B.—l

The recent addition of seven school nurses to the medical-inspection staff is an important step, the success of which is already assured. Besides assisting the Medical Inspectors in the examination of school-children, the school nurses " follow up " cases notified for defects, visiting the parents and giving advice and assistance in connection with such matters as diet, clothing, and the treatment of minor ailments and injuries. They are thus forming a valuable link between the home and the school. Work of the nature indicated above has occupied a great deal of the Medical Inspectors' time, with the result that the number of children medically examined in the schools reached a smaller total in 1916 than in previous years. It appears that 8,845 children were examined at the routine examination, and 1,846 were examined as special cases suspected of suffering from some physical defect. Numbers of children, however, came under the notice of the Medical Inspectors for whom records were not compiled. The percentages of physical defects discovered vary very little from year to year, the Medical Inspectors calculating roughly that from one-half to twothirds of the pupils in public schools require the attention of a dentist, an oculist, or a physician. They report, however, that each year they find increasing numbers of children whose parents have already taken steps to have their children's teeth attended to or adenoids operated upon when necessary. The proportion of cases attended to as the result of the Medical Inspectors' notifications to parents varies from 30 to 65 per cent, according to locality. This proportion, the work of the school nurses will, it is expected, materially increase. From the fact that the roll number of primary schools in 1916 was over 180,000, and that the Medical Inspectors were able to examine less than 11,000 children, it is obvious, that a larger staff of Medical Inspectors and of school nurses will be necessary before the work necessary to be done in this direction can be adequately discharged. For each child to be examined only once in its school life about 22,000 would need to be examined yearly. Schools with an average attendance of less than 120 are entirely excluded from the medicalinspection scheme at present, and a number of schools above this limit cannot be visited every year. An arrangement by the State for the dental treatment of school-children, especially in country districts, is still urgently demanded, and a scheme to carry this work, into effect, partly by means of a travelling dental clinic for country districts, is at present under consideration. The Medical Inspectors' report on school premises in respect of lighting, heating, ventilation, cleaning, &c, and, although they are as yet by no means satisfied with the hygienic conditions prevailing in many of the schools, they have nevertheless been instrumental in effecting many valuable improvements in this respect. The medical inspection of children is a means of conserving the public health, and is not therefore an integral part of the education system, though the children are most conveniently attended to at the schools and the work is most suitably carried out by the Education Department. The medical inspection of children in private schools, to which some attention has recently been given, is therefore to be regarded merely as a more convenient means of seeing the children than by visiting their homes. The expenditure on medical inspection for the year ended 31st March, 1917, was —Salaries, £1,920; travelling-expenses, £419; telephones, &c, £26: total, £2,365. The cost is therefore only about 3d. per head of the school roll. The expenditure on physical education for the same period was—Salaries, £2,090; travelling-expenses, £1,289; other expenses, £171 : total, £3,550. Manual Instruction. (E.-2, Appendix C, Tables Gl, G2, and G3.) Classes for elementary handwork were carried on under the Regulations for Manual Instruction in connection with 81 per cent, (an increase of 4 per

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