HNE 28 BOROUGH OF HENDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH for the year 1951 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 1951 A. FAIRCRIEVE ADAMSON, M.D., D.P.H., Medical Officer of Health CONTENTS OF REPORT Page Members of Borough Council and Public Health Committee 3 Introductory Remarks of Medical Officer of Health 4 SECTION A . STATISTICS AND SOCIAL CONDITIONS OF THE AREA: Physical Conditions and Amenities 6 Comparative Rainfall 7 Statistics 7 General 7 Births, Birth Rate, Still Births, Still Birth Rate 8 Deaths, Death Rate 8 Maternal Mortality 9 Infantile Mortality 9 Summary of Vital Statistics for year 1951 12 Table showing Causes of Death during 1951 13 Table showing Age Distribution of Deaths during 1951 14 SECTION B: PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES: Notifications 15 Age Distribution of Infectious Disease 16 Ward Distribution of Infectious Disease 17 Food Poisoning 18 Poliomyelitis and Polio-encephalitis 18 Notes on other Infectious Diseases 19 Diphtheria Immunisation 22 Tuberculosis 25 Report of Chest Physician 27 SECTION C: GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA : Laboratory Facilities 28 Establishments for Massage and Special Treatment 30 Welfare of Old People 30 Public Burials 32 Action under Section 47, National Assistance Act, 1948 32 Hospital Facilities 32 Health Services provided by Middlesex County Council 32 SECTION D : SANITARY CIRCUMSTANCES OF THE AREA : Housing 33 Inspection of Dwelling-houses during the year 35 Water Supply 35 Summary of Inspections carried out by Sanitary Inspectors 37 Notices Served 37 Disinfection and Disinfestation 38 Smoke Abatement 38 Swimming Baths 39 Cinemas and Places of Entertainment and Licensed Houses 39 Rodent Control 39 Administration of Factories Acts, 1937 and 1948 41 SECTION E: INSPECTION AND SUPERVISION OF FOOD : Inspection of Food Shops and Food Stores 43 Clean Food Campaign 43 Unsound Food 44 Action taken in connection with Food Shops and Stores 47 Milk Supply 47 Milk (Special Designations) Regulations 47 Milk Sampling 48 Ice Cream 48 Slaughterhouses 48 2 COUNCIL of the BOROUGH 1951/1952 The Mayor: Alderman R. J. KNOWLES, M.M., J.P., M.I.W.M. The Deputy Mayor: Alderman J. L. FREEDMAN, J.P., M.A., LL.B. 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., J.P., M.I.W.M., A. A. NAAR, M.B.E., G. J. PRYKE, F.I.A.C., A.M.I.S.E., J. H. RODWAY, J.P., C. H. SHEILL. Councillors : L. ANDREWS, S. E. ARRIDGE, E. G. BURMAN, M.I.T.A., W. CANNELL, M.M., M.R.C.S. L.R.C.P., D.P.H., L.D.S., R.C.S., 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., L. A. HILLS, E. M. D. JONES, F.C.A., 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, G. N. WARNOCK, O.B.E. PUBLIC HEALTH COMMITTEE. Chairman : Councillor L. C, CHAINEY. Vice-Chairman: Councillor (Miss) M. EATON Aldermen : A. W. CURTON, F.R.S.A., M.Inst.B.E., R. J. KNOWLES, M.M., J.P., M.I.W.M. (Mayor). Councillors s W. CANNELL, M.M., M.R.C.S. L.R.C.P., D.P.H., L.D.S., R.C.S., S. A. FROST, C. G. MONK, M.A., A. PAUL, A. V. SULLY, M.C., F.C.A., (Mrs.) D. THORNYCROFT, M.A., B. H. O'RYAN TURRALL. 3 ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR 1951 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 1951, this being my twenty-second report as Medical Officer of Health. The general standard of health in the Borough as measured by vital statistics remains high. It will be seen that the infantile mortality rate, whilst remaining low, increased from last year's remarkably low figure of 16 per 1,000 live births to 22 in the year under review. This compares with 29 for the Country generally. Of the 47 children who died under one year of age, 34 died in the first four weeks, the commonest causes being prematurity and congenital defects. This is a group of conditions in which it is difficult to effect a real reduction, and the only improvements likely to be effective will be as a result of increased knowledge of the causes and possibly more intensive ante-natal care, although real advances are being made in the care of premature infants and in the treatment of certain of the more common congenital defects. With regard to infectious diseases, I am glad to report that the decline in the incidence of Poliomyelitis has been maintained, six cases only been notified. Three of these developed paralysis and one death occurred. It will be seen that deaths from Tuberculosis increased by two, but it is gratifying to observe that the notifications of new cases showed a decrease compared with the previous year. For the second year in succession no cases of Diphtheria were notified, a tribute to the effectiveness of immunisation. There is, however, a danger that as Diphtheria ceases to be a reality to the younger mothers, they may be reluctant to accept immunisation for their children. So far this has not 4 occurred, but the importance of doctors and health visitors continuing their efforts to ensure that as many as possible are immunised cannot be exaggerated. No action was taken under Section 47 of the National Assistance Acts which deal with the compulsory removal to hospitals or institutions of elderly and infirm persons who are incapable of looking after themselves or are in need of proper care and attention. Nevertheless, an increasing number of such cases were referred to the Public Health Dpartment, but in each a solution was found, either by the provision of a home nurse or home help, or by invoking the assistance of one of the voluntary organisations which are playing such a useful part in assisting the aged. The increasing numbers of old persons in the community will ultimately create a problem necessitating a co-ordination of all efforts if a satisfactory solution is to be found. In my view, every effort should be made to keep the old persons at home in familiar surroundings where they are happier than they are likely to be in any institution however well managed. There is, however, a need for hostel accommodation so that elderly persons may have periods of re-habilitation and so that the families may have a much needed rest. It is unfortunate that numbers of families do not appear to have a sufficient sense of responsibility towards the older members, and tend to regard the solution of their problem as being a matter for the local authority, or one or other of the organisations concerned. This attitude in certain instances, but by no means in all, is due to lack of adequate accommodation which tends to aggravate the situation. The endeavour to maintain housing conditions at a reasonable standard has, as in previous years, occupied much of the time of the Public Health Department. In conclusion, I should like once again to thank the Members of the Council for their interest in all matters affecting the public health, and the staff of the Department for their sustained and efficient work during the year. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, A. FAIRCRIEVE ADAMSON, Medical Officer of Health. 