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828f82ad-90e3-42c5-8eaa-b6d83e7493f2 | Removal of 104 Miscellaneous Sanitary Inspections 96 Miscellaneous Sanitary Work carried out 98 Notices Served 98 Offensive Trades 102 Office Accommodation 105 Out-workers 100-101 Parks and Open Spaces 108 Paving 97 Piggeries 102 Premises and Occupations controlled by Byelaws and Regulations 95, 101-103 Public Cleansing 89-91 Rainfall 83 Rats and Mice Destruction Act, 1919 103-104 Refuse Disposal 91-93 Refuse Storage and Collection 89-90 Refuse Tips 91-93 Registered Workshops 100 Repairs, General 97-98 River Roding 83-89 Rivers and Streams 83-89 Sanitary Inspection of the Area 94-104 Sanitary Work, Summary of 96-98 School Closure 109 Schools, Sanitary Inspection of 110 Shops Act, 1934 104 Sinks 97 Smoke Abatement, |
c939f381-d998-48bb-afa3-3f3b30bd56d2 | etc 105-107 South Essex Waterworks Company Supplies 81-82 Stables 102-103 Street Cleansing 91 Swimming Baths and Pools 107-108 Tents, Vans and Sheds 102 Ultra Violet Light Radiation 109 Underground Sleeping-rooms 102 Vacant Sites 90-91 Water Sampling 81-82, 83-89, 108 Water Supply 81-82, 97 6 Section C.—Continued Page Wells 82 Workplaces, Inspection of 95 Workshops, Inspection of 95 Section D.—Housing. |
11fcc4a9-66fa-4761-b8a1-c0e7483228b1 | Clearance Areas 118-123 Clearance Areas (Table) 119-122 Houses Built in the District, 1926—1938 116 Houses Erected during the Year 113 Housing Act, 1936 117-123 Housing Conditions 115-123 Housing Defects Remedied 114—115 Housing Inspections 113 Inhabited Houses, Number of 115 Overcrowding 117—118 Proceedings under Barking Corporation Act, Section 148 115 Proceedings under Public Health Acts 114 Proceedings under the Housing Act, 1936 114-115 Redevelopment 118, 123 Rehousing 116, 117, 118 Small Dwellings Acquisition Act 115 Temporary Buildings 115 Unfit Dwelling Houses 113-115 Section E.—Inspection and Supervision of Food. Adulteration of Food 130-131 Animals Slaughtered 127 Bacteriological Examination of Ice-Cream 126, 131 Bacteriological Examination of Milk 125, 131 Bakehouses 128 Barking Corporation Act, |
9ee7cfb5-486f-4621-b9b0-a6867185d0eb | 1933 126, 129 Biological Examination of Milk 125, 131 Bottling of Milk 126 Chemical and Bacteriological Examination of Food 125, 126, 130, 131 Diseased Meat Condemned 127 Food and Drugs (Adulteration) Act, 1928 130-131 Food Byelaws 129 Food Poisoning 129 Food Preparing Premises, Supervision of 128 Graded Milk Licences Granted 126 Ice-Cream 126,131 Meat and Other Foods 126-129 Milk (Special Designations) Order, 1936 126 Milk Supply 125-126 Nutrition 131-132 Prosecutions 129, 130 Slaughter-houses 126-127 Unsound Food Destroyed 129 Section F.—Prevalence of, and Control over, Infectious and Other Diseases. |
66792ad9-3f63-4f19-9bc9-49b6e3073be3 | Acute Anterior Poliomyelitis 133-134, 135-136, 139 Admissions to Barking (Isolation) Hospital (Table) 139 Artificial Immunisation 140 7 Section F.—Continued. Page Barking (Isolation) Hospital 139 Cancer 140-142 Cerebro-Spinal Fever 134, 135—136, 139 Diphtheria 133, 134, 135-136, 137, 139, 140 Diphtheria Notifications (Monthly Summary Table) 137 Dysentery 134, 135—136, 139 Enteric Fever 134, 135-136, 139 Erysipelas 134, 135-136, 139 Food Poisoning 134, 135-136, 139 Infectious Diseases (Tables) 134-137 Influenza 138 Measles 137 Measles and Pneumonia 134, |
200665c1-2617-4526-9d0e-9974850cf870 | 135-136 Non-Notifiable Acute Infectious Diseases 137-138 Notifiable Infectious Diseases 133-137 Notifications classified according to Wards and Age Groups (Table) 135-136 Ophthalmia Neonatorum 134, 135-136, 139 Pathological Laboratory 133 Pemphigus Neonatorum 134, 135-136, 139 Pneumonia 134, 135—136, 139 Prevention of Blindness 142-143 Puerperal Pyrexia 134, 135-136, 139 Rheumatic Fever 138 Scabies 138 Scarlet Fever 133, 134, 135-136, 137, 139, 140 Scarlet Fever Notifications (Monthly Summary Table) 137 Smallpox134, 135-136 Summer Diarrhœa 137 Tuberculosis 143-145 Tuberculosis, New Cases and Deaths (Table) 143 Unnotified Fatal Cases of Tuberculosis 144 Whooping Cough 137, |
6246f641-11fe-435b-88e2-3d2272d329b1 | 140 SCHOOL MEDICAL SERVICE Table of Contents will be found on Pages 150 and 151. 8 STAFF, 1938. Medical Officer of Health, School Medical Officer, Medical Superintendent Barking and Upney Hospitals: C. LEONARD WILLIAMS, B.Sc., M.R.C.S., L.R.C.P., D.P.H. Deputy Medical Officer of Health and Deputy School Medical Officer: J. MERVYN THOMAS, M.D., B.Sc., D.M.R.E., L.R.C.P., D.P.H. Assistant Medical Officers of Health and Assistant School Medical Officers : WILLIAM HOGG, M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. (Resigned 1st April, 1938.) THOMAS M. CLAYTON, M.B., B.S., B.Hy., D.P.H. (Commenced 10th October, 1938.) |
55a4a057-7e66-463f-8d19-50a2924830bd | MARGARET A. GLASS, B.Sc., M.B., Ch.B., D.P.H. VIOLET SPILLER, M.D., M.R.C.S., L.R.C.P., D.P.H. (Commenced 7th February, 1938.) MURIEL M. OSBORN, M.R.C.S., L.R.C.P. (Commenced 1st September, 1938.) Consultant Ophthalmic Surgeon : WILLIAM ADAMSON GRAY, M.B., Ch.B., Ph.D., F.R.C.S. Consultant Orthopcedic Surgeon : B. WHITCHURCH HOWELL, M.B., B.S., F.R.C.S. Consultant in Obstetrics and Gynœcology: JAS. VINCENT O'SULLIVAN, M.D., F.R.C.S. |
aacda9a8-943d-4278-b787-c5fa8a22e7b7 | Consultant Ear, Nose and Throat Surgeon: CYRIL R. SANDIFORD, M.D., F.R.C.S. Resident Medical Officer, Barking Hospital: JOSIE M. OLDFIELD, M.R.C.S., L.R.C.P. (Commenced 4th April, 1938. Resigned 11th December, 1938.) Resident Medical Officer, Upney Hospital: CALVIN P. BAMPFYLDE WELLS, M.R.C.S., L.R.C.P. Scientist: EVELYN M. HILL, Ph.D. (Lond.), Dip. Bact. 9 Denial Surgeons : W. H. FOY, L.D.S., R.C.S. M. COHN, L.D.S., R.C.S. (Resigned 5th March, 1938.) R. O. BORGARS, L.D.S., R.C.S. |
f8fdff6e-af70-407a-8469-a206cb3d0a9f | (Commenced 3rd January, 1938.) Miss E. F. GAWN, L.D.S., R.C.S. (Commenced 1st April, 1938.) Sanitary Inspectors: N. Bastable (Chief Sanitary S. Cook (b and c). Inspector), (6, c, d, and f). E. G. Tweedy (a and c). H. H. Carr (b, c, e and l) H. H. Madams (a and c). Matron, Barking and Upney Hospitals—Inspector of Midwives: Miss M. W. HEDGCOCK (h, i and j). Health Visitors, etc.: *Miss P. M. Fawcett (Senior Health Visitor and School Nurse) (g, h and i). *Miss M. Baerlocher (a, h and k). Miss P. M. Barns (Masseuse) (n). |
b7898304-af0a-4ab3-bb16-644ca3237128 | (Resigned 17th September, 1938.) Miss G. D. Conte (Chiropodist) (s and i). (Commenced 11th July, 1938, Resigned 24th December, 1938.) *Miss C. Court (g, h and i). *Miss E. Fisher (g, h and i). Miss G. Geden (Dental Nurse) (q). Miss S. Gibson (School Nurse) (j). *Miss L. Goodacre (g, h and i). Miss J. Harris (Masseuse) (n). (Commenced 12th September, 1938.) *Miss R. Hobbs (g, h and i). (Commenced 26th September, 1938.) *Miss G. Jones (g, h and i). Miss R. Llewelyn (Dental Nurse) (h and i). |
57c2969d-e043-4b87-809d-9b3a866d4162 | *Miss M. McAlister (g, h, i and j). *Miss M. McCandie (g, h and i). *Miss J. McGilvray (g, h and i). *Miss E. Parry (g, h and i). Miss A. K. Roe (Masseuse) (n). Mrs. G. Stokes (g and i). Miss L. F. Swain (School Nurse) (h and i). Miss M. Thompson (Masseuse) (n). (Commenced 10th October, 1938.) *Miss C. M. Williams (g, h and i). (Resigned 31st August, 1938.) District Municipal Midwives : Mrs. L. Back (h and i). Miss K. C. Hand (h and i). Mrs. E. Bishop (h). Miss G. Thomas (h). Mrs. |
ae724a98-876c-4cad-b008-0dee0a51b519 | I. Bronnick (h and i). Miss G. M. Verney (h). (Commenced 4th April, 1938.) (Transferred to Hospital 11th February, 1938.) 10 Clerical Staff: Chief Clerk—F. Read. C. G. Eaglesfield Miss H. Nunn. (Senior Assistant) (r). Miss H. King. H. Davis. Miss A. Liggins. F. Yates (o). Miss D. Foulsham. G. H. Ruff. Miss I. Cast. K. F. Calway (p). Miss G. Cooper. E. A. Ellis (m). Miss J. Wilkinson. D. Scott. Miss G. MacLean. L. J. Dexter. Miss J. MacLean P. J. Olver. (Commenced 7th Feb., 1938.) |
a37b99c4-c8cb-4552-98b0-7b583057be2b | (Commenced 1st Sept., 1938.) Miss P. Sparkes. (Commenced 8th Feb., 1938.) Disinfector and Mortuary Attendant: H. Long. In addition to the foregoing, there are sisters and nurses and other staff at the Barking Hospital and the Upney (Maternity) Pavilion. It is to be noted also that the Minor Ailments Clinics at Central Clinic and Woodward Clinic and Ante-Natal Clinics are staffed by the nurses of the Plaistow Maternity Hospital and District Nurses' Home. (a) Sanitary Inspector's Certificate of the Sanitary Inspectors' tion Board. (b) Sanitary Inspector's Certificate of the Royal Sanitary Institute. (c) Meat, etc., Inspector's Certificate of the Royal Sanitary Institute. (d) Smoke Inspector's Certificate of the Royal Sanitary Institute. (e) Building Inspector's Certificate of the Worshipful Company of Carpenters. |
afa6b659-c658-4442-9d68-175ed5e48570 | (f) Sanitary Science Certificate of the Royal Sanitary Institute. (g) Health Visitor's Certificate of the Royal Sanitary Institute. (h) Certificate of the Central Midwives Board. (i) General Hospital Training. (j) General Fever Training. (k)Health Visitor's Diploma of the Board of Education. (l) Smoke Inspector's Certificate of the L.C.C. School of Engineering. (m) Sanitary Inspector's Certificate of the Royal Sanitary Institute and Sanitary Inspectors* Examination Joint Board. (n) Certificate of the Chartered Society of Massage and Medical Gymnastics, Medical Electricity, Light and Electro-Therapy. (o) Final Examination of the National Association of Local Government Officers. (p) Inter. Examination of the National Association of Local Government Officers. (q) Registered Sick Children's Nurse. (r) Inter. Examination of the Incorporated Secretaries Association. (s) Diploma of the National School of Chiropody. (*) Combined appointment—Health Visitor and School Nurse. |
