[Report 1970] / Principal School Medical Officer of Health, Warwickshire County Council.

  • Warwickshire (England). County Council.
Date:
1970
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: [Report 1970] / Principal School Medical Officer of Health, Warwickshire County Council. Source: Wellcome Collection.

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    in schools and this requires very close relations with teachers, as well as parents, within the school organisation. 10. Provision of other services for children, e.g., speech therapy, physiotherapy in a school-orientated setting so that there is a positive integration with education and as little time as possible is lost from school. 11. The maintenance of close contact with colleagues responsible for the child during the pre-school years and with family doctors and other medical specialists, social agencies and educationalists. This is by no means an exhaustive list of functions which may be summarised as being directed to ensure that the child is enabled to reap the full benefit from the educational system, and to ensure that illness, disability, or handicap does not prejudice a child educationally, or his later functioning as an adult. This somewhat restricted summary, with its emphasis on the detection and amelioration of defects so readily carried out in a “captive” group such as school children, reflects the general pattern of the Service from its inception. There is no prospect of these important needs being met by an existing service other than the School Health Service, whose personnel are the only ones with an adequate training. The service is now moving into a broader important sphere—the prevention of ill-health in childhood. Whilst scientific and medical advances, periodic assessments and screening procedures will help to find the defects at an earlier stage, and increasing knowledge of genetics, metabolism, etc., will prevent some defects happening, there is an increasing awareness that much of the mental ill-health of childhood could be prevented. Recent reports on the incidence of emotional problems in school life have revealed the extent of the problem. Medical, social and educational factors are all involved—many children becoming severely disturbed as a result of educational failure. Close co-operation between the school medical officer and the teacher should result in a co-ordinated approach to the individual child. Placement of a child in any form of special education and ongoing review of his needs should be as a result of joint discussions between the educational and medical staff, taking into account all the child’s individual needs. Barriers between the professions are steadily breaking down. The Service has not yet fulfilled its potential in the sphere of research into child health in general. As a normal part of its work it acquires a great body of information not otherwise available, and oppor¬ tunities exist to extend the value of this in the preventive field. Work needs to be carried out in particular subjects, for example, emotional disturbance in young children, obesity of childhood, subacute and chronic infections, and the multiple problems of adolescence. Extension of the work to include the problems of student health in colleges of education, technical colleges and other establishments for further education is another potential field. The practice of school medicine differs from other clinical practice in that: 1. It attempts to be preventive; discovering unrecognised early deviations from normal and advising on treatment. 2. It is concerned with a developing organism—the child. The approach is that of developmental paediatrics rather than treatment of frank disease. 3. It is particularly related to a specific environment—the school—and a detailed knowledge of this environment is essential. There are therefore very cogent reasons why the School Health Service should continue as a specialised service but this must retain close links with the medical services concerned with community preventive health. The school child cannot be considered as a separate entity from the pre-school child or the adolescent in employment. The concept of the “school physician” as a doctor intimately associated with school life is therefore becoming fairly clear. There must be close involvement with the assessment of the pre-school child’s development. Although there may be administrative divisions between the pre-school and the school child, in practice in the field most of the medical staff are concerned with both age groups. The medical officers also receive reports from family doctors, consultants, and other agencies and should be able to give valuable information about the child on entry into school, particularly in respect of those “at risk” of educational difficulty for physical, emotional, social or limited intellectual reasons.