Library HEN 37 BOROUGH OF HENDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1960 J. L. PATTON, M.B., Ch.B., D.P.H. Medical Officer of Health F. H. DAY, M.R.S.H., M.I.P.H.E., M.A.P.H.I. Chief Public Health Inspector BOROUGH OF HENDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1960 J. L. PATTON, M B., Ch.B., D.P.H. Medical Officer of Health F. H. DAY, M.R.S.H., M.I.P.H.E., 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 AN J) SOCIAL CONDITIONS OF THE AREA: General 6 Births, Birth Rate, Stillbirths, Stillbirth Rate 6-7 Deaths, Death Rate 7 Maternal Mortality 8 Infantile Mortality 8-10 Summary of Vital Statistics for the year 1960 10-11 Table Showing Vital Statistics for the years 1934-1960 12 Table Showing Certain Vital Statistics for the County of Middlesex for 1960 13 Table Showing Causes of Death for the year 1960 14-15 Health Statistics 16-17 Smoking in Youth Clubs 17-18 Deaths from Cancer of Lung and Bronchus 19 Road Traffic Accidents 20-22 SECTION B: PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES: Notifications 23 Age and Ward Distribution of Infectious Diseases 24-25 Notes on Infectious Diseases 26-29 Diphtheria and Diphtheria Immunisation 30-31 Poliomyelitis Immunisation 32 Smallpox Vaccination 32 International Certificates of Vaccination 32 Chest Disease 33-34 Report of Chest Physician, Edgware Chest Clinic 35-39 SECTION C: GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA: Establishments for massage or Special Treatment 40 Middlesex County Council Act, Section 357 - Trichology 40-41 National Assistance Act, 1948 and National Assistance (Amendment) Act. 1951 - Section 47 41-42 National Assistance Act, 1948 - Section 50 - Public Burials 42 Hospital Facilities 42 Health Services Provided by the Middlesex County Council 43 Medical Practitioner Service 43 Laboratory Facilities 43-44 Welfare of Old People 44-47 Her.don Old People's Housing Society 48 Staff Medical Examinations 48 SECTION D: SANITARY CIRCUMSTANCES OF THE AREA: Water Supply 49 Housing - Report of Housing Officer 50 Public Health Inspection - Summary of Inspections 51-52 Notices Served 52-53 Inspection of Dwelling Houses During the Year 53 Legal Proceedings under Public Health Act, Section 94 53-54 Housing Act, 1957 54-55 Rent Act, 1957 55-56 Overcrowding 56 Local land Charges Enquiries 57 Choked Drains 57 Cesspools 57 Drain Tests 58 Insect Pests 58-59 Disinfection 59 Domiciliary Laundry Service 59-60 Premises Licensed for Public Entertainment 60 Licensed Premises 60 Agriculture (Safety, Health and Welfare Provisions) Act, 1956 61 Factories Acts 1937-1959 61 and Appendix on pages 84-85 Rag Flock and Other Filling Materials Act, 1951 61 Pet Animals Act, 1951 61 Hairdressers and Barbers 61-62 Prevention of Damage by Pests Act, 1949 62-63 Swimming Baths 64-66 Diseases of Animals Act 66-68 Clean Air Act, 1956, and Measurement of Atmospheric Pollution 68-72 SECTION E: INSPECTION AND SUPERVISION OF FOOD Food and Drugs Act, 1955, and Milk and Dairies (General) Regulations, 1959 - Legal Proceedings 73 Food Shops Classified According to Principal Trades 74 Inspections and Matters Dealth With 74-75 Condemnation of Food 76 Milk Supply 76-77 Milk and Dairies (General) Regulations, 1959 77 Milk (Special Designations) Regulations 77 Ice Cream 78-79 Registration of Hawkers of Food 80 The Meat (Staining and Sterilisation) Regulations, 1960 80-81 Food and Drugs Act,. 1955 - Report of Chief Officer, Public Control Department, Middlesex County Council 81-83 COUNCIL OF THE BOROUGH (31.12.60) MAYOR: ALDERMAN L.A. HILLS, J.P. DEPUTY MAYOR: COUNCILLOR S. D. GRAVES, J. P. , P. R. I. C. S. , F.A.I. ALDERMEN: L. C. Chainey D. A. Davis J.L. Freedman, J. P., M. A., LL. B. R.J. Knowles, M.M., J. P., M.I.W.M. A. A. Naar, M. B. E. A. Paul, J.P. C.H. Sheill S. R. C. Sumpter, F. B. A. A. COUNCILLORS: W. P. Ashman W. G. Barnes J. S. Champion J.K. Connolly (Mrs.) N.I. Cull inane J.H. Felton, F.L. A. S., A.R. I.C.S. A.P. Fletcher B. E. Fletcher, B. Com. W. Gairns, C. B. E., C. A J.D. Gordon-Lee C. F. Harris A. A. Hoskins, B. Sc. (Econ.) P.T. Lester B.L. Leverton W. Lloyd-Taylor G. W. Mathews, M. A., F.R. I.C.S. K. G. Pamplin D. Roberts R. Robinson F. A. Sharman, B.Sc. (Eng.), A. C.G.I., M. I.C.E. J.W. Shock, M. A., F.C.A. D. F. Simons A. C. B. W. Spawforth (Mrs.) C.M. Thubrun F.L. Tyler, B.A. A. Young, LL. B. PUBLIC HEALTH COMMITTEE (31.12.60) CHAIRMAN: COUNCILLOR J.D. GORDON-LEE VICE-CHAIRMAN: ALDERMAN A. A. NAAR, M. B. E. ALDERMEN: L.A. Hills, J.P. (Mayor) A. Paul, J. P. S. R. C. Sumpter, F. B. A. A. COUNCILLORS: W, Gairns, C.B.E., C. A. S.D. Graves, J.P. F.R. I.C.S., F.A. I., (Deputy Mayor) A. A. Hoskins, B. Sc. (Econ.) P.T. Lester B. L. Leverton (Mrs.) C. M. Thubrun F.L. Tyler, B.A. A. Young, LL. B. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the year I960 To the Mayor, Aldermen and Councillors of the Borough of Hendon Mr. Mayor, Ladies and Gentlemen, I have the honour to submit my Report for the year 1960. During the year the health statistics were good. The population figure for the 1961 Census is 151,500. One realises that the Registrar-General's estimates of population for each of the previous ten years have been very accurate. Of special interest is the decline in poliomyelitis. During the year 1960 no case of this disease was notified, and this remarkable achievement must be due to the success of the enthusiastic immunisation campaign. The national average acceptance rate for poliomyelitis immunisation, age group 0-18 years, in England and Wales is 77% (31st March 1961) and in districts where this average has been achieved or exceeded no epidemic of polio has occurred, a finding which suggests that the child least likely to get polio is the one who is himself immunised and whose playmates and associates are also immunised. The comparable acceptance rate for Middlesex is 83%. The living conditions in the Borough show a gradual improvement and year by year one sees the benefits of redevelopment. The Council's redevelopment of the New Brent Street area made great progress during 1960. Here several streets of wornout houses have been removed and replaced by modern living conditions in a new and stimulating environment. Clean Air is a matter of increased public enthusiasm and a study of the records kept at the Smoke Measuring Stations during the last three years shows a progressive improvement which, to the public in general, is also demonstrated fay fewer fogs in winter and possibly also by more sunshine in summer. No local measurement is made of the amount of sunlight, but there does appear to be an increase in the number of people who wear sunglasses. The interest in Clean Air is causing a demand for the control of garden bonfires and there is scope for some improvement in the disposal of garden refuse in built-up 4 areas. The No.1 Smoke Control Area at Edgware has been working well and no emission of smoke has been seen from any chimney there, but residents in Smoke Control Areas should ensure that their fireplaces are capable of burning coke until the supply of "premium" fuels is stabilised. The Council has been interested in pollution by fumes from diesel vehicles and the attention of owners of offending vehicles has been drawn to this form of pollution. In almost every instance the owner has sent his thanks for the information and promised to investigate. Although diesel exhaust fumes are not detrimental to health, they are obnoxious and a hazard to road safety. The practice of writing to vehicle owners as a means of reducing pollution aroused considerable interest at a meeting of the Clean Air Society. The standards of food hygiene have improved since the introduction of the Clean Pood Regulations and more foods are packaged, but with all the improvement in food hygiene in recent years the lack of hand-washing facilities for customers in many licensed premises is now more obvious. Food comes from many exotic sources and new possibilities for bacterial contamination have to be guarded against. During the year the Department was able to assist the Director of the Colindale Laboratory in an investigation into the contamination of imported coconut by food poisoning organisms and as a result of the findings measures were taken in at least one exporting country, Ceylon, to perfect the cleanliness of the product. In the Annual Report of the Medical Officer of Health for Hendon for 1910 the disease non-pulmonary tuberculosis was responsible for the death of ten children between the age of one and five years. This disease was commonly spread by infected milk until the widespread adoption of pasteurisation made milk safe. One further step towards the perfection of our milk supply was taken on the 1st March, 1960, with the final eradication of non-attested herds in England and Wales. I have included in my Report 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. 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 General: WARDS (9) AREA IN ACRES Edgware 2,327 Burnt Oak 477 Mill Hill 2,695 West Hendon 1,143 Central 1,139 Park 580 Golders Green 748 Garden Suburb 669 Childs Hill 593 Area of the Borough 10,371 Population figures supplied by Registrar General 151,850 Density of population,i.e., number of persons per acre 14,6 Number of inhabited houses at 31st December 1960 (according to Rate Book) 44,490 Average number of persons per house 3,41 Rateable value as at 31st December 1960 £3,603,732 Sum represented by a Penny Rate £14, 380 Births LIVE RIRTHS: Male Female Total Legitimate 945 907 1,852 Illegitimate 53 56 109 998 963 1,961 6 Live Birth Rate per 1,000 Home Population 12.91 Birth Rate corrected for comparison with other areas 12.39 Illegitimate live births per cent of total live births 5.5% Comparability factor supplied by Registrar-General 0.96 Corrected Birth Rate per 1,000 Home Population, County of Middlesex 15.4 Birth Rate per 1,000 Home Population, England & Wales 17.1 Corresponding Rate for the Borough of Hendon for the year 1959 12.45 STILLBIRTHS: Male Female Total Legitimate 16 15 31 Illegitimate 2 1 3 18 16 34 Stillbirth Rate per 1,000 Total Births 17.04 Stillbirth Rate per 1,000 Total Births, England & Wales 19.7 Stillbirth Rate per 1,000 Home Population 0.22 Stillbirth Rate per 1,000 Home Population, England & Wales 0.34 Deaths: Male Female Total 798 809 1,607 Death Rate per 1,000 Home Population 10.59 Death Rate corrected for comparison with other areas 11.11 Comparability factor supplied by Registrar-General 1.05 Corrected Death Rate per 1,000 Home Population, County of Middlesex 11.1 Death Rate per 1,000 Home Population, England & Wales 11.5 Corresponding Rate for the Borough of Hendon for the year 1959 11.52 7 Maternal Mortality: Number of women dying in consequence of childbirth Nil Maternal Mortality Rate per 1,000 total births Nil Comparative figure for the County of Middlesex 0.20 Comparative figure for England & Wales 0.39 Infantile Mortality; Deaths of infants under 1 year of age: - Male Female Total Legitimate 24 18 42 Illegitimate 1 - 1 25 18 43 Death Rate of infants under 1 year of age per 1,000 live births 21.92 Death Rate of infants under 1 year of age per 1,000 live births - legitimate 22.67 Death Rate of infants under 1 year of age per 1,000 live births - illegitimate 9.17 Death Rate of infants under 1 year of age per 1,000 live births, County of Middlesex 18.6 Death Rate of infants under 1 year of age per 1,000 live births, England and Wales 21.7 Deaths of infants under the age of 4 weeks:- Male Female Total Legitimate 19 13 32 Illegitimate 1 - 1 20 13 33 Neo-natal Mortality Rate per 1,000 live births 16.82 Neo-natal Mortality Rate per 1,000 live births, County of Middlesex 14.5 Neo-natal Mortality Rate per 1,000 live births, England and Wales 15.6 8 An analysis of the causes of death and the age at the time of death reveals the following figures:- Age at the time of death Causes of death Under 1 day 1-7 days 1-2 weeks 2-3 weeks 3 weeks to 1 month TOTAL UNDER 1 MONTH 1-3 months 3-6 months 6-9 months 9-12 months TOTALUNDER 1 TEAR Prematurity 4 10 - - - 14 - - - - 14 Congenital defects 1 5 - - - 6 1 - - 1 8 Intracranial haemorrhage - - - 1 - 1 - - - - 1 Pneumonia and bronchitis - 1 - - - 1 1 3 - 1 6 Thrombophlebitis - - - - - - - 1 - - 1 Inhalation of vomit - - - - - - 1 - - 1 Gastro-enteritis - - - - - - - - - 1 1 Atelectasis 3 6 - - - 9 - - - - 9 Asphyxia Neonatorum 1 - - - - 1 - - - - 1 Haemolytic disease - 1 - - - 1 - - - - 1 9 23 - 1 - 33 2 5 - 3 43 The infant deaths were distributed throughout the wards of the Borough as follows: - Mill Hill 4 Burnt Oak 5 West Hendon 5 Central 1 Park 7 Golders Green 4 Garden Suburb 7 Childs Hill 5 Edgware 5 43 9 TABLE 1 The following table shows the Infantile Mortality Rates over the various years. Year Death rate of infants under one year of age per 1,000 live births 1900 133 1910 80 1920 47 1930 50 1940 54 1950 16 1951 22 1952 21 1953 16 1954 21 1955 21 1956 18 1957 21 1958 14 1959 19 1960 22 SUMMARY OF VITAL STATISTICS FOR THE YEAR 1960 England and Wales Borough of Hendon BIRTHS Rates per 1,000 Home Population Live births 17. 1 12.39 Still births 0. 34 0. 22 19.7(a) 17.04(a) deaths All causes 11.5 11.11 Borough of Hendon Tuberculosis 0.07 Pneumonia 0.46 Influenza 0.01 10 DEATHS continued All causes under 1 year of age England and Wales Borough of Hendon Rates per 1,000 Live Births 21.7 21.9 NOtifications (corrected) (for totals see page 23) Borough of Hendon Rates per 1,000 Home Population Meningococcal Infection 0.00 Scarlet Fever 0.75 Whooping Cough 1.00 Erysipelas 0.05 Measles 0. 52 Pneumonia 0. 34 Acute Poliomyelitis Paralytic 0.00 Non-Paralytic 0.00 Food Poisoning 0.09 Puerperal Pyrexia 52.6 (a) 18.5 * (a) Per 1,000 Total (Live & Still) Births * This is the rate when the figure relating to Hendon residents only is taken. 11 TABLE II VITAL STATISTICS FOR THE YEARS 1934-1960 Year Population Live Births Live Birth rate per 1,000 Population Deaths Death rate per 1,000 Population Deaths of Infants under 1 year of age Infantile Mortality rate Maternal Deaths Maternal Mortality rate per 1,000 Total Births 1934 131,075 1,643 12.53 1,065 8.12 71 43 3 1.77 1935 134,160 1,724 12.85 1,146 10.07 87 50 3 1.69 1936 140,650 1,835 13.04 1,166 9.78 81 44 4 2.10 1937 143,800 1,792 12.46 1,291 10.59 81 45 5 2.69 1938 145,100 1,877 12.93 1,153 9.38 72 38 4 2.06 1939 142,000 1,837 12.94 1,184 8.41 63 34 5 -Not available - 1940 132,490 1,601 12.08 1,417 12.41 92 54 3 1941 125,360 1,410 11.65 1,408 11.20 81 57 4 1942 132,200 2,081 15.74 1,298 9.82 70 34 5 1943 133, 970 2,223 16.95 1,387 10.35 86 39 4 1944 132,360 2,245 16.96 1,347 10.18 72 32 4 1945 137,770 2,239 16.25 1,379 10.01 65 29 3 1.30 1946 153,820 2,651 17.23 1,481 9.63 77 29 3 1.10 1947 158,670 2,671 16.83 1,522 9.59 77 27 4 1.45 1948 156 , 4 00 2,292 14.65 1,406 8.90 47 21 6 2.56 1949 158,430 2,251 14.36 1,522 10.56 50 22 5 2.17 1950 158,200 2,261 14.29 1,501 9.49 36 16 2 0.87 1951 155,700 2,082 13.36 1,635 10.50 47 22 2 0. 