BAR 4 I THE HEALTH AND WELFARE OF THE LONDON BOROUGH OF BARNET 1970 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 1970 MELVILLE WATKINS, M.R.C.S., L.R.C.P., D.P.H. Health and Welfare Department, London Borough of Barnet, Gateway House, 322 Regents Park Road, Finchley, N.3, The Mayor, Aldermen and Councillors of the Council of the London Borough of Barnet. It is with pleasure, though somewhat belatedly, that I present my Report on the Health and Welfare services of the Borough for the year 1970. With the introduction of the Social Services Act 1970 effective from the 1st April, 1971, the year proved to be one of considerable involvements, not the least of which was that of considering staff who would be transferred by reason of the work undertaken by them to the new Social Services Directorate. With a combined Health and Welfare Department which saw the integration of Health and Welfare services under a common executive and management structure, the assimilation of fragmented posts presented many problems for the future Health administration. The organisation of the Department since April 1965 had, I think, proved an efficient and economical one and the services being provided were, having regard to the availability of resources, able to meet the major needs of the community. The developments planned and which had been approved by the Council for Health and Welfare projects were far seeing and formed the nucleus of a realistic service provision in the years to come. For this reason the new Social Services Directorate would have a solid basis of developments on which to build their future structure. Examples of projects commenced under Health and Welfare were the Old People's Homes to be built at Perryfields, West Hendon, Brunswick Park, New Barnet and Grahame Park. In addition, the planning of a Day Centre for the elderly mentally infirm at Meadowside had been approved in principle and a 60 place workshop for the mentally handicapped was to proceed at Broadfield Estate, Edgware, plus a 150 place adult training centre, a Hostel for the mentally handicapped, and later a day centre for elderly mentally infirm. Other projects for development within the years immediately following 1970 were an Old People's Home at Vale Farm and a Hostel for elderly mentally infirm at Brunswick Park Road, East Barnet. Additional projects planned for Grahame Park were a Welfare Centre for the physically handicapped, etc., and a 60 place Day Nursery. Many other schemes for development of the welfare and mental health services were forecast and though, in some instances, the sites could not be firmly determined, much progress had been made at various levels to further the projects ultimately becoming viable schemes. 1 It is always sad to see the break up of a department which can rightfully claim a fair measure of success, and all I can hope is that the implementation of the new legislation which includes the Chronically Sick and Disabled Persons Act, will provide residential and community services which will meet the needs of the Borough. The problem of homelessness has continued to present difficulties and I envisage that there will always be a demand for additional units of accommodation within the foreseeable future. The conversion of Manor Cottages, Finchley, N.2. to provide additional units should go some way towards relieving the problem. In regard to family planning, 1970 saw considerable progress being made in the provision of a comprehensive service, but here again, it appears obvious to me that this is a service which will continue to expand with ever increasing demands being made. The development of health centres continues and the first one was opened at East Barnet in January, 1970. Although not a purpose built Centre, the extension of the East Barnet Clinic and adaptations made within the premises have provided a most viable unit. The interest of General Medical Practitioners continues and I foresee that in the not too distant future, health centres (purpose built) will be required in a number of districts within the Authority's boundaries and furthermore, there will be a need to extend and equip existing clinics to provide health centre accommodation. This is a priority service insofar as the Government is concerned and the provision of such establishments does much to provide for total health care within the community. From the statistical tables shown on pages 11 to 23 it will be seen that the number of live births has continued the decrease which began in 1964, the corrected birth rate in 1970 having fallen to 12.9 per 1000 population, from 13.2 in 1969. The illegitimate birth rate has increased from 6.9% of all live births in 1969 to 7.4%, reversing the downward trend of the previous four years. There were 57 stillbirths, a rate of 13,7 per 1000 live and stillbirths, as against 50 stillbirths in 1968, a rate of 11.8. The infant (under one year) death rate per 1000 live and stillbirths showed a substantial increase at 17.8 over the 1969 rate of 12.8; the longterm trend however continues to be downward. The neo-natal death rate rose from 8.6 to 13.4, the early neo-natal death rate from 7.2 to 11.2, and the pre-natal death rate (stillbirths and deaths under one week of age) from 23.4 to 24.8. Deaths from all causes decreased from 3,664 in 1969 to 3,582, the corrected rate per 1000 population falling from 10.6 to 10.5. There was no serious outbreak of infectious disease during the year. A number of visits were paid to the Department by representatives of the various professions who were anxious to obtain the views of staff employed in the various divisions of the Department and responsible for particular services. 2 The Minister of State, Health, Lord Aberdare was also a visitor to the Borough in September 1970 and included in his itinerary a visit to East Barnet Health Centre. As I have often said before, for any department to be successful there must be team work and personal involvement of individuals, and during 1970 this was most apparent, and I thank all members of the staff for the part that they played. Finally, I wish to pay tribute to the valuable services rendered by the Voluntary Organisations and voluntary helpers, and to express with deep sincerity my appreciation of the support given to me by the Chairman, Vice-Chairman and members of the Health and Welfare Committee. I also acknowledge with gratitude the continued co-operation of my fellow Chief Officers and their Staffs. 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 27 ENVIRONMENTAL HEALTH SERVICES 31 MENTAL HEALTH SERVICES 73 WELFARE SERVICES 83 PERSONAL HEALTH SERVICES 97 SCHOOL HEALTH SERVICES 117 GENERAL SERVICES 135 INDEX 151 5 HEALTH AND WELFARE COMMITTEE as at 31st December, 1970 Councillor Mrs. R.A. Freedman (Chairman) Councillor H.R. Brooks (Vice-Chairman) COUNCILLORS: E.A.E. Asker, J.P., F.C.I.S., A.B.A.A., (Mayor), F.J. Collisson, R.J. Finigan, B.Sc. (Econ.), Mrs. 3.M. Franklin, Mrs. E.R. Gibson, W.C. James, J.E. Park, F.C.A., J.S. Payne, Mrs. C. Riordan, R.R. Stewart, LL.M., Mrs. M.M. Symons, Mrs. Clara Thubrun, M.B.E., J.P., J.C. Tiplady, V.H. Usher. Co-opted Member: Dr. T.J. Carter, M.R.C.S., L.R.C.P. 7 STAFF OF THE HEALTH AND WELFARE COMMITTEE as at 31st December, 1970. M. Watkins, M.R.C.S., L.R.C.P., D.P.H. Medical Officer of Health G.C. Young, M.D., M.B., S.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. Joan Mulholland, M.B., Ch.B., D.P.H., D.C.H. Mary McQuaid, L.R.C.P., L.R.C.S., D.P.H. Principal Medical Officers Hannah Mushin, M.R.C.S., L.R.C.P., D.C.H. Gillian S. Simmons, M.B., Ch.B., M.R.C.S., L.R.C.P., D.R.C.O.G. Lysbeth R. Vaughan-Jones, L.R.C.P.S., L.R.F.P.S. Senior Medical Officers J.E. Wilson, D.C.M., B.Sc. (Econ.) A.A.P.S.W. (Resigned 30.11.70) 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 1970 313,080 Number of Inhabited Dwellings, 1st April, 1970 - Houses and Flats 100,838 Other properties with living accommodation 738 Rateable Value at 1st April, 1970 £22,779,527 Product of penny rate 1970/71 £90,600 LIVE BIRTHS MALES FEMALES TOTAL Legitimate 1,973 1,816 3,789 Illegitimate 156 145 301 2,129 1,961 4,090 Illegitimate live births per cent, of total live births BARNET 7.4 GREATER LONDON 11.3 INNER LONDON 16.2 OUTER LONDON 8.3 ENGLAND AND WALES 8.3 Live Birth Rate per 1,000 population:- BARNET 13.1 AREA COMPARABILITY FACTOR 0.99 CORRECTED RATE -BARNET 12.9 GREATER LONDON 14.1 INNER LONDON 14.0 OUTER LONDON 14.3 ENGLAND AND WALES (PROVISIONAL) 16.0 11 STILLBIRTHS MALES FEMALES TOTAL Legitimate 28 25 53 Illegitimate 3 1 4 31 26 57 Total live and stillbirths 2,16(1 1,987 4,147 Stillbirth rate per 1,000 live and stillbirths LEGITIMATE ILLEGITIMATE TOTAL BARNET 13.8 13.1 13.7 GREATER LONDON 12.0 INNER LONDON 12.1* OUTER LONDON 11.9* ENGLAND AND WALES (PROVISIONAL) 12.8 15.9 13.0 *Figure based upon less than 1,000 occurrences INFANT DEATHS (under 1 year of age) MALES FEMALES TOTAL Legitimate 40 23 63 Illegitimate 5 5 10 45 28 73 Infant death rate per 1,000 live births:- LEGITIMATE ILLEGITIMATE TOTAL BARNET 16.6 33.2 17.8 GREATER LONDON 17.8 INNER LONDON 20.4* OUTER LONDON 16.3 ENGLAND AND WALES 17.2 25.9 18.2 *Figure based upon less than 1,000 occurrences 12 NEO-NATAL DEATHS (under 4 weeks of age) MALES FEMALES TOTAL Legitimate 30 15 45 Illegitimate 5 5 10 35 20 55 Neo-Natal death rale per 1,000 live births:- LEGITIMATE ILLEGITIMATE TOTAL BARNET 11.9 33.2 13.4 GREATER LONDON 12.3 INNER LONDON 13.5* OUTER LONDON 11.6* ENGLAND AND WALES 11.6 17.4 12.3 *Figure based upon less than 1,000 occurrences EARLY NEO-NATAL DEATHS (under 1 week of age) MALES FEMALES TOTAL Legitimate 24 13 37 Illegitimate 5 4 9 29 17 46 . Early Neo-natal death rate per 1,000 live births:- LEGITIMATE ILLEGITIMATE TOTAL BARNET 9.8 29.9 11.2 GREATER LONDON 10.7 INNER LONDON 11.9* OUTER LONDON 10.0* ENGLAND AND WALES (PROVISIONAL) 10.2 15.2 10.6 *Figure based upon less than i,000 occurrences 13 PERI-NATAL DEATHS (Still births and Deaths under 1 week of age) MALES FEMALES TOTAL 52 38 90 Illegitimate 8 5 13 60 43 103 Peri-natal death rate per 1,000 live and stillbirths:- LEGITIMATE ILLEGITIMATE TOTAL BARNET 23.4 42.6 24.8 GREATER LONDON 22.6 INNER LONDON 23.9 OUTER LONDON 21.8 ENGLAND AND WALES (PROVISIONAL) 22.8 30.8 23.5 MATERNAL MORTALITY RATES per 1,000 total live and still births:- Excluding Abortions BARNET NIL GREATER LONDON 0.17* INNER LONDON 0.25* OUTER LONDON 0.12* ENGLAND AND WALES (PROVISIONAL) 0.14 Including Abortions BARNET NIL ENGLAND AND WALES (PROVISIONAL) 0.18 *Figure based upon less than 100 occurrences 14 DEATHS FROM ALL CAUSES MALES 1,675 FEMALES 1,907 TOTAL 3,582 Death rate per 1,000 population:- BARNET 11.4 AREA COMPARABILITY FACTOR 0.92 CORRECTED RATE - BARNET 10.5 GREATER LONDON 11.4 INNER LONDON 11.7 OUTER LONDON 11.2 ENGLAND AND WALES 11.7 15 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 2 1 — — — — — — — — 1 B5 Tuberculosis of Respiratory System 8 — — — — 1 — 1 — 2 — 4 B6(l) Late effects of Respiratory T.B 2 — — — — — — — — 1 — 1 B6(2) Other Tuberculosis 2 — — — — — 1 — 1 — — — B17 Syphilis and its Sequelae 1 — — — — — — — — — 1 — B18 Other Infective and Parasitic Diseases 5 1 — 1 — — 1 — — 2 — — B19(l) Malignant Neoplasm, Buccal cavity etc. 6 — — — — — — — 1 2 2 1 B19(2) Malignant Neoplasm, Oesophagus 8 — — — — — — — — — 2 6 B19(3) Malignant Neoplasm, Stomach 83 — — — — — — 2 6 14 22 39 B19(4) Malignant Neoplasm, Intestine 112 — — — — — — 2 7 31 22 50 B19(5) Malignant Neoplasm, Larynx 3 — — — — — — — — — 2 1 B19(6) Malignant Neoplasm, Lung, Bronchus 216 — — — — — — 5 18 54 84 55 B19(7) Malignant Neoplasm, Breast 88 — — — — — 1 2 20 28 16 21 B19(8) Malignant Neoplasm, Uterus 22 — — — — — — 2 1 8 4 7 B19(9) Malignant Neoplasm, Prostate 25 — — — — — — — 2 2 10 11 B19(10) Leukaemia 22 — 1 1 3 1 1 1 2 2 5 5 B19(ll) Other Malignant Neoplasms 215 — — — 1 5 4 14 24 46 56 65 B20 Benign and Unspecified Neoplasms 12 — — — 1 — — 2 1 2 2 4 B21 Diabetes Mellitus 19 — — — — — — — — 2 5 12 B22 Avitaminoses, etc 3 — — — — — — — — — — 3 B46(l) Other Endocrine etc. diseases 7 1 — 1 — — — — — 2 1 2 B23 Anaemias 9 — — — — — — — — — 2 7 B46(3) Mental Disorders 10 — — — — 1 — — 1 — 3 5 B46(4) Multiple Sclerosis 6 — — — — — 1 2 — 1 2 — B46(5) Other Diseases of Nervous System 27 — — — 1 — 1 2 4 4 5 10 B25 Active Rheumatic Fever 1 — — — — — — — — — — — B26 Chronic Rheumatic Heart Disease 50 — — — — — 2 2 5 13 9 19 B27 Hypertensive Disease 64 — — — — — — 2 — 13 13 36 B28 Ischaemic Heart Disease 882 — — — — — — 15 40 174 264 389 B29 Other forms of Heart Disease 163 — — — — 1 — 2 — 8 24 128 B30 Cerebrovascular Disease 437 — — — 1 1 — 3 10 39 94 289 B46(6) Other Diseases of Circulatory System 161 — — — — — — — 7 20 31 103 B31 Influenza 22 — — — — — — — 1 5 6 10 B32 Pneumonia 324 3 6 1 — 2 1 2 4 20 57 288 B33(l) Bronchitis and Emphysema 149 — 1 — — — 1 1 1 14 41 90 B33(2) Asthma 11 — — — — — — 1 — 3 4 3 B46(7) Other Diseases of Respiratory System 34 — 4 — — — — — 2 4 6 18 B34 Peptic Ulcer 18 — — — — — — — — 3 5 10 B35 Appendicitis 2 — — — — — — — — — — 2 B36 Intestinal Obstruction and Hernia 11 1 — — — — 1 1 — 1 — 7 B37 Cirrhosis of Liver 10 — — — — — — — 1 4 2 3 B46(8) Other Diseases of Digestive System 46 — — 1 — — 1 3 — 8 10 23 B38 Nephritis and Nephrosis 10 — — — — — 2 1 1 1 3 2 B39 Hyperplasia of Prostate 5 — — — — — — — — — 3 2 B46(9) Other Diseases, Genito-Urinary System 29 — — — — 1 — 1 2 3 4 18 B46(10) Diseases of Skin, Subcutaneous Tissue 2 — — — — — — — — 1 — 1 B46(ll) Diseases of Musculo-Skeletal System 20 — — — — — 1 2 2 7 3 5 B42 Congenital Anomalies 24 9 4 2 1 — 2 — 2 2 1 1 B43 Birth Injury, Difficult Labour, etc. 18 18 — — — — — — — — — — B44 Other Causes of Perinatal Mortality 21 21 — — — — — — — — — — B45 Symptons and 111 Defined Conditions 9 — — — — — — — — — 1 8 BE47 Motor Vehicle Accidents 46 — — 2 2 11 3 3 1 8 6 10 BE48 All Other Accidents 51 1 1 — 1 2 5 5 5 5 6 20 BE49 Suicide and Self-inflicted Injuries 43 — — — — 7 4 5 9 11 6 1 BE49 All other external causes 6 — — — — 1 1 1 1 1 — 1 TOTAL ALL CAUSES 3,582 55 18 9 11 34 35 85 182 571 845 1,737 16 17 18 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 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 1970 4090 13.1 73 17.8 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 8 2 10 0.032 0.019 Other Tuberculosis 1 1 2 0.006 0.014 Cancer of lung and bronchus 162 54 216 0.690 0.617 Other Cancer 232 364 596 1.904 1.773 19 20 LIVE BIRTHS BY AGE AND PARITY OF MOTHER AND PLACE OF OCCURRENCE Parity of Mother * Place of Delivery Age of Mother All Ages Under 20 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 and over 0 1A 3 3 1B 1523 ( 0.2%) 144 - 721 ( 0.2%) 460 - 132 - 53 - 13 - - 2 62 (95.47.) 3 ( 9.0%) 30 (45.2%) 25 (28.8%) 3 ( 8.3%) 1 ( 3.3%) (0.8%) - 3 7 ( 3.9%) (0.2%) 6 ( 1.9%) 1 ( 1.6%) ( 0.2%) ( 0.1%) — - 4 2 ( 0.4%) - 1 ( 0.4%) ( 0.1%) 1 - — - - 1597 (0.1%) - ( 0.1%) — ( 0.1%) - - - 1 1A 1 1 1B 1105 ( 0.1%) 30 - 339 ( 0.1%) 468 - 189 - 69 - 13 - 1 - 2 44 (90.5%) ( 2.5%) 7 (27.8%) 24 (38.3%) 11 (15.1%) 1 ( 5.7%) 1 ( 1.1%) ( 0.1%) 3 69 ( 3.6%) 2 - 25 ( 0.6%) 29 ( 2.0%) 12 (0.9%) 1 ( 0.1%) ( 0.1%) - 4 2 ( 5.7%) ( 0.2%) ( 2.0%) ( 2.4%) 2 (1.0%) ( 0.1%) - — 1221 (0.2%) — — — ( 0.2%) — — — 2 1A 1B 490 - 1 - 65 - 194 - 144 - 73 - 13 - - 2 28 (85.4%) ( 0.2%) 1 (11.3%) 9 (33.8%) 12 (25.1%) 5 (12.7%) 1 ( 2.3%) - 3 54 ( 4.9%) - 12 ( 0.2%) 20 ( 1.6%) 16 ( 2.1%) 5 (0.9%) 1 ( 0.2%) - 4 2 ( 9.4%) — 1 ( 2.1%) ( 3.5%) 1 ( 2.87.) (0.9%) ( 0.2%) — 574 ( 0.3%) — ( 0.2%) — ( 0.2%) — — - 3 1A 1B 203 - - 12 - 48 - 82 - 49 - 11 - 1 - 2 9 (85.3%) — ( 5.0%) 4 (20.2%) 4 (34.5%) 1 (20.6%) (4.6%) (0.4%) 3 26 ( 3.8%) 4 1 - 6 (1.7%) 13 (1.7%) 6 (0.4%) — - 4 (10.9%) - ( 0.4%) ( 2.5%) (5.5%) (2.5%) - - 238 - - - - - - - - 4 1A - 1B 88 - - 4 - 17 - 31 - 25 - 10 - 1 - 2 5 (91.7%) - ( 4.2%) (17.7%) 1 (32.3%) 3 (26.1%) 1 (10.4%) (1.0%) 3 3 ( 5.2%) — — — 2 (1.07.) 1 (3.17.) (1.0%) — 4 - ( 3.1%) 4 - - (2.17.) (1.0%) - - 96 - - — - — — ~~ 21 Live Births by Age and Parity of Mother and Place of Occurrence (continued) Parity of Mother * Place of Delivery ... Aee of Mother All Ages Under 20 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 and over 5-9 1A _ — _ _ 1B 58(93.6%) — l (1.6%) 5 (8.1%) 18 (29.0%) 23 (37.1%) 11(17.7%) - 2 2(3.2%) — — — — 1 (1.6%) 1 (1.6%) — 3 2(3.2%) - - - — 1 (1.6%) 1 (1.6%) — 4 - — — — — — — — 62 10-14 1A — — — — _ — 1B (100.0%) - - - - 1 (50.0%) 1 (50.0%) - 2 — — — — — — — — 3 - - - - - - - - 4 - - - — — — — — 2 15 and over 1A — — — - - - - - 1B — — — — — — — — 2 - - - - - - - - 3 — — — — — — — — 4 — — — — — — — — Illegit 1A _ __ 1B 285 (94.7%) 84 (27.9%) 105 (34.9%) 48 (15.9%) 23 (7.6%) 16 (5.3%) 8 ( 2.7%) 1 ( 0.3%) 2 3 (1.0%) 1 (0.3%) 1 (0.3%) - — 1 (0.3%) — - 3 11 (3.7%) 1 (0.3%) 5 (1.7%) 3 (1.0%) 1 (0.3%) 1 (0.3%) - - 4 2 (0.7%) 2 (0.7%) — — — — — — 301 TOTAL 1A 4 (0.1%) — 4 ( 0.1%) — - - — - 1B 3754 (91.8%) 259 (6.4%) 1247 (30.5%) 1240 (30.3%) 615 (15.4%) 309 (7.6%) 80 (2.0%) 4 (0.1%) 2 153 (3.7%) 4 (0.1%) 39 (1.0%) 62 (1.5%) 31 (0.8%) 13 (0.3%) 4 (0.1%) — 3 172 (4.2%) 3 (0.1%) 49 (1.2%) 59 (1.4%) 44 (1.1%) 15 (0.4%) 2 (0.1%) — 4 8 (0.2%) 2 (0.1%) 2 (0.1%) — 4 (0.1%) — — — 4091 * 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 22 STILLBIRTHS BY AGE AND PARITY OF MOTHER AND PLACE OF OCCURRENCE Parity of Mother *Place of Delivery AGE OF MOTHER Total Under 20 20-24 25-29 30-34 35-39 40-44 45 & over 0 1A — — - — — — — — — — — — — 1B 26 (96.3%) 1 (3.7%) 11 (40.7%) 10 (37.0%) 3 (11.1%) 1 (3.7%) — — — — 2 _ — — — — — — — — — — — — — — — 3 — _ _ — _ — — — _ — _ — _ — — 4 i (3.7%) - - 1 (3.7%) - - - - - - - - - - 27 1 1A - _ _ _ _ _ _ _ _ _ _ _ 1B 11 (84.6%) — — 3 (23.5%) 4 (30.8%) 3 (23.5%) 1 (7.7%) - — — — 2 2 (15.4%) — — — — 2 (15.4%) — — — — — — — — 3 - — — — — — — - — — — — — — — — 4 — — — — — — — — — — — _ — — — — 13 2 1A - - - - - - - - - - - - - - - - 1B 5 (100.0%) - - — — 1 (20.0%) 3 (60.0%) 1 (20.0%) — — — — 2 — — — — — — — — — — — — — — — — 3 _ — — — — — — — — — — — — — _ — 4 - - - - - - - - - - - - - — — 5 3 1A - - _ _ - - - - - - - - - - - 1B 6 (85.7%) - - 1 (14.3%) - - 3 (42.8%) 1 (14.3%) 1 (14.3%) - — 2 — — — — — — — — — — — — — — — — 3 1 (14.3%) — — — — — — 1 (14.3%) — — — — — — 4 - — - — — - — - - - - - - - - - 7 4 1A - - - - - - - - - - - - - - - - 1B 3 (100.0%) - - - - - - - - 2 (66.7%) - - 1 (33.3%) 2 — — — — — — — — — — — — — — — — 3 _ _ _ 4 - - - - - - - - - - - - - - - - 3 23 Stillbirths by Age and Parity of Mother and place of occurrence (continued) Parity of Mother *Place of Delivery AGE OF MOTHER Total Under 20 20-24 25-29 30-34 35-39 40-44 45 % over 5-9 1A — — — - — — — — — — — — — — — — 1B _ — — — — _ — - — — __ — _ — — 2 — — — — — — — — — — — — — — — — 3 — — — — — — — — — — — — — — — — 4 - - - - - - - - - - - - - - - - - 10-14 1A _ _ — — — — — _ _ _ — _ _ 1B — — — — — — — — — — — — — _ _ _ 2 — — — — — — — — _ _ — — — _ — _ 3 — — — — _ — — — — — _ _ _ _ _ 4 - - - - - - - - - - - - - - - - - 154 1A _ _ _ _ _ _ _ _ __ — _ _ _ — 1B — — — — — — — — — — — — — — — — 2 — — — — — — — — — — — — — — — — 3 — — — — — — — — — — — — — — — — 4 - - — - - - - - - - - - - - - - - Illegit 1A - - - - - - - - - - - - - - - - 1B 4 (100.0%) 2 (50.0%) — _ 2 (50.0%) — _ _ — _ _ _ 2 — — — — — — — — _ — — — — — — — 3 4 - - - - - - - - - - - - - - - - 4 Total 1A _ 1B 55 (93.3%) 3 (5.1%) 15 (25.4%) 17 (28.8%) 12 (20.3%) 6 (10.2%) 1 (1.7%) 1 (1.7%) 2 2 (3.4%) — — — — 2 (3.4%) — — — — — — — _ 3 1 (1.7%) — — — — — — 1 (1.7%) — — — — — — 4 1 (1.7%) - - 1 (1.7%) - - - - - - - - - - 59 * 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 5 (4) Acute poliomyelitis - (-) Anthrax - (-) Cholera - (-) Diphtheria - (-) Dysentery 33 (228) Food poisoning 94 (63) Infective jaundice 58 (51) Leprosy - (-) Leptospirosis - (-) Malaria 2 (-) Measles 1363 (672) Ophthalmia neonatorum 5 (5) Paratyphoid fever 2 (6) Plague - (-) Relapsing fever - (-) Scarlet fever 81 (61) Smallpox - (-) Tetanus - (-) Tuberculosis Respiratory 59 (80) Meninges and C.N.S. 1 (-) Other 24 (33) Typhoid fever 4 (2) Typhus - (-) Whooping cough 81 (30) Yellow fever (-) 1812 1235 Figures in parenthesis represent notifications for 1969. 27 Two cases of paratyphoid occured during the year; one was a 7-year-old girl who had been to Italy on holiday and the other a 5-year-old boy who on investigation was found to have visited and eaten at a pie shop with his father, neither he nor his parents having been out of the country. 3oth cases made an uneventful recovery, and all contacts were tested and no related cases found. Four cases of typhoid fever were notified during the year. One case was a girl of 21, a laboratory technician at a London hospital, who had not been out of the country but had been working on a specimen of faeces from another typhoid case. She made an uneventful recovery. The three other cases had been either living or staying abroad; one case, a child of 2, came from Karachi with her mother and during investigations of contacts it was discovered that one of the contacts, a man of 35, was a carrier of typhoid but of a different strain. He was admitted to hospital for treatment and subsequently discharged, but moved into the Borough of Camden. The Medical Officer of Health of Camden was notified. All cases made uneventful recoveries, and contacts were tested and no related cases found. Two cases of malaria were notified, one a girl of 3 and the other a woman of 25 years. In both cases the disease was contracted naturally abroad. 