435i HAMP 64 Metropolitan Borough of hampstead. Report on the Health of the Borough. 1963 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. 1963 R. D. DEWAR, B.Sc., M.B., CH.B., D.P.H. Medical Officer of Health. 2 CONTENTS PAGE Aged and Infirm Persons 16, 57 Atmospheric Pollution 23 Factory Acts, 1937 to 1959 44 Food and Drugs 30, 47 Health Education 25 Housing 26, 43, 54 Infectious Disease 3, 12, 39 Inspection of the Borough 20, 43 London County Council, Division 2 8, 60 Mortuary 42 Population; Births; Deaths 10, 36 Public Health Committee; Staff 8, 9 Rodent and Pest Control 22 , 43 , 46 Statistical Summary 36 Index 62 3 Public Health Department, 98a Avenue Road, Hampstead, N.W.3. 25th May, 1964. TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE METROPOLITAN BOROUGH OF HAMPSTEAD. Mr. Mayor, Ladies and Gentlemen, I have the honour to present my Annual Report on the health and sanitary circumstances of the Borough of Hampstead during 1963. One of the important functions of the public health services is the control of communicable diseases, and whilst the importance of some diseases, such as scarlet fever, has considerably declined because they no longer cause an appreciable number of deaths, and because they are susceptible to treatment by modern methods, and whilst the incidence of other diseases has declined, the prevention of the spread of diseases is one of the major contributions to the health and welfare of our society. Not all communicable diseases are notifiable, and it is not practicable nor indeed advisable always to prevent some of the common infectious diseases of children. For example mumps is a somewhat painful but not dangerous disease in children, but it can be much more serious if contracted in adult life, and german measles, which is a very mild disease, can have very serious consequences for the unborn child if it is contracted by an expectant mother during the first few months of pregnancy. At the other end of the scale smallpox is a very infectious disease with a very high death rate, and one in which treatment, other than good nursing, has little effect, but it is a disease which can be prevented by vaccination, and it is by vaccination that the disease has been completely eradicated from this country, any cases occurring being due to the importation of the disease from abroad. Similarly diphtheria has now fortunately become a comparatively rare disease because of its control by immunisation. It is perhaps early yet to say what effect immunisation has had on poliomyelitis. During the epidemic of 1947 there were some 7,000 cases throughout the country which caused about 700 4 deaths, and in the following year there were substantial numbers. Following immunisation, first with the killed vaccine and later with the live vaccine, the number of cases has dropped, and in 1963 there were only 78 cases in England and Wales, and of this number only 8 cases in the County of London, and only three out of these eight were paralytic cases. Not enough is yet known about the spread of poliomyelitis and why the disease suddenly becomes epidemic at times, and it would, therefore, be wrong to attribute the very small number of cases only to the use of vaccines. It can only be hoped that the use of vaccines has indeed played a major part in this happy result, and that the results of future years will confirm this. However effective "vaccination and immunisation is in the control of infectious diseases, the control will be lost if the numbers so protected are not maintained, and whilst the public generally will flock to obtain this protection during an epidemic, they will not show any great enthusiasm when the disease is apparently non-existent in the country. Consequently it is of the greatest importance that a campaign should be continuous and energetic, particularly to encourage parents to have their young children protected. In this field the London County Council and its officers have been both persistent and successful, and it is largely due to their efforts that I am able to give such a satisfactory report concerning the incidence of infectious diseases in Hampstead. Particulars of the other health services are set out in the report, but I should mention in particular Health Education and action under the Housing Act, 1961. We are fortunate in Hampstead in having an able, enthusiastic health education officer, and whilst it is difficult to assess the results of his efforts, it is quite clear that more is being done in Hampstead to spread information concerning hygiene and healthy living than is being done in any other parts of the area. New advances in public health depend very largely on the acceptance of higher standards by the public, and this can only be achieved by a spread of knowledge, and in this I believe that both the schools and the public health department are playing their full part. The Housing Act of 1961 gives powers to the local authority to require improvements or the provision of additional sanitary amenities in houses which are occupied by more than one family. The Act has been used in Hampstead more than in any other metropolitan borough, and although 5 gress has bean slower than the Council would wish, due to the difficulty of obtaining additional qualified staff and the often very considerable difficulty in obtaining access for inspection, (many of the occupiers going out to work), progress has been made, and landlords or owners have in general been cooperative, and there has been a minimum of evictions which was at one time feared. The statistical section of an annual report cannot be completed until information is obtained from the Registrar General concerning births and deaths, and as this is not usually available until the end of April or in May, this will be the final report before the amalgamation of the Borough of Hampstead with the Boroughs of Holborn and St. Pancras. On the amalgamation the responsibility for the health services which are at present provided by the London County Council will be transferred to the new Borough of Camden. These include some services which were transferred to the London County Council in 1948 and some which were not previously provided by the metropolitan boroughs. In general the services were at a low ebb in 1948. The maternity and child welfare services were intentionally reduced during the war to encourage the evacuation of expectant mothers and young children, or to discourage their return to London, following which building and even the repair of houses had to be very strictly controlled. The National Health Service Act was passed in 1946, although it did not come into effect until 1948, and in the intervening period there was not any great encouragement to extend services which were to be transferred, especially if this would in any way hinder programmes on housing which were the major preoccupation in the immediate post-war years. Some of the services which were transferred have changed a good deal. Formerly home helps were mainly used in maternity cases and in some cases of illness, whereas now the majority of cases helped are old people. The Mental Health services are a new and expanding service, and even the London County Council has a limited experience in this field. No one could deny the excellence of the health services provided by the London County Council, but in the administration of personal health services there are certain drawbacks in dealing with a population in excess of 3 millions. It is natural to try and provide a" uniform service and, in areas where, in 1948, the services were not up to the full standard, the services have been brought into line with the rest of 6 London. This process has been one of levelling up and not levelling down, but even so it does mean that in the more progressive areas the speed of further improvement has probably been somewhat restricted. A criticism of the London County Council which has been made at times is that the authority is so large that the services have become impersonal. This can be misleading, because it does not generally apply to the public who deal with the same familiar individuals at clinics and offices, but it does in many cases apply to the staff, many of whom feel quite remote from the elected members of the authority, and even from their own chief and senior officers; this applies both to paid and voluntary workers. The Borough of Camden will have a great opportunity to provide outstanding health services. It has many natural advantages in the number of world renowned hospitals, medical schools and allied establishments; it will have adequate resources both financially and in population, and it will start with the very sound basis of the present London County Council services and staff, which are to be transferred, I feel sure that the new Council of the Borough of Camden will not wish merely to ensure that the services are continued at the level at present provided, but will wish to see them expanded and improved, In particular the services for old people and services under the Mental Health Act are daily expanding, and with vigour and vision, (and probably at least some added expense), the services in Camden could become an example to Greater London and the whole country. During the latter part of 1963 I took over, as a temporary measure, the additional duties of Medical Officer of Health for the Borough of Holborn, and for some little time this required that I should spend a disproportionate part of my time in Holborn. During that period my Deputy, Dr. McQuaid, the Chief Public Health Inspector, Mr. Armstrong, and the Chief Clerk, Mr. Slade, accepted without question a good deal of additional responsibility, and I am very grateful to them and all the other members of the staff for their loyal support during this time and throughout the year. I am also indebted to the other Chief Officers and their staffs for their co-operation and help. I am particularly grateful to the Chairman of the Public Health Committee and to the Members for their help and encouragement. 7 I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, R. DUNCAN DEWAR, Medical Officer of Health. 8 PUBLIC HEALTH COMMITTEE The Worshipful the Mayor (Councillor N. Oatway, J.P.) ex-officio member. Chairman: Councillor J.J. Tobin, M.A., LL.B, Aldermen Miss D.R. Bailey Mrs. F.E. Cayford, J.P., L.C.C. Councillors Miss E. Beer (Vice-Chairman) Mrs. L. Campbell, L.C.C. Mrs. D. Davis Miss M. du Mont, M.A. Miss P. Frankau, F.R.S.L. P.R. Phillips A.W. Roome Miss J. Silver L.J. Walker Vice-Chairman of the Housing Committee. REPRESENTATIVES ON OUTSIDE COMMITTEES AND OTHER ORGANISATIONS CONNECTED WITH PUBLIC HEALTH WORK. Hampstead Council of Social Service: Aldermen Miss D.R. Bailey, R.M. Brodtman, The Hon. Mrs. Ruth Bennett, E, Snowman, M.V.O., O.B.E., E.P. Wallis-Jones, M.A., LL.B.; Mrs. R.S.G. Carnegie, Hampstead Old People's Housing Trust, Ltd.: Alderman R.M. Brodtman; Councillors Miss S.H. Ayliff, Mrs. H.M. Young, M.B.E., J.J. Tobin, M.A. LL.B.; Mrs. M. Gidden. Hampstead Old People's Welfare Association: Alderman R.J. Cleaver, L.C.C.; Councillors Miss E. Beer, Miss M. du Mont, M.A., Mrs. R.S.G. Carnegie, Mrs. H.M. Young, M.B.E. Mrs. D. Davis, Mrs. J.P. Lawson; D.F. Ridgley, London County Council Divisional Health Committee. Division 2: Alderman Miss D.R. Bailey; Mrs. D, Davis. Councillors Miss E. Beer, National Society for Clean Air: Councillor J.J. Tobin, M.A., LL.B., The Medical Officer of Health. The London and Home Counties Clean Air Advisory Council: The Smoke Inspector. 