AC. 4351 HAMP 58 Metropolitan Borough of Hampstead. Report on the Health of the Borough. 1957 R. U. 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. 1957 R. D. DEWAR, B.Sc., M.B., CH.B., D.P.H. Medical Officer of Health. 2 CONTENTS Page Public Health Committee; Staff 6, 7, 16 Population; Births; Deaths 14, 37-39 Infectious Disease 8-12, 40 Inspection of the Borough 18-21, 43 Atmospheric Pollution 22-26 Food and Drugs 26-29, 47-50 Housing 30, 51-54 Rodent and Pest Control 33-35 Mortuary 42 Statistical Summary 37 Aged and Infirm Persons 43, 55-57 Factory Acts, 1937 and 1948 44 L.C.C. Division 2 58, 59 Index 60 3 Public Health Department, 98a, Avenue Road, Hampstead, N .W.3. 2nd May, 1958. TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE METROPOLITAN BOROUGH OF HAMPSTEAD. Mr. Mayor, Ladies and Gentlemen, I have the honour to present my Annual Report on the health and sanitary circumstances of the Borough during 1957. The health of the population as judged by the vital statistics and the notifications of infectious disease was satisfactory, although it must be remembered that the majority of illnesses are not notifiable. For example, the epidemic of influenza which affected most parts of the country caused a very large number of cases in Hampstead during September, October and November. As the disease is not notifiable the precise number Is not known, but a number of general medical practitioners very kindly supplied information of cases occurring in their practices and it is evident that there were some thousands of persons affected. The majority were mild attacks and the number of deaths was very small. Whilst the records of births, deaths and infectious disease give some limited indication of the standard of health of the population it is extremely difficult to find figures which will provide a standard for the environment. It is true that the last census in 1951 provided Information on the number of persons per room, the number of households with sinks, cooking stoves, baths, etc., the extent to which these facilities were shared and information on other matters and It was possible on these points to compare conditions in Hampstead with other areas. It is not possible, however, to obtain the Information to compare present conditions in Hampstead with those existing in 1951. Some idea of changing conditions can be obtained from the number of intimation notices served in respect of statutory nuisances. Since 1957 these have been as follows;- 4 Year Intimations Year Intimations Year Intimations 1937 1558 1944 997 1951 1411 1938 1664 1945 901 1952 1159 1939 1503 1946 1641 1953 1024 1940 682 1947 2844 1954 959 1941 492 1948 2701 1955 958 1942 720 1949 2135 1956 706 1943 1057 1950 1530 1957 383 This decrease in the number of notices served could have been brought about by several different causes but these causes are not clearly identifiable from the records. At the end of 1957 some alterations were made in the methods by which information coming to the Public Health Department is recorded and it is hoped that in future years this will allow of more precise analysis of the nature and number of complaints and of the action taken and that they will give some clearer indication of the trends in environmental matters. Although it is not possible to quote figures it is quite evident that the public are taking a greater interest in the prevention of disease as distinct from the cure of illness. In this the press have helped considerably and whilst there may be some criticism of the sensational way in which they have dealt with such subjects as the incidence of poliomyelitis or "Asian flu" and the distribution of vaccines for protection against these diseases, there is no doubt that the public have been stimulated and Informed on the preventive aspects. The local press in Hampstead has been very helpful and although their references to the Council and to the Public Health Department have at times been far from complimentary, they have done much to encourage the public particularly in the field of food hygiene where the attitude of the consumer can do so much to improve standards. The Report which follows summarises the work of the Public Health Department for the year, but there were several matters which aroused particular interest. The Rent Act, 1957 was a piece of legislation which caused considerable controversy. By the end of the year it was far too early to assess the effects of the Act but the number of applications for Certificates of Disrepair was a good deal less than had been anticipated, although there were many enquiries from both tenants and landlords at the Public Health Department, and it is understood a great many more at the enquiry bureau set up at the Town Hall. 5 Under the Clean Air Act It was decided after considerable discussion that the first smoke control area in the Borough should be the small isolated area of the Vale of Health. During the year, the scheme was submitted to the Ministry for preliminary approval and a start was made on the survey of a larger area in the southern part of the Borough. The public health laundry service was put into operation in January, 1957 and the Report includes details of the first full year's operation. The service was proved of considerable help to a large number of bedfast and incontinent persons and has made it possible for a number of persons to be nursed at home rather than be admitted to hospital. In the early part of the year the lease having expired the Public Health Department was transferred from premises at 33, Lancaster Grove to 98a, Avenue Road, N.W.3. This building was formerly used as a nurses home for the adjoining St. Columba's Hospital, and it occupies part of the site which was purchased by the Borough Council for the erection of a Civic Centre. The accommodation is much more satisfactory than that at Lancaster Grove and it is much more conveniently situated for the public In respect of public transport, although the building itself is rather hidden away. During 1957 an investigation into the working of the Public Health Department was carried out by a team from the Organisation and Methods Committee of the Metropolitan Boroughs' Standing Joint Committee. Recommendations in the report of this investigation have resulted in some reorganisation of the department, mainly of a minor nature, details of which are set out in the Report. I am again indebted to the Members of the Council and particularly to the Chairman and Members of the Public Health Conmittee for their help and encouragement throughout the year, to the Chief Officers of the Council and their staffs for their co-operation and assistance on all occasions, and to my own staff for the loyal and efficient way in which they have assisted me . I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, R. DUNCAN DEWAR, Medical Officer of Health. 6 PUBLIC HEALTH COMMITTEE The Worshipful the Mayor (Councillor Lt.-Col. H. Ashley-Scarlett, D.S.O.,J.P.) ex-officio member . Chairman; Councillor Miss E. Beer, Aldermen S .A . Boyd, M .S., F.R.C.S . (Vice -Chairman) Mrs. R .S.G . Carnegie. Mrs. F.E. Cayford, J.P.,L.C.C. Councillors Miss D.R. Bailey. D. F. Ridgley. O.H. Belam, M.R.C.S., L.R.C.P ., K.Sames, Ph.D.,F.R.C. F.F.A.R.C.S . Miss D.M. Stedman . Miss M. du Mont, M.A. Mrs. P. Unwin. B.J.J. West. The Chairman of the Housing Committee. Sub-Committee; Drainage Plans. REPRESENTATIVES ON OUTSIDE COMMITTEES AND OTHER ORGANISATIONS CONCERNED WITH PUBLIC HEALTH WORK Hampstead Council of Social Service: Aldermen Mrs. R.S.G.Carnegie. E.Snowman, O.B.E.; Councillors Miss S.H. Ayliff, Miss D. R. Bailey, R. M. Brodtman. The Hon. Mrs. Ruth Bennett. Hampstead Old People's Housing Trust Ltd; Alderman E. Snowman, O.B.E.; Councillors Miss S.H.Ayliff, R.M.Brodtman, 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, L.C.C.; Councillors Miss S.H.Ayliff, Mrs.J.Lowry, J. Manfield, D.F.Ridgley, A .E .Skinner. Mr. J. Holloway. Hospital Management Committees; Archway Group: Mr.A.C.Morson, O .B 0E .,F .R .C .S 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 .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; Councillor Miss E. Beer. The Medical Officer of Health. 7 STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health; R.D. Dewar, B .Sc.,M.B .,Ch.B .,D.P .H., Barrister-at-law. Deputy Medical Officer of Healths: G.M. Frizelle, T.D.,M.D.,B.Ch.,B.A .O.,D.P .H. Chief Public Health Inspector: J.F. Armstrong (a)(b) Deputy Chief Public Health Inspector: F .V. Outlaw (a)(b) Public Health Inspectors: Mrs. C.G . Speechley (a)(d)(e)(f) R. Clark (a) L.E. Trigg (a)(b) E. Ulrich (a)(b)(c) W.F. Newport (a)(b) C.S.T. Dancer (a)(b) D.W. Malcolm (a) R.W.M. Cook (a) G.L. Nicklin (a) C .F . Pidgeon (a) (from 1.8 .57) Trainee Public Health Inspectors; C .F . Pidgeon (up to 31.7.57) D.G. Ring C.J. Bailey (up to 21.7.57) Chief Clerk: A .H .C. Slade Clerical Staff: G .W. Bedell J .A. Gilbody Mrs. M.C. Rabin Miss H. Marriott Mrs. G .A . Fletcher (from 29.7.57) Public Analyst: E.Voelcker, A .R .C .S .,F .R .I .C., 1, Tudor Street, E.C.4. Mortuary Keeper; S . King Public Health Station Keeper; H. Howe (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. 8 INFECTIOUS AND OTHER DISEASES Notifiable infectious disease remained at a reasonablylow level during the year. Of the 1,235 notifications received, 829 were of measles. Of the non-notifiable illnesses influenza became prevalent in September, The exact number cases is not known but It was apparent that a high percentage of the population was affected during the next few months. I give below some details of the individual diseases. Dysentery. The number of cases of dysentery was lower than for several years, and of the 26 cases notified 15 were due to the Sonne organism, 2 to Flexner and 9 were unspecified. Pour family outbreaks were responsible for 10 of the cases - three cases occurring in each of 2 families and 2 cases also in each of 2 families. Altogether 15 children and 11 adults were notified. Encephalitis. (Acute Infective.) Very little information was obtainable concerning the single case of this disease . The notification was received over 2 months after the onset of the illness, the patient being a doctor on the staff of a local hospital. Erysipelas. Thirteen cases were notified. They occurred mainly In the higher age groups, only 2 (10 years and 24 years) were below the age of 40. Eight of the cases were facial erysipelas. Malaria . A foreign student who had only been In this country a short time was notified as suffering from malaria . The Infection had been contracted before arrival here. Measles. Measles tends to recur in epidemic proportions periodically the interval being frequently but not invariably 2 years. There were 829 cases of measles, a figure lower than the two previous epidemics of 1953 and 1955 (1186 and 1028). The first 7 weeks of the year produced only 39 cases but there were a further 193 cases before the end of March. In April the number of weekly cases averaged 50 and the peak number 70, was reached In the first week of May. The epidemic then gradually subsided and the last week In August produced no cases at all. Generally speaking, the epidemic was not severe and was of short duration. The percentage of cases removed to hospital was 2.4 per cent, an extremely low figure. 