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in ill-health for many months retired on 7th July, 1948, but died, I regret to record,
four months later ; Dr. Letitia Fairfield and Dr. J. N. Dobbie, both Senior Medical
Officers, retired on 3rd September and 16th December, respectively; Dr. R. C.
Harkness, who for some years had been Principal Medical Officer of the Hospitals
Division and Acting Deputy Medical Officer of Health, was transferred on 5th July
to the service of the new Hospital Authority ; he was appointed jointly by the four
Metropolitan Regional Hospital Boards as Liaison Officer with the Council, and retains
his office at County Hall—this is a very happy and satisfactory arrangement.
The hospital services of the Council will carry on, but under new management;
July 5th, 1948, however, marked the passing of one service which disappears. That
is the provision under the Poor Law Acts of a medical service for the destitute. From
at least the reform of the Poor Law over a hundred years ago, any person destitute of
medical care could apply to the Relieving Officer of his district, who would refer him
to the District Medical Officer. If need be, he could also issue an order for the patient
to be admitted to hospital—but that is a different question.
Now that everyone is entitled to a free medical service, the District Medical
Officers have become redundant, and I should like to pay a very warm tribute to their
work. They were always available. At some periods of the war, in some districts,
they were the only doctors whose services could be readily obtained at night, and the
gallantry with which, without hesitation, they set off to visit during air raids an
urgent case of sickness is beyond all praise.
Foreign Visitors.—The flow of visitors coming to County Hall in quest of information
about the health services continues. During 1948, four delegations consisting of
107 persons (6 from Argentine ; 26 from Austria; 20 from Canada ; 20 from Italy;
15 from the United States and a group of 20 who were attending the International
Congress of Industrial Medicine) visited County Hall. They were addressed on matters
relating to public health and arrangements were made for them to pay visits to
hospitals, clinics, etc. Individual visitors, numbering over 50, from many countries,
including North and South America, India, Pakistan, Australia, New Zealand, China,
Sweden, Denmark, Holland and France, had the work of the department explained
to them and were given facilities to investigate the field work of the department.
Population
VITAL STATISTICS
The Registrar-General estimates the civilian population of the county in the
middle of 1948 to have been 3,339,100, compared with 3,309,700 a year earlier. The
corresponding estimates for metropolitan boroughs are shown in Table 2 on page 115,
and the rates given in this annual report are calculated upon these figures.
Table 1 shows the sex and age distribution of the population at the middle of
each year from 1921, as estimated by the Registrar-General. Though exact figures
are unavailable, it is clear that the number of the aged in the population of London
is increasing substantially.
Migration
Toward the end of the third decade of this century, there began an accelerated
movement of population from the centre of London, i.e., the administrative county,
to the growing urban areas in the outer ring of greater London. This was partly due
to a desire of the population for a dormitory in less built-up surroundings though
they continued to work in the central area, partly due to the drift of industry to
new factory sites on the fringe of the London area, and partly due to the active steps
taken by the Council to decant population from overcrowded slum areas to new housing
estates wherever these could be provided, in most instances outside the county.
Reference was made in the Report for 1946 to the possibility that this migration has
been selective in so far as the people who moved were younger and healthier than the
average and that the effect may be to increase the divergence in mortality between
the administrative county and the outer ring.