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

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London County Council 1934

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

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room for premature babies, labour room for "suspect" cases, balconies and accommodation
for staff. Arrangements have been made to keep the "booked" cases,
which have received ante-natal care entirely separate from the potentially infectious
cases. The unit is staffed by the obstetrical teaching staff of the British Postgraduate
Medical School under Professor James Young.

The number of patients seen at the Council's ante-natal clinics has increased as follows :—

Year.New cases.Total attendances.

Not only has the number of attendances increased, but the percentage of women
confined in the Council's hospitals who have had ante-natal care over an adequate
period has also risen. (The figures for 1933 are shown in brackets.)
L.C.C. clinics 11,436 (9,685) 87 (83) per cent.
L.C.C. in-patient only
Private doctor or other sources
Nil 1,630 (1,999) 13(17) „
Not stated
* Total 13,066 (11,684)
* These figures include 11 (16) women who died during the ante-natal period. The figure for 1934
also includes 4 cases where the 3rd stage only was conducted in a Council's hospital, and 1 case where
death from toxaemia of pregnancy occurred before the 28th week.
The average number of attendances of those attending the Council's hospital
clinics may be considered to be very satisfactory, but it does not adequately represent
the amount of work done. A number of the women who make one or two attendances
only at Council's clinics are under regular supervision from their midwife or doctor
or at a borough clinic, and have been referred to the hospital for consultation purposes
only. A system is now in full working order whereby cases which "lapse" from
the Council's clinics are visited by the borough health visitors and urged to return,
but these instances are very few.
The staffing of the clinics has been strengthened and efforts have been made to
reduce the period of waiting and the number of patients seen at each session. The
blood pressure is taken in every case, and in many hospitals at every attendance. A
Wassermann test is made on each new patient. The demand for dental treatment,
which was formerly reluctantly accepted, has now risen rapidly and is putting heavy
pressure on the dental services of the hospitals.
Careful attention is paid to the nutrition of the mothers. Milk and other forms
of extra nourishment can be obtained from the borough authorities under the
maternity and child welfare scheme or from the relieving officer as the circumstances
of the case indicate. At St. Mary Abbots hospital special research is being undertaken
into the effect of nutrition in toxæmic patients.
New premises for ante-natal clinics were opened during the year at Dulwich,
St. Giles' and Paddington hospitals, and a ward was adapted for temporary use as a
clinic at St. Stephen's hospital.
The number of new cases at post-natal clinics has again greatly increased, and
the hospitals report that these clinics are doing most valuable work in detecting
pathological conditions left after confinements. There were 4,078 new patients, who
made a total of 6,013 attendances during the year.
The strenuous efforts made by all concerned to reduce the maternal mortality
rate have had a gratifying result. The figures for the year 1934 show a substantial
improvement on the records for previous years.
As has been pointed out in previous reports, the special conditions prevailing in
the Council's hospitals make comparison with the general mortality rate of the country
an extremely difficult matter. The main cause of discrepancy is the very large
number of abortions admitted to the hospitals, but the admission to the wards of
numerous cases of general disease coincident with pregnancy (e.g., influenzal pneumonia
or heart disease) also tends to over-weight the mortality rate. An arbitrary