AC 4351 Gck HAMP 56 Metropolitan Borough of Hampstead Report on the Health of the Borough. 1955 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. Gck d 24.6.56. Metropolitan Borough of Hampstead Report on the Health of the Borough. 1955 DENNIS H GEFFEN, O.B.E., Vf.D., B.S., M.R.C.S., L.R.C.K D.I'.H., Medical Officer of Health. 2 Public Health Department, 33 Lancaster Grove, Hampstead, N.W.3. 31st March, 1956. TO THE MAYOR, ALDERMEN AND COUNCILLORS OP THE METROPOLITAN BOROUGH OF HAMPSTEAD. Mr. Mayor, Ladies and Gentlemen, This is the sixth Annual Report which it has been ray privilege to present. It will also be the last, for the Council has determined to appoint a full-time Medical Officer of Health to the Borough of Hampstead, a decision I have advised and with which I heartily concur. I shall therefore be relinquishing my office as Medical Officer of Health as from 31st March, 1956. I have thought it wise in these circumstances to recall some of the major items of interest and the various changes which have affected the Public Health Department since my appointment on 1st September, 1950. Barbers and Hairdressers In 1951 I reported on the general condition of barbers and hairdressers establishments in the Borough. In that report it was found that on the whole the standard of barbers and hairdressers was reasonably satisfactory, though there was room for improvement in some cases. Since then in accordance with the London County Council (General Powers) Act, 1954, all barbers and hairdressers must be registered as from such time as may be determined by each Council and in Hampstead the date chosen was 1st October, 1955. In addition the General Powers Act gave authority to make byelaws governing the cleanliness of premises, instruments and employees. The Hampstead Council made byelaws which came into force on 1st December, 1955. Steps were taken to secure the registration of barbers and hairdressers and by the end of the year 70 had been so registered. In order to get a uniform standard of hygiene each barbers shop in the Borough so far registered has been inspected 3 by the Deputy Chief Sanitary Inspector and the proprietors have been informed of the various improvements that are required to meet the requisite byelaws. In future each District Sanitary Inspector will be responsible for the inspection of those barbers shops which are in his area. During the course of 1955, 102 visits were made to barbers shops. Accidents A report on Accidents was made in my Annual Report for 1952. It was shown that of all accidents which occurred in the Borough and were admitted to hospital, more than half occurred in the home. The remainder were at work, on the road, or in other public places. Injuries and deaths resulting from accidents now form major causes of disability and mortality. The majority of accidents, however, are preventable particularly those which occur in the home. It is obvious therefore that a new concept of the work of Sanitary Inspectors and Nurses is required; a concept which will embrace advice as to how home accidents are caused and can be prevented* Old Persons In 1953 a detailed report was made on Old Persons. The care of the aged Is still a problem which is not dealt with comprehensively. Responsibility is divided between the County Council, the Borough Council and voluntary bodies. Although some years ago agreement was reached between the London County Council and the Metropolitan Boroughs Standing Joint Committee that centralisation of the care of the aged should be effected through the Borough Town Halls, in practice this ideal has not yet been achieved. The care of the aged Is one of our most important problems. As the years go by the proportion of old people increases and the number of those who are unable to maintain themselves without help becomes greater. So that there may be no misconception I would like to say immediately that there has been excellent co-operation between the Hampstead Old People's Welfare Association, the Hampstead Council of Social Service, The Red Cross Society, the Home Help Department of the London County Council, the District 4 Nursing Associations and the Public Health Department of the Borough Council. The help of all these bodies is needed if old people are to be kept happy and as independent as possible in their own homes. Our Sanitary Inspectors advise and help as part of their routine work, and in addition the Public Health Department's help was sought directly during 1955 in no less than 48 cases. These were referred to us by friends and relatives, neighbours, the Home Help Department, Hospital Almoners, Doctors, Landlords, the National Assistance Board, and Welfare Associations. Census 1951 In my Annual Report for 1953 I included a survey of the Census of 1951; the composition of the population; the condition of housing of the people of Hampstead, and a comparison with other metropolitan boroughs. It was shown that Hampstead is a residential borough with a higher than average number of persons in the middle years of life living in rooms in single person households. There was also a larger proportion of females to males than in the majority of other London boroughs. Suicides In 1954 I reported on the suicides in Hampstead and again compared them with other metropolitan boroughs. The Hampstead suicide rate is higher than the average for the country as a whole, No definite conclusions could be drawn but the investigation suggested that this might be associated with the large number of immigrants who have found their way to Hampstead in recent years. Dr. M.D, Warren In referring to the above reports I would like to pay a tribute to Dr. M.D. Warren who was Deputy Medical Officer of Health to the Borough from December, 1952 to December, 1954, His fluent pen and his capacity for detailed investigation were of the greatest assistance to me in presenting these reports to you. Sanitary Inspectors The basic work of a Public Health Department originates from routine inspections carried out by the staff of Sanitary Inspectors, and complaints received in the Public Health Department. It is from these two factors that the work of the Department is built up. The achievements of the Department will 5 therefore depend on the keenness and efficiency of its staff of Sanitary Inspectors. It will also depend on having a sufficient number. During the past five years a number of Acts of Parliament have been passed whose administration has become the responsibility of the Public Health Department and which have therefore increased the work of its officers. These Acts include the - Housing Act, 1949, Pet Animals Act, 1951, Rag Flock and Other Filling Materials Act, 1951, Heating Appliances (Fireguards) Act, 1952, Housing Repairs and Rents Act, 1954, Food and Drugs Act, 1955 and the Food Hygiene Regulations, London County Council (General Powers) Acts, including the Registration and Inspection of Barbers Shops. The establishment for Sanitary Inspectors in 1950 was 11. In 1951 the establishment was raised to 12 but between the years 1951 and 1954 there was only one year when we had a full complement of Inspectors. In 1955 the establishment was raised to 15 but in fact there were only 12 Inspectors on the staff and the position remains the same today. The Council has realised that the shortage of Sanitary Inspectors is not only local but national, for the response to advertisements has been quite unsatisfactory. In March, 1955 a clerlk/trainee inspector was appointed in an endeavour to overcome the shortage of sanitary inspectors, and in December, 1955 a further clerk/trainee was appointed. In addition to these two appointments there was already one junior clerk who was undergoing a course of study for the Sanitary Inspector's Certificate. The Housing; Repairs and Rents Act, 1954 The Housing Repairs and Rents Act, 195 lays down the principles we should look for when assessing a house for fitness for human habitation. This is a very useful guide for the Sanitary Inspector in his work, especially when dealing with slum clearance. The same Act also introduced Certificates of Disrepair for houses which were not fit in every respect for habitation. It was hoped this Act would induce landlords to Pender their property fit for human habitation in all respects and to supply proper amenities. This object has been only achieved to a very limited extent. During the year 1955, 75 certificates of disrepair were granted and 4l revoked upon completion of the necessary work. 6 The following table sets out the progress since the Act came into force. The table indicates that landlords prefer to accept the previous controlled rent and not put themselves into the position of being presented with a certificate of disrepair, and sometimes even an intimation notice to remedynuisances which have been discovered when inspection is made in connection with the Act. There are other sections of this Act which in my opinion have not proved as useful as we had hoped. Section 11 deals with securing fitness for occupation in houses let in lodgings. The owner, however, has the opportunity of reducing the number of persons occupying the house instead of providing 7 the appropriate amenities and this irrespective of the security of tenure which the occupants might hold under previous Acts. As a result, local authorities have not felt inclined to take action which might have the effect of allowing landlords to determine tenancies during a time of serious housing shortage. The Food and Drugs Act, 1955 The Food and Drugs Act, 1955 and the Food Hygiene Regulations came into effect at the end of the year and provide very welcome powers to supervise food handlers. They require- that cuts or injuries be covered with a water proof dressing; that there shall be no smoking or spitting in food premises; that precautions shall be taken to prevent the contamination of food; that the wrapping of foods with newspaper shall be prohibited. There are effective penalties and these Regulations should make the task of the Sanitary Inspector easier. He will endeavour to introduce improvements by education and persuasion but failing this he will have the force of law to support him. On the other hand there will indeed be need of additional staff if steps are to be taken to see that all food premises in the Borough are regularly inspected. Atmospheric Pollution From a public health point of view I am happy to say that there is an increased awareness of the nuisance and indeed ill-health caused by atmospheric pollution. This interest is no doubt due to the Clean Air Bill which is before the House of Commons and also the publicity given to the correlation between smoking, a polluted atmosphere, and cancer of the lung. The prevention of the fouling of the air is a major Public health concern. It is possible that this will cost a great deal of money in the way of new installations in factories, and new heating appliances in the home, but it will be amply repaid by improved health and in economy in maintaining our buildings free from soot and grime. In recent years complaints of smoke nuisance have increased and the following smoke observations have been made by your Inspectors: 1950 1951 1952 1951 1954 1955. 19 57 52 59 220 232 8 Housing Act, 1949 Section 4 of the Housing Act, 1949 enables the Council to assist residents to purchase their own houses. It entails considerable work in the Public Health Department for each house must be fit, or rendered fit, for human habitation if the Council is to grant a loan. Similar work is involved under Section 20 which deals with improvement grants. In each case initial inspections have to be made and supervision carried out whilst repairs are in progress. Further visits will have to be made to see that the premises are maintained in a satisfactory condition. The following tables and diagram show the extent of the work carried out in the past years. It will be seen that 83 applications were received in 1955 for loans under Section 4, i.e. from persons desiring to buy and own their own home with help from the Council and that this number has increased year by year since 1951• The number of improvement grants is not yet large but it must be noted that 21 applications were received in 1955, compared with 8 in 1954. Applications received for Section 4 Loans Applications received Loans Applications withdrawn Granted Refused 1951 January - June 1 1 - - July - December 9 2 2 5 1952 January-June 7 5 2 - July-December 6 2 2 2 1953 January-June 13 6 1 6 July-December 14 10 1 3 1954 January-June 16 14 2 - July-December 36 25 8 3 1955 January-June 32 22 9 1 July-December 51 46 4 1 TOTALS 185 133 31 21 9 Improvement Grants 1954-1955. Applications Received Granted Refused Withdrawn 1954: Jan.-June 2 2 - - July-Dec. 6 3 3 - 1955: Jan.