4c43baa2-5501-4e56-9da7-58586417aa13 | II ANNUAL REPORT of the Medical Officer of Health for the Borough of Barking, in the County of Essex, for the Year ended 31st December, 1938. Public Health Offices, Barking, Essex. June, 1939. To the Mayor, Aldermen and Councillors of the Borough of Barking. Mr. Mayor, Ladies and Gentlemen, Once again I present for your favourable consideration my Report as Medical Officer of Health for the year ended the 31st December, 1938, and in so doing make an apology for the lateness in its presentation, which was unavoidable this year on account of services being commandeered for three months in connection with Air Raid Precautions. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, C. LEONARD WILLIAMS, Medical Officer of Health. 13 SECTION A. STATISTICS AND SOCIAL CONDITIONS OF THE AREA. 1. General Statistics. |
4cf002ee-bc4f-4afa-94b7-045a224a78c5 | Area (acres) 4,174 Ward areas 3,874 Tidal Water H.W.M. Thames 240 Roding 58 Loxford Water 2 300 4,174 Population (1931 Census) 51,277 Population (June, 1938) (Registrar-General's Estimate) 76,790 Number of Inhabited Houses, March, 1939, according to Rate Books:— Houses 18,554 Shops 1,332 Total 19,886 Population Density, i.e., No. of persons per acre 18.4 Rateable Value—General £721,906 0 0 Sum represented by a penny rate £2,971 16 3 Education rates:— Elementary *Secondary Included in General Rate Figure 3s. 4½d. 10d. General Rate 14s. 2d. * Including County Precept. 14 2. Extracts from Vital Statistics for the Year. Live Births:— Total. |
d190b1aa-e2a1-4cbb-ade1-d470e5f327b9 | Males. Females. Birth Rate. Legitimate 1,086 545 541 14.14 Illegitimate 27 16 11 .35 Totals 1,113 561 552 14.49 Still-births:- Rate per 1,000 total births:- Legitimate ... 45 21 24 41.3 Illegitimate ... 3 2 1 Deaths ... 548 272 276 Death Rate 7.1. Percentage of total deaths occurring in public institutions. 51.8. Rate per 1,000 total Deaths from puerperal causes :— Deaths, (live and still) births. Puerperal sepsis 2 1.72 Other puerperal causes 1 0.86 Totals 3 2.58 Number of deaths of infants under one year of age:— Males. Females. Total. Death Rate. Total Infantile Death Rate. |
ba6bb532-542d-4fba-b10d-c47f770fa55c | Legitimate 21 21 42 38.7 39.5 Illegitimate 1 1 2 74.1 No. of deaths from Cancer (all ages) 75 (77) ,, „ Measles (all ages) – „ ,, Whooping Cough (all ages) 2 ,, ,, Diarrhoea (under 2 years of age) 6 (5) (N.B.—Where the Registrar-General's figures and rates differ from those prepared locally, the former are shown separately in brackets.) 15—16 3. BIRTH-RATE, DEATH-RATE, AND ANALYSIS OF MORTALITY DURING THE YEAR 1938. (England & Wales, London, 126 Great Towns, and 148 Smaller Towns and BARKING.) Rate per 1,000 Total Population. Annual Death Rate per 1,000 Population. Rate per 1,000 Live Births. Live Births. Still-births. |
4d8af9f8-dc57-46d2-a8bd-f544052796d0 | All Causes. Enteric Fever. Small-pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Influenza. Diarrhoea and Enteritis (under two years). Total Deaths under one year. England and Wales 15.1 0.60 11.6 0.00 0.00 0.04 0.01 0.03 0.07 0.11 5.5 53 126 County Boroughs and Great Towns, including London 15.0 0.65 11.7 0.00 0.00 0.05 0.01 0.03 0.07 0.10 7.8 57 148 Smaller Towns (Estimated resident populations, 25,000 to 50,000 at Census, 1931) 15.4 0.60 11.0 0.00 0. |
1b51a57b-1fff-41c5-aa63-463214aa02fc | 00 0.03 0.01 0.02 0.06 0.11 3.6 51 London 13.4 0.48 11.4 0.00 0.00 0.06 0.01 0.03 0.05 0.06 13.1 57 BARKING 14.49 0.63 7.1 0.01 0.00 0.00 0.00 0.03 0.18 0.12 5.4 39.5 Puerperal Sepsis. Others. Total. The maternal mortality rates for England and Wales are as follows : per 1,000 Live Births 0.89 2.19 3.08 „ ,, Total Births 0.86 2.11 2.97 17—18 4. VITAL STATISTICS OF WHOLE DISTRICT FROM 1927 TO 1938. |
457e6a1a-eb0c-43e3-8702-ce482f60e1d4 | Year. 1 Population estimated to Middle of each Year. 2 Births. Nett. Total Deaths Registered in the District. Transferable Deaths. Net Deaths belonging to the District. Of Nonresidents registered in the District. 7 Of Residents registered out of the District. 8 Under One year of age. At all Ages. Number. 3 Rate. 4 Number. 5 Rate. 6 Number. 9 Rate per 1,000 Live Births. 10 Number. 11 Rate. 12 1927 39,900 710 17.7 251 6.2 7 162 47 66.1 406 10.1 1928 40,870 805 19.7 276 6.7 6 144 51 63.3 414 10.1 1929 42,160 787 18.7 291 6.9 8 152 42 53. |
2b9810fa-05dc-441a-be71-2cad5f9afbb9 | 4 435 10.3 1930 45,000 799 17.7 256 5.7 7 186 49 61.3 435 9.7 1931 51,830 947 18.3 328 6.3 7 215 61 64.4 536 10.3 1932 60,330 1105 18.3 283 4.7 17 239 59 53.4 505 8.4 1933 68,840 1204 17.4 290 4.2 13 247 67 55.6 524 7.6 1934 72,290 1252 17.4 311 4.3 9 288 71 56.7 590 8.2 1935 72,650 1226 16.9 270 3.7 13 301 64 52. |
49d5f8aa-8be8-49e9-943e-9e37abdde50f | 2 558 7.7 1936 76,000 1195 15.72 313 4.1 13 308 67 56.07 608 8.0 1937 76,470 1133 14.82 302 3.9 8 306 61 53.8 600 7.8 1938 76,790 1113 14.49 290 3.8 9 267 44 39.5 548 7.1 19 (5) DEATHS. (a) General.—There were 290 deaths registered in Barking in 1938. Of these 9 were deaths of nonresidents. Barking residents to the number of 267 died elsewhere during the year. Including the latter and excluding the deaths of visitors, the net number of deaths was as follows:— Males. Females. Total. |
1f4a47c4-2f04-4af2-9749-8421458427b3 | 272 276 548 The death rate for 1938 was 7.1 per 1,000, compared with 7.8 in 1937, 11.6 for England and Wales, 11.7 for the hundred and twenty-six County Boroughs and Great Towns, including London, 11.0 for the one hundred and forty-eight Smaller Towns, and 11.4 for London. The above rate is commonly spoken of as “the crude death rate.” It is of little use for comparative purposes. Some towns inevitably have a high percentage of elderly people, and here of course the crude death rate is bound to be high, whilst in other towns there is a gradual exodus of people as they get towards middle age, and this factor tends to reduce the crude death rate. It is a matter of satisfaction that the death rate in Barking has fallen to a new low level of 7.1 per thousand population. |
8133952c-3d8a-4587-a95b-976f6fe7220f | 20 (b) Age Mortality.—The deaths in various age groups, according to the figures obtained locally, were as follows:— Age group. No. of deaths. Under 1 year 44 1 to 2 years 4 2 to 5 years 15 5 to 15 years 21 15 to 25 years 22 25 to 35 years 33 35 to 45 years 44 45 to 55 years 51 55 to 65 years 75 65 to 75 years 108 Over 75 years 131 Total 548 It is to be noted with satisfaction that nearly onequarter of the deaths were in respect of persons of 7.5 years and over, and that the age group 65 to 75 years, likewise, accounts for over a fifth. (c) Causes of death in 1938.—The table under subsection (f) shows the principal causes of death at various ages. |
2fd85488-db66-4cc9-87db-c107980c7fd9 | Those diseases, etc., causing most deaths 21 or important from a public health aspect were as follows:— Disease. No. of Deaths. Percentage of total net deaths registered. Cardio-vascular system 163 29.90 Cancer 75 13.69 Tuberculosis (all forms) 36 6.57 Pulmonary affections (exclusive of tuberculosis), viz. |
fece79dc-a4e0-42b8-99e3-46190dd59d3e | : Bronchitis 7 1.26 Pneumonia (all forms) 43 7.85 Other respiratory diseases 5 .91 Zymotic Diseases 23 4.19 (d) Deaths from Zymotic Diseases.—These diseases caused 4.19 per cent, of the total deaths, such deaths being caused in the following numbers:— Enteric Fever 1 Measles - Whooping Cough 2 Scarlet Fever –- Diphtheria 14 Diarrhœa 6 Smallpox - 22 I should like to comment upon the 14 deaths from diphtheria, because I do feel that, where we have such a readily available and an effective method of reducing the number of deaths, the public ought to take a greater interest than they do in diphtheria immunisation. (e) Inquests.—Coroner's inquests were held on 30 deaths. 23—24 (f) Causes of and ages of death during the year 1938. |
15d6a982-6c07-48c2-9fc6-6a55d6e39cf7 | (Net Deaths). Causes of Death. Deaths at the subjoined ages of " Residents " whether occurring in or beyond the Under one year. 1 and under 5 5 and under 15 district. RegistrarGeneral's Figures. 15 and under 25 25 and under 45 45 and under 65 65 and Total upwards Typhoid and Paratyphoid Fevers . |
7551f9d3-750e-4fcd-9249-ec4e5bb54177 | - - - - 1 - - 1 1 Measles — — — — — — — - — Scarlet Fever — — — — — — — - — Whooping Cough 1 1 — — — — — 2 2 Diphtheria — 8 6 — — — — 14 14 Influenza — — — 1 2 1 5 9 11 Encephalitis Lethargica — — — — — — 1 1 1 Cerebro-Spinal Fever — — — — — — — — — Pulmonary Tuberculosis — — 1 7 12 11 — 31 30 Non-Pulmonary Tuberculosis — 3 1 1 — - - 5 6 Syphilis — — — — — — — — — General Paralysis of the Insane, etc. — — — — — 1 — 1 2 Cancer — — — — 9 29 37 75 77 Diabetes — — |
f26c39cd-d666-4427-9afd-dc0922db3206 | — — — 4 3 7 7 Cerebral Haemorrhage — — — 2 2 5 25 34 44 Heart Disease — — — — 12 17 90 119 120 Aneurysm — — — — 1 3 — 4 6 Other Circulatory Diseases — — — — — 15 25 40 18 Bronchitis — — — — — 1 6 7 9 Pneumonia (all forms) 11 5 3 1 4 9 10 43 38 Other Respiratory Diseases — — — — 1 3 1 5 4 Peptic Ulcer — — — — 1 3 — 4 4 Diarrhoea (under 2 years) 6 — — — — — — 6 5 Appendicitis — 1 1 — — — 1 3 5 Cirrhosis of Liver — — — — — — — — — Other Diseases |
