HAMP 51 Metropolitan Borough of Hampstead Abridged Report on the Health of the Borough. 1 950. DENNIS H. GEFFEN, m.d., b.s., m.r.c.s., l.r.c.p., d.p.h., Medical Officer of Health. ■ f 3 Public Health Department, 33-35, Lancaster Grove, Hampstead, N.W.3. 25th June, 1951. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Hampstead. Mr. Mayor, Ladies and Gentlemen, I have pleasure in submitting to you the Annual Report on the health of the residents of Hampstead for the year 1950. It was only during the last four months of the year that I was your Medical Officer of Health. Prior to this, Dr. H. Leslie Oldershaw had been responsible for the work of the Department. I would like immediately to express my gratitude to the Council for its welcome and to Dr. Oldershaw for facilitating my work by his very careful explanation of the activities of the Department. It has been very gratifying since my appointment to work in harmony with him as Divisional Medical Officer and to be associated with a colleague and friend of so many years' standing. During the course of the year the population has increased by 310 and has now reached the total of 97,400. This is the Registrar General's estimate for the middle of the year, 1950. A more accurate figure will be available later when the results of the 1951 Census are available. I would call attention to the fact that the Infantile Mortality Rate was 19, the total number of children under 1 year that died being 28. The graph on page 4 shows the Infantile Mortality Rate in Hampstead since 1900. Infantile mortality is considered to be an index of the general health of a community. Where sanitary circumstances are bad, food unsatisfactory, and social amenities few, it will be found that the infantile mortality is high. The control of health in infancy and childhood depends not only on the personal health services available to children but the environmental conditions under which they live. It has been suggested that a low infantile mortality means that a large number of unfit and weakly children who would otherwise die are saved only to live with impaired health and to die young. This is based on the argument that a high infantile mortality secures the survival of the fittest. This argument is wrong. When there is a high mortality rate among infants there is also a high rate of sickness. The weakly may die and the strong survive with impaired health. A low infantile mortality rate means a low infantile morbidity rate and it usually indicates that the circumstances of living in a particular area for all classes of the community are improving. If this be so, then the figure of 19 deaths per 1,000 births in the Borough of Hampstead, the lowest figure that has been recorded in the Borough, is an indication which can be accepted as a general improvement in the health of the Borough as a whole. This leaves, however, no room for complacency, for if we turn to the other end of the scale we find that there is a crying need to help the older residents of the Borough. Tribute should be paid to the excellent work which is being carried out by the voluntary associations. The (6428) A 2 4 meals supplied by the British Red Cross Society in conjunction with the Women's Voluntary Service have proved a boon to a number of recipients, as have the Homes provided by the Hampstead Old People's Housing Trust. Few people realise, however, the extent to which the help of the Borough Council is sought in connection with the conditions under which old people are living. Since my appointment on 1st September to the time of writing this Report, the Public Health Department has INFANTILE MORTALITY SINCE 1900. been asked to help in no less than 49 cases in respect of old persons varying in age between 63 and 91 years. In addition to the cases found by the Sanitary Inspectors on complaint and during their routine visits, reports have come to us from members of the Council, relatives, doctors, health visitors, landladies, the Old People's Welfare Association, the Fitzroy Club, friends and neighbours. The usual request is to help some aged person who, by reason of his years, often associated with other physical defect, is unable to look after himself. Every one of these 5 cases has been visited, sometimes repeatedly, by the Deputy Medical Officer of Health together with your Chief Sanitary Inspector or the District Sanitary Inspector. The object has been to understand the complete problem of the individual concerned and to determine what steps can be taken to enable him to continue his life in comfort, in his own home, in the neighbourhood to which he is accustomed. This is often achieved in conjunction with the doctor in charge of the case by providing nursing in the home and by seeking the help of various services supplied either by the London County Council, such as the Home Help Service, or by voluntary agencies such as the British Red Cross Society and the Women's Voluntary Service, or through the services which the Borough itself may provide. In most cases we have been able to achieve the aims set out above, but where this has been impossible we have secured admission to hospital or an institution. I think we have been able to bring considerable help to a number of people but I feel, nevertheless, that there is much more that we could do. I should like to feel that we had assisted in ameliorating the loneliness from which many old people suffer, that meals could be provided to them more often, or that arrangements could be made to supply meals where, by reason of lack of facilities, an aged person is unable to prepare a meal in his own home. I should like, too, to see holidays provided for old people as apart from actual convalescence. These are thoughts that occur to me immediately, but they are by no means comprehensive and I hope in conjunction with the voluntary agencies in the Borough to give further consideration to these possibilities. Your Public Health Department has also given careful consideration to the problem of persons in the Borough who are notified as suffering from tuberculosis. The following figures show the position in the Borough over a period of the last five years: No. of cases on Register. New notifications received during year. No. of Deaths. Population. 