Borough of Finchley ANNUAL REPORTS FOR THE YEAR 1936 of the MEDICAL OFFICER OF HEALTH a nd the CHIEF SANITARY INSPECTOR FINC 19 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1936 Members of the Public Health Committee Chairman: Councillor Jones, LL.B. The Mayor. Councillor Grobel. The Deputy Mayor. „ Grocott. Alderman Briant. „ Mrs. Legge. „ Pike. „ Mrs. Murphy Councillor Collis. ,, Steward. Staff of the Public Health Department. Medical Officer of Health: *A. A. Turner, m.c., m.d., ch.b., d.p.h. Assistant Medical Officer of Health: *Miss C. Russell, m.b., ch.b., d.p.h. Chief Sanitary Inspector: *E. J. Franklin, f.r.san.i., f.s.i.a. Assistant Sanitary Inspectors: J. Gray, cert.r.san.i. G. H. cockell, cert.r.san.i. w. H. nlcholls, cert.r.san.i. Each of the Sanitary Inspectors holds the special diploma of the Royal Sanitary Institute for the inspection of meat and other foods. Health Visitors and School Nurses: *Miss J. Hull. *Miss F. Hughes. *Miss C. Hemming. Chief Clerk: W. L. N. Relleen. Clerks: Miss K. M. Nichol. Miss P. Parry. Miss J. Musgrove. Miss F. Taylor. *Salary contribution made under the Public Health Acts or by Exchequer grants. 2 To the Mayor, Aldermen and Councillors of the Borough of Finchley. June, 1937. I have the honour to submit my Annual Report for 1936 on the health of the Borough. This report has been drawn up in accordance with the Ministry of Health Circular 1561 of the 16th October, 1936. The vital statistics are very satisfactory. The increase in the birth rate, which was reported last year, has been maintained, while the death rate has fallen slightly. The incidence of, and mortality from, the principal infectious diseases have been exceptionally low. I wish to express my indebtedness to Dr. Russell, Mr. Franklin, and the whole staff of the Public Health Department for their loyal co-operation and assistance throughout the year. I am, Your obedient servant, A. TURNER. 3 SOCIAL CONDITIONS. Area (in acres) 3,384 Population, 1936 (Registrar-General’s Estimate) 64,110 Number of Inhabited Houses (end of 1936) ... 17,37o Rateable Value (1936) ... ... ... ... £806,129 Sum represented by a Penny Rate £3,218 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR. Live Births: Total. Males. Females. Legitimate 797 385 412 Illegitimate 36 18 18 Birth rate, 12.99 per 1,000 estimated resident population. Total. Males. Females. Stillbirths 25 14 11 Rate, 29.13 per 1,000 total (live and still) births. Total. Males. Females. Deaths 643 290 353 Death rate, 10.03 Per 1000 estimated resident population. Deaths from diseases and accidents of pregnancy and child birth:— From sepsis 2 From other causes 1 Death rate of Infants under one year of age:— All infants per 1,000 live births 43.21 Legitimate infants per 1,000 legitimate live births 37.64 Illegitimate infants per 1,000 illegitimate live births 166.6 Deaths from Cancer (all ages) 89 Deaths from Measles (all ages) 2 Deaths from Whooping-cough (all ages) 1 Deaths from Diarrhoea (under 2 years of age) 6 4 POPULATION. According to the estimate of the Registrar-General the population on the 30th June, 1936, was 64,110, an increase of 1,450 over the previous year. This is the largest increase for several years, but for several reasons 1 am of the opinion that the population is still under-estimated, and that the figure for mid-year 1936 should have been approximately 65,500. The natural increase, i.e., the excess of live births over deaths, was 190, which is the highest for many years. BIRTHS. The number of live births registered during 1936 was 833, an increase of 26 over the previous year. This gives a birth-rate of 12.99 Per 1,000 of the population as compared with 12.88 in 1935 and a rate of 14.8 for England and Wales. This is the highest number of births since 1921, and the highest birth-rate recorded since 1931. This is one of the reasons which lead me to think that the population is larger than the official estimate. A remarkable feature about the births for 1936 is that girls outnumber the boys by 430 to 403. The average proportion of male to female births for England and Wales over many years is 1,040 to 1,000, but the proportion in Finchley in 1936 is 937 males to 1,000 females. It is to be hoped that this state of affairs, which has never happened in Finchley before, is merely accidental and does not indicate that the males are now losing even at birth the numerical superiority which in the past they have enjoyed for the first few months of life. Thirty-six illegitimate births were registered as compared with 35 in 1935. The number of still-births registered was 25, giving a rate of 29 per 1,000 of all births. 5 7 8 BIRTH AND DEATH RATES FOR THE PAST 25 YEARS. Rates per 1,000 Population. Blft7 H IZO T£ _ 0£0TH RfiTc. , DEATHS. The number of deaths registered in 1936 was 643, which gives a crude death rate of 10.03 as compared with 10.47 for the previous year, and a standardised rate of 9.83 as compared with 10.26. The death rate for England and Wales for 1936 is 12.1. No particular cause of death calls for comment with the exception of Violence, to which 32 deaths were attributed as compared with 17 in 1935. Fifty-four per cent. of the total deaths were of persons over 65 years of age, 43% over 70, 30% over 75, and 17% over 80. INFANTILE MORTALITY. In 1936 there were 36 deaths of infants under the age of one year, giving an infantile mortality rate of 43.21 per 1,000 live births. The rate is a little higher than in 1935 when, after excluding deaths in institutions, it was 35.94. In 1936 I am glad to say that these institutional deaths have been greatly reduced, and it is not considered necessary to calculate two separate mortality rates. The corresponding rate for England and Wales is 59 and for London 66. Of the 36 deaths no less than 23 occurred during the first four weeks of life, and 14 actually during the first week. The corresponding figures for 1935 were 12 and 8 respectively. Of the 23 neonatal deaths, 21 were classified as being due to congenital debility, premature birth and congenital malformations. This is a very high proportion and it is difficult to find a reason for it, but it is interesting to compare the still-birth rate and the neonatal mortality rate for infants born in institutions, with those of infants born at home:— No Still-birth rate Neonatal mortality per 1,000 births rate per 1,000 live births. Infants born at home 342 20.5 9 Infants born in institutions 453 44 46 9 It must be remembered that a small proportion of the confinements taking place in institutions are emergency cases, and also a higher proportion of complicated cases will enter institutions than remain at home, but even when due allowance is made for such cases there would appear to be no doubt that, so far as the infant is concerned, it is safer to be born at home than in an institution. Only 4 children between the ages of 1 and 5 years and 4 between the ages of 5 and 15 died during 1936. POOR LAW RELIEF. During the year 561 families were in receipt of outdoor relief, and the total amount expended on such relief was £9,3013s. od. Seven hundred and ninety-six persons were admitted to the Wellhouse Hospital, and of these T38 were admitted to the Lying-in Ward. 10 11 12 INFANTILE MORTALITY RATES FOR THE PAST 25 YEARS. Rate per 1,000 live births. INFANTILE MORTALITY DURING THE YEAR 1936. Deaths from stated causes at various ages under one year of age. Cause of Death. Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3-6 months. 6-9 months. 9-12 months. TOTAL. WARDS. N E W All Causes Certified 14 6 3 23 3 6 3 1 36 12 9 15 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken Pox ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... 1 1 1 ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... 1 ... ... ... 1 ... ... 1 Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... 1 ... ... 1 1 ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... 1 ... ... 1 ... ... 1 Pneumonia (all forms) ... 3 ... ... ... 1 1 ... 5 ... 2 3 Diarrhoea ... ... ... ... ... 1 2 2 ... 5 2 2 1 Enteritis ... ... ... 1 1 ... ... ... 1 1 ... ... Gastritis ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... Suffocation, Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... Injury at Birth ... ... ... ... ... ... ... ... ... ... ... ... ... Atelectasis ... ... ... ... ... ... ... ... ... ... ... ... ... Congenital Malformations 3 ... ... 2 5 ... ... ... ... 5 3 1 1 Premature Birth 7 2 ... ... 9 1 1 ... ... 11 2 3 6 Atrophy, Debility and Marasmus ... 1 ... ... 1 ... ... ... ... 1 ... 1 ... Other causes 4 ... ... ... 4 ... ... ... 4 2 ... 2 Totals 14 6 ... 3 23 3 6 3 1 36 12 9 15 ]3 CAUSES OF, AND ACES At, DEATH DURING THE YEAR. No. CAUSES OF DEATH. NET DEATHS AT THE SUBJOINED AGES OF "RESIDENTS" WHETHER OCCURRING WITHIN OR WITHOUT THE DISTRICT. Total Deaths whether of 4 Residents ' or ' NonResidents' in Institutions in the District. WARDS. All Causes Certified 643 All Ages. Under 1. 