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STATES OF GUERNSEY BOARD OF HEALTH WORKING TOWARDS A BETTER HEALTHIER WAY OF LIFE 95th ANNUAL REPORT of the Medical Officer of Health REPORT FOR THE YEAR 1993 : BOARD OF HEALTH MEMBERS 1993 President: Conseiller R M Chilcott Vice President: Deputy Mrs S M Plant Senior Member: Deputy R L Le Poidevin Other Members: Deputy O D Le Tissier Deputy AAJ Bran Deputy B Russell Mr G V F Birch o . tir ha ark b< ‘ 4 8 bed Vite eee Ree eS, renkiMek vaei i (8 abe ae Huh sna beA l auc te fame, SC eke ee mk at ala rte tg ’ m , 7 ; ~ a ay flasit.a? tt C)iphy saet wals’ er = ad tA Vihar aire el Uh ey ts oe 7 Vv a, }t ii / : a eee i ot oe ae ‘ae BOARD OF HEALTH Objectives To maintain and improve the health of the people of Guernsey and Alderney as cost effectively as possible: * Identifying health needs - now and in the future. Planning the future provision of health services to meet these needs. Ensuring that the quality of health services provided is high and standards are maintained through careful monitoring. Ensuring that only appropriate and effective care or treatment is given, by monitoring the outcome of such interventions. Informing people on health matters, promoting a healthy lifestyle and environment. Checking that all health services provided are as cost-efficient as possible. Promoting managerial and professional excellence within health services. Recruiting, traininagn d developing sufficient healthcare staff to achieve these objectives. arf to riled ert avagmi brie mi 1200 Bs << ne ish weldiezog- za evil adi.ni bas won - ebesn inet oF a faa ol esoViwe Attea 16 noigive i cast rut ong =39 aS Mp 3) DAbWetG beanies r1)'s an ty villeup ert arinchrom Ulewe Apuoid 1 bonisingeny ote : or‘ e Ore afangrat ggs ving:j enoinavistin ue to emnieaine act anivchiagiy ratioceritige leyG r. ‘CeO INTRODUCTORY LETTER TO THE BOARD OF HEALTH Madam President, Members of the Board This is the 95th Annual Report of the Medical Officer of Health for Guernsey. Unfortunately, Guernsey did not have a full-time Medical Officer of Health during 1993, and so compiling a Report to accurately and adequately reflect the health of the Island during this period has presented something of a challenge. After discussion with medical colleagues, and the support of senior members of the Department of Health, this challenge has been addressed in two ways. The Annual Report which I now have the honour to present has been compiled in the traditional format. Following a brief introduction, this Annual Report summarises the various public health activities and achievements of 1993. This is followed by the Annual Statistical Returns presented in the usual way, but with a brief commentary on each. Secondly and more importantly however, a companion volume to this Report entitled ““Health for Guernsey People” will be published in early 1995. This volume will take a far more strategic view of health in Guernsey. It will analyse the major causes of death and potential years of life lost amongst Guernsey residents, and compare these with other English speaking countries, and our neighbours in Europe. It will also highlight areas for potential further “health gain”’’. It will also identify those areas where more health information is required, if progress towards improved health is to be measured. This Annual Report therefore summarises public health activities during the recent past. Together with its companion volume “Health for Guernsey People’’, it should provide the factual basis required to assist the Board of Health towards its future objective: “To maintain and improve the health of the people of Guernsey and Alderney as cost effectively as possible.” I am indebted to my medical colleagues, and Board of Health officers and staff, both for providing high level public health services during 1993, and for their contribution to this present Report. Yours faithfully Dr David Jeffs MEDICAL OFFICER OF HEALTH Director of Public Health aa : ars? a, to. 293/TiO ig vb ninthu: t Poose yo it trie vis 1ey7u9oM Oo) oqo. B gniliqqim n. ‘Oe b ir boinsesrd esd bol aa ist bm, bastal pa nh mines Jo neqque ody bas .teggeclion Inorbaent sii ove cibhey (oad gee sgrotiests vii attlasit to tea : 5: vie <> 101 efi it +A 9") ry) ‘qonneat * cpt a fd | Wort ' dittes , 11a cul) auloubownn tend: a wird? (he Aeirtin Heel sibatey a Dim) ‘VilsG ined siti anoitey. gid a ; aa iGute i) i beinseewr annie (oie biiewA anes o (i; 1) TPS FMNGTTE TET ries ai TV 2irt) ol obverale MOA Twi Yavewionl vihituariys ‘iy ; of ‘W0 eT Shrw lenea"t SATU ERaO shire ings a. Mate VTP sft ' oy Tie! itive od rj e if 7 t¢ Koy taste fie Mn. le seine wien uF Fr > ‘ports 1 FTP 4p rt] Lele PRs Linh. wate eratef na! lee i ‘ae Th ty a} ere y iy? ny | Mee ae bd Wy bein - . ding eri y i eryb itss ol ' a “a? ¥e) MOET ye WiHMeel sinw “Sti vir PROut “Aen hoeerle a kg va ‘beatuachl te testa) § re ant * 7 a ' oii a (Dire sity ool wen i naib , i). 90! lost” stawiey Ba ru | J UMN pas eats | imran Miaa" A ps ty frre) Teh siyoury wal be colanie b sve ragertt Wy NLaarn wwe 4 yet TNO figs te Pingo. ine PS ay 28°) naeteb vooieter cifnesdt CONTENTS Members of the Board of Health 1993 Objectives of the Board of Health Introductory Letter Health in Guernsey - Challenges and Opportunities Introduction - Board of Health Objectives Importance of traditional approaches Need for improved health data “The New Public Health” Conclusions 1993: The year in retrospect Public health overview Establishment of Public Health Directorate Public health overview Public health funding Present Organisational Structure Environmental Health Environmental Health Introduction Food safety Control of the physical environment Health Promotion Unit Health Promotion Introduction Coronary heart disease Cancer prevention Alcohol and drugs Accident prevention AIDS and sexual health Family health Mental health Schools The Lifestyle Survey Staff training Resources Conclusion Infectious disease control Immunisation programmes Disease notifications Special Treatment Clinic Occupational Health Occupational Health Clinic Guernsey Breast Screening Programme Breast Cancer in Guernsey The need for Breast Screening The Guernsey Breast Screening Programme 1993 results Drug importation Advice to other States Departments Annual Statistical Returns - Commentary Population Growth Family Health Immunisation and Infectious Disease Causes of Mortality Premature deaths Appendix I Annual Statistical Returns Appendix II Staff providing public health services during 1993