Metropolitan Borough of hamstrad. Report on the Health of the Borough. 1956 R. D. DEWAR, B.Sc., M.B., CH.B., D.P.H. Medical Officer of Health Metropolitan Borough of hampstead. Report on the Health of the Borough. 1956 R. D. DEWAR, B.Sc., M.B., CH.B., D.P.H. Medical Officer of Health 2 CONTENTS Page Public Health Committee; Staff. 5, 6, 21 Population; Births; Deaths 7, 45-47 Infectious Disease. 8-12, 48-50 Aged and Infirm Persons. 13-£0 Pood and Drugs. 21-25, 55~59 Atmospheric Pollution. 25-29 Public Health Inspection. 30, 31, 51, 54 Factories Act, 1937 & 1948. 31-33, 52, 53 Rodent and Pest Control. 33"36 Housing. 37 -44, 60-62 Mortuary. 50 Statistical Summary. 45-62 L.C.C. Division 2. 63, 64 Index. 65-69 3 Public Health Department, 98a, Avenue Road, Hampstead, N.W.3. 9th May, 1957. TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE METROPOLITAN BOROUGH OF HAMPSTEAD. Mr. Mayor, Ladles and Gentlemen, I have the honour to present the Annual Report on the health and sanitary circumstances of the Borough of Hampstead during the year 1956. The report which follows sets out those figures of births, deaths and cases of notifiable infectious disease which attempt to express mathematically the state of the health of the residents of the Borough. The report also gives a summary of the work of the Public Health Department during the year, also largely reduced to figures. This method is convenient because it allows of easy comparison with previous years and with other districts, but it is necessarily incomplete and the effect or otherwise of the work of the Department on the health of the people cannot readily be shown. One reason for this is that public health measures frequently show their effects only after a long period. A child brought up in good surroundings is likely to live longer and he may figure in the death returns after a period of say 70 years instead of 40 or 50 years. Another reason is that the improved standards of living have had a major effect on the health of the people. There can be little doubt that improved housing has played a greater part in raising the standard of health than any single public health measure. Adequate food, clothing, medical services, etc. which we enjoy in this country have raised our standard of health far above those of less fortunate countries. Not all aspects of a better standard of living, however, necessarily improve health. Diet during the period of rationing was well balanced as was evident from the health of the children; the present freedom for individual choice and the greater quantity and variety of food does not necessarily mean that everyone has a better diet from a physiological point of view. The increased number of motor cars 4 on the road does not tend to prolong life and the increase in television viewing has been criticised. It is probable, however, that it is how people live rather than where they live which is important. Habits cannot be altered merely by an Act of Parliament, but if a person is given an environment in which he can live healthily then he probably will live healthily. Good housing will encourage good habits. Nobody now would consider a bathroom, a hot water supply or an indoor lavatory as luxuries. An efficient heating system usually provides or encourages efficient ventilation, good lighting is followed by cleanliness and improved conditions of employment usually result in improved conditions in the home. If a person can take pride in his surroundings he will usually take pride in himself. It is, I believe, the wish and intention of the Council that every effort should be made to provide such an environment and this can best be obtained by advice, help and encouragement. The work of the public health inspectors is not merely to enforce the provisions of the law but it is to assist in producing those circumstances, and those habits, which will lead to an improvement in the health of the public. The mere figures of the visits of the inspectors do not adequately reflect their work in this sphere. As I have indicated, this Report is inadequate as an assessment of the health of the people of the Borough, but I feel that the Members of the Council can be reasonably satisfied of the effectiveness of the services provided during 1956 no less than in previous years. I would like to express my thanks to the Members of the Council and particularly to the Chairman arid Members of the Public Health Committee for their help and encouragement. My thanks are also due to the other Chief Officers and their staffs for advice and cooperation at all times and especially to my own staff for their loyal support. I am particularly indebted to the Chief Public Health Inspector, Mr. J.F. Armstrong, and to the Chief Clerk, Mr. A.H.C. Slade, for the generous way in which their wide knowledge and experience of the Borough was placed at my disposal when I took up my appointment in April, 1956. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, R. DUNCAN DEWAR, Medical Officer of Health. 5 PUBLIC HEALTH COMMITTEE The Worshipful the Mayor (Councillor Miss D.R. Bailey, J.P.) ex-officio member. Chairman: Alderman S.A. Boyd, M.S.,F.R.C .S. Aldermen Mrs. R.S.G. Carnegie. Mrs. F.E. Cayford, J.P.,L.C.C. Councillors Miss E. Beer. DF. Ridgley. O.H. Belam, M.R.C .S.,L.R.C .P. K. Sames, Ph.D.,F .R.I .C . P F R.C.S. Mies D.M. Stedman. Miss M. du Mont, M.A. Mrs. P. Unwin. N. Oatway (Vice-Chairman) B.J.J. West. The Chairman of the Housing Comnittee. Sub-Commit tees: Drainage Plans; Housing Repairs & 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, R.M. Brodtman, E. Snowman. The Hon. Mrs. Ruth Bennett. Hampstead Old People's Housing Trust Ltd: Councillors Miss S.H. Ayliff, R.M. Brodtman, E. Snowman, J .J . Tobin, M.A.,LL.B., Mrs. H.M. Young. Hampstead Old People's Welfare Association: Aldermen Mrs. R.S.G. Carnegie, R.J. Cleaver, Councillors Miss S.H. Ayliff, Mrs. J. Lowry, J. Manfield, D.F. Ridgley, A E . Skinner. Mr. J. Holloway. Hospital Management Committees: Archway Group: Mrs. M. Ormerod, B.A., Mrs. M.J. Oatway, S.R.N. Paddington Group: No.5 House Committee; 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 O.H. Belam, M.R.C.S.,L.R.C .P.,F.F.A.R.C .S. National Smoke Abatement Society: Alderman S.A. Boyd, M.S.,F.R .C .S. The Medical Officer of Health. 6 STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health: D.H. Geffen, O.B.E.,M.D.(Lond.),M.B.,B.S.(Hons. ),M.R.C .S., L.R.C.P.,D.P.H. (up to 31.3.56) R.D. Dewar, B.Sc.,M.B.,Ch.B .,D.P.H., Barrlster-at-law (from 27.4.56) Deputy Medical Officer of Health: S .A. Boyd, M J) .(Vienna), D.P.H. (formerly I.A. Bolz) (up to 13.5.56) G.M. Frizelle, T.D.,M.D.,B.Ch.,B.A .0.,D.P.H. (from 27.7.56) Chief Public Health Inspector: J.F. Armstrong (a)(b) Deputy Chief Public Health Inspector: F.V. Outlaw (a)(b) Public Health Inspectors: Mrs. C. Speechley (a)(d)(e)(f) E. Ulrich (a)(b)(c) L.E. Trigg (a)(b) C.S.T. Dancer (a)(b) WJ. Newport (a)(b) G.R. Young (a)(b) D.W. Malcolm (a) (up to 31.12.56) G.L. Nicklin (a) R.W.M. Cook (a) R. Clark (a) Chief Clerk; A.H.C. Slade . Clerical Staff: G.W. Bedell. J .A . Gilbody. Mrs. M.C. Rabin. D. Ring. C.F. Pidgeon. C.J. Bailey Mrs. G.A. Fletcher. (from 2.1.56) Public Analyst: E.Voelcker, A .R.C .S.,F.R.I .C., 1, Tudor Street, E.C.4. Mortuary Keeper: S. King. (a) Public Health 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. 7 POPULATION There was a natural increase in population of 446 i.e. the number of births exceeded the deaths by that figure. The Registrar General's estimate of the population as at the middle of 1956 was 97,580. BIRTHS The number of births was 1,475, being 760 males and 715 females, giving a birth rate of 15.1 per 1,000 of the estimated population. DEATHS There were 1,029 deaths of Hampstead residents. This figure was a little higher than the previous year but the increase was not larger than the normal fluctuation which one expects with statistics and does not call for particular comment. The death rate was 10.5 per 1,000 of the estimated population. The individual causes of death do not show any marked variation from the normal. Small upward or downward trends can only be shown by a detailed analysis over many years and such an analysis is not possible in each year's annual report. F6r what it is worth, however, the following are the major changes compared with the figures for 1955. Deaths from tuberculosis dropped from fifteen to four. This is probably the lowest figure ever achieved in Hampstead for tuberculosis deaths. Heart and circulatory diseases caused 390 deaths compared with 344 in 1955.The increase was principally in coronary disease and angina which showed an increase of 16 male deaths and 29 female deaths. The total deaths from cancer showed little change, 216 compared with 220. Cancer of the lung and bronchus, however, showed a decrease from 56 to 34. Cancer of the stomach increased from 23 to 30 and cancer of the breast from 17 to 26. Motor vehicle accidents were responsible for four deaths against 10 for 1955 and deaths from all other accidents also showed a small drop, from 19 to 16. 8 The number of deaths from suicide dropped from 29 to 25 but this is not large enough to be of much significance and one hopes this figure will show a much bigger reduction in future years. There were two deaths from infectious disease, one of meningococcal infection and one of poliomyelitis. Among the notified cases of pneumonia there were three deaths. One death was attributed to pregnancy and childbirth. The infant mortality rate of 25 per 1,000 live births was a little higher than in recent years. Altogether 34 infants died under the age of one year, of whom 27 died before reaching the age of one month. INFECTIOUS DISEASE The year 1956 proved to be a comparatively healthy one in Hampstead. The total number of cases of notifiable disease was 566, of which 243 were cases of measles. Although the incidence of measles did not reach epidemic proportions it is interesting to note the steady increase in the monthly number of cases up to July and the decrease during the second half of the year. Measles Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. 