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. This is done by comparison of the signature on the certificate with a file specimen of the doctor's signature previously supplied by him. During the year, 11,795 such certificates were authenticated in the Department. 28 ENVIRONMENTAL HEALTH SERVICES ENVIRONMENTAL HEALTH SERVICES Man began to pollute the environment when he first made fire and throughout the centuries he has recognised the unwholesomeness of waste products. It is but comparatively recently that an explosive increase in the production of durable goods and the wider use of the products of an expanding chemical industry has created conditions which without check may well adversely affect man's health and comfort. In the public health service we have since the middle of the 19th century been seeking not only to remedy unhealthy conditions but to prevent them. Today we take for granted a pure domestic water supply, and recognise that adequate means of sewerage and sewage disposal, and arrangements for the collection and disposal of domestic refuse and the products of industry, are indispensable to a healthy environment. High standards are called for in the production, storage and distribution of food and shortcomings in these respects are frequently treated by the Courts in exemplary fashion. Smoke-free atmosphere, not yet universal, is rapidly extending, paradoxically more in the big towns than elsewhere, and in Barnet our target is to make the Borough smoke-free by 1976. Housing legislation now recognises the need not only to provide homes and to keep them in good repair, but to create an environment in total which is socially acceptable. We really owe our present environmental health services to the enthusiasm of the sanitary reformers of a hundred years ago and it is our purpose today to exploit the advances made in the creation of a healthy environment and, within the boundaries of our authority, to seek to prevent conditions inimical to health. The detailed account required by Regulations and meeting the requests of Government Departments shows the range of work involved and the results achieved by the whole staff of the Division. WATER SUPPLY The supply of water to the Borough is distributed by three companies, namely the Colne Valley Water Company, the Lee Valley Water Company and the Metropolitan Water Board. It is satisfactory in quantity and quality. Raw water and water going into supply are regularly sampled by the companies for bacteriological and chemical examination, and the results were reported to conform to satisfactory standards of purity. The waters are not liable to plumbosolvent action. 31 The amount of naturally occurring 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 0.2 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 standpipe. FOOD Formal and Informal Samples Five hundred and eighty samples of food were submitted to the Public Analyst during the year. A table identifying the commodities and showing the results is set out below. The number of samples reported as unsatisfactory was 7.2. per cent of the total submitted, a slight decrease on the figure for 1969. In addition twenty samples of foodstuffs and drugs, the subjects of complaint were also examined by the Public Analyst. SAMPLE FORMAL INFORMAL Satisfactory Unsatisfactory Satisfactory Unsatisfactory Alcoholic Beverages, Beers 2 Alcoholic Beverages, Cream Snowball 1 Alcoholic Beverages, Advocaat Punch Drink 1 Alcoholic Beverages, Whisky 2 Almond Orgeat 1 Beans, Baked 1 Beans in Tomato Sauce 1 Beef Stew 1 Biscuits 2 Blackcurrant Health Drink 3 Bread 1 Breakfast Cereal 1 Butter 3 Cake 1 3 1 Cake and Pastry Mixes 2 Cheese 1 3 12 4 Cheese Spread 7 32 SAMPLE FORMAL INFORMAL Satisfactory Unsatisfactory Satisfactory isfactory Chilli Powder 2 Coffee 1 Coffee and Chicory Essence 1 Coffee Mate 1 Confectionery 8 Cooking Fat 2 Corn Chips 1 Cornflour 2 Cream 9 1 Creme de Marrons 1 Curry Powder 2 Custard Powder 1 Dessert Preparations 4 1 Dripping 3 Egg Mundels 1 Farina 1 Fish Cakes 2 Fish. Canned 12 Flour, Plain 5 Flour. Rye 1 Flour, Self-raising 12 Flour, Soya 1 Flour, Whole Wheat 1 Food Colour, Artificial 1 1 Fruit, Canned 26 4 Fruit, Dried 4 Fruit Nectar 2 Fruit Preserve 2 Glace Cherries 1 Glycerine 1 Gravy Mixes and Powders 3 Groundnut Oil 2 Herbs, Dried 1 Honey 1 Horseradish Cream 1 Hydrogen Peroxide Solution 1 Ice Pops 1 Ice Lolly Mixture 2 Icing Sugar 1 Jams 13 Jellies 19 Lard 6 Laxative, Fruit 1 Lemon Curd 2 Lemon Juice 1 Liver. Pig's 3 Macaroni Shells 1 Malted Milk 1 Margarine 10 1 33 SAMPLE FORMAL INFORMAL Satisfactory Unsatisfactory Satisfactory Unsatisfactory Marmalade 6 Marzipan 1 Meat, Canned 22 1 Meat Pies and Puddings 15 1 Meat Products, other 1 12 Milk, Condensed 2 Milk, Dried 4 1 Milk, Evaporated 4 Milk Puddings, Canned 6 Milk Shake Syrup 1 Mincemeat 2 Mint Sauce 3 Oatmeal 4 Olive Oil 1 Paracetamol Tablets 1 Pastes and Spreads, Fish 3 Pastes and Spreads, Meat 3 Pease Pudding 2 Pickles 5 Pie Filling 1 Pure di Mele 1 Rice 3 Rice, Ground 3 Sage and Onion Stuffing 1 Sago 1 Salad Cream and Mayonnaise 6 Sandwich Spread 1 Sauces 3 Sausage Meat, Beef 9 1 Sausage Meat, Pork 15 1 Sausages, Beef 18 1 Sausages, Pork 17 2 Scone Meal 1 Semolina 2 Shandy 4 Soft Drinks 26 1 Soups, Canned 34 1 Soups, Dried 6 4 Spaghetti in Tomato Sauce 2 Spices 3 Suet 2 Sweetners, Low calorie 1 Tea 8 Tomato Chutney 1 Tomato Juice 1 Tomato Ketchup 5 Tomatoes, Canned 10 Tonic Water 3 Tooth paste 1 34 SAMPLE FORMAL INFORMAL Satisfactory Unsatisfactory Satisfactory Unsatisfactory Vegetable Juice 2 Vegetables, Canned 18 2 Vegetables, Dehydrated 5 Vegetarian Foods 6 Yoghurt 3 TOTALS 4 4 537 35 The following comments are made regarding some of the unsatisfactory samples:Cream Cheese Comments have been made in the two previous Annual Reports concerning the practice of selling full fat soft cheese as cream cheese. This practice has continued in spite of the fact that as long ago as 1962 the Food Standards Committee made recommendations for the fat content of all soft cheeses, which recommendations were subsequently incorporated in the Cheese Regulations 1965. These Regulations were subsequently amended by the Cheese Regulations 1970. During the year four samples of "cream cheese" were found in fact to be full fat soft cheese. Legal proceedings were instituted in three of the cases and a fourth case concerning a sample taken during 1968 was also heard during the year under review. In each of the cases a fine of £10 was imposed. Margarine Ten samples of margarine were examined during the year and in no instance was there found to be a deficiency in the declared vitamin content. One sample however contained a slight excess of moisture and the attention of the packer was drawn to the matter. Dried Milk Again one sample of dried milk was found to contain excessive moisture. As in previous cases where excessive moisture has been found the milk was packed in a waxed paper bag inside a light cardboard carton and the attention of the distributors concerned was drawn to this unsatisfactory method of packing an article which is readily susceptible to the absorption of moisture. Canned Fruit Two cans of fruit preserve imported from India were examined; the first contained as a preservative Benzoic acid which is not permitted as a preservative in this type of product and the contents also showed black stains due to traces of iron which were thought possible to have come from a pan in which the preserve was prepared. In the case of the second can, Sorbic acid was present which is not permitted by the Preservative in Foods Regulations 1962 as a preservative in fruit preserve. A claim was also made on the label for vitamins which was not justified in view of the minute amounts present. 35 Soups The butter fat content of one can of cream of tomato soup was found to be slightly below the standard recommended in the Code of Practice with regard to the composition and labelling of canned soups, and this was brought to the notice of the manufacturers. In the case of dehydrated soups it was found that when reconstituted in accordance with the instructions given on the packets, the fat content of the reconstituted soup was insufficient to justify the description "Creamed". The substitution of the words "Creamed Style" after the normal description of the soup by its contents was considered to be a reasonable compromise in respect of the description of one of the soups sampled. In the other instances the manufacturers agreed to the amending of the recipe. An imported dried soup claimed the presence of vitamins but gave no quantitative statement of the amounts present. The attention of the importers was drawn to this omission. Local Anaesthetics Three phials of local anaesthetic used in a Dental Clinic were examined because of minute traces of white material in suspension. This material was found to consist of a paraffin wax like material which possibly came from the lining of the sealing cap. However, two of the samples had a Lignocaine content of 2.4 and 3.4% respectively instead of the 2% declared on the label. Cream Of the cream samples examined, one sample of double cream was found to be deficient in milk fat whilst the filling of two samples of "cream" horns was found to consist of custard and not cream. Sausages and Sausage Meat An informal sample of pork sausages and one of pork sausage meat purchased from the same butcher showed deficiencies of 9 and 16 per cent in the meat content respectively. After investigation which showed the proportions of the ingredients to be correct it was assumed that they had been insufficiently mixed. This matter was taken up with the retailer and subsequent samples proved satisfactory. The other three samples of sausages and sausage meat reported unsatisfactory related to the finding of undeclared preservative. The average meat content of the total sausage and sausage meat samples examined was 61.5% in respect of the beef variety and 68.3% in respect of the pork. Other Samples In addition to the above samples, the following were examined in the Department:- 36 ARTICLE NUMBER OF SAMPLES SATISFACTORY UNSATISFACTORY Artificial Sweetener 1 - Milk 36 Mince 4 - Soups, Canned 1 - Dried 3 2 Vegetables, Dried - 1 Vinegar - 1 ice Cream There are three small premises in the Borough where ice cream is manufactured. The following table shows the number of samples of ice cream submitted for examination under the Ice Cream (Heat Treatment etc.) Regulations 1959 and 1963. TYPE GRADING TOTALS 1 2 3 4 HARD ICE CREAM PREMISES Prepacked 21 4 - - 25 VANS Loose 102 40 46 33 221 SOFT ICE CREAM PREMISES 2 1 3 1 7 LOLLIES PREMISES ALL SATISFACTORY 12 Liquid Egg Nineteen samples of liquid egg were taken from bakeries to check that the egg had been properly pasteurised. All the samples were reported as being satisfactory. 37 Milk Licensing and Sampling One hundred and eighty-one premises are registered for the sale of milk and the following licences for the sale of graded milk have been issued:- "Untreated" Milk 40 "Pasteurised" Milk 150 "Sterilized" Milk 108 "Ultra-heat Treated" Milk 74 One hundred and thirty-five samples of raw milk were submitted to the Laboratory for the screening milk ring test. A positive reaction in one small herd serving a closed community was followed up and one animal was isolated and eventually sent for slaughter when biological examination proved the cow to be infected with Brucella abortus. The results of a further sixteen biological examinations were negative. One sample of untreated milk was bacteriologically unsatisfactory. Two subsequent samples from the same source were satisfactory. Food Complaints Two hundred and fifty-six complaints were received as to quality, soundness or the presence of foreign bodies in food. In most cases advice and information was given with the object of avoiding a further similar incident but in thirty cases the offence justified formal proceedings. There was an increase of just over 15 per cent in the number of complaints received during the year but this was not so great an increase as that reported last year. It is perhaps of interest to note that in nearly l/5th of the cases the complaint was not substantiated. This is the highest figure ever reported under this category. The table below classifies the nature of the complaints: 1. Foreign Bodies (a) Insects 40 (b) Metal objects 7 (c) Glass, stones, etc. 17 (d) Paper, wood, string, etc. 6 (e) Oil, grease etc. 15 (f) Fabric, plastic, rubber etc. 6 (g) Cigarette ends 1 (h) Harmless matter, e.g. burnt dough in bread 9 101 2. Quality (a) Unsoundness 14 (b) Mould growth 48 (c) Rancidity, sourness etc. 9 71 38 3. Damaged or Dirty Containers (a) Damaged containers 13 (b) Dirty containers, e.g. milk bottles 17 30 4. Labelling or Misdescription 2 2 5. Complaints not substantiated 52 52 256 The problems confronting the dairy companies remain as great as ever, and it is a fact that a number of the complaints are the result of thoughtlessness on the part of the customer who previously received milk in the particular bottle. Notes containing messages for the milk roundsman and metal caps pushed into the bottle are the two greatest offenders in this respect and it would be a great help to all concerned if notes left for the milk roundsman were placed under the empty bottle rather than in the neck. The growing mechanization of the food industry increases the risk of contamination of foodstuffs with oil and grease from moving parts, and the inclusion of the occasional loose nut or washer still gives rise to complaints in spite of the care taken by the industry to avoid such possibilities. The complaints relating to the presence of insects were largely in cans of vegetables or fruits. Here again it is known that all the well known canners go to great lengths to avoid such incidents. Food unfit for human consumption The following list sets out the food stuffs condemned during the year:- Fresh Food Meat 1501 lbs. Offal 117 lbs. Fish 214 lbs. Poultry 2022 lbs. Tinned Fruit/fruit juices 3616 tins/bottles Meat 550 Vegetables 1896 Soups 127 Milk 296 Fish 332 39 Tinned - continued Milk Puddings 80 Meat puddings/pies 233 Cream 20 Jams 206 Unidentified 891 Frozen Foods (in packets or cartons) Cream/ice cream 156 Fish/fishcakes 7722 Meat 2805 Puddings/pies/pastry 2007 Vegetables 7317 Fruit 660 Poultry 33 Mousse 4186 Miscellaneous Confectionery 1799 packets Cereals 98 packets Pastry/flour 240 lbs. Biscuits 286 lbs. Chocolates/sweets 4153 packets Sauces/pickles 10 bottles Dried Fruit 62 lbs. Butter 13 lbs. Animal foods 192 tins Cheese 10 packets 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 housekeeping methods. 40 The Food Hygiene (General) Regulations 1970 which consolidate and amend the Food Hygiene (General) Regulations 1960 and 1962 were made in August 1970 and they come into operation on 1st March, 1971. During the year it was found that 145 catering establishments employed some staff of non United Kingdom origin; some employees in fact had no knowledge of English. Those of European origin or Near East origin are sporadically distributed and in many cases are employed in family businesses where relatives speak English fluently and they present no problem. The main communication problem is with the Chinese employees. These form a close-knit group which shows little inclination to integrate with the local population. None of the 90 Chinese found was employed other than in one of the 26 Chinese restaurants in the Borough all of which were wholly staffed by Chinese. Of these 90 persons it is estimated that 80% were incapable of taking part in a colloquial conversation. There are numerous dialects in Chinese and any attempt at instruction verbally, even with the aid of an interpreter, would be of little or no value. There is however a prospect that the written word in basic Chinese characters may be understood by most groups, and with the aid of a fluent English speaking Chinese gentleman it is hoped to draft a simple Code of Hygiene. With respect to other Asians, most Indians or Pakistanis are employed in Indian restaurants, but there is not the same exclusiveness about them as the Chinese and with patience a workable understanding is achieved. 41 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 clothes or other cleaning and drying facilities (Regulation 19). Class of Business Number at end of 1970 Number Complying with Reg. 16 Number to which Reg. 19 applies Number Complying with Reg. 19 Bakehouses and Bakers Shops 116 116 116 116 Butchers 177 177 177 177 Canteens 201 201 201 201 Confectioners 273 273 152 151 Dairies 9 9 9 9 Fishshops 71 71 71 71 Greengrocers 172 172 142 142 Grocers 325 325 325 325 Licensed Premises 227 227 219 219 Restaurants/cafes 274 274 274 274 5,472 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. Markets There are two markets in the Borough. One owned by the Council at Burnt Oak is known as the Watling Market; this 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 are required to be registered under Section 11 of the Middlesex County Council Act 1950, in those areas formerly Middlesex County districts. At the close of the year there were 41 such hawkers on the register. Slaughterhouses There are no slaughterhouses operating in the Borough at present. One person was licensed by the Council under the Slaughter of Animals Act 1951 as a fit person to slaughter animals. 42 Poultry Inspection 1970 (i) Number of poultry processing premises within the district 1 (ii) Number of visits to these premises 10 (iii) Total number of birds processed during the year 1970 11,580 (iv) Types of birds processed Hens (v) Percentage of birds rejected as unfit for human consumption None (vi) Weight of poultry condemned as unfit for human consumption None (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 farm. 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 carcasses 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 carcasses are retained and inspected in accordance with the procedures recommended in Circular 22/61 of the Ministry of Health. Labelling of Food Samples of canned fruit, fruit preserves, stringless beans, spaghetti and minced beef, cream, snowball drink, cheese blended with beer, soup and artificial sweetner had omissions or misleading errors in their labelling. Labels printed in foreign languages were again encountered and representations were made to the importers to use labels printed in English. 43 LEGAL PROCEEDINGS IN RESPECT OF FOODSTUFFS Date Court Offence Fine  6. 1.70. Hendon Sale of milk bottle containing cigarette end. £10 £5. 28. 1.70. Highgate Sale of lemon tart containing piece of wire. £25 £5. 2. 2.70. Hendon Sale of pork pie affected with mould. £20. £5. 5. 0. 2. 2.70. Hendon Sale of cream cheese deficient in fat. £10 £10. 2. 2.70. Hendon Sale of double cream cheese deficient in fat. £10 £10. . 23. 2.70. Hendon Sale of Cornish Pasty affected with mould. £30 £5. 5. 0. 15. 4.70. Barnet Sale of bottle of sour milk. £10 £6. 116. 2.70. Hendon Sale of chocolate eclairs affected with mould. Case dismissed 9. 2.70. Hendon Sale of mouldy loaf. £15 £5. 5. 0. 17. 2.70. Barnet Sale of mouldy loaf. £25 £2. 2. 3.70. Hendon Sale of milk in bottle containing a slug. £30 £10.10.0. 2. 3.70. Hendon Sale of milk in bottle containing a slug. £30 £10.10.0. 2. 6.70. Hendon Sale of cake containing a piece of flint. £50 £10.10.0. 1. 7.70. Barnet Sale of breakfast cereal containing insects. £40 £5. 15. 7.70. Barnet Sale of mouldy steak and kidney pie. £25 £10 15. 7.70. Barnet Sale of loaf with oil staining. £50 £10 29. 7.70. Highgate Sale of fresh cream Dairy Dessert affected with mould. £20 £5. 1. 9.70. Hendon Sale of loaf with oil staining. £100 £20. 12.10.70. Hendon Sale of mouldy cake. £15 £10. 14.10.70. Highgate Sale of loaf containing piece of cloth. £100 £10. 14.10.70. Barnet Sale of mouldy pork pie. £25 £6. 21.10.70. Highgate Sale of strawberry tart containing piece of glass. £15 £15. 9.11.70. Hendon Sale of breadroll containing a fly. £15 £10. 11.11.70. Highgate Sale of milk in a dirty bottle £50 £15 16.11.70. Hendon Sale of unfit chicken. Adjourned sine die 1 4.11.70. Barnet Sale of brown loaf containing screw. |£15 £10. 44 Continued LEGAL PROCEEDINGS IN RESPECT OF FOODSTUFFS Date Court Offence Fine Costs 21.12.70. Hendon Sale of cream cheese deficient in milk fat. £10 £5. 21.12.70. Hendon Sale of cream cheese deficient in milk fat. £10 £5. 21.12.70. Hendon Sale of loaf containing piece of metal £20 £5. 5. 0. 14.12.70. Hendon Sale of cod roes affected with mould. £25 £10. LEGAL PROCEEDINGS UNDER FOOD HYGIENE REGULATIONS Date Court Offence Fine  7. 