LI BRARY HEN 29 BOROUGH OF HENDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH for the year 1952 A. F AIRGRIEVE ADAMSON, M.D., D.P.H., Medical Officer of Health. BOROUGH OF HENDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH for the year 1952 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‡ Statistics 6 General 6 Births, Birth Rate, Still Births, Still Birth Rate 6,7 Deaths, Death Rate Maternal Mortality 7 Infantile Mortality 8, 9, 10 Summary of Vital Statistics for year 1952 11 Table showing Vital Statistics for years 1932—1952 12 Table showing Causes of Death during 1952 13 Table showing Age Distribution of Deaths during 1952 14 Road Traffic Accidents 14, 15, 16 SECTION Bs PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES ‡ Notifications 17 Age Distribution of Infectious Disease 18 Ward Distribution of Infectious Disease 19 Food Poisoning 20 Poliomyelitis 20,21 Notes on other Infectious Diseases 21, 22, 23 Diphtheria 23, 24, 25 Diphtheria Immunisation 25,26 Smallpox and Vaccination 27,28 Tuberculosis 28,29 Report of Chest Physician 30, 31, 32 SECTION C‡ GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA: Establishments for Massage and Special Treatment 32 Public Burials 33 Action under Section 47, National Assistance Act, 1948 33 Hospital Facilities 33 Health Services provided by Middlesex County Council 34 Laboratory Facilities 34,35 Medical Examinations 35 Welfare of Old People 35, 36, 37 SECTION D ‡ SANITARY CIRCUMSTANCES OF THE AREA ‡ Water Supply 37,38 Housing 38,39 Summary of Inspections carried out by Sanitary Inspectors 40 Notices Served 41 Legal Proceedings under Public Health Act, 1936 41 Inspection of Dwelling-houses during the year 41, 42 Cinemas and Places of Entertainment and Licensed Houses 42 Smoke Abatement 42 Cess Pools 42 Disinfection and Disinfestation 42,43 Swimming Baths 43 Rag, Flock and other Filling Materials Act, 1951 43 Pet Animals Act, 1951 43 Rodent Control 44,45 Administration of Factories Acts, 1937 and 1948 45,46,47 SECTION E‡ INSPECTION AND SUPERVISION OF FOOD ‡ Inspection of Food Shops and Food Stores 48 Unsound Food 49, 50, 51 Action taken in connection with Food Shops and Stores 51 Milk Supply 51,52 Milk (Special Designations) Regulations 52 Milk Sampling 52 Ice Cream 52 Slaughterhouses 52 COUNCIL of the BOROUGH (31-12-52) Mayor : Alderman S. R. C. SUMPTER, J.P., F.B.A.A. Deputy Mayors Alderman R. J. KNOWLES, M.M., J.P., M.I.W.M. Aldermen: W. R. CLEMENS. J.P., F.C.A., A. A. NAAR, M.B.E., J. J. COPESTAKE. J.P., J. H. RODWAY. J.P.. A. W. CURTON. F.R.S.A., M.Inst.B.E.. C. H. SHEILL. J. L. FREEDMAN. J.P.. M.A., LL.B., Councillors x Burnt Oak Ward: Garden Suburb Ward: Edgware Ward: R. A. COWTON, (Miss) M. EATON. S. E. ARRIDGE. A. PAUL. J.P., S. D. GRAVES. H. M. MATTHEWS. S. E. SHARPE. F.R.I.C.S., F.A.I.. T.D.. W. ROWLEY. K. G. PAMPLIN Central Ward: Golders Green Ward: Park Ward: L. C. CHAINEY, S. J. PATMORE, J. D. GORDON-LEE. L. A. HILLS, A.M.I.Mech.E., J. HARLEY. T.D.. W. LLOYD-TAYLOR. A.M.I.E.E.. A.R.Ae.S.. A.I.B.. B. H. O. TURRALL. A. V. SULLY. M.C., G. N. WARNOCK. O.B.E. J.P., F.C.A. Childs Hill Ward: Mill Hill Ward: West Hendon Ward : W. G. BARNES. W. A. CANNELL. M.M.. E. C. HOOKER. D. A. DAVIS. M.R.C.S., L.R.C.P.. R. T. REED. D. G. PARSONS. D.P.H.. L.D.S., R.C.S., (Mrs.) D. TIIORNY- D. F. SIMONS. CROFT. M.A. (Mrs.) C. M. THUBRUN. PUBLIC HEALTH COMMITTEE. (31-12-52) Chairman x Councillor (Miss) M. EATON Vice-Chairman : Councillor A. V. SULLY, M.C., F.C.A. Aldermen x A. A. NAAR. M.B.E., S. R. C. SUMPTER. J.P., F.B.A.A. (Mayor). C. H. SHEILL. Councillors x W. G. BARNES. S J. PATMORE. A.M.I.Mech.E.. A.M.I.E.E.. W. A. CANNELL, M.M.. M.R.C.S., A.R.Ae.E., L.R.C.P., D.P.H., L.D.S., R.C.S., A. PAUL, J.P., L. C. CHAINEY. (Mrs.) D. TIIORNYCROFT, M.A. K. G. PAMPLIN, 3 ANNUAL REPORT OF THE Medical Officer of Health FOR THE YEAR 1952 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 1952, this being my twenty-third report as Medical Officer of Health. It will be seen from the vital statistics that the health conditions continue to be satisfactory. The infantile mortality rate was the second lowest in the history of the Borough and reflects a very high standard of maternal care. The incidence of Tuberculosis shows a slight decline over the years but this may be greater than appears as the more precise methods of diagnosis now employed are probably resulting in the discovery of an increasing number of early cases of this disease. An investigation into the efficacy of B.C.G. Vaccine has been carried out amongst school leavers in the Borough. This is part of a much wider investigation being conducted by the Medical Research Council, the results of which will take a considerable time to emerge, but there appears to be enough evidence from other sources to justify the giving of B.C.G. Vaccine to children who are known to be home contacts of infectious cases of Tuberculosis. The Housing Committee has continued the policy of awarding additional points to housing applicants where the presence of an infectious case of Pulmonary Tuberculosis constitutes a danger of infection to children. No case of Smallpox occurred in the Borough during the year but it was disappointing to see that a further decline in infant vaccination has taken place, only 667 children having been vaccinated out of approximately 2,000 births. Much of the work of the Sanitary Inspectors has been concerned with endeavours to maintain housing at a reasonable standard. This 4 is proving increasingly difficult and more resort is having to be had to statutory action. The Clean Food Bye-laws have now been in operation for a full year and much experience has been obtained in their operation. The Bye-laws have permitted improvements to be effected at numbers of premises and much advice given and I am glad to report that the food traders generally have been willing to co-operate, and resort to legal action has not so far been found necessary. An increasing number of representations have been made by members of the public concerning elderly persons whom they state are not receiving proper care and attention and are living in insanitary conditions and urging that they should be removed to institutional care. The policy, however, has been continued of endeavouring to help the elderly person to live his own life in his normal surroundings by the provision of a Home Help and, where necessary, a Home Nurse, and institutional care has only been sought where the person concerned has indicated his willingness to be removed and no compulsory action was taken under Section 47 of the National Assistance Act of 1948. It should be added that the work of the voluntary Associations concerned with the care of the elderly is proving of the utmost value . In submitting this report I should like to take the opportunity of thanking the Members of the Council for the interest they have taken in all matters affecting the public health, and also the members of my staff for the efficient and successful manner in which they have carried through a growing volume of work. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, A. FAIRGRIEVE ADAMSON, Medical Officer of Health. 