Ac 4351 HAMP 54 Metropolitan Borough of Hampstead. Report on the Health of the Borough. 1953. DENNIS H. GEFFEN, O.B.E., M.D., B.S., M.R.C.S., L.R.C.P., D.P.H., Medical Officer of Health. Metropolitan Borough of Hampstead. Report on the Health of the Borough. 1953. DENNIS H.GEFFEN, O.B.E., M.D., B.S., M.R.C.S., L.R C.P.,D.P.H., Medical Officer of Health. 2 PUBLIC HEALTH DEPARTMENT, 33 LANCASTER GROVE, HAMPSTEAD, N.W.3 1st May, 1954. TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE METROPOLITAN BOROUGH OF HAMPSTEAD. Mr. Mayor, Ladies and Gentlemen, I have pleasure in submitting to you my Annual Report for the year 1953• Last year I gave you some indication as to the role of the Public Health Department In the care of the aged and of the number of persons who had been referred for help in solving their problems. It is now some time since the Department has taken an active part in this very serious problem and I have therefore thought it wise to place before you some of the facts and figures concerning those whom we have attempted to assist. The responsibility of the Borough Council emanates from two sources. In the first place a Ministry of Health memorandum dated 1925 lays down the general functions of the Medical Officer of Health in the following terms:- "To safeguard the health of the area for which he acts by such means as are at his disposal and to advise his authority how knowledge of public health and preventive medicine can be made available and utilised for the benefit of the community. He should endeavour to acquire an accurate knowledge of the influences, social, environmental and industrial, which may operate prejudicially to health in the area, and of the agencies, official or unofficial, whose help can be invoked in amelioration of such influences" In the second place the Medical Officer of Health has a specific duty under Section 47 of the National Assistance Act, 1948, to secure that any person suffering from grave chronic disease or who is aged, infirm or physically incapacitated and who is living in insanitary conditions shall be transferred to the appropriate hospital or institution unless the conditions under which he is living can be so ameliorated that he can 3 remain there without injury to his own health or nuisance to his neighbours. I am very conscious of the implications of these paragraphs and I would not feel that I was carrying out my duty to the area I serve if I did not place before you the conditions which I have observed during the past few years in respect of the care of old people, and the difficulties which have been met. Between September 1st 1950, and August 31st 1953, there have been referred to the Public Health Department 200 persons for general investigation to see in what way the Public Health Department could assist. As a routine, a visit is made as soon as possible by the District Sanitary Inspector who carries out a preliminary survey of the situation and indicates what services he considers are necessary. This visit may be followed by a visit from the Medical Officer of Health or his Deputy, and the Chief Sanitary Inspector. The policy of the Department has been to make every effort to maintain the old person at home by means of providing the appropriate amenities. We have now enquired as to the position relating to each of these persons as on September 1st 1953, and it will therefore be seen that the time of follow up of each case varies from a few weeks to three years. Of the 200 cases referred to the Department, 54 were males and 146 females. Of this number, 11 cases were below the age usually taken as the definition of old age, i.e. 65 years for males and 60 years for females, the age at which each sex can draw the contributory old age pension. These 11 cases were referred to us on account of chronic illness and have been excluded from this survey, which now includes 189 old persons, of whom 49 were males and 140 females. The excess of females is accounted for partly by the fact that we have included an extra quinquennium, i.e. 60-64 years and also by the considerably greater number of elderly ladies who live in Hampstead. The 1951 census population shows that there were 3,724 males over 65, and 10,842 females over 60, a ratio similar to the sex distribution of the cases upon which we are reporting, i.e. one male to each three females. Of the 140 females, 65 were unmarried, i.e. 46 per cent, of the total female cases. One immediately enquires whether this is the normal proportion taking the population as a whole. It is not. The number of single women over 60 in the population is 29 per cent, and the excess in our survey, which we must remember constitutes persons we were called in to help, is probably due to the fact that spinsters have neither husband nor children to care for them and are therefore more liable to need some form of help. This is a point, which I think must be considered when plans for the care of the aged are made and when a criticism is levelled at the younger generation for not taking care of their parents. 4 In Table I, I set out the age groups of the persons we were called in to help together with the incidence per 1,000 population. TABLE I Males Age Group No.of Cases Population Census 1951 Incidence per 1,000 65-69 9 1541 6 70-74 9 1105 8 75-79 15 692 22 80-84 10 286 35 85-89 6 82 73 90-94 – 17 – 95 + – 1 – Total 49 3724 13 Females Age Group No.of Cases Population Census 1951 Incidence per 1,000 60-64 8 3228 2 65-69 7 2801 3 70-74 30 2125 14 75-79 34 1481 23 80-84 33 804 41 85-89 15 300 50 90-94 13 91 143 95 + – 12 – Total l4o 10842 13 By and large, it becomes obvious that it is in the age groups over 75 that help is required. I think this must be considered in conjunction with controversies and arguments which are now taking place as to the proper age of retirement. The Council will be aware that with the present increase in the span of life, a heavy financial toll rests on the community in providing for retirement pensions. It has been argued, however, that with this increase in the span of life there is also an increase in the span of working capacity and that individuals over 60 and 65 are more able to continue their normal employment than heretofore. Certainly our figures show that it is in age groups well over 60 and 65 that help is required and our own experience justifies the statement that the average person cannot be considered old in any sense of the word either at 60 or 65. 5 Source of Notification. Table II shows how cases were referred to the departments:- TABLE II By whom notified No .of cases Relative 38 Doctor 32 Landlord 22 Member of Council 15 Friend 13 Tenant 12 Voluntary Body 11 Hospital Almoner 10 Housing Estates Manager 5 Home Helps 4 District Nurse 3 Sanitary Inspector 2 Health Visitor 1 Psychiatric Social Worker 1 L.C.C.Welfare Department 1 Hampstead. Old Peoples Welfare Assoc. 1 Clergyman 1 Solicitor 1 Unknown 19 Total 192 X x Double notifications were received in three cases. The diversity of source from which our help was sought gives some indication of the widespread concern of the public and social workers as to this problem on which we are writing. As would be expected our help was sought more in winter than in summer months, but not to the extent which one would have expected. In fact, taking October to March as covering the colder half of the year, there are 112 cases compared with 77 in the warmer months, 59 per cent, as compared with 4l per cent. Accommodation Occupied. Table III analyses by floor and rooms occupied the accommodation in which the old people lived. 6 TABLE III Floor No. of Rooms Unknown Rooms Total Percentage of Floor Known Comparison 1 2 3 4 Basement 3 8 – – 6 17 13 Ground 10 2 4 3 17 36 29 First 16 8 3 – 15 42 33 Second 4 4 – – 5 13 25 Third l 2 – – 1 4 Top 4 1 l – 8 14 Unknown 11 2 – 1 35 49 – Total 49 27 8 4 87 175 Note: In addition to the 175 above, 11 people lived in or shared a whole house, 2 lived in flats and 1 in a maisonette. Taking only the 126 cases where the floor occupied is known, one third lived on the first floor, just over a quarter lived on the ground floor, a quarter on the second, third or "top" floor and an eighth in the basement. Thus about three-quarters of the cases had to negotiate at least one flight of stairs. Turning to the number of rooms occupied there is a large group where the number was not recorded. But of the 88 where the information was available 56 per cent, lived in one room only, 30 per cent. in two rooms and the remainder in three or more. It is encouraging to find that 62 per cent, lived on the ground or first floor, as it is often assumed that because of the frequent association of poverty with old age, the old people can only afford basement or attic rooms. Nevertheless with 25 per cent, on the second, third or top floor, there is obviously a real problem of housing. Stairs are undoubtedly one of the difficulties and hazards of old age, especially if fuel has to be carried up and if the water supply and the W.C. are situated on another floor. The problem is further aggravated by the fact that old people who are merely experiencing difficulty due to stairs are not in a particularly advantageous position for rehousing compared for instance with married couples with children who are over-crowded, short of bedroom space, and who lack essential housing amenities. Nearest Relative. The present younger generation are frequently accused of neglect or denying their responsibility to their parents, It . has been argued that whereas in the past there was a legal responsibility not only for parents to look after their children, 7 but for children to look after their parents, recent legislation has entirely removed legal responsibility in the latter case and as a result thereof there has been given legal and therefore moral sanction to an attitude whereby children are entitled to say that their parents are no longer their responsibility. It is not our duty, nor would it be wise for us to say, whether in fact such an attitude exists.We can only report the facts as we found them in our survey of 189 old persons whom we were called in to help. In 16 per cent, the old people were actually living with their children, and If the spinsters be excluded then the percentage increases to 25 per cent. If those living with brothers and sisters or with their spouse are included then 32 per cent, were living in the same premises as a near relative. A further 6 per cent, were living with more distant relatives or friends. The fact remains, however, that no less than 62 per cent. were living alone. This is higher than the London figure which can be estimated from the 1951 census figures as 33 per cent, but it must be remembered that dealt with here are selected cases. Many old persons might live a happier, fuller life and retain their independence for a longer period if some arrangements were made whereby old age could be associated with family life and freed from loneliness and isolation in time of sickness and need. It is not our intention to pass any reflection on the younger generation. On the other hand, we would say this - it has been our experience over and over again to see unmarried daughters spending the best years of their lives looking after an aged parent. Whilst we admire this expression of filial affection and devotion we would state that children generally have no right to look to the unmarried sister as the one whose duty it is to devote herself to her parents. She has a right to her own life in the same way as her brothers and sisters and the least she can expect is their co-operation and assistance so that she may have as full a life as they have. We do not consider that the provision of board and lodging is a full compensation for many of the sacrifices that such unmarried daughters are expected to make. State of Health. Table IV sets out the state of health at the first visit from the department. TABLE IV State of Health No.of Cases Percentages Bedridden 20 17 Bedridden & Incontinent 12 Poor 54 28 Pair, Frail, Senile 81 43 Good 22 12 Total 189 100 8 Sanitary Condition. TABLE V Sanitary Condition No.of Cases Percentage Clean 108 57 Fair 39 21 Dirty 24 13 Insanitary 18 9 Total 189 100 As one of the factors that must be investigated before any legal proceedings under Section 47 of the National Assistance Act, 1948 can be taken, is the sanitary condition, especial interest is attached to Table V. 9 per cent, were definitely insanitary and another 13 per cent, dirty, making a combined total of 22 per cent. 57 per cent, on the other hand were considered to be clean. It might at first be thought that this proportion is rather high, when it is considered that there is a tendency to refer only the more difficult cases to the department. Perhaps part of the explanation is that in 22 per cent, of all cases the home help service was already attending at the time of the first visit (see Table VI). Services considered necessary. TABLE VI Services in attendance at time of first visit Services Required No.of Cases Percentage No.of Cases Percentage Home Help 41 22 38 19 District Nurse 41 22 13 6.5 Mobile Meals 24 12.5 11 5.5 Hospital 83 42 Home 37 18.5 N.A.B. 1 .5 D.A.O. 16 8 Action under S.47 – – Total 106 56.5 199x 100 x The excess is due to some patients requiring more than one service. Table VI shows the services in attendance and services considered necessary at the time of the first visit. 