EBAR 038 FORTY-SEVENTH Annual Report of the Health and Sanitary Condition OF THE East Barnet Valley Urban Sanitary District FOR THE YEAR 1920, BY W. H. ELAM, F.R.C.S., L.S.A. (Lond.), Medical Officer of Health to the Council & Assistant School Medical Officer TOGETHER WITH THE ANNUAL REPORT OF J. LEWIS, Memb. Inst. Mun. & Cy. Engrs., Cert. Inst. San. Engrs., Cert. Roy. San. Inst., Medallist Building Const. & Sanitation. BUILDING SURVEYOR and SANITARY INSPECTOR. W. H. Brown, T.U. Printer, Marriott Yard, Barnet ('Phone 864) 2 East Barnet Valley Urban District Council. LIST OF MEMBERS, 1919-20. Chairman—Mr. Councillor A. E. Passingham. V ice-Chairman— Mr. Councillor R. A. Brown. Members— Mr. Councillor Amos Ford, J.P., C.C. „ „ S. E. Frusher „ „ J. Humphreys „ „ J. Long „ „ A. E. Morgan „ „ J. A. G. Neve „ „ E. Smith „ „ W. Stutters, J.P. „ „ H. Walker, M.A. W. J. White East Barnet Valley Urban District Council. Annual Report OF THE Medical Officer of Health FOR THE YEAR 1920. To the Chairman and Members of the East Barnet Valley Urban District Council Gentlemen, I have the honour of submitting to you the 47th Annual Report of matters relative to the statistics, health and general sanitary conditions of your District, being for the year 1920. Physical Features and General Character of the District. The Urban Sanitary District of East Barnet Valley is within the Administrative County of Hertford, being situate on the extreme southern portion of the County. Geographically, however the District is almost surrounded by the County of Middlesex, the exception being the north western portion of the boundary, which adjoins the Urban Sanitary District of Barnet (Herts). The remaining Districts adjoining the Council's area are all urban sanitary districts, situate within the County of Middlesex, viz:—On the north, Enfield; on the south and south-east, Southgate ; on the south-west, Friern Barnet. The District Council was formed in April 1894, to succeed he old Local Board. The District comprises the Parishes of 4 East Barnet, Barnet Vale and Monken Hadley. As its name implies it lies on the side of a valley extending from Hadley to the north, to Brunswick Park in the south. The principal portion of the District is divided by the main line of the Great Northern Railway from King's Cross to the north, while it is also bounded on the east and west respectively by the main roads leading from London northwards through Southgate and Barnet. The general character of the District is residential; the area on the west of the railway has been conveniently planned, and consists principally of good-class detached and semi detached villa residences, the altitude varying from 200 to 400 feet above Ordnance Datum. The District forms a portion of a much wider area noted for the healthiness of its climate, and popularly known in and around the Metropolis as the "Northern Heights.'' On the east of the railway are situate the older portions of the District, including the village of East Barnet, and Brunswick Park at the southern extremity, most of which is developed for a much smaller class of property and is consequently more densely populated. On the north-east boundary of the District are the beautiful Hadley Woods and Common, partly grazing land and partly wooded, being parts of the old Enfield Chase. Negotiations are in progress by the Council to lease from the Hadley Commoners a portion of Hadley Common (about 4 acres in extent), including a large lake, until recently part of Beech Hill Park Estate, to be used as a recreation ground. It is expected that bathing, boating and fishing facilities will be available in the lake. The whole acquisition will make a considerable addition to the attractiveness of the District. Water. The water is obtained from wells sunk through the clay, Reading beds and borings deep into the chalk. The wells are at New Barnet, East Barnet, Potters Bar, Tettenhanger and one at 5 North Mimms. It is pumped direct into the mains or into reservoirs at New Barnet and Rowley Green. It is of great purity, pleasant to drink and almost free from organic matter or objectionable hacteria. Like all London water, it is of considerable hardness, varying in the different wells from 22 to 26 degrees of hardness (1 degree of hardnes is equal to 1 in 100,000 paits, 0.7 grains of carbonate of lime in 1 gallon of water). Much of the hardness might be remedied by boiling; this process precipitates the lime, but at the same time by boiling out the oxygen, renders the water less pleasant to the taste. So far as is known the hardness has no deleterious effect, such as causing disease of the blood vessels or the so called rheumatic affections of joints. On the other hand, those who use it are free from the diseases associated with the consumption of softer water obtained from reservoirs, such as rickets and lead poisoning. The only possible source of contamination of water obtained from the chalk would be through "swallow-holes," which are cavernous openings commonly found at the junction of the Reading beds and the chalk into which streames disappear. One of these "swallow-holes" is found near North Mimms, where water from nearly 20 square miles of land disappears. Frequent examinations of the water are made so that contaminations may be at once detected. Drainage and Sewerage. The District is sewered and drained on the separate system. The sewage is conveyed to an irrigation farm of 50 acres in area at Brunswick Park, but before it is turned on to the land, it is passed through percolating filters and finally into Pymmes Brook. Samples of the effluent are occasionally taken by the Lee Conservancy Board, but no complaints have been received. The surface water drainage is conveyed to Pymmes Brook by several brooklets. These are constantly inspected and kept free from objectionable matter. 