5 SECTION A: STATISTICS AND SOCIAL CONDITIONS OF THE AREA. STATISTICS. General. Wards (9). Area in Acres. Edgware 2,327 Burnt Oak 477 Mill Hill 2,695 West Hendon 1,143 Central 1,139 Park 580 Golders Green 748 Garden Suburb 669 Childs Hill 593 Area of the Borough (in acres) 10,371 Population figure supplied by Registrar General 156,400 Density of Population, i.e., No. of persons per acre 15.08 No. of inhabited houses at 31st December, 1952 (accord ing to Rate Book) 42,329 Rateable Value at 31st December, 1952 £2,019,073 Sum represented by a penny rate £8,130 EXTRACTS FROM VITAL STATISTICS FOR YEAR 1952. Births. Live Births : Male. Female. Total. Legitimate 971 924 1895 Illegitimate 37 49 86 1008 973 1981 6 Live Birth Rate per 1,000 Home Population 12.66 Birth Rate corrected for comparison with other areas 11.52 Comparability factor supplied by Registrar General 0.91 Birth Rate per 1,000 Home Population, England and Wales 15.30 Corresponding Rate for the Borough of Hendon for 1951 12.26 Stillbirths: Male. Female. Total. Legitimate 18 11 29 Illegitimate 5 1 6 23 12 35 Stillbirth Rate per 1,000 Total Births 17.35 Stillbirth Rate per 1,000 Home Population 0.22 Stillbirth Rate per 1,000 Home Population, England and Wales 0.35 Stillbirth Rate per 1,000 Total Births, England and Wales 22.60 Deaths. Male. Female. Total. 763 835 1598 Death Rate per 1,000 Home Population 10.22 Death Rate corrected for comparison with other areas 11.04 Comparability Factor supplied by Registrar-General 1.08 Death Rate per 1,000 Home Population, England and Wales 11.30 Maternal Mortality. Number of women dying in consequence of childbirth 1 Maternal Mortality Rate per 1,000 total births 0.49 Comparative Figure for England and Wales 0.72 7 Infantile Mortality. Deaths of Infants under 1 year of age:— Male. Female. Total. Legitimate 22 12 34 Illegitimate 3 4 7 25 16 41 Death Rate of Infants under 1 year of age per 1,000 live births 20.7 Death Rate of Infants under 1 year of age per 1,000 live births, England and Wales 27.6 Deaths of Infants under the age of 4 weeks:— Male. Female. Total. Legitimate 14 9 23 Illegitimate 3 3 6 17 12 29 Neo-Natal Mortality Rate per 1,000 live birhts 14.6 8 An analysis of the causes of death and the age at death reveals the following fiures:— 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 7 — — — 11 — — — — 11 Prematurity and Atelectasis 1 2 — — — 3 — — — __ 3 Prematurity and Respiratory Failure 1 — — — — 1 — — — — 1 Prematurity and Cerebral Oedema 1 — — — — 1 — — — — 1 Broncho- Pneumonia — 2 — — — 2 — 2 2 1 7 Haemorrhagic Pneumonia — 1 — — — 1 — — — — 1 Broncho-Pneumonia & Whooping Cough — — — — — — — 1 — — 1 Pneumonia and Cerebral Diplegia — — — — — — — — 1 — 1 Broncho - Pneumonia and Congenital Abnormality of Heart 1 — — 1 — 2 — — — — 2 Pneumonia and Atelectasis — — 1 — — 1 — — — — 1 Atelectasis — 2 — — — 2 — — — — 2 Congenital Convulsions and Pulmonary Stenosis 1 — — — 1 — — — — 1 Influenza — — — — — — — 1 — — 1 Asphyxia — — — — — — — — 1 — 1 Kernicterus — 2 — — — 2 — — — — 2 Congenital Malformations — — — — — — — — — 1 1 Meningococcal Meningitis — — — — — — — 1 — — 1 Haemorrhage — 2 — — — 2 — — — — 2 Marasmus and Gastro-Enteritis — — — — — — 1 — — — 1 TOTALS 8 19 1 1 — 29 1 5 4 2 41 9 TABLE I, 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 1952 21 10 SUMMARY OF VITAL STATISTICS FOR THE YEAR 1952. England and Wales. 160 County Boro's & Great Towns including London. 160 smaller Towns (Resident Population 25,000—50,000 at 1951 Census) London Administrative County. Borough of Hendon. Births: Rates per 1,000 Home Population. Live Births 15.30 16.90 15.50 17.60 12.66 Stillbirths 0.35 0.43 0.36 0.34 0.22 22.60(a) 24.60(a) 23.00(a) 19.20(a) 17.35(a) Deaths: All causes 11.30 12.10 11.20 12.60 10.22 Typhoid & Paratyphoid 0.00 0.00 0.00 — 0.00 Whooping Cough 0.00 0.00 0.00 0.00 0.00 Diphtheria 0.00 0.00 0.00 0.00 0.00 Tuberculosis 0.24 0.28 0.22 0.31 0.17 Smallpox 0.00 — — — 0.00 Acute Poliomyelitis and Polioencephalitis 0.01 0.01 0.00 0.01 0.02 Pneumonia 0.47 0.52 0.43 0.58 0.34 Influenza 0.04 0.04 0.04 0.05 0.02 Deaths : Rates per 1,000 Live Births. All causes under 1 year of age 27.60(b ) 31.20 25.80 23.8 20.7 Enteritis and Diarrhœa under 2 years of age 1.10 1.30 0.50 0.70 — Notifications (Corrected): Rates per 1,000 Home Population. Typhoid Fever 0.00 0.00 0.00 0.00 0.03 Paratyphoid Fever 0.02 0.02 0.03 0.01 0.00 Meningococcal Infecttion 0.03 0.03 0.03 0.02 0.06 Scarlet Fever 1.53 1.75 1.58 1.56 1.32 Whooping Cough 2.61 2.74 2.57 1.66 3.25 Diphtheria 0.01 0.01 0.03 0.01 0.00 Erysipelas 0.14 0.15 0.12 0.14 0.15 Smallpox 0.00 0.00 0.00 — 0.00 Measles 8.86 10.11 8.49 9.23 5.54 Acute Poliomyelitis (including Polioencephalitis): Paralytic 0.06 0.06 0.06 0.06 0.07 Non-Paralytic 0.03 0.03 0.02 0.03 0.04 Food Poisoning 0.13 0.16 0.11 0.18 0.06 Rates per 1,000 Total (Live and Still) Births. Puerperal Pyrexia 17.87(a) 23.94(a) 10.22(a) 30.77(a) 68.45(a) (a) Per 1,000, total (live & still) Births, (to) Per 1,000 related live births. 11 TABLE II. VITAL STATISTICS FOR THE YEARS 1932—1952. Year Population Live Births Live Birth Rate Per 1,000 Population Deaths Death Rate per 1,000 Population Deaths of Infants under 1 year of age Infantile Mortality Rate Maternal Deaths Maternal Mortality Rates per 1,000 total Births 1932 123,200 1,688 13.70 1,036 8.40 86 51 8 4.62 1933 127,600 1,673 13.11 1,013 7.93 65 38 3 1.74 1934 131,075 1,643 12.53 1,065 8.12 71 43 3 1.77 1935 134,160 1,724 12.85 1,146 10.07 87 50 3 1.69 1936 140,650 1,835 13.04 1,166 9.78 81 44 4 2.10 1937 143,800 1,792 12.46 1,291 10.59 81 45 5 2.69 1938 145,100 1,877 12.93 1,153 9.38 72 38 4 2.06 1939 142,000 1,837 12.94 1,184 8.41 63 34 5 — 1940 132,490 1,601 12.08 1,417 12.41 92 54 3 — 1941 125,360 1,410 11.65 1,408 11.20 81 57 4 — 1942 132,200 2,081 15.74 1,298 9.82 70 34 5 — 1943 133,970 2,223 16.95 1,387 10.35 86 39 4 — 1944 132,360 2,245 16.96 1,347 10.18 72 32 4 — 1945 137,770 2,239 16.25 1,379 10.01 65 29 3 1.30 1946 153,820 2,651 17.23 1,481 9.63 77 29 3 1.10 1947 158,670 2,671 16.83 1,522 9.59 77 27 4 1.45 1948 156,400 2,292 14.65 1,406 8.90 47 21 6 2.56 1949 158,430 2,251 14.36 1,522 10.56 50 22 5 2.17 1950 158,200 2,261 14.29 1,501 9.49 36 16 2 .87 1951 155,700 2,082 13.36 1,635 10.50 47 22 2 .94 1952 '56,400 1,981 12.66 1,598 10.22 41 21 1 .49 12 TABLE III. CAUSES OF DEATH DURING THE YEAR ENDED 31st DECEMBER, 1952. Cause of Death. Male. Female, , Total. Tuberculosis, respiratory 17 8 25 Tuberculosis, other 0 1 1 Syphilitic disease 3 1 4 Diphtheria 0 0 0 Whooping Cough 1 0 1 Meningcococcal Infections 1 0 1 Acute Poliomyelitis 3 0 3 Measles 1 0 1 Other infective and parasitic diseases 1 4 5 Malignant neoplasm, stomach 18 22 40 Malignant neoplasm, lung, bronchus 62 10 72 Malignant neoplasm, breast 0 35 35 Malignant neoplasm, uterus 0 19 19 Other malignant and lymphatic neoplasms 73 91 164 Leukaemia, aleukaemia 5 2 7 Diabetes 7 8 15 Vascular lesions of nervous system 76 151 227 Coronary disease, angina 148 90 238 Hypertension with heart disease 19 33 52 Other heart disease 73 140 213 Other circulatory disease 27 50 77 Influenza 2 2 4 Pneumonia 26 27 53 Bronchitis 56 39 95 Other diseases of respiratory system 5 2 7 Ulcer of stomach and duodenum 16 3 19 Gastritis, enteritis and diarrhœa 3 3 6 13 Cause of Death. Male. Female . Total. Nephritis and nephrosis 12 6 18 Hyperplasia of prostate 15 0 15 Pregnancy, childbirth, abortion 0 1 1 Congenital malformations 3 8 11 Other defined and ill-defined diseases 59 57 116 Motor vehicle accidents 9 3 12 All other accidents 12 11 23 Suicide 10 8 18 Homicide and operations of war 0 0 0 All causes—TOTAL 763 835 1598 TABLE IV. AGE DISTRIBUTION OF DEATHS DURING THE YEAR ENDED 31st DECEMBER, 1952. Age Group. Male. Female. Total. Percentage. 