22 per cent, of the cases were already being attended by the Home Help Service and 22 per cent, by the District Nurse. Frequently, the department was summoned because it was considered to be impossible to continue treatment at home, and help was sought to expedite admission to hospital. This is 9 borne out by the fact that in 83 cases (42 per cent.) admission to hospital was considered to be the service required. In about 19 per cent, it was considered that the individual would be better off in a home. 16 cases (about 8 per cent.) were considered to need mental treatment and were referred to the Duly Authorised Officer, who took the necessary statutory action in respect of 13 cases. Of the 120 people who, it was considered, needed admission to hospital or a home, 86 (72 per cent.) were willing to go, and 34 (28 per cent.) were unwilling, at least when their admission was first suggested. Most of them later became willing as can be seen from the fact that in no case was it necessary to take court action to enforce removal under Section 47. The Follow-up. The primary object of this survey was to record the follow-up of those cases we had been called in to see, for in this we hoped would be our final assessment of the success or failure of our efforts. As previously stated we chose September 1st as the final date, being three years from the time when the first case in the series was referred to us. 45 per cent, had died,11 per cent,were patients in hospital and 5 per cent, were in homes. 22 per cent, were still at home. 17 per cent, had left their old addresses and we were unable to trace them. We have some difficulty in evaluating the above figures. It has never been my contention that persons should be removed to a hospital or institution just because they were dying, and indeed most people would, I imagine, prefer to die in their own home surrounded by the people who are nearest and dearest to them. In our series of cases however, it must be remembered that no less than 62 per cent,of the persons we were called in to see were living entirely alone and for them when serious sickness occurred there was little that could be done other than to remove them to surroundings where they could be made comfortable and be cared for. There is considerable difficulty throughout the country in obtaining admission to hospital for certain categories of old people. By and large, most hospital staffs are not anxious to accept patients who need little surgical or for that matter medical care, for whom little can be done, and who may occupy a bed for some very considerable time. It has been argued that if such persons be admitted the essential work of the hospital will be prejudiced and admission will have to be refused to acute surgical and medical cases where immediate treatment is needed and can effect a cure. The cases we are speaking of, however, are not cases that could alternatively be sent to an institution for their condition is such that they need a degree of nursing and medical care that can only be provided in a hospital. It is a fact that as our figures show, a large proportion (no less 10 than 45 per cent.) die within a short time. Of those who survive only a small proportion remain permanently in the hospital. Some recover sufficiently to be transferred to an institution or home for the aged, whilst others can be rehabilitated and return home, if the local authority is prepared to provide a certain amount of help and assistance in the home. In a realisation of these facts we would ask the hospital authorities to take as sympathetic an attitude as possible to the acceptance of the aged sick. We would make it clear immediately that the problem as we see it is not one which applies particularly to the Borough of Hampstead, where we have received every help from the hospitals and institutions concerned, but one which needs national understanding and realisation. Of the 85 who died, 57 survived less than 6 months from the time they were notified to us. Details of 43 cases still at home. Of the 43 cases still at home, 12 were considered to be in a poor state of health and may well require to go to hospital in the near future. 22 of the 43 eases were living alone and in 14 cases a home help was in attendance, in 4 cases the district nurse, and in 4 the mobile meals visit twice a week. These cases should be visited regularly so that further help may be obtained at the earliest opportunity. If they were visited once a month, this would mean a further 600 visits a year. At present the average figure for the last two years for visits by the Sanitary Inspectors is 566, and this figure includes certain re-inspections to certain cases, but not routine monthly re-inspections to all cases. Conclusions. In my opinion a time has come when the Medical Officer of Health of a local authority should have available to him notification of persons, of certain age groups, living in his district. Without this, any attempt to deal with the care of the aged will be piece-meal and will fail to prevent much of the unhappiness and many of the tragedies which it has been our lot to see. It is not sufficient that the Medical Officer of Health should be called in when there has been a breakdown in the independence of the old person. He should be able to supervise those members of his area before such an occurrence, for I am satisfied that with the use of many of the services available today much could be done to prevent and avoid the conditions which we are attempting to cure. In some boroughs staff have already been appointed to care for the aged in health rather than in sickness, and to bring to them those amenities which will prevent an eventual breakdown. Under adequate supervision the majority of old people can continue to live an active and happy life far beyond the three score years or even four score years mentioned in the Bible. Somehow or another we have to re-establish the old person as a member of the community and 11 to provide him with a life of usefulness and interest. The family doctor often with the assistance of the district nurse can secure that the aged person receives prompt treatment for minor ailments and discomforts. The home help can carry out those taskswhich are too heavy for the aged and which if neglected turn a home into a hovel. Clubs, meals at home and meals in restaurants, laundry service, library service, provision of wireless providing interest and obviating loneliness, chiropody clinics, and geriatric advisory clinics, help the old person to keep mobile and active. The voluntary visitor supervises and brings interest into the life of the individual, and the provision of holidays makes a welcome change not only to the old person but very often to those who have to look after him. The institution and the hospital or the home for the aged are a last resort. Housing can and in fact does do much to help. There are probably many children who would be more willing to have their parents living with them if the house or flat were designed to give some sort of separate accommodation for the father or mother-in-law. At least one authority has adopted a scheme of providing actual work suitable for old people. I think we may yet have to consider the possibility of accommodating old people by a scheme of fostering them. There are surely many younger people who would be prepared to accept a reasonably active old person in their household provided that the local authority paid what must be a generous remuneration for the responsibility they undertake, and they must be assured that in time of illness there will be hospital accommodation available until the old person has recovered. In the past we have realised the need of supervision of new bom babies and pre-school children where they have been deprived of parents. We sought originally to place them in institutions only to realise how much better off they were if they could live their lives with families and with family surroundings. Surely our position is the same in connection with the aged. Child welfare has proved its value over and over again, not only In the happiness and improvement in health that it has brought to children but in the actual financial economy it has effected. A proper understanding of the needs of the aged and the means to preserve them in health and happiness rather than to treat them when loneliness, sickness, poverty and disease has overtaken them, must be equally important in a community such as ours which year by year sees an increase in the proportion of old people in the population. This report would be incomplete if I failed to pay a tribute to the work of the Hampstead Old Peoples' Welfare Association and the various voluntary bodies associated with the care of the aged. In particular, I would refer to the help I have received from General Practitioners, Home Helps, District Nurses and last but by no means least the members of the Public Health Department. 12 I feel justified in saying,however, that the time is past when any Council can look to a Voluntary Body or a combination of Voluntary Bodies to deal entirely with the problem of the aged even supported with Local Authority finance. We should recognise,as we do,the pioneer work of such agencies. Comparison, however, is justly made with Child Welfare work which starting as a voluntary effort, proved its case so completely that it called for National adoption and Local Government administration, the greatest tribute that can be paid to any voluntary pioneer work. It is the composite administration of Local Government that is now required. If we are to see happy and healthy old age our schemes must be complete and not a question of chance and sporadic effort. As a Medical Officer of Health of nearly 30 years standing my conscience would not be clear if I did not state quite clearly my views on a position which I consider of National importance in the field of health. None has greater faith in voluntary effort than I have, but I have served Local Government nearly all my working life and I know how much it can achieve, how well and completely it could deal with this problem eertainly in happy co-operation with the work and inspiration of the voluntary movement. It is my pleasure once again to thank the members of the Council and in particular to the Public Health Committee for the courtesy and help I have received during the year. Lastly, I would refer to the fact that after being with us since 1st December, 1952 Dr. Warren has received promotion and will be leaving us to take up the position of Senior Assistant Medical Officer to the London County Council. Dr. Warren has shown a keen understanding of many of the problems of Public Health. I am indebted to him for most of the information In the opening remarks of this report, of an excellent survey last year of accidents in the home and a composite review on the population of Hampstead carefully extracted from figures of the 1951 census. Each month his value to me and to the Department has increased and whilst regretting his departure, I am glad of the promotion which he well deserves. