Library HEN 35 BOROUGH OF HENDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1958 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 Officer TOWN HALL, HENDON, N.W.4 Telephone No.: HENdon 8282 BOROUGH OF HENDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1958 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 Officer TOWN HALL, HENDON, N.W.4 Telephone No.: HENdon 8282 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1958 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 1958. In the early days of Public Health when the information published in the Bills of Mortality showed the important causes of death, the aims of preventive medicine were obvious and simple. Last year in Hendon the health statistics were good and included the lowest infant mortality rate ever recorded in the Borough. Two important diseases, cancer of the lung and coronary thrombosis both showed an increased death rate. The cause of the former was mentioned in last year's report. Coronary thrombosis has shown a nation wide increase since 1940 but the cause of this increase is not known. The disease is found to be more prevalent in countries with a high standard of living but better facilities for more accurate diagnosis may account for this fact. Three possible causes for the disease have been suggested; too much fat in the diet, which is one of the factors common to people with a high standard of living; too little exercise, because the disease is common in countries where cars and T.V. sets are plentiful, and the third possible factor is emotional strain. The Russian author, Pasternak, has his character Dr. Zhivago say as a possible explanation of his heart disease "The great majority of us are required to live a life of constant systematic duplicity.Any one or all of the above factors may play some part in the causation of this disease. The real problem of preventive medicine today is not so much how we can add years to life but how we can add life to years. There are many and varied possibilities. The extent of ill health in the community can be judged by a study of sickness certificates issued to staff and work people in the Council's service. Most noticeable as a cause of sickness absence is chronic bronchitis, which is responsible for about one sixth of the working time lost. One hopes that progress with Clean Air will in time reduce wastage from this cause. Much of the work of the Public Health Department aims at better houses, and with less dampness we should expect less of the rheumatic diseases attributed to that cause, Some of the older houses have dark staircases and kitchens and as these are dealt with falls on stairs should diminish and kitchen hygiene improve. The number of older people is increasing and their demands for housing are often less articulate than those of younger people but their needs are very real. They need better standards than a younger, fitter family can tolerate — failing vision demands the best possible illumination with bright contrasting colours; physical weakness calls for the 4 elimination of stairs and steps. Simple easily managed flatlets will be needed for the increasing number of elderly people who, in such an environment, are capable of living an existence independent of many of the services of the welfare state. In the Station Road flatlets where many elderly people live alone, only a small percentage of the occupants are using the services of Home Help, District Nurse or Health Visitor at any one time. Good progress was made during the year in the rehousing of occupants of unfit properties except in the case of single persons or married couples requiring single bedroom accommodation. There appears to be a great shortage of Council-owned accommodation of this type and the number of these persons awaiting rehousing from unfit properties continues to grow. During the year the number of cases of food poisoping showed an increase but this increase may be due to better notification because early in the year at the suggestion of the Ministry of Health attention was drawn to the value of full and prompt notification of this disease. I have included an extract from the report of the Hendon Old People's Housing Society and the report of the Chairman of the Borough of Hendon Old People's Welfare Committee with its story of the Chiropody Service. I would like to thank the members of the Committee 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 669 Childs Hill 593 Area of the Borough 10,371 Population figure supplied by Registrar General 151,500 Density of population, i.e., number of persons per acre 14,69 Number of inhabited houses at 31st December 1958 (according to Rate Book) 45,050 Average number of persons per house 3.36 Rateable value at 31st December, 1958 £3,354,764 Sum represented by a Penny Rate £13,450 Births Live Births: Male Female Total Legitimate 967 887 1,854 Illegitimate 48 46 94 1,015 933 1,948 Live Birth Rate per 1,000 Home Population 12.85 Birth Rate corrected for comparison with other areas 12.33 Illegitimate live births per cent of total live births 4.8 Comparability factor supplied by Registrar-General 0.96 Corrected Birth Rate per 1,000 Home Population, County of Middlesex 14.2 Birth Rate per 1,000 Home Population, England & Wales 16.36 Corresponding Rate for the Borough of Hendon for the year 1957 11.93 6 STILLBIRTHS: Male Female Total Legitimate 12 14 26 Illegitimate - 1 1 12 15 27 Stillbirth Rate per 1,000 Total Births 13.67 Stillbirth Rate per 1,000 Total Births, England & Wales 21.56 Stillbirth Rate per 1,000 Home Population 0.17 Stillbirth Rate per 1,000 Home Population, England & Wales 0.36 Deaths: Male Female Total 831 752 1,583 Death Rate per 1,000 Home Population 10.44 Death Rate corrected for comparison with other areas 11.17 Comparability factor supplied by Registrar-General 1.07 Corrected Death Rate per 1,000 Home Population, County of Middlesex 11.1 Death Rate per 1,000 Home Population, England & Wales 11.67 Corresponding Rate for the Borough of Hendon for the year 1957 10.58 Maternal Mortality Number of women dying in consequence of childbirth 1 Maternal Mortality Rate per 1,000 total births 0.51 Comparative figure for the County of Middlesex 0.39 Comparative figure for England & Wales 0.43 Infantile Mortality Deaths of infants under 1 year of age Male Female Total Legitimate 17 8 25 Illegitimate 2 2 17 10 27 Death Rate of infants under 1 year of age per 1,000 live births 13.86 Death Rate of infants under 1 year of age per 1,000 live births — legitimate 13.48 Death Rate of infants under 1 year of age per 1,000 live births — illegitimate 21.27 Death Rate of infants under 1 year of age per 1,000 live Births, County of Middlesex 18.9 Death Rate of infants under 1 year of age per 1,000 live births, England & Wales 22.51 7 Deaths of infants under the age of 4 weeks:— Male Female Total Legitimate 12 7 19 Illegitimate - 1 1 12 8 20 Neo-natal Mortality Rate per 1,000 live births 10.27 Neo-natal Mortality Rate per 1,000 live births, County of Middlesex 14.2 Neo-natal Mortality Rate per 1,000 live births, England and Wales 16.2 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 3 4 - - - 7 - - - - 7 Pneumonia and Bronchitis - - 1 - - 1 2 2 - - 5 Atelectasis 4 1 - - - 5 - - • - 5 Asphyxia 1 - - - - 1 - - - - 1 Congenital defects 1 2 - - - 3 - 1 - 2 6 Intra-cranial haemorrhage - 3 - - - 3 - - - - 3 9 10 1 - - 20 2 3 - 2 27 8 The infant deaths were distributed throughout the wards of the Borough as follows:— Mill Hill 3 Burnt Oak 5 West Hendon 2 Central 3 Park 5 Golders Green 1 Garden Suburb - Childs Hill 4 Edgware 4 27 TABLE 1. 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 1958 14 9 SUMMARY OF VITAL STATISTICS FOR THE YEAR 1958 England and Wales Borough of Hendon Rates per 1,000 Home Population Births Live births 16.36 12.33 Still births 0.36 0.17 21.56(a) 13.67(a) Deaths All causes 11.68 11.17 Borough of Hendon Tuberculosis 0.09 Pneumonia 0.45 Influenza 0.046 All causes under 1 year of age England and Wales Borough of Hendon Rates per 1,000 Live Births 22.5 13.86 Borough of Hendon Rates per 1,000 Home Population NOTIFICATIONS (CORRECTED) Meningococcal Infection 0.01 Scarlet Fever 0.74 Whooping Cough 0.28 Erysipelas 0.07 Measles 3.98 Pneumonia 0.49 Acute Poliomyelitis Paralytic 0.01 Non-Paralytic - Food Poisoning 0.24 Puerperal Pyrexia 56.7 (a) (a) Per 1,000 Total (Live & Still) Births 24.81*(a) * This is the rate when the figure relating to Hendon residents only is taken. 10 TABLE II VITAL STATISTICS FOR THE YEARS 1933-1958 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 1943 133,970 2,223 16.95 1,387 10.35 86 39 4 1944 132,360 2,245 16.96 1,347 10.18 72 32 4 1945 137,770 2,239 16.25 1,379 10.01 65 29 3 1.30 1946 153,820 2,651 17.23 1,481 9.63 77 29 3 1.10 1947 158,670 2,671 16.83 1,522 9.59 77 27 4 1.45 1948 156,400 2,292 14.65 1,406 8.90 47 21 6 2.56 1949 158,430 2,251 14.36 1,522 10.56 50 22 5 2.17 1950 158,200 2,261 14.29 1,501 9.49 36 16 2 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 1958 151,500 1,948 12.85 1,583 10.44 27 14 1 0.51 * The interval between the maternal condition and the date of death in one case exceeded 1 year. 11 TABLE IE. COUNTY COUNCIL OF MIDDLESEX CERTAIN VITAL STATISTICS FOR THE YEAR 1958 District Population mid-1958 Live 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 (a) Crude Adjusted Crude Adjusted Pulmonary Tuberculosis (a) Cancer (a) Infant (a) Neo-natal (a) (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Acton 65,360 15.1 14.2 11.0 11.4 0.06 (4) 2.2 (147) 22.2 (22) 18.2 (18) - (-) Brentford & Chiswick 57,150 14.0 13.2 11.2 11.2 0.12 (7) 2.2 (127) 17.5 (14) 12.5 (10) 1.23 (1) Ealing 183,000 14.4 14.0 10.4 11.2 0.05 (10) 2.2 (398) 14.8 (39) 11.4 (30) - (=) Edmonton 95,180 13.0 12.9 9.9 11.2 0.07 (7) 2.1 (200) 17.0 (21) 13.0 (16) 0.80 (1) Enfield 109,300 13.8 13.8 10.8 10.5 0.06 (7) 2.1 (228) 19.2 (29) 15.2 (23) - (-) Feltham 50,780 16.6 16.1 7.4 11.7 0.02 (1) 1.4 (73) 21.3 (18) 16.6 (14) - (-) Finchley 69,080 13.1 12.8 11.9 10.8 0.03 (2) 2.2 (153) 20.0 (18) 10.0 (9) 1.09 (1) Friern Barnet 28,540 11.5 12.9 14.1 9.0 0.04 (1) 2.2 (62) 12.2 (4) 3.0 (1) - (-) Harrow 214,300 13.2 13.5 9.3 11.1 0.04 (8) 1.9 (414) 17.0 (48) 13.8 (39) 0.70 (2) Hayes & Harlington 67,780 16.6 15.6 7.4 12.0 0.06 (4) 1.5 (101) 15.1 (17) 13.3 (15) - (-) Hendon 