HENR 10 THE RURAL DISTRICT OF HENDON. ANNUAL REPORT of the Medical Officer of Health for the Year 1920. Area: 11321 Acres. Population, 1911 Census. 14,161. Estimated Population 1920. 17,545. Mr. Chairman, Ladies & Gentlemen, I have the honour of presenting you with my Annual Report upon the sanitary condition of your District for the year 1920. Area and General Description of District. The area of the District is 11321 acres. It lies upon the southern and western slopes of the spur of high land running from the Barnet district and jutting out into the Weald of Harrow. The dividing lines of the five Parishes run approximately north and south, the northern portion of the Parishes resting on the hill and the southern lying in the valley. The highest point in the District, 502 feet above Ordnance datum, is oh the Watford Road at the Hertfordshire boundary. The lowest point, about 150 feet, is to be found at the south* east corner of Pinner Parish. The District is distinctly a residential one, being somewhat heavily timbered, and has a very small acreage of arable land. The agricultural portion of it is laid down m grass, and the chief agricultural product is hay. Running from east to west, the parishes come in the following order : Edgware, Little Stanmore, Great Stanmore, Harrow Weald, and Pinner. The District lies upon the great London clay bed, which is capped on the higher land by patches of gravel of varying thickness. In some places, notably in the north-east corner of Harrow Weald, the subsoil water rises to within a foot or eighteen inches of the surface of the gravel. Public Open Spaces: Besides the Stanmore Cricket Ground (seven acres) Stanmore Marsh (14 acres) the Little Common, Stanmore, (6¼ acres) and the Pinner Beds (10 acres) the principal common lands are these of Harrow Weald and Great Stanmore. The area of the former is 34¾ acres, of the latter 12l½ acres. VITAL STATISTICS:- Estimated Population. The estimated population according to the Registrar General is 17545, divided among the Parishes as follows Edgware 1523. Little Stanmore 2134. Great Stanmore 2284. Harrow Weald 2823. Pinner 8781. Births and Birth Rate. There were 346 births in the District, of which 11 were r « ■J ' illegitimate. The total births last year was 254. The birth rate for this year is 19.72; last year it was 14.45 and the previous year 13.82. Deaths and Death Rate. The number of deaths registered in the District was 126; last year the number was 118. There were 12 deaths of non-residents registered in the District, and 27 deaths of residents occurred outside the district. The corrected figure therefore is 141, giving a death rate of 8.036, as against death rate of 9.364 of last year, and 12.716 of the previous year, a decrease which speaks well for the healthy condition of the district. Principal causes of death. Diseases of the respiratory organs caused 24 deaths namely: Phthisis 5, Bronchitis 11, and Pneumonia 8. Only one death took place from Influenza. Cancer caused 31 deaths, 6 of which occurred outside the district. The ages and sex were Male: 54, 68, 79, 33, 70, 63, 60, 54, 62, 61, 44, 43, 61. Total 13. Female: 63, 57, 73, 74, 76, 54, 45, 56, 29, 66, 42, 67, 63, Total 18. 60, 73, 33, 58, 32. Total 18 Last year there were 16 deaths from this disease, equally divided between the sexes. Infantile Mortality. Sixteen infants under one year old died during the year. The death rate per 1000 nett births is 46.53. Last year it was 51.18, and the year before 55.77, a very steady decrease. Of these 16 deaths 5 were due to premature birth, one to injury at birth, and 4 to congenital debility. Principal Zymotic Diseases. Deaths for this year under the above heading total 5, giving a death rate of 0.284. The number last year was 16, of which number influenza caused 13. The total of 5 is accounted for as follows Measles 2, Diphtheria 1, Influenza 1, Erysipelas 1. Poor Law Relief. The amount expended on Poor law relief (outdoor) in the district for the year 1920 is £383, and there are I understand no special Poor Law Orders in the district. Hospitals. The Hospitals serving this district are The Stanmore & Bushey Heath Cottage Hospitals,the Hendon Union Infirmary, Stanmore Isolation Hospital, the Willesden & Harrow Isolation Hospitals, and various Metropolitan Hospitals. SANITARY CIRCUMSTANCES OF THE DISTRICT. Water Supply. The district is supplied by the ???olne Valley Water Company, and practically every house is connected. It is a constant service of very pure water obtained from deep wells in the chalk near Watford. It is artificially softened. No complaints were received during the year. Rivers. The river Pinn and the Edgware Brook run through the