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WELbeck 7766
Public Health Department,
Town Hall,
St. Marylebone, W.1.
To the Mayor, Aldermen and Councillors of the Metropolitan Borough of St. Marylebone.
Mr. Mayor, Ladies and Gentlemen,
I have the honour to present to you my Annual Report on the health of the Borough during 1963.
At the request of the Minister of Health, the report retains its usual form and gives full details of the
water supply, sewerage and common lodging houses in the Borough.
Public health in St. Marylebone continued to be generally satisfactory, the incidence of infectious
disease remaining unspectacular throughout the year. Although the overall number of notifications
received rose from the record low figure of 277 in 1962 to 428—wholly attributable to the expected
biennial increase in the cases of measles reported, which numbered 311 compared with 107 in the
previous year—the Borough remained free from smallpox, diphtheria and poliomyelitis. Neither of
the two cases of typhoid fever notified was connected with the Zermatt epidemic mentioned on page
27. That disastrous outbreak, involving many British tourists, served as a salutary reminder of the
primacy of sanitation in relation to health, besides emphasizing the need for travellers abroad to
be immunized against the enteric fevers.
There was a slight decrease in the resident population during the year, although the standardized
birth and general death rates remained virtually stationary and infant mortality again declined (the
rate per thousand live births falling from 22.22 in 1962 to 18.04 in 1963). The stillbirth rate rose
slightly from 11.63 to 12.72 per thousand total births and, unhappily, there was one maternal death,
the first for two years. Another unwelcome feature was the increase in the number of deaths from
cancer of the lung and bronchus, 53 being recorded, compared with 42 in 1962. On both sides of
the Atlantic the evidence incriminating the smoking of cigarettes as the major cause of lung cancer
mounted impressively. The main causes of death among adults, however, continued to be diseases
of the cardiovascular and respiratory systems and cancer in various forms, a pattern particularly
marked in an area where one in six of the inhabitants is of retirement age.
On pages 6-9 of this report will be found details of the activities of the Public Health Department
on behalf of the elderly, and of the St. Marylebone Old People's Welfare Association : particulars
of the services available to old people are listed on pages 40 and 41. Thanks to the St. Marylebone
Housing Association, plans for the establishment of a day centre at York Street Chambers took firm
shape during the year and the Borough Council readily agreed to give generous financial support to
this exciting venture. Another notable event was the purchase of a second "Meals-on-Wheels"
van early in the summer, thus enabling the total number of meals delivered in 1963 to approach 11,000.
The new vehicle offers scope for a further expansion during the current year of this essential service
in regard to both the number of old people receiving meals and the frequency of delivery. It would
not have been possible to operate the second van without the help and co-operation of the British
Red Cross Society members, who have now joined the Women's Voluntary Service in staffing the
vehicles. No praise is too high for these ladies and indeed for all those helpers who provide the elderly
with that comfort and companionship which means so much in the evening of life.
Comfort and companionship can only ease the ageing process, in which the eyes grow dim, hearing
and smell become less acute and the balance more precarious. Hence the need to take these failing
faculties into account in the home to prevent as far as possible those accidents to which the aged
are so prone. To this end much effort is devoted to home safety propaganda and the importance
attached to this aspect of public health practice is reflected in the account on page 10 of the work
of the department in this field. The Borough Council co-operates closely with the Royal Society
for the Prevention of Accidents and the London County Council in meeting the challenge presented
by accidental injury at home. How formidable that challenge is can best be illustrated by the grim
fact that far more fatal accidents occur in the home than on the roads. The need to be constantly
on the alert in the cause of prevention is beyond dispute.
Food hygiene is another field in which constant vigilance is necessary. In St. Marylebone there
are more than 1,400 hotels, restaurants, retail food shops, and other premises where food is sold,
and the proper surveillance of these premises and their food handling staffs entails much exacting
work. An essential part of co-operation with the proprietors is the giving of advice and help on the
many facets of hygienic storage, preparation and handling of food. This requires a comprehensive
knowledge of the most up-to-date methods, techniques and equipment. In the last analysis, however,
good premises and modern equipment are not enough. The food handler is paramount and his crucial
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