6 Scavenging. The house refuse is collected weekly by the Council's own staff and conveyed to the tip at Brunswick Park and there burnt. The provision of a refuse destructor will have to receive the consideration of the Council in the near future. Industries and Occupations. The industries carried on within the District are at the factories of Messrs. Carr & Son, alto Messrs. Tyler & Co. at Brunswick Park. The new factory of Messts. Maw, Son & Sons has been completed. The factories and workshops in the District (including laundries and bakeries) number 129. These are periodically inspected, and the condition of etnplyment found generally satisfactory, and no special circumstance exists which is prejudicial to public health. Housing. The area of the District is 2,644 acres and the number of houses is 2,626, being 46 more than last year. This gives rather more than one acre for each house, and about 54 inmates for each house, showing that there is not much serious overcrowding, although there is considerable demand for houses. Eighteen houses are in course of erection by private enterprise. There were 26 houses completed during the year in the Council Estate houses, and there are 138 in course of erection, making a total of Council houses of 164 when the present contracts are finished probably at the end of 1921. This will considerably minimise the shortage of houses. 7 Schools. The schools in your District have been regularly visited and sanitary defects observed were duly remedied by the School Managers. There were a considerable number of children excluded from school either themseives suffering from infectious diseases or were "contacts" in the first quarter of the year, for the most part measles, but there were also cases of mumps and whooping cough. In January 35 cases of measles, February 85 cases and in March 14.2 cases. In all, 262 cases of measles were notified. It appeared desirable to close the schools, consequently Potters Road school was closed from 29th February to March, Margaret road, Victoria Road and East Barnet Schools were ' closed from 27th February to the 22nd March. Trent Park girls and infants schools were closed from the 7th to the 24th May. There were only 12 cases notified in April. In the first quarter of the year 262 notification certificates were recorded, and in the last quarter only 26. Further details will be found in Table 1. Infectious Disease. During the year, 419 notification certificates of infectious diseases were received, mostly cases of measles. In the first quarter of the year, 309 notification certificates were received, viz January 48, February 103, March 158. This number was so alarming that it was deemed desirable to close the Day Schools and recommend the closure of Sunday Schools. Accordingly, Potters Road Schools, Margaret Road, Victoria Road Schools and Brunswick Park Infants' Schools were closed from about the 27th February to the 22nd March. 8 This closure appeared to have a very beneficial effect, for in April the notifications fell to 20. In May, there were many cases of Measles in Trent Park, girls and infants, 24 certificates being received, consequently this School was closed from the 7th to the 24th May ; in June only 16 notification certificates were received. During the first half of the year 369 cases of infectious diseases were notified, in the second half only 50. There were 39 cases of Scarlet Fever notified, 16 occuring in December. Of these 13 were at an Institution in East Barnet, each member of one side of the house became infected. Another outbreak was amongst Boy Scouts from East Barnet, who occupied one tent at Jamboree at Olympia in July; 7 of the 12 boys became infected, fortunately the disease did not spread to their homes as each boy was removed to the Isolation Hospital at Barnet as he became ill, and the remaining 5, before being allowed to return to their homes, were themselves and their clothes carefully disinfected. Every case of Scarlet Fever or Diptheria is removed at once to the Isolation Hospital as a general rule, and the house of the infected person disinfected within a few hours. Antiloxius is kept at the Council Offices, and can be immediately obtained, also material for obtaining bacteriological examination of any patmological specimens. Diptheria. The cases of Diptheria were not numerous, being 15 only and fortunately there was 110 fatal one ; this disease has lost its terrors since the anti-diptheria vaccine has been used ; if this vaccine were given at once there should be no fatal end in any case of diptheria. Notification of infectious diseases may perhaps be considered a doubtful advantage, but at least it enables one to take every care to keep children in an infected house excluded from school, and adults from attending business where they might possibly spread infection. 9 Closing of the schools for preventing the spread of infectious disease may be considered a questionable method for preventing the spread of disease, but the fact already mentioned that the number of infectious diseases notified dropped from 158 in March when the schools were closed to 20 in April is a notable event. The aim is, on the one hand to prevent infectious diseases as much as possible, and on the other, to do ail that is possible to render people immune to disease. No case of small pox, enteritis fever or spotted fever were notified. Further particulars of infectious diseases appear in subsequent tables. Births The number of Births registered during the year was 254, being 131 males and 123 females. Six of them were illegitimate, 3 males and 3 females. This number gives the birth-rate per 1,000 inhabitants of approximately 17.9. No record is obtainable of the number of still-born children. Vaccination The number of successful Vaccination Certificates received by Mr. Baldock, Vaccination Officer, of children under 14 years of age was 86. The number of statutory declarations of conscientious objections was 143. No reliable figures are obtainable of vaccinations of persons over 14 years of age. Deaths The number of deaths registered was 125—males 55, females 70, giving an estimated death-rate of 8.8 per 1,000 inhabitants. 