FINC 26 BOROUGH OF FINCHLEY ANNUAL REPORT FOR THE YEAR 1945 of the MEDICAL OFFICER OF HEALTH BOROUGH OF FINCHLEY ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1945 TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE BOROUGH OF FINCHLEY. September, 1946. I have the honour to submit my Annual Report for the year 1945. The vital statistics are excellent. The Death Rate is the lowest since 1939. The Infantile Mortality Rate is low and. the Maternal Mortality and Still Birth Rates are both very satisfactory. Deaths from the common infectious diseases have never been so few. The attendances at the Infant Welfare Centres, the antenatal and other clinics continued to increase. Every effort has been made to ensure the wholesomeness of food and milk in the Borough and to improve whenever possible the living conditions of the people which have deteriorated so much throughout the war years. I wish to express my thanks to all members of the Staff for their good work during 1945. - 2 - SOCIAL CONDITIONS Area (in acres) 3,477 Population (estimated) on 30.6.45 61,370 Number of Inhabited houses (end of 1945) 19,079 Rateable Value (1st April, 1945) £908,371 Sum represented by a penny rate £3,692 EXTRACTS FROM VITAL STATISTICS Live Births: Total Males Females Legitimate 919 433 436 illegitimate 68 30 38 Birth rate; 16.08 per 1,000 estimated resident population. Stillbirths: Total Males Females 14 8 6 Rate; 13.98 per 1,000 (live and still) births. DEATHS: Total Males Females 725 341 384 Rate; 11.81 per 1,000 estimated resident population. Deaths from diseases and accidents of pregnancy and childbirth: From sepsis - Other maternal causes 1 Death-rate of infants under one year of age: All infants per 1,000 live births 36.37 Legitimate infants per 1,000 legitimate live births 37.0 Illegitimate infants per 1,000 illegitimate live births 29.41 - 3 - Deaths from Cancer (all ages) 119 Deaths from Measles (all ages) 1 Deaths from Whooping Cough (all ages) - Deaths from Diarrhoea (under 2 years of age) 1 POPULATION The Registrar-General estimated that the population on the 30th June, 1945 was 61,370, an increase of 1,640 over 1944 hut 3,770 less than in 1938. Men and women in the Services are not included in the estimate. THE BIRTH RATE The number of registered live births in 1945 was 987, fifty less than in 1944. The birth rate was 16.08 per 1,000 of the estimated population and is almost exactly the same as the birth rate for England and Wales which was 16.1. There were 68 illegitimate births, which is 13 more than in 1944. The natural increase in the population, or excess of live births over deaths, was 262. STILLBIRTHS There were only 14 stillbirths in 1945 as compared with 33 in 1944. The stillbirth rate was 13.98 per 1,000 total births, which is a very low figure. - 4 - THE DEATH RATE In 1945 there were 725 deaths, no less than 105 fewer than in 1944. The following table shows the number of deaths in age groups for the past two years. 1944 1945 0-1 year 34 36 1-5 years 9 4 5-15 years 8 3 15 - 25 years 20 10 25 - 45 years 56 38 45 - 65 years 233 174 Over 65 years 470 460 830 725 It will be seen that there is a saving in lives at all ages, except during the first year of life, and that it is most marked in earlier years. There were 41 fewer deaths from cancer in 1945 than in 1944, 34 less from violence, 10 loss from infectious diseases, 8 less from ulceration of the stomach or duodoum and 18 less from miscellaneous causes, whilst there were 18 more from disease of the heart and blood vessels. INFANTILE MORTALITY There were 36 deaths of infants (2 illegitimate) under one year of age, as compared with 34 in 1944 and 57 in 1943. The infantile mortality rate was 36.37 per 1,000 live births, which is very satisfactory. The rate for England and Wales was 46. - 5 - MATERNAL MORTALITY Only one mother died in 1945 from maternal causes, giving a maternal mortality rate of 1 per 1,000 births. INFECTIOUS DISEASE The following table shows the number of notifications of the principal infectious diseases received during the past four years 1942 1943 1944 1945 Diphtheria 19 9 3 4 Scarlet Fever 141 194 125 109 Smallpox - - 3 - Enteric Fever 1 1 - - Cerebro-Spinal Fever 4 3 1 1 Pneumonia 42 60 49 38 Measles 593 364 83 618 Whooping Cough 116 78 201 57 Measles was prevalent but all the other diseases were below the average. There were 4 cases of diphtheria and none of them had been immunised. Scarlet Fever continued to decline and was once more mild in character. The mortality from infectious disease was remarkably low, there being only one death which was due to measles. IMMUNISATION Eight hundred and sixty-seven children, mostly one year of age, were immunised during the year. In addition, 