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When the Minister decides on the appointed day, all landlords will have to be notified as to the
permitted number and six months after the appointed day it will be the duty of the inspectorial staff
to see that the Housing Act, 1936, is being complied with.
Failure to comply with the Act will require to be reported in the same way as any other failure
to comply with any other Act for which the Health Department is responsible.
Provision as to Staff.
The number of outdoor staff employed on this inspectorial work is at present seven. Three of
these are non-technical assistants who are temporary and whose work will cease when all the houses .
have been measured. Three are qualified Sanitary Inspectors, two of whom are temporary and who
will be required after the measurement is over in connection with the inspectorial work of the sanitary
department. It is therefore recommended that these two temporary Sanitary Inspectors should be
made permanent. They are aged 24 and 37 years, respectively, and have done satisfactory work.
GEORGE F. BUCHAN,
Medical Officer of Health.
November 17th, 1936.
APPENDIX Q.
HEALTH DEPARTMENT.
MEMORANDUM BY THE MEDICAL OFFICER OF HEALTH.
MOTHERHOOD IN WILLESDEN.
In submitting the Report of the Consultant Obstetrician printed and circulated on 17th
November, 1936, on the first 3,000 cases admitted to the Willesden Maternity Hospital between 19th
February, 1931, and 5th February, 1936, I think I should in this covering memorandum endeavour
to explain some of the terms used which are of general interest.
(1) Total Puerperal Mortality.—The Registrar-General calls the number of deaths classed to
pregnancy and childbirth the '' Total Puerperal Mortality.'' The causes of these deaths are as follows :—
Post-abortive sepsis.
Abortion not returned as septic:—
(1) Haemorrhage following abortion.
(2) Without record of haemorrhage.
Ectopic gestation.
Other accidents of pregnancy.
Puerperal haemorrhage :—
(ia) Placenta Praevia.
(b) Other puerperal haemorrhage :—
Post-partum haemorrhage.
Adherent or retained placenta.
Accidental haemorrhage.
Puerperal sepsis not returned as post abortive.
Puerperal albuminuria and convulsions.
Other toxaemias of pregnancy.
Puerperal phlegmasia alba dolens, embolism and sudden death.
Other accidents of childbirth (e.g., contracted pelvis, craniotomy, difficult and prolonged
labour, rupture of uterus, etc.).
Other or unspecified conditions of the puerperal state :—
(1) Puerperal insanity.
(2) Puerperal diseases of the breast.
(3) Childbirth (unqualified).
(2) Total Mortality from or associated with Pregnancy and Childbirth.—In addition to the deaths
under 1 above there are a number of deaths stated to have been complicated by the existence of the
puerperal state.
These deaths are not classed to pregnancy and child-bearing but are returned as associated
therewith. They are classed to non-puerperal headings. The largest numbers are classed to
pneumonia, heart disease, tuberculosis, influenza. They are due to risks to which the general population
of women is exposed and would have occurred if the women had not been pregnant.
The Registrar-General shows these as deaths from non-puerperal causes and goes on to give a
" Total Mortality from or associated with pregnancy or childbirth " which includes these deaths.
(3) Criminal Abortion.—The Registrar-General states that in addition to all the above deaths
there are others from criminal abortion which are assigned to various forms of violence, e.g., suicide,
murder, etc., but as these deaths result from illegal interference with pregnancy it is not the practice
to include them in the Maternal Mortality Rate.
(4) Still Births.—Reliable statistics as to still births were not available before 1928. The total
births, i.e., live and still births, provide a closer approximation to the number of women exposed to
the risk of dying from puerperal conditions than do live births alone.