Library Hen 36 BOROUGH OF HENDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1959 J. L. PATTON, M.B., Ch.B., D.P.H. Medical Officer of Health A. H. SMITH, M.A.P.H.I. Chief Public Health Inspector BOROUGH OF HENDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1959 J. L. PATTON, M.B., Ch.B., D.P.H. Medical Officer of Health A. H. SMITH, M.A.P.H.I. Chief Public Health Inspector TOWN HALL, HENDON, N.W.4 Telephone No.: HENdon 8282 CONTENTS OF REPORT Page Introductory Remarks of Medical Officer of Health 4-5 SECTION A: STATISTICS AND SOCIAL CONDITIONS OF THE AREA: General 6 Births, Birth Rate, Stillbirths, Stillbirth Rate 6 — 7 Deaths, Death Rate 7 Maternal Mortality 7 Infantile Mortality 7-9 Summary of Vital Statistics for the year 1959 10 Table Showing Vital Statistics for the years 1933-1959 11 Table Showing Certain Vital Statistics for the County of Middlesex for 1959 12 Table Showing Causes of Death for the year 1959 13— 14 Health Statistics 15-10 Smoking in Youth Clubs 16 Deaths from Cancer of Lung and Bronchus 17 Road Traffic Accidents 18—19 SECTION B: PREVALENCE OF, Mffs CONTROL OVER, INFECTIOUS AND OTHER DISEASES: Notifications 20 Age and Ward Distribution of Infectious Diseases 21—22 Notes on Infectious Diseases 23—26 Diphtheria and Diphtheria Immunisation 26—28 Poliomyelitis Immunisation 28 Smallpox Vaccination 28 International Certificates of Vaccination 28 Chest Disease 29—30 Report of Chest Physician Edgware Chest Clinic 31—35 SECTION C GENERAL. PROVISION OF HEALTH SERVICES FOR THE AREA: Establishments for Massage or Special Treatment 36 Action under Section 47, National Assistance Act, 1948 36—37 National Assistance Act, 1948, Section 50 - Public Burials 37 Hospital Facilities 37 Health Services provided by the Middlesex County Council 37—38 Medical Practitioner Service 38 Laboratory Facilities 38 Edgware Group Health Services Liaison Committee 39 — 40 Welfare of Old People 40 — 44 Hendon Old People's Housing Society 44—45 Staff Medical Examinations 45 SECTION D. SANITARY CIRCUMSTANCES OF THE AREA, Water Supply 45 Housing - Report of Housing Officer 46— 47 Public Health Inspection- Summary of Inspections 47 — 48 Notices Served 48 Inspection of Dwelling Houses 48 Legal Proceedings under Public Health Act, 1936 49 Housing Act. 1957 49—50 Rent Act 1957 51 Premises Licensed for Public Entertainment 51 Licensed Premises 51 Schools 52 Cesspools 52 Overcrowding 52 Insect Pests 53 Disinfection 53-54 Local Land Charges Enquiries 54 Choked Drains 54 Drain Tests 55 Swimming Baths 55 Rag Flock and Other Filling Materials Act, 1951 55 Pet Animals Act, 1951 55 Hairdressers and Barbers 56 Prevention of Damage by Pests Act, 1949 56-57 Factories Acts, 1937 to 1959 58 & Appendix on pages 70-71 Clean Air Act 1956 and Measurement of Atmospheric Pollution 58 — 62 The Skyscraper Bronchitics 63 SECTION E INSPECTION AND SUPERVISION OF FOOD Food and Drugs Act, 1955 - Legal Proceedings 64 Action taken in connection with Food Shops, Stores, Cafes, etc. 64 Pood Shops and Food Manufacturing Premises 64 Premises Registered under Section 16, Food and Drugs Act, 1955 65 Registration of Hawkers and Premises 65 Milk Supply 66 FoSdlT DrugsAct 19 55-Report of Chief Officer Public Control Dept.,Middlesex County Council 66-69 Slaughterhouses 69 Publication by Member of Staff 69 COUNCIL of the BOROUGH (31 12 59) Mayor COUNCILLORS. D, GRAVES. J.P.,F.R.I C-S-,F A I. Deputy Mayoir ALDERMAN A- PAUL, J P. Aldermen S. E. Arridge A. A. Naar M. B. E. L. C.Chainey C.H. Sheill J.L. Freedman, J.P. , M. A. , LL. B. A. V. Sul ly, M. C. J. P. P. C. A. R. J. Knowles, M. M. . J. P. M. I. W. M. S. R. C. Sump te r P. B. A. A. Councillors W. P. Ashman P.T.Lester W.G.Barnes W.Lloyd Taylor T. Beirne, A. M. I. Struct. E. G. W. Mathews M - A. P. R. I, C, S. J.S.Champion (Mrs.) J.Miller J.K.Connolly KG.Pamplin D.A.Davis D.Roberts A. C. Paul ds, Assoc. I.N. A. J. H,Rodway J, P. A. P. Fletcher p. A. Sharman B-Sc. (Eng, A C G I- M- I C E, B. E. Fletcher, B. Com. J, W, Shock. M. A. . F. C. A. W. Gairns, C. B. E. , C. A. D.F.Simons J. D. Gordon Lee A.C. B. W, Spawforth L. A. Hills (Mrs.) C. M- Thubrun A. A. Hoskins, B. Sc. (Econ. ) P.L.Tyler. B, A. PUBLIC HEALTH C0IHM3T7EE (31.12.59) Chairman ALDERMAN A Ao NAAR, MB E Vice-Chai nan COUNCILLOR J. D. GORDON-LEE Aldermen A. Paul J, P, (Deputy Mayor) S, R C Sumpter F B A A Councillors W. P. Ashman A. A. He skins B, So. Econ.) B. E, Fletcher, B.Com. P. T. Lester W. Gairns. c. B. E. . C. A- W. Lloyd Taylor S. D. Graves, J.P. ,F. R. I. C. S. „ F. A. I. , (Mayor) (Mrs.) C-M-Thubrun ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1959 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 1959. Last year in Hendon the health statistics were good and showed no feature worthy of special mention. The Registrar General has estimated that the population is the same as in the previous year. The total number of deaths was the highest ever recorded, but this is no more than an indication of the higher ratio of older people resident in the Borough. In the absence of statistics that show any serious cause for concern public health must look more and more from disease prevention towards improvements on the aesthetic side of life, and when one does so it is very satisfying to compare the excellent standards of cleanliness found in the Council s swimming pools with the contrasting standards of some of the beaches at popular resorts. It is satisfying too, to see the continual improvement in housing accommodation which is gradually replacing the olders worn-out properties of the Borough many of which have been dealt with by this Department in recent years. The people who have moved to them enjoy better lighting, better ventilation and freedom from dampness and when further progress is made with Smoke Control Areas their living conditions will be better than ever before. Although there has been no serious outbreak of food poisoning an investigation was made into possible sources of origin of the food poisoning germs and as a result of this investigation attention is now drawn to the possible risk of contamination from organisms found in certain pet foods and in organic fertilisers such as bone meal. Today there is scope for the promotion of better health in many directions, Road traffic accidents are an important and not uncommon causeofmuch unhappiness and everything possible should be done to encourage the highest possible standard of care in drivers. More research is needed into the possible methods of making drivers more careful. For example, we should know if breath analysis by the use of modern medical equipment will help to reduce accidents caused by alcoholism and whether there is a need for an alteration in motor car design because we ought to know whether the driver of the bubble car, who sits near to the point of impact, is more careful than the driver protected by the long bonnet of an old style sports car. 4 Cancer of the lung is almost certainly due to cigarette smoking but neither smoker nor non-smoker seems to have any real incentive to discourage the practice and so in the meantime the national incidence of lung cancer increases. Children's teeth in England are said to be the worst since Saxon times although medical research and experience in the United States for many years has shown the value of adding fluoride to water supplies deficient in this trace element and the fluoridation of public water supplies as a public health measure now has the support of the British Dental Association and the British Medical Association. There has been an increase in the number of deaths from suicide to 23 from the previous year's total of 14, but the rate per 100 thousand of the population still compares very favourably with that in neighbouring London boroughs such as Hampstead Paddington and Holborn. Mention of suicide draws attention to the problem of mental health. Some of the most difficult environmental problems dealt with by the Department during the last year were those where abnormal mental attitudes had blurred the perception about the standards of behaviour that neighbours might be expected to tolerate. The occurrence of a sanitary nuisance is sometimes the first visible consequence of a deranged mind. The new Mental Health Act, 1959 means that more of those people who find personal relationships difficult are being encouraged to live in a community instead of in the mental hospitals and much help will be needed to encourage them to adjust to their neighbours with the least possible disturbance to both parties. Towards the end of the year Mr. A. H, Smi th retired from the office of Chief Public Health Inspector after 44 years work in Hendon. In his different capacities as Inspector of Nuisances, Sanitary Inspector and Senior Public Health Inspector, he had studied public health problems which ranged from the early days of the now forgotten privy midden to modern problems like radio activity. It is very difficult to assess the value of the abstract nature of the work of the Public Health Inspector, but few of us would doubt that his many years of loyal and conscientious service played no unimportant part in raising the hygiene standards of Hendon to their present level. 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 in my report. I would like to thank the members of the Public Health 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 0ak 477 Mill Hill 2 695 West Hendon 1,143 Central 1,139 P a rk 580 Golders Green. 748 Garden Suburb. 669 Childs Hill 593 Area of the Borough 10 371 Population figures supplied by Registrar General. 151,500 Density of population i.e., number of persons per acre. 14.6 Number of inhabited houses at 31st December 1959 (according to Rate Book) 45,200 Average number of persons per house 3,35 Rateable value at 31st December., 1959 £3,559,018 Sum represented by a Penny Rate £14,350 Births Live Births Mai e Female Total Legitimate 968 908 1,876 Illegitimate 50 39 89 1,018 947 1,965 Live Birth Rate per lf 000 Home Population 12.97 Birth Rate corrected for comparison with other areas 12.45 Illegitimate live births per cent of total live births 4.5% Comparability factor supplied by Registrar General 0.96 Corrected Birth Rate per 1,0 00 Home Population, County of Middlesex 14.4 Birth Rate per 1,000 Home Population. England & Wales 16.5 Corresponding Rate for the Borough of Hendon for the year 1958. 12. 33 6 Stillbirths Male Female Total Legitimate 19 13 32 Illegitimate 2 3 5 21 16 37 Stillbirth Rate per 1 000 Total Births 18.83 Stillbirth Rate per 1,000 Total Births England & Wales . 20.7 Stillbirth Rate per 1,000 Home Population,. 0.24 Stillbirth Rate per 1, 000 Home Population, England & Wales 0.35 Deaths Male Female Total 846 802 1,648 Death Rate per 1 000 Home Population 10.87 Death Rate corrected for comparison with other areas 11.52 Comparability factor supplied by Registrar General 1,06 Corrected Death Rate per 1 000 Home Population County of Middlesex 11.4 Death Rate per 1 000 Home Population England & Wales 11.6 Corresponding Rate for the Borough of Hendon for the year 1958 11. 17 Ma'toeirnaii Mortality Number of women dying in consequence of childbirth 3 Maternal Mortality Rate per 1 000 total births 1.53 Comparative figure for the County of Middlesex 0.39 Comparative figure for England & Wales 0.38 Infantile Mortality Deaths of infants under 1 year of age Male Female Total Legitimate 15 19 34 Illegitimate 4 4 15 23 38 Death Rate of infants under 1 year of age per 1 000 live births 19,33 Death Rate of infants under 1 year of age per 1 000 live births legitimate 18.12 Death Rate of infants under 1 year of age per 1,000 live births illegitimate. 44.94 Death Rate of infants under 1 year o f age per 1 000 live births County of Middlesex 19-4 Death Rate of infants under 1 year of age per 1, 000 live births. England and Wales 22.0 7 Deaths of infants under the age of 4 weeks Male Female Total Legitimate 13 17 30 Illegitimate - 2 2 13 19 32 Neo natal Mortality Rate per 1 000 live births 16.28 Neo-natal Mortality Rate per 1,000 live births, County of Middlesex 15.5 Neo-natal Mortality Rate per 1; 000 live births, England and Wales 15.8 An analysis of the causes of death and the age at the time of death reveals the following figuresr:- Causes of death Age at the time of death Under 1 day 1-7 days 1-2 weeks 2- 3 week s 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 8 7 1 - - 16 - - - - 16 Pneumonia and Bronchitis - - - 1 - 1 2 - - - 3 Atelectasis 1 3 - - - 4 - - - - 4 Congenital defects 1 4 2 1 - 8 1 - 1 - 10 Infanticide 1 - - - - 1 - - - - 1 Asphyxia 1 - - - - 1 - 1 - - 2 Haemolytic disease 1 - - - - 1 - 1 - - 2 13 14 3 2 - 32 3 2 1 - 38 8 The infant deaths were distributed throughout the wards of the Borough as follows:- Mill Hill - Burnt Oak 3 West Hendon 6 Central 2 Park 7 Golders Green 5 Garden Suburb 4 Childs Hill 6 Ed gw are 5 38 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 19 40 54 1950 16 1951 22 1952 21 1953 16 1954 21 1955 21 1956 18 1957 21 1958 14 1959 19 9 SUMMARY OF VITAL STATISTICS FOR THE YEAR 1959 England and Wales Borough of Hendon. Rates per 1.000 Home Population Births Live births 16. 5 12.45 Still births 0.35 0.24 20.7(a) 18.83(a) Deaths All causes 11.6 11.52 Borough of Hendon Tuberculosis 0.46 Pneumonia 0.59 Influenza 0. 32 England and Wales Borough of Hendon Rates per 1,000 Live Births All causes under 1 year of age 2 2.0 19.3 Borough of Hendon Rates per l,000 Home Population NOTIFICATIONS (CORRECTED) (for totals see page 20) Meningococcal Infection 0.00 Scarlet Fever 0.99 Whooping Cough 0.21 Erysipelas 0.05 Measles 8.46 Pneumoni a 0.75 Acute Poliomyelitis Paralytic 0.03 Non-Paralytic 0.03 Pood Poisoning 0.24 Puerperal Pyrexia 62.9(a) (a) Per 1,000 Total (Live & Still) Births 23.9* *This is the rate when the figure relating to Hendon residents only is taken. 