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His Worship the Mayor, Aldermen and Councillors of the Metropolitan Borough of Paddington.
Mr. Mayor, Ladies and Gentlemen,
I have the honour to present the Annual Report of the Medical Officer of Health for the year 1952.
Readers of this record of the work of the Public Health Department are accustomed to note slow, steady and
unspectacular progress towards better health and improved environmental conditions for those living in the borough.
It is seldom that in any one year a marked change can be observed in a particular field. Even over longer periods
of, say, five or ten years it may not be easy to discern either improvement or deterioration and when the effect of
unexplainable factors obtrudes, the interpretation of the figures presented may be difficult.
A notable exception has been the incidence and death rate of diphtheria, both figures now reaching vanishing
point. This satisfactory position has been commented on in previous reports and attention drawn to the need to
maintain this high degree of immunity by continuous attention to immunisation campaigns. The statistics for this
year suggest that the diphtheria figures may be joined by the tuberculosis figures in showing remarkable progress.
The tuberculosis notification rate has been constant during the last three years. There have been a succession of
mass X-ray examinations in the borough. These surveys bring to light cases of tuberculosis which might otherwise
remain undetected. One would expect an increase in the number of cases notified, but in spite of the investigations
carried out by the mass X-ray Unit the notification rate is stationary. The number of deaths from tuberculosis was 33,
the lowest figure recorded in the borough, which is 22 less than the previous lowest, 55 in 1950. It would be prudent
at this point to warn that this may be a temporary improvement, that many times in the past improvements have not
been maintained. On the other hand the greatly improved treatment by antibiotics, the other new drugs, improved
surgical technique, the introduction of B.C.G. on a large scale, the improved social services available for tuberculous
patients should lead to improvement and we should expect the improvement to be evident again in future reports.
In the last month of the year London experienced one of the worst fogs on record, and there was a considerable
increase in the number of deaths recorded at this time. The fog and the resultant deaths affected an area much
wider than the borough and is to be the subject of intensive study. It would therefore be premature to make
further comment at this time.
The birth rate shows a further fall, but the number of illegitimate births remains regrettably high. This is a subject
which requires enquiry. On the credit side mention must be made of the very low infant mortality figures among
illegitimate children. The usual experience is to find a high infant death rate among the illegitimate which adversely
affects the infant mortality as a whole. The reverse has been the case this year, the figures for the illegitimate infants
helping to produce a low infant mortality rate generally.
The large number of cases of measles indicates an epidemic, but the 1952 figures alone do not give a complete
picture, the high incidence being carried on into 1953.
The difficulty experienced in obtaining adequate repairs to a certain class of property has been a source of concern
for several years. Property may deteriorate rapidly and become unfit for human habitation because the owner has
no funds. In certain cases the Council can, and does, carry out repairs, recovering the cost by Housing Act procedure.
This can be done only where the Council can recover the cost from the rents in a reasonable time. Experience has
shown that the number of properties which can be dealt with in this manner is limited and as the cost of repairs increases
and the rents remain static there seems little hope of expanding the use of this method in the future.
It is important to remember that housing accommodation can be lost because there is no authority available
to spend say some hundreds of pounds to maintain property in occupation, which, if demolished, will cost thousands
to replace. Admittedly the hundreds spent will not produce property with as long a life as new property, but it would
prevent the loss of accommodation already in occupation. This subject has been touched on in previous reports and
one would have imagined that the saving of existing accommodation would have been as valuable as the building of new
and that there might be sound financial reasons for trying to do this. However, successive governments have failed to
see any attraction in the idea and no action has been taken. The problem is so bound up with the Rent Restrictions
Acts that it may be unreasonable to expect an early solution.
The visits paid by the Lady Visitors show a considerable increase, particularly in the number of visits paid to old
people, from 241 in 1951 to 561 in 1952. This increase is related to the reconstituted Old People's Welfare Committee
and the appointment of an Organiser. The Lady Visitors receive much valuable information from the Organiser which
has resulted in the larger number of visits paid. It is hoped to give a fuller account of these activities in the next
annual report. The section dealing with the Holiday Home will be of interest to many.
My best wishes go to my successor, Dr. H. L. Oldershaw, who, by reason of his dual appointment, will be able to
link the work of the Borough with that of the County to their mutual advantage.
It is my final and pleasant duty to express my most sincere thanks to the Members of the Council, to my colleagues
in other departments, and to the Public Health Department staff for the help, support, and friendliness which it has
been my happy privilege to receive during the last six years.
I have the honour to be
Mr. Mayor, Ladies and Gentlemen,
Your obedient servant,
Medical Officer of Health.