5 SECTION A: STATISTICS AND SOCIAL CONDITIONS OF THE AREA. Physical Conditions and Amenities. The Borough of Hendon, comprising the ancient Civil Parishes of Hendon and Edgware, has an area of 10,371 acres, and is bounded on the north by the County of Hertfordshire, on the south by the Metropolitan Borough of Hampstead and the Borough of Willesden, on the east by the Metropolitan Borough of Hampstead and the Borough of Finchley, and on the west by the Urban District of Harrow and the Borough of Wembley. Its greatest length is approximately 7.3 miles and greatest breadth about 3.6 miles. In spite of great expansions the Borough still possesses in many places a rural aspect and views from the vantage points in the neighbourhood afford evidence of its undulating nature, and of the many trees and woods. The River Brent and Silk Stream are the principal water courses. Both these streams, after flowing for some distance through the Borough, finally discharge into the Welsh Harp or Brent Reservoir, which covers an area of about 350 acres. The district is well supplied with parks and open spaces. These, together with Golders Hill Park and the Hampstead Heath Extension, provide an area of over 1,100 acres. A proportion of these open spaces is comprised in the proposal known as the " Green Belt ". This scheme, which forms part of the Greater London Plan, is designed to retain for all time a belt of open land along a substantial portion of the northern boundary of Middlesex. In addition the Town Council has, as a private open space, the Mote Mount Golf Course, which has an area of 186 acres. Hard Tennis Courts, Bowling Greens, Putting Greens, and a large number of Cricket, Hockey and Football pitches are available for public use in the various parks. Hendon is well served as regards means of communication. The Northern Line of the Underground Railway connects the Borough with the City and West End and the road travelling facilities are good. The London Midland Region Railway passes through the Borough. 6 The shopping facilities in the Borough are excellent and a plentiful and pure water supply is maintained by the Metropolitan Water Board and the Colne Valley Water Company. Comparative Rainfall. The following tables give the comparative rainfall for the years 1950 and 1951:— 1950. 1951. January 1.02 inches 2.77 inches February 3.64 „ 5.17 „ March .80 „ 3.49 „ April 2.07 „ 2.71 „ May 1.76 „ 2.18 „ June 1.26 „ 1.10 „ July 3.94 „ 1.05 „ August 1.87 „ 3.69 „ September 2.55 „ 3.38 „ October .43 „ .99 „ November 4.80 „ 5.10 „ December 1.65 „ 1.50 „ TOTAL 25.79 „ 33.13 „ STATISTICS. i General. Area of the Borough (in acres) 10,371 Population figure supplied by Registrar General 155,700 Density of Population, i.e., No. of Persons per acre 15.01 No. of inhabited houses at 31st December, 1951 42,269 Rateable value at 31st December, 1951 £2,008,200 Sum represented by a penny rate £8,130 7 EXTRACTS FROM VITAL STATISTICS FOR YEAR 1951 Births. Live Births: Male. Female. Total. Legitimate 1050 914 1964 Illegitimate 56 62 118 1106 976 2082 Live Birth Rate per 1,000 Home Population 13.36 Birth Rate corrected for comparison with other areas 1,2.26 Comparability factor supplied by Registrar General 0.91 Birth Rate per 1,000 Home Population, England and Wales 15.50 Corresponding Rate for the Borough of Hendon for 1950 13.15 Male. Female. Total. Stillbirths: Legitimate 20 20 40 Illegitimate 1 1 2 21 21 42 Stillbirth Rate per 1,000 total births 20.10 Stillbirth Rate per 1,000 Home Population 0.27 Stillbirth Rate per 1,000 Home Population, England and Wales 0.36 Deaths. Male. Female. Total. 791 844 1635 Death Rate per 1,000 Home Population 10,50 Death Rate corrected for comparison with other areas 11.34 Comparability Factor supplied by Registrar General 1.08 Death Rate per 1,000 Home Population, England and Wales 12.50 8 Maternal Mortality. Number of women dying in consequence of childbirth 2 Maternal Mortality Rate per 1,000 total births .94 Comparative Figure for England and Wales .79 Infantile Mortality. Deaths of Infants under 1 year of age:— Male. Female. Total. Legitmate 25 16 41 Illegitimate 4 2 6 Total 29 18 47 Death rate of Infants under 1 year of age per 1,000 live births 22.0 Death rate of Infants under 1 year of age per 1,000 live births, England and Wales 29.6 Deaths of Infants under the age of 4 weeks:— Male. Female. Total. Legitimate 18 11 29 Illegitimate 4 1 5 Total 22 12 34 Neo-Natal Mortality Rate per 1,000 live births 16.3 9 An analysis of the causes of death and of the age at death reveals the following figures:— Age at time of death. Causes of death as certified. Under 1 day. 1-7 days. 1-2 weeks. 2-3 weeks. 3 wks - 1 mth. Total under 1 month. 1-3 months. 3-6 months. 6-9 months. 9-12 months. Total deaths under 1 yr. Prematurity 4 9 — — — 13 — — — — 13 Atelectasis and Prematurity 1 2 — 1 — 4 — — — — 4 Atelectasis 3 1 — — — 4 — — — — 4 Congenital Abnormalities 1 — — — 1 2 — — — — 2 Broncho- Pneumonia — 2 1 — — 3 3 2 1 3 12 Broncho - Pneumonia, Spina Bifida and Infected Meningocele — — 1 — — 1 — — — — 1 Haemorrhagic, Broncho - Pneumonia associated with Prematurity — — 1 — — 1 — — — — 1 Bronchitis — — 1 — — 1 — — — — 1 Spina-Bifida, Internal Hydrocephalus — 1 — — — 1 — — — — 1 Peritonitis 1 1 Erythroblastosis — 1 — — — 1 — — — — 1 Asphyxia 1 — — — — 1 1 — — — 2 Cerebral Haemorrhage 1 1 — — — 2 — — — — 2 Marasmus — — — — — — — 1 — — 1 Meningitis, Hyrocephalus, Meningocele — — — — — — — — 1 — 1 TOTALS 11 17 4 1 1 34 4 3 2 4 47 10 TABLE 1. The following table shows the Infantile Mortality Rates over various years:— 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 1951 22 11 SUMMARY OF VITAL STATISTICS FOR THE YEAR 1951 England and Wales. 126 County Boro's & Great Towns including London. 148 smaller Towns (Resident Population 25,000—50,000 at census). London Administrative County. Hendon. Borough of Births : Rates per 1,000 Home Population. Live Births 15.50 17.30 16.70 17.80 13.36 Stillbirths 0.36 0.45 0.38 0.37 0.27 Deaths : All causes 12.50 13.40 12.50 13.10 10.50 Typhoid & Paratyphoid 0.00 0.00 0.00 0.00 0.00 Whooping Cough 0.01 0.01 0.01 0.01 0.00 Diphtheria 0.00 0.00 0.00 0.00 0.00 Tuberculosis 0.31 0.37 0.31 0.38 0.20 Smallpox 0.00 0.00 0.00 0.00 0.00 Acute Poliomyelitis and Polioencephalitis 0.00 0.01 0.01 0.00 0.00 Pneumonia 0.61 0.65 0.63 0.61 0.43 Influenza 0.38 0.36 0.38 0.23 0.23 Deaths : Rates per 1,000 Live Births. All causes under 1 year of age 29.6(a) 33.9(a) 27.6(a) 26.4(a) 22.6(a) Enteritis and Diarrhoea under 2 years of age 1.4 1.6 1.0 0.7 0.0 Notifications (Corrected): Rates per 1,000 Home Population. Typhoid Fever 0.00 0.00 0.00 0.01 0.01 Paratyphoid Fever 0.02 0.03 0.02 0.01 0.03 Meningococcal Infecttion 0.03 0.04 0.03 0.03 0.03 Scarlet Fever 1.11 1.20 1.20 1.10 0.94 Whooping Cough 3.87 3.62 4.00 3.11 3.87 Diphtheria 0.02 0.02 0.03 0.01 0.00 Erysipelas 0.14 0.15 0.12 0.15 0.13 Smallpox 0.00 0.00 0.00 0.00 0.00 Measles 14.07 13.93 14.82 14.64 10.39 Pneumonia 0.99 1.04 0.96 0.72 1.37 Acute Poliomyelitis (including Polioencephalitis : Paralytic 0.03 0.03 0.03 0.02 0.02 Non-Paralytic 0.02 0.02 0.03 0.02 0.02 Food Poisoning 0.13 0.15 0.08 0.23 0.14 Rates per 1,000 Total (Live and Still) Births. Puerperal Fever and Pyrexia 10.66 13.77 8.08 14.90 49.90 (a) Per 1,000 related live births. 