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6
ities have done, the Council has not been permitted by the Minister of
Health to give this service.
The third of the three main groups of health activity provided now
by the local authority is the school medical service. This it exercises
under powers delegated by the local education authority, the Middlesex
County Council. Because not one of the constituent authorities which
combined to form the district of Harrow in 1934, was in 1902 of sufficient
population, in spite of the large population and the very large number of
school children, the Council was not until the middle of 1945, responsible
for local education, and so not for the school medical, service. To-day
that service is now integrated with the maternity and child welfare
arrangements, the staff transferring from the county council (two medical
officers and three school nurses) merging with the Council's own staff so
that each member undertakes work in both branches. The small staff
allocated for this work prevents more being done at the moment than
some routine school medical inspections, attendances at a number of
minor ailment clinics, cleanliness surveys at the schools and a limited
amount of home visiting.
For those interested in the financial aspects of the health service, the
following figures being the annual expenditure on various branches of the
service in the year 1944/45 are included:—The gross expenditure on
maternity and child welfare, including centres, was about £20,000, with
recoveries of £7,500, most of this being from the sale of foodstuffs at the
clinics. The running of the war nurseries in this year cost £21,000, all
recoverable from the parents' contributions of £3,500 or from Government
grants. The gross cost of the midwifery service, including meeting
the claims of medical practitioners summoned on medical aid notices, of
£7,500, was reduced to a net cost of £4,000 by the receipts from patients
of £2,000 and a Government grant of £1,500. The gross expenditure of
£9,000 for the general administration of the Health Department was
reduced by a grant of £1,700. The cost of running the infectious diseases
hospital was £10,000.
In so far as they reflect the standard of the health of the community,
the vital statistics for last year were very satisfactory and compared
favourably with the national rates. The death rate at 9.03 showed a
decline on last year's figure of 9.3 and even a slight decline on the
commonest rate of 9.1 for most of the war years; the national rate was
11.4. The infant mortality rate of 32.2 was a decline on the figure of
34 for 1945, and appreciably lower than the national rate of 46. The
birth rate which in 1945 was 18.7—the highest recorded figure for this
area—fell to 16.0, the national rate being 16.1. The maternal mortality
rate of 1.26, though greater than the exceptionally low figure of 0.56 in
1945, compared favourably with the rate of 1.79 for the country as a
whole. Notifications of, and deaths from, tuberculosis showed a further
fall on the previous year's figures, though the number of new cases each
year is still much above the number brought to notice in the pre-war
years. It will be some years before the present rate of fall will result
in as satisfactory a position as the district was in immediately before the
war. Of the infectious diseases the only one exhibiting any marked
prevalence was measles, over 2,000 cases being notified in the course of