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against a marked decrease in the groups one to four weeks and
four weeks to one year, must indicate a closer attention to the
cause of premature babies, causes which lie in the ante-natal and
natal periods. Again for similar reasons tnere has been no improvement
in the stillbirth rate (chart 7). The marked saving in
maternal death (chart 6) speaks well for the improvement in
the maternity services.
The ageing population, in spite of the increase in the birth
rate for 1946 must affect the death rate which remains comparatively
stationary. We have not had any severe epidemics
during recent years nor has the type of the common infections
been as severe as in years past.
With the increased practice of communal feeding, the
establishment of civic restaurants, school meals and works canteens,
a closer attention to hygiene in the kitchens and the
handling of food becomes more than ever essential. An investigation
carried out in Bromley by Dr. R. I. Hutchinson, of the
Ministry of Health Emergency Pathological Laboratory, Downe,
and by Mr. G. R. Woods, Chief Sanitary Inspector, into the dish
washing at canteens and restaurants has demonstrated
bacteriologically the dangers that exist from inadequate attention
to the hygiene in the washing and drying of utensils used
at these communal feeding establishments. This valuable report
has been published in the medical Press and with the kind
permission of the Editor of the British Medical Journal I am
permitted to reprint the Report later in the Annual Report,
under the heading Supervision of Food section.
The uncertainty of the future of Government of the Health
Services has made it impracticable to develop or submit a programme
for the future services in the prevention of disease, so
the report for the year 1946 is mostly a submission of details of
routine carried out by the Department and of its almost universal
appeal to the public. As is well known, the services have
been so organised as to bring them to the public and not the
public to the services. Thus we have the two ad hoc clinics,
one at the North and the other at the South, the daily use of
school premises at Hayes and Burnt Ash for minor ailment
treatment and inspection, and the use of district halls for the
holding of nine welfare sessions. This is decentralisation in
practice, and it is on this principle that the future Health
Services and Health Centres under the new Health legislation
should function, bringing into the existing health services the
medical care service.