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5
ANNUAL REPORT OF THE
MEDICAL OFFICER OF HEALTH
To the Chairman and Members of the Urban District Council
of Harrow.
Mr. Chairman, Ladies and Gentlemen,
I beg to submit the Annual Report on the Health and Sanitary
Circumstances of the District for the year 1950.
There was no occurrence in 1950 which affected the health of the
district to which special attention need be drawn. The sanitary inspectors
each year get through their very large volume of unspectacular work
and there was, fortunately, no breakdown to cause any of those events
which alone seem to figure as health news. The campiagn for clean food
made steady and quite satisfactory progress.
That the vital statistics of the district are that much better than
those of the country as a whole is now commonplace, as this happens
year after year. To be able to record that in a whole year only one member
of the population of over 220,000 succumbed to diphtheria stirs no one;
memories are so short that already it seems to be forgotten that only
just before the war a district of this size could be expected to have
anything between 200 and 400 cases in a year, of which between 10 and 40
could be expected to have proved fatal. The infant mortality rate was
13.6. At the beginning of the century the national rate was 150. The
fall of this rate is one of the achievements of the modern public health
service—a service guided by those who today are dubbed "administrative
officers with some medical knowledge." About 30 years ago the figure
of 40 was thought to be the irreducible minimum; since that time figures
of 20 have been recorded. The previous lowest figure for this district
was 20.7 in 1949. It is pleasant to be able to draw attention to the fact
that in this last year there was a substantial fall in the number of new
cases of tuberculosis brought to notice. In 1950 the country was once
more subjected to invasion by poliomyelitis and this district had its due
proportion of sufferers.
The National Health Service Act has now been in operation for
nearly three years—a short enough time, no doubt, for the new arrangements
to take shape, especially in view of post.war difficulties and world
disturbances, but long enough to give some indication of whether the
upheavals which have been brought about are to result in conditions
more satisfactory than those which they replaced.
As to the Part III services, there is nothing today to suggest that
their administration is likely to have been improved as the result of the
new arrangement. This does not mean that the design was necessarily
wrong. It might well be that in parts of the country the inhabitants of
some districts are enjoying better services than they were before or
better than they possibly would have had the change not been made.
But in such areas as this where the Authority previously responsible
for the administration of these services was one controlling an area of
sufficient population, possessing sufficient wealth, and where the Authority