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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1953
[Report of the Medical Officer of Health for London County Council]
- Published
- 1954
- Pages
- 170
- Tables
- 122
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Page 5
The Census report provides some interesting facts about old people residing within the County, which are shown in the following table : Persons aged 60 years and over in London A.C. Census 1951
Status Number % Heads of: All private households % 1 person households % 2 person households % -
Page 7
There were 3,614 illegitimate live births (7.1 per cent. of the total live births). The Illegitimacy percentages in recent years were :
Year London A.C. England and Wales -
Page 8
* The sharp changes that occurred between 1939 and 1940 are attributable to two causes. In the first place, the Registrar-General abandoned the rates of selection which had hitherto operated in multiple causes of death, and, as from 1940, accepted the principal cause of death as shown on the medical certificate. In addition, the International List of Causes of Death, which was revised in 1938, was applied in 1940, in accordance with international agreement. The general movements resulting from these alterations are estimated to be :
Cause Approximate change as a percentage of those formerly assigned to this cause † -
Page 9
Mortality (per 1,000) from cardiovascular—renal disease and bronchitis
-
Page 9
Age specific rates since 1948 are shown below : London A.C. : Cancer Mortality Rates per 1,000 living (total population)
-
Page 12
Comparative rates for London and England and Wales in recent years are :
Year(s) London England and Wales -
Page 13
The distribution of causes of death in the first four weeks of life in descending order of magnitude in 1952 and 1953 was as follows :
Cause No. of deaths Per cent. of total 1952 1953 1952 1953 -
Page 14
A summary of maternal mortality statistics is given below. Comparative figures for England and Wales in recent years are shown in Table 8 (page 150).
Year Live births and stillbirths Deaths in pregnancy or child-birth excluding abortion Post-abortion deaths Notification of puerperal pyrexia No. Rate No. Rate No. Rate -
Page 14
The following analysis has, therefore, been made on the basis of numbers and not rates.
Cause of death Post-abortion Other pregnancy and child birth Total -
Page 15
The leading causes of death in London in 1953 were as follows :
Deaths Rate per 1,000 population General -
Page 18
The sex and age distribution was :
Age Males Females -
Page 18
There were 514 deaths (0.15 per 1,000) from influenza during the year. During recent years the deaths have been :
Year Influenza deaths Year Influenza deaths -
Page 19
The ratio of notifications to deaths at various ages was as follows :
Age Deaths Notifications Deaths as percentage of notifications -
Page 19
Ophthalmia neonatorum
Number of cases Domiciliary confinements Institutional confinements Total -
Page 19
The condition at the end of the year of the 146 cases was :
-
Page 20
The age incidence in 1953 was as follows :
Age No. % -
Page 20
There was again an increase in the proportion of notifications falling in the 0-4 years age group, but this is seen in better perspective in the following figures from 1947 onwards :
Year Percentage of notifications in the 0-4 age group -
Page 20
Deaths from heart disease under 45 years
Year 0-4 5-14 15-44 Total Rate per 1,000 living (0-44) -
Page 21
The death-rates per 1,000 living in 1953 in London and for the whole country were :
Pulmonary Non-pulmonary -
Page 24
Tuberculous milk The following are details of the sampling for biological examination of milk coming into London and the results of the examinations :
Source of sample Designation Samples Percentage positive of completed samples Total Positive Incomplete Negative 1953 1952 -
Page 25
Examinations by the Council's ophthalmologists.
Classification Certified blind Not blind Grand Total Male Female Total Male Female Total -
Page 26
The causes of blindness in the 17 children under five years of age who were certified during the year were as follows :
-
Page 26
Blind persons examined as to suitability for training and the results were :
Male Female Total -
Page 26
Registration of nursing homes At the end of the year there were 48 nursing homes on the register, the same number as in 1952. In the 48 homes there were 858 beds distributed as follows :
Number of beds in home Number of homes Patients accommodated All types† Medical and surgical only* Total -
Page 34
A large proportion of the new brands of paint submitted during the year by manufacturers for examination was rejected as being of unsatisfactory quality ; details are :
Approved Rejected -
Page 50
Division 9 —Stormont Road, Battersea. —Maternity and child welfare centre. Agreement had not been reached with the Battersea Metropolitan Borough Council on the use of this site.
