FINC C439(1) FINCHLEY, ddx Borough of Finchley ANNUAL REPORTS FOR THE YEAR 1938 of the MEDICAL OFFICER OF HEALTH & SCHOOL MEDICAL OFFICER together with THE ANNUAL REPORT OF THE CHIEF SANITARY INSPECTOR 2.√ FINC 021 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1938 Members of the Public Health and Maternity and Child Welfare Committee. Chairman: Councillor Major Steward. The Mayor (Councillor J. Hugh Joxes, ll.b.) The Deputy Mayor (Alderman C. S. Syrett). Alderman Briant Councillor Col. Beach, c.b. „ Grocott. „ Grobel. „ Pike, O.B.E., J.P. „ Mrs. Murphy. „ Wells. „ Norman. 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. †Miss E. M. Pakeman, M.B., B.S. Chief Sanitary Inspector: *E. J. Franklin, f.r.san.i., f.s.i.a. Assistant Sanitary Inspectors: J. Gray, cert.r.san.i. W. H. Nicholls, cert.r.san.i. J. Yates, cert.r.san.i. K. J. Millen, 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 C. Hemming. *Miss F. Hughes. Midwives: Mrs. A. B. Talbot. Miss A. M. Davey. Day Nursery Nurses: Miss L. M. Nelmes. Miss D. Phillips. Chief Clerk: W. L. N. Relleen. Clerks: Miss K. M. Nichol. A. Field. Miss M. Batty. Miss M. Powley. *Salary contribution made under the Public Health Acts or by Exchequer grants. † Part-time. 2 To the Mayor, Aldermen and Councillors of the Borough of Finchley. June, 1939. I have the honour to submit my Annual Report for 1938 on the health of the Borough. The vital statistics are excellent. The infantile mortality rate—35.59— is the lowest ever recorded, and for the first time on record the maternal mortality rate is nil. The death rate has fallen and the birth rate has risen. The incidence of diphtheria remains very low, and the number of cases of scarlet fever shows a considerable drop, while there has been no death from either disease. The death rate for tuberculosis, 0.39 per 1,000 of the population, remains very low. Throughout the year, and especially during the later months, much time has been taken up by work in connection with Air Raid Precautions, and in consequence the routine work of the department has suffered to some extent. I wish to express my thanks to Dr Russell, Mr. Franklin, and all members of the staff for their loyal assistance. I am, Your obedient Servant A. A. TURNER, 3 SOCIAL CONDITIONS. Area (in acres) 3,477 Population, 1938 (Registrar-General's Estimate) 65,140 Number of Inhabited Houses (end of 1938) 17,434 Rateable Value (1938) £864,821 Sum represented by a Penny Rate £3,490 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR. Live Births: Total. Males. Females. Legitimate 881 463 418 Illegitimate 46 22 24 Birth rate, 14.23 per 1,000 estimated resident population. Total. Males. Females. Stillbirths 19 8 11 Rate, 20.08 per 1,000 total (live and still) births. Total. Males. Females. Deaths 662 329 333 Death rate, 10.16 per 1,000 estimated resident population. Deaths from diseases and accidents of pregnancy and child birth:— From sepsis — From other causes — Death rate of Infants under one year of age:— All infants per 1,000 live births 35.59 Legitimate infants per 1,000 legitimate live births 31.78 Illegitimate infants per 1,000 illegitimate live births 108.7 Deaths from Cancer (all ages) 125 Deaths from Measles (all ages) 4 Deaths from Whooping-cough (all ages) 1 Deaths from Diarrhoea (under 2 years of age) 5 4 POPULATION. The Registrar-General estimates that the population on the 30th June, 1938, was 65,140, an increase of 615 over the previous year. As stated in previous reports there is reason to believe that the population is really higher than this figure, and I estimate it to be 67,500. The natural increase, or the excess of births over deaths, was 265. BIRTHS. In 1938 the number of registered live births was 927 as compared with 895 in 1937. The birth rate is 14.23, the highest for ten years. The rate for England and Wales was 15.1. There were 46 illegitimate births as compared with 59 in 1937. Nineteen stillbirths were registered, giving a rate of 20.08 per 1,000 of all births. INFANTILE MORTALITY. In 1938 there were 33 deaths of infants under the age of one year, giving an infantile mortality rate of 35.59 per 1,000 live births. This is the lowest rate that has ever been recorded in Finchley. The corresponding rate for England and Wales was 53 and for London 57. Of the 33 deaths no less than 25 were of males and only 8 of females although the number of male births was only slightly higher than those of females. Eleven deaths occurred during the first week of life and 15 during the first month. 5 8 7 DEATHS. In 1938 there were 662 deaths as compared with 704 in 1937, giving a crude death rate of 10.16, while in 1937 it was 10.84. The standardised rate was 9.95 as compared with the rate of 11.6 for England and Wales as a whole. The deaths from malignant disease show an increase while those from heart disease have decreased. Otherwise no important change has occurred. POOR LAW RELIEF During the year 495 families were in receipt of outdoor relief, and the total amount expended on such relief was £11,552 6s. 0d. 9 11 12 INFANTILE MORTALITY DURINC THE YEAR 1938. 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 11 1 3 ... 15 8 6 1 3 33 9 16 8 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken Pox ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... 1 ... ... 1 ... 1 ... Pneumonia (all forms) 2 ... ... ... 2 2 2 1 2 9 3 3 3 Diarrhœa ... ... ... ... ... ... ... ... ... ... ... ... ... Enteritis ... ... ... ... ... ... 2 ... 1 3 2 1 ... Gastritis ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... Pickets ... ... ... ... ... ... ... ... ... ... ... ... ... Suffocation, Overlying ... ... ... ... ... ... ... ... ... ... ... ... ... Injury at Birth ... ... ... ... ... ... ... ... ... ... ... ... ... Atelectasis 2 ... 1 ... 3 ... ... ... ... 3 ... 3 ... Congenital Malformations 1 1 ... ... 2 2 ... ... ... 4 1 2 1 Premature Birth 4 ... 1 ... 5 1 ... ... ... 6 1 2 3 Atrophy, Debility and Marasmus 1 ... 1 ... 2 3 1 ... ... 6 2 3 1 Other causes 1 ... ... ... 1 ... ... ... ... 1 ... 1 ... Totals 11 1 3 ... 15 8 6 1 3 33 9 16 8 13 CAUSES OF, AND AGES 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 'Residents' or 'NonResidents' in Institutions in the District. WARDS. All Causes Certified 662 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 4 ... 2 1 1 ... ... ... ... ... 1 ... 3 3. Scarlet fever ... ... ... ... ... ... ... ... ... ... ... ... ... 4. Whooping cough 1 ... ... 1 ... ... ... ... ... ... ... ... 1 5. Diphtheria ... ... ... ... ... ... ... ... ... ... ... ... ... 6. Influenza 11 ... ... ... ... 1 ... 6 4 1 7 1 3 7. Encephalitis lethargica ... ... ... ... ... ... ... ... ... ... ... ... ... 8. Cerebro-spinal fever ... ... ... ... ... ... ... ... ... ... ... ... ... 9. Tuberculosis of respiratory system 22 ... ... ... ... 2 11 7 2 1 6 11 5 10. Other tuberculous diseases 4 ... 1 ... 2 ... 1 ... ... ... 2 1 1 11. Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... 12. General paralysis of the insane, tabes dorsalis 3 ... ... ... ... ... ... 3 ... ... 2 1 ... 13. Cancer, malignant disease 125 ... ... ... ... 1 1 50 73 12 43 36 46 14. Diabetes 8 ... ... ... ... ... ... 2 6 1 7 ... 1 15. Cerebral hæmorrhage, etc. 24 ... ... ... ... 1 ... 9 14 5 6 10 8 16. Heart disease 189 ... ... ... 1 3 6 39 140 18 51 57 81 17. Aneurysm 4 ... ... ... ... ... ... 2 2 1 ... 2 2 18. Other circulatory diseases 44 ... ... ... ... ... 1 10 33 3 11 17 16 19. Bronchitis 14 1 ... ... ... ... ... ... 13 2 5 4 5 20. Pneumonia (all forms) 41 7 1 1 ... ... 2 9 20 7 18 11 12 21. Other respiratory diseases 6 ... ... ... ... 1 ... 4 1 4 2 3 1 22. Peptic ulcer 9 ... ... ... ... 1 ... 5 3 3 3 3 3 23. Diarrhœa, etc. (under 2 years) 5 5 ... ... ... ... ... ... ... 1 2 2 1 24. Appendicitis 5 ... ... ... 1 ... 1 2 1 1 1 2 2 25. Cirrhosis of liver 4 ... ... ... ... ... ... 3 1 ... 2 ... 2 26. Other diseases of liver, etc. 2 ... ... ... ... ... ... 1 1 ... ... ... 2 27. Other digestive diseases 11 1 ... ... ... 1 2 3 4 3 3 3 5 28. Acute and chronic nephritis 18 ... ... ... ... 2 1 8 7 2 5 6 7 29. Puerperal sepsis ... ... ... ... ... ... ... ... ... ... ... ... ... 30. Other puerperal causes ... ... ... ... ... ... ... ... ... 1 ... ... ... 31. Congenital debility, premature birth, malformations, etc. 20 19 ... 1 ... ... ... ... ... 6 3 11 6 32. Senility 6 ... ... ... ... ... ... ... 6 1 2 2 2 33. Suicide 8 ... ... ... ... 1 5 2 1 2 2 4 34. Other violence 31 ... ... 1 2 3 6 3 16 20 12 7 12 35. Other defined causes 43 ... 1 1 3 3 8 11 16 15 14 14 15 36. Causes ill-defined or unknown ... ... ... ... ... ... ... ... ... ... ... ... ... TOTALS 662 33 5 6 10 20 45 179 364 109 210 206 246 15 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 Diarrhœa. (under 2 years). 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 50.8 5 1 7 1931 761 12.9 588 10.0 42 55.2 1 ... 6 1932 698 11.6 621 10.3 35 50.0 4 3 3 1933 671 10.97 592 9.7 27 40.2 ... 3 6 1934 712 11.54 658 10.67 42 59.0 1 13 4 1935 807 12.88 656 10.47 39 48.5 ... ... 17 1936 833 12.99 643 10.03 36 43.21 2 1 6 1937 895 13.84 704 10.84 36 40.22 ... 1 7 1938 927 14.23 662 10.16 33 35.59 4 1 5 17 GENERAL PROVISIONS OF HEALTH SERVICES IN THE AREA. Hospitals, 1. 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 1938 is as follows:— Accommodation. Adults. ren. Institution. Male. Female. Type of case County Sanatorium, 150 150 60 Pulmonary—sanatorium. Harefield 4 4 10 do. observation. County Sanatorium, Clare Hall, do. late sanatorium and hospital. South Mimms 132 66 — 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. 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. 3. 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 Pyrexia are admitted to the North Western Hospital and Queen Charlotte's Isolation Hospital. Cases of Ophthalmia Neonatorum are admitted to St. Margaret's Hospital. 4. 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. 5. 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) County Hospitals.—Finchley patients are admitted to several of the County Hospitals, but the great majority go to the North Middlesex County Hospital at Edmonton. During 1938, 561 Finchley cases were admitted including 88 maternity cases. 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. 19 Ambulance Facilities. (a) Infectious Cases.—Arrangements have been made by the Joint Hospital Committee with the London County Council for the conveyance ol all cases of infectious disease from their homes to the Joint Isolation Hospital. (b) Non-Infectious 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 368 accidents and 485 private cases. Mortuary. During 1938, 68 bodies were received in the Mortuary, 11 of these belonging to Friern Barnet. The new Mortuary on the North Circular Road is now in use and so far has proved to be very satisfactory. 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) Day Nursery 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, 655, High Road, N.12 ... Middlesex County Council Venereal Disease Clinic Royal Northern Hospital, Holloway 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 74 cases as maternity nurse. Legislation in Force. Details were set out in the report for 1934 and it is not considered necessary to repeat them. 22 SANITARY CIRCUMSTANCES OF THE AREA. Water. The water supply of the Borough was dealt with at length in the report for 1937. Routine samples were taken throughout 1938 and all were satisfactory. Each month a copy of a report of an independent bacteriologist was furnished by the Barnct District Gas and Water Company, and in each case this report was satisfactory. Removal of House and Trade Refuse. House refuse is collected weekly, and in the summer months a bi-weekly collection is made from a certain number of flats. Trade refuse is collected on payment. The contract for refuse removal changed hands during the year and a new type of rear loading van is employed. All the refuse is incinerated. Schools. The sanitary condition of the schools is, on the whole, satisfactory, but in some of the non-provided schools the closets and washing accommodation are poor. This matter is at present engaging the attention of the Education Committee. Swimming Baths and Pools. The water at both the open air and enclosed baths has been kept under close observation. The water is tested for the presence of chlorine several times a day, and samples are sent for bacteriological examination from time to time, and especially during busy periods. The reports have invariably been highly satisfactory, and much credit is due to the staff for the very efficient manner in which thev carry out their duties. 