The weekly medical exams are a major clue that this is not a normal school. No normal school requires weekly medical examinations out of concern for its students. That would not only be cost prohibitive, it would also be far too time-consuming. As long as students are basically healthy, the teachers would be far more concerned with their academic performance and progress than with weekly health check-ups. This excessive concern for their short-term physical well being is a clue that student academic performance is not the primary concern of the guardians of the school. The guardians are more apparently concerned with bodily health than with mental acumen and academic progress.
A second red flag is the Hailsham guardian's excessive concern with creativity in artistic achievement. Art would be a creative elective or perhaps another valued course at most good schools. Good artists would be encouraged and others would be encouraged to continue to improve or perhaps to focus on other talents. Not so at Hailsham. The fact that lack of artistic creativity is a major concern for both faculty and students reveals that this is a major value. Why? Could it be imposed upon the school by the guardians, perhaps reflecting the requirements of the school's clients. What clients? This is another red flag.
The constant surveillance at Hailsham is another clue that the creators of Hailsham have another objective aside from the well-being of their charges. Why waste the resources ensuring there is a complete lack of privacy if this is simply another school for children?
Madame's gallery and her fear of the students is another indicator that the school has an external focus beyond the needs or requirements of the students themselves. The gallery is, in fact, a showroom for outside clients. It functions as a catalog or brochure for clients to browse and select from.
The medical, academic, recreational, and other care at Hailsham is only necessary at a certain level. Beyond that, it is just an elaborate ruse to lull the children into a false sense of security and to help the guardians sublimate or assuage their guilt for using their charges as short-term tissue factories.