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It is my opinion that the reduction in infant mortality, so
marked during the last three years, is largely due to this Order.
A favourite argument in favour of the appointment of health
visitors is based on the assumption that she will dispel the ignorance
of the mother, said to be a potent cause of a high infantile
mortality. If this be so one must be driven to the conclusion that
the mothers in many Yorkshire and other Northern districts are
much worse instructed than those of the agricultural districts of
the more southerly counties.
Proper and sufficient food is often far more necessary than
advice or medicine, and any scheme whereby the administrative
expenses for professional help are diminished, and the money thus
saved applied as a contribution to the supply of nourishment in the
really necessitous cases, may well be thought of when the idea of
new appointments and fresh centres comes under consideration.
It is usually claimed that they should be used as advisory and preventive,
although how these two can be divorced from treatment, except
theoretically, I know not. Their being used as treatment centres,
of course, tends to make people take the easier path and come to
depend on the municipality rather than going to their own doctor,
particularly when such benefits as dried milk, etc., at cost or
reduced price can be obtained. This can hardly fail to pave the
way for a policy of spoon-feeding and for a State medical service
for all—a consummation little enough to be desired. It is contended
that those who attend the centres are those who could not
afford a private doctor; but my impression is it is just the class
who could do so if they wished, that form the bulk of their clients;
but if my opinion be wrong, other and less expensive methods are
possible in aid of those who, by reason of poverty, cannot help themselves
but who need a helping hand.
Maternity centres have decided advantages, in that they are a
social meeting place for mothers, and the mild dissipation of a
cup of tea and a talk under comfortable conditions may well be a
pleasant interlude in an otherwise drab life. The social intercourse,
in the voluntary ones especially, with a number of self-denying
women who esteem it a pleasure to do work without fee, reward, or
political advantage has an immense moral and intellectual benefit,
and this is a strong plea for the policy of subsidising voluntary
centres rather than the establishment of municipal ones with thenpaid
staff.
A complete volte face in the policy of this Council as regards
the employment of health visitors took place in February, 1921. As
stated in the 1920 Keport, this matter came before the Public Health
Committee in December, 1919, on which I addressed to that body a
statement adverse to the appointment. The matter was then proceeded
with no further, but in January, 1921, the Maternity Committee,
surrendering a position which had so long and so successfully
resisted attacks, both official and non-official, from within and
without the Council, passed a resolution, which was affirmed by the