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B. ADMINISTRATION
I.—GENERAL.
Staff of the Department.—Mr. S. W. Wingfield (one of the Inspectors of Houses let
in Lodgings), who joined up in 1914, resigned his appointment under the Council in August,
1919. Miss Durant, the senior Health Visitor, resigned in November, 1920. Neither vacancy
had been filled at the close of 1920.
Prevention of Infectious Disease. — Table XXII., Appendix, shows very clearly
the amount of work accomplished during the past two years and only a few words in
amplification are necessary. During 1909-13, the enquiries made by the Inspectors—male
and female—averaged 10,662 per annum, rose to 10,876 during 1914-18, and fell to 8,108
in 1919 and 8,280 in 1920. The reduction in the number of enquiries in connection with
tuberculosis is due to the opening of the two Dispensaries.
The admissions to hospitals—of all descriptions—in 1920, notably exceeded the annual
averages for 1909-13 (666) and 1914-18 (618).
Disinfection.—The weight of goods removed by the Contractor has been reduced by
change in practice, disinfection of beds, etc., after measles and cancer being no longer a
matter of routine. The increased charges for the work necessitated by post-war prices
have resulted in an increase in expenditure by some 60 per cent., notwithstanding the
smaller weight (over 16 per cent, less than the 1914-18 average) dealt with.
Bacteriological Work.—The total number of specimens examined annually averaged 471
during 1909-13 and 676 during 1914-18. The total for 1919 (635) was slightly below the
latter average, but that for 1920 (1,600) was much in excess. The great increase in 1920
was due to extensive "swabbing" of suspected cases of diphtheria, including carrier cases.
Diphtheria.—Of the 1898 "swabs" submitted during 1919-20, 225—11.8 per cent, only—were reported
to be positive, i.e. to contain the Klebs-Lofflcr bacillus. Such proportion of positive swabs was much below
the proportions recorded during 1909-13 (20.8 per cent.), or during 1914-18 (16.7 percent.).
Enteric Fever.—Of the 8 blood specimens examined during 1919-20, 3 (37.5 per cent.) gave Widal reactions,,
the corresponding proportions for 1919-13 and 1914-18 being 39.0 and 32.5 respectively.
Tuberculosis.-—The number of specimens of sputum received in 1919 (144), was notably less than the
annual average (215) for 1914-18, and although the total increased to 173 in 1920, that figure was far below
the average. The figures given here cannot be accepted as evidence of neglect of the microscopical examination
of sputum as an aid to diagnosis. The Dispensary Medical Officers make use of the test—performed at the
Dispensaries—and doubtless many general practitioners do their own microscopical examinations. The
proportion of "positive" examinations—58 out of a total of 317—during 1919-20 was 18.2 as compared with
23.3 during 1914-18, and 21.3 during 1909-13.
Miscellaneous.—Included among the 12 miscellaneous specimens examined during the two years, were
six of Japanese shaving brushes. The anthrax bacillus was found in two of the specimens.
Schools.—The ratios given in Table XXIII, Appendix, are based on data derived from
"Form 84" received from the schools. The ratios (rates per 1,000 places provided) show how
the diseases mentioned have varied from year to year since 1914. The rates for 1919 were
in general below the averages for 1914-18, whereas those for 1920 were, with exceptions, higher.
The figures show that as a rule the diseases specified are more prevalent in the Provided than
in the Non-provided Schools—verminous conditions being, however, an exception. No
suggestion can be offered in explanation, unless it is to be found in the fact that the Non-provided
are much smaller than the Provided Schools. In the former class (17 schools) just over 8,500
places are provided, averaging 500 per school, while in the latter (8 schools) the average is over
1,300 per school.
In the course of the two years over 8,000 "exclusion forms" were sent to the schools
within the Borough, 1,719 relating to notified diseases (other than measles) and 6,309 to
measles, whooping cough and chickenpox. In addition 537 notices were sent to the Medical
Officers of Health of the circumjacent districts relating to children living in Paddington but
attending schools in those districts.