0— 5 years 28 18 46 2.9 5—10 years 3 2 5 .3 10—15 years 2 — 2 .1 15—20 years 2 2 4 .3 20—30 years 10 11 21 1.3 30—40 years 15 14 29 1.8 40—50 years 58 31 89 5.6 50—60 years 108 77 185 11.6 60—70 years 215 163 378 23.6 70—80 years 193 253 446 27.9 80 years and over 129 264 393 24.6 TOTAL 763 835 1598 100.0 ROAD TRAFFIC ACCIDENTS. The following tables show the road traffic accidents and casualties occurring within the Borough of Hendon during the year 1952 and the comparative figures and casualties for the years 1949, 1950, 1951 and 1952. 14 It should be noted that the figures shown refer not only to Hendon residents but also to persons living in other areas who were involved in accidents within the Borough. The figures for fatalities shown in these tables do not agree, therefore, with those in the list of causes of death supplied by the Registrar-General. The latter refer to the deaths of Hendon residents only, and the death may have occurred within the Borough of Hendon or some other outside district. I am indebted to the Town Clerk for supplying me with the figures. TABLE V. ROAD TRAFFIC ACCIDENTS, 1952, WITHIN BOROUGH OF HENDON. Month Adults Children No. of Accidents Killed Seriously Injured Slightly Injured Killed Seriously Injured Slightly Injured Totals January 67 2 10 58 — 2 4 76 February 32 1 2 29 — 1 4 37 March 43 — 3 40 — 1 5 49 April 57 — 7 48 — 1 9 65 May 75 3 12 52 — 5 17 89 June 59 1 5 42 — 1 17 66 July 67 — 12 47 — 2 15 76 August 57 — 7 50 — 1 11 69 September 65 1 16 46 — 2 11 76 October 53 3 11 56 1 1 7 79 November 63 1 15 56 — 1 4 77 December 76 3 15 68 — 3 6 95 TOTAL 714 15 115 592 1 21 110 854 15 TABLE VI. Borough of Hendon. COMPARATIVE FIGURES OF ACCIDENTS AND CASUALTIES FOR THE YEARS 1949, 1950, 1951 and 1952. 1949 1950 1951 1952 Total number of road accidents involving personal injury 522 603 706 714 Accidents per mile of road 3.28 3.77 4.41 4.37 Casualty Figures: Adults: Killed 13 14 18 415 Seriously injured 54 79 116 115 Slightly injured 488 496 609 592 Totals 555 589 743 722 Children (0—15 years) : Killed 2 Nil Nil 1 Seriously injured 9 16 14 21 Slightly injured 84 105 117 110 Totals 95 121 131 132 Combined Adults and Children Totals 650 710 874 854 Casualties per mile of road 4.09 4.43 5.46 5.23 16 SECTION B: PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES. TABLE VII. 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. Scarlet Fever 216 105 Whooping Cough 508 29 Acute Poliomyelitis:— Paralytic 11 11 Non-Paralytic 7 7 Measles 867 31 Pneumonia 114 41 Dysentery 28 3 Enteric or Typhoid Fever 5 4 Erysipelas 23 6 Meningococcal Infection 9 8 Food Poisoning 9 3 Puerperal Pyrexia 138 137 Ophthalmia Neonatorum 30 30 TOTAL 1965 415 17 TABLE VIII. AGE DISTRIBUTION. Disease. Age Groups. TOTALS. Under 1 year. 1—2 3—4 5- -9. 10—14. 15—24. 25 & over. Age not known. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Scarlet Fever — — 7 6 20 19 78 61 8 10 2 2 — 3 — — 216 Whooping Cough 22 16 50 64 61 72 104 101 4 2 1 1 4 5 1 — 508 Acute Poliomyelitis: 11 Paralytic — — 4 — — 1 — 1 — — 4 — 1 — — — Non-Paralytic Measles — — — 1 — — 2 — — — — — 4 — — — 7 6 5 69 67 113 89 235 242 12 2 3 12 2 5 4 1 867 TOTALS 28 21 130 138 194 181 419 405 24 14 10 15 11 13 5 1 1609 Disease. Age Groups. TOTALS. Under 5 years. 5—14. 15—44. 45—64. 65 &over Age not known. M. F. M. F. M. F. M. F. M. F. M. F. Pneumonia 6 4 4 6 16 18 17 20 11 11 — 1 114 Dysentery 4 3 4 9 1 4 2 — — 1 — — 28 Enteric or Typhoid Fever — — 1 — 1 3 — — — — — — 5 Erysipelas — — 1 1 4 2 8 4 — i — — 23 Meningococcal Infection 2 1 1 1 1 1 — 1 — — — — 9 Food Poisoning — 1 — — 1 i 1 — — 1 — — 9 Puerperal Pyrexia — — — — — 138 — — — — — — 138 Ophthalmia Neonatorum 23 7 — — — — — — — — — — 30 TOTALS 35 17 11 17 24 171 28 25 11 16 — 1 356 TABLE IX. WARD DISTRIBUTION. Number of cases of Infectious Disease notified in each Ward of the Borough. Disease. Mill Hill. Burnt Oak. West Hendon Central. Ward. Park. Golders Green. Garden Suburb. Childs Hill. Edgware. Total. Scarlet Fever 49 19 43 21 22 14 6 10 32 216 Whooping Cough 72 108 82 38 79 44 16 36 33 508 Acute Poliomyelitis:— Paralytic 4 1 - 1 - 3 1 1 - 11 Non-Paralytic 4 — — 1 — — — 1 1 7 Measles 154 83 53 169 108 52 91 50 107 867 Pneumonia 29 13 11 11 9 14 2 12 13 114 Dysentery 6 — 2 10 2 2 3 2 1 28 Enteric or Typhoid Fever 1 2 — — 1 1 — — — 5 Erysipelas 2 3 3 3 2 2 2 2 4 23 Meningococcal Infection 2 2 — 1 — — 1 3 — 9 Food Poisoning 1 — 2 1 3 — 1 — 1 9 Puerperal Pyrexia 8 97 2 6 5 7 2 9 2 138 Ophthalmia Neonatorum — 24 1 2 1 1 — 1 — 30 TOTAL 332 352 199 264 232 140 125 127 194 1965 61 Feed Poisoning. Nine notifications of Food Poisoning were received during 1952. The cases were distributed throughout the year as follows:— First Quarter. Second Quarter. Third Quarter. Fourth Quarter. — — 5 4 The notifications were confined to single cases and there was no outbreak of Food Poisoning as such. In three cases the cause of the infection was unknown and the agent was identified in six—Salmonella Typhi Murium 4, Staph Aureus 2. There was a reduction of thirteen in the number of notifications received, twenty-two cases having been notified in 1951. Poliomyelitis. The decreased incidence of this disease evident last year was not maintained during 1952, eighteen cases being notified compared with six in 1951. The figure, however, was lower than those for 1950 and 1949 when twenty¬one and thirty¬two cases respectively were notified. With the exception of one case, which was notified in April, all occurred in the second half of the year and were spread as follows:—July 6, August 2, September 4, October 2, November 2, and December 1. The disease was not confined to any particular age group, the ages of the patients being from 1| years to 47 years. Unfortunately there were three deaths. The following table gives particulars of the cases which were notified:— 20 TABLE X. Name. Age. Sex. Notified. Diagnosis. Ward. Remarks. J.K. 19 M. 29/4/52 Poliomyelitis Garden Suburb Paralytic. Died 29/4/52. A.L. 2¼ M. 10/7/52 Poliomyelitis Mill Hill Paralytic. Left leg effected. M.O's 31012 F. 11/7/52 Poliomyelitis Childs Hill Paralytic. Left arm affected. M.B. 23 M. 17/7/52 Poliomyelitis Golders Green Paralytic. Died 16/7/52. J.H. 22 M. 24/7/52 Poliomyelitis Mill Hill Paralytic. Right arm and leg affected. R.J.C.P. 34 M. 24/7/52 Poliomyelitis Mill Hill Non-Paralytic. A.G. 32 M. 26/7/52 Poliomyelitis Mill Hill Non-Paralytic. I.R. 5 M. 15/8/52 Poliomyelitis Mill Hill Non-Paralytic. F.S. l812 M. 23/8/52 Poliomyelitis Burnt Oak Paralytic. Left shoulder. P.F. l½ M. 1/9/52 Poliomyelitis Central Paralytic. B.F. 23 M. 2/9/52 Poliomyelitis Golders Green Paralytic. Right facial. C.B. 47 M. 2/9/52 Poliomyelitis Mill Hill Paralytic. Died 4/9/52. R.O. 2 M. 30/9/52 Poliomyelitis Mill Hill Paralytic. Right arm. M.T. 7 M. 3/10/52 Poliomyelitis Edgware Non-Paralytic. S.B. 21012 F. 10/10/52 Poliomyelitis Central Non-Paralytic. K.Y. 36 M. 3/11/52 Poliomyelitis Mill Hill Non-Paralytic. A.O. 26 M. 13/11/52 Poliomyelitis Childs Hill Non-Paralytic. D.S. 7 F. 17/12/52 Poliomyelitis Golders Green Paralytic. Typhoid Fever. Five cases of the disease were notified during the year. The details of the cases are as follows:— Case No. 1. The patient, a woman, had been on a Mediterranean cruise 21 from which she returned to this country on 11th July. She