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CITY AND COUNTY OF BRISTOL EDUCATION COMMITTEE

Annual Report

of the

Principal School Medical Officer

R. C. WOFINDEN, M.D.. M.R.C.P., D.P.H., D.P.A.

A. L. SMALLWOOD, M.D., D.C.H., D.P.H.

( Principal SflHPMedical Officer, School Health Service)

1970

SIXTY-THIRD YEAR

INDEX

Blind children

Cardio-rheumatic clinic

Cerebral palsy assessment clinic ...

Child and family guidance service
Children’s chest clinic

Children unsuitable for education at school
Chiropody service ...

Deaf children

Deaths of school children ...

Delicate children

Dental clinics

Ear, nose and throat service
Educationally sub-normal children
E.S.N. school-leavers
Employment of children
Entertainments, Children in
Enuresis clinics
Epileptic children ...

Eye clinics ...

Handicapped children
Health education in schools
Hearing assessment
Home teaching
Hospital teaching ...

Infectious diseases ...

Infestation ...

Maladjusted children
Medical inspections in schools
Milk and meals in schools ...

Milk, food and hygiene inspections
Multiple handicaps. Children with
Orthopaedic and postural defects ...
Partially hearing children ...

Partially sighted children ...

Physically handicapped children ...

Physical education ...

Physiotherapy
School attendance ...

School nursing service
Speech defects. Children with
Speech therapy

Staff

Statistical tables

Teachers, Medical examination of
Tuberculosis, Protection against ...

Youth employment service

Page

23
18
18
18
26
19
19

28
30

31
19
19
24

33
26

34
5

BRISTOL EDUCATION COMMITTEE

Chairman :

Councillor J. B. SPRACKLING

Vice-Chairman :

Councillor Mrs. R. M. ROWLEY

SPECIAL SERVICES COMMITTEE

Chairman :

Alderman F. G. W. CHAMBERLAIN

Chief Education Officer :

H. S. THOMPSON, M.B.E., B.Sc.

Principal School Medical Officer and
Medical Officer of Health and Social Services :

R. C. WOFINDEN, M.D., M.R.C.P., D.P.H., D.P.A.

Principal Medical Officer, School Health Service :

A. L. SMALLWOOD, M.D., D.C.H.. D.P.H.

CITY AND COUNTY OF BRISTOL

Population (June 1970) ... ... ... ... 426,370

Number of pupils on registers of maintained primary,
secondary, special and nursery schools (January 1970) 68,474

STAFF

PRINCIPAL SCHOOL MEDICAL OFFICER AND MEDICAL OFFICER OF HEALTH AND SOCIAL SERVICES

R. C. WOFINDEN, M.D., M.R.C.P., D.P.H., D.P.A.

DEPUTY PRINCIPAL SCHOOL MEDICAL OFFICER AND DEPUTY MEDICAL OFFICER OF HEALTH

J. F. SKONE, M.D., D.C.H., D.P.H., D.I.H.

PRINCIPAL MEDICAL OFFICER, SCHOOL HEALTH SERVICE

A. L. SMALLWOOD, M.D., D.C.H., D.P.H.

SCHOOL MEDICAL OFFICERS (Joint Appointments with the Local Health Authority),

A. M. Fraser, L.R.C.P., L.R.C.S., D.P.H.

Helen M. Gibb, M.B., Ch.B., D.P.H. (to 7.6.70)

J. E. K. Kaye, Med. Dip. (Warsaw), D.P.H.

J. L. S. James, M.R.C.S., L.R.C.P. (to 30.9.70)

P. Tomlinson, M.D., D.P.H.

Isabel M. Price, M.B., Ch.B., D.C.H.

Kathleen E. Faulkner, M.B., Ch.B., D.C.H. , D.P.H.

Enid M. Tulloch, M.B., Ch.B., D.P.H.

E. E. Warr, M.B., Ch.B., D.P.H.

D. W. Maxa, M.B., Ch.B., D.P.H.

Heather S. Kerr, B.Sc., M.B., Ch.B., L.R.C.P., M.R.C.S., D.P.H., D.Phys.Med.

(to 1.9.70)

J. F. Hamblin, M.B., Ch.B., D.P.H.

Patricia A. Boulton, M.B., Ch.B. (to 28.2.70)

E. P. Hamblen, M.D., D.C.H., D.P.H., D.T.M. & H. (to 1.10.70)

J. P. W. Paget, M.D. (Lille), D.P.H.

Judith M. Smith, M.B., Ch.B.

Margaret J. Bowie, M.B., Ch.B. (part-time) (from 1.4.70)

Jean M. Ross, M.B., Ch.B., D.Obs. (part-time) (from 1.4.70)

S. J. P. Woods, M.B., Ch.B., R.C.O.G., (from 1.6.70)

W. J. Poulsom, M.B., B.Sc., L.R.C.P., M.R.C.S., D.Obst., R.C.O.G.,

(from 14.9.70)

CONSULTANTS— PART-TIME

Ear, Nose and Throat ...

Orthopaedic

Ophthalmic

Cardio-Rheumatic

Dermatology

Orthoptists

J. Freeman, M.B., F.R.C.S., D.L.O.

R. K. Roddie, M.B., F.R.C.S.*

D. M. Jones, M.B., M.Ch.(Orth.), F.R.C.S.*

A. H. C. Ratliff, M.B., F.R.C.S.* (to Nov. 1970)

P. Jardine, F.R.C.S.(E), D.P.M.S.

H. Bannerman, M.B., D.O.M.S.*

A. S. Shah, M.B., B.S., D.O.M.S., D.O.*

S. C. Jordan, M.D., M.R.C.P.

(by arrangement with Lfnited Bristol Hospitals)

C. D. Evans, M.A., M.D.*

Miss M. J. Smith, S.R.N., D.B.O.*

Mrs. P. Farris, D.B.O.*

DENTAL SERVICE (joint Appointments with the Local Health Authority)

Principal School Dental Officer... J. McCaig, L.D.S., F.R.P.S.

Divisional Dental Officers ... G. J. Tucker, B.D.S.

M. P. Evans, B.D.S.

School Dental Officers ... ... R. D. Hepburn, L.D.S.

W. J. Constantine, L.D.S.

J. Hornsby, L.D.S.

P. W. Carnie, B.D.S., M.B., B.S.

G. Duggan, B.D.S.

Rene C. Capper, L.D.S.

Ruth A. Yearn, B.D.S., L.D.S., R.C.S.
V. T. Scard, L.D.S. (to 16.1.70)

J. R. Gordon, L.D.S.

Helena Jones, B.D.S. (to 19.2.70)
Valerie N. Jordan, B.D.S. (from 3.8.70)
R. K. Valteris, B.D.S. (from 8.10.70)

J. A. Pearson, B.D.S. (from 23.1 1.70)

CHILD AND FAMILY GUIDANCE SERVICE

Medical Director
Consultant Psychiatrists

Senior Psychiatric Registrar

Psychiatric Registrar

H. S. Coulsting, M.B., Ch.B., D.P.M.*

W. L. Walker, M.D., D.P.H., D.P.M.

J. Gordon-Russell, M.B., M.R.C.P., D.P.M.*

M. J. Gay, M.B., Ch.B., D.C.H., D.P.M.

R. Magnus, M.D., D.P.M.

(from February 1970 to 12.8.70)

P. Copus, M.A., M.B., B.Ch., D.P.M. (from 12.8.70)

K. Friend, M.B., B.S. (to December 1970)

Clinical Assistant to Dr. Coulsting
Senior Educational Psychologist . . .
Educational Psychologists

Lay Psychotherapist
Head Social Worker
Senior Social Workers ...

Psychiatric Social Workers
Clerical Staff

(part-time)

B. Walley, M.B., B.S., D.P.FI., D.C.H.

N. Jones, B.A., D.M.A.f
Mrs. S. Perks, B.Sc.

Mrs. L. Goswell, B.A.

N. W. R. Sims, M.A., B.D.

H. C. M. Carroll, B.Sc. (to 31.5.70)
Miss M. Holder, B.Sc.

Mrs. M. Bennathan, M.Com., B.A.

Miss A. Davies, B.A. (from 21.9.70)
Miss P. K. Bowyer, B.Sc. (from 21.9.70)

Miss K. Hunt, B.A.

Mrs. B. Gibson-Hamilton, B.A.

Miss M. B. E. Shearman

Miss W. A. Maitland

Mrs. A. E. Porter (from 1.7.70)

Miss M. Porch, B.Sc.

Miss J. F. Fletcher

Mrs. P. A. Buffin (to 13.12.70)

Mrs. J. B. Grimes

Mrs. A. E. Kemp

Mrs. V. S. Stone

Mrs. J. Solomon (to 27.5.70)

Miss E. E. Starling

Mrs. M. Hinman

Mrs. P. McClure (from 27.7.70)

Mrs. J. D. Murphy (from 1.10.70)

R. V. Saunders, M.A., B.Ed.

* By arrangement with the Regional Hospital Board
f Joint appointment with United Bristol Hospitals

CHIROPODY

Chief Chiropodist
Deputy Chief Chiropodist
Chiropodists

SPEECH THERAPY

Senior Speech Therapist
Speech Therapists

AUDIOMETRY

NUTRITIONIST

J. Pugh, F.R.S.H., M.Ch.S., S.R.Ch.

R. L. Townson, M.Ch.S., S.R.Ch.

R. Atkinson, S.R.Ch.

A. Hynam, M.Ch.S., S.R.Ch.

Mrs. Foulk, M.Ch.S., S.R.Ch.

Mrs. Hopkins, M.Ch.S., S.R.Ch.

Miss J. Leatherbarrow, M.Ch.S., S.R.Ch.

(until August 1970)

F. Lawrence, M.Ch.S., S.R.Ch.

Mrs. D. Tann, M.Ch.S., S.R.Ch.

Mrs. Beryl Saunders, L.C.S.T.

Mrs. J. Spencer, L.C.S.T.

Mrs. B. R. Harding, L.C.S.T. (to 31.3.70)
Philippa M. Jones, L.C.S.T. (to 18.12.70)
Barbara A. Bond, L.C.S.T. (from 12.1.70)
Anthea M. Halliday, L.C.S.T. (from 19.1.70)
Moira G. McKinnon, L.C.S.T. (from 2.2.70)
Pauline Ball, L.C.S.T. (from 14.9.70)
Claremont School
Mrs. A. L. Wilks, L.C.S.T.

Mrs. G. L. Bradshaw, L.C.S.T.

Mrs. R. F. R. Broomhead
Miss S. Egerton-Hall

Miss M. Chapman

NURSING SERVICE

Chief Nursing Officer ... ... Miss M. Marks Jones, S.R.N., S.C.M., H.V., N. A. C.

Deputy Chief Nursing Officer ... Miss J. M. Marsh, S.R.N., S.C.M., H.V.,

Dip. P.H. Nursing (McGill)

ADMINISTRATIVE AND CLERICAL STAFF

Senior Administrative Assistant
Senior Assistant (Records)

Assistant (Records)

Clerical Assistants

Clerk/Shorthand Typists

F. J. Oldfield, D.M.A.

K. E. K. Eddolls, S.R.N., Q.N.

E. J. Pike
Miss H. Greet
Miss M. Portwood
E. J. Davis

Miss M. Durnford (to 26.5.70)

Miss V. Benjafield (to 31.5.70)

Miss B. Cockton (to 30.11.70)

Mrs. K. Barrett

Miss J. C. Spencer

Mrs. S. Thrush

C. Forsey

Miss S. King (from 8.6.70)

R. Williams (from 10.8.70)

J. Stockbridge (from 14.12.70)

Mrs. S. E. Lovell

Miss P. Howard (to 2.8.70)

Mrs. S. Parker (from 7.9.70)

Persons, other than those whose names appear in the list of staff, who have contributed to this
report are the following : —

Miss J. A. Battersby, Organiser of School Meals

Miss I. M. Bond, B.A., Head of Kingsweston School for E.S.N. Senior Children
G. J. Creech, M.B.E., Chief Public Health Inspector

J. C. Cummings, Head of Kingsdon Manor Residential School for E.S.N. Senior Boys
Miss J. Davis-Morgan, Head of Henbury Manor School for E.S.N. Junior Children
Miss J. R. W. Dawson, Inspector of Schools and Organiser of Physical Education
B. M. Dyer, M.B.E., B.A., Principal Careers Officer

Barbara Hale, M.B., Ch.B., D.C.H., D.Obst., R.C.O.G., Assistant School Medical Officer

Mrs. J. E. Ireson, Head of Croydon Hall Residential School for E.S.N. Senior Girls

R. R. Jenkins, Inspector of Schools and Organiser of Physical Education

P. Mackintosh, B.A., Health Education Officer

Miss M. J. Ram, B.A., Head of Claremont School

A. J. Rowland, M.B., D.P.tl., Senior Medical Officer {Epidemiology)

J. N. Tolley, Head of Florence Brown School for E.S.N. Children
M. Watts, S.Sc.D., Chief School Welfare Officer

F. C. Wilkinson, Head of Periton Mead Residential School for Delicate Children

G. Williams, Head of South Bristol School

R. D. Williams, Head of Elmfield School for the Deaf

INTRODUCTION

To the Chairman and Members of the Education Committee :

I have much pleasure in presenting the Annual Report of the Bristol School
Health Service for 1970, the 63rd report in the series.

