Library HEN 34 BOROUGH OF HENDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1957 J. L. PATTON, M B., Ch.B., D.P.H. Medical Officer of Health A. H. SMITH, M.A.P.H.I., Chief Public Health Inspector. BOROUGH OF HENDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1957 J. L. PATTON, M B., Ch.B., D.P.H. Medical Officer of Health A. H. SMITH, M.A.P.H.L., Chief Public Health Inspector. CONTENTS OF REPORT Page 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 Mortality 7 Infantile Mortality 7-8 Summary of Vital Statistics for the year 1957 10 Table Showing Vital Statistics for the years 1933-1957 11 Table Showing Certain Vital Statistics for the County of Middlesex for 1957 12 Table Showing Causes of Death for the year 1957 13-14 Notes on Vital Statistics 15-16 Deaths from Cancer of the Lung and Bronchus 16 Smoking in Youth Clubs 16-18 Road Traffic Accidents 19 SECTION B. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES: Notifications 22 Age and Ward Distribution of Infectious Diseases 23-24 Notes on Infectious Diseases 25-27 Diphtheria and Diphtheria Immunisation 28-29 Smallpox Vaccination 29 Chest Disease 30-31 Report of Chest Physician 32-35 Mass X-Ray 35 SECTION C: GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA: Establishments for Massage or Special Treatment 36 Action under Section 47, National Assistance Act, 1948 36-37 Section 50, National Assistance Act, 1948, Public Burials 37 Hospital Facilities 37 Health Services Provided by the Middlesex County Council 38 Medical Practitioner Service 38 Laboratory Facilities 38-39 Edgware Group Health Services Liaison Committee 39 Welfare of Old People 41 Hendon Old People's Housing Society 43 Medical Examinations 43 SECTION D; SANITARY CIRCUMSTANCES OF THE AREA Water Supply 44 Housing - Report of Housing Officer 45-46 Summary of Inspections carried out by Public Health Inspectors 47 Notices Served 47 Inspection of Dwel1inghouses 47 Legal Proceedings Under Public Health Act, 1936 48 Housing Act, 1936 - Action Under 48 Housing Repairs and Rents Act, 1954 49 Cinemas and Places of Entertainment and Licensed Houses 50 Smoke Abatement 50 Cesspools 50 Disinfestation and Disinfection 50 Swimming Baths 51 Rag Flock and Other Filling Materials Act, 1951 51 Pet Animals Act, 1951 51 Hairdressers and Barbers 51 Rodent Control 51-52 Administration of Factories Acts, 1937 and 1948 53 Clean Air Act, 1956 55-56 Atmospheric Pollution 55-59 SECTION E: INSPECTION AND SUPERVISION OF FOOD Food and Drugs Act, 1955 - Legal Proceedings 60 Action taken in connection with Food Stores and Shops 61 Number and Type of Food Premises in the Area 61 Food and Drugs Act, 1955 - Section 16 61 Registration of Hawkers and Premises 61 Milk Supply 62 Unsound Food 62-64 Food and Drugs Act, 1955 - Sampling 64-66 Merchandise Marks Acts, 1887-1926 66 Labelling of Food Order, 1953 66-67 Slaughterhouses 67 COUNCIL of the BOROUGH (31-12-57) Mayor: COUNCILLOR S. E. ABRIDGE, J.P. Deputy Mayor: COUNCILLOR L. C. CHAINEY Aldermen: J. J. COPESTAKE, J.P. S. E. SHARPE A. W. CURTON, F.R. S. A., M. Inst.B.E. C. H. SHEILL J. L. FREEDMAN, J.P. , M, A. , LL.B. A. V. SULLY, M.C. , J.P. , F.C.A. R. J. KNOWLES, M.M. » J.P. , M.I.W.M. , S. R. C. SUMPTER, F.B.A.A. A. A. NAAR, M.B.E. Councillors: W. P. ASHMAN A. A. HOSKINS, B. Sc. (Econ. ) W. G. BARNES W. LLOYD-TAYLOR T. BEIRNE. A.M. I. Struct. E. G. W. MATHEWS, M.A., F.R.I. C. S. J. S. CHAMPION (Mrs.) J. MILLER J. K. CONNOLLY R. J. MOWATT D. A. DAVIS K. G. PA1WLIN (MISS) M. EATON A. PAUL, J.P. A, P. FLETCHER J. W. SHOCK, M. A., F.C.A. B. E. FLETCHER, B.Com. D. F. SIMONS J. D. GORDON-LEE A. C. B. W. SPAWFORTH S. D, GRAVES, F.R. I.C. S., F.A.I. (MRS.) C. M. THUBRUN P.G. HAYES C. V. L. VEGRASS, A.R.I. C. S., M.R.S.H. L. A. HILLS PUBLIC HEALTH COMMITTEE (31 - 12 - 57) Chairman: COUNCILLOR (MRS.) C. M. THUBRUN Vice-Chairman: COUNCILLOR (MISS) M. EATON Aldermen: A. A. NAAR, M.B.E. S. E. SHARPE S. R. C. SUMPTER,, F. B. A. A. Councillors: S. E. ARRIDGE, J.P. (Mayor) Ex-officio P. G. HAYES W. LLOYD-TAYLOR W. P. ASHMAN. A. PAUL, J.P. B. E. FLETCHER, B.Com. C. V, L. VEGRASS, A.R. I.C. S. , M.R.S.H. J. D. GORDON-LEE ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1957 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 1957. The vital statistics for the year show a satisfactory state of affairs. There has been an estimated slight decrease in the total population. The infant mortality rate, which has been accepted as a measure of the standard of public health is at the low figure of 21.9 per 1,000 live births. I am pleased to report too that no maternal death occurred during the year. In 1957 two important anniversaries were celebrated. First of all the Borough of Hendon received its Charter in 1932 and so celebrates its first quarter-century. Secondly, the Hampstead Garden Suburb was onened in 1907 and so celebrated its Jubilee in 1957. The Hampstead Garden Suburb introduced a high standard of suburban housing which has had a nation-wide influence. A description of the progress made in public health and preventive medicine in the last 50 years in Hendon would fill many pages of this report. It is, however, interesting to look back at some of the Annual Reports of former years and to read, for example, that in 1923 Dr. Mcintosh reported that there were no houses unfit for human habitation remaining on the books of the Public Health Department. It is even more interesting to contemplate what progress we may achieve in the next 50 years. Progress has been so fast in the last 50 years that we may expect it to be equally fast in the next 50 years. Cleaner air is certain to come, and we have been given a good lead by the Ministry of Housing and Local Government with the Clean Air Act, and steady progress is being made with the Smoke Control Area in the north of Edgware Ward. There is, however, no reason why one should wait for the setting up by the Council of a Smoke Control Area before using smokeless fuel. Indeed, it is hoped that more and more of our public spirited citizens will adopt the use of smokeless fuel in their own homes and so set a fashion which, in time, will spread to every householder. An increased demand for smokeless fuel will undoubtedly stimulate the manufacturers to produce more and more of it, and the results will be most beneficial. Not only would cleaner air improve our health, but we would be spared a lot of unnecessary expense on laundry, furnishings and paintwork because it has been estimated that the expenditure on these items as a result of burning bituminous coal costs between £3 and £10 per head per annum: At this rate smoke may cost Hendon as much as £1,000,000 a year. 4 Another modification in environment which one hopes to see in the next 50 years is the introduction of the fluoridation of drinking water. There is no doubt whatever that the amount of tooth decay could be reduced if drinking water in Hendon contained a minute and tasteless quantity of fluoride as it does in more fortunate places, such as South Shields and Slough, where fluoride occurs naturally in the drinking water and Watford, where it is added artificially. At the present time children bom and bred in Hendon are fated to suffer an unnecessary amount of pain from bad teeth and the use of dentures is accepted fatalistically by too many adults. The cost of fluoridation of the drinking water at 6d. per head per annum seems trivial when related to the nation's present expenditure of about £1 per head per year on dental treatment. Another change that we may expect in the next 50 years may occur in our smoking habits, because as the risk of cancer of the lung from cigarette smoking becomes more widely known, so the fashion of cigarette smoking must inevitably change. I have included the report of the Chairman of the Borough of Hendon Old People's Welfare Committee and an abstract from the report of the Hendon Old People's Housing Society. I would like to thank the Members of the Council for their support and encouragement and also the members of the staff for their loyal and conscientious service during the year. 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 the Borough 10,369 Population figure supplied by Registrar General. 152,600 Density of population, i.e., number of persons per acre. 14.69 Number of inhabited houses at 31st December 1957 (according to Rate Book) 44,073 Average number of persons per house 3.46 Rateable value at 31st December, 1957 £3,295,148 Sum represented by a Penny Rate £13,300 Births: Live Births: Male. Female. Total. Legitimate 960 878 1,838 Illegitimate 46 33 79 Total 1,006 911 1,917 Live Birth Rate per 1,000 Home Population 12.56 Birth Rate corrected for comparison with other areas 11.93 Comparability factor supplied by Registrar-General 0.95 Corrected Birth Rate per 1,000 Home Population , County of Middlesex 13.80 Birth Rate per 1,000 Home Population, England & Wales 16.10 Corresponding Rate for the Borough of Hendon for the year 1956 12.35 6 Stillbirths: Male. Female. Total. Legitimate 13 9 22 Illegitimate 1 2 3 14 11 25 Stillbirth Rate per 1,000 Total Births 12.94 Stillbirth Rate per 1,000 Home Population 0.16 Stillbirth Rate per 1,000 Total Births, England & Wales 22.40 Stillbirth Rate per 1,000 Home Population, England & Wales 0.36 Deaths. Male. Female. Total. 785 740 1,525 Death Rate per 1,000 Home Population 9.99 Death Rate corrected for comparison with other areas 10.58 Comparability factor supplied by Registrar-General 1.06 Corrected Death Rate per 1,000 Home Population, County of Middlesex 10.90 Death Rate per 1,000 Home Population, England & Wales 11.50 Corresponding Rate for the Borough of Hendon for the year 19 56 10.67 Maternal Mortality. Number of women dying in consequence of childbirth Nil Maternal Mortality Rate per 1,000 total births Nil Comparative figure for the County of Middlesex 0.40 Comparative figure for England and Wales 0.47 Infantile Mortality. Deaths of infants under 1 year of age:- Male. Female. Total. Legitimate 20 17 37 Illegitimate 3 2 5 23 19 42 Death Rate of infants under 1 year of age per 1,000 live births 21.9 Death Rate of infants under 1 year of age per 1,000 live births. County of Middlesex 17.7 Death Rate of infants under 1 year of age per 1,000 live births, England and Wales 23.0 7 Deaths of infants under the age of 4 weeks:- Male. Female. Total. Legitimate 15 13 28 Illegitimate 3 2 5 18 15 33 Neo-natal Mortality Rate per 1,000 live births 17.21 Neo-natal Mortality Rate per 1,000 live births, County of Middlesex 13.30 Neo-natal Mortality Rate per 1,000 live births, England and Wales 16.50 An analysis of the causes of death and the age at the time of death reveals the following figures: - Causes of death Age at the time of death 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 6 1 - - 14 - - - - 14 Pneumonia 1 2 - 1 1 5 3 1 1 - 10 Atelectasis - 2 - - - 2 - - - - 2 Asphyxia - - - - - - - - - - - Septicaemia - - - - - - - 1 - - 1 Congenital defects 2 1 4 1 - 8 1 - - - 9 Intra-Cranial haemorrhage 4 - - - - 4 - - - - 4 Tumours - - - - - - 1 - 1 - 2 TOTAL 14 11 5 2 1 33 5 2 2 - 42 8 The infant deaths were distributed throughout the wards of the Borough as follows:- Mill Hill 7 Burnt Oak 2 West Hendon 6 Central 4 Park 2 Golders Green 7 Garden Suburb 6 Childs Hill 6 Edgware 2 42 TABLE I. The following table shows the Infantile Mortality Rates over the 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 1950 16 1951 22 1952 21 1953 16 1954 21 1955 21 1956 18 1957 21 9 SUMMARY OF VITAL STATISTICS FOR THE YEAR 1957. England and Wales. Borough of Hendon. Births Rates per 1 000 Home Population. Live births 16.10 11.93 Still births 0.37 0.16 22.4(a) 12.94(a) Deaths All causes 11.50 10.58 Typhoid & Paratyphoid Fever 0.00 - Whooping Cough 0.00 - Diphtheria 0.00 - Tuberculosis 0.10 0.09 Smallpox - - Acute Poliomyelitis & Polioencephalitis 0.00 0.02 Pneumonia 0.52 0.41 Influenza 0.15 0.09 Rates per 1,000 Live Births All causes under 1 year of age 23.00 21.90 NOTIFICATIONS (CORRECTED) Rates per 1.000 Home Population Typhoid Fever 0.00 - Paratyphoid Fever 0.00 0.03 Meningococcal Infection 0.02 0.00 Scarlet Fever 0.65 1.03 Whooping Cough 1.89 1.35 Diphtheria 0.00 0.00 Erysipelas 0.07 0.07 Smallpox - - Measles 14. 