94 1952 156,400 1,981 12.66 1,598 10.22 41 21 1 0.49 1953 155,500 2,008 12.91 1,479 9.51 32 16 1 0.49 1954 154,800 2,008 12.97 1,392 8.99 42 21 2 0.98 1955 154,000 1,934 12.55 1,559 10.12 40 21 1 0.51 1956 153,200 1, 998 13.00 1,558 10.16 36 18 Nil Nil 1957 152,600 1,917 12.56 1,525 9.99 42 21 Nil Nil 1958 151, 500 1,948 12.85 1,583 10.44 27 14 1 0.51 1959 151,500 1,965 12.97 1,648 10.87 38 19 3 1.53 1960 151,850 1,961 12.91 1,607 10. 59 43 22 Nil Nil 12 13 TABLE III COUNTY COUNCIL OF MIDDLESEX CERTAIN VITAL STATISTICS FOR THE YEAR 1960 District Estimated population mid-1860 Live birth rate per 1000 population Death rate per 1000 population Specific death rates per 1000 population Infant mortality per 1000 live births Maternal mortality per 1000 total births (a) Crude Adjusted Crude Adjusted Coronary disease, angina (a) Cancer (a) Infant (a) Neo-natal (a) (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Acton 64, 550 16.8 16.0 10.7 10.9 2.0 (131) 2.4 (153) 24.9 (27) 18.5 (20) - (-) Brentford and Chiswick 57,070 15.8 15.0 10.4 10.4 2.0 (113) 2.1 (122) 11.1 (10) 10.0 (9) - (-) Ealing 183,390 15.0 14.6 11.2 12.0 2.0 (369) 2.4 (438) 16.0 (44) 14.5 (40) 0.36 (1) Edmonton 93,890 14.1 14.1 10.2 11.2 1.7 (161) 2.2 (202) 23.5 (31) 18.9 (25) - (-) Enfield 110,240 14.7 14.7 10.1 11.1 1.8 (201) 1.8 (203) 21.0 (34) 17.3 (28) - (-) Felthara 52,290 17.9 17.2 7.2 11.4 1.3 (69) 1.6 (82) 18.2 (17) 12.8 (12) - (-) Finchley 68, 980 15.3 14.7 10.7 9.6 2.3 (159) 2.1 (148) 13.3 (14) 10.5 (11) - (-) Friern Barnet 28,670 12.3 13.8 13.0 9. 5 1.7 (48) 2.7 (77) 14.1 (5) 11.3 (4) - (-) Harrow 214,370 14.5 14.9 9.5 11.2 1.7 (358) 2.3 (493) 18.6 (58) 14.4 (45) 0.32 (1) Hayes and Harlington 69,400 18.4 15.4 7.3 11.8 1.3 (88) 1.6 (113) 21.1 (24) 17.6 (20) - (-) Hendon 151,850 12.9 12.4 10.6 11.1 2.0 (308) 2.4 (372) 21.9 (43) 16.8 (33) - (-) Heston and Isleworth 105, 270 13.1 13.1 10.3 11.1 1.9 (202) 2.2 (230) 18.2 (25) 13.8 (19) - (-) Hornsey 96, 570 19.6 18.4 11.5 10.2 2.5 (242) 2.5 (242) 19.0 (36) 14.2 (27) - (-) Potters Bar 23,140 17.1 15.2 8.1 11.3 1.8 (42) 1.3 (30) 20.2 (8) 15.2 (6) - (-) Ruislip and Northwood 75, 470 14.3 14.3 8.1 10.1 1.6 (119) 1.7 (130) 19.5 (21) 15.8 (17) - (-) Southall 53,150 15.4 16.0 13.2 12.1 2.9 (156) 2.2 (116) 17.1 (14) 14.7 (12) 1.21 (1) Southgate 69,880 13.5 14.7 13.3 11.0 2.9 (200) 2.7 (189) 14.8 (14) 9.5 (9) - (-) Staines 49, 400 19.0 17.3 8.3 10.9 1.5 (75) 1.8 (87) 18.1 (17) 11.7 (11) 1.04 (1) Sunbury 31,600 23.6 20.8 10. 5 12.2 1.4 (45) 2.2 (71) 20.1 (15) 13.4 (10) - (-) Tottenham 115, 030 16.7 16. 5 11.6 12.2 2.2 (255) 2.4 (276) 23.4 (45) 18.7 (36) 0.51 (1) Twickenham 103,450 13.9 14.3 11.9 11.4 2.2 (230) 2.4 (247) 13.2 (19) 12.5 (18) - (-) Ux bridge 64,620 17.2 15. 5 9.2 ll.6 1.8 (117) 2.0 (128) 23.4 (26) 18.0 (20) 0.88 (1) Wembley 126,120 13.1 13.2 8.9 10.2 1.8 (232) 2.3 (286) 13.3 (22) 9.1 (15) - (-) Willesden 172,430 20.9 19.4 9.7 10.8 1.9 (329) 2.2 (386) 15.0 (54) 11.1 (40) 0.27 (1) Wood Green 48,160 15.0 15.2 11. 5 11.0 2.5 (118) 2.3 (113) 30.4 (22) 23.5 (17) - (-) Yiewsley and West Drayton 23,430 16.9 15.2 8.6 12.4 2.0 (47) 1.6 (37) 25.3 (10) 15.2 (6) - (-) COUNTY 2,252,420 15.7 15.4 10.3 11.1 2. 0(4,414) 2.2(4571) 18.6(655) 14. 5(510) 0.20 (7) Note (a) Absolute numbers are given in parenthesis in addition to rates to afford valid comparison 14 TABLE IV DEATHS OF HENDON RESIDENTS DURING THE YEAR 1960 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 3 2 2 7 F 1 1 1 3 2. Tuberculosis, other M F 1 1 2 3. Syphilitic Disease M 1 1 2 F 1 1 4. Diphtheria M F 5. Whooping Cough M F 6. Meningococcal Infections M F 7. Acute Poliomyelitis M F 8. Measles M F 9. Other Infective & Parasitic Diseases M 1 1 1 3 F 1 1 10. Malignant Neoplasm, Stomach M 10 11 9 30 F 5 6 15 26 11. Malignant Neoplasm, Lung, Bronchus M 30 20 16 66 F 9 6 15 12. Malignant Neoplasm, Breast M F 1 25 8 8 42 13. Malignant Neoplasm, Uterus M F 1 5 4 3 13 14. Other Malignant & Lymphatic Neoplasms M 1 1 41 22 22 90 F 1 1 7 31 23 27 90 15. Leukaemia, Aleukaemia M 2 1 3 F 1 1 2 4 16. Diabetes M 1 1 1 3 F 2 2 4 17. Vascular lesions of Nervous System M 1 18 24 38 81 F 1 10 28 83 122 15 18. Coronary Disease, Angina M 5 74 61 53 193 F 21 35 59 115 19. Hypertension with Heart Disease M 4 7 11 F 4 6 15 25 20. Other Heart Disease M 1 7 10 38 56 F 1 5 18 80 104 21. Other Circulatory Disease M 1 5 15 26 47 F 8 13 47 68 22. Influenza M F 1 2 3 23. Pneumonia M 4 6 5 11 26 F 3 1 1 6 9 25 45 24. Bronchitis M 11 22 19 52 F 3 11 14 25. Other Diseases of Respiratory System M 1 2 3 6 F 26. Ulcer of Stomach and Duodenum M 3 2 4 9 F 1 4 5 27. Gastritis, Enteritis & Diarrhoea M 1 1 F 1 1 2 4 28. Nephritis & Nephrosis M 1 2 3 F 1 1 29. Hyperplasia of Prostate M 2 3 6 11 F 30. Pregnancy, Childbirth, Abortion M F 31. Congenital Malformations M 2 1 2 1 6 F 1 1 2 4 32. Other Defined & Ill-defined Diseases M 18 2 1 4 11 4 15 55 F 12 1 1 3 12 14 22 65 33. Motor Vehicle Accidents M 1 2 1 1 2 7 F 1 2 3 34. All Other Accidents M 1 1 5 2 1 4 3 17 F 1 1 1 6 9 18 35. Suicide M 2 6 5 13 F 6 6 12 36. Homicide and Operations of War M P M 25 5 4 10 26 236 217 275 798 F 18 4 1 3 27 153 183 420 809 All Causes TOTALS 43 9 5 13 53 389 400 695 1,607 Health Statistics Population According to the figure supplied by the Registrar-General the estimated mid-year population for 1960 was 151,850. This is 4,007 less than the Census figure for 1951. Births The number of live births recorded during the year decreased by 4, 1,961 occurring compared with 1,965 in 1959, giving a decreased corrected birth rate of 12.39 per 1,000 Home Population compared with 12.45 last year. The rate is less than that for the County of Middlesex which is 15.4 and less than that for England and Wales, which is 17.1 per 1,000 Home Population. The number of stillbirths decreased from 37 to 34, giving a stillbirth rate of 17.04 per 1,000 total births compared with 18.83 in 1959. The rate for the Borough of Hendon compares favourably with that for England and Wales, which is 19.7 per 1,000 total births. Deaths There was a decrease of 41 in the number of deaths. This gives a corrected death rate of 11.11 per 1,000 Home Population compared with 11.52 in 1959. This rate is slightly higher than that for the County of Middlesex, which is 11.1 per 1,000 Home Population; the rate for England and Wales is 11.5 per 1,000 Home Population. As in previous years, heart and associated diseases accounted for the largest number of deaths, 619 people dying from these causes. Second in the principal causes was cancer. Deaths from motor vehicle and other accidents remained the same as in 1959, 45 people dying from these causes. Twenty-five people committed suicide, an increase of 2 on the previous year. Infantile Mortality Forty-three children died in the first year of life compared with 38 in 1959, giving an infantile mortality rate of 21.92 per 1,000 live births. The rate for England and Wales is 21.7 per 1,000 related live births. The rate for the County of Middlesex is 18.6 per 1,000 live births. 16 Of the 43 children, 33 died before reaching the age of 1 month, giving a neonatal mortality rate of 16.82 per 1,000 live births compared with 15.6 for England and Wales. Maternal Mortality I am pleased to report that no mother died as the result of childbirth. Deaths from Cancer of the Lung and Bronchus During the year in Hendon 30 men and 9 women under 65 years of age died from this cause. Smoking in Youth Cluhs An investigation into the smoking habits of a sample of members of two youth clubs has been recorded. These clubs are similar in that smoking is not permitted on the club premises and there are relatively fewer smokers than in some clubs visited in previous years. At Edgware Maccabi the non-smoking girls outnumber the smoking girls in a ratio of 2:1. A noticeable feature at this youth club is the number of boys who claim to be pipe smokers. SPUR ROAD YOUTH CLUB Age Never smoked Non-smoker Pipe smoker Cigarette smoker No. of cigarettes smoked per week BOYS (23) 13 14 15 1 10 16 11111 1 11111 35 25 10 5 120 17 1 1 1 1 1 1 40 30 35 18 1 1 1 1 120 140 19 1 50 20 1 GIRLS (14) 13 1 14 1 1 1 6 15 1 1111 112 1 16 1 1 17 1 1 1 120 50 70 18 19 20 17 18 SMOKING IN YOUTH CLUBS continued EDGWARE MACCABI YOUTH CLUB BOYS (79) GIRLS (44) Age Never smoked Non-smoker Pipe smoker Cigar smoker Cigarette smoker No. of cigarettes smoked per week Age Never smoked Non-smoker Cigarette smoker No. of cigarettes smoked per week 11 11 1 12 1 1 12 1 13 1111 1 13 1 1 1 1 14 1111 1111 11111 10 2 2 1 10 14 1 1 1111111 11111 20 2 10 2 40 15 1 1 11111 1 111111 111111 111111 1 40 3 20 10-20 12 100 8 10 5 5 10 1 2 2 5 3 1 00 2 00 10 4 15 11111 11111 1 1 20 5-10 16 1 1 11111 1111 1 111111 1111 10 8 20 1 100 50 100 3 45 100 16 1 1 20 20 17 1 1 1 1 1 1 1 1 17 1 1 1 1 1 10 1 23 18 1 1 1 1 11111 35 60 40 60 80 18 1 1 1 1 1 50 5 20 19 1 21 1 1 1 5 35 22 1 1 7 23 1 Seven spoiled papers 19 Road Traffic Accidents The following tables show the-road traffic accidents and casualties occurring within the Borough of Hendon during the year 1960 and the comparative figures for the years 1957, 1958 and 1959. 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 86 3 15 93 1 1 8 121 February 93 2 15 99 - 4 8 128 March 82 2 22 88 - 1 3 116 April 74 - 15 85 - - 11 111 May 102 - 19 99 - 2 11 131 June 98 2 21 89 1 4 19 136 July 126 - 26 114 - 3 13 156 August 68 1 15 57 - 2 13 88 September 128 - 25 125 - 5 18 173 October 100 - 20 100 - 3 9 132 November 109 1 28 113 - 4 28 174 December 111 - 21 125 - 2 7 155 TOTALS 1,177 11 242 1,187 2 31 148 1,621 20 TABLE VI CLASSES OF ROAD USER KILLED OR INJURED DURING I960 MONTH Pedestrians Motor Drivers Motor Cyclists Pillion Passengers Pedal Cyclists Other Road Users Killed Serious Slight Killed Serious Slight Killed Serious Slight Killed Serious Slight Killed Serious Slight Killed Serious Slight January 3 5 15 - 6 24 - 1 15 - - 2 - - 12 1 4 33 February - 7 11 2 5 30 - 3 28 - - 2 - - 8 - 4 28 March 1 5 13 1 4 32 - 10 15 - 2 4 - - 3 - 2 24 April - 4 11 - 2 27 - 4 8 - 1 2 - 1 11 - 3 27 May - 4 15 - 5 36 - 7 21 - 1 4 - 3 11 - 1 23 June - 8 19 - 5 16 1 8 22 1 - 9 1 2 6 - 2 36 July - 10 17 - 6 24 - 7 33 - 1 4 - 3 18 - 2 31 August 1 7 15 - - 14 - 8 13 - 1 1 - 1 9 - - 18 September - 12 17 - 6 44 - 7 32 - - 6 - 1 14 - 4 30 October - 9 17 - 4 22 - 5 29 - - 9 - 1 8 - 4 24 November - 12 26 - 4 35 - 6 21 1 - 4 - 3 9 - 7 46 December - 7 23 - 3 50 - 5 18 - 1 - - - 7 - 7 34 TOTALS 5 90 199 3 50 354 1 71 255 2 7 47 1 15 116 1 40 344 TABLE VII COMPARATIVE FIGURES OF ACCIDENTS AND CASUALTIES FOR 1957, 1958, 1959 & 1960 1957 1958 1959 1960 Total number of road accidents involving personal injury Accidents per mile of road 873 1, 089 1,103 1,177 5.09 6.33 6.41 6.82 Casualty Figures Adults Killed 21 21 16 11 Seriously injured 188 229 219 242 Slightly injured 802 990 1,057 1,187 Totals: 1,011 1,240 1,292 1,440 Children (0-1 5 years, Killed 2 2 20 22 27 31 Slightly injured 100 168 148 148 TotaIs: 122 190 175 181 1,133 1,430 1,467 1,621 6.61 8.32 8.53 9.39 21 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 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 1960 5 90 199 3 50 354 1 71 255 2 7 47 1 15 116 1 40 344 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 1957 2 10 41 - 4 23 - 6 36 1958 - 15 65 - 6 53 - 1 50 1959 - 11 65 - 12 44 - 4 39 1960 1 25 55 1 3 34 - 3 57 I am indebted to the Borough Engineer and Surveyor for supplying me with the figures. 22 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 114 10 Whooping Cough 153 2 78 - Acute Poliomyelitis Paralytic - - Non-Paralytic - - Diphtheria - - Pneumonia 52 7 Dysentery 44 6 Paratyphoid Fever - - Typhoid Fever 1 1 Erysipelas 7 3 Meningococcal Infection 1 1 Food Poisoning 14 4 Puerperal Pyrexia 105 105 Ophthalmia Neonatorum 3 2 TOTAL 572 141 23 24 TABLE IX AGE DISTRIBUTION AGE GROUP DISEASE Scarlet Fever Whooping Cough Acute Poliomyelitis Measles Qysentery Meningococcal Infection Paralytic Non-Paralytic M. F. M. F. F. M. F. M. F. M. F. M. F. Under 1 year - - 6 8 - - - - 2 - - 1 - - 1 - year 1 1 2 7 - - - - 8 5 1 - - - 2 - years 2 2 6 5 - - - - 3 3 - 1 - - 3 - years 10 2 9 5 - - - - 7 3 - 1 - - 4 - years 5 5 10 2 - - - - 5 6 1 1 - - 5-9 years 32 28 34 32 - - - - 11 22 12 3 - - 10-14 years 10 6 9 8 - - - - 1 - 3 3 - - 15-24 years 1 7 1 4 - - - - - 2 3 4 - - 25 & over - 2 2 3 - - - - - - 3 7 - 1 Age unknown - - - - - - - - - - - - - - TOTAL 61 53 79 74 - - - - 37 41 23 21 - 1 AGE GROUP Pneumonia Erysipelas Food Poisoning Puerperal Pyrexii i Typhoid Fever Paratyphoid Fs/er M. F. M. F. M. F. F. M. F. M. F. Under 5 years 4 - - - 1 2 - - - - - 5-15 years 4 - - - 1 2 - - - - - 15-44 years 2 4 2 1 3 3 105 1 - - - 45-64 years 9 8 1 3 - - - - - - - 65 & oyer 10 11 - - - 2 - - - - - Age unknown - - - - - — - - - - - TOTAL 29 23 3 4 5 9 105 1 - - - 25 WARD DISTRIBUTION NUMBER OF CASES OF INFECTIOUS DISEASE NOTIFIED IN EACH WARD OF THE BOROUGH DISEASE WARD TOTAL Mill Hill Burnt Oak West Hendon Central Park Golders Green Garden Suburb Chi Ids Hill Edgware Scarlet Fever 19 16 23 6 13 11 2 9 15 114 Whooping Cough 29 13 4 - 10 30 18 18 31 153 Acute Poliomyelitis Paralytic Non-Paraltyic - - - - - - - - - - Measles 4 6 1 1 6 10 30 18 2 78 Meningococcal Infection - - - - - 1 - - - 1 Pneumonia 23 11 2 1 2 3 2 4 4 52 Dysentery 20 6 1 5 5 2 - 3 2 44 Erysipelas 1 3 1 - - - - 1 1 7 Food Poisoning 2 5 - 1 3 - 1 - 14 Puerperal Pyrexia 4 74 5 4 5 3 1 4 5 105 Ophthalmia Neonatorum - 2 - - 1 - - - - 3 Typhoid Fever - - - - - 1 - - - 1 Paratyphoid Fever - - - - - - - - - - TOTAL 102 136 37 18 45 61 54 57 62 572 Notifications other than Tuberculosis Poliomyelitis No cases of Poliomyelitis were notified during the year. The disease was first made notifiable in 1950 and this is the first year in which no case was notified. The immunisation campaign of the Ministry of Health has, no doubt, played an important part in reducing the number of cases, together with the cool and wet summer experienced in 1960, Puerperal Pyrexia There was a decrease in the number of cases of Puerperal Pyrexia, 105 cases occurring compared with 126 in 1959. Of the 105 cases 37 only were Kendon 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 I960 is 52-6 per 1,000 total (live and still) births. If the figure for the Hendon residents only is taken, the rate is 18-54 per 1,000 total (live and still) births. Ophthalmia Neonatorum Three cases were notified compared with none in 1959, Scarlet Fever There was a decrease in the number of cases notified, 114 cases occurring compared with 151 in 1959. The disease continued to be mild in character. Illeasles During the course of this year, 78 cases of measles were notified compared with 1,283 in 1959. Measles tend to occur in epidemic form every two years. An epidemic can be expected about Spring 1961. Whooping Cough There was an increase in the number of the cases notified during the year, 153 compared with 32 in 1959. 