9.70. Hendon Various offences under Food Hygiene Regulations £150 £30. 26.10.70. Hendon Various offences under Food Hygiene Regulations Dismissed on points of law. No cost awarded against Council 45 CLEAN AIR A table showing the position reached in the Smoke Control Programme is on page 47 Progress this year was not as good as it might have been because of the shortage of solid smokeless fuel. I referred in my Report for 1969 to the fact that confirmation of the No. 11 Order was likely only if operations were delayed until 1st April, 1971: in the event the Minister of Housing and Local Government made the commencement date the 1st of July 1971. Indeed, during the year a step backwards was taken. Fears of serious shortage of fuel in the winter of 1970/71 led the London Boroughs Association to recommend constituent authorities to consider applying for suspension of Smoke Control Orders. The Minister of Housing and Local Government agreed in Circular 63/70 that he was willing to do this in total or part. The London Borough of Barnet Council decided to ask for temporary suspension of 40% of existing Orders in accordance with the final recommendation of the London Boroughs Association, such a proportion being considered adequate to meet a calculated shortage of 17% of solid smokeless fuel. Table B shows the Orders suspended from 10th November, 1970 until 31st March 1971. Steps were also taken to hasten the conversion of coke fired boilers in Clinics, Homes and Schools and other Council buildings to gas and oil firing so as to free supplies of coke for domestic use. When an area to be recommended as a smoke control area is surveyed it is frequently found to contain buildings whose fate is uncertain: dwellings which are unfit and await assessment as to repair, improvement or demolition, or buildings likely to be demolished for road improvements — the M.I. for instance. A date has to be set for recommending the making of a Smoke Control Order but this rarely coincides with action on these other matters. Clearly if a house has only a very short future life it would be a waste of money to include it in the Order, pay grant for conversions to fireplaces and then to find it shortly pulled down. On the other hand to exclude properties from the Order only to find when in operation that the project has been abandoned or deferred, can result in an unacceptable source of smoke in the middle of a clean air zone for years. Decision can only be taken having regard to the best available information at that time. Recognising this, provision is made in the Clean Air Act 1956 for varying a Smoke Control Order and in June the Health and Welfare Committee recommend the making of a Variation Order to remove the excmption of fireplaces in a dwelling within the area of the London Borough of Barnet Smoke Control (No. 10) Order. The house has been included in road proposals connected with Grahame Park but a subsequent revised plan made demolition unnecessary. Unfortunately, the same procedures concerning publicity, display of Notices, and advertisements in the press, opportunities for appeal etc. must be undertaken in connection with a Variation Order as with a Smoke Control Order. This represents a lot of work — seemingly unnecessary if the person or people concerned are themselves anxious to carry out conversion of fireplaces with the aid of grant. 46 47 TABLE A SMOKE CONTROL ORDER DATE MADE DATE CONFIRMED DATE TN OPERATION ACREAGE NO OF DWELLINGS OTHER PREMISES Orders made by London Borough of Barnet and Constituent Authorities As at 31st December 1969 10,596 59,578 3,664 London Borough of Barnet (Colindale and West Hendon) (No. 10) 5-5-69 24-7-69 l-7-70 393 2,692 148 London Borough of Barnet (Hendon) (No. 11) 25-3-70 10-7-70 1-7-71 402 3,120 256 London Borough of Barnet (Cricklewood) (No. 12) 10-8-70 11-11-70 1-8-71 383 1,925 157 TOTAL 1,178 7,737 561 GRAND TOTAL 11,774 67,315 4,225 Acreage of Borough 22,124 Approximate number of premises (all types) 118,376 The Clean Air (Suspension of Smoke Control - Barnet Order 1970. TABLE B Table showing Smoke Control Orders Suspended. Made Confirmed Operative Houses Other Premises P Acres GROUP I Barnet U.D.C. No. 2 19 12.60 27. 4.61 30. 9.62 468 10 164 ,, ,, No. 3 27. 7.61 6.12.61 30. 9.62 479 14 122 ,, ,, No. 4 11. 9.62 21.11.62 1.10.63 685 2 135 ,, ,, No. 5 19.10.63 1. 1.64 1.10.64 274 18 79 ,, ,, No. 6 30. 7.64 28.10.64 1.10.65 619 21 104 2,525 65 604 GROUP II Borough of Hendon ,, ,, ,, No. 1 3. 9.58 31. 8.59 1. 9.60 639 19 721 ,, ,, ,, No. 7 18. 3.63 26. 7.63 1. 7.64 880 27 520 ,, ,, ,, No. 8 21. 5.63 10. 9.63 1. 9.64 1,465 25 104 ,, ,, ,, No. 9 16. 9.63 19.12.63 1.10.64 509 11 269 ,, ,, ,, No. 10 19.12.63 24. 3.64 1.10.64 432 24 64 ,, ,, ,, No.11 30. 4.64 30. 7.64 1. 7.65 886 135 104 ,, ,, ,, No.12 10. 9.64 29.12.64 1. 7.65 724 51 118 ,, ,, ,, No.13 16.11.64 15. 7.65 1. 7.66 691 119 116 London Borough of Bamet No. 2 2. 2.66 10. 5.66 1.10.67 5,043 228 917 ,, ,, ,, No. 6 18. 8.67 8.11.67 1. 7.68 2,244 87 282 13,513 726 3,215 GROUP III East Bamet No. 1 14.12.59 16. 3.60 1.10.60 872 3 173 ,, ,, No. 2 23.12.60 15. 3.61 1.10.61 874 5 200 ,, ,, No. 3 29.12.61 21. 3.62 1.10.62 1,160 58 178 ,, ,, No. 4 17.12.62 28. 3.63 1.10.63 1,357 55 162 ,, ,, No. 5 16.12.63 10. 3.64 1.10.64 1,440 23 204 ,, ,, No. 6 14.12.64 9. 3.65 1.10.65 1,007 14 163 Friern Bamet No. 2 4.12.61 20. 3.62 1.10.62 786 16 102 ,, ,, No. 3 27. 9.62 31. 1.63 1.10.63 902 17 127 London Borough of Bamet No. 1 22.11.65 24. 2.66 1. 9.66 448 15 58 ,, ,, ,, No. 5 31. 8.66 7.12.66 1. 9.67 956 48 214 9,802 254 1,581 TOTAL 25,840 1,045 5,400 48 HOUSING Provision of Housing Accommodation The year 1970 was one of marked progress in the Council's continuing efforts to meet the overall housing demand in the Borough. Several factors combined to make this possible, the main one being the provision of new estates, an addition of 925 dwellings having been constructed during the year. Moreover, in March the Council reviewed its housing waiting list by circulating all applicants, with the result that many were found to have moved away or obtained their own accommodation without having notified the Council. In consequence the number of registered applicants was reduced from 6,142 at the beginning of March to a total of 4,402 at the end of the review. These developments enabled the Council to lower the minimum waiting period for new housing applicants from twelve to six months before their claims could receive active consideration. At the same time it proved possible to give additional assistance to some of the more hard-pressed inner London Boroughs by increasing the agreed quota of Greater London nominees wishing to be rehoused in Barnet. By 31st December a total of 1,170 families in all categories had been rehoused, of which 65 families were decanted from Housing Areas scheduled for redevelopment in the Council's current programme. Provision for homeless families evicted from their homes for various reasons remained a serious problem but the acquisition of a number of houses in different parts of the Borough as additions to the Council's pool of temporary accommodation under the National Assistance Act 1948 did contribute to some easement of the problem as a whole. During th year the Borough Housing Officer rehoused 47 families from the various units of temporary accommodation into permanent Council dwellings, and, in addition, allocated tenancies direct to 49 families who had been rendered homeless under Court Orders and who otherwise would have had to be admitted into welfare accommodation. In June, The Croft, East Road, Burnt Oak, a new purpose built homeless families unit providing accommodation for a total of 15 families was brought into use. Situated within the North Road Housing Area this will replace the now obsolescent Redhill Lodge scheduled for demolition early next year as part of the same redevelopment scheme. I am indebted to the Borough Housing Officer for the above details relative to the progress made during the year in meeting the demand for Council housing accommodation. 49 Clearance Areas One clearance area located at The Villas, Burnt Oak, Edgware involving two properties was represented to the Council under Part III of the Housing Act, 1957. A Clearance Order was made and because the houses were immediately adjacent to the North Road Housing Area, already programmed by the Local Authority for redevelopment, a Compulsory Purchase Order was made. Demolition of all the properties in the Lodge Lane, North Finchley Clearance Area was carried out. Rehousing of all the tenants from the two other clearance areas at The Burroughs, Hendon and East End Road, East Finchley had not been completed by the end of the year. Detailed surveys were commenced in respect of sixty-two properties in North Finchley in order that consideration could be given to the preparation of a report on two further clearance areas as forecast by the slum clearance programme submitted to the Ministry of Housing and Local Government last year for the period 1970/73. Individual Unfit Houses Fourteen dwellings were reported during the year as being unfit for human habitation and incapable of repair at reasonable cost. In two cases the making of Demolition Orders was appropriate whilst in the remaining instances, as the dwellings were not capable of demolition in isolation, it was necessary to recommend the making of Closing Orders. In two cases the making of Closing Orders was not however proceeded with, since as the properties were within an area scheduled by the Local Authority for eventual redevelopment the owners agreed to sell at this stage to the Council. In consequence of this action, together with that which had been initiated in earlier years, eighteen unfit houses were demolished and ten dwellings closed. Fifteen families comprising in all a total of thirty-eight persons vacated unfit properties. In two instances the tenants found themselves suitable alternative accommodation. In all other cases rehousing was arranged by the Council. Seven 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. The seven properties were adapted so as to provide nine units of accommodation. Slum Clearance and Re-Development Outside the areas which the Council have programmed for comprehensive redevelopment under Part V of the Housing Act, 1957, there are no large locations of unfit housing in the Borough, the problem of unfitness continuing to be confined to individual houses or comparatively small groups of properties. 50 Approximately twenty dwellings per annum continue to be identified, as a result of complaints and the routine inspection of the district, which 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 redevelopment areas for designation under Part V of the Housing Act 1957. A re-appraisal was however made of the Cromwell Road Housing Area which in 1968 was designated by the Council for re-development. This followed representations from a group of the owners concerned that the future of the area should be reconsidered having regard to the provisions of Part II of the Housing Act, 1969 in respect of General Improvement and rehabilitation and in consequence the Council re-affirmed their earlier decision to proceed with comprehensive re-development. During the year Compulsory Purchase Orders were confirmed, each without modification, in respect of three Housing Areas at Sydney Road, Sanders Lane and Cricklewood Lane South. On completion re-development will provide for some 162 units of accommodation in localities previously occupied by 91 mainly substandard properties with an appreciable element of multi-occupation. By the end of the year re-development of the first phase of the Ridge Road Housing Area (18 units) was completed, whilst redevelopment of the Swan Lane Housing Area was well advanced. The latter scheme provides for 36 dwellings and a school site in a locality which was previously occupied by 57 unfit or substandard properties with an appreciable amount of multi-occupation. Improvement of Houses The Housing Act 1969, whilst retaining the main features of the original scheme, sought to give more discretion and greater flexibility to local authorities in addition to increasing the upper limit of the financial assistance available towards the cost of improving older houses which still have an acceptable life but which presently lack amenities in the form of hot water supply, a fixed bath or shower, wash hand basin, sink, and inside water closet. 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 order to encourage them to undertake improvement with the aid of appropriate grants. In twenty cases a favourable response was received and improvement schemes were carried out or put in hand. With the higher levels of grant together with the more realistic rents for certain categories of tenancy made available by the new legislation a steady increase in the number of properties improved is now looked for. During the year a total sum of £40,212 was paid in respect of grant aid, made up of 137 Standard Grants, 20 Discretionary Improvement Grants, and 1 Special Grant relating to a house in multiple occupation. I am informed by the Borough Treasurer that during the same period 337 Housing Act Advances were made for house purchase, involving a gross sum of £1,400,530. 51 Section 19 of the Housing Act, 1964 enables the tenant of an individual dwelling to make representation to the Council to take action to secure the provision of satisfactory amenities. During the year three such representations were received. In one instance the tenant moved to other accommodation elsewhere in the district after which the dwelling which comprised living accommodation over a shop was taken out of residential use by the owners. In a second case discussions had commenced with the owner regarding an improvement scheme, whilst in the third case no firm undertaking had been received from the owner by the 31st December and the indications were that it would be necessary for the service of formal notices to be considered. Improvement works in respect of the two cases which were the subject of representations during 1969 were not carried out. These comprised purpose built ground and first floor units in two storey property, described colloquially as maisonettes, and after taking Counsel's Opinion the Town Clerk ruled these to form part of a tenement block necessitating action to be considered under Section 20 and not Section 19. The initial approach must come from the tenant in these cases and it is discouraging to find how little this provision, which was 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. 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 an area, the authority should themselves undertake work 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. Approved expenditure in respect of such works based upon a sum of not more than £100 per dwelling within the area, will attract grant from the Ministry, the contribution to be a sum equal to one half of the annual loan charges, payable for twenty years. In November 1969 the Council after considering the implications of the new provisions decided that they should receive a report upon the action possible by way of area improvement in order to deal with unsatisfactory housing conditions within selected areas in the Borough. During the year a survey was carried out in order to identify any such areas and in conjunction with the Borough Planning Officer there was consultation with officers of the Ministry of Housing and Local Government on the suitability of the areas 52 considered for designation as General Improvement Areas. In all, twelve areas, with a total content of 4,300 dwellings, were included in the survey and at the end of the year the appropriate officers were considering in more detail the merits of three selected areas before making a recommendation to proceed with one of these as a pilot scheme. Although the Housing Act 1969 repealed the power given in earlier legislation to make Improvement Areas, local authorities are nevertheless able to deal appropriately with those areas already declared. In this respect by the end of the year all work possible had been completed in the Council's first Improvement Area at Prospect Road, Childs Hill — 35 of the 38 houses having been fully improved, the balance being occupied by elderly owners not prepared to undertake the improvement works involved. As the redevelopment of the first phase of the Ridge Road Housing Area, immediately adjacent, was also completed, integration of the two areas in order to achieve overall environmental improvement, as originally visualised, was achieved. Work continued towards the completion of improvement schemes for the 91 houses in the second Improvement Area at Brent Terrace, Cricklewood. 95 of the 136 houses in Campion, Needham, Johnston and Midland Terraces, Cricklewood, had also been improved to the full standard by the end of the year. Before formal 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. In addition to the improvement of the housing stock the owners have undertaken for the estate as a whole improvements to the communal garden areas and the provision of additional parking spaces and garage accommodation. The whole operation is therefore proving to be highly successful in achieving the overall improvement of what had been a somewhat run-down British Rail Estate. Overcrowd ing 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. (a) Number of dwellings known to be overcrowded at end of year 6 Number of families in occupation 7 Number of persons in occupation 49 (b) Number of new cases reported 2 53 (c) Number of cases relieved 7 Number of persons concerned 32 These are the only cases of statutory overcrowding which are known to the Department. Other cases do undoubtedly exist but the entire extent of the problem within the Borough is not considered to represent a serious hazard. Overcrowding seldom 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 often supported by medical certificates and referred by the Housing Department for special consideration on the grounds of overriding medical priority. 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 in houses which are occupied by persons who do not form a single household. 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 the opportunity is now being taken to reconsider these standards in order that any appropriate amendments may be made. Consideration has also been given to the desirability of introducing a scheme 54 of registration having regard to the extensions given to Section 22 of the Housing Act 1961 by the Housing Act 1969. This has however been rejected on the grounds that the extent and character of multi-occupation in the Borough at the present time and as it is indicated for the foreseeable future does not warrant the making of a registration scheme. There are certain clearly defined, and in some instances well established, sectors in parts of Cricklewood, Childs Hill, Golders Green, Finchley and Friern Barnet where relatively high concentrations of multi-occupation are known to exist. 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 more adverse conditions. Whilst comparatively few complaints reach the Department from persons occupying this type of accommodation, it is of vital importance that an adequate programme of inspection should be maintained so as to secure the proper maintenance of such premises and the provision of acceptable standards. It has been confirmed that this is best achieved by undertaking house to house visits in selected areas already known to be vulnerable with detailed inspections of all houses found to be in multi-occupation. During the year 185 properties were inspected in this way and in consequence, together with action initiated earlier, 34 have been equipped and repaired so as to make them suitable for the number of individuals or families in occupation. A Direction in accordance with Section 19 of the Housing Act 1961 was made in respect of a house in the Cricklewood area which could not physically be provided with adequate facilities, limiting the occupants to a number appropriate to the services available. Similar action was contemplated in respect of a second house in East Finchley but before formal action could be initiated the owner/occupier disbanded the five lettings having a total of 16 persons and the house now remains in single family use. 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, regardless of the number of persons at risk or the standards which were otherwise maintained. 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 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 40 houses have been modified to such standards. Leaflets printed both in English and a number of 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. 