DAY NURSERIES.

Day Nurseries are mainly intended to provide for the care of healthy infants and young children between the ages of about nine months and three years whose mothers are obliged to engage in daily work which takes them from their homes. It is of course desirable that women with young children should whenever possible remain at home and look after their children instead of going out to work, and a Day Nursery is only needed as a permanent institution where there are a number of women who are unable to do this.

The circumstances of each Day Nursery have been reviewed in order to ascertain whether it meets a real need and is fully utilised, and as a result a few of these institutions have been closed. The number of Day Nurseries is now 135, of which 32 are maintained by Local Authorities and 103 by voluntary bodies.

HOMES AND HOSPITALS.

Reference has been made in previous reports to the deficiency of the accommodation in Homes and Hospitals for maternity cases and for complications of pregnancy, and it is possible to report some further progress towards meeting this need.

On the 1st January, 1922, there were recorded in the Department 123 Maternity Homes (61 municipal and 62 voluntary) containing 1,675 beds, as compared with 88 Homes and 1,145 beds on the 1st July, 1920. On the other hand there was a reduction in the number of Homes for mothers and babies from 116 to 104, and in the number of Homes for children under five from 44 to 33.

As regards hospital accommodation for children under five there. are now 45 institutions (including observation wards) with 608 beds, as compared with 48 institutions containing 577 beds in July, 1920. There are also 22 Convalescent Homes with 434 beds for mothers with babies or for children under five.

The total number of institutions of all these classes known to the Department on the 1st January, 1922, was 327, of which 89 were conducted by Local Authorities and 238 by voluntary agencies.

SUPPLY OF MILK.

The efforts made by the Department to reduce the heavy expenditure of the last two years on the supply of milk at less than cost price to expectant and nursing mothers and young children were neutralised to a great extent by the distress due to unemployment which prevailed during the year. The stringent conditions laid down by the Department for regulating the administration of this service have, it is believed, been generally observed by Local Authorities throughout the year, but the reduction in expenditure anticipated as a result of these conditions has not been realised. It is, however, hoped that a reduction in the price of milk and improved industrial conditions may enable economies to be effected in the expenditure on milk in the current financial year.

The opinion of Local Authorities was obtained during the year on the possibility of substituting meals for milk in the case of expectant and nursing mothers. It appeared from the replies received that it was generally considered that the practical difficulties of making this

provision were too great to admit of its general adoption. It was therefore decided to continue during 1922-23 the arrangements at present in force for the supply of milk, with such safeguards against abuse as it has been possible to devise, allowing Local Authorities to substitute meals for milk in the case of expectant and nursing mothers where they desire and are able to do so; and this decision is being applied in fixing the maximum net expenditure in 1922-23 which will be recognised for grant.

INFANT MORTALITY.

The infant death rate for England and Wales of the year 1920, namely 80 per 1,000 births (the lowest hitherto recorded), was slightly exceeded in 1921, when the rate was 83 per 1,000 births. The lowest rate previous to 1920 was 89 in the year 1919, and the rates of these three years afford a striking comparison with the average rate of about 150 at the beginning of the century. It is to be hoped that the check imposed at the present time on extensions of Maternity and Child Welfare work will not tend to prevent a still further reduction of this rate in the near future.

Welfare of the Blind.

BLIND PERSONS ACT, 1920.

Important developments have taken place during the year in connection with the welfare of the blind by reason of the application of the Blind Persons Act, 1920, which came into operation on the 10th September, 1920.

Under section 1 of this Act blind persons who had attained the age of 50 were entitled to receive such pensions as they would have been entitled to receive under the Old Age Pensions Acts if they had attained the age of 70.

On the 31st March, 1922, 9,107 blind persons in England and Wales between the ages of 50 and 70 were in receipt of Old Age Pensions. From the date of operation of the Act to the 31st March, 1922, 3,267 appeals relating to claims made under the Act were received. Of these, 1,423 were referred to the Regional Medical Staff and 45 to ophthalmic specialists on the question of the degree of blindness.

Section 2 of the Act requires the Councils of Counties and County Boroughs to make arrangements to the satisfaction of the Minister for promoting the welfare of blind persons ordinarily resident in their area. The schemes submitted by these Councils in pursuance of this. section have received, or are in course of receiving, approval. These schemes propose as a general rule to make the fullest use of existing voluntary agencies for the blind, and where necessary to give financial assistance towards the cost of carrying out the different services.

Section 3 requires the registration of charities for the blind, and a list of charities so registered has been compiled by the Charity Commissioners. It is satisfactory to record that these registration. provisions have resulted in the suppression of several charities which were not of a bonâ fide character.

GRANTS.

During the year a sum of £69,886 has been distributed among the voluntary agencies for the blind in respect of the grant-earning services performed by them. This amount has been allocated between the various services as follows:

The two grant-earning services which have shown most marked development are those of home teaching and the provision of regularised assistance to home workers. The latter service aims at the provision of materials to trained blind persons who, for one reason or another, are unable to attend workshops, help and supervision in the making of saleable articles, and assistance in the marketing of the finished articles.

Extracts are given below from a report made to his Committee by the Superintendent of the London Society for Teaching the Blind, Swiss Cottage, on the working of a typical scheme which covers the Counties of Essex, Hertford, Middlesex, Berkshire and London north of the Thames :

The idea is not new. Fifty years ago Dr. Armitage exerted himself to get the Institutions of the country to carry out what was then called the Saxon System of care and supervision of former pupils. The Dresden Institutions continued their assistance to pupils after they had finished training, and looked after them in their own homes by providing material and by selling their goods. In spite of Dr. Armitage's efforts the Saxon System was never adopted by the British Schools, and the opinions of the pundits consolidated on the position that the workshop was the only cure. To plead the cause of extension of workshops was good, but to exclude the need for auxiliary services was to refuse to face facts.

