WES 51 AC 4344 CITY OF WESTMINSTER REPORT of the MEDICAL OFFICER OF HEALTH for the year 1941 ANDREW J. SHINNIE, M.D., D.P.H., (Lond.) Medical Officer of Health and Administrative Tuberculosis Officer. CITY OF WESTMINSTER INTERIM REPORT OF THE MEDICAL OFFICER OF HEALTH for the year 1941 Mr. Mayor, My Lords, Ladies and Gentlemen, I beg to submit an abridged report of the health and sanitary conditions of the City of Westminster. The report consists of statistical data largely relating to the activities of the various health services in abbreviated form as prescribed by the Ministry of Health for war time reports. The health of the City remained satisfactory in spite of the extremely disturbing circumstances during part of the year. Although statistics, based on a population more mobile than in peace time, are bound to be misleading, it is an encouraging fact that the incidence of infectious disease was considerably less than in 1940. Immunization against diphtheria was actively pursued. In addition to the well established facilities at the Child Welfare Centres, whereby both children under 5 years and those of school age receive protective inoculations, a considerable number of children, especially those from other districts, were inoculated by the medical officers attending public shelters. The total of children immunized in 1941 was 723. The shelter and medical nursing services continued in full operation during black-out periods throughout the year as did the regular night inspections by the Sanitary Inspectors. These preventive services contributed greatly to the good standard of health and cleanliness of those using the shelters. Severe air raids were experienced during the first half of 1941, resulting in a considerable number of casualties and damage to premises. The First Aid services again proved themselves equal to their task and tribute is due to all branches for their courage and efficiency in most difficult and dangerous conditions. There is no doubt that many lives were saved by efficient first aid and speedy removal to hospital where skilled surgical treatment was given them. As regards fatal casualties, no praise can be too high for the services which the staff of the Public Health Department voluntarily carried out at the war time mortuary. As it was known that typhus fever had become prevalent in Eastern Europe, special measures, in conjunction with adjoining boroughs, were organized in order to combat the infection should it make an appearance in this country. Fortunately there was no occasion to put the scheme into operation. Food and Food Premises Co-operation was maintained with the officers of the Ministry of Food in dealing with the many war time problems relating to food. These included investigation of products, mostly beverages, purporting to contain the essential ingredients of fruit. The sampling of staple food-stuffs continued. Analysis showed a lower proportion of adulteration. Food salvage, resulting from bomb damage, was carried out in conjunction with the Ministry of Food. As a result of the careful work of the Food Inspectors it transpired that 60 per cent of food removed from damaged food premises remained fit for human consumption, or by processing could be retained for animal food. Only 40 per cent was condemned for destruction. - 2 - Maternity and Child Welfare The work of the Centres continued to expand as the demand for this service steadily increased. Arrangements for the confinements of expectant mothers in London and at the Maternity Hospital -it Ripls (under the aegis of Westminster Hospital) worked regularly and smoothly. The supplement to diet, such as cod liver oil and fruit juices, and the issue of National Milk, have of course imposed much additional clerical work on the Health Visitors whose time for visiting is thus curtailed. war Time Day Nursery In view of the policy of the Ministers of Health and Labour to enable mothers of young children to undertake war work, the City Council decided to submit proposals to the Ministry of Health for opening a war time nursery at No. 1. Bessborough Street, in the premises formerly occupied by the City of Westminster Day Nursery Association, a voluntary Day Nursery which had moved to the country in September, 1939. The war has brought far closer co-operation between the medical practitioners of Westminster and the health department than could ever have been achieved in peace time. Some of the doctors hav been serving at First Aid Posts, some in shelters or other spheres of the public service. This has engendered among them a stronger spirit of comradeship ana mutual help which is of inestimable value now and will prove of still greater value after the war. The meetings of the local Medical War Committee (composed of doctors practising or residing in Westminster and Holborn) takes place in the office of the Medical Officer of Health and gives unique opportunities for consultation on matters affecting the health of the community. It may be that this most useful war time expedient might be transformed into a permanent advisory Committee of local medical practitioners after the war. At the close of another year of war, I would like to express my appreciation and gratitude to all members of my staff for their devotion to duty and this expression extends to all Civil Defence personnel working under the control of the Medical Officer of Health. % I have the honour to be Your obedient Servant, ANDREW J. SHINNIE. 