151,500 12.9 12.4 10.4 11.1 0.07 (10) 2.2 (330) 13.9 (27) 10.3 (20) 0.51 (1) Heston & Isleworth 105,100 12.0 12.0 10.6 11.3 0,05 (5) 2.0 (214) 16.6 (21) 12.7 (16) - (-) Hornsey 96,670 18.1 16.8 11.8 10.6 0.06 (6) 2.2 (214) 18.9 (33) 16.6 (29) - (-) Potters Bar 22,000 18.1 16.3 7.7 10.6 0.18 (4) 1,4 (31) 10.1 (4) 5.0 (2) - (-) Ruislip-Northwood 74,930 13.4 13.4 8.0 10.1 0.04 (3) 1.8 (137) 12.9 (13) 9.9 (10) - (-) Southall 52,830 15.5 16.0 12.0 10.1 0.08 (4) 2.6 (136) 20.7 (17) 15.9 (13) - (-) Southgate 70,940 11.4 12.3 13.3 10.9 0.11 (8) 2.2 (155) 21.0 (17) 16.1 (13) - (-) Staines 46,850 18.2 16.7 8.8 11.2 0.02 (1) 2.0 (94) 23.5 (20) 15.3 (13) - (-) Sunbury 28,440 19.6 17.6 10.5 11.9 0.14 (4) 2.0 (58) 14.4 (8) 5.4 (3) - (-) Tottenham 117,700 14.9 14.6 11.2 12.0 0,08 (10) 2.5 (297) 21.7 (38) 16.0 (28) 0.56 (1) Twickenham 103,500 13.3 13.7 11.4 10.8 0.13 (13) 2.1 (222) 24.0 (33) 17.4 (24) - (-) Uxbridge 63,120 17.7 16.1 9.9 12.9 0.06 (4) 1.9 (119) 29.6 (33) 26.9 (30) 0.88 (1) Wembley 126,800 12,0 12.1 8.8 10.3 0,06 (7) 2.1 (262) 19.1 (29) 12.5 (19) - (-) Willesden 173,100 18,6 17.1 10.0 11.3 0.08 (14) 2.1 (363) 21.5 (69) 16.5 (53) 0.61 (2) Wood Green 49,100 12,9 12.9 11.7 11.3 0.08 (4) 2.6 (129) 23.6 (15) 15.7 (10) 1.54 (1) Yiewsley & West Drayton 23,950 17,2 15.5 7.3 10.5 - (-) 1.4 (34) 19.4 (8) 14.5 (6) 4.75 (2) COUNTY 2,247,000 14.5 14.2 10.3 11.1 0.07 (148) 2.1 (4698) 18.9 (615) 14.2 (464) 0.39 (13) Note: (a) Absolute numbers are given in parenthesis in addition to rates to afford valid comparison. Deaths of Hendon residents during the year 1958 — classified according to age grouds and sexes. 12 Mote: (a) Absolute numbers are given in parenthesis in addition to rates to afford valid comparison Deaths of Hendon residents (luring the year 1958 — classified according to age groups and sexes. Causes of death AGE GROUPS S Under 1 year 1-4 years 5-14 years 15-24 years 25-44 years 45-64 years 65-74 years 75 years & over 1. Tuberculosis, respiratory M 5 1 6 F 1 1 2 4 2. Tuberculosis, other M 1 1 F 2 1 3 3. Syphilitic Disease M 1 1 2 F 1 1 4 Diphtheria M F 5. Whooping Cough M F 6. Meningococcal Infections M F 7. Acute Poliomyelitis M F 8. Measles M F 9. Other Infective & Parasitic Diseases M 1 1 1 3 F 1 1 2 10. Malignant Neoplasm, Stomach M 14 5 6 25 F 5 4 14 23 11. Malignant Neoplasm, Lung, Bronchus M 2 33 31 7 73 F 1 5 3 5 14 12. Malignant Neoplasm, Breast M F 14 11 9 34 13. Malignant Neoplasm, Uterus M F 2 6 5 2 15 14. Other Malignant & Lymphatic Neoplasms M 2 1 1 2 27 26 17 76 F 5 24 13 28 70 15, Leukaemia, Aleukaemia M 1 1 1 3 F 1 2 3 16, Diabetes M 2 2 F 1 2 5 8 17, Vascular lesions of Nervous System M 2 17 28 49 96 F 14 41 68 123 18, Coronary Disease, Aagina M 3 76 73 51 203 F 13 30 48 91 13 Deaths of Hendon Residents — Continued TABLE IV* (Continued) Causes of death AGE GROUPS TOTALS Under 1-4 5-14 15-24 25-44 45-64 65-74 75 years 1 year years years years years years years & over 19. Hypertension with Heart Disease M 2 3 7 12 F 6 6 19 31 20. Other Heart Disease M 3 14 12 31 60 F 8 19 72 99 21. Other Circulatory Disease M 4 10 16 25 55 F 2 7 7 34 50 22. Influenza M 1 2 3 F 4 4 23. Pneumonia M 4 1 10 5 19 39 F 1 1 3 4 20 29 24. Bronchitis M 1 17 22 19 59 F 1 1 1 1 8 12 24 25. Other Diseases of Respiratory System M 1 1 3 3 1 9 F 1 1 1 3 26. Ulcer of Stomach and Duodenum M 1 6 2 9 F 2 3 6 11 27. Gastritis Enteritis & Diarrhoea M 1 1 2 F 3 3 2 8 28. Nephritis & Nephrosis M 7 1 1 9 F 1 1 3 1 6 29. Hyperplasia of Prostate M 2 7 9 F 30. Pregnancy Childbirth Abortion M F 1 1 31. Congenital Malformations M 5 1 1 1 8 F 3 3 32. Other Defined & III. defined Diseases M 8 1 1 3 6 5 8 32 F 6 1 2 14 17 26 66 33. Motor Vehicle Accidents M 1 3 5 2 2 2 15 F 1 2 3 34. All Other Accidents M 1 1 1 3 3 5 14 F 1 1 3 1 9 15 35. Suicide M 4 2 6 F 1 2 4 1 8 36. Homicide and Operations of War M F M 17 7 3 8 38 262 238 258 831 F 10 1 2 4 20 138 185 392 752 All Causes TOTALS 27 8 5 12 58 400 423 650 1,583 14 VITAL STATISTICS Population According to the figure supplied by the Registrar-General the estimated mid-year population for 1958 was 151,500. This is 1,100 less than that for the year 1957 and 4,357 less than the Census figure for 1951. Births The number of live births recorded during the year increased by 31, 1,948 occurring compared with 1,917 in 1957, giving an increased corrected birth rate of 12.33 per 1,000 Home Population compared with 11.93 last year. The rate is less than that for the County of Middlesex which is 14.2, and less than that for England and Wales, which is 16.4 per 1,000 Home Population. The number of stillbirths increased from 25 to 27, giving a stillbirth rate of 13.67 per 1,000 total births compared with 12.94 in 1957. The rate for the Borough of Hendon compares favourably with that for England and Wales, which is 21.56 per 1,000 total births. Deaths There was an increase of 58 in the number of deaths. This, coupled with the fact that the population figure was less than that for last year, gives an increased corrected death rate of 11.17 per 1,000 Home Population compared with 10.58 in 1957. This rate is slightly higher than that for the County of Middlesex, which is 11.1 per 1,000 Home Population, but is less than the rate for England and Wales, which is 11.67 per 1,000 Home Population. As in previous years, heart and associated diseases accounted for the largest number of deaths, 601 people dying from these causes. Second in the principal causes was cancer. Deaths from motor vehicles and other accidents increased, 47 people dying from these causes compared with 44 in 1957. Fourteen people committed suicide, five less than last year. The number of men aged 45—64 dying from coronary disease has increased from 59 to 76. Infantile Mortality Twenty-seven children died in the first year of life compared with 42 in 1957, giving an infantile mortality rate of 13.86 per 1,000 live births, the lowest figure ever recorded in Hendon. The rate for the Borough compares favourably with that for England and Wales, which is 22.5 per 1,000 related live births. The rate for the County of Middlesex is 18.9 per 1,000 live births. Of the 27 children, 20 died before reaching the age of 1 month, giving a neo-natal mortality rate of 10.27 per 1,000 live births compared with 16.2 for England and Wales. Maternal Mortality One woman died as a result of childbirth, giving a maternal mortality rate of 0.51 per 1,000 total (live and still) births. 15 Deaths from Cancer of the Lung and Bronchus During the year in Hendon 35 men and 6 women under 65 years of age died from this cause, once more an increase on the total for the previous year. SMOKING IN YOUTH CLUBS An investigation into the smoking habits of a sample of members of Youth Clubs has been recorded. On this occasion the ratio of smokers to non-smokers was about 50—50, a much higher proportion of non-smokers than was noticed last year. This reduction in the number of smokers may have been due to the effects of health education, or alternatively it is possible that a high proportion of non-smokers would be found at a lecture on football by a Tottenham Hotspur. INVESTIGATION OF SMOKING in a sample of members of Youth Clubs who attended a lecture given by Mr. George Robb of Tottenham Hotspurs at Woodcroft School. The boys attending this lecture were from the following Clubs Chistchurch Boys' Club, 5th Hendon Boys' Brigade, Faircourt Boys' Club, Watling Boys' Club, St. John Bosco Youth Club. Never Non Pipe Cigarette No. of cigarettes Smoked Smoker Smoker Smoker smoked per week 14 1. 1. 1. 25. 15 1.1.1.1.1.1. 1.1. 1.1.1.1. 25,2.1.4. 16 1.1.1. 1. 1.1,1.1.1.1.1. 5-10.80-100.50. 5.5.30.60. 17 1. 1. 1.1.1. 80.50.25. 18 1. 70. 20 1 (loz) Total number of boys attending — 43. 16 BOROUGH OF HENDON NUMBER OF DEATHS DEATHS FROM CANCER OF LUNG AND BRONCHUS 17 INVESTIGATION OF SMOKING in a sample of members of various Clubs who attended a meeting at the Burroughs Recreation Ground for a 3-mile evening run. The boys attending this meeting were from the following Clubs Christ Church Boys' Club, Mill Hill Youth Club, Mill Hill Catholic Youth Club, St. Mary's C. of E. Youth Club, St. Mary Magdalen Youth Club, Shaftesbury Harriers, Spur Road Youth Club. Age Never Smoked Non-Smoker Pipe Smoker Cigarette Smoker No. ,of cigarettes smoked per week 14 1. 1.1,1. 15 1.1.1. 16 1. 1. 1.1. 70. 70. 17 1.1. 40. 50. 18 1.1. 1.1.1.1.1. 1.1. 40.2. Total number of boys attending — 22. ROAD TRAFFIC ACCIDENTS The following tables show the road traffic accidents and casualties occurring within the Borough of Hendon during the year 1958 and the comparative figures for the years 1955, 1956, 1957 and 1958 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. 18 TABLE V. MONTH No. of Accidents ADULTS CHILDREN TOTAL Killed Seriously Injured Slightly Injured Killed Seriously Injured Slightly Injured January 67 1 9 58 - 1 8 77 February 77 1 16 65 - 1 14 97 March 61 1 18 53 - 2 12 86 April 82 - 20 84 - 3 15 122 May 104 6 5 99 - 1 24 135 June 97 1 18 93 - 1 14 127 July 94 - 13 88 - 1 13 115 August 89 3 20 79 - 3 11 116 September 79 2 6 70 - 3 18 99 October 114 2 28 91 - 3 21 145 November 112 3 38 105 - 1 9 156 December 113 1 38 105 - 2 9 155 TOTALS: 1,089 21 229 990 - 22 168 1,430 TABLE VI. CLASSES OF ROAD USER KILLED OR INJURED DURING 1958. 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 9 - - 19 - 4 12 - - 2 - 3 10 1 1 14 February - 3 13 1 4 17 - 1 13 - - 1 - 1 7 - 8 28 March - 5 9 1 4 18 - 3 7 - - 2 - 3 12 - 5 17 April - 5 12 - 3 19 - 7 21 - 1 5 - - 10 - 7 32 May 5 3 14 - 1 22 - 1 26 - - 6 - - 35 - 1 20 June 1 4 19 - 6 19 - 4 22 - 1 4 - 1 24 - 3 19 July - 1 14 - 2 15 - 4 28 • 2 7 - 1 18 - 4 19 August 1 4 9 - 6 17 1 7 21 - 2 5 - 1 14 1 3 24 September 1 2 15 - 2 12 1 - 16 - - 5 - 2 13 - 3 27 October 2 7 23 - 8 17 - 10 24 - 1 3 - 1 23 - 4 22 November - 5 17 2 7 26 l 13 21 - 2 3 - 3 10 - 9 37 December - 6 10 1 11 44 10 18 - 1 1 - 3 8 - 9 33 TOTALS 10 47 164 5 54 245 3 64 229 - 10 44 1 19 184 2 57 292 19 TABLE VII. COMPARATIVE FIGURES OF ACCIDENTS AND CASUALTIES FOR 1955, 1956, 1957 and 1958. 