BOROUGH OF HORNSEY. ANNUAL REPORT OF THE Medical Officer of Health AND School Medical Officer FOR 1939 R. P. GARROW, M.D , D.P.H. Printed by "The Horcusey Journal," Ltd., 161, Tottenham Lane. N.8. Borough of hornsey ANNUAL REPORT for 1939 of the Medical Officer of Health. 1 To the Mayor, Aldermen and Councillors of the Borough of Hornsey. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit my Annual Report on the health of the Borough for the year ending December 31st, 1939. The birth rate (11.39) and death rate (11.16) have remained almost stationary for the last decade, but the infant mortality rate has been reduced to the exceptionally low figure of 27 per 1,000 live births, as compared with an average of 53 for all towns in England and Wales of 50,000 population and over. There were no deaths from puerperal sepsis and only one from other puerperal causes. This gives a maternal mortality rate of 0.87 per 1,000 births, as compared with 2.82 for England and Wales. The notifications of and deaths from the common infectious diseases are also below the average. The year under review was disturbed in its first eight months by the ever-increasing menace of war and in its last four months by an actual state of war. Modern war imposes an immense strain on civil populations in numerous ways—there is the disturbance of family life and interference with education resulting from the evacuation of large numbers of children from dangerous to safer areas; the inconvenience of the black-out; the restriction of food supplies; and especially the abnormal conditions associated with sheltering from aerial bombardment. All of these carry potential dangers to the public health. In the circumstances it is a matter for congratulation that after fifteen months of war the health and morale of the population have never been higher. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, R. P. GARROW, Medical Officcr of Health. 31st December, 1940. 2 HEALTH COMMITTEE as at 31st December, 1939. Councillor L. J. Valette (Chairman), 59, Allison Road, N.8. The Mayor, Alderman H. G. J. Williams, J.P., 105, The Chine, N.21. Alderman S. G. Goulding, Woodlands, Cranlev Gardens, N.10. ,, W. W. Kelland, M.A., 14, Hillside Mansions, N.6. J. W. Rowlands, J.P., 25, Cholineley Park, N.6. ,, R. Steeds, 19, Coolhurst Road, N.8 ,, C. Wink ley, 72, Woodside Avenue, N. 10. Councillor Mrs. J. H. Barrenger, 18, Fordington Road, N.6. ,, Elliott E. Brooks, 122, Crouch Hill, N.8. Mrs. C. M. Cave, 10, Wood Vale, N.10. ,, J. Edwards, 102, Turnpike Lane, N.8. ,, W. J. Grimshaw, 25, Sheldon Avenue, N.6. ,, Mrs. M. N. Hill, 16, Bishopswood Road, N.6. ,, G. K. M. Hutchinson, 8, Grosvenor Gardens, N.10. ,, G. F. N. Norman, 12, Woodberry Crescent, N.10. ,, F. L. Pascoe, 110, Highgate Hill, N.6. ,, T. Tivendale, 12, Colney Hatch Lane, N.10. ,, W. V. Wall, 10, Winchester Place, N.6. ,, F. Wilders, 14, Summerland Mansions, N.10. 3 STAFF OF PUBLIC HEALTH DEPARTMENT †*Medical Officer of Health and School Medical Officer ... R. P. Garrow, m.d., d.p.h. †*Deputy Medical Officer of Health and Assistant Medical Officer of Schools and Maternity and Child Welfare Centres Jean Sutherland, m.b., ch.b., d.p.h., d.c.o.g. (Resigned 15th Nov., 1939.) 1 †*Assistant Medical Officer of Health and Assistant Medical Officer of Schools and Maternity and Child Welfare Centres Marian LONEs, b.SC., m.r.C.S., l.R.c.P., d.p.h., m.b. b.S. (Appointed 9th Mar., 1939.) ‡ Consultants (Puerperal Fever and Pyrexia Regulations) Dr. A. W. Bourne, 12, Wimpole Street, W.l. Dr. W. Mck. H. McCullagh, 149, Harley Street, W.l. Dr. L. H. W. Williams, 89, Harley Street. W.l. ‡Dentist (M. & C.W. Dental Scheme) H. A. Creeke, l.d.s. † *Senior Sanitary Inspector, Petroleum Inspector, Shops Acts Inspector, Young Persons Act Inspector. Factory Act Inspector Henry Eastwood, M.R.San.I. M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Foods. †*Sanitary Inspectors and Shops Acts Inspectors, Young Persons Act Inspectors, Factory Act Inspectors J. H. Jesse, M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Foods. J. D. Chance, M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Foods. W. J. Wilson, M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Foods. 4 †*Sanitary Inspectors and Shops H. Foster, Acts Inspectors, Young Perm.s.i.a. sons Act Inspectors, Factory Cert. R.San.I. Cert. Insp. of Meat and Foods. Act Inspectors (contd.) Cert. San. Science. Cert. Smoke Inspector. E. Hundy, M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Foods. R.. Downes, M.S.I.A. Cert. R.San.I. (Appointed Temporary, 1st December, 1939.) † Chief Clerk W. Gilroy. † Assistant Clerks E. Cheesman. N. Smith. Miss P. Aylward, W. A. Simons. (On Active Service from 27th October, 1939.) T. Hadley, (Appointed Temporary. 13th November, 1939.) † Health Visitors Mrs. E. Durnford, H.V. Cert., C.M.B. Miss A. Godden, H.V. Cert., S.R.N., C.M.B. Miss E. Hart, H.V. Cert., S.R.N., C.M.B. M iss E. K. Cumming, H.V. Cert., S.R.N., C.M.B. Mrs. L. Hatton, H.V. Cert., S.R.N., C.M.B. (Part time.) † Midwives Miss M. Andrews, c.m.b. Mrs. M. Jamison, c.m.b. Miss L. Hughes, c.m.b. † Mortuary Keeper C. F. Catlin. † Disinfectors W. H. Lewis. P. Hall. † Medical Services Motor Driver P. Martin. ‡ Veterinary Inspector under Diseases of Animals Acts F. G. Buxton, m.r.c.v.s. 15, Jackson's Lane, N.6. Note:—† Whole-time Officers. * Officers in respect of whom salary contribution is made under the Public Health Acts or by Exchequer Grants. ‡ Part-time Officers. 5 STATISTICS FOR 1939. (Section A). Social and Economic Statistics. Area (acres) 2,872 ,, (square miles) 4.49 Population (Census 1931) 95,524 Do., Registrar-General's estimate (mid 1939) — (a) Eor Birth rate 96,610 (b) For Death rate or incidence of notifiable diseases 90,780 Number of inhabited houses (end of 1939), according to Rate Books 23,688 Rateable value (General Rate) at 31st December £1,093,557 Product of a penny rate £4,225 *LIVE BTRTHS— Legitimate Males 553 ,, Females 501 Illegitimate Males 22 ,, Females 25 Total 1,101 Birth Rate 11.39 per 1,000 population (Registrar-General's estimate). STILL-BIRTHS— Legitimate Males 19 ,, Females 20 Illegitimate Males 1 ,, Females 1 Total 41 Rate per 1,000 total (live and still) births 35.9 *DEATHS— Males 483 Females 531 Total 1,014 Death Rate 11.16 per 1,000 population (Registrar-General's estimate). 