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Public Health Department,
Town Hall,
St. Marylebone, W.l.
To the Mayor, Aldermen and Councillors of the Metropolitan Borough of St. Marylebone.
Mr. Mayor, Ladies and Gentlemen,
I have pleasure in presenting my Annual Report for 1956, which follows lines similar to those of
its immediate predecessors. The general standard of public health in St. Marylebone may be regarded
as having been satisfactory throughout the year and the birth and death rates at 10.93 and 15.57
respectively remained almost the same as for the previous year. The rate for stillbirths, however,
which fluctuates a good deal from year to year, at 26.83 was the highest since 1945. There were no
major epidemics and infectious disease notifications fell from 924 in 1955 to 419, due mainly to 1956
not having been a " measles year." Of poliomyelitis there were only 2 cases and again no diphtheria
was notified, the last having been in 1948.
Amongst the more important legislation, the long-awaited Clean Air Act, 1956, was passed during
the year and the Food and Drugs Act, 1955, and the Food Hygiene Regulations, 1955, came into
operation. By Act of Parliament as from the 2nd August the time-honoured title " sanitary inspector "
was changed to " public health inspector."
The year under review marks the centenary of an important event in local history, the first medical
officer of health for St. Marylebone, Dr. Robert Dundas Thomson, F.R.S., having been appointed to
this office by the Vestry in 1856. He prefaced his annual report for that year as follows :—
'"To point out the existence of any nuisance, or other local causes, which are likely to originate
and maintain diseases increasing the rate of mortality, and injuriously affect the health of the
inhabitants,' is the compendious definition which the Act of Parliament supplies of the duties
of the Medical Officer of Health. But what a vast field of inquiry does this brief sentence open up !
The various conditions of the air we breathe, and everything calculated to alter its normal condition,
the water which we use for domestic purposes, and the stagnating influence of moisture upon the
ambient atmosphere ; the nature of the earth, and its contaminations by retrograde civilization,
and, even, moral influences, are all included in the category embraced by this benevolent sanitary
law."
These remarks hold good today. Many of the same problems with which Dr. Dundas Thomson
was faced still remain and there is a special topicality about his reference to " the air we breathe."
Nevertheless, great changes have taken place and he would not now recognise much of St. Marylebone.
The district has grown vastly in commercial and industrial importance and former residential areas
have been given over to these purposes. Although the daytime population is probably something
approaching half a million, the number of residents has reduced from 175,441 to 73,040. The death
rate has fallen from 20 (the average for the previous 10 years was 24) to 15.57 per thousand and,
although no figures are given in his report for births or infant mortality, there has undoubtedly been
a great reduction in the proportion of deaths of children under 5 years of age. Expressed as a
percentage of total deaths the rate for this group has fallen from 42 per cent. to just under 1 per cent.
in 1956. Little statistical information of housing conditions is given in that early report but the general
picture conveyed is of the poorer inhabitants in some quarters of the Borough living in a state of great
squalor and overcrowding, many of them huddled together in cellars and other underground dwellings.
This was probably one of the worst problems that faced the original medical officer of health and his
inspectors. Sickness and disease were rife and infectious conditions appear to have accounted for over
one-fifth of the total deaths. One of the main sources of disease was thought to be the domestic water
supply. There were 44 street pumps and Dr. Thomson refers many times to the impurity of these
waters. He considered pump water as totally unfit for public consumption and recommended that it
should be used only for washing or watering the streets. Today, domestic water is supplied through
the mains of the Metropolitan Water Board and is invariably beyond reproach. There were 120
slaughterhouses in the Borough and a large, though unspecified, number of cowhouses for a milk
supply which was undoubtedly extremely unsatisfactory.