Selective medical examinations for school entrants: the way forward.

Routine medical inspections have been a traditional part of starting school in the United Kingdom since the early 1900s. When the school health services were incorporated into the NHS in 1974 medical inspections ceased to be a statutory requirement, and the numbers of routine medical examinations of children over the age of 5 have declined. Most areas have, however, retained a system of routine medical examinations for all children when they start primary school, sometimes including a thorough neurodevelopmental assessment as well as a physical examination.' 2 The value of this system was questioned by the Court Committee on Child Health Services,3 and in later reports.4 5 Retrospective analyses of school entry medical examinations have not shown routine examination of all children to be particularly advantageous 9 and, increasingly, the value of such routine examinations is being challenged.9 10 Systems of selective medical examination at the time of entry to primary school are already successfully in operation in some parts of Britain and Australia.' '-'3 This paper describes the organisation of selective school entrance medical examinations in a socially deprived inner city district of London with a mobile population, and presents the results of the initial pilot study that assessed the feasibility of such a system.