10 The number of deaths occuring in children was somewhat alarming, being 12 under one year, 5 males and 7 females; of these 9 were under six months, three being due to premature birth; in one case twins, and 2 to congenital heart defect. The largest number of deaths of all causes were in October 15, January 14, and December 13. Transferable deaths, i e. occuring outside the District in London Hospitals and other places numbered 34. Three deaths occured from violence, and two from suicide; four inquests were held. There was one death from infantile diarrhcea. Details of the causes of death and ayes at which death occured will be seen in the accompanying tables. It is notable that 49 of the 125 who died lived to be 70 years of age and upwards. Tuberculosis The report referring to Tubercular Disease is rather more favourable than last year's. At the commencement of the year there were under Dispensary, Domicilary, Institutional or Sanatorium treatment, 36 sufferers—27 males and 9 females; at the end of the year there were 21 only —17 males and 4 females. Of the 36 cases mentioned, 8 at the end of the year were at work or at school, having, apparently, fully recovered; of the affected persons, in 7 the disease appeared to be at least stationary, and they are being kept under observation. The number of deaths occurring from pulmonary tuberculosis was eleven—females 6, males 5; one death from tuberculous meningitis in a girl aged 7 who died in a London Hospital, and one from tuberculous disease of the bones of the neck in a girl also died in a London Hospital, the whole totalling 13 deaths. The number of Notification Certificates received of tubercle in different parts of the body, but mostly in the lungs, was 24. 11 In the first half of the year the carcases of three tubercular cattle were inspected and the whole condemned as unfit for human food and destroyed. There is a distinct evidence that tubercular disease in cattle is decreasing. Milk The importance of an adequate supply of clean, healthy milk of a high nutritious standard has been constantly under observation. Specimens of milk have been examined, and, with few exceptions, were found satisfactory, every individual complaint being investigated. The farms, dairies and milk shops were frequently visited and every care was taken to prevent as much as possible any chance of contamination. There is less ground for fearing tuberculous infection of milk. Sanitation Considerable progress has been made in improving the sanitary condition of the houses and general cleanliness. There is less overcrowding, the number of inmates to each house being approximately 5.4. The danger of vermin and the importance of clean backyards, fresh air and sunlight being constantly insisted upon. There are a few points in the report to be noted of a favourable character, viz the births are 51 more than last year, and the number of deaths'is 15 fewer. More houses have been built both privately and by the Council and there is less overcrowding. 12 No marked epidemic prevailed except measles early in the year, but this was of the non-malignant type; also much has been done to improve the general sanitary conditions of the houses. Details of these matters will be found in subsequent parts of the report. I have to express with pleasure my thanks to the Chairman and Members of the Council for the considerate manner in which my suggestions and recommendations have been received. Also my indebtedness to Mr. York the District Surveyor and Mr. Lewis, Sanitary Inspector for their valuable assistance. W. H. ELAM, M.O.H. and Assistant School Medical Officer 13 TABLE I. Climatic conditions in 1920. Mean Sunshine per day. hours Rainfall, inches Number of days on which rain fell Notification Certificates received Deaths January 1.48 3.03 16 48 14 February 2.14 0.55 15 103 7 March 4.26 1.52 13 158 11 April 2.90 3.85 20 20 9 May 7.42 1.30 7 24 8 June 7.23 1.64 8 16 8 July 4.77 4.50 12 13 6 August 5.10 3.97 22 7 7 September 3.57 2.34 8 4 8 October 4.32 0.84 13 6 15 November 2.13 1.95 11 4 8 December 0.90 4.75 17 16 13 14 TABLE II. Vital Statistics of District during 1920 and previous years. 1.—year. 2.—Population estimated to middle of each Year. Births. Total Deaths registered in the District. Transferable Deaths. Nett Deaths belonging to the District. 3.—Uncorrected Number. 4.—Number. 5.—Rate. 8 —Of NonResidents registered in District. 9.—Of Residents not registered in District. Under 1 Year of age At all ages. 6.—Number. 7.—Rate 10.—Number. 11.—Rate per 1,000 Nett Births. 12.—Number. 13.—Rate 1909 12963 277 21.5 119 92 16 20 72 135 10.4 1910 13240 272 20.5 83 6.3 13 12 44 96 7.2 5 1911 12400 261 21 85 7 14 18 68.5 94 7.6 1912 12600 225 230 18.2 102 8.1 1 23 15 65 124 9.8 1913 12300 224 228 18.5 107 8.7 1 25 12 52.7 132 10.7 1914 12380 231 233 18.9 78 6.3 1 24 7 34.3 101 8.1 1919 13250 203 15.3 105 7.7 4 35 1 49 140 10.3 1920 14118 254 17.9 125 8.8 11 34 12 43.1 114 8.07 Notifiable Disease. Number of Cases Notified. Total Cases Notified in each locality. Total cases removed to Hospital At all Ages At Ages: Years I—East Barnet 2—Barnet Vale 3—Monken Hadley 4-Brunswick Park Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Small Pox ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Cholera (C) Plague (P) ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Diptheria (including Membranous Croup) 17 ...... 1 5 11 ...... ...... ...... 13 2 ...... 2 17 Erysipelas 2 ...... ...... ...... ...... 1 1 ...... 2 ...... ...... ...... ...... Scarlet Fever 37 ...... 1 25 11 ...... ...... ...... 