FRI 28 FRIERN BARNET URBAN DISTRICT COUNCIL. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1950 W. W. MILLEN , M.B, Ch. B. MEDICAL OFFICER OF HEALTH. FRIERN BARNET URBAN DISTRICT COUNCIL. Public Health Department, Town Hall, N.11. The Chairman, and Members of the Friern Barnet Urban District Council. Mr. Chairman, Ladies and Gentlemen, I have the honour to submit my Annual Report as Medical Officer of Health of the district for the year 1950. It will be seen that so far as the general, health of the district was concerned, the year 1950 was uneventful. The Birth and Death Rites both shewed a slight increase compared with 1949, whilst the Infantile Mortality Rate, although higher, compared favourably with the figure for the whole country. The Infectious Sickness Rate also shewed an increase, but this was almost entirely due to the fact that the number of Whooping Cough notifications was considerably more than the previous year, and has little prectieal significance. A slight increase was also recorded in the number of Measles notifications. For the second year in succession there were no cases of Diphtheria. Five cases of Polio-myelitis were notified, but no source of infection was traced, nor were any of the cases known contacts. The figures for Tuberculosis compare closely with the previous year, but shew a slight decrease in the number of new cases. I am grateful to the Chairman and Members of the Public Health Committee for their support during the year, -2- and I again acknowledge the assistance and co-operation of the staff of the Public Health Department. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient Servant, W.W. MILLEN, M.B. ,Ch.B. Medical Officer of Health. -3- PUBLIC HEALTH COMMITTEE. AT 31st DECEI'IBER, 1950. Councillor A, C. Henry " J. E. Pickering,J.P. " L. W. McClane, J.P. " R. P. Matthews " J. Foley " Mrs. H. E. McCarthy " J. D. Peart " Mrs. M. C. Pugh " R. F. Pugh (Chairman) (Vice-Chairman) (Chairman of the Council) (Vice-Chairman of the Council) PUBLIC HEALTH STAFF. Medical Officer of Health. Chief Sanitary Inspector. Sanitary Inspector. Sanitary Inspector. Chief Clerk. Assistant. Rodent Operative. W.W. Millen, M.B., Ch.B. W.R. Jackaman. S. Ceine. J.J. Wisdom. J. Wilson. Miss E. Glasscock. E.T. Crawshaw. STATISTICS OF THE AREA. Area (in acres) 1,341.2 Registrar General's estimate of population 29,260 (District) 26,820 (Friern Hospital) 2,440 Number of inhabited houses according to the rate-books (31.12.50) 7,486 Rateable Value (31.12.50) £287,708 Sum represented by a penny rate £1,165 -4- EXTRACTS FROM VITAL STATISTICS. LIVE BIRTHS. Mele. Female. Total. (Legitimate.) 197 183 380 (Illegitimate) 11 6 17 (Total) 208 189 397 BIRTH RATE per 1000 of the estimated population 15.3 STILL BIRTHS. Male. Female. Total. (Legitimate) 1 7 8 (Illegitimate) 1 1 2 (Total) 2 8 10 STILL BIRTH RATE per 1000 Births (Live and Still) 25.2 DEATHS. Male. Female. Total. (From all causes and at all ages) 143 124 267 DEATH RATE per 1000 of the estimated population 9. 8 DEATHS OF WOMEN IN CHILDBIRTH. From Puerperal Sepsis 0 From other Maternal causes 0 Total 0 DEATH RATE per 1000 Births (Live and Still) 0.0 DEATHS OF INFANTS (Under 1 year of age). Male. Female. Total. (Legitimate) 6 5 11 (Illegitimate) 0 1 1 Total 6 6 12 DEATH RATE OF INFANTS (Under 1 year per 1000 Births) 30.2 DEATHS FROM MEASLES (all ages) 0 DEATHS FROM WHOOPING COUGH (all ages) 0 DEATHS FROM DIARRHOEA (Under 2 years of age) 0 -5- BIRTHS. The total of births during the year was 397, an increase of 9 over the preceding year. Of these births, 208 were males and 189 females. The uncorrected Birth-Rate for the year was therefore 14.8 per 1000 of the population. The correcting factor for age and sex distribution is 1.04 and this gives a corrected Birth-Rate for comparative purposes of 15.3. The corresponding Birth-Rate for England & Wales was 15.8 and for London 17.8. Births and Birth-Rates for the past five years have been as follows:- Year. No. of Births. Birth- Rates, Friern Barnot, England & Wales. London. 1946 491 18.9 19.1 21.5 1947 510 19.0 20.5 22.7 1948 375 14.1 17. 