AC4351 HAMP6o Metropolitan Borough of Hampsteab. Report on the Health of the Borough. 1959 R. D. DEWAR, B.Sc., M.B., CH.B., D.P.H. Medical Officer of Health. Metropolitan Borough of Hampstead. Report on the Health of the Borough. 1959 R. D. DEWAR, B.Se., M.B., CH.B., D.P.H. Medical Officer of Health. 2 CONTENTS Page Public Health Committee; Staff 9, 10 Population; Births; Deaths 11, 42-45 Infectious Disease 14-16, 46 Inspection of the Borough 19, 50 Atmospheric Pollution 25 Food and Drugs 34, 54-57 Housing 21, 58 Rodent and Pest; Control 24 Swimming Baths 29 Mortuary 49 Statistical Summary 42 Aged and Infirm Persons 17, 60 Factory Acts, 1937 to 1959 51 L.C.C. Division 2 63 Index 65 3 Public Health Department, 98a, Avenue Road, Hampstead, N.W.3. 2nd May, 1960. TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE METROPOLITAN BOROUGH OF HAMPSTEAD. Mr, Mayor, Ladies and Gentlemen, I have the honour to present my Annual Report on the Health of the Borough during 1959. The law requires that the Medical Officer of Health shall make a report each year and that it must contain a certain minimum of information. The report contains a summary of some of the records and statistics and these are usually presented in a form which allows of easy comparison with previous years and with other local authority areas. The writing of the report does, however, present a particular opportunity for a critical assessment of the aims and purposes of the Public Health Department and the success or otherwise of the year's achievements. By tradition the Medical Officer of Health is permitted not only to record the facts but to make observations, criticisms and suggestions which may not necessarily agree with the views of his Council. It is usual to express comments of this kind in the introductory letter rather than in the body of the report but there are certain difficulties in a restriction of this nature. To be of the maximum use to Members of the Council, the report should be made at the earliest possible date but certain information, for example from the Registrar General, Is not available for some months after the end of the year. It is therefore convenient to prepare the report in sections and in addition it is probably more helpful to the Members of the Council for any comments to be included with other information on the particular service, and this has therefore been done and It Is hoped that the Members will find the comments of some use. 4 The aim of the public health service is twofold. First to try and ensure that there is a healthy environment in which people can live and work and secondly, to try and persuade the public to live in a healthy way„ As a very simple example, a room should have a proper window to provide light and ventilation, but the occupier must also be persuaded not to cover it so much as to exclude the light nor to keep it permanently closed to prevent proper ventilation. A great deal has already been done to provide a good environment and although there is no reason for complacency or satisfaction there are powers under the various Acts of Parliament dealing with Housing, Factories and Public Health to provide and maintain at least a minimum standard. It is not possible to foresee the time when these powers will be unnecessary. Houses get old and worn and need repair; other houses are inhabitated in a way which was not intended when they were built and they require alteration or improvement; manufacturing processes and techniques may bring new risks which must be guarded against. Nevertheless Hampstead is fortunate in having an establishment of public health inspectors who have great experience and ability in this work and the decreasing number of complaints of unsatisfactory conditions is a measure of their success. Persuading the members of the public to live in a healthy manner is a much more difficult matter. It is usual to speak of it today as "Health Education", almost as if this were something new whereas in its wider sense it started with the beginnings of civilisation. Health education in Hampstead has always been a function of the Public Health Department but it is by no means a prerogative. A great deal of work is done by the London County Council, by doctors and nurses, school teachers, the press, societies, clubs and associations and by the public themselves. Health education like most of medicine is composed of a little special knowledge and a great deal of commonsense. It must be based on the fact that the population is very largely composed of sensible people who, if given the necessary information, will act sensibly. To reach the whole public is, however, an enormous task. Posters and leaflets have their uses but only some people consciously notice them and very few are influenced by 5 what they see. Without doubt the best method is personal contact but this must perforce be limited to a comparatively small proportion of the population, and it is necessary therefore to choose small but influential groups. As an example, improvements in food hygiene and food handling have largely been brought about by the helpful, gentle and yet persistent advice of inspectors responsible for food premises over many years. The Food Hygiene Regulations were merely putting into legal form the ideas which had already been accepted by the majority of good food traders and although they have been exceedingly useful in improving conditions in premises which were lagging behind, they could not have come into existence without the health education of the past. The selection of other groups is not quite so easy but fashion plays a great part in the alteration of habits and behaviour. It is now most unusual to see persons spit in the street and the main reason for this is that such behaviour is socially unacceptable. Fortunately, there are in all communities certain people who set the fashion for their own particular groups and if they can be persuaded in some aspect of healthy living they can have a good deal of influence on many other people. During the past year an endeavour has been made to extend the scope of health education by talks and discussion groups to audiences from various sectors of the community. If the particular aspect of the subject is presented as a problem the audience can often be persuaded into some argument and by allowing persons to participate rather than merely to listen, a deeper and more lasting effect is produced. Although there have been some disappointments, the work is progressing and it is hoped that some of the "leaders of fashion" within their groups, whether they be school children, teenagers or persons of established reputation will consciously or unconsciously extend the effects of our efforts. Not only must the techniques of public health be revised from time to time but the needs must also be examined. Notifiable infectious diseases which were at one time a major preoccupation are now of comparatively less importance. 6 The reasons for this are that with a number of diseases the method of spread of infection is more widely known and guarded against by the general public. There is fairly general (though not universal) acceptance of the need to wash ones hands after going to the lavatory and of the need for cleanliness in the handling of food, and the campaign of "Coughs and Sneezes Spread Diseases" has not been without effect. Another reason is that modern methods of treatment are enormously more effective in the cure of some of the infectious diseases and this not only lessens the importance and danger of the disease to the patient but also reduces the period during which he is infectious to others. Some diseases also, notably scarlet fever, have changed their character and are not now of such importance. On the other hand new diseases, some of them of major importance, are discovered from time to time and the increasing speed of travel makes it necessary to guard against diseases which are not endemic in this country but are common abroad. In addition it is becoming more fully recognised that many of the non-infectious diseases, although they cannot be passed from one person to another, are preventable to some degree and certain forms of heart disease, diabetes etc. are being increasingly studied. The number of elderly people in the community is increasing and the services required for them must be expanded. Forecasts have been given of the percentage of elderly people that there will be in the population in the future and some of these figures seem quite alarming, but it must be remembered that only a small proportion of the persons who have reached the age of retirement are in need of the services provided by the local authorities and voluntary bodies. Also, any person who now reaches retiring age must have been of an age to pay the compulsory 10 years contributions which would entitle him to a retirement pension, although there will be a few cases where for one reason or another he is not so entitled. Some of the most distressing cases have been amongst widows of persons of good social and financial position whose fixed incomes have become quite inadequate because of the 7 decreased purchasing power of money and who for reasons of personal pride have been unwilling to apply for the help to which they are entitled. It is hoped that with the more general recognition of the need to make proper provision for old age, both personally and through national schemes these cases will diminish and that with a condition of full employment the incentive to continue some, though perhaps part-time, employment after reaching retiring age will improve the lot of the old people in the coming years. In all the circumstances it is necessary to expand the services for old people but it is hoped that the numbers needing the services will not show a substantial increase. The statistics and details of other services are dealt with in some detail in the report but it may be well to draw attention to the report on suicides. Since it was pointed out that Hampstead had the highest suicide rate for the whole country in 1950 it has been assumed by some people that this has continued to be so. This is not correct and some figures are given relating to Hampstead and to neighbouring boroughs in the report. During the past two years, however, it has been felt that as the number of suicides has been high some positive effort should be made to try and prevent people taking their lives and several meetings have been held, attended by persons interested in mental health, religion, social welfare and public health to discuss preventive measures. The primary difficulty is, of course, to get in touch with those persons who might attempt suicide and it must be remembered that although we speak of high figures only one person in 4,000 does in fact commit suicide. Hampstead is very liberally served with organisations, societies and services which provide companionship and which can. meet the mental, spiritual and physical needs of most people and it is perhaps the greatest tragedy that people who attempt suicide will often not seek, and in some cases will not even accept, the help which is so freely available. A great deal is done by general medical practitioners, psychiatrists, churches and others but as their work 8 is almost invariably completely confidential it is not possible to show the variety and extent of the help given,, Nevertheless I am quite sure that Hampstead is well cared for in this way and it will he no less well served now that the stigma of having the highest suicide rate has been removed. I have received much assistance in the preparation of this report not only from Mr. A.H.Co Slade, Chief Clerk, in. the presentation of the statistics, and from Mr. J.,Fo Armstrong, Chief Public Health Inspector on the work of the inspectors hut also from the deputy chief and specialist inspectors concerning those sections dealing with their particular work. I am grateful to the Members of the Council and in particular to the Chairman and Members of the Public Health Committee for their encouragement and support„ My thanks are also due to the Town Clerk and the other Chief Officers and their staffs for their unfailing assistance, to my deputy, Dr„ M„ McQuaid and to my own staff for their loyal and excellent work during the year„ I have the honour to be, Mr„ Mayor, Ladies and Gentlemen, Your obedient Servant, R0 DUNCAN DEWAR, Medical Officer of Health. 