10 TABLE II VITAL STATISTICS FOR THE YEARS 1933-1959 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 Materna1 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 2,24 5 16.96 1,347 10.18 72 32 4 1945 137,770 2,239 16.2 5 1,379 10.01 65 29 3 1.30 1946 153 820 2,65 1 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 12.9 1 1,479 9.51 32 16 1 0.49 1954 154800 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 1959 151,500 1,965 12.97 1,648 10.87 38 19 3 1.53 11 12 TABLE III. COUNTY COUNCIL OP MIDDLESEX CERTAIN VITAL STATISTICS FOR THE YEAR 1959 District Estimated Population mid-1959 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 Crude Adjusted Crude Adjusted Coronary Disease, angina Cancer Infant Neo-natal (a) (a) (a) (a) (a) (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Acton 64,800 16.0 15.2 11.6 11.8 2.1(134) 2.1(136) 19.2(20) 17.3(18) -(-) Brentford and Chiswick 56,970 14.3 13.6 10.5 10.5 1.8(104) 2.1(121) 27.1(22) 22.2(18) 1.21(1) Ealing 182,700 14.7 14.3 10.8 11.7 1.9(341) 2.2(393) 16.7(45) 12.6(34) -(-) Edmonton 94,420 13.6 13.6 10.9 12.1 1.6(152) 2.4(231) 23.3(30) 20.2(26) -(-) Enfield 109,700 13.4 13.4 10.1 10.8 1.5(167) 2.1(227) 19.7(29) 14.2(21) 0.67(1) Feltham 51,750 15.6 15.0 8.6 13.5 1.3(69) 1.4(71) 24.8( 20) 19.9(16) -(-) Finchley 68,920 13.5 13.0 11.5 10.4 2.0(136) 2.4(164) 20.4(19) 13.9(13) -(-) Friern Barnet 28,660 12.0 13.4 14.8 10.5 2.0(57) 2.3(66) 43.6(15) 40.7(14) -(-) Harrow 213,700 13.7 14.1 9.7 11.4 1.8(379) 2.1(444) 15.0(44) 11.6(34) -(-) Hayes and Harlington 68,670 16.2 15.2 8.0 13.0 1.5(104) 1.8(122) 18.0(20) 14.4(16) 0.88(1) Hendon 151,500 13.0 12.5 10.9 11.6 1.9(286) 2.3(347) 19.3(38) 16.3(32) 1,50(3) Heston and Isleworth 105,000 12.1 12.1 10.9 11.1 1.7(181) 2.2(227) 16.5(21) 14.1(18) 0.77(1) Hornsey 96,430 18.0 16.7 12.3 10.9 2.4(227) 2.3(225) 24.8(43) 21. 4(37) -(-) Potters Bar 22,750 16.0 14.2 8.8 12.2 1.6(37) 1.5(34) 19.3(7) 8.3(3) -(-) Ruislip and Northwood 75,330 13.4 13.4 8.2 10. 3 1.4(106) 1.9(143) 16.8(17) 12.9(13) 0.98(1) Southall 52,900 14.0 14.6 12.1 11.4 2.2(114) 2.1(113) 22.9(17) 17.5(13) 1.33(1) Southgate 70,680 12.0 13.0 13.3 10.9 2.5(177) 3.0(211) 15.3(13) 12.9(11) 1.15(1) Staines 47,910 18.7 17.2 9.6 12.2 1.7(82) 2.0(97) 15.7(14) 13.4(12) -(-) Sunbury 29,710 19.4 17.3 10.7 12.3 1.3(38) 2.3(68) 17.3(10) 12.1(7) -(-) Tottenham 116,100 15. 1 14.9 11.6 12.3 2.0(227) 2.4(280) 24.0(42) 19.4(34) 0.56(1) Twickenham 103,600 13.2 13.6 12.1 11.5 2.3(237) 2.2(229) 16.8(23) 12.4(17) -(-) Uxbridge 63,730 16.7 15.0 9.1 11.7 1. 5(93) 1.7(110) 19.7(21) 19.7(21) 0.92(1) Wembley 126,300 12.6 12.7 9.7 11.3 1.9(237) 2.2(278) 14.4(23) 13.2(21) -(-) Willesden 172,800 19.6 18.2 10.5 11.9 1.8(303) 2.4( 420) 19.5(66) 14.5(49) -(-) Wood Green 48,520 14 .1 14.2 12.4 11.9 2.1(104) 2.9(141) 20.5(14) 14.7(10) 1.43(1) Yiewsley and West Drayton 23,450 18.8 16.9 7.4 10.7 1.4(34) 1.7(41) 18.1(8) 13.6(6) -(-) COUNTY 2,247,000 14.7 14.4 10.6 11.4 1.8(4126) 2.2(4939) 19.4(641) 15.5(514) 0.39(13) Note (a) Absolute numbers are given in parenthesis in addition to rates to afford valid comparison. 13 TABLE IV. Deaths of Hendon residents during the year 1959 classified according to age groups and sexes. Causes of death AGE GROUPS TOTALS Under 1 year 1-4 years 5 14 years 15 24 years 25' 44 years 45 64 years 65 74 years 75 years & over 1, Tuberculosis, respiratory M 1 4 1 6 F 2. Tuberculosis, other M F 1 1 3. Syphilitic Disease M F 4. Diphtheria M F 5. Whooping Cough M F 6. Meningococcal Infections M F 7. Acute Poliomyelitis M 1 1 F 1 1 8. Measles M F 9. Other Infective & Parasitic Diseases M 1 1 2 F 2 2 10. Malignant Neoplasm, Stomach M 2 14 4 9 29 F 1 5 4 6 16 11. Malignant Neoplasm, Lung, Bronchus M 1 32 21 13 67 F 7 2 3 12 12. Malignant Neoplasm, Breast M F 3 23 12 8 46 13. Malignant Neoplasm, Uterus M F 3 3 3 9 14. Other Malignant & Lymphatic Neoplasms M 1 1 4 28 23 25 82 F 1 1 4 20 26 34 86 15. Leukaemia, Aleukaemia M 1 3 1 5 F 2 1 3 6 16. Diabetes M 1 1 2 F 3 3 6 17. Vascular lesions of Nervous System M 2 21 17 47 87 F 24 32 80 136 18. Coronary Disease, Angina M 6 73 57 54 190 F 1 17 29 49 96 14 Deaths of Hendon Residents — Continued TABLE IV ( Continued) Causes of death AGE GROUPS TOTALS Under 1 year 1-4 years 5-14 years 15-24 years 25-44 years 45-6 4 years 65-74 years 75 years & over 19. Hypertension with Heart Disease M 1 3 8 12 F 1 2 5 13 21 20. Other Heart Disease M 1 9 16 38 64 Fs 1 1 9 18 69 98 21.Other Circulatory Disease M 1 14 8 18 41 F 2 8 8 28 46 22.Influenza M 1 2 11 21 35 F 1 3 10 14 23. Pneumonia M 1 1 1 6 10 25 44 F 1 2 7 36 46 24.Bronchitis M 1 2 14 17 26 60 F 3 1 18 22 25.Other Diseases of Respiratory System M 1 2 4 2 9 F 1 1 3 5 26. Ulcer of Stomach and Duodenum M 5 1 3 9 F 3 2 5 27. Gastritis Enteritis & Diarrhoea M 1 1 1 3 F 1 3 2 4 10 28.Nephritis & Nephrosis M 1 1 1 3 F 1 1 1 4 7 29. Hyperplasia of Prostate M 4 3 7 F 30.Pregnancy Childbirth Abortion M F 1 2 3 31. Congenital Malformations M 2 1 1 4 F 2 1 3 32.Other Defined & 111 defined Diseases M 11 2 1 4 10 9 12 49 F 15 2 1 2 13 12 27 72 33. Motor Vehicle Accidents M 2 3 2 1 2 10 F 1 2 1 4 34. All Other Accidents M 1 1 3 7 1 13 F 2 3 2 11 18 35. Suicide M 2 1 4 3 2 12 F 1 1 4 2 3 11 36. Homicide and Operations of War M F M 15 4 2 8 36 250 220 311 846 F 23 1 2 5 19 162 175 415 802 All Causes TOTALS 38 5 4 13 55 412 395 726 1648 HEALTH STATISTICS Population According to the figure supplied by the Registrar General the estimated raid year population for 19 59 was 151,500. This is the same as in 19 58 and 4,357 less than the Census figure for 19 51. Births The number of live births recorded during the year increased by 17, 1 965 occurring compared with 1,9 48 in 1958 giving an increased corrected birth rate of 12.45 per 1,000 Home Population compared with 12.33 last year. The rate is less than that for the County of Middlesex which is 14.4 and less than that for England and Wales, which is 16.5 per 1 000 Home Population. The number of stillbirths increased from 27 to 37, giving a stillbirth rate of 18.83 per 1,000 total births compared with 13.67 in 1958. The rate for the Borough of Hendon compares favourably with that for England and Wales, which is 20.7 per 1.000 total births. Deaths There was an increase of 65 in the number of deaths. This, the highest total ever recorded in Hendon, gives an increased corrected death rate of 11.52 per 1,000 Home Population compared with 11.17 in 1958. This rate is slightly higher than that for the County of Middlesex, which is 11.4 per 1,000 Home Population, but is less than the rate for England and Wales which is 11.6 per 1,000 Home Population. As in previous years, heart and associated diseases accounted for the largest number of deaths, 568 people dying from these causes. Second in the principal causes was cancer. Deaths from motor vehicles and other accidents decreased, 45 people dying from these causes compared with 47 in 1958. Twenty-three people committed suicide, an increase of 9 on the previous year. Infantile Mortality Thirty-eight children died in the first year of life compared with 27 in 1958, giving an infantile mortality rate of 19.33 per 1,0 00 live births. The rate for the Borough compared favourably with that for England and Wales, which is 22.0 per 1,000 related live births. The rate for the County of Middlesex is 19.4 per 1,000 live births. Of the 38 children, 32 died before reaching the age of 1 month giving a neo natal mortality rate of 16.28 per 1,000 live births compared with 15.8 for England and Wales. 15 Maternal Mortality Three women died as a result of childbirth giving a maternal mortality rate of 1.53 per 1 000 total (Live and still) births, Deaths fro* Cancer of the Lung and Bronchus During the year in Hendon 33 men and 7 women under 65 years of age died from this cause a pause in the year to year increase in deaths from this cause SMOKING IN YOUTH CLUBS As in previous years an investigation into the smoking habits of a sample of members of a youth club has been recorded, In this particular youth club the noticeable feature was the large number of cigarettes smoked weekly by many of the smokers in the club, The number was considerably higher than the totals recorded in previous years at other youth clubs. The club investigated was the Claremont Youth Club. There were seven spoiled returns. Age Never Smoked NonSmoker Pipe Smoker Cigarette Smoker No of cigarettes smoked per week BOYS 13 1. 70. 14 1. 1. 15-20 15 1. 1.1. 1. 10-20.30-40.10.20. 16 1.1.1. 1.1.1.1. 1.1.1.1. 100.100.100.75. 70.80.100.25. 17 1. 1. 1.1.1.1. 50.70.60.320. 18 1. 1.1.1.1.1.1. 150.70.140.200. 150.140. 19 1. 1.1. 20.60. 20 1. 1. 115. 21 1.1. 1. 1.1.1. 1. 200.200.115. 120. GIRLS 13 1. 110. 14 1.1.1.1. 1. 1.1. 50.50. 15 1.1.1.1.1. 1.1.1. 10.10.10.20. 16 1. 1.1. 40.25. 17 1. 1.1. 30.150. 18 1. 35. Total number of members present 66 Total number of smokers 42 Total number of non smokers 24 16 BOROUGH OF HENDON DEATHS FROM CANCER OF LUNG AND BRONCHUS DEATHS FROM RESPIRATORY TUBERCULOSIS 1951 - 1959 NUMBER OF DEATHS 17 ROAD TRAFFIC ACCIDENTS The following tables show the road traffic accidents and casualties occurring within the Borough of Hendon during the year 1959 and the comparative figures for the years 1956, 19 57, 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. TABLE V. MONTH No. of Accidents ADULTS CHILDREN TOTAL Killed Seriously Injured Slightly Injured Killed Seriously Injured Slightly Injured January 83 1 18 78 - - 5 102 February 60 1 13 69 - 1 6 90 March 80 1 16 71 - 1 11 100 April 83 - 14 73 - 4 13 104 May 101 - 15 96 - 2 16 129 June 99 - 20 86 - 2 19 127 July 105 2 35 96 - 3 16 152 August 78 2 14 73 - 3 13 105 September 78 2 7 82 - 2 13 106 October 107 4 28 111 - 4 12 159 November 116 1 14 119 - - 13 147 December 113 2 25 103 - 5 11 146 TOTAL S 1,103 16 2 19 1,057 - 27 148 1,467 TABLE VI CLASSES OF ROAD USER KILLED OR INJURED DURING 1959. MONTH pedestrians Motor Drivers Motor Cyclists Pillion Passengers Pedal Cyclists 0ther Road Users Killed Serious Slight Killed Serious Siight Killed Serious Slight Killed Serious Slight Killed Serious Slight Killed Serious Slight January - 4 12 - 4 28 - 4 13 - 1 1 1 1 10 - 4 19 February 1 1 7 - 2 22 - 1 14 - - 5 3 4 - 7 23 March 1 6 13 - 5 20 - 3 19 - - 3 - - 7 - 3 20 April - 9 17 - 3 16 - 3 13 - 1 3 - 1 13 - 1 24 May - 3 23 - 4 24 - 4 29 - - 2 - 3 14 - 3 20 June - 4 22 - 3 14 - 7 31 - 1 3 - 3 12 - 4 23 July 1 5 16 - 5 20 - 14 25 - 5 6 1 6 18 - 3 27 August 1 3 8 1 4 23 - 6 20 - 2 4 - 2 13 - - 18 September 2 1 11 - - 25 - 4 18 — 1 6 - 3 19 - - 16 October 1 11 13 2 3 27 - 9 31 - 3 3 - 2 9 1 4 40 November 1 5 26 - 2 35 - 4 15 - 1 3 - 1 17 - 1 36 December 1 11 14 - 6 31 - 4 23 - - 4 - 3 6 1 6 36 TOTALS 9 63 182 3 41 285 - 63 251 - 15 43 2 28 142 2 36 302 18 TABLE VII COMPARATIVE FIGURES OF ACCIDENTS AND CASUALTIES FOR 1956 1957 1958 and 1959 1956 1957 1958 1959 Total number of Road Accidents involving personal injury 892 873 1,089 1,103 Accidents per mile of road 5.23 5.09 6.33 6.41 CASUALTY FIGURES Adults Killed 17 21 21 16 Seriously injured 171 188 229 219 Slightly injured 813 802 990 1,057 Totals 1,003 1,011 l,240 1,292 Children (0—15 years) Killed 2 2 - - Seriously injured 29 20 22 27 Slightly injured 109 100 168 148 Totals 140 122 190 175 Combined Adults and Children Totals: 1,141 1,133 1,430 1,467 Casualties per mile of road 6.69 6.61 8.32 8.53 CLASSES OF ROAD USERS KILLED OR INJURED YEAR 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 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 1959 9 63 182 3 41 285 - 63 251 - 15 43 2 28 142 2 36 302 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 1956 1 18 42 1 8 33 - 3 34 1957 2 10 41 - 4 23 - 6 36 1958 - 15 65 - 6 53 - 1 50 1959 - 11 65 - 12 44 - 4 39 I am indebted to the Borough Engineer and Surveyor for supplying me with the figures, 19 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 151 11 Whooping Cough 32 - Measles 1,283 5 Acute Poliomyelitis Paralytic 5 5 Non-Paralytic 5 5 Diphtheria - - Pneumonia 121 41 Dysentery 95 19 Paratyphoid Fever 1 1 Erysipelas 7 - Meningococcal Infection - - Food Poisoning 36 7 Puerperal Pyrexia 126 125 Ophthalmia Neonatorum - - TOTAL 1,862 219 20 21 TABLE IX AGE DISTRIBUTION AGE GROUP DISEASE Scarlet Fever Whooping Cough Acute Poliomyelitis Measles Dysentery Meningococcal Infection Paralytic Non-Paralytic M. F. M. F. M. F. M. F. M. F. M. F. M. F. Under 1 year - - 1 - - - - - 13 13 1 - - - 1— year - - 2 - - - - - 45 52 4 4 - - 2— years 4 9 - 4 - - - - 66 75 4 2 - - 3— years 8 5 3 2 - 1 - - 87 78 1 6 - - 4-years 8 7 1 1 - - - - 84 87 2 2 - - 5 -9 years 45 39 10 7 2 - 2 1 308 309 20 9 - - 10-14 years 9 10 1 - - - - 1 29 19 4 6 - - 15-24 years 2 2 - - - - - - 4 4 2 5 - - 25 & over 1 2 - - 1 1 - 1 4 6 10 13 - - Age unknown - - - - - - - - . - - - - - TOTAL 77 74 18 14 3 2 2 3 640 643 48 47 - - Pneumonia Erysipelas Food Poisoning Puerperal Pyrexia Paratyphoid Fever M. F. M. F. M. F. M. F. M. F. Under 5 years 5 4 - - 4 7 - - - - 5-14 years 4 7 - - 2 2 - - - - 15-44 years 16 13 - 1 5 8 - 126 - 1 45-64 years 20 16 3 3 3 2 - 1 - - 65 & over 19 17 - - 2 1 - - - - Age unknown - - - - - - - - - - TOTAL 64 57 3 4 16 20 - 126 - 1 22 TABLE X, WARD DISTRIBUTION NUMBER OP CASES OP INFECTIOUS DISEASE NOTIFIED IN EACH WARD OF THE BOROUGH Disease Ward TOTAL Mill Hi11 Burnt Oak West Hendon Central Park Golders Green Garden Suburb Childs Hill Edgware Scarlet Fever 16 26 37 10 16 12 4 17 13 151 Whooping Cough 2 3 10 2 5 8 1 1 - 32 Acute Poliomyelitis Paralytic 1 3 - - - 1 - - - 5 Non Paralytic - 3 - - - - 1 - 1 5 Measles 245 195 202 67 57 107 91 80 239 1,283 Meningococcal Infection - - - - - - - - - - Pneumonia 28 17 6 4 10 14 8 27 7 121 Dysentery 10 19 15 3 10 14 1 16 7 95 Erysipelas 1 - - - - 3 - 2 1 7 Food Poisoning 2 16 - 2 3 1 2 7 3 36 Puerperal Pyrexia 