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During 1931 they have been increasingly made use of. 87 were supplied free, 7 at full cost
and 3 at part cost.
(2) Specialist Help.—The Council accept responsibility for the payment of the fee of one
of their specialists called in by a medical practitioner to assist him in connection with
a difficult case of labour occurring in a Willesden resident. 3 such consultations were
paid for in 1931.
(3) Provision of Aneesthetist.—The Council further accept responsibility for the payment of a
fee to an anaesthetist, called in by a medical practitioner in connection with confinement
cases. No such fees were paid in 1931.
Maternal Mortality.—The Council has continued to take part in the investigation of deaths
of mothers in childbirth for the Maternal Mortality Committee of the Ministry of Health. The
investigations are carried out by the Council's Consultant Obstetrician. 13 cases were inquired
into during 1931.
The services of the Council's Consultant Obstetrician are also available in cases of Puerperal
Fever and Puerperal Pyrexia when desired by the practitioner in attendance.
During the year the Council had under consideration Circular 1167 and Memorandum 156/MCW
relative to maternity and child welfare and maternal mortality. Notes by the Medical Officer of
Health appear as Appendix L. Arising thereout, the Council passed the following recommendations:—
(i.) That a booklet be prepared giving full information as to the facilities which exist
in respect of Maternity and Child Welfare.
(ii.) That such booklet be given to all doctors and midwives.
(iii.) That the booklet or similar information be given to such others of the public as
may be considered desirable.
(iv.) That arrangements be made for doctors, if they so desire, to examine at the Health
Centre patients, either those who directly engage the doctor, or those in respect
of whom the doctor may be called in by the midwife in an emergency.
(v.) That if it is so desired, the Council will be prepared to make up the deficit in cases
where midwives are employed as Maternity Nurses whenever a Maternity Nurse
is required. (It may be that in some cases home helps would be employed with
midwives.)
(vi.) That steps be taken to secure the recognition of Willesden Maternity Hospital
as a Training Centre for Midwives.
(vii.) That all practising midwives be afforded the opportunity of attending lectures
and refresher courses from time to time.
Such a booklet has now been prepared, and the other recommendations are in operation with
the exception of the recognition of the Willesden Maternity Hospital as a Training School for Midwives,
which is in hand.
Health Visiting of Children between the Ages of 1 and 5 Years.
Children between the ages of 1 and 2 years are visited in their homes six monthly, and children
between the ages of 2 and 5 years annually. Where the children are ailing or the home conditions
unsatisfactory, visits are made as often as necessary and possible. Regular attendance at the Health
Centres is advised, and in addition where the parents are agreeable, appointment cards are given
for special medical inspection by the Health Centre Doctor at the ages of 18 months, 2 years, 3 years
and 4 years, on the lines of the school medical inspection. The feeding of the young child requires
supervision, and the mother frequent advice as to its care and management. Dental defects, rickety
conditions, general debility, irregular habits, insufficient sleep, uncleanliness, lack of control and
unsuitable management are too long in coming to notice under the present arrangements. Sir George
Newman states in his 1930 Annual Report on the Health of the School Child that rickets can be
prevented by proper diet, sunlight, fresh air and exercise. Yet 156 children under 5 years of age
received treatment for rickets at the Council's Orthopaedic Clinic during 1931, and 112 received
treatment for general debility at the Sunlight Clinics. Children should be visited at home as a
routine practice at least three-monthly during their second year of life, and at least six-monthly
between the ages of 3 and 5 years.
Ophthalmia Neonatorum.— The number of cases of this disease notified during the year
was 41, giving a case rate of 14.4 per 1,000 registered live births. A private doctor attended at the
confinement in 18 cases, a midwife in 6 cases, 16 cases were born in hospital, and in 1 case no information
was available. Treatment was obtained at a hospital in 16 cases, at the Municipal Centres in
12 cases, and by a private doctor at home in 13 cases. 1 child died from convulsions and otitis media,
and in 6 cases the result was not known.