6 Deaths of Infants under 1 Year of Age. Legitimate Males 15, Females 11 = 26 Illegitimate ,, 2, ,, 2=4 Total 30 Death Rate of Infants under 1 Year of Age. All infants per 1,000 live births 27.25 Legitimate infants per 1,000 legitimate live births 24.66 Illegitimate infants per 1,000 illegitimate live births 85 Deaths from Special Causes. Deaths from Cancer (all ages) 164 Deaths from Measles (all ages) 0 Deaths from Whooping Cough (all ages) 2 Deaths from Diarrhrea (under 2 years of age) 2 Note.—The following arrangements have been adopted by the Registrar General for the statistical treatment of Non-civilian Deaths and of Transferable Births and Deaths during the prevailing war conditions:— (1) Non-civilian deaths will not be assigned to local administrative areas, but will be tabulated for the whole of England and Wales and included as a separate class in the annual reports issued by this Office. N.B.—Non-civilians are defined as all males serving in H.M. Armed Forces. They do not include women serving in auxiliary corps, nor any members of A.R.P., auxiliary fire-brigade or other similar auxiliary or civil defence services. Deaths from Puerperal Causes. Deaths. Rate per 1,000 total (live and still) births. England and Wales.[/##] Puerperal sepsis 0 00.00 0.74 Other puerperal causes 1 0.87 2.08 Total 1 0.87 2.82 7 (2) Transferable Deaths.—Up to the 30th September, 1939, the pre-war practice of transference to area of usual residence has been maintained. From and after the 1st October, in the case of a person temporarily residing away from home on account of the war, the death will not be transferred to the area of usual residence, but will be assigned to the area of temporary residence. Where such a person dies in an Institution the assignment will likewise be to the area of temporary residence. (3) Transferable Births.—Up to the 30th September, 1939, the pre-war practice of transference to areas of the mother's usual residence has been maintained. From and after 1st October the primary assignment for the purpose of calculating Birth rates will be likewise in accordance with pre-war practice, but for the purposes of calculating Infant and Maternal Mortality a secondary assignment will be made corresponding to that adopted for deaths, viz., to the area in which a mother may be temporarily residing as a result of the war. (4) Population Estimates.— Separately computed popula tions appropriate for the calculation of Birth and Death rates based on the numbers of Births and Deaths resulting from the procedure set out will be supplied with the annual records. 8 GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA. (Section B). Under this heading the Minister of Health asks for an account of any developments or changes during the year, with an indication of those made owing to war, in— 1.—(a) Laboratory Facilities. (b) Ambulance Facilities. No Material (c) Nursing in the Home. Changes (d) Treatment Centres and Clinics. During 1939 (e) Hospitals: Public and Voluntary. 3.—(i) Midwifery Service (ii) Maternity Services (iii) Institutional Provision for Mothers Special or Children (iv) Health Visitors. Section (v) Child Life Protection. (vi) Dental, Orthopaedic, Etc., Treatment. LABORATORY FACILITIES. The specimens examined in the laboratory at the Isolation Hospital during 1939 were as follows:— Diphtheria specimens Negative. Positive. Total. 877 63 940 Sputum (T.B.) ,, 194 16 210 Swabs for Streptococci 30 48 78 ,, ,, Staphylococci 1 0 1 Other 16 3 19 Total 1,118 130 1,248 AMBULANCE FACILITIES. The ambulance arrangements with the London County Council for the transport of infectious cases, and the Council's ambulance for street accidents and general ambulance services, are unaltered and continue to be satisfactory and adequate. The "Morris Viceroy" motor conveyance for the transport of mentally and physically defective children, purchased in October, 9 1931, continues in service. It travelled 9,182 miles and 23,959 passengers were carried up to the beginning of September. At the outbreak of war the schools were closed and the conveyance was not again in use until the middle of December, when it was loaned to the A.R.P. casualty services for the conveyance of personnel. The following is a statement of the work done by the Borough Ambulance under the Fire Brigade up to 3rd September, 1939, and under the A.R.P. Medical Officer for the remainder of the year:— Calls- Accidents and illness in street 486 Private cases 784 1,270 Persons conveyed 1,268 Mileage 8,599 Hours ambulance was engaged 986 NURSING FACILITIES. BOROUGH OF HORNSEY NURSING ASSOCIATION. In view of the increasing amount of work being undertaken bv the Nursing Association, necessitating the employment of extra staff and provision of additional accommodation, the Council decided in March to increase their annual subscription to the Association's funds from £l00 to £l50 per annum. The following is a statement of the infectious diseases nursed during the year by the Queen's District Nurses: — TYPE OF CASE. Total No. of Cases. No. of Visits. No. Convalescent. No. sent to Hospital. No. Died at Home. Pneumonia 8 123 7 — 1 Tuberculosis 5 210 — 2 1 Influenza 22 154 19 1 — Scarlet Fever 6 90 4 2 — Diphtheric Throat 1 2 1 — — Other diseases in children under 5 44 141 44 — — Elementary School Children 43 160 43 — — 10 NURSING HOMES.—There are 10 Nursing Homes in the Borough registered with the Middlesex County Council under the Nursing Homes Registration Act, 1927. Eight of these, with a total of 58 beds, are registered for the reception of maternity cases. NORTH MIDDLESEX HOSPITAL.