5 87 6 6 5 5 2 6 4 126 Ophthalmia Neonatorum - - - - - - - - - - Paratyphoid Fever 1 - - - - - - - - 1 TOTAL 311 369 276 94 106 165 110 156 275 1,862 NOTIFICATIONS OTHER THAN TUBERCULOSIS Poliomyelitis In recent years we have learned to associate a long hot summer with a severe outbreak of poliomyelitis. The summer of 1959 was such but the immunisation campaign of the Ministry of Health no doubt played an important part in reducing the number of cases below what might have been expected, A total of ten cases was notified whereas in 1955 which was also a hot summer before the immunisation scheme was introduced 55 cases were notified. Of the ten cases notified five were of the paralytic form. None of these five had been immunised, Three of che cases were small children who during the hot weather had indulged in water play in the Silkstream shortly after a period when the Council had been cleaning out some of the dirtier parts of the stream and when much of the mud at the bottom of the stream had been stirred up. It was alleged that one of the children had drunk some water from the stream Streams have been accused of spreading poliomyelitis from time to time and in view of the association of the epidemic with the Silkstream the Public Health Laboratory Service agreed to examine some samples of the water for the poliomyelitis virus, but no organisms were detected. Poliomyelitis is also believed to be spread by a droplet infection from the infected upper respiratory passages in the same way as the common cold but it is sometimes difficult to understand where the virus rests in the interval between epidemics. It would seem that immunisation of the substantial proportion of the population against the disease is not only of great benefit to the individuals concerned but also helps to prevent the spread of the disease amongst the unimmunised in the community. Puerperal Pyrexia Since 1st August 1951 Puerperal Pyrexia applies to any febrile condition occurring in a woman in whom a temperature of 100 4 degrees Fahrenheit (or 38 degrees Centigrade) has occurred within fourteen days after childbirth or miscarriage, There was an increase in the number of cases of Puerperal Pyrexia 126 cases occurring compared with 112 in 1958. Of the 126 cases 48 only were Hendon residents the remainder being women from other areas who entered the maternity hospital in the Borough for their confinements. Notification in respect of these cases has to be accepted by the Borough of Hendon and not by the Authority within whose area the patient is normally resident. In consequence the rate for Hendon is high, That for the year 1959 is 62.9 per 1,000 total (live and still) births- If the figure for the Hendon residents only is taken, the rate is 23.9 per 1,000 total (live and still) births. 23 Ophthalmia Neonatorum No notifications of ophthalmia neonatorum were received during last year, Scarlet Fever There was an increase in the number of cases notified 151 compared with 113 in 1958. The disease was of a mild form and it was only necessary for 11 of the cases to be removed to hospital. As in previous years the greatest incidence occurred in the age group 5-9, 84 cases being notified. Measles There was an increase in the number of cases notified during the year 1283 compared with 603 in 1958. Measles in epidemic form occurs at intervals of 2 years. The next measles epidemic may be expected in the spring of 1961. Whooping Cough This disease showed a decrease on the 19 58 figure 32 cases being notified compared with 42. Sonne Dysentery There was a decrease in the number of cases notified 95 compared with 330 in 1958. The disease has proved very infectious among small children but the clinical course of the illness has been mild. Food Poisoning Towards the end of the year and in the early part of 1960 an investigation into the possible sources of origin of food poisoning organisms was made and in this connection it was found that organic garden fertilisers such as bone meal and dried blood and pet foods (dog and cat meat prepared and fresh) sometimes contain organisms which could cause food poisoning, therefore particular attention should be paid to hand washing after using these substances. During the year 36 cases of food poisoning were notified the same number as in 1958. The following is a copy of a report made to the Ministry about the organisms responsible for the individual and family outbreaks. (a) Food poisoning notifications (corrected) First Quarter Second Quarter Third Quarter Fourth Quarter Total - 16 16 4 36 (b) Cases otherwise ascertained First Quarter Second Quarter Third Quarter Fourth Quarter Total - 1 8 1 10 24 Particulars of Outbreaks AGENT No. of Family Outbreaks No. of cases Total No. of cases Notified Otherwise ascertained Agent identified Salmonel1a Cholera Suis 1 2 2 Salmonella Typhi-Murium Phage type la Var.l 1 2 1 3 Salmonella Typhi-Murium Phage type 14 1 2 2 Salmonella Typhi-Murium Phage type 2a 1 2 2 Salmonella Typhi-Murium unidentified 1 2 2 C1. welchii 1 2 2 TOTALS 6 10 3 13 Agent not identified 2 7 7 Single Cases AGENT No. of cases Total NO. Of cases Notified Otherwise ascertained Agent identified:- Salmonella Thompson 3 3 Salmonella Blockley 1 1 Salmonella Bredney 1 1 Salmonella Saint Paul 1 1 Salmonella Typhi Murium Untypable 3 ” ” Phage type la Var. 2 1 1 ” ” Phage type la 1 1 ” ” Phage type 24 1 1 ” ”Phage type 2a 1 1 CI. welchii 1 1 Esch. Coli 1 1 TOTALS 8 7 15 Agent not identified 11 11 25 The progress made by the Public Health Laboratory Service in the detailed classification of the various Salmonellae into separate types should help in tracing the methods of spread of food poisoning. It is known for example that the rare Salmonella Typhi-Murium Phage type la Var, 2 was brought to England in a certain ship from Hong Kong in a cargo of Chinese egg albumin,, How the organism got to Hendon is something of a mystery but some interesting possibilities were explored EPIDEMIC VOMITING In January, 1959, there was an outbreak of epidemic vomiting at Wooderoft Junior School and at Wooderoft Girls Secondary Modern School. The outbreak was first noticed when the children returned to school after the Christmas holiday and by some parents was attributed to the effects of the holiday Typical illness consisted of acute abdominal pain followed an hour or so later by vomiting and a temperature the same evening. The following day diarrhoea often occurred and two or three days later the child developed a cough The children were noticeably pale, and in many instances nausea persisted for a week or more. No definite organism was found although several throat and stool swabs were examined for viruses by the Public Health Laboratory service, Paratyphoid Fever One case of this disease was notified. The patient was employed in a laboratory where research on this disease takes place. Diphtheria No case of diphtheria was notified during the year, The following table shows the number of cases and the deaths from diphtheria since immunisation was introduced on a large scale in 1935 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 - - 1952 - - 1953 1 - 1954 - - 1955 - - 1956 1 - 1957 - - 1958 - - 1959 - - 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 1959. 27 TABLE XII. NUMBER OF CHILDREN RESIDENT IN THE BOROUGH OF HENDON WHO RECEIVED IMMUNISING INJECTIONS DURING 1959 Age at time of injection Primary Inoculations Reinforcing Injections Diphtheria only Combined Diphtheria and Whooping Cough Whooping Cough only Diphtheria only Diphtheria and Whooping Cough Under 1 year of age 519 333 435 - - 1 year of age 424 90 377 3 - 2-4 years of age 36 24 27 125 7 5-14 years of age 58 13 1 1,247 24 15 years and over - - - 1 - TOTALS 1,037 460 840 1,376 31 POLIOMYELITIS IMMUNISATION The number of people who completed immunisation against poliomyelitis was 18,351. 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 1959. TABLE XIII Age at 31st December 1959 Under 1 year 1 year 2—4 years 5-44 years 15 years and over TO TAL Number vaccinated 1,099 69 27 52 96 1,343 Number re-vaccinated - - 8 42 459 509 INTERNATIONAL CERTIFICATES OF VACCINATION During the year, 1620 International Certificates of Vaccination were stamped by the Public Health Department. 28 CHEST DISEASE Notification of Tuberculosis The following table shows the number of cases of tuberculosis notified for the first time during the year 19 59, and transfers into the district. TABLE XIV. Age Group in years Respiratory Non Respiratory Males Females Males Females TOTAL New Cases Transfers into District New Cases Transfers into District New Cases Transfers into District New Cases Transfers into District Under 5 years 1 - 2 - - - - - 3 5—14 2 3 2 - - - - - 7 15—24 2 4 6 9 - - 1 - 22 25—44 12 22 13 12 3 1 2 3 68 45—64 23 3 7 1 - - 1 - 35 65 & over 10 2 3 2 - - 2 - 19 Age unknown - 1 - 1 - - - - 2 TOTAL 50 35 33 25 3 1 6 3 156 The ward distribution of tuberculosis for the year 1959 is shown below. The figures refer to primary notifications only and do not include cases transferred into the district. TABLE XV. WARD Mill Hill Burnt Oak West Hendon Central London Park Golders Green Garden Suburb Childs Hill Edgware TOTAL Respiratory 12 11 14 6 11 15 4 7 3 83 Non Resp i ratory 2 1 2 - 1 - 3 - - 9 TOTAL 14 12 16 6 12 15 7 7 3 92 29 The following table shows the primary notification of tuberculosis, excluding inward transfers for the ten-year period 1950 1959. TABLE XVI. YEAR Respiratory Non-Respiratory TOTAL M. F. M. F. 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 1959 50 33 3 6 92 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 A11 forms of Tuberculosis Male Female Total Male Female Total Male Female Total 6 - 6 - 1 1 6 1 7 The number of cases of tuberculosis remaining on the Register at the end of the year is as follows: Respiratory Non Respiratory Total Male Female Male Female Male Female 808 624 85 87 893 711 1,432 172 1,604 30 THE EDGWARE CHEST CLINIC I am indebted to Dr. H. J. Trenchard, Physician-in-Charge of the Edgware Chest Clinic, from whose Annual Report I have extracted the following information MEDICAL STAFF Assistant Physicians: W. C. Harris M. B., M. R. C. P. R. W. Rowan M. D., M. R. C. P. Registrar Dorothy Jill Pearse M. B., B. S., M. R. C. S. . L. R. C. P. Visiting Consultants Physicians W. E. Snell, M. A., M. D., F. R. C.P., D. P.H. R. Grenville-Mathers, M. A., M. D., (Cantab) F. R. C.P. (Ed)., F. P, F. P. S. G. Thoracic Surgeons 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. Area Served The catchment area of the Edgware Chest Clinic includes the Borough of Hendon, the Edgware and Stanmore postal districts of the Borough of Harrow and the Borough of Wembley north of the Kingsbury Road. Health Visitors and Welfare Staff appointed by the Middlesex County Council work at the clinic as a sociomedical team with the medical staff and are responsible primarily for the area mentioned. Nevertheless, many patients living outside the area attend the clinic if referred by their practitioners for an opinion. Liaison On the public health and welfare side of the work close liaison is maintained with the Middlesex County Council's Health Department, and in particular with the Area Medical Officers and their Staffs and with the School Health Service, The co-operation of the Medical Officers of Health of the Boroughs of Harrow Hendon and Wembley is often sought and invariably received. The Welfare Department of the Clinic has liaison with both statutory and voluntary organisations such as Employment Exchanges, the National Assistance Board, local Ministry of National Insurance Officers, the Housing Departments of Local Authorities, the Chest and Heart Association, local Councils of Social Services, etc. etc. For the diagnostic and therapeutic aspects of our work there is close co-operation with Edgware General and Colindale Hospitals of whose staffs our physicians are members. Patients are also often referred to Clare Hall, Harefield and St, Charles 31 Hospitals where thoracic surgical units are situated. For radiotherapy treatment use is made of facilities at the Middlesex and Mount Vernon Hospitals. Reference of Patients to the Clinic The majority of the patients are referred by their general practitioners, and considerable use is still made of the facilities provided for chest X-ray without previous appointment. For this miniature radiography with the Odelca camera unit is employed. Other sources are the Mass X ray Units, transfer of patients from other chest clinics on change of address, and the outpatient departments of Edgware General Hospital. Tuberculosis The number of cases on our tuberculosis register continues to fall, and the newly diagnosed cases number about two thirds of what was diagnosed 5 years ago. There is now virtually no delay in arranging for the admission of a tuberculous patient requiring hospital treatment. This has diminished considerably the burden of work in the clinic welfare department, and we are now able to employ only one Welfare Officer instead of two as formerly. Carcinoma of Lung This important condition is one that is still frequently diagnosed in the chest clinic especially amongst those who have been heavy cigarette smokers for many years. It is more common amongst men than women. Chronic Bronchitis Chronic bronchitis, emphysema and associated conditions are common amongst chest clinic patients of all ages, but especially so amongst the older age groupsparticularly in males. It is the result, no doubt, of many factors amongst which a very important one is atmospheric pollution, In the Report for 1957 mention was made of the scheme in hand for sending some severe bronchitics to country hospitals early in the winter, both as a means of benefiting the patient by treatment in the bron chitis unit