As regards sub-head H, £200 is for office travelling. It is sometimes necessary to send an indoor officer to the country to consult with local officers upon special matters which could not be undertaken by the outdoor staff. For example, there are matters in connection with elections. Miscellaneous minor services represent the usual charges for the cost of advertisements, daily newspapers, Local Government publications, petty office expenses, and expenses of messages— tram fares—when urgent delivery of letters is required. The increase under the sub-head for this year is due to the inclusion of the amount required to meet expenses of the Trade Section under the following heads:
Advertisements and petty cash
|
£80
|
Advisory Committee travelling expenses
|
120
|
Purchase of samples
|
200
|
Testing quality of commodities
|
300
|
|
£700
|
I do not think it necessary to deal with telegrams and telephones under sub-head H (2). Sub-heads I and J are recurrent. Sub-head K deals with the grant for maternity and child welfare. The disbursements from the grant in 1925-26 amounted to £14,369. Of that total £6,065 went to twentysix local authorities, the balance being paid to eighty-six voluntary agencies. The classification of the latter is as follows:
Health visiting
|
69
|
Institutions
|
7
|
Centres
|
4
|
Boarding out
|
6
|
The infant mortality in Saorstát Eireann—67 per 1,000 births—for 1925 showed a reduction as compared with 1924, and was only fractionally higher than the record year 1923. This improvement was specially noticeable in urban districts where the infant death rate for 1925 was below the figure of 1923. The high mortality amongst illegitimate infants continues to be an unfavourable feature, but efforts have been made on the part of the Department to effect improvement by the circulation of recommendations for concerted remedial action to the local authorities and voluntary agencies in Dublin County, and county borough, where the loss of life among this class is abnormally heavy.
The Estimate for the coming financial year provides for an expansion of services, especially on the part of local authorities, who have generally shown disposition to enlarge their activities for child welfare. The national grant defrays 50 per cent. of the net cost of approved services. The principal undertaking assisted is the provision of health visitors, that is to say, trained nurses who get in touch with expectant and nursing mothers, and children under five years of age, and give advice as to maternal health and as to the care and management of young children. The primary object of health visiting is preventive, so as to forestall the development of conditions of ill-health. The work is carried on by whole-time officers in the larger centres of population, and elsewhere the services of district nurses have been utilised on part-time conditions. Twenty-six local authorities and eighty-six voluntary agencies participate in the grant. The general infant mortality for 1925 was as follows:—
Whole country
|
67 per 1,000 births
|
Urban districts
|
97 ,, ,, ,,
|
Rural districts
|
53 ,, ,, ,,
|
In 1924 the statistics were:—
Whole country
|
71 per 1,000 births.
|
Urban districts
|
102 ,, ,, ,,
|
Rural districts
|
55 ,, ,, ,,
|
Sub-head L deals with the grant for school medical service. In 1925-26 this amounted to £570, which was applied to five voluntary schemes and the two municipal schemes in Cork and Clonmel. The latter have developed in accordance with the results ascertained on the preliminary inspections, and arrangements have been made for the treatment of dental defects and of affections of the eyes and throat. In Dublin the Commissioners have been furnished by the Medical Superintendent Officer of Health with a report on the requirements, and still have the matter before them. In Waterford the Corporation are considering a report on a scheme of school medical service submitted by their medical officer. In the administrative counties the matter is closely associated with the appointment of county medical officers, one of whose early duties will be to formulate recommendations suitable to the requirements of their respective areas.
Sub-head M deals with school meals. The expenditure on school meals was incurred in two county boroughs, namely, Dublin and Cork, and in fourteen urban districts, namely, Athy, Navan, Brí Chualann, Carlow, Ceannanus Mór, Clonmel, Dungarvan, Dun Laoghaire, Kilkenny, Killarney, Listowel, New Ross, Wexford and Youghal. Recoupment from the grant is made in respect of half the actual expenditure from rates for the provision of food for school meals. Primary schools under the control of the Christian Brothers will, as a result of arrangements made between the Department of Education and the Christian Brothers, come under the terms of the School Meals Acts. About sixty-seven primary schools under the control of the community will be covered by the new arrangement. The extension of the school meals scheme will not affect the grant until the year 1927-28, as recoupment therefrom in any year is only made in respect of expenditure incurred during the preceding financial year.
