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66054
BOROUGH OF WILLESDEN
Health Department,
54, Winchester Avenue,
To the Mayor, Aldermen and Councillors of the Borough of Willesden. Kilburn, London, N.W.6.
July, 1954,
Mr. Mayor, Ladies and Gentlemen,
I beg to submit the annual report on the health and sanitary circumstances of the Borough for the
year 1953.
There has been a slight decrease in the population, but this does not give a clear picture of the
continuous fairly large-scale migration in and out of the Borough. The census figures reveal that Willesden
is the worst district in the County for housing conditions and sanitary circumstances. The pollution of the
atmosphere from the power stations, railway sidings and many industries in the area contribute to the illeffects
that overcrowding and insanitary conditions produce on health.
Cancer of the lung has now become one of the most important problems; in Willesden it kills three
times as many as tuberculosis. The cause of the disease is still largely unknown, although there has already
been some proof of its association with cigarette smoking, but it would not be surprising to find that dust
and impurities in the air both inside and outside the factories play an important rôle.
The large number of deaths from bronchitis, pneumonia and other respiratory diseases is also
probably a reflection on atmospheric pollution, although, of course overcrowding and bad housing conditions
also have a profound influence. The latest census figures of the Registrar General show conclusively
that improvements in the conditions of the people in the poorer classes would soon produce a considerable
reduction in the number of deaths from respiratory diseases, tuberculosis and gastric ulcer.
The number of fatal accidents in the home has been reduced, but is still almost double that caused
by motor vehicles. A survey of accidents in the home in Willesden has illustrated how much suffering could
be avoided and many lives saved by introducing simple preventive measures and improving the care and
environment of the young and the old.
Despite the welcome reduction in the number of deaths from tuberculosis, it still remains the
worst infectious disease in the Borough; the case rate is practically the same as it was before the war,
while in all other infectious diseases, excepting anterior poliomyelitis, it has been reduced. Much has been
done in the Borough to treat patients without delay by improving hospital bed provision, and by the new
methods of treatment with antibiotics and artificial pneumothorax in the home. Liaison between the Public
Health Department and the Chest Clinic has been particularly close during the year and has probably contributed
to improvements in tracing contacts and caring for the patient in the home. B.C.G. vaccination
of school leavers was started in the year, and will probably add its modest contribution to reducing tuberculosis
in the Borough; but, above all, housing and nutrition must be improved if this disease is to be finally
conquered.
There has been a welcome reduction in infant mortality and in the stillbirth rate, but the number
of children who died under the age of four weeks still remains high. The latest figures of the Registrar
General provides confirmation of the experience in this area which has shown that although there has been
a marked improvement in infant mortality, the differences between the various social classes remain as
large as ever. Again, the conclusion to be drawn is that improvements in social conditions will save many
infant lives, and in the cost of the curative services.
Many houses in the area are old and have outlived their normal life. By extending their surveys
of housing the Council are ensuring that preventive repairs are carried out to save these houses, and also
avoiding heavy costs on them in the future. These improvements not only help the landlords in this respect,
but also provide the tenants with better living conditions and so probably prevent their health deteriorating.
It is hoped that the new Housing Repairs and Rents Bill, when it comes into operation, will help
in improving the general sanitary conditions in the area, but if higher rents cause people to spend less money
on food, the possible gain in health achieved by better housing may be out-weighed by the harm caused by
malnutrition.
For the first time since the Act, the Annual Report includes a section on the personal health
services. This has been done to preserve information which may be of value in the future when Willesden
once again is considered a large enough district for administering its own personal health services.
There has been no striking improvement in the personal health services over the past five years.
The main difficulty arises from the fact that no new clinic has been built in Willesden during the last 24
years, and with the health services expanding in character and popularity, there has been a serious pressure
on the outdated clinics, two of which in converted houses have been in the Borough for almost 40 years.
As an emergency, two church halls have been used as part-time clinics and the fact that they have already
become overburdened with work illustrates the need for more clinics in the many areas of Willesden now
without any. Also urgently needed in the area are clinics for the treatment of squint and for teeth and jaw
irregularities, and for an extension of speech therapy. The serious shortage of health visitors has also
hindered the very important work that they do in the care of mothers and children, and more recently of
the aged, and in the care and after-care of illness.
There has been a welcome reduction in the waiting list at both the physically handicapped and
educationally subnormal day schools, but there is still a marked shortage of places for those children with
defects who require residential accommodation, particularly if they have double defects. There is also need
for more schools for the maladjusted and for grammar schools for children with physical defects. New
schools are needed urgently to replace the two day schools in the area for handicapped pupils.
The home-help and midwifery services are now running smoothly, but there are still people who
require the home-help service and do not have it because of cost. There appears to be too high a proportion
of mothers having their babies in hospital (more than 8 out of 10).
Finally, a word on administration. The transfer of the personal health services to larger authorities
has produced considerable delays in getting essential services to the people who require them; "the
personal touch" which existed between elected representatives and the public has been largely lost, and the
machinery of administration of a large authority is so cumbersome that by the time the solution of a particular
problem is arrived at, it is often inappropriate, for the simple reason that the problem has changed
its character in the time taken to deal with it.
The Health Committee of the Borough Council have been very active during the year in improving
housing conditions, food hygiene, health education, and the care of the aged. The Councillors, members
of the staff, and the sanitary inspectors, have all contributed to the successes that have been achieved during
the year.
I have the honour to be,
Your obedient servant,
S. LEFF,
Medical Officer of Health.