Library HEN 31 BOROUGH OF HENDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1954 J. L. PATTON, M.B., Ch.B., D.P.H. Medical Officer of Health (From 17th January, 1955) 1 BOROUGH OF HENDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1954 J. L. PATTON, M.B., Ch.B., D.P.H. Medical Officer of Health (From 17th January, 1955) Borough of Hendon With the Compliments of the Medical Officer of Health Town Hall, Hendon, N.W.4. TELEPHONE: HENDON 8282 1 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. General 6 Births. Birth Rate. Stillbirths, Stillbirth Rate 6-7 Deaths, Death Rate 7 Maternal and Infantile Mortality 7-9 Summary of Vital Statistics for the year 1954 10 Table Showing Vital Statistics for the years 1932-1954 11 Table Showing Causes of Death During 1954 12 Table Showing Age Distribution of Deaths During 1954 13 Notes on Vital Statistics for 1954 13-15 Road Traffic Accidents 15-16 SECTION B: PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES: Notifications 17 Age & Ward Distribution of Infectious Diseases 18-19 Notes on Infectious Diseases 20-23 Diphtheria and Diphtheria Immunisation 23-24 Smallpox and Vaccination 25 Tuberculosis 25-26 Report of Chest Physician 27 Mass X-Ray 28-29 SECTION C: GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA: Establishments for Massage and Special Treatment 29-30 Action under Section 47, National Assistance Act, 1948 30 Public Burials 30 Hospital Facilities 31 Health Services Provided by Middlesex County Council 31 Laboratory Facilities 32 Medical Examinations 32 Welfare of Old People 32-34 SECTION D: SANITARY CIRCUMSTANCES OF THE AREA Water Supply 35 Housing - Report of Housing Officer 36-37 Summary of Inspections carried out by Sanitary Inspectors 37-38 Notices Served 38 Inspection of Dwe11ing houses 38 Legal Proceedings under Public Health Act, 1936 38 Return of Clearance Areas and Individual Unfit Houses 39 Housing Repairs & Rents Act, 1954 40 Cinemas and Places of Entertainment & Licensed Houses 40 Smoke Abatement 40 Cesspools 41 Disinfestation and Disinfection 41 Swimming Baths 41 Rag Flock and Other Filling Materials Act, 1951 42 Pet Animals Act, 1951 42 Hairdressers and Barbers 42 Rodent Control 42-43 Administration of Factories Acts. 1937 and 1948 44-45 SECTION E: INSPECTION AND SUPERVISION OF FOOD: Food and Food Premises 46 Action taken in connection with Food Stores and Shops 46 Number and Type of Food Premises in the Area 47 Food & Drugs Act. 1938 - Section 14 47 Registration of Hawkers and Premises 47 Milk Supply 47-48 Unsound Food 48-51 Food & Drugs Act. 1938 - Sampling 51-53 Merchandise Marks Acts 1887-1953 53 Labelling of Food Order 1953 54 Slaughterhouses 54 COUNCIL of the BOROUGH (31-12-54) Mayor: COUNCILLOR S. E. SHARPE, J.P. Deputy Mayor: COUNCILLOR A. V. SULLY, M.C., J,P,, FoC.Ao 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., LLB. S„ R. C. SUMPTER, F, B.A.A. R. J. KNOWLES, MM, J,P„ , M.I.W.M. Councillors S E ARRIDGE W. LLOYD-TAYLOR W. G. BARNES (MRS.) G. McCALL A. G. BRAND, A A.C.C.A. K. G. PAMPLIN H. D. E. CARTER S. J. PATMORE, A.M.I. Mech.E. L. C. CHAINEY A.. M. I.E.E. A. R. Ae. S. J. K. CONNOLLY A. PAUL, J.P. R. A. COWTON R. T. REED D. A. DAVIS D. F. SIMONS (MISS) M. EATON (MRS.) D. THORNYCROFT, M.A. A. P. FLETCHER (MRS.) C. M. THUBRUN J. D. GORDON LEE C. V. L. VEGRASS, A. R.I.C. S. S. D. GRAVES, F. R. I.C. S. , F.A. I. H. E. WILSON J. HARLEY, T.D. L. A. HILLS PUBLIC HEALTH COMMITTEE (31-12-54) Chairman COUNCILLOR A. V. SULLY, M.Co, J.P., F.C.A. (Deputy Mayor) Vice-Chairman COUNCILLOR A. G. BRAND, A.A.C.C.C.A. Aldermen: A. A. NAARa M.BE. C. H SHEILL S. R. C. SUMPTER, F. B. A. A, Councillors: W, LLOYD TAYLOR (MRS.) CM. THUBRUN (MRS.) G. McCALL C. V. L. VEGRASS, A.R.I.C. S A. PAUL, J.P. H. E. WILSON (MRS) D. THORNYCROFT, M.A. 3 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 19 54 To the Mayor, Aldermen and Councillors of the Borough of Hendon. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit the Annual Report of the Medical Officer of Health for the year 1954. Dr. A. F. Adamson retired on 9th November, and Dr. K. M. Bodkin served in a temporary capacity until 16th January, 1955, after which date I commenced duty. Dr. Adamson's services were divided so that for 40% of his time he was Medical Officer of Health for the Borough and responsible for the environmental services, and for the remaining 60% he served with Dr. Turner of Finchley as Joint Area Medical Officer in the Middlesex Area 4 (Hendon and Finchley) with joint responsibility for the administration of the personal health services. The terms of the appointment have now been altered so that 70% of my time is allotted to the Borough of Hendon as Medical Officer of Health with responsibility for the environmental services, and for the remaining 30% I am employed as an Assistant Medical Officer on the staff of the Area Medica 1 Officer. Dr. Bodkin is Deputy Medical Officer of Health for 10% and Area Medical Officer for 90% of her time. Comment and statistical information is included in the body of the report. Of special interest are the infectious disease figures which were the lowest for many years. The low total of measles notifications probably means that measles is returning to the pre-war pattern of a 24 month epidemic cycle. Large scale immunisation against whooping cough was first introduced three years ago and since then the number of whooping cough notifications has shown a progressive decline. One disappointing series of statistics are those relating to road accidents which show a 17% increase on the total for 1953. The number of deaths caused by road accidents now exceeds the number caused by tuberculosis. Housing is still a problem and later in the report reference is made to the action taken under the Housing Act, 1936, and the Housing, Repairs and Rents Act, 1954. The observations of the Housing Officer and the Honorary Secretary of the Old People's Welfare Committee are also included. The Station Road flatlets for elderly ladies make a valuable contribution to one of the problems of old age. The flatlets were provided at low initial cost by converting an old house and are let to 21 elderly ladies who have found the management 4 of a family size house becoming too difficult as they got older, The accommodation unit consists of a bed-sitting-room, a bathroom shared with three other tenants and a separate gas cooker in a communal kitchen. This simplified environment enables the occupants to enjoy the longest possible period of comfortable independence. A public health question which must be considered in the future is the fluoridation of drinking water to reduce dental caries, Hendon has two different water supplies, one with no fluoride and the other containing only a very small amount. Research carried out has now proved that the incidence of dental caries is much lower when fluoride is present in the drinking water to the extent of one part per million. Certain American towns have used this knowledge and added fluoride to the drinking water. The evidence from these towns after 10 years of trial now shows that there is a 40-50% reduction in dental caries in the youngest age groups. I wish to thank everybody for the kindly and generous welcome 1 have received. The Chairman and Members of the Public Health Committee have been most helpful and encouraging as indeed have Members of the Council as a whole. I would like to pay tribute to the work of my predecessor. Dr. A. Fairgrieve Adamson, whose record of service in public health is well known. Dr. Adamson has been a frequent visitor to the Town Hall and has given me every possible assistance in connection with the work of the Department. 1 have received the most friendly co-operation from my fellow Chief Officers and as I was not in office during the year to which the report relates I would like to thank Dr. Kathleen M. Bodkin, Mr. A. H. Smith, Chief Sanitary Inspector, Mr, C. C. Knudsen and the staff of the Department for their loyal and efficient service. