FRI 14 FRIERN BARNET URBAN DISTRICT COUNCIL. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR ENDING DECEMBER 31ST 1925. To the Chairman & Members OF the Friern Barnet Urban District Council Mrs Bailey & Gentlemen. I beg to submit my annual report on the Health Conditions of this District for the year 1925. This report is a Survey Report and will review the conditions for some years back besides dealing specifically with matters arising in 1925. I have followed the order of the paragraphs set out in the Circular No. 648 issued from the Ministry of Health in December 1925. The statistical and topographical data embodied in this report has been compiled by your Sanitary Inspector from records kept by him and an intimate knowledge of the district acquired during his service as your inspector, and has been verified and revised by the latest available information from the General Register Office & Ordnance Survey. The figures for population, death, birth, and infectious disease rates will differ slightly in some instances from those given in previous reports owing to the fact that more reliable data are now available than at the time of the preparation of those between the figures belonging England & Wales (abbreviated to E & W report) proper corrections have been take them fairly comparable. to the Members of the Council to my colleagues for their ever he past year. am Mrs Bailey & Gentlemen Your obedient Servant F.R.C.S. (ENG) D.P.H. Medical Officer of Health. Dated this 12th day of March 1926. FRI 14 FRIERN BARNET URBAN DISTRICT COUNCIL. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR ENDING DECEMBER 31ST 1925. To the Chairman & Members of the Friern Barnet Urban District Council Mrs Bailey & Gentlemen. I beg to submit my annual report on the Health Conditions of this District for the year 1925. This report is a Survey Report and will review the conditions for some years back besides dealing specifically with matters arising in 1925. I have followed th3 order of the paragraphs set out in the Circular No. 648 issued from the Ministry of Health in December 1925. The statistical and topographical data embodied in this report has been compiled by your Sanitary Inspector from records kept by him and an intimate knowledge of the district acquired during his service as your inspector, and has been verified and revised by the latest available information from the General Register Office & Ordnance Survey. The figures for population, death, birth, and infectious disease rates will differ slightly in some instances from those given in previous reports owing to the fact that more reliable data are now available than at the time of the preparation of those reports. Where comparisons are made between the figures belonging to this district and those for England & Wales (abbreviated to E & W In the tables and body of the report) propor corrections have been applied to the crude rates to make them fairly comparable. I wish to express my thanks to the Members of the Council for their unfailing courtesy and to my colleagues for their ever ready & able assistance during the past year. I am Mrs Bailey & Gentlemen Your obedient Servant F.R.C.S. (ENG) D.P.H. Medical Officer of Health. Dated this 12th day of March 1926. MEDICAL OFFICER'S ANNUAL REPORT 1925 SHEET 2 of DRAFT NATURAL AND SOCIAL CONDITIONS OF THE AREA. Area (in acres) 1304. POPULATION Census 1921-17381. Estimated 1925 by Registrar General 18540. I have in previous reports commented upon the difficulty of estimating accurately the population of a small district in the suburban area of Greater London, various methods have been tried with more or less success amongst which may be mentioned (1) The Registrar General's method of computing it from the two latest census returns. The accuracy of the result obtained by this method depends entirely upon the assumption that the population is varying at the same rate and same manner as it did in the 10 past inter-censal years, local observation shows that such an assumption would be misleading. (2) The method of taking the number of poeple per inhabited house on the night of the Census and multiplying it by the estimated number of inhabited houses as obtained from the rate books at the middle of the year. This method gives a result fairly near the truth, but owing to the various classes of house it is of no use in estimating the population of a part of the district such as a Ward. (3) The method of making use of actual data conveniently obtained in the middle of the year in the compilation of the half yearly Register of electors. I find that for various areas the proportion of electors to population remains very constant over a long period and the Register of Electors gives us at present the most accurate estimate of our population in the middle of the year that is obtainable. The Registrar kindly supplies an estimate of our population but as it is received too late in the year to enable an early preparation of the annual report I have used the estimate based on local knowledge. The population given in the tables for the years subsequent to 1921 are obtained by method (3). The populations for years previous to 1921 are computed from the Census returns and will therefore differ slightly from the estimates of such population as given in my previous reports. Estimate of population middle year 1925. North Ward Electors 1814 Population 3755 South Ward " 3326 „ 7400 Central Ward " 2855 „ 5385 District " 7995 „ 16540 Asylum mean of 10 years. Total „ 2889 7995 „ 19429 PHYSICAL FEATURES AND GENERAL CHARACTER OF THE DISTRICT. Friern Barnet is an Urban District of Middlesex co-terminal with, the ancient Parish (and formerly a part of the Barnet Rural District') situated on the Northern Heights about 8 miles N. N. W. of Charing Cross with a middle latitude of 51-33-0 North and Longitude 0-10-0 West, it comprises 1304.9 acres of land and inland water. The surface is undulating, there are two principal valleys running roughly parallel in an easterly direction, the ridge of the dividing watershed being defined by Friern Barnet Road which is about 220 feet above 0. D. The crown of this ridge consists of a clean sandy gravel about 10 feet thick. •> MEDICAL OFFICER'S ANNUAL REPORT SHEET 3 OF DRAFT The watercourse to the North of Friern Barnet Road is about 160 feet above 0. D. and receives two tributaries running in a S. E.ly direction, the ridge between these tributaries being roughly defined by Friern Lane with its highest point-290 feet above O.D. opposite the entrance lodge to the golf links. The watercourse to the south of Friern Barnet Road is at about 140 feet above O. D. and receives a tributary running S. E. whose course is roughly defined by Colney Hatch Lane, and another tributary running N.W. across the Halliwick Park allotments and draining the Muswell Hill portion of the South Ward. The whole of the District south of Friern Barnet Road is a clay soil with a subsoil of the London Clay and during the winter time surface water is retained in the hollows on the surface. During the heavy rains of November & December of this year the surface pools have been rather more conspicuous than usual on the open spaces unbuilt upon in the South Ward and some of the inhabitants have been un-necessarily alarmed because this water has shown itself rather more than usual. The same natural occurrence may be observed in other parts of the district especially on the East side of Friern Lane where the surface water is collected in a series of small ponds. So long as this surface water is prevented from collecting under houses no harm to the public health can arise therefrom, and in my opinion the Council would not be justified in calling upon owners of vacant land to provide surface water drains until it was proposed to erect dwelling houses, when of course it would receive attention under the Building Byelaws requiring the sites of houses to be properly drained. The remaining portion of the district north of the Parish Church of St. James is high land at or above 300 feet above O.D. with a gravelly soil in patches (not so clean as that along the Friern Barnet Road ridge) overlying the London Clay. This gravelly oil contains a considerable amount of sub-soil water which drains off in an easterly direction by the head waters of three small watercourses. All the streams and watercourses drain to the Lea, Some of the older houses in the north ward have cellars