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. North Ward. East Ward. West Ward. Uncertified 1. Typhoid and paratyphoid fevers ... ... ... ... ... ... ... ... ... ... ... ... ... ...2. Measles 2 1 ... 1 ... ... ... ... ... ... 1 ... 1 3. Scarlet fever ... ... ... ... ... ... ... ... ... ... ... ... 4. Whooping cough 1 1 ... ... ... ... ... ... ... ... ... ... 1 5. Diphtheria 1 ... ... ... 1 ... ... ... ... ... ... 1 ... 6. Influenza 3 ... ... ... ... ... ... 1 2 ... 3 ... ... 7. Encephalitis lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... 8. Cerebro-spinal fever ... ... ... ... ... ... ... ... ... ... ... ... ... 9. Tuberculosis of respiratory system 26 ... ... ... ... 3 9 4 ... 1 5 10 11 10. Other tuberculous diseases 2 1 ... ... ... ... ... 1 ... ... 2 ... ... 11. Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... 12. General paralysis of the insane, tabes dorsalis 2 ... ... ... ... ... 1 1 ... ... ... 1 l 13. Cancer, malignant disease 89 ... ... ... ... 1 5 12 31 14 35 26 28 14. Diabetes 8 ... ... ... ... ... ... 2 6 1 3 4 1 15. Cerebral haemorrhage, etc. 40 ... ... ... ... ... 2 11 27 9 12 14 14 16. Heart disease 200 ... ... ... ... 3 13 38 146 19 54 59 87 17. Aneurysm 2 ... ... ... ... 1 ... ... 1 ... ... 1 1 18. Other circulatory diseases 15 ... ... ... ... ... ... 2 13 1 7 4 4 19. Bronchitis 17 1 ... ... ... ... 1 2 13 2 4 8 5 20. Pneumonia (all forms) 55 5 ... ... ... ... 6 13 30 8 19 21 15 21. Other respiratory diseases 6 ... ... ... ... ... ... 1 5 2 2 3 1 22. Peptic ulcer 12 ... ... ... ... ... 1 6 5 4 2 4 6 23. Diarrhoea, etc. (under 2 years) 6 6 ... ... ... ... ... . ... 2 5 ... 1 24. Appendicitis 6 ... ... ... 1 ... 1 2 2 ... 2 2 2 25. Cirrhosis of liver 1 ... ... ... ... ... ... ... 1 ... ... 1 ... 26. Other diseases of liver, etc. 1 ... ... ... ... ... ... ... 1 1 1 27. Other digestive diseases 10 ... 1 1 ... 1 7 6 6 1 3 28. Acute and chronic nephritis 18 ... ... ... 1 1 1 7 8 1 6 8 4 29. Puerperal sepsis 2 ... ... ... ... ... 2 ... ... ... 1 1 ... 30. Other puerperal causes 1 ... ... ... ... ... 1 ... ... 1 1 ... 31. Congenital debility, premature birth, malformations, etc. 21 21 ... ... ... ... ... ... ... 2 7 6 8 32. Senility 11 ... ... ... ... ... ... ... 11 1 2 3 6 33. Suicide 6 ... ... ... ... ... 2 3 1 ... 2 3 1 34. Other violence 32 ... ... ... ... 7 2 8 15 15 13 11 8 35. Other defined causes 47 ... ... ... 1 3 9 15 19 12 14 12 21 36. Causes ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... TOTALS 643 36 2 2 4 19 56 180 344 102 209 204 230 I5 16 VITAL STATISTICS FOR THE PAST TWENTY YEARS. Year. Total Births. Birth Hate. Total Deaths Death Rate. Total Infant Deaths. Infantile mortality rate. Deaths from Measles. Deaths from Whooping Cough. Deaths from Diarrhoea. (under 2 years). 1917 728 14.5 447 8.89 34 46.7 5 5 1 1918 620 12.1 548 10.69 31 50.0 3 8 2 1919 725 14.3 476 9.4 42 57.93 ... ... 9 1920 1051 22.4 413 8.82 59 53.2 3 1 2 1921 879 18.8 524 11.3 64 71.6 ... 6 15 1922 781 16.6 496 10.5 37 47.3 ... ... 4 1923 738 15.6 426 9.0 28 38.0 ... 1 ... 1924 759 15.9 449 9.2 38 50.0 7 2 1 1925 724 14.9 515 10.6 42 58.0 4 3 1 1926 722 14.3 480 9.5 37 51.2 2 1 3 1927 709 13.8 515 10.0 23 51.2 2 1 3 1928 760 14.3 511 9.6 28 36.8 10 7 2 1929 704 12.8 604 11.0 32 45.5 1 6 5 1930 748 13.3 557 9.9 38 34.7 5 1 7 1931 761 12.9 588 10.0 42 46.0 1 ... 6 1932 698 11.6 621 10.3 35 43.0 4 3 3 1933 671 10.97 592 9.7 18 26.8 ... 3 6 1934 712 11.54 658 10.67 29 40.73 1 13 4 1935 807 12.88 656 10.47 29 35.94 ... ... 17 1936 833 12.99 643 10.03 36 43.21 2 1 6 17 GENERAL PROVISIONS OF HEALTH SERVICES IN THE AREA. Hospitals. i. Tuberculosis (County of Middlesex Scheme). I am indebted to Dr. Tate, the County Medical Officer, for the following information:— "The total number of beds reserved for the sole use of the County Council at the close of 1936 is as follows:— Accommodation. Institution. Adults. Children. Type of case Male. Female. County Sanatorium, 150 150 60 Harefield 4 4 10 Pu1monary—sanatorium. do. observation. County Sanatorium, Clare Hall, South Mimms 120 66 – do. late sanatorium and hospital. Victoria Home, Margate — — 6 Non-pulmonary. In addition to the above, further beds for pulmonary cases, and beds for non-pulmonary cases are obtained, as and when required, at a large number of voluntary and municipal hospitals and sanatoria, not under the control of the County Council, and situated in various parts of the country.” 2. Maternity.—There is a well-equipped lying-in ward in the Wellhouse Hospital, Barnet. One hundred and thirty-eight Finchley cases were admitted to this ward in 1936. 3. Children.—A grant of £20 per annum is paid by the Local Authority to the Royal Northern Hospital, and in return the staff of the hospital see cases of difficulty referred to them by one or other of the Maternity and Child Welfare Centres. 4. Infectious Diseases.—Cases of the common infectious diseases are admitted to the Finchley, Hornsey, Wood Green and Friern Barnet Joint Isolation Hospital at Muswell Hill, N.10. The hospital contains 150 beds. 18 Cases of Puerperal Fever and Ophthalmia Neonatorum are admitted to the North Western Hospital and St. Margaret's Hospital respectively, by arrangement with the London County Council. 5. Smallpox.—The provision of hospital accommodation for cases of Smallpox is undertaken by the County Council, and by arrangement with the London County Council all cases are admitted to that authority's hospital at Joyce Green, Dartford. 6. Other Hospitals :—(a) The Finchley Memorial Hospital contains 72 beds and receives annually a grant of two hundred pounds from the Local Authority. The Local Education Authority has arranged with the Memorial Hospital for the operative treatment of elementary school children suffering from adenoids or from enlarged tonsils. (b) The Wellhouse Hospital, Barnet. This is a modern institution of 200 beds belonging to the Hertfordshire County Council and admitting cases from this part of the County of Middlesex. During *936, 796 Finchley cases were admitted to this hospital. Other Institutions. 1. Unmarried mothers :— A grant of ten guineas per annum is paid by the Council to the Hornsey Deanery Association in respect of unmarried mothers admitted to their institution. 2. Illegitimate Infants and Homeless Children :— Wright-Kingsford Home, 120 children. Nazareth House, N.2, 45 children. These Homes are in no way supported by the Local Authority. x9 Ambulance Facilities. (a) Infections Cases.—Arrangements nave been made by the Joint Hospital Committee with the London County Council for the conveyance of all cases of infectious disease from their homes to the Joint Isolation Hospital. (b) Non-Infections and Accident Cases.—The Council provide a Motor Ambulance for the conveyance of non-infectious sick and cases of accident. During the year the ambulance was called out in connection with 273 street accidents and 447 private cases. A sum amounting to £330 was recovered from the various users. Mortuary. Some progress has been made towards the erection of a new mortuary to replace the existing one in Summers Lane. Plans have been approved by the Council for a well equipped modern building, and the approval of the Minister of Health is awaited. During 1936, 51 bodies were received in the mortuary, 6 of these belonging to Friern Barnet. 20 Clinics and Treatment Centres. Name and Situation Nature of Accommodation By whom provided Maternity and Child Welfare (a) Centres Congregational Hall, N. 12 Accommodation for consultations, weighing of babies, waiting room, etc. Local Authority Wesleyan Hall, Essex Park, N.3 Do. Do. Bourchier House, Oak Lane, N.2 Do. Do. (b) Ante-natal Clinic Do. Do. Do. (c) Creche Do. Two large rooms Do. School Clinics (a) Minor Ailments Do. Waiting room and treatment room Do. Summerside School Waiting room and treatment room Do. (b) Dental Clinic Bourchier House, Oak Lane, N.2 Waiting room, 2 treatment rooms and recovery room Do. (c) Ophthalmic Clinic Martin School Waiting room and retinoscopy room Do. (d) X-Ray Clinic University College Hospital (e) Tonsils and Adenoids Clinic Finchley Memorial Hospital Tuberculosis Dispensary Chester Villa, High Road, N.12 ... Middlesex County Council Venereal Disease Clinic Royal Northern Hospital, Hollo way Road, N.7 ... Do. 21 Professional Nursing in the Home. The Finchley District Nursing and Benevolent Society provides three nurses for attendance upon the sick poor of the district. The Society has indicated its readiness to co-operate with the Local Authority should the need arise. No financial contribution is paid to the Society by the Local Authority. The Finchley Women Citizens' Association have instituted a scheme whereby families can have the services of a visiting nurse on the payment of an entrance fee of 5/'- and an annual subscription of 10/-. The home nursing of cases of infectious disease is not undertaken