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14
The tuberculosis visitors working from the chest clinics visit all tuberculous households to
ascertain home conditions and to advise patients on such matters as isolation, steps to be taken to
avoid the spread of the disease, and diet. Home contacts are urged to attend for x-ray examination or
Mantoux testing and, where necessary, B.C.G. vaccination, and to attend clinic sessions for the
purpose of surveillance.
The tuberculosis visitors also follow up patients who do not visit the chest clinic as regularly as
required and, where rehousing is sought, their detailed reports on home conditions assist with the
award of "points" for priority of the family's application. Where insanitary conditions appear to exist
the matter is referred to the public health inspector for further investigation.
Whooping Cough
There was a significant decrease in the number of cases of whooping cough, only two notifications
being received during 1969 compared with fourteen in the previous year. The figure for this year,
which is the lowest recorded, is in accord with the sharp decline in the total number of cases notified
in England and Wales.
MASS MINIATURE RADIOGRAPHY
The future of the mass miniature radiography service has been considered by the Standing
Medical Advisory Committee to the Secretary of State for Social Services and, acting on the recommendations
of this Committee, the Department of Health and Social Security has now asked all
regional hospital boards to consider, in consultation with local health authorities, how the need for
chest x-ray services in their regions can best be met, with a view to integrating mass miniature radiography
units with hospital radiological departments.
It is the Department's view that in many areas the proportion of new cases of active respiratory
tuberculosis currently being found by general factory and office surveys and volunteers from the
general public does not justify the continuation of this work, and that this part of the service should be
terminated as soon as the resources at present devoted to providing it can be redeployed. However,
the Department has stated that provision should continue to be made for the examination of volunteers
from the general public by hospital static units, perhaps at stated times on certain days, until an
assessment is possible of the demand for their use.
There is a higher than average yield of new cases of active respiratory turberculosis from special
surveys, from examination of persons in prisons and borstals, from examination of contacts, and from
examinations of school children with positive Mantoux tests. It is clearly desirable that this work
should continue. In some of these groups, however, the numbers examined are relatively small, and
Boards are asked to consider, in consultation with local health authorities, to what extent it may be
practicable and economically advantageous for some of this work to be performed in hospital
departments.
During 1969 however the North West and the South West London Mass X-ray Services continued
to provide regular public sessions at numerous points in Westminster in addition to various closed
surveys. The South West London Service also undertook six-monthly surveys in conjunction with the
Westminster Hospital Chest Clinic for the residents of the City Council's Lodging House at Bruce
House, Kemble Street, W.C.2. and in this connection they acted in close liaison with the City
Council's Health and Welfare Departments. Twice yearly X-ray sessions incorporating a special
service for the early discovery of lung cancer in men over 45 years of age were provided for all City
Hall staff and staff of adjacent office blocks, in addition to the sessions for personnel at the Council's
Gatliff Road Depot.
INTERNATIONAL CERTIFICATES OF VACCINATION AND INOCULATION
Arrangements continued for the authentication by the Medical Officer of Health of international
certificates of vaccination and inoculation completed by medical practitioners in Westminster.
These certificates are required by persons proceeding abroad from this country and the purpose of the
authentication is to provide proof to those health authorities abroad who desire it that the signature of
the person issuing the certificate is that of a registered medical practitioner. After normal office hours,
at weekends and on public holidays, certificates can be authenticated upon application to the Duty
Officer at City Hall.
During the year under review 20,996 (18,336) such certificates were authenticated, the demand
being largely due to people going abroad for holidays.
The Medical Officer of Health also issues, on request and in appropriate circumstances, certificates
to the effect that no cases of smallpox have occurred in the district during the preceding month.