Chapter 1 — Department of Education

Part 5 The inspection system

The principal duties of the Medical Inspector were: (1)protecting the health of the children; (2)making arrangements for the children when they are sick or when they need some medical attention such as for eyes, teeth etc.; (3)general health considerations – food and clothing, sleeping facilities, conditions of work and so on; (4)evaluating the medical services to schools, i.e. care provided to children by the school doctor, including: (a)keeping a record of the medical examination given to a child when committed; (b)the medical examination the school doctor performs on the children when he/she visits the school from time to time.

Dr McCabe’s appointment coincided with efforts to revise the system used for recording medical information on pupils and the issue was the subject of two Department circulars between 1940 and 1943. The first of these, Circular 205/39, issued to Resident Managers on 5th June 1940, announced the introduction of a ‘standardised’ form, which would give both the particulars of the medical examination on admission and the subsequent medical history of the child while in the school. Such a record, which was the responsibility of the Manager, had the advantage of easy reference and was intended to be forwarded with the child on transfer to another school. In terms of medical history, the form included a record of illness section, under which was entered any treatment a child received in either the school infirmary or external hospital. A quarterly reading of height and weight was also to be entered on the form. It was evident from the documentation available that the Department placed great importance on the physical health of the children and wrote to the schools following Dr McCabe’s suggestions regarding referrals for treatment and dietary recommendations. A continuous reduction in weight would raise concerns in relation to adequacy of diet.

A second circular was issued on 28th September 1943 to remind Resident Managers of their responsibilities in the matter of the ’safeguarding’ of the health of the children. They were also advised that the Minister attached the ‘utmost importance’ to the punctilious observance of Rule 22 of the Rules and Regulations for Certified Schools, which required the appointment of a medical officer for the school who would issue quarterly medical reports on the sanitary state of the school and the health of the children. The circular continued: It frequently happens that the Quarterly Medical Return furnished by a School to this Department states that no children, or merely a small number, are suffering from disease, while the inspection by the Department’s Medical Inspector carried out at the end of the quarter in question, reveals that a much larger number of children are suffering from diseases. It should be clearly understood that the primary responsibility for the health of a School rests on the Resident Manager and on the School Medical Officer. The function of the Department’s Medical Inspector in this matter is to satisfy herself that their arrangements for keeping a watch on the children’s health and providing medical attention where required are working satisfactorily.

The annual reports of the Department of Education frequently refer to the fact that the medical inspector had viewed the quarterly medical reports kept by school Managers in consultation with the local medical officers. Furthermore, despite what appears as initial resistance to their use by some school Managers, Dr McCabe was able to cite evidence from medical records as proof of underfeeding in schools in the mid 1940s.

Not all schools were inspected each year, as required by the legislation. The frequency of school inspection varied from school to school and from year to year and some schools were visited more frequently than others.

For example, Baltimore school was subject to three inspections in one year (1947), while Artane went three years without any inspection (1950-52). The records did not reveal why some schools were inspected more often than others. In certain cases complaints or issues of a serious nature were brought to the Department’s attention and a special inspection of a school was ordered. Geography and accessibility may also have been a factor. In 1949, for example, no Industrial School in either Connacht or Ulster received a visit from a Department inspector. In the same year, the inspectors had five contact days (days where the inspector was present in a school to conduct a general or medical inspection or both) with Dublin’s seven Industrial and Reformatory Schools; seven contact days with the 12 schools in the rest of Leinster; and five contact days with the Munster schools. The following year, 1950, the number of contact days between the Department and the various schools revealed the following regional spread: Connacht (1); Dublin (1); Leinster (9); Ulster (2); and Munster (3).

Province	No of schools	Total no of inspections	Average inspections per school per year
Connacht	9	74	.82
Dublin	6	43	.72
Leinster	12	112	.93
Munster	21	146	.70
Ulster	2	14	.70
Total	50	389	.78

With regard to the rate of inspections Dr McCabe wrote in 1943: I agree that these institutions should be subject to frequent inspection – my practice at present is to pay a visit at least once a year to such institutions and if there is any need I revisit them within three or four months to find if my instructions have been carried out.