9 PUBLIC HEALTH COMMITTEE The Worshipful the Mayor (Councillor Miss D.E. Newman, J.P.) ex-officio member. Chairman: Councillor K. Sames, Ph.D.,F.R.I.C. Aldermen S.A. Boyd, M.S.,F.R.C.S. Mrs. R.S.G. Carnegie. Mrs. F.E. Cayford, J.P.,L.C.C. Councillors Miss D.R. Bailey Miss M. du Mont, M.A. Miss E. Beer (Vice-Chairman) D.F. Ridgley V.A. Bonafont Miss J. Silver G. Finsberg, M.B.E. L.J. Walker The Chairman of the Housing Committee. Sub-Committee: Drainage Plans. REPRESENTATIVES ON OUTSIDE COMMITTEES AND OTHER ORGANISATIONS CONCERNED WITH PUBLIC HEALTH WORK Hampstead Council of Social Service; Aldermen Mrs .R.S.G.Carnegie, E.Snowman, O.B.E.; Councillors Miss D.R.Bailey, R.M.Brodtman, S.P.Pyke. The Hon. Mrs. Ruth Bennett. Hampstead Old People's Housing Trust Ltd.: Alderman E.Snovman, O.B.E.; Councillors Miss S.H.Ayliff, R.M.Brodtman, J.J.Tobin, M.A.,LL.B., Mrs.H.M.Young. Hampstead Old People's Welfare Association; Aldermen Mrs.R.S.GoCarnegie, R.J.Cleaver, L.C.C.; Councillors Miss S.H.Ayliff, Mrs .D.Davis, Miss M. du Mont, M.A., D.F.Ridgley, K.Sames, Ph.D.,F.R.I.C., A.E.Skinner. Hospital Management Committees: 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, K.Sames, Ph.D.,F.R.I.C. National Society for Clean Air: Councillor K. Sames, Ph.D.,F.R.I.C. The Medical Officer of Health. 10 STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health:- R.D. Dewar, B.Sc.,M.B.,Ch.B.,D,,P.H,,,Barrister-at-laW. Deputy Medical Officer of Health;- Miss M. McQuaid, L.R.C.P.,L.R.C.S(I).,D.P.H. Chief Public Health Inspector;- J.F. Armstrong (a)(b) Deputy Chief Public Health Inspector:- F.V. Outlaw (a)(b) Specialist Inspectors;- Old People's Welfare: Mrs. C.G. Speechley (a)(d)(e)(f) Housing: L.E. Trigg (a)(b) R. Clark (a) Food: W.F. Newport (a)(b) Clean Air Act: E. Ulrich (a)(b)(c) Health Education: G.L. Nicklin (a) District Inspectors:- D.W. Malcolm (a) C.F. Pidgeon (a) G.L. Nicklin (a) P.C.F. Griffiths (a)(b) R.W.M. Cook (a) A.M. Norton (a) (from 27th July) Student Public Health Inspectors:- L.T. Pithers (from 14.11.59) D.G. Ring, H.A. Shitta-bey, A.M. Norton (up to 27.7.59) Chief Clerk:- A.H.C. Slade Clerical Staff:- G.W. Bedell J.A. Gilbody Mrs.M.C. Rabin Mrs. M. Roe Mrs, G.A. Fletcher Public Analyst;- £. 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. 11 POPULATION The natural increase in population, i.e. excess of "births over deaths was 551. The estimate of the Registrar General for the population at mid-1959 was 96,810, giving an increase over the previous year of 330. The last time the Registrar General estimated an increase in population was 1954. BIRTHS The number of births was 1,602, being 108 more than in 1958. The birth rate for each of the last four years has shown an increase and the rate for 1959 (l6.5) is the highest since the post war "bulge" in 1947 (l8.l). The Registrar General gives an area comparability factor which takes into account the proportion of women of child bearing age and allows of comparison with other areas. The adjusted birth rate for Hampstead is 12.4. Of the births 824 were males and 778 females. The number of illegitimate births, 171, expressed as a percentage of the total number of births was slightly lower than in 1958. DEATHS There were 1,051 deaths of Hampstead residents during 1959 giving a death rate of 10.9 per thousand of the population. This is slightly lower than in the previous year when there were 1,075 deaths and a death rate of 11.1. There are no marked differences in the proportion of deaths from different causes when compared with recent years. Respiratory tuberculosis was responsible for seven deaths as compared with nine in 1958 and an average of eight during the previous five years. There has been a trend in recent years for deaths from this disease to decrease although the number of persons on the tuberculosis register notified as suffering from tuberculosis is increasing. Deaths from cancer of the lung numbered 38. In 1958 the number was 51 and the average for the five years 1954-58 was 45. The smaller number of deaths during 1959 cannot unfortunately be taken as an indication that there is likely to be any decrease in the cases of this disease at present. Influenza was responsible for 19 deaths, many of them in elderly people. 12 There were 36 deaths of children under the age of one year as compared with 30 in the previous year. Accidental Deaths During the year six Hampstead residents were killed in road accidents involving mechanically propelled vehicles. Two of these were men who were drivers of a motor cycle and a motor scooter respectively. The other four persons were women and all were pedestrians •whose average age was 73 years. Deaths from other kinds of accident numbered 24, but particulars are only available of 23 of them. Age Distribution Age 15- 25- 45- 65- 75- 85 upwards Total Male 1 2 4 - 1 2 10 Female - 1 3 1 5 3 13 TOTAL 1 3 7 1 6 5 23 Cause of Accident Male Female Average Age Fall in the house 3 5 76 years Fall outside house 1 3 64 years Fire 1 2 84 years Coal gas poisoning 1 3 46 years In addition one man died from each of the following causes:- fall off a horse; fall between a train and the platfom drowning; accidental overdose of medicine. It will be noted that these accidental deaths of Hampstead. residents did not necessarily occur within the Borough. There were no accidental deaths of children below the age of 15 years but of the 29 accidental deaths (including road accidents) almost half (l4) were of persons over 75 years. Suicides In the Annual Report for 1954 a detailed report was given of the investigation and analysis of all the suicides which had occurred in Hampstead in the four years 1950 to 1953* because the Registrar General had commented on the fact that in the year 1950 Hampstead had had the highest suicide rate in the country. 15 Since that time it has been assumed that Hampstead has continued to hold this unenviable record and as complete figures for other areas are not available in some cases for a long time it has not been practicable to disprove this assumption. It has, however, been possible to obtain the necessary information from the Annual Reports on other Boroughs and it will be seen from the table below that for the last three years for which figures have been published, 1956, 1957 and 1958, the suicide rate for Hampstead is lower than for one or more of the neighbouring Boroughs. Suicides per 100,000 population Borough 1956 1957 1958 Hampstead 25 24 28 Chelsea 14 22 32 Holborn 13 31 55 Kensington 24 24 19 Paddington 22 36 36 St. Marylebone 25 23 25 Westminster 32 19 22 It should be remembered that these rates are calculated from comparatively small numbers of cases and they can for this reason be somewhat misleading. For example, in 1956 the national average rate of suicides per 100,000 of the population was 11.8. In that year the rate in Holborn depended on three deaths giving a rate of 13.27 which is 12½ go per cent. above the national average. Had there been one less death the rate would have been 25 per cent. below the national average. It is perhaps of interest to note that the statistical report of the World Health Organisation for 1956 (reported in "The Times" 7th March, 1960) states that the suicide rate for men per 100,000 of the population in certain areas was:- West Berlin 42.2; Finland 570; Austria 52.4; Switzerland 31.9; Sweden 31.2; and Denmark 30.2. All these rates are higher than the highest recorded in Hampstead. During 1959 there were 25 suicides which compares with 27 cases in 1958 or with an average of 25 over the previous five years. The 23 cases for which information is available have been analysed as follows:- 14 Age Distribution Age 25- 35- 45- 55- 65- 75 upwards All ages Males 2 2 2 4 1 1 12 Females 2 2 2 2 3 - 11 Of the methods of committing suicide the commonest was by poisoning (Barbiturates 6, Domestic coal gas 6 and other poisons 2). Hanging was used in four cases and falling from a height in two cases. The remaining three cases died by shooting, electrocution and in front of a motor vehicle. Of the women who killed themselves, one was single, six were married and four were widowed. The occupations showed a cross section of the community and ranged from a labourer to a professor. There was no significant variation from the analysis of the cases made in the Report for 1954• INFECTIOUS AND OTHER DISEASES Although the notifiable infectious diseases appear to become of diminishing importance in the work of the Public Health Department, there Is always the possibility of large scale outbreaks of communicable diseases. Immunisation has played a large part in the control of these diseases and by this means smallpox has been completely eliminated in this country and cases of diphtheria have been reduced to very small numbers. With the absence of actual cases the need for immunisation is not so apparent to the general public and continued propaganda and persuasion is all the more necessary if a reasonable proportion of the future generation is to be given adequate protection. There is a limit to the number of injections to which most mothers will subject their children and there has been some difficulty in producing a "programme" of immunisation largely because of the differing views on the advantages or risks of combined immunisation against two or more diseases and on the relative dangers of different diseases. Dr. Ian Taylor, for the London County Council has, however, produced a programme or timetable which meets most of the requirements and although every child is an individual and 15 requires individual consideration and whilst it would "be unwise to consider anything in medicine as perfect, this may well he an important item in the continuing campaign for adequate immunisation. The total number of cases of notifiable infectious disease was 687 as compared with 997 in 1958. The reduction was largely due to the smaller number of cases of measles (344) which was the lowest figure since 1956. Diphtheria There was again as in 1958, one case of diphtheria in the Borough. This was a little girl who, fortunately, was never seriously ill and in whom the diagnosis was in doubt for some time. Other persons who had been in contact with the child were investigated but no other case or carrier was discovered. The infecting organism from the patient was of the mitis type. Dysentery Seventy-nine cases of dysentery were notified, the infecting organism in almost all cases being shigella sonnei. Of the total number 25 cases occurred in a mother and baby home and all these cases were admitted to hospital for treatment. Although some of the very young children were quite ill they all recovered. Of the remaining number, in two instances three persons in the same family were affected and in five other families there were two cases each, whilst in another house there were two cases but in different families. Poliomyelitis There were five confirmed cases of poliomyelitis, three being non-paralytic. Of the two paralytic cases, one, a man of 50 years of age, was admitted to hospital and died on the following day; the other a boy of 4, had paralysis affecting the left side of the face and left arm and he made a good recovery. The ages of all the patients were 4, 5, 6, 17 and 30 respectively. Twelve other notifications of poliomyelitis were received but the diagnosis was not confirmed. One other case of poliomyelitis in the Borough was a paralytic case of a boy of 1½ years who had recently arrived from the Far East. The family had stayed temporarily in Holborn, where the disease was notified, before coming to reside in Hampstead. 16 Typhoid Fever There were five cases of typhoid fever notified in Hampstead. In two cases the disease was contracted during coach tours of Spain (different coach tours) and two others were visitors to this country from the Far East. The remaining case was a native of India who had been in England for a period of four months before developing the disease. In the last case the source of infection was not discovered. One of the patients who contracted the disease in Spain had a comparatively mild attack and the diagnosis was not made until she had almost recovered. She was treated at home and arrangements were made for her daughter to stay with friends in Woodford where she was examined and immunised before her return. Tuberculosis The figures for the notification of tuberculosis are not included with the other notifiable infectious diseases and they are also separated in the tables given in the statistical section. The number of new cases of respiratory tuberculosis was 58 males and 35 females and non-respiratory tuberculosis, 2 males and 4 females as compared with 50, 32, 7 and 6 respectively for 1958. A total of 8 persons died from this disease as compared with 11 deaths In the previous year. MEDICAL EXAMINATIONS Ninety-six examinations were undertaken during the year. Forty were in respect of new appointments to the staff; 35 were for transfer to the permanent staff; 16 were of persons on whom a special report was required in connection with absence through sickness; 5 were carried out on behalf of other authorities. Two persons were found to be unfit to carry out their duties and were recommended to be placed on superannuation. NATIONAL ASSISTANCE ACT, 1958 SECTION 50 Eleven funerals were carried out under this Act, at a total cost of £100.5s.5d. Of this amount, £89.7s.11d. was recovered from the estates of the deceased or from relatives. 