10 14. 11 Pneumonia 0.72 0.79 Acute Poliomyelitis Paralytic 0.07 0.15 Non-Paralytic 0.03 0.05 Food Poisoning 0.20 0.17 Puerperal Pyrexia 15.99(a) 59.7(a) 26.2* (a) (a) Per 1,000 Total (Live & Still) Births. *This is the rate when the figure relating to Hendon residents only is taken. 10 TABLE II VITAL STATISTICS FOR THE YEARS 1933-1957. 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 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 1543 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 0.87 1951 155,700 2,082 13.36 1,635 10.50 47 22 2 0.94 1952 156,400 1,981 12.66 1,598 10.22 41 21 1 0.49 1953 155,500 2,008 12.91 1,479 9.51 32 16 1 0.49 1954 154,800 2,008 12.97 1,392 8.99 42 21 2* 0.98* 1955 154,000 1,934 12.55 1,559 10.12 40 21 1 0.51 1956 153,200 1,998 13.00 1,558 10.16 36 18 Nil Nil 1957 152,600 1,917 12.56 1,525 9.99 42 21 Nil Nil *The interval between the maternal condition and the date of death in one case exceeded 1 year. 11 12 TABLE III, COUNTY COUNCIL OF MIDDLESEX. CERTAIN VITAL STATISTICS FOR THE YEAR 1957. District Population mid-1957 Birth rate per 1,000 population Death rate per 1,000 population Specific death rates per 1,000 population Infant mortality per 1,000 live births Maternal mortality per 1,000 total births Pulmonary tuberculosis Cancer Infant Neo-natal Crude Adjusted Crude Adjusted (a) (a) (a) (a) (a) (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Acton 65,840 14.2 13.3 10.6 11.1 0.08 (5) 2.2 (148) 19.2 (18) 13.9 (13) - (-) Brentford & Chiswick 57,700 13.8 13.0 10.9 11.0 0.07 (4) 2.3 (131) 16.3 (13) 13.8 (11) - (-) Ealing 183,600 14.5 13.9 10.3 11.2 0.11 (20) 2.2 (412) 17.6 (47) 10.9 (29) 0.74 (2) Edmonton 96,530 12.9 12.6 9.8 11.1 0.04 (4) 2.1 (202) 13.6 (17) 12.0 (15) - (-) Enfield 109,200 13.4 13.4 10.9 9.9 0.07 (8) 2.2 (242) 10.3 (15) 6.8 (10) 2.01 (3) Feltham 50,000 16.3 15.8 7.0 11.1 0.02 (1) 1.5 (76) 19.6 (16) 16.0 (13) - (-) Finchley 69,380 13.3 12.8 11.3 10.3 0.10 (7) 2.4 (168) 17.3 (16) 15.1 (14) 1.06 (1) Friern Barnet 28,490 11.2 12.5 16.9 9.6 0.21 (6) 2.4 (69) 3.1 (1) 3.1 (1) - (-) Harrow 215,000 12.9 13.2 9.0 10.7 0.06 (12) 2.0 (425) 14.0 (39) 9.7 (27) 0.35 (1) Hayes & Harlington 67,190 15.9 14.9 7.6 12.3 0.10 (7) 1.8 (118) 14.0 (15) 10.3 (11) - (-) Hendon 152,600 12.6 12.0 10.0 10.6 0.07 (11) 2.2 (330) 21.9 (42) 17.2 (33) - (-) Heston & Isleworth 105,100 12.4 12.3 10.3 11.0 0.07 (7) 2.0 (205) 23.0 ( 30) 17.6 (23) - (-) Hornsey 96,890 16.2 15.1 11.5 10.2 0.07 (7) 2.3 (225) 17.2 (27) 15.3 (24) 0.62 (1) Potters Bar 20,370 15.5 14.3 8.5 11.2 0.05 (1) 1.1 (23) 15.8 (5) 9.5 (3) - (-) Ruislip - Northwood 75,280 13.4 13.4 7.4 9.3 0.05 (4) 1.7 (128) 23.8 (24) 17.8 (18) - (-) Southall 53,000 15.0 15.5 13.0 11.3 0.25 (13) 2.0 (108) 21.4 (17) 16.4 (13) - (-) Southgate 71,250 11.2 12.1 12.6 10.5 0.13 (9) 2.8 ( 202) 20.1 (16) 15.0 (12) - (-) Staines 45,770 18.4 17.1 7.9 10.0 0.09 (4) 1.3 (60) 14.3 (12) 8.3 (7) - (-) Sunbury 27,690 22.4 20.4 9.2 11.9 0.04 (1) 1.5 (41) 19.4 (12) 14.5 (9) - (-) Tottenham 119,300 13.9 13.5 11.0 11.8 0.08 (9) 2.4 ( 283) 25.3 (42) 20.5 (34) 1.18 (2) Twickenham 103,600 12.9 13.3 10.8 10.4 0.08 (8) 2.2 (228) 16.5 (22) 12.0 (16) - (-) Uxbridge 60,780 17.1 15.6 9.1 12.0 0.10 (6) 1.7 (104) 21.1 (22) 15.4 (16) - (-) Wembley 127,500 11.4 11.4 9.2 10.9 0.05 (6) 2.0 ( 260) 18.5 (27) 14.4 (21) - (-) Willesden 174,100 16.5 15.2 9.7 11.2 0.07 (13) 2.3 (405) 16.7 (48) 11.8 (34) 0.68 (2) Wood Green 49,500 13.2 13.2 9.8 9.6 0.12 (6) 2.2 (107) 16.8 (11) 16.8 (11) - (-) Yiewsley & West Drayton 23,340 19.4 17.7 7.1 10.2 0.13 (3) 1.4 (33) 15.5 (7) 8.8 (4) 2. 16 (1) COUNTY 2,249,000 14.1 13.8 10.0 10.9 0.08 ( 182) 2. 1 (4733) 17.7 (561) 13.3 (422) 0.40 (13) Note: (a) Absolute numbers are given in parenthesis in addition to rates to afford valid comparison. 13 TABLE IV Deaths of Hendon residents during the year 1957 - classified according to age groups and sexes. Causes of Death AGE GROUPS TOTALS Under 1 year 1 - 4 years 5 - 14 years 15 - 24 years 25 - 44 years 45 - 64 years 65 - 74 years 75 years and over 1. Tuberculosis, respiratory M 4 2 1 1 8 F 3 3 2. Tuberculosis, other M 1 1 2 F 1 1 3. Syphilitic Disease M 1 2 3 F 1 1 4. Diphtheria M F 5, Whooping Cough M F 6. Meningococcal Infections M 1 1 F 7. Acute Poliomyelitis M 2 1 3 F 1 1 8. Measles M F 9. Other Infective & Parasitic Diseases M F 1 1 10. Malignant Neoplasm, Stomach M 10 4 3 17 F 1 3 6 12 22 11. Malignant Neoplasm, Lung, Bronchus M 2 33 16 10 61 F 7 4 2 13 12. Malignant Neoplasm, Breast M F 2 15 7 7 31 13. Malignant Neoplasm, Uterus M F 1 6 1 2 10 14. Other Malignant &Lymphatic Neoplasms M 1 2 7 20 25 36 91 F 1 7 28 29 20 85 15. Leukaemia, Aleukaemia M 1 1 5 2 9 F 1 1 2 4 16. Diabetes M 1 2 3 F 3 4 7 17. Vascular lesions of Nervous System M 16 16 30 62 F 1 12 27 72 112 18. Coronary Disease, Angina M 5 59 61 44 169 F 1 15 28 36 80 14 Deaths of Hendon Residents - Continued TABLE IV (Continued) Causes of Death AGE GROUPS TOTALS Under 1 year 1 - 4 years 5 - 14 years 15 - 24 years 25 - 44 years 45 - 64 years 65 - 74 years 75 years and over 19. Hypertension with Heart Disease M 2 4 3 7 16 F 3 8 15 26 20. Other Heart Disease M 1 7 5 41 54 F 2 9 22 71 104 21. Other Circulatory Disease M 2 10 13 21 46 F 2 1 8 12 29 52 22. Influenza M 1 3 3 7 F 1 2 2 3 8 23. Pneumonia M F 2 2 1 1 4 1 8 2 21 21 37 26 24. Bronchitis M 1 1 1 19 22 16 60 F 2 4 5 15 26 25. Other Diseases of Respiratory System M 3 3 9 15 F 1 3 2 6 26. Ulcer of Stomach and Duodenum M 8 3 4 15 F 2 2 4 27. Gastritis, Enteritis & Diarrhoea M 1 1 F 2 3 5 28. Nephritis & Nephrosis M 1 1 1 3 F 1 3 2 6 29. Hyperplasia of Prostate M 3 3 F 30. Pregnancy, Childbirth, Abortion M F 31. Congenital Malformations M 3 1 1 2 7 F 6 6 32. Other Defined & Ill-defined Diseases M 15 1 2 11 13 12 54 F 8 2 1 1 3 12 25 22 7.4 33. Motor Vehicle Accidents M 1 2 4 1 4 12 F 1 1 2 1 5 34. All Other Accidents M 1 1 2 5 3 3 15 F 1 2 3 6 12 35. Suicide M 8 1 1 10 F 1 2 5 1 9 36. Homicide & Operations of War M 1 1 F M 23 3 7 4 38 230 206 274 785 F 19 2 3 4 26 141 198 347 740 All Causes TOTALS 42 5 10 8 64 371 404 621 1525 VITAL STATISTICS Population. According to the figure supplied by the Registrar-General the estimated mid-year population for 1957 was 152,600. This is 600 less than that for the year 1956 and 3,257 less than the Census figure for 1951. Births. The number of live births recorded during the year decreased by 81, 1,917 occurring compared with 1,998 in 1956, giving a decreased corrected birth rate of 11.93 per 1,000 Home Population compared with 12.35 last year. The rate is less than that for the County of Middlesex which is 13.8, and less than that for England and Wales, which is 16.1 per 1,000 Home Population. The number of stillbirths decreased from 38 to 25, giving a stillbirth rate of 12.94 per 1,000 total births compared with 18.66 in 1956. The rate for the Borough of Hendon compares favourably with that for England and Wales, which is 22.4 per 1,000 total births. Deaths. Although there were 35 fewer deaths than last year, owing to the fact that there was a fall in population, the corrected death rate of 10.58 per 1,000 Home Population is higher, but is less than the rate for England and Wales, which is 11.5 per 1,000 Home Population, and the County of Middlesex, which has a corrected death rate of 10.9 per 1,000 Home Population. Heart and associated diseases again accounted for the largest number of deaths, and second in the principal causes was cancer. Deaths from motor vehicle and other accidents increased, 44 people dying from these causes compared with 31 in 1956. Nineteen people committed suicide, one more than last year. Infantile Mortality. Forty-two children died in the first year of life compared with 36 in 1956, giving an infantile mortality rate of 21.9 per 1,000 live births. The rate for the Borough compares favourably with that for England and Wales, which is 23.0 per 1,000 related live births. The rate for the County of Middlesex, 17.7 per 1,000 live births, is lower than that for Hendon. 15 Of the 42 children, 33 died before reaching the age of 1 month, giving a neonatal mortality rate of 17.21 per 1,000 live births compared with 16.5 for England and Wales. Maternal Mortality. For the second year in succession, I am pleased to report that no mother died as the result of childbirth. Deaths from Cancer of the Lung and Bronchus. The number of deaths from cancer of the lung and bronchus has again increased. At the 1958 Health Congress the Minister of Health, in his presidential address, said "the Medical Research Council have established as reasonable, a connection between smoking, particularly heavy smoking of cigarettes, and cancer of the lung. As with any other hazard to health which can be avoided by personal action, it becomes a part of the responsibility of the Ministry of Health and the local health authorities to make the public aware of the hazards and what can be done to avoid them." During the year in Hendon 61 men and 13 women died from this cause, 42 of whom were under 65 years of age. An increase of four compared with the previous year. INVESTIGATION OF SMOKING IN YOUTH CLUBS. An investigation was carried out into the smoking habits of a sample of members of certain youth clubs in Hendon. The following questions were asked:- 1. Have you ever smoked? 2. If you smoke, how many cigarettes do you smoke per week, or do you smoke tobacco in any other form? 3. Have you heard about the risks to health of cigarette smoking? 4. What was the nature of this risk, and where did you learn about it. The results of the findings have been recorded in the table attached. 134 returned satisfactory answers to the questions, and there were 12 spoiled papers, most of which had omitted one or other of the answers. The survey revealed that only 3 out of the 134 persons in the age groups 14-21 who were questioned were unaware of the possibility that cancer could follow cigarette smoking. In spite of this knowledge there was a large number of cigarette smokers, but three pipe smokers were discovered at the St. Michael and All Angels Youth Club at Mill Hill. (Details on page 18). 16 BOROUGH OF HENDON 17 18 INVESTIGATION OF SMOKING IN YOUTH CLUBS NAME OF CLUB: ANNUNCIATION CATHOLIC YOUTH CLUB Age Boys- Total 9 No. of cigs. Smoked per week Age Girls- Total 10 No. of cigs. Smoked per week Never Smoked NonSmoker Pipe Smoker Cigarette Smoker Never Smoked Non Smoker Cigarette Smoker 16 1 1 20 15 1 1 60 17 1 1 1 1 100. 100. 17 1 1 18 1 1 60. 60. 18 1 1 1 1 19 1 19 1 21 1 100 NAME OF CLUB: GOLDBEATERS SCHOOL OLD SCHOLARS' ASSOCIATION Boys - Total 24 Girls- Total 18 14 1 1 1 1 1 60. 4. 10 14 1 1 1 2 15 1 1 1 1 1 1 1 1 10. 10. 40. 20. 60. 20. 15 1 1 1 1 1 1 1 1 1 3. 2. 25. 25. 2. 5. 16 1 1 1 1 1 20. 40. 10. 7. 16 1 1 1 3. 90. 17 1 35 17 1 1 20 19 1 1 1 1 60. 4 10. 18 1 21 1 160 NAME OF CLUB: MILL HILL CATHOLIC YOUTH CLUB Boys- Total 18 Girls - Total 22 15 1 1 10. 10. 15 1 1 1 1 1 1 1 25. 25. 16 1 1 1 1 1 1 35. 30. 25. 16 1 1 1 1 1 1 17 1(½oz) 1 15 17 1 1 1 1 1 80. 5. 18 1 1 1 1 1 1 140. 280. 20. 90. 18 1 1 19 1 1 19 1 1 NAME OF CLUB: ST. MICHAEL & ALL ANGELS YOUTH CLUB Boys- Total 11 Girls - Total 3 15 1 15 1 16 1 1 50. 10. 15 17 1 1 1 17 1 1 18 1 1 40 19 1(10z) 1(10Z) 1 20 20 l(10z) NAME OF CLUB: RATLING BOYS' CLUB - Total 18 15 1 1 1 1 75. 15. 40. 50. 16 1 1 1 1 1 40. 10. 70. 70. 17 1 1 1 1 1 60. 70. 60. 65. 18 1 1 80 19 1 100. 20 l 100. ROAD TRAFFIC ACCIDENTS. The following tables show the road traffic accidents and casualties occurring within the Borough of Hendon during the year 1957 and the comparative figures for the years 1954, 1955, 1956 and 1957. 