KEN 23 The Royal Borough of Kensington. ANNUAL REPORT (ABRIDGED) OF THE MEDICAL OFFICER OF HEALTH. 1919. Vail & Co , Printers and Stationers, 170, Farringdon Road, E.C. O 3482-300—5-20. To the Mayor, Aldermen and Councillors of the Royal Borough of Kensington. Me. Mayor, Ladies and Gentlemen,— I have the honour to submit the Annual Report on the Health of the Borough for the year 1919. Dr. Sandilands was Medical Officer of Health during the period under review, but he was unable to present an annual report before his departure for India in the early part of last January. I did not come into office in Kensington until February of this year and, consequently, I cannot write from my own direct knowledge of events, which occurred in the year 1919. I have decided, therefore, to confine this report largely to statistics required by the Ministry of Health. I would like to call attention to the tables dealing with Maternity and Child Welfare work carried out by various voluntary bodies in the Borough. In due course it will be my duty to submit recommendations to the Council in regard to this work and many of my conclusions will be based on the statistics herein given. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, JAMES FENTON, Medical Officer of Health. VITAL STATISTICS Population.—To meet the diminution and abnormal constitution of the population caused by the war, the Registrar-General has estimated the population of Kensington in 1919 as 164,470 for the purpose of calculating the birth rate, and as 157,886 for the calculation of death rates. Table A. District. Population. Births, Deaths and Rates per 1,000. D. B. Births. Rate. Deaths. Rate. The Borough 157,886 164,470 2,653 16.1 2,413 15.2 North Kensington 80,675 84,087 1,824 21.7 1,341 16.6 South Kensington 77,211 80,383 829 10.3 1,019 13.2 St. Charles 20,850 21,701 475 21.9 319 15.3 Golborne 23,344 24,403 649 26.6 409 17.5 Norland 19,422 20,222 443 21.9 337 17.3 Pembridge 17,059 17,761 257 14.4 276 16.1 Holland 18,580 19,340 171 8.8 237 12.7 Earl's Court 16,152 16,816 231 13.7 258 15.9 Queen's Gate 13,099 13,636 111 8.1 138 15.3 Redcliffe 17,510 18,231 216 11.8 258 14.7 Brompton 11,870 12,360 100 8.1 128 10.7 Unknown — — — — 53 — Dividing the two populations given for the Borough in 1919 by the Census population in 1911, which was 172,317, the following factors will be obtained, namely, .9544 and .9162. The populations for the various districts in the Borough have been in each case arrived at by multiplying the census population of the district by the second factor to obtain the death rate population shown in the first column of the table, headed "D," and by the first factor, .9544, to obtain the birth rate population in the second column, which is headed "B." Births —The number of births registered was 2,653, after correction for inward and outward transfers. Distributed according to sex and legitimacy the births were as follows:— Male. Female. Total. Legitimate 1,209 1,188 2,897 Illegitimate 143 113 256 Total 1,852 1,801 2,653 The birth rate for the Borough was 16T per ],000 as compared with a rate of 20.0 in the decennium 1901-10. Notification of Births.—Two thousand four hundred and twenty-two live births were notified to the Medical Officer of Health within 36 hours or at most a few days after their occurrence; also 62 still births and 246 births belonging to the Borough, but which occurred in institutions outside, were notified. The total number of birth notifications received was 2,730. Details are given in the following table:— Source of Notification. Number of Births Notified. Still Births. Live Births. Total Births. Midwives 33 1,627 1,660 Parents 3 220 223 Medical Practitioners 26 473 499 Other Persons — 102 102 Births in the Borough 62 2,422 2,484 Institutions outside the Borough 5 241 216 Total 67 2,663 2,730 Deaths.—The net deaths belonging to the borough numbered 2,413, and were equivalent to a death rate of 15.2 per thousand, as compared with a death rate of 14.3 in the ten years 1901-10. The mortality in the several wards has already been shown in Table A. The principal causes of death in the several age periods of life are set out in Table III., Appendix. Infantile Mortality.—The deaths among infants under the age of one year numbered 270, the infantile, mortality rate being equivalent to 102 per 1,000 births. The following Table shows the mortality among infants in the several wards:— Table B. INFANTILE MORTALITY. District. Deaths under one year. Deaths per 1,000 Births. North Kensiugton 207 113 South Kensington 63 76 St. Charles 47 99 Golborne 73 112 Norland 54 122 Pembridge 33 128 Holland 29 169 Earl's Court 12 52 Queen's Gate 5 45 Redcliffe 12 56 Brompton 5 50 The Borough 270 102 The principal causes of deaths in the first four weeks and in the later months of infancy will be found in Table IV., Appendix. The same table shows that the mortality amongst illegitimate infants, of whom no less than 46 died, was equivalent to a rate of 179 per 1,000, as compared with a rate of 93 per 1,000 among those born in wedlock. Health Visitors.—The Health Visitors visit infants notified under the Notification of Births Act, cases of ophthalmia in the newly born, infants suffering from tuberculosis and notified cases of puerperal fever. They assist in the work of the voluntary schools for mothers. During the year 2,147 infants were visited shortly after birth and 10,092 visits in all for the purposes mentioned above were made. INFECTIOUS AND OTHER DISEASES. The following Table shows the number of notifications of infectious disease, the number of deaths, and the percentage of deaths to notified cases:— Disease. Number of Notifications. Number of Deaths. Percentage of Deaths to Notified Cases. Scarlet Fever 260 2 .8 Diphtheria 274 16 5.8 Enteric Fever 16 2 12.5 Erysipelas 79 3 3.8 Cerebro-Spinal Meningitis 6 1 16.6 Measles 672 14 2.08 German Measles 154 — — The age period of cases notified and the ward distribution will be found in Table II., with the age period of deaths in Table III., Appendix. Diarrhoea.—One hundred deaths were registered as due to Diarrhoea or Enteritis, 73 of which occurred during the first year of life. Small Pox.—No case of Small Pox occurred in the Borough during the year. Twentyeight cases were notified in London. Puerperal Fever.—Eleven cases were notified during the year, the average annual number being ten. There were seven deaths from this disease. Ophthalmia Neonatorum.—Twenty-one cases of ophthalmia in newly born infants were notified during the year. Tuberculosis.—Four hundred and eignty-nine persons were notified for the first time as suffering from tuberculosis of the lungs; and 93 as suffering from other forms of tuberculosis. The following tables set out the Deaths from Tuberculosis and Death Rates per 1,000 of the population, the distribution of the notified cases in the several wards of the Borough, and the Forms of Tuberculosis in the persons notified:— Deaths from Tuberculosis and Death Rates per 1,000. Tuberculosis of Lungs. Other Tuberculous Diseases. Tuberculosis—All Forms. Deaths. Death Rate. Deaths. Death Rate. Deaths. Death Rate. Annual Average 1911-1915 179 1.04 60 0.35 239 1.3 1919 169 0.90 38 0.22 207 1.11 Notified cases of Tuberculosis in Wards. District. Tuberculosis of Lungs. Other Forms. All Forms. North Kensington 371 74 445 South Kensington 118 19 137 St. Charles 93 11 104 Golborne 121 29 150 Norland 101 23 124 Pembridge .56 11 67 Holland 32 4 36 Earl's Court 26 5 31 Queen's Gate 15 1 16 Redcliffe 27 6 33 Brompton 18 3 21 The Borough 489 93 582 Forms of Tuberculosis in Persons Notified. Number of Cases. Site of Disease. Lungs 489 Larger joints and bones above wrist and ankle 24 Lymphatic glands other than mesenteric 29 Vertebral column (Spine) 10 Smaller joints and bones of wrist, ankle, hand, foot 2 Mesenteric glands, bowel, peritoneum 10 Meninges of brain 6 Skin 5 Other parts 7 Total cases 582 Cancer.