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report of the medical officer of health
for the city of LONDON for the year 1947.
To the Right Honourable The Lord Mayor, Aldermen and Commoners of the Corporation of London.
Public Health Department,
Guildhall, E.C. 2.
July, 1948.
My Lord Mayor and Gentlemen
I have the honour to submit the following report on the work of my department during 1947.
Vital Statistics.
Though the day population of the City is estimated to be over half-a-million the resident
population is so small that vital statistics are of little value. For example, the total number of live
births was 47 including 2 illegitimate births; but these two were newly born infants found dead in
lavatories on railway stations in the City. They are presumed to have been illegitimate and they
have to be accepted as City deaths, though there is no reason to believe that their mothers were
resident in the City. The infant mortality rate for legitimate infants was therefore nought, but for
illegitimate infants it was 1,000 and for all births 42.5 per 1,000 births.
Similarly the single still-birth recorded refers to the body of a still-born child found in Puddle
Dock, Upper Thames Street. There is no reason to suppose that it was a City child, the body probably
floated into Puddle Dock from the River Thames, but it must be accepted as a City still-birth, and the
still-birth rate therefore appears as 21.28 per 1,000 total births.
National Health Service Act.
During the year progress was made with the arrangements for the taking over by the County
Council on "the appointed day," July 5th, 1948, of the "personal health Services." The County of
London is to be divided into nine divisions for the administration of these services, and the City is
in Division 5 with Bethnal Green, Stepney and Poplar. Details of the scheme remain to be settled,
but it seems probable that, for some time, the existing City services will be undisturbed, except for
the change in administrative responsibility.
Mass Miniature Radiography.
The Mass Radiography Unit of the London County Council operated in the City between June
25th and November 13th, 1947. Arrangements were again made for the Unit to be stationed in St.
Bartholomew's Hospital, and it is desired to acknowledge gratefully the courtesy of the Governing
Body of the Hospital in affording the facilities and the helpfulness of the Staff in preparing the
accommodation. Owing to the large number of volunteers for examination, the Unit remained in the
City longer than was at first intended. This caused some inconvenience to the hospital and delayed
a scheme of internal re-organisation, but the unfortunate results of closing down until all those who
had applied for examination before the List day fixed for the acceptance of applications had been
given an opportunity to be X-rayed, was recognised and consent to the necessary extension was
graciously granted.
I do not know which Authority will be responsible for the operation of Mass Radiography Units
after the appointed day for the coming into operation of the National Health Service Act, but it
seems probable that in future the necessary accommodation may not be available at St. Bartholomew's
Hospital.
Large numbers of workers have come forward for examination on both occasions that the Unit
has visited the City, and employers have readily granted facilities for attendance. It is therefore
desirable that accommodation should be found in the City whenever a Mass Radiography Unit is
available. Undoubtedly St. Bartholomew's Hospital is from all points of view the best situation,
but if a change has to be made other accommodation must be found, and Gresham College occurs to
me as very suitable, if the Gresham Committee would agree.
The total number of City workers whoso names were submitted for examination was 22,702.
Of these 19,575 (10,803 men and 8,712 women) were actually examined. Of these 611 persons (3.1 per
cent.) were asked to attend for a full-size X-ray film; 234 showed old healed lesions; 206 (1.1 per
cent.) were referred to their doctors as probably tubercular; 16 showed lesions of the heart.
The percentagc of examinees reported as probably tubercular was the same as on the last visit
of the Unit in 1945. The figure of 1.1 por cent. may appear small, but when it is realised that it
means that in a crowded suburban train there are probably five or six persons; or in a big football
crowd five or six hundred; or coining into the City daily some 5,000 persons who probably have
consumption and aro unaware of the fact, it is easy to appreciate why the tubercle bacillus is
ubiquitous in urban communities and that, if we are to bring pulmonary tuberculosis under control,
we must not neglect any means at our disposal for diagnosis at the earliest possible stage of the
disease. Shortage of beds in sanatoria should not deter us. The care of the consumptive is not a
question of sanatorium treatment or nothing. Many will recover unaided, never having known that
they had had the infection; but many more will recover, evon in their own homes, if the disease is
diagnosed and if they receive and follow sound advice as to their mode of life. Moroover, once the
disease is diagnosed, the open case can be detected and tho control of the sproad of infection can be
extended.