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 may not agree, therefore, with those shown in the list of causes of death supplied by the Registrar-General. The Registrar-General's figures refer to Hendon residents only, and the death may have occurred within the Borough of Hendon or outside the district. TABLE V. Month No. of Accidents Adults Children TOTAL Killed Seriously Injured Slightly Injured Killed Seriously Injured Slightly Injured January 50 2 10 49 - - 1 62 February 40 - 5 35 - 2 5 47 March 69 - 18 56 1 1 8 84 April 75 4 14 66 - 4 11 99 May 87 2 11 85 1 2 13 114 June 66 1 20 52 - 2 6 81 July 80 1 19 67 - - 13 100 August 74 - 13 79 - 1 6 99 September 83 5 19 76 - 3 13 116 October 88 3 20 69 - 1 7 100 November 74 1 16 82 - 2 12 113 December 87 2 23 86 - 2 5 118 TOTALS 873 21 188 802 2 20 100 1,133 19 TABLE VI CLASSES OF ROAD USER KILLED OR INJURED DURING 1957. MONTH PEDESTRIANS MOTOR DRIVERS MOTOR CYCLISTS PILLION PASSENGERS PEDAL CYCLISTS OTHER ROAD USERS Killed Serious Slight Killed Serious Slight Killed Serious Slight Killed Serious Slight Killed Serious Slight Killed Serious Slight January 2 4 8 - 2 10 - 2 12 - - 3 - 2 6 - - 11 February - 2 10 - - 9 - 3 11 - 1 - - 1 5 - - 5 March 1 7 9 - 2 10 - 2 19. - - 5 - 4 8 - 4 13 April 4 4 3 - 2 15 - 5 21 - - 2 - 6 13 - 1 23 May 2 4 15 - 3 20 - 3 15 - 1 5 1 2 14 - - 29 June 1 6 11 - 1 7 - 8 17 - 2 7 - 1 11 - 4 5 July 1 4 13 - 3 10 - 8 21 - 3 6 - - 15 - 1 15 August - 2 7 - 1 19 - 4 20 - 2 7 - 3 9 - 2 23 September 1 5 12 - 5 22 3 3 13 - 1 2 - 2 10 1 6 30 October 2 7 11 1 3 11 - 5 21 - 1 4 - 3 10 - 2 19 November 1 4 17 - 2 24 - 6 10 - 1 2 - 2 8 - 3 33 December - 5 13 1 7 30 - 2 12 - 1 1 - 3 9 1 7 26 TOTAL 15 54 129 2 31 187 3 51 192 - 13 44 1 29 118 2 30 232 TABLE VII. COMPARATIVE FIGURES OF ACCIDENTS AND CASUALTIES FOR 1954, 1955, 1956 AND 1957. 1954 1955 1956 1957 Total number of Road Accidents involving personal injury 776 930 892 873 Accidents per mile of road 4.64 5.57 5.33 5.19 CASUALTY FIGURES: Adults. Silled 17 17 17 21 Seriously Injured 148 196 171 188 Slightly Injured 706 830 813 802 Totals: 871 1,043 1,001 1,011 Children. killed 1 1 2 2 (0 - 15 years) Seriously Injured 28 16 29 20 Slightly Injured 92 117 109 100 Totals: 121 134 140 122 Combined Adults and Children Totals: 992 1,177 1,141 1,133 Casualties per mile of road 5.09 7.05 6.82 6.74 20 CLASSES OF ROAD USERS KILLED OR INJURED. YEAR Pedestrians Motor Drivers Mo tor Cyclists Pillion Passengers Pedal Cyclists Other Road Users Killed Serious Slight Killed Serious Slight Killed Serious Slight Killed Serious Slight Killed Serious Slight Killed Serious Slight 1954 8 59 167 1 11 135 8 45 149 - 9 30 1 25 139 - 27 178 1955 12 52 151 - 44 172 3 55 203 - 12 34 1 22 154 2 27 233 1956 11 71 123 1 24 215 3 46 192 - 5 34 1 22 128 3 32 230 1957 15 54 129 2 31 187 3 51 192 - 13 44 1 29 118 2 30 232 Included in the above table are the Children's Accident figures which are as follows:- YEAR Pedestrians Pedal Cyclists Other Road Users Killed Serious Slight Killed Serious Slight Killed Serious Slight 1954 1 16 51 - 6 23 - 6 18 1955 - 12 40 - 3 36 1 1 41 1956 1 18 42 1 8 33 - 3 34 1957 2 10 41 - 4 23 - 6 36 I am indebted to the Borough Engineer and Surveyor for supplying me with the figures. 21 SECTION B. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. TABLE VIII The following table shows the total number of corrected notifications, other than tuberculosis, received during the year. Disease Total number of cases notified Cases removed to hospital Scarlet Fever 158 30 Whooping Cough 207 3 Measles 2164 28 Acute Poliomyelitis Paralytic 24 23 Non-Paralytic 8 7 Diphtheria - - Pneumonia 121 33 Dysentery 25 4 Paratyphoid Fever 5 5 Erysipelas 12 1 Meningococcal Infection 1 1 Food Poisoning 27 7 Puerperal Pyrexia 116 112 Ophthalmia Neonatorum 16 16 TOTAL 2884 270 22 23 TABLE IX AGE DISTRIBUTION AGE GROUP DISEASE Scarlet Fever Whooping Cough Acute Poliomyelitis Measles Dysentery Meningococcal Infection Paralytic Non-Paralytic M. F. M. F. M. F. M. F. M. F. M. F. M. F. Under 1 year - - 6 2 - 1 - - 12 22 2 1 - - 1 - year 2 1 7 3 - - - - 77 57 1 - - 1 2 - years 7 3 10 10 - 1 1 - 115 98 1 1 - - 3 - years 5 4 7 13 - 1 1 1 129 115 1 - - - 4 - years 12 3 15 8 1 3 - - 163 142 2 - - - 5-9 years 42 50 42 56 2 2 1 2 598 563 3 2 - - 10 -14 years 17 7 6 11 1 2 - - 23 20 1 1 - - 15 -24 years 3 1 1 1 - - - 1 4 9 1 - - - 25 & over 1 - 2 7 6 4 1 - 3 10 2 6 - - Age unknown - - - - - - - - 1 6 - - - - TOTAL 89 69 96 111 10 14 4 4 1122 1042 14 11 - 1 Pneumonia Erysipelas Food Poisoning Puerperal Pyrexia Paratyphoid Fever M. F. M. F. M. F. M. F. M. F. Under 5 years 2 1 - - 2 1 - - - - 5-14 years 7 5 - - 1 1 - - - 1 15-44 years 21 11 1 - 2 5 - 116 - 4 45 - 64 years 19 18 3 4 - 6 - - - - 65 & over 11 26 1 2 3 6 - - - - Age unknown - - - 1 - - - - - - TOTAL 60 61 5 7 8 19 - 116 - 5 24 TABLE X, 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 Park Golders Green Garden Suburb Childs Hill Edgware Scarlet Fever 20 20 7 15 28 23 11 17 17 158 Whooping Cough 20 30 27 15 29 19 15 22 30 207 Acute Poliomyelitis Paralytic 3 2 3 3 1 4 1 4 3 24 Non-Paralytic - - - 1 1 2 2 1 1 8 Measles 244 166 67 208 287 248 199 276 469 2164 Meningococcal Infection - - - 1 - - - - - 1 Pneumonia 16 27 9 15 13 6 - 22 13 121 Dysentery 4 7 3 2 - - - - 9 25 Erysipelas 2 1 1 - - 4 1 3 - 12 Food Poisoning 2 2 2 2 3 5 - 9 2 27 Puerperal Pyrexia 5 73 3 7 10 6 3 5 4 116 Ophthalmia Neonatorum 2 12 2 - - - - - - 16 Paratyphoid Fever - - - 1 2 1 - - 1 5 TOTAL 318 340 124 270 374 318 232 359 549 2884 NOTIFICATIONS OTHER THAN TUBERCULOSIS POLIOMYELITIS There was an increase in the number of cases of Poliomyelitis notified during the year, 32 cases occurring compared with 13 in 1956. Of the 32 cases, 24 were paralytic and 8 non-paralytic. Three of the cases were fatal and a fourth notified in November 1956 died in February, 1957. The cases, with the exception of 3, occurred in the second half of the year and the monthly distribution was as follows:- January 2 February - March - April - May 1 June - July 2 August 12 September 6 October 6 November 2 December 1 Twenty of the cases occurred in children up to the age of 14 years, the remaining 12 being adults. The cases were spread throughout the Borough and the ward distribution was as follows: - Mill Hill 3 Burnt Oak 2 West Hendon 3 Central 4 Park 2 Golders Green 6 Garden Suburb 3 Childs Hill 5 Edgware 4 In the U.S.A. , where large-scale immunisation against Poliomyelitis has been carried out, the number of paralytic cases dropped in 1957 to 4,153 from an average figure of 22,000 for the previous five years. It is to be hoped that immunisation against this crippling disease will proceed apace and bring the same benefit here as soon as possible. 25 Puerperal Pyrexia. There was an increase in the number of cases of puerperal pyrexia. 116 cases occurring compared with 113 in 1956. Of the 116 cases, 51 only were Hendon residents, the remainder being women from other areas who entered the maternity hospital in the Borough for their confinements. Notifications in respect of these cases have to be accepted by the Borough of Hendon and not by the Authority within whose area the patient is normally resident. In consequence, the rate for Hendon is high. That for the year 1957 is 59.7 per 1,000 total (live and still) births. If the figure for the Hendon residents only is taken the rate is 26.2 per 1,000 total (live and still) births. The rate for England and Wales is 15.99. Ophthalmia Neonatorum. There was an increase of 3 in the number of cases notified - 16 cases, compared with 13 in 1956. All the cases were admitted to hospital. Scarlet Fever. There was an increase of 22 in the number of cases of scarlet fever notified during the year, 158 cases occurring compared with 136 in 1956. 30 of these cases were removed to hospital. Fortunately, today scarlet fever is a mild complaint compared with the disease which occurred in the earlier part of this century. Measles. During the course of the year 2164 cases of measles were notified, compared with 295 in 1956. As mentioned in my last report it was expected that an epidemic would occur in the spring of 1957. It is interesting to note that most of the cases occurred in the first half of the year, and in the last quarter no case was notified. Measles tends to occur in epidemic form every two years. An epidemic, therefore, may be expected in the spring of 1959. Whooping Cough. This disease showed an increase on the 1956 figure, 207 cases being notified compared with 135 last year. Dysentery. Twentyfive cases of dysentery were notified compared with 54 in 1956. The cases were spread throughout the Borough. 26 Recent research into the spread of Sonne Dysentery shows that this disease is most easily spread when humidity is high, the temperature low, and there is a lack of sunlight, a combination of circumstances not uncommon in school lavatories. Food Poisoning. Twentyseven notifications of food poisoning were received during 1957, three more than in 1956. The cases were distributed throughout the year as follows:- First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. 13 4 5 5 27 In ten cases the organism was identified as salmonella typhi-murium and one as salmonella dublin. Eight cases occurred in an old persons home, for which no definite cause was found; the remainder of the cases were reported in different families scattered throughout the Borough. A report that food poisoning germs are common in bone meal, dried sludge and certain fertilisers, led to an enquiry into the possible association between cases of food poisoning and the use of organic fertilisers, but no case was traced to this source. Paratyphoid Fever. Five cases of paratyphoid fever were notified during the year compared with six in 1956. These were isolated cases and were spread throughout the Borough with no common source of infection. Two of the patients had returned to this country from holidays abroad just prior to notification, another had been on holiday at the seaside. Influenza. An outbreak of Asian influenza occurred in October, 1957. The highest illness attack rates were in school children, of whom some two-thirds were ill. About a quarter of the pre-school children and of young adults had the disease, and a lower proportion of older adults, The first case was reported in Hendon on the 9th September. Diphtheria. No case of diphtheria was notified during the year. The following table shows the number of cases and the deaths from diphtheria since immunisation was introduced on a large scale in 1935. 27 TABLE XI Year Number of cases of Diphtheria. Number of Deaths from Diphtheria. 1935 189 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 - - 1955 - - 1956 1 - 1957 - - 28 DIPHTHERIA IMMUNISATION The following table, the figures for which I am indebted to the Area Medical Officer, shows the number of children resident in the Borough of Hendon who received immunising injections during 1957. TABLE XII. NUMBER OF CHILDREN RESIDENT IN THE BOROUGH OF HENDON WHO RECEIVED IMMUNISING INJECTIONS DURING 1957. Age at time of injection Primary Inoculations Reinforcing Injections Diphtheria only Combined Diphtheria and Whooping Cough Whooping Cough only Diphtheria only Combined Diphtheria and Whooping Cough Whooping Cough only Under 1 year of age 208 715 116 . . . 