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Annual Report of the Principal School Medical
Officer for the year 1972
Dr. J. Stuart Horner, M.B. Ch.B., 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 the
calendar year 1972. The uncertainty which has surrounded the future of the school health service
since the first Green Paper on the reorganisation of the National Health Service published in 1968,
was resolved during the year by a statement that the personnel would be employed by the area health
authorities, with the relationships between the transferred staff and the present local education
authorities to be determined following recommendations by the Working Party on Collaboration.
In November the publication of the National Health Service Reorganisation Bill made it clear that
responsibility for the provision of special educational treatment would remain with the local education
authority, whilst the present responsibility to provide facilities for the medical inspection and
treatment of school children would be transferred to the Secretary of State for Social Services.
This decision, which allows the development of a comprehensive child health service and which will
permit closer relationships with medical and allied staff in the National Health Service generally than
has previously been possible is welcomed although it is important to ensure that each local education
authority is permitted to define the standard of service required.
The total number of routine medical inspections completed during 1972 showed a reduction
from the high figures of the previous year when children not examined earlier were also included.
There was a marked increase in the number of special inspections and re-inspections as greater
emphasis was given to the child with health problems. Many such children had previously been
identified by school teachers and the service may be expected increasingly to concentrate in the
future upon such children rather than upon the examination of large numbers of normal children.
The working party of school medical officers completed its report during the year by recommending
a more comprehensive examination at or near school entry with a more selective type of
examination at later ages. It is now necessary to plan pilot projects to determine the practical
difficulties associated with such arrangements, but in view of the tremendous changes which are
currently taking place it would be prudent to introduce amendments to well established procedures
slowly and with considerable care. During the year changes in the health services available for school
leavers entering industry resulted in the creation of the Employment Medical Advisory Service,
which will depend heavily for its medical advice in respect of every child upon information provided
by the school health service. Thus decisions to abandon a school medical inspection at the end of
the child's school career, would appear to be inopportune in view of the responsibility now placed
upon the school medical officer to provide information about medical contra-indications to particular
career choices. Nevertheless in certain cases it may still be more appropriate to obtain the required
medical information by an extended interview with the school medical officer, rather than by a
physical examination of every part of the school child.
The trend towards an improved training of school medical officers and the provision of more
complex diagnostic aids continued and a test of colour discrimination developed in the County of
Hampshire and suitable for the examination of five-year old children was introduced as part of the
routine examination. It has been customary to examine colour vision of children at the intermediate
medical examination for many years, but this new test has allowed assessment of children at school
entry. It is not yet known whether modern methods of teaching mathematics in primary schools
may place the colour defective child at a disadvantage. By making this initial assessment it may be
possible to obtain accumulating statistics which could prove helpful for research purposes, whilst the
knowledge that a particular child who is having difficulty with the new methods also has apparent
difficulties discriminating between similar colours, will be of great value to the class teacher.
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