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medical, nursing and dental staff being engaged on duties in both spheres.
This step was taken, with the result that while two medical officers transferred
from the County Council to be engaged on school work, in point of
fact all the medical officers spent some time on each, the total time so
spent being the equivalent of the whole time of two officers. Similarly
all the health visitors, including those who transferred, are engaged
part-time on school work, the total time spent by them being equivalent
to that of three whole-time school nurses.
LOCAL SCHOOL MEDICAL SERVICES.
1. Medical Inspection.
For many years the routine of the inspection of children attending
elementary schools was that the child should be examined as soon as
possible in the 12 months following his admission to school, on his attaining
the age of eight years and on his attaining the age of twelve years.
Each child was therefore examined as a routine three times in his school
life. For a while many have advocated a fourth inspection, a policy
adopted by the Middlesex Education Committee, the children being
examined as entrants, at seven years, at ten years and as leavers.
The schedule of examination for scholars at places of higher education
was an examination during the first term after admission, and an examination
in each subsequent year, a complete examination being made at
12 and at 15 years of age.
At routine examinations time is spent by the medical officer seeing
large numbers of normal children. This practice has been criticized by
experienced school medical officers who feel the time could be better
employed by the medical officer examining not all children, but those
submitted by teachers, parents, or as the result of his own more cursory
inspection. While many agree as to the defects of the existing practice
and the desirability of its being replaced by some alternative, there is
no agreement as to what that alternative should be. The local practice
has been to continue these routine inspections, and as far as possible on
the basis of four examinations in the school life of the child. Shortage
of County Council staff prevented their aim to examine on this basis
being anything like achieved. The result is that there has been so much
lee-way to be made up, that it will be some time before it can be felt that
the routine inspections are based on a smooth schedule of operation.
Attention has been concentrated in the first place on the examination
of the entrants. Each term, too, especially to enable certificates to be
sent to the Employment Exchange, children due to leave at the end of
the term have been dealt with. Many seven-year-olds have been seen,
but few of the ten-year-olds had by the end of the year. By this time,
though, most of the serious arrears of entrants had been overtaken, and
the programme arranged that no school department would not have had
the attention of the medical and nursing staff within twelve months of
the service being locally administered.
Preparatory to the medical inspection of the children, it was common
practice for them to be weighed and their heights taken. While use
might at times be made of such records, and they can demonstrate, as