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, DENNIS GEFFEN, Medical Officer of Health. 13 PUBLIC HEALTH COMMITTEE (as at 31st December, 1953) His Worship the Mayor (Mr. Councillor E,Snowman, J.P.), ex-officio member. Chairman; Councillor N. Oatway. Alderman S.A. Boyd, M.S.,F.R .C .S ., J .P. " Mrs. R.S.G. Carnegie. Councillor Miss D.R. Bailey, L.C.C. n L.H.H.G. Baldwin. " Miss E. Beer. " Mrs. F.E. Cayford, J.P.,L.C.C. n L.A. Curtis, A.M.H.C.I. " R.M. Matheson. " Mrs. Margaret Roome, S.R.N. " Mrs. P. Unwin. " Miss A.E. Walton, M.A. The Chairman of the Housing Committee. Sub-Committee: Drainage Plans. STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health: Dennis H. Geffen, O.B.E.,M.D.,B.S.,M.R.C.S., L.R.C.P.,D.P.H. Deputy Medical Officer of Healths M.D. Warren, M.D.,D.P.H.,D.I.H. Chief Sanitary Inspector: J.F. Armstrong (a), (b). Deputy Chief Sanitary Inspector: W. Robinson (a), (b) (up to 15.4.53) F.V. Outlaw (a), (b) (from 20.4.53) 14 Sanitary Inspectors: Mrs. C. Speechley (a), (d), (e), (f). 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), (b) (up to l8.10.55). R. Clark (a). F.E. Jackson (a), (b) (up to 1.3.53). G.A. Buckingham (a) (from 25.5.53). E. Ulrich (a), (b), (c) (from 1.10.53). Chief Clerk: A.H.C. Slade. Clerical Staff: R.Johnson (up to 15.5.53). G.W. Bedell. Mrs. M.C.Rabin. G.R.Young (National Service from 5.3.53). C.F. Pidgeon. M. Adams (Temporary. Up to 8.4.53). Mrs. G. Fletcher (Temporary. From 20.4.53). Mrs. P. Johns (Temporary.From 20.4.53 to 21.ll.53). J.A, Gilbody (from 29.6.53). Public Analyst: E. Voelcker, A.R.C.S ,F.R.I.C., 1 Tudor Street, E.C.4. Mortuary Keeper: S. King. (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. 15 LONDON COUNTY COUNCIL Public Health Department DIVISION NO.2 List of Clinics, Day Nurseries and School Treatment Centres, etc. situated within the Metropolitan Borough of Hampsteadi:- DAY NURSERIES (normally open all day, Monday to Friday) 1. Woodchurch, 11/13 Woodchurch Road, N.W.6. MAI 2937 2. Parkhill, 2 Parkhill Road, N.W.3. GUL 4759 3. Pond Street 27/29 Pond Street, N.W.3. HAM 1686 MATERNITY AND CHILD WELFARE CENTRES 1. 60 West End Lane, N.W.6. MAI 5381 2. 230 Haverstock Hill, N.W.3. PRI 3666 3. Hampstead Wells, Christchurch Hill, N.W.3. HAM 9534 4. 40 College Crescent, N.W.3. PRI 8033 5. Solent Road, Sumatra Road, N.W.6. HAM 5978 6. Lithos Road, N.W.3. HAM 4763 SCHOOL TREATMENT CENTRES 1. Kilburn Treatment Centre, 107 Kingsgate Road, N.W.6. MAI 3005 2, Lithos Road Centre, Finchley Road,N.W.3. HAM 4763 SPEECH THERAPY CENTRE West End Lane Welfare Centre, 60 West End Lane, N.W.6. BATHING CENTRE Hampstead Bathing Centre, Lithos Road, N.W.3. (This Is a Borough Council establishment at which school children receive treatment under arrangements made between the London County Council and the Borough Council.) DISTRICT NURSING ASSOCIATIONS Hampstead District Nursing Association, 3 Pond Street, N.W.3. HAM 6406 Kilburn & West Hampstead District Nursing Association, 20 Dennington Park Road, N.W.6. HAM 4232 16 TUBERCULOSIS CHEST CLINIC 54 Eton Avenue, N.W.3. PRI 7137 HOSPITALS Hospital Controlling Authority No. of Beds Marie Curie Hospital, 66 Fitzjohns Avenue, N.W.3. Harefield & Northwood Group 16 50 HAM 3150 New End Hospital, New End, N.W.3. Archway Group 19 236 HAM 5444 Queen Mary's Maternity Home, 124 Heath Street, N.W.3. Board of Governors, London Hosp. 42 HAM 6333 Hampstead General & N.W. London Hospital, Haverstock Hill, N.W.3. Board of Governors, Royal Free Hospital 140 PRI 1151 Royal Free Hospital, N.W. Branch, Lawn Road, N.W.3. do. 300 PRI 7671 Garrett Anderson Maternity Home, 40 Belsize Grove, N.W.3. do. 26 PRI 2246 St. Columbas Hospital, 98 Avenue Road, N.W.3. Paddington Group 21 32 PRI 4230 AMBULANCE FACILITIES The London County Council, as local health authority, is responsible under Section 27 of the National Health Service Act, 1946, for the provision of ambulance facilities within the administrative county of London. The Home Service Ambulance Department (Order of St. John of Jerusalem and British Red Cross Society) and the Hospital Car Service act as agents of the County Council in supplying some of the ambulance and car transport provided under the Act. 17 The Headquarters of the London Ambulance Service are at The County Hall, Westminster Bridge, S.E.1. Ambulances may be summoned as follows:- (1) Accidents ) Dial "999" (or follow Sudden illness in the ) the instructions given streets, public places ) on the telephone or places of employment. ) instrument) and ask (Note: for sudden ) for "AMBULANCE" illness in the home a ) doctor, not an ambulance ) should be summoned) ) (2) Maternity patients (who ) Telephone have booked a bed in a ) hospital or maternity ) WATerloo 6000 home) ) CENtral 63O1 Very urgent illness in ) REGent 4000 the home (provided a ) RELiance 3622 or doctor certifies that ) NEW Cross 2645 the case is one of life ) or death and arrange- ) ments have been made with ) a hospital for the ) patient's admission) ) (3) Illness, Infectious ) disease, etc. - removal to ) Hospitals, etc. For full ) particulars telephone ) WATerloo 3311 or write to the Officer- ) in-Charge, London Ambulance ) Service, The County Hall, ) S.E 1. ) STATISTICS AND SOCIAL CONDITIONS Area (acres) 2,265 Population: Registrar-General's estimate mid-1953 97,970 Census, 1951 95,131 Rateable Value, March, 1953 £1,675,560 Sum produced by 1d.rate £6,760 CENSUS, 1951 During the year the Registrar-General's Report on the County of London, based on the 1951 Census, was published. All the information relating to Hampstead has been abstracted and is printed together with comments, as an Appendix to this Report. 18 BIRTHS Live births:- Total Legitimate Illegitimate Males 738 658 80 Females 680 624 56 1,4l8 1,282 136 Birth rate per 1,000 of the estimated population l4.5 (Rate for London; 17.5) Area Comparability Factor .75 Number of Stillbirths .24 Rate of Stillbirths per 1,000 (live and still) births l6.6 DEATHS Net deaths (males, 519; females, 635) 1154 Death rate per 1,000 of the estimated population 11.8 (Rate for London: 12.5) Area Comparability Factor .94 Deaths from maternal causes 2 Deaths of infants under 1 year (males, 12; females, 11) 23 Infants under 1 years Infant Mortality Rates: All Infants per 1,000 live births 16 Legitimate infants per 1,000 legitimate live births 15 Illegitimate infants per 1,000 illegitimate live births 29 Deaths of infants under 4 weeks (males, 9l females, ll) 20 The causes of death, arranged under the headings of the short list used by the Registrar-General, are set out in the following list. There has been a slight Increase in the total number of deaths during the year (1,154 as compared with 1,097 in 1952). 19 The most striking difference is the increase in deaths as certified due to cancer, but most of this increase is due to a change of procedure in registration of deaths adopted by the Registrar-General during 1953, whereby deaths occurring in St. Columbas Hospital have been included in Hampstead's figures and not as in previous years, in the home town of the patient concerned. The number of deaths due to coronary disease which in the last 20 years has been increasing has actually fallen by one in Hampstead during the current year. The number of deaths due to street accidents was 9,an increase of 3 over last year, but deaths from other accidents decreased from 28 to 15. Causes of death 1. Tuberculosis, respiratory 11 2. Tuberculosis, other 1 3. Syphilitic disease 6 4. Diphtheria – 5. Whooping cough – 6. Meningococcal infections 1 7. Acute poliomyelitis 2 8. Measles 9. Other infective and parasitic diseases 2 10. Malignant neoplasm, stomach 53 11. Malignant neoplasm, lung, bronchus 77 12. Malignant neoplasm, breast 61 13. Malignant neoplasm, uterus 29 14. Other malignant and lymphatic neoplasm 190 15. Leukaemia, aleukaemia 9 16. Diabetes 6 17. Vascular lesions of nervous system 1ll 18. Coronary disease, angina 18l 19. Hypertension, with heart disease 23 20. Other heart disease 99 21. Other circulatory disease 46 22. Influenza 6 23. Pneumonia 49 24. Bronchitis 51 25. Other diseases of respiratory system 5 26. Ulcer of stomach and duodenum 10 27. Gastritis, enteritis and diarrhoea 6 28. Nephritis and nephrosis 9 29. Hyperplasia of prostate 4 30. Pregnancy, childbirth, abortion 2 31. Congenital malformations 2 32. Other defined and i11-defined diseases 6l 33. Motor vehicle accidents 9 34. All other accidents 15 35. Suicide 17 36. Homicide and operations of war –. 1,154 20 INFECTIOUS DISEASE The majority of notifications were due to an epidemic of measles in the early part of 1953• Whooping cough was the next most common disease notified. But it is to be expected now that immunisation against it is freely available at the Child Welfare Clinics, this disease will become much less common. Notifications of dysentery and food poisoning both increased and this emphasises a continual need for instruction in food handling. The one case of malaria that was notified occurred in a person recently returned from overseas. Hampstead was fortunate in not experiencing an epidemic of poliomyelitis during the year, particularly in view of the small epidemic that occurred in the Highgate district bordering on Hampstead Disease Notifications Removals to Hospitals Deaths Acute Encephalitis. Post Infectious 1 1 – Diphtheria – – – Dysentery 40 10 – Erysipelas 7 3 – Food Poisoning 21 2 – Malaria 1 1 – Measles 1,186 60 – Meningococcal Infection 3 3 1 x Ophthalmia Neonatorum 5 3 – Pneumonia 53 16 3 Poliomyelitis (Non-Paralytic) 2 1 – do. (Paralytic) 10 8 2 Ø Puerperal Pyrexia 34 33 – Scabies 24 – – Scarlet Fever 44 15 – Whooping Cough 215 21 – TOTAL: 1,646 177 6 Cancelled cases have not been included. x Death of un-notified case. ø Including one un-notified death. SMALLPOX No case of smallpox occurred in the Borough during 1953. 