9 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) G.L.Nicklin (a) R.W.M.Cook(a)(b) P.C.F.Griffiths (a)(b) A.M.Norton (a)(b) L.S.Willett (a)(b) L.T.Pithers (a)(b) R.Staples(a)(b)(from 17.6.63) Student Public Health Inspectors:- Miss C.R.Hughes(up to 31.10.63) D.R.Roberts, R.C.Martin. Chief Clerk:- A.H.Slade Clerical Staff:Miss M.Sharp J.A.Gilbody R.E.Davis G.W.Bedell (up to 31-3.63) Mrs.G.A.Fletcher Mrs.M.Roe Mrs.P.Bush (from 2.9.63) Public Analyst:- E.Voelcker,A.R.C.S.,F.R.I.C. Mortuary Keeper:- S.King Public Health Station Keeper:- H.Howe Survey Assistants(Clean Air Act):- J.Woodman Miss B.P.Dimmock Miss A.J.Ferst (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. 10 POPULATION The Registrar General's estimate of the mid-year population for 1963 is 97,980, a decrease of 260 from the estimate for the previous year. The natural increase in the population, i.e. the excess of births over deaths was 754 and the population estimate therefore supposes that more than 1,000 persons left Hampstead and were not replaced. Hampstead has a somewhat larger floating population than many other areas and 20,000 to 25,000 persons leave the Borough and are replaced by others every year. BIRTHS The number of live births was 1,748, a decrease of 27 from the figure for 1962. Of the total 914 were boys and 834 were girls - a comparative rate of nearly 110 boys for every 100 girls. This is a somewhat greater difference than is usually found. The birth rate is 17.8 per 1,000 of the population but there has been for many years a much greater proportion of women in Hampstead as compared with the country as a whole and the Registrar General's comparability factor of 0.64 gives an adjusted birth rate of 11.4 Of the births 250 were illegitimate. The percentages of illegitimate births during the past 10 years are given below and it will be seen that there has been a slight decrease in the proportion as compared with 1962. Similar decreases have occurred before and it would be unwise to take an optimistic view of the trend particularly as the rate, in spite of the present decrease, is nearly 60 per cent above the rate for ten years ago. Year The number of stillbirths decreased by one to 23, but the stillbirth rate per 1,000 live and stillbirths remains the same at 13. Per Cent. Year Per Cent. 1954 9.1 1959 10.7 1955 8.9 1960 11.5 1956 10.0 1961 13.3 1957 9.4 1962 15.0 1958 11.0 1963 14.3 11 IMFANT MORTALITY Thirty children under one year of age died and of these twenty-three died within the first week. The infant mortality rate (deaths of infants under one year per 1,000 live births) was 17. DEATHS The number of Hampstead residents who died during 1963 was 994, as compared with 1,050 during the previous year. This gives a death rate of 10.1 per 1,000 of the population as compared with 10.7 in 1962, but the adjusted death rate, which takes account of the age structure of the population, is 11.2 as compared with the adjusted rate of 10.7 for 1962. It is of interest to note the differences in the ages at which death occurred, which have taken place in the past 50 years. In 1913 the population numbered 86,346, and there were 951 deaths. In 1963 the population was 97,980 with 994 deaths, and these occurred at the following ages. Under 1 year 1 - 4 5 - 14 15 - 24 25 - 44 45 - 64 Over 65 No. of deaths in 1913 91 58 23 37 118 265 359 No. of deaths in 1963 30 3 1 7 55 226 672 It will be seen that there has been a very substantial reduction in the deaths of infants under one year, that the deaths of young people between the ages of one year and twentyfive years is less than one tenth of those that occurred 50 years ago, and that the only increase is in the deaths of old people. In fact of the 672 deaths in 1963 of persons over 65 years of age, no less than 453 were of people over the age of 75 years. The individual causes of death are set out in detail in the statistical section. There is little difference in the proportion of deaths from any particular cause from previous years, the most marked difference being in the smaller number of deaths from cancer and other malignant diseases, the total from these causes being the lowest since 1954. In spite of the very severe weather during the first three 12 months of 1963, the number of deaths both from heart disease and from diseases of the lungs were lower than in the previous year. Deaths from motor vehicle accidents dropped from 18 in 1962 to 8 in 1963, but 1962 was a black year for these accidents and the figure for 1961 was 5. These deaths, it should be pointed out, are related to the place in which the persons lived and not the place at which the accident occurred. The number of suicides was 28 which is fractionally higher than the average in the past 10 years. INFECTIOUS AND OTHER DISEASES, The total number of cases of infectious disease notified was 927 as compared with 423 during 1962, but if cases of measles are excluded the total of other notifications was 190 as compared with 230. Whilst some of the infectious diseases or important complications of the disease can now be treated very successfully with modern drugs, the prevention of communicable disease is largely dependent on the use of vaccines to protect the individual, combined with the tracing and isolation of the source of infection. In Hampstead diphtheria immunisation was started in 1934; vaccination against smallpox was compulsory, at least in theory, until 1948, and protection became available against other diseases during the years before and after the war. When it became apparent that parents were not prepared to subject their children to an unlimited number of injections the manufacturers were successful in combining two or more vaccines to be given at the same time. The diseases against which protection was recommended were smallpox, diphtheria, whooping cough and more recently poliomyelitis and tetanus, with at a later date (usually on leaving school) tuberculosis. There was however considerable difference of opinion as to the order in which these vaccines should be given so as to be most effective. With the exception of smallpox the vaccines require at least two and preferably three injections to be effective, the vaccines are less effective in very young infants and whooping cough in particular is a far more dangerous disease during the first year of life than in older children. In addition there was the contention that the combined vaccines were more liable to precipitate paralysis in a case of poliomyelitis which would otherwise have been of a non-paralytic type 13 It was largely due to the work of Dr Ian Taylor of the London County Council, together with many other medical officers that the Ministry in 1961 produced a recommended schedule of immunisation. This has now been generally accepted both by general practitioners and clinic medical officers and it has led to more effective protection as well as simplifying the procedure if the family moves to another area. The schedule has been modified recently in that it is now recommended that vaccination against smallpox should be deferred until the child is over one year old instead of being carried out at the age of 4 - 5 months. Smallpox. No cases of smallpox were notified during 1963. Following the importation of cases from the Far East in 1961-62 a more careful check of persons arriving in this country was made and as information was received that a number of cases of smallpox had occurred in Stockholm all visitors from the Scandinavian countries were subjected to careful surveillance, particularly those who had no evidence of recent vaccination and who had refused vaccination on entry into this country. In several cases general medical practitioners asked for a second opinion in cases where they were in doubt. The majority of these were found to be chickenpox. Diphtheria. No cases of diphtheria occurred in the Borough during the year. Cases did occur in adjoining areas and in children who attended schools which were also attended by Hampstead children, but early and effective action by the other Boroughs prevented the spread of the disease here. Thirty years ago, before the introduction of immunisation against diphtheria it was not uncommon to have fifty to one hundred cases in Hampstead per year with deaths in about one tenth of the cases. Now it is a matter of comment if there is one case, but this position has only been arrived at by ensuring that a high proportion of children are protected by immunisation and it can only be maintained by the continuation of immunisation at the same level. Typhoid Fever. At the end of February and early March, 1963, an outbreak of typhoid fever occurred at Zermatt, Switzer]and, which affected a number of people who had gone there on holiday. The nature 14 of the disease was not disclosed as quickly as might have been hoped. It is perhaps natural that such a holiday resort would not wish unnecessarily to publish information which would deter visitors, but the delay did cause a good deal of inconvenience and much anxiety to certain people who had been to Zermatt or who had been in close contact with such visitors. Only one Hampstead resident contracted the disease from this outbreak, and she was amongst the first cases which occurred. A large number of contacts or possible contacts were examined, but fortunately no secondary cases arose. The only other case of typhoid which was notified in Hampstead was a lady who had had an attack of typhoid fever 43 years ago and who had presumably been a typhoid carrier for many years. Medical treatment proved ineffective, and finally an operation for the removal of the gall bladder was recommended and performed. The patient continued to excrete the organisms for a further two months, following which the tests became and have remained negative. Two nurses who work for a nurses agency in Hampstead nursed a patient who after admission to hospital was found to be suffering from typhoid fever. The nurses were required to cease their occupation until the end of the incubation period and until tests had shown them to be free from infection. The Council used for the first time its powers to compensate the nurses for their loss of earnings during the period when they were compelled to cease their work. Poliomyelitis. For the first time for more twenty years there were no cases of poliomyelitis notified in the Borough during the year. Measles. Epidemics of measles tend to occur in alternate years, and in 1963 there were 737 cases notified as compared with 193 in 1962 and 1093 in 1961. Deaths from measles are comparatively rare and usually are caused by the complications of the disease such as bronchopneumonia or in cases where the patient is suffering from some other disease at the time. In Hampstead since the war there has been with extraordinary regularity one death from measles every six years, and unfortunately one such death occurred in 1963. 