- June 14 6 3 5 July-Dec. 7 4 2 1 Totals 29 15 8 6 10 Infectious Disease At the beginning of 1955 an outbreak of measles occurred. The total number of cases notified was 1,028. Only 10 were reported as severe. On 6 occasions measles was complicated by severe bronchitis, on 2 occasions with unduly severe conjunctivitis and 2 further cases with otitis media. There were no deaths and indeed looking at the figures for the past 10 years death has only occurred once in 1946 and once in 1951. Of the total number of 1,028 cases 37 were removed to hospital, i.e. 3.6 per cent. which is the lowest percentage for the past 10 years. Removal has very little relationship to the severity of the attack; rather is it associated with adverse housing conditions. If a general practitioner wishes to prevent or attenuate an attack of measles in a patient who has been in direct contact with a case, he may apply to the Public Health Laboratory Service for gammaglobulin. The use of gammaglobulin is indicated to prevent measles in a very young child or in a child already suffering with whooping cough or some other illness to which the complication of measles might have serious results. There was only one small outbreak of dysentery apart from cases which occurred in individual households. This was in a school and affected 9 people. The illness was very mild and was soon brought under control. It occurred at the beginning of the Easter holiday and one of the children who was a carrier left for a school holiday the day after the faecal specimen was collected. Unfortunately we were compelled to cut short this girl's holiday and bring her home again. The total number of food poisoning cases notified was 56, an increase on the previous 5 years. Medical journals regret that only in 60 per cent. of cases is the causative agent discovered and suggest that this is due to late notification. By the time the general practitioner is called in and has notified the Medical Officer of Health all the suspected food has been consumed or destroyed and very frequently the patient has recovered. I am pleased to report that of the above 56 cases of food poisoning, in 45 instances the agent was identified so that in Hampstead we have done very much better than in the country at large. For this I am indebted to the speedy investigations on the part of the staff of the Department. Only 10 cases of food poisoning were removed to hospital, which is an indication that the remainder were not severe. There were no deaths. 11 There was an outbreak of poliomyelitis of moderate severity throughout the country and it affected the population of Hampstead as well. We had 9 cases of paralytic poliomyelitis and 28 non-paralytic. No death occurred. Immunisation against poliomyelitis is to be introduced in the middle of 1956 and offered to children between the ages of 2 and 9. It is hoped that one tenth of the children In this age group will be immunised before the seasonal increase of poliomyelitis commences. By the end of 1956 there should be enough vaccine available to immunise everybody who wishes to be protected. The English vaccine is stated to be as safe as any vaccine can be made. It is similar to one used in the United States of America and Canada, of which 20 million doses have been given to 10 million children. The American experience has undoubtedly been of the greatest help in the preparation of the vaccine to be used here, and in fact the English vaccine will not contain that virulent type of polimyelitis virus which was responsible for some of the unfortunate events which occurred in the United States. It is certain moreover that no batch will be released until it has passed the most stringent safety tests. The vaccine is likely to reduce the incidence of paralytic poliomyelitis quite considerably in those who receive it and will be given in two doses at an interval of not less than 3 weeks. I would warn the public against expecting too much. It is not suggested that this vaccine will prevent poliomyelitis in all those who receive it. It is a first step towards the conquering of this disease which in recent years has caused so much fear and anguish to parents. 4 cases of typhoid fever were notified. 2 of them were associated with an outbreak affecting Polish nationals. This outbreak originated from a birthday party which was given by a Polish lady who had typhoid fever some 27 years ago and was still a carrier of the typhoid bacillus. She had infected the food supplied to her guests and from this party 11 cases of typhoid occurred, 2 of them residing in Hampstead. It is of interest to note that 2 of the patients in this outbreak presented themselves to their doctors with symptoms of gall bladder complaint. Their gall bladders were removed and only on subsequent investigation was it discovered that they were suffering from typhoid fever. The number of new cases of tuberculosis notified was 88. 12 In 195° to 1954 there were 105, 111, 115, 109 and 102 cases notified respectively. This is a definite trend in the right direction and I am confident it will accelerate in the years to come. The number of deaths was 15, compared with 19, 12 and 12 in the years 1952, 1953 and 1954, and I hope this figure will show the same downward trend. Of the new cases notified only 4 were non-respiratory tuberculosis and there were 2 deaths in this group. It is fair to say that non-respiratory tuberculosis has been substantially controlled. During the summer months an outbreak of infectious disease occurred which affected a number of hospitals in Hampstead and St. Pancras belonging to the Royal Free Hospital Group. Infection spread from the staff of one hospital to another. The outbreak mostly affected the nurses and resident staff. This epidemic caused very great concern to the Governor: of the Hospitals, the consultant staff and all those whose dutylay in the Group. One by one it was necessary to close each hospital to prevent the spread of the disease and in some cases because nursing staff was not available to look after the patients In due course a complete report will be published and I do not wish to anticipate its conclusions. Some 300 individuals contracted the disease and I am pleased to say that at the time of writing this report no deaths were recorded directly due to the disease, and in fact all but 4 or 5 have recovered. Even those still ill are showing signs of improvement. Appendix The Annual Report of the Medical Officer of Health is very often used for reference purposes by members of the Council who are called upon for advice on many matters with a medical or social aspect. I have therefore thought it wise to include an Appendix in which I have set out details of the many statutory and voluntary bodies engaged in the welfare of persons in the Borough, and in some cases a brief description of the services they perform. Conclusion I am now left with the pleasant task of thanking those who have helped me during the five and a half years I have been Medical Officer of Health to Hampstead. I have received unfailing courtesy from the Aldermen and Councillors themselves, and at much indebted indeed to the Chairmen of the Public Health Committee and of the Housing Committee, whose help and 13 encouragement I have consistently received. I hope I have contributed to the health of the Borough in which I received my early education at its largest public school, namely, University College School. The years have passed very quickly and very happily and for this I am indebted to the co-operation and help I have received from the Chief Officers and the members of my own Department. I would like to give a welcome to Dr. Duncan Dewar, a colleague and a friend who now succeeds me, and to wish him every success in his appointment. I have the honour to be, Mr, Mayor, Ladies and Gentlemen, Your obedient Servant, DENNIS GEFFEN, Medical Officer of Health. 14 PUBLIC HEALTH COMMITTEE (as at 31st December, 1955) The Worshipful the Mayor (Councillor Miss D.R.Bailey, L.C .C., J.P.), ex-officio member. Chairman: Alderman S.A. Boyd, M.S .,F .R .C .S. Alderman Mrs. R.S.G. Carnegie. Councillor L.H.H.G. Baldwin. " Miss E. Beer. „ Mrs. F.E. Cayford, J.P.,L.C.C. " L.A. Curtis, A.M.H.C.I. „ Mrs. R. Mactaggart. " R.M. Matheson. „ N. Oatway (Vice-Chairman). " Mrs. Margaret Roome, S.R.N. " Mrs. P. Unwin. " B.J.J. West. The Chairman of the Housing Committee. Sub-Committees; Drainage Plans. Housing Repairs and Rents Act. Representatives on outside Committees and other Organisations concerned with Public Health work: Hampstead Council of Social Service: The Worshipful the Mayor Councillor Miss D.R.Bailey, J.P.,L.C.C., Alderman Mrs. R.S.G. Carnegie, Councillors Miss S.H. Ayliff, Mrs. Margaret Roome, S.R.N., E. Snowman. The Hon. Mrs. G. Ruth Bennett. Hampstead Old People's Housing Trust Ltd.; Councillors Miss S.H. Ayliff, R.M. Brodtman, E. Snowman, Mrs. H.M. Young« Hampstead Old People's Welfare Association: Aldermen Mrs. R.S.G. Carnegie, R.J. Cleaver, L.C.C., Councillors Miss S.H< Ayliff, Miss E. Beer, Mrs. R.Mactaggart, Mrs. Margaret Roome, S.R.N., A.E. Skinner. Hospital Management Committees; Archway Group: Mrs.M.Ormerod, B.A., Mrs.M.J,Oatway. 15 Paddington Group: No.4 House Committee; Councillor Mrs.H.M.Young. N0.5 House Committee: Councillor Mrs.C.L.Sadler. London County Council Divisional Health Committee, Division 2: Aldermen S.A.Boyd, M.S.,F.R.C .S.,Mrs.R.S.G.Carnegie, Councillor Mrs. C.L. Sadler. National Smoke Abatement Society: Alderman S.A. Boyd, M.S.,F.R.C .S., the Medical Officer of Health. STAFF OF THE PUBIC HEALTH DEPARTMENT Medical Officer of Health: Dennis H. Geffen, O.B.E.,M.D.(Lond.), M.B.,B.S.(Hons.), M.R.C .S.,L.R.C.P.,D.P.H. Deputy Medical Officer of Health: (from 1.2.55) I.A. Bolz, M.D.(Vienna), D.P.H. Chief Sanitary Inspector: J.F. Armstrong (a), (b). Deputy Chief Sanitary Inspector: F.V. Outlaw (a), (b). Sanitary Inspectors: Mrs. C. Speechley (a), (d), (e), (f). L.E. Trigg (a), (b). W.F. Newport (a), (b). D.W. Malcolm (a). G.L. Nicklin (a). R. Clark (a). G.A. Buckingham (a) (up to 31.5.55). E. Ulrich (a), (b), (c). G.R. Watkin (a), (b) (up to 31.8.55). C.S.T. Dancer (a), (b) (from 1.9.55). G.R. Young (a) (from 15.3.55). R.W.M. Cook (a) (from 1.3.55). 16 Chief Clerk: A.H.C. Slade. Clerical Staff: G.W. Bedell. Mrs. M.C. Rabin. C.F. Pidgeon. J.A. Gilbody. Mrs. G. Fletcher. D. Ring (from 14.3.55) 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. 17 STATISTICS AND SOCIAL CONDITIONS Census 1951. Ward Statistics Ward Acreage Population persons per acre Private Households Structurallyseparate dwellings occupied 1. Town 693 12,832 18.5 4,210 3,343 2. Belsize 270 15,894 58.9 6,258 4,279 3. Adelaide 318 14,193 44.6 5,844 2,876 4. Central 314 13,606 43.3 4,938 3,514 5. West End 248 13,971 56.3 4,909 3,096 6. Kilburn 187 12,929 69.1 4,841 2,157 7. Priory 235 11,706 49.8 4,970 2,851 The Borough 2265 95,131 42.0 35,970 *22,116 x A further 894 structurally separate dwellings were unoccupied. Registrar General's estimate of Population mid-1955 97,710 Rateable Value, March, 1955 £1,698,875 Sum produced by Id. rate £6,907 No. of separate rating assessments of dwelling houses, flats and other residences 21,751 Births: Total Legitimate Illegitimate Males; 736 666 70 Females: 642 589 53 1,378 1,255 123 Birth rate per 1,000 of the estimated population 14.1 Area Comparability Factor 0.75 Number of stillbirths 32 Rate of stillbirths per 1,000 (live and still) births 23 Deaths Net deaths (males, 48l : females, 500) 98l Death rate per 1,000 of the estimated population 10.0 Area Comparability Factor 0.94 Deaths from maternal causes NIL Deaths of infants under 1 year (males, 13 : females, 11) 24 18 Infants under 1 year: Infant Mortality Rate; All infants per 1,000 live birthS 17 Legitimate infants per 1,000 legitimate live births 16.7 Illegitimate infants per 1,000 illegitimate live births 24.4 Deaths of infants under 4 weeks (males, 9; females, 10) 19 The causes of death for 1954 and 1955, arranged under the headings of the short list used by the Registrar-General, are set out in the following list: 1954 1955 1. Tuberculosis, respiratory 10 13 2. Tuberculosis, other 2 2 3. Syphilitic disease 5 4 4. Diphtheria - - 5. Whooping Cough - - 6. Meningococcal infections 1 - 7. Acute poliomyelitis - - 8. Measles - - 9. Other infective and parasitic diseases 5 5 10. Malignant neoplasm, stomach 17 23 11. Malignant neoplasm, lung, bronchus 28 56 12. Malignant neoplasm, breast 16 17 13. Malignant neoplasm, uterus 7 10 14. Other malignant and lymphatic neoplasm 101 108 15. Leukaemia, aleukaemia 5 6 16. Diabetes 4 4 17. Vascular lesions of nervous system 103 116 18. Coronary disease, angina 185 178 19. Hypertension, with heart disease 24 19 20. Other heart disease 80 78 21. Other circulatory disease 49 69 22. Influenza 5 3 23. Pneumonia 35 40 24. Bronchitis 45 55 25. Other diseases of respiratory system 8 6 26. Ulcer of stomach and duodenum 10 13 27. Gastritis, enteritis and diarrhoea 1 3 28. Nephritis and nephrosis 9 9 29. Hyperplasia of prostate 8 6 30. Pregnancy, childbirth, abortion l - 31. Congenital malformations 8 9 32. Other defined and ill-defined diseases 68 71 33. Motor vehicle accidents 6 10 34. All other accidents 21 19 35. Suicide 22 29 36. Homicide and operations of war 1 - TOTAL 890 981 19 INFECTIOUS DISEASE Disease Notifications Removed to Hosp. 1955 Deaths 1955 1951 1952 1953 1954 1955 Diphtheria 1 - - - - - - Dysentery 72 15 40 73 32 6 - Encephalitis: Acute Infective - - - - 1 1 - Post Infectious 2 1 1 1 3 3 1 Erysipelas 11 10 7 13 7 4 - Pood Poisoning 23 6 21 19 56 10 - Malaria - - 1 2 - - - Measles 1187 561 1186 36 1028 37 - Meningococcal Infection 1 1 3 2 2 2 - Ophthalmia Neonatorum 3 3 5 1 1 - - Paratyphoid Fever 3 2 - - - - - Pneumonia 74 37 53 47 53 22 4 Poliomyelitis: Non-paralytic - 4 2 - 28 22 - Paralytic 2 7 10 2 9 8 - Puerperal Pyrexia 28 45 34 41 22 22 - Scabies 16 17 24 23 26 - - Scarlet Fever 70 112 44 50 23 6 - Typhoid Fever - - - - 4 4 - Whooping Cough 289 193 215 169 114 13 - TOTAL: 1782 1014 1646 480 1409 160 5 One death occurred of a female aged 69 from post infectious encephalitis following herpes zoster. Two other cases of post infectious encephalitis occurred, one (male, aged 48) following herpes zoster, and one (female, aged 39) following measles. One case of acute infective encephalitis occurred in a female aged 15. The only other deaths from notifiable disease were 4 °f cases of pneumonia. 