II BAR 3 THE HEALTH AND WELFARE OF THE LONDON BOROUGH OF BARNET 1969 MELVILLE WATKINS, M.R.C.S., L.R.C.P., D.P.H. THE LONDON BOROUGH OF BARNET ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH AND PRINCIPAL SCHOOL MEDICAL OFFICER FOR THE YEAR 1969 MELVILLE WATKINS. M.R.C.S.. L.R.C.P.. D.P.H. Health and Welfare Department, Gateway House, 322 Regents Park Road, Finchley, N.3. To the Mayor, Aldermen and Councillors of the Council of the London Borough of Barnet. Mr. Mayor, Ladies and Gentlemen, It is with pleasure that I present my report on the Health and Welfare services of the Borough for the year 1969. The year under review saw headway in the development of most services and though economic circumstances continued to have a limiting effect very real progress was still possible. Each year brings new legislation. During 1969, the Housing Act 1969 became operative in August. The basic principles of the Act provide for the conversion of controlled tenancies into regulated tenancies subject to the dwelling concerned providing all the standard amenities necessary. The work involved in operating this Act is quite considerable both from the Public Health Inspectorate and the Administrative points of view. It becomes abundantly apparent that the Council will have to give consideration to a revision of establishments where officers will be involved in the work connected with the Act. The problem of homelessness still remains one of major importance and as indicated in my report for 1968 the need for additional units of accommodation became an urgent necessity. Fortunately progress was possible in regard to the purchase of houses strategically placed throughout the Borough. The need to provide for additional units for a number of years seems to be inevitable. As referred to in my report for 1968, the Council's proposals for family planning, namely that of a comprehensive service, were fully implemented in August. In my report for next year, I shall be able to comment more specifically in regard to the progress made. The Special Investigation Clinic, which was established at Vale Drive Clinic in 1967, continues to develop and expand to meet the ever-increasing demands. The majority of referrals are as previously for severe nocturnal enuresis and total attendances at the Clinic increased by nearly one-third over the 1968 figures. 1969 saw the completion of the attachment of all nursing staff to general practitioners and meetings held with the general practitioners confirmed the value of these nursing services attachments. With the introduction of the Health Services and Public Health Act 1968 and especially insofar as this Act revised the Nurseries and Child Minders Regulation Act 1 1948, the Department was involved in an increasing amount of work insofar as the visiting a5nd reporting on cases was concerned and for subsequent registration. This, inter alia, gave rise to the Council approving of an additional post of Assistant Nursing Officer. In 1969 considerable steps were taken to effect the closure of Redhill House and, by co-operation of the Hospital Services, it was possible to close the Sick Bay and to generally reduce the number of residents by effecting transfers to vacancies as they arose in other Council Homes. The training of Local Authority staff proceeded at an increased level and through the medium of the Barnet College of Further Education a new course was started for Home Helps. This College also commenced a course of training for potential play group supervisors, due to an increasing number of play groups being established in various parts of the Borough. It will be seen from the table on Page 18 that since 1964, when the total number of Live Births was 4,979, there has been a continuous downward trend and during the year under review the figure was 4,203 reflecting a corrected birth rate of 13.2 per 1,000 population; over the past four years, the illegitimate birth rate per cent of total Live Births has shown a corresponding reduction, i.e. 6.9% (1969), 7.5% (1968), 8.0% (1967) and 8.1% (1966). There was an increase in Stillbirths to 50 (45 in 1968) representing a rate of 11.8 (10.4 in 1968) per 1,000 Live and Still Births. The infant death rate per 1,000 Live and Still Births (including neonatal, early neonatal and perinatal deaths) shows considerable decreases; infant deaths 12.8 (16.3 in 1968), neonatal 8.6 (11.9 in 1968), early neonatal 7.4 (10.2 in 1968) and perinatal 19.0 (20.5 in 1968). There was also a decrease in deaths from all causes i.e. 3,664 compared with 3,732 in 1968; however, having regard to the variation in population and change in the area comparability factor, this in fact shows an increase in the corrected rate, i.e. 10.6 per 1,000 population (1968) to 10.8 for 1969. There was no serious outbreak of infectious disease during the year. As was the case in 1968, the staffing situation showed some improvement but in the administrative and clerical field a number of vacancies remained unfilled for a considerable period of time. For any Department to be successful, it must depend upon team work and personal involvement of individuals and it is therefore with extreme pleasure that I thank all members of the staff for the part that they have played. It would be remiss of me if I did not once again refer to the valuable services rendered by voluntary organisations and voluntary helpers for without such assistance the Local Authority services would not operate at the required level. 2 Finally, I would like to say that it is with deep sincerity that I record my appreciation of the support given to me by the Chairman, Vice-Chairman and Members of the Health and Welfare Committee. I also wish to acknowledge with gratitude the help and co-operation which my fellow Chief Officers and their staffs have so readily given. M. WATKINS Medical Officer of Health ■3 CONTENTS Page COMMITTEE MEMBERS, CHIEF AND SENIOR OFFICERS 7 VITAL STATISTICS 11 PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES 25 ENVIRONMENTAL HEALTH SERVICES 29 MENTAL HEALTH SERVICES 69 WELFARE SERVICES 79 PERSONAL HEALTH SERVICES 91 SCHOOL HEALTH SERVICES 113 GENERAL SERVICES 129 INDEX 1/n 5 HEALTH AND WELFARE COMMITTEE as at 31st December 1969 Councillor Mrs. R.A. Freedman (Chairman) Councillor H.R. Brooks (Vice-Chairman) COUNCILLORS: E.A.E. Asker, J.P., F.C.C.S., A.B.A.A. F.J . Collisson R.J. Finigan B.Sc., (Econ.) Mrs. B.M. Franklin V.H. Usher (Mayor) J.E. Park F.C.A. J.S. Payne Mrs. C. Riordan B.R. Stewart LL.M. Mrs. M.M. Symons Mrs. E.R. Gibson W.C. James G.H. Jobbins Mrs. Clara Thubrun, M.B.E., J.P. Co-opted Member: Dr. T.J. Carter, M.R.C.S., L.R.C.P. 7 STAFF OF THE HEALTH AND WELFARE DEPARTMENT as at 31st December, 1969 M. Watkins, M.R.C.S., L.R.C.P., D. P.H. Medical Officer of Health G.C. Young, M.D., M.B., B.Ch., B.Sc., D.P.H., L.M.S.S.A. Deputy Medical Officer of Health R.C. Greenberg, M.B., B.S., D.P.H., D.M.J. (Clin.), Mem .Brit.Acad.Forensic Sc. Mary Watson, M.B., Ch.B. (Resigned 25.10.69) Joan M. Mulholland, M.B., Ch.B., D.P.H., D.C.H. (Appointed 1.12.69) Mary McQuaid, L.R.C.P., L.R.C.S., D.P.H. (Appointed 1.4.69) Principal Medical Officers Mary K. Astin, M.B., Ch.B., D.P.H. (Resigned 16.2.69) Joan M. Mulholland, M.B., Ch.B., D.P.H., D.C.H. (Appointed 1.4.69) Hannah Mushin, M.R.C.S., L.R.C.P., D.C.H. (Appointed 26.5.69) Gillian S. Simmons, M.B., Ch.B., M.R.C.S., L.R.C.P., D.R.C.O.G. (Appointed 19.5.69) Lysbeth R. Vaughan-Jones, L.R.C.P. (Appointed 1.12.69) Senior Assistant Medical Officers J.E. Wilson, D.C.M., B.Sc.(Econ.), A.A.P.S.W. Principal Welfare Officer Mrs. J.M.A.W. Foulkes, S.R.N., S.C.M., H.V. Principal Nursing Officer R.L. James, L.D.S., R.C.S. Principal Dental Officer Miss E. Johnston, S.R.N., S.C.M., Q.N., H.V. Health Education Officer and Home Safety Organiser C.H. Machin, A.M.R.S.H. Principal Administrative Assistant K.J. Millen, M.R.S.H., F.A.P.H.I. Principal Public Health Inspector W.J .A. Ward, M.S.M.W.O. Principal Mental Welfare Officer 8 STATISTICS STATISTICS Area (in acres) 22,124 Population — Registrar-General's Estimate Mid 1969 314,530 Number of Inhabited Dwellings, 1st April, 1969 Houses and flats 100,122 Other properties with living accommodation 747 Rateable Value at 1st April, 1969 £22,669,056 Product of penny rate 1969/70 £90,000 LIVE BIRTHS MALES FEMALES TOTAL Legitimate 2,023 1,892 3,915 Illegitimate 153 135 288 2,176 2,027 4,203 Illegitimate live births per cent, of total live births:- BARNET 6.9 ENGLAND AND WALES 8.4 RATE PER 1,000 POPULATION BARNET 13.4 AREA COMPARABILITY FACTOR 0.99 CORRECTED RATE 13.2 ENGLAND AND WALES (PROVISIONAL) 16.3 11 STILLBIRTHS MALES FEMALES TOTAL Legitimate 20 25 45 Illegitimate 2 3 5 22 28 50 Total live and stillbirths 2,198 2,055 4,253 RATE PER 1,000 LIVE AND STILLBIRTHS BARNET ENGLAND AND WALES (PROVISIONAL) Legitimate 11.4 12.9 Illegitimate 17.1 16.2 Total 11.8 13.2 INFANT DEATHS (under 1 year of age) MALES FEMALES TOTAL Legitimate 24 25 49 Illegitimate 4 1 5 28 26 54 NEO-NATAL DEATHS (under 4 weeks of age) MALES FEMALES TOTAL Legitimate 18 15 33 Illegitimate 2 j iigaii! 3 20 16 36 RATE PER 1,000 LIVE BIRTHS BARNET ENGLAND AND WALES (PROVISIONAL) Legitimate 8.4 11.6 Illegitimate 10.4 16.5 Total 8.6 12.0 EARLY NEO-NATAL DEATHS (under 1 week of age) MALES FEMALES TOTAL Legitimate 15 13 28 Illegitimate 2 1 3 17 14 31 RATE PER 1,000 LIVE BIRTHS BARNET ENGLAND AND WALES (PROVISIONAL) Legitimate 7.2 9.9 Illegitimate 10.4 14.4 Total 7.4 10.3 PERI-NATAL DEATHS (Stillbirths and Deaths under 1 week of age) MALES FEMALES TOTAL Legitimate 35 38 73 Illegitimate 4 4 8 39 42 81 RATE PER 1,000 LIVE AND STILLBIRTHS BARNET ENGLAND AND WALES (PROVISIONAL) Legitimate 18.4 22.7 Illegitimate 27.3 30.4 Total 19.0 23.4 MATERNAL MORTALITY RATES (including abortion) per 1,000 total live and stillbirths BARNET 0.2 ENGLAND AND WALES (PROVISIONAL) 0.2 DEATHS FROM ALL CAUSES MALES 1,768 FEMALES 1,896 TOTAL 3,664 RATE PER 1,000 POPULATION BARNET 11.6 AREA COMPARABILITY FACTOR 0.93 CORRECTED RATE 10.8 ENGLAND AND WALES (PROVISIONAL) 11.9 14 CAUSES OF, AND AGES AT, DEATH No. Cause of Death Total all ages Under 4 weeks 4 weeks and under 1 year Age in years 1 - 5 - 15 - 25 - 35 - 45 - 55 - 65 - 75 and over B4 Enteritis and other Diarrhoeal Diseases 4 3 — — — — — — — 1 — B5 Tuberculosis of Respiratory System 5 — _ — _ _ 2 _ _ 1 — B6 Other Tuberculosis, incl. Late Effects 1 — 1 B17 Syphilis and its sequelae 6 — — — — — — — — 1 5 _ B18 Other Infective and Parasitic Diseases 6 _ _ 1 _ _ 2 2 1 B19(l) Malignant Neoplasm, Buccal Cavity etc. 12 — — — — — — 5 1 1 5 B19(2) Malignant Neoplasm, Oesophagus 14 — — — — — — — 3 3 2 6 B19(3) Malignant Neoplasm, Stomach 81 — —— — — — 2 1 6 19 29 24 B19(4) Malignant Neoplasm, Intestine 93 — — — — — — 4 5 14 33 37 B19(5) Malignant Neoplasm, Larynx 3 — — — — — — — — — 1 2 B19(6) Malignant Neoplasm, Lung,Bronchus 196 — — — — — — 2 16 67 78 33 B19(7) Malignant Neoplasm, Breast 75 — — — — — 1 3 13 23 16 19 B19(8) Malignant Neoplasm, Uterus 15 — — — — — — — — 2 8 5 B19(9) Malignant Neoplasm, Prostate 25 — — — — — — — — 4 10 11 B19(10) Leukaemia 31 — — — —— 3 — 2 4 10 7 5 B19(11) Other Malignant Neoplasms 254 — — — — 5 3 13 18 73 74 68 B20 Benign and Unspecified Neoplasms 12 — — — 1 — — — 2 3 2 4 B21 Diabetes Mellitus 22 — — — — — — 2 — 3 7 10 B46(1) Other Endocrine etc. Diseases 9 — — — — — — — 1 2 1 5 B23 Anaemias 12 — — _ 1 — — — — 1 — 10 B46(2) Other Diseases of Blood, etc 2 — — 1 — — — — — — — 1 B46(1) Mental Disorders 8 — — — — — —— — — 1 1 6 B24 Meningitis 3 1 1 — 1 B4b(4) Other Diseases of Nervous System etc. 41 — 1 — 1 1 2 — 5 3 15 13 B26 Chronic Rheumatic Heart Disease 56 _ _ _ _ 1 — 2 5 8 14 26 B27 Hypertensive Disease 72 7 11 13 41 B28 Ischaemic Heart Disease 902 _ _ _ — — 1 6 40 173 280 402 B29 Other forms of Heart Disease 226 — — _ _ 1 — 2 1 13 38 171 B30 Cerebrovascular Disease 455 — — _ 1 1 — 4 14 48 106 281 B46(5) Other Diseases of Circulatory System 174 — — — — — — — 6 15 36 117 B31 Influenza 29 — — — 1 — — — 3 7 9 9 B32 Pneumonia 291 2 2 1 _ — 1 2 1 20 64 198 B33(1) Bronchitis and Emphysema 156 — — — — — — — 6 25 65 60 B33(2) Asthma 7 — — — — — 1 2 1 — 2 1 B46(6) Other Diseases of Respiratory System 41 — 7 1 — 1 — — 1 4 6 21 B34 Peptic Ulcer 28 3 2 8 15 B35 Appendicitis 6 — — — 1 — — — — 2 2 1 B36 Intestinal Obstruction and Hernia 17 — — — — — — — 1 1 4 11 B37 Cirrhosis of Liver 12 — — — — - - — 3 5 2 2 B46(7) Other Diseases of Digestive System 25 — — — — 1 - - 1 3 9 11 B38 Nephritis and Nephrosis 12 — — — — — — 1 2 5 2 2 B39 Hyperplasia of Prostate 3 — — — — — — — — — 1 2 B46(8) Other Diseases, Genito-Urinary System 29 — — — — — — — 2 2 3 22 B41 Other complications of Pregnancy, etc. 1 — — — — — — 1 — — — — B46(9) Diseases of Skin, Subcutaneous Tissue 2 — — — — — — — — — 1 1 B46(10) Diseases of Musculo-Skeletal System 13 — — — — — — 1 — 3 3 6 B42 Congenital Anomalies 15 5 1 3 — — — — 1 3 1 1 B43 Birth Injury, Difficult Labour, etc. 16 16 — — — — — — — — — — B44 Other Causes of Perinatal Mortality 12 11 1 — — — — — — — — — B45 Symptoms and 111 Defined Conditions 9 1 — — — — — — — 1 — 7 BE17 Motor Vehicle Accidents 41 _ — 1 2 6 5 3 6 6 5 7 BE48 All Other Accidents 44 — 1 — — 2 2 1 4 3 4 27 BE40 Suicide and Self-inflicted Injuries 33 — — — — 3 4 4 9 6 4 3 BE50 All Other External Causes 7 - 1 - - 1 1 — 1 1 — 2 TOTAL ALL CAUSES 3,664 36 18 8 8 26 25 56 198 599 976 1,714 15 BIRTH RATE (For the areas covered by the five constituent authorities) 16 INFANTILE MORTALITY RATE (For the areas covered by the five constituent authorities) 17 VITAL STATISTICS FOR THE PAST TWENTY YEARS (For the areas covered by the five constituent authorities) YEAR TOTAL LIVE BIRTHS BIRTH RATE (CRUDE) TOTAL INFANT DEATHS INFANTILE MORTALITY RATE 1950 4486 13.9 78 17.4 1951 4138 13.0 97 23.4 1952 4107 12.8 85 20.7 1953 4048 12.7 78 19.3 1954 4019 12.6 78 19.4 1955 4013 12.6 83 20.7 1956 4137 13.0 67 16.2 1957 4032 12.7 80 19.8 1958 4131 13.1 57 13.8 1959 4129 13.0 100 24.2 1960 4285 13.5 74 17.3 1961 4388 13.9 91 20.7 1962 4573 14.4 84 18.4 1963 4656 14.7 82 17.6 1964 4979 15.7 74 14.9 1965 4900 15.5 62 12.7 1966 4679 14.8 62 13.3 1967 4564 14.5 73 16.0 1968 4293 13.6 70 16.3 1969 4203 13.4 54 12.8 NUMBER OF DEATHS AND DEATH RATES FROM TUBERCULOSIS AND CANCER NUMBERS RATE PER 1,000 POPULATION MALES FEMALES PERSONS BARNET ENGLAND AND WALES Respiratory Tuberculosis 2 3 5 0.016 0.022 Other Tuberculosis 1 - 1 0.003 0.015 Cancer of lung and bronchus 146 50 196 0.623 0.610 Other Cancer 273 342 615 1.955 1.740 18 19 LIVE BIRTHS BY AGE AND PARITY OF MOTHER AND PLACE OF OCCURRENCE Parity of Mother * Place of Delivery All Ages Under 20 Age of Mother 20 - 25 - 30 - 35 - 40 - 45 + 0 1A _ _ _ _ _ IB 1,432 (95.0%) 149 (9.9%) 672 (44.6%) 443 (29.4%) 116 ( 7.7%) 39 ( 2.5%) 13 ( 0.9%) _ 2 57 ( 3.8%) _ 27 ( 1.8%) 17 ( 1.1%) 10 ( 0.7%) 3 ( 0.2%) _ _ 3 16 ( 1.1%) 1 (0.1%) 8 ( 0.5%) 5 ( 0.3%) 1 ( 0.1%) 1 ( 0.1%) _ _ 4 2 ( 0.1%) - - 2 ( 0.1%) - - - - 1,507 1 1A - - - - IB 1,199 (85.5%) 37 (2.7%) 327 (23.3%) 503 (35.9%) 219 (15.6%) 98 ( 7.0%) 13 ( 0.9%) 2 (0.1%) 2 74 ( 5.3%) 1 (0.1%) 19 ( 1.4%) 42 ( 3.0%) 6 ( 0.4%) 4 ( 0.3%) 2 ( 0.1%) _ 3 120 ( 8.6%) 7 (0.5%) 48 ( 3.5%) 47 ( 3.4%) 16 ( 1.1%) 2 ( 0.1%) — _ 4 8 ( 0.6%) 1 (0.1%) 4 ( 0.3%) 3 ( 0.2%) - - - - 1,401 2 1A - - - - _ IB 486 (80.4%) 4 (0.7%) 71 (11.8%) 174 (28.8%) 162 (26.8%) 61 (10.1%) 14 ( 2.3%) _ 2 39 ( 6.5%) _ 1 ( 0.1%) 18 ( 3.0%) 17 ( 2.8%) 3 ( 0.5%) —- _ 3 76 (12.6%) 14 ( 2.3%) 35 ( 5.8%) 23 ( 3.8%) 4 ( 0.7%) _ _ 4 3 ( 0.5%) - 3 ( 0.5%) - - _ 604 3 1A _ _ _ IB 189 (78.4%) _ 10 ( 4.1%) 47 (19.5%) 75 (31.1%) 49 (20.3%) 8 ( 3.3%) _ 2 17 ( 7.1%) 6 ( 2.4%) 4 ( 1.7%) 5 ( 2.2%) 2 ( 0.8%) _ 3 35 (14.5%) 1 (0.4%) 2 ( 0.8%) 19 ( 7.9%) 8 ( 3.3%) 5 ( 2.2%) - _ 4 241 _ 4 1A _ IB 79 (95.2%) — 3 (3.6%) 11 (13.3%) 29 (34-9%) 27 (32.5%) 9 (10.8%) _ 2 2 ( 2.4%) — _— _— 2 ( 2.4%) _ _ _ _ _ 3 2 ( 2.4%) - 1 (1.2%) 1 ( 1.2%) _ _ _ 4 — — — — _ _ _ 83 20 Live Births by Age and Parity of Mother and Place of Occurrence (continued) Parity * Place of of Mother Delivery All Ages Under 20 Age of Mother 20 - 25 - 30 - 35 - 40 - 45 + 5-9 1A 1 B 76 (100.00%) — 2 ( 2.67.) 5 ( 6.6%) 24 (31.6%) 32 (42.1%) 12 (15.8%) 1 (1.3%) 2 — — — — — —— —— — 3 — — — — — —— —— — 4 — — — — — — — — 76 10-14 1A — — — — — — — — — — — IB 3 (100.0%) —— —— —— 1 (33.3%) — 2 (66.7%) —- 2 -— —- —- —- — — —- —- 3 —— —— — —— — — —— —— 4 —— —— —— —— — — —— —— 3 15 + 1A — — — — — — — — IB — — — — — — — — 2 — — — — — — — — 3 — — — — — — — — 4 — — — — — — — — Illegit. 1A 2 ( 0.7%) — 2 ( 0.7%) — — — — IB 262 (91.0%) 71 (24.6%) 98 (34.0%) 52 (18.0%) 21 ( 7.3%) 1 3 (4.5%) 7 (2.4%) 2 6 ( 2.1%) 2 ( 0.7%) 3 C 1.0%) — - 1 (0.4%) — 3 15 ( 5.2%) 3 ( 1.0%) 2 ( 0.7%) 6 ( 2.1%) 4 (1.4%) -— — 4 3 ( 1.0%) 2 ( 0.7%) 1 ( 0.4%) — — —— — 288 TOTAL 1A 2 ( 0.170) 2 ( 0.0%) IB 3726 (88.6%) 261 ( 6.2%) 1183 (28.2%) 235 (29.4%) 647 (15.4%) 31 9 (7.6%) 78 (1.9%) 3 (0.1%) 2 195 ( 4.6%) 3 ( 0.1%) 50 ( 1.2%) 83 ( 2.0%) 39 ( 0.9%) 1 6 (0.4%) 4 (0.1%) — 3 264 ( 6.3%) 12 ( 0.3%) 75 ( 1.8%) 113 ( 2.7%) 52 ( 1.2%) 1 2 (0.3%) —— —— 4 16 ( 0.4%) 3 ( 0.1%) 5 ( 0.1%) 8 ( 0.2%) - —- —- —- 4203 * Place of Delivery 1A N.H.S. Hospitals — With G.P. Maternity IB N.H.S Hospitals — Without G.P. Maternity 2 Non-N.H.S. Hospitals (Mainly Maternity Homes) 3 At Home 4 Other 21 STILLBIRTHS BY AGE AND PARITY OF MOTHER AND PLACE OF OCCURRENCE parity of Mother *Place of Delivery All Ages Under 20 AGE OF MOTHER 20- 25- 30- 35- 40- 45 + 0 1A — — — — — — —— — IB 17 (100%) 2 (11.8%) 6 (35.3%> 6 (35.3%) 3 (17.6%) - —- — 2 —- — — — — — — — 3 — — — — — — — — 4 —- — — — — — — — 17 1 1A — — — — — — — — IB 15 (93.7%) — 5 (31.2%) 6(37.5%) 2 (12.5%) 2(12.5%) — — 2 —— — — — — — — — 3 1 ( 6.3%) —— 1 ( 6.3%) —— — — — — 4 —— -— — — — — —— — 16 2 1A — — — — — — —— — IB 7 (87-5%) — — 3(37.5%) 1 (12.5%) 3(37.5%) — — 2 — — — — — — — — 3 1 (12.5%) — — — 1 (12.5%) — — — 4 - - - — — — — —— 8 3 1A - —- — — — — — — IB 1 (100%) —— —— 1 (100%) — — — — 2 — — — — — — — — 3 — _ _ — — — 4 - -— —- —- — — — — 1 4 1A — — — _ _ IB 2(100%) — — — — 2(100%) -— —- 2 — — — — — — — — 3 — — — — — — — — 4 —- — — — — — — — 2 — 22 Stillbirths by Age and Parity of Mother and place of occurrence (continued) Parity of Mother *Place of Delivery All Ages Under 20 AGE OF MOTHER 20 - 25 - 30 - 35 - 40 - 45 + 5-9 1A _ _ _ — — — — —— 1B 1 (100%) — — —v— — 1 (100%) —- — 2 — — — — — — — — 3 — — — — — — — 4 — — — — — — — — 1 10-14 1A — — — — — — — — 1B — — — — — — — — 2 — — — — — — — — 3 — —- — — — — — — 4 — — — — — — — — 15 + 1A — — — — — — — — 1B — — — — — — — — 2 — — — — — — — — 3 -— — — — — — — — 4 — — — — — — — — Illegit 1A — — — — — — — 1B 5 (100%) 1 (20.0%) 4 (80.0%) — — — — — 2 — — — — — — — — 3 — — — — — — — — 4 — — _ — — — — — 5 Total 1A — — — — — — — — 1B 48 (96.0%) 3 (6.0%) 15 O0.0%) 16 (32.0%) 6 (12.0%) 8 a6.0%) — —— 2 — — — — — — — — 3 2 (4.0%) —— 1 (2.0%) — 1 (2.0%) — — — 4 — - — — — — — — 50 * Place of Delivery 1A N.H.S. Hospitals — With G.P. Maternity 1B N.H.S. Hospitals — Without G.P. Maternity 2 Non-N.H.S. Hospitals (Mainly Maternity Homes) 3 At Home 4 Other PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES The following Table shows the total number of corrected notifications received during the year: — Acute encephalitis _ (-) Acute meningitis 4 (4) Acute poliomyelitis — (-) Anthrax — (-) Cholera — (-) Diphtheria — (-) Dysentery 228 (71) Food poisoning 63 (31) Infective Jaundice 51 (21) Leprosy - (-) Leptospirosis - (-) Malaria — (-) Measles 672 (334) Ophthalmia neonatorum 5 (-) Paratyphoid Fever 6 (-) Plague — (-) Relapsing Fever - (-) Scarlet Fever 61 (23) Smallpox - (-) Tetanus — (-) Tuberculosis Respiratory 80 (109) Meninges and C.N.S. - (-) Other 33 (21) Typhoid Fever 2 (1) Typhus - (-) Whooping Cough 30 (53) Yellow Fever - (-) * Acute pneumonia (15) * Puerperal pyrexia (72) 1235 (755) Figures in parenthesis represent notifications for 1968. * No longer notifiable 25 E. Coli 0111 In April nine babies in a Mother and Baby Home were affected with E. Coli 0111. They were admitted to hospital and all made a satisfactory recovery. Haemolytic Streptococci Group A During the year an outbreak of haemolytic streptococci Group A occurred at a Police Training School, an Orphanage and a Primary School. Investigations in each case showed a considerable number of persons to be carrying the organism. The recommended treatment with penicillin was given and the infection eventually cleared from each establishment. Typhoid and Paratyphoid Fever Two cases of typhoid fever and six cases of paratyphoid fever occurred during the year, and with one exception were in persons returning to this country from abroad. All were admitted to hospital and eventually recovered. One case of an unusual type occurred in a man who had been a patient in a psychiatric hospital since 1957. Salmonella typhi Phage type D.4. was isolated, a type unknown in this country since 1919. Tests subsequently taken from ward contacts of this man and also from staff revealed another male patient admitted to the hospital in 1919, to be a carrier of the same organism. No further cases were found. INTERNATIONAL CERTIFICATES OF VACCINATION Three forms of International Certificates of Vaccination, namely:— smallpox, cholera and yellow fever require authentication of the signature of the doctor providing the vaccination or inoculation of persons proceeding abroad. During the year, 10,642 such certificates were authenticated in the Department. 