26 Sonne Dysentery There was a decrease in the number of cases notified - 44 compared with 95 in 1959. The disease still continues to be mild in character, but very infectious among small children. Typhoid Fever There was one case of Typhoid Fever notified in Hendon. The patient was a cafe proprietor who came into contact with a wide variety of nationalities. Stool specimens were taken from all known contacts, all of which proved negative. Typhoid is a dangerous disease in food handlers whose standards of hygiene are low as they can easily pass it on to the consumer, but in this case the standards of the patient were excellent and this, no doubt, prevented the spread of the disease. Food Poisoning During the year 14 cases of food poisoning were notified compared with 36 in 1959. The following is a copy of a report made to the Ministry about the organisms responsible for the individual and family outbreaks. (a) I'ood Poisoning Notifications (corrected\) First Quarter Second Quarter Third Quarter Fourth Quarter Total 1 16 6 14 (b) Cases otherwise ascertained First Quarter Second Quarter Third Quarter Fourth Quarter Total 1 3 5 6 15 27 Particulars of Outbreaks AGENT No. 'of outbreaks No. of cases Total No. of cases Family outbreaks Other outbreaks Notified Otherwise ascertained Agent identified: Salmonella Typhi-Murium, Phage "Type 12a 1 1 6 7 Salmonella Typhi-Murium 1 2 2 Salmonella Typhi-Murium, Phage Type 2c 1 2 2 TOTALS 3 5 6 11 Single Cases AGENT No. of cases Total No. of cases Notified Otherwise ascertained Agent identified: Salmonella Typhi-Murium 3 2 5 Salmonella Anatum 1 1 Salmonella Typhi-Murium Phage Type 32 1 1 Salmonella Thompson Phage Type 19 1 1 Salmonella Enteriditis Jena Variety 1 1 Salmonella Typhi-Murium ii ii Phage Type la 1 1 2 ii ii Phage Type 2c 1 1 2 ii » Phage Type 9 1 1 » » Phage Type 1 1 1 TOTALS 7 8 15 Agent not identified 2 1 3 28 During the year the Department, in the course of routine investigations of the sources of food poisoning, was able to participate in a study arranged by the Director of the Colindale Public Health Laboratory into the standards of desiccated coconut and the findings were reported in a paper*. It was realised though the handling of desiccated coconut was satisfactory in this country there was room for considerable improvement in the exporting countries and in the early stages of manufacture. Shortly afterwards the Chairman of the Desiccated Coconut Association was able to say that draft regulations were prepared applicable to the manufacture and shipping of desiccated coconut which should revolutionise the industry. Paratyphoid Fever No case of Paratyphoid Fever was notified during the year. ' Salmonellae in Desiccated Coconut. An Interim Report. N.S. Galbraith, M.B., D.P.H.. Betty C. Hobbs, D.Sc., Ph.D., Dip.Bact., F.R.S.H., Muriel E. Smith, Central Public Health Laboratory, Colindale, and A.J.H. Tomlinson, M.B., Public Health Laboratory Service, County Hall, London. 29 Diph therla 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. 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 - - 1960 - - 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 1960. 30 31 TABLE XII NUMBER OF CHILDREN RESIDENT IN THE BOROUGH OF HENDON WHO RECEIVED IMMUNISING INJECTIONS DURING 1960 Age at time of injection PRIMARY INOCULATIONS REINFORCING INJECTIONS Diphtheria only Whooping Cough only Tetanus only Combined Diphtheria and Whooping Cough Combined Diphtheria and Tetanus Combined Diphtheria Tetanus and whooping Cough Diphtheria only Combined Diphtheria and Whooping Cough Combined Diphtheria and Tetanus Combined Diphtheria Tetanus and Whooping Cough Under 1 year of age 199 157 - 97 46 987 - - - 3 1 year of age 173 155 - 50 10 283 3 - - 2 2-4 years of age 29 14 - 12 6 61 150 11 1 33 5-14 years of age 36 2 1 6 13 21 938 15 4 121 15 years & over 5 - 2 - - - - - - - 442 328 3 165 75 1352 1091 26 5 159 Poliomyelitis Immunisation The number of people who completed immunisation against poliomyelitis was 10, 506. 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 1960. TABLE XIII Age at 31st December 1960 Under 1 year 1 year 2-4 years 5-14 years 15 years & over TOTAL Number vaccinated 1, 033 113 57 64 103 1,370 Number re-vaccinated - 1 10 61 435 507 International Certificates of Vaccination During the year 1,345 International Certificates of Vaccination were stamped by the Public Health Department. 32 Chest Disease Notification of Tuberculosis The following table shows the number of cases of tuberculosis notified for the first time during the year 1960, and transfers into the district. TABLE XIV Age Group in years Respiratory Non-Respiratory TOTAL Males Females Males Females New Cases Transfers into District New Cases Transfers into District New Cases Transfers into District New Cases Transfers into District Under 5 years 1 1 - - - - - - 2 5-14 1 -- 3 2 1 - - - 7 15-24 7 2 4 8 1 1 1 -- 24 25-44 15 17 11 12 5 - 5 -- 65 45-64 19 2 4 2 2 - 1 - 30 65 & over 6 1 1 - - - - - 7 Age unknown - - - - - - - - 1 TOTAL 49 23 23 24 9 1 7 - 136 The ward distribution of tuberculosis for the year 1960 is shown below. The figures refer to primary notifications only and do not include cases transferred into the district. TABLE XV WARD TOTAL Mill Hill Burnt Oak West Hendon Central Park Golders Green Garden Suburb Childs Hill Edgware Respiratory 12 4 13 8 9 9 6 7 4 72 Non- Respiratory 3 3 1 2 1 2 - 1 3 16 TOTAL 15 7 14 10 10 11 6 8 7 88 33 The following table shows the primary notification of tuberculosis, excluding inward transfers, for the ten-year period 1951-1960, TABLE XVI YEAR Respiratory Non-Respiratory TOTAL Male FemaIe Male Female 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 1955 60 38 4 12 114 1957 56 45 6 3 110 1958 56 50 9 13 128 1959 50 33 3 6 92 1960 49 23 9 7 88 Deaths According to the figures supplied by the Registrar-General the following deaths occurred from tuberculosis during the year. Tuberculosis of Respiratory System Other forms of Tuberculosis All forms of Tuberculosis Ma I e. Female Total Ma le Female Total Ma le F emale Total 7 3 10 - 2 2 7 5 12 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 Fema le Male Female 822 619 91 86 913 705 1,441 177 1,618 34 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.S., B. S., M. R.C.S., L. R. C. P. Physician 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.), Thoracic Surgeon T.W. Stephens, F. R. C. S. E. F. R. F. P. S. G. " "C.A. Jackson, M.B.E., F.R.C.S. Orthopaedic Surgeon V. C. Snell, F. R. C. S. 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 official catchment area of the Edgware Chest Clinic includes the whole of the Borough of Hendon and the Edgware, Stanmore, Queensbury and Kingsbury areas of the Boroughs of Harrow and Wembley. In fact, however, many patients whose homes are outside the area are referred by their medical practitioners for an opinion. The Middlesex County Council appoint Health Visitors and Welfare staff whose work is based on the chest clinic, dealing primarily with the catchment area. Liaison Close liaison is maintained with the Health Department of the Middlesex County Council - in particular with the Area Medical Officers and their staffs and the School Medical Service. Co-operation between the medical staff of the clinic and the Medical Officers of Health of the Boroughs of Harrow, Hendon & Wembley is necessary and is maintained. The Welfare Department of the clinic maintains touch with a number of statutory and voluntary organisations such as the Employment Exchanges of the Ministry of Labour, the local officers of the National Assistance Board and 35 Ministry of National Insurance, the Housing Departments of Local Authorities, Councils of Social Service, the Chest & Heart Association, Regimental Benevolent Associations, etc. In the medical sphere there is close liaison with Edgware General, Colindale & West Hendon Hospitals of whose staffs our physicians are members. A number of patients are also referred to Clare Hall, Harefield, Pinewood and St. Charles Hospitals for treatment of tuberculosis, for thoracic surgery and for treatment in Bronchitis Units. Patients for radiotherapy are referred to the Middlesex Hospital and to Mount Vernon Hospital. Source of Patients Most of our patients are referred by their general practitioners. Considerable use is made of the facilities for X-ray of the chest without previous appointment. For about eight years most of this work was dor.e using an Odelca 70mm miniature film camera unit, but this has been discontinued as the unit has worn out and large X-ray films are now employed. Patients are also referred from the various divisions of the Out-patient Department of Edgware General Hospital, from other chest clinics on change of their home address, and by both the static and mobile Mass X-ray Units. Tuberculosis The primary function of the Chest Clinic is to deal with the tuberculosis problem in the area. This has changed considerably in the last ten years as can be seen from the tables of General Statistics and the Tuberculosis Register. These include for comparison the figures for 1948, the year in which the National Health Service commenced, and 1950, which is ten years ago. The number of new cases is much less than it was. Deaths have also declined but not so markedly. This is partly because deaths occur in tuberculous persons as in the population in general and not all the deaths are actually due to the disease of tuberculosis. Patients live longer because of modern treatment by drugs which is more satisfactory than the old treatments using collapse of the lung. the attendance for refills is but a fraction of its former numbers. On the debit side it is to be noted that new cases are still being discovered at the rate of 134 per annum and there is still need to maintain an active anti-tuberculosis programme. In future years the B.C. G. vaccination scheme operated by the School Health Service will probably help to decrease the incidence of new cases particularly in the younger age groups. The necessity for routine ante-natal X-ray of the chest is illustrated by the numbers who are still found to be suffering from active tuberculosis during pregnancy. By treatment in good time the disease can be brought under control and the mother made non-infectious before the birth of the baby: the separation of mother and child, which in years gone by was necessary, is now very seldom advised. 36 Cancer of the Lung This disease continues to be a problem and involves a good deal of work. Although no age or sex is entirely free, lung cancer is more common in men than women and particularly in the elder age groups. Nearly all our cases occur in smokers and the patients have usually been heavy cigarette smokers. In spite of our efforts to secure earlier diagnosis, only one quarter are suitable for operative treatment which offers the best chance of recovery. Our physicians and surgeons co-operate in the treatment of lung cancer, and use is made of the thoracic surgical units at Colindale, Clare Hall & St. Charles hospitals. Other patients are treated by medical measures locally and some receive radiotherapy at the Middlesex & Mount Vernon Hospitals. Chronic Bronchitis Many patients with this condition continue to attend the clinic: and the scheme, mentioned in earlier reports, for sending some chronic bronchitic patients to special units in hospitals outside the metropolitan "smog area" (Clare Hall & Pinewood Hospitals) was continued in the winter of 1960/61. Hypnotherapy One of our physicians has taken up this method of treatment which is of considerable help in the treatment of selected patients with some respiratory condition - such as asthma. Special sessions exist for this therapy - patients being seen by appointment. Waiting Room An attractive feature in the chest clinic waiting room is an aquarium which was provided and is maintained by the Hendon Aquatic Society. This amenity is much appreciated, and the clinic staff are most grateful to the Society for their interest and help and for the splendid voluntary work that this job entails. Research During 1960 the clinic staff have assisted in various research projects organised by the Medical Research Council and the British Tuberculosis Association (mainly into bronchitis and tuberculosis.) Teaching Post-graduate students have attended the chest clinic during the year for various periods for instruction in the practice of chest medicine and social medicine. A large proportion of these students have been from overseas. 