9 Ophthalmia Neonatorum. All of the 27 notifications of ophthalmia neonatorum related to hospital confinements. Nineteen of these were patients whose home address was outside the Borough of Hampstead. In none of the 8 Hampstead cases was the vision impaired and the final report in each case was satisfactory. Pneumonia. Notifications of pneumonia, 48, have remained fairly constant over the last 5 years. There were 5 deaths. Twenty-one of the cases and all of the 5 deaths occurred during the period of the influenza epidemic, September to November. Poliomyelitis. Four cases of non-paralytic poliomyelitis and 11 cases of paralytic poliomyelitis occurred. The non-paralytic cases occurred in 3 children each aged 5 years, and one woman aged 28 years. One of the children had been in contact with a case of paralytic poliomyelitis. Six of the paralytic cases occurred in children under 4 years of age, the remaining 5 cases being adults aged 22, 28, 32, 35 and 41. Three of the children had been in contact with each other at a day nursery. In addition to the above, 9 cases were admitted to hospital as suspected poliomyelitis but were finally diagnosed as suffering from other illnesses; 4 were found to be influenza, 2 tonsillitis, 2 pneumonia and 1 influenzal meningitis. One other case at first notified as poliomyelitis (not admitted to hospital) was subsequently found to be a recurrence of a rheumatic condition. Puerperal Pyrexia. There were 85 notifications, all relating to hospital patients, but of these 59 patients lived outside Hampstead. In addition, we were informed of 33 cases of Hampstead residents whose confinement took place in hospitals outside Hampstead. The actual number of cases occurring in Hampstead residents were therefore 59. Very little information is available concerning the causes of the pyrexia. Of the 118 cases brought to our notice in only 67 was a probable cause of infection indicated. The chief causes were uterine infection 25, and urinary infection 15. Ten cases were attributed to respiratory infection, pneumonia or influenza. 10 Scarlet Fever. Scarlet Fever of which 55 cases were notified was slightly more prevalent than in recent years but was still of a mild form. The cases were spread evenly throughout the year. The highest number (l8) occurred in children of 4 or 5 years of age. Smallpox. No case of smallpox occurred in Hampstead. In June we received notification that a case had been confirmed in an unvaccinated child in another borough. As the patient had been an inmate of a large general hospital there were numerous contacts. All Hampstead medical practitioners were informed of the circumstances and numerous visits were paid by the Public Health Inspectors to contacts who lived in Hampstead to give any necessary advice and ensure the contacts' early vaccination. In order to avoid delay a number of contacts attended at the Public Health Department for vaccination. Subsequent investigation revealed that altogether 6 cases of smallpox had occurred, originating in a man who had been to West Africa on a business trip. There was one death. When knowledge of the outbreak became public, there was a considerable demand for vaccination and the moral is that routine vaccination in infancy is still as important as ever it was. Typhoid Fever. There were 3 cases of typhoid fever. In 2 cases the infection was contracted outside Hampstead. The first case was a foreigner who was removed to hospital from a hotel in Paddington, but by the time the illness had been diagnosed the patient's family had moved into Hampstead. The second case was an employee at London Airport, but although extensive enquiries were made the source of infection was not traced. The third case, a young girl who had been abroad on holiday and contracted the illness whilst in Spain or Italy, was admitted to hospital in Italy and was discharged after two weeks and returned home. Three days after her return to school, however, she again became ill and was admitted to hospital as a relapsed case of typhoid fever. 11 Whooping Cough. The Incidence of whooping cough declined progressively during the year. The March quarter produced 69 cases, the June quarter 24, September quarter 9 and the December quarter 7, making a total for the year of 109 cases. This figure, while a little higher than 1956, is still comparatively low but one feels that if full advantage were taken of the facilities for immunisation against whooping cough, it may well have been lower still. Tuberculosis. The 1957 figure for notification of new cases of pulmonary tuberculosis (108) is rather higher than the previous year (89) but when compared with the average for the post war years (97) the increase is less significant. Notifications of males (62) have been slightly above the post war average for 2 years now, but the first 6 post war years produced 315 notifications which compares with 332 between 1952 and 1957 so that the tendency for this figure to rise is very slight. Notifications of females (46) although considerably higher than 1956 are almost on a level with the average for post war years (43) and cannot be considered exceptional. There were 4 deaths from pulmonary tuberculosis. There were 9 cases of non-pulmonary tuberculosis, all of them female. The cases were spread evenly through the age groups from 7 to 63 and were classified as follows:tuberculous meningitis 1; spine 2; knee 1; kidneys and bladder l; cervical adenitis 4. There was one death of an un-notified case of non-pulmonary tuberculosis./ Mass X-ray. The Mobile Mass X-ray Unit was not available for members of the general public although the Unit did visit Hampstead for the purpose of closed surveys at 2 firms. The facilities of the permanent Mass X-ray Unit at 32 Drayton Park N. 5. are available for Hampstead residents at any time. No appointments are required, although separate times are set aside for males and females. Food Poisoning. There were no large outbreaks of food poisoning. Four single cases occurred of which 2 were due to salmonella typhimurium. The cause of the other two was not identified. Four family outbreaks were responsible for 10 cases, 8 of which were due to salmonella typhimurium and 2 to Clostridium welchii. In the case of these last 2 patients, Clostridium welchii was found to be present in some braised beef which they 12 had eaten at home. It was not possible to confirm exactly the food responsible In the other cases. In three Instances duck eggs, pork luncheon meat and tinned steak were suspect. Winter Epidemics. During April, May and June, outbreaks of influenza occurred in the Far East and gradually spread to the European countries. The Ministry of Health asked to be informed at the earliest possible moment of any Indication that Influenza had spread to this country and accordingly local medical practitioners were written to and asked to report cases occurring in their practices. On the 17th June a traveller by air from Bombay was reported to be suffering from a disease resembling influenza and the Ministry were at once informed. Arrangements were made for specimens to be collected and examined by the Colindale Laboratories. The epidemic became severe in Hampstead during the third week in September when local practitioners reported a record number of cases (one doctor reported 50 - 60 cases per day). By the end of October, however, the number of cases was reported as "moderate" and in a further two or three weeks the epidemic had spent itself. On the whole there were few serious cases and few unusual features. Verminous Persons. Thirteen cases of scabies were notified, and In addition 1 previously notified case was reported as a relapsed case, and 2 cases were reported as "suspected" scabies. All cases were visited and treatment of 10 cases and 1 contact was carried out at the Cleansing Station. The remaining 6 cases were treated either at home or at hospital. Eighteen adults and 6 children under 5 years of age were treated for verminous conditions other than scabies. The London County Council Clinic for treatment of school children operated on one afternoon a week and 36 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 this power was not used during the year. 13 MEDICAL EXAMINATIONS Sixty-seven examinations were undertaken during the year. Fifty-one were in respect of new appointments to the staff, 13 were of persons on whom a special report was required in connection with absence through sickness and 3 were carried out on behalf of other authorities. One person was found to be unfit for transfer from the temporary to the permanent staff, one person was recommended for superannuation and consideration of one person was deferred for a year. NATIONAL ASSISTANCE ACT. 1948. SECTION 50 Eleven funerals were carried out under this Act at a total cost of £96.13s .6d . An amount of £83.l6s.0d. was recovered from the estates of the deceased or from relatives. In 6 instances the full amount of the funeral expenses was recovered and in 4 cases the expenses were written off as Irrecoverable . In 1 case the funeral expenses were partially recovered. DISINFECTION AND DISINFESTATION The volume of work in connection with disinfection again decreased during the year. The number of rooms disinfested after vermin was 157, and the rooms disinfected after infectious disease 188; 132 parcels of clothes were disinfected prior to despatch abroad; 31 filthy and verminous rooms were cleared after the death or removal of the occupant, an increase of 17 over the previous year. Regular visits are paid to 2 hospitals for the disinfection of wards and laundry. The work of the Public Health Laundry is also carried out by the disinfecting staff who have been kept very fully occupied despite the shorter amount of time spent on disinfection. Apart from the more usual work of disinfection and disinfestation requests were received for the destruction of 26 wasps nests. 