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to the demands which the war effort was making on the woman-power
of the country, and to the fact that the remuneration authorised could not
compete with the wages paid in the war industries and in private employment.
The Day Nurseries served a very useful purpose: both were
recognised as training institutions for Nursery Nurses and Assistants;
and the best tribute which can be paid to the constant care and supervision
exercised by the Matrons of the Nurseries, and the Assistant
Medical Officers of Health is the fact that, during the six years of their
existence, only one extensive outbreak of infectious disease occurred
this being an outbreak of a mild type of Dysentery.
On July 5th, 1948, the Corporation was employing five Health
Visitors ; there were ten Infant Welfare Centre sessions held every week
and two Ante-natal clinics. The average number of home visits
annually was about 10,000, and in 1947 the attendances at the Infant
Welfare Centres totalled 33,328.
Glancing back over the old records, it is noticeable that when there
was only one Health Visitor, she managed to make over 3,000 home visits
a year ; this was largely because there was then only one Infant Welfare
Centre held each week, and all the rest of her time was devoted to home
visits. The increase of Welfare Centres was necessary as the district,
developed, but I have never regarded the large number of attendances,
at these as a criterion of the efficiency of the service. The Health
Visitors most valuable work is done in the homes, and it is regrettable
when the pressure of attendances at clinics encroaches on time
could be better employed : nevertheless it is necessary to maintain the
efficient working of Infant Welfare Centres by increasing the number of
sessions when the attendances at any particular Centre tend to become
excessive and unwieldy. The remedy is to increase the number of
Visitors, but in recent years the demand for these officers has greatly
exceeded the supply.
Growth of services does not necessarily imply increase in efficiency.
It is not very easy to assess precisely the results of a personal health
service. Those who work in the service among the mothers and babies
know from their own experience and observation how great an improvement
has taken place over the years in the health, care and management
of infants and young children; but these are subjective impressions
cannot really be conveyed in a comprehensible way to other persons
The only statistical information readily available relates to
mortality rates, and to the Infantile Mortality Rate and the Maternal
Mortality Rate in particular.
I think that the following tables do provide some evidence of
improvement in the welfare of Infants and Mothers since the Maternity
and Child Welfare Service came into operation over 40 years ago.It
is fair to assume that decline in mortality has been accompanied by
reflects a decline in morbidity.
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