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REPORT OF THE MEDICAL OFFICER OF HEALTH
FOR THE CITY OF LONDON FOR THE YEAR 1946.
To the Right Honourable The Lord, Mayor, Aldermen and Commoners of the Corporation of London.
Public Health Department,
Guildhall, E.C. 2.
September, 1947.
My Lord Mayor and Gentlemen,
I have the honour to submit the following report on the work of my department during 1946.
This has been the first year of peace and we have begun to realise how painfully slow will be our
recovery from the effects of the war. The shortage of labour and materials and the concentration
on the production of goods for export to enable us to import essential raw materials and food, has
imposed at home a continuation of the policy of " make do and mend." We find ourselves struggling
hard to prevent further deterioration rather than advancing to higher standards. Scarcity results
in controls designed to achieve fair distribution of what is available, but controls are at best a necessary
evil; they mean the filling up of endless forms ; long periods of delay and uncertainty with consequent
discouragement; and the destruction of the sense of personal responsibibity and therefore of
interest and enthusiasm.
Meanwhile we plan for the days of plenty as well as peace; but Cornucopia is not within mortal
sight.
The National Health Service Act.
During the year your Worshipful Committee gave very careful consideration to Part III of the
National Health Service Bill, under which it appeared that the personal health services administered
by the Corporation would be transferred to the London County Council as the " local health
authority " for the County. Every practicable step was taken by the Corporation to obtain amendment
of the Bill so that the City of London should, for the purposes of Part III, be deemed to be a
County Borough and thus the local health authority for the City, but without avail. After the
appointed day therefore, the Maternity and Child Welfare services in the City will be administered
by the County Council, as will also the vaccination and immunisation and the ambulance service;
and the Corporation will not be responsible for the institution of the new personal health services;
health centres, extended health visiting and home nursing.
The Maternity and Child Welfare Clinics, as also the Tuberculosis and the Venereal Diseases
Clinics in the City, though administered directly by the Corporation, have been held in St.
Bartholomew's Hospital; the Medical Officers in Clinical Charge have been Consultants on the Staff of
the hospital and all the hospital's facilities for diagnosis and treatment have been freely available
to the Clinics, which have therefore been both highly efficient and economical. The resident
population of the City is small and it has consequently been possible to give individual attention
to those who avail themselves of the personal health services provided by the Corporation. There
is no doubt that the technical efficiency of the services will be fully maintained by the London County
Council. The loss will be in the art, not the science of medicine ; which is only part of a general
trend that has been obvious for a good many years by reason of the rapid advance of scientific knowledge,
but which is now being accelerated by the administrative changes imposed by post-war
legislation.
Committee of Enquiry into the Closing Hours of Shops, etc.
During the year Your Worshipful Committee submitted written evidence to the Committee of
Enquiry into the Closing Hours of Shops ; Health Welfare and Safety in Places not regulated under
the Factories and Quarries Acts ; and the Hours of Employment of Young People. Your Medical
Officer subsequently attended to give oral evidence before the Committee.
Though the resident population of the City is small, nearly half a million people spend their
working day within the square mile. The main part of the work of your staff has therefore been for
many years, in the field of environmental hygiene. These are days of scarcity of accommodation, of
materials, of labour and of food ; and much that we would wish to do and that many employers of
labour and owners and occupiers of property are anxious to do, to improve environmental conditions,
cannot be done. It is a question of making the best of what is available. There is a danger that as
the years pass,we shall become tolerant of lower standards, that they will cease to disturb us Just
as we have ceased to be shocked by the sight of the devastated areas in the City. It is therefore
desirable that a Committee with such wide terms of reference in regard to environmental conditions
should be sitting now. Their work must be long and difficult and must demand very careful consideration
of what is practicable under present circumstances,as well as in the future when the
erection of new, or even extensive improvements to, existing commercial buildings can be undertaken.
Though we await the recommendations of the Committee with great interest we need not be impatient
because it certainly appears that it will be some years before they can be implemented.
Housing.
By comparison with the housing problems in residential areas the City's housing problem is
small, but it exists and presents difficulties out of proportion to its size because there are very few
premises which are suitable for conversion into dwellings ; satisfactory sites for temporary houses
cannot be found even in the devastated areas; and the provision of permanent housing in the City
can, on economic grounds alone, only be on a very limited scale.