Division Premises Service Work involved -
Page 51
Continued from previous page...
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Page 51
In addition to the schemes not commenced during the year 1953-54 the programme for 1954-55 includes the following new projects :
Division Premises Work involved -
Page 54
Opportunities were taken wherever possible to acquire suitable properties and sites for health service purposes or to secure long-term leasehold tenancies. The following acquisitions and leasehold tenancies were completed during the year.
Division Property Interest obtained Service -
Page 55
clue to the expansion of educational activities at welfare centres (see page 92). The following table gives comparative statistics:
Year Ante-natal Clinics at end of year (including combined ante-natal and post-natal) Sessions per month Attendances Percentage of pregnant women making at least one attendance at ante-natal clinic First Total -
Page 60
The accommodation provided in the Council s 104 maintained and 6 grant-aided day nurseries at 31st December, 1953, as compared with the previous year when the numbers were 105 and 6, respectively, was:
Age Group Maintained Grant-aided Total -
Page 60
The number of child-minders, both statutorily and voluntarily registered, as compared with 1952, were as follows:
At 31st December 1952 1953 -
Page 67
Domiciliary confinements attended by London County Council, Hospital and Nursing Association midwives —1953.
-
Page 68
Total number of domiciliary confinements attended by London County Council, Hospital and Nursing Association midwives —1948-1952
Year Maternity Nursing Cases Midwifery Cases Grand Total L.C.C. Hospital District Nursing Association Total L.C.C. Hospital District Nursing Association Total -
Page 69
The action taken by the emergency obstetric service was:
Treatment given Removed to Hospital Remained at at Home Total -
Page 71
An analysis of the notifications for 1953 shows:
Midwives Maternity nurses -
Page 71
The number of medical aid notices issued by midwives during 1953 was :
-
Page 71
1948 1949 1950 1951 1952 1953 -
Page 72
HEALTH VISITING AND NURSING SERVICES An average of 369 health visitors were occupied during the year in connection with the various health services apart from the tuberculosis service and the school health service. During 1953, these health visitors made 832,504 visits, apart from clinic and other duties. The following table analyses the visits paid since the beginning of 1951 :
1951 1952 1953 -
Page 74
The completed treatments related to the following conditions :
Number Percentage of total -
Page 74
These patients were referred to the nursing organisations by :
Number Percentages of total -
Page 76
The following figures illustrate the extent of the increase over the last three years :
1951 1952 1953 -
Page 77
The increase in other applications was probably largely due to heavy demands on the service during the early part of the year as a result of the severe fogs.