by the Local Authority apart from what the health visitors are able to do in the course of their routine visits to the homes. Midwives. During the year 9 midwives notified their intention of practising within the area, and they attended 53 cases in the capacity of midwife and 32 cases as maternity nurse. No midwives are employed or subsidised by the Council. Legislation in Force. Details were set out in the report for 1934 and it is not considered necessary to repeat them. SANITARY CIRCUMSTANCES OF THE AREA. Water. With the exception of a few houses which are supplied by the Metropolitan Water Board the district receives its water supply from the Barnet District Gas and Water 22 Company. The water, being derived from deep wells, is pure and wholesome but has a high degree of hardness. The supply has been adequate. Removal of House and Trade Refuse. House refuse is collected weekly, and during the summer months a bi-weekly collection is made from a number of flats in the Borough. Trade refuse is collected on payment. Schools. The sanitary condition of the Council Schools is satisfactory, but in the case of certain non-provided schools there is room for much improvement in the provision of adequate sanitary accommodation, facilities for washing, and an easily accessible supply of drinking water. In certain instances representations have been made to the Managers, but so far the results have not been encouraging. As long ago as 1879 the Medical Officer of Health referred to the unsatisfactory conditions existing in the National Schools in the area, and the following is a quotation from his Annual Report for that year:- "It is extraordinary that institutions which are usually under the exclusive personal charge of clergymen, and therefore of persons of refinement, and in which the laws of decency and health are or ought to be taught, should be So often striking examples of breaches of these laws." Swimming Baths and Pools. A description of the bathing facilities was included in last year's report, and there is no need to repeat it here. 23 THE PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. Diphtheria. During the past 4 years the incidence of diphtheria has remained exceptionally low. In 1936 there were 28 cases as compared with 29 in 1935 and 30 in 1934. A number of the cases were of a very severe character and, although there was only one death, several patients were extremely ill for many weeks. All the cases were removed to hospital. The supply of anti-toxin which is kept at the Public Health Department for the use of General Practitioners is seldom used. Immunisation against Diphtheria. Immunisation has gone on steadily throughout the year and 1,036 children received the full course of 3 injections of T.A.F. The work has been done very largely in the junior elementary schools. At first children up to 8 years were dealt with, and then the age was extended to 11 years, and when all the schools have been completed it is anticipated that between 70% and 80% of the children up to 11 years, will have been immunised. The Schick test was applied to 911 children who had previously been immunised, mostly in 1935 and of the 903 who were subsequently examined 887 were negative and 16 positive. This means that 98.2% had been successfully immunised. No child who had received the full immunising course developed diphtheria, but one child who had received only one injection developed a very mild attack of the disease. Valuable assistance has been rendered by the Head Teachers, and in many cases it has been due to their influence that parents have consented to have their children protected. 24 INCIDENCE OF DIPHTHERIA FOR THE PAST 25 YEARS. The following table shows the number of children dealt with during 1936:- Ages Number of Children who received Schick tested Result 1 injection. 2 injections 3 injections Negative Positive Absent 1 - - 4 3 3 - - 2 3 2 48 44 42 2 - 3 1 3 37 41 40 - 1 4 4 3 44 62 62 - - 5 6 12 165 200 192 3 5 6 3 8 145 201 196 5 - 7 4 5 143 218 213 4 1 8 4 5 119 105 102 2 1 9 3 3 132 22 22 - - 10 1 3 132 11 11 - - 11 1 1 44 4 4 - - 12 1 - 14 - - - - 13 - - 9 - - - - 14 1 - - - - - - Totals 32 45 1036 911 887 16 8 Scarlet Fever. There was a sharp drop in the number of cases of scarlet fever in 1936 over the previous year, the figures being 91 as compared with 171. The incidence of the disease was lower in 1936 than at any time during the past 25 years. Seventy cases were removed to hospital and there was no death. Enteric Fever. One case of paratyphoid B. was notified during the year. The patient was an elderly lady and she recovered from the attack. Pneumonia. The number of notifications received was 45, and there were 55 deaths. 27 Measles. Measles was very prevalent in 1936, but the disease was comparatively mild in character. There were two deaths. Twenty-seven cases were treated at the Isolation Hospital. Whooping Cough. Whooping Cough was not prevalent in 1936. There was 1 death. Influenza. Influenza in epidemic form appeared the last few weeks of the year, but the deaths did not begin to take place until early in 1937. In 1936 there were 3 deaths from influenza. Erysipelas. Erysipelas was fairly prevalent, 22 cases being notified, and there was 1 death. Smallpox. No case of smallpox occurred in 1936. Vaccinations. No primary or re-vaccinations were performed by the Medical Officer of Health under the Public Health (Smallpox Prevention) Regulations, 1917. Bacteriological Work. The bacteriological work for the district is carried out at the Joint Isolation Hospital, and during 1936 the following- specimens were dealt with:- Positive. Negative. Total. Diphtheria 25 569 594 Pulmonary Tuberculosis 6 70 76 Enteric Fever - 8 8 Other Specimens 1 6 7 685 28 INCIDENCE OF SCARLET FEVER FOR THE PAST 25 YEARS. The following table shows the conditions as to overcrowding of the households invaded by Diphtheria and Scarlet Fever during 1936:- Housing Conditions. Less than 1 person per room. 1-2 persons per room. More than 2 persons per room. Cases under 15 years of age. Susceptibles (including those attacked) under 15 years of age. Cases under 15 years of age. Susceptibles (including those attacked) under 15 years of age. Cases under 15 years of age. Susceptibles (including those attacked) under 15 years of age. Diphtheria: Home Cases - - - - - - Hosp. Cases 8 13 16 37 - - Scarlet Fever: Home Cases 16 28 1 1 - - Hosp. Cases 22 46 25 61 1 2 TOTALS 4b 87 42 99 1 2 (These figures do not include 5 cases which occurred in institutions). Health Education. During the year 250 copies of "Better Health" have been distributed monthly through the medium of the Infant Welfare Centres. I have received many reports as to the excellence of the material contained in "Better Health," and I am satisfied that the small expenditure incurred in distributing this publication is amply justified. 31 NOTIFIABLE DISEASES DURING THE YEAR 1936. DISEASE. Under 1 year. 1 and under 2 years. 2 and under 3 years. 3 and under 4 years. 4 and under 5 years. 5 and under 10 years. 10 and under 15 years. 15 and under 20 years. 20 and under 35 years. 35 and under 45 years. 45 and under 65 years. 65 years and over. TOTAL. WARDS Removed to Hospital. N. E. W. Diphtheria Cases Notified ... ... 1 3 3 12 6 ... 2 1 ... ... 28 15 7 6 28 Deaths ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 ... ... Scarlet Fever Cases Notified ... 2 6 4 6 34 15 5 13 5 1 ... 91 27 23 41 70 Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia (Influenzal) Cases Notified i ... ... ... ... ... ... ... 1 1 5 2 10 2 7 1 2 Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia (Other forms) Cases Notified 2 2 2 2 2 2 4 ... 5 2 7 5 35 5 18 12 5 Deaths 5 1 ... ... ... ... ... ... 2 4 13 30 55 19 21 15 ... Erysipelas Cases Notified 1 ... ... ... ... ... ... 1 3 5 11 1 22 5 8 9 10 Deaths ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... 1 ... Enteric Fever Cases Notified ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... ... Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever Cases Notified ... ... ... ... ... ... ... ... 1 ... ... ... 1 1 ... ... 1 Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Pyrexia Cases Notified ... ... ... ... ... ... ... ... 5 2 ... ... 7 5 2 ... 4 Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Poliomyelitis Cases Notified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Encephalitis Lethargica Cases Notified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-Spinal Fever Cases Notified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ophthalmia Neonatorum Cases Notified 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... Deaths ... ... ... ... ... ... ... ... ... Malaria Cases Notified 1 ... ... ... 1 1 ... ... ... Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Smallpox Cases Notified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... TOTALS Cases Notified 5 4 9 9 11 48 25 6 31 16 24 9 197 61 67 69 120 Deaths 5 1 ... ... ... ... 