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BOROUGH OF WILLESDEN
Health Department,
54, Winchester Avenue,
Kilburn, London, N.W.6.
July, 1961.
To the Mayor, Aldermen and Councillors
of the Borough of Willesden.
Mr. Mayor, Ladies and Gentlemen,
I am often asked by my colleagues in the medical profession, and by many other people, what there
is left for public health to do today, now that infectious diseases have largely been conquered, and maternal
and infant mortality reduced to the lowest known figures.
The answer is clear. Public health still has an important part to play in its traditional fields of
work: in the care of mothers and infants, in preventing infectious diseases by immunisation, and by improving
the environment. But, in addition, there are new battles where public health measures are called on to
protect people: the respiratory diseases, mental disorders, mental and physical crippling by accidents, and
the disturbances which affect old people. Also, successful work in the traditional fields will often prevent
illness and disorder in later years.
There may be criticism that the battle against these conditions should be a combined operation, with
others taking the lead. It is true that the hospital and general medical services have great interests in these
aspects of ill health and do much useful work, but there is also no doubt that the community health services
are indispensable allies in the medical struggles against disease. It is important that the various sections of
the health services should understand more clearly how they can help each other.
If we survey the battle against respiratory diseases we can see immediately how public health extends
its influence. Over the past fifteen years, bronchitis and cancer of the lung have displaced tuberculosis as
a main cause of illness, disablement and death. Public health has already had many years of useful experience
in dealing with tuberculosis, and recently, even more effective ways have been introduced.
When public health teaches mothers how to feed themselves and their babies properly, when public
health helps to improve the diet of children in day nurseries, school children and old people, tuberculosis
receives a serious blow. This is reinforced with better housing and the reduction of overcrowding. Vaccination
of school children and of special contacts is also a useful weapon in the fight. And the final steps
towards victory are the tracing of contacts, and the education of school children and factory workers in ways
of preventing the spread of the disease.
Bronchitis has only recently come into prominence, although it is one of the main causes of disablement,
absence from work, and death. Once again prevention starts in the early years. Mothers who
learn how to avoid respiratory infection in their babies can prevent chronic diseases. Better feeding and
housing helps to raise resistance. Immunisation against infectious diseases and the control of their spread
can lower the numbers who have respiratory complications. Breathing purer air can help to keep the lungs
clear, and smokeless zones can play a part in overcoming chronic bronchitis and cancer of the lung.
But trouble is caused not only by smoke in the air but by smoke in the cigarettes. Health education
in the schools and factories can help in the battle against bronchitis and cancer of the lung. It is significant
that not only factory workers but school children are asking for talks on how to stop smoking. There is no
doubt about the need of a combined operation against bronchitis.
In Willesden, there is close liaison with a research unit and through them with the hospital and
general medical services. At the Pound Lane Clinic the research unit started an experiment to help people
with bronchitis to understand their disease by talks, films, records, and individual and group discussions. To
help them recover good health after influenza they receive special inoculations against this disease. They
are also treated with antibiotics to try and cut short infections, and they are given an Airwick bottle containing
ammonia to use at home during fog. Smokers are encouraged to stop smoking by group discussions. If
these methods prove successful, they will encourage many others to promote similar measures against bronchitis.