district. They have not given rise to any trouble during the year, and no pollutions found. A serious pollution of a ditch caused by the '' ' •' ' •. t t ' N ( effluent of a soap factory was found in a field on our boundary pn December 31st. As this ditch ultimately drains into a small stream outside the district, this source of pollution was evidently very dangerous, and your attention was called ???it in my report. You decided to take immediate action, and the factory has since been removed. Drainage and Sewerage. The district is well sewered and except for a very few outlying houses, all are connected with the main drainage. There are 3 sewage farms for the disposal of sewage; one at Pinner, one at Grea,t Stanmore, and one for Edgware and Little Stanmore. The farms do their work effectively; samples of the effluent have been taken from time to time and are found quite satisfactory. The Harrow Weald sewage is treated at Wealdstone by arrangement with the Wealdstone Urban District Council. The sewer in Cornwall Road gave way - it has been remedied. A slight extension of the sewer in Pinner Hill Road was found necessary for the draining of new houses on Pinner Hill site. New sewers have been laid for the new houses in Harrow Weald, Great Stanmore and Little Stanmore, also on the Grange Estate, Pinner, which is ready for development. Closet Accommodation. The large majority of houses in the district have water closets which connect with the main sewer: but there are several instances, notably the Upper Square, Great Stanmore, where the closet arrangements, though connected with the sewer, are both inadequate and detrimental to the morals and decency of the people. Two water closets in this open square, with no attempt at privacy, supplying the needs of six cottages grouped around them, ere a blot on the civilization of 1921. With reference to another group of six cottages in Great Stanmore, which I mentioned in last year's report as having privy middens owing to their distance from any sewer, the emptying and cleansing of these places has now been satisfactorily 'settled. Scavenging. The collection and disposal of house refuse has been carried out by contractors throughout the district, except in Pinner, where you decided to do the work with your own men and horses. This arrangement has proved satisfactory, and complaints from this Parish are now rare. There have been very few complaints from Harrow Weald, but on the other hand in Sdgware, Little Stanmore and Great Stanmore, considerable trouble was experienced with the men during March and April. Complaints were very numerous at that time. Almost every house in the district has a portable dustbin, with proper covering. The costs of scavenging in the district are as follows Pinner £1366. 8 0. Harrow Weald £283 0 0 Edgware & Little Stanmore £648 0 0 Great Stanmore £394. 0. 0. The refuse is tipped at Pinner and Great Stanmore Sewage Farms, at Bacon Lane and Harrow Weald brickfields; it is there sorted and the residue burnt. No complaints have been made as to this disposal. Sanitary Inspection. The sanitary inspection of the district has made good progress during the year. The total number of inspections made during the year numbered 1286. Inspections under the Housing Acts numbered 336; preliminary notices under the Housing Acts 124; Statutory Notices under the same Acts 35; Inspections re Infectious Disease 85. A cottage at Edgware was closed voluntarily by the Owner after receiving notice to do certain repairs; two cottages in Little Stanmore were also intended to be closed by the Owners as the roofs were unsafe, and they would not do the repairs; owing to shortage « of houses one of these is still occupied. A classified Table giving numbers of Inspections etc. made during the year will be found at the end of this Report. Common Lodging Houses. Underground Sleeping Rooms. There are none of these in the District. Offensive Trades. A Factory for re-boiling and refining soap was started at the end of the year in Kenton Lane, Harrow Weald. The buildings erected were temporary ones and did not comply with the Council's Bye-laws. Proceedings were instituted against the Company, and the Factory has since been removed. Schools. The Schools of the District have been visited on many occasions, and there is nothing particular to report about them. All the Schools are connected with the Colne Valley Water system. FOOD. Milk Supply. No complaints were received during the year as to the milk and no samples were taken. Dairies, cowsheds and milkshops are visited twice a year. There are 27 persons or firms on the Register, and there were three contraventions of the Bye-laws. Number of Cowsheds 44, Inspections 87. One unregistered person was detected in Harrow Weald. This was at once rectified, the cowshed was properly drained and water laid on. There are 37 dairies, milkshops and milk stores. 