View report page

4
" That it be referred to the Parliamentary Committee to take the necessary steps for
promoting in the next session of Parliament a bill to enable the metropolitan borough
councils (1) to provide and maintain creches for the reception of young children and to make
charges for the accommodation so provided and food for the children; and (2) to contribute
towards the maintenance of creches established by voluntary effort; "
The consideration of this report stands adjourned.
It appears to me to be quite clear that there is a demand for creche accommodation in London,
and that if creches are not provided by representative bodies a certain small section of the population
must necessarily make shift for themselves, either by paying small sums to neighbours or by resorting
to the creches provided by voluntary societies.
Creches, from a health point of view, are undoubtedly to some extent an evil, in so far as they
may tend to the discouragement of breast feeding, and, by aggregating susceptible children,
to spread of infectious disease, but in the light of experience they must be looked upon as a necessary
evil, and under proper management the good they do may be made to outweigh the harm.
The existing creche provision is reported to be inadequate for the needs of London, and, speaking
generally it is capable of being considerably improved upon in certain matters of detail. There
would therefore, in my opinion, be advantage in obtaining powers to enable metropolitan borough
councils to provide and maintain creches.
If creches are provided, recommendation No. (44) might advantageously be acted upon, and
I observe that the Education Committee are prepared to co-operate in giving effect to this
recommendation.
(11) Reporis from local authorities.
The Committee recommend that such reports compiled " according to certain specified requirements
" should be furnished to the central authority, and thus form a basis of comparison between
different districts.
The Local Government Board already prescribes the form in which reports of medical officers of
health are to be made. Apparently the Committee think that in order to emphasise responsibility
reports of local authorities should also be prepared upon somewhat similar lines and in such a
manner as would facilitate comparison being made as regards such questions as " infant death-rate,
number of cellar and back-to-back dwellings, with the tale of occupants in each dwelling and the
minimum amount of cubic feet allowed for each person, the character of the water supply and
sewerage arrangements and the means for the disposal of refuse, and any cognate matters, information
on which would afford a clue as to the character of the administration."
The paragraphs 121-123 of the Committee's report in which this matter is discussed appear
to show that they did not have before them in any detail the system of reporting at
present adopted, and if the Committee had had brought to their notice the Memorandum of the
medical officer of the Local Government Board on Annual Reports with its appended tables, they
would have seen that the need of a system of reporting " according to specified requirements " was
already fully appreciated by the Board.
It is, however, capable of some development, and I may mention that recently, with a view
to obtaining a statement on a uniform plan from medical officers of health as to workshops, I
brought this question before the metropolitan medical officers of health, and a form was agreed upon,
which, with some modification, has been adopted by the Home Office and Local Government Board.
In the same way a form has also quite recently been prepared for reporting upon the frequency of
inspection of, and proceedings as to, premises, such as cowsheds, houses let in lodgings, etc., and upon
the administration of the by-laws. This form has been adopted by many London medical officers
of health and is embodied in their annual reports.
(13) Medical inspection of factories.
The recommendations made under this head are to the effect that—
" The existing powers of certifying factory surgeons should be extended (1) so as to
enable them to examine employees for purposes of qualification at a later age than 16 ; (2) so
as to enable them to re-examine when necessary at definite intervals. Further, even if it be
necessary that inspectors of factories and medical officers of health should have to some
extent co-ordinate powers with regard to insanitary conditions in factories, an arrangement
should be made whereby each authority should notify to the other any defects that may be
apparent, although coming within the other's province. Similarly it should be the certifying
surgeon's duty to notify to the factory inspector or the medical officer of health, as the case
may be, such defects as may come under his notice."
The first two recommendations relate to questions concerning which I have no administrative
experience, and I can only say that on general grounds it is clear that certain advantages would
accrue from effect being given to them. But the Committee do not define the frequency of inspection
or on whose initiative it should take place.
As regards the third recommendation as to exchange of information concerning insanitary
conditions, the Committee may like to have before them the fact that the factory inspector
administers the special provisions of the Factory and Workshop Act in factories, while the duties
of local authorities are thus stated in a Home Office memorandum—
" In the case of factories the duties of a district council are few. The council is charged
with the duty of seeing that every factory in its district is provided with means of escape in
case of fire ; and also has special duties in regard to bakehouses and domestic factories.
These duties, which apply also in the case of workshops, will be further referred to below.
Another duty in regard to factories, though not arising under the Factory and Workshop