HEN 27 BOROUGH OF HENDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH for the year 1950 A. FAIRCRIEVE ADAMSON, M.D., D.P.H., Medical Officer of Health. ' . ' - BOROUGH OF HENDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH for the year 1950 A. FAIRCRIEVE ADAMSON, M.D., D.P.H., Medical Officer of Health. COUNCIL of the BOROUGH 1950/1951 The Mayer Alderman J. L. FREEDMAN, J.P., M.A., LL.B. The Deputy Mayor : Alderman G. J. PRYKE, F.I.A.C., A.M.I.S.E. Aldermen: W. R. CLEMENS, J.P., F.C.A., J. J. COPESTAKE, J.P., A. W. CURTON, F.R.S.A., M.Inst.B.E., J. L. FREEDMAN, J.P., M.A., LL.B., R. J. KNOWLES, M.M., M.I.W.M., A. A. NAAR, M.B.E., G. J. PRYKE, F.I.A.C., A.M.I.S.F.., J. H. RODWAY, J.P., C. H. SHEILL. Councillors: L. ANDREWS, S. E. ARRIDGE, E. G. BURMAN, M.I.T.A., L. C. CHAINEY, A. J. CHOWN, D. A. DAVIS, (Miss) M. EATON, S. A. FROST, J. GRIFFITHS, J.P., J. HARLEY, T.D., A.I.B., R. HARRISON, L. A. HILLS, E. M. D. JONES, F.C.A., W. R. LAWRENCE, M.A., LL.B., W. LLOYD-TAYLOR, H. M. MATTHEWS, T.D., C. G. MONK, M.A., D. G. PARSONS, S. J. PATMORE, A.M.I.Mech.E. A.M.I.E.E., A.R.Ae.S., A. PAUL, W. ROWLEY, S. E. SHARPE, D. F. SIMONS, A. V. SULLY, M.C., F.C.A., S. R. C. SUMPTER, F.B.A.A., (Mrs.) D. THORNYCROFT, M.A., B. H. O'RYAN TURRALL. PUBLIC HEALTH COMMITTEE. Chairman: Councillor L. C. CHAINEY. Vice-Chairman: Alderman C. H. SHEILL. Aldermen: W. R. CLEMENS, J.P., F.C.A., G. J. PRYKE, F.I.A.C., A.M.I.S.E. (Deputy Mayor). Councillors t (Miss) M. EATON, S. A. FROST, R. HARRISON, C. G. MONK, M.A., A. PAUL, S. R. C. SUMPTER, F.B.A.A., (Mrs.) D. THORNYCROFT, B. H. O'RYAN TURRALL. 2 ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR 1950. To the Mayor, Aldermen and Councillors of the Borough of Hendon. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit my Annual Report for the year 1950, this being my twenty-first report as your Medical Officer of Health. The general standard of health in the Borough was high and the following facts are particularly worthy of comment. The infantile mortality rate fell to a record low figure of 15.9 per 1,000 live births as compared with that of the country generally of 29.8. In my Annual Report of 1946, in which year the infantile mortality rate was 29, I stated "It is unlikely that an infantile mortality rate as low as has prevailed during the last two years will be materially reduced excepting in the light of further scientific knowledge." This observation as you will see has already been disproved and the present rate reflects the greatest credit on the parental care now being exercised and particularly on that of the mothers, many of whom are raising their families under conditions of real difficulty. I am glad to report also that both the notifications and deaths from Tuberculosis have declined. The situation as regards Diphtheria is unique, as for the first time on record no cases were notified in the Borough, a tribute, 1 believe, to the value of the scheme for 3 tion first started in 19,35 and continued steadily since that date. The Borough in common with the country generally suffered another invasion by Acute Poliomyelitis though on a slightly lower scale than in the previous year. The continued higher incidence of this disease over the last six years suggests that there is little likelihood of the country being as free from the disease as it was prior to the year 1946. Housing conditions continue to present a social problem, the solution of which would make the greatest contribution to the health and happiness of the community. Unfortunately Housing Authorities are finding that the provision of new housing on anything like an adequate scale is surrounded with difficulties entirely beyond their control. The Sanitary Inspectors have devoted much of their time to endeavouring to maintain the standards of the older properties which have tended to deteriorate rapidly particularly because of over occupation and also because of the high costs of repairs which are now disproportionate to the rents being received. The Public Health Committee has given much consideration to methods for the improvement of food hygiene which should bear fruit during the coming year, particuarly as the powers of dealing with food handling generally have been increased by the recent Bye-Laws issued by the Ministry of Food and in the operation of which it is anticipated that the co-operation of the great majority of those in the food trade will be obtained. In closing I should like to take this opportunity of thanking the members of the Council for their continued interest and concern in all matters affecting the health of the community and the staff of the Public Health Department for their loyal and conscientious service during the year. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, A. FAIRGRIEVE ADAMSON, Medical Officer of Health. 