73 inspections were made and 2 contraventions found. In one case the washings of milk churns found its way into a ditch. Arrangements were made to filter it. Milk & Cream Regulations. These are carried out by the County Council. Milk (Mothers & Children) Order 1919. The County Council is the Authority under this Order. Other Foods. Meat and Fish. There are eight licensed Slaughterhouses in the district, all of which have been frequently visited. Since Food Control came to an end a certain amount of slaughtering is now done in the district, but very much less then before the War. The slaughterhouses have been kept in a good and clean condition. There is no public abattoir in the district. As I have before pointed out, it is impossible for one Sanitary Inspector to efficiently inspect the meat when the killing may go on simultaneously in as many as eight different slaughterhouses scattered over such a wide district. Action was taken under Section 117 of the Public Health Act 1875 on 24i lbs of tainted bacon, which was condemned, also the carcase of a cow and all its organs was seized and condemned. This latter case was the subject of a prosecution, when three men were convicted and fined for dealing with the meat in this tuberculous condition. Slaughter-houses Table:- (4). 1914. January 1920. December 1920. Registered. - - - Licensed. 8. 8. 8. Other Foods (continued). Four stones of unsound fish were seized; 22 lbs of sausages and 26 bags of currants were also seized and condemned. Bakehouses. These have been kept on the whole in a clean condition. Sale of Food & Drugs Acts. These are carried out by the County Council. PREVALENCE OF & CONTROL OVER INFECTIOUS DISEASES. Infectious Diseases. There were 109 cases of Infectious disease notified during the year, of which 60 were Scarlet Fever, 15 Diphtheria, 11 Pneumonia, 16 Pulmonary Tuberculosis and 2 of other forms of Tuberculosis; 2 Erysipelas; 1 of Ophthalmia Neonatorum; 1 Puerperal Fever and 1 Encephalitis Lethargica. Scarlet Fever. Of these 60 cases, 36 came from Pinner, 9 from Harrow Weald, 7 from Great Stanmore, 2 from Little Stanmore, and 6 from Edgware. Diphtheria. Of the 15 Diphtheria cases, 5 came from Pinner, 7 from Harrow Weald, and one each from Little Stanmore, Great Stanmore, and Edgware Encephalitis Lethargica. This case came from Pinner, the source of infection was never traced. The patient, a woman, recoverod. Pneumonia. There were 11 cases notified of Pneumonia, 2 of which were influenzal. Tuberculosis. There were 16 cases of Pulmonary Tuberculosis notified during the past year; last year the number was 18. Of these 16 cases. 8 were treated in Hospital or Sanatoria, the others being treated by the Tuberculosis Medical Officer in the various dispensaries, or at home by their own Doctors. There were also two cases notified as suffering from others forms of Tuberculosis. Disinfection &c. All cases of infectious disease are visited on notification by your Sanitary Inspector, and disinfectants left. All cases of Scarlet Fever and Diphtheria, including carriers of the latter, which cannot be satisfactorily nursed and isolated at home, are removed to your Isolation Hospital, after which the rooms occupied by the Patient are disinfected and infected bedding removed and treated in your steam disinfector. All carriers of Diphtheria are notified as suffering from the disease and treated as such, with excellent results in preventing the spread of the disease. Your Council pays for the examination of swabs from any suspected throat and antitoxin is distributed free of charge to any medical man in the district requiring it. Influenza. Cases of Influenza which cannot be xxxxxx. nursed at home are removed to the Isolation Hospital. (5) Tuberculosis. In cases of Tuberculosis visits are at once paid by the Sanitary Inspector; disinfectants are left together with leaflets setting forth the necessary precautions to be adopted to prevent the spread of infection. All contacts are kept under observation and in addition your Council allows the free examination of sputum for those unable to pay for it. On the termination of a case owing to death or removal to hospital the room and bedding are thoroughly disinfected. Notification of Tuberculosis. The regulations as to notification of this disease are well carried out in this district and information always given me as to the removal to or from Sanatorium or Hospital, but I should like to point out that the chain of information is defective so