14 POPULATION For the third successive year the Registrar General has estimated a slight decrease in population, the latest figure being 97,130. The natural increase in population, i.e. excess of births over deaths was 472 so that a movement of almost a 1,000 residents away from Hampstead is indicated. As the number of separate rating assessments increases each year it means that fewer people are living in a greater number of premises, in other words, that homes are shared less frequently. BIRTHS The number of births, 1,492, rose slightly, being 17 higher than 1956. The birth rate was 15.4 per 1,000 of the population. The number of males born was 776, and the number of females 716. There were 140 illegitimate births, 72 males and 68 females. Stillbirths numbered 27. DEATHS There were 1,020 deaths of Hampstead residents, 9 fewer than in 1956. The death rate was 10.5, again commendably low. Comparison of the main groupings of the causes of death with the figures for 1956 is as follows;- 1956 1957 Total deaths: Males 438 458 Females 591 562 TOTAL:- 1,029 1,020 Tuberculosis, all forms 4 5 Infective and parasitic diseases 4 9 Cancer, all forms 216 250 Heart and circulatory diseases 390 355 Diseases of respiratory system 102 128 Pregnancy, childbirth, abortion 1 1 Congenital malformations 8 7 All accidents 20 21 Suicide 25 23 In 1957 the deaths of males increased by 20 and the deaths of females decreased by 29, making the total deaths 9 fewer than 1956. The increase in deaths of males was attributed to cancer of the lung, 25 deaths compared with 12 deaths in 1956, and influenza and pneumonia 9 deaths against no deaths in 1956. Both these increases were in the age group 45 - 65. 15 There were 9 fewer female deaths from all causes in the age group 25-45, 8 fewer between 45 and 65, and 21 fewer between 65 and 75. There were, however, 17 more deaths in the age group over 75. This shift to the higher age group fits in with the general pattern of living longer, but with such small figures as these it is impossible to draw any firm conclusions. It was most noticeable in deaths of females from all forms of cancer which were 7 less in the age group 25-45, but 6 more in the age group 45-65; heart and circulatory disease which were 9 fewer in the age group 45-65 and 16 fewer in the age group 65-75 but were 14 more in the years over 75. Respiratory disease, mainly influenza and pneumonia, was also responsible for 13 more female deaths over 75 years of age. The total deaths, males and females, from all forms of cancer showed an increase of 14 while the total deaths from heart and circulatory diseases decreased by 35. Deaths from influenza, pneumonia, bronchitis, etc. were 26 higher than in 1956. The only death from a notifiable infectious disease (other than tuberculosis) was of a boy aged 4 who died from measles. Deaths from tuberculosis were again low, there being 4 from pulmonary tuberculosis and 1 from non-pulmonary tuberculosis. Although the number of notifications does not fall, modern methods of treatment have greatly reduced the seriousness of this disease. There were 27 deaths of babies under 1 year, a drop of 7 from last year's rather high figure. The infantile mortality rate was 18.1. Of the 27 infant deaths, 23 occurred under 4 weeks of age. There was 1 death from pregnancy or childbirth. Ten deaths, 8 of which were of males, resulted from motor vehicle accidents. This figure is rather high but the figure for all other accidents was a low one, 11, making the total figure for accidents 21, which is slightly below the average. Hampstead maintained its good record in that no child under 15 years of age died as the result of an accident, but 13 of the total of 21 deaths were of persons over 65 years of age and a great deal of work needs to be done to reduce the accident rate among the elderly. For some years now, attention has been focussed on the number of deaths from suicide in Hampstead and this year's figure, 23, shows no decline from the recent average. Thirteen males and 10 females committed suicide, of whom 5 males and 5 females were below the age of 45. 16 STAFF During 1957 an investigation of the working of the Public Health Department was carried out by a team from the Metropolitan Boroughs' Organisation and Methods Committee. No major changes in the running of the department were recommended but as a result of the report of the investigating team the Council agreed to some alteration. Previously, there has been no specialist public health inspector, the establishment consisting of a Chief Inspector, a Deputy Chief Inspector and eleven District Inspectors. The new establishment is reduced to a total of twelve consisting of the Chief Inspector and his deputy, a full time food inspector, a full time (woman) inspector for infectious diseases and old persons, a housing inspector who also carries out some district work, a smoke Inspector also doing district work and six district inspectors. The reduction in the total number of inspectors was largely made possible by the granting of car allowances to all the public health inspectors who were able and willing to provide cars for use in their work. Hampstead is a difficult area for public transport and whilst there are three main north south routes, the services from east to west leave a great deal to be desired. It was found moreover that even in dealing with a district directly adjoining the Public Health Department the use of a car would save an inspector at least one hour per day. The Council also agreed to some modification of the conditions for trainee public health inspectors. Previously, trainees have been employed as clerks and have been given opportunity to gain the necessary experience in public health work, whereas now they are primarily trainees who do some clerical duties and this has allowed of a better and more intensive training programme which is not so dependent on the amount of clerical work to be done . The establishment allows for the employment of three trainee public health inspectors. This has involved an Increase In the clerical establishment by one Junior clerk, and in spite of the difficulty of getting recruits for these Junior positions in local government, it has been possible to fill this post. Another minor alteration was to have the three inspectors' assistants trained as rodent operatives and to make the duties of these three assistants and the two rodent 17 operatives interchangeable . It is not anticipated that there will be any appreciable increase in the work of rodent control but the interchangeability removes some of the difficulties which arise from the sickness of staff and during annual holidays. Some changes have also been made in the form and number of records which are kept in the department primarily for the purpose of allowing a more complete analysis which will, it is hoped, give fuller information on the trends in public health and so indicate those matters which should receive increased attention and allow of some intelligent anticipation of the staff and their duties to meet these needs. It should also indicate those duties or services which appear to require an excessive amount of time or work for the results achieved. It is also intended that the amount of clerical work which the Inspectors have to carry out will be reduced. The extent to which changes can be made in the number of records kept and the form in which they are recorded is limited to some extent by the legal requirements, and it is necessary to ensure that the records are not so altered as to prevent comparison with former years. In the first half of the year there was one vacancy in the establishment of public health inspectors and advertisement did not produce a suitable candidate. Later the vacancy was filled by the appointment of one of the Council's trainees who successfully sat for the qualifying examination. For some years the Public Health Department was housed in property at 33, Lancaster Grove, the lease for which expired. The Department was transferred in March, 1957 to premises at 98a, Avenue Road, N.W.3. This building, which stands on the site acquired by the Council for the erection of a new Civic Centre, was formerly used as a nurses home for the St. Columba's Hospital, which is now transferred to The Elms, Spaniards Road. The building required a minimum of adaptation and is much more conveniently situated for the public, being on a number of bus routes and on the Bakerloo Underground line. 18 INSPECTION OF THE BOROUGH The number of intimation notices served in respect of "nuisances" averaged about 1,550 before the War. This figure naturally dropped during the war but rose again to a peak of 2,844 in 1947, with a gradual drop to 960 in 1954 and 1955 and it has since dropped sharply to 706 in 1956 and 383 in 1957. There are some obvious reasons for these changes. Before the War there was a large number of registered tenement houses. These were subject to special byelaws and a fair proportion of the intimation notices served were in respect of the periodical cleansing or other requirement of the byelaws. The Housing Repairs and Rents Act, 1954 repealed the byelaws and substituted other powers in Sections 11 and 12 of this Act. Section 11 was designed to secure the fitness of the premises for occupation by the number of families accommodated but it gave the owner the alternative of carrying out the necessary work or of evicting one or more families so that the amenities provided would be adequate for the remaining families. The section also took away for this purpose the security of tenure which the tenants had under the Rent and Mortgage Interest Restrictions Acts. At that time security of tenure was valuable, alternative accornnodation was extremely difficult to obtain and landlords were well aware that it was much more profitable to let houses furnished both from a financial and management point of view. It was felt, and I believe rightly, that Section 11 was unusable at least in London at that time, and that the service of a notice under this section would create great hardship whilst achieving very little in the way of improved conditions. As a result, the hundreds of notices served under the byelaws before the War were not replaced by notices served under the above mentioned sections. Sections 11 and 12 of the Housing Repairs and Rents Act, 1954 have been repealed but have been re-enacted in the same form in Sections 36 and 90 of the Housing Act, 1957. The great increase in the number of notices served in the immediate post-war period is largely artificial. At that time a building licence was required if works were to be carried out costing more than a very small amount and a 19 licence was more likely to be obtained if it could be shown that the works required