16 8 3 10 35 Typhus Fever ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Enteric Fever ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Fever Relapsing (R) Continued (C) ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Puerperal Fever ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Cerebro-spinal Meningitis ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Poliomyelitis ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Opthalmia Neonaturum ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Pulmonary Tuberculosis 22 ...... 1 4 2 11 4 ...... 16 2 ...... 4 ...... Other forms of Tuberculosis 2 ...... ...... 1 ...... 1 ...... ...... 2 ...... ...... ...... ...... Chicken Pox 21 1 9 3 6 1 1 ...... 11 2 ...... 5 ...... Pneumonia 3 ...... ...... ...... ...... 2 1 ...... 2 ...... ...... 1 ...... Polioencephalitis ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ............ Encephalitis Lethargica ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Trench Fever ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Dysentry ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Malaria ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... German Measles ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... Whooping Cough 3 1 1 1 ...... ...... ...... ...... 2 ...... ...... 1 ...... Totals 107 2 13 39 30 16 7 64 14 3 23 52 TABLE IV. Causes of and Ages at death during the year 1920. Causes of Death. Net Deaths at the subjoined ages of Residents whether occurring within or without the District. Total Deaths in Public Institutions in the District. All Ages. Under 1 year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45 45 and under 65. 65 and upwards. Enteric Fever Small Pox Scarlet Fever Whooping Cough 1 1 Diphtheria and Croup Influenza 1 1 Erysipelas Phthisis (Pulmonary Tuberculosis) 11 2 3 6 Tuberculosis Meningitis 1 1 Other Tuberculous Diseases 1 1 Cancer, Malignant Disease 14 3 4 7 Rheumatic Fever Meningitis Organic Heart Disease 20 1 4 6 9 Bronchitis 9 2 3 4 Pneumonia (all forms) 9 1 3 3 2 Other Diseases of Respiratory Organs 1 1 Diarrhoea and Entiritis 1 1 Appendicitis and Typhlitis Cirrhosis of Liver 1 1 Alcoholism Nephritis and Bright's Disease 3 3 Puerperal Fever Accidents and Diseases of Pregnancy and Parturition Congenital Debility and Malformation including premature Birth 6 5 1 Violent Deaths excluding Suicide 2 1 1 Suicide 2 1 1 Other defind Diseases 40 2 1 1 3 9 24 Diseases ill-defined or unknown 3 2 1 Totals 126 14 1 1 1 5 22 34 48 17 TABLE V. Infant Mortality, 1920 Nett deaths from stated causes at various ages under 1 year of age. Cause of Death. Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks Tot under 4 wks. 1-3 months 3-6 months 6-9 months 9-12 months Tot. under 1 yr. Small Fox Chicken Pox Measles Scarlet Fever Whooping Cough 1 1 Diptheria and Croup Erysipelas Tuberculous Meningitis Abdominal Tuberculosis Other Tuberculous Diseases Meningitis (not Tuberculosis) Convulsions Laryngitis Bronchitis 1 1 Pneumonia (all forms) Diarrhoea 1 1 Enteritis Gastritis Syphilis Rickets Suffocation (overlying) Injury at birth Congenital Malformations 1 1 1 Premature Births 3 1 4 1 5 Atrophy Debility & Marasmus Other Causes 1 1 2 2 Atelectasis Totals 4 1 1 1 7 1 2 1 11 Annual Report of Medical Officer of Health for 1920. For the Urban District of East Barnet, Valley on the administration of the Factory and Workshop Act, 1901, in connection with Factories Workshops, Workplaces and Homework. 1.—Inspection of Factories, Workshops and Workplaces. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions Factories (Including Factory Laundries) 22 4 Workshops (Including Workshop Laundries) 127 10 Workplaces 10 2 Total 159 16 2—Defects found in Factories, Workshops and Workplaces. Particulars. Number of Defects. Number of Prosecutions Found Remedied Referred to H.M. Inspector Nuisances under the Public Health Acts- Want of cleanliness 10 10 Want of ventilation 1 1 Overcrowding 1 Want of drainage of floors 1 Other nuisances Defective drains 9 2 Animals kept 9 Sanitary accommodation insufficient 1 unsuitable or defective not seperate for sexes 3 3 Offences under the Factory and Workshop Act- Illegal occupation of underground bakehouse (S. 101) Breach of special sanitary requirements for bakehouses (SS. 97 to 100) Other offences (Excluding offences relating to outwork which are included in Part 3 of this report) Total 26 26 Including those specified in Section 2, 3, 7 and 8 of the Factory and Workshop Act, as remediable under the Public Health Acts. 19 3—HOME WORK. Outworkers' Lists * (S. 107)— Lists received from other Councils— Wearing Apparel—(i) making, etc. 17 Outworkers—Workmen 2 4—REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at end of year. Number Workshops 64 Domestic Workshops 32 Workshop Laundries 2 Workshop Bakehouses 9 Domestic Laundries 3 Workplaces 4 Total number of Workshops on Register 114 5—OTHER MATTERS. Class. Number Matters notified to H.M. Inspector of Factories— Failure to affix Abstract of the Factory and Workshop Act (S. 133) Action taken in matters referred by H.M. In¬, spector as remediable under the Public Health, Acts, but not under the Factory and Workshop Act (S 5) 'Notified by H.M. Inspector 1 Reports (of action taken) sent to H.M. Inspector 2 Underground Bakehouses (S. 101)— Certificates granted during the year In use at the end of the year 3 * The Lists should be received twice in the year. The year's figures required in the Table are then obtained by adding together the two half-yearly totals 20 East Barnet Valley Urban District Council. Sanitary Inspector's Report for the year 1920. Gentlemen, I have the honour of submitting the following Report on the work of the Public Health Department, on behalf of the previous Inspector who resigned, and for the remaining period of the year following my appointment on September 6th, 1920, and compiled from the records and books kept in accordance with the Ministry of Health requirements. Preparing statistics for a year in which a change of officials has taken place is always difficult; especially when no cleiical assistance is provided, the system of filing, indexing and referencing is not so complete as one would deslie, and much valuable