12 TABLE II. CAUSES OF DEATH DURING THE YEAR ENDED 31st DECEMBER, 1951. Cause of Death. Male. Female. Total. Tuberculosis, respiratory 20 7 27 Tuberculosis, other 1 4 5 Syphilitic disease ,3 4 7 Diphtheria 0 0 0 Whooping Cough 2 1 3 Meningococcal infections 0 0 0 Acute Poliomyelitis 0 0 0 Measles 1 1 2 Other infective and parasitic diseases 0 1 1 Malignant neoplasm, stomach 16 23 39 Malignant neoplasm, lung, bronchus 36 5 41 Malignant neoplasm, breast 0 29 29 Milignant neoplasm, uterus 0 18 18 Other malignant and lymphatic neoplasms 80 65 145 Leukaemia, aleukaemia 3 7 10 Diabetes 4 11 15 Vascular lesions of nervous system 76 107 183 Coronary disease, angina 139 91 230 Hypertension with heart disease 31 43 74 Other heart disease 77 136 213 Other circulatory disease 25 42 67 Influenza 15 22 37 Pneumonia 33 33 66 Bronchitis 68 43 111 Other diseases of respiratory system 9 6 15 13 Cause of Death. Male. Female. Total. Ulcer of stomach and duodenum 20 3 23 Gastritis, enteritis and diarrhoea 3 8 11 Nephritis and nephrosis 4 13 17 Hyperplasia of prostate 10 0 10 Pregnancy, childbirth, abortion 0 2 2 Congenital malformations 6 7 13 Other defined and ill-defined diseases 65 68 133 Motor vehicle accidents 13 10 23 All other accidents 24 25 49 Suicide 7 9 16 Homicide and operations of war 0 0 0 All causes—TOTAL 791 844 1635 TABLE III. ACE DISTRIBUTION OF DEATHS DURING THE YEAR ENDED 31st DECEMBER, 1951. Age Group. Male. Female. Total. Percentage. 0— 5 years 34 22 56 3.3 5—10 years 2 3 5 .3 10—15 years — 3 3 .2 15—20 years 3 5 8 .5 20—30 years 7 9 16 1.0 30—40 years 22 21 43 2.6 40—50 years 46 36 82 5.0 50—60 years 129 101 230 14.0 60—70 years 219 152 377 23.0 70—80 years 228 257 485 29.6 80 years and over 101 235 336 20.5 Total 791 844 1635 100.0 14 SECTION B : PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. TABLE IV. Notifications. The following table shows the total number of notifications other than Tuberculosis, received during the year :— Disease. Total Number of Cases Notified. Cases Removed to Hospital. Total Number of Deaths among Notified Cases. Scarlet Fever 147 75 — Whooping Cough 604 13 — Acute Poliomyelitis 6 7* 1 Measles 1618 21 — Pneumonia 213 43 — Dysentery 74 22 — Puerperal Pyrexia 106 105 — Enteric or Typhoid Fever 1 1 — Paratyphoid Fever 4 3 — Erysipelas 21 9 — Meningococcal Infections 5 4 Food Poisoning ,22 2 — Ophthalmia Neonatorum 21 21 — TOTAL 2842 326 — * One of these cases was not confirmed. 15 16 TABLE V. ACE DISTRIBUTION. The following table shows the age distribution of cases of Infectious Disease notified during the year. Disease. Age Groups. Under 1 year. 1—2 3—4 5—9. 10—14. 15—25. 25 & over Age not known. TOTALS. M. F. M. F. M . F. M. F. M. F. M. F. M. F. M. F. Scarlet Fever – – 2 4 13 16 45 39 7 10 4 5 1 1 – – 147 Whooping Cough 19 19 61 63 76 99 96 137 4 7 2 2 5 11 1 – 604 Acute Poliomyelitis : Paralytic – – – – 1 – – 1 – – 1 – – – – – 3 Non-Paralytic – – – – – – – 1 1 – – – 1 – – – 3 Measles 21 16 170 128 278 221 357 349 12 26 9 7 3 10 4 5 1618 TOTALS 40 35 233 195 368 336 502 527 24 43 16 14 10 22 5 5 2375 Disease. Age Groups. Under 5 years. 5—14. 15—44. 45—64. 65 & over Age not known. TOTALS. M. F. M. F. M. F. M. F. M. F. M. F. Pneumonia 13 4 10 6 22 39 34 34 20 20 – 1 213 Dysentery 17 12 6 11 8 9 4 5 — 2 — — 74 Puerperal Pyrexia — — — — — 106 — — — — — — 106 Enteric or Typhoid Fever – – – – – – – – – 1 – – 1 Paratyphoid Fever — — 1 — 1 — 1 1 — — — — 4 Erysipelas — — — — 1 5 1 8 3 3 — — 21 Meningococcal Infections — 1 — — 2 — 1 — — 1 — — 5 Food Poisoning 3 1 1 4 5 2 3 1 2 — — — 22 Ophthalmia Neonatorum 13 8 – – – – – – – – – – 21 TOTALS 46 26 18 21 39 161 44 49 25 37 — 1 467 17 TABLE VI. WARD DISTRIBUTION. Number of cases of Infectious Disease notified in each Ward of the Borough. Disease. Ward. Mill Hill. Burnt Oak. West Hendon Central. Park. Golders Green. Garden Suburb. Childs Hill. Edgware. Total. Scarlet Fever 32 12 15 13 18 11 6 17 23 147 Whooping Cough 95 69 152 45 39 40 48 49 67 604 Acute Poliomyelitis — 2 — — — 2 — 1 1 6 Measles 358 173 241 66 214 116 109 95 246 1618 Pneumonia 45 30 27 30 33 14 12 12 10 213 Dysentery 9 13 6 8 3 14 2 14 5 74 Puerperal Pyrexia 5 76 4 4 3 3 4 6 1 106 Enteric or Typhoid Fever – – 1 – — — — — — 1 Paratyphoid Fever – 1 — — 1 — 1 — 1 4 Erysipelas 3 2 3 1 4 1 2 1 4 21 Meningococcal Infections 2 1 1 1 — — — — — 5 Food Poisoning — 1 2 3 6 3 — 5 2 22 Ophthalmia Neonatorum 1 15 1 1 — — 1 1 1 21 TOTAL 550 395 453 172 321 204 185 201 361 2842 Food Poisoning. Twenty-two notifications of Food Poisoning were received during the year. The cases were distributed throughout the year as follows :— First Quarter. Second Quarter. Third Quarter. Fourth Quarter. 10 2 8 2 There were no outbreaks of Food Poisoning as such, the notifications being confined to single cases. In these cases the agent was identified in 9—Salmonella Thompson 1, Shigella Sonnei 1, Salmonella Typhi Murium 7— and the cause unknown in the remaining 13. There was a reduction in 10 in the number of notifications, 32 having been received in 1950. Poliomyelitis and Polioencephalitis. The increased incidence of this group of diseases evident in recent years was not maintained in 1951, 6 cases being notified compared with 21 in 1950 and 32 in 1949. The following table gives particulars of the cases which were notified. It will be seen that four of the cases occurred in children under 10 years of age and the remaining two, 20 years and 25 years respectively. Two of the children notified were members of one family. The cases were spread throughout the year, two occurring in January, one in June and three in October. 18 TABLE VII. Name. Age. Sex. Notified. Diagnosis. Ward. Remarks. J.B.* 20 M. 21/1/51 Polioencephalitis Childs Hill Paralytic. Patient died. H.G. 4 M. 4/1/51 Poliomyelitis Golders Green Paralytic. G.M.S. 8 F. 8/6/51 Poliomyelitis Golders Green Paralytic. Legs. S.C. 6 F. 8/10/51 Poliomyelitis Burnt Oak No Paralysis, abortive case. A.C. 9 M. 8/10/51 Poliomyelitis Burnt Oak No Paralysis, abortive case. —.L. 25 M. 9/10/51 Poliomyelitis Edgware Oak No Paralysis. * This case, a service man, although his home address was in the Borough of Hendon, was attached at the time of his death to a service station elsewhere. In consequence, his death was assigned to that area and is not shown in the death returns for the Borough of Hendon. Typhoid Fever. The one ease notified during the year was a woman, said to be suffering from Gastro-Enteritis, who was admitted to hospital. Bacteriological investigations, however, indicated, and ultimately confirmed, that she was suffering from Typhoid Fever. No likely source of infection could be ascertained, the patient being an elderly woman who left her house very little and had no occasion to take meals elsewhere. There were, however, three contacts who were remotely concerned with the preparation and handling of food. These contacts were excluded from work pending the results of bacteriological examinations, which, when received, proved to be negative. Para-Typhoid Fever. All the four cases notified were confirmed as ParaTyphoid B. They were isolated cases between which there was no connection. 