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By the time statistics for next year's report are available the office of Medical Officer of
Health will have ceased to exist. Since the mid 1800s when decimating outbreaks of infectious
disease were by far the most important causes of death and demonstrated the need for a medically
qualified official to control infection, to advise his Local Authority on improvement of the sanitary
circumstances of the area and on "the exclusion of all noxious influences", the MOH can show a
record of 125 years solid achievement. In 1834 Dr.John Snow was able to stop a London cholera
outbreak which had, in 10 days, caused 500 deaths within a 250 yard radius of the polluted well in
Broad Street, by the simple expedient of taking away the handle of the pump.
Today's community health problems are less acute but very much more difficult to solve.
Indeed there is little the MOH or his Local Authority can do alone to check the increase in VD,
the toll of smoker's cancer, the premature deaths from coronary thrombosis, the high incidence of
mental illness and the shortage of hospital beds, especially for the elderly. So complex are the
major health problems of today that an integrated approach at national level is clearly necessary
to encompass them. Almost half of all the hospital beds in Britain are occupied by mental patients
and half the remainder are geriatric.
The era of the MOH added 25 years to our life expectancy. During the period of sanitary
reform diseases due to contagion and environmental factors were controlled largely by sanitary
engineering, pure water, safe drains, cleaner food, etc., and prompt isolation when every
considerable town had its own fever hospital. This was followed by the period of communal
responsibility for personal health with the establishment of free health clinics for mothers and
young children, the provision of health visitors, district nurses and midwives as well as a free
School Health Service. Malnutrition between the wars was combated by welfare foods and vitamins.
Since 1948 prevention by immunisation has virtually eliminated infectious disease; neglected
medical conditions should never occur with a free National Health Service while Social Security
provides protection from the malnutrition of poverty.
Most of us (especially if we are non-smokers) can expect far to exceed the scriptural three
score years and ten but it is the quality of life rather than its duration with which we should now
be concerned. Elimination of infectious disease, improved health care and nutrition throughout the
world has led to a population explosion, especially in the under-developed countries, which
threatens by sheer overcrowding of our planet to make life extremely difficult if not insupportable.
A rational family planning policy and the early abortion of unwanted pregnancies may hold this
progress in check for a time but the continuing survival of more and more people to great age and
infirmity inevitably increases the burdens upon those of working age who must support and care
for them. Despite the influx of many hundreds of Commonwealth immigrants who are predominantly
of the younger age groups and have (compared with the home population) an unusually high
proportion of children, the number and proportion of elderly people in our local population
continues to rise:

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