20 37 cases of poliomyelitis occurred, the highest number of cases ever notified in one year in Hampstead. There were, however, no deaths. A large proportion of the cases were of a mild type, there being altogether 28 cases of non-paralytic poliomyelitis and 9 paralytic. From the following table it will be seen that 25 cases occurred in children under 15 years of age, of whom 15 were boys between 5 and 9 years. Aee Males Females paralytic Non-paralytic Paralytic iNon-paralytic 0-4 2 - 1 5-92 13 1 2 10-14 1 1 - 2 15-19 1 1 1 20-24 - 2 - 1 25 - 29 1 - 1 2 30 - 34 35 - 39 - l 40 - 44 - - - - 45 - 49 - - - 50-54 - - - - 55 - 59 - - -1 All ages 5 19 4 9 There were 32 cases of dysentery, which compares favourably with recent years. 14 were single cases; in three instances 2 cases occurred in a family and in one instance 3 cases occurred in one family. The remaining 9 cases were associated with a school where scholars and members of the kitchen staff were affected. A further 4 cases connected with the school were confirmed bacteriologically but were not formally notified. The 4 cases of typhoid fever notified occasioned a great deal of work in tracing contacts. One case occurred in a hostel, the patient being a member of a visiting school party from Germany. The hostel had accommodation for 60 to 70 boys whose length of stay varied from one day to a week. Many of the boys were on walking tours etc. and had been unable to give adequate addresses on departure, so that the task of tracing the contacts was an almost impossible one. As far as is known, no secondary cases occurred. Two cases of typhoid fever were notified in persons of foreign residents who had attended a party given in a neighbouring borough. A large number of people had attended 21 the party but no record was available of the names and addresses of the guests and considerable time was spent in trying to trace possible contacts. Altogether 11 cases spread over five boroughs are known to have arisen through attendance at the party. The fourth case of typhoid fever was a medical practitioner on the staff of one of the London hospitals. Numerous enquiries were made but no evidence was forthcoming as to the source of infection. The vast majority of notification certificates received were in respect of measles. Altogether there were 1,028 cases, the main epidemic being spread over the months of February to June. It is pleasing to record that there were no deaths. The total number of cases of notifiable diseases, omitting measles, in the last five years is shown in the table below. The figure for 1955 is the lowest for this five year period. The figures show a steady improvement. 1951 595 cases 1952 453 " 1953 460 " 1954 444 " 1955 38l " No case of smallpox was notified in the Borough during the year. In March notification was received that a vessel had arrived in the Port of London and had had a case of smallpox on board. 20 passengers from the ship came to addresses in Hampstead and were kept under observation for the appropriate period. FOOD POISONING Two outbreaks of food poisoning affected a hospital but in neither instance were patients affected. The first outbreak, in January, appeared to be caused by meat stew consumed in the refectory. Two strains of B. Welchii were isolated from the stew. Altogether 46 cases among staff occurred but only 11 were resident in Hampstead and are included in Hampstead statistics. In June five cases were notified after a meal of soup, veal stew, vegetable and sweet, at the same hospital. Four of these cases lived outside the Borough. Cl. Welchii was isolated from stools but it was not Possible to examine the suspected article of food, veal pie, as this was completely disposed of. 22 One other large outbreak occurred in a College and was attributed to a septic finger of one of the food handlers. Altogether 39 cases were ascertained of which 20 were notified. Milk from a churn was the common item of food. In the two remaining outbreaks it was not possible to determine bacteriologically the agent causing the outbreak. Ham purchased from a shop, the name and address of which could not be traced, was the suspected cause of illness of five cases in one family, and another family outbreak of four cases was attributed to tinned carrots. Of the 15 single cases it will be seen that 12 were due to Salmonella Typhimurium and 1 to Salmonella Bredency. As a general rule in only about sixty per cent, of food poisoning outbreaks is the cause established and it is satisfactory to note that in 3 out of 5 outbreaks and 13 out of 15 single cases in Hampstead the cause was identified. The majority of the cases appear to have been mild and the patients made a quick recovery. There were no deaths. Food Poisoning Notifications (Corrected) received during 1955 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total 12 9 25 10 56 Outbreaks due to Identified Agents Total Outbreaks: 3 Total Cases: 32. Outbreaks due to: B. Welchii; Coliform Bacilli; C1. Welchii. Outbreaks of Undiscovered Cause Total Outbreaks: 2. Total Cases 9. Single Cases Agent Identified: 13. Unknown Cause: 2. Total Cases: 15. Agent Identified: Salmonella Typhimurium - 12 cases. Bredency - 1 case. 23 TUBERCULOSIS During the year 1955, 88 new cases of Tuberculosis were notified, 84 being cases of pulmonary tuberculosis and 4 of other forms of the disease. The following table gives an analysis of the newly notified cases and deaths during 1955. Age Periods New Cases Deaths Respiratory Non Respiratory Respi ratory Non Respiratory M. F. M. F. M. F. M. F. Under 1 - - - - - - - - 1-4 3 1 - - - - - - 5-14 - 1 - - - - - - 15-24 5 15 - 1 - - - - 25-34 20 10 - 2 2 1 - - 35-44 5 5 - - 1 - - - 45-54 9 2 - 1 4 - - - 55-64 5 - - - 1 - 1 - 65 and upwards l 2 - - 3 1 1 - TOTALS 48 36 - 4 11 2 2 - MINIATURE MASS X-RAY The Mass X-ray Unit did not visit Hampstead during 1955 BACTERIOLOGICAL EXAMINATIONS (infectious Diseases) The record of examinations carried out during the year by the Central Public Health Laboratory, Colindale, was as follow Throat/Nose Swabs: Diphtheria Bacilli found Nil Haemolytic Streptococci found 18 Vincent's Angina Organisms found 1 Negative 56 Faeces: Shigella found 40 Salmonella found 6 Negative 214 Pertussis; Positive 1 Negative 10 24 In all, 346 examinations were carried out on behalf of Hampstead doctors. The Department has an arrangement whereby specimens left at the offices by 2.30 p.m. are dispatched by hand to the Laboratories the same day, and 320 specimens were sent to the Laboratories by this means. 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 27 adults and 48 children received treatment: Verminous conditions Cases Treatments Adults 17 19 Children under 5 15 17 Children over 5 28 29 During the second half of the year one family had no less than 33 treatments at the Public Health Station. The mother had five treatments for head and body lice and her eight children had from 2 to 6 treatments each. This family has received treatment in previous years and requires constant supervision from the Health Visitors and Sanitary Inspectors. A second family with whom the Department has experienced considerable difficulty consisted of husband and wife and three children. The whole family received treatment and on two occasions disinfestation of the rooms and bedding was carried out. This family had received treatment in 1954 when their living accommodation was also treated for vermin. Scabies Cases Treatments Adults 10 30 Children under 5 2 6 Children over 5 3 11 Contacts 7 7 29 cases of scabies were brought to the notice of the Department during the year. Notification certificates were received in respect of 26 of these cases, the remaining 3 cases being second or subsequent cases in a family and not notifiable under the Regulations. All cases were investigated by the Sanitary Inspectors and treatment carried out at the Cleansing Station in respect of 15 cases and 7 contacts. The remainder received treatment either at home, or at hospital outpatient departments. 25 During the year, the following treatments were carried out at the Centre on behalf of the London County Council Verminous conditions No. of school children treated 4l No. of treatments given 4l Scabies No cases occurred amongst school children. London County Council (General Powers) Act, 1953 Section 43 empowers the Council 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. PUBLIC HEALTH STATION On four occasions during the year a party of nurses from one of the Hospital Preliminary Training Schools attended at the Public Health Station for a lecture and demonstration by Mrs. Speechley, Sanitary Inspector, and the staff of the Public Health Station. The subjects dealt with included disinfection and disinfestation, the cleansing and bathing of verminous persons, the notification and investigation of infectious disease. The number of student nurses at the lectures varied from 9 to 25. DISINFECTION AND DISINFESTATION The following is a record of the work carried out by the Disinfecting Staff during 1955 No* of calls by borough van 3,706 No. of articles passed through steam chamber 4,06l No. of rooms disinfested after vermin 317 No. of rooms disinfected after infectious disease 280 Requests for the disinfection of articles of clothing for despatch abroad continued, and during the year l62 parcels were disinfected at the request of l42 senders. Many complaints were received of nuisance caused by wasps nests, and in no less than 28 instances the disinfectors were able to destroy the nests. STAFF MEDICAL EXAMINATIONS 106 examinations were undertaken as follows:- 26 64 medical examinations were carried out of new entrants to the Superannuation Scheme. Of these 3 were classed as unfit. 10 examinations were made of persons on whom a special report was required in connection with absence through illness. 32 examinations were undertaken for other authorities. PUBLIG MORTUARY, NEW END During the year, 252 bodies were admitted to the Mortuary and 248 post-mortem examinations were carried out. The following table shows how the bodies were admitted and the cause of death;- Natural Causes 208 Suicides: Hanging 3 Railway 1 Coal gas poisoning 11 Drugs 6 21 Accidental: Falls 6 Motor vehicle accidents 3 Coal gas poisoning 1 10 Post operative 6 Homicide 1 Bodies brought for accommodation only 6 Total 252 No. of bodies admitted by order of: Coroner 213 Police 3 Ambulance 21 Marie Curie Hospital10 New End Hospital 3 Others 2 252 NATIONAL ASSISTANCE ACT, 1948. SECTION 50 8 funerals were carried out during 1955, compared with 16 in 1954. In three cases the full amount of the funeral expenses was recovered, either from the estate of the deceased or from liable relatives. 2 burials were of newly bom children found on the Heath and in both cases the police were unable to trace the parents. The three remaining cases were still outstanding at the end of the year but it did not appear likely that the Council would succeed in recovering more than a small portion of the cost of burial. 27 The total cost of the funerals was £53.3s.3d. and an amount of £32.19s.7d.was recovered during the year. NATIONAL ASSISTANCE ACT. 1948. SECTION 47. I am glad to report that, although no less than 48 aged and Infirm persons were notified to me as being in urgent need of care and attention, I was fortunately not compelled to invoke the powers of compulsory removal to a home or hospital conferred by the above section. The assistance we were able to give may be classified as follows:- Home Help arranged in 22 cases District Nurse „ „ 16 „ Mobile Meals „ „ 14 „ Removal to Hospital „ 13 „ Removal to a Home „ 9 „ Duly Authorised Officer informed in 2 „ I have referred in the opening of this report to the valuable assistance afforded by various organisations in connection with old people. I would also express my appreciation to the Geriatric Unit of the Whittington Hospital, Highgate, under Dr. Exton-Smith, for their unfailing co-operation. Hospital accommodation for the chronic sick is taxed to the utmost, particularly in spells of severe winter weather, but somehow room has been found to accommodate the urgent chronic cases referred to him by my Department. SANITARY CIRCUMSTANCES OF THE AREA I am indebted to the Chief Sanitary Inspector, Mr. J.F. Armstrong, for the compilation of this section of the Annual Report. STAFF There were two further resignations from the Inspectorial Staff;- Mr. G.A. Buckingham, who was appointed to Ruislip-Northwood Urban District Council, and Mr. G.R. Watkin, who secured an important appointment with the Fishmongers' Company. Mr. C.S. Dancer, Deputy Chief Sanitary Inspector from Reigate, was appointed to one vacancy but, so far, we have been unable to fill the other, despite repeated advertisements. 28 I fear there is no prospect of any improvement in the public health Inspectors' staffing position until the present salary awards are revised and the change of designation recommended in the Government Working Party's Report is implemented. This Council is making a substantial contribution in an endeavour to improve the recruitment of Sanitary Inspectors. Three clerks are now being given facilities to train and study for the Inspectors' qualifying examination. The policy is a long-term one as the training period is of four years' duration. statistical summary. 