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she is going to be delivered. It is becoming increasingly difficult to book beds for women needing hospital
confinement on social rather than on medical grounds, and there has been a marked increase in the number
of requests for admissions under the Emergency Bed Service. Occasionally, because of the delay, the mother
has to have the baby in unsuitable surroundings. Fortunately in Willesden no medical complications have
arisen as a result of this, but it is difficult to gauge what effect the anxiety and distress has had on the mother's
mind.
Although there was a slight rise in the infant mortality rate, it still compares favourably with that of
England and Wales. Each death is thoroughly investigated and some are undoubtedly due to poor social
conditions, but until we learn more about prematurity and the causes of congenital abnormalities we shall not
be able to make an appreciable reduction in the infant mortality and stillbirth rates.
There was no reduction in the waiting list of the day nurseries. Indeed, during the year the number
on the waiting list reached a new record height.
The borough maintained its good record in having no cases of diphtheria and has started a new one
with no cases of poliomyelitis. This is probably due to the increase in the number of children and adults
inoculated against the disease. Many children had a fourth reinforcing dose during the year and many adults
were vaccinated at their place of work.
However, the largest recorded outbreak of measles in the borough took place in 1961, but although
there were over 3,000 cases there was only one death. Now that measles vaccine is becoming a feasible
proposition it will be interesting to note how many of these cases actually had complications, so that we
could determine how far the vaccine should be used.
The typhoid fever outbreak was confined to the members of one family, but despite investigations
in the borough and in the Isle of Wight, where they had eaten a meal in a restaurant, it was impossible to trace
the source of the infection. Last year we were worried about the increase in the number of whooping cough
cases, but in 1961 there was a marked decline in the incidence.
There was no outbreak of food poisoning during the year, which is probably a reflection of the
general improvement in handling, preparation, storage and sale of food. In general, attempts are made to
improve standards in food premises by talks, lectures and persuasion. However, some owners had to be
prosecuted before they were prepared to improve their premises and methods of food handling. The public
are co-operating in bringing specimens of contaminated food to the department. Most firms are officially
cautioned, but a minority are prosecuted.
There were no outbreaks of dysentery for the first time since 1951, and the number of cases confirmed
was also the lowest since 1951 except for 1957.
The improvement of housing conditions still remains a very important function of the health department.
The survey of the proposed Church Road Comprehensive Redevelopment Area has now been completed
together with a further survey of Carlton Ward not at present included in the South Kilburn Redevelopment
Area. The Minister of Housing and Local Government has confirmed, with modifications, the
Middlesex County Council scheme for the Stonebridge Proposed Redevelopment Area. Two owners were
prosecuted for allowing occupation of basements where closing orders had been made, and one owner was
prosecuted twice for contravening the overcrowding provisions of the Housing Act. Much work has been
done informally to reduce overcrowding in houses, particularly those let for multiple occupation.
The Neasden Clinic, replacing the one formally held at St. Catherine's Church Hall, was officially
opened in July. Plans are already available for the replacement of the Kilburn Clinic, the oldest in the district,
and of St. Martin's Church Hall. The County Valuer has also been asked to find another site for the
Sneyd Road Church Hall Clinic. When this has been done all the church hall clinics in the area will be
replaced by purpose-built clinics.
Liaison between the general practitioners and the public health staff is further encouraged by meetings
at the clinics where points of interest can be discussed over a cup of tea. Already one health visitor is
attached to a doctor's infant welfare clinic, one family doctor attends the micMives' clinic, and an experiment
is being carried out in attaching a home nurse to a partnership of doctors. There is an urgent need for
closer working together of the family doctor and public health staff.
Once again, this has been a most interesting year for public health in Willesden, and my sincere thanks
go to councillors, members of the staff and public health inspectors who have played such an important part
in the health and welfare of the people of the borough.
I have the honour to be,
Your obedient servant,
S. LEFF,
Medical Officer of Health.