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BOROUGH OF WILLESDEN
Health Department,
54, Winchester Avenue,
Kilburn, London, N.W.6.
November, 1949.
To the Mayor, Aldermen and Councillors
of the Borough of Willesden.
Mr. Mayor, Ladies and Gentlemen,
I beg to submit the Annual Report on the health and sanitary circumstances in the Borough for the
year 1948.
Since the presentation of my last Report, considerable changes have occurred in the administration
of the local health services. The National Health Service Act, 1946, which became operative on July 5th,
1948, transferred the administration of the personal health services of the Willesden Council to other authorities.
The School Medical Service was transferred to the Middlesex County Council on April 1st, 1945, under
the Education Act, 1944. The powers of the Middlesex County Council in this respect were delegated to the
Willesden Divisional Executive, and local interest and initiative was maintained by a strong representation
on this body of local councillors and local persons connected with education.
The National Health Service Act, 1946, transferred the whole of the maternity and child welfare functions
of the Council to the Middlesex County Council, which became the local health authority of the area.
The Middlesex County Council was divided into ten areas for the purposes of the exercise of many of
these functions. Willesden was combined with Wembley to form Area No. 6 (population 310,950), which is
administered by an area health committee, acting as a sub-committee of the Health Committee of the
Middlesex County Council. This sub-committee is composed of representatives of the Willesden and Wembley
Councils and the Middlesex County Council and local health workers' organisations. A system of efficient
delegation of functions to the area committee and the harmonious working of the three major constituent
authorities—Willesden, Wembley and the Middlesex County Council—has not yet been worked out, with
the result that local interest and initiative has not had the same stimulus as in the past.
The School Health Service functions of the Willesden Divisional Executive, except for school medical
and dental inspection, were also transferred to the area committee.
The supervision of foster children and the administration of the residential nursery, Connaught Hostel,
are now the functions of the Children's Committee of the Middlesex County Council, reponsible to the Home
Office. This committee was formed as a result of the Children's Act, 1948.
The two local authority hospitals, the Willesden Isolation Hospital and the Willesden Maternity Hospital,
together with the Central Middlesex Hospital and the Willesden General Hospital, were transferred to the
North-West Metropolitan Regional Hospital Board, and the general administration of these hospitals is
discharged by the Central Middlesex Hospital Management Group. The members of this body are appointed
by the Hospital Board, who are themselves appointed by the Minister. The representation on these committees
of local elected representatives or local "consumer" interest has been small, and it has therefore been difficult
to keep alive the local interest and pride in the hospitals.
The maternity service has unfortunately suffered a serious division in its administration. The maternity
beds are controlled by the local Hospital Management Committee, the ante-natal clinics conducted by the
assistant medical officers of health and the domiciliary midwives by the local health authority, and the general
practitioner obstetricians by the local Executive Committee which organises the work of doctors, dentists,
pharmacists, etc. A smooth-running, efficient, unified service finds some difficulty in emerging from this
gestation.
Progress in the development and administration of the health service is hampered by the fact that the
reorganisation of local government powers and boundaries is long overdue.
The health services retained by the Willesden Council are largely impersonal environmental services,
and there has been a considerable expansion in the work of housing inspection and repairs, and in the
supervision of factories and food hygiene.
It is gratifying to note that the general health of the Borough has been maintained at a high level, and
it is particularly pleasing to note that the infant mortality rate has continued to decline from 31.44 in 1947
(53.91 in 1938) to 23.51 in 1948. In contrast, the number of tuberculosis cases on the register has increased
from 1,389 in 1947 (863 in 1938) to 1,504 in 1948.
I wish to thank all members of the staff who have given such valuable and loyal service to the Council
over many years, and especially those who worked so hard with unstinting energy to make the " change-over"
as smooth as possible.
I have the honour to be,
Your obedient servant,
S. LEFF,
Medical Officer of Health.