1 ... 3 4 13 30 57 19 22 16 ... 33 34 Tuberculosis. During the year 41 new cases of pulmonary tuberculosis were notified comprising 23 males and 18 females. Twelve non-pulmonary cases were notified comprising 5 males and 7 females. There were 26 deaths from pulmonary tuberculosis as compared with 18 in 1935, and 2 from non-pulmonary tuberculosis as compared with 5 in 1935. This gives a total of 28 deaths from all forms of tuberculosis, 18 males and 10 females. The death rate for the disease is 0.43 per 1,000 of the population. In 32.1% of the cases dying from tuberculosis, no previous notification had been received. Dr. Dobson, the Tuberculosis Officer, has been good enough to supply me with the following figures:- Number of patients Diagnosed as non-tubercular 59 examined for first Diagnosed as tubercular 35 time during 1936 Undiagnosed and under observation 1 Number of tubercular cases transferred into district 9 Number of cases suffering from tuberculosis examined at the dispensary during 1936 175 Number of cases under observation at the dispensary, etc., on 31/12/36 131 35 TUBERCULOSIS DURING THE YEAR 1936. Age-periods New Cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M. F. M. F. M. F. M. F. Under 1 year ... ... ... ... ... ... 1 ... 1 to 5 years ... ... ... 1 ... ... ... ... 5 to 15 years ... 1 ... 1 ... ... ... ... 15 to 25 years 5 6 2 3 2 1 ... ... 25 to 35 years 7 8 2 2 1 5 ... ... 35 to 45 years 4 ... 1 ... 3 ... ... ... 45 to 55 years 2 1 ... ... 5 3 1 ... 55 to 65 years 4 2 ... ... 5 1 ... ... 65 & upwards 1 ... ... ... ... ... ... ... Totals 23 18 5 7 16 10 2 ... North 8 6 4 3 5 ... 2 ... Wards: East 12 2 • • • 3 5 5 ... ... West 3 10 1 1 6 5 ... ... Removed- to Hospital or Sanatorium 26 16 4 2 ... ... ... ... 36 MATERNITY AND CHILD WELFARE. The scheme as a whole has continued to expand throughout the year and increased attendances are recorded at all the centres. The ladies of the Voluntary Association have continued to give much valuable help at the centres. The work which they do in this respect and in the organisation of the supply of milk and accessory foods is greatly appreciated by the mothers, and also relieves the Council of considerable expense in the saving of staff. Infant Welfare Centres. In 1936 there were 17,004 attendances of children at the three centres as compared with 16,712 in 1935 and 12,000 five years ago. Children under one'year of age made 9,129 attendances and children over one year made 7,875. The number of examinations made by the doctor during the year was 6,685. The average attendance per session was 48. Ante-Natal Clinic. There has been another marked increase in the number of women attending during the year, the total being 319 as compared with 234 in 1935 and 159 in 1934. The total attendances were 1,192 as compared with 773 in 1935. The number of mothers who attended the clinic during the year was equal to 37% of the total registered births, live and dead. Maternity Accommodation. The Registrar-General has allocated 858 births (833 live and 25 stillbirths) to the Borough for the year, while the Public Health Department had knowledge of only 795. It would appear that the discrepancy, which occurs every year, is due to the fact that a number of births which belong to Finchley, and which take place outside the Borough, are transferred to the Borough without our knowledge. Of the 795 births known to the Department, 326 took place in hospitals outside the Borough — 125 at Wellhouse, 60 at the North Middlesex Hospital, and 141 at various London hospitals. 37 Sixty births took place in nursing homes and 20 in private homes outside the Borough. Fifty-nine births took place in nursing homes in Finchley and 322 in private houses. No less than 60% of the total births took place away from home and 52% outside the Borough. The accommodation at the Wellhouse Hospital continued to become more restricted, and 60 mothers had to be diverted to the North Middlesex Hospital. Several meetings were held between representatives of the Boroughs of Hornsey, Wood Green and Finchley, and strong representations were made to the Middlesex County Council to provide more maternity accommodation easily accessible to the three Boroughs, and it would appear that the County Council are giving the matter serious consideration. The Wellhouse Hospital is deservedly very popular with Finchley women and I am sure they would be satisfied, and the needs of the Borough would be met, if adequate accommodation were made available at that institution. Maternal Mortality. In 1936 there were 3 maternal deaths giving a rate of 3.49 per 1,000 births as compared with 3.81 for England and Wales. Two of the deaths were the subject of Coroner's inquiries, one was due to a ruptured extra-uterine pregnancy and the other to peritonitis following incomplete abortion. The third death was due to sepsis following child-birth in hospital. There is no cause to think that any of these deaths were due to any lack of ante-natal supervision. The Supply of Milk for Mothers and Children. The supply of milk and accessory foods for children is organised by the Voluntary Association, and for that purpose the Association receives an annual grant of £75 from the Council. Milk for necessitous expectant and nursing mothers is provided by the Council free or at half-price according to an income scale. All the milk provided must be pasteurised. During the year 58 mothers were supplied with milk free of cost and 5 at half price. 38 Puerperal Pyrexia and Puerperal Fever. In 1936 seven eases of puerperal pyrexia were notified. Four were removed to hospital and 3 nursed at home. All reeovered. One case of puerperal fever was notified. The patient was removed to hospital and recovered. Ophthalmia Neonatorum. One case of ophthalmia neonatorum was notified. It was a mild case and recovered without any damage being done to the infant's eyes. Home Visiting. During the year the health visitors made 4,811 visits in connection with Maternity and Child Welfare work, as compared with 4,556 in 1935. Dental Treatment. Expectant and nursing mothers who are in need of dental treatment are referred by the doctor at the Centres to the Council's dentist. Under the Council's scheme treatment is limited to extractions and fillings, but the Voluntary Association give assistance to necessitous mothers to enable them to obtain dentures. Periodical visits are made by the dentists to the Welfare Centres for the purpose of inspecting the teeth of the children in attendance. The amount of work done shows a considerable increase on the previous year, and two sessions per week instead of one have been held since the 1st April, 1936. Mothers Children Number inspected 118 313 Number treated 98 178 Number of attendances 462 393 Fillings 205 274 Extractions 571 294 Gas administrations 88 87 Other operations 33 81 Dentures supplied 36 - Dentures repaired 7 - Visits re dentures 106 - 39 Creche. The number of attendances at the Creche is almost the same as in the previous year. 1936 1935 Children attending 82 83 Total attendances 6,405 6,483 Receipts from Mothers £159 12 6 £160 15 10 CHILDREN ACT, 1908. PART l. AND CHILDREN AND YOUNG PERSONS ACT, 1932. At the beginning of the year there were on the register 19 mothers receiving 44 children, while at the end of the year there were 17 mothers receiving 37 children. Practically all the children attend the Infant Welfare Centres, but frequent home visits are also paid by the Health Visitors. No case called for any special action by the Council. Housing Statistics for the Year 1936. Number of New Houses erected during the Year:— (a) Total (including numbers given separately under (b) (i.) By the Local Authority Nil (ii.) By other Local Authorities Nil (iii.) By other bodies and persons 584 (b) With State assistance under the Housing Acts:- (i.) By the Local Authority. (a) For the purpose of Part II of the Act of 1925 Nil (b) For the purpose of Part III of the Act of 1925 Nil (c) For other purposes Nil (ii.) By other bodies and persons Nil 1.—Inspection of Dwelling-houses during the Year:(1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts)1,551 (b) Number of inspections made for the purpose 5,867 40 (2) (a) Number of dwelling-houses (included under sub-head (i) above) which were inspected and recorded under the Housing- Consolidated Regulations, 1925 346 (b) Number of inspections made for the purpose 1,542 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 12 (4) Number of dwelling-houses (exclusive of those referred to under the preceding subhead) found not to be in all respects reasonably fit for human habitation 165 2.—Remedy of Defects during the Year without Service of formal Notices:- Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 158 3.