—The deaths from cancer numbered 240; males 91, and females 149. FOOD SUPPLY. Milkshops.—At the end of the year there remained on the Council's Register 177 premises where milk was sold. Of these premises 117 were milkshops, 28 were general shops and 32 were restaurants. Cowsheds —The licence of the only cowshed in the Borough was renewed by the London County Council for ten cows. The number kept does not as a rule exceed four. Ice-cream.—At the end of the year 190 premises were shown in the Register of places where ice-cream is prepared or sold as compared with 189 premises at the end of the preceding year. Bakehouses.—There are 90 bakehouses in the Borough, and of this number 68 are underground. Slaughter-houses.—Six slaughter-houses were licensed by the London County Council in October. Special conditions as to notice and hours of slaughtering attach, as reported in 1916, to the licence of the house in the Walmer Road, where a considerable number of pigs are killed. Other Premises Used for Sale, &c., of Food.—These premises are entered in a Register under the date on which they were finally inspected and found to comply as regards structure with the sanitary regulations in S. 8 of the London County Council (General Powers) Act, 1908. At the end of the year the following shops or premises remained on the Register, namely:— Provision Res- Butchers' Fried Fish Fish- Green- Other Dealers. taurants. Shops. Shops. mongers. grocers. Shops. 283 171 96 30 51 102 15 Unsound Food —The unsound food surrendered and destroyed during the. year is shown in the following list:— Bacon (lbs.) 1,984 Beef (lbs.) 595 Butter (lbs.) 101 Cows (tuberculous) — 2 Cheese (lbs.) 146 Coffee and Milk (tins) 5 Dates (lbs.) 210 Dates (boxes) 33 Fish (boxes) 4 Fish (lbs.) 102 Fish (stones) 13 Milk (tins) 6 Mutton (stones) 6 Ox Liver (lbs.) 15 Pork (lbs.) 36 Kidney (lbs.) 18 Rabbit (lbs.) 124 Rabbit (boxes) 37 Salmon (tins) 2 Smoked Haddocks (stones) 3 Tomatoes (boxes) 65 Veal (stones) 13 Pigs' Heads (tuberculous) — 4 Pigs' Carcases, etc., (tuberculous) — 8 Pigs' Liver, Lungs and Kidneys (tuberculous) — 1 Pigs' Pluck (tuberculous) — 1 Potatoes (tons) Poultry — 13 Sale of Food and Drugs Acts.—During the year the Sanitary Inspectors collected 658 samples under the above Acts and submitted them to the Public Analyst for analysis. Of the samples submitted 49, or 7 per cent., were reported as adulterated. Proceedings were taken in 39 cases for adulteration or other offences, the fines and costs inflicted amounting to £280 13s. Od. Public Health (Milk and Cream) Regulations, 1912 and 1917.—No action was taken during the year under these regulations. HOUSING OF THE WORKING CLASSES. Lodgings provided by the Council.—The Council provide within the Borough 120 tenements of one, two, or three rooms for the working classes. Latterly all the Council's tenements have been let. Houses Let in Lodgings.—The number of houses let in lodgings on the Council's register at the end of the year was 2,067. In 1913, 187 of the registered houses were let in furnished lodgings at a charge of Is. per night per room. The lodgings in the remainder of the registered houses are let unfurnished. The inspections and re-inspections of lodging houses numbered 6,870. Notices requiring the remedy of defects found were served in 653 instances, and 8 cases of overcrowding were abated. The owners of four lodging houses were summoned tor failing to carry out sanitary repairs and for breach of by-laws for houses let in lodgings. 842 houses were reported as having been cleansed in accordance with the requirements of By-Law 16. Common Lodging Houses.—The Common Lodging Houses in the Borough number 15 and contain accommodation for some 495 persons. Six are for male and 9 for female lodgers. Housing (Inspection of District) Regulations, 1910.—The house-to-house inspections for the purpose of these Regulations and the detection of nuisances numbered 1,078. This figure does not include re-inspections, inspections on complaint or inspections of registered lodging houses for the purpose of enforcing the lodging house by-laws. In accordance with the directions in the Local Government Board Circular of 4th August, 1915, only urgently necessary wcrk has been required, with the result that it has not been possible to proceed with the scheme of housing work which had been instituted on the lines laid down in the regulations. Inland Revenue Acts.—Under these Acts 20 certificates were issued by the Medical Officer of Health, in respect to 20 tenements in 7 houses containing a total number of 20 separate dwellings. Water Supply to New Houses.—No inspections of newly-erected houses were made during the year for the purpose of certification before occupation as having a proper and sufficient supply of water Remedy of Defects,—A tabular statement showing in detail the work carried out under the direction of the Sanitary Inspectors for the remedy of various sanitary defects in dwelling houses is entered month by month and for the year in the registers of the Public Health Department. The registers are available for reference and render the publication of a detailed statement in the Annual Report unnecessary. In twenty cases legal proceedings were instituted against persons who had failed to comply with the sanitary requirements of the inspectors. Fines amounting to £40 were inflicted. FACTORIES AND WORKSHOPS. The Council is required to keep a register of workshops and is responsible for the sanitary conditions of all workshops and workplaces in the Borough. For the sanitary condition of factories the Home Office is directly responsible, the duties of the Council in factories being limited to securing the provision of suitable and sufficient sanitary conveniences for the persons employed. Where women are employed the inspections are made by the Council's Lady Sanitary Inspectors. The following list shows the number of workshops and factories in the Borough. (A) Premises on which female labour is employed— Workshops. Factories. Dressmakers and ladies' tailors - 275 5 Laundries 90 46 Other premises 387 11 Total (A) 552 62 (B) Premises on which female labour is not employed— Bakehouses 74 16 Bootmakers 171 7 Builders 115 8 Tailors 112 0 Printers 0 28 Other Premises 518 134 Total (B) 990 193 Workshops and factories in the Borough 1542 255 Home Work.—The following figures show the approximate number of out-workers and home-workers in the Borough:— Out-workers in workshops and factories 97 Out-workers in domestic workshops 46 Out-workers in their own homes 133 Total out-workers 276 The number of out-workers' lists received were as follows:— Number of Lists. Number of Names thereon. Once in the year 41 225 Twice in the year 13 382 Totals 54 607 SANITARY WORK Sanitary Inspectors (Male).—The last monthly report of the Medical Officer of Health for the year 1919 sets forth in tabular form the principal items of the work of the male sanitary inspectors during the year. The same return in greater detail, showing the number of inspections made, the sanitary notices issued and the sanitary works completed, is available for reference in registers kept for the purpose in the Public Health Department. Lady Sanitary Inspectors.—A summary of the monthly reports shows that the Lady Sanitary Inspectors paid in all 2,362 visits—1,345 to factories and workshops, 841 to cases of tuberculosis, and 176 for other purposes. Disinfection,—The disinfecting staff disinfected 1,007 rooms in 874 tenements or dwelling houses. The bedding from 875 households was disinfected by steam or by washing and boiling at the disinfecting station at Wood Lane. The number and weight of the articles dealt with was as follows:— Articles disinfected only 9,133 Articles disinfected and washed 648 Total number of articles 9,781 Total weight of articles 30 tons 7 cwt. Verminous Persons.