The School Health Service was introduced in response to the scandal that hit society when it was realised, at the beginning of this century, that three in five men called for armed service in the Boer War were unfit to fight. The Government set up a committee to look into the causes for this 'physical deterioration'• At that time women had no financial support from the Government in pregnancy, infant welfare clinics had not been started, family planning could not be discussed in public, sick women and children were obliged to turn to charity. The School Health Service, with its emphasis on detecting defects and referring to minor ailments clinics was a first-aid service in response to a crisis situation) It took pioneers many years of campaigning, of facing public abuse, of Parliamentary dialogue and reform, to produce the far-reaching changes in the fabric of society which gradually reduced the ravages of poverty, malnutrition and infectious disease. Today, services caring for women consider their health even before conception• The family doctor and community child health services are freely available to parents and their children from birth to adulthood• With such extensive change, the continuing need for a School Health Service has been widely debated over the past 20 years. After extensive enquiry, the Court Report, 19762 unhesitatingly recommended the continuation and development of the service and even recommended that every child should have a statutory examination six months prior to school entry. A decade later, the report of the National Children's Bureau (NCB) 'Investing in the Future, '3 again reiterated that there should be • . . 'a comprehensive examination of all primary school entrants, round about the age of five years, by the doctor and nurse . . , with parents present. Thereafter, the doctor should see children at parent or teacher request rather than routinely.' The report also recommended 'a routine health interview between thirteen years and a year before leaving school for all pupils' with an open-door arrangement for confidential counselling• Practice throughout the UK has not been standardised. The National Working Party on Child Surveillance in their draft report (1988), 4 discussed procedures with the under-fives in great detail, but only outlined the development of work amongst school-aged children. The assessment which follows was prepared to demonstrate the numbers of children and types of problems meriting surveillance in a school entry group and in year groups at more advanced stages of their schooling. This work is presented as one example of how the refined recommendations of the NCB report, evolved from those of the Court Report, work in small prosperous towns in the South East of England. It must be stated from the outset that, after their extensive review of children all over the UK, the Court Report stated that 'the majority have exchanged stability for prosperity, and the minority are as disadvantaged as ever'. Subsequent work 5,6 has confirmed the effects of disadvantage on child health and recent evidence suggests that as many as one in four, or even one in three children in Britain today lives in poverty. The greatest causes of poverty are the