15 Dysentery. The number of cases of dysentery notified was 54, a slight decrease from the previous year, but the same as the average number during the past five years. The cases were mainly quite mild, and were spread fairly evenly over the first three quarters of the year. General. Other cases of infectious disease do not call for any special comment. The number of cases of individual diseases notified with figures for the previous four years for comparison are given in the statistical section. Tuberculosis. Cases of tuberculosis are shown in a separate table from the other notifiable diseases in the statistical section. The number of cases of non-pulmonary tuberculosis notified was 10 which is one less than in the previous year, but this is still one more than the average for the past ten years. The number of cases of pulmonary tuberculosis notified was 54 (31 male and 23 female), which is the same as for 1961 and eleven, more than in the previous year. MASS X-RAY. No visit was paid to Hampstead by the Mobile Unit during 1963, but for the purposes of examination of staff and others whom it was necessary to refer, use was made of the permanent units of the North-West Metropolitan Regional Hospital Board situated at 32 Drayton Park, N.5, and Maida Vale (at junction with Carlton Vale, W.9.) Sessions for both men and women are held as follows:- 32 Drayton Park Monday 2.00 p.m. - 4.15 p.m. and 5.00 p.m. - 7.15 p.m. Tuesday 9.45 a.m. -12.30 p.m. and 2.00 p.m. - 5.30 p.m. Wednesday 9.45 a.m. -12.30 p.m. and 2.00 p.m. - 5.30 p.m. Thursday 2.00 p.m. - 4.15 p.m. and 5.00 p.m. - 7.15 p.m. Maida Vale Monday 2.00 p.m. - 4.30 p.m. and 5.00 p.m. - 7.30 p.m. MEDICAL EXAMINATIONS. Appointments to the Council's permanent staff are subject 16 to passing a medical examination, which includes a chest X-ray usually carried out by the permanent mass radiography units at Drayton Park and Maida Vale. Examinations are normally carried out by the Medical Officer of Health (or the Deputy Medical Officer of Health in the case of female staff). Eighty-five examinations were undertaken during the year. Forty were in respect of new appointments; 33 were for transfer to the permanent staff; 8 sere special reports required because of absence through sickness; 3 were for extension of service; 1 was on behalf of another authority. Six persons were found to be unfit to carry out their duties and were recommended to be placed on superannuation. NATIONAL ASSISTANCE ACT. 1948. SECTION 50. In eighteen instances the Public Health Department were called upon to arrange the burial of a person who was either without any known relative, or the relatives were unable to meet the cost of arranging a private funeral. The total cost of the burials was £212. 18s. 3d., and of this amount £170. 7s. 2d. has so far been recovered from the estates of the deceased, from relatives or from death grants. CARE OF THE AGED. The number of old people seeking the assistance of the Department during 1963 was 151. In only two cases however was it considered necessary to apply to the Magistrates for an Order for compulsory removal to a hospital or home. One case was an old lady of 86 who was not able to devote to herself proper care and attention by reason of age, mental condition, and the fact that she was living in insanitary conditions. An order was obtained for her removal to a London County Council Welfare Home for a period of three weeks, but she agreed to remain in the home voluntarily and no further Order was required. The second case, a lady of 82 years, also living in insanitary conditions and unable to look after herself by reason of age and infirmity finally agreed to go into a hospital voluntarily, and the Magistrate's Order was not required. The problem of providing adequate services in order that elderly and frail persons might be cared for in their own homes 17 rather than removed to hospital was given considerable attention during the year. As from the 1st April, 1963, the Borough Council assumed the full financial responsibility for the Meals-on-Wheels Service previously partly provided by the London County Council After discussion with the voluntary bodies who had formerly organised the service it was agreed that the Borough Council should provide an extra vehicle and driver, and that the service should be increased from two meals per week to four meals per week. Although the Borough Council assumed responsibility for the provision of meals as well as providing transport and drivers, the voluntary bodies undertook to provide a helper who would actually serve the meals. The responsibility for visiting applicants for meals also remained with the voluntary organisations. The increased service commenced operation on the 14th January, 1964. Towards the end of the year investigations were made concerning the provision of a day care service for elderly persons. The object of such a scheme is for an elderly person to be visited frequently by a neighbour who would perform some services such as cleaning and shopping, but whose main job would simply be to visit and see that "all was well". The neighbour would receive payment for her services. Such a scheme would supplement the existing Home Help Service but much thought and time must be given to its organisation, and this idea will need to be further pursued in 1964. Attention was also drawn in 1963 to a further improvement in the services for the care of the aged, by the provision of an Information Bureau through which members of the public, social service workers, general practitioners and others might contact all municipal and social services during normal waking hours (7 a.m. to 11 p.m.) seven days a week throughout the year. As a first step the Council agreed to the appointment of a Social Welfare Officer and accepted the view that the early establishment of a comprehensive Health and Welfare Centre should be aimed at. INVALID MEALS. Under the London County Council (General Powers) Act, 1961, Borough Councils have a right to provide a service of meals for invalids or patients requiring special diets. The London 18 County Council, who administer this service, suggested that the Borough Councils were the appropriate authorities for running this service, and after discussion between the Boroughs and the London County Council it was agreed that the Boroughs should accept the service and prepare a suitable scheme. Enquiries made from local medical practitioners however did not reveal a large demand for a service of this nature in Hampstead, and in view of the proposed extension of the Mealson-Wheels Service it was felt that the matter should be reviewed at a later date when an Invalid Meals Service might possibly be incorporated with the Meals-on-Wheels Service. The transfer of the Invalid Meals Service from the London County Council to the Boroughs depends in part on uniform action by all the Metropolitan Boroughs. PUBLIC HEALTH LAUNDRY. The number of persons requiring the assistance of the Public Health Laundry showed a very slight increase during the year, and varied between 28 and 32. At 31st December, 1963, two of the patients had been having the laundry service for more than four years, three for more than three years, one for more than two years, and one for more than a year. The soiled articles are collected, laundered and delivered twice a week, and the total number of articles dealt with during the year was 15,799. DISINFECTION AND DISINFESTATION. During the year 116 rooms were disinfected after infectious disease in 78 premises and a total of 4,138 articles were passed through the steam chamber. This figure includes a regular weekly collection from one hospital of approximately 75 blankets. It is still necessary for used clothing to be disinfected prior to dispatch abroad, and 84 parcels belonging to private individuals were disinfected to comply with the regulations in the receiving countries. A total of 148 rooms in 61 premises were treated for various types of infestation during 1963. In addition to the ordinary disinfection or disinfestation of premises, 29 filthy or verminous rooms were cleared after vacation by their occupants. 19 In 12 Instances the Department assisted in drying bedding, carpets, etc. after homes had suffered flooding from burst pipes, etc. The Department was also called upon to dispose of the body of a deceased swan (cause of death unknown). 20 SANITARY CIRCUMSTANCES. Water supply. All the drinking water used in the Borough is supplied by the Metropolitan Water Board. There are no private wells in use. All the dwelling houses in the Borough have a piped supply direct to the houses, and none is supplied by standpipes. Regular and frequent sampling is carried out by the Metropolitan Water Board, but examination is only carried out by the Borough Council after receipt of a complaint, or if there is any reason to suspect the purity of any particular supply. One sample of tank water was submitted to bacteriological examination and found to be unsatisfactory. The following is an extract from the Annual Report for 1963 of the Metropolitan Water Board, kindly supplied by the Director of Water Examination "The water supply was generally satisfactory both in quantity and quality during the year. No new sources of supply were instituted by the Board. There were no important extensions of trunk mains and there were no changes in the general scheme of supply. New mains were _laid to the extent of 1,261 yards. The source of water is derived from the River Thames, stored in the Board1s reservoirs in the Thames Valley and filtered and chlorinated at the Ashford Common, Hampton and Kempton Park Works." The following figures are extracted from the average results of examination of water supplied to the Borough of Hampstead. Ashford Common Kempton Park Hampton Natural Fluoride (milligrammes per litre) 0.25 0.25 0.25 No. of samples taken 52 52 52 Coliform count. Per cent samples negative in 100 ml 99.87 98.46 100.0 No. of samples taken 768 650 1,091 Sewerage. All the houses in Hampstead are connected to the main drainage system, the sewerage passing eventually to the London County Council*s main sewers and to the sewage disposal works outside the Borough. The widening of Finchley Road has 21 involved very extensive alterations to sewer connections and drainage manholes due to the taking up of hundreds of forecourts. This has involved constant supervision by your Inspectors. Barbers and Hairdressers. Twenty-six inspections were made of barbers' premises, 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. Ninety-two premises are registered under Section 18 of the London County Council (General Powers) Act, 1954. Shops Act, 1950- Lighting, washing facilities, facilities for taking meals, temperature, ventilation and sanitary conveniences are mainly the responsibility of the Borough Council, although the London County Council operates such powers in respect of seven premises licensed for public entertainment. No contraventions were reported. The Rag Flock and Other Filling Materials Act, 1951. There are now no firms in the Borough registered for the use of filling materials used in manufacturing bedding and other articles of upholstery. Common Lodging Houses, There are no common lodging houses in the Borough. General Public Health Inspection. A summary of the work of the Public Health Inspectors in connection with complaints and nuisances, inspections of schools, public buildings, bombed sites, private roads and passageways, drainage work, factories, etc, will be found in the Statistical Section. Colas Mews. I am glad to report that at long last this derelict site has been acquired commercially as an extension of business premise in Kilburn High Road. For over forty years this area has been a source of almost constant public health nuisance arising principally from misuse by the many fruit and vegetable street traders in the vicinity. The area was declared a Slum Clearance Area in 1957, and 22 the premises therein were demolished in 1958, since when the nuisances have been aggravated owing to the whole site being used as a dump for unwanted refuse of every description. Various proposals have since been made for the acquisition and redevelopment of the site, and it was seriously considered by the Council for use for a much needed public convenience. The plan was not proceeded with owing to the redevelopment taking place on the Willesden side of Kilburn High Road. This includes the erection of a public convenience for which both Councils will share the cost of construction and subsequent maintenance. PREVENTION OF DAMAGE BY PESTS ACT - 1949 DESTRUCTION OF RATS AND MICE. Surface Treatment. The Prevention of Damage by Pests Act, 1949, Part 1, Section 3, imposes an obligation upon an occupier of land to give notice to the Local Authority, in writing, if it comes to his knowledge that rats and mice are living on or resorting to the land in substantial numbers. Section 13 of Part II of the Act imposes a similar obligation to be given in writing to the Minister by every person whose business consists of the manufacture, storage, transport and sale of food. In practice this Department receives complaints alike from both categories above, in addition to which your Public Health Inspectors and Rodent Operators, as far as possible, inspect adjoining premises when investigating complaints. Treatment in conformity with the approved recommendations of the Ministry of Agriculture, Fisheries and Food is put in hand forthwith, and in only a few cases is it necessary to perform re-treatments. There appears to be but little connection between sewer and surface infestation by rats, and it is seldom, these days, that any such infestation can be attributed to a defective drainage system and the consequent passage of rats from sewer to building. A table showing the summary of surface treatments appears in the Statistical Section. Control of Rats in Sewers. I am indebted to the Borough Engineer and Surveyor for particulars in regard to the control of rats in sewers. 