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TO THE MAYOR, ALDERMEN, AND COUNCILLORS
OF THE LONDON BOROUGH OF LEWISHAM
I have the honour of presenting a report on the health services in Lewisham for the
year 1970.
Undoubtedly the greatest single health hazard in this borough at this time is cigarette
smoking. Dr. Farquharson of the Chest Clinic at Lewisham states in her report that:
"Our recent findings indicate that only about 10% of our patients (with cancer of
the lung) are operable. This year has shown an increase in new cases of cancer of the
lung and a noteworthy increase in the proportion of women affected (1970—22%;
1967—7£%)." Interestingly, this correlates with Dr. J. P. V. Rigby's report from the
Chest Clinic in Deptford: "I also did a study of heavy cigarette smokers—it does
seem that heavy cigarette smoking has been much more recently acquired as a habit
by womenfolk in the Deptford area". The total number of deaths in the borough due
to smoking is much greater than the 248 ascribed to cancer of the lung. Although it is
known that the long-term results of any form of anti-smoking treatment are unsatisfactory,
any attempt to reduce dependency on cigarette smoking is worth while.
During the year the Health Department has increased its attempt to meet this challenge
by instituting five-day crash courses for groups of smokers. The only real solution
to this problem is "no smoking", and this will only occur as a result of a change in
the attitude of the whole community.
Another common cause of death, obesity, practically never appears on a death
certificate. During the year a number of groups were started to help individuals
overcome this disability.
The perinatal and infant mortality figures give no cause for complacency, being
above average for England and Wales. Indeed, viewed against international figures,
the position for England and Wales must be regarded as unsatisfactory. The local
situation will be a matter for study during the current year.
I would draw attention to the Louise House Screening Clinic (Page 31), a new
development during the year. This screening service is devoted to the discovery of
disease, in people of middle age, prior to the onset of symptoms. Working as it does
to the lists of family doctors, it is possible to identify the percentage of "at risk"
population who attend and the actual persons who fail to attend. This is only one of
the advantages of moving towards an integrated service.
A small but noteworthy development during the year has been the assessment of
elderly mentally confused and, possibly, physically ill patients in their own homes
by the health visitor. The health visitor uses her developed skills of observation to
produce a comprehensive report which is submitted to the psychiatrist, geriatrician
and family doctor. This type of assessment represents a considerable step forward in
the diagnosis leading to the appropriate treatment and care of a group of elderly
persons whose well-being causes considerable anxiety.
Before the publication of this report, the Local Authority Social Services Act 1970
and the Education (Handicapped Children) Act 1970 will have been implemented.
It will be some years before the health services will be unified and doubtless that will
not be the last reorganisation. I would like to pay a tribute to the Health Committees
who, in the past, have created the services transferred of which we can be proud. I wish
to express my thanks to my colleagues who are now in the Social Services Department
and the Inner London Education Authority for their loyalty to the Health Department
and myself, and for their services to the people of this borough. I can be sure that they
will be valued in their new spheres. I wish them health, happiness and success.
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