View report page

141
accommodation may bccome available before long, to meet the
needs of this useful service.
14 The arrangement for operative treatment as in-patients
at the Queen's Hospital of children suffering from Enlarged
Tonsils, Adenoids or Mastoid disease has been working satisfactorily
for some years and I do not think it calls for further
comment.
15 The arrangement with regard to Nursing Assistance has also
worked satisfactorily for some years but I would draw attention
to the fact, mentioned in my last Annual Report, that the District
Nursing Association finds increasing difficulty in raising voluntary
funds and is apparently understaffed.
16 It is extremely difficult to express an opinion on the utility
of the Breast-Fceding Clinic. Although appropriate advice and
treatment are administered, so many external factors may intervene
and so prejudice the possibility of achieving good results
that it might be questioned whether the time of the staff engaged
on this work could not be more beneficially utilised on other
branches of the work.
17 The continued demand for advice is evidence of the value
of the Mothers' Clinic. If the present progress is continued and
maintained it is probable that the facilities may require to be
extended in the future.
III.
Supplementary Report re Maternal Mortality.
Although some of the means of reducing maternal mortality
and illness are dealt with incidentally in the foregoing report,
the Committee may wish to have a special note on this subject,
arising out of the recent circular of the Ministry of Health.
Bethnal Green has for many years had a much more satisfactory
record in this respect than the country as a whole. The
maternal death rate for the Borough has been consistently and
substantially below the rate for England and Wales for the
last 24 years with the exception of 1916, 1929 and 1931 when big
fluctuations, to be expected with a comparatively small population,
took place.
All the suggestions contained in the Ministry's circular
have been carried out. Further improvement is therefore
mainly a matter of securing the fuller use of existing measures.
There has been a remarkable change in the place of confinement
during the past 10 years. Births at home have fallen from 83
per cent. in 1923 to 41 per cent. in 1933. This fact does not seem,
however, to have affected the maternal mortality rate which only
shows the slight improvement which might reasonably be
expected from greater knowledge and better facilities, and
these of course apply both to confinement at home and in hospital.
The Borough is exceptionally well provided with midwifery
services. For confinement at home, there are the Borough