far as regards the movements of a case from one district to another. Non-notifiable diseases. There were very few non-notifiable infectious diseases in the district this year. Smallpox. No primary or re-vaccinations were performed by me as Medical Officer of Health during the past year. Anthrax and Rabies. No case of either of these occurred in the district during the past year. Ophthalmia Neonatorum. One case occurred in the district during the year, without any untoward results. SANITARY ADMINISTRATION. Staff. There is one Sanitary Inspector who is also Inspector of Nuisances, Inspector of Petrol Stores end Inspector to the Food Committee. He also supervises the removal of house refuse. Your Council give him assistance when necessary. Isolation Hospital and Accommodation. Caees. 126. Deaths 4. The<accommodation of this Hospital consists of 26 beds and cots. During the year 126 cases were treated. Last year the number was 84. I regret to say there were 4 deaths, all from Diphtheria, Of these 126 cases, 68 were Scarlet Fever, 1 Influenza, and 57 Diphtheria. At the end of the year there were still in Hospital 9 cases of Scarlet Fever and 11 of Diphtheria. The majority of Diphtheria cases came from outside the district, chiefly from Wealdstone. There was a severe epidemic of this disease at the time both in Wealdstone and Harrow, and I much regret to have to report that three of the cases died whilst in the Isolation Hospital. The type of infection appeared to be much more virulent than one has been accustomed to of late years, and at one time I feared the mortality would be much higher. Thanks, however, to the unremitting attention and skill of Sister Streeter and her able Staff the greater number of these very dangerous cases survived. I tender them my sincere congratulations. (6) Smallpox Accommodation. We have had no cases of Smallpox during the year, but we have accommodation ready for at least ten patients in the form of tents which can be erected at a few hours notice on the site rented by the Council at Marsh Farm, Stanmore. Local Acts. (1) Middlesex General Powers Act. 2 Public Health Act 1875. (3) Public Health Acts Amendment Act 1907. Chemical & Bacteriological Work. Arrangements are in force with Dr. Eastes, Pathological Laboratory. 6, Harley Street, W. for the examination of diphtheria and tubercle bacilli. All medical men in the district are supplied with swabs and sterile bottles for examinations of material free of charge. Parke Davis's Diphtheria Anti-toxin in vials of 2000 and 4000 units are also supplied free of charge. HOUSING. General housing condition of the District. The total number of houses in the district is 4002, divided as follows:- Edgware 344. Little Stanmore 482. Great Stanmore 437. Harrow Weald 504. Pinner. 2235. The number of working class houses is 2069. There were 49 new houses erected for the working class during the year and there are 191 in course of erection. Population. The population of this district has remained practically stationary, owing to so many factories having been closed, and as new houses have been already erected, the situation is easier. Shortage of houses. I estimate that 330 houses are still required, divided among the district as follows:- Edgware 110. Little Stanmore 30. Great Stanmore 50. Harrow Weald. 40. Pinner 100. New houses have been erected during the year as follows Edgware 3. Little Stanmore 4. Groat Stanmore 2. Harrow Weald. 14. Pinner 33. Total. 56. Plans have been passed by your Council for the erection of 221 new houses, and 1 new shop, divided as follows Houses. Shops. Edgware 9 0 Little Stahmore 55 0 Great Stanmore 1 0 Harrow Weald 52 1 Pinner 104 0 Overcrowding:. There is still a good deal of overcrowding in the district, chiefly caused by the high rents of the new houses, and also owing to the shortage of houses. Tenants of small cottages complain that they cannot afford the rents of the new houses and in some cases this is true, but in others where high wages are being earned I am afraid that no effect is made to move, as they trade upon the fact that your Council has been naturally unwilling to put pressure upon them owing to the shortage of accommodation. If it were not for this shortage I should long ago have strongly urged you to close the Upper Square Stanmore among other like places in the district, and this is a matter which cannot be left indefinitely. There are 5 cases of overcrowding in Great Stanmore, 3 in Edgware, 1 in Little Stanmore, 2 in Pinner, and 3 in Harrow Weald. Fitness of houses. The majority of the houses in the district are in good repair, and the dilapidations have as a rule been made good, but there has sometimes been unavoidable