View report page

2
mental hospitals, for a group of hospitals. The membership of most of these Committees
includes a member or officer of the Council. Apart from these links frequent
consultations between officers of the Council and of the hospitals are necessary in
order to effect satisfactory liaison.
While all these arrangements for a smooth transfer of the hospital service were
going on, an equally complex administrative change had to be prepared for, as a
result of the transfer to the Council from the City of London and the 28 Metropolitan
Boroughs, of the maternity and child welfare services, the vaccination and immunisation
services and of the officers employed in the care and after-care of the tuberculous.
This involved the transfer to the Council of 4,843 staff, including 50 whole-time
and 152 part-time medical officers, 2 full-time and 35 part-time dental surgeons,
and 350 health visitors. These officers were welcomed to the Council's service at a
reception given by the Chairman of the Council. There was also a transfer of
70 premises owned by borough councils and of 252 tenancy arrangements for buildings.
In some cases, the County Council, a Borough Council and a Regional Hospital
Board were all concerned in the future use of a building. The National Health
Service Act also placed on the Council responsibility for certain services wholly or
mainly new both to it and to the Boroughs, for example, the Home Nursing service
and the provision of health centres. Further, there was need to expand the ambulance
service and to take over from the Social Welfare Department the arrangements for
placing mentally disordered persons under care.
The Council decided that there should be decentralisation of the services to the
greatest extent possible, and that London should be divided into nine divisions
each containing between two and five Boroughs. For each Division there is a
Divisional Health Committee, some two-thirds of the members of which are appointed
after consultation with the constituent boroughs. A divisional medical officer, a
nursing officer and an administrative officer were appointed for each division,
together with the necessary staff: and divisional offices had to be found and equipped.
Much thought was also given to the best method of utilising the services of the
Borough Medical Officers in the new scheme, and discussions were still proceeding
at the end of the year. The transfer of these borough services was effected with the
same smoothness as occurred in the hospital service, and the mother attending a
clinic or taking her baby to a day nursery, was unaware of the administrative change.
Tribute for this must be paid to the Divisional staffs and to the Borough Medical
Officers of Health, who did not spare themselves in their efforts to facilitate a
transfer which was naturally distasteful to them. Brief reports of the divisional
medical officers will be found on pages 95 to 106.
Despite all this " general post " and detailed planning for the despatch of the
old and the arrival of the new services, the very considerable volume of the Council's
public health work which was outside these changes had to be continued. A
description of its main features will be found in the body of this report.
A summary of the vital statistics for the year, shows a small increase in the
population from 3,326,000 at the beginning +0 3,374,000 at the end of the year and
still substantially below the pre-war population of 4,062,800 which again was much
less than the peak figure of 4,605,400 in 1926.
The birth-rate (17.9 per 1,000 of the total population) has declined considerably
from the peak post-war rate of 1947 (20.9).
Generally mortality (death-rate 11.1 per 1,000 of the civil population) was
substantially lower than in 1947, mainly due to the very low mortality rates
experienced for influenza, pneumonia and bronchitis, and for heart disease. For
respiratory diseases, the mortality rate was about one-half of the immediate pre-war
figure and for heart disease the rate was about 10 per cent. below the pre-war level.
There were further substantial falls in infant and maternal mortality and new low
records have again been attained.