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The medical examination of these juveniles reveals a number of remediable defects in those passed as fit for work, as well as in the small number who are rejected. In all cases a letter is sent to the parents or guardians advising them to consult their own doctor regarding treatment. As the number of industrial health nurses in the Division increases, it is planned that they will follow up this advice with personal visits, as is done by District Health Nurses in the case of school-children. (5) Organization of First Aid It cannot be too often stressed that treatment of industrial casualties is not the ■primary objective of an occupational health service. The primary objective is to alter conditions and to alter practices and habits so that-work becomes healthier and safer. In the future the Division must be judged by the degree to which it has succeeded in doing this, rather than by counting the number of chromium-plated surgeries and swift ambulances available in factories. Nevertheless, the industrial casualty must be treated, and a close contact with casualties throws light on necessary preventive measures. It is proper, therefore, both on humane grounds and as a step to prevention, for the Division to concern itself closely with the treatment of accidents and illness arising from work. In countries where there are very large industrial concerns, industrial medicine has tended to develop as unconnected units in individual factories. Thus, a firm like Austin Motors in Great Britain employs several doctors, a number of nurses, has a full x-ray-plant, and a.large rehabilitation workshop for the injured. Such a development in this country is quite impossible, and perhaps fortunately so, for not only are these individual units isolated from one another, but the mass of workers, who, even in the highly industrialized countries, work in small factories, still have no adequate service. In this country there are no really large factories and it would appear uneconomic use of trained staff to encourage, except in the rarest instances, the employment of whole-time industrial nurses or the provision of elaborate surgery accommodation by individual firms. A far more efficient and complete coverage appears possible by establishing suitably sited industrial health clinics, staffed by industrially trained nurses, under the direction of the District Industrial Medical Officers, which any worker in the surrounding area can attend. A start in this direction has been made during the past year on the Wellington waterfront. At the end of 1947 a survey was made of the first-aid facilities and amenities on the Wellington waterfront, and a report to the Minister of Health recommended that the Harbour Board be asked to make available a room equipped after the manner of a factory surgery and staffed by one of the industrial health nurses for an experimental period of six months. This was approved, and the Wellington Harbour Board provided and equipped a room at Glasgow Wharf. The surgery was opened on 3rd June, 1948. At the end of the first six months it was unanimously agreed by the interested parties —namely, the Wellington Harbour Board, the Waterfront Industry Commission, the New Zealand Waterside Employers' Association, and the New Zealand Waterside Workers' Union —that the experiment had been a success, and they recommended that in future the surgery should be open from 8.30 a.m. to 5 p.m. Subsequently Cabinet approved that the Wellington Waterfront Industrial Health Clinic be administered by the Health Department, the expenditure on staff, maintenance, and equipment to be a charge against the Department, and the premises to be provided by the Harbour Board. The centre is now under the direction of Dr. Janet Brown, and one of the industrial nurses is in attendance from 8.30 a.m. to 5 p.m. During the seven months June to December, 1948, the attendances at the centre numbered 2,468. In April, 1948, a further report was submitted to the Waterfront Industry Commission on conditions at the Lyttelton waterfront, and after the appointment of an Industrial Medical Officer to the Christchurch area similar arrangements to those existing at Wellington were recommended there. The Lyttelton Waterfront Industrial Health Centre is likely to be opened during 1949.

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