55 Rent Acts and Housing Act 1969 Once again little advantage was taken by tenants during the year of the opportunity under the provisions of the Rent Acts to apply to the Council for Certificates of Disrepair. This action is possible when a tenant of a controlled tenancy considers that his accommodation is not being maintained in a satisfactory state of repair, having regard to age, character and locality. The procedure is somewhat cumbersome and time consuming and this probably accounts for the fact that no applications were received during the year. One application for cancellation of a Certificate of Disrepair was made and this was issued. The picture was very different in relation to applications by landlords for Qualification Certificates under the provisions of Part III of the Housing Act 1969. This new legislation enabled a landlord to apply to the Council for a qualification certificate in relation to a controlled tenancy, and if the premises were in a condition to qualify for the issue of a Certificate, the tenancy then became regulated as distinct from controlled, and a fair rent could be fixed by the Rent Officer following consultation with the landlord and the tenant. 989 applications were received from landlords relating to controlled tenancies where standard amenities (bath, sink, wash hand basin all with hot and cold water supplies and an internal water closet) were available. The Act requires that a tenant shall be provided with a copy of the landlord's application and afforded an opportunity within a twenty-eight day period, of making written representations to the Council as to the condition of his tenancy. Advantage was taken of this opportunity by a large proportion of tenants. Whether or not such representations are received, it is the policy of this Department that in every instance an inspection of the dwelling be carried out. It was found that in numbers of cases, the only way in which this could be accomplished was by the District Public Health Inspector making evening and week-end appointments. Following such inspection the decision was then made as to whether a Qualification Certificate should be issued or refused or whether, bearing in mind the nature of repair works considered necessary, opportunity should be afforded to the owner to carry out the repair works within a reasonable period of time, at the termination of which the position would be adjudged as to issue or refusal of a Qualification Certificate. Both tenant and landlord have a right of appeal to the County Court within a period of twenty-eight days following the issue or refusal of a certificate. Having obtained a Qualification Certificate, a landlord is entitled to have a fair rent fixed by the Rent Officer, and the tenancy becomes a regulated one. This new legislation imposed an onerous burden on the Division requiring many hundreds of inspections and revisits. It is nevertheless gratifying that although 652 Qualification Certificates were issued and 419 refused, no appeals to the County Court were made either by landlords or tenants. 56 Housing Statistics 1. Inspection of Dwelling Houses (i) (a) Total number of dwellings inspected for housing defects (under Public Health or Housing Acts) 4,131 (b) Number of inspections made for the purpose 11,724 (ii) Number of dwellings found to be unfit for human habitation 16 (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 1,852 (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 23 (v) Number of dwellings inspected in connection with improvement areas Improvement Grants Scheme 121 2. Remedy of defects during the year without service of formal notices: Number of defective dwellings repaired or rendered fit in consequence of informal action 285 3. Action under statutory powers during the year (a) Proceedings under Sections 9 and 10 of the Housing Act 1957 (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 Nil (b) By Local Authority in default of owners Nil 57 (b) Proceedings under Public Health Acts: (i) Number of dwellings in respect of which notices were served requiring defects to be remedied 41 (ii) Number repaired or rendered fit (a) By owners 19 (b) By Local Authority in default of owners (c) Proceedings under Sections 16 and 17 of the Housing Act 1957 (i) Number of dwellings in respect of which Demolition Orders were made 3 (ii) Number of dwellings demolished in pursuance of Demolition Orders 7 (iii) Number of dwellings in respect of which Closing Orders were made 14 (iv) Number of dwellings closed in pursuance of Closing Orders 11 (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) 7 (vii) Number of dwellings in respect of which Demolition Orders were revoked under Section 24 (2) Nil 4. Houses in multiple occupation - Housing Act 1961 (i) Number of properties made suitable for occupation by number of occupants accommodated (Section 15) 34 (ii) Number of properties provided with means of escape from fire (Section 16) 40 5. Compulsory Improvement-Housing Act 1964 Number of dwellings in improvement areas improved to the full standard 12 Number of dwellings outside improvement areas improved to the full standard - Section 19 Nil 58 CARAVANS Under the Caravan Sites and Control of Development Act 1960, there are two sites licensed in the Borough, one on either side of the Barnet By Pass at Stirling Corner. The sites are well maintained and managed and at the end of the year there were 95 caravans stationed thereon. Ministry of Housing and Local Government Circular No. 38/70 draws attention to the fact that Part II of the Caravan Sites Act 1968 which required local authorities to provide sites for gypsies in their areas came into force on the 1st April, 1970. The question of need and the possibility of providing a site was still under consideration at the end of the year. INSPECTIONS AND COMPLAINTS 1970 Some 7,355 complaints and requests for services were investigated and, where possible, defects or unsatisfactory conditions were remedied. The following table shows the nature and number of inspections made. Housing Public Health and Housing Acts 9,014 Multiple Occupation 1,422 Other housing visits 1,288 11,724 Clean Air Observations 298 Surveys proposals and claims 1,143 Other clean air visits 6,812 8,253 Food Premises Bakehouses 406 Butchers 680 Dairies and Milkshops 77 Grocers 734 Ice Cream 125 Restaurants, Cafes 913 School Meals Kitchens and Canteens 709 Stalls 132 Unsound Food 452 Other food premises visits 1,244 5,472 59 Factories Powered/non-powered 353 Sites 26 Outworkers 111 490 Offices, Shops and Railway Premises 2,381 Drainage Drainage and Plumbing Works 2,284 Cesspools 593 2,877 Infectious Diseases 3,440 Animals Pet Shops 37 Riding Establishments 43 Boarding Establishments 16 Diseases of Animals Act 149 Others 35 280 Miscellaneous Visits Accommodation roads/passages 120 Noise nuisance 850 Accumulation of rubbish 1,302 Hairdressers 21 Caravans 113 Water courses 402 Not classified 2,086 4,894 39,811 Of the 2,914 informal notices served, 1,571 were complied with and 91 statutory notices were required, and of these 54 had been complied with at the end of the year. LOCAL LAND CHARGES 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 10,385 properties. 60 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. Investigations into noise complaints can be very time consuming and take up a considerable amount of the Public Health Inspectors' time. Many visits are often needed, frequently at night and early mornings, and sometimes negotiations for the alleviation of the complaint can be very protracted. Many of the complaints received during the year stem from the close proximity of dwellings to industrial premises. During the year 56 complaints of noise nuisance were received; these related to noise from business and industrial activity, and also from domestic and social causes. 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 Shops' 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 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 3,166, a slight reduction on the previous year, although 264 premises were newly registered during the year. In addition to the number of premises registered by the Council, there are 298 registered premises where the Act is enforced by the Factory Inspectorate and 10 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:- 61 Table A — Registrations and General Inspections Class of premises No. of premises newly registered during year Total registered premises at end of year Registered premises receiving a general inspection Offices 98 880 107 Retail shops 136 2006 1,119 Wholesale shops, warehouses 3 51 34 Catering establishments open to the public, canteens 27 225 102 Fuel storage depots — 4 1 TOTALS 264 3,166 1,363 Table B - Number of visits of all kinds by Inspectors to Registered Premises 5,500 Table C - Analysis of persons employed in registered premises by workplace Class of workplace No. of persons employed Offices 14,764 Retail Shops 8,291 Wholesale departments, warehouses 1,474 Catering establishments open to the public 1,550 Canteens 215 Fuel Storage Depots 28 TOTAL 26,322 Total males 13,333 Total females 12,989 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, 62 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 Ministry of Labour 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 76 23 5 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority. 632 330 25 — (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 21 26 — — TOTAL 729 379 30 — Cases in which defects were found:— Particulars Number of cases in which defects were found No. of Cases 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.l) 3 2 - - — Overcrowding (S.2) - - - - — Unreasonable temperature (S.3) — - - - — Inadequate ventilation (S.4) 1 - - - — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7) (a) Insufficient — — (b) Unsuitable or defective 21 6 1 6 - (c) Not separate for sexes 1 - - 1 - Other offences against the Act (not including offences relating to outwork) 6 5 — — — TOTAL 32 13 1 7 - 63 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 112 outworkers so notified engaged in the following trades:- Wearing apparel 80 Furniture and upholstery 4 Artificial flowers 3 Making of boxes etc. 19 Soft toys 3 Lamp shades 3 The Public Health Inspectors made 111 visits to such premises. No unsatisfactory conditions were noted. 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 (indoor) High Road, North Finchley Daws Lane, Mill Hill Goldsmith Avenue, West Hendon Water treatment to public pools is carried out by filtration and "break point" chlorination method. Public Slipper Baths are available at Squires Lane, Finchley, others that were available at West Hendon are to be closed during 1971. 64 Charges for washing and swimming are various. Special charges are agreed for school use for swimming. Washing is free at prescribed times for Old Age Pensioners. SANITARY CONVENIENCES There are 70 male and 68 female public conveniences adjoining the highway and within the curtilage of the Council's parks and open spaces, hand washing facilities are provided at 47 male and 47 female conveniences. The use of conveniences including hand washing facilities is free in the Borough. The convenience at Glebe Land on the North Circular Road has been enlarged and modernised during the year and new conveniences have been built at Bittacy Park. The sanitary fittings in all the public conveniences have been thoroughly descaled and cleaned by a firm of specialist contractors and it is anticipated that this will now be done annually. 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. In the Hendon Wood Lane area, which is not sewered, a scheme has been implemented by the Council to eliminate cesspool drainage. Treatment and disposal is at the Greater London Council (West Middlesex) works, Mogden. 65 In the more rural parts of the Northern area there are some properties which drain to cesspools, for which a free emptying service is carried out by the Council 8 times per year. Generally speaking surface water is handled by discharge of surface water sewers to natural water courses. REFUSE COLLECTION AND DISPOSAL Refuse is collected by direct labour in various types of specially manufactured vehicles. The number of collection rounds is 44. Disposal is effected by 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, some from part of the Borough being handled at the new station at Edmonton. 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, the Pet Animals Act 1951 and the Riding Establishments Acts 1964/70 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 force: Animal Boarding Establishments Act 1963 2 Pet Animals Act 1951 19 Riding Establishments Acts 1964/70 9 The Public Health Inspectors are "authorised officers" for enforcing the provisions of the Diseases of Animals Act 1950 and the numerous Orders and Regulations 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 58 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 isolation of the animals for the required periods. 66 Under the Movement (Records) Orders made under the Diseases of Animals Act, 1950, 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. The records show that the average numbers of stock held were:- Cattle 1,035 Pigs 6,062 Sheep 6 Goats 3 Poultry 16,212 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 disease. The boiling plants may only be operated if satisfactory and licensed. Twelve licences were in force at the end of the year. Under the Regulation of Movement of Swine Order 1959, licences wete 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. Mr. J.R. Stockman, M.R.C.V.S., continues to act on a consultancy basis to assist in the inspection of animals and premises where necessary, and his ready co-operation is much appreciated. RODENT CONTROL The Prevention of Damage by Pests Act 1949 places on the occupier of land the onus of ridding his land and premises of rats and mice; however in practice it is found that the provisions of the Act are best administered by the Council providing a control service. A trained staff of Rodent Operatives is employed and the methods used are in accord 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 are made with the cooperation of the Borough Engineer and Surveyor. The following table summarises the work carried out and is in the form required by the Ministry of Agriculture, Fisheries and Food:- 67 Properties other than Sewers Type of Property Non-Agricultural Agricultural Number of properties in the district 119,711 40 2. (a) Total number of properties (including nearby premises) inspected following notification 2,222 3 (b) Number infested by (i) Rats 1,185 1 (ii) Mice 843 — 3. (a) Total number of properties inspected for rats and/or mice for reasons other than notification 524 23 (b) Number infested by (i) Rats 31 — (ii) Mice 11 - The Rodent Operatives made 12,048 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. The requests for advice and assistance in dealing with insect pests continue to increase 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 co-operation of his experts in the identification of numerous insects. Because of complaints from some residents in regard to damage etc. caused by the common squirrel invading roof spaces, the Council hire out traps on request for which a fee of £1.25 per fortnight is charged. During the year 87 such requests were received. "Wild" or "Feral" Pigeons are a widespread pest and continue to cause nuisance. A Special Contractor has again been employed to reduce the numbers of pigeons at several major centres of infestation in the Borough, but their work continues to be impaired by the well meant but misplaced kindness of people who regularly provide food at all seasons. 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. 68 MORTUARY The public mortuary and post mortem room provided by the Council is situated in the North Circular Road, N.3., adjacent to the Disinfecting Station. In the course of the year 552 bodies were received in the mortuary. EXHUMATIONS Licences issued by the Home Office 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". Seven 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. 69 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, and this Borough will need to increase facilities to keep abreast of the modern approach to mental health community care. The special needs are highlighted in an important report of the Psychiatric Rehabilitation Association on "Mental Illness in City and Suburb", which points out that poverty is not necessarily synonymous with mental illness. The middle-aged women from well favoured boroughs were not, for the most part, suffering from diseases attributable to poverty. Social isolation seems to be a factor of equal importance, and areas which exhibit a style of life which is conducive to this isolation, whether in the affluent suburbs or in the furnished bedsitter domains, will tend to have larger numbers of people suffering from either psychiatric illness or its consequences. Also, successful rehabilitation requires a framework of support from the community itself - stable family life, good housing, superior educational facilities, plentiful enjoyment opportunities,- etc., - and when these supports are weak, additional community care via the local authorities is more urgently needed to compensate for the deficiencies of the environment. The most pressing priorities in considering plans for future development still show up in greater needs for services for the adult subnormal and mentally infirm elderly. Casework At the end of the year, the total known caseload of both psychiatric patients and mentally handicapped was 1,105; 452 psychiatric patients and 563 mentally retarded patients. Social work with the mentally handicapped under 16 years of age was continued by the Health Visitor with enormous benefit to families and to the staff themselves. The general picture which emerges from a study of the statistical details is of a steadily increasing volume of work undertaken .but not so obvious from mere figures, is the quality and variety of social work being done by the Mental Welfare Officers. Some indication of this can be gathered from the fact that, although the number of mentally ill persons being referred increases, the number of admissions to hospital under the Mental Health Act, 1959, continues to decrease. Whereas in 1967 50% of cases referred were admitted to hospital, in 1970 only 30% were admitted. The use of emergency admissions under Section 29 has now been reduced to 10%% of the total referrals. 73 The source of referrals is changing; whereas previously some 50% were from General Practitioners and 28% from other sources, the present percentages are 33 and 40 respectively. This is due to a number of factors of which direct referral to hospitals by doctors, including General Practitioners and the Principal Medical Officer, as is usual in physical illness, is one very welcome trend. Day Centres - Elderly Mentally Infirm f 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 because the far-sighted plans of the Council have a high therapeutic content, which means that negotiations have to go on with the North West Metropolitan Regional Hospital Board to reach agreement on the sharing of costs, with all the difficulties that ensue with the present divided Health Service. 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 that there is also a considerable need for social clubs for the mentally handicapped and educationally subnormal, and much is being done by excellent local voluntary associations. 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 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. However, an increasing burden is thrown on staff by the greater degree of disturbance found in patients referred for after-care nowadays. Modern methods of treatment and the increase of local authority hostels generally, probably account for the fall in the numbers of patients simply requiring the facilities of a "half way house". 74 Hospital Services Napsbury Hospital remains the major psychiatric hospital providing cover for the mentally ill in the Borough. However, we are particularly fortunate in having close ties with the Teaching Hospitals in North West London, including St.Luke's, Woodside. Hence, admission can to some extent be made to suit the particular patient's problem. Napsbury Hospital also provides out-patient facilities at the two local General Hospitals - this service being of particular advantage 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 was be possible to set up localised psychiatric services which will alleviate, if not resolve, problems of distance, time and transport. Other Mental Health 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 by the Principal Medical Officer, being a member of the Drug Discussion Group at the King Edward VII Hospital Centre. The number of notified Heroin addicts with addresses in the Borough remained about 10. There is, however, an ominous increase in the number of L.S.D. and Marijuana takers, particularly in the under 20's. 