19 Scarlet Fever. There was a considerable reduction in the number of cases of Scarlet Fever notified during the year, 147 cases being notified compared with 260 in 1950. The disease was of a mild form and 75 of the cases were removed to hospital. The greatest incidence occurred in the age group 5—9 years, 84 cases being notified. Puerperal Pyrexia. The number of cases notified was double that for last year, 106 cases being notified compared with 53 in 1950. This may be accounted for by The Puerperal Pyrexia Regulations, 1951, which came into operation during the year and revoked the previous regulations relating to this illness. Under the new Regulations " Puerperal Pyrexia " means any febrile condition occurring in a woman in whom a temperature of 100.4° Fahrenheit (38° Centigrade) or more has occurred within fourteen days after childbirth or miscarriage. Under the previous regulations the temperature of 100.4° Fahrenheit had to be sustained during a period of 24 hours or had to recur during that period. The new regulations, however, make it necessary only for the temperature to occur. The notification rate for Puerperal Pyrexia in respect of the Borough of Hendon is 49.9 per 1,000 total (live and still) births which is much higher than the rate of 10.66 per 1,000 total births for the Country as a whole. This is accounted for by the fact that a Maternity Hospital situated in the area provides accommodation not only for the Borough of Hendon but also for the surrounding districts, the condition occurring in women normally resident in these outside districts who enter the hospital for their confinement. Of the 106 cases notified 35 only were resident in Hendon and if this figure is taken the notification rate per 1,000 total (live and still) births is 16.5. 20 Diphtheria. For the second consecutive year no case of Diphtheria was notified within the Borough. This is particularly gratifying and proves the value of immunisation. The steady decline in the number of notifications received since the inception of the Diphtheria Immunisation Scheme is shown in the following table:— TABLE VIII. Year. No. of Cases of Diphtheria Notified. No. of Deaths from Diphtheria. 1935 138 9 1936 86 2 1937 121 7 1938 195 4 1939 150 3 1940 70 3 1941 58 1 1942 38 2 1943 31 2 1944 17 — 1945 20 1 1946 33* — 1947 10* — 1948 8 1 1949 10* — 1950 — — 1951 — — * of these the diagnosis was confirmed in 8 cases in 1946, 8 cases in 1947, and 4 cases in 1949. 21 diphtheria immunisation. The following tables show the position of Immunisation in the Borough of Hendon at the 31st December, 1951:— TABLE IX. Number of children resident in the Borough of Hendon who received immunising injections during 1951. Age at Time of Injection. Number given Primary Inoculations. Number given Reinforcing Inoculations. Age at Time of Injection. Number given Primary Inoculations. Number given Reinforcing Inoculations. Under 1 year of age 1162 — 5—9 years 70 1356 1 year of age 518 — 10—14 years 12 325 2 years of age 63 3 .3 years of age 30 7 4 years of age 27 242 total 1800 252 total 82 1681 TABLE X, Number of children resident in the Borough of Hendon under the age of 15 years on 31st December, 1951, who had completed a course of Immunisation at any time since 1st January, 1937. 1—4 years. 5—14 years. Year of Birth. Number considered to be immunised. Year of Birth. Number considered to be immunised. 1951 306 1946 to 1942 8097 1950 1405 5—9 years 1949 1557 6497 1948 2212 1941 to 1937 1947 2256 10—14 years total 7736 total 14594 22 Total immunised in all age groups .22,330. The Scheme, as is that for vaccination, is administered by the Area Office of the Middlesex County Council by whom the figures have been supplied. The percentage of the child population immunised in each age group is as follows:— 0—4 years—67.4% 5—14 years—77.1% Smallpox. BRIGHTON OUTBREAK. In this connection it transpired that 17 persons resident in Hendon had been concerned with the hospital in Brighton where the cases were temporarily isolated or with patients discharged from that hospital. All these cases were kept under observation. The measure of control was satisfactory and no case of Smallpox occurred in the Borough as a result of the outbreak. S,S. " RANCHI." Owing to the dispersal of passengers and crew from S.S. " Ranchi " from which a case of Smallpox was removed, 18 contacts proceeded to addresses in the Borough and were kept under supervision. Only one contact gave rise to any concern, an Indian boy aged 9 years who was reported as being unwell and having a rash. Successive examinations showed no symptoms indicating Smallpox and the boy recovered. S.S. " STRATHMORE." A 12-year-old girl passenger who had embarked at Bombay on the 26th January, 1951, became ill on the 28th and from 30th onwards was isolated in the ship's hospital as a case of Chickenpox. She was admitted as such to a hospital in Essex, but on the 13th February the case was reviewed in the light of further information and this led to a suspicion that she was, in fact, suffering from Smallpox. This diagnosis was subsequently confirmed. 14 contacts of this case, who proceeded to Hendon, were kept under observation. One of these, a child, who developed a rash, was seen by me in consultation, but she was not suffering from Smallpox. 23 In addition, a further case was seen in consultation, but in this instance there was no known contact of the disease and again the patient was not suffering from Smallpox. The measures taken proved effective and no case of Smallpox occurred within the Borough. In addition to the above-mentioned, the following two cases were also brought to my notice:— CASE NO. 1. On the evening of Saturday, 20th October, I was asked by a local practitioner to see a patient suffering from an acute pustular rash suspected to be Smallpox. The patient had arrived in this Country on the previous Saturday from Israel. She had been vaccinated in infancy and again six months prior to her illness but no scarring from the second vaccination could be found although she was positive that the revaccination had been successful. The distribution of the rash was not suggestive of Smallpox and the patient was not sufficiently ill considering the severity of the rash, nor had she the usual prodromal symptoms, although she stated she had been suffering from a " cold ". In my opinion this was not a case of Smallpox but in view of the patient's recent return from the Near East I asked one of the Consultants of the Ministry of Health to see her. He confirmed my opinion. CASE NO. 2. On Saturday, 29th December, a message was received from St. Marylebone Public Health Department stating that a resident of Hendon had been admitted to the Hospital of St. John and St. Elizabeth on the 27th suffering from Pneumonia and that a rash had subsequently appeared, strongly suggestive of Smallpox. On investigation it was found that the patient had flown to Canada on 3rd December, returning by air on the 15th. There was a history of successful vaccination in April, 1948. His son had also flown to Canada on the 3rd December, returning to France and Germany on the 15th and, ultimately, to England on the 26th. The patient was kept under observation during the week-end but the diagnosis of Smallpox was not, ultimately, confirmed. 