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135
as well as at the numerous voluntary hospitals in or near the
Borough render additional provision by the Borough Council
quite unnecessary. So far as the second item is concerned I should
mention that there are two Day Nurseries in the Borough run by
Voluntary Committees performing useful work, but I believe that
their financial position is very unsatisfactory.
II.
Adequacy of Service.
Having thus outlined the actual services of the Council, the
Committee may desire to know to what extent these are used
and whether they satisfy all the needs which may exist. It is
rather difficult to answer this fully without extremely elaborate
figures, but the following summary indicates the broad tendencies
at the moment.
1. The Health Visiting staff was last increased in 1925, making
the total then ten. including the Superintendent. The most
important feature of their work is the routine visiting of young
children but the time actually available for this is naturally effected
by other duties, e.g., visiting Measles cases or attendance at
Welfare Centre Clinics. So far as the first is concerned, arrangements
have been made for some years to secure more adequate
attention to Measles at epidemic periods by the engagement of
a special temporary Health Visitor and this has relieved the
pressure on the permanent staff at those times. With regard
to Clinic attendances, it is undoubtedly the fact that additional
sessions have been arranged during the past few years and these
have the effect in reducing the time available for outdoor work,
although this has been minimised by some improvement in the
filing methods and the procedure for dealing with milk grants.
Upon examination of the actual statistics of the Health Visitors'
outdoor work, I find that while the visits to babies under one have
risen from an average of 3.9 per baby per year in 1925 to 8.4 in
1933, those to children between one and five have been practically
stationary at 2.6 per child per year. The amount of visitation to
babies is certainly very adequate, but the visits to the older children
are much below what is desirable, especially when considered
in conjunction with figures which I shall submit later as to the
inadequate attendance of these children at the Welfare Centres.
The facts which have been revealed upon the medical examination
of school entrants indicate that during the three or four years
before school age children require much closer medical supervision
than they are now getting. I have previously drawn attention
to this subject in a special report to the Public Health Committee
in March, 1933, and I am still of the opinion expressed
in that report that the Health Visiting staff should be increased,
with the specific purpose of enabling a greater number of visits