21st December, 1942. - 3 - STATISTICS AND SOCIAL CONDITIONS Area (acres): 2,502.7. Population (Census 1931) 129,579 Population, 1941, (Registrar General's estimate) 63,350 Number of inhabited houses (Census 1931) 22536 Rateable value, March 1942 £10,110,000 (estimate) BIRTHS For calculation of Birth Rate For calculation of Infant and Maternal Mortality Rates Live Births Total Males Females Live Births Total Males 'emales Legitimate 532 254 278 Legitimate 389 192 197 Illegitimate 111 51 60 Illegitimate 105 49 56 643 305 338 494 241 253 Births_ Notified 141. Birth rate per 1,000 of the estimated resident population: 10.1 (Rate for London: 8.9; for England & Wales; 14.2) Number of Stillbirths 23 Rate of Stillbirths per 1,000 total (live & still) births 44.4 DEATHS Net deaths 1357 (males 738, females 619) Death rate per 1,000 of the estimated resident population:- 21.4 (Rate for London: 16.3; for England & Wales: 12.9) Deaths from puerperal causes 2 (4.0 per 1000 births) Deaths of infants under 1 year 37 (males l8; females 19) Death rate of infants under 1 year:- All infants per 1,000 live births 74.8 Legitimate infants per 1,000 legitimate live births 82.2 Illegitimate infants per 1,000 illegitimate live births 47.6 Rate for London 68 Deaths from measles (all ages) 1 " " whooping cough (all ages) 3 " " diarrhoea (under 2 years) 4 „ „ cancer 180 INFANT MORTALITY - Causes of Death: Total Legitimate Illegitimate Injury Birth 1 1 — Diarrhoea & Enteritis Congenital malformation 4 4 " Prematurity etc 15 10 5 Respiratory diseases 1 1 — Broncho-pneumonia 2 2 — Accident 2 2 — Syphilis 1 1 — Bronchitis 2 2 — Other violent causes 4 4 — Whooping Cough 3 3 — Pneumonia 2 2 - 37 32 5 Couses of Death (at all ages) Males Females Total Influenza 5 4 9 Meningitis & Convulsions - 1 1 Cerebro Spinal Meningitis — 5 5 Diarrhoea & Enteritis 2 3 5 Septic diseases 6 10 16 Syphilis 5 2 7 Diabetes 5 4 9 Tuberculosis of Lungs 52 12 64 Non-pulmonary Tuberculosis 4 1 5 Malignant growths 87 93 180 Congenital debility) 8 Malformation etc.) 9 17 Old Age 6 11 17 Locomotor ataxia & general paralysis 2 1 3 Diseases of nervous system. 4 5 9 Circulatory diseases 169 186 355 Bronchitis 45 20 65 Broncho-pneumonia 24 23 47 Pneumonia 13 3 16 Respiratory diseases 4 5 9 Alcoholism 7 1 8 Cirrhosis of liver 1 1 2 Appendicitis - 2 2 Digestive diseases 30 12 42 Bright's disease 11 14 Cystitis 17 9 26 Accidents & negligence 35 15 50 Suicide & Murder 12 3 15 Other defined diseases 7 3 10 Ill defined diseases 1 3 4 Parturition — 2 2 Other violent causes 174 150 324 Measles — 1 1 Whooping cough - 3 3 Diphtheria - 3 —7 Erysipelas 1 - 1 738 619 1357 INFECTIOUS DISEASE. Notifications Removal to Hospital Deaths Polio-myelitis 1 1 - Encephalitis Lethargica 1 - - Diphtheria 31 31 3 Erysipelas 26 19 1 Scarlet Fever 42 42 - Enteric Fever 2 2 — Puerperal Fever 2 2 — Puerperal Pyrexia 7 7 — Cerebro Spinal Meningitis. 24 24 5 Ophthalmia Neonatorum 5 5 — Measles 58 34 1 Pneumonia 14 9 16 Dysentery 5 4 — Whooping cough 66 38 3 Relapsing Fever 2 2 — Malaria 1 1 — . Non-notifiable diseases - removed to hospital:- German Measles 2 cases Chickenpox 10 " Mumps 7 " VACCINATION Persons vaccinated by Public Vaccinators: Primary 109 Secondary 5 - 5 - BACTERIQLOGIGAL EXMANIATIONS Diphtheria - negative 78, positive 6 Tuberculosis - negative 109, positive 45 TUBERCULOSIS Pulmonary; 153 new cases, including 8 transfer's and 14 non-notified deaths. Non-pulmonary: 12 new cases, including 1 transfer, 2 non-notified deaths and 1 posthumous notification. (1940 - Pulmonary: 154 new cases. Hon-pulmonary 26 new cases) New Cases and Deaths Age Periods Mew Cases Deaths Pulmonary Non-pulmonary Pulmonary Non-pulmonary M F M F M F M F Under 1 year - - - - - - - - 1 to 5 years 2 - — 1 — — 1 1 5 „ 10 „ - - 1 — I - — — 10 „ 15 „ 1 — — 1 - — — 15 „ „ 6 5 1 — 2 1 2 - 20 „ „ 5 16 1 1 1 2 — — 25 „ 3 16 14 2 — 4 4 - - 35 " 45 25 5 2 - 4 4 - - 45 55 30 4 - - 15 1 - - 55 „ 65 18 1 - — 17 - - - 65 & upwards 4 1 1 1 8 — 1 - Totals 107 46 8 4 52 12 4 1 Deaths from Tuberculosis:- Pulmonary 64.; Non-pulmonary 5; Death rate per 1,000- 1.08 WORK OF TUBERCULOSIS DISPENSARY, 1941 The work of the Dispensary continued throughout the year on normal