2 6 2 6 17 25 59 48 28 32 9 9 If eases of measles are excluded the totals for the remaining notifiable diseases have shown a steady improvement in the last six years. 1951 1952 1953 1954 1955 1956 595 453 460 444 381 323 The summer of 1956 proved to be completely free of poliomyelitis in Hampstead. The two cases which did occur, both of the paralytic variety, occurred in March. It is with regret that I record the death of one of these cases, a woman of 29 years of age. The other case, in a boy aged 2¼ years was comparatively mild. The diagnosis of polionyelitis is often extremely difficult and it is becoming increasingly common for cases to be admitted to hospital for diagnosis. During the year 17 cases were admitted to hospital as "Query Poliomyelitis" but in all 9 cases the diagnosis proved to be some infection or disease other than poliomyelitis. One hesitates to comment on these admissions, A proportion and possibly a high proportion of these cases would have required hospital admission in any case, but moving a patient who is in the early stages of a major attack of poliomyelitis can be fraught with danger. The question of the advisability of admission to hospital is most difficult to decide and it is no help to know that if your decision is right the absence of paralysis in the patient proves nothing whereas a wrong decision is only too often shown by the subsequent unfortunate condition of the patient. Five cases admitted as "Query Diphtheria" were found to be glandular fever with or without some additional disease. One case admitted as "Continued Fever" was finally diagnosed as acute streptococcal tonsillitis. Three cases removed as "Query Meningococcal Infection" were discovered to be acute follicular tonsillitis (2 cases) and acute respiratory catarrh. These "query" cases represent a vast amount of work in the Department. They are all visited by the Public Health Inspector and are followed up in hospital until final diagnosis Is reached. There were two confirmed cases of meningococcal infection, a male aged 68, and a boy of 7 who unfortunately died. Two cases of acute infective encephalitis occurred, one a girl of 7 years, the other aged 20 was a nurse In a local hospital. There were two cases of post infectious encephalitis, males aged 6 and 30, and in both cases the encephalitis was associated with mumps. One case of typhoid fever was notified. The patient was a laboratory technologist employed in a hospital and a week before the onset of the illness had been working on typhoid culture. Observation was continued during 1956 on a typhoid carrier who had been notified in November, 1955. 36 specimens were examined, one of which proved positive for salmonella anatum but it was not possible to establish precisely the source of this infection. The patient was still under observation as a typhoid carrier at the end of the year. 10 Of the 35 cases of dysentery notified, 20 were single cases. Of the remainder, 6 cases occurred in one household, 3 cases in another, and in three instances there were two cases in a family. The number of cases of whooping cough was low compared with recent years. January, February and March provided a total of 4 cases whereas 30 cases occurred during the month of August. A case of brucellosis was brought to the attention of the Department and on investigation it was found that the patient's family had been on holiday in Ireland and had stayed at a farm where the children had been allowed to drink untreated milk from a herd of T.T. cows. The number of cases of food poisoning notified was the lowest for the last 4 years. There were 10 isolated cases, in 8 of which the infection was attributed to salmonella typhimurium. The cause of infection in the remaining 2 cases was not discovered. Two small family outbreaks occurred involving a total of five cases. In both instances the cases were attributed to salmonella typhimurium. A larger outbreak where 12 cases were ascertained (but not notified) occurred in a small canteen. The outbreak was fairly severe and was apparently caused by some roast beef which had been cooked on the previous day and then reheated on the day of consumption* The causal organism was probably C1. Welchii. There were no cases of smallpox. In fact, for the first time for many years, we received no notification of contacts arriving in Hampstead from abroad. During the winter months, on the advice of the Ministry of Health the scheme for reporting epidemics of influenza continued in force. The Medical Officer of Health is asked to inform the Ministry of any unusual prevalence of influenza, and in order to obtain early information on this subject medical practitioners in various parts of the Borough were approached and asked to act as "spotters". Fortunately, the incidence of influenza remained at a low level and no reports were received of any outbreak. Tuberculosis The total number of newly notified cases of Tuberculosis (101) showed an increase of 13 over 1955, but was still below 11 the average for the last five years (105). Respiratory tuberculosis among males (60 cases) showed an increase of 12 cases but among females (29 cases) there was a decrease of 7 cases compered with the previous year. Non-respiratory tuberculosis which had shown a steady decrease for a number of years rose to a total of 12 cases, the highest since 1951. There were 4 deaths from respiratory tuberculosis. Mass X-ray The Mass Radiography Unit visited Hampstead in June and spent 7 days on a site in Finchley Road and 4 days in Hampstead High Street. The first three days at Finchley Road were reserved for firms and offices, the public sessions occupying the remaining four days. At Hampstead High Street one day was taken up by firms and offices and three by open sessions for the general public. No figures are available of the numbers attending or of the numbers recalled for large films but the Unit was fully occupied during its stay in Hampstead. In addition to the above the Unit spent one day at the Borough Council's Depot in Lymington Road for the perpose of X-raying the staff of the Borough Engineer's Department. VERMINOUS PERSONS 31 cases of scabies were brought to the notice of the Department. 25 of these were notified cases, the remaining 6 cases being second or subsequent cases in a family and not requiring notification. The Public Health Inspectors visited all cases and treatment of 14 cases and 6 contacts was carried out at the Cleansing Station. The remainder were treated either at home or at hospital. 10 adults and 8 children under 5 years of age were treated for verminous conditions other than scabies. The London County Council Clinic for treatment of school children continued to function on one afternoon a week and 38 children with verminous heads attended. No case of scabies occurred amongst school children. Under the London County Council (General Powers) Act, 1953 the Council has power to cleanse an aged person in his own home but in no instance was such action necessary in 1956. 12 DISINFECTION AND DISINFESTATION The work of the disinfecting staff tends to become more varied each year, and more time is spent on miscellaneous Jobs not connected with routine disinfection. Last year 14 wasp nests were destroyed; 14 filthy and verminous rooms were cleared after the death or removal of the occupant; in 16 instances bedding, carpets, etc., were removed for drying after burst water pipes; and 156 parcels of clothes were disinfected prior to despatch abroad. One entire hospital training school was disinfected on two occasions after outbreaks of disease, on each occasion the school was closed and the disinfection was spread over several days. The number of rooms disinfested after vermin was low, being l80 as compared with 317 the previous year. The rooms disinfected after infectious disease dropped to 215 from 280 in 1955- MEDICAL EXAMINATIONS 107 examinations were undertaken as follows 88 carried out for new entrants to the Superannuation Scheme. Of these, 8 were classed as unfit. 16 were made of persons on whom a special report was required in connection with absence through sickness. 3 were carried out on behalf of other authorities. NATIONAL ASSISTANCE ACT. 1948. SECTION 50 10 funerals were carried out under this Act at a total cost of £107.1s.9d. An amount of £83.9s.3d. was recovered from the estates of the deceased or from relatives. In seven Instances the full amount of the funeral expenses was recovered and in two cases the expenses were written off as irrecoverable. One case was still outstanding at the end of the year. In September the undertakers asked for the contract charges for the burial of adults, and for removal of bodies, to be increased. The total cost of an adult funeral is now £10.l2s.6d. The fee for removal of an adult body is now £1.10s.9d. and for a child £1.0s.0d. 13 NATIONAL ASSISTANCE ACT. 1948. SECTION 47 The following table summarises the source of information to, and the action taken by, the Department under the above Act. Reported by No. of cases ACTION TAKEN Voluntary Removal to a Home or Hospital Removed on Magistrates Order Removed by Duly Authorised Officer Regularly visited at home, together with provision of Home Help, Meals Service, District Nurse, Laundry Service and/or other voluntary services. Welfare Officer 2 1 - - 1 Neighbour/ Friend 12 5 - - 7 Patient 2 1 - - 1 Councillor 1 1 - - - Almoner General 7 2 - - 5 Practitioner Hampstead Council of Social 12 5 1 - 6 Service 1 1 - - - Housing Dept. 3 1 - 2 Police 2 1 - - 1 Landlord 4 2 - - 2 Relative 5 - - 1 4 District Nurse 1 1 - - - Public Health Inspector 3 1 - 1 1 Home Help Organiser 3 - - - 3 British Red Cross Scty. 1 1 - - - Old People's Housing Asscn. 