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Circular 179 suggested that the Regional Hospital Boards should plan the future
organisation and development of services for school-pupils in consultation and agreement
with local education authorities, but, in fact, the final word on any growth of the
specialist side of the school health service would appear to lie with the hospital boards
as is apparent from the extreme difficulty which has been experienced (by the local
education authority) in securing from some boards additional specialist sessions for
school-pupils.
In the area of one of the four hospital boards which serve London, the Council
has been endeavouring for some time to secure extra vision sessions, to meet the increased
demands which have arisen as the school population has increased. The Board, however,
has not, for financial reasons, been able to accede to these requests, although
approving in principle the provision of additional sessions.
In the meantime, waiting lists become accumulatively longer in the area of that
Board. A survey of the position, made by the Divisional Medical Officers concerned,
at the end of December, 1953, revealed that the waiting lists, counting both new cases
and those old cases due for re-examination, contained the names of 5,152 school pupils.
The staff concerned, both Council's officers and Board's specialists, are very conscious
of the problem, and, by screening and selecting, endeavour to arrange that the most
urgent cases are seen as soon as possible. Nevertheless, the time of waiting for an
appointment varies according to the clinic from one to three months for the new cases,
and from five to eleven months (after the date due for re-examination) for the old cases.
Negotiations with the Board were still proceeding at the end of the year.
School treatment centres

† Several of these are ' twin ' surgeries.
* Specialists provided in most cases by regional hospital boards.
Treatment of school pupils at hospitals
The co-operation between the London school health service and the hospitals dates
back to the earliest days of the school health service, a Children's Care Organiser being
appointed as long ago as 1911 to the London Hospital to direct the flow of patients
and act as a liaison officer between the care committees and the hospital authorities.
To-day this co-operation between the school health service and the hospitals takes
several forms, in all of which the children's care organisers working in the Public
Health department play an important role. At some hospitals special sessions are
provided for the treatment of school pupils, and organisers make the appointments
and attend the sessions. At other hospitals the organiser, although not present at the
sessions, undertakes the making of the appointments. At certain other hospitals the
organisers attend to carry out the liaison between the children's out-patient department,
the specialist clinics, the school health service and the children's care organisation.