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To: The Mayor, Aldermen and Councillors of the Borough:
The statistics relating to 1968 may be regarded as being reasonably satisfactory, but in Public
Health and Welfare work one can never be satisfied. The object is, of course, to remove as far as possible
all disease and other deleterious conditions affecting normal living, and the nearer one gets to the total
elimination of these things the more successful one is.
Possibly the best illustration of this thesis is seen in the consideration of two infectious diseases—
diphtheria and poliomyelitis. Over the years these two conditions have been virtually eliminated by
intensive immunisation procedures. In the case of diphtheria, if the experience of 30 years ago was
repeated now, one could expect in this Borough an annual incidence of something like 300 cases.
Similarly in the case of poliomyelitis, a disturbing number of cases could be expected. In both these
conditions the fatality rate is high and may be up to 10% or so. Reference to the Infectious Disease
Table (page 20) will show that no cases of these diseases occurred during the year—in fact there has
been no case of diphtheria in the Borough area since 1949, and the last case of poliomyelitis was in 1962.
The cost benefit of this exercise in infectious disease prevention must be obvious. Both these
conditions, apart from their high mortality, involve their victims in extensive paralyses and other
disabilities, and their treatment involves long periods of weeks, or even months, in hospital. The cost
of this at present day prices would be quite astronomical. Not only is this saving in the use of hospital
beds made possible, but provision of special hospitals for the treatment of infectious diseases is no
longer necessary, with a further consequential saving.
The proximity of the Airport compels me once again to draw attention to the necessity for vaccination
against smallpox. There is a continuing fear that a case of smallpox will be imported into the
Country through the Airport, with the consequent involvement, not only of Health Control medical
staff, but also of Airport personnel of all types. In addition the great increase in foreign travel necessitates
smallpox vaccination in the case of a great many travellers. Primary vaccination in adults is an
unpleasant and often painful procedure, whereas re-vaccination causes comparatively little trouble.
The best time for primary vaccination is in the second year and once a child has been vaccinated, revaccination
causes no trouble. Vaccination therefore should be regarded as part and parcel of the
ordinary immunisation schedule, which is, in general, universally accepted. I make no apology for
drawing attention once again to this matter of possible smallpox importation, but because of its peculiar
geographical situation, this Borough is at more than average risk, and it is only right that the inhabitants
of the district should be aware of the position.
Infectious disease is no longer thought of as a killer. As in recent years, in 1968, cardiovascular
conditions and cancer are the "Captains of the men of death". This will readily appear from a perusal
of the Table on page 18. The Table on page 17 shows the cancer experience in the Borough, which is
lower than in England and Wales as a whole. The figure for cancer of the lung and bronchus in men
has slightly decreased, from 116 in 1967 to 102 in 1968, but that for women has, in fact, risen from 27
in 1967 to 34 in 1968. Is this a further step towards equality—has the increased cigarette consumption
among women in recent years begun to show itself in increasing lung cancer incidence?
Work in the Maternal and Child Health Section went on very much as before, with an increase
in work carried out in connection with cytology. In every case where cervical smears were taken full
gynaecological examinations were carried out in addition, with some interesting results, which are set
out on page 65.
During the year a replacement Mobile Clinic was brought into use and a picture of this is shown
(Plate 1). Over the years the Mobile Clinic has proved its worth in taking the Maternal and Child
Health services into those parts of the district not yet provided with purpose built Clinics, and not
having suitable premises capable of being hired and adapted for Clinic use.
Further steps were taken to bring about a closer integration of all the Health and Welfare services.
One would like to have seen an improvement in the facilities available for the care of the aged, but
this was not possible on the lines considered desirable because of a shortage of the requisite professional
staff. Preliminary steps were, however, taken to set in motion the complicated machinery necessary for
the provision of a specialised Home for the elderly mentally confused. This is a group of old people
which would in previous years have been provided for permanently in Mental Hospitals. Hospital