London's Pulse: Medical Officer of Health reports 1848-1972

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Harrow 1941

[Report of the Medical Officer of Health for Harrow]

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3
which at the present rate of deterioration it seems inevitable will need
to be the subject of action under the slum clearance provisions of the
Housing Acts.
While the principles on which town planning was based are sound
enough, it is questionable whether the circumstances of the occupants
of many of the smaller types of villa residences are really benefited by
the limitation of density imposed. The many uncultivated gardens
demonstrate only too forcibly that there needs to be catered for quite a
substantial section of the community in habitations without these
gardens. It seems quite likely, even if the same total density is retained,
that the part of land not covered by the actual buildings might be better
apportioned, perhaps restricting the garden while providing nearby
allotments for those who wish to cultivate them, and playing fields or
playgrounds for the children. Apart from the cost of the land and other
building costs which are higher with the semi-detached type of development,
there is the real disadvantage that the more the houses are spread
the more transport is required, transport in conditions not conducive to
health and which subtracts appreciably from the leisure time of the
workers.
It can probably be said to-day that very few of the social services
completely meet the demands. A reduction in the population and
especially the differential reduction consequent on the falling birthrate
will, in certain cases, so reduce the demand that the existing services
will then prove sufficient to meet it. Such certainly would quite soon
have been the case in regard to tuberculosis. In time the differential
reduction in population will result in the diminution in the population
of ages 15 to 34 at which ages tuberculosis causes 35 to 40 per cent, of
the total deaths. In the same way the pre-war school medical staff
would, with the reduced number of children attending school, be sufficient
to enable them to carry out the desirable fourth routine medical inspection
; and the relative increase in the dental staff would go some way
to reducing the present inadequacy of the dental service which is common
throughout the country. In the field of maternity and child welfare,
though, it is quite possible that increasing demands made by existing
numbers will outweigh any reduction in the actual numbers ; for instance,
the steadily growing proportion of the women who wish to be
confined in hospital will probably for long result in the demand for
institutional accommodation not being met.
The low birth rate with consequent changes in the age distribution
of the population will lead to an increased proportion of those of greater
ages coincident with a lower proportion of those at younger and in time
intermediate ages. Doubt has been expressed as to whether this growing
proportion of the aged can continue to be supported by the efforts of
the smaller number of workers, and whether there will not need to be
a reversal of the movement which was leading to more persons retiring
at younger ages. Apart from this aspect, though, there will need to
be considered the arrangements for the care of the elderly. In a previous
generation when the family unit was larger and there was much less
movement of the younger members of the family away from the neighbourhood
of the home, although the children one by one left the home it