4 GENERAL HEALTH CONDITIONS. VITAL STATISTICS: The Registrar General's estimate of the population on the 30th June, 1950, was 158,200. Birth Rate: The number of live births registered was 2,261, this being 4 more than in the previous year. TABLE I. Live Births M. F. Total Legitimate 1112 991 2103 Illegitimate 89 69 158 2261 The comparability figure for the Borough is 0.92 which allows for the varying age and sex distribution of the population in different areas and is given so that a comparison may be made with other districts and with the country as a whole. The crude birth rate, therefore, was 14.29 and the corrected birth rate 13.15 as compared with 15.8 for the country generally. Death Rate: The number of deaths registered during the year was 1,501 as compared with 1,522 in the previous year. The crude death rate being 9.49 but when corrected by the comparability figure, in this case 1.09, the correct death rate becomes 10.34 as compared with that of the country generally of 11.6. Infantile Mortality: The infantile mortality rate, that being the number of deaths of infants under one year of age, as related to the number of live births registered is the lowest ever recorded, namely, 15.9 as compared with 22 in the previous year. The rate for the country generally was 29.8. 5 A singular feature was that out of 1'58 illegitimate births notified only 2 deaths were recorded, giving an infantile mortality rate for this group of 12.66. This is a reversal of what has prevailed in the past and even as recently as 1938 the mortality amongst illegitimate children was double that of legitimate. I believe that the increasing care which is being devoted to the unmarried mother and her child and which in return is reflected in a higher sense of maternal responsibility on the part of the unmarried mother is responsible for this change. The gradual diminution which has taken place in the infantile mortality rate is illustrated in Table 11 below:— TABLE II. Year. Death rate of infants under one year of age per 1,000 live births. 1900 133 1910 80 1920 47 1930 50 1940 54 1941 57 1942 34 1943 39 1944 32 1945 29 1946 29 1947 27 1948 21 1949 22 1950 16 6 Stillbirths: There were 26 stillbirths in 1950, giving a rate of 0.16 per 1,000 population as compared with 0.37 for England and Wales. Maternal Mortality: 2 deaths were registered as being directly due to or associated with pregnancy or childbirth giving a maternal mortality rate of 0.87 per 1,000 total births. This rate was almost identical with that for the country generally, namely 0.86. The following table shows the causes of death during the year classified under the 36 headings based on the abbreviated list of the International Statistical Classification of diseases, injuries and causes of death:— TABLE III. CAUSES OF DEATH. Cause. Male. Female. Total. Tuberculosis, respiratory 19 8 27 Tuberculosis, other 2 1 3 Syphilitic disease 10 — 10 Diphtheria — 1 1 Whooping Cough — — — Meningococcal infections — — — Acute Poliomyelitis 2 — 2 Measles — —. — Other infective and parasitic diseases 1 2 3 Malignant neoplasm, stomach 24 20 44 Malignant Neoplasm, lung, bronchus 45 10 55 Malignant neoplasm, breast — 29 29 Malignant neoplasm, uterus — 12 12 7 Cause. Male. Female. Total. Other malignant and lymphatic neoplasms 69 87 156 Leukaemia, aleukaemia 8 4 12 Diabetes 3 12 15 Vascular lesions of nervous system 72 96 168 Coronary disease, angina 143 74 217 Hypertension with heart disease 36 39 75 Other heart disease 87 149 236 Other circulatory disease 25 28 53 Influenza 5 5 10 Pneumonia 27 34 61 Bronchitis 30 20 50 Other diseases of respiratory system 11 6 17 Ulcer of stomach and duodenum 11 4 15 Gastritis, enteritis and diarrhoea 4 3 7 Nephritis and nephrosis 5 8 13 Hyperplasia of prostate 14 — 14 Pregnancy, childbirth, abortion — 2 2 Congenital malformations 7 12 19 Other defined and ill-defined diseases 45 75 120 Motor vehicle accidents 7 10 17 All other accidents 10 13 23 Suicide 4 8 12 Homicide and operations of war 2 1 3 All causes—TOTAL 728 773 1501 Infectious Diseases: The number of eases of infectious diseases as compared with previous years is shown on Table IV and from this and other information available in the Department certain significant features emerge. 8 TABLE IV. CASES OF INFECTIOUS DISEASES OTHER THAN TUBERCULOSIS NOTIFIED DURING 1945, 1946, 1947, 1948, 1949 and 1950. Disease Removed Total cases notified during to Hospital, 1945 1946 1947 1948 1949 1950 1950 Scarlet Fever 180 199 152 241 265 260 133 Diphtheria 20 33 10 8 10 — — Pneumonia 129 139 128 139 159 121 28 Acute Poliomyelitis 4 16 18 5 29 20 17 Acute Polioencephalitis — — — 3 1 1 Measles 2013 558 973 1289 1195 1029 24 Whooping Cough 162 367 394 516 329 494 16 Meningococcal Infection 4 8 10 2 5 5 5 Typhoid or Enteric Fever 1 3 3 1 1 Erysipelas — — — 38 23 27 8 Dysentery — — — 27 7 14 8 Diphtheria: No case of this disease was notified during the year For the purpose of comparison it will be of interest to note that in my first Annual Report as your Medical Officer of Health in the year 1930 there were 192 cases of Diphtheria notified with 7 deaths. The steady decline which has taken place is shown on Table IV. 9 It is a fact recognised by anyone whose experience of infectious disease extends over a sufficiently long period that changes in incidence and severity take place from time to