ABSTRACT
The State, the child and health The report of the Inter-Departmental Committee on Medical Inspection and the Feeding of School Children noted that while there did not appear to be any 'specific statutory provision' for LEAs to conduct medical inspections of school pupils, by 1905 85 LEAs had appointed school medical officers and in 49 of these authorities a definite system of inspection was operating. The variations in the prescription of the school medical officers' duties meant, inevitably, that the quality of inspection provided varied between these authorities; in the case of some small authorities, all. the elementary school children were inspected whereas in the larger ones a sampling technique was usually the norm. But despite the revelations of these inspections only in a very few instances had medical treatment been provided, partly because free treatment was a socially and politically more contentious issue than inspection. The first Inter-Departmental Committee had been firmly opposed to treatment being provided by LEAs while Dr James Kerr, the LCC's school medical officer, forbade it on the grounds that free medical treatment might pauperise the parents. Another school medical officer, Dr Rhys Davies, pointed out that when he had been first appointed by a school board:
I was expected ... to ask the single question, 'Do these children suffer from any physical defect which interferes with their reasonable progress in school?' I was not expected to ask 'What is the cause of this defect?' nor the further question, 'How can I, as Medical Officer, treat these children?,l
It was not surprising, therefore, that among even these (relatively) progressive education authorities the rate aid required for their school medical services was minimal. In most county borough councils the average annual expenditure on inspection, including staff costs, was £100 to £150 per annum, that is a t2d rate in Burnley and a tsd rate in Halifax while at the urban district council level, the average expenditure was £50 per annum or between a tsd rate in Keighley and a tod
rate in Eastbourne. Even in London, where the annual salary costs for Kerr and his staff were £6783, the rate requirement was ~od. 2
The 1905 Inter-Departmental Committee noted their predecessor's injunction against treatment by LEAs, observing that the increased costs involved as well as the potential opposition from private practitioners might constitute major obstacles to such treatment. None the less, they were sufficiently moved by the evidence presented by their witnesses to comment that under the current system not only would the child of negligent parents continue to suffer but there were also many parents who wanted their child treated but could neither afford the loss of time from work nor find the means to do so. Consequently, they believed that
... the results leave something to be desired, and that there is much opening for improvement. It is to be remembered that the Local Authority does not attempt treatment of the children's defects, it merely points out to the parent their existence, and except in very rare cases it has no power to force him to have the defect remedied. We have not sufficient data, upon which to base any estimate of the percentage of cases not receiving treatment; such percentage probably varies greatly from area to area, but we fear there is no doubt that it is a large one.3