of the hospital and to prevent the inevitable admission to a local hospital bed with acute respiratory infection during the months of January and February when pressure on beds is at its highest. It has been difficult to continue this scheme owing to the reluctance of the medical staff of one of the country hospitals to accept patients. A review of what occurred in the last three years may. however, be of interest. There were 16 patients all of whom were considered suitable: 5 of these accepted the 32 offer of treatment in a country hospital during the winter in one, two or three of the years 1956-57, 1957 58 and 1958-59; 4 patients declined the offer and all were subsequently admitted with pneumonia-like illnesses - 2 of them fatal; 7 patients were transferred to a country hospital after requiring an admission to a local hospital with winter respiratory illness, and in subsequent years accepted the offer of such admission in good time. Of those who went to country hospitals all derived some benefit, although their general condition was such that they were bound to remain invalids; two, however, died within a week of being returned home from the country hospital. These deaths may have been associated with renewed contact with the atmospheric pollution of London but one cannot be sure. Staff It is with great regret that it is necessary to record that owing to ill health Mr. R. Laird has been obliged to give up his attendance at the Chest Clinic. He has been for twelve years a highly valued member of our visiting staff. Postgraduate students, many from overseas have again been attached to the clinic for various periods during 1959 to enable them to study the methods employed at Edgware. Publications Margaret Coltart Helen Raine Elizabeth Harrison Social Work in Tuberculosis (Chest & Heart Association) London 1959) 33 STATISTICS, General 1955 1956 1957 1958 1959 New patients referred to Clinic 9,439 10,909 10,769 10,728 9,628 Total attendances at consultative sessions 22,802 24,290 23,573 22,971 22,212 Total attendances for refills 8,652 7,454 6,299 4,212 2,609 Number of persons X-rayed 16,544 17,173 17,709 17,902 16,125 Sessions held 1,192 1,198 1,211 1,218 1,277 Number of home visits by physicians 286 411 431 424 281 TUBERCULOSIS REGISTER New respiratory cases 147 149 152 143 103 New non-respiratory cases 24 27 17 21 13 Total new tuberculous cases 171 176 169 164 116 Tuberculous cases on register at 31st December 1,788 1,733 1,600 1,508 1,460 Removal from register as (a) Dead 24 44 25 29 35 (b) Recovered 57 68 155 85 96 ANTENATAL PATIENTS Antenatal patients X rayed 1,482 1,040 1,140 1,180 1,169 Number found to have active tuberculosis 1 1 1 4 2 LUNG CARCINOMA REGISTER New cases diagnosed 41 50 55 72 62 Cases known to have died during the year 36 36 36 57 60 34 ANALYSIS OP CASES REFERRED APRIL-DECEMBER 1959. MALE FEMALE Ch 15-24 25-34 35-44 45-54 55-64 65+ Ch 15-24 25-34 35-44 45-54 55-64 65+ Notified Tuberculosis 5 10 22 18 17 16 12 2 19 24 17 9 1 5 Observation Tuberculosis 3 5 12 12 28 14 12 3 10 19 15 10 13 7 Hypertension 1 2 2 3 2 Bronchitis, Emphysema, Cor Pulmonale 10 7 16 14 33 56 43 2 3 10 15 28 39 26 Asthma 5 3 5 1 3 2 2 3 3 3 2 Cardiac Failure 2 Pneumonia, Pneumonitis 7 7 7 12 21 19 23 6 4 8 11 10 12 3 Carcinoma 1 6 24 10 1 1 1 Upper Respiratory Tract Infection 12 3 5 6 1 5 2 5 11 6 1 2 Spontaneous Pneumothorax 2 2 1 2 1 1 Pleurisy 3 1 1 1 2 5 2 2 Pulmonary Embolism 1 1 Silicosis and Pneumoconiosis 1 1 Bronchiectasis 2 1 1 3 3 2 1 4 2 5 Haemoptysis 1 6 10 11 7 6 4 5 7 2 7 8 4 6 Valvular Heart Disease 1 1 1 Thoracic Cage Abnormality 1 Sarcoidosis 1 3 1 Pulmonary Fibrosis 1 3 3 1 1 Angina Pectoris 1 Erythema Nodosum 1 1 1 1 1 2 Lung Abscess 1 Coronary Thrombosis 1 Miscellaneous 7 8 14 10 20 16 15 4 8 13 18 15 18 6 N. A. D. 15 8 17 20 15 13 9 10 19 22 17 6 7 8 35 SECTION C. GENERAL PROVISION OP 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 3 Renewals of Licences 28 Certificates lodged under Section 363 by members of the Chartered Society of Physiotherapy 3 Licences Refused 1 National Assistance Act, 1948 National Assistance (Amendnent) Act, 1951 Section 47 This section deals with securing the necessary care and attention by removal to a hospital or other place of 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. In no instance was it considered necessary to use the powers available under the Act, but nevertheless the Act is valuable in that the knowledge that the statutory power of removal exists often helps towards an effective decision. Experience in dealing with these cases suggests that the "Section 47 case" often falls into a certain definite psychological category in which the inability to trust others is a prominent feature, This attribute may have its origins in psychological trauma in early life. 36 One of the most difficult cases was an intelligent lady of over 80 who had refused medical and nursing attention and refused admission to hospital. She told a life-story which began with a most unhappy childhood. Her story began My mother died the day I was born " Eighteen 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 est he or she 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. 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 case it appears to the Council that no suitable arrangements for the disposal of the body have been or are being made. During the year four burials were carried out, three adults and one child. General Hospital Facilities Edgware General Hospital. Hendon District Hospital. Infectious Diseases - Hospital Accommodation West Hendon Hospital. Neasden Isolation Hospital, Willesden. Any other Infectious Disease Hospital controlled by the North-Western Metropolitan Regional Hospital Board, Tuberculosis Treatment and Hospital Accomodation Edgware General Hospital. 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:- 37 *Care of mothers and young children (Section 22) *Midwives Service (Section 23) *Health Visiting (Section 24) *Home Nursing (Section 25) *Vaccination and Immunisation (Section 26) *Domestic Help (Section 29) School Health Services and Dental Services (Provided under Education Act 1944 the Borough of Hendon being an Excepted District.) *These services are administered on an area basis Area 4 consisting of the Boroughs of Hendon and Finchley. The Area Health Committee acts as a Sub-Committee of the Health Committee of the County Council and consists of representatives of the two Boroughs, Middlesex County Council, certain professional bodies and other persons with special knowledge of these services, Medical Practitioner Service The Middlesex Executive Committee has classified the different wards of the Borough into two categories, (1) Intermediate Area Burnt Oak, Central Childs Hill. Edgware, Mill Hill 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, Golden 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 is shown elsewhere in the report. 38 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 three times in 1959 to consider problems of liaison and a summary is given in its report as follows:The Welfare of Children in Hospital The Committee considered the report of the Committee of the Central Health Services Council on this subject, under the guidance of Dr. Baber, Paediatrician at Edgware General HospitaL. In the course of the discussion it appeared that most of the recommendations mentioned in the Report were already being carried out at Edgware General Hospital. On the question of the admission of mothers to hospital it was considered that only in exceptional cases would mothers of small children have to be admitted to hospital, but that arrangements had been made in Edgware General Hospital for the admission of mothers of breast fed infants. Report of the Maternity Services Committee (The Cranbrook Report) Under the guidance of Mr. Rosser Consultant Obstetrician and Gynaecologist of Edgware General Hospital the Committee considered the conclusions and recommendations of the Cranbrook Report, and with the undermentioned exceptions agreed with the report. 328. The local health authority is the appropriate authority to determine whether social reasons made a home confinement undesirable and they should always be consulted by hospital authorities before a decision is made tO book a patient solely on social grounds." The Committee is of the opinion that the words in consultation with the general practitioner" should be added after the words is the appropriate authority''. 329. Sufficient hospital maternity beds to provide for a national average of 70 per cent of ail confinements to take place in hospital should be adequate to meet the needs of all women in whose case the balance of advantage appears to favour confinement in hospital." The Committee considered that the extra beds to be provided should be general practitioner maternity beds. 331. Experience in this country justifies adherence to a period of ten days as the normal (not average) length of stay in hospital after delivery." The Committee considered that in certain circumstances there is scope for a much shorter stay in hospital, 39 350. The obstetric list should be continued, More uniform criteria should be applied for admission to and retention on it." The Committee was of the opinion that some pre registration experience of mid wifery is essential for all general practitioners. The Committee is always glad to consider any matters of liaison which would benefit by such discussion between the separate sections of the National Health Service," WELFARE OP 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 1959/60. "Since the last Annual Report was published certain new activities have been initiated by the Committee and in the case of others there have been important changes. TRANSPORT For reasons of which members are aware it was found desirable to discontinue the use of the welfare coach Polly". A sum of £100 was set aside as a transport fund to enable organisations to continue and possibly increase the number of outings for elderly people. In making this allocation the Committee had in mind the needs of the disabled and housebound, and it is hoped by this means to provide at least one day in the country during the summer for some of those who otherwise do not leave the house from one year s end to another. Last summer before the formation of this fund, an anonymous donation which we had received was placed at the disposal of the British Red Cross Society who organised three afternoon trips and about 100 disabled people were able to see something of the countryside. For those who took part, these outings were events to be remembered and they appear also to have been a great encouragement to the volunteer workers who made the arrangements. Since last autumn this fund has been contributing to the costs of coach hire incurred by the Edgware and District Blind Club who formerly had the use of "Polly" to bring members to the fortnightly meetings of the club, SPECIAL HOLIDAYS Although the Committee arranges a week's holiday each year at Cliftonville„ those who go on it pay the full hotel and transport costs. The Committee's contribution is limited to gratuities and other incidental charges. It was felt that there must be numerous cases of elderly people who were in great need of one or two weeks recuperation but for whom holidays at suitable places could not be provided from the various sources available to hospital almoners, A sum of £150 was set aside for 40 ing such cases. In the period under review contributions totalling £60 have been made, usually on the recommendation of the patient's own doctor or of the hospital almoner concerned. By this means ten people who badly needed a change were got away to the sea for one or two weeks. CHIROPODY SERVICE For the three year period ending on March 31st 1959 the Chiropody Service was financed by annual grants from the National Corporation for the Care of Old People. These grants ceased on that date. As it was known that the question of a Chiropody Service was under discussion at Government level, the Committee decided, while awaiting a decision on the future of this important service, to continue operating the existing scheme. In June 1959 the Health Committee of the Middlesex County Council reported that it had approved, in principle, an extension of the Chiropody Service, under Section 28 of the National Health Service Act, 1946 with priority in the early stages to elderly people, the physically handicapped and expectant mothers, In March of this year we received a letter from the Middlesex County Council setting out proposals and conditions for the continuation of the service by voluntary organisations, We were also informed that a payment of £170 was being made to this Committee to meet the costs of the service for the period from April 1st 1959 to March 31st 1960. Certain details are still the subject of discussion with the County Authority but it would appear that the Middlesex County Council proposes to treat the existing scheme as an interim measure only. The County Council proposes to establish eventually a Chiropody Service which would be carried out at the County Council's clinics, operated by chiropodists employed by the County, rather than to proceed, as the Hendon Old People's Welfare Committee have been doing; on the pattern of the general practitioner services, which would have permitted chiropody treatment at the chiropodists' own surgeries. We give below a summary of treatments given during the period under review No. o f Patients Treated. No. o f Treatments given. At the patient's home 112 307 At Red Cross Clinics 67 450 At surgeries 90 420 269 1,177 41 HANDCRAFTS On the 19th and 20th August the Middlesex Old People's Welfare Committee held a Handcrafts Exhibition for Over 60's at Middlesex Guildhall. A total of 84 exhibits was sent from this Borough and 22 certificates of merit were awarded among them. FUND RAISING ACTIVITIES This was the third year that we had made a postal appeal for funds. 