HAY 23 AC 439(3) HAYES & HARLINGTON FORTY - FOURTH ANNUAL REPORT on the HEALTH of the Urban District of HAYES & HARLINGTON Middlesex J. STANLEY LLOYD, M.D., F.R.C.S.Edin. Medical Officer of Health 1948 THE URBAN DISTRICT OF HAYES AND HARLINGTON Members of the Council, 1948 Chairman: Councillor E. K. Harding, J.P. Vice-Chairman: Councillor A. H. Smith Councillors: Mrs. R. E. Beard, A. J. C. Beck, H. Blackburn, R. Bristow, P. J. Burke, H. C. Eurnett, S. G. Chilton, W. W. Chubb, G. R. T. Clarke, F. W. Coleman, B. E. Cooper, J. H. Dawson, Mrs. B. F. Frost, H. R. Hann, W. C. Mongor, H. B. Radley, N. L. Shakespeare, R. M. Smith, A. E. Stokes, F. Strong, R. Tabor, G. Triscott, M.B.E. Public Health Committee, 1948 Chairman: Councillor H. R. Hann. Councillors: H. C. Burnett, S. G. Chilton, B. E. Cooper, A. E. Stokes, F. Strong. Staff of the Public Health Department Medical Officer of Health: J. Stanley Lloyd, M.D., F.R.C.S., Edin. Medical Officer in Charge of Diphtheria Immunisation Clinic: (Until 5/7/48) Mary L. Lloyd, M.A., M.B., Ch.B., D.P.H. Chief Sanitary Inspector, Inspector under the Shops Acts and Petroleum Inspector: Richard Bill, Cert.R.San.Inst., and Certified Meat Inspector. Deputy Chief Sanitary Inspector: Sydney Greenhead (from 30/9/48) Additional Sanitary Inspectors: S. H. G. Stevens (to 20/6/48), S. Greenhead (to 29/9/48), G. W. C. Cassidy (from 10/1/48 to 31/8/48), P. M. Ennis (from 1/6/48), E. A. Williams (from 2/11/48), R. Finn (from 8/11/48). Rodent Control Officer: W. K. Tonkin (from 1/8/48). Clerks: F. E. Pollard, P. Bailey. 1 MEDICAL OFFICERS ANNUAL REPORT Public Health Department, Town Hall, Hayes, Middlesex. May, 1949 To the Chairman and Members of the Council, Mr. Chairman, Ladies and Gentlemen, I have the honour to present to you the Forty-Fourth Annua. Report on the health of your Urban District. On the 5th July, 1948, the National Health Service Act, 1946, came into operation and this has resulted in some alterations in the medical services. On this date all hospitals in the area passed under the control of the North-West Metropolitan Regional Hospital Board and the ambulance services were taken over by the Middlesex County Council. The Diphtheria Immunisation Clinic at the Hayes Cottage Hospital was discontinued and the responsibility for administering the scheme passed to the Middlesex County Council. The free distribution of insulin to needy persons also lapsed on that date as the patients became eligible for receiving insulin from their own panel doctors. The population of Hayes and Harlington has diminished by just over 1,000, while the number of inhabited houses has increased by 384. This has resulted in a slight amelioration of overcrowding but the improvement is so small that large numbers of people are still living under most undesirable conditions. The birth rate is about the same as that of similar towns in England and Wales whereas the death rate is only two-thirds of that for other towns of comparable size. The health of this Urban District may be regarded as good. I have the honour to be, Your obedient Servant, J. STANLEY LLOYD, Medical Officer of Health. 2 SECTION A STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (acres) 5,171 Population (census 1931) 23,646 Population (mid-year 1948) Registrar-General's Estimate: Civilian population figure 65,620 Number of Inhabited Houses as at 31st December, 1948 16,955 Rateable Value (estimate) as at 31st December, 1948 £441,650 Product of a Penny Rate £1,713 EXTRACTS FROM VITAL STATISTICS OF THE YEAR Live Births— M. F. Total Birth Rate per 1,000 of the estimated resident population 19.2 Legitimate 647 560 1,207 Illegitimate 23 25 48 Stillbirths— Legitimate 12 9 21 Rate per 1,000 total (live and still) births 17.22 Illegitimate 1 — 1 Deaths 242 211 453 Death Rate 6.9 Deaths from puerperal causes Nil Death Rate of Infants under one year of age:— (a) All infants per 1,000 live births 27.88 (b) Legitimate infants per 