1 1 - - - 60 24 1 2 33 14 A considerable amount of time is taken up in dealing with the problem of the many aged and infirm persons who are notified to me as being in urgent need of care and attention. Despite repeated efforts extending over a period of nearly twelve months, we were unable to effect any improvement in the living conditions of an old lady of 73 years, who was existing under such an appalling insanitary state, of her own making, that conditions became intolerable for the remainder of the tenants in the house. She was quite incapable of looking after herself and flatly refused to go to hospital or to accept help in any form. The Magistrate made an order for her removal for a period of 3 weeks to Whittington Hospital but unfortunately she died a few days after admission* Naturally, every conceivable avenue of improvement, voluntary and otherwise, is thoroughly explored before such a drastic step as compulsory removal has finally to be taken. I have great pleasure in paying tribute to the valuable assistance afforded by the Hampstead Old People's Welfare Association and many other voluntary bodies in connection with the welfare of old persons. I would also express appreciation to Dr. Exton Smith and the Geriatric Unit of the Whittington Hospital, Highgate, for unfailing cooperation. LAUNDRY FOR INCONTINENT PERSONS PUBLIC HEALTH (LONDON) ACT. 1936. SECTION l22(l) This Section empowers a Local Authority to cleanse articles which are certified by the Medical Officer of Health to be "in such a filthy, dangerous or unwholesome condition that health is affected or endangered thereby" and to remove the article for that purpose. Local Authorities have no power to provide a general laundry service for articles which would not come within the above category. In view of the obvious and increasing need for a frequent laundry service for incontinent persons (strongly confirmed and supported by the District Nursing Associations, the Hampstead Old People's Welfare Association and the Home Help Organiser), this matter was the subject of comprehensive 15 reports to the Public Health Committee and in January, 1957 this service came into operation. The photographs give an idea of the particularlypleasing and well-planned lay-out of the laundry, which has ample light and provides adequate space for the efficient operation of the excellent modern machinery which has been installed. Fortunately, very little adaptation of the existing laundry at the Public Health & Cleansing Station was required beyond the provision of "three-phase" electric supply and the replacement of special deep rinsing sinks. The following equipment was installed One large Washing Machine. One Hydro Extractor. One Electric Ironer. One Laundry Truck. The total cost of the new equipment and alterations amounted to £963, but the service has already proved to be such a boon to many harassed and distressed old folk that this expenditure would appear to be well worth while. A twice weekly service of collection and delivery has been instituted and the work is being carried out by the existing staff at the Public Health Station. The Council has no power to make a charge and the service operates under the following conditions 1.- Only articles of bed clothing and personal clothing contaminated with faeces, urine or discharges can be dealt with. 2.- When a request for the service is received, Mrs. Speechley or another Public Health Inspector visits the person concerned in order to be satisfied that the articles in question fall to be dealt with under Section 122 and that the family is unable to deal with the situation. Certificates to the effect that bed linen and/or personal clothing is in such a condition that health is likely to be endangered thereby are submitted to the Public Health Committee each month together with a report of the cases for which Certificates have been signed. In those cases where persons have not possessed at least three changes of linen the Hampstead Old People's Welfare Association and National Assistance Board have been most helpful. 16 17 18 THE CARE OF THE AGED Agencies concerned with the Care of the Aged Hampstead Old People's Welfare Association, MAI 3652 107, Kingsgate Road, N.W.6. Hampstead Council of Social Service, HAM 0049 Burgh House, New End Square, N.W.3. Hampstead Old People's Housing Trust Ltd., PRI 9860 Hon. See. - Mrs. D.M. Page, 127, Fellows Road, N.W.J. Women's Voluntary Service, HAM 9552 249, Finchley Road, N.W.3. British Red Cross Society, HAM 7171 98, Avenue Road, N.W.J. National Assistance Board, HAM 9027 Old Post Office, Downshire Hill, N.W.J. Ministry of Pensions & National Insurance, 245, Finchley Road, N.W.3, and HAM 9641 194, Euston Road, N.W.1. EUS 6451 Home Help Organiser, HAM 4136 251, Finchley Road, N.W.3. Welfare Officer (Applications for WEL 5619 residential accommodation for persons in need of care and attention) Luxborough Lodge, Luxborough Street, W.l. Admitting Officer (Enquiries regarding WEL 0966 inmates at above). Services provided for Aged Persons Laundry. The Borough Council operate a laundry service for incontinent persons. Application should be made to the Medical Officer of Health, 98a, Avenue Road, N.W.J. HAMpstead 7171, Ext. 275. 19 Meals. Meals are taken to the homes of house-bound old people by the British Red Cross Society. It is only possible for meals to be delivered twice weekly. Dinner Clubs. These are held at- St. Stephen's Church Hall, Pond Street, N.W.3. on Tuesday, Wednesday, Thursday. 12 noon. Health Institute, 107, Kingsgate Road, N.W.6. on Tuesday, Wednesday* Thursday, Friday. 12 noon. Burgh House, New End Square, N.W.3. (This Club was discontinued in November, 1956 through lack of support.) Library. A van provided by Hampstead Old People's Welfare Association takes books on Monday afternoons to homebound old people. The books are provided by the Borough Council and a member of the library staff accompanies the van. Holidays. The Hampstead Old People's Welfare Association have facilities for arranging special cheap holidays for old people. Chiropody Service Clinics. Monday 2 p.m. to 5 P.m. St. Stephen's Church Hall, Pond Street, N.W.3. Tuesday, 9 a.m. to 1 p.m. Shoot-up Hill, N.W.2. Tuesday, 2 p.m. to 5 P.m. 107, Kingsgate Road, N.W.6. Wednesday, 10 a.m. to 1 p.m. do. do. The Rotary Club of Hampstead provide transport to the clinics for those who are too feeble to travel. Domiciliary Chiropody. Patients are visited and treated in their own hones on Friday mornings. This service is reserved for those who are really too frail to attend the clinics even if taken by car. Appointments for treatment. Application should be made to the Hampstead Old People's Welfare Association. Baths. Old Age Pensioners are allowed to use the slipper baths at the Central Baths, Finchley Road, and the Branch Baths, Flask Walk and Palmerston Road, free of charge. 20 Hones, A list of homes in the Harapstead area can be obtained on application to the Medical Officer of Health, 98a, Avenue Road, 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.I. (Victoria 9977) Hospital Care. Applications for admission of old people to hospital should be made by the patient's doctor to Dr. Exton Smith, Whittington Hospital, Higbgate Wing, Dartmouth Park Hill, N.19. (ARChway 3070) In cases of difficulty further advice can be obtained from the Medical Officer of Health. Clubs. Darby and Joan Clubs St. Stephen's Hall, Wednesdays 2 - 4.30 p.m. Pond Street, N.W.3. All Souls, Loudoun Road, N.W.8. Tuesdays 2-4 p.m. St. Mary's, Priory Road, N.W.6. Thursdays 2-4 p.m. St. James Hall, Wednesdays 2-4 p.m. Netherwood Street, N.W.6. Brondesbury Fellowship Club, Daily 2-5 p.m. 107, Kingsgate Road, N.W.6. Good Companions Club, Mondays 5-8 p.m. Burgh House, New End Square,N.W.3. Good Neighbours Club, Wednesdays 2.30 - 5 P*m. 51, Belsize Square, N.W.3. Burgh House Club, Daily 2-7 p.m. Burgh House, New End Square,N.W.3. Friendship Clubs Belsize Park Club, Monday afternoons. 22, Eton Villas, N.W.3. The Synagogue, Thursday afternoons. Dennington Park Road, N.W.6. The Broadhurst Club, Monday and Wednesday Levine House, Broadhurst Gdns., evenings. N.W.6. 21 SANITARY CIRCUMSTANCES OF THE AREA STAFF Sanitary Inspectors (Change of Designation) Act. 1956 This Act received the Royal Assent on the 2nd August, 1956 and in consequence Sanitary Inspectors throughout the country are now more aptly designated as "Public Health Inspectors". It is improbable, however, that the change of designation alone will make any appreciable difference to the shortage of inspectors which exists at present. There are two vacancies for Public Health Inspectors in the Department, one having existed for over twelve months and the other being due to the resignation of Mr. G.R. Young who secured an appointment as Public Health Inspector with the Uxbridge Urban District Council from 1st January, 1957• The response to advertisements to fill these vacancies has not been encouraging. Although this report is concerned with the year 1956, it would perhaps be appropriate to say that the Council decided that useful information might well be obtained, as has been the case with other Departments, by an investigation by an Organisation and Methods team and a survey of the Public Health Department was started early In 1957. As it seemed possible that some reorganisation would be recommended, it was felt that the question of filling the two vacancies mentioned might well be deferred until the report of the Organisation and Methods team had been received. INSPECTION OF FOOD AND FOOD PREMISES The Food & Drugs Act. 1955. The Food Hygiene Regulations. 