37 Publicatlons Grenville-Mathers, R. Harris, W.C. Trenchard, H. J. Tuberculous primary infection in Pregnancy and its relation to Congenital Tuberculosis. Tubercle 1960. Statistics GENERAL New patients referred to clinic 1948 1950 1957 1958 1959 1960 4257 4156 10769 10728 9628 9119 Total attendances at Consultative sessions 7877 14586 23573 22971 22212 20680 Attendances for refills 9191 11711 6299 4212 2609 1175 Number of persons X-rayed No X-ray Dept. 16717 17709 17902 16125 16919 Sessions held No record No record 1211 1218 1277 1224 Home visits by physicians 87 358 431 424 281 140 Tuberculous patients awaiting admission 105 115 2 0 0 0 TUBERCULOSIS REGISTER 1948 1950 1957 1958 1959 1960 New respiratory cases 214 172 152 143 103 116 New non-respiratory cases 26 21 17 21 13 18 Total new tuberculous cases 240 193 169 164 116 134 Tuberculous cases on register at 31st December 1561 1750 1600 1508 1460 1409 Recorded from register as: Dead 49 31 25 29 35 27 Recovered 48 62 155 85 96 93 NEW TUBERCULOSIS CASES Age Group Under 15 15-24 25-34 35-44 45-54 55-64 over 64 Males: Respiratory 5 10 10 17 12 15 9 Non-respiratory 5 1 2 Females: Respiratory 4 8 12 2 7 1 4 Non-respiratory 1 1 5 2 1 38 ANTENATAL PATIENTS 1956 1957 1958 1959 1960 Antenatal patients X-rayed 1040 1140 1180 1169 1092 Number found to have active tuberculosis 1 1 4 2 3 LUNG CARCINOMA REGISTER 1956 1957 1958 1959 1960 New cases diagnosed: Males 53 50 57 59 58 Females 9 8 9 6 7 39 SECTION C: General Provision of Health Services for the Area Establishments for Massage or Special Treatment Middlesex County Council Act, 1944, Sections 353-363 The Council continued to exercise its function as the licensing authority under the provisions of the above-mentioned Act. A person requiring a licence or renewal of a licence under this part of the Act must make application to the Local Authority giving certain information, such as age, nationality, technical qualifications and the nature of the establishment and the business conducted thereat. The Council considered and granted the following applications:- New Licences 3 Renewals of Licences 29 Certificates lodged under Section 363 by members of the Chartered Society of Physiotherapy 3 Licences Refused 1 Middlesex County Council Act, Section 357 Trichology A member of the Institute of Trichologists applied for a licence to practice trichology under the above-mentioned Act. Members of the Institute, who work in association with hairdressers, offer treatment for a variety of scalp conditions such as seborrhoea, pityriasis, alopecia areata, ringworm, headlice and eczema, and in addition to simpler methods of treatment the applicant proposed to use infra-red and ultra-violet lamps. Members of the Institute of Trichologists are licensed to practise on these lines by at least one local authority, but this would appear to be the first time that an application by a member of the Institute had been submitted in Middlesex. The Hendon Borough Council decided that the applicant, although a member of the Institute of Trichologists, did not "possess such technical qualifications as may be reasonably necessary" to carry out such treatment. The applicant appealed against this decision to the Hendon Magistrates' Court and the Appeal was taken on his 40 half by the solicitors to the Institute of Trichologists. During the course of the Hearing it appeared that the training of members of the Institute is such that they do not have the opportunity to gain.that minimum knowledge and experience of general medicine necessary to ensure that conditions demanding medical attention and lightsensitive conditions are recognised. On behalf of the Institute it was suggested that this difficulty was overcome in the area of another authority which required the trichologist to carry out ultraviolet treatment on condition that he does so "only in accordance with the directions given by a Registered Medical Practitioner with reference to each person to whom treatment is given", but under the Disciplinary Notice of the General Medical Council, to which all medical practitioners are subject, a medical practitioner is liable to erasure from the Register if lie practises in association with an unqualified person, although the Notice makes it clear that this rule does not affect "the legitimate employment of nurses, inidwives, physiotherapists, dispensers and other persons trained to perform specialised functions relevant to medicine, surgery and midwifery, provided that the medical practitioner concerned exercises effective supervision over any person so employed and retains personal responsibility for the treatment of the patient." The Appeal was dismissed. The case was of some interest in that it was, so far as can be ascertained, the first occasion on which a local authority has challenged the qualification of the Institute of Trichologists. National Assistance Act, 1948 National Assistance (Amendment) 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 cases" often fall 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. Nine 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 41 person was considered individually and advised how best 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 six burials were carried out, all adults. General Hospital Facilities Edgware General Hospital. Hendon District Hospital. The needs for mental treatment are served by Napsbury 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 Accommodation Edgware General Hospital. Admissions are also arranged through the Regional Hospital Board to the Regional Chest Hospitals, particularly Clare Hall and Colindale. The Chest Clinic at Edgware serves primarily those living in the Borough of Hendon and the Stanmore, Queensbury and Kingsbury districts of Harrow and Wembley. 42 Health Services provided by the Middlesex County Council The following services are provided by the Middlesex County Council under Part III of the National Health Service Act, 1946:- * Care of mothers and young children (Section 22) * Midwives Service (Section 23) * Health Visiting (Section 24) * Home Nursing (Section 25) * Vaccination and Immunisation (Section 26) * Chiropody Service (Section 28) * 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 Areas - Burnt Oak, Central, Childs Hill, Edgware, Mill Hill, Park and West Hendon. In these areas the number of patients on the average general practitioner's list is reasonable. New practices may be established in such areas but the initial practice allowance is not likely to be paid. (2) Restricted Areas - Garden Suburb and Golders Green. 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. 43 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. Welfare of Old People I am indebted to County Councillor Miss E.M. Weavers, B. A., F. R. S. A., Chairman of the Hendon Old People's Welfare Committee and to Mr. E.B. Pinder Davis, Hon. Secretary, for the Report for the year 1960-61. "The most important change in any one activity during the past year has been the extension of the chiropody service which the Committee has been operating for the Middlesex County Council since April 1st 1959. For the twelve month period ending March 31st, 1960 there was no change in the service except that the County became responsible for the grant of £170 which had previously been received from the National Corporation for the Care of Old People. Under the Extended Scheme, which started on April 1st 1960, all old age pensioners became eligible for treatment in private surgeries approved by the Medical Officer of Health to the Borough and which were already on our panel. This resulted in a substantial increase in the number of treatments given in the first two quarterly periods. When the totals for the first two periods had been received, the Health Committee of the Middlesex County Council ruled that, for the future, the number of treatments in any quarter must not exceed the figure for the period April 1st to June 30th 1960. This meant, for a certain time, placing new patients on a waiting list and, where possible, extending the intervals between visits for other patients. The situation was, however, eased in December when chiropody sessions started in the County Council's permanent clinics in the Borough. Below are the totals of treatments for the twelve month period April 1st 1960 to March 31st 1961. In private surgeries At home 1960 April-June 512 113 July-September 845 160 October-December 629 166 1961 January-March 554 168 During this period there have been several changes affecting categories of patients and charges for treatment. Form filling and paper work have, however, been kept to a 44 minimum and we have received satisfactory co-operation from the chiropodists on our panel in making this scheme run smoothly and particularly in getting back to the quotas authorised by the County Council. The Committee are most appreciative of the valuable work done by Mrs. McCabe who travels many miles each year to give treatment to housebound patients. They are also grateful to the Middlesex County Council for their readiness to discuss with us the various problems which have arisen during this period of transition. Holidays A party of 51 went for the customary week's holiday to the Hatherley Hotel, Cliftonville from May 27th to June 3rd. The party was again accompanied by Red Cross Nurse 0' Brien to whom the Committee's most grateful thanks are due. We continue to give assistance with special holidays which may be recommended to us by the hospital almoners, doctors and others. Handcrafts A most successful exhibition of work by Over 60's was held at the Hodford Hall on Saturday, May 14th. Over 300 exhibits were received. As an experiment, neighbouring boroughs were invited to compete and eight sent group exhibits. Besides individual cash prizes, two trophies, made for us by pupils of Barnfield Road Secondary School, were awarded. The group trophy was won by the British Red Cross Society and that for neighbouring boroughs by Finchley. The standard of work was commendably high. Judging was done by Miss Hincks and Miss Bickers of the Middlesex County Council Welfare Department. The exhibition was opened by the Mayor, Councillor S.D. Graves and the Mayoress presented the trophies. Mr. Holland, the Area Welfare Officer, and his assistants, staged a most interesting exhibit showing work done by blind craftsmen and the facilities available for their training and instruction. Information Pamphlet Starting in April, the Ministry of Pensions and National Insurance have agreed to send this to each new old age pensioner. A loose leaf has been printed to bring the pamphlet up to date. Clubs The clubs for elderly people which are run by the various organisations represented on the Committee continue to flourish. The Committee are most grateful to the voluntary organisations and to their members without whose hard work and enthusiasm these clubs could not continue to exist. We welcome a newcomer among the Friendship Clubs - The Alyth Club which meets weekly in the very pleasant hall attached to the Synagogue in Alyth Gardens, N.W. 11. The "Over 60's Club", being open, as it is, on every week day afternoon and also 45 on certain evenings, must be regarded as being in rather a different category from other clubs in this Borough. It is felt strongly, however, that this is the type of club for the elderly which is most needed and particularly in the northern parts of the Borough. It is satisfactory to know that suitable provision for this purpose is being made in new municipal housing projects where there will be a substantial proportion of elderly people. Owing to the very large membership of "The Over 60's Club" and to the fact that most of the members also belong to other clubs, it was decided to discontinue the annual New Year party. Toc H continue to give monthly film shows at Station Road during the winter months and these are invariably "sold out". A new activity to which the Committee attach great importance - a club for the housebound - was started last November. It meets once a month at Station Road and is known as the "Third Thursday Club". Members are chosen with great care from among those who otherwise hardly get out at all. As the same people are invited each month they have become acquainted with each other and our helpers now know the members individually. Help has been readily forthcoming from the various women's organisations and we are particularly grateful to those ladies of the Committee who have identified themselves so closely with this Club. We are fortunate in having Mrs. M. Tanzer as honorary musician. The great problem is, of course, transport. With an average attendance of 30, not less than ten cars are usually required. The Committee offer their grateful thanks to the volunteer drivers who are giving us their help and upon whom the continued existence of this club depends. Christmas Activities As in previous years we supplied pre-cooked Christmas dinners for distribution by the W.V.S. "Meals on Wheels" Service. Special food parcels were taken to certain elderly people whom we visit. At Station Road there was an exhibition of work by members of the Over 60's Club, an evening Whist Drive and informal celebrations. The decorations in the club rooms were greatly improved. A piece of spontaneous hospitality must be recorded. A party of eleven elderly people who had no plans for Christmas were entertained in a private house on Boxing Day. A lavish Christmas dinner was provided and the party continued until the late evening. Visiting Requests for personal visits continue to be received from hospital almoners, doctors, health visitors and private people. A preliminary visit is in most cases paid from the office. If continued visiting is felt to be needed particulars are sent to one of the organisations or to a private person living in the neighbourhood. It is satisfactory to know that the various clubs do regular visiting among their own members when it is needed. 46 Radio and Television During the last year we have made several applications for wireless sets to the Wireless for the Bedridden Society. The sets are supplied with a minimum of delay and give great satisfaction. The Committee's thanks have been expressed to the Society. The Committee would be glad to have suggestions which would lead to their being able to supply television for housebound elderly people. Gifts We have received from Miss H. E. Welham an H.M.V. combined wireless and record playing equipment together with a large and well-chosen collection of records. This is now installed in the club room at Station Road, where it has already proved itself a most valuable acquisition. The owner of a textile warehouse in the West End sent us a gift of 120 high quality woollen scarves. These have been distributed among the various organisations and clubs. Staff There have been no changes in the staff. The Organising Secretary and her assistant continue to perform their duties in a very satisfactory way and to give the personal service which is so essential for success in any form of social work. The Extended Chiropody Service has led to a considerable increase in the administrative work done in the office. This has been handled by Mrs. Eutler in a way which has satisfied the exacting standards of the County Treasurer's Department. Conclusion It should be remembered that, apart from ill-health, loneliness is one of the worst afflictions which beset certain elderly people and in many cases this particular trouble is in no way connected with limited material resources. In most walks of life and among people of all ages the club is a natural and valuable means of social intercourse. The type of club needed - as already mentioned - should have its own premises and be open at all reasonable times when a sufficient number of members wish to use it. Members should be free to come and go as they please and to do what they feel inclined to do. It is also essential that any suggestion of patronage or charity in its material sense should be avoided. This is perhaps less easy than it sounds. Unfortunately only very few of the clubs in this Borough are able to offer the facilities which are needed to attract a wider and more varied membership. Loneliness is happily an affliction which yields to treatment and the right sort of club can be a valuable specific." 