1946 642 114 34 89,720 1947 644 96 42 95,650 1948 668 99 39 95,480 1949 668 113 32 97,090 1950 774 105 27 97,400 Tuberculosis is not an acute infectious disease which plays its course in the question of a few days or weeks. A tuberculous person may remain infectious for a large number of years and it is important that the Department should always be aware of the number of persons in the Borough suffering from this disease and that steps should be taken to secure that their living conditions are such that they are unlikely to spread infection. This is no easy task in a Borough such as Hampstead, where there are no less than 4,135 families awaiting rehousing. I hope in due course to be able to place before you a comprehensive survey recording the number of persons notified as suffering from tuberculosis and an estimate of the proportion who arc infectious and some indication of the conditions under which they are living. Tuberculosis is probably the most serious endemic disease with which we have 6 to deal. It is a very costly disease to cure and every avenue should be sought to prevent its spread and to control its incidence. Newer methods of treatment are prolonging the life of the tuberculous person and there are suggestions that in due course immunisation may enhance resistance to the disease. In the end, however, the main factors which will control its spread and prevent its incidence are better housing and environmental conditions and a good adequate wholesome diet. Satisfaction with our low infantile mortality rate is only justified if at the same time we realise the problems of the aged and the possibilities of preventing tuberculosis. During 1950 there were notified 14 cases of poliomyelitis (infantile paralysis). This compares with 25 cases in 1949. Research into the causation and method of spread of this disease is being pursued and it is hoped that a time will not be far away when further knowledge will bring us near to its prevention and cure. I think we ought to realise that the public fear of poliomyelitis is out of proportion to the actual number of cases that are being recorded. It is true that in 1947, 1949, and 1950, the number far exceeded that of previous years and the fear has been expressed that we are likely in the future to have to contend with this disease as a more frequent occurrence than in the past. This may be possible, but it is, after all, only speculation. Many cases, moreover, are mild and are not complicated by paralysis in a recognised form, whilst of the remainder who do develop paralytic symptoms, the majority make a complete recovery. At the time of writing this report there is some indication that the number of cases is increasing, though they are certainly less than in the corresponding period of 1950. I am often asked what steps should be taken to avoid poliomyelitis, or to minimise the risks of paralysis. Generally, there is no need to take any particular precaution unless there are definite indications that a considerable number of cases of poliomyelitis are occurring in the district. Under such circumstances crowded places should be avoided, and children and young adults should not become overtired by strenuous competitive exercise or late nights. Food should be protected from contamination, the hands carefully washed after using the toilet, and on any sign of minor illness rest in bed is advisable, for it has been suggested that undue exertion during the early days of infection may increase the risk of paralysis. With all this it is as well to keep a sense of proportion of the risks involved. Road accidents killed 6 times as many people as did poliomyelitis in the big epidemic of 1947, and maimed 35 times as many. There is a very happy contact between the Public Health Department, the local hospitals, and the London County Council for consultation as to any further steps that might be taken should the number of cases of poliomyelitis be unduly heavy. The value of the Public Health Department is best assessed by an indication of the use the public make of it. During 1950, no less than 2,311 complaints were made as to nuisances which might be remedied with the assistance of the Public Health Department. Every one of these complaints was carefully and fully investigated by your Sanitary Inspectors and where the complaint was found to be justified and one capable of being dealt with by a local authority the appropriate steps were taken to secure the abatement of the nuisance. During the year it will be seen that 1,530 intimation notices and 436 statutory notices were served. It was only in 11 cases that we had to ask for a summons. 7 I have stated already in these remarks that one of the essentials of health is good wholesome food. It will be seen that 504 samples of food were analysed and the appropriate steps were taken where any defect in composition was found. In addition, 90 samples of milk and ice-cream were submitted to bacteriological test. The work in connection with the Fair at Hampstead Heath which was commenced by your Public Health Department nearly 3 years ago was continued during 1950, and I feel sure that you would wish me to pay tribute to the co-operation of the stallholders who sell food at the Fairs which are held at Easter, Whitsun and August Bank Holiday. Reports have been submitted to the Public Health Committee after each Fair, but a summary is not out of place in this Annual Report. We have now secured that all food stalls at each of the three fairgrounds have been centrally placed away from the immediate vicinity of the contaminating dirt and dust caused by the Fair machinery. All such stalls are now situated within a few feet of an adequate clean water supply which has been provided at our request. Moreover, the stalls are now easier to supervise. Arrangements have been made to deal with refuse and the stallholders are co-operating with us in securing the protection of food from dust and flies, the careful handling of food products, and the cleansing and sterilising of utensils. Eleven samples of ice-cream were sent for bacteriological examination at the Easter fair of this year and all of them were found to be Grade 1, that is, the best of the 4 grades into which ice-cream is divided after the appropriate bacteriological test. We have also conducted enquiries into shellfish and conditions under which it is packed, stored and sold. We are obtaining further particulars as to the conditions under which food is stored before being brought to the Fairground and for this we are indebted to much help from the Public Health Departments of neighbouring Boroughs. Sanitary conditions generally on the Heath still leave much to be desired, but I think a start has been made and progress achieved in improving the Fairground of Hampstead Heath and in making it worthy from a health point of view of its history and fame. I would wish to express my thanks to the Chairmen of the various Committees whose help I have received, to the members of the Public Health Committee in particular, and to my colleagues for their help during the months since my appointment to Hampstead. