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The number of deaths of nurse-infants during the year was only 51 as compared with 103 during
the previous year. In 16 cases an inquest was held. In 12 cases the verdict was death from natural
causes, in 1 case accidental death, and in 3 cases death from misadventure. One of the misadventure
cases was due to a foster-mother administering an overdose of a medicine containing strychnine.
Irregularities were discovered in 432 cases, in 416 of which written cautions were sent. In 16
cases legal proceedings were taken and convictions were otained. In 13 cases penalties and costs were
imposed amounting to f 18 8s. 6d. In three cases defendant was sentenced to imprisonment without
the option of a fine.
Towards the end of the year the Council was approached by the London War Pensions Committee
with a view to making arrangements for the inspection of homes in which the Committee propose to
place the neglected children of deceased or serving soldiers and sailors. The negotiations had for their
object the carrying out of the work as part of the routine inspection of the visitors under the Children
Act. Owing to the fact that this work has only been in operation for such a short period this year I
do not propose including any details in the present report.
Scheme for the Diagnosis and Treatment of Venereal Disease.
As the outcome of the findings of the Royal Commission, the Local Government Board issued in
July, 1916, the Public Health (Venereal Diseases) Regulations, which placed on county councils, etc.,
the duty of making arrangements for the diagnosis and treatment of venereal disease within their areas.
In preparing a scheme it became apparent that any facilities provided for London would be utilised by
many patients from surrounding areas, and the authorities of these areas were therefore invited to
co-operate with the Council in a joint scheme. After conferring on the subject, the county councils of
Bucks, Essex, Hertford, Kent, Middlesex and Surrey, and the county boroughs of East Ham, West Ham
and Croydon agreed to participate. Negotiations with the governing bodies of the principal London
hospitals were entered into, with the result that 22 of these institutions intimated their willingness to
undertake the following services in connection with the treatment of venereal disease, (a) The
appointment of a competent staff; (b) the provision of beds for patients; (c) the treatment of outpatients
at evening sessions and at other suitable times; (d) the supply of salvarsan or its substitutes
to medical practitioners on an approved list; (e) the supply to practitioners of apparatus for taking
samples of blood, etc., and the furnishing of reports on specimens sent by practitioners; (f) the provision
of free instruction for practitioners and students, and opportunities for practitioners to act as clinical
assistants at approved rates of remuneration; (g) the employment of women doctors in clinics for
women ; and (h) the supply of statistical information of work done.
The scheme came into force on 1st January, 1917, and has continued in operation.
In considering the arrangements for the year 1918, certain districts not conveniently served by
the existing facilities were provided for by the inclusion in the scheme of th ee additional hospitals, and
a further hospital was added in 1919. Provision was also made at hostels for certain persons, who whilst
undergoing treatment at the hospitals, continued in employment, and whose lodging did not permit of
the requisite privacy.
The need for special facilities for treatment for infected pregnant women had not been provided
for up to the end of 1919. Efforts were made in 1918 and in the following year, to secure the inclusion
in the scheme of one or more of the large lying-in hospitals, but the authorities of these institutions found
it impossible to co-operate. It is expected, however, that at least one of the lying-in hospitals will, in
the course of the year 1920, be in a position to provide the necessary facilities.
The provision of in-patient t eatment for children, especially female children suffering from
gonorrhoea, has been a difficult problem, such cases being unsuitable for admission to the general wards
of a children's hospital, and the authorities found themselves unable to provide the requisite facilities
for isolation, prolonged treatment and the employment of a special staff of nurses. In considering the
arrangements for the year 1920, special attention was again given to this subject aud negotiations were
entered into with the Federation of Children's Work Committees for the establishment of a medical home
in South London for the reception and treatment of children so suffering, provision also being made for
the education of the children whilst in residence.
Additional facilities for hospital treatment were included in the scheme for the year 1920. In
the south-western portion of the county, a district hitherto inadequately served in this respect, an
agreement was entered into with a local general hospital for the provision of at least three clinics a
week together with the necessary in-patient treatment. Further it was found possible to include in
the scheme provision for the hospital treatment of ophthalmic conditions associated with venereal
disease. Efforts to secure this were first made in 1916 in view of the large amount of blindness (total
and partial) well known to be due to venereal diseases, much of which is undoubtedlv preventable.