9 20.1 1949 388 14.4 16.7 18. 5 1950 397 15.3 15.8 17.8 DEATHS. The total number of deaths during the year was 268, giving an uncorrected Doath-Rate of 10.0. However, since the preparation of the Death-Table, the Registrar General has assigned only 267 deaths to the district, and this gives an uncorrected Death-Rate of 9.9 per 1000. The correcting factor for age and sex distribution is 0.99, and this gives a corrected Death-Rate for comparative purposes of 9.8 per 1000. The corresponding Doath-Rate of England & Wales was 11.6 and for London 11.8. The total number of deaths was 15 higher than the preceding year. 143 were males and 124 females. 168 deaths or 63% were of persons above the ago of 65. The chief causes of death at all ages were Heart Disease and Cancer. The Deaths and Death-Rates for the past five years have been:- Year. No. of Deaths. Death- Rates. Friern Barnot. England & Wales. London, 1946 261 10.0 11.5 12, 7 1947 264 9.9 12.0 12.8 1948 232 9.0 10.8 11.6 1949 252 9.2 11.7 12.2 1950 267 9.8 11.6 11.8 There were 12 deaths of infants under 1 year of age, giving an Infantile Death-Rate of 30.2 per 1000 births, compared with 10 deaths and a rate of 26 in 1949. The comparative rates for England & Wales and for London wore 29.8 and 26.3 respectively. Of the 12 infant deaths 9 occurred during the first week of life. -6- TABLE 1. ANALYSIS OF CASES OF NOTIFIABLE INFECTIOUS DISEASES NOTIFIED DURING THE YEAR ENDING 31st. DECEMBER, 1950. DISEASE. NUMBER OF CASES NOTIFIED. CASES IN EACH WARD. NO. REMOVED TO HOSP. All. Un. 1. 1-5. 5-15. 15-25. 25-45. 45-65. 65&0. North. South. Cent. East. West. Friern Hosp. Measles. 327 4 119 201 2 1 - — 140 36 56 28 67 - 4 Whooping Cough. 151 9 75 62 1 3 1 - 55 60 4 7 25 - 5 Scarlet Fever. 40 - 12 24 2 2 - - 13 9 9 3 4 2 18 Pneumonia. 21 - 1 2 1 4 8 5 4 4 3 1 3 6 1 Poliomyelitis. 5 - -1 1 2 1 - - 3 1 1 - - - 5 Dysentery. 3 1 - - - 1 1 - - 2 - - - 1 1 Erysipelas. 7 - - - - 1 5 1 1 - - - 4 2 1 Pulm. Tuberculosis 34 - - 2 6 14 11 1 4 6 3 4 8 9 - Non-Pulmonary Tuberculosis. 1 - 1 - - - - - - 1 - - - - - Typhoid. 5 - - - 3 1 1 - - - - 1 4 1 Para-typhoid. 1 - - - - - 1 - - - - - - 1 - TOTAL. 595 14 209 292 14 30 28 8 220 119 76 43 112 25 36 -7- TABLE 2. ANALYSIS OF CASES OF TUBERCULOSIS NOTIFIED DURING 1950, AND THE MORTALITY FROM THE DISEASE OVER THE SAME PERIOD. AGES. NEW CASES. DEATHS. PULMONARY. NON-PULMONARY. PULMONARY. NON-PULMONARY. HALES. FEMALES. MALES. FEMALES. MALES. FEMALES. MALES. FEMALES. 0-1 - - - - - - - - 1-5 - - 1 - - - - - 5-10 - 1 - - - - - - 10 - 15 1 - - - - - - - 15 - 20 2 2 - - - 1 - - 20 - 25 i 1 1 - - - - - - 25 - 35 2 5 - - - - - - 35 - 45 6 2 - - 1 - 1 - 45 - 55 2 3 - - 1 - - - 55 - 65 4 2 - - - - 1 - 65 & Over. i - - - - 1 - - - TOTAL 18 16 1 - 3 1 2 - - 8 - TABLE REGISTER OF TUBERCULOSIS. PULMONARY. NON-PULMONARY. TOTALS. MALE. FEMALE. MALE. FEMALE. Cases on Register at 1.1.50. 95 67 4 24 190 Cases notified for first tile 1950. 18 16 1 - 35 Other cases added to Register 1950. 13 7 - - 20 Cases removed from Register 1950. 23 12 2 6 43 Cases remaining on Register 31. 12. 50. 103 78 3 18 202 - 9 - TABLE INFANTILE MORTALITY. NETT DEATHS FROM STATED CAUSES AT VARIOUS AGES UNDER YEAR OF AGE. 1950. Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months Total under 1 year. All Causes:- Certified. 9 - - - 9 1 1 1 — 12 Un-Certified. - - - - - - - - - - Asphyxia. 2 - - - 2 - - - - 2 Atelectasis. 1 - - - 1 - - - - 1 Cerebral Haemorrhage. 1 - - - 1 - - - - 1 Congenital Malformation. - - - - - 1 - - - 1 Haemolytic disease of newborn. 1 - - - 1 - - - ~ 1 Intercranial haemorrhage. 1 - - - 1 - - - - 1 pneumonia. 1 - - - 1 - 1 1 - 3 Prematurity. 2 - - - 2 - - - - 2 -10- TABLE 5 ANALYSIS OF THE CAUSES OF AND AGES AT DEATH DURING THE YEAR 1950 FOR THE WHOLE DISTRICT. Cause of Death. No. Reg. In Tran. At-Ages. Wards. M. F. Nett Deaths. 0-1 1-2 2-5 5-15 15-25 25-45 45-65 65-75 75&0. N. S. C. E. W. Accident. - 3 - - - - - - - - 3 - - 1 - 2 - 3 3 Acute Poliomyelitis. - l - - - - 1 - - - - l - - - - 1 - 1 Bronchitis. 