data is lost. To briefly state in words and show by means of figures what has been accomplished is a simple matter, but it is difficult to convey to you any idea of the work entailed in visiting people and explaining to them the advantage of making sanitary, or the disadvantage of making insanitary, any premises of which they have the control. In practice I take every opportunity to disseminate knowledge as to what is meant by sound sanitation and hygiene amongst the Public. If the Public better knew the reasons why Local Authorities require certain laws and regulations to be observed, and why Health Officers ask for certain measures to be carried out, such officers would find less opposition to their work and their demands. The general standard of houses is good. Inspections under the Housing Acts for the most part reveal defective roofs, dampness and want of cleaning, and lack of attention to sanitary appliances. 21 Tenants are not slow to notify the Sanitary Inspector of obvious defects which arise from time to time, but they have yet to learn that it is their duty to take proper care of the premises they occupy, and keep in a cleanly state the W.C. pans, sink and drain gullies and storage cistern. Much expense could be saved, and renewals less frequent if tenants were made directly responsible for the proper care of Sanitary appliances in their homes and by the exercise of common sense and care a vast amount of sickness and ill health can be prevented. The ordinary Sanitary operations of the department have continued to receive unremitting attention. House to house inspections of Cottage property are made whenever the general routine of duties permit, but single handed there is seldom time to devote to this important work, as each day brings its own series of requests for inspections and reinspections, in various parts of the district. The occupiers of the houses in certain areas, lay wait on the Inspector when in the district and invite him to inspect their houses, for the purpose of having some minor defect remedied, and the year's work was increased by reason of the number of complaints from occupiers (under the Kent and Mortgage Act) of insanitary conditions which had occured through neglect during the war period, the increase being almost 40% over prewar complaints. This work has made heavy demands on the Inspector's time and doubled the clerical work in the office, and in consequence the routine house to house inspections has had to he suspended, which without some assistance cannot be attempted under the present conditions. Since I took up my duties I am pleased to be able to state that, in the majority of cases, an intimition to the owners of the existence of nuisances or defects on specified premises, with a request to execute remedial works, of which particu ars are specified in detail, has been sufficient to secure the abatement of nuisances, and other minor defects remedied. 22 In no instance has legal proceedings been instituted although occasionally much pressure has to be brought to bear on the dilitary owner. The requirements set nut in the County " House Inspection Report " having regard to applications under Section 2, Sub Section 2, Increase of Rent (Restrictions) Act, 1920 as follows— Standard of Construction of house reasonably fit for human habitation. Free from serious dampness and having efficient through ventilation and satislactory lighting. Adequate sanitary arrangements and cleaning facilities for each family. Efficient drainage and suitable arrangements for the disposal of slop water, ashes, etc. Good general repair. A special "Form of Notice" was drafted to deal with the numerous Sanitary Surveys, which were requested by occupiers, who on the payment of one shilling were under the impression the Local Authority could enforce re-decoration and painting throughout, and have new kitcheners and coppers installed. The receipt by a tenant of the owner's notice to Increase the Rent in the majority of cases prompted them to call in the Sanitary Inspector, to get something done as a quid-pro-quo. The result of these inspections brought to light many conditions which are attributal to the lack of care and interest, by tenants, with regard to Sanitary and other fitments provided for their use. The most serious being the state of w.c. pans and traps, these are extensively fouled by urinary deposits and in some instances the incrustation is so thick that frequent blockage of the trap occurs. Sink waste pipes and gullies are found thick with foul deposits of grease and soapy matter. Tenants do not appreciate the necessity of keeping the w.c. pan and trap free from such deposits. Neither has it been found the practice to systematically cleanse the house gullies. 23 Unhealthy Areas and Unfit Houses. Until much more has been done to overcome the existing shortage of housing accommodation it would obviously be unwise to attempt to put into operation drastic measures for clearing unhealthy areas. Under the difficult conditions which at present prevail one must be content to obtain the best results at the least cost. Wherever practicable such houses should be so repaired as to be at least passable for the time being. In connection with improvement or reconstruction schemes there are legal, financial and practical difficulties to be considered and, to meet these, owners are interviewed and the premises visited in their company, and the most urgent matters are requested to be put in hand at once, other defects to be remedied as funds permit; all this takes time, but a gradual improvement is thereby assured. By tactful handling an Officer can more readily secure the co-operation of owners, the carrying out of sanitary requirements to the benefit of the health ot the inhabitants of the district. I am of the opinion that owners appreciate the efforts of an Official who is reasonable in his demands and who insists on the tenants using the houses with reasonable