope to save a great deail of the public money that is now absolutely wasted because utilised too late to do any good. THE FIRST YEAR. The system of medical inspection of schools came into. force last year. It is, therefore, im- possible to adequately guage the value of the work done; but welcome light on the subject is thrown by the first report presented by the three Medical Inspectors for Carnarvonshire, who commenced their duties on October ist, 1908. These three School Medical Inspectors are also the Medical Officers of Health for their respective divisions:, and this combination of the two -services has already proved most advan- tageous and beneficial from every point of view. Th)e officers are: --Central division, Dr. E. Ll. Parry-Ediwardis; Northern, division, Dr. G. Lewis Travis; Southern division, Dr. E. Lloyd Owen. COMBINED APPOINTMENTS. Here let me deal for the first time with the advantages arising from one officer holding the two appointments of Medical Officer of Health (under the District Council) and, School Medical Inspector (under the County Education Aufch- ority). Perhaps this point can be best made clear by a few quotations from the annual re- port presented in July of the present year. Dr. Parry-Edwards says — i. Lnder the present arrangement the School Medical Officer has not only the health of the school child under considlenatin, but as Medical Officer of Health he has opportunity Oil both investigating and correcting to a great ex- tent most of the causes which account for the Selects in the child's health, arising from errors in ventilation and lighting, warming, over- crowding, in-sanitary conditions, &c. 2. The one .service helps the other, as when ill-clad, dSrty, or badly nourished children come under the School Medical Officer's notice he instructs the Sanitary Inspector to investi- gate the cleanliness,'&c., of the child's home. The cleansing and disinfecting power under i-ection 122 of the Children's Act can, under these arrangements, be more efficiently carried out. In some places I found it necessary to advise the abatement, &c., of nuisances near schools. This was done without the dSelay which would necessarily arise under the dualJ control system. 3. Another very important subject is the closing of schools and the excluding of children. In our appointment we can survey the question from every aspect. As Health Officers, we look upon the question from a purely health point; as School Medical Officers from an educational point and its bearing upon Parliamentary grants. A dual appointment, if such existed, wouiki in time, I am afraid, cause friction, as the two departments view the school closing question? from different standpoints. "4. The general sanitary administration is in the hands of the District Council for the area in which the school is situated, and the Medical Officer of Health reports to the Council; whilst the School Medical Officer reports on the sanit- ary arrangements of school buildings to the Education Authority. 1, however, fail to see the necessity for this dual report, as the Medical Officer of Health could influence the District Councils in their opinion on. school sanitary questions. I have been impressed on this point where I am Medical Officer of Health but not School Medical Officer, and the same remark applies to the closing of schools. "5. The Medical Officer of Health has the control of the water supply, and this the School Medical Officer has nothing to do with except to report. The combination of duties, there- fore, has been found by us to be an advantage. 6. The Medical Officer of Health can, through the District Council, order a school to be cleansed and disinfected, and the Education Authority have to do it at their own expense, failing which the Sanitary Authority do it. The School Medical Officer has only the power to recommend it to be done. "7. If there be Phthisis (consumption) or other infectious disease in a family, the fact is recorded on the child's schedule, and is to' the Medical Officer of Health am equivalent to a n-otification,. -A-Itho.u,gh, the child itselsf might be in good health, the parents can be adlvisedi as to the precautions to be taken. 8. The School Medical Officer looks after the children dumin.g school hours, but as the -Medical Officer of Health is able to perfotm some of his duties in the district after the medi- cal inspection of school children is over. "9. The combined appointment resuflts in a higher degree of efficiency. The Medical In- spector is from his own knowledge and experi- enloe able to have a concise idea of his whole district, whereas in the dual appointment he would have to rely on figures procured from other sources. Further, it wilil be seen that the health of the ohilden is, as Dr. OWieTh points out, a good index of the community, and through them the Medical Officer of Health can comein.to touch with almost every home in the district. "10. The Acts of Parliament which have re- cently been: passed have in view the era- dication of disease, the betterment of the sur- roundings of the people, and, above all, the im. provement of their moral and social well-being. Ag far as I can see, the only way in which these can be accomplished is by watching and guarding the future generation and trying at the same time to improve the existirng state of affairs, and, in my opinion, this can best be done either (I) by the combined appointment of whole-time Medical Officers of Health and School Medical Officers for districts, or (2) by appointing School Medical Officers under the Medical Officer of Health." THE HOlME LIFE OF THE PEOPLE. On this important point, the advantage aris- ing from one and the same person being the Medical Officer of Health and Medical Inspector of. School Ghiidiren, a most valuable paper has been prepared by Dr. E. Lloyd Owen, and is included as an, appendix to his report. Dr. E. Lloyd Owen, (who is a son of the late Rev. Dr. Llugwy Owen, of Conway and Golwyn Bay), in his remarkably interesting paper, covers the whole ground in a manner which throws a flood of light both upon the neoosStiity for the new scheme of inspectin of school childnm and the spirit and method in which that scheme is carried out in Carnarvonshire. I hope to give the report in complete form in the next issue of the ç. Weekly News."

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