4 - - - - l - - 4 - - 2 1 - - 1 3 1 4 Congenital Malformation. - l 1 - - - - - - - - 1 - - - - - 1 1 Coronary disease angina 40 15 1 - - - - - 9 20 25 15 9 15 4 12 31 24 55 Hypertension with heart disease. 7 - - - - - - - 1 3 3 2 - 1 1 3 4 3 7 Malignant neoplasm of lung, bronchus. 3 3 - - - - - - 4 1 1 1 1 2 1 1 5 1 6 Malignant neoplasm of breast. 1 2 - - - - - -~ 1 1 1 - 1 1 1 - - 3 3 Malignant neoplasm of stomach. 2 - - - - - - - - 1 1 1 - 1 - - - 2 2 Other malignant & lymphatic neoplasms. 9 16 - - - - - 4 10 9 2 6 5 5 1 8 7 18 25 Nephritis. 3 5 - - - - - 1 2 2 3 1 - 5 - 2 6 2 8 Other circulatory diseases 5 5 - - - - - - 1 4 5 4 1 2 - 3 3 7 10 Other defined and ill-defined dis. 4 15 7 - - - - 1 5 2 4 7 5 3 1 3 12 7 19 Other Hoart disease. 34 16 - — - - - 2 12 19 17 6 12 17 4 11 27 23 50 Carr.forward. 112 82 9 - - - 1 8 49 62 65 47 35 53 13 46 99 95 194 -11- TABLE 5 continued. ANALYSIS OF THE CAUSES OF AND AGES AT DEATH DURING THE YEAR 1960 FOR THE TOOLE DISTRICT. Cause of Death. No. Reg. In Tran. At-Ages. Wards. M. F. Nett Deaths. 0-1 1-2 2-5 5-15 15-25 25-45 45-65 65-75 75&0. N. S. C. E. W. Brought forward. 112 82 9 - - - 1 8 49 62 65 47 35 53 13 46 99 95 194 Other infective and parasitic disease. 1 - - - - - - - - 1 - - - 1 - - 1 - 1 Respiratory Tuberculosis. 4 - - - - - 1 1 1 1 - 1 2 - 1 - 3 1 4 Other Tuberculosis. 1 1 - - - - - 1 1 - - 1 - 1 - - 2 — 2 Other diseases of Respiratory system. 3 3 - - - - - 2 - 2 2 4 - - - 2 3 3 6 Pneumonia. 12 8 3 - - - - 1 4 4 8 7 3 5 2 3 10 10 20 Vascular legions of nervous system. 15 12 - - - - - - 8 7 12 5 6 7 1 8 12 15 27 Suicide. 3 3 - - - - 1 1 3 1 - 1 1 1 1 2 4 2 6 Ulcer of Stomach. 2 - - - - - - - - 1 1 - 2 - - - 2 - 2 Gastritis, enteritis etc., 1 - - - - - - - - 1 - - - 1 - - 1 - 1 Motor vehicle accident - 5 - - - 1 2 1 1 - - 1 3 1 - - 4 1 5 TOTAL. 154 114 12 - - 1 5 15 67 80 88 67 52 70 18 61 141 127 268 -12- THE NATIONAL HEALTH SERVICE ACT. The provisions of the Act relating to the care of expectant and nursing mothers' and young children, the domiciliary midwifery service, the health visiting service, the home nursing service, arrangements for vaccination and immunisation, the ambulance service, the arrangements for the prevention of illness, care and after-care, and the domestic help service', are administered by the Middlesex County Council as the Local Health Authority. Day to day administration of these services has been delegated to the Area Health Committee on which your Council has been represented by the Chairman of the Public Health Committed, (Councillor A.C. Hanry) and by Councillor Mrs. H.E. McCarthy. BACTERIOLOGICAL WORK. The bacteriological work required for the district was carried out either at the Central Public Health Laboratory, Colindale, or at the Sab-Laboratory at Coppetts Wood Isolation Hospital. The following specimens were examined Throat or Nose. 117 Faeces 34 Sputum 15 Ice-cream 49 Miscellaneous 38 SANITARY SERVICES. This part of the Report deals with those services for which the Council, through the Public Health Committee and Public Health Department, are directly responsible. They include such matters as housing (in its relation to health), food inspection and hygiene, the sanitary conditions in shops and factories, rodent control, the investigation end control of infectious disease, and the investigation and improvement of conditions which are likely to affect adversely the health of the community. -13- SUMMARY OF INSPECTIONS-. Visits to premises on complaint 578 Visits in connection with infectious disease 98 Visits to shops and places where food is prepared, stored or sold 460 Visits to dairies and milkshops 26 Visits to factories 81 Visits to petroleum installations 48 Visits under Housing Act, works in progress and re- inspections 2047 Visits for appointments and special visits 403 Visits re infestation and disinfestation of verminous premises 6 Visits for the purpose of rodent control 20 Visits to piggeries 26 Attendances at Court 3 3796 Visits by Rodent Operative in connection with Rodent control 2022 Total 5818 SERVICE OF NOTICES. Number of informal noticss served 336 Number of informal notices complied with 299 Number of statutory