23 24 THE PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES. Diphtheria. Although the number of cases notified in 1938 was slightly higher than in 1937, namely 22 as compared with 11, it was still very low, and it is very gratifying that once again there was no death from this disease. Twenty...one cases were removed to hospital, and 1 mild case in a good class house was kept at home. Immunisation against Diphtheria. During the year immunisation of the children in the junior elementary schools was continued. Approximately 75% of these children have now been immunised. Five hundred and forty...four children received the full course of three injections of T.A.F. The Schick Test was applied to 419 children who had previously been immunised, and of the 409 of these who were subsequently examined, 406 were negative and three positive. Thus 99.2% had been successfully immunised. No immunised child contracted diphtheria in 1938. I wish once more to record my appreciation of the valuable co...operation of the head teachers in making this scheme a success. The following table shows the number of children dealt with during 1938 DIPHTHERIA IMMUNISATION, 1938 Report. Ages Number of Children who received Result 1 injection. 2 injections 3 injections Schick tested ' Negative Positive Absent 1 1 ... 4 ... ... ... ... 2 7 1 22 10 9 ... 1 3 6 11 18 24 24 ... ... 4 6 5 25 19 19 ... ... 5 23 27 158 84 84 ... ... 6 8 22 108 58 57 ... 1 7 8 10 69 61 60 1 ... 8 10 8 54 56 54 ... 2 9 ... 4 36 33 31 1 1 10 ... 8 33 45 42 1 2 11 1 ... 11 23 23 ... ... 12 ... ... 4 2 2 ... ... 13 ... ... 2 4 1 ... 3 70 96 544 419 406 3 10 25 26 INCIDENCE OF DIPHTHERIA FOR THE PAST 25 YEARS. Scarlet Fever. There was a decrease in the number of cases of scarlet fever in 1938 over the previous year, the figures being 115 as compared with 146. The disease was mild in character and there were no deaths. Ninety-three cases were removed to hospital. Enteric Fever. One case of typhoid and two cases of paratyphoid B were notified. All were removed to hospital and all recovered. In no case was it possible to ascertain the source of infection. Pneumonia. The number of notifications received was 22, and the number of deaths 52, which included 11 deaths from influenzal pneumonia. Measles. There was an extensive epidemic of measles in 1938. Seventeen complicated cases were removed to the Isolation Hospital and of these 4 proved fatal. Whooping Cough. Whooping cough was fairly prevalent in 1938, but the disease was fairly mild in character. There was one death. Influenza. Influenza was not very prevalent in 1938, and the number of deaths, namely 11, was just one-half of those in 1937. Poliomyelitis. Two cases were notified in 1938. Both were females aged 15 and 25 respectively, and both were so mild that they were not diagnosed until late. Both made complete recoveries. Dysentery. No case of dysentery was notified in 1938. 27 Erysipelas. Twenty cases of erysipelas were notified in 1938, and 9 of these cases were removed to the Isolation Hospital. There were no deaths. Smallpox. No case of smallpox was notified in 1938. Vaccinations. No vaccinations were performed by the Medical Officer of Health under the Public Health (Smallpox Prevention) Regulations, 1917. Isolation Hospital. The Isolation Hospital is owned jointly by Finchley, Hornsey, Wood Green and Friern Barnet. It is situated at Coppetts Road, N.1o, and contains 150 beds. The accommodation has proved adequate for the needs of the constituent Authorities and at no time during the year has any difficulty been met in getting patients admitted. By arrangement with the London County Council patients are conveyed to hospital by their ambulances, a scheme which works exceedingly well. 28 29 3° HEALTH EDUCATION Two hundred and fifty copies of ''Better Health" have been distributed monthly at the Infant Welfare Centres and they are greatly appreciated. 31 Bacteriological Work. The bacteriological work for the district is carried out at the Joint Isolation Hospital, and during 1938 the following specimens were dealt with:— Positive Negative Total Diphtheria 30 416 449 Pulmonary Tuberculosis 5 78 83 Enteric Fever — 2 2 Other Specimens 5 24 29 563 The following table shows the conditions as to overcrowding of the households invaded by Diphtheria and Scarlet Fever during 1938:— 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. Suscepti... bles (including those attacked) under 15 years of age. Cases under 15 years of age. Suscepti... bles (including those attacked) under 15 years of age. Cases under 15 years of age. Suscepti... bles (including those attacked) under 15 years of age. Diphtheria: Home Cases ... ... ... ... ... ... Hosp. Cases 4 7 13 29 ... ... Scarlet Fever: Home Cases 7 9 9 19 2 2 Hosp. Cases 20 27 30 72 7 28 TOTALS 31 43 52 120 9 30 (These figures do not include thirteen cases which occurred in institutions.) 33 34 NOTIFIABLE DISEASES DURINC THE YEAR 1938. 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 1 2 3 1 7 ... 2 3 1 1 ... 22 13 4 5 21 Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever Cases Notified ... 3 15 8 3 59 12 7 6 2 ... ... 115 64 19 32 93 Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia (Influenzal) Cases Notified ... ... ... ... ... ... 1 ... ... ... 2 ... 3 3 ... ... 3 Deaths ... ... ... ... ... ... ... 1 ... ... 7 3 11 7 1 3 ... Pneumonia (Other forms) Cases Notified 1 ... ... ... 1 2 ... 3 4 1 1 4 18 6 9 3 1 Deaths 7 1 1 ... ... ... ... ... ... 3 8 21 41 19 11 11 ... Erysipelas Cases Notified ... ... ... ... ... ... ... ... 4 ... 12 4 20 8 4 8 5 Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever Cases Notified ... ... ... ... ... ... ... 1 2 ... ... ... 3 ... ... 3 3 Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Pyrexia Cases Notified ... ... ... ... ... ... ... ... 2 ... ... ... 2 1 1 ... 2 Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Poliomyelitis Cases Notified ... ... ... ... ... ... ... 1 1 ... ... ... 2 2 ... ... ... Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Encephalitis Lethargica Cases Notified ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 1 1 Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-Spinal Fever Cases Notified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ophthalmia Neonatorum Cases Notified 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Malaria Cases Notified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Smallpox Cases Notified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Dysentery Cases Notified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Deaths ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... TOTALS Cases Notified 3 4 18 10 5 68 14 14 22 4 16 9 187 98 36 52 126 Deaths 7 1 1 ... ... ... ... 1 ... 3 15 24 52 26 12 14 ... Tuberculosis. During the year 74 new cases of pulmonary tuberculosis were notified comprising 47 males and 27 females. Fourteen non...pulmonary cases were notified comprising 4 males and 10 females. There were 22 deaths from pulmonary tuberculosis, the same as in 1937, and 4 from non...pulmonary tuberculosis as compared with 2 in 1937. This gives a total of 26 deaths from all forms of tuberculosis, 16 males and 10 females. The death rate for the disease is 0.39 per 1,000 of the population. In 15.38% 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 87 examined for first Diagnosed as tubercular 53 time during 1938 Undiagnosed and under observation 1 Number of tubercular cases transferred into district 21 Number of cases suffering from tuberculosis examined at the dispensary during 1938 219 Number of cases under observation at the dispensary, etc., on 31/12/38 163 35 36 TUBERCULOSIS DURING THE YEAR 1938. Age-periods New Cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M. F. M. F. M. F. M. F. Under 1 year ... ... ... ... ... ... ... ... 1 to 5 years 1 ... ... 1 ... ... ... 1 5 to 15 years 2 1 ... 2 ... ... 2 ... 15 to 25 years 12 14 ... 1 1 1 ... ... 25 to 35 years 10 6 1 4 4 5 1 ... 35 to 45 years 10 3 1 2 2 ... ... ... 45 to 55 years 9 2 2 ... 4 2 ... ... 55 to 65 years 3 1 ... ... 1 ... ... ... 65 & upwards ... ... ... ... 1 1 ... ... Total 47 27 4 10 13 9 3 1 North 13 9 ... 3 2 4 1 1 Wards: East 17 10 2 4 8 3 1 ... West 17 8 2 3 3 2 1 ... Removed to Hospital or Sanatorium 39 | 22 2 ... ... ... ... ... MATERNITY AND CHILD WELFARE. There has been no change in the number of sessions at the welfare centres, but the numbers attending have again shown an increase over the previous year. The voluntary workers have continued to give much valuable service at the welfare centres which is greatly appreciated by everyone concerned. Infant Welfare Centres. The attendances of children at the centres in 1938 were 18,904 as compared with 18,581 in 1937. Children under one year of age made 10,449 attendances and children over one year 8,455. The number of examinations made by the doctors in attendance was 6,851. The average attendance per session was 54. The overcrowding at the centres at Essex Park and the Congregational Hall, Nether Street, has been partially relieved by the removal of the Hendon children to a centre of their own which has been established at St. Barnabas Hall. Ante-Natal Clinic. Four hundred and twenty women attended the antenatal •clinic in 1938, as compared with 395 in 1937, and they made 1,427 attendances. The number of women attending represented 44.4% of the total notified births. Midwives Act, 1936. The Local Supervising Authority is the County Council but the Town Council act as their agents in the provision of a domiciliary midwifery service in pursuance of the above Act. 'Two Municipal Midwives were appointed by the Council in October 1937, and they have rapidly established themselves. During 1938 they attended 96 cases in the capacity of midwife and 27 as maternity nurse. A number of letters of appreciation of the services of these nurses have been received from their patients. 37 The following table shows the places of birth of Finchley children for the past four years:— 1935 1936 1937 1938 Private homes in Finchley 324 322 334 357 Nursing Homes in Finchley J 70 59 59 57 Wellhouse Hospital, Barnet 125 125 136 36 North Middlesex County Hospital 9 60 73 88 London Hospitals 128 141 97 134 Nursing Homes outside Finchley 81 68 121 167 Private homes outside Finchley 2 20 24 9 739 795 844 848 Accommodation for Maternity Cases. According to the Registrar-General 946 children were born to Finchley parents in 1938, but the Public Health Department had knowledge of only 848. As a direct result of the provision of Municipal Midwives a number of women with suitable accommodation have had their babies at home instead of going into an institution, and the results have been so good that it is sincerely hoped that wherever possible this practice will spread. If the conditions are satisfactory, and the competent attention can be assured, I have no doubt that the best place for a mother to have her baby is in her own home. On the other hand there are many mothers who cannot have their babies at home, and it is regrettable to have to report once again that the prospect of the provision of adequate maternity accommodation within a reasonable distance does not seem to have improved at all during the year. The Town Council have agreed to sell to the County Council a site for a Maternity Hospital, and it is fervently hoped that the scheme will begin to take shape at a very early date. 38 Maternal Mortality. It is very pleasing to be able to report that in 1938, for the first time on record, there was no maternal death. This happy state of affairs reflects credit not only on all the doctors and nurses who have taken care of the mothers during pregnancy and confinement, but also on the mothers themselves, who at long last have come to realise the importance of ante...natal supervision to their own safety and the well...being of their offspring. The rate for England and Wales was 3.08 per 1,000 births. The Supply of Milk for Mothers and Children. The supply of milk and accessory foods for children under school age is organised by the Voluntary Association, and for that purpose a grant of £75 was made by the Council. In 1938, owing to an increase in the amount of milk issued at less than cost price, this grant was increased by £25. Milk for necessitous expectant and nursing mothers is provided by the Council free or at half-price according to an income scale. Up to two pints a day may be given at the discretion of the Medical Officer. All the milk provided must be pasteurised. The number of mothers in receipt of milk showed a decrease compared with the previous year — 79 free and 15 at half...price. The figures for 1937 were 98 free and 20 at half...price. The cost to the Council was approximately £130. Puerperal Pyrexia. In 1938 two cases of puerperal pyrexia were notified. Both were removed tc hospital and both recovered. Ophthalmia Neonatorum. One case of ophthalmia neonatorum was notified in 1938. Rome Visiting. During the year the health visitors made 4,836 visits in connection with Maternity and Child Welfare work, as compared with 4,857 in 1937. 