excavated in these patches of gravel, and in several instances these cellars have become flooded by subsoil water necessitating rather expensive works of drainage. I should like to call the attention of persons about to erect houses on a gravel soil in this district not to excavate the gravel on the site, by so doing they are spoiling what would otherwise be a dry and healthy site. For administrative purposes the district is divided into three Wards each returning four members to serve on the District Council one third of such members retiring annually there are five polling districts which at the middle of 1925 contained electors as follows:- District P. comprising the whole of the North Ward -- 1814 Electors „ R „ part of the Central Ward 958 „ N „ „ „ „ „ „ & part of the South Ward 2,209 „ „ 0 „ part of the South Ward 848 „ „ q „ „ „ „ „ „ 2,167 „ The London County Council Hospital for Mental Diseases at Colney Hatch is situated on a fine site sloping towards the South, completely self contained and surrounded by a brick wall and for statistical purposes has been ignored so far as the Births & Deaths are concerned and only such parts of the population of this colony are included as really form part of the population of the district such as the staff resident on the estate and the workers engaged in the Asylum who are resident in the district proper. The District possesses some excellent open spaces and the Council continues its interest in the East Barnet Playing Fields situated on our East boundry. MEDICAL OFFICER'S ANNUAL REPORT SHEET 4 OF DRAFT. Recently the Council has acquired an additional open space in the valley to the North of Friern Barnet Road part of the Bethune Estate, which has been laid out as permanent allotments and playing fields. The drainage works carried out in this area by direct labour under the direction of the Engineer and Surveyor will tend to mitigate to a great extent the cold fogs which up to the present have been a source of discomfort to the inhabitants of the houses on the slope of the valley with a northern aspect. The playing fields will be of great benefit to the district. The playing of organised games by children under proper supervision is not only good physically but tends to promote discipline and to mould character in the direction of sound citizenship. Social Conditions. The number of Inhabited houses at the 1921 Census was 2928 with 3543 separate families or occupiers. Friern Barnet is practically a residential suburb with few factories and workshops. The 1921 census showed for the first time the number of persons daily moving into and out of the district, namely that 3920 persons sleep in the district but work elsewhere and 923 persons work in the district but sleep elsewhere. This daily migration to and fro of practically 5000 persons is dealt with by Train, Omnibus and tram the length of double track of the latter being just over a mile. There does not appear to be any particular disease associated with the social conditions of the inhabitants of this district. The rateable value of the District is increasing and for the year under review is: for Poor Rate Purposes £114785 and for General District purposes £112068.10,0 and the product of a 1d rate about £470. There has not been any extensive call for Poor Law relief and judging from the enquiries that I have received from the Almoners of the various London Hospitals asking for particulars of the home conditions of the various applicants for medical and surgical assistance, I should say that there has not been any extraordinary call upon the London Hospitals for gratuitous relief. VITAL STATISTICS. These I present in tabular form as far as practicable at the end of the report, as a general rule the vital statistics of a district over a short period are not to be trusted to give a true indication of the social and health conditions for that particular district, but where it is possible to get them over long periods such as 10 year intervals they become a valuable index of the progress of a district in its sanitary conditions. The deathrates often quoted as evidence of the healthiness or otherwise of a district are very misleading and a glaring instance of this occurred this year where this district was advertised in a prominent evening paper as having a deathrate of 7 per 1000. Such a crude deathrate may exist, in fact it was published in the Registrar General's Statistical Review but it means nothing (it was obtained by overestimating the population) except that if the population were stationary the average length of life would be no less than 143 years. It is with a view to correcting these erroneous deductions from published vital statistics that I have inserted in this report a "Table of comparative deaths and death rates from 1891 onwards to the present date." In column 1 will be found the periods under review, in column 2 the population on which the rates are computed, up to 1921 these populations are computed from census figures and are as near the truth as it is possible to obtain. In column 3 will be found the recorded or transient deathrate influenced by the age and sex distribution of the population of the district itself, and in column 5 the standard deathrate. It is only this latter rate that is to be used as a measure of the hygienic conditions of the district because it is the deathrate that would be recorded in the district if the age and sex distribution of the population MEDICAL OFFICER'S ANNUAL REPORT SHEET 5 OF DRAFT remained constant over a large period of years. It will therefore be seen that the deathrate of this district has not varied to any extent over a period of 30 years. It is an exceptionally favourable one and shows that if the population was constant as to age and sex distribution and stationary in number the average length of life would be 85 years. It is a fact that the deaths of residents in this district are mostly those of persons well above the age of 65 and it is not uncommon to have the death of persons registered at the age of 90 and over. Whilst our deathrate has remained low and constant, that for England and Wales has greatly decreased, but the latter is not yet as low as the rate for this District. With regard to the infantile mortality rate it will be noticed that we have practically halved this rate in a period of 30 years whereas that for E. & W. for the same period has been reduced only one third. It will be seen that these reductions have taken place since 1910 a period that corresponds to the period of practical effort to reduce child mortality carried out throughout the country and with particularly encouraging results. With regard to the rates shown for the years 1920 onwards one should not draw any definite conclusions from them, for one thing the numbers on which they are based are small and there may be a possible error of 2% more or less. The populations too on which they are based are ESTIMATED and of course an error in this estimate is reflected in the rates computed from it. BIRTHS, These numbered 239 giving a crude birth rate of 14.5 the lowest ever recorded for this district. The number of births assigned to the district by the Registrar General is 272 giving a corrected birth rate of 16.5 compared with that for England & Wales of 18.3. The difference between the number of births registered in the District and the number assigned to it is accounted for by the fact that certain cases of pregnancy from the District are treated in the London Hospitals and we have no record of these until the middle of March of the following year. The number of births notified was 244 a notification of 90% only compared, with 95% in 1924. DEATHS. The number of deaths registered in the district was 285 of these 189 were of persons not belonging to the district. The number of persons belonging to the district but dying outside were 63, giving the number of nett deaths assignable to the district of 159. This gives a nett deathrate of 9.65 per 1000 and a corrected deathrate of 9.66 compared with 8.85 for 1924. The figure for England & Wales for 1925 is 12.2. Although the general deathrate is somewhat higher than last year, the number of deaths at the age period 15-45 is very low and there is also a diminution of the number of deaths of infants. CAUSES OF DEATH. Measles, Scarlet Fever, & Diphtheria, None. Tuberculosi s 11 Pulmonary) 13 in all, a very satisfactory figure. 