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BOROUGH OF WILLESDEN
Health Department,
54, Winchester Avenue,
Kilburn, London, N.W.6.
July, ig5o.
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 of the Borough for the
year 1949.
There have been many difficulties in compiling this report, as this is the first full year following the
transfer of the Borough Council's personal health and hospital services to other authorities. The Borough
Council, on the advice of their Medical Officer of Health, is responsible for safeguarding the health of the
area and for applying the knowledge of public health and preventive medicine for the benefit of the community.
The Medical Officer of Health is responsible for acquiring an accurate knowledge of the influences, social,
environmental and industrial, in the area which may be harmful to the health of the people and he must know
the agencies, official or unofficial, who can help in improving these conditions.
The Borough Council cannot introduce improvements in the personal health services, because its duties
are restricted to the impersonal environmental services; neither can it give advice to the responsible authorities,
because the Borough Council is often ignorant of some of the services which they provide. The Borough
Council is also handicapped by the fact that only 40 per cent of the time of the Medical Officer of Health is
allocated to Borough Council duties.
The Medical Officer of Health has no direct official contact with the many agencies responsible for
the personal health services of the community; the local executive committee organising the work of the
doctors, dentists, pharmacists, etc., the local welfare department caring for deprived children, and the local
hospital management committee. He is, therefore, handicapped in giving advice on how the various agencies
can co-operate to improve the health of the community.
There is, therefore, no authority which can adequately survey the health services and needs of the
people in the district and make arrangements for the various agencies to work harmoniously together. The
fact that a few Willesden Councillors are appointed to the hospital management committees and the local
area health committee does not solve this major problem.
The Medical Officer of Health unofficially works in conjunction with the local health agencies, but
cannot always obtain the necessary co-operation because the interests of these bodies often differ. There is no
local authority responsible for resolving these differences in the interests of the public. During the year
difficulties have arisen, particularly in the midwifery services and in the services dealing with old people.
It is disappointing to note that there has been no appreciable extension of the health services during
the year.
There has been a further expansion of the work in environmental services; in the work of housing
inspection and repairs and in the supervision of factories and food establishments. Unhealthy houses and
overcrowding remain the major factors affecting adversely the health and welfare of the people in the Borough.
The infectious diseases rates in the Borough have remained favourable. There was a decrease in the
number of children who suffered from measles, diphtheria or whooping cough, but there was a slight increase
in the number of scarlet fever cases. The anterior poliomyelitis epidemic was the only one of note and was
far more severe than in 1948, but not so serious as in 1947. Tuberculosis, with the shortage of hospital and
sanatorium accommodation, is still the most serious problem in the prevention of infectious diseases, for
although there was a reduction in both the death and case rates, there was an increase in the number of cases
on the tuberculosis register.
There was a marked fall in the birth rate, but there was an increase in the general death rate, and in
the infant mortality and still-birth rates for legitimate children; there was, however, a marked reduction in
the infant mortality rates for illegitimate children. There is urgent need for improving facilities for the care of
premature babies.
I wish to thank all members of the staff, and particularly the sanitary inspectors, for the good work
carried out during the year, and the members of the Health Committee and Borough Council for the interest
they take in improving the health of the people in Willesden.
I have the honour to be,
Your obedient servant,
S. LEFF,
Medical Officer of Health.