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eight of the three hundred and twenty deaths classified under heart
and circulatory diseases dying of angina. Nineteen persons died of
cancer of the lung and this, too, is a yearly increasing figure. In these
two directions alone lies a field of preventive work for Public Health
Authorities. If carcino-genic factors exist in polluted atmosphere,
then the atmosphere must be made clean. If "stress and strain"is
part of the modern way of life and work, then we must learn that
periodic rest and relaxation are essentials. It is known that cardiovascular
diseases are more common in the "executive" class than
among the "skilled" and "unskilled" workers, and it is also known
that, in Orpington, out of every 1,000 persons over 18 years of age
employed, three hundred and thirty-two are classified as executives,
a higher rate per 1,000 than in either Bromley or Chislehurst and
Sidcup. It becomes, therefore, of paramount importance, especially
in Orpington, that attention should be given to the prevention of the
increase in these stress diseases. It may not lie wholly within the
power of the Health Committee, but it certainly places responsibility
on the General Practitioner. I believe, more and more, that the
General Practitioner must now come into the Public Health Services
and take an active part in the prevention of illness. I believe that the
future Public Health Services will be directed towards such matters
as these, for the pattern of service laid down some thirty years ago is
overdue for remodelling. With the improvement of the treatment
services at home, at work and in hospital, there has developed a tendency
to overlook the importance of the Public Health Services in the
prevention of disease and in the correction of the conditions that lead
to an overload on the hospital beds. I believe it is more important
than ever before that the services of the hospital, the General Practitioner,
Public Health and of Industrial Medicine, should combine
efforts to abate those illnesses that cause so much anxiety and loss of
efficiency, and to give more attention to prevention generally. One
has only to look at the successes of the Public Health Services in the
last thirty years to know what can be done. One has only to read
carefully of the work of the Sanitary Inspectors, as recorded in this
report, to realise what is being done so well in Orpington.
I would commend to the Council the good services of Mr. Crowe
and the staff of his department. It has been my pleasure to work
with them since 1948 and to take part in their successful endeavours.
I would also like to take this opportunity to thank Mr. King and his
fellow officers for their help and advice, and, not least, to the Health
Committee who have been so patient with my endeavours to advise
them in the past six years.
I am,
Your obedient Servant,
K. E. TAPPER,
Medical Officer of Health
May, 1954.