24 Vaccination. The following table shows the number of persons vaccinated and re-vaccinated in the Borough of Hendon during 1951:— TABLE XI. Age at 31st December, 1951. Under 1 year. 1—4 years. 5—14 years. 15 years or over. Total. Number Vaccinated 798 142 118 209 1267 Number Re-Vaccinated — 39 148 1211 1398 TUBERCULOSIS. New Notifications. The following table shows the number of cases of Tuberculosis notified for the first time during the year 1951:— TABLE XII. Age Group. Respiratory. Non-Respiratory. Total. M. F. M. F. 0— 1 – 1 – – 1 1— 5 2 – 2 2 6 5—10 4 3 3 – 10 10—15 1 4 2 2 9 15—20 6 6 2 – 14 20—25 17 12 – 1 30 25—35 11 16 1 4 32 35—45 15 5 1 2 23 45—55 10 2 – – 12 55—65 10 2 – – 12 65 and over 5 1 1 – 7 Age unknown – – – – – TOTAL 81 52 12 11 156 In addition to these cases the following cases were brought to notice other than by formal notification or were restored to the register after having been previously removed:— Respiratory. Non-Respiratory. M. F. M. F. Total. 2 3 11 7 25 The following table shows the notification of Tuberculosis for the ten-year period 1942—1951:— TABLE XIII. Year. Respiratory Non-Respiratory. Total. M. F. M. F. 1942 141 93 14 27 275 1943 100 74 19 18 211 1944 112 96 4 19 231 1945 101 70 15 15 201 1946 84 65 14 12 175 1947 109 80 7 10 206 1948 84 86 13 10 193 1949 112 81 16 10 219 1950 81 71 8 11 171 1951 81 52 12 11 156 Deaths. According to the figures supplied by the Registrar General the following deaths occurred from Tuberculosis during the year Tuberculosis of Respiratory System. Male. Female. Total. Other forms of Tuberculosis. Male. Female. Total. All forms of Tuberculosis. Male. Female. Total. 20 7 27 1 4 5 21 11 32 The number of cases of Tuberculosis remaining on the register at the end of the year is as follows:— Respiratory. Non-Respiratory. Total. M. F. M. F. 696 569 78 80 1265 158 1423 I am indebted to Dr. H. J. Trenchard, Physician-in-Charge of the Edgware Chest Clinic for the following report on the work of the Clinic during the year 26 "Statistics giving corresponding figures for previous four years for comparison,, 1. General. 1947. 1948. 1949. 1950. 1951. New patients referred to clinic 4,110 4,257 4,332 4,156 6,107 Total attendances at clinic 14,044 17,035 20,665 26,297 30,046 Attendances for special treatments 6,126 9,191 10,614 11,711 12,214 Total number X-rayed in Clinic X-Ray Depot – – 10,011 16,717 14,552 Number of home visits by physicians 93 87 281 358 294 2.—Chest Clinic Tuberculosis Register. 1947. 1948. 1949. 1950. 1951. New Respiratory Tuberculosis Cases 249 214 225 172 178 New Non-Respiratory Cases 22 26 19 21 24 Total New Tuberculosis Cases 271 240 244 193 202 Cases on Register on 31st December (adjusted for cases transferred in, transferred out, recovered, lost sight of, or died) 1,531 1,561 1,669 1,750 1,753 Deaths from Tuberculosis 79 49 56 31 40 Removed from Register as recovered 28 48 26 62 66 3. Number of tuberculosis patients awaiting admission to hospital on 31st December – – 103 115 91 Edgware Chest Clinic serves primarily those living in the Borough of 1 Hendon and the Stanmore, Queensbury and Kingsbury districts of Harrow and Wembley—a population probably in excess of 220,000. The Middlesex County Council, as local Health Authority, provides the staff of the Welfare Department of the clinic and Tuberculosis Health Visitors. In this way, the clinical work of the hospital service staff is augmented so as to provide facilities for the full practise of social medicine. The work of the chest clinic has tended to increase considerably over the last few years as is shown in the statistical details given above. There has been a tendency for 27 losis to decline in incidence during the last five years. Deaths from the disease have diminished, probably owing to the use of new drugs, in particular, streptomycin, which has helped considerably in treatment. There is still a shortage of beds for male patients, but the position has improved. In the case of female patients it has usually been possible to arrange admission of urgent cases without undue delay. A good many patients are treated in the tuberculosis wards of Edgware General Hospital and Hendon Isolation Hospital where 28 and 10 beds respectively are under the charge of the Clinic Physician. Admissions are also arranged through the waiting list of The Regional Hospital Board to the regional chest hospitals, particularly Colindale and Clare Hall Hospitals. During 1951 a more satisfactory appointments system has been introduced, and every effort continues to be made to ensure that the waiting time at the clinic is kept to a minimum. In the later half of the year, the shortage of X-ray films, which is general throughout the Country, hampered the work of the Clinic, as an X-ray is so important in the diagnosis and treatment of chest conditions. In November the Ministry of Health provided on loan an Odelca Camera Unit which enables a smaller sized film to be used. Trial <of this apparatus has given encouraging results, and it is hoped that, by its means, the difficulties of the X-ray film shortage may be overcome. At the same time, the new apparatus may lead to considerable financial economies." SECTION C: GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Laboratory Facilities. These are provided at the Central Public Health Laboratory at Colindale. I would like to express my gratitude to the staff of the Laboratory who have co-operated whole-heartedly with the Public Health Department. A record of the work carried out on behalf of the Health Department is given below:— 28 29 TABLE XIV. RECORD OF EXAMINATIONS. Year 1951. Throat/Nose Swabs. Faeces. Sputum. Pertussis. Milk. Ice Cream. Domestic Water Supply. Swimming Pools. Miscellaneous. Total. January 76 75 9 4 15 11 – 10 200 February .36 196 13 25 12 7 4 – 32 325 March 44 101 7 16 4 6 – – 12 190 April 56 27 7 7 16 11 – – 23 147 May 26 21 9 1 6 15 – – 7 85 June 53 37 8 – 10 11 – 6 10 135 July 38 22 9 1 6 7 – 23 11 117 August 30 27 6 1 6 6 – 6 20 102 September 55 24 12 – 12 10 – – 16 129 October 26 23 8 3 12 12 – – 23 107 November 36 16 11 4 17 7 – – 6 97 December 21 19 13 — 18 .2 – – 10 83 TOTAL 497 588 112 62 134 105 4 35 180 1,717 Establishments for Massage and Special Treatment. MIDDLESEX COUNTY COUNCIL ACT, 1944, SECTIONS 353—363. The Council continued to exercise its function as a licensing authority under the provisions of the above-mentioned Act. A person requiring a licence or renewal of a licence under this part of the Act must make application to the Local Authority giving certain information, such as age, nationality, technical qualifications and the nature of the Establishment and the business to be conducted thereat. The Council considered the following number of applicants:— New Licences 3 Renewals of Licences 19 Certificates lodged under Section 363 by members of the Chartered Society of Physiotherapy 7 Licences Refused 2 In the eases where the licences were refused the person who proposed to carry out the treatment did not possess the technical qualifications reasonably necessary. Welfare of Old People. I am indebted to the Honorary Secretary of The Old People's Welfare Committee for the following