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14
Mental Deficiency Act, 1913.
Information was received by the Clerk of the Asylums and Mental Deficiency Committee, from
various sources, of alleged mental defect in 435 cases during 1917, and 347 of these were dealt with by
the local authority. The remainder were still under consideration at the end of the year or were otherwise
disposed of. Among the 347 cases dealt with, 165 were sent to institutions, 170 were placed under
supervision, 8 were placed under guardianship, 26 were sent to places of safety pending the presentation
of a petition, and 12 were referred to the Poor Law.

Midwives Act, 1902.
The number of midwives with London addresses excecds 5,000, of whom 554 notified their intention
to practise in the county during the year. Of these, 359 were enrolled as a result of examination,
150 held a certificate of training, granted before the passing of the Midwives Act, and 45 were in bona
fide practice for at least a year before the Act was passed. During the yfcar the title of the inspectors
of midwives was changed to that of "medical inspectors" and the number increased from 2 to 4.
1,662 inspections were made during the year.
The number of births notified under the Notification of Births Act, 1907, by ceitified midwives
during the period under review was 37,822, and 3,159 notifications were received by the Council that,
medical aid had been advised by ceitified midwives. The occurrence of 551 stillbirths was reported,
the foetus in 305 cases being macerated and in 234 cases not macerated ; in 12 cases no particulars were
given. During the year inquests were held on the bodies of 3 women and 77 children, arising out of
cases in which certified midwives had been in attendance.
Under the Order made by the Council extending the provisions of Section 55 of the Public Health
(London) Act, 1891, to ophthalmia neonatorum, 641 notifications were received, 238 being in respect
of cases in the practice of certified midwives. Of this number 215 were curcd, impairment of vision
resulted in 7 cases, 5 infants died and in 11 instances information could not be obtained owing to the
removal of the parents.
In all, 199 cases of puerperal fever were notified in the county, and the Registrar-General
records 115 deaths from puerperal septic disease. Of the notified cases, 75 proved fatal, the
remaining 40 deaths recorded by the Registrar-General not having been notified. If these 40 cafes
be added to the 199 notified cases, a total of 239 cases is obtained, 71 of which occurred in the
practice of certified midwives. The Registrar-General also records 163 deaths from other accidents
of childbirth, of which 14 were in the practice of midwives.
The establishment of prima facie cases of negligence and misconduct on the part of 14 midwives
was reported to the Central Midwives Board, the names of nine being subsequently removed from the roll
of midwives. The remaining five were cautioned, subsequent reports as to the conduct and methods of
practice of four of them being required by the Board at the expiration of three months and again at
the expiration of six months from the date of the hearing of the charges. One midwife voluntarily
surrendered her certificate of enrolment. The name of a midwife who had on a previous occasion
been cautioned by the Board and against whom further irregularities were alleged, was removed at
her own request from the roll, the Council raising no objection to this course on the understanding that
her name would not at any future period be restored to the roll without the Council's knowledge. The
name of a midwife was removed from the roll in consequence of her conviction for an offence.
At the end of the year, 222 lying-in homes remained on the register, 45 having been added during
the year and registration in respect of 6 having either been cancelled or the use of the premises having
been discontinued.
Maternity and Child Welfare.
In 16 boroughs voluntary schemes are in operation ; in one an official scheme, and in 11 both
official and voluntary schemes. In connection with this work some 49 whole time and 23 part time
health visitors are employed by the borough councils, and in addition the various voluntary agencies
contribute a large staff of workers. Ante-natal work is undertaken in practically all the boroughs and
arrangements are made for hospital treatment where necessary. The work of the Council's inspectors
under the Midwives Act stands in close relation to that, of the several Maternity and Child Welfare
Centres, and the Local Government Board recognises this work for the purposes of grant.
Census of Homeless Persons.
In accordance with the practice which has obtained for several years, a census of homeless
persons in the county of London was taken on the night of 9th February, 1917. The area covered was
practically coincident with the area covered at previous censuses. The night was moonlight and frosty.
As on previous occasions the homeless persons were mostly found in the more centrally-situated
districts. Persons sheltering under arches or on staircases totalled four—all females—the lowest number
yet recorded
The homeless persons in the streets also showed a considerable reduction. On the night in question,
19 men and 5 women were found, as compared with 21 men and 16 women in 1916, and 296 men and
76 women in the early part of 1914 before the war.