time and may continue for extensive periods. Nevertheless, the change which has taken place in this disease has coincided with the implementation of the scheme for immunisation. The change is so dramatic that it is a reasonable assumption that in this instance we are dealing with cause and effect. Whilst the duty of providing immunisation now rests with the Middlesex County Council under the provisions of Section 26 of the National Health Service Act, 1946, which came into force on the 5th July, 1948, it had previously been the duty of the Borough Council who inaugurated the Scheme and up to the date of transfer had been responsible for immunising approximately 25,000 children. The accumulated totals up to date are also shown on Table VI. Poliomyelitis and Polioencephalitis: The increased incidence of this group of diseases which has been evident for a number of years was continued though on a slightly lesser scale, altogether 21 cases were notified as compared with '32 in the previous year. The following table gives particulars of the cases which were notified from which will be seen that the majority of cases occurred in the months from June to September inclusive, that 5 cases were of persons over the age of 21 years and only 4 eases occurred in children up to the age of 5 years. It will also be noticed that the distribution of the cases was spread throughout the Borough generally with the highest incidence in Park and Burnt Oak Wards, but on investigation in only one instance was there a direct contact with a known case of this disease. 10 TABLE V. Name. Age. Sex. Notified. Diagnosis. Ward. Remarks. J.L. 12½ F. 2/ 1/50 Poliomyelitis Park Mild attack. Residual weakness in muscles of neck. G.K. 4½ M. 4/ 1/50 Poliomyelitis Park Attack of mild severity with residual paralysis of face and shoulder girdle. A.H. 5 F. 18/ 1/50 Poliomyelitis Childs Hill Mild attack. No residual paralysis. V.M. 16 F. 12/ 6/50 Poliomyelitis Park Mild attack. No residual paralysis. J.M. 30 M. 21/ 7/50 Poliomyelitis West Hendon Mild attack. Slight residual paralysis left arm. W.F. 14 M. 17/ 8/50 Poliomyelitis Burnt Oak Mild attack. No residual paralysis. O.Y. 18 F. 16/ 8/50 Poliomyelitis Park Severe attack. Patient ultimately died 18/8/50. B.McA. 18 F. 25/ 8/50 Poliomyelitis Park Mild attack. No residual paralysis. Y.G. 17 F. 30/ 8/50 Poliomyelitis Edgware Severe attack. Residual paralysis of waist and arm muscles. J.C. 14 F. 30/ 8/50 Poliomyelitis Burnt Oak Attack of moderate severity. Residual paralysis, right leg. J.F. 11 F. 26/ 8/50 Poliomyelitis Burnt Oak Mild attack. No residual paralysis. P.P. 24 M. 1/ 9/50 Poliomyelitis Golders Green Mild attack. No residual paralysis. D.T. 21 F. 30/ 8/50 Poliomyelitis Burnt Oak Mild attack. No residual paralysis. I.M. 15 M. 16/ 9/50 Poliomyelitis Golders Green Mild attack. No residual paralysis. S.S. 52 M. 19/ 9/50 Poliomyelitis Garden Suburb Severe attack. Patient died 26/9/50. J.B. 11 M. 21/ 9/50 Poliomyelitis Golders Green Mild attack. No residual paralysis. 11 Name. Age. Sex. Notified. Diagnosis. Ward. Remarks. R.A. 2 M. 4/10/50 Poliomylitis Edgware Mild attack. No residual paralysis. P.D. 1½ F. 23/10/50 Poliomyelitis West Hendon Attack of moderate severity. Residual paralysis, right shoulder. J.A. 18 M. 7/11/50 Poliomyelitis Mill Hill Severe attack. Patient died 8/11/50. P.J. 30 F. 1/12/50 Poliomyelitis Burnt Oak Severe attack. Extensive residual paralysis, right leg. In addition one case of Acute Encephalitis was notified. Scarlet Fever: The incidence of this disease still remains comparatively high but the numbers which it is found necessary to admit to hospital are declining. There has, in my opinion, been a modification in the severity of this disease over the last 20 years and complications such as nephritis, mastoid disease and heart conditions have become much less common. This doubtless can to some extent be attributed to the increased potency of the therapeutic measures now at hand, namely, the sulphonnamides and the antibiotics such as penicillin. Nevertheless, these things apart, I am convinced that there has been a steady decline in the severity of this disease so much so that it is rare nowdays to see a really serious case and when it is borne in mind that the original Isolation Hospital Acts had as their main concern the isolation and treatment of the severe types of Scarlet Fever then prevalent and the serious and often fatal types of Diphtheria it will be appreciated what a marked change has taken place. Whether this change, particularly in the case of Scarlet Fever in which no immunising agent of real value has been so far produced, is likely to be of a permanent character remains to be seen. 12 TABLE VI. Year. No. of Cases of Diphtheria notified. No. of Deaths from Diphtheria. Accumulated total of immunised children. 