1 - 2 years of age 122 211 80 3 3 - 2 - 4 years of age 43 50 11 126 21 2 5-14 years of age 63 12 2 1773 58 1 15 years and over - - - - - - TOTAL 436 988 209 1902 82 3 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 1957. TABLE XIII. Age at 31st December 1957 Under 1 year 1-2 years 2-4 years 5-14 years 15 years and over TOTAL Number vaccinated 1,088 71 55 104 127 1,445 Number re-vaccinated - 1 15 72 796 884 29 CHEST DISEASE Notification of Tuberculosis The following table shows the number of cases of tuberculosis notified for the first time during the year 1957 and transfers into the district. TABLE XIV Age Group in years. Respiratory Non-Respiratory TOTAL Males Females Males Females New cases Transfers into District New Cases Transfers into District New Cases Transfers into District New Cases Transfers into District Under 5 years 1 - 1 1 - - - - 3 5-14 1 1 1 2 1 - 1 - 7 15-24 10 2 10 11 1 - - 1 35 25-44 24 18 23 18 2 1 - 1 87 45 - 64 18 8 7 2 1 - 1 1 38 65 & over 2 2 3 1 1 - 1 - 10 Age unknown - - - - - - - - - TOTAL 56 31 45 35 6 1 3 3 180 The ward distribution of tuberculosis for the year 1957 is shown below. The figures refer to primary notifications only and do not include cases transferred into the district. TABLE XV WARD TOTAL Mill Hill Burnt Oak West Hendon Central Park Golders Green Garden Suburb Childs Hill Edgware Respiratory 11 11 11 17 13 11 7 12 8 101 Non- Respiratory 1 - 1 - 1 - 1 2 3 9 TOTAL 12 11 12 17 14 11 8 14 11 110 30 The following table shows the primary notification of tuberculosis, excluding inward transfers, for the ten-year period 1948-1957. TABLE XVI Year Respiratory Non-Respiratory TOTAL M. F. M. F. 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 1955 58 34 5 13 110 1956 60 38 4 12 114 1957 56 45 6 3 110 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 8 3 11 2 1 3 10 4 14 The number of cases of tuberculosis remaining on the Register at the end of the year is as follows:- Respiratory Non-Respiratory Total M. F. M. F. M. F. 777 625 87 85 864 710 1402 172 1574 31 THE CHEST CLINIC I am indebted to Dr. H. J. Trenchard, Physician-in-Charge of the Edgware Chest Clinic, from whose Annual Report I have extracted the following information:"Area Served The normal catchment area of the Edgware Chest Clinic includes the Borough of Hendon, those parts of the Borough of Harrow included in the Edgware and Stanmore postal districts and the Borough of Wembley north of the Kingsbury Road. The sociomedical team at the Clinic, which comprises Health Visitors and Welfare staff appointed by the Middlesex County Council to work under the immediate direction of the medical staff, is responsible primarily for this area. However, as an important function of the Chest Clinic is to provide a consultative service for the neighbourhood, many patients whose addresses are slightly outside the boundaries mentioned are referred by their practitioners for opinion. Liaison. Close liaison is maintained with the Middlesex County Council Area Medical Officers and with the Medical Officers of Health of the Boroughs of Harrow, Hendon and Wembley. There is exchange of information and mutual assistance between the clinic staff and the School Medical Service who undertake B.C.G. vaccination of school children. Use is made of the results of pre-vaccination tuberculin tests carried out by the School Service to select appropriate home contacts of the positive reactors for radiological examination. In consequence of this work fewer tuberculin surveys have been carried out by the clinic than in previous years. The level of tuberculinisation in the area remains in general low, but is slightly higher in the more southern than in the northern parts. The Welfare Department of the Clinic maintains a liaison with other organisations, both voluntary and statutory, concerned in the welfare of patients (e.g. local secretaries of Soldiers, Sailors and Airmen's Families Association, the National Association for the prevention of Tuberculosis, the Disablement Resettlement Officers at the local Employment Exchanges, area officers of the National Assistance Board, the local officers of the Ministry of National Insurance, housing departments of Local Authorities, etc. etc.). Occasionally general practitioners also get into direct touch with the Welfare Department over problems of their (and our) patients. Certain wards in Edgware General and Colindale Hospital are in the charge of members of the medical staff of the clinic and it is into these beds that many patients are admitted. Some, as mentioned later in this report, are sent further afield when this is necessary for the condition from which they are suffering. 32 Consultative Services. The main consultative functions of the Chest Clinic have continued as in previous years. The volume of work has been maintained. There is a slight decline in total attendances due principally to a diminution in the numbers of patients for refill treatment. Collapse measures are less frequently used in the treatment of tuberculosis than formerly as long term chemotherapy is taking the lead as a favourite method of control. Most of the patients seen are referred by their practitioners and considerable use is made of the system of "Chest X-Ray Only" for which no prior appointment is necessary. B. C. G. Vaccination. The Clinic staff have continued to undertake B.C.G. vaccination of suitable members of the staff of the Group and those needing it amongst domiciliary contacts of our tuberculous patients. Tuberculosis. The total number on the Tuberculosis Register decreased slightly. It will, it is hoped, show a further decrease in future years. There has been a big decrease in deaths, but the 1956 figure is not typical and is a bad comparison for 1957, for in the early months of 1956 an extra number of deaths occurred during exceptionally cold weather. So the improvement is not so great as might appear at first sight. Domiciliary treatment - particularly using chemotherapeutic drugs - has been continued on a considerable scale. This has shortened the time necessary for inpatient treatment and ensured that the waiting list has remained small. Antenatal Patients. There are reasons for believing that abdominal X-rays of pregnant women should be avoided unless essential. Chest X-rays are in a different category and the Odelca is specially coned to prevent exposure of the abdomen. So it is safe for pregnant women . For some years a scheme operated by Edgware and Harrow Chest Clinics has given facilities for chest X-ray for pregnant women. The Edgware results are detailed in the accompanying table and give an incidence of 1.3 cases of active tuberculosis per 1000 X-rayed, which is about the same rate as is found for women by Mass X-Ray Units operating in the vicinity. It has been estimated that in Hendon the percentage of women aged 15 to 44 who may be expected to be pregnant at any one time is 4.7. The percentage for the Borough 33 of Harrow similarly calculated is 4.72. It seems reasonable to presume, therefore, that very nearly 1 in 20 of women aged 15 to 44 may be expected to be pregnant at any one moment. In the years 1953 to 1957 there were 66 cases of active tuberculosis diagnosed in women aged 15 to 44, of whom 8 were pregnant at the time of diagnosis. This is an incidence of approximately 1 in 8; so that the results obtained at Edgware Clinic suggest that the risk of women having tuberculosis when pregnant is at least as great as at any other times - and possibly greater - and that the antenatal X-rays are a wise precaution. There is a sound case also for encouraging the X-ray of expectant fathers (and in fact of all adults in the household into which a baby will arrive). During 1957 a death occurred of a young infant from tuberculosis (the first in the area for a number of years). The child had been infected by its father who, unknown to himself and feeling well, was nevertheless a case of infectious tuberculosis. A diagnosis was made as a result of investigations which followed the diagnosis of tuberculosis in the child. Had he been X-rayed during his wife's pregnancy this tragedy might have been avoided. Carcinoma. A number of cases of carcinoma of the lung continue to be diagnosed at the clinic - the majority occur in heavy smokers. In their treatment close liaison is maintained with the thoracic surgical units at Clare Hall, Colindale and St. Charles Hospitals and with the radiotherapeutic departments of the Middlesex and Mount Vernon Hospitals. Those suffering from the disease are usually steady and responsible middle-aged or elderly people - often with a little business of their own, A large proportion of the follow-up work and attention to the social aspects of the problem is undertaken at the Clinic. A number of patients who have had treatment are encouraged to return to work. At the end of the year 23 were back at work. Chronic Bronchitis. Special interest is taken in the clinical, social and preventive aspects of this problem which causes much suffering. The clinic has acted as one of the centres in the Medical Research Council's research investigation into the relation between chronic bronchitis and atmospheric pollution. In the treatment of the condition close touch is maintained with general practitioners, the physical medicine department of Edgware General Hospital and the bronchitis units at Clare Hall and Pinewood Hospitals. 34 Arrangements were made at the end of November to send to these country hospitals a number of chronic bronchitis cases, so as to ensure that in the winter months they were outside the built-up area of Greater London with its liability to fog. Those selected were liable quickly to become casualties under fog or smog conditions and so to require immediate admission to hospital at a time of the year when considerable pressure on hospital bed accommodation is the rule. Such cases exposed to fog can in a couple of hours change from ambulant though wheezy individuals into emergencies requiring oxygen tents as a life saving measure. Their evacuation to country hospitals is consequently of preventive as well as therapeutic value. About 20 were recommended for such admission - more should have gone, but there is a limited amount of accommodation for them. It is often difficult to persuade a patient to agree to move in time (i.e, before the fog season), and two deaths occurred in early December in patients where there had been delay in the recommended transfer to a hospital outside London. GENERAL 1953 1954 1955 1956 1957 New patients referred to Clinic 8,295 8,459 9,439 10,909 10,769 Total attendances 30.644 30,841 32.454 31,744 29,872 Total attendances for refills 10,114 9,523 8,652 7,454 6,299 Number of persons X-rayed 16.537 17,096 16,544 17,173 17,709 Number of home visits by physicians 383 415 286 411 431 Sessions held 861 861 1,192 1,198 1,211 TUBERCULOSIS REGISTER. New respiratory Tuberculosis cases 171 180 147 149 152 New non-respiratory Tuberculosis cases 16 26 24 27 17 Total new Tuberculosis cases 187 206 171 176 169 Tuberculosis cases on register on 31st December 1,764 1,767 1,788 1,733 1,600 Removed from register because of death 44 32 24 44 25 Removed from register as recovered 54 89 57 68 155 LUNG CARCINOMA REGISTER. New cases diagnosed 38 33 41 50 55 Cases known to have died (all causes) 23 19 36 36 36 Antenatal patients X-rayed 970 1,489 1,482 1.040 1,140 Number found to have active tuberculosis 1 4 1 1 1 MASS X-RAY During the year the Mass X-Ray Unit 5B under the direction of Dr. J.R. Mikhail, Medical Director of the Unit visited the Borough. Public sessions were held in West Hendon, The Hyde, Colindale, Burnt Oak Broadway, Edgware, Mill Hill Broadway and Mill Hill East. In addition, a street to street survey was carried out in an area adjoining Hendon Isolation Hospital and the staffs of various small firms and shops were also X-rayed. 35 SECTION C. GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. Establishments for Massage or Special Treatment. 