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There are other figures which show that health has been well maintained. The death
rate was 16.2, which compares with 13.0 in 1939, 20.5 in 1940 and 18.9 in 1944. The birth rate
at 17.6 was higher than it has been since 1925, with the one exception of 1944 when it was 18.1.
This increased birth rate has entailed another problem, that of maternity accommodation.
Owing to enemy action the hospital accommodation for maternity cases in London has been
considerably reduced. Furthermore the destruction of homes, the increase in overcrowding
and the inability to get help has made hospitalisation necessary where previously confinements
could take place at home. Even all the available hospital beds cannot be utilised on account
of shortage of midwifery and domestic staff.
It has not been possible to provide proper midwifery accommodation for those who
needed it, let alone for those who asked for it. Lack of midwives is a very serious problem,
as is also lack of midwifery accommodation. It has been argued, and rightly so, that childbirth
is a normal function and can take place in normal surroundings, possibly more safely
than in the environment of a hospital where a mother is exposed to germs to which she may
be intolerant. This argument is a good one in districts where housing is good and where a
mother during child-birth can find a relative or a friend to look after her family. It cannot
be considered as advisable in the majority of the homes in St. Pancras, which are definitely
unsuitable for the conduct of a confinement. The position at the time of writing this report
is even more acute owing to the increased number of births. The demobilised man wishes
to resume family life, to marry if he is single, to have children if he is childless, and he looks
to the State to provide him with a home and the amenities for having children and rearing a
family.
The daily post of a Medical Officer of Health contains many letters in no indefinite
terms, setting forth the demands of the ex-service man. In many cases these letters have
shown that during his absence on service he has not realised the difficulties with which his wife
has had to contend: the bad housing, the queueing, the difficulties of providing the right and
proper food for children. His return home has added to his wife's domestic difficulties, for
there has been one more to house and one more to feed. The letters I have received certainly
do not show that the returned soldier is as patient about the conditions as they now exist as his
wife was during the dreadful days and the trying experiences she suffered during the war.
Perhaps this is best so; for it is not by submission to unsatisfactory conditions that progress is
ultimately achieved.
Diphtheria Immunisation.
During the course of the year the responsibility for securing immunisation against
diphtheria was placed upon each individual health visitor insofar as the children in her district
were concerned. This responsibility has been well received. There were 2,069 live births
notified during 1945, and 1,794 children were immunised during the year. At the time of
writing this report there were 9,938 children in the borough under the age of 15 who had
been immunised. This figure is not complete, for there are many children returned to the
borough who were immunised whilst evacuated and for whom no records have been available.
Recent investigations have shown, however, that in all probability 65 89 per cent. of the
children under five in the borough are immunised, or 86 08 of those between 1 and 5, as
immunisation does not usually begin until a child is one year old. During the course of the
year there were notified 104 cases of diphtheria, but in only 69 cases was the diagnosis confirmed.
There was not one single death in the borough due to diphtheria.