GENERAL

The wind of change continued to blow; nevertheless, the shelving — at least temporarily
— of the Redcliff Maud proposals allowed time to absorb some of the recent changes
and to prepare for those scheduled to take place in the near future. Among the latter
are the Seebohm recommendations (some already implemented in Bristol and others
due to take effect from January 1971) and the transfer to the Local Education Author-
ity in April 1971 of responsibility for severely subnormal children of school age.

There may still be the chance that any reforms brought about by the impending
reorganisation of the National Health Service can be implemented simultaneously
with any local government remodelling, thus avoiding the difficult administrative
hiatus which many people foresaw with some apprehension last year.

STAFFING

The year was an average one as far as staff movements were concerned. The retire-
ment early in the year of two of our longest-serving doctors, Drs. Gibb and James, left
serious gaps because of the highly specialised duties they had been undertaking. Dr.
Gibb in the hearing assessment service, and Dr. James as dental anaesthetist. However,
thanks to increased sessions given by Dr. Price and Dr. Tulloch at Clifton Hill, the
hearing assessment service is continuing satisfactorily; but a successor to Dr. James
has not yet been found and Consultant Anaesthetist cover for the dental service is at
the moment being provided by the hospital authorities. Dr. Heather Kerr left us at
the end of August to marry and settle in London, while Dr. Patricia Boulton started
new family commitments. Congratulations are also due to Dr. Eric Hamblett who
during the year took up his new duties in charge of the Occupational Health section.

THE YEAR’S WORK

The total number of medical inspections carried out during the year has decreased
slightly, this being due mainly to the closure of schools during October and November
in connection with the strike of manual workers. Nevertheless, some of the ground lost
at that time has since been recovered. One of the consolations of these enforced sus-
pensions of normal duties is the opportunity provided to catch up with problems which
would otherwise be pushed into the background. I refer to such matters as keeping in
touch, medically and educationally, with children who for various reasons have been
put on the home tuition roll. This is important work of which we are sometimes apt
to lose sight. The opportunity was also taken to intensify medical examinations of
certain classes of the Corporation’s working staff, e.g. school meals employees.

Participation in various surveys continued during the year. In addition to the
enquiry by the Department of Education and Science into numbers and categories of
physically handicapped schoolchildren mentioned in last year’s report, there was a
preliminary survey during the Summer term into the incidence and severity of hay
fever attacks and their effect on schoolchildren. More detailed information is given
elsewhere about this survey which was restricted to 6ve large comprehensive schools,
and is intended to be the forerunner of a further and more scientific study next summer.

The storm generated last year by the possibility of prosecuting parents for neglect-
ing their children’s dental health subsided somewhat, due to the difficulty of establish-
ing with certainty that such neglect was endangering the children’s health. A more
positive step towards good dental health was taken when the Committee decided to
make available to all five-year-old school entrants dental packs each containing a letter
from the Chief Dental Officer together with a toothbrush, a tube of toothpaste and a
plastic beaker imprinted with a suitable slogan. Nor were these efforts confined to
primary schoolchildren. As the year closed trials were under way in three large
comprehensive schools to ascertain the value of regularly brushing the teeth with a
fluoride preparation. These trials, which were of course on a voluntary basis, involved
the free issue of toothbrushes and paste to about 1,000 twelve-year-old schoolchildren.

Concern was expressed at the growing incidence of venereal disease, particularly
among young people, and the Education Committee considered carefully a report
from the city’s consultant venereologist that some young persons of school age were
aflfected. It is inevitable, I suppose, that in today’s permissive society V.D. and drug
taking will find their way into almost all walks of life; but to suggest that our schools
are becoming centres of promiscuity and drug-peddling would be the grossest exagger-
ation. The most effective safeguard against the spread of both is a sustained pro-
gramme of health education and efforts to this end have continued throughout 1970,
as the Health Education Officer’s article later in this report will testify.

In December the new health centre at Horfield was opened and already this is
bringing benefits in easing the overloading of services at other clinics in adjoining
areas.

Services provided to students within the city have continued, as have the special
arrangements for Heaf tests and B.C.G. vaccinations for immigrant schoolchildren.
Facilities for chest x-ray examinations were again available for teachers, with mammo-
graphy for women requesting it. A campaign was commenced during the summer to
provide rubella vaccination for 13-year-old schoolgirls and it is hoped to extend this
protection eventually to all girls of secondary school age.

As the year came to an end, final plans were being made to undertake a short
survey into the diet and nutrition of a small sample of about 100 primary school-
children. This survey, which will be carried out in three schools during the Spring
Term 1971 with ‘follow-ups’ in subsequent years, is a joint venture between the
Authority and the Department of Health and one of its main aims is to provide a
“before” and “after” assessment of the effect of impending legislation regarding school
meals and milk.

HANDICAPPED CHILDREN

Discussions have continued on the administrative and practical problems associated
with the transfer ne.xt April of responsibility for severely subnormal children of school
age. Despite all the planning involved in such a move, however, there are almost
bound to be some last minute difficulties. It is to be hoped that these will be kept to a
minimum and that the children themselves will not be adversely affected by them.

Construction of the new special school to replace South Bristol school is proceed-
ing according to schedule and all concerned are looking forward to the transfer into
the new building next September.

There have been consultations with neighbouring Authorities on the provision of
educational places for maladjusted children and it seems likely that there will be an
improvement in the situation as a result. Plans are in hand for the introduction of
several special units attached to ordinary .schools within the region. The Committee

recently gave approval to the expansion of the Child and Family Guidance Service
following consideration of a report of expected developments within this field over the
next five years and it seems clear that the demand for the service will continue to grow.

CONCLUSION

It is fitting to end this report with an acknowledgement of the part played in main-
taining the health and welfare of the city’s schoolchildren by the many agencies with
whom we are associated. Dr. Smallwood and his staff, who are concerned with the
day to day activities of the School Health Service, have maintained excellent working
relationships with hospital staffs, general practitioners. Heads of schools and their
staffs, etc., whilst the co-operation of the Chief Education Officer and his departmental
staff has always been in evidence. It is a pleasure to record my thanks to them all, as
well as to the Committee members for their continuing support and encouragement.

R. C. WOFINDEN,

Principal School Medical Officer

CARDIO-RHEUMATIC CLINIC

S. C. Jordan

The Cardio-Rheumatic Clinic held once a week at the Children’s Hospital is concerned with the
investigation of children referred who are suspected of having cardiac disease. Many of these
are picked up at routine school medical examinations. About 200 children a year attend this
clinic, either initially or for follow-up.

With the reduction in acute rheumatism that we have seen over the last ten years, there are
fortunately few patients now with established rheumatic heart disease. Patients with organic con-
genital heart disease can be assessed regarding the need for special investigations with a view to
possible surgical treatment. Many, however, have mild lesions which are unlikely to affect the
prognosis and do not therefore need investigation or treatment.

Many children are referred on account of systolic murmurs picked up at routine examin-
ation. Although a few of these have organic heart disease, many have functional systolic murmurs.
It is important, for the child and for the parents, that a firm decision is made early on with regard
to the presence or absence of organic heart disease. Where a simple functional systolic murmur
only is present the parents can be firmly reassured and no follow-up is necessary.

CHILD AND FAMILY GUIDANCE CLINIC

H. S. Coulsting

This year has been a more encouraging one than the last, largely because it became possible in
April to fill our establishment completely, thereby giving all area clinics full team cover. This
enabled us to transfer the work done for the courts and Children’s Department out to the areas
concerned, so that for the first time we have a situation where all areas are fully responsible for
the total functioning of the Child and Family Guidance Service within their boundaries. These
boundaries have been temporarily defined, largely on grounds of convenience to clients; in other
words, dependent to a great extent on the transport services, and this will apply until a more
general divisionalisation of community services takes place. The importance of community areas
coinciding cannot be over-emphasised, as where they do not match to a reasonable extent, clinic
staffs are expected to relate to, and work with, far too great a number of personnel from other
departments. This is essentially uneconomical and inefficient, and we look forward to a possible
definition of areas when the Social Services Department is fully functioning.

Committee consideration has been given to the needs of professional staff to cover develop-
ments planned on the educational side, which were referred to in last year’s report, and it has
been possible to estimate the extent of the staff increase that will be necessary to cover this aspect
of the clinic’s work over the next five years. It is of interest, in view of this development, that we
have been able to place quite a number of children at the day maladjusted school at Warmley,
which is very close to our border, and serves well the East Bristol area. This has given us initial
experience of Day Maladjusted Schools quite apart from its enormous value to the children we
have been able to place there.

A further progressive development has been the recognition that our psychiatric social
workers and our psychologists need realistic career structures and initial consideration has been
given to this by the committee; it is envisaged that this should commence to be useful in the
coming year. On the social work side this will mean the appointment of a deputy, who will be
able to take some of the load off the Principal Psychiatric Social Worker, and indeed extend the
supportive services necessary to newly-trained personnel who join us. There is an obvious need to
examine the tasks that we expect various members of our staff to perform, and the forms of in-
service support or training necessary to enable this to be done effectively; as the service grows a
clearer definition of roles will become essential.

With the setting up of the Social Services Department the requirements of professional time
from this clinic’s staff will have to be considered and evaluated over the next few years. It may
well be another twelve months before it is practicable to ask this newly-established service to have
defined their policies adequately for this to be done. However, the task remains an urgent one.
The various changes in boundaries and medical services which seem likely to go hand in hand
over the next four years are of enormous importance to our functioning.

As an initial token of our recognition of impending boundary changes it may be that we
should try and obtain at least standardisation of records throughout this area. It is of interest
that the Child and Family Guidance Service is demonstrating one of the most evolved of the
Community Services and we can be forgiven for thinking that it may well, in some ways, serve
as a model that can be extended to other aspects of the Community Mental Health field. It is
most encouraging to hear the increasing community orientation amongst psychiatrists in the adult
and geriatric fields. Apart from their traditional role the clinics are maintaining and increasing
their outward looking and community orientation, much closer liaison occurring with teachers
and health clinics wherever it seems useful to devote clinic time to this. It is hoped that this
change of attitude towards recognition of the community need will be a progressive one leading to
progressively earlier recognition of emotional disturbances and the giving of more effective early
help to these families. It is in this side of the work, with its higher prophylactic element, that we
hope to participate to an ever increasing extent in the future. It could well be that much more
effective work will be possible when all those with a caretaking role among families of pre-school
children develop skills in early recognition of disturbed relationships within them.

ANNUAL STATISTICS

Psychiatric

1969

1970

Diagnostic interviews ...

596

564

Treatment interviews ...

... 2,925

2,784

Parent interviews

208

113

Others interviewed

Other visits

Psychological

Examinations, including Juvenile
Court cases

401

438

Treatment interviews ...

293

Parent interviews

Others interviewed

Home visits

Social

Interviews with parents

... 4,344

4,450

Interviews with others ...

139

152

Home visits

817

542

Other visits

CHILDREN’S CHEST CLINIC

Barbara Hale

'There was a slight decrease in the number of patients attending the clinic but an increase in the
total attendances due to the earlier discharge of the less severe cases of persistent cough and re-
current infections and a closer follow up of the remaining asthmatic patients.

A course of desensitization injections was given to 6 patients; 5 of these showed a marked
improvement in symptoms and will have a further course next year. The sixth patient moved
away from the area in the Spring. Skin testing was carried out on 5 children, 4 of whom are to
be desensitized.

Influenza vaccine was given to 5 patients and 3 children were also treated for enuresis.

The following referrals were made: —

Physiotherapy — breathing exercises and/or

postural drainage ... ... ... 19

Short wave diathermy ... ... 11

E.N.T. Consultant ... ... ... ... ... 3

Heaf test (all negative) ... ... ... ... ... 4

Child Guidance ... ... ... ... ... ... 2

Orthopaedic ... ... ... ... ... ... 1

Two children have been placed on the waiting list for special schools and two further
children have continued their attendance at Periton Mead and South Bristol Schools.

1970

1969

No.

of patients

No.

of attendances ...

203

193

CHIROPODY SERVICE

J. Pugh

Statistics (Figures for 1969 in parenthesis)

Defect

Of infective origin ;

Verrucae
Tinea Pedis ...