—The following table shows the number of persons dealt with at the Council's Cleansing Station during the year:— Children cleansed 1,810 Adults cleansed 70 Number of baths given 4,877 Verminous Rooms.—281 verminous rooms were cleansed in response to notices, 5 verminous beds were destroyed and 51 dirty beds were cleansed. In addition 85 beds were disinfected by steam at Wood Lane and 51 verminous rooms were fumigated by the Council's disinfecting staff. Rag Flock.—No samples of rag flock were taken during the year. Mortuary.—During the year 269 bodies were deposited at the Mortuary. In 126 cases post-mortem examinations were made and 182 bodies were deposited for the holding of inquests at the instance of the coroner. 45 bodies were deposited in the Chapel of Rest. MILK (MOTHERS AND CHILDREN) ORDER, 1918 During the year 164 new applications were granted and 228 applications were renewed. A Sub-Committee of the Maternity and Child Welfare Committee considered the applications received, and those granted were for families who were necessitous in the sense that it was ascertained that the income was insufficient for the purchase of milk in quantity sufficient for the bodily and health needs of the expectant or nursing mother, or children of the family under five years of age. The grants were usually made for cow's milk, to be supplied by dairymen at less than current retail price, but in a few cases the milk was granted free of cost. One to three pints daily were granted for varying periods, but, generally, for about four weeks. After the expiry of the period of grant the cases were re-considered on receipt of an application for renewal. The estimated cost to the Council for the year was £380 14s. 2d., and application will be made to the Ministry of Health for the return of 50 per cent, of this amount. 9 Statistics showing Work Done, Income and Expenditure, and Staff engaged at various Child Welfare Institutions in the Royal Borough of Kensington SCHOOLS FOR MOTHERS. Statistics for the Year ending March 31st, 1920. (In the case of Bramley Road, the figures of work done are for the year ending December 31st, 1919) 1. No. of births notified to the Centre by the Public Health Dept. Archer Street Bramley Road with Henley Street extension Campden Hill Earl's Court, Warwick Road Golborne Lancaster Road Raymede Totals 135 520 95 214 310 294 438 2006 2. No. of individual expectant mothers who attended 74 128 9 33 29 6 174 453 3. Total attendances of expectant mothers 216 427 16 182 406 10 396 1653 4. No. of sessions on which dodlors attended for expectant, mother consultations. (Where no sessions are shown, the expectant mothers are seen at Infant Consultations) 52 5 — — 1 38 96 5. No. of individual children (under 5) who attended 243 634 147 230 451 302 654 2661 6. Total attendances of children 2623 2527 1900 1985 4089 2264 2697 18085 7. Average attendance per session of children 26 19 21 21 43 23 27 — 8. No. of Sessions on which doctors attended for infant consultations 100 133 90 96 93 93 98 703 9. No. of first visits paid by salaried workers to homes of expectant mothers 85 299 18 38 81 3 271 795 10. Total number of home visits by salaried workers to expedtant mothers 610 591 49 73 135 3 543 2004 11. No. of first visits paid by salaried workers to homes of children 243 380 100 256 165 313 133 1590 12. Total number of visits paid by salaried workers to homes of children 3947 1232 1423 2233 478 1085 2217 12615 13. No. of home visits paid to children by voluntary workers — 675 — 66 1035 8 307 2091 14, No. of sessions on which dentist attended — 22 — — — 10 45 77 15. „ „ mothers who received dental treatment — 55 5 — 18 20 571 669 16. „ „ children „ „ „ „ — 7 — — 2 — 114 123 17. ,, „ dentures provided. — 16 4 — 2 4 54 80 18. ,, „ lectures on health, nursing, etc., at Centre — 61 — 36 40 — 33 ] 70 19. „ „ mothers' attendances at lectures — 708 — 747 446 — 642 2513 20. „ „ cooking classes held — — — — 39 — 16 55 21. „ „ mothers' attendances at cooking classes — — — — 464 — 172 636 22. ,, „ sewing classes held 50 42 38 — 34 64 46 274 23. „ „ mothers' attendances at sewing classes 487 206 127 — 195 906 1161 3082 24. „ ,, dinners given — — — — 2742 1295 7122 11159 25. ,, ,, individual mothers attending dinners — — — — 64 10 89 163 26. „ „ „ children „ „ — — — — — 9 67 76 Every Saturday the Medical Officer of Health sends a weekly list to each School for Mothers giving the births which have occurred in the area allotted to that institution and including births occurring in hospitals, etc., in those cases where the Mothers have come from the area of the Welfare Centre (the births occurring in homes where it is obvious that no attention will be required from Schools for Mothers or Health Visitors are omitted from the list). The number of live births notified to the Medical Officer of Health for the year ending March, 1920, was 3,210, and it will be seen in Item 1 of the above table that 2006 of these were reported to the Welfare Centres. The weekly lists were not sent to Archer Street before the second week in September, 1919, and it is probable that the births notified to that Centre would have been about 230 if the lists had been sent for the whole year. The attendances of expectant mothers at Bramley Road and Golborne include attendances at lectures, dinners, etc., in addition to those at consultations. The total attendances of children at doctor's consultations at Golborne were 1311; the total 4089 includes attendances at weighings as well as consultations. At Lancaster Road special sessions for expectant mothers were commenced just before the close of the year. A session is a half-day of two or three hours. ARCHER STREET Dental treatment commenced in April, 1920 GOLBORNE Dental cases treated at Raymede. LANCASTER ROAD Dental sessions held at Henley Street Centre SCHOOLS FOR MOTHERS. Statement of Payments and Receipts for the Year ending March 31st 1920. Archer Street Bra m ley Road with Kenley Street extension Campden Hill Earl's Court, Warwick Koad Golborne Lan. caster Road Raymede Totals PAYMENTS. £ £ £ £ £ £ £ £ 1. Salaries of Medical Officers 192 139 101 100 94 68 142 839 2. „ „ N urses, other helpers, caretakers and housekeepers (including uniform, laundry allowance and value of any food allowed) 281 225 155 251 244 149 358 1,667 3. Payments to other bodies for teaching, affiliation, etc. — 2 1 — — — 38 41 4. Furniture and equipment 6 6 10 2 40 15 14 96 5. Rent, rates and taxes 72 51 28 85 37 42 77 393 6. Heating, lighting and cleaning 33 10 9 13 75 72 61 277 7. Printing, stationery, postage, etc, 22 28 1 9 6 11 28 106 8. Dentist's fees — 63 21 — 2 27 108 222 9. Expenses of cooking classes (materials, etc.) — — — — — — — — 10. „ „ sewing „ ( „ „ ) 3 — 1 — 2 87 49 144 11. Cost of dinners — — — — 100 32 137 270 12. „ „ drugs, and other medical requisites 50 27 27 8 10 62 33 218 13. „ „ cheap milk for mothers and children (dried and fresh) 127 100 66 52 60 160 567 14. Cost of mothers teas 1 9 16 — 12 — — 39 15. Laundry charges 10 — — 9 15 10 3 49 16. Repairs 141 192 — 1 — — — 334 17. Bazaar expenses 38 — — — — — 38 18. Bank charges, insurances, telephone and petty cash 6 10 5 1 9 7 13 54 Totals 988 868 444 482 703 645 1,230 5,362 RECEIPTS. £ £ £ £ £ £ £ £ 1. Grant from Ministry of Health or Board of Education 292 323 121 199 296 154 341 1,730 2. „ „ London Parochial Charities 25 30 — — 20 75 3. „ „ Campden Charities — 13 13 5 10 6 — 49 4. „ „ Jewel Fund 150 — 15 — — — — 165 5. „ „ Alexander Day Fund — 8 — 8 8 — 8 32 6. ., „ American Red Cross — — — — — — 50 50 7. „ „ London County Council (for lectures) — — — 9 — 4 10 24 8. Voluntary contributions and donations, 136 142 126 175 185 423 319 1,508 9. Jumble sales, bazaars, etc. 166 101 72 90 84 33 62 611 10. Receipts from mothers for dental treatment — 45 10 — 2 17 111 187 11. „ „ „ at cooking classes 1 1 12. „ sewing — 3 3 — 7 42 52 110 13. „ „ „ for dinners — — — — 22 — 68 91 14. „ „ „ „ drugs & other medical requisites 22 25 15 15 5 17 33 135 16. „ „ „ „ milk (dried and fresh) 127 88 19 — 47 17 160 460 17. ,, ,, ,, ,, teas — 5 8 — — — — 14 18. Incidental — 5 2 7 — — 1 17 19. Sub-letting part of house — 41 — — — — — 41 Totals 920 829 409 510 700 718 1,220 5,305 Shillings and pence are omitted in order to save space and to simplify examination; but the various totals given were ascertained before the omissions were made. Apportionments have been made in certain cases where items of expenditure as shown above have not been kept separately in the books at the Welfare Centres; also, in soma cases where a school for mothers and a day nursery are maintained on the same premises, it has been necessary to make apportionments in order to arrive at the figures to be included in this table. 