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(g) Education Act, 1944—The major changes introduced by the Education Act, 1944,
inasmuch as they concerned maladjusted children, are mentioned in part III. In 1945,
however, the Association of Education Committees appointed a committee 'to consider
and report upon the full content of the psychological functions of local education authorities
in association with the discharge of their statutory duties . . .' This committee, in a lengthy
report, expressed the view that the child guidance clinic should be replaced by a child
guidance service incorporating a psychological service, all of which should be a part of
the education service, and that its organisation should rest with the educational psychologist.
The Council did not accept this view, and did not consider that the circumstances in
London and the position reached since 1929 called for the considerable re-orientation
advocated.
(h) Developments from 1945 to 1948—Whereas up to as late as 1945 the Council was
still proceeding cautiously in the field of child guidance, by 1948 the picture had changed
completely. Payments to clinics were progressively raised; the position of educational
psychologist, vacant since 1932, was filled; the establishment of Council child guidance
clinics and centres was authorised; and in 1948 the Council took over full administrative
and financial responsibility for one voluntary clinic and opened a part-time clinic in a school
treatment centre.
(i) National Health Service Act, 1946 and Circular 179 of 4 August, 1948—Ministry of
Education circular 179, which dealt with the overall relationship between the pre-existing
school health service of free medical treatment and the newly formed national health
service, and which broadly allocated 'specialist' work to the N.H.S. and 'non-specialist'
work to the school treatment service, attempted to apply this concept of divided responsibility
to child guidance.
Paragraph 18 of the circular was as follows :
"Child guidance work of the type at present undertaken by local education authorities is in the main
an educational service closely linked with the school and home. Thus the needs of most of the children
who are maladjusted, whether to a degree which calls for their ascertainment as handicapped pupils
or to a lesser degree, can be met by social and educational adjustments. Much of the work is carried out
at the schools in co-operation with the parents and teachers by the educational psychologists and specially
qualified social workers appointed by the (local education) authorities. The educational, physical and
psychiatric aspects of the work are, however, inseparable and at the child guidance centres established
by (local education) authorities the team of workers includes a psychiatrist and also, as a rule, a paediatrician.
Some of the children may be found to need psychiatric treatment; the Minister (of Education)
in agreement with the Minister of Health, considers that these children should normally be referred by
the (local education) authority to the clinics which will be provided in due course by the regional hospital
boards and which in some instances are already available; similarly these clinics will refer appropriate
cases to the child guidance centres ".
This attempt to distinguish between 'clinics' and 'centres' (which was not withdrawn
until circular 347 was issued in 1959) led to protracted negotiations over the next few
years, which cannot but have hampered development.
In 1948 the Council took the view that the main difficulty lies in deciding at what point
a child was in need of psychiatric treatment as opposed to social and educational adjustment
and that it was questionable whether it was good for a child under investigation or
treatment to be transferred from one team of workers to another after initial investigation
or during the course of his or her treatment.
Independently, in the same year, my predecessor headed a deputation to the Ministry
of Education from the School Health Group of the Society of Medical Officers of Health,
stated the objections to the separation of child guidance work into diagnosis and treatment
and its division between the hospital and the local education authority and said that it
would be preferable to do the work of both child guidance 'centres' and 'clinics' in
ad-hoc ' units ' administered by the local education authority.
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