—Action under Statutory Powers during the Year:- A. Proceedings under Sections 17, 18 and 23 of the Housing Act, 1930:- (1) Number of dwelling-houses in respect of which notices were served requiring repairs - (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By Owners 1 (b) By local authority in default of owners — B. Proceedings under Public Health Acts:- (1) Number of dwelling-houses in respect of which notices were served requiring delects to be remedied 3 41 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:- (a) By Owners 2 (b) By local authority in default of owners - C. Proceedings under Sections 19 and 21 of the Housing Act, 1930:- (1) Number of dwelling-houses in respect of which Demolition Orders were made 2 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders - D. Proceedings under Section 20 of the Housing Act, 1930:- (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil 4.—Housing Act, 1935 — Overcrowding:- (a) Number of families found to be overcrowded as a result of the Survey 126 (b) Number of new cases of overcrowding discovered after the Survey 12 (c) (i) Number of cases of overcrowding relieved during the year 75 (ii) Number of persons concerned in such cases 482 (d) (i) Number of dwellings overcrowded at end of the year 63 (ii) Number of families dwelling therein 63 (iii) Number of persons dwelling therein 474 42 5-Number of houses owned by the Local Authority as follows:- (1) Housing Act, 1890 160 (2) Housing Act, 1919 200 (3) Housing Act, 1923 54 (4) Housing Act, 1925, Part 111 121 (5) Other houses owned and let (mainly for occupation of Council employees) 38 HOUSING. The survey under the Housing Act, 1935, was completed early in 1936. A total of 8,523 families were dealt with and of these 126, or 1.47% were found to be overcrowded according to the standard laid down in the Act. Of the 7,969 families living in privately owned houses 97 or 1.2% were found to be overcrowded, while in the 558 Council houses 29 families, or 5.2% were overcrowded. At the completion of the survey a communication was sent to the owners and occupiers of dwellings in which overcrowding was discovered and before the end of the year many families were able to obtain adequate accommodation, either in Council houses or in private dwellings. Altogether 75 cases of overcrowding, including 11 in Council houses, were relieved during the year, and the total cases remaining at the end of the year was 63. Some further progress was made with the Red Lion Hill Scheme during the year, but it is not expected that any flats will be available for occupation before the spring of 1938. FOOD. Meat and Other Foods. Under the Public Health (Meat) Regulations, 1924, 9,828 carcases were inspected, and a large amount of meat was condemned as unfit for the food of man. A full account of this work will be found in the report of the Chief Sanitary Inspector. 43 MILK SUPPLY. Details of the inspection of dairies, cowsheds and milk shops, together with the bacteriological results of samples will be found in the report of the Chief Sanitary Inspector. Sale of Food and Drugs Act. Mr. Robinson, of the Public Control Department of the County of Middlesex, has been good enough to supply me with the following figures:- List of Samples taken in Finchley during the Year ended 31 st December, 1936. Article. Samples Taken. Adulterated. Milk 63 - Cinnamon 1 - Cream 1 - Cream Cakes 2 2 Gin 1 - Hake 7 - Lemon Sole 1 - Minced Beef 2 - Lard 6 - Sausages 6 1 Whisky 2 - Vinegar .2 - Totals 94 3 44 FACTORIES AND WORKSHOPS. All the factories and workshops in the district have been inspected during the year and the various sanitary defects remedied as a consequence. Very little homework appears to be given out in the district. At some of the workshops the work done is for firms in London, but the total amount is not large. 1.—Inspection of Factories, Workshops and Workplaces. Inspections made by the Sanitary Inspectors:- Premises Inspections Number of Written Notices Occupiers prosecuted Factories 269 2 - (including Factory Laundries) Workshops 261 - - (including Workshop Laundries) Workplaces (Other than Outworkers' Premises) 110 - - TOTALS 640 2 - 45 2.—Defects Found in Factories, Workshops and Workplaces. Particulars. Number of Defects. Number of offences in respect of when Prosecutions were instituted. Found. † Remedied Referred to H.M. Inspector. Nuisances under the Public Health Acts:* Want of Cleanliness 47 45 - - Want of Ventilation — - — — Overcrowding 1 1 — — Want of drainage of floors — — — — Other Nuisances 44 39 — — Sanitary accommodation insufficient 4 3 — — unsuitable or defective 41 38 - - not separate for sexes 1 - - - Offences under the Factory and Workshop Acts: Illegal occupation of underground bakehouse - - - - Other Offences (Excluding offences relating to outwork and offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921) - - - - TOTALS 138 126 - - *Including those specified in Sections 2, 3, 7, and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. †Including defects standing over from the previous year. 46 ANNUAL REPORT of the CHIEF SANITARY INSPECTOR FOR THE YEAR 1936 BOROUGH OF FINCHLEY ANNUAL REPORT OF THE Chief Sanitary Inspector For the Year 1936 To the Mayor, Aldermen and Councillors of the Borough of Finchley. I have the honour to present to you my Thirty-fifth Annual Report dealing with the work carried out by your Sanitary Inspectors during the Year 1936. The total number of inspections made during the year was 10,969. At 1,242 of the houses and other premises visited, defects or nuisances to the number of 3,336 were discovered, and at the end of the year 2,611 of these had been remedied or abated, the work in connection with 643 was in hand, and the remaining 82 were outstanding. In order to ascertain that the sanitary defects were being properly remedied, 1,415 visits were paid to the respective premises while the work was in progress. 48 Inspections. The total number of inspections made in regard to each section of work is recorded in the appended table, together with a summary of the sanitary improvements carried out:- House-to-House Inspections 346 Special Inspections 2984 Inspections of Houses-let-in-Lodgings 104 Re-Inspections 2918 Inspections of Works in Progress 1415 Inspections of Factories, Workshops and Workplaces (including Bakehouses and Restaurant kitchens) 673 Visits to Slaughterhouses 823 Inspections of Cowsheds, Dairies and Milkshops 122 Inspections of Ice Cream Premises 124 Inspections of Meat, Fish and other Food Shops 205 Inspections of Shops (Shops' Act) 287 Visits re Infectious Disease 722 Miscellaneous 246 Total number of Inspections and Re-inspections 10,969 Total number of Houses inspected under:- (a) Public Health Acts 1034 (b) Housing Acts 517 1551 Total number of other premises visited 1040 Overcrowding Survey. Number of visits in connection with the overcrowding survey, including visits to measure rooms for the purpose of furnishing landlords with information for entry in rent books 5052 49 Summary of Sanitary Improvements Carried Out. Drainage. Number of Houses and Premises re-drained 14 Repairs or amendment to existing- drains 76 Drains or Gullies unstopped or cleansed 147 Length in yards of Stoneware Drains laid 378 Length in yards of Heavy Cast Iron Drains laid 24 Manholes provided 26 Manholes repaired 35 Intercepting Traps fixed 3 Fresh Air Inlets provided or repaired 45 New Gully Traps fixed 45 Gully Curbs provided or repaired 44 New Soil Pipes and Ventilating Shafts fixed 25 Soil Pipes and Ventilating Shafts repaired 11 Water Tests applied 196 Smoke Tests applied 11 Air Tests applied 29 Water Closets and Sanitary Fittings. New W.C. Basins fixed 148 W.C.'s unstopped, cleansed or repaired 104 New Flushing Boxes fitted to W.C.'s 29 Existing Flushing Boxes repaired 47 Joints between W.C.'s and Flush Pipes repaired 11 New W.C. Apartments provided 30 Ventilated Lobbies provided 9 Existing W.C. Apartments improved 14 Urinals provided 6 Urinals abolished 1 Urinals cleansed or repaired 13 Lavatory Basins provided 88 Baths provided 33 New Impervious Sinks provided 38 New Waste Pipes fixed 146 Waste Pipes trapped, repaired or unstopped 82 50 Miscellaneous. New Roofs constructed 12 Roofs repaired 195 Eaves Guttering renewed, cleansed or repaired 87 Stack Pipes provided, repaired or unstopped 51 Stack Pipes disconnected from Drains 3 Damp Walls remedied 171 Walls repointed, repaired or under-pinned 75 Ventilation under floors provided 14 Yards Paved 17 Paving of yards repaired 33 Floors of Rooms relaid 10 Floors of Rooms repaired 59 Rooms cleansed, distempered or repapered 630 Means of Ventilation to Rooms provided 23 Windows repaired and/or made to open 115 New Windows provided 32 New Sash Cords provided 449 Window Sills repaired or provided 44 Doors provided or repaired 35 Doorsteps provided or repaired 14 Artificial Lighting to Staircases provided 1 Natural Lighting to Staircases provided 10 Staircases repaired 21 Ventilated Food Stores provided 3 New Ranges and Stoves provided 33 Stoves and Ranges repaired 61 Coppers provided 4 Coppers repaired 20 Workrooms (including Bakehouses) cleansed and repaired 41 Cisterns provided 9 Cisterns repaired, cleansed and covered 23 Water Supply provided 1 Water Service Pipes repaired 19 Movable Sanitary Dustbins provided 219 Offal Bins provided 5 Nuisances from the keeping of animals abated 16 51 Nuisances from Smoke abated 4 Accumulations of refuse removed 76 Accumulations of water removed 1 Manure Receptacles provided 1 Accumulations of manure removed 5 Miscellaneous 105 Notices Served. Informal Notices 552 Statutory Notices 12 Enquiries—Outstanding Sanitary Notices. 