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131
NURSERIES AND CHILD MINDERS REGULATION ACT, 1948
During the year one child minder, who was registered and allowed to
take up to four children ceased to act in this capacity.
One new child minder was registered during the year, and allowed to
take up to three children.
School Health Service
THE CHANGING FACE OF SCHOOL MEDICINE
By Mary L. Gilchrist, m.d. d.p.h.
For a long time now the criticism of the School Health Service which has irritated
me most is the one which declares that we are in a " rut", and are merely carrying
out, in an unimaginative way, duties that were laid down nearly half a century ago.
I am prepared to accept criticism which is constructive, which points out our deficiencies,
inadequacies and mistakes, and to improve and amend these when necessary,
but I am not prepared to accept the criticism that the service is out of date and has
never changed since its inception.
I hope to show this afternoon how it has progressed logically and has undergone
that " organic development " predicted by Newman, the first Chief Medical Officer to
the then Board of Education ; how it has met each new need as it has been revealed
by our experience and how it has catered for those needs in whatever manner has been
required and justified by the resources at our disposal. I should also like you to
remember that I speak to you not from the standpoint of the administrative officer
seated at a desk, but out of the experience gained over a period of 22 years as a field
worker engaged daily in school and clinic and conscious all the time of the parents and
children who are my teachers. I have chosen the title of my address deliberately
because I am so deeply aware of the changes that have come over not only our service
but these same children and ourselves.
How best to show this change gave me much thought. At first it seemed best to
do it with graphs and charts and much statistical material but, after spending much
of my own time and that of our clerical staff in producing rows of figures, I decided
it was not the right method. If I demonstrate to you that the deaths from rheumatic
fever and heart disease in children under 15 years of age have shown a steady fall
from 1930—as shown in Table I—it would look as though I were claiming this as our
achievement.

That, of course, would not be true; we are but one of many and diverse factors
operating in this field. Equally misleading I found graphs of defects noted at routine
medical inspections since severity of defects may lessen though still noted, or, because
of expanding services, comparisons between one year and another became impossible.