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that the sanitary work of the last 30 years has done much to reduce the mortality from phthisis, and I
believe that still better results will be attained when a stricter supervision can be exercised over
the inhabitants of tenement houses, to obviate overcrowding and dirt. To reduce the mortality
from the tubercular diseases of young children, I think more attention will be required to be given
to the milk supply. I am of opinion that the time has come when milk should be systematically
examined by the bacteriologist—not only to prevent the spread of tuberculosis and other diseases,
but also to secure the supply being clean and wholesome.
The duty is laid upon me by the Local Government Board to point out what I consider to be.the directions in which the hygienic control of the Borough requires to be extended. At the present
time I would respectfully urge upon your consideration three questions. I refer to (a) the
undue proportion of infants dying in the first year of life; (b) the supervision of houses let in
lodgings, or tenements; and (c) the supervision of workplaces. To deal with the first, I believe
one, if not two, female inspectors are required. They should be nurses as well as inspectors,,
women who can not only point out mistakes in feeding and tending infants, but give instruction
in right methods.
From the work which has been accomplished during the past four or five years in the registration
and supervision of tenement homes, I am convinced that good results can be obtained by a full
use of the powers vested in the Council under the Public Health (London) Act, 1891. I should,
however, like to see this work of supervision carried out concurrently with the provision of more
homes, and I may perhaps be permitted to express my satisfaction that this latter subject has already
engaged your attention. At the same time, I hope that you will place me in a position to carry
out the proper supervision of all tenement houses. If this is to be done, the Staff of the Department
must be increased, and I would respectfully commend this matter to your consideration.*
The present office accommodation is quite inadequate to the work which has to be carried out, but
that defect will, I hope, be shortly remedied. The Officers and Staff of the Department have
done their work well during the year.
It affords me much pleasure to refer to the sympathy and co.operation which I continue to
receive from my professional brethren practising in the Borough.
In closing these introductory remarks, I desire to place on record my sense of gratitude to the
members of the late Sanitary Committee of the Yestry and of the Public Health Committee of the
Council. I am especially indebted to the Chairman of both the Committees, Sir George D.
Harris, J.P., &c., for his cordial sympathy and support. If I may be permitted to say so, it has
been a pleasure to serve and work with the Chairman and the Committee, and I trust that our
present relations will continue for many years to come.
I have the honour to be,
Mr. Mayor and Gentlemen,
Your most obedient Servant,
m.a., m.b., d.p.h.,
Medical Officer of Health.
Public Health Department,
Town Hall, Paddington.
June, 1901.
* The inspection of workplaces has hitherto been very imperfectly carried out, being attended to only when,
other work could be safely set aside for the time being.