to be done were in respect of a nuisance or of some condition which was dangerous or injurious to health. For this reason owners of property were only too willing to bring defects to the notice of the local authority and not only encouraged their tenants to do this but did so themselves. It is not, however, easy to be sure of the cause of the most recent drop in the number of notices served, but it is probable that it is due in part to the better co-operation between landlords and tenant. With a good tenant and a good landlord repairs which are necessary are done without them being brought to the notice of the local authority. There has further been a considerable increase in the past few years of encouragement in the press and elsewhere to "do-it-yourself" and this, together with a number of legal decisions that landlords were not responsible for internal decorations in ordinary circumstances, has led to a great deal of work being done by tenants - including minor repairs for which the tenant was probably not responsible. A further point is that inspectors have been encouraged to deal informally with owners, either by meeting at the property or speaking over the telephone, and the effectiveness of this is shown by the much larger number of houses put in repair by "informal action of the local authority" than the total number of intimation notices served. The advantage of this method of approach is not merely the saving of clerical work but that it is frequently possible by encouragement and persuasion to get additional works of improvement done which would not be enforceable under a notice. Not all notices are, of course, in respect of repairs to houses, and although as mentioned earlier the present records do not lend themselves to detailed analysis, it is interesting to note the reasons for the complaints received at the Public Health Department. Just over one-third were complaints of lack of repair, consisting of 13 per cent. of general dilapidations, 13 per cent. of dampness and 9 per cent. of defects in the roof or gutters. Totals were as follows:- Percentage Lack of repair or dampness 35 Insects l6 Drainage or water supply 13 Smells 7 Food 5 20 Percentage Accumulations of rubbish 5 Lack of dustbins 4 Smoke or fumes 4 Annoyance from other persons 2 Miscellaneous 9 Of the complaints concerning insects just over half were of cockroaches; some of the complaints of smoke or fumes concerned defective fireplaces or flues and should perhaps be included in the item of repair; and the miscellaneous complaints included a number which were not matters for the Public Health Department. Apart from inspections on complaint, routine inspections are carried out in certain special premises, particularly food premises, of all kinds. A number of inspections of houses follow on the notification of a case of infectious disease and a certain number of inspections of houses are carried out with a view to proceedings under Section 9 of the Housing Act, 1957 which replaces Section 9 of the Housing Act, 1936. Action under Section 9 has not been popular partly because the nuisance procedure under the Public Health Act is so much simpler. There it is merely necessary to set out the defects and to require the owner to remedy them, but under Section 9 it is necessary in the first place for the Council to be satisfied that the work can be done at reasonable cost. This means not merely setting out the defects but preparing a schedule of the works to be done, estimating the cost of the works and obtaining an estimate of the value that the property would have when the works are completed . Where the work to be done is small, the accuracy of the estimates is not very important, but where the work is extensive a correct estimate may be of major importance. Under Section 9 also the notice must state that the works set out will render the house fit for human habitation and whilst it may not be legally necessary to include every defect, it would be misleading to the owner to omit defects and require their repair at a later date. Where a notice has been served under Section 9 and the work is not carried out the Council may (and probably should) do the work in default. This is normally done by a private firm after tender and it usually means that the cost of the work has to be collected from the rent of the property over a long period. 21 Section 9 cannot be used for properties in a slum clearance area for here it is the Council's contention that the work cannot be done at reasonable cost and it is also obviously unwise to use this procedure in areas that the Council is intending to acquire either compulsorily or by agreement for the purposes of redevelopment. There has recently been some clarification of the Council's programme on redevelopnent and it is intended that where the position is now clear, there will be an increased use of Section 9 procedure to make premises fit. A number of inspections are also carried out in respect of applicants for rehousing. Housing applications are sent to the Public Health Department and the premises are inspected not only to ascertain the condition of the premises, but also to record the number of rooms occupied by the applicant, 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 any medical conditions which might be improved by rehousing. During the year, 640 such visits were made and reports submitted to the Housing Department. "points" being awarded in 228 cases. The pointing is done by the Housing Manager and recommendations from the Public Health Department are confined to those made on medical grounds only. In all but very exceptional cases medical points are not recommended unless the application is supported by a certificate from a general medical practitioner. I would like to acknowledge the help given me by the medical practitioners of Hampstead in arriving at a fair estimate of the benefit which an applicant could derive from rehousing. In addition to the above visits and reports, a further 64 cases were investigated but were found to have obtained other accommodation without the help of the Borough Council, and a further 9 reports on applications were submitted to the London County Council and 6 to other boroughs. 22 THE CLEAN AIR ACT. 1956 Atmospheric Pollution. The greater part of this Act came into force on the 31st December, 1956 so that the Department's work in connection with atmospheric pollution took on more positive aspects during the year under review. The aim of the Council is to secure that ultimately the whole of the Borough will be a Smoke Control Area. This, however, must be a long-term policy, particularly having regard to the amount of air pollution emanating from the railways, of which, as is well-known, there are more main lines running through Hampstead than any other London Borough, In view of the volume and importance of this work, Mr. E. Ulrich, one of the District Public Health Inspectors, was appointed a specialist Smoke Inspector and allotted duties in co-ordinating and advising generally on the formation of Smoke Control Areas. The deposit gauges and lead peroxide instruments at Barrow Hill Reservoir and Fortune Green Road Cemetery have been in use for some years, and it was felt that the monthly readings from these instruments had given a reasonable amount of basic information which was not likely to show any appreciable change until some steps had been taken to reduce the amount of atmospheric pollution in the Borough or in adjoining districts. On the other hand, there was probably insufficient information on local variations throughout the Borough. After consultation with the Department of Scientific and Industrial Research, the station at the Barrow Hill Reservoir was closed down and the Public Health Committee recommended that three continuous filters giving daily records should be installed at appropriate points, in addition to the continuous filter which operates at the Public Health Department. This arrangement should give additional useful information without increased cost to the Council. The co-operation of the headmasters of various schools was enlisted as it was thought that the Council would be assisted in the recording of the daily measurements and at the same time the instruments and records would provide matters of interest to the students. Three headmasters subsequently agreed to accept and supervise the operation of the instruments but delays in 23 supply of parts of the apparatus have meant that installation will not be effected until early in 1958. The two tables here are intended to indicate the inverse relationship between temperature and pollution levels. Table 1 shows the expected drop in pollution with the rise in temperature during the summer months. It also indicates that the relative variation of SO2 is less than that for smoke (i.e., the suspended soot, etc.) in the atmosphere. Inasmuch as it is known that SO2 emission is directly proportional to the amount of fuel consumed, irrespective of the type of appliance on which it is burned, the relative increase of smoke, as compared with SO2, during the winter months would seem to be attributable to domestic open fireplaces which are used only in the winter months. 