asked the Minister for Health whether his Department are in a position to say that every Irish primary school child is given one comprehensive medical examination in his or her primary school career.
17.
Ceisteanna—Questions. Oral Answers. - School Health Service.
16.
asked the Minister for Health if he will indicate any weaknesses which exist in the school health service; and what action he is taking in the matter.
With your permission, a Cheann Comhairle, I propose to take Question Nos. 16 and 17 together.
I would refer the Deputy to the report of the study group on the child health services which contained a detailed assessment of the school health service. The principal weaknesses found in the service were that the routine examination of large numbers of healthy children occupied an excessive amount of medical time, that psychological disorders were not being adequately discovered and that the attendance rate of parents at school medical examinations was low in many areas.
On average, each child has three medical examinations while at national school, and a large volume of health defects are discovered at these examinations. The comprehensiveness of the examinations varies considerably, depending particularly on the number of children due for examination by a doctor.
I have already announced that I intend to implement a four year programme, commencing this year, for the improvement of the child health services for both pre-school and national school children.
In the current year, the aim is that the initial training of assistant chief medical officers in developmental paediatrics will be completed, medical staffing requirements will be reviewed by health authorities, the obligation on doctors to carry out routine school medical examinations will be reduced, comprehensive entrance medical examinations with specific requirements will be introduced in schools, and parents and teachers will become more involved in the school health service.
Would the Minister not agree that we have an unhappy situation when he cannot give this House a guarantee despite the complexity of the problem—and I am accepting that it is a complex problem—that every school-going child will receive at least one comprehensive medical examination while at primary school? Would the Minister also not agree, going on his reply of last week, that there has been a decline in the figures he then gave? There has been a decline from 146,000 children examined in 1966 to 128,000 in 1968—a decline of 18,000 in the number of school-going children examined—paralleled by a decline of from 1,601 schools participating in 1965 to 1,643 in 1968, whereas, in 1960, 2,301 schools took part in the scheme. Whatever about his plans for the future, would the Minister not agree that this is a very serious situation and would he not agree that it is a paradoxical situation that the Minister and his Party recently burgled portion of the Proclamation to cherish——
This is not a question. The Deputy may not make a speech on these questions. Deputy O'Leary may not continue.
The Deputy is talking nonsense. The school medical examinations up to now, while they obviously required improvement, have not been inadequate. I am not going to conduct a post-mortem into a policy which was good for its day but now needs improvement and in the case of anything I do in health policy I am not going to undertake post-mortems into a service which, while excellent of its kind, needs improvement. The health services have been steadily improving in the last ten years and if I can get one comprehensive school examination for a child entering a school, the child having previously had examinations in the pre-school period, I am doing what all the experts advise me to do and it should result in the discovery of many mental and physical defects in children with a consequent ability to cure them at less cost, thus releasing more expenditure for other and improved health services.
Has the Minister any remedy for the extremely serious situation where a great number of children do not receive any examination? The Minister is now repeating a very familiar Fianna Fáil exercise: "tremendous plans for 1975", but what is he doing about school-going children who at present do not receive any examination at all?
Every child receives now on an average three school examinations.
18.
asked the Minister for Health the number of medical personnel at present employed in the school medical service.
I would refer the Deputy to my reply last week to a similar question put down by him, when I indicated that about 70 assistant chief medical officers are employed on school health examinations.
Is the Minister considering any increase in this number for this year and next year to meet a serious defect in the present service?
Six vacancies are likely to be filled shortly by the Local Appointments Commission and three others will be filled. We will probably require about 90 posts. Health authorities are to be asked to review their medical staffing in the light of the four year programme for child health services.
Is the Minister doing anything to meet the short fall of 84 new medical officers?
I have just said that we are planning to have more child health officers. We have even made arrangements to have a change in the type of course offered in order to attract more people for this particular service. I can assure the Deputy this plan will go into operation no matter how much he does not wish it to go into operation.
Does the Minister not agree——
Question No. 19.
What is the Minister doing to fill the 84 vacancies?
I have just told that to the Deputy.
(Interruptions.)