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xi
The figures for Oldham, a manufacturing town of 140,969 inhabitants, taken by
themselves, support the view that much good has been done by health visitors.
The average mortality rate for infants for ten years previous to their appointment
was 180 per thousand births, while the average rate for the five years ended 1906
was 152. There is, however, another side to this picture, for I find that in
Camberwell for the same ten years our rate was 155.7 per 1,000, while the average
rate for the second period ended 1906 was 134.1. Had we gone down in the same
ratio as Oldham our figures would have been a little under 132. The strong
support which was, apparently, given by Oldham's figures is much discounted, for in
Camberwell, with no visitors, we did very nearly as well.
Of the London Boroughs, the following had appointed health visitors in
1906:-
Bethnal Green.
Hampstead.
Woolwich.
Hammersmith.
Kensington.

The London Medical Officers of Health, where health visitors have been appointed,
speak highly of the work they are doing, with the exception of Hammersmith,
where the Medical Officer finds that instead of a decrease following their
appointment an actual increase was registered.
It frequently happens that children are left for a greater part of the day to the
care of a foster-mother, while the proper parents go out to work. Hence it will be
necessary for the health visitors not to confine their duties to the proper mother, but
also to instruct the foster-mother. I mention this point as an example to show that
the visiting is not such a straightforward business as might be imagined.
It seems to be fully recognised that permission to adopt the Act will be made
conditionally of the appointment of health visitors, otherwise we should gain some
advantage by its adoption, inasmuch as we should then obtain information of the
locality of births without any expense.
It will be remembered that it was agreed that I should try and obtain particulars
among the employers of women shortly before and after childbirth ; this enquiry
was to have begun in January, but I have delayed making a start in order to ascertain
whether there is any chance of the Act being adopted, and thereby saving the borough
the expense of twopence for the particulars of each birth.
In conclusion, taking the actual results which have been obtained by those
Boroughs who have appointed health visitors and those who have not, I am bound
to come to the opinion that the advantage of their appointment is not proven, tor in
Camberwell, where we confined our attention to sending out a pamphlet on Infant
Feeding," using some discretion as to where they were to go, we make by no means
a discreditable appearance.
(Signed) FRANCIS STEVENS, Medical Officer of Health.
A complaint was received from the Works calling
attention to the nuisance caused by the sorting of dust at Nunhead
Station. I visited the premises, and was of opinion that, taking