Introduction

This article was originally commissioned as ‘Do we still need school doctors?’ The problem with this title is that it carries some historical presumptions that deserve further examination in their own right. We also need to look more deeply at the issue of children's current health needs at school-age and how best to address these in a whole system, which includes clinicians working in or for schools.

Until recently, the tendency has been to fail to see children's health in terms of family, school and community environments that interact to affect the whole child and thus health outcomes. The French philosopher Michel Foucault, understood this when he described the way modern medicine and medical practice initially evolved into a description of categories of illness rather than ecologies of care, the latter being the predominant paradigm across several centuries earlier.1

From the 1970s, Urie Bronfenbrenner rekindled interest in ecological systems theory. He described the intimate relationship between the wider environment and the family and the family in turn with the child. Bronfenbrenner's ecological description of child health provided the impetus behind creation of the Head Start programme in the USA and, in turn, the foundation for the Sure Start programmes in the UK.2

In 2000, From Neurons to …