26 ENVIRONMENTAL HEALTH SERVICES ENVIRONMENTAL HEALTH SERVICES The table of inspections carried out by the Public Health Inspectors, Technical Assistants and other Staff is an indicator only of the volume of work done; by itself it fails to reflect the real importance of the total effort of the Division. Food premises and food handling methods, are never wholly satisfactory in any district; many premises are well equipped and suitable for their purpose, but the quality of staff varies very much and it is important always that management should set high standards in food handling practices at manufacturing, wholesale and retail outlets. Where short-comings are detected or brought to notice, every effort is made by giving information and advice to educate employees in the need to practise proper techniques and good housekeeping methods. Because of frequent changes of staff in the food trades this calls for a continuing effort and like "mothers work", is never done. There is little property in the Borough so seriously defective as to be unfit for human habitation, nevertheless individual houses or small groups of houses call for action, either to secure their repair or to demolish them, or close them until they are repaired, provided with amenities, and restored to an acceptable standard. With this object in view every encouragement is given to owners to avail themselves of the Improvement Grant Provisions of the Housing Act 1969. This policy, which restores a dwelling to the total housing resources of the locality and at the same time obviates the risk of a local eyesore being created by a building otherwise left derelict, has been followed with a good measure of success. A reduction of smoke in the atmosphere has created a number of benefits and I think it is worthwhile to quote an extract from the summary of a report prepared by the Research and Intelligence Unit of the Department of Planning and Transportation of the Greater London Council, namely: — "The dramatic reductions in air pollution have had a number of beneficial results for the people of London. These include reductions in mortality and hospital admissions associated with air pollution, and a reduction in the response of bronchitics to air pollution as periods of high pollution have become less frequent. The amount of winter sunshine has increased both in central and suburban London, while the frequency of fog appears to have decreased in step with the progress in smoke control orders. Increases in sunshine and decreases in fog have led to a very large increase in visibility. It is possible that the substantial reduction in smoke concentration has led to a change in the local meteorology of London. The removal of the smoke "blanket" over London is allowing more sunshine to penetrate to ground level and this is leading to the more effective breaking up of 29 temperature inversions and dispersal of pollution. As air pollution has diminished, there have been other less tangible but beneficial changes, not so well documented, such as the increase of plant types and bird species in London." WATER SUPPLY Three companies, namely, the Colne Valley Water Company, the Lee Valley Water Company, and the Metropolitan Water Board distribute water to the Borough. The supply is satisfactory both as to quality and quantity. Samples of raw water and water going into supply are regularly sampled by the companies for bacteriological and chemical examination, and such were reported to conform to acceptable standards of purity. The waters are not liable to plumbo solvent action. The amount of naturally occuring fluoride varies; that supplied by the Colne Valley Water Company has a content of less than 0.1 p.p.m., that supplied by the Metropolitan Water Board has a content of 0.25 p.p.m., and in the case of the Lee Valley Water Company, in general, the content is less than 0.2 p.p.m. The whole district receives mains water direct and none is supplied by a permanent stand pipe. FOOD Formal and Informal Samples Five hundred and sixty-five samples of food were submitted for analysis during the year. A table identifying the commodities and showing results is set out below. The number of samples reported as unsatisfactory was 8% of the total submitted, an increase of nearly 1 per cent on the figure for 1968. SAMPLE FORMAL INFORMAL Satisfactory Unsatisfactory Satisfactory Unsatisfactory Angelica 1 Arrowroot 1 Artificial Sweetener 1 1 Asian Foods 4 Aspirin 1 Beefburger Meat 1 1 30  FORMAL INFORMAL Unsatis factory factory factory factory Beef/Ham/Porkburgers 1 13 Beer 1 Biscuits 1 Blackcurrant Health Drink 1 Butter 6 Butter, Brandy 1 Cake Decorations, Edible 4 Cake Mixes 2 Cheese 8 Cheese, Cream 2 1 Cheese Spreads 7 Chicken in Jelly 3 Chilli & Curry Powders 3 Chocolate & Malted DRI NKS 4 Cocktail shrimps 1 Coffee, Instant 6 Cooking fat 1 Corn Meal 1 Cornish Pasty Filling 1 Cream 8 De ssert Preparations 3 1 Dripping 1 Egg Dye 1 Fish Cakes 5 Fish, Canned 1 Flour Plain 3 Flour Self-raising 5 Flour Wholemeal 1 Fruit, Canned 23 2 Fruit, Dried 6 Fruit Juice 3 Fruit Puree 2 Fruit Slice I Fruit Syrup Glucose Tablets 1 Glycerin Golden Syrup 1 Gravy Mix 1 Halibut Oil Capsules Herbs, Dried 4 Honey 1 Ice Cream 1 Ice Lolly Syrup 1 Instant Whisk 1 Jams 12 Jellies 7 Lard 7 Liqueur Chocolate Eggs 1 Lemon Curd 3 31  FORMAL INFORMAL Satisfactory Unsatisfactory Satisfactory Unsatisfactory Lemon Juice 4 Lemon Tea Drink 1 Macaroni 1 Margarine 3 — 11 4 Marzipan 2 Meat, Canned 38 4 Meat Pies & Puddings 24 1 Milk, Dried 5 2 Milk, Evaporated 5 Mince 1 Mincemeat 3 Mint Sauce 3 Oatmeal 1 Olive Oil 4 Pastes and Spreads, Fish 6 Pastes and Spreads, Meat 8 Peanut Butter 2 Peel, Mixed 6 Pepper, White 1 Pickles 4 Pimentoes 1 Rice 11 Rice, Ground 1 Rose Floral Water 1 Rose Hip Syrup 3 Rose Hip Tablets 1 Rose Petals in Heavy Syrup 1 Rose Syrup 1 Rye Flour 1 Sal Volatile, Spirit of 2 1 Salad Cream 3 Sauce 9 Sausage Meat, Beef 4 Sausage Meat, Pork 8 Sausages, Beef 15 2 Sausages, Pork 18 4 Shandy 8 Soft Drinks 23 1 Soups 22 1 Soya Flour 2 Spaghetti 2 Spices 4 Spirits 3 Suet 4 Sugar 1 Sugar Confectionery 8 2 Tea 7 Tomatoes, Canned 16 1 Tomato Ketchup 2 32 SAMPLES FORMAL INFORMAL factory factory factory factory Tonic Water 1 Toothpaste 2 1 Vegetables, Canned 9 Vegetables, Dehydrated 2 Vegetable Juices 1 1 Vegetable Oils 3 Vegetable Oil Shortening 1 Vitamin Liquids 1 Vitamin Tablets 1 Wheat, crushed 1 Yeast 1 Yoghourts 5 4 TOTALS 7 3 513 42 In addition to the above samples, the following were examined in the office ARTICLE NO. OF SAMPLES Satisfactory Unsatisfactory Total Cereal 1 1 Confectionery 1 — 1 Fruit 4 — 4 Margarine 2 _ 2 Meat, Canned 1 _ 1 Milk SO — 50 Mince 13 1 14 TOTALS 72 1 73 The following comments are made regarding some of the unsatisfactory samples. Cream Cheese Comment was made in my 1968 Report concerning the practice of selling Full Fat Soft Cheese as Cream Cheese in spite of the fact that the Cheese Regulations 1965 laid down specific standards for the fat content of all soft cheeses. Formal samples taken during the latter part of 1969 revealed two instances where this practice was being carried out and at the close of the year legal proceedings were pending against the proprietors of the shops concerned. 33 Margarine In four informal samples of Margarine the Vitamin A content was found to be deficient by amounts varying from 34 to 41 per cent. the margarines, though of differing quality, were all manufactured by the same company and advice was given and emphasis made on the care required in mixing the ingredients. Subsequent formal samples were found to be satisfactory. Egg Dye Samples of dye sold in four different colours and imported from Cyprus were all found to contain prohibited colouring matter. These dyes are used in Cyprus and Greece for the colouring of shells of eggs during various national festivals and holidays. Eggs thus coloured were understood in some instances to be baked in bread or cakes, when the colour was absorbed by the dough. The shopkeeper voluntarily surrendered his small stock of dyes when the possible dangers were pointed out to him. Mince One sample of mince was found to contain preservative and legal proceedings were instituted against the butcher. Soft Drinks An Almond Drink was found to contain no significant proportions of almond substance and was, therefore, misdescribed. The amount of artificial sweetener exceeded the permissible amount as did also the amount of preservative present. A Rose Syrup manufactured by the same company also contained excessive artificial sweetener and preservative. Discussions with the chemist appointed by the company resulted in the recipes for the drinks being revised and subsequent samples were found to be satisfactory. Dried Milk One sample of dried milk packed in a waxed paper bag inside a light cardboard carton was found to contain excessive moisture. Discussions with the distributors revealed that the powder was being imported from France with a moisture content almost that of the permitted level. Repacking the powder in an unsatisfactory container enabled further moisture to be absorbed and this caused the total moisture content to exceed the permitted limit by the time the product was sold. A more suitable package was adopted and the exporters were asked to supply powder with a lower moisture content. Dehydrated Soup A packet soup labelled "Creamed Vegetable Soup" was found on being reconstituted to contain only 1 per cent of fat. Discussions ensued with the manufacturers with the view to altering the recipe or the omission of the word "Creamed" from the label. 34 Ice Cream The following table shows the number of samples submitted for bacteriological examination and the results:— TYPE GRADING TOTALS 1 2 3 4 Hard Ice Cream Premises Prepacked 21 3 - - 24 Loose 132 39 49 31 251 Vans Loose - - - - - Soft Ice Cream Premises 17 11 11 1 40 Vans - 1 1 3 5 Lollies Premises All satisfactory 6 Pre-packed ice cream was of good quality and bacteriological cleanliness. Continuous attention is necessary to ensure that ice cream dispensed from cans or from extrusion units is not exposed to risk of contamination. Liquid Egg This is an important product in the baking and confectionery industry, and since the introduction of Regulations in 1964 requiring it to be Pasteurised is uniformally of good quality. Thirty-seven samples were examined and all were found to be satisfactory. Milk-Registration, Licensing and Sampling One hundred and seventy-nine premises were registered for the sale of milk and the following licences for the sale of graded milks were issued:— "Untreated" milk 48 "Pasteurised" milk 153 "Sterilised" milk 15 "Ultra-Heat Treated" 74 There are 10 producers of milk in the Borough. Two are in closed communities which use the milk untreated. Thirty-five samples of untreated milk were submitted for bacteriological examination. Four were not satisfactory and particulars were notified to the Advisory Officer of the Ministry of Agriculture Fisheries and Food. 35 Fifty-five sample of raw milk were examined for the presence of brucella abortus and none indicated evidence of infection. Towards the end of the year one bulk sample showed evidence of the presence of Rickettsia burneti. Whilst the farmer sent the majority of his milk implicated by this sample for heat treatment, a small amount was retained for the production of cream which was sold direct to the public from the farm. In view of the fact that this organism is communicable to man an Order was served on the farmer under Regulation 20(1) of the Milk & Dairies (General) Regulations 1959 prohibiting the sale of milk and cream unless heat treated. At the end of the year investigations were proceeding to isolate the affected animals. A further five samples were submitted for biological examination for the presence of tubercle bacilli. All the samples were free of such organisms. Food Complaints Two hundred and twenty-two complaints were received as to quality or soundness or the presence of foreign bodies in food; 17 were examined by the Public Analyst. In 31 cases the offence justified proceedings and in a further 13 cases the Council authorised the sending of a "warning letter". The remaining cases were dealt with by advice from the Department to the retailers or manufacturers concerned. The table below classifies the nature of the complaints. 1. Foreign Bodies (a) Insects 37 (b) Metal objects 11 (c) Glasses, stones, etc. 7 (d) Paper, wood, string, etc. 6 (e) Oil, grease, etc. 10 (f) Fabric, plastic, rubber etc. 2 (g) Cigarette ends 2 (h) Harmless matter, e.g. burnt dough in bread 11 86 2. Quality (a) Unsoundness 22 (b) Mould growth 41 (c) Rancidity, sourness etc. 10 73 3. Damaged or Dirty Containers (a) Damaged containers 13 (b) Dirty containers, e.g. milk bottles 25 38 36 4. Labelling or Misdescription 3 3 5. Complaints Unfounded 22 22 222 There was an increase of over 20 per cent in the number of complaints received during the year. The increase was accounted for mainly by the greater number of complaints received during the warm days of the prolonged summer, of the presence of mould on wrapped sliced bread and of an unaccountable increase in the complaints received concerning the presence of various insects in foodstuffs. Some of the complaints invite comment. Two bottles of a well known antiseptic purchased at opposite ends of the district were found to contain a fine black sediment which examination showed to be due to precipitation caused by the exposure of the product to strong light either in the shops or the customers' homes. The manufacturers have been asked, when the labels of the product are reprinted, to include a warning against storage in strong light. The problems confronting the dairy companies with relation to glass bottles are as numerous as ever. How a holly leaf came to be delivered in a bottle of milk in midsummer was never solved, but the presence of a common garden slug in two bottles delivered within a few days of each other was, after investigation thought to be due to new bottles having been stored for a short time in a field during the summer. The slugs probably entered the bottles in search of moisture and their slime, hardened by the sun, fixed their bodies so securely to the interior surfaces of the bottles that the subsequent washing process failed to remove them. The public continues to show some resistance to accepting milk in cartons and this might well be due to some measure to the slightly increased cost of the carton, it would seem however that this is the only solution to the problem of the dirty bottle. One large dairy company has commenced supplying its shops with cartoned milk only, for sale over the counter. One complaint received concerning a third pint carton of school milk was the finding therein of a filler head from the filling machine; the staff of the dairy company had not realised it was missing until the machine was dismantled for cleaning later in the day, by which time the milk had been sent out for distribution. 37 Food unfit for human consumption The following list sets out the food stuffs condemned during the year:— Fresh Food Meat 4,048 lbs. Offal 121 lbs. Fish 196 lbs. Poultry 236 lbs. T inned Fruit/fruit juices 5,761 tins/bottles Meat 946 Vegetables 1,328 Soups 270 Milk 224 Milk puddings 57 Meat puddings/pies 39 Cream 26 Unidentified 1,549 Frozen Foods (in packets or cartons) Cream/Ice Cream 566 Fish/fish cakes 1,668 Meat 1,616 Puddings/pies/pastry 1,245 Vegetables 9,836 Fruit 1,029 Confectionery 3,585 Poultry 81 Cheeseburgers/Cheese 15 Whole dinners 179 Sausages, savouries etc. 473 Miscellaneous Confectionery 1,342 packets Preserves 427 jars Cheese 68 packets Sauces/Pickles 34 jars Sugar 48 packets Cereals 902 packets Biscuits 1,826 packets Animal Foods 162 lbs. Animal Foods 344 tins 38 Most of the food was voluntarily surrendered by retailers anxious to maintain a good record for fresh produce of good marketable quality. This is one area of his work in which the Public Health Inspector has for many years been accepted as an advisor rather than as an enforcement officer. Food Hygiene The Food Hygiene (General) Regulations 1960/62 contain provisions as to the cleanliness of food premises and the hygienic handling of food; the construction of food premises, their repair and maintenance and the facilities to be provided. Here again, compliance with good standards is best achieved by regular visits of the Public Health Inspector in which food handlers can be advised and encouraged in good housekeeninp methods. At the request of the Department of Health and Social Security, a list of food premises grouped in categories of trade is set down below containing particulars of the premises provided with wash hand basins and an adequate supply of hot and cold water, soap and towels (Regulation 16) and those provided with sinks, hot and cold water, soap, clean cloths or other cleaning and drying facilities (Regulation 19) as required by the Food Hygiene (General) Regulations, 1960. Class of Business Number at end of 1969 Number Complying with Reg. 16 Number to which Reg. 19 applies Number Complying with Reg. 19 Bakehouses and Bakers Shops 117 117 117 117 Butchers 167 167 167 167 Canteens 184 184 184 184 Confectioners 276 273 139 136 Dairies 10 10 10 10 Fishops 73 73 73 73 Greengrocers 169 169 134 134 Grocers 318 318 318 318 Licensed Premises 232 232 221 221 Restaurants/cafes 259 259 259 259 6,489 visits were made to secure the observation of hygienic practices in clean and properly equipped premises. Generally the equipment of retail and wholesale food premises is satisfactory. 39 Markets There are two markets in the Borough; one owned by the Council at Burnt Oak and known as the Watling Market operates on one day a week only. The other, privately owned, is at Barnet, and opens two days a week. Hawkers Hawkers of food and their storage premises in the former Middlesex County Council area are required to be registered under Section 11 of the Middlesex County Council Act 1950. At the close of the year there were 38 such hawkers on the register. Slaughterhouses There are no slaughterhouses operating in the Borough at present. Two persons were licensed by the Council under the Slaughter of Animals Act 1951 as fit persons to slaughter animals. Poultry Inspection (i) Number of poultry processing premises within the district 1 (ii) Number of visits to these premises 7 (iii) Total number of birds processed during the year 1969 10,592 (iv) Types of birds processed Hens (v) Percentage of birds rejected as unfit for human consumption Nil (vi) Weight of poultry condemned as unfit for human consumption Nil (vii) The live birds are bought by individual selection from farms in Hertfordshire. Any birds which do not show a healthy live appearance are isolated, killed and, if diseased, disposed of at the farms. The processing premises consist of a building divided into two sections — for killing and for dressing. The staff engaged in the business are the proprietor, one male employee, and one female employed part-time. The birds are killed by dislocation of the neck and are not eviscerated. The carcases are immersed in a thermostatically controlled scalding tank and plucked in an electric defeatherer. They are delivered the same or the following day after slaughter to butchers in the Golders Green, Finchley, Harrow, Tottenham, Watford, Elstree and Cockfosters area for sale in the fresh trade. As the birds are uneviscerated, inspection at the place of slaughter is limited but doubtful carcases are retained and inspected in accordance with the procedures recommended in Circular 22/61 of the Ministry of Health. 40 Labelling of Food The Labelling of Food Order 1953 requires that foodstuffs should have informative labelling which does not mislead the purchaser. Generally all prepacked foods should have on the label or wrapper the name and address of the packer or labeller or altertively a trade mark with the words "Registered Trade Mark". There should also be a list of ingredients. A total of 541 visits were made to premises concerning the Order and 2,163 labels were examined to verify the correctness of their claims. A larger number than usual of misleading labels was dealt with during the past year and the following are some of the more interesting cases. Brewer's Yeast A claim for the presence of vitamins was made on the label but no quantitative statement printed with it. Beetroot Juice Extravagant claims regarding vitamin and mineral contents were not accompanied by any quantitative statement of vitamin content. The claim regarding mineral content was not justified. Ice Cream An illustration on a rather expensive ice cream pack showing whole strawberries was considered to be misleading and the company concerned agreed to its withdrawal. Toothpaste A claim on a toothpaste tube and packet that the use of the toothpaste would prevent and treat scurvy was regarded as misleading and false and the manufacturer agreed to its removal. Slewed Steak in Gravy The total meat content of a can was found to be satisfactory but half the meat was in a shredded condition and completely unlike the illustration of chunks on the label. The packers on being approached immediately agreed to a new label for the can showing fewer chunks. Samples of canned fruit salad, wholemeal biscuits, fine oatmeal, milk powder, yoghourt, chewing gum and sausages were also found to have omissions or errors in their labelling. 41 Legal Proceedings DATE OFFENCE FINE COSTS 22. 1.69 Cigarette end in loaf Absolute Discharge £10.10.0d. 3. 2.69 Mouldy chocolate cake £10 £ 5. 0.0d. 19. 2.69 Wire in Danish Pastry £ 5 £ 3. 3.0d. 26. 2.69 Piece of metal in meat pie £ 5 £10.10.0d. 3. 3.69 Mouldy loaf £25 £ 5. 5.0d. 3. 3.69 Hessian fibres in loaf £25 £ 5. 5.0d. 3. 3.69 Dirty milk bottle £20 £ 5. 5.0d. 3. 3.69 Dirty milk bottle £20 £ 5. 5.0d. 3. 3.69 Watered gin £ 5 £ 9.19.0d. 10. 3.69 Loaf contaminated with oil £15 £10.10.0d. 26. 3.69 Bandage in sliced loaf £75 £15.15.0d. 21. 4.69 Insect in bread roll £25 £10.10.0d. 21. 4.69 Fly-blown sausages £15 £10.10.0d. 21. 4.69 Piece of glass in sausage £15 £10.10.0d. 15. 5.69 Mouldy loaf Conditional Discharge No costs 23. 6.69 Dirty milk bottle £20 £ 5. 5.0d. 28. 7.69 Brass nail in rye loaf £15 £ 5. 0.0d. 4. 8.69 Preservative in mince £25 £10. 0.0d. 22.10.69 Loaf containing piece of folded cloth £100 £10.10.0d. 29.10.69 Baby food containing spider beetle £30 £ 5. 0.0d. 10.11.69 Loaf containing nail £50 £26. 5.0d. 17.11.69 Dirty milk bottle £10 £ 5. 5.0d. 17.11.69 Possession of unsound chickens £20 £ 5. 5.0d. 8.12.69 Dirty milk bottle £30 £10.10.0d. 8.12.69 Bread roll containing cigarette end £25 £10.10.0d. 17.12.69 Mouldy Sausage rolls £10 £ 5. 0.0d. National Pesticide Survey No further samples were examined during 1969 for pesticide residues as the final report of the survey undertaken during the period August 1966 — July 1968 has not yet been published. The report concerning the first year's sampling revealed few 42 samples containing sufficient residue to indicate the need for special action though a large proportion contained traces of pesticides which, too small to affect the product's fitness for food for human consumption, were sometimes larger than had been expected for that particular pesticide or for the particular variety of food. The recommendations for the future pattern of sampling will be awaited with interest. None of the samples obtained in the Borough during the survey received an adverse report. CLEAN AIR Progress was maintained in the smoke control programme and the table on page 44 shows the position at 31st December 1969. In June a report was submitted to the Health and Welfare Committee pointing out the advantages, environmental and financial, which would accrue if the programme were speeded up so as to be completed in 1973 instead of 1976. Acceleration whilst being less costly overall would have meant an increase in annual expenditure albeit for a lesser number of years, but the Committee felt that having regard to all the circumstances no explicit variation was called for. However, they resolved that endeavour should be made to accelerate the completion of the programme to a date earlier than 1976 should financial and staffing conditions permit. As the year progressed it became clear that because of a reduction in the manufacture of gas coke, the progress of smoke control was likely to be slowed down. The Solid Smokeless Fuels Federation when approached for an assurance on the adequacy of fuel supplies for the projected No.11 Area were unable to give this, unless operation of the Order was delayed until 1st April 1971. The basic solid smokeless fuel on which the whole concept of control was conceived by the late Lord Beaver, was gas coke. With the increasing use of oil for the manufacture of town gas the supply of coke had not been increasing for some years, but the advent of the supply of North Sea Gas meant the end of coal carbonisation by the gas industry. The National Coal Board some years ago had completed research into the manufacture of solid smokeless fuel but because of delays in commencing production on an adequate scale, need more time to increase supply. They have undertaken to meet demand by the Spring of 1971. The National situation is critical and is causing concern in many quarters; not least in the Borough as regards the substitution of an alternative for gas coke presently used for heating the Council's schools, clinics and homes. The Minister of Housing and Local Government took powers in the 1968 Clean Air Act to require reluctant local authorities to designate smoke control areas. These have now a reason for continuing to reject their responsibilities in the national bid to reduce air pollution. 43 The Council has power to increase the usual grant of 7/10ths of the "reasonably necessary" cost of adapting fireplaces in dwellings in smoke control areas to cover SMOKE CONTROL ORDER DATE MADE DATE CONFIRMED DATE IN OPERATION ACREAGE NO. OF DWELLINGS OTHER PREMISES Orders made by London Borough of Barnet and Constituent Authorities As at 31st December 1968 10,091 55,104 3,217 London Borough of Barnet (No. 8) (Child's Hill and Cricklewood) 30-8-68 5-12-68 1-7-69 164 1,327 131 London Borough of Barnet (No. 9) (North Finch ley) 18-10-68 27-2-69 1-9-69 341 3,147 316 London Borough of Barnet (No. 10) (Colindale and West Hendon) 5-5-69 24-7-69 1-7-70 393 2,692 148 London Borough of Barnet (No. 11) (Hendon) SURVEY IN PROGRESS - (402) - (3,120 - (256) TOTAL 898(402) 7,166(3,120) 595 (256) GRAND TOTAL 10,989 62,270 3,812 Acreage of Borough 22,124 Approximate number of premises (all types) 118,376 the whole cost where the applicant has only limited means. 18.2% of applicants were allowed increased grants during the year and it is thus reassuring to know that no one suffers hardship through meeting their community obligations. Many old people, beginning to find the physical effort of handling coal and ashes a little too much for them find the gas fire a blessing — perhaps an unexpected incidental welfare benefit within the Clean Air Act! A number of applications were received under Section 6 of the 1968 Act for the determination of chimney height. It is encouraging to note an increase in willingness on the part of the architects, engineers, combustion consultants and others to accept the need for adequate chimney height. This I am sure, is based on an increasing awareness generally of the dangers resulting from ever more intensive development. Measurement of smoke and sulphur dioxide every day of the year continued at the Council's five measuring stations and the data supplied to the Ministry of Technology for use in the National Survey. HOUSING Provision of Housing Accommodation During the year the number of purpose-built housing units provided by construction was 432. This allowed for an appropriate "mix" of accommodation dictated by the current need for various sizes of housing unit and the locality in which the building was taking place. No units of housing accommodation were acquired from private owners, the Council having earlier discontinued its previous policy in this connection for financial reasons. Towards the end of the year it was, however, agreed that suitable properties should, as they became available, be purchased for special needs, i.e. conversion for the use of elderly persons; adaptation for homeless families. A total of 832 families had been rehoused by the 31st December of which 88 families were decanted from Housing Areas scheduled for re-development in the Council's current programme. Pressure continued to remain high on the type of accommodation suitable for elderly persons often unable to climb stairs or similarly restricted and, wherever necessary, the Borough Housing Officer seeks my views on the medical aspects of such cases. Despite the progress made in all aspects of rehousing, the number of persons applying to the Council for accommodation continued to increase, it being noteworthy that a high proportion of these were young married couples unable to find accommodation in the borough within the private sector and suitable to their means. At the end of the year a total of 6099 applications were registered. 