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10
During the year, a Green Paper was published on the future
structure of the health services. This document is in the process of
being overtaken by events and has already been discussed and commented
upon at great length. At this stage, therefore, it would
appear superfluous to make more than a passing mention.
I must now turn to a consideration of the year under review.
The vital statistics reflect an over-all satisfactory position and these
are analysed in detail in the body of the report. Total notifications
of infectious diseases increased slightly but this was due mainly
to measles although its incidence was greatly reduced as a result
of our immunisation campaign. There is no doubt, however, that
protection against measles is lagging behind other protective
measures since the demand for this vaccine has proved to be less
than anticipated. Tuberculosis, both pulmonary and non-pulmonary,
continues to decline but there was a sharp increase in
food poisoning due to an isolated outbreak involving 58 persons.
There is one disturbing trend, potentially socially disruptive, to
be reported: the incidence of venereal disease, in all its forms, is
increasing at a rate which, if it continues, must be described as
alarming. New cases of residents treated show an over-all increase
of 36 per cent and syphilis alone increased by 71 per cent. Since
venereal disease is not a notifiable disease, it is almost certain that
these figures do not reflect the full picture and there are likely to
be many more untreated cases acting as carriers. As with the
drug problem, it is difficult not to escape the conclusion that this
increase is due to changing standards of ethics and morals and one
can only hope that all the experts in the behavioural sciences who
influence the pattern of our society will accept the warnings that
are becoming so obvious.
Domiciliary confinements continue to decline: more mothers are
electing to have their babies in hospital and we are fortunate in
Greenwich in having an over-all adequacy of maternity beds for
our needs. However, early discharges are increasing and we are
hoping that local authority midwives can play an increasingly
close part in the total midwifery service.
The home nursing service has increased both in the numbers
of patients receiving care and in total attendances. This trend is
to be expected with the emphasis on early hospital discharge and
an ageing population requiring more attention. Attachment
schemes involving district nurses also increase the work load and
at present 33 general practioners and 13 district nurses are working
in partnership.