24 Table 2 shows for December, 1957 the dally breakdown of temperature (indicated inversely), smoke and SO2 Taking the year as a whole, as in Table 1, there can be no surprise that as temperature rises so pollution falls. I think it surprising, however, that pollution levels should oppose temperature in such consistent fashion from day to day as is indicated in Table 2. Consistent depressions in the pollution graphs are indicated at weekends (1st, 2nd, 8th, 9th etc.) and this is not easily explained. It is tempting to argue that it is the result of industry shut-down, or to suggest that domestic fireplaces are in more consistent use at weekends. But Christmas gave what was, in effect, a week's holiday in this month, yet did not give the same indications. Vale of Health Smoke Control Area The Council having resolved that one part of the Borough should be the first, or "pilot" Smoke Control Area, a house-to-house survey was made in May and June. The area concerned, the Vale of Health, must be nearly unique in London in its character and location It is In effect a village of some seventy occupied premises, no industry, and is surrounded by Hampstead Heath. Any improvement brought about by smoke control will be immediately apparent, yet it is true that complete success will make a negligible contribution to the problem as a whole, or even in the Borough. In fact, the choice of the area was certainly open to argument as to whether or not it was worthwhile. However, now that confirmation is about to be given, It Is raising problems on fuels, conversions and costs which will be of great value when the second and larger Control Area, which is now under preliminary survey. reaches implementation. New heating installations Towards the end of the year, applications for approval of new heating installations began to come in. So far, nearly all have been in respect of oil-burning appliances and, subject to undertakings on instrumentation, type of oil to be supplied, and full information on the manufacturers' rating of both the boiler and the combustion unit, approval is being indicated. Complaints During the year complaints have been received, and found justified, of oil-fired plants which are emitting no 26 visible smoke but which are causing deposits of sooty smuts. With all the indications of an increase in numbers of small oil-burning appliances, this matter continues to receive the close attention of my staff. The railway tunnel ventilating shafts which have been referred to in earlier reports continue to emit quantities of smoke and ash from time to time, although complaints about them have not been numerous. Individual smoke nuisances from small factories, blocks of flats and incinerators have been reported periodically and in all cases have been dealt with informally, almost always with good effect. INSPECTION AND SUPERVISION OF FOOD Meat. There are no slaughterhouses in the Borough, All the butchers shops are regularly inspected. Ice Cream, Seven additional premises were registered for the sale of ice cream under Section 16 of the Food & Drugs Act, 1955. In each case the ice cream is wrapped. The total number of premises registered is 237. 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 Foods. Fifty-two 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. Food Sampling (a) Bacteriological examination. This service is undertaken by the Central Public Health Laboratory, I am greatly indebted to the Director of the Laboratory for unfailing co-operation and help. 27 Details of the ice cream and milk samples submitted to bacteriological examination appear under the respective headings. Sixty 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) Chemical analysis „ Mr. Eric Voelcker, A .R .C .S .,F R. I .C Public Analyst to the Borough, has examined and reported upon 507 samples which can be classified under the following broad headings;- Milk, cream, condensed milk, etc. 12 Butter, margarine, cooking fat, cheese 50 Ice cream, lollies 23 Fruits, vegetables (including canned and tinned) 44 Tinned fish, shellfish 15 Meat and meat products 56 Herbs, condiments, spices, sauces, etc. 65 Flour, flour confectionery, puddings, cakes, etc. 50 Beverages, non-alcoholic 30 do. alcoholic 43 Jams, preserves 21 Sweets, confectionery 57 Miscellaneous 41 507 All the samples of milk proved satisfactory, the average milk fat content being 3.76 per cent. The legal minimum is 3 per cent. Nine samples of pork sausages were taken, the average meat content being 68.3 per cent; the lowest meat content was 66 per cento Two samples of beef sausages each gave meat contents of 51 per cent. There were 28 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 Dust Wharf for disposal with other trade refuse. 28 Food Hygiene Regulations. 1955, Immediately following the coming into force of these Regulations in 1956, a letter was sent to all food businesses in the borough enclosing a copy of the Regulations and offering the assistance of the Public Health Inspectors in advising the occupiers as to their application . During the last 18 months, continual efforts have been made by the Inspectors to encourage the proprietors to bring their shops and restaurants etc. up to a standard approaching that required by the Regulations,and a substantial improvement has resulted generally. However, experience has shown that there are frequently limitations to what can reasonably be required because of (a) the character and tradition of the business, and (b) the size and construction of the premises. The essential requirements of cleanliness of both premises and staff has, of course, been enforced but the measures for the prevention of food contamination in its less obvious forms - bacteriologicial contamination - have been difficult to apply. These measures would include:— (a) The protection of open food exposed, for example on shop counters and self service displays, in shop windows, on buffet counters of licensed premises, in restaurants, cafes and cafeterias. (b) The storage of certain foods, not for immediate consumption, at temperatures prohibiting the growth of bacteria and development of toxins. Section 8 of the Regulations requires (inter alia) that "open" food shall not be placed as to involve any risk of contamination. Whilst we endeavour to interpret this Regulation in a commonsense and practical manner, recent court decisions, including one in the High Court, have laid down that the law obliges a local authority to prove that the contamination is prejudicial to health. This is fraught with difficulty and renders the prospect of successful legal proceedings in respect of food contamination an extremely hazardous and costly matter. As I have stated previously, the question of the temperature at which certain foods is to be kept (vide S,25) is very difficult to apply in many types of premises, in particular, licensed houses with buffets. Underground bakehouses. One further basement bakehouse was closed during the year. The Certificate of Suitability relating to 98, West End Lane expired on the 30th September, 1957. This bakehouse was first registered in 1903. 29 When the Factory & Workshops Act, 1901 came into force there were no less than 40 basement bakehouses operating in the Boroughs 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. 7. Fairhazel Gardens. Catering Hygiene at Hampstead Heath Fairsa As usual, the Public Health Inspectors were on duty throughout each Fair day. Every food stall was checked in relation to the requirements of the Food Hygiene Regulations. In the main, "open" food was being adequately protected by cellophane wrappings and plastic covers and the stalls were closed on the sides, top and back. "Washing-up" facilities were provided and most retailers had a supply of sterilising agent. Some of the shellfish stalls now use plastic non-reusable "plates", a practice we have been advocating for some time. Similar types of drinking beaker were also in use. Hand-washing facilities comprising a bowl, hand or roller towels, a scrubbing brush and soap were provided at all the stalls. Heating was usually by primus stove or calor gas; some traders had lagged storage tanks which were periodically replenished with hot water from a central supply. Samples for both chemical and bacteriological purposes are regularly taken. The co-operation of the Fishmongers Company was enlisted in connection with contaminated shellfish samples. A large supply of coconuts (nearly 3,000) was condemned as unfit at the Easter Fair. The general tendency towards standardisation in foodstuffs is increasingly apparent and investigation of all the "hot dog" and hamburger stalls revealed that only two brands of Frankfurter sausage were in use. Similarly, the variety of ice cream is steadily decreasing and the bulk of ice cream consumed could be traced to three manufacturers. Apart from picking out isolated improvements, it is clear that the greatest benefit from our work at the Fair is the fact that we do it. As one stallholder said "When we come to Hampstead, we know that the Inspectors will be round". 30 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 facilityjudging by the number of towels which have been issued. HOUSING ACT. 1949 Loans granted (s.4) Improvement Grants (S.20) Despite the slight hiatus caused by the increase in the Bank Rate, extensive work has been carried out in connection with surveys of property for prospective purchasers wishing to obtain a mortgage from the Council. 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 1957 January - June 34 22 9 3 July - December 34 20 8 6 TOTAL:- 333 214 78 41 31 Improvement Grants 1954 - 1957 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 - 1957 January - June 19 17 1 1 July - December 5 5 - - TOTALS :- 66 44 15 7 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". 32 This procedure was again used on two occasions, tenders being obtained from local builders and the lowest tender being accepted in each case. 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 FILING 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. Three 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. PLEASURE FAIR BYELAWS Despite previous successful prosecutions and an undertaking given to the Magistrates and the Council that sanitary conveniences would be provided for the public attending the private fairground at the Vale of Health, nothing was done. The two defendants were again fined the maximum penalty of £5 each and £3.3s.0d. costs. At the end of the year, the conveniences had still not been provided. 33 ROAD TRAFFIC ACT. 1956,, SECTION 42 Protective Helmets for Motor Cyclists. As far as could be ascertained, there were no premises in the Borough retailing these helmets during 1957. One shop did open early in 1958. PREVENTION OF DAMAGE BY PESTS ACT. 1949 Rodent Control. There has been little change in the incidence of rat and mouse infestation in the Borough. We are fortunate in the fact that major infestations are comparatively rare and there have been no known infestations by ship (black) rat. The majority of complaints arise through rats gaining access to premises via broken sub-floor ventilating gratings, damaged cellar windows or doors, etc. Only in 17 instances was the course traced with any degree of certainty to defective drainage. The number of premises treated for rat infestation was 263 and for mice 586, which shows an increase of 60 and 133 respectively over the figures for 1956 (calendar year). This has not been due to an increased number of complaints but arises from additional surveys undertaken by the rodent operators and the subsequent treatment of infestations discovered as a result thereof. It remains to be seen whether this more intensive survey will be effective in reducing still further the complaints made to the Departments The Ministry of Agriculture, Fisheries and Food pay a grant of 50 per cento of the approved net expenditure incurred in the destruction of rats and mice.Infestations in dwelling-houses are treated free of cost to the occupier but expenditure incurred in business and commercial premises is re-charged to the owners at the rate of 17s.0d. per hour for the operative's time and includes the cost of baiting materials and poison. After the 31st March each year, the Minister requires the Council to submit details showing (l) the extent of infestation in the Borough, (2) special circumstances to which any undue presence of rats and mice might be attributed and (3) the nature and extent of co-operation with contiguous authorities. The following table shows the details submitted to the Minister for the year ended 31st March, 1958. 