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. The Council considered and granted the following applications:- New Licences 2 Renewals of Licences 29 Certificates lodged under Section 363 by members of the Chartered Society of Physiotherapy 4 Licences Refused Nil. NATIONAL ASSISTANCE ACT, 1948. NATIONAL ASSISTANCE (AMENDMENT}) ACT, 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. It was not found necessary to take formal action in any case. Twenty-one cases, however, where it was thought that the person might be in need of some attention, were brought to the notice of the Public Health Department. Each person was considered individually and advised how best they could be helped by the existing voluntary and statutory services. In those cases where removal was essential, the old people concerned agreed to 36 go into hospital or other accommodation voluntarily. In dealing with the problem the co-operation of Mr. R. R. Holland, the Area Welfare Officer, has been greatly appreciated. There is, however, a need for the power and the facility to cleanse the home of an old person who is admitted temporarily to a hospital or institution. For example, an old lady lives happily on her own with a large number of cats, and her home becomes dirty. If she is admitted to hospital there would appear to be an opportunity to clean the house for her return, but under present legislation this cannot easily be done. Many of these cases, although in need of attention, do not come within the provision of Section 83 of the Public Health Act of 1936, or the scope of the Home Help Service. There is also an occasional need for the services of an organisation willing to carry out this unpleasant work, and to "spring clean" these homes when such an opportunity occurs. NATIONAL ASSISTANCE ACT, 1948. SECTION 50 - PUBLIC BURIALS. Under Section 50 of the National Assistance Act, 1948, the 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 two burials were carried out, one being an unknown child and the other an adult. GENERAL HOSPITAL FACILITIES. Edgware General Hospital. Hendon District Hospital. INFECTIOUS DISEASES - 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. Admissions are also arranged through the Regional Hospital Board to the Regional Chest Hospitals, particularly Clare Hall and Colindale. The Chest Clinic at Edgware serves primarily those living in the Borough of Hendon and the Stanmore, Queensbury and Kingsbury districts of Harrow and Wembley. 37 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 Dental Services. (Provided under Education Act, 1944, the Borough of Hendon being an Excepted District.) *These services are administered on an area basis, Area 4 consisting of the Boroughs of Hendon and Finchley. The Area Health Committee acts as a Sub-Committee of the 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. MEDICAL PRACTITIONER SERVICE. The Middlesex Executive Committee has classified the different wards of the Borough into two categories. (1) Intermediate Area - Burnt Oak, Central, Childs Hill, Edgware, Mill Hill, Park and West Hendon. In these areas the number of patients on the average general practitioner's list is reasonable. New practices may be established in such areas but the initial practice allowance is not likely to be paid. (2) Restricted Areas - Garden Suburb and Golders Green Wards. These are areas in which the number of doctors is adequate. Normally application by doctors to start new practices is not granted. LABORATORY FACILITIES. These are provided at the Central Public Health Laboratory, Colindale. Specimens may be sent direct to the Laboratory by Medical Practitioners 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. 38 I would like to express my appreciation of the work carried out by the staff at the Laboratory who, during the course of the year, has given considerable advice and help to the Public Health Department. The number of samples taken in respect of milk, ice cream, domestic water supplies and swimming pools are shown elsewhere in the report. THE EDGWARE GROUP HEALTH SERVICES LIAISON COMMITTEE. The Medical Liaison Committee was set up in 1956 to improve liaison between the different sections of the National Health Service. The Committee meet about four times a year to consider problems of liaison and some of its activities during the past year are summarised below: Liaison between Hospital Consultants and General Practitioners. The Secretary of the Medical Staff Committee of Edgware General Hospital has now arranged for a note to be sent to the general practitioner on the day his patient is discharged from hospital. Liaison between Health Visitors and General Practitioners. The Committee has suggested that the best liaison between Health Visitors exists in areas where the Health Visitors have made appointments by telephone with medical practitioners, visited them and explained the scope and possibility of the health visiting service. Liaison between Health Visitors and Hospital Staff. Arrangements have been made for Health Visitors to attend the geriatric and diabetic Outpatient Departments of the Edgware General Hospital so that they would be able to help patients with social, nursing or dietetic problems. Liaison between Hospital and Local Health Authority Clinic Medical Staff. The Paediatrician of Edgware General Hospital and the Area Medical Officers of Hendon and Wembley have made an arrangement for the interchange of a medical officer between the two branches of the Health Services concerned. Ante-Natal care of cases booked for hospital confinement. The Committee, together with representatives of Harrow Division of the B.M.A. , discussed the arrangements for the ante-natal care of women booked for confinement in Edgware General Hospital. Discussion is still proceeding. Specialist reports from Local Health Authority Clinics. School Medical Officers refer cases directly to Ophthalmic, Orthopaedic and E.N.T. Specialists unless the child's own doctor has requested the Area Medical Officer to make alternative arrangements for his patients. 39 Influenza. The Chief Medical Officer of the Ministry of Health had written to the County Medical Officer to ask Liaison Committees to consider the emergency arrangements needed in the event of a serious outbreak of influenza. The Liaison Committee (and other similar committees in Middlesex) made a variety of suggestions for augmenting the general practitioner and home help services in the event of a serious influenza epidemic. Fortunately the epidemic was successfully dealt with by the existing services. X rays in Pregnancy. Dr. Alice Stewart of Oxford has suggested that leukaemia in childhood is frequently associated with ante-natal pelvic X-rays. The Committee heard papers on this subject from Dr. Topham, the Consultant Radiologist, and from Mr. Rosser, the Consultant Obstetrician and Gynaecologist, who described the risks of and the indication for X-Ray during pregnancy. Dr. Scott, the County Medical Officer of the London County Council, had arranged that Chest X-rays of expectant mothers should not be carried out during the first three months of pregnancy. After hearing the two papers the Committee considered that serious damage could be done to the foetus by extensive radiological examination and for that reason accepted Mr. Rosser's dictum that "no woman should have a pelvic X-ray except in the fortnight following a normal menstrual period during the childbearing years of her life." Proposed Hospital at Nortbwick Park. The Committee expressed concern at the abandonment of the proposal to build a general hospital at Northwick Park by the Board of Governors of Charing Cross Hospital. The existence of this proposal for many years has served as a reason to defer the building of other new hospitals in the area and also to prevent the much needed extension of the hospitals which now serve the district. The Committee is strongly supporting the resolution sent to the North West Metropolitan Regional Hospital Board by the Willesden Borough Council. The Colindale Hospital. There is a non-tuberculous chest unit for males over the age of 16 of twentyfive beds at Colindale Hospital, for the investigation and treatment of pulmonary conditions other than tuberculosis. Cases of cardiac failure etc. are also admitted, but its aim in the main is to treat acute conditions or acute conditions in chronic 40 cases. Thoracic surgery is available where necessary. Admission is direct by telephone from the general practitioner and there is no restriction on the locality from which patients are admitted. (Tel. Colindale 7276). Admission can nearly always be arranged immediately. There is also a small, similar unit for females, but there may be some delay in admission to this unit. It will be necessary for transport to be arranged by the doctor sending the case. I am indebted to Dr. G. Barwell, Chairman of the Edgware Group Health Services Liaison Committee for this report. WELFARE OF OLD PEOPLE I am indebted to Alderman J. L. Freedman, J.P. , M.A., LL.B., Chairman of the Hendon Old People's Welfare Committee for the Report for the year 1957-58. "During the year under review the work of the Committee has been maintained quietly but efficiently and, as was envisaged in last year's report, the convenience of having our office in premises used exclusively by ourselves has been of enormous advantage. The highlight of the year was the presentation to us last September by Mrs. Gerald Legge's Fund for Old People of a Coach for the use of Old People in the Borough together with a sum in cash towards the first year's operating expenses. Operational details had to be worked out and the colder weather came on before we had been able to make as much use of the Coach as we would have desired, but, given clement weather, the various Organisations in the Borough will, we trust, take full advantage of the Coach during the coming Summer. We have continued to keep our Office open every week day except Saturday, and a perusal of the Day Book shows the prompt and helpful way in which our capable Organising Secretary deals with all the problems referred to her. VISITING. Much hard work has been put in during the year to complete the drawing up of a panel of volunteers in every part of the Borough who are prepared at short notice to call on Old Folk, and although scarcely a day passes without a request for the making of such a call being received, it is now possible for the Organising Secretary almost immediately to arrange for the visit to be made. Our best thanks are due to those many voluntary helpers who have undertaken this task. CHIROPODY. The extension of the chiropody service mentioned in last year's report has been put into operation, and, under our aegis, many Old People now receive treatment at Chiropodists' Surgeries. The British Red Cross Society has continued to hold Clinical 41 Sessions at their local Headquarters, and housebound patients are still treated in their own homes. We are grateful to the National Corporation for the Care of Old People for their generous financial support towards the cost of this scheme. CLUBS. Our Club at 158 Station Road, Hendon, which is open every weekday afternoon except Saturday, continues to be a most popular institution. Apart from it providing a congenial place where the Old People can enjoy each other's company, instructive talks, film shows and entertainments are given there from time to time and the Constituent Organisations who provide the Duty Officers also organise in turn a monthly evening Whist Drive which is much enjoyed by all attending. On one occasion such a Whist Drive has been organised by a lady not directly connected with the Committee as a token of her appreciation of the Committee's work. The members of the Club have set up a Cheer Fund to which they contribute themselves in order to provide small gifts to cheer any members who may be confined to home through sickness. Our Constituent Organisations who run weekly Club afternoons in various parts of the Borough have maintained such activities throughout the year. ANNUAL HOLIDAY. In an endeavour to introduce some change of venue for the Annual Holiday which we organise, arrangements were made last summer for the party to go to Eastbourne. All who went had a thoroughly enjoyable time, but it seems that our Old People do not like changing things to which they have become accustomed and we have been requested to revert to Cliftonville as the place for the holiday this coming summer. Bookings have been made accordingly. CHRISTMAS GIFTS. The Salvation Army held a Christmas Gift Service and allocated the gifts brought by those attending the Service to the Old People of the Borough. They entrusted the distribution of the gifts to our Committee and as a result, many Old Folk in all parts of the Borough received parcels of "extras" for Christmas, and in some cases a small gift of cash. We ourselves provided, as usual, Christmas Dinners without charge to homebound old people, the distribution being undertaken by the W.V. S. Meals on Wheels Service. OTHER GIFTS. We have to acknowledge with thanks the gift of a Piano Player for our Club and numerous other gifts of produce, clothing and the like which were placed where they could be of most benefit. 