Septic lesions

Orthopaedic anomalies

Hammer toes
Meta tarsalgia
Pes Cavus ...

Hallux Valgus et Rigidus ...

Nail conditions
Ingrowing

Onychia or Paronychia

Other

Corns

Other conditions requiring
treatment or advice

First visit Other treatments

,010

(1,655)

7,806

(6,236)

(8)

(14)

(7)

(1)

(8)

(20)

(11)

(28)

(2)

(8)

(4)

(1)

(22)

108

(74)

(3)

(2)

(14)

(37)

129

(89)

167

(136)

(22)

(13)

Totals 2,343 (1,845) 8,217 (6,570)

Total sessions = 582 (441) Total treatments = 10,560 (8,415)

Clinics at which chiropody sessions are held

Charlotte Keel Clinic

Wednesday

a.m.

Bcdminster Health Centre

Thursday

p.m.

Southmead Health Centre

Friday

a.m.

Portway Clinic

Monday

p.m.

Lawrence Weston Clinic

Tuesday

a.m.

Mary Hennessy Clinic

Thursday

a.m.

John Milton Clinic

Monday

a.m.

Speedwell Clinic

Wednesday

a.m.

Stockwood Health Centre

Tuesday

p.m.

Knowle Clinic

Tuesday

p.m.

Central Clinic

Wednesday

a.m.

During the year the number of sessions was increased for chiropody treatment, to make up
for the loss of some minor ailment sessions previously covered by medical staff. This can be seen
in the increased number of cases dealt with, in two different ways; there is reflected in the
statistics a wider coverage of the city for this service, thus reducing the time the child is away
from school, and also the increase in the number of foot ailments of infective origin dealt with by
the chiropodist where active health education talks can be given to the child and mother (when
they are together, as they are now quite often).

A talk given to one large secondary school on foot health education proved very popular,
and a showing of the film “Feet First” evoked many questions, not only about chiropody, but
also about chiropodists, (career prespects?). As there are two copies of this film in the Health
Education Section at Central Health Clinic, perhaps wider publicity could be given to Heads
of all secondary schools of the existence of this film, for showing on suitable occasions. Education
for Health is as important as education for any other aspect of life and success in achievements
in academic subjects will not be fully realised in the objective rewards if bodily health is poor
to the point of interfering with normal recreational pursuits. Poor foot health is in this context,
and most of the conditions are preventable in this age group, when seen at an early stage of
development. Success in health education talks to groups at secondary school age does not lie in
the concept of instant cures for all ailments, but to make the pupil aware of the nature of the
problem. Prevention is self-help once they know all the facts.

DEATHS OF SCHOOL CHILDREN

During 1970 the number of deaths of Bristol children (aged 5 to 15 years) was 15, 8 boys and 7
girls. Causes of death were as follows ; —

Age in

years Boys Girls

Dysgerminoma

Leukaemia

Aplastic anaemia

Peritonitis, uraemia

Bronchopneumonia, acute renal failure

Cystinosis, uraemia

Road Accident ..

Other accidents (asphyxiation)

(burns)

(gunshot wounds)
Unconfirmed ...

15 — 1

5 1 —

8 1 —

6 — 1

14 — 1

5 — 1

10 — 1

14 1 —

6 1 —

9 1 —

6 — 1

14 1 —

6 — 1

15 1* —

12 1 —

* attending public school. — 8 7

It will be seen that road and other accidents accounted for half the deaths : of the remainder
20% are attributable to new growths. The unconfirmed death concerns a 12-year-old boy found
dead on a golf course and is still the subject of police enquiries.

DENTAL CLINICS

J. McCaig

Dental inspection of children should take place as soon as they start school and should be repeated
annually. This annual inspection is very important, because in its way it assesses dental needs and
brings the subject of dental health to the minds of children and parents, when the children take
home the acceptance forms for signature. This year the annual dental inspection in all schools
was not possible as the schools closed in October for three and a half weeks due to the Council
workers’ strike; 52,000 children were inspected, however, as against an average of 58,000. The
parents have a choice of treatment for their children, either through the School Dental Service
or the General Practitioner Service. This treatment stimulates a demand for more dental care
but has little impact on reducing the incidence of dental disease. The main hope of more rapid
progress must lie in preventive measures aimed at reducing the incidence of the disease and the
most effective measure is the fluoridation of the public water supply. Dental decay among children
in Balsall Heath, Warwickshire, has been reduced by 66% and in Northfield, Birmingham, by
50%, since fluoridation. Dental health education plays an important part, too, in the prevention
of dental disease and the public should be made aware of the need of regular inspection and
treatment. However, patients cannot be forced into having their teeth attended to, or the close
link between patient and dentist would be destroyed. It is usual for dentists to discuss with their
patients the nature of the trouble in their mouths and the steps which will be necessary to restore
full oral health. Dental disease is not a dramatic killer, and many people are only driven by pain
to the dental chair. The treatment received then is not conducive to changing the attitude of
those whose only expectation of dentistry is the relief of pain. Irregular attendance at the dentist
arises from fear of the dental situation and the long-standing frightening mythology in regard
to dentistry. Dentists may at times feel like giving up the struggle against decay, but as more
mouthfuls of caries present themselves, dentists are not willing to accept defeat nor resist the
challenge. There is insufficient staff time to spend on persuading many people to receive regular
attention, e.g. it is estimated that, to change an irregular to a regular attender, the dentist has
two and a half times as much work to do for that person in any one year.

This year a three-year dental study involving a trial programme of a new kind of tooth-
paste starts in Bristol schools. The study is a joint research project between the Local Authority
Dental Service, the University Dental School and Unilever Laboratories. The children taking
part in this are dentally inspected at the beginning of the survey and after each of the three years.
The children receive supplies of toothpaste and brushes for the whole of the three-year period. A
control group is included in the study. As a matter of departmental policy all new entrants to
infant schools in Bristol now receive dental hygiene kits comprising a toothbrush, a tube of
toothpaste, a beaker embossed with a simple rhyme and a letter to the parents from the Chief
Dental Officer. This is yet another aspect of dental health education.

Dangers of anaesthesia for patients with the sickle-cell trait from African and West Indian
countries have led to all such children being given the Sickledex Screening Test before anaesthesia
is carried out. Positive reactors are referred to the Dental Hospital for treatment. Three centres
have been opened where the test can be obtained and they are : — Central Health Clinic, William
Budd Health Centre and Southmead Health Centre.

The table at the end of this section shows the work carried out by the School Dental Service
during the year.

EAR, NOSE AND THROAT SERVICE

Weekly E.N.T. sessions have continued throughout the year under Mr. R. K. Roddie and Mr. J.
Freeman, by arrangement with the Regional Hospital Board, and particulars of attendances are
given below :

1969 1970

Ears

Nose and throat

First

.812

325

Other

120

Total

432

404

First

273

277

Other

118

Total

391

365

637

199

836

550

206

756

Latest figures showed that 658 children under 16 years of age were on the waiting lists of local
hospitals for tonsillectomy and/or adenoidectomy. Many of these, however, were not Bristol
children and many others had been referred direct by their G.P.s. The corresponding figure for
the previous year was 1,161.

1.5

HEARING ASSESSMENT CLINIC

J. E. K. Kaye
E. M. Tulloch

As in previous years, we have continued the routine screening for hearing of all children in Bristol,
firstly at the age of seven months and secondly at the beginning of school life in infant school.
The initial test at seven months is carried out by the Health Visitor in the local clinic. Any babies
failing this first screening test are referred for full assessment by the medical officers at the
Hearing Assessment Clinic. The second test is carried out by audiometricians in the child’s own
school and failures in this test are referred for fuller testing by medical officers of the Hearing
Assessment Team either in the school or at the local clinic. The following figures show the number
of school children examined during the year :

School Screening

( Total number screened 4,439

iTotalfailed 986 (22-2%)

Follow-up Clinics Total number examined 2,236

Passed hearing test and discharged 909

Referred for further examination 1,015

Referred to E.N.T. Consultant 118

Referred to Hearing Assessment Clinic 55

Failed routine test but already under

treatment 139

2,236

In addition to routine diagnostic work in schools, we followed up all children with impaired
hearing. Children in Elmfield School for the Deaf and in Partially Hearing Units are seen at least
once per term and all children with impaired hearing in ordinary schools have their hearing
and educational progress assessed annually. Parents of these children are encouraged to contact
us at the Hearing Assessment Clinic at any time if they feel they have any problems. We have very
close co-operation with the Peripatetic Teacher of the Deaf who supervises partially hearing
children in ordinary schools and informs us of any difficulties they may have.

We are particularly aware that multiply handicapped children and children with impaired
hearing may be classified as retarded and therefore we have screened the hearing of children in
special schools to check their educational placements in this respect.

The screening and assessment of hearing in schools is often very difficult owing to local
conditions and our work is made possible only by the co-operation of head teachers and their
staff. We should like to express our appreciation for the help in our work that we receive in all
schools.

At the Hearing and Speech Centre we work as a team consisting of Otologist, School Medical
Officers, Psychologist and Teachers of the Deaf. The educational placement of deaf and partially
hearing children is decided at a conference after a period of observation and auditory training.
At this conference the Hearing Assessment Team and the Head of the School for the Deaf, Mr.
Derek Williams, are present. The Hearing Assessment Team members meet once a month for a
case conference and to discuss any problems associated with their work. To this conference are
invited people who are interested or concerned about children in their care.

Apart from babies and children referred to the Hearing and Speech Centre because of failure
in screening tests, a considerable number are referred because of defective or delayed develop-
ment of speech, and we are fortunate in having a very close liaison with the Speech Therapy
Department and the Language Development Unit. Dr. Price, who is the medical officer to this
unit, is also a member of the Hearing Assessment Team.

Children with multiple handicaps present a special problem and often deafness is only one
of many handicaps. Assessment of these children is tedious and time-consuming. It involves not
only the Hearing Assessment Team but also other special investigations and here we arc fortunate
in having the help and guidance of consultant paediatricians.

Apart from the routine work at the Hearing and Speech Centre, we have a hearing assess-
ment session once a month in the Bristol Royal Hospital for Sick Children, where we see children
referred by consultants.

As in previous years, we continue training of newly-appointed health visitors and carry out
demonstrations of assessment to medical students.

Staff Changes

We were very sorry to lose the services of Dr. Helen Gibb who retired in June. Dr. Gibb was one
of the first medical officers at the start of the Hearing Assessment service to children in Bristol.
With her great experience of handicapped children and her sound knowledge and judgment, she
was an invaluable member of the team and is greatly missed by all her colleagues. Dr. Tulloch
has been appointed in her place and Dr. Price of the Language Development Unit joined the team.
Mrs. Marion Bennathan was appointed as Education Psychologist to the Hearing and Speech
Centre in January 1970. Miss S. M. Bullock, teacher of the deaf, who attended the Manchester
University Course of Advanced study in Audiology leading to the Diploma in Audiology, qualified
in July and has returned to the department. Miss S. Egerton-Hall who had worked as a full-time
audiometrician, married and now works part-time with us.

The following figures show the work carried out :

No. of new cases referred

637

Total attendance of new cases under 5

507

730

over 5

223

Total attendance of old cases under 5

233

640

over 5

407

Total attendance at Medical Officers sessions
(of these 232 attended from outside City of Bristol)

1,370

No. attendance at Consultant Clinic under 5 ...

139

445

over 5

306

No. attendance for Psychological Assessment

under 5

over 5

Total attendances at Hearing and Speech Centre
No. referred for E.N.T. treatment

188

1,895

Analysis of New Cases

No. referred by Medical Officers

234

No. referred by Consultants

131

No. referred by Health Visitors

110

No. referred by General Practitioners ...

No. referred by Psychologists ...

No. referred by Speech Therapists

No. referred by Others ...

637

Of these 637 children 226 were in the risk group
(under 5 — 171. Over 5 — 55)

No. of profoundly deaf under 5 ..

over 5 ..

No. of profoundly deaf with other handicaps

under 5 ..

over 5 ..

No. of partially perceptive bilateral under 5 ...

over 5 ...

No. of partially perceptive unilateral under 5 ...

over 5 ...

No. of partially perceptive with other handicaps

under 5 ...

over 5 ...

No. of partially conductive under 5

over 5 ...

