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If, however, the routine inspections are considered merely as the bare foundation
upon which a complete edifice of children's care in the schools is erected, the plaint
loses its force.
Over and over again it has been shown that it is unsafe to rely upon the teachers
for bringing before the school doctors children who appear to them to need medical
examination as a basis upon which to found the medical work in the schools. It
is strange that, while some medical officers are deploring the time spent in routine
inspections, others with strong public support are advocating regular " vetting "
of all classes of the population at periodical intervals, and there is at present a
vigorous campaign being prosecuted by social workers with the object of securing
more frequent examinations of all children in the schools, particularly at the younger
ages, and of providing routine inspection for those who have left school.
If the routine inspections were abolished, or had they never been prescribed
by the Board of Education, it is highly probable that public opinion would demand
and secure their resumption or introduction.
An instance arose in the past year which brought into prominence the great
importance of the routine inspection of school children. A girl fell suddenly dead
in school immediately before her school-leaving examination. The teachers in the
school and the girl's parents were alike ignorant of the fact that she was not a healthy,
normal girl. At the coroner's inquest it was established that she suffered from
advanced valvular heart disease of, probably, rheumatic origin.
When these facts were reported, close investigation was made as to why the
scholar's condition had not been discovered earlier. It transpired that the only
illness of note the girl had ever had was an attack at the age of 11 of tonsillitis, for
which she had attended hospital.
Upon scrutiny of her school medical record it was found that the second intermediate
examination at age 11-12 had been omitted, the explanation being that she
belonged to the group of 12-year-old children whose examination was omitted in
the year 1933. The absence of one of the routine inspections in that year, owing to
the change in the age groups examined, was, therefore, the reason why her condition
had not been discovered.
Upon the routine inspection of the children as one of the foundations is built
a complete system of care in which reference of children is made to special modifications
of education, to convalescence, to supervisory centres for rheumatism, or for
nutritional observation, or to treatment centres or hospitals for defects of all kinds.
Many children detected at primary examinations to have defects are kept under
continuous observation by systematic re-inspection until the school doctor is satisfied
with their condition, and, apart from routine inspections, increasing numbers of
children not falling within the age groups are examined by the school doctors as
special cases at the instance of teacher, care worker, parent, or attendance officer.
The average roll of children in London elementary schools for the year 1935-6
was 507,392, and the average attendance 444,349.
The number of elementary school children examined in the three statutory
age groups (entrants, children aged 7 and children aged 11) during the year 1936
was 135,838. These were made up of 50,508 entrants, 37,264 children aged 7, and
48,066 children aged 11.
The children aged 8 coming under preliminary survey by the school doctors
numbered 10,258, of whom 1,977 were submitted to detailed examination. In
addition, 48,895 children were examined in detail in the term prior to that in which
they were due to leave school, and 1,226 children in special schools were examined
on reaching their respective age groups.
In addition to routine groups, children referred by nurses, school teachers, care
committee workers, divisional officers, etc., for examination for special reasons
numbered 122,963 ; and 30,535 were examined in connection with outbreaks of
infectious disease.