17 In addition, the sum of £11.4s.0d. was received in respect of a case outstanding from last year. In eight instances, the amount of the funeral expenses were recovered in full. Three cases were written off by the Town Clerk, involving the sum of £10.17s.6d, these all referred to unknown babies found on the Heath. DISINFECTION AMD DISINFESTATION The number of rooms disinfested after vermin was 305 and the rooms disinfected after infectious disease 136. There was a steady demand for disinfection of parcels of clothing prior to despatch abroad and 165 parcels were dealt with. Twentysix filthy and verminous rooms were cleared after the death or removal of the occupant. Regular visits were paid to two hospitals for the disinfection of wards and laundry. Since July, a regular weekly collection and return of approximately 100 blankets from a hospital has been in operation. These blankets are disinfected and folded to meet the requirements of the hospital authorities. An exceptional number of requests was made for the destruction of wasps nests. Where the nests were accessible they were dealt with at a nominal charge and 83 nests were destroyed. PUBLIC HEALTH LAUNDRY The laundry service for incontinent persons carried out by the disinfecting staff is a much appreciated service and since the inception of the scheme in 1957, 106 people have been assisted in this way. There is a twice-weekly collection and the number of people using the service at any one time has varied from 24 to 34 throughout the year, The total number of articles dealt with was 11,875. NATIONAL ASSISTANCE ACT, 1948. SECTION 47 Investigations were made during the year on the welfare of 150 new cases which were reported to the department by relatives, neighbours, social workers, hospital almoners, medical practitioners, etc. Help was given to all these cases and they have been revisited throughout the year. The services of a specialist inspector appointed to 18 deal with the welfare of the aged has been of great value to the service as a whole and provides a good liaison with medical practitioners and all those associated with the care of old people. The Laundry Service continues to he of great benefit to old persons and is greatly appreciated by the District Nursing Associations and the relatives of incontinent patients. The demand for Home Helps has increased and so has the requests for meals-on-wheels. All of these services are working to full capacity. The number of geriatric hospital beds is still inadequate to meet the needs of an increasing aged population and the waiting list for Homes for the Aged still remains large. It was necessary to make one application to the Magistrates for an order to enforce the removal of one patient. This was a woman of 75 years, living alone under insanitary conditions and incapable of caring for herself. The necessary order (6 weeks) was obtained and she was removed to a London County Council home. The original order was extended for a further six weeks but the patient finally settled down and voluntarily decided to remain permanently. HEALTH EDUCATION Health education in the sense of informing and advising the public on health matters is part of the work of all the public health Inspectors in their daily contact with the members of the public and in the particular matters which have required a visit from the inspector. Apart from cases of notifiable infectious disease, however, the inspectors' visits are mainly following a complaint by a member of the public and an effort has therefore been made to approach sections of the population who might not otherwise be met. During the year letters were sent to the secretaries of many of the societies and organisations in the Borough offering the services of the department for lectures, demonstrations, informal talks and leadership in group discussions on health and allied local government subjects. The stocks of lecture and visual aids have been increased and a colour slide library of subjects with a local interest is being compiled. 19 Lectures and talks, supported in many cases by film strips and slides were given during the year as follows:- Church organisations 9 Schools 6 Student Nurses 14 British Red Cross Society 4 Youth Clubs 7 Progress in this branch of the work of the department has been largely due to the interest and enthusiasm of Mr. G.L. Nicklin, Public Health Inspector. BARBERS AND HAIRDRESSERS Barbers and Hairdressers premises are registered under the model Byelaws made by the Council under Section 18, London County Council (General Powers) Act, 1954. Nineteen 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. The number of premises on the register at the end of the year was 83. 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 for the supply to dwellings. SHOPS ACT, 1950 Arrangements for the Health and Comfort of Shops Workers 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 also deal with temperature, ventilation and sanitary conveniences in shops. The County Council still retain such powers and duties in respect of seven premises licensed for public entertainment. 20 Ninety-six 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. One inspection was carried out which showed the premises to be in a satisfactory condition. COMMON LODGING HOUSES There are no common lodging houses in the Borough. ROAD TRAFFIC ACT, 1956, SECTION 42 There is only one shop in the Borough retailing protective helmets for motor cyclists to which this Section applies. Visits were paid and all helmets found to conform to the British Standards Specification. SLUM CLEARANCE PROGRAMME 1956-60 Premises remaining to be dealt with: No. of Dwellings Quex Mews 5 Elizabeth Mews 6 Steeles Mews North 6 Cottage Mews 3 Loveridge Mews 8 None of these areas is large enough to be redeveloped for housing purposes without additional land and adjoining properties in all cases are not at present representable as clearance areas. Several of the individual dwellings in the original list have been so improved that they are not now representable but their 21 stability would be affected by the demolition of those dwellings which are unfit. It is anticipated that a further number will he improved and the remainder will be dealt with by Individual closing orders. Slum Clearance. Future Programme A further survey of the Borough has been carried out and this shows that there are no comprehensive areas in the Borough which could be regarded as slum clearance areas in the immediate future. There are, however, some individual premises which are unfit and which cannot be made fit at reasonable cost. These will be dealt with by individual demolition or closing orders hut the rate of progress depends in part on the availability of accommodation for rehousing. If closing orders are made without the possibility of rehousing, even essential maintenance may be neglected and the occupiers conditions are made worse. Repair of Houses A great deal of the work of the public health inspector is related to the repair of houses and a large proportion of the complaints received at the Public Health Department concerns housing defects. In general, landlords have shown a greater willingness to carry out repairs and an intimation notice under the Public Health (London) Act, 1936 is usually effective and indeed an informal letter or telephone message to the agent or owner in many cases produces the desired result. A somewhat disturbing practice has, however, arisen in that a few landlords in making an agreement with a tenant require that the tenant shall be responsible for all the internal repairs. In a few instances the defects found in the house have arisen over many years and repairs would involve major structural work for which the tenant ought not to be responsible and it has been quite clear that in his anxiety to get a house the tenant did not appreciate the implications of the agreement and the liabilities he was accepting. Whilst it is not suggested that there is anything illegal in these agreements, and indeed in some instances they are signed with full knowledge in recognition of a low rental, many are reminiscent of the "conditions in small print" which were attached in the past to some insurance and hire-purchase agreements. Fortunately, the above does not apply to the great majority of property owners and agents in Hampstead but the few cases one does meet are distressing. 22 HOUSE PURCHASE AMD HOUSING ACT, 1959 Powers of local authorities (a) to make Improvement Grants on properties and (b) to make advances for house purchase Improvement Grants - "Standard" This important new Act is not yet sufficiently appreciated "by property owners Judging by the comparatively few applications received for Standard Grants. A house owner can get up to £155 as a right if he adds five standard improvements to his house. They are a bath or shower in a bathroom (£25), a washhand basin (£5), internal water closet (£40), hot water system (£75), and food store (£10). He can get smaller sums (as indicated in brackets) if the property needs fewer of these improvements but it is a condition of the grant that the house contains all five of these amenities. The amount of the Standard Grant in respect of each of the five items is half the cost of the work, subject to the maxima before mentioned. From August to 31st December, 1959, the number of Standard Grants approved was three. Improvement Grants "Discretionary" The machinery has been somewhat amended but a house owner can still submit more extensive proposals than for Standard Grants to the Council with a view to a grant at their discretion. These proposals have been confined to conversions and allow for an amount up to £400 per dwelling or one half of the cost of the work (whichever is the less). The following table shows the progress of the Improvement Grant Scheme since its inception in 1954:- Improvement Grants 1954-1959 Received Granted Refused or withdrawn or under negotiation at 31.12.59 1.1.54 - 30. 6.54 2 2 _ 1.7.54 - 31.12.54 6 3 3 1.1.55 - 30. 6.55 14 6 8 1.7.55 - 31.12.55 7 4 3 1.1.56 - 30. 6.56 9 4 5 1.7.56 - 31.12.56 4 3 1 1.1.57 - 30. 6.57 19 17 2 1.7.57 - 31.12.57 5 5 - 1.1.58 - 30. 6.58 3 3 - 1.7.58 - 31.12.58 9 6 3 1.1.59 - 30. 6.59 12 5 7 1.7.59 - 31.12.59 25 7 18 TOTAL:- 115 65 50 23 House Purchase The new Act extends the powers to help house purchasers and is used considerably in this Borough. 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- All the mortgaged premises are revisited at least bi-annually to ensure that they are maintained in accordance with the terms of the mortgages. Loans for House Purchase Received Granted Refused or withdrawn or under negotiation at 31.12.59 1.1.51 - 30. 6.51 1 1 — 1.7.51 - 31.12.51 9 2 7 1.1.52 - 30.6.52 7 5 2 1.7.52 - 31.12.52 6 2 4 1.1.53 - 30.6.53 13 6 7 1.7.53 - 31.12.53 14 10 4 1.1.54 - 30.6.54 16 14 2 1.7.54 - 31.12.54 36 25 11 1.1.55 - 30.6.55 32 22 10 1.7.55 - 31.12.55 51 46 5 1.1.56 - 30. 6.56 42 24 l8 1.7.56 - 31.12.56 38 15 23 1.1.57 - 30. 6.57 34 22 12 1.7.57 - 31.12.57 34 20 14 1.1.58 - 30. 6. 