No. No significant hearing loss but

defective speech under 5 ... 157

over 5 ... 16

No. No significant hearing loss but

other handicaps under 5 ... 13

over 5 ... 12

No. Hearing Aids issued Commercial ... 17

National Health ... 20

Total attendance for training and parent

guidance by Teachers of the Deaf .. ... 422

EMPLOYMENT OF CHILDREN

During the year 296 children were examined in
employment. Work permits were issued as follows :

order to

ascertain their

fitness

Employment

Boys

Girls

Total

Newsagents

105

135

Others

161

296

for part-time

CHILDREN IN ENTERTAINMENTS

Throughout the year licences were issued to 18 boys and 6 girls to take part in performances,
mainly at the Ice Rink or at the Old Vic Theatre. Another group of 10 girls, exempt under the
new regulations, took part in ice skating; also 274 girls were permitted to engage in dancing
displays in aid of various charities. In addition, 1 girl from another Authority was supervised
during the local filming of “A Day in the Life of Joe Egg” in which 50 children from a local
primary school took part on location.

ENURESIS CLINICS

J. Paget

In 1970, 322 children (320 school children and 2 pre-school children) attended the clinic. Of
these 124 were new cases and 198 continued attendance from the previous year. The total number
of attendances made was 1,137. Three doctors specialise in this work covering a total of four
sessions each week. Fifteen cases were referred to a consultant at the Royal Hospital for Sick
Children for further investigation either because of repeated urinary infections or poor response
to treatment; but no organic abnormality was found in these cases. Two children were referred
to the Child and Family Guidance Clinic for assessment.

One hundred and twenty-one children were issued with the nocturnal enuresis buzzer and
the majority of these achieved success.

It was decided this year to follow-up patients six months after discharge from the clinic. As
a preliminary investigation we sent a simple proforma to 165 children who had been discharged
in 1969 and early 1970. We received 111 replies (plus 4 marked ‘gone away’.) The results were
as follows : —

75 completely dry

15 only occasionally wet — patients and parents satisfied

5 have returned to the clinic for further treatment

6 requested further treatment but failed to attend. They were originally discharged for
non-attendance.

10 majority originally discharged without completing treatment for various medical and
social reasons and still do not wish to attend.

These results were encouraging as on close analysis only 7 patients showed a true relapse,
although we cannot disregard the 50 who failed to reply. Many of the parents expressed their
gratitude for the help given and were impressed with the increase in confidence and the resolution
of many behaviour problems both at home and at school.

EYE CLINICS

P. Jardine

During the year 3,938 children were examined with a total attendance figure of 5,869.

Comparable figures for 1969 were 3,783 children with 5,266 attendances. Orthoptic depart-
ment figures for attendances at the Central Health Clinic and the Mary Hennessy Clinic showed
an increase — 3,503 as against 2,861 attendances in 1969.

Squint operations performed at the Bristol Eye Hospital on Bristol school-children numbered

167 as against 168 last year.

Regular visits were arranged throughout the year to examine the vision of handicapped
children at Claremont and South Bristol Schools.

HANDICAPPED CHILDREN AND SPECIAL SCHOOLS

BUND CHILDREN

.A.t the end of 1970, 4 children (3 boys and 1 girl) were being maintained at the Ysgol Penybont,
Bridgend. These children come home each weekend in transport provided by this Authority and
this arrangement is made use of by other neighbouring Authorities also maintaining children at
the Bridgend School. In addition one boy was at Condover Hall, two boys were following further
courses at the Royal Normal College, and two other boys joined Worcester College for the Blind.

PARTIALLY SIGHTED CHILDREN

In December 1970 there were ten partially sighted children at South Bristol School. Four boys
were being maintained as boarders at Exhall Grange School, Coventry, one boy at the West of
England School for the Partially Sighted, Exeter, and one girl at Chorleywood College, Rick-
mansworth.

DEAF AND PARTIALLY HEARING CHILDREN

R. D. Williams

General

At the end of 1969 a team of H.M. Inspectors carried out a week-long survey of the service for all
children with hearing impairments in Bristol. Their report, received in June, was very helpful to
us in our planning for the future. We were relieved to receive confirmation that our over-all
strategy was on the right lines, and happy to start implementation of a number of recommend-
ations.

EImfield School for the Deaf

The ‘bulge’ of younger children continued while the number of secondary-age children remained
low. Only one boy left school during the year. He had taken a part-time course at the College of
Art and was accepted as a trainee artist in the display department of a large city store.

The older children spent a week in and around London during May. Their experiences at
Windsor Castle, London Airport, Runnymede and many other places gave rise to much follow-
up work on their return. Most of the other children made day visits to places of interest and,
again, they benefited very much from their personal involvement.

Teams of children from the school and Hengrove P.H.U. entered for the National Deaf
Schools Athletic and Swimming Championships. Despite the small numbers in the teams they
did extremely well in both. In Art and Craft Competitions, too, the children won a large number
of awards.

There was only one change of staff during the year, a more stable situation which one hopes
will continue.

EImfield P.T..\. celebrated its 21st birthday in February. This Association has been of
inestimable assistance to families with a deaf member ever since its inception. Long may it con-
tinue. During June and July four students from the Oxford Department for Education of the Deaf
carried out their final teaching practice at EImfield and the P.H.U.’s.

PARTIALLY HEARING UNITS

Two changes of staff occurred, at Eastville and Hengrove. Despite this change, the secondary
children settled down in their new surroundings at Hengrove and we look forward to a long and
close association with the school.

The numbers in the P.H.U.’s continued to rise slightly over the year. It seems inevitable
that we shall have to seek extra infant and primary accommodation in 1971 : this is partly due
to families moving into Bristol.

A further difficulty we are experiencing is that of deaf and partially hearing children who
have additional learning problems which are aggravated by their lack of verbal communication.
It is possible that these children will benefit by grouping for even more intensive special help.

The importance of an understanding school staff to the children is often underestimated.
We are grateful to all concerned.

PERIPATETIC SERVICE AND CLINIC

Again this year we have had a change of peripatetic staff. We were, under the continuing short-
age, fortunate to be able to continue this assistance to hard of hearing schoolchildren. However,
obtaining the services of only one teacher meant that her roll had to be reduced. The visits and
assistance given to these children is geared to their needs as far as possible and is very much
dependent on the co-operation of the class teachers.

One of the two teachers at the Hearing and Speech Centre was away for the year gaining a
further specialist qualification.

The diagnostic and assessment work, together with parent guidance and teaching undertaken
so effectively at the Hearing and Speech Centre, is the basis of our varied educational programme.
Without it the education of hearing impaired children would be made immeasurably more diffi-
cult.

RESIDENTIAL SCHOOLS FOR THE DEAF

In addition to the children at Elmfield, deaf children were being maintained at the following

residential schools :

Boys Girls Total

Burwood Park School, Walton-on-Thames ... ... ... 1 — 1

Larchmoor School, Stoke Poges, Bucks. ... ... ... — 1 1

Mary Hare Grammar School, Newbury ... ... ... 1 1 2

Royal School for the Deaf, Exeter ... ... ... ... 4 — 4

6 2 8

EDUCATIONALLY SUB-NORMAL CHILDREN — DAY SPECIAL SCHOOLS

Henbury Manor Special School Jean Davis-Morgan

1970 was like the proverbial parson’s egg, “good in parts” ! In an era when daily life seems to be
so turbulent it is increasingly difficult to maintain the serenity and stability so necessary for the
sound scholastic and emotional development of handicapped children.

The programme of our day seems to be constantly interrupted by a long succession of
visitors, by workmen (the school was painted from January to June), and more recently by
strikes. It is the children who are in our special schools who are most often adversely affected by
these upheavals.

Our numbers have been reduced by the multiplicity of defects suffered by our present pupils,
and their consequent needs.

Although the category of the school remains officially E.S.N., I doubt whether there is one
child who is simply “dull and backward”. The majority have dual handicaps and quite a few
have a dominant handicap such as that of speech or maladjustment, for which there is no specific
provision other than in a special school for the educationally sub-normal. The teaching staff,
therefore, need to be both knowledgeable and adaptable and almost specialists in several fields.

Our school summer holiday, which has become almost traditional, had a new venue in 1970.
From our customary trip to Croyde we moved to Fishguard and rented a delightful house over-
looking the harbour. Eighteen children went on holiday and the welcome from Wales was heart-
warming.

Staff coped magnificently with the situation caused by the October strike and it says much
for their efforts that the good relationship between parents and school was maintained throughout.

Healthwise, we have had yet another change : Dr. Isabel Price is now the school’s medical officer
and looks after the Manorial family. The ratio of boys to girls remains fairly constant, being

10 30. The number of young borderline S.S.N. children admitted on trial has increased and

with the new Act (1971) I imagine this may continue, though it is hoped that once all mentally
handicapped children are under the L.E.A. umbrella, transfer from one school to another will be
made easier and with less delay.

Florence Brown School J- N. Tolley

The beginning of 1970 saw the new school well established with its full complement of children,
although there was still a preponderance of senior boys. This situation was partly remedied by
mid-summer by which time an unprecedented number of boys (36) were eligible to leave.
A number of early minor difficulties with the new building, — defective heating, inadequate hard
play area, insufficient storage space — were either overcome or alterations to improve the situation
were agreed.

These early days also saw the gradual working together of new and older members of
teaching staff besides additional school helpers. It was encouraging to see how quickly this came
about; we became a team determined to make the new building a success and to mould our
largely new children into a happy tightly-knit family.

September saw a quite large intake of children, but even this made little impact on a growing
waiting list of admissions which by the end of the year stood at some forty children.

The Autumn term began with great promise. The first Anniversary Assembly was held at
which prizes were presented to the children by Mrs. Florence M. Brown. It is hoped to make
this an annual event. Unhappily the long drawn out strike of Corporation Manual Workers
intervened and, because of the resulting closure of the school, upset much of the progress we
aimed to make. Later on less severe disruption was caused by power cuts, but these were happily
ended in time to permit the usual Christmas Festivities. Our Christmas Party had to be seen to
be believed !

Kingsweston School I. M. Bond

This is still our transition period. Some good steady work has been accomplished and progress
has been made in many directions. The boys have been admitted in the lower half of the school
and during 1971 the last all-girls class will be leaving. In 1970 we were forced to restrict the
entry for a time; this situation is likely to be cleared when additional accommodation is provided.

At present we are catering for senior pupils requiring special education from the north of
the city, and older girls from the whole of Bristol. We have five classrooms, a well equipped
Housecraft section (with a delightfully real flat attached), a pottery room, a very fine gymnasium
complete with changing rooms and showers, a well-equipped woodwork and metalwork crafts
room. We have been able to offer as well a high standard of remedial reading teaching, a well-
organised and lively leavers’ programme and good needlework.

Of course there have been many problems and difficulties, as natural in a transition period
when buildings are adapted, but thanks to the valiant efforts of the staff, these have been
minimised.

The acquisition of the minibus from the Variety Club afforded us many extra opportunities.
We were able to send three groups to a cottage in Wales in the Brecon area. We could see the
S.S. Great Britain, watch the building of the new motorway and preparations for the bridge over
the Avon. Two parties visited the Ideal Homes Exhibition in London and other excursions were
made to places in Bristol and its surroundings.

An interesting link was forged with Kingsweston Police Station which is near to the school.
Dog handlers and a mounted policeman visited us so that we could hear of this work.

I hope to see a development in further education and the extension of support for our girls
and boys in the care of the local authority.

EDUCATIONALLY SUB-NORMAL CHILDREN
Special Classes for E.S.N. Children in Ordinary School

During 1970, 15 special classes for educationally sub-normal children were opened, 1 in a primary
.school and 14 in secondary schools. By the end of the year there were 131 classes altogether, 64
in primary and 67 in secondary schools.

Other day provision for E.S.N. children

During the year four girls were transferred from neighbouring Authorities and the Committee
assumed responsibility for them at the following schools ;

2 girls attending Warmley School, Warmley.

1 girl attending Stokesbrook School, Filton.
and 1 girl attending Ravenswood School, Nailsea.

EDUCATIONALLY SUB-NORMAL CHILDREN — RESIDENTIAL SPECIAL SCHOOLS

Kingsdon Manor School J. C. Cummings

The school has during the year maintained its number of sixty and, with a waiting list, we have
been able to fill each vacancy as soon as it arose. Though the greater proportion of the boys come
from Bristol, seventeen are from other Authorities as far apart as Hereford, Cardiff, Cornwall,
Reading and Germany. It is worthy of note that both the Reading and Southampton Authorities
are so aware of the importance of their boys maintaining contact with their homes that they are
prepared to send a Welfare Officer to collect and return the boys by car for an occasional weekend.
Consequently, these boys feel neither rejected nor isolated from their homes but regard their
Authority as reliable, kindly people who care sufficiently to go to trouble and expense on their
behalf.

Of our present complement of sixty educationally retarded boys many are emotionally un-
stable and have other associated handicaps. Five have only partial hearing, one is physically
handicapped and 39 others have varying degrees of maladjustment.

