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Annual Report of the Principal School Medical
Officer for the year 1971
Dr. J. Stuart Horner, M.B. Ch.B., M.F.C.M., D.P.H., D.I.H.
The Chairman and Members of the Education Committee.
Ladies and Gentlemen,
I have pleasure in reviewing the progress of the School Health Service in Hillingdon during
1971, the first full calendar year for which I have been responsible. There remain many doubts
and uncertainties concerning the future role of the school health service, and none of these were
resolved during the year. It was most encouraging that the Committee was able to accept my
advice to the London Boroughs Association that the staff of the school health service should
transfer to the new Area Health Authority, but that the Local Education Authority should retain a
significant role determining the objectives and organisation of the services provided.
The year was marked by dramatic improvements in recruitment of skilled professional staff
to undertake the routine duties which form the essential foundations of the service. During the year
five medical officers were recruited on a full-time basis together with some improvement in the
recruitment of part-time school medical officers. This happy outcome may in part be related to
the extension of the Borough's very progressive training policies to medical and dental staff.
As a result of these improvements the normal programme of routine medical inspections was
resumed and significant extensions towards a more comprehensive school dental service were
introduced. It will be seen from the following pages that the number of medical inspections
undertaken exceeded by 51% the figure for 1970.
There are many today who would question the necessity for these routine medical examinations,
although it is significant that such critics are rarely found amongst parents and teachers
who recognise the value to be gained by the close involvement of skilled medical staff in the
many problems which the satisfactory teaching of all children of school age presents to the
Education service. Nevertheless, the quality of the examination and the significance of its clinical
results are kept constantly under review. During 1971 a small working party of school medical
officers exclusively engaged in clinical duties in the department was set up with wide powers to
review and make recommendations upon present methods of examining school children in this
area. It may well be found that a more comprehensive and time consuming examination is necessary
upon school entry whilst a drastically modified form of examination would be sufficient for the
examination in secondary schools with its emphasis upon the occupational health needs of the
adolescent about to enter employment. During the year each school medical officer in regular
practice within the Borough was issued with a special test of speech discrimination developed in
a neighbouring local authority in order to obtain a more accurate assessment of the child's speech
at school entry. Delays in acquiring verbal fluency are known to be associated with reading delay,
and a survey in the Isle of Wight has shown that the latter carries a particularly poor prognosis.
It is most important that such children are identified as soon as possible, and that scarce speech
therapy resources are concentrated upon the acquisition of language in the 4-7 age group.
Treatment Facilities
The improvement in medical staffing has also allowed increased attention to be given to the
continuing statutory responsibility to ensure that satisfactory treatment facilities are available for
all school children. Dr. Karim took over responsibility for the orthopaedic clinic. The dramatic
reduction in serious orthopaedic problems in school children in recent decades has allowed
increased medical attention to be given to common but apparently insignificant orthopaedic
abnormalities. In the majority of cases it is not known whether the treatment of such defects is
either necessary or desirable. Nevertheless the problem presented by the enormous demand for
chiropody amongst the elderly suggests a continuing need for skilled medical officers to look for
possible contributory factors in childhood. In October an experimental enuresis clinic was commenced
under the clinical direction of Dr. Jennings. In recent years there has been a dramatic
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