BAR 5 I THE HEALTH OF THE LONDON BOROUGH OF BARNET 1971 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 1971 MELVILLE WATKINS, M.R.C.S., L.R.C.P., D.P.H. Health 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. I have pleasure in presenting my Report on the Health Services of the Borough for the year 1971. As foreseen in my previous Report, the major organisational change arose from the implementation of the Social Services Act, 1970. The Act came into force on the 1st April and, apart from relatively minor matters, the transfer of the welfare and certain health functions of the former Health and Welfare Department to the Social Services Directorate had been completed by the end of August. It is much to be hoped that the efforts of those involved in the re-organisation will be rewarded by the achievement of a more effective service to the public. No reference is made in this Report to the transferred functions. Reversing the trend since 1964, there was a rise in the birth rate from 13.1 to 13.6 births per 1000 population, while the infant death rate dropped from 17.8 to 14.5 per 1000 live births. There were no major outbreaks of infectious disease, but an increase from 84 to 118 in the total number of notifications of tuberculosis was a reminder of the need for constant vigilance. A shortage of smokeless fuel caused a delay of some months in the Smoke Control Programme; the situation has since eased, and the Programme can still be completed, as planned, in 1976. Significant progress continues to be made in meeting the shortage of housing, as the figures supplied by the Borough Housing Officer indicate (see page 44). The first few dwellings have been let on the Grahame Park Estate, which will eventually provide approximately 1,800 rented homes for applicants on the Borough's waiting list and on the Greater London Council's list. The new health centre, which will be the base for community health services for the Estate, is in an advanced stage of construction. It proved possible during the year to recruit additional Dental Officers, who contributed to a substantial increase in the level of treatment given to mothers, expectant mothers, young children and school children. 1 My thanks are due to all the staff of the Department for their loyal collaboration in a year of change and stress, and to the voluntary organisations and helpers for their valuable contribution. Finally, I take this opportunity to express my gratitude to the Chairman, ViceChairman and Members of the Health Committee for their unfailing support, and to my fellow Chief Officers and their staffs for their continuing co-operation. M. WATKINS, Medical Officer of Health 2 CONTENTS Page COMMITTEE MEMBERS, CHIEF AND SENIOR OFFICERS 5 VITAL STATISTICS 9 PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES 25 ENVIRONMENTAL HEALTH SERVICE 29 PERSONAL HEALTH SERVICE 65 SCHOOL HEALTH SERVICE 83 GENERAL SERVICES 97 INDEZX 111 3 HEALTH COMMITTEE as at 31st December, 1971 Councillor Mrs. R.A. Freedman (Chairman) Councillor Mrs. M.M. Symons (Vice-Chairman) ALDERMAN: A.D. Cohen, J.P., M.A. Mrs. E. Constable, J.P., A.P. Fletcher, Mrs. B.M. Franklin, Mrs. E.R. Gibson, K.W. Hughes, F.I.O.B., F.R.S.H., (Mayor), COUNCILLORS: Mrs. E.P. James, C.A.R. Latlirope, P.K. Lawrence,' J.D. Roith, L.D.S., R.C.S.I., W. Seagroatt, J.P., A.C. Seaton, Miss R. Thorpe-Tracey, Mrs. Clara M. Thubrun, M.B.E., J.P. Co-opted Member: Dr. T.J. Carter, M.R.C.S., L.R.C.P. 5 STAFF OF THE HEALTH DEPARTMENT as at 31st December, 1971 M. Watkins, M.R.C.S., L.R.C.P., D.P.H., Medical Officer of Health G.C. Young, M.D., M.B., B.Ch., B.Sc., D.P.H., L.M.S.S.A. Deputy Mcdical 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 Mrs. J.M.A.W. Foulkes, S.R.N., 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 Officer K.J. Millen, M.R.C.H., F.A.P.H.I. Principal Public Health Inspector 6 STATISTICS STATISTICS Area (in acres) 22,124 Population - Registrar - General's Estimate Mid 1971. 305,770 Number of Inhabited Dwellings, 1st April, 1971 Houses and Flats 102,108 Other properties with living accommodation 726 Rateable Value at 1st April, 1971 £23,000,954 Product of Penny rate 1971/72 £221,000 LIVE BIRTHS MALES FEMALES TOTAL Legitimate 1,951 1,883 3,834 Illegitimate 168 144 312 2,119 2,027 4,14 6 Illegitimate live births per cent of total live births:- BARNET 7.5 GREATER LONDON 11.5 INNER LONDON 16.6 OUTER LONDON 8.6 ENGLAND AND WALES 8.4 Live Birth Rate per 1,000 population:- BARNET 13.6 AREA COMPARABILITY FACTOR 0.99 CORRECTED RATE-BARNET 13.5 GREATER LONDON 15.4 INNER LONDON 15.3 OUTER LONDON 15.5 ENGLAND AND WALES 16.0 STILLBIRTHS MALES FEMALES TOTAL Legitimate 21 18 39 Illegitimate 3 2 5 24 20 44 Total live and still births:- 2,143 2,047 4,190 Stillbirth rate per 1,000 live and still births:- LEGITIMATE ILLEGITIMATE TOTAL BARNET 10.1 15.8 10.5 * GREATER LONDON 11.7 INNER LONDON 11.5 * OUTER LONDON 11.9 * ENGLAND AND WALES 12.2 16.1 12.5 * Figure based upon less than 1,000 occurrences. INFANT DEATHS (under 1 year of age) MALES FEMALES TOTAL Legitimate 30 26 56 Illegitimate 2 2 4 32 28 60 Infant death rate per 1,000 live births:- LEGITIMATE ILLEGITIMATE TOTAL BARNET 14.6 12.5 14.5 * GREATER LONDON 17.4 INNER LONDON 19.2 * OUTER LONDON 16.4 ENGLAND AND WALES 16.9 24.1 17.7 * Figure based upon less than 1,000 occurrences. 10 NEO-NATAL DEATHS (under 4 weeks of age) MALES FEMALES TOTAL Legitimate 19 16 35 Illegitimate 2 1 3 21 17 38 death rate per 1,000 live births:- LEGITIMATE ILLEGITIMATE TOTAL BARNET 9.1 9.6 9.2 * GREATER LONDON 11.6 INNER LONDON 12.7 * OUTER LONDON 10.9 * ENGLAND AND WALES 11.3 15.1 11.8 * Figure based upon less than 1,000 occurrences. EARLY NEO-NATAL DEATHS (under 1 week of age) MALES FEMALES TOTAL Legitimate 15 13 28 Illegitimate 2 1 3 17 14 31 Early Neo-Natal death rate per 1,000 live births:- LEGITIMATE ILLEGITIMATE TOTAL BARNET 7.3 9.6 7.5 * GREATER LONDON 9.7 INNER LONDON 10.6 * OUTER LONDON 9.1 * ENGLAND AND WALES 9.6 13.2 9.8 * Figure based upon less than 1,000 occurences. 11 PERI-NATAL DEATHS (Still births and Deaths under 1 week of age) MALES FEMALES TOTAL Legitimate 36 31 67 Illegitimate 5 3 8 41 34 75 Peri-natal death rate per 1,000 live and stillbirths LEGITIMATE ILLEGITIMATE TOTAL BARNET 17.4 25.2 17.9 * GREATER LONDON 21.3 INNER LONDON 22.0 OUTER LONDON 20.9 ENGLAND AND WALES 21.6 28.8 22.3 MATERNAL MORTALITY RATES (per 1,000 total live and still births):- BARNET 0.48** GREATER LONDON 0.12** INNER LONDON 0.71** OUTER LONDON 0.10** ENGLAND AND WALES 0.17 * Figures based upon less than 1,000 occurrences. * * Figures based upon less than 100 occurrences. 12 DEATHS FROM ALL CAUSES MALES 1,674 FEMALES 1,879 TOTAL 3,553 Death rate per 1,000 population:- BARNET 11.6 AREA COMPARABILITY FACTOR 0.92 CORRECTED RATE - BARNET 10.7 GREATER LONDON 11.5 INNER LONDON 12.3 OUTER LONDON 11.0 ENGLAND AND WALES 11.6 13 CAUSES OF. AND AGES AT. DEATH No. Cause of Death All Ages Under 4 Weeks 4 weeks and under 1 year Age in Years 1-4 5-14 15 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75 and _Over B4 Enteritis & other Diarrohoeal Diseases 2 — — 1 — — — — 1 — — — B5 Tuberculosis of Respiratory System 3 — — — — — — — — 2 1 — B6(2) Other Tuberculosis 5 — — — — — — 1 — 1 — 3 B17 Syphilis fit its Sequelae 2 — — — — — — — — 2 — — B18 Other Infective & Parasitic Diseases 4 — — — — — — 1 — 2 — 1 B19(l) Malignant Neoplasm, Buccal Cavity, etc. 6 — — — — — — 1 — — 1 4 B19(2) Malignant Neoplasm, Oesophagus 23 — — — — — — — — 7 9 7 B19(3) Malignant Neoplasm, Stomach 61 — — — — — — 1 4 13 21 22 B19(4) Malignant Neoplasm, Intestine 98 — — — — — 1 — 5 16 42 34 B19(5) Malignant Neoplasm, Larynx 2 — — — — — — — — 1 — 1 B19(6) Malignant Neoplasm, Lung, Bronchus 196 — — 1 — 1 1 — 9 69 78 37 B19(7) Malignant Neoplasm, Breast 95 — — — — — — 6 17 24 28 20 B19(8) Malignant Neoplasm, Uterus 18 — — — — — — — 3 8 3 4 B19(9) Malignant Neoplasm, Prostate 30 — — — — — — — — 4 9 17 B19(10) Leukaemia 25 — — — 3 1 2 — 2 5 6 6 B19(ll) Other Malignant Neoplasms 218 — — — — 2 6 9 21 54 64 62 B20 Benign & Unspecified Neoplasms 8 — — — — 1 — — 2 1 3 1 B21 Diabetes Mellitus 27 — — — — 1 — 1 2 3 8 12 B46(l) Other Endocrine etc. Diseases 13 — 1 — 1 — 1 — — 3 1 6 B23 Anaemias 6 — — — — — — — 1 — — 5 B46(3) Mental Disorders 3 — — — — — — — — — 2 1 B24 Meningitis 3 1 — — — — — 1 — — — 1 B46 Multiple Sclerosis 4 — — — — — — 1 1 2 — — B46(5) Other Diseases of Nervous System 37 — —- 1 2 1 — 2 2 9 8 12 B26 Chronic Rheumatic Heart Disease 52 — — — — — — 3 4 7 16 22 B27 Hypertensive Disease 71 — — — — 1 2 4 — 11 19 34 B28 Ischaemic Heart Disease 883 — — — — — — 5 54 151 265 408 B29 Other forms of Heart Disease 194 — — — — 1 1 2 6 8 32 144 B30 Cerebrovascular Disease 443 — — — — — 1 — 12 42 88 300 B46(6) Other Diseases of Circulatory System 163 — — — — — — — 6 16 36 105 B31 Influenza 6 — 1 — — 1 — — — — 1 3 B32 Pneumonia 332 2 2 1 — — — 3 1 26 53 244 B33(l) Bronchitis fit Emphysema 168 — 1 — — — — 2 2 18 51 94 B33(2) Asthma 7 — — — — — — — 2 2 2 1 B46(7) Other Diseases of Respiratory System 29 — 7 1 — — — — — 2 5 14 B34 Peptic Ulcer 19 — — — — — — — — 1 10 8 B35 Appendicitis 4 — — — — — — — — 3 — 1 B36 Intestinal Obstruction & Hernia 18 2 2 — — — 1 — — — 4 9 B37 Cirrhosis of Liver 12 — — — 1 — — 1 1 5 3 1 B46(8) Other Diseases of Digestive System 32 — — — — 2 — 1 2 3 14 10 B38 Nephritis & Nephrosis 11 — — — — — — — 2 2 2 5 B39 Hyperplasia of Prostate 7 — — — — — — — — — 2 5 B46(9) Other Diseases, Genito-Urinary System 25 1 — — — — — 1 2 6 2 13 B46(10) Diseases of Skin, Subcutaneous Tissue 3 — — — — — — — — 1 1 1 B46( 11) Diseases of Musculoskeletal System 13 — — — — — — 1 — 1 3 8 B42 Congenital Anomalies 24 6 6 4 2 3 1 — — — 2 — B43 Birth Injury, Difficult Labour, etc. 16 15 1 — — — — — — — — — B44 Other Causes of Perinatal Mortality 10 10 — — — — — — — — — — B45 Symptoms fit 111 Defined Conditions 9 1 1 — — — — — — — — 7 BE47 Motor Vehicle Accidents 43 — — 1 — 11 3 1 2 6 9 10 BE48 All Other Accidents 43 — — 2 2 5 1 2 4 1 8 8 BE49 Suicide & Self Inflicted Injuries 28 — — — — 1 4 1 8 10 4 — BE50 All Other External Causes 9 — — — — 1 2 — 3 2 1 — TOTAL ALL CAUSES 3553 38 22 12 11 33 27 51 181 550 917 1771 14 15 16 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 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 1971 4146 13.6 60 14.5 NUMBER OF DEATHS AND DEATH RATES FROM TUBERCULOSIS AND CANCER NUMBERS RATE PER 1,000 POPULATION MALES FEMALES PERSONS BARNET ENGLAND AND WALES Respiratory Tuberculosis 2 1 3 0.010 0.016 Other Tuberculosis 3 2 5 0.016 0.009 Cancer of lung and bronchus 150 46 196 0.641 0.550 Other Cancer 242 334 576 1.884 1.522 17 LIVE BIRTHS BY AGE AND PARITY OF MOTHER ANd PLACE OF OCCURRENCE-1971 Parity of Mother *Place of Delivery All Ages Under 20 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 and over % % % % % % % % 0 1A 2 ( 0.1) 1 (0.1) 1 (0.1) — — – – – 1B 1636 (96.3) 147 ( 8.7) 671 (39.5) 599 (35.3) 165 (9.7) 40 (2.4) 13 (0.8) 1 (0.1) 2 50 ( 2.9) 3 (0.2) 29 (1.7) 13 (0.8) 4 (0.2) 1 (0.1) – – 3 7 ( 0.4) 1 (0.1) 4 (0.2) 1 (0.1) 1 (0.1) — – – 4 3 ( 0.2) 1 (0.1) 1 (0.1) 1 (0.1) – – — – 1698 153 706 614 170 41 13 1 1 1A – – — — – – – – 1B 1142 (90.8) 19 (1.5) 311 (24.7) 520 (41.4) 200 (15.9) 83 (6.6) 9 (0.7) – 2 63 (5.0) – 18 (1.4) 31 (2.5) 12 (1.0) 1 (0.1) 1 (0.1) – 3 50 (4.0) 4 (0.3) 18 (1.4) 21 (1.7) 7 (0.6) – — – 4 2 (0.2) – 2 (0.2) – – – – – 1257 23 349 572 219 84 10 – 2 1A – – — – — – – – 1B 494 (86.2) 3 (0.5) 68 (11.9) 182 (31.8) 166 (29.0) 63 (11.0) 11 (1.9) 1 (0.2) 2 26 (4.5) – 2 (0.3) 13 (2.3) 8(1.4) 2 (0.3) 1 (0.2) – 3 51 (8.9) 1 (0.2) 16 (2.8) 21 (3.7) 10 (1.7) 3 (0.5) – – 4 2 (0.3) - - 1 (0.2) 1 (0.2) – _ – – 573 4 86 217 185 68 12 1 3 1A – – – – – – – – _ 1B 165 (90.7) -– 13 (7.1) 53 (29.1) 55 (30.2) 35 (19.2) 8 (4.4) 1 (0.5) 2 6 (3.3) – 1 (0.5) – 3 (1.6) 2 (1.1) – – 3 4 11 (6.0) – 1 (0.5) 2 (1.1) 6 (3.3) 2 (1.1) – -– 182 – 15 55 66 39 8 1 4 1A – – — – – – – – 1B 52 (92.9) – 1 (1.8) 12 (21.4) 20 (35.7) 12 (21.4) 7 (12.5) _– 2 1 (1.8) – -– – 1(1.8) – – – 3 3 (5.4) – 1 (1.8) – 1(1.8) — 1 (1.8) – 4 —– – –- – -– – – – 56 – 2 12 22 12 8 – 18 Live Births by Age and Parity of Mother and Place of Occurrence (continued) Parity of Mother *Place of Delivery All Ages Under 20 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 and over % % % % % % % % 5-9 1A — — — — — — — — 1B 60 (95.2) — 2 (3.2) 8 (12.7) 23 (36.5) 19 (30.2) 8 (12.7) — 2 1 (1.6) — — — — 1 (1.6) — — 3 2 (3.2) — — 2 (3.2) — — — — 4 - — — — — — — — 63 — 2 10 23 20 8 — 10-14 1A - — — — — — — — 1B 3 (100) — — 1 (33.3) — — 2 (66.7) — 2 — — — — — — — — 3 — — — — — — — — 4 — — — — — — — — 3 — — 1 — — 2 — 15 & Over 1A — — — — — — — — 1B — — — — — — — —— 2 — — — — — — -— — 3 — — — — — — — — 4 — — — — — — — — Illegit 1A 1(0.3) 1 (0.3) — — — — — — 1B 287(91.9) 71 (22.8) 98 (31.4) 62 (19.9) 28 ( 9.0) 20 (6.4) 8 (2.6) —— 2 7 (2.2) 3 (1.0) 1 (0.3) 1 (0.3) — 2 (0.6) — — 3 11 (3.5) 2 (0.6) 2 (0.6) 2 (0.6) 3 (1.0) (0.3) 1 (0.3) — 4 6 (1.9) 4 (1.3) 1 (0.3) — 1 (0.3) — — — 312 81 102 65 32 23 9 — TOTAL 1A 3 (0.1) 2 (0.1) 1 (0.1) — — — — — 1B 3839 (92.6) 240 (5.8) 1164 (28.1) 1437 (34.7) 657 (15.9) 272 (6.6) 66 (1.6) 3 (0.1) 2 154 (3.7) 6 (0.1) 51 (1.2) 58 (1.4) 28 (0.7) 9 (0.2) 2 (0.1) — 3 135 (3.3) 8 (0.1) 42 (1.0) 49 (1.2) 28 (0.7) 6 (0.1) 2 (0.1) — 4 13 (0.3) 5 (0.1) 4 (0.1) 2 (0.1) 2 (0.1) — — — 4144 261 1262 1546 715 287 70 3 CODE "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 19 STILLBIRTHS BY AGE AND PARITY OF MOTHER AND PLACE OF OCCURRENCE - 1971 AGE OF MOTHER Parity of Mother *Place of Delivery Total Under 20 20-24 25-29 30-34 35-39 40-44 45 & Over % % % % % % % % 0 1A — — —- -— — — — — 1B 2 22 (95.7) 3 (13.0) 10 (43.8) 8 (34.8) 1 (4.3) — — — 3 — — — — — — — — 4 1 (4.3) -— — -— — 1 (4.3) — — 23 3 10 8 1 1 — — 1 1A — — — — — — — — 1B 6 (100) 1 (16.7) — 3 (50.0) 2 (33.3) — — -— 2 — — — — — — — — 3 — — — — — — — — 4 — — — — — — — — 6 1 3 2 2 1A — — — — — — — 1B 8 (100) —- 2 (25.0) 2 (25.0) 1 (12. 