During the year we have been fortunate in being able to consolidate our programme of
evening activities. Judo is now a regular activity and nine boys have been graded 5th Kyu and
two were chosen to represent Somerset and Dorset in the National Championship. With a recent
increase of mat area we hope to increase considerably the size of the group. Pottery is also a going
concern giving a great deal of pleasure and success. The other activities — cookery, toy-making
and knitting, woodwork, art, swimming have retained their popularity and many boys are having
to be selective in their choice. There are, however, still some boys who choose not to take advan-
tage of anything we offer. It is unfortunate that among these are those most in need of a more
relaxed period with an adult than is possible in the classroom; but it is important for them and
the school as a whole, that the choice of an activity is free.

The pattern of the day-time work has been maintained with normal class-work in the morn-
ings and more specialised groups in the afternoon when each boy is able to take in turn woodwork,
art, rural crafts, P.E. and games and mathematics. It is understandable that our first qualified
P.E. teacher should be greeted with enthusiasm, but adults might be surprised at a similar
reaction being shown for mathematics. It is evident we adults are not the only ones with worries
over decimalisation.

We have taken a big step and entered our first pupil for C.S.E. and also G.C.E. examination
and hope this is a successful foundation of an established course.

Preparation for work is a vital task in which we can play an important part by regular visits
to places of employment, the performing of regular tasks about the school and, where possible, in
involving the boys in “work experience”. We are fortunate in having the help and co-operation
of Mr. Bird, our Careers Officer, who endeavours to make our task easier with the same devotion
he applies to helping place our boys in employment. A number of firms have been approached to
enlist their co-operation in a work experience scheme and as soon as the boys are old enough we
hope to be able to take advantage of their offer.

We have had during the year a mixture of pets — rabbits, guinea pigs, hamsters, gerbils,
birds, stick-insects and, for the winter term, two donkeys. These pets had varied success : the
guinea pigs and rabbits have thrived in their open air pens, some gerbils and hamsters suffered
from the cruelty of two boys, while the donkeys proved a problem in keeping them in an enclosure.
We have learnt from the experiment that the interest of adults is essential, but have been impressed
by the care and devotion of the majority of the boys.

Our hopes for the future revolve around the building of a team of trained resident Child
Care Officers in the school and a regular visiting Psychiatric team; both are so necessary in the
establishment of an efficient therapeutic atmosphere for our growing number of emotionally
disturbed children.

Croydon Hall School J, E. Ireson

The past year has been one of achievement in many ways. Perhaps the highlight of the year was
being able to use our new swimming pool during the lovely summer weather. The girls had

helped a great deal with the preparation of the site for its installation, carrying plastic buckets
and bowlfuls of ashes and sand until they had moved over 14 tons in all.

VVe were able to join the Somerset special schools in the swimming gala and did quite well
in the athletics meeting at Taunton. Our biggest surprise was when we won the cup at the netball
rally — almost accidentally ! However, we showed little or no progress when the rounders season
started, but enjoyed the social side of visits we paid to other schools, and their visits to us.

Our schemes for helping future school leavers went on apace. We were able to send five of
them to join in the leavers’ course that Somerset special schools hold annually at Kilve Court.
Here they worked freely with boys and girls of other schools for a complete week, and were
given glimpses of life after schooldays, both with regard to work and leisure. Later in the year,
four girls took part in our first work experience venture and came through it extremely well.

Another interesting experiment took place last summer, when we took part in exchange
visits with girls from a Devon school — again for a week. Our girls had a most interesting time
visiting Plymouth and the neighbourhood, and we looked with fresh eyes at our own environment,
as we showed our visitors round. As we tend to live in a rather remote spot, it was good experience
for our girls to have to cope with a much larger boarding school than we have here.

Altogether we had a year of solid achievement but we still have to cope with a great number
of disadvantages, chiefly connected with buildings unsatisfactory in a number of ways and shortage
of child-care staff.

OTHER RESIDENTIAL SPECIAL SCHOOLS

At the end of 1970 the following children were being maintained at other residential schools for

educationally sub-normal children :

All Souls’ School, Hillingdon ...

Boys

Girls

Total

Amberley Ridge School, Nr. Stroud

—

Besford Court R.C. School, Worcs.

—

Bownham Park School, Amberley, Stroud

Pitt House School, Torquay, Devon

—

Rocklands School, Chudleigh, Devon ...

—

St. Johns School, Brighton

—

Westhaven School, Weston-super-Mare

—

CHILDREN UNSUITABLE FOR EDUCATION AT SCHOOL

Under Section 57 of the Education Act (as amended by the Mental Health Act, 1959), the
Education Committee decided that 10 children (6 boys and 4 girls) were suffering from such
disability of mind as to make them unsuitable for education at school, and furnished reports of
those decisions to the Mental Health Authority. Their ages were as follows :

Age

6
7

Boys Girls Total

1 — 1

2 2 4

1 — 1

6 4 10

During 1970 only extreme cases were referred to Mental Health in order to eliminate un-
necessary distress to children and parents and to avoid unnecessary procedures pending legislation
which transferred responsibility for the education and training of all children under the age of
16 years to the Education Authority.

E.S.N. SCHOOL LEAVERS, 1970

Referred to the Local Health Authority
for informal supervision
Referred to special school welfare
officer for after-care ..

Boys

Girls

Total

MALADJUSTED CHILDREN

At the end of the year 69 maladjusted children were being maintained in residential schools and

hostels as listed below. The previous year’s total was 72.

In addition

two boys and one

attended as day pupils at the Woodstock School, Kingswooc

, Bristol.

Boys

Girls

Total

Badgworth Court, Nr. Cheltenham

—

Berrow Wood School, Nr. Staunton, Worcs.

—

Bicknell School, Bournemouth ...

—

Blaisdon Hill Salesian School, Longhope, Glos. ..

—

Breckenbrough School, Thirsk, Yorks. ...

—

Bredon School, Pull Court, Bushley, Tewkesbury

—

Burn Norton School, Chipping Camden

—

Cam House, Dursley, Glos

—

Chelfham Mill School, Barnstaple, Devon

—

Childscourt School, Nr. Wincanton, Somerset ...

Clouds House School, East Knoyle, Shaftesbury

—

Dawlish College, Kenton, Exeter

—

Devonport House, Buckfastleigh, Devon

Falcon Manor School, Towcester, Northants. ...

Farmhill House, Stroud, Glos. ...

—

Grangewood Hall, Wimborne, Dorset ...

—

Heanton School, Braunton, Devon

—

Holbrook Manor School, Hereford

—

Marchant Holliday School, Templecombe, Somerset

—

Marland School, Torrington, Devon

—

New Barns School, Toddington, Glos. ...

Peredur Home School, East Grinstead, Sussex ...

—

Q.E.H., Clifton, Bristol ...

Red Maids School, Westbury, Bristol ...

—

St. Audrie’s School, West Quantoxhead, Somerset

—

Sompting Abbotts, Lancing, Sussex

—

Shotton Hall School, Shropshire ..

Sutcliffe School, Winsley, Wilts. ..

Wells Cathedral School, Wells ...

—

Wessington School, Woolhope, Herefordshire ...

—

DELICATE AND PHYSICALLY HANDICAPPED CHILDREN

Periton Mead School, Minehead F. C. Wilkinson

“Welcome to Minehead, Gateway to Exmoor” announces a large, colourful, roadside sign as you
approach the school. Certainly the school is beautifully situated between the hills and the sea
and enjoys a very favourable climate. It showed signs of snowing one evening and the boys were
very excited at the prospect; but the next morning the grass was as green as ever. The school
has the advantage of town at the bottom of the hill, so none of the children feels isolated and
‘lost’. One smiles, as, in the summer months the boys and girls identify themselves with the visitors
to the resort and an amazing number of picture postcards is sent to their families and friends.

It is an unending source of pleasure to see children growing up happily, gaining in health,
more active and lively as time passes. Sometimes the progress is nothing short of marvellous. The
most striking examples of ‘before’ and ‘after’ are those who come because of general debility and
the like. Their stay is no more than three or four terms, a period of healthy routine, balanced
diet and sea air long enough to ensure fitness sufficient to warrant a return to ordinary school.
Not many of our pupils have so short a stay, however, the average being about two years. Our
‘oldest inhabitant’ has been here almost ten years and is now Head Girl. Many of the children
transfer to their senior school at the appropriate time, but we appreciate all those ex-pupils who
keep in touch, either through their friends still here or through attending our annual Open Day.

During the year the average number on roll was 67 and 26 left school as statutory age leavers
or were transferred to day or other boarding schools more suited to their needs. Of 26 children
admitted two were re-admissions, but instances were few when children did not settle in their

new school. When the year ended there were 69 children on roll, 27 delicate and 42 emotionally
disturbed. Of this total 54 children were from Bristol districts and the other 15 from seven
counties in the south from Kent to Cornwall. In passing a mention is made of the ‘mixture as
before’; both sexes, complete age-range from six to sixteen, cross-section of backgrounds and
intelligence, the whole making a comprehensive school in miniature. A small but interesting point
is the steady increase in the number of disturbed children admitted in the last few years : 7 in
1966, 24 in 1967, 39 in 1968 and remaining much the same percentage since, a satisfactory figure.
During the year an additional teacher was appointed and there are now five classes. In the
mornings the basic subjects are taught with some specialisation in the afternoons, half past one to
four o’clock. The four-term year is now thoroughly established and works extremely well. During
the winter terms the two senior classes have a lesson prep, period from 4.30 to 5.30 p.m., the
older pupils taking external examinations with a satisfying degree of success.

The kitchen has been modernised, enlarged and fully re-equipped with all the latest mod.
cons, in stainless steel; the floor has been quarry-tiled, walls tiled, and new lighting and ventil-
ation installed.

We have also changed over from solid fuel to automatic gas-fired central heating which is
most satisfactory.

South Bristol School C. Williams

An interesting but, due to circumstances beyond our control, not a vintage year.

Our 133 pupils went on a wide range of educational visits by train, coach, service bus,
school ambulance and private cars. Experience of varied forms of transport is useful as well as
interesting. Journeys were made to factories, ships as different as “Nonsuch” and the “Great
Britain” and places of value in and around the city. The most ambitious and valuable excursion
was to Llandogo (Mon.) where a large party spent a pleasant few days. Eleven staff gave time
and money and were pleased to do so.

School work went on in our old collection of five separate buildings and we were encouraged as
we saw the new school taking shape on what used to be our sports field. Parents had the usual
opportunities, either by individual visit or on Open Days/Evenings, to see how their children
were progressing. Often, because of serious and sometimes multiple handicapping, movement is
discouragingly slight.

The year was marred and children and parents bewildered by industrial action which closed
the school for several weeks. Our full-time staff is all the better for being a true cross section of
political belief, but is completely united in opposing anything which hits our children.

A number of our pupils suffer from progressive and incurable complaints of a distressing
nature. It seems invidious that they should suffer by the action of a small portion of the com-
munity.

Home Tuition

As reported last year here we seek to deal with just over a dozen pupils in an average week. They
are home-bound due to a wide range of physical or emotional disorders. Two full-time teachers
continue to operate this service.

Mr. Hardie, who has given ten years’ good service to various departments, joined the staff
of a college of education at the end of the year.

Hospital Teaching

Seven teachers, three of them full-time, continue to visit child patients in three of the city’s
hospitals. Southmead Hospital and Bristol Royal Infirmary are visited in the afternoons. \
representative session at the former will see about ten pupils available and about half a dozen
fit for lessons at the latter hospital.

The Royal Hospital for Sick Children’s groups total between thirty and forty patients. Here
the full and part-time staff also visit a psychiatric ward. It is pleasing to report that yet another
disturbed patient from here has been successfully placed in South Bristol School.

As always, we are grateful for the co-operation and consideration of the hospital staffs.
Particularly this year for those concerned in making a new school room available at St. Michael’s
Hill.

DELICATE AND PHYSICALLY HANDICAPPED CHILDREN AT RESIDENTIAL SCHOOLS

At the end of the year the Authority was maintaining six delicate children at residential schools
— one boy at the Pilgrim’s School, Seaford, Sussex, one boy and three girls at Heathercombe
Brake School, Newton Abbot, and one boy at Mounton House School, Chepstow.

2.5

The following children were at residential schools for the physically handicapped :

Chailey Heritage Craft School, Nr. Lewes
Craig-Y-Parc School, Pentyrch, Cardiff ...
Florence Treloar School, Alton, Hants. ...
Lord Mayor Treloar School, Alton, Hants.
St. Rose’s School, Stroud ...

Trueloves School, Ingatestone, Essex

Boys Girls Total

2 — 2

— 2 2

— 1 1

1 — 1

— 1 1

1 — 1

4 4 8

Under further education arrangements two boys and one girl were undergoing training a!
St. Loyes College, Exeter, and one boy at Dene Park, Tonbridge, Kent.

