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Public Health Department,
92, Bath Road,
Hounslow.
To the Mayor, Aldermen and Councillors of the Borough of Heston and Isleworth.
Ladies and Gentlemen,
I have the honour to present my Annual Report on the health, vital statistics
and sanitary circumstances of the Borough for the year 1963. Having completed 25 years
as your Medical Officer of Health. I have taken the liberty on this occasion of a
backward look and of hazarding a glance to the future. As Area Medical Officer. I have
continued to have responsibility for the health services transferred from the Borough
to the County Council by the Education Act 1944 and the National Health Service Act,
1946, and now to be returned under the London Government Act, 1963 and so I have included
some notes on these services, as they have operated in the Borough.
For some time now the population of the Borough has shown only minor fluctuations
near the 100,000 mark. While the total shows little change there has been considerable
alteration in the age distribution. At the 1921 census the proportion of the population
aged 65 years and over was 6 per cent, but by the 1961 census this proportion had risen
to 12 per cent and the indications are that it will continue to rise for some years.
This increasing proportion of elderly persons in the population brings with it medical
and social problems of some magnitude. The work of the late Dr. Marjorie Warren (West
Middlesex Hospital), Drs. Anderson and Cowan (Rutherglen local authority/hospital clinic),
Dr. Maddison (Teddington local authority clinic) and others has shown that health impairment
in elderly persons can be postponed. Surveys have shown that only too often
the aged accept deterioration as inevitable and that there is much more ill health
among them than their visits to or by doctors would indicate. Men and women today can
anticipate some 10-15 years of retirement. Some preparation for this and some type of
health supervision are necessary if these years are to be reasonably happy and fulfilling.
Health in elderly persons is closely linked with their social conditions and because of
this some controversy arises as to whether the general practitioner of the local health
authority should accept responsibility for their general care. Medical treatment must
be a matter for the general practitioner, but local health authorities might consider
providing clinics where general advice on diet exercise, hobbies social services, etc.
could be given. Such clinics, like infant welfare clinics, should be so distributed as
to be within reasonable reach of the majority of the population, and should work in close
association with the general practitioners and local voluntary organisations.
The rise in the birth rate during the later war and immediate post war years was
not maintained and the rate reached its lowest level in the Borough records in 1955. In
recent years the rate has shown a steady rise again and this seams to be linked with a
lowering of the average age at marriage. Of live births the percentage illegitimate has
risen from 4.2 in 1939-43 (war years) to 5.4 in 1959-63. This is a matter of some concern
especially in relation to the youth of some of the mothers.
The still birth rate has fallen from 22.1 per 1,000 total births in 1939-43 to
16.0 in 1959-63.

In other words the reduction in infant mortality has been brought about largely by the
elimination of infections and efforts must now be concentrated on the problem of prematurity
and congenital defects. There has also been a change in the age distribution
of infant deaths. Of the total infant deaths. 38 per cent occurred in children under
the age of one week in 1939-43 as compared with 67 per cent in 1959-63. The same factors
are probably in operation in causing still births and early infant deaths, and this can
be expressed collectively in the peri natal mortality rate (stillbirths and deaths under
one week per 1,000 total live and stillbirths). For 1939-43 this rate was 49.8 but fell
to 27.9 in 1959-63 The recent report of the British Perinatal Mortality Survey has
shown that further improvement is possible and has indicated some of the lines on which
action could be taken.
The Borough death rate has always been below the National level. The lowest
recorded was in 1955 but since then there has been a slow but steady increase.
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