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SCHOOL HEALTH SERVICE
The health of the school child should be measured not so much in terms of the statistics of
the school health service or by the absence of disease and disorder in the school child as by signs
of "complete physical, mental and social wellbeing" (World Health definition). It is easier to invent
parameters of health however, than it is to define what is being measured. A study was made some
years ago of the incidence and causation of health amongst 10—11 year old school children in the
Borough of Bexley. Two significant results which emerged from the physical, mental and personality
assessments were that good ante-natal care and birth weight were common features of the
early histories of the most healthy children.
A more recent study, in which the Department has been involved, concerned seven-year old
children. This study was of children born during one week in March 1958, when all births in
England, Scotland and Wales were the subjects of a survey sponsored by the National Birthday
Trust Fund and the Royal College of Obstetricians and Gynaecologists. In the First Report of the
National Child Development Study on these seven-year old children two conclusions were reached,
firstly, that the need for specific teaching of reading skill is not by any means confined to infant
schools and classes and, secondly, the extent of educational backwardness and other difficulties in
school at the infant stage is greater than has been realised hitherto. Educationally, socially and
medically, boys were found to be more vulnerable than girls. Boys were more likely than girls to
have learning and speech difficulties, accidents, medical conditions and develop mental problems.
There were, however, no sex differences related to vision and hearing and the proportions with
defective vision being found in the survey children and in the Bexley children of approximately
the same ages in 1970 were similar.
One fundamental aspect of a child's health and education is his eyesight and the Department
has always placed much emphasis and given much priority to this part of the service. It was of
particular interest, therefore, that in June 1970 a meeting was convened by the Senior Administrative
Medical Officer of the South East Metropolitan Regional Hospital Board to discuss the
future arrangement of the school eye clinics in the Region. The Ophthalmic Sub-Committee of
the Regional Board thought it advisable that all new referrals should be supervised by a consultant.
Attempts had been made by this Department since 1965 to secure consultant ophthalmologists
for the expansion of this work but none was available. It was obvious from this meeting and from
previous knowledge that when and where they were available for this work, it was possible to
integrate all the desirable features of the local authority and hospital services into one scheme. It
was hoped in future to include work in the school eye clinic in the contracts of newly appointed
consultants in ophthalmology. The Department's school ophthalmic arrangements, although not
integrated with the hospital, continued nevertheless to function throughout the year in a comprehensive
and satisfactory manner.
Despite the changes and shortages of departmental medical officers, it was always possible to
staff the school health service with the medical members of the Department rather than temporary
or sessional doctors.
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