1965 1956 1957 1958 Total number of Road Accidents involving personal injury 930 892 873 1,089 Accidents per mile of road 5.46 5.23 5.09 6.33 CASUALTY FIGURES Adults Killed 17 17 21 21 Seriously injured 196 171 188 229 Slightly injured 830 813 802 990 Totals: 1,043 1,001 1,011 1,240 Children Killed 1 2 2 - (0—15 years) Seriously injured 16 29 20 22 Slightly injured 117 109 100 168 Totals: 134 140 122 190 Combined Adults and Children Totals: 1,177 1,141 1,133 1,430 Casualties per mile of road 6.91 6.69 6.61 8.32 CLASSES OF ROAD USERS KILLED OR INJURED Pedestrians Motor Drivers Motor Cystiats Pillion Passengers Pedal Cyclists Other Road Users YEAR Killed Serious Slight Killed Serious Slight Killed Serious Slight Killed Serious Slight [ Killed Serious Slight Killed Serious t 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 1958 10 47 164 5 54 245 3 64 229 - 10 44 1 19 184 2 57 292 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 1955 - 12 40 - 3 36 1 1 41 1956 1 18 42 1 S 33 - 3 34 1957 2 10 41 - 4 23 to 6 36 1958 - 15 65 - 6 53 - 1 50 I am indebted to the Borough Engineer and Surveyor for supplying me with the figures. 20 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 113 28 Whooping Cough 42 - Measles 603 11 Acute Poliomyelitis Paralytic 2 2 Non-Paralytic - - Diphtheria - - Pneumonia 74 17 Dysentery 330 25 Paratyphoid Fever - • Erysipelas 11 - Meningococcal Infection 2 2 Food Poisoning 36 7 Puerperal Pyrexia 112 111 Ophthalmia Neonatorum 6 6 TOTAL 1,331 209 21 * TABLE IX, AGE DISTRIBUTION AGE GROUP DISEASE Scarlet Fever Whooping Cough Acute Poliomyelitis Measles Dysentery Meningocoocal Infection Paralytic Non-paralytic M. F. M. F. M. F. M. F. M. F. M. F. M. F. Under 1 year - - 3 2 - - - - 4 8 7 2 1 - 1— year 2 - 1 - - - - 23 29 10 7 - - 2— years 1 4 5 2 - - - - 46 35 20 16 - - 3— years 4 6 3 4 - - - 37 49 10 8 - - 4— years 3 13 1 1 - - - 42 52 17 11 - - 5— 9 years 32 30 10 8 1 - - - 129 129 69 59 - - 10—14 years 3 13 1 1 - 1 - - 4 6 18 28 - - 15—24 years 1 1 - - - - - - 4 4 3 2 - - 25 & over - - - - - - - - 1 1 19 21 1 - Age unknown - - - - - - - - - -- - 3 - - TOTAL 46 67 24 18 1 1 - - 290 313 173 157 2 - Pneumonia Erysipelas Food Poisoning Puerperal Pyrexia Paratyphoid Fever M. F. M. F. M. F. M. F. M. F. Under 5 years 1 1 - - 4 6 - - - - 5—14 years 2 3 - - 5 4 - - - - 15—44 years 7 10 1 - 6 5 - 112 - - 45—64 years 13 15 3 2 2 2 - - - - 65 & over 10 9 3 2 - 2 - - ° - Age unknown 1 2 - - - - - - - - TOTAL 34 40 7 4 17 19 - 112 - - 22 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 29 14 9 10 10 10 2 12 17 113 Whooping Cough 5 2 - - 2 2 18 1 12 42 Acute Poliomyelitis Paralytic - - - - - 1 1 - - 2 Non-aralytic - - - - - - - - - - Measles 121 85 55 46 107 42 18 73 56 603 Meningococcal Infection - - 1 - - - - - 1 2 Pneumonia 11 16 1 11 9 6 3 9 8 74 Dysentery 62 31 5 4 24 136 3 48 17 330 Erysipelas 1 1 - - - 3 1 - 5 11 Food Poisoning 8 5 1 6 1 7 3 1 4 36 Puerperal Pyrexia 9 76 3 5 4 9 - 3 3 112 Ophthalmia Neonatorum - 4 1 1 - - - - - 6 Paratyphoid Fever - - - - - - - - - - TOTAL 246 234 76 83 1ST 216 49 147 123 1,331 23 NOTIFICATIONS OTHER THAN TUBERCULOSIS Poliomyelitis There was a decrease in the number of cases of Poliomyelitis notified during the year — 2 cases occurred compared with 32 in 1957. Several years must elapse before the results and effects of vaccination can be assessed, because the incidence of poliomyelitis varies so much from year to year but American experience of the vaccine is very encouraging. Puerperal Pyrexia There was a slight decrease in the number of cases of Puerperal Pyrexia, 112 cases occurring compared with 116 in 1957. Of the 112 cases, 49 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 consequences, the rate for Hendon is high. That for the year 1958 is 56,7 per 1,000 total (live and still) births. If the figure for the Hendon residents only is taken the rate is 24.81 per 1,000 total (Live and still) births. Ophthalmia Neonatorum There was a decrease of 10 in the number of cases notified r— 6 cases compared with 16 in 1957. All the cases were admitted to hospital. Scarlet Fever There was a reduction in the number of cases of Scarlet Fever notified during the year, 113 cases being notified compared with 158 in 1957. The disease was of a mild form and 28 of the cases were removed to hospital. The greatest incidence occurred in the age group 5-9, 62 cases being notified in this group. Measles Measles tends to occur in epidemic form every two years, and at present in Hendon reaches a peak early in the even numbered years. There was therefore a reduction in the number of cases notified during the year, 603 cases occuring compared with 2,164 in 1957. Whooping Cough The homes of the majority of notified cases of whooping cough were visited during the year, to observe the effect of immunisation against whooping cough on those children who were over one year of age and under five years of age. Ten cases of whooping cough were notified in this age range, and of these six had not been immunised and four had been immunised. In the four immunised cases the mothers reported that no definite whoop had been heard, and it would seem that in these cases the diagnosis was 24 usually made because the child had been in contact with a known case and had suffered from paroxysmal cough and vomiting. It would seem that there are now two different kinds of whooping cough — one the well-known and more serious, classical whooping cough which occurs in the unimmunised child and another, a much milder disease, which is usually associated with a paroxysmal cough and vomiting, but often without a whoop in the child who has been immunised. " Sonne Dysentery Sonne dysentery is a mild form of dysentery which is very infectious, especially among infant children in certain circumstances. The modern view about the spread of this disease is that the organism thrives best in a cold, damp and dark environment. In 1958 330 cases of sonne dysentery were notified in Hendon. The disease began in epidemic form in the middle of November and persisted through a long spell of sunless, foggy weather. Cases were reported from 18 different schools in the Borough, but three school suffered especially severely. Dysentery is a difficult disease to deal with from an administrative point of view, because there are two schools of thought as to how to approach the problem of the prevention of its spread. One school of thought advises complete exclusion of infected children from school until successive negative tests prove them free from infection, while another school of thought prefers to treat dysentery in the same way as a common cold and exclude only those children who are ill for the duration of their illness. These administrative difficulties probably arise from the fact that the infectivity of the organism is not constant — at some times it seems to be more infectious than at others — and there seems little evidence that the adoption of the second method of control is less successful than the more complex method. If it is a fact that sonne dysentery is commoner in sunless weather, then it may be that we will soon include it in the list of diseases which we hope to prevent when smoke control makes a cleaner atmosphere. In the course of the epidemic it was noticed that some of the early cases carried the organism for the longest period. This fact supports the idea that sonne dysentery may be more virulent in the early stages of the outbreak and that there is a waning of the infectivity of sonne dysentery towards the end of the outbreak. Many of the children experienced loss of appetite for some weeks after the illness. The number of notified cases decreased fairly rapidly during a long spell of dry weather in January of the following year. Food Poisoning Thirty-six notifications of food poisoning were received during 1958, nine more than in 1957. In recent years much progress has been made in the classification of the different organisms 25 responsible for food poisoning, which are now sub-divided into many groups, and this sub-division often helps in tracing the source of an outbreak. A variety of sources appeared to be responsible for the several cases of food poisoning which were spread throughout the Borough because, as the table shows, a number of different types were involved. In one instance organisms of the food poisoning type were probably the cause of an attack of acute appendicitis. Salmonella Typhi-Murium — 1 case of Type 1 5 cases of Type 1a 4 cases of Type 2c 4 cases of Type 2d 6 untypable strains several cases were not typed. Salmonella Stanley — 1 case Salmonella Anatum — 2 cases Coagulase positive staphylococci phage pattern 187—2 cases. The cases were distributed through the year as follows:— First Quarter Second Quarter Third Quarter Fourth Quarter TOTAL 8 7 18 3 36 Paratyphoid Fever No case of paratyphoid fever was notified during the year, compared with 5 cases in 1957. 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 larjp scale in 1935. 26 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 a - 1952 - 1953 1 - 1954 - 1955 1 1956 1 - 1957 - 1958 - 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 1958, 27 TABLE XII. NUMBER OF CHILDREN RESIDENT IN THE BOROUGH OF HENDON WHO RECEIVED IMMUNISING INJECTIONS DURING 1958. 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 518 360 416 - - - 1 year of age 395 111 352 5 1 - 2—4 years of age 63 26 25 130 11 - 5—14 years of age 81 3 - 1,324 35 - 15 years and over - - - 2 - - TOTAL 1,057 500 793 1,461 47 - 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 1958. TABLE XIII. Age at 31st December 1958 Under 1 year 1 year 2—4 years 5-14 years 15 years and over TOTAL Number vaccinated 1,111 53 30 34 125 1,353 Number re-vaccinated - - 13 62 574 649 INTERNATIONAL CERTIFICATES OF VACCINATION International Certificates of vaccination for persons travelling to certain countries abroad are required in respect of Smallpox, Yellow Fever and Cholera. Vaccination against any disease other than yellow fever can be done by a person's own doctor, or exceptionally(by arrangement) at a hospital. So long as vaccination is done under the National Health Service, whether by a person's own doctor or at a hospital, no charge may be made for it, but in either case the doctor concerned may chargefor issuing an International Certificate. Yellow fever vaccination must, for international and technical reasons, be done only at a Centre designated by the Government; in London the Hospital for Tropical Diseases, 4 St. Pancras Way, N.W.1. 