731 children were re-immunised. This is done at approximately 4 years after the original treatment in order to ensure the continuity of immunity. - 6- TUBERCULOSIS The following table shows the number of notifications of, and deaths from, pulmonary and non-pulmonary tuberculosis for the years 1938 to 1945 inclusive. There was a slight increase in notifications and in deaths. YEAR New Cases. Deaths. Pulmonary Non-Pulmonary. Pulmonary Non-Pulmonary M. F. M. F. M. F. M. F. 1938 47 27 4 10 13 9 3 1 1939 34 30 6 8 16 7 2 - 1940 28 21 4 4 16 10 2 2 1941 34 38 5 7 18 15 2 1 1942 40 39 4 3 14 19 1 1 1943 41 39 7 5 14 11 3 5 1944 48 30 8 8 14 9 3 2 1945 49 41 8 1 17 9 5 1 BACTERIOLOGICAL WORK The bacteriological work for the district is carried out at the Joint Isolation Hospital and, during 1945, the following specimens dealt with:- Positive Negative Total Diphtheria 2 201 203 Tuberculosis 7 42 49 Other conditions 18 24 42 294 SCABIES AND VERMIN There was a steady improvement in both conditions throughout the year and, generally, infected persons willingly attended the centres for treatment. -7- MATERNITY AND CHILD WELFARE There were 20,858 attendances at the three Infant Welfare Centres in 1945, nearly 1,000 more than In 1944. After the end of the War in Europe, families started to return from evacuation, and the cessation of aerial attacks allowed the Clinics to be conducted in safety. The Voluntary Workers continued to carry out their valuable work at the Centres, as they have done so faithfully throughout the whole war period, and have earned the gratitude of all who attend these Clinics. The Ante-natal Clinic was attended by 772 expectant mothers, as compared with 601 in 1944. This increase presaged a rise in the number of births in 1946 and at the same time rendered the task of placing mothers in hospital for their confinements more difficult than ever. Owing to the lack of beds in the London Area the Government Evacuation Scheme for expectant mothers continued to operate after the termination of hostilities. Out of 926 cases in which the place of confinement was known, 699 births took place in Hospitals or Nursing Homes and 277 at home. The Council's Midwives attended 168 births. ANTE-NATAL EXERCISES. Classes for expectant mothers were started on the 24th October, 1945; they are conducted by Miss Barbara Rooke, CS.S.PT. The aim of the ante-natal exercises is to teach mothers muscular relaxation, with a view to getting shorter and easier labour, and to encourage good posture, 8 thereby helping to lessen fatigue. The exercises are very much appreciated, and though the classes are small the members are enthusiastic. It is early as yet to assess the results so far as the labours are concerned, but mothers who have been seen after their confinements are convinced that the exercises have helped them. POST-NATAL CLINIC The post-natal clinic is held twice a month and the attendances are gradually increasing. During the year, 131 patients attended, which is an Increase of 42 over 1944. Most of the women who attend for post-natal examination attended the ante-natal clinic and had been delivered by the Municipal Midwives. Those who attended the ante-natal clinic but were delivered in hospital usually went back to hospital for examination. Those who required further investigation or treatment were referred to hospital. SUNLIGHT CLINIC One hundred and fifty-four children and 23 mothers received courses of ultra-violet radiation and made 1,648 attendances. PREMATURE INFANTS ILLEGITIMATE CHILDREN The provisions made for dealing with these children are the same as described in the report for 1944, and they proved to be adequate and satisfactory during the year under review. -9- 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. Complete dental treatment is available to all who require and desire it. Although operative treatment is given at a nominal cost to the patient (one shilling per treatment visit) the scheme for supplying dentures is self-supporting. The Voluntary Association renders great assistance in that it undertakes the collection of fees for dentures on a scale which provides for a reduction in the cost of dentures to necessitous mothers. Mothers. Children. Number inspected 204 347 Number requiring treatment 203 163 Number treated 187 148 Number of attendances 849 334 Fillings 490 306 Extractions 430 139 Scalings 138 — Gas administrations 66 57 Other operations 79 70 Dentures supplied 66 - Dentures repaired 6 - HOME HELPS Assistance in 111 homes was provided in 1945 and at the end of the year 4 full-time and 1 part-time helps were employed. DOMESTIC HELPS A scheme for the supplying of domestic help in homes where, owing to illness or infirmity, the