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 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 early intervention, skilled counselling and a wide range of day and residential accommodation that these complex and often heart breaking problems can be solved. 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. 75 One of the most important factors for the handicapped child is establishing social competence, and noticeable progress has been observed through expanding outside activities. An excellent film on this theme has been made by the staff of the Hendon Junior Training School. 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 word and, in handing them to the Education Department in 1971, am confident that they will not cease to educate these children in an exemplary manner. 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. 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. Discussions are taking place with the North West Metropolitan Regional Hospital Board to provide Day Hospitals for these patients. 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 many patients benefited from this service during the year. It is particularly fortunate that the Principal Medical Officer is Hon. Consultant to Buckets and Spades organisation with a Home at St.Leonards, Sussex, which provides excellent holiday care for the majority of children. Residential Care The effective stop on admissions to Psychiatric Hospitals for the mentally retarded has increased the difficulties which have been growing steadily. The very heavy burden placed on the parents of severely disturbed or physically handicapped retarded children and adults is difficult to relieve at the present time. For children, the 10 place hostel at 55 Christchurch Avenue, North Finchley, has proved a great success. This has been much admired and visited by Architects, Doctors, Educationalists and Administrators from all over the world, and is regarded as a model for small family homes. Two 25 place hostels for adults are at the advanced planning stage. 76 Adult Training Centres The numbers needing adult training are naturally increasing and, although the Council has provisions for 100 places at two existing training centres, the 150 places in the adult training centre shortly to be built on the Broadfields Estate will satisfy most of the demands for the immediate future. It is intended that 40 of the places at this new establishment shall be specifically set aside for intensive training to fit higher grade patients, particularly immature leavers from Educationally Sub-Normal Schools, for outside employment. 77 78 Number of persons under Local Health Authority care at 31st December, 1970 Mentally Ill Elderly Mentally Infirm Psychopathic Mentally handicapped Severely Mentally handicapped 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) (11) (12) (13) (14) (15) (16) (17) (18) (19) 1 Total number 9 5 134 202 25 75 2 8 4 134 100 67 56 107 87 1015 2 Attending workshops, day centres or training centres (including special units) 3 3 11 18 6 4 19 22 60 40 63 53 302 3 Awaiting entry to workshops, day centres or training centres (including special units) 3 5 2 8 2 1 5 5 4 35 4 Receiving home training 5 Awaiting home training 6 Resident in L.A. home/hostel 4 5 1 5 3 18 7 Awaiting residence in L.A. home/hostel 1 4 6 1 12 8 Resident in other home/hostel 19 12 1 9 12 9 4 16 6 88 9 Boarded out in private household 1 1 2 10 Attending day hospital 3 9 12 11 Receiving home visits and not incl. in lines 2-10 (a) suitable to attend a training centre 17 28 12 48 1 106 (b) others 9 5 85 140 2 2 109 69 5 10 27 28 491 79 Number of persons referred to Mental Welfare Officers during 1970 Mentally Ill Psychopathic Mentally handicapped Severely Mentally handicapped 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 (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) :i3) (14) (15) [16) (17) (a) General practitioners 133 268 401 (b) Hospitals, on discharge from in-patient treatment 1 65 77 2 2 2 1 150 (c) Hospitals, after or during out-patient or day treatment 26 55 2 2 1 86 (d) Local education authorities 3 1 1 1 17 5 7 12 47 (e) Police and courts 19 21 40 (f) Other cources 4 4 172 257 4 3 2 5 1 1 453 (g) Total 7 5 415 679 1 1 23 12 11 18 3 2 1177 The terms mentally handicapped and severely mentally handicapped are now used in place of subnormal and severely subnormal. ACTIVITIES OF MENTAL WELFARE OFFICERS Attendances at:- Out Patients' Clinics 174 Social Clubs 203 Day Centres 164 Total 541 Visits to:- Mentally Ill Persons 5,962 Mentally Handicapped Persons 659 Total 6,621 * * Includes 518 visits outside office hours Emergency Night and Weekend Standby Service:- Monday - Friday Night Calls 161 Weekend Calls 83 Total 244 80 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 at 31st December, 1970, 230 people were on the waiting list. During the year "Merrivale" (one of the four replacement homes for Redhill House) was opened and the first residents were admitted on 23rd February, 1970. Redhill House, a former poor law institution was closed down completely on 14th March, 1970. Residents from there were transferred to other Council Homes. The residential accommodation in Council Homes for the elderly at the end of the year was 349 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 Merrivale, Burnt Oak, Edgware. 60 Mixed Morton Lodge, Ashfield Road, Southgate, N.14. 50 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 - 349 The Council was financially responsible for 40 people accommodated in other local Authority Homes, and 7 residents in our establishments were chargeable to other Authorities. We are financially responsible for 467 persons in the Homes of Voluntary Organisations. During the year 76 people were admitted to the Council's Homes; 43 residents died, 54 were transferred to hospital and 8 returned to their home address. Short-stay accommodation was provided for 87 persons, to enable relatives who normally care for them to take a holiday, 134 persons were admitted to Voluntary Organisation Homes of whom 10 were for short stays. Improvements and maintenance of buildings, furniture and equipment have been maintained at a high standard, with due regard to economy. 83 A Handicrafts Instructor attends the Home to assist those residents who are willing to accept such instruction. Outings to the coast and countryside are arranged. Film shows and outings are provided frequently at modest cost to the Council, and additional outings, lunches, theatre parties etc. are frequently 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. Registered Homes for the Elderly and Handicapped There are 52 Registered Homes for the Elderly and Handicapped in the Borough providing places for 1118 persons. At the end of the year 780 resided in Homes run by Voluntary Organisations, and 170 in Private Homes for the elderly. One new Voluntary Home was registered during the year, and two private and one voluntary registrations were cancelled. Services provided for the Elderly (Persons of pensionable age) Residential accommodation for persons who by reason of age and infirmity are in need of care and attention. Grants to Old People's Welfare Committees, British Red Cross Society, Finchley Guild of Social Services, W.R.V.S., to assist them in providing handicraft classes, social and luncheon clubs, meals on wheels, visitors, etc., for the general benefit of the elderly in the area. Provision of Day and Work Centres and Transport thereto, where necessary. Home Nursing, Home Helps, Health Visiting, Chiropody, Recuperative Holidays. Claremont Clinic A Day Centre at this clinic for 15 elderly people is staffed on a voluntary basis by the League of Jewish Women. The Centre functions on Tuesday and Thursday of each week, and has proved most successful, enabling housebound elderly people to be collected from their homes, and enjoy the facilities at the Centre. Handicraft is organised under the supervision of the Council's Handicraft Instructor. Etchingham Park Centre, Finchley The popularity of this Centre continues. Day care is provided for 15 elderly houseboundpersons, enabling the members of their families, who normally care for them, to follow their own occupations and to give necessary care for those who live alone. The Matron is responsible for the very successful results achieved in the handicrafts section. A Work Centre 84 provides 40 active elderly people with clean work in a very pleasant sociable atmosphere and a modest amount of pocket money. 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 and is on similar lines to the Council's Work Centre. Meals on Wheels The service is provided mainly by The Women's Royal Voluntary Service, as Agents of the Council, and 66,979 meals were delivered during the year. Not all parts of the Borough receive a 5-day service, but there has again been a substantial increase in the number of meals 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 have a lunch Club for the elderly once each week, and The League of Jewish Women supply Kosher meals to a number of elderly people in the Finchley area. The Luncheon Clubs operated by all the Organisations mentioned play a very important role in caring for the needs of the elderly, and during the year a total of 19,465 meals were served in these Clubs in the Borough. 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 Social Welfare Officers 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). 85 Educational grants for further studies. Social Clubs Industrial and Social Rehabilitation for Partially-rSighted persons, whose sight is likely to deteriorate. Handicraft Classes. Financial assistance with holidays. Dancing Classes and Dances (see Blind Services). 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 194 persons are registered as partially-sighted, an increase of 24 during the year. AGE GROUPS 0-1 2-4 5-15 16-20 21-49 50-64 65+ Total Males - - 9 3 11 15 33 71 Females - - 9 3 16 17 78 123 Total - - 18 6 27 32 111 194 86 Registered Partially-Sighted Persons other than those near or propsectively blind Age Groups 16-20 21-49 50-64 65+ Total Mainly Industrially Handicapped Employed: Males 2 8 5 — 15 Females — 7 3 — 10 Available for and capable of training for work: Males — — — — — Females — — — — — Requiring observation only: Males — 1 — 17 18 Females 1 5 6 32 44 Children, 16 and over, still at school: Males 1 — — — 1 Females 1 — — — 1 5 21 14 49 89 Age Groups 0-5 5-16 Total Children under 16: Attending special schools: Males — 6 6 Females — 5 5 Attending other schools: Males — 2 2 Females — 3 3 Not at school: Males — 1 1 Females — 1 1 — 18 18 87 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 Social Welfare Officers 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) organised by Voluntary Organisations 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.) 88 Number of Registered Blind Persons at 31.12.70 Age Groups 0-1 2-4 5-15 16-20 21-49 50-64 65+ Total Males — 1 2 4 39 50 145 241 Females — 1 4 5 35 51 364 460 Total — 2 6 9 74 101 509 701 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 — — — — 2 2 15 19 Females — — 2 — 3 3 50 58 Total — — 2 — 5 5 65 77 Employment 83 registered Blind persons were in employment at the end of the year; 7 in special Workshops, 8 in Home Workers Schemes and 68 in open employment were as follows:- Masseurs & Physiotherapists 8 Lecturers, Teachers, Instructors 3 Barristers & Solicitors 2 Musicians 3 Social, Welfare and related workers 2 Proprietors, Managers & Executive Workers 3 Typists, Shorthand Typists & Secretaries 6 Braille Copyists 1 Clerical Workers 2 Telephone Operators 10 Working Proprietors & Shop Managers 2 Sales Representatives, Agents & Collectors 2 Machine Tool Operators 5 Fitters & Assemblers 3 Viewers, Inspectors & Testers 1 Packers 2 Carpenters & Joiners 1 Knitters (Hand & Machine) 3 Upholsterers 1 89 Basket Makers 3 Chair Seaters 1 Wireworkers 1 Piano Tuners 1 Craftsmen and Production Process Workers 8 Labourers 2 Domestic/Canteen Workers 3 Miscellaneous Workers 4 83 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 our Register at 31st December, 1970 was 105 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 23 10 54 65 years or over 11 10 28 49 Total 33 34 38 105 90 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 1976, in the following age groups:- under 16 years of age 21 16 years to 64 years 703 over 65 years 1252 Total 1976 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 91 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 212 persons availed themselves of the Council's Assisted Holiday Scheme for the physically-handicapped. 7 families enjoyed a holiday of up to 13 days each in the caravan at Monckton, Kent, given to us by the students of Orange Hill School, but due to illness at last moment full use of the caravan was not maintained. Adaptations to the homes of physically-handicapped persons were carried out in 119 cases at a total cost of £4,861. 528 aids to daily living were issued at a cost of £1,611. 3s. 8. of which 136 were second-hand and were supplied from stock. All these aids were loaned free of charge. Homeless Families The year brought major changes in the Council's provision for families which had lost their homes. Redhill Lodge (accommodation for 25 families) and Redhill House Welfare Home (accommodation for up to 10 families plus a reception unit) were progressively closed during the months following the opening in April of The Croft, a purpose-built hostel for up to 15 families. The Housing Department of the Council supplemented the reduced accommodation by providing homes for 47 families as against 24 in 1969. 92 The accommodation at Kelvedon, 27 Woodside Avenue, N.12. (12 families) and a 2 Edward Road, New Barnet (4 families) has remained in full use. Families Persons Number accommodated at 1.1.70. 56 234 Number of applications during 1970 (Family Units) 190 – Number of admissions during 1970 60 237 Number re-housed by Housing Department 47 199 Number discharged to other accommodation 16 63 Children born to residents – 15 Husbands rejoining families – 5 Number remaining at 31.12.70. 53 229 Number of Men (aged 16 and over) resident at 31.12.70. 34 Number of Women (aged 16 and over) " " " 56 Number of Children (aged 5 — 15) " " " 66 Number of Children (aged under 5) " " " 73 229 93 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 113. Co-ordination and Co-operation with Hospital and General Practitioner Services Links with the hospitals have been strengthened. A health visitor now visits the Paediatric Unit at Edgware General Hospital and joins the meetings of social workers and others concerned with patients in the Unit. Another health visitor combines regularly a visit to the Barnet General Hospital Paediatric Unit with a visit to the Hospital's Premature Baby Unit. Health visitor/group advisers have visited the wards at Edgware General Hospital and offered assistance with regard to patients' social problems. At Barnet General Hospital health visitor/group advisers and home nurses have co-operated with the staff of the Geriatric Department. In September a senior midwife holding the Midwifery Tutor's Diploma was appointed and arrangements were made for her to visit Edgware General Hospital to give lectures to pupil midwives in preparation for their period of training on the district. A newly formed relationship within the teams attached to general practitioners needed time to become established, but there has been a growing understanding amongst members of the team of the role that each has to play. At the beginning of the year the conversion of the East Barnet Clinic to a Health Centre was completed and two of the general practitioner suites were occupied. The arrangements for the joint operation of general practitioner and local authority services have worked smoothly and have greatly benefited the residents in that part of the Borough. Health Visiting This has been a year of consolidation for the service. Health visitors attended a number of courses during the year. The first in-service course for those interested in teaching health education in school was organised by the health education officer and health visitors are now teaching in 18 schools. Health visitors continue to be associaated with research projects carried out by a number of agencies. Three health visitor students successfully completed their studies and are now members of the staff. Assistance was given for the training of six health visitor students from other authorities and eight child care students were placed with health visitors for two weeks. They also welcomed two social work students from Durham and London Universities, respectively. 97 Home Visiting Cases First Effective Total Effective No. Access Visits at request of G.P. or Hospital Expectant Mothers 825 1187 277 — Children born in: 1970 4154 8067 1820 — 1969 2999 5695 1405 — 1965-68 4689 9439 2183 — Persons aged 65 or over 2015 4748 720 1390 Mentally disordered 244 741 108 199 Persons discharged from hospital (other than mental hospitals) 178 278 25 199 Households — Tuberculous 332 477 212 - Households — other infectious diseases 169 227 41 — Other visits as Health Visitors 1361 3271 598 — Total as Health Visitors — 34130 7389 1788 Cases seen as School Nurse — 2108 302 — Total No. of hours devoted to G.P. Surgery 3041¾ Prevention of Homelessness (Problem Families) The department's social workers have continued to make every effort to reduce the risk of homelessness in the borough and family case workers have carried out intensive case work with problem families. The fullest support possible was given to families rehoused from temporary accommodation. Care of Mothers and Young Children Notification of Births Numbers of Births in the London Borough of Barnet during 1970 as adjusted by inward and outward transfers:- 98 (i) Live Births (a) Domiciliary 168 (b) Institutional 3893 4061 (ii) Still Births (a) Domiciliary 1 (b) Institutional 56 57 4118 Attendance at combined Mothercraft and Relaxation Clinics Combined Mothercraft and Relaxation No of Sessions Total Attendances Average attendance per Session Central 22 111 5.2 Childs Hill 31 103 3.3 East Barnet 12 74 6.2 Edgware 24 84 3.5 Mill Hill 18 61 3.4 Oak Lane 22 94 4.3 Oakleigh Road 29 113 3.6 Sutton Road 10 26 2.6 Torrington 52 379 7.3 Vale Drive 32 300 9.4 Watling 14 60 4.3 West Hendon 40 82 2.0 Osidge 5 37 7.4 TOTALS 311 1524 4.9 Congenital Malformation During the year 71 cases of malformation were notified in respect of children born to parents normally resident within the area. Since January 1964 details of 406 cases have been passed to the Registrar General. Mothers' Discussion Groups Discussion groups were in operation at the end of this year at the following clinics:- Vale Drive Oakleigh Road Torrington Oak Lane Brunswick Park (Osidge) Holly Park Mill Hill Sutton Road Childs Hill 99 Child Welfare Centres The following table shows the sessions held and attendances 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 Broadfields 47 2176 46.3 682 25 Central 94 2661 28.3 1450 Childs Hill 102 3511 34.4 1580 47 Claremont 24 516 21.5 292 14 Colindale 53 1883 35.5 725 1 Dollisfield 22 250 11.4 174 12 East Barnet 100 3045 30.5 1541 8 Edgware 48 1430 29.8 641 13 Etchingham Park 105 2332 22.2 1210 — Holders Hill 22 469 21.3 241 — Holly Park 52 1465 28.2 857 — Mill Hill 95 2404 25.3 1195 39 Oak Lane 103 2935 28.5 1568 6 Oakleigh Road 52 1392 26.8 857 — Osidge 104 3141 31.2 1436 — St.Barnabas 52 2489 47.9 837 24 St.Marks 11 109 9.9 88 — St. Stephens 24 425 17.7 265 3 Sanders Lane 25 618 24.6 277 31 Sutton Road 53 1313 24.8 699 — Torrington 102 2948 28.9 1257 — Vale Drive 26 1021 39.3 477 4 Watling 28 563 20.1 261 — West Hendon 102 2262 22.2 906 4 Sessions without a Doctor Broadfields 1 16 16 — — Central 15 197 13.1 — — Claremont 6 62 10.6 — — East Barnet 1 2 2 — — Edgware 13 169 13 — — Holders Hill 8 80 10 — — Inglis Barracks 9 98 10.9 — — Sanders Lane 5 62 12.4 — — St.Marks 3 17 5.6 — — Torrington 4 37 9.2 — — Vale Drive 4 24 6 — — Developmental Clinics Broadfields 1 4 4.0 — — East Barnet 4 6 1.5 — — Holly Park 3 36 12.0 — — Mill Hill 3 16 5.3 — — Osidge 6 58 9.7 — — Oak Lane 13 103 8.0 — — St. Barnabas 8 75 9.4 — — Childs Hill 3 13 4.3 — — TOTALS 1556 42433 27.3 19516 231 100 Number of children who attended during 1970:- Born in 1970 3623 Born in 1969 3003 Born in 1965-1968 3317 9943 Midwifery As in previous years the decline in the number of home confinements conducted by domiciliary midwives continued with 168 deliveries taking place during the year (254 in 1969). Patients nursed at home following hospital confinement numbered 758 (724 in 1969). Sixteen pupil midwives received their district training in the borough and resided at Gervase Road, Edgware during the training period. Home Nursing The upward trend in the demand on the home nursing service has continued. The number of visits during the year showed an increase of 910 over the previous year. A proportion of these visits must be attributed in some measure to the success of the home nurse/general practitioner attachment scheme which has now become an established way of working within the borough. A full establishment of home nurses and nursing auxiliaries was maintained throughout the year. Eight of the home nursing staff attended training courses and were successful in obtaining the National Certificate. One senior home nurse attended a Practical Work Instructor's course. No. of cases nursed 4935 No. of patients under 5 at first visit 182 No. of patients 65 or over at first visit 3224 Marie Curie Memorial Foundation The authority continues to act as agents for the Foundation and during the year 15 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 agents of the authority in providing the loan of nursing equipment, apart from large items which are hired or purchased by the local authority. A small charge is collected by the Society towards the replacement of equipment, except in hardship cases, when the charge is paid by the Council. . 