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218
" Although the School Medical Service was established
primarily as a means of ensuring that the school
child was physically and mentally fit to take advantage
of the education provided by the State, it has, during its
twenty-five years' existence as an organised system,
widened its scope of utility. In a word, it has become
almost automatically an essential part of the public
health service of the nation. Whilst every year it has
become more integrated in itself, it has also become an
organic link in the national health, even one of its principal
foundations. It is a link between all the children under
five years of age and the adolescent population above
fourteen years of age. We cannot isolate or " block off"
the child population, as if it were a watertight group
having no relation to those who come before and those
who come after school age. We cannot deal with the
troubles of childhood as and when they arise ; we must
deal with their origins and their results, with a continuing
process. We cannot divide the child up on a
calendar basis any more than the adult; nor can we
separate the disease liability of the one from the disease
experience of the other. Hence, we must beware of
thinking in compartments and providing some make-shift
remedy as the need arises, for ascertainment has demonstrated
a process, a succession and a continuity of disease
from one age period to the next."
Even with regard to the recommendations contained in the two
Circulars under consideration it is clear that no one of the three
Committees concerned can take action which does not concern
the other two.
The recently issued Circular 1550 of the Ministry of Health
states:—
"It is clearly desirable, whenever possible, that the
Medical Officer who will supervise the health of children
after they enter school should be responsible for their
supervision during pre-school years."
It is equally clearly desirable that such continuity of supervision
should apply, not only to the medical, but also to the
dental and nursing staff of the two responsible Authorities.
The way to ensure co-ordination is to do away with the
necessity for it by the formation of a single Health Committee,