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SCHOOL HEALTH SERVICE
Routine Medical Inspection
Fifty years have elapsed since the Education (Administrative Provisions)
Act 1907 authorised medical inspection of children attending State
schools. While the administrative procedure for routine examination
of each child on admission into school, and at stated intervals afterwards,
has remained substantially unchanged over the years, the nature and
number of defects found have changed almost beyond recognition. In
the early days it was inevitable that the service should be an almost
purely medical service. There were so many obvious defects and diseases
for which little was being done and which equally obviously prevented
or hampered the child from benefiting from the education it was supposed
to receive.
The school physician concerned in the early days, by sheer pressure
of the volume of work, with the routine tasks of diagnosis and reference
to others for treatment, now has opportunity to practice also the more
positive aspects of a health service—by assessment of individual optimum
health standards and by giving advice on the maintenance of health and
prevention of disease. With co-operation of teacher and parent he is
able to study the child in school and family setting and, in the case
particularly of older children out-of-school life in their social, recreational
and occupational setting. This change from a medical to a health service
is an answer in itself to critics who regard the duties of school medical
inspection as merely the detection and recording of defects and complain
that it leads to considerable expenditure in time and money on unproductive
work. With health and education closely meeting in an expanding
field of special education now available to the handicapped child, the role
of the doctor in the school health service need never be one of monotonous
routine; nor unrewarding in its opportunity to practise preventive
medicine on a scale regrettably unknown, even after ten years working
of the National Health Service, in hospital or general medical practice.
As in this Area, now for nearly twenty years, many local authorities
encourage the practice of sessional interchanges with hospital practice—
through medical officers undertaking sessional clinical work in hospital
out-patient departments (in particular paediatrics) and registrars
(specialists in training) undertaking sessional work in the local authority
services. Such arrangements may well enhance the quality of the doctor's
work in the clinical aspects of routine school medical inspections.
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