AC 4351 HAMP 59 Metropolitan Borough of Hampstead. Report on the Health of the Borough. 1958 R. D. DEWAR, B.Sc., M.B., CH.B., D.P.H. Medical Officer of Health. 67325 Metropolitan Borough of Hampstead. Report on the Health of the Borough. 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 Population; Births; Deaths 14, 4l-43 Infectious Disease 8-12, 44 Inspection of the Borough 16, 48-51 Atmospherio Pollution 31-40 Pood and Drugs 21, 52-55 Housing 20, 25, 56 Rodent and Pest Control 26 Mortuary 47 Statistical Summary 4l Aged and Infirm Persons 30, 58 Factory Acts, 1937 and 1948 49 L.C.C. Division 2 6l Index 63 3 Tele: HAMpstead 7171 Public Health Department, 98a, Avenue Road, Hampstead , N .W .3 . 2nd May, 1959. TO THE MAYOR, AIDERMEN AND COUNCILLORS OF THE METROPOLITAN BOROUGH OP HAMPSTEAD. Mr. Mayor, Ladies and Gentlemen, I have the honour to present my Annual Report on the health of the Borough during 1958. The health of the population remained satisfactory in spite of the poor weather which was experienced throughout the whole of the summer months. The outstanding public health measure of the year was the great national effort to immunise children against poliomyelitis and it is pleasing to record that there were only two cases of poliomyelitis in the Borough during 1958 as compared with 15 in the previous year. It is, of course, quite uncertain how much of this reduction was due to immunisation, particularly when it is remembered that six of the cases in 1957 were adults. Following the report of the Organisation and Methods Committee on the work of the Public Health Department the Council created several specialist posts for public health inspectors. One of these was the post of Food Inspector and Mr. W. F. Newport was appointed. I would like to pay a tribute to the very thorough and conscientious manner in which he has endeavoured to improve the food hygiene standards of the Borough. The report which follows sets out some information and figures concerning this aspect of the work of the Public Health Department but the figures themselves cannot adequately represent the hours of patient work spent in helping and advising those concerned with food supplies in the Borough. During recent years great advances have been made in refrigeration equipment but it must be used intelligently and not all the smaller traders are able to provide this expensive apparatus. In some cases it is necessary for traders to provide better equipment and to improve the premises but much of this is not enforceable and must be done 4 by persuasion. The trader must also be advised on the best and safest use that can be made of existing premises and equipment for it cannot be assumed that all persons concerned with food have even an elementary knowledge of the principles of bacteriology. The Food Inspector is now responsible for the sampling of food and he does in fact take the majority of food samples himselfo This has prevented undue duplication and it gives a more comprehensive check on the food sold throughout the Borough without any substantial increase in the number of samples required. As will be seen from the table given of the action taken on unsatisfactory samples, it has been felt that the main function of the Department is to help and advise and that legal proceedings should only be taken where there has been real carelessness or an intention to mislead or defraud the public. Work for old people has increased a great deal during the past year and since our Woman Public Health Inspector, Mrs. Speechley, was transferred to this work the number of cases brought to the attention of the Department has more than doubled. The Public Health Laundry has given increasing help to the bedfast and incontinent and the Old People's Workshop opened by the Hampstead Old People's Welfare Association with financial assistance from the Borough Council has provided a very welcome and worthwhile new avenue to health and happiness for some of the old people In the Borough. The main work for old people, however, still remains in ensuring the necessary provision for those who through age or infirmity are unable to provide adequately for themselves, and the Home Helps, District Nurses and Meals-onWheels have, as always, been invaluable. The problems are individual problems and require a very sympathetic and understanding approach, the more so because some of these old people could not by any stretch of Imagination be described as "dear old ladies" or "dear old gentlemen". In this connection it is heartening and encouraging in this materialistic age to see the patience, kindness and generosity which is so frequently shown by neighbours. The Report which follows summarises the other services which are provided through the Public Health Department and I think it is fair to say that it shows some progress towards a better environment and that something has been done to maintain the position that Hampstead is the best part of the County of London in which to live. 5 The administrative changes in the Department which I have indicated above, although mainly of a minor nature, involved a number of small but none the less irritating difficulties and I am much indebted to the Chief Public Health Inspector, Mr. J.F. Armstrong, for his ever ready help and advice in maintaining the smooth running of the Department. Some of the changes made in recording information which were excellent in theory were found to create serious practical difficulties and a further change was necessary during the year. This involved a great deal of extra work for the Chief Clerk, Mr. A.H. Slade, and my thanks are due to him for the very efficient manner in which he dealt with all these problems. I am also indebted to both Mr. Armstrong and Mr. Slade for a great proportion of the work in the preparation of this Report. My deputy, Dr. G.M. Frizelle, resigned at the end of the year on obtaining the post of Medical Officer of Health to the East Hertfordshire Combined District and I would like to take this opportunity of thanking him for his loyal support and assistance. I would like to thank the Members of the Council, particularly the Members of the Public Health Committee for their continued help and support and especially Councillor Miss E. Beer, the Chairman of the Public Health Committee, for her great interest and encouragement throughout the year. The other chief officers of the Council and their staffs have as always, freely given of their advice and help and for this I am very grateful. 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. Chairmans Councillor Miss E. Beer. Aldermen S .A . Boyd, M.S .,F.R.C.S. (Vice-Chairroan) Mrs. R.S.G. Carnegie. Mrs. F.E. Cayford, J.P.,L.C.C. Councillors Miss D.R. Bailey. Mrs. D.M. Dollery. O.H. Belam, M.R.C.S .,L .R.C .P., Miss M. du Mont, M.A. F.F.A.R.C.S. D.P. Ridgley. V.A. Bonafont. K. Sames, Ph.D.,F.R.I.C . R.W.M. Clouston, B.Sc.(Eng.), A .M.I .Mech.E. The Chairman, 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 D.R. Bailey, R.M. Brodtman, S.P. Pyke. 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 Associations: Aldermen Mrs. R.S.G. Carnegie, R.J. Cleaver, L.C.C.; Councillors Miss S.H. Ayliff, Mrs. J. Lowry, J. Manfield, Miss M. du Mont, M.A., D.F. Ridgley, A.E. Skinner. Hospital Management Conmittees: Archway Group? Mr. A.C. Morson, O.B.E.,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: Alderman Mrs. R.S.G. Carnegie; Councillors Miss E. Beer, O.H. Belam, M .R.C .S .,L.R.C .P .,F.F.A .R.C .S . National Society for Clean Air; Councillor Miss E. Beer. The Medical Officer of Health. 7 STAFF OF THE PUBLIC HEAUH DEPARTMENT Medical Officer of Health; R.D. Dewar, B.Sc.,M.B .,Ch.B.,D .P .H .,Barrister-at-law. Deputy Medical Officer of Health: G.M. Prizelie, T.D.,M.D.,B.Ch.,B.A .O.,D.P.H. (up to 31.12.58) 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) E. Ulrich (a)(b)(c) L.E. Trigg (a)(b) C .S .T . Dancer (a)(b) W.F. Newport (a)(b) (up to 19.4.58) D.W. Malcolm (a) R.W.M. Cook (a) G.L. Nicklin (a) C.F. Pidgeon (a) R. Clark (a) P.C.F. Griffiths (a)(b) (from 16.6.58) Student Public Health Inspectors: D.G. Ring A.M. Norton (from 1.1.58) H.A. Shitta-bey (from 1.1.58) Chief Clerk: A.H.C. Slade Clerical Staff: G.W. Bedell Miss H. Marriott Mrs. M.C. Rabin (up to 21,2.58) Mrs. G.A. Fletcher Mrs. M. Roe J .A. Gilbody (from 3.3.58) Public Analvst: 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 The number of cases of notifiable infectious diseases was 997, nearly 240 less than in the previous year. The reduction was mainly due to a smaller number of cases of measles and whooping cough. It was anticipated by some persons that the epidemic of influenza which affected Hampstead together with most of the country in the autumn of 1957 would show a recrudescence in the following spring, but happily although there were some cases of influenza they did not reach the proportions of an epidemic. In the prevention of infectious disease one of the most important weapons is the protection of persons at risk by immunisation. Immunisation by the Borough Council against diphtheria started in 1933 during which year there were 104 cases of diphtheria notified and 3 deaths. Immunisation against this disease was intensified during the war years resulting in an almost complete absence of cases since the war. In recent years the proportion of children immunised has not been completely satisfactory, probably because lack of cases has not impressed the need for this protection. The Divisional Medical Officer has informed me that during 1958 the following number of persons were immunised:- Diphtheria only Primary course 159 Reinforcing injections 83 Combined Diphtheria /Whooping Cough Primary course 479 Reinforcing injections 15 Combined Diphtheria/Whopping Cough/Tetanus Primary course 239 Reinforcing injections 49 (live births in 1957 numbered 1,492) Immunisation against poliomyelitis cotimenced in 1956. At that time supplies of vaccine were small and immunisation was restricted to children born during the years 1947 to 1954 inclusive. Since that time the categories have been extended as followss:- In July 1957 - Children born in 1955 and 1956. 9 In January. 1958 - Children born In 1943 to 1946 Inclusive. Expectant mothers. Children of six months of age or over. General practitioners and their families. London Ambulance Service personnel. In November. 