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101
The activities of the school health service are so many and varied
that these introductory comments can only highlight those features
of special moment in 1971.
Nutrition was very much to the forefront during the year with
the ending of the provision of free school milk for all junior schoolchildren.
Under the Education (Milk) Act, which received the
Royal Assent in the late summer, children aged from seven to
eleven years are now eligible to be provided with free milk at
school by a local education authority only if this is certified to be
necessary on health grounds; milk continues to be supplied free
of charge for all pupils attending special schools. Accordingly,
arrangements were put in train to medically examine all those
children in the affected age-group possibly in need of free school
milk on health grounds, entailing the closest liaison between school
doctor, nurse, teacher, parent and general practitioner. By the end
of the year some 300 children out of nearly 16,000 junior schoolpupils
attending ordinary schools in the Borough had been recommended
for free milk at school on health grounds. The rapid and
smooth manner in which this formidable assignment was completed
reflected the greatest credit on all concerned.
Milk is an excellent nutrient in childhood in view of its protein
and calcium content and the increasingly familiar sight of the
overweight child does not gainsay this value. Obesity is readily
recognisable but in the absence of florid signs it is extremely difficult
to detect other forms of malnutrition clinically. Thus, although
height, weight, general health record and school performance are
clearly relevant in the assessment of general nutrition, only blatant
undernourishment is likely to be detected on medical examination.
It is precisely because of this difficulty that the view has been put
forward that all young children should receive free school milk
as an essential preventive measure. In Wandsworth the Council
decided to provide free milk at primary schools to all pupils
resident in the Borough who were no longer eligible for free school
milk from a local education authority following the enactment of
the Education (Milk) Act, 1971.
In general the incidence of infectious illness reported from
schools remained at a low level. Only one outbreak of note
occurred—an episode of acute viral gastro-enteritis affecting 58
children and five teachers at a junior and infants school in the latter
part of November; fortunately the illness was not severe. Nonetheless
epidemic winter vomiting is an unpleasant disease often
mistaken for food poisoning until laboratory investigations prove
negative. Ironically enough, one of the kitchen staff routinely
tested in relation to this outbreak was found to be a carrier of a
Salmonella organism commonly associated with food poisoning,
illustrating the continuing necessity for scrupulous personal hygiene
on the part of food handlers.