1935 138 9 27 1936 86 2 130 1937 121 7 381 1938 195 4 725 1939 150 3 1124 1940 70 3 1729 1941 58 1 5868 1942 38 2 11068 1943 31 2 15506 1944 17 — 16970 1945 20 1 19555 1946 33* — 21478 1947 10* — 23890 1948 8 1 26346 1949 10* — 28376 1950 — — 30091 *of these the diagnosis was confirmed in 8 cases in 1946, 8 cases in 1917, and 4 cases in 1949. Smallpox: The threat of serious outbreaks of this disease is increasing because of the now largely unvaccinated state of the population and also because air transport permits a journey to be made from almost any part of the World in a time which is within the incubation period of the disease. On two separate occasions contacts arriving in the Country were kept under observation. Only one case, however, which aroused any suspicion was seen by me in consulation. The patient was a ship steward who had recently returned from a cruise in the Mediterranean and who had been ashore at ports where Smallpox was prevalent. An attempted vaccination five weeks previously had been unsuccessful. The 13 patient, in my opinion, did not suffer from Smallpox but from a very severe attack of Chickenpox, but owing to his recent history I asked the Ministry of Health for the services of a Smallpox Consultant who confirmed my opinion. No eases of Smallpox occurred in the Borough during the year. Tuberculosis: The following Table shows the notifications of tuberculosis since 1941:— TABLE VII. Year. Notifications. Pulmonary. Non-Pulmonary. Male. Female. Male. Female. 1941 68 90 9 21 1942 141 93 14 27 1943 100 74 19 18 1944 112 96 4 19 1945 101 70 15 15 1946 84 65 14 12 1947 109 80 7 10 1948 84 86 13 10 1949 112 81 16 10 1950 81 71 8 11 I am indebted to Dr. Trenchard, the Tuberculosis Officer at the Edgware Chest Clinic, for the following observations:— "Edgware Chest Clinic, (situated at Edgware General Hospital) serves a population of about 220,000, and includes in its area the Stanmore districts of Harrow and the Kingsbury districts of Wembley besides the Borough of Hendon. The work has increased as is shown by the following:— 14  31/12/49 31/12/50 Total number of notified cases on Clinic register 1,669 1,737 1949 1950 New cases diagnosed as tuberculosis during the year 244 21.3 Total attendances at Clinic 20,446 26,297 Total new cases referred to Clinic 1,284 2,777 Total number X-rayed 7,489 16,717 Total deaths of tuberculous cases attending Chest Clinic 56 28 It is to be observed that there has been a slight decrease in the number of new cases of tuberculosis and a considerable fall in the deaths, due no doubt to the fairly extensive use of new drugs (such as streptomycin) in treatment. Owing to a great shortage of beds there have been considerable difficulties in admitting patients to hospital for treatment and much treatment has had to be given at home. At the beginning of the year, the Hendon Group Hospital Management Committee opened an additional twelve beds for the use of patients attending Edgware Chest Clinic, and there was some increase in the number of sanatorium beds in the North West Metropolitan Hospital Region during the year. Nevertheless, the number of patients waiting for admission on 31st December 1949 was 103, and on 31st December 1950 was 115. One of the important measures for preventing the spread of tuberculosis is the provision of satisfactory housing conditions. Early in the year the Housing Committe kindly agreed to consider reports on cases, where there was a danger of the spread of tuberculosis in a household, submitted by the Physician to Edgware Chest Clinic through the Medical Officer of Health. This procedure, which has enabled some of the dangerously urgent problems to be dealt with can, however, be employed on on only a very small scale owing to the general shortage of houses." 15 Castro Intestinal Infections: The following notifications of this group of diseases were received during the year. Notified as Typhoid Fever: One notification was received. The disease in this instance was of long standing and the diagnosis was based entirely on clinical findings as no pathogenic organisms were recovered from the patient and his blood reaction was negative. His employment necessitated his having meals in various parts of London and no source of infection was traced. Notified as Paratyphoid B. 4 notifications of this disease were received. The source of infection was not ascertained in any of these cases but in one instance the patient had returned from France within two days of the onset of disease and it is assumed that he became infected in that Country. In another case 3 other members of the family were found to be carriers but none of these developed any symptoms and their carrier state was eventually cleared. Notified as Dysentery: 14 notifications were received, 4 of the cases occurred in one family but bacteriological investigation was negative. Of the remaining cases bacteriological investigation was positive in 3, the infecting organism concerned being sh sonnei in 2 eases and bact typhimurium in the other. In this last case the patient ultimately died but he was an elderly man already suffering from disease of the heart and blood vessels, and this infection while contributory was not the primary cause of death. In the remaining cases no bacteriological investigations had been carried out, the patients having recovered before the notifications were received. Notified as Food Poisoning: 32 notifications were received. These can be grouped as follows:— 8 in one household, bacteriological investigation, no intestinal pathogenes isolated. 