2 Non-Pulmonary) The deathrate from this disease has not varied to any extent sincs 1891 in this district although the rate for the whole country has been practically halved in the same time. My remarks in the report for 1922 still hold good. Cancer. This disease is still one of the chief causes of death at middle life and continues to baffle the efforts of research workers to find a cause and cure. Early diagnosis and surgery appears to be the only available means of mitigating the misery caused by the disease. . MEDICAL OFFICER'S ANNUAL REPORT SHEET 6 OF DRAFT DIARRHOEA AND ENTERITIS. This caused five deaths, all of infants taken to outside hospitals for treatment. This disease is peculiarly fatal to infants, especially during a dry and hot summer, and one cannot repeat too often, that early medical advice and conscientious action on that advice will lead to a diminution of the deaths from this disease. The disease is to a great extent preventable, the infecting organisms being conveyed to the alimentary tract by way of the mouth, Strict cleanliness of food is essential. Too much attention cannot be paid to the cleanliness of the feeding bottles the milk should never be allowed to dry on to the bottles and teats, after use they should be soaked in cold water, washed well in warm water, and then BOILED in a saucepan and kept in the saucepan under the water in which they have been boiled until required for use. As soon as parents fully realise this and act accordingly so will this disease decrease and lose its terrors. "Clean food, cleanly kept, cleanly prepared, and cleanly served" is the best known means for preventing the onset of this disease. GENERAL PROVISION OF HEALTH SERVICES IN THE AREA. Hospitals provided. or subsidized by the Local Authority or the County Council. Tuberculosis. The Middlesex County Council is the Local Authority for Tuberculosis administration and the County Sanatoria are situated at Harefield between Denham and Rickmansworth and the majority of the tuberculosis patients fit for Sanatorium treatment from this district are treated at this Institution. The Middlesex County Council also send pulmonary cases to Clare Hall Hospital South Mimms, but this is not a County Institution but a hospital obtained primarily for the treatment of Small Pox. Non-Pulmonary tuberculosis cases are treated at The Royal Sea-Bathing Hospital Margate and at St. Anthony's Hospital Cheam, Surrey. Some of the pulmonary cases from this district are treated in Sanatoria other than the County Institutions such as The National Sanatorium Benenden, The Mount Vernon Hospital Ventnor and the Grosvenor Sanatorium Nr. Ashford Kent. Maternity Hospitals. There are none in the district, occasionally we receive a notification of a birth from the Queen Charlotte's Lying In Hospital, and we have also received requests from the Lady Almoners of several London Hospitals for particulars of the home conditions of expectant mothers who are to receive hospital treatment at or about the termination of the pregnancy. CHILDREN'S Hospitals. There are none in the district, we have received many applications from the Children's Hospital Great Ormond Street for reports of the Home conditions of children who are to receive treatment for pathological condition of tonsils and adenoid tissue growths in the air passages, and where such conditions are found (E.G. Overcrowding) as would predjudice the chances of an EARLY and good recovery from the operation the patient is detained in hospital until the wound is seen to be doing well. Fever Hospitals. There are none in the district, but the Council has made satisfactory arrangements with the Southgate Council for the use of 12 beds at the Tottenhall Road Hospital Palmers Green. MEDICAL OFFICER'S ANNUAL REPORT SHEET 7 OF DRAFT Small Pox Hospitals. There are none in the District but the Council is one of the constituent authorities of the Middlesex Districts Joint Small Pox Hospitals Board. Other Hospitals. There are none in the District but the Council contribute a donation to each of the cottage Hospitals of Finchley Wood Green and Barnet, Any Institutional Provision for unmarried mothers, illegitimate children and homeless infants in the Area. There is one rescue home in the District. Ambulance facilities. The Council have this year made satisfactory arrangements with the Finchley Council for the use of the ambulance maintained by that Authority for street accident cases, and the same ambulance is available at a very reasonable charge for the removal of private cases to and from hospital. We are still dependant upon the horsed ambulance of the Finchley Council for the removal of infectious cases to hospital. During the year the Sanitary Inspector presented a full report on this matter to the Public Health Committee and negotiations are now in progress with the Southgate Council with a view to the provision of a motor ambulance to serve the hospital of the latter authority at Palmer's Green and to deal with the Friern Barnet patients using that hospital. Clinics & Treatment Centres. There are two in the District, one in connection with the public primary schools, provided and maintained by the M.C.C. and situated at the Holly Park Schools of that Authority. This Clinic has done some excellent work in mitigating future disablement and it is a very pleasing feature to note that the County Council's Health Visitor follows up the work of the Clinic in the District and that the parents of the children appreciate her practical instruction in dealing with the minor ailments of the school children. The second clinic is situated in the South Ward, provided and maintained by the South Ward Nursing Association. There are two other nursing associations one in the Central Ward, and One in the North Ward but up to the present neither have established treatment clinics. Maternity & Child Welfare. This work continues under the auspices of the Middlesex County Council. It has been, decided to establish an additional Maternity & Child Welfare Centre in the North Ward making three centres in all one in each Ward. A central ante-natal clinic has been established where expectant mothers can obtain expert advice and if necessary proper hospital treatment. The maternal deaths in this district due to complications of pregnancy and/or puerperal sepsis are very few indeed, there being only 21 deaths attributable to these causes in 40 years and of these eight occurred during the War Years 1914 to 1918 but it is hoped that a still better standard may be obtained if the result of the use of sensitised strep to cocal vaccine early in manipulative cases prove to be trustworthy. The infantile mortality rate for the year is 73 per 1,000 births a satisfactory figure and below that for the Country generally I append a table showing causes of and ages at death of infants under one year. MEDICAL OFFICER'S ANNUAL REPORT SHEET 8 OF DRAFT. Cause of Death. Number of deaths. Age. Diarrhoea & Enteritis 5 3,3,4,4, & 5 Months. Prematurity 7 45,45 Mins 3 & 15 hours 3, 6 & 7 days. Pneumonia 2 5 & 9 Months. Whooping Cough 1 9 Months. Congenital defects 1 8 hrs. Atelectasis 2 24 hrs. & 3½ months. Inanition 1 10 days. Malnutrition 1 2 months. Total 20 Under one year. Public Health Officers of the Local Authority. One Medical Officer of Health (part time) a general medical practitioner in private practice F.R.C.S. & D.P.H. One Sanitary Inspector (Whole time) Professional Nursing in the Home. See previous remarks under the heading "Clinics & Treatment Centres" Midwives. The M.C.C. is the local authority under the midwives Acts. There are two midwives working in the district and there are two Maternity Homes registered by the M.C.C. under the powers given by the Middlesex County Council's (general powers) Acts. Chemical Work, The administration of the Food & Drugs Acts is in the hands of the Middlesex County Council but your Sanitary Inspector works in conjunction with the Officers of the M.C.C. in matters coming under his notice that can properly be dealt with by them, several complaints of suspected adulteration have been investigated, and samples taken. The sewage effluents are examined in the laboratories of the University College Hospital by Prof. Kenwood and his staff. The bacteriological work such as the examination of swabbings, sputum etc. is carried out by the Clinical Research Association. Bacteriological Examination made during 1925. Examination & Result. Diphtheria