28 An International Certificate of vaccination against yellow fever will be supplied, after vaccination, at the Centre at which the vaccination is done. The International forms for smallpox and cholera (for completion by the person's own doctor) must be obtained by the traveller himself and taken to the doctor; it is NOT for the doctor, or a Local Authority, or the Medical Officer of Health, to supply them. The forms can usually be obtained by the traveller from the Company arranging his transport, or he can get them from the Ministry of Health, Savile Row, London, W.1. After completion by the Vaccinator, certificates must be franked with an approved stamp for the purpose of verifying the signature of the vaccinator. Approved stamps have been prescribed for the United Kingdom. If the Vaccinator is not himself an authorised user of a stamp, the person vaccinated must take or send the certificate for stamping to the Local Authority in whose area the Vaccinator practices. In England and Wales this is the Town Council, Urban District Council or Rural District Council. It should be noted that this is not necessarily the area in which the person vaccinated lives. During the year, 1,652 International Certificates of Vaccination were stamped by the Public Health Department. CHEST DISEASE Notification of Tuberculosis The following table shows the number of cases of tuberculosis notified for the first time during the year 1958, 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 2 - 1 1 1 - - - 5 5-14 - - 1 - - - 2 - 3 15-24 13 8 10 10 - - 3 - 44 25-44 16 16 25 21 6 - 5 - 89 45-64 20 9 11 5 1 - 1 - 47 65 & over 5 4 2 - 1 - 2 - 14 Age unknown - 1 - • . - - - 1 TOTAL 56 38 50 37 9 - 13 - 203 29 The ward distribution of tuberculosis for the year 1958 is shown below. The figures refer primary notifications only and do not include cases transferred into the district. TABLE XV. WARD Mill Hill Burnt Oak West Hendon Central Park Golders Green Garden Suburb Childs Hill Edgware TOTAL Respiratory 15 11 21 9 10 5 11 15 9 106 Non- Respiratory 3 4 - 2 1 3 1 3 5 22 TOTAL 18 15 21 11 11 8 12 18 14 128 The following table shows the primary notification of tuberculosis, excluding inward transfers, for the ten-year period 1949—1958. TABLE XVI. YEAR Respiratory Non-Respiratory TOTAL M. F. M. F. 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 1958 56 50 9 13 128 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 Total Male Female Total Male Female Total Male Female 6 4 10 1 3 4 7 7 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. 799 646 90 84 889 730 1,445 174 1,619 30 THE CHEST CLINIC I am indebted to Dr. H.J. Trenchard, Physician-inCharge of the Edgware Chest Clinic, from whose Annual Report I have extracted the following information MEDICAL STAFF Assistant Physicians : W.C. Harris, M.B., M.R.C.P., R.W. Rowan, M,B., M.R.C.P. Registrar : Dorothy Jill Pearse, M.B., B.S,, M.R.C.S., L.R.C.P. Visiting Consultants : Physician W.E. Snell, M.A., M,D., F.R.C,P., D.P.R, ,, R. Grenville-Mathers, M.A., M.D,, (Cantab) F.R.C.P.(Ed), F.R.F.P.S.G. Thoracic Surgeon R. Laird, Ch.M., F.R.C.S.E. ,, ,, T.W. Stephens, F«R,C.S.E., ,, ,, C.A. Jackson, M.B.E., F.R.C.S. Orthopaedic Surgeon V.C. Snell, F.R.C.S. Assistant Radiologist J.M. Burbury, M.R.C.S., L.R.C.P., D.M.R. Radiotherapist A.M. Jelliffe, M.D., M.R.C.P., F.F.R. TIME TABLE OF CLINIC SESSIONS Telephone : EDG 3406 Mon. Tues. Weds. Thurs. Fri. "X-ray Only" at request of practitioner (no appointment required) 9.30 2.30 2.30 2.30 4.0 Medical Consultative Sessions (appointment required) :- Dr. H.J. Trenchard 11.0 11.0 9.30 9,30 Dr. W.E, Snell 9.30 Dr. R. Grenville-Mathers 11.0 Dr. W.C. Harris 9.30 9.30 Dr. R.W. Rowan 9.30 9.30 Regjstrar 9.30 9.30 Special Consultative Sessions (appointment required) Thoracic Surgery: Mr. R. Laird & Mr. T.W, Stephens(altern.) Thursdays at 12.30 Mr. C.A. Jackson (monthly) Monday at 6 Orthopaedic Surgery: Mr. V.C. Snell (quarterly) Monday at 5 Radiotherapy ; Dr. A.M. Jelliffe (monthly) Friday at 3.30 Refills: Thursday 5 Friday 5 Tuberculin Testing : Saturday 9.30 Contacts : Friday at 2 and evenings by arrangement Allergy ) B,C.G, ) Special clinics as required 31 STATISTICS GENERAL 1954 1955 1956 1957 1958 New patients referred to Clinic 8,459 9,439 10,909 10,769 40,728 Total attendances at consultative sessions 21,318 22,802 24,290 23,573 22,971 Total attendances for refills 9,523 8,652 7,454 6,299 4,212 Number of persons X-rayed 17,096 16,544 17,173 17,709 17,902 Sessions held 861 1,192 1,198 1,211 1,218 Number of home visits by physicians 415 286 411 431 424 TUBERCULOSIS REGISTER New respiratory cases 180 147 149 152 143 New non-respiratory cases 26 24 27 17 21 Total new tuberculous cases 206 171 176 169 164 Tuberculous cases on register at 31st December 1,767 1,788 1,733 1,600 1,508 Removed from register as (a) Dead 32 24 44 25 29 (b) Recovered 89 57 68 155 85 ANTENATAL PATIENTS Antenatal patients X-rayed 1,489 1,482 1,040 1,140 1,180 Number found to have active tuberculosis 4 1 1 1 4 LUNG CARCINOMA REGISTER New cases diagnosed 33 41 50 55 72 Cases known to have died 19 36 36 36 57 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. Sessions were held in Brent Street, Hendon Central, Temple Fortune and Golders Green for the public and the staff of various small firms and shops, and a total of 4,060 people were X-rayed. 32 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 function 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 Renewals of Licences 28 Certificates lodged under Section 363 by members of the Chartered Society of Physiotherapy 4 Licences Refused 1 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 neeessary to take formal action in any case. Fifteen 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 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. 33 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 five burials were carried out, all adults. 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. 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. 34 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 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, Golders Green and Park Wards. These are areas in which the number of doctors is adequate. Normally applications 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. 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 met twice last year to consider problems of liaison and a summary is given in the report as follows — Nursing Recruitment Poster for Display in General Practitioners' Surgeries The Committee considered a poster submitted by the Secretary of the Hendon Group Hospital Management Committee, which was designed for display in general practitioners' surgeries to stimulate nursing recruitment. The poster was approved and distributed to general practitioners in Hendon, Harrow and Wembley. Northwick Park Hospital The Committee supported a Resolution to the North-West Metropolitan Regional Hospital Board submitted by the Willesden Borough Council, expressing 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 Committee were pleased to learn from the Board of Governors of Charing Cross Hospital that the Minister of Health had informed them that a non-teaching general hospital would be built 35 at Northwick Park, and that there would be some enlargement of the Harrow and Wembley hospitals to provide additional hospital accommodation in the area. Smoking and Lung Cancer Mr. Penn, the County Health Education Officer, addressed the Committee on the County Council's policy regarding education and the prevention of lung cancer by smoking. Children often begin to smoke at the early age of 8 or 9 years, and he proposes to carry out more research into a number of schools in Middlesex to try to discover the origins of the habit. Communication of Information from Hospitals to General practitioners The Committee suggested that patients should be told by the hospital authorities that their own doctor is not likely to have a letter from the hospital for six days. The Committee suggested that some consideration should be given to the choice of size of notepaper for specialists' reports, in order that these should fit the 8" x 5" envelope record card provided by the National Health Service, and that the triplicate form used in some local health authority clinics should also be adjusted so that, when folded once, it too should fit the envelope record card. Accidents in the Home The Liaison Committee suggested to the County Medical Officer that the technical memorandum on Burns and Scalds should be distributed to all general practitioners. 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 and to Mr. E.B. Pinder Davis, Hon.Secretary for the Report for the year 1958-59. "During the year now under review we have been much encouraged by spontaneous and in some cases quite unexpected acts of kindness which show that there exists a widespread feeling of goodwill towards the older members of the community. This is particularly pleasing when it is through the young that such feelings are given practical demonstration. Last summer three schools sent us very substantial harvest offerings of fruit, vegetables and groceries for distribution. During a Youth Festival the entire proceeds of a concert and an athletic meeting were handed to the Committee. In a girls' school the pupils in one form decided to earn by their own efforts a sum of £5. so that an old person, who would otherwise not get a holiday, might go with our party to Cliftonville. Recently the Hon. Secretary was asked to be present at a cinema to receive a gift of groceries from the Saturday morning children's cinema club. Gifts arrive from most unexpected sources, and the mention of the words "old people" nearly always brings a sympathetic response when some special service or facility is requested. Our Constituent Organisations, in particular, continue to devote a gratifying part of their time and resources to the service of the elderly, and 36 are at all times ready to give their help and cooperation in assisting the activities of the Committee. CLUBS The weekly clubs run by the Constituent Organisations have continued their useful work in bringing elderly people together and providing recreation and social intercourse. Unfortunately, year by year, certain members cease to attend simply because