[From Education Week,1926]

Medical Care of the Children.

THE School Medical Service, which is responsible for the Medical Supervision of School Children, was brought into being by the Education Authority in the year 1929. Although so lately introduced into the Island, the Authority were able to profit from the experience -of the system which had grown up in England and Wales since the year 1907.

The system employed may be outlined as follows :-

Elementary Schools.

1. Routine Medical Inspection of all children

(a) on entering school,
(b) at eight years of age,
(c) at twelve years of age.

These examinations are carried out on the School premises, and the parents are invited to attend. An encouraging feature of School Medical Inspection is the increasing recognition on the part of the parents of the value of these inspections, which so often result in the detection of defects in their early and easily remediable stages.

2. Following up of cases noted for treatment or observation.

Cases noted for treatment are re-inspected every, six months, and where necessary the parents are visited from time to time by the School Nurses. Sometimes a great deal of perseverance and tact on the part of the Nurses is required to obtain consent to the necessary treatment, but an increasing number of parents are now welcoming the opportunities for treatment offered by the Authority.

3. Treatment.-All cases noted for treatment are referred in the first place to their Family Doctors. Should the Parent be unable to afford private fees, or should the Doctor be unwilling to undertake the treatment involved, the School Medical Service takes charge of the case, should it fall within the following categories:-

(a) defective vision.
(b) enlarged tonsils and/or adenoids.
(c) Minor ailments-such as discharging ears, sore eyes, certain skin diseases, etc.
(d) X-ray treatment of ringworm.

Other Conditions not falling within these categories are referred to Hospital for treatment.

Treatment of Minor Ailments is carried out at the School Clinics, situated in Douglas, Ramsey, Castle-town, Peel and Laxey, by the School Nurses under the direction of the School Medical Officer.

Defective Vision is treated at the Douglas Clinic by the School Medical Officer, all serious and difficult cases being referred to the Consulting Ophthalmic Surgeon on his visits to the Island.

Enlarged Tonsils and Adenoids are treated by ar-rangement at Noble's Hospital, Douglas, or Ramsey Cottage . Hospital, the children being kept in Hospital for a minimum of 48 hours.

X-ray Treatment of Ringworm is undertaken by arrangement by the Radiologist to Noble's Hospital.

4. Dental Inspection and Treatment are carried out by the School Dental Officer. The Inspection is carried out at the Schools, and treatment at the School Clinics.

85% of the children examined during 1924, and 76.2% during 1925 were found to be suffering from dental decay.

Wherever possible, children are referred to the family dentists, but in the great majority of cases in Elementary Schools, at any rate when the School Dental inspection started, the family dentist was a rara avis. There is, however, a decided improvement noted in this direction. There is a gradual increase in appreciation of the fact that an unhealthy mouth is the starting point of many diseases. and parents are responding in greater numbers to opportunities for dental treatment.

Exceptional Children.

There are certain children who, by reason of physical or mental defect, are unable to benefit by receiving the ordinary standard of education. The blind and the deaf and dumb are, by arrangement admitted to special schools in England when vacancies occur. A special class for myopes and partially blind children is to be opened shortly in Douglas. The problem of dealing with mentally deficient children is still unsettled, but it is a matter that will soon have to be faced.

Secondary Schools.

Medical Inspection in the Secondary Schools is undertaken when pupils reach their twelfth and. fifteenth years. Many will have been examined in the Elementary Schools, but certain others entering from other schools are examined as soon after entry as possible. Treatment is usually under-taken by the family doctors and dentists, but where the parents cannot afford private fees the School Medical Service undertakes the treatment if the defect falls within the categories mentioned above.

Statistics.

It has been stated that the Isle of Man, by virtue of its health giving air, and by its lack of an industrial community, should not require a School Medical Service. It is interesting therefore, to compare the figures for the Isle of Man with those of England and Wales as a whole, and those of London. The percentages of children noted for treatment (exclusive of dental defects) at Routine Inspections are :-

The main defects noted, apart from Dental decay, were as follows:-

It will be seen from these figures that there is proportionately a rather higher incidence of defects in the Isle of Man than is found in England and Wales as a whole. It must, however, be remembered that the School Medical Service has been in operation many years in England and Wales, and that parents more readily seek advice and treatment before their children start their School lives.

The School Clinic.

The School Clinic in Tynwald Street, Douglas, is the centre of the School Medical Service. The records of all cases are kept there, and the building contains a waiting room, a room for the treatment of minor ailments, a dental surgery and recovery room, a medical inspection room, and a dark room for testing eyesight.

At Ramsey, Castletown and Peel, a room in the School is used for the treatment of minor ailments and for dental work.

At Laxey a room in the Working Men's Institute is used for the same purpose.