21 POLIOMYELITIS Age Paralytic Non-Paralytic M. F. M. F. Under 1 year 2 – – – 2 years old 1 – – – 3 " " 1 – – – 5 " " – 1 – – 12 " " 1 – – – 13 " " 1 – – – 15 " " – 1 – – 17 " " 1 – – – 24 " " 1x – – – 33 " " – – – – 4o " " – – – l x Died, There was also one un-notified death from paralytic poliomyelitis of a male aged 22, TUBERCULOSIS During the year 1955, 109 new cases of Tuberculosis were notified, 103 being cases of Pulmonary Tuberculosis and 6 of other forms of the disease. The following table gives an analysis of the newly notified cases and deaths during 1953. Age Periods New Cases Deaths Respiratory Non Respiratory Respiratory Non Respiratory M. F. M. F. M. F. M. F. Under 1 – – – – – – – – 1 - 4 – 1 – – – – – – 5-14 2 1 – – – – – – 15 - 24 10 13 – 1 1 – – – 25 - 34 13 8 – 3 1 3 – – 35-44 14 9 –* – – – – – 45-54 12 4 1 1 2 1 – 1 55-64 7 4 – – – – – – 65 and upwards 7 2 – – 3 – – – Totals 61 42 1 5 7 4 – 1 22 MASS X-RAY The Mass X-ray Unit was available to Hampstead residents from March 9th to April 1st 1953, when the Unit visited the North Western Polytechnic, Prince of Wales Road, N.W.5, and on the 27th, 28th and 29th of April when the Unit was in operation at the Royal Free Hospital, Lawn Road, N.W.3. No figures are available of attendances at the North Western Polytechnic, but approximately 1,400 appointments were made during the visit to the Royal Free Hospital, mainly of employees in the Borough. FOOD POISONING During the year we received 21 notifications of cases of Food Poisoning as follows:- 1st Quarter 1953 4 cases 2nd Quarter 1953 3 cases 3rd Quarter 1953 5 cases 4th Quarter 1953 9 cases Out of 11 single cases, the cause was unknown in six instances, and the Agent identified in the other five was as unders:- (i) Salmonella Typhimurium 3 cases (ii) Salmonella Heidelberg 1 case (iii) Coagulase-positive staphylococci 1 case There were two outbreaks involving four cases where the cause was undiscovered, and two outbreaks of six cases where the Agent identified was revealed as:- (i) Salmonella Typhimurium 3 cases (ii) Coagulase-positive staphylococci 3 cases BACTERIOLOGICAL EXAMINATIONS (infectious Diseases) The record of examinations carried out during the year by the Central Public Health Laboratory, Colindale, is as follows:- Throat/Nose Swabs Diphtheria Bacilli found Nil Haemolytic Streptococci found 20 Vincent's Angina organisms found 1 Negative 76 Faeces Shigella found 20 Salmonella found 13 Negative 109 23 Sputum T.B.Found 2 Other organisms found 6 Negative 14 Pertussis Positive 9 Negative 19 in all, 289 examinations were carried out on behalf of Hampstead doctors. The Department has an arrangement whereby specimens left at the offices by 2.3O p.m. are dispatched by hand to the Laboratories the same day. This service is used extensively. PUBLIC MORTUARY. NEW END During the year 248 bodies were brought to the mortuary; 10 by the Police, and 206 by order of the Coroner. 244 postmortem examinations were made. CLEANSING AND DISINFECTION OF VERMINOUS PERSONS AND THEIR BELONGINGS The following cleansing and medicinal baths were carried out at the Borough Council Cleansing Centre, during the year, where 31 adults and 11 children received treatment:- Verminous conditions; Adults 13 Children under 5 3 Children over 5 1 Scabies: Adults 18 Children under 5 7 Children over 5 – 24 cases of scabies were notified during the year. These were investigated by the Sanitary Inspectors and, where necessary, treatment arranged at the Public Health Station. This is an Increase of 7 over the previous year and is a reversal of the continuous drop that has occurred since 1946 when the notifications were 197. 24 During the year, the following treatments were carried out at the Centre on behalf of the London County Councils:- Verminous conditions: No. of school children treated 75 No. of treatments given 75 No. of pre-school children treated 2 No. of treatments given 2 This number is slightly less than last year. Scabies: No cases of school children arose during 1953• London County Council (General Powers) Act, 1953 Under Section 43 of this Act which came into force during the year, the Council are empowered to cleanse an aged person, on the application or with the consent of that person, at his home address. No case arose, however, where it was necessary for such action to be taken. DISINFECTION AND DISINFESTATION The following is a record of the work carried out by the Disinfecting Staff during 1953:- No. of calls by borough van 3,5l6 No. of articles passed through steam chamber 5,075 No. of rooms disinfested after vermin 28l No. of rooms disinfected after infectious disease 286 Requests for the disinfection of articles of clothing for despatch abroad has increased, and during the year 200 parcels were disinfected at the request of 162 senders. STAFF MEDICAL EXAMINATIONS 61 medical examinations were carried out of new entrants to the superannuation scheme or of persons on whom a special medical report was required. 50 of these were found to be fit, and 11 unfit. In addition, requests were received from education authorities for the examination of two teachers who resided in the Borough, and 15 medical examinations were carried out on behalf of the London Electricity Board. 25 NATIONAL ASSISTANCE ACT, 1948 Section 50 During the year 13 funerals were carried out under this Section. In five cases the full amount of the funeral expenses was recovered, either from the estate of the deceased or from liable relatives. Two cases were of newly born babies found on Hampstead Heath, the police being unable to trace the parents in either case. In three cases the funeral expenses were partially recovered, and in three cases negotiations were still in progress at the end of the year for recovery from liable relatives, or from the estate. The total cost of the funerals was £107.12s.3d. and an amount of £89.6s.l1d. was recovered, of which £7.10s.4d. was handed over to the Treasury Solicitor. SANITARY CIRCUMSTANCES OF THE AREA STAFF I regret to report the deaths of two members of the staff during the year - Mr. W. Robinson, who first came to Hampstead as a Sanitary Inspector in 1934, and was promoted to Deputy Chief Sanitary Inspector in 1949, and Mr. W. Stevens, Rodent Operative, who was transferred from the Light Rescue Service at the end of the War. Messrs. F.E. Jackson and K.F. Overy both resigned on securing appointments as Sanitary Inspectors elsewhere. Mr. F.V. Outlaw was promoted to Deputy Chief Sanitary Inspector and the vacancies were filled by Messrs. G.A. Buckingham, E. Ulrich andW.G. Clarkson (who commenced duties on 1st January, 1954). Despite so many staff changes, the work of the Department has been well maintained during the year. STATISTICAL SUMMARY. 1953 Sanitary Inspection Houses inspected on complaint 2,027 " " after infectious disease 559 " " under Sec.9, Housing Act, 1936 Nil House to House inspections 166 Inspections and revisits in connection with Loans under Sec.4, Housing Act, 1949 209 Special visits and re-inspections 10,198 26 Rehousing Visits and revisits in connection with the investigation of 856 rehousing applicants 1,665 No.of reports submitted to Hampstead Housing Estates Manager 6l4 " " " " " L.C.C.Estates Dept. 93 " " " " " L.C.C.Divisional Medical Officer 98 " " " other Boroughs 51 Notices Intimation Notices served 1,024 Statutory Notices served 318 Pood Premises Inspection of Bakehouses 97 " " Dairies and Milk shops 174 " " Catering establishments 618 " " Ice Cream premises 227 " " other food premises, stalls, markets etc 1,727 The Factories Act, 1937 Inspections and re-inspections made 204 Pharmacy and Poisons Act, 1933, Poisons Rules, 1952 Inspections made 37 Rag Flock, etc. Act, 1951 Inspections made 6 Shops Act, 1950 (Sec.38. Arrangements for health and comfort of shop workers) Inspections made 314 Drainage Works Plans and applications deposited for:- (a) Voluntary additional sanitary fittings or alterations to drainage 218 (b) Drainage and sanitary fittings required by Sanitary Notices 21 27 INSPECTION AND SUPERVISION OF FOOD AND FOOD PREMISES The new London County Council By-laws for the protection of food made under Section 15 of the Food and Drugs Act, 1938, came Into operation on the 3rd November, 1952. Every food trader, trading association, food staff organisations, Chamber of Commerce and street trader in the Borough has been notified of the requirements of the new By-laws. The new Food and Drugs Amendment Bill has been before Parliament and will soon become law. Its main objects are to revise the provisions for protecting the public against the sale of food containing injurious ingredients, and against the misdescription of food and drugs in labels and advertisements, and to provide fuller powers to secure that food is not contaminated in the course of preparation, distribution and sale. Local authorities, traders, organisations, etc. have had the opportunity of commenting on draft Food Hygiene Regulations which are expected to follow the new legislation. It is hoped that such Regulations when issued, will materially assist the local authority's officers in coping with present food hygiene problems, particularly with regard to the street trader and food vendors at Fairs and the . like. Proprietors of local catering establishments and licensed premises, together with members of the Public Health staff took part in the recording of a programme dealing with Food Hygiene which was subsequently broadcast by the B.B.C. Talks on Health Education generally, with Food Hygiene taking a prominent part, continue to be given by the Sanitary Inspectors at regular intervals to members of local schools, associations, societies, and organisations. Inspection of Food Premises Type of Premises No. on Register No. of Inspections Milkshops and Dairies 45 174 Ice cream premises 211 227 Butchers and Prepared Meat premises 79 687 Fishmongers 32 215 Fried Fish Shops 10 63 Bakers 39 97 Restaurants and Catering Establishments 165 618 28 Type of Premises No. on Register No. of Inspections Public Houses 36 172 Delicatessen 18 633 Confectionery 89 Grocers 118 Greengrocers 83 Off Licences 32 ICE CREAM The wholesale introduction of ice cream conservators and freezing cabinets and the vast increase in the production of wrapped ice cream have led to a considerable increase in the number of applications made to the Council for the registration of premises used for the manufacture, sale and/or storage of this commodity. Many types of business now wish to sell ice cream, in conjunction with their main business. Tobacconists, newsagents, fancy goods stores, stationers, general stores, greengrocers, fishmongers and butchers have all made application to be registered and the Council has had to give careful consideration as to whether, in its opinion, ice cream can safely be sold from such premises. In certain cases, written undertake have been secured that the ice cream shall be prepared and stored quite separately from other goods, and that the staff serving ice cream shall not handle other produce sold in the shop. The following statement sets out the types of premises registered under Section 14, Food and Drugs Act, 1938, for the sale, etc. of ice cream in the Borough:- Confectioners 47 Greengrocers 22 Grocers 46 Butchers 2 Tobacconists 7 Fishmongers 4 Restaurants 40 Garage 1 Dairies 18 Bakers 5 Stores 5 Toy Shop 1 Clubs 5 Florist 1 Off-Licence 1 Kiosks and Stalls 5 Public House 1 TOTAL: 211 MIIK SUPPLY The number of Licensed Distributors operating in the Borough is MILK (SPECIAL DESIGNATION) REGULATIONS In addition to obtaining milk samples from distributors direct, it is customary to take samples for both chemical analysis and Methylene Blue Test and Phosphatase Test from the various hospitals, schools and institutions in the Borough, 29 These have yielded excellent results, 4l satisfying the Methylene Blue and Phosphatase Tests which indicate keeping quality and efficiency of heat treatment, and 30 samples being genuine chemically.The average milk fat content was 3.8 per cent, as against a legal minimum of 3 per cento The number of Licences issued to traders is as follows;- Main Licence Supplementary Licence Pasteurised Milk 37 25 Tuberculin Tested Milk 33 26 Accredited Milk 5 5 Sterilised Milk 42 30 HAMPSTEAD HEATH FAIR The accompanying photographs give an indication of the high standards of cleanliness which now exist at many of the stalls owned by the fairground caterers; standards which have been achieved by the co-operation, good will and good sense of the stallholders and the unremitting and unstinted work of the Sanitary Inspectors. In this connection, I would particularly refer to the work of Mr. T.H. Marshall during the past five years. Whilst there has obviously been a considerable improvement in cleanliness at food stalls during this period, It must not be imagined that I feel any complacency regarding the present position. There is still plenty of room for further Improvement, but I doubt whether this can be obtained whilst the London County Council's present practice with regard to the letting of plots continues, viz. by tender to the highest bidder, without preliminary enquiries as to the cleanliness of the premises wherein the food to be sold is stored or prepared. Members of the Inspectorial staff and their assistants were on duty throughout the Easter, Whitsun and August Bank Holiday fairs. Apart from the general hygienic supervision of the fairground catering arrangements, your Inspectors took 105 samples for bacteriological examination and 70 for chemical analysis. My thanks are again due to Dr. Betty Hobbs, Principal of the Food Hygiene Section of the Government Central Public Health Laboratory, Colindale, for her very valuable co-operation and assistance, even to the extent of personal visits to the Heath to see for herself the particular catering hygiene problems involved. 