42 ACKNOWLEDGEMENTS. We gratefully acknowledge the work done for the Old People during the year by our Constituent Organisations and Co-opted Members, both as part of their own work and in co-operation with the Committee. Thanks also are due to the Borough Medical Officer of Health and the County Welfare Officer who always are prepared promptly to deal with cases where their assistance is required. We further have to thank the Hendon Borough Council, the Middlesex County Council Sunday Entertainments Fund and the National Corporation for the Care of Old People for their continued financial support and those many individuals and organisations who have arranged functions in support of or have directly contributed to our funds. We would also thank the Local Press for the publicity which they continuously give to our endeavours. Finally, I wish, personally, to thank my Fellow Officers, the members of the Executive Committee and our indefatigable Organising Secretary, all of whom have been untiring in their efforts to fulfil our task of giving a Helping Hand to the Old People of Hendon whenever it may have been required," HENDON OLD PEOPLE'S HOUSING SOCIETY. There is a need for more small homes for the increasing number of old people in the population. The era of the institutional care, when old people were housed in large numbers in large buildings, has passed. Today our aim should be directed towards care on a local or even a parochial basis, so that eventually we have a small home of the Church Walk House type for each ward of the Borough. Church Walk House, in the Childs Hill Ward, has done most valuable work in providing accommodation for 48 elderly people. I am indebted to the Honorary Secretary, Mr. A. E. Harvey of 36 Grampian Gardens, N.W.2, for the Second Annual Report, in which he stresses the need for more old people's homes and points out that in the Borough of Hendon there are approximately 23,000 persons over the age of 60. STAFF MEDICAL EXAMINATIONS. During the year under review 110 new entrants or employees of the Hendon Borough Council were medically examined for superannuation purposes. Of this number, 99 employees were passed as fit, 6 were unfit and in 5 cases the decision was deferred pending further medical examination. The number of examinations in respect of each department of the Council was as follows:- Town Clerk's 13 Borough Treasurer's 11 Borough Engineer's 55 Library 21 Housing 10 110 43 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 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 44,073 (b) by means of standpipes Nil Number of population supplied from public water mains:- (a) Direct to houses 152,600 (b) by means of standpipes Nil Natural fluoride content of water supplies:- Colne Valley Water Company: Fluoride content - Nil Metropolitan Water Board: Fluoride content -0.15 parts per million. The water supplied to Hendon is deficient in fluoride when compared with supplies in certain other places such as Slough, South Shields and Burnham-on-Crouch, where fluoride is present naturally in the water, or in Watford where it is now being added in the interest of better dental health. The incidence of dental decay in children is reduced by more than half when the drinking water contains adequate fluoride. 44 In the future I have no doubt that fluoride will be added to all supplies which are deficient in order to promote better dental health. HOUSING. I am indebted to the Housing Officer for the following observations and statistics relevant to the housing situation. "Marked progress has been maintained during the past year in providing accommodation for persons in need of alternative accommodation and 334 families were rehoused into permanent houses and flats. The number of Council dwellings at 31st December 1957 was 3,523 of which 2,233 have been erected in post-war years. Notwithstanding these additional dwellings the number of applications for accommodation has continued and the demand has far outstripped the Council's resources. The coming into force of the Rent Act 1957 resulted in a sharp increase in the number of new applications from persons who either feared they would not be able to obtain other accommodation should their landlords reclaim possession or who anticipated that they would not be able to afford increased rentals. The total number of outstanding applications at 31st December 1957 was 4,097. Scarcity of building land now compels the Council to develop flat accommodation and an outstanding feature of the dwellings completed this year has been the 11-storey point blocks at Spur Road, Edgware and Claremont Road, Hendon. Also forming an essential part of these modern estates has been 2 and 4-storey "slab blocks" providing the larger three bedroomed flats, The point blocks contain 43 2-bedroomed and one single bedroom flat which is situated at ground level, These flats are fully provided with central heating and constant hot water and have lifts to all floors. Flats are wired for ready installation of telephones and television and the ultimate aim is to secure an estate which is attractive in appearance, comfortable to live in and convenient. In due course communal facilities will be furnished for meetings and recreation. The redevelopment of the older parts of the Borough has entailed the acquisition by the Council of properties in these areas. Apart from the areas in general need of redevelopment cases arise where isolated properties have fallen into an advanced state of disrepair and in order to close these to human habitation as soon as possible it is the policy of the Council to assist the occupants with permanent accommodation. Families residing in unfit houses are given consideration according to their special needs. In accordance with the provisions of the Requisitioned Houses and Housing 45 (Amendment) Act 1955 the release of requisitioned properties has continued and the Council have negotiated the purchase of several houses in order to increase the number of permanent dwellings. All new estates have a proportion of conveniently designed homes for accommodating elderly persons and during the year these have been used to help several elderly couples and unattached persons. However, the demand from this type of applicant is very heavy and it is only possible to satisfy a small number of cases. The assistance afforded in the past by the New and Expanded Towns has continued and many families have been nominated by the Council for rehousing in those areas. Some indirect benefit is also derived by reason of the fact that 'key' workers in industries established in the New Towns are provided with accommodation by Development Corporations and as many of these persons may have been occupying houses and flats, their removal has released a certain amount of private accommodation in the Hendon area. The policy of transferring Council tenants living in accommodation in excess of their requirements to smaller dwellings, has enabled the larger type of houses and flats to be re-let to bigger families and has relieved many cases of overcrowding. Every opportunity has been taken to co-operate with other local authorities and private property owners to secure exchanges of tenancies which have proved mutually beneficial. The following table sets out the number of housing applicants assisted during the year ending 31st December 1957. 1. Number of families rehoused in permanent accommodation, (a) Pre-war Houses, etc. 30 (b) Post-war Houses 304 (c) Temporary Bungalows 2 336 2. Transfers arranged to deal with overcrowding, under-occupation, etc. on Council estates 177 3. Families given emergency accommodation in Half Way Houses 5" 46 SANITARY INSPECTION. The following summary of the inspection work, together with a report on the various duties performed by the Public Health Inspectors, has been submitted to me by Mr. A. H. Smith, Chief Public Health Inspector. During the year under review inspections were carried out as set out below:- Inspections made 6,165 Re-inspections after order or notice 12,747 Complaints received and investigated 1,284 Bakehouses 96 Butchers Shops 241 Caravans 135 Clean Air Act Inspections 144 Dairies 20 Drain tests 222 Factories 92 Hawkers and food delivery vans) 27 Hawkers storage premises and stalls) Ice Cream Samples 16 Ice Cream premises 36 Infectious Disease 365 Licensed premises 118 Milk samples 77 Other food shops 994 Overcrowding 13 Outworkers 48 Piggeries 17 Public entertainment in connection with licensing 81 Restaurants, cafes, etc. 348 Smoke observations 188 Stables 27 Swimming baths 20 Pet Animals Act 1951 15 Hairdressers and Barbers premises 44 Notices Served. Informal or cautionary 732 Complied with 695 Statutory Notices. Applied for 126 Served under Public Health Acts 69 Outstanding from 1956 10 Complied with during 1957 55 Outstanding at end of 1957 24 Inspection of Dwelling-Houses During 1957. Total number of dwellinghouses inspected for housing defects (under Public Health Acts) 1,483 Number of inspections made for the purpose 3,915 Number of dwellinghouses found not to be in all respects reasonably fit for human habitation 483 47 Legal Proceedings under Public Health Act., 1936. During the year it was found necessary to institute legal proceedings in three cases. In one instance the Magistrates made an order requiring the nuisance to be abated within 28 days, and awarded the Council £3.3.0. costs. The owner appealed to the Quarter Sessions this appeal was dismissed and the Council awarded 25 guineas costs. The next case was for non-compliance with a Notice served under Section 39 of the Public Health Act 1936; the Magistrates imposed a fine of £2.0.0. and awarded the Council £2 2.0, costs. The work was carried out by the Council in default, and the cost recovered from the owner The third case was for an abatement of a nuisance arising from the keeping of cats The Magistrates granted a Nuisance Order requiring it to be complied with in 14 days, a fine of £2.0.0 being imposed and the Council awarded 10/6d costs. It was also necessary in this case for a Warrant for Sitry to be applied for by the Public Health Inspector. HOUSING ACTS, 1936-1957. During the year under review 32 houses were dealt with under the Housing Acts, 1936 or 1957, involving the making of 21 Demolition Orders and 9 Closing Orders, In one of the remaining cases the Council accepted an undertaking from the owner to carry out the works necessary to render the house fit, and in the other, the owner on being notified of the Council's intention to consider the making of a Closing Order, proceeded forthwith to carry out the necessary works and rendered the house fit. Certificates of Unfitness were issued under the Housing Subsidies Act, 1956 in respect of 18 houses in the Council's ownership. Of the 50 houses, 15 were actually closed during the year, and 2 were demolished. In addition, 14 houses were closed and 14 demolished in respect of which Closing or Demolition Orders had been made prior to 1957, During 1957, 43 families involving 148 persons were displaced from unfit properties, 37 families involving 130 persons being rehoused by the Council and 6 families involving 18 persons being rehoused by other authorities or finding their own accommodation. Proceedings were taken against the owner of a house for allowing the house to be occupied where the Closing Order had not been determined. The Defendant was fined £10.0.0. and ordered to pay £4.10.0. costs. 