39 Child Life Protection. Public Health Act, 1936. Part VII. At the beginning of the year there were on the register 20 mothers receiving 40 children, while at the end of the year there were 20 mothers receiving 35 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. 40 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. Mothers. Children. 1937 1938 1937 1938 Number inspected 176 181 289 317 Number treated 170 154 212 153 Number of attendances 626 722 451 358 Fillings 351 366 365 355 Extractions 823 754 473 380 Gas administrations 61 53 119 95 Other operations 82 83 83 57 Dentures supplied 47 40 — — Dentures repaired 6 7 — — Visits re dentures 142 201 — — Day Nursery. The number of attendances at the Day Nursery shows a slight increase on the previous year. 1937 1938 Children attending 68 71 Total attendances 6,586 6,695 Receipts from mothers £152.3.8 £152.1.6 Housing Statistics for the Year 1938. Number of New Houses erected during the Year:— (a) Total (including numbers given separately under (b) (i.) By the Local Authority 36 flats, (ii.) By other Local Authorities Nil (iii.) By other bodies and persons 489 (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 36 flats (ii.) By other bodies and persons Nil 1.—Inspection of Dwelling-houses during the Year:— (1) (a) Total number of dwelling-houses spected for housing defects (under Public Health or Housing Acts) 1,616 (b) Number of inspections made for the purpose 7,984 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 596 (b) Number of inspections made for the purpose 3,556 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 30 (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 302 41 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 300 3.—Action under Statutory Powers during the Year:— A. Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which notices were served requiring repairs 5 (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By Owners 6 (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 defects to be remedied 20 (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 11 and 13 of the Housing Act, 1936:— (1) Number of dwelling-houses in respect of which Demolition Orders were made — (2) Number of dwelling-houses demolished in pursuance of Demolition Orders — 42 D. Proceedings under Section 12 of the Housing Act, 1936:- (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, 1936 — Part IV — Overcrowding : (a) (i) Number of dwellings overcrowded at the end of the year 30 (ii.) Number of families dwelling therein 30 (iii.) Number of persons dwelling therein 238 (b) Number of new cases of overcrowding ported during the year 15 (c) (i) Number of cases of overcrowding lieved during the year 28 (ii) Number of persons concerned in such cases 161 (d) Particulars of any cases in which crowding was abated and again recurred — 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 III 121 (5) Housing Act, 1936 36 flats (6) Other houses owned and let (mainly for occupation of Council employees) 70 43 HOUSING. Thirty-six flats were erected by the Council in 1938 on the Red Lion Hill site. These flats were filled almost entirely by overcrowded families and families displaced from two small clearance areas. Six large houses to accommodate large overcrowded families were nearing completion at the end of the year. At the beginning of the year there were 43 overcrowded families on the register, 15 new cases were added and 28 cases were alleviated, leaving 30 cases outstanding at the end of the year. Sixty-five flats are in course of erection, and it is anticipated that by the autumn of 1939 all outstanding cases of overcrowding will have been relieved. Unfit Houses. Details as to unfit houses dealt with in clearance areas or as individual houses will be found in the report of the Chief Sanitary Inspector. FOOD. Meat and Other Foods. Under the Public Health (Meat) Regulations, 1924,. 12,467 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. 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. 44 45 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 31st December, 1938. Article. Samples Taken. Adulterated. Milk 135 1 Butter 4 — Cream Pastries 2 — Arrowroot 1 — Mustard 1 — Hake 1 — Lard 4 — Calf's Liver 1 1 Pepper 1 — Sausages 2 — Whisky 4 — Totals 156 2 46 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.—Inspections for purposes of provisions as to health. Inspections made by the Sanitary Inspectors:— Premises Number of Inspections Written Notices Occupiers prose... cuted Factories with mechanical power (Including Factory Laundries) 264 ... ... Factories without mechanical power 268 ... ... Other premises (Other than Outworkers' Premises) 53 ... ... TOTALS 585 ... ... 47 2.—Defects Found. Particulars Number of Defects Number of defects in respect of which Prosecutions were instituted Found Remedied t Referred to H.M. Inspector Want of Cleanliness 51 52 ... ... Overcrowding ... ... ... ... Unreasonable temperature ... ... ... ... Inadequate ventilation ... ... ... ... Ineffective drainage of floors ... ... ... ... Sanitary Conveniences Insufficient 1 1 ... ... Unsuitable or defective 29 29 ... ... Not separate for sexes 1 1 ... ... Other offences (Not including offences relating to Home Work or offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921, and re...enacted in the Third Schedule to the Factories Act, 1937.) 20 22 ... ... TOTALS 102 105 ... ... †Including defects standing over from the previous year. ANNUAL REPORT of the CHIEF SANITARY INSPECTOR FOR THE YEAR 1938 BOROUGH of FINCHLEY ANNUAL REPORT OF THE Chief Sanitary Inspector For the Year 1938 To the Mayor, Aldermen and Councillors of the Borough of Finchley. I have the honour to present to you my Thirty-seventh Annual Report dealing with the work carried out by your Sanitary Inspectors during the Year 1938. The total number of inspections made during the year was 15,570. At 1,314 of the houses and other premises visited, defects or nuisances to the number of 5,967 were discovered, and at the end of the year 5,172 of these had been remedied or abated, the work in connection with 672 was in hand, and the remaining 123 were outstanding. In order to ascertain that the sanitary defects were being properly remedied, 2,024 visits were paid to the respective premises while the work was in progress. 50 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 596 Special Inspections 3465 Inspections of Houses-let-in-Lodgings 133 Re-Inspections 4373 Inspections of Works in Progress 2024 Inspections of Factories, Workshops and Workplaces (including Bakehouses and Restaurant kitchens) 673 Visits to Slaughterhouses 671 Inspections of Cowsheds, Dairies and Milkshops 122 Inspections of Ice Cream Premises 115 Inspections of Meat, Fish and other Food Shops 205 Inspections of Shops (Shops' Act) 1840 Visits re Infectious Disease 889 Miscellaneous 432 Hairdressers' Premises 32 Total number of Inspections and Re-inspections 15,570 Total number of Houses inspected under:— (a) Public Health Acts 822 (b) Housing Acts 794 1616 Total number of other premises visited 1305 Summary of Sanitary Improvements Carried Out. Drainage. Number of Houses and Premises re-drained 12 Repairs or amendments to existing drains 89 Drains or Gullies unstopped or cleansed 110 Length in yards of Stoneware Drains laid 428 Length in yards of Heavy Cast Iron Drains laid 90 Manholes provided 41 Manholes repaired 38 Intercepting Traps fixed 9 Fresh Air Inlets provided or repaired 44 New Gully Traps fixed 70 51 Gully Curbs provided or repaired 58 New Soil Pipes and Ventilating Shafts fixed 6 Soil Pipes and Ventilating Shafts repaired 18 Water Tests applied 247 Smoke Tests applied 8 Air Tests applied 16 Water Closets and Sanitary Fittings. New W.C. Basins fixed 102 W.C.'s unstopped, cleansed or repaired 93 New Flushing Boxes fitted to W.C.'s 15 Existing Flushing Boxes repaired 26 Joints between W.C.'s and Flush Pipes repaired 16 New W.C. Apartments provided 12 Ventilated Lobbies provided 7 Existing W.C. Apartments improved 4 Urinals provided 1 Urinals abolished — Urinals cleansed or repaired 9 Lavatory Basins provided 43 Baths provided 20 New Impervious Sinks provided 29 New Waste Pipes fixed 73 Waste Pipes trapped, repaired or unstopped 52 Miscellaneous. New Roofs constructed 5 Roofs repaired 163 Eaves Guttering renewed, cleansed or repaired 81 Stack Pipes provided, repaired or unstopped 76 Stack Pipes disconnected from Drains 2 Damp Walls remedied 204 Walls repointed, repaired or underpinned 94 Chimney Stacks repaired 5 Ventilation under floors provided 32 Site of room concreted — Yards Paved 21 Paving of yards repaired 68 Mews Paved — Floors of Rooms relaid 8 Floors of Rooms repaired 121 52 Rooms cleansed, distempered or repapered 1090 Means of Ventilation to Rooms provided 13 Windows repaired and/or made to open 427 New Windows provided 18 New Sash Cords provided 686 Window sills repaired or provided 35 Doors provided or repaired 77 Doorsteps provided or repaired 59 Artificial Lighting to Staircases provided 12 Natural Lighting to Staircases provided 146 Handrails to Staircases provided 49 Staircases repaired 53 Ventilated Food Stores provided 24 New Ranges and Stoves provided 93 Stoves and Ranges repaired 144 Coppers provided 7 Coppers repaired 46 Workrooms (including Bakehouses) cleansed and repaired 36 Cisterns provided 6 Cisterns repaired, cleansed and covered 22 Water Supply provided 2 Water Service Pipes repaired 10 Movable Sanitary Dustbins provided 132 Offal Bins provided 6 Nuisances from the keeping of animals abated — Stables cleansed 1 Nuisances from Smoke abated 1 Accumulations of refuse removed 51 Accumulations of water removed — Manure Receptacles provided — Accumulations of manure removed 2 Miscellaneous 268 Conservancy System. Number of houses provided with pail closets 5 Notices Served. Informal Notices 703 Statutory Notices 45 53 Enquiries—Outstanding Sanitary Notices. 810 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 204 Verminous rooms sprayed and fumigated 64 Number of articles disinfected 6,215 Number of verminous premises dealt with 58 889 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. Eradication of Bugs. The number of houses found to be infested with bugs and dealt with during 1938 was as follows:— Council Houses — Other Houses 58 The methods employed for freeing infested houses from bed bugs are the use of insecticides combined with fumigation with sulphur. In all cases where necessary wall and/or ceiling paper is stripped off and mouldings, skirtings, etc., are eased or removed. Bedding and similar articles are removed and subjected to steam disinfection. The foregoing methods of disinfestation are carried out by the Corporation's own staff. The houses occupied by persons about to remove to Council dwellings are examined by the Housing Manager or one of the Sanitary Inspectors and any infested articles therein are either disinfested or destroyed. In 19 such cases the furniture was fumigated in special vans by hydrogen cyanide gas. This fumigation was carried out by contractors who specialise in this work. 54 The houses which have been disinfested are revisited in order to ascertain whether or not further treatment is necessary, and the tenants are requested to co-operate with the department by keeping their houses in a cleanly state and reporting any reappearance of bugs. 