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INTRODUCTION.
THE Report for 1949 is naturally much restricted in scope, since the
Health Services administered locally have been greatly reduced.
Most of the services remaining are those concerned with sanitary
matters, environmental hygiene and the supervision of food : all of
these matters are dealt with in detail in the report of the Chief Sanitary
Inspector.
We are still responsible for investigating outbreaks of infectious
disease, though active processes of immunisation which seem to me to
be an integral part of disease prevention, are administered by the County
Authority. There are also one or two minor matters, such as the supervision
of registered Nursing Homes.
It would be idle to pretend that even before the transfer of services,
the Health Departments of Local Authorities, who were not responsible
for hospitals, received very much information respecting the amount of
sickness, other than notifiable infections, which occurred in their
districts: but we did have a comprehensive knowledge of the health of
mothers, infants and young children; and we did know the proportion
of children protected against diphtheria, thereby being enabled to direct
our efforts, without delay, in the required direction. Now we do not
know how many babies are born in the district; we do hear how many
births have been registered with the local Registrar, but we do not know
how many of them were the children of Beckenham residents. So, the
first thing we hear of some infants is that they are dead. However, since
we are in no way responsible for the care of infants, this is of no
practical importance, and it is in keeping with the position which has
always existed with respect to older children and grown up persons:
we never knew what illnesses they suffered from during their lives—
unless the illnesses were notifiable—but we were invariably told from
what illnesses they died. It is true that death returns are an interesting
study, but the information derived therefrom is mainly statistical, and
in the absence of other information, any ideas of prevention must
inevitably be purely speculative. There are of course, a few death
certificates which tell their own story.
Naturally, we are aware of any environmental conditions which
are likely to be prejudicial to health, and in this field alone it is possible
to carry out any measures of Preventive Medicine. I do not wish in any
way to appear to belittle their value.
I have felt for some time, that Preventive Medicine could progress
but little further on the old lines. The services which have been built up
with so much care and hard work have achieved very great results. No
doubt they will continue to give results and to improve still further the
conditions with which they were designed to deal. No doubt continued
observations on the same lines will provide us with solutions for dealing
with some conditions of which our knowledge is still incomplete,But
our control over environmental factors and over notifiable infectious
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