—The number of beds at North Middlesex Hospital is 1,426, a decrease of 4 since the last Annual Report. The number of maternity beds is normally 80, plus 24 antenatal. At the 31st December last there were 48 maternity beds but no ante-natal beds. The number of maternity cases from Hornsey admitted in 1939 was 127, as compared with 167 in 1938. HORNSEY CENTRAL HOSPITAL.— The Hospital normally has 61 beds, but the number has now been increased to 72. The Hospital is provided with up-to-date X-Rav and UltraViolet Ray Departments. There were 891 cases treated during the year, of which 714 belonged to the Borough. In addition, 3,077 out-patients were treated. The Council subscribes an annual sum of £200 to the Hospital funds. HORNSEY DEANERY ASSOCIATION.—An annual sum of £50 is subscribed by the Council to this Home for Unmarried Mothers in Eastern Road. OPEN-AIR SWIMMING POOL. The number of persons using the Pool was 54,932 as compared with 71,742 in 1938. The season-ticket holders numbered 337, a decrease of 101 on the figures for 1938. The satisfactory condition of the water is maintained by a system of filtration, aeration and chlorination, and regular inspections are made by the Medical Officer of Health. 11 SANITARY CIRCUMSTANCES OF THE AREA. (Section C.) SANITARY INSPECTION. The following statement of the work of the Sanitary Inspectors has been prepared by Mr. Henry Eastwood, Chief Sanitary Inspector:— Visits. Complaints 836 House-to-house inspections 325 Special inspections 557 Re-inspections 6,831 Families re-housed 59 Overcrowding surveys 63 Notifiable infectious diseases 237 Deaths 1 Scabies 11 Verminous houses 87 Shops Acts 1,406 Dairies and milkshops 33 Bakehouses 52 Slaughter-houses 23 Butchers shops 27 Restaurant kitchens 28 Other food shops 275 Factories and outworkers 176 Offices (workplaces) 10 Other workplaces 28 Cinemas, etc. 10 Petroleum stores 181 Rag Flock Act 5 Offensive trades (fish frying) 16 Annual licences (Music and Dancing) 27 Stables 3 Piggeries 4 Conveniences 4 Smoke observations 7 Sidings 2 Refuse tips 6 12 Passages 18 Drainage 149 Drainage Fee tests 1 2 Water tests applied (new drains) 60 Smoke and chemical tests applied (old drains) 80 Drains examined under Sees. 48 and 287. Public Health Act, 1936 3 11,648 NOTICES. The Notices served during the year are as follows: — Under the— Verbal Preliminary Statutory Public Health and Housing Acts 424 731 32 Housing Bye-laws — 53 15 Shops Acts 71 54 — Factory Acts — 3 3 495 841 50 SUMMARY OF SANITARY IMPROVEMENTS CARRIED OUT. Drainage. Number of houses and promises redrained 48 Repairs or amendments to existing drains 109 Drains or gullies unstopped or cleansed 43 Manholes provided 52 do. repaired 36 Intercepting traps fixed 4 New gulley traps fixed 99 New soil pipes and ventilating shafts fixed 55 Soil pipes and ventilating shafts repaired 25 Fresh-air inlets provided or repaired 37 13 Water-Closets and Sanitary Fittings. New water-closet buildings 6 New water-closet basins fixed 158 Water-closets unstopped, cleansed or repaired 52 New check cisterns fitted to water-closets; existing check cisterns repaired 60 New sinks provided 160 New lavatory basins provided 68 New waste-pipes fixed 143 Waste-pipes trapped, repaired or unstopped 116 Waste-pipes diverted into proper drain 12 Baths provided or made usable 51 Urinals cleansed 3 Miscellaneous. Roofs repaired 270 Eaves guttering renewed, cleansed or repaired 150 Rain-water pipes provided, repaired 100 Damp walls remedied 147 Damp-proof courses inserted 149 Paving of yards repaired 118 Premises structurally repaired 819 Rooms cleansed, distempered or papered 546 Premises disinfested of vermin 87 Drinking-water cisterns repaired, cleansed and covered 29 Water supply (additional) provided 6 Windows and skylights provided or made usable 93 Sub-floor ventilation 78 Floors repaired 107 Windowsills repaired 126 Sash cords and fittings repaired 206 Sanitary dustbins provided 75 Accumulations of manure and refuse removed 36 Stoves, ranges and coppers repaired or renewed 146 Sundry items 198 Food stores provided 9 4,832 14 Factories. Defects Remedied. Sanitary accommodation—Insufficient 1 Unsuitable or defective 1 Workrooms cleansed or repaired 8 Ventilation improved 2 Thermometer provided 1 13 FACTORY ACT, 1937. The new Factory Act, 1937, came into operation on the 1st July, 1938. It made certain changes, which niay be briefly summarised as follows:— (1) All workplaces affected bv the new Act are now termed Factories. (2) It contains provisions assigning to Local Authorities a share in the enforcement of certain general requirements relating to cleanliness, overcrowding, temperature, ventilation, drainage of floors and sanitary conveniences. The general rule that every Factory shall be kept in a clean state is supplemented by two new definite requirements:— (a) Accumulations of dirt and refuse must be removed daily from floors and benches of workrooms and from the staircases and passages. (b) The floor of every workroom must be cleaned at least once a week by washing or, if it is effective and suitable, by sweeping or other methods. Further— (c) The provisions as to cleaning or whitewashing or colour washing walls and tops of rooms, passages and staircases at least once in every 14 months are modernised and made more precise. The first essential was the appointment of the District Sanitary Inspectors as Inspectors for the purposes of the Factories Acts. 15 The second was the compilation of a new Register, including records of conditions found and action taken. Unfortunately about this time there was a surfeit of new legislation, which included the new Public Health Act and the new Shops Acts as examples, bringing new duties in their train. In spite of this, however, progress was made and the Register was completed. Since the outbreak of war, however, little could be done to keep the Register up to date, owing to A.R.P. and other requirements. The number of Factories inspected during the year is 122 and the defects found, which were relatively small, are those recorded in the Appendix. BASEMENT BAKEHOUSES. There are three basement or semi-basement bakehouses in the Borough and these have been examined as to their suitability for use as such, as regards construction, height, light, ventilation, etc. The Council being satisfied that the bakehouses were suitable as regards the matters aforesaid, certificates under the Factories Act. 1001. were allowed to continue to operate so long as the bakehouses may otherwise lawfully be used, but without prejudice to the power of the Council to revoke the certificates as a result of subsequent examinations nnder the Act. 16 BYELAWS RELATING TO HOUSES INTENDED OR USED FOR OCCUPATION BY THE WORKING CLASSES AND LET IN LODGINGS OR OCCUPIED BY MEMBERS OF MORE THAN ONE FAMILY. The number of lodging-houses on the register at the end of the year was 575. Fifty-three houses have been dealt with under these Byelaws during the year and the following works carried out:— Byelaw. 