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. 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:— Avenue Road, N.12 2 Brackenbury Road, N.2 77 Wooders Cottages, Chapel Street 6 Elmfield Road, N.2 30 Fredericks Place, N.12 24 Hamilton Road, N.2 39 High Road, N.20 14 Hutton Grove, N. 12 32 Leopold Road, N.2 48 Lodge Lane, N.12 61 Manor Park Road, N.2 96 Naylor Road, N.20 20 New Oak Road, N.2 8 New Trinity Road, N.2 30 Stanhope Road, N.12 54 Swan Place, N.20 11 Theobalds Avenue, N.12 22 William Street, N.12 22 596 55 The 596 premises comprise 673 separately rated houses and tenements. As a result of these house-to-house inspections, no less than 3,567 defects or nuisances were discovered and dealt with, and these are enumerated in the appended summary:— Defective drains 5 Blocked drains — Defective and short ventilating shafts to drains 8 Dilapidated W.C. apartments 63 Insufficient W.C. accommodation — Light and ventilation to W.C. apartments insufficient 9 Defective and insanitary W.C. basins 35 Defective joints between flush pipes and W.C. basins 2 Defective W.C. seats 7 W.C. flushing boxes out of order 21 Defective manholes — Defective fresh air inlets to drains 20 Defective house roofs 95 Dirty and defective ceilings and walls of rooms 889 Defective brickwork and pointing to walls 81 Defective doors 53 Defective doorsteps 47 Defective stairs and handrails, etc., to staircases 86 Unsatisfactory lighting to staircase 306 Defective floors of rooms 111 Absence of sink — Insanitary stone troughs and/or defective sinks 8 Defective and untrapped waste pipes 34 Defective, absence of, or insufficient yard paving 57 Absence of, or defective eaves guttering and stack pipes 135 Nuisances from dampness 149 Absence of, or defective gratings to ventilation openings under floors 24 Absence of sufficient ventilation to rooms 17 Windows, defective or not made to open 342 Defective window sills 54 Dirty, defective or uncovered service water cisterns 27 Defective service water pipes 4 56 Defective kitchen ranges 78 Defective stoves 100 Defective coppers 48 Defective chimneys 7 Defective chimney pots 13 Broken sash cords 534 Defective dustbins 30 Absence of, or defective gully curbs 19 Absence of, or unventilated food stores 12 Miscellaneous 37 An analysis of the house-to-house records for the year 1938 has been made, and the following statistical information compiled therefrom:— Dwelling Houses. Number of houses inspected 596 Number of Rooms. Living Rooms 1,393 Sleeping Rooms 1,613 Bed-living Rooms 52 3,058 Occupants. Number of Occupants, Adults 2173 ,, Children 373 Average number of persons per house 4.271 ,, ,, room 0.833 ,, ,, bedrooms 1,529 Sub-Letting. Houses occupied by one family 429 ,, ,, two families 163 ,, ,, three ,, 4 ,, ,, four ,, - Number of houses sub-let—167 or 28.02 per cent. 57 Rents. Annual Rental of £16 or under 3 ,, ,, £16 to £26 40 ,, ,, £26 to £40 125 ,, ,, over £40 356 Owned by occupiers 72 596 Sanitation. Number of houses where defects were found 469 Number of houses found to be in some respect unfit for human habitation 251 Notices. Number of informal notices served 436 Number of statutory notices served 4 Unfit Dwelling-houses Closed or Demolished. During the year three blocks of unfit dwelling houses were dealt with as clearance areas as follows:— Clearance Area No. 1. 1, 2, 3, 4, 5 and 6, Wooders Cottages, Chapel Street, N.2. This area comprised six small back-to-back houses. The Clearance Order in regard to the area was confirmed by the Minister of Health and the houses have since been vacated and demolished. Clearance Area No. 2. 1123, 1125, 1127, 1129, 1131, 1133, 1135, 1137, 1139, 1139a, 1141, 1143 & 1145, High Road, Whetstone, N.20. This area comprised a terrace of thirteen dwellings. The Clearance Order in regard to the area was confirmed by the Minister of Health and at the end of the year the necessary action was being taken to obtain possession for the purpose of demolition. Clearance Area No. 3. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 & 12, Swan Place, N.20. This area comprised a terrace of eleven small houses situated in a court yard. 58 The official representation respecting this area was made by the Medical Officer of Health in December, 1938. The necessary action consequent thereon is being taken. 1, 2, 3, 4, 5, 6 & 7, Dixons Cottages, and 1 & 2, Goodyear's Cottages, High Road, N.20. These cottages were demolished voluntarily by the owner. OVERCROWDING. The actual position at the end of 1938 was as follows:— Number of overcrowded families (1st Jan., 1938) 43 Number of new cases recorded during 1938 15 58 Number of families relieved during 1938 28 Number of cases outstanding at end of 1938 30 Entries in Rent Books. Sixty-one applications were received for information as to the "permitted number" in relation to 210 houses. The rooms were measured and the necessary certificates issued. Houses Let in Lodgings. During the year 20 additions were made to the Register of Houses let in Lodgings. The number of registered premises in the district is now 84. Common Lodging Houses. There are no common lodging houses in the district. Sanitary Conveniences. There are 25 conveniences attached to licensed houses within the district. These premises are inspected periodically. 'There are nine public conveniences in the district, including two in the Victoria Recreation Ground which are situated close to the public highway. Seven of these conveniences provide accommodation for both sexes and two accommodation for males only. 59 Complaints. Four hundred and fifty-nine complaints were received with reference to the following matters, viz.:— Blocked or defective drains 40 Insanitary condition of mews and passages 11 Insanitary or defective condition of houses 110 Defective roofs 24 Non-removal of refuse — Verminous condition of houses 5 Nuisance from dampness 24 Nuisance from overcrowding 6 Nuisance from the keeping of animals 6 Nuisance from the burning of refuse 12 Accumulations of refuse or manure 33 Absence of, or defective dustbins 10 Smoke nuisance 10 Smells from public sewers 23 Premises infested with rats 19 Premises infested with insects 12 Shops Acts 14 Flooding 3 Noise 6 Other complaints 41 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 29. 60 Factory and Workshop Acts, 1901—1937. The total number of Factories, Workshops and Workplaces on the Register is 393. The trades carried on at the respective premises are as follows:— Bakehouses 37 Boot Polish Manufacturer — Boot repairers 44 Builders' Workshops 21 Cycle Makers or Repairers 7 Farriers and Blacksmiths 5 Glass Blowers 1 General Engineers and Motor Engineers 60 Laundries 10 Monumental Masons 7 Motor Accessory Manufacturers 2 Potato Crisp Factory 1 Prepared Meat Factories 2 Printers and Printers' Accessories 17 61 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 73 Factories, Workshops and Workplaces (including Bakehouses and Restaurant Kitchens) 393 Fried Fish Shops 8 Ice Cream Premises 104 Places of Public Entertainment 29 Public House Conveniences 25 Slaughterhouses 5 Shops re Food Supplies 235 872 Restaurant Kitchens 65 Sheet Metal Workers 3 Sports Accessory manufacturers 2 Tailors and Dressmakers 30 Timber Merchants and Sawyers 13 Tyre Re-treading 2 Upholsterers 14 Watch and Clock Repairers 7 X-Ray Apparatus 1 Other Trades 42 393 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 2 Ventilated lobby provided 2 W.C. apartments screened — New W.C. Pans provided 3 W.C.'s cleansed or repaired 21 Urinals provided - Urinals cleansed 2 Joints between flush pipes and W.C. pans repaired 2 Flushing Cisterns provided — Flushing Cisterns repaired 1 New Sinks provided 1 New Sink Waste Pipes provided 2 Drains unstopped or repaired 12 Fresh air inlet shafts repaired 1 Roofs repaired — Floors repaired and/or cleansed 12 Dustbins provided 6 Workshops cleansed 39 Accumulations of refuse removed 7 Smoke nuisance abated 4 Yards cleansed or repaired 6 Yards paved — Miscellaneous 14 62 Hairdressers' and Barbers' Premises. In February, 1938, the Minister of Health confirmed the byelaws made by the Council for the purpose of securing the cleanliness of any premises in the Borough used for the carrying on of the business of a hairdresser or barber and of the instruments, towels and materials used in such premises. All the hairdressers' and barbers' premises in the district have been visited and steps were taken to secure reasonable compliance with the provisions of the byelaws, a copy of which was handed to the occupier of each of the premises involved. Inspection of Offices. During the year 81 offices were inspected in which 164 males and 234 females were employed. The following matters received attention:— Sanitary Accommodation. There are six offices without suitable and sufficient sanitary conveniences but accommodation is to be provided for these premises in connection with the reconstruction of the railway station at Church End, Finchley. In six cases provision is made for the joint use of sanitary accommodation owing to the division of premises originally planned for one occupation. Ventilation and Cleanliness. The ventilation and cleanliness of the offices visited were satisfactory. Overcrowding. No case of overcrowding was found in any of the offices visited. There does not appear to be any legal definition of overcrowding in relation to an office and it is suggested that the standard of air space for each person prescribed under the Factory Act, 1937, is also suitable for an office. Nuisances—Smoke and "Grit" Emission. Complaints were received again during the year with respect to a nuisance arising from the emission of 4'grit" from a certain factory chimney. The chimney in question is connected to two large modern boilers fitted with mechanical stokers and with fans to create a forced draught. 63 Further representations were made to the company with the result that chain grit arresters were fitted and catch pits constructed in the boiler flues. Since the completion of this work no further complaints have been received. Other factory chimneys in the district have been kept under observation from time to time 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. The 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. No less than 447 notifications of intention to slaughter animals were received. These notices are not infrequently delivered later than 5.0 p.m., and as there are no fixed times for slaughtering to take place it is a somewhat onerous duty to provide for the necessary inspection to be made on all occasions. A large proportion of meat inspection in the slaughterhouses is carried out before or after the usual office hours and on Sundays, and, with few exceptions, the carcases and organs of all animals slaughtered in the district have been inspected. Seven 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. 64 65 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 disease are as follows:— Cattle excluding Cows Cows Calves Sheep and Lambs Pigs Number killed 65 1 58 10,682 1,897 Number inspected 65 1 58 10,449 1,894 All Diseases except Tuberculosis:— Whole carcases condemned None ... None 3 3 Carcases of which some part or organ was condemned 12 ... None 260 229 Percentage of the number inspected affected with disease other than tuberculosis 18.462 ... ... 2.517 12.248 Tuberculosis only:— Whole carcases condemned 2 ... ... ... 3 Carcases of which some part or organ was condemned 6 ... 1 ... 134 Percentage of the number inspected affected with tuberculosis 12.308 ... 1.724 ... 