[Report 1930] / Medical Officer of Health, Middlesex County Council.

  • Middlesex (England). County Council. n 99020326.
Date:
1930
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1930] / Medical Officer of Health, Middlesex County Council. Source: Wellcome Collection.

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    TO THE CHAIRMAN, ALDERMEN AND MEMBERS OF THE MIDDLESEX COUNTY COUNCIL. Sir, My Lord, Ladies and Gentlemen, I have the honour to present my Annual Report for the year 1930. This is the second of the “ survey ” reports which the Ministry of Health requires to be drawn up every five years. Accord¬ ingly, it will be found to be materially increased in size as compared with its predecessors of the past four years. From the point of view of public health the year 1930 will always remain memorable as the one in which the provisions of the Local Government Act, 1929, came into force, with the consequent transference to the County Council of the powers and duties of the late Guardians in respect of the provision of medical assistance for the necessitous. Whilst the Local Government Act contains many provisions affecting public health and of a far-reaching character, the vesting in the County Council of the responsibility for the control and management of the many large institutions and hospitals, initiated and developed by the late Boards of Guardians, stands out as the most prominent feature of the Act. During recent years public opinion has undergone a marked change with regard to the character of the provision for the treatment of the sick which it is considered should properly be made by the authorities responsible for the administration of the Poor Law. This change has been much more evident in some areas than in others, and in consequence different Boards of Guardians have interpreted their duties in different ways. This is reflected in the County of Middlesex, where it was found that the standard of service provided at the several transferred hospitals was far from uniform. During the nine months in which the County Council has been responsible for the management of the hospitals, &c., endeavour has been made gradually to create an equally efficient hospital service throughout the whole County. It is a matter for congratulation that so far as can be ascertained the change over in management of the hospitals and institutions has not been attended by any disorganisation but rather the reverse, and the work in these establishments has continued without hitch or interruption. In this connection I would venture to refer to the wholehearted manner in which the members of the committees of management of the various hospitals and institutions have accepted their very onerous responsibilities. The enormous demands on their time and energies, which the new duties have made upon them, have been met with sympathy and cheerfulness, and it is this spirit of helpfulness and enthusiasm which has contributed in no small degree to the success which has attended the County Council’s exercise of its new powers. The five years dealt with in this report have been marked by a very rapid development in many parts of Middlesex. This has been commented upon by local Medical Officers of Health, but, hitherto, no trustworthy statistics have been available. In April, 1931, the decennial census was taken, and the results of this enumeration of the population have been utilised in estimating the population in 1930. From the census returns it is clear that the County of Middlesex is the most rapidly growing area of its size in the Kingdom. Between 1921 and 1931 the population has increased by no less than 30-8 per cent., and from local knowledge it is evident that the greatest growth has taken place during the later years of this decade, and is continuing at the present time. These facts in themselves indicate the difficult character of the problem of providing efficient social services which the County Council of Middlesex has to face. Even if no improvement or advance in any service were required, to maintain the proportion of accommodation in institutions, hospitals, sanatoria, schools, &c., to population which was available ten years ago, would require an increase of nearly 40 per cent, on the provision available at that time. When to this factor must be added the evergrowing tendency of the public to make use of services provided by local authorities, it is evident that large expenditure (both in respect of capital and maintenance) in this County is inevitable. As a whole the vital statistics for the year 1930 are satisfactory, and indicate the continued healthiness of the population in Middlesex. The general death-rate, the infantile mortality-rate and the death-rate from tuberculosis are all the lowest recorded, whilst the birth-rate, although slightly lower than that for 1929, in view of the correction of population resulting from the census, may be regarded as stationary. There is one disquieting feature revealed by the year’s statistics, however, and this is the alarming increase in the rate of maternal mortality, which this year has reached the figure of 4*15 per 1,000 births. It is especially to be regretted that more than half the deaths are recorded as due to puerperal sepsis, and it is to be hoped that this experience may not be repeated in future years. I am indebted to the County Solicitor for an interesting memorandum on the County Council’s Bill for conferring upon the Middlesex County Council powers as a main sewerage authority in so far as the western area of the County is concerned. No apology is needed for setting this out at some length, for the problem of providing for the efficient disposal of sewage at a minimum number of
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