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effective prevention has yet been found, the incidence of infectious diseases
during 1957 can be regarded with satisfaction. Poliomyelitis cases fell to
four. There is little doubt that the vaccination scheme is beginning to have
some influence on the effects of this disabling affliction. There were no
deaths from any of the notifiable infectious diseases.
The Food Hygiene Regulations have added appreciably to the effective
control over the conditions under which food is prepared, stored and sold
and inspection and supervision of food is claiming an increasing share of
the time of the public health staff. An outbreak of food poisoning did
occur during the year in a large institution as they do from time to time,
but it should be observed that all the evidence pointed to the infection
having been conveyed by canned meat imported from abroad and there was
nothing to suggest any breach of hygienic practice in this country.
The relief of overcrowding remains disappointingly slow. Progress is
certainly being made and the number of such cases is falling steadily, but
there is still a disturbingly high number of families who, whilst not legally
overcrowded, are in dire need of adequate accommodation. Unfortunately
in the present state of inadequate new construction, their claims have to
compete with those living in unfit premises for whom rehousing is equally
urgent.
Public health is undoubtedly influenced to a considerable degree by
the services provided by local authorities which include those devoted to
sanitation and environmental hygiene and the personal health services such
as maternal and child welfare and school health. The present review of
local government organisation can therefore have a big effect for better or
worse on the contribution which the local authority services make to the
general well-being. So much of this work is of a personal and human nature
that if economy of administration proves to be the criterion by which the
future pattern is determined, there will be a grave risk to efficiency. The
administration of the services established under Part III of the National
Health Service Act, suffer at present from inadequate provision for the
utilization of local interest and knowledge and there is need for increased
participation in the local direction of these services by locally elected
representatives who have a close and detailed knowledge of local needs and
an informed opinion as to what measures are likely to be effective with the
people they represent. The crux of this question is what constitutes the
optimum unit of administration. This has to reconcile two conflicting
considerations; it must be large enough to work economically and small
enough to maintain effective local interest and close contact with the public.
In a health service the latter is the more important.
My thanks to the staff of the department are again rendered for their
willing and effective assistance.
I am, Mr. Chairman, Ladies and Gentlemen,
Your obedient Servant,
F. LAWRENCE SMITH,
Medical Officer of Health.
July, 1958.
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