5) 2 (25.00) 1 (12.5) -— 2 — — — — — — — — 3 -— -— -— — — — — -— 4 — — — — — — - -— 8 — 2 2 1 2 1 3 1A — — — — — — — 1B 1 (100) -— — — — 1 (100) - — 2 — — — — — — - -— 3 — —- —- — -— — — — 4 — — —— — -— -— - — 1 — — — — 1 — 20 Stillbirths by Ag« and Parity of Mother and place of occurrence—1971 (continued) AGE OF MOTHER Parity of Mother *Place of Delivery Total Under 20 20-24 25-29 30-34 35-39 40-44 45 & Over] % % % % % % % % 4 1A – – – – – – – – 1B 1(100) – –- – 1 (100) – – – 2 — – – – – – – – 3 4 – – – – – – – – 1 1 5-9 1A – – – – – – – – 1B – – – – – – – – 2 –' – – – – – – – 3 – – – – – – – – 4 – – – – – – – – 10-14 1A – – – – – – – – 1B – – – – – – – –- 2 — – – – – – – – 3 – – – – – – – – 4 – – – – – – – – 15 & over 1A _ – – – – – – – 1B – – – – – – – – 2 – – – – – – – – 3 – – – – – – – – 4 – – – – – – – – Illegit 1A – – – – – – – – 1B 4(80.0) – 1 (20.0) 1(20.0) 2(40.0) – – – 2 – – – – – – – – 3 1(20) – – 1(20.0) – – – – 4 – – – – – – – – 5 1 2 2 21 22 Stillbirths by Age and Parity of Mother and place of occurrence - 1971 (continued) AGE OF MOTHER Parity of Mother *Place of Delivery Total Under 20 20-24 25-29 30-34 35-39 40-44 45 & Over % % % % % % % % Total 1A — — — — — — — — IB 42 (95.5) 4 (9.1) 13 (29.5) 14 (31.8) 7 (15.9) 3 (6.8) 1 (2.3) — 2 — — — — — — _ 3 1 (2.3) — — 1 (2.3) — 4 1 (2.3) — — — — 1 (2.3) — — 44 4 13 15 7 4 1 — CODE * Place of 1A — N.H.S. Hospitals — with G.P. Maternity Delivery IB — 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 9 (5) Acute poliomyelitis - (-) Anthrax - (-) Cholera - (-) Diphtheria - (-) Dysentery 25 (33) Food poisoning 87 (94) Infective Hepatitis 43 (58) Leprosy - (-) Leptospirosis - (-) Malaria 7 (2) Measles 1101 (1363) Ophthalmia neonatorum 1 (5) Paratyphoid fever - (2) Plague - (-) Relapsing fever - (-) Scarlet fever 31 (81) Smallpox - (-) Tetanus - (-) Tuberculosis Respiratory 76 (59) Meninges and CNS 2 (1) Other 30 (24) Typhoid fever 2 (4) Typhus - (-) Whooping Cough 55 (81) Yellow fever - (-) 1469 (1812) Figures in parenthesis represent notifications for 1970 25 Two cases of typhoid fever occurred during the year and were admitted to hospital, one, a boy of 13, returned from a tour in Tunisia and became ill. The second case was a young man who had come to this country from Uganda via Bombay. No other related cases were found and the patients made a good recovery Of the 87 notifications of food poisoning received in the year, one case was of special interest. This particular patient, a boy of one year and eight months old, was found to be infected with Salmonella Java, which is of reptillian origin. Two others in the family also contracted this infection and it was found that the child first ill had visited neighbours who kept terrapins as pets in a tank placed at floor level. A sample of water from the tank was found to be positive to Salmonella Java and there is in this case a clear indication of the likely source of infection. An outbreak of diarrhoea at an old people's home (private) in the Borough occurred in August. Specimens were obtained from all patients and staff, 21 in all, of whom 20 showed infection by Clostridium Welchii. Boiled chicken had been eaten but none remained for laboratory examination and the Bacteriologist stated that in view of the frequency of the presence of Clostridium Welchii in man results were inconclusive. All the patients made a good recovery. Several cases of Malaria were notified. In all cases the disease was contracted directly abroad. INTERNATIONAL CERTIFICATES OF VACCINATION Three forms of International Certificates of Vaccination, in respect of smallpox, cholera and yellow fever, require authentication of the signature of the doctor providing the vaccination or inoculation of persons proceeding abroad. During the year the signatures were verified on 11,692 such certificates. 26 ENVIRONMENTAL HEALTH SERVICES ENVIRONMENTAL HEALTH SERVICE The chronicle which follows contains figures, tables and text, and is set down to fulfil the requests of Government departments and to satisfy the Regulations which call for an account of the sanitary circumstances of the district. It demonstrates the wide-ranging activities of the Public Health Inspectors, Technical Assistants and other supporting field and clerical and administrative staff. As the general standard of living has improved, people have become less tolerant of conditions which offend a more fastidious standard of comfort; but with all this it is man himself who creates conditions which militate against an aesthetically acceptable and wholly healthy environment. Striving for near-perfection in the presentation of foodstuffs by wrapping and packing in non-porous bags and containers, manufacturers sometimes create conditions conducive to mould growth, and twice as many of complaints about food affected by mould were received in 1971, as in 1970. Probably the most bizarre complaint related to a bottle of vodka which upon examination was found to be 100 per cent water.. The complainant's disappointment was happily short-lived, for the retailer supplied a bottle of the real stuff in lieu. WATER SUPPLY The supply of water to the Borough is distributed by three companies, namely the Colne Walley 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 plumbo-solvent action. 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. 29 FOOD Formal and Informal Samples Four hundred and ninety-eight samples of food were submitted for analysis during the year. A table identifying the commodities and showing the results is set out below. The number of samples reported as unsatisfactory was 8.4 per cent of the total submitted compared with 7.2 per cent for 1970. In addition eighteen samples of foodstuffs and drugs were also examined by the Public Analyst in consequence of complaints. SAMPLE FORMAL INFORMAL Satisfactory Unsatisfactory Satisfactory Unsatisfactory Alcoholic Beverages, Beer 1 2 Alcoholic Beverages, Spirits 3 1 Almonds, Ground 1 Almond Oil 1 Anchovies 1 Angelica 1 Apple Juice 1 Arrowroot 1 Anti-pasto 1 Back-ache, Kidney and Bladder Pills 1 Barley Flakes 1 Beans, Baked 4 1 Bean Curd 1 Biscuits 3 Bread 1 3 Butter 2 Cheeses 6 3 Chilli Powder 2 Chocolate Drink 3 Chutney 1 Cinnamon, Ground 3 Citric Acid 1 Confectionery 1 Cooking Fat 2 Cooking Oil 1 Cough Mixture 1 Cream 5 Curry Powder, Mixes etc. 6 Custard Powder 2 Dental Cream 1 Dessert Preparations 3 2 Dripping 3 30 SAMPLE FORMAL I INFORMAL Satisfactory Unsatisfactory Satisfactory Unsatisfactors. Fish Cakes 1 3 Fish, Canned 15 2 Flour, Plain 7 Flour, S.R. 5 Food Colouring and Flavouring 5 Fruit, Canned 20 Fruit, Dried 6 1 Fruit, Juice 3 Fruit, Natural 3 Fruit, Preserved 1 Fruit Pudding 1 Ginfer, Ground 1 Glace Cherries 1 Glycerine Thymol 1 Gravy Mix 3 Ice Cream Mix 1 Ice Pops 1 Imipramin Tablets I Jam 4 Jellies 14 Lard 6 Lemon Curd 2 Margarine 2 17 Marmalade 5 Marzipan 1 Meat, Canned 19 2 Meat Pies and Puddings 5 Meat Products and Others 1 22 1 Milk 2 Milk, Dried 1 2 1 Milk, Top of 1 Milk, Evaporated 2 Milk Puddings, Canned 2 Mince 1 Mincemeat 2 Mint Sauce and Dried Mustard 2 Mustard 2 Nutmeg, Ground 1 Oats 1 Olive Oil 2 Paella Parsley and Thyme Stuffing 1 Paste, Fish and Meat 5 Pastry and Cake Mix 5 Pease Pudding 1 Peel, Mixed 3 Pickle 3 Pie Filling 2 Potato Crisps I 3 Pudding Sponges and Canned 2 31 SAMPLE FORMAL INFORMAL Satisfactory Unsatisfactory Satisfactory Unsatisfactory Ravioli 3 Rice 1 Rice Flour 2 Rice, Ground 2 Salad Cream 5 Sauces 4 Sauerkraut 1 Sausages, Beef Sausages, Pork 13 1 Sausages, Hot Dogs 1 Sausage Meat, Beef 4 1 Sausage Meat, Pork 5 Sausage Rolls 1 Seasoning Mix Semolina 4 Soft Drinks 34 1 Soups, Canned 15 Soups, Dried 2 1 Soya Flour 1 Spaghetti and Mixes 4 Spice 1 Suet 2 Sugar 1 Tapioca 1 Taramosalata 1 Tea 5 Toast Savouries • 1 Tomatoes, Canned 10 Tomato Paste and Puree 8 1 Tomato Juice 3 Tonic Water 3 Turmeric Powder 3 Vegetables, Canned 21 2 Vegetables, Frozen 1 Vegetables, Hydrated 2 Vegetables, Natural 1 Vinegar, Wine 1 Vine Leaves, Stuffed 1 Vitorange Tablets 1 Waffles 2 Wheat Noodles 1 Yeast 1 Yo ghourts 4 4 TOTALS 8 3 451 36 32 In addition to the above samples, the following were examined in the Department:- ARTICLE NO. OF SAMPLES Satisfactory Unsatisfactory Apple Sauce Mix — 1 Cream 9 — Fish, Canned — 2 Milk 83 2 Mince 6 2 Red Lentils 2 — TOTALS 100 7 The following comments are made regarding some of the unsatisfactory samples:- Sausages One sample of sausages was found to contain preservative in excess of the amount permitted by the Preservatives in Food Regulations 1962, whilst another sample contained preservative which had not been declared. Mince One sample of minced beef was found to contain sulphur dioxide preservative to the extent of 2.300 p.p.m. A fine of £75 with £25 costs was imposed when proceedings were instituted against the butcher concerned. Porkettes A meat product prepared and packed on the premises of a supermarket was found to contain a non-permitted colour which had been absorbed from the print on a label placed on the meat before being wrapped in polythene film. Peche Dessert A sample of imported dessert was found to contain sorbic acid to the extent of 65 p.p.m. This is not permitted under existing legislation in this country in respect of a product of this type. 33 Soups A dehydrated vegetable soup contained 8 1% of fat, but when reconstituted the prepared soup contained less than 1% which was considered poor for a soup described as "creamed style". Tomato Paste A small can of tomato paste was found to have an excessive content of tin and copper. Further cans in the shop were opened and in view of the fact that in every instance the internal lacquering of the cans was peeling, the shop owner surrendered his stock of this particular brand. Whisky One sample contained 1% added water which appeared to be due to the optic having been rinsed just prior to the sample having been purchased. Soft Drinks In one sample of Apple Juice the Vitamin C content was below the amount declared on the label by 8mg. per fluid ounce; whilst a sample of Orangeade contained the artificial sweetener saccharin which was not declared on the label. Comments on the other samples reported as being unsatisfactory by reason of labelling defects will be found under the section headed "Labelling of Food". Ice Cream There is one factory 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 — — — 21 Loose 97 38 12 20 167 Mobiles Loose — — — — — SOFT ICE CREAM Premises 24 8 10 5 47 Mobiles 1 — — 2 3 34 Pre-packed ice cream was of good quality and bateriological cleanliness. Continuous attention is necessary to ensure that ice cream dispensed from cans or from extrusion units is not exposed to risk of contamination. Liquid Egg Twenty-one samples of liquid egg were taken from bakeries to check that the egg had been properly pasteurised. Three of the samples did not satisfy the alpha-amylase test but investigations failed to reveal any reason for this and subsequent samples of the same brands proved satisfactory. Milk - Registration, 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 39 Pasteurised Milk 175 Sterilized Milk 108 Ultra-heat treated Milk 136 One hundred and eleven samples of raw milk were submitted to the laboratory for the milk ring test, a screening test to determine whether brucella organisms might be present in the milk. Eight positive results were reported in respect of one herd. All the milk sold from this farm for human consumption was already being heat treated but the danger of consuming raw milk was pointed out to the farmer and his employees who received free untreated milk. Subsequently, following the high rate of aborted calves, the farmer decided to cease milk production and to concentrate in the future on beef cattle. Thirty-seven samples of untreated milk examined bacteriologically were found to be satisfactory, whilst a further twenty-seven submitted for biological examination for the presence of tubercle bacilli were all found to be free of the organism. 35 Food Complaints Two hundred and fifty-six complaints were received as to quality, soundness or the presence of foreign bodies in food. This was the same total of complaints as was received in 1970. In 169 cases the matter was dealt with by the Department by the giving of advice or caution to the shopkeeper or company concerned. In 31 cases the offence justified proceedings and in a further 23 cases the Council authorised the sending of a '' warning letter". In 33 instances, approximately 13 per cent of the total complaints, it was considered that the complaint was unfounded. The table below classifies the nature of the complaint:- 7. Foreign Hodies (a) Insects, rodents etc. 36 87 (b) Metal objects 8 (c) Glasses, stones, etc. 9 (d) Paper, wood, string, etc. 6 (e) Oil, grease etc. 6 (f) Fabric, plastic, rubber etc. 10 (g) Cigarette ends 1 (h) Harmless matter, e.g. burnt dough in bread 11 2. Quality (a) Unsoundness 31 (b) Mould growth 56 (c) Rancidity, sourness etc. 6 (d) Adulteration 3 96 3. Damaged or dirty containers (a) Damaged containers 7 (b) Dirty containers, e.g. milk bottles 21 28 4. Labelling, Misdescription or Coding 12 12 5. Complaints unfounded 33 33 256 No apology is made for once again pointing out the problems created for the diary industry by the misuse of milk bottles. During the power cuts milk bottles used as improvised candle holders were found to have the candle end pushed into them from whence it could only be removed by the smashing of the bottle. In spite of appeals to the public, firework time brings its annual quota of contaminated bottles, due to their having been used as rocket launching pads, whilst a proportion of the gimmicky plastic toys given with some packeted foods eventually find a home in the milk bottle. Opposition to the plastic 36 container and the waxed carton is still very strong but unless the public can be educated to treat the glass bottle with greater care there would appear to be no alternative from the disposable container or the occasional "dirty" bottle which a regular sampling programme of washed bottles has shown to be sterile after it has passed through the washing process. Only one complaint was received concerning the presence of a cigarette end in a foodstuff but the food concerned was a packet of children's sweets and its presence together with shreds of tobacco was most objectionable. The