View report page

65
APPENDIX
THE PUBLIC HEALTH STORY OF ISLINGTON
(Extracted from Handbook of Centenary Health Exhibition
24th September to 6th October, 1956)
The beginnings of the Public Health Department of the Borough in its present
form date back to 1856. The Metropolis Local Management Act and the Nuisances
Removal Act for England in 1855, established the Vestry as the Local Authority,
required the appointment of a Medical Officer, and authorised the appointment of a
Sanitary Inspector and Inspector of Nuisances.
The Vestry of the Parish of St. Mary, Islington, on 18th January, 1856,
approved the appointment of a Medical Officer and a Sanitary Inspector in accordance
with these Acts. The appointment was duly advertised at a salary (after some
disagreement among the members of the Vestry) of £250 per annum, and the Vestry
were fortunate to appoint Dr. Edward Ballard as their first Medical Officer. At that
time, although Medical Officers of Health had been appointed respectively to the
City of Liverpool and the City of London, there was very little public health
legislation, and although in general the scope of the job to be done appeared
fairly obvious, the manner in which such duties were carried out under statutory
controls had not yet been fully established. It was, in fact, left to individual
Medical Officers of Health to lay down their own paths to a very considerable extent
and to guide not only their Authorities but also point the way to the Central
Government Authority as to how the administrative basis of the prevention of illhealth
could best be laid down. Therefore the individual personalities and vision
of the early Medical Officers of Health were very important and it was indeed
fortunate that in the Parish of St. Mary, Islington, Dr. Ballard was not only an
enthusiast in preventive medicine but also had the administrative ability to lay
down the foundation of such work for the future—and, in fact the foundation
which he laid continued in a relatively unchanged form for about forty years after
he was appointed.
Health conditions in Islington and in London certainly warranted special
attention. In fact, it was the particular circumstances of London which made it
necessary for the Government of the time to pass legislation for the appointment
of Medical Officers and Sanitary Inspectors to the Vestries of the Metropolis
before they were appointed in general to the remainder of the County.
The population in Islington in 1856 was estimated at 123,130. The birth rate
was high, there being 4,306 births, representing a rate of 35 and if the birth rate
was high, the death rate was also high at 22 per thousand, although Dr. Ballard
remarks that it appeared favourable in comparison with that of the Metropolis
generally. Distinguishing features at this time were the high proportion of deaths
due to the zymotic or infectious diseases, which were responsible for a quarter of
all deaths, as against approximately one in two hundred now.
Since most (approximately 70 per cent) of the zymotic deaths occurred in
young children, a very high proportion of the total deaths from all causes were due
to deaths under five years of age. In fact, in 1856, 46} per cent of all deaths were
in those under five years, and of these deaths half took place in the first year of life.
Even in his first Annual Report, Dr. Ballard pointed to the effect of social
conditions on the zymotic mortality. He made the following comment in the
1856 Report :—
"Not only are the houses inhabited by the poorer classes smaller in the East
Sub'district than in the West, but more persons occupy the same houses, and
as if this were insufficient to spread and aggravate disease, the houses altogether
are in a very much worse condition as to airiness and ventilation ... This
condition, as a fact, operated remarkably in the instance of the mortality from