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(a), (b), (c) and (j)—Medical inspections
"We feel that the question of the frequency of periodic inspections can only be
answered in the light of what alternative could be substituted. Fundamentally all
substitute schemes depend on special medical inspection of cases specially picked out by
teacher, parent, school health visitor, etc. We feel that whilst such special inspections are
a very important part of a school health service and should be encouraged, they should
be additional to, and not in substitution for, periodic inspections. Such special references
would probably tend to become something in the nature of child guidance consultations,
and as such are to be welcomed, but reliance on special references only (without any
period inspections) would probably mean that asymptomatic and minor physical
conditions would remain undetected.
"The view was expressed that the general medical inspection of the healthy, whether
for insurance, armed forces or school health purposes, was probably the most difficult
task the clinician was asked to tackle, compared, for example, with diagnosis of the sick
patient. Obviously, therefore, complete reliance could not be placed on the comprehensive
health surveys done by school health visitors.
"Considering all the relevant data, particularly the results of the findings at the four
periodic inspections and the percentage of parents attending at such inspections, and
noting that an 'age-group' amounted to less than 10 per cent. of the total of all
inspections, we unanimously recommend that at least four age group inspections should
be carried out. The alternative of two inspections, entrants and leavers only, with
special references in between, we rejected because we are not satisfied that any system
of special references is an adequate substitute for general medical inspections.
" Prior to 1933 periodical inspections were held at entry, 8 years, 12 years and on
leaving. The intermediate inspections were then altered to 7 and 11 years. The change
from 8 to 7 years was associated with the provisions under the 1921 Act whereby pupils
were not compelled to attend special schools until the age of 7 years; and the change
from 12 to 11 years was associated with an economy whereby ad hoc inspections of
junior county scholars at age 11 years prior to transfer to secondary schools were avoided.
"The reasons for these changes, which were cogent in 1933, are no longer
relevant, and we now recommend that inspections should take place after entry to each
new school or department, and should be linked to the transfer, and not to age, since
the actual age of transfer is, to some extent, flexible.
"The age groups suggested are:—
(i) Entrants to infants' schools (the examination to be held even if the child
had been medically examined whilst attending at a nursery school or class).
(ii) Entrants to junior schools (age not to be specified, since Heads are permitted
to transfer before 7, or hold back for two terms after 8 years).
(iii) Entrants to secondary schools (age not to be specified).
(iv) All pupils in the term before their 15th birthday.
(v) 'Leavers' (this will coincide with (iv) for pupils leaving at age 15 years).
"The scheme of annual medical surveys of pupils attending grammar schools was
originated many years ago to provide a substitute follow-up precedure at those grammar
schools where the normal care committee, re-inspection, and follow-up systems did not
operate. The desirability of dropping these inspections was accepted a few years ago,
and the fall in the numbers of inspections carried out reflects the implementation of this
decision at a number of schools. However, it is understood that, at some of the voluntary
aided grammar schools the school authorities have, so far, been reluctant to agree to the
abandonment of these annual inspections.
"We consider that, in the light of our recommendations as to the ages at which
inspections should be held in all secondary schools, the annual surveys still carried out
should be given up.
"Although we consider that periodic inspections should be continued, nevertheless,
we feel that within the framework of the Council's divisional organisation there is room
for experimentation in small areas."
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