47 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 Annual Report for 1960 which describes the work of the Society at Church Walk House. The Report includes the following interesting comments - "The Future On a number of occasions we have been asked if we are going to extend. There has always been a problem of supplying suitable houses for the elderly. Many organisations are giving a great deal of attention to this; almshouses have been built; old fashioned bungalows and such-like. There are many disadvantages to this type of property. Coal £8-£9 per ton; where only one room is heated, other rooms are cold and damp; an open fire is often unsuitable for the elderly person since it carries the risk of getting their clothes on fire. No one to look after them when they are ill, etc. etc. There are many ideas as to how old people should be housed. The modern trend is blocks of flatlets. They find them easy to run; they appreciate central heating. They are able to look after themselves without finding this a burden. If, in an emergency, help is needed, they know this is close at hand in the Warden Service. They can enjoy the privacy of their own lives, whilst sharing the companionship of other occupants of the block. from my observation, I think there are too many folk in old people's homes, who are still capable of looking after themselves, thus occupying beds which could be used by those in more urgent need of care and attention." Staff Medical Examinations During the year under review 107 new entrants or employees of the Hendon Borough Council were medically examined for superannuation purposes. Of this number 101 employees were passed as fit, 1 was unfit and in 5 cases the decision was deferred pending further medical examination. The number of examinations in respect of each department of the Council was as follows:- Town Clerk's 10 Borough Treasurer's 12 Borough Engineer's 42 Borough Librarian's 22 Borough Housing Officer's 19 Medical Officer of Health's 2 107 48 SECTION D: Sanitary Circumstances of t.lie Area Water Supply The Borough has a dual source of supply. ''Tie northern part is supplied by the Colne Valley Water Company and the central and southern portion by the Metropolitan Water Board. Hie Colne Valley water is derived from deep wells sunk into the chalk and before distribution to the consumers the water is under constant supervision of a chemical and bacteriological staff which carries out examinations in modern laboratories situated at the works. The water supplied by the Metropolitan Water Board is selected Thames water which has been subjected to purification by storage in which time it is freed of the bulk of organisms. It is filtered through rapid and then slow filters, attaining a degree of purity which compares favourably with the general supplies in Great Britain, but as a further safeguard terminal chlorination is applied which ensures a first class water in every respect. Samples of water are examined bacteriologically, chemically and for taste and other special purposes on every working day. The supply to all areas was satisfactory in quality and quantity. Number of dwellinghouses supplied from public water mains:- (a) Direct to houses 44,490 (b) by means of standpipes Nil Number of population supplied from public water mains:- (a) Direct to houses 151,850 (b) by means of standpipes Nil Natural fluoride content of water supplies:- Colne Valley Water Company: Fluoride content - Nil Metropolitan Water Board: Fluoride content - 0.15 parts per million. The water supplied to Hendon is deficient in fluroide and dental decay is more prevalent here than in those areas where the element is present in optimum quantity. 49 Housing I am indebted to the Housing Officer for the following observations and statistics relevant to the housing situation. "The main feature of this year's housing programme has been the progress made in the New Brent Street Redevelopment Scheme. At the end of the year a further 99 flats had been built and occupied in this area, and early completion of Phase Two of the scheme is anticipated. The majority of the families allocated these flats were rehoused from areas also scheduled for redevelopment in the near future, principally Hermitage Lane and Granville Road, and in the latter area the demolition of the old properties has started and rebuilding operations will be commenced in the early part of 1961. The Council has continued to provide for the rehousing of elderly persons and in the year under review "Taylorsmead" comprising eleven bed-sitters specifically designed to cater for the needs of elderly persons living alone, was built and occupied. This most attractive building, fitted with central heating and modern amenities, also includes quarters for a resident caretaker. Accommodation of a similar type has also been provided by the purchase of a large house in the Central Ward and converting the premises to give bed-sitters for seven elderly persons. Another interesting aspect of the year's programme has been the modernisation of the pre-war Bittacy Hill Plats. These 52 flats lacked modern facilities and to bring them in keeping with present day standards the Council, with the aid of a government grant, has provided each flat with a separate bathroom, hot water supply, modern type kitchen and other necessary amenities, including an outdoor brick built fuel and storage shed. The Council has directly sponsored in the region of one hundred families for rehousing in the New and Expanded Towns during the year, the majority of which were included in the Housing Waiting List. By so doing the relief of unsuitable housing conditions has been brought about or accommodation has been released for re-letting to other families. New applications for inclusion on the Housing Waiting List numbered 387 excluding single elderly persons who are recorded separately. The Housing Waiting List numbered 2,679 applications at the close of the year, a slight increase on last year's figure. Applicants assisted in the course of the year were as follows: - (a) rehoused into permanent accommodation (pre-war) 32 " " " (post-war) 79 (b) transfers to resolve cases of overcrowding or under- occupation on Council Estates etc. 314 At the close of the year the total number of dwellings controlled by the Council was 4,326 including purchased properties acquired for the housing pool." 50 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. Inspections The following inspections were made during the year General Public Health Inspections No. of inspections Dwelling houses (in connection with defects or other insanitary conditions) Caravans 10,443 93 Certificates of Disrepair (Rent Act, 1957) 50 Drain Tests 372 Drainage and Plumbing Works 691 Overcrowding 39 Pests 44 Verminous conditions 70 Clean Air Smoke Observations 224 Volumetric Smoke Measuring Apparatus and Deposit Gauge - attendances at 576 Smoke Control Areas - inspection of premises in 2, 004 Boiler houses etc. inspections 19 Food Premises Bakehouses 50 Bakery and Confectionery Shops 50 Butchers Shops 273 Canteens 42 Confectionery (Sweet) Shops 165 Fish Shops 31 Greengrocers & Fruiterers 141 Grocery & Provision Shops 276 Hawkers 19 Ice Cream Premises 511 51 Food Premises continued No. of inspections Dairies 21 Restaurants & Cafes 279 School Meals Kitchens 29 Stalls 106 Pood Delivery Vans 6 Hawkers' Vans 14 Factories In which mechanical power is used 171 In which mechanical power is not used 29 Licensed Premises Justices Licences 205 Public Entertainment Licences 103 Others Accommodation roads, passages, etc. 169 Hairdressers 62 Infectious Diseases 286 Pet Animals Act 52 Shops Act, 1950 (Sanitary, etc. arrangements) 1340 Stables 23 Miscellaneous 2169 Samples Taken Ice Cream 162 Milk 95 Swimming Bath Water 51 Animal Feeding Stuffs 136 Organic Fertilisers 22 Bottle Rinses (Milk bottle Washing Plant) 90 Notices Served To deal with unsatisfactory conditions found during the course of the above inspections, the following notices were served:- Informal or cautionary 680 52 Notices served continued Statutory Notices Served under Public Health Acts 49 Served under other Acts, Regulations etc. 49 As will be seen from these figures, the vast majority of matters found requiring attention were successfully dealt with by informal action. Inspection of Dwelling Houses During the Year Total number of dwelling houses inspected for housing defects or other insanitary conditions (under Public Health or Housing Acts) 2,202 Number of inspections made for this purpose 10,443 Number of dwelling houses inspected under the Housing Consolidated Regulations 1925 – Number of houses surveyed in areas in need of redevelopment 94 Number of dwelling houses found to be unfit for human habitation and incapable of repair at reasonable expense 56 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 513 Legal Proceedings under Public Health Act, Section 94 It was only necessary to deal with one premises by way of legal proceedings during the year. In 1959 the Magistrates had granted Orders prohibiting any recurrence of nuisances caused by the keeping of a large number of cats at the premises and awarded the Council costs. Proceedings had to be instituted again during 1960. On the first occasion 29 charges were made of failing to comply with the Order to prevent nuisance from the burning of cats' excreta on the kitchen boiler, 2 charges of failing to comply with Orders prohibiting the recurrence of nuisances in the house and garage, and application made for an Order to abate a nuisance from a heap of filth in the garden. The defendant, who was represented by Counsel, pleaded not guilty to the charges and denied the complaint. The Magistrates convicted on each charge relating to the burning and imposed fines of 10/- each (total £14. 10. 0.) 53 plus £6. 16. 0. costs. Upon a technical objection to the form of the Orders as drawn up by the Court, the Magistrates dismissed the charges relating to the nuisances in the house and garage, but made an Order for the abatement of the nuisance from the heap of filth within 14 days. Further proceedings had to be instituted later. Defendant was again represented by Counsel and all charges denied. The Council's submissions were however upheld by the Court which imposed fines totalling £27. 10. 0. plus £10. 10. 0. costs and granted two Nuisance Orders relating to conditions inside the house and garage. As a result of these proceedings, the Council being of the opinion that further summary proceedings would afford an inadequate remedy for any recurrence of the stautory nuisances, gave instructions that in the even; of there being sufficient evidence of any of the present Orders having been contravened without reasonable excuse, for proceedings to be commenced in the High Court under Section 100 of the Public Health Act, 1936. At the time of the writing of this report, these proceedings were under consideration. Housing Act, 1957 During the year under review 11 houses were dealt with under the Housing Act, 1957 involving the making of 1 Demolition Order and 10 Closing Orders. Certificates of Unfitness were issued under the Housing (Financial Provisions) Act, 1958 in respect of 45 houses in the Council's ownership. Of the 56 houses, 16 were actually closed during the year and 19 were demolished. In addition, 17 houses were closed and 45 demolished in respect of which Closing or Demolition Orders had been made or Certificates of Unfitness issued prior to 1960. During 1960, 7 5 families involving 180 persons were displaced from unfit properties, 67 families involving 164 persons being rehoused by the Council and 8 families involving 16 persons being rehoused by other authorities or finding their own accommodation. 94 surveys were carried out of properties in areas considered to be in need of redevelopment and reports submitted to the Council as a result of which two such areas were defined - (a) Sanders Lane, Mill Hill, N.W.7. comprising 50 properties. (b) Cricklewood Lane (South) N.W.2. comprising 44 properties. The properties will now accordingly be acquired by the Council for demolition and the areas subsequently redeveloped. 58 premises were surveyed and reports thereon submitted to the District Valuer for use in connection with his negotiations for the acquisition of the properties for 54 the Council. Steady progress was maintained during the year in dealing with unfit properties. 291 such properties had been dealt with by the end of the year under the 5-year programme called for by the Minister of Housing and Local Government under the Housing Repairs and Rents Act, 1954. A further survey of the Borough will be carried out during 1961 and fresh proposals submitted to the Minister under Circular 2/60. Most of the unfit properties are, however already known to the Department and it is anticipated that some 120 remain to be dealt with. The majority are in areas scheduled for redevelopment. As in previous years, it was generally found that the most satisfactory way of dealing with unfit houses in areas so scheduled was the issue of Certificates of Unfitness under the Housing (Financial Provisions) Act, 1958 after the properties had passed into the Council ownership. The fact that the houses are unfit is, of course, known to the District Valuer at the time of purchase as a result of the reports on the surveys submitted to him. The progress made in dealing with houses let in muIti-occupation was very limited. The absence of proper statutory standards for the provision of amenities and a proper enforceable code of management, coupled with the fact that action under the Housing Act, 1957 might lead to the eviction of families which the Council could not at present rehouse, makes progress in this field of housing work difficult. Rent Act, 1957 The following figures show the number of applications for Certificates of Disrepair and Revocation received and the action taken during the year. Applications for Certificates of Disrepair No. of applications for certificates 9 No. of decisions not to issue certificates – No. of decisions to issue certificates 9 (a) in respect of some but not all defects 8 (b) in respect of all defects 1 No. of applications outstanding at end of year – No. of undertakings given by landlords under paragraph 5 of the First Schedule 4 No. of undertakings refused by Local Authority 1 No. of certificates issued 7 (One certificate was in response to an application received in the previous year). 