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34
ADMINISTRATION—WELFARE WORK.
Although there are 241 boats on the Register, 9 being added during the year, only 128 can be
actually accounted for. Several boats are known to have been dismantled, but there have been no
applications to remove them from the Register. On the 102 boats inspected during the year 111 children
were found, of whom 70 were of school age.
In May last the Minister of Health forwarded to the Council a Memorandum calling attention to
the Order made by him in July, 1922, under Sec. 10 of the Canal Boats Act, 1882, under which the
Canal Boats Acts of 1877 and 1884 are to apply to vessels which, although to all intents and purposes
are "canal boats," have been by recent custom registered as "ships," thereby escaping the supervision,
etc., prescribed by the Canal Boats Acts. Such vessels are in future to be registered as canal boats.
WELFARE WORK.
Ante-Natal.—In addition to the Clinics held weekly at St. Mary's Hospital and by the School
for Mothers, an unknown number of expectant mothers attend Clinics at Queen Charlotte's Hospital,
Middlesex Hospital and elsewhere.
At the St. Mary's Hospital Clinic 320 expectant mothers were seen during the past year, and at
that of the School for Mothers 297, making a total of 617 for the two Clinics. It has been impossible
to obtain any returns for other Clinics. There appears, however, to be no doubt that a considerable
proportion of all expectant mothers who cannot afford paid medical advice attend at the various
Clinics.
The Health Visitors made 657 visits to expectant mothers, and the Visitors attached to the School
for Mothers 545. Requests for visits from Clinics at outlying hospitals are frequent.
Post-Natal (Health) Visiting.—The Council's Health Visitors have been instructed that the
first visit to the mothers of new-born infants is not to be made, as a rule, before the tenth day following
labour, by which day the doctor or midwife may be expected to have ceased attendance. So early a
visit implies that the birth has been duly notified, otherwise the visit will be delayed until information
of the birth is received—it may be as late as the sixth or seventh week when report of the registration of
the birth comes to hand.
Last year the Health Visitors made "first calls" to 1,752 infants, as compared with 1,883 in 1922
—the fall in the number naturally following the reduction in the number of children born. Of those
first visits, 1,412 (rather more than 80 per cent.) were made during the four weeks following the births
of the infants. When first visited, 1,610 infants (91.9 per cent.) were being fed at the breast, 62 (3.5
per cent.) were on artificial foods only, and 80 (4.6 per cent.) on a mixed diet of breast and artificial
foods. Of the infants visited during the first four weeks of their lives just on 95 per cent. were breast
fed, and of those visited at later dates, 80.
Of the 1,752 infants visited for the first time, 37 died before the end of 1923, 17 of the deaths
taking place in institutions. The 37 deaths were equivalent to a mortality of 21 per 1,000 births, the
rate for breast-fed infants being 18, that for infants on a mixed diet 25, and that for those artificially
fed 97.
After the visit or visits by the Health Visitor, the "Birth Card" is passed to the Paddington
School for Mothers, under whose care the infant or child remains until school attendance begins.
Neglecting ineffective calls ("out," "gone away"), the Staff of the School made 22,242 visits to the
homes of infants, the infants being seen on 13,575 occasions. These figures refer to all infants and
children under the care of the School and not to infants born during 1923 only.
The School maintains six Consultation Centres (see p. 62) at which eight sessions are held during
the week (Saturday being the only day without a session). A Medical Officer attends at each session.
During the year 14,702 attendances at the consultations were made by 7,589 infants and children,
2,042 attendances being made by infants (children) over 18 months old. The returns made by the
School do not show the numbers of attendances made by individual infants and children. On 7,284
occasions the infants were seen by the Medical Officers. Among the children under the care of the
School there were 52 deaths during the year, 29 at ages under 1 year and 23 at ages 1 to 5 years.
Respiratory diseases caused 25 of the deaths, and diarrhceal diseases 9.
In addition to the infants who attended the Consultation Centres maintained by the School,
an unknown number attended consultations at Queen Charlotte's Lying-in Hospital and others
in the adjacent districts.
The sales of dried milks of various brands at the School Centres realised £1,228 odd, and the sales
to infants in receipt of relief £14 odd. The cost of the dried milks purchased by the Council during the
year was just over £1,238.
Grants of Milk and Dinners.—The Grants Sub-Committee of the Maternity and Child Welfare
Committee considered 230 new and 290 renewed applications during the year. Of the new applications,
104 were refused, either as beyond the scale laid down or because the circumstances of the
families could only be dealt with adequately by the Poor Law. The orders issued numbered 532-483