1955 The Food and Drugs Act, 1955 came into operation on the 1st January, 1956. The Aet is a consolidating Act and, as a result of its provisions, the Food and Drugs Act, 1938, the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, the Food and Drugs Act, 195^ and a number of Orders have been included In the one comprehensive statute. It brings into effect the provisions of the last named Act, but there is little which is new except for a number of detailed alterations in the law which affect the work of your Inspectors and Sampling Officers. On the whole, I would say that the Food Hygiene Regulations are working well and are being reasonably observed by the great majority of the food traders in Hampstead, all of whan have been supplied with a copy of the Regulations. 22 All the prosecutions instituted in respect of contaminants in food, viz.:- a nail, a cigarette end and mice droppings, concerned foodstuffs manufactured outside the Borough and the appropriate Medical Officers of Health were informed. Various cautionary letters have been sent concerning minor infringements of the Regulations. In the event of non-compliance with our requests, these will be followed up and such action taken as is warranted. SECTION 16. FOOD & DRUGS ACT. 1955 Ice Cream Eleven additional premises were registered for the sale of ice cream. In each case the ice cream Is wrapped. The total number of premises registered is 253. 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. Cooked Poods 56 premises are registered for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food, comprising the following types of premises:grocers, provisions, butchers, delicatessen, factory, cafe. HAMP5TEAD HEATH FAIRS Catering Hygiene As usual, members of the staff were on duty throughout the whole period of all the various Bank Holiday Fairs. We have an arrangement with the London County Council whereby prior notification is given of applicants who apply for licences to sell food on the Heath. Thus, before the licences are issued by the County Council we are able to investigate the 23 applicant's methods of food production, storage and equipment. Should these be unsuitable or unsatisfactory, the London County Council is notified and a trading licence is refused. Most of the applicants reside in other Boroughs and I am indebted to their Medical Officers of Health for cooperation in supplying reports on these itinerant food vendors. As may well be imagined, it is a very difficult matter indeed to keep track of all the itinerant food traders who cater for the large crowds which assemble on Hampstead Heath on Bank Holidays but, taken by and large, quite a fair amount of supervision is successfully undertaken by your Inspectors. The majority of the mobile vans are provided with food hygiene equipment of a very high order, in fact, most of our troubles arise in persuading food handlers that the equipment is there for use and is not merely a show-piece I So far as the Food Hygiene Regulations, 1955 are concerned, the principal matters which called for comment were 1.The need to provide more adequate protection for "open foods" displayed for sale. 2. The omission of the inscription of the names and addresses of food vendors on their stalls. 3.Smoking whilst preparing food. All these matters were immediately drawn to the attention of the vendors concerned and were followed up by cautionary letters indicating that, should further offences of a like nature be discovered, legal proceedings would be instituted. All 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 cooperation and assistance at all times. 24 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 1956 25 19 4 - 2 92.0 FOOD SAMPLING (a) Bacteriological examination of food stuffs This service is undertaken by the Central Public Health Laboratory. I am greatly indebted to the Director of the Laboratory for unfailing cooperation 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. (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 503 samples which can be classified under the following broad headings:- 25 Milk, cream, condensed milk, etc. 39 Butter, margarine, cooking fat, cheese 25 Ice cream, lollies 19 Fruits, vegetables (including canned and tinned) 4l Tinned fish, shellfish 24 Meat and meat products 87 Herbs, condiments, spices, sauces, etc. 47 Flour, flour confectionery, puddings, cakes, etc. 82 Beverages, non-alcoholic 51 do. alcoholic 27 Jams, preserves 11 Sweets, confectionery 40 Miscellaneous 12 503 All the samples of milk proved satisfactory, the average milk fat content being 3.71 per cent. The legal miniraui is 3 per cent. 13 samples of pork sausages were taken, the average meat content being 68.9 per cent; the lowest meat content was 66 per cent. 3 samples of beef sausages gave meat contents of 51, 52 and 52 per cent. There were 15 adulterated or unsatisfactory samples, details of which are given in the Statistical Summary. UNSOUND FOOD 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. ATMOSPHERIC POLLUTION The work of the Department in this connection resolved itself into three aspects. 1.Investigation of complaints and action to abate nuisances, 2.Continuation of cooperation with the Department of Scientific & Industrial Research on the investigation into the trends of air pollution, and 26 3.Exploratory work in connection with the Clean Air Act, 1956. In the first of these connections, 21 complaints were received of alleged nuisances from smoke or grit emissions and a total of 419 observations, inspections and interviews was made by the Public Health Inspector to determine if nuisances existed and to effect remedies. The nuisances established were diverse and included smoke and smells caused by the burning of old tyres at a car-breakers; severe grit emission from large automatic-feed coal boilers at a hostel; an industrial furnace which had been converted to burn sump oil but which was being fired with wood and coke and excessive smoke emission from the chimney of a Nurses' home. All such cases were dealt with by advice and cooperation and results generally varied from complete abatement of nuisance to considerable and continuing improvements. A few sporadic complaints have recurred regarding emission from the numerous railway tunnel ventilating shafts scattered throughout the Borough. There are more main railway lines running through Hampstead than any other London Borough and, although the attention of British Railways is immediately drawn to any complaint regarding excessive smoke, etc. emission from their shafts, it would not appear possible completely to eliminate this trouble until their long term policy of electrification and/or substitution of steam engines with Diesel oil-fired engines is completed. The measurement of variations of air pollution has continued in collaboration with the Fuel Research Station. Monthly results from deposit gauges and lead peroxide instruments at Barrow Hill Reservoir and Fortune Green Road Cemetery have been recorded and passed on for inclusion in the national survey. Daily readings of smoke and sulphur dioxide concentrations have been taken from the continuous filter at the Public Health Department and I append Tables to illustrate that the concentration of sulphur dioxide in the air of Hampstead is consistently below that prevailing in London generally. The Clean Air Act, 1956 (Appointed Day) Order, 1956 brought into operation, as from the 31st December, 1956, the provisions of the Act relating to smoke from furnaces, Smoke 27 Control Areas, etc. and the Smoke Control Areas (Authorised Fuels) Regulations, 1956 declared certain fuels as authorised fuels for the purposes of the Act. A Model Byelaw making obligatory the provision of appliances which could operate without the emission of smoke was also issued by the Ministry of Housing and Local Government and will doubtless form the basis of the new Byelaws to be issued by the London County Council. As a preliminary step in preparation for the implementation of the Act, all applicants for advances under Section 4 of the Housing Act, 1949 and for Improvement Grants, were advised that they should make arrangements to ensure that all heating appliances in the premises were smokeless or would be converted to obviate any emission of smoke therefrom. Circular letters are also sent to the Owners, Builders and Architects concerned with all new buildings, or conversions into flats, asking for their cooperation so as to ensure that no solid fuel appliances in which smokeless fuel cannot be burned satisfactorily will be fixed in new or converted houses or flats or business premises, A list of the domestic solid fuel appliances recommended by the Solid Smokeless Fuels Federation is sent to all applicants on request. In addition, the Public Health Inspectors were instructed, when completing inspections of every type of property, to take note of all the heating arrangements therein. The information thus gained will be of value should the Council decide to make a Smoke Control Zone. Various of your Inspectors have also attended a special course run by the Coal Utilisation Council at which latest developments in approved types of firegrate for use with smokeless fuels were described and demonstrated, while five of the Public Health Inspectors are undertaking a course of study with a view to qualifying as Smoke Inspectors. Many houses in Hampstead are used for single room occupation and, as would be expected, it is unusual to find solid fuel appliances used in rooms so let. Gas and electric fires are mainly used and I believe that the number of such houses in the Borough is so great as to have a sensible effect, not only on present air pollution, but on the extent and cost of future proposals for elimination of domestic smoke. 28 TABLE 1. Table showing the monthly average of Sulphur Dioxide concentration in Hampstead and in London. Expressed as parts per 100 million. 29 TABLE 2. Table showing the highest concentrations of Sulphur Dioxide (expressed as parts per 100 million) recorded each month in Hampstead and in London. 