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FIFTY YEARS OF THE
WEST HAM SCHOOL HEALTH SERVICE
This is the fiftieth anniversary of the inception of the School Health Service
and it is appropriate that we should reflect upon it. It is not intended to present a
statistical analysis or to compare the number of defects found in 1907 with those in 1957.
This would be a complicated task, as the figures could not be compared directly but would
have to be appropriately standardised. The Ministry of Education has compiled national
statistics embodying the figures for West Ham and there is no reason to believe that the
trends in the health of the school children in West Ham differ appreciably from those in
the country as a whole.
Let us rather take this opportunity to reflect upon the history and development
of the School Health Service in our borough. It is an example of steady growth and
improvement, with the more subtle and intricate problems emerging as the size of the
problem declines numerically. The problems we are facing in the School Health Service
to-day are not really new but they have hitherto been obscured by the more dramatic and
obvious conditions which are fortunately less prevalent now. When so much time and
effort had to be devoted to the many children suffering from smallpox, diphtheria,
tuberculosis and malnutrition there was little opportunity to find and treat the child
who was maladjusted, partially deaf or "delicate". During the last fifty years so much
has been achieved by improvement in the environment and by the personal health services
that we are now able to turn our attention to these more subtle problems which are very
important to the child's health and happiness. To help these children effectively a
combination of specialised skills is required, necessitating much consultation and team
work - hence the increasing complexity of our service.
Although the school population was considerably larger than today and the number
of defects much greater, the school medical service in West Ham started off in 1908 with
the "impressive" staff of the School Medical Officer (who was also the Medical Officer of
Health) two Medical Inspectors, four School Nurses and one "statistical clerk". One
consulting medical officer was appointed to deal with special cases, particularly those
in whom visual acuity was found to be less than 6/9 in both eyes. By 1912, the staff
included three Medical Inspectors, one Oculist and one Dental Surgeon.
Originally the statutory duty of the Local Education Authority was limited to
periodic medical inspections of all entrants (ages 4 to 5 years) and leavers (ages 13
to 14 years) in public elementary schools. Vision was tested at the age of 13 years.
The school medical inspections were extended to secondary schools in West Ham in 1915.
The annual report on the School Medical Service published in 1908 makes fascinating
reading. One cannot fail to express appreciation for the initial administrative effort and
skill required to get this vast scheme under way, and for what was achieved in the face of
some natural resistance to a new scheme. For instance, when the children were asked to
remove their boots before being weighed and measured, this turned out to be a somewhat
delicate operation for which privacy had to be provided. Undressing was not required but
the boys had to loosen their ties and expose the front of their chests to allow for sounding
of the heart and lungs.
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