1958 - Young people born in 1933 or later. Hospital staffs coming into contact with poliomyelitis patients, medical students and the families of these groups of persons. Third injections to be offered not less than seven months after the second inje ction. The Divisional Medical Officer has also kindly supplied the figures of persons immunised in 1958:- Poliomyelitis Immunisation Children 5282 Adults 489 The degree of protection given by poliomyelitis vaccination is still somewhat uncertain. That it gives some protection is beyond doubt but the near 100 per cent, protection given by diphtheria and smallpox vaccination is probably not achieved. The length of time that protection lasts is also in doubt and must remain so until sufficient time has elapsed to enable some evaluation to be made. At the time of writing this report (April, 1959) the response of the young adults to the offer of immunisation had been disappointing until the death of a well known footballer from poliomyelitis. A great deal of publicity on a national scale followed this unfortunate event and there was a great increase in the numbers of persons attending for immunisation, particularly at the open sessions arranged by the London County Council. It seems somewhat ironical that a man must die before the public will accept protection which is offered and particularly so in this case where the footballer was in fact slightly above the present age limits for immunisation. The number of persons vaccinated against smallpox was:- Smallpox - Primary Vaccination Children 945 Adults 12 10 Smallpox - Revaccinatlon Children 18 Adults l62 Diphtheria There was one case of diphtheria affecting the tonsils and larynx of a girl of 8 years who died from the infection. The child was reported to have been Immunised as a baby, although the actual record was not available, and she had received a "booster dose" in January, 1956. This is the first case of diphtheria which has occurred in Hampstead sinoe 1951 and the first death from diphtheria since 1943. Dysentery The number of cases of dysentery notified was 60, the highest figure since 1954. The majority of the cases were due to the Sonne organism, although a few were attributed to the Flexner type. Included in the tota1 there were three family outbreaks of 3, 4 and 5 persons respectively, and six cases in which two persons of the same family were affected. Although the total is high it compares favourably with an adjoining borough in which there were 112 cases within 2 weeks. Encephalitis There was one case of encephalitis following an attack of measles in a girl of 12 years. Measles Measles frequently shows a periodicity, recurring in larger numbers in alternate years and this has been very evident in Hampstead in recent years. In 1958 however, when a low number might have been expected, there were 706 cases as compered with 829 in 1957. There were no deaths from this disease. Poliomyelitis Only two cases of poliomyelitis were notified during the year. Both cases were paralytic, one in a girl of 11 months and the other in a boy of 5 years. The boy had been immunised against poliomyelitis. Fortunately, both cases were mild; the little girl has removed from the district and the boy has fully recovered. It is reasonable to suppose that had the boy not been immunised the course of the disease might have been more severe. Seventeen other cases were notified as suspected 11 poliomyelitis but the diagnosis was not confirmed. Paratyphoid Fever There was one case of paratyphoid fever which occurred in a girl of 20 who had been admitted to hospital for a throat operation. It is thought that the infection was transmitted by food which the patient herself took into the hospital, but this was not confirmed. Typhoid Fever Two cases of typhoid fever were notified. One was a man employed by a shipping company who had returned from the Far East some 12 days before, and the other was a man who had Just returned from a holiday in France and who was staying only temporarily in Hampstead. In both cases the patients had had symptoms of the disease before returning to England. Tuberculosis The number of cases of tuberculosis notified during the year was 82 pulmonary and 13 non-pulmonary, as compared with 108 and 9 the previous year. In addition, there were 3 cases of pulmonary tuberculosis and one non-pulmonary case notified after death. Although the total is less than in 1957 there has been no significant change in the number of cases notified during the past 40 years. This does not necessarily mean that the number of cases in the community is unchanged, because there have been great advances in the use of X-rays (including mass miniature radiography) and other diagnostic methods. It is probable that the actual number of cases is less but that the ascertainment of cases is more complete. One somewhat disturbing point is that in common with other areas the largest number of new notifications in males is in men over the age of 45 years. Pulmonary tuberculosis used to be considered as particularly affecting the young adult and whilst this still in large measure applies to women, the pattern in men is changing. That smoking plays a contributory part in the causation of cancer of the lung is now beyond doubt, its contribution to pulmonary tuberculosis and bronchitis, which is now becoming known as the "British disease" would bear further investigation. Deaths from tuberculosis in all forms have shown a 12 marked improvement during the same period, and this is due to the great improvements in treatment. Whilst it is still difficult to obtain a cure of the disease - and freedom from symptoms and signs for a period of five years is not necessarily the best criterion - patients either do not die from tuberculosis or only die at a much later date. Below is given a table of the notifications of and deaths from tuberculosis in Hampstead for the past 4l years. Prom 1918 to 1950 inclusive the figures are given as the yearly averages, and from 1951 to 1958 the actual figures for those years. Whilst the deaths in 1958 were higher than for the previous two years as might happen by chance with such small numbers, the trend is well marked. Year Notifications Deaths Pulmonary Non-Pulmonary Totals Pulmonary Non-Pulmonary Totals 1918-20 191 57 248 57 15 72 1921-25 98 33 131 55 11 66 1926-30 74 12 86 43 7 50 1931-35 81 18 99 38 7 45 1936-40 78 14 92 35 5 40 1941-45 103 16 119 42 6 48 1946-50 96 10 106 31 4 35 1951 99 12 111 25 4 29 1952 105 10 115 15 4 19 1953 103 6 109 11 1 12 1954 96 6 102 10 2 12 1955 84 4 88 13 2 15 1956 89 12 101 4 - 4 1957 108 9 117 4 1 5 1958 82 13 95 9 2 11 MEDICAL EXAMINATIONS Sixty examinations were undertaken during the year. Twenty-nine were in respect of new appointments to the staff; eighteen were for transfer to the permanent staff; thirteen were of persons on whom a special report was required in connection with absence through sickness. Four persons were found to be unfit to carry out their duties and were recommended to be placed on superannuation. 13 NATIONAL ASSISTANCE ACT. 1948. SECTION 50 Fourteen funerals were carried out under this Act at a total cost of £130.8s.3d. An amount of £91.5s.3d. was recovered from the estates of the deceased or from relatives. In 10 instances the full amount of the funeral expenses was recovered and in 3 cases the expenses were written off as irrecoverable. In one case which had been referred to the Treasury Solicitor, the claim for reimbursement of expenses was still outstanding at the end of the year. DISINFECTION AND DISINFESTATION Contrary to our experience in recent years, the volume of work in connection with disinfection increased during 1958. The number of rooms disinfested after vermin was 389, and the rooms disinfected after infectious disease 154:12 parcels of clothes were disinfected prior to despatch abroad; 22 filthy and verminous rooms were cleared after the death or removal of the occupant. Regular visits are paid to 2 hospitals for the disinfection of wards and laundry. Sixteen wasp nests were destroyed. PUBLIC HEALTH LAUNDRY The work of the laundry, which deals with the bedding, clothing, etc. of incontinent persons, is also carried out by the disinfecting staff. During 1958, the first complete year in which the laundry has been in operation, a total of 10.347 articles was dealt with. The number of people using the laundry service at any one time varied from 22 to 31. HOME SAFETY Section 82 of the London County Council (General Powers) Act, 1957 conferred upon Borough Councils the power to make arrangements for the dissemination of information and advice on precautions to be taken for avoiding the occurrence of accidents in the home. As one of the most vulnerable groups for accidents is the elderly, all the clubs and associations dealing with the care of the elderly were written to and the services of a lecturer offered. One club replied that they had already arranged for a lecturer from the Royal Society for the Prevention of Accidents and arrangements were made for Mr. Nicklin, Public Health Inspector to give a talk, illustrated with a film strip, to two other clubs. 14 In November the London County Council held a Home Safety Campaign and the Borough Council were asked to cooperate in giving publicity to the campaign and in displaying posters and handbills. Unguarded open fires can be a great danger and I would like to draw attention to the fact that in certain cases fireguards can be loaned free of charge to households where there are young children or elderly or handicapped persons. During their routine housing, factory and shop inspections, the public health inspectors also take special note of conditions possibly predisposing to accidents, in particular those relating to fire prevention. POPULATION As in 1957 there were more births than deaths in the Borough, the natural increase in 1958 being 419. At the same time the Registrar General's estimate of the population at 96,480 is 650 less than the estimate for the previous year indicating that some 1,070 residents have moved away from Hampstead. BIRTHS The number of births was 1,494, almost exactly the same as in the previous year. The birth rate per 1,000 of the population is 15.5. The Registrar General gives an area comparability factor which takes into account the proportion of women of child bearing age in the population as compared with the proportion throughout the country and so allows of comparison with other areas. The factor for the year is 0.75 which gives an adjusted birth rate of H.6. Of the births there were 115 males for every 100 females, an excess of males which is greater than usual, and of the total births 165 were illegitimate as compared with 140 in 1957 • DEATHS There were 1,075 deaths of Hampstead residents during the year, giving a death rate of 11.1. As the area comparability factor for deaths is l.0 the adjusted rate is the same as the crude death rate of 11.l. This is an increase over the adjusted rate of 10.7 for 1957 and is in fact the highest rate since 1953 when the adjusted rate was the same as for 1958. Deaths from certain causes or groups of causes are given below with the figures for 1957 by way of comparison. 15 1957 1958 All deaths: Males 458 486 Females 562 589 Totals- 1,020 1,075 Tuberculosis, all forms 5 11 Infectious diseases 9 6 Cancer, all forms 230 257 Heart and circulatory diseases 355 374 Diseases of respiratory system 128 119 All accidents 21 34 Suicide 23 27 The deaths from tuberculosis and other infectious diseases are so small in number that the differences between 1957 and 1958 although proportionately large do not indicate any significant trend. The number of cases of cancer of the lung dropped from 57 in 1957 to 51 in 1958, but the increase in the total number of deaths from all forms of cancer has been a tendency for some years. It is unfortunate that proposals for giving publicity about cancer have not met with a great deal of approval either from the medical profession or from other interested bodies and there is still a great deal of ignorance and of misunderstanding amongst the public. One idea which is quite incorrect is that cancer is never cured. This is probably due to the fact that whilst the human body is capable of overcoming the great majority of diseases and injuries if left alone in reasonable circumstances, the cure of cancer depends on medical treatment. Other diseases may be ignored and may cure themselves; cancer will never cure itself and if ignored will merely proceed to such a state that our present means of treatment will be ineffective„ Even with an enlightened public the position is not without difficulty because for the most part and in the early stages at least, cancer is comparatively painless and may not give rise to any symptoms that the patient can distinguish. It is unfortunate that much more publicity is not given to those cases of cancer which are cured in order to convince those persons who will only believe either that the condition has not been cured or that it never was cancer anyway. Still more important perhaps is to prevent cancer developing. Many substances which are used