3reat care was taken with the preparation of the mailing list, the roads which were considered most promising being selected from the Electoral Register. A total of 4,200 letters was sent out, a copy of the information folder being enclosed with each. The total received was £215. 2. 6d. and the cost between £45 and £50. This result can only be regarded as most disappointing and compares unfavourably with the previous year when a much smaller number of letters was sent out. It has been decided this year to restrict the list to a few hundred and possibly to ask donors to consider the signing of seven year covenants. The question of employing other methods of raising money may now need to be carefully considered. INFORMATION PAMPHLET This continues to be most useful and is a quick and efficient means of giving needed information to individuals who send us their enquiries and to organisations concerned with the well-being of the elderly in the Borough. ANNUAL HOLIDAY This was again at Cliftonville and took place during the week commencing Friday May 22nd. The party numbered 62 and our thanks are again offered to Nurse O'Brien of the Red Cross, particularly as on this occasion the calls made upon her seem to have been rather heavy. Bookings for the 1960 holiday started, as is customary, early in the year. Suitable enquiries have been made when there was any reason to doubt an applicant's fitness on medical grounds to join the party. CLUBS The various groups of clubs run by the constituent organisations continue to play a most important part in the lives of their members. The devoted work and enthusiasm of the club leaders and their helpers cannot be praised too highly. We would make particular mention of those clubs which are run for the blind and disabled. Visits which have been paid to some of these leave no doubt as to their tremendous value in maintaining and improving morale and in offering to handicapped people something to look forward to at regular intervals. 42 The Over 60's Club continues to prosper. For some time past the club has been open on two evenings a week for television, whist and such other recreation as the members select. These evenings have proved very popular and the attendance seems to be increasing. Fortnightly evenings for old time dancing have also been started. This year we broke with custom and instead of having the whole club membership to a New Year Party in a hired hall, it was decided to give three separate parties in the club rooms. The experiment appears to have been a success. But with an increasing membership some further plan may need to be thought up for 1961. Our grateful thanks are offered to the ladies who give such invaluable service to the club, and to the Toc H Film Unit for their monthly film shows. The active membership of the Over 60's Club is over 150 which makes the average weekly attendance of 120 appear rather low. Attendances on weekday afternoons vary from over 50 to as low as 20 - 24 If attendances were evenly spread over the week there should be room for another 40 or 50 members. It is just possible that in the Central area of the Borough, there are too many, clubs catering for the needs of the elderly. BOARDING OUT SCHEMES During recent months information has been collected on schemes in operation in various parts of the country for boarding out elderly people in private houses. After careful consideration it was decided that an endeavour ought to be made to discover whether some such scheme should, and could, be operated in Hendon, A meeting was therefore arranged for Monday March 7th to hear an address by Miss M. Webb, Secretary to the North West Kent Council of Social Service in whose area a successful scheme has been in operation for about four years. Invitations were sent to members of public and voluntary organisations concerned and to Old People's Welfare Committees in neighbouring Boroughs, and the meeting was very well attended, CHRISTMAS ACTIVITIES The pre-cooked Christmas Dinners seem to give great satisfaction and 72 were distributed by the W.V. S. "Meals on Wheels" Service and by ourselves. We were also able to make up some food parcels for certain old people whom we visit from time to time. Each year, in submitting our list for the Mayor's Fund we are able to add a number of names of old people who have been visited during the previous twelve months and who we feel should be included. CENTENARIANS Two residents in the Borough have celebrated a 100th Birthday. Mrs, Fanny Barrett on February 24th. Mr. Charles T, Luck on March 2nd. In each case a visit was paid by the Hon. Secretary to offer congratulations and a suitable gift from the Committee. 43 GENERAL We continue to co-operate with other organisations. Last April we were invited by the notary Club of Hendon to assist in arranging a party for disabled and housebound elderly people which was given at the Hodford Hall. About 80 were entertained. We have been asked to help again with a similar party this year. Last September the Round Table of Hendon organised a day's coach outing to the sea for disabled old people to which the Committee made a contribution of £22, In all activities of this kind, where the object is to get the housebound or severely handicapped out of their homes for a few hours, transport is the limiting factor. The Committee are most grateful to the volunteer car drivers who give their services so readily. Visiting continues to be an important activity and in this we receive ready help from our constituent organisations and from church welfare committees. Requests for visits to discuss personal problems are generally handled from the office and when necessary reports are made to the appropriate Authority, It is clear from information which we receive that a very large amount of visiting and other social work is done by the constituent organisations and the churches, and in a Borough as large as Hendon this is clearly the most satisfactory system. The Committee wish to express their thanks both to public and voluntary organisations for the willing cooperation and help which they always receive. STAFF There have been no changes since the last Report was presented. The Organising Secretary and her assistant continue to carry out their duties in a very satisfactory manner. It will not be possible, for some months, to judge the effects of the changes in the Chiropody Service, but there seems every reason to expect that a noticeable increase in administrative and clerical work will result.'* 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 Fourth Annual Report, which describes the work of the Society at Church Walk House. The Report includes the comments - "The good general health of the residents over the past years has been maintained, having regard to the average age o'f 88 years. There has been seven new admissions. Six residents were sent to hospital and returned; three deaths and five left for various reasons. There is still a growing need for Homes. The waiting list of the Middlesex County Council is over 600, the London County Council list 800. Our own geriatric unit in Hendon has bed problems of getting patients into Homes after treatment, thus restricting the intake of new patients requiring treatment, and we do our best to 44 co-operate with the Edgware General Hospital wherever possible, and they likewise reciprocate. " 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 93 were passed as fit, 2 were unfit and in 9 cases the decision was deferred pending further medical examinations. The number of examinations in respect of each department of the Council was as follows:- Town Clerk's 10 Borough Treasurer's 9 Borough Engineer's 48 Borough Librarian's 28 Borough Housing Officer's 12 Medical Officer of Health' s 2 109 SECTION D. SANITARY CIRCUMSTANCES OF THE AREA Water Supply The Borough has a dual source of supply. The northern part is supplied by the Colne Valley Water Company and the central and southern portion by the Metropolitan Water Board. The Colne Valley water is derived from deep wells sunk into the chalk and before distribution to the consumers the water is under constant supervision of a chemical and bacteriological staff which carries out examinations in modern laboratories situated at the works. The water supplied by the Metropolitan Water Board is selected Thames water which has been subjected to purification by storage in which time it is freed of the bulk of organisms. It is filtered through rapid and then slow filters, attaining a degree of purity which compares favourably with the general supplies in Great Britain, but as a further safeguard terminal chlorination is applied which ensures a first class water in every respect. Samples of water are examined bacteriologically, chemically and for taste and other special purposes on every working day. The supply to all areas was satisfactory in quality and quantity. Number of dwellinghouses supplied from public water mains:- (a) Direct to houses 45,200 (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 45 Natural fluoride content of water supplies:- Colne Valley Water Company: Fluoride content — Nil Metropolitan Water Hoard: Fluoride content — 0.15 parts per million. The water supplied to Hendon is deficient in fluoride and dental decay is more prevalent here than in those areas where the element is present in optimum quantity. HOUSING I am indebted to the Housing Officer for the following observations and statistics relevant to the housing situation. "Despite the limitations imposed by the small number of new dwellings erected during 1959 and the necessity to rehouse families from properties scheduled for demolition under redevelopment schemes, progress has been maintained in housing by means of transfers, re-letting of vacated premises and the purchase of private houses which have added to the pool of permanent dwellings under Council control. The total number of pre-war and post-war dwellings erected by the Council up to 31st December 1959 was 4,092 and in addition some 120 additional units of accommodation have now been provided in acquired premises. The first block of eleven flats forming part of the primary phase in the scheme for the redevelopment of the New rent Street area was completed and let during September 1959. This scheme of redevelopment will be carried out in three phases over a period of three years and will accommodate 188 families in two eleven storey and nine five storey blocks of flats incorporating the most modern features of design, including electric underfloor heating. Outside of areas selected for redevelopment there have been properties in advanced stages of disrepair where it has not proved practicable to restore them and in these instances it has been the policy of the Council to rehouse the occupants to more suitable dwellings and to effect the closing or demolition of the unfit dwellings. The release of requisitioned properties in 1958 anticipated the close of this wartime measure in the current year and by the 31st December last only three dwellings were under Council requisition out of several hundreds requisitioned during and immediately following the war years. The majority of the occupants of requisitioned properties have been rehoused by the Council but in some instances they have been accepted as statutory tenants by the owners of the property. Movement of population to the New and Expanded Towns has remained steady and where some falling off has occurred in those towns in advanced stages of completion this has been off-set by the commencement of expansion in other localities. The Council have initiated or supported the nomination of several thousands of Hendon residents during the past ten years to New and Expanded Towns and by so doing have either directly contributed to the relief of over-crowded conditions or have secured 46 the release of accommodation suitable for reletting to other families. Hendon is now 'linked' to eight New Towns and to four towns with programmes for expansion in the Home Counties. The Council have assisted in schemes introduced by private Housing Societies and have thereby been enabled to nominate a proportion of the tenants in dwellings so erected. New applications for Council accommodation were received at the average rate of 45 per month during 1959 and it is notable that ten per cent of applications were from persons of pensionable, or approaching pensionable, age. Provision of small dwellings for elderly persons continues to be made by the Council but the number of applicants requiring this type of accommodation on account of age or ill-health at present greatly exceeds the supply and cases involving hardship from unsuitable or poorly situated accommodation are known which will not be easily resolved. The housing waiting list as at 31st December 1959 included 2,617 applications. Applicants assisted in the course of the year were as follows; (a) rehoused into permanent accommodation (pre-war) 24 (post-war) 62 86 (b) transfers to resolve cases of overcrowding or underoccupation on Council estates, etc. 194" PUBLIC HEALTH 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.P.H.Day, Chief Public Health Inspector, who succeeded Mr.A.H.Smith when he retired on 1st February, 1960. Details of inspection work carried out:- Inspections made 7,159 Re-inspections after order or notice 12,985 Complaints received and investigated 1,463 Bakehouses 113 Butchers Shops 196 Caravans 168 Certificates of Disrepair (Rent Act, 1957) 53 Clean Air Act Inspections 935 Dairies 20 Drain