care ; many of the conditions found to exist could be prevented or minimised if tenants would only realise that owners are very often in a worse financial position than the tenants of their property. Lancaster Road Area. Instructions were received to prepare a special Report on this area with reference to House Inspections and cases of 24 infectious disease, and the following statistics were prepared :— Number of Houses in Lancaster Road 161 Houses inspected during the year 1919 59 Cases of Scarlet Fever notified 4 Cases of Diptheria notified 11 Houses inspected during the year 1920, January to September 72 Cases of Diptheria (same period) 4 Houses inspected since October 1st to date of Report, the period of my appointment 25 Houses re-inspected and visits made with respect to works in progress, and the abatement of nuisances 63 Cases of Scarlet Fever notified 1 Cases of Diptheria notified Nil The area inspected as a result of the Medical Officer of Health's Report contained some 21 houses; numbered 199 to 225 on the East side and numbered 122 to 128 on the West side. Houses numbered 199 to 255 are in a reasonable state of repair and only minor defects were found. The yards were clean, with the exception of Nos. 215 and 213; verbal notice only being necessary. On inspection it was found that in six instances, Fowls, Ducks and Geese were being kept but not as a nuisance, and appeared to be well kept and clean. The Sanitary conditions as regards provision of Dust-bins, conditions of Drains Water supply cisterns, and Water Closets appear very satisfactory, recent repairs having been carried out. With regard to Nos. 122, 124, 126 and 128 on the West side. These are a very poor sample of houses. Work is in hand to bring them up to a reasonable standard of repair, but I cannot say that the personal habits of the tenants are such as to take reasonable care of the apartments; especially so where there are several young children, and walls and floors are constantly damaged after repair. The apartments are always in a muddle, and this makes the interiors appear worse than they actually are. In the majority of the houses inspected, the homes (though poor) are clean. On the other hand, the dirty tenant is difficult to deal with and much tact is necessary in getting any appreciable results, however, by constant attention and periodical visits, the general tone of the area is improving, but it will take many months yet, before the whole of the properties are brought up to a satisfactory standard on the account of the lack of capital of the Owners, the cost of 25 repairs and the income from the rents after deducting the outgoings, being insufficient to pay for the amount of work necessary to be done, unless spread over a number of years. Water Supply. During the year many storage cisterns have been found situated over w.c.s and coal houses, and often without any protection of the water supply from any foul air from the w.c. and dirt from the coal houses, etc. Action has been taken in all such cases, either for the removal of the cisterns to more suitable positions, or for the provision of new airtight ceilings to w.c.s and coal houses. Water Supply Cistern These are required to be emptied and thoroughly cleansed from time to time, as often as may be necessary to prevent pollution of any water and to be provided with proper close fitting covers and so placed as to be at all times readily accessible. Infectious Disease Visits During the year the high number of notifications received increased the work of your Inspector very considerably. All information obtained is submitted to the Medical Officer of Health, and the matters contained dealt with according to his instructions. A case paper record of each case is made out and filed for reference. 26 Disinfection The methods in use in this District are :— Rooms sprayed with Formic Aldehyde: bedding, etc., removed (by arrangement with the Joint Hospital Authorities)for steam disinfection, when requested by the Medical attendant. All disinfection of rooms is carried out free of charge by the Council to the residents in the district and the bedding, clothes, etc., after notifiable cases of fever and tuberculosis, steam disinfected by the Joint Hospital Authorities. The articles are collected, disinfected and returned free of charge on request by the medical attendant. The Joint Isolation Hospital Authorities now make a charge of 17s. 6d. per journey to residents in this District for the disinfection of bedding, clothes, etc. after all non-notifiable diseases on request. The Council supply disinfectant soap free after cases of infectious disease, also in cases where supplies are thought to be desirable to facilitate and ensuring cleanliness. This should greatly influence people to thoroughly cleanse their premises and so ward off any likelihood of recurring cases. Disinfection figures for the year are No. of Rooms Houses from which houses Disinfected bedding was removed. 66 101 3 One bundle of clothes was removed from the Mortuary and destroyed by burning. Public Elementary Schools. These are inspected at intervals and more frequently after the occurrence of cases of infectious disease. 