11 SCHOOLS FOR MOTHERS. Time Table for the Year 1919-1920 Day. Archer Street. Bramlcy Road with Kenley Street Extension. Campden Hill. Earl's Court, Warw ick Road Golborne. Lancaster Road. Raymcde. Monday 12.30 to 4.—Infant weighings by Borough Health Visitor. 2 to 4.—Doctor's consultations for infants. 12.30.—Dinners to expectant and nursing mothers. 2 to 4.—Sewing and dressmaking class. 12.30.—Dinners for mothers and children. 1.30 to 4.—Infant weighings by Borough Health Visitor. 2 to 4.—Doctor's consultations for infants and expectant mothers. 1 to 3.30.—Infant weighings by Borough Health Visitor. 2 to 4.—Doctor's consultations for infants. 2 to 3.30.—Doctor's consultations for infants and cxpcctant mothers. 2 to 4.—Cobbling class or cooking class (winter only). 2.30.—Devotional Meeting. 2 to 3.—Library open. Tuesday 2.30 to 4.30.—D o c t o r's consultations for infants. 2 to 4.—Sewing class. 2 to 4.—Doctor's consultationsfor expectant mothers (monthly). 2 to 4.—Doctor's consultations for infants and expectant mothers. 12.30.—Dinners to expectant and nursing mothers. 2 to 4.—Doctor's consultations for infants. 12.30.—Dinners for mothers and children. 4 to 6.—Dental clinic at Kenley Street (fortnightly) 2 to 5.—Dental clinic. 2.30 to 3.30. Lecture on Infant Care, &c. 3.30 to 4.—Lecturt on Infant Care, &c. 6.0.—Massage for children Wednesday 2.30 to 4.30.—Doctor's consultations for expectant mothers 2.30.—Cobbling class. 2 to 4.—Sewing class. 2 to 4.—Doctor's consultations for infants and expectant mothers. 12.30.—Dinners to expectant and nursing mothers. 2 to 4.—Sewing class. 12.30.—Dinners for mothers and children. 2.30 to 3.30.—Doctor's consultations for infants and expectant mothers at Kenley Street. 2 to 4.—Doctor's consultations for cxpcctant mothers (recently commenced and held once monthly). 2 to 3.—Sewing class. 2.30 to 4.—Sewing class. 3 to 4.—Social class. 3 to 4—Lecture to mothers (monthly) Thursday 2.30 to 4.30.—Sewing class. 2 to 4.—Doctor's consultations for infants and expectant mothers. 2 to 4.—Doctor's consultations for infants. — 12.30.—Dinners to expectant and nursing mothers. 2 to 4.—Cobbling class. 12.30.—Dinners for mothers and children. 2.30 to 4.30 —Dental clinic (fortnightly; commenced April 1920) 1.30 to 4.—Infant weighings by Borough Health Visitor. 1 to 3.30.— Infant weighings by Borough Health Visitor. 2 to 4.—Doctor's consultations for infants. 2 to 3.30.—Doctor's consultations for infants and expectant mothers. Friday 10 to 1.—Dental anæsthctics (monthl; commcnced April, 1920). 2 to 3.30.—Infant weighings by Borough Health Visitor. 2 to 4.—B a t h s for mothers. — 12.30.—Dinners to expectant and nursing mothers. 2 to 4.—Infant weighings by Borough Health Visitor. 12.30.—Dinners for mothers and children. 2.0.— Jumble Sale. 3 to 4.—Lecture to mothers by Sisterin-Charge. 2.0. —Cooking and knitting classcs. 2 to 4.—Doctor's consultations for infants. 2.30 to 4.- Doctor's consultations for expectant 2.30 to 4.30.—D o c t o r's consultations for infants. 6.0. —Massage for children. mothers [Care, &c. 2.30.—Lecture on Infant The spare time of the Nursing Staff of each Centre is devoted to the treatment of minor ailments, home visiting and book-keeping. The following Clubs have been organised:— Blanket Club Boot ,, Holiday ,, Day Trip ,, Maternity ,, Fireguard „ Minor operations are performed at Kenley Street. On Monday mornings children can be left at the Welfare Centre for 2 hours to enable mothers to do their washing, etc. Expectant mothers are visited on behalf of St. George's and York Road Lying-in-Hospitals There is a Thrift Club, and perambulators are lent out on hire. The Cobbling class was held on 41 occasions and there were 389 attendances. The Cobbling Class was held on 10 occasions and there were 87 attendances. The following Clubs have been organised:— Maternity Provident Club. Savings Bank. Convalescent Home treatment arranged for mothers and children. The following clubs have been organised: Holiday Club. Sick Club. War Savings Certificates Club. Free dinners are prepared at the centre and are taken home by mothers. There is a Thrift Club, a Mothers' Council and a Library. Country holidays and summer parties are arranged. There is a Baby Show Competition, and a Prize Distribution at Christmas. Receipts for baby minding were 4s. 9d. for the year. Two baths with hot water have been installed; 157 baths have been given, and the receipts were £2 Is. 4d. for the year. Informal health talks arc given at sewing classes. A Sale of Clothing Club has been organised. SCHOOLS FOR MOTHERS. Particulars as to Staff, May 1920 (Dentists and Anaesthetists not included). Name of School Duty Name Qualifications Salary Allowances Archer Street Medical Officer Infant Consultations Dr. E. M. Barker M.D. £1 1s. per session* — Medical Officer Expectant Mother Consultations Dr. M. H. Kettle M.R.C.S., L.R.C.P. £1 11s. 6d per session* — Nurse-in-Charge Miss Barber Trained General Nurse and Trained Mid-wife £135 per annum Free Rooms Assistant Nurse Miss Carter Trained Mid-wife £85 per annum Free Rooms Caretaker E. Calder — £1 5s. per week — Bramley Road with Kenley Street Extension Medical Officer Dr. Carter M.D., M.R.C.S., L.R.C.P. £11s. per session* Medical Officer Dr. Olive Langmead M.B., B.S. £11s. per session* — Medical Officer (Kenley Street) Dr. Lock M.R.C.S., L.R.C.P. £11s. per session* — Nurse-in-Charge Miss Rogers Trained General Nurse £160 per annum — Caretaker Mrs. Hayes £1 5s. per week — Campden Hill Medical Officer Infant Consultations Dr. Mabel Paine M.B., B.S. £11s. per session* — Medical Officcr Expectant Mother Consultations Dr. Victoria Bennett M.B., B.S. £1 11s. 6d per session* — Nurse-in-Charge Miss Wigglcsworth Trained Mid-wife £135 per annum — Caretaker Mrs. Beck — £26 10s. per annum — Earls Court Warwick Road Medical Officer Dr. Mills M.D. £11s. per session* — Medical Officer Dr. Brookes M.B., F.R.C.S. £11s. per session* — Nurse-in-Charge Mrs. Durnford Trained Mid-wife £130 per annum Uniform and Laundry Assistant Nurse Vacant — £60 per annum Uniform and Laundry Caretaker Mrs. Tyler — 15s. weekly Free Rooms and Coal Golborne Medical Officer Dr. Mills M.D. £11s. per session* — Medical Officer Dr. Olive Langmead M.B., B.S. £11s. per session* — Nurse-in-Charge Miss Cowans T Trained General Nurse £140 per annum Dinners, Teas, Laundry and Uniform allowance Cook M. Gill — £30 per annum Board and Residence Maid 1 — 16s. weekly Board Charwoman 1 — 2/- per half-day — Window Cleaner 1 — £6 per annum — Lancaster Road Medical Officer Infant Consultations Dr. Mabel Paine M.B., B.S. £11s. per session* — Medical Officer Expectant Mother Consultations Dr. Victoria Bennett M.B., B.S. £1 11s. 6d per session* — Nurse-in-Charge Miss Currie † Trained General Nurse £100 per annum Board, Residence, Laundry