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another increase to a maximum of 19.5 in 1930, but another decrease followed
when the situation worsened. There has been a steady rise during the last two
years.
The death-rate has on the whole steadily declined and the decrease amounts in
all to 10.9 per cent., although there was a tendency to increase prior to the outbreak
of the War. The influenza epidemics are reflected in the peaks of 1918, 1922 and
1929; the peak in 1915 was mainly due to respiratory disease.
Infantile mortality has steadily declined by 35 per cent. during the past 25
years, in spite of peaks in the years 1911, 1915, 1918 and 1929. The work of health
visitors, infant welfare centres, hospitalisation of young children suffering from
infectious diseases, the lessening of the fly nuisance as a result of the replacement
of horses by motor cars, and the more efficient control of milk supplies are among
the causes of this gratifying result.
There has been a steady decrease in mortality from tuberculosis, once known as
the "great white plague." This decrease has been coincident with the development
of a national scheme for combating the disease and with the general rise in the standard
of living of the working classes.
The death-rate from enteric fever has been practically eliminated as a result
of improved sanitation and food supply control during the period in question.
Housing.
The past 25 years have seen a great movement to deal with insanitary housing,
a movement gradually gathering momentum, although interrupted from time to
time by the War and by periods of legal and financial difficulty, until, in the year
1934, it is possible to say that within two or three years practically all the larger
insanitary areas in London capable of being dealt with under Section I of the
Housing Act of 1930 will have been represented by the medical officer of health.
During these years there has been a series of Acts of Parliament adding to or
amending the powers contained in the Housing of the Working Classes Act of 1890.
Under these Acts it has been possible for local authorities to clear insanitary areas
and to provide rehousing for the displaced persons.
It is not my province to enlarge upon the great schemes which have been undertaken
for the provision of new houses for the working classes—that is fully dealt
with in Vol. II of the Annual Report and other publications of the Council—but it is
of interest to mention that at 31st March, 1935, 68,629 houses and flats had been
provided by the Council, of which 60,090 had been erected since 1st April, 1910.
The total accommodation houses nearly 307,000 persons at a capital cost, including
the cost of the clearance of unhealthy areas, of some £44,000,000.
In connection with the work of slum clearance it has been the duty of the
medical officer's housing section to survey the whole of London to discover insanitary
areas, to consult with the borough medical officers of health, and to represent
to the Council those areas suitable for clearance.
Prior to the Great War eight large areas had been represented to the Council
and "declared," and work thereon had either been completed or was in progress.
These areas involved the displacement of some 21,000 persons. Between 1919 and
1927 twenty areas were represented and "declared," involving the displacement of
some 22,000 persons. From 1927 to 1930 there was an absence of representations,
due mainly to legal difficulties in the working of the Acts, but in 1930 representations
were resumed, and, from then up to and including 1933, 30 areas were represented
involving the displacement of nearly 13,000 persons. During 1934 the pace has been
much accelerated, and no less than 59 clearance areas occupied by over 20,000
persons have been represented.
Inevitably this increase of work has necessitated an increase of staff, and, whereas
in the early years of the period under review the part-time services of one medical
officer and 2 to 4 sanitary inspectors was sufficient, there are at present (1935)
engaged on this work 6 whole-time medical officers and 18 whole-time inspectors.
Venereal
diseases.
The Public Health (Venereal Diseases) Regulations, 1916, made by the Local
Government Board required that the councils of counties and county boroughs,