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, J. L. PATTON, 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 667 Childs Hill 593 Area of Borough (in acres)10,369 Population figure supplied by Registrar General 154,800 Density of Population, i..e., Number of persons per acre 14.96 Number of inhabited houses at 31st December , 1954 (according to Rate Book) 43,010 Rateable Value at 31st December, 1954 £2,058,805 Sum represented by a Penny Rate £8,230 Live Birth Rate per 1,000 Home Population 12.97 Birth Rate corrected for comparison with other areas 12.19 Comparability factor supplied by Registrar General 0.94 Corrected Birth Rate per 1,000 Home Population, County of Middlesex 12.70 Birth Rate per 1,000 Home Population, England & Wales 15.20 Corresponding Rate for the Borough of Hendon for the year 1953 12.14 Births Live Births: Male. Female. Total. Legitimate 995 916 1,911 Illegitimate 50 47 97 1,045 963 2,008 6 Stillbirths: Male. Female. Total. Legitimate 14 15 29 Illegitimate 2 1 3 16 16 32 Stillbirth Rate per 1,000 Total Births 15.68 Stillbirth Rate per 1,000 Home Population .21 Stillbirth Rate per 1,000 Total Births, England and Wales 24.0 Stillbirth Rate per 1,000 Home Population, England and Wales .36 Deaths. Male. Female. Total. 706 686 1,392 Death Rate per 1,000 Home Population 8.99 Death Rate corrected for comparison with other areas 9.35 Comparability factor supplied by Registrar General 1.04 Corrected Death Rate per 1,000 Home Population, County of Middlesex 9,9 Death Rate per 1,000 Home Population, England and Wales 11.3 Corresponding Rate for the Borough of Hendon for the year 1953 9.89 Maternal Mortality. Number of women dying in consequence of childbirth 2* Maternal Mortality Rate per 1,000 total births .98* Comparative figure for the County of Middlesex.53 Comparative figure for England and Wales .69 7 * The interval between the maternal condition and the date of death in one case exceeded 1 year. Infantile Mortality. Deaths of infants under 1 year of age:- Male. Female. Total. Legitimate 27 10 37 Illegitimate 2 3 5 29 13 42 Death Rate of infants under 1 year of age per 1,000 live births 20.9 Death Rate of infants under 1 year of age per 1,000 live births, County of Middlesex 18,8 Death Rate of infants under 1 year of age per 1,000 live births, England and Wales 25.5 Deaths of infants under the age of 4 weeks:- Male. Female Total Legitimate 23 7 30 Illegitimate 2 2 4 25 9 34 Neo-natal Mortality Rate per 1,000 live births 16.9 Neo~natal Mortality Rate per 1,000 live births, County of Middlesex 14.2 Neo-natal Mortality Rate per 1,000 live births, England and Wales 17.7 An analysis of the causes of death and 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 weeks to 1 month TOTAL UNDER 1 MONTH 1-3 months 3-6 months 6-9 months 9-12 months TOTAL UNDER 1 YEAR Prematurity 7 4 - - - - 11 - - - - 11 Atelectasis 8c Prematurity 2 1 1 - - - 4 - - - - 4 Atelectasis 2 2 - - - - 4 1 - - - 5 Intracranial Haemorrhage 1 - - - - - 1 - - - - 1 Kernicterus - 1 - - - - 1 - - - - 1 Subarachnoid Haemorrhage & Prematurity - 1 - - - - 1 - - - - 1 Congenital Heart Disease - - - 1 - - 1 1 - - - 2 Asphyxia 1 1 - - - - 2 - - - - 2 Bilateral Confluent Broncho-Pneumonia - - 1 - - - 1 - - - - 1 Tentorial Tear 3 1 - - - - 4 - - - - 4 Meningitis & Broncho-Pneumonia - 1 - - - - 1 - - - - 1 Septicaemia & Prematurity - 1 - - - - 1 - - - - 1 Haemorrhage 8c Broncho-Pneumonia - 1 - - - - 1 - - - - 1 Cerebral Anoxia 1 - - - - - 1 - - - - 1 Meningococcal Septicaemia - - - - - - - - - - 1 1 Acute Capilliary Bronchitis - - - - - - - - 1 - - 1 Broncho-Pneumonia - - - - - - - - - 3 - 3 Fallots Tetralogy - - - - - - - - - - 1 1 TOTAL 17 14 2 1 - - 34 2 1 3 2 42 8 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 1952 21 1953 16 1954 21 9 SUMMARY OF VITAL STATISTICS FOR THE YEAR 1954. England and Wales. 160 Great Towns. 160 Smaller Towns. Borough of Hendon. Rates per 1.000 Home Population. Births. Live Births 15.2 15.2 ]4.90 12.19 Stillbirths 0.36 0.44 0.35 0.21 24.0 (a) 23. 3(a) 24.0(a) 15.68 (a) Deaths. A11 causes 11.3 11.10 11.3 9.35 Typhoid and Paratyphoid Fever 0.00 0.00 0.00 0.00 Whooping Cough 0.00 0.00 0.00 0.00 Diphtheria 0.00 0.00 0.00 0.00 Tuberculosis 0.18 0.20 0.18 0.08 Smallpox 0.00 0.00 0.00 0.00 Acute Poliomyelitis and Polioencephalitis 0,00 0.00 0.00 0.00 Pneumonia 0.41 0.45 0.41 0.38 Influenza 0.04 0.03 0.04 0.02 All causes under 1 year of age Rates per 1,000 Live Births. 25.5 25.2 26.6 20.9 Enteritis and Diarrhoea under 2 years of age - 0.90 0.40 - (a) Per 1,000 total (live and still) births. 10 TABLE II VITAL STATISTICS FOR THE YEARS 1932-1954. 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 Rate 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 Not available 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 156,400 1,981 12.66 1,598 10.22 41 21 1 .49 1953 155,500 2,008 12.91 1,479 9.51 32 16 1 .49 1954 154,800 2,008 12.97 1,392 8.99 42 21 2* * .98 * The interval between the maternal condition and the date of death in one case exceeded 1 year. 11 TABLE III CAUSES OF DEATH DURING YEAR ENDED 31ST DECEMBER, 1954. Cause of death. Male. Female. TOTAL Tuberculosis, respiratory 8 3 11 Tuberculosis, other 1 - 1 Syphilitic Disease 4 - 4 Diphtheria - - - Whooping Cough - - - Meningococcal Infections 1 1 2 Acute Poliomyelitis - - - Measles - - - Other infective and parasitic diseases 1 2 3 Malignant neoplasm, stomach 17 17 34 Malignant neoplasm, lung, bronchus 49 9 58 Malignant neoplasm, breast - 40 40 Malignant neoplasm, uterus - 10 10 Other Malignant and lymphatic neoplasms 73 80 153 Leukaemia, Aleukaemia 2 4 6 Diabetes 2 4 6 Vascular lesions of nervous system 62 94 156 Coronary disease, angina 160 85 245 Hypertension with heart disease 15 24 39 Other heart disease 72 114 186 Other circulatory disease 34 39 73 Influenza - 3 3 Pneumonia 25 32 57 Bronchitis 31 23 54 Other diseases of respiratory system 14 2 16 Ulcer of stomach and duodenum 16 5 21 Gastritis, enteritis and diarrhoea 4 2 6 Nephritis and Nephrosis 2 9 11 Hyperplasia of prostate 13 - 13 12 Cause of Death Male. Female. TOTAL Pregnancy, childbirth, abortion - 2 2 Congenital malformations 4 3 7 Other defined and ill-defined diseases 63 59 122 Motor vehicle accidents 14 2 16 All other accidents 12 9 21 Suicide 7 7 14 Homicide and operations of war - 2 2 All causes - TOTAL 706 686 1,392 TABLE IV AGE DISTRIBUTION OF DEATHS DURING THE YEAR ENDED 31ST DECEMBER, 1954. Age Group Male Female Total Percentage 0-5 years 28 17 45 3.2 5-10 years 1 1 2 .2 10-15 years 1 1 2 .2 15-20 years 2 5 7 .5 20-30 years 7 5 12 .9 30-40 years 11 14 25 1.7 40-50 years 33 35 68 4.8 50-60 years 102 64 166 11.9 60-70 years 162 141 303 21.8 70-80 years 229 192 421 30.3 80 years and over 130 211 341 24.5 TOTAL 706 686 1,392 100.0 VITAL STATISTICS. Population. The home population figure supplied by the Registrar General is 154,800. This is less than in 1953. The estimated total population for England and Wales is 44,480,000, an increase of 190,000 over the estimate for 1953. 13 The estimated home population for England and Wales for the year 1954 is 44,274,000. Births. The number of live births recorded is 2,008, the same as last year. In view of the fact that the population figure fell the birth rate for 1954 is slightly higher, the corrected rate being 12.19 per 1,000 home population compared with 12.13 in 1953. This rate is lower than that for England and Wales which is 15.2 per 1,000 home population. Deaths. The number of deaths recorded fell by 87, 1,392 people dying compared with 1,479 in 1953. This gives a corrected death rate of 9.35 compared with 9.89 last year. The rate for England and Wales is 11.30 per 1,000 home population. Heart and associated diseases accounted for the largest number of deaths, 543 people dying from these causes. Second in the principal causes was Cancer, 295 deaths occurring. This was an increase of 6 over the number of Cancer deaths in 1953. The deaths from Cancer of the Lung and Bronchus increased by 2, 58 persons dying compared with 56 last year. Forty-nine men died from lung Cancer compared with 9 women. Deaths from Tuberculosis showed a marked decline, 12 people dying compared with 26 in 1953. Deaths from Pneumonia, Bronchitis and Influenza all showed a reduction in the number. Motor vehicle accidents accounted for 16 deaths compared with 17 in 1953. There were fewer cases of suicide, 14 people taking their own lives compared with 21 last year. Infantile Mortality. The Infantile Mortality Rate while not reaching last year's record low figure is still one of the lowest on record. The rate of 20.9 per 1,000 live births compares very favourably with that for England and Wales which at 25.5 per 1,000 live births is the lowest ever recorded in the Country. Of the 37 infant deaths, 5 were illegitimate, giving an infantile mortality rate for this group of 51.3 per 1,000 illegitimate live births. Stillbirths. The number of stillbirths was two less than in 1953, 32 occurring compared with 34, giving a stillbirth rate of 15.68 per 1,000 total births compared with 16.65 in 1953. 