and Uniform House-keeper 1 — £20 per annum Board, Residence and Laundry Charwoman 1 — £23 10s. per annum Partial Board and Laundry Raymede Medical Officer Infant Consultations Dr. Ronald Carter M.D. £11s. per session* — Medical Officer Expectant Mother Consultations Dr. Wilks M.D. £11s. per session* — Nurse-in-Charge Miss Gulland Trained General Nurse £145 per annum Dinners Assistant Nurse Miss Garlick Trained Children's Nurse and Trained Mid-wife £120 per annum Dinners Treasurer Mrs. Swyny — £11s. per month — Lecturcr Miss Pearson — £11s. per week — Sewing Teacher Miss Stewart — 10s. per week — Charwoman 1 — 10s. per week Dinners Cook 1 — 10s. per week Dinners A large amount of administrative, secretarial and financial work is carried out by ladies who give their services free of charge. These ladies also assist at the consultations, perform home visiting, and undertake the management of various clubs. The numbers of regular workers who give their services free are as follows:—Archer Street 8; Bramley Road with Kenley Street 12; Campden Hill 8; Earls Court 7; Golborne 9; Lancaster Road 12; Raymede 10. There are in addition other workers but their services are occasional only. *A Session is an afternoon of 2 or 3 hours and it is anticipated that the doctors will receive £1 lis. 6d. per Session in the future. †Also superintends Day Nursery attached to School for Mothers. 13 DAY NURSERIES. Statistics for the Year ending March 31st, 1920. Golborne. Kensal Creche (Medical Mission) Lancaster Road. Notting Hill Day Nursery Raymede St. Clement's, Tread»old St. St. Luke's Fulham Road Totals 1. Whole day attendances of children under 3 years of age 4474 2226 3030 9211 1628 3031 4066 27666 2. Whole day attendances of children over 3 years of age 2415 1100 2935 2312 276 926 535 10499 3. Total whole day attendances 6889 3326 5965 11523 1904 3957 4601 38165 4. Charges made for each attendance of a child (Pence) 8 7 8 6 9 12 12 — 5. Half-day attendances of children under 3 years of age — 225 — — 54 536 — 815 6. Half-day attendances of children over 3 years of age — 95 — — 8 160 — 263 7. Total half-day attendances — 320 — — 62 696 — 1078 8. Charges made for each attendance of a child (Pence) — 4 — — 6 6 — — 9. Average daily attendance of children 31 22 26 51 15 24 20 189 PAYMENTS. £ £ £ £ £ £ £ £ l. Salary or remuneration of Medical Officer — — 35 36 4 29 — 104 2. ,, „ „ Matron — 20 56 62 54 60 52 304 3. Salaries or „ „ nurses and other workers 146 30 124 211 113 92 115 833 4. Furniture and equipment 117 25 69 94 51 34 246 640 5. Rent, rates and taxes 7 11 42 53 52 45 79 291 6. Heating, lighting and cleaning 72 30 72 227 89 37 122 653 7. Food and provisions 286 124 335 435 128 237 261 1809 8. Printing, stationery, postage, bank charges, etc. 6 1 11 14 15 10 11 70 9. Chemist — — — 13 — 26 — 40 10. Laundry — — 69 — — 20 28 118 11. Insurance and incidentals 3 — — 4 3 — 3 14 12. Repayment of loan and advances — 116 — 116 13. Payment of mortgage, interest, law expenses — — — 410 — — — 410 Totals 639 360 815 1563 513 594 922 5408 RECEIPTS. £ £ £ £ £ £ £ £ l. Grant from Ministry of Health 166 171 214 250 173 130 275 1383 2. „ „ „ Munitions 17 — 156 — 26 — — 200 3. „ London Parochial Charities 10 — — — 10 4. „ Campden Charities 3 — 6 — — — — 10 5. Voluntary contributions and donations 334 — 423 694 295 187 143 2078 6. Jumble sale, collection box, matinee, etc. — — 19 — — 60 133 213 7. Payments by probationers — — — 9 — — — 9 8. Payments by mothers or other persons for care of children 206 111 181 306 74 195 206 1282 9. Loan — 76 — — — — — 76 10. Interest on Deposit — — — 4 4 4 — 13 Totals 738 360 1002 1265 574 578 759 5279 In the tables of Payments and Receipts, shillings and pence are omitted in order to save space and to simplify examination ; but the various totals given were ascertained before the omissions were made. In some cases the accounts of the Nursery were included with those of a School for Mothers and an apportionment has been necessary. At the Golborne Centre, the Medical Officers of the School for Mothers inspect the Nursery twice weekly without extra remuneration. At the Kensal and St. Luke's Creches, the Medical Officers are not remunerated. Raymede Nursery was closed from July 31st, 1919, to January 1st, 1920. All Centres are open from Mondays to Fridays inclusive, except St. Clement's which is closed on Mondays. Times of opening vary from 7.30 a.m. to 8 a.m., and times of closing from 6 p.m. to 8 p.m. Raymede opens on Saturdays from 7.30 a.m. to noon, and St. Clement's from 7.45 a.m. to 2 p.m. No children were permanently resident during the year except at Lancaster Road, where the two children of one of the Nursery workers were in residence for nine months. At Golborne, children from the age of three to five years are taught on the Montessori system, and at the Notting Hill Nursery a Froebel College trained teacher gives Nursery School instruction daily. 14 DAY NURSERIES. Staff on March 31st, 1920. Name of Nursery Duty Name Qualifications Salary Allowances Golborne Medical Officer Dr. Mills M.D. f £1 Is. per session) Medical Officer Dr. Olive Langmead M B., B.S. at School for Mothers Matron Miss Gowans General Trained Nurse £ 140 per annum as Nurse in charge of School for Mothers Supervises Day Nursery without extra remuneration Nurse-in-Charge Miss Bone General Trained Nurse and Trained Mid-wife £50 per annum Board, Residence, Uniform and Laundry Nurse Miss Lipscombe Partial Hospital Training £30 per annum Board, Residence, Uniform and Laundry Probationer 1 — £12 per annum Board, Residence, Uniform and Laundry Probationer 2 — £12 per annum Board, Residence, Uniform and Laundry Domestic Laundrymaid — 12s. per week Two Children in Nursery free of charge Domestic Odd-worker — 12s. 6d. per week Two Children in Nursery free of charge and free dinners Domestic Girl — 8s. per week Dinners and Teas free Domestic Charwoman — 2s. 6d. per half day Dinners free Kensal Creche (Medical Mission) Medical Officer Dr. Haines M.D., M.Ch. Honorary — Matron Miss Ward Creche Trained £20 per annum Board, Residence and Laundry Nurse Miss Newcome — £18 per annum Board, Residence and Laundry Nurse Mrs. Ash by — 8s. per week Dinners and Teas free Domestic Charwoman — 2s. 6d. one day weekly Dinners and Teas free Lancaster Road Medical Officer Dr. Mabel Paine M.B., B.S. £11s. per session Matron Miss Currie General Trained Nurse £50 per annum Board, Residence, Uniform and Laundry; also paid £50 per annum as Superintendent of School for Mothers Nurse Miss Birt Trained at Skin Hospital £30 per annum Board, Residence, Uniform and Laundry Nurse Miss Stokes Trained at Skin Hospital £30 per annum Board, Residence, Uniform and Laundry Lady-Cook keeper Miss Stevens — £54 8s. per annum Board Domestic 1 — £22 per annum Board, Uniform and Laundry Domestic 2 — £22 per annum Board, Uniform and Laundry Notting Hill Medical Officer Dr. Mabel Paine M B., B.S. £1 Is. per session — Matron Miss Lazenby Creche Trained £65 per annum Board, Residence and Laundry Nurse Miss Saines Convalescent Home Trained £34 per annum Board, Residence and Laundry Nurse Miss Walford Creche Trained £25 per annum Board, Residence and Laundry Nurse Miss Howe Creche Trained £18 per annum Board. Residence and Laundry Nurse Miss Hood — £18 per annum Board, Residence and Laundry Probationer 1 — Board, Residence and Laundry Probationer 2 — Board, Residence and Laundry House Matron Miss Seal — £28 per annum Board, Residence and Laundry Teacher Miss Hacking Froebel College Trained 37s. 6s. per week — Secretary Mrs. Grant £25 per annum Raymede Medical Officer Dr. Mills M.D. £12 12s, per annum — Matron Miss Pickwell General Trained Nurse and Children's Hospital Training £80 per annum Board, Residence and Laundry Nurse Miss Whyte Fever Hospital Training £40 per annum Board, Residence and Laundry