30 SANITARY CONVENIENCES AT RAILWAY AND UNDERGROUND STATIONS In view of complaints made to the Department, a survey was made of all the conveniences at the stations listed below. Improvements were effected as the result of our representations to the Railway authorities, but it was not possible for either the British Railways or the London Transport Executive to instal washing facilities at the less important stations owing to the cost and difficulties of supervision and maintenance. It will, of course, be appreciated that the Council has no specific jurisdiction over the British Transport Commission in respect of the provision of sanitary accomnodation. British Railways Kilburn High Road South Hampstead Hampstead Heath Finchley Road and Frognal West End Lane West Hampstead London Transport Executive Swiss Cottage Finchley Road West Hampstead Chalk Farm Belsize Park Hampstead Conveniences are provided in all these stations. Washing facilities are provided for ladies only at Swiss Cottage and Chalk Farm Stations and for men and women at the Finchley Road (London Transport Executive) Station. No washing facilities are provided for passengers at the other stations. 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. 31 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. Advice was given regarding the Regulations to an importer of foreign made appliances. 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. 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. SECTION 54. THE FACTORIES ACT. 1937. UNDERGROUND BAKEHOUSES The basement bakehouses at No. 228, Belsize Road and No. 279, West End Lane, not having been used as such for a period exceeding twelve months, automatically ceased to function and must not be used as bakehouses again. Appropriate notice was given to the owners and the occupiers. The Certificate of Suitability relating to the basement bakehouse at No. 63, Hemstal Road expired on the 30th September, 1956 and this bakehouse must not be used again for this purpose. All these three basement bakehouses were first registered in 1903. 32 When the Factory & Workshops Act, 1901 came into force there were no less than basement bakehouses operating in the Borough. This number was reduced to 22 after the passing of the 1901 Act and to 7 by the time the present Factories Act came into force. Now there remains only one basement bakehouse continuing in operation in Hampstead, viz.:- No. 7, Fairhazel Gardens. THE FACTORIES ACT. 1937. PART Till. OUTWORKERS For the first time for many years, the Department was able to make a thorough survey of all the premises in the Borough where outwork is known to be carried on. Section 110 of The Factories Act, 1937 (lists of outworkers to be kept in certain trades) provides (inter alia) that every occupier of a factory shall (a) keep lists showing the names and addresses of all persons employed in the business of the factory who work outside the factory, (b) send such lists to H.M. Inspector of Factories and (c) send to the district Council during the months of February and August in each year copies of those lists, showing all outworkers so employed during the preceding six months. The classes of homework to which the Act applies are specified by Regulations made by the Secretary of State. These are very comprehensive and range over thirty-one varieties of trades and occupations. Section 111 (Employment of persons in unwholesome premises), provides that where the outworker's premises are injurious or dangerous to health of persons employed therein the district Council may take appropriate action by way of notice and there are penal provisions regarding non-compliance therewith. It is forbidden for outwork to be carried on from premises where certain specified infectious diseases are known to exist. The most recent lists received showed that seventyeight people were on the Register. Visits by your Public Health Inspectors revealed that 11 persons no longer carried on homework and 6 had removed. The remainder were employed in the following trades;- 33 25 engaged in altering or repairing, etc. of wearing apparel 19 engaged in making or filling Xmas crackers 1 '' '' packing of buttons, hooks, pins, etc. 5 " " making of artificial flowers 2 '' " making toys 1 " " making or altering curtains and furniture hangings 1 " " making of plastic goods 3 '' " making of lampshades 2 " " making of boxes 1 '' " carpet cleaning 1 " " handbag repairing. 61 Having regard to present day trends and the desire of most people to augment the family income by doing extra work in their own time, I find it somewhat surprising that so little outwork is carried on in the Borough. It will be noted that the home packing of confectionery or, indeed, of any apsect of food preparation, has now ceased. It is very pleasing to report that conditions were usually quite good; there was no overcrowding and no premises were found to be in an unwholesome condition. The attention of two manufacturers was drawn to their omission to send their lists of outworkers. RODENT AND PEST CONTROL Prevention of Damage by Pests Act. 1949 Eradication of rats and mice has continued during the year under review, under the general supervision of the Deputy Chief Public Health Inspector. The work has been carried out by two rodent operatives and shows an increase over that done in 1955. The total number of premises treated during the year was 656 of which 203 related to rats and 453 to mice infestation. The addition in the number of premises treated for rat 34 infestation was mainly due to an increasingly thorough survey of properties adjoining those from which complaints emanated and the subsequent treatments of a greater number of properties. There were two cases of rat infestation which were of particular interest 1.A heavy recurrent infestation underneath a basement floor, although there was no evidence that the rats broke out into the dwelling. There was no indication as to how they gained access. The domestic drainage had been renewed within the last few years and was constructed of cast iron. The actual line of the old pipe sewer was not known with any certainty but the application of a smoke test over the raking arm of the domestic drainage intercepting trap revealed without any doubt that it ran underneath the infested house and was defective. The section was relaid in a different position and it was not until after completion of the work that there was any break out of the rodents from the sub-floor space into the dwelling, where they were obviously in search of food. One treatment was then completely successful in determining the subsequent minor infestation. No trouble has since been experienced. 2.A basement tenant complained that she had seen a rat which escaped down the trap of the water closet. Upon investigation of the drainage system the access chamber into which the branch soil drain discharged revealed numerous rodent foot-prints on the benching. A second chamber some 15-20 feet away was found complete with rat nest constructed on the upper part of the benching. The domestic drainage system and sewer connection was subjected to a test and found to be sound. In this instance the route of infestation had been from house to drain instead of, as is usual, from drain to house. It also proved beyond doubt that the water-seal to the trap of a W.C. is not a fully effective barrier to rats. Charges for Rodent Extermination As a result of a review of the cost of rodent work, the charge to business premises was increased from 7s.6d. to the more realistic figure of 17s.Od. per hour. It was at first thought that the increased charge would deter traders from taking advantage of the Council's rodent service, but this has not been so. 35 Maintenance Treatment for Rats in Sewers This aspect of rodent control continues to be undertaken by the staff of the Borough Engineer and I am indebted to him for particulars of the treatment given. Two treatments were carried out in the year, the first from 16th January to 4th February, using a sausage Rusk bait and 2½ per cent, phosphide poison medium, and the second from 2nd to 2lst July with bread rusk and 10 per cent. arsenious oxide. The following table indicates the result of the two treatments:- January 1957 July 1957 No. of manholes baited 717 757 No. of manholes showing prebait take 322 392 No. of manholes showing complete prebait take 85 25 The second treatment would appear to indicate a more widespread infestation but a decreased rat population. Insect and other Pests In addition to the usual complaints of ants, bugs, cockroaches, fleas, flies, lice, pigeons, wasps, woodlice and woodworm there have been increasing numbers of complaints from tenants of new blocks of flats of the pest "Bryobia praetiosa" or Clover Mite. The source of infestation would appear to be importation on turves or in grass seed. The infestations have proved very obstinate to treatment and do not respond to the usual D.D.T. and B.H.C. insecticides. Experimental treatments have been carried out using Gammexane and Malathian and with successful results. 36 Autumnal flies, namely "Thaumatomyia notata" have given a lot of trouble during the months of September/October. Nothing can be done to deal with these at source but when they attempt to hibernate and gain access to dwellings they can be readily killed with persistent insecticides D.D.T. and B.H.C. PROVISION OF DUSTBINS 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 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. No such appeal was made during 1956. PLEASURE FAIR BYELAWS In view of the lack of legal control over the persistent public health nuisances caused by the absence of sanitary conveniences at the private Yale of Health Amusement Park, the Council determined to make Byelaws in pursuance of the powers contained in the London County Council (General Powers) Act, 1939. These Byelaws were confirmed by the Home Office and came into operation on 1st October, 1954. Despite the fact that there had been two previous successful prosecutions, it was found necessary to issue three further Summonses in respect of the absence of sanitary accommodation at the Vale of Health private fairground. The maximum penalty of £5 was imposed in each case and Costs were awarded to the Council. Plans were afterwards deposited showing new conveniences at both fairgrounds. BARBERS AND HAIRDRESSERS Two new premises were registered during 1956 bringing the total number of premises registered to 76. 