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The live birth notifications in 1969 for Westminster totalled 2899 so the immunisation rate according to
the Department of Health and Social Security's calculation would be:
1742 x 100 = 60%
2899
However the removals of 1969 births out of Westminster in 1969 were 460 more than the removals in
during the same period (716 removals out + 45 deaths — 301 removals in = 460); therefore a truer reading
would be based on a birth rate of 2439 which would be:
1742 x 100 = 71%
2439
Since the first injection is not given until six months of age or over and the second two months later,
transfers of 1969 births in 1970 should also be taken into account. Here again the outward transfers
exceeded inward transfers by 261 so the 71% could be under-estimated by 7% assuming that the outward
transfers exceed the inward transfers at an average of 21 per month (261)/(12) and that immunisation is not
completed until the child is nine months.
An investigation was carried out in a Maternal and Child Health Centre situated in one of the poorer
parts of the City. A complete breakdown of 1969 immunisation statistics was undertaken by using the
immunisation records kept in the centre, taking into account the removals in and out of the centre which
were checked with the Maternal and Child Health records at City Hall. The results of this enquiry showed
the primary immunisation rate for the area to be 76%.
Two other points emerged from this enquiry —
(a) A Health Visitor at the centre who is attached to a general practitioner reported that out of 25
children born in 1969 at present on her area, all of whom had been given the primary
immunisation course by the general practitioner, there are no Department of Health Immunisation
Forms EC73 (forwarded via the Executive Council to local authorities showing completion of
immunisations) for five of them. It is presumed they were lost while being forwarded to or
returned from the Department of Health.
(b) The EC73 is kept with the child's medical records until the other immunisations are completed. Thus
if a child has completed his primary diphtheria course but fails other immunisations the form is not
sent to the Department of Health.
The above are examples of how other discrepancies can occur in the immunisation statistics.
A third investigation was carried out at another maternal and child health centre, in an area where some
of the families attend a doctor privately (i.e. not under the National Health Service). In this type of area the
immunisation rate is very high but does not appear so on the Department of Health's returns as the doctors
do not fill in E.C.73 forms for private patients. Thus the 1969 immunisation statistics for that area
according to the returns will be as follows:—
Number of children born in 1969 now in area — 141
Number of immunisation notifications of these — 103