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99
AREA SCHOOL HEALTH SERVICE
Routine Medical Inspection
Fifty years have elapsed since the Education (Administrative
Provisions) Act 1907 authorised medical inspection of children
attending State schools. While the administrative procedure for
routine examination of each child on admission into school, and at
stated intervals afterwards, has remained substantially unchanged
over the years, the nature and number of defects found have changed
almost beyond recognition. In the early days it was inevitable
that the service should be an almost purely medical service.
There were so many obvious defects and diseases for which little
was being done and which equally obviously prevented or hampered
the child from benefiting from the education it was supposed to
received.
The school physician concerned in the early days by sheer
pressure of the volume of work,, with the routine tasks of diagnosis
and reference to others for treatment, now has opportunity to
practise also the more positive aspects of a health service - by
assessment of individual optimum health standards and by giving
advice on the maintenance of health and prevention of disease.
With co-operation of teacher and parent he is able to study the
child in school and family setting and in the case particularly
of older children out of school life in their social recreational
and occupational setting. This change from a medical to a health
service is an answer in itself to critics who regard the duties of
school medical inspection as merely the detection and recording of
defects and complain that it leads to considerable expenditure in
time and money on unproductive work. With health and education
closely meeting in an expanding field of special education now
available to the handicapped child, the role of the doctor in the
school health service need never be one of monotonous routine nor
unrewarding in its opportunity to practise preventive medicine on
a scale regrettably unknown, even after ten years working of the
National Health Service, in hospital or general medical practice.
As in this Area, now for nearly twenty years, many local authorities
encourage the practice of sessional interchanges with hospital
practice - through medical officers undertaking sessional
clinical work in hospital out patient departments (in particular
Paediatrics) and registrars (specialists in training) undertaking
sessional work in the local authority services. Such arrangements
may well enhance the quality of the doctor's work in the
clinical aspects of routine school medical inspections.