751 letters were received during the year from the Town Clerk enquiring whether or not there were any outstanding sanitary notices with respect to certain properties in the district. The necessary searches were made and the required information furnished. Disinfection. Number of rooms sprayed and fumigated after infectious disease 149 Verminous rooms sprayed and fumigated 57 Number of articles disinfected 6,704 Number of verminous premises dealt with 43 722 visits were made by your inspectors and disinfectors in connection with cases of infectious disease and the necessary investigations were made in order to furnish the Medical Officer of Health with the detailed information he required. 52 Cremation of Bodies of Domestic Animals. The Royal Society for the Prevention of Cruelty to Animals undertake the humane destruction of dogs and cats suffering from disease, injury, old age or for some other sufficient cause. In order to assist them in this work, the department collects the bodies of these animals which are cremated at the Borough Council's Destructor. During the year the disinfectors collected the bodies of 85 dogs and 560 cats. House-to-House Inspection. The inspections under this heading are those made in compliance with the Housing Consolidated Regulations, 1925 and 1932. The houses inspected during the year in the areas scheduled to be dealt with under these Regulations were as follows:- Albert Place, N.3. 5 Britannia Road, N.12 4 Chapel Street (Wooders Cotts.) N .2 6 East End Road, N.2. 8 Finchley Park, N.12 16 Green Road, N.20 15 Hendon Lane, N.3 10 High Road, N.20 70 King Street, N.2 10 Long Lane, N.3 117 Oakleigh Road, N.20 2 Park Road, N.2 4 Prospect Place, N.2 4 Rasper Road, N.20 37 Shakespeare Road, N.3 5 Sherwood Street, N.20 15 Solomons Terrace, High Road, N.20 8 Swan Place, N.20 10 346 53 The 346 premises comprise 385 separately rated houses and tenements. As a result of these house-to-house inspections, no less than 2,077 defects or nuisances were discovered and dealt with, and these are enumerated in the appended summary:- Defective drains 1 Blocked drains 2 Defective and short ventilating shafts to drains 12 Dilapidated W.C. apartments 28 Insufficient W.C. accommodation 4 Light and ventilation to W.C. apartments insufficient 8 Defective and insanitary W.C. basins 14 Defective joints between flush pipes and W.C. basins 3 Defective W.C. seats 8 W.C. flushing boxes out of order 15 Defective manholes 2 Defective fresh air inlets to drains 11 Defective house roofs 74 Dirty and defective ceilings and walls of rooms 476 Defective brickwork and pointing to walls 69 Defective doors 52 Defective doorsteps 6 Defective stairs and handrails, etc., to staircases 23 Unsatisfactory lighting to staircase 9 Defective floors of rooms 80 Absence of sink 10 Insanitary stone troughs and/or defective sinks 9 Defective and untrapped waste pipes 32 Defective, absence of, or insufficient yard paving 33 Absence of, or defective eaves guttering and stack pipes 89 Nuisances from dampness 125 Absence of, or defective gratings to ventilation openings under floors 2 Absence of sufficient ventilation to rooms 16 Windows, defective or not made to open 146 Defective window sills 33 54 Dirty, defective or uncovered service water cisterns 13 Defective kitchen ranges 62 Defective stoves 64 Defective coppers 35 Defective chimneys 49 Broken sash cords 326 Insufficient water supply 5 Defective service water pipes 5 Defective dustbins 42 Absence of, or defective gully curbs 28 Miscellaneous 54 An analysis of the house-to-house records for the year 1936 has been made, and the following statistical information compiled therefrom:- Dwelling Houses. Number of houses inspected 346 Number of Rooms. Living Rooms 711 Sleeping Rooms 811 . Bed-living Rooms 55 1,577 Occupants. Number of Occupants, Adults 1141 ,, Children 172 Average number of persons per house 3.794 ,, ,, room .832 ,, ,, bedrooms 1.516 Sub-Letting. Houses occupied by one family 292 ,, ,, two families 52 „ ,, three ,, 2 Number of houses sub-let—54 or 13.607 per cent. 55 Rents. Annual Rental of £16 or under 6 „ „ £16 to £26 58 „ ,, £26 to £40 129 „ „ over £40 121 Owned by occupiers 32 346 Sanitation. Number of houses where defects were found 296 Number of houses found to be in some respect unfit for human habitation 110 Notices. Number of informal notices served 249 Number of statutory notices served - Unfit Dwelling-houses Closed or Demolished. Cambridge Cottage, King Street, N.2. The work of demolishing this house, which was commenced by the owner at the end of 1935, was discontinued and left in an incomplete state. After some little delay, the demolition of the house was completed by the Corporation in the owner's default. 1 and 2, Rustic Cottages, Dunger Place, N.12. A demolition order was made by the Corporation with respect to these cottages, and legal proceedings were taken to obtain possession of one of the houses, the other being already vacant. The actual demolition of the property has, however, been allowed to stand over for a time pending the closing and demolition of an adjoining house. 56 3, 4, 5 and 6, Rustic Cottages, Dunger Place, N.12. As a result of representation made to the owner by the department, he has agreed to demolish the above houses and to erect on the site three new dwellings of a modern type. It is anticipated that this work will be commenced early in 1937. 34 and 36, Lichfield Grove, N.3. The above houses, which are divided into six self-contained flats, and which had been vacant for a long period, were thoroughly reconditioned and made fit for habitation. OVERCROWDING. Housing Survey—Housing Act, 1936. The preliminary survey of the dwelling-houses in the Borough occupied, or of a type suitable for occupation, by persons of the working classes was practically completed by the end of 1935 and with the assistance of four temporary enumerators the detailed investigation of all cases of suspected or actual overcrowding was immediately proceeded with. As a result of the second and more detailed survey the following information was compiled:- Number of houses surveyed 604 Number of separate families 1077 Number of families not overcrowded 951 Number of families overcrowded:- (a) In privately owned houses 97 (b) In houses owned by the Corporation 29 — 126 A joint report by the Medical Officer of Health and myself, which contained a full and detailed account of the survey was submitted to the Council on the 5th March, 1936. 57 Since the completion of the survey, 75 cases of overcrowding have been abated. Twenty-one cases were relieved by removal of the families to Council Houses. Fifty-four cases were relieved by the families removing to other dwellings or by obtaining additional accommodation in the houses which they already occupied. A few cases were relieved by the marriage of a member of the family and by death. During the same period twelve new cases of overcrowding have been discovered. The number of cases outstanding at the end of the year was 63. Entries in Rent Books. The Housing Act provides that the rent book or similar document relating to any working class house must contain (inter alia) a statement of the "permitted number" of persons who may occupy the house. Upon the application of the landlord or the occupier of any such house it is the duty of the Local Authority to inform the applicant in writing of the number of persons constituting the "permitted number" in relation to the house. In order to obtain this information it is necessary to visit the house and measure the various rooms. A number of applications have been received from property owners and others for the information to enable them to comply with the above requirement and with the help of one enumerator these applications have been dealt with. The following is a summary of the work done under this heading at the 31st December, 1936:- Number of dwelling-houses for which applications had been received 2693 Number of such dwelling-houses which had been measured— Houses 2593 Rooms 13535 Number of such dwelling-houses for which certificates had been issued 2593 58 It is estimated that there are in the Borough approximately 4,700 dwelling-houses respecting which no applicacation had been received at the end of 1936. Steps are being taken to expedite the recording in the department of the necessary information in relation to these houses and action will be taken to ensure reasonable compliance with this provision of the Housing Act. Houses Let in Lodgings. The number of houses let in lodgings on the register is 64. During the year there were three houses added to the register and fourteen were deleted therefrom for the following reasons, namely:—seven houses were found to be each occupied by only one family, six houses, including two exceptionally large premises, were converted into self-contained flats, and one very large house was demolished and the site utilised for the building of a block of flats. Consequent upon the district having assumed the status of a Municipal Borough, the existing code of byelaws was repealed and a new code containing somewhat similar provisions has been submitted to the Minister of Health for approval. The usual routine inspection of houses let in lodgings has been carried out and action has been taken to ensure reasonable compliance with the byelaws. Common Lodging Houses. There are no common lodging houses in the district. Sanitary Conveniences. There are 26 conveniences attached to licensed houses within the district. These premises are inspected periodically. 