45 I am indebted to the Borough Housing Officer for the above information on the progress made by the Council during the year in providing housing accommodation. Clearance Areas One clearance area located in East End Road, East Finchley involving four properties was represented to the Council under Part III of the Housing Act 1957. A Clearance Order was made and because the houses were directly in the line of a major road improvement scheme included in the Council's capital programme it was agreed the area should be made the subject of a Compulsory Purchase Order. At the end of the year demolition of the four houses in the Lodge Lane, North Finchley Clearance Area had been commenced, these properties being contained within a larger area for which the Council has long term plans in respect of redevelopment under Part V of the Housing Act 1957. Demolition of all the properties in The Walks, East Finchley Clearance Area was completed, and the tenants of all but two of the houses in The Burroughs, Hendon Clearance Area were rehoused. Individual Unfit Houses A total of nineteen dwellings were reported as being unfit for human habitation and incapable of repair at reasonable cost. In seven cases the making of Demolition Orders was appropriate and in nine instances, as the dwellings were not capable of demolition in isolation, it was necessary to recommend the making of Closing Orders. In one case, the property being in the ownership of a Group Hospital Management Committee, formal action was not possible but agreement was reached for demolition to be undertaken as soon as the re-housing of the tenants had been achieved. In a further case the house was closed by arrangement with the owners pending the completion of a re-development scheme involving this and a number of adjacent properties, whilst in a third instance the making of a Closing Order was postponed pending consideration being given to the inclusion of the house in a Clearance Area. In consequence of this action, together with that which had been initiated in earlier years, thirty unfit houses were demolished and fourteen dwellings closed. Twenty-six families comprising in all a total of sixty-three persons vacated unfit properties. In two instances the tenants found themselves suitable alternative accommodation. In all other cases re-housing was arranged by the Council, in one instance in conjunction with the Greater London Council. Eleven Closing Orders which had been made during previous years were determined. In each case the property was completely rehabilitated and provided with full standard amenities so as to have an acceptable future life as a fit dwelling. 46 Similarly one Demolition Order was revoked. The twelve properties were adapted so as to provide thirteen units of accommodation. Slum Clearance and Re-development In November local authorities in England and Wales were requested by the Ministry of Housing and Local Government in Circular 92/69 to submit their programmes for the four years 1970 to 1973, in order to deal with outstanding unfit properties. Outside the areas which the Council have programmed for comprehensive redevelopment under Part V of the Housing Act, 1957 there are no localities of unfit housing in the Borough, the problem of unfitness remaining confined to individual houses or small groups of properties. During the next four years it is therefore envisaged that 55 properties will need to be considered for representation under Part III of the Housing Act, 1957 and that 69 properties are likely to be cleared from declared clearance areas. During the same period 131 unfit properties npw existing in Housing Areas defined under Part V of the Housing Act, 1957 should be demolished. As a result of complaint and the routine inspection of the district some twenty dwellings per annum are found to be unfit and incapable of repair at reasonable cost and necessitate action under Part II of the Housing Act, 1957. No further surveys were undertaken during the year in respect of potential areas for designation under Part V of the Housing Act, 1957 but following representations from a group of the owners concerned, the Council agreed in respect of the Cromwell Road Housing Area, designated in 1968 that a re-appraisal of the area should be undertaken in the light of the provisions of Part II of the Housing Act, 1969 in respect of General Improvement Areas. By the end of the year arrangements had been completed for the carrying out of this re-appraisal which it was indicated would involve the detailed inspection of 100 dwellings. Following completion of demolition, contractors took over in the West Hendon Housing Area, the largest of the re-development areas included in the Council's programme. On completion this will provide 646 units of accommodation in an area previously.occupied by some 450 mainly sub-standard properties with an appreciable element of multi-occupation. Re-development of the first phase of the Ridge Road Housing Area was also commenced. Here the final scheme will provide for 30 units of accommodation on a site previously occupied by 22 properties with a high degree of multi-occupation. Improvement of Houses On the grounds that the scale and type of work done to improve or repair the existing stock of houses in a local authority's area should form an integral part of 47 their overall housing programme, the Housing Act 1969, which received Royal Assent on the 25th July, 1969, introduced a new and self contained code for the grant-aided improvement and conversion of houses. Whilst retaining the main features of the original scheme with its various amendments it sought to give greater discretion and more flexibility to local authorities in addition to increasing the upper limit of the financial assistance available. Three forms of grant are now available (a) improvement grants, still payable at the discretion of the local authority for the improvement, conversion and repair of properties likely to have a useful life of thirty years, and up to one half of the grant may now be for repairs which can be related to the improvement; (b) standard grants obtainable by owners as of right for the installation for the first time of standard amenities in the form of hot water supply, a fixed bath or shower, sink, wash-hand basin and inside water closet in dwellings with an estimated life of fifteen years; and (c) a new form of grant known as a special grant to enable, at the local authority's discretion, the installation of standard amenities in houses in multiple occupation, if necessary, with a degree of sharing of amenities. As a matter of policy, older type houses are inspected and when found to be suitable for improvement information and advice is proffered to owners in the hope that they will undertake improvement with the aid of the grants which are available. In fifteen cases a favourable response was received and improvement schemes were carried out or put in hand. With the increased levels of grant made available under the new Act better results are looked for in the future in response to an intensified programme of persuasion which will now be pursued. During the year 157 Standard Grants and 25 Discretionary Improvement Grants were paid, and by the end of the year the effects of the new Acl were already beginning to show themselves as reflected in the increase in the number of applications for grants submitted to the Council. Area Improvement Part II of the Housing Act 1969, confers upon local authorities powers to deal with the improvement of living conditions in predominantly residential areas by declaring General Improvement Areas. It is envisaged that in addition to securing the improvement of the dwellings within the area, the authority should themselves undertake works to improve the general environment. The type of improvement works considered to be desirable are tree planting, providing play spaces, grassed or paved areas, parking spaces and garages. It is also suggested that street lighting may be renewed, road surfaces repaired and road patterns replanned. Certain financial assistance will be made available to local authorities in respect of these works. On the grounds that Part II of the Housing Act, 1964 which introduced for the first time compulsory powers for the provision of satisfactory amenities in dwellings in defined areas, had been found to be cumbersome in practice and did not enable an 48 authority to improve an area as a whole, the new Act bases the success of area improvement upon the ability of local authorities to enlist the co-operation and support of the owners of houses and of the persons in occupation, increased grant aid being made available for the house improvement works involved. In November the Council after considering the implications of these new provisions decided that they should receive a report upon the action which they should take by way of area improvement to deal with unsatisfactory housing conditions in selected areas in the Borough. By the end of the year arrangements had been made to undertake a survey in order to identify these areas and to consult the Ministry of Housing and Local Government on the suitability of such areas for designation as General Improvement Areas. Although the new legislation repealed the power to make further Improvement Areas under the Housing Act 1964, the local authorities are nevertheless able to deal appropriately with those areas already declared. In this respect by the end of the year virtually all works found to be possible had been completed to the 38 houses in the Council's first Improvement Area at Prospect Road, Childs Hill and as the re-development of the adjoining Ridge Road Housing Area had also commenced the integration of the two areas in order to achieve overall environmental improvement, as originally visualised, was in sight. Improvement to the full standard had been completed at about 60% of the 91 houses houses in the second Improvement Area at Brent Terrace, Cricklewood and Grant applications made in respect of the remaining houses. 60 of the 136 houses in Campion, Needham, Johnston and Midland Terraces, Cricklewood, had also been improved to the full standard. Before designation as an Improvement Area, the owners of this estate gave an undertaking to the Council in 1968, to carry out complete modernisation of properties as they became vacant and to improve the remaining houses including those where the sitting tenants were desirous of purchasing for owner/occupation. This operation has proved to be highly successful in securing the overall improvement of what was previously a somewhat neglected estate. Section 19 of the Housing Act, 1964, enables the tenant of an individual dwelling to muke representation to the Council to take action to secure the provision of satisfactory amenities. Two such representations were received and by the 31st December no firm undertakings were forthcoming from the owners to carry out the necessary works and arrangements were being made for formal notices to be served. The initial approach must come from the tenant in these cases and it is discouraging to find how little this provision, which is not repealed by the Housing Act 1969, is used. It may well be that the new provisions in respect of the rents of controlled tenancies will result in the initiative for the improvement of this type of house being taken by the landlords rather than the tenants. Overcrowding The following statement provides a summary of the known cases of overcrowding existing or dealt with during the year, the standard of assessing overcrowding being that specified by the Housing Act, 1957. 49 (a) Number of dwellings known to be overcrowded at end of year 8 Number of families in occupation 9 Number of persons in occupation 59 (b) Number of new cases reported 10 (c) Number of cases relieved 10 Number of persons concerned 59 These are the only cases of statutory overcrowding which are known to the Department. Other cases do undoubtedly exist but the extent of the problem within the Borough is not considered to represent a serious hazard. Overcrowding only rarely comes to light during the course of normal routine inspections or as a result of direct complaint. In the main, cases are brought to notice by tenants alleging over-occupation who are seeking to improve their position on the Council's housing waiting list. The existing standards were first introduced in 1935 when, compared with earlier standards, they were considered to be high. However, after more than thirty years they can no longer be regarded as satisfactory in the light of modern living conditions. When assessing housing needs in respect of applications for housing accommodation, the Council therefore maintains a more realistic approach by awarding "points" on an ascending scale according to the degree of insufficiency of proper bedroom accommodation. During the year the Department was actively concerned with an increasing number of applications for Council housing, in some cases supported by medical certificates, referred by the Housing Department for special consideration on medical grounds. I wish to record that each application made for Council housing accommodation which was supported by the Department received the fullest consideration by the Borough Housing Officer. Common Lodging Houses There are no common lodging houses in the Borough. Houses in Multiple Occupation The Housing Acts 1961 to 1969 provide powers for dealing with unsatisfactory living accommodation at houses in multiple occupation. Whilst the Housing Act 1969 did not make major legislative changes, it did nevertheless introduce some significant amendments. The new definition of what constitutes a house in multiple occupation based upon "households" rather than "families" is welcomed, difficulties having, in the past, 50 been experienced in houses inadequately equipped and occupied by large numbers of persons, usually immigrants, and all allegedly having some family relationship. The power to take part of a house out of use for living accommodation either by means of an undertaking or by the making of a closing order so that the remainder of the house may be provided with suitable means of escape from fire at reasonable cost is considered useful. To this end it has always been the practice, where this could be arranged, to accept undertakings to take out of use lettings on the top floors of three storey houses and so simplify the fire precaution works involved. The introduction of "special grants", at the local authority's discretion for the installation of standard amenities in houses in multiple occupation with a degree of sharing of amenities where conversion into self contained dwellings is not feasible, is particularly welcomed. Difficulty has often been experienced in the past to persuade owners to provide bathrooms in multi-occupied houses when no offer of financial assistance could be given in respect of the improvements. In October 1965 the Council adopted comprehensive standards in respect of facilities and amenities to be applied in houses in multiple occupation. In the light of the experience gained since that time it is now felt to be appropriate to reconsider these standards in order to see what amendments are needed, and, at the same time, consideration will be given to the desirability or otherwise of introducing a registration scheme having regard to the extensions given to Section 22 of the Housing Act 1961 by the new legislation. There are many multi-occupied houses in the Borough often of the bed-sitting room type providing for the single person which, if well maintained, help to fulfil a housing need not otherwise satisfied. There are some clearly defined and well established sectors, namely in parts of Cricklewood, Childs Hill and Golders Green where relatively high concentrations of multi-occupations are found. There are also many smaller groups and individual houses throughout the Borough which are not so readily identified and which may well conceal some of the most adverse conditions. During the year, a Control Order, which had been made by one of the constituent authorities immediately before the formation of the present Borough in April, 1965, was revoked and the property handed back to the owners with vacant possession. 210 houses in multiple occupation were inspected in detail and 53 have been equipped and repaired so as to make them suitable for the number of individuals or families in occupation. One most important matter, namely the need of means of escape from fire, calls for comment and special emphasis. In the houses inspected there had been an almost total neglect to carry out work to provide means of escape from fire, regardless of the number of persons at risk. The hazard from fire in older type properties occupied by several families is much increased by the multiplicity of means of cooking, space heating and the sometimes 51 inexpert additions to electrical circuits. Much can be done to limit the spread of fire by making doors and partitions fire resisting and to check the spread of flame and smoke by fire stops and smoke screens. The code of practice of the Greater London Fire Brigade for means of escape in the case of fire in houses in multiple occupation is applied and 47 houses have been modified to such standards. Leaflets printed both in English and a number or foreign languages are distributed when necessary, drawing attention to the added risk of fire when paraffin heaters are used and when supplies of paraffin are stored inside a house. Rent Control The Rent Acts amongst their numerous provisions permit a controlled tenant to apply for a Certificate of Disrepair when he considers that his accommodation is not being maintained in a satisfactory state of repair having regard to its age, character and locality and thus seek an Abatement of his rent; the provisions continued to be little used, largely it is felt because to most tenants the essential procedure is somewhat lengthy and involved. Four such applications were received. In two cases landlords gave formal undertakings to carry out repairs; in the remaining two cases Certificates of Disrepair were issued. Part III of the Housing Act 1969 introduces an entirely new system governing the rents of privately owned properties enabling controlled tenancies to be converted to regulated tenancies provided specified standards are achieved, the new rents being determined under the Rent Act 1968, the Rent Officer being responsible for fixing a fair rent in each case. The Act provides for two types of case. The first where the dwelling is to be provided with some or all of the standard amenities after the commencement of the Act, and the second where the dwelling is already suitable equipped, the standard amenities being the basic amenities which can be provided for the first time by means of a Standard Grant. In both types of case the qualifying conditions are the same, i.e. that all the standard amenities are available for the exclusive use of the occupants of the dwelling, that it is in good repair, having regard to its age, character and locality, and that it is otherwise fit for human habitation. There is no intention of imposing an immediate and general increase in rent levels, controlled tenancies becoming regulated between 1st January 1971 and 1st January 1972 on a descending scale of rateable values, after which the actual rent increases will be phased over five equal annual stages. In addition the tenants' legitimate interests are safeguarded in the Act at appropriate stages of the procedures laid down. The chief responsibility of local authorities in relation to these rent provisions is 52 to deal with applications for certificates relating to the state of the dwelling where it is let on a controlled tenancy and the Council decided that the Department should deal with those applications made under Section 44 (1) of the Housing Act, 1969 — dwellings already having all the standard amenities at the commencement of the Act. By the end of the year 560 applications had been received for this category of Qualification Certificate and it was quite clear that this was by no means the total number with which it would be necessary to deal at this stage. Furthermore, understandably with tenants facing an unknown but appreciable rent increase even though it was not to be immediate, a very large proportion were likely to submit representa tions to the Department on the grounds that their dwellings were not in a satisfactory state of repair. Housing Statistics 1. Inspection of Dwelling Houses (i) (a) Total number of dwellings inspected for housing defects (under Public Health or Housing Acts) 3,290 (b) Number of inspections made for the purpose 10,476 (ii) Number of dwellings found to be unfit for human habitation 23 (iii) Number of dwellings (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 1,609 (iv) Number of dwellings surveyed in existing Housing Areas and designated under Part V of the Housing Act 1957 in connection with the Council's negotiations for acquisition 26 (v) Number of dwellings inspected in connection with proposed Improvement Areas and Improvement Grants Scheme 284 2. Remedy of defects during the year without service of formal notices: Number of defective dwellings rendered fit in consequence of informal action 219 3. Action under statutory powers during the year (a) Proceedings under Sections 9 and 10 of the Housing Act 1957 53 (i) Number of dwellings in respect of which notices were served requiring repairs Nil (ii) Number of dwellings which were rendered fit after service of formal notices: (a) By owners 1 (b) By Local Authority in default of owners Nil (b) Proceedings under Public Health Acts: (i) Number of dwellings in respect of which notices were served requiring defects to be remedied 69 (ii) Number rendered fit (a) By owners (b) By Local Authority in default of owners 26 Nil (c) Proceedings under Sections 16 & 17 of the Housing Act 1957 (i) Number of dwellings in respect of which Demolition Orders were made 9 (ii) Number of dwellings demolished pursuance of Demolition Orders 3 (iii) Number of dwellings in respect of which Closing Orders were made 9 (iv) Number of dwellings closed in pursuance of Closing Orders 13 (v) Number of dwellings in respect of which undertaking accepted under Section 16(4) Nil (vi) Number of dwellings in respect of which Closing Orders were determined under Section 27(2) 11 (vii) Number of dwellings in respect of which Demolition Orders were revoked under Section 24(2) 1 54 4. Houses in multiple occupation — Housing Act 1961 (i) Number of properties made suitable for occupation by number of occupants accommodated (Section 15) 53 (ii) Number of properties provided with means of escape from fire (Section 16) 47 5. Compulsory improvement — Housing Act 1964 Number of dwellings in improvement areas improved to the full standard 25 Number of dwellings outside improvement areas improved to the full standard —Section 19 Nil CARAVANS There are two sites licensed under the Caravan Sites and Control of the Development Act 1960; one on either side of the Barnet Bye Pass at Stirling Corner for 130 caravans and in general they are well maintained and managed. Having regard to the Caravan Sites Act, 1968 investigation continues into the need for and the possibility of providing a caravan site for gypsies and other travellers. INSPECTIONS AND COMPLAINTS Some 5,243 complaints and requests for services were investigated and where possible, defects and unsatisfactory conditions were remedied. The following table shows the nature and number of inspections made:- Housing Public Health and Housing Acts 7,792 10,499 Multiple Occupation 1,385 Other housing visits 1,322 Clean Air Observations 1,089 8,572 