tests 263 Factories 94 Hairdressers and Barbers premises 37 Hawkers and food delivery vans 17 Hawkers storage premises and stalls 7 Ice Cream Samples 15 Ice Cream premises 28 Infectious Disease 522 47 Licensed premises 120 Milk samples 37 Other food shops 707 Overcrowding 14 Outworkers 63 Pet Animals Act 1951 26 Piggeries 15 Premises licensed for public entertainment 90 Restaurants, cafes, etc. 324 Samples of Animal Feeding Staffs and Organic Fertilisers (re Salmonella Infection) 44 Samples of Coconut (re Salmonella Infection) 54 School Meals Service Kitchens 28 Shops Act, 1950 (Section 38) (Ventilation, heating, lighting, sanitary conveniences and washing facilities) 898 Smoke observations 202 Stables 33 Swimming baths - water samples 39 Miscellaneous 51 Notices Served To deal with unsatisfactory conditions found during the course of the above inspections, the following notices were served: - Informal or cautionary 699 Statutory Notices Served under Public Health Act, 1936 43 Served under other Acts, etc. 13 As will be seen from these figures, the vast majority of matters found requiring attention are dealt with by informal action, statutory action becoming necessary in less than 8% of these cases. Inspection of Dwelling Houses during the year Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 1,588 Number of inspections made for this purpose 3,799 Number of dwelling houses inspected under the Housing Consolidated Regulations, 1925 Number of houses surveyed in areas in need of redevelopment 370 Number of dwelling houses found to be unfit for human habitation and incapable of repair at reasonable expense 48 Number of dwelling houses (exclusive of those referred to under preceding sub-heading) found not to be in all respects reasonably fit for human habitation 483 48 Legal Proceedings under Public Health Act, 1936, Section 94. During the year it was necessary to institute legal proceedings in only six cases in connection with the abatement of nuisances. In three of these cases the work required to abate the nuisances had not been carried out at the time of the Hearings and the Magistrates made Nuisance Orders, awarded the Council costs in each case and in one case imposed a fine of £5. In one case the Nuisance Order was not complied with and at a further Hearing the Magis trates imposed a fine of £5 and awarded the Council £6.6.0. costs. The work had not been completed at the close of the year and further proceedings were under consideration. In two other cases the work necessary to abate the nuisances was carried out shortly before the Hearings, but the cases were proceeded with and the Magistrates awarded the Council costs in each case. The last case related to statutory nuisances arising in connection with the keeping of cats. Three complaints were made by the Council that although the nuisances had been abated they were likely to recur. The defendant was represented by Counsel and denied all three complaints. The Magistrates, however, granted Orders prohibiting any recurrence of the nuisances and awarded the Council a total of £9. 3. 6d. costs. HOUSING ACT, 1957 During the year under review 13 houses were dealt with under the Housing Act, 1957, involving the making of 3 Demolition Orders and 10 Closing Orders. Certificates of Unfitness were issued under the Housing (Financial Provisions) Act, 1958, in respect of 35 houses in the Council's ownership. Of the 48 houses, 29 were actually closed during the year and 7 were demolished. In addition, 21 houses were closed and 55 demolished in respect of which Closing or Demolition Orders had been made or Certificates of Unfitness issued prior to 1959. During 1959, 48 families involving 140 persons were displaced from unfit properties, 42 families involving 130 persons being rehoused by the Council and 6 families involving 10 persons being rehoused by other authorities or finding their own accommodation. Steady progress was maintained during the year in dealing with unfit properties, and towards the end of the year a further survey was carried out to ascertain the number remaining to be dealt with. It was found that whereas in 1955, when proposals were submitted to the Minister of Housing and Local Government under the Housing Repairs and Rents Act, 1954, the number of unfit properties was estimated at 173, 49 the total number with which the Council will eventually have had to deal will be 330. The increase is due largely to owners and tenants in areas which the Council has determined to be areas in need o f redevelopment, knowing that the houses are destined for demolition, ceasing to carry out repairs with the result that the properties, already old, have rapidly deteriorated and eventually become unfit. The Council continues to find that generally the most satisfactory way of dealing with these properties is the issue of Certificates of Unfitness under the Housing (Financial Provisions) Act, 1958, after the houses have passed into the Council's ownership. The District Valuer, who negotiates the purchase of properties in these areas on behalf of the Council, is supplied with a report on the condition of each property, whether unfit or not, to assist him in the assessing of its value. The reports are prepared by the Public Health Inspectorate. It is anticipated that this revised slum clearance programme will be completed by August 1962. By then, other properties in these areas for redevelopment will no doubt have reached the stage of disrepair which makes them unfit, and the work of dealing with them will continue. It is also reasonable to assume that the minimum standard of housing fitness will improve as the standard of living rises, and that housing work will continue with us for several years to come. One aspect of housing in which little progress was made was in dealing with houses let in multi-occupation. The absence of proper statutory standards for amenities and the fact that action under the Housing Act, 1957, might lead to eviction of families which the Council could not at present rehouse, makes progress in this field of housing work difficult. The close of the year saw most of the work of this Department in the New Brent Street Area of Redevelopment completed. Of the 114 properties in this area 71 were found to be unfit for human habitation and have been dealt with either by making of Closing or Demolition Orders under the Housing Act, 1957, or the issue of Certificates of Unfitness under the Housing (Financial Provisions) Act, 1958. It is rewarding to see the demolition of these terraced blocks of houses with their rising dampness, rotten floors, dark steep staircases and lacking in those necessary amenities - hot water, baths, lavatory basins, internal water closets and ventilated larders - and the tenants rehoused in the modern blocks of flats with their splendid amenities. The fact that the redevelopment site will also provide accommodation for families from unfit properties in other parts of the Borough is also gratifying. 50 RENT ACT, 19 57 The following figures show the number of applications for Certificates of Disrepair and Revocation received and the action taken during the year. Applications for Certificates of Disrepair No. of applications for certificates 29 No. of decisions not to issue certificates - No. of decisions to issue certificates 24 (a) in respect of some but not all defects 18 (b) in respect of all defects 6 No. of applications outstanding at end of year 5 No. of undertakings given by landlords under paragraph 5 of the First Schedule 17 No. of undertakings refused by Local Authority 1 No. of certificates issued 8 (One certificate was in respect of an application received in 1958. ) Applications for Cancellation of Certificates No. of applications by landlords to Local Authority for cancellation of certificates 11 No. of objections by tenants to cancellation of certificates 5 No. of decisions by Local Authority to cancel in spite of tenants' objections 2 No. of certificates cancelled by Local Authority 5 No. of applications outstanding at end of year 3 The number of applications for Certificates of Disrepair is small compared with the number of tenants who are paying the maximum rent irrespective of whether repairs are carried out or not. The involved procedure under the Rent Act no doubt acts as a deterrent to many would be applicants. Premises Licensed for Public Entertainment In accordance with the usual practice, inspections were made of the sanitary arrangements at cinemas and other premises licensed for public entertainment and reports thereon submitted to the Middlesex County Council in connection with the renewal of the licences. 49 premises were inspected and at 12 of these works of repair, improvement or redecoration were found to be necessary. The licensees were notified of these and at the end of the year all the necessary works had been com pleted or were in hand. 90 visits were paid to these premises by the Public Health Inspectors. Licensed Premises Inspections were carried out of the 40 licensed premises in the Borough and a report submitted on conditions found in the bars, cellars, kitchens and sanitary conveniences in time for consideration at the Brewster Sessions when applications for renewal of the licences are dealt with. At 19 of the premises matters were found which required attention. These related principally to cleaning and redecoration of kitchens cellars and sanitary 51 conveniences, renewal of kitchen equipment, provision of additional washing facilities for staff and improvement of hot water supplies for cleansing of equipment. 120 inspections were made during the year of these premises and in all cases arrangements were made for the necessary works to be carried out. Schools At the request of the Middlesex County Council a detailed survey was made of all schools in the Borough and reports submitted on lighting (natural and artificial), ventilation and heating of classrooms, adequacy and condition of sanitary and washing accommodation for pupils and staff, accommodation for meals, drinking water supplies, kitchens and kitchen equipment, first aid facilities, drainage, refuse storage and disposal, boiler houses, etc. Recommendations for improvements were made in connection with several of the schools and it is pleasing to note that some of these have already been implemented. Cesspools A number of the properties in the more rural parts of the Borough have cesspool drainage. The cesspools were emptied by the Council on 222 occasions during the year. Overcrowding The following report on overcrowding for the year ending 31st December 1959 was submitted to the Minister of Health as required by the Public Health Officers Regulations, 1959. (a) Number of dwellings known to be overcrowded at end of year 10 Number of families dwelling therein 11 Number of persons dwelling therein 52 Equivalent number of persons dwelling therein (Sec.77, Housing Act, 1957) 38 (b) Number of new cases of overcrowding reported 11 (c) Number of cases of overcrowding relieved 3 Number of persons concerned 7 Equivalent number of persons concerned (Sec. 77, Housing Act 1957) 614 (d) Cases in which dwelling-houses in respect of which Local Authority has taken steps for abatement of overcrowding and have again become overcrowded Nil (e) Other particulars with respect to conditions in relation to overcrowding upon which the Medical Officer of Health considers it desirable to report. It is very unlikely that the above represents the entire extent of the overcrowding in the Borough but they represent the only cases known to the Department. These cases were brought to our notice either by tenants seeking to improve their "points" position on the Council's housing applications list or by owners endeavouring to secure possession of their properties on the grounds that they were overcrowded. 52 Insect Pests Complaints of ants, bees, book-lice, bugs, carpet beetles, clover-mite, cockroaches, crickets, earwigs, fleas, flies, furniture mites, 1 rder beetles, silver fish, thaumatomyia notata, wasps, wood boring insects, and wood lice 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. 13 cases of bug infestation and 9 of infestation by fleas were successfully dealt with by one of the Council's rodent operatives, part of whose time is devoted to pest destruction. He also destroyed no less than 569 wasps' nests. This number is considerably greater than any experienced in previous years and was no doubt due to the long dry summer. Despite this undue prevalence of wasps not a single complaint was received of their presence in food shops. In previous years this has been a difficult problem to deal with, particularly in bakers'and confectioners' shops. Periodical closing down to enable the premises to be treated with aerosols and the placing of all confectionery in closed cases, etc., did not effectively keep the wasps at bay. It would appear that as the Council's service became so widely known and the existence of nests quickly reported, subsequent destruction lowered the wasp population to an extent which prevented their becoming a nuisance in shops. Another troublesome although harmless insect which invaded buildings in enormous swarms and hung to the ceilings was thaumatomyia notata. These are tiny yellow flies with black markings which invade buildings, particularly those near large trees, in swarms which almost cover ceilings. It has been found that the best way of removing them is with the use of a vacuum cleaner extension. Clover mite also proved troublesome, particularly in the ground and first floor flats of new Council point blocks, where the vegetation and grass had been taken right up to the dwellings without intervening areas of paving. During the year 262 inspections were made by the Public Health Inspectors of furniture, bedding and accommodation of families who were to take up occupation in Council houses and flats or who were being transferred to other Council accommodation. These inspections are to ensure that the accommodation and effects are vermin-free. It is only very infrequently nowadays that the presence of vermin is found. 