The decrease in the present year's Estimate is due principally to the dropping of the school meals scheme framed by the Rathmines and Rathgar Urban District Council. Urban authorities have been reminded of their powers as regards the provision of school meals, but the general views of the councils who have not adopted schemes were that there was no necessity for such arrangements in their districts. During the year 1924-25, approximately 12,478 school children were fed, of whom 6,061 were dealt with in Dublin County Borough, and it is estimated that 1,521,953 meals were supplied.
Sub-head N deals with Welfare of the Blind. There is but little change to be recorded in the position as regards the provision required to be made for the blind. The number of workshop employees and of inmates in the institutions for the blind shows a slight decrease, which accounts for the reduction of £100 in the grant as compared with last year. The scheme adopted by the Commissioners for Dublin County Borough for the welfare of the blind has been continued for a further year and has been extended by the Dublin County Council to their area. Similar arrangements are being brought into operation in Cork Co. Borough, and consideration has also been given to their adaptation for Limerick County Borough. The training of the blind in this country is not a problem of any great extent. Particulars as to the number of blind persons between the ages of five and thirty years in the several counties of the Saorstát have been secured through the County Boards of Health, and, omitting Dublin county, in which a scheme is operating, and the four county boroughs, the total number of blind persons between these ages is found to be, approximately, 116, or an average of less than five such persons per county. In Dublin blind persons are admitted to the register on a certificate from a recognised ophthalmic surgeon or specialist. Provision is made for the education, training, employment and maintenance of suitable blind persons in the existing schools, workshops and homes for the blind. The wages of blind workers employed in those workshops and living in their own homes are being augmented under the scale. I do not think it is necessary to give that scale, as I gave it last year.
Sub-head O is for the treatment of tuberculosis. The administration of county tuberculosis schemes was transferred, in pursuance of Section 15 of the Local Government Act, 1925, from the county tuberculosis committees to the county boards of health as from 1st October last. In addition to the existing tuberculosis schemes in twenty-two counties and two county boroughs, comprehensive arrangements for dealing with the disease are under consideration at present in Cork County and County Borough, Limerick County Borough, Meath County and Roscommon County. The Cavan County Council are completing a tuberculosis hospital at Keadew, Cavan, and several other councils are also considering proposals for advanced case institutions. It is somewhat difficult at present to estimate the effect of these projects in increasing the claims on the National Tuberculosis Grant in the present year, but an additional sum of £3,500 has been included to cover the contingencies of the adoption of new schemes, the operation of new institutions and the increase of patients under treatment, due to the operation of the compulsory notification of tuberculosis in pursuance of Section 17 of the Local Government Act, 1925. The total number of patients dealt with under approved tuberculosis schemes during the year 1924-25 was 10,131, composed of 2,680 insured and 7,451 uninsured persons, and the amount issued from the grant as recoupment in respect of their treatment was, approximately, £34,300.
The mortality rate from tuberculosis for the year 1924 was 1.45 per thousand of population. This was a slight increase on the previous year's figure of 1.41 per thousand of population. Such an increase was not unexpected in view of the disturbed conditions of the two previous years. The comparative progress made in this country in reducing the mortality from tuberculosis may be estimated by examining the time which has been occupied in this and the neighbouring countries in securing the same measure of improvement in the death rate from the disease. The highest rate of mortality in Ireland from tuberculosis was 2.9 per thousand of the population, and this figure was last attained in the year 1904. The lowest record for the Saorstát was reached in 1923 in the rate of 1.41 per 1,000 of the population. Thus the reduction of the rate from 2.9 to 1.41 per 1,000 population has been effected in nineteen years. England last showed a death rate from tuberculosis of 2.9 per 1,000 population in the year 1878, and the rate did not fall below 1.5 until 1910. This gives a period of thirty-two years for the corresponding diminution of the rate as against nineteen years in Ireland. Scotland's rate of mortality from tuberculosis was 2.9 per thousand of the population in the year 1883, and it did not go below 1.5 per thousand until the year 1919, or thirty-six years afterwards. This country has, therefore, achieved in nineteen years the same reduction in the death rate from tuberculosis which was effected in England in thirty-two years, and in Scotland in thirty-six years.