Surveys, proposals and claims 1,775 Other clean air visits 5,708 55 Food Premises Bakehouses and bakers shops 297 Butchers 773 Dairies, Milkshops and Processing Plants 170 Grocers 612 Labelling and Sampling 614 Ice Cream 119 Restaurants, cafes 800 School Meal Kitchens and Canteens 86 Stalls 172 Unsound Food 583 Other Food premises visits 2,263 6,489 Factories Powered/non -powered 744 Sites 40 Outworkers 93 877 Offices, Shops and Railway Premises 1,989 1,989 Drainage Drainage and Plumbing Works 2,396 Cesspools 366 2,762 Infectious Diseases 5,771 5,771 Animals Pet Shops 89 Riding Establishments 22 Boarding Establishments 32 Diseases of Animals Act 168 Others 89 400 Miscellaneous Visits Accommodation roads/passages 227 Noise nuisance 788 Accumulations of rubbish 1,661 Hairdressers 65 Caravans 137 Watercourses 311 Not classified 2,017 5,206 42,565 Of the 2,281 informal notices served, 1005 were complied with and 146 statutory notices were required, and of these 84 had been complied with at the end of the year. 56 LOCAL LAND CHARGE ENQUIRIES These refer to enquiries from the Town Clerk concerning outstanding notices, the progress of housing schemes and smoke control areas in relation to all types of property in the Borough, in pursuance of the provisions of the Land Charges Act 1925. The necessary searches were made and information supplied in respect of 8,977 properties. NOISE The Noise Abatement Act 1960 and the Public Health Act 1936 together with byelaws as to street noises, noisy animals etc., provide measures for dealing with noise or vibration which is a nuisance. This does not apply to noise or vibration caused by aircraft or by statutory undertakers in the exercise of their powers. During the year 81 complaints were received and investigated; the majority relating to noise from business or industrial activity and the remainder from domestic or social causes. Although not all were dealt with to the satisfaction of complainants, occupiers of factories and other business premises were not unco-operative. SHOPS AND OFFICES The Offices, Shops and Railway Premises Act 1963 and a number of Regulations made thereunder regulate working conditions in offices and shops. Public Health Inspectors and Shop Inspectors of the Town Clerk's Department, collaborate in these measures to secure the health, safety and welfare of persons employed in such premises. The Town Clerk is also responsible for the registration procedure and the publication of an Annual Report to the Secretary of State for Employment and Productivity. The total number of registered premises at the end of the year was 3,181, a slight reduction on the previous year although 380 premises were newly registered during the year. At the end of the year there were 1,097 shop premises where the Act is not applicable. In addition to the number of premises registered by the Council there are 281 registered where the Act is enforced by the Factory Inspectorate (by demarcation arrangement) and 11 premises where the Act is enforced by the Greater London Council. The following is an extract from the Report, setting out the number of premises registered, an analysis of persons employed and the number of general inspections made:- 57 Table A — Registrations and General Inspections Class of premises No. of premises Total registered premises at end of year Registered premises receiving a general inspection Offices 88 836 155 Retail shops 253 2,049 1,288 Wholesale shops, warehouses 8 59 15 Catering establishments open to the public, canteens 31 233 34 Fuel storage depots - 4 4 TOTALS 380 3,181 1.496 Table B — Number of visits of all kinds by Inspectors to Registered Premises 5,233 Table C — Analysis of persons employed in registered premises by workplace Class of workplace No. of persons employed Offices 14,201 Retail Shops 8,504 Wholesale departments, warehouses 1,482 Catering establishments open to the public 1,574 Canteens 216 Fuel Storage Depots 22 TOTAL 25,999 Total males 12,974 Total females 13,025 FACTORIES AND WORKPLACES The Local Authority is responsible for enforcing the provisions of the Factories Act 1961 and associated Regulations, in respect of cleanliness, overcrowding, temperature, ventilation, 58 drainage of floors, and sanitary conveniences in factories where no mechanical power is used, and the provisions as to sanitary conveniences only in factories in which power is used. The following tabulated report in the form specified by the Secretary of State for Employment and Productivity shows the number of factories registered, the number of inspections made and defects found and remedied. Premises Number on Register Number of Inspections Written Notices Occupiers prosecuted (1) (2) (3) (4) (5) (i) Factories in which Section 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 75 82 8 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority. 609 662 47 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 21 40 - - TOTAL 705 784 55 - Cases in which defects were found: — Particulars Number of cases in which defects were found Number of in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector (1) (2) (3) (4) (5) (6) Want of cleanliness (S. 1) 5 3 - - - Overcrowding (S.2) 1 1 - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) 1 1 - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient 11 1 - - - (b) Unsuitable or defective 77 43 - 6 - (c) Not separate for sexes - - - 3 - Other offences against the Act (not including offences relating to outwork) 12 7 3 - - TOTAL 107 56 3 9 - 59 OUTWORKERS Section 133 of the Factories Act 1961 requires the occupier of a factory to notify to the Local Authority the names and addresses of persons employed in their own homes. There are 177 outworkers so notified engaged in the following trades Wearing apparel 130 Curtains and furniture hangings 2 Brass and brass articles 9 Artificial flowers 5 Making of boxes, etc. 21 Stuffed toys 3 Cosaques, Christmas stockings etc. 1 Lamp shades 6 The Public Health Inspectors made 93 visits to such premises. No unsatisfactory conditions were noted, and in no case was it necessary to request employers to cease giving out work. RAG FLOCK AND OTHER FILLING MATERIALS The Rag Flock and Other Filling Materials Act 1951 requires the registration of premises where filling materials are used in the manufacture of bedding, toys, baby carriages and other articles of upholstery and the licensing of premises where rag flock is manufactured or stored for distribution. Regulations made under the Act apply standards of cleanliness for filling materials and prescribe a form of records to be kept by occupiers of registered or licensed premises. Five premises registered under the Act were inspected and found to be satisfactory. SWIMMING POOLS AND BATHS There are four public swimming establishments provided and maintained at:- Squires Lane, Finchley (Indoor) High Road, North Finchley. Daws Lane, Mill Hill. Goldsmith Avenue, West Hendon. Water treatment to the pools is carried out by filtration and "break point' chlorination method. 60 Public Slipper Baths are available in the Borough at Borthwick Road, West Hendon, Squires Lane, Finchley and Cloister Road, Childs Hill. SANITARY CONVENIENCES There are 69 male and 67 female public conveniences adjoining the highways and within the curtilage of the Council's parks and open spaces. New conveniences have been built at Victoria Park, Finchley and Brent Park, Hendon. The sanitary fittings in all the public conveniences were thoroughly descaled and cleaned by a firm of specialist contractors, and it is anticipated that this will now take place annually. The use of washing facilities are free in the Borough and only at a few is a charge made for the toilet. SEWERAGE AND SEWAGE DISPOSAL The system of sewerage in the Barnet area is partially separate and partially combined, whilst the rural areas of Arkley and Totteridge are unsewered. Treatment and disposal is partly at the Greater London Council (East Middlesex) main drainage works, Deephams, Edmonton, and partly at West Hertfordshire main drainage works Rickmansworth, Herts. Apart from isolated cases, the Friern Barnet area is entirely sewered. Only a small area exists where there is a combined drainage sewerage system. Treatment and disposal is at Edmonton. The whole of the Finchley area has a separate sewerage system and is sewered. Treatment and disposal is at Edmonton. In the East Barnet area there is a separate sewerage system except for the older development in Monken Hadley area where it is partly combined. The whole of the district is sewered and treatment and disposal is at Edmonton. The Hendon area has a separate sewerage system except for small areas of old development which are partly combined, and these are being eliminated as housing redevelopment projects progress. The Hendon Wood Lane area is not sewered and there are also a few isolated sites where gravity drainage cannot be provided to sewers. Treatment and disposal is at the Greater London Council ( West Middlesex) works Mogden. In the more rural parts of the Northern area there are some properties which drain to 61 cesspools for which, an emptying service is operated by the Council whereby eight clearances are carried out free of charge. REFUSE COLLECTION AND DISPOSAL The collection of refuse is made by direct labour in various types of specially manufactured vehicles. The number of collection rounds is 44. Disposal is effected by a destructor at Hendon on the North Circular Road and by transfer station at Summers Lane, Finchley. All disposal is the responsibility of the Greater London Council. Special arrangements are made for the regular clearance of trade refuse as required, whilst a service is available on pre-payment for the collection and disposal of unwanted cars, furniture, garden refuse, rubble etc. ANIMALS The Animal Boarding Establishments Act 1963, with the Pet Animals Act 1951 and the Riding Establishments Act 1964 provide protective legislation to secure the wellbeing of cats and dogs, animals sold for pets and horses hired out for riding. At the end of the year the following licences were in forcer:- Animal Boarding Establishments Act 1963 3 Pet Animals Act 1951 21 Riding Establishments Act 1964 1 0 The Public Health Inspectors are "authorised officers" for enforcing the provisions of the Diseases of Animals Act 1950 and the numerous orders made thereunder. There is one establishment in the Borough, licensed by the Ministry of Agriculture, Fisheries and Food, for the detention of cats and dogs under quarantine following importation to this country. During the year 110 dogs were received at the premises after being authorised to land. The premises are kept under observation by the police and the Public Health Inspectors to check on the detention of the animals for the required isolation periods. Information was received from a Veterinary Officer of the Ministry of Agriculture, Fisheries and Food that an approximately 8 week old kitten had been illegally imported into the country. On the facts obtained there appeared to be an infringement of the Importation of Dogs and Cats Order 1928, and in view of the Council's duty to enforce the Order, proceedings in respect of the offence were taken against the person responsible. 62 The pers on pleaded guilty and was fined £5 and £2 costs for the Council and £5 costs for the Ministry of Agriculture, Fisheries and Food. Under the Movement (Records) Orders detailed records have to be kept by stockholders of the movement of cattle, sheep, goats and pigs to and from their premises. Farm premises were visited to inspect the record books to ensure that the appropriate entries were made and that the animals were retained. Under the Regulation of Movement of Swine Order 1959, three licences were issued for the movement of pigs to a slaughterhouse from a local farm before the expiration of the 28 days normal detention period after the last movement of the pigs. The Diseases of Animals (Waste Food) Order 1957 requires that all waste foods to be used for the feeding of animals must be boiled to minimise the risk of spread of animal diseases. The boiling plants may only be operated if satisfactory and licensed. 13 licences were in force at the end of the year. Mr. J. R. Stockman, M.R.C.V.S., continued to act on a consultancy basis to assist in the inspection of animals and premises where necessary. RODENT CONTROL The Prevention of Damage by Pests Act 1949 places the onus on the occupier to rid his land and premises of rats and mice, but in practice it is found that the provisions of the Act are best administered by the Council providing a control service. This is carried out by a trained staff of Rodent Operatives and in accordance with the recommendations of the Ministry of Agriculture, Fisheries and Food. In the case of dwelling houses, treatment is undertaken by the Council free of charge, and on a "time and cost" basis in respect of business premises. Treatment of sewers to reduce the number of rats was again carried out three times during the year. Fluoracetamide, a dangerous poison was used, and the work carried out by a specialist firm under contract. The arrangements for the work and its supervision are made with the co-operation of the Borough Engineer and Surveyor. 63 The records show that the average numbers of stock held were: Cattle 884 Pigs 3,960 Sheep - Goats 1 Poultry 17,843 The following table summarises the work carried out and is in the form required by the Ministry of Agriculture, Fisheries and Food: Properties other than Sewers Type of Property Non-Agricultural Agricultural Number of properties in the district 118,335 41 2. (a) Total number of properties (including nearby premises) inspected following notification 2,639 4 (b) Number infested by (i) Rats 1,785 4 (ii) Mice 731 - 3. (a) Total number of properties inspected for rats and/or mice for reasons other than notification 482 10 (b) Number infested by (i) Rats 169 - (ii) Mice 13 — The Rodent Operatives made 14,697 visits during the year. DISINFECTION AND DISINFESTATION Facilities for steam disinfection and disinfestation, and for the personal cleansing of verminous persons are provided at the Disinfecting Station, North Circular Road, N.3. Requests for advice and assistance in dealing with insect pests increased in number and range over a wide variety. Many of these insects are of no public health significance, but steps are taken to assist all enquiries. One must again express thanks to the Director of the Department of Entomology of the Natural History Museum for the helpful cooperation of his experts in the identification of numerous insects. Because of complaints from some residents in regard to damage and nuisance caused by the common squirrel, the Council decided to obtain traps and to hire them out on request. During the year some 41 requests were received. "Wild" or "feral" Pigeons are now a widespread pest. A Specialist Contractor has been employed to reduce the number of pigeons at several major centres of infestation in the Borough. Their work however is impaired by the well meant but misplaced kindness of 64 those who regularly provide an ample food supply at all seasons thus enabling birds to maintain a high breeding rate. A charge is made for disinfection and disinfestation, with the exception of terminal disinfection carried out after a notifiable disease, and the cleansing of verminous people. The following table shows the work done by the Disinfectors:- Disinfection Rooms 72 Articles 301 Disinfestation Ants 16 Beetles 17 Bugs 16 Cockroaches 13 Crickets 2 Fleas 64 Flies/Fly Maggots 5 Insects 6 Lice — Scabies 18 Mites 3 Moths 1 Drying Processes Premises 4 Articles 4 MORTUARY The public mortuary serving the Borough is situated adjacent to the Disinfecting Station, North Circular Road, N.3; in the course of the year 605 bodies were received. EXHUMATIONS Licences for the removal of human remains under the Burial Act 1857 state, inter alia, "it is considered advisable that the Medical Officer of Health should be notified whenever such a licence is granted in order that he may be in a position to take any action that may be necessary in the interests of public health". Thirteen exhumations were carried out during the year and, where appropriate, were observed by a Public Health Inspector, to ensure compliance with the conditions in the Licence. 65 MENTAL HEALTH SERVICES MENTAL HEALTH SERVICES Throughout the year there was again a steady increase in the demand for community services, particularly in the field of mental illness. It is becoming more apparent with the advances in modern methods of treatment that the need for long term hospital care is decreasing and it is expected that the numbers of persons needing help will continue to grow. With this in mind and anticipating the demands which will be made upon the existing services, it is clear that in common with many forward-looking authorities, this borough will need to introduce new ideas to keep abreast of the modern approach to mental health community care. There was also an increase of 5% in new referrals for subnormality and although the Borough services appeared to be good in this respect, it is clear that increased facilities are now urgently required particularly for severely subnormal adults. The most pressing needs will therefore be taken into account in considering plans for future development with high priority being given to services for the adult subnormal and mentally infirm elderly. Mental Illness I mentioned in my last report that because of the increasing complexities of the service it was important the Field Worker should be fully experienced and qualified in Social Work. The practice has therefore continued to second two members of staff per year to appropriate courses to receive training. I am confident the long term value of such training will permit the Mental Welfare Officer to specialise in the fields of social work and to deploy his skills more broadly. Although there was some movement of staff the Department was most fortunate in attracting new staff with good social work qualifications. Allied to staffing generally the service has provided practical placement facilities for four students from professional courses. Three from High Wycombe College and one from Chiswick Polytechnic. Casework At the end of the year the total known caseload of both psychiatric patients and mentally handicapped was 1,255 — 906 psychiatric patients and 349 mentally handicapped over 16 years of age. Social Work with the mentally handicapped under 16 years of age continued, in the main, by the Health Visitor but in close co-operation with the Social Workers, and therefore the overall case load was somewhat in excess of the figures quoted. 69 During the year 5,889 community care visits were made. It is gratifying to note that statutory admissions within the borough's catchment area have dropped by 9% in 1969. However a great deal of social work time is spent on this work as the borough continues to discharge statutory duties in respect of patients from other boroughs in the neighbouring psychiatric hospitals where for various reasons it is not considered practical for the responsible authority to undertake the work. Supervisions and discussion of cases is available for all the Mental Health Social Workers each being responsible for their own case load, and continuing care of the patient. In this way the Social Worker concerned is better able to establish the necessary relationship and provide effective long term support. Day Centres — Elderly Mentally Infirm Day centre facilities for the elderly mentally infirm remained a high priority in the plans for the development of the service and it had been hoped that in addition to extending the Centre at Park House Hostel which commenced as an experiment in 1966, a further 45 place purpose built Day Centre would have been completed by 1969 to supplement the service. Unfortunately there have been setbacks and the new centre is not likely to be functional before 1972. The Borough is therefore grateful to the London Borough of Harrow which continues to allocate vacancies at their Marlborough Day Centre. Social Clubs The two social clubs for the mentally ill are organised and run by the Department's Officers who are also greatly assisted by the local voluntary organisation dealing with mental health activities. It is felt there is also a considerable need for social clubs for the mentally handicapped and educationally subnormal, but steps have not as yet been taken to extend this area due to the already heavy demands made upon the Department's Officers. However this is a matter which will be receiving active consideration in conjunction with the local voluntary societies. Park House Hostel Applications for admission to the hostel continued at a steady rate throughout the year and the fact that the hostel did not have all 30 places occupied was mainly due to the criteria for admission. Potential residents must be ready to return to their previous employment or be ready to seek employment thus the danger of the hostel becoming silted with residents unable to progress to unsupervised accommodation is minimised and more 70 important the residents are at a stage where they can cope with some of the demands which will be made on them in the community. Residents who rehabilitate to a point where they are able to leave the hostel are encouraged to return at intervals and have the occasional meal thereby maintaining a useful link and means of support. Close social work support was given by senior members of the Department's social work staff, and residents who had already had the services of a Social Worker within the hospital or placing Authority were encouraged to maintain such contact. Ideally the next step forward from a hostel or indeed even from a hospital should be a 'group home' and it is hoped the setting up of such an establishment will be included in the Council's long term plans for future development. Hospital Services Napsbury Hospital remains the sole psychiatric hospital providing cover for the mentally ill in the Borough. The hospital also provides excellent out-patient facilities at the two local General Hospitals, this service being of particular advantiage since Napsbury is situated some considerable distance outside the catchment area which presents difficulties in arranging early referral and maintaining contact with former patients. It is hoped that in time it will be possible to set up localised psychiatric services which will alleviate if not resolve problems of distance, time and transport. The Mental Health Social Workers regularly attended meetings with the consultants at Napsbury and took part in general case conferences. This enables ease of admission work, follow up of patients and thus making for good co-ordination between all the services. Preventative Work On the medical side the Principal Medical Officer conducted seminars for pupil midwives in the district on 'psychiatric problems of pregnancy and puerperium', and gave courses of lectures on mental health to the local detachment of the British Red Cross. In the field of addiction, liaison was maintained with other bodies involved with this problem, and the Principal Medical Officer joined the Drug Discussion Group at the King Edward VII Hospital Centre. It will be appreciated that all Mental Health Social Workers are involved with drug dependency in their day to day work and have formal or informal contact with other agencies. Community Care of the Subnormal and Severely Subnormal Each year a great deal of thought is given to the type of community care service which 71 will best meet the different and complex needs of each family with a handicapped child or adult. Every endeavour is made to co-ordinate the services to provide not only 'first aid' but supporting help and encouragement to assist the family to achieve some measure of independence irrespective of the degree of handicap of the person in their care. There is seldom a simple answer when a crisis situation arises but it is only through accepting the challenge of resolving the difficult problems that new ideas are born and become the foundations of future development. Training Schools The provisions available in the two junior training schools have been found to be adequate for present needs and therefore there is no immediate proposal to increase the number of schools. One of the most important factors for the handicapped child is establishing social competence and noticeable progress has been observed through expanding outside activities. Fund raising by voluntary bodies enabled the National Society for Mentally Handicapped Children to provide a Touch Tutor—Frostig and Autobates equipment. An experimental programme of one year was commenced during 1969 which involved specially written programmes with some of the more handicapped children including some from the Special Care Unit. A member of the National Society's staff visited regularly in order to test the children and record progress. At the end of the period of one year, there will be sufficient experimental evidence available for a decision to be made about the continued use of Touch Tutors as part of the school's normal activities. These various forms of special equipment have proved a great value in teaching co-ordination, accelerating reading and language development and stimulating untapped resources within the mentally handicapped child. I am pleased to acknowledge that the success and progress of these schools is attributable to the tireless efforts of the staff to avail themselves of every opportunity to seek new approaches to the work. Special Care Units The provision of more special care unit accommodation remains one of the most urgent priorities particularly for the more severely physically handicapped child and young adult. Discussions are taking place with the North West Metropolitan Regional Hospital Board to ascertain what provisions can be made available in the foreseeable future for those cases whose prime requirement is nursing care. Without these units and the devotion of the staff who run them, it would be impossible for some families to go on caring for the handicapped in their midst. 