In 1905, AK Chalmers, the medical officer of health in Glasgow, wrote: “The physical inspection of children is specially referable to the school period of their life, at which for convenience it is conducted…we should keep in mind the facts disclosed on the periods of life which precede and follow it…”
School health services were established across Scotland’s school authorities in 1908, with the school boards of Glasgow and Govan taking earlier steps towards their establishment.
The origin of the service arose from a general concern at the beginning of the 20th century, about the state of the nation’s health, underlined by the level of infant mortality, falling birth rate and the poor physique of army recruits during the Boer Wars.
The Royal Commission on Physical Training (Scotland)1903, and the Inter-Departmental Committee on Physical Deterioration1904, were appointed to investigate conditions and make recommendations.
The former advocated the need for physical training in schools. It recommended, among other things, the provision of systematic medical inspection in schools.
Both groups pointed out that the period of school life afforded the only opportunity for taking stock of the whole nation and securing conditions most favourable to healthy development.
In 1904, following publication of the report on physical deterioration, Dr Chalmers began an enquiry into the health and housing conditions of 750 children attending schools in the city.
In the same year, the Royal Sanitary Institute recommended the establishment of regular and systematic inspection of school children, asking that the matter should be brought before school boards.
In 1905, Glasgow took the matter into its own hands and recorded the measurements of 72,857 children attending Glasgow’s schools.
A 1907 report to Parliament described the investigation as the most extensive ever undertaken in Britain of the heights and weights of children attending primary and higher-grade schools.
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Govan Parish School Board also anticipated the legislation, introducing the systematic medical inspection of children attending schools in their area in 1907. It appointed ten part-time medical officers of health with much wider duties than those undertaken by Glasgow.
The Education (Scotland) Act 1908 established Scotland’s school health services. Their powers were to supplement and not supersede those of the local public health authorities and their medical officers of health.
The school health services were to report on the sanitary conditions of schools and to supervise and inspect school children in reference to infectious diseases in the first instance.
It did not include the provision of medical treatment; inspecting medical officers of health being simply authorised to advise the parent or guardian that treatment was necessary. They could, however, supply food and clothing in necessitous cases.
It soon became evident that without authority to provide treatment, the local authority faced the problem of how to deal with children found to require nutritional support for their recovery, but whose parents were unable to provide the necessary treatment.
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In 1912 the Court of Session ruled that school boards had no power under the Act to give treatment paid for by the rates. Shortly afterwards, the Scottish Education Department established grants for the treatment of children in need.
Glasgow’s first treatment clinics were opened in October 1912 with dentists, anaesthetists, opticians, ear specialists and dermatologists. An Act of 1913 legalised the provisions of schemes for medical treatment of school children.
That same year, Glasgow opened Strathblane Children’s Home and Open-Air School, providing long-term care for chronically sick children.
With the agreement that treatment could be provided, school health services evolved gradually and, on the whole, without interruption.
In 1930 the education authority, which included Glasgow and Govan, was transferred to Glasgow Corporation. The school service was amalgamated with the general public health service, furthering existing coordination.
The results of medical inspection during the first decades provided evidence of the value of creating a school health service.
Many of the defects found in the examinations had not previously been detected, preventing children from attaining a grave or chronic illness at a stage which would have been more resistant to treatment.
By 1948 and the establishment of the NHS, school health services had gathered a continuous medical record to compare the physical condition of school children at various periods – a record which was unavailable for any other group of the population.
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