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BOROUGH OF WILLESDEN
Health Department,
54, Winchester Avenue,
Kilburn, London, N.W.6
July, 1952.
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 1951.
I regret to report a setback in the health of the people as shown in the figures available for the year
under review. The warning given in the previous report about the possible after-effects of the deterioration
in the living conditions—housing and nutrition—seems to have been justified. There was a slight increase
in the general and infant mortality, and in the number of tuberculosis cases. There has been a decline
in the birth rate, and consequently the population is no longer reproducing itself; although it is, of course,
still affected by a fairly large-scale movement of population into and out of the area.
The increase in the death rate for cancer is in part probably due to the ageing population and in part
to improved diagnosis, but there is also perhaps a rise in the true incidence of the disease. There was a
marked increase in cancer of the lung and bronchus, particularly in males; cancer of the breast still remains
at a high level and there was an appreciable increase in cancer of the uterus. There would appear to be a
need for further health education of the public on the early diagnosis of cancer of organs in accessible sites,
such as the breast, uterus, skin, larynx, bladder; since-the favourable prognosis of early treatment may save
many lives.
Although the winter was not severe and there was no widespread epidemic of influenza, there were
striking increases in the deaths from pneumonia and bronchitis. It may well be that these are not unconnected
in some way with the smoke nuisances from the power stations in the district.
Deaths from accidents, other than street accidents, are probably in a large part preventable and local
research into this question could be very helpful in the work of prevention.
It is a pleasure to record that there were no deaths from measles, whooping cough, diphtheria or
acute poliomyelitis during the year. Although there were no deaths from measles, the fact that there were
over 2,000 cases indicates that it still presents an important infectious disease problem. It is significant to
note that the three worst wards were Roundwood, Carlton and Stonebridge, with 199, 196 and 176 cases
respectively, as compared with only 72 in Neasden. These differences are too large to be accounted for by
differences in the child structure of the population alone; they clearly reflect living conditions, particularly
the degree of overcrowding in the wards. It can be generally stated, however, that the preventive health
services have now conquered the infectious diseases but for tuberculosis, which could be defeated too in one
generation if general living standards were improved. Many lives of adults with tuberculosis and of infants
generally could be saved if the standards of living were raised in the borough as a whole to reach the
standards enjoyed by the people in the ward with the best tuberculosis and infant mortality rates.
The time is rapidly approaching when the health of an area will not be determined almost entirely
on the basis of a study of its mortality statistics, but upon its morbidity figures as well. Much valuable
information contained in hospital, family doctor and clinic records is at present almost completely neglected.
If it were abstracted, studied and co-ordinated, useful suggestions for improvements in the health of the
community would doubtless emerge.
It is disappointing to record no marked improvement in the provision of health services in the area.
Restrictions of expenditure on new clinics and new houses must inevitably affect the health of the people.
A new part-time maternity and child welfare clinic was opened in the Daisley Hall, a Church Hall in Sneyd
Road, Cricklewood, on 6th February 1951, but one was closed in Princess Road, Kilburn, at the same time.
This has resulted in a falling off in attendances of mothers and children from an area which is most in need
of clinic facilities.
One cannot record, too, any appreciable improvements in the living conditions of the area. Satisfactory
housing accommodation still remains scarce and many houses are rapidly becoming slums. It is
doubtful whether there has been an improvement in the nutritional standards of the people; the rising ccsts
of food together with the economic hardships associated with redundancy may have serious effects on the
health of the people in the future. Already there has been an increase in the infant and general death rate
and in the number of tuberculosis cases.
Despite many attempts of co-operation within the service, the setting up of a liaison committee and
the friendly working together at officer level, there are still considerable difficulties in co-ordinating the work
of the many health agencies in the area. Hospital and local health authority services appear to be somewhat
remote from the influence of public opinion, and thus it is more difficult to organise them for the benefit of
the people. In some instances the huge administrative machinery appears to have become over-burdened,
and projects consequently take a considerable time before they receive official sanction. There is nothing
more frustrating than to find that when a decision is arrived at, it no longer fits the situation for which it was
designed because a change has occurred in the interval.
Within its limitations, the work of the borough council has expanded by obtaining further improvements
in environmental hygiene. Housing conditions, food hygiene, health education and the care of the
aged have mainly engaged the attention of the public health department, and many councillors have shown
an increasing interest in this work.
I wish to thank all members of the staff, and particularly the sanitary inspectors, for the work they
have carried out during the year.
I have the honour to be,
Your obedient servant,
S. LEFF,
Medical Officer of Health.