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11
It is difficult to reconcile this ruling with the Maternity and
Child Welfare Act, which authorises any local authority, within the
meaning of the Notification of Births Act, 1907, to make such
arrangements as may be sanctioned by the Minister (with the exception
of the establishment of a general domiciliary service by medical
practitioners) for attending to the health of expectant and nursing.
mothers and children who have not attained the age of five years and
are not under the care of the school authorities.
It is certainly very unfortunate that the work of the Centres and
Health Visitors cannot be followed up where necessary by nursing
assistance.
An expenditure on nursing assistance of £150, amounting to
less than the whole.time services of one nurse, is evidently inadequate
in such a Borough as Hackney, with an average of 5,000 births a
year, particularly when it is borne in mind that the new Centre will
require the presence of a nurse at several of the clinics.
It should be remembered that all the families assisted are in
distressed circumstances and that, if the King.s Home for Nurses are
unable to supply a nurse, these cases must undoubtedly be neglected.
Tuberculosis.
The Tuberculosis Death.rate shows a slight decrease, the
mortality being 1.12 per 1,000 of the population, as compared with
113 for 1923, and there were 27 fewer primary notifications as
compared with 1923.
One of the outstanding features of the tuberculosis service is
the extremely unsatisfactory conditions under which the treatment
of advanced cases is carried out. These cases are permitted to
remain at home to infect other members of the family, there being
no adequate provision for the institutional treatment of advanced
pulmonary tuberculosis and no means by which young children
exposed to almost certain infection can be removed to safe
surroundings.