30 Water being drawn for use at a food stall from one of the many stand pipes provided within 30ft. of all food stalls. An unlimited supply of mains water is thus provided. The gullies are provided to receive the waste waters from food stalls. 31 The interior of a mobile food preparation van. Here all food is prepared for immediate service to the customers at the temporary snack bar adjacent to the van. Typical of many similar outfits provided at a Bank Holiday Fair on the Heath. The policy is to encourage traders to prepare all food under hygienic conditions at the Fair, and to discourage food preparation in domestic kitchens, where the sanitary inspector has little or no control. 32 This is an example of a well organised system of washing up at a busy snack bar. The wash-up section is separate from the service section of the stall and separate bowls are being used for washing and sterilising the utensils in water to which has been added a bactericidal agent. 33 This is a typical example of Shellfish Stalls at the Fair. Metal table tops are provided and shellfish exposed for sale is reduced to the minimum. The stall is well protected, and a standpipe can be observed at the rear of the stall. 34 The following table shows the grading of Ice Cream samples taken at the fairground since the Wart:- Year No. of Samples Taken Grading under Meth Blue Test Percentages of Grades 1 and 2 Samples 1 2 4 1948 8 Nil 3 2 3 37.5 1949 9 1 2 3 3 33.3 1950 20 10 4 3 3 70.0 1951 38 23 6 4 5 77.8 1952 38 15 10 11 2 65.7 1953 42 18 10 4 10 66.6 FOOD SAMPLING (a) Bacteriological examination of food stuffs This service is undertaken by the Central Public Health Laboratory. I am greatly indebted to Colonel H.J. Benstead, the Director of the Laboratory, for unfailing co-operation and help. Details of the ice cream and milk samples submitted to bacteriological examination appear under the respective headings. Seventy-nine other samples were taken for examination. Some were routine samples} others for confirmation of unsound or defective tinning, etc. and a proportion were from suspected cases of food poisoning. The following table shows the variety of the examinations made and the results thereof:- Nature of Sample No. of Samples Satisfactory Unsatisfactory Spam sandwich 2 2 – Ham sandwich 5 4 1 Cockles 12 11 1 Mussels 3 2 1 Whelks 8 7 1 Jellied eels 3 3 – Cooked beef 1 l – Carried forwards 34 30 4 35 Nature of Sample No. of Samples Satisfactory Unsatisfactory Brought forward: 34 30 4 Gravy beef 1 1 – Tinned quartered apples 1 1 – Hamburger 4 4 – Meat pie 3 1 2 Sausage roll 2 1 1 Brisket sandwich 1 1 – Hot dog 4 4 – Steak pie 1 1 – Egg & veal pie l – 1 Pork pie 1 – 1 Veal & ham pie 1 – 1 Chopped pork 1 – 1 Beef roll 1 – 1 Pressed beef sandwich 1 – 1 Sausage sandwich 1 1 – Salmon & cucumber sandwich 1 1 – Corned beef sandwich 1 l – Ham roll 2 1 1 Pork luncheon meat roll 1 1 – Spam & tomato roll 1 1 – Tin grapefruit segments 3 3 – TOTALS: 67 53 14 In addition to the above, 12 samples of wash-up waters from ice cream servers were examined. (b) Samples submitted to Chemical Analysis Mr, Eric Voelcker, A.R.C.S.,F.R.I.C., Public Analyst to the Borough, has examined and reported upon 500 samples, of which 14 were classed as adulterated or unsatisfactory. Particulars of Adulterated Samples Sample No. Article Offence How dealt with 1 Piquant Appetiser Contained Hexamine Preservative Stock returned to country of origin. 2 Pearl Caviar do. do. 36 Sample No, Article Offence How dealt with 14 Medicine (Sumbul) Contained liquid extract of Belladonna instead of Tincture of Sumbul Pharmaceutical Society informed. (Manufacturers in liquidation). 156 Concentrated Tomato Paste Contained excessive amounts of copper and tin (Informal sample). Formal sample taken. 162 Tomato Paste Contained excessive copper Stocks withdrawn. Retailer and Wholesaler cautioned. Ministry of Food notified. 164 do. do. do. 171 Concentrated Tomato Paste Contained excessive amount of copper Stocks withdrawn and destroyed. Retailer and wholesaler cautioned. Ministry of Food notified. 232 do. do. do. 197 Chopped pork Contents only partially cooked and unfit for human consumption Stocks withdrawn and destroyed. Retailer and wholesaler cautioned. Ministry of Food notified. 324 Tomato Puree Excessive copper on dry matter Importers warned. Ministry of Food notified. 326 do. do. do. 447 do. do. do. 471 Cheese and Macaroni False description of cheese Formal sample taken. 481 Cream of Onion Soup Deficient in fat Manufacturer advised to alter label. 37 The percentage of adulterated samples in 1953 was 3.57 per cent, as compared with 1.97 per cent, in 1952 and 3.0 per cent, in 1951. FREE WASHING FACILITIES - PUBLIC CONVENIENCES In connection with the clean food drive, the Council has provided free washing facilities at its four public conveniences. Liquid soap and paper hand towels are available. The public and the street traders would appear to appreciate this facility Judging by the number of towels which have been issued. UNSOUND FOOD SURRENDERED DURING 1953 Article Quantity Almonds 18 cartons Baby Food 24 tins Bacon 9 lbs. Barley 16 lbs. ” 27 tins Biscuits 15 lbs. Cake Mixture 84 packets Cheese 188 lbs. Chocolate Cakes 32 Coconuts 1,400 Coconut Shredded 35 lbs. Confectionery 3½ lbs. Cream 8 tins Dried Figs 14 lbs. Fish 114 tins ” Cod 11 stone) ” Herring 14 stone) Total ”Rock Salmon 6 stone) ” Skate 3 stone) 60 stone w Whiting 26 stone) Flour 6 lbs. Fruit 2,042 tins Fruit Juice 9 tins Ham 39 lbs. Jam 95 lbs. Jam Rolls 149 lbs. Marmalade 29 lbs. Marshmallows 1,464 Meat 486 tins " Beef 3,478 lbs. ) ”Calves Head 283 lbs. ) " Chicken 253 lbs. ) ”Chicken Liver 75 lbs. ) " Duck 36 lbs. ) " Geese 287 lbs. ) " Lamb 133 lbs. ) 38 Article Quantity Meat Liver 12 lbs. ) ”Mutton 87 lbs. ) " Ox Brains 95 lbs. ) " Ox Heart 605 lbs. ) ” Ox Liver 122 lbs. ) Total " Ox Tongue 607 lbs. ) " Pigs Hearts 126 lbs. ) 7,239½ " Pork 671 lbs. ) " Rabbit 114 lbs. ) lbs. " Sausages 106 lbs. ) Sheeps Plucks 38 lbs. ) " Sweetbreads 46 lbs. ) ” Turkey 60 lbs. ) " Veal 5½ lbs.) Milk 227 tins Mincemeat 5 lbs. Nuts 28 lbs. Prunes 30 lbs. Raisins277 lbs. Rice 87 lbs. Salt 15 packets Sauerkraut 112 lbs. Soup 50 tins Spaghetti 25 lbs. Sultanas 213 lbs. Syrup 3 tins Tea Cakes 242 Vegetables 621 tins. Wherever possible, such food is salvaged for use either for animal feeding stuffs, soap manufacturing or other industrial purposes. Other condemned food is either destroyed at the Public Health Station or removed to the Council's Dusting Wharf for disposal with other trade refuse. HOUSING 1. Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 2,752 2. Number of dwelling-houses (included in (l) above) which were inspected and recorded under the Housing Consolidated Regs,1925 and 1932 (House to House Inspection) 166 3. Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil 39 4. Number of dwelling-houses found not to be in all respects fit for human habitation 1024 HOUSING ACT, 1936, PART II, SECTION 9 Repair of Insanitary Houses Except in very exceptional circumstances, the Council has discontinued the use of this Section. In fact, the ratio between rents and the cost of repairs is now so disproportionate that the Section is virtually inoperable. HOUSING ACT. 1936. SECTIONS 9, 10 and 16 Action under Statutory Powers Number of dwelling-houses In respect of which Notices were served requiring repairs Nil Number of dwelling-houses which were rendered fit after service of formal notices 3 HOUSING ACT, 1936, PART II, SECTIONS 11 and 12 No Demolition Orders were made during the year. Closing Orders were made on a mews dwelling of two rooms over a workshop, and on three second floor rooms of a tenement house. No Closing Orders were made on underground rooms. APPLICATIONS FOR REHOUSING It is the practice now to submit to the Public Health Department applications for housing in order that we may advise as to the number of points, 0 - 20, which might be awarded on medical grounds. In this respect it should be noted that cases are pointed by the Housing Estates Manager in respect of period on waiting list, overcrowding, bedroom deficiency, insanitary conditions, lack of facilities, separated families, half-way house accommodation, separate home, and service in Forces. Points awarded by the Public Health Department are made on medical grounds only. During the course of the year 603 applications were submitted and in each case investigations were made to ascertain the number of rooms occupied by the family, the sex and ages of the members of the family, the conditions under which they were living, and any medical conditions which might be improved by rehousing. 40 We wish to acknowledge the help we have received from the general practitioners of Hampstead who co-operate with us freely in order that a fair estimate can be made of each case. The following table sets out the points that were awarded. No points were given in 318 cases as there were no medical grounds which would not be met by points allocated by the Housing Estates Managers No. of cases Points given 318 Nil 2 2 118 5 88 10 53 15 24 20 603 x x This figure includes all those applications supported by a medical certificate which were on the waiting list in January, 1953, when the new points system came into operation, as well as the new applications since the middle of January, 1953. INCREASE OF RENT AND MORTGAGE INTEREST (RESTRICTIONS) ACTS No certificate was issued during the year. LEGAL PROCEEDINGS Public Health (London) Act. 1936 It is pleasing to record that for the first time for many years, it was necessary in only one instance to prosecute for non-compliance with a Statutory Notice. The work was done prior to the hearing and the Summons was dismissed on payment of £2.2s.0d. costs. London County Council Drainage By-laws Two builders were prosecuted in respect of infringements of these By-laws. In one case not only had the work been done improperly, but no notification was given to, nor plans deposited with, the local authority. Fines totalling £10 were imposed and £5.5s.0d. costs awarded to the Council. COMMON LODGING HOUSES There are no common lodging houses in the Borough. 41 WATER SUPPLY The Borough's water supply is provided entirely by the Metropolitan Water Board and has been satisfactory in quality and quantity. All the dwelling-houses in the Borough are supplied from public water mains direct to the houses. There are no wells or stand pipes. 