The preliminary survey resulted in 78 names being recommended to the Ministry for acceptance as recognised Home Workers. Additional recognitions have been given at various dates, till the numbers stand at present at 59 men and 43 women. They are divided according to occupations

as follows:

Up to the present the problem of the hand knitters has remained largely unsolved. Not only is the competition of machine-made goods very formidable, but the quality of much of the work renders it unsaleable. It is to be feared that some of the low grade workers will need to come off the register. The machine work is more hopeful than the hand work, and several women have been kept busy. Continuous efforts are being made to open up fresh markets, and hopes are entertained that a much greater output will be absorbed next year.

More success has attended the work in connection with the pianoforte tuners and teachers of music. Local interest has been stimulated by advertisement and display cards, and in one case the Education Committee has been induced to give to a local blind tuner the care of its school pianos.

With regard to the mat makers the same difficulty of short demand aggravated by poor workmanship has been experienced. The good worker has been a comparatively easy proposition, while the man who can turn out only indifferent stuff is, in these days, unemployable.

The basket makers in Berkshire afford an example of successful assistance. Regular work has been found for four, in addition to suitable workshop accommodation for two who required it, and advantageous terms for material bought locally.

A survey of the six months' working shows clearly that a scheme such as this can be of great value to the scattered blind. The times have been exasperatingly bad, so that many efforts which would have spelt success in normal years have led to nothing. In spite of this, enough has been done to show the directions in which success will ultimately be achieved. It can be said that the work has proved much more rich in human interest than was anticipated. For enlarging one's knowledge of human nature nothing more enlightening could be recommended than six months' experience of a Home Workers' Scheme. The 102 cases embrace many types, from the patient hand knitter who has been content to plod away at sweated rates-50 hours for 6s.-to the man who refuses an order because he cannot get as much for it as in the inflated days of war-time trade.

GENERAL.

The two Inspectors for the welfare of the blind have continued. their inspection of the voluntary agencies, and as a result of their recommendations a considerable number of improvements have been effected. The services of the Inspectors have also been placed at the disposal of Local Authorities in preparing their schemes under section 2 of the Blind Persons Act, 1920, and it is understood that their advice and assistance has been most helpful.

An essential part of the arrangements made by Local Authorities. in connection with schemes under section 2 of the Blind Persons Act will be the maintenance of adequate records of the blind, and in order to avoid duplication of work it was decided during the year to discontinue the maintenance of the central register of the blind.

The Advisory Committee on the Welfare of the Blind, reconstituted so as to afford representation to Local Authorities under the Blind Persons Act, and to Boards of Guardians, as well as to voluntary agencies, have made numerous recommendations to the Department on matters relating to the care of the blind, and after consultation with this Committee a memorandum has been addressed to Local Authorities on the question of the augmentation of the wages of blind persons, registration, and the provision of employment.

The Committee appointed to investigate and report on the causes of blindness expect to conclude their deliberations at an early date. An Interim Report on the alleged danger to the eyesight of actors and actresses engaged in film production, a question which was specially referred to the Committee, has been published and placed on sale (price 3d. net) as a Stationery Office paper.

Inspection and Supervision of Food.

MILK.

Reference was made in the Report for last year to the scheme under which licences are issued by the Department authorising the use of special designations for milk produced under specially hygienic conditions. There has been an extension of the numbers of producers and dealers wishing to take advantage of the system, and the numbers of licences in force on the 31st March, 1922, were as follows: Producers of Grade A (Certified) Milk, 27; producers of Grade A Milk, 18; dealers in milk of either description, 100.

MEAT INSPECTION.

The Departmental Committee on Meat Inspection, of which Sir Horace C. Monro, K.C.B., was Chairman, submitted their Report on the 16th July, 1921. The Report has been published and placed on sale (price 1s. net) as a Stationery Office paper.

The Committee made a number of suggestions designed to secure that meat for human consumption shall reach the consumer free from disease and in a clean condition. Some of the recommendations would require legislation, and it has not yet been found possible to give effect to them. Other recommendations, involving administrative action by the Department, or executive action by Sanitary Authorities under their existing statutory powers, have been carefully examined. A circular was issued to Sanitary Authorities on the 16th March, 1922, expressing general agreement with the views of the Committee, and bringing before the Authorities and their officers certain matters referred to by the Committee in which action might be taken under the present law. These had reference to (1) uniformity in meat inspection, (2) variations in the amount of inspection, (3) variations in the standards of judgment and practice of individual Inspectors, and (4) the qualifications of Inspectors.

The Committee prepared a detailed code of instructions as to the inspection of carcases of animals intended for human consumption. This code was embodied in an official memorandum (Memo. 62/Foods) which was issued with the circular, and was recommended to Local Authorities and their officers as a considered and detailed scheme for inspection and (where necessary) condemnation for disease. It is hoped that the general adoption of this code will lead to a substantial increase in the uniformity and reliability of meat inspection in this country.

It has also been decided to prepare regulations under the Public Health (Regulations as to Food) Act, 1907, giving effect to the recommendations of the Departmental Committee as to the marking of meat, and for the purpose of securing cleanly conditions in the handling, transport, etc., of meat,