1955 Sanitary Inspection Houses inspected on complaint 2,506 after infectious disease 688 " " under Section 9, Housing Act, 1956 Nil House-to-House inspections 120 Inspections and revisits in connection with Loans under Section 4, Housing Act, 1949 333 Special visits and re-inspections 11,480 Rehousing Visits and revisits in connection with the investigation of 65 rehousing applicants 1,110 No. of reports submitted to Hampstead Housing Estates Manager 440 " " " " " L.C.C. Estates Dept. 87 " " " " " l.C.C .Divisional Medical Officer 45 " " " " " Other Boroughs 30 Notices Intimation Notices served 958 Statutory Notices served 221 Food Premises Inspection of Bakers' Shops and Bakehouses 73 " " Dairies and Milk shops 60 " "Catering Establishments 605 " " Ice Cream premises 196 " " other food premises, stalls, markets, etc. 1,300 29 The Factories Act, 1937 Inspections and re-inspections made 71 Pharmacy & Poisons Act, 1933. Poisons Rules, 1952 Inspections made 9 Rag; Flock, etc. Act, 1951 Inspections made 4 Shops Act, 1950 (Section 38). Arrangements for health and comfort of shop workers Inspections made 4l Drainage Works Plans and applications deposited for:- (a) Voluntary additional sanitary fittings or alterations to drainage:- 205 (b) Drainage and sanitary fittings required by Sanitary Notices 18 INSPECTION OF FOOD AND FOOD PREMISES The Food & Drugs Act, 1955 The Food Hygiene Regulations, 1955 These new measures are now in force and form a very welcome addition to the powers of local authorities and their Inspectors in dealing with offences relating to every aspect of food production, sale, storage and hygiene. In order that local tradesmen and manufacturers should become fully aware of their responsibilities under the new legislation, a circular letter, accompanied by a copy of the Food Hygiene Regulations, was delivered by hand by the Public Health Department staff to the proprietor of every food shop, catering establishment, canteen and stall throughout the Borough. The circular stated as follows:- "The Food Hygiene Regulations, 1955 I have pleasure in enclosing herewith a copy of the abovementioned Regulations. 30 Most of the Regulations are in operation as from the 1st January, 1956, but others involving major alterations are deferred until the 1st July, 1956. There are various major matters which are new and to which I would particularly direct your attention. The following summary is by no means complete and you are urged to study the Regulations themselves in order that you may be fully aware of your responsibilities. Protection of Food from Contamination 1.- Food in any forecourt, yard, market or stall must not be placed lower than 18" from the ground unless it is adequately protects Personal Cleanliness Persons handling food must:2.- Cover open cuts or abrasions with a suitable waterproof dressing 3- Refrain from spitting in food premises. 4.- Refrain from the use of tobacco (including snuff), when handling open food or in any food room where there is open food. Carrying and Wrapping of Food 5.- Food must not be carried in a vehicle or container, or with any live animal or poultry, without taking proper precautions against contamination. 6.- It is not permissible to use any wrapping material or container which is not clean, or to allow printed material to come into contact with any food other than uncooked vegetables. Persons Suffering from Certain Infections 7.- Any person engaged in the handling of food, on becoming aware that he is suffering from, or is the carrier of typhoid fever, paratyphoid fever or any other salmonella infection, or dysentery or any staphylococcal infection likely to cause food poisoning, must inform - (a) the occupier of the food premises; (b) the owner of the food premises. 51 The owner or occupier must notify the Medical Officer of Health of the district in which the premises are situated immediately. Requirements Relating to Food Premises Sanitary Conveniences 8.- No food room which communicates directly with a room or other place which contains a sanitary convenience shall be used - (a) for the handling of open food, or (b) for the cleaning of equipment. 9.- There shall be displayed at every sanitary convenience a notice requesting users to wash their hands after using the convenience. Water Supply to be Provided 10.- A constant, clean and wholesome water supply must be provided. (Date of operation 1st July, 1956.) Wash Hand Basins to be Provided 11.- Suitable and sufficient wash basins must be provided with hot and cold water supply, soap, nail brush and clean towels. (Date of operation 1st July, 1956.) First-aid Materials to be Provided 12.- Suitable and sufficient bandages, dressings and antiseptic must be provided and maintained. Accommodation for Clothing, etc. 13.- There must be suitable and sufficient cupboard or locker modation for clothing and footwear. (Date of operation 1st July, 1956.) Facilities for Washing Food and Equipment 14.- Suitable and sufficient sinks, together with adequate supply of hot and cold water, soap or other suitable detergent, and of clean cloths must be provided, together with adequate and suitable cleaning and drying facilities. (This regulation does not apply in relation to food premises in which no open food is handled.) (Date of operation 1st July, 1956.) 32 Lighting and Ventilation of Food Rooms 15.- This must be adequate and satisfactory. Temperature at which Certain Foods are to be kept l6.- Food consisting of meat (including game and poultry), fish, gravy or imitation cream, or prepared from or containing any of those substances or any egg or milk, must be kept in accordance with the temperatures set out in Section 25 of the Regulations. (Date of operation 1st July, 1956.) The above-mentioned Regulations are designed to achieve the reduction in food-borne diseases that everyone hopes to see, and I am confident that I will have your full support and cooperation in complying with these new Regulations. I also enclose a form in respect of premises used for the sale, etc. of ice cream and/or the preparation or manufacture of sausages or potted, pressed, pickled or preserved food, and would be much obliged if you would complete and return it to me as soon as possible. Should you so desire, the Inspectorial staff of the Public Health Department are available to call and advise you in connection with any problem arising out of this new legislation on your arranging an appointment for the purpose." The interpretation of "Food Business" has now been extended to include canteens, clubs, schools, hospitals or institutions, whether carried on for profit or not, and any undertaking or activity carried on by a public or local authority. Previously, there was extreme doubt as to whether we had a right of entry to many such premises, but all will now have to conform with the new Regulations. It is, however, a moot point as to whether the many hundreds of private boarding houses in the district fall within the purview of the present legislation. There is no doubt that many of the clauses of the Hygiene Regulations are highly controversial and the interpretation thereof can only be effectively decided by the Courts. In the absence of such legal decisions, reliance must be placed on the Co-operation and goodwill of the trade and the sensible and reasonable interpretation of the Regulations by the Sanitary Inspector. 33 It is, however, a matter of regret that the Regulations are not more positive and explicit in certain directions. For example, sanitarians have only one definition of what constitutes a "wash-hand basin" but the Court may still have to decide whether the elementary provision of a bowl inside a sink satisfies the legal requirement for the provision of facilities for hand washirng Likewise Clause 25, which is most important from the food poisoning aspect, dealing as it does with the temperature at which certain foods are to be kept, is capable of various interpretations. It is not even clear whether the powers imposed by the Section relate only to restaurants or cover a far wider field. Some guidance from the Ministry on these and various other points would avoid anomalies and lead to a more uniform administration. A systematic inspection of every food establishment in the Borough is being instituted so as to ensure, as far as possible, full compliance with the new requirements. At the same time, opportunity Is being taken of overhauling and revising the Department's food administration and bringing up to date the records and registers involved. Inspection of Food Premises Type of Premises No. on Register No. of Inspections Milkshops and Dairies 50 60 Ice cream premises 243 196 Butchers and Prepared Meat Premises 73 395 Fishmongers 20 110 Fried Fish Shops 9 30 Bakers 36 73 Restaurants and Catering Establishments 134 605 Public Houses 39 67 Delicatessen 23 97 Confectionery 104 75 Grocers 137 322 Greengrocers 78 105 Off Licences 33 14 Other food premises - 85 34 ICE CREAM Fourteen additional premises were registered for the sale of Ice Cream. In each case the ice cream is wrapped. 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 undertakings 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 58 Greengrocers 26 Grocers 50 Butchers 2 Tobacconists 11 Fishmongers 4 Restaurants 46 Garages 1 Dairies 18 Bakers 5 Stores 5 Toy Shops 1 Clubs 5 Florist 1 Off-Licences l Kiosks and Stalls 6 Patisserie 1 Delicatessen 2 TOTAL:- 243 Of the above, it is interesting to note that we now have only one actual manufacturer of Ice Cream in the Borough. He sells his ice cream unwrapped. SAUSAGES. COCKED MEATS, ETC. Types of premises registered under Section 14, Food and Drugs Act, 1938 for preparation and sale of sausages and cooked meats, etc. Grocers 8 Delicatessen 5 Provisions 4 Factory 1 Butchers 37 Cafe 1 TOTAL:- 56 35 MILK SUPPLY The number of Licensed Distributors operating in the Borough is 80. 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. These have yielded excellent results,34 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 3.6 per cent, as against a legal minimum of 3 per cent. The number of Licences issued to traders is as follows:- Main Supplementary Licence Licence Pasteurised Milk 39 28 Tuberculin Tested Milk 34 28 Sterilised Milk 48 32 HAMPSTEAD HEATH FAIRS Catering Hygiene. During Bank Holiday periods members of the Inspectorial staff have continued to exercise a vigilant supervision of the itinerant vendors of food and the food stalls which are such a popular part of the attraction of the fair. Apart from actual sampling activities - and these were quite considerable, totalling 88 samples - much time is spent in giving advice on food hygiene. There is an arrangement with the L.C.C. (who let the food Plots to tender), for all the tenderers first to submit a certificate from the Medical Officer of Health of the district in which they operate that their arrangements for food production, storage and handling are satisfactory and hygienic. The L.C.C. then notify the Public Health Department of the name and address of the successful tenderers and the following note is addressed to all of them:- 36 "Dear Food Handler, Hampstead Heath Fair During the coming holiday many people will be seeking relaxation and entertainment at the Traditional Fair at Hampstead Heath, and I understand that you will be contributing to their pleasure by providing food there. It is particularly important that the occasion should not be marred by any outbreak of food borne disease, whether it be a mild attack of diarrhoea or an outbreak of typhoid or dysentery. THE PREVENTION OF SUCH DISEASES IS LARGELY IN YOUR HANDS. That brings me to my first point :- CLEAN HANDS. Food infections are caused by germs which are found on the hands. They may get there either from the bowels or are present in cuts and boils. Therefore, there are a few simple rules to obey :- (1) The less you handle food, the less it is liable to contamination. (2) Wash your hands EVERY TIME after you use the toilet. (3) ALWAYS cover cuts, etc. with a waterproof dressing. (Cloth bandage will NOT do.) We have ensured an adequate water supply and drainage points; your job is to supply and USE basin, soap, nailbrush and clean towel. PREVENTION OF CANAMINATION After you have received foodstuffs from your supplier, it may be contaminated by bad storage, careless preparation or unprotected display. How can we prevent this? Storage. Disease germs require time, warmth and moisture in which to multiply. Keep food for as short a time as possible at as low a temperature as possible and in dry, clean conditions. Preparation. Disease germs may enter food by careless handling, dirty utensils and unwashed hands. 37 Therefore, always keep your hands clean and cuts covered and see that the utensils in which food is prepared are absolutely clean. Display. Disease germs lurk in dust, and in the nose and throat of many people. If your foodstuffs are exposed to such contamination, disease may arise. Protect your food by wrappings or covers. Your goods will look more attractive if covered by glass or transparent covers. Food handlers in clean, white overalls attract customers. Let me summarise briefly the points I have made:- (1) Clean hands and habits (2) Covered Cuts (3) Clean storage and utensils (4) Clean stalls and covered display (5) Clean clothing - CLEAN FOOD. And please remember that the Council's Sanitary Inspectors before the day of the Fair, and the Inspectors on duty at the Pair, will always be happy to advise you." The Council has already (a) improved the temporary toilet facilities; (b) improved the water supply and the number of stand pipes; (c) sited the food stalls in a compound as far as possible away from the dirt and dust of the fair machinery; (d) endeavoured to persuade individual stallholders to instal and use water heaters and supplies of detergents and sterilants for washing-up purposes. It is obvious, however, that much remains to be done and we do not look upon the present arrangements for the catering protection of the fairground public with any degree of complacency. On fine Bank Holidays the volume of business is often so great that this is offered as an excuse for loose hygienic Practices. In fact, it is virtually impossible for your Inspectors, in such circumstances, to take samples, let alone bring home to the vendors, the need for personal hygiene. 