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School Health Service
Dr. J. W. E. Bridger (Principal Medical Officer)
Part I
MEDICAL INSPECTION IN SCHOOLS
Historical Background
The School Medical Service came into being through the passing of the Education (Administrative
Provisions) Act of 1907. In the years following the advent of the principle of education for
all children (Elementary Education Act of 1870), teachers, school boards and others became
increasingly aware that large numbers of children in the schools were unable to take advantage
of the education offered because of chonic illness, malnutrition, poor clothing and a very unsatisfactory
environment. Some attempts were made by individual Boards of Education to help
remedy these evils by appointing medical officers and nurses to their staff to advise upon the
health and treatment of pupils. This medical cover was sketchy and only some 85 authorities had
appointed medical officers by 1905; fewer still had nurses.
The reports published by three Royal Commissions just after the turn of the century were
instrumental in drawing the Government's attention to the medical plight of school children and
adolescents. The Report of the Royal Commission on Physical Training in Scotland 1903 remarked
upon the poor condition of children attending Board Schools giving convincing examples of
glaring physical defects and suggested medical inspection and feeding of school children. The
Inter-departmental Committee on Physical Deterioration 1904 enquired into the physical condition
of young men offering themselves as Army recruits, and the rejection of many of them due to
physical causes. Among this Committee's recommendations were that a systematised medical
inspection of children at school should be the duty of every school authority and that provision
should be made by local authorities for feeding necessitous children; recommendations which
reinforced findings of the Scottish Royal Commission.
The third report was that of the Interdepartmental Committee on Medical Inspection and
Feeding of Children Attending Public Elementary Schools 1905. A great deal of evidence was
taken which showed, without any doubt, that very many children were in poor physical condition,
were poorly nourished, poorly clothed and verminous. The Committee also reported that medical
inspection by every local education authority was a necessity and that school meals provisions
should be improved.
A result of these various reports was the passing of two Acts of Parliament: (1) The Education
(Provision of Meals) Act, 1906, and (2) Education (Administrative Provisions) Act, 1907.
The first allowed local education authorities to provide meals for children attending elementary
schools if the children were unable to take advantage of the education through insufficient feeding.
The second Act laid a duty upon local education authorities to provide medical inspection for all
children in elementary schools and to make arrangements for treatment of their physical condition.
The School Medical Service was firmly established.
In the years following, school treatment clinics were gradually set up throughout the country.
Treatment at first was simple, being applied to those conditions which were easily remedied,
for instance, the treatment of various skin conditions and the eradication of vermin. Later, when
arrangements were made with local hospitals and doctors in private practice, more sophisticated
treatments were applied. Specialist clinics for the treatment of ophthalmic and orthopaedic
conditions were soon followed by clinics for other specialties, i.e. ear, throat and nose, speech
therapy, child guidance, and audiometry. Dental treatment clinics were also established soon after
the school medical service began and were extended to most parts of the country in the following
years.
Undoubtedly the health of school children has improved since those early days. In addition
to the searching out of frank disease and defects in the physical and mental health of children,
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