Tuberculosis Typhoid Primary 70 12 3 Positive 10 3 2 Result Negative 60 9 1 MEDICAL OFFICER'S ANNUAL REPORT SHEET 9 OF DRAFT. Legislation in Force. The year under review has seen some important legislation placed upon the statute hook the most important being the consolidated Housing Act and the Public Health Acts Amendment Act. The Clerk of the Council has fully reported upon these Acts and no useful purpose can be served by a detailed review of them. I shall however refer to them under the appropriate headings when dealing with the housing conditions of the District. The Byelaws respecting Slaughterhouses have been revised and the use of the mechanically operated killing instrument will become compulsory early in 1926. Up to the present the effect of this byelaw has been to stop slaughtering in this area and the local butchers now slaughter in a neighbouring district where the byelaw is not in force, this has made the work of meat inspection somewhat more difficult as your Inspector is deprived of the opportunity of inspecting the organs and offals which but for the operation of the byelaw he would have had an opportunity of properly examining, judgement of the home killed meat exposed for sale in this district is thus confined to the carcase alone AFTER IT IS EXPOSED FOR SALE. The result of the byelaw has therefore been to impose a risk on the public that did not otherwise exist and no benefits have been bestowed upon the animals destined for human food as they are still stunned by poleaxe and mallet, the remedy is to make the byelaw universal, and applicable to all districts. SANITARY CIRCUMSTANCES OF THE AREA. WATER SUPPLY. The water supply is from the chalk, the district being part of the area of supply of the Barnet District Gas & water Company. There is no service reservoir in this district the nearest pumping station being at the wells in the adjoining district of East Barnet Valley about 600 yards from our eastern boundary. Like all London water it is of considerable hardness varying in the different wells from 22 to 26 degrees on Clarkes Scale, this would be equal to about 17 grains of chalk per gallon of water. Much of this hardness is of a temporary character and is lost on boiling. The water is of great purity and pleasant to drink. So far as is known the hardness has no deleterious effect and those who use it are free from the risk of lead poisoning which is very real in those districts where a soft moorland or lake water is supplied. MEDICAL OFFICER'S ANNUAL REPORT SHEET 10 OF DRAFT. The chalk from which the water is derived, underlies the London Clay, and the gathering grounds would be the range of high ground extending from about Beaconsfield northeasterly to Buntingford and clearly demonstrated by the cuttings at Tring. The only possible source of contamination would be through "Swallow holes" which are openings found at the junction of the chalk with other geological strata and into which streams sometimes disappear. Such a swallow hole is found at Water End near North Mymms where water from nearly 20 square miles of land disappears, Frequent examinations of the water are made by the Company's analysts so that contamination may be promptly detected. The district has a constant and up to the present adequate supply, but owing to the growth of the population in the Company's area of supply the Company are seeking additional powers to increase the sunply by fresh borings in the upper portion of the Lea Valley. There are still too many badly situated cisterns exposed to rain and dirt where unless the covers are kept in good repair a good water may become polluted and Injurious to the health of the users. Rivers and Streams. I have already described the principal streams of the district, they are the natural means of drainage for a considerable area outside this district and receive the outfalls of many surface water sewers, consequently in wet weather they are very swollen and cause temporary flooding of the low-lying area to the north of Friern Barnet Road. In dry summers there is very little flow and as the inhabitants cannot be expected to differentiate between the soil and surface water drains of their houses soap suds frequently get into the surface water sewers with consequent temporary pollution of the brooks, Several complaints have been received respecting the soapy condition of the brook north of Friern Barnet Road, and. this has been more marked since the rapid development of the North Finchley District. Your Surveyor has had the course of the brooks properly cleaned and taken steps to prevent the stagnation in their beds during the summer months. Sewers & Sewage Disposal. The district is well sewered, the sewage system being designed by B. Latham C.E. and constructed in 1884. The main sewers follow the lines of the valleys the connections being made by tunnelling under the ridges. These tunnel sewers are situated below the Council's housing site in the North Ward and from the valley near the Council Offices into the Colney Hatch Lane. With the exception of a small area in the Avenue District the sewage is conveyed from houses to works by gravitation. There is a small ejector station at Ely Place in the dip near the stream at Oakleigh Road S. The main purification works are situated in the adjoining district of Wood Green and originally comprised settling tanks and contact beds with the accessory machinery for sludge pressing and pumping, working the lime mixers and providing power for working the hydraulic pumps at the Ely Place pumping station. The power was obtained from two Cornish coal fired boilers working two horizontal steam engines of the mill type, the power being conveyed from them by shafting and belting to the pumps and lime mixers. This machinery served a useful purpose for 40 years but owing to excessive cost in working and maintenance and the inefficiency of the old hydraulic pumps at Ely Place this machinery is now disused. Since 1920 a complete new plant has been installed under the direction of your Engineer & Surveyor. This comprises a modern magneto fired gas engine working with town gas, the power of this engine is conveyed by shafting and belting to the lime mixers and MEDICAL OFFICER'S ANNUAL REPORT SHEET 11 OF DRAFT air Compressors. The latter supply compressed air to a storage reservoir, whence it is drawn as required to the ejectors used for raising the sludge from the sludge wells into which the sludge gravitates from the settling tanks. The old hydraulic pumps at Ely Place have been replaced by modern sewage ejectors worked by compressed air drawn from the reservoir at the sewage works through a new air main that follows practically the course of the old hydraulic main, and since this plant has been working no complaints have been received respecting the brook pollution. The method of treatment remains the same as when the works were installed and produces a very satisfactory effluent. The outfall chamber contains the outfalls from the district proper and from the Asylum the latter is a strong domestic sewage in a fresh condition and contains at times washings from slaughterhouse and piggeries. The mixed town and asylum sewage runs through the main building of the works down a stepped incline (known as the salmon ladder) and during its course receives a proper mixture of slaked Buxton lime and aluminoferric, the latter being the trade name of a mixture of sulphate of iron and alum. The dosed sewage is then received into settling tanks and is retained for such time as to allow the sludge to settle, this time depends upon the temperature to a great extent and is regulated by the works manager. After treatment in the tanks is completed, the sewage is drawn off in a thin film over adcill about 2 feet wide and drops a few inches into the channels which lead it to the contact beds. The manner of drawing off the sewage from the tanks is important inasmuch as at this stage it is possible and desirable to thoroughly aerate the sewage. The contact beds consist of an underdrainage of perforated stoneware pipes covered with about three feet of graded burnt ballast, from the size of a walnut to that of a pea, the top layer consists of about 9" of loam soil, and it is in this layer that the principal amount of purification takes place. The sewage is held up in the contact beds for a definite period and is then drawn off into the effluent chamber with a minimum disturbance of the material