38 Most modern food stalls have good equipment; It is, however, quite apparent that the average fairground trader needs much more education and needs to use the equipment if the aim the safety of food - that everyone desires, is to be achieved. Warnings have previously been given as to the methods of retailing shellfish. The present system is so unsatisfactory and uncleanly as to be a potential source of outbreaks of food poisoning. This issue is again being raised with the vendors of this popular commodity and the Council is hopeful of receiving their co-operation in giving a higher standard of cleanliness and safety. The following table shows the grading of Ice Cream samples taken at the fairground since the War:- Year No. of Samples Taken Grading under Meth. Blue Test Percentages of Grades 1 and 2 Samples 1 2 3 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 1954 34 28 2 - 4 82.3 1955 11 10 - - 1 90.9 All the bacteriological samples are speedily reported upon by the Central Public Health Laboratory at Colindale, and I must once more express to Dr. Betty Hobbs, Principal of the Food Hygiene Section, my thanks for her co-operation and assistance at all times. 39 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. 51 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 examination: made and the results thereof:- Nature of Sample No. of Samples Satisfactory Unsatisfactory Cockles 18 18 - Whelks 11 11 — Mussels 2 2 — Eels 3 3 — Jellied Eels 3 3 — Prawns 1 1 — Tank Water 3 3 — Tap Water 1 1 - Chocolate Lolly 1 1 - Candy Floss Powder 1 l - Liver Pate 1 l - Smoked Saithe 2 - 2 Tinned Tomatoes 1 - 1 Ham 1 - 1 Bacon 1 — 1 Soup 1 l — TOTALS: 51 46 5 40 (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 8 were classed as adulterated or unsatisfactory. Particulars of Adulterated Samples-1955 Sample No. Article Offence How dealt with 1. Bread Contained charred dough, dirt, etc. Manufacturer cautioned. 26. Buttered Rolls False description (not butter) Prosecution.£5 Fine. £4.13s. Costs. 86. Milk in Contaminated Bottle Bottle contained dust and dirt Dairy cautioned. 170. Pure Olive Oil False description. Arachis Oil Manufacturer cautioned. 211. Rolls and Butter Butter and Margarine Vendor cautioned. 359. Sal Volatile B.P. Deficient in Ammonium Carbonate and Ammonia Letter to Manufacturer and Retailer. (Old stock.) 366. Butter Rahm Not a cream cheese; deficient in milk fat Importers cautioned. 367. Cod Roe Caviar Unsatisfactory description. Caviar is Sturgeon not Cod Roe Retailer cautioned. The percentage of unsatisfactory samples is 1.6 per cent, This compares with 2.4 per cent, 3.57 per cent. and 1.97 cent, for the previous 3 years. 41 UNSOUND FOOD SURRENDERED DURING 1955 Article Quantity Butter 1 lb. Cake Mixture 356 packets Cheese 126 1bs. Coffee 3 tins Confectionery 48 1bs. Dried Fruit: Raisins, Figs 20 lbs. Fish; Tinned; Whiting; Dog Fish 188 tins 32 stone F1our 5 lbs. Fruit; Fruit Juice 448 tins Jam; Marmalade 36 tins Macaroni l 1b. Meat: Tinned: Bacon; Beef; Chicken; Corned Beef; Ham; Kidney; Lamb; Mutton; Ox Cheek; Ox Liver; Pork; Salami; Sausages; 248 tins Steak; Turkey; Veal 2,044 lbs. Milk 102 tins Mincemeat 1 tin Nutmeg 23 packets Pickled Herrings ½ barrel Sauce 11 bottles Sauercraut 112 1bs. Smoked Saithe 1,536 packets Tomato Puree 36 tins Vegetables 503 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. 42 LEGAL PROCEEDINGS Offences relating to Food and Food Premises Sections 3, 9 and 83, Food and Drugs Act, 1938 Date of Hearing Court Premises and Nature of Offence Result of Proceedings 31.8.55. Hampstead Justices Court West End Lane. Food & Drugs Act, 1938. Flies in Bread Fined £5 and £2.2s Costs on each of two summonses. 9.3.55. Hampstead Justices Court Heath Hurst Road. Contravention of Sees.9 and 83(3) of the Food & Drugs Act, 1938. Cigarette end in bread Fined £3 and £2.2s Costs. 23.3.55. Hampstead Justices Court Hampstead High Street. Contravention of Sec. 3, Food & Drugs Act, 1938. Roll and Margarine Fined £5 and £4.13s. Costs. Section 13. Food & Drugs Act, 1938 and L.C.C. By-Laws for the Protection of Food Date of Hearing Court Premises and Nature of Offence Result of Proceedings 1.2.55. Marylebone Magistrates Court West End Lane. Contravention of Sec.13, Food & Drugs Act, 1933 and Clean Food By-Laws. Dirty Bakehouse Fined a total of £20 and £10.l0s. Costs. 43 ATMOSPHERIC POLLUTION Twelve complaints were received regarding localised smoke emissions and 334 observations were made thereon by the Sanitary Inspectors, whose advice to the users of the offending equipment was generally effective in minimizing any nuisance. Fewer complaints were received regarding smoke and fumes from the railway ventilating shafts and periodic observation of the shafts indicated that some improvement has possibly occurred. However, nothing less than complete elimination of emissions from these shafts, situated as they are in the midst of good residential property, can be regarded as satisfactory. Co-operation with the Fuel Research Station on the measurement of atmospheric pollution continued and, in fact, has been extended. The work undertaken now falls under four main headings:- 1. Deposit gauges are placed at Barrow Hill Reservoir and Fortune Green Cemetery, in which rainfall and general "fallout" of air pollution are collected over each month. The collected matter is subjected to analysis by the Public Analyst and yields information on the amount and composition (e.g. ash and grit, the acidity factor of rainfall) of actual deposits from the air of that particular locality. 2. Lead peroxide instruments at the reservoir and the cemetery, in which lead peroxide is exposed over periods of one month and, again on analysis, provide an index of the activity of sulphur dioxide in the atmosphere. 3. The continuous filter which is operated permanently at the Public Health Department and from which daily readings are taken by the Sanitary Inspectors of the amounts of smoke and other suspended impurities in the atmosphere. Starting in January, 1955, an adjunct to the continuous filter has been used to calculate the concentration of sulphur dioxide. This is again carried out every day (Sundays excepted). At the request of the Fuel Research Station the ladings from the continuous filter (3 - 4 above) were stepped up to 3 and 4 per day in times of thick fog, but in the period under review this was found necessary only on the 30th November and 1st December. 44 It is necessary to appreciate that the inferences to be drawn from this work must be limited in their application to Hampstead. All four types of apparatus are liable to casual error - it has been found that deposit gauges placed 50 yards apart show sensible variations in results and, in any case, only purport to indicate conditions in their immediate locality. The Lead peroxide gauge at Barrow Hill, for example, only shows the activity of sulphur dioxide in the air at Barrow Hill Reservoir and not in Hampstead generally. The whole purpose of the work is one of collaboration with the Fuel Research Department of the Department of Scientific and Industrial Research, where results from local authorities and other co-operating bodies throughout the country are received, collated and analysed. The Fuel Research Station have estimated that a long period of observation, preferably 5 years, is needed before reliable conclusions can be drawn about the average level of pollution or about the rate at which it is produced. However, now that a second year of this work has been completed it is reasonable to indicate certain trends. From the deposit gauge readings it can be shown that during the year the amount of foreign matter falling from the air on to Hampstead is only three-quarters of the average figure for the Metropolitan area as a whole. This might reasonably be expected in view of the absence of power stations and heavier industry in this Borough. On the other hand, it is obvious that favourable wind conditions do bring air pollution to the Borough and the readings at Barrow Hill Reservoir reflect the proximity of the heavy steam locomotive depot at Chalk Farm. The following tables represent part of the information obtained from measurement of suspended impurities in the air by means of the continuous filter. It will be seen that the average contamination is notably and consistently less in the summer months than in the winter, due mainly, of course, to reduced domestic heating. The two peaks in Table I occurred in conditions of moderately bad fog on 20th January and 50th November, 1955,and the intention of Table II is to illustrate the relative state of impurity of the air we breathe in a winter month. 45 46 SURVEY OF BARBERS' & HAIRDRESSERS' ESTABLISHMENTS. LONDON COUNTY COUNCIL (GENERAL POWERS) ACT. 1954 SECTION 18 1. Legislation Prior to the introduction of this Act, Metropolitan Borough Councils had not the power fully to enforce modern standards of hygiene in barbers' and hairdressers' salons, although model By-laws had been adopted by many provincial authorities under powers conferred by the Public Health Act, 1936. After 1st October, 1955, no person may carry on the business of a barber or hairdresser on any premises unless he and those premises are registered by the Borough Council. If any person carries on such a business without being so registered fines not exceeding £20 and daily penalties of £5 may be imposed by the Courts. After registration, a copy of the By-Laws, together with a Certificate of Registration (reproduced below), were sent to all hairdressers in the Borough. These must be displayed on the registered premises and penalties are also provided for failure in this respect. 2. Analysis of Survey Total number of premises registered 74 * Catering for men only 23 „ „ ladies only 43 „ „ both sexes 8 Total No. of Staff and Assistants engaged - Males 62, Females 159 221 * An increase of 8 over the survey made in 1951. 3 - Breaches of By-Laws (a) General cleanliness of premises and equipment; condition of walls and ceilings 10 (b) Cleanliness and repair of floors 1 47 (c) Unsatisfactory litter containers 19 (d) Inadequate lighting and ventilation 2 (e) Inadequate hot water supply 5 (f) Inadequate sterilization of implements 16 (g) Sanitary conveniences - defective, unsuitable or insufficient 6 (h) Washing facilities inadequate 6 Briefly, the By-Laws deal with - 1. The structure and equipment - cleanliness and state of repair. 2. Staff - personal hygiene and clothing. Mr. Outlaw reports that, on the whole, the standard of hygiene of the premises was very good and the breaches observed above, in the majority of cases, were of a minor character. A variety of containers were used for waste hair, ranging from the ideal impervious, pedal-operated binettes to hinged footstools and temporary cardboard cartons. All the proprietors with inadequate equipment were urged to provide impervious treadle bins with close fitting lids and this was done or orders placed for the requisite containers. Instruments and Equipment The custom of using headrests on chairs is declining, but where now used they are invariably covered with a clean towel or paper tissue. The practice of some hairdressers of folding and re-using towels for this purpose for at least four customers is unsatisfactory. Arrangements for the disinfection and/or sterilization of instruments and equipment varied considerably. A very high standard obtained in many establishments, in others it was indifferent. Likewise, many types of disinfectant were used for wiping or dipping implements, but it appeared that the strength of the solution used varied according to the sense of smell of the individual who made it up. 48 It was interesting to note that several proprietors stated that some of their customers objected to the use of disinfectant, particularly the odour therefrom. In one case, a customer is alleged to have left the premises after seeing the barber dismantle and disinfect his clippers. He was convinced that the previous client suffered from a skin disease or was verminous !! The introduction of a new perfumed disinfectant, designed specifically for use by hairdressers, may solve the difficulty. The prevention of the transmission of infection does entail the need almost for clinical standards, but the practical difficulties greatly militate against such an ideal. A number of sterilizing cabinets have been installed and if used conscientiously should be effective. Formalin vapour is usually employed, but if used in strong concentrations has caused complaints of eye irritation. Metal instruments are sometimes discoloured when left in the cabinet. In many salons hair brushes are not now used. Nylon brushes are preferable to ordinary bristle owing to the ease with which they can be cleansed and disinfected. Solid soap has given place to the use of soap powders and was found to be used by only four barbers. The question of more adequate washing facilities for the personal use of the staffs is receiving our attention. In only three instances was it necessary to require improvements in the supplies of hot and cold water for shampooing purposes. Conclusions The survey has been well worth while and has been facilitated by the trade themselves who generally welcomed the By-Laws and were most co-operative and helpful throughout. The few criticisms made above have been readily met and I feel sure the strict observance of the By-Laws will assist materially in maintaining a high standard of hygiene and do away with the risk of the transmission of infection. 