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. The Council employ two rodent operators. Complaints of other pests and vermin are dealt with by the disinfecting staff. The number of complaints of rodents received during the year was 467 of which 150 related to rats and 317 to mice. The figures for 1952 were 545, of which 169 were rats and 376 mice infestations. Other pest infestations dealt with related to ants, bugs, cockroaches, fleas, flies, lice, pigeons, wasps, wood lice and woodworm. Charges for Rodent Extermination The Public Health Committee resolved that, until otherwise decided, no charge be made for the destruction of rats and mice by the Council at private premises, except in cases where, as a result of the lack of co-operation on the part of the owner or occupier, it was found necessary to serve a notice under Section 4 of the Act. Besides relieving the Department of much administrative work, this decision has materially assisted the staff in dealing speedily with complaints of rodent infestation. Charges continue to be made, in accordance with the Ministry's request, in respect of all Infestations at business premises. Sewer Maintenance - Treatment against Rodent Infestation As part of the organised campaign throughout the country for the eradication of rats In sewers, etc., the whole of the sewerage system was prebaited and poison baited twice during the year. I am indebted to the Borough Engineer for the following information regarding this aspect of rodent control. 42 The firsttreatment of sewers against rodent infestation for 1953 was commenced on 5th January and completed on 24th January. It was carried out in conjunction with the other Authorities of No.4 London Workable Area. The Ministry of Agriculture & Fisheries no longer assist Local Authorities by the loan of their rodent operators so the treatment was carried out entirely by the Borough Engineer's Department. As an experiment, motor transport was reduced to a minimum being used only for carrying gangs to their initial baiting places at the beginning of each day instead of remaining with the gangs. The daily areas were then traversed on foot and the materials transported by handcart. The arrangement was very satisfactory and Shewed a considerable saving in cost. The treatment was carried out on a three-day cycle as opposed to the four-day cycle previously in use. The procedure was to prebait for two days and poison on the third day at manholes where there had been a complete or partial take on the previous day's prebait. In the four-day cycle the fourth day was used for recording the results of the poison bait takes and counting the number of dead rats. The visit on the fourth day is not necessary since the effectiveness of the treatment Is determined from the prebait take figures. The prebait used was sausage rusk, with 2½ per cent, of zinc phosphide added for poisoning. Table I below gives the results of this treatment, tabulated for comparison with those for the corresponding period of 1952. TABLE I January 1952 January 1953 Increase (+) or decrease (-) of 1953 over 1952 No. of manholes prebaited 688 706 per cent. + 2.62 No. of manholes shewing complete prebait take 218 158 -27.5 No. of manholes shewing partial prebait take 170 388 +128.3 No. of manholes shewing no prebait take 300 160 -46.6 The comparative decrease in the proportion of complete takes to the number of manholes prebaited is from 31.7 per cent. in 1952 to 22.4 per cent. in 1953, while the increase in the proportion of partial takes to prebaits is from 24.7 per cent. to 55 per cent. (Table II). In the second treatment, which was carried out in June, 1953, 721 manholes were prebaited and the percentage of "complete takes" was further reduced to 8.17. 43 TABLE II 1951 1952 1953 No. of manholes prebaited 575 688 706 No. of complete takes 318 218 158 Percentage of prebaits shewing complete takes 55.4 31.7 22.4 The above figures shewing a gradual decrease in the number of "complete takes" indicate a further reduction in the rat population in the sewers. FACTORIES ACTS, 1937 and 1948 The following tables give details with regard to inspection, etc. under this ,Act:- Inspections Premises No. on Register Inspections Written Notices Occupiers Prosecuted (i) Factories in which Sec.l, 2, 5, 4 and 6 are to be enforced by Local Authorities 311 26 1 (il) Factories not included in (i) in which Sec.7 is enforced by the Local Authority 281 211 11 (iii) Other premises in which Sec.7 is enforced by the Local Authority (excluding outworkers' premises) 4 TOTAL: 596 237 12 - 44 Defects Found Particulars Number of cases in which defects were found Found Remedied Referred to H.M. Inspector Want of cleanliness (S.1) 16 8 1 Overcrowding (S.2) – – – Unreasonable temperature (S.3) – – – Inadequate ventilation (S.4) 3 – – Ineffective drainage of floors (s.6) 2 1 – Sanitary conveniences (S,7) (a) Insufficient 2 1 – (b) Unsuitable or defective 7 5 – (c) Not separate for sexes – – – Other offences against the Act (not including offences relating to outworkers) 3 3 1 TOTAL: 33 18 2 During 1953 no prosecution was instituted under the Factories Acts, 1937 and 1948, with regard to factories. OUTWORKERS In accordance with the Factories Act, 1937, 23 Hampstead firms sent in lists of persons employed as home workers. Of the 246 persons so employed, 56 only resided in the Hampstead area. Information concerning 78 outworkers resident in Hampstead but employed by firms outside the Borough was received from other authorities. PHARMACY AND POISONS ACT, 1933 During the year 112 applications for the renewal of poisons licences were granted. In 9 instances new licences were Issued and 5 firms ceased to sell poisons. 45 SECTION 54,THE FACTORIES ACT, 1937 Underground Bakehouses Proceedings were instituted under Section 54, Factories Act, 1937 in regard to an underground bakehouse which had become established without a certificate of suitability., The bakehouse concerned was originally an underground restaurant kitchen but the nature of the business gradually changed to that of baking cakes and pastries. The summons was eventually adjourned sine die on the receipt of an undertaking by the proprietor to re-arrange his premises by August, 1954. SWIMMING BATHS Samples of water were regularly taken for chemical examination and bacteriological analysis from the Hampstead Swimming Baths. These proved to be satisfactory. PET ANIMALS ACT. 1951 The administration of this Act is conducted by the Public Health Department; the Sanitary Inspectors and I have been authorised to act as Inspection Officers. Although this is a comparatively modest additional burden, there are some somewhat complex practical difficulties arising in connection with the licensing and inspection of pet shops, which require careful investigation. Five licences were issued during the year. HEATING APPLIANCES (FIREGUARDS) ACT, 1952 This Act received the Royal Assent on 1st August, 1952, and came into force on 1st October, 1953. The Act prohibits the sale or letting of unguarded domestic electric fires, gas fires or oil heaters, empowers authorised officers of local authorities to inspect and list appliances kept on any premises for sale or letting and imposes penalties for contraventions. This new legislation has been referred to the Public Health Department for enforcement. ATMOSPHERIC POLLUTION As a result of discussion between the London and Home Counties Smoke Abatement Society, the Department of Industrial and Scientific Research, and the Metropolitan Boroughs' Standing Joint Committee, it was decided that in order to make a useful study of pollution in the metropolitan area an additional 56 stations for the measuring, recording etc. of atmospheric pollution were needed. 46 So far as Hampstead was concerned it was suggested that two stations should be provided, the apparatus at each station to consist of (i) a deposit gauge (similar to a rain gauge) for recording pollution by ash or grit and (ii) a lead peroxide instrument for recording the activity of sulphur dioxide in the atmosphere in attacking the fabric of buildings. The sites selected for the stations were: the Hampstead Cemetery, Fortune Green Road, and the Metropolitan Water Board Reservoir, Barrow Hill. The installation was completed by the end of the year, and it was arranged for readings to commence on the 1st January, 1954. EMERGENCY WATER TANKS The problem of nuisance arising from disused emergency water tanks has received much consideration and it has been decided that the maintenance of emergency water tanks will now rank for civil defence grant. The responsibility for maintaining the tanks in London is that of the London County Council, but the local Borough Councils have agreed to act as agents for the cleaning out of the tanks. The tanks on the following sites were cleaned out once during the year by the Borough Council, the cost of £485 being reimbursed by the London County Councils 177 Adelaide Road 86 Adelaide Road Carlingford Road and Willoughby Road 63 Fitzjohns Avenue 20 Lindfield Gardens 47 Greencroft Gardens 1 Belsize Road Kilburn Priory and Springfield Lane Sumatra Road. Special inspections of the tanks were made to ascertain whether it would be possible to drain the tanks into existing intercepting chambers, but in only one case, Sumatra Road, was it found possible, and the London County Council agreed to make arrangements for this work to be carried out. THE RAG FLOCK & OTHER FILLING MATERIALS ACT. 1951 Only one firm has been registered under this Act. The premises of many other firms have been visited but in each case the work only concerned repair and reconditioning and did not therefore come within the purview of the Act. No samples of filling materials have been analysed during the year. 47 APPENDIX COUNTY OF LONDON CENSUS REPORT. 1951 48 COUNTY OP LONDON CENSUS REPORT, 1951 In my Annual Report for 1952 I drew attention to the age and sex construction of the population of Hampstead. With the publication of the County Report for London of the Census 1951 (H.M.S.0.1953) further details can now be given of the constitution of the population and of the housing accommodation of the residents. The total population in 1921 was 86,153, in 1931 88,947, and in 1951 95,131. There has therefore been a constant increase during the last 30 years. This is In contrast to the figures for the County of London which have shown a decline since 1931. This decrease in the County has affected more especially the central areas and the areas around the docks. Other Boroughs that have shown an increase are Lewisham and Woolwich. Density of Population. The density of population of persons per acre in Hampstead is shown in Table I. It will be seen that Kilburn Ward with 69.1 persons per acre is the most densely populated, followed by the Belsize and West End Wards. The Town Ward at 18.5 persons per acre is least crowded. These figures do not give a complete picture of overcrowding, as for instance included in the Town Ward there would be many acres of the Heath. These figures can be compared with the development figures for the County of London Plan which permit densities up to 136 in a large part of the Priory Ward and a small area round Oppidans Road, up to 100 in the Kilburn Area and most of the Belsize Ward, and up to 70 in parts of the Town and Central Wards. The constitution of the Parliamentary Constituency and of the Petty Sessional Division is the same as for the Borough. Age and Sex Structure of Population. The number and sex in each quinquennium and their civil state are shown in Table II. 58 per cent, of the total population of the Borough are female and this is in excess of the figure for the County of London as a whole, which is 53 per cent. This greater excess of females is also present in Chelsea, Kensington and St. Marylebone, boroughs which will be seen to have many other features in common. In Hampstead the excess of females is most marked in the quinquennia 15-19 and 20-24 where there are 164 females per 100 males, and 168 females per 100 males respectively. 44 per cent, of the population are single, 46 per cent, married and 10 per cent, widowed or divorced. These figures are similar to the other Metropolitan Boroughs except for a slightly greater percentage of widowed and divorced, with a slightly smaller figure for married people. This feature is also found in Chelsea, Kensington and St. Marylebone. 