34 Local Authority Dwelling Houses All Other Premises Total No. of properties 19 23,031 5,195 28,245 Properties inspected; (a) After notification 13 864 29 906 (b) Survey 3 246 14 263 (c) For other reasons - 9 3 12 Total visits 67 3,923 78 4,068 Properties infested by; (a) Rats (Major) - - (Minor) 5 284 3 292 (b) Mice (Major) - - (Minor) 9 567 20 596 Properties treated 14 851 23 888 No o of treatments 14 90 0 29 943 Notices served: (a) Treatment - - (b) Structural Work - 8-8 Cases in which default action was taken after serving notice - - - - Legal proceedings - - "Block" control schemes carried out - 8-8 Maintenance Treatment for Rats in Sewers. I am indebted to the Borough Engineer for the details of the treatment of sewer infestations which are dealt with by his staff. The treatments are carried out at six monthly intervals in April and October, coinciding with an organised campaign throughout the metropolitan area,. The poisoning mediums used were 2\ per cento zinc phosphide and 10 per cent, arsenious oxide in sausage rusk base, together with a preservative, paranitrophenol 0.25 per cento The table below illustrates the results achieved at these two treatments. 35 April October Manholes baited 718 757 Manholes showing prebait take 286 289 Manholes showing complete prebait take 38 51 Prebait take on each occasion was in the region of 37 per cento of the manholes treated. The better keeping qualities of the bait made possible by the addition of paranitrophenol probably accounts for the increased number of complete takes, as the appearance of bait was still good at the end of the extended period, the growth of moulds, etc. having been inhibited. Destruction of Pigeons. Numerous complaints continue to be made to the Department concerning quite severe nuisances and damage caused to buildings by "rock" or "house" pigeons. At present we have to rely upon a private firm specialising in the destruction of bird pests to deal with the complaints. Owing to various difficulties, the contractor, although necessarily authorised by the Council to catch pigeons on the highway and to enter private premises for this purpose (subject, of course, to the consent of the householder), is not under any binding contract with the Council. This arrangement has not proved entirely satisfactory and has often led to delays in dealing with urgent complaints. Usually, when this firm does operate in the area, their employees are approached by irate, bird-loving, members of the community and accused of cruelty and inhumane treatment to the birds. The somewhat Gilbertian situation then arises of frantic calls being made to the police and my department from pigeon lovers, followed by equally bitter complaints of the filth and damage caused by these birds. Insect and other Pests. Complaints of ants, bugs, clover-mite, cockroaches, fleas, flies, lice, pigeons, woodlice and woodworm are dealt with as part of our normal routine but the solution to the problem of a boa-constrictor, kept as a pet in a furnished house, had not previously confronted the public health inspector. Complaint was made that this snake was left by its owner, a cabaret artist, in the bath from whence it often escaped and meandered into the garden or rested in the gas geyser of the neighbouring tenant, much to the consternation of all concerned. Alas, the snake died before the inspector could exercise his ingenuity. 36 RADIATION HAZARDS Attention was drawn by H.M. Inspector of Factories to premises occupied by a firm who luminised watch dials. It had been found that the amount of radioactivity in a workroom was in excess of that which is considered safe for the health of a person regularly employed there. With the assistance of the firm, who were at all times helpful and co-operative, arrangements were made for the contents of the room to be removed and disposed of in a safe way. NATIONAL ASSISTANCE ACT. 1948. SECTION 47 Requests for help concerning the welfare of old and infirm persons continue to be received from relatives, neighbours, social workers, hospital almoners, medical practitioners, etc., and 62 cases were investigated. Where possible, the services of a home help, a district nurse, and the meals service were arranged In order to enable the patient to continue living at home. Even with these facilities, however, a number of patients could not manage to look after themselves and it was necessary to apply for their admission to a home. Following upon the report of the Organisation and Methods Team, the Council decided to appoint a whole time specialist inspector to deal with the welfare of old persons. Mrs. C.G. Speechley, who is a trained nurse and has many years of experience in dealing with the types of problems involved, was transferred to the new appointment on the 1st January, 1958. There was an immediate increase in the number of cases referred to the Department and in the first four months of 1958, 66 new cases were dealt with. BARBERS AND HAIRDRESSERS Three applications for registration were received, but in each case it was a change of ownership of premises already registered. The number of premises on the register is 76. 37 STATISTICAL SUMMARY Area of Borough 2,265 acres Registrar General's estimate of Population mid—1957 97,130 Rateable Value March, 1957 £2,245,700 Sum produced by ld. rate £9,105 No. of separate rating assessments of dwelling houses, flats and other residences 22,453 No. of structurally separate dwellings, Census 1951 23,010 No. of private households, Census 1951 35,970 BIRTHS Total Legitimate Illegitimate Males 776 704 72 Females: 716 648 68 1,492 1,352 l40 Birth Rate 15.4 Area Comparability Factor 0.75 No. of Stillbirths 27 Stillbirth Rate 17.8 DEATHS Net deaths (Males 458; Females 562) 1,020 Death Rate 10.5 Area Comparability Factor 1.02 Deaths from maternal causes 1 Deaths of infants under 1 years: (Males 15; Females 12) 27 Deaths of infants under 4 weeks: (Males 13; Females 10) 23 Infant Mortality Rate; All infants 18.l Legitimate infants 17 Illegitimate infants 28.6 38 CAUSES OF DEATH 1957 Cause of Death Total Males MALES - AGES Total Females FEMALES - AGES Total Males & Females 0 - 1 - 5 - 15 - 25 - 45 - 65 - 75 - 0 - 1 - 5 - 15- 25- 45- 65- 75- Tuberculosis respiratory- 3 - - - - - 2 1 - 1 - - - - - 1 - - 4 Tuberculosis other - - - - - - - - - 1 - - - - — - - 1 1 Syphilitic disease 1 - - - - - - - 1 4 - - - - - - - 4 5 Diphtheria - - - - - - - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - - - - - - - - Acute poliomyelitis - - - - - - - - - - - - - - - - - - - Measles 1 - 1 - - - - - - - - - - - - - - — 1 Other infective and parasitic diseases - - - - - - - - - 3 - - - - - 1 1 1 3 Malignant neoplasm, stomach 9 _ - - - - 2 4 3 7 - - - - - 2 1 4 16 Malignant neoplasm, lung, bronchus 45 - - - - — 25 11 9 12 - - - - 1 5 5 1 57 Malignant neoplasm, breast - - - - - - - - - 28 - - - - 2 15 9 2 28 Malignant neoplasm, uterus - - - - - - - - - 12 - - - - 1 4 5 2 12 Other malignant and lymphatic neoplasm 45 - 1 - - 2 10 17 15 65 - - - - 1 24 19 21 110 Leukaemia, aleukaemia 3 - - 1 - - - 1 1 4 - - - - - 2 - 2 7 Diabetes 1 - - - - - - 1 - 7 - - - - - 2 2 3 8 Vascular lesions of nervous system 37 - - _ - - 11 9 17 83 - - - - - 12 24 47 120 Coronary disease angina 95 — - — - 2 36 27 30 88 - - - - - 13 22 53 183 39 Hypertension with heart disease 7 _ _ _ _ _ 2 2 3 11 _ _ _ _ _ _ 3 8 18 Other heart disease 27 1 - - 1 1 3 12 9 61 - - - - 2 4 10 45 88 Other circulatory disease 31 _ _ _ 3 4 10 14 35 _ _ _ _ 1 5 5 24 66 Influenza 6 - - - _ - 4 2 _ 8 _ _ _ _ _ 1 - 7 14 Pneumonia 17 1 1 - - - 5 4 6 34 1 - - - 1 3 6 23 51 Bronchitis 38 - - - - - 9 15 14 19 1 - - - - 1 2 15 57 Other diseases of respiratory system 5 _ _ _ _ _ 1 _ 4 1 _ _ _ _ _ _ _ 1 6 Ulcer of stomach and duodenum 5 _ _ _ _ —_ 2 3 _ 4 _ _ _ _ 1 _ 3 9 Gastritis, enteritis and diarrhoea 2 _ _ _ _ l _ _ 1 1 _ _ _ _ _ _ 1 _ 3 Nephritis and nephrosis 4 _ _ _ _ 3 _ _ 1 3 1 _ _ _ 1 1 7 Hyperplasia of prostate 9 _ —_ _ _ - 1 8 _ _ _ _ _ _ _ _ _ 9 Pregnancy, child birth abortion _ _ _ _ _ _ _ _ _ 1 _ _ _ _ 1 _ _ _ 1 Congenital malformations 4 l _ _ _ _ 3 _ _ 3 2 _ _ _ 1 _ _ _ 7 Other defined and illdefined diseases 34 12 _ _ _ _ 8 5 9 51 8 _ _ 1 5 11 5 21 85 Motor vehicle accidents 8 _ _ _ _ 1 2 3 2 2 _ _ _ 1 _ _ _ 1 10 All other accidents 8 - - _ - 3 1 3 1 3 _ _ _ - - - - 3 11 Suicide 13 _ _ _ 1 4 5 3 - 10 _ _ _ 2 3 2 2 1 23 Homicide and operations of war _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ TOTAL:- 458 15 3 1 2 20 136 133 148 562 12 1 -_ 4 19 110 122 294 1020 40 INFECTIOUS DISEASE DISEASE Notifications Removed to Hosp. 1957 Deaths 1957 1953 1954 1955 1956 1957 DysenteryEncephalitis; 40 73 32 35 26 7 - Acute Infective - - 1 2 1 - - Post Infectious 1 1 3 2 - - - Erysipelas 7 13 7 7 13 1 - Food Poisoning x 21 19 56 15 10 2 - Malaria 1 2 - - 1 1 - Measles 1186 36 1028 243 829 20 1 Meningococcal Infection 3 2 2 2 - - - Ophthalmia Neonatorum; Hampstead residents 5 1 1 4 8 8 Non-residents - - - 3 19 19 - Pneumonia 53 47 53 54 48 21 5 Poliomyelitis: Non-Paralytic 2 - 28 - 4 3 - Paralytic 10 2 9 2 11 11 - Puerperal Pyrexias Hampstead residents 34 41 22 14 26 26 Non-residents - - - 31 59 59 - Scabies 24 23 26 25 13 - - Scarlet Fever 44 50 23 32 55 6 - Typhoid Fever - - 4 1 3 3 - Whoocins Coueh 215 169 114 94 109 5 - TOTAL:- 1646 479 1409 566 1235 192 6 x 4 further cases were ascertained but not notified in 1957* TUBERCULOSIS Age Periods Respiratory Non-Respiratory New Cases Deaths New Cases Deaths M F M F M F M F 0 - - - - - - - - 1 2 4 - - - - - - 5 1 2 - - - 2 - - 15 9 14 - - - 2 - - 25 31 19 - - - 3 - - 45 14 3 2 1 - 2 - - 65 5 2 1 - - - - - 75 - 2 - - - - - 1 TOTAL; 62 46 3 1 - 9 - 1 41 FOOD POISONING Cases Notified Otherwise Ascertained Total Cases Deaths 1st Quarter - - - - 2nd " 4 2 6 - 3rd " 6 2 8 - 4th " - - - - Particulars of Outbreaks No. of Outbreaks Family Other Cases Notified Otherwise Ascertained Total Cases Salmonella 3 - 6 2 8 Typhimurium Clostridium Welchii 1 - - 2 2 Single Cases Cause Cases Notified Otherwise Ascertained Total Cases Salmonella Typhimurium 2 - 2 Not identified 2 - 2 Salmonella Infections not Food-borne ... NIL BACTERIOLOGICAL