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The rate of infantile mortality was 31 per 1,000 live births, compared with an
average of 63 during the ten pre-war years. The neo-natal and maternal mortalities
were 17.5 and 0.77 per 1,000 live and total births respectively, compared with the
average for the ten years prior to the war of 25 and 2.8.
The tuberculosis statistics underline the urgent need to improve the segregation
of infectious patients by reducing the present far too long waiting lists for sanatoria.
Mortality shows a slight decline but the notification rate shows a small upward
tendency. It must, however, be borne in mind that the detection of early cases is
now more efficient and in consequence the recorded new cases are more numerous
than they would otherwise be, but there should be no underestimation of the very
real challenge which the figures represent.
Signs of the success of diphtheria prophylaxis continue but they are dependent
on the maintenance of a high level of immunisation, and it is vitally important to
ensure that as many infants as possible are immunised.
The number of new cases of venereal disease remains greater than before the
war, but shows a reduction on the figures for 1947.
The number of calls on the accident ambulance service again increased by 13 per
cent. over the figure for 1947, while the demand on the general section increased by
18 per cent.
One of the most discussed sections of the National Health Service Act has been
that dealing with the provision of health centres. The Council's problems in this
connection are dealt with on page 28.
The home help service is expanding rapidly. It provides assistance at the rate
of 2,000,000 hours per year in homes where there is sickness or a maternity case (p. 41).
The dental scheme for school-children and, since the "appointed day," other
priority classes has caused concern. The difficulties under which this service has
laboured are discussed by the Chief Dental Surgeon (p. 83).
Changes had to be made in the Mental Health Service as a result of the National
Health Service Act and some difficulty was experienced in obtaining admission of
patients to "observation wards" (p. 57). The provision of occupation centres for
mentally deficient patients became the responsibility of the department in July, 1948,
and continuous progress has been made in the provision of centres and in the handicrafts
taught (p. 60).
The full impact of the National Health Service on that of the School Health
Service still remains to be seen. The most difficult problems arose in connection with
child guidance and with the school ophthalmic service. Every endeavour is being
made to ensure that the children requiring treatment obtain it with at least the ease
and facility with which they did so before the change (p. 62).
It is proposed each year to devote special attention to one aspect of the Council's
work. This year domiciliary midwifery has been selected and a description of the
service will be found on pages 106 to 114.
Appointments.—The reorganisation of the department necessitated several
promotions and appointments, of which the most senior were : Dr. J. A. Scott as
Deputy Medical Officer of Health and Deputy School Medical Officer; Dr. M.
MacGregor as Principal Medical Officer ; Dr. Margaret Hogarth as a Senior Medical
Officer ; Mr. W. Ritchie Young as Chief Dental Surgeon ; and Messrs. D. J. B. Cooper
and W. H. Joyce as Principal Clerks. The appointments of Divisional Medical
Officers for the nine new health divisions were all new appointments and the names of
the officers will be found on pages 95 to 106.
Retirements.—The department lost by retirement during the year the services of
six members of the senior staff, all of whom had given many years of devoted service
to the work of the Council: Dr. A. M. Hewat, Principal Medical Officer, retired on
30th April, 1948, and Mr. R. Coleman, Principal Clerk of the Hospitals Division on
3rd July, 1948 ; Major-General Helliwell, Consulting Dental Surgeon, who had been