number of complaints received concerning foodstuffs affected by mould was more than twice as great as in 1970. A large percentage of these related to pre-packed cheese where mould had occurred due to condensation having taken place on the inside surface of the transparent film wrapper. It may well be that a choice will have to be made between the hygienic presentation of cut cheese portions and the risk of occasional mould growth when the cheese is displayed in a supermarket display where there is a possibility of temperature variation. In two cases, complaints concerning alleged adulteration of beer and spirits were unfounded but in a third case a bottle of Vodka purchased from a supermarket late one Saturday afternoon was found to be 100% water. Extensive enquiries failed to shed any light on where the switch occurred. The seal on the bottle was intact. The following list sets out the foodstuffs condemned during the year:Fresh Food Meat 2696lbs. Fish 3 stone 351 lbs. 2—14 lb. boxes Offal 339 lbs. Poultry 369 lbs. Canned Foods Fruit/fruit juices 3057 cans Meat 851 cans Vegetables 1864 cans Soups 187 cans Milk 43 cans Fish 594 cans Milk Puddings 31 cans Meat/puddings, pies 243 cans Cream 94 cans Jam 103 cans Spaghetti/baked beans 44 cans Unidentified 900 cans Frozen Foods Cream/ice cream 1512' packs Fish/fishcakes 5894 packs Meat 2907 packs Puddings, pies, pastry/cakes 2088 packs Vegetables 4552 packs Fruit 182 packs Poultry 401 packs Trifles, mousse 1888 packs Cheeseburgers 18 packs Miscellaneous Confectionery/sugar 322 packets Cereals 51 lbs. Pastry/flour 42 packets Biscuits/crispbreads 23 packets Chocolates/sweets 65 boxes/packets Sauces/pickles 47 jars/bottles Dried foods/fruits 532 packets Butter 2 lbs. Animal Foods 142 tins/packets Cheese 137 lbs. Coffee/tea 25 lbs. Baby foods 34 tins/packets Unidentified 20 tins/packets Labelling of Food The greatest number of offences under this heading occurred in respect of the absence of lists of, or wrongly listed, ingredients on packets or containers of prepacked foodstuffs having two or more ingredients. Containers of Goat's Milk Yoghourt, Fruit Salad, Mangoli, Preserved Apples, Exquis Neige (Dessert) and Creamed Tuna were all deficient in this respect. With regard to a can of Creamed Tuna it was felt the description was not appropriate in respect of a product which consisted, in the main, of flaked fish. A dessert consisted of a medium fat soft cheese and strawberry jam. The list of ingredients appeared in very small black print on a dark coloured foil cap and was almost impossible to read. The cheese used was stated to be low-fat and not medium-fat as reported by the Council's Analyst. The cap of the carton has now been re-designed. A West Indian fruit preserve was found to be free of any significant proportion of fat and was misdescribed as "Guava Cheese" It was pointed out to the manufacturers of a Strawberry Yoghourt containing only 0.1 per cent of fat that it should be described as a low-fat yoghourt. 38 A sales promotion during the year for a certain brand of potato crisps claimed that the crisps had added protein. The attention of the manufacturers was drawn to the fact that whilst the claim "with added protein" was justified, there could be misunderstanding as the extra protein present made no sifnificant contribution to the protein content of diet. 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, CLASS OF BUSINESS Number at end of 1971 Bakehouses and Bakers Shops 105 Butchers 175 Canteens 230 Confectioners 266 Dairies 9 Fish Shops 70 Greengrocers 174 Grocers 319 Licensed Premises 226 Restaurants/Cafes 303 7838 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 and known as Watling Market. This operates on one day a week only. The other privately owned, is at Bamet, 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. At the close of the year there were 45 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. 39 Poultry Inspection 1971 (i) Number of poultry processing premises within the district 1 (ii) Number of visits to these premises 7 (iii) Total number of birds processed during the year 10721 (iv) Type of birds processed Hens (v) Percentage of birds rejected as unit 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 carcases are immersed in a thermostatically controlled scalding tank and plucked in an electric defeatherer. They are delivered the same or the following day after slaughter to butchers in the Golders Green, Finchley, Harrow, Tottenham, Watford Elstree and Cockfosters area for sale in the fresh trade. As the birds are uneviscerated, inspection at the place of slaughter is limited but doubtful carcases are retained and inspected in accordance with the procedures recommended in Circular 22/61 of the Ministry of Health. 40 LEGAL PROCEEDINGS IN RESPECT OF FOODSTUFFS - 1971 Date Court Offence Fine Costs 11. 1.71. Hendon Sale of beefsteak pie containing a fly. £10 £5 11. 1.71. Hendon Sale of cream cheese deficient in milk fat. £10 £5 25. 1.71. Highgate Sale of cream cheese deficient in milk fat. £20 £10 10. 2.71. Barnet Sale of loaf with oil staining. £50 £10 15. 3.71. Hendon Sale of loaf containing fragments of kapok. £10 £5.25 22. 3.71. Hendon Sale of orange crush with mould growth. £20 £10 24. 3.71. Barnet Sale of mouldy loaf. £10 £10 5. 4.71. Hendon Sale of meat paste containing a match stick. £15 £10 21. 4.71, Barnet Sale of milk containing mould growth. £15 £15 28. 4.71. Barnet Sale of beet slaw salad affected with mould. £40 £10 12. 5.71. Barnet Sale of sliced loaf containing a piece of paper. £5 12. 7.71. Hendon Sale of sausages which were unsound. £25 £3 2. 8.71. Hendon Sale of "Jelly Babies" with cigarette end. £15 £5 6. 9.71. Hendon Sale of black pudding containing a nail. £20 £5 20. 9.71. Hendon Sale of bread pudding affected with mould. £20 £10 18.10.71. Hendon Sale of loaf containing piece of towelling. £50 £15 18.10.71. Highgate Sale of orange crush containing foil cap. £35 £5 18.10.71. Highgate Sale of cheese affected with mould. £50 £5 29.10.71. Hendon Sale of mince containing preservative. £75 £25 1.11.71. Hendon Sale of milk in dirty bottle. £75 £10 8.11.71. West LoneIon Petty Sessions — do — £15 £8 8.11.71. — do — — do — £15 £3 15.11.71. Hendon Sale of fruit pie affected with mould. £20 £5 15.11.71. Hendon Sale of loaf affected with mould. Dismissed 22.11.71. Hendon Sale of milk containing strawberry weevil. £50 £10 41 CLEAN AIR A table showing the position reached in the Smoke Control Programme is on page 43. Owing to the shortage of smokeless fuels in the winter of 1970/71, along with other authorities in the London area the Council agreed to suspend 40% of the operative Smoke Control Orders from November 1970 until 31st March 1971. This shortage of fuel caused the Minister in confirming the No. 11 Order to postpone the operative date from 1st April 1971 until 1st July 1971. With this knowledge the operative date for the No. 12 Order was proposed and confirmed as 1st August 1971. The No. 13 Order was made in August and submitted for confirmation which is expected early in 1972. There are assurances that adequate supplies of smokeless fuels are now available and that there is no further need to slow down progress towards the completion of our clean air programme. Efforts towards the elimination of domestic smoke have been made over many years and as each Order comes to its operative date it is found that a lower percentage of house owners claim grant for the conversion of appliances, because they have already decided to improve their standard of heating and comfort by the installation of modern appliances and central heating systems. It is likely therefore that the Council may be able to make Orders covering a large number of houses as the programme nears its conclusion, without any increase in cost to the Council. 42 43 19 7 1 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 1970 10,989 62,270 3,812 London Borough of Barnet (No. 11) (Hendon) 25-3-70 10-7-70 1-7-71 402 3,120 256 London Borough of Barnet (No. 12) (Cricklewood) 10-8-70 11-11-70 1-8-71 383 1,925 157 London Borough of Barnet (No. 13) (Golders Green and Hendon) 13-8-71 14-3-72 1-10-72 479 4,006 302 TOTAL 1,264 9,051 715 GRAND TOTAL 12,253 71,321 4,527 Acreage of Borough 22,124 Approximate number of premises (all types) 122,574 HOUSING Provisioti of Housing Accommodation The pattern of progress established during 1971 in the Council's efforts to meet the overall housing demand in the Borough continued to be maintained during the year under review. This was again mainly attributable to the construction of additional new dwellings to a total of 388. On 31st December 1971, the Council's housing stock stood at 15,907 dwellings. The main Estate, on which construction was partly completed during the year, was located at West Hendon, whilst further north, on the site of the former Hendon Aerodrome, the first few dwellings on the new Grahame Park Estate were let before the end of the year. This is a joint development between Barnet and the Greater London Council, under which the latter Authority will have right of nomination to 60% of all the rented dwellings thereon - approximately 1,800 in all - by the time the Estate is completed. In addition, the Council agreed to accept from the Greater London Council a quota of 200 nominees during 1971 for rehousing anywhere in the Borough. Both these agreements symbolized the Council's desire to make a significant contribution to the housing problems of the more hard pressed Inner London Boroughs, whilst at the same time rehousing the most needy of its own citizens. In the latter category the number of tenancies allocated .to applicants on the Council's housing waiting list during 1972 totalled 644, in addition to which 98 families were rehoused from Housing Areas scheduled for redevelopment in the Council's current programme. The problem of providing accommodation for families rendered homeless for various reasons under Court Orders was an ever present theme throughout the year. This was reflected in the Council's decision to purchase a number of houses located in various parts of the Borough as an addition to its existing pool of Temporary Accommodation acquired under the National Assistance Act 1948. During the year the Borough Housing Officer rehoused from the various units of Temporary Accommodation 24 families and also allocated tenancies direct to 32 families who had been rendered homeless under Court Orders and who otherwise would have had to be admitted to welfare accommodation. The Council continued its policy of assisting as many persons as possible, mainly the elderly, whom I had recommended be rehoused solely on medical grounds; in other words, persons whose existing accommodation, though adequate in size and amenities in the normal course, was likely to cause or aggravate a serious medical condition. Most of these people required alternative accommodation without stairs, and during the year it was found possible to deal satisfactorily with no less than 57 such cases. 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. 44 Individual Unfit Houses Eleven properties comprising a total of thirteen dwellings were reported during the year as being unfit for human habitation and incapable of repair at reasonable cost. In three 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 consequence of this action, together with that which had been initiated in earlier years, nineteen unfit houses were demolished and eleven dwellings closed. Sixteen families comprising in all a total of thirty-seven persons vacated unfit properties. Three families found themselves suitable alternative accommodation. In all other cases rehousing was arranged by the Council. Three 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. The three properties were adapted so as to provide four units of accommodation. Clearance Areas Two clearance areas involving forty-two properties in Albert Street, Lodge Lane and William Street, North Finchley were defined under Part III of the Housing Act, 1957. Authority was given for the making of a Compulsory Purchase Order as the site was required by the Local Authority as part of their planned programme for the locality within which the clearance areas were situated. Action in respect of a third clearance area containing a further twenty properties in Lodge Lane was deferred in order to permit the Finchley Society to submit, at their request, proposals for the rehabilitation and improvement of the dwellings. Following a public inquiry confirmation was received from the Department of the Environment of a Compulsory Purchase Order in respect of Nos. 3 and 4, The Villas, Burnt Oak, Edgware, which had been reported under Part III of the Housing Act, 1957 during 1970 - these multi-occupied houses are immediately adjacent to the North Road Housing Area already programmed by the Local Authority for comprehensive redevelopment. By the end of the year one family only remained to be rehoused. Rehousing of the families in the two outstanding Clearance Areas at The Burroughs, Hendon and East End Road, East Finchley was also completed, and in the latter area the properties demolished. Redevelopment and Slum Clearance Completion of redevelopment in respect of areas of predominantly obsolescent housing, designated as Housing Areas and dealt with under Part V of the Housing Act, 1957, is now programmed and no further surveys were undertaken during the year for possible new areas. 