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To the MAYOR, ALDERMEN and COUNCILLORS
Sir, Ladies and Gentlemen,
The report of the health department for 1940 is again a mere interim statement
which records only the basic facts of the work done.
Up to the middle of August, 1940, the clinics were almost the pre-war number
and were well attended. The first air raid then took place, and for a period from
7th September raiding became intensive. As a result there was a large amount of
re-evacuation of young children, but even at the end of the year it was estimated
that some 30 per cent. of the pre-war number of under-fives (about 1,700 in all)
were still living in the borough. The clinic attendances from September onwards
suffered fairly considerably and as a result some of the clinics were closed down.
Health visiting in the homes, which after all is probably the most important part of
a health visitor's duties, was persevered with, and the figures for the various divisions
of health visiting do not show much diminution on those for 1939.
In July, 1940, the National Milk Scheme was started. This ensured the provision
of one pint of milk a day to children under five years of age and to expectant or
nursing mothers. Later, for children under one, this was allowed to be substituted
by dried milk. The medical officer of health was appointed as milk officer, duplication
of staff being thereby avoided and co-ordination with other welfare work being
ensured, and the scheme has seemed to work quite smoothly and satisfactorily.
The total number of babies born and classified as belonging to the borough
shows a decrease from 1,113 to 916. The great majority of these were born outside
the borough. The infantile mortality rate for the year went up to 69, which is
disappointing though not altogether surprising. It will be seen from the causes of
death that the main increase in the deaths of infants was due to pneumonia, which
of course indicates a rise in respiratory and catarrhal infections generally.
The problem of the immediate future for children under five years of age is a
large and difficult one and does not appear to be even approaching a satisfactory
solution. The emphasis on evacuation has been on school-children, to the relative
exclusion of the under-fives. The tendency of the Ministry to ask local authorities
to set up day nurseries in the evacuation areas will do little to help the problem, but
it is still hoped that it may be possible to proceed with a scheme for the setting up of
residential nurseries in reception areas. Meanwhile, in raiding conditions, and to
a lesser extent in the lull periods, children under five are sleeping in public or private
shelters. It is very difficult to state definitely what, if any, harm is being caused
to them by this. The general belief is that shelter life, particularly in the larger
basement or tube shelters, must be harmful, and therefore continued attempts have
been made primarily to remove the under-fives from the borough, but secondarily
to ameliorate shelter conditions. The fear one has, however, is that, although it
is difficult to prove here and now that the children are adversely affected, it may be
that the adverse effects will show themselves suddenly and indeed tragically in a
severe epidemic of disease.
With regard to their mental outlook, the position is probably a happier one.
Gross mental trouble in the way of hysteria and anxiety was conspicuous by its
absence during the autumn raids. There was some mild anxiety during the first
few days, but as soon as there was a pause in the blitzing the individual adult
returned very rapidly to normal. The effect on the child under five in any case is
not likely to be great unless the child is personally injured, or has an over-anxious