49 BY-LAWS AS TO HAIRDRESSERS AND BARBERS MADE BY THE Mayor, Aldermen and Councillors of the Metropolitan Borough of Hampstead under Section l8(4) of the London County Council (General Powers) Act, 1954 1. (1) In these By-laws, unless the context otherwise requires - "hairdresser or barber" means any person carrying on the business of a hairdresser or barber on premises registered under Section l8(l) of the London County Council (General Powers) Act, 1954; "day" means a day on which business is carried on. (2) The Interpretation Act, 1889, applies to the interpretation of these By-Laws as it applies to the interpretation of an Act of Parliament. 2. For the purpose of securing the cleanliness of the premises, a hairdresser or barber shall comply with the following provisions;- (a) all internal walls, partitions and ceilings shall be painted, distempered, whitewashed, papered, decorated, furnished or otherwise treated and shall be capable of being kept clean, kept in good repair and cleansed as necessary; (b) The floor and any coverings shall be kept in good repair, and shall be cleansed at least once a day and swept as necessary to prevent the accumulation of hair clippings, neck wool or other litter; (c) all such sweepings and all other litter shall be placed in suitable covered receptacles, which shall be emptied as necessary and at least once a day, and kept clean; (d) every chair or seat shall be cleansed as necessary; (e) every shelf, table, cabinet, washbasin and other fitting shall be kept clean. 3. For the purpose of securing the cleanliness of any instruments, towels, materials and equipment used in the premises, a hairdresser or barber shall comply with the following provisions:- 50 (a) before use In connection with any customer - (i) any gown, wrap, overall or other protective clothing shall be clean; (ii) any paper or other covering placed on the back of a chair and any towel, cloth, hairnet, neck wool or other article which is applied to the face, head or neck shall be clean, and shall not previously have been used in connection with any other customer unless it consists of a material (other than paper or wool) which can be, and has been adequately cleansed; (iii) any metal instrument shall have been sterilised or otherwise adequately cleansed; (iv) any hairbrush, comb or similar instrument shall be clean, and shall have been sterilised, or otherwise adequately washed or cleansed, at least once a day; (v) any soap in solid form shall have been adequately rinsed; (b) a fresh supply of water shall be used for purposes of shaving, shampooing or washing each customer, and all articles used for purposes of shaving (including any styptic in solid form) shall be adequately cleansed immediately after use; (c) there shall be provided washing facilities which are adequate for the purposes of any cleansing carried out in pursuance of this By-Law. 4. For the purpose of securing the cleanliness of persons employed in the premises, in regard to both themselves and their clothing, a hairdresser or barber shall - (a) cause every such person to keep his hands and clothes in a clean condition; (b) provide and maintain suitable and sufficient washing facilities for the use of such persons; (c) cause any overalls worn to be clean; 51 (d) cause every such person who has an open boil or sore on an exposed part of the body to keep such open boil or sore effectively covered by an impermeable dressing while attending to any customer. THE COMMON SEAL of the MAYOR) ALDERMEN AND COUNCILLORS of ) the METROPOLITAN BOROUGH OF ) HAMPSTEAD was affixed hereto) pursuant to a resolution of ) the Council passed at a Meeting held on the 21st day of July 1955 in the presence of;- (Signed) DORIS BAILEY, Mayor P.H. HARROLD, Town Clerk. The foregoing By-Laws are hereby ) confirmed by the Minister of ) Housing and Local Government ) this fifteenth day of October ) 1955, and shall come into operation) on the first day of December 1955 ) (Signed) S.G.G. WILKINSON Assistant Secretary, Ministry of Housing and Local Government. 52 Metropolitan Borough of Hampstead LONDON COUNTY COUNCIL (GENERAL POWERS) ACT 1954 SECTION 18 (HAIRDRESSERS & BARBERS) Certificate of Registration of a Hairdresser or Barber and his Premises This is to Certify that pursuant to Section 18 of the London County Council (General Powers) Act, 1954 has been registered by the Hampstead Borough Council as a hairdresser and/or barber carrying on business in the Borough at which premises have also been registered. Dated this day of 19 Certificate No Town Cerk The Medical Officer of Health 33, Lancaster Grove, N.W.3 TOWN HALL, HAVERSTOCK HILL, N.W.3 53 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. HOUSING SLUM CLEARANCE PROGRAMME, 1956-60 A survey of the whole Borough was carried out, as a result of which, as a provisional programme, details and plans of properties suitable for slum clearance were submitted to the London County Council. Subsequently, the programme was discussed with the County Medical Officer of Health and finally, in consultation with the Town Clerk and the County Council, the following proposals for Clearance Areas were submitted jointly by the County Council and the Borough Council to the Minister of Housing and Local Government:- No. of Dwellings Alexandra Mews 24 Quex Mews 5 Colas Mews 8 Elizabeth Mews 20 Steeles Mews North 7 Cottage Mews 4 Flask Walk (24,26,28) 3 New End (36,38,40) 3 Loveridge Mews 8 TOTAL:- 82 It was also agreed that the London County Council would deal with the area at 36/40 New End. 54 HOUSING - STATISTICS 1. Total number of Selling-houses Inspected for housing defects (under Public Health or Housing Acts) 3,3l4 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) 120 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 4. Number of dwelling-houses found not to be In all respects fit for human habitation 958 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. CLEARANCE AREAS AND INDIVIDUAL UNFIT HOUSES PART A - CLEARANCE AREA (Housing Act. 1936) No. of dwelling-houses demolished during the year No. of persons displaced Unfit Houses Other Houses Land coloured "pink" Nil - Nil Land coloured "grey" - Nil Nil PART B - HOUSES NOT INCLUDED IN CLEARANCE AREA DEMOLITION & CLOSING ORDERS Number of Houses Persons Displaced 1. Housing Act, 1936 (a) Houses demolished as a result of formal or informal procedure under Section 11 Nil Nil (b) Houses closed in pursuance of an undertaking given by the owners under Sec.11 and still in force Nil Nil (c) Parts of buildings closed under Sec.12 7 Nil Continued; 55 PART B continued:- DEMOLITION & CLOSING ORDERS Number of Houses Persons Displaced 2. Housing Act, 1949 (a) Closing Orders made under Section 3(l) Nil Nil (b) Demolition Orders determined and Closing Orders substituted under Section 3(2) Nil Nil 3. Local Government (Misc.Provns.) Act, 1953 Closing Orders made under Sections 10(1) and 11(2) 1 2 REPAIRS No. of Houses INFORMAL ACTION 4. No. of unfit or defective houses rendered fit during the period as a result of informal action by the local authority under the Public Health or Housing Acts ACTION UNDER STATUTORY POWERS 958 5. Public Health Acts No. of houses in which defects were remedied after service of formal notices (a) by owners 176 (b) by local authority in default of owners Nil 6. Housing Act, 1936 No. of houses made fit after service of formal notices Secs.9,10,11 and 16 (a) by owners Nil (b) by local authority in default of owners Nil 7. Housing Repairs & Rents Act, 1954 Houses reconstructed, enlarged or improved and Demolition Orders revoked (Sec. 5) Nil 56 APPLICATION 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 the Forces, Points awarded by the Public Health Department are made on medical grounds only. 440 applications were submitted by the Housing Estates Manager to the Public Health Department and we visited every case 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. In addition, 132 reports on rehousing applications were submitted by us direct to the London County Council and 30 to other Boroughs. A further 52 cases were investigated for the Housing Estates Manager but were found to have obtained alternative accommodation without recourse to the Borough Council. I wish to acknowledge the help received from the general practitioners of Hampstead who co-operate with the Department 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 222 cases as there were no medical grounds which would not be met by points given by the Housing Estates Manager. No. of Cases Points given Cases Rehoused 222 Nil 58 78 5 9 2 7 — 67 10 9 19 15 7 47 20 7 435 90 Of the 47 cases where the maximum points, 20, were given on medical grounds, 31 were on account of active tuberculosis and the remaining 16 were for various disabilities including disseminated sclerosis (3 cases) and angina pectoris 57 (3 cases). On account of the extreme shortage of housing accommodation it is regretted that of these urgent cases only 4 were successful in being rehoused during the year. A further cases where maximum points had been awarded in previous years were also rehoused. OVERCROWDING 1955 1954 1953 1952 New cases reported during year 127 279 219 125 No. rehoused during year 48 37 53 66 No. remaining on Register 1075 996 754 588 Of the 48 overcrowded families rehoused, 42 were by Hampstead and 6 by the London County Council. HOUSING REPAIRS AND RENTS ACT, 1954 CERTIFICATES OF DISREPAIR Applications received Certificates Applications Outstanding Certificates Revoked Granted Refused 1954 102 71 16 15 6 1955 69 73 6 5 41 SECTION 54. THE FACTORIES ACT, 1937. UNDERGROUND BAKEHOUSES There are now only five underground bakehouses functioning in the Borough. The Certificates of Suitability of two of these expire on 30th September, 1956 and 30th September, 1957 respectively and underground baking at 63 Hemstal Road and 98 West End Lane will then cease completely. All the underground bakehouses are regularly inspected by the Sanitary Inspectors and are maintained as well as can be expected in such fundamentally unsuitable and unsatisfactory Premises. 58 SECTION 93, PUBLIC HEALTH (LONDON) ACT. 1936 A somewhat unusual case was dealt with under this Section which enables the Borough Council to deal with the removal of obnoxious matter from premises. In quite a good class residential part of the Borough a complaint was received of smells emanating from rooms on the first and second floors. The rooms were locked and it was impossible to contact the tenant, a woman who only visited the premises occasionally. Finally the fire brigade was called in to deal with a small outbreak on the second floor and the entrance doors were forced open. This revealed most deplorable and insanitary conditions. Apparently, no household refuse had been collected for years and filth, refuse, stale food and obnoxious matter of every foul kind was stacked in the room from floor to ceiling. The necessary Notice was served and the Council after 24 hours removed no less than 3½ tons of filth from the rooms. The tenant never returned and has not been traced. The owner has applied for possession of the rooms. The following photograph gives some slight idea of the conditions prevailing:- Second floor back room right 59 FACTORIES ACTS, 1937 and 1948 The following tables give details of the number of inspections made, notices served and defects found under these Acts. No.on Register Inspections Written Notices Occupiers Prosecuted (i) Factories in which Sec. 1,2,3,4 and 6 are to be enforced by local authority 298 10 3 - (ii) Factories not included in (i) in which Sec.7 is enforced by the local authority 279 40 5 - (iii) Other premises in which Sec.7 is enforced by the local authority (excluding outworkers' premises) 4 - - - TOTAL: 581 50 8 - Defects Found Particulars Number of cases in which defects were found Found Remedied Referred to H.M. Inspector Want of cleanliness (S.1) 5 4 1 Overcrowding (S.2) - - 2 Unreasonable temperature (S.3) - - - Inadequate ventilation (S.4) - 1 - Ineffective drainage of floors (S.6) - - - Sanitary conveniences (S.7) (a) Insufficient 2 1 - (b) Unsuitable or defective 5 3 - (c) Not separate for sexes - - - Other offences against the Act (not including offences relating to outworkers) 1 - 1 TOTAL:— 13 9 4 No prosecution was instituted under the Factories Acts, 1937 and 1948 with regard to factories. 60 COMMON LODGING HOUSES There are no common lodging houses in the Borough. 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 house. There are no wells or stand pipes. RODENT AND PEST CONTROL Prevention of Damage by Pests Act. 1949 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 411, of which 110 related to rats and 301 to mice. The figures for 1954 were 520, of which 115 were rats and 405 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 are made to business premises on a time and material basis. 