16 An investigation into another case revealed the fact that altogether 6 members of the family were affected of which 3 were found to be harbouring sh sonnei. 3 further cases were notified in one family. Bacteriological investigation was negative both as regards the patient and suspected articles of food. Of the remaining cases where bacteriological investigations had been carried out infecting agents were bact typhimurium 3, salmonella infection 3. As a result of a notification of of food poisoning in a canteen worker, an investigation was made when it was found that amongest those habitually using the canteen, 17 persons complained of having attacks of gastro enteritis at about the same time. Their bacteriological findings were, however, consistently negative as were those of certain suspected articles of food. From these findings and from the nature of the symptoms it appeared that some extraneous matter had been used in the preparation of meals and that this outbreak, the only one occurring during the year was not a true instance of what is generally understood as food poisoning. I would like at this stage to express my gratitude to the staff of the Central Public Health Laboratory at Colindale, who have co-operated whole-heartedly in these and other investigations of public health interest and whose work on behalf of the Public Health Department and the practitioners in the Borough is recorded in the following Table:— TABLE VIII. RECORD OF EXAMINATIONS. Throat/Nose Swabs. Faeces. Sputum. Pertussis. Milk. Ice Cream. Water. Miscellaneous. TOTAL. 794 236 147 30 166 150 36* 253 1839 *Swimming Pools 35 Domestic Supplies 1 17 POOD HYGIENE: Clean Food Publicity: The Council had under consideration during the year various proposals for raising the standard of hygiene amongst food handlers and, amongst other matters, considered in particular the inauguration of Pood Guilds, Exhibitions and Educational Courses for food workers. By arrangement with the Central Office of Information, a film display was held at the Central Libary on Friday, 10th November. Six separate sessions were held on this date and at three of these, films of public health interest were exhibited, viz:— "Another Case of Poisoning" "Souring of Milk" " Town Rats " A list of food traders in the Borough, of which there are approximately 1,200, was compiled and classified in this Department under their various trades and forwarded to the Central Office of Information, who issued an invitation to each trader. The 2 p.m. session was poorly attended, only 7 being present, but at the session at 3.30 p.m., 75 were present and at the evening session at 7 p.m., at which the Chairman of the Public Health Committee presided, 50 attended. Clean Food Bye-Laws: The Model Bye-Laws prepared by the Ministry of Food for securing the observance of sanitary and cleanly conditions and practices in connection with the handling, wrapping and delivery of food and sale of food in the open air were received. The Council in considering their adoption suggested certain additions and amendments. 18 ESTABLISHMENTS FOR MASSAGE AND SPECIAL TREATMENT. MIDDLESEX COUNTY COUNCIL ACT, 1944, SECTION 353—363: The Council continued to exercise its function as a licensing authority under the provision of the above-mentioned Act. A person requiring a licence or renewal of a licence under this part of the Act must make application in writing to the Local Authority giving certain information, such as age, nationality, technical qualifications and nature of the establishment and business to be conducted thereat. The Council considered the following number of applications:— New Licences 9 Renewals of Licences 14 Certificates lodged under Section 363 by Members of the Chartered Society of Physiotherapy 8 Licences Refused Nil SANITARY CIRCUMSTANCES OF THE AREA. HOUSING: I am indebted to the Housing Officer for the following observations and statistics relevant to the housing situation in the Borough during the year under review:— "The Council has continued to give earnest attention to the rehousing of families living under inadequate housing conditions. During the course of the past twelve months 190 families have been rehoused in Council Houses, but even so the number of housing applicants requiring alternative accommodation continues to increase, and the number still awaiting rehousing shows an increase over last year's figures. A feature of the past year has been the number of transfers arranged whereby families not fully occupying houses have been moved to smaller property thus making the larger type house available for the bigger families. 