72 Short Term Care It is recognised that it is an essential part of community care for practical relief to be given to families from the continual care of the handicapped member. It is frequently the short term care rather than the supporting help which enables the family to go on. Voluntary organisations are the main source of short term care vacancies and 46 patients benefited from this service during the year. Residential Care Permanent care grows more difficult to obtain each year and many patients, both children and adults, who require hospital care are unable to receive it either through shortage of staff or lack of accommodation in the hospital. The very heavy burden placed on parents is recognised and the council provides relief where ever possible in the form of permanent care through voluntary organisations and private individuals. It is envisaged that the provision of additional Council own hostels will help to solve the problem of both long and short term care. A small beginning has already been made in the opening of a ten place hostel 'Harwood' on the 5th May for ten mentally handicapped children; despite staffing difficulties a full service was maintained throughout the year. Parents of the children are encouraged to have their child home, where possible, for the occasional weekend and also for holiday periods during the summer months; this is not only beneficial to the child but is effective in releasing a bed for short term care and helps in a small way with the numerous emergency placements constantly required. Adult Training Centres The numbers needing adult training are increasing and although the Council has provision for 40 places at each of the two training centres there is no doubt that the 150 places in the adult training centre planned for completion during 1970/71 will be fully utilised. With the increasing number of places more diverse training can be planned and it may well be that with two or more centres a higher level of up-grading would be possible permitting extension of development so that a greater proportion can be fitted for outside employment. 73 74 Number of persons under Local Health Authority care at 31st December, 1969 Mentally 111 Elderly Mentally Infirm Psychopathic Subnormal Severely subnormal Total Under age 16 16 and over Under age 16 16 and over Under age 16 16 and over Under age 16 16 and over M F M F M F M F M F M F M F M F M F (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (ID (12) (13) (14) (15) (16) (17) (18) (19) 1 Total number 1 1 97 177 21 49 3 8 8 115 84 61 43 103 89 860 2 Attending workshops, day centres or training centres (including special units) 5 3 12 17 7 7 18 16 51 30 59 52 277 3 Awaiting entry to workshops, day centres or training centres (including special units) 1 1 6 7 4 2 21 4 Receiving home training 5 Awaiting home training 6 Resident in L.A. home/hostel 4 6 1 5 2 18 7 Awaiting residence in L.A. home/hostel 8 Resident in other home/hostel 19 12 1 8 9 8 4 15' 6 82 9 Boarded out in private household 1 1 2 10 Attending day hospital 3 6 9 11 Receiving home visits and not inc in lines 2-10 (a) suitable to attend a training centre 11 14 9 31 1 66 (b) others 1 1 55 136 3 92 62 2 6 28 33 419 cn Cases of Mentally III Persons referred to Mental Welfare Officers during 1969 REFERRED BY MENTALLY ILL TOTAL UNDER AGE 16 16 AND OVER M F M F 1 2 3 4 (a) General Practitioners 2 136 238 376 (b) Hospitals, on discharge from in-patient treatment 1 75 66 142 (c) Hospital, after or during outpatient or day treatment 49 58 107 (d) Local education authorities (e) Police and courts 40 19 59 (f) Other sources 3 2 138 213 356 (g) Total 6 2 438 594 1040 Persons Under Local Authority Care At 31.12.69 MENTALLY ILL ELDERLY MENTALLY INFIRM SUBNORMAL TOTAL Under 16 years 16 years & over Male Female Male Female Male Female Male Female ##] 1 1 77 159 21 48 191 158 WELFARE SERVICES WELFARE SERVICES The Welfare Services provided by the Council, by virtue of the National Assistance Act, 1948, have been expanded during the year in relation to the care of the aged, the physically handicapped, and the homeless members of the community. Residential Accommodation The demand for residential accommodation continues to increase, and the number requiring admission at 31st December, 1969 had grown to 227. The number of people accommodated in Council Homes for the elderly at the end of the year was 370, and was made up as follows:— Name of Home No. of Beds Disposition Beach Lodge, 66 Hendon Lane, N.3. 32 Female The Cedars, Richmond Road, New Barnet 38 Mixed The Leys, Barnet Lane, Elstree 47 Mixed Morton Lodge, Ashfield Road, Southgate, N.14. 50 Mixed Redhill House, Burnt Oak Broadway, Edgware 81 Mixed Storth Oaks, 1 Downage, Hendon, N.W.4. 31 Mixed Woodhill House, Kentish Lane, Essendon, Herts. 41 Mixed Meadowside, 58 Holden Road, N.12. 50 Mixed Total 370 During the year the new "Meadowside" Welfare Home in Holden Road, Finchley was opened; it will be recalled that this replaces the former Home of the same name, demolished in 1967. In my 1967 Report I referred to Redhill House the former Poor Law Institution and the programmed closure of these premises in 1972/3 and that the Ministry of Health at that time had given approval to 4 replacement homes. It will be seen from the above table that at the end of the year the number of beds at this home had been reduced to 81 compared to 251 in 1965. The completion at the close of the year of the first replacement Home will further accelerate the closure of Redhill House and in fact it is hoped that this will be achieved during the coming year. The new Home "Merrivale" built within the grounds of Redhill House, will accommodate 60 people. During the year 102 people were admitted to the Council's Homes; 62 residents died, and 46 were transferred to hospital. Short-stay accommodation was provided for 37 persons, to enable relatives who normally care for them to take a holiday. 79 Improvements and maintenance of buildings, furniture and equipment was maintained at a high standard, with due regard to economy. A part-time Handicrafts Instructor attended the Homes to assist those residents willing to accept such instruction. Film shows and outings were provided frequently by the Council and additional outings, lunches, theatre parties, etc., were provided by voluntary organisations. The interest shown and the contribution made by the many voluntary societies in the Borough towards the welfare of the elderly is greatly appreciated. The Council was financially responsible for 52 people accommodated in other local authority Homes, and 8 residents in Barnet Homes were chargeable to other authorities. The Council was financially responsible for 401 persons in the Homes of Voluntary Organisations. Registered Homes for the Elderly and Handicapped There were 54 Registered Homes for the Elderly and Handicapped in the Borough, providing accommodation for 937 persons; 746 resided in Homes run by Voluntary Organisations and 191 in Private Homes for the elderly. Four additional Homes were registered during the year, and the same number were cancelled. Workroom/Day Centre Facilities The Day Centre for 15 elderly people introduced at Claremont Clinic in 1968 continued to operate during the year. The Centre functioned on Tuesday and Thursday of each week, and proved most successful, enabling housebound elderly people to be collected from their homes and enjoy the facilities at the Centre. The popularity of the Etchingham Park Workroom/Day Centre continued. Day care was provided for 15 elderly housebound persons, enabling the members of their families, who normally care for them, to follow their own occupations. The Work Centre, catering for 40 active elderly persons adds to the value of the service provided. Finchley Work Centre This Centre is organised by the Finchley Guild of Social Service, and provides a most worthwhile and interesting service for elderly persons in the East Finchley area. Meals on Wheels This service organised by the Women's Royal Voluntary Service, as Agents of the Council, provided 59, 642 meals during the year. Not all parts of the Borough received a 5-day service, but there was a substantial increase in the number of meals 80 provided this year, and the ultimate aim is a daily service in all areas of the Borough. In addition, the Hendon Old People's Welfare Committee, and the Watling Community Centre held a lunch Club for the elderly once each week, and The League of Jewish Women supplied Kosher meals to a number of elderly people in the Finchley area. The Luncheon Clubs operated by all the Organisations mentioned play an important role in caring for the needs of the elderly, and during the year a total of 18,982 meals were served in these Clubs in the Borough. Homeless Families Provision for homeless families evicted from their homes for a variety of reasons continued to be a serious and increasing problem. This is borne out by the fact that both homeless family.hostels i.e. Kelvedon, 27 Woodside Avenue, Finchley, N.12 (accommodation 12 families) and Redhill Lodge, Burnt Oak, Edgware (accommodation 25 families) were in full occupation throughout the year; in addition, a property at 2 Edward Road, New Barnet was adapted to provide housing for four families and this accommodation was also filled. The Reception unit at Redhill House Welfare Home was in constant occupation and an overflow of up to 10 families were accommodated at various periods in other parts of this Home. The Council again determined that a minimum of 15 families should be rehoused into permanent accommodation from the two homeless family hostels and by 31st December it had been possible to rehouse 33 families in this way. The building of The Croft a new homeless family unit was commenced during the year and completion is anticipated in the early part of 1970. Fami lies Persons Number accommodated as at 1.1.69 41 177 Number of applications during 1969 (Family Units) 109 - Number of admissions during 1969 51 188 Number re-housed by the Council's own housing 24 103 Number discharged to other accommodation etc. 12 39 Children born to residents during 1969 — 8 Husbands rejoining families during 1969 — 3 Number remaining as at 31.12.69 56 234 81 Number of Men, Women and Children resident at 31st December Men (aged 16 and over) 37 Women (aged 16 and over) 57 Children (aged 5-15) 65 " (aged under 5) 75 Total 234 Services for the partially sighted These are persons substantially and permanently handicapped by congenitally defective vision, or in whose case illness or injury has caused defective vision of a substantial and permanently handicapping character, which brings them within the scope of the welfare services which the local authority are empowered to provide for blind persons. Services Provided Employment of Home Teachers to assist in promoting general welfare, and to give instruction on reading embossed literature if required. Christmas parcels for the lonely and housebound. Talking Book Machines, if surgeon agrees that the person cannot read print. Tape Recorders, large print books (Available from local Library). Educational grants for further studies Social Clubs Industrial and Social Rehabilitation for Partially-Sighted persons, whose sight is likely to deteriorate. Handicraft Classes. Financial assistance with holidays. Dancing Classes and Dances (see Blind Services — Page 84) Provision of clothing, furniture and meals, etc. by W.R.V.S. North Middlesex Horticultural Society for the Blind Financial assistance from Middlesex Association for the Blind, if in need, e.g. electric or gas bill, clothing, household repairs and decorations, provision of furniture, etc. Sheltered employment in Workshops or Home Workers. Handicraft Materials Aids 82 170 persons were registered as partially-sighted, an increase of eight over last year. Age Groups 0-1 2-4 5-15 16-20 21-49 50-64 65+ Total Males — — 9 2 8 10 24 53 Females — — 8 1 15 14 79 117 Total — — 17 3 23 24 103 170 Registered Partially-Sighted Persons other than those near or prospectively blind 16-20 21-49 50-64 65+ Total Mainly Industrially Handicapped Employed: Males 3 6 5 — 14 Females 1 6 3 — 10 Available for and capable of training for work: Males — — — — — Females 1 — — l Requiring observation only: Males — 1 — 13 14 Females 1 5 5 28 39 Children, 16 and over, still at school: Males — — — — — Females 1 — — — 1 0 7 18 13 41 79 0-5 5-16 Total Chil< iren under 16: Attending special schools: Males — 4 4 Females — 4 4 Attending other schools: Males — 3 3 Females — 2 2 Not at school: Males — 2 2 Females — 2 2 — 17 17 83 Services for the Blind "A person so blind as to be unable to perform any work for which eyesight is essential". Services Provided: Employment of Home Teachers to assist in promoting general welfare and to give instruction on reading embossed literature. Financial assistance from Middlesex Association for the Blind if in need, e.g. electricity or gas bill, repairs, etc. Magazines in Braille and letterpress. Christmas Parcels from Middlesex Association for the Blind Talking Book Machines Library Service of literature in Braille Wireless Set from Wireless for the Blind Fund Wireless Licence Exemption Certificate from London Borough of Barnet Bus Passes from London Transport Educational Grants for further studies, tape recorders, etc., from Voluntary Organisations Pensions for the assistance of Blind People from charities. 5 Social Clubs — (4 afternoon, 1 evening) 3 Handicraft Classes and yearly exhibition Industrial and Social Rehabilitation Financial assistance for holidays Dancing classes and dances: Hendon Dancing Class for the Blind (Education Department, Transport by Welfare) Tottenham Deaf/Blind Class (Transport by Welfare) Provision of clothes, furniture, meals, etc. by W.R.V.S. North Middlesex Horticultural Society for the Blind: Spring and Summer Shows. Free Bulbs Guide dogs for totally blind Sheltered employment in Workshops or Home Workers. Financial assistance by London Borough of Barnet Cinema Passes for blind (Rank Organisation) Handicraft Materials, incl. card games, etc. (Paid at cost price) Aids Loan of typewriters and tape recorders Escort duties by B.R.C.S. and League of Jewish Women Various house and garden jobs by Task Force Home Helps Industrial Rehabilitation (organised by R.N.I.B.) 84 Number of Registered Blind Persons at 31.12.69 Age Groups 0-1 2-4 5-15 16-20 21-49 50-64 65+ Total Males 1 - 7 4 41 47 153 253 Females 1 - 3 5 35 50 358 452 Total 2 - 10 9 76 97 511 705 During the year 124 persons were added to the Register, in the following Age Groups:— Age Groups 0-1 2-4 5-15 16-20 21-49 50-64 65+ Total Males 1 — 1 1 1 6 36 46 Females 1 — — — 4 9 64 78 Total 2 — 1 1 5 15 100 124 Employment 90 registered Blind persons were in employment at the end of the year; 7 in special Workshops, 8 in Home Workers Schemes and 75 in open employment. The occupations of the 90 Blind persons in employment were as follows Masseurs & Physiotherapists 9 Lecturers, Teachers, Instructors 3 Barristers & Solicitors 2 Musicians 3 Social, Welfare and related workers 3 Proprietors, Managers & Executive Workers 4 Typists, Shorthand Typists & Secretaries 8 Braille Copyists 1 Clerical Workers 1 Telephone Operators 12 Working Proprietors & Shop Managers 2 Sales Representatives, Agents & Collectors 1 Machine Tool Operators 5 Fitters & Assemblers 3 Viewers, Inspectors & Testers 1 Packers 1 Carpenters & Joiners 1 Knitters (Hand & Machine) 3 Upholsterers 1 85 Basket Makers 3 Chair Seaters 1 Wireworkers 1 Piano Tuners 1 Craftsmen and Production Process Workers 9 Labourers 2 Domestic/Canteen Workers 4 Miscellaneous Workers 5 90 Services for the Deaf and Hard of Hearing Deaf (a) Without speech: "Those who have no useful hearing, and whose normal method of communication is by signs, finger spelling, or writing". (b) With speech: "Those who (even with a hearing aid) have little or no useful hearing, but whose normal method of communication is by speech and lip-reading". Hard of Hearing: "Those who (with or without a hearing aid) have some useful hearing, and whose normal method of communication is by speech, listening and lip-reading". Services Provided Employment of Welfare Officer for the Deaf, to give advice and guidance on problems relating to the deaf and act as interpreter. Assistance with holidays Aids: Mountcastle Silent Bell Hearing Aids — outside National Health Service Liaison with Disablement Resettlement Officer Clubs, lip-reading classes, etc. Grants to "Hard of Hearing" Groups in Hendon and Chipping Barnet. The number of persons on the Register at 31st December, 1969 was 111, in the following age groups Age Group Deaf with speech Deaf without speech Hard of hearing Total Under 16 1 1 — 2 16-64 years 21 24 10 55 65 years or over 12 12 30 54 Total 34 37 40 111 86 The "Hard of Hearing" Groups at Chipping Barnet and Hendon continued to flourish under active leadership, and provided valuable assistance to my Department and to the individuals concerned. Services for the Physically Handicapped "Persons who are substantially and permanently handicapped by illness, injury or congenital deformity, or such other disabilities as may be prescribed by the Minister." Services Provided Social Welfare Officers assist in overcoming effects of disabilities and give help on personal problems. Necessary aids are available on free loan Adaptations to property — up to £25 free of charge to client; assessed if estimate is above this amount. No charge if Borough Council property . Financial assistance with holidays Transport to Centres and to special functions Rehabilitation Centre (Deansbrook Road, Edgware) Home Helps Clubs and Handicraft Classes — some in co-operation with the British Red Cross Society Functional Assessment Unit — arrangements made for attendance at hospital Various house and garden jobs by Task Force Liaison with Disablement Resettlement Officer Financial Assistance for employment in Work Centres of other Authorities and Organisations This Group includes spastics, epileptics, sufferers from multiple sclerosis, muscular dystrophy, arthritis, poliomyelitis, cardiac disease and other permanent disabilities. The number registered at the end of the year was 1657, in the following age groups:- under 16 years of age 15 16 years to 64 years 609 over 65 years 1033 Total 1657 The daily Work Centre at Heriot Road continued to operate successfully, attendance of an average of 30 persons daily was maintained. The Rehabilitation Centre at Deansbrook Road, Edgware, provided a useful service 87 for the physically handicapped and the blind. The number of persons attending daily varied between 20 and 40, most of whom were conveyed by Council transport. The British Red Cross Society continued to operate weekly Handicraft Classes at Edgware, Hendon, Finchley and High Barnet. During school term, a choral class was held in North Finchley. Transport to these classes was provided by means of the Council's specially-adapted vehicles. During the year 134 persons availed themselves of the Council's Assisted Holiday Scheme for the physically-handicapped. Five families enjoyed a holiday of up to 14 days each in the Caravan at Monkton, Kent, given to the Council by the students of Orange Hill School, but greater use of this will be made in the coming year. Adaptations to the homes of physically-handicapped persons were carried out in 122 cases, at a total cost of £1575. 2. 0; 437 aids to daily living were issued at a cost of £1483. 8. 7. and 84 second-hand aids were supplied from stock; all these aids were loaned free of charge. 88 PERSONAL HEALTH SERVICES PERSONAL HEALTH SERVICES Existing Clinic Provision Full information in respect of the Council's clinics and the key to the services provided, is set out in a table to be found on page 108. Co-ordination and Co-operation with Hospital and General Practitioner Services Meetings took place between the staff of Edgware General Hospital, General Practitioners and the Authority's staff with a view to commencing, early in 1970, an early discharge plan for cold surgery cases. The liaison between the Authority's home nursing staff and hospital nursing staff was further improved by the commencement of regular visits by the Authority's staff to local hospitals to discuss those cases for discharge that were to be nursed in the community, and to provide information on the social aspects of cases being admitted to hospital. Home nurses now attend General Practitioners' surgeries during surgery hours and are able to give injections and other treatment requested by the doctor on the spot instead of, as previously, attending the patient's home after receiving a request from Central Control. This conservation of time means that the nurse can carry out more treatment for house-bound patients unable to attend the doctor's surgery. General Practitioners appreciate the role and skills of the home nurse and are able to use her services very effectively. She is dealing with the important social aspects of treatment to a greater extent than previously. Owing to the changing midwifery pattern, domiciliary midwives have been able to form a closer liaison with the local hospital maternity units by attendance in the wards and in ante-natal Out-patients Departments. Some midwives have the opportunity of delivering their patients who are booked for early discharge from the hospital, thereby providing a continuity of patient care. By the end of the year, all health visitors had changed from working in a geographical area to working in a group practice or with two or more independent Practitioners. Where practicable, the health visitor is allotted accommodation in the General Practitioner's premises in order that she may see patients when they need her. Health Visiting It has been a year of great change for the health visiting service. Although spending a total of 2955 hours during the year in attendance at General 91 Practitioners' surgeries, health visitors remain centred in Local Authority Clinics and are encouraged to maintain an active interest in all clinic activities. Health Education is now being given by health visitors in both General Practitioners' surgeries and local authority premises. Home Visiting Cases First Effective Total Effective No.Access Visits at request of G.P. or Hospital Expectant Mothers 1025 1486 342 — Children born in: 1969 4665 8753 2056 — 1968 3589 6749 2054 — 1964-67 5839 10650 2348 — Persons aged 65 or over 2319 5354 716 1235 Mentally disordered 210 701 126 159 Persons discharged from hospital (other than mental hospitals) 236 298 60 210 Households — Tuberculous 453 662 280 — Households — other infectious diseases 156 212 40 — Other visits as Health Visitors 1370 2140 489 — Total as Health Visitor — 37005 8511 1604 Cases seen as School Nurse — 2146 485 — Prevention of Homiessness (Problem Families) Intensive case work with problem families has continued by family case workers, and the Department's social workers played their part in reducing the risk of homelessness in the Borough. Families re-housed from temporary accommodation during the year were given all possible support. Care of Mothers and Young Children Notification of Births Number of births in the London Borough of Barnet during 1969 as adjusted by inward and outward transfers.