27 The question of washing accommodation, the use of a common towel and the common drinking cup is a cause of much concern during the School periods. These inspections have resulted in bringing to the Manager's notice, the following- defects:— Defective Water Supplies 3 Defective Covers to Cisterns 2 Defective flush to Latrines 8 Defective Wash-hand Basins 3 Dirty Floors 1 Limewashing of Latrines 5 Five elementary schools in the district were thoroughly disinfected during the year. Factory and Workshop Act, 1909 Two large factories, one at Oakleigh Road, Brunswick Park and the other at Cromer Road, New Barnet, have been completed and it is estimated some 600 employees will be engaged. Messrs. Carr's factory at Brunswick Park has 412 employees. The condition of the factories and workshops throughout the district are now up to a fair standard ; much has been done to bring them up to their pre-war standard of cleanliness. Outworkers In accordance with the provisions of the Factory and Workshop Act, several lists of outworkers residing in this district have been received during the year, from persons employing home workers. These lists have mostly come through the office 28 of the Corporation of London, and other Metropolitan Boroughs. The premises specified in these lists have been visited for the purpose of ascertaining the sanitary condition under which the work is done. In all cases where defects were found the remedial works have been carried out. The Factory and Workshops Act, 1901, requires the registration and regular inspection of such places and the keeping of a series of books for that purpose. The Workshops in the district are very suitable and well adapted for the several processes that are carried on therein, the light, ventilation and air space is well maintained, and general sanitary conditions good. Sale of Food and Drugs Act This Act is administered in this Council's district through one of the Inspectors appointed by the County Council for that purpose. At the time of going to print, I have not been supplied with information as to samples of articles of food taken for analysis from retailers within this Council's Area during 1920. Diseased and Unsound Food The following' is unsound food that has been voluntary surrendered and destroyed during the year— 8 carcases of beef and offal, affected with tuberculosis 25-lbs. raisins 48-lbs. tomatoes 52-lbs. Australian jam 29 40 cases of blown condensed milk were received by a pig keeper for feeding purposes. With regard to this an intimation from the Corporation of London, notified their arrival in the district and their disposal as "pig food" was closely observed. An undertaking in writing from the pig keeper was also obtained for their safe disposal. Dairies, Cowsheds and Milk Shops The number of these premises within the district is : Dairies and Cowsheds 9 Milk Shops 6 Purveyors only within the Urban area 4 Several visits were paid to these premises throughout the year. The local dairymen and purveyors of milk appear to be plying their trade with due regard to the protection of the milk supply from contamination. Limewashing of premises is carried out in May and October. The hygiene of Cowsheds, Dairies and Slaughterhouses and other places where food is stored or handled is constantly under observation, and kept up to a high standard of cleanliness. Manure Notices. With regard to periodical removal of manure from stables, notices are circulated throughout the District during the summer months to have all manure removed from stables, etc,, at least twice a week, in order to prevent the breeding of flies. The notices are complied with and the results satisfactory. 30 Bakehouses. There are nine bakehouses in the district, three of which are underground. Notices under Section 99 of the Factory and Workshop Act, 1901, were sent out to all occupiers of bakehouses,throughout the district, requiring them to thoroughly limewash their bakehouse premises twice a year, and all the Notices with one exception were complied with. The one exception, after second notice, was put in a cleanly condition. Offensive Trades Under the provisions of the Public Health Act, Amendment Act, 1907, Section 12 of the Public Health Act; 1875, the establishment of the Trade of fish-frier is an offensive trade, within the Urban area. Slaughter Houses. There are two licensed and three registered slaughter houses in the district, and these are being maintained in a satisfactory manner. Limewashing and cleansing is carried out regularly and systematically. In the course of my inspection of slaughter houses, I have found the following methods of slaughtering adopted by the butchers within the Urban District :— Mr. Pullen, Station Road— Both Pole-axe and Humane killer in use. Mr. Daniels, East Barnet Road— Both Pole-axe and Humane killer in use. 31 Messrs. Frusher, Folly Farm— Both Pole-axe and Humane killer in use. Mr. Lenden, Henry Road— Pole-axe only in use. Mr. J. Stewart, Plantagenet Road— Pole-axe only in use. The general opinion expressed by the Slaughter-men and their employers is :—"That an experienced man prefers the poleaxe as a more sure and instantaneous method of stunning animals and a mis-directed blow is the exception rather than the rule." Humane killers are brought into use should the animal become restive or in the case where apprentices are being taught the art of slaughtering. Where the Humane killer is in use it sometimes happens that the supply of cartridges runs out and the Pole-axe is again brought into use. Summary of Statistics I append to this report a summary of statistics relating to the sanitary work effected in the District, in the form prepared by the County Medical Officer of Health for co-ordinating the records throughout the County. The information desired has been supplied as fully as possible, but in some instances the items are not applicable to an Urban District. Public Health Legislation The work of my department has proceeded along the usual lines during the year, and resolved itself into several main 32 features, viz.— (a) Inspecting premises on complaint, or for special purposes, as after infectious diseases. (b) Inspections for supervision of works in hand to comply with notices. (c) Inspections under Factory and Workshop Acts, Dairies, Cowsheds and Milkshop Regulations, Slaughter Houses, etc. For the information of the Council, and in accordance with the requirements of the Ministry of Health, I append hereto a table showing the defects found to exist on the properties inspected during the year— Statistics of Inspections, Nuisances, etc.