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, DENNIS GEFFEN, Medical Officer of Health. (6428) A8 8 PUBLIC HEALTH COMMITTEE (as at 31st December, 1950.) His Worship the Mayor (Mr. Alderman R. J. Cleaver, J.P., ex-officio member). Chairman: Mr. Alderman S. A. Boyd, M.S., F.R.C.S., J.P. Alderman Mrs. R. S. G. Carnegie. ,, Mrs. F. E. Cayford, J.P., L.C.C. Councillor Miss D. R. Bailey. Mr. Councillor L. H. H. G. Baldwin. „F. J. Clark, L.C.C. „O. J. E. Graystone. „ A. A. Joseph. „A. C. Morson, O.B.E., F.R.C.S. ,, N. Oatway. C. A. Power, A.C.V., C.T.V. Councillor Mrs. B. C. Wells. The Chairman of the Housing Committee. Sub-Committee: Drainage Plans Staff of the Public Health Department. Acting Medical Officer of Health: H. Leslie Oldershaw, M.D., State Medicine (Lond.), B.S., M.R.C.S. (Eng.), I..R.C.P. (Lond.), D.P.H. (Up to 31.8.50.) Medical Officer of Health: Dennis H. Geffen, M.D., B.S., M.R.C.S., L.R.C.P., D.P.H. (From 1.9.50.) Acting Deputy Medical Officer of Health: J. Gastrell Lewis, M.B., Ch.B., D.P.H., D.R.C.O.G. (Up to 31.8.50.) Senior Medical Officer: S. M. Tracy, M.R.C.S., L.R.C.P., D.P.H. (From 1.9.50.) Chief Sanitary Inspector: J. F. Armstrong (a), (b). Deputy Chief Sanitary Inspector: W. Robinson (a), (b). Sanitary Inspectors: Miss C. Lambe (a), (d), (e), (f). F. V. Outlaw (a), (b). L. E. Trigg (a), (b). W. F. Newport (a), (b). D. W. Malcolm (a). T. H. Marshall (a), (b), (c). G. L. Nicklin (a). K. F. Overy (a). R. Clark (a). (From 16.1.50.) Chief Clerk: A. H. C. Slade. Clerical Stqjf: R. Johnson (Sanitary Records Clerk). G. W. Bedell (Infectious Disease Clerk). Mrs. M. C. Rabin (Senior Shorthand Typist). F. E. Jackson. G. R. Young. 9 Public Analyst: H. E. Cox, D.Sc., Ph.D. (Lond.), F.I.C., 10, Billiter Square, E.C.3. (a) Sanitary Inspector's Certificate. (b) Food Inspector's Certificate. (c) Smoke Inspector's Certificate. (d) Health Visitor's Certificate. (e) State Registered Nurse. (f) State Certified Midwife. STATISTICS AND SOCIAL CONDITIONS. Area (acres) 2,265 Population 97,400 Rateable Value, March, 1950 £1,638,500 Sum produced by 1d. rate £6,615 BIRTHS. Live births— Total. Legitimate. Illegitimate. Males 809 748 61 Females 696 623 73 1,505 1,371 134 Birth rate per 1,000 of the estimated civilian population (Rate for London: 17.8) 15.5 Number of Stillbirths 28 Rate of Stillbirths per 1,000 (live and still) births 18.3 DEATHS. Net deaths (males, 423; females, 553) 976 Death rate per 1,000 of the estimated civilian population (Rate for London: 11.8) 10 Deaths from maternal causes (0.66 per 1,000 births) 1 Deaths of infants under 1 year (males, 16; females, 12) 28 Infants under 1 year: Infantile Mortality Rate All infants per 1,000 live births 19 Legitimate infants per 1,000 legitimate live births 17 Illegitimate infants per 1,000 illegitimate live births 37 The causes of death, arranged under the headings of the short list used by the Registrar-General, were as follows:— 1. Tuberculosis, respiratory 24 21. Other circulatory disease 51 2. Tuberculosis, other 3 22. Influenza 8 3. Syphilitic disease 10 23. Pneumonia 40 4. Diphtheria — 24. Bronchitis 45 5. Whooping cough — 25. Other diseases of respiratory system 7 6. Meningococcal infections — 7. Acute poliomyelitis 2 26. Ulcer of stomach and 8. Measles — denum 12 9. Other infective and parasitic diseases 2 27. Gastritis, enteritis and diarrhoea 1 10. Malignant neoplasm, stomach 22 28. Nephritis and nephrosis 8 11. Malignant neoplasm, lung, bronchus 25 29. Hyperplasia of prostate 5 30. Pregnancy, childbirth, abortion 1 12. Malignant neoplasm, breast 33 13. Malignant neoplasm, uterus 15 31. Congenital malformations 8 14. Other malignant and lymphatic neoplasms 94 32 Other defined and ill-defined diseases 89 15. Leukæmia, aleukæmia 6 33. Motor vehicle accidents 4 16. Diabetes 11 34. All other accidents 19 17. Vascular lesions of nervous system 103 35. Suicide 28 36. Homicide and operations of war 18. Coronary disease, angina 127 19. Hypertension, with heart disease 39 976 20. Other heart disease 134 (6428) A4 10 Public Mortuary, New End. During the year 217 bodies were brought to the mortuary, 4 by the Police and 206 by order of the Coroner. 214 post-mortem examinations were made. Infectious Disease during 1950. Notifications Removals to Hospitals Deaths Acute Encephalitis. Post Infectious 1 1 — Diphtheria — — — Dysentery 16 6 — Erysipelas 21 5 —- Food Poisoning 42 2 —- Measles 588 26 —- Meningococcal Infection 1 1 - Ophthalmia Neonatorum 3 3 Paratyphoid 5 5 —- Pneumonia 44 10 5 Poliomyelitis 14 12 2 Puerperal Pyrexia 7 5 — Scabies 24 — — Scarlet Fever 77 30 — Whooping Cough 189 12 — Total 1,032 118 7 Cancelled cases have not been included. Smallpox No case of smallpox occurred in the Borough during 1950. Poliomyelitis During the year 14 cases of poliomyelitis were notified. The age distribution of the cases is shown by the following table:— Age. Males. Females. Cases. Deaths. Cases. / Deaths. Under 1 year —- —- —- —- 1-2 years 1 —- —- —- 3-4 „ — — 1 —- 5-9 ,, 1 — — — 10-14 „ 1 — 2 — 15-24 ,, — — 4 — 25 and over 2 1 2 1 Total 5 1 9 1 11 Tuberculosis NEW CASES AND MORTALITY DURING 1950 During the year 1950, 105 new cases of Tuberculosis were notified, 95 being cases of Pulmonary Tuberculosis and 10 of other forms of the disease. The following statistical table gives an analysis of the newly notified cases and deaths during 1950. Age Periods. New Cases. Deaths. . Respiratory. NonRespiratory. Respiratory. NonRespiratory. M. F. M. F. M. F. M. F. 0—1 — — — — — — — — 1—5 2 1 — — — — — — 5—15 — 2 2 2 — — — — 15—25 8 15 1 1 1 1 — — 25—35 15 13 — 1 2 1 — — 35—45 5 12 2 1 — 1 1 — 45—55 5 5 — — 5 — 1 1 55—65 4 2 — — 4 1 — — 65 and upwards 6 — — — 8 — — — Totals 45 50 5 5 20 4 2 1 Public Health (Tuberculosis) Regulations, 1930. There were 671 Pulmonary and 103 Non-Pulmonary cases of tuberculosis known to the Department at the end of the year 1950. Mass Miniature Radiography Although it was not possible for the Mass Radiography Unit to find accommodation within the Borough, a Unit situated in an adjoining Borough during November and December was made available for Hampstead residents and employees. The Unit originally requested that 750 names of Hampstead persons be provided, but the response from those desiring to be X-rayed was so great that 920 names were submitted. As a result, the Unit extended its stay. Twenty-five firms were invited to send their staff, and of these twelve accepted and sent a total of 438 individuals. Arrangements were made for 317 of the Council's staff to attend, and the remaining 150 were residents of two special areas. These two special areas consisted of two streets in the Borough, and an attempt was made to obtain the mass radiography of all the residents therein, with the exclusion of children. 