in industry are known to cause cancer and steps have been taken to safeguard 16 the employed persons who use them. Smoking, and cigarette smoking in particular, has been known to be a factor in the causation of cancer of the lung for some years but many people still seem to be unconvinced. The position is that a comparatively small proportion of the population will get a cancer of the lung whatever their habits are, a much larger proportion will not get cancer of the lung however intemperate their smoking habits may be, and in between these two groups there is a third group who will only get a cancer of the lung if they irritate their lungs sufficiently with tobacco smoke. The difficulty arises in that it is impossible to discover to which group any person belongs - until it is too late. It is however somewhat inconsistent that so much should be done to prevent the 500 or so deaths from poliomyelitis throughout the country, and so little done to prevent the 20,000 deaths from cancer of the respiratory tract. Suicides in Hampstead have again remained at a high level (27) the number being above that for the previous two years but less than the figure for 1955° The number of deaths from road accidents (10) was the same as for 1957 but deaths from all other accidents rose from 11 in 1957 to 24 in 1958. During 1958 there were 30 deaths of children under one year of age and of these 24 died within the first four weeks of life - the majority on the first day. The infant mortality rate of 20.1 per 1,000 live births is satisfactory although it is slightly higher than the rate for 1957. INSPECTION OF THE BOROUGH The statistical summary of the work of the Public Health Inspectors which is given towards the end of the Report is set out In somewhat greater detail than in previous reports. The methods used in the keeping of records were modified following the report of the Organisation and Methods team which Investigated the working of the Public Health Department and a punch card system was started which would enable a much more detailed analysis of the records at a later date and this was combined with improvements in the filing system which allows all the information concerning any particular property to be immediately available in a single folder. It was found, however, that the punch card system caused delays in that the card could not be completed until the 17 particular case had been fully dealt with, which in some cases where work was required, extended to several months and that the possibility of detailed analysis at a later date was only being achieved at the expense of considerable lessening of the day-to-day control of the work of the Department. The methods of recording were therefore changed somewhat during the year and now incorporate many of the advantages of the punch card system without its disadvantages. It will be seen that whilst the number of complaints fell from 1,631 in 1957 to 1550 in 1958 the number of intimation notices and statutory notices increased by 9 per cent. and 20 per cent. respectively, although it is very satisfactory to report that in the cases of complaints on housing it was necessary to resort to legal proceedings in only one case. The figures given for overcrowding have in past years tended to be unrealistic. The Department is notified of cases rehoused by the Borough Council or the London County Council from overcrowded conditions, but no information is obtained concerning those who are rehoused by other local authorities or make their own arrangements. As the majority of cases of overcrowding come to light by reason of applications for rehousing it had been felt that revisits merely for the purpose of confirming that conditions had not changed might well arouse false hopes. During 1958, however, all the persons who were on the register as living in overcrowded conditions were visited and it was possible to remove over 1000 names from the list. The figure given for 1958 of 178 is probably reasonably accurate although it will be appreciated that there are changes from day to day. Inspections for particular or special purposes are set out in some detail in the summary and call for no special comment. BARBERS AND HAIRDRESSERS Barbel's and Hairdressers premises are registered under the model Byelaws made by the Council under Section 18, London County Council (General Powers) Act, 1954. Twelve registered premises were visited and in no instance was it found necessary to serve written notice, such minor defects as were found being dealt with on the Inspector's verbal request. 18 RADIATION HAZARDS Disposal of radio-active materials The question of the protection of the individual and the public from harmful radiation and radioactive wastes is one which the Department cannot afford to neglect in this age of nuclear activity. A course on radiation hazards organised by the Services group of the Society of Medical Officers of Health was attended by the Deputy Medical Officer of Health, Dr. G.M. Frizelle. The Deputy Chief Public Health Inspector, Mr. P.V. Outlaw, also attended a course of lectures on this subject arranged by the Sir John Cass College, Aldgate. Practical assistance has been requested on three occasions in advising and disposing of radioactive wastes and treating contaminated premises of small plants engaged in luminising processes. This was done with the cooperation of the Assistant Civil Defence Officer, Mr. L.G. Stroud-osbourn, for whose assistance with the necessary monitoring aids I am indebted. SURFACE WATER DRAINAGE. PRIMROSE HILL For some considerable time, nuisances have been caused to residents and premises in St. Stephens Close and Avenue Road owing to serious flooding from surface water draining naturally from Primrose Hill Fields (Crown land) on to ground at a lower level. After protracted negotiations, we were able to arrange for the existing private drain in Radlett Place to be extended to the boundary of Primrose Hill and, although the Ministry of Works stated they did not regard themselves liable for such natural surface water, they finally agreed to carry out a drainage scheme to relieve the flooded area. The cost of the scheme will impose a considerable burden on public funds, nevertheless it is felt that the benefit derived will be commensurate therewith. The work will be conmenced during the present financial year. 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 dwellinghouses in the Borough are supplied from public water mains direct to the house. There are no wells or stand pipes used for the supply to dwellings. 19 SHOPS ACT. 1950 (Arrangements for the health and comfort of shops workers) Transfer of Powers As from 1st January, 1959 certain powers and duties of the London County Council relating to lighting, washing facilities and facilities for taking meals were transferred to the Borough Council and are now carried out by the Public Health Inspectors, who already deal with temperature, ventilation and sanitary conveniences in shops. The County Council still retain such powers and duties in respect of premises licensed for public entertainment. In this connection the following premises, for all the purposes of the Shops Act, come within the purview of the London County Council:- Essoldo Theatre, Kilburn High Road, N.W.6. Everyman Cinema Theatre, Holly Bush Vale, N.W.3. Hampstead Playhouse, 6 Pond Street, N.W.3. Kilburn Grange Cinema, Kilburn High Road, N.W.6. Odeon Theatre, FInchley Road, N.W.3. Odeon Theatre, Haverstock Hill, N.W.3. Carlton Rooms, Maida Vale, N.W.6. One hundred and sixty-one inspections were made of shop premises. All were found to comply reasonably with the provisions of the Act. HEATING APPLIANCES (FIREGUARDS) ACT. 1952 The Act prohibits the sale or letting of unguarded domestic electric fires, gas fires or oil heaters; empowers authorised officers of local authorities to inspect and list appliances kept on any premises for sale or letting and imposes penalties for contraventions. No contravention of the Act was reported. THE RAG FLOCK AND OTHER FILLING MATERIALS ACT. 1951 There Is one firm in the Borough of Hampstead whose premises are registered for the use of filling materials used in manufacturing bedding and other articles of upholstery. Four inspections have been oarried out which showed the premises to be in a satisfactory condition. 20 COMMON LODGING HOUSES There are no common lodging houses in the Borough. ROAD TRAFFIC ACT. 1956. SECTION 42 As far as could be ascertained, there is only one shop in the Borough retailing these helmets. Visits were paid and all helmets found to conform to the British Standards Specification. SLUM CIEARANCE PROGRAMME 1956-1960 Suimiary of action taken Address No. of How dealt with dwellings Alexandra Mews 24 Premises improved by owner, withdrawn from programme. Quex Mews 5 Premises not now used for human habitation. Closing Orders to be made. Colas Mews 8 Premises demolished,, Elizabeth Mews l4 Six premises removed from programme, having more or less lost their identity as dwellings. Two premises improved. Remainder under consideration for improvement. Steeles Mews North 7 Closing Order on one dwelling revoked. Premises rendered fit. Cottage Mews 4 One dwelling improved. Remainder to be improved• Flask Walk 5 Compulsory Purchase Order firmed . Site to be developed by the Council. New End 3 Represented by L.C.C. Compulsory Purchase Order confirmed. Loveridge Mews 8 Under consideration for Closing and/or improvement. 21 INSPECTION AND SUPERVISION OF FOOD Meat There are no slaughterhouses in the Borough. All the butchers shops are regularly inspected. Ice Cream Five 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 239• One application for registration of premises for the sale of ice cream was refused owing to the risk of contamination Involved by the sale of paraffin from the same premises. Twenty-one samples of ice cream were examined by the Public Analyst. The average fat content was 11.26 per cent.; the lowest fat content was 8.36 per cent. Bacteriological examination was made of 49 samples, of which 9 were unsatisfactory and appropriate action was taken. Cooked Foods Fifty-eight 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, fried fish, 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 cooperation and help. Details of the samples submitted for examination can be found in the Statistical Summary. (b) Chemical analysis. Mr. Eric Voelcker, A.R.C.S., F.R.I.C., Public Analyst to the Borough, has examined and reported upon 501 samples which can be classified under the following broad headings?- 22 Milk, cream, tinned milk 26 Butter, cheese, cooking fat 45 Ice cream, ice cream powder 22 Flavourings, sauces, pickles 58 Fruit and vegetables, tinned and dried 43 Meat products 109 Fish, tinned 28 Wines, spirits, beer 4l Beverages, non-alcoholic 25 Flour, flour products, cakes, puddings 12 Spreads, pastes 19 Jam, honey 10 Medicines 11 Sweets, confectionery 14 Jellies, blancmanges 12 Mincemeat, Xmas puddings 8 Rice products 5 Miscellaneous 13 501 All the samples of milk proved satisfactory, the average milk fat content being 3.7 per cent. The legal minimum is 3 per cent. Twenty-three samples of pork sausages were taken, the average meat content being 67.3 per cento; the lowest meat content was 65 per cent. There were 21 adulterated or unsatisfactory samples, details of which are given in the Statistical Summary. A much greater variety of foods has been analysed than in previous years and, on the suggestion of the Public Analyst, particular attention was given to imported products, a number of which have been found to have misleading descriptions but to be otherwise satisfactory, both chemically and bacteriologically. Variety is indeed the spice of life, but I must confess one somewhat boggles at the thought of consuming some of the delicacies from the East now readily available for our delectation. These include such items as fried grasshoppers, fried silkworms, roasted caterpillars, chocolate covered ants, broiled octopus on sticks and seasoned bumble-bees. They are not inexpensive and apparently the market demand is considerable. 