notices served 52 Number of statutory notices complied with 46 -14- summary of sanitary improvements and defects remedied during the year as a result of action by the department. Water-Supply. Store cisterns provided, repaired or covers provided 7 Fittings and services repaired 21 Drainage, Drains cleared or repaired 24 Inspection chambers reconstructed or repaired 6 Inspection covers provided 9 Soil and vent pipes provided or repaired 5 Now sinks provided 10 Sink waste-pipes provided or repaired 13 W.C's. W. C. pans and traps provided or repaired 26 W. C. seats, doors, windows, floors renewed or repaired 16 Walls and ceilings repaired and distempered 52 Flashing cisterns provided, repaired or regulated 28 Floors. Floors renewed or repaired 74 Roofs. Roofs repaired 137 Gutters and downspouting renewed or repaired 82 Cleansing. Walls repaired, cleansed and redecorated 455 Ceilings renewed or repaired. 431 Windows. Sashes and frames renewed 125 Sills renewed or repaired 116 Sashcords provided (number of houses) 43 Brickwork. Damp-proof courses provided 4 Brickwork repaired 26 Chimney stacks rebuilt or repaired 5 Walls re-pointed or rendered 84 Woodwork. Doors renewed, repaired or re-hung 24 Staircases repaired 20 Yards. Yard paving renewed or repaired 23 Refuse. Dustbins provided 26 Accumulations of refuse removed 7 General. Ranges or grates renewed or repaired 93 Wash-boilers renewed or repaired 6 Verminous rooms cleansed 3 Other defects (unclassified) remedied 62 -15- WATER SUPPLY. The water sup-ply of the district is obtained from deep wells sunk into the chalk end is provided by the Barnet District Water Company. It has been satisfactory in both quality and quantity. All houses in the district have a piped supply, and there have been no complaints of unsatisfactory or insufficient supply. Bacteriological and chemical examinations of the water were carried out 'at regular intervals, end the following is characteristic of reports received:- "This is a very satisfactory water. It is clear and bright in appearance and of the highest standard of bacterial purity, indicative of a pure and wholesome water suitable for the purpose of a public supply". RATS AMD MICE. THE PREVENTION OF DAMAGE BY PESTS ACT, 1949. This Act came into operation on the 31st. March 1950, on which date the Rats and Mice (Destruction) Act 1919 was repealed. An important effect of this Act is that District Councils are now directly vested with powers and responsibilities in connection with rodent control whereas formerly County Councils were responsible for administration of this service with power to delegate the duties to District Councils willing to accept them. An obligation is now laid on local authorities to ensure that, as far as practicable, their areas are kept free from rats and mice. Apart from the natural repugnance generally felt towards rats and mice their control and destruction is important for three good reasons. 1. To reduce wastage of food. Rats and mice need food to live, and they may either eat it or render it unfit for use by fouling it. Community life necessitates the storage of large quantities of food, and thereby provide conditions inviting to infestations. 2. To reduce structural damage caused by gnawings and burrowings. 3. To prevent the spread of diseases which may be carried by rats and mice. Effective control calls not only for the treatment of reported sources of infestation, but for the systematic examination of promises and land for infestations hitherto unknown or unreported and for the regular treatment of sowers which are a common source of infestation. During the year 406 private and business promises were examined for infestations by rats, and treatments were carried out in 280 instances. In addition, public undertakings such as the Sewage Works, Refuse Tip, Depots and Porks were regularly visited and treatments were carried out when and where found to be required. Two treatments of the district sowers were carried out during the year when the number of manholes shewing signs of -16- infestations was 17. When these sewer treatments wore