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. 53 In cases other than notifiable infectious disease the service is carried out on request, an appropriate charge being made. During the year 290 library books and 5 gramophone records were disinfected. The number of rooms disinfected during the year was 191. Local Land Charges Enquiries During the year enquiries were made by the Town Clerk in respect of 4,261 properties as to whether there were any notices outstanding, whether in a Smoke Control Area or whether any Certificate of Disrepair was in force under the Rent Act, 1957. The necessary searches were made and the information supplied. Choked Drains During the year, the Council's workman cleared no less than 912 choked drains at private premises. This is unpleasant work which the local building contractors appear to be quite content to leave to the Council to carry out. A charge is made for this service based on the time taken by the workman, transport charges and necessary overheads. The average charge is about 10/6d. Complaints are received from time to time that the charge is excessive, but I suggest that it is a charge with which few local builders would care to compete. The Public Health Inspectors also frequently have to deal with the mistaken belief, even amongst builders, that the section of drain between the intercepting trap and the Council's sewer is the responsibility of the Council. The belief arises from the fact that this section of drain is usually under the Council's highway, but the drain is nevertheless the responsibility of the owner of the property until it reaches the Council' s sewer. The service, however, continues to grow, the number of requests for the clearing of drains increasing each year. Requests are also received for a service of periodical cleaning and flushing of drains of private and commercial premises, but this is not a service which the Department has been able to undertake, only one employee being available for all drain testing and cleaning work. The above figure does not include choked drains at Council houses, which are dealt with by the Borough Housing Officer's Department. The commonest cause of drain stoppages is obstruction of the intercepting trap, which is now happily omitted from modern drainage schemes. The dispensing with these traps also eliminates that other source of trouble, the fresh-air inlet. Where these have been fitted, as is most commonly the case, at garden level, they are usually found to be broken. For some years now the Department has, instead of calling for their replacement, simply requested owners to have them removed and the pipe thereto sealed off in the wall of the chamber. Some hundreds have now been dealt with in this way and in no case has any subsequent trouble with ventilation of the drainage system been experienced. 54 Drain Tests The following drain tests were carried out:- (a) For prospective purchasers of properties and reports submitted 22 (b) In connection with applications for advances for the purchase of properties under the Housing (Financial Provisions) Act, 1958 122 (c) In connection with the investigation of nuisances 55 Total 199 For this service under (a) and (b) a fee, usually of £2.2.0., is charged. This work also continues to grow in extent. Swimming Baths There are two municipal-owned swimming baths in the district, one at West Hendon and one at Mill Hill. The long, hot summer produced big attendances at both, a total of 170,596 persons using Mill Hill bath and 67,438 West Hendon. 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. Swimming bath water often in advertently becomes drinking water, particularly where schoolchildren are concerned, and therefore the water in swimming baths should as nearly as possible reach the standard of drinking water. The cleanliness of these swimming pools is quite remarkable when compared with the bacteriological standards reported by the Medical Research Council (Memorandum No.37) which followed an investigation into the contamination of bathing beaches in England and Wales. In this report a typical beach examined by the Medical Research Council showed a coliform count which ranged between 40 per 100 ml. at the lower end of the scale to 25,000 per 100 ml. at the upper end of the scale. 30 samples were taken at the two Hendon pools, and no coliform organisms were found in any of these samples. Report No.71 of the Ministry of Health in the Bacteriological Examination of Water Supplies also recommends that in 75% of the samples taken, the 24-hour plate count at 37°C. from 1 ml. of water should not exceed 10 colonies and the remainder should not exceed 100 colonies. Of the 30 samples taken 75% did not, in fact, exceed 10 colonies and in only 2 cases did the count exceed 100 colonies. One of the latter samples was found to have been due to the chlorinator having been out of action for some 2 hours prior to the taking of the sample, due to a burst water main. The other sample was taken after August Bank Holiday week-end, when there had been very high attendances at the bath. Rag Fiock and Other Killing materials Act, 1951 Number of Registered Premises 3 Pet. Animals Act, 1951 Number of Licences granted 10 55 Hairdressers and Barbers 37 inspections were made in connection with the Byelaws made under Sec. 282 of the Middlesex County Council Acts, 1944. Prevention of Damage by Pests Act, 1949 - Rodent Control Rodent destruction in dwelling houses 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 dwelling houses, 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, 1959, is given in the following table. As will be seen, most of the infestations were of a minor character occurring at private dwelling houses. These were most prevalent in the vicinity of water courses and where animals were kept. 56 TABLE XVII. 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) I. Total number of properties in Local Authority's District 19 45, 200 6,094 51,313 10 2. Number of properties inspected as a result of (a) Notification 6 698 68 772 - (b) Routine inspection - 1,079 142 1,221 - 3. Total inspections carried out - including reinspections 96 13,731 1,456 15,283 - 4. Number of properties inspected (under Section 2) found to be infested by (a) Rats (Major - - - - - (Minor 3 1,481 129 1,613 - (b) Mice (Major - - - - - (Minor 3 105 19 127 - 5. Number of infested properties (under Section 4) treated by the Local Authority 6 1,583 134 1,723 - 6. Total treatments carried out - including retreatments 15 2,151 221 2,387 - 7. Number of notices served under Section 4 (a) Treatment - 2 1 3 - (b) Structural work (i.e., Proofing) - - - - - 3. 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. - 229 1 230 - 57 Factories Acts, 1937 to 1959 At the request of the Minister of Labour the tables showing the work carried out in the administration of the health provisions of the factories Acts are given in the prescribed form as an annex to this Report. Although the standard of sanitary accommodation at the factories in the Borough is generally high, it is desirable that this should be inspected at least once a year. It is hoped that this will be achieved in future. At none of the outworkers' premises inspected were conditions found to b e unsatisfactory. No lists of out-workers were received from factories in the Borough. CLEAN AIR ACT, 1956 The Borough of Hendon Smoke Control (No. 1) Order, 1958, declared a portion of the northern part of the Edgware Ward a Smoke Control Area and, after a Public Inquiry, was confirmed by the Minister of Housing and Local Government on the 31st August 1959, with a modification making it come into force on the 1st September, 1960. The Minister of Housing and Local Government asked all local authorities in "black areas", of which Hendon is one, to submit a phased programme for establishing Smoke Control Areas over the next five years, with a target year for the completion of the whole programme. With the ultimate object of making the whole of the Borough a Smoke Control Area, a Ward basis to be carried out in twenty stages was approved in principle. A detailed survey of the heating appliances used and of the fuels consumed now, together with an estimate of the cost of adaptation of the existing appliances and the amounts of smokeless fuels needed, has to be made, and an additional Public Health Inspector has been appointed to carry out this survey. A preliminary survey of Phase 1 of the Garden Suburb Ward has now been made and will form the Borough of Hendon Smoke Control (No.2) Area. The area is situated in the south-east part of the Borough and is approximately 446 acres in extent and consists of approximately 2,559 dwellings and other miscellaneous premises. It links up with Smoke Control Areas proposed by neighbouring boroughs, so that within the next three years a large smoke controlled area will almost surround the Hampstead Heath made up of Smoke Control Areas established in Hendon, Hampstead, Finchley and Hornsey. Measurement of Atmospheric Pollution The measurements recorded during the year show a definite improvement on the results obtained in the previous year. This may be due to the increased use of smokeless fuels, but some of the improvement may have been due to the relatively hi gh wind velocity in November and December. 58 TABLE XVIII. DEPOSIT GAUGE, TOWN HALL Table showing monthly deposit of total solids: 1959 Rain ins. Total solids Tons per sq. mile January 1.93 15.77 February - 21.37 March 1.97 19.41 April 2.44 14.97 May 0.27 11.04 June 0.79 13.31 July 0.95 12.54 August 1.22 12.90 September - 14.07 October 2.32 14.24 November 2.44 13.30 December 3.55 22.11 TOTAL 17.88 185.03 TABLE XIX. DAILY AVERAGE OF SMOKE AND SULPHUR DIOXIDE AT EDGWARE AND GOLDERS GREEN MEASURING STATIONS. 1959 Edgware Golders Green *Smoke †Sulphur *Smoke †Sulphur January 18.0 11.7 30.0 15.3 February 19.0 12.1 28.0 15.6 March 10.0 7.2 14.0 7.3 April 5.0 4.3 9.0 6.3 May 4.0 3.3 4.0 3.7 June 3.0 2.5 4.0 3.5 July 3.0 2.9 3.0 3.0 August 3.0 3.0 3.0 3.3 September 4.0 3.1 4.0 3.8 October 7.0 4.9 9.0 6.6 November 15.0 9.1 17.0 11.1 December 10.0 7.3 14.0 8.5 TOTAL 101.0 71.4 139.0 88.0 * Average daily smoke concentration in mgms. per 100 cu. metres of air. † Average daily sulphur concentration per 100 million volumes of air. 60 SMOKE FILTER AND SULPHUR DIOXIDE STATIONS 1959 DEPOSIT GAUGE — TOWN HALL THE SKYSCRAPER BRONCHITICS Mortality from chronic bronchitis is much less in certain Continental countries than England, andno doubt there are several factors which may explain the difference. One possible factor is that in Continental cities more people live in very tall buildings and therefore escape, to some extent, from the dense layer of smoke pollution that occurs at or near ground level, especially in foggy weather. An investigation carried out by the Warren Spring Laboratory of the Department of Scientific and Industrial Research showed that, over a period of one winter month in a building in Central London, smoke concentrations at the height of some 70 feet above ground were consistently lower than at a height of about 15 feet; on the average the concentrations at 70 feet amounted to 85% of ground level concentrations. It would seem that people in top storey flats are exposed to lower levels of pollution than those living nearer the ground. Although the percentage differences found are not large, the Director of the Warren Spring Laboratory considers that they could make an appreciable difference to actual levels of pollution at different heights during periods of high pollution. In one attempt to find out if people who occasionally suffered from bronchitis derive any benefit when moved from the normal type of dwellinghouse to the higher levels in 11 storey point blocks an investigation was carried out at Edgware, where such blocks were erected two years ago. Eleven of the tenants now living at or above the eighth floor had submitted a medical certificate to say that one or more members of the family had suffered at some time from "bronchitis"; they were aware when applying for rehousing that there was a possibility of some degree of preference being given to them when such a medical certificate was submitted. The families were visited in November 1959, after most of them had lived for about two years in their high level homes, and an enquiry was made from either the patient or a near relative to find out how he or she had fared. Several of the residents who lived on the eighth floor or higher claimed that they frequently looked out from their flats in a clear and bright environment down on to the foggy weather at street level below. People living on the upper floors said, too, that the wind seemed much stronger. The general impression was that older men, who often had to walk further to reach public transport, derived no benefit from the move and might indeed, even be worse. On the other hand, housewives and children who did not have to face the problem of longer travel to work and who spent more time in the cleaner atmosphere claimed to be much better for living in their new environment. Women, unlike the men, seldom complained that the central heating made the air uncomfortably dry, but this is possibly due to the fact that they spend more time in the kitchenette where humidity is higher. The results could not be conclusive because of the small numbers involved, but 63 they were of sufficient interest to suggest that some people who suffer from chronic bronchitis may benefit by rehousing on the topmost floors. SECTION E. INSPECTION AND SUPERVISION OP POOD FOOD AND DRUGS ACT, 1955 Legal Proceedings. It was necessary to institute legal proceedings under the Pood and Drugs Act, 1955, in the following cases:- Charge Plea Result (a) Selling food unfit for human consumption— fine oatmeal containing rodent droppings.