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Syphilis.
Syphilis in the pregnant woman may lead to eye disease and blindness of the baby. Syphilis
is a disease of long duration and can be diagnosed clinically only during the acute or later stages of
the disease. For a long period the woman may be infectious without showing symptoms and a
diagnosis can only be made by a blood test. In some ante-natal clinics such a test is carried out
as a matter of routine and the number of cases actually detected is of the order of 1 to 2 per cent. Such
a procedure is desirable, but it has not been recommended in Willesden because existing services
have been used so fully.
Other Considerations.
There are at least 201 blind persons within the meaning of the Blind Persons Act, 1920, in
Willesden. Without practical experience of the working of a scheme such as is indicated by the
Minister, it is not in any way easy to estimate the number of such persons who either might have come
under a scheme for the prevention of blindness or are still in need of treatment to prevent further
blindness. The importance of provision for the prevention of blindness may be realised when it is
stated that the total net expenditure for England and Wales in 1936-37 out of the rates on work for
the welfare of the blind was £1,093,691, and to this sum must be added the cost of granting old age
pensions to blind persons at an earlier age than to the other pensioners (at 50 instead of at 70) and the
comparatively large sums subscribed voluntarily by the public for objects connecting with the welfare
of the blind.
In my opinion this matter of the prevention of blindness is of great importance. There would
not be any great difficulty in working a scheme in the proposed new Health Centre (2). At the present
time, however, there is neither sufficient accommodation nor staff to deal with existing services and
the extension of services depends on the premises and staff which the Committee decide to provide.
GEORGE F. BUC.HAN,
Medical Officer of Health.
December 22nd, 1937.
APPENDIX Q.
HEALTH DEPARTMENT.
Willesden Maternity Hospital—Extension.
Preliminary Report by the Medical Officer of Health.
I beg to report in accordance with the following minute
"Arising from the Conference with the County Council's representatives on the
question of the provision of maternity hospital accommodation in the Borough, we have
requested the Medical officer of Health to submit a memorandum to us setting out the
considerations involved in any extension of the Maternity Hospital." (Report of Hospital
Visiting Sub-Committee, 21-7-37.)

It will be observed from the above table that the proportion of institutional to domiciliary
confinements is steadily and rapidly increasing.
1,745 births took place in institutions in 1936, as follows:—
Willesden Maternity Hospital 885
Central Middlesex County Hospital 387
Other institutions or nursing homes 473
Total 1,745