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The concept of an overall plan to promote health as a community ideal and to provide
solutions for immediate national and local health problems will not bear fruition immediately.
However, an important contribution to effective preventive medicine can be made by the broadly
based education service outlined. Expansion is expected and 1972 should prove to be an exciting
year for health education in the London Borough of Hillingdon.
The continuing world-wide decline in the number of cases of smallpox except in countries
where eradication programmes are being pursued resulted in a decision to discontinue the policy
of infant vaccination in the United Kingdom. The risk of importation of the disease to this country
has been progressively reduced and it is almost ten years since the last major outbreak of the
disease. Smallpox vaccination carries a small risk of complication which is now considered to be
greater than the risk of contracting the disease for most members of the community. There remain
specialist groups within the community who are more likely to come into contact with the disease
imported from abroad, and it is most important that the vaccination levels amongst these staff
should remain high. Doctors, nurses and ambulance drivers constitute such special groups, but
because of the presence of the busiest international airport in the world within the Borough's
boundaries others resident in the area also fall into this category. Employees of airlines and those
involved in passenger handling duties must also be included, and the facilities of the department
have been offered to all airlines operating at London (Heathrow) Airport who have employees
involved in receiving passengers or baggage from countries in which smallpox is endemic.
The smallpox vaccination rate in this area has been disappointing for many years and was
far too low to provide reliable community protection against a major importation of the disease.
This rationalisation of policy is therefore welcome.
Feasibility studies continued throughout the year to determine whether existing vaccination
and immunisation records could be transferred to computer processing. Investigations appeared
to show that such a transfer would offer relatively little advantage compared with the existing
system in relation to the children who are currently immunised by the department's own medical
staff. Approximately half of the children are, however, immunised by family doctors and for these
groups computer processing seems likely to bring readily identifiable advantages. The situation
was complicated by the transfer of existing Council computer services from the present Leo III
computer to an "On-line" system, and by the transfer of vaccination and immunisation records
to the Area Health Authority in 1974. It became clear to the working party that any computer
system introduced would almost certainly remain in operation for at least five years and with
over two-thirds of family doctors in the area anxious to participate in the scheme, its value in
promoting co-ordination within the National Health Service could not be under-estimated.
Arrangements were therefore made for all immunisation records for children born after 1st January
1971 to be transferred to computer processing.
BCG Vaccination—Production of acquired resistance to tuberculosis
BCG vaccination is offered to all children in the second year of the secondary schools. The
vaccination is carried out in the schools by specialist teams of doctors and nurses. 2,766 children
were eligible for BCG vaccination this year; 2,259 children were heaf tested and of this number 2,170 children were vaccinated.
IMMUNISATION