EPILEPTIC CHILDREN

In addition to the 18 epileptic children (11 boys and 7 girls) for whom special educational treat-
ment was provided at our own day schools, 3 boys and 2 girls were being maintained at the end
of the year at the Lingfield Hospital School for Epileptic Children, Surrey.

CHILDREN WITH SPEECH DEFECTS

At the end of the year, ten children were in the special class for children with delayed speech at
St. James’ and St. Agnes’ Nursery School and six in the unit at Easton Road School.

CHILDREN WITH MULTIPLE HANDICAPS

In December 1970, 10 children with multiple handicaps were maintained at St. Christopher’s
School, an independent school in Bristol for children in need of special care, 2 boys and 1 girl as
boarders and 3 girls and 4 boys as day pupils. In addition 2 boys and 2 girls (including 1 boarder)
were attending under further education arrangements.

CEREBRAL PALSY CLINIC E. E. Warr

The work of this weekly clinic continues to revolve mainly around the problems of cerebral palsy.
Children with spina bifida are also seen there if they are thought to need special educational help.
The existence of the new assessment unit in the grounds of Claremont school, due to open in May,
1971, will alter the character of the cerebral palsy clinic slightly. It is to be hoped that children
will be referred to the clinic at even younger ages, once the capacity for their assessment is
expanded. It is hoped that children will be placed in the unit for short periods of assessment both
with a view to assisting in the decisions as to their educational placement and also in the hope
that more help, advice and guidance will be made available to teachers when physically handi-
capped children are placed in normal schools.

There have been changes in the para medical personnel attending the clinic. Miss Wheatley,
the senior physiotherapist, has left the Children’s Hospital; she has been an efficient member of
the cerebral palsy clinic from its inception. It is impossible that she will not be missed. Mr.
Carroll, the educational psychologist, who had been assessing children both in the clinic and in
the school for two years, has left Bristol and has been replaced in the clinic by Miss M. Holder.
Despite these changes, the clinic has maintained its multi-disciplinary character and is still
assisted by the presence of Mrs. West, the Spastic Society’s social worker.

Dr. Schutt remains a key figure in the organisation of the service. Mr. Griffiths and Mr.
Eyre-Brook, orthopaedic surgeons, attend Claremont school at regular intervals, seeing children
there rather than in their clinics, and thus helping to produce greater co-ordination and continuity
in the care of the children there. It is hoped that the new unit will allow even more scope for such
inter-disciplinary co-operation.

Claremont School M. E. Ram

We have had an average of 50 children on the registers throughout the year; the proportion
coming from outside the Bristol boundaries has remained at about one-third of this total. Eight to
nine places are always occupied by children with spina bifida.

Three children suffering from a spastic type of cerebral palsy are visited by a teacher of the
deaf. We have fifteen athetoids in the school between the ages of ten and three, but none of these
has a hearing loss. Only one child is registered as partially-sighted, but we have a large number

of pupils suffering from eye defects. These pose educational problems but the teachers have been
greatly helped by the work of the orthoptist who can analyse the difficulties for us and suggest
remedial techniques.

The school is still very “young” and we have only seven children of secondary age. Three
children left to go to normal school during the year, one C.P. Bristol girl and two Gloucestershire
girls with spina bifida. Boarding school was advised for two children for social reasons and one
Bristol girl with spina bifida was referred to the Mental Health Authorities.

In the spring work was started on the new assessment nursery and on 15 May the first turf
was cut by the chairman of the Van Neste Foundation, in the presence of Alderman Chamberlain,
representatives of the Education Authority and Professor Neville Butler. The unit is planned to
take up to 20 multiply handicapped young children for varying periods of assessment.

A school meals kitchen is included in this building project to supply both the old and the
new parts of the school. This will be a great advantage as it will be possible to adjust the meals
more closely to the needs of the children, especially to those of our slimmers.

In April I was invited with Heads of other local schools to the opening of Henleaze Public
Library. We were delighted to see that this building had been planned to give easy access to
wheel chairs. Our children have taken advantage of this, and have made a number of library
expeditions.

In common with all schools, we deeply regretted losing six weeks’ work at the time of the
strike of Corporation employees. At first the staff tried to minimise the effect upon the children
by making a number of home visits. When, as time went on, this proved very inadequate, we
managed to have the children in greatest need brought in to school several times a week. In
spite of these measures, we lost ground that was very difficult, in some cases, to make up. Apart
from these events our programme has gone on much as usual. In our Peto work we have been
encouraged by contact with parallel schemes in two of the Spastic Society schools and by a
week-end conference with Dr. Hari, the director of the Institute in Budapest. We continue to keep
film records of the children’s progress.

The Parents’ Association has organised its usual educational and fund raising events and has
given the school two record players as well as a number of smaller gifts. Some of the members
arranged working parties, when they did minor repairs and made apparatus for the classrooms.

HEALTH EDUCATION

P. Mackintosh

Early in 1970 it was agreed by a representative panel of Heads of schools in association with
officers of the Education Department and the Health Education Section that Health Education
in primary schools should develop along the following lines :

1. Work based on routine example within the school environment i.e. involving not only teaching
staff but also caretakers, cleaners, nursery nurses, ancillary workers, canteen staff etc.

2. Special health topics included in project work or in direct teaching

The former approach was helped by discussions between the panel and members of the
staff mentioned above with a view to placing greater stress on health matters during staff training.
Assistance from outside sources and from the Health Education Section was given with project
work and direct teaching.

Other work in primary schcools consisted of talks to Parent/Teacher Associations, the use
of B.B.C. filmstrips and tapes, notably the much publicised programme on “Growing Up”. At the
end of the year the Education Department, together with the National Marriage Guidance
Council organised a three-day residential course on “Personal Relationships in the Primary
School.”

As far as Secondary schools were concerned a vigorous programme of health education was
pursued. Topics covered such things as venereal disease, drugs, and smoking and health, the
latter being supplemented by the issue to secondary schools of the special sets of posters produced
by the Health Education Council as well as by films.

Other work among secondary school children included visits to health centres, a one-day
conference on “Personal Relationships in Secondary Schools” and a “Health Week”, involving
talks, discussions and exhibitions, organised at one of the large comprehensive schools.

The meetings between the Education Department’s Officers, the Secondary School Health
Co-ordinators and the Health Education Officers proved very fruitful and the future programme

of health education in secondary schools is planned to follow the pattern now emerging, whereby
the help of school teaching staffs is enlisted in developing topics and priorities as agreed at these
meetings.

The Training Officer continued with his First-Aid programme in schools. Instruction in
mouth-to-mouth resuscitation was given to 4,180 pupils; 106 pupils attended talks on life-saving
first aid and a further 70 pupils took the full First Aid Course, and passed the examination to take
their certificate.

It is just 25 years since Bristol’s first Health Education Officer was appointed. Doubtless the
next quarter century will witness even more striking developments than have characterised the
years since 1945.

INFECTIOUS DISEASES

A. J. Rowland

In general terms this has been a relatively quiet year for infectious diseases. With the advent of
measles vaccine the biennial incidence of measles has tended to disappear and for the last two
years the notifications in children of school age have remained similar at a little over 500. Much
of the effort in measles vaccination during 1970 was concentrated on pre-school children and we
may, therefore, hope to see a reduction in the incidence of measles in school children in the near
future.

An exception to the general rule in 1970 has been infective jaundice. This year proved to
have the highest number of cases notified (all age groups) since 1961; there was a corresponding
rise in the incidence in school children. Most cases occurred during the first two quarters of the
year. Although several schools reported a number of cases there was no large outbreak.

The following table shows notifications of infectious diseases in children aged 5-14 years in
1970 and expresses them as percentages of notifications in all age groups. Previous years are
included for comparison.

Infectious disease notifications in children aged 5-14 years

Bristol County Borough 1970

1970

1969

1968

No.

Measles

536

520

279

Rubella

185

462

1,891

Infective jaundice

356

136

Dysentery

145

Scarlet Fever ...

107

Whooping Cough

107

Food poisoning

Tuberculosis ...

Tuberculosis

With the decline in tuberculosis over recent years the majority of cases represent the infection of
previous generations and occur as recrudescences or breakdowns of long standing quiescent
tubercle in middle-aged or older adults. The occurrence of active infection in children is now
rare; each case calls for careful investigation for it indicates the presence of an infectious adult
somewhere in the child’s environment.

There were four new notifications of pulmonary infection in children of school age during
the year. Two were members of one family, the source of infection being their grandfather.
Another child was infected by his father, while in the fourth case the source of infection has not
yet been traced.

Protection against Tuberculosis

Susceptible children found to be in close contact with recognised cases of tuberculosis are given
B.C.G. at once. Apart from this all children in their third year in secondary school are oft'ered
skin testing (Heaf Test) and if Heaf negative they are susceptible to infection and are given
B.C.G. vaccine. The acceptance rate this year was 80% compared with 82% in 1969. Rather
unusually the acceptance rate for independent and private schools fell this year below that of
maintained schools to 77%. The year’s work may be summarised as follows:

B.C.G.— SCHOOL CHILDREN

Number skin tested

5,383

Number defaulting reading

495

Number tested and read ...

4,988

Number found negative ...

4,255

Number with previous history of B.C.G

found positive to skin test

438

found negative and re-vaccinated

found positive Grade 1 and re-vaccinated

Number positive with no history of B.C.G.

295

Natural conversion rate ...

5-8%

Children who show evidence of natural conversion are offered a chest X ray if they have a
Grade 3 or Grade 4 reaction to the Heaf test. In 1970, 21 of the 295 natural converters were
either Grade 3 or Grade 4. 20 were X rayed and one new case of pulmonary tuberculosis was
found in a nineteen year old boy from overseas.

The natural conversion rate has been falling steadily in recent years, and this year’s rate of
5 ‘8% is the lowest ever recorded. Indicating as it does a declining degree of exposure of children
to the tuberculosis bacillus, this steady fall is a good augury for future generations of children.

The continuing decline of tuberculosis may force us to reconsider our policy concerning
B.C.G. in future years. Should the disease be finally eradicated in this country, we would have
to decide whether it would be necessary to continue vaccination on a mass basis. The age at
which B.C.G. should be given has also been under review recently, and there have been suggest-
ions that earlier administration might be desirable. However, these are matters for the future;
there is no change of policy in immediate prospect.

MEDICAL EXAMINATION OF TEACHERS

During 1970, 211 intending teachers were medically examined in Bristol prior to appointment
with the Local Education Authority; in addition 142 were examined by other Authorities for
employment in Bristol, while 20 teachers were examined for other Authorities at their request.
The number of young persons examined in connection with admission to teacher training colleges
was 549 and 4 entrants to college were examined for other Authorities.

Chest X-rays

Appointments for chest X-ray examinations were offered to 1,508 teachers during the year and
809 accepted (54%). Of those recalled for larger films to be taken, it was considered desirable in
20 cases to notify their general practitioners of the findings which concerned mostly minor cardio-
vascular or lung conditions.

MEDICAL INSPECTIONS IN SCHOOL

A complete periodic medical inspection was made of 12,975 children attending the Authority’s
schools. All children are medically inspected during their first year in the infants’ school and
older children on entering a maintained school for the first time. A periodic medical inspection
is also made of all children at the age of 14. In addition, 6,646 children were re-examined in
primary, secondary or special schools and 539 specially examined at the request of school nurse,
teacher, parents or others. In nursery schools and classes, all children were examined on entry,
and 667 re-examinations took place. The total number of inspections in schools was 20,827.

Co-operation of Parents

The number of parents present at periodic medical inspections during the year was as follows:

Age groups inspected

No.

Parents

Per cent

(by year of birth )

examined

present

1966 (and later)

973

948

97-4

1965

... 1,700

1,619

95-2

1964

... 4,390

3,862

88-0

1963

414

300

72-5

Age groups inspected

No.

Parents

Per cent

( by year of birth )

examined present

1962

224

162

72-3

1961

146

58-2

1960

152

55-9

1959

334

217

65-0

1958

267

173

64-8

1957

149

49-0

1956

423

198

46-8

1955 (and earlier) ...

3,803

852

22-4

INFESTATION

The following table shows the number of children found to be infested each

School

year since

No.

Population

Per cent

1961

748

65,853

1-13

1962

672

65,242

ro3

1963

606

65,671

0-92

1964

691

66,374

1-04

1965

717

66,710

1-07

1966

714

66,132

1-08

1967

639

65,999

•97

1968

609

67,149

•91

1969

576

67,787

•85

1970

569

68,474

•83

MILK AND MEALS IN SCHOOLS

J. A. Battersby

The number of Primary and Special School pupils taking milk was 34,861 representing 91 ’5%
of pupils on roll.