4 (b) Water supplies 2 4 (c) Washing accommodation 4 4 (d) Food stores 71 5 (b) Means of carrying off waste water 8 5 (f) Ventilation to the bedroom and room with cooking apparatus 4 5 (h) Handrails provided 3 92 Offices. The number inspected and recorded is 201. Generally speaking, the class of office in this Borough is excellent and it is pleasing to report that in no instance was action necessary. CLEANSING AND DISINFECTING STATION. Cleansing Station. Thirty-four children and 19 adults have been treated at the Station for scabies and 3 adults for verminous heads. One hundred and sixty-five school children were treated for verminous heads under arrangements made by the Local Education Authority. 17 I Disinfecting Station. Work done by disinfectors:— Disinfection. Premises disinfected after notifiable infectious diseases 270 „ ,, ,, non-notifiable diseases 89 „ T.B 33 ,, ,, ,, death 89 ,, ,, ,, other diseases 12 No. of articles disinfected 3,984 ,, ,, destroyed 244 ,, rooms disinfected 447 Collection and disinfection of library books:— Received. Returned. Destroyed. Public Libraries 121 121 — School Libraries 41 41 — Private Libraries 47 22 25 Disinfestation. Premises infested- with bugs 87 ,, ,, ,, cockroaches 2 ,, ,, , ants 6 ,, wasps 2 flies 1 ,, ,, ,, insects under floor 1 ,, ,, ,, moth 6 Miscellaneous. Conveyance of drain-testing apparatus 57 Milk samples taken to laboratory for analysis 18 Visits to Welfare Centres 105 Conveyance of A.R.P. apparatus 875 A.R.P. blankets disinfested 1,365 18 HOUSING STATISTICS. (Section D). The housing statistics of the year as required by the Ministry of Health are set out below:— 1. Inspection of Dwelling-houses during the Year: — (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 1,604 (b) Number of inspections made for the purpose 5,733 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 325 (b) Number of inspections made for the purpose 371 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation — (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 937 2. Remedy of Defects during the Year without service of formal Notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 912 3. Action under Statutory Powers during the Year:— A.—Proceedings under Sections 17, 18 and 23 of the Housing Act, 1930:— (1) Number of dwelling-houses in respect of which notices were served requiring repairs (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners (b) By local authority in default of owners — 19 B.—Proceedings under Public Health Acts: — (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 28 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 25 (b) By local authority in default of owners — C.—Proceedings under Sections 19 and 21 of the Housing Act, 1930:— (1) Number of dwelling-houses in respect of which Demolition Orders were made 11 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders — D.—Proceedings under Section 20 of the Housing Act, 1930:— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 1 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit — 4. Housing Act, 1936. Overcrowding: (a) (i) Number of dwellings overcrowded at the end of the year 25 (ii) Number of families dwelling therein 27 (iii) Number of persons dwelling therein 165 (b) Number of new cases of overcrowding reported during the year 2 (c) (i) Number of cases of overcrowding relieved during the year 37 (ii) Number of persons concerned in such cases 251 20 HOUSE-TO-HOUSE INSPECTIONS. The number of house-to-house inspections has been higher, but the withdrawal of the inspectors from their duties for A.R.P. service in September and the shortage of materials militated against the carrying out of the sanitary work required. Ward. Road. No. Highgate Orchard Road 9 North Road 34 North Hill 4 Muswell Hill Fortis Green Cottages 11 Fields Cottages 2 Woodside Cottages 5 Crouch End Park Road 63 Central Hornsey Myddelton Road 45 Boyton Road 8 Brook Road 30 North Haringey Alexandra Road 3 Turnpike Lane 2 Stroud Green Montague Road 19 Spencer Road 33 Hanbury Road 21 Enfield Road 27 Finsbury Park Osborne Grove 9 Total 325 OTHER HOUSING ACTIVITIES. (1) COMPULSORY PURCHASE. — The Hornsey (Camps- bourne) Compulsory Purchase Order, 1939. involving houses in Brook and Boyton Roads, received the sanction of the Minister of Health following an inquiry held at the Town Hall in May. (2) DEMOLITION AND RE-HOUSING.—Demolition notices were served in respect of 1, 2, 3, 4. and 5, Constitution Hill, 1, 2 and 3, School Place, and 39, 41 and 43, 21 Southwood Lane, and re-bousing of the displaced tenants so far as practicable was carried out by the Borough Council. (3) VOLUNTARY DEMOLITION.—Two cottages in Fortis Green, known as Margaret Cottage and Rose Cottage, were demolished by the owners and the site has since been converted into a private car park. (4) CLOSING OF BASEMENT ROOMS.—No. 5, Haringey Grove.—The owner of this cottage gave written undertaking not to use the basement rooms as living or sleeping rooms, owing to their dark and damp condition. Nos. 65-85, Park Road.