37 HOUSING SLUM CLEARANCE PROGRAMME. 1956-60 The following is the list of properties comprised in the Council's approved slum clearance programme made in accordance with Section 1 of the Housing Repairs and Rents Act, 1954. No. of Dwellings Alexandra Mews 24 Quex Mews 5 Colas Mews 8 Elizabeth Mews 14 Steeles Mews North 7 Cottage Mews 4 Flask Walk (24, 26, 28) 3 New End (36, 38, 40) 3 Loveridge Mews 8 TOTAL:- 76 * Nos. 20, 23, 24, 25, 26 and 27, Elizabeth Mews have now been deleted from the programme. (None of these premises is used for human habitation.) To be dealt with by the London County Council. Colas Mews was officially Represented pursuant to Section 25 of the Housing Act, 1936 as being unfit for human habitation and that the most satisfactory method of dealing with the conditions in the area was the demolition of all the buildings therein. This matter was the subject of an objection by the individual Owner of seven of the premises, Nos. 1, 3, 5, 7, 9, 11 and 12, Colas Mews and a private local Inquiry was ordered by the Minister of Housing & Local Government. The Clearance Order was subsequently confirmed by the Minister without modification. The Colas Mews Clearance Order, 1956 became effective on the 22nd December, 1956 and appropriate measures are being taken to secure the complete demolition and clearance of all the premises comprised in the area. The following photograph gives a general impression of the conditions existing at Colas Mews. 38 Colas Mews. 39 Nos. 24, 26 and 28, Flask Walk were also declared a Clearance Area and a Compulsory Purchase Order was made. The owner of the three premises subsequently lodged an objection which is to be the subject of an Inquiry by the Minister. HOUSING REPAIRS AND RENTS ACT. 1954 CERTIFICATES OF DISREPAIR The following table shows the paucity, both of the tenant's applications for Certificates of Disrepair, and the landlords' for the revocation thereof. Of the total number of 174 Certificates issued from the commencement of the Act until 31st December, 1956 landlords applied for the revocation of 71• Landlords are obviously not troubling to apply for revocation of the outstanding Certificates because the increased rents will not apparently recompense them for the expensive repairs involved. 40 LONDON COUNTY COUNCIL (GENERAL POWERS) ACT. 1955. SECTION 27 This most useful Section provides that "(l) Where a sanitary authority are satisfied that - (a) any house in their district is in such a state (in this section referred to as a 'defective state') as to be a nuisance or injurious or dangerous to health; and (b) having regard to all the circumstances unreasonable delay in remedying the defective state would be occasioned by following in relation to such house (in this section referred to as 'the premises') the procedure prescribed in the Fifth Schedule to the Act of 1936, the authority may (instead of serving a nuisance notice under the said Fifth Schedule) serve, upon the person upon whom it would otherwise have been appropriate under the said schedule to serve such a nuisance notice, a notice to the effect that the authority intend to remedy the defective state of the premises themselves and specifying the defects which they intend to remedy". This procedure was used on two occasions, tenders being obtained from local builders and the lowest tender being accepted in each case. HOUSING ACT. 1949 SECTION 4. LOANS GRANTED. SECTION 20. IMPROVEMENT GRANTS Work in connection with the above continues to be of quite a substantial character, as is illustrated in the following diagram and table. Before advancing money under Section 4 the Council is required to be satisfied that houses to be acquired are, or will be made, "in all respects fit for human habitation". Very comprehensive surveys are undertaken by your Public Health Inspectors, in conjunction with the Council's Valuers. Schedules of works to render the premises fit are served on the applicant and the estimated cost of the repairs 4l is retained out of the moneys to be advanced, until the works are completed. Thus, not only is a large number of properties being brought into a good state of repair, but the applicants have the knowledge that, generally speaking, they are safeguarded against untoward heavy commitments on their houses for a very reasonable period. SECTION 4. LOANS GRANTED 42 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 1956 January - June 42 24 14 4 July - December 38 15 16 7 TOTALS:- 265 172 61 32 IMPROVEMENT GRANTS 1954-1956 Applications Received Granted Refused Withdrawn 1954 January - June 2 2 - - July - December 6 3 3 - 1955 January - June 14 6 3 5 July - December 7 4 2 1 1956 January - June 9 4 5 - July - December 4 3 1 - TOTALS:- 42 22 14 6 43 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. Housing applications are sent to the Public Health Department for visits to be made to ascertain the number of rooms occupied by the family, the sex and ages of the members of the family, the permitted number of occupants for the accommodation, the conditions under which the family is living and the condition of the premises and any medical conditions which might be improved by rehousing. The actual pointing is done by the Housing Estates Manager and points are allocated In respect of the period on the 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. In order to obtain the maximum uniformity in this service which affects the lives of so many people all the visits are made by the Woman Public Health Inspector (Mrs. Speechley) so far as is possible. During the year visits were made and reports submitted concerning 4l6 applications. In addition, 75 reports on rehousing applications were submitted direct to the London County Council and 29 to other Boroughs. A further 68 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 cooperate 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 242 cases as there were no medical grounds which would not be met by points given by the Housing Estates Manager. 44 No. of cases Points given Cases Rehoused 242 Nil 35 1 3 - 86 5 16 60 10 21 15 15 10 12 20 10 416 92 Of the 12 cases where the maximum points, 20, were given on medical grounds, 11 were on account of active tuberculosis and one on account of Parkinson's disease. On account of the extreme shortage of housing accommodation it is regretted that of these urgent cases only 2 were successful in being rehoused during the year. A further 8 cases where maximum points had been awarded in previous years were also rehoused (three cases had been "pointed" in 1955, four in 1954 and one in 1953). 45 STATISTICAL SUMMARY Area of Borough 2,265 acres Registrar General's estimate of Population mid-1956 97,580 Rateable Value March, 1956 £1,717,039 Sum produced by 1d. rate £6,967 No. of separate rating assessments of dwelling houses, flats and other residences 22,104 No. of structurally separate dwellings, Census 1951 25,010 No. of private households, Census 1951 35,970 BIRTHS Total Legitimate Illegitimate Males: 760 682 78 Females: 7tf 644 71 1,475 1,326 149 Birth rate 15.1 Area of Comparability Factor 0.75 No. of Stillbirths 25 Stillbirth Rate 16.7 DEATHS Net deaths (Males 438, Females 591) 1,029 Death Rate 10.5 Area Comparability Factor 1.02 Deaths from maternal causes 1 Deaths of infants under 1 year (Males 18, Females 16) 54 Deaths of infants under 4 weeks (Males 15, Females l4) 27 Infant Mortality Rate: All infants 25 Legitimate infants 24.9 Illegitimate infants 6.7 46 CAUSES OF DEATH 1956 Cause of Death Total Males MALES - AGES Total Females FEMALES - AGES Total Males& Females 0- 1- 5- 15- 25- 45- 65- 75- 0- l- 5- 15- 25- 45- 65- 75- Tuberculosis respiratory - - - - - - - - - 4 - - - - 3 1 - - 4 Tuberculosis other - - - - - - - - - - - - - - - - - - - Syphilitic disease - - - - - - - - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - - - - - - - Meningococcal infections 1 - - 1 - - - - - - - - - - - - - - - Acute poliomyelitis - - - - - - - - - 1 - - - - 1 - - - 1 Measles - - - - - - - - - - - - - - - - - - - Other infective and parasitic diseases 1 1 - - - - - - - 1 - - - - - 1 - - 2 Malignant neoplasm, stomach 16 - - - - 1 5 2 8 14 - - - - 1 4 6 3 30 Malignant neoplasm, lung, bronchus 28 - - - - - 12 13 3 6 - - - - 1 1 3 1 34 Malignant neoplasm, breast - - - - - - - - - 26 - - - - 1 16 5 4 26 Malignant neoplasm, uterus - - - - - - - - - 9 - - - - 1 4 4 - 9 Other malignant and lymphatic neoplasm 41 - - - - 1 11 18 11 72 - - - 1 8 20 17 26 113 Leukaemia, aleukaemia 3 - - - - 1 1 l - 1 - - - - - l - - 4 Diabetes 3 - - - - - 1 2 - 4 - - - - - - 1 3 7 Vascular lesions of nervous system 38 _ - - - 2 8 10 18 90 - - - - 1 15 23 53 128 Coronary disease angina 127 - - - - 6 40 39 42 96 - - - - - 18 31 47 223 47 Hypertension with heart disease 13 - - - - - 1 4 8 13 - - - - - - 4 9 26 Other heart disease 23 - - - - - 3 8 12 60 — — — - 1 8 11 40 83 Other circulatory disease 23 - - - - 1 3 7 12 35 - - - - - 5 10 20 58 Influenza — — — - - - - - - 2 — — - - - 1 1 - 2 Pneumonia 18 5 - - - - - 4 9 27 - — - - 1 1 6 19 45 Bronchitis 27 - - - - - 7 8 12 23 - - - - - 5 5 13 50 Other diseases of respiratory system 4 - - - - - l 1 2 1 - - - - - - - 1 5 Ulcer of stomach and duodenum 12 - - - - - 5 3 4 5 - - - - - - - 5 17 Gastritis, enteritis and diarrhoea - - - - - - - - - 6 - - - 1 - - 2 3 6 Nephritis and nephrosis 4 - - - - - 2 1 l 2 - - - - - - - 2 6 Hyperplasia of prostate 6 - - - - - 1 3 2 - - - - - - - - - 6 Pregnancy, child birth abortion - - - - - - - - - - - - - - 1 - - - l Congenital malformations 1 1 - - - - - - - 7 4 2 - - - 1 - - 8 Other defined