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2
CITY OF WESTMINSTER
Telephone: Health Department,
TATe Gallery 8070 City Hall,
Victoria Street,
London, S.W.I.
To The Right Worshipful The Lord Mayor, Aldermen and Councillors of the City of Westminster.
My Lord Mayor, Aldermen and Councillors,
I have the honour to present for your information a report on matters affecting the health of the City
of Westminster which I am required to submit annually to the Minister of Health.
This report deals in detail with the work carried out by the Health Department during the calendar
year, 1965, although it was not until April, 1965, that the "new" City of Westminster came into existence.
In 1900 the "old" City of Westminster was formed by the amalgamation of five parishes: and the
then Medical Officer of Health wrote in his Annual Report for 1901 of the amount of time spent in
reorganising the work of his Department. In 1965 the new City of Westminster was formed by the
amalgamation of three Metropolitan Boroughs, and the transfer of some of the functions previously
carried on by the London County Council, and a similar large amount of time has been spent in duties
connected with reorganisation.
So far as the new Health Department is concerned, work has proceeded smoothly, and this is good
testimony to the careful planning undertaken during the previous two years. The continued use in
the Paddington and St. Marylebone area of locally familiar buildings as administrative offices and
advice centres enabled much of the Department's service to the public to be continued on a local
basis, and obviated any possible criticism of a remote impersonal service administered from a distant
headquarters. The reorganisation was effected without any disruption of service; indeed, it is doubtful
whether the majority of the citizens of the new City are conscious of the great changes which have
taken place.
I do not propose in this Introduction to deal in detail with the work carried out by the Department
during the past year, since this is amply covered in the sections which follow. The services now provided
by the Health Department are wide and varied; they affect every facet of daily life not only from the
cradle to the grave, but in the periods prior to birth and after death, when the Department has to clear
up the estates of persons for whom no arrangements for burial have been made.
On this occasion, details of the Department's functions have been set out at some length in order
that those interested may be aware of the scope of the work now undertaken. No comparative
statistics have been included this year, since on this occasion they would not be strictly comparable
due to variations in systems in the merging authorities.
The vital statistics for 1965 are set out on page 6, and it is unfortunate in this first report to record
three maternal deaths. The maternal death rate is, however, comparable with previous years; and it
must be borne in mind that with the considerably larger population some itemised figures will appear
unusually high although they are, in fact, on a par with previous years.
One item among the statistics must give rise to continuing concern. The fact that more than
eighteen in every hundred children born alive in the City are illegitimate is alarming in itself. Even
more alarming is the fact that pregnancies of unmarried mothers accounted for just over a quarter
of all the stillbirths and early neonatal deaths recorded in Westminster during the year. It has been
said, and is probably true, that many unmarried pregnant girls come to central London to seek not
only anonymity but also the excellent maternity services which are available. That maternity services
are good in Westminster is reflected in the fact that the perinatal mortality rate in the City is below
the average for England and Wales and even for the area of the old County of London, in spite of the
high proportion of perinatal deaths of illegitimate children. Nevertheless, the fact remains that one
and a half times as many illegitimate pregnancies result in stillbirth or early neonatal death as do the
comparable legitimate pregnancies, a very high figure, even when one allows for the fact that many
illegitimate births result from first pregnancies. Even this figure does not in all probability represent
the true facts so far as the lone mother is concerned because we know, although accurate statistics are
not available, that many of the registered illegitimate births are in fact births in homes where, although
the mother and father are not legally married, there is stable cohabitation comparable with that of the
normal married couple. On statistical evidence alone there is the strongest possible case for further
detailed study to discover what may be done to prevent lone motherhood or failing this to provide for
the lone mother the means by which she may have the best chance of giving birth to a live child and
bringing it to a healthy and useful maturity.