14 The stillbirth rate per 1,000 total births for England and Wales is 24.0. Maternal Mortality. Two women died as a result of childbirth compared with one in 1953, giving a rate of 0.98 per 1,000 total births as against 0.49 in 1953. The rate for England and Wales is 0.69 per 1,000 total births and that for the County of Middlesex 0.53. Included in the figure is one case where the interval between the maternal condition and the date of death exceeded 1 year. ROAD TRAFFIC ACCIDENTS. The following tables show the road traffic accidents and casualties occurring within the Borough of Hendon during the year 1954 and the comparative figures and casualties for the five year period 1950-1954. Itshould 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 may not agree, therefore, with those in the list of causes of death supplied by the Registrar General. The latter refer to Hendon residents only, and the death may have occurred within the Borough of Hendon or outside the district. TABLE V ROAD TRAFFIC ACCIDENTS 1954 WITHIN THE BOROUGH OF HENDON. Month No. of Accidents Adults. Children TOTAL Killed Seriously Injured Slightly Injured Killed Seriously Injured Slightly Injured January 60 4 5 60 - 1 8 78 February 49 - 11 43 - 3 5 62 March 49 2 12 52 - 1 - 67 April 50 - 15 43 - 1 4 63 May 75 1 15 57 - 2 16 91 June 63 - 10 64 - 1 5 80 July 61 - 13 47 - 5 11 76 August 60 1 7 49 - 3 13 73 September 67 1 11 70 - 3 6 91 October 72 3 10 70 - 1 8 92 November 79 4 14 67 1 6 6 98 December 91 1 25 84 - 1 10 121 TOTAL 776 17 148 706 1 28 92 992 15 TABLE VI BOROUGH OF HENDON. COMPARATIVE FIGURES OF ACCIDENTS AND CASUALTIES FOR THE FIVE YEAR PERIOD 1950-1954. Total number of road accidents involving personal injury 1950 1951 1952 19 53 1954 603 706 714 695 776 Accidents per mile of road 3.77 4.41 4.37 4.17 4.64 Casualty Figures Adults. Killed 14 18 15 13 17 Seriously Injured 79 116 115 117 148 Slightly Injured 496 609 592 584 706 TOTALS 589 743 722 714 871 Children (0-15 years) Killed Nil Nil 1 Nil 1 Seriously Injured 16 14 21 20 28 Slightly Injured 105 117 110 114 92 TOTALS 121 131 132 134 121 Combined Adults and Children. TOTALS 710 874 854 848 992 Casualties per mile of road 4.43 5.46 5.23 5.09 5.94 I am indebted to the Borough Engineer and Surveyor for supplying me with the above figures, 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 142 49 Whooping Cough 144 3 Measles 49 3 Acute Poliomyelitis Paralytic 1 1 Non-Paralytic 2 2 Pneumonia 94 35 Dysentery 108 39 Paratyphoid Fever 4 4 Erysipelas 17 7 Meningococcal Infection 5 5 Food Poisoning 20 4 Puerperal Pyrexia 147 147 Ophthalmia Neonatorum 30 30 Malaria (Contracted abroad) 1 1 Acute Encephalitis (Infective) 1 1 TOTAL 765 331 17 18 TABLE VIII AGE DISTRIBUTION Disease Age Groups Under 1 year 1-2 years 3-4 years 5-9 years 10 - 14 years 15 - 24 years 25 years and over Age not known TOTAL M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Scarlet Fever - - 3 2 23 16 43 25 19 6 1 3 1 - - - 142 Whooping Cough 6 4 13 14 14 21 35 28 2 1 - 2 2 1 - 1 144 Acute Poliomyelitis Paralytic - - - - - - - - 1 - - - - -- - - 1 Non-Paralytic - - - - 1 - - - - - - - 1 - - - 2 Measles - - 10 4 6 9 7 6 1 2 1 2 - - 1 - 49 TOTAL 6 4 26 20 44 46 85 59 23 9 2 7 4 1 1 1 338 Disease Age Groups Under 5 years 5 - 14 years 15-44 years 45 - 64 years 65 years and over Age not known TOTAL M. F. M. F. M. F. M. F. M. F. M. F. Pneumonia 3 3 6 7 11 12 20 17 6 7 - 2 94 Dysentery 21 19 17 16 7 24 2 2 - - - - 108 Erysipelas - - 1 - 2 2 4 5 - 3 - - 17 Meningococcal Infection 2 1 1 - 1 - - - - - - - 5 Food Poisoning 4 1 2 5 3 3 1 1 - - - - 20 Puerperal Pyrexia - - - - - 147 - - - - - - 147 Cphthalmia Neonatorum 19 11 - - - - - - - - - - 30 Malaria (Contracted abroad) - - - - 1 - - - - - - - 1 Acute Encephalitis (Infective) 1 - - - - - - - - - - - 1 Paratyphoid Fever - 1 - - - - 1 1 - 1 - - 4 TOTAL 50 36 27 28 25 188 28 26 6 11 - 2 427 19 TABLE IX WARD DISTRIBUTION. NUMBER OF CASES OF INFECTIOUS DISEASE NOTIFIED IN EACH WARD OF THE BOROUGH. Disease Ward. TOTAL Mill Hill Burnt Oak West Hendon Central Pa rk Golders Green Garden Suburb Childs Hill Edgware Scarlet Fever 37 12 23 20 11 14 8 5 12 142 Whooping Cough 18 16 31 9 16 4 10 20 20 144 Acute Poliomyelitis Paralytic - - - - - 1 - - - 1 Non-Paralytic - 1 - - - - - - 1 2 Measles 3 1 5 2 10 o o 8 6 6 49 Pneumonia 11 15 9 21 7 11 4 6 10 94 Dysentery 2 38 23 1 10 3 29 2 - 108 Paratyphoid Fever 1 1 1 - - - - - 1 4 Erysipelas 3 1 2 3 1 2 1 2 2 17 Meningococcal Infection 2 - - 2 - - - - 1 5 Food Poisoning 2 1 2 7 2 2 - 3 1 20 Puerperal Pyrexia 10 94 4 6 10 4 1 13 5 147 Ophthalmia Neonatorum - 22 2 - - - - 4 2 30 Malaria (Contracted Abroad) - - - - - 1 - - - 1 Acute Encephalitis (Infective) - - 1 - - - - - - 1 TOTAL 89 202 103 71 67 50 61 61 61 765 Notifications other than Tuberculosis, There was a decrease of 2,391 in the number of cases notified during 1954, 765 notifications being received compared with 3,156 in 1953. This was the lowest number to be notified since 1937, when 672 cases of infectious disease occurred. It should be pointed out, however, that in 1937 Measles and Whooping Cough had not become notifiable and the population of the Borough was 11,000 less. Puerperal Pyrexia. The number of cases notified during the year was 147, all occurring in hospital. The notification rate for Puerperal Pyrexia in respect of the Borough of Hendon is 72 per 1,000 total (live and still) births, which is a high rate. This is due to the fact that situated within the Borough is a Maternity Hospital which provides accommodation not only for the Borough of Hendon but also for the surrounding districts. When Puerperal Pyrexia is notified in residents from these outside districts who enter the hospital for their confinements, the notifications have to be accepted by the Borough of Hendon. Of the 147 cases notified, only 66 were Hendon residents. If this figure is taken the notification rate per 1,000 total (live and still) births is 32.35. Poliomyelitis. There was a marked reduction in the number of cases notified during the year. Three only occurred compared with 19 in 1953. Of these 3 cases 2 were non-paralytic and one paralytic. Details of these are given in the following table. TABLE X. Name. Age Sex Notified Diagnosis. Ward Remarks. R.R. 11½ M. 10.6.54. Poliomyelitis Golders Green. Paralytic Left arm. R.B. 4 M. 20.7.54. Poliomyelitis Burnt Oak. Non-Paralytic J.U.B. 3 M. 11.9.54. Poliomyelitis Edgware. Non-Paralytic 20 Scarlet Fever. There was a reduction of 75 in the number of cases of Scarlet Fever notified during the year, 142 cases occurring compared with 217 in 1953. Forty-nine of these were removed to hospital. Measles. Owing to a considerable outbreak of Measles in 1953 it was expected that the incidence during 1954 would be low, Chly 49 cases were notified compared with 2.096 the previous year. In view of the fact that outbreaks of the disease appear to occur every other year an epidemic incidence can be expected at Easter 1955 and 1957. Whooping Cough This disease, also, showed a reduction, 144 cases occurring compared with 407 in 1953. In 1952 the Middlesex County Council instituted a scheme of immunisation against Whooping Cough. Figures supplied by the Area Medical Officer show that during the years 1952 to 1954, 4.060 children received protection against the disease. In these years the number of notifications received were as follows:- 1951- 604; 1952- 508; 1953- 407; 1954- 144. This shows a progressive decline in the incidence of the disease and it would appear to indicate that immunisation is having some effect. Food Poisoning. Twenty notifications of Food Poisoning were received during 1954. The cases were distributed throughout the year as follows:- First Quarter. Second Quarter. Third Quarter. Fourth Quarter. 