housewife is unable to carry out her household duties, was started in May 1945. The necessity for such a scheme was amply proved by the many genuine demands for help which wore received. -10- In the 7 months during which the scheme operated, help for varying periods was given in 170 homes. The staff employed at the end of the year consisted of 1 part-time supervisor, 16 whole-time and 5 part-time helps. The scheme is financed by the Ministry of Health. DAY NURSERIES The three War-time Nurseries and the Council's Nursery at the Health Centre wore used to their full extent throughout the year. The attendances were frequently affected by the common infectious diseases, for which each nursery was placed in quarantine from time to time, but there was no evidence that the nursery children suffered more from these diseases than other children of the same age and circumstances. After the cessation of hostilities it soon became difficult to obtain girls for training as nursery nurses and there is no doubt that this is largely due to the low rate of remunoration which they receive. JOINT AMBULANCE SERVICE In accordance with the instructions of the Ministry of Health the Civil Ambulance Service was taken over from the Civil Defence on the 1st January, 1945, and two ambulances were manned day and night. At the invitation of Hornsey Town Council a conference was held to discuss the amalgamation of the ambulance services Of the Boroughs of Finchley, Hornsey and Wood Green and the Urban District of Friern Barnet and it was agreed that an amalgamation should take place, that the ambulances should -11- be pooled and that the service should operate from Finchley. The Joint Service started on the 1st July and up to the end of tho year 3,477 oases were removed. MORTUARY Forty-six bodies were received in the Mortuary and nine of these were from Friern Barnet. FOOD Food inspection still continues to be an important duty carried out by your inspectors, 709 visits having been made during the year to various premises in connection therewith. In spite of the amount condemned, every precaution is taken to avoid waste by the careful inspection of foodstuffs, food preparing premises and stores and the co-operation of traders and the Ministry of Food. Whenever possible condemned foods are salvaged, processed and used for various purposes including animal feeding. Although the amount of food condemned appears to be large, there is in the District a Government Meat Distributing Centre serving Barnet, Finchley and Hendon, Government buffer stores and several large wholesalers. The quality of the meat and offals inspected at the meat centre was generally good as is seen by the small amount condemned (357 lbs) and shown in tho list below, which includes that condemned at a private slaughterhouse used for occasional slaughtering by permission of the Ministry of Food. No food was damaged by enemy action. - 12- Four private slaughterhouses are licensed. Legal proceedings were taken against a fishmonger for the sale of unsound fish and the defendant was fined £2 and ordered to pay £10-10-0 costs. LIST OF UNSOUND FOOD TUBERCULOSIS Swine 2 heads. ) 2 plucks. ) 47 lbs. (Total weight 35½ lbs. 2 mesenteries.) plus 1 head.) 1 spleen. ) DISEASES OTHER THAN TUBERCULOSIS Bovines 50 lbs. Ox Kidneys. 223½lbs. Beef (82½ lbs. decomposition, 141 lbs. sour) 25 lbs. Ox Tails, (sour) Swine 1 Pig's Pluck (Pneumonia and Cirrhosis) lbs. Sheep 3 lbs. Lambs' Sweetbreads (Sour) 1 set Sheep's Lungs (Abscess) 2 lbs. Total 357 lbs. MISCELLANEOUS. 4736 lbs. tinned meat. 45 tins meat roll. 22 tins meat and vegetable dinner. 1 doz. brawns. 12 meat pies. 112 lbs. sausages. 14½ lbs. ham. 152 lbs. rabbits. 246 tins vegetables. 407 tins fish. 6 tins fruit. 1299 tins milk. 30 tins soup. 2 tins Golden Syrup. 102 tins jam or marmalade. 2 lbs. honey. -13- 180 stones fish. 3½ bushels winkles. 2 bushels whelks. 58 lbs. fish cakes. 5 hens. 1¾ lbs. rice. 197½ lbs. dates. 94½ lbs. sugar. 112 lbs. split peas. 26 lbs. semolina. 12 lbs cake flour. 18 lbs. soya flour. 2258 lbs. oatmeal. 4 lbs. ground rice. 20 lbs. spaghetti. 16 lbs. margarine. 600 lbs. soya grits. 106 lbs. peas. 40 lbs. onion substitute. 7l¾ lbs. sweets. 25 packets breakfast cereal. 43 packets soup powder. 16 packets dried egg. 50 jars meat and fish paste. 23 jars pickles. 2 bottles mixed fruit. 1 lbs. mincemeat. 1½ lbs. bacon. 55 lbs. macaroni. 6¼ lbs. cheese. 904 eggs. 152¾ lbs. dried fruit. 226 lbs. tea. 72 lbs. lentils. ll½ lbs. pea flour. 492 lbs. pudding mixture. 3 lbs. flour. 1 lb. 14 ozs. curry powder. 6 lbs. pearl barley. 54 lbs. biscuits. 19 lbs, porridge oats. 1 lb. butter. 24 lbs. sutox. 36 lbs. carrots. 112 lbs. milk chocolate. 112 lbs. oranges. 13 packets dried herbs. 