(Section 8) Guilty The Magistrates granted a conditional discharge and ordered the Company to pay £3.3.0. costs. (b) Selling a cake containing a part of a rubber fingerstall. (Section 2) Guilty Pined £20.0.0. and £2.2.0. costs. (c) Selling food not of the substance demanded (milk containing broken glass) (Section 2) Guilty Fined £25.0.0. and £3.3.0. costs. In case (a) it was established that the oatmeal was contaminated before delivery to the retailer. In both cases (b) and (c) the defendants had been previously convicted on a number of occasions for similar offences. In addition warning letters were sent in eight instances. ACTION TAKEN IN CONNECTION WITH FOOD SHOPS, STORES, CAFES, etc. 92 cautions were given or notices served in connection with infringements of the Pood and Drugs Act, 1955, or Pood Hygiene Regulations, 1955. These had all received or were receiving attention at the end of the year and in no case was it necessary to institute legal proceedings. FOOD SHOPS AND FOOD MANUFACTURING PREMISES The classification of the various food shops and food manufacturing premises in the Borough is as follows:- Bakers and Confectioners 56 Butchers 102 Caterers Production Kitchen 1 Confectionery (Sweet) Shops 135 Fishmongers 40 Greengrocers 56 Grocers and Provision Merchants 198 Restaurants and Cafes 135 School Meals Kitchens 22 School Meals Centres 32 Works Canteens 45 Total 822 64 PREMISES REGISTERED UNDER SECTION 16, FOOD AND DRUGS ACT, 1955 Registered Premises Inspections Ice Cream Premises 234 28 Preservation of Food 69 29 15 samples of ice cream were taken during the year and submitted for logical examination to the Central Public Health Laboratory Colindale. The results of the ice cream samples were as follows Grade Number of samples I 14 II 1 REGISTRATION OF HAWKERS AND HAWKERS' PREMISES UNDER SECTION 11. MIDDLESEX COUNTY COUNCIL ACT, 1950. Number Registered Number of Inspections Hawkers 74 17 Premises 25 7 MILK SUPPLY Number of registered dairymen and distributors 46 Number of registered dairies not being dairy farms 11 Number of visits made to dairies during the year 20 MILK AND DAIRIES REGULATIONS, 1949 During the year there were no contraventions of the Act and in no case was it necessary to institute legal proceedings. MILK (SPECIAL DESIGNATIONS) REGULATIONS The following table shows the number of licences issued under these Regulations during 1959. Dealers Licences: Tuberculin Tested 38 Pasteurised 37 Sterilised 44 Dealers Supplementary Licences: Tuberculin Tested 20 Pasteurised 20 Sterilised 20 MILK SAMPLING The number of samples taken during the year is as follows Pasteurised 9 Tuberculin Tested Pasteurised 4 Sterilised 3 Milk in cartons (Pasteurised) 2 Raw Tuberculin Tested Bulk 19 In addition 80 samples of bottle rinses were taken, 65 CONDEMNATION OF FOOD The amount of food condemned shows a reduction on previous years. This is due to the transfer from the Borough of a central distributing depot of a multiple firm. Condemned foods are disposed of by incineration at the Council's Refuse Disposal Wo rks. LIST OF FOODSTUFFS CONDEMNED DURING 1959 MEAT 613 lb. 5 oz. (including - Bacon, Beef, Chicken, Corned Beef, Ham, Lamb, Offal, Pork, Sausages, Veal) 8 cartons Liver (176 lb.) 150 Pies and 9 lb. Pie 1 Turkey, 3 Bath Chaps PISH 3 st. (including Bream, Kippers) TINNED POOD Meat 203 Milk 48 Fruit 422 Vegetables 160 Soup 7 Fish 35 Jam 28 Fruit Juice 12 Tomato Juice 5 Ham 48 (491 lb.) DRIED FRUIT, Currants 56 lb. AND VEGETABLES Muscatels 5½ lb. Potatoes 81 cwt. MISCELLANEOUS Butter 3 lb. GOODS Cake, Fruit 2 lb. Cereal 5 pkts. Cheese 50 lb. 4 oz. Coconut 18½ lb. Cream 2 tins Flour 34 lb. Gherkins 2 jars Jam 25 jars Pickles 4 jars Potato Mash Powder 42 lb. Pudding 1 tin Rice 28 lb. Yoghurt 49 cartons and 12 bottles FOOD AND DRUGS ACT, 1955 The Middlesex County Council is the Food and Drugs Authority for the Borough oJ Hendon and I am indebted to Mr. John A. O' Keefe, the Chief Officer of the Public Control Department, for the following report on the work of his Department during the year. 66 "LIST OP SAMPLES PROCURED IN THE BOROUGH OP HENDON DURING THE YEAR 1959 ARTICLE TOTAL SAMPLES PROCURED UNSATISFACTORY Milk (Various) 197 Butter 42 Cakes and Biscuits 4 1 Cheese 31 6 Cooked Meat 6 1 Cream 35 Drugs 37 Fish & Fish Products 25 Fruit- Fresh, Canned & Dried 19 8 Fruit Juice, etc. 6 2 Ice-Cream 43 Liver 22 Margarine 23 1 Meat and Meat Products 87 5 Preserves 5 Sausages, etc. 6 Spirits 7 4 Sweets 8 Vinegar 25 Miscellaneous 14 1 (Jelly) 642 29 With regard to the samples noted on that list as being unsatisfactory, I add the following comments:- Cakes and Biscuits. The one sample pronounced unsatisfactory under this heading was a "Seedless Pig Bar Biscuit" which upon examination was found to contain crushed seeds. Representations were made to the makers for either the omission of the seeds or the renaming of the product; the latter course was adopted. Cheeses. All six samples referred to as unsatisfactory were samples of soft cheeses claimed to be "Cream Cheeses". There is no statutory standard for cheese, and the power of deciding a standard and of maintaining the quality of the article is in the hands of the Courts. A court can decide upon the evidence before it what is a reasonable standard, and in Middlesex the Pood and Drugs Authority submits that a fat percentage of 50% on the whole cheese is a reasonable standard. Pour of the samples referred to were Continental pre-packed cheeses. On the Continent the fat content of a cheese is stated as a percentage of the dry solids (i.e. excluding the water content of the cheese), and the conversion of this figure to a percentage of the whole cheese has shown a fat content much lower than is considered desirable for a cream cheese. In each case the importers were approached and the matter concluded satisfactorily. The other two cases were in respect of sales of a non pre-packed whole milk cheese mistakenly described by the vendors as "Cream Cheese". One official caution was issued. 67 Cooked Meats. One sample of pork luncheon meat was considered unsatisfactory, being deficient in meat content. In the case of luncheon meats there is an agreement between the manufacturers for a minimum meat content of 80%, this standard being one that could be submitted to a Court in evidence of current practice on the lines indicated above in respect of cream cheeses. It was found that the sample in question was old stock and the vendors, who were also the packers, were cautioned. Fruits. A retailer displayed a show ticket on tins of "Red Plums" describing them as "Victoria Plums". Examination of the plums showed them to be Prune plums. The firm was prosecuted and fined £3 with costs of 3 guineas. In three cases retailers were found displaying Clementine oranges with tickets claiming the oranges to be seedless. One retailer was prosecuted and fined £2 on each of two summonses with costs of 6 guineas. In the other two cases there were mitigating circumstances which led to cautions being given. Fruit Juices. A ''Fruit Juice" must be fruit juice with nothing added. A concentrate of fruit juice and sugar is a "Fruit syrup". Two cases of fruit syrups being described as fruit juices were disclosed and the persons responsible for labelling the products were cautioned. Margarine. a sample of margarine was found to contain 18.4% of water. The statutory standard for water content of margarine is not more than 16%. The company concerned discovered that whereas their normal water content checks were efficient for the checking of bulk blends, it was not so when applied to special purpose blends in small quantities. An official caution was issued in respect of this sample. Meat. Five samples of minced beef obtained from a retailer were found to contain sulphur dioxide preservative. There is an absolute prohibition against adding preservative to fresh meat, and the retailer was prosecuted. A fine of £5 on each of three summonses was inflicted together with costs of £19. 4s. Spirits. Samples of spirits obtained from licensed premises were found to be adulterated with water. Proceedings were instituted against the licensee under the Merchandise Marks Act, 1953, instead of the Food and Drugs Act, 1955, by reason of a defence available that spirits may be adulterated with water providing the proof spirit is not less than 65° proof. In the case of the two samples for which proceed ings were undertaken, gin of 58° proof and whiskey of 65° proof, each was sold from a bottle of proprietary branded spirit marked TO0 proof. The licensee was fined £10 on each of two summonses with 15 guineas costs. Miscellaneous. A table jelly was found to have its ingredients incorrectly marked. A letter was sent to the firm concerned and the matter corrected. Merchandise larks Acts, 1887 - 1953. The majority of the inspection work carried out under the provisions of these Acts relates to ensuring that the requirements of the various Marking Orders made under the provisions of the Act of 1926 are complied 68 with. These Orders apply to the marking of the country of origin on imported foodstuffs principally meat, apples, tomatoes, dried fruits, bacon, ham poultry, butter and honey, upon sale and exposure for sale. The inspections were made at 275 premises of 889 displays of these foodstuffs. Most of the infringements detected were of a minor nature and were dealt with by verbal warning. In one case an official caution was issued in respect of unlabelled meat and offal. One firm was officially cautioned for libelling Argentine beef as Empire. Another firm and its manager was similarly cautioned for marking Polish bacon as English, the particular circumstances and the excellent record of the company being taken into consideration. Labelling of Food Order 1953. This order requires pre-packed food to be marked with the name and address, or with the registered trademark of the packer or labeller. It also requires such food to be labelled with its common or usual name (if any) and in the case of a compounded food, with the names of the ingredients in descending order of proportion by weight. 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 664 articles of pre packed food was examined at 178 different premises to ascertain whether there was compliance with the above Order. False and Misleading Descriptions. Food advertisements and labels have been scrutinised for false and misleading statements and descriptions. No serious infringements were disclosed. Corrective action taken within the whole area of the County had equal effect within the sub-districts, and work under this heading is combined with inspections made in connection with the Merchandise niarks Acts and the Labelling of Food Order. Corrective action was sought for example where slimming claims were made in association with lemon juice drinks. Some extravagant claims in respect of medical remedies were challenged and the advertisements withdrawn. Special designated milks. During 1959 50 samples of designated milks were taken, all of which were certified to be satisfactory, One Dealer's (Pasteuriser's) licence in respect of premises within your area where milk is processed was issued. The premises were regularly inspected and compliance with statutory requirements was well maintained. No infringements were reported during the year. Safe milk. In addition to the foregoing 6 samples of raw milk were procured within your district and submitted to test for the presence of tubercle bacilli. None was found contaminated." SLAUGHTERHOUSES There are no licensed slaughterhouses in the district. PUBLICATION BY MEMBER OF STAFF During the year a book entitled "Domestic Sanitation", on the modern principles and practice of domestic sanitation, written by F. G. Gordon, F, R. I. B. A, , and J. Downing, M. R. S. H., A. M. I. P. H. E. , was published by Estates Gazette Ltd. 69 APPENDIX FACTORIES ACTS, 1937 to 1959 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH IN RESPECT OF THE YEAR 1959 FOR THE BOROUGH OF HENDON IN THE COUNTY OF MIDDLESEX Prescribed Particulars on the Administration of the Factories Act, 1937 PART 1 OF THE ACT 1- INSPECTIONS for purposes of provisions as to health (including inspections made by Public Health Inspectors) Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (1) (2) (3) (4) (5) (i) Factories in which Sections 1,2, 3, 4 and 6 are to be enforced by Local Authorities 28 3 3 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 389 94 12 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 10 - - - Total 427 97 15 - 2- Cases in which DEFECTS were found Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector (1) (2) (3) (4) (5) (6) Want of cleanliness (S.1) 17 8 Nil 1 - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient - - - - - (b) Unsuitable or defective 6 5 - - - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to Out-work) 20 15 - - - Total 43 28 - 1 70 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) Wearing apparel- Making etc., Cleaning and Washing 92 Making of Curtains and furniture hangings 5 Furniture making and Upholstery 2 Brass and brass articles 1 Artificial flowers 4 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 2 Making of brushes 1 Feather sorting 2 Cosaques, Christmas stockings, etc. 5 Making of Lampshades 6 TOTAL 120 71 Printed & Published by Hendon Borough Council.