Number of applications -
Page 83
Vehicles
-
Page 84
Work performed by the directly provided service
Year Accident Section General Section Total Patients Non-patient carrying journeys Total journeys (calls) Mileage Patients Journeys Mileage Patients Journeys Mileage -
Page 84
Work performed by the agency and supplementary services
Year City of London Police Home Ambulance Service Hospital Car Service West Ham C.B.C. Total Patients Mileage Patients Mileage Patients Mileage Patients Mileage Patients Mileage -
Page 84
Work performed by both sections of the directly provided service and by the agency and supplementary services
Year Total Emergency Work Total General Section Work Grand Total Patients Mileage Patients Mileage Patients Mileage -
Page 85
Analysis of Accident section work
-
Page 86
Summary of Statistics, 1952 and 1953
1952 1953 -
Page 87
Summary of Statistics, 1952 and 1953— continued
1952 1953 -
Page 88
In some health divisions skin testing of pre-school infants and toddlers at day nurseries and infant welfare establishments has been undertaken with a view to tracing cases of tuberculosis among adult contacts of positive reactors. Summary of investigations made into tuberculosis ' incidents ' at Council establishments in 1953
Establishment Notified case Children Adults Tuberculin tested Positive reactors X-rayed Abnormal X-rayed Abnormal -
Page 89
Summary of investigations made into tuberculosis ' incidents ' at Council establishments in 1953— continued
Establishment Notified case Children Adults Tuberculin tested Positive reactors X-rayed Abnormal X-rayed Abnormal -
Page 89
The following are particulars of sessions, attendances, etc. :
Year *Clinic sessions New cases Attendances Staff (in terms of whole-time units) -
Page 90
Pulmonary tuberculosis mass X-ray units, 1953
Regional Hospital Board unit Metropolitan boroughs visited during 1953 Total number X-rayed during year (a) Diagnostic classification Active Inactive Males Females Total Males Females Total Rate per 1,000 Males Females Total -
Page 91
I here was no appreciable change in the defaulter rate. The table below gives the number of patients completing treatment and of defaulters as shown by analysis of the returns from the clinics for 1953 :
Syphilis Gonorrhoea Male Female Male Female -
Page 92
A statement showing the number of admissions to recuperative holiday homes during 1953, as compared with 1952, is given below :
Unaccompanied children Expectant and Nursing Mothers Accompanied Children Other Adults Total under 5 years School children -
Page 93
The following table shows how they were dealt with :
1953 1952 Male Female Total -
Page 93
The ultimate disposal of the patients admitted to observation wards (including 167 patients in wards on 1st January, 1953) is shown below :
1953 1952 Male Female Total -
Page 94
social workers being employed for the purpose. Both associations were very helpful in arranging the smooth transfer of 129 current cases. 244 new cases were referred for help during the remainder of the year from the following sources :
-
Page 94
The weekly charges tor maintenance were as follows :
-
Page 95
Mental Deficiency Acts The following table shows the sources from which cases were brought to notice under the Mental Deficiency Acts and the action taken thereon:
Sources of information 1950 1951 1952 1953 Totals from 1.4.14 to 31.12.53 -
Page 95
The position at 31st December, 1953, with regard to the cases referred to in the last column of the preceding table is shown below, together with the position on the same date in the three preceding years:
1950 1951 1952 1953 -
Page 96
Continued from previous page...
1950 1951 1952 1953 -
Page 96
The following is a summary of the cases dealt with during 1953, with the comparable figures for the three preceding years:
1950 1951 1952 1953 -
Page 100
Details of the medical inspections carried out in 1953, with comparable figures for 1952, are as follows:
1952 1953 -
Page 101
Continued from previous page...
1952 1953 -
Page 101
Pupils referred for treatment.
Age group and sex 1950 1951 1952 1953 -
Page 101
The following table shows the percentages of delects (other than infestation, teeth or errors of refraction) found in pupils at general medical inspections, and for which the children were referred for treatment or observation, with comparable figures for previous years :
1950 1951 1952 1953 -
Page 103
The following table gives the results of such vision tests carried out during 1953:
Visual acuity (with glasses, if worn) Pcrcent. referred for treatment 6/6 6/9 6/12 or worse % wearing glasses Total Already wearing glasses Not wearing glasses -
Page 104