6 7 6 1 In nine cases the type of the infection was unknown and in eleven cases was identified as follows:- Salmonella Typhi Murium 8 Salmonella Anatum 1 Salmonella Muenchen 1 Shigella Sonnei 1 Of the twenty cases, four occurred in one family, the others being single cases spread throughout the Borough, 21 Paratyphoid Fever. Four cases of Paratyphoid Fever were notified during the year, compared with one in 1953. Details of the cases are as follows:- Case No. 1. An elderly lady aged 73 years was admitted to a London Nursing Home suffering from a heart condition and Pneumonia. Eight days after admission she had an attack of diarrhoea and vomiting. Bacteriological examination showed an infection with Salmonella Paratyphi B. She died soon after admission to Isolation Hospital, The cause of death was Paratyphoid Enteritis associated with Arteriosclerosis and senility. Case No. 2. A man aged 42 years with a five year history of Colitis and Anaemia was admitted to hospital on 19th October, 1954, and notified as Paratyphoid B on 4th November, 1954. Case No.3. A woman aged 57 years; bacteriological examination found her to be infected with Salmonella Paratyphi B and she was admitted to Isolation Hospital. Investigation of the case and the contacts revealed no explanation for her infection. Case No. 4. A baby boy aged 15 months was admitted to hospital on 5th December, 1954, for observation. Salmonella Paratyphi B was diagnosed later. The child was discharged from hospital on 16th December, 1954. Psittacosis. In January, 1954, a woman and her daughter were admitted to hospital with Glandular Fever and Virus Pneumonia They were discharged in February and the final diagnosis in the case of the daughter was Psittacosis. The attention of the Public Health Department was drawn to the cases after their discharge. Enquiries revealed that these people had bought a budgerigar from a dealer in Hendon. This bird died in December 1953 and was replaced by another from the same dealer, which died in January 1954. 22 The first bird was obtained from a breeder in the district and the second from a breeder in a neighbouring district. Both breeders obtained their original stock from another breeder outside the area. The latter and his wife had suffered from Psittacosis in 1952. Investigations were made at all the breeders' premises and it was ascertained that all stocks and likely contacts of the birds were in good health. A full report on these cases was sent to the Ministry of Health. Diphtheria. No case of Diphtheria was notified during the year. The following table shows the number of notifications received and the deaths from Diphtheria since the inception of the Immunisation Scheme in 1935. TABLE XI Year Number of cases of Diphtheria. Number 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 8 - 1947 8 - 1948 8 1 1949 4 - 1950 - - 1951 - - 1952 - - 1953 1 - 1954 - - DIPHTHERIA IMMUNISATION. The following tables, for which I am indebted to the Area Medical Officer, show the position of immunisation in the Borough of Hendon at 31st December, 1954. 23 TABLE XII NUMBER OF CHILDREN RESIDENT IN THE BOROUGH OF HENDON WHO RECEIVED IMMUNISING INJECTIONS DURING 1954. Age at time of injection. Number given primary inoculations. Number given re-inforcing injections. Age at time of injectio Number given primary inoculations. Number given re-inforcing inj ections. Under 1 year of age 1, 111 5-9 years 77 1,025 1 year of age 460 1 10 - 14 years 7 962 2 years of age 69 6 3 years of age 26 3 4 years of age 35 272 TOTAL 1,701 282 TOTAL 84 1,987 TABLE XIII NUMBER OF CHILDREN RESIDENT IN THE BOROUGH OF HENDON UNDER THE AGE OF 15 YEARS ON 31ST DECEMBER, 1954, WHO HAD COMPLETED A COURSE OF IMMUNISATION AT ANY TIME SINCE 1ST JANUARY, 1940. 1-4 years. 5-14 years. Year of birth Number considered to be immunised. Year of birth Number considered to be immunised. 1954 207 1949-1945 (5-9 years) 11,089 1953 1,352 1952 1,438 1944-1940 (10 - 14 years) 9,195 1951 1,475 1950 1,858 TOTAL 6,330 TOTAL 20,284 24 The total number of children immunised in all age groups is 26,614. SMALLPOX. Vaccination The following table, the figures for which I am indebted to the Area Medical Officer, shows the number of persons vaccinated or re-vaccinated in the Borough of Hendon during 1954, TABLE XIV Age at 31st December 1954 Under 1 year 1 - 4 years 5-14 years 15 years or over TOTAL Number vaccinated 1,078 102 26 97 1,303 Number re-vaccinated - 19 77 730 826 TUBERCULOSIS. Notification The following table shows the number of cases of Tuberculosis notified for the first time during the year 1954 and transfers into the district. TABLE 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 1 1 - - - - 1 - 3 5 - 10 1 1 - - 1 - - - 3 10 - 15 2 - 4 1 - 1 - - 8 15 - 20 11 1 7 4 - - - 1 24 20 - 25 2 4 4 8 - - 6 1 25 25 - 35 11 17 15 17 1 1 4 1 67 35 - 45 7 4 6 8 - - 1 - 26 45 - 55 10 5 4 1 - 1 1 - 22 55 - 65 8 3 3 - - - - 1 15 65 & over 9 1 4 - - - 1 - 15 Age unknown - - - - - - - - - TOTAL 62 37 47 39 2 3 14 4 208 25 The following table shows the primary notification of Tuberculosis, excluding inward transfers,for the ten year period 1945 - 1954. TABLE XVI. Year Respiratory Non-Respiratory TOTAL M. F. M. F. 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 1953 71 51 6 8 136 1954 62 47 2 14 125 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 of Tuberculosis. All forms of Tuberculosis. Male. Female. Total. Male. Female. Total. Male. Female. Total 8 3 11 1 - 1 9 3 12 The number of cases of Tuberculosis remaining on the Register at the end of the year is as follows:- Respira tory Non-Respiratory Total M. F. M. F. M. F. 745 613 80 84 825 697 1,358 164 1,522 26 I am indebted to Dr. H. J. Trenchard, Physician-in-Charge of the Edgware Chest Clinic, which serves an area comprising the Borough of Hendon and the Stanmore, Queensbury and Kingsbury districts of Harrow and Wembley, for the following report on the work of the Clinic during the year:- "The attendances at Edgware Chest Clinic have remained at the high level reached in 1951 and maintained in subsequent years. During 1954 it has been possible to bring into use a third consulting room, and this has helped the appointments system to work more smoothly, and has considerably reduced waiting time for patients at the Clinic. There has been little change in the incidence of new cases of tuberculosis in the area served, and deaths show some decrease. The most important change has been the diminished waiting period for admission to hospital and the smaller waiting list one seventh of the figure for 1950. This improved position has been of considerable help and encouragement to the staff. It is to a great extent due to a diminution in the number of tuberculous patients requiring treatment in the hospital region as a whole, resulting in a decreased general demand for chest hospital beds. A great deal of general chest consultation work is undertaken, amongst which the problem of diagnosis and treatment of cancer of the lung is reaching important proportions. Close liaison is maintained with Thoracic Surgical Units at St. Charles, Harefield and Clare Hall Hospitals to which patients with chest conditions amenable to treatment by surgical means are referred." STATISTICS. General. 1950. 1951. 1952. 1953. 1954. New patients referred to Clinic 4, 156 6,107 7,133 8,295 8,459 Total Attendances 26,297 30,046 30,183 30,644 30,841 Total attendances for refills 11,711 12,214 11,443 10,114 9,523 Number of persons X-rayed 16,717 14,552 18,388 16,537 17,096 Number of home visits by physicians 358 294 300 383 415 27 TUBERCULOSIS REGISTER. 1950. 1951. 1952. 1953. 