lines, and the facilities for treatment of patients remained as in time of peace. The numbers attending showed some increase on the late months of 1939, but the number of new cases was still much below the normal. As air raids occurred throughout the first half of the year, . the number of patients available, especially of children, was still low. The Dispensary figures do not reflect the increase in Tuberculosis which was becoming manifest throughout the country, owing to the effect of war-time conditions on the population of Westminster. There was reason to suspect, however, that the proportion of new cases of acute type was showing some increase. The number of new patients attending in 1941 was 194, as compared with 374 in 1938. 73 cases were considered to be definite cases of Tuberculosis, 65 pulmonary and 8 non-pulmonary. The total of new cases, who were children, was only 14, suggesting that evacuation figures were still high. 3 of these children were considered te ba suffering from Tuberculosis. 124 X-ray examinations were arranged during the year. In addition X-ray reports from hospitals and sanatoria were available in many cases. AUTERNITY AND CHILD WELFARE The welfare scheme during 1941 was as set out in the Report for 1938. Midwifery and consultant services were maintained, but classes in mothercraft etc., had to be somewhat curtailed. Midwifery visits 211 (2691); Confinements attended 17 (150) - 6 - VISITS BY HEALTH VISITORS To expectant mothers 1500 " children under 1 2081 " " between 1 and 5 3105 ANTE AND POST-NATAL CLINICS A.N. P.N. No. of women attending 1069 118 INFANT CLINICS Attendances 995 MILL SUPPLIES TO EXPECTANT MOTHERS Dried 2410 lbs. HOME NURSING Number of cases attended during year 1193 HOME HELPS Supplied in 3 cases. Cost £4. 10. 0d. DENTAL TREATMENT - Clinic Reports New Cases Re Appointments Extractions Fillings Other Operations Anaesthetic Local uaier 1940 217 826 816 221 418 18 176 1941 84 305 361 3.52 197 8 72 DIPHTHERIA - IMMUNISATION TREATMENT aND SCHICK TESTING Immunisation At Clinics At Public Air Raid Shelters Total New cases completed 246 622 376 " " not completed Evacuated Refused 3) 92 101 111 in hospital 1) 255 468 723 Schick Testing 1941 cases retested All negative 7 Earlier c: ses retested 35 L.C.C. School Children (treated at school) Negative 45 Positive 10 97 SANITARY CIRCUMSTANCES. For particulars of general services, see previous reports. drainage and sanitary WORKS Plans submitted 71 Combined Drainage Orders made 1 7 ~~ DISTRICT SANITARY INSPECTION Inspections of Dwelling Houses 1916 „ „ other {premises 2073 „ „ sanitary works 422 NUISANCES * Intimation Notices served 122 Statutory „ „ 4 WATER SUPPLY Metropolitan Water Board notices of withdrawal 6 Deep Wells. No. of examinations made 67 SHOPS ACT. 1934 Shops inspected 1319 Inspections made 1478 Notices served 6 FACTORIES AND WORKPLACES 18 defects under the Public Health Acts were found. All were remedied without legal proceedings. Visits to Outworkers' premises other than factories 106 Workrooms measured 12 Visits of enquiry re employment of women IT Outworkers 79 NUISANCE FROM PIGEONS Complaints: 23. Pigeons destroyed: 1455 PHYSICALLY INCAPACITATED PERSONS REMOVED TO INSTITUTIONS The Statutory Powers to effect removal did not require to be brought into operation. DISINFECTION Rooms: 294. Articles:. 18,039' Articles washed: 5,800. Articles destroyed: 36. Books disinfected: 224. Vehicles: 12. Business premises CLEANSING- OF PERSONS - (Head Lice, Body Lice, Scabies). Children: 232. Adults: 629. Total: 86l. CLEANSING OF REFUGEES Refugees cleansed 167 Articles of clothing 1712 ERAPICATION OF BED BUGS Premises found to be infested - Council flats - 12 Other houses - 32. All premises disinfected. TREATMENT OF BEDDING FROM CASUALTY DEPOTS. REPORT CENTRES, etc. Articles of bedding, etc., disinfected 10,361. INSPECTION AND SUPERVISION OF FOOD Samples purchased for analysis 1813 Visits to premises 2104 Notices served 6 Samples found to be adulterated 75 Prosecutions 26 Convictions 16 Fines: £35. 0. 0d. Costs: £55- 13. 0d. - 8 - AIR RAID 'SHELTERS (Public and Communal Domestic). Number of visits 4,128. ICE CREAM PREMISES Premises on Register at 31st December, 1941 182 Premises registered during the year PRESERVED MEAT etc. PREMISES. Premises on Register at 31st December, 1941 124 Premises registered during the year MILK (SPECIAL DESIGNATIONS) ORDER. 1936 & 1938 Licences issued 51 REGISTRATION OF DAIRYMEN '& DAIRIES Premises Persons On Register at 31st December 1941 169 259 Registered during the year 3 1 Inspections made 1 - Notices served — — CORONER'S COURT & MORTUARY Bodies received 289 Causes of Deaths- Drowning 1 Street accidents 13 Other accidents 52 Murder 2 Suicide 55 Natural causes 162 Misadventure 4 miscellaneous causes 20 Inquests held 136 Post-mortem examinations 243