Chapter 1 — Department of Education

Part 5 The inspection system

Following Dr McCabe’s retirement in 1965 the Department of Education left the post of Medical Inspector unfilled until the appointment of Mr Graham Granville in 1976. In the intervening decade a number of changes took place. In the absence of a dedicated Medical Inspector, inspections were initially augmented by, and then replaced with, medical reports by medical officers retained by each individual school. From 1961 to 1963, these medical reports were submitted to the Department on a quarterly basis. From 1963 to 1978, the medical reports were submitted on a twice-yearly basis.

The benchmarks for standards of residential care were set out in the Rules and Regulations that were issued to school Managers by the Department on certification. Department circulars were issued from time to time to supplement them.

The general inspection covered premises including playground, dormitory, kitchen; living conditions generally such as clothing or diet; as well as staff and accounts. The report was based in part on a printed checklist with entries for accommodation, equipment, sanitation, health, food and diet, clothing, recreation facilities and precautions against fire. The reports were impressionistic in character – they were structured so as to give a general account of conditions within a school, dealing generally with the quality of residential care provided and the condition of the children. They left out everyday treatment, including corporal punishment. They did not give detailed information and did not deal with policy matters.

The inspectors’ reports were not published. If a school was satisfactory, the inspection would result in only a short record. After the particular headings, there was a section for general observations and suggestions, which might be as brief as ‘well-run school’. On the other hand, where there was something wrong, these observations could run for several pages. Comments in inspection reports under the various headings ranged from excellent to fair to poor. Where standards fell below what was expected (e.g. inadequate diet) the Department wrote to the Resident Manager in the school with a view to having this rectified, though with mixed success.

The Cussen Report (para 86) was critical of the inspection system operated by the Department of Education up to that point. Cussen described as ‘unsatisfactory’ the system of medical inspection in schools and urged that, in addition to the medical examination of children on admission, a periodic medical examination should be carried out by a doctor ‘specially trained in the diagnosis of children’s diseases, physical and mental’. In response, Dr Anna McCabe was appointed in April 1939. One part of the medical report was a checklist focussed on the health of individual children, with headings such as teeth, thyroid, nail biters, stammer, eyesight.

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.