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Existing
special
investigation
clinics
A school medical officer at an inspection session in a school often has neither
sufficient time nor suitable accommodation or facilities to examine some pupils as
thoroughly as may seem desirable at the time. In the new schools which are being
equipped with medical suites the work can be done, as it should be, in the school, but
in the older schools the problem has been approached in various ways. One way has been
a development of the minor ailment session at a school treatment centre, so that the
school medical officer who carries out the medical inspections in the school also holds
sessions in the local minor ailment centre where he can investigate more thoroughly the
difficulties disclosed at the inspection done in the school.There has also been increasing
use of nutrition and other clinics for the same purpose. In most divisions, however,
special investigation sessions are being held.
Nutrition
clinics
Nutrition clinics were started by the Council in 1935. From the outset, children other
than those suffering from malnutrition were examined, and the function of the clinics
developed rapidly, so that further inspection and advice for a wide range of conditions
were given. This is well illustrated in the report for 1935 (pages 20-26). The problem
of malnutrition has changed enormously since the war and there really is no purpose in
holding special clinics under this heading. The nutrition work can conveniently form
part of the special investigation clinics.
Rheumatisrr
advisory
clinics
The South East Metropolitan Regional Hospital Board in 1954 discontinued
rheumatism supervisory clinics as such, as far as that Board was concerned, on the
ground that the facilities for those children requiring specialist advice were available at
normal cardiological, orthopaedic or paediatric clinics staffed by hospital specialists.
Discontinuing clinics on the part of the Board did not necessarily mean the closing of
the clinics as far as the Council was concerned. Patients were divided into those needing
speciahst advice, who were referred to hospital, and those children who would benefit
by supervision and follow-up, but a speciahst would not be necessary for this purpose.
The treatment of these latter children is supervised by a school medical officer. This work
of inspection and advice is thus closely allied to the work carried out at special investigation
clinics. Other Regional Hospital Boards will follow a similar line when vacancies
for rheumatism advisory clinic specialists arise.
Special
investigation
clinics
(new
classification)
In view of the development of the consultative, existing special investigation and
nutrition clinics already described, and of the future use of rheumatism supervisory
clinics, there is no longer any need to distinguish between these various types of clinic
and it is more satisfactory to have only one type called ' special investigation ' to deal
with pupils requiring further inspection, investigation, supervision or advice. Divisional
medical officers have surveyed the facilities available in their divisions and have made
any necessary adjustments, such as combining existing sessions or arranging new
sessions where the need arises. The treatment statistics given later should be read in the
light of what has been written above. The reclassified special investigation clinics, which
include the nutrition clinics, commenced operation on 1st July, 1956, and consequently
the figures for nutrition clinics are applicable to only half the year. Those for the
rheumatism supervisory clinics are lower than those for 1955 because of the transfer of
some of the work to special investigation clinics. Accordingly, the returns for the special
investigation clinics are considerably higher than for 1955.
Special
investigation
clinics—
problem and
potential
problem
families
Miss T. E. Watts, an assistant organiser of children care work in the public health
department writes :
Constructive preventive case work for families referred to these clinics by school
doctors, minor ailments clinics and, occasionally, infant welfare clinics is now possible.
These families often present psychological, physical or moral problems. ' Hard core '
families, where one or both parents are mentally backward are often dealt with.
The referral of a child because of some symptom of disturbed behaviour such as
nail biting, nervous tics or anti-social behaviour by a school medical officer, often
points to disharmony in the home and the possible uncovering of a family problem.
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