23 These samples satisfy the requirements of the Food & Drugs Act as to genuineness but, as the Public Analyst observes "these samples were most unusual and unexpected a I have examined many queer samples over the years but never have I come across anything like them. It would be interesting to learn who eats this type of product and why and how. It may well be that now man made fibres have such a standing in the textile industry that the hard working silkworm is beginning to become redundant so far as silk is concerned, and that a new outlet for it, in the form of a 'succulent savoury' is about to be launched on to the public. I regret I could not face the prospect of putting the samples to more practical tests by eating them". Unsound Food Wherever possible, food which is unfit for human consumption, is salvaged for use either for animal feeding stuff, 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. Food Hygiene Regulations. 1955 More and more emphasis is continually being placed upon the importance of Clean Food, and during the last year attention has been focussed upon improving the conditions under which food is prepared and sold in the Borough. It is regretted that the Food Hygiene Regulations, 1955 under which most of this work falls, whilst enumerating a number of very desirable principles, have been found to be virtually unenforceable through the Courts in many respects, particularly with regard to the adequate protection of exposed cooked foods and their storage under refrigerated conditions when not for inmediate consumption. There can be little doubt that in many instances foods, such as cooked meats, are sold in unsatisfactory condition because of the large number of living bacteria which they contain although to all outward appearances they are quite satisfactory. Recent samples have been found on bacteriological examination to give plate counts of several millions and if the organisms had been of the kind causing food poisoning Instead of comparatively harmless ones the consequences could have been serious. Generally speaking, little, if any, difficulty has been experienced in persuading the larger food traders to provide proper protection and storage of exposed foods. In 24 the smaller shops the problem Is more difficult, both as regards finance and space. Pood traders in all branches of the trade are becoming increasingly aware of their responsibilities under the Food Hygiene Regulations. This view is being fostered by frequent sampling of food products, particularly exposed cooked foods. The advice of the Pood Inspector is always readily available on any aspect of this important subject. Underground Bakehouses The one underground bakehouse now remaining In the Borough continues to function and is regularly visited by the Public Health Inspector. The Certificate of Suitability expires on 31st March, 1959 and every effort will be made to bring the premises to a more reasonable, modern standard before the issue of the next quinquennial certificate . Hampstead Heath Fairs. Catering Hygiene The Pood Inspector and other members of the staff were on duty before and during the whole of the Bank Holiday Fairs. The continued pressure which is being applied to ensure that food purchased on the Heath at Fair times Is safe to eat is having a very good effect on the vendors. To quote a recent press article on the subject, one trader is reported to have said "we know that when we come to Hampstead Heath we have to be careful. The sampling of foods at the Fairs is becoming increasingly restricted so far as variety is concerned. All the "hot dog" stalls retail tinned hamburgers; ice cream is mainly wrapped and the product of one or other of the big manufacturers, and the shell fish is usually obtained from Billingsgate fresh from the market on the day of the Pair. It is encouraging to note that although conditions at the Pairs present considerable difficulties in maintaining good standards in food hygiene, the samples of food which have been taken have provided mainly good bacteriological reports, indicating that the continued supervision and advice of the Inspectors is achieving positive results. 25 The usual cooperation continues with the licensing authority, the London County Council, who require a certificate from the Medical Officer of Health of the area where the food is prepared or stored, before issuing a trading licence. Likewise the County Medical Officer of Health is informed of any shortcomings of stallholders so far as the Food Hygiene Regulations are conce med. HOUSING (FINANCIAL PROVISIONS) ACT. 1958. Sections 30 & 43 Powers of local authorities (a) to make Improvement Grants on properties and (b) to make advances for house purchase Although the high interest rates which operated for some time did not encourage work under these Sections, there has been an increase as can be seen from the tables below. Every application for a loan for the purchase of a house or for an improvement grant is dealt with by the Housing Inspector, Mr. L.E Trigg. In each instance the house is thoroughly surveyed, in the case of improvement grants with the Council's Architect, and in the case of mortgages, in conjunction with the Council's Valuer. It is a condition of the loan or the grant that the house to be acquired or improved be made in all respects fit for human habitation, and much valuable work has been done by way of repair and improvement. Applications for Improvement Grants 1954-58 Applications Received Granted Refused Withdrawn 1954 January-June July-December 2 2 - - 6 3 3 - 1955 January-June July -December 14 6 3 5 7 4 2 1 1956 January-June July-December 9 4 5 - 4 3 1 - 1957 January-June July-December 19 17 1 1 5 5 - - 1958 January-June July-December 3 3 - - 9 6 2 1 TOTAL: - 78 53 17 8 26 Applications received for Mortgages Applications Received Granted Refused Withdrawn 1951 January-June July-December 1 1 - - 9 2 2 5 1952 January-June July-December 7 5 2 - 6 2 2 2 1955 January-June July-December 13 6 1 6 14 10 1 3 195^ January-June 16 14 2 - July-December 36 25 8 3 1955 January-June July-December 32 22 9 1 51 46 4 1 1956 January-June July-December 42 24 14 4 38 15 16 7 1957 January-June July-December 34 22 9 3 34 20 8 6 1958 January-June July-December 40 30 5 5 63 39 19 5 TOTAL :- 436 283 102 51 PREVENTION OF DAMAGE BY PESTS ACT. 1949 This aspect of public health work has continued with little change, nevertheless valuable work has been done. It is noteworthy that there has been a very low incidence of rats or mice within food premises, or, in fact, any business premises, and there is no doubt that this desirable state of affairs has been considerably helped by the advent of the Pood Hygiene Regulations® Immediate reporting of any infestation or suspected infestation has materially assisted the prevention of any spread. In all such cases reported, the full and willing cooperation of owners and occupiers alike has been readily forthcoming. In no instance has legal proceedings been necessary. The rodent staff have continued to operate the methods 27 of control advocated by the Infestation Control Division of the Ministry of Agriculture, Fisheries and Food. The main poisons used have been Warfarin and zinc phosphide and to a lesser degree arsenious oxide. The vast majority of cases have been cleared by one routine treatment and only a few instances of reinfestation have been experienced. Mice continue to be more numerous than rats and more difficult to eradicate. Contributory factors in these difficulties are the fears of occupiers that their children and/or their domestic pets may pick up the poison baits, and also the absence of occupiers at work or for some other reason. This is particularly difficult when a house is in multiple occupation and to be really effective it is necessary to treat all the lettings within the house at the same time. In numerous cases, the operators have arranged visits in the early morning or after normal office hours to facilitate treatment. In one case a valuable cat died at the same time that treatment with poisonous baits was being carried out. Unfortunately on the previous occasion some years ago, when rat treatment was being carried out at this house the cat which the owner then had died from oauses which were clearly not connected with the rat poisoning. It appeared to the owner that it was stretching coincidence too far for this to happen again and he was convinced that the death of the cat was due to the poisons being used, A post-mortem examination showed that the animal died from natural causes. Unlike the experience of many Metropolitan authorities, very few rat infestations have been found to be due to defective drainage. In 17 instances only has this been proved to be the cause of infestations; exactly the same number as in 1957• By virtue of the provisions of Section 11 of the Prevention of Darrage by Pests Act, 1949. the Ministry have made a 50 per cent, contribution towards expenditure incurred in the eradication of rodents, but by the authority of Section 4, Local Government Act, 1958, such grants will cease after 3lst March, 1959. The following table indicates the number of premises surveyed and/or treated during the years- Business Premises Dwellings Rats 12 495 Mice 18 745 28 Maintenance Treatment for Rats in Sewers I am indebted to the Borough Engineer & Surveyor for details of the treatment of sewer infestations which are dealt with by his staff. These treatments are normally carried out at six-monthly intervals during April and October, During 1958 it was not possible to commence operations until late May and early June. The second treatment due November/December, was for reasons of staff shortage and pressure of other work, impracticable and consequently postponed until early 1959. For the treatment carried out the poison medium was arsenious oxide 10 per cent, in sausage rusk with the addition of 0,25 per cent. paranitrophenol as a preservative. Details of this operation are as follows;- Manholes baited 746 Manholes showing prebait take 296 Manholes showing complete prebait take 56 Prebait take was in the region of 40 per cent., a slight increase over 1957. Complete takes were also increased, a factor most likely due to the better keeping quality of the bait induced by the addition of the preservative, YALE OF HEAUH PRIVATE FAIRGROUND Sanitary Conveniences It is pleasing to record that, at long last, the "Clochemerle" episode at the Vale of Health fairground is now closed, I am not sure whether the sanitary structure evolved is really worthy of the efforts made by the Department over a period of nearly ten years, but it appears to be all the owners are prepared to provide, The history of this case makes almost fantastic reading. In the summer of 1949 it was reported to the Public Health Comnittee that the toilets at the fairground were in a "blitzed" and derelict condition and we were instructed to press for their reinstatement. Prolonged negotiation ensued and finally plans of new conveniences were deposited and approved. So far, so good. The owners then apparently came to grief with their war damage claim and found themselves unable to proceed with the project. 