1954. New respiratory tuberculosis cases 172 178 184 171 180 New non-respiratory tuberculosis cases 21 24 28 16 26 Total new tuberculosis cases 193 202 212 187 206 Cases on regis ter, 31st December 1,750 1,753 1,761 1,764 1,767 Removed from register because of death 31 40 47 44 32 Removed from register as recovered 62 66 72 54 89 Number of tuberculous patients awaiting hospital admission 115 91 95 48 16 Mass X-Ray, The Mass X-Ray Ifait visited the Borough of Hendon twice during the year. A private survey was carried out at one factory in the Colindale area and at a second the survey was open to outside groups. The following is a summary:- Private Survey at one factory. Men. Women. Total. Number x-rayed 1,292 287 1,579 Number re-called for large films 41 7 48 No further action 26 7 33 Referred for further medical advice 10 - 10 Decisions pending 5 - 5 Survey open to all groups. Number x-rayed 1,776 1,757 3,533 Number re-called for large films 39 34 73 No further action 25 21 46 Referred for further action 5 8 13 Re-check at later date 3 2 5 Decisions pending 6 3 9 28 It will be seen from the above figures that 3,068 men and 2,044 women, giving a total of 5,112 persons, were x-rayed during the visit to the Colindale area On the second occasion, from 7th to 9th December, 1954, the Unit carried out a survey of selected groups when the number of vacancies available to the general public was limited A report on this survey is as follows:- Men. Women. Total. Total examined 696 247 943 Re-called for large films 7 1 8 Disposal of large films (a) No further action 3 1 4 (b) To return to Unit for further examination at later date 1 _ 1 (c) Further medical advice recommended - - - (d) Result not available 2 - 2 Did not attend 1 - 1 I am indebted to Dr. J. R. Mikhail, Medical Director of Mass X-Ray Unit 5B, for supplying me with the information. SECTION C. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Establishments for Massage and Special Treatnent. MIDDLESEX COUNTY COUNCIL ACT, 1944. SECTIONS 353-363. The Council continued to exercise its functions as the 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, 29 The Council considered the following number of applications:- New Licences 3 Renewals of Licences 26 Certificates lodged under Section 363 by members of the Chartered Society of Physiotherapy 6 Licences refused Nil National Assistance Acts, 1948-1951. Section 47. This section deals with securing the necessary care and attention for persons who (a) are suffering from grave chronic disease or, being aged, infirm or physically incapacitated, are living in insanitary conditions, and (b) are unable to devote to themselves, and are not receiving from other persons, proper care and attention,. During the year under review it was found necessary to take formal action under this section in one case. This was an old lady over 80 years of age Many efforts, extending over a considerable period, were made to effect an improvement in her condition and after all persuasive methods had failed, the necessary application was made to a Justice of the Peace who made an order for her removal, and she was removed to a County Council Home. The premises she occupied were cleaned by the Public Health Department and she returned home, help being given to her by the provision of a home help. 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 three cases:- one stillborn child, one child aged 1 day, and a boy aged 6 years, The necessary steps were taken to recover the cost in all cases 30 General Hospital Facilities. Edgware General Hospital. Hendon District Hospital. Infectious Disease Cases - Hospital Accomodation. 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 Accomodation. 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. A Chest Clinic at Edgware serves 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:- * Care of Mothers and Young Children (Section 22). * Midwives Service (Section 23). * Health Visiting (Section 24). * Home Nursing (Section 25). * Vaccination and Immunisation (Section 26). * Domestic Help (Section 29). School Health Services and School Dental Services (Provided under Education Act, 1944, the Borough of Hendon being an Excepted District) * These services are administered on an area basis. Area No. 4 consisting of the Boroughs of Hendon and Finchley. The Area Health Committee 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. 31 Laboratory Facilities, These are provided at the Central Public Health Laboratory, Colindale. Specimens may be sent direct by Medical Practitioners to the Laboratory or by special collection from the Public Health Department provided they are received not later than 3.30 p.m. Monday to Friday and 11.0 a.m. Saturday. I would like to express my appreciation of the work carried out by the staff of the Laboratory vho have co-operated whole-heartedly with the Public Health Department, The numbers of samples taken in respect of milk, ice cream, domestic water supplies and swimming pools are contained elsewhere in the report. Medical Examinations. During the year 89 employees of the Hendon Borough Council were medically examined for superannuation purposes WELFARE OF OLD PEOPLE. The following extracts are from the Report for the year 1954-55 of the Borough of Hendon Old People's Welfare Committee. I am indebted to Mr, A. E. Harvey, The Honorary Secretary, for supplying me with the information. Visiting. This service is one of the most important undertaken by the Committee. Through it, contact is maintained with the more frail and lonely people and at the same time it enables the Committee to discover and to meet any special needs. Loneliness is one of the most dreaded accompaniments of old age. The difficulty is that of finding the lonely person who does not attend a church or belong to any organisation Chiropody This service, instituted in 1953, continues to be provided by the British Red Cross Society, and during the year 273 cases were dealt with. Any deficit has been met by the Old People's Welfare Committee, which during the year has itself instituted a service to meet the needs of the bedridden person. The British Red Cross Society also provided a Chiropody Service in most of its Evergreen Clubs. 32 Night Attendant Service. This service continues to be available and no charge is made in necessitous cases. It is regretted, however, that very few people have availed themselves of these facilities. In many parts of the country this service has proved a great asset. Holiday Scheme. In May a party of 130 old people spent an enjoyable week's holiday at Cliftonville. All arrangements, as in previous years, were made by the Committee and financial assistance was given where necessary. Clubs. Old people's clubs continue to retain their popularity and the Borough is well served in this respect The British Red Cross Evergreen Clubs meet at Colindale, Childs Hill, Edgware, Golders Green, Hampstead Garden Suburb and West Hendon; the W.V.S. Darby and Joan Clubs at Burnt Oak and Mill Hill; whilst the Watling Community Association Veterans' Club meets at the Watling Centre Special facilities exist for Jewish people of pensionable age, there being three Friendship Clubs attached to the Synagogues at Edgware, Golders Green and Hendon, The over 60's Club, for which the Old People's Welfare Committee is responsible, continues to meet at the Methodist Church Hall. The membership has now reached 207. All clubs meet weekly and have provided for a variety of interests during the past year. Christmas Dinners and New Year's Party. Continuing the provision of Christmas dinners to lonely and bedridden old people in the Borough, 136 dinners were supplied on Christmas Eve, an increase of 16 on the previous year's figure. This year, thanks to an anonymous donor, it was possible to provide a New Year's Party for 144 old people. Meals on Vheels. This service is operated by the W.V.S. and during the year nearly 7,000 dinners were supplied to old people in their own homes. Housing. Too little attention has been paid in the past to the special housing needs of old people, particularly having regard to the fact that old people constitute approximately 14 per cent of the population. It is pleasing, therefore, to report that during the year work was started at Childs Hill on the first home of its kind 33 in Hendon. Designed primarily for cases coming within the provisions of Part III of the National Assistance Act, it will provide accommodation for 40 old people. It is pleasing also to report that the Hendon Borough Council's scheme for providing accommodation by the conversion of old properties continues to be extended wherever possible VISITS, ETC., FROM 1ST APRIL, 1954, TO 31ST MARCH. 