100 packets lemon flavouring. 6 packets egg substitute. 4 jars meat extract. 8 bottles sauce. 8 tins lemon ice foam. MILK Fewer complaints with regard to milk have been received during the year and, in spite of the transport difficulties that still prevailed, the milk generally has been in better condition than during the previous war years. Dairies and milkshops have been inspected and a number of samples taken for bacteriological examination. In one of the large dairies a new mechanical churn washer has been installed and is giving good results. DESIGNATED MILKS Licences were granted by the Council in respect of designated milk for the year ended the 31st December, 1945, as follows:- Dealers' Licences to sell milk as Tuberculin Tested 8 Dealers' Licences to sell milk as Pasteurised 10 Supplementary Licences to sell milk as Pasteurised 2 - 14 - 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 WATER Three samples of water were submitted for analysis and all proved satisfactory. HOUSING I regret to have to report a further deterioration in the housing situation. The number of families requiring re-housing owing to statutory overcrowding or inadequate housing considerably increased. Several factors are responsible for this position, the chief being houses destroyed or damaged by enemy action; no now houses being erected; the return of members of H.M. Forces and evacuated persons and the shortage of building labour and materials. The lack of maintenance to existing property has resulted in the standard of fitness being greatly reduced and, if allowed to continue, it will, in the near future add still further to the list of insanitary and unfit houses, thus creating a still greater housing shortage. This is a matter of grave concern to the Department. It is inevitable that sub-letting must occur under the foregoing circumstances and a number of large houses have been let to families, who live under most unsatisfactory conditions, often in so-called furnished rooms with the minimum of furniture, comfort and amenities, but to the benefit of the landlord. A number of such cases have been, or are being dealt with. 108 visits have been paid to premises - 15- registered as houses let in lodgings. During the year 1,615 houses were visited by the sanitary inspectors and defects numbering 2,094 were recorded and dealt with. The following is a list of the work carried out, which necessitated a further 2,693 visits. LIST OF WORKS Drainage Premises re-drained 11 Drains altered or repaired 19 Drains unstopped 115 Yds. stoneware drain laid 88 Inspection Chambers provided 8 Inspection Chambers altered or repaired 5 New inspection chamber covers 15 Intercepting traps fixed 3 Fresh air inlets fixed 2 Fresh air inlets repaired 2 New gullies provided 9 Gully curbs provided and repaired 3 Soil pipes and vents fixed 1 Soil pipes and vents repaired 1 Water tests applied 29 Smoke tests applied 23 W.C' s. etc. W.C. Accommodation provided 1 W.C. apartments provided 3 Ventilated lobbies provided 1 W.C. pans fixed 42 W.Cs. unstopped, cleansed or repaired 16 W.C. apartments cleansed 1 W.C. cisterns fixed 13 W.C. cisterns repaired 23 Lavatory basins provided 2 Sinks provided 11 Wastepipes repaired or unstopped 20 Wastepipes provided 3 Urinals cleansed or repaired 5 Miscellaneous New roofs 4 Roofs repaired 71 Gutters renewed 5 Gutters repaired 22 -16- Rain water pipes provided 4 Rain water pipes repaired or unstopped 9 Rain water pipes disconnected 1 Dampness remedied 16 Brickwork repaired or repointed 9 Yards paved 1 Yards repaired 5 Floors relaid 7 Floors repaired 25 Walls and ceilings cleansed 80 Plasterwork repaired 98 Ventilated food stores provided 1 Windows provided 1 Windows repaired 33 Sash cords renewed 60 Window sills repaired 6 Doors provided 2 Doors repaired 6 Staircases repaired 3 Handrails provided 1 Storage cisterns provided 7 Storage cistern repaired, cleansed & covered 5 Water service pipes repaired 34 Dustbins provided 48 Offal bins provided 2 Accumulations of manure removed 3 Accumulations of refuse removed 11 Workrooms cleansed 5 Stables cleansed 1 Piggeries cleansed 1 Bakehouses cleansed 4 Coppers provided 2 Ranges provided 1 Ranges repaired 3 Stoves renewed 6 Stoves repaired 11 Chimney pots renewed 1 Miscellaneous 54 GENERALLY The number of complaints of nuisances received during the year showed an increase; 533 having been investigated and dealt with. Other urgent matters including investigation of infectious diseases, drainage work and the inspection of factories have been dealt with and in connection therewith 7,854 visits have been made by the sanitary inspectors. Factory premises still require special attention owing to premises of all types