529 invitations were sent out and appointments were made for 150 persons to attend the Unit. 12 Bacteriological Examinations (Infectious Diseases.) On 1st January, 1950, a new arrangement for the examination of bacteriological specimens came into force. This work, which had previously been carried out by the Laboratories of Pathology and Public Health, 6, Harley Street, W.1, was transferred to the Central Public Health Laboratory, Colindale. The record of examinations carried out during the year is as follows:— Throat/Nose Swabs. Diphtheria Bacilli found Nil Hæmolytic Streptococci found 31 Vincent's Angina organisms found 6 Negative 88 Fœces. Shigella found 3 Salmonella found 1 Negative 36 Sputum. T.B. found 2 Other organisms found 2 Negative 2 Pertussis. H. pertussis found 1 Negative 3 Food Poisoning 42 cases of food poisoning were notified, 24 of which occurred in an outbreak at one of our local hospitals. Of the remaining 18 cases the agent causing illness was identified in 4 instances, but was unknown in 14 cases. Disinfection and Disinfestation The following is a record of the work carried out by the Disinfecting Staff during 1950:— Number of houses or parts of houses and contents disinfected 671 Number of verminous rooms disinfested 294 Cleansing and Disinfection of Verminous Persons and their Belongings The following cleansings and medicinal baths were carried out at the Borough Council Cleansing Centre, during the year, where 27 adults and 17 children received treatment:— Verminous conditions:— Adults 14 Children under 5 2 Children over 5 6 Scabies:— Adults 36 Children under 5 8 Children over 5 12 During the year, 294 verminous rooms in 162 houses were cleansed and freed from vermin. 13 24 cases of scabies were notified during the year. These were investigated by the Health Visitors and, where necessary, treatment arranged at the Public Health Station. During the year, the following treatments were carried out at the Centre by staff of the London County Council:— Verminous conditions :— No. of school children treated 63 No. of treatments given 139 No. of pre -school children treated — No. of treatments given — Scabies:— No. of school children treated 14 No. of treatments given 45 No. of pre-school children treated — No. of treatments given — The annual number of cases of scabies notified since the war is as follows:— 1945 196 1946 197 1947 88 1948 36 1949 24 1950 24 NATIONAL ASSISTANCE ACT, 1948, SECTION 50 During the year 8 funerals were carried out under the National Assistance Act, 1948. The work involved in this function of the Public Health Department is very extensive. We are fortunate in Hampstead in not having a very large number of cases to deal with, but each case has to be very fully investigated. In the case of elderly persons who have lived alone, the task of tracing relatives and friends is not an easy one. Insurance policies, bank balances, pensions, death grants have all to be dealt with. Personal effects have to be sold or disposed of, and, if necessary, the Treasury Solicitor communicated with. In two cases—a male aged 71 and a newly born female, where there was no possibility of recovering any money from the estate of the deceased and no liable relatives could be traced—the amounts of the funeral expenses were written off. One case of a Danish national was referred to the Town Clerk for further investigation into the affairs of the deceased. In four cases the funeral expenses were recovered in full and in the remaining case payment was being made by instalments. The total cost of the funerals carried out during the year was £56 15s. 6d. and an amount of £36 17s. 2d. was recovered from liable relatives and the estates of deceased persons. National Assistance Act, 1948, Section 47 I have already alluded in the foreword to this Report to the desperate plight of many aged and infirm persons living in the Borough under insanitary conditions and in need of care and attention. Fortunately, my Department was able to deal with the sixty-seven cases brought to its notice without recourse to the Courts for orders for compulsory removals to hospitals or institutions. 14 There has been some improvement during the year in the waiting period for admission to hospital of such cases. Inspection and Supervision of Food Hygiene of Food Premises. This most important aspect of the Department's activities has again received close attention. The work entailed covers a large field and the District Sanitary Inspectors are responsible for the visits and inspections which have been made to the following variety of food premises:— Bakehouses 217 Butchers 260 Confectioners 111 • Dairies and Milk Shops 195 Fishmongers 161 Fried Fish Shops 111 Greengrocers and Fruiterers 216 Grocers and Provision Shops 214 Hotels and Licensed Premises 90 Ice-cream premises 255 Restaurants and Canteens 440 Other Food Premises 183 Other Inspections (Stalls, etc.) 140 2,593 Milk Supply. There are 95 Distributors on the Register. Samples of milk were taken in course of delivery to the various schools, day nurseries and hospitals in the district, as follows:— Bacteriological Examination. Chemical Analysis. Hospitals 10 5 Day Nurseries 5 2 Schools 14 8 All were found satisfactory. The average milk fat content was 3.41 per cent. Milk (Special Designations) Regulations. Milk (Special Designations) Regulations. 