7,042,287 meals were served in 1970, which is a reduction of approximately 14% since last
year. This is partially explained by the closure of schools for four weeks, due to the manual
workers’ strike. In addition there has been a considerable drop in numbers of secondary pupils
taking meals. Enquiries show that pupils buy snacks or chips only, or school tuck shop food for a
mid-day meal. This appears to be a national trend and School Meals Organisers are becoming
concerned that many pupils of this age group may have a high calorie, low protein intake or a
low intake of any form of food between the overnight meal and the next evening meal. Steps are
therefore being taken to introduce a cafeteria service with a choice of food into most secondary
schools.

A kitchen was provided at the new Spring Woods Nursery which opened in April and three
kitchens were opened in September at St. George, Stockwood Green and Elmlea Infants’ new
schools. New canteen serveries were provided at Bishop Road J.M. School and Baptist Mills
new Infants’ School.

Despite the continued rise in the cost of foodstuffs from suppliers, the correct nutritional
standard of the meal has been maintained with only a moderate increase in the cost of food
per meal.

MILK, FOOD AND HYGIENE INSPECTIONS

G. J. Creech

Schools and School Kitchens

MILK

Sampling

Routine sampling at schools throughout the city resulted in 73 samples being submitted for both
bacteriological and chemical examination. All the samples satisfied the tests applied to them for
chemical composition, heat treatment and keeping quality. These samples were taken at regular
intervals from the various processors supplying milk to schools.

Complaints

Nine complaints were received regarding milk or milk bottles during the year; most concerned
minor incidents relating to the condition of the bottle in which the milk had been supplied. Seven
of these were dealt with informally, in one case, the County Authority for a processor being
informed. One complaint, regarding a large number of rust particles found in a bottle just as a
pupil was about to drink the milk, resulted in legal proceedings under the Milk and Dairies
(General) Regulations, 1959.

The remaining complaint concerned 1 1 bottles of milk alleged to have been delivered con-
taining small pieces of chicken wire. Investigation at the dairy failed to reveal anything remotely
similar to the wire and it was concluded that this wire had gained entry to the bottles at the
school, possibly the result of a childish prank, as the foil caps bore signs of tampering.

FOOD

Sampling

A selection of foods was taken from various school kitchens for analysis by the Public Analyst
and in all 148 samples were examined in this way. No adverse report was made on any sample.

Complaints

Of 15 complaints submitted two concerned dried milk powder, two water (one drinking and one
washing up), two maggots in chocolate bar, both from the same source — a small tuck shop used
by the school children. The problem of general infestation of this kind at the shop was resolved
when the shop closed for redevelopment. There were six complaints of foreign bodies in food, one
of worms in cod fillet, and two of the smell of canned meat.

Investigations were carried out in all of these and, where supported, appropriate action was
taken with the manufacturer or supplier and the kitchen was reimbursed.

On several other occasions the services of the food and drugs inspector were sought to
adjudicate on the soundness or otherwise of a particular food. Where necessary condemnation
certificates were issued and disposal arranged.

Food Hygiene

124 school kitchens are regularly inspected under the Food Hygiene (General) Regulations, 1960.
These inspections are made at least twice a year and during 1970 324 visits were made and 27
defects discovered.

Food Poisoning/Dysentery/Gastro-Enteritis

This is the first year when the liaison between the school meals section and this department has
been discontinued. The duties regarding domiciliary visits for dysentery and gastro-enteritis
passed to the Central Health Clinic during the latter months of 1969.

ORTHOPAEDIC AND POSTURAL DEFECTS

During 1970, 24 sessions were held at the Central Health Clinic by the Orthopaedic Surgeons,
Mr. D. M. Jones and Mr. A. H. C. Ratliff. This is fewer than last year as Mr. Ratliff discontinued
his sessions after October. An analysis of the cases seen is given below, together with the previous
year’s figures (in brackets) for comparison.

ORTHOPAEDIC INSPECTION CLINIC ATTENDANCES

School Children Pre-School Children

No. of

Total

No. of

Total

cases seen

attendances

cases seen

attendances

Paralysis (a) Flaccid

fl)

(1)

—

(1)

(b) Spastic

(4)

(6)

—

(1)

T.B. bones and joints ...

—

(2)

—

(2)

—

(1)

(2)

Congenital abnormality of bones

and joints

(35j

(51)

(29)

(47)

Flat foot

(99)

143

(131)

(24)

(34)

Knock knee

(49)

(63)

(15)

(17)

Spina bifida

(2)

(3)

—

(— )

Spinal curvature (non T.B.) ...

(34)

(60)

(2)

(3)

Talipes ..

(6)

(11)

(8)

(10)

Torticollis

(3)

(4)

(1)

Miscellaneous

(84)

(123)

(28)

(40)

231

(319)

363

(455)

(110)

117

(156)

PHYSIOTHERAPY

During the first half of the year the department with its full complement of three physiotherapists
was able to continue its work among schoolchildren throughout the city.

Besides the four sessions provided each week at the Central Clinic, treatment was also given
at Lawrence Weston, St. George, William Budd and Stockwood Health Centres. One physio-
therapist continued to give three treatment sessions weekly at South Bristol School. Orthopaedic
clinics were also held each month in the Physiotherapy department.

The second half of the year brought many problems due to the resignation of one physio-
therapist and the shortage of staff meant curtailment of some treatment sessions.

In addition to the treatment sessions mentioned above several talks were given in conjunction
with the Health Education department, such as the teaching of correct breathing techniques
during the Anti-Smoking Campaign.

PHYSICAL EDUCATION

R. R. Jenkins

Facilities for Physical Education continue to improve year by year, and the construction of the
Sports Hall at St. George School and the playing field at Newfoundland Road have been signifi-
cant developments in a district where conditions are less favourable than in other parts of the
city. There is the usual shortage of good indoor training facilities in the area and the new Sports
Hall goes some way towards meeting this need. The playing field at Newfoundland Road will
provide a most welcome grass area in the midst of a heavily congested area of substandard
housing, factories and busy roads. The Education Committee, realising the inadequacy of playing
fields in the area, made provision in 1969 to transport groups of older pupils once a week to
playing fields in other parts of the city. At least for St. Barnabas and Newfoundland Road schools
this will no longer be necessary, as children in these two schools will be able to walk to the new
playing field.

The number of primary schools having swimming baths on site has been increased by the
construction of a learners’ pool at Hotwells J.M. & I. School. This was a project promoted by the
Parent Teachers’ Association, supported by a grant from the Education Committee. A similar
project approved for Headley Park J.M. & I. School should be completed in 1971.

The pattern of physical education in schools is becoming fairly clear : at the primary stage an
emphasis on movement training, mobility, agility skills and expressive work introduced through
Dance, while in the secondary schools the concentration seems to be on games and individual
skill training in the early years and a preparation in the later years for the post-school leisure
activities. The traditional team games and sports supplemented with sailing, canoeing, camping,
badminton, tennis etc. provide a choice of activities to whet the appetites of most young people.

Courses in swimming, diving, tennis, badminton and camping for teachers have been offered
during the year, while selected pupils are chosen to attend courses in Outward Bound Schools.

The manual workers’ strike caused interference with the in-school and out-of-school physical
education programme during the Autumn term, but a concentrated effort in the remaining weeks
of the term made up the lost ground.

Jean Dawson

The principal moves in girls’ and infant physical education in the year under review have been to
integrate the programme much more into the general field of education. With this in mind,
teachers’ courses have been run in the development of language through physical education and
the linking of verbal expression and dance. Films are available showing the wide development of
creative movement of many kinds and the link-up with the other arts. A number of secondary
schools have made use of creative dance and drama, together with art, as a part of the religious
education programme. Cassettes have been made and shown to teacher training groups, parent/
teacher associations and children in schools. The British Dance Drama Group visited the city in
the Autumn term and played to a number of primary schools.

The All England Netball Association this year chose Bristol to be the venue of the National
Schools’ Netball Tournament, the first time this event has been held outside London. It was sited
at Hengrove School and the headmaster and all the staff of the school made tremendous prepar-
ations for the event. Physical education specialists from other schools also came to help and many
families in the city entertained young netball players from all over the country for the weekend
'Fhanks to the excellent organisation and the goodwill shown by Bristolians, the event was a
memorable one for all those who took part. Meetings of heads of department of girls’ physical

education have continued to be held throughout the year and schools showing particular points
of interest have been visited. The first Schools’ Hockey Rally, which was held in 1969, was
repeated this year by special request and 19 schools took part. This has encouraged the Teachers
Hockey Committee to propose that this shall be an annual event in future.

The teaching stall of the ice-rink have organised practical courses for teachers which have
])roved very popular. These have enabled teachers to participate with the pupils, rather than
watching from the side of the rink.

The summer holiday play centres, which have been running in the city for many years, but
which are increasing in numbers year by year, have grown to such proportions that it has been
decided to appoint a temporary play centre leader for the Summer of 1971 to organise the staffing
and arrangements of these centres.

SCHOOL ATTENDANCE

M. Watts

The school attendance return for 1970 shows an average attendance of 90' 8%; compared with
1969, this is a decrease of O' 1%.

The attendance in the three sections of schools as compared with 1969 is as follows: —

Secondary Schools 90 '5% — a decrease of O' 1%

Primary Schools 91' 1 % — a decrease of O' 1%

Day Special Schools 87 '3% — an increase of 1'4%

The overall annual percentages for all schools are : —

I960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970

90-7 89'5 90-6 89'4 90'6 90'5 89'3 90-9 90'5 90'9 908

fflu)

Every effort has been made to maintain children in regular attendance at school throughout
the year. 41 prosecutions were taken under section 40 of the Education Act 1944 (as amended)
for non-attendance at school and 29 prosecutions were taken under section 66 of the Children
and Young Persons Act 1963 for breach of probation or supervision occasioned by non-attendance
at school. In addition, the parents of 146 children were interviewed at this office because of their
children’s irregular attendance at school and a final warning administered. For the purpose of
this return, schools were classed as closed during the recent industrial dispute.

SCHOOL NURSING SERVICE

Miss M. Marks Jones

This has been another year of steady progress in the School Nursing Service. The Health Visitors
continue to make their own arrangements with the Heads for visiting schools. In the primary
schools the aim is for the Health Visitor to examine each child once a year. Vision testing is
regarded as of special importance from the first year onwards. Defects already found are followed
up and any child is seen on the request of parent or teacher. In the secondary schools vision
testing is carried out in the first, third and, when appropriate, fifth years.

All boys are tested for colour vision defects in the first year of secondary school life, and as in
the primary schools, children with known defects are followed up and any children are seen at
the request of a member of the staff. The Health Visitors are associated with schools in their areas
and are able to contribute useful information, but with the development of attachment schemes
of Health Visitors to general medical practitioners it is foreseen that they will not be able in the
future to know all the children attending the school. It is encouraging to report again that during
the year Health Visitors are more and more participating in health education programmes for.
above all, their main function is that of health educators.

School Staff Nurses

19 School Staff Nurses are now employed in comprehensive schools, six of these schools having
full coverage. As vacancies have occurred new members of the staff appointed have been given in-
service training in the department.

This group of nurses continues to meet at least once in each term. In the spring term Dr.
A. T. M. Roberts, chest physician, spoke about hay fever. This session was in preparation for a

pilot study of tlie occurrence of hay fever in pupils at five comprehensive schools. The objective
was to work out a suitable method for the main study which is planned to take place in the
summer of 1971.

The summer term meeting was to inform the nurses of the rubella campaign which was
planned to start in the autumn term. Unfortunately this started slowly because of difficulty with
vaccine supplies; however, this protective measure will now become a routine procedure in the
school health programme, being offered to all girls in the second senior school year.

An interesting visit was made in the autumn term to Youth House where Mr. Holland,
Youth Officer and one of the full time youth leaders talked about the organisation of the Youth
Service in the city.

The majority of the school staff nurses have now been working in the comprehensive schools
long enough to see pupils through their entire life within these schools, and this continuity in
working in such a role is a great asset in the service given. The following table relates to the work
of the Health Visitors and School Staff Nurses during the year.

Number of children seen .. . ... ... ... ... 69,283

Uncleanliness (first found this year) ... ... ... 569

Uncleanliness other ... ... ... ... ... 532

Number of Homes visited .. ... ... ... ... 3,148

SPEECH THERAPY

Beryl Saunders

It is with pleasure that I am able to report a most welcome development within the speech
therapy service during 1970.

Early in the year, it was agreed that the Senior Speech Therapist should be seconded for two
sessions weekly to the Bristol Royal Hospital for Sick Children. There are obvious advantages in
providing a unified service for the children of Bristol. By doing this, time-wasting dual referrals
for speech therapy can be avoided; it is possible to build up a working liaison with the occupa-
tional therapy and physiotherapy departments when treating physically and/or mentally handi-
capped children, who may eventually attend one of the city’s special schools, and the therapist is
able to contact personally the medical staff. In-patients may also be seen from time to time when
appropriate. It is to be hoped that further integration may follow in the years to come between
the hospital and L.E.A. speech therapy services.