being used and, in many circumstances, for purposes for which they are entirely unsuitable. Complaints of noise and smells have been dealt with and additional and -17- separate W.C. and washing accommodation provided. A complaint of grit emission from one of the larger factory chimneys was dealt with and the work carried out to remedy the nuisance appears to have had satisfactory results. Sixty-seven verminous premises, including 52 infestations of bugs and 5 of fleas, have been disinfested. With the introduction of new insecticides; D.D.T. and Gammexane it is hoped that the nuisance from vermin and various insect pests will show a decrease in the future as the residual effects of these chemicals should go a long way to bring about an initial cure and prevent re-infestation. A summary of the work carried out by the disinfectors is given below. DISINFECTION SUMMARY Visits. Rooms disVerminous Articles Articles infected rooms. disinfected. destroyed. after infectious disease. Sprayed. Fumigated. Sprayed. Fumigated. 1033 204 15 95 91 4818 153 RODENT DESTRUCTION The following is a summary of the work carried out during the year. Rats. Mice. Wasps. Hedgehogs. Fox. Complaints 235 81 11 2 1 Visits 2396 185 15 2 8 Prebaits 1022 - - - - - 18 «  Rats. Mice. Wasps. Hedgehogs• Fox. Poisonings Zinc Phosphide 250 81 - - - Arsenic 27 - - - Red Squills 24 - - - - Barium Carbonate 3 - - - - Gassings 72 - 15 «■» 4 There was a reduction in the number of complaints regarding rats but a large increase in complaints regarding mice and of all complaints the proportion where poultry or rabbits were kept increased from 33 per cent to 44 per cent. No. of Premises proofed Air Gratings fitted 40 Defective brickwork remedied 4 Concreting under shop windows 2 Concreting of Floors 2 Pipe casing sealed with expanding metal 1 Sanitary Defects Found and Remedied Accumulation of Rubbish 5 Defective Drainage 4 Defective Fresh Air Inlets 4 Blocked Drains 9 No stoppers to Intercepting Traps 11 Defective Manholes 1 Open junction on Public Sewers and/or untrapped fittings 9 Smoke Tests Two smoke tests applied to rat runs revealed defects in sewers or drains. -19- Yearly Contracts Seven yearly contracts have been entered Into, monthly visits being paid to each. They consist of:- Date of Termination 1 Foodshop (mice) 20.12.45 2 Food Preparing Premises 27.4.46 1 Pig Club 25. 1.46 1 Refuse Destructor & Sewage Works 31.3.46 2 Private Houses 9.5.46 Disinfestation of Sewers A scheme for the disinfestation of sewers was submitted to the Ministry of Pood (Infestation Control), together with an application for additional manpower. In August, ten Italian collaborators were allocated for 12 weeks to assist in this work, and it is worthy of note that owing to the manner in which these men co-operated with Council employees we were able to dispense with their services a week ahead of schedule. The scheme consisted of dividing the district into 10 areas with well defined boundaries; two Italians and one Council employee operating In each area. Manholes were prebaited on four successive days, poison bait being laid on the fifth day, followed by an inspection for recording poison takes. A second treatment was carried out within one month of the initial treatment and on similar lines, except that the bait base and poison were changed from Rusk and Zinc Phosphide to Bread and Barium Carbonate. -20- No. of Manholes Estimated No. Average kill baited. of Rats killed. per manhole. Northern Southern Northern Southern half. half. half. half. 1st Treatment 1200 1567 1882 1020 1.04 2nd Treatment 682 573 246 480 0.578 4022 3628 Major Infestations An occupier made application for assistance to disinfest his premises. This proved to be a major infestation. The whole of the land and buildings were inspected, and owing to the large area within the curtilage of the premises it was decided to mark all baiting points by the use of flags. This method proved to be invaluable, especially when used in connection with sewer recording form No. 2. Some 74 dead rats were found which taken at the conservative estimate of 10 per cent represents 740 rats destroyed. The two treatments were carried out in a similar manner to that adopted for the sewers. Mice. The number of requests by householders for assistance to disinfest houses of mice has increased 100 per cent, and the numbers of requests is likely to increase still further. -21 - Generally This concludes a very satisfactory year's progress and, while it is too early to say whether the number of complaints of Rats will continue to decrease, I feel that some, if not all, of the worst areas within the district have now been given efficient treatment. A.A. TURNER. Medical Officer of Health.