1,000 legitimate live births 27.34 (c) Illegitimate infants per 1,000 illegitimate live births 41.66 M. F. Total Deaths from Cancer 47 50 97 Deaths from Measles — — — Deaths from Whooping Cough — — — Deaths from Diarrhoea (under 2 years of age) 1 1 2 Deaths from Tuberculosis of respiratory system 10 7 17 Deaths from Tuberculosis—other forms 2 2 4 Deaths from Heart Disease 51 45 96 Deaths from Bronchitis 16 8 24 Deaths from Pneumonia (all forms) 22 10 32 3 BIRTH RATES, CIVILIAN DEATH RATES. ANALYSIS OF MORTALITY, MATERNAL MORTALITY AND CASE RATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR 1948. PROVISIONAL FIGURES BASED ON QUARTERLY RETURNS England and Wales 126 County Boroughs and Great Towns including London 14ft Smaller Towns (Resident Populations 25,000 to 50,000 at 1931 Census London Administrative County Haves and Harlington Rates per 1,000 civilian population Births— Live Births. 17.9(a) 20.0 19.2 20.1 19.2 Still Births 0.42a 0.52 0 43 0.39 0.33 Deaths— All Causes 10.8(a) 11.6 10.7 11.6 6.9 Typhoid and Paratyphoid 0.00 0.00 0.00 0.00 - Whooping Cough 0.02 0.02 0.02 0.01 — Diphtheria 0.00 0.00 0.00 0.01 — Tuberculosis 0.51 0.59 0.46 0.63 0.32 Influenza 0.03 0.03 0.04 0.02 0.03 Smallpox — — — — — Acute Poliomyelitis & Polioencephalitis 0.01 0.01 0.01 0.00 - Pneumonia 0.41 0.38 0.36 0.54 0.48 Notifications— Typhoid Fever 0.01 0.00 0.01 0.00 — Paratyphoid Fever 0.01 0.01 0.01 0.01 — Cerebro-spinal Fever 0.03 0.03 0.02 0.03 — Scarlet Fever 1.73 1.90 1.82 1.37 1.23 Whooping Cough 3.42 3.51 3.31 3.13 5.63 Diphtheria 0.08 0.10 0.09 0.10 — Erysipelas 0.21 0.23 0.21 0.22 0.04 Smallpox — — — — — Measles 9.34 9.75 8.84 9.17 8.39 Pneumonia 0.73 0.84 0.60 0.57 0.76 Acute Poliomyelitis 0.04 0.05 0.04 0.04 0.03 „ Polioencephalitis 0.00 0.00 0.00 0.00 0.01 Deaths— Rates per 1,000 Live Births All causes under 1 year of age 34(6) 39 32 31 27.88 Enteritis and Diarrhoea under 2 years of age 3.3 4.5 2.1 2.4 1.59 Rates per 1,000 Total (Live and Still) Births Maternal Mortality— Abortion with sepsis 0.11 Figures not avail able. — Abortion without sepsis 0.05 — Puerperal infections 0.13 — Others 0.73 0.78 Notifications— Puerperal Fever and Puerperal Pyrexia 6.89 8.90 4.71 7.34c 3.13 (a) Rates per 1,000 total population. (b) Per 1,000 related births, (c) In London Puerperal Fever alone was 0.61. (A dash — signifies that there were no deaths or no notifications). 4 CAUSES OF DEATH DURING 1948 Cause of Death Male Female All causes 242 211 1. Typhoid and Paratyphoid Fevers — — 2. Cerebro-spinal Fever — — 3 Scarlet Fever — — 4. Whooping Cough — — 5. Diphtheria — — 6. Tuberculosis of Respiratory System 10 7 7. Other forms of Tuberculosis 2 2 8. Syphilitic diseases 3 — 9. Influenza 1 1 10. Measles - - 11 Acute Poliomyelitis and Polioencephalitis — — 12. Acute infantile Encephalitis — — 13. Cancer of buccal cavity and oesophagus (M) and uterus (F) 4 6 14. Cancer of stomach and duodenum 10 13 15. Cancer of breast — 9 16. Cancer of all other sites 33 22 17. Diabetes 1 3 IB. Intra-cranial vascular lesions 17 27 19. Heart disease 51 45 20. Other diseases of circulatory system 7 10 21 Bronchitis 16 8 22. Pneumonia (all forms) 22 10 23. Other respiratory diseases 4 2 24. Ulcer of stomach and duodenum 5 2 -5. Diarrhoea (under 2 years of age) 1 1 26. Appendicitis 5 1 27. Other digestive diseases 1 1 28. Nephritis 3 4 29. Puerperal and post-abortive sepsis — — 30. Other maternal causes - 1 31. Premature Birth 6 — 32. Congenital Malformations, Birth Injuries, Infantile Diseases 12 12 33. Suicide 1 — 34. Road traffic accidents 7 1 35. Other violent causes 6 3 36. All other causes 14 20 Deaths of Infants: Legitimate 23 10 Illegitimate — 2 Total 23 12 Live Births: Legitimate 647 560 Illegitimate 23 25 Total 670 585 Stillbirths : Legitimate 12 9 Illegitimate 1 — Total 13 9 Population (mid-year): 65,620. 