[School health services in Israel: past without future or future without past?]

This editorial is a commentary on an article published in this issue of the journal describing and analyzing telephone interviews on knowledge and attitudes of both teachers and parents of elementary and high school pupils, regarding provision of School Health Services (SHS) in Israel. The editorial presents, in a nutshell, the history of SHS since its founding in 1919 by "Hadassah" and under the jurisdiction of the Ministry of Education since the establishment of the State of Israel in 1948. As a result of an amendment to the National Health Insurance Law in 1997, the SHS has become the responsibility of the Ministry of Health. In the 10 years that followed, the Ministry of Finance conducted profound cuts to the SHS budget, reducing its manpower in spite of the gradual increase in the student population and addition of many schools and classes throughout the country. The parents' interviews were performed at the nadir of the SHS budget and manpower, three months before the implementation of the government decision to privatize the service--a first of its kind, on 10 April 2007. The current SHS in Israel is actually conducted without the role of "school nurse" which was replaced by a team of physician and nurses entering the school or a class to perform activities instructed and supervised by the Ministry of Health. This is contrary to the world trend to strengthen SHS e.g. the WHO initiative of Health Promoting School project and the establishment of School Based Comprehensive Health Centers in the USA. Time will tell as to what will be the impact of the new system on the health of school children in the long run.