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42
When the new department has had time to settle down to its duties it is hoped that the resulting benefit
to the public will prove these changes to have been worthwhile. In the meantime, however, it must be
recognised that the latter half of 1971 was a period of frustration, confusion and disappointment for
members of the Health Department who have experienced three major changes in organisation and duties in
the past 25 years, and are now having to carry on the service as best they can under the threat of further
changes in 1974.
INFANT AND CHILDHOOD DEATHS
Because of a fall in births one would naturally expect some fall in the number of infant deaths, but this
year the decrease has been considerably greater than would be expected from this cause alone.
Consequently both the perinatal and the infant mortality rates have now reached the lowest point of 18
and 13 respectively.
Deaths occurring in the first week of life amounted to 19 and of these 12 were due to prematurity and
allied causes.
There was a total of 35 deaths of infants under 1 year during 1971. The causes are classified in Table 2,
page 70. There were 3 unexpected sudden deaths in infancy; two occurred in hospital and the other at
home. All infants had previously been making good progress and were well cared for. There were five
infants who died from bronchitis or pneumonia — in one of them there was also cerebral palsy. Nine infants
died from congenital malformation, six of them malformations of the heart and great vessels. Interestingly
enough, all the four children born alive suffering from spina bifida/hydrocephalus survived the first year.
There were 7 deaths in the age group 1-5 years. Five were due to congenital heart disease, one
complicated by hydrocephalus. Four of these children were resident abroad and brought to London for
treatment. One death in this age group was from leukaemia. One tragic death occurred in a boy of 2½ who
had been admitted to hospital with unexplained injuries. Shortly after his discharge home he received
further injuries which proved fatal. A charge of manslaughter was brought against a co-habitee.
There were 12 deaths in children in the 5-15 age group — 2 from leukaemia, 2 from other neoplasms, 5
from congenital abnormalities, 2 as a result of accidents and 1 from cerebrovascular disease.
It is perhaps interesting to note that apart from bronchitis and pneumonia there were only three deaths
from infection in the under one group and no deaths from infection in those between one and fifteen.
(Table 2, page 70).
MATERNAL MORTALITY
There was unfortunately one maternal death during 1971.
The person concerned was not a resident of Westminster. A multigravida, domiciled in France, came to
England to have a 15 week pregnancy terminated. The operation was performed in a private nursing home
approved for the purpose. The patient collapsed four hours after the operation and in spite of intensive
treatment died six hours later from haemorrhage due to perforation of the uterus.
MATERNAL AND CHILD HEALTH
Antenatal and Postnatal Care
97% of births in the area are booked for hospital delivery. Antenatal care is undertaken mainly by the
hospital units with intermediate examinations by General Practitioner Obstetricians or at the local health
clinics. The number of attendances at the clinics has continued to decline, but it is interesting to note some
increase in the number attending mothercraft and exercise classes. The number of postnatal attendances has
been maintained, chiefly because at one large maternity unit these examinations have been combined with
family planning advice and have been held in the local authority clinic.