7.233 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. Bovines. Carcases and Offal 2 Heads and Tongues 2 Sets of Lungs 7 Livers 2 Mesenteries 3 Swine. Carcases and Offal 3 Heads 80 Mesenteries 112 Plucks 9 Spleens 5 Hearts 5 Livers 2 Sets of Lungs 3 Kidneys 2 Conditions other than Tuberculosis. Bovines. Livers : 5 Flukes,1½ Cirrhosis, 1 Echinococ- cus Veterinorum 7½ Swine. Carcases and Offal : 2 Dropsy, 1 Peritonitis 3 Sets of Lungs : 58 Congestion, 2 Pleurisy, 90 Pneumonia 150 Plucks: 6 Congestion, 1 Pleurisy 7 Kidney : Nephritis 1 Livers : 67 Cirrhosis, 1 Fatty Infiltration, 1 Peritonitis, 6 Congestion, 4 Cysts 79 Mesenteries : 2 Cysts, 4 Congestion 6 Hearts : 13 Pericarditis, 2 Congestion, 2 Pneumonia 17 Spleens : 2 Congestion, 1 Rupture, 1 Cyst 4 Head : Abscess 1 66 Sheep. Carcases : 1 Emaciated, 2 Suffocation 3 Lungs : 3 Abscesses, 103 Congestion, 43 Strongulus Rufescens} 23 Pneumonia, 1 Pleurisy, 8½ Parasites 181½ Livers : i8½ Flukes, 7 Distomatosis 38½ Parasites, 2 Congestion, 2 Cirrhosis, 7½ Abscesses, 1 Mutilation, 13 Cysts, 11 Strongulus Rufescens 1oo½ Hearts : 6 Congestion 6 Plucks : 2 Congestion, 1 Fchinococcus, 1 Abscess, 3 Flukes, 1 Pleurisy 8 Miscellaneous. 1 4lb. tin "Turkey and Ham" Galantine. 2 tins Jellied Veal. Quantity of imitation almond paste and puff pastry. 1 Cod. 2 Hake. 2 lbs. Smoked Fillet. 2 Bream (4lbs. 140ZS.) 5 stone of Skate Wings. 6 Rabbits. 1 Turkey. 1 Sheep's Head. 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 671. 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. 67 The Slaughter of Animals Act, 1933. Humane Slaughter of Animals. In accordance with the provisions of this Act all animals, including sheep, 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 satisfactory. Licensed Slaughtermen. The Act also provides that no animal shall be slaughtered or stunned by any person who is not the holder of a licence granted by the local authority. The licences granted by the Town Council have to be renewed annually. The number of persons licensed under the Act during 1938 was 12. Butchers' Shops. There are 51 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 37. During the year 2 new bakehouses were opened and 5 existing bakehouses closed. At 28 bakehouses motive power is used and the premises, therefore, constitute "factory bakehouses." The remaining 9 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. 68 Dairies, Cowsheds and Milkshops. There are 73 dairies, cowsheds and milkshops in the district, and in addition 32 purveyors of milk whose premises are not in Finchley are registered for the purpose of retailing milk within the district. There were 16 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 of 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. The Milk (Special Designations) Order, 1936. Licences were granted by the Council in respect of designated milk for the year ended 31st December, 1938, as follows:— Dealers' Licences to sell milk as "Tuberculin 'Tested" 9 ,, ,, ,, ,, ,, ,, "Accredited" 2 ,, ,, ,, ,, ,, ,, "Pasteurised" 14 Supplementary Licence to sell milk as "'Tuberculin 'Tested'' 3 ,, ,, ,, ,, ,, ,, "Pasteurised" 2 Licence in respect of establishment at which 'Tuberculin 'Tested Milk is bottled 1 Licences in respect of establishments in which the process of pasteurising milk is carried on 2 Five samples of "Tuberculin 'Tested," 1 sample of "Accredited" and 6 of "Pasteurised" milk were taken on behalf of the Council and submitted for bacteriological examination. 'These samples complied with the prescribed conditions. Ice Cream Premises. The number of ice cream premises on the register is 104. The premises were visited during the summer months. 69 Coffee Stalls. The number of coffee stalls in the district is 6, Five 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. Two applications were received for the CounciPs consent to establish the business of a fish fryer at 369, Regents Park Road, N.3. These applications were refused. 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—1936. Systematic inspection of the shops in the district has been continued during the year and the new Register is now practically complete. Particulars in regard to the Shops on the Register are as follows:— Total number of shops on Register 1,000 Number of shops closed 26 Changes in occupation of shops 144 Number of registered Jewish traders 2 Number of registered Jewish retail meat dealers 1 Number of shops which close on Saturday 70 Number of shops which open on Thursday 356 Number of shops which open on Sunday 212 Total number of visits to shops 1,840 70 Infringements Dealt With. Prescribed notices not filled in correctly 44 Failure to exhibit prescribed notices 772 Failure to keep prescribed registers 57 Young Persons employed for more than 48 hours per week 20 Improvements Carried Out. Means of heating provided 11 Washing accommodation provided 3 Additional sanitary conveniences provided 3 Sanitary accommodation repaired 1 Complaints. Eight complaints were received regarding alleged infringements of the above mentioned Acts. These complaints were promptly investigated and in five instances appropriate action was taken. Motor Traders Exemption Order. In January an application was received signed by all the traders in the district engaged in the sale of motor cars requesting the Town Council to make an Order under the Shops Act, 1912, wholly exempting their particular class of shop from closing not later than 1 o'clock in the afternoon on one weekday in every week. Consequent upon the receipt of this application, the Town Council made the necessary Order under Section 4 (4) of the Shops Act, 1912. 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. 71 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 94 No. of applications granted 94 Quantity of petroleum spirit which may be kept in licensed stores 127,520 gallons. Carbide of Calcium. No. of applications for licences 2 No. of applications granted 2 Quantity of carbide of calcium which may be kept on licensed stores 448 pounds Licence fees paid during 1938 £66.3.9 Nearly all the petroleum spirit is kept in bulk in underground storage tanks and there are now installed in the district no less than 181 of these tanks to which are connected 157 petrol supply pumps. Most of the hand-operated pumps have now been replaced by 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. Staff. This is the last Annual Report I shall have the honour to submit, owing to my retirement in April, 1939. I, therefore, wish to take this opportunity to express my deep appreciation to the principal officers of the Council and to their staffs for the kindly help I have received from them on every possible occasion. During my term of office six Medical Officers of Health have served the Council and my relationship with all of them has been of the most cordial character. I am deeply indebted to Dr. Turner, your present Medical Officer of Health, with whom I have had the privilege to work for the last fourteen years, and to his predecessors, for their great kindness, encouragement and support. 72 Seventeen Assistant Sanitary Inspectors have served under me and it is most gratifying to record that eleven of them became Chief Inspectors of important districts. I am fully conscious of the debt I owe to my Assistants and other members of the staff for their great loyalty and their unremitting help and co-operation. Mr. Gray, my Senior Assistant, has now been appointed Senior Sanitary Inspector and Mr. Yates as his deputy. I am confident they will fill their new positions to the entire satisfaction of the Council. I desire to place on record my great appreciation of the assistance I have received from time to time from owners of property, their agents and advisers, and the proprietors of business undertakings with whom I have been brought into official contact. It has been mainly the result of their cooperation that has made it possible to secure compliance with the various Public Health, Housing and other Acts, by informal action. Very few statutory notices have been served and only on comparatively rare occasions has it been necessary for the Council to resort to legal proceedings. In conclusion, I wish to express my gratitude for the kind consideration and unfailing support I have received from the Council during my 37 years service as Sanitary Inspector for the District. I am, Your obedient Servant, E. J. FRANKLIN, Chief Sanitary Inspector. Public Health Department, 308, Regents Park Road, N.3. 73 ANNUAL REPORT of the SCHOOL MEDICAL OFFICER FOR THE YEAR 1938 BOROUGH OF FINCHLEY. MEMBERS OF THE EDUCATION COMMITTEE. Chairman: Councillor W. C. Langlands. Vice-Chairman: Alderman F. J. Grocott. The Mayor. The Deputy Mayor. Councillor Col. G. Beach, C.B. „ W. L. Brooksbank. „ A. C. D. Collis. „ J. connorton. „ Mrs. E. Murphy. „ H. A. Rutt. H. H. Wilmot. Co-opted Members: Miss L. Davey, M.A., Mrs. A. S. Miall, B.A., Mr. D. A. A. Merry. Director of Education: H. L. Hume, LL.M. 76 BOROUGH OF FINCHLEY. SCHOOL MEDICAL STAFF. School Medical Officer: A. A. Turner, M.C., M.D., D.P.H. Assistant School Medical Officer: C. Russell, M.B., Ch.B., D.P.H. Ophthalmic Surgeon: C. Lomas Harris, M.B., Ch.B. Radiologist: J. Rhynland Parry, M.B., Ch.B., D.M.R.E. School Dentist: C. R. Wilshaw, H.D.D. (Edin.), L.D.S. (Eng.). Assistant School Dentist: W. B. Priest, L.D.S. (Eng.). School Vurses and Health Visitors: Miss J. Hull. Miss C. Hemming. Miss F. Hughes. Clinic Nurse: Miss J. R. Sharpe. Dental Attendants: Miss P. Parry. Miss E. G. Sommerfield. Clerk: Miss D. Martin. 77 FINCHLEY SCHOOLS. ELEMENTARY SCHOOLS. School. Department. No. on roll. Average Attendance 1938. Alder Senior 297 270 Alder Infants 131 113 Northside Senior 236 209 Northside Junior 483 410 Manorside Senior 279 251 Manorside Junior 531 451 Martin Junior 451 396 Summerside Junior 494 438 St. Mary's Junior 503 435 St. John's Junior 288 247 Christ Church Senior 218 199 Holy Trinity Junior 304 266 Our Lady of Lourdes Mixed & Infants 288 251 4503 3936 SECONDARY SCHOOLS. On Roll. County School Boys & Girls 334 Christ's College Boys 466 Woodhouse Boys & Girls 352 1152 78 To the Chairman and Members of the Education Committee of the Borough of Finchley. I have the honour to submit my report on the work of the School Medical Service for 1938. There are no new developments to report but the work in all departments has gone on smoothly throughout the year. There was an extensive epidemic of measles in the Spring, but the incidence of most of the other infectious diseases was below normal. Immunisation of the children against diphtheria continued and the schools remained remarkably free from this disease—only two cases being notified. Much good work was done at the Dental Clinic, Eye Clinic and Minor Ailments Clinics. Once again I have pleasure in recording my indebtedness to the Director of Education for his co-operation — to the Heacf Teachers for their willing assistance and to all members of the School Medical Staff for their loyal service during the year. I am, Ladies and Gentlemen, A. A. TURNER, School Medical Officer. 