report on the activities of the Committee during the year:— " The office of the Committee is situated in the Methodist Church Hall, The Burroughs, Hendon, N.W.4, telephone Hendon 0404, and is open Mondays, Tuesdays, Wednesdays and Fridays to deal with any enquiry relating to old people and for interviews. Casework of all kinds is dealt with, including finding accommodation of every kind from ordinary board and lodgings to private homes and nursing homes, arranging cheap holidays, visiting 'difficult' old people and helping them to find new interests. OLD PEOPLE'S CLUB. A Club was opened in February, 1951. A committee of Club members was formed in May and is responsible for the routine running of the Club. The activities include day trips 30 to the sea and countryside, handiwork, thrift club, flower show, lectures and entertainments. Members visit one another when ill and take a small gift purchased with club funds. Everything possible is done to persuade members to help one another and contribute to the community as much as they can. The Club meets every Monday afternoon, 2 p.m. to 5 p.m. VISITING. The total number of visits made on behalf of the Old People's Welfare Committee during the period May, 1951 to February, 1952, was 486. The Committee works in conjunction with the Edgware General Hospital in taking care of old people discharged from hospital, e.g.:— 1. Collection of pensions. 2. Shopping. 3. 'Sitting in' in order to relieve relatives ally. 4. Reading to the aged sick. 5. Helping with the preparation of meals. 6. Visiting and providing company for those persons who are living entirely alone. HOLIDAY SCHEME. In May, 1951, 70 old people were taken to Ramsgate for a week's holiday, cost £3 12s. 6d., including fare. This scheme was subsidised by the Old People's Welfare Committee. Another scheme for 1952 is now in operation. DAY TRIP TO SEASIDE. Two coach loads of old people were given a free trip to Eastbourne. CHRISTMAS DINNERS. 112 dinners were delivered to old people who were mainly housebound or living alone. NEW YEAR'S PARTY. 120 old people were entertained to a tea and variety show at Hendon Way Hotel. CIRCULARISATION OF INFORMATION. All available names and addresses on record in the Housing Department are being circularised in districts telling them where they can apply for help and what is available." 31 NATIONAL ASSISTANCE ACT, 1948. Section 50. Public Burials. During the year 1951 Public Burial was carried out by the Council under section 50 of the National Assistance Act, 1948, in ,5 cases. The necessary steps were taken to recover the cost of the burials in all cases. NATIONAL ASSISTANCE, ACT, 1948. Section 47. It was not found necessary to take formal action under the above-mentioned section of the National Assistance Act during the year. General Hospital Facilities. Edgware General Hospital. Hendon District Hospital. Infectious Disease Cases—Hospital Accommodation. Hendon Isolation Hospital. Neasden Isolation Hospital, Willesden. Any other Infectious Disease Hospital controlled by the North-Western Metropolitan Regional Hospital Board. Tuberculosis Treatment and Hospital Accommodation. Edgware General Hospital. Hendon Isolation Hospital. Admissions are also arranged through the Regional Hospital Board to the Regional Chest Hospitals, particularly Colindale and Clare Hall Hospitals. There is also a Chest Clinic at Edgware serving primarily those living in the Borough of Hendon and the Stanmore, Queensbury and Kingsbury districts of Harrow and Wembley. Health Services provided by the Middlesex County Council. The following services are provided by the Middlesex County Council under Part III of The National Health Service Act, 1946:— Maternity and Child Welfare Services, including Priority Dental Service and Domiciliary Midwifery. 32 Health Visiting. Home Nursing. Domestic Help. Day Nurseries. Vaccination and Immunisation. These services are administered on an area basis, Area No. 4 consisting of the Boroughs of Hendon and Finchley. An Area Committee has been formed which acts as a SubCommittee of the Public Health Committee of the County Council and consists of representatives of the two Boroughs, Middlesex County Council, certain professional bodies and other persons with special knowledge of these services. SECTION D: SANITARY CIRCUMSTANCES OF THE AREA. HOUSING. 1 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 125 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 advance over last year's figures. The policy of transferring to smaller accommodation those Council tenants who were living in accommodation in excess of their requirements, has been continued during the past year. By so doing it has been possible to make the larger types of houses available for reletting to the bigger families, and so relieved the overcrowding formerly experienced in such cases. A feature of 1951 has been the number of Hendon families who have been allocated houses in Hemel Hempstead and Stevenage under the 'linked authority' scheme. By means of the scheme 100 former Hendon families are now living and working in one or other of the Expanded Towns. The demand from evicted families continues to be heavy, and although 51 such families have been offered emergency 33 accommodation in Half-Way Houses during the year, in many cases it has not been possible to assist. The following table sets out the number of housing applicants assisted during the year ending -31st December, 1951:— TABLE XV. 1. Number of families rehoused in permanent accommodation:— (a) Pre-War Houses 45 (b) Post-War Houses 76 (c) Temporary Bungalows 4 - 125 2. Transfers arranged to relieve overcrowding on Council Estates 120 3. Number of families rehoused in requisitioned property 43 4. Number of homeless families given emergency accommodation in Half-Way Houses 51." TABLE XVI. Proceedings under Sections 11 and 13 of the Housing Act, 1936: Number of dwelling-houses unfit for human habitation 1 Number of dwelling-houses in respect of which Demolition Orders were made Nil Number of dwelling-houses demolished in pursuance of Demolition Orders Nil Number of dwelling-houses in respect of which an undertaking was given under Section 11 1 Proceedings under Section 12 of the Housing Act, 1936: Number of dwelling-houses on 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 2 34 Number of dwelling-houses which were rendered fit after service of Formal Notices :— (a) by Occupiers 1 (b) by Local Authority in default Nil Inspection of Dwelling-houses during 1951: Total number of dwelling-houses inspected for housing defects (under Public Health and Housing Acts) 1969 Number of inspections made for the purpose 6821 Number of dwelling-houses found not to be in all respects reasonably fit for human habitation 533 Remedy of defects without Service of Formal Notices: Number of dwelling-houses rendered fit in consequence of informal action by the Local Authority 459 Proceedings under Public Health Acts: Number of dwelling-houses in respect of which Formal Notices were served requiring defects to be remedied 163 Number of dwelling-houses in which defects were remedied after service of Formal Notices:— (a) by Owner 117 (b) by Local Authority in default 1 WATER SUPPLY. The Borough has a dual source of supply:— The Metropolitan Water Board supplies an area bounded on the West by the London Midland Region of British Railways, on the north by a line along the Mutton Brook to Bridge Lane and on the East by the Eastern Division of British Railways. The remaining northern portion of the Borough is supplied by the Colne Valley Water Company. 