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15
[1922
In Circular M. & C.W. 4, dated August 9, 1918, the Ministry of Health state "that
the district with about 400 births a year will be as much as one Health Visitor can undertake,
unless the district is very compact, or is of such a class that many infants do not need
visiting." Regarding the factor- compactness of the district this can be disregarded, as
compact, moderately scattered, and widely scattered are equally balanced in Islington.
In 1921, 7,886 births were registered, about 2,550 infants have to be deducted, as they
are of such a class that they did not need to be visited by the Health Visitors.
This 2,550 is made up of 350 children under one year in our records marked as attending
the four voluntary Welfare Centres, and the balance, 2,200, are marked as "Visits declined"
or "unnecessary" or "above standard."
Deducting 2,550 from 7,886 leaves 5,336, for the 7 Municipal Health Visitors, or the
average for each Health Visitor was over 750 for the current year instead of 400.
If £2,000 extra were granted for the Council's side of the scheme, this would provide
on the present lines for double the staff, including administrative expenses, and would carry
out the work according to the Ministry of Health's standard.
A plea for more money during this present economy campaign may appear unreasonable
and unwise, but if the public could recognise that an increased expenditure now for
[Maternity and Child Welfare work means in the future an increase in population, and an
increase in economic value of the future citizen, then they would realise that this is true
economy.
Carrying on the work under present conditions means that over 12,000 children are
not visited as often as necessary, and that the infant mortality and "damaged" rate is
higher than it ought to be for the lack of stall. It is against human nature not to worry
over this seemingly preventable loss amongst Islington children, and further the work of
the Council's Health Visitors is disheartening, as about one-third of the mothers have
lapsed from attending the Voluntary Centres, and are either indifferent or out when visited,
or unable to act on advice given because, owing to financial stress, they are compelled to
go out to work.
The following are instances of several seemingly preventable infant deaths: (1) a
baby died, age 46 days, two days after the birth had been registered, death being due to
enteritis and marasmus. As this was a non-noticed birth, the Health Visitor had no
opportunity of calling and advising the mother regarding her own health or the baby's
feeding; (2) the Health Visitor called to see twins and advised the mother respecting feeding;
further visits were declined, and one of the twins died four months later from diarrhaa
and vomiting.
Nox-Notified Births.—Non-notified births have largely occurred in the practices
of a few Doctors and Certified Midwives who are being urged to fulfil the requirements of
the Notification of Births Act, and it is hoped further action will be unnecessary. The
difference between Registered Births and Notified Births was 585 (still-births are deducted
as these are not as yet registerable). 26 non-notified births were untraced, and 559 were
investigated. The parents mostly pleaded ignorance of the Act, and a few that they
understood it was the Doctor's or Certified Midwife's duty to notify.