197 licences were issued during the year to sell specially designated milk as follows:— Dealers' Licence. Supplementary Licence. To sell " Pasteurised " milk 37 27 „ „ "Sterilised" milk 38 27 ,, ,, "Tuberculin Tested " milk 32 26 „ ,, "Accredited " milk 6 4 In view of the unsatisfactory sanitary conditions likely to be prejudicial to health and the contravention of certain of the provisions of 15 the Milk and Dairies Regulations, 1949, a milk distributor was invited to appear before the Public Health Committee to show cause why his registration should not be cancelled. After hearing the evidence and receiving the explanation of the milk dealer, the Committee resolved that his registration as a milk distributor be cancelled. Food Sampling (a) Bacteriological Examination of Foodstuffs. We have received every co-operation and speedy assistance and advice throughout the year from the Central Public Health Laboratory Service, Colindale, N.W.9, to whom one hundred and forty-seven samples were submitted during the vear. Of these, 60 were in respect of Ice Cream, and were graded under the Methylene Blue Test as follows:— Grade I 24 II 18 „ III 7 „ IV 11 17 of the above ice-cream samples were purchased on Hampstead Heath on Bank Holidays. Of these, 8 were Grade I, 3 Grade II, 3 Grade III, and 3 Grade IV. Thirty samples of Pasteurised Milk satisfied both the Methylene Blue and Phosphatase Tests prescribed by the Milk (Special Designation) Regulations and the Heat Treatment (Prescribed Tests) Order, 1944. Other samples were taken as follows:— Nature of Sample. No. of Samples. Satisfactory. Unsatisfactory. Chocolate Spread 2 2 - Water 2 2 — Butter 1 1 — Washup water from ice-cream servers, etc. 25 15 10 Jellied Eels I 1 - Whelks 2 — 2 Cockles 3 - 3 Shrimps 1 1 — Fish and chips 1 1 — Tinned veal and ham 1 1 — Tinned luncheon meat 2 2 — Toffee apple 1 1 — Lemon cordial 1 1 — Orange squash 1 1 — Tinned meat soup 1 1 — (b) Samples submitted to Chemical Analysis. A total of 504 samples was sent for analysis. Adulterated and unsatisfactory samples. The percentage of adulterated samples was again very small. 8, or 1.6 per cent., as compared with 3.8 per cent. in 1949 and 4.6 per cent. in 1948. Several of these were more or less venial offences. 16 Particulars of the number classed as "adulterated" are as follows:— Sample No. Article. Offence. How dealt with. 12 Marmalade (Home made) Contaminated with iron, probably due to cooking in an Householder advised. 121 Coffee Beans, before and after roasting iron saucepan Coffee beans slightly contaminated with naphthalene but no trace after roasting Shopkeeper advised all coffee beans in consignment to be roasted before sale. 155 Curry Powder Slightly deficient in spices Manufacturer advised. (Curry Powder Order not in force until October, 1950, as regards retail sales.) 199 Ginger Wine Essence Not a wine essence, or a wine when diluted as directed Sample was the last of old stock held by retailer. Retailer cautioned. 347 Unsweetened Table Jelly Contains no sugar and though genuine with regard to Food and Drugs Act does not comply with the Table Jellies Order Referred to Ministry of Food. 370 Mincemeat Slightly deficient in soluble solids 62.7 per cent.—minimum 65.0 per cent. Manufacturer cautioned. 411 Low Sugar Raspberry Jam Contains 53.6 per cent. soluble solids instead of the standard 68.5 per cent. required Manufacturer cautioned. 455 Curry Powder Deficient in spices. Contained less than 85 per cent. spices Manufacturer cautioned. Legal Proceedings. Summonses under Sections 9 and 83(3) of the Food and Drugs Act. 1938, were served upon the manufacturers in respect of the sale of a sliced wrapped loaf of bread found to contain a cigarette end. The Bench imposed a fine of £15 with £5 5s. costs. Hygiene of Food and Food Premises. The revised Byelaws for the protection of food in the Metropolis have not yet been issued. It is hoped they will assist the efforts both of the Public Health Department and the food trades in improving the standard of cleanliness of food. Lectures and demonstrations on clean food have again been given to local organisations and small groups of food traders. Food Hygiene at Hampstead Heath Fairs. I have referred to this in the opening to this Report. So far as I know this is the first really organised effort of a local authority to control the hygienic conditions under which food is manufactured, stored and sold at fairgrounds. Significant results have already been achieved, the radical improvements in the siting of stalls and general cleanliness being confirmed by highly satisfactory bacteriological findings. 17 I am most grateful to Col. Benstead, the Director of the Laboratories, and particularly to Dr. Betty C. Hobbs, who is in charge of the Laboratory's Food Hygiene Division, for the interest they have taken and the assistance they have given in our efforts to improve the conditions of food hygiene on Hampstead Heath during Bank Holidays, even to the extent of affording facilities for delivery of food samples at times when the Laboratory is normally only open for urgent cases, such as food poisoning, infectious diseases, etc. In fact, Dr. Hobbs herself has spent Bank Holidays on the Heath in order to get first-hand knowledge of the conditions there. Meat. No slaughtering is carried on in the Borough. Unsound Food. The following list shows the amount of food seized or voluntarily surrendered during the year 1950:— Article. Quantity. Cake 67 lbs. Cake Mixture 43 packets Cheese 5 lbs. Chutney 12,240 jars Coconuts 54 Coffee 14 bottles Confectionery 42 lbs. Dates 8 lbs. Eggs 432 ,, (frozen) 12 lbs. Figs 40 lbs. Fish (tins) 1,705 tins „ Paste 175 tubes ,, (fresh) Cod 17 stones ,, ,, Haddock 12 „ ,, ,, Halibut 3 „ ,, ,, Kippers 7 „ ,, „ Plaice 4 „ „ „ Rock Salmon 3 „ ,, „ Sole 4 „ „ ,, Whiting 2 „ Flour 42 lbs. Fruit 615 tins Fruit Juice 126 „ Hors d'œuvres 295 „ Jam 111 ,, Margarine 11 lbs. Marmalade 154 tins Meat (tins) 558 „ „ (fresh) Bacon 26 lbs. ,, ,, Beef 437 „ „ ,, Calves Head 11 „ ,, ,, Chicken 154 „ ,, „ Duck 75 ,, „ ,, Lamb 5 ,, ,, „ Luncheon Sausage 35 „ ,, ,, Ox Brains 65 „ „ ,, Salami 224 „ 18 Article. Quantity.  Meat (fresh) Sausages 69 lbs. ,, ,, Sheeps' Heads 70 ,, ,, Tongue 60 lbs. ,, ,, Turkey 18 „ Milk 882 tins Mustard 94 jars Oatmeal 28 lbs. Peaches 1,008 Potatoes 16 cwt. Prunes 131 lbs. Pumpernickel 80 packets Salad Cream 306 jars Soup 167 tins Suet 46 lbs. Sultanas 56 „ Tea 4 „ Tomato Puree 11 bottles Vegetables 1,117 tins Xmas Pudding 37 lbs. Sanitary Circumstances of the Borough Sanitary inspection. Summary of sanitary works accomplished during 1950:— Total complaints received 2,311 Public Health (London) Act, 1936. Premises inspected on complaint 2,186 „ „ after infectious disease 150 Special visits and re-inspections 16,581 Smoke observations 19 Noise nuisances 51 Housing Act, 1936. Overcrowding Regulations 271 Rehousing. Applications investigated 552 Drainage. Plans and applications received (excluding structural conversions and new buildings which are dealt with by the Borough Engineer):— (a) Under notice 61 (b) Voluntary 206 Food Premises. Bakehouses 217 Milk premises 195 Restaurants and eating houses 670 Other food premises 1,511 Shops Act. Inspections 139 Pharmacy and Poisons Act. Inspections 114 Notices. Intimation notices served 1,530 Statutory notices served 436 19 SUMMARY PROCEEDINGS The results of the legal proceedings instituted in respect of my Department for the year are as follows:— Date of Hearing. Court. Premises and Nature of Offence. Result of Proceedings. 