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ii.
to the remarks re "Hopeless Births " (see page 41). The deaths of the children there referred
to are due to ante-natal causes, and not to maternal ignorance or neglect. The figures given
suggest an increase in the mortality rate from such deaths, accompanying a decrease in that
due to post-natal causes. Much, it would appear, remains to be attempted to secure the
preservation of infant life-—a work rendered increasingly urgent by the continued, and
apparently accelerating, fall in the birth-rate.
In earlier (special) reports attention has been directed to the need of supplementing the
crusade, on general sanitary lines, against consumption, by the adoption of special efforts
directed against the disease itself. For that reason the Order of the Local Government
Board requiring the notification of pulmonary consumption in persons in receipt of medical
relief, is to be welcomed not onlv for the greater knowledge of the disease which will accrue
from the working of the Order, but also as an earnest of further steps towards the general
notification of the disease. Last vear was, as far as the Borough is concerned, signalized by
the opening of the Dispensary for Consumption—the first in England. I regard that event as
one of the first importance, believing that the " Dispensary System," worked on proper lines,
will do much to limit the spread of the disease, and be of great utility in its treatment. I do
not think that that system is, of itself, able to stamp out the disease ; it can only do its part
in the co-ordinated scheme for so doing. Dispensary work will give more certain information
of the prevalence of the disease, and will make it easier to understand what steps are
necessary to be taken in the direction of hospital provision, &c. Last year there were
161 deaths from consumption. The total number of known cases ("definite" and "suspect ")
was 801, 72 of the patients dying during the year. From a comparison (not given in the report)
of the age-distribution of the remaining 89 deaths, and of the occupations of those deceased
persons, it seems reasonable to conclude that the 89 deaths represent cases in much the same
stations of life as the 72 deaths which occurred among the reported living patients (801).
If that conclusion be right, it is possible to tentatively suggest that the 161 deaths represent
some 1,600 cases of consumption; in other words that the number of consumptives living in
the Borough at any time—in various stages of the disease, not all necessarily capable of
spreading infection—is ten times the number of deaths recorded during the year.
Last vear was marked by the passing of legislation from which much is expected—I mean
the Housing, Town Planning, &c., Act, 1909. The transference of certain important
administrative work under the Housing Acts from the Police Courts to the Council, will
greatlv facilitate the task of dealing with unhealthy houses. It will, however, take some little
time to find out what powers the new Act gives. Indeed it is very probable that an
amending and codifying measure will be necessary to render workable the new machinery
provided. I think it will be advisable to proceed very cautiously in making use of the Act,
and I trust that, should the results appear to be disproportionately small during the first year
or two, the seeming inactivity will be attributed to caution, and not to neglect.
The Staff of the Department underwent some changes last year, two of the Inspectors
retiring under the Council's Standing Order relating to age. Neither of the vacancies was filled
up, the retiring Inspectors'duties being distributed among the rest of the Staff. Until last year
the Department has been able to secure the services of Women Students, who have greatly
helped the Women Inspectors, but during the greater part of last year no Students were
available. If Students cannot be relied upon, much of the work with reference to infants
will, of necessity, have to be given up, as, even with the help of the Health Society's Visitors,
the Women Inspectors cannot do sufficient visiting to ensure a continuance of the progress in
the improvement of child-rearing which has taken place.