London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1912

[Report of the Medical Officer of Health for London County Council]

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79
Report of the County Medical Officer—General.
district councils. It was followed by a further circular letter, dated 6th July, 1912, addressed to county
councils and county borough councils, dealing with provisional arrangements for the treatment of
insured persons recommended for sanatorium benefit, and urging that complete schemes relating to the
whole population, and not only to insured persons, should be prepared in conference with the insurance
committees and sanitary authorities, the unit area for such schemes to be generally the county or county
borough.
" At the beginning of August, 1912, it was intimated that, as a result of the consideration of
representations made on behalf of the County Council's Association in connection with the proposal
that schemes for the treatment of tuberculosis should extend to the whole community, the Government
would contribute annually a sum, representing approximately half the total estimated cost of treating
the non-insured persons as well as the dependants of insured persons. This sum would be distributed
to local authorities which undertook schemes, to be approved by the respective local government boards,
for the general treatment of tuberculosis in the areas under their jurisdiction.
"On 27th July, 1912, a circular letter was sent by the Board to county councils, sanitary
authorities and insurance committees in England and Wales relative to the domiciliary treatment
of insured tuberculous persons."
Further correspondence took place between the Council and the Board, and ultimately on the
11th December, 1912, the Board addressed to the Council a letter suggesting that the Council should
prepare a scheme for dealing with the disease in London.
Homeless persons.
It has been the practice for some years past for the Council during the months of January or
February to undertake an enumeration of homeless persons in London. The seventh of these enumerations
was made on the night of the 9th February, 1912, and a report on the results obtained in the
several years with comparative tables is included here in Chapter XXXIIa. In order to prevent duplication
in counting, the method adopted was for certain groups of officers to work from the centre outwards
and other groups to work from the boundary of the selected area inwards. Inasmuch as counting
was begun at 1 o'clock a.m. in both directions there was little likelihood of the same persons being
observed more than once on the same evening. The officers principally engaged in the work have had
many years' experience of the homeless and common lodging-house classes of the population, and there
is every reason to assume that the persons counted in the street were absolutely homeless. Consideration
of the appended report will show that the numbers reached a maximum in 1910, the year of maximum
charitable effort, and that the figures obtained in February, 1912, were some 1,500 less than in the
earlier year. It cannot, however, be said that this reduction in numbers was entirely due to the
alteration of method adopted by charitable organisations, and, indeed, later figures show that other
more obscure factors must have had no small influence on the decline in numbers. Evidence of this
will be found in the two most recent reports on this subject giving the results of enumerations made
on the nights of 14th February and 24th October, 1913.
Sanitary officers.
During the year under review the eleventh return of sanitary officers in London was published
and is included in Chapter XXXIIa of this report. The return gives details as to the officers employed in
the several boroughs with their duties and salaries. Reference to this return will show that while there
is an increase in the total number of officers as compared with previous years there is still considerable
variation among the several districts in the amount of work allotted per inspector on the basis of population,
and in some of the annual reports of medical officers of health comment is made on the inadequacy
of the staff. For instance, the average population to each inspector throughout London, excluding the
City of London as not comparable, is, on the revised Census figures of 1911, roughly 14,570 persons.
Sixteen boroughs have a smaller average population than this, whilst the remaining twelve boroughs
exceed the mean average population to each sanitary inspector by the numbers stated. The figures
are given to the nearest hundred. Islington, 300; Stepney, 1,000; Greenwich, 1,400; Lewisham,
1,500; Chelsea, 2,100; Stoke Newington, 2,300; Poplar, 3,500; Shoreditch, 4,000; Fulham, 4,600;
Lambeth, 5,300; Camberwell, 5,500; Wandsworth, 9,400. This statement, of course, though serving
as a rough guide to the amount of work to be performed, deals only with one criterion, and that a comparatively
unimportant one in the combination of circumstances which must be taken into consideration
in forming an estimate of the adequacy of the staffs engaged in the administrative work arising out
of the Public Health and cognate Acts in London. It is, in fact, impossible to arrive at any true
judgment without detailed knowledge of the widely varying conditions obtaining in each borough, and
the absurdity of adopting a uniform standard for such boroughs as Finsbury, Hampstead, Shoreditch,
and Wandsworth would be obvious to the most casual observer. For this reason no general standard of
efficiency can be adopted, and regard must be paid to the reports on the subject presented by the
medical officers of health of the district concerned.
Attention has been directed in the following instances to the inadequacy of the staff—
Dr. Lennane, in a special report written early in 1912, discussed the effect of the large increase
of duties imposed by recent legislation, and pointed out that in Battersea the determination of the
Council not to fill the place of the woman workshop inspector, who had resigned at the beginning of
1911, had not reacted to the benefit of the borough, the necessary readjustment of duties among the