became ill on 12th July but a final diagnosis was not made until 19th August. On investigation it seemed likely that the disease was contracted at one of the Mediterranean Ports which was visited during the cruise. Cases Nos. 2 and 3. These two cases occurred in the same family, the patients being the mother and son. The family had been on holiday at the seaside. Shellfish, gathered by the family from the beach, had been eaten. From information received it appeared that this was a prohibited area and it is assumed that the shellfish were the source of infection. Bacteriological examinations were made of the rest of the family and the results proved to be negative. Case No. 4. This was an Indian student who had arrived in this country 2½ years previously from Calcutta. He had been inoculated against Typhoid Fever in 1949. The case history provided no evidence as to where the infection had been acquired. Case No. 5. The patient, a girl of 18 years, a laboratory worker, was admitted to hospital as suffering from Gastro-Enteritis. The final diagnosis was one of Typhoid Fever. Para-Typhoid Fever. Information was received of an outbreak of Para-Typhoid Fever among cadets in an Army Cadet Camp. Twenty persons normally resident in the Borough of Hendon attended the camp and were, therefore, regarded as contacts. They were kept under observation and no case occurred amongst the contacts in this district. Scarlet Fever. There was an increase in the number of cases of Scarlet Fever notified during the year, 216 cases being notified compared with 147 in 1951. 22 The disease was of a mild form and 105 of the cases were removed to hospital. The greatest incidence occurred in the age group 5—9 years, 139 cases being notified in this group. Measles. There was a considerable reduction in the number of cases of Measles notified during the year, 867 cases occurring compared with 1,618 cases in 1951. Of the 867 cases, 621 were notified in the last quarter of the year. This would appear to indicate that the incidence of this disease is likely to be very much higher in 1953 than in 1952. Whooping Cough. This disease also showed a reduction on the 1951 figure. 508 cases were notified compared with 604 last year. Puerperal Pyrexia. There was an increase in the number of cases of Puerperal Pyrexia notified during the year, 138 compared with 106 in 1951 and 53 in 1950. The year 1952 was the first full year following the coming into operation of The Puerperal Pyrexia Regulations, 1951, and this, plus the fact that there is a Maternity Hospital situated in the area which provides, not only accommodation for the Borough of Hendon, but also for the surrounding districts, would appear to account for the increase in the notifications. Of the 138 cases notified 54 were resident in the Borough of Hendon. In the remaining 84 cases the condition occurred in women normally resident in outside districts who had entered the hospital for their confinement. Diphtheria. In the Borough of Hendon during the three years 1937, 1938, and 1939, 466 children contracted Diphtheria and 14 children died. In the three years 1950, 1951 and 1952; no child in the Borough contracted this disease. The reason for this dramatic change is that in the intervening years over 30,000 children were protected by immunisation. 23 This highly satisfactory state of affairs is, however, accompanied by one danger, namely, that the young mother who has now no fear of Diphtheria may feel that it is not worth while for her children to be immunised. There can be no greater mistake as there is ample evidence to show that the germ causing Diphtheria has by no means disappeared and that the present position has only been achieved and maintained by immunisation. There is a growing volume of evidence that immunisation against Whooping Cough, whilst not so effective as is that against Diphtheria, does tend to reduce the incidence of the disease and the severity of the attacks. In view of this, a scheme for the protection of children against Whooping Cough was put into operation in April. Fortunately the antigen of Diphtheria combines well with that of Whooping Cough so that the combined immunity can be conferred with only one additional injection and this combined prophylaxis is now that most frequently sought by the parents for their children. 24 * of these the diagnosis was confirmed in 8 cases in 1946, 8 cases in 1947, and 4 cases in 1949. DIPHTHERIA IMMUNISATION. The following tables show the position of Immunisation in the Borough of Hendon at the 31st December, 1952:— 25 TABLE XI. The steady decline in the number of notifications received since the inception of the Diphtheria Immunisation Scheme is shown by the following table:— Year. No. of Cases of Diphtheria Notified. No. of Deaths from Diphtheria. 1935 138 9 1936 89 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 — — 1952 — — TABLE XII. Number of children resident in the Borough of Hendon who received immunising injections during 1952. 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 975 — 5—9 years 84 1525 1 year of age 459 — 10—14 years 5 497 2 years of age 91 1 3 years of age 28 10 4 years of age 42 262 TOTAL 1595 273 TOTAL 89 2022 TABLE XIII. Number of children resident in the Borough of Hendon under the age of 15 years on 31st December, 1952, who had completed a course of Immunisation at any time since 1st January, 1938. 1—4 years. 5—14 years. Year of Birth. Number considered to be immunised. Year of Birth. Number considered to be immunised. 1952 187 1947 to 1943 1951 1383 5—9 years 8993 1950 1617 1949 1628 1942 to 1938 1948 2248 10—14 years 6663 TOTAL 7063 TOTAL 15656 The total number of children immunised in all age groups is 22,719. 26 Smallpox. CASE No. 1. On the evening of Saturday, 2nd February, I was asked to see, in consultation with a local practitioner, a case of suspected Smallpox. The patient was an air hostess travelling regularly between London, Gibraltar and Malta. She had returned from the latter place on the previous day. Enquiry also ascertained that she had been there thirteen days before, that being the approximate incubation period of the disease. A history showed that she had been feeling off colour for a few days, and that spots commenced to appear on the body and face on Friday, 1st February, and that these had become profuse on the following day. The distribution and the nature of the rash, however, did not suggest Smallpox and there was a history of successful vaccination in November, 1951. The final diagnosis was that of Chickenpox. CASES 2, 3, 4, and 5. In addition to the above-mentioned case, I was called in during the year to see four other cases in which a suspicious rash occurred. Two of the cases were women aged 40 and 45 years and the others two children 10½ years and 4½ years old. There was a history of vaccination in the case of the two women and the child aged 10½ years, but the remaining child had not been vaccinated. The final diagnosis in each case was one of Chickenpox. R.M.S. "STRATHNAVER." Four persons on board R.M.S. "Strathnaver," which docked at Tilbury on 30th November, were reported by the Ship's Surgeon to have, or to have had, Chickenpox during the voyage from Sydney. One of the cases, a male Asiatic steward, showed a distribution which, although the case was clinically undoubtedly Chickenpox, was somewhat wider than might be expected in such a mild case. Consequently the Ship's Surgeon dispatched by air from Marseilles a sample of scabs and vesicular material for laboratory examination. As a result of the laboratory report it was decided to treat the case administratively as suspected Smallpox. Owing to the dispersal of the passengers and crew, eight contacts proceeded to the Borough of Hendon. The necessary arrangements were made for the surveillence of the contacts but, before they could be put into operation, information was received that, as a result of a second laboratory report, the case was not one of smallpox. 