23 In accordance with the policy of the Ministry, the method of pre-baiting and poisoning with Zinc Phosphide, Arsenious Oxide or an Anti-Coagulant, has been discontinued in favour of Fluoracetamide. The effect of this change will not be appreciated until 1964, when a pre-bait can be carried out. ATMOSPHERIC POLLUTION CLEAN AIR ACT 1956. In the report under this heading for last year reference was made to the intention that the Council's programme on Smoke Control areas should be accelerated. The planned increase in staff was not effected, but with Mr, J.A. Woodman, one of the original Survey Assistants, undertaking more direct responsibility it did seem that progress would be quicker. Area No. 5 was made, confirmed by the Minister and became effective on 1st October. By November Area No. 6 was secured and confirmed for operation on 1st July, 1964, and the surveys of Areas 7 and 8, carried out simultaneously, were all but complete by late Autumn, However early in the year it became known that a "limited Circular" from the Ministry had been issued to local authorities in North and North West England intimating that previously anticipated supplies of "open fire coke" would not be forthcoming, and advising basic changes in the principles and practice of securing Smoke Control Orders. In May, answering a question in the House, the Minister of Housing and Local Government stated that supplies of graded coke suitable for use on open fires could no longer be expected to increase. Indeed the long term prospect must be a lower output, so that a national Clean Air policy could no longer be based on such fuel. It is to the credit of the Minister, and indeed of the Government, that it was not left to local authorities to comb Hansard for this information, but it was immediately published and circularised. On the face of it it might seem remarkable that such a long term and expensive programme should have been planned on the basis of persuading householders to change over to, and indeed to convert their fires to burn a fuel which apparently, quite suddenly, was seen to be in diminishing supply. The President of the National Society for Clean Air would not normally be out of touch in this context, and in October, 1962, Lord Cohen of Birkenhead, in that capacity, addressed the National Clean Air Conference on the availability of open fire coke, the reliance 24 which must be placed on it as a. standard fuel, and the necessity of determined reassurance to all as to its excellance Twelve months later the same conference was opened by Lord Hastings, Joint Parliamentary Secretary to the Ministry of Housing and Local Government, with confirmation that supplies could no longer be expected to meet demand, that future Smoke Control Areas would need to be based on other fuels, and that an immediate review of the National Fuel situation was in hand. To make capital of all this would be easy. That no one, nor anybody of real weight has done so, indicates that the situation has not been brought about by lack of foresight or by irresponsibility. The fact is that in this, as in other fields, reasonable foresight has been defeated by the pace of technology. Ten years ago, when the Beaver Committee was preparing the ground for the Clean Air Act of 1956, the Gas Boards bought their coal, heated it to form town gas, and were then left with coke. It was fair to assume that as gas consumption increased, so would the production of this particular type of coke which was so suitable for open fires. As Smoke Control Areas were progressively secured a fair balance of change to either gas heating or the open coke fire could be maintained by the basis of grant and by the adjustment of price differentials as between coke and gas. Quite suddenly, it seemed, two factors arose which completely upset this balance. Vast sources of natural gas became available which, imported at low cost in liquid form, could be released into the gas grid with minimal treatment. Secondly the production of town gas from oil became practicable, and this in plant which therm for therm represents perhaps a quarter of the capital expenditure required by the traditional gas works. Here was the normal and planned increase in gas consumption from smaller, cleaner and less costly and unsightly installations, But obviously no coke evolves from these new processes, and it will be increasingly uneconomic to sink capital into the repair and maintenance of the old plants which do produce it. It is probably fair to say that, with their selective needs in quality and sizing, the Gas Boards are not the valued customers of the rationalized National Coal Board that they were ten years ago. The Government's view of these facts and future prospects was published in a White Paper in December, 1963, and with it was issued a Circular setting out the revised procedure in future Smoke Control Areas. In most future Areas the 25 emphasis will be on gas room heaters, offpeak electric storage heaters, and on openable stoves which can use the hard and less reactive coke still in plentiful supply. Grants to householders will be increased to cover the higher costs of these appliances, so that future programmes will cost more. The overall increase in householders* costs will be more apparent than real, as the tendency to fit these superior appliances has long been clear. A grant can now be based on actual costs instead of on notional costs of a cheaper and less efficient appliance which until now has left an increasing number of householders paying far the greater part of the cost of the conversion they selected. From now on progress in this field will be slower and more costly. In many homes the necessary changes will be more radical. Those authorities who have been dragging their feet will see in this justification for their inactivity. But better standards of heating are no more than one factor in a better standard of living, and the new situation will do no more than bring the Clean Air programme into line with the standards that most prople are already seeking. HEALTH EDUCATION. During the year the scope of Health Education in the Borough has widened considerably. This is a natural development for, as its practice increases, so fresh problems will emerge. Additional subjects have been included in the programme under review, and new audiences have accepted the Borough's lecture services. The first serious work on the problems of smoking and health was commenced in 1963- In May a campaign against smoking was held in which the Central Council for Health Education supplied a lecture unit for service in the Borough. A programme of lectures and demonstrations was arranged, which brought the unit into personal contact with a series of young audiences in schools throughout the Borough, The Unit also had meetings with the Hampstead Rotary Club, the Diocesan Chapter, Youth Leaders working in the Borough, and with Student Teachers of Domestic Science at Berridge House. Later in the year L.C.C. Division 2 carried out a similar project in schools, and this was supported by a poster display throughout Hampstead and the issue of leaflets and bookmarks. During the whole of the year a continuous programme of lectures, films and demonstrations on this subject was carried out in Youth 26 Clubs and Hospitals by Borough lecture staff. An opportunity has been created to commence work on the problems of venereal disease, and the work of World Health Organisation has similarly been embraced as another new lecture. Their inclusion has not meant that the subjects already offered have been neglected, There has been a continuous demand for information on the work of the Public Health Department, which has presented the opportunity to teach aspects of public health and civics. The year has produced an increase in activity in health education and, as in the past, this has not been solely confined to Hampstead. Among the organisations accepting the Department's services are included:- Church groups of varied ages and denominations; Hampstead General Hospital; Youth Organisations; Schools, L.C.C. and private; Howard House; South East London Technical College; Political Organisations; National Dairymen's Association; Hampstead Ranger Group; Milk Marketing Board, There is cause for encouragement, both in the increased scope of the work carried out during the year and the results achieved. Audiences have demonstrated a willingness to listen and to discuss problems, and their satisfaction has been shown in a large proportion of return bookings. HOUSING. Slum Clearance, The position regarding slum clearance has not altered since last year, and it has not been necessary to submit proposals to the Minister of Housing and Local Government for clearance for the period ending in 1965. Individually unfit houses and bad basements are still being dealt with, but progress on these is controlled by the rehousing problems involved. Redevelopment Areas. Further extensive redevelopment proposals are in various stages of progress, and there is little doubt that within a very 27 few years the character of many areas of the Borough will have changed completely. Housing Surveys. Much of your Inspector's time has been taken up with surveys and reports on groups of properties or individual premises where there have been allegations of undue pressure on tenants, or where, leases having fallen in, cases of hardship among displaced tenants have been investigated. Improvement Grants. The response to this scheme has been disappointing and reveals that comparatively little use is being made of Improvement Grants in the Borough. Of the 29 applications received for "Standard Grants" 9 were in respect of owner occupied premises, and the remainder for tenants. So far as "Discretionary Grants" are concerned the figures were 11 and 8 respectively. This response has been all the more disappointing in view of the Department's activities in connection with the improvement of houses in multiple occupation. It was anticipated that this would result in a material increase in the number of applications for Standard Grants, but so far our experience has proved otherwise. The causes for this would appear to be fourfold, viz:- (1) in the case of tenement properties, the inability of landlords to provide the five standard amenities required, i.e. a fixed bath, wash hand basin, hot water supply to bath, basin and sink, a W.C. and satisfactory facilities for food storage, so that they are for the "exclusive" use of the individual tenants or families; (2) the unwillingness of tenants to forfeit part of their living accommodation to enable the provision of baths, etc.; (3) the restrictive nature of the rent limits imposed on the landlord; and (4) the inability or unwillingness of some tenants to pay the statutory rent increase of 12½% of the cost of the improvements which the landlord is allowed to charge. The requirements of the new Housing Bill partially meet these objections, but the prime factor is still to provide additional housing at