The figures show that in the 1950s the average number of inspections increased significantly. By the 1960s the number of inspections fell again, to below 1940s levels. There were on average 0.78 inspections per school per year during the 1960s, although the number of schools decreased steadily in the second half of the decade as a result of closures. Another reason for the decline in inspections at this time was the retirement in the mid-1960s and non-replacement of Dr Anna McCabe as Medical Inspector.

144 inspections for 32 schools were carried out during the 1970s, representing an average of 0.45 inspections per school per year. The lowest point was 1975, when the Department inspected no residential or special school.

A significant limitation that runs through the school system was that the Department’s inspectors were in no position to promise or provide additional resources to schools to enable them to address shortcomings and bring about improvements. Inspections and action taken on the basis thereof were pursued within the context of the available resources at the relevant time. The focus was confined to material and physical aspects of residential care and, until the establishment of the Child Care Advisor, was without reference to the developmental and emotional needs of children. It would appear that, in the main, schools were given advance notice of inspector’s visits and residents have described how, as a result, proper blankets, eiderdowns, dishes – never otherwise used etc. – were all on display. However, unannounced visits were not uncommon and were used on occasion to check on schools where concerns had arisen. The Resident Manager of Letterfrack, for example, protested that Dr McCabe periodically visited the school unannounced.

Instances of abuse would not normally be brought to the attention of inspectors during the course of a routine inspection of a school. Occasionally, as in Newtownforbes in 1940, inspectors identified evidence of mistreatment, and in this case the threat of censure was mooted: ‘I was not satisfied in finding so many of the girls in the infirmary suffering from bruises on their bodies’, Dr McCabe informed the Resident Manager in a letter: ‘I wish particularly to draw attention to the latter as under no circumstances can the Department tolerate treatment of this nature and you being responsible for the care of these children will have some difficulty in avoiding censure.’

However, most of the abuse cases were not discovered as a result of normal school inspections.

Official concern at conditions in the school – and also the incomplete character of the information available and perhaps a feeling of helplessness – was apparent from the response of the senior childcare officer in the Department of Health to the medical report of the death of a child in St Joseph’s Ferryhouse. She wrote: This shocking report confirms some unofficial information that I have had over the years concerning Ferryhouse...from what I have heard the ill treatment of the boys could do with investigation also. One person who spoke to me about this matter was an inspector of the ISPCC. It is scandalous that only the death of one of the boys has led to the conditions there coming to light.

Sometimes particular complaints or episodes were serious enough to lead to an inspector’s being sent to make a more wide-ranging investigation than the usual regular visit. The following are examples from the Department’s records.

In Rathdrum in December 1947 a child of three was put in to a very hot bath and died a few days later from his injuries. Dr McCabe was sent to inquire and discovered that at the time the victim was in the care of a 14½-year-old laundry maid. The school was inadequately staffed, partly because the 14 nuns in the Rathdrum Convent were old and incapable. The next month Dr McCabe returned to see what improvements had been made and wrote the following internal report: I informed the Resident Manager that I did not consider she had sufficient staff at present and that she should employ at least two extra helpers immediately, one religious if possible and the other a capable woman with experience of children. She told me she accepted this suggestion and would try to meet my requirements. She then informed me that she expected a castigation since the school had been ‘in the news’ so often. I told her that the most recent episode amounted, in my opinion to criminal negligence... I then informed her that I had given her one last chance to remedy her deficiencies and that if the school had any further complaints, which on investigation proved to be true that I would ask for her removal. Also I informed her that I would like to see the Mother-General in Carysfort and ask her aid in insisting on this Resident Manager carrying out her duties properly. One facet of the resident manager I do not like is that she is inclined to be parsimonious and grasping about money and again on this occasion she said the grant was not adequate. I told her not to talk nonsense that schools catering for big boys 10-16 years could very well manage and that these boys eat far more than little boys and required more clothes! I consider it would be well to follow up my visit with a letter insisting on my suggestions being carried out and warning the resident manager that if she cannot cope with the situation she will have to be replaced.