Probationer 1 — £12 per annum Board, Residence, Uniform and Laundry Probationer 2 — £12 per annum Board, Residence, Uniform and Laundry Probationer 3 — £12 per annum Board, Residence, Uniform and Laundry Cook Mrs. Williams — £1 per week Dinners and Teas free Treasurer Mrs. Swyny — £1 Is. per month — Domestic Housemaid — 18s. per week Dinners and Teas free Domestic Charwoman — 18s. per week Dinners and Teas free Domestic Charwoman — 12s. per week Dinners and Teas free St. Clement's Treadgold Street Medical Officer Dr. Mills M.D. £1 Is. per session — Matron Miss Parry Creche Trained £60 per annum Board, Residence and Laundry Nurse Miss Park Creche Trained £35 per annum Board, Residence and Laundry Probationer 1 — 10s. per week Board, Uniform and Laundry Probationer 2 — 10s. per week Board, Uniform and Laundry Cook-General Mrs. Mitchell — 13s. per week Board and Laundry Domestic Charwoman — Is. 9d. 2 hours per week One meal free St. Luke's Medical Officer Dr. Ironside M.R.C.S., L.R.C.P. Honorary — Matron Miss Hartwell Creche Trained £55 per annum Board, Residence, Uniform and Laundry Nurse Miss Springate Creche Trained £40 per annum Board, Residence, Uniform and Laundry Probationer Miss D'Main — £20 per annum Board, Residence, Uniform and Laundry Probationer Miss Amor — £12 per annum Board, Residence, Uniform and Laundry Probationer Miss Travers — £15 per annum Board, Residence, Uniform and Laundry Domestic Charwoman — £1 per week Board A number of Ladies give voluntary assistance at the Nurseries, especially in connection with administration, book-keeping and the collection of funds. 15 Homes for Deserted, Widowed and Unmarried Expectant or Nursing Mothers and their Children ANNUAL STATISTICS. 124, Elgin Crescent 65, Lancaster Road 2, Upper Phillimore Place Totals YEAR ENDING March 31, 1920 April 30, 1920 Dec. 30, 1919 1. No. of expectant or nursing mothers in residence at commencement of year 9 8 5 22 2. No. admitted during the year 15 27 40 82 3. No. remaining in residence at the end of the year 8 8 7 23 4. Average duration of stay before confinement (in days, — — 30 to 60 — 5. Average duration of stay after confinement (in days) 130 273 121 to 182 — 6. No. of infants and children under 5 years of age in residence at beginning of year 9 11 5 25 7. No. admitted during the year 15 33 28 76 8. No. remaining in residence at end of year 8 11 — 19 9. Average duration of stay (in days) 130 273 and over 121 to 182 — PAYMENTS YEAR ENDING March 31, 1920 Dec. 31, 1919 Dec. 31, 1919 £ £ £ £ 1. Rent, rates and taxes 126 84 136 347 2. Salaries and wages 209 91 98 398 3. Furniture and equipment 51 68 24 143 4. Heating, lighting and cleaning 73 30 34 139 5. Food and provisions 356 140 162 659 6. Printing, stationery, postage, etc. 14 14 16 44 7. Medical expenses 31 — — 31 8. Travelling expenses 13 — 5 18 9. Girls' outfits, etc. — 2 3 6 10. Laundry 54 2 10 66 11. Drugs — 4 1 5 12. Repairs — — 30 30 13. Telephone, insurances, sundries, etc. — 1 27 28 Total 930 439 550 1920 RECEIPTS YEAR ENDING March 31, 1920 Dec. 31, 1919 Dec. 31, 1919 £ £ £ £ 1. Voluntary contributions and donations 435 250 244 930 2. Grant from Ministry of Health 290 140 80 510 3. Payments by or on behalf of inmates 260 99 96 457 4. Sales of work, special collections, etc. — — 80 80 5. Interest on investments 10 — 3 14 Totals 997 489 506 1993 Shillings and Pence are omitted from the Tables of Payments and Receipts in order to save space and to simplify examination; but the various totals given were ascertained before the omissions were made. No confinements take place in any of the homes. Expectant Mothers are not received at Elgin Crescent and Lancaster Road. Lancaster Road was closed during March and April of 1919. STAFF. Name me Duty Name Qualifications Salary Allowances 124, Elgin Crcscent Superintendent Miss Brown Trained Rescue Worker £70 per annum Board and Residence Nurse Miss Harding Trained Midwife £40 per annum Board, Residence and Laundry Domestic (1) Nursing Mother — 10s. per week Board, Residence and Laundry Domestic (2) Nursing Mother — 10s. per week Board, Residence and Laundry Domestic (3) Nursing Mother 10s. per week Board, Residence and Laundry (Each of these mothers return £1 per month for care of baby 65, Lancaster Rd. Superintendent Miss Petremant General Hospital Trained Trained Midwife £60 per annum Board, Residence and Laundry Nurse Mrs. Smith Cottage Hospital Trained £40 per annum Board, Residence and Laundry Domestic (1) Nursing Mother — 5s. per week Board, Residence, Laundry, and baby kept free of charge Domestic (2) Nursing Mother — 5s. per week Board, Residence, Laundry, and baby kept free of charge Kensingt'n Home for Friendless Girls. 1, Upper Phillimore Place Superintendent Mrs. Harvey Children's and General Hospital Trained £70 per annum Board, Residence and Laundry Matron Miss Carpenter Orphanage Trained £30 per annum Board, Residence and Laundry Domestic The inmates carry out the domestic work without receiving any special remuneration 16 THE MOTHERCRAFT TRAINING SOCIETY 29-31, TREBOVIR ROAD. Work done for year ending March 31st, 1920 Number of In residence on March 31st, 1919 Admitted during the year Remaining in residence on March 31st, 1920 Average duration of stay. (a) Nursing mothers 8 46 6 15 days (6) Infants under 1 year 17 97 24 40 days No confinements take place in the Institution. Summary of Payments during the twelve months ending March 31st, 1920 £ s. d. 1. Rent, Rates and Taxes 502 1 9 2. Salaries and Wages 1845 9 6 3! Furniture and Equipment 55 17 5 4. Heating, Lighting and Cleaning 434 3 10 5. Food and Provisions 1688 14 8 6. Printing. Stationery, Postage, etc. 372 5 9 7. Other items of Expenditure— £ s. d. £ s. d. Literature 217 14 4 Travelling 106 0 0 Depreciation 87 14 8 Repairs, etc. 67 5 3 Law Costs 20 10 0 Medical 119 9 8 Clothing, Bedding and Drapery 47 3 3 Telephone, etc. 19 4 8 685 1 10 Total £5583 14 9 Receipts during the twelve months ending March 31st, 1920 £ s. d. 1, Voluntary contributions and donations 4434 19 8 2. Grant from Ministry of Health 1550 0 0 3. Payments by or on behalf of inmates 203 13 3 4. Proceeds from Ball 857 17 5 5. Proceeds from Jumble Sale 123 15 0 6. Training Fees 755 16 6 7. Literature, emulsion and sundries 395 5 2 Total £8321 7 0 STAFF Duty Name Qualifications Salary Allowances. Matron Miss Liddiard General Hospital Training (Trained Midwife) £165 per annum Board, residence and laundry Staff Sister Miss Read General Hospital Training £70 per annum Board, residence and laundry Staff Sister Miss Hansard General Hospital Training (Trained Midwife) £70 per annum Board, residence and laundry Foster Mother Mrs. Bushe — £32 10s. per annum Board, residence and laundry Secretary Miss Clark — £200 per annum — Office 2 clerks — £143 each per annum — Domestics (resident) 8 — £8 10s. weekly — Domestics (non-resident) 3 — This Institution receives patients from all parts of the country and does not provide for Kensington cases any more than for those from other metropolitan boroughs; therefore, although situated in the Royal Borough, it cannot be regarded as a Kensington institution in the same sense as the other bodies dealt with in these tables. Besides giving treatment to children and advice to mothers, particularly in regard to dietetic errors, the Institution is a teaching Centre for practical training in Child Welfare. The courses of instruction are intended for General Hospital nurses, maternity nurses and welfare workers. 