rentals which the lower and middle group 28 tenants can afford. One application was received for the conversion of a house to form 13 flats for old persons. It should be emphasised that no works which may be the subject of an application for an Improvement Grant may be started without the prior approval of the Council. Several applications were disallowed for this reason. Repair of Houses. Section 9, Housing Act, 1957. Statutory Notices have been served in respect of the following premises:— 39 Denning Road; 3 Ellerdale Road; 63 Hemstal Road; Northcote House, Heath Street; 19 Priory Road; 13 New End. At two premises the Council is executing the work as a result of the Owners' default at a total cost of £2,106. Work is being carried out by the owners of three properties, and negotiations are in progress on the other one. The total estimated costs to put all these properties in a reasonable state of fitness for habitation amounted to no less than £6,350, which accounts for a considerable amount of the Housing Inspector's time, both on survey and in the course of subsequent negotiations and finally, supervision of the necessary works. Houses in Multiple Occupation- One of the main objects of the Housing Act, 1961, is the improvement of old, but otherwise sound properties which, although originally designed for single family occupation, have between the World wars and since, become multipally occupied. The lack of amenities in such dwellings has always been a problem. With the steady influx of immigrants into the Country, and the general migration to the metropolis, the position has become progressively worse. In 1962 a pilot scheme was launched involving the survey of 75 such dwellings. It was decided in the first place to attempt by way of persuasion, rather than statutory action, to 29 secure the additional amenities required by the Act to bring premises up to a reasonable standard of habitation. Informal notices were, therefore, served upon the owners of the properties inspected in all those cases where amenities were lacking and the premises needed repair and maintenance. Generally speaking the response to these informal approaches was good; owners and agents alike appeared to appreciate the method of approach, and to agree that the additional amenities required were reasonable and just. An experienced additional Inspector was engaged, and commenced duty in May, 1963. A team of four Inspectors, headed by the Deputy Chief Public Health Inspector, Mr. F.V. Outlaw, was concentrated specifically for the purpose of carrying out surveys of properties in multiple occupation and on Section 9 repairs, During the year under review 513 properties have been surveyed and informal notices served in respect of 410 of them. The properties were situated mostly in the Kilburn and West End Wards, and consisted of 2, 3 and 4-storey terraced type dwellings, with a family resident on each floor. In addition there were quite a number of single room lettings. The following table indicates the number of properties and their occupancy:— Properties 513 Lettings involved 1,283 Rooms 3,400 Numbers in occupation:- Adults 1,584 Children 696 Of the above 103 houses were found to be satisfactory in all respects. Every effort has been made to apply the agreed standard incorporated in the Code of Practice formulated by the Metropolitan Boroughs and set out hereunder. The notices served required the provision of the following additional amenities:- Hot Water Supplies 982 Baths 158 Sinks 289 W.C.'s 17 Food Storage Accommodation 250 Space Heating Facilities 57 Cooking Facilities 72 30 The fact that only a few additional water closets have been required is no doubt due to the old Tenement House Byelaws which were energetically enforced in Hampstead during the years immediately preceding World War II. As the Survey progressed it became abundantly clear that unless a scheme was evolved whereby families could be rehoused such items as additional bathrooms or even, in fact, a single bathroom in those properties not so equipped, would be almost impossible to attain. Nevertheless such provision was continually pressed, but in most instances the requirements have had to be left in abeyance until such time as the owner obtains possession or part possession when they will become obligatory. Another difficulty has been tenant resistance to improvements. In some 60 cases letters have been received from tenants stating that they do not require a sink within their room, a hot water supply over existing sinks or the provision of a bathroom, As far as possible most of these cases have been visited in order to ascertain the reasons for refusal. Generally speaking they appear to fall into three categories:- (a) ELderly people suspicious or fearful of gas or electrical appliances. (b) Suspicion that the provision will affect rent control. (c) Resistance to rent increase. In one or two isolated cases tenants objecting under (c) have subsequently installed their own appliances. Thirty-six cases of overcrowding have been discovered. These were mainly the result of natural family increase, and have been dealt with informally. The owners of the properties concerned have been cautioned that in the event of the overcrowded accommodation becoming vacant it must not be re-let so as again to cause overcrowding. Experience has taught us that even with the most co-operative owners, several months must elapse between the service of a notice and the commencement of the work. INSPECTION & SUPERVISION OF FOOD. Food & Drugs Act, 1955. Food Hygiene (General) Regulations, I960, Purpose built food supermarkets have continued to multiply in number, and are obviously now receiving the patronage of a 31 great proportion of Hampstead's residents, Competition between them, which has been enhanced by price cutting and the trading stamp war, has so far reacted favourably for the public because quality and service have not suffered due to the high standards set by those organisations who rely on these qualities alone. Where self-service has been adopted by the smaller trader conditions have been more difficult due to the lack of space in small existing premises where the provision of really adequate preparation and storage rooms would reduce the selling area to inconvenient and impracticable proportions. This limitation has frequently resulted in the overstocking of an undue proportion of pre-packed perishable foods over which very strict control of stock rotation must be carried out if such goods are to be sold at their peak of "freshness", This suggestion of lack of "freshness" has been brought to our notice, and although no question has arisen as to the commodity being actually unfit for consumption, the frequent overstocking and lack of adequate and efficient rotation of foodstuffs is the cause of some concern. An insufficient number of refrigerated display cabinets in these shops leads to their overloading above the efficiency level, and a partial defrosting and a consequent deterioration in quality of quick-frozen foods by loss of flavour, which quickly occurs if the recommended temperatures are not maintained up to the time of sale. Normally, since the public do not complain on this score, it appears that it is being conditioned to accept many foods which are almost entirely devoid of their 'natural' taste. In fact, most present developments in food marketing encourage the housewife to accept pre-packed prepared foods to a much greater degree, and a careful check of them has been maintained by informal sampling. In the relatively few cases where these samples have proved unsatisfactory on analysis, the producers, importers or retailers concerned have willingly co-operated with the Councileither by withdrawing the particular food from sale or by amending the labels to comply with the requirements of the Food and Drugs Act, 1955. The Hampstead Consumer Group is very active regarding the preparation and distribution of foods and frequently applies for information regarding specific investigations they may be conducting. They are to be complimented on their efforts to encourage the public in its discrimination in the selection of foods and of retailers upon whom its patronage is bestowed. 32 Many more restaurants and shops are being opened which specialise in continental and eastern foods. Their proprietors or staffs either experience great difficulty in understanding the requirements of the Food Hygiene Regulations, 1960, or pretend to do so. To overcome this situation it is anticipated that these regulations will shortly be printed in a number of languages, copies of which will be made available to the staffs concerned. This has already been done in the Borough of Hammersmith with some success. Fairgrounds - Catering Hygiene. As usual the Food Inspector, Mr. W.F. Newport, and his assistants were on duty throughout the period of the Hampstead Heath Fairs on each of the Easter, Whitsun and August Bank Holidays. No less than 154 samples of all the popular foods traditionally sold on fair days were taken for chemical analyses and bacterial examinations. The variety of foods ranged from ice cream and ice lollies to every conceivable kind of shell-fish, "hot-dogs", steak pies, etc., and concluded with samples of spirituous liquors from the surrounding hostelries. It is gratifying to record that all the 66 samples analysed chemically were found to be wholesome and genuine, and fault was found with only 10 of the 88 submitted for bacteriological examination. The latter contained no pathogenic bacteria. In addition to this very comprehensive sampling schedule particular attention was paid to all the vans and stalls where food was being sold in order to ensure that there was adequate cleanliness of clothing and equipment, and that arrangements for sterilization of all ice cream equipment conformed with modern practice. Clean Food Guilds. The setting up of these guilds was raised as the result of one enquiry into the recommended use of the paper sack method of refuse collection, particularly in those cases where such refuse has to be taken through the food premises for collection. I reported thereon as follows "The setting up of clean food guilds became popular in the post war years partly because of the change in eating habits which arose during the war and the much greater use of 33 canteens and restaurants, partly because of the concern which was expressed because of the great increase in cases of food poisoning and partly to encourage the necessary improvements in shops and restaurants following the lack of maintenance which had occurred during the war and in the immediate post war period when building or rebuilding was severely restricted by building licensing. The guilds were a free association of food traders which were supported by the traders themselves making an annual subscription, and they were given the moral support of local authorities. It was usual to grant a badge or document which could be displayed as an advertisement to those premises which attained a standard which was approved by the guild. Advice on standards was normally given by the local authorities, but the traders themselves fixed their own standard, usually in accordance with the advice given, but not always so, In general the officers of the local authority, as being unbiassed observers, carried out the inspections for the necessary approval before the badges or other emblems were awarded. Many difficulties were experienced in the operation of these guilds after the first enthusiasm had died away. It was particularly difficult to judge at what stage the lowering of the standards justified taking away the badge of approval. It was also difficult to obtain any improvement of the agreed standards in accordance with improvements in the techniques of food handling or the introduction of new materials or apparatus (e.g. new impermeable surface materials (formica, etc.) and new refrigerated stores and display furniture). There was also in some cases a difficult position created when a prosecution on food matters appeared to be justified in premises which bore the guild's badge of approval. In practice it was found that if any shop or restaurant lost the approval of the guild they at once resigned from the guild. At the other extreme some of the large firms - such as Sainsbury's and Marks & Spencer - refused to join the guilds on the grounds that their standards were always and in every way superior to the standards of the guilds. Gradually the badge of a clean food guild became a sign of mediocrity and it was generally with a sigh of relief both by traders and local authorities that the coming of the Food Hygiene Regulations, 1956, gave a good cause for killing off the clean food guilds. 