constituting the bed. The contact beds are worked intermittently the period of rest being governed by their condition and the atmospheric conditions. The top layer of the beds tends to consolidation and this condition is detrimental, it is therefore necessary at intervals to thoroughly rest the beds and dig them over, cleaning them and remaking the surface to a fine tilth. It is remarkable that the lower portions of the beds keep very clean, and beyond careful working do not require further attention for years at a stretch. Closet Accommodation. This district is entirely a W.C. district, with, the exception of two cottages in the north ward all the houses are now connected to the water carriage sewerage system, and every house having a watercloset has a proper check cistern fitted to the W.C. Scavenging. Since the issue of my last Survey Report in 1920 the Council MEDICAL OFFICER'S ANNUAL REPORT SHEET 12 OF DRAFT has ceased to rely on contractors for the removal of house refuse and the latter is now collected by the Council's workmen using the Council's own conveyances and horses. The workmen and vehicles are under the control of the Council's Engineer & Surveyor and at present consist of three horsed covered vans, which work a set part of the district each day of the week. Owing to the rapid growth of the district the Council's staff and workmen engaged on this work are fully occupied and it has been necessary to supplement the house refuse collection by a hired van and horses. The refuse is still disposed of by tipping in the hollows of the land attached to the Sewage Works, and I am glad, to note that the Council have instructed the Engineer & Surveyor to report upon the matter. SANITARY INSPECTION OF THE DISTRICT. Attached to this report is the classified statement of the number of premises visited, this is a summary of the reports presented to the Public Health Committee at each meeting. Since the Sanitary Inspector was appointed the population of the district has increased from 9875 to 16,540, & there has been no increase in the staff of the Public Health Department. SMOKE ABATEMENT. There are no chimneys in the district sending forth black smoke in such ouantity as to be a nuisance. PREMISES AND OCCUPATIONS WHICH CAN BE CONTROLLED BY BYELAWS & REGULATIONS. There is only one licensed slaughterhouse in the district, and I have fully dealt with those premises governed by Regulations under the heading of Inspection and supervision of Food. SCHOOLS. There are two schools for primary education provided by the Middlesex County Council both are fine modern schools well built and provided with excellent sanitary accommodation and well maintained One is situated in the South Ward and is used for the infants the other is in the Central Ward and has accommodation for Boys & Girls (senior) Mixed and also for infants (mixed). There are two Church of England Schools in the North Ward one for boys only in Friern Lane and one in the Oakleigh Road North for Girls and infants. There are also three other Church of England Schools, two in the South Ward, one in the Cromwell Road for senior boys and girls, one in the St, Paul's Road for boys,girls and infants, and one in the Central Ward for girls and infant3, all these schools are State ass isted. There are two privately owned Grammar Schools in the Central Ward one for boys and one for girls, and several small private schools (adapted private houses). The accommodation of these schools is as follows: Name & Situation of School Number of Scholars October 1925. St. James's Friern Lane (Boys only) 85 All Saint's Oakleigh Road N. (Girls & Infants) 100 Holly Park M.C.C. (Boys Girls & Infants) 440 St. Paul's Schools (Boys Girls & Infants) 262 MEDICAL OFFICER'S ANNUAL REPORT SHEET 13 OF DRAFT. Name & Situation of School. Number of scholars October 1925. Cromwell Road (Boys & Girls) 365 Sydney Road M.C.C. (infants) 240 St- John's Schools Glenthorne Road (Girls & Infants) 160 Friern Barnet Grammar (Boys) 150 Friern Barnet Grammar (Girls) 80 The Sanitary accommodation at the church and private schools has been modernised, as far as practicable and the buildings extended and adapted for modern requirements as far as the sites will allow. The medical inspection of the school children is under the control of the Public Health Department of the Middlesex County Council and I feel certain that this has contributed in no small degree to the District's enjoyment of the freedom from serious epidemic infectious diseases during the past five years. The system of inter-notification of infectious disease between, school teachers,,school attendance officer, District Medical Officer of Health and School Medical service has worked well and there has been no need to close schools on account of infectious disease, during the past five or six years. PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASES. Scarlet fever. This disease has been of a very mild type for many years past and there has not been a death from it since 1920. The mortality from it throughout the country appears to be gradually decreasing being ten times greater in 1920 than in 1925. The average length of treatment in hospital has been halved being now about 3 weeks. This early discharge has had no appreciable effect on the incidence of the disease in this district and there have not been any so called "Return cases". In 1924 the Ministry of Health appointed a departmental committee to encuire into the incidence, treatment of, and mortality from this disease and it is with interest we await the report of that committee. From my replies to the questionaire sent out by that Committee I find that there has been only 15 deaths from this disease in 38 years. The extreme mildness of this disease of late years has made it very difficult to diagnose, many cases must occur in which no medical practitioner is consulted, and this is a possible explanation of the sporadic manner in which the disease now shows itself, these missed cases being the foci of infection. Diphtheria. This disease has been of a very mild type in this district for several years past and there has been only one death since 1920, During 1925 no less than four cases were "carriers" only and in two instances the disease notified as such was proved not to be diphtheria. Of the 24 cases notified, 21 were removed to hospital the average length of stay in hosnital being 36 days. The mortality from this disease throughout the country is steadily declining, but it is still about three times greater than that from Scarlet Fever. Typhoid Fever. The district is practically free from this disease and those cases that do occur are of a very mild. type. The two cases notified in the district were removed to hospital and were discharged after 26 and 32 days respectively, We still get a few cases of this disease of a severe type amongst the inmates of the Mental Hospital and the three cases notified from this Institution during the year all proved fatal, Pneumonia. 57 Cases were notified during the year of which 47 occurred in the mental hospital. No administrative action is taken on the notification of this disease and it is difficult to see what useful purpose is served by the notification. MEDICAL OFFICER'S ANNUAL REPORT SHEET 14 OF DRAFT. Malaria, Dysentery & Trench Fever. No notifications have been received under the regulations of January 1919, with the exceptions of a few cases of Dysentery notified from the Mental Hospital. This Dysentery is not of the type occurring in tropical and sub-tropical countries, and so far as this District is concerned we have no evidence that these "War Diseases" have increased or even established themselves. Measures taken on the Notification of Infectious disease. Steam Disinfection of bedding etc. is practised, Room disinfection by spraying, and the use of aerial disinfectants such as Sulphurdi-oxide and formalin, but the chief measures of stripping, and thorough cleansing are more reliable. It is doubtful whether rooms and furniture can be properly disinfected, without serious damage to the contents. The public have however been educated to expect some form of chemical disinfection to take place after notifiable infectious disease and undoubtedly this indirectly leads to a more thorough cleansing and aeration of the infected premises, than would perhaps take place, if no work of this nature was carried out, It is noteworthy that a second case of