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closely related to the health services. Again, as the health authority,
the district council concerns itself with environmental conditions such
as circumstances which might become sanitary nuisances and cause
injury to the health of the public. In this way the Council is concerned
with the condition of the houses in which people are living; the freedom
from pollution of the atmosphere; the freedom from pollution of rivers;
the safe state of food and drink, and to a limited extent with the conditions
under which some people work. The local health authorities,
the major authorities, in this case the Middlesex County Council, provide
the personal services including the school medical services and the
Part III Services of the National Health Service Act, many of which
were, before July, 1948, provided by the maternity and child welfare
authorities. These Part III Services include home nursing and a wide
range of activities of the domestic or home helps. Hospitals of all sorts
have passed to the Minister to be administered by him through the
Regional Hospital Boards and, in turn, by the Hospital Management
Committees. Without very efficient basic sanitary circumstances, such
as a pure water supply and efficient drainage, an urban community of
this size could not for long remain in a sound sanitary state, no matter
at how high a degree of efficiency the Part III Services and the hospital
and associated clinical services might be maintained. Given sound
basic sanitary services, it would not be held that the health of the district
was dependent on the Part III or the hospital services. A district such
as this starts at a great advantage in that it is in the south and more
than that, in the south-eastern part of the country where it would seem
the easier climatic conditions put this and other districts here in a
position more favourable than that of some towns in the north. It is
not an industrial area; although by no means free from smoke pollution,
if only because of the great number of domestic chimneys belching their
smoke into the atmosphere, the air is that much more free from contamination
than that of many industrial towns. Much of the district
grew when development was subject to some building density restrictions
and the height of the buildings in relation to the width of roads and
gardens helps to ensure freedom from darkness and from courts and
alleys to which the sun has no access. Most of the houses in the district
have been built comparatively recently and are better laid out than
the houses in many of the towns which developed before the first world
war. Although conditions under which many are living leave much to
be desired, the actual degree of overcrowding, even to-day, is relatively
slight. To these factors must be added that of the comparative affluence
of the general run of the population, a state which enables a sound and
nutritional state to be maintained. These are the factors which contribute
to the satisfactory state of the public health of the district. This
is not to decry the importance of the personal and of the hospital services.
These, however badly they may be needed by any individual person,
and when required at all, are wanted very badly, are required by the
individual. Admittedly, there may be some 1,000 mothers who need
the services of midwives in the course of the year, and another 1,000
who need to be admitted to hospital for their confinements; some
hundreds who need the services of a home help and further hundreds