58 40 30 10 1.7.58 - 31.12.58 63 39 24 1.1.59 - 30.6.59 53 31 22 1.7.59 - 31.12.59 77 21 56 TOTAL:- 566 335 231 24 r~* PREVENTION OF DAMAGE BY PESTS ACT, 1949 Mice 1959 1958 1957 1956 1955 No. of complaints dealt with. 429 745 568 453 301 Rats No. of complaints dealt with 412 495 263 453 110 No complaints were received from business premises relating to rat infestation but eleven business premises (mainly catering establishments) were troubled with mice. It is compulsory for the occupiers of food premises to notify the local authority of rodent infestation. The rodent control staff paid 3,859 visits to premises either by way of survey or treatment. Continuous research is undertaken by the Ministry of Agriculture, Fisheries & Food into methods of rodent destruction and the results are passed on to local authority staffs by instruction courses which have been attended by all the rodent control staff. The three assistants to the Public Health Inspectors have also been trained in this work and assist the two regular operatives whenever necessary, particularly during holiday periods, absences due to sickness, etc. Maintenance Treatment for Rats in Sewers I am indebted to the Borough Engineer and Surveyor for information regarding the treatment of sewer infestations. Every endeavour is made to carry out treatments twice yearly and two such operations were performed in 1959 during the months of March and November. During March the orthodox method of disinfestation with 10 per cent. Arsenious Oxide was used. Details and results of the operation were as follows:- Number of manholes baited 700 Manholes showing prebait take 292 Manholes showing complete prebait take 67 Following successful experiments by other authorities and after consultation with representatives of the Infestation Control Division of the Ministry of Agriculture, Fisheries & Food, 25 it was decided that Warfarin might be used in the sewers. Eight ounce baits containing Warfarin placed in polythene bags, were suspended from the manhole step-irons by string. The advantages of such a system are that in the event of sewer surcharge the baits are not washed away and a more accurate assessment of poison "takes" can readily be recorded. The results were disappointing as will be appreciated from the following record:- Number of manholes baited 750 Manholes showing partial take 35 Manholes showing complete take NIL A neighbouring authority was most successful with this method of treatment and it is odd that for no apparent reason it should fail. in Hampstead. In some instances it was recorded that the string used to suspend the polythene bag containing the bait was gnawed through and the bag thus deposited on the manhole benching was subsequently untouched. ATMOSPHERIC POLLUTION Smoke Control Areas The Smoke Control Order affecting the Vale of Health came into operation on 1st September, 1959 and the No.2 Order relating to the South East corner of the Borough became effective on 1st November, 1959. These two areas jointly comprise an area of 115 acres and some 820 private dwellings and observations have shown that the Orders have been very effective and that smoke from private dwellings within the areas has been almost completely eliminated. Just before and after the Orders came into effect a number of enquiries were made by householders concerning stocks of bituminous coal which they still held. It seems possible that the general publicity on the progress of the Orders and the effective date was not entirely adequate and some householders ordered and received coal at the reduced summer price, whilst in other cases the unusually mild winter of 1958-59 resulted in fuel remaining unused. These residents were advised how to burn the coal together with smokeless fuels so as to avoid smoke or reduce it to a minimum and they have cooperated very well In surmounting this difficulty. The number of fireplaces known to have been adapted or replaced is much less than was anticipated. This may be due in 26 part to the increased use of portable heaters using oil or electricity, the use of some of the proprietory brands of smokeless fuel which will burn in some grates which would not satisfactorily bum coke and in a few instances the replacement or adaptation of grates for which no grant has been requested. On the other hand, the cost of these conversions is proving to be consistently above the estimated cost. These costs are, of course, checked before any work is done and before any agreement is reached as to the amount of grant which will be paid but although, quite large reductions have been agreed in first estimates, approved costs are still higher than expected. However, the house property in both areas is predominently of the type which contains either very old fashioned (and large) or otherwise unusual fireplaces. The question of standard of finish and aesthetic appearance of any conversion which can still be regarded as "necessary" has arisen frequently and the number of "standard" conversions carried out, for example, by the North Thames Gas Board at (say) £6 each is likely to be less in Hampstead than in most areas. The Minister has given preliminary approval for a third control area which will cover 350 acres and the detailed survey was commenced in October. This survey is being carried out by two assistants, Miss B. Dimmock and Mr. J.A. Woodman, who are to be complimented on the way in which, with only a short period of instruction, they have undertaken visits, advice and reports which this work entails. It proved possible at the beginning for each of these assistants to complete reports on upwards of 100 separately occupied private dwellings each week, but as each road is worked through a proportion of "no access" visits are inevitable and now that return visits to, and requests for definite appointments, are being made the rate of progress decreases. It is intended that as far as possible every separate householder will receive:- (a) a visit by one of the survey assistants; (b) if access is not gained, a second visit at which, if again unsuccessful, the assistant will leave explanatory literature and a simple form inviting the householder either to submit certain particulars as to their arrangements for heating the premises; or (c) write or telephone for a definite appointment so that 27 advice can be offered and the necessary Information obtained at a third visit. It is not proposed to make any further attempt at this survey stage to interview any householder missed by these three contacts and to include in the final statistics the premises concerned by an adjustment on average. This may seem arbitrary but it is probable that 95 per cent. of the dwellings can be accurately reported on in 9 months while the remaining 5 per cent. of "hard cases" could easily run away with a further 3 months of valuable time. If and when the Order is confirmed every reasonable step will be taken to inform all persons resident in the area of the position and particularly those who were not actually seen during the survey. New Installations The system under which the Borough Engineer and Surveyor passes on information of all proposed new buildings, large conversions, etc. has continued to work effectively. The number of architects or builders who have been contacted by this means has totalled 85 and the enquiries to them resulted in 27 notifications of new installations of over 55,000 B.T.U. rating. Of these, only two cases requested prior approval of their proposals and submitted full specifications and details. A further nine notifications were made without any form of enquiry from my department and the Public Health Inspector noticed and reported two cases where work was in progress without prior notification. In only one of these cases was notification necessary. The system does at least bring to the notice of architects, builders and the trade generally the requirement of Section 3 of the Clean Air Act that the local authority must be informed before the larger installations are effected. I have little doubt, however, that this requirement is not yet widely appreciated, that numbers of new boilers are being installed without notification and that some time will elapse before the building trade generally accepts the fact that, just as they automatically notify drainage and building alterations, so they must let us know of new boilers and furnaces. It may be that some effective publicity from a central authority would be useful in this matter and at this time. 28 Smoke Nuisances Railway tunnel vent shafts, a large (3 Lancashire boiler) automatic installation at a hospital, an automatic underfeed furnace of a Cinema and another automatic installation at a Nurses' Hostel have produced the major visible smoke emanations over the year. So far as the railway tunnel vents are concerned it is difficult to get details which would allow the railway authorities to identify the particular train. It is not possible to be certain in which direction the train is travelling, whether it is a goods or passenger train and even the time is unreliable, for the train may have passed some little while before the smoke appears. Correspondence and telephone calls have resulted in assurances that firing is kept to an absolute minimum while trains are within the numerous tunnels which pass under parts of the Borough" but more hope is entrusted to the assurance from the Railway authorities that the effect of diesel replacements on these lines will really be noticed by 1961. The engineering staff at the hospital have been most helpful and seem to be genuinely concerned at the emissions from their plant. Substantial alterations to the plant have improved matters in that persistent smoking has been eliminated but periodic bursts of nearly black smoke, in large quantities and of (usually) 20 seconds duration are still seen regularly. As the hospital in question is due for complete rebuilding in the foreseeable future it is understandable that it is desired to avoid any great expenditure on the existing plant. At the Nurses' Hostel the Smoke Inspector was pleased to note that an adjustment recommended by him immediately abated the nuisance. Smut emissions from oil fired plant, waste-wood burning at a wood machining factory and disposal of oil and oily wastes at another premises have been dealt with by advice and/or cautions. Garden bonfires, particularly in Smoke Control Areas have caused some comment because they are not affected by the Order. Gardening enthusiasts must, however, meet the requirements of Section 16 of the Clean Air Act that they must not cause a nuisance to the inhabitants of the neighbourhood. The advice given Is that the quantity of rubbish to be burned should be kept to a minimum and that on a suitable day and when the rubbish is dry it should be burned as quickly as possible. Several complaints concerning garden bonfires have been settled amicably. 29 SWIMMING BATHS Circular No.l/60 of the Ministry of Health requires the inclusion in the Report of certain information concerning public swimming baths and I am indebted to Mr. J.W. Webster, the Baths Superintendent for much of the information which follows. The swimming baths in Hampstead are situated in Finchley Road. The baths were built in 1887 and the administrative block on the Finchley Road frontage was rebuilt 10 years later when the underground railway which runs under this portion of the baths was constructed. There are three swimming pools which are known as the Fairfax Pool, the Goldhurst Pool and the Youth Pool. The Fairfax; Pool is 100 feet long, 33 feet broad and has a depth varying from 3 feet to 5 feet 8 inches and it has a capacity of 100,000 gallons. The pool is open throughout the year for public swimming but from 8 p.m. it is reserved for swimming clubs. The pool is also open on Sunday mornings from 8 a.m. to 12 noon and during the summer season on Sundays from 2 p.m. to 6 p.m. The Goldhurst Pool has a length of 90 feet, breadth of 33 feet and depth varying from 2 feet 6 inches to 5 feet 8 inches and a capacity of 90,000 gallons. The Goldhurst Pool is open only during the summer season from April until September for public swimming. The Youth Pool is 57 feet long, 24 feet broad and has a depth varying from 3 feet to 5 feet 4 inches and a capacity of 45,000 gallons. It is used in the mornings and afternoons by the schools for instruction in swimming which is given by instructors employed by the Borough Council. From 4.30 p.m. until 6 p.m. and on Saturdays from 9 a.m. to 12 noon it is used for individual instruction and in the evenings from 6 p.m. to 9 p.m. it is reserved for use by the smaller swimming clubs. The water used in all the swimming pools is obtained from the Metropolitan Water Board. There is no private well or other supply. The water in all the pools is treated by constant filtration through pressure filters, but through two separate systems. For the Youth Pool the filters were installed in 1930 and they have a capacity of 9,000 to 11,500 gallons per hour. The filters are "back-washed" about twice a week during the summer and once a week during the winter, the frequency 30 depending on the extent of the reduction in the capacity of the filters which in turn depends on the use that is "being made of the bath. The "back-washing" is carried out with water from the bath which then runs to waste and this may use up to 10,000 gallons