EXAMINATIONS (infectious Diseases) Throat/Nose Swabs: No. of Examinations Diphtheria Bacilli found NIL Haemolytic Streptococci found 36 Vincent's Angina Organisms found 3 Negative 64 Faeces: Shigella found 10 Salmonella found 13 Clostridium Welchii found 5 Negative 156 Pertussis; Positive - Negative 3 Sputum: Negative 10 300 42 HAMPSTEAD BOROUGH COUNCIL CLEANSING CENTRE Verminous conditions Scabies Cases Treatments Cases Treatments Adults 18 21 9 24 Children under 5 6 9 1 2 Children over 5 - - - - Contacts - - 1 1 L.C.C. School Children 36 36 - - London County Council (General Powers) Act. 1953 Persons cleansed at home NIL DISINFECTION AND PISINFESTATION No. of calls by borough van 4,112 No. of articles passed through steam chamber 3,393 No. of rooms disinfested after vermin 157 No. of rooms disinfected after infectious disease 188 No. of rooms cleansed after death or removal 31 Parcels of clothes for despatch abroad 132 PUBLIC MORTUARY. NEW END Bodies admitted by order of:- Coroner 181 225 Ambulance 28 Police 5 Marie Curie Hospital 9 New End Hospital 2 Causes of death Natural Causes ••• 180 Suicides:- Coal Gas Poisoning 12 Hanging 1 Drugs 6 Falls l Knife Wounds 1 Railway l 22 Accidental:- Falls 4 Road Accidents 10 14 Post Operative 3 Foetus 3 Bodies brought for accommodation 2 Post Natal 1 225 No. of post mortem examinations carried out ••• 223 43 PUBLIC HEALTH LAUNDRY 836 bags of laundry have been dealt with since the Laundry was put into operation on the 21st January, 1957 and 1,113 calls made by the van. Draw sheets 1160 Shirts 130 Sheets 1245 Vests 365 Blankets 155 Towels 66l Pillow-cases 983 Pants 118 Nightdresses & Miscellaneous 452 Pyjamas 658 Total Articles 5,927 Of the total of 41 patients who have availed themselves of the service, 4 have used the laundry since its inception (11 months), 8 for between 6 and 10 months and 16 for between 2 and 4 months. At its commencement the laundry dealt with 9 patients each week. This figure increased to 21 by the end of the year. PUBLIC HEALTH INSPECTION Inspections Houses inspected on complaint 1,631 after infectious disease 425 under Sec .9, Housing Act, 1957 10 House-to-House inspections 86 Inspections and revisits in connection with Loans under Sec.4, Housing Act, 1949 507 Special visits and re-inspections 10,086 Notices Intimation Notices served 383 Statutory Notices served 70 The Factories Acts. 1937-1948 (including Outworkers) Inspections and re-inspections 182 Pharmacy & Poisons Act. 1933. Poisons Rules. 1952 Inspections 18 44 Rag Flock, etc. Act. 1951 Inspections 3 Shops Act. 1950 (Sec. 38). Arrangements for health and comfort of shop workers Inspections 28l Drainage Works Plans and applications deposited for:- (a) Voluntary additional sanitary fittings or alterations to drainage 179 (b) Drainage and sanitary fittings required by Sanitary Notices 16 Rodent Control Premises treated for infestation by rats 263 mice 586 FACTORIES ACTS. 1937 & 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 296 73 11 – (ii) Factories not included in (i) in which Sec.7 is enforced by the local authority 276 72 21 – (iii) Other premises in which Sec. 7 is enforced by the local authority (excluding outworkers' premises) 4 – – – TOTAL:- 576 145 32 — 45 Defects Found Number of cases in which defects were found Found Remedied Referred to H.M. Inspector Want of Cleanliness (S.l) 15 15 1 Overcrowding (S.2) - - - Unreasonable temperature (S.3) 4 4 2 Inadequate ventilation (S.4) 4 4 2 Ineffective drainage of floors (s.6) 1 1 1 Sanitary conveniences (S.7) (a) Insufficient 1 - - (b) Unsuitable or defective 6 6 - (c) Not separate for sexes 1 1 - Other offences against the Act (not including offences relating to outworkers) 2 1 – TOTAL;- 34 32 6 OUTWORKERS No. of Hampstead firms making return 20 Outworkers notified by Hampstead firms 277 Outworkers resident in Hampstead 29 No. of Outworkers notified to us from other boroughs 94 No. of visits by Public Health Inspectors 13 Classes of Work No. of Outworkers Alterations to clothing ... 84 Basket making ... 5 Curtains and furniture hanging ... 1 Making of Christmas crackers ... 15 Making of artificial flowers ... 2 Carding of buttons, etc. ... 1 Making or repairing lampshades ... 8 Feather sorting ... 2 Making of toys ... 3 Repairs to furniture 0... 2 TOTAL:- 123 46 PET ANIMALS ACT. 1951 New licences issued 1 Licences discontinued 1 Licences renewed 4 Visits by Public Health Inspectors 14 PHARMACY & POISONS ACT. 1933 New licences issued 1 Licences renewed 102 Ceased to sell poisons or removed 8 No. on Register at end of year 103 Visits by Public Health Inspectors 18 LEGAL PROCEEDINGS Public Health (London) Act. 1936 London County Council (General Powers) Act. 1939 Pleasure Fair Byelaws. 1954 Date of Hearing Premises and Nature of offence Result of Proceedings 14.1.57 Frognal. Breach of L.C.C. Drainage Byelaws Fined £10 . £5 .5s .0d . costs . 5.4.57 Bolton Road. Non-compliance with nuisance notice Summons withdrawn» Work completed before hearing. 5 .4.57 & 3.5 .57 Kingsgate Road. Non-compliance with nuisance notice Order to abate nuisance within 21 days. 23.8.57 Vale of Health. Breach of Pleasure Fair Byelaws Both defendants were fined £5 and £3 .3s .0d . costs . No legal proceedings were taken in connection with food or food premises. Cautionary letters were sent in respect of various first breaches of the Food Hygiene Regulations. 47 FOOD PREMISES The total number of foodshop premises is 773. In the following table the number of inspections relates to premises, i.e. inspections have only been entered under the principal trade carried on at a shop. There are 301 shops with multiple trades and for the purposes of the Register^ shops have been entered under each type of trade carried on. No. on Register No. of Inspections Milkshops and Dairies 50 53 Ice cream premises 237 53 Butchers and Prepared Meat Premises 82 258 Fishmongers 23 77 Fried Fish Shops 6 43 Bakers Shops and Bakehouses 37 80 Restaurants and Catering Establishments 168 476 Public Houses 51 75 Delicatessen 24 151 Confectionery 113 52 Grocers and Provisions 162 269 Greengrocers 79 71 Off Licences 43 12 Chemists 28 Factory (Sauces, Salad Creams, etc.) 1 Herbalist 1 214 Coffee Stall 3 F airground 1 TOTAL:- 1,109 1,884 PREMISES REGISTERED UNDER SECTION 16. FOOD & DRUGS ACT„ 1955 Ice Cream Sausages, Cooked Meats, etc. Confectioners 62 Greengrocers 20 Grocers 6 Grocers 48 Butchers 2 Provisions 4 Tobacconists 7 Fishmongers 4 Butchers 35 Restaurants 43 Garages 1 Delicatessen 6 Dairies 21 Bakers 8 Factory 1 Stores 6 Toy Shops 1 TOTAL:- 52 Off Licences 3 Florists 1 Patisserie 1 Kiosks & Stalls Delicatessen 4 TOTAL:- 237 48 BACTERIOLOGICAL EXAMINATION OP FOOD Nature of Sample No .of Samples Satisfactory Unsatisfactory Baked Beans 4 4 - Blancmange, Jelly & Cream 1 1 - Braised Beef 1 - 1 Cheese 3 2 1 Cockles 11 9 2 Corned Beef 1 1 - Double Cream 1 - 1 Fat Bacon 1 1 - Imitation Cream 1 l - Jellied Eels 8 8 - Jelly 1 1 - Meringue Powder 1 1 - Mushrooms l l - MusseIs 1 1 - Oysters l 1 - Prawns 3 3 - Sausages 6 5 1 School Meal 1 1 - Soup Powder l 1 - Stewed Steak 1 1 - Whelks 11 9 2 TOTAL: 60 52 8 Mine SUPPLY Milk (Special Designation) Regulations Dealers (Premises in Hampstead) Supplementary (Premises outside Borough) No 0 of milk sellers 50 33 Licences issued:Pasteurised 42 29 Tuberculin Tested 35 29 Sterilised 49 32 Milk Examination Methylene Blue and Chemical Phosphatase Tests Analysis Pasteurised 8 6 T.T« Pasteurised 2 All the samples were satisfactory. Average milk fat content 3 <,76 per cent, (legal minimum 3 per cent.) 49 ADULTERATED SAMPLES Sample No. Article Offence How dealt with 53) Baked Beans Metallic contamination Stock surrendered and destroyed. 59) 60) 61) 62) 133) Cottage Cheese Should be described as Skinned Milk Cheese Letter sent to manufacturers. 156) 148 Pale Ale Contained mould Manufacturer cautioned. 173 Ice Cream Lemon Flavour Water ice flavoured with lemon ditto. 202 Pork Pie Contained mould Retailer and manufacturer cautioned. 203 Bre ad Contained mould No action owing to age of sample. 269 Chilli Sauce Contained 216 p.p.m. benzoic acid Importer warned. 319 Madeira Cake Contained charred cake dough No action. 346 Orange Squash 30% deficient in sugar Manufacturer cautioned. 421 Double Cream Cheese 40.88% fat Importer warned. 422 Triple Cream Cheese 53.76% fat ditto. 446) Buttered Rolls Contained margarine Formal sample taken. 454) 455) 456) 461) 450) Bread & Butter ditto. ditto. 460) 459 Buttered Rolls Margarine ditto. Continued. 50 ADULTERATED SAMPLES - continued. Sample No. Article Offence How dealt with 478 Curd Cake Inadequately labelled Importer warned. 479 Biscuit Cake ditto. ditto. 480 Lemon Cake ditto. ditto. 497 Gin 7% added water Licensee cautioned. Formal sample taken. The percentage of unsatisfactory samples is 5.6 per cent. This compares with 2.4 per cent, 3.57 per cent, and 3.0 per cent, for the previous 3 years. UNSOUND FOOD SURRENDERED Article Quantity Buttered Brazils ... ... 24 packets Cakes ... ... 115 dozen Cheese ... ... 33½ lbs. Coconuts ... ... 36 bags Dried Peas ... ... 14 lbs. Fish ... ... 4 stones 2 lbs., 236 tins Pish Paste ... ... 40 tins Fowls ... ... 12 Frankfurter Sausages ... ... 55 Fruit ... ... 519 tins Fruit Juices ... ... 14 bottles Fruit Malt Syrup ... ... 24 bottles Ham ... ... 70^ lbs., 29 tins Lemonade Powder ... ... 107 packets Mayonnaise ... ... 9 tubes Meat ... ... 1744 lbs 0, 157 tins Milk ... ... 75 tins Plated Meals ... ... 215 Preserves ... ... 75 tins Raspberry Powder ... ... 18 lbs., 106 packets Saithe ... ... 480 packets Spaghetti ... ... 20 lbs. Tomato Paste ... ... 18 tins Vegetables ... ... 230 tins Miscellaneous?- Beef Steak Pudding 1 tin; cereals 2 tins; cream 1 tin; Dover soles 4; Golden Dressing 5 lbs; Poussins 12; Soup 2 tins; Xmas Pudding 1. 51 HOUSING 1. Dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 2,152 2. Dwelling-houses (included in (l) above) which were inspected and recorded under the Housing Consolidated Regs . 