first started in 1947, 53 manholes were found to be infested. It is estimated that as a result of these various treatments some S385 rats wore destroyed. In addition to the foregoing, 47 premises were treated for infestations by mice. INSPECTION AND SUPERVISION OF FOOD. MILK SUPPLY. The following licences were issued under the Milk (Special Designation)(Pasteurised and Sterilised Milk) Regulations 1949, and the Milk (Special Designation) (Raw Milk) Regulations 1949:- Dealer's Licences. Pasteurised 3 Tuberculin Tested 4 Sterilised 9 Supplementary Licences. Pasteurised 8 Tuberculin Tested 9 Sterilised 8 During the course of the year legal proceedings were taken against one milk retailer for supplying milk in a dirty bottle. The Court imposed a fine of £5. FOOD INSPECTION. A considerable quantity of food was examined at the various shops and stores of which the following was certified as unfit for human consumption:- Beef 217 lbs. Lamb 30 lbs. Tripe 100 lbs. Bacon 92 lbs. Fish 301 lbs. Chickens 65 lbs. Rabbits 180 lbs. Butter 1 lb. Fruit 35 lbs. Sweets 9 lbs. Tinned Corned Beef/Matton 102 tins. " Vegetables 72 tins. " Meat 59 tins. " Milk 26 tins. " Fish 24 tins. " Fruit 32 tins. " Bacon 1 tin. " Fruit Jaice 36 tins, " Soup 38 tins, " Sausages 2 tins. " Jam 6 tins. -17- ICE CREAM. Certificates of registration were issued in respect of 11 premises during the year, making a total of 46 premises now registered for the sale of ice cream in the district. Inspections were made, of all registered premises, and such minor improvements as were considered desirable carried out. 54 samples of ice cream of 14 different makes were obtained for bacteriological examination. Of these:- 39 were placed in Grade 1. 12 " " " " 2. 2 " " " " 3 1 was " " " 4 In explanation of these Grades, it should be pointed out that no statutory standard of purity of ice-cream-has yet been laid down, probably because no completely satisfactory test has yet been devised. A provisional test, known as the Methylene Blue test, is recommended and generally used, which is based on the ability of organisms to reduce the colour of a certain dye. According to the time taken to reduce the colour an indication is obtained as to the bacterial state of the sample, and four grades hove been adopted. It can be said that samples placed in Grades 1 or 2 are to be considered satisfactory, and those falling into Grades 3 or 4 unsatisfactory. Of the samples taken during the year where they were not placed in Grade 1, the methods of distribution of the retailers concerned were more closely examined. With one exception, the ice-cream was sold unwrapped and simple faults in connection with the utensils used were found. The retailers were advised on methods, and subsequent samples were pieced in Grade 1. In the one exception referred to, the ice-cream was sold wrapped as supplied by the manufacturer. The local authority of the district in which the ice-cream was manufactured was notified, and in this instance also subsequent samples were in Grade 1. FOOD POISONING. Only one case was notified during the year, and the patient made a rapid and satisfactory' recovery. The causative agent was not traced. The Department was asked to co-operate in the investigation of an outbreak of food-poisoning at a school meals centre in another district, in which certain meat supplied from a store in this district was found to be heavily contaminated with an organism which was concluded to be the causative agent. During these investigations, a member of the staff of this store was found to bo excreting a similar organism, and although this did not necessarily indicate that this person was the cause of the outbreak, he was excluded from handling food until his conditio had cleared up. -18- PREVALENCE OF AND CONTROL OVER, INFECTIOUS DISEASE. Table 1 on Pago 7 of this Report gives details of all cases of infectious disease notified during the year. The total of 595 shows an appreciable increase over that of the previous year, which was 493. This increase is accounted for by a rise in the number of cases of Whooping Cough, and