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medical practitioners were exempted during the year. In 1920 the Ministry of Health issued a memorandum
(151M & C.W.) which indicated the standards of measurements suitable for the accommodation
of maternity cases. The space suggested was 960 cubic feet a bed for wards to contain patients with
infants, 800 cubic feet a bed for wards to contain only the mother at night, and 600 cubic feet a bed for
wards to contain ante-natal cases. The Council has decided that, when considering applications for
registration, it will have regard to these standards.
Under the powers conferred by Part IV. of the Act of 1915 as superseded by Part IV. of the Act
of 1921, the Council on 1st March, 1921. delegated to the Greenwich Metropolitan Borough Council for
one year extending to 30th June, 1922, its powers of inspection of lying-in homes in that
borough.
Midwives.
Under the Midwives Act, 1902, the duties of the Council, as the local supervising authority
for London were chiefly disciplinary in connection with the conduct, professional or otherwise, of midwives
or persons practising as midwives within the county. To enable it to carry out these and allied
duties the Council appointed four qualified women medical practitioners, to inspect midwives and to
investigate special cases. The Midwives Act, 1918, passed to amend the Act of 1902, enlarged the Council's
responsibilities, the chief alteration dealing with the provision of medical assistance for midwives. By
section 14 midwives are required to summon medical aid in any case of emergency as defined by the rules
of the Central Midwives Board. The fees of the medical man so called in are payable by the Council (in
accordance with a scale fixed by the Local Government Board and amended by the Ministry of Health),
which has power to recover them from the patient, her husband, or other person liable to maintain
her, unless it can be shown that such person is unable to pay the fees. From 1st April, 1921, to 31st
March, 1922, the Council's expenditure under this head was about <5,000, of which about £1,000 was
recoverable. Owing to the difficulty of assessing the sums to be recovered, the Council has adopted a
scale of assessments graduated according to net income, after allowing a deduction in respect of each
maintainable child or other dependant. Coupled with this, the practice in operation since the passing
of the Act of 1918, of relying upon information as to means obtained by special inquiry officers was
discontinued.
Under Section 5 of the Act of 1902, as amended by section 2 of the Act of 1918, any adverse
balance in the accounts of the Central Midwives Board is apportioned between the councils of the several
counties and county boroughs in proportion to population at the last census, and the Council's proportion
for the year 1921 was £474.
Notifications during the year by midwives of intention to practise during the year numbered 721;
of intention to practise for specific periods less than a year, 24 ; and of having acted in specific cases, 13.
The number of births attended by midwives formed about 45 per cent. of the total number (99,839)
of births registered. There were 355 cases of puerperal fever and 665 of ophthalmia neonatorum. Seventeen
inquests were held on women, and 57 on children. Seven prima facie cases of negligence of
misconduct were reported to the Central Midwives Board. In two of these the Board found that
charges had been established and removed the name of the midwife from the roll; in two other cases the
Board censured the midwife for neglecting to observe its rules, and in one case the Board cautioned the
midwife as to strict observance of its rules. In one case the Board was of opinion that the midwife
was at fault in certain respects, but that the matter could be satisfactorily dealt with by the Council,
and in one case the Board found the charges not proved, as the midwife had acted as a maternity nurse
and not as a midwife.
Early in 1920 model by-laws under section 26 of the Housing, Town Planning, etc., Act, 1919,
with regard to houses divided into separate tenements were issued by the Minister of Health, and on
27th July, 1920, the Council made by-laws based on the model by-laws, and applied for confirmation
of the same. The by-laws are still being considered by the Minister.
Houses
divided into
separate
tenements.
Many transmigrants arriving in this country from Eastern Europe on their way to America come
from countries where typhus, typhoid fever, small-pox, and other dangerous infectious diseases are
prevalent, and the Council on 13th July, 1920, decided to urge the Home Secretary to ensure that transmigrants
during their stay in London should be released only to persons known to have suitable accommodation
for them. As a result it was arranged that the shipping companies engaged in this traffic
should make every endeavour to acquire premises in London to accommodate about 1,000 persons, but
at the end of 1920 nothing definite appeared to have been done. On 25th January, 1921, the Council
decided to ask the Minister of Health to receive a deputation, but he suggested in reply that, having
regard to the companies' negotiations, the attendance of the deputation might be unnecessary at the
moment, but that if at a later date the Council considered it advisable that a deputation should attend he
would be pleased to arrange for its reception. A licensed common lodging-house in Poplar has since been
converted into a hostel for the accommodation of transmigrants. These premises, although quite satisfactory
for this purpose, are unsuitable for the reception of persons who have recently been in contact with
dangerous infectious diseases, and the shipping companies have been approached with a view to all such
cases being diverted to their premises at Eastleigh. Arrangements have also been made with the shipping
companies to notify the Council's medical officer of health of all cases of transmigrants housed elsewhere
than in the above-mentioned hostel. By this method information can quickly be obtained concerning
the movements of these persons within London.
Housing of
transmigrants.
Censuses were taken by the medical officer, in continuation of those in previous years, of homeless
persons in order to ascertain the use made of common lodging-houses, and the provision existing for the
accommodation of persons of the poorest class. The censuses were taken on a winter night, and the
total numbers of homeless persons found in streets, on staircases and under arches were : Februarv,
1915, 178 ; 1916, 44 ; 1917, 28 ; 1918, 9 ; 1919, 8 ; 1920, 51 ; and 1921, 56.
Census of
homeless
persons.
61742
K