VII

11.—31

As soon as a scholar is suspected of suffering from an infectious disease he should be sent away from school. Most Committees and schoolmasters understand this; but this equally important fact is not so well appreciated : that unless some disinfection of the room which the patient occupied is made, the danger to the other children is not removed by prohibiting the suffering child from coming to school. Whenever a case of infectious disease appears in a school the earliest opportunity should be taken by the Committee of disinfecting everything with which the child has come in contact. Most teachers, Committees, and Education Boards are willing to admit this; the difficult}' lies in the carrying-out of the best counsels. This question lias been repeatedly referred to me, and the best answer is to be found in the system of medical inspection of school-children which I have had the honour of laying before you. Medical Inspection of Schools. By the authority of the Hon. J. McGowan (then Acting Minister of Public Health), I submitted the suggested system of inspection to the Education Department, and all the Education Boards, School Inspectors, school-teachers, the medical, and the dental professions. In every instance the scheme was approved. As I have pointed out, to establish such supervision was to follow in the footsteps of most of the older countries. It was no fresh experiment, but an absolute necessity, if we were to pay that regard to.child-health which it is our duty to do. The private schools in England and Scotland have long done more than is suggested should be done under the proposed system. The colleges in New Zealand carry it out. As far back as 1860 Germany instituted these examinations, and they obtain in Belgium, France, Switzerland, and the United States. Our most recent ally, Japan, lias more Medical Inspectors of Schools than the whole of the Old World put together—6,soo. I have had many conversations with the various Inspectors serving under the Education Boards, and in every instance I have found them fully alive to the importance of the sanitation of the schools; But they have one and all expressed their desire for expert help in bringing about the reform they have deemed necessary. It may be advantageous to set out briefly again the scheme suggested. With a sparsely populated country such as ours it would be unwise to attempt to set up a system of medical inspection such as obtains in Belgium, Germany, France, America, or England. On the Continent of Europe, in addition to inspection during school life, all children are carefully examined before they are allowed to begin their studies. That this is of the very greatest value is attested by the fact that last year about 11 per cent, of the children about to begin school were referred back for periods varying from one to more years. Such a system of inspection would not be impossible here; but I suggest that we should begin in the manner least likely to entail a large initial or annual expenditure. Again, in nearly all of the countries where medical examination obtains all children attending school are examined by the medical officer. I have suggested that, instead of the medical inspector sorting out the abnormal from the normal, this should be done by the teacher. It may be said that the teacher cannot do the work as well as an expert. That must be admitted, and here again the sacrifice of efficiency is done solely to lessen the cost. After all, the number of cases that will be missed by the teacher will be small. I have found throughout the colony that the teachers, with few exceptions, do take a great interest in the physical welfare of their pupils, and as a matter of fact many of them are actually doing the work which I suggest should be done by them under the suggested scheme. It is proposed that the schoolmaster should keep a list of all his pupils who, in his opinion, are below normal in health. The child who complains that he cannot see the figures on the blackboard, the scholar who always turns one ear to the teacher, who sits with open mouth, who complains of frequent headaches, suffers from constant toothache, who coughs, suffers from a rash, who mopes or limps about the playground, or who suggests in any way that he is not well, should be placed upon the list. This list would be given to the Medical Inspector at his visit. Thus, instead of having to examine the whole school, his time would be spent over, say, some 10 or 12 per cent. With this reduced number it would be possible, I think, for four or five officers to examine all the schools in the colony. There would certainly be plenty of work for them to do; but, at any rate, the scheme might be begun with such a staff. Contkol op Mile consumed in the Colony. The relation between infantile mortality and impure milk has been acknowledged by sanitarians the world over. It is<an. interesting fact that while the birth-rate has been decreasing the death-rate has gradually been lowered. But for this the shrinkage in population would have caused- more alarm. Speaking of this, the Health Officer for Liverpool makes the following statement: —