delay owing to tne scarcity of material. Unhealthy Areas. There are still one or two unhealthy areas in the district, by which I mean groups of cottages unfit for occupation - but most of the houses reported under this heading last year have been put in fairly good condition. There are still houses requiring attention at Pinner and Great Stanmore. Bye-laws. There is no difficulty in the working of the existing Bye-laws which are all that are required for the district. In conclusion, ladies, and Gentlemen, I wish to take this opportunity of thanking Mr. Webb and Mr. Johnson for their kind assistance during the year, and also for their aid in compiling this Report. May I also express my appreciation of the courtesy and attention which I have always received from your Chairman and all the Members of the Council. I am, Ladies & Gentlemen, Yours faithfully, (Sgd) R.L. ROMER. (8) ' : '• ' V it'; * ■ Jt ' ' . »"• 'v APPENDICES to Annual Report of the Medical Officer of Health, for the Year ended 31st December 1920. Sanitary Table of Work done during the year. Total number of Inspections made. 1286. Total preliminary Notices, Public Health Acts &c. (including Notices re removal of House Refuse). 241. Ordinary Statutory Notices. 9. Inspections under the Housing Acts. 336. Preliminary Notices under the Housing Acts. 124. Statutory Notices under the Housing Acts. 35. Inspections re Infectious Disease. 85. Drains examined. 58. Drains repaired. 53. Waste pipes & ra.in water pipes repaired. 24. Vent pipeB repaired. 17. New vent pipes fixed. 2. New manholes constructed. 2. Water closets built. 3. Water closets improved. 42. Cesspools emptied. 3. New Dustbind provided. 15. Cases of Dampness remedied. 57. Nuisances re keeping of Animals remedied. 7. Overcrowdings abated. 2. Rooms renovated. 139. Yards improved. 5. Foul ditches cleansed. 11. Nuisance from Caravan abated. 1. (9). ; 'jwce iic:. f'tV Ww"'w 'a. \ • . $ ■■« ■■ ^ •-{J J.Oi.vCKTT'j-,T* :>v. •v v' 'v.. v ...»03 J -. 'J.;. v * Ait? C? i i -J * . "/ . jj; .00«? X»0;Vd .1 ' £«j" r Q jj i" J} 9 « ' -** * J .#? b L 07.0 (? 1-? X. 0 *.•• Q J L ■ ;.Lr/iuo • ;;• o/Tii V.. V.*:- • V • O 3V 0 i HOUSING CONDITIONS. Statistics. 1. General. 1. Estimated population. 17545. 2. General death-rate. 8.036, 3. Death rate from tuberculosis. - 4. Infantile mortality re 1000 nett births. 46.53. 5. Number of dwelling-houses of all classes. 4002. 6. Number of working class dwelling-houses. 2069. 7. Number of new working-class houses erected. 49. 2. Unfit Dwelling-houses. 1. Inspection:- (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts). 464. (2) Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations 1910. 336. (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation. 4. (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonable fit for human habitation. 130. II. Remedy of Defects without Service of formal Notices:- Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers. 91. III. Action under Statutory Powers:- A. Proceedings under section 28 of the Housing, Town Planning Sc. Act 1919. (1) Number of dwelling-houses in respect of which notices were served requiring repairs. 35. (2) Number of dwelling-houses which were rendered fit: (a) by owners. 31. (b) by Local Authority in default of Owners. 0. (3) Number of dwelling-houses in respect of which closing Orders became operative in pursuance of declarations by owners of intention to close. 4. B. Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied. 10. (2) Number of dwelling-houses in which defects were remedied: (a) by owners. 10. (b) by Local Authority in default of owners. 0. (10) 4 • • ' C. Proceedings under sections 17 and 18 of the Housing, Town Planning &c. Act 1909. (1) Number of representations made with a view to the making or Closing Orders. 4. (2) Number of dwelling-houses in respect of which Closing Orders were made. 4. (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwellinghouses" having been rendered fit. 2. (4) Number of dwelling-houses in respect of which Demolition Orders were made. 0. (5) Number of dwelling-houses demolished in pursuance of Demolition Orders. 0. 3 Unhealthy Areas. Areas represented to the Local Authority with a view to Improvement Schemes under (a) Part I or (b) Part II of the Act of 1890:- (1) Name of Area. (2) Acreage. (3) Number of working-class houses in area. NIL. (4) Number of working-class persons to be displaced. 4. Number of Houses not complying with the building bye-laws erected with consent of Local Authority under section 25 of the Housing, Town Planning &c. Act 1919. Nil. 5. Staff. Staff engaged on housing work: 1 Inspector who is also Sanitary Inspector and Inspector of Petrol Stores. (11)