1. The Metropolitan Water Board supplies selected Thames water which has been subjected to purification by storage in which time it is freed of the bulk 35 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 water 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 constant supervision of a chemical and bacteriological staff which carries out examinations in modern laboratories situated at the Works. The water supply to all areas was satisfactory in quality and quantity. Number of dwelling-houses supplied from Public Water mains;— (a) direct to houses 42,269 (b) by means of standpipes Nil Number of the population supplied from Public Water mains:— (a) direct to houses 155,700 (b) by means of standpipes Nil 36 The following summary of the inspection work performed by the Sanitary Inspectors in connection with environmental health, food inspection, etc., has been submitted to me by Mr. A. H. Smith, Chief Sanitary Inspector. In the report for 1950 attention was drawn to the increasing difficulty in getting essential work carried out due to the continued rise in the cost of material, labour, etc., whilst the rents of controlled dwellings remain stationary. These factors still prevail to-day to even a greater extent. During the course of the year under review inspections were carried out as set out below:— Inspections made 6,220 Re-inspections after order or notice 11,322 Complaints received and investigated 1738 Bakehouses 87 Butchers Shops 433 Caravans 47 Dairies 81 Drain Tests 232 Factories 222 Hawkers and Food Delivery Vans 69 Hawkers Storage Premises and Stalls Ice Cream samples 108 Ice Cream Premises 114 Infectious Disease 449 Licensed Premises 62 Milk Samples 242 Other Food Shops 1,337 Overcrowding 149 Outworkers 79 Piggeries 26 Public Entertainment in connection with licensing 96 Restaurants, Cafes, etc. 287 Smoke Observations 82 Stables 2 Swimming Baths 35 Notices Served: Informal or cautionary 937 Complied with 809 37 Statutory Notices: Applied for 323 Served under Public Health Acts 184 Complied with 135 Outstanding 49 Disinfection and Disinfestation. Disinfection of rooms by formalin spray is carried out after cases of notifiable infectious disease and in the case of Tuberculosis on request of the Chest Physician. An arrangement exists with the North-West Regional Hospital Board for the steam disinfection of bedding and clothing, a charge being made by the Board for this service. In cases other than notifiable infectious disease the service is carried out on request, an appropriate charge being made. During the year 250 library books were disinfected and five destroyed at the request of private libraries. Number of rooms disinfected during the year 304 Treatment of Verminous Houses. 27 houses were successfully treated:— Privately owned 22 Council houses 5 An arrangement exists whereby the Housing Officer notifies the department of the transfer of tenants in Council Houses. Inspections were made of furniture, bedding and accommodation before transfer and disinfestation performed where necessary. The method employed is the application of a D.D.T. solution in spray form and in the case of heavy infestation the work is carried out by specialist firms. Cesspools. A number of houses in the more rural portions of the Borough are drained into cesspools. These were emptied by the Council on 195 occasions during the year. Smoke Abatement. Number of observations made during the year 82 In this connection advice was given were necessary. 38 Swimming Baths. There are three swimming baths within the district used by the Public, two, one at West Hendon and one at Mill Hill, owned by the Local Authority and one owned privately. The purification and filtration plant at the baths of the Local Authority consists of filters of the horizontal pressure type, together with centrifugal pumps, chlorination plant and cascade aerators. The total quantity of bath water can be passed through the filters in four hours, but during slack bathing periods this is extended to six hours. 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. The use of ammonia and chlorine gas is for the destruction of harmful bacteria and the prevention of the growth of algae in the water. In order to assist in the cleaning and efficient working of the filters a coagulant and alkaline salt are introduced into the water between the pumps and filters. This process has resulted in a high standard of purity being maintained. No. of samples taken from Municipal Swimming Baths 32 No. of samples taken from privately owned Pool 3 Cinemas and Places of Entertainment and Licensed Houses. During the year these premises have been inspected by the Sanitary Inspectors and detailed reports submitted to the respective licensing authorities. PREVENTION OF DAMAGE BY PESTS ACT, 1949. Rodent Control. Rodent destruction is carried out by one Rodent Foreman and four operatives working under the general direction of the Sanitary Inspectors. Dwelling-houses are dealt with free of charge, while in the case of business premises, a charge, based on the men's time, cost of material used and overhead expenses, is made. All treatment is carried out in accordance with the recommendations of the Ministry of Agriculture and Fisheries. 39 A report on the work carried out for the year ended 31st December, 1951, is given below:— Type of Property. Local Authority. Dwelling Houses. Agricultural. All other (including Business and Industrial). Total. I. Total number of properties in Local Authority's District 15 41911 10 4554 46490 II. Number of properties inspected by Local Authority during 1951 as a result— (a) of notification, or (a) 4 629 – 91 724 (b) otherwise (b) 5 928 – 125 1058 III. Number of properties (under II) found to be infested by rats Major 1 4 5 Minor 3 831 – 66 900 IV. Number of properties (under II) found to be seriously infested by mice 1 277 – 22 300 V. Number of infested properties (under III and IV) treated by the Local Authority 5 1108 – 92 1205 VI. Number of notices served under Section 4 : (1) Treatment – – – – – (2) Structural Works (i.e., Proofing) – – – – – TOTAL – – – – – VII. Number of cases in which default action was taken by Local Authority following issue of notice under Section 4 – – – – – VIII. Legal Proceedings – – – – – IX. Number of "Block" Control Schemes carried out 1 40 FACTORIES ACTS, 1937 and 1948. The following is a report on the work carried out by the Sanitary Inspectors during the year:— Part 1 of the Act. 1.—INSPECTION'S for purposes of provisions as to health (including inspections made by Sanitary Inspectors). Premises. Number on Register. Number of Inspections Number of written . Notices. (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 48 50 16 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 377 154 17 (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 8 18 TOTAL 433 222 33 2.