through age or infirmity they can no longer use public transport. This is a problem which will have to be tackled. Certain tentative suggestions which might lead to a solution have already been made. The Over 60's Club which meets on weekday afternoons at Station Road now has a membership of 200 with an average weekly attendance of about 150. This number also came to the New Year party at Hodford Hall. The Club Constitution has been revised and the House Committee meets monthly. In spite of not unexpected teething troubles this hag been most beneficial and the Club is now a much more live institution. An exhibition of handcrafts was held shortly before Christmas, a choir has been started, and the Club Committee now run a monthly whist drive. Since her appointment last August as Assistant to the Organising Secretary, Mrs. Wheals has been in charge of the Club and this has been a most satisfactory arrangement. Our thanks and those of all the Club members are due to Duty Officers and to members of Constituent Organisations for all the help and service which they have given during the past year. CHIROPODY0 For the twelve months ending March 31st last, the grant from the National Corporation for the Care of Old People was increased to £170, During this period 185 patients received 772 treatments in private surgeries, at the Red Cross Clinic and in their homes. Approximately half of all these patients are housebound. Our thanks are due to Mrs. McCabe who travels many miles to all parts of the Borough to attend to their needs. In March, at. the suggestion of Dr. Patton, the Borough Medical Officer of Health, the chiropodists operating the scheme were invited to a meeting at Station Road.(A report on this meeting is attached).The period of the three year grant from the National Corporation for the Care of Old People ended on March 31st this year, and application for a suitable grant has now been made to the Middlesex County Council. Meanwhile, we are continuing to operate the scheme without alteration. VISITING The problem of discovering those old people who need visting because they are lonely lends itself to no easy solution. The greater number of requests for a visit received in t0he office are in connection with some specific problem or difficulty. In nearly all such cases the first visit is made from Station Road. Advice is given and, when necessary, the required action is taken. Even when little or nothing can be done to help — as with housing problems — the mere fact of a prompt response to the request seems to have a good effect. Requests for regular visits are sent to lady 37 visitors on our files or to a Constituent Organisation. From the reports which we have received it is clear that these latter do an impressive amount of visting which probably accounts for the relatively small number of visiting requests, unconnected with difficulties or problems, which come to the office. The number of visits paid direct from the office since last May is approximately 200. HOLIDAYS AND OUTINGS The holiday at Cliftonville which we organise annually took place during the week commencing Friday May 9th. In spite of the 'bus strike two 33 seater coaches got away only slightly late. They were accompanied by Nurse O'Brien of the Red Cross to whom our thanks are due. Rooms have been booked at the same hotel for this year. A noteworthy outing to Southend took place in July as a sequel to the visit to the Borough by Her Majesty The Queen Mother. We were fortunate in the weather and 84 elderly people were given an exceptionally good and enjoyable day. Owing to the felicitious circumstances, this outing received considerable publicity and the name "Golden Key" seems to have stuck. FUND RAISING ACTIVITIES The annual postal appeal which took place in October yielded a profit of £141.17s.0d. This result, although hardly spectacular for a Borough of the size of Hendon, shows nevertheless a marked improvement on 1957. The sole expense incurred was for postage as the printing was done entirely free of charge by the Hendon Printing Works to whom the Committee offers its grateful thanks. It has been decided to make a similar appeal this autumn and work has already started on preparation of the mailing list. CHRISTMAS GIFTS Groceries received from various sources were made up into parcels and taken to selected old people on our visiting list. 72 pre-cooked Christmas dinners were distributed by the W.V.S. Mealson-Wheels Service and by ourselves. These gifts, particularly if attractively done up and delivered personally, give quite exceptional pleasure. Possibly something on a much larger scale should be attempted this Christmas. OTHER GIFTS By the generosity of the Watts family of "The White Swan", Golders Green Road, a 17" H.M.V. television set was presented to the Committee for use in the Club. The aerial was installed free of charge by Mr. S. Thaine as a donation to the Annual Appeal. Other gifts of furniture, clothing and produce have been placed where they were most needed. THE WELFARE COACH "POLLY" The coach continues to perform a useful service. Since last autumn it has been used regularly twice each month by the Edgware Blind Club and there are regular bookings in connection with other clubs. The revised London Transport schedules sometimes make it difficult to obtain drivers at the exact times when they are needed. We have therefore approached Cricklewood Garage and they have already taken on several bookings. 38 In offering our thanks to these drivers we cannot praise too highly the friendliness and the willing help which is always forthcoming from them, particularly when conveying blind or disabled old people. The satisfactory running of a coach on these lines is not at all easy. We cannot afford to employ a paid driver and the exacting and complicated schedules to which the volunteer drivers have to adhere must always present a problem. We realise that club leaders cannot quickly communicate with their members and every effort is made by the office to avoid last minute changes or cancellations. We should, however, be concealing the truth if we suggested that "Polly" is not sometimes a cause for worry. INFORMATION PAMPHLET Committee members have received a copy of a small pamphlet which lists and explains the services which the Committee offers. It gives also particulars of public and voluntary bodies about which the Old Age Pensioner should know. Criticisms and suggestions for the improvement of this pamphlet will be welcomed before it goes into print. THE CONSTITUENT ORGANISATIONS It had been intended to include a brief report on the activities of each Organisation represented on the Committee. It was found, however, that this would occupy too much space and it would have been to a large extent a duplication of facts which are to be found in the Information Pamphlet. But we would, however, like to take this opportunity to congratulate the Hampstead Garden Suburb Fellowship on the recent completion of their new Fellowship House — a beautifully appointed club house in delightful surroundings. This is an event of some importance. : We are very conscious that the Club at Station Road can be of use only to the limited number of old people who live in the central part of Hendon. It may well be that similar clubs with their own premises are needed in other parts of the Borough. This is a question requiring serious consideration. The Committee would welcome information and suggestions on this subject. ACKNOWLEDGMENTS We are most fortunate in the friendly relations which exist between ourselves and the officials and staffs of the public bodies with whom we come in contact. Requests for advice or assistance invariably meet with a most ready response and action is taken, where necessary, with an absolute minimum of formality. To the Voluntary Organisation, whose names are far too numerous to mention here,, we offer our most grateful thanks for all the work which they have carried out in furtherance of the aims of the Committee during the past year. Their services cover an extensive field which embraces large scale catering, meals on wheels, escort work, visiting, cinema shows, clubs, outings, entertainment and countless other activities. In tendering our thanks to the Constituent Organisations we hope they will always remember that the Committee exists, in part, to be of assistance to them, and that they will never hesitate to approach us if it is felt that we can be of help. 39 OFFICE STAFF Our thanks are due to the Organising Secretary and her Assistant not only for the really hard work which they have put in but also for their friendliness and patience towards the many old people whom they meet. Both Mrs. Butler and Mrs. Wheals have given freely of their leisure in performing such varied and unconvenanted tasks as catering, taking down and hanging curtains and general spring cleaning, in which activities they have on occasion been ably abetted by their respective husbands. CONCLUSION It is suggested sometimes that under the Welfare State the scope for voluntary work has become much restricted, even if the need for it exists at all. Experience contradicts this view. The State may provide a basis of security but it cannot give help in every contingency nor can it always dispel fear and anxiety. And for many old people there is still ample cause for both. It should be remembered that material standards are continually rising. Today's luxuries will be tomorrow's necessities. To define what is a reasonable standard of living is not easy, but it should be something more than just keeping going. The State does now provide a great deal and fortunately the various public welfare services are administered by trained and sympathetic people with a high sense of duty. But the need for voluntary service will always exist. We would all be poorer without it." CHIROPODY SERVICE FOR O.A.P's. Dr. J.L Patton, M,B., Ch.B., D.P.H., Medical Officer of Health to the Borough of Hendon, gave the following summary of the work of the Chsropody Service since its inception. For 13 years the British Red Cross has maintained a chiropody service for old people at their Headquarters in Hendon. In addition, the British Red Cross have also made arrangements for cases to be treated at Edgware General Hospital