736dbb8a-1deb-4134-939f-da90982b7ccd | of Liver — — — — 3 — 1 4 4 Other Digestive Diseases 2 — 1 1 1 — 1 6 12 Acute and Chronic Nephritis — — — 1 8 6 4 19 16 Puerperal Sepsis — — — — 2 — — 2 2 Other Puerperal Causes — — — — 1 — — 1 1 Congenital Debility, Premature Birth, etc. |
c1552e91-64d1-4ea1-8a8b-86d29ca47fb6 | 21 — — — — — — 21 24 Senility — — — — — — 17 17 15 Suicide — — — — 2 4 1 7 8 Other Violence 1 1 4 5 3 5 2 21 24 Other Defined Diseases 2 — 4 3 13 10 7 39 20 Causes ill-defined or unknown — — — — — — — Totals 44 19 21 22 78 127 237 548 550 25 (g) Infant Mortality during the year 1938. The following table gives the actual causes of death of children dying under one year of age. Causes of death under 1 year of age, year 1938 :— 0-1 mth. 1-3 mths. 3-6 mths. 6-9 mths. 9-12 mths. Total under 1 year Accident — — 1 — — 1 |
e99fdec4-dafd-4e21-97bc-79261c5ffef2 | Atelectasis 1 — — — — 1 Bronchitis — — 1 — — 1 Broncho-Pneumonia — 1 5 2 1 9 Broncho-Pneumonia & GastroEnteritis - - 1 1 - 2 Broncho-Pneumonia & Whooping Cough - - - 2 - 2 Congenital Debility & Prematurity 1 - - - - 1 Congenital Heart Disease 1 —- 1 - — 2 Congenital Inanition 1 — — — — 1 Congenital Spinal Meningocele 1 — — — — 1 Convulsions & Broncho-Pneumonia - 1 - - - 1 Convulsions & Dentition — — — — 1 1 Deficient Inherent Vitality & Prematurity 1 - - - - 1 Gastro-Enteritis — — 1 1 1 3 Gastro-Enteritis & Pyloric |
fb6b28de-54a4-4dcc-af5d-c08ba7fb3330 | Stenosis - 2 - - - 2 Intestinal Obstruction — — — 1 — 1 Marasmus & Prematurity 1 — — — — 1 Meningitis 1 — 1 — — 2 Prematurity 7 — — — — 7 Prematurity & Hare Lip 1 — — — — 1 Septicajmia 1 — — — — 1 Spina Bifida 1 — — — — 1 Tentorial Tear 1 — — — — 1 Totals 19 4 11 7 3 44 Net Births in the Year:- Legitimate 1,086 Illegitimate 27 1,113 26 Net Deaths in the year :— Legitimate 42 Illegitimate 2 44 (h) Neo-Natal Mortality during the year 1938. Neo-Natal Mortality means deaths among the newly born. Causes of Neo-Natal deaths, year 1938 :— Under 1 wk. |
f198e9cf-a1c4-4e30-9237-98ba56041265 | 1-2 wks. 2-3 wks. 3-4 wks. Total. Atelectasis 1 - - 1 Congenital Debility & Prematurity 1 - - - 1 Congenital Heart Disease 1 — — — 1 Congenital Inanition 1 — — — 1 Congenital Spinal Meningocele — — — 1 1 Deficient Inherent Vitality & Prematurity 1 - - - 1 Marasmus & Prematurity — — — 1 1 Meningitis — — — 1 1 Prematurity 7 — — — 7 Prematurity & Hare Lip 1 — — — 1 Septicaemia 1 — — — 1 Spina Bifida 1 — — — 1 Tentorial Tear 1 — — — 1 Totals 16 — — 3 19 It will be seen from the tables that of the forty-four deaths under the age of one year, |
e21a79a8-c033-4aa6-bf7d-371cddd77a80 | no less than nineteen were four weeks of age or under, and prematurity is given as the cause of death or as a contributory cause in the cases of eleven babies, who died within the first four weeks of life. The fact that nineteen died within the first month, leaving only twenty-five deaths for the remaining 27 eleven months of the first year of life, shows that our chief problem at the present time is still the mortality among the newly born. Out of the nineteen babies who died under the age of one month, no less than sixteen died within the first week. I am glad to say there has been a significant drop from thirty to nineteen babies who died within the first month of life. This is a step in the right direction. In my last Report I gave some details regarding the causes of death in the neo-natal period, and these remain the same for the present Report. |
ca11d7fc-0dee-45cb-a5dc-2f39cc71ffeb | It was suggested that routine post mortem examinations on such cases might lead to some significant discovery which would enable the number of such deaths to be reduced, but this service has not been in operation, as I have stated elsewhere. Your attention is drawn to the new low infant mortality rate of 39.5. This is the lowest figure yet reported to you, and it must be some satisfaction that the co-operation of the services you have made available, together with the attention and the following-up methods employed by the health visitors, have done much to produce this result. The number of deaths from respiratory diseases, I am still pleased to say, has shown a slight decline. The following table shows the comparative figures of infant mortality and neo-natal mortality for the past ten years :— Year Infantile Mortality Infantile Mortality Rate Neo-Natal Mortality Neo-Natal Mortality Rate 1929 42 53.4 28 18.9 1930 49 61 24 19. |
a9d48011-2957-4c24-ab8c-fa87964b8b2d | 2 1931 61 64 31 29.4 28 Year Infantile Mortality Infantile Mortality Rate Neo-Natal Mortality Neo-Natal Mortality Rate 1932 59 53 28 25 1933 67 55.6 29 24 1934 71 56.7 39 31.15 1935 64 52.2 35 28.5 1936 67 56.07 38 31.8 1937 61 53.8 30 26.5 1938 44 39.5 19 17.1 (i) Post Mortem Examinations.—Progress in connection with post mortem examinations in still-births and neonatal deaths has unavoidably been held up during the year. (6) BIRTHS. |
de8b94e6-456c-42ba-9048-6c88c1a92ee4 | The net number of births registered in 1938 was 1,113, affording an annual birth rate of 14.49 per 1,000 population, compared with 14.82 in 1937, 15.72 in 1936, 16.9 in 1935, 17.4 in 1934, 17.4 in 1933, 18.3 in 1932, 18.3 in 1931, 17.8 in 1930, and 18.7 in 1929. Of all births, 27 were illegitimate, giving a percentage of 2.43 of the total births. Notification of Births Acts, 1907-1915.—During 1938 there were 1,096 live births notified, excluding II cases transferred from the district. In addition, notifications of still-births belonging to the district totalled 42. |
374b83bf-d486-4abb-93fc-05bc3ecbaa80 | Ten live births and 3 still-births were not notified, and these cases are not included in the totals of notified births given above. (7) SOCIAL CONDITIONS. (a) General.—The population has again shown an increase during the year, and this must be expected until the area is house-saturated. The amenities of the 29 Town are increasing too, in that there has been a considerable exodus of population from the crowded areas of Barking to the new housing estate at the Scrattons Farm Estate. It must be noted, however, that this is not quite comparable with the transfer of people from the London areas to the Becontree Estate, because the so called overcrowded areas in Barking are indeed much in advance of conditions which in other areas would be accounted as satisfactory. This fact will, therefore, have a very important effect upon the future health of the Barking population. The Registrar-General classifies occupations into five groups known as " social classes " broadly corresponding with their scale of remuneration. |
3495e2e5-b2eb-4a7e-afa2-a33b6830a844 | These classes are :—(I) Professional, etc., (2) Intermediate, (3) Skilled Artisans, (4) Semi-skilled, (5) Unskilled Labourers. The population of Barking is largely confined to classes 3, 4 and 5, with a majority in class 5. (b) Industries.—Some of the chief industries carried on in the area are as follows :— The production of electricity, gas, benzole, naphtha and zinc oxide. The manufacture of asbestos goods, joinery, icecream, letter files, mineral waters, marine lights, disinfectants, printing ink, sausage skins, cabinets and furniture, nautical instruments, paint, iron goods, tin boxes, lifebelts, rubber goods, wireless equipment and batteries, matches, soap, chemical manure, wood-paving, concrete paving, collapsible tubes, tin foil and food products. The storage of petrol, oil, fuel and timber. Electrical welding, structural engineering and joinery works. |
a9d7dc42-24f4-4a03-bce0-19483cc7076c | 30 The population of Barking is a working population. (c) Unemployment.—The following table is compiled from information kindly supplied by the Manager of the Ministry of Labour Employment Exchange, Barking :— Copy of comparative statement of local unemployed by industries, as at December, 1937 and December, 1938:- Dec. 1937. Dec. 1938. Men. Women. Men. Women. Food 12 5 8 3 Electrical and W ireless 26 46 2 1 Building Trade and Painters 178 — 179 1 Works of Construction 141 — 146 — Engineering 23 3 31 2 Domestic 18 18 18 50 Rubber Workers 17 21 34 19 Commercial 3 — 3 3 Road and Water Transport 21 1 43 1 Clothing 4 38 12 35 Distributive Trades 68 18 133 52 Government and Professional 13 2 1 — Tin Box Manufacture |
52e7058a-5a41-4ac2-8686-c1d3118c5a94 | 5 11 7 9 Matches 2 13 3 3 Chemicals 25 1 26 4 Printing 11 7 17 13 Asbestos 4 4 7 14 Woodworking and French Polishing 14 6 7 2 Agriculture 7 31 7 25 General Labourers and Factory Hands 816 128 633 185 Mineral Water Manufacture 6 3 — 1 Leather Trades 4 4 — Gas and Water 60 2 42 — 1,478 359 1,363 423 I have no statistical evidence to offer in regard to the result of unemployment upon the health and physique of children and adults in Barking. It is, however, a matter of concern that a number of Barking women still present themselves at the antenatal clinics, in whose blood the amount of red colouring matter is significantly below normal. |
35924448-35a6-45c4-8186-0764c3c20794 | A scientific 31 enquiry into this problem has been undertaken at your pathological laboratory, and you are referred to pages 75 to 79 which deal with the work of this laboratory. It would be rash at the present time to associate directly the incidence of this form of anaemia with unemployment, indeed, it should be stated quite clearly that the factors leading to this anaemia are still obscure, but I cannot help feeling that a more generous diet, even if we do not know the precise item it would supply, would be likely, materially, to alter the incidence of these cases of anaemia. |