29 Appeals and pressure being of no avail and in view of the lack of legal control over the persistent public health nuisances caused at the Yale of Health Amusement Park, the Council took the only course available to them, viz:- to make Byelaws in pursuance of the powers relating to fairgrounds contained in the London County Council (General Powers) Act, 1959• These Byelaws were confirmed by the Home Office and came into operation on 1st October, 1954. They provide (inter alia) that:- "The Manager of a pleasure fair not being a pleasure fair the whole of which is comprised within a building or buildings, shall where adequate public sanitary accommodation is not already available within reasonable distance of all parts of such pleasure fair, take any necessary steps:- (a) to provide in suitable situations 'sufficient and suitable sanitary conveniences for persons employed in or about the pleasure fair and for the public attending the pleasure fair'; (b) to label separate conveniences for men and for women respectively in such proportions as may be appropriate; and (c) to maintain the conveniences in good.repair and in a reasonably clean and wholesome condition." The penalty for an offence against the Byelaw is a maximum fine not exceeding £5. Copies of the Byelaws were sent immediately to the proprietors at the fairground• Further negotiation took place; fresh plans were deposited, a builder instructed and again, owing to disagreement between the respective owners, nothing came to fruition. Repeated summonses were then issued in respect of failure to provide adequate sanitary accommodation and these resulted in penalties and costs amounting to some £60 being imposed by the Court. On the last occasion, both Defendants were not only fined but were bound over in the sum of £20 to be of good 30 behaviour for twelve months. The effect of this was that, if during the ensuing twelve months either defendant was again convicted of the same offence the sum of £20 would be levied by way of additional penalty. Both Defendants appealed to the London Quarter Session against the last conviction and the added imposition. This Appeal was dismissed but the binding over was struck out, as the Recorder considered it inappropriate in a case of this nature. It was only after the Council had decided to take proceedings in the High Court through the Attorney-General by way of Relator action to obtain a mandatory injunction, that the Defendants finally succumbed. Apart from the above-mentioned fines and costs, their own legal costs must have been very considerable - probably more than the cost of the convenience NATIONAL ASSISTANCE ACT. 1948. SECTICN 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 in the past twelve months the new cases investigated rose from 62 to 163. This increase may be, in part, due to the fact that it has become generally known that the Council has appointed a specialist inspector to deal with the welfare of the aged, and in part to the provision of a laundry service for incontinent persons, most of whom, of course, are also aged. The laundry service has proved of immense help and is greatly appreciated by the District Nursing Associations and the relatives of the patients. The demand has necessarily increased also for home helps and mealson-wheels, but in spite of all these facilities admission to a home or hospital has had to be sought in a large number of cases0 Idaison with the London County Council Welfare Department, the Old People's Welfare Association, Hospital Almoners, General Practitioners and other interested bodies is very good, but the fact still remains that there is not yet a sufficient number of hospital beds for chronic sick persons nor sufficient vacancies in homes for the aged, and it is not always possible to arrange Just the type of service required at the time it is required most. It was necessary to consider making application to the Magistrates for an order to enforce the removal of two patients. 31 One case was of a woman aged between 70 and 80 who was infirm and unable to keep herself and her home clean. She had been receiving help from voluntary sources, including meals-on-wheels, and also from other occupiers in the house, but eventually even this help was not sufficient. Her only relative was an aged brother who was an inmate of a mental hospital. Application was made to the Magistrate's Court but at the last moment the patient agreed to be admitted to hospital. The second case was of a woman aged 85 years, who lived alone and refused all offers of help. She was also living in insanitary circumstances and was unable to look after herself properly# This lady was very forgetful, argumentative and wandered about the house and streets after dark. She was visited by an officer of the London County Council and a psychiatrist but was found not to be certifiable. Arrangements were made for a hospital bed and an ambulance was sent on two occasions but the patient refused to enter hospital. The only relative was a step-brother who was himself a semi-invalid and lived some distance away. Application was made to the Magistrates who made an order providing for the detention of the patient in the Geriatric Unit of a hospital for a period of three months. The patient was subsequently transferred to a mental hospital where she remained as a voluntary patient until her death early in 1959 • ATMOSPHERIC POLLUTION The ultimate aim of the Council is to make the whole of the Borough a smoke control area. This will take some years and will depend somewhat on the rate of progress made with the electrification and conversion to diesel engines of the railways. As is well known, there are a large number of ventilating shafts to the tunnels with which Hampstead is honeycombed and it is virtually impossible to prevent nuisances from smoke and fumes from locomotives passing through the tunnels. During the year under review the Department's work in connection with air pollution fell under four main headings:- 1. Securing of Smoke Control Areas. 2. Abatement of nuisances. Measurement of air pollution. Supervision of newly installed appliances. 32 These headings represent in descending order the actual time spent on each aspect by the Public Health Inspector mainlyresponsible for smoke control, Mr,, E. Ulrich. 1. Smoke Control Areas At the end of 1958 three smoke control areas had been or were being considered by the Council. Area 1. Vale of Health. A "pilot" scheme involving 5½ acres and 70 premises in a self-contained village. Area 2. St. John's Wooda 110 acres of good class residential property including some 750 premises in the southern part of the Borough and extending the smoke control area in the adjoining Borough of St. Maiylebone. Area 3. An extension northwards from Area 2 towards the centre of the Borough covering 350 acres and comprising an estimated 3.500 mixed residential and business premises. Following objections by the residents in the Yale of Health, the Order for Area 1, which comes into force on 1st September, 1959. was only confirmed by the Minister after a Local Inquiry. This Inquiry was only the second to be held in the London area, the first being at Wandsworth. The Yale is a completely self-contained small village set in the midst of Hampstead Heath. It is beset with adaptation problems and, as such, was treated as a pilot scheme designed to afford valuable data which would materially help in dealing with larger areas. The main objection to the confirmation of the Order was that sufficient supplies of approved smokeless fuels would not be available. This objection could not be sustained but at the Inquiry other matters were raised by the objectors including the toxicity of coke fumes, difficulties envisaged in connection with the caravans and diesel engines at the permanent fairground in the Vale, the cost of adapting "period" fireplaces, the additional cost and difficulties of storage of approved fuels and perhaps the most valid of all the objections, why should the Vale of Health, being surrounded by the smokeless area of Hampstead Heath and producing comparatively little smoke in any case, be chosen as the first smoke control area in the Borough? It is only fair to record that in spite of the very 33 genuine objections (even though the objections may not have been well founded) and the feeling that they were being used as "guinea-pigs" the residents in the Vale of Health have been most helpful and cooperatives. No objections were made to the Order in respect of Area No.2 (St. John's Wood) and this was confirmed without a Local Inquiry by the Minister in April, 1959. The third area is a more ambitious project and at the time of writing this report the preliminary survey was in progress. There can be no doubt that the reduction of atmospheric pollution through Smoke Control Areas is sound and that in the promotion of health, clean air is as important as other forms of cleanliness, although it must be remembered that Smoke Control Areas do little, if anything, to reduce the invisible pollution caused by the oxides of sulphur. The present procedure for making Smoke Control Orders is, however, cumbersome and, it is suggested, wasteful. It is obviously necessary that there should be a reasonable estimate of the cost, particularly the cost to the local authority and to the Treasury® The cost to the individual householder is also important but perhaps not to the same extent, because he has a more immediate and direct control of the expenditure. There must also be an estimate of the amount of smokeless fuel to be used. Practice has shown that in spite of the tremendous amount of time required to effect the detailed survey - and this at a period when trained staff are at a premium, the final estimates, both of cost and fuel requirements are, to say the least, empirical. Pinal figures are made up from very many individual estimates so that a small degree of error or latitude in each estimate is magnified in the total. Most householders have a very inexact idea of the total amount of fuel used and here again the final total is the sum of a large number of guesses. In addition, as soon as residents become aware that a particular area is being considered for the purpose of a Smoke Control Order and are informed of new appliances and their efficiency, a surprisingly large number make the necessary alterations without waiting for the Order to be confirmed. It would seem that a flat rate for the cost of conversion, based on the experience of local authorities and on the information which the Ministry already has, would give estimates which would be comparable with those obtained from detailed surveys and indeed that the estimates of fuel requirements might be more 34 accurate a In this way, a general survey could well replace the detailed survey which is now required and work of making the whole Borough a Smoke Control Area could be speeded up without the employment of the additional staff which will be necessary under the present procedure. It is appreciated that detailed examination is necessary in some cases; usually indicated by the exterior appearance of the house. In Hampstead, for instance, there is an unusually high proportion of non-standard coal and even wood burning appliances which are still in regular use; some of these firegrates are of great aesthetic and probably pecuniary value. They defy any standard form of conversion and their owners are usually loth to part with, or even to alter, them. The fact is that these installations are part of the character of the houses in which they are found and although in most cases replacement by a free-standing convector is practicable, it is usually not acceptable to the owner or occupiere Here again, pricing for conversions is often more hopeful than accurate. Some examples of firegrates found recently on survey are shown, captioned by what might be considered apposite extracts from the Ministry's Memorandum on Smoke Control Areas. 