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develop a voracious appetite for manpower and money.
In 1947, the peak year of the bulge, there were 2,089 births;
in 1962, the second bulge has produced 1,623. The arrangements for
these confinements are far from satisfactory. We lose 30 babies per
year many of whom could be saved; and others are born with a risk
to their health which could have been avoided. For many years now
there has been an increasing demand for hospital confinements
especially for first births, fourth and subsequent births, complicated
births, and births in bad social conditions. The demand for hospital
accommodation is of the order of 70 per cent. and tends ,to creep
higher. There is only accommodation for about 50 per cent. Many
mothers who should be accepted fail to obtain hospital bookings. At
the last minute and when in labour such a mother is admitted through
the emergency bed service to a hospital perhaps far away where she
is unknown, perhaps difficult of access for her relatives, and in
circumstances which I think are appalling and inhuman. In Salisbury,
Southern Rhodesia, every birth takes place in hospital under safe
conditions, carried out by the mother's own district midwife, assisted
if need be by an obstetrician. We could have the same arrangement
here if we had two units one say in Twickenham and one in Teddington,
each of about 40 to 50 beds and provided with several labour rooms
and all the necessary equipment. Confinements in these units could
be carried out by our district midwives, assisted when necessary
by practitioner obstetricians, with consultant help on call. In
these circumstances the confinements would be safe, the babies less
in danger, the journeys short, the mothers could go home early, they
would be attended to both at the confinement and later by their own
professional attendants.
In this country there is no preventive medical service as such
for older people. In my report on our work in the experimental clinic
for preventive medicine for older people 2. I have pointed out that
almost everyone in later life has numerous disabilities, many of
which are capable of being prevented, ameliorated or cured. We
have described techniques for acheiving this happy state. There is a
crying need for preventive services for older people conducted either
in the clinics of the local authorities or by practitioners. Our
preventive service has grown so much that we are in urgent need of
a bigger and better clinic. I am disappointed that work on the new
clinic for Teddington cannot be started before April 1965.
Over this last 18 months we have always been short of inspectors.
For some of the time we have had only two district inspectors. Mr.
Easter and his four remaining inspectors have been kept at full
stretch to try to keep going as much of the routine work in the
health department which requires at least 8 inspectors. They have to
cover the inspection and supervision of houses, factories, shops,
places of entertainment, schools, canteens, restaurants and cafes;;
they have to investigate hundreds of complaints, nuisances, and
follow up and trace contacts in certain infectious diseases; they
have to inspect and supervise food; they have done their best with
the smoke control programme. It has been a difficult and anxious
time.
Hence it is that I commend with greater emphasis and pleasure
than usual the zeal and devotion to duty of your inspectors and
2. Maddison. J, (1963) Horn to Keep the Old Folks Young. Middlesex County
Health Department, High Street, Teddington.
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