—CASES IN WHICH DEFECTS WERE FOUND. Particulars. Number of cases in which defects were found. Found. Remedied. Referred by H.M. Inspector. Want of cleanliness (S.1) 39 35 3 Overcrowding (S.2) – – 1 Unreasonable temperature (S.3) – – – Inadequate ventilation (S.4) 3 2 2 Ineffective drainage of floors (S.6) – – – Sanitary Conveniences (S.7): (a) Insufficient; – – 1 (b) Unsuitable or defective 13 13 1 (c) Not separate for sexes – – – Other offences against the Act (not including offences relating to Outwork) 30 27 2 TOTAL 85 77 10 41 Part VIII of the Act. OUTWORK. (Section 110.) Nature of Work. No. of out-workers in August list required by Sect. 110(1) (c). Wearing apparel—Making, etc. 139 Household linen 2 Brass and brass articles 15 Fur pulling 1 Umbrellas, etc 1 Artificial flowers 2 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 3 Brush making 1 Feather sorting 2 Carding, etc., of buttons, etc 3 Stuffed toys 7 Cosaques, Christmas crackers, Christmas stockings, etc. 5 Lampshades 1 TOTAL 182 42 SECTION E: INSPECTION AND SUPERVISION OF FOOD. Food Shops and Food Stores. 2,225 inspections were made at premises where food intended for sale for human consumption was prepared, stored or sold. Considerable attention was given to these premises, including those of street hawkers, particular emphasis being placed on the observance of cleanliness by persons employed in food stores, both in regard to the rooms and all articles, apparatus and utensils therein, and in regard to themselves and their clothing. The local food retailers are very conscious of their responsibility to supply sound and wholesome food to the public. This is demonstrated by the fact that for a considerable time an understanding has existed between them and the Public Health Department whereby the Sanitary Inspectors are notified of any article of food about the quality of which they are in doubt before the food is exposed for sale in their shops. In consequence a large amount of food, unwholesome or unfit for human consumption, was withdrawn from sale. The Clean Food Bye-laws adopted by the Council and approved by the Ministry of Food came into operation during the year, copies being sent to each food trader in the Borough. Particular attention has been given to the enforcement of the Bye-laws. It was not necessary, however, during the period under review to take legal action in this respect. The Public Health (Clean Food) Sub-Committee has met during the year and has adopted, in conjunction with the Food Traders' Organisations and Chambers of Commerce in the Borough, a " Code of Practice " which was circulated to all members of Food Trades and has been enthusiastically received. Further meetings of the Sub-Committee are being arranged with a view to implementing the campaign. 43 List of Foodstuffs condemned during 1951. MEAT : 16 cwt. 3 qts. 14 lbs. 5 oz. (including Pork, Beef, Lamb, Sausages, Bacon, Cooked Ham, Turkey, Ducks. FISH: 63 st. (including Plaice, Haddock, Cod, Lemon Soles, Grey Sole, Mackerel, Halibut, Kippers, Dog Pish, Smoked Salmon. Skate. Melts'). TINNED POOD: Meat 1,027 Pish 569 Milk 603 Vegetables 1,425 Soup 1,335 Fruit 1,223 Ham (2,903 lbs. 2½ oz.) 272 Jam, Marmalade, Syrup, etc. 288 Fruit Juice 147 Puddings 58 Fish Paste 29,179 FRUIT and VEGETABLES : Dates 141 pkts. Dried Peas 46 lbs. Figs 53 lbs. 10½ oz. Mushrooms 5 lbs. Raisins 350 lbs. Cherries 12 pkts. Prunes 501 lbs. Potatoes 26 lbs. MISCELLANEOUS GOODS: Baby Food 8 pkts. Butter ½ lb. Bournvita ½ lb. Bicarbonate of -Soda 9 cartons. Baking Powder 1 tin. Bovril, etc. 4 jars. Blancmange 47 pkts. Bengers Food 63 tins. Biscuits 67½ lbs. Bread Rolls 150 and 1 pkt. 44 Chickens 2 and 9 tins. Cake Mixture 198 pkts. Cereal 251 pkts. Cow & Gate 1 pkt. Cocoa ½ lb. Chocolate Spread 18 cartons. Coffee 4 tins, ¾ lb. and 2 bottles. Custard Powder 19 pkts. Cake 11½ lbs. and 1. Crush 3 bottles. Crystalised Fruits 5 boxes and jars. Cheese 20 lbs. 4½ oz. and 3,387 cartons. Desiccated Coconut 28 pkts. (7 lbs.). Dried Eggs 7¼ lbs. Eggs 890. Emulsion of Cod Liver Oil 2 bottles. Fruit Pies 13. Fish Balls 91. Fish Cakes 28. Fruit 62 jars. Flour 117 lbs. Frozen Fruit 68 pkts. Frozen Vegetables 74 pkts. Frozen Meat 24 pkts. Ginger Bread 24 tins. Ginger Wine Glace Pineapple 1bottle. Fingers 25 lbs. Gravy Powder 35 pkts. Horlicks 8 jars. Iron Tonic 1 bottle. Icette 6 tubes. Jam 3 jars. Junket 12 cartons and 1 bottle. Jelly 15 pkts. Mixed Nuts 7 pkts. Munchmallows 1 box. Macaroni 29 lbs. Oxo 60 cubes. 45 Peanut Butter 6 jars and 1 tin. Pickled Herring/ Rollmop 23 jars. Pickles 204 jars. Pearl Barley 5 lbs. Peel 28 pkts. Potato Crisps 24 pkts. Robertson Croats 1 pkt. Ryvita 4 pkts. Raspberry Roll 1. Rice 45½ lbs. Semolina 6 pkts. Soup 3,167 pkts. Sugar 90 lbs. Synthetic Cream (Soreen, etc.) 41 cartons. Stuffed Dates 8 tins. Soya Malt 4 jars. Salad Cream 59 jars. Sauce 29 bottles. Sandwich Spread and Paste 54 jars. Salt l½ lbs. Shrimps 1 jar. Spaghetti 50 tins. Skimmed Milk Powder 112 lbs. Suet ½ lb. Tea 12¼ lbs. Tapioca 5 lbs. Vinegar 1 bottle. Vermicelli ½ lb. Xmas Pudding 10. CONFECTIONERY: Assorted Sweets 179 lbs. 9 oz. 46 Action taken in connection with Food Shops and Food Stores. 154 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 127 notices had been complied with. The principal matters dealt with were:— Sanitary Accommodation: Defective sanitary conveniences 9 Defects in drainage systems 5 Choked drains 6 Compartments cleansed 27 Provision of washing facilities: Provision of hot water supply 48 Refrigerators: Interiors cleansed 8 General: Insufficient accommodation for storage of refuse 17 Want of cleanliness 74 Other defects 268 Milk Supply. Number of registered Dairymen and Distributors 50 Number of registered Dairies not being Dairy Farms 13 81 visits have been made to dairies during the year. Milk (Special Designations) Regulations. The following table shows the number of licences issued under these Regulations during 1951:— Dealers Licences: Tuberculin Tested 36 Pasteurised 32 Sterilised 30 Dealers Supplementary Licences: Tuberculin Tested 18 Pasteurised 18 Sterilised 16 47 Milk Sampling. The number of samples taken during the year was as follows:— Pasteurised Milk 84 Raw Bulk Milk (Tuberculin Tested) 23 Tuberculin Tested (Bottled) 12 Sterilised Milk 7 Bulk Supply (Raw Milk) 2 Chocolate Milk 1 Homogenised Milk 5 There was one unsatisfactory sample of raw Tuberculin Tested Milk In addition, 104 samples of Bottle Rinses were taken during the year. Ice Cream. 105 samples of ice cream were taken during the year and submitted for bacteriological examination to the Central Public Health Laboratory, Colindale. The results of the samples were as under:— Grade. Number of Samples. Grade I 73 Grade II 19 Grade III 9 Grade IV 4 Where unsatisfactory samples were obtained investigations were carried out by the Sanitary Inspectors at the producers plant and advice given. Slaughterhouses. The Livestock (Restriction of 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. Hendon Printing Works Limited, 42/44, Victoria Road, N.W.4. 'Phone: IIENddn 1004