—The agents agreed to discontinue the use of the basement rooms as far as practicable for living or sleeping purposes and definitely to disuse them when they became empty. During the year 27 houses were erected and 23 houses converted into flats, by private enterprise. No houses or flats were erected by the Council. The Council re-housed 45 families, representing 192 persons, from various roads in the Borough. INSPECTION AND SUPERVISION OF FOOD. (Section E.) Dairies and Milkshops. At the end of the year the register showed 55 shops classed as dairies and 75 classed as milkshops, the principal trade of which is not dairy produce. Of the dairies, 32 are situated outside and operate also inside the Borough. The dairies and milkshops have been inspected periodically and a high standard of cleanliness continues to exist. These inspections have been amplified by the taking of 18 informal samples for bacteriological examination during the year. There are no cowsheds in the Borough. 22 Special Designated Milk Licences. Producers of, and dealers in, special designated milks are required to obtain licences annually. During the year licences were in force as follows: — Sale of Pasteurised Milk 16 ” ” (Supplementary) 3 ” T.T. ,, 5 ,, ,, ,, (Supplementary) 3 Meat and Other Foods. Under the Public Health (Meat) Regulations, 1924, notice of intention to slaughter animals has to be sent by the butchers to the Medical Officer of Health. In this way the Inspectors are enabled to examine the carcase and organs of every animal killed for human consumption. During the year the carcases and meat offal of 178 animals have been inspected under the Regulations. Meat offal weighing 11 lbs. was condemned, surrendered and destroyed. The following were also condemned and destroyed:— Article. Reason. Weight. 6 Tins of Ham Putrefaction 50 lbs. 1 Case of Haddock Putrefaction 91 lbs. 1 Leg of Lamb Caseous Lymphangitis 3½ lbs. 1 Flank and Topside of Fibrosis of the 36 lbs. Argentine Beef Musculature Total 180½ lbs. Articles of food brought from London markets and found to be unsound on arrival at their destination are submitted for examination, condemned, surrendered and destroyed, and a "condemnment" note is given, which enables the dealer to obtain credit from the wholesaler. This arrangement is quite good and results in prompt notification. 23 FOOD AND DRUGS ACT, 1938. REGISTRATION OF PREMISES USED IN CONNECTION WITH THE MANUFACTURE AND/OR SALE OF ICE-CREAM OR PRESERVED FOODS, &c. (a) For the sale or the manufacture for the purpose of sale of ice-cream or the storage of ice-cream intended for sale 61 (b) For the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale (for the purpose of this sub-section the preparation of meat or fish by any process of cooking shall be deemed to be the preservation thereof) 57 MIDDLESEX COUNTY COUNCIL (GENERAL POWERS) ACT, 1938. REGISTRATION OF HAWKERS OF MEAT, FISH, FRUIT AND VEGETABLES, AND PREMISES USED BY HAWKERS. Hawkers 28 Premises 23 INFECTIOUS DISEASES. (Section F.) The incidence of twenty of the common and uncommon infectious diseases in the Borough for a period of 29 years is set out in Table G. MEASLES AND WHOOPING COUGH. These two infectious diseases were made notifiable under the Measles and Whooping Cough (Provisional) Regulations, 1939, as from 23rd October, 1939. DIPHTHERIA IMMUNISATION. The Saturday morning monthly clinic for immunisation of children against diphtheria, started in 1936, is held at each of the four Welfare Centres in rotation. 24 At the end of 1938 . 8,058 children had been injected and there were 817 completed cases, i.e., each receiving the requisite three injections. The following table shows the figures for 1939: — Total injections. Completed Cases. Town Hall Centre ... 1,455 422 Wightman Road Centre ... 1,204 360 Highgate Centre ... 239 97 Coldfall Sub-Centre ... 831 129 3,729 1,008 Three injections, each of 1 c.c. Burroughs Wellcome T.A.F., are given at intervals of one month. VACCINATION. The Public Vaccinators inform me that they performed vaccination of persons in the Borough during 1939 as follows:— Dr. E. Buckler 121 Drs. A. Dickie and Mackay 234 PREVENTION OF BLINDNESS. (PUBLIC HEALTH ACT, 1925, SECTION 66.) Seven cases of ophthalmia neonatorum were notified. Three were treated in hospital and four were nursed at home. All the hospital cases were in-patients of North Middlesex County Hospital. There was no case of blindness resulting from this infection. Cases Vision unimpaired. Vision impaired. Total blindness. Deaths. Notified. Treated. At home. In hospital or nursing home. 7 4 3 7 0 0 0 25 TUBERCULOSIS. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS. No occasion has arisen in the course of the year to put these powers into action. Sanatorium provision for all forms of Tuberculosis in Hornsey is made by the Middlesex County Council. There are 411 beds available solely for Middlesex under the Middlesex County Council scheme for the treatment of Tuberculosis in sanatoria, namely: — Harefield Sanatorium, Uxbridge 189 beds For Clare Hall Sanatorium, South Mimms 177 ,, pulmonary White House. Milford, Hants. 39 ,, cases Victoria Home, Margate 6 ,, For non- pulmonary cases Pulmonary and non-pulmonary cases in excess of these numbers are maintained by the County Council in sanatoria and hospitals in various parts of the country. The total number of cases on the Tuberculosis Register at the end of 1939 was 844, viz., pulmonary 641, non-pulmonary 203, a decrease of 2 on the total for last year. A table showing the history of eases of Tuberculosis during the year will be found on Table H. MORTUARY. Eighty-five bodies were received at the mortuary and inquests held on 31 of them. DISEASES OF ANIMALS ACT. Mr. F. G. Buxton, the Veterinary Inspector, has kindly supplied me with details of his work in the Borough under the Diseases of Animals Acts and Orders during 1939 as follows:— Inspections made under the Diseases of Animals Acts 12 Animals inspected 251 pigs Removal Licences issued 29 No action was necessary under the Tuberculosis Order, 1925. 