19 The demand from evicted families still continues to be heavy, and although 71 such families have been offered emergency accommodation in Half-Way Houses during the year, it has been impossible to assist in very many cases. The following table sets out the number of housing applicants assisted during the year ending 31st December, iu?,n • TABLE IX. 1. Number of families rehoused into Permanent Accommodation:— (a) Pre-War Houses 34 (b) Post-War Houses 150 (c) Temporary Bungalows 6 190 2. Transfers arranged to relieve overcrowding on Council Estates 80 3. Number of families rehoused into Requisitioned Property 65 4. Number of homeless families given emergency accommodation in Half-Way Houses 71" TABLE X. Proceedings under Sections 11 and 13 of the Housing Act, 1936: Number of dwelling-houses unfit for human habitation 11 Number of dwelling-houses in respect of which Demolition Orders were made 3 Number of dwelling-houses demolished in pursuance of Demolition Orders 1 Number of dwelling-houses in respect of which an undertaking was given under Section 11 8 20 Proceedings under Section 12 of the Housing Act, 1936: Number of dwelling-houses ou which Closing Order was made in respect of part of the building 1 Proceedings under Section 9 of the Housing Act, 1936: Number of dwelling-houses in respect of which notice was served requiring repairs 1 Number of dwelling-houses which were rendered fit after service of Formal Notices:— (a) by Occupiers Nil (b) by Local Authority in default Nil inspection of Dwelling-houses during 1950: Total number of dwelling-houses inspected for housing defects (under Public Health and Housing Acts) 2045 Number of inspections made for the purpose 7110 Number of dwelling-houses found not to be in all respects reasonably fit for human habitation 688 Remedy of defects without Service of Formal Notices: Number of dwelling-houses rendered fit in consequence of informal action by the Local Authority 531 Proceedings under Public Health Acts: Number of dwelling-houses in respect of which Formal Notices were served requiring defects to be remedied 120 Number of dwelling-houses in which defects were remedied after service of Formal Notices:— (a) By Owner 94 (b) by Local Authority in default Nil 21 The following summary of the inspection work performed by the Sanitary Inspectors has been submitted to me by Mr. A. II. Smith, Chief Sanitary Inspector. The work of the Department is becoming' increasingly difficult in view of the continued rise in the cost of repairs whilst the rents of controlled dwellings remains stationary. Many of the houses had little or no repairs carried out during the war period and the expenditure now required to render a house fit is not commensurate with its value. During the course of the year under review inspections were carried out as set out below Inspections made 7260 Reinspections after order or notice 11193 Complaints received and investigated 1816 Nuisances discovered and dealt with 4836 Visits paid to Infected houses 622 Infected rooms disinfected 495 Cesspools emptied 170 Drains unstopped 775 Drains Tested 222 Dairies 46 Butchers and Other Food Shops 1475 Hawkers Storage Premises and Stalls 79 Overcrowding 261 Restaurants, Cafes, etc., including Licensed Premises 232 Caravans 123 Notices Served: Informal or cautionary 813 Complied with 663 Statutory Notices: Applied for 285 Served under Public Health Acts 171 Complied with 101 Outstanding 70 22 DTSTNFESTATION: Treatment of Verminous Houses. 31 houses were successfully treated. Privately owned 25 Council houses 6 Inspections were made of furniture and bedding and rooms in the occupation of tenants before transfer into Council houses and disinfestation was performed where necessary. Work of disinfestation is done by the Local Authority or by Specialist Firms where verminous conditions were discovered, these cases were followed up after removal. FACTORIES ACT, 1937: Number of inspections 103 Notices served to remedy defects 26 Notices complied with 22 Matters notified by H.M. Inspector of Factories 3 Lists of Outworkers received 60 Outworkers premises inspected 16 Nature of defects remedied at Factories: Sanitary Accommodation: Unsuitable or defective 1 Improperly ventilated or defective 4 Want of Cleanliness 5 Other offences 10 INSPECTION AND SUPERVISION OF FOOD: 1,991 inspections were made at premises where food intended for sale for human consumption was prepared, stored or sold. During the year the Ministry of Food issued Model Byelaws under Section 15 of the Food and Drugs Act, 1938, in connection with the Handling, WTrapping and Delivery of Food. 23 The Council submitted draft Byelaws with certain amendments for the approval of the Ministry of Food—the amendments were not accepted by the Ministry but a delegation of Officials of the Council awaited upon the Ministry with the result that the Ministry's approval was obtained to certain amendments to the Model Byelaws, the most important being the following which reads:— 3. (b) No person shall smoke or spit whilst handling, wrapping or delivering any food which is not prepacked or otherwise protected by a suitable cover against the risk of contamination unless, having regard to the nature of the food, such protection is not reasonably necessary. During the year the Public Health Committee formed a Clean Food Sub-Committee to consider the