and illdefined diseases 32 11 - 1 - 2 5 6 7 57 12 - 1 - 5 6 12 21 89 Motor vehicle accidents 2 - - - 1 1 - - - 2 - - - - 1 - - 1 4 All other accidents 5 - - - - 2 - 1 2 11 - 1 - - - 3 2 5 16 Suicide 10 - - - - 7 3 — - 15 — - - 3 2 9 - 1 25 Homicide and operations of war - - - - - - - - - - - - - - - - - - - TOTAL:- 438 18 - 2 1 24 109 131 153 591 16 3 1 5 28 118 143 277 1029 48 INFECTIOUS DISEASE DISEASE Notifications Removed to Hosp.1956 Deaths 1956 1952 1953 1954 1955 1956 Dysentery 15 40 73 32 35 8 - Encephalitis: Acute Infective - - - 1 2 2 — Post Infectious 1 1 1 3 2 2 — Erysipelas 10 7 13 7 7 3 - Food Poisoning * 6 21 19 56 15 7 - Malaria — 1 2 — — - - Measles 561 1186 36 1028 243 8 - Meningococcal Infection 1 3 2 2 2 2 1 Ophthalmia Neonatorum 3 5 1 1 7 6 - Paratyphoid Fever 2 - - - - - - Pneumonia 37 53 47 53 54 22 3 Poliomyelitis: Non Paralytic 4 2 - 28 - - - Paralytic 7 10 2 9 2 1 1 Puerperal Pyrexia 45 34 41 22 45 43 — Scabies 17 24 23 26 25 - - Scarlet Fever 112 44 50 23 32 2 - Typhoid Fever — - - 4 1 1 — Whooping Cough 193 215 169 114 94 14 - TOTAL:- 1014 1646 479 1409 566 121 5 * A further 12 cases were ascertained but were not notified. TUBERCULOSIS AGE PERIODS Respiratory Non-Respiratory New Cases Deaths New Cases Deaths M F M F M F M F 0- - - - - - — - - 1- 2 - - - - - - - 5- 2 1 - — - 1 - — 15- 9 9 - - - 4 - - 25- 26 13 - 3 1 4 — - 45- 15 3 — 1 1 1 — - 65- 4 2 - - — - — - 75- 2 l - - - - - — TOTAL:- 60 29 - 4 2 10 - - 49 FOOD POISONING NOTIFICATIONS (CORRECTED) 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total 1 3 1 10 15 No. of outbreaks due to Identified Agents 2. Total cases 5. Outbreaks due to:Salmonella Typhimurium. No. of outbreaks of Undiscovered Cause Nil. No. of Single Cases 10. Agent Identified 8. Unknown cause 2. Agent Identified; Salmonella Typhimurium. BACTERIOLOGICAL EXAMINATIONS (Infectious Diseases) Throat/Nose Diphtheria Bacilli found No. of examinations Swabs: Nil Haemolytic Streptococci found 45 Vincent's Angina Organisms found 5 Negative 82 Faeces: Shigella found 26 Salmonella found 15 Negative 190 Pertussis: Positive 1 Negative 9 Sputum: Negative 20 393 DISINFECTION AND DISINFESTATION No. of calls by borough van 4,362 No. of articles passed through steam chamber 3,908 No. of rooms disinfested after vermin 180 No. of rooms disinfected after infectious disease 215 No. of rooms cleansed after death or removal 14 Parcels of clothes for despatch abroad 156 50 HAMPSTEAD BOROUGH COUNCIL CLEANSING CENTRE Verminous conditions Scabies Cases Treatments Cases Treatments Adults 10 13 14 39 Children under 5 8 9 - - Children over 5 - - - - Contacts - - 6 11 L.C.C. School Children 38 38 - - London County Council (General Powers) Act,1953 Persons cleansed at home Nil. PUBLIC MORTUARY, NEW END No. of post-mortem examinations carried out 232 Causes of death Natural Causes 188 Suicides: Coal Gas Poisoning 14 Hanging 1 Drugs 3 Falls 1 Drowning 2 Railway 1 22 Accidental: Falls 3 Coal Gas Poisoning 2 Road Accidents 6 Burns 2 Railway 1 14 Post operative 6 Open Verdict 2 Bodies brought for accommodation only 1 Total: 233. No. of bodies admitted by order of: Coroner 189 Ambulance 30 Police 9 Marie Curie Hospital 4 Public Health Dept. l Total: 233 51 PUBLIC HEALTH INSPECTION Inspections Houses inspected on complaint 2,199 „ „ after infectious disease 409 „ „ under Section 9, Housing Act, 1936 1 House-to-House inspections 109 Inspections and revisits in connection with Loans under Section 4, Housing Act, 1949 421 Special visits and re-inspections 11,167 Notices Intimation Notices served 706 Statutory Notices served 206 The Factories Act, 1937 (including Outworkers) Inspections and re-inspections made 199 Pharmacy & Poisons Act, 1933. Poisons Rules. 1952 Inspections made 15 Rag Flock, etc. Act, 1951 Inspections made 4 Shops Act, 1950 (Section 38).Arrangements for health and comfort of shop workers Inspections made 101 Drainage Works Plans and applications deposited for:- (a) Voluntary additional sanitary fittings or alterations to drainage 231 (b) Drainage and sanitary fittings required by Sanitary Notices 26 52 FACTORIES ACTS. 1937 and 1948 No. on Register Inspections Written Notices Occupiers Prosecuted (i) Factories in which Ss. 1,2,3,4 and 6 are to be enforced by local authority 299 15 1 - (ii) Factories not included in (i) in which Sec. 7 is enforced by the local authority 282 44 5 - (iii) Other premises in which Sec. 7 is enforced by the local authority (excluding outworkers' premises) 4 - - - TOTAL: 585 59 6 - Defects Found Particulars Number of cases in which defects were found Found Remedied Referred to H.M. Inspector Want of cleanliness (S.l) 3 3 1 Overcrowding (S.2) 1 1 — Unreasonable temperature (S.3) — — 2 Inadequate ventilation (S.4) - — 2 Ineffective drainage of floors (S.6) 2 1 2 Sanitary conveniences (S.7) (a) Insufficient 1 1 - (b) Unsuitable or defective 5 5 - (c) Not separate for sexes 1 1 - Other offences against the Act (not including offences relating to outworkers) 1 - - TOTAL: 14 12 7 53 OUTWORKERS No. of Hampstead firms making return 19 No. of Outworkers notified 193 „ „ „ resident in Hampstead 30 „ „ „ notified to us from other boroughs 132 „ „ visits by Public Health Inspectors 91 Classes of Work No, of Outworkers Alterations to clothing 112 Carpet cleaning 1 Making of Christmas crackers 19 Making of Cardboard boxes 4 Making of artificial flowers 7 Carding of pins, hooks, etc. l Making or repairing lampshades 5 Feather sorting 2 Making of cake decorations 2 Making of toys 7 Repairing of handbags 1 Repairs to furniture l TOTAL: 162 PET ANIMALS ACT, 1951 New licences issued Nil Licences renewed 6 No. of visits by Public Health Inspectors 21 PHARMACY & POISONS ACT, 1933 New Licences issued Licences Renewed Ceased to sell poisons or removed No. on Register at end of year No. of inspections 2 108 8 110 15 54 swimming baths No. of Samples Chemical Analysis Bacteriological Examination Satisfactory Unsatisfactory Satisfactory Unsatisfactory 24 8 - 16 - LEGAL PROCEEDINGS Public Health (London) Act, 1936 London County Council (General Powers) Act, 1939 Date of Hearing Premises and Nature of Offence Result of Proceedings 1956 15th February Vale of Health Breach of Pleasure Fair Byelaws - Failure to provide adequate sanitary conveniences. Fined £5. 13th June Roderick Road Non-compliance with a statutory notice. Order to abate within 35 days. 10th August Vale of Health Breach of Pleasure Fair Byelaws. Fined £5 £l.ls.0d. costs. „ „ -do- Fined £5 £l.ls.0d. costs. 21st September Hampstead High Street Breach of Drainage and W.C. Byelaws. Fined £29 £9.9s.0d. costs. 55 INSPECTION OF FOOD PREMISES No. on Register No. of Inspections Milkshops and Dairies 49 53 Ice cream premises 253 92 Butchers and Prepared Meat Premises 59 376 Fishmongers 17 122 Fried Fish Shops 4 29 Bakers Shops and Bakehouses 26 136 Restaurants and Catering Establishments 85 594 Public Houses 38 122 Delicatessen 18 171 Confecrtionery 77 73 Grocers 103 409 Greengrocers 64 57 Off Licences 32 14 Other food premises 3 79 PREMISES REGISTERED UNDER SECTION 16, FOOD & DRUGS ACT, 1955 Ice Cream Confectioners 63 Greengrocers 26 Grocers 51 Butchers 2 Tobacconists 11 Fishmongers 4 Restaurants 46 Garages 1 Dairies 18 Bakers 6 Stores 6 Toy Shops 1 Clubs 5 Florists 1 Off Licences 1 Kiosks and Stalls 6 Patisserie 1 TOTAL: 253 Delicatessen 4 Sausages, Cooked Meats, etc. Grocers 8 Provisions 4 Butchers 37 Delicatessen 5 Factory 1 Cafe 1 TOTAL: 56 56 MILK SUPPLY No. of Licensed Distributors 82. Milk (Special Designation) Regulations Licences issued Type of Licence Pasteurised Tuberculin Tested Sterilised Dealers 42 34 48 Supplementary 28 28 31 Milk Examination Designation Methylene Blue and Phosphatase Tests Chemical Analysis Pasteurised 17 22 T.T. Pasteurised 1 2 TOTAL: 18 24 All the samples were satisfactory. Average milk fat content 3.71 per cent. (legal minimum 3 per cent.) BACTERIOLOGICAL EXAMINATION OF FOOD Nature of Sample No. of Samples Satisfactory Unsatisfactory Cake 1 1 — Roast Beef 1 — 1 * Cockles 14 14 - Shrimps 1 1 - Prawns 2 1 1 * Whelks 11 9 2 * Jellied Eels 6 6 - Mussels 2 2 - Server Water 4 4 — Cooked Sausage 1 1 — National Dried Milk 1 1 - Red Salmon 1 1 - Processed Peas 1 1 — Margarine 2 2 — Glace Cherries 1 1 — Flood Water 1 1 - Silt (after flood) 1 1 - TOTAL: 51 47 4 * Excessive bacterial content. 57 ADULTERATED SAMPLES Sample No. Article Offence How dealt with 1 Sweet Chocomilk. Fat tainted. Commodity not fit for consumption. Stock surrendered and destroyed. 33 Cream Meringue. Contained imitation cream. Vendor cautioned. 34 Cream Doughnuts. „ „ „ „ „ 85 Triple Cream Cheese. False description . 50.47% milk fat. „ „ 135 Angel Cake. Contained dust and dirt. Vendor cautioned. Stock surrendered and destroyed. 149 Cake. Contained rodent droppings. Vend or prosecuted fined £10 and costs. 180 Ice Cream Cornet. Contained foreign matter consisting of charred farinaceous matter. No action. 197 Chocolate Liqueurs. Contained insect eggs. • Vendor cautioned. 309 Pure White Spirit. l40°proof. Misleading description. White Spirit is a Hydrocarbon oil and not an alcohol. The sample is a mixture of ethyl alcohol and water. Referred to Ministry of Agriculture, Fish and Food with recommendation that the Labelling of Food Order be amended so that spirit of this strength be labelled "dangerous not to be used unless diluted". 303 Strawberry Flavour. Contained prohibited preservative, 290 ppm.benzoic acid. Manufacturer cautioned. Label altered. Continued. 58 ADULTERATED SAMPLES - continued Sample No. Article Offence How dealt with 343 Pineapple Milk Flavouring. Contained prohibited preservative. 268 ppm. benzoic acid. Manufacturer cautioned. Label altered. 348 Chocolate Flavour. Contained prohibited preservative. 326 ppm. benzoic acid. „ „ „ 362 Debris in Milk Bottle. Contained veg. matter probably derived from breakfast food. Bottler cautioned. 466 Gin. Added water 2.3% (based on 65° proof spirit) Warning sent by Town Clerk to Licencee. 