17 TELFORD ROAD BABY CLINIC Statistics of work done for year ending 31st March, 1920. l. No. of individual expectant mothers who attended institution 101 2. Total attendances of expectant mothers 327 3. No. of sessions for expectant mothers 52 4. No. of individual children (under 5) who attended institution 908 5. Total attendances of children 5,675 6. Average attendance per session 38 7. No. of sessions on which doctors attended for infant consultations 151 8. No. of visits paid to homes of children by salaried workers (prospective operation cases and home treatment) 82 9. No. of dental sessions 26 10. No. of mothers who received dental treatment 52 11. „ „ children „ ,, „ „ 61 12. „ „ dentures provided 7 Expenditure for year ending 31st March, 1920. £ s. d. l. Salary of Medical Officers 202 12 0 2. „ „ Nurses 130 7 0 3. „ „ Dispenser 79 14 6 4. „ „ Caretaker (including cleaning and washing clothes bags) 52 12 0 5. Furniture and equipment 6 13 1 6. Rent, rates and taxes 53 14 4 7. Heating and lighting 26 1 1 8. Printing, stationery, postage, etc. 22 15 1 9. Dentist's fees 27 6 0 10. Cost of drugs and other medical requisities 208 4 4 11. Cost of cheap milk for mothers and children (Glaxo) 186 16 0 12. Laundry and sundries 9 2 3 13. 14. Cost of mother's teas Insurances 0 5 16 12 6 4 15. Repairs 179 14 6 16. Legal charges 1 1 0 17. Telephone 6 10 0 *Total £1,199 12 0 Outstanding on March 31st, 1920—£293 9s. 9d. Receipts for year ending 31st March, 1920. £ s. d. l. Grant from Ministry of Health 413 16 3 2. Voluntary contributions and donations 254 2 0 3. Receipts from mothers for dentures 9 12 3 4. „ „ „ „ bottles 4 17 11 5. Collection boxes (mothers contributions) 4 8 6 6. Receipts from mothers for bandages 1 4 0 7. „ „ „ „ milk (Glaxo) 162 18 8 8. Telephone box 0 5 0 9. Interests and Dividends 11 5 0 10. Rent returned in lieu of decorations and repairs 38 0 0 Total £900 9 7 TIME TABLE. Monday 2 to 5.—Doctor's consultations for infants. Thursday 2 to 5.—Dental treatment for mothers (twice monthly) Tuesday 2 to 3.30.—Doctor's consultations for expectant mothers. (Nursing mothers also seen and treated at this session.) 2 to 5.—Dental treatment for children (once monthly) Wednesday 2 to 5.—Doctor's consultations for infants Friday 2 to 5.—Doctor's consultations for infants. Thursday 2 to 5.—Operations (once monthly). Each morning the nurse is engaged in dressings and the treatment of minor ailments. Treatment is provided, as far as possible, for all chronic and sub-acute illness. Children acutely ill are sent home to care of local doctors or to Hospital or Infirmary. Small operations (tonsils, adenoids, circumcisions, etc.) are undertaken at the Clinic; the doctors attended on 10 occasions for this purpose and performed 42 operations during the year under review. Children needing major operations are sent to appropriate institutions. The Clinic also carries out the work of Infant Consultations on lines somewhat similar to those at Schools for Mothers; but home visiting is not undertaken except in connection with operations and treatment. The scheme for dental treatment had been in operation for eight months by the end of the year. It provides for the treatment of expectant and nursing mothers and children under five. Dentures are provided, but mothers have to pay the full amount of the assessment made before receiving them. STAFF. Name Qualifications Salary Allowances Dr, Ethel Bentham M.D. £1 1s. per session — Dr. Honor Bone M.D. £1 1s. per session — Dr. Anne Gilliat t M.D. £1 1s. per session — Nurse Westcott General Hospital Trained £8 1s. 6d. per month — Nurse Jeffery General Hospital Trained and Trained Midwife 7s. 6d. per session — (about 7 sessions per month) Miss Hill Qualified dispenser £1 10s. per week — Mrs. Nott (Caretaker) — £ 1 per week 2 rooms free Seven ladies give regular voluntary assistance. 18 LADBROKE ROAD BABY CLINIC IN-PATIENT HOSPITAL. 127, Ladbroke Road taken over in April 1919, and opened for the reception of patients on October 13th, 1919 Work done for Year ending May 7th, 1920, In residence on October 13th, 1919 (children under 5) ... ... ... 2 Admitted since October 13th, 1919 (,, ,, ,,) .... ... ... 28 Remaining in residence May 7th, 1920 ( ,, ,, ,,) ... ... ... 13 Average duration of stay:— 9 have been in for 7 or 8 months 1 has been in for 2 months 2 ,, ,, ,, ,, 3 ,, Others have been in 3 weeks or less Capital Expenditure £1,409 13 0 Of this amount £114 4s. 5d was outstanding on March 31st, 1920 Expenditure other than capital outlay during the Year ending March 31st, 1920 £ s. d. 1. Rent, rates, taxes and insurances 91 4 7 2. Salaries and wages (cleaning included) 256 13 6 3. Furniture and equipment 21 5 7 4. Heating and lighting 173 4 6 5. Food and provisions 211 2 6 6. Printing, stationery, postage, etc. 8 17 10 7. Drugs and medical stores 20 8 9 8. Laundry 46 8 2 9. Telephone 8 5 0 10, Interest on Loan 15 16 8 11. Caretaker and sundries 7 12 0 12. Advertisement 0 5 6 Total 861 4 7 Of this total £181 1s. l0d. was outstanding on March 31st, 1920. Receipts for the Year ending March 31st, 1920 £ s. d. 1. Voluntary contributions 315 19 0 2. Grant by Kensington Borough Council 100 0 0 3. Payments by or on behalf of inmates 1 0 0 4. Legacy via Labour Party 237 10 0 5. Proceeds from a Dance, Pound Day Collection and Drawing Room Meeting 206 19 0 861 8 0 Loan 900 0 0 Total 1,761 8 0 Note:—No grant had been received from the Ministry of Health by the end of the year. STAFF. Staff Name Qualifications Salary Allowances Doctors Dr. Bentham M.D. Not settled — Dr. Honor Bone M.D. ,, — Dr. Anne Gilliatt M.D. ,, — Matron Miss Stainton Trained Nurse £65 per annum Board residence, laundry and uniform Nurses Miss Vanes ,, £45 per annum ,, Miss Burrows ,, £45 per annum ,, Probationers Miss Bland — £20 per annum ,, Miss Spinks — £20 per annum ,, Miss Jones — £20 per annum ,, Cook 1 — 18s. weekly Board residence and laundry Servants (daily) Housemaid — £1 3s. 9d. weekly Board Charwoman — 10s. 3d. weekly ,, Laundress — £1 3s. 9d. weekly ,, As patients were not admitted until October 13th, 1919, it is impossible to make a true comparison between work done and expenditure incurred. 19 FINANCIAL SUMMARY ANNUAL EXPENDITURE £ (1) Seven Schools tor Mothers (Bramley Road and Kcnley Street counted as one) 5362 (2) Seven Day Nurseries 5408 (3) Three Homes 1920 (4) Telford Road Baby Clinic 1199 (5) Ladbroke Road Baby Clinic In-patient Hospital) (opened October 13th, 1919) 861 Total £14,750 Schools for Mothers. Day Nurseries. Homes. Telford Rd. Baby Clinic. Ladbroke Rd. Baby In-patient Hospital. Totals. ANNUAL RECEIPTS. ££££££ (1) Treasury Grant 1730 1583 510 413 Not yet received 4236 (2) Borough Council Grant — — — — 100 100 (3) Public Charities, Voluntary Contributions, Donations, Jumble Sales, etc. (the results of voluntary effort) 2490 2311 1010 254 760 6825 (4) Receipts from Mothers (drugs, dental fees, mill;, teas, payments for children homes, nurseries, &c., &c.) 998 1282 457 183 I 1 2921 (5) Other receipts 87 103 16 50 — 256 Totals 5305 5279 1993 900 ‡861 14338 ‡ Excluding loan of £900 which was utilised in connection with capital outlay. If these Maternity and Child Welfare Institutions were taken over by the Borough Council and maintained exactly on the present lines, contributions from charities, voluntary subscriptions and donations would probably cease and the income would consist of mothers' payments together with a Treasury Grant of 50 per cent, of the expenditure after deducting the amounts paid by the mothers. Based on last year's figures, the annual burden to be borne by the Borough Funds is shown in the following table:— Seven Schools for Mothers. Seven Day Nurseries. Three Homes. Telford Rd. Clinic. Ladbroke Rd. BabyIn-patient Hospital. Totals. ££££££ (1) Annual Expenditure 5362 5408 1920 1199 861 14750 (2) Mothers' Contributions 998 1282 457 183 1 2921 4364 4126 1463 1016 860 11829 (3) Fifty per cent. Treasury Grant 2182 2063 732 508 430 5915 Total Annual Charge on Borough Funds 2182 2063 731 508 430 5914 The calculations above given are only approximately accurate and arc intended for rough guidance. Before drawing conclusions several points should be borne in mind— (1) No