2. Abatement of Smoke Nuisances Three main nuisances arose from smoke emissions or continued through the year,, Vent shafts from railway tunnels remain a persistent cause of trouble and, in spite of assurances from the railway authorities that all reasonable care is taken to minimise locomotive firing while in these tunnels, it is certain that no real improvement will be effected until diesel or electric locomotives come into more general use. The worst single source of trouble in the Borough has been a hospital chimney which frequently emits black or near black smoke in quite short bursts. Negotiations with the hospital governors and their staff have resulted in experiments in firing techniques and changes in fuel. No great improvement has resulted but more basic alterations are planned for Spring 1959 when the plant can be relieved of full load. Occasional nuisance has arisen from a large (some 350 flats) block of privately owned property heated by oil-fired boilers. The nuisance takes the form of an occasional shower of fluffy soot, in particles up to ½ inch in size, which descends on to adjoining streets and pavements, houses and carso The result in spoliation of property and the fouling of paintwork, curtains and on occasions lines of clean washing, is felt to be a serious matter. 35 simple open fire may in total be more expensive than the installation of a free standing eonvector fire which can be fitted without removing the existing fire back. (7) The cost of new appliances may in most cases be judged reasonable if it corresponds broadly with the cost of appliances installed in houses provided by local authorities. But the installation of appliances with elaborate extra fittings or of superior finish is not necessary nor is the use of inherently expensive systems of space heatina and water heating even 36 authority dwellings. Example: Central heating, multi-point gas and electric water heaters. (8) Portable gas. electric and oil tires cannot rank for grant since no works of adaptation are required. Where necessary, however, gas or electric points may be installed to serve instead of existing fireplaces. (9)The alteration of fire backs. flues, hearths, etc.. may be a necessary accompaniment 10 the adaptation of an existing grate or its replacement. The provision of new fireplace surrounds should be accepted for grant 37 (6) In judging the costs of alternative works of adaptation the cost of the appliance, the cost of installation and the cost of incidental works should be viewed as a whole. Example: The replacement of a grate with cast iron fire back by a simple open fire may in total be more expensive than the installation of a free standing convector fire which can be fitted without removing the existing fire back. (7) The cost of new appliances may in most cases bo judged reasonable if 38 Example: If a dwelling has a range cooker (with boiler) and also a gas or electric cooker, it is not necessary to replace the range cooker. It may, however, be necessary to provide water and or space heating. (4) Where it is reasonably practicable and cheaper, the adaptation rather than the replacement of an existing appliance is all that is necessary. Example: Altering the spacing of fire bars in a grate or providing gas ignition for an open fire otherwise capable of burning smokeless fuel. (5) Where replacement of an appliance is necessary, reasonable freedom of choice should be aiven to the owner or occupier as between solid fuel. 39 It is possible that legal proceedings will arise from this nuisance but inasmuch as "smoke includes soot (etc.) emitted in smoke" (definition in Clean Air Act) and this nuisance arises at times when offending chimneys are completely free of visible smoke, there is some doubt in the matter. Positive steps which have been taken include new injector pumps, a complete change of fuel oil (from 200 sec to 35 sec) and increase of permanent air irSets to the boiler rooms. By the end of 1958 the plant was running free of nuisance but I cannot report that I am fully satisfied no further trouble will arise. The Public Health Inspectors have dealt with complaints due to inconsiderate use of bonfires and incinerators and have advised on the lighting of domestic boilers, etc. where annoyance was being caused to some neighbour. Pour cases of nuisance from carbon smuts from newly installed oil-fired plants, have been dealt with but in truth have really cured themselves as the plant "settled in" and received routine adjustments. Measurements of Air Pollution Cooperation with the Fuel Research Station in the operation of measuring instruments has continued through 1958. At the Public Health Department a continuous filter which indicates sulphur dioxide and general smoke concentrations has been operated daily, At another point in the Borough static instruments which also provide information on general air pollution and sulphur activity have been recorded monthlyo The results for these instruments have been supplemented by an experiment in which three schools were provided with continuous filters. The purpose In this was a dual one, in that it was felt that operation of the apparatus would provide a useful practical exercise for the students, while the results would provide some indication of variations in air pollution levels at different points in the Borough. Because of the weekly school break from Friday to Monday and, of course, the long school holidays, the results obtained from these Instruments are not acceptable for inclusion in the published statistics. The Idea has much merit and the results so obtained are most interesting. Unfortunately, at one school repeated breakages of the expensive equipment have been suffered and also there has been a marked inconsistenoy in the results recorded. I would like to thank the Headmasters, members of the teaching staffs and the pupils for their assistance with this experiment. This work on the measurement of air pollution has now continued for some six years,, The most recent information showed that over 300 bodies were cooperating in this work and between them 40 operated over 2,000 measuring instruments. It is clear that the weight of statistics produced, and still being produced, is of some magnitude. Dr Lessing, some time President of the National Society for Clean Air, has been known to use the expression "statistical indigestion" when acknowledging the tremendous amount of effort which has gone into this work. It is certain that very few people can hope to remain on terms with more than a fraction of the collated results which emerge monthly and annually and it is to be hoped that the more positive work on Smoke Control Areas and smoke abatement generally will allow for reductions not only in the figures recorded by these instruments, but also in their numbers. 4. Supervision of New Appliances Section 3 of the Clean Air Act, 1956, is a general requirement that new furnaces shall be as far as practicable smokeless# It also requires that the installation of all'new nondomestic, and all domestic furnaces above a certain heat rating, shall be notified to the local authority. The section also provides for prior approval of such installations in accordance with plans and specifications if this is requested. There is little doubt that this requirement of prior notification is not yet fully appreciated by the trades concerned and it is probable that some installations have been effected without the necessary formality. However, the Council's Engineer and Surveyor has cooperated most fully in this respect and has sent to my Department notifications of all proposed new building, alterations and conversions in the Borough. In every case the person responsible for the proposed new work, usually an architect or builder, has been informed of the requirement that the Council must be notified of any new boilers or other such equipment and provided with a return slip which is, on completion, accepted as a notification. This system has worked well and during the year some 40 notifications have been received» In each case inspections have been made of the new installation and in only one instance has it been necessary to advise some modification of the scheme proposed. As yet, the London Boroughs have no byelaw with which to control the arrangements for heating or cooking in new private property. However, the same information relating to new building has proved of value in this respect. In several instances the Smoke Inspector has been able, by persuasion, to effect the fitting of non-smoke producing appliances in cases where this was not originally intended. 41 STATISTICAL SUMMARY Area of Borough 2,265 acres Registrar General's estimate of Population mid 1958 96,480 Rateable Value March, 1958 £2,129,838 Sum produced by Id. rate £8,620 No. of separate rating assessments of dwelling houses, flats and other residences 23,028 No. of structurally separate dwellings, Census 1951 23,010 No. of private households, Census 1951 35,970 Total Legitimate Illegitimate Live Birthss Males 799 706 93 Females 695 623 72, TOTAL 1,494 1,329 165 Live birth rate per 1,000 population 15.5 Area Comparability Factor 0.75 Adjusted birth rate 11.6 Still-births (Males 17; Females 9) 26 Still-births rate per 1,000 live and still-births 17.1 Total live and still-births 1,520 Infant Deaths (Males 20; Females 10) 30 Neo natal deaths (first four weeks of life)(M.l6; F.8) 24 Infant Mortality Rates: All infants per 1,000 live births 20.1 Legitimate infants per 1,000 legitimate live births 20 .3 Illegitimate " " " illegitimate live births 18.2 Neo Natal per 1,000 live births 16.1 Illegitimate live births per cent, of total live births 11 Maternal deaths (including abortion) NIL Maternal mortality rate per 1,000 live and still-births NIL Deaths: Males 486 Females 589 TOTALs 1,075 Death rate per 1,000 population 11.1 Area Comparability Factor 1.0 Adjusted death rate 11.1 42 CAUSES OF DEATH 1958 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 5 — — 1 — 1 2 1 — 4 — — — — 1 1 1 1 9 Tuberculosis other 2 — — — — 1 — 1 — — — — — — — — — — 2 Syphilitic disease 1 — — — — — — — 1 2 — — — — — — — 2 3 Diphtheria — — — — — — — — — 1 — — 1 — — — — — 1 Whooping Cough — — — — — — — — — — — — — — — — — — — Meningococcal infections — — — — — — — — — — — — — — — — — — — Acute polionyelitis — — — — — — — — — — — — — — — — — — — Measles — — — — — — — — — — — — — — — — — — — Other infective and parasitic diseases — — — — — — — — — 2 — — — — — 1 — 1 2 Malignant neoplasm, stomach 7 — — — — — 2 3 2 14 — — — — — 7 3 4 21 Malignant neoplasm, lung, bronchus 37 — — — — 1 17 16 3 14 — — — — 2 7 3 2 51 Malignant neoplasm, breast — — — — — — — — — 18 — — — — — 9 1 8 18 Malignant neoplasm, uterus — — — — — — — — — 14 — — — — 2 6 2 4 14 Other maligiant and lymphatic neoplasm 68 — — — — 4 20 27 17 79 — — — — 4 27 24 23 147 Leukaemia,aleukaemia Diabetes 3 — 1 1 1 3 — — — — 1 2 — — 6 2 — — — — — 1 1 — 5 — — — — — 1 1 3 7 Vascular lesions of nervous system Coronary disease 53 — — — 1 1 11 16 24 66 — — — — — 7 15 44 119 52 211 angina 101 — — — — 4 42 34 21 110 — — — — — 25 33 Hypertension with heart disease 9 — — — — — 1 2 6 18 — — — — — 1 3 14 27 Other heart disease 32 — — — — 1 7 7 17 51 — — — — 1 8 7 35 83 Other circulatory disease 19 — — — — — 5 6 8 34 — — — — — 2 3 29 53 Influenza — — — — — — — — — 1 — — — — — — — 1 1 Pneumonia 21 2 — — — — 4 8 7 32 — 1 — — 1 5 5 20 53 Bronchitis 30 1 — — — — 6 12 11 23 — — — — — 2 3 18 53 Other diseases of respiratory system 8 — — — — — 3 1 4 4 — — — — — 2 2 — 12 Ulcer of stomach and duodenum 9 — — — — — 3 3 3 10 — — — — — — 3 7 19 Gastritis ,enteriti s and diarrhoea 1 — — — — 1 — — — 3 — — — — — 1 1 1 4 Nephritis and nephrosis 5 — — — — — 2 2 1 4 — — — — — — — 