1950 24th January Marylebone Magistrate's Court 106, Alexandra Road. Public Health (London) Act, 1936 Order by consent to abate nuisance within 28 days 10th January Do. 6, Strathray Gardens. Nuisance; non-compliance of Abatement Order. Public Health (London) Act, 1936 Fined £5 and ordered to pay £2 2s. costs. Do. Do. Do. Fined £5 and £2 2s. costs. 17th January Do. 23, Daleham Gardens. Contravention of L.C.C. Drainage Byelaw No. 9(1) Adjourned sine die upon owners undertaking to comply with Byelaw. Do. Do. 23, Daleham Gardens. Contravention of L.C.C. Drainage Byelaw No. 14 Adjourned sine die upon owners undertaking to comply with Byelaw. 7th March Do. 12, Palmerston Road. Nuisance. Public Health (London) Act, 1936 Work done. Summons withdrawn. Do. Do. 4, Priory Road. Nuisance. Public Health Work proceeding; summons withdrawn. Do. Do. (London) Act, 1936 2, Priory Road. Nuisance. Public Health Work proceeding; summons withdrawn. 18th July Do. (London) Act, 1935 116, Belsize Road. Nuisance. Public Health (London) Act, 1936 Order to abate within 21 days and ordered to pay 12s. 6d. costs. 28th November Do. 41, Belsize Park Gardens. Nuisance. Public Health (London) Act, 1936 Order to abate nuisance within 21 days and ordered to pay £2 2s. costs. Do. Do. 5, Southampton Road. Nuisance. Public Health (London) Act, 1936 Works completed. Summons withdrawn on payment of £2 2s. costs. 7th November Do. 116, Belsize Road. Failure to comply with an order to abate a Public Health Nuisance Fined £5 and £1s. costs. Do. Do. 6, Strathray Gardens. Failure to complv with an order to abate a Public Health Nuisance. Fined £3 and 30s. costs. Do. Do. Do. Fined £3. 20 In addition, sixty-nine cases were referred to the Town Clerk and Solicitor of the Council of premises where Statutory Notices had not been complied with. The necessary works to comply with these notices were executed after the Town Clerk's warning that summonses would be issued in default of compliance therewith. Details of legal action under the Food and Drugs Act appear in the Food Section of this report. Whitestone Pond. The question of the regulation of the use of this pond was considered by the Council last year, as a result of which the following measures were recommended:— (1) The pond to be regularly emptied and cleansed. (2) During the summer the pond to be dosed twice daily with sodium hypochlorite and copper sulphate. (3) Notices to be erected drawing attention to the fact that the pond is not maintained for bathing and paddling. Despite the above precautions, I continue to receive a spate of complaints, particularly during the summer holiday period, concerning the use of this pond for bathing and paddling purposes by numerous children. There is not much else the Council can do except totally to prohibit the use of the pond for bathing and paddling. I certainly think, however, that parents should discourage their chilrden from using the pond for these purposes. Flooding by Storm Water. The sewer relief works were completed early in 1949, and although there has been no rainstorm quite comparable with those which caused the previous floodings, it is again gratifying to report that there has been no inundation of dwelling-houses in the Sumatra Road and Netherwood Street areas. Nevertheless, the Borough Engineer emphasises that the works which have been carried out cannot, owing to the physical condition of the areas concerned, be regarded as a remedy for all flooding. Two underground rooms were closed during the year, not only because they did not comply with the Underground Room Regulations, but on account of their liability to flooding. Increase of Rent and Mortgage Interest (Restrictions) Acts. One certificate was issued during the year. Housing 1. Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 2,140 2. Number of dwelling-houses (included in (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 45 3. Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 7 4. Number of dwelling-houses found not to be in all respects fit for human habitation 1,530 21 HOUSING ACT, 1936. PART II. Sections 11 & 12. Two houses were Represented to the Housing Committee for Demolition Orders. Undertakings were subsequently received from the Owners, in accordance with the Act, that the premises would not be used for human habitation. Closing Orders were made or undertakings similarly accepted in respect of ten underground rooms at four premises. There are many other premises in the Borough which warrant procedure under this part of the Act, but action thereon is impossible whilst the present rehousing situation continues. HOUSING ACT, 1936. Sections 9, 10 & 16. Action under Statutory Powers. Number of dwelling-houses in respect of which Notices were served requiring repairs 29 Number of dwelling-houses which were rendered fit after service of formal notices 12 (In one case the work was executed by the Council's contractors, in default of the Owner, at a cost of £63.) Number of dwelling-houses where works were in progress at the end of the year 10 (Of these, three were premises where works were being executed by the Council's contractors in default of the Owner, at a total cost of approximately £1,850.) Number of premises rendered fit by the Owners after service of informal notices 5 (These were houses which could not be rendered fit at “reasonable expense " in accordance with Section 9.) From the above it will be noted that there has been a considerable increase in the work of the Department in connection with the Repairs Section of the Housing Act. To cope with this, in June, 1950, Mr. W. Robinson, Deputy Chief Sanitary Inspector, was delegated full time to housing repair work. It is estimated that the cost of the repairs required by the Section 9 Notices served so far (formal and informal), amounted to the substantial amount of £14,699. The fundamental basis of Section 9 notices is that houses can be rendered fit for human habitation at “reasonable expense". Post-war economic considerations have, however, completely upset the balance between income and expenditure on house property. For example, comparing pre-war conditions, rentals are substantially the same, whereas the cost of repairs has more than trebled. HOUSE-TO-HOUSE INSPECTIONS. (Tenement House Byelaws, Housing Consolidation Regulations.) On the 16th January, 1950, Mr. R. Clark was appointed as a temporary Sanitary Inspector, vice Mr. Parry (resigned), and he continued the survey of premises in the Belsize, Kilburn, Priory and West End Wards. 