45 Compulsory Purchase Orders were confirmed, each without modification, in respect of two Housing Areas at Cromwell Road and Ridge Road, Childs Hill. In the first case an appreciable housing gain will be possible, 202 units of accommodation with the necessary environmental amenities replacing 100 mainly substandard properties with an appreciable element of multi-occupation. The second will enable the Ridge Road scheme to be completed with a total of 29 dwelling units, the first phase having already been undertaken during 1970. All the properties included in the slum clearance programmes for the periods 1966/1970 and 1970/1973 have been, or are currently being, dealt with and no localities of unfit housing now remain within the Borough. The problem of unfitness is confined to individual houses or small groups of properties capable of being dealt with as they arise under Part II of the Housing Act, 1957. Experience shows the annual wastage in this respect to be between 20 and 25 units. Improvement of Houses As a matter of departmental policy, older type houses are inspected and when they are found to have an acceptable future life but lack essential amenities, information and advice is proffered to owners in order to encourage them to undertake improvement schemes with the aid of appropriate grants. In some twenty-five cases favourable response was received and improvements were undertaken or put in hand. During the year a total sum of £92,031 was paid in respect of grant aid, made up of 186 Standard Grants, 66 Discretionary Improvement Grants and 4 Special Grants relating to houses in multiple occupation. This represented an increase over last year of approximately 130 per cent in the total amount of financial assistance given, with more than a 200 per cent increase in approvals of Discretionary Improvement Grants. This reflected the initial success of the Housing Act, 1969 which, 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 offered. In the same period the Borough Treasurer made 263 advances for house purchase, involving a gross sum of £1,129,520. This was only slightly below the figure for last year but related to 22 per cent less properties. 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 four such representations were received. In one instance the representation could not be acted upon because the application fell outside the provisions of the Act. In two cases discussions commenced regarding improvement schemes with the owners who showed a willingness to proceed provided grant aid was available, whilst in the remaining case no firm undertaking had been received from the owner by the 31st December and the indications were that formal notices would have to be served. Authority was obtained during the year for the service of formal notices under Section 20 for the improvement of four units contained in two tenement blocks which had earlier been the subject of Section 19 representations. 46 The initial approach must come from the tenant in these cases and it is discouraging to find how little this provision is used although its usefulness in General Improvement Areas must not be overlooked. 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 the number of dwellings in the area will attract grant from Central Government. Following upon the survey of the Borough undertaken during 1970 in order to identify areas having the essential characteristics needed to justify designation as General Improvement Areas, the Council considered alternative schemes for three selected areas and agreed to proceed with a pilot scheme for Brunswick Crescent, New Southgate, subject to the residents indicating their willingness to co-operate. 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. Following completion of the improvement of the housing stock in the Prospect Road, Childs Hill area in the previous year 1971 saw the Council's second Improvement Area at Brent Terrace, Cricklewood, with a total content of 91 dwellings, brought to a satisfactory conclusion. Further, the completion of improvement schemes for the 136 houses in Campion, Needham, Johnston and Midland Terraces, Cricklewood continued during the year. Before formal designation as an Improvement Area, the owners of this estate gave an undertaking to the Council 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, and so contributing elements of environmental improvement. Overcrowding The following statement provides a summary of the known cases of overcrowding existing or dealt with during the year, the standard of assessing overcrowding being that specified by the Housing Act, 1957. 47 (a) Number of dwellings known to be overcrowded at end of year 5 Number of families in occupation 5 Number of persons in occupation 43 (b) Number of new cases reported 6 (c) Number of cases relieved 6 Number of persons concerned 38 These are the only cases of statutory overcrowding which are known to the Department. Other cases do undoubtedly exist but the extent of the problem within the Borough is not considered to be serious. Overcrowding seldom comes to light as a result of direct complaint and in the course of normal routine inspections is encountered most frequently in multi-occupied properties. Frequently 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, but as yet it is not opportune for a statutory upgrading of the standards. When assessing housing needs in respect of applications for housing accommodation, the Council 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 Powers are available to local authority under the Housing Acts, 1961/1969 to deal with unsatisfactory conditions in houses which are multi-occupied. During the year, the opportunity was taken in the light of experience gained, to amend and extend the standards relating to amenities and facilities within such premises, and this new set of standards was considered and approved by the Council. 48 Relatively large concentrations of multi-occupation are known to exist within certain defined areas of the Borough, and programmes of house-to-house inspections within these sectors are undertaken as a routine. Individual houses outside these areas may also, of course, be in multiple occupation and these are not so readily identifiable. One channel of identification which has proved of value has been through local land charge searches, when prospective purchases of properties are informed by the Town Clerk that standards relating to houses in multiple occupation have been adopted by the Council and that if the enquirer is aware that the house is so occupied, or is likely to be used in this way he should contact the Health Department with a view to an inspection being carried out and the premises brought up to the Council's standards, if appropriate. During the year and in the course of systematic house to house inspections relating to multiple occupation, 323 properties were inspected and 63 were equipped and repaired so as to make them suitable for the number of individuals or families in occupation. When inspections of this nature are carried out, it is almost invariably found that suitable means of escape in case of fire have been overlooked or neglected, although older standards may be adequate and well maintained. Fire hazard in older multi-occupied premises is obviously a factor of great importance. The Code of Practice of the Greater London Council for means of escape in case of fire in houses in multiple occupation has been adopted by the Council and is applied as necessary. During the year 86 houses were modified in such a way as to meet the requirements of the Code and thus provide a degree of safety for the occupants which was not previously available. 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 Rents 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. In the course of the year 238 further applications for Qualification Certificates were made to the Department by owners or their agents. These applications related to controlled tenancies which owners desired to have taken out of control with the aid of a Qualification Certificate, thus enabling a fair rent to be fixed for the tenancy. In every instance the tenant was given the opportunity to make written representations to the Council regarding the condition of his premises and inspections were carried out whether or not such representations were received. Based on the condition of the property, the decision was reached as to whether a Qualification Certificate should be issued or refused, or whether the applicant should be afforded the opportunity to carry out the necessary works within a reasonable period of time, dependent on the nature of the repairs involved. Both landlord and tenant have a right of appeal to the County Court following the issue of refusal of a Qualification 49 Certificate. In fact, no appeals against such issue or refusal were made in the course of the year. A large number of inspections and revisits with an associated volume of clerical work were necessary to deal with the many applications received. 50 Housing Statistics 1. Inspection of Dwelling Houses (i) (a) Total number of dwellings inspected for housing defects (under Public Health or Housing Acts) 3,516 (b) Number of inspections made for the purpose 9,078 (ii) Number of dwellings found to be unfit for human habitation 39 (iii) Number of dwellings (exclusive of those referred to under the preceeding sub-head) found not be in all respects reasonably fit for human habitation 1,645 (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 20 (v) Number of dwellings inspected in connection with proposed improvement areas and Improvement Grants Scheme 175 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 488 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 b) Proceedings under Public Health Acts (i) Number of dwellings in respect of which notices were served requiring defects to be remedied 39 (ii) Number repaired or rendered fit (a) By owners 19 (b) By Local Authority in default of owners Nil 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 1 (iii) Number of dwellings in respect of which Closing Orders were made 9 (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) 3 (vii) Number of dwellings in respect of which Demolition Orders were revoked under Section 24 (2) Nil 51 4. Houses in multiple occupation - Housing Act, 1961 (i) Number of properties made suitable for occupation by number of occupants accommodated (Section 15) 63 (ii) Number of properties provided with means of escape from fire (Section 16) 86 5. Compulsory Improvement - Housing Act, 1964 (i) Number of dwellings in improvement areas improved to the full standard 18 (ii) Number of dwellings outside improvement areas improved to the full standard (Section 19) Nil 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 caravans stationed thereon. Itinerant caravan dwellers continued to create problems and the question of providing a site in the district for these persons was still under active consideration at the end of the year. INSPECTIONS AND COMPLAINTS A concern with the conditions in which people live is a raison d'etre of a Health Department; but of equal importance is the character and quality of the environment. The following account of the sanitary circumstances of the Borough and of the work done by the Public Health Inspectors and their supporting staff in creating healthy conditions in which people live and work and play is herein detailed to meet the requests of Government Departments and to satisfy the Public Health Officers' Regulations. Some 7,910 complaints and requests for services were investigated and where possible, defects and unsatisfactory conditions were remedied. 52 The following table shows the nature and number of inspections made:- Housing Public Health and Housing Acts 9,078 Multiple Occupation 1,487 Other housing visits 1,274 11,839 Clean Air Observations 397 Surveys, proposals and claims 1,621 Other clean air visits 3,012 5,030 Food Premises Bakehouses and bakers shops 492 Butchers 583 Dairies, Milkshops and Processing Plants 352 Grocers 395 Labelling and Sampling 1,539 Ice Cream 148 Restaurants, cafes 992 School Meal Kitchens and Canteens 876 Stalls 245 Unsound Food 410 Other Food premises visits 1,806 7,838 Factories Powered/ non-powered 478 Sites 17 Outworkers 127 622 Offices, Shops and Railway Premises 2,481 2,481 Drainage Drainage and Plumbing Works 2,143 Cesspools 1,400 3,543 Infectious Diseases 2,915 2,915 Animals Pet Shops 145 Riding Establishments 18 Boarding Establishments 18 Diseases of Animals Act 138 Others 36 355 53 Miscellaneous lisits Accommodation roads/passages 122 Noise nuisance 857 Accumulation of rubbish 1,303 Hairdressers 20 Caravans 115 Watercourses 415 Not classified 3,105 6,037 40,660 Of the 2,090 informal notices served, 1,610 were complied with and 181 statuory notices were required, and of these 127 had been complied with at the end of the year. LOCAL LAND CHARGE ENQUIRIES These refer to enquiries from the Town Clerk concerning outstanding notices, the progress of housing schemes and smoke control areas in relation to all types of property in the Borough, in pursuance of the provisions of the Land Charges Act, 1925. The necessary searches were made and information supplied in respect of 11,069 premises. NOISE The Noise Abatement Act, 1960, makes noise or vibration which would amount to a nuisance at Common Law a statutory nuisance which can be dealt with according to the procedure in Part 3 of the Public Health Act, 1936. The Act does not apply to noise or vibration caused by aircraft or by statutory undertakers in exercise of their powers. During the year 60 complaints were received, the majority relating to noise from business or industrial activity and the remainder from domestic or social causes. There are no specially noisy industrial processes and the most intractable cases arise from business uses or light industrial activity in smaller factories or workshops which are intermingled with or adjacent to houses. Complaints are investigated promptly but some require numerous visits at night as well as during the day and sometimes it is difficult to obtain a solution to a noise nuisance without what may seem to complainants as an unreasonable delay. Although it is not always possible to reduce noise to a level which satisfies complainants there is a good degree of co-operation from business firms. 