of water, the level of the bath "being made up with fresh water from the Metropolitan Water Board. The whole bath is emptied for cleaning every 12 to 18 months but it will, of course, be realised that the constant use of water for cleaning the filters and the "topping up" with fresh water provides for renewal of the water at much more frequent intervals. The Goldhurst Pool and the Fairfax Pool use the same filters and during the summer season when the Goldhurst Pool is in use the water is mixed and filtered at the same time, although there is a difference of 9 inches in the level of the water in the two baths. The present filters were brought into use in 1951. There are three pumps and with two of them in use the total capacity of the baths can be dealt with in 4 hours. With the use of the third pump the period can be reduced to three hours. Each pump has a capacity of 23,000 to 26,000 gallons per hour but the total capacity of the three pumps together is only 62,000 gallons per hour. The "back-washing" of the filters is carried out about twice a week in the summer and once a week during the winter depending on the use which is being made of the baths. The quantity of water used each time is between 10,000 and 15,000 gallons which, as with the Youth Pool, goes to waste and is replaced by water from the Metropolitan Water Board. The Goldhurst Pool is emptied each September for the winter and the Fairfax Pool is emptied for cleaning every 12 to 18 months. In all the filters after cleansing by "back-washing" it is necessary to form a new "bed" in the filter and for this purpose alum and soda are added to the water. The modern practice is to add the full amount of alum (about 15-20 lbs. for the big baths, and 5-6 lbs. for the Youth Pool) at one time and to add the soda intermittently over the period, the object being to maintain the chemical reaction of the water at a pH value of 7.6 to 7.8. Apart from treatment of the water by filtration the bacterial content of the water is controlled by the injection of chlorine. This is used in the form of chlorine gas which is supplied in cylinders under such pressure as to render the chlorine liquid. The injectors are Paterson Chloronames of 1930 pattern made by the Paterson Engineering Co.Ltd., which although old are very satisfactory in operation. One of the injectors is used for the Youth Pool and up to five injectors can be used for the two large baths. The concentration of 31 chlorine is kept as far as possible at two parts per million of water and the amount of chlorine is tested by the staff at frequent intervals, that is, about every two hours during the summer and rather less frequently in the winter. The maintenance of a regular concentration of chlorine presents some difficulty. The sudden influx of a large number of bathers on a hot day, particularly if the bathers are perspiring freely before they enter the water, can reduce the chlorine content to nil within a few minutes, whilst increasing the amount of chlorine much above the usual level in anticipation of large numbers of bathers can cause some discomfort, particularly a stinging feeling in the eyes. One cannot always correctly forecast the behaviour of the public, particularly as the number of bathers can be greatly altered by variations in our uncertain climate and although there have, from time to time, been some complaints due to excess of chlorine in the water, I feel sure that within limits the freedom of the water from organisms which might carry disease is of more importance than a possible temporary discomfort. Samples of water from the swimming baths are taken regularly for bacteriological examination and also for chemical analysis. The Colindale Laboratory of the Public Health Laboratory Service attach the following note to their reports:- "Swimming-bath water is exposed not only to faecal contamination but also to contamination with organisms from the skin and nasopharynx of the bathers. Therefore, it is recommended that:- 1. No samples from a bath should contain any coliform organisms in 100ml. of water. 2. In 75% of samples examined the 24 hour plate count at 37°C. from 1ml. of water should not exceed 10 colonies and the remainder should not exceed 100 colonies. (From: Report on Public Health & Medical Subjects-No.71 The Bacteriological Examination of Water Supplies-p.19)" The plate count at the Colindale Laboratory is carried out for two days which might slightly but not materially increase the number of colonies found in any sample. It is usual when taking samples of swimming bath water to take two samples at the same time from different parts of the bath. A summary of the reports is as follows:- A summary of tlie reports is as follows:- 32  Total Samples Plate Count No. of Samples containing coliform bacilli f Samples containing faecal coli 0-10 colonies 11-100 colonies more than 100 colonies Fairfax & Goldhurst Pools 40 30 7 3 - - Youth Pool 24 20 3 1 - - Two of the samples showing more than 100 colonies on the plate count were taken at the end of July and the other two in the group were taken early in August before the reports on the two previous samples had been received. Five of the samples showing more than 10 but less than 100 colonies were also taken either during this period or in the following week. The Public Analyst has reported on 24 samples submitted for chemical analysis, which are summarised as follows:- Parts per million Average Highest Lowest Total solids 835 1,014 564 Combined Chloride (as Cl) 277 394 128 Combined Chloride (as NaCl) 456 647 227 Free Chlorine 2.3 5.0 0.5 Free and Saline Ammonia 104 138 68 Albuminoid Ammonia 130 183 65 Oxygen absorbed from N/80 Permanganate for 3 hours at 98°F. 1.83 2.49 1.36 Nitrites Trace Trace Nil Nitrates Trace Trace Nil Reaction pH. 7.6 8.4 7.2 All the samples were reported as satisfactory Taut the Public Analyst commented on the very high free chlorine content in three samples. The present swimming baths have been considered unsatisfactory in some respects for many years and proposals were being considered for their replacement during the late 1930's. The war prevented any rebuilding but at the present time with the consent of the Ministry of Housing and Local Government, plans 33 are being prepared for the erection of a new public swimming bath on the Council's site at Swiss Cottage. Slipper Baths Slipper baths are provided at the Central Baths in Finchley Road and also at the two branch baths at Palmerston Road and at Flask Walk. At the Central, Baths there are 12 baths for women and there are 10 ordinary baths for men and 4 shower baths. The shower baths have become very popular and they account for approximately 35 per cent. of the men's trade. The Palmerston Road Baths and the Flask Walk Baths were originally provided by the Wells and Campden Trust in 1887. Early in this century they were leased to the Council at a nominal, rent. At Palmerston Road there are 14 slipper baths and two showers and at Flask Walk there are 8 slipper baths and two showers. In both cases the baths are used by men and women on alternate days. At all the establishments extra towels, soap and bath cubes can be obtained for an additional charge. The use of the baths has not decreased with the building of new flats and houses containing bathrooms or with the addition of bathrooms to existing houses, and this Is probably due to the very large number of people in Hampstead who occupy bed-sitting room or similar accommodation which is either without a bathroom or where the bath Is shared. The use of the slipper baths and showers runs at about 80,000 per year. Washhouses There is no public washhouse at the Central, Baths, the laundry being used for washing towels, etc. used at the swimming baths and in the Council's establishments. At the Palmerston Road Baths the washhouse is equipped with six electrically operated washing machines which were adapted to automatic control in 1959. Other equipment comprises five hydro-extractors (spin dryers) two tumbler dryers, 24 steam heated drying horses, 11 hand-washing stalls and two electrically powered mangles and facilities for Ironing clothes. The Flask Walk Baths has four electrically operated washing machines which are manually controlled, two hydroextractors, 16 steam heated drying horses, 16 hand-washing stalls, an electrically powered mangle and facilities for Ironing clothes. 34 The washing machines are the same in both establishments hut although the actual washing period is the same the operating cycle has been reduced by the automatic control at Palmerston Road from 41 minutes to 35 minutes. The machines will take up to 21 lbs. dry weight of clothes and in the ordinary way these are boiled during washing but the temperature can be reduced for woollen clothes, etc. It is thought that these washhouses provide a better service than the commerical "self-help" laundries using semidomestic type washing machines which normally will only take 9 lbs. dry weight of clothes and in which the clothes are not boiled. Gymnasia There is a permanent gymnasium at the Central Baths occupying what was previously a swimming pool but which became defective in 1937- There is the normal gymnastic equipment sufficient for school needs but it does not have specialised equipment. A second gymnasium is provided during the winter months over the Goldhurst Pool-which is, of course, closed for swimming during this season. The gymnasia are used by some 13 badminton clubs and one gymnastic club during the evenings. INSPECTION AMD SUPERVISION OF FOOD The year has marked the development of several new tendencies in food businesses such as the widening in the scope of the vending machine for both liquid and solid foods, the multiplication of self service stores; and a rapid extension in the retailing of poultry of the "ready for the oven" variety or "ready roasted". Whilst vending machines are limited in their application to the sale of milk and similar commodities which can be kept under refrigeration, no serious problems are likely to arise, but immediately solid foods are so dispensed a much stricter control of their fitness and quality will have to be exercised by frequent sampling for both chemical and bacteriological examination. The increase in the number of self service stores has meant that there is a much greater quantity of pre-packed foods, some of which is of a very perishable nature and liable 35 to contamination If not properly wrapped and displayed under suitable conditions, as frequent test sampling has demonstrated, Although there are obviously advantages both to the retailer and the public if perishable food is mass pre-packed under controlled conditions, there is the disadvantage that some of these foods deteriorate more rapidly when packed and any left unsold from one day to the next, although still displayed for sale, may be stale. The housewife Is less well able to judge what she is buying with the kind of wrapper which obscures the contents, but the use of transparent materials for wrapping is Increasing. The campaign which has been waged for years to encourage fish retailers to install closed fronts in their premises is now showing encouraging results and the open fronted fish shop is now in the minority. This is a big step forward in preventing the contamination of fish and poultry by road dust and reducing the nuisance from flies but It appears to be an Innovation which the public accepts with reservations since some housewives still expect to handle such foods before buying them. The very rapid Increase in the production of poultry for the table, particularly of the broiler variety, has not yet raised any serious local problems. It is not practicable to ensure the Inspection of every bird in the same way that every beef carcase can be examined and in addition it Is known that in the cooking of these birds the temperatures reached in deeper parts of the leg meat is insufficient to ensure sterilisation. In spite of this no case has been brought to the notice of the department of any poultry being unfit for human consumption. It is to be hoped that the producers are and will remain fully alive to their responsibilities not to distribute birds which when being dressed are found to have any condition which renders them unfit for consumption. Both spit and oven roasting of those birds by retailers is now quite common and where this is done the premises must be registered. Many premises not previously liable to registration will thus be brought under greater supervision by the inspectors. Chemical Sampling of Foods The general aim has been to check the greatest possible variety of foods on sale. Greater attention has been given to those foods which have in past years been found to be 36 unsatisfactory in some respect, but the Public Analyst found little of a serious nature to criticise. Some imported products have been unsatisfactory on account of there being different standards and labelling requirements in the countries of origin. It would appear in some instances that the matter could best be dealt with at a higher level prior to import licences being granted. In only very few instances were "foreign bodies" found in foods and bearing in mind the great increase in the use of machinery in its preparation and handling, great credit is due to the producers for developing preventive methods and detecting the presence of alien materials. None of these methods can be expected to be completely effective but pressure is continually being exerted to ensure that they are as perfect as human ingenuity can devise. In the case of bottled milk, it would appear at the present time that the only complete answer to the problem of the dirty bottle is the extension of the use of the expendable container and it is understood that development work on the numerous problems which a change to this system would involve are well advanced. Perhaps the greatest deterrent to such a change is the efficiency of the present system. In Hempstead, the number of complaints received is in the region of one for every 5,000,000 bottles of milk sold and in almost all the cases complained of, the consumption of the milk would not have had. any ill effects. 