'There are seven public conveniences in the district. Five of these conveniences provide accommodation for both sexes and two accommodation for males onlv. J 59 Complaints. Four hundred and thirty-seven complaints were received with reference to the following matters, viz.:— Blocked or defective drains 53 Insanitary condition of mews and passages 7 Insanitary or defective condition of houses 113 Defective roofs 16 Non-removal of refuse 1 Verminous condition of houses 15 Nuisance from dampness 27 Nuisance from overcrowding 11 Nuisance from the keeping of animals 9 Nuisance from the burning of refuse 27 Accumulations of refuse or manure 50 Absence of, or defective dustbins 5 Smoke nuisance 2 Smells from public sewers 1 Premises infested with rats 15 Premises infested with insects 13 Shops Acts 9 Flooding . 7 Other complaints 56 The complaints were investigated promptly, and in those cases in which the Council had power to intervene the necessary steps were taken to remove the cause of complaint. Places of Public Entertainment. In accordance with the request of the Minister of Health contained in Circular 120, the cinemas, dance halls, and other places of public entertainment have been inspected, special attention being given to the condition and adequacy of the sanitary accommodation. The defects discovered as a result of these inspections were remedied, after notice had been given to the persons responsible. A report upon the premises was submitted to the Middlesex County Council, which is the licensing authority for the district of Finchley. The number of premises dealt with was 26. 60 Premises Periodically Inspected. The following premises were visited periodically during the year, and any matters found requiring attention were dealt with:— Description of Premises. No. in District. Dairies, Cowsheds and Milkshops 64 Factories, Workshops and Workplaces (including Bakehouses and Restaurant Kitchens) . 394 Fried Fish Shops 8 Ice Cream Premises 109 Places of Public Entertainment 26 Public House Conveniences 26 Slaughterhouses 5 Shops re Food Supplies 248 880 Factory and Workshop Acts, 1901 and 1907. The total number of Factories, Workshops and Workplaces on the Register is 394. The trades carried on at the respective premises are as follows:— Bakehouses 41 Boot Polish Manufacturer 1 Boot repairers 47 Builders' Workshops . 20 Cycle Makers or Repairers 8 Farriers and Blacksmiths 5 Glass Blowers 1 General Engineers and Motor Engineers 61 Laundries . 10 Monumental Masons 7 Motor Accessory Manufacturers 2 Prepared Meat Factories 2 Printers and Printers' Accessories 17 Restaurant Kitchens 59 61 Sheet Metal Workers 3 Sports Accessory manufacturers 1 Tailors and Dressmakers . 31 Timber Merchants and Sawyers 15 Tyre Re-treading 2 Upholsterers 12 Watch and Clock Repairers 8 Other Trades 41 394 These premises have been visited from time to time,, and as a result of action taken by the department the following works have been carried out:— W.C. apartments provided or reconstructed 4 Ventilated lobby provided 1 New W.C. Pans provided 2 W.C.'s cleansed or repaired 34 Urinals cleansed 1 Joints between flush pipes and W.C. pans repaired 4 Flushing Cisterns provided 1 Flushing Cisterns repaired 1 New Sinks provided . 1 New Sink Waste Pipes provided 3. Drains unstopped or repaired 2 Fresh air inlet shafts repaired 4 Roofs repaired 1 Floors repaired and/or cleansed 3. Dustbins provided 10 Workshops cleansed 27 Accumulations of refuse removed 9 Smoke nuisance abated 3 Yards cleansed or repaired 1 Overcrowding abated 1 Miscellaneous 46 62 Smoke Abatement. The Factory Chimneys in the district have been kept under observation, and appropriate action has been taken in several instances with respect to nuisance arising from the emission of black smoke. Rag Flock Acts, 1911 and 1928. A small quantity of rag flock is used in the district. The supply of this material is obtained from manufacturers who guarantee that it complies with the requirements of the above Acts. Rag flock is not manufactured or sold in the district. Exchange of Toys, etc., for Rags. It is not lawful for any person to distribute from any barrow, vehicle or premises used in connection with the business of a rag and bone merchant any article of food or any balloon or other toy. In two instances evidence was obtained respecting persons who collected rags from children outside the Council's schools in exchange for such articles as pencils, pens, notebooks, combs, etc. No barrow or other vehicle was used. Rats and Mice Destruction Act, 1919. The above Act is administered by the Middlesex County Council. A number of complaints have been received in respect of premises alleged to be infested with rats. These complaints were immediately forwarded to Mr. A. Chudley, the Rats Destruction Officer for this district. The Inspection and Supervision of Food. Inspection of Meat. The inspection of meat is mainly controlled by the provisions of the Public Health (Meat) Regulations, 1924. These regulations provide that any person intending to slaughter an animal for human consumption must notify the local authority three hours before the time of slaughtering. These notices may be given at any time as the local authority are not empowered to regulate the hours of slaughter. 63 In addition to the regular times fixed by certain butchers when slaughtering is to be carried out, 530 individual notifications of intention to slaughter were received. As in former years, it has on many occasions proved somewhat difficult to arrange for the inspection of the carcases and organs of the animals slaughtered owing to the uncertain times when slaughtering takes place and the delivery after office hours of notices of intention to slaughter. With very few exceptions, however, the necessary inspections have been made. Five certificates were issued to butchers at their request, certifying that certain meat had been inspected and found to be unfit for the food of man and destroyed. The total, number of carcases of animals (including organs) inspected after slaughter during the year and the number and percentage found to be affected with tuberculosis are as follows:— No. Examined. Found to be tuberculous. Percentage. Beasts 191 32 I6.754 Calves 87 5 5.747 Pigs 2,110 113 5.355 Sheep 7,440 — — 9,828 Diseased or Unsound Meat, etc., Destroyed. The following is a list of the diseased or unsound meat and other food which was detected by your inspectors and subsequently destroyed:— Tuberculosis. Bo vines. Carcases and Offal 2 Carcases and Offal (Calves) 2 Heads and Tongues 3 Sets of Lungs 16 64 Livers 5 Mesenteries 11 Forequarters 2 (288 lbs.) Heart 1 Spleen 1 Swine. Carcases and Offal 2 Heads 65 Mesenteries 81 Plucks 12 Spleens T Livers 1 Hearts 2 Leg and loin 1 Conditions other than Tuberculosis. Bovines. Heads and Tongues : Actinomycosis 1 Sets of Lungs : 3 Pleurisy, 1 Abscess 4 Livers: 9½ Flukes, 2 Abscesses 11½ Heart : Congestion 1 Spleen : Peritonitis 1 Swine. Carcases and Offal : 1 Pneumonia, 2 Fevered, 5 Swine Fever, 3 Erysipelas, 1 Septicaemia 12 Sets of Lungs : 34 Congestion, 40 Pneumonia, 6 Pleurisy 80 Plucks : Congesticn 8 Kidneys : Cysts 3 Livers : 35 Cirrhosis, 3 Congestion, 1 Fatty Infiltration, 3 Necrosis 42 Mesenteries : 4 Congestion, 2 Cysts, 1 Abscess 7 Hearts: 2 Congestion, 18 Pericarditis 20 Spleens : 9 Congestion, 1 Cysts, 1 Rupture, 2 Abscesses . 