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vii
year since the war. Some very large buildings, e.g., Dorchester Hotel
and Strand Palace Hotel, were completed during the year. Such as these
entail a very great deal of study of plans and supervision of sanitary
construction while the buildings are in course of erection.
The Local Government Act, 1929, has affected the health administration
only to the extent of transferring the duties under the Vaccination
Acts and Orders. The Minister has also made Orders in connection with
the cessation of the percentage, grants formerly received for Tuberculosis
and Maternity and Child Welfare services. It is no longer necessary to
obtain the Minister's approval for the appointment of certain officers
and for developments in these services.
In Maternity and Child Welfare, consideration has been given to
the Minister's circular dealing with the care of children between infancy
and school age. As a first step the Council appointed an additional health
visitor in order that the home visiting of those children might be adequately
undertaken. For the better organisation of the work a rearrangement
of the health visitors districts was made. It is gratifying to note that
infantile mortality has fallen from 73-6 in 1920 to 59-21 in 1930. The
problem of obtaining day nursery accommodation on a scale to meet
the demand for this service still awaits solution.
The question of maternal mortality was brought prominently forward
in the interim report of the Minister of Health's Departmental Committee.
On the resignation of Miss Irving, the Council's midwife, an
opportunity was given of reviewing midwifery services and in co-operation
with Westminster Hospital the Council instituted at the end of the year
a complete midwifery service as part of its Maternity and Child Welfare
scheme.
The fall in maternal mortality has unfortunately not been maintained.
In 1929 it was 3-6 but in 1930 it rose to 7-3 per 1,000 births. A study
of the notes on these deaths in the Maternity and Child Welfare section
suggests that at least half of them might have been prevented had antenatal
care been sought. Illegitimacy is still the sinister factor exacting
a growing toll of the lives of mothers and infants. The secrecy and
furtiveness which almost always surround these cases prevent the health
services from taking eSective action for their care and treatment.
The health of the City has been maintained at a satisfactory level.
The general death rate has fallen from 14.8 in 1929 to 11.7 in 1930,
owing to the absence in the latter year of the severe climatic conditions