26 PETROLEUM INSPECTOR'S REPORT. The total number of licences issued for the storage of petrol for the year is 75 and the quantity of petrol stored under licence 102,104 gallons, 99,850 gallons in steel tanks, mostly underground, and 2,254 gallons in sealed two-gallon cans. Hydro-Carbon. One licence was issued for the storage of 100 gallons of hydro-carbon. Naphtha. One licence was issued for the storage of 2,000 gallons of naphtha. Cellulose Spirit. Two premises were licensed for the storage of 90 gallons of cellulose spirit. Carbide of Calcium. There was one premises licensed for the storage of 10 cwts. of carbide of calcium. H. EASTWOOD, Chief Sanitary Inspector and Petroleum Inspector. 27 LIST OF TABLES. TABLE A.—Vital Statistics, 1911-39. TABLE B.—Causes of, and ages at, death in 1939. TABLE C.—Summary of causes of death, 1931-1938. TABLE D.— Infant Mortality in 1939. Causes of, and ages at, death. TABLE E. Births, Deaths, Infant Deaths, and Deaths from certain diseases, 1911-1939. TABLE F.—Cases of Infectious Disease notified in 1939. TABLE G.—Cases of Infectious Disease notified 1911-1939. TABLE H. -(1) Notification of, and deaths from, Tuberculosis, 1939. ,, (2) Tuberculosis Register, 1939. TABLE I.—Inspection of Factories, Outworkers, etc. 1939. 28 TABLE A. BOROUGH OP HORNSEY VITAL STATISTICS, 1911.1939. Year Estimated Mid.Year Population. Birth Kate per 1,000 Population. Death Kate per 1,000 Population. Infant Mortality per 1,000 live Births. 1811 84,592 (Census). 17.5 9.6 78 1912 84,840 16.3 9.9 75 1913 85,122 16.7 9.7 56 1914 85,456 17.8 9.2 57 1915 85,800 15.5 12.2 80 1916 86,147 16.0 11.5 46 1917 86,450 11.3 10.9 70 1918 86,942 11.7 13.8 61 1919 87,100 13.6 11.4 64 1920 87,410 19.3 10.3 54 1921 87,691 (Census). 16.7 11.0 49 1922 88,007 15.4 11.2 54 1923 88,325 14.4 10.5 51 1924 88,661 13.4 10.4 41 1925 89,064 13.6 10.6 43.6 1926 89,850 13.4 10.3 47.2 1927 90,000 13.3 11.2 38.3 1928 90,250 12.1 12.1 61.3 1929 90,500 Regr..Gen.'s Estimate. 88,450 13.8 12.7 54.05 1930 88,450 13.7 11.8 41.35 1931 Census. 95,524 11.9 11.2 52.6 1932 Regr-.Gen.'s Estimate 96,990 11.37 11.45 46.2 1933 96,070 10.85 12.2 43.2 1934 95,306 11.07 11.68 37.91 1935 95,330 11.83 10.84 48.7 1930 96,160 12.0 11.98 40.0 1937 96,520 12.07 11.95 45.49 1938 96,680 12.38 11.26 32.58 1939 (a)96,610 (b)90,780 11.39 11.16 27.25 ENGLAND and WALES (Rates in 1939) 15.0 12.1 50 126 County Boroughs and Great Towns, including London (Rates in 1939) 14.8 12.0 53 148 Smaller Towns Populations 25,000 to 50.000 (Rates in 1939) 15.6 11.2 40 London (Rates in 1939) 12.3 11.9 48 Total. All ages 0-1 1-2 2-5 5-15 15-25 25-35 35-45 45-55 55-65 65-75 75 & over M F M F M F M F M F M F M F M F M F M F M F M F 1. Typhoid and paratyphoid fevers 1 0 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 2, Measles 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 3. Scarlet Fever 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 4. Whooping cough. 2 2 0 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 5. Diphtheria 4 4 0 ... ... ... ... 1 ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 6. Influenza 17 4 13 1 ... ... ... ... ... ... ... ... ... ... ... ... 2 1 2 ... 2 1 4 1 3 6 7. Encephalitis lethargica 1 1 0 ... ... ... ... ... ... ... ... ... ... ......... ... ... ... ... ... 1 ... ... ... ... ... 7 8. Cerebrospinal fever 2 I 1 ... ... ... ... ... ... 1 1 ... ... ... ......... ......... ... ... ... ... ... ... ... ... ... 8 9. Tuberculosis of respiratory system 51 29 22 ... ... ... ... ... 1 ... 1 4 6 3 7 4 3 7 1 5 3 5 ... ... ... 9 10 10. Other tuberculous diseases 3 1 2 ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... 11. Syphilis 3 2 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... 11 12. General paralysis of the insane, tabes dorsalis 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 13. Cancer, malignant disease 164 77 87 ... ... ... ... ... ... ... ... ... ... 3 1 3 10 10 11 18 12 24 26 19 27 13 14. Diabetes 20 7 13 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 4 5 4 1 4 14 15. Cerebral haemorrhage, etc. 56 24 32 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 1 4 3 11 12 7 15 15 16 Heart disease 329 140 189 ... ... ... ... ... ... ... ... 2 ... ... 4 ... 4 8 7 22 21 55 42 52 111 16 17. Aneurysm 4 3 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 1 ... ... 17 18. Other circulatory diseases 57 31 20 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 5 7 12 3 13 15 18 19. Bronchitis ... 17 7 10 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 3 3 7 19 20. Pneumonia (all forms) 51 32 19 4 ... 1 ... 1 1 ... ... ... ... ... ... 4 3 4 1 8 2 4 6 5 5 20 21 Other respiratory diseases 5 3 2 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 ... 1 ... ... 1 21 22. Peptic ulcer 15 12 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 4 1 2 1 4 1 22 23. Diarrhoea, etc. 4 0 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... 23 24 Appendicitis 13 4 9 ... ... 1 ... ... 1 ... ... 1 1 ... 1 ... 2 ... ... 1 1 1 1 ... 2 24 25. Cirrhosis of liver 2 2 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... 25 26. Other diseases of liver, etc. 4 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 1 1 26 27. Other digestive diseases 9 4 5 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 2 ... 1 2 ... 2 27 28. Acute and chronic nephritis 25 7 18 ... ... 1 ... ... ... 1 ... ... 1 ... 1 ... 3 ... ... 1 1 2 10 2 2 28 29. Puerperal sepsis 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 29 30. Other puerperal causes 1 0 1 ... ... ... ... ... ... ... ... ......... ... ... 1 ... ... ... ... ... ... ... ... ... ... 30 31. Congenital debility, premature birth, malformations, etc. 20 12 8 11 8 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 31 32. Senility 9 3 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 6 32 33. Suicide 16 11 5 ... ... ... ... ... ... ... ... ... ... 2 2 2 1 1 2 2 ... 4 ... ... ... 33 34. Other violence 37 20 17 ... 1 ... ... 1 ... ... 1 6 ... ... 1 ... ... ... ... 1 1 2 3 5 10 34 35. Other defined diseases 72 38 34 ... ... ... ... ... ... ... ... 2 1 3 7 2 ... ... 