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11
There was almost complete agreement in regard to the desirability of the alteration
of the age from 12 to 11, but the change from 8 to 7 years involved a serious
administrative difficulty, owing to the fact that in the year of the change one
group of children at age 8 would fail to receive a routine medical examination
between the age of entrance and that of 11 years.
The Council decided that the changes should be made subject to the alteration
from 8 years to 7 years being spread over five years by a scheme whereby all the
8 year old children in 1934 (born in 1926) will be cursorily inspected by a medical
officer, and those whose condition appears to need it will be inspected in detail
together with a proportion of children born in 1927. In 1935 the remainder of the
children born in 1927 will be cursorily inspected and a larger number of children
aged 7 (born in 1928) examined in detail and so on. Under this scheme it is anticipated,
that after 5 years all children will be fully examined when aged seven years.
Length of
time spent
over each
individual
child.
At a routine inspection session normally lasting 2½ hours, the school doctors
deal with 25 children. This gives an average of 6 minutes per child. It is found
that the school doctors are able to carry out the inspection at this rate to their own
satisfaction, but any attempt to increase the numbers seen results in dissatisfaction,
and the feeling of racing against time.
Still more detailed inspections could, of course, be carried out, but this must
result in slowing down inspections with greatly increased cost without an equivalent
gain, since there is no evidence that with the present method defects requiring action
are not detected.
In the early instructions and reports of the Board of Education the following
statements occur:—
"It is considered that the inspection of each child should not occupy on
the average more than a few minutes."
"A more elaborate form could readily be devised but the Board's knowledge
of the circumstances in which the work has to be done, led to the belief that
greater elaboration would defeat its own end and create rather than remove
difficulties. The experience of the authorities would appear to indicate that
where the official schedule has been properly used and appropriately applied,
and, in the case of infants, suitably modified, few cases of physical weakness
have escaped detection whilst little or nothing of what might be thought of as
inquisitorial, or unnecessarily clinical, investigation has taken place. It is
necessary that the examination of each child should not as a rule occupy on the
average more than say six or seven minutes."
The latest pronouncement of the Board on the subject is contained in the report
of the chief medical officer, for 1931, issued at the end of 1932, in which the following
statement occurs:—
"The question has often been raised as to what amount of time is needed
in order to carry out effectively a routine medical examination, and the Board
have expressed the view that an average of about six minutes per child is a
reasonable allowance."
The chief medical officer, however, qualifies this statement by reference to certain
conditions which must be fulfilled if this estimate of time is to hold, viz., in the first
place the medical officer needs to have some assistance, preferably, of course, from a
school nurse. In the second place this routine examination should be in the nature of
a sifting process and children found to have any physical or mental defect, the nature
and extent of which are not immediately obvious, should be given a fuller examination
subsequently. This further examination will, in urban areas at any rate, usually
take place at a clinic.
At medical inspections in London there are normally present, the child, the
mother, the doctor, the nurse, the head teacher or representative, and a representative
of the care committee ; there are also present in the room very commonly or close at
hand (1) the child just examined with parent and (2) being prepared for examination,
the child next to be seen with parent.