48 HOUSING REPAIRS AND RENTS ACT, 1954. The following figures show the number of applications for Certificates of Disrepair and Revocation and the action taken during the year. Certificates of Disrepair Number of applications received 4 Number of certificates issued 2 Number of applications refused 1 Number of cases in which the applicant was not entitled to a certificate or the application was withdrawn 1 Revocations Number of applications received 1 Number of certificates of revocation issued 1 Number of applications refused RENT ACT, 1957 Applications for Certificates of Disrepair Number of applications for certificates 64 Number of decisions not to issue certificates 1 Number of decisions to issue certificates 51 (a) in respect of some but not all defects. 34 (b) in respect of all defects 17 Number of undertakings given by landlords under paragraph 5 of the First Schedule 30 Number of undertakings refused by Local Authority 2 Number of Certificates issued 6 Applications for Cancellation of Certificates Applications by landlords to Local Authority for cancellation of certificates 19 Objections by tenants to cancellation of certificates 12 Decisions by Local Authority to cancel in spite of tenants" objection 2 Certificates cancelled by Local Authority 9 49 Cinemas and Places of Entertainment and Licensed Houses During the year 199 inspections were made by the Public Health Inspectors and detailed reports submitted to the respective licensing authority. Smoke Abatement. Number of observations made during the year 188 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 254 occasions during the year. Disinfestation of Verminous Houses. 7 houses were successfully treated, Privately owned 6 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. During the year 335 library books and 13 gramophone records were disinfected. The number of rooms disinfected during the year was 220. 50 Swimming Baths There are two swimming baths within the district owned by the Local Authority, one at West Hendon and one at Mill Hill, Visits are paid by the Public Health Inspectors and samples taken of the water particularly during hot weather when the baths are most frequently used. Twenty-one samples taken from the Municipal Swimming Baths were all satisfactory. Rag Flock and other Filling materials Act, 1951. Number of Registered Premises 3 Pet Animals Act, 1951. Number of Licences Granted 11 Hairdressers and Barbers. Forty-four inspections were made in connection with the Byelaws made under Section 282 of the Middlesex County Council Act, 1944. 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 Public Health Inspectors and in accordance with recommendations of the Ministry of Agriculture, Fisheries and Food. 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. During the year under review it was found necessary to serve one notice under Section 4 of the Act. This was complied with and legal proceedings were not necessary. A report on the work carried out for the year ended 31st December, 1957, is given in the following table, which is based on the return sent to the Ministry of Agriculture, Fisheries and Food. 51 TABLE XVII Type of Property Non-Agricultura1 (1) (2) (3) (4) (5) Local Authority Dwelling Houses (inc, Council Houses) All othe (inc. Business Premises) Totals of Cols. (1). (2) and (3) Agricultural 1. Total number of properties in Local Authority's District 17 44,073 5,702 49,792 10 2. Number of properties inspected as a result of (a) Notification 4 756 86 846 - (b) Survey under the Act - 543 54 597 - (c) Otherwise - 347 108 455 - 3. Total inspections carried out including reinspections 40 12,068 1,324 13,432 - 4. Number of properties inspected (under Section 2) which were found to be infested by (a) Rats (Major - - 1 1 - (Minor 3 1,352 154 1,509 - (b) Mice (Major - - - - - (Minor - 156 25 181 - 5 Number of infested properties (under Section 4) treated by the Local Authority 3 1,507 169 1,679 - 6. Total treatments carried out including re-treatments 7 2,031 199 2,237 - 7. Number of notices served under Section 4 (a) Treatment - - - - - (b) Structural work (i.e., Proofing) - 1 - 1 - 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 - 41 3 44 - 52 Factories Acts, 1937 and 1948 The following is a report on the work carried out by the Public Health Inspectors during the year:- Part I of the Act. 1. - Inspections for purposes of provisions as to health (including inspections made by the Public Health 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 35 12 4 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 378 90 7 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers premises). 8 4 2 TOTAL 421 106 13 2. - Cases in which defects were found. Particulars Number of cases in which defects were found Found Remedied Referred by H.M. Inspector Want of cleanliness (S.1) 7 7 2 Overcrowding (S.2) - - - Unreasonable temperature (S.3) - - - Inadequate ventilation (S.4) - - - Ineffective drainage of floors (S.6) - - - Sanitary Conveniences (S.7) (a) Insufficient 1 1 1 (b) Unsuitable or defective - - - (c) Not separate for sexes - - - Other offences against the Act (not including offences relating to Outwork) 10 10 - TOTAL 18 18 3 53 Part VIII of the Act. OUTWORK. (Sections 110 and 111) No. of outworkers in August Nature of Work. list required by Sect. U0(l)(c). Wearing apparel - Making, etc. 88 Household linen 2 Jewellery 3 Trimming 3 Artificial flowers 6 Hie making of boxes or other receptacles or parts thereof made wholly or partially of paper 5 Leather Goods 2 Carding, etc., of buttons, etc. 3 Chocolates and sweetmeats 1 Cosaques, Christmas crackers, Christmas stockings, etc. 7 Surgical appliances 1 TOTAL 121 54 CLEAN AIR ACT, 1956. With the passing of the Clean Air Act in 1956 the Council gave consideration to the formation of a Smoke Control Area in the North-Western part of the Borough. Instructions were given to proceed with the preliminary work of inspection in the Area comprising some 658 properties including 471 municipally owned houses and flats. The area is approximately one square mile in extent and is defined by the shaded portion on the accompanying map (p. 56) which also shows the siting of the Smoke Measuring and Deposit Gauge Stations. In order to obtain approximate estimates of the numbers, type and cost of adaptations required and the amount of bituminous and smokeless fuels being used in the area, a 15% representative survey was carried out by the Public Health Inspectors. A report on the result of the preliminary survey was considered by the Public Health Committee in June 1957 and instructions given for the proposal to be submitted to the Ministry of Housing and Local Government for preliminary approval. The Minister gave provisional clearance in November and indicated that the Council could proceed with a detailed survey of the area preparatory to making a Smoke Control Order at a later date. MEASUREMENT OF ATMOSPHERIC POLLUTION. In October two Smoke Measuring Stations and a Deposit Gauge were brought into operation. The Smoke Measuring Stations were installed in Edgware and Golders Green Public Libraries, and a daily estimation of sulphur dioxide in the air is carried out. The term "sulphur dioxide" includes all acid=producing gases in the air, with the exception of carbondioxide, and is the "net acidity" of the air calculated as sulphur dioxide. At each Smoke Station a measured volume of air is drawn through a filter paper and the degree of staining of the filter paper compared with a standard scale. The findings obtained are shown on the graphs. The Deposit Gauge is sited on the roof of a building behind the Town Hall, and a monthly measurement is carried out to show the rainfall in millimetres, the amount of water-insoluble matter expressed in tons per square mile per month and the amount of water-soluble deposit expressed in tons per square mile. The various graphs and tables demonstrate clearly how pollution increased in winter thereby suggesting that the pollution is due to the domestic consumer rather than to the industrial user. 55 56 The recording is done in collaboration with the Fuel Research Station of the Department of Scientific and Industrial Research, where results from local authorities and other co-operating bodies throughout the country are received, collated and analysed. Scientists at the Fuel Research Station suggest that a long period of observation, preferably 5 years, is needed before reliable conclusions can be drawn about the average level of pollution or about the rate at which it is produced. The records now being collected can not only be compared with those of other places, but they will serve for comparison in other periods of time and as more and more smokeless fuel is used there should be a progressive improvement, so that in time posterity may look back with interest on the records of Hendon' s murky past. DEPOSIT GAUGE,, TOWN HALL. Table showing monthly deposit of total solids. 1957 Rain ins. Total solids Tons per sq. mile October 2.01 16.01 November 2.17 21.71 December 2.01 23.81 DAILY AVERAGE OF SMOKE AND SULPHUR DIOXIDE AT EDGWARE AND G0LDERS GREEN MEASURING STATIONS. Edgware Golders Green 1957 Ø Smoke † Sulphur Ø Smoke † Sulphur October 12.06 4.2 16.3 8.9 November 12.1 5.1 13.7 8.3 December 21.0 10.4 31.0 16.5 Ø Average daily smoke concentration in mgms. per 100 cu. metres of air. † Average daily sulphur concentration per 100 million volumes of air. 57 Daily average Sulphur per 100 million vols of air - Golders Green Daily average Sulphur per 100 million vols. of air - Edgware Daily average Smoke concentration in mgms, per 100 cu. metres of air - Golders Green Daily average Smoke concentration in mgms per 100 cu. metres of air - Edgware 58 59 SECTION E. INSPECTION AND SUPERVISION OF FOOD FOOD AND DRUGS ACT, 1955 Legal Proceedings. It was necessary to institute legal proceedings under the Food and Drugs Act, 1955, in the following cases:- Charge Plea Result Selling bread containing a piece of metal Guilty Fined £10 and £2.2.0. costs Selling bread containing string Guilty Fined £10 and £2.2.0. costs Selling a cake containing a metal screw Guilty Fined £10 and £2.2.0. costs Selling food not of the substance demanded (Glass in milk) Guilty Fined £10 and £3.3.0. costs Selling food not of the substance demanded (Glass in milk) Not Guilty Case dismissed. FOOD HYGIENE REGULATIONS, 1955. Daring the year three summonses were issued against the same defendant for using tobacco in a food room The Defendant was fined £2 on each of the three charges and ordered to pay £3.3.0. costs. Proceedings have also been taken under the Food Hygiene Regulations in a case reported by the Police in which meat was being transported through the Borough in an open lorry also conveying sacks of potatoes and onions, the meat not being protected from risk of contamination. Summonses were issued against the owner and driver of the vehicle, who failed to appear on the day of the hearing, and the Magistrates issued warrants for their arrest. The Defendants were apprehended and at the adjourned hearing, although both Defendants pleaded "Not Guilty" and the owner gave evidence that the meat was not intended for human consumption but for the feeding of greyhounds, both Defendants were convicted, the Owner being fined £25 and the driver £5. In addition the Corporation were awarded £7 12 8d. costs. 