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:- Milk, cream, yoghurt, condensed milk, butter, margarine 27 Cheese, cheese spread 31 Soups 3 Meat products, meat 77 Fish, shell fish, fish products 42 Sauces, pickles, flavourings, oil, etc. 65 Vegetables, fruit 63 Nuts 8 Puddings, cake, bread, flour products 34 Fruit juice, drinks 14 Beverages 13 Wines and spirits 42 Liqueur chocolates, brandy butter, rum butter 8 Sugar 2 37 Suet 2 Creamed rice 3 Herbal preparations 7 Jam, honey 16 Confectionery 9 Ice cream, ice lolly, ice cream mix 17 Miscellaneous 18 501 All the samples of milk proved satisfactory, the average milk fat content being 3.53 per cent. The legal minimum is 3 per cent. There were 26 adulterated or unsatisfactory samples, details of which are given in the Statistical Summary. Food Hygiene Regulations, 1955 Whilst it is necessary to exercise constant vigilance to ensure that the Food Hygiene Regulations are observed the food traders in the Borough have been most cooperative and any breach which has been brought to their notice has almost invariably been dealt with at once. An exception was a greengrocer's assistant who was repeatedly warned against smoking in food premises and was finally prosecuted and fined £7.0s.0d. with £2.2s.0d. costs. Cautionary letters have also been sent to other offenders in respect of smoking infringements. It is perhaps worth mentioning that the general attitude towards smoking is somewhat inconsistent, Smoking is a bad habit with few redeeming features. We discourage the young from smoking but persist in it ourselves. A food handler may not smoke whereas the customer may do as he pleases, although it is well known that a food handler who smokes is far more dangerous to himself than to the person to whom he sells food. The Government is well aware of the dangers of smoking to the health of the public now and in the future, but for financial or for other reasons has done nothing to discourage smoking except to impose a tax on tobacco which is so high as to cause grumbles but not high enough to deter. It is unlikely that there will be any major change in habits whilst the present scale of advertisements and inducements to smoke persist, but it is to be hoped that it will gradually be accepted by the public that smoking is a private vice which should be indulged in privately and that public and open acknowledgment of it is to be deplored. 58 One class of traders who present great difficulties are the unlicensed street traders. Many of them sell fruit and vegetables and they are adept in the art of avoiding the consequencies of breaches of the Regulations. On the approach of "authority" in the person of the police or the public health inspectors they brush off their customers and push their barrows along the road with an air of triumphant innocence or with a justifiable faith in the honesty of the public disappear leaving their barrows behind until the "trouble" has departed. They cause a great deal of nuisance by the indiscriminate dumping of vegetable refuse, their general standard of personal hygiene is poor, and it is a matter of the utmost difficulty to obtain the necessary evidence for the purpose of prosecution for offences. Bacteriological Sampling of Foods The food inspector, Mr. W.F. Newport, has again taken a large number of samples of cooked meats for bacteriological examination. These have been obtained from premises representing a fair cross section of those selling such food in the Borough. Since the inception of the Food Hygiene Regulations this has now become a routine measure which has been adopted in order to obtain information as to the relative merits or demerits of various methods of the display and handling of food, particularly susceptible to contamination and the spread of food poisoning organiams„ Analysis of the results has demonstrated the great value of adequate refrigeration and screening and adverse reports have helped considerably in persuading vendors to expend considerable sums of money in providing refrigerated displays and Improving the screening and handling of foods. Many premises still display "open" foods under unsatisfactory conditions, either in the windows or on shelves or shop counters, and it is hoped gradually to improve the standard of display throughout the Borough. It should, of course, be borne in mind that these adverse reports must only be regarded as an index of unsatisfactory conditions at some point in the production, display and handling of these foods, since in no case did the bacteriologist find harmful organisms which rendered them unfit for consumption. Once again, I am indebted to Dr. Betty Hobbs of the Central Public Health Laboratory, Colindale, for many helpful 39 suggestions and for her continued assistance in this campaign to make exposed foods less liable to contamination. Food Poisoning Food poisoning notifications have tended to rise but investigations have not shown in any single family case that infection was caused by food which, at the time of its purchase, was bacteriologically or chemically unfit for consumption, which reflects considerable credit on the retailers. Careless handling or improper storage or cooking in the house appear to be the root causes of these foods becoming inoculated with pathogenic organisms and their development to such a degree as to produce food poisoning symptoms. Two outbreaks of food poisoning occurred in other Boroughs and some of the persons affected were found, after some days had elapsed, to reside in Hampstead and still to be infected, although no notifications in respect of these had been received. It is to be regretted that there is often delay in the notification of food poisoning and this makes it difficult, and at times impossible, to trace the source of infection and thereby control its spread. Unsound Food Seizure of foods unfit for consumption is almost a thing of the past. The food retailers in the Borough generally provide a very good service for their customers and no doubt appreciate that their prosperity depends on the quality of the food they sell and the service they give. Quite apart from this, they have now realised that by deliberately selling foods which might be unfit, not only do they make themselves liable to heavy fines, but sacrifice the good relationship which has grown up between themselves and the inspectors, whose advice and help they are continually seeking. They, therefore, now usually submit for examination any foods of which they are in doubt and willingly surrender anything which is considered unfit. By this method they are generally able to obtain credit for the condemned foods and the interests of the public are protected. Where possible, unsound food 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. 40 Hampstead Heath Fairs, Catering Hygiene As usual, the Food Inspector and other members of the Public Health Department staff were on duty throughout the various Bank Holiday periods when the fairs were in action. Intensive sampling of food is undertaken, no less than 84 samples being submitted for bacteriological examination and 51 for chemical analysis. On the whole, the results have been most satisfactory and indicate that the continued pressure exercised by the department is not without effect so far as the purity and wholesomeness of food are concerned. A small supply of coconuts offered as prizes was found to be unsound and was surrendered at the Inspector's request. Very little "loose" ice cream is retailed and the average fat content of the ice cream samples taken was 13.5 per cent. compared with the legal requirement of 5 per cent. Shellfish, cockles, mussels, whelks and oysters, which are so popular with the holiday crowds were found to be bacteriologically satisfactory but some samples indicated the need for Improvement from the cleanliness aspect. Underground Bakehouses The one certified underground bakehouse now remaining in the Borough continues to function and is regularly visited by the Public Health Inspector. Meat There are no slaughterhouses in the Borough. All the butchers shops are regularly inspected. Ice Cream Eleven 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 247. Fourteen samples of ice cream were examined by the Public Analyst, The average fat content was 11.75 per cent.; the lowest fat content was 7.39 per cent. Bacteriological examination was made of 29 samples, of which 5 were unsatisfactory and appropriate action was taken. 41 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, cafė. STAFF The Deputy Medical Officer of Health, Dr. G.M. Frizelle, resigned his appointment at the end of 1958 and the Council appointed. Dr. M. McQuaid to fill the vacancy. Dr. McQuaid devotes four sessions per week to the work of the Borough Council and the remaining seven sessions to the London County Council. In view of the increasing amount of work to he done on the repair of houses and work in connection with the granting of loans for house purchase and grants for improvements, the Council increased the establishment of public health inspectors from 12 to 13. To fill the vacancy Mr. A.M. Norton who had previously been a student inspector from 1st January, 1958 was appointed. Mr. D.G. Ring also took the examination and qualified as a public health inspector later in the year, but as there was no vacancy on the establishment he applied for and obtained a post as inspector with the Edmonton Borough Council. The two vacancies for students were subsequently filled to maintain the establishment of three. 