advisability of setting up a Food Traders Guild or similar Organisation. Meetings have been arranged with Food Traders Organisations and the Chambers of Commerce in the Borough with the object of deciding how best this can be achieved. From the following list of food condemned as being unfit for human consumption and destroyed, it will be seen that an increase in the amount of food has occurred over previous years. This is accounted for by the fact that a Multiple Firm has opened up a Central Distributing Depot, within the area which serves its many branches throughout London. LIST OF FOODSTUFFS CONDEMNED DURING 1950. Meat: 1,213 lbs. 10 ozs. and 4 haras (including:—Beef, Bacon, Ducks, Lamb, Sausages, Chickens, Rabbits, Mutton, Kosher Meat, Turkey, Brawn, Offals and Luncheon Sausage). Meat Pies: 6. Fish: 238£ stones (including:—Skate, Roes, Plaice, Cod, Haddock, Salmon, Hake, Herrings, Dog Fish. Whiting, Dover Soles, Lemon Soles, Smoked Fillets, Kippers, Milts, Cat Fish. 24 Tinned Food: Fish Paste 20,477 Meat 745 Milk 514 Fish 756 Vegetables 975 Fruit 594 Jam 269 (including Marmalade, Syrup, etc.) Soup 372 Fruit Juice 153 Puddings 35 Fresh Fruit and Vegetables: Apples ½ case and 10 lbs. Almonds 1¼ tons. Prunes 268 lbs. Dried Peas 18 lbs. Dates 16 boxes and 70½ lbs. Figs 52 lbs. 7½ ozs. and 66 pkts. Miscellaneous Goods: Aspro 150 pkts. Baby Food 1 tin. Baking Powder 4 tins. Barley Flakes 13½ lbs. Barley Patent 1 tin. Bengers Food 51 tins. Biscuits 217 lbs. Blancmange 6 pkts. Cakes 538 and 22 lbs. Cake Mixture 240 pkts. Cereals 250 pkts. Coffee 1 bottle and 18 tins. Chocolate Spread 1 carton. Cocoa, Ovaltine, etc. 7 tins. Cheese 484 boxes and 46 lbs. 9 ozs. Cod Liver Oil Emulsion 5 bottles. 25 Cow and Gate 5 tins. Crumpets 96. Custard Powder 117 pkts. Eggs 4,416. Essence 15 bottles. Flour 621½ lbs. Flavoured Wines 33 bottles. Fruit 24 bottles and jars. Frying Oil ½cwt. Gravy Powder 29 lbs. Horseradish Cream 4 jars. Herring Fillets 59 jars. Icettes 4. Junket Powder 3 bottles. Jam (jars) 15. Jelly 3 pkts. Lemonade Powder 3 pkts. Margarine 50 lbs. Macaroni 38½ lbs. Matzos 2 pkts. Minerals 2 bottles. Mint Sauce 3 bottles. Mustard 2 (jars and tins). Oats 7 1¾ lbs. Olives 3 jars. Oxo 5 cubes. Pickles (including Salad Cream, Onions, Sauces, etc.) 494 jars and bottles. Pearl Barley 3 lbs. Paste 158 jars. Potato Crisps 1 tin and 8 pkts. Peanut Butter 1 jar. Pudding Mixture 226 pkts. Pom 4 pkts. Pumpernickel 24 pkts. Rice 28½ lbs. Soup 24 pkts. Suet 5 pkts. Sweephat, Ka-Fat, etc. 106 pkts. 26 Soyasem 29¾ lbs. Sugar 75 lbs. Soya Flour 14 lbs. Salt 38 pkts. Semolina 14 lbs. Sago 8 pkts. Sandwich Spread 72 jars. Shrimps 1 jar. Spaghetti 6 lbs. Squash 5 bottles. Tea 1¼ lbs. Tomato Cocktails 2 bottles. Vermicelli 14 lbs. Vinegar 2 bottles. Yeast 8 pkts. Confectionery: Assorted Sweets 693 lbs. 6 ozs. 2 tins. 10 slabs. 868 pkts. Informal action taken in connection with Food Shops and Food Stores: 130 Notices were served on occupiers of Shops and Stores for infringements of the Food and Drugs Act, 1938, where proper precautions were not being taken against contamination of food. At the end of the year a remedy had been effected in 104 instances. The principal matters dealt with were;— Sanitary accommodation: Defective sanitary conveniences 4 Defects in drainage systems 5 Choked drains 5 Compartments cleansed 43 Provision of washing facilities: Provision of hot water supply 44 Refrigerators: Interiors cleansed 7 27 General: Insufficient accommodation for storage of refuse 7 Want of cleanliness 56 Other defects 106 MILK SUPPLY: Number of registered Dairymen and Distributors 12 Number of registered Dairies not being Dairy Farms 8 46 Special visits have been made of dairies under the Milk and Dairies Regulations 1949. Milk Special (Designations) Regulations: The following table shews the number of Licences issued under these Regulations during 1950. Dealers Licences: Tuberculin Tested 34 Pasteurised 32 Sterilised 30 Dealers Supplementary Licences: Tuberculin Tested 16 Pasteurised 18 Sterilised 15 There is one large pasteurising establishment in the district which is licensed by the County Council and during the past year '20 samples of pasteurised milk and 2 samples of bottled tuberculin tested (pasteurised) milk taken immediately after machine capping were submitted for bacteriological examination. 24 samples of raw bulk milk were taken from rail tanks and 138 bottles immediately after cleansing in the bottle washing machines. The total number of milk samples taken for examination was 132; Tuberculin Tested 27, Pasteurised 91, Sterilised 11 and Non-Designated 3. 28 The total number of samples (including cleansed bottles) was '294. With one exception, the samples were satisfactory. ICE CREAM: 138 Samples of ice cream were taken during the year and submitted for bacteriological examination to, the Central Public Health Laboratory, Colindale. Results in accordance with the Provisional grade scheme recommended by the Ministry of Health were as follows:— Provisional Grade. Number of Samples. 