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To: The Mayor, Aldermen and Councillors of the Borough:
I have pleasure in presenting this report for 1966—the first complete year in which the Health and
Welfare Services were administered by the Hillingdon Borough Council.
In the department there was a consolidation of the work begun in the previous year and it was
possible to tie up a number of loose ends which had become apparent in the take-over process which
came to an end on March 31st, 1965. Every opportunity has been taken to integrate the work of the
various sections of the Health and Welfare Department with the view of saving manpower, avoiding
overlapping and saving costs. As time goes on this process will be extended, as far as it is possible
within the scope of this department, to the other organisations, both statutory and voluntary, which
deal with the social services.
The vital statistics may be regarded as satisfactory. The birth rate is 15.5, compared with that of
England and Wales of 17.7, while the death rate is 10.6, compared with the national rate of 11.7. The
infant death rate is as low as 13.8, compared with the rate for England and Wales of 19.0. There were
no maternal deaths, and the perinatal death rate, i.e. stillbirths and deaths under one week combined,
was 20.96, compared with the national rate of 26.3. Infant deaths are still a problem and the details
of those that did occur are set out on pages 15-17. From the information given there it will be seen
that these infant deaths occurred from causes which at present are not preventable because the real
origins are unknown. It is necessary for very careful ante-natal supervision to be given to all expectant
mothers; intensive research needs to be continued into the causes giving rise to infant deaths, and it
should be realised also that the same causes are responsible for the majority of stillbirths.
The main killing diseases are cancer and diseases of the heart and vascular system. In Hillingdon
deaths from cancer were 1.95 per thousand of the population, compared with the national rate of 2.25.
The death rate for cancer of the lung was 0.57, compared with the national rate of 0.56. While this
latter comparison is still disappointing, it will be noted that there were 26 fewer cases of lung cancer
than in the previous year.
Medical opinion all over the world is still quite definite that most cases of lung cancer are caused
by prolonged and excessive cigarette smoking. A great deal of health education has been carried out
with a view to securing a reduction in the amount of cigarette smoking in all age groups, but the response
has not been very impressive. One can only go on reiterating the connection between cigarette smoking
and lung cancer, hoping that by constant repetition the message will get through to at least a proportion
of individuals. Particularly, it is the duty of parents to do everything they can to discourage their
children from commencing the smoking habit.
Formerly in presenting annual reports it was the custom to have a good deal to say on the subject
of infectious diseases. In recent years, because of the modern methods of controlling infectious diseases,
it has not been necessary to do more than draw attention to the low incidence of the important infections.
There has been no case of diphtheria in the Borough area since 1949. The Borough remained free
from poliomyelitis, and there was no case of typhoid or smallpox.
In connection with smallpox it is necessary once again to draw attention to the peculiar position
of Hillingdon in this respect. The presence within the Borough of Heathrow Airport means that travellers
are constantly arriving from endemic or epidemic areas, and of course many of the aircraft crews and
associated workers are at risk in having contact with these passengers. It is recommended, therefore,
that vaccination against smallpox should be the rule, the primary vaccination being carried out preferably
in the second year. Because of the constant danger of the importation of smallpox and because
of the frequent necessity for vaccination to be carried out to meet the requirements of international
travel, it is wise to have this protection established as early as possible. Once primary vaccination has
been performed, subsequent revaccination for whatever purpose becomes a trivial and comparatively
safe procedure.
Although the incidence of serious infectious diseases has been so low, this situation cannot be
continued without meticulous attention to the immunisation level reached in the infant population
and also with very careful attention to case and contact tracing. The work of health visitors and public