54 \ SHOPS AND OFFICES The Offices, Shops and Railway Premises Act, 1963, and a number of the 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 also responsible for the registration procedure and the publication of an Annual Report to the Secretary of State for Employment. The total number of registered premises at the end of the year was 3,134, a slight reduction on the previous year. Of this total 179 were premises newly registered during the year. At the end of the year there were 1,110 shop premises where the Act is not applicable i.e. family businesses. In addition to the number of premises registered by the Council, there are 301 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:- 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 47 900 57 Retail shops 112 1947 1211 Wholesale shops, warehouses 3 49 30 Catering establishments open to the public, canteens 17 237 127 Fuel storage depots — 1 — TOTALS 179 3134 1425 Table B — Number of visits of all kinds by Inspectors to Registered Premises 4965 55 Table C - Analysis of persons employed in registered premises Class of workplace No. of persons employed Offices 14,821 Retail Shops 7,870 Wholesale departments, warehouses 1,458 Catering establishments open to the public 1,577 Canteens 214 Fuel Storage Depots 3 TOTAL 25,943 Total males 13,138 Total females 12,805 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, 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 Department of Employment and Productivity shows the number of factories registered, the number of inspections made and defects found and remedied. Premises Number on Register Number of Inspections Written Notices Occupiers prosecuted (1) (2) (3) (4) (5) (i) Factories in which Section 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 75 53 6 _ (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority. 635 425 33 _ (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 21 17 _ _ TOTAL 731 495 39 _ 56 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. 1) 4 3 - - - Overcrowding (S. 2) - - - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) 1 1 - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient - - - - - (b) Unsuitable or defective 44 23 2 3 - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to outwork) 22 14 3 - - TOTAL 71 41 5 3 - OUTWORKERS Section 133 of the Factories Act, 1961, requires the occupier of a factory to notify the Local Authority of the names and addresses of persons employed in their own homes. There are 164 outworkers so notified engaged in the following trades:- Wearing apparel 128 Curtains and furniture hangings 4 Brass and brass articles 2 Artificial flowers 8 The making of boxes etc. 12 Brush making 2 Stuffed toys 4 Lampshades 4 The Public Health Inspectors made 127 visits to such premises. No unsatisfactory conditions were noted. 57 RAG FLOCK AND OTHER FILLING MATERIALS The Rag Flock and Other Filling Materials Act, 1951, requires the registration of premises where filling materials are used in the manufacture of bedding, toys, baby carriages and other articles of upholstery and the licensing of premises where rag flock is manufactured or stored for distribution. Regulations made under the Act apply standards of cleanliness for filling materials and prescribe a form of records to be kept by occupiers* of registered or licensed premises. Five premises registered under the Act were inspected and found to be satisfactory. SWIMMING POOLS AND BATHS There are four public swimming establishments provided and maintained at:- Squires Lane, Finchley (Indoor) High Road, North Finchley Daws Lane, Mill Hill Goldsmith Avenue, West Hendon Water treatment to the pools is carried out by filtration and "break point" chlorination method. I Public Slipper Baths are available at Squires Lane, Finchley but the facilities at West Hendon were closed during March, 1971. Charges for washing and swimming are various. Special charges are agreed for school use for swimming and washing is free at prescribed times for old age pensioners. SANITARY CONVENIENCES There are 70 male and 68 female public conveniences adjoining the highways 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 all public conveniences, including hand washing facilities is free in the Borough. The sanitary fittings in all the public conveniences have been descaled during the year by a firm of specialist contractors. 58 SEWERAGE AND SEWAGE DISPOSAL The system of sewerage in the former Barnet Urban District Council area is partly separate and partly combined. Arkley and Totteridge rural areas are unsewered. Treatment and disposal are partly at Greater London Council (East Middlesex) Main Drainage Works, Deephams, Edmonton and partly as West Hertfordshire Main Drainage Works, Rickmansworth, Herts. Friern Barnet, apart from isolated cases, is entirely sewered. Only a small area exists where there is combined drainage sewerage system. Treatment and disposal are at Edmonton. In the Finchley area there is a separate sewerage system and the whole district is sewered. Treatment and disposal are at Greater London Council (East Middlesex) Works, Deephams, Edmonton. In the East Barnet area there is a separate sewerage system except for the older development in Monken Hadley where it is partly combined. The whole of the district is sewered. Treatment and disposal are at Greater London Council (East Middlesex) Works, Deephams, Edmonton. In the Hendon area there is a separate sewerage system except for small areas of old development which are partly combined; these are being eliminated as housing redevelopment projects progress. A scheme has been implemented by the Council in the Hendon Wood Lane area to eliminate cesspool drainage and these sewer works were nearing completion at the end of the year. Treatment and disposal are at Greater London Council (West Middlesex) Works, Mogden. In the more rural parts of the Northern area there are some properties which drain to cesspools which are emptied eight times a year by the Council free of charge. In general, surface water is handled by the discharge of surface water sewers to natural watercourses. REFUSE COLLECTION AND DISPOSAL Refuse is collected by direct labour in various types of specially designed vehicles. The number of collection rounds is 45. Disposal is effected by transfer loading stations at Summers Lane, Finchley, N.12., and at Hendon on the North Circular Road. All disposal is the responsibility of the Greater London Council. Special collections of old furniture etc., are made on a rechargeable basis. Refrigerators are collected free of charge. 59 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 well-being of cats and dogs, animals sold for pets and horses for riding. At the end of the year the following licences were in force:- Animal Boarding Establishments Act, 1963 2 Pet Animals Act, 1951 22 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 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, 95 dogs were received at the premises. Under the Movement (Records) Order 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 640 Pigs 5,395 Sheep 20 Goats 7 Poultry 6,575 The Diseases of Animals (Waste Food) Order, 1957, requires that all waste foods to be used for the feeding of animals must be boiled to minimise the risk of spread of animal diseases. The boiling plants may only be operated if satisfactory and licensed. 12 licences were in force at the end of the year. Mr. J.R. Stockman, M.R.C.V.S., continued to act on a consultancy basis to assist in the inspection of animals and premises where necessary. RODENT CONTROL The Prevention of Damage by Pests Act, 1949, places the onus on the occupier to rid his land and premises of rats and mice, but in practice it is found that the provisions 60 of the Act are best administered by the Council providing a control service. This is carried out by a trained staff of Rodent Operatives and in accordance with the recommendations of the Ministry of Agriculture, Fisheries and Food. In the case of dwelling houses, treatment is undertaken by the Council free of charge, and on a "time and cost" basis in respect of business premises. Treatment of sewers to reduce the number of rats was again carried out during the year. Fluoracetamide, a dangerous poison, was used, and the work carried out by a specialist firm under contract. The arrangements for the work and its supervision are made with the co-operation of the Borough Engineer and Surveyor. The following table summarises the work carried out and is in the form required by the Ministry of Agriculture, Fisheries and Food:- Properties other than Sewers Type of Property Non-Agricultural Agricultural Number of properties in the district 121,516 38 2. (a) Total number of properties (including nearby premises) inspected following notification 2,388 2 (b) Number infested by (i) Rats 1,055 1 (ii) Mice 1,092 1 3. (a) Total number of properties inspected for rats and/or mice for reasons other than notification 415 9 (b) Number infested by (i) Rats 38 - (ii) Mice 1 - The Rodent Operatives made 13,964 visits during the year. DISINFECTION AND DISINFESTATION Facilities for steam disinfection and disinfestation, and for the personal cleansing of verminous persons are provided at the Disinfecting Station, North Circular Road, N.3. Requests for advice and assistance in dealing with insect pests 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. Thanks must once again 61 be expressed to the Director of Entomology of the Natural History Museum for the helpful co-operation of his experts in the identification. Complaints are increasingly received from residents concerning damage and nuisance caused by the common squirrel and traps purchased by the Council are hired out on request. During the year 126 requests were received. "Wild" or "feral" pigeons continue to be a widespread pest. The well-meant but misplaced kindness of those who regularly provide an ample food supply at all seasons enables these birds to maintain a high breeding rate and the problem is thereby increased. A Specialist Contractor has again been employed to reduce the number of birds at several major centres of infestation within the Borough. A charge is made for disinfection and disinfestation, with the exception of terminal disinfection carried out following a case of notifiable disease and the cleansing of verminous people. MORTUARY The public mortuary serving the Borough is situated adjacent to the Disinfecting Station, North Circular Road, N.3; in the course of the year 572 bodies were received. EXHUMATIONS Licences for the removal of human remains under the Burial Act, 1857, state, inter alia, "it is considered advisable that the Medical Officer of Health should be notified whenever such a licence is granted in order that he may be in a position to take any action that may be necessary in the interests of public health". Eight 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. 62 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 78. Health Visiting A full establishment of Health Visitors was maintained for most of the year. Their complete attachment to general practitioners for more than 3 years has resulted in a widening of their field of work. During the year Health Visitors attended [n-service training courses on health teaching in schools and psycho-physical training for childbirth. Home Visiting Cases First Effective Total Effective No Access Visits at request of G.P. or Hospital Expectant Mothers 783 1087 319 - Children bom in: 1971 4599 7500 1790 - 1970 2647 5163 1224 - 1966-1969 4345 8462 2591 - Persons aged 65 or over 2468 5060 877 1456 Mentally disordered 216 562 117 160 Persons discharged from hospital (other than mental hospitals) 297 494 56 255 Households — Tuberculous 313 495 199 - Households — other infectious diseases 109 146 32 - Other visits as Health Visitors 1959 3125 665 - Total as Health Visitors 17736 32094 7870 1871 Cases seen as School Nurse - 1583 1156 - 65 Care of Mothers and Young Children Notification of Births Numbers of Births in the London Borough of Barnet during 1971 as adjusted by inward and outward transfers:- (i) Live Births (a) Domiciliary 123 (b) Institutional 4007 4130 (ii) Still Births (a) Domicilary - (b) Institutional 42 42 4172 Attendance at combined Mothercraft and Relaxation Clinics Combined Mothercraft and Relaxation No. of Sessions Total Attendances Average attendance per Session Central 14 84 6.0 East Barnet 11 65 5.9 Edgware 31 328 10.6 Oak Lane 41 95 2.3 Oakleigh Road 33 158 4.2 Torrington 44 299 6.8 Vale Drive 44 158 3.6 Watling 22 193 8.8 West Hendon 41 171 4.2 Osidge 6 42 7.0 TOTALS 287 1593 5.6 Congenital Malformations Information about congenital defects has been collected and recorded. During the year 72 cases were notified to the Department by Hospitals, General Practitioners and Domiciliary Midwives and details of these were passed to the Registrar General. Names of the children affected have been added to the Observation Register so that they can be examined at the appropriate time and treatment given when required. Mothers' Discussion Groups Discussion groups were in operation at the end of this year at the following clinics:- East Barnet Oakleigh Road Vale Drive Broadfields Brunswick Park (Osidge) Watling Mill Hill Torrington Holly Park 66 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 Attendance j No. of cases seen by A.M.O. No. of cases referred elsewhere Infant Welfare Sessions Broadfields 49 2730 55.7 707 16 Central 112 2804 25.0 1339 Childs Hill 100 3461 34.6 1430 36 Claremont 34 616 18.1 278 23 Colindale 52 2014 38.7 791 16 Dollisfield 22 236 10.7 175 1 East Barnet 103 2633 25.6 1177 1 Edgware 84 2001 23.8 749 17 Etchingham Park 102 2294 22.5 1279 - Holders Hill 33 526 15.9 252 - Holly Park 52 1496 28.8 942 1 Mill Hill 113 2795 24.7 1253 16 Oak Lane 102 2823 27.7 1484 11 Oakleigh Road 52 1359 26.1 750 2 Osidge 104 2794 26.8 1302 - St. Barnabas 51 2263 44.4 912 28 St. Marks 14 73 5.6 44 - St. Stephens 24 501 20.9 306 1 Sanders Lane 41 841 20.5 338 7 Sutton Road 51 1174 23.0 557 - Torrington 103 3145 30.5 1286 - Vale Drive 85 2322 27.3 1410 2 Watling 31 576 18.6 242 - West Hendon 103 2502 24.3 1031 21 Sessions without a Doctor Broadfields 4 71 17.8 - - Central 52 679 13.1 - - Claremont 24 284 11.8 - - East Barnet 3 54 18.0 - - Edgware 38 486 12.8 - - Holders Hill 24 224 9.3 - - Mill Hill 51 223 4.4 - - St. Marks 11 63 5.7 - - Sanders Lane 16 184 14.0 - - Vale Drive 19 207 10.9 - - Development Clinics Central 1 4 4.0 - - East Barnet 31 118 3.6 - - Garth Road 20 78 3.9 - - Holly Park 11 140 12.7 - - Mill Hill 10 56 5.6 - - Oak Lane 50 487 9.7 Contd. over 67 Child Welfare Centres (contd.) CLINICS No. of Sessions Total Attendance Average Attendances No. of cases seen by A.M.O. No. of cases referred elsewhere Development Clinics (contd.) Oakleigh Road 10 78 7.8 - - Osidge 37 331 8.9 - - St. Barnabas 24 192 8.0 - - Sutton Road 13 65 5.0 - - Vale Drive 3 24 8.0 - - Torrington 5 26 5.2 - - TOTALS 2074 48053 23.2 20029 199 Number of Children who attended during 1971 Born in 1971 3713 Born in 1970 3209 Born in 1966 — 1969 3641 10563 Midwifery The number of home confinements conducted by domiciliary midwives has continued to decline with 125 deliveries taking place during the year (168 in 1970). Patients nursed at home following hospital confinement numbered 667 (758 in 1970). Twenty-four pupil midwives received their district training in the borough. Twenty-one resided at Gervase Road, Edgware during the training period; Home Nursing A full establishment of Home Nurses and Nuring Auxiliaries was maintained throughout the year. During February and March Nursing Auxiliaries received a 3-day period of In-service training. No. of cases nursed 4725 No. of patients under 5 at first visit 203 No. of patients 65 or over at first visit 3049 Marie Curie Memorial Foundation The authority continues to act as agents for the Foundation and during the year 25 patients were provided with day and/or night nursing to assist relatives in caring for them. 68 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. 