4 9 Hyperplasia of prostate 5 — — — — — 1 2 2 — — — — — — — — — 5 Pregnancy, child birtlw abortion — — — — — — — — — — — — — — — — — — Congenital malformations 7 4 1 — 1 — 1 — — 7 4 1 1 — 1 — — — 14 Other defined and illdefined diseases 32 12 — — — 3 3 4 10 37 6 — 1 — 3 7 6 14 69 Motor vehicle accidents 5 — — — 1 — — 1 3 5 — — — 1 — — 1 3 10 All other accidents 9 — — 1 — 4 1 1 2 15 — — — — 2 — 4 9 24 Suicide 14 — — — 2 2 6 3 1 13 — — — 6 5 2 — 27 Hani aide and ope rations of war 1 1 — — — — — — — — — — — — — — — — 1 TOTAL: - 486 20 1 2 5 23 139 152 144 589 10 2 4 1 24 126 123 299 1075 43 44 INFECTIOUS DISEASE DISEASE Notifications Removed to Hosp. 1958 Deaths 1958 1954 1955 1956 1957 1958 Diphtheria - - - - 1 1 1 Dysentery 73 32 35 26 60 10 - Encepba litiss Acute Infective - 1 2 1 - - - Post Infectious 1 3 2 - 1 1 - Eiysipelas 13 7 7 13 5 2 - Food Poisoning 19 56 15 10 15 6 - Malaria 2 - - 1 - - - Measles 36 1028 245 829 706 29 - Meningococcal Infection 2 2 2 - 1 1 - Ophthalmia Neonatorum! Hampstead residents 1 1 4 8 6 6 Non-residents - - 3 19 3 3 - Paratyphoid Fever - - - - 1 1 - Pneumonia 47 53 54 48 40 12 1 PoliomyelitisjNon-Paralytic - 28 - 4 - - - Paralytic 2 9 2 11 2 - - Puerperal Pyrexia: Hampstead residents 41 22 14 26 30 28 - Non-residents - - 31 59 39 39 - Scabies 23 26 25 13 33 - - Scarlet Fever 50 23 32 55 51 8 Typhoid Fever - 4 1 3 2 1 - WhooDine Couch 169 114 94 109 21 4 - TOTAL; 479 1409 566 1235 997 152 2 TUBERCULOSIS Age Periods Respiratory N on-Respiratory New Cases Deaths New Cases Deaths M F M F M F M F 0 - - - 1 - - - 1 - 2 - - - - - - 5 2 1 1 - 1 - - - 15 5 7 - - - 1 - - 25 19 16 1 1 2 2 1 - 45 21 5 2 1 3 2 - - 65 1 1 1 1 - 1 1 - 75 2 - - 1 - - - - TOTAL j 50 32 5 4 7 6 2 - 45 FOOD POISONING Gases Notified Otherwise Ascertained Total Cases Deaths 1st Quarter 1 - 1 - 2nd Quarter - 3 3 - 3rd Quarter 3 2 5 - 4th Quarter 11 9 20 - Particulars of Outbreaks No. of Outbreaks Cases Notified Otherwise Ascertained Total Cases Family Other Agent identified - - - - - Agent not identified 1 - 3 - 3 Sinele Cases Cause Cases Notified Otherwise Ascertained Total Cases Salmonella Bredeney and Melingrides 1 - 1 Salmonella Typhimurium 6 - 6 Salmonella Newport 1 5 6 CI. Welchii 1 - l Not identified 3 9 12 Salmonella Infections not Food-borne Nil BACTERIOLOGICAL EXAMINATION (infectious Diseases) Throat/Nose Swabs: No. of Examinations Diphtheria Bacilli found Nil Haemolytic Streptococci found 15 Vincent's Angina Organisms found 1 Negative 62 Faeces: Shigella found 51 Salmonella found 26 Clostridium Welchii found 1 Negative 247 403 46 HAMPSTEAD BOROUGH COUNCIL CLEANSING CENTRE Verminous conditions Scabies Cases Treatments Cases Treatments Adults 11 12 7 18 Children under 5 1 1 5 17 Children over 5 - - 1 3 Contacts 2 2 - - L.C.C. School Children 87 87 - - London Countv Council (General Powers) Act. 1953 Persons cleansed at home Nil DISINFECTION AND DISINFESTATION No. of calls by borough van 6,574 No. of articles passed through steam chamber 5,916 No. of rooms disinfested after vermin 389 No. of rooms disinfected after infectious disease 154 No» of rooms cleansed after death or removal 22 Parcels of clothes for despatch abroad 112 PUBLIC HEALTH IAUNDHY A twice weekly service is in operation and 1,611 bags of laundry have been dealt with during the year. The number of calls made by the van was 2,405. Articles laundered* Draw Sheets 2,162 Shirts 286 Sheets 2,032 Vests 349 Blankets 320 Towels 1,159 Pillow-cases 1,676 Pants 492 Nightdresses and Pyjamas 1,481 Miscellaneous 390 Total Articles 10,347 The number of people using the laundry service has varied from 22 to 31 per month. 47 PUBLIC MORTUARY. NEW END Bodies admitted by order of:- Coroner 208 Ambulance 29 Police 8 Marie Curie Hospital 11 Public Health Department 1 257 Causes of deathi- Natural Causes 198 Suicides;- Coal Gas Poisoning 14 Hanging 2 Drugs 12 Falls 1 Drowning 1 50 Accidental!- 257 Coal Gas Poisoning 3 Drugs 1 Burns 1 Lift 1 Fa11s 2 Road Accidents 7 15 Post Operative 5 Foetus 6 Bodies brought for accommodation 1 Post Natal 1 Strangulation 1 No. of post mortem examinations carried out 256 48 PUBLIC HEALTH INSPECTION Inspections: Housing defects 1,016 Housing (Financial Provisions) Act, 1958 Loans for house purchase 139 Improvement grants 12 Housing Act, 1957 Repair of unfit houses 30 Demolition and closing orders 13 Overcrowding 24 Rent Act, 1957 Certificates of Disrepair, etc. 87 House-to-House 53 Underground rooms (other than closing orders) l4i Accumulations of refuse 33 Dustbins 21 Nuisance from trees 2 " " bonfires 8 Improper keeping of animals 1 Noise 11 Smoke (Timed observations) 106 Other nuisances 147 Re-insoections: 5,856 Inspections: Schools 13 Public buildings, Hospitals, etc. 23 Clubs, Institutions, etc. 13 Offices, Business premises 2 Railway premises 6 Bombed site or open space 13 Mews or Stable Yard 13 Private Roads or Passageways 13 Re-inspections: 266 InsDections: Drainage workj Under Notice 25 Voluntary 461 Installation of Heating Apparatus 78 Housing Applications 428 Aged or Infinn Persons 560 Infectious Diseases Cases 343 Premises 5 Special Surveysi Smokeless Zones 1,025 Overcrowding 981 Infestationsi Rodent 341 Other 45 Re-inspections: 4,179 49 Inspections: Foodshops 750 Shops other than foodshops 51 Shops Act 161 Merchandise Marks Act 52 Hairdresser 12 Pet Animals 4 Pharmacy & Poisons 10 Rag Plock 4 Fairground 14 Re-inspections: 1,252 Lectures 11 Total complaints received 1,550 Informal Notices (verbal notice, letter) 360 Intimation Notices served 419 Statutory Notices served 94 Attendances at Court or Inquiries 15 FACTORIES ACTS. 1937 & 1948 No. on Register Inspections Written Notices Occupiers Prosecuted Factories in which Ss. 1,2, 3,4 and 6 are to be enforced by local authority 211 16 2 - Factories not included above in which S .7 is enforced by the local authority 389 89 8 - Other premises in which S.7 is enforced by the local authority (excluding outworkers premises) 4 - - - TOTAL- 604 105 10 -- 50 Defects Pound Found Remedied Referred to H.M. Inspector Want of Cleanliness (S.l) 1 1 Overcrowding (S.2) - - - Unreasonable temperature (S.3) - - - Inadequate ventilation (S .4) 1 1 1 Ineffective drainage of floors (S.6) - - - Sanitary conveniences (S.7) (a) Insufficient 1 1 - (b) Unsuitable or defective 14 10 - (c) Not separate for sexes - - - Other offences against the Act (not including offences relating to outworkers) 4 3 2 TOTAL; - 21 16 3 OUTWORKERS No. of Hampstead films making return 18 Total Outworkers notified by Hampstead firms 257 Outworkers resident in Hampstead (included in above) 40 Outworkers notified to us from other boroughs 92 Visits paid by Public Health Inspectors 40 Classes of Work No. of Outworkers Alterations to clothing 80 Household linen 3 Curtains and furniture hangings 2 Furniture and upholstery 1 Artificial flowers 1 Paper bags 2 Making of paper boxes 1 Feather sorting 1 Carding of buttons, eto. 1 S tuffed toys 5 Basket making 5 Christmas crackers, etc. 24 Lampshades 6 TOTAL: - 132 51 PET ANIMALS ACT. 1951 New Licences issued — Licences discontinued — Licences renewed 4 Visits by Public Health Inspectors 4 PHARMACY & POISONS ACT. 1933 New Licences issued 4 Licences renewed 97 Ceased to sell poisons or removed 6 No. on Register at end of year 101 Visits by Public Health Inspectors 10 EXAMINATION OF WATER FROM SWIMMING BATHS Satisfactory Unsatisfactory Chemical Analysis 10 - Bacteriological Examination 18 4 EXAMINATION CF SUB-SOIL WATER Two samples of sub-soil water were examined in an endeavour to trace the origin of the water. No trace of sewage was found. IEGAL PROCEEDINGS Public Health (London) Act. 1936 Pleasure Fair Byelaws. 1954 Date of Hearing Premises and Nature of offence Result of Proceedings 7. 3.58 Lyndhurst Gardens. Noncompliance with nuisance notice Order to abate nuisance within 56 days. £3 .l8s .Od. costs . 27. 6.58 Vale of Health. Breach of Pleasure Fair Byelaws Both defendants fined £5 and £3.3s.0d. costs and bound over to keep the pea ce for 12 months. IO.IO.58 Vale of Health. Appeal against above to London Sessions Sentence varied so as to quash condition of binding over« Otherwise appeal dismissed and £21 costs awarded to Council. 52 FOOD PREMISES The total number of foodshop premises is 797, There are 305 shops with multiple trades and for the purposes of the Register, shops with multiple trades have been entered once under each type of trade carried on. A new method of recording inspections has been adopted and since 1st October, 1958, inspections of multiple trade premises have been counted once under each trade. A direct comparison of the figures with previous years is not therefore possible. No. on Primary- Register Inspections Baker 36 72 Butcher 82 88 Canteens and Clubs 55 21 Confectioner 121 51 Delicatessen and Grocer 195 153 Fishmonger 23 20 Fried Fish 5 16 Greengrocer 84 42 Ice Cream 239 40 Milkshop and Dairy 55 30 Off Licence 45 23 Public House 54 44 Restaurant 120 95 Street Trader or Stallholder 46 Chemists 28 Factory 1 55 Herbalist l Fairground 1 1.191 750 In addition, over 1,000 revisits were paid to foodshops. PREMISES REGISTERED UNDER SECTION 16. FOOD & DRUGS ACT. 1955 Ice Cream Potted. pressed. pickled or preserved food Confectioners 63 Greengrocers 21 Grocers 7 Grocers 50 Butchers 2 Provisions 4 Tobacconists 7 Fishmongers 5 Butchers 35 Restaurants 42 Garages 1 Delicatessen 6 Dairies 20 Bakers 8 Factory 1 Stores 6 Florists 1 Fried Fish _5. Off licences 3 Kiosks & Stalls 5 TOTAL: 58 Patisserie 1 TOTAL; 239 Delicatessen 4 53 BACTERIOLOGICAL EXAMINATION OF FOOD Nature of Sample No . of Samples Satisfactory Unsatisfactory Barley Water 1 1 Batter 1 1 Cockles 12 12 Dried Figs 1 1 Drinking Water 2 2 Ice Cream 49 40 9 Iced Lemon Drink 1 1 Jellied Eels 10 8 2 Lettuce 1 1 Milk 14 14 Mussels 3 3 Potato Salad 1 1 Processed Peas 1 1 Raw Sliced Onion 2 2 Sausages 5 5 Stewed Steak 1 1 Toffee Apples 2 2 Veal 1 1 Whelks 11 11 TOTAL: 119 106 13 MILK SUPPLY Milk (Special Designation) Regulations Dealers (Premises in Hampstead) Supplementary (Premises outside Hampstead) No. of milk sellers 55 32 Licences issued:- Pasteurised 46 28 Tuberculin Tested 38 28 Sterilised 51 31 Milk Examination Methylene Blue and Phosphatase Tests Chemical Analysis Pasteurised 11 10 T.T. Pasteurised 2 — All the samples were satisfactory. Average milk fat content 3.7 per cent, (legal minimum 3 per cent.) 54 ADULTERATED SAMPLES Article Offence How dealt with Bread and Butter (3 samples) Butter and margarine mixed. Warning letter in each case. Butter Rahm Deficient in milk fat. Stock exhausted. Sample to be taken when commodity available. Pork Sausages Undeclared preservative. Warning letter sent. Cream of Veal with Mushroom Soup Mix False description. Deficient in fat. Label amended. Real Cream Eclair Imitation cream. Warning letter sent. Fromage de Monsieur Fromage Deficient in fat. False description. Manufacturers warned. Label amended. Strong Coffee and Chicory Unjustified use of word "strong" . Manufacturers warned. Label amended. Creme Doughnut False description. Warning letter. Ammoniated Tincture of Quinine Deficient in ammonia. Excess of quinine. Retailer warned. Sandwich Contained pellet of grease and flour. Manufacturer warned. Cream of Lobster Soup, with french cognac. False description. No brandy present. Importers warned. Label altered. Truffel Kasecrème False description. do. Triple Crème Chambourcy Cheese False description. Distributor warned. Butter Vanilla Flavour False description. Retailer warned. Sale of commodity discontinued. 