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School Journeys
Arrangements for the medical and hygiene inspection of pupils before departure on
school journeys or visits to holiday camps were continued. During the year 23,703 such
examinations were carried out. The metropolitan borough medical officers of health
were asked to co-operate by forwarding information when infectious disease occurred
in a home from which a pupil had pone on a school journey.
Holidays
for
diabetic
and
epileptic
children
During the summer the Diabetic Association again organised holidays tor diabetic
children and the British Epilepsy Association, under a similar scheme, a holiday for
epileptic children.
A small number of London diabetic and epileptic children, who would otherwise
have been denied a holiday because of the problems associated with their handicaps,
were provided with holidays at Kingsdown, Kent, Barrow, Lancashire (diabetic
children), and Brackley, Northants (epileptic children).
Medical treatment
Section 3 of the National Health Service Act, 1946, places upon the Minister of Health
the duty of providing, through Regional Hospital Boards and Boards of Governors of
Teaching Hospitals, the services of specialists at hospitals, health centres, clinics, etc.
The Council, as Local Education Authority, also has a duty under Section 48 (3) of the
Education Act, 1944, ' to make such arrangements ... as are necessary for securing
that comprehensive facilities for free medical treatment are available to its pupils either
under this Act or otherwise'. Guiding principles on the specialist work carried out at
local education authority clinics were laid down in Circular 179 issued by the Minister
of Education and after discussions with the Boards it was agreed that responsibility for
the provision of specialists at rheumatism, ear, nose and throat, vision and orthoptic
clinics lay with the Metropolitan Regional Hospital Boards, while the Council remained
wholly responsible for the minor ailment, audiology, special investigation, nutrition and
dental clinics. 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 Regional
Hospital Boards.
The evolution of the school health service in recent years, particularly its relationship
with the national health service since 1948, reached a point where it appeared desirable
to review the classification of certain types of clinic held at school treatment centres to
remove anomalies which had developed during this period of evolution. During
discussions with the four Metropolitan Regional Hospital Boards on the question of
responsibility for school health service clinics, it became apparent that certain of the work
of investigation and supervision carried out by the Council at these clinics, which had
been regarded in principle as specialist, was not acceptable as such by the Boards since
it did not necessarily require the services of a medical officer of consultant or specialist
status. This work was thenceforward regarded as the duty of the Council under
Section 48 (3) of the Education Act, 1944, and the clinics at which it had been performed
are for convenience classified below.
Consultative
clinics
There was room tor experiment in the methods of dealing with enuresis, and certain
clinics previously called 'enuresis' were renamed 'consultative' to avoid confusion
with the specialist enuresis clinics held at a number of hospitals, but not only enuresis is
dealt with at these consultative clinics. In some health divisions children are also treated
for minor behaviour problems, whilst in other divisions they also advise on nutrition
and investigate children referred from school medical inspections for further examination.
Children with enuresis seen at the Council's consultative clinics requiring specialist
treatment are referred to hospital enuresis clinics. The work of the consultative clinics
has now been absorbed, however, into that of the special investigation clinics.
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