55 Application for Cancellation of Certificates No. of applications by landlords to Local Authority for cancellation of certificates 8 (One application also outstanding from previous year) No. of objections by tenants to cancellation of certificates 7 No. of decisions by Local Authority to cancel in spite of tenants' objections 5 No. of certificates cancelled by Local Authority 6 No. of applications outstanding at end of year 1 Very little use now appears to be made by tenants of this procedure to secure the execution of repairs under the Rent Act, 1957. Overcrowding The following report on overcrowding for the year ending 31st December 1960 was submitted to the Ministry 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 10 Number of persons dwelling therein 50 Equivalent number of persons dwelling therein (Section 77 Housing Act, 1957) 40 (b) Number of new cases of overcrowding reported 10 (c) Number of cases of overcrowding relieved 12 Number of persons concerned 60 Equivalent number of persons concerned (Section 77 Housing Act, 1957) 45& (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 crowding upon which 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 application list or by owners endeavouring to secure possession of their properties on the grounds that they were overcrowded. 56 Local Land Charges Enquiries During the year enquiries were made by the Town Clerk in respect of 3385 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 Department's drainage operative cleared no less than 1111 drains on request at private premises. Owing to the increase in the number of these requests for this service, the Council decided to make fixed charges for the work. These are as follows: - During normal working hours 12.6d Evenings - Monday to Friday £1. 5.0. Saturdays and Sundays £2.10. 0. These have been found to be economic charges and allow for the payment of overtime rates to operative and van driver. The monies are paid to the workman and a receipt (previously prepared in the office) given by him, so avoiding the necessity of submitting accounts and recovering the costs. The service continues to grow, the local builders apparently being only too pleased to leave this unpleasant task to the Council. In the event of the operative being unable to clear the drain by rodding the owner is then advised to call in his own builder or alternatively the Public Health Inspector will serve a notice under a Local Act requiring the clearing of the drain within 24 hours failing which the Borough Engineer & Surveyor's Department carry out the work in default and the expense is later recovered from the owner. 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 183 occasions during the year. 57 Drain Tests The following drain tests were-carried out:– (a) for prospective purchasers of properties and reports submitted 14 (b) in connection with applications for advances for the purchase of properties under the Housing (Financial Provisions) Act, 1958 185 (c) in connection with the investigation of nuisances or on completion of repairs 173 TOTAL 372 For this service under (a) and (b) a fee, usually £2.2.0. is charged. This fee is at present under consideration. Insect Pests Complaints of ants, bees, book-lice, bugs, carpet beetles, clover-mite, cockroaches, fleas, flies, furniture mites, larder beetles, silver fish, 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. 11 cases of bug infestation and one 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 451 wasps nests. This is a free service given by the Council. The nests were situated as follows:– (1) in open ground 130 (2) in buildings 173 (3) in roofs of buildings 148 451 Where the provision of ladders is required, or the removal of roof tiling or the taking up of flooring etc, is necessary to expose the nest, this work has to be undertaken by the householder. The Council's operator attends with the builder, destroys the nest when it is exposed and leaves the builder to reinstate the roof, etc. 58 This public health service has become widely known throughout the Borough and is readily sought. It was noticeable again this year that not a single complaint was received of wasps becoming a nuisance in shops. During the year 311 inspections were made by the Public Health Inspectors of furniture, bedding and accommodation of families who were to take up occupation in Council houses or 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. The progress in the standard of living conditions in the past 25 years has been remarkable. At that time the Council had one and sometimes two operatives working whole-time on dealing with bug and flea-infested houses. The only pests presenting a problem with which little success was achieved during the year were feral pigeons. There is no adequate general legislation to deal with them and no Authority appears to have any responsibility in the matter. They can, however, become a serious nuisance causing damage to roofs and by their fouling of gutters, ledges, etc. allow dried excreta to blow into buildings. 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. In cases other than notifiable infectious disease the service is carried out on request, an appropriate charge being made. Library books taken from houses where cases of certain notifiable infectious diseases have occurred are disinfected before being returned to the library. Parcels of clothing are also disinfected on request, and an appropriate certificate given, when they are being sent abroad. During the year the following were dealt with:- Rooms 122 Bedding and/or Clothing 234 Library Books 290 Parcels of Clothing to be sent abroad 35 Domiciliary Laundry Service During the year 9,577 soiled articles were collected from the homes of incontinent persons and cleansed under the provisions of Section 84 of the Public Health 59 Act, 1936, as amended by Section 42 of the Middlesex County Council Act, 1956. The service is restricted to persons who have no suitable relative living with them who is able to deal with the articles. 44 persons were given the benefit of this service, soiled articles being collected twice weekly. Premises Licensed for Public Entertainment In accordance with the usual procedure, inspections were made of the sanitary arrangements, kitchens, etc. at premises licensed for public entertainment, and reports thereon submitted to the Middlesex County Council in connection with applications for the renewal of the licences. 47 premises were inspected and at 15 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 completed or were in hand. 103 visits were paid to these premises by the Public Health Inspectors. Licensed Premises Inspections were carried out of the 43 licensed premises in the Borough and a report submitted on the conditions found to the Licensing Justices for consideration at the Brewster Sessions, when applications for renewal of the licences are dealt with. The inspections covered bars, kitchens, storerooms, cellars and sanitary conveniences and at 28 premises works were found to be necessary. These related principally to repair or redecoration of sanitary conveniences, renewal of kitchen equipment and redecoration of kitchens, bars and cellars. All premises now have, as a result of work in previous years, adequate staff washing facilities, including hot water supplies, but regrettably few have such facilities available for the use of customers about to take meals or refreshment at the premises. The power to enforce the provision of such an everyday essential amenity in such premises is long overdue. Agriculture (Safety, Health and Welfare Provisions) Act, 1956 Inspections were carried out of the 13 "agricultural units" in the area to ensure that the provisions of the Act relating to the providing and maintaining of suitable sanitary conveniences for the workers were being complied with. At 3 farms it was found that sufficient conveniences were not available and at 2 others that they were not being properly maintained. The necessary notices were served and by the end of the year all of these matters had been rectified. 60 Factories Acts, 1937-1959 At the request of the Ministry of Health 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 the report. Factories are required to supply the Local Authority twice yearly with lists of the names and addresses of persons employed by them as outworkers, i.e. carrying out work in their own homes. The lists are submitted in February and August. The homes are then inspected by the Public Health Inspectors to ensure that conditions there are suitable. In August, 11 local firms submitted lists indicating that they were employing 64 outworkers. 50 of these resided outside the Borough and details were forwarded to the Medical Officers of Health of the districts concerned. In turn, notifications were received from other Local Authorities of 109 outworkers residing in Hendon but employed in factories elsewhere. The homes of all these outworkers were inspected. 4 were found to be employing other persons and details were forwarded to the Borough Engineer & Surveyor for investigation as to possible Town Planning contraventions. At 2 houses the workroom was found to be in need of redecoration and general cleansing. Notices were served and the necessary work was carried out. Rag, Flock and other Filling Materials Act, 1951 4 premises are registered under this Act. It was not found necessary to take any action under the Act during the year. Pet Animals Act, 1951 10 applications were received for licences to keep pet shops. The premises were inspected and at two works were found to be necessary to improve means of ventilation, provide better fire precautions, improved refuse disposal arrangements and to carry out repairs and redecorations. These were completed satisfactorily and all licences issued. Hairdressers and Barbers 62 inspections were made of these establishments to ensure that the Council's Byelaws were being complied with. At very few of the premises was a copy of the Byelaws exhibited in accordance with Section 282 of the Middlesex County Council Act, 1944. The Council has therefore had copies of the Byelaws printed in suitable notice 61 form and these are being distributed to the hairdressers and barbers in the Borough. Prevention of Damage by Pests Act, 1949 Rodent Control Rodent control in dwelling houses and business premises is carried out by a foreman, three whole-time and one part-time operatives working under the supervision of the District Public Health Inspectors and in accordance with recommendations of the Ministry of Agriculture Fisheries & Food. Hie foreman and operatives attend refresher courses arranged by the Ministry from time to time to ensure that they are properly aware of the latest methods, and poisons, etc. in use. Treatment of sewers is carried out by the Borough Engineer & Surveyor's Department. In the case of dwelling-houses, treatment is undertaken by the Council free of charge. In the case of business premises a charge based upon time, cost of materials and overhead expenses, is made. An estimate of the cost is prepared and submitted to the occupier of the business premises and it is open to him to either accept it, engage a private specialist firm or undertake the work himself. Almost invariably the Council's estimate is accepted. Should an occupier elect to do the work himself, the District Public Health Inspector ensures that the treatment is successfully carried out. In a number of cases it was necessary to have accumulations of rubbish removed, gardens or land cleared of excessive growth or buildings rendered rat-proof. In all cases the work was carried out as a result of representations made by the Public Health Inspectors without recourse to statutory action. A report on the work carried out during the year, as submitted to the Ministry of Agriculture Fisheries and Food, is given in the following table. 62 TABLE XVII Twelve Months Ended 31st December, 1960 TYPE OP PROPERTY Non-Agricultural Agricultural Local Authority Dwelling houses (including Council houses) All other (including business premises) Total of 1, 2 and 3 (1) (2) (3) (4) (5) 1. Number of properties in Local Authority's District 19 45,100 6,186 50,965 10 2. Number of properties inspected as a result of (a) Notification 2 647 81 730 – (b) Survey under the Act – 561 69 630 – (c) Otherwise – 423 82 505 – 3. Total inspections carried out including reinspections 43 11,578 1,536 13,157 – 4. Number of properties inspected (in 2) found to be infested by (a) Rats Major – – – – – Minor 1 1,166 132 1,299 – (b) Mice Major – – – – – Minor 1 145 20 166 – 5. Number of infested properties (in 4) treated by the Local Authority 2 1,310 141 1,453 – B. Total treatments carried out including retreatments 9 1,800 225 2, 034 – 7. Number of notices served under Section 4 of the Act:- (a) Treatment – – – – – (b) Structural Work (i.e. Proofing) – – – – – 8. Number of cases in which default action was taken – – – – – 9. Legal Proceedings – – – – – 10. Number of "Block" control schemes carried out – 196 4 200 – 63 Swimming Baths There are two municipal-owned and one privately-owned public swimming baths in the Borough. The Ministry of Health has suggested that the following details relating to the baths should be included in this report:- Mill Hill Swimming Bath Size of Bath 132' X 75' Capacity 365,000 gallons Source of Water Supply Colne Valley Water Company Frequency of Changing Water Turnover period 4 hours Method of Purification Breakpoint chlorination Position of inlets and outlets 12 inlets, 6 at each end. 3 main outlets along centre of pool. Attendances during 1960 Adults 10,564 Children 27,574 Season Tickets 4,529 Schools 12,084 54,751 Samples taken during 1960 Satisfactory 26 Unsatisfactory 1 27 The unsatisfactory sample which was taken shortly after the opening of the bath in May was only slightly in excess of the suggested standard for the plate count i.e., 130 colonies, the accepted maximum being 100 colonies. On no occasion was coliform bacillus found. The results can be regarded as highly satisfactory. West Hendon Swimming Bath Size of Bath 132' X 66' Capacity 250,000 gallons Source of Water Supply Colne Valley Water Company 64 West Hendon Svimming Bath (continued) Frequency of Changing Water Turnover period 8 hours Method of Purification Breakpoint chlorination Position of inlets and outlets 5 inlets at shallow end. 2 outlets at deep end. Attendances during 1960 Adults 4,622 Children 9,550 Season Tickets 1,736 Schools 5,498 21,406 Samples taken during 1960 Satisfactory 15 The highest plate count was 36 and no coliform bacillus was found. Again the results can be regarded as highly satisfactory. Privately-owned Swimming Pool Size of Pool 100' X 25' Capacity 81,830 gallons Source of Water Supply Metropolitan Water Board Frequency of Changing Water Turnover period 6 hours Method of Purification Filtered and chlorinated Position of inlets and outlets Aerating tower at shallow end. Single outlet in floor of pool at deep end. Attendances during 1960 Not known Samples taken during 1960 Satisfactory 11 Unsatisfactory 1 12 A very minor coliform contamination (3 per 100 ml) was found on one occasion, but all other results were highly satisfactory. Broadfields Junior School At the beginning of the summer terra a teaching swimming pool, which had been constructed by the Parent-Teacher Association of this school, was opened. 