61 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. This work is undertaken by the staff of the Borough Engineer. PROVISION OF DUSTBINS - New Legislation The vexed question of who should provide the dustbin the Owner or the Occupier, has been relieved, so far as the Borough Council is concerned, by the new provisions contained in Section 12 of the London County Council (General Powers) Act, 1954. It is now the practice for the Council to ask the owner to supply the dustbin. The owner may appeal to the Magistrates Court against the requirements of the notice within 21 days. PLEASURE FAIR BY-LAWS In view of the lack of legal control over the persistent public health nuisances caused by the absence of sanitary conveniences at the private Vale of Health Amusement Park, the Council determined to make By-laws in pursuance of the powers contained in the London County Council (General Powers) Act, 1939. These By-laws were confirmed by the Home Office and came into operation on 1st October, 1954. Two prosecutions were instituted under the By-laws against the proprietors of the Vale of Health private fairground in respect of the absence of sanitary conveniences for members of the public attending the Fair on August Bank Holiday. Fines totalling £10 were imposed on the Defendants and Costs of £5.5s.0d. awarded to the Council. SWIMMING BATHS A total of twenty-two samples of water were taken from the Hampstead Swimming Baths - eight for chemical analysis and fourteen for bacteriological examination. The results proved to be satisfactory. 62 HEATING APPLIANCES (FIREGUARDS) ACT. 1952 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. No contravention of the Act was reported. THE RAG FLOCK AND OTHER FILLING MATERIALS ACT. 1951 There is one firm in the Borough of Hampstead whose premises are registered for the use of filling materials used in manufacturing bedding and other articles of upholstery. Four inspections have been carried out which showed the premises to be in a satisfactory condition. LEGAL PROCEEDINGS Public Health (London) Act, 1936 Date of Hearing Court Premises and Nature of Offence Result of Proceedings 22.1.55. Marylebone Magistrates Court Dynham Road. Noncompliance with Nuisance Order Order to abate within 14 days, £2.2s. Costs. 1.2.55. ditto. Alexandra Road. Non-compliance with Nuisance Order Order to abate nuisance within 14 days, £2.2s. Costs. 8.2.55. ditto. Buckland Crescent. Non-compliance with Nuisance Order Summons withdrawn Work completed. 16.2.55. Hampstead Justices Court Netherwood Street. Non-compliance with Abatement Order Work completed. £2.2s. Costs. 21.4.55 Marylebone Magistrates Court Fellows Road. Nuisance. Order to abate nuisance within 42 days, £2.2s. Costs. Continued: 63 Legal Proceedings (Contd.) Date of Hearing Court Premises and Nature of Offence Result of Proceedings 4.5.55. Hampstead Justices Court Roderick Road. Nuisance Order to abate nuisance within 48 days. 20.5.55. Marylebone Magistrates Court Broadhurst Gardens. Nuisance Work completed before Hearing. Summons withdrawn. 21.6.55. ditto. Kilburn High Road. Nuisance Order to abate nuisance within 21 days. £2.2s. Costs. 30.11.55. ditto. Gascony Avenue Nuisance Order to abate nuisance within seven days. OUTWORKERS In accordance with the Factories Act, 1937, 21 Hampstead firms sent in lists of persons employed as home workers. Of the 229 persons so employed 34 only resided in the Hampstead area. Information concerning 118 outworkers resident in Hampstead but employed by firms outside the Borough was received from other authorities. PHARMACY AND POISONS ACT. 1933 During the year, 114 applications for the renewal of poisons licences were granted. In 2 instances new licences were issued and 5 firms were removed from the Register. At the end of the year 116 firms were on the register. PET ANIMALS ACT, 1951 6 licences were renewed during the year, and 1 new licence was granted. 65 APPENDIX Authorities and Organisations concerned with health and welfare in the Borough of Hampstead. 66 HOSPITALS AND CLINICS Hampstead comes within the area of the North West Metropolitan Regional Hospital Board, 11, Portland Place, W.1., MUSeum 3380. Hospital Controlling Authority New End Hospital, New End, N.W .3. (236 beds. HAM 5444) Archway Group Hospital Management Committee, "Copley Dene", 46 Cholmley Park, N.6. ARChway 3070 Hampstead General & N.W. London Hospital, Haverstock Hill, N.W.3. (140 beds. PRI 1151) Board of Governors, Royal Free Hospital, Gray's Inn Road, W.C.1. TERminus 6411 Royal Free Hospital, N.W. Branch, Lawn Road, N.W.3. (300 beds. PRI 7671) ditto. Garrett Anderson Maternity Home, 40 Belsize Grove, N.W.3. (26 beds. PRI 2246) ditto. St. Columba's Hospital, 98 Avenue Road, N.W.3. (32 beds. PRI 4230) Paddington Group Hospital Management Committee, 285 Harrow Road, W.9. CUNningham 6071 Tuberculosis Chest Clinic, 54 Eton Avenue, N.W.3. (PRI 7137) ditto. Mass Radiography Unit No.5b, 285 Harrow Road, W.9. (CUN 6071) ditto. Queen Mary's Maternity Home, 124 Heath Street, N.W.3. (42 beds. HAM 6333) Board of Governors, London Hospital, Whitechapel, E.1. BIShopsgate 3255 67 Hospital Controlling Authority Marie Curie Hospital, 66 Fitzjohn's Avenue, N.W.3. (50 beds. HAM 3150) Harefield & Northwood Group Hospital Management Conmittee, Mount Vernon Hospital, Northwood. Northwood 2665 VENEREAL DISEASE CLINICS A full list of clinics may be obtained from the Public Health Department, 33 Lancaster Grove, N.W.3, or from the Public Health Department, County Hall, S.E.I. The clinics nearest to Hampstead are the following:- Middlesex Hospital, Male &) Mortimer Street, W.1. Female) Royal Free Hospital, Male,) Gray's Inn Road,N.W.1. Male) Female) & Children) St. Mary's Hospital, Male &) Norfolk Place, Female) Paddington, W.2. University College Hosp.) Gower Street, W.C.1. Male) ) ) Female) ) Wednesday evening. Tuesday 2.30-4.30 p.m. Tuesday & Friday 5-7 p.m. Monday to Saturday mornings and afternoons. Monday to Friday evenings. Monday to Saturday mornings. Monday to Friday afternoons and evenings. Saturday 11 a.m. to 2 p.m. Monday to Friday 12-2 p.m. and evenings. Saturday 11.30 - 12.30 p.m. Tuesday and Thursday afternoons and Monday to Friday evenings. NATIONAL HEALTH SERVICE London Executive Council, Insurance House, Insurance Street,W.C.1. TERminus 7833 National Insurance Offices:- 245 Finchley Road, N.W.3. HAMpstead 9641 (for residents east of Finchley Road) 194 Euston Road, N.W.1. EUSton 6451 (for residents west of Finchley Road) 68 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, free of charge. Ambulances may be summoned as follows (1) Accidents (wherever occurring) ) and sudden illness (in the) streets, public places or places) of employment) ) Dial "999" and ask for "AMBULANCE" (or follow the instructions given on telephone Instrument) (2) Very urgent illness at home-) provided a doctor certifies the) case is one of life or death) and that arrangements have been) made with a hospital for the) patient's admission) Telephone- WATerloo 6000 NEW Cross 2645 RELiance 3622 CENtral 6301 REGent 4000 (3) Maternity cases. Where an) expectant mother has booked a) hospital bed, she will be in) possession of a hospital) admission card) Follow instructions on hospital admission card (Form L.A.S. 23) In cases of emergency, in the) street or other public places,) if hospital bed has not been) booked) Dial "999" and ask for "AMBULANCE" (or follow the instructions given on telephone instrument) In all other cases application) should be made by a doctor or) midwife to the Emergency Bed) Service) Telephone-HOP 7l8l (4) Other illness. For removal to ) and from hospital. Application ) must be made by the hospital ) authority, the Emergency Bed ) Service or by a private doctor ) Telephone-WATerloo 3311 or apply in writing to London Ambulance Service, County Hall, S.E.1. Further particulars may be had on application to the Officer-in-Charge, London Ambulance Service, County Hall, S.E.1. Telephone enquiries relating to the ordering of ambulances to WATerloo 3311; general enquiries to WATerloo 5000, Ext.6950. 69 INTERNATIONAL CERTIFICATES OF VACCINATION International Certificates of Vaccination and Inoculation for persons travelling to certain countries abroad are required in respect of smallpox, yellow fever, cholera, etc. These certificates must be authenticated by the Medical Officer of Health and should be sent to him at the Public Health Department, 33, Lancaster Grove, N.W.3. BLOOD TRANSFUSION SERVICE Blood Transfusion Services are held periodically in the Borough. Blood donors are urgently required, and details may be obtained from the British Red Cross Society, 33, Lancaster Grove, N.W.3. HAMpstead 7171. LOAN OF HOME NURSING EQUIPMENT Beds, bedding, nursing equipment, invalid chairs, etc. may be borrowed for the assistance of cases of illness nursed at home. Further particulars may be obtained from:- The British Red Cross Society, 33, Lancaster Grove, N.W.3. HAMpstead 7171. The Divisional Medical Officer, 313, Harrow Road, W.9. CUNningham 4815. PRINCIPAL LOCAL CHARITIES Wells & Campden Charity. Grants to poor persons. Clerk to the Trustees, Mr. F.R.D'O. Monro, B.A., 116 Fitzjohn's Avenue, N.W.3. Rumsey's Charity. Coal for poor persons. Hon.Sec. and Treasurer, Mr. P.J. Knight, 28 Hampstead High Street, N.W.3. H.J. Ogden's Bequest. Grants to poor persons. Trustee - His Worship the Mayor. Stock's Charity. Clothing for fatherless school children. Hon. Secretary, The Town Clerk, Town Hall, N.W.3. 70 J.S. Henderson Trust. Convalescent Home near Hastings for Hampstead residents. Chairman - Mr. E. Watson Shields, 1 Holly Bush Vale, N.W.3. THE CARE OF THE AGED Agencies concerned with the Care of the Aged Hampstead Old People's Welfare Association, 107, Kingsgate Road, N.W.6. MAI 3652 Hampstead Council of Social Service, Burgh House, New End Square, N.W.3. HAM 0049 Hampstead Old People's Housing Trust Ltd., Hon. Sec. - Mrs. D.M. Page, 127, Fellows Road, N.W.3. PRI 9860 Women's Voluntary Service, 249, Finchley Road, N.W.3. HAM 9552 British Red Cross Society, 33, Lancaster Grove, N.W.3. HAM 7171 National Assistance Board, Old Post Office, Downshire Hill, N.W.3. HAM 9027 Ministry of Pensions & National Insurance, 245, Finchley Road, N.W.3. and 194, Euston Road, N.W.1. HAM 9641 EUS 6451 Home Help Organiser, 251, Finchley Road, N.W.3. HAM 4136 Welfare Officer (Applications for residential accommodation for persons in need of care and attention) Luxborough Lodge, Luxborough Street, W.1. WEL 5619 Admitting Officer (enquiries regarding inmates at above) WEL 0966 Meals. Meals are taken to the home of house-bound old people by the British Red Cross Society. It is only possible for meals to be delivered twice weekly. 71 Dinner Clubs. These are held at- St. Stephen's Church Hall, Pond Street, N.W.3. Health Institute, 107, Kingsgate Road, N.W.6. Burgh House, New End Square, N.W.3. Chiropody Service. A chiropody clinic is held at 107, Kingsgate Road, N.W.6. (MAI 3652) on Tuesdays from 4.0 p.m. Appointments are made through the Hampstead Old People's Welfare Association. In special cases visits can be paid to the patient's home. Baths. Old Age Pensioners are allowed to use the slipper baths at the Central Baths, Finchley Road, N.W.3. free of charge. Homes. A list of homes in the Hampstead area can be obtained on application to the Medical Officer of Health, 33, Lancaster Grove, N.W.3. Details of Homes in the London area outside Hampstead can be obtained from the Old People's Homes Committee, 296, Vauxhall Bridge Road, S.W.1. (Victoria 9977). Hospital Care. Applications for admission of old people to hospital should be made to Dr. Exton-Smith, Whittington Hospital, Highgate Wing, Dartmouth Park Hill, N.19. (ARChway 3070). Clubs. Darby and Joan Club, St. Stephen's Hall, Pond Street, N.W.3. Wednesdays 2 - 4.0 p.m. Darby and Joan Club, All Souls, Loudoun Road, N.W.8. Tuesdays 2 - 4.0 p.m. Darby and Joan Club, St. Mary's, Priory Road, N.W.6. Thursdays 2 - 4.0 p.m. Brondesbury Fellowship Club, 107, Kingsgate Road, N.W.6. Daily 2 - 5.0 p.m. Good Companions Club, Moreland Hall, Holly Bush Vale, N.W.3. Mondays 5 - 8.0 p.m. St. Peter's Vicarage Club, Belsize Square, N.W.3. Wednesdays 3 - 5.0 p.m. 72 Burgh House Club, Burgh House, New End Square, N.W.3. Daily 2 - 7.0 p.m. Friendship Club, Congregational Church Hall, Lyndhurst Road, N.W.3. Thursdays 3 - 5.0 p.m. Friendship Club, The Synagogue, Dennington Park Road, N.W.6. Thursdays 3 - 5.0 p.m. WELFARE SERVICES IN RESPECT OF CHILDREN Divisional Treatment Organiser, 313, Harrow Road, W.9. CUN 4815. Deals with the health of school children and arranges medical treatment. Works in conjunction with the voluntary school care committee workers and the District Care Organiser. Divisional Education Officer, 71, Gloucester Place, W.1. WEL 1174. Is concerned In cases referred to the N.S.P.C.C. He is also the Secretary of the Borough Youth Committee and his staff includes organisers of youth service whose duties are the encouragement and co-ordination of youth activities in Division 2 of the L.C.C. School Inquiry Officer, 71, Gloucester Place, W.1. WEL 1174. Investigates absence from school and irregular attendance. Deals with infringements of employment by-laws. District Care Organiser, 11, Maida Avenue, W.2. PAD 6661. Organises social work connected with the school child through voluntary care committees attached to the schools. Arranges follow-up of cases of molestation or sexual misbehaviour. Complementary to the Divisional Treatment Organiser. Principal Youth Employment Officer, 9, Carmelite Street, E.C.4. CEN 7631 • Is concerned with vocational guidance and placing of youth up to the age of 18 years in employment. The Area Children's Officer, 313, Harrow Road, W.9. CUN 3244. Local representative of the L.C.C's. Children's Officer. Child Welfare Officer. 