Given under the Seal of the Minister of Transport this 23rd day of December One thousand nine hundred and twenty-four.

Circular 556

MINISTRY OF HEALTH.

HOUSING.

Local Bonds.

1. By Section 7 of the Housing (Additional Powers) Act, 1919, Local Authorities, with the consent of the Minister, were enabled to exercise borrowing powers under the Housing Acts by the issue of Local Bonds under the conditions set forth in the Act and the Regulations made thereunder. These conditions include provision that the minimum period for which bonds can be issued is 5 years and that the bonds bear interest at the rate prescribed by the Treasury.

2. Many Local Authorities adopted this system of borrowing to finance the assisted housing schemes carried out under the provisions of the Housing, Town Planning, etc., Act, 1919, and the bonds issued in the year 1920 for the minimum period, i.e., 5 years, will become due for redemption during the present year.

3. So far as maturing bonds are not redeemed by the application of moneys available for the purpose in the sinking funds of the Local Authority, the sums required for redemption will fall to be raised by re-borrowing. It is necessary, therefore, that a Local Authority who have issued bonds which mature in the near future should give consideration to the position and should determine the means by which they will make the necessary provision for the redemption of the expiring bonds and the form of borrowing which they propose to adopt for the purpose.

4. Having regard to the fact that the Local Authority in many cases will be raising capital for housing schemes authorised under the Housing Acts of 1923 and 1924, the Minister does not propose to lay down any precise method for the re-borrowings in connection with the assisted schemes under the Act of 1919, as no doubt the Authority may desire to adopt some uniform method for all their housing borrowings. It rests, however, with the Local Authority to take the requisite steps to ensure that the necessary money has been provided to enable them to meet their obligation at the due dates in respect of the bonds which become due for redemption.

5. In most cases the Local Authority will doubtless, in the first instance, communicate with the holder of each bond which is falling due for redemption to ascertain whether he is prepared to accept a new bond for a further period of not less than 5 years at the rate of interest prescribed by the Treasury. This rate has now been fixed at 4 per cent. per annum. It is

suggested that the Local Authority should communicate with the bondholders approximately two months before the dates on which the bonds are due for redemption and should request that a reply be made within a specified period, e.g., four weeks. At the expiration of that period the Authority will know the extent to which the bonds can be redeemed by the issue to the existing holders of a fresh certificate for new bonds at 4 per cent. and also the amount required for the redemption of bonds by repayment in cash. It will then be open to the Authority to receive applications for Local Bonds from new lenders or to make arrangements for borrowing this sum by other means.

In this connection, Local Authorities are reminded that, except with the approval of the Minister, they may not borrow money for the purposes of the assisted housing schemes under the Housing, Town Planning, etc., Act, 1919, above a certain rate of interest. At present this rate is 4 per cent. per annum.

MINISTRY OF HEALTH,
Whitehall, S.W. 1,

February, 1925.

Circular 557.

TRAINING OF HEALTH VISITORS.

MINISTRY OF HEALTH,

Whitehall, S.W. 1.

9th February, 1925.

SIR,

1. I am directed by the Minister of Health to forward, for the information of the Local Authority, copies of a Memorandum which he has issued specifying the conditions on which grants will in future be made from the Exchequer for the training of Health Visitors. It will be observed that as from the 1st April, 1925, these grants will be paid by the Minister instead of the Board of Education.

2. It will be remembered that in the Memorandum of July, 1922 (Memo. 65/M.C.W.) with reference to the training of Health Visitors, certain qualifications were mentioned as being desirable for a woman appointed as Health Visitor. This question has again been under consideration in the light of the experience gained since the issue of Memo. 65/M.C.W. and in connection with the transfer to this Department of the responsibility for the administration of the Exchequer grants in aid of training.

3. The duties of a Health Visitor vary according to the district in which she is employed. Her primary duty consists in the home visiting and general supervision of children under school age in her district; she is also usually expected to attend at the Maternity and Child Welfare Centre and may be called upon to advise the mothers on a variety of questions concerning the care and upbringing of their children, as well as their own personal health and hygiene during pregnancy and lactation. In addition, her duties may frequently include school nursing, visiting of tuberculous patients, making special inquiries or investigations, and so forth. It is therefore necessary that a Health Visitor should possess not only good sense and an acceptable personality, but also the trained mind and the professional qualifications which will enable her to deal wisely with the problems which may come before her. There appears to be general agreement that as a rule the duties of a Health Visitor can best be carried out by a woman who has been trained as a hospital nurse, is a certificated midwife, and has passed through a special course of training designed to equip her with a knowledge of the preventive and public health aspects of her work.

4. After careful consideration and consultation with the Associations of Local Authorities and other bodies interested in this matter, the Minister has decided that on and after the 1st April, 1928, he will not approve the appointment of a woman

for the first time as a whole-time officer of a Local Authority with Health Visiting duties, unless she has obtained the Certificate mentioned in paragraph (4) of the enclosed Memorandum. It will be seen that this Certificate will be obtainable by a woman desiring employment as a Health Visitor who passes the examination referred to in that paragraph and

(i) Is a "trained nurse," as defined in paragraph 1 of the conditions of grant, who has obtained the Certificate of the Central Midwives Board and has completed an approved course of training in public health work, lasting for at least six months; or,

(ii) Has undergone a course of training of two years' duration already recognised under the Board of Education (Health Visitors' Training) Regulations, 1919, together with six months' training in Hospital, and has obtained the Certificate of the Central Midwives Board.

5. It will be observed that paragraph 3 (3) of the conditions of grant requires that the practical instruction comprised in the six months' course of training in public health work shall, so far as practicable, be conducted in co-operation with the Public Health Department of the Local Authority for the area in which the course is given. The Minister trusts that the Local Authorities concerned will give all possible facilities to the training institutions in order that the students may have an opportunity of observing the ordinary duties of a Health Visitor under normal conditions.

6. It will, of course, be realised that the position of existing Health Visitors should be fully safeguarded, and in the case of such Visitors who are appointed to serve in districts other than those in which they may be engaged prior to the 1st April, 1928, the Minister will be prepared to approve their appointment without further qualifications. But he desires especially to call attention to the provision which is explained in paragraph (6) of the Memorandum for enabling a woman who has given at least five years' satisfactory service as a Health Visitor to obtain the new Certificate, and he trusts that Local Authorities will assist and encourage their Health Visitors to prepare and enter for the examination leading up to that Certificate.

7. The Minister is anxious that facilities should be provided for those who are already engaged in Health Visiting to obtain occasional "Refresher" courses, and he is prepared to approve the payment by Local Authorities of the reasonable expenses of their Health Visitors (including fees, maintenance and travelling expenses) in attending whole-time courses lasting from two to four weeks and designed with a view to extending both their practical and theoretical knowledge. It is hoped that such courses will be organised in London and other large centres by bodies familiar with the kind of instruction required and having special facilities for obtaining suitable lecturers. The expenditure incurred by Local Authorities in connection with courses