The following table gives the results of the personal hygiene inspections carried out during 1953:
Total Number of Inspections Pupils found to be verminous (*) Number Percentage -
Page 104
The following table indicates the extent of this decline :
Year No. of pupils on school rolls No. of nurses' hygiene inspections No. of occasions oh which pupils were found to be 'verminous' Column (4) as a percentage of column (3) No. of individual children comprising column (4) Percentage of the school population of the individual children in col. (6) (1) (2) (3) (4) (5) (6) (7) -
Page 106
The following statistical data was compiled of the results of the experiment:
School nursing Sisters Doctors -
Page 107
The following table gives the main contra-indications disclosed at the medical inspections of the 27,768 school leavers during 1953:
Contra-indications Boys Girls -
Page 108
The numbers or cases or the principal diseases thus reported during 1953 and the preceding years are as follows:
Year Chicken-pox German measles Measles Mumps Ophthalmia and Conjunctivitis Ringworm Scarlet Fever Whooping Cough -
Page 110
The following table shows the number of clinics available in school treatment centres for the treatment of each defect :
Type of clinic -
Page 111
The total attendances of school pupils in departments of Guy s Hospital covered by the organisers was 6,530. The main details are given in the following table :
Department New Cases Attendances -
Page 111
An organiser also works in certain departments of the Evelina Hospital for Children, which is part of the Guy's Hospital Group, and the following is a summary of her report :
Department New Cases Attendances -
Page 111
Care should therefore be exercised before attempting to draw conclusions about the incidence of defects or the extent to which treatment has been obtained, from the figures that follow:
Type of clinic 1950 1951 1952 1953 -
Page 113
educational treatment should be provided, or whether it could be discontinued. The number of examinations in each category was as follows:
Category Pupils not in special school Pupils already in special school -
Page 113
The recommendations in respect of the 4,478 pupils not already in special schools were as follows:
Special School for the: Vision Hearing E.S.N. Maladjusted Epilepsy Physically handicapped Delicate -
Page 114
Continued from previous page...
Special School for the : Vision Hearing E.S.N. Maladjusted Epilepsy Physically handicapped Delicate -
Page 114
The morbid conditions from which the 316 pupils who were examined regarding physical defects, and recommended to attend school, were suffering are given in the following table:
Morbid condition: Day P.H. Boarding P.H. Ordinary B G B G B G -
Page 118
Rheumatism scheme The number of admissions to the acute unit at Queen Mary's Hospital for Children, Carshalton, during 1953 was fewer than in recent years:
1950 1951 1952 1953 -
Page 119
minimising cardiac disablement. The condition on admission of the cases admitted during 1953 was as follows :
Articular Rheumatism Boys Girls -
Page 119
The follow-up of the cases after discharge from hospital by school doctors and rheumatism supervisory centres still continues to be an important integral part of the scheme:
1950 1951 1952 1953 -
Page 121
The following table gives details of the work carried out during the year at the four units for which the Council is responsible:
Brixton Battersea Earls Court Woodberry Down Total -
Page 123
Table I
Total Establishment Staff Equivalent in Full-time Staff Sessions Total Sessions Total Number employed Fulltime Part-time School Seruice MCW Service School Service MCW Service School Service MCW Service Fulltime Part-time Fulltime Part-time -
Page 125
Table II Attendances and treatments
1950 1951 1952 1953 -
Page 125
Table III Ratio of permanent teeth restored to permanent teeth extracted
-
Page 126
The following table (IV) summarises his work in these special sessions :
1950 1951 1952 1953 -
Page 126
Table V
1950 1951 1952 1953 -
Page 127
Table VI
1950 1951 1952 1953 -
Page 128
T able VII Dental hygienists—Attendances and treatments
1950 1951 1952 1953 -
Page 130
The net cost of the services after allowing for Government grant, expressed in terms of rate in the £ was 10.6d., divided as follows:
d. -
Page 130
The gross cost of the various services in 1952-53—including central administrative charges and contributions to the Superannuation Fund but excluding debt charges—and the contributions recovered from recipients of the services were:
Service Cost Amount recovered in charges -
Page 136
This service was developed as far as financial resources would permit. The following figures illustrate progress during the year.