5 7 10 11 13 10 35 36. Causes ill-defined or unknown 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 36 Totals 1,014 483 53l 17 13 5 1 3 4 6 3 17 8 16 21 21 33 37 30 88 67 143 129 222 Special causes included in 35 above , Small-pox Poliomyelitis Polioencephalitis 29 TABLE C—CAUSES OF, AND AGES AT, DEATH, 1931-1938. All Ages 1931 All Ages 1932 All Ages 1933 All Ages 1934 All Ages 1935 All Ages 1936 All Ages 1937 All Ages 1938 M F M F M F M F M F M F M F M F 1. Typhoid and paratyphoid lever ... ... ... ... ... ... ... ... 1 ... ... 2 ... ... ... 1 2. Measles ... ... 3 3 ... ... 4 1 1 ... 2 1 ... 1 3 3 3 Scarlet Fever ... 1 ... ... ... ... 1 1 ... ... 1 ... ... 1 ... ... 4. Whooping cough ... 2 1 2 2 1 1 1 ... ... 1 1 2 1 1 3 5. Diphtheria 2 3 ... 4 1 1 ... 2 ... 1 ... 1 ... 1 1 3 6. Influenza 7 16 11 20 20 25 5 3 7 8 6 7 17 23 4 5 7 Encephalitis lethargica ... 1 ... ... 1 2 1 ... 1 ... 2 2 ... ... 1 ... 8. Cerebro-spinal fever ... ... ... 1 ... ... 1 ... ... ... 1 ... ... ... ... ... 9. Tuberculosis of respiratory system 21 31 23 ... 25 19 27 32 27 27 36 22 27 16 21 16 10 Other tuberculous diseases 3 2 3 31 11 9 7 ... 6 8 4 1 9 2 7 7 11. Syphilis 1 3 ... 6 ... 1 ... 1 3 ... 1 ... 3 ... 2 ... 12. General paralysis of the insane, tabes dorsalis 3 ... 4 3 4 ... 6 ... 4 ... 3 1 5 1 3 1 13 Cancer, malignant disease 72 107 66 94 75 96 64 112 78 92 83 98 82 97 73 86 14. Diabetes 4 12 3 10 8 14 6 7 5 11 6 13 6 10 5 12 15. Cerebral haemorrhage, etc. 17 52 25 40 23 28 23 35 12 24 18 34 17 33 20 32 16. Heart disease 110 150 109 181 117 163 111 174 103 168 137 195 153 154 144 204 17. Aneurysm 2 ... 4 1 2 3 ... 3 4 1 7 3 5 2 3 2 18. Other circulatory diseases 25 29 24 22 22 31 31 43 24 21 23 42 24 35 25 38 19. Bronchitis 15 15 21 8 13 18 14 16 13 14 16 17 11 18 10 10 20. Pneumonia (all forms) 28 40 32 34 34 46 34 39 29 37 31 27 43 37 24 39 21. Other respiratory diseases 5 6 9 8 3 3 6 2 6 2 1 7 8 6 3 1 22. Peptic ulcer 7 4 8 3 8 2 11 2 11 4 8 2 11 8 12 4 23. Diarrhoea, etc. 2 3 4 4 4 6 4 1 13 3 4 6 8 4 5 2 24. Appendicitis 3 4 2 5 6 2 2 6 2 5 7 4 7 2 7 5 25. Cirrhosis of liver 2 1 5 2 1 ... 5 1 0 3 3 1 1 1 2 1 26. Other diseases of liver, etc. 3 1 3 1 1 2 3 4 1 3 4 6 1 2 2 5 27 Other digestive diseases 10 10 7 14 10 17 15 13 11 12 15 16 5 10 9 11 28 Acute and chronic nephritis 19 15 12 14 13 14 18 9 16 16 13 22 17 21 8 18 29. Puerperal sepsis ... 2 ... 4 ... 1 ... 2 ... 2 ... 1 ... 1 ... ... 30. Other puerperal causes ... 3 ... 2 ... 3 ... 1 ... 1 ... 2 ... 2 ... 3 31. Congenital debility, premature birth, malformations, etc. 24 16 15 17 17 10 14 14 18 13 13 12 25 16 12 13 32 Senility 8 11 10 24 5 17 8 16 5 16 10 14 5 10 ... 14 38. Suicide 9 2 9 2 12 4 14 6 4 7 5 4 13 8 7 7 84. Other violence 16 13 25 18 22 17 24 18 15 22 17 25 17 11 13 21 35. Other defined diseases 44 41 48 47 41 45 53 34 45 46 44 41 48 48 36 59 36. Causes ill-defined or unknown ... ... ... ... ... 1 ... ... 1 1 ... ... ... 1 ... ... Totals 462 596 486 625 501 601 515 599 466 568 522 630 5 70 583 463 626 1.058 1.111 1.102 1.114 1,034 1,152 1.153 1,089 30 TABLE D. INFANT MORTALITY, 1939. CAUSES OF DEATH. Deaths from stated causes at various Ages under One Year of Age. Total Deaths under One Under 1 Day Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks Total under 4 Weeks. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. M F M F M F M F M F M F M F M F M F M F M F Premature Birth 1 3 4 2 ... ... ... ... ... ... 5 5 ... 1 ... ... ... ... ... ... 5 6 Injury at Birth 1 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 1 1 Inattention at Birth ... 1 ... ... ... ... ... ... ... ... 0 1 ... ... ... ... ... ... ... ... 0 1 Congenital Malformation ... ... ... 1 ... ... ... ... ... ... 0 1 1 ... 1 ... 1 ... ... ... 3 1 Pneumonia ... ... 1 ... ... ... ... ... ... ... 1 0 2 ... ... 1 1 ... ... ... 4 1 Influenza ... ... ... ... ... ... ... ... ... ... 0 0 ... ... ... ... ... ... 1 ... 1 0 Bronchitis ... ... ... ... ... ... ... ... ... ... 0 0 1 ... ... ... ... ... ... ... 1 0 Diarrhoea ... ... ... ... ... ... ... ... ... ... 0 0 ... 2 ... ... ... ... ... ... 2 0 Atelectasis 1 ... ... ... ... ... ... ... ... 1 0 ... ... ... ... ... ... ... ... 1 0 Icterus Neonatorum ... ... ... ... 1 ... ... ... ... ... 1 0 ... ... ... ... ... ... ... ... 1 0 Syphilis ... ... ... ... ... ... ... 1 ... ... 0 1 ... ... ... ... ... ... ... ... 0 1 Total 3 5 5 3 1 0 0 1 0 0 0 9 4 3 1 1 2 0 1 0 17 13 30 31 TABLE E. BIRTHS, DEATHS, INFANT DEATHS, AND DEATHS FROM CERTAIN DISEASES, 1911-1939. YEAR. Population Total Live Births Total Stili Births Total Deaths Total Infant Deaths (under one year, Deaths from Measles Deaths from Whooping Cough Deaths from Diarrhoea (under two yrs. Deaths from Scarlet Fever Deaths from Diphtheria Deaths from Typhoid Fever Deaths from Cancer ( Deaths from Tuberculosis (Pulmonary Deaths from Tuberculosis (NonPulmonary) 1911 Census 84,592 1.479 ... 812 116 20 15 35 1 6 1 103 55 23 1912 1,385 ... 840 105 5 2 13 3 2 2 114 43 17 1913 1,4'.'5 ... 821 81 12 8 12 0 4 3 96 55 14 1914 1,529 ... 791 88 1 4 21 1 7 1 82 44 10 1915 1,894 ... 1,007 112 37 7 23 3 11 2 99 58 19 1916 1,404 ... 928 64 0 5 8 0 11 1 106 84 20 1917 1,038 ... 906 73 14 6 3 0 6 0 113 58 25 1918 1,037 ... 1,094 64 6 13 7 2 8 0 130 76 13 1919 1,188 ... 992 76 0 0 6 2 3 1 119 66 11 1920 1,707 ... 903 93 4 7 7 3 20 2 119 61 12 1921 87,691 1,468 ... 968 72 1 2 15 3 13 0 136 74 12 1922 1,372 ... 992 72 3 7 3 3 7 0 143 60 13 1923 1,217 ... 928 64 4 1 5 1 4 1 130 47 11 1924 1,189 ... 928 48 2 2 1 1 2 0 146 55 7 1925 1,214 ... 946 53 1 8 3 0 1 0 143 48 7 1926 1,206 ... 928 57 8 3 2 0 1 1 117 59 8 1927 1,201 ... 1,012 46 0 0 4 1 6 1 131 58 6 1928 1,191 ... 995 73 6 1 3 2 6 1 132 59 10 1929 1,2? 1 ... 1,128 67 0 13 2 0 7 0 143 58 15 1930 1,209 45 1,047 50 4 0 10 2 4 0 ] 56 57 7 1931 95,524 R.