79 CO-ORDINATION WITH OTHER HEALTH SERVICES. Close co-operation exists between the Public Health Department and the School Medical Service; the Medical Officer of Health is also School Medical Officer, while the Assistant School Medical Officer and the three School Nurses also carry out the Maternity and Child Welfare work in the Borough. The School Nurses know most of the children before they are admitted to school, and they are also acquainted with their home circumstances. Medical Inspection. Routine Medical Inspection is carried out on the elementary school premises and the three age groups laid down by the Board of Education are dealt with, namely:— Five year olds, eight year olds, and twelve year olds. All new admissions to the schools which do not fall into any of these groups are also examined. "Special" children referred by parents, teachers or school nurses are examined in the schools or at the appropriate school clinic, while "re-inspections" are dealt with in the same manner In 1938 the total number of medical inspections was 4,517 as ccmpared with 4,169 in 1937. Findings of Medical Inspections. The number of defects, apart from dental defects and uncleanliness, found at routine medical inspection in the schools and at other inspections is set out in Table II. Of the 1,523 who were submitted to routine inspection 115 or 7.55% were found to be in need of medical treatment. (a) Malnutrition. The Board's classification of the nutrition of the children submitted to routine examination was used through- 80 out the year and the following summary of the results clearly shows that very little malnutrition exists. No. of children inspected A (Excellent) B (Normal) C (Slightly sub-normal) D (Bad) 1523 No. % No. % No. % No. % 212 13.92 1223 80.3 88 5.78 - - (b) Uncleanliness. Every effort is made to keep the standard of cleanliness as high as possible and it is now very rarely that one sees a child with vermin in its head. All children are examined by the School Nurses as soon as possible after the commencement of each term and the unsatisfactory ones are reviewed at frequent intervals. All new admissions are examined at the earliest possible moment. Every case of uncleanliness however slight is recorded. Until a very few years ago one frequently came across children whose bodies were covered with flea bites, but now such cases are never seen. The nurses paid an average of 61 visits to each school for uncleanliness inspections during the year; 16,577 inspections were made and 179 individual children were found not to comply with the rigid standard which is enforced. At routine medical inspection the heads of 43 or 2.82% of the children were found not to be entirely satisfactory while 2 or 0.13% had dirty bodies. (c) Minor Ailments and Skin Diseases. Few cases of minor ailments are found at routine inspection as these are sent to the school clinics by parents, teachers, and school nurses as soon as they are discovered. 81 Two cases of scabies, one case of impetigo and two of other skin diseases were found at routine inspections, while at special inspections, 1 case of ringworm of the body, 73 cases of impetigo, 28 cases of scabies and 25 of other skin diseases were discovered. (d) Visual Defects and External Eye Disease. Forty-six or 3.02% of the children at routine inspections' were found to be suffering from some fairly serious defect of vision while 8 others were found at special inspections. A considerable number of children who had already been supplied with spectacles were referred to the School Oculist as a result of re-examination. In all 202 children were referred for refraction. Three cases of blepharitis and 1 case of conjunctivitis were found at routine inspection and at special inspections 1 case of blepharitis, and 16 of conjunctivitis. (e) Nose and Throat Defects. At routine medical inspection 14 children were found to be in need of surgical treatment for enlargement of the tonsils or adenoids, or both, while 21 were referred for observation. At special inspections 25 were referred for treatment and 28 for observation. (f) Ear Disease and Defective Hearing. As a result of routine and special examinations, 20 cases of discharging ears were referred for treatment. (g) Orthopaedic and Postural Defects. Four cases of deformities were referred for treatment, and 3 cases of deformities and 1 of spinal curvature were referred for observation. 82 (h) Heart Disease and Rheumatism. One case of functional heart disease was found at routine inspection. (i) Tuberculosis. No case of tuberculosis was discovered during the year. (j) Other Defects and Diseases. These form a very miscellaneous group and in all 21C cases were referred for treatment from routine and special inspections. Following up. There are three Health Visitors and School Nurses who devote approximately two-fifths of their time to school work. There is a whole-time Clinic Nurse who does the minor ailments and supervises the Dental Clinic, and there is also a whole-time and a part-time Dental Attendant. Home visits are paid by the School Nurses in connection with the treatment of defects; in connection with uncleanliness cases, and to arrange for children to go to special schools. The following is a summary of the work done by the School Nurses during the year:— Visits to schools 610 Visits to clinics 404 Home visits 402 1416 Number of examinations of children— heads, bodies, clothing, etc. 16,577 83 Medical Treatment. (a) Minor Ailments. The Clinic at Bourchier House is open every morning from 8.30 a.m. and the clinic at Summerside School on Tuesday afternoons. On occasions the number of patients has been so large as to necessitate a second weekly session which has been held on Friday afternoons. One thousand, seven hundred and eighty children received treatment at these clinics during the year, making 9,402 attendances, as compared with 1,340 children making 9,417 attendances in 1937. (b) Tonsils and Adenoids. Four children were operated on for tonsils and adenoids at the Finchley Memorial Hospital under the Committee's Scheme while 18 others whose parents contributed to the Hospital Savings Association received treatment at various hospitals. (c) Tuberculosis. All cases of tuberculosis occurring among school children are referred to the Tuberculosis Officer of the Middlesex County Council. (d) Skin Disease. The treatment of cases of skin disease is carried out at the Minor Ailments Clinics; 464 children were treated during the year. Ringworm of the Scalp. No case of ringworm of the scalp was discovered in 1938. (e) External Eye Disease. Children suffering from external eye disease are treated at the Ophthalmic Clinic and at the Minor Ailments Clinics; 77 children were treated during the year. 84 (f) Vision. The Ophthalmic Surgeon attends one session per week at the Clinic at the Martin School and examines all children suffering from defects of vision or other eye conditions referred to her. During 1938, 202 children were referred for examination; 180 were submitted to refraction — spectacles were prescribed in 164 cases and 136 actually obtained spectacles. In 18 of these cases the parents were unable to pay the whole cost of the spectacles and the Children's Care Committee subscribed varying sums towards the purchase. (g) Ear Disease and Hearing. Children suffering from ear discharge and defective 'hearing are dealt with at the Minor Ailments Clinic at Bourchier House. During the year 85 children were treated. (h) Dental Defects. I am indebted to Mr. C. R. Wilshaw, the Senior Dental Officer for the following report on the year's work. DENTAL REPORT, 1938. The objective of the School Dental Service is to seek out and remedy all caries in the teeth of the children and to maintain the maximum of dental efficiency by retaining all saveable teeth. With this end in view, annual dental inspections are carried out at the schools where the parents concerned are invited to be present. The parents who attend are informed of the treatment required and, if they desire their child to be treated at the clinic, they are invited to sign the consent form. Constant endeavour is made at these inspections to note defects by their earliest signs, whether it be caries or threatened irregularity by overcrowding. The details of treatment required are recorded at the time of inspection and are indicated on the consent form which is sent to the parents of 85 each child requiring treatment. Appointments for treatment at the clinic are sent to all who desire such treatment as soon as possible after the return of the consent form appropriately signed. Treatment of a conservative nature is stressed and in accordance with this an acceptance is only deemed valid if the parents consent to all the treatment recommended. Extractions are not undertaken where consent to fillings is withheld, because although it may at first seem to the parent to be the easier way out, it is not in the child's best interest to have gaps where teeth should be. Fortunately it is usually an easy matter to convince parents of this, and the number who refuse on this account is steadily diminishing. In order to keep the conservation of teeth in the forefront all fillings, as far as is practicable, are completed for the child before any necessary extractions are made. Were this course not adhered to, some children after having had their extractions would fail to keep their filling appointments ; not only would saveable teeth become unsaveable as a result of this, but much clinical time would be wasted by broken appointments. 'The value of this policy is indicated by the proportion of teeth saved. The ratio of extractions to fillings in permanent teeth in Finchley for the year 1938 is 1: 8.58 which compares very favourably with the average ratio for all areas which is 1: 2.2 (1937 figures). These figures include extractions to relieve overcrowding. 'The filling to extraction ratio is included in this report because it is a more accurate gauge of the soundness of a service than is the acceptance rate per cent. From it may be judged the completeness of treatment given as well as the permanence of the fillings inserted. If fillings proved unsatisfactory the teeth would subsequently need to be extracted and thus the ratio would be adversely affected. One of the main causes of irregularity of teeth is overcrowding, and this is treated as soon as it is threatened or noticed by judicious extractions. The smaller percentage that need regulation by appliance are at present referred to one of the Dental Hospitals. 86 Root canals are treated at the clinic in the case of incisor teeth—usually those devitalised by an accidental blow . which fractures the tooth. These are preserved that the space and root may be retained in a healthy condition for subsequent crowning. General anaesthetics are administered by a School Medical Officer who attends for that purpose at special sessions. No extractions of any kind are performed without the use of either local or general anaesthetic. Specials are those who attend the clinic other than as routine cases. Their reasons for attendance vary and include accidents to teeth, discomfort subsequent to failure to attend when given the opportunity, defects noticed by parents to develop between routine inspections and quite often parents bring their children in order to obtain advice on the position of the erupting teeth. Children whose parents have refused treatment in the past are allowed re-entry to the scheme at the next routine inspection providing they consent to all necessary treatment, and any teeth requiring fillings are filled before extractions are made, as in routine cases. Acquaintance with the service reveals two disquieting factors. The first is that the teeth of the new entrants, the children aged five years, are in a more carious condition than those of any other school year. It is apparent that many of these children do not have their teeth cleaned for them at bedtime, neither are they given the benefit of the cleansing action of a piece of apple to conclude their last meal; but instead have the remains of biscuits or cake clinging to their teeth which, during the long night, starts the process of decay. Realising that temporary teeth are as necessary to a child as permanent teeth are to an adult, it is a little disconcerting to reflect that many parents show greater interest in the early arrival of their baby's teeth than concern at their too early loss from want of systematic care. The other factor for concern, which is fortunately one which can be remedied within the service, is that there are still many children who do not use their toothbrush correctly. Until the lesson has been learned by all (and the school 87 lation is a changing population) it is necessary to stress the formation of the correct habit. Children who clean their teeth 'naturally' brush their teeth crosswise, generally with their morning wash. This usually precedes breakfast by ten minutes, which means that their teeth are clean for so many minutes in twenty-four hours. Further, crosswise brushing does not remove the all-important particles from between the teeth. To be beneficial it is necessary to clean the teeth after the last food has been taken for the night and after breakfast in the morning in order that teeth may be free from food particles for the longest possible periods. To be effective, brushing must be from the gums towards the biting edges of the teeth —forcing the bristles in between the teeth. Dentists see the children after damage may have occurred from this cause. Teachers however are in a more advantageous position, and as the benefits of correct oral hygiene last for so many years, it is worth the risk of repetition, or of preaching to the converted, to solicit the further aid of teachers to give instruction in a matter so important to the children's welfare. One of the most satisfactory features of the scheme is the active co-operation of Head teachers. The smooth working of the scheme particularly in relation to kept appointments is largely to the credit of teachers. 