In connection with sub-head P, I have to say that the attitude of the majority of the local authorities towards the provision of facilities for the treatment of these diseases is generally adverse. The five approved schemes for Dublin County Borough, and the counties of Dublin, Kildare, Wicklow and Monaghan have been continued. In addition, approval has been given to the general outlines of schemes for the diagnosis and treatment of venereal disease in Cork County Borough and in Offaly County, and it is expected that these arrangements will shortly come into operation. In County Westmeath the council have approved of the resumption of their approved scheme, which has been in abeyance for some years past.
As regards the work performed in connection with existing schemes during the year ended 31st March, 1925, it is to be noted that the out-patient attendances at the treatment centres were 26,076, as compared with 25,292 in the previous year, and the number of in-patient days amounted to 7,591, as against 7,022 in the preceding year. It does not necessarily follow from these increased statistics that the disease is becoming more prevalent, but the figures probably indicate that the facilities for treatment afforded under the schemes are becoming more widely known and utilised. The total cost of the approved arrangements for dealing with the disease during the year ended 31st March, 1925, was £8,707 13s. 4d., of which 75 per cent. or £6,530 14s. 11d. was refunded from the State grant, leaving only £2,176 18s. 5d. to be met from the rates. The total cost for the financial year 1923-4 was slightly higher, £8,913 18s. 6d.
Progress in housing is being sustained. The total amount included in the present year's estimate is £348,000. Of this amount £2,000 is in respect of three schemes which were carried out under the Housing Act, of 1919, viz., schemes undertaken by Dalkey Urban District Council, Balbriggan Town Commissioners, and St. Barnabas Public Utility Society, Dublin. In the first two schemes the subsidy payable is based on the annual deficit on the schemes, and in the case of the Public Utility Society the subsidy equals 50 per cent. of the loan charge on the approved expenditure. The Exchequer subsidy under the 1919 Act to local authorities was a payment on basis of loan charges pending the completion of the houses, and when the houses were completed of a payment of 35/- for each £1 of rent collected, the subsidy not to exceed the actual deficit incurred. Final payment in respect of any year's subsidy is not made until the accounts are audited. With the high building costs prevailing at the time no progress could be made, and the schemes local authorities had in view were deferred pending more favourable conditions. Compared with the conditions which prevailed up to 1922 the present rate of progress must be considered satisfactory. The Government has already provided over one million and a quarter for housing grants, and this year a further sum of £348,000 is required. Under the £1,000,000 grant which was made available for urban housing in 1922, schemes providing for about 2,100 houses have been undertaken by urban councils and with one or two exceptions are now completed. The sum of £20,000 included in the Estimate represents the balance of the grant.
The numbers of houses which are being provided under the 1924 and 1925 Acts are as follows: The number of houses constructed by private persons under the 1924 Acts is 2,745 and the number provided by local authorities 864, making a total of 3,609. Of this total there have been built 1,079 in county boroughs, 357 in urban districts, 65 under town commissioners, and 2,108 in rural districts. Under the 1925 Act grants have been allocated in respect of 2,507 houses to be erected by private builders, 90 by public utility societies and 769 by local authorities, making a total of 3,366. This number of 3,366 houses is allocated between urban and rural areas as follows: County boroughs, 1,045; urban districts, 278; town commissioners, 64, and rural counties, 1,979. From price schedules which have come to the notice of this Department the cost of building shows a slight downward tendency. Under the schemes of the Civic Commissioners the building cost of five-roomed houses in Dublin during the past twelve months averaged between £500 and £535, while in the smaller municipal areas houses of similar accommodation are being built at between £450 and £500.