49 11.9 per cent, of the population are aged 65 or over, as compared to 11.1 per cent, so aged for the County. 14.5 per cent, of the population are aged 14 or less and 47.4 per cent .are between the ages of 15 and 44, with 26.2 per cent, aged 45 to 64. The total number of school children is lower than the average which is about 20 per cent. The City of London, Holborn, St. Marylebone and Westminster also have a lower proportion of school children. Place of Birth. A total of 19,349 people were born outside the United Kingdom and the Irish Republic and Table III shows the totals from each continent. Of these, 3,699 came from Commonwealth countries and from the Colonies. The proportion of the population who are immigrants (20 per cent.) is higher in Hampstead than in the County of London, (7.1 per cent.) and this figure itself is nearly 2 ½ times the proportion for the country as a whole. A large part of this excess of London over the remainder of the country is accounted for by the increase of numbers of Commonwealth and Colonial born persons. 62.5 per cent, of the present population of London were born in London, but it is calculated that below 45 per cent, of the population of Hampstead were born in Hampstead. Social Class. The Registrar General divides the working population into five social classes, which are constituted approximately as follows:- Social Class 1 - Professional etc. occupations. " " 2 - Intermediate occupations. " " 3 " Skilled occupations. " " 4 - Partly skilled occupations. " "5 - Unskilled occupations. The total figures for each class and the proportions per 1,000 of the total are shown in Table IV. As is the case in the County and in all the Metropolitan Boroughs, the biggest proportion of the male population over 15 occurs in class 3 and in Hampstead the second largest class is class 2, followed by class 1. This distribution only occurs in Chelsea, Kensington and St. Marylebone. Hampstead has a low proportion of classes 4 and 5 (15.4 per cent.). This figure is the lowest amongst all the Metropolitan Boroughs, the average for the County of London being 28 .8 per cent. This distribution ties up with the other findings in this report. The relatively low density of the population and the lower proportion of children 50 are both factors which have been repeatedly shown to be associated with the upper social classes. A further finding similarly related is the fact that 34 per cent, of persons aged 15-19 are still in full-time attendance at educational establishments. This is the highest figure for any Metropolitan Borough. Housing Conditions. The population of Hampstead is made up of 35,970 private households, of which in 20,800 the head of the house is married. Considering the age of the heads of all the households 11,4l8 (32 per cent.) are under 40, 14,777 (4l per cent.) are aged between 40 and 59, and 9,775 (27 per cent.) are over 60 as compared with 30 per cent., 4l per cent, and 29 per cent, respectively for London as a whole, showing that the average age for the head of the house in Hampstead is somewhat lower than for the County. These private households contain 88,119 persons, i.e. 92.6 per cent, of the population of the Borough. The remaining 7.4 per cent, live in non-private households. 2,932 (3.1 per cent.) people live in the larger hotels and boarding houses (with 10 or more rooms) and 646 people (0.7 per cent.) live in the smaller hotels and boarding houses. 433 people are housed in educational establishments and children's homes and 1,369 people were at the time of the census in hospital or a nursing home. 201 people were in a home for the disabled or aged, and a small miscellaneous number were in other communal establishments. The 201 people in homes for the disabled and aged were made up as follows: 8 persons (5 inmates and 3 staff) were in a home for the blind, and 193 persons of whom 168 were inmates were living in nine old persons homes. Of the 168 inmates 24 were male and 144 female. There was one person detained in a Police Station on the night of the Census in Hampstead. There are 179 hotels in the Borough with 10 or more rooms, made up as follows:- 102 hotels with 10 to 14 rooms 54 " "15 to 24 " 19 " " 25 to 49 " 4 " " more than 50 rooms and at the time of the census there were 1,978 resident guests in these hotels, a number exceeded only by Kensington with 5,986 and Paddington with 3,853. The distribution of the private households and the density of occupation by wards are shown in Table V. It will be noticed that the Kilburn Ward is the most densely occupied with 5.4 per cent, of persons at more than two per room. Priory Ward is second and Adelaide Ward is third, it is interesting to note that the density of occupation is not of the same order as the persons per acre as shown in Table I. 51 The greater density of occupation of Priory and Adelaide Wards is in part due to the fact that much property in these areas is let as rooms, as can be seen from the fact that these wards have the lowest number of structurally separate dwellings occupied. Table VI shows the number of rooms in each structurally separate dwelling and the number of households who occupy these rooms. This table does not show the number of persons living in these rooms which is shown in Table VII. It will be seen that of the 23,010 total structurally separate dwellings 8,639 (38 per cent.) consist of 1-3 rooms, 5/666 (25 per cent.) 4-5 rooms, 8,705 (37 per cent.) of 6 or more rooms compared with an average for England and Wales of 15 per cent, with 1-3 rooms, 64 per cent. 4—5 rooms, and 21 per cent, with 6 and over. The differences are linked with the changing social scene and are derived from the fact that 50 or more years ago the large houses (together with associated mews dwellings for their staff) were built for the type of families who then lived in Hampstead, whilst outside the main development has been of 4-5 room semi-detached houses. The figures for the County of London approximate nearer to the Hampstead figures. At the time of the census there were 894 (3.9 per cent.) dwellings vacant compared with 2.7 per cent, in the County of London Table VII shows the constitution of the households by number of persons and the number of rooms each household occupies and thus give., an indication of the degree of overcrowding in the Borough. Thus for instance, there are 77 households consisting each of 4 or more persons living in one room, 24 households of 6 or more persons living in 2 rooms and there is apparently one household of 10 or more persons living in 3 rooms. Unfortunately, these figures cannot be compared with the survey carried out in 1935 with regard to the overcrowding in the Borough as these latter figures related to the "equivalent number" of persons actually in occupation compared with the "equivalent number" of persons permitted to occupy that accommodation, whereas the present census figures relate to the actual number of persons in occupation of a certain number of rooms, no allowance being made for the size of thus room. It is difficult to make true comparisons with other Boroughs on these individual figures as there are so many variables concerned. However, taking the three Boroughs with a similar total population to Hampstead, the figures are as given in Table VIII. The 35,970 households contain 88,119 persons. 29 per cento (10,297) of the households are composed of single persons, 32 per cent. (11,587) of 8 persons, 19 per cent. (7.001) of 3 persons, 11 per cent. (3.999) of 4 persons and 9 per cent. of 5 or more. This compares with 19.7 per cent, 29.3 per cent, 22.9 per cent, 15.5 per cent and 12.6 per cent. respectively for the County. The greater number of single households is at once apparent and is, of course, an expected finding in view of the other characteristics of the population and housing in Hampstead. 52 This relatively greater number of small households is also a feature of Chelsea, Holborn, Kensington, Paddington, St. Marylebone, St.Pancras and Westminster. These Boroughs which are contiguous form the north-west area of the County of London. Of the total 88,119 persons in the private households in the Borough, 10,852 (12 per cent.) live in one room,l4,8l0 (17 per cent.) live in two rooms, and 23,649 (27 per cent.) in three rooms. The remainder live in four or more rooms. The figures for the County as a whole are 5 per cent., 14 per cent. and 29 per cent. respectively. Thus again the relative excess of single room occupation is seen. The average number of persons per room for the Borough as a whole is 0.8 as compared with 0.83 for the County in 1951, and 0.98 persons per room in 1931, and 1.05 in 1921. The figure for England and Wales in 1951 was 0.73. The second half of Table VII shows the number of households in shared dwellings, the first part of the Table referring to households in all (separate and shared) dwellings. As might be expected 72 per cent. of single person households share a dwelling. This is slightly higher than the overall figure for London which is 64 per cent. Taking all households it is found that 56 per cent. share a dwelling compared with 48 per cent. for the County. This again is a feature common to those Boroughs with a larger number of small households. Table IX shows the density of occupation (persons per room) of the private households. 81.1 per cent. of the private households in Hampstead live at a density of 1 or less person per room, compared with 79.2 per cent. for the County as a whole. The figure for Hampstead is by no means the highest in the County, for instance Woolwich has a figure of 86 per cent., St. Marylebone 85 per cent. and Wandsworth and Westminster 84 per cent. The lowest figure is 70 per cent. for Shoreditch. It will be noticed that this 8l per cent, of households represents only 72 per cent. of the population in private households. The percentage of persons living at more than 2 per room is 2.71 per cent. compared with a figure of 4.13 per cent. in 1931. The figures for the County of London are 2.55 per cent. in 1951 and 13.13 per cent. in 1931.comparing this with the other Metropolitan Boroughs, the lowest figure is 1.26 per cent. for Wandsworth and the highest 5.22 per cent. for Paddington. The area with the greatest improvement in this respect since 1931 forms a group of Boroughs centering on Stepney, an area affected by the pre-war slum clearance programme, the bombing, and the spreading of commerce from the City with a consequent retreat of the residential population. About 23 per cent. of the persons in each Borough lived at more than 2 persons per room in 1931, whereas in 1951 the figure was about 3 per cent. In the census of 1951 census questions were asked for the first time regarding certain household amenities, viz. availability of piped water, cooking stove, kitchen sink, watercloset, and fixed bath. 53 The information was derived from questions answered by the householder and not from data compiled by the census enumerator, as was the case with the number of rooms. The Registrar General remarks in his introduction to his report that there has been some inconsistency among heads of households in interpreting the meaning of the word "sharing" as well as a certain amount of inconsistency with the definition of the amenities themselves. However, he considers despite these inconsistencies that the record gives a reasonably accurate broad picture of these household arrangements. Table 13 of the Registrar General's Report shows the number of private households having exclusive use, sharing, or entirely without, the above household amenities. In Hampstead, 38 per cent. of private households have exclusive use of piped water, cooking stove, kitchen sink, watercloset, and fixed bath.78 per cent. have exclusive use of a cooking stove and sink, but a further small percentage have exclusive use of one or other, but not both. 34 per cent. of the households share a piped water supply and there are apparently 59 households out of a total of 35,970 entirely without piped water. Similarly, It was found that 4l per cent. share a W.C. and 60 households are apparently without. The figures of the households without water and without a W.C. would need careful checking to make sure that they did not arise from misinterpretation of the instructions on the census form. Unfortunately, in this respect, the census returns are entirely confidential and It is not possible to obtain the addresses of these households. 