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There has been a change in the type of cases attending the clinics. We know that
there has been a great deoline illness due to malnutrition and skin infections such as
impetigo, scabies, ringworm, septic eye conditions, discharging ears, eto.; conditions
which used to fill the minor ailment clinics in past years.
One cannot escape the conclusion that several important factors have brought
about the decline in the numbers of children suffering from these conditions - improved
standards of living in general, better hygiene, and the introduction of antibiotics. It
would seem that other factors as well as the availability of free medical attention have
contributed to these beneficial changes.
The Specialist Clinics, Eye, E.N.T., Paediatrios, and West Ham Child Guidance
Clinic, were established before the Inception of the National Health Servioe, but it is
very gratifying to note that in 1951 the Regional Hospital Board confirmed the position
by continuing the provision of specialist clinics within the framework of the school
health servioe. These include the services of ophthalmologist, paediatrician, ear, nose
and throat specialist, dental anaesthetist and child guidance psychiatrist. The servioes
of such specialists have been extended to the Spastic Unit which was opened in 1954 as
part of the Elizabeth Fry Special School for Physically Handicapped Children, and to the
Autiology Unit which was opened in 1955 as part of the Maternity & Child Welfare Servioe.
Certain other changes might be mentioned, for instance, the provision of spectacles
under the National Health Service Act. This enabled parents to obtain speotacles for
their children and to exercise free choice of optician. Provisions are also made under
the Act for the repairs of spectacles free of charge, while surgical and orthopaedic
appliances are now provided by appropriate hospital departments.
As far as handicapped pupils are concerned, the Education Act of 1944 gave the
main impetus for the development of this type of work within the School Health Servioe,
and no doubt the availability of all specialist and hospital services which became free
under the National Health Service Act, provided the necessary diagnostic aids whioh are
so essential to the accurate assessment and ascertainment of handicapped pupils.
One should also emphasise the importance of Section 24 of the National Health
Servioe Act in relation to the School Health Service. This Section deals with the
revised duties of the Health Visitor who now extends her supervision to the whole
family and combines the duties of Health Visitor and School Nurse. This enables her to
utilise her knowledge of the pupil's home background and to carry forward into the
school life her knowledge of and familiarity with the child from birth. In turn this
enables the medical officer to get a better understanding of the underlying causes of
the child's condition and restilts in better assessment and management.
These comments have dwelt mainly on the positive effects of the National Health
Servioe Act on the School Health Service but it might be appropriate to mention also
some of the negative effects which are of a more temporary nature. It is obvious that
the demands of other sections of the community for free treatment has caused a loss of
oert ain facilities to children; this is illustrated by the shortage of dental surgeons
in the School Dental Service, and a certain temporary delay in the supply of glasses for
school children.
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