42 STATISTICAL SUMMARY Area of Borough 2,265 acres Registrar General's estimate of Population mid-1959 96,810 Estimated Population of Children 30th June, 1959:- Under 1 1-4 Total under 5 5-14 Total under 15 1,560 4,340 5,900 8,700 14,600 Rateable Value March, 1959 £2,146,462 Sum produced by 1d. rate £8,583 No. of separate rating assessments of dwelling houses 23,357 No. of structurally separate dwellings, Census 1951 23,010 No. of private households, Census 1951 35,970 Live Births: Legitimate: Males 759. Females 692) Illegitimate: " 85. " 86)Total 1,602 Live birth rate per 1,000 population 16.5 Illegitimate live births per cent. of total live births 10.7 Area Comparability Factor 75 Adjusted birth rate 12.4 Still-births (Males 16; Females 10) 26 Still-birth rate per 1,000 live and still-births 16 Total live and still-births 1,628 Infant Deaths (Males 23; Females 13) 36 Neo-natal deaths (first four weeks of life)(M.l6; F.10) 26 Early Neo-natal deaths (first week of life)(M.13; F.8) 21 Infant Mortality Rates: All Infants per 1,000 live births 22 Legitimate Infants per 1,000 legitimate live births 21.7 Illegitimate infants per 1,000 illegitimate live births 29.2 Neo-natal deaths per 1,000 live births 16.2 Early Neo-natal deaths per 1,000 live births 13.1 Perinatal Mortality Rate (Stillbirths & deaths under 1 week per 1,000 live and still-births) 28.9 Maternal deaths (including abortion) Nil Maternal mortality rate per 1,000 live and still-births Nil Deaths: Males 493; Females 558 Total 1,051 Death rate per 1,000 population 10.9 Area Comparability Factor 1.0 Adjusted death rate 10.9 43 Year Population Birth Rate Death Rate Infant Mortality Rate Maternal Mortality Rate 1900 81,230 20.0 11.3 104 2 1905 83,430 16.1 9.5 94 4 1910 85,210 14.0 8.6 60 1 1915 81,760 15.3 12.1 76 4 1920 91,519 17.1 9.4 48 2 1921 86,890 15.4 11.2 65 3 1922 86,920 14.8 11.1 56 5 1923 87,410 14.1 10.8 42 3 1924 87,600 13.5 11.7 56 3 1925 88,040 12.2 10.5 55 5 1926 87,530 12.3 10.6 60 3 1927 86,160 11.9 12.2 51 5 1928 85,880 11.6 11.6 54 6 1929 84,830 11.4 13.5 54 5 1930 84,830 11.8 11.5 58 6 1931 87,740 11.2 11.7 61 2 1932 90,130 10.9 11.6 54 2 1933 90,380 9.6 11.0 38 Nil 1934 90,000 10.4 11.3 53 4 1935 90,600 11.0 11.2 49 1 1936 90,700 11.5 11.3 66 3 1937 90,690 11.2 11.6 54 3 1938 90,480 11.7 11.4 57 1 1939 90,170 10.9 11.6 38 1 1940 71,520 11.1 16.2 49 5 1941 58,760 10.9 15.9 59 1 1942 63,240 14.5 14.2 49 5 1943 69,320 16.6 14.3 43 2 1944 69,840 16.1 14.6 62 1 1945 74,390 16.2 13 A 42 2 1946 89,720 17.4 11.8 36 1 1947 95,650 18.1 11.2 29 2 1948 95,480 15.7 10.3 29 1 1949 97,090 14.7 10.5 29 2 1950 97,400 15.5 10.0 19 1 1951 97,750 14.5 H.5 27 l 1952 97,700 14.9 11.2 24 Nil 1953 97,970 14.5 11.8 16 1 1954 98,210 14.7 9.1 17 1 1955 97,710 14.1 10.0 17 Nil 1956 97,580 15.1 10.5 23 1 1957 97,130 15.4 10.5 18 1 1958 96,480 15.5 11.1 21 Nil 1959 96,810 16.5 10.9 22 Nil 45 CAUSES OF DEATH 1959 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 - - - - 2 2 1 - 2 - - - - - 2 - - 7 Tuberculosis other - - - - - - - - - 1 - - - - - 1 - - 1 Syphilitic disease 5 - - - - 1 2 2 - 2 - - - - - 1 - 1 7 Diphtheria - - - - - - - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - - - - - - - Meningococcal infections l - - - - - 1 - - - - - - - - - - — 1 Acute poliomyelitis l - - - - 1 - - - - - - - - - - - - 1 Measles - - - - - - - - - - - - - - - - - - - Other infective and parasitic diseases 2 - - - - 1 - - 1 1 - - - - - 1 - - 3 Malignant neoplasm, stomach 11 - — - - - 5 3 3 13 - - - - - 2 5 6 24 Malignant neoplasm, lung, bronchus 31 - - - - 1 19 7 4 7 - - - - - 1 6 - 38 Malignant neoplasm, breast - - - - - - - - _ 1 24 - - - - 2 10 5 7 24 Malignant neoplasm, uterus - - - - - - - - - 14 - - - - - 6 6 2 14 Other malignant and lymphatic neoplasm 57 - - 1 - 4 20 17 15 58 - - - - 5 16 15 22 115 Leukaemia, aleukaemia 5 - - 2 - - - 3 - 4 - - - - 1 2 - 1 9 Diabetes 3 - - - - - 2 1 - 5 - - - - - - 2 3 8 Vascular lesions of nervous system 31 - - - - 3 7 ll 10 58 - - - - - 6 16 36 89 Coronary disease angina 114 - - - - 3 41 37 33 107 - - - - 2 11 32 62 221 Hypertension with heart disease 8 - - - - - - 3 5 14 - - - - - 1 5 8 22 Other heart disease 24 - - - - 2 6 5 11 56 - - - - 2 7 ll 36 80 Other circulatory disease 26 - - - - - 6 10 10 21 - - - - - 4 1 16 47 Influenza 6 - - - 1 - l 1 3 13 1 - - - 1 3 3 5 19 Pneumonia 24 2 1 - - - 4 4 13 27 1 - - - - 1 5 20 51 Bronchitis 41 2 - - - - 8 12 19 23 - - - - 1 2 3 17 64 Other diseases of respiratory system 5 - - - - - 2 2 1 5 - - - - - 1 - 4 10 Ulcer of stomach and duodenum 11 - - - - 1 2 5 3 8 - - - - - 1 4 3 19 Gastritis,enteritis and diarrhoea 5 1 - - - - 2 - 2 2 1 - - - - 1 - - 7 Nephritis and nephrosis 2 1 - - - - 1 - - 4 - - - - 1 1 2 - 6 Hyperplasia of prostate 8 - - - - - - 1 7 - - - - - - - - - 8 Pregnancy,child birth,abortion — - - - - - - - - - - - - - - - - - - Congenital malformations 3 2 - - — 1 - - - 3 1 - - 1 1 - - - 6 Other defined and illdefined diseases 39 15 - - 1 1 7 10 5 56 9 - 1 1 5 8 8 24 95 Motor vehicle accidents 2 - - - 1 - l - - 4 - - ~ - - 1 1 2 6 All other accidents 9 - - - - 2 4 - 3 15 - - - - 2 4 1 8 24 Suicide 14 - - - - 6 6 1 l 11 - - - - 4 4 3 - 25 Homicide and operations of war - - - - - - - - - - - - - - - - - - - TOTAL:- 493 23 1 3 3 29 149 136 149 558 13 - 1 2 27 98 134 273 1051 46 INFECTIOUS DISEASE DISEASE Notifications Removed to Hosp. 1959 Deaths 1959 1955 1956 1957 1958 1959 Diphtheria - - - 1 l 1 - Dysentery 32 35 26 60 79 34 - Encephalitis: Acute Infective 1 2 1 - - - - Post Infectious 3 2 - 1 1 1 - Erysipelas 7 7 13 5 8 2 - Food Poisoning 56 15 10 15 26 3 - Malaria - - 1 - - - - Measles 1028 243 829 706 344 19 - Meningococcal Infection 2 2 - l 2 2 1 Ophthalmia Neonatorum: Hampstead residents 1 4 8 6 11 10 - Non-residents - 3 19 3 14 14 - Paratyphoid Fever - - - 1 - - - Pneumonia 53 54 48 40 47 12 1 Poliomyelitis:Non-Paralytic 28 - 4 - 3 3 - Paralytic 9 2 11 2 2 2 1 Puerperal Pyrexia: Hampstead residents 22 14 26 30 19 17 - Non-residents - 31 59 39 34 34 - Scabies 26 25 13 13 17 - - Scarlet Fever 23 32 55 51 37 5 - Typhoid Fever 4 1 3 2 5 4 - Whooping Cough 114 94 109 21 37 13 - TOTAL: 1409 566 1235 997 687 176 3 TUBERCULOSIS Age Periods Respiratory Non-Respiratory New Cases Deaths New Cases Deaths M F M F M F M F 0 1 1 - - - - - - 1 1 - - - - - - - 5 2 1 - - - 1 - - 15 9 10 - - 1 2 - - 25 27 13 2 - 1 - - - 45 15 9 2 2 - 1 - 1 65 3 1 1 - - - - - 75 - - - - - - - - TOTAL: 58 35 5 2 2 4 - 1 47 FOOD POISONING Cases Notified Otherwise Ascertained Total Cases Deaths 1st Quarter 2 - 2 - 2nd Quarter 9 2 11 - 3rd Quarter 10 - 10 - 4th Quarter 5 3 8 - Particulars of Outbreaks No. of Outbreaks Family Other Cases Notified Otherwise Ascertained Total Cases Agent identified 3 2 6 5 11 Agent not identified 1 - 2 - 2 Single Cases Cause Cases Notified Otherwise Ascertained Total Cases Salmonella Typhimurium 7 - 7 Salmonella Newport 1 - 1 Cholerae-Suis 1 - 1 Virchow 1 - 1 Not Identified 8 - 8 Salmonella Infections not Food-borne NIL BACTERIOLOGICAL EXAMINATIONS (Infectious Diseases) Throat/Nose Swabs: No. of Examinations Diphtheria Bacilli found Nil Haemolytic Streptococci found 15 Vincent's Angina Organisms found 4 Negative 52 Faeces: Shigella found 47 Salmonella found 30 Clostridium Welchii found 1 Negative 252 401 48 HAMPSTEAD BOROUGH COUNCIL CLEANSING CENTRE Verminous Conditions Scabies Cases Treatments Cases Treatments Adults 9 10 7 15 Children under 5 2 2 2 5 Children over 5 - - - - Contacts 1 1 - - L.C.C. School Children 23 23 - - London County Council (General Powers) Act, 1953 Persons cleansed at home Nil DISINFECTION AND DISINFESTATION No. of calls by borough van 6,876 No. of articles passed through steam chamber 7,086 No. of rooms disinfested after vermin 305 No. of rooms disinfected after infectious disease 136 No. of rooms cleansed after death or removal 26 Parcels of clothes for despatch abroad 165 PUBLIC HEALTH LAUNDRY A twice weekly service is in operation and 1,750 bags of laundry have been dealt with during the year. The number of calls made by the van was 2,801. Articles laundered: Draw Sheets 3,122 Shirts 221 Sheets 2,072 Vests 607 Blankets 230 Towels 1,306 Pillow-cases 1,641 Pants 400 Nightdresses and Pyjamas 1,967 Miscellaneous 309 Total Articles 11,875 The number of people using the laundry service has varied from 24 to 34 per month. 49 PUBLIC MORTUARY, NEW END Bodies admitted by order of:- Coroner 195 Ambulance 34 Police 6 Marie Curie Hospital 4 Public Health Department 2 241 Causes of death:- Natural Causes 182 Suicides:- Coal Gas Poisoning 15 Hanging 4 Drugs 6 Falls 2 Drowning 1 Corrosive Poisoning 2 Cut Throat 1 Shooting 1 Electrocution 1 33 Accidental:- Drowning 2 Drugs 1 Burns 2 Railway 2 Falls 3 Road Accidents 5 15 Post Operative 7 Stillborn 1 Bodies brought for accommodation 5 241 No. of post mortem examinations carried out 237 Of the 241 bodies admitted to the Mortuary, 158 were of Hampstead residents. 50 PUBLIC HEALTH INSPECTION Inspections: Housing defects 8l6 Housing (Financial Provisions) Act, 1958 Loans for house purchase 154 Improvement grants 65 Housing Act, 1957 Repair of unfit houses 35 Demolition and closing orders 10 Overcrowding 39 Rent Act, 1957 Certificates of Disrepair, etc. 30 House-to-House 43 Underground rooms (other than closing orders) 54 Accumulations of refuse 166 Dustbins 55 Nuisance from trees 12 " " bonfires 26 Improper keeping of animals 6 Noise 25 Smoke (Timed observations) 162 Other nuisances 186 Re-Inspections: 6,576 Inspections: Schools 7 Public buildings, Hospitals, etc. 7 Clubs, Institutions, etc. 9 Offices, Business premises 10 Bombed site or open space 7 Mews or Stable Yard 65 Private Roads or Passageways 16 Re-inspections: 519 Inspections: Drainage work: Under Notice 24 Voluntary 426 Installation of Heating Apparatus 207 Housing Applications 369 Aged or Infirm Persons 207 Infectious Disease 252 Special Surveys: Smokeless Zones 5,858 Overcrowding 466 Infestations: Rodent 202 Other 405 Re-inspections: 6,589 51 Inspections: Foodshops 968 Shops other than foodshops 24 Shops Act 96 Merchandise Marks Act 36 Hairdresser 39 Pet Animals 5 Pharmacy & Poisons 5 Rag Flock 1 Fairground 15 Re-Inspections: 2,091 Lectures 17 Total complaints received 1,404 Informal. Notices (verbal notice, letter) 219 Intimation Notices served 339 Statutory Notices served 137 Attendances at Court or Inquiries 23 FACTORIES ACTS, 1937 to 1959 No. on Register Inspections Re-inspections Written Notices Factories in which Ss.1,2, 3,4 and 6 are to he enforced by local authority 205 154 57 12 Factories not Included above in which S.7 is enforced by the local authority 377 202 363 44 Other premises in which S.7 is enforced by the local authority (excluding outworkers premises) 4 4 3 - TOTAL:- 586 360 423 56 No prosecutions were undertaken during the year. 52 Defects Found Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of Cleanliness (S.l) 24 24 - - Overcrowding (S.2) 2 2 - - Unreasonable temperature (S.3) - - - - Inadequate ventilation (S.4) 1 1 1 - Ineffective drainage of floors (S.6) 1 1 2 - Sanitary conveniences (S.7) (a) Insufficient 4 4 - 1 (b) Unsuitable or defective 27 27 - 3 (c) Hot separate for sexes 2 1 - 1 Other offences against the Act (Not including offences relating to outworkers) 2 2 1 - TOTAL:- 63 62 4 5 No prosecutions were undertaken during the year. OUTWORKERS No. of Hampstead firms making return 17 Total Outworkers notified by Hampstead firms 223 Outworkers resident in Hampstead (included in above) 49 Outworkers notified to us from other boroughs 108 Visits paid by Public Health Inspectors 83 Classes of work In which No. of Outworkers are employed Outworkers Wearing Apparel - making etc. cleaning and washing 84 Household linen 2 Curtains and furniture hangings 3 Furniture and upholstery 1 Artificial flowers 8 Paper bags 2 Making of "boxes or other receptacles or parts thereof made wholly or partially of paper 1 Feather sorting 1 Carding, etc. of buttons, etc. 2 Stuffed toys 12 Basket making 9 Cosaques, Christmas stockings, etc. 28 Lampshades 4 TOTAL:- 157 There were no cases of default in sending lists to the Council and no instances of work in unwholesome premises. No notices were served or prosecutions undertaken. 55 PET ANIMALS ACT, 1951 New Licences issued 1 Licences discontinued 1 Licences renewed 3 Visits by Public Health Inspectors 5 PHARMACY & POISONS ACT, 1955 New Licences issued 5 Licences renewed 93 Ceased to sell poisons or removed 8 No. on Register at end of year 98 Visits by Public Health Inspectors 5 EXAMINATION OP WATER FROM SWIMMING BATHS Satisfactory Unsatisfactory Chemical Analysis 21 1 Bacteriological Examination 58 6 EXAMINATION OF SUB-SOIL WATER One sample of water from a basement was examined after a complaint of defective drainage and found to be sub-soil water. DRINKING WATER One sample of tap water was submitted for chemical analysis and four samples for bacteriological examination. All were satisfactory. LEGAL PROCEEDINGS Date of Hearing Nature of Offence Result of Proceedings 12. 6.59 Goldhurst Terrace. Smoking whilst handling food. Fined £7. 0s. 0d. Costs £2. 2s. 0d. 30.10.59 Belsize Avenue. Failing to prevent nuisance from dust in demolition of buildings; failing to erect a hoarding. Fined £25. 0s. 0d. Costs £5. 