allowance has been made for the large amount of excellent unpaid work now being carried out by interested ladies. If the Borough Council took over control of these Institutions many of the ladies would cease their activities and would have to be replaced by paid workers. (2) Municipal administration would differ from the systems now in vogue in many respects. (3) Ladbroke Road Hospital was open for only six months of the year. The Trebovir Road Institution does not specially cater for the needs of Kensington children therefore it has been omitted from this Summary. These Tables, and particularly the Summary on this page, have not been prepared as an argument to support any preconceived line of policy. The method of arranging the various figures was thought out before it was known what the results would show. On future occasions reports on various branches of Maternity and Child Welfare work will be presented to the Maternity and Child Welfare Committee, and, therefore, it is desirable to submit these tables now so that members of the Committee may have an opportunity of studying them before the reports are presented for consideration. JAMES FENTON, Medical Officer of Health. 20 APPENDIX. Local Government Board Tables I.—IV TABLE I. Vital Statistics of Whole District during 1919 and previous Years. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Transferable Deaths. Nett Deaths belonging to the District Uncorrected Number. Nett. of Nonresidents registered in the District. of Residentsnot registered iq the District. Under 1 Year of Age At all Ages. Number. Rate. Number. Rate. Number. Rate per 1,000 Nett births Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1914 171,400 3,019 3,153 18.4 2,624 15.3 767 432 298 95 2,289 13.4 1915 ‡l55,795 2,917 3,074 19.7 3,100 19.9 942 493 365 119 2,636 16.9 1916 ‡165,535 B 2,861 3,027 18.3 3,183 20.9 1,275 429 258 85 2,337 15.4 152,144 D 1917 J‡168,919 B 2,201 2,378 14.8 3,280 21.6 1,329 523 309 130 2,474 16.3 151,535 D 1918 ‡173.463 B 2,220 2,308 13.3 3,735 24.1 1,508 524 224 97 2,751 17.8 154,814 D 1919 ‡164,470 B 2,281 2,658 16.1 3,429 18.8 1,454 438 270 102 2,413 15.2 157,886 D * Rates calculated per 1,000 of estimated population. †Civil Population as estimated by the Registrar-General, and upon which the rates in the year are based. ‡B. Population as estimated by the Registrar-General for the calculation of Birth rate. D ,, ,, ,, ,, ,, ,, ,, Death rate. At Census of 1911. Area of District in acres (exclusive of area covered by water) 2291 Total population at all ages 172,317 Total families or separate occupiers 38,387 21 TABLE II. Cases of Infectious Disease notified during the Year, 1919. Notifiable Disease Number of Cases Notified. Total Cases Notified in each Ward Total Cases Removed to Hospital. At all Ages. At Ages.—Years. St. Charles. Golborne. Norland. Pembridge. Holland. Earl's Court. Queen's Gate. Redcliffe. Brompton. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Small-Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous croup) 274 1 66 140 36 26 3 2 41 61 69 32 23 18 9 16 5 258 Erysipelas 79 3 2 7 7 21 27 12 15 11 14 4 4 7 8 8 8 1 Scarlet fever 260 1 48 162 28 17 4 49 39 52 45 15 19 5 24 12 210 Typhus fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric fever 16 ... ... 2 2 7 4 1 1 1 1 3 3 2 1 2 2 13 Continued fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Relapsing fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal fever 11 1 9 1 2 3 3 ... ... 2 1 2 Anthrax ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-Spinal Meningitis 6 1 8 2 ... ... ... ... 1 ... 4 ... 1 ... ... ... ... 6 Poliomyelitis 2 1 1 ... ... ... ... ... ... 2 ... ... ... ... ... ... ... Pulmonary Tuberculosis 489 1 8 102 115 193 65 5 93 121 101 56 32 26 15 27 18 249 Other forms of Tuberculosis 93 3 16 53 12 6 2 1 11 29 23 11 4 5 1 6 3 42 Ophthalmia Neonatorum 31 31 ... ... ... ... ... . . . 8 8 8 3 2 1 ... ... 1 9 Measles 672 37 280 290 38 26 1 ... 150 158 98 92 59 22 32 31 30 46 German Measles 154 ... 26 61 30 34 3 ... 12 7 14 17 25 16 19 26 18 14 Pneumonia 245 6 18 32 37 96 35 21 35 31 40 32 23 29 9 19 27 3 Malaria 63 ... ... 14 43 6 10 11 12 6 6 6 3 2 7 1 Dysentery 6 ... ... 1 ... 5 ... ... 1 1 ... 1 ... 1 1 1 ... ... Totals 2401 84 468 853 320 483 151 42 429 481 441 302 197 154 104 162 131 854 22 TABLE III. Causes of, and Ages at, Death during the Year 1919. Causes of Death Nett Deaths at the subjoined ages of" Residents " whether occurring within or without the District. All Ages. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and upwards. All causes Certified 2,413 270 49 55 74 92 270 616 987 Uncertified — — — — — — — — — Enteric Fever 2 ... ... ... ... ... 2 ... ... Small-pox ... ... ... ... ... ... ... ... ... Measles 14 3 6 5 ... ... ... ... ... Scarlet Fever 2 ... ... 2 ... ... ... ... ... Whooping-Cough 4 2 1 1 ... ... ... ... ... Diphtheria, and Croup 16 1 5 9 ... ... 1 ... Influenza 151 2 1 5 4 13 43 33 50 Erysipelas 3 1 ... ... ... ... ... 1 1 Phthisis (Pulmonary Tuberculosis) 169 1 ... 1 6 29 65 53 14 Tuberculous Meningitis 21 5 1 10 4 ... ... 1 ... Other tuberculous diseases 17 1 1 3 5 3 4 ... Cancer, Malignant disease 240 ... ... 1 1 1 21 119 97 Rheumatic Fever 9 ... ... ... 4 ... 3 1 1 Meningitis 7 3 2 ... 1 1 ... ... ... Organic Heart Disease 265 ... . . . ... 4 5 13 86 157 Bronchitis 238 27 5 2 ... ... 6 48 150 Pneumonia (all forms) 229 36 15 16 10 14 30 50 58 Other diseases of Eespiratory Organs 50 1 2 ... ... 1 5 14 27 Diarrhoea and Enteritis 100 73 8 ... 2 ... 1 8 8 Appendicitis and Typhlitis 15 ... . . . 2 3 2 1 4 3 Cirrhosis of Liver 15 ... ... ... ... ... 2 8 5 Alcoholism ... ... ... ... ... ... ... Nephritis and Bright's Disease 79 1 ... ... 3 4 8 32 31 Puerperal Fever 7 ... ... ... ... ... 7 ... ... Other accidents and diseases of Pregnancy and Parturition 7 ... ... ... ... ... 6 1 ... Congenital Debility and Malformation including Premature Birth 82 80 ... ... 1 ... 1 ... ... Violent Deaths, excluding Suicide 66 9 2 ... 5 7 11 16 16 Suicide 15 ... ... ... 1 4 8 2 Other Defined Diseases 589 25 4 2 12 11 37 131 367 Diseases ill-defined or unknown 1 ... ... ... ... ... ... 1 ... 2,413 270 49 55 74 92 270 616 987 23 TABLE IV. INFANT MORTALITY DURING THE YEAR 1919. Nett Deaths from stated Causes, at Various Ages, under One Year of Age. Cause of Death Under 1 week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 4 Weeks 1-3 Months. 3-6 Months. 6-9 Months. 9 12 Months. Total Deaths under One Year. All Causes. 1 Certified 61 13 6 4 84 66 55 37 28 270 (Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... 2 1 3 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping-cough ... 1 ... ... 1 ... 1 ... ... 2 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... 1 ... ... ... 1 Tuberculous Meningitis ... ... ... ... ... 1 2 1 1 5 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... 1 ... ... 1 ... ... ... ... 1 Meningitis (not Tuberculous) ... ... ... 2 2 ... 1 ... ... 3 Convulsions ... ... 1 3 2 ... ... 4 9 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... 10 9 5 3 27 Pneumonia (all forms) ... 2 ... ... 2 8 6 12 8 36 Diarrhœa ... ... ... ... ... 3 8 6 1 13 Enteritis ... 1 ... ... 1 21 21 8 7 58 Gastritis ... ... ... ... ... 1 1 ... ... 2 Syphilis ... ... ... ... 1 1 1 ... ... 3 Rickets ... ... ... ... ... 1 ... ... ... 1 Suffocation, overlaying 6 ... ... ... 6 ... ... ... ... 6 Injury at birth 1 ... ... ... 1 ... ... ... ... 1 Atelectasis 3 ... ... ... 3 ... 1 ... ... 4 Congenital Malformation 2 1 ... ... 3 3 ... ... ... 6 Premature Birth 32 2 2 ... 36 4 1 ... ... 41 Atrophy, Debility, and Marasmus 11 5 1 ... 17 7 ... ... 2 26 Other causes 5 ... 2 ... 7 3 8 3 1 22 61 13 6 4 84 66 55 37 28 270 Nett Births in the year legitimate, 2,397. illegitimate, 256. Nett Deaths in the year of legitimate infants, 224. illegitimate infants, 46. 24