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64
It is satisfactory to note that, despite the exceptional fatality from this one group of diseases,
the infantile mortality of 1906 compares very favourably with the decennial average, having been
indeed the lowest on record ; to wit 132 deaths under one year of age to every 1,000 births
registered, as compared with an average of 158 per 1,000 in the preceding ten years. Infant lives,
therefore, to the number of 90. may be regarded as having been saved in the year, and the number
would have been greater but for the abnormal fatality of diarrhceal diseases. This satisfactory
result may, I believe, be fairly attributed, in some measure, to the work of the health visitor, a fact
which cannot be other than gratifying to the Council, and to the Public Health Committee upon
whose advice the appointment was made, in March, 1905—a year in which, also, there was noted a
considerable reduction in the rate of infantile mortality, as compared with preceding years.
With a view to effecting a permanent reduction in the rate of infantile mortality, two factors
of the greatest importance are (1) early notification of births, and (2) the appointment of a sufficient
number of health visitors to advise mothers with regard'to the care of their infants. As regards
notification of births, reference has already been made to the views of the National Conference
on Infantile Mortality, and to the Art by which this desideratum has been realized for the county
borough of Huddersfield.
The Council had previously (in 1904) taken action with a view to secure earlier registration
of births, in regard to which TheTimes, in the issue of 10th September, made reference as follows :—
" The lead which was given by the Kensington Borough Council in pressing for legislation
to secure an earlier registration of births, has been followed by practically all the other borough
councils. At the present time six weeks are allowed, in England, for the registration of the
birth of a child, and it has been felt that this period is too long, especially in view of the
heavy mortality among infants of a few weeks old. Three weeks has been suggested as the
utmost limit of time during which registration should be carried out in Seotland the
law only allows 21 days after the birth for the purpose.* An even earlier notification of birth
is desirable, as a lady health visitor may thus visit the home, and give the advice which
may mean all the difference between a weakling and a healthy child The notification,
of course, does not relieve the informant from the duty of registration, which must be performed
as well. It is confidently asserted tbat the earlier registration of births would, in some measure,
lessen infant mortality."
No one who heard the Inaugural Address of the President of the Conference, or his reply, as
President of the Local Government Board, to the Executive Committee of that body (vide page 62)
can doubt that the right honourable gentleman is in sympathy with all practicable efforts for
bringing about a lower rate of infantile mortality; and it may be hoped that this sympathy will,
ere long, find practical expression in Parliament, and lead to the passing of a Notification Act
on the Huddersfield lines, and amending legislation in regard to registration of births in accordance
with the views of the Council, whose "lead ", as The Times observes, " in pressing for such legislation,
has been followed by practically all the other metropolitan borough councils."
The subject of Health Visitors was considered by the Public Health Committee of the
County Council, when reporting on the recommendations, as to the legislation in public health
matters, which the Council should promote in the Session of 1907. They stated that the Council,
in 1900, on their recommendation, resolved to inform the Local Government Board that it " would
be willing to contribute in respect of salaries of female sanitary inspectors, who, in addition to
their other duties, would take opportunities of inculcating habits of cleanliness, and the best
methods of utilizing food. F urther duties (they added) would relate to the giving of advice with a view
to diminishing infant mortality, limiting the spread of infectious disease, etc." The Committee " deemed
it essential that such duties should be performed by borough councils through their inspectors," and
they stated that they were in communication with the Local Government Board as to the powers of
the Board with regard to the creation of a special class of sanitary inspector, whose duties would
be those of a health visitor, and who would act under the direction of the Medical Officer of
Health." They concluded by intimating that " in the event of the Board being unable to take any
action in this direction, they would deem it advisable, at a later date, to recommend the promotion of
legislation on the subject." The formal expression of the views of the Board on the subject will
be awaited with interest; there being reasonable ground for the expectation that they will be
favourable to the appointment of health visitors.
The Work of the Health Visitor.—I may be allowed to express my appreciation
of the Council's action in re-appointing our Health Visitor, Miss Gauntlett, in March,
for a further period of twelve months.t The only regret associated with her work
* In France registration must take place within three days after the occurrence of the birth. I recommended that
registration should be effected within seven days: notification within 48 hours would, obviously, more effectively secure the
object in view.
† Miss Gauntlett has since been placed on the Council's permanent staff.