65 The pool, which is 50 feet in length, 15 feet in width and has a depth of water varying from 2' 9" to 3' 3", is constructed in reinforced concrete. Its capacity is 14,000 gallons, the source of water-supply being Colne Valley Water Company's mains. Filtration is by means of a reverse action filter with graded Leighton Buzzard sand and chlorination by an automatic drip feed ty float. The turnover period is approximately 8 hours. 9 samples were taken during the year for bacteriological examination. The earlier samples could not be regarded as satisfactory, but after improved regulation of the chlorine input the later samples taken were highly satisfactory. Diseases of Animals Acts Foot-and-Mouth Disease On 5 occasions during the year the movement of animals (cattle, sheep, goats, pigs and deer) became controlled in the Borough as a result of Orders made by the Ministry of Agriculture, Fisheries & Food following the occurrence of outbreaks of the disease in neighbouring areas. There were 19 stockholders affected by the restrictions imposed by the Orders. Licences to move animals within the infected area were granted only in essential cases. In no case was any infringement of the Orders noted, the stockholders being only too anxious to avoid taking any risks which might lead to the introduction of the disease to their premises. Some £5!4 million has been paid out by the Government in compensation to owners of cattle slaughtered because of foot-and-mouth disease during the past five years. Swine Fever No cases of swine fever occurred in or near to the Borough during the year. The Government has announced that a slaughter policy is to be introduced against this disease. Fowl Pest Two poultry keepers reported the death of birds which they thought might be due to fowl pest. The carcases were examined when death was found to have been due to other causes. It was not necessary to impose restrictions on the movement of poultry in the area during the year. There are now no poultry slaughterers in the Borough. The Movement of Animals (Records) Order, 1960 This Order, which came into operation on 1st March 1960, introduced new 66 ments relating to the keeping of records of the movement of animals. Details, as set out in the Order, are to be kept of the movement of all bovine animals (bulls, cows, oxen, heifers and calves) and retained for a period of 3 years. This is to enable the movement of animals from farm to farm etc. to be traced when tuberculosis is found in an animal, and so give the Ministry's veterinary officers an opportunity of investigating the source of infection and tracing and examining all animals which have been in contact with the infected animal. The records are also useful when dealing with outbreaks of foot-and-mouth disease. Records relating to sheep, goats and pigs have only to be retained for one year. All stockholders were supplied with details of the new form of record and are visited from time to time to ensure that the Order is being complied with. Diseases of Animals (Waste Foods) Order, 1957 The officers of the Ministry of Agriculture Fisheries and Food enquire very thoroughly into the circumstances of each outbreak of foot-and-mouth disease and swine fever and report that all too frequently it is associated with swill feeding either directly or indirectly. Persons collecting and feeding waste swill to animals or poultry are required to have proper boiling plant for this purpose and to hold a licence to operate the plant under the above-mentioned Order from the Local Authority. No uncooked swill is to be allowed to come into contact with the animals and all swill must be boiled for at least one hour before being fed to them. The carriage of waste food is also controlled. Nine such licences have been issued by the Council and the premises are visited by the Public Health Inspectors, the temperature of the cooking swill checked and inspections made of the vehicles bins, etc., to ensure that the requirements of the Order are being met. Importation of Dogs and Cats Order, 1928 During the year the Ministry of Agriculture, Fisheries and Food approved a further 20 kennels at the premises established at Mill Hill for the detention and isolation of imported dogs undergoing quarantine. The premises are under the control of qualified verterinary surgeons and the total number of imported dogs which may be detained there at any one time is now 35. When a licence is issued by the Animals Health Division of the Ministry authorising the landing of a dog and its detention at these premises, a copy of the licence is forwarded to this Council. Dogs are required to be kept strictly isolated from all other dogs during the 67 six months period of quarantine. The premises are inspected by t"he Police and the Council's Diseases of Animals Act Inspector to check on the presence and isolation of the dogs. During the year 46 licences were issued by the Ministry. The death of a dog in quarantine must be notified by telephone or telegram to the Minister of Agriculture, Fisheries and Food by the Veterinary Surgeon in charge of the premises. Any animal developing symptoms of suspected rabies would be dealt with immediately under the Rabies Order of 1938. The continued careful and strict observance of the Importation Order is emphasised when one considers the statement recently issued by the World Health Organisation that more than 145,000 people were treated for rabies in the Philippines in 1958, about 60,000 in the United States and many thousands in other countries throughout the world. Out of the 75 countries covered in a World Health Organisation report, 52 said the disease had occurred in 1958. The disease was eradicated from this country in 1922. Clean Air Act, 1956 Smoke Control Areas On the 1st September 1960, the Borough of Hendon Smoke Control (No. 1) Order came into force. Of the 658 properties in the Area conversions or adaptations of fireplaces were considered to be necessary at 116. Despite repeated notices, letters and visits by the Public Health Inspectors, applications for approval of proposed works were very slow in being sent in. As this was the first Area in the Borough, Statutory Notices were served in a number of cases to assist those who had delayed in submitting their proposals so enabling them to claim grant, but even so it is doubtful whether the number of adaptations in respect of which claims will have been received will exceed 40% of the total. The date of operation, i.e. 1st September was also found to be too early, many people having just returned or still being on holiday, the majority having left the matter of the fireplace adaptation to be dealt with on their return. In future areas it is proposed to make the date of operation 1st October. Whilst a number of householders have carried out the works and are not claiming grants or have changed to central heating, it does appear that a large percentage are relying on the fact that they can burn "premium" smokeless fuels easily (if not efficiently) on their ordinary stool bottom grates and expect to be able to continue to do so. It has been pointed out to them that with the growth of smoke control areas there will be increased demands on the supplies of these fuels and there may be 68 occasions when they will have to rely on coke which will not burn readily in the the ordinary grate, and that they should avail themselves of the opportunity of installing suitable appliances to do so whilst the grant was available. A few responded to this suggestion, but several are obviously continuing as before. The area was, however, kept under observation throughout the winter and it is satisfying to be able to record that not a single contravention of the provisions of the Act relating to the emission of smoke was noted. Provisional clearance was given by the Minister of Housing and Local Government for a 100% survey to be carried out of the Hampstead Garden Suburb Ward, Smoke Control (No. 2) Area, which is 461 acres in extent and comprises some 2640 properties. This was nearing completion at the end of the year. Industrial Premises 224 observations were made by the Public Health Inspectors of chimneys of industrial or commercial premises in response to complaints or as a result of their own inspections. Smoke was found to be emitted on a number of occasions this in each case being due to failure to maintain or operate the plant properly. As a result of advice given and informal representations made by the Inspectors the difficulties were overcome and in no instance was it necessary to take statutory action. measurement of Atmospheric Pollution The measurements recorded during the year show a definite improvement on the the results obtained in the previous year. 69 TABLE XVIII DAILY AVERAGE OF SMOKE AND SULPHUR DIOXIDE AT EDGWARE, MILL HILL AND GOLDERS GREEN MEASURING STATIONS 1960 EDGWARE GOLDERS GREEN Smoke* Sulphur** Smoke* Sulphur** January 11 7.5 17 9.6 February 11 7.4 17 9.3 March 8 6.5 9 6.7 April 5 4.8 7 5.7 May 4 4.3 5 4.9 June 2 3.2 3 3.2 MILL HILL July 2 2.6 3 2.2 August 4 2.7 4 3.0 September 6 3.1 5 3.7 October 9 4.7 9 6.7 November 10 5.8 13 8.5 December 16 7.6 20 10.3 TOTAL 88 60.2 112 73.8 * Average daily smoke concentration in mgms. per 100 cu. metres of air. ** Average daily sulphur concentration per 100 million volumes of air. In June I960, owing to the rebuilding of the Edgware Library, the measuring station was closed temporarily. A third smoke measuring station was established at Mill Hill Library. 70 71 SMOKE FILTER AND SULPHUR DIOXIDE STATION GOLDERS GREEN 1960 72 SECTION E: Food INSPECTION AND SUPERVISION OF FOOD Food and Drugs Act, 1955 Milk and Dairies (General) Regulations, 1959 Legal Proceedings It was necessary to institute legal proceedings in the following cases:– Charge Plea Result 1. Selling food not of the substance demanded - bar of chocolate cream containing grub. (Section 2, Pood & Drugs Act, 1955) Guilty The Magistrates imposed a fine of £5 and awarded the Council £2.2.0. costs. 2. Selling currant bread containing cloth. (Section 2, Pood & Drugs Act, 1955) Guilty The Magistrates imposed a fine of £5 and awarded the Council £3.3.0. costs. 3. Selling a loaf of bread containing a piece of mutton cloth. (Section 2, Pood & Drugs Act, 1955) Guilty The Magistrates imposed a fine of £5 and awarded the Council £3.3.0. costs. 4. Failing to ensure cleanliness of milk container before use. (Sections 27(1) and 34, Milk & Dairies (General) Regulations, 1959) Guilty The Magistrates imposed a fine of £15 and awarded the Council £3.3.0. costs. In six other instances warning letters were sent to manufacturers or retailers as a result of complaints received, and in three other cases it was considered that the evidence was insufficient to warrant any action being taken. 