60 ACTION TAKEN IN CONNECTION WITH FOOD STORES AND FOOD SHOPS. 94 notices were served on occupiers of shops and stores drawing attention to infringements of the Food and Drugs Act, 1955, and Food Hygiene Regulations, 1955. At the end of the year 73 notices had been complied with. NUMBER AND TYPE OF FOOD PREMISES IN THE AREA Grocers and provision merchants 204 Butchers 95 Bakers and confectioners 56 Greengrocers 97 Fishmongers 40 Confectionery shops 133 Restaurants and Cafes 170 Butter Blending Factory 1 Works Canteens 45 Food Warehouses 2 FOOD AND DRUGS ACT 1955 - SECTION 16 Registered Premises. Inspections. Ice Cream Premises 209 52 Preservation of Food 67 40 Eighteen 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 ice cream samples were as follows:- Grade Number of samples I 12 II 4 III 1 IV 1 MIDDLESEX COUNTY COUNCIL ACT 1950 - SECTION 11 Registration of Hawkers and Premises. Number Registered, Number of Inspections. Hawkers 66) 27 ) Premises 24) 61 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 20 MILK AND DAIRIES REGULATIONS, 1949 Daring the year it was necessary to institute legal proceedings in one case:- Charge Plea Result Failing to clean milk Guilty Fined £10 and bottle before use. £5.5 0. costs MILK (SPECIAL DESIGNATIONS) REGULATIONS. The following table shows the number of licences issued under these Regulations during 1957. Dealers Licences. Tuberculin Tested 34 Pasteurised 33 Sterilised 41 Dealers Supplementary Licences. Tuberculin Tested 21 Pasteurised 21 Sterilised 20 MILK SAMPLING. The number of samples taken during the year is as follows:- Pasteurised 2 Tuberculin Tested Pasteurised 2 Raw Bulk Milk (Tuberculin Tested) 14 Sterilised 1 Milk in cartons (Pasteurised) 24 In addition 40 samples of bottle rinses were taken during the year. CONDEMNATION OF FOOD The amount of foodstuffs condemned during the year shows little change from 1956. A large proportion of the food condemned in the Hendon area is accounted for by the fact that a multiple firm has a central distributing depot within the Borough serving many branches throughout London Condemned foodstuffs are disposed of by incineration at the Council s Refuse Disposal Works. 62 LIST OF FOODSTUFFS CONDEMNED DURING 1957. MEAT 1,665 lb. 11 oz, (including:- Bacon, Beef, Chicken, Lamb, Offal, Pork, Rabbit, Sausages, Veal.) 75 Chicken Cutlets, 4 Pies, 3 Boxes Poultry. FISH 13 st. (including:- Bream, Cod, Coley, Haddock, Roes, Rock Salmon) TINNED FOOD Meat 305 Milk 235 Fruit 1,000 Vegetables 319 Soup 35 Fish 607 Jam 63 Fruit Juice 52 Tomato Juice 16 Ham 37 (416 lb. 15 oz.) FRESH FRUIT, Currants 48½ lb. DRIED FRUIT Dates 6 oz. AND VEGETABLES Dried Peas 5 lb. Prunes 30 lb. Raisins 7½ lb Sultanas 15 lb. MISCELLANEOUS Bicarbonate of Soda ½lb, GOODS Biscuits 26 lb. 9½ oz. Blancmange Powder 2 pkts. Breadcrumbs 1 pkt. Bread Rolls 3 pkts. Cakes 19 Cake Mixture 32 pkts. Cereal 364 pkts. Cheese 282 lb, 6 oz. & 34 pkts. Chocolate Spread 3 cartons Coffee 38 tins Confectionery 36 lb. 3 oz. Cornflour 13 pkts. Cream 2 tins Custard Powder 1 pkt. Curry Powder 1 carton Fish 2 jars Flour 18 lb. Fruit 5 jars Fruit Juice 48 cartons Gravy Powder 2 pkts. Horseradish 1 jar Jam 26 jars Jelly 3 pkts. Junket 50 bottles Macaroni 6½ lb. 63 Milk Foods/Beverages 17 tins Mustard 5 tins Paste 1 tube Peanuts 12 tins/410 pkts. Pepper 24 tins Pickles 2 jars Potato Crisps 10 pkts. Pudding Mixture 30 pkts. Rice 19 lb./7 tins Salad Cream etc. 1 jar Semolina 11 lb. Spaghetti 1 carton Spice 10 cartons Squash 1 bottle Suet 3½ lb. Sugar 115 lb. Tapioca ½ lb. Tea 11¾ lb, Vermicelli 4 pkts. FOOD AND DRUGS ACT, 1955. The Middlesex County Council is the Food and Drugs Authority for the Borough of Hendon and I am indebted to Mr. John A, O'Keefe the Chief Officer of the Public Control Department for the following report on the work of his Department during the year. LIST OF SAMPLES PROCURED IN THE BOROUGH OF HENDON DURING THE YEAR 1957. Article Total Samples Procured Unsatisfactory Milk (New) 63 11 Milk (Various) 132 3 Butter 35 - Cakes 14 3 Cheese 3 - Cream 38 - Drugs 46 2 Fish and Fish Products 27 5 Fruit (Fresh) 3 2 Fruit (Canned) 4 - Fruit Juice,, etc. 4 - Ice-cream 29 - Liver 25 - Margarine 20 - Meat and Meat Products 42, 1 Preserves 7 - Sausages etc. 15 - Spirits 9 - Sweets 10 2 Vinegar 32 4 Miscellaneous 23 - TOTALS 581 33 64 FOOD AND DRUGS ACT, 1955 "Regarding the samples noted as unsatisfactory, I add the following comments - Milk The 11 samples of new milk which were found unsatisfactory we re obtained from six dairy farmers who were consigning milk to a depot in your district, in every case there was a deficiency in the milk fat content. Also in every case, the unsatisfactory milk was only part of the consignment and the remaining samples taken from all the other churns in these six consignments were satisfactory. Two samples of hot milk were obtained from a restaurant, one being a preliminary investigation and the second being submitted to the Public Analyst. This latter sample was certified as containing a small proportion of added water and an official caution was sent to the trader. A sample of condensed milk was found on preliminary investigation to be slightly deficient in milk fat from the standard prescribed; a subsequent sample of the same brand was found to be genuine and no further action was called for. Cakes. Of the three unsatisfactory samples of cakes, two were described as “Cream Doughnuts" and one as "Cream Eclairs", in each case the filling was imitation cream. Proceedings were instituted against one of the retailers concerned and a fine of £5 was imposed. An official caution was sent to the second retailer concerned Drugs, A sample of Glauber's Salt was certified by the Public Analyst to be of a definite pink colour as the result of having dried out; in all other respects it complied with the requirements of the British Pharmacopoeia. The trader admitted that it was old stock and the matter was dealt, with by way of verbal caution A preliminary sample of iodine was found to contain iodine in excess of that prescribed by the British Pharmocopoeia. A subsequent sample from the same source was found to be genuine and no further action was called for. Fish and Fish Products. Two samples of caviare were obtained from one retailer and each was found to be imitation caviare and also to contain preservative, the presence of which is prohibited in this class of food. An official caution was sent to the importers concerned. Two further samples of caviare were obtained from a second retailer; each was found to consist of the roe of lump fish, In this case also a letter of caution was addressed to the importers A sample of mayonnaise herring fillets was found to contain benzoic acid, no preservative is permitted in canned fish and an official caution was sent to the importer. Fruit. A retailer had exposed for sale a stack of plums label led "Victoria Plums". An examination of the fruit showed them to be a mixture of Victoria plums and Giant Prune plums; a letter of caution was addressed to the trader concerned. A 65 second trader was found to have two stacks of Packham Triumph pears exposed for sale labelled "William Pears" and when a purchaser asked for "Wi lliam Pears" he was served from one of the mis-marked stacks. Proceedings were instituted in respect of all three offences and the trader was fined a total of £6 and ordered to pay £1.1.0d. costs. Meat and Meat Products. A sample sold as "Venison Ragout in Cream Sauce" was found to contain such a small amount of milk fat that the description was likely to be misleading. The attention of the importers was drawn to this matter and an undertaking received that no further imports would be accepted unless they were labelled with a correct description of the food Sweets. An article of food which had the general appearance of chocolate was sold under the description "Milk Block". The Public Analyst certified that the article had been made with skimmed milk and not with whole milk. The manufacturers had sold it to the retailer under a suitable description and it was the latter who had applied the offending description An official caution was therefore sent to the retailer concerned. A sample of a food sold as "Milk Chocolate Egglets" and which, when cut in half, in some respects resembled in appearance the interior of an egg, was found to be a sugar fondant coated with chocolate. A letter of caution was addressed to the manufacturers concerned. Vinegar. A preliminary sample of vinegar was found to be deficient in acetic acid, A subsequent sample was obtained which the Analyst certified as being also deficient in acetic acid. An official caution was addressed to the retailer. A preliminary sample of vinegar obtained from a second retailer was found to be similarly deficient, but a subsequent sample was found to be genuine. A third retailer, when asked for vinegar, supplied non-brewed condiment. He received an official caution. Merchandise Marks Acf, 1887-1953. 231 inspections of shops were undertaken to ensure that the Marking Orders relating to certain imported foodstuffs made under the Merchandise Marks Act, 1926, were complied with, 863 separate displays of meat, apples, tomatoes, poultry, dried fruit and butter were examined, and in addition a number of test purchases were made. An official caution was sent to one retailer who was found to have Guernsey tomatoes exposed for sale labelled "Home Grown". Labelling of Food Order, 1953 At 92 premises 318 articles of pre-packed food were examined to see that they bore a label which gave a clear statement of the designation of the food and, in the case of compound foods, the ingredients, and 66 also the name and address of the packer or labeller. One infringement of this Order was detected. Tins of Chicken with Rice were found in one shop not bearing the prescribed statement of ingredients. This food had been canned abroad and an official caution was sent to the importers concerned, False or Misleading Descriptions. As in previous years a considerable amount of work has been done in the detailed scrutiny of advertisements and the labels on pre-packed foods, and taking suitable action in those cases where a label or advertisement contains a false or misleading description of the food to which it relates. This work is of benefit to the whole County irrespective of where within the County offences may be detected. During the year under review corrective action has been secured in respect of salmon with potato salad, crystallized jelly pineapple slices, pure egg mundelech, cherry juice, lime juice, imitation cream, cream filled biscuits, cream filled Easter eggs and cheese. In every case the person responsible agreed to make necessary suitable amendments to labels as a result of my representations. In no case was it necessary to institute proceedings. Special Designated Milk During the year in question one licence was issued by my Council in respect of the use of the special designation "pasteurised" for milk processed within your area. These premises were regularly inspected, and compliance with the requirements of the Act and of the appropriate Regulations was maintained. 37 samples of pasteurised milk were taken, all of which were certified as being satisfactory. Safe Milk. In addition to the foregoing. 5 samples of raw milk were procured within your Borough and submitted to test for the presence of tubercle bacilli. None was found contaminated," SLAUGHTERHOUSES. There are no slaughterhouses licensed in the district, 67