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London County Council.
ANNUAL REPORT OF THE COUNCIL, 1925.
CHAPTER I.
REPORT OF THE COUNTY MEDICAL OFFICER OF HEALTH (Dr. F. N. K.
MENZIES) PREPARED IN COLLABORATION WITH SIR WILLIAM
HAMER, WHO WAS MEDICAL OFFICER UNTIL THE END OF 1925.
This annual report, the thirty-fourth of the series to which it belongs, com
pletes the second chapter of the official record of the work of the Public Health
Department. The occasion prompts casting a backward glance over the ground
traversed, and presenting a review of London's health record during the existence
of the Council, studied in the light of changes in mortality from certain specified
causes during that period.
Dr. James Niven prepared three years ago, on his retirement from the post
of Medical Officer of Health of Manchester, "Observations on the History of Public
Health Effort" in that city. The period of time covered dated nominally from
1868, the year in which the first medical officer of health of Manchester, Mr. John
Leigh, was appointed, but for the most part the " Observations " relate to the years
of Dr. Niven's own official life (1894-1923). The first medical officer of the County
of London (the late Sir Shirley Murphy) was appointed in 1890 and an account of
public health effort in London, since that date fairly corresponds in time with the
years of Dr. Niven's survey. The close similarity of experience in the two administrative
areas is remarkable, though such differences as are exhibited (now
in favour of the one and now of the other area) are very instructive.
Dr. Niven held that "by far the most important influence which has governed
the improvement of the public health in Manchester, apart from economic conditions,
has been the removal of organic filth, whether without or within the habitations
of the people"; and that "probably the next in importance has been the
control of infectious disease." He further referred to housing, parks, the physical
care and training of children, the provision of public baths and washhouses, and the
supply of pure water and food of good quality; finally, he says, " the part played by
education has been far from small."
Broadly, this summary may be accepted as applying also to London, though
in the working out of the desired reforms the methods adopted (owing of course
to the differing environmental circumstances of the two areas) have been in some
respects wholly dissimilar. Manchester, quite early, had secured an unexceptionable
water supply, London has had to put the finishing touches to that problem very
largely in the course of the last three decades, and has done the work on quite
different lines from those of Manchester.
On the other hand, in London, already in 1890, "dry disposal" and even
cesspools, had almost become things of the past, while Manchester was for some
years after that date still grappling with the difficulties of middens, privies and
the pail system. Most striking of all have been the differences in the distribution
of administrative duties between various authorities in the two areas, and yet
the results aimed at, and in large measure attained in both, during the last 35 years,
present fairly close resemblances.
In London, on Shirley Murphy's appointment in 1890, the working of the new
Housing of the Working Classes Act of that year, and the shaping of the Public
Health London Act, 1891 (that was to be), were the two great problems to be faced.