5 SECTION B. GENERAL PROVISIONS OF HEALTH SERVICES FOR THE AREA (a) Hospitals. Cottage Hospital, Grange Road, Hayes. Cottage Hospital, Sipson Lane, Harlington. County Hospital, Hillingdon. Joint Isolation Hospital, Kingston Lane, Uxbridge. (b) Ambulance Service. Motor ambulances are provided by the Middlesex County Council for the conveyance of all cases to hospital. (c) Tuberculosis. Provision is made by the Middlesex County Council for treating cases of Tuberculosis at South Mimms Hospital, Harefield Hospital and other places, the Tuberculosis Dispensary being situated at the Local County Offices, High Street, Uxbridge. (d) Child Welfare Clinic, etc. The Middlesex County Council also administers the numerous Maternity and Child Welfare Clinic in the district. These are open frequently and are at the disposal of all residents free of cost. SECTION C. SANITARY CIRCUMSTANCES OF THE AREA Water.—The Rickmansworth and Uxbridge Valley Water Company supplies the greater part of the water in the district, the remainder being supplied by the South West Suburban Water Company. Chemical and bacteriological examinations of the water have been regularly made by the Clinical Research Association, and the supplies have been satisfactory both in quality and quantity. The number of samples obtained was as follows: Rickmansworth and Uxbridge Valley Water Co. South West Suburban Water Co. *24 (*By H. & H. U.D.C., 4 ; by other Authorities, 20). In addition two samples were obtained from private wells. In the first case the report from the Clinical Research Association showed that the water was potentially dangerous, and following negotiations with the owners of the premises concerned, the use of the well was discontinued and the premises connected to the mains supply. In the second case the report showed that although the water, in its present state, was fit for drinking purposes, it was liable to intermittent polution, and, as in the first case, could be potentially dangerous. Negotiations are in progress for the improvement of the supply. 6 SANITARY INSPECTION OF THE AREA 1.- Complaints. During the year 806 complaints were received with respect to the following matters: Choked and defective drains 122 Insanitary or dilapidated conditions of houses or premises 240 Offensive accumulations or deposits 36 Cesspools overflowing 17 Defective dustbins 297 Verminous premises 12 Other nuisances 82 2.- Inspection of the District. Number of houses and premises inspected 1,732 ,, „ ,, ,, re-inspected 1,001 ,, houses inspected and recorded (Housing Act) 3 ,, miscellaneous visits 553 „ food inspections 449 „ slaughterhouses inspected 8 „ dairies inspected 11 ,, factories and bakehouses inspected 135 ,, water supplies inspected 2 visits re infectious diseases 108 „ petroleum stores inspected 63 ,, inspections re tents, vans and sheds 124 „ verminous premises inspected 26 ,, smoke observations taken 15 ,, premises disinfected or disinfested 95 ,, inspections under the Shops Acts 87 „ Housing Act (Overcrowding) inspections 725 ,, public urinals inspected 13 „ ice-cream samples taken 28 ,, water samples taken 9 Total 5,187 Number of inspections re rat and/or mice infestation (1/8/48 to 31/12/48 only) 140 3.—Notices Served. Served Complied with Outstanding Informal notices 446 297 149 Statutory notices: Section 93, Public Health Act, 1936 25 19 6 Section 75, Public Health Act, 1936 24 24 — Section 11, Housing Act, 1936 1 — 1 Section 155, Housing Act, 1936 10 — 10 7 THE FACTORIES ACT, 1937 One hundred and thirty-five inspections of factories, with and without mechanical power, have been made during the year. There are one-hundred and thirty-five factories with mechanical power and eleven factories without mechanical power on the register, classified as under: Factories with mechanical power: Aircraft 1 Mineral waters 1 Art reproductions 1 Motor repairs 12 Bakers 10 Music rolls 1 Body and coach builders 2 Oil blending 2 Boot repairers 13 Optical lens grinding 2 Building materials 3 Plastics 1 Caravans 1 Potato crisps 1 Carbon products 1 Printing 5 