313, Harrow Road, W.9. CUN 3244. Deals with applications for children to be received into official care; with the rehabilitation of homes so that children already in care can return home as soon as possible; supervises children placed in households for adoption; finds foster homes and supervises children in them; has special duties in connection with Juvenile Court work. 73 WELFARE OF THE BUND AND PARTIALLY SIGHTED Home visits are made by visitors attached to the L.C.C. Welfare Department, 5, Princes Row, Victoria, S.W.1. VIC 0162. WELFARE OF OTHER HANDICAPPED PERSONS Welfare services for handicapped persons, other than the blind, are dealt with at 5, Princes Row, Victoria, S.W.1. VIC 0162. Accommodation - Welfare Home. Officers on the staff of Luxborough Lodge, Luxborough Street, W.1. (WEL 5619) deal with applications for residential accommodation for persons in need of care and attention not otherwise available to them and visit homes of the applicants. Welfare Office for the Homeless. Applications for temporary residential accommodation for homeless families should be made to the L.C.C. Welfare Office, 12, Northumberland Avenue, W.C.2. (WHI 8907). After office hours applications should be made to Newington Lodge, 182, Westmoreland Road, S.E.17. (ROD 4201). MENTAL HEALTH SERVICE Applications regarding cases of urgent mental illness should be made to:- The Duly Authorised Officer, County Hall, S.E.1. Telephone number during office hours WATerloo 5000 Ext. 273. Telephone number after office hours WATerloo 5000 Ext. 7005. Correspondence should be addressed to the Medical Officer of Health (B.2), London County Council, County Hall, S.E.1. Particulars of persons who are alleged to be suffering from mental deficiency should be referred to the Medical Officer of Health (B.1), London County Council, County Hall, S.E.1. WATerloo 5000 Extension 6206. Psychiatric Preventive Care and After-care of patients who are not in need of out-patient or in-patient psychiatric treatment is dealt with by the Medical Officer of Health (PH/B.1(f)) London County Council, County Hall, S.E.1. WATerloo 5000 Extension 7178. 74 LONDON COUNTY COUNCIL. DIVISION 2. PUBLIC HEALTH DEPARTMENT Divisional Medical Officer: H. Leslie Oldershaw, M.D.,B.S.,D.P.H., 313/319, Harrow Road, W.9. CUNningham 4815. Hampstead Sub-Office: 251, Finchley Road, N.W.5. HAMpstead 8450. List of Clinics, Day Nurseries and School Treatment Centres situated within the Borough of Hampstead DAY NURSERIES (Normally open all day, Monday to Friday) Woodchurch, 11/13, Woodchurch Road, N.W.6. MAI 2937 Parkhill, 2, Parkhill Road, N.W.3. GUL 4759 Pond Street, 27/29, Pond Street, N.W.3. HAM 1686 MATERNITY AND CHILD WELFARE CENTRES 60, West End Lane, N.W.6. MAI 5381 250, Haverstock Hill, N.W.3. PRI 3666 Hampstead Wells, Christchurch Hill, N.W.3. HAM 9534 40, College Crescent, N.W.3. PRI 8033 Solent Road, Sumatra Road, N.W.6. HAM 5978 SCHOOL TREATMENT CENTRES Kilburn Treatment Centre, 107, Kingsgate Rd.,N.W.6. MAI 3005 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. MAI 5381 BATHING CENTRE Hampstead Bathing Centre, Lithos Road, N.W.3. HAM 7171 (This is a Borough Council establishment at which school children receive treatment under arrangements made between the London County Council and Borough Council.) DISTRICT NURSING ASSOCIATIONS Hampstead District Nursing Association, HAM 6406 5, Pond Street, N.W.5. Kilburn & W. Hampstead District Nursing Association HAM 4232 20, Dennington Park Road, N.W.6. 75 For detailed information on the following subjects application should be made to the Divisional Medical Officer, Harrow Road, W.9. CUNningham 4815. Care of Mothers and Young Children. Child Guidance Units. Deprived or Neglected Children. Rehabilitation of Mothers. Child Minders and Day Nurseries. Health Visiting. Home Nursing. Welfare Centres. Midwifery. Domestic Help Service. Family Planning. Recuperative Holidays. Foot Clinics. Tuberculosis Care and After-care. Prevention of illness, care of persons suffering from illness or mental defectiveness and the after-care of such persons. Treatment centres for school pupils for;- Minor Ailments, Dental, Vision, Orthoptics, Stammering and other speech defects, Rheumatism, Ear, Nose and Throat, Eneuresis, Nutrition. Vaccination and Immunisation. OFFICIAL AND VOLUNTARY ORGANISATIONS Citizens Advice Bureau, Hampstead East, Burgh House, New End Square, N.W.3. HAMpstead 0048. Citizens Advice Bureau, Hampstead West, 107, Kingsgate Road, N.W.6. MAIda Vale 2007. Poor Man's Lawyer: Burgh House, New End Square, N.W.3. Monday 6 - 7 p.m. HAMpstead 0048. 107, Kingsgate Road, N.W.6. Monday at 5.45 p.m. MAIda Vale 2007. Local Information Bureau, 214, Haverstock Hill, N.W.3. HAMpstead 7171. Free Legal Aid and Advice Act: The Secretary, Legal Aid Dept., 5/6, Clements Inn, W.C.2. HOLborn 7266. 76 Superintendent Registrar (Births, Deaths, Marriages), 224, Haverstock Hill, N.W.3. HAMpstead 7171. Women's Voluntary Services, Local Office, 249, Finchley Road, N.W.3. HAMpstead 9552. Soldiers' Sailors' and Airmen's Families Association, Local Office, 107, Kingsgate Rd. MAIda Vale 2314. Ministry of Labour and National Service, 104, St. Pancras Way, N.W.1. GULliver 4l8l. Rent Tribunal, Central House, Upper Woburn Place, W.C.1. EUSton 1550. Beauchamp Lodge, Family Club, Warden, Miss E. Jackson, Beauchamp Lodge, Warwick Crescent, W.2. CUNningham 3688. Board of Guardians and Trustees for the Relief of the Jewish Poor, 127, Middlesex Street, E.1. BIShopsgate 1602. British Legion, 49, Pall Mall, S.W.1. WHEtehall 8131. British Red Cross Society, 14, Grosvenor Crescent, S.W.1. SLOane 9151. British Sailors' Society, 747, Commercial Road,E.l4. EASt 4191. The Catholic Marriage Advisory Council, 38-39, Parliament Street, S.W.1. WHEtehall 0817. Catholic Social Welfare Committee, 27, Tavistock Place, W.C.1. EUSton 1681. The Children's Aid Society, 55, Leigham Court Road, S.W.16. STReatham 2131/2. The Church Army, 55, Bryanston Street, W.1. PADdington 9211. Church of England Children's Society, Old Town Hall, Kennington Road, S.E.11. RELiance 2441. Church of England Moral Welfare Council, Room 251, Church House, Dean's Yard, S.W.1. ABBey 6269. 77 London Diocesan Council for Moral Welfare Work, 38, Grosvenor Hill, W.1. MAYfair 1594 - Outdoor Worker, Miss Hartley, 73, Dynham Road, N.W.6. Family Service Unit, 159, Westbourne Grove, W.11. BAYswater 6357. Family Welfare Association, Denison House, Vauxhall Bridge Road, S.W.1. Victoria 7334. Invalid Children's Aid Association, 4, Palace Gate, W.8. WEStern 3914. Area Office, Tavistock Place, W.C.1. EUSton 2492. London Marriage Guidance Council, 78, Duke Street, W.1. MAYfair 2731. The Mental After-care Association, 108, Jermyn Street, S.W.1. TRAfalgar 5953. The National Adoption Society, 4, Baker Street, W.1. WELbeck 7211. National Association for Mental Health, 39, Queen Anne Street,W.1. WELbeck 1272. National Association of Parents of Backward Children, 84, Chancery Lane, W.C.2. CHAncery 3096. National Baby Welfare Council, 31, Gloucester Place, W.1. WELbeck 6857. National Children Adoption Society, 71, Knightsbridge, S.W.1. SLOane 7231. National Council for the Unmarried Mother and Her Child, 21, Coram Street, W.C.1. TERminus 1891. National Society for the Prevention of Cruelty to Children, Leicester Square, W.C.2. GERrard 2774. The Save-the-Children Fund, 20, Gordon Square, W.C.1. EUSton 8591. 78 INDEX PAGE Accidents 3 Aged Persons: Care of the Aged 3, 27, 70 Cleansing of 25 Clubs 71 Meals service and Dinner Clubs70 Ambulance Facilities 68 Area of Borough 17 Area Children's Officer 72 Area Comparability Factors 17 Atmospheric Pollution 7, 43 Bacteriological Examinations: Food 39 Infectious Disease 23 Swimming Bath Water 61 Bakehouses 33, 57 Barbers and Hairdressers 2, 46 Bathing Centre 24, 74 Baths, Old Persons 25, 71 Beauchamp Lodge 76 Births, Birth Rate 17 Blind, Welfare of 73 Blood Transfusion Service 69 Board of Guardians & Trustees for Relief of Jewish Poor 76 British Legion 76 British Red Cross Society 70, 76 British Sailors Society 76 Burials 26 Catholic Marriage Advisory Council 76 Catholic Social Welfare Conmittee 76 Census 1951 4, 17 Certificates of Disrepair 5, 57 Certificates of Suitability 57 Charities, Principal Local 69 Chemical Analysis: Food 40 Swimming Bath Water 6l Children's Aid Society 76 Children's Welfare Services 72 Chiropody Service 71, 75 Church Army 76 Church of England Children's Society 76 79 PAGE Church of England Moral Welfare Council 76 Citizens Advice Bureau 75 Cleansing Station 24 Clearance Areas 54 Clinics 66 Closing Orders 54 Common Lodging Houses 60 Complaints 28 Contamination of Food 39 Conveniences, Free Washing Facilities 53 Cooked Meats, etc. 34 Darby and Joan Clubs 71 Day Nurseries 74 Deaths: Chief Causes 18 Death Rate 17 Infant Mortality 17 Materna1 Mortality 17 Mortuary 26 Suicides 4, 13 Demolition Orders 54 Dinner Clubs 71 Disinfecting and Cleansing Station 24 District Care Organiser 72 District Nursing Associations 74 Division 2, London County Council 74 Divisional Health Committee 15 Divisional Education Officer 72 Divisional Treatment Organiser 72 Domestic Help Service 70, 75 Drainage 29 Dustbins, Provision of 61 Dwellings: Structurally separate 17 Rate Assessments 17 Educational Officer, Divisional 72 Factories Act: Inspections 29, 59 Outworkers 63 Underground Bakehouses 57 Fair, Hampstead Heath 35 Fairground By-laws 61 Family Planning 75 Family Service Unit 77 80 PAGE Family Welfare Association 77 Food: Adulterated Samples 40 Bacteriological Examination 39 Bakehouses, Underground 57 Chemical Analysis 40 Cooked Meat Premises 34 Food and Drugs Act, 1955 7, 29 Food and Drugs Act, 1938, Sec.l4 34 Food Hygiene at Hampstead Heath Fair 35 Food Hygiene Regulations 7, 29 Ice Cream 33, 34, 38 Inspections 28, 33 Legal Proceedings 42 Milk 33, 35 Premises 28, 33 Sampling 39, 40 Unsound Food 41 Food Poisoning 10, 21 Foot Clinics 71, 75 Free Washing Facilities 53 Free Legal Aid 75 Hairdressers and Barbers 2, 46 Hampstead Council of Social Service 14, 70 Hampstead Heath Fair 35 Hampstead Old People's Housing Trust Ltd. 14, 70 Hampstead Old People's Welfare Association 14, 70 Handicapped Persons, Welfare of 73 Health Visiting 73 Heating Appliances (Fireguards) Act, 1952 62 Home Help Organiser 70, 75 Home Nursing Equipment 69 Homeless Persons 73 Homes, Old Persons 71 Hospitals 66 Hospital Management Committees 14, 21 House-to-House Inspections 28 Houses let in lodgings 6 Housing: Applications for Rehousing 28, 56 Clearance Areas 54 Closing and Demolition Orders 54 Housing Act, 1949, Section 4 8, 28 ditto. Section 20 8 Housing Act, 1936, Section 9 28,54 Housing Repairs and Rents Act, 1954 5, 57 Local Govt.(Miscellaneous Provisions) Act, 1953 55 81 housing: Contd. PAGE Slum Clearance Programme 53 Statistics 54 Unfit Houses 54, 58 Overcrowding 57 Ice Cream 33, 34, 38 Improvement Grants 8 Infant Mortality 17 Invalid Children's Aid Association 77 Infectious Diseases 10, 19, 23 International Certificates of Vaccination 69 Intimation Notices 28 Loans for House Purchase 8, 28 Local Information Bureau 75 Legal Proceedings 42,62 Local Govt. (Miscellaneous Provisions) Act, 1953 55 London County Council 15, 74 London County Council (General Powers) Act,1953. S.43 25 ditto. ditto. 1954. S.12 6l ditto. ditto. 1954. S.18 46 London Diocesan Council for Moral Welfare Work 77 London Marriage Guidance Council 77 Luxborough Lodge 70 Mass X-ray 23, 66 Maternal Mortality 17 Maternity & Child Welfare Centres 74 Mental After Care Association 77 Mothers and Young Children, Care of 75 Medical Examinations, Staff 25 Mental Health Services 73 Milks Distributors 35 Premises 33 Special Designations, etc. Regulations 35 Supply to Schools and Hospitals 35 Ministry of Pensions and National Insurance 70 Ministry of Labour and National Service 76 Mobile Meals Service 70 Mortuary 26 National Adoption Society 77 National Assistance Act, 1948, Section 50 26 ditto. Section 47 27 National Assistance Board 70 National Association of Parents of Backward Children 77 82 PAGE National Association for Mental Health 77 National Baby Welfare Council 77 National Health Service 67 National Insurance Offices 67 National Children's Adoption Society 77 National Council for the Unmarried Mother and her Child 77 National Society for the Prevention of Cruelty to Children 77 National Smoke Abatement Society 15 Neo-Natal Mortality 18 Old Persons 5, 27, 70 Outworkers 63 Overcrowding 57 Pet Animals Act, 1951 63 Pharmacy & Poisons Act, 1933 29,63 Pleasure Fair By-laws 61 Poliomyelitis 11, 20 Poor Man's Lawyer 75 Population 17 Prevention of Damage by Pests Act, 1949 60 Principal Youth Employment Officer 72 Public Analyst's Report 40 Public Conveniences 53 Public Health Committee 14 Public Health Laboratory 23, 39 Public Health (London) Act, 1936, Section 93 58 Public Health Station 25 Public Mortuary 26 Rag Flock etc. Act, 1951 29, 62 Rateable Value 17 Recuperative Holidays 75 Registrar of Births and Deaths 76 Rehousing 56 Rent Tribunal 76 Rodent Control 60 Sampling 39 Sanitary Circumstances of the Area 27 Sanitary Inspectors 4, 15, 27 Save the Children Fund 77 Scabies 24 School Treatment Centres 74 School Inquiry Officer 72 Sewers, Rodent Control 61 83 PAGE Shops Act, 1950 29 Slum Clearance 53 Smallpox 19 Smoke Abatement 7, 43 Soldiers' Sailors' & Airmen's Family Association 76 Speech Therapy Centre 74 Staff: Public Health Department 15 Inspectorial 4, 27 Medical Examination 25 Statistics: Sanitary Circumstances 28 Vital 17 Wards 17 Statutory Notices 4, 26 Stillbirths 17 Structurally Separate Dwellings 17 Suicides 4,26 Swimming Bath Water 61 Treatment Organiser, Divisional 72 Tuberculosis: Chest Clinic 66 Mass X-ray 23, 66 Notification and Deaths 11, 23 Care and After-care 75 Underground Bakehouses 57 Unsound Food 41 Vaccination and Immunisation 75 Vaccination, International Certificates 69 Venereal Disease Clinics 67 Verminous Persons 24 Ward Statistics 17 Warren, Dr. M.D. 4 Water Supply 60 Women's Voluntary Service 70, 76 Welfare of the Blind 73 Welfare of Handicapped Persons 73 Welfare Services, Children 72 Welfare Centres 74 Welfare Officer, Persons in need of care and attention 70 Youth Employment Officer 72