Both. They often refused to ring me when she was in severe pain or ill. Once they did ring, but when I got up there I was met by the secretary who gave me a long rant about how she did not believe dd was really ill at all- all very loudly and in dd's hearing (she had an ear infection and a high temperature). But of course, their story was that they never noticed dd having episodes in school.
When the paed came to the school and explained about dd's extremely painful chronic condition (3 years after she had first explained it in writing), the only question put to her by the school was "how can we know she is really in pain?". In other words, yes, you have explained that this condition causes severe pain, but we still think she could be lying through her teeth- how do we know?
They refused to let her use the disabled toilet though she was in a wheelchair - she had to crawl on her hands and knees to use the ordinary toilet. When she was unable to make her way up the stairs to access her maths class, they left her sitting in a classroom alone doing worksheets, instead of either moving the sets round so her set was on floor level or letting her change sets. When we complained, the explanation given was that dd "refused to go upstairs" (she was in a bloody wheelchair!).
So yes, dd definitely knew what they thought. And had to sit through interminable lectures on attendance. And noticed when the Head sent Social Services round. And of course, she read her own report card.
Throughout those years, I (and dh) did everything in our power to make the school see I was not a loony. We attended innumerable meetings, we sent in every scrap of medical evidence, we arranged for the paed and the OT to visit the school, we rang the school office every morning for an update when dd was off, we did everything in our power to make sure she was not behind in her education. But we could not give the Head the one thing he wanted: a perfect attendance record. So he wanted us out. 
Perhaps we should have moved her. But I really did not see why she should have to move from her local school, away from all her friends, when she had done nothing wrong.