infectious disease seldom takes place in a house where the patient is removed to the isolation hospital promptly and thorough cleansing has been carried out. An analysis of the cases of notifiable diseases will be found attached to this report. GENERAL HOUSING CONDITIONS IN THE AREA. The general,housing is good and the district Is rapidly developing. Building activity is general throughout the district. Since the end of 1920 545 houses have been built and occupied by private enterprise, and 121 by the local authority under the Assisted Housing Schemes. The new assessments vary from £20 to £96 averaging about £28. The erection of houses by private enterprise for letting has ceased for the time being, all the houses recently erected and in course of erection are for sale only and it is remarkable how quickly such houses are occupied. There are still some of the old houses empty, some have remained so for a long time the owners refusing to let. As houses become empty and so uncontrolled by the Increase of Rent & Mortgage Interest (Restrictions) Acts they are readily re-occupied at greatly increased rents. The new houses are mostly occupied by persons formerly residing outside the district and owing to high rents there is still a considerable amount of overcrowing in the Central & South Wards. In certain blocks of houses in the South Ward the overcrowding is acute particularly in the Avenue District and the Sydney & Cromwell Roads. The people occupying these houses either cannot or will not afford to pay more than about 8/- per week consequently we have houses containing two and three families which were only intended to house one family. MEDICAL OFFICER'S ANNUAL REPORT SHEET 15 OF DRAFT. Such houses when occupied by undesirable tenants become dirty and internally dilapidated and a considerable portion of your Sanitary Inspector's time is taken up in inspecting and re-inspecting property inhabited by this class of tenant. I estimate that there are about 50 houses in that part of the District South of the Mental Hospital, 60 houses in the Avenue District, 30 houses in the Central Ward, and 20 in the North Ward., that are more or less in a dirty condition owing to the class of tenant occupying them. Attached to this report I give particulars of the conditions found in a block of six houses in the South Ward which shows the difficulties that have to be met In providing proper housing accommodation. It is manifest that private enterprise is unable to provide three bedrooms and a living room with the proper sanitary conveniences (the accepted minimum requirements for the average labouring class family if they are to be properly housed) at a rent of say 10/6 inclusive. The houses erected under the assisted housing schemes are of far too high a rental for these people to take and experience has shown that where the Council has let houses to these people they have sub-let to enable them to pay the rents and an excessive amount of cleaning and stripping has been required to keep the houses reasonably fit. The defects met with in the inspection of old houses are principally dilapidations of walls and ceilings internally, and dampness caused by defective roofs and gutters, especially those built with the M roofs and zinc valley gutters so prevalent in the working class house erected about 40 years ago. Drainage and sanitary fittings are generally good, most of the older houses having been properly redrained. It is seldom found necessary to reconstruct the drains of houses, the nuisances now found therein being such that may be abated by repair work only. There are no unhealthy areas in the district the most crowded portion of the district being known as The Avenue, where the houses are of the narrow frontage type with back additions placed at a density of about IB to the acre. The following are particulars of the Council's Assisted housing Schemes at the end of 1925. North Ward Scheme 1 1919 Number of Houses 41 Total Acreage 36.35 Less Allotments 4.5 Scheme II 1925 " " " 32 Tenant purchase " " " 10 (Not completed 1925) South Ward Scheme I 1919 " " " 38 (Not completed) 1925. Scheme II 1925 " " " 10 Total Houses end of 1925 121 Rents (including water and rates) (Class A 21/- per week (Class A 20/- per Week North Ward (Class B 17/3 per week South Ward (Class B 17/- " " (Class C 14/9 " " (Class C 14/- " " MEDICAL OFFICER'S ANNUAL RFPORT SHEET 16 OF DRAFT. Tents, Vans, Sheds, etc. Only one instance of van-dwellers having encamped in the district has been noted by the Sanitary Inspector in the past five years. Fifteen to twenty years ago these van and tent dwellers were frequently observed in this district and gave rise to considerable nuisance from the dirty and untidy condition in which they left their camping grounds. I attach the Housing statistics in tabular form and in the order suggested in Circular 648 amongst the other tables at the end of this report. INSPECTION & SUPERVISION OF FOOD. This has received due attention from your Sanitary Inspector who regularly inspects the premises where food is prepared or offered for sale. There are three cookshops in the district all clean and well conducted. Bread. There are five bakehouses in the district one of which is entirely underground, they are all on old premises and not up to the standard of modern requirements, but have been made as fit as possible. Forty years ago it seemed that any situation was good enough for a bakehouse. Two are situated at the rear of the bakers shops in close proximity to stables and two are situated in yards attached to the shops. Under these conditions it is practically Impossible to keep the floors as clean as they should be on account of the continued walking to and fro from shop to bakehouse over an open space. There is a considerable amount of bread sold and delivered to the consumer by the milksellers. This bread is not made in the District and is very liable to be soiled in course of delivery and it is quite a common experience to find bread left on the doorstep or window sill uncovered and unprotected. I am pleased to note that several of the large bakeries now supply their bread "wrapped" and the consumer would greatly benefit if this practice was universal. Meat. There are 14 butchers shops in the District and the majority draw their supplies from the London Markets. Generally the meat exposed for sale is of good quality but with meat as with bread and other food stuffs it is too much exposed to contamination by dust dirt and flies during its passage from producer to consumer. I am pleased to report that there are no street stalls in the district where meat is exposed and that all the butchers shops have glazed windows and that the proprietors endeavour to protect their meat to a certain extent, but the custom of selling from the street side of the window still continues and until the purchaser declines to accept meat from tradesmen following this practice one of the principal sources of contamination will remain. It is this surface contamination not noticeable to the eye and nose that produces that taint in meat that so often develops after the housewife has bought the joint, and which she tries to remove by washing in vinegar and water and similar practices. These expedients may remove the taint or lessen its immediate manifestation, but the taint is due to the growth of numerous germs and moulds, fortunately not all harmful, but nevertheless some of those germs or toxin products are MEDICAL OFFICERS ANNUAL REPORT SHEET 17 OF DRAFT. the cause of a considerable amount of those digestive troubles which every medical practitioner notices during a period of warm weather. Although the heat of cooking destroys the greater portion of the germs and moulds it does not render harmless the products of their growth and greater care and cleanliness in the handling of meat would not only prevent to a large extent the waste that annually takes place at all the large markets and stores but would substantially reduce those gastre-intestinal troubles that are always prevalent during the "hot months" of the year. Fish There are five fish shops in the district three of which sell cooked fish during a portion of the day. The fish offered for sale is generally of very good quality and all the fish vendors if in doubt as to the condition of their wares consult your Sanitary Inspector before offering it for sale. Owing to the fish being boxed at the port of entry before being