0s. 0d. 54 FOOD PREMISES The total number of food shop premises is 838. There are 316 shops with multiple trades and for the purposes of the following table these have been entered once under each type of trade carried on. No. on Register Primary Inspections Baker 37 68 Butcher 86 47 Canteens and Clubs 57 8 Confectioner 128 52 Delicatessen and Grocer 198 155 Fishmonger 25 19 Fried Fish 6 5 Greengrocer 85 78 Ice Cream 247 64 Milkshop and Dairy 64 46 Off Licence k6 15 Public House 53 26 Restaurant 125 82 Street Trader or Stallholder 55 295 Chemists 28 Factory 5 19 Herbalist 2 Fairground 1 1,242 957 In addition, 2,091 revisits were paid to shops (including shops other than foodshops). PREMISES REGISTERED UNDER SECTION 16, FOOD & DRUGS ACT, 1955 Ice Cream Potted, pressed, pickled or preserved food Confectioners and Tobacconists 76 Butchers 2 Grocers and Delicatessen 12 Fishmongers 5 Grocer & Delicatessen 55 Garages 1 Provisions 4 Restaurants 41 Bakers 8 Butchers 34 Dairies 21 Florists 1 Factory 2 Stores 6 Kiosks & Stalls 5 Fried Fish 6 Off Licences 2 Club 1 TOTAL:- 58 Patisserie 1 TOTAL:- 247 Greengrocers 22 55 BACTERIOLOGICAL EXAMINATION OF FOOD Nature of sample No. of Samples Satisfactory Unsatisfactory Candy floss 1 1 Custard tart 1 1 Cooked meats 77 35 42 Shellfish 40 34 6 Herring tidbits 1 1 Ice cream and lollies 29 24 5 Lemonade, cordials, etc 6 6 Milk 18 18 Pies 8 7 1 Rolls and sandwiches 6 2 4 Salads 3 2 1 Sausages 3 2 1 Toffee apples 1 1 Veal stew 2 2 Wedding cake and constituents 4 4 200 140 60 A note on the bacteriological examination of food appears on page 58. MILK SUPPLY Milk (Special Designation) Regulations Dealers (Premises In Hampstead) Supplementary (Premises outside Hampstead) No, of milk sellers 64 31 Licences Issued:- Pasteurised 55 27 Tuberculin Tested k2 27 Sterilised 57 50 Milk Examination Methylene Blue and Phosphatase Tests Chemical Analysis Pasteurised 16 6 T.T. Pasteurised 2 - All the samples were satisfactory. Owing to the very warm, weather during the summer it was not always possible to obtain an accurate methylene blue test. Average milk fat content 3.53 per cent. (legal minimum 3 per cent.) 56 ADULTERATED OR UNSATISFACTQRY SAMPLES Article Offence How dealt with Superb creamery cheese False description Letter to manufacturers Label amended. Raspberry syrup Fermenting Withdrawn from stock. Herbal bitter tonic Exaggerated claims Referred to Pharmaceutical Society. "The Blessed Root" (Mukomis) do. do. Elixir of Life Plant do. do. Milk bottle containing foreign matter Bottle contained soap Producers warned. Sugar containing green colouring matter Colouring found to be harmless Complainant informed accordingly. Pickled gherkins Undeclared preservative Label amended. Curry paste Excessive preservative Stocks withdrawn. Letter to importers. Katrella (pickle) do. do. Chilli pickle do. do. Prawn balchov do. do. Pure lemon drink: (2 samples) Deficient in fruit Juice Vendor warned. Currant loaf Contained rabbit pellet Producer warned. Boldo slimming tablets Unsatisfactory label. Producer warned. Label amended. Double cream cheese Deficient in fat Distributor warned. 57 ADULTERATED OR UNSATISFACTORY SAMPLES - continued Article Offence How dealt with Sild (2 samples) Contained prohibited preservative Stocks withdrawn and surrendered. Raspberry cordial Deficient in sugar and fruit juice Retailer warned. Gin (2 samples) Added water Formal sample taken. Satisfactory. Whisky do. do. Carambola in syrup Tin contamination Stocks surrendered. Bottle of milk Contained mortar on base Warning letter sent. Vienna loaf Contained glass do. UNSOUND FOOD Ninety-nine unsound food certificates were issued covering the following items:- Butter and margarine 148 lbs. Cereals 7 pkts; 3 tins Cheese 1 tin Coffee 1 tin Coconuts 50 Fish 3 stone; 222 tins Flour 9 bags Fruit 15 trays; 42 lbs; 718 tins Jam 63 jars Meat products, meat, etc. 1484 lbs; 130 tins Chickens 31 Milk 30 tins Oriental fruits, pickles, spices, etc. 194 tins Puèes 48 tubes; 1 tin Soups 27 tins Sweets 11 boxes; 6l bars; 73 pkts. Vegetables 184 tins 58 HOUSING Dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,329 Dwelling-houses (included in above) which were inspected and recorded under the Housing Consolidated Regs. 1925-1932. (House-to-House inspection) 43 Dwelling-houses found to he in a state so dangerous or injurious to health as to he unfit for human habitation 9 Dwelling-houses found not to be in all respects fit for human habitation 558 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 and 55, Housing Act, 1957 1 Parts of Buildings closed 8 Persons displaced 21 Families displaced 10 Unfit Houses made fit and Houses In which Defects were Remedied By Owner By Local Authority After informal, action by local authority £58 NIL After formal notice: Public Health Acts 101 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 59 OVERCROWDING Dwellings Families Adults Children On register 31.12.58 178 178 461 264 New cases 1959 39 39 90 75 217 217 551 339 Rehoused 1959 5 5 13 8 On register 31.12.59 212 212 538 331 CERTIFICATES OF DISREPAIR Applications for certificates 11 Applications withdrawn or cancelled NIL Certificates refused NIL Authority to issue certificates - (a) in respect of some hut not all defects 5 (b) in respect of all defects 6 11 Undertakings given by landlords 5 Undertakings refused NIL Certificates issued 6 Applications for cancellation of certificates 7 Objections by tenants to cancellation of certificates 2 Decisions to cancel in spite of tenants objection 2 Certificates cancelled 7 HOUSING ACT, 1957. SECTION 9 Repair of Insanitary Houses Primary Inspections were made of 43 premises by the Public Health. Inspectors under this section. REHOUSING Visits and revisits in connection with the investigation of 315 rehousing applicants 81)0 No. of reports submitted to Hampstead Housing Manager 300 No. of reports submitted to Other Boroughs 15 60 THE CARE OF THE AGED Agencies concerned with the Care of the Aged Hampstead Old People's Welfare Association, Secretary - Miss 0. Courtney Jones, 107 Kingsgate Road, N.W.6. MAI 3652 Hampstead Council of Social Service Burgh House, New End Square, N.W.3. BAM 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, 30 Boston Square, N.W.I.- for N.W.3.area only EUS 6451 122/6 Kilburn High Road, N.W.6.- N.W.6 and N.W.2 area 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.I. 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. SAM 7171 61 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 hometound old people. The hooks 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 Palmers ton Road, free of charge. Homes. Information may be obtained from the Medical Officer of Health, 98a, Avenue Road, N.W.3* the Hampstead Old People's Welfare Association, 107 Kingsgate Road, N.W.6 or the Old People's Homes Committee, 296 Vauxhall Bridge Road, S.W.1. VIC 9977. Workshops for the Elderly, 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 farther 62 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. Wednesdays 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. Wednesdays 2-4 p.m. Brondesbury Fellowship Club, 107 Kingsgate Road, N.W.6. Daily 2-5 P.m. Good Companions Club, Burgh. House, New End Square, N.W.3. Mondays 5-8 p.m. Good Neighbours Club, 51 Belsize Square, N.W.3. Wednesdays 2.30 - 5 P.m. Burgh House Club, Burgh House, New End Square, N.W.J. Daily 2-7 P.m. Friendship Clubs - Belsize Club, 22 Eton Villas, N.W.3. Monday afternoons. The Synagogue, Pennington Park Road, N.W.6. Thursday afternoons. The Broadhurst Club, Monday and Wednesday Levine House, evenings. Broadhurst Gardens, N.W.6. Congregational Church Hall, Lyndhurst Road, N.W.3. Thursday afternoons. 63 LOUDON COUNTY COUNCIL, DIVISION 2. PUBLIC HEALTH DEPARTMENT Divisional Medical. Officer: H. Leslie Oldershaw, M.D.,B.S.,D.P.H. 313 Harrow Road, W.9. CUN 4815. Hampstead. Sub-Office: 251 Finchley Road, N.W.5. 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 Parkhill 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 Finchley Road, N.W.3. Maternity and Child Welfare Centres 60 West End Lane, N.W.6. MAI 5581 2 Parkhill Road, N.W.3. GUL 4759 Hampstead Wells, Christchurch Hill, N W.3. HAM 9554 5/5 Daleham Gardens, N.W.3. SMI 3424 9 Solent Road, N.W.6. HAM 5978 Welfare Foods (National dried milk, orange juice, cod liver oil, etc.) are obtainable from these centres. School Treatment Centres Kilburn Treatment Centre, 107 Kingsgate Road, N.W.6. MAI 3005 Dental Clinic, Lithos Road, Finchley Road, N.W.6. HAM 4765 Speech Therapy Centre Welfare Centre, 60 West End Lane, N.W.6. MAI 5381 Immunisation and Vaccination Clinics Diphtheria Immunisation 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. 60 West End Lane, N.W.6. on Tuesdays 10-11 a.m. Diphtheria and Poliomyelitis immunisation of babies can also be dealt with at the Maternity 8s Child Welfare Centres by arrangement. 64 Hampstead Bathing Centre, Lithos Road, N.W.3. HAM 7171 Domestic Help Service Home Help Organiser, 251 Finchley Road, N.W.3. HAM 4136 District Nursing Associations Hampstead District Nursing Association, 3 Pond Street, N.W.3. HAM 6406 Kilbura & W. Hampstead District Nursing Assoc., 20 Dennington Park Road, N.W.6. HAM 4232 For detailed Information on the following subjects application should he 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. 65 INDEX PAGE Accidents 12 Aged Persons: Care of the Aged 17,60 Cleansing of48 Laundry Service 17,48 Area of Borough 42 Area of Comparability Factors 42 Atmospheric Pollution 25 Bacteriological Examinations: Food 38,55 Infectious Disease 47 Swimming Bath. Water 29,53 Bakehouses 40 Barbers and Hairdressers 19,51 Bathing Centre 48 Baths, Old Persons 48,6l Births, Birth Rate 11,42 British Red Cross Society 60 Burials 16 Catering Hygiene 34,40 Certificates of Disrepair 50,59 Certificates of Suitability 40 Chemical Analysis: Food 35,56 Swimming Bath Water 29,53 Chiropody Service 6l Clean Air Act, 1956 25 Cleansing Station 48 Clearance Areas 20,58 Clinics 63 Closing Orders 58 Clubs, Old Persons 62 Common Lodging Houses 20 Camplaints 50 Contamination of Food 56 Cooked Meats 41,54 Council Representatives on other Organisations 9 Darby and Joan Clubs 62 Day Nurseries 63 Deaths: Chief Causes 11,44 Death Rate 11,42 Infant Mortality 12,42 66 PAGE Maternal Mortality 42 Mortuary 49 Suicides 12,49 Demolition Orders 58 Dinner Clubs 6l Disinfection and Disinfestation 17,48 District Nursing Associations 64 Division 2, London County Council 63 Divisional Health Committee 9 Domestic Help Service 64 Drainage 50 Dwellings: Rate Assessments 42 Structurally Separate 42 Factories Acts: Inspections 51 Outworkers 52 Underground Bakehouses 40 Fair, Hampstead Heath 40 Food: Adulterated Samples 56 Bacteriological Examination38,55 Bakehouses, Underground 40 Chemical Analysis 35,56 Cooked Meat Premises 41,54 Food Hygiene at Hampstead Heath Fair 40 Food Hygiene Regulations 37 Ice Cream 40,54 Inspections 34,54 Milk 36,55 Premises 34,51,56 Sampling 35,56 Unsound Food 39,57 Food Poisoning 39,47 Foot Clinics 6l Hairdressers and Barters 19,51 Hampstead Council of Social Service 60 Hampstead Heath Fair 40 Hampstead Old People's Housing Trust Ltd. 60 Hampstead Old People's Welfare Association 60 Health Education 18 Heating Appliances (Fireguards) Act, 1952 20 Home Help Organiser 60 Home Safety 12 Homes, Old Persons 6l 67 PAGE House to House Inspections 50 Housing: Applications for Rehousing 50,59 Clearance Areas 20,58 Closing and Demolition Orders 50,58 House Purchase and Housing Act, 1959 22,50 Housing Act, 1957, Section 9 21,50,59 Overcrowding 59 Rent Act, 1957 50,59 Statistics 58 Unfit Houses 21,50,58 Ice Cream 40,54 Improvement Grants 22,50 Inf&nt Mortality 42 Infectious Diseases 14,46 Inspection of the Borough 50 Intimation Notices 51 Laundry Service 17,48 Legal Proceedings 53 Loans for House Purchase 22,50 London County Council, Division 2 63 London County Council (General Powers) Act, 1955 S.43 48 Maternal Mortality 42 Maternity & Child Welfare Centres 63 Medical Examinations, Staff 16 Milk: Distributors 55 Premises 36,55 Sampling 36,55 Special Designations, etc. Regulations 55 Ministry of Pensions and National Insurance 60 Mobile Meals Service 6l Mortuary 49 National, Assistance Act, 1948. Section 50 16 ditto. Section 47 17 National Assistance Board 60 Old Persons 17,60 Outworkers 52 Overcrowding 59 Pet Animals Act, 1951 51,53 Pharmacy and Poisons Act, 1955 51,53 Poliomyelitis 15 Population 11,42 68 PAGE Prevention of Damage by Pests Act, 1949 24 Public Analyst's Report 35,56 Public Health Committee 9 Public Health Laboratory 38,47,55 Public Health Laundry 17,48 Public Mortuary 49 Rag Flock, etc. Act, 1951 20,51 Rateable Value 42 Rehousing 50,59 Rent Act, 1957 50,59 Road Traffic Act, 1956, Section 42 20 Rodent Control 24 Sampling 35,55 Sanitary Circumstances of the Area 50 Scabies 48 School Treatment Centres 63 Sewers, Rodent Control 24 Shops Act, 1950 19,51 Slum Clearance 20,58 Smoke Abatement 25 Speech Therapy Centre 63 Staff: Medical Examination 16 Public Health Department 10, 4l Statistics: Public Health Inspection 50 Statistical Summary 42 Statutory Notices 51 Stillbirths 42 Structurally Separate Dwellings 42 Suicides 12,49 Swimming Baths 29,53 Tuberculosis l6,46 Underground Bakehouses 40 Unsound Food 39,57 Verminous Persons 48 Washhouses 33 Water Supply 19,53 Welfare Centres 63 Welfare Officer, L.C.C. 60 Women's Voluntary Service 60 Workshop, Old People's 6l