467 Gin. Added water 1.3% (based on 65° proof spirit) „ „ „ The percentage of unsatisfactory samples is 3.0 per cent. This compares with 1.6 per cent. 2.4 per cent. and 3.57 per cent. for the previous 3 years. LEGAL PROCEEDINGS Offences relating to Food and Food Premises. Sections 2, 8 and 113 Food and Drugs Act, 1955 Date of Hearing Premises and Nature of Offence Result of Proceedings 15th February Fleet Road, Food not of quality demanded (nail in cake). Fined £5. l6th May Broadhurst Gardens. Food not of quality demanded (cigarette end in bread). Fined £5 and £2.2s.0d.costs. 10th August Fleet Road. Food not of quality demanded. (Mouse excrement in cake). Fined £10. £2.2s.0d.costs. 59 UNSOUND FOOD SURRENDERED Article Quantity Bicarbonate of Soda 3¾ lbs. Bovril, Marmite 2 jars. Butter and Margarine 62 lbs; 48 pkts. Cake 20 lbs. Cereals 497 lbs. Cheese 36 lbs. Chocolate, etc 108 bars. Coffee 7 lbs. Confectionery 16 lbs. Desiccated Coconut 154 lbs. Dried Fruit l6l lbs. Eggs 330. Fish (72 tins. (34 stone 13 lbs. Flour, Golden Raising Powder 77 lbs. Fruit and Fruit Juice 793 tins; 168 lbs. Ground Ginger ??? lbs. Jam and Preserves 4 tins; 43½ lbs. Marzipan 14 lbs. Meat (185 tins. (2,738¼ lbs. (2 chickens. Milk (103 tins. (2 quarts. Mixed Peel, Glace Cherries l8 lbs. Salt 24 lbs; 24 pkts. Soup 30 tins. Suet 12 lbs, Sugar 170 lbs. Sugared Chicks 326 lbs. Tea 25 lbs. Vegetables 177 tins; 168 lbs. Miscellaneous Packets:- Vermicelli, Macaroni, Farfals, Maltesers, Cereals, Lemonade Powder, Jellies, Sponge Pudding and Sponge Mixture 211 Miscellaneous Tins:- Ginger Pudding, Chocolate Spread, Steak Pudding, Frozen Eggs, etc. 64 Miscellaneous Bottles;- Lemon and Orange Squash, Essence, Sauce 54 60 HOUSING 1. Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 2,718 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) 109 3. Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 7 4. Number of dwelling-houses found not to be in all respects fit for human habitation 706 HOUSES IN CLEARANCE AREAS AND UNFIT HOUSES ELSEWHERE PART A - Houses Demolished Clearance Areas.Housing; Act. 1936 and Housing; Repairs & Rents Act. 1954 Houses Persons Displaced Families Displaced (l) Houses unfit for human habitation Nil Nil Nil (2) Houses included by reason of bad arrangement, etc. „ „ „ (3) Houses on land acquired under Section 27 Housing Act,1936 „ „ „ Not in Clearance Areas (4) As a result of formal or informal procedure under Section 11 Housing; Act, 1936 1 6 3 PART B - Unfit Houses Closed (5) Under Section 11 Housing Act, 1936 and Sections 10(l) and ll(2) Local Government (Miscellaneous Provisions) Act, 1953 2 5 3 (6) Under Sections 3(l) and 3(2) Housing Act, 1949 Nil Nil Nil (7) Parts of buildings closed under Section 12 Housing Act. 1936 4 5 3 6l PART C - Unfit houses made fit and houses in which defects were remedied By Owner By Local Authority (8) After informal action by local authority 464 Nil (9) After formal notice under - (a) Public Health Acts 103 Nil (b) Housing Act, 1936 Nil Nil (10) Under Section 5 Housing Repairs and Rents Act. 1954 Nil PART D - Unfit Houses in temporary use (Housing Repairs and Rents Act. 1954) No. of Houses No. of separate dwellings (11) Retained for temporary accommodation:- (a) Under Section 2 Nil — (b) Under Section 3 Nil — (c) Under Section 4 Nil — (12) Licensed for temporary occupation under Section 6 Nil — PART E — Purchase of Houses by agreement No. of Houses No. of occupants (13) Houses in Clearance Areas other than those included in Confirmed Clearance Orders or Compulsory Purchase Orders, purchased in the year Nil — OVERCROWDING 1956 1955 1954 1953 1952 New cases reported during year 130 127 279 219 125 No. rehoused during year 43 48 37 53 66 No. remaining on Register 1162 1075 996 754 588 Of the 43 overcrowded families rehoused, 35 were by Hampstead and 8 by the London County Council. 62 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. 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 1956 28 30 3 - 24 REHOUSING Visits and revisits in connection with the investigation of 520 rehousing applicants 1,218 No. of reports submitted to Hampstead Housing Estates Manager 4l6 ″ ″ ″ ″ ″ L.C.C. Estates Department 44 ″ ″ ″ ″ ″ L.C.C. Divisional Medical Officer 31 ″ ″ ″ ″ ″ Other Boroughs 29 63 LONDON COUNTY COUNCIL. DIVISION 2. PUBIJC 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.3. 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.J. GUL 4759 Pond Street, 27/29, Pond Street, N.W.J. HAM 1686 MATERNITY AND CHILD WELFARE CENTRES 60, West End Lane, N.W.6. MAI 5381 230, Haverstock Hill, N.W.3. SWI 3666 Hampstead Wells, Christchurch Hill, N.W.3. HAM 9534 3/5* Daleham Gardens, N.W.3. SWI 3424 Solent Road, Sumatra Road, N.W.6. HAM 5978 Welfare Foods. (National dried milk, orange juice, cod liver oil, etc.,) are obtainable from these centres. SCHOOL TREATMENT CENTRES Kilburn Treatment Centre, 107, Kingsgate Road,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 the Borough Council.) 64 DISTRICT NURSING ASSOCIATIONS Hampstead District Nursing Association, 3, Pond Street, N.W.3. HAM 6406 Kilburn & W. Hampstead District Nursing Assoc. 20, Dennington Park Road, N.W.6. HAM 4232 Home Help Organiser, 251, Finchley Road, N.W.3. HAM 4l36 For detailed information on the following subjects application should be made to the Divisional Medical Officer, 313/319, Harrow Road, W.9. CUNningham 48l5. 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. 65 INDEX page Aged Persons: Care of the Aged 13 Cleansing of 11,50 Laundry Service 14 Area of Borough 45 Area of Comparability Factors 45 Atmospheric Pollution 25 Bacteriological Examinations: Food 24,56 Infectious Disease 49 Swimming Bath Water 54 Bakehouses 31 Barbers and Hairdressers 36 Bathing Centre 11,50 Baths, Old Persons 11,19,50 Births, Birth Rate 7,45 British Red Cross Society l8 Burials 12 Certificates of Disrepair 39,62 Certificates of Suitability 31 Chemical Analysis: Food 24,57 Swimming Bath Water 54 Chiropody Service 19 Cleansing Station 11,50 Clearance Areas 37,60 Clinics 63 Closing Orders 60 Common Lodging Houses 31 Complaints 51 Contamination of Food 56,57 ,58 Conveniences, Free Washing Facilities 30 do. Railway Stations 30 Cooked Meats, etc. 22,55 Council Representatives on other Organisations 5 Clubs, Old Persons 20 Darby and Joan Clubs 20 Day Nurseries 63 66 PAGE Deaths: Chief Csuses 7,46 Death Rate 7,45 Infant Mortality 8,45 Maternal Mortality 8,45 Mortuary 50 Suicides 8 Demolition Orders 60 Dinner Clubs 19 Disinfection and Disinfestation 11,12,49 District Nursing Associations 64 Division 2, London County Council 63 Divisional Health Committee 5 Domestic Help Service 64 Drainage 51 Dustbins, Provision of 36 Dwellings: Structurally separate 45 Rate Assessments 45 Factories Acts Inspections 51,52 Outworkers 51,53 Underground Bakehouses 31 Pair, Hampstead Heath 22 Fairground Byelaws 36 Foods: Adulterated Samples 57 Bacteriological Examination 24,56 Bakehouses, Underground 31 Chemical Analysis 24,57 Cooked Meat Premises 22,55 Food and Drugs Act, 1955 21,55 Food Hygiene at Hampstead Heath Fair 22 Food Hygiene Regulations 21 Ice Cream 22,55 Inspections 55 Legal Proceedings 58 Milk 56 Premises 21,55 Sampling 24,57 Unsound Food 25,59 Food Poisoning 49 Foot Clinics 19 Free Washing Facilities 30 67 PAGE Hairdressers and Barbers 36 Hampstead Council of Social Service l8 Hampstead Heath Pair 22,36 Hampstead Old People's Housing Trust Ltd. l8 Hampstead Old People's Welfare Association l8 Heating Appliances (Fireguards) Act, 1952 31 Home Help Organiser 64 Homes, Old Persons 20 House-to-House Inspections 51 Housing: Applications for Rehousing 43,62 Clearance Areas 37,60 Closing and Demolition Orders 60 Housing Act, 1949, Section 4 40,51 ditto. Section 20 40 Housing Act, 1936, Section 9 51,62 Housing Repairs and Rents Act, 1954 39,62 Local Govt.(Miscellaneous Provisions) Act, 1953 60 Statistics 60 Unfit Houses 60 Overcrowding 6l Ice Cream 22,55 Improvement Grants 40 Infant Mortality 8,45 Infectious Diseases 8,48 Intimation Notices 51 Laundry Service 14 Loans for House Purchase 40,51 Legal Proceedings 54,58 Local Govt.(Miscellaneous Provisions) Act, 1953 60 London County Council, Division 2 63 London County Council (General Powers) Act, 1953.S.43 11,50 ditto. ditto. 1954 .S .12 36 ditto. ditto. 1955.S.27 40 Luxborough Lodge 18 Mass X-ray 11 Maternal Mortality 45 Maternity & Child Welfare Centres 63 Medical Examinations, Staff 12 68 PAGE Milk: Distributors 56 Premises 55 Special Designations, etc. Regulations 56 Ministry of Pensions and National Insurance 18 Mobile Meals Service 19 Mortuary 50 National Assistance Act, 1948, Section 50 12 ditto. Section 47 15 National Assistance Board 18 Neo-Natal Mortality 8,45 Old Persons 15 Outworkers 32,53 Overcrowding 6l Pet Animals Act, 1951 53 Pharmacy & Poisons Act, 1933 51,53 Pleasure Fair Byelaws 36 Poliomyelitis 8,48 Population 7,45 Prevention of Damage by Pests Act, 1949 33 Public Analyst's Report 24 Public Conveniences 30 Public Health Conmittee 5 Public Health Inspectors 21 Public Health Laboratory 24,49,56 Public Health Station 11,12,49 Public Mortuary 50 Railway Stations, Conveniences 30 Rag Flock etc. Act, 1951 31,51 Rateable Value 45 Rehousing 43,62 Rodent Control 33 Sampling 24,57 Sanitary Circumstances of the Area 21,51 Sanitary Inspectors 21 Scabies 11,48,50 School Treatment Centres 63 69 Sewers, Rodent Control 35 Shops Act, 1950 51 Slum Clearance 37 Smallpox 10 Smoke Abatement 25 Speech Therapy Centre 63 Staff: Public Health Department 6 Inspectorial 21 Medical Examination 12 Statistics: Statistical Summary 45 Public Health Inspection 51 Statutory Notices 51 Stillbirths 45 Structurally Separate Dwellings 45 Suicides 8 Swimming Bath Water 54 Tuberculosis: Mass X-ray 11 Notification and Deaths 10,48 Underground Bakehouses 31 Unsound Food 25,59 Verminous Persons 11,50 Water Supply 31 Women's Voluntary Service 18 Welfare Centres 63 Welfare Officer, Luxborough Lodge 18