[Report 1950] / Medical Officer of Health and School Medical Officer of Health, West Riding of Yorkshire County Council.

  • West Riding of Yorkshire (England). County Council.
Date:
1950
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1950] / Medical Officer of Health and School Medical Officer of Health, West Riding of Yorkshire County Council. Source: Wellcome Collection.

    49/138 (page 49)
    PART V THE HEALTH OF THE SCHOOL CHILD (This, together with the following part VI on the County Dental Service constitutes the report for the year 1950 on the School Health Service, being the IfSrd Annual Report of the School Medical Officer). Introduction The year 1950 has been so far as the School Health Service is concerned a mixture of im¬ provement in some directions and stasis in others. There has as yet been little change in the composition of the medical staff, but recruitment of doctors to preventive medicine is showing a levelling off which is likely to be followed by a decline. The main reason for this lies in the discrepancy in salaries in the hospital and preventive fields. Salaries in the public health field still compare unfavourably with those in the Hospital Service. The number of doctors taking additional qualifications for work in the School Health field, e.g. D.P.H., D.C.H., or other higher medical degrees and diplomas is likely to diminish (an attempt is being made to remedy this in the case of the D.P.H. by the establishment at Leeds University of part-time courses over an extended period). The present position is in many ways alarming. The school doctor must have a full' preventive outlook; he must be an expert in the field of nutrition, epidemiology, physical medicine and social and mental hygiene, and have an intimate knowledge of educational matters to enable him to advise what special educational facilities are required for the various types of handicapped child. Such knowledge can only be obtained in the degree that it Is needed by prolonged study and much hard won practical experience. If we cannot persuade young keen medical men and women to undertake this then the School Health Service will suffer, but of far greater importance, the health and education of our children will suffer more. The general situation, since the passage of the National Health Service .\ct, 1946, is still far from clear. The change brought about by this Act was so drastic that it is singularly difficult to work out all the many side effects. This is particularly true of the School Health Service which in many ways seems to have deteriorated rather than improved. The following few points have been chosen for comment to illustrate some of the exceptional difficulties. During the year further steps have been taken to relate the work of the School Health Service to that of the general practitioner by ensuring that any child who is considered by the school doctor to require a specialised opinion (other than an ophthalmic examination), shall be referred to the specialist through the general practitioner. This arrangement could and should work to the advantage of the child and lead to an increase in the spirit of co-operation between hospitals, health depart¬ ments and general practitioners. Much more still needs to be done to bind together the work of the School Health Service with that of general practitioners and hospitals. In time it will be unthinkable, e.g. that a hospital should consider its duty discharged until it has taken steps to see that the school health department and the general practitioner are made fully aware of all points relevant to the child’s health and education. This spirit of co-operation cannot be brought about by enactments and regulations but can be made to grow if the interest of the child is always the first consideration. For many years there has been a growth of specialist clinics organised by the school health department situated away from hospitals; this development received great impetus by the Education Act of 1944, which made provision of comprehensive and full treatment for all school children the duty of the Local Authority. The National Health Service Act has, to a large extent, reversed the process, placing specialist children’s clinics back in hospitals, often coupling the work with that provided for out-patients of all ages. This must eventually lead to a change from an out¬ look of prevention, and promotion of health to one of remedy and treatment of disease. Schools should be much better equipped for medical work. Not only is this essential to an effective School Health Service but also it enables the work of the school to continue uninter¬ rupted during visits of the doctor and auxiliary medical staff. In the drive for economy in school building the provision of medical units (suitable for medical inspections and special examinations) has been much reduced in primary schools. Thus, even in many new schools, medical inspection, which is such an essential part of the work of the service, will not be carried out in rooms specially designed and set apart for the purpose. One of the most unfortunate aspects of this shortsighted economy is to be found in the relationship of the medical and teaching staff for it often results in the presence of the doctor and nurse in the school being unwelcome, just at the time when we have at last come to understand that doctor, nurse and teacher must work together in a team. During 1950 no special schools were opened for handicapped children by this Authority, but Ingleborough Hall became fully used and progress was made towards increasing accommodation for delicate pupils at Netherside Hall, and for those educationally sub-normal children requiring residential accommodation at Baliol (Sedbergh), Meltham Mills, and Springfield House (Horsforth). The number of defects in all categories requiring treatment shows a decline when compared with the previous year, although the number of children inspected remained about the same. The nutritional state of the children shows similar improvement. Full employment, the re¬ distribution of income, a gradual improvement of the standard of child care in the home, school and hospital, may all take a share of the credit in this favourable change.