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. 533,568 pads and 1248 pairs of waterproof pants and linings were issued during the year. Clinics for the Elderly A total of 51 sessions were held at West Hendon and Watling (Edgware) Clinics and 1286 attendances made. Chiropody The number of persons treated during the year again increased. 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 Organisations Elderly persons 3761 647 Physically handicapped 27 - Expectant and nursing mothers 9 - Schoolchildren 24 - Children under 5 years 5 - Totals 3826 647 69 The nursing homes named below are registered with the Borough in accordance wit the provisions of the Public Health Act, 1936, the Nursing Homes 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 1971 No. of Beds The Garden Clinic, Maternity 3 46 Sunny Gardens Road, N.W.4. Surgical/Medical/ Chronic 13 Brent Nursing Home, 4-6 Heather Gardens, N.W.ll. 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 13 Highwood House Nursing Home, Highwood Hill, N.W.7. Medical/Chronic 21 Braeside Clinic, 76 Park Road, New Barnet. Surgical 10 Ravenscroft Park Nursing Home, 4 Ravenscroft Park, Barnet. Medical/Chronic 14 Heath Hall Nursing Home, The Bishops Avenue, N.2. Medical/Chronic 35 Bedford House, Hammers Lane, N.W.7. Chronic 23 Convent of St. Mary at the Cross, Hale Lane, Edgware. Incurable Orthopaedic (Female) 48 70 Registration of Nursing Homes Nursing Homes registered year ended 31st December 1971 (contd.) No. of Beds Manor House Hospital, North End Road, N.W.ll. Medical/Chronic 157 Stuart House, 66 West Heath Road, N.W.3. Chronic 8 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. Court Nurses Agency 397 Hendon Way, N.W.4. Albany Nurses Agency 7/7a Station Road, N.3. Universal Nursing Service 61 High Street, Edgware. were inspected during this year and their licences renewed. Priority Dental Service Attendances and Treatments Children under 5 Expectant and Nursing Mothers First Visit 613 107 Subsequent Visits 554 172 Total Visits 1167 279 Number of Additional Courses of treatment commenced 67 18 Treatment Provided Number of fillings 954 247 Teeth filled 885 231 Teeth extracted 101 32 General anaesthetics 43 2 Emergency visits 15 6 Patients x-rayed 22 42 Patients treated by scaling etc. 52 76 Teeth otherwise conserved 176 - Teeth root filled - 4 Inlays/Crowns - 7 Number of Courses of treatment completed during the year 311 57 71 Prosthetics Patients supplied with full upper or full lower (first time) 8 Patients supplied with other dentures 12 Number of dentures supplied 20 Anaesthetics General anaesthetics administered by dental officers Nil Inspections Children under 5 Expectant and Nursing Mothers No. of patients given first inspection 506 73 No. of patients who required treatment 276 67 No. of patients who were offered treatment 276 67 Number of Dental Officers sessions devoted to maternity and child welfare patients 152 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 1971. Respiratory Non-Respiratory Men Women Children Total Men Women Children Total 1344 987 68 2399 58 92 2 152 72 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, 1971. Men Women Children Total A. Respiratory Non-Bacteriologically Confirmed 46 30 * 94 170 B. Respiratory Bateriologically Confirmed 23 13 - 36 TOTALS 69 43 94 206 * This figure includes 90 school children (or immigrants under school age) who were found to be tuberculin positive on Heaf testing and had not previously had B.C.G. 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 1971. Men Women Children Total 11 13 1 25 4. Number of cases included in 1 above whose broncho-pulmonary secretion was positive during the year - 29. 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. 73 Cervical Cytology This service continued during the year at the following clinics:- Torrington Childs Hill Watling Vale Drive West Hendon Oak Lane 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. 1260 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 24 237 259 10.8 East Barnet 9 81 109 12.8 Oak Lane 19 143 164 8.5 Torrington 40 199 283 7.7 Vale Drive 16 67 81 5.0 Watling 33 310 349 10.6 West Hendon 22 136 159 7.2 Osidge 10 87 113 11.3 TOTALS 173 1260 1517 8.7 Vaccination and Immunisation Smallpox Vaccination In July I was informed by the Department of Health and Social Security that the Secretary of State had accepted the advice of the Joint Committee on Vaccination and Immunisation that vaccination against smallpox need no longer be recommended as a routine procedure in early childhood and I therefore instructed the Department's medical staff to delete smallpox vaccination from existing routine schedules. Vaccination continues to be recommended for travellers to and from countries where smallpox is endemic or where eradication programmes are in progress and for health service staff who may come into contact with patients. 74 Statistical tables for the immunisation of persons under the age of 16 are given Delow. Table 1. Completed Primary Courses Type of Vaccine or Dose Year of Birth Others under age 16 TOTAL 1971 1970 1969 1968 1964-67 1. Quadruple DTPP — _ 2. Triple DTP 92 1973 724 50 44 7 2890 3. Diphtheria/Pertussis — 1 2 — 1 — 4 4. Diphtheria/Tetanus 2 110 76 21 74 36 319 5. Diphtheria - - - - 1 2 3 6. Pertussis — - — — - - - 7. Tetanus 3 1 1 2 41 382 430 8. Salk - — — — - - - 9. Sabin 82 2050 779 80 135 148 3274 10. Measles 4 875 872 291 416 27 2485 11. Rubella — — — — — 1183 1183 12. Total immunised against Diphtheria (Lines 1-2-3-4-5) 94 2084 802 71 120 45 3216 13. Total immunised against Whooping Cough/Pertussis (Lines 1-2-3-5) 92 1974 726 50 45 7 2894 14. Total immunised against Tetanus (Lines 1-2-4-7) 97 2084 801 73 159 425 3639 15. Total immunised against Polio (Lines 1-8-9) 82 2050 779 80 135 148 3274 Table 2. Re-inforcing Doses Type of Vaccine or Dose Year of Birth Others under age 16 TOTAL 1971 1970 1969 1968 1963-67 1. Quadruple DTPP _ _ _ — — — — 2. Triple DTP 13 149 168 32 527 72 961 3. Diphtheria/Pertussis - - . - - - - - 4. Diphtheria /Tetanus 1 15 35 20 2215 343 2629 5. Diphtheria - - - - 15 12 27 6. Pertussis — - - 2 1 1 4 7. Tetanus — 3 5 9 118 1444 1579 8. Salk — — — — - - - 9. Sabin 15 160 187 54 2597 1984 4997 75 Table 2. Re-inforcing Doses (Contd.) Type of Vaccine or Dose Year of Birth Others under age 16 TOTAL 1971 1970 1969 1968 1963-67 10. Total immunised against Diphtheria (Lines 1-2-3-4-5) 14 164 203 52 2757 427 3617 11.Total immunised against Whooping Cough Pertussis (Lines 1-2-3-6) 13 149 168 34 528 73 965 12. Total immunised against Tetanus (Lines 1-2-4-7) 14 167 208 61 2860 1859 5169 13. Total immunised against Polio (Lines 1-8-9) 15 160 187 54 2597 1984 4997 B.C.G. Vaccination against Tuberculosis School children and students were vaccinated at school and at establishments for further education by the Department's medical staff and contacts of tuberculosis were vaccinated at Chest Clinics in the Borough. A tuberculin test was offered to young immigrants arriving in the Borough during the year and, where the result was positive, arrangements were made for further investigation and supervision at a chest clinic. Tuberculin Test and B.C.G. Vaccination No. of persons vaccinated through the Authority's approved arrangements under Section 28 of the National Health Service Act. (a) CONTACTS (i) No. skin tested 125 (ii) No. found positive 8 (iii) No. found negative 117 (iv) No. vaccinated 129 76 (b) SCHOOL CHILDREN AND STUDENTS (excluding those known to have hud B.C.G. vaccination already) (i) No. skin tested 3,188 (ii) No. found positive 309 (iii) No. found negative 2,611 (iv) No. vaccinated 2,608 (c) SCHOOL CHILDREN AND STUDENTS (known to have previously had B.C.G. vaccination) (i) No. skin tested 248 (ii) No. found positive 196 (iii) No. found negative 41 (iv) No. vaccinated 51 77 CLINIC PREMISES Main Clinics Clinic Sessions (See Key Table on page Brunswick Park Road, N.ll. I.W.C. C D SP DV (Osidge) OPH ORT T Town Hall, Hendon, N.W.4. I.W.C. CSC D OPH ORT (Central) SP CHIR DV A/N A/NE-M/C Garth Road, N.W.2. I.W.C. C D SP CHIR DV A/N A/NE-M/C CSC 149 East Barnet Road, I.W.C. CSC C D SP Barnet. DV A/NE-M/C A/N(M) Holly Park, N.ll. I.W.C. D SP CHIR DV A/N CSC Hartley Avenue, N.W.7. I.W.C. CSC D SP CHIR (Mill Hill) DV A/N A/NE-M/C M/C Oak Lane, N.2. I.W.C. C D SP CHIR DV A/N A/NE-M/C OPH ORT CSC T Oakleigh Road, N.20. I.W.C. DV A/N A/NE-M/C CSC T Sutton Road, N.10. I.W.C. SP DV A/N A/NE-M/C CSC T Torrington Park, N.12. I.W.C. C CSC SP CHIR A/N A/NE-M/C DV Vale Drive, Barnet I.W.C. CSC SIC C D SP DV A/NE-M/C OPH ORT A/N(M) PAU 36 Cressingham Road, I.W.C. CSC C D SP Burnt Oak CHIR A/NE-M/C OPH ORT CE York Road, N.W.9. I.W.C. CSC C D SP (West Hendon) CHIR A/N A/NE-M/C DE Claremont Way, N.W.2. I.W.C. Approach Road, Edgware I.W.C. CSC SP CHIR A/N A/NE-M/C 78 Other Premises Etchingham Park Road, N.3. I.W.C. CHIR St. Andrew's Church Hall, I.W.C. DV Lynford Gardens, Edgware. (Broadfields) St. Stephens Hall, I.W.C. Bells Hill, Barnet Dollisfield, I.W.C. Totteridge Lane, N.20. United Free Church Hall, I.W.C. Sanders Lane, N.W.7. St. Barnabas Church Hall, I.W.C. DV Cranbourne Gardens, N.W.ll. St. Mark's Hall, I.W.C. Woodville Road, Barnet. Congregational Church Hall, I.W.C. Colin Close, N.W.9.' St. Mary Magdalene Church I.W.C. Hall, Holders Hill Road, N.W.4. KEY TABLE I.W.C. Infant Welfare Clinic CSC Consultative School Clinic A/N Ante-Natal Clinic CE Clinic for Elderly OPH Ophthalmic SP Speech Therapy M/C Mothercraft only A/NE-M/C Combined Ante-Natal Exercises and Mothercraft ORT Orthoptic A/N(M) Ante-Natal Clinic - Midwife only D Dental CHIR Chiropody 79 KEY TABLE (Contd.) DV Development Clinic T Toddlers Clinic C Cervical Cytology SIC Special Investigation Clinic PAU Paediatric Assessment Unit 80 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 the facilities provided under the National Health Service Act, 1946. In accordance with the requirements of the Education Act, 1944, 103 children were reported to the Authority during the year as suffering from a disability requiring some form of special educational treatment. School Population The following table shows the school population in the Borough as at 31st December, 1971:- Schools No. of Pupils Primary Schools 26,313 Secondary Schools 19,867 1 Residential Special School (E.S.N.) 178 4 Day Special Schools (E.S.N.) 389 1 Diagnostic Unit 32 1 Autistic Unit 4 46,783 Periodic Medical Inspections The routine medical inspection of school entrants and leavers together with an intermediate examination during the last year at primary school is the continuing policy of the Authority. The following table shows the number of children inspected by years of birth and the state of their physical condition:- 83 Year of Birth Number of Pupils Inspected Physical Condition of Pupils Inspected Satisfactory Unsatisfactory 1967 & later 392 392 - 1966 2,025 2,025 - 1965 1,580 1,580 1964 295 295 - 1963 245 245 - 1962 201 201 - 1961 1,033 1,032 1 1960 2,134 2,134 - 1959 865 865 - 1958 365 365 - 1957 1,834 1,829 5 1956 & earlier 1,156 1,156 - TOTAL 12,125 12,119 6 Percentage of pupils inspected whose physical condition was found:- Satisfactory 99.95% Unsatisfactory 0.05% 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. Infestation with Vermin 22,422 pupils were examined in school by the nursing staff in accordance with Section 54 of the Education Act, 1944. 