27 28 Vaccination. The following table, the figures for which have been supplied by the Area Office of the Middlesex County Council, shows the number of persons vaccinated and re-vaccinated in the Borough of Hendon during 1952 :— TABLE XIV. Age at 31st December, 1952. Under 1 year. 1—4 years. 5—14 years. 15 years or over. Total. Number Vaccinated 667 145 18 99 929 Number Re-Vaccinated — 17 103 923 1052 TUBERCULOSIS. Notification. The following table shows the number of cases of Tuberculosis notified for the first time and the number of transfers into the district during the year 1952:— TABLES XV. Age Group Respiratory Non-Respiratory Total Male. Female Male Female New Cases Transfers into District New Cases Transfers into District New Cases Transfers into District New Cases Transfers into District 0— 1 - - - - - - - - - 1— 5 4 — — 1 — — — — 5 5—10 1 — 3 — 1 — — 1 6 10—15 — 1 — — 1 — 1 — 3 15—20 8 4 7 2 1 — — 1 23 20—25 10 5 15 6 1 1 1 1 40 25—35 19 8 10 20 4 2 3 1 67 35—45 12 11 6 5 — — 2 — 36 45—55 18 4 4 1 — — — — 27 55—65 8 — 2 — — — — — 10 65 and over 2 1 — — 1 — 1 — 5 Age Unknown — — — 1 — — — — 1 TOTAL 82 34 47 36 9 3 8 4 223 In addition to these cases the following were brought to notice other than by formal notification or were restored to the register after being previously removed:— Respiratory. Non-Respiratory. M. F. M. F. Total. 2 — 1 — 3 The following table shows the notification of Tuberculosis for the ten year period 1943—1952:— TABLE XVI. Year. Respiratory Non-Respiratory. Total. M. F. M. F. 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 1952 82 47 9 8 146 Deaths. According to the figures supplied by the Registrar-General the following deaths occurred from Tuberculosis during the year:— Tuberculosis of Respiratory System. Other forms of Tuberculosis. All forms of Tuberculosis. Male. Female Total. Male. Female . Total. Male. Female. Total. 17 8 25 — 1 1 17 9 26 The number of cases of Tuberculosis remaining on the register at the end of the year is as follows:— Respiratory. Non-Respiratory. . M. F. M. F. 699 585 83 73 1284 156 1440 29 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:— " Statistics giving Corresponding Figures for Previous Four Years for Comparison. 1. General. 1948. 1949. 1950. 1951. 1952. New patients referred to clinic 4,257 4,332 4,156 6,107 7,133 Total attendances 17,035 20,665 26,297 30,046 30,183 Attendances for refill treatment 9,191 10,614 11,711 12,214 11,443 Total number X-rayed at Clinic — 10,011 16,717 14,552 18,388 Number of home visits by physicians 87 281 358 294 300 2.—Chest Clinic Tuberculosis Register. 1948. 1949. 1950. 1951. 1952. New Respiratory Tuberculosis Cases 214 225 173 178 184 New Non-Respiratory Tuberculosis Cases 26 19 21 24 28 Total New Tuberculosis Cases 240 244 193 202 212 Cases on Register on 31st December 1,561 1,669 1,750 1,733 1,761 Deaths from Tuberculosis 49 56 31 40 47 Removed from Register as recovered 48 26 62 66 72 Number of Tuberculous patients awaiting hospital admission on 31st December - 103 115 91 95 Edgware Chest Clinic serves an area comprising the Borough of Hendon, and the Stanmore, Queensbury and Kingsbury districts of Harrow and Wembley. The Middlesex County Council as local health authority provides the staff of the welfare Department of the Clinic and the Tuberculosis Health Visitors. In this way the work of the Medical staff is augmented so as to provide a team for the full practice of social medicine. Although Tuberculosis is perhaps a less serious problem than it was immediately at the end of the war, there is no ground for complacency, and the Clinic statistics do not indicate any local decline in Tuberculosis during the last three years, and the deaths have actually increased slightly, possibly associated with the severe winter weather. 30 The work of the Chest Clinic has increased considerably over the last five years, but the rate of increase in numbers of attendances has tended to slacken recently. The medical staff is especially hard pressed particularly as Dr. Brett, who formerly attended for three sessions per week, has been obliged to devote more time to mass radiography duties. There is still a shortage of beds for the treatment of tuberculosis, particularly for male patients, and the position has not improved materially over the course of the year. A good many patients are treated in Edgware General and Hendon Isolation Hospitals where 28 and 10 beds respectively are under the charge of the clinic medical staff. Admissions are also arranged through the North-West Metropolitan Regional Hospital Board's waiting list to regional chest hospitals particularly Colindale and Clare Hall Hospitals. The shortage of beds is to some extent mitigated by the use of domiciliary treatment. In connection with the prevention of Tuberculosis, B.C.G. vaccination of suitable contacts has been carried out, and surveys of some schools have been undertaken at the request of Medical Officers of Health. Special visits and reports on housing conditions have been made in a number of cases where adverse living conditions made the spread of disease likely. The appointments system for patients attending the clinic has been continued and is on the whole successful. Towards the end of the year certain re-organisation which the Ambulance Service found necessary to make had the effect of making time of arrival of ill patients being brought to the clinic more difficult to anticipate and consequently made the appointments system very uncertain in operation at times. The installation of the Odelca miniature X-ray unit at the commencement of 1952 has enabled a full diagnostic radiological service to be continued and has on the whole been most successful. It has been possible to introduce a scheme for the routine X-ray of pregnant women as part of the ante-natal care and to arrange X-ray films of contacts where formerly much reliance had to be placed only on screen examinations. Most of the routine work of the clinic is now undertaken with miniature X-rays and this has led to some financial economy. The X-ray of patients referred by their doctors often with comparatively trivial symptoms has led to the discovery of a number of 31 cases of tuberculosis. The early diagnosis of cancer of the lung has also frequently resulted from this system of examination. The Chest Clinic staff have assisted in the Medical Research Council's investigation into the results of certain methods of treatment and a number of Post-graduate scholars have been attached for various periods in order to obtain experience in chest diseases." SECTION C; GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. 