101 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. 102624 pads and 828 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 1970 Age under 65 in 1970 Total Chronic sick or Tubercular Mentally disordered Maternity Others Number of Cases 1856 188 4 81 328 2457 Neighbourly Help Service 38 Neighbourly helps were employed at the end of the year and were providing assistance to 38 households. Day Nurseries The number of places available at the Council's three day nurseries remained at 165 and these were filled by children in the priority categories. Despite staff movements a reasonable staff ratio was maintained during the year. The day nurseries continued to offer practical training to student nursery nurses from Barnet College of Further Education, and observation visits were paid by speech therapy students and student child care officers. Day Nursery No. of approved places Children on Register at 31st December 1970 Attendances for the year Average daily attendances 0-2 2-5 0-2 2-5 Lakeview 60 12 50 3047 9496 48 Kingswood 50 12 37 2177 8033 39 Wood Street 55 10 44 2059 8781 42 TOTALS 165 34 131 7283 26310 129 102 Private Day Nurseries and Registered Child Minders During the year applications for registration under the Nurseries and Child Minders Regulation Act, 1948, as amended by Health Services and Public Health Act, 1968, continued to be received and reports on the home conditions and the suitability of persons concerned were submitted by the nursing officers who visited the applicants. At the end of the year there were 226 registered child minders and 67 private day nurseries. Clinics for the Elderly A total of 52 sessions were held at West Hendon and Watling (Edgware) clinics and 1430 attendances made. Chiropody There was a further increase in the number of persons treated during the year. Treatment is provided through a directly operated domiciliary and clinic scheme in the former Middlesex part of the borough and in the former Hertfordshire part of the borough the Hertfordshire County Council's scheme of treatment by chiropodists in private practice continues. The service was supplemented by work undertaken by voluntary bodies on behalf of the authority. Category Persons provided with Treatment Directly by the Authority (including those treated by private chiropodists on behalf of the Authority) Through arrangements with Voluntary Or ganisations Elderly persons 2423 677 Physically handicapped 23 _ Expectant and nursing mothers 4 _ Schoolchildren 20 _ Children under 5 years 3 _ TOTALS 2473 677 Recuperative Holiday Homes Recommendations for holidays were received from general practitioners, hospitals and medical staff of the Department, and during the year 26 persons were admitted to recuperative holiday homes. There were also 26 applications approved but later withdrawn. 103 Registration of Nursing Homes The nursing homes named below are registered with the Borough in accordance with the provisions of the Public Health Act, 1936, the Nursing Home Act, 1963 and Part 3 of the Mental Health Act, 1959, and were regularly inspected during the year. Nursing Homes registered year ended 31st December 1970 No. of Beds St. Mary's Nursing Home, 46, Sunny Gardens Road, N.W.4. Maternity, Surgical and Medical 5- Maternity 6- Medical Brent Nursing Home 4—6 Heather Gardens, N.W.11. Medical & Chronic 32 "Cartref", 196 Watford Way, N.W.4. Chronic 2 Edgware Nursing Home, 36—38 Orchard Drive, Edgware. Medical & Chronic 13 "Clovelly", 81, Torrington Park, N.12. Medical & Chronic 19 Arkley Lawn Nursing Home, Arkley, Barnet. Medical & Chronic 26 Ellern Mede Nursing Home, Totteridge Common, N.20. Chronic 34 Preston Lodge Nursing Home, 38, Station Road, New Barnet. Medical & Chronic 12 Highwood House Nursing Home, Highwood Hill, N.W.7. Medical & Chronic 21 Braeside Clinic, 76, Park Road, New Barnet. Surgical 10 Ravenscroft Park N. Home, 4, Ravenscroft Park, Barnet. Medical & Chronic 10 Bedford House, Hammers Lane, N.W.7. Chronic 23 Manor House Hospital, North End Road, N.W.ll. Medical & Chronic 139 104 Cursing Homes registered year ended 31st December 1970 No. of Beds Stuart House, 66, West Heath Road, N.W.3. Chronic 8 Convent of St.Mary's at the Cross, Hale Lane, Edgware. Incurable Orthopaedic 48 National Kidney Centre, 1, Fairholme Gardens, N.3. 3 Northumberland House, 237 Ballards Lane, N.3. Psychiatric 30 Nurses Agencies The nurses' agencies: Harley Nurses 84, Edgware Way, Edgware. Finchley Nurses Co-operative 24, Eton Avenue, N.12. Mill Hill Nurses Agency 2, Beechwood Close, N.W.7. were inspected during this year and their licences renewed. The Nul-Sal Agency 335, Long Lane, N.2. was transferred under the name: Albany Nurses Agency to premises at, 7/7a Station Road, N.3. and after inspection of the new premises, the licence was renewed. Licences were issued during the year for the following agencies to be established: Court Nurses Agency 397, Hendon Way, N.W.4. Universal Nursing Service 61, High Street, Barnet. Priority Dental Service 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. 105 Attendances and Treatment Children under 5 Expectant and Nursing Mothers First Visit 396 66 Subsequent Visits 445 158 Total Visits 841 224 Number of additional courses of treatment commenced 40 15 Treatment Provided: Number of fillings 603 168 Teeth filled 572 149 Teeth extracted 90 33 General anaesthetics 45 3 Emergency visits 16 3 Patients x-rayed 9 29 Patients treated by scaling etc. 46 88 Teeth otherwise conserved 181 — Teeth root filled — 2 Inlays/Crowns — — Number of courses of treatment completed during the year 197 33 Prosthetics Patients supplied with full upper or full lower 31 (first time) Patients supplied with other dentures 7 Number of dentures supplied 38 Anaesthetics General anaesthetics administered by dental officers 2 Inspections Children under 5 Expectant and Nursing Mothers Number of patients given first inspections 326 48 Number of patients who required treatment 204 42 Number of patients who were offered treatment 204 42 Number of Dental Officer sessions devoted to maternity and child welfare patients 135 106 Tuberculosis 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, 1970. Respiratory Non-Respiratory Men Women Children Total Men Women Children Total 1492 1047 171 2710 65 86 4 155 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 1970: Classification Non-Bacteriologically Confirmed Bacteriologically Confirmed Men Women Children Total Men Women Children Total Group I 47 21 4 72 5 5 - 10 Group II 3 8 - 11 9 3 - 12 Group III 1 - - 1 9 3 - 12 Totals 51 29 4 84 23 11 - 34 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 1970:- Men Women Children Total 14 14 1 29 4. Number of cases included in 1 above whose broncho-pulmonary secretion was positive during the year — 42 107 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. Tuberculous pleural effusions, pleural thickening, lung involvement and enlarged Hilar lymph glands are placed in Group I. The Care of the Unsupported Mother The Authority has one Mother and Baby Home, Guilford House, providing 14 antenatal beds and 11 post-natal beds with 11 cots. No deliveries take place in the home. A relaxation class was conducted by a member of the health visiting staff and mothers were taught the general principles of mothercraft and infant care. Group discussions were held when mothers were encouraged to talk about their problems. Of the 59 referrals to the department 39 were admitted to Guilford House, 8 were admitted to other authority homes and 12 were not admitted. In addition 32 cases were admitted to Guilford House from other Authorities. Family Planning A comprehensive family planning service, including a domiciliary service continued to be provided through the medium of the Family Planning Association acting as the Council's full agent. The service was available at the following centres:- The Family Planning Association, Barnet & District Clinic, 133 Wood Street, Barnet. Edgware Clinic, Approach Road, Station Road, Edgware. West Hendon Clinic, 215 The Broadway, N.W.9. Oak Lane Clinic, Oak Lane, Finchley, N.2. Claremont Clinic, Claremont Road, N.W.2. East Barnet Health Centre, 149 East Barnet Road, New Barnet. 108 Cervical Cytology This service continued during the year at the following clinics:- Torrington Childs Hill Watling Vale Drive West Hendon Oak Lane Edgware Brunswick Park (Osidge) East Barnet Health Centre Fortnightly sessions were held at the clinics and all women who attended had a full examination of the breast, abdomen and pelvis. 1440 patients attended for the first time during the year and in every case the patient and her doctor were informed of the result of the test. There were no positive results. Clinic No. of Sessions New Cases Total Attendances Average attendances per session Childs Hill 23 261 275 11.9 East Barnet/ Osidge 24 201 236 9.8 Oak Lane 15 92 105 7.0 Torrington 43 270 378 8.8 Vale Drive 20 119 150 7.5 Watling 28 328 346 12.5 West Hendon 20 169 191 9.5 TOTALS 173 1440 1681 9.7 Vaccination and Immunisation Rubella Vaccination In July, in accordance with Circular 11/70 issued by the department of Health and Social Security, I made arrangements for the introduction of rubella vaccination and invited general practitioners to participate in these arrangements. The Joint Committee on Vaccination and Immunisation has recommended that vaccination against rubella should be offered to all girls between their 11th and 14th birthdays and that initial priority should be given to older girls, i.e., those who are in their 14th year. The purpose of this recommendation is to ensure that as many girls 109 as possible are offered protection against rubella by vaccination before reaching child bearing age because of the known association of certain foetal abnormalities with rubella infection in pregnancy. Statistical tables of the immunisation of persons under the age of 16 are given below: - Table 1. Completed Primary Courses Type of Vaccine or Dose Year of Birth Others under age 16 TOTAL 1970 1969 1968 1967 1963-66 1. Quadruple DTPP — — — — — — — 2. Triple DTP 140 1797 721 35 33 5 2731 3. Diphtheria/Pertussis 1 — 2 — — — 3 4. Diphtheria/Tetanus 5 233 73 21 104 26 462 5. Diphtheria — 3 — — 2 — 5 6. Pertussis — 1 — 1 — — 2 7. Tetanus — 2 2 1 11 347 363 8. Salk — — — — — — — 9. Sabin 137 1961 763 52 150 150 3213 10. Measles 13 547 728 273 395 51 2007 11. Rubella — — — — — 146 146 12. Total immunised against Diphtheria (Lines 1-2-3-4-5) 146 2033 796 56 139 31 3201 13. Total immunised against Whooping Cough/Pertussis (Lines 1-2-3-6) 141 1798 723 36 33 5 2736 14. Total immunised against Tetanus (Lines 1-2-4-7) 145 2032 796 57 148 378 3556 15. Total immunised against Polio (Lines 1-8-9) 137 1961 763 52 150 150 3213 Table 2. Re-inforcing Doses Type of Vaccine or Dose Year of Birth Others under age 16 TOTAL 1970 1969 1968 1967 1963-66 1. Quadruple DTPP — — — — — — — 2. Triple DTP — 136 258 69 392 57 912 3. Diphtheria/Pertussis — — 2 — 10 — 12 4. Diphtheria/Tetanus — 27 61 33 2258 407 2786 5. Diphtheria — — — — 3 — 3 6. Pertussis — — — — — — 7 . Tetanus — 2 4 12 93 938 1049 8. Salk — — — — — — — 9. Sabin — 151 291 100 2708 1627 4877 110 Table 2. Re-inforcing Doses (Contd.) Type of Vaccine or Dose Year of Birth Others under age 16 TOTAL 1970 1969 1968 1967 1963-66 10. Total immunised against Diphtheria (Lines 1-2-3-4-5) - 163 321 102 2663 464 3713 11. Total immunised against Whooping Cough/Pertussis (Lines 1-2-3-6) - 136 260 69 402 57 924 12. Total immunised against Tetanus (Lines 1-2-4-7) - 165 323 114 2743 1402 4747 13. Total immuhised against Polio (Lines 1-8-9) - 151 291 100 2708 1627 4877 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 tested133 (ii) No. found positive 13 (iii) No. found negative 120 (iv) No. vaccinated 104 111 (b) SCHOOL CHILDREN AND STUDENTS (excluding those known to have had B.C.G. vaccination already) (i) No- skin tested 3,090 (ii) No. found positive 377 (iii) No. found negative 2,495 (iv) No. vaccinated 2,459 (c) SCHOOL CHILDREN AND STUDENTS (known to have previously had B.C.G. vaccination) (i) No. skin tested 204 (ii) No. found positive 145 (iii) No. found negative 51 (iv) No. vaccinated 41 Smallpox Vaccination There were no reports of cases of generalised vaccinia or post-vaccinal encephalomyelitis or death from any other complications of vaccination. 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 5 — 3 — 6 months 26 — 6 — 9 months 16 — 9 —12 months 3 — 1 year 1087 — 2 — 4 years 564 93 5 —15 years 124 643 TOTALS 1825 736 112 CLINIC PREMISES Main Clinics Clinic Sessions (See Key Table on page 109) Brunswick Park Road, N.ll. (Osidge) I.W.C. c D SP DV OPH CSC Town Hall, Hendon N.W.4. (Central) I.W.C. CSC D OPH ORT SP CHIR DV A/NE-M/C Garth Road, N.W.2. I.W.C. C D SP CHIR DV A/NE-M/C CSC East Barnet Road, Barnet. I.W.C. CSC C D SP DV A/NE-M/C CHIR Holly Park, N.ll. I.W.C. D SP CHIR DV CSC Hartley Avenue, N.W.7. (Mill Hill) I.W.C. CSC D SP CHIR DV A/NE-M/C Oak Lane, N.2. I.W.C. C D SP CHIR DV CSC A/NE-M/C OPH Oakleigh Road, N.20 I.W.C. DV CSC A/NE-M/C Sutton Road, N.10 I.W.C. SP CSC A/N A/NE-M/C Torrington Park, N.12 I.W.C. C CSC SP CHIR A/NE-M/C Vale Drive, Barnet I.W.C. CSC SIC c D SP DV ORT OPH A/NE-M/C Cressingham Road, I.W.C. CSC C D SP Burnt Oak CHIR A/NE-M/C OPH CE York Road, N.W.9. I.W.C. CSC C D SP (West Hendon) CHIR A/NE-M/C CE Claremont Way, N.W.2. I.W.C. Approach Road, Edgware I.W.C. CSC SP CHIR A/NE-M/C Other Premises Etchingham Park Road,N.3. I.W.C. CHIR St. Andrew's Church Hall, Lvnford Gardens. Edeware. I.W.C. DV 113 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. KEY TABLE I.W.C. Infant Wel fare Clinic CSC Consultative School Clinic A/N Ante-Natal Clinic CE Clinic for Elderly OPH Ophthalmic SP Speech Therapy A/NE-M/C Combined Ante-Natal Exercises and Mothercraft ORT Orthoptic D Dental CHIR Chiropody DV Development Clinic C Cervical Cytology S.I.C. Special Investigation Clinic. 114 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 Service Act, 1946. In accordance with the requirements of the Education Act, 1944, 84 children were reported to the Authority during the year as suffering from a disability requiring some form of special educational treatment. School Population The school population for the Borough continued to increase and the following table shows the position at 31st December, 1970:- Schools No. of Pupils Primary Schools 25,229 Secondary Modern and Bilateral School 11,260 Grammar School 7,999 1 Residential Special School (E.S.N.) 182 2 Day Special School (E.S.N.) 268 1 Autistic Unit 4 44,942 Periodic Medical Inspections The Authority's policy of routine medical inspection of school entrants and leavers, together with an intermediate examination during the last year at the primary school was continued, and the close contact between the Medical Officer of Health and Head Teachers was maintained. 117 The following table shows the number of children inspected by years of birth and the state of their physical condition:- Y ear of Birth Number of Pupils Inspected Physical Condition of Pupils Inspected Satisfactory Unsatisfactory 1966 & later 246 246 - 1965 1,966 1,963 3 1964 1,730 1,728 2 1963 339 339 - 1962 160 160 - 1961 134 134 - 1960 897 897 - 1959 2,002 2,002 - 1958 837 837 - 1957 330 330 - 1956 2,189 2,189 - 1955 & earlier 1,029 1,029 - TOTAL 11,859 11,854 5 Percentage of pupils inspected whose physical condition was found:- Satisfactory 99.96% Unsatisfactory 0.04% 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 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 an orthoptic service is also provided. In co-operation with Mr. P.A. Gardiner, Consultant Ophthalmologist, I introduced in April, squint diagnostic clinics for young children at the Central Hendon, Oak Lane and Vale Drive clinics. An orthoptist who works with Mr. Gardiner at Barnet General Hospital and at the Authority's eye clinics sees each child referred, whether by a general practitioner or the Council's medical staff and if she believes squint is present, refers the case to 118 Mr. Gardiner or an ophthalmologist working under his supervision, although, of course, general practitioners are free to send a child elsewhere if they or the parents wish it. Where a diagnosis is doubtful the orthoptist uses her judgment. The results to date are encouraging and I will report further on these clinics when they have been in operation for 12 months. 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. It was unfortunate, however, that, due to the ill-health and subsequent resignation of one of the operators, for nearly half the year the work of testing fell to one operator, and as a consequence, the full number of routine tests required could not be carried out. The following table shows the number of pupils whose hearing was tested:- Sweep tests 8,251 Re-tests 618 Special tests 1,181 Re-tests 316 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 Barnet. Peripatetic teachers of the deaf attached to these units already provide a service for the children in the care of the units, but a number of children in the Borough in the care of various London hospitals were not receiving a service and a peripatetic teache of the deaf was appointed by the Authority in September to supervise the training of these children and the training of children in ordinary schools with some significant hearing loss. The peripatetic teacher reports:- "There are in excess of 2,000 school children in Barnet at any one time with a significant hearing loss who are not receiving any special educational help. Although many of these children will not require individual help, their teachers should be notified so that they will be alerted to possible symptoms (particularly 119 in the case of severe unilateral, and high frequency losses) and given guidance, and a pamphlet has been produced for this purpose. The notification of children with hearing loss to Head Teachers and their placement in class is also supervised in co-operation with the School Health Service. This process must be continuous as schools often fail to pass on this information from year to year. To introduce the new programme to the schools the peripatetic teacher attended the meeting of Head Teachers arranged by the Chief Education Officer. 35 Partially Hearing children have been supervised in schools with regard to their hearing aids and their educational progress, and 10 continue to be tutored on a weekly basis. Other visits were made at the invitation of Head Teachers to those schools with individual problems - in some cases it was necessary to test the children's hearing when the results were dealt with by and in co-operation with the School Health Service. Any individual teacher should be able to call on the peripatetic teacher for advice or guidance. Parents should also be able to ask for personal help from the peripatetic teacher if they wish and parents of pre-school deaf and some parthearing children should be given regular help. In this respect 18 homes have been visited, in some cases several times, giving help and guidance and two parenteducation meetings were organised which were very successful. Discussions to promote co-operation and liaison, to the benefit of the service and the well-being of the children, have been held with Medical Officers, Health Visitors, Speech Therapists, Audiometricians and Social Workers for the deaf and deaf/blind. These consultations and attendance at clinic sessions when children under the teacher's supervision are seen have proved helpful to all concerned. Personal contact and visits have been made to six hospitals and two hearing aid centres. The Nuffield Hearing & Speech Centre The Hospital for Sick Children, Great Ormond Street The Royal Northern Hospital Barnet General Hospital Edgware General Hospital University College Hospital St. Mary's Hospital, Praed Street Consequently, discussion of cases has been possible and help given to the children as envisaged by the Hospital Consultants. Cumulative Records have been compiled on all children needing help." Supplies of batteries and spare parts for hearing aids have been obtained by the peripatetic teacher and are available for children in her care. 120 During the year 15 school children were provided with hearing aids and at the end of the year 91 school children 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 at the Finchley Centre reports:- "The year 1970 was marked by the appointment of a Consultant Psychiatrist and Medical Director to the second Child Guidance Centre at Vale Drive Clinic, High Barnet, in June. From the point of view of the psychiatric services, the two clinics were then administered separately. During the year, 149 new cases were referred to the Psychiatrist at the Finchley Child Guidance Centre, of whom 82 cases were accepted for diagnostic examination. 