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London County Council V
REPORT OF THE
COUNTY MEDICAL OFFICER OF HEALTH
AND SCHOOL MEDICAL OFFICER
FOR THE YEAR 1946
By Sir Allen Daley, M.D., F.R.C.P., K.H.P., County Medical Officer of Health
and School Medical Officer
INTRODUCTION
The difficulties through which the country passed in 1946 were, to a large extent,
reflected in the public health work of the Council. Not only did the shortage of
housing accommodation result in the number of applications for rehousing on grounds
of ill-health being increased to more than ten times that for 1945 (p. 28), but the
priority given to the building of housing accommodation retarded the work of reinstating
the accommodation in hospitals, schools, etc., which had been reduced
by enemy action during the war. Many public health activities had to be carried
on in buildings, such as school treatment centres, which were still war damaged.
The shortage of manpower in the country generally has also been reflected in the
Council's public health work, q,nd, in spite of strenuous efforts to recruit the necessary
staff, especially nursing and domestic, the shortage has been so acute that some
thousands of equipped beds are closed because of lack of nursing staff.
Large numbers of Londoners returned to the metropolis during the year and
the population, which had dropped from the pre-war figure of 4,000,000 to 2,500,000
at the end of the war, rose again above 3,000,000 (p. 2). By the end of the year
it was estimated to be 3,277,100.
The birth-rate (20.0 per 1,000 of the total population) was in the region of
50 to 60 per cent, above the pre-war level, and was higher still during the first half
of 1947.
General mortality (death-rate 12.6 per 1,000 of the civil population) showed a
return to pre-war level, especially was there a reduction in the number of deaths
from heart disease, cancer, tuberculosis (in which the ground lost during the war
has been recovered), and respiratory diseases. The fatality from infectious diseases
has also continued to fall, while in infant and maternal mortality low records have
been attained.
The rate of infantile mortality was 38 per 1,000 live births, compared with an
average of 63 during the ten pre-war years. The neo-natal and maternal mortalities
were 22 and 1.26 per 1,000 live births, compared with the averages for ten years
prior to the war of 25 and 2.9.
Although much remains to be done to secure more extensive immunisation
against diphtheria, there are evident signs of the success of diphtheria prophylaxis
(p. 11).
The number of cases of venereal disease is greater than before the war, and,
probably owing to the enlightenment of the public as to the dangers of the disease,
the number of persons attending the clinics and found not to be suffering from
venereal disease was almost double that for 1938 (p. 29). On the other hand, there
has been a sharp decline in the number of notifications under Regulation 33B. This
is probably due to extensive demobilisation during the year, as the majority of the
notifications came from the Services (p. 30).
As less bed accommodation was available for the treatment of tuberculosis,
more patients were treated at home, and the waiting list for residential treatment
700 (M.C. 521155-6) 1-12-47. 3735. (1) A