'The details of the year's work are set out below and on pages 15, 16, 37 and 38. During the year 4,204 children were inspected, 3,817 as routines and 387 as specials. Of this total 3,252 or 77.85% were found to require treatment and of this number 2,203 or 67.74% were actually treated at the Clinic. The following table shows in comparative form for each school, the number of children with sound teeth, the number with unsound teeth, the numbers treated, and the percentage dentally sound, when treatment has been completed:— 88 ELEMENTARY SCHOOLS, 1938 School Number sound Number requiring treatment Percentage requiring treatment Number actually treated Percentage actually treated % of school total dentally sound or rendered so by treatment Holy Trinity 56 193 77.51 122 63.21 69.00 Alder 72 296 80.43 203 68.58 72.00 St. Mary's 95 335 77.91 255 76.12 79.32 Christ Church 57 149 72.33 83 55.7 67.48 Manorside 177 633 78.15 416 65.72 69.6 Summerside 116 378 76.52 264 69.84 75.88 Martin 120 298 71.29 247 82.88 86.47 Our Lady of Lourdes 44 205 82.33 125 60.97 66.24 Northside 122 572 82.42 349 61.01 65.26 St. John's 66 193 74.52 139 72.02 77.5 Totals 925 3252 77.85 2203 67.74 72.51 89 1937 1938 Number of children inspected and re-inspected 4057 4204 Number of children treated 2219 2203 Number of attendances at Dental Clinic 3700 3501 Number of fillings 4001 4491 Number of extractions 3947 3268 Number of other operations 330 356 Number of general anaesthetics 791 572 Parents' Contribution Towards Cost of Treatment The sums recovered from parents in respect of dental and medical treatment are as follows:— 1937 1938 £ s. d. £ s. d. Dental Treatment 100 15 0 103 4 0 Operative 'Treatment of 'Tonsils and Adenoids 8 19 0 1 18 0 Treatment of Minor Ailments 3 11 6 2 14 3 £113 5 6 £107 16 3 Contributions for dental treatment are collected at the Dental Clinic when the child attends for treatment. The charge is 1/- for each child treated. At the Minor Ailments Clinic an endeavour is made to collect 3d. a week for each child attending, but treatment is never withheld on account of inability to pay. Contributions for the operative treatment of tonsils and adenoids are collected by the Education Department. 90 Infectious Diseases. The following list gives the number of cases which were brought to the notice of the School Medical Officer for the past three years. 1936 1937 19 38 Chicken-pox 283 301 95 Diphtheria 5 2 2 Measles 255 116 350 Mumps 3 96 8 Scarlet Fever 28 72 44 Whooping Cough 15 137 64 599 724 563 Measles was very prevalent in 1938 but the other infectious diseases were below the average. Only two cases of diphtheria occurred in school children and for this happy state of affairs credit must be given to the large number of parents who have taken advantage of the Council's Immunisation Scheme and to Head Teachers who have largely contributed to the success of the scheme. 91 Exclusion of School Children on Account of Infectious Disease. Disease PATIENTS Period of exclusion CONTACTS Period of exclusion SCARLET FEVER: (a) Hospital Cases Until 14 days after discharge from hospital. All children in the family must be excluded until 10 days after disinfection of premises. (b) Home Cases Until 14 days after disinfection of premises. DIPHTHERIA: (a) Hospital Cases Until 28 days after discharge from hospital. All children in the family must be excluded until 10 days after disinfection of premises. (b) Home Cases Until 28 days after disinfection of premises. SMALLPOX Until Medical Officer of Health certifies that child may attend. All children in the family must be excluded until the Medical Officer of Health certifies that they may attend. MEASLES Until 28 days after commencement of illness. All children in the family who have not had the disease must be excluded until 16 days after the commencement of the last case in the house. MUMPS Until at least 21 days after commencement of illness. No exclusions. GERMAN MEASLES Until 14 days after commencement of illness. No exclusions. CHICKEN POX Until at least 14 days after commencement of illness, and longer if scabs have not fallen off head and body. No exclusions. WHOOPING COUGH Until at least 5 weeks after commencement of illness, and so long as characteristic cough continues. No exclusions. N.B.—These periods may be modified by the medical practitioner in attendance or by the Medical Officer of Health, but in such cases a special certificate will be sent to the Head Teacher from the Education Office. 92 Open-Air Education. No organised scheme of open-air education exists in the district. In a few of the schools, classes are conducted in the playgrounds during the summer months, and occasional school journeys are undertaken. No school camps have been held. Four places, two for boys and two for girls, are reserved by the Education Committee at the Russell Cotes School of Recovery, Parkstone. During the year 27 children were sent to Parkstone, and without exception, their health was greatly improved. Two places are also reserved, during the winter months, at the Children's Hostel, Collington Manor, Bexhill-on-Sea. Four boys and four girls were sent there for a period of six weeks. Physical Training. I am indebted to the Director of Education for the following report on physical training:— The year under review represents the first year's service of the Man and Woman Organisers of Physical Training appointed by the Middlesex County Council Education Committee and the autonomous areas of Finchley, Hornsey and Wood Green. Regular visits have been made to all departments under the Finchley Education Committee and valuable contact has been established through discussion with Head Teachers and Staffs. During the year in question most children have been able to provide their own gymnastic shoes. The Committee has undertaken the provision of shoes to necessitous children and shoe racks have been supplied to accommodate the shoes which are the property of the Committee. It is hoped to encourage more extensive changing of clothing for Physical Training so far as present accommodation permits. The organisation of swimming presents a difficulty owing to the distance of most schools from the Bath. In spite of 93 this, however, the majority of children have the opportunity of learning to swim before leaving school. The Playing Fields of the area, some 12 acres in extent, are well used, and with further pavilion accommodation this use could be more widely developed. An additional small field is being procured by the Committee at Stanley Road. During the year the following courses for the further training of Teachers and Leaders have been held in which Teachers from the Borough have fully participated: — 1. Recreative Course for Women Teachers. 2. Recreative Course for Women Teachers of Voluntary Organisations. 3. Recreative Course for Men Teachers and Leaders. In the above-mentioned Courses the Board of Education's Handbook "Recreation and Physical Fitness" (1937) was introduced. 4. Course for Men Teachers in Junior Departments. Work on the Board of Education's Syllabus (1933) was revised. 5. Course for Men Teachers in Senior Departments. A Gymnastic Scheme for Senior Boys' Schools was introduced. Further Courses are planned for the first quarter of 1939, for Women 'Teachers in Infants' and Junior Departments as well as Courses for Teachers in Swimming. A party of Danish schoolboys gave a Demonstration of Gymnastics in July at the Summerside Playing Field. This was attended by 3,000 Elementary and Secondary School children and Teachers, and proved of great value. Provision of Milk in Schools. The number of children having milk in school continues to increase. On the 1st October 62% of the children on the roll were having milk. Necessitous cases are referred to the Children's Care Committee by Head Teachers and 56 children were given milk free of cost. 94 The following table shows the numbers receiving milk in each school department on the 1st October, 1938. School. Department Number of pupils on the register Number of pupils receiving milk % of pupils receiving milk Alder Senior 308 163 53 Alder Infants 105 79 75 Northside Senior 236 58 25 Northside Junior 491 282 57 Manorside Senior 273 179 66 Manorside Junior 504 216 43 Martin Junior 439 335 76 Summerside Junior 554 419 76 St. Mary's Junior 484 300 62 St. John's Junior 280 240 86 Christ Church Senior 223 100 45 Holy Trinity Junior 257 176 68 Our Lady of Lourdes Mixed 274 209 76 Totals 4,428 2,756 62 School Baths. The Council's baths in Squires Lane are available for the use of the children of all the elementary schools, and during the year 16,525 attendances were made by 1,561 children. Co-operation of Parents. During the year 65% of parents attended routine medical inspections. The attendance is very good in the case of younger children but it tends to fall off as the children grow older, and this is more marked in the case of boys. Many mothers cannot attend because they go out to work and there does not appear to be any means of avoiding this. Very few parents neglect to carry out the recommendations of the medical officers as regards medical treatment but unfortunately the same is not yet true in the case of dental treatment. Co-operation of Teachers. The closest co-operation exists between the Teachers and the School Medical Service, and in many instances the Teachers have been instrumental in persuading parents to obtain the treatment for their children which has been recommended by the School Medical Officer. Many children 95 are referred by Head Teachers for special examination and children found to be suffering from minor ailments are sent to the school clinics at the earliest opportunity. Co-operation of School Attendance Officers. Weekly lists are prepared by the School Attendance Department of all children absent from school on account of illness, and a weekly list of all children who enter or leave school is submitted to the School Medical Officer. The names of all children excluded from school by the School Medical Officer are notified forthwith to the Attendance Department. The Attendance Officers also inform the School Medical Officer of any children in their districts who are suspected to be physically or mentally defective and thus give valuable assistance in drawing attention to children who might otherwise escape medical supervision. Co-operation of Voluntary Bodies. During the year the Children's Care Committee sent 27 boys and 27 girls to Bexhill-on-Sea for a period of two weeksTwelve boys were sent to Walmer for a similar period, and 8 girls were sent to Shoeburyness for a period of two weeks. In 18 cases assistance was granted in the purchase of spectacles. One boy was assisted in the purchase of surgical appliances, and six children were supplied with boots. The Children's Care Committee also defrayed the cost of milk supplied to fifty-six children. Blind, Deaf, Defective and Epileptic Children. Every effort is made to ascertain children suffering from "special" defects and it is very unlikely that any are missed. Physically defective children are few, and so far it has not been found necessary to establish an Orthopaedic Clinic in the Borough, but arrangements have been made whereby the Education Committee assume responsibility for the maintenance in the Royal Orthopaedic Hospital of any cripple child recommended for admission by the School Medical Officer. 