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14
from which they are administered. In the London districts where,
for example, the school medical and other services are administered
by the London County Council from Westminster, while other
health services are administered by the Metropolitan Borough
Councils, no ideal unit of health administration can be obtained.
For health services to be efficiently administered, they should
be locally administered, and the area which the local authority
supervises should not be too extensive. In Ilford, with a few
exceptions (such as the administration of the tuberculous services),
the whole of the health services, including sanitary, school medical,
maternity and child welfare and Isolation Hospital, are all under
the control of one authority, and are administered locally, not
from some far-distant authority.
In the quinquennial Report for 1925, I pointed out, among
other things, the importance of the provision of an open air school
and of a clinic for remedial exercises and massage for cases of minor
degrees of physical disability, and it will be seen from the body of
the Report how successful these have already been.
I also pointed out the necessity of the provision of cubicle
wards at the Isolation Hospital. These also have now been
provided and further extensions have already been approved.
In 1925, I drew attention to the fact that four women died in
childbirth. In 1930, seven women died during childbirth, the
maternal mortality rate being 3.7, only a little lower than that for
England and Wales. I have noted in the Report that in the Ilford
Maternity Home the average maternal mortality rate for the past
ten years was 0.92, as compared with the maternal mortality rate
in the district generally of 3.
The need for further extensions to the Maternity Home, both
for cases which can be booked and for cases which have not been
booked and have proved to be difficult cases requiring special
provision, hardly needs emphasis, when the above figures are
considered.
The Public Health Services of Ilford are economically
administered. The estimated cost for the year 1931-2 of the
whole of the maternity and child welfare services was only 1.5d.
rate, while that for the school medical service was 0.9d. rate.
It is unsatisfactory for me to have to report that the deaths of
children of school age in 1929, as in 1928, form a higher percentage
of the total deaths registered than do the deaths of children of