55 ADULTERATED SAMPLES - continued Article Offence How dealt with Orange Drink with added Glucose Contained mould spores and hyphae on inside of bottle Warning letter. Fromage de St. Gildas des Bois False description. Manufacturer warned. Louis d'or Cheese False description. Retailer and distributor warned. Onion Puree Excess preservative. Retailer warned. Stocks exhausted. Rum Butter No trace of rum. Further samples satisfactory. UNSOUND FOOD Bacon, Ham, Kidneys and Spleens, Sausages 209¾lbs; 91 tins Cakes and Tarts 160 Cheese 16 lbs; 3 boxes Chickens 3 Evaporated Milk 15 tins Pish 1 stone; 535 tins Fondant Cream 160 lbs Fudge 165 lbs Fruit, Fruit Pulp and Juices 482 tins Jams 51 Lemon Squeezes 24 Plated Meals 208 Raisins 14 lbs Rice Puddings 31 tins Steak Puddings, etc. 13 tins Vegetables 165 tins Miscellaneous: Cream 1 tin; Golden Pudding 1 tin; Pickled Onions 3 Jars; Sauerkraut 1 tin; Sausage Rolls 7. \ 56 HOUSING Dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,673 Dwelling-houses (included in above) which were inspected and recorded under the Housing Consolidated Regs. 1925-1932. (House-to-House inspection) 53 Dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 8 Dwelling-houses found not to be in all respects fit for human habitation 779 HOUSES IN CLEARANCE AREAS AND UNFIT HOUSES ELSEWHERE Houses Demolished Clearance Areas, Housing Act, 1957 NIL Not in Clearance Areas NIL Unfit Houses Closed Under Sections 16 & 17, Housing Act, 1957 NIL Parts of Buildings closed 8 Persons displaced 21 Families displaced 6 Unfit Houses made fit and Houses in which Defects were Remedied By By Local Owner Authority After informal action by local authority 606 NIL After formal notices Public Health Acts 6l NIL Housing Act, 1957 NIL NIL Under Section 24, Housing Act NIL NIL Unfit Houses in Temporary Use Under Sections 17, 34, 46, 48 & 53 Housing Act NIL Purchase of Houses by Agreement Houses in Clearance Areas other than those included in Confirmed Clearance Orders or Compulsory Purchase Orders, purchased NIL 57 OVERCROWDING 1954 1955 1956 1957 1958 New cases reported 279 127 130 115 47 Number removed from Register 37 48 43 33 1113 Number remaining on Register 996 1075 1162 1244 178 CERTIFICATES OF DISREPAIR Applications for certificates 38 Applications withdrawn or cancelled 8 Certificates refused NIL Authority to issue certificates - (a) in respect of some but not all defects 13 (b) in respect of all defects 17 30 Undertakings given by landlords 16 Undertakings refused 1 Certificates issued l4 Applications for cancellation of certificates 30 Objections by tenants to cancellation of certificates 4 Decisions to cancel in spite of tenants objection 2 Certificates cancelled 24 HOUSING ACT. 1957. SECTION 9 Repair of Insanitary Houses Thirty inspections were made by the Public Health Inspectors under this section. REHOUSING Visits and revisits in connection with the investigation of 4l4 rehousing applicants 889 No. of reports submitted to Hampstead Housing Manager 400 No. of reports submitted to Other Boroughs 14 58 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 107 Kingsgate Road, N.W.6. MAI 2007 Hampstead Old People's Housing Trust Ltd., Hon. Sec. - Mrs. B. Gibson, 7 Harley Road, N.W.3. PRI 2950 Women's Voluntary Services, 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, 119 Cholmley Gardens, N.W.6. - General information only HAM 0317 194 Euston Road, N .W.1. - for N.W.3. area only EUS 6451 122/6 Kilburn High Road, N.W.6.- N.W.6. area only MAI 0804 Home Help Organiser (L.C.C.) 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.1. VIC 0162 Admitting Officer (Enquiries regarding inmates of Luxborough Lodge) 5 Princes Row, S.W.l. VIC 0162 Public Health Department, Specialist Public Health Inspector - Mrs. C. Speechley 98a, Avenue Road, N.W.3. HAM 7171 59 Services provided for Aged Persons laundry. For incontinent persons only. Applications to the Medical Officer of Health, 98a, Avenue Road, N.W.3. HAM 7171. Meals. Delivered twice weekly by British Red Cross Society and Women's Voluntary Services. Dinner Clubs. These are held at - St. Stephen's Church Hall, Pond Street, N.W.3. on Tuesday, Wednesday, Thursday. 12 noon. Health Institute, 107 Kingsgate Road, N.W.6. on Tuesday, Wednesday, Thursday, Friday. 12 noon. 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. Arranged by the Hampstead Old People's Welfare Association. Chiropody Service. Weekly sessions are held in N.W.6 and N.W.3. The Rotary Club of Hampstead provide transport to the clinic for those too frail to travel. Patients who are unable to attend the Clinic even by car, are visited and treated in their own homes. Appointments for treatment are made on application 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 at Flask Walk and Palmerston Road, free of charge . Homes. Information may be obtained from the Medical Officer of Health, 98a, Avenue Road, N.W.3. or the Old People's Homes Committee, 296 Vauxhall Bridge Road, S.W.1. VIC 9977. Old People's Workshop. 107 Kingsgate Road. N.W.6. Organised by the Hampstead Old People's Welfare Association. Hospital Care. Applications should be made by the patient's doctor to Dr. Exton Smith, Whittington Hospital, Highgate Wing, Dartmouth Park Hill, N.19. ARC 3070 . In cases of difficulty 60 further advice can be obtained from the Medical Officer of Health, 98a, Avenue Road, N.W.3. HAM 7171. Ext. 275. Clubs Darby and Joan Clubs - St. Stephen's Hall, Pond Street, N.W.3. Wednesday 2 - 4.30 p.m. All Souls Church Hall, Loudoun Road, N.W.8 . Tuesdays 2 - 4 p.m. Unitarian Church Hall, Quex Road, N.W.6. Thursdays 2-4 p.m. St® James Hall, Netherwood Street, N.W.6. Wednesday 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, April - October 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, Monday and Wednesday Broadhurst Gardens, N.W.6. evenings. Congregational Church Hall, Lyndhurst Road, N.W.3 Thursday afternoons . 61 LONDON COUNTY COUNCIL. DIVISION 2 . PUBLIC HEALTH DEPARTMENT Divisional Medical Officers: H. Leslie Oldershaw, M.D.,B.S .,D.P.H. 313 Harrow Road, W. 9. CUN 4815. Hampstead Sub-Offices: 251 Finchley Road, N.W.3. HAM 8450. Clinics. Day Nurseries & School Treatment Centres L.C.C. Day Nurseries (normally open all day, Monday to Friday) Woodchurch ll/l3 Woodchurch Road, N.W.6. MAI 2937 Parkhill 2 ParkMll Road, N.W.3. GUL 4233 Pond Street 27/29 Pond Street, N.W.3. HAM 1686 A list of private day nurseries can be obtained from the Hampstead Sub-Office, 251 Pinchley Road, N.W.3. Maternity and Child Welfare Centres 60 West End lane, N.W.6. MAI 5381 2 Parkhill Road, N.W.3. GUL 4759 Hampstead Wells, Christchurch Hill, N.W.3. HAM 9534 3/5 Daleham Gardens, N.W.3. SWI 3424 9 Solent Road, N.W.6. HAM 5978 Welfare Poods (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 Dental Clinic, Li thos Road, Finchley Road, N.W.6. HAM 4763 Speech Therapy Centre Welfare Centre, 60 West End Lane, N.W.6. MAI 5381 Immunisation and Vaccination Clinics Diphtheria Inmunisation and Smallpox Vaccination, 60 West End Lane, N.W.6. on Fridays at 2 p.m. Poliomyelitis Inoculations, 3/5 Daleham Gardens, N.W.3.on Thursdays 10-11 a.m. Diphtheria and Poliomyelitis immunisation of babies can also be dealt with at the Maternity & Child Welfare Centres by arrangemente. 62 Bathing Centre. (This is a Borough Council establishment at which school children receive treatment under arrangements made between the London County Council and the Borough Council.) Hampstead Bathing Centre, Lithos Road, N.W.3. HAM 7171 Domestic Help Service Home Help Organiser, 251 Finchley Road, N.W.3. HAM 4l36 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 For detailed information on the following subjects application should be made to the Divisional Medical Officer, 313/319 Harrow Road, W.9. CUN 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. 63 INDEX PAGE Aged Persons: Care of the Aged 30,58 Cleansing of 46 Laundry Service 13,46 Area of Borough 4l Area of Comparability Factors 4l Atmospheric Pollution 31 Bacteriological Examinations: Pood 21,53 Infectious Disease 45 Swimming Bath Water 51 Bakehouses 24 Barbers and Hairdressers 17,49 Bathing Centre 46 Baths, Old Persons 46,59 Births, Birth Rate l4,4l British Red Cross Society 58 Burials 13 Catering Hygiene 23 Certificates of Disrepair 48,57 Certificates of Suitability 24 Chemical Analysis: Pood 21,54 Swimming Bath Water 51 Chiropody Service 59 Clean Air Act, 1956 31 Cleansing Station 46 Clearance Areas 20,56 Clinics 6l Closing Orders 56 Clubs, Old Persons 60 Common Lodging Houses 20 Complaints 17,48 Contamination of Food 54 Cooked Meats 21,52 Council Representatives on other Organisations 6 Darby and Joan Clubs 60 Day Nurseries 6l Deaths: Chief Causes l4,42 Death Rate l4,4l Infant Mortality 41 Maternal Mortality 4l Mortuary 47 Suicides 16,47 64 PAGE Demolition Orders 56 Dinner Clubs 59 Disinfection and Disinfestation 13,46 District Nursing Associations 62 Division 2, London County Council 61 Divisional Health Committee 6 Domestic Help Service 62 Drainage 43 Dwellings: Hate Assessments 4l Structurally Separate 4l Factories Acts: Inspections 49 Outworkers 50 Underground Bakehouses 24 Fair, Hampstead Heath 24 Fairground Byelaws 28,51 Food: Adulterated Samples 54 Bacteriological Examination 21,53 Bakehouses, Underground 24 Ghemical Analysis 21,54 Cooked Meat Premises 21,52 Food Hygiene at Hampstead Heath Fair 23 Food Hygiene Regulations 23 Ice Cream 21,52 Inspections 21,52 Milk 22,53 Premises 21,49,52 Sampling 21,54 Unsound Food 23,55 FoodPoisoning 45 Foot Clinics 59 Hairdressers and Barbers 17,49 Hampstead Council of Social Service 58 Hampstead Heath Fair 24,28 Hampstead Old People's Housing Trust Ltd. 58 Hampstead Old People's Welfare Association 58 Heating Appliances (Fireguards) Act, 1952 19 Home Help Organiser 58 Home Safety 13 Homes, Old Persons 59 House-to-House Inspections 48 Housing: Applications for Rehousing 48,57 Clearance Areas 20,56 Closing and Demolition Orders 48,56 65 PAGE Housing Act, 1957, Section 9 48,57 Housing (Financial Provisions) Act, 1958 25,48 Overcrowding17,57 Rent Act, 1957 48,57 Statistics 56 Unfit Houses 48,56 Ice Cream 21,52 Improvement Grants 25,48 Infant Mortality 4l Infectious Diseases 8,44 Inspection of the Borough 16,48 Intimation Notices 17,49 laundry Service 13,46 Legal Proceedings 51 Loans for House Purchase 25,48 London County Council, Division 2 6l London County Council (General Powers) Act, 1953 S.43 46 Maternal Mortality 4l Maternity & Child Welfare Centres 6l Medical Examinations, Staff 12 Milk: Distributors 53 Premises 22,53 Sampling 22,53 Special Designations, etc. Regulations 53 Ministry of Pensions and National Insurance 58 Mobile Meals Service 59 Mortuary 47 National Assistance Act, 1948. Section 50 13 ditto• Section 47 30 National Assistance Board 58 Old Persons 30,58 Outworkers 50 Overcrowding 17,57 Pet Animals Act, 1951 49,51 Pharmacy and Poisons Act, 1933 49,51 Pleasure Pair Byelaws 28,51 Poliomyelitis 10 Population 14,4l Prevention of Damage by Pests Act, 1949 26 Primrose Hill, Surface Water 18 Public Analyst's Report 21,54 Public Health Committee 6 66 PAGE Public Health Laboratory 21,45,53 Public Health Laundry 15,46 Public Mortuary 47 Radiation Hazards 18 Rag Flock etc. Act, 1951 19,49 Rateable Value 41 Rehousing 48,57 Rent Act, 1957 48,57 Road Traffic Act, 1956,' Section 42 20 Rodent Control 26 Sampling 21,53 Sanitary Circumstances of the Area 16,48 Scabies 46 School Treatment Centres 6l Sewers, Rodent Control 28 Shops Act, 1950 19 Slum Clearance 20,56 Smoke Abatement 31 Speech Therapy Centre 6l Staff: Medical Examination 12 Public Health Department 7 Statistics: Public Health Inspection 16,48 Statistical Summary 4l Statutory Notices 49 Stillbirths 4l Structurally Separate Dwellings 4l Suicides 16,47 Swimming Bath Water 51 Tuberculosis 11,44 Underground Bakehouses 24 Unsound Food 23,55 Vale of Health Fairground 28,51 Verminous Persons 46 Water Supply l8 Welfare Centres 61 Welfare Officer, L.C .C. 58 Women's Voluntary Service 58 Workshop, Old People's 59