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SCHOOL HEALTH SERVICE
The Inner London Education Authority is responsible for the school health service,
but by virtue of an agreement required by Section 32 of the London Government
Act 1963 there is joint use by the Authority and the Borough Council of professional
staff, premises and equipment. The Medical Officer of Health is the Principal School
Medical Officer of the Inner London Education Authority for the area and responsible
to that authority for the day-to-day running of the service.
There are 44,794 children of school age in the Borough and the overall picture
of their health remains good. Routine medical examination of the children is undertaken
at four stages in their school careers. Of these, the examination at school
entry is perhaps the most important, in that a higher proportion of parents attend
for this examination than subsequently. This allows for a three-cornered discussion
of various aspects of the child's health and education between doctor, head teacher
and parents. Subsequent examinations, although less well attended by parents,
remain an important facet in the continuing supervision of the child's health. At
the school leaver's examination attention is paid to any defects in the child which
may affect the choice of future employment.
Criticism has been levelled at the system of routine examination of school children
and the Borough is to co-operate during the coming year in a trial of detailed medical
examination of five-year-old entrants. If subsequently adopted, these may obviate
the need for some later routine examinations and provide a profile for each child;
distinguishing those who may have later learning difficulties and to whom teachers
may be required to give special help. Six schools in the Borough will participate
in this trial. Preliminary training sessions for doctors and nurses were carried out
during the year by doctors from the Department of Education and Science and Guy's
Hospital.
To control infectious diseases in schools, the maintenance of a high level of
immunisation is extremely important and school doctors carry out immunisation
sessions for diphtheria, tetanus, poliomyelitis and BCG prophylaxis. Among other
communicable diseases which are the concern of the school doctor and nurse, is
ringworm of the scalp. When a case of scalp ringworm is notified, other children
in the school concerned are examined with the aid of a special Woods lamp, the
light of which causes hairs infected by ringworm to fluoresce and enables early cases
to be identified. An unusual type of scalp ringworm exists, in which infected hairs
do not fluoresce and recognition of early cases by Woods lamp illumination is not
possible. During the year cases of this type of ringworm were found in three schools
in the Borough and I am indebted to Dr. Clayton, from a London hospital, who
visited these schools and took brush samples of scalp hairs from all contacts. From
this action other early cases were found and were referred for treatment, preventing
further spread.
School doctors carry out, in addition to routine examinations, other special
examinations where parents, teachers and education authorities feel concerned about
the health of a child and its fitness for ordinary school. Wherever possible, children
with handicaps are educated in ordinary schools, but for some children this is not
possible and placement in a day or boarding special school is recommended. A child
with severe asthma involving frequent absence from school may benefit from the
more sheltered atmosphere and special facilities of a school for the delicate, or a
child with weakness of the legs may be suitably placed in a primary school built
entirely on one level, but will require special placement at the transition to secondary
school, when faced with the stairs and constant activity of a comprehensive school.
Referrals are also made to the Health Department where transport to school is
needed or where home tuition is required for children unable to attend school. The
level of referral to special investigation clinics for enuresis, nutrition problems and
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