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13
2. MATERNITY AND CHILD WELFARE.
National Health Service Act, 1946 - Comment.
On July 5th. 1948, the provisions of the National Health
Service Act, 1946, transferred the liabilities of the Council
for the Maternity and Child Welfare Services to the Surrey
County Council.
This transfer brought to an end a long period of valuable
public welfare work by your Council which began in 1918. By
the transfer some 84 members of the Council's staff passed overnight
to the County Council, and buildings and equipment concerned
became the responsibility of the County Council, together with
the function of directing policy.
Your Medical Officer continues to direct the work in the
Royal Borough of Kingston-upon-Thames, which is grouped with
its immediate neighbours, the borough is of Maiden and Coombe,
Surbiton, and the Urban District of Esher, to form the North
Central Division of Surrey, for which he has been appointed
Divisional Medical Officer.
It is natural, upon such a fundamental change, to consider
what has been accomplished by your Committees and staff, and
what may reasonably be expected to happen to the services which
were developed during their period of responsibility.
The available records are complete from the year 1921 and the
vital statistics from then to the year under review make interesting
reading.
The population in 1921 was recorded as 39,520. It slightly
increased in the succeeding years, reaching a figure of 40,430 in
1924. This was followed by a slight decline, and in 1937 it was
39.970. The war years saw a progressive drop to 34,780 in 1944,
succeeded by a rise to 39,670 in 1946, end to 40,780 in 1947, which
is also the figure for 1948.
Turning first to the Birth Rate and the annual number of Live
Births a rough graph No. 1, shows a steady decline from 1921, when
the birthrate was 20 per 1,000 of the population, to the low
figure of 11.8 per 1,000 in 1932 since when there has been a gradual
rise with small peaks in 1936, 1943. and a post war peak in 1947 when
the rate was 21.3 per 1,000 of the population. The curve for
1948 is again downward the rate being 17.7 per 1,000.
Thus, in the special post war circumstances of 1947, the number
of live births slightly exceeded those fbr 1921, i.e. 870 as against
799, which numbers can be roughly compared as the total population
differs but slightly.
The number of live births in 1948 has fallen to 722, so it is
apparent that the downward trend has again set in.
The infant mortality rate is considered a fairly sensitive
index of the welfare of mothers and young children, and a glance at
rough graph No,2, gives the story in figures from 1921 to the present
day. With a comparatively small population such as that of Kingston,
and with less than 1,000 births each year, it is to be expected that
the course of the graph will not be smooth, because particularly
adverse factors in any one year, plus a small number of births,
will tend to increase the infant mortality rate. It is clear,
however, that notwithstanding many recessions in particular years,
the trend of the curve is steadily downwards. The main check to the
downward progress occurred in t he war years 1940 - 42, since when the
curve takes a steeper downward course to reach an all-time low level
in 1947s with a very similar rate for 1948. The infant mortality rate
for 1921 was 60 per 1,000 live births for 1947 it was 21.84, and
for 1948 23.55.