34 As far as I am aware no local authority now supports a clean food guild, and all those that I have been able to get in touch with who previously did have guilds have said very forcibly that they would not do so again. Now that the Food Hygiene Regulations are in force, and set a standard not only for premises but for the manner in which the premises can be used, and also a standard for the behaviour of the staff (washing hands, clean clothes, etc.) it would seem that the setting up of a clean food guild would be a retrograde step in which the recognised minimum standards might well come to be regarded as a satisfactory maximum. The question of clean food guilds came before the Committee mainly on the question of the use of disposable paper sacks for the removal of refuse. It is obviously undesirable for an uncovered dustbin to be carried through food premises in order to be emptied. A dustman will always (and perhaps not unreasonably) remove the lid before lifting and carrying the bin, and the use of a paper sack is a much more satisfactory method of removal. It must be pointed out however that if a paper sack is overfilled, as may well happen at times, its advantage over an ordinary dustbin largely disappears. Moreover for the storage of refuse within a food premises pending its removal a metal or rigid plastic bin with a well fitting cover is much better than a paper sack. Even where it is possible to keep the refuse in a rear yard pending disposal, a metal or plastic bin is better unless the paper sack can reasonably be protected from the worst of the weather. Again, if waste food is to be used for animal feeding an ordinary bin is preferable. It is not possible to lay down any rigid rules for the use of paper bags as against ordinary bins to suit all conditions. A restaurant must obviously have a waste food receptacle within the kitchen and a fishmonger within the shop Other premises such as a grocers might well have a waste receptacle outside, but it would not be practicable to replace all bins by paper sacks. Indeed the Food Hygiene Regulations specify that metal bins must be used in certain circumstances to keep certain foods apart (e.g. certain offals, unskinned game and unplucked poultry from meat and other food which has been prepared). In summary it is most undesirable for uncovered refuse to be taken through food premises for disposal. The real remedy is to ensure that refuse can be disposed of at the rear of the premises. If this is not possible the use of paper sacks 35 will improve matters in many circumstances, but they are neither practicable nor desirable in all conditions. Clean food guilds have not been found to be a lasting success in any local authority area, and the setting up of a guild in order to encourage the use of the paper sack method of disposal of refuse is likely to create even greater problems." 36 STATISTICAL SUMMARY Area of Borough 2,266 acres No. of structurally separate dwellings, Census 1961 30,545 No. of private households, Census 1961 40,370 No. of separate rating assessments of dwelling houses 24,706 Rateable Value, March, 1963 £2,326,223 Sum produced by a 1d. rate £9,356 Population: Registrar Gerneral's Estimate mid-1963 97,980 Estimated Population of Children 30th June, 1963:- Under 1 1-4 Total 5-14 Total Under 15 1,690 5,210 under 5 6,900 8,400 15,300 Live Births: Legitimate: Males 788 Females 710) Illegitimate: " 126 " 124) Total:- 1,748 Live birth rate per 1,000 population 17.8 Illegitimate live births per cent, of total live births 14.3 Area Comparability Factor .64 Adjusted birth rate 11.4 Still-births: Males 14 Females 9 Total:- 23 Still-birth rate per 1,000 live and still-births 13 Total live and still-births 1,771 Infant Deaths: Males 16 Females 14 Total:- 30 Neo-natal deaths (first four weeks of life) (M.14 F.10) 24 Early neo-natal deaths (first week of life) (M.13 F.10) 23 Infant Mortality Rates:- All infants per 1,000 live births 17.2 Legitimate infants per 1,000 legitimate live births 14.7 Illegitimate infants per 1,000 illegitimate live births 32 Neo-natal deaths per 1,000 live births 13.7 Early Neo-natal deaths per 1,000 live births 13.2 Perinatal Mortality Rate (still-births and deaths under 1 week per 1,000 live and still-births) 25.9 Maternal deaths (including abortion) 2 Maternal mortality rate per 1,000 live and still-births 1.1 Deaths:- Males 460 Females 534 Total:- 994 Death rate per 1,000 population 10.1 Area Comparability Factor 1.11 Adjusted death rate 11.2 37 CAUSES OF DEATH. CAUSE of DEATH. MALES-AGES FEMALES-AGES Total Males and Females Total Males Under 4 weeks 4 weeks and under 1 year 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75 and over Total Females Under 4 weeks 4 weeks and under 1 year 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75 and over Tuberculosis respiratory 3 - - - - - - - 1 - 2 - 2 - - - - - - 2 - - - - 5 Tuberculosis other - - - - - - - - - - - - - - - - - - - - - - - - - Syphilitic disease 3 - - - - - - 1 1 - - 1 2 - - - - - - - - 1 - 1 5 Diphtheria - - - - - - - - - - - - - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - - - - - - - - - - - - - - Acute poliomyelitis - - - - - - - - - - - - - - - - - - - - - - - - - Measles 1 - - 1 - - - - - - - - - - - - - - - - - - - - 1 Other infective and parasitic diseases - - - - - - - - - - - - 2 - - - - - - - - - 1 1 2 Malignant neoplasm, stomach 9 - - - - - - 1 - 4 2 2 17 - - - - - - 1 _ 1 3 12 26 Malignant neoplasm, lung, bronchus 31 - - - - - - - 4 10 10 7 8 - - - - - - - - 3 2 3 39 Malignant neoplasm, breast - - - - - - - - - - - - 26 - - - - - - 1 8 5 6 6 26 Malignant neoplasm, uterus - - - - - - - - - - - - 8 - - - - - - 1 l 3 1 2 8 Other malignant and lymphatic neoplasm 38 - - - - - - - - 12 10 16 46 - - - - - - 3 6 13 13 11 84 Leukaemia, aleukaemia 2 - - - - - - - - - - 2 5 - - - - - - - 1 2 - 2 7 Diabetes 2 - - - - - - - - - 1 1 5 - - - - - 1 - - - 1 3 7 Vascular lesions of nervous system 35 - - - - - 1 1 2 4 12 15 68 - - - - - 1 1 1 5 18 42 103 Coronary disease, angina 142 - - - - - 1 4 19 40 29 49 109 - - - - - 1 - 2 4 33 69 251 Hypertension with heart disease 4 - - - - - - - 1 - 2 1 4 - - - - - - - - 1 2 1 8 Other heart disease 27 - - - - - - - - 2 7 18 61 - - - - - - 1 1 4 12 43 88 Other circulatory disease 18 - - - - - 1 - 1 3 1 12 35 - - - - - - - 1 5 8 21 53 Influenza 3 - - - - - - - - - 1 2 1 - - - - - - - - - - 1 4 Pneumonia 37 - 2 2 - - - - 1 4 9 19 40 - - - - - - 1 - 1 7 31 77 Bronchitis 25 - - - - - - 1 1 8 6 9 14 - - - - - - - - 2 1 11 39 Other diseases of respiratory system 4 - - - - - - - - 2 1 1 4 - - - - - - - - 2 - 2 8 Ulcer of stomach and duodenum 1 - - - - - - - 1 - - - 3 - - - - - - - 1 - 1 1 4 Gastritis, enteritis and diarrhoea 3 - - - - 1 1 - 1 - - - 3 - - - - - - - 1 1 1 - 6 Nephritis and nephrosis 3 - - - - - 1 1 - - - 1 3 - - - - - - - 1 1 1 - 6 Hyperplasia of prostate 1 - - - - - - - - - - 1 - - - - - - - - - - - - 1 Pregnancy, child birth, abortion - - - - - - - - - - - - 2 - - - - - 2 - - - - - 2 Congenital malformations 2 2 - - - - - - - - - - 4 - 2 - - - - - 2 - - - 6 Other defined and ill-defined diseases 35 11 - - 1 - - 2 1 2 8 10 38 10 2 - - 1 - 1 3 2 4 15 73 Motor vehicle accidents 6 - - - - 1 1 1 2 - 1 - 2 - - - - - 1 - - - - 1 8 All other accidents 8 1 - - - 1 1 2 1 1 1 - 10 - - - - 1 1 1 _ 3 - 4 18 Suicide 16 - - - - 1 7 3 1 2 1 1 12 - - - - - - 4 4 2 - 2 28 Homicide and operations of war 1 - - - - 1 - - - - - - - - - - - - - - - - - - 1 TOTAL:- 460 14 2 3 1 5 14 17 38 94 104 168 534 10 4 - - 2 7 17 33 61 115 285 994 38 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 9.3 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 1925 88,040 12.2 10.5 55 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 13.4 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 10 1 1951 97,750 14.5 11.5 27 1 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 1960 98,080 17.1 10.4 20 1 1961 96,990 17.7 10.1 16 1 1962 98,240 18.1 10.7 16 NIL 1963 97,980 17.8 10.1 17 1 39 INFECTIOUS DISEASE DISEASE Notifications Removed to Hosp.1963 Deaths 1963 1959 1960 1961 1962 1963 Diptheria 1 1 — — - — - Dysentery 79 48 16 62 54 4 - Encephalitis: Acute Infective - — — 1 - - - Post Infectious 1 4 3 3 - - — Erysipelas 8 6 1 4 3 2 - Food Poisoning 26 23 13 12 6 1 — Measles 344 86 1,093 193 737 9 1 Meningococcal Infection 2 3 2 1 1 1 - Opthalmia Neonatorum: Hampstead residents 11 - 22 16 12 12 - Non-residents 14 5 - 27 7 7 - Paratyphoid Fever - 2 1 3 - - - Pneumonia 47 12 19 22 17 3 3 Poliomyelitis:Non-Paralytic 3 - 3 1 - - - Paralytic 2 3 4 - - - - Puerperal Pyrexia: Hampstead residents 19 7 3 16 9 9 - Non-residents 34 21 13 12 16 16 - Scabies 17 15 10 9 17 - - Scarlet Fever 37 18 38 20 10 1 - Typhoid Fever 5 2 2 4 2 1 - Whooping Cough 37 58 25 17 26 5 - TOTAL:- 687 314 1,248 423 927 71 4 TUBERCULOSIS Age Respiratory Non-Respiratory New Cases Deaths New Cases Deaths M. F. M. F. M. F. M. F. 0 — - - - - - - - 1 1 - - - — 1 - - 5 1 2 - - — - - - 15 5 5 - - - — — — 25 14 9 - 2 5 2 - — 45 9 6 1 - 1 - - - 65 1 1 2 - - - - - 75 - — — - 1 - - - TOTAL:- 31 23 3 2 7 3 - - 40 FOOD POISONING. 1st. Qtr. 2nd Qtr. 3rd Qtr. 4th Qtr. Total Cases notified 2 — 1 3 6 Otherwise ascertained - - - - - Deaths — — — — - Outbreaks No.of Outbreaks Cases notified Otherwise Ascertained Total Cases Family Other Agent identified - - - - - Agent not identified - - - - - Single Cases Cause Cases Notified Otherwise Ascertained Total Cases Salmonella Typhimurium 2 - 2 Salmonella Bredeney 1 - 1 Not identified 3 — 3 Salmonella Infections not Food-borne NIL BACTERIOLOGICAL EXAMINATIONS Infectious Diseases. Throat/Nose Swabs:- No.of Examinations Diptheria Bacilli found NIL Haemolytic Streptococci found 6 Negative 47 Faeces:- Shigella found 45 Salmonella Typhimurium found 2 Salmonella Bredeney found 1 Salmonellas typhi found 20 Negative 321 41 HAMPSTEAD BOROUGH COUNCIL CLEANSING CENTRE Verminous Conditions Scabies Cases Treatments Cases Treatments Adults 7 7 15 35 Children - - - - Contacts - - — - London County Council (General Powers) Act, 1953. Persons cleansed at home NIL DISINFECTION AND DISINFESTATION. Calls by borough van 6376 Articles passed through steam chamber 4138 Rooms disinfested after vermin 148 Rooms disinfected after Infectious disease 116 Rooms cleansed after death or removal 16 Parcels of clothes for despatch abroad 84 Articles on medical loan collected and disinfected on behalf of London County Council 33 Contents of rooms dried after burst pipes 12 Wasps nests destroyed 28 PUBLIC HEALTH LAUNDRY A twice weekly service is in operation and 1,693 bags of laundry have been dealt with during the year. The number of calls made by the van was 2,629. Articles Laundered:- Draw Sheets 5,231 Shirts 292 Sheets 2,871 Vests 791 Blankets 288 Towels 1,585 Pillow-cases 1,592 Pants 924 Nightdresses and Pyjamas 2,225 Total Articles 15,799 The number of people using the laundry service has varied from 28 to 32 per month. 