73 Food Shops Classified According to Principal Trades 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 Dairies 11 Fishmongers 40 Greengrocers 56 Grocers & Provision Merchants 198 Restaurants & Cafes 135 School Meals Kitchens 17 School Meals Centres 32 Works Canteens 45 828 Inspections During the year inspections were made of Pood Premises as follows:- Bakehouses 50 Bakery and Confectionery Shops 50 Butchers Shops 273 Canteens 42 Confectionery (Sweet) Shops 165 Pish Shops 31 Greengrocers & Fruiterers 141 Grocery and Provision Shops 276 Hawkers 19 Ice Cream Premises 511 Dairies 21 Restaurants & Cafes 279 School Meals Kitchens 29 Stalls 106 74 Matters Dealt With As a result of the above inspections it was necessary to serve notices regarding the premises or issue cautions in connection with contraventions of the Pood Hygiene (General) Regulations at 219 establishments. These were all dealt with without recourse to statutory action. They related to - Cleansing and redecoration required 37 General repairs required 61 Choked or defective drains 2 Sanitary conveniences not properly maintained 58 Unsatisfactory washing arrangements for use of persons handling food 74 Refrigerators requiring repair 22 Unsatisfactory arrangements for storage of refuse 18 Presence of vermin 2 Inadequate facilities for washing food and equipment 22 Unsuitable equipment used in connection with handling or preparation of food 26 Dirty conditions 37 Adequate first-aid materials not provided 13 Suitable accommodation for outdoor clothing not provided 13 Suitable notices not provided requiring washing of hands after using sanitary conveniences 45 Person engaged in handling of food smoking whilst so engaged 1 Pood not properly protected from risk of contamination 24 Condemnation of Food The following shows the amounts of foodstuffs condemned during the year as unfit for human consumption. It is rarely nowadays that one actually finds unsound food deposited for or displayed for sale. All of the food detailed below was condemned as a result of requests received by the Public Health Inspectors from retailers to inspect the food which had become unfit from such causes as breakdown of refrigerators at week-ends, delay in transit to the premises or contamination by other articles. Condemned foods are disposed of by incineration at the Council's Refuse Disposal Works. Lists of Foodstuffs condemned during 1960 meat (including Beef, Ham, Offal, Pork, Veal & Sausage) 459 lbs 14 ozs 75 MEAT (continued) 17 cases offal 2 cartons poultry tinned foods Chopped Pork 1 tin Cream 11 tins Fish 21 tins Fruit 227 tins Fruit Juice 28 tins Ham 47 tins Jam 5 tins Meat 110 tins Milk 35 tins Pudding 1 tin Soup 10 tins Vegetables 182 tins frozen foods Wish 151 packs Fruit 140 packs Ice Cream 1,132 packs Meat 111 packs Mousse 370 packs Pastry 12 packs Sponge 11 packs Vegetables 419 packs Waffles 26 packs miscellaneous goods Cheese 19 lbs Confectionery 1 lb Oatmeal 12 lbs Paste 1 jar Peaches 13 lbs Peanut Butter 2 jars Pies 2 Prunes 417 lbs Soup 58 packets Synthetic Cream 16 packets Yoghurt 1 jar Milk Supply Number of registered dairymen and distributors 51 Number of registered dairies not being dairy farms 11 Number of inspections made of dairies during the year 21 76 milk and Dairies (General) Regulations, 1959 During the year no contravention of these Regulations was noted. Milk (Special Designations) Regulations The following table shows the number of licences issued under these Regulations during 1960. Dealers Licences: Tuberculin Tested 44 Pasteurised 44 Sterilised 51 Supplementary Licences: Tuberculin Tested 18 Pasteurised 18 Sterilised 19 The Milk (Special Designations) Regulations, 1960, replace and consolidate with amendments the Milk (Special Designation)(Raw Milk) Regulations, 1949 to 1954, and the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 to 1953. Amongst the amendments was one which transferred the issue of Producers' and Dealers' Licences from this Council to the Middlesex County Council as the Food and Drugs Authority. These Regulations came into operation on the 1st October, 1960, in so far as they relate to Producers' Licences, and on the 1st January, 1961, for Dealers' Licences. Samples The following samples were taken for bacteriological examination:- Tuberculin Tested (Pasteurised) 6 Tuberculin Tested (Raw) 6 Pasteurised 8 Sterilised 4 Milk from milk vending machines 51 TOTAL 75 77 2 samples of tuberculin tested Raw Milk were found to be positive to a test for Rickettsia Burnetti. They were not produced locally and the matter was referred to the Medical Officers of Health of the areas concerned. 2 samples of milk taken from a vending machine were found to be unsatisfactory. On examination of the machine a mechanical defect, governing the temperature at which the milk was being kept, was discovered. This was rectified and subsequent samples were satisfactory. Bottle Rinses To test the efficiency of the bottle washing and sterilising processes at a large milk bottling establishment in the Borough rinses are taken from a series of bottles from a machine and submitted for bacteriological examination. The mean bacteriological count expressed as points should not exceed 50. 120 rinses were taken during the year and the mean count in each case was satisfactory. Ice Cream An inspection was made during the year of all premises in the Borough registered for the sale of ice cream. 76 premises were removed from the register, the sale of ice cream having been discontinued. 55 premises were found to be under different proprietorship and the registration was amended accordingly. 236 registered premises were inspected and the following conditions found:- Premises and equipment satisfactory 173 Premises unsatisfactory 58 Method of serving loose ice cream unsatisfactory 5 TOTAL 236 The matters requiring attention at the premises were:- Repairs or redecoration of part of premises required 48 Inadequate personal washing facilities 27 No "Now Wash Your Hands" notice displayed in watercloset compartment 16 Absence of First Aid equipment 2 Cleansing of refrigerator required 1 No proper facilities provided for storage of outdoor clothing 1 Other displayed foods not protected against contamination by customers 1 78 Water closets or lobbies incorrectly being used for storage purposes 3 Yards etc. requiring cleaning up 1 Arrangements for sterilising of ice cream serving equipment unsatisfactory 5 In addition, ice cream is sold at 50 hotels, restaurants, and cinemas, which are not registrable under the Act, and also from a number of mobile vans. 153 samples of ice cream were taken during the year and submitted to the Central Public Health Laboratory Service for bacteriological examination and grading according to the Ministry of Health's Provisional Grading Scheme, with the following results Grades 1 and 2 are satisfactory. Grade 3 calls for investigation of the methods of production and/or handling. Grade 4 is unsatisfactory. No. of Samples Taken Results Prepacked 90 Grade 1 20 " 2 1 " 3 2 '' 4 Loose 13 " 1 4 " 2 2 " 3 21 4 TOTAL 153 As will be seen, little trouble is experienced from ice cream sold prepacked as received from the suppliers, but fairly frequent inspections and supervision of the methods used in handling loose ice cream, particularly in restaurants and cafes, have been found to be necessary. The lack of or inadequate use of a suitable sterilant in which to keep the servers and the leaving of conservators open for prolonged periods exposing the contents to falling dust, etc., have been found to be the principal causes of the unsatisfactory samples. When unsatisfactory samples are obtained the supplies are check-sampled as they are received from the suppliers and have invariably been found to be satisfactory. After the cause of the unsatisfactory samples has been ascertained and rectified, repeat samples are taken from time to time to ensure that proper methods of handling are maintained. 511 visits were paid by the Public Health Inspectors to ice cream premises during the year. 79 Registration of Hawkers of Food During the year only one new hawker was registered under Section 11 of the Middlesex County Council Act, 1950, bringing the total number in the register to 74. These are classified as follows:- Fruit and vegetables 57 Groceries 3 Fish 7 Fried fish and chips 1 Shellfish 2 Ice cream 2 Dairy Produce 1 Bread and Confectionery 1 74 The only matters which had to be dealt with related to failure to have the hawker's name and address legibly inscribed on the vehicle, particularly after a change of vehicle. Several of the registered hawkers have not been seen in the Borough for some years and it is proposed to thoroughly review the register during 1951. 19 inspections of hawkers' storage premises were made when no matters of any significance were found which required attention. The Meat (Staining and Sterilisation) Regulations, 1960 These Regulations which came into operation on the 1st November 1960 require that (a) all unfit meat from slaughterhouses must be sterilised. (b) all meat from Knackers' Yards must be stained or sterilised before leaving the premises Sterilising is to be done by boiling or by steam under pressure until every piece is cooked throughout, and staining is to be by the application, immersion in, or injection of, one of a number of approved green dyes. The object of the Regulations is to prevent any such meat being sold for human consumption. It is an offence for any butcher or retailer of pets' meat to have in his 80 possession any such meat which has not been dealt with as indicated. The Public Health Inspectors therefore visited all the pet shops in the area, examined the meat on sale and checked on the sources of supply. In each case it has been found that the meat on sale was horseflesh fit for human consumption, either from slaughterhouses undertaking the slaughter of horses where the meat is properly inspected and passed as fit for human consumption by a Public Health Inspector, or frozen horseflesh imported from abroad and accompanied by a Veterinary Certificate approved by the Ministry of Agriculture, Fisheries and Food. Food and Drugs Act, 1955 The Middlesex County Council is the Food and Drugs Authority for the Borough of Hendon and I am indebted to Mr. John A. O'Keefe, the Chief Officer of the Public Control Department, for the following report on the work of his Department during the year. "LIST OF SAMPLES PROCURED IN THE BOROUGH OF HENDON DURING THE YEAR I960 Articles Total Samples Procured Unsatisfactory Milk (Various) 187 Butter & Margarine 71 Cakes & Biscuits 4 Cream 26 Drugs 44 Pish & Pish Products 58 1 Fruit - Canned & Dried 7 Ice - Cream 17 Liver 16 Heat & Meat Products 90 Preserves 5 Soft Drinks, Fruit Juice etc. 9 Spirits 12 Sweets 12 4 Vinegar&non-brewed condiments 66 Miscellaneous 18 TOTALS 642 5 With regard to the samples noted on that list as being unsatisfactory, I add the 81 following comments:Fish A purchase of smoked haddock proved to be cod and the inexperienced manager of the shop from which the fish was purchased was cautioned. Sweets Three samples of milk chocolate brandy creams and one sample of rum truffles proved to be deficient in alcohol content. Investigation suggested that the alcohol content of such sweets declines rapidly with storage and whilst the alcoholic flavour remains, the actual alcohol content is difficult to determine. Negotiations were entered into with the manufacturers who agreed to alter the descriptions of the sweets concerned. Merchandise Marks Act, 1887-1953 The majority of inspection work carried out under the provisions of these Acts relates to insuring that the requirements of the various marking orders made under the provisions of the Act of 1926 are complied 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. Inspections were made at 248 premises of 958 displays of these foodstuffs. Most of the infringements detected were of a minor nature and were dealt with by verbal warnings. Stronger action however was taken in the following cases:- Legal proceedings were instituted against a butchery company for false trade descriptions of origin on Argentine steak. The company was fined £10 on each of two summonses and was ordered to pay £4. 4. Od. costs. Fifteen summonses were issued against a second butchery company for false trade descriptions of Australian and Argentine lamb and beef. The company cross summoned the manager of the shop concerned and was granted an absolute discharge whilst the manager was fined a total of £32 on sixteen summonses. Five summonses were issued against a third company for falsely describing the origin of Australian lamb. A fine of £1 on each summons was imposed. Twelve summonses were issued against another company for removing indications of origin from Chilean meat. Fines totalling £36 were imposed and an order for £12. 12. Od. costs was made, and a further company was fined £2 on each of two summonses and ordered to pay £2. 2. Od. costs for displaying Argentinean and Chilean meat not bearing an indication of origin. It will be apparent that in the early months of 1960 there was a high incidence of this type of offence in the borough of Hendon. Since these prosecutions, however, a considerable improvement in the labelling and marking of meat has been noted. Labelling of Food Order, 1953 This Order requires prepacked food to be marked with the name and address or with 82 the registered trade mark of the packer or labeller. It also requires such food to be labelled with its common or usual name (if any), and 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 658 articles of prepacked food was examined at 197 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 has equal effect within the subdistricts and work under this heading is combined with inspections made in connection with the Merchandise Marks Acts and the Labelling of Pood Order. Corrective action was sought, for example, where cream doughnut and jam cream sponge contained imitation cream; where oranges, grape fruit and tangerines were described as seedless but contained seeds, and where television and press advertisements falsely suggested that a cheese was a cream cheese. Special Designated Milks During 1960, 49 samples of designated milks were taken, all of which were certified to be satisfactory. One, Dealers' (Pasteurisers') licence in respect of premises within your area where milk is processed was issued. The premises were regularly inspected and compliance with the statutory requirements was well maintained. No infringements were reported during the year. Safe Milk In addition to the foregoing, five samples of raw milk were procured within your district and submitted to tests for the presence of tubercle baccilli. None was found contaminated." 83 APPENDIX Factories Acts, 1937-1939 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH IN RESPECT OF THE YEAR 1960 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 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 11 29 6 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 365 171 21 — (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out- workers' premises) 10 — — — TOTAL 386 200 27 — 2 - Cases in which DEFECTS were found (If defects are discovered at the premises on two, three or more separate occasions they should be reckoned as two, three or more "cases") 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) 9 7 - - - Overcrowding (S.2) 3 3 - - - Unreasonable temperature (S.3) 6 6 - - - Inadequate Ventilation (S.4) - - - - - Ineffective drains of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient 1 1 - - - (b) Unsuitable or defective 23 20 _ 2 — (c) Not separate for sexes - - - - Other offences against the Act (not including offences relating to Outwork) _ . - _ . TOTAL 42 37 - 2 - 84 Part VIII of the Act OUTWORK (Sections 110 and 111) Nature of Work Section 110 and Section 111 Number of Outworkers in August list required by Section 110(1) (c) Number of instances of work in unwholesome premises Wearing apparel - Making etc. Cleaning and Washing 87 2 Making of Curtains and furniture hangings 3 - Furniture making and upholstery 3 - brass and brass article - - Artificial flowers 5 - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 3 - making of Brushes - - Feather sorting - - Cosaques, Christmas Stockings, etc 4 - Making of Lampshades 7 - Household Linen 5 - Surgical Appliances 1 - Jewellery 2 - Stuff Toys 2 - Church Furnishing 1 - 123 2 85 Printed & Published by Hendon Borough Council.