Many of the professional workers of the department have long been employed on a part-time basis. An official definition of part-time service, applicable throughout the department, was, however, lacking. Such a definition has now been promulgated. During the year a careful study was made of the sanitary code, of the regulations of the department, and of all forms of board orders which prescribe or require any kind of alteration to buildings, with a view to establishing perfect consistency between the regulations of the board of health and those of other city and state departments. As a result of this study conflict of orders, confusion, and unnecessary expense to citizens will be avoided.

An order was issued forbidding employes of the department to enter into or to maintain business relations with, or to accept any fee for the performance of professional services for any milk or other firm whose activities are under the supervision of the department of health.

The chief of the division of research and efficiency in the bureau of child hygiene was detached from that bureau and assigned to the office of the commissioner, where his services will be utilized for the benefit of the department as a whole.

The high per capita cost of operating the department clinics for school children was materially reduced by arranging for surgical operations in these clinics every week day in place of every other day.

In every possible way efforts have been made to lighten the burdens of the department and incidentally of the taxpayers, by transferring to private physicians clinical and other functions which such physicians are able to perform without danger to the public health. A notable instance of the application of this new policy is acceptance on a child's admission to school of the certificate of a private physician in lieu of examination by the department's own medical inspectors.

Throughout the year studies of the various activities of the department were made, with a view to the more effective utilization of available means and forces. In consequence of these studies, a number of unproductive activities were discontinued. By means of office consolidation in the Richmond borough office,

several valuable employes, who, owing to the limited amount of work to be done in the Richmond borough office, were little more than supernumeraries there, were transferred to branches of the service where their help was badly needed. A similar study of the work of the Queens borough office has since been undertaken. The departmental board of promotions, which previously consisted of three individuals, was reorganized early in the year, so as to include as members of the board all bureau chiefs.

A uniform method of dealing with requests for "leave of absence with pay" was inaugurated.

In order to show each chief of bureau precisely where his bureau stands in the matter of supplies, and whether in a given month goods have been consumed in excess of the available appropriations for any particular purpose, a form was inaugurated for monthly distribution showing the following facts:

1. Amount of annual appropriation for supplies (each appropriation item to be separately stated).

2. Amount of monthly appropriation calculated as one-twelfth of annual appropriation.

3. Amount of requisitions, item by item, during the month covered by the report.

4. Amount available for the period since the beginning of the fiscal year (on a pro-rata basis).

5. Amount actually used since the beginning of the fiscal year. Inquiry having indicated that in some of the divisions of the department important instructions to groups of workers had been given orally, in so informal a manner that it would be impossible to prove conclusively when such instructions were issued, to whom issued and with what emphasis, heads of bureaus were instructed that all orders which are equivalent to rules and which affect groups of workers should invariably be reduced to writing and formally promulgated.

Statements have been completed showing the unit cost of functions and activities of the department; these figures will prove of value to the department. Departments of health in other cities will be urged to follow suit, and valuable and instructive comparative data will, it is hoped, thus be obtained. Many inspectors and other field workers of the department

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were without comprehensive printed codes of instructions. spectors were expected to carry in their minds many of the instructions given them. Each bureau chief was therefore directed to formulate a code of instructions applicable to the field workers of his particular bureau.

In order to meet the frequent requests from department employes for permission to attend conventions and conferences in this city and elsewhere in the department's time and at the expense of the department, a committee was appointed to prepare an official list of annual conventions and meetings representation at which is clearly desirable in the interest of the department.

Acknowledgments

Many of the procedures of the department this year have been new. In all of the bureaus the pace has been quickened. A serious effort has been made to hold each employe of the department up to a high standard of personal achievement. Officers and employes have been asked to make sacrifices to which they have not been accustomed. In some instances salaries have been reduced: and except in a few cases, it has been impossible, owing to the financial stringency, to reward zealous and efficient workers according to their merit. Under these circumstances, eagerness to serve the department could not reasonably have been anticipated. Nevertheless, there has been manifested throughout the department a steadfast devotion to duty, and in many instances even a high degree of enthusiasm.

That the health department of the city of New York is permitted by the mayor to conduct its affairs wholly untrammelled by interests foreign to its fundamental purpose of conserving life and health, must serve as a lesson to every city where health administration fails because less favorable conditions prevail.

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DISCUSSION OF PUBLIC HEALTH AND SANITATION

THE TENEMENT HOUSE DEPARTMENT

JOHN J. MURPHY

Commissioner of the Tenement House Department

BOUT fifteen years ago it was recognized that the multiple dwell

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ing problem in the city of New York was growing to such proportions as to need particular treatment. From 1867, when the first tenement house laws were placed on the statute books, up to 1900, the enforcement of such laws was divided among a number of city departments. The department of health had many of them, the bureau of buildings some, the fire department some, the police department some, and as usually happens when there is a division of responsibility, it was found that there was a waste of effort and considerable non-enforcement of the law. Accordingly, the tenement house commission concluded that the best way to solve the problem was by creating a special department into whose care should be committed practically the entire regulation of multiple dwellings. If you want to understand the precise position which the tenement house department occupies in the municipal scheme, you must get the legal definition of a tenement house and not the colloquial use of the term. A tenement house in New York is "any building or part thereof which is occupied as the residence of three families or more living independently of each other and doing their own cooking on the premises." It includes apartment houses, flat houses and all other houses of similar character. The size of the problem in New York may be judged from the fact that we have to-day one hundred four thousand recognized, legal tenement houses occupied by about four and a quarter millions of population. The work of the tenement house department is in a sense almost as simple as the work of the health department as described to you by Dr. Goldwater is complex. Its work is to attempt to prevent evil conditions by operating in three directions-structural, sanitary and sociological.

We have jurisdiction over the erection of all new multiple dwellings. All plans for new multiple dwellings or tenement houses have to be submitted to the tenement house department for examination as to light, ventilation, fireproofing, fire egress, and sanitation, before the plans are forwarded to the bureau of buildings for its action. During the process of erection every new building is continually inspected by