81f859fb-01aa-4179-ab60-f23633c8d510 | During the later months of pregnancy this falling off in the amount of haemoglobin, as the red colouring matter is named, is met with even in fine, upstanding and well fed athletic women, and of course where you have this abnormal drain upon the resources of the expectant mother it is not to be expected that some added nourishment during the later months of pregnancy is likely, at one and the same time, to arrest this added drain and augment significantly the amount of haemoglobin in the blood. (d) Housing.—The conclusions taken from the evidence given before the Royal Commission on the Geographical Distribution of the Industrial Population show that the factors most important in enhancing the death rates of residents in towns are (1) crowding together of houses ; (2) crowding together of people into houses too small for them ; (3) the apparent aggravation by urban conditions of other adverse effects of economic pressure upon the standard of living and environment ; and (4) the production of smoke from factories and homes which reduces the effective sunshine. |
58b5e640-70f2-44fb-a66a-772f01a377a2 | In my Annual Report for 1937, I stressed the view that we ought to consider the number of persons to 32 the acre, rather than the number of houses to the acre, when expressing an opinion upon density, and I am glad to be able to say that my views are supported in the evidence given before the Royal Commission upon the Geographical Distribution of the Industrial Population at the end of 1938, when the conclusion was that the density of houses per acre was less important in its association with mortality than the crowding of people per room. Continuing the remarks upon social conditions, I am glad to be able to record the continued improvement in the layout of the Council's housing estates. Social consciousness has been awakened to the fact that the good quality of housing depends primarily upon the good quality of the neighbourhoods and towns in which houses are erected. |
8f4a1b2d-b5af-47e4-99c2-651efd05a53c | To be a real home the house in which we live should not be in a mean street, or if in a good street not in a mean neighbourhood or if in a good neighbourhood not in a generally mean and disorderly town. ' Many of the tenants removed from the central area of the town and similarly those from East London to the Becontree Estate have shown by their use of the new accommodation how much they prize the change from their previous circumstances. Unfortunately, we still have something like 5 per cent, of these transfers who tend for some time to show no improvement and it is with these that we must continue our health education. (e) Travelling Facilities.—There has been no improvement in the standard of travelling conditions to and from Barking during the year, and I can only continue to deplore that such conditions should exist. |
9e0e43b3-685c-46d6-a3bb-4a0187e01e77 | (f) Malnutrition.—With the increasing facilities at the clinics, whereby dried milks, baby preparations and 33 chemical foods can be obtained at the minimum cost and with the minimum of trouble, malnutrition should not be expected. This I can say is so, and it reflects the high standard which your services are maintaining. Our statistics in regard to malnutrition only deal with school-children and are as follows :— Of 4,716 children examined by routine at school medical inspection, 5 were found to be suffering from malnutrition, 287 were found to have slightly subnormal nutrition, 3,243 normal nutrition, and 1,181 with excellent nutrition. 35 SECTION B. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. (i) GENERAL HEALTH SERVICES. (a) Laboratory Facilities.—The following table shows the routine work which has been carried out by arrangement with the Essex County Council at the Counties' Public Health Laboratories, situated in Queen Victoria Street, London, E.C.4 :— Specimen. No. |
a402a374-5d7b-49cc-ac08-f79b1438d904 | examined. Diphtheria 1,066 Sputa 311 Typhoid 7 Milk 64 Water 19 Ice-cream 28 General 45 Total 1,540 In addition to the above, 4 biological tests were carried out to test the virulence or otherwise of germs of the diphtheria group. During the year laboratory facilities have been developed. It is not so much that new facilities have actually been opened up, but that facilities already existing have been consolidated and used to fuller and better advantage. Your own laboratory has continued its work at the Barking Hospital, and has continued, together with Dr. F. E. Camps, of Chelmsford, its special work in 36 investigating the large family of germs which can be termed generally as hasmoclastic streptococci. |
5f46290a-a6b3-4312-8766-7b099e9d0ff2 | Here we are collecting data which we believe may have some results in elucidating the problems of the hospitalisation of scarlet fever, the treatment of puerperal fever, and perhaps the incidence of rheumatism. The facilities offered by the Essex County Council also continue to become better and better, and your own scientific department is not only charged with undertaking those examinations which can only be or which can be better carried out locally, but also with seeing that the various officers of the Corporation avail themselves of the facilities which are offered by the County, or at least that they are fully acquainted with these facilities. It would of course be futile for such a highly developed laboratory as your own to do the hack work of diphtheria swabs, which are of no value in diagnosis and which are only of value- in helping to determine when a person who has had diphtheria is reasonably free from infection. |
5e88e9fb-5fff-4a65-b801-b69e27a74032 | As time goes on it would be of advantage if the facilities of this local laboratory were placed at the service of the general medical practitioners, in the same way as they are placed at the service of your own staff. Personally, I would recommend this. The Report by Dr. E. M. Hill on the work of the Pathological Unit is one which will be read with avidity by all those who are interested in the welfare of your services. That particular part of her work which deals with the different strains of certain organisms which cause scarlet fever, can, of course, be only fully appreciated by those who are acquainted with all the technical 37 details, but there are other parts of her report which are perfectly sound and which will appeal to a much wider public. There is a great deal of anaemia among women of Barking and it is true that much of this anaemia is due to continued malnutrition. |
67ca7ca9-ef7b-4db7-aa6b-f03dc428eb0c | It is true that during 1938 no cases of puerperal fever were due to the more hostile germs which are so highly infectious and which cause such a high mortality—they were due in large part to germs which were able to obtain fopthold because of anaemia or haemorrhage. Particularly, I want you to note Dr. Hill's evidence of good work you are doing amongst girls of school age, especially her remark that this work may confidently be expected to bring its own reward when these selfsame girls take upon themselves the responsibility of motherhood in the years to come. It will be quite obvious that this Unit has been founded on sound lines. (b) Ambulance Facilities.—It can be well understood that during this year of the Crisis, the question of ambulances has been very much in the forefront. |
8b872d05-4d54-4c3c-9cbe-a3d1941b6148 | Incidentally, I may remind you that during this year the Du Cros Ambulance, which has been running for very many years, has been replaced by one built on an Austin chassis, but has been retained for the training of ambulance drivers in the Air Raid Precautions Scheme. You already have an adequate ambulance service, especially having regard to the fact that you have reciprocal agreements with all neighbouring boroughs, but perhaps the time has come when areas in extrametropolitan Essex should look for reciprocal agreements with every authority within reasonable distance 38 and not with just their immediate neighbours, so that particularly in a time of crisis the ambulances in any one general area may be used most profitably. (c) Hospitals (Public and Voluntary).—The work at the Barking Hospital has been relatively light and developments have been limited to detail. |
7153dd92-e351-4c1c-bc9f-f71723d446dd | An illustration of this can be given by mentioning that some 6 cubicles, by means of pipes, can be supplied with those gases, such as carbon dioxide and oxygen, which are at times necessary in the treatment of pneumonia. On the other hand, the work at your maternity pavilion has been particularly heavy and it has been necessary to limit the number of cases, and indeed to reduce demand. If the practice of hospitalization of maternity cases is likely to continue with the strides it has made of recent years, it will be necessary for you to build another maternity pavilion, and already you have approved plans for a second maternity pavilion. Although not situated in Barking, there are many voluntary hospitals catering for the needs of the people of Barking. A sum of money is set aside by you each year for distribution among these hospitals. |