on the recommendation of a hospital speci aljst. Three years ago the National Corporation for the Care of Old People were good enough to promise the Borough of Hendon Old People's Welfare Committee a grant of £60 a year for three years towards the cost of a chiropody service. The Committee were fortunate to have the benefit of Mrs. Marsh's experience of the working of the British Red Cross Society's chiropody service, and decided to give a more widespread service to more old people in the Borough. Chiropodists in private practice in Hendon are registered by the Hendon Borough Council under the Middlesex County Council Act, and registration is limited to chiropodists who at e e ther members of the Society of Chiropodists or the Institute of Chriopodists, or who were m practice before the Byelaws and Regulations were made. There are 24 chiropodists serving a population of 153,000,9 of whom are Fellows, Members or Associates of the Society of Chiropodists. All the chiropodists were invited to attend a meeting in May, 1957, to discuss the possibility of setting up a service for old people. In order to save long journeys by the patients, it was decided that arrangements should be made for treatment to be carried out at the chiropodists' own surgeries, 40 In the first instance the service was offered to all old age pensioners in the Borough. Four months later, in October 1957, the Committee realised that the cost of the service would far exceed the grant, and since then it has been found necessary to restrict the service to the limited number of those old age pensioners in receipt of National Assistance even though the National Corporation for the Care of Old People had agreed to increase the grant towards the cost of the service. The numbers treated have been relatively small, but that is not surprising as the scheme was essentially experimental in nature. In February, 1959, it was decided to invite the chiropodists to come to another meeting to comment on the working of the scheme, Shortly after the arrangements for the meeting were made, the Minister of Health stated that, under Section 28 of the National Health Service Act, those local authorities who wished,to contribute to the funds of voluntary organisations for the purpose of providing chiropody would no longer need to seek his approval. This was a definite change in policy, because in the past the local health authorities had been allowed to contribute only to those chiropody schemes which had been in existence before the National Health Service Act was passed . The future trend for chiropody services for old people would appear to be for the Local Health Authority, that is for the Middlesex County Council, either to subsidise schemes devised by voluntary organisations such as the Old People's Welfare Committee, or alternatively to administer the scheme directly. A scheme organised by the voluntary organisations would allow scope for treatment at the chiropodists' own surgeries and also for domiciliary treatment On the other hand, were the scheme to be administered directly by the Local Health Authority, there would be some degree of medical supervision, the treatment would probably be carried out at the Council's clinics and the chiropodists employed would have to satisfy the statutory requirements for registration as medical auxiliaries. Mr .J.R. Hall, President of the Society of Chiropodists, then gave a report on his recent meetings with officials of the Ministry of Health and other Government Departments who would be concerned with administration in the event of chiropody being brought within the Health Service. He also emphasised the point that if it should be decided to establish clinics there would be great difficulty in finding sufficient chiropodists with qualifications required by the Ministry. It would appear that for some time to come it would be necessary to make use of existing private surgeries to the greatest possible extent. This would in fact be an extension of the type of service which has been in operation for the last two or three years in Hendon and certain other Boroughs. But the cost would be met from public instead of private funds. A discussion followed. It appeared that the chiropodists operating the scheme were satisfied with the way it was working and hoped it would continue on its present lines. It appeared from information supplied by Mis. Marsh that the Red Cross Clinic at Mary lands was somewhat overloaded which led to patients having to wait up to two months for an appointment. 41 It was suggested that new patients should be sent to Station Road. They would then receive treatment in private surgeries nearest to their homes. It was felt further that the Red Cross needs more chiropody sessions and that they might consider making an application to the Old People's Welfare Committee for two extra sessions each month. This would lead to a considerable reduction in the interval between individual treatments. DETAILS OF TREATMENTS GIVEN IN 1958 No. of Patients No. of Treatments Treated at home 91 206 Treated at Red Cross Clinic (approx.) 65 389 Treated at surgeries 30 177 186 772 The following were present at the meeting: Miss C.R. Beckwith, M.Ch.S., 618A Finchley Road, N.W.11. Mr. Douglas M. Limbrey, M.Ch.S., 68 Edgwarebury Lane, Edgware. Mr. D.B. Johnston, M.Ch.S., 236 Station Road, Edgware. Miss H.E. Welham, F.Ch.S., 7 Rosslyn Mansions, Watling Avenue. Mrs. A. Scott, M.Ch.S. 43 Hale Lane, N.W.7. Miss D. Goodman, M.Ch.S., 162a The Broadway, N.W.9. Mrs. M. Allum, M.Ch.S. 58 Glengall Road, Edgware (Red Cross Clinic). Mrs. E. McCabe, M.Ch.S., 206 Camrose Avenue,Edgware. also Dr. Patton, Medical Officer of Health. Mrs. F. Marsh. Mr. J.R. Hall, F.Ch.S. Mr. E.B. Pinder Davis. Alderman J.L. Freedman, J.P., M.A., LL.B. Mrs. K. Butler." HENDON OLD PEOPLE'S HOUSING SOCIETY. I am indebted to the Honorary Secretary, Mr. A.E. Harvey of 36 Grampian Gardens, N.W.2. for the Third Annual Report which includes the following important statement. "Applications received for admittance to the Home are far greater than it is possible to accommodate. The experience of almost every one who is trying to find accommodation for an old person is 'no vacancies'. The rate at which homes are being built at present cannot meet the demand and the situation seems likely to continue unless it becomes possible for local authorities to spend large capital sums on building in the near future. The recommendations of the Royal Commission on the Law relating to mental illness, when they are put into force, will mean a greater demand for homes for a large number of old people, who are no longer in need of hospital treatment, but would probably need much care and attention. Then again it is necessary to find the right home for the right person. " 42 STAFF MEDICAL EXAMINATIONS During the year under review 109 new entrants or employees of the Hendon Borough Council were medically examined for superannuation purposes. Of this number 96 employees were passed as fit, 4 were unfit and in 9 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 9 Borough Treasurer's 4 Borough Engineer's 54 Borough Librarian's 24 Borough Housing Officer's 16 Medical Officer of Health's 2 109 43 SECTION D. SANITARY CIRCUMSTANCES OF THE AREA Wafer 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 45,050 (b) by means of standpipes Nil Number of population supplied from public water mains (a) Direct to houses 151,500 (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. HOUSING I am indebted to the Housing Officer for the following observations and statistics relevant to the housing situation. "Steady progress has been maintained in providing accommodation for persons in need of rehousing and 405 families were rehoused into permanent houses and flats during the past year. The number of Council dwellings at 31st December 1958 was 4,079 of which 2,789 have been erected in post-war years 44 A feature of the year's building programme has been the commencement of the first phase in the redevelopment of the New Brent Street area. This redevelopment will be carried out in three phases spread over three years, and when completed will provide accommodation for some 188 families, housed in two eleven storey and nine five storey blocks of flats. The design and construction of these flats are on the most modern lines and incorporate electric floor storage heating — the most up to date medium of space heating for dwellings. Apart from the areas chosen for 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. During the course of the year 82 families were rehoused from dwellings which had been scheduled as unfit for human habitation. The triennial review of the Housing Waiting List was undertaken during the year, and on the 31st December 1958 the number of families still in need of suitable housing accommodation was 2,540. There has again this year been a marked increase in the demand for the rehousing of elderly persons, and in recognition of this growing demand the Council have ensured that a proportion of all new building schemes includes the provision of accommodation suitable for occupation by this class of applicant. In accordance with the provisions of the Requisitioned Houses and Housing (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 available for letting. 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 Council have also supported schemes initiated by private Housing Societies and have thus been enabled in some instances to nominate housing applicants as tenants for the properties constructed. The policy of transferring Council tenants living in accommodation in excess of the 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 cooperate with other local authorities and private owners to secure exchanges of tenancies which have been mutually beneficial and records have been maintained for the purpose of effecting suitable introductions between tenants. 45 The following table sets out the number of housing applicants assisted during the year ending 31st December 1958. (a) Families rehoused into permanent accommodation: Pre-war properties 70 Post-war properties 335 405 (b) Transfers arranged to deal with overcrowing, underoccupation etc., on Council estates 331". 