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deaths in the Poor Law Institutions, which is not a satisfactory feature. It remains to be seen
what effect the National Insurance Act will have towards reducing the proportion of deaths in
Poor Law Institutions.
I have in preparation reports summarising the morbidity and mortality experienced during
the ten years 1901-1910 adjusted to the latest census returns. From those data it is my
ambition to construct a life-table. A summary of the results of the census is also in preparation,
but the date of its completion will be dependent on the publication of the Census Office Returns.
The past year was a busy one, mainly on account of the exceptional—judging from past
experience—amount of sickness among school children. How far the increases observed last
year were due to more careful and systematic reporting by school teachers time only will show.
It is believed that last year's increase was largely due to that cause, and that the present high
figures may be expected to be maintained. If so, it emphasises the need of more Women
Inspectors.
There was a considerable increase in the work consequent on the notification of
pulmonary tuberculosis—work which experience has convinced me is more efficiently carried
out by women. It has to be remembered that it is not a matter of one visit only to each
reported case. In some instances several visits are necessary to complete the preliminary
inquiries, and in others visits at fairly frequent intervals are required, both for the sake of the
patient as well as for the protection of the public. This work will be still further increased by
the extension of notification to all forms of tuberculosis, which came into effect in February last.
Moreover, additional work is confidently anticipated in connection with the administration of
the Sanatorium Benefit of the National Insurance Act. The work in connection with the
preservation of infant lives has not received from the Staff that amount of attention which its
importance demands. Fortunately, last year the "School for Mothers" was able and willing
to make good some of the deficiency, but it has been intimated that the School cannot continue
to undertake the amount of visiting hitherto performed. The present Staff (two women) is quite
inadequate to cope with the growing demands on the Department. I trust that the Council
will take steps at an early date to appoint additional Women Inspectors or Health Visitors,
otherwise the most useful part of the Department's activities will be very seriously curtailed.
The work connected with the Housing Acts entailed a considerable increase in administration,
especially that in connection with the " Cirencester Street Improvement Scheme." It
is hoped that the amended series of by-laws with reference to tenement houses will result in
improved domestic hygiene, a matter not dealt with in old series, which was limited to landlords'
liabilities. Now the tenants are required to take their share in maintaining domestic cleanliness.
The inquiries with reference to the rents of tenements have disclosed an unexpected fall in rents
during the seven years 1906 to 1912. A perusal of that part of the Report which deals with
administration will show that the Staff as a whole has been very fully occupied. All members
have discharged their duties to my satisfaction, and, I trust, to that of the Council.
I cannot conclude without expressing my deep gratitude to the Council and to the Public
Health Committee for the support and consideration I have always received not only during
the past year, but ever since I have had the honour to occupy my present position. My thanks
are also due to the members of the Medical Profession practising in the Borough for their cordial
co-operation in my efforts to promote the health of the inhabitants of the Borough.
I have the honour to be,
Mr. Mayor, Ladies and Gentlemen,
Your most obedient servant,
m.a., m.b., d.p.h., f.s.s.,
Medical Officer of Health.
Public Health Department,
Town Hall,
Paddington, W.,
1st July, 1913.