- 92 (i) Live Births (a) Domiciliary 254 (b) Institutional 3940 4194 (ii) Still Births (a) Domiciliary 2 (b) Institutional 49 51 4245 Ante-Natal and Post-Natal Clinics There was an appreciable fall in attendances at ante-natal and post-natal sessions in the early part of the year, and the holding of these sessions could no longer be justified. Ante-natal and post-natal patients could be seen after infant welfare sessions or at any other conveniently arranged time, and with the exception of Sutton Road Clinic, ante-natal and post-natal sessions at clinics were therefore discontinued with effect from 1st April. Ante-Natal Clinics (Combined with Post-Natal) Clinics No. of sessions held Total No. of Attendances Ante-Natal Post-Natal Oak Lane 12 42 (61) 2 (-) Torrington 12 67 (56) 3 (2) Central Hendon 6 21 (71) - (2) Childs Hill 12 36 (53) - (2) Mill Hill 11 64 (122) - (7) West Hendon 15 147 (105) 3 (-) Holly Park 12 9 (9) - (6) Oakleigh Road 12 - (-) - (-) Edgware 11 22 (21) - (-) Sutton Road 39 190 (-) - (-) TOTALS 142 598 (498) 8 (19) Note: - Figures in brackets denote the number of attendances of ante-natal and post-natal patients at infant welfare sessions. A total of 260 women attended clinics in the Borough for ante-natal examination and 13 for post-natal. 93 Attendance at combined Mothercraft and Relaxation Clinics Combined Mothercraft and Relaxation No of Sessions Total Attendances Average attendance per Session Central 24 162 6.8 Childs Hill 25 73 2.9 East Barnet 33 197 6.0 Edgware 42 194 4.6 Mill Hill 29 179 6.2 Oak Lane 21 48 2.3 Oakleigh Road 45 183 4.1 Sutton Road 30 101 3.4 Torrington 74 468 6.3 Vale Drive 31 241 7.8 Watling 6 15 2.5 West Hendon 38 129 3.4 TOTALS 398 1990 5.0 Congenital Malformations Information about congenital defects has been collected and recorded. During the year 74 cases were notified to the Department by Hospitals, General Practitioners and Domiciliary Midwives and details of these were passed to the Registrar General Names of the children affected have been added to the Observation Register, so that they can be examined at the appropriate time and treatment given where required. Mothers' Discussion Groups Discussion groups were in operation at the end of the year at the following clinics:- Vale Drive Torrington Brunswick Park (Osidge) Mill Hill Childs Hill Oakleigh Road Oak Lane Holly Park Sutton Road Child Welfare Centres The following table shows the sessions held and attendance at each of the Child Welfare clinics: CLINICS No. of Sessions Total Attendance Average Attendances No.of cases seen by A.M.O. No.of cases referred elsewhere Infant Welfare Sessions Broadf ields 52 2024 38.9 762 — Central 87 3196 36.7 1703 23 Childs Hill 101 4144 41.0 1872 53 Claremont 31 708 22.8 381 18 Colindale 50 1856 37.1 833 2 Dollisfield 23 346 15.0 223 5 East Barnet 95 2807 29.6 1420 2 Edgware 65 1529 23.5 689 13 Etchingham Park 103 2377 23.1 1242 — Holders Hill 24 494 20.6 248 1 Holly Park 52 1236 23.8 759 — Mill Hill 96 2762 26.7 1408 — Oak Lane 115 2608 22.7 1555 18 Oakleigh Road 52 1157 22.3 601 — Osidge 117 3690 31.5 1532 2 St. Barnabas 52 2514 48.3 852 21 St. Marks 12 162 13.5 104 1 St. Stephens 22 451 20.5 248 2 Sanders Lane 26 594 22.8 270 — Sutton Road 50 1232 24.6 693 — Torrington 102 2692 26.4 1168 — Vale Drive 29 691 23.8 423 8 Watling 21 202 9.6 113 West Hendon 98 2095 21.3 857 8 766 Finchley Road 48 921 19.2 518 3 Watling G.P. attachment 51 796 15.6 524 _ 108, Watling Avenue 29 872 30.1 542 — Sessions without a doctor Broadfields 1 38 38.0 _ _ Central 40 529 13.2 Claremont 19 311 16.4 — Dollisfield 3 14 4.7 — East Barnet 4 86 21.5 Edgware 36 414 11.5 Holders Hill 25 326 13.6 Mill Hill 7 107 15.3 St. Marks 12 109 9.1 St. Stephens 2 32 16.0 Sanders Lane 22 243 11.0 — Vale Drive 1 17 17.0 Inglis Barracks 43 607 14.1 — — Developmental Clinics Broadfields 7 46 6.6 46 — Central 11 59 5.4 59 — Claremont 6 45 7.5 45 — East Barnet 12 43 3.6 12 — Garth Road 6 31 5.2 6 — Holly Park 5 44 8.8 5 — Mill Hill 7 60 8.6 7 — Oak Lane 24 310 12.1 24 — Oakleigh Road 6 47 7.8 6 — Osidge 7 78 11.1 7 — St. Barnabas 15 192 12.8 15 — Sutton Road 6 46 7.7 6 — Vale Drive 3 5 1.7 3 — TOTALS 1933 47995 24.8 21781 180 95 Number of children who attended during 1969: Born 1969 Born 1968 Born 1964-67 3738 2839 3147 9724 Midwifery There has been a continued reduction in the number of home deliveries by domiciliary midwives, 254 deliveries taking place during the year, (316 in 1968) with medical aid being summoned in 30 cases (22 in 1968). 724 cases were attended by domiciliary midwives following hospital confinement although, due to the greater bed availability in hospital maternity units, the number of cases discharged early from hospital was considerably smaller than the number planned. During the year it was recommended that the phenistix method of screen testing infants for phenylketonuria should be replaced by the Guthrie blood test method and arrangements were made with Barnet General Hospital for all staff who would be concerned with this to receive instruction regarding the collection of blood specimens. Home Nursing A full establishment of home nurses and nursing auxiliaries was maintained throughout the year. Senior home nurses advised on nursing matters in welfare homes and played a large part in the assessment of the health requirements of residents in Redhill House Old People's Home prior to its anticipated closure in 1970. No. of cases nursed 4025 No. of patients under 5 at first visit 151 No. of patients 65 or over at first visit 2752 Marit Curie Memorial Foundation The Authority continues to act as agent for this society and during the year 17 patients were provided with day and/or night nursing to assist relatives in caring for them. Loan of Nursing Equipment The British Red Cross Society continued to act as agent of the Authority in providing for the loan of nursing equipment, apart from large items. Items such as ripple mattreses, hoists and special beds, are hired or purchased by the Authority. A small loan charge is collected by the Society towards the replacement of equipment, except in hardship cases, when the charge is paid by the Council. Incontinence Pads and Clothing Incontinence pads and clothing are provided free for suitable cases recommended by General Practitioners or home nurses and are available at all main clinics, 98,000 pads and 480 pairs of waterproof pants and linings were issued during the year. Home Help Service The following shows the type of assistance given during the year. Aged 65 or over in 1969 Age under 65 in 1969 Chronic sick or Tubercular Mentally disordered Maternity Others Total Number of Cases 1419 131 16 124 543 2233 Neighbourly Help Service 60 Neighbourly helps were employed at the end of the year and were providing assistance to 60 households. Day Nurseries During the year the number of places available at the Council day nurseries remained at 165 and these were filled mainly by children coming from one parent families. There was, however, an increasing number from families where the mother or both parents were psychiatrically disturbed and as these children — together with a small number of children in each nursery admitted because of a physical or mental handicap — were not always regular attenders, the total attendances at the nurseries were not as high as they were in the previous year. 97 A reasonable staffing ratio was maintained during the year. Day Nursery No. of approved places Children on Register at 31st December 1969 Attendances for the year Average daily attendances 0-2 2-5 0-2 2-5 Lakeview 60 15 42 2476 8948 45 Kingswood 50 13 39 1622 8117 38 Wood Street 55 6 43 1537 7888 37 TOTALS 165 34 124 5635 24953 120 Private Day Nurseries and Registered Child Minders 98 During the year a large number of applications for registration under the Health Services and Public Health Act 1968 were received, particularly from prospective child minders wishing to receive one or 2 children, and visits were made to these applicants by the nursing officers who submitted reports on the home conditions and suitability of the person concerned. The number of private day nurseries and play groups remained at the level of the previc year. A new course was mounted by Barnet College of Further Education in January, which provides training for potential play group supervisors, and some of the supervisors of well established play groups have also benefited from attendance at the course. It operate on a one day a week basis during the full academic year and is held at Holly Park School. A nursing officer has attended on several occasions to talk about registration procedures. At the end of the year there were 43 registered child minders and 70 private day nurseries. Clinics for the Elderly A total of 54 sessions were held at West Hendon and Watling (Edgware) clinics and 1118 attendances made. Chiropody The number of persons treated continued to increase. Treatment is provided througn a directly operated domiciliary and clinic scheme in the former Middlesex part of the Borough and the Hertfordshire County Council's scheme of treatment by chiropodists in private practice continued. The service was supplemented by work undertaken on behalr or the Authority by voluntary bodies. Category Persons provided with Treatment Directly by the Authority (including those treated by private chiropodists on behalf of the Authority) Through arrangements with Voluntary Organisations Elderly persons 1766 693 Physically handicapped 12 — Expectant and nursing mothers 3 — Schoolchildren 18 — Children under 5 years 2 — Name and Address Arkley Lawn Nursing Home, Arkley, Barnet, Herts. Ellern Mede Nursing Home, Totteridge Common, N.20. Preston Lodge Nursing Home, 38 Station Road, New Barnet, Herts. Braeside House Nursing Home, 76 Park Road, New Barnet, Herts. Highwood House Nursing Home, Highwood Hill, Mill Hill, N.W.7. Jay-Jay Nursing Home, 2 Queens Road, Barnet, Herts. Bedford House, Hammers Lane, Mill Hill, N.W.7. Convent of St. Mary at the Cross, Hale Lane, Edgware. Manor House Hospital, (The Industrial Orthopaedic Society) North End Road, N.W.ll. Stuart House, 66 West Heath Road, N.W.3. The National Kidney Centre, 1 Fairholme Gardens, N.3. Northumberland House Mental Nursing Home, 237 Ballards Lane, N.3. No. of Beds 26 Medical/Chronic 34 Chronic 12 Medical/Chronic 12 Medical/Chronic 21 Medical/Chronic 4 Medical/Chronic 23 Chronic 48 Incurable Orthopaedic (Female) 139 Medical/Chronic 8 Chronic 3 30 Mental Nurses Agencies The three nurses' agencies: The Hertford Nurses Bureau, 45 Manor Road, Barnet The Finchley Nurses Co-operation, 24 Eton Avenue, N.12. 100 Nul-Sal Agency, 335 Long Lane, N.2. were inspected during the year and their licences renewed. The agency at Rupert House, Stonegrove, Edgware, was tranferred to premises at 84 Edgware Way, Edgware and, after inspection of the new premises, the licence was renewed. A licence was issued during the year for the Mill Hill Agency to be established at 2 Beechwood Close, N.W.7. Priority Dental Services The number of expectant and nursing mothers and children under 5 years of age receiving dental treatment at clinics, continued to decline and it is assumed that this is attributable to the fact that a greater number of patients are seeking free treatment from their own private dental practitioner. Attendances and Treatment Children under 5 Expectant and Nursing Mothers First Visit 559 91 Subsequent Visits 562 191 Total Visits 1121 282 Number of additional courses of treatment commenced 41 4 Treatment Provided: Number of fillings 768 185 Teeth filled 741 170 Teeth extracted 177 59 General Anaesthetics 74 2 Emergency visits 25 3 Patients X-rayed 1 29 Patients treated by scaling, etc. 35 93 Teeth otherwise conserved 259 - Teeth root filled - - Inlays/Crowns - 3 Number of courses of treatment completed during the year 275 38 Prosthetics Patients supplied with full upper or full lower (first time) 20 Patients supplied with other dentures 19 Number of dentures supplied 39 101 Anaesthetics General anaesthetics administered by dental officers 3 Inspections Children under 5 Expectant and Nursing Mothers Number of patients given first inspections 341 42 Number of patients who required treatment 186 31 Number of patients who were offered treatment 186 31 Number of Dental Officers sessior maternity and child welfare pat is devoted to lents 176 T uberculosis The Borough is served by two chest clinics, viz. Edgware Chest Clinic (attached to Edgware General Hospital) Chest Physician — Dr. H.J. Trenchard, and Barnet Chest Clinic (attached to Barnet General Hospital) Chest Physician — Dr. J.G. Hounslow. The Department's health visitors and T.B. visitors continued to carry out social visiting and act as liaison between the patients and the Chest Physicians. 1. Number of cases of tuberculosis under treatment or supervision at 31st December, 1969. Respiratory Non-Respiratory Men Women Children Total Men Women Children Total 1695 1250 179 3124 56 66 4 126 2. Number of cases of respiratory tuberculosis (whether notified or not) included under Section 1 above which were new to the clinics (but excluding transfers from other clinics) during the year ended 31st December 1969: 102 *C!assification Non-Bacteriologically Confirmed Bacteriologically Confirmed Men Women Children Total Men Women Children Total Group I 19 21 87 0 127 6 7 - 13 Group II 6 2 - 8 10 4 - 14 Group III 4 2 1 7 8 6 - 14 Totals 29 25 88 142 24 17 - 41 0 Includes 82 school children found tuberculin positive under school scheme and who had not previously received B.C.G. * The three sub-divisions of new respiratory cases are estimated as follows from the standard P.A. film. Group I Total area of disease not exceeding one third of one lung in aggregate Group II Total area of disease not exceeding two thirds of one lung in aggregate Group III Total area of disease exceeding (including miliary disease) two thirds of one lung in aggregate Tuberculosis pleural effusions, pleural thickening without obvious lung involvement and enlarged hilar glands are placed in Group I 3. Number of cases of non-respiratory tuberculosis included in 1 above, new to the clinics (but excluding transfers from other clinics) during the year ended 31st December 1969:- Men Women Children Total 8 14 2 24 4. Number of cases included in 1 above whose broncho-pulmonary secretion was positive during the year — 42 The Care of the Unsupported Mother The Authority has one Mother and Baby Home, Guilford House, and this provides 14 ante-natal beds and 14 post-natal beds with 14 cots. No deliveries take place in the home. A revision of the establishment of this home and the introduction of trained nursery nurses to replace attendants was effected this year and this led to an improvement in the standard of care the babies received. The nursery nurses were also helpful in teaching the mothers the general principles of mothercraft and infant care and showed an interest in the general running of the home. Of the 96 referrals to the department, 68 were admitted to Guilford House, 20 were admitted to other Local Authority Homes and 8 were not admitted. In addition, 84 cases were admitted to Guilford House from other Authorities. 103 Family Planning From August, a comprehensive Family Planning Service, including a domiciliary service, was provided through the medium of the Family Planning Association acting as the Council's full agent. The service was available at the following centres:- Family Planning Association, Barnet and District Clinic, 133 Wood Street, Barnet. Watling (Edgware) Clinic, Approach Road, Station Road, Edgware. West Hendon Clinic, 215 The Broadway, N.^' 9. Oak Lane Clinic, East Finchley, N.2. Cervical Cytology This service continued during the year at the following clinics: Torrington, Childs Hill, East Barnet, Watling, Vale Drive, West Hendon, Oak Lane and Edgware. Fortnightly sessions were held at the clinics and all women who attended had a full examination of the breasts, abdomen and pelvis. 1282 patients attended for the first time during the year and in every case the patient and her doctor were notified of the result of the test. There were 4 positive results and these patients were referred, through their general practitioners, to gynaecologists for further investigation. Clinic No. of Sessions New Cases Total Attendances Average attendances per session Childs Hill 23 238 253 11.0 East Barnet 21 167 198 9.4 Oak Lane 20 96 119 6.0 Torrington 39 291 343 7.0 Vale Drive 22 152 171 7.8 Watling 17 177 183 10.8 West Hendon 22 137 149 6.8 Edgware 2 24 24 12.0 TOTALS 166 1282 1440 8.7 104 Vaccination and Immunisation Proposed Surveillance of Pertussis Vaccines I was informed in April by the Public Health Laboratory Service that the survey of pertussis vaccines, in which the Department had taken part, had shown that the preparations in use in recent years conferred an unsatisfactory degree of protection and that the M.R.C. Committee on the Development of Vaccines and Immunological Procedures had recommended that, in future, the efficacy of pertussis vaccines should be kept under surveillance. It was proposed that this should continue along the lines of the P.H.L.S. Survey involving the observations of attack rate in vaccinated children exposed to a notified case of pertussis in the home, and I agreed to participate. Measles Vaccine The Department of Health and Social Security notified me in March that one manufacturer had advised immediate suspension of the use of their attenuated measles vaccine because 3 children, all in the second year of life, had been reported as suffering from a condition clinically diagnosed as encephalitis, the onset of which had occurred about a week after vaccination. Vaccine continued to be made available by other manufacturers and, as the demand for vaccine fell short of what had been expected, no distribution difficulties were experienced by the Department. Statistical tables of the immunisation of persons under the age of 16 are given below:- Table 1. Completed Primary Course Type of Vaccine or Dose Year of Birth Others under age 16 TOTAL 1969 1968 1967 1966 1962-65 1. Quadruple DTPP _ — _ _ _ _ 2. Triple DTP 182 1735 279 21 55 13 2285 3. Diphtheria/Pertussis — 5 2 2 1 — 10 4. Diphtheria/Tetanus 7 123 46 11 80 35 302 5. Diphtheria - 1 — 1 3 3 8 6. Pertussis — — — — — — _ 7. Tetanus — 4 — 3 32 464 503 8. Salk — — — — — — _ 9. Sabin 203 1824 355 55 124 104 2665 10. Measles 1 164 423 284 361 43 1276 11. Total immunised against Diphtheria (Lines 1-2-3-4-5) 189 1864 327 35 139 51 2605 12. Total immunised against Whooping Cough/Pertussis (Lines 1-2-3-6) 182 1740 281 23 56 13 2295 13. Total immunised against Tetanus (Lines 1-2-4-7) 189 1862 325 35 167 512 3090 14. Total immunised against Polio (Lines 1-8-9) 203 1824 355 55 124 104 2665 105 Table 2. Re-inforcing Doses Type of Vaccine or Dose Year of Birth Others under age 16 TOTAL 1969 1968 1967 1966 1962-65 1. Quadruple D.T.P.P. _ _ _ 2. Triple D.T.P. 1 255 887 88 641 70 1942 3. Diphtheria/Pertussis - 1 1 - 10 - 12 4. Diphtheria/Tetanus - 45 154 46 1585 311 2141 5. Diphtheria - 1 2 - 12 9 24 6. Pertussis - — — — — - — 7. Tetanus - 3 7 11 60 1030 1111 8. Salk - — - — — - — 9. Sabin 2 298 1062 168 2402 1728 5660 10. Measles — — - — — — — 11. Total immunised against Diphtheria (Lines 1-2-3-4-5) 1 302 1044 134 2248 390 4119 12. Total immunised against Whooping Cough/Pertussis (Lines 1-2-3-6) 1 256 888 88 651 70 1954 13. Total immunised against Tetanus (Lines 1-2-4-7) 1 303 1048 145 2286 1411 5194 14. Total immuhised against Polio (Lines 1-8-9) 2 298 1062 168 2402 1728 5660 B.C.G. Vaccination against Tuberculosis School children and students were vaccinated at school and at establishments for further Education by the Department's medical staff and contacts of tuberculosis were vaccinated at Chest Clinics in the Borough. A tuberculin test was offered to young immigrants arriving in the Borough during the year and, where the result was positive, arrangements were made for further investigation and supervision at a chest clinic. Tuberculin Test and B.C.G. Vaccination No. of persons vaccinated through the Authority's approved arrangements under Section 28 of the National Health Service Act. (a) CONTACTS (i) No. skin tested 175 (ii) No. found positive 28 (iii) No. found negative 147 (iv) No. vaccinated 131 106 (b) SCHOOL CHILDREN AND STUDENTS (excluding those known to have had B.C.G. vaccination already) (i) No. skin tested 4,125 (ii) No. found positive 366 (iii) No. found negative 3,461 (iv) No. vaccinated 3,428 (c) SCHOOL CHILDREN AND STUDENTS (known to have previously had B.C.G. vaccination) (i) No. skin tested 188 (ii) No. found positive 145 (iii) No. found negative 33 (iv) No. vaccinated 30 Whooping Cough Vaccination The Authority continued to co-operate in the investigation by the Public Health Laboratory Service of the sero-types currently responsible for cases of whooping cough. Smallpox Vaccination There were no reports of cases of generalised vaccinia or post-vaccinal encephalomyelitis or death from any other complications of vaccination. 107 Smallpox Vaccination Persons aged under 16 Age at date of Vaccination Number of persons vaccinated or re-vaccinated Number Vaccinated Number Re-Vaccinated 0 — 3 months 6 — 3 — 6 months 26 — 6 — 9 months 17 — 9 —12 months 12 — 1 year 844 13 2—4 years 435 89 5 —15 years 187 166 TOTALS 1527 268 CLINIC PREMISES Main Clinics Clinic Sessions (See Key Table on page 109) Brunswick Park Road,N.11. I.W.C. C D SP DV OPH ORT T Town Hall, Hendon, N.W.4. I.W.C. CSC D OPH ORT SP CHIR DV A/N A/NE-M/C Garth Road, N.W.2. I.W.C. C D SP CHIR DV A/N A/NE-M/C CSC 149 East Barnet Road, I.W.C. CSC C D SP Barnet DV A/NE-M/C A/N(M) Holly Park, N.ll. I.W.C. D SP CHIR DV A/N CSC Hartley Avenue, N.W.7. I.W.C. CSC D SP CHIR DV A/N A/NE-M/C M/C Oak Lane, N.2. I.W.C. C D SP CHIR DV A/N A/NE-M/C OPH ORT CSC T Oakleigh Road, N.20 I.W.C. DV A/N A/NE-M/C CSC T Sutton Road, N. 10 I.W.C. SP DV A/N A/NE-M/C CSC T Torrington Park, N.12 I.W.C. C CSC SP CHIR A/N A/NE-M/C Vale Drive, Barnet I.W.C. CSC SIC C D v SP DV A/NE-M/C OPH ORT A/N(M) 36 Cressingham Road, I.W.C. CSC C D SP Burnt Oak CHIR A/NE-M/C OPH ORT CE York Road, N.W.9. I.W.C. CSC C D SP CHIR A/N A/NE-M/C CE Claremont Way, N.W.2. I.W.C. Approach Road, Edgware I.W.C. CSC SP CHIR A/N A/NE-M/C Other Premises Etchingham Park Road,N.3. I.W.C. CHIR St. Andrew's Church Hall, I.W.C. DV Lynford Gardens. Edgware. 108 Other Premises (continued) St. Stephens Hall I.W.C. Bells Hill, Barnet Dollisfield, Totteridge I.W.C. Lane, N.20. United Free Church Hall, I.W.C. Sanders Lane, N.W.7. St. Barnabas' Church Hall I.W.C. DV Cranbourne Gardens, N.W.ll. St. Mark's Hall I.W.C. Woodville Road, Barnet Congregational Church Hall I.W.C. Colin Close, N.W.9. St. Mary Magdalene Church I.W.C. Hall, Holders Hill Road,N.W.4. KEY TABLE I.W.C. Infant Welfare Clinic CSC Consultative School Clinic A/N Ante-Natal Clinic CE Clinic for Elderly OPH. Ophthalmic SP Speech Therapy M/C Mothercraft only A/NE-M/C Combined Ante-Natal Exercises and Mothercraft ORT Orthoptic A/N(M) Ante-Natal Clinic — Midwife only D Dental CHIR Chiropody DV Development Clinic T Toddlers Clinic C Cervical Cytology S.I.C. Special Investigation Clinic. 109 SCHOOL HEALTH SERVICE SCHOOL HEALTH SERVICE Introduction The regular medical inspection of children in attendance at Local Authority Schools continued, any necessary treatment being obtained either at Clinics or through facilities provided under the National Health Services Act, 1946. The School Health Service continued to foster co-operation between Departments of the Authority and outside agencies in regard to handicapped children, and as a further step in this direction, I have arranged that a handicapped child before leaving school shall be discussed at a case conference, to assess the child's ability and advise the welfare agencies and Youth Employment Service of the future needs of these young people. In accordance with the requirements of the Education Act, 1944, 91 children were reported to the Authority during the year as suffering from a disability requiring some form of special educational treatment. School Population The overall increase in the school population for the Borough continued during the year, and the following table shows the position at 31st December, 1969:- Schools No. of Pupils Primary Schools 24,449 Secondary Modern and Bilateral Schools 10,816 Grammar Schools 7,882 1 Residential Special School (E.S.N.) 178 2 Day Special Schools (E.S.N.) 259 43,584 Periodic Medical Inspections The Authority continued the policy of routine medical inspection of school entrants and leavers together with an intermediate examination during the last year at the primary school. In addition a close contact was maintained between the School Medical Officers and Head Teachers. 