1955. Old people who called at the office for advice 831 Visits made from the office to ill or home-bound people 268 Visits made by other Lady Visitors 796 1,895 Old people helped to find accommodation 34 Old people helped to find part employment 34 Help given in arranging for holidays and convalescence 13 Cases under care from 31st March, 1954. 79 New cases 1st April, 1954, to 31st March, 1955. 106 Cases sent in by:- Welfare Officer 3 Hospitals 31 Local Authorities 34 Brought to notice (other than above) 38 Districts:- Edgware 199 Mill Hill 161 Burnt Oak 183 West Hendon and Colindale 321 Hendon Central 478 Childs Hill 245 Garden Suburb 145 Golders Green 163 1,895 The office of the Committee is situated in the Methodist Church Hall (Room 3) 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. 34 SECTION D. SANITARY CIRCUMSTANCES OF THE AREA. Water Supply. The Borough has a dual source 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.ER.) Line to Borough Boundary with Finch ley. 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 safeguard 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 dwellinghouses supplied from public water mains:- (a) direct to houses 43,010 (b) by means of standpipes Nil Number of the population supplied from Public Water Mains:- (a) direct to houses 154,800 (b) by means of standpipes Nil Fluoride content of water supplies. Colne Valley Water Company:- Fluoride Content - Nil. Metropolitan Water Board:- Fluoride Content- 0.15 to 025 parts per million. 35 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. "During the year under review the progress made in providing accommodation for inadequately housed persons has been maintained, and a further 225 families were rehoused into permanent Council Houses. The number of permanent Council dwellings now amounts to 3,271, of which 1,985 have been erected in post war years. Despite this progress, however, the number of housing applicants registered as in need of alternative accommodation continues to increase and, at the close of the year, the waiting list totalled 5,581. The need to put to the best use the diminishing amount of land left available in Hendon for building purposes is reflected in the increased flat development undertaken by the Council, and the majority of schemes in progress, or proposed, are planned on this basis. The assistance afforded in the past by the New and Expanded Towns has continued, and during the past twelve months many families have been nominated by Hendon for rehousing in those areas. Without this help these families, who are now happily settled in decent living conditions, would have been obliged for many years to come to exist in unsatisfactory housing accommodation. The clearance of outdated dwellings has progressed, and the Cricklewood Lane Redevelopment, providing 140 flats, is now nearing completion, while an early start on the Hendon Park Row Redevelopment is expected. This latter scheme will provide 36 flats. The welfare of elderly persons has not been overlooked despite the pressing problems presented by overcrowding. Apart from the conversion of premises purchased and converted by the Council to bed-sitting room accommodation, all new Estates provide for a proportion of dwellings specially designed for rehousing the older members of the community. The policy of transferring to smaller accommodation Council tenants living in accommodation in excess of their requirements has been continued., By so doing it has been possible to make the larger types of houses available for re-letting to bigger families and so relieve many cases of overcrowding. Advantage has also been taken of opportunities to co-operate with other local authorities and private property owners to secure exchanges of tenancies which have proved mutually beneficial. 36 The demand from families evicted or threatened with eviction shows signs of improvement but emergency accommodation in Half-Way Houses is not always available and, although 25 families were helped during 1954, in a number of other instances it proved impossible to assist. The following table sets out the number of housing applicants assisted during the year ending 31st December, 1954. (1) Number of families rehoused in permanent accommodation:- (a) Pre-war houses, etc. 27 (b) Post-war houses, etc. 192 (c) Temporary bungalows 6 225 (2) Transfers arranged to relieve overcrowding on Council Estates 182 (3) Number of families rehoused in requisitioned property 36 (4) Number of families given emergency accommodation in Half-Way Houses 25" SANITARY INSPECTION. 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. Daring the year under review inspections were carried out as set out below:- Inspections made 7,014 Re-inspections after order or notice 12,556 Complaints received and investigated 1,562 Bakehouses 106 Butchers Shops 320 Caravans 157 Dairies 41 Drain tests 273 Factories 210 Hawkers and Food Delivery Vans 62 Hawkers Storage Premises and Stalls Ice Cream Samples 34 37 Ice Cream Premises 45 Infectious Disease 376 Licensed Premises 99 Milk Samples 154 Other Food Shops 1,117 Overcrowding 60 Outworkers 15 Piggeries 41 Public Entertainment in connection with licensing 106 Restaurants, Cafes etc, 249 Smoke Observations 193 Stables 1 Swimming Baths 15 Pet Animals Act, 1951 24 Hairdressers and Barbers Premises 60 Notices served. Informal or cautionary 947 Complied with 787 Statutory Notices. Applied for 150 Served under Public Health Acts 103 Complied with 114 Outstanding 18 Inspection of Dwellinghouses during 1954. Total number of dwellinghouses inspected for housing defects (under Public Health and Housing Acts) 1,849 Number of inspections made for the purpose 5,669 Number of dwellinghouses found not to be in all respects reasonably fit for human habitation 573 Legal Proceedings under Public Health Act, 1936. It was necessary to institute legal proceedings in 8 cases. Nuisance orders were made in 3 cases with payment of costs; in one case a nuisance order was made and the defendant fined £2.2,0, with £2.8.0, costs and in the remaining 4 cases the summonses were withdrawn before the hearing on payment of costs by the defendants. 38 TABLE XVII CLEARANCE AREAS AND INDIVIDUAL UNFIT HOUSES. RETURN FOR THE YEAR ENDED 31ST DECEMBER, 1954. PART A- CLEARANCE AREAS (HOUSING ACT, 1936) Number of dwellinghouses demolished in the period Number of Persons displaced. Unfit houses Other houses (1) Land coloured 'pink' 25 - 100 (2) Land coloured 'grey' - - - PART B - HOUSES NOT INCLUDED IN CLEARANCE AREAS. Houses Number of Persons displaced. DEMOLITION AND CLOSING ORDERS (1) Housing Act, 1936. (a) Houses demolished as a result of formal or informal procedure under Section 11 2 2 (b) Houses closed in pursuance of an undertaking given by the owners under Section 11, and still in force Nil Nil (c) Parts of buildings closed (Section 12) 2 5 (2) Housing Act, 1949. (a) Closing Orders made under Section 3(1) Nil Nil (b) Demolition Orders determined and Closing Orders substituted under Section 3(2) Nil Nil (3) Local Government (Miscellaneous Provisions) Act, 1953. Closing Orders made under Section 10(1) 6 30 REPAIRS Informal Action Number of Houses (4) Number of unfit or defective houses rendered fit during the period as a result of informal, action by the Local Authority under the Public Health or Housing Acts 473 Action under Statutory Powers (5) Public Health Acts. Number of houses in which defects were remedied after service of formal notices (a) by owners 82 (b) by Local Authority in default of owners Nil (6) Housing Act, 1936. Number of houses made fit