ec013536-3c08-45cf-99e2-35f8ab0a0bdc | The following table shows the amount of money which has been contributed to each hospital, and represents roughly the use to which they are put by the people of Barking :— £ East Ham Memorial Hospital 54 King George Hospital 54 London Chest Hospital 16 Princess Elizabeth of York Hospital for Children, Shadwell 34 Queen Mary's Hospital, Stratford 16 St. Mary's Hospital, Plaistow 16 39 Hospital for Sick Children, Great Ormond £ Street 5 Poplar Hospital 29 London Hospital 76 Total £300 (d) Clinics and Treatment Centres.—During 1938 the total attendances at Infant Welfare, Ante-Natal and Minor Ailments Clinics have increased—see tables on pages 41 to 44. Once again there has been an increase in the total attendances at the Maternity and Child Welfare Centres and the service itself has been increased to serve the needs of the population of the area, notably in the extension of the food preparations obtainable at the various centres. |
c8be1782-18cf-475f-bb19-ee58cf0ba325 | During the year sessions for minor ailments, infant welfare and ante-natal work have been a permanent feature of the Porters Avenue Clinic, which has now become one of the main centres for this work. The minor ailments section was opened primarily to relieve the extreme congestion, which had been reported to you in previous years, at the Woodward Clinic, but the result has not been quite what was anticipated— instead it has made available to a section of the community the services which previously could be had but at considerable inconvenience to those desiring them. The Porters Avenue Clinic has, therefore, done little to relieve the congestion at the Woodward Clinic, but has become a full live centre of its own, catering for the Northern Section of the Becontree Estate in Barking. It is not anticipated that the work of this clinic will decrease and the replacing of the present temporary premises by a permanent building must be considered and entertained. 40 The ultra-violet light clinic is still held in the Manor School. |
b461e180-b478-4b52-af10-4fcf6f9418ac | It is anticipated that when this clinic is transferred to the new proposed out-patient department in Upney Lane the attendance figures will increase. A special clinic for mothers is held in the Humphrey Ward, a building adjoining the Upney Maternity Pavilion. The numbers here are steadily increasing and although the attendances from the area in which the clinic is situated were expected to be higher, it does fulfil a need, in as much as difficult cases about to enter the maternity hospital and cases after confinement at the hospital are seen at this clinic by the resident medical officer. Also, the clinic is used once a month as a birth control centre. Foot Clinic.—July saw the inauguration of a Municipal Foot Clinic, and sessions, including evening ones, are held at the Central and Woodward Centres. This service is much appreciated by the public, and meets a very real need. |
8122eb7a-76a9-49e7-8faf-d933692897b5 | (e) Nursing in the Home.—I have been very favourably impressed when, in the course of my journeyings, I have come across communities of peoples where hospitalisation is carried to such an extent that virtually there is no nursing in the homes. It appears that unfortunately this is a very long way off in England, and that we must in this way or in that provide nursing in the homes of the people, and if we accept the principle it can only be said that we ought to provide more than we do at present. At present the work is done in Barking by the Plaistow Maternity Charity and District Nurses' Home and the East Barking District Nursing Association, both of whom now receive substantial grants from the Corporation. The Plaistow Maternity Hospital and District Nurses' Home, with their large home, are able more or less to second nurses to Barking 41—42 CLINIC AND TREATMENT CENTRES. Name and Situation. When Held. Nature of Accommodation. |
bac86034-c977-4642-9ab5-b7f184608590 | By Whom Provided 1. Maternity and Child Welfare. (a) Infant Welfare Centres :— * Central Clinic, Vicarage Drive, Ripple Road Tuesdays and Fridays, 2 p.m. Modern clinic premises with accommodation for consultations, weighing of babies, waiting rooms, etc. Local Authority. Woodward Clinic, Woodward Road Tuesdays, Thursdays and Fridays, 2 p.m. do. do. * Greatfields Centre, Movers Lane Mondays and Thursdays, 2 p.m. Accommodation for consultations, weighing of babies, waiting rooms, etc. do. * Alexandra Centre, St. Paul's Road do. do. do. Porters Avenue Centre, Porters Avenue Mondays, Wednesdays and Fridays. do. do. (6) Ante-Natal Clinics :— 2 p.m. |
9c4a1262-49fe-4b56-96cc-0996f2185f0f | Central Clinic, Vicarage Drive, Ripple Road Tuesdays and Wednesdays, 2 p.m., and Fridays, 10 a.m. Modern clinic premises with accommodation for consultations, etc. do. Woodward Clinic, Woodward Road Tuesdays and Wednesdays, 9.30 a.m. do. do. Porters Avenue Centre, Porters Avenue Thursdays, 9.30 a.m. Accommodation for consultations, etc. do. Humphrey Ward (near Maternity Pavilion), Upney Lane. Mondays, Tuesdays, Wednesdays and Fridays, 10.30 a.m. do. do. Specialist-Consultant Clinic at Central Clinic, Vicarage Drive, Ripple Road. Third Tuesday in each month 3.30 p.m., except August and December. Modern clinic premises with accommodation for consultations, etc. do. |
9d433366-6d1c-4456-86ab-7dc8494300cd | (c) Gynaecologica] Clinics :— Central Clinic, Vicarage Drive, Ripple Road As and when required. Modern clinic premises with accommodation for consultations, etc. do. Woodward Clinic, Woodward Road do. do. do. Porters Avenue Centre, Porters Avenue do. Accommodation for consultations, etc. do. Humphrey Ward (near Maternity Pavilion), Upney Lane. do. do. do. (d) Birth Control Clinic :— Humphrey Ward (near Maternity Pavilion), Upney Lane. do. do. do. * Since the end of 1938 the Clinics held at the Alexandra Centre have been discontinued, and the undermentioned additional Infant Welfare Sessions have been commenced :— Central Clinic, Vicarage Drive, Ripple Road Thursdays, 2 p.m. Greatfields Centre, Movers Lane Wednesdays, 2 p.m. |
a2170148-3034-4e30-b568-9214315db47f | 43—44 CLINIC AND TREATMENT CENTRES. Name and Situation. When Held. Nature of Accommodation. By Whom Provided 2. School Medical Service. (a) Inspection Clinics and Treatment of Minor Ailments :— Central Clinic, Vicarage Drive, Ripple Road Daily, 8.30 a.m. Modern clinic premises with inspection, waiting and treatment rooms, etc. Local Authority. Woodward Clinic, Woodward Road do. do. do. Porters Avenue Centre, Porters Avenue do. Accommodation for consultations, etc. do. (b) Ophthalmic Clinic :— Central Clinic, Vicarage Drive, Ripple Road Tuesdays and Fridays, 10 a.m. Modern clinic premises with inspection, waiting and treatment rooms, etc. do. Woodward Clinic, Woodward Road Thursdays, 2 p.m. do. do. |
85817245-1efd-4f16-9f06-c002ef09e089 | (c) Dental Clinics :— Central Clinic, Vicarage Drive, Ripple Road Daily, 9 a.m. and 2 p.m. do. do. Woodward Clinic, Woodward Road do. do. do. East Street Clinic do. Inspection, waiting and treatment rooms do. (tf) Orthopaedic Clinic :— (i) Specialist's Clinic, Manor School First Thursday in each month, 9 a.m. Three rooms do. (ii) Remedial Exercises Clinic, Ultra Violet Light Therapy, etc. :— Faircross School Daily, 9 a.m. and 2 p.m. One room do. Manor School do. Three rooms do. (e) Ear, Nose and Throat Clinic :— Woodward Clinic, Woodward Road Tuesdays and Fridays, 2 p.m. Modern clinic premises with inspection, waiting and treatment rooms, etc. do. 3. |
2d7deb56-89d3-4e3f-9196-f57072fec13d | Immunisation Clinic (Diphtheria, Scarlet Fever and Whooping Cough):— Central Clinic, Vicarage Drive, Ripple Road Mondays, 10.30 a.m. Modern clinic premises with inspection, waiting and treatment rooms. do. Woodward Clinic, Woodward Road Mondays, 9 a.m. do. do. 4. Foot Clinic. Central Clinic, Vicarage Drive, Ripple Road By appointment do. do. Woodward Clinic, Woodward Road By appointment do. do. 5. Tuberculosis. 37, Linton Road Mondays, 3-5 p.m. Tuesdays, 7-8 p.m. Thursdays, 10.30 a.m.-12.30 p.m. Three rooms Essex County Council. 6. Venereal Diseases. Oldchurch Hospital and London hospitals, etc. — - Bv arrangement with Essex County Council 45 in accordance with the demands which are being made upon them. |
0f132d1a-06e3-41bb-ae5f-def8f0f97d46 | During the year the East Barking District Nursing Association has increased its staff from two to three nurses. Speaking particularly of the latter, I am to say that if the various grants which its energetic Secretary has been able to obtain were to be discontinued, the work could not be carried on. The amount of money collected locally is only a small part of that which is expended. To my mind this is unsatisfactory. I am confident that you share this opinion with me, in which circumstance you might entertain helping to promote legislation which would make it possible for local authorities to set up general domiciliary nursing services, or alternatively, to subsidise completely those people who are willing to set up such services. (2) MATERNITY AND CHILD WELFARE SERVICES. The work in connection with Maternity and Child Welfare is carried on under powers given in the following Acts :— Notification of Births Act, 1907. Notification of Births (Extension) Act, 1915. |