dispatched to the markets it is one of the cleanest food stuffs we have on the other hand it is of a delicate texture and will not keep good so long as meat. Sometimes we find that good fish has been spoiled by being put into unclean boxes but such happenings are rare. The practice of continually washing fish to freshen it up is not so prevalent as formerly and ice safes are more often used. The fish frying ranges in those shops selling cooked fish are of modern type and very well kept and there is no doubt that the fried fish sold in this district is a clean and wholesome article of food. It has been noticeable for some years past that the dried fish such as haddock and fish fillets and kippers have been hygienically packed in clean well fastened deal boxes; some of the kippers are wrapped in transparent wrappers before boxing and the fish need not be touched by hand from the packing shed to the cooking utensil. This practice is to be commended as it would not be worth while to so treat fish of doubtful quality. Vegetables. There are 10 greengrocers shops In the District. Supplies are obtained from the London Markets and the quality of the wares are very good. Itinerant vendors of food stuffs. There are four regular hawkers of food stuffs in the district who do not possess any shop premises. Their wares are chiefly fish, rabbits, fruit and vegetables. It is practically impossible for food to be hawked about in an open poney or donkey cart without becoming contaminated, and we have no knowledge where the unsold food Is stored during the night. The itinerant butcher has not been observed In the district for some years. Milk. There is one producer who is also a milk retailer and 6 milksellers having shop premises in the district. It is satisfactory to note that the milk selling from open vessels in the small general shop has ceased in this district your officers having persuaded the shopkeepers to give up this part of their business. There are several small general shops that sell milk sterilized in sealed bottles. Building operations hive greatly curtailed the grazing land in the Central Ward and the producer now keeps a small herd In the cowshed for the greater part of the year. This Cowshed and Dairy premises has been redraincd and the yard properly concreted. One large retailer has installed a modern milk cleaning and pasteurising plant but it MEDICAL OFFICER'S ANNUAL REPORT SHEET 18 OF DRAFT. was not in working order at the end of 1925. Two retailers now have modern pasteurising plant with cold stores. The small retailers have improved their can and bottle washing arrangements but there is still room for improvement. Practically the whole of the milk supply for this district Is rail borne and. it will be seen that your sanitary officers have no control over the premises in which such milk is produced. The fact that the large distributors find it necessary to instal, work and maintain expensive plant to clean the milk before distribution shows that the milk is not produced under good conditions. It has been proved that clean wholesome milk can be produced and disposed of under commercially economic conditions every day in the year and if this was universal there would be no need for the elaborate machinery now used to clean the milk. There is no doubt that the consumer is getting a much cleaner milk due in a large measure to the milk distributing companies being forced to clean and pasteurise the milk to prevent it going sour but this milk is not a raw milk with the valuable vitamins intact and until the consumer demands a clean untreated milk the retail price will remain high and the consumption of this excellent article of food restricted. There has been a successful effort, to place a clean untreated milk on the marked in the Grade A Tuberculin Tested Milk and I am often asked what are the advantages of this Milk. They are (1) The milk is from healthy cows. (2) The food value of the milk is unimpaired. (3) It will keep good for at least 2 days even in hot weather. (4) It is delivered from producer to consumer in clean sterilized sealed containers. (5) There need be only one delivery of milk per day (6) The consumer knows the exact age of the milk. (7) It cannot be adulterated or interfered with, without the consumers knowledge. (8) It has to conform to a high hygienic standard and is the best possible "Nursery Milk" There are two disadvantages (1) The price is higher than ordinary milk (2) It is not bottled by the producer unless the producer happens to be the retailer. There is a growing tendency for milk to be delivered in bottles but there is no advantage in this unless it is certain that the milk Is clean before bottling and that the bottles have been properly cleaned sterilized, and securely sealed before delivery. The consumer is often at fault by allowing the milk to dry on the bottles before returning them to the retailer and it is most difficult to properly clean such a bottle, When it is borne in mind that many thousands of dirty bottles have to be cleaned one realizes that it is the cleansing operations that cost so much money and so adds to the price of milk. The consumer can help in maintaining a clean milk supply by rinsing the bottles in cold water before returning them to the retailer. Complaints are received that the milk delivered in the morning Is often bad before evening. The principal cause of this is that the milk is old before it is delivered. Pasteurising stops souring, but it does not make a dirty milk clean and such dirty milk soon becomes putrid. The remedy lies greatly with the consumer. Dirty milk should not be purchased, and until the public demand milk of a high hygienic standard the producer and retailer are not encouraged to supply it. A clean wholesome milk, hygienically produced and distributed is one of the best means we have of reducing the amount of illness and suffering caused by bovine tuberculosis, and one cannot emphasise too much the value of a clean and wholesome milk supply. Milk (Designations) Order 1922. This is an Order made by the Minister of Health under powers purporting to be given to him under Section 3 of the Milk & Dairies (Amendment) Act 1922. There are four grades of Milk that may be sold under the Order viz. "Certified" Grade A Tuberculin Tested" MEDICAL OFFICER'S ANNUAL REPORT SHEET 19 OF DRAFT. "Grade A" & "Pasteurised" Four grades of Milk are to say the least somewhat confusing to the general public, and I would suggest a numerical index "certified" Grade A. T.T. being No.l. There are no less than three licensing authorities viz. the Minister of Health, The County (3c County Borough) Councils and the Sanitary Authorities (Urban 3c Rural). The functions of a Sanitary Authority are (1) to license the distributors of the Graded Milks (2) to take samples to of the Graded Milks as distributed in their respective districts and submit them for bacteriological examination at an approved laboratory. There have been only two supplementary licences issued by this Authority one for "Certified" and one for "Pasteurised" milk, both to one firm in an adjoining district which is in itself only a distributor of "Certified" milk and the pasteurisers and bottlers of the "Pasteurised" milk. FACTORY & WORKSHOPS. The following are particulars of the Factories & Workshops in the District at the end of 1925. Number Description Remarks. There has been no infectious disease notified from outworker's premises for many years past. The Lists of outworkers have been regularly received from the City & Metropolitan Boroughs, There are no firms employing outworkers in this district. MEDICAL OFFICER'S ANNUAL REPORT SHEET 20 OF DRAFT REPORT OF MEDICAL OFFICER REQUIRED BY SECTION 132 OF THE FACTORIES & WORKSHOPS ACT 1901 Premises Inspections Number of Written Notices Prosecutions Factories 7 1 0 Workshops 24 1 0 Workplaces 28 0 0 Total 59 2 0 (2) Defects found in Factories Workshops & Workplaces. Particulars Number of defects found Found Remedied Referred to H.M. Insp. Prosecution Want of Cleanliness 2 2 0 0 Other Nuisances 0 0 0 0 Medical Officer of Health March 12th 1926. Note:- A copy of this report together with a copy of the paragraph of the general report under the heading "Factory & Workshops" must be sent to the Secretary of State (Home Office). There is no need to send a copy of the whole of the Medical Officer's Annual Report HEALTH WEEK OCTOBER 4th - 10th 1925. The Council held a very