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 7,001 Re-inspections after order or notice 11,929 Complaints received and investigated 1,232 Bakehouses 51 Butchers Shops 225 Caravans 147 Clean Air Act Inspections 322 Dairies 13 Drain tests 210 Factories 186 Hawkersand food delivery vans) Hawkers storage premises and stalls) Ice Cream Samples 17 Ice Cream premises 17 Infectious Disease 548 Licensed premises 89 Milk samples 32 Other food shops 714 Overcrowding 3 Outworkers 34 Piggeries 4 Public entertainment in connection with licensing 95 Restaurants, cafes, etc. 250 Smoke observations 209 Stables 31 Swimming baths 29 Pet Animals Act 1951 16 Hairdressers and Barbers premises 29 46 Notices Served Informal or cautionary 750 Complied with 716 Statutory Notices Applied for 103 Served under Public Health Acts 63 Outstanding from 1957 4 Complied with during 1958 48 Outstanding at end of 1958 19 Inspection of Dwelling.Houses During 1958 Total number of dwellinghouses inspected for housing defects (under Public Health Acts) 1,632 Number of inspections made for the purpose 4,269 Number of dwellinghouses found not to be in all respects reasonably fit for human habitation 423 Legal Proceedings under Public Health Act, 1936, Section 94, During the year it was found necessary to institute legal proceedings in two cases for the abatement of nuisances. One case arose from the keeping of cats, and the Magistrates granted an Order for the abatement of the nuisance within seven days and awarded the Council £5.5.0. costs. It was also necessary in this case for a Warrant of Entry to be applied for by the Public Health Inspector. The other case arose from failure to comply with an Abatement Notice requiring the carrying out of repairs and although the work was executed shortly before the Hearing, the case was proceeded with and the Magistrates awarded the Council £3.3.0. costs. HOUSING ACT, 1957 During the year under review 34 houses were dealt with under the Housing Act, 1957, involving the making of 4 Demolition Orders and 30 Closing Orders. Certificates of Unfitness were issued under the Housing Subsidies Act, 1956 in respect of 22 houses in the Council's ownership. Of the 56 houses, 23 were actually closed during the year, and 4 were demolished. In addition, 48 houses were closed and 11 demolished in respect of which Closing or Demolition Orders had been made or Certificates of Unfitness issued prior to 1958. During 1958, 89 families involving 297 persons were displaced from unfit properties, 82 families involving 281 persons being rehoused by the Council and 7 families involving 16 persons being rehoused by other authorities or finding their own accommodation. The steady progress already made in dealing with the unfit houses listed in the survey of the Borough carried out under the Housing Repairs and Rents Act, 1954, was maintained throughout the year and very few houses now remain to be dealt with outside the areas defined by the Council as being in need of redevelopment. 47 In these areas it has been found that the most satisfactory procedure is the issue of Certificates of Unfitness under the Housing Subsidies Act, 1956, (now the Housing (Financial Provisions) Act, 1958) after the unfit properties have been acquired by the Council. Formerly, in those cases where the procedure for the making of Demolition or Closing Orders was running concurrently with the negotiations of the Borough Treasurer or District Valuer for the acquisition of the properties, owners have not infrequently expressed a fear that the Council was using its powers to condemn the properties in order to obtain the sites for nothing. Now, wherever practicable, action by the Public Health Department is withheld until after the purchase of the properties by the Council has been completed. Certificates of Unfitness are then issued and forwarded to the Minister of Housing and Local Government for confirmation and the matter referred to the Borough Housing Officer for the rehousing of the tenants. In order to assist in the negotiations for the acquisition of properties in the areas of proposed redevelopment, a preliminary survey of all the properties is carried out by the Deputy Senior Public Health Inspector and reports on their condition submitted to the Borough Treasurer and District Valuer. These reports indicate which properties are so unfit as to warrant, the making of Demolition or Closing Orders and indicate the state of repair of the others. This assists in the assessment of the value of the properties and also gives an indication of the number of families in respect of which the Council might expect to receive "slum clearance" subsidies. RENT ACT, 1957 The following figures show the number of applications for Certificates of Disrepair and Revocation received and the action taken during the year. Applications for Certifcates of Disrepair Number of applications for certificates 63 Number of decisions not to issue certificates 2 Number of decisions to issue certificates: 56 (a) in respect of some but not all defects 47 (b) in respect of all defects 9 Number of undertakings given by landlords under paragraph 5 of the First Schedule 41 Number of undertakings refused by Local Authority - Number of Certificates issued 37 Applications for Cancellation of Certificates Applications by landlords to Local Authority for cancellation of certificates 10 Objections by tenants to cancellation of certificates 4 Decisions by Local Authority to cancel in spite of tenants' objection 1 Certificates cancelled bv Local Authority 7 48 Some of the certificates issued had been applied for late in 1957 and other applications received late in 1958 were outstanding at the end of the year. Cinemas and Places of Entertainment and Licensed Houses During the year 184 inspections were made by the Public Health Inspectors and detailed reports submitted to the respective licensing authorities. Smoke Abatement Number of observations made during the year 209. A number of complaints were received of individual smoke nuisances. These were all dealt with informally and in most cases little subsequent trouble was experienced. Cesspools A number of houses in the more rural portions of the Borough are drained into cesspools. These were emptied by the Council on 245 occasions during the year. insect Pests Complaints of ants, book-lice, bugs, carpet beetles, clover-mite, cockroaches, crickets, fleas, flies, furniture mites, larder beetles, silver fish, wasps and woodlice, were all dealt with during the course of the year by the Public Health Inspectors as part of their normal routine duties, and advice given on the best means of eradicating the pests and preventing a re-infestation of the premises. In the case of bugs and fleas the actual work of disinfestation is carried out by an operative working under the supervision of the Public Health Inspectors in co-operation with the tenants. During the year 14 premises were successfully treated for bug infestation and 5 for fleas. 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. 49 During the year 226 library books and 6 gramophone records were disinfected. The number of rooms disinfected during the year was 138, 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»seven 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 10 Hairdressers and Barbers Twenty-nine 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. A report on the work carried out for the year ended 31st December, 1958, is given in the following table, which is based on the return sent to the Ministry of Agriculture, Fisheries and Food. 50 TABLE XVIL Type of Property Non-Agricultural Agricultural Local Authority Dwelling Houses (including Council Houses) All other (including Business Premises) Totals of Cols. (1) (2) and (3) (1) (2) (3) (4) (5) 1. Total number of properties in Local Authority's District 17 45,050 5,874 50,941 10 2. Number of properties inspected as a result of (a) Notification 3 634 88 725 - (b) Survey under the Act - 593 39 632 - (c) Otherwise - 197 73 270 - 3. Total inspections carried out including reinspections 50 12,042 1,394 13,486 - 4. Number of properties inspected (under Section 2) which were found to be infested by (a) Rats Major - - 1 1 - Minor 2 1,242 139 1,383 - (b) Mice Major - - - - - Minor 1 96 22 119 - 5. Number of infested properties (under Section 4) treated by the Local Authority 3 1,336 146 1,485 - 6. Total treatments carried out including retreatments 14 1,834 202 2,050 - 7. Number of notices served under Section 4 (a) Treattnent - - - - - (b) Structural work (i.e.;, Proofing) - - - - - 8. Number of cases in which default action was taken following the issue of a notice under Section 4 of the Act - - - - - 9. Legal Proceedings - - - - - 10. Number of 'Block' control Schemes carried out - 192 1 193 - 51 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 31 4 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 373 180 12 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers premises). 9 2 - TOTAL 413 186 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.l) 11 11 - Overcrowding (S.2) - - - Unreasonable temperature (S.3) - - - Inadequate ventilation (S.4) 3 3 - Ineffective drainage of floors (S.6) 1 1 - Sanitary Conveniences (S.7) (a) Insufficient 1 1 1 (b) Unsuitable or defective 2 2 2 (c) Not separate for sexes 2 2 2 Other offences against the Act (not including offences relating to Outwork) 20 20 - TOTAL 40 40 5 52 Part VIII of the Act. OUTWORK (Sections 110 and 111) Nature of Work No. of Outworkers in August list required by Section 110(1)(C) Making, altering, ornamenting and finishing wearing apparel 86 Making of bed linen 1 Making of curtains and furniture hangings 5 Cabinet and Furniture making and Upholstery 2 Artificial Flowers 4 Making of cardboard boxes 5 Making of brushes 1 Making of Christmas Crackers 7 Making of lampshades 9 TOTAL 120 CLEAN AIR ACT, 1956 During the course of the year a detailed survey was carried out for the making of a Smoke Control Area in the north-western part of the Borough, to be known as the Borough of Hendon Smoke Control (No.l) Order,, 1958. Notices on behalf of the Council were published and posted and appropriate publicity was given in the area affected by the Order. Measurement of Atmospheric Pollution The Smoke Measuring Stations and Deposit Gauge have now been operating for a full year. The various graphs and tables demonstrate clearly how pollution increases in the winter. The December measurement shows a six fold increase on June; the important factors are the domestic fire burning bituminous coal and the calm weather common in November and December, , The Smoke Measuring Stations are installed in Edgware and Goldets Green Public Libraries and a daily esti mation of sulphur dioxide in the air is carried out. 