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 conducted thereat. The Council considered the following number of applications :— New Licences 5 Renewals of Licences 20 Certificates lodged under Section 363 by members of the Chartered Society of Physiotherapy 6 Licences Refused 5 In four of the cases where the licences were refused the persons who propsed to carry out the treatment did not possess the technical qualifications reasonably necessary and in the remaining case the applicant was a person under the age of 21 years. Legal Proceedings. In three of the above-mentioned cases appeals were lodged against the decisions of the Borough Council. Two of the appeals were dismissed and one allowed. In the latter case the decision of the Court was reversed on appeal by the Council in 1953 to the Appeal Committee of the Quarter Sessions. 32 NATIONAL ASSISTANCE ACT, 1948. SECTION 50. Public Burials. Under Section 50 of the National Assistance Act, 1948, the Hendon Borough Council is required to arrange for the burial or cremation of any person who has died or been found dead in their area if in such cases it appears to the Council that no suitable arrangements for the disposal of the body have been or are being made. During the year, burial was carried out by the Council in 8 cases, made up as follows:—4 adult males, 1 male and 1 female child each 3 hours old and 2 stillborn children. The necessary steps were taken to recover the cost of the burials in 'all cases. SECTION 47. It was not found necessary to take formal action under the above-mentioned Section of the National Assistance Act, 1948. Seven cases, 3 males and 4 females were dealt with by informal action, thereby bringing about the necessary improvement in their condition. 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. 33 Heath 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. 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 Sub-Committee 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. Laboratory Facilities. These are provided at the Central Public Health Laboratory, 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 in the following table:— 34 TABLE XVII. RECORD OF EXAMINATIONS. Year 1952. <D C/3 O /h « 3 « o S P Faeces. Sputum. Pertussis. Miscellaneous. Total. January 40 38 10 8 43 139 February 43 18 13 17 22 113 March 52 23 25 4 3 107 April 53 80 20 — 20 173 May 51 41 16 4 26 138 June 35 24 11 3 9 82 July 49 24 6 5 10 94 August 32 15 9 — 12 68 September 27 24 3 2 7 63 October 25 12 11 — 14 62 November 53 7 4 1 25 90 December 45 8 17 1 9 80 TOTAL 505 314 145 45 200 1209 The numbers of samples taken in respect of Milk, Ice Cream, Domestic Water Supplies and Swimming Pools are contained elsewhere in this report. Medical Examinations. During the year 74 employees of the Hendon Borough Council were medically examined for superannuation purposes. Welfare of Old People. I am indebted to the Honorary Secretary of The Borough of Hendon Old People's Welfare Committee for the following report on the activities of the Committee during the year 1952-53:— "This year has been a very busy one. The work has increased steadily; the Committee has become more widely known to Almoners, Doctors, old people and the general public. The Hendon Borough Council has very generously given the sum of £4,000 towards 35 manent club premises to be situated in Central Hendon. Unfortunately some difficulty is being experienced in obtaining suitable accommodation. During the year a Chiropody Service was started in conjunction with the British Red Cross Society, patients attending monthly for treatment. The main Committee has met four times during the year and the Finance and Executive Sub-Committee on six occasions. VISITING. This service continues to grow every week; from statistics elsewhere in this Report will be seen the amount of work which has been done in this connection. Further volunteers are still needed. CHRISTMAS DINNERS. This service was repeated again and 112 dinners were taken out on Christmas Eve to lonely people in need. HOLIDAY SCHEME. In May, 1952, a party of 70 old people was taken to Ramsgate for a week's holiday at a greatly reduced cost. For 1953 the Committee decided to change the destination to Cliftonville. So far there are 115 applicants and arrangements have been made to accommodate them in two adjoining hotels. By this plan they will all be together instead of, as in previously years, in small boarding houses all over the town. Financial assistance is given in necessitous cases. DAY TRIP. Two coach loads of over 75 old people made another visit to Eastbourne on 28th August. OVER SIXTIES CLUB. Membership of the Club is now 168 and is still growing. It continues to meet every Monday afternoon and remains self-supporting. During the year under review its numerous activities have included tea and entertainment by the Free Church Women's Council; visit to Bovington; outing to Clacton ; cinema shows by Toe H every two months; "Bring and Buy" sales have also been held, and entertainments by" The Gay Guilders." 36 Christmas party. The Annual Party for old people was held at the Hendon Way Hotel. visits, etc., from 1st april, 1952, to 31st MARCH, 1953. Old people who called at the office for advice 338 Visits made from the office to ill or home-bound people 197 By other Lady Visitors 729 Old people helped to find accommodation 3 Old people helped to find employment 3 Help given in arranging for holidays and convalescence 14 Cases sent in by:— Welfare Officer 5 Hospitals 12 Local Authorities 20 Brought to notice (other than above) 31 Cases under care from 31st March, 1952 59 New cases—1st April, 1952, to 31st March, 1953 67 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." SECTION D: SANITARY CIRCUMSTANCES OF THE AREA. WATER SUPPLY. The Borough has a dual scource of supply. The Northern part is supplied by the Colne Valley Water Company and the Central and Southern portion by the Metropolitan Water Board. The boundary between the two areas is formed by the Borough Boundary at the Welsh Harp Reservoir, Pollard Road, West Hendon Broadway, Station Road, Hendon to Hendon Station, British Railways (Midland Region) Line to junction of Eastern Region Line, British Railways Eastern Region (formerly L.N.E.R.) Line to Borough Boundary with Finchley. 37 The Colne Valley water is derived 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 supplied by the Metropolitan Water Board is 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 water are examined bacteriologically, chemically and for taste and other special purposes on every working day. The supply to all areas was satisfactory in quality and quantity. Number of dwelling houses supplied from Public Water Mains:— (a) direct to houses 42,329 (b) by means of stand-pipes — Number of the population supplied from Public Water Mains:— (a) direct to houses 156,400 (b) by means of stand-pipes — 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 made every endeavour to further the provision of accommodation for inadequately housed families during 1952, and the figure of 279 families rehoused in Hendon shows an increase over the previous year's total. Despite this a steady receipt of new applications is maintained and approximately 5,000 applicants are now known to be in need of alternative accommodation. The increase of allocations of houses and flats to Hendon families continues in the new and expanding towns of Hemel Hempstead, Stevenage, Hatfield and Blechley and development of these and other towns in the years to come promises to be a major feature in assisting applicants to find suitable employment and a home nearby. Since development commenced some 250 families from Hendon have been found accommodation in these areas. 