SCHOOLS AND THE HEALTH AUTHORITIES (Hansard, 27 April 1978)

§ Baroness MASHAM of ILTON
My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.

§ Lord WELLS-PESTELL
My Lords, we are not aware that there has been any deterioration or that further guidance on this matter is required at the present time, but we shall review the situation in the light of any relevant recommendations which may be made by the committee of inquiry into educational provision for handicapped children. Perhaps the noble Baroness would tell me whether she has some particular problem in mind.

§ Baroness MASHAM of ILTON
My Lords, while thanking the noble Lord for his Answer, may I ask him whether he is aware that a boy died in a local comprehensive school near to me from a heart defect; that the eye of a child fell out during a P.E. lesson and that none of the teachers knew anything about these children having had defects? Does the Minister not think that a card with useful information for teachers about children with defects in their schools would be advisable?

§ Lord WELLS-PESTELL
My Lords, I am not aware of either of those instances, and I do not think that my Department 1970 or, for that matter, the Department of Education and Science can be expected to know of every incident, bad though some of them may be, that takes place in schools. However, I take the point which the noble Baroness has made. It is a valid point. It is perfectly true that the attempt on the part of the Department of Education and Science is to integrate a child into normal school life, wherever that is possible. We in the Department of Health and Social Security have a specialist in community medicine in every area. Ninety per cent. of all children attend a health clinic during the first 12 months after birth and the specialist in community medicine calls upon children, on the advice of health visitors, if it is suspected that between birth and five years of age there is reason to help them. Then any information which amounts to a defect is passed on to the education authority.

§ Lord BELSTEAD
My Lords, what standing machinery exists for the Department of Health and Social Security and the Department of Education and Science to check the work of the Health Service for schools? For instance, by what method will the points which the noble Baroness has raised today be considered by both Departments?

§ Lord WELLS-PESTELL
My Lords, I think that both Departments will take up this matter in the light of what the noble Baroness has said. We receive information from time to time. In fact, some school inspectors feel that there has been a decline in services of this nature, but when this point was communicated to the Department of Education and Science they immediately undertook a thorough investigation and could not find evidence to support the suggestion that there had been a deterioration. The Area Health Authority notifies the education authority regarding a child's needs if defects are found, so that they can be taken into account by the head teacher and by the teacher who is responsible for the child.

§ Lord BELSTEAD
My Lords, will the noble Lord accept that I realise that the primary responsibility is at local level? But will the noble Lord also accept that, as the transfer of the school health service from Education to Health was something which was new in 1974, one 1971 would have assumed that there would be some standing machinery whereby the two Government Departments could keep an eye on how the Health Service for schools developed and worked? Is the noble Lord really telling the 1-louse that there is no such standing machinery?

§ Lord WELLS-PESTELL
My Lords, I am not telling your Lordships that there is no machinery. The present policy is set out in the Department of Education and Science circular which was sent out early in 1975. I will send a copy to the noble Lord and also to the noble Baroness, if she has not seen it. I think that the circular is as near foolproof as anything can be. However, the noble Lord has asked whether either the Department of Education and Science or my own Department could follow this up by getting a return—I take it, at regular intervals—as to what is the situation, and I must tell him that I should have to take advice on that matter.

Lord WINSTANLEY
My Lords, further to those most helpful and informative replies, would the noble Lord beat in mind that, since the inception of the school medical service, the financial barrier between many children and their family doctors has now largely and quite rightly disappeared? Does the noble Lord agree that this means that now there should be a much closer association between the school medical service and the family doctor service, and vice versa?

§ Lord WELLS-PESTELL
My Lords, I should not like to commit myself on that, although obviously the general practitioner has an important part to play in this type of situation. But what I should like to ask your Lordships to do is this: the Warnock Committee has produced a report after sitting for three years. It has just reached my right honourable friend the Secretary of State, who hopes to publish it fairly soon—and I mean fairly soon. There has appeared quite recently the Court Report which in some measure has also explored this particular area. Once we have been able to look at the Warnock Committee Report and to look again at the Court Report, I think it will mean that some of the recommendations will enable us to tighten up the situation so that these things do not happen.

§ Lord HAILSHAM of SAINT MARY-LEBONE
My Lords, is the noble Lord fully satisfied that the schools realise that there are defects in children which emerge after the early examination. For instance, he has referred to eyesight which affects a child's ability to read and which may not he discerned in the early stages. Or there may be some small I defect of the hand which affects the child's ability to write. Is he fully satisfied that these matters are properly examined in the schools and at local level?

§ Lord WELLS-PESTELL
My Lords, I could not really give a proper answer to the noble and learned Lord on this. All I can say, and indeed I have already said it, is that 90 per cent. of the children are seen by the specialist in community medicine during the first 12 months. The health visitors are in regular touch with children under live, and therefore they pick up defects at two, three and four, and then the children are invited to go back to see the specialist community service. After that age there are the school doctors and the school nurses and also the family doctor, any one of whom should be able to observe these things and to refer the matter to the specialist in community medicine.

§ Baroness PHILLIPS
My Lords, is the noble Lord aware that, at any rate for the reassurance of certain of your Lordships, speaking as the chairman of governors of a London school, I can assure him that the medical records are well up-to-date, and as an ex-teacher I can say that it has always been within the knowledge of the teacher and I am amazed to learn that some have slipped through the net. That is certainly not true in the case of the London authorities.

§ Lord WELLS-PESTELL
My Lords, I am glad to hear that, but I do accept that it is probably not 100 per cent. foolproof. If noble Lords have any indication of happenings of this kind, I hope they will let me know.

§ Lord GLENKINGLAS
My Lords, will the noble Lord consider one other point? My noble and learned friend raised the question of eyesight, but there is also the question of hearing. In many cases children are thought to be stupid, either because they cannot fully see the 1973 blackboard or because they cannot hear what is being said. This is perhaps a minor matter, but is the noble Lord aware that it happens probably more often than most people realise.

§ Lord WELLS-PESTELL
My Lords, I do not think it is a minor matter because I have had some experience of children who have been thought at the age of 10 or 11 to be a little stupid, but when they have been properly and thoroughly examined they have been found to have an eyesight defect which ought to have been picked up long ago, or sometimes a hearing defect.

§ Baroness MASHAM of ILTON
My Lords, if I may ask one last question and also thank the noble Lord for his information, would he not agree that for young teachers to have a child in the class who falls down in an epileptic fit is very worrying if they do not know that such cases exist in their class?

§ Lord WELLS-PESTELL
My Lords, I take the point: it can he very frightening to some people.