BEX 007 1941 G. F. B R AM LEY. M.D.,D.P.H. MEDICAL OFFICER OF HEALTH. TELEPHON E, BEXLEYH EATH 2244-/5. BEX 7 Health Department 14 Bramton Road Bexleyheath, Kent . My Ref (please quote) Your Reff l6th June, 1942. ANNUAL REPORT OF THE MEDICAL OFFICER OP HEALTH FOR 1941. The report is again restricted in accordance with Ministry of (1) Health Circular 2604 of the 24th March, 1942. A summary of vital statistics is appends a from which it will be seen that the general health of the Borough has been maintained (2) at a high standard. The birth rate again shows a slight fall which is usual in war (3) time. The death rate is slightly raised eve pre-war years, but lower than in 1940. The infantile mortality rate is the lowest ever recorded in this Borough, and the reduction appears to be chiefly due to a reduction in the deaths under one month, that is in the neonatal mortality rate, which is usually taken as a reflection upon the antenatal care, and in this connection it is interesting to note that more mothers than ever attended the Corporation Antenatal Clinics where in fact 74% of the expectant mothers of the Borough were seen, and it is known that 96% of expectant mothers received antenatal medical care. These figures compare with approximately 45% and 67% in 1940. The large increase in the number of expectant mothers attending antenatal clinics necessitated holding additional sessions, and additional work upon your full-time Medical Officers which was not easily fitted in having regard to their additional war time duties in connection with Civil Defence etc., but it was not deemed an opportune time to come to the Council for an additional Medical Officer, especially in view of the shortage of doctors throughout the country. The Corporation Maternity Home has been fully occupied again and there has been greater responsibility on all members of the staff in view of the absence of beds in the London hospitals for abnormal cases. Accommodation at the Home was booked up six or seven months ahead and it will be an urgent post-war duty on the Council or other hospital authority to provide additional maternity institutional accommodation for this area. During the year there was a gradual change in outlook from one of passive defence to active production which led to the call of women to war work including women with young children. The Council therefore took the step of adopting the principle of providing war time day nurseries. I have no doubt that the Council as a Welfare Authority have taken on a furthen Borough of Bexley. Annual Report of the uedical Officer of Health for 1941, dated 16th June, 1942 ERRATUM. Please note that the figure in Para,6, Lino 7, should read 7,410 and not 7,011. The corporation ambulance service continues very actively, but more calls had to be transferred to outside ambulances owing to the Corporation ambulance being out when required. One of the Council's first duties after the war will be the provision of a second ambulance. G. F. BRAM LEY. M.D.,D.P.H. MEDICAL OFFICER OF HEALTH. TELEPHON E, BEXLEYH EATH 224.4-/5. BEX 7 Health Department 14 Bramton Road Bexleyheath, Kent . My Ref. (please quote) Your Ref 16th June, 1942. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1941. The report is again restricted in accordance with Ministry of (1) Health Circular 2604 of the 24th March, 1942. A summary of vital statistics appended from which it will be seen that the general health on the Borough has been maintained (2)at a high standard. The birth rate again shows a slight fall which is usual in war (3) time. The death rate is slightly raised over pre-war years, but lower than in 1940. The infantile mortality rate is the lowest ever recorded in this Borough, and the reduction appears to be chiefly due to a reduction in the deaths under one month, that is in the neonatal mortality rate, which is usually taken as a reflection upon the antenatal care, and in this connection it is interesting to note that more mothers than ever attended the Corporation Antenatal Clinics where in fact 74% of the expectant mothers of the Borough were seen, and it is known that 96% of expectant mothers received antenatal medical care. These figures compare with approximately 45% and 67% in 1940. The large increase in the number of expectant mothers attending antenatal clinics necessitated holding additional sessions, and additional work upon your full-time Medical Officers which was not easily fitted in having regard to their additional war time duties in connection with Civil Defence etc., but it was not deemed an opportune time to come to the Council for an additional Medical Officer, especially in view of the shortage of doctors throughout the country. The Corporation Maternity Home has been fully occupied again and there has been greater responsibility on all members of the Staff in view of the absence of beds in the London hospitals for abnormal