38 per cent, share a fixed bath and 16 per cent, are entirely without a fixed bath, but 10 per cent, of these households who either share or are without a fixed bath have exclusive use of all the other arrangements mentioned, so that by the addition of a fixed bath in these households, each household would have exclusive use of all the household arrangements. The sharing of piped water by households is high in those Boroughs which have a large number of one and two room occupations, and also in some of the East End Boroughs. The overall percentage of households sharing or not having a piped water supply for London is 31 per cent. and this compares with 17 per cent, for England and Wales. Similar considerations with regard to single room occupation and households of 1 person, account for the high incidence of households who share the domestic facilities in Hampstead, but it is notable that the number of households without any access to these facilities is low. Summary. The figures quoted in this survey reveal the composition of the population and the condition of the housing of the people of Hampstead and compare these facts with the County of London and other Metropolitan Boroughs. It is shown that Hampstead is essentially a residential Borough with a higher than average number of persons In the middle years of life, living in rooms in single person households. 54 TABLE I. Density of Population. (Table 3 Registrar General) Ward A creage Population 1931 1951 Persons Persons Males Females Persons per acre No. 1 Town 693 12,481 12,832 5,158 7,674 18 .5 No. 2 Belsize 270 14,334 15,894 6,624 9,270 58.9 No. 3 Adelaide 318 11,137 14,193 5,544 8,649 44.6 No. 4 Central 314 10,580 13,606 5,563 8,043 43.3 No. 5 West End 248 14,167 13,971 6,063 7,908 56.3 No. 6 Kilburn 187 15,124 12,929 5,899 7,030 69.1 No. 7 Priory 235 11,124 11,706 4,961 6,745 49.8 The Borough 2,265 88,947 95,131 39,812 55,319 42.0 55 TABLE II. Age and Sex Structure of Population. (Table 21 Registrar General) Age Last Birthday Persons MALES FEMALES Total Single Married Widowed Divorced Total Single Married Widowed Divorced All Ages 95,l3l 39,812 16,545 21,560 1,172 535 55,319 25,486 22,017 6,475 1,341 0-4 6,022 3,145 3,145 2,877 2,877 5-9 4,511 2,271 2,271 2,240 2,240 10 - 14 3,285 1,623 1,623 1,662 1,662 15 - 19 3,698 1,400 1,394 6 — — 2,298 2,217 81 — — 20 - 24 7,137 2,666 2,190 474 — 2 4,471 3,129 1,329 4 9 25-29 8,885 3,930 1,851 2,059 1 19 4,955 2,134 2,703 30 5,628 2,142 260 1,738 102 42 3,486 1,071 1, 606 694 115 60-64 5,164 1,936 222 1,528 152 34 3,228 1,013 1,245 889 81 65-69 4,342 1,541 168 1,172 176 25 2,801 819 875 1,061 46 70 - 74 3,230 1,105 97 778 220 10 2,125 596 509 999 21 75 - 79 2,173 692 76 442 167 7 1,481 393 247 830 11 80 - 84 1,090 286 31 157 97 1 804 223 92 487 2 85 - 89 382 82 9 33 39 1 300 71 12 217 — 90 - 94 108 17 2 5 10 — 91 24 3 64 — 95 & over 13 1 — — 1 — 12 1 2 9 - Note: For age and sex distribution shown for each year up to age of 20 see Table 23 of the County of London Report. 56 TABLE III. Place of Birth. (Table 20 Registrar General) Africa 902 America 1,161 Asia 1,925 Australasia 787 Europe 13,890 Oceania 6 Born at Sea 9 Birthplace not stated 669 19,349 TABLE IV. Social Class. (Table 27 Registrar General) Social Class Occupied and Retired males aged 15 and over Proportions per 1,000 total I 3,580 119 II 7,877 262 III 14,023 465 IV 2,420 80 V 2,242 74 All classes 30,142 1,000 57 TABLE V. Private Households and Density of Occupation by Wards. (Table 3 Registrar General) Private Households and Dwellings 1951 Ward Private Households Population in Private Households Structurally separate dwellings occupied Rooms occupied Density of Occupation Persons per room Percentage of persons at more than two per room No. 1 Town 4,210 11,518 3,343 17,412 0.66 1.3 No. 2 Belsize 6,258 14,182 4,279 17,642 0.80 1.6 No. 3 Adelaide 5,844 12,843 2,876 15,246 0.84 3.1 No. 4 Central 4,938 12,009 3,514 15,732 0.76 1.8 No. 5 West End 4,909 13,503 3,096 18,056 0.75 1.4 No. 6 Kilburn 4,841 12,661 2,157 13,730 0.92 5.4 No. 7 Priory 4,970 11,403 2,851 12,951 0.88 4.3 The Borough 35,970 88,119 22,116 110,769 0.80 2.7 58 TABLE VI. Structurally Separate Dwellings - Nos. of Rooms and Households (Table 10 Registrar-General) Structurally Separate Dwellings No.of rooms 1 room 2 rooms 3 rooms 4 rooms 5 rooms 6 rooms 7 rooms 8 or 9 rooms 10 or more rooms all sizes Occupied Total Dwellings occupied by:1 Private Household 1567 2698 3753 3161 1764 1345 664 786 457 16195 63570 64202 by 2 Private Households — 27 75 172 231 578 476 639 188 2386 15735 16298 by 3 or more Private Households — — 11 53 84 236 342 1582 1227 3535 31464 32240 Total dwellings occupied 1567 2725 3839 3386 2079 2159 1482 3007 1872 22116 110769 112740 Dwellings wholly vacant: Furnished 104 131 137 74 45 32 15 27 5 570 1877 Others 25 48 63 43 39 25 17 28 36 324 1602 Total dwellings occupied and vacant 1696 2904 4039 3503 2163 2216 1514 3062 1913 23010 110769 116219 Number of Private Households therein 1567 2752 35970 Miscellaneous habitations and institutions housing non-private households 375 N.B. The above section includes 5 caravans comprising 5 rooms occupied by 5 households. 59 TABLE VII. Constitution of households by persons and rooms. (Table 11 Registrar-General) Part (a) Households in all Dwellings No. of persons in household No. of households occupying the following number of rooms Total Households Total Persons in Households Total rooms occupied Average No. of persons per room 1 room 2 rooms 3 rooms 4 rooms 5 rooms 6 rooms 7 rooms 8 or 9 rooms 10 or more rooms 1 5789 2254 1463 463 164 88 29 28 19 10297 10297 18542 0.56 2 1855 3110 3743 1650 620 323 117 117 52 11587 23174 33312 0.70 3 340 1245 2374 1569 670 407 171 154 71 7001 21003 25270 0.83 4 59 499 1205 992 509 328 175 146 86 3999 15996 16551 0.97 5 12 91 370 4o6 294 249 119 158 68 1767 8835 8860 1.00 6 5 19 101 176 110 126 74 94 57 762 4572 4288 1.07 7 l 4 31 55 60 50 35 67 51 354 2478 2336 1.06 8 — 1 6 20 16 13 10 27 31 124 992 910 1.09 9 — — 3 5 4 3 4 10 15 44 396 362 1.09 10 or more — — l 4 4 4 4 8 10 35 376 292 1.29 Total Households 806l 7223 9297 5340 2451 1591 738 809 460 35970 Total Persons 1O852 14810 23649 16157 8206 5790 2922 3519 2214 88119 0.80 Rooms Occupied 8061 14446 27891 21360 12255 9546 5166 6761 5237 110723 Distribution per 1000 households by rooms occupied 224 201 258 149 68 44 21 22 13 1000 I 60 TABLE VII„ Constitution of Households by persons and rooms. (Table 11 Registrar-General) Part (b) Households in Shared Dwellings No. of persons in household No. of households occupying the following number of rooms Total Households Total persons in Households Total rooms occupied Average number of persons per room 1 room 2 rooms 3 rooms 4 rooms 5 rooms 6 rooms 7 rooms 8 or 9 rooms 10 or more rooms 1 4758 1534 898 185 50 17 3 8 3 7456 7456 11731 0.64 2 1423 1803 2155 671 155 43 15 6 2 6273 12546 15389 0.82 3 268 771 1390 653 189 71 13 10 3 3368 10104 10167 0.99 4 41 336 761 380 l40 64 15 7 3 1747 6988 5796 1.21 5 4 66 237 186 96 49 22 12 6 678 3390 2682 1.26 6 — 12 71 77 49 35 16 11 1 272 1632 1211 1.35 7 or more — 3 33 51 40 21 13 16 7 184 1369 946 1.45 Total Households 6494 4525 5545 2203 719 300 97 70 25 19978 Total Persons 5592 9220 14275 6783 2557 1183 434 324 117 43485 0.91 Rooms Occupied 6494 9050 16635 8812 3595 1800 679 579 278 47922 Distribution per 1000 households by rooms occupied 325 226 278 110 36 15 5 4 1 1000 61 TABLE VIII. Comparison with other Boroughs, (Table 11 Registrar-General) Borough Population 4 or more persons in 1 room 6 or more persons in 2 rooms 10 or more persons in 3 rooms Southwark 97,221 36 50 3 Stepney 98,858 66 53 4 Westminster 99,048 57 26 1 Hampstead 95,131 77 24 1 TABLE IX.. Private Households - Persons per Room (Table 12 Registrar-General) Total Over 3 3 and over 2 2 and over 1 ½ 1 ½ and over 1 1 or less Households in ALL dwellings at successive densities 35970 83 (0.2%) 502 (1.4%) 2927 (8.1%) 3298 (9.2%) 29160 (81.1%) Number of households in shared dwellings at successive densities 19978 49 385 2122 1899 15523 Population in ALL households at successive densities 88119 379 2006 8943 13480 63311 62 INDEX PAGE Aged Persons; Cleansing of 24 Survey 2 Ambulance Facilities 16 Area of Borough 17 Area of Wards 54 Area of Comparability Factors 18 Atmospheric Pollution 45 Bacteriological Examinations; Food 34 Infectious Disease 22 Bakehouses 45 Bathing Centre 15 Births l8 Burials 25 Census, 1951 17,48 Cleansing Station 23 Common Lodging Houses 40 Complaints 25 Contamination of Food 34, 37 Conveniences, Free Washing Facilities 37 Day Nurseries 15 Deaths; Chief Causes 19 Death Rate 18 Infant Mortality 18 Maternal Mortality l8 Disinfecting and Cleansing Station 24 District Nursing Associations 15 Division 2, London County Council 15 Drainage 26 Dwellings, structurally separate 51, 58 Emergency Water Tanks 46 Factories Act; Inspections 26, 43 Outworkers 44 Underground Bakehouses 45 Fair, Hampstead Heath 29 Food; Adulterated Samples 35 Bacteriological Examination 34 Bakehouses, Underground 45 By-laws 27 Chemical Analysis 35 Food and Drugs Amendment Bill 27 63 PAGE Food: (Contd.) Food Hygiene 27 Ice Cream 28, 34 Inspections 26, 27 Milk 28 Premises 26, 27 Sampling 35 Unsound Food 37 Food Poisoning 22 Free Washing Facilities 37 Hampstead Heath Fair 29 Heating Appliances (Fireguards) Act, 1952 45 Health Education 27 Hospitals 16 House-to-House Inspections . 25, 38 Households, Census 1951 59, 60 Housing: Applications for rehousing 26, 39 Census 1951 50 Closing and Demolition Orders 39 Housing Act, 1949, Section 4 25 Housing Act, 1936, Section 9 39 Housing Consolidated Regulations 38 Rent and Mortgage Interest (Restrictions) Act 40 Statistics 38 Unfit Houses 38 Ice Cream 28, 34 Infant Mortality 18 Infectious Disease 20 Intimation Notices 26 Legal Proceedings 40 London County Council 15 London County Council (General Powers) Act, 1953 24 Mass X-ray 22 Maternal Mortality l8 Maternity and Child Welfare Centres 15 Milk: Distributors 28 Special Designations, etc. Regulations 28 Supply to Schools and Hospitals 28 Mortuary 23 National Assistance Act, 1948, Section 50 25 National Assistance Act, 1948, Section 47 2, 9 Old People Survey 2 Outworkers 44 Overcrowding 51, 59 64 PAGE Parliamentary Constituency, Constitution of 48 Pet Animals Act, 1951 45 Petty Sessional Division, Constitution of 48 Pharmacy and Poisons Act, 1933 26, 44 Poliomyelitis 21 Population 17 Prevention of Damage by Pests Act, 1949 4l Public Conveniences 37 Public Health Committee 13 Public Mortuary 23 Rag Flock etc. Act, 1951 26, 46 Rateable Value 17 Rehousing 26 Rent and Mortgage Interest (Restrictions) Act 40 Rodent Control 4l Sampling 35 Sanitary Circumstances of the Area 25 Scabies 23 School Treatment Centres 15 Sewers, Rodent Control 4l Shops Act, 1950 26 Social Class of Population 49, 56 Smallpox 20 Speech Therapy Centre 15 Staffs Public Health Department 13 Inspectorial 25 Medical Examinations 24 Statistics: Sanitary Circumstances 25 Vital 17 Statutory Notices 26 Stillbirths 18 Structurally Separate Dwellings 58 Survey of Aged Persons 2 Swimming Bath Water 45 Tuberculosis: Chest Clinic 16 Mass X-ray 22 Notifications and Deaths 21 Underground Bakehouses 45 Unsound Food 37 Verminous Persons 23 Wards, Area and Population 48, 54 Water Supply 4l