1925-1932. (House-to-House inspection) 86 3. Dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 5 4. Dwelling-houses found not to be in all respects fit for human habitation 383 HOUSES IN CLEARANCE AREAS AND UNFIT HOUSES ET.SEWHKRF. HOUSES DEMOLISHED Clearance Areas. Housing Act. 1957 (1) Houses unfit for human habitation NIL (2) Houses included by reason of bad arrangement etc. NIL (3) Houses on land acquired under Section 43(2) NIL Not in Clearance Areas (4) As a result of formal or informal procedure under Section 17 NIL UNFIT HOUSES CLOSED (5) Under Section 17(l) 3 Persons displaced 14 Families displaced 6 (6) Under Section 17(3) NIL (7) Under Section 18 - Parts of Buildings closed: 2 Persons displaced 5 Families displaced 2 UNFIT HOUSES MADE FIT AND HOUSES IN WHICH DEFECTS WERE REMEDIED By owner By Local Authority[/### (8) After informal action by local authority 609 NIL (9) After formal notice (a) Public Health Acts 93 2 (b) Housing Act, 1957 NIL NIL (10) Under Section 24, Housing Act NIL NIL 52 UNFIT HOUSES IN TEMPORARY USE (11) Under Sections 17, 46 and 48 NIL PURCHASE OF HOUSES BY AGREEMENT (12) Houses in Clearance Areas other than those included in Confirmed Clearance Orders or Compulsory Purchase Orders, purchased NIL OVERCROWDING 1953 1954 1955 1956 1957 New cases reported 219 279 127 130 115 Number rehoused 53 37 48 43 33 Number remaining on Register 754 996 1075 1162 1244 Of the 33 overcrowded families rehoused, 25 were by Hampstead and 8 by the London County Council. CERTIFICATES OF DISREPAIR Housing Repairs & Rents Act. 1954 (January - June) Applications for certificates 5 Certificates refused NIL Certificates granted 5 Applications for revocations of certificates 29 Revocations granted 22 Revocations refused 7 Rent Act. 1957 (July - December) Applications for certificates 42 Certificates refused 1 Authority to issue certificates - (a) in respect of some but not all defects 25 (b) in respect of all defects 15 40 Undertakings given by landlords 16 Undertakings refused NIL Certificates issued 17 Applications for cancellation of certificates 7 Objections by tenants to cancellation of certificates NIL Decisions to cancel in spite of tenants objection NIL Certificates cancelled 7 53 SLUM CLEARANCE PROGRAMME 1956-1960 Sumnary of action taken Address No . of dwellings How dealt with Alexandra Mews 24 Premises improved by owner, withdrawn from prograimie. Quex Mews 5 Premises not now used for human habitations Closing Orders to be made. Colas Mews 8 Premises demolished. Elizabeth Mews 14 Six premises removed from programme, having more or less lost their identity as dwellingsc Two premises being improvedo Remainder under consideration for improvement. Steeles Mews North 7 Closing Order made on one dwellings Remainder under considerations. Cottage Mews 4 One dwelling improveds Remainder to be improved. Flask Walk 3 Compulsory Purchase Order confirmeds Site to be. developed by the Council. New End 3 Represented by L.C.C. Objection to Compulsory Purchase Order the subject of a Ministry Inquiry. Loveridge Mews 8 Under consideration for Closing and/or improvement. 54 HOUSING ACT. 1957. SECTION 9 Repair of Insanitary Houses Ten inspections were made by the Housing Inspector under this section. REHOUSING Visits and revisits in connection with the investigation of 655 rehousing applicants 1,363 No. of reports submitted to Hampstead Housing Manager 640 " " L.C.C. Estates Department 6 " " " " " L.C.C. Divisional Medical Officer 3 " " " " " Other Boroughs 6 55 THE CARE OF THE AGED Agencies concerned with the Care of the Aged Hampstead Old People's Welfare Association, Secretary - Miss o. Courtney Jones, 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. B. Gibson, 7, Harley Road, N.W.3. PRI 2950 Women's Voluntary Service, 119, Cholmley Gardens, N.W.6. HAM 9552 British Red Cross Society, 98, Avenue Road., N.W.3. HAM 7171 National Assistance Board, Old Post Office, Downshire Hill, N .W .3 . HAM 9027 Ministry of Pensions & National Insurance, 1191 Cholmley Gardens, N.W.6. HAM 9641 194 Euston Road, N.W.I. 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) 5, Princes Row, S.W.I. VIC 0162 Admitting Officer (Enquiries regarding inmates of Luxborough Lodge) 5, Princes Row, S.W.I. VIC 0162 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 .3 • HAMpstead 7171, Ext. 275. 56 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 o 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. Library» A van provided by Hampstead Old People's Welfare Association takes books fortnightly 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. Three weekly sessions in N.W.6. and one monthly. Two weekly sessions in N.W.J. The Rotary Club of Hampstead provide transport to the clinic for those who are too feeble to travel. Domiciliary Chiropodya Patients are visited and treated in their own homes one morning weekly. This service is reserved for those who are unable 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. Homes. A list of homes in the Hampstead 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 Conmittee, 296, Vauxhall Bridge Road, S.W.I. Victoria 9977. 57 Hospital Care. Applications for admission of old people to hospital should be made by the patient's doctor to Dr. Exton Smith, Whittington Hospital, Highgate Wing, Dartmouth Park Hill, N .19. ARChway 3070. In cases of difficulty further advice can be obtained from the Medical Officer of Health, 98a, Avenue Road, N.W.3. HAMpstead 7171. Ext. 275. Clubs. Darby and Joan Clubs St. Stephen's Hall, Pond Street, N.W .3 . Wednesdays 2 - 4.30 p.m. All Souls Church Hall, Loudoun Road, N.W.8. Tuesdays 2-4 p.m. St. Mary's Church Hall, Priory Road, N.W.6. Thursdays 2-4 p.m. St. James Hall, Netherwood Street, N.W.6. Wednesdays 2-4 p.m. Brondesbury Fellowship Club, 107, Kingsgate Road, N.W.6. Daily 2-5 p.m. Good Companions Club, Burgh House, New End Square, N.W.3. Mondays 5 - 8 p.m. Good Neighbours Club, 51, Belsize Square, N.W.3. Wednesdays 2.30 - 5 P.m. Burgh House Club, Burgh House, New End Square, N.W.3. Daily 2-7 p.m. Friendship Clubs Belsize Club, 22, Eton Villas, N .W .3 . Monday afternoons. The Synagogue, Dennington Park Road, N.W.6. Thursday afternoons. The Broadhurst Club, Levine House, Evenings Broadhurst Gardens, N.W.6. Monday and Wednesday. Congregational Church Hall, Lyndhurst Road, N .W .3. Thursday afternoons. 58 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.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, Wood church 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 WE IF ARE 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, Dale ham Gardens, N.W.3. SWI 3424 9, Solent 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.) 59 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 4136 For detailed information on the following subjects application should be made to the Divisional Medical Officer, 313/319, 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. 60 INDEX PAGE Aged Persons: Care of the Aged 55 Cleansing of 12,42 Laundry Service 43,55 Area of Borough 37 Area Comparability Factors 37 Atmospheric Pollution 22 Bacteriological Examinations: Food 26,48 Infectious Disease 41 Swimming Bath Water 46 Bakehouses 28 Barbers and Hairdressers 36 Bathing Centre 42,58 Baths, Old Persons 12,42,56 Births, Birth Rate 14,37 British Red Cross Society 55 Burials 13 Catering Hygiene 29 Certificates of Disrepair 52 Certificates of Suitability 28 Chemical Analysis: Food 27 Swimming Bath Water 46 Chiropody Service 56 Clean Air Act, 1956 22 Cleansing Station 12,42 Clearance Areas 51,53 Clinics 58 Closing Orders 51 Clubs, Old Persons 57 Common Lodging Houses 32 Complaints 19,43 Contamination of Food 27,49 Conveniences, Free Washing Facilities 30 Cooked Meats 26,47 Council Representatives on other Organisations 6 Darby and Joan Clubs 57 Day Nurseries 58 61 PAGE Deaths? Chief Causes 14,38 Death Rate 14,37 Infant Mortality 15,37 Maternal Mortality 37 Mortuary 42 Suicides 13 Demolition Orders 51 Dinner Clubs 56 Disinfection and Disinfestation 13,42 District Nursing Associations 59 Division 2, London County Council 58 Divisional Health Committee 6 Domestic Help Service 59 Drainage 44 Dwellings: Rate Assessments 37 Structurally separate 37 Factories Acts: Inspections 43,44 Outworkers 45 Underground Bakehouses 28 Pair, Hampstead Heath 29 Fairground Byelaws 32 Foods: Adulterated Samples 27,49 Bacteriological Examination 26,48 Bakehouses, Underground 28 Chemical Analysis 27 Cooked Meat Premises 26,47 Food Hygiene at Hampstead Heath Fair 29 Food Hygiene Regulations 28 Ice Cream 26,47 Inspections 26,47 Legal Proceedings 46 Milk 27,48 Premises 26,47 Sampling 26,49 Unsound Food 27,50 Food Poisoning 4l Foot Clinics 56 Free Washing Facilities 30 Hairdressers and Barbers 36 Hampstead Council of Social Service 55 62 PAGE Hampstead Heath Fair 29 Hampstead Old People's Housing Trust Ltd. 55 Hampstead Old People's Welfare Association 55 Heating Appliances (Fireguards) Act, 1952 32 Home Help Organiser 59 Homes, Old Persons 56 House-to-House Inspections 43 Housings Applications for Rehousing 21,54 Clearance Areas 51,53 Closing and Demolition Orders 51 Housing Act, 1949 • Section 4 30,43 ditto. Section 20 30 Housing Act, 1957• Section 9 20,43,54 Housing Repairs and Rents Act, 1954 18,52 Overcrowding 52 Rent Act, 1957 18,52 Statistics 51 Unfit Houses 51,54 Ice Cream 26,47 Improvement Grants 30 Infant Mortality 37 Infectious Diseases 8,40 Influenza 3 Inspection of the Borough 18 Intimation Notices 3,18,43 Laundry Service 43,55 Legal Proceedings 46 Loans for House Purchase 30,43 London County Council, Division 2 58 London County Council (General Powers) Act, 1953. S .43 12,42 ditto. ditto. 1955. S.27 31 Mass X-ray 11 Maternal Mortality 37 Maternity & Child Welfare Centres 58 Medical Examinations, Staff 13 Milk: Distributors 48 Premises 47 Sampling 27 Special Designations, etc. Regulations 48 Ministry of Pensions and National Insurance 55 63 PAGE Mobile Meals Service 56 Mortuary 42 National Assistance Act, 1948. Section 50 13 ditto. Section 47 36 National Assistance Board 55 Old Persons 36,55 Outworkers 45 Overcrowding 52 Pet Animals Act, 1951 46 Pharmacy and Poisons Act, 1933 43,46 Pigeons 35 Pleasure Fair Byelaws 32 Poliomyelitis 9,40 Population 14,37 Prevention of Damage by Pests Act, 1949 33.44 Public Analyst's Report 27 Public Health Committee 6 Public Health Inspectors 16,43 Public Health Laboratory 26,41 Public Health Laundry 43,55 Public Mortuary 42 Radiation Hazards 36 Rag Flock etc. Act, 1951 32,44 Rateable Value 37 Rehousing 21,54 Rent Act, 1957 18,52 Road Traffic Act, 1956. Section 42 33 Rodent Control 33,44 Sampling 26,49 Sanitary Circumstances of the Area 18,43 Scabies 12,42 School Treatment Centres 58 Sewers, Rodent Control 34 Shops Act, 1950 44 Slum Clearance 51,53 Smallpox 10 Smoke Abatement 22 Speech Therapy Centre 58 64 PAGE Staff: Inspectorial 16 Medical Examination 13 Public Health Department 7,l6 Statistics: Public Health Inspection 18,43 Statistical Summary 37 Statutory Notices 43 Stillbirths 37 Structurally Separate Dwellings 37 Suicides 13 Swimming Bath Water 46 Trainee Public Health Inspectors 16 Tuberculosis: Mass X-ray 11 Notification and Deaths 11,40 Underground Bakehouses 28 Unsound Pood 27,50 Vale of Health Smoke Control Area 24 Verminous Persons 12,42 Water Supply 32 Welfare Centres 58 Welfare Officer, L.C.C. 55 Women's Voluntary Service 55 R1/68