At the beginning of the year three full-time therapists were appointed, followed by a fourth
in September; the year ended with a full complement of full-time staff. Unfortunately, it was
necessary to dispense with the services of some sessionally-employed therapists. I wish to record
my thanks to them for the way in which they helped the department during a difficult period.

All clinics, health centres and special schools have been visited weekly during the year. Even
so, and with a full complement of staff, there are waiting lists for treatment in many areas. An
increased awareness of the need for, and value of, speech therapy amongst medical officers, G.P.s
at health centres, health visitors, teachers and other allied disciplines is doubtless the reason for
this, and their co-operation is much appreciated.

The Language Development Unit at Easton Road School for children of infant/junior age
has now been in existence for just over one year, whilst the nursery unit is in its eighth year. Both
units have been full throughout 1970; numerically boys still greatly exceed girls.

The number of children with no significant hearing loss who are referred to the Hearing and
Speech Centre for investigation into delayed language development has again increased compared
with former years. Almost all these children are under-fives; it is noticeable that the age of
referral of all children requiring speech therapy is falling, whatever the type of disorder.

The number of patients seen and treatments given is listed below.

School Children Pre-School Children

Year

Stammer

Sp. Defect

Stammer

sp.

Defect

Total

1st

other

1st

other

1st

other

1st

other

1st

other

1969

515

874

6,250

240

567

1,224

7,358

1970

130

531

1,070

7,736

336

671

1 ,548

8,974

YOUTH EMPLOYMENT SERVICE

B. M. Dyer

Physically handicapped

The team of three officers dealing with the handicapped continues to be fully employed by the
special schools and by referrals from colleagues who work in the comprehensive schools. Un-
happily, the increasing number of these referrals is not only due to the fact that schools are
becoming more aware of the help available for their physically and mentally disabled, but is also
due to the present difficulty in finding suitable vacancies. A greater number of minimally handi-
capped who a short time ago would have needed little or no extra help are now experiencing
trouble when leaving school. We are pleased to be able to report, however, that although these
young people may remain unemployed for a longer time than usual, we are eventually able to
place them in a suitable occupation. There was a smaller number of physically handicapped
special school leavers this year — twenty-five — of whom the majority have been placed in open
employment. Five have gone to Further Education and assessment centres and three into sheltered
employment.

Educationally Sub-Normal

About fifty-two left schools for the educationally sub-normal during the year, over twenty going
into sheltered employment. Those placed in employment, however, entered worthwhile occupa-
tions such as the sewing industry, sales and printing. One girl started a course at Lufton Manor
in September.

One of the main difficulties for the educationally sub-normal is that of acclimatization to the
working environment. The recent move of Florence Brown School (ex-Russell Town) from the
centre of the city to Knowle, has made for some problems in this respect, as the leavers’ group is
now not in such close proximity to the sort of work, and working conditions that they can expect
to enter — though the school has been able to make a number of new and useful contacts among
employers in their new situation. This is also a major problem for Kingsdon Manor Residential
Special School, which we can only try to overcome with planned visits locally and in Bristol to
find the sort of jobs that these boys will be doing.

Another difficulty here is that many of the boys at Kingsdon Manor are from areas other
than Bristol; it is not always easy to give careers guidance away from the context of the work
available, but it is a problem we try to overcome with close co-operation with the Careers Officers
in whose areas these boys reside.

Over this period there were twenty-four leavers from Florence Brown School and eighteen
(seven of whom came from outside Bristol) from Kingsdon Manor School. Three entered the Bush
Training Centre, two Mr. Baker’s Workshops and one is in the process of applying to the Lufton
Manor Farming School, having had a period of unemployment since leaving school. The rest
entered a variety of employments, including super-markets, laundries, warehouses, one into a
hotel, others into simple engineering, woodworking, brush-making and so on.

STATISTICAL TABLES

Year ended 31st December, 1970

PART I

MEDICAL INSPECTION OF PUPILS ATTENDING MAINTAINED PRIMARY AND
SECONDARY SCHOOLS (INCLUDING NURSERY AND SPECIAL SCHOOLS)

TABLE A— PERIODIC MEDICAL INSPECTIONS

Age Groups
inspected
(By year of birth)

No. of
pupils
who have
received a
full medical
examination

Physical condition
of pupils inspected

Un-
satisfactory satisfactory
No. No.

Pupils found to require treatment
{excluding dental diseases and
infestation with vermin)
for for any

defective other Total

vision condition individual

{excluding recorded pupils

squint) at Part II

1966 and later

973

963

1965

1,700

1,689

162

196

1964

4,390

4,371

133

367

485

1963

414

413

1962

224

222

1961

146

145

1960

152

149

1959

334

330

1958

267

265

1957

149

147

1956

423

420

1955 and earlier

3,803

3,789

287

394

642

TOTAL

12,975

12,903

(99-45%)

(0-55%)

635

1,277

1,816

TABLE B— OTHER INSPECTIONS

NOTES — A special inspection is one that is carried out at the special request of a parent, doctor,
nurse, teacher or other person.

A re-inspection is an inspection arising out of one of the periodic medical inspections
or out of a special inspection.

Number of special Inspections ... ... 8,658

Number of Re-inspections ... ... ... 14,710

Total ... 23,368

TABLE C— INFESTATION WITH VERMIN

(a) Total number of individual examinations of pupils in schools by school nurses or

other authorised persons ... ... ... ... ... ... ... ••• 69.283

(b) Total number of individual pupils found to be infested ... ... ... ... 569

(Section 54(2), Education Act, 1944) ... ... ... •■. ... ••• 36

(d) Number of individual pupils in respect of whom cleansing orders were issued

(Section 54(3), Education Act, 1944) ... ... ... ... ... ••• Nil

PART li

DEFECTS FOUND BY PERIODIC AND SPECIAL MEDICAL INSPECTIONS DURING THE YEAR

NOTE — All defects, including defects of pupils at Nursery and Special Schools, noted at period
and special medical inspections are included in this Table, whether or not they were
under treatment or observation at the time of the inspection.

Defect Periodic Inspections Special

Code No. Defect or Disease

Entrants

Leavers

Others

Total

Inspection

Skin

179

316

173

331

146

528

263

Eyes — (a) Vision

189

296

150

635

326

625

325

127

1,077

649

(b) Squint

124

100

163

210

161

Ears— (a) Hearing

125

105

431

513

506

(b) Otitis Media

264

309

255

108

Nose and Throat

112

182

163

1,015

146

116

1,277

838

Speech

334

421

255

Lymphatic Glands

295

334

267

Heart

165

227

232

Lungs ...

291

382

319

Developmental —

(a) Hernia

(b) Other

145

384

532

447

Orthopaedic —

(a) Posture

112

(b) Feet

153

261

148

257

383

252

Nervous System —

(a) Epilepsy

(b) Other

121

107

Psychological —

(a) Development

357

118

523

556

(b) Stability

638

785

738

Abdomen

Other

186

212

172

T = requiring treatment O = requiring observation

PART III

TREATMENT OF PUPILS ATTENDING MAINTAINED PRIMARY AND SECONDARY
SCHOOLS (INCLUDING NURSERY AND SPECIAL SCHOOLS)

NOTES — These tables show the total numbers of ; —

(i) cases treated or under treatment during the year by members of the Authority’s own
staff ;

(ii) cases treated or under treatment during the year in the Authority’s school clinics under
National Health Service arrangements with the Regional Hospital Board; and

(iii) cases known to the Authority to have been treated or under treatment elsewhere during
the year.

TABLE A— EYE DISEASES, DEFECTIVE VISION AND SQUINT

Number of cases known
to have been dealt with

External and other, excluding errors of refraction and squint ...

Errors of refraction (including squint)

1,397

3,938

Total

5,335

Number of pupils for whom spectacles were prescribed ...

1,840

TABLE B— DISEASES AND DEFECTS OF EAR, NOSE AND THROAT

Number of cases known
to have been dealt with

Received operative treatment : —

(a) for diseases of the ear

(b) for adenoids and chronic tonsilitis

Received other forms of treatment

548

2,751

Total ... ... 3,450

Total number of pupils still on the register of schools at 31st December,

1970, known to have been provided with hearing aids: —

(a) during the calendar year 1970 ... ... ... ... ... 37

(b) in previous years ... ... ... ... ... ... ... 169

TABLE C— ORTHOPAEDIC AND POSTURAL DEFECTS

Number known
to have been treated

(a) Pupils treated at clinics or out-patients departments ...

(b) Pupils treated at school for postural defects

425

120

Total

545

TABLE D— DISEASES OF THE SKIN

(excluding uncleanliness, for which see Table C of Part I)

Number of pupils known
to have been treated

Ringworm — (a) Scalp

...

(b) Body

Scabies

Impetigo

Other skin diseases ...

5,456

Total

5,579

TABLE E— CHILD GUIDANCE TREATMENT

Number known
to have been treated

Pupils treated at Child Guidance clinics ...

514

TABLE F— SPEECH THERAPY

Number known
to have been treated

Pupils treated by speech therapists

1,200

TABLE G— OTHER TREATMENT GIVEN

Number known
to have been treated

(a) Pupils with minor ailments

(b) Pupils who received convalescent treatment under

37,269

School Health Service arrangements

(d) Other than (a), (b) and (c) above.

4,732

Children’s Chest Clinic

Chiropody

2,343

Enuresis

320

Nutrition

228

T.B. Contacts ...

U.V.L.

Total (a)-(d)

45,018

PART IV

SCREENING TESTS OF VISION AND HEARING

1. (a) Is the vision of entrants tested as a routine within their first year at school? Yes.

(b) If not, at what age is the first routine test carried out?

2. At what age(s) is vision testing repeated during a child’s school life?

Once a year in Primary Schools; every two years in Secondary Schools.

3. (a) Is colour vision testing undertaken? Yes.

(b) If so, at what age? 12 years.

4. (a) By whom is vision testing carried out? School nurses.

(b) By whom is colour vision testing carried out? School nurses.

5. (a) Is routine audiometric testing of entrants carried out within their first year at school?

Yes. First or second year.

(b) If not, at what age is the first routine audiometric test carried out?

PARTY

DENTAL INSPECTION AND TREATMENT

Inspections

Number of pupils

Requiring

Offered

Inspected

treatment

(a) First inspection — school

52,605 )

f 24,858

(b) First inspection — clinic ..

5,156 j

31,906

3,723

2,076

Totals

61,484

33,982

24,858

Ages

Ages Ages

5 to 9

10 to 14 15 and over

Total

Visits (for treatment only)

First visit in the calendar year

8,264

5,726

1,538

15,528

Subsequent visits

9,052

9,425

2,904

21,381

Total visits ...

17,316

15,151

4,442

36,909

Courses of Treatment

Additional courses commenced

511

427

111

1,049

Total courses commenced ...

8,775

6,153

1,649

16,577

Courses completed ...

—

15,139

T reatment

Fillings in permanent teeth ..

10,066

14,415

4,603

29,084

Fillings in deciduous teeth .. .

9,814

961

—

10,775

Permanent teeth filled

9,261

12,926

4,207

26,394

Deciduous teeth filled

9,187

915

—

10,102

Permanent teeth extracted ..

431

1,784

437

2652

Deciduous teeth extracted ...

5,582

1,629

—

7,211

Number of general anaesthetics ...

1,640

677

2,372

Number of emergencies

510

364

932

Orthodontics

Number of Pupils X-rayed ...

788

Prophylaxis

2,647

Teeth otherwise conserved ...

1,822

Number of teeth root filled ...

Inlays

Crowns

New cases commenced during year

Cases completed during year

Includes

Cases discontinued during year

cases treated

No. of removable appliances fitted

by appliance

No. of fixed appliances fitted

only

Pupils referred to Hospital Consultant

19~2

Dentures

Number of pupils fitted with dentures for
the first time

Ages

5 to 9

Ages

10 to 14

Ages

15 and over

Total

(a) with full denture

___

... —

(b) with other dentures

Total

Number of dentures supplied
(first or subsequent time)

Anaesthetics

Number of general anaesthetics administered by Dental Officers ...

Sessions

Number of clinical sessions worked in the year

Adminis-

trative

School Service

Dental

Inspection Treatment Health
at School Education

M. & C.fV. Service
Dental
Treatment Health
Education

Total

sessions

Dental Officers
(inch P.S.D.O.)

.331

5,619

469 —

6,521

Dental Auxiliaries

—

— —

—

Dental Hygienists

—

— —

—

Total

331

5,619

469 —

6,521

Dental Health Education

Activities undertaken by the Authority: Talks, film shows in schools and clinics. Leaflets and
posters supplied to schools on request. Leaflets given out to patients attending clinics.

P&S DEPT. T29«

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