9edb9455-d8cb-4e71-9c0b-e26640e0d242 | Maternity and Child Welfare Act, 1918. Part I of the Children Act, 1908, as amended by Part V of the Children and Young Persons Act, 1932. Midwives Acts, 1902-1936. Public Health Act, 1936. (a) Ante-Natal Supervision.—Ante-Natal Clinics are held at four centres—three sessions weekly at the Central Clinic, two sessions weekly at the Woodward ' J Clinic, one session weekly at the Porters Avenue Clinic, and four sessions weekly at the Humphrey Clinic. The 46 extension of afternoon sessions to the latter clinic have been started and the time may arrive when a further clinic, to be held at the Porters Avenue Centre, will be required. The following tables show the attendances at these clinics during the year :— Central Clinic. Woodward Clinic. Humphrey Clinic. Porters Avenue Clinic. No. |
c72d4473-c664-4467-b5c3-a763ab43c9d2 | of Sessions 154 103 207 52 First attendances 467 270 149 192 Re-attendances 2,527 1,401 686 964 Total attendances 2,994 1,671 835 1,156 Total First Attendances ... • • • 1,078 „ Re-Attendances ... ... 5,578 ,, Attendances ... ... 6,656* „ Sessions ... ... 516 * In addition there were 385 Post-Natal, and 349 Gynaecological Attendances. Mr. O'Sullivan, the Specialist Consultant, holds a special consultant ante-natal clinic monthly at the Central Clinic, and the following table shews the attendances made during the year :— Number of sessions 10 First attendances 65 Re-attendances 20 Total attendances 85 In addition there were 59 Post-Natal and Gynaecological Attendances. |
f8fea862-a11c-4792-8d1a-458dbadaa7cd | 47 It is worthy of note that out of about 1,150 births, 1,078 women attended at your ante-natal centres during 1938. This only leaves 100 or less women who did not attend your clinics. This gives a very high percentage of cases attending your centres, and is one which does not leave a great margin upon which to improve. The great increase this year is probably due to the fact that the majority of the cases engaging midwives do attend the clinics regularly. Mothers attending for the first time are seen firstly by the sister in attendance, who, if the mothers have not made arrangements for the confinement, gives them information about obtaining the services of a midwife and about admission to the Upney Hospital. They are than seen by the medical officer in attendance who examines and makes full notes on each case, including the histories of previous confinements. The Consultant Obstetrician and Gynaecologist, as in previous years, attends monthly and all cases requiring specialist examination are referred to him. |
a344e88a-9f6a-481b-bc90-11281eda24e0 | It has not yet become the practice in Barking to take a specific blood examination of all expectant mothers for venereal disease, and this to my mind is a definite medical entity which must have a far-reaching effect upon mother and child. The encouraging of free dinners, free milk and free tonics, etc., in necessitous cases, still obtains and much is done to ensure that it is commenced in the early stages of the pregnancy. (b) Still-births.—There is nothing to add to my remarks of last year in regard to the discovery of the causes of still-births. It had been hoped that with the inauguration of routine post-mortem examinations in all cases of still-birth, something might have been discovered which would lead to methods for reducing 48 the number of these deaths, but this service has not been put into operation, as stated in another section of this Report. |
a7fec386-8084-4b81-9774-c3c7952aed65 | (c) Midwifery.—The Council has been the Local Supervising Authority for Midwives since the 1st April, 1935- Forty-six midwives notified the Local Supervising Authority of their intention to practise or that they had practised within the Borough during the period 1st January, 1938, to the 31st December, 1938, and the number who were engaged in practice in the Borough at the end of the year was as follows:— At Upney Hospital 6 Municipal District Midwives 5 At the District Nurses' Home of the Plaistow Maternity Hospital 3 At the Salvation Army District Nurses' Home 3 In private practice 3 The number of visits of inspection paid by the Inspector of Midwives was 53. |
5dafcec9-7c11-4202-abd6-a01ae94cb456 | The following is a summary of notifications received from midwives :— Medical Help 201 Deaths of Mother or Child 1 Laying out the Dead 8 Still-births 12 Liability to be a source of Infection 12 Artificial Feeding 11 245 49 The following is a summary of the 201 cases in which medical help was sought:— Mother:— Anaesthetic 33 Haemorrhage—Ante-partum 18 Post-partum 6 Malpresentations 11 Miscarriage 3 Prolonged labour 16 Rise of temperature 3 Retained placenta 6 Ruptured perineum 25 Uterine inertia 1 Miscellaneous causes 31 153 Child:— Discharging eyes 27 Prematurity 2 Unsatisfactory condition 5 Miscellaneous causes 14 48 By agreement, dated 1st January, 1924, with the Plaistow Maternity Hospital and District Nurses'Home, |
7e8ed918-10f2-4f0d-96e6-5ccfa0014fbf | the Council annually subsidised the Hospital on any deficit from ^300 in respect of the district midwifery 50 work of their midwives in Barking. This agreement is now superseded by a further one made pursuant to the Midwives Act, 1936, which agreement came into operation on 1/10/38. A payment of £114 12s. 6d. was made to the Hospital on account of their district midwifery work during the nine months ended 30/9/38- The year 1938 has seen steady and slow progress in the development of the midwifery service in Barking. I think the Council can reasonably hold the opinion that these developments have been on sound lines. |
d5e62da0-c7c1-4fcb-abe3-85098be0a754 | My readers are asked to refer to the general remarks I made on pages 42 and 43 of my last year's Report, in which I pointed out that so far as midwives directly under the control of the Council are concerned they had commenced their work, and that so far as voluntary bodies, to wit, the Salvation Army and the Plaistow Maternity Hospital and District Nurses' Home were concerned negotiations were still pending at the end of 1937. During 1938 these negotiations have been concluded and both of these organisations' nurses are an integral part of the Barking scheme. The system for the collection of fees is entirely in the hands of the Council. During the year there have been two or three conferences among the midwives and between the midwives and the health visitors, at which many of the minor difficulties which are bound to be encountered at the inception of such a service have been discussed and straightened out. |
f34906b4-da74-4626-9690-be6a8a3027e3 | Particular care has been taken by the Corporation in co-ordination to avoid overlapping of the midwives and the health visitors in their visits to the homes of expectant mothers. (d) Upney Hospital.—The admissions to the Maternity Home during 1938 numbered 596 of which 92 were admitted for ante-natal treatment. 51 During the past year the daily average number of beds occupied was twenty-four. The total number of bed-days was 8,687. From the above figures it will be appreciated that the number of cases wishing to enter the Hospital were in excess of the beds actually available there, and in an endeavour to meet the situation part of the old maternity pavilion was reopened. Towards the end of the year, however, it was found necessary to limit the number to be admitted to the Hospital. In order to do your best to see that those cases in which hospitalisation was obligatory were not overlooked, it was necessary for you to enquire of each applicant concerning her domestic circumstances. |
7a79b0ee-53b4-4b22-a647-bb29af6ead9d | It will be appreciated by those people that these enquiries into their personal circumstances were not intended to be inquisitorial, but were wholly and solely for the purpose of seeing that the Hospital was used to the best advantage of those who had the most claim to it on social and medical grounds. A small beginning has been made in endeavouring to get so many as it is possible of the women who are to be confined in the Hospital to attend, either the clinic in the Humphrey Ward, situated in the grounds of the Hospital, or to such other clinics where they can be seen by the Resident Medical Officer of the Hospital himself, particularly after 30 weeks of pregnancy. It is hoped that this slow beginning will develop until it can be said that all those women who are to be confined in the Hospital will have been ante-natalled in the later stages of their pregnancies by the Resident Medical Officer, who, of course, will be responsible 52 for delivery. |
f48b2691-1103-4438-bda8-6c74a2109dbe | It is obviously desirable more and more to develop this work along lines which will ensure that the person conducting the confinement is fully aware of the whole of the history of the case. (e) Post-Natal Care.—During the year there has been an increase in the number of post-natal examinations carried out at your clinics and this is due in a large measure to the opportunity which is given to every mother to attend at one of your clinics after her confinement for a concluding examination, if I may so call it. Should any residual disability be discovered at this examination, then necessary advice and, in some instances, treatment are given, and if required the advice of the Consultant Obstetrician and Gynaecologist is obtained. (f) Gynecological Clinics.—During the year there has been an increase in the numbers attending these clinics. May I once again point out that where any woman wishes to seek medical attention for some complaint which comes within the purview of women's diseases, she is always welcome to attend one of these clinics. |
