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7
MOTOR AMBULANCE SERVICE.
The Motor Vehicles are all in their ninth year of service, and have covered a total of 443,577
miles. During the year under review the calls upon them have been exceptionally heavy, and it is
satisfactory to record that these have been met without accident. There have been 3,600 calls for
ambulances (including infectious cases), 2,300 houses visited for disinfection, and 130 mentally and
physically defective children have been carried to and from school each day.
MOTHERS AND CHILDREN UNDER FIVE YFARS.
Municipal Centres.—At the Municipal Clinics expectant mothers attended the medical
consultations on 2,490 occasions; nursing mothers 11,791; and children under 5 years, 27,186;
making a total of 41,467 attendances. There was a considerable fall, approximating 42 per cent.,
in the number of attendances during the last quarter of 1921, as compared with the previous quarter,
after the inauguration of the annual registration fee of 2s. 6d. on the 1st October, 1921.
During the year 1921, 255 children under 1 year died in Willesden. Of this number 65 attended
the Clinics, and 190 did not, giving an infant mortality rate of 65.7 per thousand births amongst
babies attended the clinics, and 76.7 per 1,000 births amongst those who were not in attendance.
The infant mortality rate for all babies was 73.6 per thousand births.
These 65 deaths of Clinic babies are reckoned as Clinic deaths, no matter how many months
elapse between death and the last Clinic attendance, and no matter how few attendances have been
made at the Clinics. In 12 cases (including two children under one month) only one attendance was
made, and in addition, in 2 cases 2 months elapsed between death and the last Clinic attendance, in
4 cases 3 months elapsed, in 1 case 4 months elapsed, in 1 case 5 months elapsed, and in 1 case 6
months elapsed between death and the last Clinic attendance, or 21 deaths in all who only attended
once or otherwise did not attend for a considerable interval before death. In addition, 1 child under
1 month died who attended the Clinic twice. Of the 65 deaths reckoned as Clinic deaths 36 were
certified by Private Doctors, 16 by the Municipal Hospital, 10 by other Hospitals, 2 by Inquest, and 1
by a Clinic Medical Officer.
I have set out the basis on which deaths are reckoned as Clinic deaths as misunderstanding
seems to have arisen. Statistical evidence cannot be treated as a problem in pure mathematics, but
has got to be carefully balanced in the light of all possible sources of error. When all these sources
have been considered the comparison of the Infantile Mortality rate of Clinic babies with non-clinic
babies still points to the conclusion that the continuous medical supervision of the mother and child
is of great benefit to the community.
Voluntary Centres.—Two Voluntary Maternity and Child Welfare Centres are at work in
Willesden, namely, the Princess Road Infant Welfare Centre and the Infant Welfare Centre, carried
on by the Women's Civil Corps. Both do good work. A scheme of Co-ordination was submitted
during the year by the Committee of the Princess Road Infant Welfare Centre, but owing to financial
restrictions the Scheme was not put into operation.
PUBLIC ELEMENTARY SCHOOL CHILDREN.
Medical Inspection.—Article 58 (b) of the Code of Regulations for Public Elementary Schools
requires annually the medical inspection of the following groups of children to be undertaken:—
(1) All children admitted to the schools.
(2) All children between 8 and 9 years of age; and
(3) All children between 12 and 13 years of age, together with children over 13 years
of age who have not been examined on reaching the age of 12.
No routine medical inspection has been carried out since the summer term of 1918, when the
Medical inspection of two age groups in part of the district was discontinued.
Arrangements have been made, however, for the Medical Inspection of one age group, namely,
" entrants," to commence on the 24th January, 1922, and the work will be extended to include the
two remaining age groups, when suitable arrangements can be made to deal efficiently with the additional
work entailed by the inspection of these three code groups according to regulations.
With 24,152 children on the school roll this would mean the annual inspection of over 8,000
children.
Medical Treatment.—During the year 1921, school children came under the notice of
the Medical Officer on account of 19,137 medical defects and 5,734 dental defects. Treatment was
obtained for 21,923 of the defects which came under notice and were found to require treatment.
97.7 per cent. of the medical defects were treated and 70.7 per cent. of the dental defects. Of the
total medical defects treated, 87.2 per cent., and of the total dental defects treated, 95.8 per cent.
were dealt with by the Education Committee through the Clinics, Municipal Hospital or Home Visitation.
The remainder or 12.8 per cent. of the Medical defects and 4.2 per cent. of the dental defects
treated were dealt with by private practitioners, voluntary Hospitals or other charitable institutions
or the Poor Law. In connection with the defects treated, the children concerned made 64,750 attendances
at the school clinics in 1921, as compared with 75,258 in the previous year, and spent a total
of, approximately, 4,300 days in hospital in 1921, as compared with 6,000 days in 1920. The decrease
in the attendances at the School Clinics was due to the fact that on October 1st, 1921, an annual
registration fee of 2s. 6d. was instituted for every case attending on and after that date. The fee had
the effect of reducing attendances by some 45 per cent.