113 The following table shows the number of children inspected by years of birth and the state of their physical condition - Year of Birth Number of Pupils Inspected Physical Condition of Pupils Inspected Satisfactory Unsatisfactory 1965 8s later 260 260 1964 1,999 1,997 2 1963 1,585 1,584 1 1962 358 357 1 1961 301 300 1 1960 254 254 _ 1959 873 872 1 1958 1,729 1,728 1 1957 646 644 2 1956 326 326 — 1955 2,350 2,350 — 1954 & earlier 1,263 1,261 2 TOTAL 11,944 11,933 11 Percentage of pupils inspected whose physical conditions was found:- Satisfactory 99.91% Unsatisfactory 0.09% Medical Treatment In the tables of statistics which follow this section of the report, details are given of treatment (excluding uncleanliness and dental disease) of pupils attending maintained primary and secondary schools (including nursery and special schools), whether provided directly by the Council or arranged for through other agencies. Ophthalmic Clinics The five school ophthalmic clinics continued to operate at centres dispersed throughout the Borough, with ophthalmologists provided by the North West Metropolitan Regional Hospital Board and at Central Hendon Clinic and Vale Drive Clinic an orthoptic service is provided. Audiometry Two Audiometer Operators carry out three routine hearing tests during the school life of those children in the Borough attending the Authority's schools and also test, as special cases, those children suspected of having a hearing loss 114 The following Table shows the number of pupils whose hearing was tested:- Sweep tests 10,564 Re-tests 654 Special tests 939 Re-tests 268 Audiology Those children requiring further investigation for a loss of hearing are referred to the Consultant Otologist at one of the audiology units established in the London Borough of Haringey and the London Borough of Brent. Peripatetic Teachers for the Deaf attached to these units visit those children in schools in this Borough who are in the care of the units and require supervision or training. It has still not been possible to appoint a Peripatetic Teacher for the Deaf to care locally for those other children who are attending Consultants at the various London Hospitals. During the year 23 school children and one child under school age were provided with hearing aids and at the end of the year 88 school children and 5 children under school age (4 of whom were attending the Local Authority Day Nurseries) were known to have hearing aids. Child Guidance Service Under the joint administrative responsibility of the Chief Education Officer and myself the Local Authority Child Guidance Service operates from centres at:- 304, Regents Park Road, Finchley, N.3. and The Health Clinic, Vale Drive, Barnet, Herts. Dr. A.D. Black, Consultant Child Psychiatrist and Medical Director reports:- "Until September, 1968, this Borough was without a Child Guidance Centre. A School Psychological Service had been in existence for some years, but in September, 1968, a Child and Family Psychiatric Service was initiated at Finchley with a Professional Staff consisting of:- 115 1. A part-time Consultant Psychiatrist and Medical Director (3 sessions per week) 2. Three full-time Psychiatric Social Workers 3. One full-time Psychotherapist and able to make use of the Consultant Services of 4. Three full-time Educational Psychologists who were jointly appointed to the Psychiatric Service and School Psychological Service. A second Clinic is opening at Vale Drive Health Clinic in June, 1970. Since our psychiatric resources have been very limited we decided to concentrate our work on consultative services. We have held regular meetings with School Medical Officers, Health Visitors, Speech Therapists, Education Welfare Officers, Supervisors of Pre-School Play Groups and other community workers. Clinical work has, however, taken up the majority of our time. In the year ending 31st August, 1969, 369 children and their families were referred to the Clinic, of these we accepted 322 and were able to suggest to the referrer ways of seeking help for the others whom we were unable to accept. In some cases we contacted other psychiatric Clinics, who agreed to see children whom we were unable to see. We have also been able to offer a limited service to the Courts who have asked us to see children for psychiatric assessment and court reports. Origin Total Referral Agency No. (Assistant Medical Officer 86 ( (Educational Welfare Officers 14 School Services 178 ( (Educational Psychologists 51 ( (Schools 27 (General Practitioners 37 Other Medical Services 80 ( (Other Clinic and Hospitals 43 (Probation Officers 11 Other Social Services 18 ( (Child Care Officers 7 Direct 46 Parents 86 Adolescents 46 TOTAL 322 TOTAL 322 116 This table shows the main sources of our referrals. It will be seen that the majority of our referrals come from the School Health Service and the School Psychological Service, either directly or indirectly. Other medical referrals form the next largest group, as many coming from other Hospitals and Clinics as have come from General Prattitioners. In line with most other Child Guidance Clinics and the Underwood Committee recommendations, we accept direct referrals from parents although we in all cases request permission to contact the General Practitioners. This is rarely refused. Diagnostic Categories The largest number are classified as anti-social conduct disorders, neurotic illnesses and the primary behaviour disorders of childhood. There is a small but significant number of children with depressive illnesses, with psychotic illnesses of the schizophrenic type and autism. We have seen a small number of children with psychosomatic illnesses and we are increasingly recognising children with brain damage and brain dysfunction. Much emotional and behavioural disturbance in childhood is however multi-factorial in origin. Treatment Drug Therapies We make use of drug therapies to alter mood and aggressive behaviour in particular, to sedate and tranquillise anxious and hyper-active children; in the treatment of nocturnal enuresis, and in psychosis. Environmental Manipulation Environmental manipulation involving casework with parents and counselling of teachers; placement in a special environment. Psychotherapy Various forms of psychotherapy are the mainstay of our therapeutic armamentarium but our psychotherapeutic sources are extremely limited. All the professional staff at the Clinic are involved in psychotherapeutic work with children, parents and whole family groups. We recognise however that even if our staff were to be doubled in size we would not be able to meet the therapeutic needs of the community and in common with other Child Guidance Clincs are exploring newer methods of treatment and prevention. Crisis Consultation We are particularly interested in developing a Crisis Consultation Service as we feel there is a real opportunity to help families at the point of crisis and thus possibly prevent some of the pathological long term effects known to ensue from inadequately worked-through situations of overwhelming grief, or anxiety, such as in bereavement or traumatic events. We give priority to young children referred to us, to children with school refusal and children with behaviour disorders following the death of a parent, in order to try to offer crisis therapy where appropriate. 117 The setting up of the Child Guidance Centre has revealed the necessity in this Borough for a service for handicapped children, in particular children who are maladjusted, or who have multiple handicaps. There is a great need for day and boarding placement for severely maladjusted children within the Borough. There is a need of a wide range of both medical and non-medical placements for children coming to the Clinic. Many multi-problem families are referred to us whose needs could much more adequately be met by a Family Service Unit if one existed in the Borough. % Conclusion Comparing the figures of children referred to our psychiatric services in the Borough with those at other boroughs, with longer established child guidance clinics it is clear that an unsatisfied demand for psychiatric services exists in the Borough. I think it is unlikely that our high referral rate is an artefact due to the fact that we are getting children referred who have been waiting some years for help, nor can we hope that the numbers referred will drop off significantly. What is more important, the number of children referred with acute disturbances is increasing, and these are the children who may be helped most economically with short term or family group therapy. Even if the staffing establishment in Child Guidance Centres within the Borough is increased, it is unlikely that the needs of disturbed children within the Borough will be adequately met from these Centres alone. The staff of Child Guidance Centres must spend time increasingly therefore in working with people in the community who are involved with children, particularly parents, teachers, doctors, nurses and social workers, in order to help raise the level of therapeutic skills and also increase the Borough's range of preventive services, in the hope this will lessen the number of children who need help." Speech Therapy There are five whole-time speech therapists employed by the Authority who undertake sessions within the School Health Service at clinics and in the Day Special Schools and Junior Training Schools in the Borough. The diagnosis and treatment of speech and language disorders is the responsibility of the speech therapists who give advice to parents and teachers so that treatment can be continued outside the ilinic sessions. During the year a total of 618 children received treatment and supervision. National Child Development Study There has been a second follow-up of children born in the week 3rd to 9th March, 1958. The survey is intended to gather information about the educational progress, health, physical development and home background of these children and, for this purpose 56 children in the Borough were examined by Medical Officers and parental 118 interview forms were completed by the Nursing Staff. The results of these investigations have been sent to the Study's Senior Research Officer for analysis. Handicapped Pupils The various categories of handicapped pupils are defined by The School Health Service and Handicapped Pupils Regulations, 1959, as follows:- Blind Epileptic Partially Sighted Maladjusted Deaf Physically Handicapped Partially Hearing Delicate Educationally Subnormal Children suffering from Speech Defects Section 34 of the Education Act, 1944, makes it a duty of the Local Education Authority to ascertain what children in the area require special educational treatment and to provide such treatment either in special school or, otherwise, by special methods appropriate to the handicap of the particular child. The Authority maintains three special schools for handicapped children. Oak Lodge Day Special School for Educationally Subnormal Pupils, Oak Lane, East Finchley, N.2. Northway Day Special School for Educationally Subnormal Pupils, The Fairway, Mill Hill, N.W.7. Swaylands Residential Special School for Educationally Subnormal Boys, Penshurst, Tonbridge, Kent. Children with handicaps in other categories are found placement by the Chief Education Officer in special schools maintained by other authorities or independent bodies. Future provisions for special education in the Borough, as outlined in the Education Development Plan, includes two Day Special Schools for Maladjusted Children and a Day Special School for Delicate/Physically Handicapped Children. Also envisaged in the plan is the provision of a Residential Special School for Maladjusted Boys by means of future extensions to Swaylands School. There appears to be a general shortage of Special School places in England and Wales and the latest report of the Chief Medical Officer of the Department of Education and Science shows that for every 6-7 children in Day Special Schools and every 2-3 children in Residential Special Schools there is one child still requiring to be placed in that type ot school I am concerned that this Authority is now experiencing difficulty in obtaining Da> Spec ial School placements for handicapped children, 119 particularly the deaf, partially hearing and physically handicapped requiring special educational treatment. There are also children in ordinary schools who would benefit from the less rigorous regime and medically beneficial atmosphere of a Day Special School for Delicate Children, but the long journey, twice daily, to the nearest school of this kind makes such a recommendation pointless. When leaving school handicapped children, having been educated either in Special School or having had some other special educational treatment, have greater problems regarding future employment and social adjustment than other school children, and it becomes apparent that the majority of them require the continual help of the welfare services of the Authority into adult life. In finding suitable work for them the Youth Employment Service should have as much information on their ability as is known to the various Departments of the Authority. Case conferences have therefore been arranged so that the needs of handicapped school leavers can be considered by a panel consisting of the Principal Medical Officer for Mental Health, the Principal Welfare Officer, the Principal Youth Employment Officer and the Borough Childrens Officer or their representatives, together with appropriate Officers nominated by them and the Chief Education Officer. The Principal Medical Officer for Child Health is the Co-ordinating Chairman of the panel, supplying them with all relevant reports and information and recording their decisions, so that when these children leave school consistent advice and continuing support is available. The following Table shows the number of handicapped pupils as at 31st December, 1969. Special Day Schools Special Residential Schools Maintained Primary & Secondary Schools Independent Schools Not at School Total B G B G B G B G B G B G Blind 2 4 1 4 3 Partially Sighted 5 4 1 1 - 1 - 1 - - 6 7 Deaf 3 3 2 4 1 - - - 3 1 9 8 Partially Hearing 11 7 2 - 3 2 - 1 1 1 17 11 Delicate 8 1 8 5 - 1 1 - 1 - 18 7 Educationally Subnormal 91 76 23 6 1 1 1 , 1 _ 117 83 Epileptic - - 2 - 1 - - - - - 3 - Maladjusted 1 3 44 12 12 3 6 1 1 - 64 19 Physically Handicapped 22 11 10 6 3 1 1 - 2 3 38 21 Speech Defects - - - 1 1 1 — — — — 1 2 Total No. Handicapped Pupils 141 107 96 36 22 10 9 3 9 5 277 161 120 Special Transport to School Section 55 of the Education Act, 1944, provides for the provision of transport to facilitate the attendance of pupils at school and, during the year, special transport was recommended on medical grounds for 24 children attending ordinary schools. The length of time for which the transport was required varied according to the needs of the individual cases. Home Tuiton During the year 20 children were recommended home tuiton, under Section 56 of the Education Act, 1944, for varying periods in accordance with their disability. SCHOOL HEALTH SERVICE STATISTICAL TABLES PUPILS FOUND TO REQUIRE TREATMENT AT MEDICAL INSPECTION (excluding dental disease and infestation with vermin) Year of Birth For defective vision (excl. squint) For any of the other conditions recorded Total Individual Pupils 1965 & later 5 6 11 1964 53 114 156 1963 56 160 191 1962 20 25 44 1961 13 13 24 1960 13 11 20 1959 46 90 129 1958 145 141 239 1957 58 40 90 1956 28 17 46 1955 295 134 391 1954 & earlier 172 62 218 TOTAL 904 813 1,559 121 PERIODIC INSPECTIONS Defect Code No. Defect or Disease Entrants Leavers Total incl. all others age groups Special Inspections 4 Skin T O T O T O T O 28 61 27 38 85 153 3 - 5 Eyes. a) Vision 129 371 428 188 904 820 79 93 b) Squint 39 19 14 20 74 59 8 _ c) Other 3 7 4 3 7 23 3 2 6 Ears a) Hearing 44 142 14 22 85 221 12 46 b) Otitis Media 12 49 3 4 21 66 1 8 c) Other 7 7 1 - 11 12 1 - 7 Nose & Throat 30 129 6 28 48 208 6 10 8 Speech 35 67 4 4 58 85 17 5 9 Lymphatic Glands 1 27 - 5 2 35 - I 10 Heart 5 42 1 18 8 84 2 2 11 Lungs 8 61 7 8 27 118 3 4 12 Developmenta 1: a) Hernia 4 17 2 5 14 35 3 2 b) Other 2 86 5 4 28 119 3 7 13 Orthopaedic: a) Posture 1 22 13 29 58 84 — 1 b) Feet 17 62 24 31 75 137 3 6 c) Other 8 23 4 11 23 47 - 1 14 Nervous System a) Epilepsy 3 18 1 6 10 33 2 1 b) Other - 10 3 2 3 22 - - 15 Ps ychological a) Development 2 22 1 6 7 52 4 2 b) Stability 1 72 1 22 9 151 12 16 16 Abdomen 1 14 7 7 8 31 - - 17 Other 59 178 28 42 161 275 23 25 T — requiring Treatment O — requir'ng Observation 122 TREATMENT OF PUPILS ATTENDING MAINTAINED PRIMARY AND SECONDARY SCHOOLS (including Nursery and Special Schools) GROUP 1: No. of cases known to have been treated Eye Diseases (e.g. blepharitis, conjunctivitis). Defective Vision and Squint (a) External & other, excluding errors of refraction & squint 9 (b) Errors of refraction, including squint 2,095 TOTAL: 2,104 (c) No. of pupils for whom spectacles were prescribed 703 GROUP 2: Diseases and Defects of Ear, Nose and Throat Received operative treatment for: (a) Diseases of the ear - (b) Adenoids and Chronic Tonsilitis 54 (c) Other nose and throat conditions - Received other forms of treatment - TOTAL: 54 Total No. of pupils in schools who are known to have been provided with hearing aids: (a) in 1969 23 (b) in previous years 65 GROUP 3: Orthopaedic & Postural Defects No. of pupils known to have been treated in clinics or at out-patients departments - GROUP 4: Diseases of the skin (excluding uncleanliness) Ringworm (i) scalp 3 (ii) body 3 Scabies 17 Impetigo 12 Other skin diseases — TOTAL: 35 GROUP 5: Child Guidance Treatment No. of pupils treated at Child Guidance Clinics 304 GROUP 6 Speech Therapy No. of pupils treated by speech therapists 618 GROUP 7: Other Treatment given: (excl. B.C.G. vaccination) (a) Minor ailments 27 (b) Convalescent treatment under School Health Service arrangements 33 TOTAL: 60 Education Act 1944 — Section 57 Cases dealt with under Section 57, Education Act, 1944 3 Cases de-notified under Section 57(a) Education Act, 1944 Nil 123 REPORT OF THE PRINCIPAL SCHOOL DENTAL OFFICER Dental Inspections at School To inspect 100% of the children in the schools each year is the aim of the Dental Surgeons in this Borough, yet each year this is not achieved; to obtain such a result it would be necessary to have a full staff working throughout the year. This has not been the case over past years and again in 1969. Whilst difficulties in recruitment exist, it is impossible to obtain a full 100% inspection rate. Staff As indicated above the staffing position in the Dental Service generally presented problems which were only partially solved by the redeployment of staff to areas where the need was greatest. It is regrettable that whole time staff find the School Dental Service less attractive than private practice. Residential School The children of Swaylands Residential School continued to have a full and comprehensive Dental Service provided. Ages 5-9 Ages 10-14 Age 15 & over Attendances and Treatment: First visit 3972 3163 698 Subsequent visits 6054 7133 1610 Total visits 10026 10296 2308 Additional courses of treatment commenced 341 137 32 Fillings in permanent teeth 2572 5317 1746 Fillings in deciduous teeth 6548 633 - Permanent teeth filled 2205 4822 1542 Deciduous teeth filled 6143 588 - Permanent teeth extracted 96 328 127 Deciduous teeth extracted 1579 771 - General anaesthetics 529 287 17 Emergencies 292 124 28 Prosthetics: Pupils supplied with full upper or lower (first time) — - - Pupils supplied with other dentures (first time) 5 8 16 Number of dentures supplies 5 8 16 124 Number of pupils X-rayed 965 Prophylaxis 1,321 Teeth otherwise conserved 2,960 Number of teeth root filled 32 Inlays 7 Crowns 87 Courses of treatment completed 5,817 Orthodontics: New cases commenced during year 277 Cases completed during year 159 Cases discontinued during year 110 Number of removable appliances fitted 554 Number of fixed appliances fitted 43 Pupils referred to Hospital consultant 3 Anaesthetics: General anaesthetics administered by Dental Officers 73 Inspections: (a) First inspection at school Number of pupils 27,978 (b) First inspection at Clinic Number of pupils 1, 576 Number of (a) and (b) found to require treatment 11,545 Number of (a) and (b) offered treatment 10,138 (c) Pupils re-inspected at school or clinic 491 Number of (c) found to require treatment 256 SESSIONS Sessions devoted to treatment 4,024 Sessions devoted to inspection 282 Sessions devoted to dental health education 20 125 GENERAL SERVICES GENERAL SERVICES Health Education Man, as one living organism amongst others, is learning to control his environment and master many diseases. Undoubtedly, new and vastly improved standards of environmental, physical and mental health, are within reach, but lack of self control threatens him with disaster. The conquest of many of the current scourges of mankind demand personal participation; they are concerned with the moulding of attitudes and the correction of behaviour, so that we avoid modes of living which are injurious to health and foster those which promote the best standards of health. An important aspect of public health is to increase the intelligent responsibilities of the individual for his own health and that of his community. To encourage this area of responsibility in the individual is the prime function of the Health Education Section. Health Education in Clinics Relaxation and Parentcraft Classes The parents understanding of the physical, mental and emotional needs, of full development, of the infant and young child is the aim of the Health Visitors who take classes in relaxation and parentcraft in the clinics. In some instances evening sessions are arranged when husbands can attend with their wives. Also for expectant mothers and their husbands the Swedish film "Barnet" (The Child) was shown on alternate months at two parts of the Borough. Mothers Discussion Groups In an ever changing environment, problems which confront mothers concerning themselves, their children and family life need to be discussed and in the mothers and toddlers groups held in many clinics such an opportunity is afforded. Many health subjects were covered with support given by the Health Education Section. Clinics for the Elderly Assistance has been given by the officers of the Health Education Section in the compilation of programmes, suitable for the elderly and in the provision of visual material. These clinics are appreciated by the old folks who enjoy receiving some mental stimulation and an interest outside of themselves. 129 Health Education in Schools Today a child's education is related to living; he learns through the opportunity of reasoning rather than the presentation of facts, and in health education this principle of helping a child to relate biological facts to everyday life and experience has been pursued. Throughout runs the theme that health behaviour is a matter of personal choice. In Primary Schools the syllabus has been arranged to meet the needs of the particular school but in all cases the basic elements of good health i.e. physical, mental and social health and the responsibility of the individual towards this state, have been presented. The pupils in the Secondary Schools have investigated their future responsibility for their own health, their contribution to community health and their role as parents-to-be. Within this context of health responsibility information was given on the health hazards of today, namely lung cancer, obesity, venereal diseases, drug abuse, mental health and parentcraft. In one school, following a mothercraft course the interest shown in child care by the girls participating resulted in their forming a one afternoon per week play group for toddlers which provided an excellent opportunity for the girls to study child development at first hand. An interesting and very well worthwhile development has been an increased participation in Parent-Teacher meetings, especially to discuss with them the sex instruction which is included within the overall context of health in the school health programme. Below are details of the school courses which were undertaken during the year:- Primary Schools 10 — 11 year old pupils Full Year's Courses 7 Two Term Courses 3 Short Courses 2 8 — 9 year old pupils Two Term Courses 2 Secondary Schools 13 — 15 year old pupils Full Year's Courses 7 Two Term Courses 1 Occasional Talks 3 130 Grammar Schools 16 — 18 year old pupils Short Courses 2 Occasional Talks 5 Special Schools (Educationally Subnormal, Junior Training Schools) Short Courses 2 Health Education in other Organisations Requests were received from time to time from local organisations for talks or films on health topics, and these requests have been met, since education in small groups is most likely to have lasting results. A synopsis of these talks is given below:- Groups requesting Talks Youth Organisations 39 Women's and Men's Organisations 28 Young Wives Group Parent/Teacher Associations 9 Old People's Groups 12 Synopsis of subjects covered First Aid 6 Child Health 4 Nutrition 2 Sex Education 7 Mental Health 2 Health of the Elderly 11 Home Safety 36 Junior Mothercraft 5 Home Nursing 4 Environmental Health 4 102 Films shows were given. General Publicity With today's overwhelming amount of visual material to be seen wherever one turns one would expect that there is no room for anything further, but the display of posters and the availability of leaflets does provide a useful media for health education. 