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ANNUAL REPORT OF THE MEDICAL OFFICER OF
HEALTH FOR THE YEAR 1919.
To the Right Honourable the Lord Mayor, Aldermen and Commons of the
Corporation of London.
Public Health Department,
Guildhall, E.C.,
June, 1920.
My Lord Mayor and Gentlemen,
I beg to present herewith the report of the Medical Officer of Health for the
Corporation of the City of London for the year 1919.
introductory.
The following record is practically my first annual report during seven years
of tenure of office. Previous summaries have consisted of abbreviated tabulations
of statistics and scant references to work done during the year. The report for
the year 1913 was the joint effort of my predecessor and myself, and in consequence
was more in the nature of a connecting link. The year 1914 marked the commencement
of the great war which continued down to the armistice in the autumn
of 1918. During the war period, work was materially interfered with and ordinary
routine as well as normal development were replaced by efforts mainly of expediency.
The annual report of the Medical Officer of Health should be a document
in which not only results and records are set out, but in which this officer is able
to bring to the notice of his Authority the arguments for and against current
proposals, and in which he is permitted reasonable latitude to state his own views
thereon. An expression of opinion of this character does not necessarily commit
the Authority but it furnishes members with information to enable them to consider
the situation and partially to be in a position to criticise, vary, or support
the policy which the Medical Officer of Health may subsequently submit for
consideration or adoption.
In the case of the City of London this requirement is as necessary as in other
districts, for although the resident population has decreased to practically insignificant
numbers it occupies the position of an Authority which has a tradition
behind it, centuries old, of interest in all matters which concern the welfare of
the inhabitants of this country in general and those of its citizens in particular.
If ever the Corporation takes the view that its responsibilities are limited to
safeguarding the health of the few thousands of resident inhabitants, then indeed
will its interest and action in public health affairs approach the parochial. Fortunately
there is neither indication nor danger of this state of affairs developing
for the Corporation continues to take the keenest interest not only in the night
population but in the welfare of those who return daily to the square mile to earn
their livelihood.
It must be acceded, as suggested above, that in many matters relating to
later developments in State Medicine, the direct interest of the City is slight.
These developments more and more emphasise the fact that the individual unit
must play an important part if future improvement is to result. In this connection
the influence of the Corporation can be most effective. The very freedom of
the City from direct interest enables it to give a decision on policy which is free
from suspicion of ulterior motive. Its judgments become those of a body influenced
only by the consideration of what is most advantageous to the many.
Historical records show that from the earliest days of this country's development
the City interested itself not only in public health matters but also in curative
medicine and in organisations of direct professional concern. The Letter Books
of the Corporation, which continue to be issued at intervals, throughout their
pages illustrate instances of the Aldermen and Court of Common Council exercising
authority. Preventive measures adopted during the plague period have proved
the basis of many modern developments. Interest in the medical treatment of the
poor was shown when the Corporation undertook responsibility for the administration
of St. Bartholomew's Hospital in the sixteenth century, and the development