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childbirth. It has been possible to record this annual proof of
the efficiency of contemporary maternity services on a number of
occasions during the last few years, so that it has now become
the expected pattern in Croydon and elsewhere. It represents a
triumph of achievement never previously attained in human
history. Nor is there any reason to believe that in pre-historic
or primitive societies where women had no alternative to
"natural childbirth" was there any similar approach to complete
absence of maternal mortality. While adverse criticisms of some
lack of amenities in our present maternity facilities may be
valid, their unprecedented success in ensuring essential safety
for mothers should not be forgotten.
Communicable Diseases
There were no cases of typhoid or paratyphoid fever, and a
record low incidence of reported food poisoning. One case of
poliomyelitis was notified, but after a period of hospital
treatment the infection was not confirmed. The diagnosis was
changed to polyneuritis so that 1965 was another year free from
cases of poliomyelitis.
Personal Health Services
The generally accepted major defect of the National Health
Service is the tripartite division of actainistration between the
hospital boards, executive councils, and local authorities. In
the former Croydon County Borough the advantages of the same
boundaries for the last two named authorities, and a roughly
identical catchment area for the hospital management committee
facilitated the establishment of closely co-ordinated local
services. On these arrangements the effect of the London Government
Act was wholly adverse. The Croydon Executive Council was
merged into the South West London and Surrey Executive Council,
and part of the present borough came into the catchment area of
a general hospital outside its boundaries. Arrangements to
compensate for these difficulties were initiated. It will however
take time to obtain results. Furthermore, proposals in the
Ministry of Health's 10-year plan for a new district hospital
"between Croydon and Redhill" indicate how deficient are present
facilities, and the complications which fall upon interim
schemes.
Staffing shortages were seriously aggravated by the advent
of 32 new all purpose London Boroughs and affected every section
of the department. Nursing personnel, particularly Health
visitors, were especially difficult to recruit. Preliminary