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85
Introduction.
The School Medical Service forms an integrant part
of the educational system, and also a no less important
one of the Public Health Services. It is for these reasons
that the closest possible co-operation must be maintained
in all services and local government directed to this end.
Any public health government which tends to separate
the administration of the environment from the
administration affecting the individual must lead to
faulty and expensive government. On these broad
principles the Public Health Services in Bromley are
administered.
The year 1933 called for continued economy in social
services, necessary because of national economic
circumstances. Unfortunately, for Bromley, this curtailment
of expenditure co-incided with a rapidly
increasing school population and an increasing demand
on the services provided through the Health Department.
Since 1926 the elementary School population has increased
by 48 per cent, and it has been increasingly difficult,
without increase in staff, to meet the requirements of a
fully functioning school medical service.
One can now say definitely of the school medical
services that they have passed the experimental stages.
They are not extravagant in ideas, although it will be
readily admitted that medical services because of their
very nature are apt to be experimental unless a strict
watch is kept on fundamentals.
I have endeavoured to avoid all experimental
services; thus we have no special clinic for the so-called
difficult " child; such children, referred to us by head
teachers, parents and others, are dealt with through the
ordinary medical clinics and treated on the principles of
commonsense management without delving into the
psycho-analytical spheres, a practice, which in my
liumble view, is rather over-stressed in medical practice
to-day. Is the establishment of child guidance clinics
necessary in order to deal with the "difficult child"?
I doubt it. The decentralisation of efforts to promote