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13
great stress and anxiety. A very great step forward has been taken
by the Council recently in adopting a scheme for the prevention
of maternal mortality, in spite of the fact that until the block grant
is reviewed no additional assistance will come from the Ministry
of Health. The scheme put forward by the Maternity and Child
Welfare Committee covered all points suggested by the Ministry
of Health in its Memorandum and Circular of December 11th, 1930,
on this subject, except that dealing with examinations by medical
practitioners which raises many debatable points, and was adopted
entirely by the Council. A full description of the scheme will
be found on page 66.
The inclusion of percentage grants for health services in the
block grant under the Local Government Act was viewed with
particular dismay by the Associations concerned with maternity
and child welfare, as it was felt that any move in the direction of
reducing health service expenditure would be assisted by this
procedure. The Association of Infant Welfare and Maternity
Centres adopted a resolution which stated that the Association
viewed with grave apprehension the proposal to substitute block
grants for the percentage grants "believing that in their present
form the provision would not make allowance for much needed
expansion within the next five years.'' The Metropolitan Boroughs'
Standing Joint Committee also concurred in this view, and agreed
on February 4th, 1929, to inform the Ministry accordingly.
The Public Health Services, whether County or Borough, are,
however, partnership services as regards expenditure. Indeed as
regards tuberculosis only one quarter of the Tuberculosis Dispensary
expenditure in reality falls directly on the rate, as three-quarters
is returned in contribution from the Ministry of Health and the
London County Council. There is also a tendency to forget that
one-half of the expenditure on salaries of sanitary staff, other than
clerical, is still a contribution from Government funds in addition
to the block grant.
The estimate of the amount to be provided out of the rate for
this department during the year 1931-32, omitting the maternal
mortality scheme referred to previously, is stated to be £36,908,
of which £11,689 is allocated to maternity and child welfare.
This amounts to a rate of approximately 4|½d. for public health
and 2d. for maternity and child welfare. It was mentioned in a report
to a Committee in 1921, by the Electrical Engineer, that if every
householder in Hackney could be induced to burn his waste paper
and other inflammable rubbish, instead of putting it in the dustbin
for removal to the destructor, the rates (at that time) could be
reduced by 3^d. in the £1. Of course prices have considerably
altered since that date but the comparison of cost is interesting.