68 new cases were actually seen diagnostically. In some of the others, preliminary interviews with our Psychiatric Social Workers lead to the family or the Centre deciding our agency was inappropriate. In a few cases, all appointments offered were failed, and in an increasing number, consultation was offered to the referring agency, which sometimes enabled resolution of the presenting problem without the family needing to be seen diagnostically at the Centre. As found previously, over 50% of families referred were at the instigation of the school, either directly or through the School Medical Officer, or the Educational Psychologist. Significantly, schools referred considerably more boys than girls, although in the total number seen at the Clinic, the sexes were approximately equally represented. On the other hand, General Practitioners who referred 25% of the cases seen, referred significantly more girls than boys. The vast work of the Clinic during 1970 was providing various forms of treatment for the families seen in 1969 which continued well into 1970. The main service that the Clinic offers to the community is psychiatric treatment in depth. The major form of treatment used at the Clinic is child and family psychotherapy and casework by Psychiatric Social Workers with parents and whole families. The child referred is often the "presenting symptom" of a complex family problem, and the diagnostic process elucidates the underlying problem of the family which might require many of its members to undergo treatment, either individually or as a family. 121 Table 1 analyses the cases by diagnostic categories using the proposed World Health Organisation Classification of childhood psychiatric disorders. This Clinic is taking part in a study of the effectiveness of the revised diagnostic categories before the final revision is published. TABLE 1 - DIAGNOSIS WHO Category M F  0 Normal Variation 1 1 2 1.0 Adaptation Reaction 6 4 10 2 Development Disorders 3 0 3 3 Conduct Disorders 9 3 12 4 Neurotic Disorders 10 12 22 5 Psychosis 1 1 2 6 Personality Disorders 5 4 9 7 Psychosomatic Disorders 1 1 2 8 Other Clinical Syndromes 3 0 3 9 Mental Subnormality only 0 0 0 Left before completion 3 0 3 42 26 65 These diagnostic categories are essentially clinical ones, pertaining to individual patients, and take no account of social interaction and pathology, particularly within a family, which is our particular interest. Since we give priority to children under 5 years and to disturbances of acute onset, it is not surprising that nearly a third of the cases that we saw last year, were cases of school refusal. TABLE 2 - SCHOOL REFUSAL WHO Diagnostic Category M F Total Adaptation Reaction 4 0 4 Neurotic Disorder 5 6 11 Conduct Disorder 2 2 4 Personality Disorder 1 1 2 Psychosis and other categories 0 0 0 12 9 21 122 Table 2 -The vulnerable ages for school refusal appear to be when starting school, when changing from Infant to Junior School, and changing from Primary to Secondary School. Most of our cases fell in the latter category, and many of them had been out of school for some time before referral. SCHOOL REFUSAL TABLE 3 - ASSOCIATED FACTORS M. F Total Recent death of parent or sibling 8 5 13 Severe financial stress 6 3 9 Mother working a) whole time 1 4 5 (all these had no father) b) part time 9 1 10 Learning problems 3 6 9 Physical illness in family 9 4 13 Psychological illness in family 7 3 10 Some of these families had multiple associated factors. In at least sixteen cases, there appeared to be a global family disorder and family treatment was indicated. Ten families had four or more siblings, and in eight further families, the child referred was an only child. In the thirteen cases where the eldest child was referred, he or she did not come from a large family, and in the nine cases where the youngest child was referred, again, significantly, none came from a large family. In the large families, it seemed to be the children in the centre of the sibship who appeared at risk. Our figures are too small for further analysis to be useful, but an analysis of the three year group would be more illuminating. Conclusion Once again this year, we have been handicapped in our work by the lack of provision in this Borough for schools for maladjusted children, and other special facilities, although the opening of the small autistic unit in the Borough at the beginning of the year and the opening of the NHS In-Patient Unit for young adolescents at Hill End Hospital, have been most helpful. The Day Unit at Daleham Gardens associated with the Child Guidance Training Centre, continues to take a proportion of our patients needing day treatment. In 1970, the only in-patient psychiatric unit for children available to us was at Maudsley Hospital in South East London, which entailed a long journey for the parents of children, who were hospitalised. 123 As last year, we were fortunate in enjoying good relationships with the specialised psychiatric and psychotherapy clinics in London, such as the Child Guidance Training Centre, the Tavistock Clinic, Paddington Day Hospital, and Great Ormond Street Hospital who accepted most of the children, referred to this Clinic, whom we could not see because of our limited facilities Speech Therapy The Authority has an establishment of five whole-time speech therapists, but during the latter part of the year only four speech therepists were in employment and undertaking sessions within the School Health Service in clinics and Special Schools During the year a total of 572 children handicapped by speech or language disorders received treatment and supervision. Handicapped Pupils 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 education appropriate to their handicaps. 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 The Authority maintains three special schools for handicapped children:- Oak Lodge Day School for Educationally Subnormal Pupils Northway Day Special School for Educationally Subnormal Pupils Swaylands Residential Special School for Educationally Subnormal Boys The School Medical Officer who had been responsible for the care of the boys at Swaylands Residential School for many years, retired in October and Dr. D.D. Law was appointed to the post of part-time School Medical Officer to the school. Although the 124 school is situated well outside the Borough boundary, I trust that the close co-operation which has always existed between the school and myself will continue at the same high level. During the year the Authority opened a Unit attached to the Grasvenor Avenue Infants School, Barnet, to provide special education for children in the Borough suffering from Autism. The following Table shows the number of handicapped pupils as at 31st December, 1970:- 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 — — — — 1 — 5 3 Partially Sighted 5 4 1 1 — 1 — — — — 6 6 Deaf 6 4 1 4 — — — — 2 2 9 10 Partially Hearing 12 9 4 — 1 1 — 1 — 1 17 12 Delicate 5 1 8 3 — 1 1 — 3 2 17 7 Educationally Subnormal 84 66 20 3 1 2 — — — 2 105 73 Epileptic — — 2 — — — — — — 1 2 1 Maladjusted 8 4 38 13 12 3 4 1 2 1 64 22 Physically Handicapped 22 14 8 6 5 2 — — 3 2 38 24 Speech Defects — — — 1 — 1 — — 1 — 1 2 Total No. Handicapped Pupils 142 104 86 32 19 11 5 2 12 11 264 160 Survey of Physically Handicapped Children in Ordinary Schools The last survey by the Department of Education & Science of physically handicapped children in ordinary schools, was about 18 years ago and the Department considered it advisable to carry out a further survey this year of children who by reason of a physical handicap require special additional attention in the school or who are unable for long periods to take a full part in all normal activities of children of their own age. With the co-operation of the Chief Education Officer, I asked Head Teachers of all ordinary schools in the Borough for details of children in this category, and :he lists obtained were compared with information on my own records. The School 125 Medical Officers examined the children considered to be handicapped, and completed the requisite questionnaires which were forwarded to the Department of Education and Science. Special Transport to School Section 55 of the Education Act, 1944, allows for the provision of transport to facilite the attendance of pupils at school and, during the year, special transport was recommended on medical grounds for 44 children attending ordinary schools. The length of time for which transport was required varied according to the needs of the individual cases. Home Tuition During the year 16 children were recommended home tuition, 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 1966 & later 8 12 20 1965 59 192 219 1964 47 167 195 1963 11 33 34 1962 8 9 15 1961 9 13 17 1960 89 51 130 1959 140 134 236 1958 70 50 112 1957 38 17 49 1956 259 81 316 1955 & earlier 108 55 147 TOTAL 846 814 1,490 126 TREATMENT OF PUPILS ATTENDING MAINTAINED PRIMARY AND SECONDARY SCHOOLS (including Nursery and Special Schools) No. of cases known to have been treated GROUP 1: Eye Diseases (e.g. blepharitis, conjunctivitis), Defective Vision and Squint (a) External & other, excluding errors of refraction 8s squint 30 (b) Errors of refraction, including squint 2,590 TOTAL: 2,620 (c) No. of pupils for whom spectacles were prescribed 758 GROUP 2: Diseases and Defects of Ear, Nose and Throat Received ope rative treatment for: (a) Diseases of the ear 3 (b) Adenoids and Chronic Tonsillitis 17 (c) Other nose and throat conditions 2 Received other forms of treatment — TOTAL: 22 Total No. of pupils in schools who are known to have been provided with hearing aids: (a) in 1970 15 (b) in previous years 76 GROUP 3: Orthopaedic 8s 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 1 (ii) body 5 Scabies 16 Impetigo 2 Other skin diseases — TOTAL: 24 GROUP 5: Child Guidance Treatment No. of pupils treated at Child Guidance Clinics 229 GROUP 6: Speech Therapy No. of pupils treated by speech therapists 572 GROUP 7: Other Treatment given: (excl. B.C.G. vaccination) (a) Minor ailments 60 (b) Convalescent treatment under School Health Service arrangements 5 TOTAL: 65 Education Act 1944 — Section 57 Cases dealt with under Section 57, Education Act, 1944 1 Cases de-notified under Section 57(a) Education Act, 1944 Nil 127 PERIODIC INSPECTIONS Defect Code No. Defect or Disease Entrants Leavers Total incl. all others age groups Special Inspections T O T O T O T O 4 Skin: 21 62 31 22 88 142 3 — 5 Eyes: a) Vision 144 272 348 165 846 720 81 59 b) Squint 26 26 14 7 80 60 6 1 c) Other 4 12 5 15 20 54 2 — 6 Ears: a) Hearing 55 106 9 14 82 164 20 39 b) Otitis Media 13 32 5 2 25 59 4 — c) Other 8 11 — 2 14 18 1 — 7 Nose & Throat 43 73 6 15 57 144 3 2 8 Speech 48 89 6 4 76 108 14 15 9 Lymphatic Glands 4 21 1 2 5 43 1 — 10 Heart 12 40 6 6 21 79 2 4 11 Lungs 17 42 2 11 26 106 — 3 12 Developmental: a) Hernia 8 11 — — 13 17 1 1 b) Other 10 72 4 3 38 140 7 9 13 Orthopaedic: a) Posture 7 15 8 8 34 65 — — b) Feet 12 38 11 10 47 104 3 5 c) Other 9 24 10 14 28 61 3 4 14 Nervous System: a) Epilepsy 1 8 — 5 3 26 2 2 b) Other 1 6 — 3 5 20 1 2 15 Psychological: a) Development 2 32 1 3 5 78 3 4 b) Stability 6 60 5 16 18 137 8 11 16 Abdomen 6 12 6 12 15 47 4 4 17 Other 94 108 18 30 163 233 28 22 T — requiring Treatment O — requiring Observation 128 REPORT OF PRINCIPAL SCHOOL DENTAL OFFICER Dental Staffing Constant problems in regard to the recruitment and retention of staff have resulted in school dental inspections falling below the required standard. It is well recognised that dental surgeons tend to seek employment at local authority clinics whilst they are deciding on the right sphere of work for their future employment. There has also been difficulty in recruiting and retaining dental surgery assistants. Incidence of Caries Dental decay had not been arrested, but until the fluoridation of the water supplies is possible, each filling can be viewed as a lost cause. Orthodontic Dental Service The orthodontic dental service shows an increase as people realise the benefits to be derived from this service. It is gratifying to know that a greater awareness of this treatment has taken place and has resulted in many more patients seeking advice. Dental Appointments The number of failed appointments is a matter of some concern, since this leads to a waste of professional and administrative time. I think it is undeniable that with more mothers working, children tend to forget the keeping of an appointment for what a child considers to be not a very pleasant experience. With the failure rate growing, the dental health of the child suffers and, to abate the loss of clinic time, it is obvious that consideration will need to be given to a greater number of appointments being made which should then reflect an increase in the number of patients treated. The Dental Laboratory The Dental Laboratory continues to function at a high level of efficiency and orthodontic appliances remain the main bulk of the work undertaken. The Authority has been fortunate in retaining the service of experienced and efficient dental technicians at a time when there are often more attractive opportunities for employment elsewhere. 129 Ages 5-9 Ages 10-14 Age 15 & over Attendances for Treatment: First visit 3018 2525 365 Subsequent visits 6611 8445 1776 Total visits 9629 10970 2141 Additional courses of treatment commenced 268 147 13 Fillings in permanent teeth 2822 6075 1891 Fillings in deciduous teeth 6150 651 — Permanent teeth filled 2335 5208 1575 Deciduous teeth filled 5531 532 — Permanent teeth extracted 117 353 107 Deciduous teeth extracted 1700 888 — General anaesthetics 583 253 15 Emergencies 251 122 14 Prosthetics: Pupils supplied with full upper or lower (first time) 6 3 6 Pupils supplied with other dentures (first time) — 3 4 Number of dentures supplies 8 12 15 Number of pupils X-rayed 1057 Prophylaxis 1120 Teeth otherwise conserved 3123 Number of teeth root filled 47 Inlays 19 Crowns 128 Courses of treatment completed 5087 Orthodontics: New cases commenced during year 179 Cases completed during year 233 Cases discontinued during year 90 Number of removable applicances fitted 541 Number of fixed appliances fitted 40 Pupils referred to Hospital consultant 5 Anaesthetics: General anaesthetics administered by Dental Officers 67 Inspections: (a) First inspection at school 26819 Number of pupils (b) First inspection at Clinic 2063 Number of pupils 130 Number of (a) and (b) found to require treatment 11794 Number of (a) and (b) offered treatment 11794 (c) Pupils re-inspected at school or clinic 963 Number of (c) found to require treatment 510 SESSIONS Sessions devoted to treatment 4068 Sessions devoted to inspection 249 Sessions devoted to dental health education — 131 GENERAL SERVICES GENERAL SERVICES Health Education In modern times there has been a crucial discovery of the concept of health. Today it is thought of as a dynamic process involving the whole person interacting with others in a complex environment. The conquest of many of the current scourges of mankind demands personal participation; it involves 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 standard of health. An important object of public health is to increase the intelligent responsibility of the individual for his own health and that of his community, and to encourage this sense of responsibility is the prime function of the Health Education Section. Given below are details of the activities of this section towards this end. Health Education in Clinics The bringing up of a family in this ever-changing environment is a difficult task for parents today and an understanding of the needs of the young child is an essential part of the equipment for good mothering. Health education in the clinics seeks to provide the young mother with the knowledge she requires, both before the arrival of her first baby and in the months and years to follow. Relaxation and Parentcraft These classes have continued and been greatly appreciated by expectant mothers. Some clinics have held an evening class at the end of the course, for husbands to attend also and in support of the classes the film 'Barnet', which gives the story of pregnancy and birth has been shown on alternate months for expectant mothers and their husbands, at both sides of the Borough. Mother and Toddlers Group Most clinics are now holding sessions where mothers can come and leave their children to play under supervision whilst they hold discussions on a wide range of subjects concerning the health and well being of their families together with other interests they choose. 135 These groups have also provided an opportunity for young mothers to meet and form friendships and share experiences and problems. Clinics for the Elderly Support is given by the Health Education section to the staff ot the i linics where these sessions for the elderly are held, by the provision of material which will be of interest and educational value. These sessions are enjoyed by the old folk who have the benefit both of the company of others and the opportunity to discuss their health problems with the clinic doctor, as well as to share their experiences and problems of growing old. Health Education in Schools Health education as carried out by Health Department staff in this Borough is not now merely concerned with the hygiene of yester-years; it is not physiological hygiene (anatomy or physiology or both of these combined); it is not just physical fitness or incidental instruction in grooming or a requirement course about drugs, alcohol, smoking, baby bathing etc; rather it is a comprehensive course planned for learning in living. Most of the courses which are carried out by Health Visitors cover a whole school year, whilst others are for one or two terms. On occasions, schools have asked for help in specific subjects and these requests have been met. Below are details of school courses which were undertaken during the year: Primary Schools 8—11 year old pupils Full year's course 8 One or two term courses 3 Short courses 1 Secondary Schools 13 — 15 year old pupils Full year's course 7 Short courses 1 Occasional talks 5 Grammar Schools 16 — 18 year old pupils Short courses 2 Occasional talks 4 Special Schools (Educationally sub-normal Junior training school) Short courses 3 136 Colleges of Further Education Assistance was given by the Health Education Section in the planning of a student health course, and in the provision of speakers, films and other visual material. Parent/Teacher Associations Interest has continued to grow in discussion between the school and home in health education, especially concerning any sex instruction undertaken. This is a welcome development and the Health Education officer and Health Visitors have had the opportunity of participating in these discussions and working together with teachers and parents in helping in the child's development towards maturity. Campaigns and Projects Family Planning Week A Family Planning Week organised in conjunction with the Family Planning Association was aimed mainly at providing social and health workers with all information regarding family planning. Displays and literature were on view and available at various centres in the Borough and staff from the F.P.A.'s clinics were at hand to discuss with the workers. The Health Education staff contributed to the organisation of the week and in the provision of literature, display material and films. Smokers Clinics Two further courses were held in April and November using the Five Day Plan, in conjunction with the British Temperance Society and had the same success as the first. These courses are in great demand with a waiting list of those who cannot be accommodated. The success rate after 6 weeks is approximately 60%; but the long term rate will not be known until there is sufficient time lapse. Disposal of Medicine Campaign This campaign is reported on under Home Safety. Immunisation Campaign Following a report on a decline in the immunisation rate both nationally and locally a poster campaign was arranged with a wide publicity. A local free newspaper with distribution to all households in the Borough gave coverage for the campaign, which should have results. Quiz in Schools The Quiz is reported on under Home Safety. 