22 The following table summarises the house-to-house inspections carried out from the 1st February, 1949, to the 30th November, 1950. Street. No. of houses inspected. No. of Notices served. No. of Notices complied with. Recommended for Section 9 Notices. Netherwood Street 55 56 56 — Palmerston Road 51 40 40 — Kelson Street 14 14 14 — Broomsleigh Street 62 49 49 — Glastonbury Street 4 4 3 1 Ravenshaw Street 78 50 45 5 Sumatra Road 126 70 69 1 Dornfell Street 14 14 14 — Bolton Road 40 25 24 1 Holtham Road 16 7 — — Eresby Road 37 20 20 — Fleet Road 19 14 12 2 Kingsford Street 6 5 5 — Dunboyne Street 7 6 6 — Southampton Road 17 3 3 — Lowfield Road 46 40 38 2 Totals 592 417 405 12 Mr. Clark was subsequently appointed to the permanent staff to take over the District vacated by Mr. Robinson. The Public Health Committee recommended the continuance of the house-to-house inspections but decided, in order to spread the work throughout the Borough, that each District Sanitary Inspector be asked to carry out house-to-house inspections in his area each month. This scheme also had the advantage of ensuring that a large number of sanitary notices would not be served at one and the same time on an individual landlord—this tends to delay the execution of work. The Public Health Committee also recommended that an additional Sanitary Inspector be appointed and the Inspectors' areas made smaller, so that the general work in the area as a whole should not suffer. The tenement, etc., properties in Kilburn, West End and Fleet Road areas would thus be substantially covered by each of six District Inspectors, in whose areas they are included. The Provision of Housing Accommodation. During the year no less than 552 housing applications were referred to my department for a Sanitary Inspector's report as to the urgency of the case. These reports were supplied not only to our own Housing Estates Department but also to the London County Council and other Local Authorities, from whom enquiries were received. A large number of housing applicants base their claims primarily on insanitary conditions, and appropriate action is taken by the service of sanitary notices where the complaints are well founded. The Housing Estates Manager has supplied me with the following information:— NEW HOUSING ESTATES. During 1950, progress was made in the provision of new housing schemes, as follows:— 23 Well Walk. In January, 15 further flats were brought into occupation to complete the Well Walk housing scheme. The scheme comprises 64 flats and the estimated cost of the land and buildings is £176,000. The new estate was officially opened by His Worship the Mayor of Hampstead (Alderman R. J. Cleaver, J.P.) on the 8th July, 1950. The name given to the new flats is " The Wells House The Royal Institute of British Architects have described The Wells House as “a building of exceptional merit" and have awarded the London Architecture Bronze Medal for the three years ended 31st December, 1949, to the Architect, Mr. C. H. James, R.A., F.R.I.B.A. The Wells House was also selected by the Ministry of Health as one of the three best designed local authority housing schemes in the London Region to be completed between the end of the war and 31st December, 1949. The Council and the Architect were awarded diplomas and a medal by the Minister of Health. King Henry's Road Building work continued throughout 1950 on the 102 flats in this scheme. By the end of the year, 34 of the flats were completed and occupied. The estimated cost of the land and buildings is £246,000. The name given to the new flats is " Primrose Hill Court Kilburn Priory. Building work also continued throughout the year on the 60 flats in this scheme. By the end of the year, eight of the flats were completed and occupied. The estimated cost of the land and buildings is £147,000. The name given to the new flats is " Kilburn Gate ". West End Lane. Building work was commenced on the 80 flats in this scheme on 1st March, 1950. The contract date of completion is March, 1952. The estimated cost of the land and buildings is £193,000. Agamemnon Road. In September, 1950, work started on the erection of 8 threestoried houses in Agamemnon Road, at an estimated cost of £20,000 for land and buildings. Additional Schemes in various preparatory stages were:— Broadhurst Gardens 163 flats Shoot-Up Hill 112 flats Lawn Road 25 flats Primrose Hill Road 75 flats Kilburn Gate (second stage) 34 flats Eton Avenue 7 flats Dennington Park Road 17 flats Total 433 flats Requisitioned Properties. During 1950, 17 dwellings were provided in requisitioned properties. At the end of the year the total number of dwellings in requisitioned properties was 1,571. Work on the provision of accommodation for 24 an additional four families was in progress. Requisitioned properties are controlled by the Council on behalf of the Ministry of Local Government and Planning, which bears financial responsibility. War Damage. Building Licences were issued during the year for the repair of severely damaged and unoccupied premises, to provide a total of 13 dwellings. Licences were also issued for the rebuilding of war-destroyed" Cost of Works "houses to provide an additional 27 dwellings. Private Conversions and Buildings. During 1950, Building Licences were issued for the conversion of large houses by private owners to provide a total of 67 dwellings. The Council received applications for licences to build 140 houses and flats by private enterprise, but were only permitted by the Ministry of Health to issue licences for 26 dwellings—14 in Hampstead and 12 in other areas by arrangement with the local authorities concerned. Applications for Accommodation. Accommodation was found by the Council during 1950 for the families of 176 applicants, comprising 594 persons. During the year, 1,258 new applications were added to the housing Waiting List, and 444 applications were withdrawn, as a result of the applicants being rehoused by the Council or other Local Authorities, or having found their own accommodation. As a result of the nett increase of 814, the total number of outstanding applications on the Waiting List rose from 4,615 as at 31st December, 1949, to 5,429 as at 