d43f258d-e0c0-4f9d-839c-aafb889492fa | (g) Pemphigus Neonatorum.—During the year one case of pemphigus neonatorum was notified and admitted to the Barking Hospital for treatment. (h) Maternal Mortality.—According to the return of the Registrar-General there were during the year 1938, three deaths from puerperal causes—two deaths from puerperal sepsis and one death from other puerperal causes. This gives a rate of 2.58 per 1,000 total births. 53 The following table gives you similar information for the last fifteen years:— Maternal Mortality—Statistics. Year. Barking. England and Wales. Deaths from Rate per 1,000 births. Rate per 1,000 births. Puerperal Sepsis. Other Puerperal Causes. 1924 1 2 3.66 *3.90 1925 — 1 1.21 *4. |
11c49f17-5e88-493f-a4b0-dea2e4b528e8 | 08 1926 — 1 1.22 *4.12 1927 2 1 4.23 *4.11 1928 — 2 2.48 4.25 1929 — 2 2.54 4.16 1930 — 3 3.72 4.22 1931 1 3 4.08 3.95 1932 — 1 0.88 4.06 1933 4 — 3.2 4.23 1934 1 4 3.82 4.41 1935 3 1 3.18 3.93 1936 1 2 2.44 3.65 1937 1 4 4.28 3.11 1938 2 1 2.58 2.97 * Rate per thousand live births—figure not available in respect of rate per thousand total births. |
360e6388-307c-447a-999f-254c65f3126d | The maternal mortality rate this year is 2.58 and it is lower than that which is given for the whole of England and Wales, although as I have reported previously it is not possible to compare these rates from area to area. It does appear that some information about the three deaths which occurred in Barking might be useful—the first case is one which was not dealt with under your own scheme and never attended an antenatal clinic. It was one in which pregnancy had only been present about three months and with the oncoming of sudden symptoms, which required urgent 54 operation, the case was fatal. This condition, known as ruptured ectopic gestation, is well known to medical science and is due to the pregnancy occurring in the female tubes and not in the uterus or womb. The progress of pregnancy in such an unusual position leads to the distension of the tube with resultant distension and final perforation, which is shown by acute sudden internal hæmorrhage. The conclusions of such a condition need no further explanation. |
1b143174-d644-4d2a-8187-9f6f2afe7dc8 | The other two cases were definitely maternal deaths. The first being one, which although having attended regularly at the Clinics had in the later stages developed some toxic signs and although the confinement was satisfactory as was the subsequent health for about a month after the confinement, the patient developed pneumonia which lead to complications and death. In the second of these two cases the patient had attended a clinic on five occasions and toxic signs were found. Recommendations were made and the patient admitted to hospital for treatment, and after a difficult labour and a prolonged illness the patient succumbed to heart failure. It must be pointed out that both of the latter cases were under the care of your Consultant Obstetrician and Gynaecologist. Finally, it must be borne in mind that over one thousand pregnancies were terminated satisfactorily in Barking during the year, and the above three cases would appear to be those in which no recommendations could be made to you whereby provision for reducing the mortality in this small number could be effected. Mr. |
14c41837-9083-4796-83b9-da9f41506921 | J. V. O'Sullivan continues as your Consultant Gynaecologist and Obstetrician and advises in all cases of difficulty. 55 (i) Ophthalmia Neonatorum.—During 1938 five cases of ophthalmia neonatorum were notified and all of these cases recovered with unimpaired vision. Three cases were treated at home and two were admitted to the Barking Hospital. (j) Illegitimate Children.—Special attention is paid by the Health Visitors to all illegitimate children. Twenty-seven illegitimate children were born during the year, and two died. (k) Tonsils and Adenoids, etc.—In another part of this Report I have recorded that during the year an Ear, Nose and Throat Clinic was commenced under the direction of Mr. C. R. Sandiford, F.R.C.S. This clinic saves parents and children from attending the Out-Patients Department of Queen Mary's Hospital and other Hospitals for specialist advice upon ear, nose and throat conditions. |
d4acf614-5ca6-41fe-848c-d88f2c742bf2 | During the year under review you have considered the question of operative treatment for tonsils and adenoids being carried out at the Barking Hospital. This would be possible when the numbers in the Hospital were such as to leave one block completely available for such cases, e.g., during the summer months. You have decided to proceed with this scheme. The advantage of children being admitted to the Barking Hospital for operative treatment of ear, nose and throat conditions is great—journeys by ambulance would be obviated and the children could be admitted to hospital prior to the operation taking place, and so allow them to become settled down, and it would also be possible for them to be kept in the hospital after the operation. In the past, I have repeatedly urged that hospitalisation is an essential part of operative treatment for ear, nose and throat conditions. 56 Needless to say, any operative treatment would be undertaken by Mr. Sandiford himself. |
e6191bc6-30a4-4d7a-b616-41269e588272 | As a matter of interest it was noted during the year that the celebrated Dionne Quintuplets all had their tonsils removed and the reports say " the tonsils of all the quins were found to be in a very diseased state." This is significant when we consider the comparatively few tonsillectomies among our school and toddler population, who are nurtured in an atmosphere and in surroundings far from medically ideal—compare this with the case of the Dionne Quintuplets. (1) Convalescent Treatment.—During 1938 a number of mothers and children were recommended for convalescent treatment. The following table shows the number of mothers and children who have been treated:— No. treated. Mothers 9 Mothers and toddlers 2 Toddlers (under 5 years of age) 7 (m) Ophthalmic Clinic.—On pages 71 —72 will be found the Report of your Consulting Ophthalmic Surgeon upon the work of the Ophthalmic Clinics during the year. |
09361e5d-d1f7-4224-b067-f1967ee765b4 | (n) Ultra-Violet Light Clinic.—This clinic still continues to be a popular feature of your service and during the year no less than 2,827 treatments were given to toddlers and expectant and nursing mothers. (o) Dental Treatment.—Once again during 1938 an attempt was made to set up a special session for toddlers. Once again I have to report that this experiment was 57 without success. This does not mean that the work amongst toddlers generally is hopeless, and it is to be noted that some 600 toddlers were treated during 1938, but what are these among so many, because we should be seeing something in the region of 3,000 toddlers per year. There is still what can almost be described as an inborn prejudice amongst mothers against necessary prosthetic work (fillings, painting with silver nitrate solution, etc.) being carried out. This is unfortunate, because prosthetic work is the basis of a sound dental scheme. |
95baa83e-8d2a-454a-ab3f-bb72debddc2d | The Senior Dental Officer's Report will be found on pages 68-70. (p) Immunisation Clinic.—The scope of this clinic has been extended during the year, in that a weekly session is now held at the Woodward Clinic. It is not possible to report fully on the benefits of immunisation for diphtheria in Barking, but I do wish to say how I deplore the small numbers taking advantage of this scheme. In another section of this Report it will be seen that there were 14 deaths from diphtheria during the year, and this is definitely unsatisfactory when the means is provided, as part of your service, whereby children may be prevented from either contracting the disease or, if they do contract it, from getting it so severely as to succumb to it. Rapid and safely produced immunity can be induced by means of injections and without any unpleasant effects—452 children were immunised during the year. |
e22c05bb-d59b-47d9-a965-3bf08401b319 | Immunisation against scarlet fever and whooping cough has also been continued throughout the year and 49 and 45 children respectively completed their courses of injections. 58 (q) Minor Ailments.—Your Minor Ailments Clinics have been held at two centres and here babies and toddlers have been treated whenever necessary ; so also have certain conditions in nursing mothers. The following table shows the work which has been carried out at your Minor Ailments Clinics:— No. of cases seen by medical officers:— Central Clinic Woodward Clinic Porters Ave. Clinic (a) New cases 397 738 428 (b) Old cases 322 654 762 No. of attendances for treatment 1,196 2,442 1,763 The number of new cases medically examined in 1938 totalled 1,563. |