137 General Publicity A monthly programme of health subjects for distribution was arranged, with posters and leaflets being sent to all Borough establishments, voluntary bodies and other agencies. A wide variety of leaflets and booklets was made available to the clinics for passing on to their clients as the need arose. The fact that more requests for health education material came from school children, teachers, youth leaders, students and others is an indication of the increasing awareness of health matters. Displays and Exhibitions. British Red Cross Centenary Two displays were mounted by the Health Education section at this event, one concerning smoking, and the other concerning immunisation, both of which were well accepted. Family Planning Week During this week displays were placed in the clinics by the Family Planning Association with the assistance of the Health Education Section. The displays were seen in five centres. Window Display Three window displays were mounted at Gateway House during the year. Subjects included were smoking and health, direworks and accidental hypothermia. Health Education in Other Organisations Health Education, on a more personal level as opposed to using the mass media, is of great importance and is considered to be of longer lasting value. For this reason every opportunity to reach the public by this means is taken. Requests for talks came from various sections of the community, as shown below: Youth Organisations 41 Mothers, Young Wives, Womens and Mens Organisations 28 Parent/Teacher Associations 7 Old Peoples Organisations 11 138 Synopsis of Subjects Covered Infectious Diseases 2 Use and Misuse of Drugs 8 Smoking 16 Child Development 10 Mental Health 3 Air Pollution 2 Food Inspection 3 Work of Health Visitor 5 Work of Public Health Inspector 4 Middle Age 2 Cervical Cytology 2 Home Safety 21 Health Education 2 A total of 138 film shows were undertaken by the Health Education Section during the year, and the Health Education Officer was engaged in lecturing at two colleges of Further Education. In-Service Training in Health Education A one-day course in poster and small display was arranged for clinic nurses to enable them to make optimum use of material sent to clinics for display. A three-day course in the teaching of psychophysical preparation for childbirth was organised for midwives and health visitors who had not previously received tuition, in order that they might train their expectant mothers. In July a one-week course in teaching method was arranged for those health visitors who are undertaking health education in schools. This was found to be of great benefit to the participants. Reviews of current films were arranged on four occasions during the year in order that staff might evaluate their possible use in health education and a lecture on The Drug Problem and Health Education was organised for a multi-disciplinary group. Help was given to many members of staff and students with projects which their course requires of them. 139 HOME SAFETY General Publicity Posters and leaflets supporting the quarterly campaigns of RoSPA were distributed. In addition extra publicity was given at Guy Fawkes Night and at Christmas, also to the servicing of all heating appliances. Barnet Civic News Home Safety Tips appeared in the Barnet Civic News using Safety Sam cartoons and covering disposal of medicines, servicing of electrical appliances, dumping of refrigerators etc. Training and Talks It is pleasing to know that many youth organisations have specific training for their members in accident prevention. The Health Education Section participated in the training and testing of these groups for their various projects. Also, talks on Home Safety were given at old people's clubs, women's meetings and at schools, in addition to the general home safety education undertaken by health visitors in their clinics and schools. Campaigns and Projects Disposal of Medicines Campaign The third of these campaigns was organised in the spring urging the public to return unwanted medicines to their chemist. The campaign lasted three weeks with dump boxes placed in chemists shops and the material being collected at the end of the period, which was then counted and weighed. This year showed an increase in material collected, some 34,000 tablets being sent for destruction, an indication of the wastage as well as the danger of unwanted pills and medicines available in the homes of our community. Home Safety Quiz The Senior Home Safety Quiz which was initiated in the previous autumn came to its final stage in the early months of this year. Preliminary rounds were played off in different areas of the Borough and the teams reaching the Final Round had the pleasure of having Cliff Richard, singing star of films and television, as their Quiz Master, before a good audience. The Senior Home Safety Cup was presented by the Deputy Mayoress. 140 During the autumn term preparations for the Junior Home Safety Quiz were commenced, with the various rounds and grand finals to take place next spring. Displays and Exhibitions h inchley Carnival and the Summer Show The Health Education section again entered a float in the procession at the Finchley Carnival, the theme this year being Water Safety. In the marquee at both events a Home Safety display was mounted with a quiz game and filmlets continuously showing. In addition a children's competition was a great attraction with 500 children participating at the Finchley Carnival and 400 at the Summer Show. Approximately 850 Home Safety handbooks were distributed at the combined functions. A display on Safety with fireworks was mounted in the window at Gateway House and a display on Safety in the Home at the British Red Cross Centenary exhibition. SUMMARY A summary of Health Education activities undertaken over the year in addition to the talks, film-shows displays and general administration of the service can be seen in the following diary: January — February Preliminary, Quarter-Final, Semi-Final and Final Round of Senior Home Safety Quiz. March Family Planning Week. April Smokers Advisory Clinic. British Red Cross Centenary Exhibition. April — May Disposal of Medicines Campaign. July Finchley Carnival In-Service Training Course in Teaching Method August The Summer Show. September Immunisation Campaign. October In-Service Training Course-Psychophysical Preparation for Childbirth. November Smokers Advisory Clinic. December Preparation for Junior Home Safety Quiz. 141 SPECIAL INVESTIGATION CLINIC Although the Total number of sessions fell from 97 (1969) to 92 (1970), the total appointments increased, 2218 (1969) to 2524 (19701 and also the average number appointed per session i.e. 23 (1969) to 27 (1970). If the number of patients discharges is compared to the number of new patients, this indicates a success rate of 97% which compares favourably with the 96% success rate obtained in 1969. The recurrence rate for 1970 was 23% compared with 28% in 1969 and an overall relapse rate of 31% for 1967 1969. This figure is encouraging and may indicate the value of using overlearning reinforcement therapy to resistance of extinction of the conditional response. The total number of annual referral increased from 236 (1969) to 283 (1970). This unfortunately lengthened the time that the children spent on the waiting list. In certain cases this can be very frustrating and demoralizing, and consideration will be given to more sessions and the possibility of redistribution of staff man-power to support the clinic. Permission was granted for a postgraduate scholar, Mr. R.T.T. Morgan, B.A., to commence research on a thesis entitled "Success and Failure in the Conditioning Treatment of Childhood Enuresis" to be presented to the University of Leicester for a degree of Ph.D. Mr. Morgan will be commencing his work in January, 1971. The research projects mentioned in the 1969 report, which include Intensity Tone Conditioning, Personality Factors and Overlearning Therapy, are continuing but insufficient date has yet been obtained for analysis. 142 A paper entitled " Treatment for Nocturnal Enuresis by Conditioning Techniques" by R.K. Turner, G.C. Young and S. Rachman was published in Behaviour Research and Therapy (1970 Behav. Res. & Ther. 8 367 - 381). BOYS GIRLS TOTAL No. of new patients seen: Under 5 12 6 18 5-9 55 43 98 10 & over 21 16 37 TOTAL 88 65 153 Total Attendances: 1118 518 1636 No. of 1st Appointment Failures: 42 32 74 Total Appointment Failures: 634 254 888 Referrals: Under 5 19 17 36 5-9 115 78 193 Referrals (contd.): 10 & over 37 17 54 Total 171 112 283 Discharged Cases: 100 48 148 (of these, discharged for 2nd or subsequent time: 33 11 44) Relapsed Cases: Discharged 1967: 1 - 1 Discharged 1968: % 1 5 Discharged 1969: 16 10 26 Discharged 1970: 17 7 24 Total 38 18 56 Total Sessions: 92 Total Appointments: 2524 Average Appointments Number/Session: 27 HOME DIALYSIS Adaptations of homes to install artificial kidney machines Department of Health Circular 2/68 describes the increasing use of artificial kidney machines in patients' homes in the treatment of chronic renal failure. This form of domiciliary treatment is being developed rapidly and in the London Borough of Barnet we now have 10 patients undergoing this form of treatment in their own homes. Hospital Authorities provide and maintain the dialysis equipment and also the relevant medical services. They pay for the extra cost of electricity and for the installation and rental of a telephone where this is necessary. They have no power to make adaptations to adaptations to the home. This is vested in the Local Authority under Section 28 of the National Health Service Act, 1946 and the Council make such charges for this service as they consider reasonable, having regard to the means of any such person. 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 38. 143 BURIAL AND CREMATION Under Section 50 of the National Assistance Act 1948 it is the duty of the local authority to cause to the buried or cremated the body of any person who had 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 persons, from any available death grant, or from any person who for the purposes of the Act was liable to maintain the deceased person immediately before his death. Six cremations or burials were carried out during the year. CREMATION CERTIFICATES The Medical Officer of Health, Deputy Medical Officer of Health and aSenior Medical Officer are appointed Medical Referees under the Cremation Acts 1902 and 1952. During the year 1301 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 available, and the cleansing and laundering of soiled linen and clothing is carried out at Colindale Hospital. 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 39 persons were receiving assistance. MEDICAL ASSESSMENTS AND EXAMINATIONS The system of medical examination prior to entry to the Council's service had been replaced for some years now by a medical questionnaire, a medical examination only being necessary in cases in which there is any doubt and matters which need further 144 consideration and consultation. It is of interest to note that out of 2004 medical questionaires scrutinized by the Staff Health Medical Officers in 1970 in only 207 cases was it necessary to call the patient for examination. During the year a total of 622 medical examinations were carried out by the Staff Health Service, an increase on the 1969 figure of 573. Medical examinations are also undertaken in regard to extended sick leave of members of the Council's staff, some of who unfortunately have to be retired on grounds of permanent ill health. As a measure of mutual convenience, arrangements exist to medically examine persons who are joining Local Authorities in various parts of the country and thus obviate their having to travel long distances again following the initial interview and appointment. Barnet obtains a reciprocal service from other Authorities. DEPARTMENTAL SPECIAL TRANSPORT Council Transport The Borough Engineer and Surveyor has allocated the following seven special purpose-built vehicles to the special requirements of the Health and Welfare Department: One 24-seater coach (alternatively 10 wheelchairs and 5 sitting passengers) and Six 12-seater coaches (alternatively 4 wheelchairs). These vehicles work to a time-table covering the following establishments: Hendon Work Centre, Heriot Road, N.W.4. Day Centre for the Elderly, Claremont Clinic, N.W.2. Deansbrook Rehabilitation Centre, Edgware. Fieldways Adult Training Centre, Wellhouse Lane, Barnet. The Hendon Junior Training School, Flower Lane, N.W.7. British Red Cross Society, The Downage, N.W.4. Friern Barnet Junior Training School, Oakleigh Road, N.20. Etchingham Park Workroom/Day Centre. Additional services covering Park House Day Centre and the Cookery Class for the Blind at Barnet Technical College are provided by non-specialised vehicles. The Borough Engineer and Surveyor also provides transport during the evenings for the following voluntary bodies and associations:- Blind Dancing Class, St. David's School, Park Road, Hendon. Starfish Swimming Club, Hampstead Swimming Baths, Swiss Cottage. Happy Social Club, Conservative Hall, Edgware. The Choral Class, Percy Road, N.2. Multiple Sclerosis Society, Mill Hill Clinic. 145 Cars are also provided to convey persons in the care of the Health and Welfare Department provided the passengers are not physically handicapped. Hired Transport Vehicles were also hired to meet occasional requirements beyond the capacity of the Council's own transport. TRAINING COURSES AND STUDENT ATTACHMENTS Staff training and development continued at a high level, through the agency of universities, polytechnics, the London Borough's Training Committee and other educational and professional bodies. Members of the staff attended course, study days and conferences on subjects which included the following:- Medical specialities Alcoholism Medical Ethics Nursing Organisation Health Visitor Training Home Nurse Training School Nursing Supervision of Midwives Psychological preparation for childbirth Midwifery (refresher courses) Welfare of elderly and handicapped persons and children Nursery education, play centres and playgroups. Management of Social Services Certificate in Social Work Environmental control Building design Health Education and Home Safety Management Techniques Reorganisation of National Health Service Mental Handicap and illness Health Visitors Three student health visitors employed by the Council, and six others sponsored by other authorities but trained in Barnet, passed their qualifying examinations. Health visitors and other members of the staff assisted in a study of twins conducted by the Medical Research Council Unit of the University of London, and in a continuing survey of children with spina bifida conducted by the Research and Intelligence Unit of the Greater London Council. 146 Midwives Fifteen pupil midwives from Edgware General and Bushey Maternity Hospitals completed three-month periods of district training in the Borough, while residing at the Nurses Home, Gervase Road, Burnt Oak. Midwives and health visitors assisted the Institute of Community Studies in a study of the provision of birth control services. Home Nurses Student nurses, social work students, senior girls from Finchley Grammar School and others received training and information from periods of up tothree days. The home nurses attended training sessions and passed the examination for the National Certificate for District Nurses. In-Service Training The Department continued to run programmes of in-service training at six-monthly intervals. Each course included lectures given by principal and senior officers of the Health and Welfare Department and by officers of other departments of the Council. The subjects studied in detail included Environmental Health, Mental Health, Welfare Services, Housing and the Nursing Service. 147 INDEX INDEX PAGE A Adult Training Centres 77 Aids and Adaptations 91 Animals 66 Ante-Natal Clinics 99 Audio logy 119 Audiometry 119 B BCG Vaccination 111 Births and Birth Rates 11,12,17, 19, 20,21,22,23 Blind and Partially Sighted 85,86,87,88,89 British Red Cross Society —Loan of Equipment 101 Burial and Cremation 144 c Cancer 19 Caravans 59 Care of Mothers and Young Children 98 Care of the Unsupported Mother 108 Cervical Cytology 109 Chest Clinics 107 Child Guidance Service 121 Child Minders 103 Child Welfare Centres 100 Chiropody 103 Clean Air 46 Clearance Areas 50 Clinics for the Elderly 103 Clinic Premises 113,114 Committee Members 7 Common Lodging Houses 54 Complaints — Environmental Health 59 Compulsory Improvement Areas 52 Congenital Malformations 99 Contents 5 Cremation Certificates 144 D Day Centres for the Elderly 84 Day Centres for the Elderly Mentally Infirm 74 Day Nurseries 102 Day Nurseries, Private 8o Registered Child Minders 101 Deaf and Hard of Hearing 90, 119, 120 Deaths and Death Rates 12, 13, 14, 15, 16, 18, 19 Dental Services, Priority 105 Dental Services, School 129 Disinfection and Disinfestation 68 Domiciliary Laundry Service 144 Drug Addiction 75 PAGE E Elderly, Clinics for 103 Elderly Persons 84 Enuresis 142 Environmental Health Service 31 Establishments for Massage and Special Treatment 143 Exhumations 69 F Factories and Work Places 62 Family Planning 108 Fire Regulations 55 Fluoride 32 Food 32 Food —Complaints 38 Food Hygiene 40 Food Samples, Formal and Informal 32 Food Unfit for Human Consumption 39 G General Practitioner —Staff Attachments 97 General Services 135 H Handicapped Pupils 124 Hawkers 42 Health Centres 2, 97 Health Education 135 Health Visitors 97 Health and Welfare Committee 7 Holiday Homes — Recuperative 103 Home Dialysis 143 Homes for the Elderly and Handicapped 84 Home Help Services 102 Home Nursing 101, 147 Home Safety 140 Home Tuition 126 Home Visiting 98 Homelessness 49,92,93,98 Hospital and General Practitioner Services 97 Hospital Services, Mental Health 75 Hostels —Mental Health 74 Houses in Multiple Occupation 54 Houses, Unfit 50 Housing 49 Housing Accommodation 49 Housing —Area Improvement 52 Housing — Improvement 51 Housing —Statistics 57 Housing Act, 1969 56 151 PAGE I Ice Cream 37 Immunisation and Vaccination 28, 109 Improvement Areas 52 Incontinence Pads and Clothing 102 Incontinence Laundry Service 144 Infectious Diseases 27 In-Service Training Course 147 Inspections — Environmental Health 59 International Certificates of Vaccination 28 J Junior Training Schools 75 L Labelling of Food 43 Land Charges 60 Laundry Services 144 Legal Proceedings 44 Liquid Egg 37 Loan of Nursing Equipment 101 M Marie Curie Memorial Foundation 101 Markets 42 Massage and Special Treatment 143 Meals on Wheels 85 Medical Assessments and Examinations 144 Medical Inspections and Treatment (Schools) 117 Mental Handicap 75 Mental Health—Case Work 73 Mental Health — Hospital Services 75 Mental Health—Hostels 75 Mental Health — Residential Care Mental Health Services 73 Mental Health Social Clubs 74 Mental Illness 73 Midwifery 101, 147 Milk — Registration, Licensing and Sampling 38 Mortuaries 69 Mother and Baby Home 108 Mothercraft and Relaxation Clinics 99 Mothers' Discussion Groups 99 N Neighbourly Help Service 102 Noise 61 Nursery Nurses 102 Nurses' Agencies 105 Nursing Homes, Registration 104 PAGE 0 Offices and Shops 61 Ophthalmic Clinics 118 Outworkers 64 Overcrowding 53 P Paratyphoid Fever 28 Partially Sighted and Blind 85 Personal Health Services 97 Physically Handicapped Persons 91 Poultry Inspection 43 Prevalence and Control of Infectious and Other Diseases 27 Prevention of Homelessness (Problem Families) 98 Psychiatric Hospitals 75 R Rag, Flock and Other Filling Materials 64 Rucuperative Holiday Homes 103 Refuse Collection and Disposal 66 Relaxation and Mothercraft Clinics 99 Rent Control 56 Residential Accommodation — Welfare Services 83 Residential Care —Mental Health 76 Rodent Control 67 s Sanitary Conveniences 65 School— Special Transport 126 School Dental Service 129, 130 School Health Service 117 School Medical Inspection and Treatment 117, 118 School Population 117 Sewerage and Sewage Disposal 65 Shops and Offices 61 Short Term Care —Mental Health 76 Slaughter Houses 42 Slum Clearance 8& Redevelopment 50 Smallpox Vaccination 112 Smoke Control 46 Social Services Directorate 1 Special Investigation Clinic 142 Speech Therapy 124 Staff 8 Staff Health Service 144 Staff Training 146 Statistics— Housing 57 Mental Health Service 78 School Health Service 126, 127,128 Vital 2, 11 152 PAGE S (contd.) Stillbirths12, 22, 23 Student Attachments 146 Swimming Pools 64 T Temporary Accommodation 92 Training Courses and Student Attachments 146 Transport (Departmental) 145 Transport (Schools) 126 Tuberculoses 19, 107 Tuberculoses BCG Vaccination111 Typhoid Fever 28 V Vacinnation and Immunisation 28, 109 Vital Statistics 2, 11 w Water Supply 31 Welfare Services 1,83 PAGE 153 Printed and Published by Barnet London Borough Council