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SCHOOL HEALTH SERVICE
Dr. Mary Douglas, Principal Medical Officer

Medical Examinations in the School Health Service
In this Borough the majority of children rising 5 are already in school. The number of nursery school placements
are rapidly increasing and many children will therefore be offered their entrant school medical examination in
the "toddler" years. It follows it is necessary to have close co-operation between the staffs of the Child Health
Clinics and of the School Health Service. Greater numbers of children will be examined in their "toddler"
years than at present and as only small numbers of these children can be examined in any one session an increase
in professional staff who are trained in developmental paediatrics is essential now and for the future. This
examination will be a fairly detailed developmental assessment as well as a general medical examination.
Doctors who are concerned with the welfare of children in the learning situation realise that it is impossible to
separate their pre-school learning period from the school period and are aware that children's abilities to learn
must be assessed from the earliest possible age and that where the possibility of handicap is elicited, skilled
therapy and teaching from both disciplines must be made available for the child and the parent. Under the
present system, the School Health Service is required to provide help for a child who is thought to be handicapped
when he or she reaches the age of 2. It is now generally accepted that for many children this is far too late and
the time lost is irretrievable.
There is a comprehensive service for children with hearing loss however young the infant. There is need to
establish such a service for children who may suffer from physical or mental handicaps and, as in the case of the
Audiology service, this would combine medical (including Health Visitors and physiotherapists) and teaching
personnel working together, both visiting families at home and giving advice or treatment in clinics under the
over-all supervision of a consultant paediatrician with special knowledge of cerebral palsy and mental subnormality.
After the National Health Service reorganisation it is to be hoped that there will be even closer co-operation
with the general practitioner and hospital services, whose facilities should be more readily available for the
support of doctors in the School Health Service.
The medical examination of the school child is designed to prevent any handicap impeding the child's ability
to learn. Particular attention is therefore directed to the supervision of the special senses.
Routine Medical Inspection of school children is undertaken on entry to school and in the final year of school
life. At other times, examination is by selection. Such children may have been found to have a difficulty at a
routine medical inspection or they may be selected for examination at the request of the parent or head-teacher.
The school doctors try to visit their schools at regular intervals so that they may be available for consultation
with the head-teacher or staff. The schools for handicapped children receive visits from a medical officer at least
once a week.
Periodic Medical Inspection
The following table shows the number of children inspected by years of birth and the classification of theii
physical condition —
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