after service of formal notices (Sections 9, 10, 11 and 16) (a) by owners 7 (b) by Local Authority in default of owners Nil 39 HOUSING ACT, 1936. During the year the Council declared Hendon Park Row, Temple Fortune, as a Clearance Area, 25 houses being involved. The tenants were rehoused and the site acquired by the Council for housing purposes. The houses have now been demolished. HOUSING REPAIRS AND RENTS ACT, 1954, This Act came into force on 30th August, 1954. One of the provisions enables landlords to increase the rent in certain cases. Provision was made, however, that where such increases were applied, the tenant had the right to apply to the Local Authority for a Certificate of Disrepair where the house failed to fulfil the conditions justifying an increase in rent., that is to say (i) that the dwellinghouse is in good repair; and (ii) that it is reasonably suitable for occupation having regard to certain conditions. Up to the 31st December, 1954, 35 applications were received and the Local Authority issued 14 Certificates of Disrepair. At the end of the year none of these Certificates had been revoked The number of Certificates applied for during this period was not so great as anticipated and it would appear that either the landlords are not availing themselves of the permitted .increase in rent or that the tenants are satisfied with the conditions under which they are living. Should the first assumption be correct then it would appear that the intention of the Act to enable landlords to meet the increased cost of repairs and to improve the standard of housing is not being achieved. 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 193 In this connection advice was given where necessary. 40 Cesspools A number of houses in the more rural portions of the Borough are drained into cesspools. These were emptied by the Council on 257 occasions during the year. Disinfestation of Verminous Houses. 15 houses were successfully treated. Privately owned 14 Council Houses 1 An arrangement exists whereby the Housing Officer notifies the Public Health Department of the transfer of tenants in Council Houses. Inspections are 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. Disinfection of rooms by formalin spray is carried out after cases of certain notifiable infectious diseases and in the case of Tuberculosis on request or by arrangement with the Chest Physician An arrangement exists with the Regional Hospital Board for the steam disinfection of bedding and clothing, a charge being made to the Local Authority for this service. In cases other than notifiable infectious disease the service is carried out on request; an appropriate charge being made. Daring the year 295 library books and 19 gramophone records were disinfected. Number of rooms disinfected during the year 230. 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. 41 During the year 9 samples were taken from the Municipal Swimming Baths and all were satisfactory. Rag Flock and Other Pilling Materials Act, 1951. Number of Registered Premises 3 Pet Aninals Act, 1991. Number of Licences Granted 10 Hairdressers and Barbers. Bye-laws were made under Section 282 of the Middlesex County Council Act, 1944, and became operative on 1st March, 1953, this being the first full year that the bye-laws have been in operation. Sixty inspections were made under these Bye-laws- Prevention of Damage by Pests Act, 1949 - Rodent Control. Rodent destruction in dwellinghouses and business premises is carried out by a foreman, three full-time and one part-time 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 dwellinghouses, treatment is undertaken 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 and agricultural holdings engage a Servicing Firm to carry out periodical treatment. 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, 1954, is given in the following table which is based on the return sent to the Ministry of Agriculture and Fisheries. 42 TABLE XVIII. Type of Property Non-Agricultural (5) (1) (2) (3) (4) Local Authority Dwelling Houses (inc. Council Houses) All other (inc. Business Premises) Totals of Cols. (1), (2) and (3). Agricultural 1. Total number of properties in Local Authority's District 17 43,163 4,721 47,901 10 2. Number of properties inspected as a result of (a) Notification 1 637 63 701 1 (b) Survey under the Act - 611 59 670 - (c) Otherwise - 275 54 329 - 3, Total inspections carried out— including re-inspections 1 10,092 824 10,917 7 4. Number of properties inspected (under Section 2) which were found to be infested by (a) Rats Major - - - - - Minor - 1,038 78 1,116 - (b) Mice Major - - - - - Minor - 226 45 271 - 5. Number of infected properties (under Section 4) treated by the Local Authority - 1,257 95 1,352 1 6. Total treatments carried outincluding re-treatments - 1,626 113 1,739 1 7. Number of notices served under Section 4 (a) Treatment - - - - - (b) Structural work (i.e., Proofing) - - - - - 8. Number of cases in which default action was taken following the issue of a notice under Section 4 of the Act - - - - - 9. Legal Proceedings - - - - - 10. Number of "Block" control schemes carried out - 13 - 13 - 43 Factories Acts, 1937 and 1948. The following is a report on the work carried out by the Sanitary Inspectors during the year:- 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 40 34 3 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 380 167 11 (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 8 9 2 TOTAL 428 210 16 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) 15 15 4 Overcrowding (S.2) - - - Unreasonable temperature (S.3) - - - Inadequate ventilation (S.4) 1 1 - Ineffective drainage of floors (S.6) - - - Sanitary Conveniences (S.7):- (a) Insufficient - - - (b) Unsuitable or defective 4 4 - (c) Not separate for sexes - - - Other offences against the Act (not including o f fences relating to Outwork) 22 19 1 TOTAL 42 39 5 44 Part VIII of the Act. OUTWORK. (Sections 110 and 111) Nature of Work. No. of outworkers in August list required by Sect. 110(T)(c). Wearing apparel— making, etc. 130 Household Linen 3 Curtains and furniture hangings 1 Brass and brass articles 1 Artificial flowers 2 Nets, other than wire nets 8 Paper bags 1 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 10 Feather sorting 4 Carding, etc., of buttons, etc. 8 Stuffed toys 1 Cosaques, Christmas crackers, Christmas stockings etc. 8 Lampshades 3 TOTAL 180 45 SECTION E. INSPECTION AND SUPERVISION OF FOOD. Food and Food Premises. 1,977 inspections were made of premises where food intended for sale for human consumption is prepared, stored or sold. Particular attention has been paid to the implementation of the Clean Food Byelaws in respect of the proper screening of foodstuffs to prevent contamination. Djring the period under review legal proceedings were taken in three cases in connection with unsound food. In all three, convictions were obtained and the defendants fined. Attention has also been given to hawkers of food, particularly in connection with their vehicles and storage premises which are required to be registered with the Local Authority under the Middlesex County Council Act, 1950. No clean food campaign was instituted during the year but talks on 'FoodHygiene' were given by the Sanitary Inspectors to certain women's organisations. Action taken in connection with food stores and food shops. 