31st December, 1950. During the latter part of 1950 and the beginning of 1951, a review of the Waiting List took place and as a result the number of families found to be still seeking accommodation from the Council at 28th February, 1951, was 4,135. Housing Statistics. Details of properties owned, controlled and planned by the Council at 31st December, 1950, are given below:— (a) Pre-war Permanent Housing Estates. Park Dwellings 42 flats South End Close 140 flats Westcroft Estate 168 flats and 122 houses 472 dwellings (b) Post-1940 Permanent Housing Estates. Garnett House 22 flats Carnegie House 24 flats Wood Field and Barn Field 92 flats The Wells House 64 flats Primrose Hill Court 34 flats Kilburn Gate 8 flats 244 dwellings (c) Temporary Bungalows, Westcroft Estate 80 dwellings (d) Requisitioned Properties 1,571 dwellings (A) Total number of dwellings completed 2,367 dwellings 25 (e) Estates in course of erection:— Primrose Hill Court 68 flats Kilburn Gate 52 flats West End Lane 80 flats Agamemnon Road 8 houses 208 dwellings (f) Requisitioned dwellings: Work in progress 4 dwellings Additional Estates approved by the Council (in various preparatory stages:- Shoot-Up Hill 112 flats Lawn Road 25 flats Broadhurst Gardens 163 flats Kilburn Gate (second stage) 34 flats Primrose Hill Road 75 flats Eton Avenue 7 flats Dennington Park Road 17 flats 433 dwellings (B) Total number of dwellings in course of erection and contemplated 645 dwellings (C) Total number of dwellings completed, in course of erection and contemplated (A) plus (B) 3,012 dwellings Factories Act, 1937. The following tables give details with regard to inspection, etc., under this Act:— 1. Inspections. Premises. Number on Register. Number of Inspections. Written Notices. Occupiers Prosecuted. (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 319 192 24 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 275 85 9 — iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) 4 — — — Total 598 277 33 — 26 2. Defects found. Particulars. Number of cases in which defects were found. Found. Remedied. Referred to H.M. Inspector. Want of cleanliness (S.1) 29 27 — Overcrowding (S.2) — — — Unreasonable temperature (S.3) — — — Inadequate ventilation (S.4) 4 4 — Ineffective drainage of floors (S.6) 7 7 — Sanitary Conveniences (S.7): (a) Insufficient 2 2 — (b) Unsuitable or defective 1 1 — (c) Not separate for sexes 1 1 — Other offences against the Act (not including offences relating to outworkers) 11 10 — Total 55 52 — During 1950 no prosecution was instituted under the Factories Act, 1937. Outworkers. In accordance with the Factories Act, 1937, 26 Hampstead firms sent in lists of persons employed as home workers. Of the 357 persons so employed, 26 only resided in the Hampstead area. Information concerning 76 outworkers resident in Hampstead but employed by firms outside the Borough was received from other authorities. It will be seen, therefore, that there are 102 outworkers in the Borough. It has not been possible during the year to investigate in detail conditions under which they were carrying out work in their homes. Pharmacy and Poisons Act, 1933. During the year 104 applications for the renewal of poisons licences were granted. In eleven instances new licences were issued and five firms ceased to sell poisons. Water. The Borough's water supply is provided entirely by the Metropolitan Water Board and has been satisfactory in quality and quantity. No complaint of contamination was received. All the dwelling-houses in the Borough are supplied from public water mains direct to the houses. There are no wells or stand pipes. Bath Waters. Samples of water were regularly taken for chemical examination and bacteriological analyses from the Hampstead Swimming Baths. These proved to be satisfactory. Rodent and Pest Control. Prevention of Damage by Pests Act, 1949. The above Act came into force on the 3rd March,1950. It repealed the Rats and Mice (Destruction) Act, 1919, and substantially strengthens the powers of the local authority in dealing with the control of pests. 27 It is now the duty of the local authority to take such steps as may be necessary to secure so far as practicable that their district is kept free from rats and mice, and, in particular— (a) from time to time to carry out such inspections as may be necessary for the purpose aforesaid; (b) to destroy rats and mice on land of which they are the occupier and otherwise to keep such land so far as practicable free from rats and mice; (c) to enforce the duties of owners and occupiers of land under the Act, and to carry out such operations as are necessary in connection therewith. So far as occupiers of land are concerned (except as hereinafter stated) they are now under an obligation to give to the local authority forthwith notice in writing if it comes to their knowledge that rats or mice are living on or resorting to the land in substantial numbers. In the case of every person whose business consists of or includes the manufacture, storage, transport or sale of food, the foregoing requirement regarding infestation has to be given to the Minister of Agriculture and Fisheries. In the case of ordinary retail food premises, etc., it is normally the practice of the Ministry to refer such complaints to the Local Authority for disinfestation and any other necessary action. Under the old Act most of the above duties fell upon the individual occupier, the local authority having power to enforce the requirements in case of default. The Council employ two rodent operators for dealing with rats and mice complaints. Complaints of other pests and vermin are dealt with by the disinfecting staff. The number of complaints of rodents received during the year was 662, of which 315 related to rats and 347 to mice. The figures for 1949 were 597, of which 290 were rat and 307 mice infestation. Other pest infestations dealt with were:— Ants 11 Bugs 85 Cockroaches 70 Fleas 14 Mosquitoes 10 Weevils 6 As part of the organised campaign throughout the country for the eradication of rats in sewers, the whole of the sewerage system in the Borough was pre-baited and poison-baited twice during the year. Details are as follows:— January. July.  (1) Bait and poison used—2½ per cent. zinc phosphide, 4 oz. sausage rusk (2) Number of manholes baited 654 591 (3) Number of manholes showing pre-bait take 528 516 (4) Number of manholes showing complete prebait take (on one or both days) 370 212 3499 p.h. 200 7/51 (6428) Printed by harrison and sons, Ltd., St. Martin's Lane, London