— Number of premises visited in house inspection,under the Public Health Acts 227 „ nuisances abated 712 „ houses inspected from complaints received 104 „ premises inspected after complaints, and no nuisance found 12 „ visits in respect of illness 72 „ visits in respect of disinfecting rooms 91 „ visits in respect of removal of bedding for disinfecting 32 „ visits for sundry purposes Numerous „ preliminary notices, letters and verbal instructions issued for the abatement of nuisances 372 „ Statutory notices issued 6 „ visits to dairies, cowsheds and milkshops 64 „ visits to slaughter houses 38 Remedial Works carried out As the result of notices issued under the Public Health Acts and the Housing and Town Planning Act, 1919, the undermentioned works have been carried out during the year— 33 I. Arrangements for Prevention of the contamination of Water Supply. Defects found— Water cisterns defective 14 „ dirty or inacessible 42 „ without covers 14 „ covers defective or dilapidated 31 Houses without water supply through defective supply pipes 17 „ supplied with tap direct from main over sink instead of through storage cistern 12 2 Closet Accommodation. Defects found. W.C. pans in foul condition 7 „ pans broken or otherwise defective 18 „ buildings structurally dilapidated or dirty 12 „ flushing cisterns defective 47 „ without flushing cisterns 2 3 Drainage. Defects. Drains in leaky condition 24 „ unventilated 5 „ without inspection chambers or same defective 14 „ communicating direct with sewer, without inter cepting trap 5 „ Choked, cleared and cleansed 5 Rain water pipes acting as ventilators to the drain disconnected and made to discharge over properly trapped gullies 9 Defective soil and ventilating pipes repaired 45 Defective traps removed and proper traps substituted 17 Premises without sufficient lavatory accommodation; additional conveniences provided 4 Premises re-drained 18 Cesspools constructed 0 Cesspools cleaned out and repaired 4 4 Condition of Dwelling Houses in regard to Light, free circulation of A ir, Dampness and Cleanliness. Defects found. Light and ventilation insufficient and windows dilapidated 14 Dwelling houses damp 35 34 Ceiling and walls of rooms cleansed 214 „ „ „ repaired 105 Defective scullery sinks 15 Defective sink waste pipes 17 Leaky and dilapidated roofs 43 Floors dilapidated and defective ventilation underneath 9 Defective staircases 7 5 Paving, Drainage and Sanitary Conditions of Yards or Outhouses. Defects found. Yards in dirty condition 9 „ without paving or drainage 11 „ with defective or insufficient paving 24 6 Arrangements for Deposit of Refuse and Ashes. Defects found. Absence of dust-bins so dilapidated as to be unfit for use 47 7 Existence of Rooms unfit for Human Habitation. Defects found. Rooms unfit for habitation ; thoroughly renovated 5 Houses unfit for habitation Houses overcrowded 4 8 Defects in other matters. Eaves, gutters and rain water pipes in defective condition 34 Animals improperly kept 5 Miscellaneous defects. 56 Removals of manure Numerous Accumulation of rubbish 7 Bedding cleansed 2 35 Periodical circular letters and reminders with regard to cleansing of Cowsheds, Piggeries, Slaughter Houses, the removal of manure and cleansing of Urinals attached to Public Houses are all dealt with systematically but I have found the clerical work of the department exceptionally heavy at times and necessitating evening work to cope with the same. In conclusion, I wish to express my indebtedness to the Chairman and members of the Council for the support which has been extended to me in carrying out the duties of my offices, and for the valuable help rendered to me by my colleagues on taking up my duties at East Barnet; especially at the time when the Council were without their Surveyor (through ill health), and the resignation of my predecessor. I beg to remain, Gentlemen, Your obedient Servant, J. LEWIS, M. In. M. & Cy. Engr. Building Surveyor and Sanitary Inspector 36 East Barnet Valley Urban District Council. Building Surveyor's Report for the year 1920. New Buildings. Plans submitted 57 Plans disapproved 9 Plans amended 4 New houses completed 19 Motor garages, etc. 5 Alterations and additions 20 Factory and Workshop buildings 6 Temporary buildings 5 Temporary buildings licensed from year to year subject to buildings being maintained in good repair and free from nuisance— No. of Licenses on Register 82 „ „ cancelled 16 „ „ on live Register 66 Drainage of Existing Buildings Plans submitted 6 Drains tested by smoke on complaint or after notification of infectious disease 32 Entirely new drains provided after notice 22 Part new drains provided after notice 23 All new drains are subjected to water test both before and after being covered in. 37 It is the exception rather than the rule to find bad workmanship, but occasionally faulty materials cause work to be done over ag"ain before the same can be passed. Relaxation of Building; Bye-Laws Section 25, of the Housing and Town Planning Acts, 1919, enables Local Authorities during a period of three years from July 31st, 1919, to consent to the erection of buildings which may not be permissable under the Local Bye-laws, but which are in accordance with regulations made by the Minister of Health. This power facilitates the erection or adaptation as dwelling houses, of Army huts, and other more or less permanent types of building-. These regulations were superseded by an amended series published in November last (1920), under the title " The Ministry of Health" (Temporary Relaxation of Building Bye-laws) Regulations, 1920. The following tabulated list of plans were submitted under the " Grants to Private Persons, Subsidized Houses" 38 Subsidized Houses Period ending December 31st, 1920. No. of Plan No. of Houses Certificates Completed In course Erection Abandoned Not yet commenced A. B. 1883 2 1 3 2 1856 1 4 1 1 1871 1 5 7 1 1878 1 6 1 1879 1 7 5 1 1846 1 3 2 1 1847 2 3 6 2 1848 8 2 4 1 1 6 1876 7 8 8 4 4 1846 1 8 8 1886 1 11 9 1 1884 8 9 8 1885 6 10 6 40 11 9 14 7 1 18 J. LEWIS, M. In. M. & Cy Eng. Building Surveyor.