38 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 bigger families and so relieve the overcrowding formerly experienced in such cases. The demand from evicted families remains acute and although 51 such families were offered emergency accommodation in Half-way Houses in the course of the year, in many cases it was impossible to assist. A feature of this year's work has been the commencement of the first post-war redevelopment scheme undertaken by the Council, and at Cricklewood Lane 40 flats are in course of erection as the initial stage to replace out-of-date dwellings in that area. The housing needs of the elderly have also been catered for to an increasing extent during the past twelve months. Many bungalows and small flatlets designed for occupation by elderly persons have been incorporated in Housing Estates erected, or in course of development, in various parts of the Borough. In addition, the Council acquired a property in Central Hendon and by a simple conversion adapted the building to accommodate eight elderly persons. This method of rehousing the elderly has proved so successful that the Council has acquired an adjacent property to be similarly converted. The following table sets out the number of housing applicants assisted during the year ending 31st December, 1952 :— (1) Number of families rehoused in permanent accommodation :— (a) Pre-War Houses 51 (b) Post-War Houses 225 (c) Temporary Bungalows 3 279 (2) Transfers arranged to relieve overcrowding on Council Estates 131 (3) Number of families rehoused in requisitioned property 43 (4) Number of families given emergency accommodation in Half-way Houses 51." 39 The following summary of the inspection work, together with a report on the various duties performed by the Sanitary Inspectors, has been submitted to me by Mr. A. H. Smith, Chief Sanitary Inspector. In previous Annual Reports attention has been 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 remained stationary. These factors still prevail to-day to even a greater extent and has resulted in a large number of cases where it has been necessary to apply statutory action. During the course of the year under review inspections were carried out as set out below:— Inspections made 7212 Re-inspections after order or notice 12191 Complaints received and investigated 1686 Bakehouses 110 Butchers Shops 378 Caravans 111 Dairies 119 Drain Tests 186 Factories 306 Hawkers and Food Delivery Vans 77 Hawkers Storage Premises and Stalls Ice Cream Samples 128 Ice Cream Premises 73 Infectious Disease 653 Licensed Premises 124 Milk Samples 259 Other Food Shops 1329 Overcrowding 141 Outworkers 15 Piggeries 59 Public Entertainment in connection with licensing 95 Restaurants, Cafes, etc. 275 Smoke Observations 67 Stables 17 Swimming Baths 25 40 Notices Served. Informal or Cautionary 1101 Complied with 953 Statutory Notices. Applied for 263 Served under Public Health Acts 149 Complied with 104 Outstanding 45 Legal Proceedings under Public Health Act, 1936, Sections 93, 94, 39, 45 and 290. Number of Cases :—18—in which 5 Nuisance Orders were made; 4 defendants were fined ; 9 Summonses were withdrawn before the hearing on an order for costs being made against the defendant. TABLE XVIII. Proceedings under Section 11 and 13 of the Housing Act, 1936. Number of dwelling-houses unfit for human habitation 6 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 6 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 Nil Proceedings under Section 9 of the Housing Act, 1936. Number of dwelling-houses in respect of which notice was served requiring repairs 2 Number of dwelling-houses which were rendered fit after service of Formal Notices:— (a) by Owners 1 (b) by Local Authority in default 1 41 Inspection of Dwelling-houses during 1952. Total number of dwelling-houses inspected for housing defects (under Public Health and Housing Acts) 2047 Number of inspections made for the purpose 7229 Number of dwelling-houses found not to be in all respects reasonably fit for human habitation 584 Remedy of Defects without Service of Formal Notices. Number of dwelling-houses rendered fit in consequence of informal action by the Local Authority 480 Proceedings under Public Health Acts. Number of dwelling-houses in respect of which Formal Notices were served requiring defects to be remedied 134 Number of dwelling-houses in which defects were remedied after service of Formal Notices :— (a) by Owners 99 (b) by Local Authority in default 2 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 authority. Smoke Abatement. Number of observations made during the year 67 In this connection advice was given where necessary. Cesspools. A number of houses in the more rural portions of the Borough are drained into cesspools. These were emptied by the Council on 201 occasions during the year. Treatment of Verminous Houses. 23 houses were successfully treated:— Privately owned 17 Council Houses 6 42 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. 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 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 405 library books were disinfected and five destroyed at the request of private libraries. Number of rooms disinfected during the year 482 Swimming Baths. There are two swimming baths within the district owned by the Local Authority, one at West Hendon and one at Mill Hill. Frequent visits are paid by the Sanitary Inspectors and samples taken of the water. During the year 18 samples were taken from the Municipal Swimming Baths and all were satisfactory. Rag Flock and Other Filling Materials Act, 1951. Number of Registered Premises 3 Pet Animals Act, 1951. Number of Licences granted 10 43 Prevention of Damage by Pests Act, 1949—Rodent Control. Rodent destruction in Dwelling-houses and Business Premises is carried out by a Foreman and four Operatives working under the supervision of the Sanitary Inspectors and in accordance with recommendations of the Ministry of Agriculture and Fisheries. Treatment of sewers is carried out by the Borough Engineer and Surveyor's Department. In the case of dwelling-houses treatment is carried out by the Local Authority, free of charge, while in the case of business premises a charge, based upon time, cost of materials and overhead expenses is made. In a small number of cases occupiers of business premises engage a Servicing Firm to carry out periodical treatment. During the year one serious major infestation by rats was discovered and dealt with by a course of the recently approved Warfarin treatment. This proved highly successful and records of the treatment were supplied to officers of the Ministry of Agriculture and Fisheries on request. It has not been found necessary to take statutory action during the period under review. A report on the work carried out for the year ended 31st December, 1952, is given in the following table :— 44 TABLE XIX. 