1932 1953 -
Page 144
APPENDIX A STATISTICS Table 1— Population*—Administrative County of London, 1921-53
Year Mid-year estimate of home population by the Registrar General Average age Total 0-4 5-14 15-24 25-44 45-64 65+ -
Page 145
T able 2 — Vital statistics — Metropolitan Boroughs and the Administrative County of London , 1953 (b)
Metropolitan boroughs arranged in divisional order Estimated home population mid 1953 Live births Death-rates Notifications of infectious disease Deaths Infant mortality (per 1,000 live births) Heart disease Other circulatory Cerebral vascular lesions Peptic ulcer Pulmonary tuberculosis Pneumonia Other respiratory diseases Cancer Violence Scarlet fever Diphtheria Poliomyelitis Meningococcal infection Acute pneumonia Measles Whooping cough Tuberculosis Paralytic Non Paralytic Pulmonary Non-pulmonary -
Page 146
Table 3— Principal vital statistics — Administrative County of London, 1896-1953
Year(s) Annual rate per 1,000 living Annual mortality per 1,000 living (b) Annual mortality Infant (per 1,000 live births) Maternal (per 1,000 total oirths (c)) Live births Marriages Deaths (all causes) Meningococcal infection - Diphtheria Enteric fever Scarlet fever Smallpox Whooping-cough Measles Influenza Tuberculosis Pneumonia (all forms) Bronchitis Other resp. diseases Heart disease Cancer Diabetes Infants 0—1 Diarrhoea and enteritis 0—2 Puerperal fever Other child-birth Pulmonary Non-pulmonary -
Page 147
T able 4 — Civilian deaths by cause — Administrative County of London , 1953
Cause Sex 0— 1— 5— 15— 25— 45— 65— 75+ Total 1953 1952 -
Page 148
T able 4 ( contd .)— Civilian deaths by cause — Administrative County of London , 1953
Case Sex 0— 1— 5— 15— 25— 45— 65— 75+ Total 1953 1952 -
Page 148
T able 5 — Live births and still-births — Administrative County of London , 1931-53
Year(s) Live births Still-births No. Rate per 1,000 total population No. Rate per 1,000 total births (live and still) -
Page 149
Table 6— Infant mortality — Administrative County of London , 1953
Cause of death Age at death Total Rates per 1,000 live births Under 1 day 1 to 7 days 1 to 4 wks. 4 wks. to 1 yr. No. Male Female Total Male Female -
Page 150
T able 7— Infant mortality by cause — Administrative County of London , 1931-1953 (Rates per 1,000 live births)
Cause of death 1931 to 1935 1936 to 1940 1941 to 1945 1946 to 1950 1951 1952 1953 -
Page 150
T able 8— Maternal mortality ( excluding abortion )— Administrative County of London and England and Wales , 1943-53 (Rates per 1,000 total births)
1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 -
Page 150
T able 9 — Tuberculosis — Statutory notifications and deaths — Administrative County of London , 1921-53 ( a )
Year(s) Pulmonary tuberculosis Non.pulmonary tuberculosis Statutory notifications Deaths Statutory notifications Deaths No. Annual rate per 1,000 living No. Annual rate per 1,000 living No. Annual rate per 1,000 living No. Annual rate per 1,000 living -
Page 151
T able 10( a )— Tuberculosis — Statutory notifications by age groups — Administrative County of London , 1953
Form of tuberculosis notified Sex Number of notifications of new cases of tuberculosis Total all ages 0— 1— 5— 10— 15— 20— 25— 35— 45— 55— 65+ -
Page 151
T able 10( b )— Numbers on the registers , 1943-53
1943 1944 1945 1946 1947 1948 1949 1950 1951 * 1952 * 1953 -
Page 151
T able 10( c)— Clinic survey of contacts
Men Women Children Total -
Page 152
T able 10( d )— Occupations of adult notifications
Registrar-Central's Short Classification of Employment Population mid 1951 Tuberculosis Notifications— 1951 Tuberculosis Notifications—1953 Males Females Males Females Males Females Number Rate per 1,000 Number Rate per 1,000 Number Rate per* 1,000 Number Rate per* 1,000 -
Page 153
T able 11( a )— Statutory notifications of tuberculosis by age and sex — Administrative County of London , 1947-53 Rates per 1,000 living (i) P ulmonary
Sex Age 1947 1948 1949 1950 1951 1952 1953 No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate -
Page 153
Table 11( b )— Tuberculosis deaths — by age and sex (i) P ulmonary
-
Page 154
T able 12— Statutory notification of non-pulmonary tuberculosis — distribution according to site — Administrative County of London , 1946-53 Rates per 1,000 living are shown in parentheses against the number of cases
Age group Year Site of tuberculosis lesion Bones and joints Abdomen Peripheral glands Meninges Other sites (a) Total -
Page 154
T able 13— Cases of infectious illness reported from schools in 1953 and preceding years— Administrative County of London
Year Chicken-pox Diphtheria Rubella Impetigo Measles Mumps Ophthalmia and conjunctivitis Poliomyelitis Ringworm Scabies Scarlet fever Whooping-cough -
Page 155
Table 14— Notifiable infectious diseases—Annual number of notifications and numbers per 1,000 of population—Administrative County of London, 1933-1953
Year Anthrax Continued fever Diphtheria Dysentery Acute Encephalitis Enteric fever Erysipelas Malaria Measles Meningococcal infection Ophthalmia neonatorum Pneumonia Poliomyelitis Puerperal pyrexia Scabies Scarlet fever Smallpox Typhus Whooping-Cough Food poisoning Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate Cases Rate -
Page 156
Table 15— Notification of certain infectious diseases — distribution by age and date of notification — Administrative County of London , 52 weeks commencing week ended 10th January , 1953
Four-weekly periods 1953 Meningococcal infection Dysentery Measles Pneumonia Poliomyelitis Scarlet fever Whooping-cough Paralytic Non-paralytic or not stated Ages Ages Ages Ages Ages Ages Ages Ages 0—4 5—14 15+ Total 0—4 5—14 15+ Total 0—4 5—14 15+ Total 0—4 5—14 15+ Total 0—4 5—14 15+ Total 0—4 5—14 15+ Total 0—4 5—14 15+ Total 0—4 5—14 15+ Total -
Page 157
T able 16— Statistics of the administrative work carried out by the Metropolitan Borough Councils in 1953
Borough Dwelling Houses Public Health (London) Act Housing Act, 1936 No. in Borough Erected by borough council Houses inspected Notices served Prosecutions Nuisances abated House to house inspections Section 9 Section 11 Closing Orders (other than underground rooms) Underground rooms Section 25 Overcrowding On complaint On notification of illness* Intimation Statutory Notices served Houses made fit Orders made Houses demolished Found to be unfit for habitation Closed or modified occupation approved Orders determined Houses represented Houses demolished Families overcrowded Families obtained alternative accommodation Houses closed Section 12 By owners By L.A. Under Order Voluntarily Orders made Orders determined -
Page 158
T able 16 ( continued )
Borough Housing Act, 1936—continued Common lodging houses Slaughterhouses Offensive trades Dairies and milk shops Ice-cream premises Restaurants and eating houses Smoke nuisances Cleansing and disinfection Extra water supply to tenement houses Houses let in lodgings No. in borough Inspections Notices served Complaints remedied Licensed Inspections Licensed Inspections Authorised Inspections Registered Inspections Registered Inspections Number Inspections Complaints received Observations Notices served Persons cleansed Rooms or premises cleansed Intimation Statutory Adults Children After infectious disease For vermin -
Page 159
Table 17— Treatment of venereal disease at London clinics
Year New cases Total venereal cases Total non-venereal cases Total attendances Syphilis S. Chancre Gonorrhoea M. F. M. F. M. F. M. F. M. F. M. F. -
Page 159
APPENDIX B STAFF OF THE PUBLIC HEALTH DEPARTMENT (AS AT 31st DECEMBER, 1 953 )
-
Page 160
Senior Officers of the Divisions
Division Divisional Medical Officer Divisional Administrative Officer Divisional Nursing Officer -
Page 160
The following statement shows the number of staff employed in the Public Health Department in December, 1953 (part-time staff being expressed as whole-time equivalents).
Type of staff Location Staff employed at other establishments (a) Total Head office staff Divisional staff