by a small increase in the number of cases of Measles. Diphtheria. For the second year in succession no cases of Diphtheria occurred in the district. Scarlet Fever. Notifications of this disease wore slightly lower than in 1949 - 40 as against 54. The type of disease was mild, and admission to. Hospital was necessary only in 18 cases. Measles. The number of cases of Measles reported during the year rose slightly from 304 in 1949 to 327 in 1950. Here again the type of disease was mild, admission to Hospital being necessary in only 4 coses. Whooping Cough. During the past year there was a substantial increase in the number of cases, of Whooping Cough - 151 notifications being received, as compared with 59 in 1949. The disease was however, of a mild type, and no deaths resulted. In 5 cases only was Hospital treatment necessary. Polio-myelitis. As noted in the introduction to the Report, 5 cases occurred during the year - 2 females aged l½- and 23 years respectively, and 3 males aged 6 years, 24 years and 28 years. There was 1 death - the man aged 24 years. The other cases all made a good recovery, the boy aged 6 years having no paralysis, and the remaining 3 only a slight paralysis. Tuberculosis. 35 new cases of Tuberculosis were notified during the year, 34 pulmonary and 1 non-pulmonary. A further 20 persons, previously notified in other areas, took up residence in this district. There were 4 deaths from pulmonary Tuberculosis - 3 male and 1 female, and 2 deaths from non-pulmonary - 2 male. The death-rate from Tuberculosis was 0.12, per 1000 of the population, as compared with 0.21 for the previous year. Scabies. The arrangements made in 1945 (following the closing down of the Scabies Clinic set up by the Council during the war) whereby infected persons were treated as out-patients at the Isolation Hospital, came to an end during the year. Those cases which wore reported were supplied with material and treated themselves at home. In one persistent cose, where facilities at the home were insufficient, arrangements were made for treatment to be given at the Cleansing Station of an adjoining authority. -19- IMMUNISATION. During the year, 326 children were immunised against Diphtheria for the first time, 188 at Clinics, and 138 privately by their medical attendants. A further 102 children under the age of 3 years received a full course of combined Diphthoria and Whooping Cough injections. In addition to these, 496 re-inforcing injections against Diphthoria wore given, mostly in our schools. This is by far the highest total yet achieved in the district. THE NATIONAL ASSISTANCE ACT, 1948. SECTION 47. REMOVAL TO SUITABLE PREMISES OF PERSONS IN NEED OF CHARE AND ATTENTION. No formal action was taken under this section. Several cases wore met with where elderly persons were found to bo living in such circumstances as to require further core and attention, but they were invariably either anxious to remove to a different environment, or could bo easily persuaded, and formal action was quite unnecessary. The problem arose in securing the suitable accommodation. -20- REPORT OF MEDICAL OFFICER REQUIRED BY SECTION 128 (5) OF THE FACTORIES ACT, 1957. 1. Inspections for purpose of provisions as to health. Number on Register. Number of Inspections. Written notices. Occupiers Prosecuted. (1) Factories in which Secs.1,2,3,4,& 6 are to be enforced by local Authorities. 15 18 — - (2) Factories not included in (1) in which Sec. 7 is enforced by the Local Authority. 60 63 3 - (3) Other premises in which Sec.7 is enforced by the Local Authority. 1 — — - Total 76 81 3 - 2. Cases in which defects were found. No. of cases in which defects were found. Found. Remedied. Referred Presecutions. To H.M. Inspector. By H. M. Inspector. Want of cleanliness 2 2 - - - Sanitary conveniences (b) Unsuitable or defective 2 2 - - ~~ (c) Not separate for sexes 1 1 — — - Other offences 1 1 - - - Total 6 6 - - - OUTWORKERS (SECTIONS 110 AND 111). Section 110. Section 111. No. of outworkers on lists received. No. of instances of work in unwholesome premises. Notices served. 48 - - -21-