114 notices were served on occupiers of shops and stores for infringements of the Food and Drugs Act, 1938, and Clean Food Bye-laws. At the end of the year 110 notices had been complied with. The principal matters dealt with were:- Sanitary accommodation: Defective sanitary conveniences 9 Defects in drainage systems 6 Choked drains 2 Compartments cleansed 32 Provision of washing facilities: Provision of hot water supply 14 Refrigerators: Interiors cleansed 7 General. Insufficient accommodation for storage of refuse 9 Want of cleanliness 41 Other defects 161 46 Number and type of food premises in the area Grocers and provision merchants 222 Butchers 93 Bakers and confectioners 49 Greengrocers 93 Fishmongers 37 Dairies and milkshops 12 Confectionery shops 92 Restaurants and Cafes 142 Butter blending factory 1 Works Canteens 45 Food Warehouses 2 Food and Drugs Act, 1938 - Section 14. Registered Premises. Inspections. Ice Cream Premises 197 79 Preservation of Food 67 54 34 samples of ice cream were taken during the year and submitted for bacteriological examination to the Central Public Health Laboratory, Colindale. Milk Supply. Number of registered dairymen and distributors 47 Number of registered dairies not being dairy farms 11 Number of visits made to dairies during the year 41 47 The results of the ice cream samples are as follows Grade. Number of samples Grade I 24 Grade II 10 Grade III - Grade IV - Middlesex County Council Act, 1950 = Section 11. Registration of Hawkers and Premises Number Registered, Number of Inspections Hawkers 63 ) 62 Premises 24 J Milk (Special Designations) Regulations. The following table shows the number of licences issued under these Regulations during 1954 Dealers Licences: Tuberculin tested 35 Pasteurised 34 Sterilised 33 Dealers Supplementary Licences: Tuberculin tested 19 Pasteurised 19 Sterilised 18 Milk Sampling The number of samples taken during the year is as follows:- Pasteurised 39 Tuberculin tested pasteurised 38 Raw bulk milk (Tuberculin tested) 8 Sterilised 9 In addition 60 samples of bottle rinses were taken during the year. Condemnation of Food Condemned foodstuffs are disposed of by incineration at the Council's Refuse Disposal Works The amount of foodstuffs condemned during the year shows a diminution onprevious years Ths is probably due to the fact that the large multiple firms are now having unsound food returned to the main distributing depots for condemnation in bulk. A large proport on of the food condemned in the Hendon area is accounted for by the fact that such a multiple firm has a central distributing depot within the Borough serving many branches throughout London. The following is a list of foodstuffs condemned during 1954 List of Foodstuffs condemned during 1954 MEAT 1879 lb 4 oz. (including:- Beef, Bacon, Ham, Lamb, Liver Sausage Mutton, Offal, Pork, Sausages Turkey and Veal) 3 Meat Pies and 2 chickens FISH 38 st 2 lb 6 oz. (including: - Cod, Dog Fish, Haddock, Herring Roe, Kippers, Mackerel and Salmon). 48 TINNED FOOD Meat 353 Milk 303 Fruit 1,638 Vegetables 756 Soup 93 Fish 215 Jam 232 Fruit Juice 87 Tomato Juice 9 Ham 21 (240 lb. 15½ oz.) FRESH FRUIT, DRIED FRUIT, AND VEGETABLES Apricots 27½ lb. Cauliflowers 25 Dates 1 lb. 9 oz. Dried Fruit 22 lb. Mixed Fruit 7 lb. Nuts 11 tins Pears 105 lb. Prunes 39½ lb. Raisins 88 lb. Sultanas 1,311 lb. MISCELLANEOUS GOODS Baby Food 247 tins Barley Water 3 bottles Biscuits 56¾ lb. Blancmange Powder 2 pkts. Bread Rolls 2 Butter 3 lb. Cakes 235 Cake Flour 26 pkts. Calves Foot Jelly 15 jars Cereal 260 pkts. Cheese 738½ lb., 209 pkts., 18 boxes and 11 portions. 49 Chocolate Eggs 51 Cherries, Cocktail and Glace 1 jar and 2 cartons Coffee 12 tins and 1 pkt. Confectionery 30 lb. 4 oz. and 57 pkts Cornflour 1 pkt. Cream 4 tins Custard Powder 20 tins Eggs 1,257 Eggs, Frozen 21 lb. Fish 37 jars Flour 56 lb. 12 oz. Fruit 16 jars Fruit Squash 1 bottle Gravy Powder 2 pkts. Ground Rice 2 lb. Jam 13 jars Jellies 4 pkts. Junket Powder 8 pkts. Macaroni 18 pkts. Meat Extract 1 jar. Milk Foods/Beverages 33 tins Milk Powder 25 lb. Mustard 4 tins Nutmeg 5 cartons Pudding 20 tins and 78 pkts. Paste 33 tins and 2 jars Peanut Butter 12 jars Pearl Barley 3 lb. Pickles 2 jars Potato Crisps 1 pkt. Rice 752½ lb. Sago 3 lb. Salad Cream etc. 64 bottles Sauce 128 bottles Semolina 9 lb. Spaghetti 1 carton 50 Squash 1 bottle Stuffing 1 pkt. Suet 8½ lb, Sugar 14 lb. Synthetic Cream 1 gallon Synthetic Cream Powder 26 tins Tapioca 3 lb. Tea 6¼ lb. Vegetables Frozen 6 lb. Vermicelli 18 pkts. Food and Drugs Act, 1938 (Sampling). The Middlesex County Council is the Food and Drugs Authority for the Borough of Hendon and I am indebted to the Chief Officer of the Public Control Department for the following report on the work of his Department during the year. SAMPLES PROCURED IN THE BOROUGH OF HENDON DURING THE YEAR 1954. Article Total Samples Procured Unsatisfactory Milk (various) 166 6 Arrowroot 3 - Blackcurrant Syrup 1 - Butter 2 - Cakes 26 - Camphorated Oil 22 - Cheese 1 - Chocolate Drink 1 - Coffee 2 - Condensed Milk 4 - Cooking Fat 1 - Cooked Meats 46 - Cream 14 1 Dressed Crab 1 - Dried Fruit 1 - Drugs 3 - Egg Vermicelli 1 - Fish 26 - Fish Cakes and Pastes 5 - Flour 2 - 51 Fruit Juices 4 - Fruit Sauce 1 - Fruit Squash 3 1 Iced Lolly 1 - Ice Cream 15 - Jam 2 - Jelly 9 - Liver 14 1 Macaroni and Cheese 1 - Marmalade 1 - Marzipan 1 - Meat Paste 2 - Meat Pies 9 - Minced Meat 24 - Nut Oil 1 - Oranges 11 1 Pepper 1 - Pickles 1 - Saccharin Tablets 1 - Sandwich Spread 1 - Sausages, Sausage Meat and Rolls 35 - Soups 2 - Suet 3 - Sweets 3 - Tripe 2 - Vinegar 36 6 Wines and Spirits 25 - TOTALS 537 16 Of the six irregular milk samples, five were in respect of samples of hot milk. Two of these, both from the one Vendor, were deficient in solids- not fat but contained no added water whilst a further two samples, again both from one Vendor, were deficient in fat. These cases were dealt with by verbal warnings to the vendors concerned, The other hot milk sample was deficient in fat but no action was taken, since an associated sample was genuine. The remaining irregular sample concerned a bottle of milk deficient in fat to an extent not sufficient to warrant immediate action. 52 The irregular sample of cream was in respect of a deficiency in fat but, since a subsequent sample was found to be correct, no action was taken. One sample of orange squash was found to contain an excess of the preservative sulphur dioxide and an official caution was issued to the manufacturers. The irregular sample of liver was a case of pigs liver being sold as lamb's liver for which the vendor was prosecuted and fined £3.0.0. with £3.3.0. costs. One sample of oranges, found to contain Thiourea, an unauthorised preservative, was dealt with by the issue of an official caution to the importers. The six irregular samples of vinegar comprised two samples from each of three vendors Che vendor sold non-brewed condiment as vinegar for which he was prosecuted and fined £1.0.0. with £3.17.0. costs. Another vendor who sold vinegar 42% deficient in acetic acid was prosecuted but was given an absolute discharge on payment of £5.5.0. costs. The third vendor who sold vinegar deficient in acetic acid received an official caution. Other activities of the Middlesex County Council as the Food and Drugs Authority were as follows:- Special Designated Milk, The premises of the one dealer/processor of pasteurised milk in the Borough of Hendon received nine inspections, whilst fifty-seven samples of pasteurised milk from that source were submitted for examination and found to be satisfactory. Merchandise Marks Acts, 1887-1953. Attention has been paid in particular to compliance with the Imported Food Orders made under the Merchandise Marks Act, 1926, In this connection, the marking of origin of meat, apples, tomatoes, poultry and dried fruit was checked by 504 inspections during which 2,438 displays or articles were examined. Only one substantial infringement was detected and this concerned Ehtch tomatoes falsely described as "English" as a result of which the retailer was prosecuted and fined £2.0.0. with £3.3.0. costs. Allied infringements were discovered during the inspections, however, and proceedings were instituted under the Defence (Sale of Food) Regulations, 1943. These infringements were all committed by one retailer who falsely described (i) Pearmain apples and (ii) Granny Smith apples as 'Newtons' and also falsely described Josephine pears as "Williams". The retailer was fined a total of £15 with £3.3.0. costs for these infringements. 53 Labelling of Food Order, 1953. To ensure compliance with this Order, 143 premises were visited and 439 articles of food examined. No infringement of substance was discovered. Slaughterhouses. There are no slaughterhouses licensed in the district, 54 Printed and produced by Hendon Borough Council