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London County Council
REPORT OF THE
COUNTY MEDICAL OFFICER OF HEALTH
AND SCHOOL MEDICAL OFFICER
FOR THE YEAR 1949
By Sir Allen Daley, M.D., F.R.C.P.
County Medical Officer of Health and School Medical Officer
INTRODUCTION
This report records the activities of the Public Health Department for the
calendar year 1949, the first full year of the operation of the National Health
Service Act of 1946. Much time was spent in discussions with the new hospital
authorities and with Executive Councils with a view to avoiding any failure of the
service which might result from a transfer elsewhere of functions formerly carried
out direct by the Council. The interlocking responsibilities of hospital authorities,
Executive Councils and the Local Health Authority affect almost every branch of
the Council's Public Health work, e.g., maternity and child welfare, the school
health, home nursing, chronic sick, tuberculosis, mental health, mental deficiency,
dental and ambulance services to mention only the more obvious. The effect has been
felt most perhaps in the Council's school health service, particularly in the ophthalmic
and dental services. There is a delay of some months between the prescription
of glasses and their supply and dentists are leaving the Council's "priority dental"
service to participate in the more highly remunerated "non-priority" work.
Much work was occasioned by the assimilation of the new and expanding services
of the Council.
The scheme of decentralisation of the principal health services has proved very
satisfactory although there have naturally been "running-in" troubles from time
to time. Regular meetings of the divisional medical, nursing and administrative
officers and the appropriate central officers were held at County Hall.
Brief reports of the divisional medical officers will be found in pp. 107 to 118.
A summary of the vital statistics for the year shows a small increase in the civil
population from 3,339,100 at mid-1948 to 3,375,470 at mid-1949. This is 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 (16.7 per 1,000 of the total population) has declined considerably
from the peak post-war rate of 1947 (20.9).
The general death-rate of 11.7 per 1,000 of the civil population was slightly
higher than the exceptionally low figure of 11.1 for 1948. There were further
substantial falls in infant and maternal mortality and new low records have again
been attained. The rate of infantile mortality was 27 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 0.69 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 start treatment early
and provide for the segregation of infectious patients by reducing the present far
too long waiting lists for sanatoria and hospitals. Mortality shows a continued
decline but the notification rate still shows a small upward tendency. It must,
however, be borne in mind that the detection of early cases is now more efficient
than formerly and in consequence the recorded new cases are more numerous than