View report page

6
HEALTH DEPARTMENT,
MUNICIPAL OFFICES,
380 OLD STREET, E.C.1.
Telephone: 01-985 3351
To His Worship The Mayor, and to the Aldermen
and Councillors of the London Borough of Hackney
Mr. Mayor, Ladies and Gentlemen,
I have the honour to present to you my Annual Report for 1968 on the
health of the Borough.
There was some improvement in the staff position in certain sections of
the Department during the year. Recruitment of public health inspectors and
health visitors did something to alleviate the previous shortage, but particularly
encouraging was the improvement in the recruitment of pupil public health
inspectors and student health visitors. However, the recruitment of nursery
nurses and student nursery nurses now gives cause for real concern. The number
of vacancies for all types of nursery staff at the end of the year was 22 in
an establishment of 100. It is obvious that this shortage of staff does much
to militate against the full effective and efficient running of the nurseries.
Although the staff in this Borough are paid the proper Whitley Council rate
for this type of work, the salary offered for all the positions is abysmally
small and it says much for the staff we have that they are prepared to do
arduous work for long hours for the remuneration they receive. This is particularly
so in London where other more remunerative and less arduous employment
is readily available, but it is probably true to say that nowhere is the work
more necessary than in the East End areas of London. I feel much could be said
for special inducements for this type of work in Inner London.
The birth rate continued to decline but it still remained well above the
rate for England and Wales and for Greater London in general. There has been
a significant rise in the rate for illegitimate births from 15.7 to 17.3 per
hundred live births compared with a slight rise for Greater London from 11.4
to 11.5 per hundred live births. The infant mortality rate which showed a
reduction in 1967 unfortunately rose in 1968 to slightly above its previous
level. An analysis of the cases shows that most of the deaths were due to
congenital abnormalities, birth injuries or perinatal causes. This would
seem to indicate that infection as a cause of death in very young children
has now been largely eliminated, leaving a hard core of deaths associated
with pre-natal conditions and conditions arising at or just after birth. It
might well be that prevention of these deaths will prove very difficult to
deal with and the only method will be continued improvement in ante-natal care
and early recognition of conditions that would make labour difficult. The
decline in the birth rate combined with the fact that maternity beds are in
good supply in Hackney has caused a further falling off in ante-natal clinic
attendances and in the demand for domiciliary midwifery services. The reason
for most domiciliary confinements is because the mother wishes to remain
home for a variety of circumstances rather than because there is no hospital
bed available. Because of this negotiations have taken place to unite the
two domiciliary midwifery services acting in the Borough, that is the direct
services of the Borough Council midwives and the services of domiciliary
midwives operating from the Mothers' Hospital.
The Health Services and Public Health Act, 1968, came into force towards
the end of the year. Details may be found in the body of the Report, but as
far as the Health Department was concerned perhaps the biggest impact was in
respect of the amendment to the Nurseries and Child-Minders Regulation Act,
1948. It is well known that a great deal of unofficial child-minding was
carried out and is still carried out in this Borough. Unfortunately, even
where this could be ascertained there were many loopholes in the 1948 Act
which prevented any action being taken. With the implementation of the new