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73
Report of the County Medical Officer—General.
City of Westminster.—Women are now in training as home helps and a register is kept of women
fitted for such work. Expectant mothers are visited. Mothercraft classes and infant consultations
are held. A creche has also been established. There are three clinics for children under school age
where the children are medically inspected, and a continuous record is kept. Dr. Allan in his report
gives details as to physical defects found at these examinations and points out that, in addition to the
preventive work done in the direction of diminishing the diseases due to improper feeding, an amount
of hospital treatment has been obtained for children with defects. Special attention is also given to
children of tuberculous parents and to suspected cases of tuberculosis and the information obtained on
these points is passed on to the school doctor when the child reaches school age.
St. Marylebone.—The borough council has formulated a scheme for linking up a maternity and
general hospital with infant consultation centres and schools for mothers, and with the public health
department. At present the women sanitary inspectors and health visitors supervise infant welfare,
and attend clinics and schools for mothers. When the scheme is fully in operation it is intended that
one of the women sanitary inspectors shall devote her whole time to this work.
Paddington.—A voluntary organisation has founded a school for mothers, and an additional
woman inspector has been appointed who visits newly born babies. Arrangements are being made for
extending help to expectant mothers. Consultations have been established at three centres, weekly
in the case of babies, monthly for older children. Cases requiring treatment are referred to hospitals
or private doctors.
Finsbury and Shoreditch.—In both cases the borough councils have decided to establish centres
and premises have already been taken.
Holborn.—The Passmore Edwards School for Mothers (Baby Clinic) is open every Monday afternoon,
and there is a needlework and instruction class for mothers every Wednesday afternoon. Dinner
tickets are given to poor deserving mothers, and modified milk is supplied at 4d. a day, and some parents
are assisted to pay this amount.
Proposals have been made to establish clinics for expectant mothers in Marylebone and
Woolwich.
This statement does not cover the whole of the work now being done, but is indicative of the
action being taken. A full account is given in a carefully compiled table published in the report of the
Medical Officer of Health of Bethnal Green. Infant consultations and baby weighing centres under the
control of the medical officer of health assisted by the health visitors and women sanitary inspectors
have been generally adopted throughout London. In one or two instances arrangements for the supply
of milk have also been made. As regards pre-natal work there is evidence that the subject is receiving
careful attention, and it may be expected that when the existing strain on the resources of the country
is relaxed, practical steps will be taken to deal with this important question.
Midwives Act, 1902.
The number of midwives giving addresses in London whose names appear on the Roll of Midwives
for 1914 is 4,949. This number includes midwives who may have removed from the
County, but, owing to the fact that they are not practising, their present addresses have not been
reported to the Central Midwives Board, and consequently appear as London addresses. Of this
number. 580 notified their intention to practise during the whole year or for shorter periods.

The midwives in classes (a) and (b) are entitled to use the description "certified midwife by
examination." Of those giving notice of their intention to practise, the untrained midwives, class (c)
represent 13.6 per cent. The 580 midwives who gave notice of intention to practise cannot be taken as
the number actually practising in the County. In some institutions it is the custom for a midwife to
act as an assistant for three months or less after she is qualified, and her place is then filled by another
newly qualified assistant, who in her turn gives notice of intention to practise. At any given time it may
be estimated that some 400 to 450 midwives, or about 10 per cent. of those on the roll are in actual practice
in London. The remaining 90 per cent. act for the most part as monthly or general nurses under medical
supervision. Of the practising midwives 37 were working entirely within poor-law institutions or lyingin
hospitals and were under medical supervision; 76 others were attending patients on behalf of
27715 l