Cheese 1 Radio 1 Chemical engineering 1 Refrigerator repairs 1 Cocoa and chocolate 2 Repair of agricultural implements 1 Electrical apparatus 1 Electro-platers 1 Rubber 1 Electric transformers 1 Sausages 2 Electric welding 3 Saw mills 1 Engineering 43 Slab partitions 1 Firelighters 1 Sports equipment 1 Furniture 3 Tarmacadam 2 Glazed tiles 1 Upholstery repairs 1 Jams 1 Valet services 1 Joinery 4 Wire 1 Wood block floors 1 Factories without mechanical power: Breeze block making 1 Photographer 1 Builders merchants 2 Printing and stationery 1 Cigarette lighters 1 Smith 1 Motor repairs 2 Stove enamelling 1 Oil blending 1 1.—Inspections. Premises Number of Inspections Written Notices Occupiers Prosecuted Factories with mechanical power 127 7 - Factories without mechanical power 8 - — Other premises under the Act (including work of building and engineering construction, but not including outworkers premises) — - - Total 135 7 — 8 2.—Defects Found. Particulars Number of defects Found Remedied Sunitary Accommodation (S.7): Insufficient 2 2 Unsuitable or defective 5 5 Not separate for sexes — — Total 7 7 OFFENSIVE TRADES There are no establishments in the district carrying on Offensive Trades. SECTION D. HOUSING During the year 1948 the following houses and prefabricated bungalows were completed. Grand,total to 1948 31/12/48 Permanent houses 318 761 Temporary bungalows — 224 Houses rebuilt after destruction by enemy action 26 57 Houses rendered habitable after serious damage by enemy action — 3 Adaptation of unoccupied buildings 1 17 1— Inspection of houses during the year. (1) (a) Total number of dwelling-houses inspected for housing defects (under the Public Health or Housing Acts) 1,732 (b) Number of inspections made for the purpose 2,733 (2) (a) Number of dwelling-houses which were spected and recorded under the Housing Consolidated Regulations, 1925 and 1932 3 (b) Number of inspections made for the purpose 15 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 3 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation Nil 9 2 — Remedy of Defects during the Year without service of Formal Notices. Number of dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 297 3 Action under Statutory Powers during the Year. (a) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936: (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices (a) By owners Nil (b) By Local Authority in default of owners Nil (b) Proceedings under Public Health Act: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 25 (2) Number of dwelling - houses in which defects were remedied after service of formal notices: (a) By owners 19 (b) By Local Authority in default of owners Ni (c) Partly complied with but not yet complete Nil (c) Proceedings under Sections 11 and 13 of - the Housing Act, 1936: (1) Number of dwelling - houses in respect of which Demolition Orders were made 1 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (,d) Proceedings under Section 12 of the Housing Act, 1936: (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil 10 SECTION E. INSPECTION AND SUPERVISION OF FOOD (a) Milk Supply. There is only one producer in the district licensed by the Middlesex County Council under the Milk (Special Designation) Orders for the production of Accredited Milk. Three milk dealers were licensed during the year to pasteurise milk. The table below gives details of the other nineteen licences granted during 1948. Designation Dealer's Licence Supplementary Licence Tuberculin Tested 5 4 Pasteurised 6 4 No refusal or revocation of licences to retailers has been made. There are now twenty-six persons registered in accordance ith the Food and Drugs Act, 1938, as under: Wholesale trades or producers of milk 8 Retail purveyors of milk with premises in the district 7 Retail purveyors of milk with premises outside the district 11 m (b) Meat. There is no Ministry of Food slaughterhouse in the district, but 38 lbs. of home killed fresh meat and 8*J lbs. of imported meat were condemned during the year. In addition 738 lbs. of canned corned beef or mutton and 70 lbs. of other canned meat were condemned. The following foods other than meat) were also condemned during the year: Cheese 25 lbs. Fruit tinned 333 tins Cereals 68 lbs. Jams 48½ lbs Egg shell 1,194 Milk 170 tins Egg(Yolk) 2,264 lbs. Poultry 12 lbs Fruit (fresh) 16 lbs. Soup 38 tins Fish 17½ stones Sugar confectionery I51¾lbs Vegetables 418 tins All others 186½ lbs. 11 SECTION F. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASES (a) General. Apart from the deaths resulting from tuberculosis and pneumonia there was no fatality from infectious disease during the year. (b) Scabies. Ten males (adult) and twenty-three females and children were treated for scabies during the year No case of infestation with lice was reported. The scabies clinic is held at the Hayes Cottage Hospital and is open twice weekly for females and children and when required for males (adult). (c) Diphtheria Immunisation. Hayes Cottage Hospital (to 5th July, 1948 only): Number of sessions 19 Number of attendances 386 Number of prophylactics given 357 Number of post-schicks and re-tests 15 Number of post-schicks and re-tests NEG 14 Number of post-schicks and re-tests POS Nil The total number of children immunised up to the 31st December, 1948 was 10,549. Notifiable Diseases (other than Tuberculosis) during the Year 1948 Diseases Total Cases Notified Total Deaths Scarlet Fever 81 — Diphtheria — — Pneumonia 50 32 (all forms) Cerebro-spinal Fever — — Puerperal Pyrexia 4 — Erysipelas 3 — Ophthalmia Neonatorum 1 — Measles 551 — Whooping Cough 370 — Dysentery 3 — Acute Poliomyelitis 2 — Malaria 1* — Polioencephalitis 1 — Enteric Fever — — Para-typhoid Fever — — Food Poisoning 2 - * Non-civilian. 12 13 analysis of total cases. Diseases AT AGES Under 1 year 1-3 3-5 5-10 10-15 15-25 25 and over Age unknown Totals Scarlet Fever — 4 15 51 8 2 1 — 81 Whooping Cough 50 100 93 113 5 3 2 4 370 Acute Poliomyelitis — — — 1 — — 1 — 2 Acute Polioencephalitis — — - 1 - - - — 1 Measles 25 160 126 233 3 2 1 1 551 Diphtheria - - - - - - - - - AT AGES Diseases Under 5 5-15 15-45 45-65 65 and over Age unknown Totals Pneumonia 7 10 14 15 3 1 50 Dysentery 2 1 - - — — 3 Smallpox — — - — — — — Acute Encephalitis Lethargica — — — — — — — Enteric Fever — — — — — — — Para-typhoid Fever — — — — — — — Cerebro-spinal Fever — — — — — — — Erysipelas - - 2 1 - - 3 Diseases All ages Puerperal Pyrexia 4 Malaria 1* Ophthalmia Neonatorum 1 Food Poisoning 2 * Non-civilian. TUBERCULOSIS New cases and mortality during the year 1948: Age Periods New cases Mortality Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. 0—1 - - 1 - - - - - 1- 5 3 2 2 2 — — 1 1 5—15 5 3 6 3 — — 1 - 15—25 15 18 1 1 1 1 - 1 25—35 12 14 1 — 2 — - — 35—45 4 9 — 1 5 2 - — 45—55 7 3 1 1 1 - - — 55—65 6 4 — — 1 3 — — 65 and over 2 2 — — - 1 - — Age unknown - - - - — - - - Totals 54 55 12 8 10 7 2 2 It has not been found necessary to take any action under the Public Health (Prevention of Tuberculosis) Regulations, 1925 relating to tuberculous employees in the milk trade, nor under thi Public Health Act, 1936, Section 172, for the compulsory removal to hospital of persons suffering from tuberculosis. Insulin. In accordance with Circular 2734 of the Ministry of Health, dated the 4th January, 1943, free insulin has been supplied to 21 persons (all females) during the period 1st January, 1948 to 4th Jul)-, 1948). the amounts being: 106 x 10 c.C. 40 unit Insulin. 187 x 10 c.c. 40 unit Insulin P.Z. 5x10 c.c. 80 unit Insulin. 8 x 10 c.c. 80 unit Insulin P.Z. 8 x 5 c.c. 80 unit Insulin P.Z. Ambulance Service. The calls answered and the total mileage for the period lit January, 1948 to 4th July, 1948, are set out below: Calls Mileage Austin Ambulance 946 9,919 Standard Ambulance Car 109 1,201 Total 1,055 11,120 MAY 1949 14 Perry & Routleff Ltd. Printers Uxbridge and Ealing