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School Medical Services (Development)

Volume 411: debated on Thursday 7 June 1945

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asked the Minister of Education whether he is aware of the difficulty likely to be experienced by local education authorities owing to the shortage of doctors and nurses in carrying out the duties imposed on them by Section 48 (3) of the Education Act, 1944, in regard to medical treatment of schoolchildren; and what steps he proposes to take to prevent authorities from throwing further burdens upon the depleted medical personnel of the country.

I am fully aware of the shortage of doctors, dentists and nurses available for civilian needs and of the strain under which they are working and I am glad to have this opportunity of supplementing the advice given to local education authorities in Circular 29. In that Circular authorities have been asked to extend their arrangements with hospitals so as to secure free hospital treatment for all children attending maintained schools, so far as accommodation and staffing conditions permit. They have also been asked, subject to the same limitation, to develop, so far as they can, those clinic services which have always been recognised as appropriate to the school medical service. I have no doubt that the needs of urban areas generally will be adequately met in this way.

The position in rural areas is more difficult and the Circular suggested that in addition to extended use of hospitals authorities should arrange for the treatment of children where necessary by local general practitioners. I recognise that such arrangements can only be made on a very limited scale in view of the pressure under which doctors are already working, but I hope that here and there doctors will be found who are willing to undertake this work in a part-time capacity under arrangements made by the authorities and approved by my Department.

As hon. Members may recollect, my right hon. Friend gave an assurance last May during the Debate on the Third Reading of the Education Bill that he would so control the development of the school medical service as to ensure that it should not be inconsistent with or duplicate provision to be made by the national health service of the future. The latter service is not yet in being and this, together with the growing medical manpower difficulties, has made it difficult to lay down lines of development for the school medical service for the immediate future. I mean, however, to fulfil the pledge my predecessor gave to the House, and, while encouraging urgent developments in those clinic and hospital services which have always been the main-stay of the school medical treatment service, I shall not, for example, approve any proposals which would lead to the setting up by local education authorities of a general medical practitioner service.

The Act has been passed and its provision must, so far as practicable, be implemented. Hon. Members will realise, however, that the goal cannot be attained in a day and that the service which can be provided in the next year or so must be limited to the extent necessary to comply with the undertaking given about its relationship with the future national health service. The scope of the service must also be restricted owing to the shortage of medical manpower.