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The London school medical service.
Medical Before dealing in detail with the work of the school medical service for the
inspection. year 1932, it may be desirable to give a brief outline of the activities of that service.
The Council is required to provide medical inspection for children attending
elementary schools (a) at entrance to school, (b) at the age of 8 years, and (c) at the
age of 12 years. The Council's own regulations provide for the examination of
leavers in the term next before they are due to leave school; also that children
must be certified medically fit before entrance to a central school.
Children noted at inspections as suffering from defects are kept under observation
by a system of re-inspections. The first usually takes place in the second term
following the inspection, and if not discharged a further re-inspection is made.
(About 40—50 re-inspections are made in one session).
"Specials," i.e., ailing children and children to whom particular attention has
been drawn by care committees, head teachers, attendance officers, tuberculosis
officers, etc., are also seen by school doctors at medical inspections.
The Council's regulations provide for the award of scholarships and free places
at educational institutions being subject to the candidate's passing satisfactorily a
medical examination. A similar condition also applies to permanent appointments
for officers under the direction of the Education Committee (teachers, schoolkeepers,
etc.). The medical examinations for such awards and appointments are
usually held at the County Hall medical examination rooms. Officers under the
direction of the Education Committee who are absent from duty on account of
prolonged ill-health or in regard to whom the question of superannuation arises, are
also referred to the school medical officer for medical examination and report.
Cases in which children are found by school doctors to be suffering from defects
which are causing injury to health are referred (if the care committee's efforts are
unsuccessful) to the special officers of the school attendance service for "pressure"
to be brought to bear on the parents. Should their services prove ineffective, cases
are frequently brought before the school doctor in order to see whether a medical
certificate can be supplied stating, in the terms of the Children Act, that the child is
"suffering from neglect of treatment which is likely to cause unnecessary suffering
and injury to health." Many of these cases are referred to the National Society for
the Prevention of Cruelty to Children to take court action where necessary and
desirable. In any such cases, where visual, aural or dental defect are involved and
the N.S.P.C.C. propose taking court action, the children are specially examined by
one of the Council's specialists.
Children found in the course of medical inspections to be anaemic and debilitated
are nominated by the school doctors for admission to the Council's residential openair
schools at Bushy Park, Margate and St. Leonards. Groups of children are sent
regularly to these schools for periods of from 4 to 6 weeks. The schools are
recognised as "special" schools, and after nomination by the school doctor a final
examination is necessary by one of the Council's certifying medical officers. Assessments
(up to 15s. a week) towards the cost of food, etc., are made by care committees.
Children taking part in school journeys are medically examined before departure,
firstly, with a view to preventing the departure of any child showing signs of infectious
disease, and, secondly, in order to exclude from the party, or to give appropriate
advice to, any child who is suffering from serious trouble such as ear disease, heart
disease, etc.
Health classes are held for children in any one school who are suffering from
deformities such as flat feet, slight curvature of the spine, etc. Appropriate
exercises are advised under medical supervision, and the children are specially
examined from time to time by the school medical staff.
Under certain conditions children between the ages of 12 and 14 years are
allowed to undertake employment outside school hours, but a medical certificate to
the effect that the child is medically fit for such employment is necessary in all such
cases. The school medical staff conduct these examinations, which are usually
treated as "specials."