131 Using this media the monthly programme of health subjects was continued and posters and leaflets covering these subjects distributed to all Borough establishments. For special campaigns, posters were provided for the public notice boards. Special publicity was given for Fireworks and Christmas safety. Displays and Exhibitions There was less opportunity for displays this year as the window of Gateway House, 322 Regents Park Road, N.3, was not often available. Displays were exhibited as follows:- July Home Safety Finchley Carnival A float was also entered in the procession August Home Safety The Summer Show October Smoking Gateway House November Fireworks Safety Gateway House Campaigns There were no large scale campaigns organised this year. Other Activities Smokers Advisory Clinic The first clinic to help smokers to relinquish the habit was organised in October using the Five Day Play in co-operation with the British Temperance Society. This was well attended with the final results, obtained after the reunion of participants, giving a 50% success rate. Home Safety General Publicity The quarterly campaigns of R.O.S.P.A. were followed with posters and leaflets being distributed locally. Barnet Civic News The cartoon illustrating "Home Safety Tips" was prepared for each issue of Barnet Civic News. Outside Talks A number of requests for talks on Home Safety was received. These were from a 132 variety of groups, including old people's clubs, young wives groups and youth organisations as well as instruction to St. John's Ambulance Brigade and the British Red Cross Society. Campaigns Disposal of Medicines Campaign This campaign organised to persuade the public to dispose of old medicines and tablets to their local chemist was again organised in April — spring cleaning time. The material returned was collected for disposal, and it was first counted and weighed; some 26,000 tablets were destroyed. An effort was made to identify the tablets in order that the cost of the amount wasted could be assessed but this was considered to be an almost impossible task. The main aim of the campaign was to protect the young and others from the dangers of having medicines and tablets lurking in the homes in the community. Finchley Carnival and the Summer Show These two events again provided a means of promoting Health Education to a captive audience. This year the theme of the float in the carnival procession was the "Old Woman who lived in a Shoe" depicting a giant size old boot with children spilling out from it, all involved in some kind of home accident. In the marquee, 40 feet of space was devoted to displays concerning different aspects of home safety, with a moving film-let to attract attention, a game and competition for children; approximately 1,000 children entered during both shows. These occasions are a good opportunity for the distribution of home safety handbooks. Guy Fawkes Night A few days before bonfire night a decorated car with loudspeaker toured certain areas of the Borough urging the public to take care to avoid accidents. This year saw a substantial reduction in the fireworks accident rate, due without doubt to the intense television publicity given, and even the small local effort may have contributed to local results. Inter-Senior-Schools — Home Safety Quiz The Home Safety Quiz in senior schools was launched during the Autumn term. All schools were circulated and those entering teams were provided with all home safety information. The preliminary, semi-final and final rounds are planned for the Spring term of 1970. Cliff Richard, star of stage, films and television agreed to act as Question Master for the final round 133 SPECIAL INVESTIGATION CLINIC The Special Investigation Clinic continued to receive a large number of referrals, but although the total number of sessions in 1969 was slightly less than 1968, the average number of patients appointed per session rose from 16 in 1968 to 23 in 1969. There was also a 29% increase in the total number of attendances as compared to 1968 and an approximate 30% increase in the number of discharged patients between the two years. The relapse rate for 1969 was 28% whereas 31% is the total relapse rate for the three years of the clinic's existence. These figures are good in relation to conditioned learning treatment and are reflected in the good attendance rate at the clinic. There are several research projects operating, and these include studies on intensity/tone conditioning, personality factors, and prognosis, and the relation of over-learning to recurrence of enuresis. Mr. R.K. Turner, voluntary Psychologist at the clinic was awarded the degree of Ph.D. (London) for a thesis concerned with learning theory procedures used in the treatment of Enuresis. Mr. Turner was appointed as Principal Psychologist, Hollymoor Hospital, Birmingham; he does, however, still maintain contact with the clinic and visits at regular intervals. Dr. Young, Deputy Medical Officer of Health, published a paper "The Problem of Enuresis". Ref.(1969) Brit.J.Hosp.Med 2. 628-632. Statistics Year Ending 31.12.69 BOYS GIRLS TOTAL No. of new patients seen: Under 5 14 8 22 5-9 64 37 101 10 — over 40 10 50 Total 118 55 173 Total attendances: 1109 422 1531 No. of 1st appointment failures 33 23 56 Total appointment failures 471 216 687 Referrals Under 5 23 12 35 5-9 86 56 142 10 & over 44 15 59 Total 153 83 236 Discharged Cases (of these, discharged for second/third time) 115 51 166 24 11 35 Relapsed cases. Discharged 1967: - - - Discharged 1968: 15 10 25 Discharged 1969: 27 10 37 Total 42 20 62 Total Sessions: 97 Total Appointments 2218 Average Appointed Number/Session: 23 134 ESTABLISHMENTS FOR MASSAGE AND SPECIAL TREATMENT The total number of establishments registered at the end of the year under Part XII of the Middlesex County Council Act, 1944, was 32. PERSONS IN NEED OF CARE AND ATTENTION Provision is made under Section 47 of the National Assistance Act 1948 as amended by the National Assistance (Amendment) Act 1951 for securing the necessary care and attention in hospital or other place, e.g. residential accommodation provided under Part III of the Act, for persons who are infirm or suffering from a serious chronic disease and who are unable to give themselves sufficient care nor are receiving it from other sources. It became necessary to apply this statute in respect of one case in March 1969, when a man living alone was found to be ill and suffering from gross malnutrition. He persistently refused to enter hospital. A Magistrate's order had to be obtained to compel him to enter Edgware General Hospital where he made a complete recovery and went to live with his sister on his discharge. BURIAL AND CREMATION It is the duty of the local authority under Section 50 of the National Assistance Act 1948 to cause to be buried or cremated the body of any person who has died in or been found dead in the area, in any case where it appears to the authority that no suitable arrangements for the disposal of the body have been or are being otherwise made. The expenses incurred may be recovered from the estate of the deceased person, by death grant subject to the contribution conditions being satisfied, or from any person who for the purposes of the act was liable to maintain the deceased person immediately before death. Four cremations or burials were carried out during the year. CREMATION CERTIFICATES The Medical Officer of Health, Deputy Medical Officer of Health and a Principal Medical Officer are appointed Medical Referees under the Cremation Acts 1902 and 1952. During the year 1085 Certificates were examined and approved. DOMICILIARY LAUNDRY SERVICE This is a service to assist families to care for the elderly, or to nurse chronically sick people of any age at home. A once a week collection and delivery is dealt with by the Department, and the cleansing and laundering of soiled linen and clothing is carried out at Colindale Hospital. 135 This service is much appreciated by all who use it and thanks are due to the Hendon Group Hospital Management Committee for their co-operation. At the end of the year 35 persons were receiving assistance. MEDICAL ASSESSMENTS AND EXAMINATIONS (Staff Health Service) During 1969 this Service continued to expand. There was an overall increase in the number of assessments dealt with and in the number of medical examinations carried out. In this latter respect the number more than doubled last year's figure. There was an increase in the number of persons employed under the Disabled Persons' Employment Acts 1944 and 1958 from eight persons in 1968 to twenty persons in 1969; all of these were also medically examined. Fifteen medical examinations were carried out in respect of staff with prolonged absence due to illness and with a view to ascertaining whether or not they were fit to undertake the duties of their posts or to be subject to early retirement. In eleven cases it was found that the staff should be subject to premature retirement on the grounds of permanent ill health. Below are the figures in respect of medical assessments and examinations carried out during the year- No. of medical forms assessed 2166 No. of medical examinations — Barnet 124 — other authorities 9 No. of medical examinations carried out under Ministry of Education Circular 249/52:- (a) Teachers' first appointments 79 (b) Entrants to Training College 326 Total No. of medical examinations performed 573 DEPARTMENTAL SPECIAL TRANSPORT Council Transport The Borough Engineer and Surveyor has seven special purpose built vehicles available to cover the transport needs of the Health and Welfare Department. Details of the vehicles and their duties are as follows:- 136 12 Seater Coach (or 4 wheelchairs) This vehicle is used for the Hendon Work Centre, Heriot Road, N.W.4. daily from 7.30 a.m. until 9.30 a.m. On Monday, Wednesday and Friday it is used for a bus service from certain homes in the N.W.ll. district from 10 a.m. to 12 noon. The Day Centre for the Elderly at Claremont Clinic, N.W.2. is held on Tuesday and Thursday and the coach is used for this purpose from 10 a.m. to 12 noon and 4 p.m. to 5.30 p.m. The coach transports handicapped persons from the Hendon Work Centre on Monday, Tuesday and Thursday afternoon from 12.30 p.m. to 3.30 p.m. 24 Seater Coach (or 10 wheelchairs and 5 other passengers) This coach is assigned to the Hendon Work Centre each day except Thursday. On Wednesday the Work Centre's afternoon's journey is extended to include a party from the British Red Cross Society. This Society uses this vehicle on Thursday from 12.30 p.m. to 6.30 p.m. Additionally on Monday, Wednesday and Friday this coach assists in the bus service in the N.W.ll district referred to above. 12 Seater Coach (or 4 wheelchairs) Used exclusively Monday to Friday by the Deansbrook Rehabilitation Centre, Edgware (7.30 a.m. to 6.30 p.m.) Because of the numbers involved the coach makes two journeys. 12 Seater Coach (or 4 wheelchairs) Used by the Fieldways Adult Training Centre, Wellhouse Lane, Barnet, 7.30 a.m. to 6.30 p.m. Monday to Friday. 12 Seater Coach (or 4 wheelchairs) The Hendon Junior Training School at Flower Lane, N.W.7. uses this coach from 7.30 a.m. to 11 a.m. daily. In the afternnon the return journey (3 p.m. to 6.30 p.m.) is combined with the British Red Cross Society's party from The Downage, N.W.4. 12 Seater Coach (or 4 wheelchairs) Used for taking children to the Friern Barnet Junior Training School, Oakleigh Road, N.20 each morning from 7.30 a.m. to 11 a.m.) The return journey commences at 2.30 p.m. and finishes at 6.30 p.m., but on Monday, Thursday and Friday the return starts at 12.30 p.m. as the coach also assists in the transport of Handicapped Persons from Hendon Work Centre. 12 Seater Coach (or 4 wheelchairs) Used exclusively each day by the Etchingham Park Workroom/Day Centre. Because of the difficulty of fitting in all the department's jobs in the daily run of a particular coach, Park House Day Centre, Monday 10.30 a.m. to 12.30 p.m. and 3.30 p.m. to 5.30 p.m. and the Cookery Class for the Blind at Barnet Technical College on Fridays (during term time) 8.30 a.m. to 2.30 p.m. are covered by the allocation of any 137 suitable vehicle available from the Transport Section of the Borough Engineer and Surveyor's Department. By long standing agreement the Counci 1 provide transport during the evenings for the following voluntary bodies and associations (a) Blind Dancing Class, St. David's School, Park Road, Hendon — Monday 6.30 p.m. to 11.30 p.m. (b) Starfish Swimming Club, Hamsptead Swimming Baths, Swiss Cottage — Tuesdays 5.30 p.m. to 11.30 p.m. (c) Happy Social Club, Conservative Hall, Edgware — 2nd Wednesday in each month 6.30 p.m. to 11.30 p.m. (d) Choral Class, Percy Road, N.2. - Wednesday 6.30 p.m. to 11.30 p.m. (e) Multiple Sclerosis Society, Mill Hill Clinic — Thursdays 6.30 p.m. to 11.30 p.m. The Borough Engineer and Surveyor's Department supply cars if available to convey persons in the care of the Department provided the passengers are not physically handicapped. Hired Transport During 1969 as in previous years, the Council hired transport to carry out additional commitments over and above the capability of its own vehicles. TRAINING COURSES AND STUDENT ATTACHMENTS During 1969 a wide variety of training courses, refresher courses, conferences and study days were made available to the staff of the Department. Continued use was made of the facilities offered by the London Boroughs' Training Committee, The Senior Assistant Nursing Officer, was successful in obtaining a scholarship to the Administrative Staff College, Henley-on-Thames, being sponsored by the Health Visitors' Association, and was granted leave of absence for eleven weeks. Courses and study days attended by staff embraced the following subjects. Diploma in Public Health Diploma in Municipal Administration Social Work Course leading to the National Certificate Diploma Course for Teachers of Mentally Handicapped Children Refresher Course for Teachers of Mentally Handicapped Children Study Days, Conferences and Seminars covering various aspects of Mental Health 138 Course for Head Teachers of Junior Training Schools Course for Staff of Adult Training Centres Conference for Matrons of Day Nurseries Developmental Paediatrics Assessment of Handicapped Children Courses for Social Workers with the Deaf District Nurse Training Health Visitor Training Senior Home Nurses Training Medical Computer Courses Midwives' Refresher Courses Preparation for Childbirth Geriatrics Course for Matrons and Wardens of Old People's Homes Public Health in many aspects including the problems of Noise and Clean Air Home Safety Many aspects of Health Education A new course for Home Helps Home Help Organiser's Course Health Visitors The Authority's three health visitor students passed their examination and 6 others, sponsored by other authorities and who trained in the Authority's area, were also successful. Hospitality was offered to 3 health visitor students from rural areas who wished to gain experience in an urban area, 8 Child Care students accompanied health visitors in their work and a sociology student of Bedford College spent 2 weeks with the staff of the department. Assistance was also given to a student of Bedford College who was carrying out research work on health visiting services. 12 Health visitors took part in a programme of intensive research into the work of a health visitor organised by Dr. Benjamin of the Greater London Council. Midwives 23 pupil midwives from Edgware General Hospital received their district training in the Borough, one residing with a midwife and the others in the Nurses Home at Gervase Road, Edgware. 3 midwives attended statutory refresher courses. Home Nurses Home nurses participated in the training of hospital student nurses throughout the year, 96 of whom accompanied home nurses on visits for one day or half a day, 4 medical students spent a day in the Borough observing the work of the home nurses. 139 9 home nurses attended training courses and were successful in obtaining the National Certificate for District Nurses, and 2 senior nurses attended a Practical Work Instructor's Course. Nursery Nurses The nursery nurse training course at the Barnet College of Further Education commenced its second year in September and the staff of the 3 day nurseries participated in the practical training of students attending the course. A full time health tutor was appointed to the course this year and maintained close contact with the day nursery matrons. Home Helps A training course for home helps commenced in September at the Barnet College of Further Education and proved very successful. 15 home helps at a time attended on one afternoon a week during the college term and, at the end of the course, received a Certificate in Health and Home Management. The home helps themselves are very enthusiastic about the scheme, as apart from the instruction, it provides them with an opportunity to get to know each other and discuss their various problems. In-Service Training In my report for 1967 I referred to the introduction of a departmental In-Service Training Course which latterly has been held at six month intervals. Since its inception, five series of lectures have been arranged and in addition to a number of staff from other departments, 152 members of the Health and Welfare Department have attended; in the main the proj ect has been acclaimed as a useful contribution to basic training and a worthwhile means of disseminating information on local organisational and administrative policies. Lectures on the under-mentioned subjects were given by Principal and Senior Officers and Officers of other departments involved in Social Services What Local Government is and how it works in Barnet Principles and Aims of Administration Budgetary Control and Statistics The Work of the Public Health Inspector The Control of Infectious Disease The Public Health Dental Services The Mental Health Services The Role of the Mental Welfare Officer Welfare Services in the Community Residential Care in the Welfare Services The Problems of Homelessness Children in Care A Municipal Housing Department 140 Public Health — Allied Nursing Services The Child Health Services The School Health Services Health Education as a service in the Borough I am appreciative of the time given by the Officers concerned, the high standard of lectures and extend my grateful thanks to the Town Clerk, the Borough Housing Officer and the Borough Children's Officer for their participation. In addition, other In-Service Training projects were organised with the Health Education Section of the department e.g. a Study Day for Clinic Nurses technique of small display making, designed to assist them in poster display and the making of small clinic displays; a three day course for Health Visitors and Midwives on Psychophysical preparation for Child Birth. 141 INDEX INDEX PAGE A Aids and Adaptations 88 Animals 62 Ante-Natal Clinics 93 Audiology 115 Audiometry 114 B BCG Vaccination 106 Births and Birth Rates 11,16,18,19,20,89 Blind and Partially Sighted 82,83,84,85 British Red Cross Society —Loan of Equipment 97 Burial and Cremation 135 c Cancer 18 Caravans 55 Care of Mothers and Young Children 92 Care of the Unsupported Mother 103 Cervical Cytology 104 Chest Clinics 102 Child Development Study 118 Child Guidance Service 115 Child Minders 1,98 Child Welfare Centres 95 Chiropody 98 Clean Air 29,43 Clearance Areas 46 Clinics for the Elderly 98,129 Clinic Premises 95 Committee Members 7 Common Lodging Houses 50 Complaints — Environmental Health 55 Compulsory Improvement Areas 48 Congenital Malformations 94 Contents 5 Cremation Certificates 135 D Day Centres for the Elderly 80 Day Centres for the Mentally 111 70 Day Nurseries 97 Day Nurseries, Private & Registered Child Minders1, 98 Deaf and Hard of Hearing 86 Deaths and Death Rates 12 .13.14,15.17.18,21,22 Dental Services, Priority 101 Disinfection and Disinfestation 124 Domiciliary Laundry Service 135 E Elderly Persons 79 Enuresis 1 Environmental Health Services 29 PAGE Establishments for Massage and Special Treatment 135 Exhumations 65 F Factories and Work Places 58 Family Planning 1,104 Food 29 Food — Complaints 36 Food Hygiene 39 Food Samples, Formal and Informal 30 Food Unfit for Human Consumption 38 G General Practitioner — Staff Attachments 1,91 General Services 129 H Handicapped Pupils 119 Hawkers 40 Health Education 129 Health Visitors 139 Health and Welfare Committee 7 Holiday Homes — Recuperative 99 Homes for the Elderly and Handicapped 79 Home Help Service 2,97,140 Home Nursing 96,139 Home Safety 132 Home Tuition — School Children 101 Home Visiting 91,92 Homelessness 1,81 Hospital and General Practitioner Services 91 Hostels — Mental Health 70 Houses in Multiple Occupation 50 Housing 1,29,45 Housing Accommodation 45 Housing — Area I mprovement 48 Housing — Improvement 47 Housing — Statistics 53 I Ice Cream 35 Immunisation and Vaccination 26,105 Improvement Areas 48 Incontinence Pads and Clothing 97 Incontinence Laundry Service 135 Individual Unfit Houses 46 Infectious Diseases 25 In-Service Training Course 140 Inspections — Environmental Health 55 International Certificates of Vaccination 26 J Junior Training Schools 72 145 PAGE L Labelling of Food 41 Land Charges 57 Laundry Service 135 Legal Proceedings 42 Liquid Egg 35 Loan of Nursing Equipment 97 M Marie Curie Memorial Foundation 96 Markets 40 Massage and Special Treatment 135 Measles Vaccine 105 Medical Assessments and Examinations 136 Medical Inspections and Treatment (Schools) 173,114 Mental Health — Case Work 69 Mental Health — Hostels 70 Mental Health — Preventative Work 71 Mental Health — Residential Care 73 Mental Health Services 69 Mental Health Social Clubs 70 Mental Illness 69 Midwifery 96,139 Milk — Registration, Licensing and Sampling 35 Mortuaries 65 Mother and Baby Home 92 Mothercraft and Relaxation Clinics 94,129 Mothers' Discussion Groups 94,129 N Napsbury Hospital 71 National Child Development Study 118 Neighbourly Help Service 97 Noise 57 Nursery Nurses 140 Nurses' Agencies 100 Nursing Homes. Registration 99 O Offices and Shops 57 Ophthalmic Clinics 114 Outworkers 60 Overcrowding 49 P Paratyphoid Fever 26 Partially Sighted and Blind 82,83,84,85 Personal Health Services 91 Persons in Need of Care and Attention 135 Pesticide Survey 42 Physically Handicapped Persons 87 Post-Natal Clinics 94 Poultry I nspection 40 Prevalence and Control of Infectious and Other Diseases 25 Prevention of Homelessness (Problem Families). 92 PAGE Psychiatric Hospitals 71 R Rag, Flock and Other Filling Materials 60 Recuperative Holiday Homes 99 Refuse Collection and Disposal 62 Relaxation and Mothercraft Clinics 94,129 Rent Control 52 Residential Accommodation — Welfare Services 79 Residential Care — Mental Health 73 Rodent Control 63 s Sanitary Conveniences 61 School — Special Transport 121 School Dental Service 124 School Health Service 113 School Medical Inspection and Treatment Treatment 113,114 School Population 113 Sewerage and Sewage Disposal 61 Shops and Offices 57 Short Term Care — Mental Health 73 Slaughter Houses 40 Slum Clearance & Redevelopment 47 Smallpox Vaccination 26,107 Smoke Control 29,43 Special Investigation Clinic 1.134 Speech Therapy 118 Staff 8 Staff Health Service 136 Staff Training 2,138 Statistics — Housing 53 Mental Health Service 74 School Health Service 121,122,123 Vital 1,11 Stillbirths 12,21,22 Student Attachments 138 Swimming Pools 60 T Temporary Accommodation 81 Training Courses and Student Attachments 138 Transport (Departmental) 136 Transport (Schools) 121 Tuberculosis 102 Tuberculosis BCG Vaccination 106 Typhoid Fever 26 V Vaccination and Immunisation 26,105 Vital Statistics 1,11 w Water Supply 30 Welfare Services 79 Whooping Cough Vaccination 107 146 Printed and Published by Barnet London Borough Council