11 Meat : Abscess 4 lbs 65 Sheep. Carcases : 1 Dropsy, 2 Fevered, 2 Pleurisy 5 Lungs : 4 Abscesses, 22 Congestion, 14 Strongulus Rufescens, 3 Pneumonia, 5 Pleurisyf 1 Fevered 49 Livers : 3 Fatty Degeneration, 68 Parasites, 3 Congestion, 4 Mutilation, 6 Abscesses 84 Hearts: Pericarditis 2 Plucks : 1 Inflammation, 1 Pleurisy 2 Meat. 100 lbs. Slaughterhouses. The number of private slaughterhouses in Finchley is as follows: Type of Slaughterhouse— Registered Nil Licensed 5 The number of visits paid to the five slaughterhouses was 823. Most of these visits have been made for the purpose of inspecting the carcases and organs of animals slaughtered for human consumption. Attention has also been given to the condition, generally, of the slaughterhouses and steps have been taken to ensure compliance with the provisions of the byelaws with respect to these premises. The Slaughter of Animals Act, 1933. In accordance with the provisions of this Act, all animals, including sheep, which are slaughtered in a slaughter-house within the district must be stunned by means of a mechanically-operated instrument kept in proper repair. This method of slaughter continues to prove quite satisfactory and steps have been taken to ensure that the provisions of the Act have been properly carried out. The number of persons licensed under the Act by the Corporation to slaughter animals was 20. 66 Butchers' Shops. There are 49 butchers' shops in the district. All the shops are provided with glass fronts. These premises have been visited periodically and the provisions of the Public Health (Meat) Regulations, which provide for the cleanliness of the premises, apparatus, utensils and vehicles, the precautions to be taken against the contamination of meat, the storage and removal of refuse, etc., have been, generally, well observed. Bakehouses. The number of bakehouses in the district is 40. During the year 2 new bakehouses were opened and 2 existing bakehouses closed. At 28 bakehouses motive power is used and the premises, therefore, constitute ''factory bakehouses." The remaining 12 bakehouses are "workshops." The bakehouses have been visited by your inspectors and steps have been taken to cause them to be maintained in a proper sanitary condition. The periodical limewashing of these premises, as required by statute, has been carried out. Dairies, Cowsheds and Milkshops. There are 64 dairies, cowsheds and milkshops in the district, and in addition 27 purveyors of milk whose premises are not in Finchley are registered for the purpose of retailing milk within the district. There were thirteen new registrations of milk purveyors during the year. The usual periodical inspection of all dairy premises has been maintained, and the provisions of the Milk and Dairies Order, 1926, with respect to the cleanliness af dairies and cowsheds, the protection of milk against infection and contamination, and the conveyance and distribution of milk have been generally well observed. The veterinary inspection of the cows kept in the district is carried out by the Middlesex County Council. 67 The Milk (Special Designations) Orders, 1923, 1934 and 1936. Licences were granted by the Council in respect of designated milk for the year ended the 31st December, 1936, as follows:— Dealers' Licences to sell milk as "Certified" 6 „ ,, - ,, ,, ,, ,, "Grade A" 3 ,, . ,, ,, ,, ,, ,, Grade A Milk Pasteurised" 4 ,, ,, ,, ,, ,, ,, Grade A (Tuberculin Tested") 7 ,, ,, ,, ,, ,, ,, "Pasteurised" 13 Supplementary Licence to sell milk as "Tuberculin Tested" 1 ,, ,, ,, ,, „ ,, "Pasteurised" 1 Licence in respect of establishment at which "Grade A" (Tuberculin Tested) Milk is bottled 1 Licences in respect of establishments in which the process of pasteurising milk is carried on 3 Two samples of "Grade A (Tuberculin Tested) Milk," three samples of "Tuberculin Tested" and six of "Pasteurised" Milk were taken on behalf of the Council and submitted for bacteriological examination. These samples complied with the prescribed conditions. The Milk (Special Designations) Order, 1936, came into operation on the 1st June, 1936. This Order supersedes the Milk (Special Designations) Orders 1923 and 1934 which are repealed. The special designations which may now be used in relation to milk are "Tuberculin Tested," "Accredited" and "Pasteurised." Ice Cream Premises. The number of ice cream premises on the register is J09. The premises were visited during the summer months. 68 Coffee Stalls. The number of coffee stalls in the district is 9. Eight of these stalls are situated in the main roads. These stalls are visited at intervals and action is taken to secure the provision of a satisfactory water supply, suitable means of food storage, cleanliness of stalls and utensils and proper means for the storage and disposal of refuse. Offensive Trades—Fish Friers. The only offensive trade carried on in this district is that of a fish frier, this business being established at 8 premises. Steps have been taken by periodical visits to secure a reasonable compliance with the bye-laws. Came Licences. Fourteen applications were received under Section 27 of the Local Government Act, 1894, from tradesmen in the district for licences to deal in game. A licence was granted in each instance. The Shops Acts, 1912 to 1928. The number of shops on the register and the infringements dealt with are as follows:— Number of shops on Register at end of 1936 915 New additions to Register during 1936 45 Changes of occupancy recorded 47 Infringements recorded 93 Storage of Petroleum. Petroleum Spirit is defined as Petroleum, which, when tested in a prescribed manner, gives off an inflammable vapour at a temperature less than 73 degrees Fahrenheit. Certain mixtures containing petroleum spirit, e.g., cellulose paint, rubber solution, etc., and also carbide of calcium come within the Petroleum Act. 69 During the year applications for licences to keep petroleum spirit and carbide of calcium were received as follows:— Petroleum Spirit. No. of applications for licences 89 No. of applications granted 89 Quantity of petroleum spirit which may be kept in licensed stores 114,813 gallons Carbide of Calcium. No. of applications for licences 3 No. of applications granted 3 Quantity of carbide of calcium which may be kept in licensed stores 504 pounds Licence fees paid during 1936 £62.12.6 Most of the petroleum spirit is kept in bulk in underground storage tanks and there are now installed in the district no less than 169 of these tanks to which are connected 152 petrol supply pumps. A large number of the handoperated pumps are being replaced bv electrically operated pumps. The various licensed premises have been inspected from time to time, and a number of contraventions of the conditions attached to the licences have been dealt with. Legal Proceedings. Legal proceedings were taken in the following instances. (1) A retail firm of butchers, etc., were summoned for exposing for sale meat which was unwholesome and unfit for human consumption. The case was dismissed but the defendants were ordered to pay £10 10s. costs. (2) A shopkeeper was summoned for keeping open a shop for serving customers after the general closing hour contrary to the provisions of the Shops Acts. The defendant was fined £1 and ordered to pay £1 10s. costs and the shop assistant was fined £1. 70 Staff. There were no changes in the sanitary staff during the year. It is with much pleasure that I take this opportunity to express my great appreciation of the invaluable help given by the assistant inspectors and the clerical staff, and again gratefully to acknowledge the kind co-operation of Dr. Turner, the Medical Officer of Health, and my colleagues in other departments. I am, Your obedient servant, E. J. FRANKLIN, Chief Sanitary Inspector. Public Health Department, 308, Regents Park Road, N.3. Index Page Report of the Medical Officer of Health 1 Members of the Public Health Committee and Staff Public Health Department 2 Social Conditions 4 Vital Statistics 4 Poor Law Relief 10 Statistical Tables—Mortality, etc. 13 General Provisions of Health Services in the Area 18 Clinics and Treatment Centres 21 Professional Nursing in the Home 22 Sanitary Circumstances of the Area 22 Infectious Diseases 24 Statistical Tables—Infectious Diseases 33 'Tuberculosis . 35. Maternity and Child Welfare 37 Housing Statistics, etc. 40 Food 43 Factories and Workshops 45 Report of the Chief Sanitary Inspector 48 Inspections 49 Summary of Sanitary Improvements Carried Out 50 Notices Served 52 Disinfection 52 House-to-House Inspection 53 Unfit Dwelling-houses Closed or Demolished 56 Overcrowding 57 Houses Let in Lodgings 59 Sanitary Conveniences 59 Complaints 60 Places of Public Entertainment 60 Premises Periodically Inspected 61 Factory and Workshop Acts 61 Exchange of Toys, etc., for Rags 63 'The Inspection and Supervision of Food 63 Dairies, Cowsheds and Milkshops 67 The Milk (Special Designations) Orders, 1923, 1934 and 1936 . 68 Ice Cream Premises 68 Coffee Stalls 69 Offensive Trades 69 Game Licences 69 The Shops Acts 69 Storage of Petroleum 69 Legal Proceedings 70 Staff 71 FINCHLEY PRESS LTD. FINCHLEY N.2