315 pupils were found to be infested and arrangements for cleansing were made. Ophthalmic Clinics The 5 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. Squint Diagnostic Clinics The Squint Diagnostic Clinics introduced in January last year at Central Hendon, Oak Lane and Vale Drive Clinics, have proved to be very successful. The numbers attending in 1970 and 1971 are given below 84 (a) No. of new patients (b) No. of patients included in (a) referred to the Ophthalmologist (c) No. of patients included in (b) found to have a squint 1970 62 32 16 1971 113 64 38 Audiometry Two Audiometer Operators carry out 3 rountine 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. Sweep tests 12,126 Re-tests 474 Special tests 2,114 Re-tests 408 Audiology The Consultant Otologist sees those children referred for further investigation of a loss of hearing at either the Tottenham or Neasden Audiology Unit. Much useful work has been done by the Authority's peripatetic teacher of the deaf in the supervision and training of children in ordinary schools with a significant degree of hearing loss. During the year 10 children were provided with hearing aids and at the end of the year 98 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 with Dr. A.D. Black, Consultant Child Psychiatrist as the Medical Director, and The Health Clinic, Vale Drive, Barnet, Herts. where Dr. Gross is acting in a locum tenens capacity as Consultant Child Psychiatrist and Medical Director following Dr. Todes' resignation from this position in the earlypart of the year. 85 No. of Cases under consultation during the year 318 Total attendances of patients to see:- (a) The Psychiatrist 375 (b) The Psychologist 233 (c) The Psychiatric Social Worker 1,322 (d) The Psychotherapist 502 Speech Therapy The Authority has an establishment of 5 Speech Therapists but only 4 Therapists were in employment as it was not possible to fill the vacancy that occurred during the latter part of last year. Sessions were undertaken within the School Health Service in clinics and special schools and during the year a total of 497 children handicapped by speech or language disorders received treatment and supervision. A pre-school language group was initiated for children of 3-5 years of age who it was thought would benefit from group therapy rather than individual treatment and I will report further on this project when results are available. Handicapped Pupils The Education (Handicapped Children) Act, 1970, provided, with effect from 1st April, for all those children who would have previously been determined unsuitable for education at school to be brought into the educational system. Therefore more than 100 children in the Borough of all ages became subject, for the first time, to Section 34 of the Education Act, 1944, which 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 five special schools for handicapped children:- Oak Lodge Day Special School for Educationally Subnormal pupils 86 Northway Day Special School for Educationally Subnormal pupils Flower Lane Day Special School for Educationally Subnormal Pupils Friern Barnet Day Special School for Educationally Subnormal Pupils Swaylands Residential Special School for Educationally Subnormal Boys The Flower Lane and Friern Barnet Schools were previously Junior Training Schools, but became Special Schools on the transfer of responsibility for the education of mentally handicapped children from the Local Health Authority to the Local Education Authority, on 1st April. There is also a Unit providing special education for children suffering from Autism, attached to the Grasvenor Avenue Infants' School. The following Table shows the number of handicapped pupils as at 31st December, 1971:- Special Day Schools Special Residential Schools Mainta ined Primary & Secondary Schools Independent Schools Not at School Total B G B G B G B G B G B G Blind 2 2 1 _ — 1 3 3 Partially Sighted 5 6 1 1 - 1 - - - - 6 8 Deaf 7 6 1 4 - - - - - - 8 10 Partially Hearing 12 13 4 - 1 1 - - - - 17 14 Delicate 9 3 9 4 4 1 1 - 1 1 24 9 Educationally Subnorma1 102 86 18 3 1 4 - - - - 121 93 Epileptic - 1 3 3 1 Maladjusted 10 6 40 15 5 3 2 1 4 1 61 26 Physically Handicapped 23 9 7 7 8 3 - - - 6 38 25 Speech Defects - - - 1 - 1 1 - - - 1 2 Total No. Handicapped Pupils 168 132 85 36 19 14 4 1 6 8 282 191 87 Special Transport to School Section 55 of the Education Act, 1944, makes provision for transport to facilitate the attendance of pupils at school and, during the year, special transport was recommended on medical grounds for 43 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 11 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 1967 & later 4 15 18 1966 44 175 196 1965 49 187 200 1964 8 41 44 1963 11 28 30 1962 11 25 31 1961 97 86 169 1960 135 165 273 1959 81 79 150 1958 29 22 39 1957 188 79 251 1956 & earlier 153 69 211 TOTAL 810 971 1,612 88 PERIODIC INSPECTIONS t Code No. Defect or Disease Entrants Leavers Total incl. all others age groups Special Inspections 4 Skin: T O T O T O T O 40 39 20 12 : 170 161 6 1 5 Eyes: (a) Vision (b) Squint (c) Other 107 32 1 270 31 7 323 13 6 165 8 13 1,190 109 19 991 93 80 90 1 45 5 6 Ears: (a) Hearing 88 163 13 40 201 379 30 28 (b) Otitis Media 16 49 11 4 59 115 5 5 (c) Other 1 7 3 6 4 29 3 3 7 Nose & Throat 34 103 2 30 58 287 7 4 8 Speech 40 101 2 10 92 167 22 5 9 Lymphatic Glands 3 12 - 2 3 52 - - 10 Heart 6 55 2 9 18 134 1 7 11 Lungs 15 52 4 20 45 164 3 6 12 Developmental: (a) Hernia 9 17 — 2 15 41 _ 2 (b) Other 7 90 3 13 32 227 12 13 13 Orthopaedic: (a) Posture 2 9 4 7 82 82 1 1 (b) Feet 7 27 9 9 56 136 1 1 (c) Other 5 18 5 11 32 95 1 2 14 Nervous Svstem: (a) Epilepsy 2 8 2 4 22 34 1 1 (b) Other 2 10 1 10 15 66 - - 15 Psychological: (a) Development 1 37 — 1 3 186 4 6 (b) Stability 3 83 4 15 21 318 10 15 16 Abdomen 3 17 - 13 5 70 - - 17 Other 87 140 31 43 234 457 35 24 T — requiring Treatment O — requiring Observation 89 TREATMENT OF PUPILS ATTENDING MAINTAINED PRIMARY AND SECONDARY SCHOOLS (including Nursery and Special Schools) GROUP 1: Eye Diseases (e.g. blepharitis, conjunctivitis), Defective Vision and Squint No. of cases known to have been treated (a) External & other, excluding errors of refraction & squint 5 (b) Errors of refraction, including squint 2,426 TOTAL: 2,431 (c) No. of pupils for whom spectacles were prescribed 687 GROUP 2: Diseases and Defects of Ear, Nose and Throat Received operative treatment for: (a) Diseases of the ear - (b) Adenoids and Chronic Tonsillitis 27 (c) Other nose and throat conditions 1 Received other forms of treatment - TOTAL: 28 Total No. of pupils in schools who are known to have been provided with hearing aids: (a) in 1971 10 (b) in previous years 88 GROUP 3: Orthopaedic & Postural Defects No. of pupils known to have been treated in clinics or at out-patients departments GROUP 4: Diseases of the skin (excluding uncleanliness) Ringworm (i) scalp - (ii) body - Scabies 3 Impetigo 10 Other skin diseases 16 TOTAL: 29 GROUP 5: Child Guidance Treatment No. of pupils treated at Child Guidance Clinics 301 GROUP 6: Speech Therapy No. of pupils treated by speech therapists 497 GROUP 7: Other Treatment given: (excl. B.C.G. vaccination) (a) Minor ailments 20 (b) Convalescent treatment under School Health Service arrangements 3 TOTAL: 23 Education Act 1944 — Section 57 Cases dealt with under Section 57, Education Act, 1944 Nil Cases de-notified under Section 57(a) Education Act, 1944 Nil 90 REPORT OF THE PRINCIPAL SCHOOL DENTAL OFFICER Staff The appointment of two full time dental officers made its impact on the number of school dental inspections, which rose by 6,000 above the number carried out in 1970. The improvement would have been still greater but for losing the services of some parttime dental officers. Equipment The policy of bringing the lighting, x-ray apparatus and air motors in all surgeries up to a high standard was continued and a programme was prepared for replacing some other dental units which, although serviceable, were obsolete and difficult to keep supplied with accessories and spare parts. Health Education It is certain that the health education programme will need major expansion in the near future, with particular reference to the form of fluoride treatment which may be selected. It is regretted that fluoridation of the water supply has to be considered for the future rather than the present. Orthodontics and Crown Work A large number of children receive orthodontics treatment and the parents show a particular interest in the results. The provision of crown work is another service well received by both parents and patients. Dental Laboratory The laboratory gives a highly satisfactory service, much appreciated by all dental surgeons. The personal service given by having a laboratory within the department is highly beneficial. Residential School The children at Swaylands Residential School continue to have a full and comprehensive dental service provided. 91 Ages 5-9 Ages 10-14 Age 15 & over Attendances for Treatment: First visit 3,992 3,333 614 Subsequent visits 6,831 7,810 1,707 Total visits 10,823 11,143 2,321 Additional courses of treatment commenced 487 308 68 Fillings in permanent teeth 3,307 6,540 3,613 Fillings in deciduous teeth 7,978 1,556 — Permanent teeth filled 2,934 5,760 3,173 Deciduous teeth filled 6,672 1,497 - Permanent teeth extracted 61 290 54 Deciduous teeth extracted 1,561 720 - General anaesthetics 482 177 12 Emergencies 225 185 24 Prosthetics: Pupils supplied with full upper or lower (first time) 1 Pupils supplied with other dentures (first time) _ 4 4 Number of dentures supplied 1 4 4 92 Number of pupils X-rayed 1,158 Prophylaxis 1,434 Teeth otherwise conserved 2,032 Number of teeth root filled 61 Inlays 5 Crowns 65 Courses of treatment completed 5,662 Orthodontics: New cases commenced during year 210 Cases completed during year 115 Cases discontinued during year 40 Number of removable appliances fitted 495 Number of fixed appliances fitted 49 Pupils referred to Hospital consultant 5 Anaesthetics: General anaesthetics administered by Dental Officers 4 Inspections: (a) First inspection at school Number of pupils 29,374 (b) First inspection at clinic Number of pupils 2,806 Number of (a) and (b) found to require treatment 12,967 Number of (a) and (b) offered treatment 11,889 (c) Pupils re-inspected at school or clinic 1,014 Number of (c) found to require treatment 237 SESSIONS Sessions devoted to treatment 4,011 Sessions devoted to inspection 206 Sessions devoted to dental health education 8 93 GENERAL SERVICES GENERAL SERVICES HEALTH EDUCATION The first Expert Committee, reporting in 1954, defined the aims of Health Education simply as (1) to make health a valued community asset; (2) to equip the individual with knowledge and skills and to change attitudes and behaviour so that he could solve many of his own health problems; and (3) to promote the development of the Health Service. Recently the Expert Committee on Research in Health Education offered a much more elaborate and sophisticated definition, i.e. that health education concerns 'all those experiences of an individual group, or community that influences beliefs, attitudes and behaviour with respect to health' and therefore needs a multidisciplinary approach. Health Education in Clinics In all clinics, information on child care, care of the elderly and healthy living generally is available to the public. Expectant Parent Groups Classes in psychophysical preparation for childbirth are held in a number of clinics, conducted mainly by Health Visitors and/or Midwives, using visual material i.e. hand-out material, slides, films and other media. Where possible, husbands are encouraged to participate in at least one of the classes. The childbirth film 'Barnet' was shown 12 times during the year for expectant parents. Mother Discussion Groups This aspect of health education functions well in some clinics, but need development elsewhere. Where these groups have functioned there has been lively discussion over a variety of subjects in which Health Education staff have been frequently involved. 97 Clinics for the Elderly Although the prime function of these clinics is screening of the elderly, the contribution which health education makes is of tremendous value. The old folk are helped to understand their needs, ways in which they can maintain their health, and the contribution they can still make to society. Within a short time, they communicate as a group showing concern and caring for each other and are appreciative of the instruction they receive in a wide variety of subjects. Health Education in Schools Not all schools can be instructed in health matters by Health Department staff and indeed, many schools prefer to undertake this teaching themselves. This becomes obvious as more and more teachers, student teachers, children and parents contact the Department for information and material on health subjects for project work. This trend is good. Health courses in schools usually comprise a complete year's work covering most aspects of healthy living. The following is a synopsis of the courses undertaken : Primary Schools, (5—11 years) Full years course 11 One or two term courses 1 Short courses 2 Secondary Schools, (13 — 15 years) Full years course 6 Short courses 2 Occasional talks 10 Special Schools, (Educationally sub-normal) Short courses 2 Occasional talks 4 Parent/Teacher Associations Instruction of the young in health matters is of utmost importance, but the backing of parents is essential in establishing healthy attitudes and havits. Subjects discussed in home/school groups have been mainly sex education of the children but infectious diseases (including the sexually transmitted diseases), smoking, drug abuse, infestation and safety are others which have been of interest. 