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48
SCHOOL HEALTH SERVICE
Section 30 of the London Government Act, 1963, places the responsibility for providing a school
health service upon the Inner London Education Authority, and the day-to-day operation of the
service in the City is my concern as Principal School Medical Officer. For its efficient and economical
working, arrangements were made under provisions in the Act for the joint use by the City Council
and the Authority of professional and clerical staff and of premises. The following report to the
Inner London Education Authority was submitted in respect of the school health service for the
year 1965:—
No major changes have marked the year, since no major change in policy was indicated, save
for the scheme of selective dental inspections. (See report on dental services below.)
Nevertheless, some changes in emphasis are evident. One of them is an increasing use of special
investigation clinics, which without a doubt, lessen the need for hospital referrals. It is probable
also that in many cases, minor behaviour problems are, by early discussion with the child and his
parent, prevented from becoming major problems. Each clinic is in the hands of the medical officer
for a school or group of schools in the neighbourhood. Every effort is made to secure maximum
co-operation with general practitioners. Increasingly children are being referred to their own general
practitioners rather than to consultant out-patient departments and there is in consequence a
decline in the number of cases referred directly to special departments.
Another development is social work in relation to handicapped children. All recommendations
for special schooling are seen by the Principal Social Worker. She or one of her staff makes sure
that there is help available to the children and parents for adjustment to the situation. The social
worker will keep in touch with the family for as long as necessary, and is responsible for coordination
with other agencies. This development of the service now extends to the families of
children at boarding schools. The social worker visits the family and a full home report is sent to
the head teacher of the school. It is intended that the social worker shall keep in close touch with
the children at boarding school and provide, where necessary, a close link between the child and his
parents.
Families presenting special social and medical problems are assisted by caseworkers in the Health
Department. These are usually long-term cases and several members of the family may require
expert help for many years.
Increasing use is made of health visitors in infant and junior schools. By this means the Health
Visitor who knows the family may continue her general supervision after the child reaches the age of
five. She is also able to provide the school medical officer, head teacher and care committee worker
with social reports. A scheme of selective school medical examinations is envisaged whereby the
health visitor's knowledge of the young schoolchild would be of even greater service.
The B.C.G. programme in secondary schools works smoothly. Efforts are being made to extend
the scheme to private schools in the area, but with little success so far. Use is made of the medical
suite at the City Hall for pupils whose head teachers do not wish the vaccinating team to go to the
school. This is much appreciated by the heads of schools concerned.
There has, so far, been very little demand for tetanus inoculation for children taking up horseback
riding. Only three enquiries have been received, and of these, arrangements made for two children
were later cancelled. (See Tables 46 and 47, page 73.)
DENTAL SERVICES
In accordance with Section 22 of the National Health Service Act, 1946, dental services are provided
for nursing and expectant mothers and children under five.
This represents approximately 10 per cent, of the local authority dental services available in
Westminster, the remainder being provided for school children under the Education Act of 1944.
The dental services are available in five dental centres—two in Paddington, two in Marylebone and
one in "old" Westminster—and are staffed by one full-time dental officer and seven part-time dental
officers, with one full-time dental surgery assistant assigned to each surgery.
In July, 1965, a Chief Dental Officer, Mr. R. E. Kean, was appointed by the City Council, who in
addition to his administrative duties operates for four sessions weekly at Lissonia Centre, as a result
of which the Council's centres are now fully functional, and provide a comprehensive dental service
daily.