First, the vast majority of them have little professional expertise or background in such services. This means they are simply not in a position to oversee, for example, the clinical decisions of medical professions. Second, there are clear questions of liability should things go wrong. Third, there are significant potential conflicts of interest especially around the 'image' of the school and the sorts of advice and service that may be necessary around sexual activity, drug usage and so on. For these reasons, school-based clinics have largely been organized as independent facilities within school campuses.
Similar issues arise in relation to other services.
Learning collaboration . Schools have to learn to work in different ways, and to accommodate the requirements of other professionals. They have tended to be little fiefdoms, isolated to a significant extent from the direct interventions of other professionals. Where schools have had to work with other agencies their relative size, statutory nature and high degree of control over what happens within their walls have often made them difficult partners. Things have tended to be done on their terms or not at all.