41928b29-74d5-4ca6-974b-40af6c0f7e22 | (r) Infant Life Protection {under Part I of the Children Act, 1908, as amended by Part V of the Children and Young Persons Act, 1932).—There were 28 foster mothers on the register at the end of the year and they had in their care 32 foster children. Beyond re-affirming my general remarks of last year, I have nothing to comment upon under this heading. (s) Maternity and Nursing Homes.—During the year no less than 508 children were born in your Maternity Home. As previously there has been a resident medical officer in charge of the Maternity Pavilion throughout 59 the year. He is also in charge of the Humphrey Clinic where ante-natal and birth control clinics are held. During the year there were reported a number of cases of " raised temperatures " which, though not serious in themselves, became notifiable as puerperal pyrexia under the Public Health Act, 1936. |
ab72cf3f-b1f5-405d-9f27-ba491105cf3f | The definition of puerperal pyrexia is " any febrile condition occurring in a woman within 21 days after childbirth or miscarriage in which a temperature of 100.oF. or more has been sustained during a period of 24 hours or has recurred during that period." To the lay mind these cases of puerperal pyrexia might give cause for alarm, but the raised temperature may be due to maternal infection on the one hand and to the far less serious conditions of influenza, etc., on the other hand. The causes of the cases reported were varied and the majority of them were not truly maternal. At the time these cases were reported there were a considerable number of patients admitted to the hospital over and above the usual number, but this should not recur in the future because you have made fixed rules regarding the number of cases to be booked in any one month for admission to the hospital. |
06c96c01-4233-4b51-b795-c1cbea790865 | It must be made clear, however, that when a certain number of cases are booked for one month, it is not possible to say when during this period these cases will be admitted, and it may occur that there will be a large number of admissions occurring at the beginning of any one month and a corresponding drop at the end of the month. This must always be so. No nursing homes are maintained in the Borough. 60 (t) Infant Welfare Clinics.—The following table shows the work carried out at your various Infant Welfare Clinics during the year:— Central. Greatfields. Alexandra. Woodward. Porters Avenue. Totals. No. of sessions 102 100 100 154 151 607 No. |
5d02f2cc-8775-4460-8ab1-3c4c2f0985c9 | of attendances of children under 1 year:— (a) New Cases 297 145 94 255 302 1,093 (b) Old Cases 4,413 2,032 1,688 4,455 4,972 17,560 No. of attendances of children 1-5 years of age:— (a) New Cases 32 38 18 178 149 415 (b) Old Cases 1,986 1,455 1,881 6,130 7,405 18,857 Average No. of attendances per session ... 66 37 37 72 85 62 No. of sessions attended by Medical Officers 102 100 100 154 150 606 Average No. of children seen by Medical Officer per session 24 18 17 23 22 21 No. |
90b3961e-8aef-4ceb-97ee-b20d08482c8b | of children seen by Medical Officer other than at above sessions :— (a) New Cases 397 - - 738 428 1,563 (b) Old Cases 322 — - 654 762 1,738 The total attendances during the year were 37,925 as compared with 34,502 in 1937. The information which is brought out by this table is that there were 1,093 individual children (new cases), under the age of one year, who attended your clinics. You will remember that the total number of live births was 1,113 which means that approximately 98 per cent. of the children born in Barking attended at your centres. The number of mothers attending regularly at the Infant Welfare Centres is on the increase and full advantage is taken of all the facilities provided. |
b77776f4-5945-477f-ba36-22042bbed8c3 | It has always been the practice for the medical officer to see 61 regular attenders once each month, but as the clinics are so well attended it has not been possible for this to take place in all cases. The inauguration of prescriptions for medicines for mothers, babies and toddlers has been much appreciated both by the medical officers and the patients. It is, of course, still not possible for your medical officers to visit patients' homes and in this respect urgent cases are always referred to the family doctor. (u) Home Visiting.—The home visits carried out by your Health Visitors are shown in detail in the following table:— No. of half-days devoted to visiting 2,206 No. of ante-natal visits:— First visits 594 Subsequent visits 433 No. of post-natal visits 973 No. of first visits to children under I year 1,151 No. |
d0155a3c-0299-497d-a0aa-55bf40678a58 | of subsequent visits to children under 1 year:(a) Attending a Centre 4,117 (b) Not attending a Centre 2,726 No. of visits to children I to 5 years of age 11,014 No. of special visits in connection with— Ophthalmia neonatorum 5 Deaths of children up to 3 years of age 42 Stillbirths 22 Puerperal pyrexia 6 Infectious diseases 300 No. of visits to foster children 304 No. of other visits 249 Total home visits of all kinds 21,936 62 (v) Provision of Fresh and Dried Milk.—Particulars of the amounts of wet milk supplied free and at reduced rates to necessitous mothers and children are given in the following table:— No. of pints supplied at reduced price. No. of pints supplied free. Total. Total cost of milk supplied. Council's liability in respect of fresh milk supplied. |
b9d4cf6f-b17f-496e-814a-ce51c2b00460 | 61,229 167,592 228,821 £3,121 0 0 £2,704 0 0 Pursuant to the receipt of Circular 1519 from the Ministry of Health, pasteurised milk was supplied as from the 1st May, 1937. Particulars of the amounts of dried milks, etc., supplied free and at reduced rates are as follows:— Name of Food. Cost Price (pkts.) Half Price (pkts.) Free (pkts.) Total (pkts.) Ostermilk No. 1 684 123 182 989 Ostermilk No. |
e45c6769-0661-4fef-86cc-2c9f64569536 | 2 2,372 309 1,129 3,810 Ambrosia 9 - 3 12 Cow and Gate 5,564 459 3,945 9,968 Cow and Gate (half-cream) 1,326 186 729 2,241 Colact 287 63 502 852 Hemolac 57 18 156 231 Lactogol 233 14 63 310 Virol 1,276 242 2,950 4,468 Parrish's Food 719 88 1,208 2,015 Paraffin 174 16 484 674 Malt and Oil 962 241 3,079 4,282 Pure Oil 476 40 441 957 Emulsion 2,120 247 2,261 4,628 Glaxo " O " Brand 45 20 95 160 Trufood 289 22 138 449 Lactogen No. |
f9a4cf8f-1933-4424-9731-2fd162cb375b | 2 48 5 29 82 Cow and Gate (Humanised) 39 - 39 16,680 2,093 17,394 36,167 63 Mothercraft Circles.—The mothercraft circle at the Porters Avenue Centre has been well attended during the year, and you have suggested that one shall now be held in the older part of the town, and it is hoped that such a circle will be started at the Greatfields Centre. (w) Services provided and Facilities for Treatment.— It is convenient to set these out in tabular form, although of course some of them are mentioned elsewhere in the Report. Ante-Natal Clinics.—Ante-Natal Clinics are held each week at four different centres, and a SpecialistConsultant holds one session per month during ten months of the year. During 1938, 85 cases attended the clinics held by the SpecialistConsultant. In addition there were 59 postnatal and gynæcological attendances. |
f611b9e6-cde2-42df-b19c-4f37c67ead72 | Baths.—In certain necessitous cases, free baths are provided for expectant and nursing mothers. During 1938, 191 baths were granted free of charge. Birth Control Clinic.—In September, 1937, a Birth Control Clinic was inaugurated. The Ministry of Health have prescribed which cases may be referred to such a clinic. Convalescent Treatment.—Convalescent treatment is provided for toddlers, for mothers and babies, on the recommendation of Medical Officers at the Infant Welfare Clinics. Charges are made to the parents in accordance with the Council's scale. During 1938, 7 toddlers, and 2 mothers with babies, and 9 mothers received treatment under this scheme. Dental Treatment.—Dental treatment for toddlers and expectant and nursing mothers is carried out at the Central Clinic, the Woodward Clinic, and the East Street Clinic. |
d986e49c-61dd-4a40-9390-52450c387dda | 64 Dinners.—Free dinners are supplied to necessitous nursing and expectant mothers and to toddlers, on the recommendation of Medical Officers at the Infant Welfare Clinics. During 1938, 6,095 dinners were supplied to mothers and 8,074 to children under this scheme. This is a marked increase over the year 1937. Ear, Nose and Throat Clinic.—Two sessions are held weekly at the Woodward Clinic on Tuesday and Friday afternoons, under the direction of Mr. C. R. Sandiford, F.R.C.S. Treatment includes ionisation, diastolisation and audiometry. Prevention of Diphtheria, Scarlet Fever and Whooping Cough.—An Immunisation Clinic is held every Monday morning at the Central Clinic and at the Woodward Clinic. Gyncecological Clinic.—Gynaecological Clinics are held as and when required. |
d47f3821-edea-4896-8a42-92b557657484 | Home Helps.—Although home helps as such are not provided by you under any particular scheme, you do make financial provision in cases of maternity which are aided by you, because your scale of charges in all such cases is drawn up so as to leave an amount of money in the family exchequer sufficient for this purpose. You have now set up a rota of approved home helps. Infant Welfare Clinics.—Infant Welfare Clinics are held each week at five different Centres. These Clinics are available for all children under the age of five years. Maternity Services.—Maternity Home.—Upney Hospital is a maternity home run by the Corporation. Applications for admission are made at the AnteNatal Clinics, and the charges are in accordance 65 with the Council's scale. The number of admissions to the hospital are limited to 36 in any one month. |
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