DEPARTMENT OF GENERAL PRACTICE.CARDIFF
The school medical examination in an
integrated group practice
C. J.WlNTLE, M.B.,B.Ch.
R. H.Davis, d.m.,f.r.cg.p.
The General PracticeUnit,
Departmentof social andoccupational medicine,Welsh National School of Medicine
able for this section of thepopulation,and served to uncover agreatdeal of ill health
whichrequiredtreatment. Morerecently theyhavelargelyformedpartof theprocess
ofscreeningchildren for defects which are either amenable totherapyorrequiresub¬
medical examination needs re-assessment in thelightof current anddeveloping patterns
of thedeliveryof medical care.
The medical staff of the General Practice Unit of the Welsh National School of
Medicine, togetherwith health visitors and district nurses seconded from the Cardiff
Local HealthAuthority, provide generalmedical services from a health centre for most
of thepopulationof a newhousingestate in Cardiff. We also undertake school medical
examinations on behalf of the local healthauthorityfor theprimary schools which
serve the estate.
The records of the Unit have beendesignedtointegratethe data
accumulatedby doctors,health visitors andnurses,thusbringing togetherthe records
of thegeneral practitionerand the local healthauthority (WallaceandDavis, 1970).
Theopportunityto evaluate the school medical examination in the context ofintegrated
communityhealth care wasconsequently possible.
the firstyearof thestudy.
Duringtheperiodof thestudythere were twoprimaryschools whichmainlyserved
theexpanding populationof a newhousingestate in Cardiff.
entrants(134 children)to these two schools underwent a routine school medical examina¬
Ninetyof these children wereregisteredwith the General Practice Unit and
formed thegroupunderstudy. There were 46boysand 44girls. Theaverage agewas
Each child was examinedbya health visitor(S.C.)and a doctor(C.J.W.) in accord¬
ance with the routinegenerally acceptedfor school medical examinations. The school
medical record card(10 M)wascompleted and,inaddition,a record was made ofany
Somedevelopmentalabnormalities such as knockknee, mild
tonsillarenlargementand flat feet were considered to bephysiologicaland thus omitted.
Dentalcaries,unlessvery gross,was so common as to be almost a normal feature and
was also not included.
Subsequently, the General Practice Unit medical record of
Journal,Royal College of GeneralPractitioners, 1972, 22,327
medical examinations have been aprominentfeature of child health care
formany years. They originatedat a time when medical care was notfreelyavail¬
In common with manyother traditionalmethods, the school
Thispaperrecords the results of
Earlyin 1971 all the