successful Health Week during the year. Councillors and Officials co-operated to make it a success and a very interesting and instructive programme was drawn up and carried out. After 4 p.m. on each day of the Week, the Central Hall at the Holly Park Schools was thrown open to the public. The Hall contained an exhibition divided into three sections, (l) Dealing generally with matters of Health (2) Dealing with Food,its storage, preparation, and Value and (3) Infant Welfare. Demonstrators were in attendance at each of the Sections up to about 8 p.m, The evenings were occupied by Lecturers who dealt very clearly with various subjects affecting the health of the people, each lecturer having practical an expert knowledge of the subjects dealt with. The attendances were good, and increased each evening. The work entailed in the carrying out of the programme was experimental, and it is difficult to judge the effect of the propaganda, but if one can judge by the amount of interest exhibited by the inhabitants the experiment was well worth the nominal expenditure incurred. FRIERN BARNET URBAN DISTRICT COUNCIL. Details of lettings, rents, occupiers, etc. at Nos. 254 to 264 Sydney Road. Muswell Hill N.10. House No. Number of families or separate occupiers. Number of adults Number of children Rents paid at present 254 4 7 3 10/6 5/- & 3/Total 18/6 256 2 4 17 10/6 8/10 Total 19/4 258 3 (sublet) 8 5 5/6 6/- 5/- Restricted Total 16/6 by Rent Acts. 260 3 6 10 9/- 8/5, 6/Total 23/5. 262 3 6 9 8/10, 7/10, 7/10. Total 24/6. 264 4 7 9 6/7, 7/10, 6/- 4/Total 24/5. 6 19 38 53 £ s d 6 6 8 per week. Numbe of rooms 36. Number of inhabitants 91. Number of inhabitants per room. 2.55. FRIERN BARNET URBAN DISTRICT COUNCIL. TABLE OF COMPARATIVE DEATH RATES FROM THE YEAR 1891 TO THE PRESENT TIME. Period Population District Recorded Death Rate Standard Factor Standard Deathrate per 1000 persons Infantile per 1000 Mortality Births Mortality per 1000 persons District Eng.& W. District E and W Scarlet Fever Diphtheria Tuberculosis Dist E & W Dist E & W Dist E & W. 1891-1900 7695 10.5 1.0774 11.31 18.1 120 153 .130 .158 .22 .263 .775 2.011 1901-1910 10430 10.9 1.0136 11.05 15.2 96 128 .029 .106 .125 .179 .960 1.653 1911-1921 13290 11.2 1.001 11.21 13.5 69 100 .015 .047 .136 .141 .98 1.427 1920 14250 10.0 " i 10.01 11.9 38 80 • 0 .038 0 .151 .98 1.133 1921 14496 10.1 " 10.11 11.3 75 83 .138 .0.34 .138 .126 .685 1.126 1922 14750 8.7 " 8.71 11.6 42 77 0 .036 0 . 107 .675 1.121 1923 15027 9.4 " 9.41 10.3 45 69 0 .026 0 .071 . 73 1.062 1924 16000 8.85 " 8.86 10.7 73 75 0 .023 0 .064 .62 1.058 1925 16540 9.65 " 9.66 12.2 73 75 0 • 0 0 1 I .07 .78 1 f ( 38 FRIERN BARNET URBAIT DISTRICT COUNCIL. ANALYSIS OF THE CAUSES OF AND AGES AT DEATH DURING THE YEAR 1925 FOR THE WHOLE DISTRICT Cause of Death No Reg. Ward Outward Transfers Inward Transfers Males Females 0-1 1-2 2-5 5-15 15-25 25-45 45-65 65 & Over N S C A Arterio-Scler 7 - - - - — - 1 7 3 1 2 2 2 1 3 5 Appendicitis 0 - - - 1 1 - - - 1 1 - - 2 — 2 Bronchitis 11 - - - ~~ - 1 3 8 3 4 2 3 3 1 6 6 Cancer 26 - - - - - 3 13 14 4 6 8 12 14 4 11 19 Cirrhosis Liver 2 - - - - - 2 - — 1 - - 1 1 - - 1 Other Diseases of Digestive tract 0 - - - - - - 2 1 - 3 - - - 3 1 2 Diabetes 2 - - - - - 1 - 2 1 2 - — 1 1 1 2 Diarrhoea & Ent 0 5 - - - - - - - 1 3 1 - - 5 3 2 Dysentery 1 - - - - - - 1 - - - - 1 1 - 1 - Epilepsy 10 - - - - 4 4 1 1 ~ - - 10 10 - - 10 Enteric Fever 3 - - - - 2 1 - - - — - 3 j 3 — 1 2 Gen-Paral-Ins 27 - - - - 1 13 13 - - - 1 26 i 26 - 22 5 Heart 83 - - - - 5 16 37 34 5 9 5 73 73 9 29 63 Hernia 2 - - - - - - 2 1 1 1 - 1 1 1 — 3 Meningitis 2 - - - 1 - 1 - - - - 1 1 1 — - 2 Nephritis 13 - - - - 1 7 5 2 2 - 4 9 10 2 4 11 Pneumonia 30 2 1 - 2 7 16 5 1 7 1 24 24 3 8 25 Prematurity 6 7 - - - - - - - - 5 2 - - 1 4 3 Pregnancy 0 - - - - - 1 - - 1 - - - — 1 - 1 Senile Decay 15 - - - - - - 1 23 9 7 7 2 3 9 9 15 Pulm Tuberc 27 - - - - 13 12 6 - 3 2 5 21 20 4 10 21 Other Tuberc 2 - - 1 - 1 - 1 - - 1 1 1 1 1 1 2 Violence 0 - - - - - 1 2 — 1 2 - - - 3 2 1 Venereal-Syph 1 - - - — - - 1 - — - - 1 1 - - 1 Whooping Cough 1 1 - 1 - - - - - - 2 - - - 1 2 — All other Diseases 14 5 1 - 1 - 6 7 5 9 7 5 4 4 11 11 14 Total 285 20 2 2 2 30 77 112 103 45 62 46 195 189 63 130 218 FRIERN BARNET URBAN DISTRICT COUNCIL. ANALYSIS OF CASES OF NOTIFIABLE INFECTIOUS DISEASES NOTIFIED DURING THE YEAR ENDING DECEMBER 31st. 1925. NUMBER OF CASES NOTIFIED CASES NOTIFIED IN EACH LOCALITY. AT AGES YEARS LOCALITY WARDS. No of Deaths No of cases removed to hospital. DISEASES ALL Under 1 1-5 5-15 15-25 25-45 45-65 65 & Over North South Central Asy Pneumonia 57 0 2 0 2 12 26 15 1 3 6 47 33 0 Diphtheria 24 1 6 12 5 0 0 0 0 19 5 0 0 21 Scarlet Fever 23 0 4 14 4 0 1 0 10 7 6 0 0 18 Erysipelas 7 0 0 1 0 3 1 2 1 4 2 0 0 0 Typhoid 5 0 0 0 2 0 3 0 0 2 0 3 3A 2 Ophthalmia Neonatorum 1 1 0 0 0 0 0 0 0 1 0 0 0Œ 0 Encephalitis Lethargica 1 0 0 0 0 1 0 0 0 1 0 0 0 0 Pulmanory Tuberculosis 16 0 0 0 5 8 3 0 2 9 3 2 11 ? Other Tuberculosis 3 0 1 1 1 0 0 0 2 1 0 0 2 1 NOTE. A. these cases were patients in the Mental Hospital. FRIERN BARNET URBAN DISTRICT COUNCIL. ANALYSIS OP NEW CASES OP TUBERCULOSIS NOTIFIED DURING 1925 AND THE MORTALITY FROM THE SAMS DISEASE OVER THE SAME PERIOD. AGE GROUPS NEW CASES DEATHS PULMONARY NON-PULMONARY PULMONARY NON-PULMONARY MALES FEMALES MALES FEMALES MALES FEMALES MALES FEMALES. 0-1 N 1 L 1-5 0 0 1 0 0 0 1 0 5-10 0 0 0 0 0 0 0 0 10-15 0 0 0 1 0 0 0 0 15-20 0 1 1 0 0 0 0 1 20-25 3 2 0 0 1 3 0 0 25-35 2 2 0 0 1 1 0 0 35-45 0 3 0 0 2 1 0 0 45-55 0 1 0 0 0 1 0 0 55-65 2 0 0 0 0 0 0 0 65 & over 0 0 0 0 0 0 0 0 Totals. 7 9 2 1 4 6 1 1 MEDICAL OFFICER'S ANNUAL REPORT SHEET 26 OF DRAFT. SANITARY ADMINISTRATION OUTDOOR WORK OF SANITARY INSPECTOR FOR THE YEAR ENDING DECEMBER 31st 1925. Number of Dwelling Houses inspected (Separate primary inspections only) (1) On complaint 177 (2) On notification of infectious disease 60 (3) On account of Tuberculosis 12 (4) House to House 26 Visits respecting infectious disease 275 Periodical Inspections (Food Shops Dairies etc.) 94 Inspections & Visits under the Petroleum Acts. 92 Re-inspections, Visits to Works, Drain tests etc. 689 Special Visits by request or appointment 63 Visits to Slaughterhouses 19 Primary Inspections under the Rent Acts. 5 Secondary " " " " " 7 Inspections & Visits respecting Disinfestation (vermine etc.) 14 Attendances at Court (Petty Sessions & County Court) 1 Total of Inspections & Visits for 1925 1534 " " " " " " 1924 1484 " " " " " " 1923 1403 " " " " " " 1922 1925 " " " " " " 1921 1927 In addition to the above 41 cases of infectious disease were removed to hospital by the Sanitary Inspector, and 51 stovings consisting of 915 articles were steam disinfected and 2 lots of dirty beddings were destroyed. HOUSING STATISTICS FOR THE YEAR ENDING DECEMBER 31st 1925. Number of New Houses erected during the year (a) Total 266 (including those under (b) (b) With State assistance under the Housing acts By the Local Authority 32 By other bodies or persons 0 Inspections (1) Total number of houses inspected for housing defects under the Housing & Public Health Acts 348 (2) Number found so dangerous as to be unfit for human habitation 1 (3) Number inspected under Inspection of District Regulations 26 (4) Number of dwelling houses (Exclusive of those in (2) not reasonably fit for human habitation 122 Remedy of defects Number of defective houses rendered fit in consequance of informal action of the Local Authority 152 Action under Statutory Powers Proceedings under Sec.3 of the Housing Act 1925 (1) Number of dwelling houses in respect of which notices were served requiring repairs 8 (2) Number of dwelling houses rendered fit by owners 2 (Appeal pending respecting 6 houses) By Local Authority 0 (3) Number of dwelling houses in respect of which Closing Orders became operative in pursuance of declarations by Owners of intention to Close 0 Proceedings under Public Health Acts Number of dwelling Houses in respect of which formal notices were served requiring defects to be remedied 27 Number of dwelling houses in which defects were remedied after service of Formal notices By Owners 27 By Local Authority 0 Proceedings under soctions 11 14 & 15 of the Housing Act 1925 Number of Representations made with a view to Closing Orders being made 1 Number of premises in respect of which Closing Orders were made 1 Number of Closing Orders Determined 0 Number of demolition Orders made 0 Number of houses demolished 0