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voluntary workers, the majority of the work was devoted to classes and lectures and Government
grants were received from the Board of Education. In 1911 a Branch Centre was opened in the
Sands End district, and six years later another branch was opened in Eustace Road. The first
Ante-Natal Clinic was opened in 1915. In 1916 the Council appointed their two first full-time Health
Visitors.
In January, 1919, a scheme for maternity and child welfare work under the provisions of the
1918 Act was adopted by the Council and provided for the extension of the Council's co-operation
with the Voluntary Committee, for the payment of a grant to the Fulham Day Nursery and an
increased grant to the Fulham Babies' Hospital, both of which had been founded by Voluntary
Committees. Under the scheme a full-time Assistant Medical Officer for maternity and child welfare
work was appointed by the Council to replace the part-time Medical Officers employed by the Voluntary
Committee. The Council's Health Visitors were also deputed to assist in the clinic work at the
centres and two additional visitors were appointed. No monetary grant was made by the Council
to the Voluntary Committee, who relied on subscriptions, until 1922 when a grant of £100 was made,
although indirect assistance by the provision of Medical and Health Visiting Assistants had, as already
stated, been provided since 1919. This grant was increased to £375 in the next year, and to £500
in each succeeding year. As the work of the clinics increased, it was found that one Assistant Medical
Officer was unable to cope with the number of consultations necessary, and the Council's Assistant
Tuberculosis Officer was deputed to carry out a certain number of sessions per week. From time
to time local practitioners were employed on a part-time basis. The number of Health Visitors has
also been increased from time to time and now numbers eleven. On the 1st April, 1930, the Borough
Council, at the request of the Voluntary Committee, decided to assume full responsibility for the
clinic work, and since that date the work has been wholly carried out under the Maternity and Child
Welfare Committee. The weekly sessions now number, for children 13, for ante-natal treatment 8,
for post-natal treatment 2, and for dental treatment 2.
The extent to which the maternity and child welfare services are utilised by inhabitants of
Fulham has already been mentioned; during 1938 71 per cent. of the children born were brought
to the clinics for advice, and a total of 30,835 attendances was made by children under five years of
age ; 77 per cent. of the women of the Borough who were confined attended the Council's ante-natal
clinics, making a total of 5,946 attendances.
As already mentioned, the Fulham Day Nursery, which is under the control of a Voluntary
Committee, of which the Medical Officer of Health is, ex officio, a member, receives an annual grant
from the Borough Council.
The Fulham Babies' Hospital was established in 1916 by a Voluntary Committee to provide
primarily for the infants and children under five years of age suffering from nutritional and dietetic
disorders. When vacancies exist, other types of disorders are also admitted. The Fulham Borough
Council made a grant of £500 per annum to the hospital and for some years also provided the services
of one of the Assistant Medical Officers of Health as Medical Superintendent. During 1937 the Committee
of the Babies' Hospital felt that the time had come for the Borough Council to assume full
responsibility for the work they were carrying on, and as from 1st April, 1938, the hospital came
under the control of the Maternity and Child Welfare Committee.
Population.
In my Annual Report for 1935, I wrote: "Should present tendencies continue, it is estimated
that the population of the country will become stationary by 1940, and subsequently begin to decline."
The problem implicit in that forecast, far from being a piece of long-term pessimism, is rapidly becoming
a matter of urgency. Figures (1) and (2) show that the structure of the population has completely
changed in one generation. The fact of the general decline in the birth-rate has been too often
demonstrated to need further proof, but the exact and imminent results of that fact are usually
pushed into the background, as some remote, and even unlikely doom. The doom, however, is not
remote, and is becoming ever more likely. In 30 years the base of the population pyramid has
narrowed alarmingly (Figures (1) and (2) ); and Table A gives a striking comparison of the number