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61
SCHOOL HEALTH SERVICE
(by w. H. Toms, M.D., Ch.B.(Edin.).
Principal Medical Officer).
Medical Officers, full and part-time, on the school health
service staff, examined 9307 children in schools in 1967. This
represents a 60% Increase over the number examined the previous
year, and means that all children were seen after school
entry, at twelve, and before leaving school. In addition, vision
and hearing were screened at more frequent Intervals by our
team of technicians. The school psychological service, through
the educational psychologists contributed more and more In the
identification and treatment of emotional problems occurring in
school children — a role they now share with the school
doctor — and which, until relatively recently has been an
entirely medical responsibility.
This all represents good clinical supervision of the child
in school and it is tempting to accept the amount and quality
of work done as in itself evidence of Its value without looking
too deeply into its relationship with the alms of the service.
Promotion of physical and mental health is the major Justification
for the existence of a school health service. Without
proper emphasis on this, its purpose can easily be frustrated.
Involvement in health education, both in groups and in more
formal courses, liaison with child guidance clinics, regular
visits in the schools leading to discussion with the staff when
they feel need for advice on either the child's physical or
mental condition — these are some of the many ways in
addition to medical examinations In which the school health
service should contribute to the welfare of the child. This
should all be part of a continuing process more important than
the ritual of medical examinations at the age of twelve and
before leaving school, except where handicap is known or suspected
to exist.
The great majority of defects should be discovered at the
first examination in infant school and with this in mind much
more time should be allowed for this examination than at
present is the practice. We have left behind the days when
children developed serious illnesses over the whole period of
their school life leaving some with severe residual defects.
Defects of vision and hearing do, of course, develop at any
time in the school career, but with regular screening tests,
independent of medical examination, these should be detected
early and specialist advice obtained.