§ 3.2 p.m.
§ The Earl of SWINTONMy Lords, I beg leave to ask the Question which stands in my name on the Order Paper.
The Question was as follows:
To ask Her Majesty's Government when they intend to introduce compulsory medical inspection for school children as recommended by the Court Committee.
§ Lord WELLS-PESTELLMy Lords, the comments which we have received on the Court Report did not suggest that there would be universal support for the introduction of new powers for the compulsory medical examination of school children. The Government will reach decisions in the light of consultations now in progress.
§ The Earl of SWINTONMy Lords, while thanking the noble Lord for that reply, may I ask whether he is aware that in certain parts of the country there is increasing anxiety among school medical officers at the number of parents who are opting out of this routine medical inspection? I should also like to ask whether the noble Lord thinks it is highly likely that the children of those parents who are opting out are those most at risk in our society?
§ Lord WELLS-PESTELLMy Lords, I am grateful to the noble Earl for calling my attention to this matter. If he is personally aware of any serious problems in any particular area, I hope that he will not hesitate to write and let me know. The other point that I should like to make is that there is a long-established practice—as I am sure he knows—on the part of the school health service to examine children, either just before they start school or immediately after. This is widespread throughout the country, but there may well be parts where this is not so, to which the noble Earl has referred. In certain circumstances, it may well be 475 that parents prefer to take their children to the family doctor, and we would not object to that.
§ Lord DAVIES of LEEKMy Lords, following the noble Earl's supplementary question, may I ask whether my noble friend is aware that often the reason why children are not taken for the medical examination is not a voluntary one but is because so many parents, including mothers, are now working and it is expensive for them to be absent from their jobs to take children for medical inspection? I am sure that if an analysis were made that would be part of the answer to this problem.
§ Lord WELLS-PESTELLMy Lords, I wonder whether it is really a problem. It has again been long-established practice in this country—I know this from personal experience—that where a mother or a father is unable to take a child to a medical inspection, she or he can usually arrange for either a neighbour or some other member of the family to take the child. This has been going on for years.
§ Baroness ELLESMy Lords, would the noble Lord agree that most medical inspections of school children take place in schools and that it is not necessary for parents to take children for these medical inspections? Would he not agree that for the child to have the benefit of best education, the school should be aware whether that child has any illness or eyesight defects, so that these may be dealt with speedily? I support my noble friend Lord Swinton in his Question.
§ Lord WELLS-PESTELLMy Lords, I would not disagree with what the noble Baroness has said. It is desirable, when a child is being medically examined in school, that, so far as possible, one or other of the parents should accompany the child. Parents are informed of the date, time and place of the examination. They are asked to complete a very simple form which requests information on what complaints the child has had, inoculations, and so on. If parents can be at the examination, then it is highly desirable that they should do so.
§ Baroness MASHAM of ILTONMy Lords, may I ask the noble Lord whether 476 another recommendation of the Court Committee is being implemented, namely, that all secondary schools should have a school nurse attached to them and all primary schools have a designated nurse which they share with other primary schools?
§ Lord WELLS-PESTELLMy Lords, as I understand the Court Report, it was suggested that medical examination should be carried out on a selective basis and that all children should have an annual interview with a nurse. The Government do not disagree with this in principle and they are at the present moment preparing a draft on good practice and prevention and child health services, including medical examinations of children. I hope that that will be sent out fairly soon.
§ Baroness FAITHFULLMy Lords, would the noble Lord agree that when there were routine statutory medical inspections in schools at the age of five, seven, 11 and before leaving school, these were enormously helpful to the child, to the teacher, to the parent and, what is more, to the GPs? Would the noble Lord agree that at the moment there is not sufficient liaison between the GPs, the schools and the school teachers?
§ Lord WELLS-PESTELLMy Lords, I suggest that these routine examinations go on. I said a moment or two ago that there is a long-established practice for children to be examined, either just before they commence school or immediately afterwards. It is a routine matter. What some noble Lords are asking for is that the Government should take steps to make it compulsory, and when one starts introducing the compulsory element it gives rise to a lot of difficulties, often counter-productive.
§ Lord ALEXANDER of POTTERHILLMy Lords, is it not a fact that the routine to which the noble Lord refers which obtained successfully until 1974, has substantially weakened since the alteration of the arrangements relating to the school medical service? My information is that what previously occurred does not now occur, and this is the problem.
§ Lord WELLS-PESTELLMy Lords, I know this view is held by a number of 477 people, but I have no evidence to believe that there has been the marked change that certain noble Lords have indicated.
§ Lord SEGALMy Lords, would my noble friend agree that the representations that have been made from all sides of the House present a strong case against any reduction of medical entry for training in the medical schools? May I ask for an answer to that question and add this one: is it contemplated that there should be any reduction in the number of medical students?
§ Lord WELLS-PESTELLMy Lords, that is rather wide of the Question, but I did say to your Lordships—I cannot remember whether I said it yesterday or the day before—that it is the intention of the Government to see that there are somewhere in the region of 4,000 medical students each year from the early 1980s.