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Borough of Twickenham.
Public Health Department,
Elmfield House,
Teddington.
August, 1938.
To the Mayor, Aldermen and Councillors of the Borough of Twickenham.
Ladies and Gentlemen,
Although the enlargement of the Borough, produced by the incorporation of the Urban
Districts of Hampton, Hampton Wick and Teddington, did not take place until April 1st, 1937,
the report, which I have the honour to submit, applies to the area of the enlarged Borough for the
whole year.
In consequence of the order of the Minister of Health, the Borough is now nearly three times
as large as before, and its population and rateable value are almost doubled. It is not always
easy to remember that Twickenham is now one of 125 large towns of England and Wales, and not
an aggregation of smaller units.
The expansion of the town has involved not merely a proportionate increase in
administration, but, at any rate as far as the Health Department is concerned, has also added
other duties and responsibilities which have been imposed in consequence of the increased
importance of the Borough.
Until amalgamation, Twickenham was an autonomous Part III. Education Authority.
It was agreed, however, that the education services in the new and enlarged Borough should be
administered by the Middlesex County Council. In the ordinary course, the School Medical
Service would have been carried out by the Local Education authority, but it was realised that
as the care of the health of the school children is an integral part of the public health services
of a district, it was undesirable for the School Medical Service to be divorced from the other
public health services of the Borough. An agreement was therefore entered into by which the
Medical Officer of Health of the Borough was made responsible for carrying out, under the
direction and control of the County Medical Officer of Health, the School Medical Services in
the. extended Borough.
All the local duties of this service are therefore carried out by the medical and nursing staff
of the Corporation throughout the entire Borough, including the medical, ophthalmic and dental
services for all the elementary and secondary schools and the new Technical College.
The duties of the Maternity and Child Welfare Services in Hampton Wick were formerly
performed by officers of the Middlesex County Council. These duties have now become part
of the health service of the Borough, and are carried out by the medical and nursing officers
of the Corporation.
As the work of all the branches of the Public Health service is now undertaken by the
officers of one Authority, not only has it been possible to reduce the personnel engaged in the
duties, but unification of methods, the avoidance of visits to homes by officers of two different
authorities, and more satisfactory control have been effected.
In October, the Minister of Health issued an order constituting the Corporation the
supervising authority under the Midwives Acts. The responsibilities thus imposed included
not only the supervision of all midwives practising in the Borough, but also the appointment
and direct employment of whole-time midwives under the Midwives Act, 1936.
In the same month the Middlesex County Council delegated to the Corporation the duties
connected with the registration and supervision of Nursing Homes.
The sudden enlargement of the Borough, the imposition of the new and additional duties
and the co-ordination and unification of the services formerly carried out in the four separate
areas, by five different authorities, have raised problems and difficulties, the solution of which has
demanded much consideration and occupied much time, but many of these had been solved,
while others were in process of solution at the end of the year.
As the office accommodation, occupied by the Health Department at the Municipal Offices
at York House, was found to be entirely inadequate for the increased staff, the offices of the
Health Department were moved to Elmfield House, Teddington, which was occupied as offices
by the Teddington Urban District Council before the abolition of that authority. After certain
alterations, this building has proved to be sufficient and satisfactory, apart from the distance
at which it is situated from the central offices in Twickenham.
As this will be the last annual report which it will be my privilege to submit, I desire to
acknowledge with grateful thanks the consideration and courtesy which has always been shown
to me by successive Councils and Committees during the past twenty-eight years, and I also
acknowledge, to the full, the friendly co-operation and help that I have received at all times from
my fellow chief officers.