42 PUBLIC MORTUARY, NEW END Bodies admitted by order of:- Coroner 223 Ambulance 39 Police 2 Marie Curie Hospital 1 Public Health Department 5 270 Causes of death:- Natural Causes 211 Suicides:- Coal Gas Poisoning 12 Drugs 16 Railway 1 29 Accidental:- Drugs 1 Falls 1 Coal gas poisoning 4 Traffic 10 Burns 3 19 Inattention at birth 1 Post Operative 3 Unknown child 1 Neglect 1 Bodies brought for accommodation 5 270 No. of post mortem examinations carried out 265 Of the 270 bodies admitted to the Mortuary, 232 were of Hampstead residents. Coroner's Court. The Hampstead and St.Pancras Coroner's Court is at Camley Street, N.W.I. Telephone EUSton 1691. Coroner:- I.Milne, Esq. 43 PUBLIC HEALTH INSPECTIONS Inspections:- Housing defects 798 Loans for house purchase 162 Improvement grants 112 Housing Act, 1957. Repair of unfit houses(Sec.9) 10 Demolition & Closing Order 8 Overcrowding 79 Housing Act, 1961. Houses in multi-occupation 606 Rent Act, 1957. Certificates of Disrepair 1 House-to-House 608 Underground rooms (other than Closing Orders) 15 Accumulations of refuse 121 Dustbins 40 Nuisance from trees 33 Nuisance from bonfires 19 Improper keeping of animals 3 Noise 40 Smoke (Timed observations) 84 Other nuisances 111 Re-inspections: 5,816 Inspections: Schools 13 Public Buildings, Hospitals, etc. 4 Clubs, Institutions, etc. 1 Offices, Business premises 2 Bombed site or open space 10 Mews or Stable Yard 54 Private Roads or Passageways 29 Re-inspections: 175 Inspections: Drainage work: Under Notice 28 Voluntary 338 Installation of Heating Apparatus 78 Housing Applications 257 Aged or Infirm Persons 248 Infectious Disease 198 Enquiries: Smokeless Zones 17,923 Infestations: Rodent 1,239 Other 200 Re-inspections: 3,533 44 Inspections: Foodshops and stalls 702 Shops other than foodshops 10 Shops Act 30 Merchandise Marks Act 20 Hairdresser 26 Pet Animals 4 Pharmacy & Poisons 8 Rag Flock — Fairground 11 Re-inspections: 513 Lectures, discussions, talks 127 Total complaints received 1,112 Intimation Notices served 433 Statutory Notices served 117 Attendances at Court or Inquiries 10 FACTORY ACT. 1961. No. on Register Inspections Re-inspections Written Notices Factories in which S.1, 2, 3, 4 and 6 are to be enforced by local authority 204 36 19 - Factories not included above in which S.7 is enforced by the local authority 269 114 128 21 Other premises in which S.7 is enforced by the local authority (excluding outworkers premises) 4 - - - TOTAL:- 477 150 147 21 No prosecutions were undertaken during the year. 45 Defect Found Remedied Referred To H.M. Inspector. By H.M. Inspector. Want of cleanliness (S.l) 12 12 - - Overcrowding (S.2) - - - - Unreasonable temperature(S.3) - - - - Inadequate ventilation (S.4) - - — - Ineffective drainage of floors (S.6) 1 1 - 1 Sanitary conveniences (S.7) (a) Insufficient - — - - (b) Unsuitable or defective 13 13 - 2 (c) Not separate for sexes — — - - Other offences against the Act (Not including offences relating to outworkers) - - - - TOTAL:- 26 26 - 3 No prosecutions were undertaken during the year. OUTWORKERS No.of Hampstead firms making return 13 Total Outworkers notified by Hampstead firms 89 Outworkers resident in Hampstead (included in above) 5 Outworkers notified to us from other boroughs 29 Visits paid by Public Health Inspectors 84 Classes of Work Outworkers Wearing Apparel-making, etc. cleaning and washing 30 Artificial flowers 1 Cosaques, Christmas stockings, etc. 2 Lampshades 1 TOTAL:- 34 No cases of default in sending lists or instances of work in unwholesome premises. No notices served or prosecutions undertaken. 46 PET ANIMALS ACT, 1951 New Licences issued Licences discontinued - Licences renewed 4 Visits by Public Health Inspectors 4 PHARMACY & POISONS ACT 1933 New Licences issued 7 Licences renewed 78 Ceased to sell poisons or removed 13 No. on Register at end of year 84 Visits by Public Health Inspector 8 PREVENTION OF DAMAGE BY PESTS ACT 1949 Destruction of Rats and Mice. Surface Treatment. No.of properties inspected as a result of:- Local Authority Dwellings (including Council Properties) All other (including business premises) Total Notification 5 614 4 623 Survey - 613 - 613 Total inspections including re-inspections 41 3,410 33 3,484 No.of properties infested by: Rats 5 205 - 210 Mice - 414 4 418 Control of Rats in Sewers. Date Manholes Baited Poison used April 724 Fluoracetamide September 724 Fluoracetamide 47 LEGAL PROCEEDINGS. Nature of Offence Result of Proceedings Sale of mouldy Pork Pie Fined £25. Costs £5.5.0. Sale of mouldy Steak & Kidney Pie Fined £5. Costs £5.5.0. Sale of mouldy Cream Sponge Fined £5. Costs £5.5.0. Sale of mouldy Sausage Rolls Fined £5. Costs £5.5.0. \ Sale of mouldy Pork Pie Fined £30. Costs £5.5.0. Sale of mouldy Steak & Kidney Pie Fined £5. Costs £4.12.0. UNSOUND FOOD One hundred and three certificates were issued in Respect of 97 consignments comprising the following items Meat: 146 packets; 131 tins; 738 lbs.15 oz. Fruit: 227 tins; 13 packets; 6 jars. Vegetables: 344 tins; 267 packets; 142 jars; 32¾ lbs; 10 bags. Fish: 16 tins; 126 packets; 63 lbs. Fruit Juice 18 tins Bacon 43 packets Rice 1 " Pastry 25 " Vegetable Juice 4 " Mousse 108 " Soup 16 " Jam 5 jars Cream 1 " Paste 124 " Frozen food to the value of Jam 3 " Mllk 10 " Borth 1 " £7.12s.6d. Paste 196 " Gafflebiter 31 " 48 EXAMINATION OF WATER. Chemical Analysis Bacteriological Examination Swimming bath water 8 34 Tank water Nil 1 (unsatisfactory) FOOD PREMISES The total number of foodshop premises is 842. There are 338 shops with multiple trades and in the following table these have been entered once under each type of trade carried on. No. on Register Primary Inspections Misc. Visits Baker, Patisserie 59 76 31 Butcher 98 60 240 Canteens and Clubs 68 18 2 Confectioner 136 67 19 Delicatessen and Grocer 182 127 194 Fishmonger 22 51 202 Fried Fish 8 15 26 Greengrocer 93 64 301 Ice Cream 258 41 71 Milkshop and Dairy 70 51 57 Off Licence 50 4 2 Public House 54 4 35 Refreshment House 59 12 20 Restaurant, Snack Bar 143 54 54 Street Trader or Stallholder 53 55 149 Chemists 27 Factory 4) Herbalist 4) 13 - Fairground 1) 1,389 712 1,403 Revisits to shops (including shops other than foodshops) - 513 49 FOOD & DRUGS ACT, 1955, SECTION 16. Ice Cream Confectioners and Tobacconists 78 Grocer and Delicatessen 56 Restaurants 40 Dairies 26 Stores 9 Off Licences 3 Greengrocers 24 Butchers 2 F1shmongers 4 Garages 1 Bakers 8 Florists 1 Kiosk & Stalls 5 Club 1 TOTAL 258 Potted, Pressed, Pickled or Preserved Food. Grocers and Delicatessen 14 Provisions 4 Butchers 34 Factory 2 Fried Fish 6 Fish Shop 2 Cinemas 2 TOTAL 64 BACTERIOLOGICAL EXAMINATION OF FOOD. Nature of Sample No. of Samples Satisfactory Unsatisfactory Ice Cream 35 33 2 Ice Lolly 10 10 - Jellied Eels 14 12 2 Whelks 10 10 — Cockles 14 10 4 Prawns 2 2 - Mussels 4 3 1 Roast Pork 1 1 - Milk 7 7 - Toffee Apple 1 1 - Steak & Kidney Pie 1 - 1 Grilled Steak 1 1 - 100 90 10 50 CHEMICAL ANALYSIS OF FOOD Summary of items sent to the Public Analyst. Milk, cream, butter, margerine etc. 47 Cheese, cheese spread 37 Soup 6 Fish, fish products 38 Meat, meat products 107 Sauces, spices, flavourings, etc. 54 Suet 3 Rice 10 Vegetables, fruit 32 Jam, honey 8 Nuts 7 Cakes, pastry, puddings, etc. 50 Jelly, gelatin 3 Flour 8 Fruit drinks, syrups 19 Egg noodles, etc. 3 Ice cream, lolly 32 Coffee 5 Alcoholic beverages 30 Mincemeat 2 Spaghetti, Macaroni, Currants, Tapioca, Oatmeal, Marzipan, Lard, Orangeade crystals, Butter Almonds, Liqueur Chocolates, Sugar, Molasses 12 513 Thirty six samples were found to contain preservative but in only two instances was this contrary to the Regulations. Altogether 22 samples were reported upon adversely by the Analyst. Details of the infringements are given in the following table. 51 ADULTERATED OR UNSATISFACTORY SAMPLES AND CONTRAVENTIONS OF FOOD & DRUGS ACT. Pork Pie. Contained mould spores and hyphae. Fined £25 and £5.5.0. costs. Bread. Contained small piece of glazed china. No action. Dutch Honey Cake. Contained dead wasp and piece of copper. Warning letter sent to manufacturer. Pivee Spezial Creme Kase. False description. Letter sent warning importers that continued distribution under present label will result in prosecution. Chopped Veal. Consisted of a mixture of veal with pork fat. Stock exhausted and will not be replaced. Peas. Consisted of dried peas. Label amended to "Quick Dried Garden Peas". Beef Goulash. Net weight incorrectly stated. Labels amended to give correct weight. Ilchester Cheese with Beer. Sample was mouldy. Remainder of stock examined and found to be satisfactory. Spitzbub Cheese 20% Fat. Incorrect description. Label amended. Bread. Contained foreign matter (oven char and vegetable oil). Warning letter sent to producers. Double Concentrated Tomato Paste. Contained excessive lead. Part of consignment surrendered and destroyed. Remainder released conditionally. Lemonade Shandy. Deficient in proof spirit. Referred to Ministry of Agriculture, Fisheries and Food. Pork Pie. Contained mould spores and hyphae. Fined £30 and £5.5.0. costs. "Socra" Salmon. Unfit due to odour. Remainder of consignment found to be in good condition. Karluendel Kasecreme 60% Fett. Deficient in fat. Consignment exhausted. Importers requested to amend label. 52 ADULTERATED OR UNSATISFACTORY SAMPLES AND CONTRAVENTION OF FOOD & DRUGS ACT (Contd.) Steak & Kidney Pie. Sample was mouldy. Fined £5. Costs £5.5.0. Macaroni with Tomato Sauce. Misleading label. Importation discontinued. Sweetened Lemon Juice. Misleading description and contained improper preservative. Label amended. Shandy. Deficient in proof spirit. Still under negotiation. Lemonade Shandy. Deficient in proof spirit. Still under negotiation. Fruit Syrup. False and misleading description. Stocks withdrawn, from sale. Further imports cancelled. Sugar Syrup. Contained improper preservative. Stocks withdrawn from sale. Further imports cancelled. Bread. Loaf contained piece of metal. Warning letter sent. Steak & Kidney Pie. Pie was mouldy. Warning letter sent. Sausages. Sausages were mouldy. Warning letter sent. i Cream Sponge. Sponge was mouldy. Fined £5. £5.5.0. costs. Sausage Rolls. Rolls were mouldy. Fined £5. £5.5.0. costs. Steak & Kidney Pie. Pie was mouldy. Fined £5. £4.12.0. costs. Cereal. Packet contained beetles. No action. MILK SUPPLY. Milk (Special Designation) Regulations. No. of milk sellers 75 Licences in force: Pasteurised 71 Tuberculin Tested 45 Sterilised 59 Seven samples of pasteurised milk were submitted to Methylene Blue and Phosphatase tests. All were satisfactory. 