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 16 42024 10 4544 46594 II. Number of properties inspected by Local Authority during 1952 as a result— (a) of notification, or (a) 1 652 — 43 696 (b) otherwise (b) 7 837 — 83 927 III. Number of properties (under II) found to be infested by rats Major 1 — — — 1 Minor 2 917 — 46 965 IV. Number of properties (under II) found to be seriously infested by mice 2 192 — 17 211 V. Number of infested properties (under III and IV) treated by the Local Authority 5 1109 — 63 1177 VI. Number of notices served under Section 4 : (1) Treatment Nil Nil Nil Nil Nil (2) Structural Works (re Proofing) Nil Nil Nil Nil Nil VII. Number of cases in which default action was taken by Local Authority following issue of notice under Section 4 Nil Nil Nil Nil Nil VIII. Legal Proceedings Nil Nil Nil Nil Nil IX. Number of "Block" Control Schemes carried out ...... ...... ...... ...... 39 Factories Act, 1937 and 1948. The following is a report on the work carried out by the Sanitary Inspectors during the year :— 45 Part I of the Act. 1.—INSPECTIONS 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 45 64 4 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 375 230 26 (iii) Other premises in which Section 7 is enforced by the Local Authority, excluding out-workers' premises) 8 12 — TOTAL 428 306 30 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.l) 26 25 1 Overcrowding (S.2) — — — Unreasonable Temperature (S.3) — — — Inadequate Ventilation (S.4) 2 2 — Ineffective drainage of floors (S.6) 1 1 — Sanitary Conveniences (S.7) :— (a) Insufficient — — — (b) Unsuitable or defective 8 7 — (c) Not separate for sexes — — — Other offences against the Act (not including offences relating to outwork) 46 39 2 TOTAL 83 74 3 46 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 120 Household Linen 1 Brass and brass articles 14 Fur pulling 1 Artificial Flowers 3 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 8 Feather sorting 1 Carding, etc., of buttons, etc 5 Stuffed toys 4 Cosaques, Christmas crackers, Christmas stockings, etc. 3 Lampshades 1 TOTAL 161 47 SECTION E: INSPECTION AND SUPERVISION OF FOOD Food and Food Premises. 2,371 inspections were made of premises where food intended for sale for human consumption is prepared, stored or sold. This is the first complete year during which the Clean Food Bye-laws adopted by the Council have been in operation and it will be seen from the summary of action taken in connection with food premises that a number of improvements have been made where premises were found not to comply with the Bye-laws, particularly relating to proper screening of foodstuffs and counters to prevent contamination. During the year it was not found necessary to take legal proceedings to enforce compliance and in only two cases was it necessary to serve formal notice under the Bye-laws. The amount of unsound food condemned as the result of Sanitary Inspectors being called in by food retailers remains high, particularly in connection with tinned foods. This is mainly due to the fact that a large Multiple Firm maintains a Central Distributing Depot in the Borough which supplies its branches throughout the London Area. During the period under review legal proceedings were taken in two cases in connection with unsound food and infringements under Section 13, Food and Drugs Act, 1938. A conviction was obtained in one case and in the other the summons was withdrawn on payment of costs. Considerable attention has again been given to the Hawkers of Food and their storage premises which are required to be registered with the Council under the Middlesex County Council Act, 1950. On the occasion of the Hendon Borough Show, held in August, 1952, opportunity was taken by the Public Health Department to display, together with other food exhibits, the Ministry of Food "Clean and Dirty Shop "Exhibit, which proved to be of considerable interest to the Public. 48 List of Foodstuffs Condemned during 1952. MEAT : 6,232 lbs. 15 oz. (including Beef, Bacon, Chickens, Offal, Salted Beef, Mutton, Lamb, Pork, Liver, Kidney, Rabbits, Sausages, Turkeys and Veal) ; 1½ sets Calves Feet, and 245 lbs. Beef Bones. FISH : 112 st. 1¾ lbs. (including Salmon, Bream, Haddock, Cod, Skate, Roe, Kippers, Whiting, Herring and Dog Fish), and 9 lbs. Fish Cakes. TINNED FOOD : Fish Paste 12,588 Meat 1,812 Ham (1,769 lbs. 13 oz.) 109 Vegetables 1,495 Fish 990 Milk 177 Soup 282 Fruit 2,427 Jam 223 Fruit Juice 130 Puddings 2 Paste 8 Chickens (87 lbs. 7 oz.) 19 Tomato Juice 20 FRESH FRUIT AND VEGETABLES : Almonds 71 lbs. (200 pkts.). Currants 56 lbs. Dates 7 pkts. Dried Fruit 22 lbs. Figs 126½ lbs. Mixed Nuts 12½ lbs. and 42 pkts. Mixed Nuts and Raisins 3 pkts. Potatoes 30 lbs. Split Peas 3 lbs. 12 oz. Walnuts ½ lb. (shelled). Prunes 573¼ lbs. 49 MISCELLANEOUS GOODS : Baking Powder 1 pkt. Barley 60 lbs. 12 oz. Barley Powder and Crystals 4½ lbs. and 7 tins. Barley Water 20 bottles. Biscuits 151 lbs. 1½ oz. and 181. Cakes 17. Cake Mixture 137 pkts. Crab 1 jar. Cereals 245 pkts. Cheese 3 lbs. 12 oz., 48 cartons and 13 portions. Chocolate Spread 1 carton. Celin Tablets 1,915. Coffee 36 tins and 2 bottles. Cocoa, etc 9 tins. Custard 1 tin. Coconut 2½ lbs., 1 tin and 1 pkt. Confectionery 486 lbs. and 288 bars. Bread Rolls 3 and 9 pkts. Eggs 250. Gherkins 11 lbs. Ground Rice 2 lbs. Glace Cherries 11 pkts. Gravy Powder 2 pkts. 6 bottles. Icing Powder 2 pkts. Jelly 15 pkts. Jam 62 jars. Fruit 96 jars. Mustard 2 jars. Macaroni 3 lbs. Milk Food, etc. 22 tins and 2 pkts. Lemonade Powder 1 pkt. Junkets 1 bottle and 2 pkts. Olives 1 jar. Pickles 179 jars. Pearl Barley 12¾ lbs. Potato Crisps 2 pkts. Peanut Butter 2 jars and 1 pkt. Prenatalac 16 oz. 50 Pudding Mixture 80 pkts. Puddings (Xmas) 9. Paste 31 jars. Rice 2 lbs. Rice Substitute 33 lbs. Stuffing 1 pkt. Sulphate Tablets 210. Iron Tonic 16 oz. Salt 1 tin. Sago 13½ lbs. Salad Cream 6 jars. Sauce 145 bottles. Semolina 14¾ lbs. Spaghetti 19 pkts. Squash 60 bottles. Strained Baby Foods 719 tins. Sugar 32 lbs. Synthetic Cream 30 pkts. Tapioca 15¾lbs. Tea 23¼ lbs. Action taken in connection with Food Shops and Food Stores. 124 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 118 notices had been complied with. The principal matters dealt with were:— Sanitary Accommodation: Defective sanitary conveniences 4 Defects in drainage systems 3 Choked drains 2 Compartments cleansed 17 Provision of Washing Facilities: Provision of hot water supply 20 Refrigerators: Interiors cleansed 6 General: Insufficient accommodation for storage of refuse 8 Want of cleanliness 70 Other defects 244 Milk Supply. Number of registered Dairymen and Distributors 50 51 Number of registered Dairies not being Dairy Farms 119 visits were made to dairies during the year. 13 Milk (Special Designations) Regulations. The following table shows the number of licences issued under these Regulations during 1952:— Dealers Licences: Tuberculin Tested 35 Pasteurised 33 Sterilised 18 Dealers Supplementary Licences: Tuberculin Tested 19 Pasteurised 19 Sterilised 18 Milk Sampling. The number of samples taken during the year was as follows:— Pasteurised 78 Tuberculin Tested Pasteurised 33 Raw Bulk Milk (Tuberculin Tested) 14 Sterilised 15 Homogenised 1 Raw Bulk Milk 1 In addition, 120 samples of Bottle Rinses were taken during the year. Ice Cream. 123 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 46 Grade II 45 Grade III 19 Grade IV 13 Where unsatisfactory samples were obtained investigations were carried out by the Sanitary Inspectors at the producers plant and advice given. Slaughter-houses. There are no slaughter-houses in the district licensed by the Ministry of Food. 52 Hendon Printing Works Ltd., 42/44, Victoria Road, N.W.4 'Phone : HEN. 1004