96 No difficulty has been experienced in placing blind, deaf and epileptic children in certified special schools. Eleven mentally defective children were in attendance at the Joint Special School situated within the area at the end of the year, and one attended a school outside the district. The Education Authority has no other Special Schools. Nursery Schools. No nursery schools have been established in the district. Secondary Schools. The School Medical Officer conducts the medical inspection in the three Secondary Schools on behalf of the Middlesex County Council. This arrangement has the advantage of co-ordinating the work in the Secondary Schools with that in the Elementary Schools. Six hundred and seven pupils were examined during the year. Continuation Schools. There are no Continuation Schools in the district- Employment of Children and Young Persons. (1) The children employed in Finchley are mostly engaged in the distribution of newspapers. The conditions of employment have been satisfactory and in no instance has a child been found to have suffered in health owing to such employment. (2) All children are referred to the School Medical Officer for examination prior to their commencing work. Ninety-seven children were examined during the year, and all were found to be fit for employment. No young persons have been referred to the School Medical Officer during the year. Special Inquiries. No special inquiries have been conducted during the year. Miscellaneous. All school teachers appointed by the Education Committee are examined by the School Medical Officer before they take up their duties. During the year no candidate has been rejected on medical grounds. 97 STATISTICAL TABLES for the Year 1938 TABLE I. RETURN OF MEDICAL INSPECTIONS. A.—ROUTINE MEDICAL INSPECTIONS. Number of inspections in the prescribed Groups:— Entrants 500 Second Age Group 412 Third Age Group 493 Total 1405 Number of other Routine Inspections 118 Grand Total 1523 B.—OTHER INSPECTIONS. Number of Special Inspections 2251 Number of Re-Inspections 743 Total 2994 100 C.— CHILDREN FOUND TO REQUIRE TREATMENT. Number of individual children found at Routine Medical Inspection to require treatment (excluding defects in Nutrition, Uncleanliness and Dental Diseases). Group For defective vision (excluding squint) For all other conditions recorded in Table IIA Total (1) (2) (3) (4) Entrants 1 38 39 Second Age Group 29 14 43 Third Age Group 11 10 21 Total (Prescribed Groups) 41 62 103 Other Routine Inspections 5 7 12 Grand Total 46 69 115 101 TABLE II. A. - Return of Defects found by Medical Inspections in the year ended 31st December, 1938. DEFECT OR DISEASE. Routine Inspections. No. of Defects. Special Inspections. No. of Defects. Requiring treatment. Requiring to be kept under observation but not requiring treatment. Requiring treatment. Requiring to be kept under observation but not requiring treatment. (1) (2) (3) (4) (5) Skin— Ringworm:— Scalp .. .. .. .. Body .. .. 1 .. Scabies 2 .. 28 .. Impetigo 1 .. 73 .. Other Diseases (Non-Tuberculous) 2 .. 25 2 Eye— .. Blepharitis 3 .. 1 .. Conjunctivitis 1 .. 16 .. Keratitis .. .. .. .. Corneal Opacities .. .. .. .. Defective Vision (excluding Squint) 46 22 8 .. Squint 7 1 .. .. Other Conditions 5 .. 19 1 Ear— Defective Hearing .. 1 8 6 Otitis Media 5 .. 15 .. Other Ear Diseases 3 .. 48 12 Nose and Throat— Chronic Tonsillitis only 3 15 6 21 Adenoids only .. 1 1 1 Chronic Tonsillitis and Adenoids 11 5 18 6 Other Conditions 1 1 54 3 Enlarged Cervical Glands (Non-Tuberculous) .. 1 5 3 Defective Speech 1 .. •• •• Heart and Circulation— Heart Disease: Organic .. .. .. .. Functional .. 1 .. .. Anaemia 2 .. 9 .. Lungs— Bronchitis 2 .. 4 1 Other Non-Tuberculous Diseases 4 .. 6 .. Tuberculosis— Pulmonary: Definite .. .. .. .. Suspected .. .. .. .. Non Pulmonary: Glands .. .. .. .. Bones and J oints .. .. .. .. Skin .. .. .. .. Other forms .. .. .. .. Nervous System— Epilepsy .. .. 2 1 Chorea .. .. 1 .. Other Conditions .. .. 3 2 Deformities— Rickets .. .. .. .. Spinal Curvature .. .. 1 .. Other forms 1 2 3 1 Other Defects and Diseases— (Excluding Defects of Nutrition, Uncleanliness and Dental Diseases) 15 3 195 25 Totals 115 55 550 85 102 B. Classification of the Nutrition of Children inspected during the year in the routine age-groups. AGE-GROUPS Number of Children Inspected. A. [Excellent]. B [Normal] c. [Slightly subnormal]. D. [Bad] No. % No. % No. % No. % Entrants 500 44 8.8 425 85 31 6.2 - - Second Age Group 412 50 12.14 337 81.8 25 6.06 — — Third Age Group 493 104 21.1 365 74 24 4.9 - - Other routine Inspections 118 14 11.86 96 81.36 8 6.78 - - TOTAL 1523 212 13.92 1223 80.3 88 5.78 - - 103 TABLE III. Return of all Exceptional Children in the Area. Blind Children. At Certified Schools for the Blind. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. - - - - - Partially Sighted Children. At Certified Schools for the Blind. At Certified Schools for the Partially Sighted. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. - 4 - - - 4 Deaf Children. At Certified Schools for the Deaf. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. 6 1 - - 7 Partially Deaf Children. At Certified Schools for the Deaf. At Certified Schools for the Partially Deaf. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. - - - - - - Mentally Defective Children. Feeble Minded Children. At Certified Schools for Mentally Defective Children. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. 12 - - - 12 Epileptic Children. Children suffering from Severe Epilepsy. At Certified Special Schools. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. 1 1 - - 2 Physically Defective Children. A. Tuberculous Children. i.—Children suffering from Pulmonary Tuberculosis (including pleura and intra-thoracic glands). At Certified Special Schools. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. - - 2 1 3 ii.—Children suffering from Non-Pulmonary Tuberculosis (this category includes tuberculosis of all sites other than those shown in i. above). At Certified Special Schools. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. - - - - - B. Delicate Children. At Certified Special Schools. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. 6 15 - - 21 C. Crippled Children. At Certified Special Schools. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. - 2 - - 2 D. Children with Heart Disease. At Certified Special Schools. At Public Elementary Schools. At other Institutions. At no school or Institution. Total. 2 1 - - 3 Children suffering from Multiple Defects. Combination of defect At Certified Special Schools. At Public Elementary Schools. At other Institutions At no School or Institution Total. - - - - - - 105—108 TABLE IV. Return of Defects treated during the year ended 31st December, 1938. Treatment Table. Group 1.—Minor Ailments (excluding uncleanliness, for which see Table VI). Disease or Defect Number of Defects treated, or under treatment during the year. Under the Authority's Scheme Otherwise Total (1) (2) (3) (4) SKIN Ringworn— Scalp (i) X-Ray Treatment - - - (ii) Other - - - Ringworm—Body 1 - 1 Scabies 30 - 30 Impetigo 406 - 406 Other skin disease 27 — 27 MINOR EYE DEFECTS— (External and other but excluding cases falling in Group II.) 77 3 80 MINOR EAR DEFECTS— 85 2 87 MISCELLANEOUS— (e.g. minor injuries bruises sores chilblains etc.) 537 7 544 TOTAL 1163 12 1175 109 TABLE IV. (Continued). Group II.—Defective Vision and Squint (excluding Minor Eye Defects treated as Minor Ailments—Group I.). Defect or Disease (1) Number of Defects dealt with Under the Authority's Scheme (2) Otherwise (3) Total (4) Errors of Refraction (including Squint). (Operations for squint are recorded separately in the body of the Report.) 202 3 205 Other defect or disease of the eyes (excluding those recorded in Group I) 25 — 25 TOTAL 227 3 230 Number of Children for whom spectacles were (a) Prescribed 164 - 164 (b) Obtained 136 3 139 110 GROUP III.—Treatment of defects of Nose and Throat. NUMBER OF DEFECTS. Received Operative Treatment. Received other forms of treatment. (4) Total number treated. (5) Under the Authority's Scheme in Clinic or Hospital. (1) By Private Practitioner or Hospital, apart from the Authority's Scheme. (2) Total. (3) (1) (2) (3) (4) (1) (2) (3) (4) (1) (2) (3) (4) — — 4 — — — 18 - — — 22 — 2 24 (1) Tonsils only. (2) Adenoids only. (3) Tonsils and Adenoids. (4) Other defects of the nose and throat. 111 GROUP IV.—Orthopaedic and Postural Defects. Under the Authority's Scheme. (1) Otherwise. (2) Total number treated. Residential treatment with education. (1) Residential treatment without education. (2) Nonresidential treatment at an orthopaedic clinic. (3) Residential treatment with education. (1) Residential treatment without education. (2) Nonresidential treatment at an orthopaedic clinic. (3) Number of children treated. — - - 1 - - 1 I I 2 TABLE V—Dental Defects. Elementary Schools. (1) Number of Children who were: (7) Administration of general anaesthetics for extractions 572 (a) Inspected by the Dentist:— Aged:— 5 149 6 458 7 444 (8) Extractions:— On account of overcrowding 8 520 Routine 9 483 Total: 3817 Age 10 492 (a) Permanent On account of advanced decay 114 Groups. 11 366 12 329 13 315 14 261 (b) Permanent 325 (b) Specials 387 (c) Temporary 2829 GRAND TOTAL 4204 (2) Found to require treatment 3252 Total 3268 (3) Actually treated 2203 (4) Half-days devoted to:— Inspection 52 Treatment 386 (9) Other operations:— Total 438 (a) Dressings 100 (5) Attendances made by children for treatment 3501 (b) Application of Silver Nitrate 106 (c) Scalings 147 (6) Fillings:— (d) Root treatment 3 Permanent teeth 3767 (e) Miscellaneous — Temporary teeth 724 Total 4491 Total 356 113 TABLE V—Dental Defects. Secondary Schools (1) Number of Children who were: (a) Inspected by the Dentist:— Aged:— (7) Administrations of general anaesthetics for extractions 1 11 90 12 167 (8) Extractions:— 13 222 14 190 On account of overcrowding Routine 15 197 Total: 1095 Age 16 158 (a) Permanent On account of advanced decay 53 Groups. 17 55 18 11 19 5 (b) Specials — (b) Permanent 74 GRAND TOTAL 1095 (c) Temporary 77 Total 204 (2) Found to require treatment 810 (3) Actually treated 457 (4) Half-days devoted to:— Inspection 14 (9) Other operations:— Treatment 120 (a) Dressings 49 Total 134 (b) Application of Silver Nitrate 3 (5) Attendances made by children for treatment 764 (c) Scalings 43 (6) Fillings:— Permanent teeth 1360 (d) Root treatment 4 Temporary teeth 2 Total 1362 Total 99 Table VI—Uncleanliness and Verminous Conditions. (1) Average number of visits per school made during the year by the School Nurses 61 (2) Total number of examinations of children in the Schools by the School Nurses 16577 (3) Number of individual children found unclean 179 (4) Number of children cleansed under arrangements made by the Local Education Authority — (5) Number of cases in which legal proceedings were taken:— (a) Under the Education Act, 1921 — (b) Under School Attendance Bye-Laws— 114 Index PAGE Report of the Medical Officer of Health 1 Members of the Public Health and Maternity and Child Welfare Committee and Staff of the Public Health Department 2 Social Conditions 4 Vital Statistics 4 Poor Law Relief 9 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 23 Infectious Diseases 24 Statistical Table—Infectious Diseases 33 Tuberculosis 35 Maternity and Child Welfare 37 Housing Statistics, etc. 41 Food 44 Factories and Workshops 46 Report of the Chief Sanitary Inspector 50 Inspections 51 Summary of Sanitary Improvements carried out 51 Notices served 53 Disinfection 54 Eradication of Bugs 54 House-to-House Inspection 55 Unfit Dwelling-houses Closed or Demolished 58 Overcrowding 59 Houses Let in Lodgings 59 Sanitary Conveniences 59 Complaints 60 Places of Public Entertainment 60 Premises Periodically Inspected. 61 Factory and Workshop Acts 61 The Inspection of Meat 64 Bakehouses 68 Dairies, Cowsheds and Milkshops 69 The Milk (Special Designations) Order, 1936 69 Ice Cream Premises 69 Coffee Stalls 70 Offensive Trades 70 Game Licences 70 The Shops Acts 70 Storage of Petroleum 71 Staff 72 PAGE Report of the School Medical Officer 75 Members of the Education Committee 76 School Medical Staff 77 Finchley Schools 78 Medical Inspection 80 Medical Treatment 84 Dental Report 85 Infectious Diseases 91 Open-Air Education 93 Physical Training 93 Provision of Milk in Schools 94 School Baths 95 Co-operation of Parents, etc. 95 Blind, Deaf, Defective and Epileptic Children 96 Nursery, Secondary, and Continuation Schools 97 Employment of Children and Young Persons 97 Statistical Tables 99 F1NCHLEY PRESS LTD. FINCHLEY, N.2 cX %