53 LOANS FOR HOUSE PURCHASE Year Applications received Granted Refused,withdrawn or under negotiation at end of year. 1962 198 83 115 1963 208 106 102 Total since 1,304 693 611 1951 IMPROVEMENT GRANTS Year Applications received Granted Refused,withdrawn or under negotiation at end of year 1962 Standard 19 13 6 Discretionary 19 9 10 1963 Standard 19 12 7 Discretionary 37 19 18 Total since 1954 295 166 129 HOUSING Dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,949 Dwelling-houses (included in above) which were inspected and recorded under the Housing Consolidated Regs.1925-1932. (House-to-House inspection) 618 Dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 4 Dwelling-houses found not to be in all respects fit for human habitation 617 54 HOUSES IN CLEARANCE AREAS AND UNFIT HOUSES ELSEWHERE. Houses Demolished Clearance Areas, Housing Act, 1957 Nil Not in Clearance Areas 1 Unfit Houses Closed Under Sections 16, 17 and 35, Housing Act 1957 Nil Persons displaced Nil Families displaced Nil Parts of Buildings closed (Section 18) 3 Persons displaced 5 Families displaced 3 Unfit Houses made fit and Houses in which Defects were Remedied. By By Local Owner Authority After informal action by local authority 482 Nil After formal notice: Public Health Acts 133 Nil Housing Acts, 1957 1 1 Under Section 24, Housing Act Nil Nil No action was taken under Sections 17, 34, 46, 48 and 53 of the Housing Act regarding Unfit Houses in Temporary Use. No houses in Clearance Areas werepurchased by agreement. OVERCROWDING Dwellings Families Adults Children On register 31.12.62 268 268 710 500 New cases 1963 77 77 232 171 345 345 942 671 Rehoused 1963 10 10 25 15 On register 31.12.63 335 335 917 656 55 CERTIFICATES OF DISREPAIR. Applications for certificates 1 Applications withdrawn or cancelled Nil Certificates refused Nil Authority to issue certificates - (a) in respect of some but not all defects Nil (b) in respect of all defects 1 Undertakings given by landlords 1 Undertakings refused Nil Certificates issued Nil Applications for cancellation of certificates Nil Objections by tenants to cancellation of certificates Nil Decisions to cancel in spite of tenants objections Nil Certificates cancelled Nil HOUSING ACT, 1957. SECTION 9 Repair of Insanitary Houses Out of 608 premises surveyed by the Housing Inspector and the District Public Health Inspectors, ten were subsequently reported to the Public Health Committee as being unfit and suitable for action under Section 9. Appropriate action under the Public Health (London) Act and Housing Act 1961 was taken with the remainder. REHOUSING Visits and revisits in connection with the investigation of 308 rehousing applicants 668 No. of reports submitted to Hampstead Housing Manager 304 No. of reports submitted to Other Boroughs 4 56 ACCIDENTS IN THE HOME - Comparative figures 1962 - 1963 Cause of Accident 1962 1963 1962 1963 L.C.C.Div.2 + County of London Fall On stairs 178 180 998 961 From ladder 25 15 101 102 From chair 16 12 149 132 Outside (i.e.windows, balconies,roofs,etc.) 41 26 198 233 In garden 14 10 219 174 In bath 3 4 23 23 From one level to another (i.e.tables,boxes,beds) 69 57 434 400 On same level (i.e. in room over objects) 125 153 751 866 Unspecified 555 576 3,692 4,009 Hit by object 30 20 221 189 Cooking Stove (saucepans,water,fats,etc.) 18 16 136 140 Teapot 6 9 53 52 Other boiling water 23 24 179 194 Electric Shock 3 8 22 43 Poisoning (including foreign objects) 36 50 340 393 Gassing 41 28 192 294 Knife-like Wounds (including spikes and cuts from glass) 46 39 326 319 Fires 35 33 185 267 Windows (trapping) 5 12 29 36 Suffocation 5 5 31 45 Not specified 39 66 328 436 TOTAL 1,313 1,343 8,607 9,308 Rate per 10,000 population 26.8 27.4 27.1 29.2 + Division 2 - Hampstead, Paddington, St.Marylebone, St.Pancras and Westminster. 57 THE CARE OF THE AGED. Agencies concerned with the Care of the Aged. Hampstead Old People's Welfare Association, Miss O.Courtney Jones, 107 Kingsgate Road, N.W.6. MAI 3652 Hampstead Council of Social Service, Burgh House, New End Square, N.W.3. HAM 0049 107 Kingsgate Road, N.W.6. MAI 2007 Hampstead Old People's Housing Trust Ltd., 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, HAM 7171 98 Avenue Road, N.W.3. (Ext. 116) National Assistance Board, Old Post Office, Downshire Hill, N.W.3. HAM 9027 Ministry of Pensions & National Insurance, 30 Euston Square, N.W.1. - for N.W.3 area only EUS 6451 122 Kilburn High Road, N.W.6. - for 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) 10 Warwick Row, S.W.1. VIC 0162 Admitting Officer (Enquiries regarding inmates of Luxborough Lodge), 10 Warwick Row, S.W.1. VIC 0162 Public Health Department, Specialist Health Inspector, Mrs.C.G.Speechley, 98a Avenue Road, N.W.3. HAM 7171 Divisional Medical Officer, London County Council, 313 Harrow Road, W.9. CUN 4815 58 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 Tuesday, Wednesday, Thursday and Friday by the British Red Cross Society and Women's Voluntary Services. Application to Hampstead Old People's Welfare Association for N.W.6 area and British Red Cross Society for N.W.3. Dinner Clubs. These are held at - Maccabi Clubx 73 Compayne Gardens, N.W.6. Monday; and Thursday, (Now Bamfield, upper Park Road N.W.3) St. Stephen's Church Hall, Pond Street, N.W.3 on Tuesday, Wednesday, Thursday, Friday at 12 noon. Health Institute, 107 Kingsgate Road, N.W.6 on Tuesday, Wednesday, Thursday, Friday at 12 noon. B*nai B*rith, 51 Belsize Square, N.W.3. Tuesday and Wednesday. Library. Books provided by the Borough Council are delivered fortnightly to homebound old people. A member of the library staff accompanies the van. Holidays. Arranged by the Hampstead Old People*s Welfare Association or The Hampstead Council of Social Service. Chiropody Service. Weekly sessions are held in N.W.6 and N.W.3. The Rotary Club of Hampstead provide transport to the clinic for those too frail to travel. Patients who are unable to attend the clinic even by car, are visited and treated in their own homes. Appointments for treatment are made on application to the Hampstead Old People's Welfare Association. Baths. Old Age Pensioners are allowed to use the slipper baths at the Central Baths, Finchley Road and the Branch Baths at Flask Walk and Palmerston Road, free of charge at any time. Homes. Information obtainable 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. 59 Hospital Care. Application 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 further advice can be obtained from the Medical Officer of Health, 98a Avenue Road, N.W.3. HAM 7171. Ext.110. Medical Loan. Items of medical equipment are available on loan from the Divisional Office, London County Council or the British Red Cross Society. Darby and Joan Clubs. St.Stephen's Hall, Pond Street, N.W.3. Wednesdays 2 - 4.30 p.m. Holy Trinity Church Hall, Tuesdays 2 - 4 p.m. Finchley Road, N.W.3 Unitarian Church Hall, Thursdays 2 - 4 p.m. Quex Road, N.W.6. 107 Kingsgate Road Wednesdays 2 - 4 p.m. Brondesbury Fellowship Men's Club. 107 Kingsgate Road, N.W.6 Daily 2 - 5 p.m. Good Companions Club Burgh House, New End Square, N.W.3. Mondays 5 - 8 p.m. Good Neighbours Club 51 Belsize Square, N.W.3. Wednesdays 2.30 - 5 p.m. Burgh House Club Burgh House, New End Square, N.W.3. Daily 2.7 p.m. Friendship Clubs Belsize Club, 22 Eton Villas, N.W.3. Monday afternoons. The Synagogue, Dennington Park Road, N.W.6 Thursday 3 - 5 p.m. Afternoon Tea Club Friends* Meeting House, Heath Street, N.W.3. Tuesday 2 - 4.30 p.m. Broadhurst Club, Levine House, Monday and Wednesday Broadhurst Gardens, N.W.6. evenings. 60 The Day Club for Over-Sixties, Monday and Thursday 51 Belsize Square, N.W.3. 11.0.a.m. - 5.30 p.m. (lunch can be provided Maccabi (Retired Jewish Gentlemen) Thursday 2.30 - 5.p.m. 73 Compayne Gardens, N.W.6. also Day Club Tuesday and Wednesday 11. - 5.30 p.m. Congregational Church Hall Thursday 3 - 5 p.m. Lyndhurst Road, N.W.3 LONDON COUNTY COUNCIL. DIVISION 2. PUBLIC HEALTH DEPARTMENT Divisional Medical Officer:- H.Leslie 01dershaw,M.D.,B.Sc.,D.P.H. 313 Harrow Road, W.9. CUN 4815 Hampstead Sub-Office:- 251 Finchley Road, N.W.3. HAM 8450 Clinics, Day Nurseries and School Treatment Centres. L.C.C.Day Nurseries (normally open all day, Monday to Friday) Woodchurch 11/13 Woodchurch Road, N.W.6 MAI 2937 Parkhill 2 Parkhill Road, N.W.3 GUL 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 5381 2 Parkhill Road, N.W.3 GUL 4759 Hampstead Wells, Christchurch Hill, N.W.3 HAM 9534 3/5 Daleham Gardens, N.W.3 SWI 3424 9 Solent Road, N.W.6 HAM 5978 Welfare 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.3 HAM 4763 61 Speech Therapy Centre 75 Dynham Road, N.W.6 MAI 3005 Immunisation and Vaccination Clinics. Smallpox Vaccination:- (children only) 60 West End Lane, N.W.6 Tuesday 10 - 11 a.m. 3/5 Daleham Gardens, N.W.3 Thursday 10 - 11 a.m. 9 Solent Road, N.W.6 Friday 10 - 11 a.m. Diphtheria and Poliomyelitis Inoculations:- (Adults & Children) 60 West End Lane, N.W.6 Tuesday 10 - 11 a.m. 3/5 Daleham Gardens, N.W.3 Thursday 10 - 11 a.m. 9 Solent Road, N.W.6 Friday 10 - 11 a.m. Diphtheria and Poliomyelitis Inoculation of babies can also be dealt with at the Maternity and Child Welfare Centres by arrangement. Domestic Help Service. Home Help Organiser, 251 Finchley Road, N.W.3 HAM 4136 District Nursing Associations Hampstead District Nursing Association, HAM 6406 3 Pond Street, N.W.3. Kilburn and W.Hampstead District Nursing Assoc. 20 Dennington Park Road, N.W.6. HAM 4232 Further information regarding the Care of Mothers and Young Children, Child Minders and Day Nurseries, Health Visiting, Family Planning, Recuperative Holidays, Foot Clinics, Tuberculosis Care and After-care, care of persons suffering from illness or Mental Defectiveness, Treatment Centres for School Children, etc. may be obtained from The Divisional Medical Officer, London County Council, 313 Harrow Road, W.9. CUNningham 4815 62 INDEX PAGE Accidents in the Home 56 Aged Persons:- Care of the Aged 16, 57 Cleansing of 41, 58 Laundry Service 18, 41, 58 Area of Borough 36 Area Comparability Factors 36 Atmospheric Pollution 23, 43 Bacteriological Examinations:- Food 49 Infectious Disease 40 Swimming Bath Water 48 Barbers and Hairdressers 21, 44 Bathing Centre 41 Baths, Old Persons 41, 58 Births, Birth Rate 10, 36, 38 British Red Cross Society 57 Burials 16 Census 36 Certificates of Disrepair 43, 55 Chemical Analysis:- Food 50 Swimming Bath Water 48 Chiropody Service 58 Clean Air Act, 1956 23, 43 Cleansing Station 41 Clearance Areas 26, 54 Clinics 60 Closing Orders 43, 54 Clubs, Old Persons' 59 Colas Mews 21 Common Lodging Houses 21 Complaints 44 Cooked Meats 49 Council Representatives on other Organisations 8 Darby and Joan Clubs 59 Day Nurseries 60 Deaths 11, 36, 38 Demolition Orders 43, 54 Dinner Clubs 58 63 PAGE Disinfection and Disinfestation 18, 41 District Nursing Associations 61 Division 2, London County Council 8, 57, 60 Divisional Health Committee 8 Domestic Help Service 61 Drainage 43 Dwellings Rate Assessments 36 Structurally Separate 36 Factory Act:- Inspections 44 Outworkers 45 Food Inspection 30, 44, 48 Food Poisoning 40 Foot Clinics 58 Hairdressers and Barbers 21, 44 Hampstead Council of Social Service 8, 57 Hampstead Old People's Housing Trust, Ltd. 8, 57 Hampstead Old People's Welfare Association 8, 57 Health Education 4, 25, 44 Home Help Organiser 57 Homes, Old Persons' 58 House-to-House Inspections 43 Housing Act, 1961 28, 43 Housing 26, 43, 53 Ice Cream 49 Improvement Grants 27, 43, 53 Immunisation and Vaccination Clinics 61 Infant Mortality 11, 36, 38 Infectious Diseases 3, 12, 39 Inspection of the Borough 20, 43 Intimation Notices 44 Invalid Meals 17 Laundry Service 18, 41, 58 Legal Proceedings 47 Loans for House Purchase 43, 53 London County Council, Division 2 8, 60 London County Council (General Powers) Act, 1954, S. 18 21, 44 London County Council (General Powers) Act, 1953, S. 43 41 64 PAGE Mass X-ray 15 Maternal Mortality 36, 38 Maternity & Child Welfare Centres 60 Medical Examinations, Staff 15 Milk 52 Ministry of Pensions and National Insurance 57 Mobile Meals Service 58 Mortuary 42 National Assistance Act, 1948, Section 50 16 National Assistance Act, 1948, Section 47 16 National Assistance Board 57 Old Persons 16, 57 Outworkers 45 Overcrowding 43, 54 Pet Animals Act, 1951 44, 46 Pharmacy and Poisons Act, 1933 44, 46 Population 10, 36, 38 Prevention of Damage by Pests Act, 1949 22 , 43 , 46 Public Health Committee 8 Public Health Laboratory 40, 49 Public Health Laundry 18, 41, 58 Rag Flock, etc. Act, 1951 21, 44 Rateable Value 36 Redevelopment Areas 26 Rehousing 55 Rent Act, 1957 43, 55 Rodent Control 22 , 43 , 46 Sampling 49, 50 Sanitary Circumstances of the Area 20, 43 School Treatment Centres 60 Sewerage 20 Sewers, Rodent Control 23, 46 Shops Act, 1950 21, 44 Slum Clearance 26, 54 Smoke Abatement 23, 43 Speech Therapy Centre 61 Staff :- Medical Examination 15 Public Health Department 9 65 Statistics Public Health Inspection 20, 43 Statistical Summary 36 Statutory Notices 44 Stillbirths 10, 36 Structurally Separate Dwellings 36 Swimming Baths 48 Tuberculosis 15, 39 Underground Rooms 43 Unsound Food 47, 51 Vaccination and Immunisation Clinics 61 Verminous Persons 41 Water Supply 20, 48 Welfare Centres 60 Welfare Office, L.C.C 57 Women's Voluntary Service 57 Workshop, Old People's 58