1 74 2 33 3 15 4 16 ■ Where unsatisfactory samples were obtained investigations were carried out by the Sanitary Inspectors at the producers plant and advice given. SLAUGHTERHOUSES: The Livestock (Restriction on Slaughtering) Order, 1940, made under the Defence (General) Regulations, 1939, prohibits the slaughter of animals for human consumption, except under the terms and conditions of a licence granted by, or under the authority of, the Minister of Food. Neither of the two slaughterhouses in the district is licensed by the Ministry of Food and slaughtering has ceased. No slaughtermen's licences were issued during the year. WATER SUPPLY: The Borough has a dual source of supply:— The Metropolitan Water Board supplying an area bounded on the West by the London Midland and Scottish Railway, on the North by a line along the Mutton Brook to Bridge Lane and on the East by the London North Eastern Railway. The remaining Northern portion of the Borough is supplied by the Colne Valley Water Company. 29 1. The Metropolitan Water Board supplied selected Thames water which has been subjected to purification by storage in which time it is freed of the bulk of organisms. It is filtered through rapid and then slow filters, attaining a degree of purity which compares favourably with the general supplies in Great Britain, but as a further safe-guard, terminal chlorination is applied which ensures a first-class water in every respect. Samples of waters and filter-beds are examined bacteriologically, chemically and for taste and other special purposes on every working day. 2. The Colne Valley Water Company derives its supply from deep wells sunk into the chalk and before distribution to the consumers the water is under the constant supervision of a chemical and bacteriological staff which carries out examinations in modern laboratories situated at the Works. A high standard of piirity is maintained. SWIMMING BATHS: There are two swimming baths owned by the Local Authority and one privately owned. The filtration plant at the Local Authority's baths consists of filters of the horizontal pressure type and cascade aerators. After passing through the filters the water is injected with ammonia gas in solution and then passes over the cascade aerators and is finally injected with chlorine gas in solution before passing into the bath. During the Season 20 samples were taken from the Local Authority's Baths and 14 samples from the privately owned bath. PREVENTION OP DAMAGE BY PESTS ACT, 1949: This Act came into force on the 31st March, 1950, and repealed the Rats and Mice (Destruction) Act, 1919. The following is a summary of the work carried out by the rodent operatives acting under the general supervision of the District Sanitary Inspectors:— 30 Local Authority's Property. Dwelling Houses. Business Premises. Number of properties inspected 10 1514 147 Number of inspections and visits made 71 5572 485 Number of treatments carried out:— (a) Rats 7 607 46 (b) Mice 3 288 42 STATISTICS. Area (in acres) 10,361 Population, 1950 (Registrar-General's Estimate) 158,200 Number of Inhabited Houses (1950) 41,450 Rateable Value (1950) £2,004,207 Sum represented by a Penny Rate £8,158 Total Live Births 2,261 Birth Rate per 1,000 population13.15 Birth Rate per 1,000 population (England and Wales) 15.8 Total Stillbirths 26 Stillbirth Rate per 1,000 (live and still) births 11.37 Total Deaths 1,501 Death Rate per 1,000 population 10.34 Death Rate per 1,000 population (England and Wales) 11.6 Infant Deaths 36 Infant Mortality Rate 15.9 Infant Mortality Rate (England and Wales) 29.8 Maternal Deaths 2 Maternal Mortality Rate 0.87 Maternal Mortality Rate (England and Wales) 0.86 31 Death Rate of infants under one year of age:— All infants per 1,000 live births 15.9 Legitimate infants per 1,000 legitimate live births 16.17 Illegitimate infants per 1,000 illegitimate live births 12.66 Deaths from Cancer (all ages)296 Deaths from Measles (all ages) — Deaths from Whooping Cough (all ages) — Deaths from Diarrhoea (under 2 years of age) 7 POPULATION: The Registrar-General has estimated the total population to be 158,200. This figure includes members of the Armed Forces stationed in the area and is practically identical with that of the previous year. BTRTHS: There were 2,261 registered live births in 1950, as compared with 2,257 in 1949 giving a birth rate in 1950 of 13.15 as compared with the country generally of 15.8. STILLBIRTHS: There were 26 stillbirths in 1950, giving a rate of 0.16 per 1,000 of the population, as compared with 0.37 for England and Wales. INFANTILE MORTALITY: There were only 36 deaths of infants under one year of age, giving an infantile mortality rate of 15.9 per 1,000 live births which is the lowest rate which has ever been recorded for the Borough of Hendon. The corresponding rate for England and Wales was 29.8. MATERNAL MORTALITY: Two women died in 1950, giving a maternal mortality rate of 0.87 per 1,000 total births, the rate for England and Wales being 0.86. DEATHS: There were 1,501 deaths in 1950, 21 less than in the previous year. Hendon Printing Works Limited, 42/44, Victoria Road, N.W.4. HEN. 1004 (19456)