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The Worshipful the Mayor, Aldermen and Councillors of the London
Borough of Hillingdon.
Mr. Mayor, Ladies and Gentlemen,
I have the honour to present my first Annual Report which covers the work of the Health
and Welfare Department for the year 1970. The original purpose of an Annual Report was to allow
the Medical Officer of Health to comment upon matters which required effective action by the
community. With changing public attitudes this need has become less apparent and the Report
now provides an opportunity for a review of the progress of services for which the Medical Officer
of Health is responsible. In this first report I have tried to review, often I fear at some length, the
whole field of the activities of the Department and to interpret the data now coming forward in
order to prepare a programme for future action. The aim has been to put forward the views of the
Council's professional advisers concerning the many changes now being witnessed in social
circumstances and the provision of appropriate services. Such a survey has necessarily involved
a considerable amount of effort by many officers within the Department, some of whose names
appear at appropriate points in the Report itself, and I am grateful to them for their willing cooperation
and helpful assistance.
Vital Statistics
There was a further increase in the perinatal mortality rate which, for the first time, exceeded
the national figure. The larger number of stillbirths during 1970 more than offset a welcome
reduction in infant deaths. This improvement during the first year of life was the result of the
smaller number of deaths from prematurity and the respiratory distress syndrome compared with
the previous year together with a reduced mortality from infection of the respiratory tract.
The total number of deaths was almost the same as the previous year but there were significant
variations within the global figure. Fluctuations from year to year for individual causes of death
made time trends difficult to discern, but the steady increase in the number of deaths from ischaemic
heart disease continued. This was the largest single cause of death. There was an abrupt reversal
of the declining trend from motor vehicle accidents and the number of deaths recorded returned
to the levels of four years ago. Malignant disease also showed a continued progression in mortality
and one third of such deaths were due to carcinoma of the bronchus. The increasing number of
deaths from this cause nationally is reflected in the local figures which show the largest number
of deaths from carcinoma of the bronchus yet recorded in this Borough. The prevention of cancer
once seemed an elusive will o' the wisp, ever desirable but never to be attained. Prevention of
almost all deaths from this particular form of cancer is now possible, and it is surely ironic that
many smokers who have it in their power to arrest this modern epidemic choose rather to risk
exposure to this unpleasant and incurable disease.
Infectious Disease
The year was notable for the reappearance of infectious diseases once thought to have been
eradicated from this country. Since London (Heathrow) Airport is within the Borough the possibility
of imported infectious disease is ever present. The increased prevalence of intestinal infection in
travellers returning from holiday attracted national interest, and added to the work of the Department,
not only in tracing flight contacts but in the follow-up of those handling food in the area. Suspected
cases of smallpox and diphtheria were timely reminders of the importance of routine programmes
of vaccination and immunisation. The present level of smallpox vaccination in this area can give
no cause for complacency in spite of the decline in world-wide prevalence of the disease.
The small but perceptible upward trend in the incidence of venereal disease, particularly in
non-specific sexually transmitted diseases reflects the apparently changing sexual mores reported
by sociologists especially among young people. Protective vaccination against these diseases is
not possible, and specific treatment in some cases seems progressively less effective. Sexual
continence before marriage and faithfulness within it remain the most effective methods of control
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