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Public Health Department,
Town Hall,
Tottenham, N.15.
To the Worshipful the Mayor,
Aldermen and Councillors.
Mr. Mayor, Ladies and Gentlemen,
It gives me great pleasure to submit my 28th Annual Report on Tottenham's Health
in the year 1963; and to see the wheel of administration about to turn full circle
within my period of service as medical officer of health.
In 1948 Tottenham, with a population then of 144,000, lost much of its autonomy
and wide-spread recognition as a progressive Authority, by the transfer of its personal
and school health services to the County Council. The public health service was split
in two, resulting in policy frustration and local difficulties of communication and
co-operation with hospital and executive council services: with the new mental health,
welfare and children's departments: with education and youth employment services and
with many voluntary and national organisations operating locally. Further it created
specialisation and mixed loyalties where none previously existed, so that to-day the
majority of recruits to senior posts have had experience either in county or borough
administration and rarely the necessary overall experience of the whole range of public
health activities of local government.
With amalgamation, as from 31st March, 1965, of Tottenham, Hornsey and Wood Green
to form the London Borough of Haringey, the new Council will no longer have to conform
in part to a uniform pattern; but organise and develop all public health services
according to local need: co-operating with neighbouring boroughs as expediency demands.
During the past year solid progress has been made in the field of environmental
health: more particularly in control of infectious disease, raising standards of
housing, further action under the Clean Air Act, supervision of food supplies and
health education in food hygiene: a salutary reminder of the necessity for unremitting
vigilance arising from the recent outbreak of typhoid in Aberdeen. Much preparatory
work has been done under new legislation and surveys undertaken in relation to improvement
of existing dwellings, registration and control of houses in multiple occupation
and the new Shops and Offices Act.
As in the environmental health services so in the personal and school health
services the past year has been an extremely busy one. The shortage of health visitors,
midwives and ancillary medical staff often placing a heavy burden on those required to
meet the increasing public demand for the services provided. An encouraging feature,
however, has been the improvement in recruitment of dental officers.
The number of births was the highest since 1947 and demonstrated a continuing rise
in the birth rate starting in 1961. Over 80% of confinements in the area occurred in
hospital and a number of mothers had to be admitted under the Emergency Bed Service
which meant that these unbooked expectant mothers did not know to which hospital they
would be admitted until the last moment. It is to be hoped that the Ministry of
Health's proposal to rationalise the use of maternity beds by allocating catchment areas
to hospitals will do something to ease the situation, although the present and foreseeable
future need would seem to be in the provision of more beds.