• J Gardemann.
• Akademie für öffentliches Gesundheitswesen, Düsseldorf.
• Gesundheitswesen. 2001 Nov 1; 63 (11): 658-66.

AbstractThe circumstances of life and the health status of children and adolescents in Germany have undergone fundamental changes. Public institutions, such as schools or kindergartens more often are not only support but a substitute for family structures. Individual medical care being guaranteed, seeking for prevention and treatment and health status differ widely according to sociological patterns. Health care and social compensation programmes on a multiprofessional basis will thus be accessible only in a very general sense to all youth at the public institution of a school. Besides all the general public health programmes in schools, medical expertise on an individual level is becoming more and more important because of the increasing number of classes integrating diseased and disabled children in regular school. The public school health services will not only act as individual medical experts themselves but more as coordinators of all medical and health promoting efforts on an administrative, school, inpatient and outpatient level. Medical professionals working in public school health services will therefore have to be trained in the following spheres: normal range of developmental milestones, knowledge of health systems and regional structures of health care, epidemiological basics, communicative and social training, clinical expertise in the fields of general paediatrics, child psychiatry and occupational health. Being fully trained in clinical paediatrics and public health will surely be an asset, but will not cover all the requirements for successfully working in school health care. For this reason the programmes of higher education in public health have to be adjusted to the recent demands in this special field of work. School health services will have to engage in occupational health and will have to be present mostly in the school buildings proper. School health services will have to report and publish epidemiological data for use by school, community and medical professionals. In case of continued compulsory medical examination of schoolbeginners wide use should be made of qualified assistant personnel, so that physicians can focus on true medical problems in school and moreover will be enabled to deliver medical expertise and treatment within the community to people and population groups in need.

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