98 General Publicity The effectiveness of posters and leaflets is debatable, but there is so much antihealth advertising that there must be some visual information to counteract it. It is ironical that if information is not available it is quickly missed. General publicity on a monthly subject basis has therefore continued. Subjects covered are as follows : Dental Health Immunisation Prevention of Burns and Scalds Nutrition and weight control Venereal Diseases Food Hygiene Holiday Health Cervical Cytology Care of the Elderly Water Safety Displays and Exhibitions Window Displays Displays were mounted at Gateway House, concerning care of the elderly and fireworks. A display showing the safe use of fireworks was also mounted at Friern Barnet Town Hall. Health Education in other Organisations Requests for talks, film shows etc. on health matters came from various organisations and sections of the community. These included : Industrial groups 1 Youth organisations 33 Mothers, Young wives, Womens & Mens 29 Parent/teacher 14 Old Peoples Clubs & Voluntary Bodies The above talks covered a wide variety of health topics. A total of 134 film shows were undertaken during the year. 99 Courses were undertaken for : The British Red Cross — Health and Hygiene Leaders of youth organisations — Home Safety Teachers at Teachers Centre — First Aid Infectious Diseases Pre-retirement Association — Health in Retirement In-Service Training in Health Education The following courses were arranged for staff and others : A one day course in poster and display for clinic nurses. A three day course for Health Visitors and Midwives on psychophysical preparation for childbirth. A five day course in teaching method for health visitors. A single session for General Practitioners and Health Department Staff on Smoker's Withdrawal Clinics. Health Education staff also participated in the following courses : Training of Pupil Midwives Training of Auxiliary Nurses In-Service Training of Health Department staff Student Health Visitor Training Home Nurse Training In addition the Health Education Officer was engaged in outside lectures at Barnet College of Further Education, North London Polytechnic, London Boroughs Training Committee, Royal College of Nursing and represented the Borough in the Greater London Home Safety Council Meetings. First Aid Championships An inter-boroughs first aid championship was organised by another Borough and eliminating contests were arranged by the Health Department to find the representative team from this Borough. Smokers Withdrawal Clinics Two further courses were held using the Five Day Plan and followed by a reunion of participants after six weeks. Each had approximately the same success rate as those held in previous years i.e. 60%. success after 6 weeks. The long term results of the 1971 clinics will be be known until 1973. 100 The results 18 months - 2 years after the 1969 clinics are as follows : Known success 29% Known failures 34% Not known 35% Home Safety Education General Publicity Posters and leaflets were widely distributed supporting the quarterly campaigns of R.o.S.P.A. To give added publicity to the dangers of fireworks, a decorated car with loud hailer toured some streets urging care in their use. Articles were prepared for the press and 'Home Safety Tips' for Barnet Civic News covering safety in the water, safety with electric blankets and fire prevention. Training and Talks As many youth organisations provide safety education (e.g. for Duke of Edinburgh's Award or Guide and Scout Accident Prevention badges) a four weeks course was organised for leaders to equip them to undertake thorough training of the young in this important subject. The response was disappointing but those who participated felt it was well worthwhile. The section also acts as a testing station for young people taking the badges. Requests for talks on home safety are frequently made by various groups and are always met. In addition education in home safety is continuous within the schools and clinics where health education is undertaken. Campaigns and Projects Disposal of Medicines Campaign The Campaign which lasted for three weeks during May was disappointing in that only just over half the pharmacists participated, resulting in a marked drop in the amount of material collected as compared with 1970. However, if even one accident was prevented the effort was worthwhile. Home Safety Quiz This year the Quiz was held in Primary Schools, twenty one schools initially entering the contest but a few withdrawing as the preliminary rounds approached. 101 Preliminary rounds were played during February and March, culminating in the Final Contest on March 19th. The Question Master was Susan Stranks of I.T.V.'s Magpie programme before a good audience. This event was relayed on Radio London's Home Run programme and the Cup was presented by the Deputy Mayoress. Preparations for the Senior Home Safety Quiz were commenced in the autumn term in readiness for the contest next spring. Displays and Exhibitions Finchley Carnival and The Summer Show The Health Education Section participated in the procession at the Carnival, entering a float featuring Old Nick O' Teen and his slaves. In the marquee displays and competitions were organised for both events. 102 SPECIAL INVESTIGATION CLINIC The clinic exists basically for the treatment of childhood enuresis and encopresis. The number of new patients seen (190) shows an increase compared with 1970 (153) but only 6 additional sessions were used. The referrals still continue to increase and this trend lengthens the period of time spent on the waiting list. This may reflect in the considerable number of first appointment failures .(110): approximately half the patients referred fail to turn up for the first appointment. This shows an uneconomic use of clinic man-power and also denies other children an earlier appointment. Detailed analyses of factors possible relating to appointment failure have been undertaken by Mr. R.T.T. Morgan as part of his Ph.D. investigation into the 1969 cohort of referred children. The following papers have been accepted for publication: 1. Non-attending Enuretic children. 2. Over-learning in the Conditioning treatment of Enuresis. 3. The treatment of Enuresis:Merits of Conditioning methods. 4. Reasons for Appointment failure among Enuretic patients. The Research work on over-learning theory has been completed and this reveals a dramatic reduction in the recurrence rate if this technique is used in conjunction with the classic conditioning method. The intensity tone conditioning experiments are near completion and analyses will be undertaken next year. BOYS GIRLS TOTAL No. of new patients seen: Under 5 3 9 12 5-9 95 54 149 10 & over 21 8 29 TOTAL 119 71 190 Total Attendances: 1041 667 1708 No. of 1st Appointment Failures: 62 48 110 Total Appointment Failures: 576 295 871 Referrals: Under 5 26 15 41 5 - 9 134 86 220 10 & over 24 21 45 TOTAL 184 122 306 Discharged Cases: 89 68 157 (of these, discharged for 2nd subsequent time: 13 14 27 ) 103 Relapsed Cases: Discharged 1967: - - - Discharged 1968: - 1 1 Discharged 1969: 2 1 3 Discharged 1970: 12 11 23 Discharged 1971: 6 7 13 TOTAL 20 20 40 Total Sessions: 98 Total Appointments: 2579 Average Appointed Number/Session: 26 OBESITY CLINIC On the 27th May, 1971, a special clinic commenced operation to treat childhood obesity. The problem of obesity has been increasing in the adult population and also in children, and the object of the clinic is to reduce the incidence in children and also to invite the parents (if obese) to participate. Where parents have expressed this desire, their general practitioners have been contacted before any treatment has commenced. Referrals for the 7 mpnth period have totalled 80 but the first appointment failure rate is approximately a half, which is similar to the rate among children attending the special investigation clinic for the treatment of enuresis. BOYS GIRLS TOTAL No. of new patients seen: Under 5 - - — 5 -9 2 6 8 10 & over 5 18 23 TOTAL 7 24 31 Total Attendances: 63 171 234 No. of 1st Appointment Failures: 14 22 36 Total Appointment Failures: 27 45 72 Referrals Under 5 1 1 5-9 5 11 16 10 & over 25 38 63 TOTAL 30 50 80 Total Sessions: 27 Total Appointments: 306 Average Appointed Number/Session: 11 104 HOME DIALYSIS Adaptations of homes to install artificial kidney machines This form of domiciliary treatment is being developed and in the London Borough of Barnet we now have 11 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 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 34. BURIAL AND CREMATION It is the duty of the Local Authority under Section 50 of the National Assistance Act 1948 to cause to be buried or cremated the body of any person who has died in or been found dead in the area, in any case .where it appears to the Authority that no suitable arrangements for the disposal of the body have been or are being otherwise made. The expenses incurred may be recovered from the estate of the deceased person, by death grant subject to the contribution conditions being satisfied, or from any person who for the purpose of the Act was liable to maintain the deceased person immediately before death. Five cremations or burials were carried out during the year. CREMATION CERTIFICATES The Medical Officer of Health, Deputy Medical Officer of Health and a Principal Medical Officer are appointed Medical Referees under the Cremation Act 1902 and 1952. During the year 1217 Certificates were examined and approved. 105 DOMICILIARY LAUNDRY SERVICE This is a service to assist families to care for the elderly, or to nurse chronically sick people of any age at home. A once a week collection and delivery is dealt with by the Department, and the cleansing and laundering of soiled linen and clothing is carried out at Colindale Hospital. This service is much appreciated by all who use it and thanks are due to the Hendon Group Hospital Management Committee. At the end of the year 45 persons were receiving assistance. MEDICAL ASSESSMENTS AND EXAMINATIONS Applicants for employment complete a health questionnaire, the replies to which are normally sufficient for a decision to be taken on their engagement. Medical examinations are given only in doubtful cases and to all student teachers and newly appointed teachers. Some examinations are also given to staff with extensive sick leave records and to prospective employees of local authorities in other parts of the country; a reciprocal service is received from other authorities. Medical Examinations — First Teaching Appointment 109 Student Teachers 394 Other Education Department Staff 67 Other Council Departments 79 Other Authorities 14 Total 663 Medical Questionnaires assessed 1922 TRAINING COURSES AND STUDENT ATTACHMENTS Members of the staff received a wide variety of training arranged by educational and professional organisations and within the department. The courses, conferences and study days covered the following subjects:- Medical Specialities Nursing Organisation Health Visitor Training Home Nursing Training Psychoprophylactic Training for Child birth Midwifery (Refresher Courses) Family Planning Welfare of elderly and handicapped persons and children 106 Community Play Centres Environmental Control Building Construction Housing Improvements Health Education and Home Safety Smoking Management Techniques Reorganisation of the National Health Service Mental Handicap and Illness Computer Appreciation Speech and Learning Problems Retirement Twenty-four pupil midwives from Edgware General and Bushey Maternity Hospitals completed 3-month periods of district training in the Borough in preparation for the Part II Midwifery Certificate. Four home nurses completed training courses and passed the examination for the National Certificate for District Nurses. 107 INDEX INDEX PAGE A Animals 60 Ante-Natal Clinics 66 Audiology 85 Audiometry 85 B BCG Vaccination76 Births and Birth Rates 9, 15, 18 British Red Cross Society - Loan of Equipment 69 Burial and Cremation 105 c Cancer 17 Caravans 52 Care of Mothers and Young Children 66 Cervical Cytology 74 Chest Clinics 72 Child Guidance Service 85 Child Welfare Centres 67 Chiropody 69 Clean Air 42 Clearance Areas 45 Clinics for the Elderly 69, 98 Clinic Premises 78 Committee Members 5 Common Lodging Houses 48 Complaints - Environmental Health 52 Compulsory Improvement Areas 47 Congenital Malformations 66 Contents 3 Cremation Certificates 105 D Deaths and Death Rates 13, 14 Dental Services, Priority 71 Dental Services, School 91 Disinfection and Disinfestation 61 Domiciliary Laundry Service 106 E Elderly, Clinics for 69, 98 Encopresis 103 Enuresis 103 Environmental Health Service 29 Establishments for Massage and Special Treatment 105 Exhumations 62 PAGE F Factories and Work Places 66 Family Planning 73 Fire Regulations 49 Fluoride 91 Food 29, 30 Food - Complaints 36 Food Labelling 38 Food Samples, Formal & Informal 30 Food unfit for human consumption 37 G General Practitioner - Staff Attachments .. 65 General Services 97 H Handicapped Pupils 86 Hawkers 39 Health Education 97 Health Visitors 65 Health Committee 5 Home Dialysis 105 Home Nursing 68 Home Safety 101 Home Tuition 88 Homelessness 44 Houses in Multiple Occupation 48 Houses, Unfit 45 Housing 44 Housing Accommodation 44 Housing - Area Improvement 47 Housing - Improvement 46 Housing - Statistics 50 Housing Act, 1969 49 I Ice Cream 34 Immunisation and Vaccination 74 Improvement Areas 46 Incontinence Pads and Clothing 69 Incontinence Laundry Service 106 Infantile Mortality 10, 106 Infectious Diseases 25 In-Service Training Course 100 Inspections - Environmental Health 52 International Certificates of Vaccination 25 L Labelling of Food 38 Land Charges 54 111 PAGE L (Contd.) Laundry Services 106 Legal Proceedings 41 Liquid Egg 35 Loan of Nursing Equipment 69 M Marie Curie Memorial Foundation 68 Markets 39 Massage and Special Treatment 105 Maternal Mortality 12 Medical Assessments & Examinations 106 Medical Inspections & Treatment (Schools) 83 Midwifery 68 Milk-Registration, Licensing & Sampling .35 Mortuaries 62 Mothercraft & Relaxation Clinics 66 Mothers' Discussion Groups 66, 97 N Noise 54 Nurses Agencies 71 Nursing Homes, Registration 70 0 Obesity 104 Offices and Shops 55 Opthalmic Clinics 84 Outworkers 57 Overcrowding 47 P Personal Health Services 65 Poultry Inspection 40 Prevalence and Control of Infectious and Other Diseases 25 R Rag Flock and Other Filling Materials 58 Refuse Collection and Disposal 59 Relaxation & Mothercraft Clinics 66 Rent Control 49 Rodent Control 60 s Sanitary Conveniences 58 School - Special Transport 88 School Dental Service 91 PAGE School Health Service 83 School Medical Inspection & Treatment 83 School Population 83 Sewerage and Sewage Disposal 59 Shops and Offices 55 Slaughterhouses 39 Slum Clearance & Redevelopment 45 Smallpox Vaccination 26, 74 Smoke Control 42 Social Services Directorate 1 Special Investigation Clinic 103 Speech Therapy 86 Staff 6 Staff Health Service 106 Staff Training 106 Statistics - Housing 50 - School Health Service 88 - Vital 2, 9, 17 Stillbirths 10, 12, 20 Swimming Pools 58 T Temporary Accommodation 44 Training Courses and Student Attachments 106 Transport (Schools) 88 Tuberculosis 17, 22 Tuberculosis - BCG Vaccination 76 Typhoid Fever 26 V Vaccination and Immunisation 26, 74 Vital Statistics 2, 9, 17 w Water Supply 29 112 Printed and Published by Barnet London Borough Council