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 graph. 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-eoluble deposit expressed in tons per square mile. , 53 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. TABLE XVIII. DEPOSIT GAUGE, TOWN HALL Table showing monthly deposit of total solids: 1958 Rain ins. Total solids Tons per sq, mile January 2.72 27.51 February 2.40 29.08 March 1.38 19.07 April 1.62 16.67 May 2.36 15.34 June 4.69 15.50 July 2.48 24.98 August 3.35 17.01 September 4.65 19.51 October 2.56 14.80 November 2.40 17.34 December 2.84 13.84 TOTAL 33.45 230,65 TABLE XIX. DAILY AVERAGE OF SMOKE AND SULPHUR DIOXIDE AT EDGWARE AND GOLDERS GREEN MEASURING STATIONS 1958 Edgwaie Golders Green *Smoke †Sulphur * Smoke †Sulphur January 15.8 8.0 18.3 10.3 February 12.6 7.3 13.9 8.6 March 10.9 7.03 12.7 7.5 April 6.4 4.2 7.4 4.9 May 4.2 2.6 4.7 4.0 June 3.6 3.4 5.8 3.8 July 3.7 2.6 6.3 3.8 August 3.2 2.7 6.1 3.5 September 3.7 3.6 8.0 4.2 October 9.0 5.6 12.9 6.8 November 18.3 8.9 22.7 11.1 December 19.6 10.8 31.7 12.3 TOTAL 111.0 66.73 150.5 80.8 #Average daily smoke concentration in mgms, per 100 cu. metres of air. †Average daily sulphur concentration per 100 million volumes of air. 54 SMOKE FILTER AND SULPHUR DIOXIDE STATIONS 1958 55 DEPOSIT GAUGE - TOWN HALL 56 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 pencil (Section 2) Guilty Fined £10 and £1.1.0. costs Selling bread containing a piece of metal (Section 2) Guilty Fined £10 and £3.3.0. costs Selling roast pork unfit for human consumption — 2 charges (Section 8) Guilty Fined £5 on each charge and £5,5.0. costs Selling lemonade unfit for human consumption (Section 8) Not Guilty Acquitted Same offence charged by first defendants against manufacturers of bottle stopper (Section 113) Guilty £5.5.0. costs Selling milk containing broken glass (Section 2) Not Guilty later changed to Guilty Fined £5 and £5.5.0. costs Selling a bun containing tobacco (Section 2) Guilty Fined £5 and £4.4.0. costs Selling sausage rolls not of the quality demanded (Section 2) Guilty Fined £10 and £2.2.0. costs ACTION TAKEN IN CONNECTION WITH FOOD STORES AND FOOD SHOPS 89 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 60 notices had been complied with. NUMBER AND TYPE OF FOOD PREMISES IN THE AREA Grocers and provision merchants 202 Butchers 95 Bakers and confectioners 56 Greengrocers 96 Fishmongers 40 Confectionery shops 133 Restaurants and Cafes 169 Works Canteens 45 Food Warehouses 1 57 FOOD AND DRUGS ACT, 19 55 - SECTION 16 Registered Premises Inspections Ice Cream Premises 218 34 Preservation of Food 69 29 17 samples of ice cream were taken during the year and submitted for bacteriological examina^ tion to the Central Public Health Laboratory, Colindale. The results of the ice cream samples were as follows Grade Number of samples I 16 II 2 III Nil IV Nil MIDDLESEX COUNTY COUNCIL ACT. 1950 - SECTION 11 Registration of Hawkers and Premises Number Registered Number of Inspections Hawkers 72 33 Premises 25 MILK SUPPLY Number of registered dairymen and distributors 45 Number of registered dairies not being dairy farms 11 Number of visits made to dairies during the year 13 MILK AND DAIRIES REGULATIONS, 1949 During 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 1958 Dealers Licences: Tuberculin Tested 37 Pasteurised 36 Sterilised 44 Dealers Supplementary Licences: Tuberculin Tested 20 Pasteurised 20 Sterilised 20 58 MILK SAMPLING The number of samples taken during the year is as follows:— Pasteurised 11 Tuberculin Tested Pasteurised 6 Sterilised 3 Milk in cartons (Pasteurised) 12 In addition 58 samples of bottle rinses were taken during the year. CONDEMNATION OF FOOD The amount of foodstuffs condemned during the year shows little change from 1957. 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 through^ out London. Condemned foodstuffs are disposed of by incineration at the Council's Refuse Disposal Works, LIST OF FOODSTUFFS CONDEMNED DURING 1958 MEAT 2,106% lbS. (including — Bacon, Beef, Chicken, Ham, Lamb, Offal, Pork, Sausages, Veal») 7 Pies. FISH 8½4 st. (including -Skate, Cod Roes) 13 packets Frozen Fish TINNED FOOD Meat 549 Milk 76 Fruit 935 Vegetables 378 Soup 42 Fish 97 Jam 46 Fruit Juice 39 Tomato Juice 3 Ham 39 (381 lbs. 14 oz.) FRESH FRUIT, Currants 50 lbs. DRIED FRUIT Dates 8 oz. AND VEGETABLES Dried Peas 8% lbs. Frozen Peas 41 packets Peaches 96 packets Raisins 3¾1% lbs. MISCELLANEOUS Bicarbonate of Soda 2 lbs. GOODS Biscuits 351/2 lbs. Blancmange Powder 8 packets Butter 23 lbs. Cakes 65 Cake Icing 8 cartons Cake Mixture 23 packets Cereal 408 packets 59 MISCELLANEOUS Cheese 15 0 lbs. 14l/2 oz. & 92 packets GOODS (cont.) Chocolate Spread 2 cartons Coffee 14 tins Confectionery 28 lb. 4 oz. Cornflour 2 pkts. Cream 2 tins and 2 bottles Custard Powder 3 pkts. Flour 45 lb. Glace Cherries lll/2 lb. Gravy Powder 3 pkts. Horseradish 12 jars Ice Cream 98 large bricks Iced Cakes 5 Jam 13 jars Jelly 17 pkts. Junket 98 bottles Macaroni 1 lb. Margarine 8½ lb. Milk Foods/Beverages 13 tins Mousse 121 pkts. Oatmeal 18 lbs. Olive Oil 1 bottle Paste 4 jars Peel Mixed 2 cartons Pepper 32 tins Pickles 12 jars Potato Crisps 30 pkts. Pudding Mixture 3 pkts. Pudding 13 tins Rice 4 lb. Rice Pudding 26 tins Sauce 4 bottles Semolina 5 lb. Spaghetti 1 carton Spice 4 cartons Squash 1 bottle and 10 cartons Suet 12 pkts. Sugar 43 lbs. Sugar Icing 2 lbs. Tapioca Flakes 2 lbs. Tea 131½ lbs. Vermicelli 1 pkt. 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. OvKeefe8 the Chief Officer of the Public Control Department,, for 60 the following report on the work of his Department during the year. "LIST OF SAMPLES PROCURED IN THE BOROUGH OF HENDON DURING THE YEAR 1958 Article Total Samples Procured Unsatisfactory Milk(Various) 208 - Butter 35 - Cakes 7 1 Cream 41 - Drugs 54 2 Fish and Fish Products 36 - Fruit, Fresh, Canneds Dried 25 3 Ice Cream 34 - Liver 38 - Margarine 18 - Meat and Meat Products 67 - Preserves 5 - Sausages, etc. 9 - Spirits 6 - Sweets 10 - Vinegar 41 - Miscellaneous 27 - TOTAL 661 6 With regard to the samples noted on that list as being unsatisfactory., I add the following comments:— Cakes. An official caution was addressed to one trader who sold flour confectionery as "Cream Slice" when the filling was imitation cream. Drugs. Two samples of tincture of iodine procured from a retailer were found to be slightly deficient in iodine content. Subsequent samples from the same source were found to be satisfactory and no further action was taken. Fruit. A sample of fresh apples was found to bear on the skin a contamination of arsenic and lead slightly in excess of the very small amount generally permitted. Contamination of this nature can readily be removed by adequate washing whichv in this case; had not been carried out by the shopkeeper concerned although, from the knowledge which he had, he should have realised that such a precaution should have been taken. This matter was dealt with by caution. A trader was prosecuted for labelling Beurre dJAnjou pears as "William Pears" and also for selling these pears in response to a purchaser's request for "William Pears". He was fined £5 on each of two summonses and ordered to pay £3.3,0. costs. Another trader was found committing similar offences in respect of Packham's Triumph pears ticketted ae and sold as "William Pears". He also was fined £5 on each of two summonses, together with £3.3.0d. costs. Merchandise Marks Acts, 1887— 1953. The majority of the inspection work carried out under the provisions of the above Acts relates to ensuring that the requirements of the various Marking 61 Orders made under the provisions of the Act of 1926, and which relate to the marking with an indication of origin of certain imported foodstuffs when exposed for sale or sold, are complied with. Inspections were made at 218 separate premises of 668 displays of meat, apples, tomatoes, poultry, butter and dried fruit. No serious infringements were detected. Labelling of Food Order, 1953, This Order requires pre-packed food to be marked with the name and address, or with the registered trade mark, of the packer or labeller. It also requires such food to be labelled with its common or usual name (if any) and with the names of the ingredients of a compounded food. It also controls the manner in which the presence of vitamins and minerals is disclosed and prescribes specific labelling of certain foods. A total of 425 articles of pre-packed food was examined at 119 premises to ascertain whether the above requirements were complied with; no serious infringements of this Order were detected. False or Misleading Descriptions. As in previous years food advertisements and labels have been scrutinised for false or misleading statements and descriptions,. Much of this scrutiny of food labels can be combined with inspection work under the Labelling of Food Order,, No serious infringements were disclosed. Corrective action was secured in relation to descriptions applied to "milk block", "Double Tea", an imitation cream powder, cakes filled with a mixture of butter and sugar, canned mixed vegetables, raspberry syrup, powdered soup mixes, medium red salmon, gorgonzola cheese spread and cheese spread. Special Designated Milk. During 1958 my Council issued one Dealer's (Pasteuriser's) licence in respect of premises within your area where milk is processed. These premi ses were regularly inspected, and compliance with statutory requirements was well maintained, A total of 52 samples of designated milk was taken, all of which were certified as being satisfactory. Safe Milk. In addition to the foregoing, 6 samples of raw milk were procured within yout Borough and submitted to test for the presence of tubercle bacilli. None was found coniam nated." SLAUGHTERHOUSES There are no licensed slaughterhouses in the district. 62 Printed & Published by Hendon Borough Council.