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38
PERSONAL HEALTH SERVICES
MARJORY A. DAWSON, M.B., Ch.B., D.P.H.,
Acting Deputy Medical Officer of Health
The decline in the City of Westminster's birth rate, perhaps related in some degree to the extension of
the City Council's free family planning service, is resulting in a smaller child population. The health visitors,
therefore, have less work to do in connection with ante-natal and infant welfare services and can devote
more time to the elderly.
With the advance of medical science the number of elderly within the community is increasing; and this
results in larger numbers requiring surveillance and assistance both from health visitors and district nurses.
The increased availability of professional help and advice, not only to residents but also to voluntary
associations dealing with the elderly, is a very real advantage.
In addition, the Health Department provides health visitor and district nurse attachments to seven
general practitioner group practices whose case loads naturally include many in the older age groups. These
attachments give considerable assistance to the family doctors and help to promote a valuable screening
service to the elderly cared for by the various practices. Not only does this save the doctor's time but
especially does it facilitate early warning of a resident's particular medical or physical needs. It will be seen
therefore that the role of the district nurse and the health visitor in particular is becoming more orientated
towards our older residents. This extension of the sphere of health care is a vital factor in the concept of an
overall community health service.
INFANT AND CHILDHOOD DEATHS
Coupled with a further decline in the number of births, there was a consequential fall in the number of
infant deaths, which totalled 30 in 1972 (35 in 1971).
Deaths occurring in the first week of life amounted to 19 (19) and of these 11 were due to prematurity
and allied causes.
The causes of death are set out in detail in Table 2, page 61. It is of interest to record that 27 out of the
30 deaths occurred in local hospitals, with 2 deaths at home; the other death related to a newly-born female
child who was found dead at Victoria Coach Station. The cause of death in this case was inhalation of
mucus. At an inquest HM Coroner recorded an open verdict, there being insufficient evidence as to the
circumstances.
In one case, a girl of some 3 months, death in a local hospital resulted from asphyxia. In this case also
HM Coroner at an inquest recorded an open verdict.
There were 2 unexpected sudden deaths in infancy; boys of 1 month and 2 months respectively. Both
deaths occurred in hospital.
In the age group 1 — 5 years there were 4 deaths during 1972. Three of these children were normally
resident abroad and had been brought to this country from Greece (2) and Libya (1) for treatment. There
was also one tragic accidental death — a boy almost 5 years of age who died in the Mount Vernon Hospital
from shock due to burns. (Table 2, page 61).
MATERNAL MORTALITY
Unfortunately there were four maternal deaths reported in Westminster during 1972, there having been
one in 1971.
The first maternal death was due to intestinal obstruction due to volvulus following a routine termination
of pregnancy at 14 weeks of the fourth pregnancy of a 22 year old woman.