cases. Accommodation at the Home was booked up six or seven months ahead and it will be an urgent post-war duty on the Council or other hospital authority to provide additional maternity institutional accommodation for this area. During the year there was a gradual change in outlook from one of passive defence to active production which led to the call of women to war work including women with young children. The Council therefore took the step of adopting the principle of providing war time day nurseries. I have no doubt that the Council as a Welfare Authority have taken on a further responsibility with regard to the care of children under the age of five which will be carried on in the years of peace. With regard to infectious disease, measles in numbers led the field, but the epidemic was of a mild character; whooping cough was also prevalent and the most fatal of the infectious diseases. There were no deaths from diphtheria but the immunisation campaign went forward well chiefly due in my opinion to the interest taken in this matter by the Ministry of Health and their wireless propaganda. By the end of the year 7,011 children had been immunised since the commencement of the scheme and not one of these has developed diphtheria. The Corporation ambulance service continues very actively, but more calls had to be transferred to outside ambulances owing to the Corporation ambulance being out when required. One of the Council's first duties after the war will be the provision of a second ambulance. -2- The waiting list for dental treatment for nursing and expectant mothers and children under the age of five steadily increased until it became necessary to do less conservative treatment and arrange for more extractions. With the return of dental surgeons to civil life from the Services after the war it will be possible and necessary to increase the number of dental sessions. During the year terminal disinfection after cases of infectious diseases such as scarlet fever and diphtheria was discontinued, and the opportunity is taken here of stating ,for the purpose of reassuring any who may have looked upon this as a step likely to increase the incidence of infectious disease, that the'number of cases of these diseases, as will be seen in the summary of vital statistics, has continued at a very low figure. During the year the Council considered reports on scabies and the head and body louse, and made arrangements for the full use of the Disinfecting Station. The work of the Sanitary section of the department has also been increased with new types of responsibility in view of the changing conditions of the war and mode of living. The water supply despite temporary dislocations due to war damage in the early part of the year has been maintained and a pure and wholesome water has been available bontinously. The collection of house refuse fell very much in arrear due to the shortage of labour, but with the institution, of the system of street bins for twice weekly collection of waste food for pig feeding, the household dustbin despite the fact that it has not been emptied for periods up to three weeks should no longer be a source of nuisance even without its lid, I have to record my indebtedness to the Council, other departments, and every member of the Health Department for the full assistance which they gave me throughout a very busy year. GEO. F. BRAMLEY, M.D. , Ch.B. , D.P.H. , Medical Officer of Health. BEX 7 SUMMARY OP VITAL STATISTICS,1941. Sngland and Wales. 126 C.Bs and Great Towns including London. 48 Smaller Toms (Resident Populations 25,000 - 50,000 at 1931 Census) London Adminstrative County. Borough of Bexley. Births - Live *Rates per 1,000 Civilian Population. 14.2 14.7 16.4 8.9 15.88 Still 0.51 0.58 0.60 0.33 0.48 Deaths - All Causes Typhoid and Paratyphoid 12.9 14.9 13.0 16.3 9.68 Fevers 0.00 0.00 0.00 0.01 0.00 Scarlet Fever 0.00 0.00 0.01 0.00 0.00 Whooping Cough 0.06 0.07 0.o6 0.04 0.04 Diphtheria 0.07 0.08 0.06 0.03 0.00 Influenza 0.19 0.17 0.20 0.15 0.01 Smallpox - — — - - Measles 0.03 0.03 0.03 0.02 0.01 Notifications Typhoid Fever 0.03 0.02 0.03 0.04 0.03 Paratyphoid Fever 0.09 0.12 0.09 0.05 Cerebro Spinal Fever 0.25 0.31 0. 20 0.30 0.07 Scarlet Fever 1.147 1.49 1.51 1. 01 1.07 Whooping Cough 4.39 4.37 4.50 3.50 5.47 Diphtheria 1.25 1.53 1.19 0.93 0.21 Erysipelas 0.30 0.36 0. 27 0.50 0.21 Smallpox - — — - — Measles 10.33 8.27 10.47 4.77 15.47 Pneumonia 1.25 1.53 1.04 1.07 0.55 Rates per 1,000 Live Births. Deaths under one year of age 59 71 56 68 35.4 Deaths from Diarrhoea & Enteritis under two years of age 5.1 7.5 4.6 6.8 0.96 Rates per 1,000 Total Births (i .e . Live and Still) Maternal Mortality Puerperal Infection (No. 14+7) 0.48 Not available 0.93 Others 1.75 1.86 Total 2.23 2.79 Notifications Puerperal Fever 11.91 15.64 9.43 2.29 13.56 Fever. Puerperal Pyrexia 19.3 includiNG Puerperal * A dash (-) signifies that there were no deaths.