-Gen.'s Estimate 1,139 44 1,058 60 0 2 5 1 5 0 179 52 5 1932 96,990 1,103 38 1,111 51 6 3 8 0 4 0 160 54 9 1933 96,070 1.041 41 1,102 45 0 3 6 0 2 0 171 14 20 1934 95,806 1.055 35 1,114 40 5 2 2 2 4 0 176 59 7 1935 95,330 1,128 36 1,034 55 1 0 15 0 1 1 170 54 14 1936 96,160 1,155 31 1,152 47 3 2 8 1 1 2 181 58 5 1937 96,520 1,165 34 1,153 53 I 3 6 1 1 0 179 43 11 1938 96,680 1,197 45 1,089 39 6 4 4 0 4 1 159 37 14 1939(a) (b) 96.610 90,780 1,101 41 1,014 30 0 2 2 0 4 1 164 51 3 32 DISEASE WARDS Total Admitted to Joint Hospital Admitted to other Hospitals In Nursinl Home. ' Nursed at Home. Registered Deaths  Highgate Muswell Hill. Crouch End Central Hornsey North Haringey South Haringey Stroud Green Finsbury Park. 0— l 1-5 5— 15 15— 25 25— 45 45— 65 65 and over Scarlet Fever 13 21 8 17 11 14 32 46 0 23 115 17 6 1 0 162 124 12 0 26 0 Diphtheria 2 16 1 21 5 1 11 5 1 18 36 3 3 1 0 62 56 2 0 4 4 Typhoid Fever 1 0 0 0 0 0 0 0 0 0 o 0 0 1 0 1 0 1 0 0 1 Pneumonia 6 12 2 13 9 5 15 2 0 2 6 4 20 21 11 64 1 23 1 39 51 Erysipelas 3 7 2 5 1 0 10 2 1 0 0 1 9 13 6 30 13 2 0 15 0 Puerperal Pyrexia 1 3 1 2 0 1 3 4 0 0 0 4 11 0 0 15 0 14 0 1 0 Ophthalmia Neonatorum 1 0 0 1 3 0 1 1 7 0 0 0 0 0 0 7 0 4 0 3 0 Pemphigus Neonatorum 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 1 0 0 0 Cerebrospinal Meningitis 2 0 1 1 0 1 0 0 0 2 2 0 1 0 0 5 2 2 1 0 2 Dysentery 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 Measles 1 1 0 1 0 1 1 0 0 1 3 0 1 0 0 5 0 0 0 5 0 Whooping Cough 0 1 0 0 2 0 0 0 0 0 3 0 0 0 0 3 0 0 0 3 2 30 61 15 62 31 23 73 61 10 46 165 30 51 37 17 356 197 61 2 96 60 Tuberculosis : Pulmonary 19 20 6 24 17 11 19 10 0 2 3 41 52 23 5 126 NorPulmonary 2 3 1 4 3 2 3 0 0 1 6 5 6 0 0 18 TOTAL 51 84 22 90 51 36 95 71 10 49 174 76 109 60 22 500 Admitted to Joint Isol. 9 35 9 32 14 12 40 46 Hospital Other Hptls 14 8 1 12 4 5 10 7 Nursing Homes 2 0 0 0 0 0 0 0 Nursed at Home 5 18 5 18 13 6 23 8 The following 50 cases were treated in the Isolation Hospital in addition to the above:—Mumps 2, 1 Enteric fever found to be T.B., Whooping cough and pneumonia 4, Whooping cough 3, Whooping cough and Gastro-enteritis 1, Whooping cough, laryngitis and bronchitis 1, Scabies 3. Chicken-pox 1, German measles 8, Pneumonia and Otitis media 1, Mastoiditis 1, Disseminated sclerosis 1, Herpes ophthalmicus 1, Vincent's Angina 1, Pyelitis 1, Follicular tonsillitis 10, Toxic rash 1. Furuncle 1, Cold 4, Reaction to immunisation 1, Dietetic upset 1, Gastritis 1, Headache due to constipation 1. 33 Excluding T.B. TABLE G—NOTIFICATIONS OF INFECTIOUS DISEASES. 1911-1939. Year. Population. Estimated Scarlet Fever. Diphtheria or Croup. | Typhoid Fever. Para Typhoid. § Puerperal Fever. Puerperal Pyrexia. Erysipelas. Cerebro Spinal Meningitis. Polio-Myelitis. Ophthalmia Neonatorum. Pemphigus 1 Neonatorum. Malaria. Dysentery. Encephalitis Lethargica. Polio Encephalitis. Pneumonia. Small-pox. Measles. Whooping Cough. German Measles. Total Attack rate per 1,000 population. 1911 84,592 (Cens'us) 179 133 6 ... 2 ... 40 ... ... ... ... ... ... ... ... ... 1 ... ... ... 361 4.2 1912 84,840 138 88 9 ... 3 ... 39 1 1 ... ... ... ... ... ... ... ... ... ... ... 279 3.2 1313 85,122 206 115 10 ... 2 ... 20 ... ... ... ... ... ... ... ... ... ... ... ... 359 4.2 1914 85,456 340 101 9 ... 1 ... 24 ... ... 11 ... ... ... ... ... ... .... ... ... 492 5.7 1915 85.800 182 105 18 ... 5 ... 35 9 3 l ... ... ... ... ... ... ... ... ... ... 358 4.1 1916 86,147 103 77 8 1 32 2 6 9 ... ... ... ... ... ... ... 207 281 726 2.7 * 1917 80,450 132 66 4 ... 1 ... 28 4 ... l ... ... ... ... ... ... ... 1,227 881 2,344 2.7 * 1918 80.942 89 67 8 ... 2 ... 23 1 3 2 ... ... ... ... ... ... ... 796 119 1,110 2.3 * 1919 87,100 203 87 6 ... 4 ... 42 4 1 5 ... 21 2 5 ... 112 ... 224 285 1,001 5.7 * 1920 87,410 245 149 6 ... 2 ... 27 1 3 8 ... 10 2 4 ... 98 ... Not now notifiable 555 0-3 1921 87,091 (Census) 591 189 2 ... 2 ... 36 ... 2 6 ... 1 1 6 ... 42 ... 878 101 1922 88,007 286 123 1 ... 2 ... 24 ... ... 10 ... 1 ... 1 ... 104 ... 552 62 1923 88,835 126 133 1 ... ... ... 24 2 ... 6 ... 4 ... 2 ... 75 ... 373 4.2 1924 88,601 215 40 3 ... 1 ... 26 ... 1 1 ... ... ... 11 ... 61 ... 359 4.0 1925 89.004 126 53 10 ... 1 ... 26 2 2 4 ... 1 1 7 ... 60 ... 293 3.3 1920 89,850 140 116 4 ... 4 6 22 ... 2 8 ... ... ... 6 ... 56 ... 364 40 1927 90,000 179 92 6 1 1 14 34 2 8 5 ... 1 ... ... ... 89 ... 427 4.7 192s 90,250 328 104 4 ... 3 22 24 4 1 6 ... 1 ... 2 ... 94 ... 593 6.5 1929 90,500 249 129 3 2 3 8 30 3 1 5 ... 2 ... ... ... 163 ... 599 6.6 1930 88.450 (R.-Gen.s Estimatel 346 115 5 4 4 15 36 1 1 1 ... ... ... ... ... 61 3 592 6.6 1931 95,524 (Census) 247 116 ... 1 7 9 32 ... 1 3 ... 1 ... 2 ... 86 ... 505 5.3 1932 96,990 (R.Gen.'s Estimate) 123 70 2 3 4 14 28 2 2 2 ... ... ... 1 ... 52 5 308 3.2 1931 90,070 241 44 1 2 4 10 46 ... 2 7 ... ... ... 2 ... 57 416 4.3 1931 95.306 283 63 1 ... 4 14 36 ... 3 10 ... 1 ... ... ... 41 ... 456 4.7 1935 95,330 245 83 1 ... 2 9 25 1 1 6 ... ... 2 1 ... 44 ... 420 4.4 1936 96,160 158 58 4 2 4 8 39 1 ... 6 ... ... 2 ... 1 58 ... 341 3.5 1937 96,520 137 105 1 1 §3 10 44 1 ... 5 1 ... 10 ... ... 80 ... 398 4.1 1938 96,680 142 116 2 1 ... 26 48 1 ... 4 1 2 4 ... ... 50 ... 397 4.1 1939 90,780 162 62 1 ... ... 15 30 5 ... 7 1 ... 1 ... ... 64 ... 5 3 356 3.8 34 TABLE H—(1) NOTIFICATION OF, AND DEATHS FROM. TUBERCULOSIS, 1939. AGE PERIODS. New Cases. Deaths Pulmonary Non Pulmonary Pulmonary Non-Pulmonary M F M F M F M F 0 — 1 0 0 0 0 0 0 0 0 1 - 5 0 2 1 0 0 1 0 1 5 — 15 0 3 3 3 0 1 0 0 15 - 25 24 17 2 3 4 6 1 0 25 35 17 18 3 2 3 7 0 0 35 — 45 4 13 1 0 4 3 0 1 45 — 55 8 4 0 0 7 1 0 0 55 — 65 7 4 0 0 5 3 0 0 65 and over 3 2 0 0 6 0 0 0 Totals 63 63 10 8 29 22 1 2 Wards : Highgate 6 13 2 0 5 4 1 0 Muswell Hill 10 10 0 3 2 3 0 0 Crouch End 4 2 0 1 2 1 0 0 Central Hornsey 14 10 4 0 5 5 0 0 North Haringey 9 8 1 2 4 4 0 1 South Haringey 6 5 1 1 4 0 0 0 Stroud Green 8 11 2 1 3 3 0 1 Finsbury Park 6 4 0 0 4 2 0 0 Totals 63 63 10 8 29 22 1 2 65 TABLE H—(2) TUBERCULOSIS REGISTER, 1939. Pulmonary. Non-Pulmonary. Total. Male. Female. Male. Female. Male. Female. (a) Number of Cases on Register at commencement of 1939 328 314 103 101 431 415 (b) Number of Cases notified for first time during year under Regulations 49 42 10 7 59 49 (c) Cases restored to Register during 1939 3 5 0 1 3 6 (d) Cases added to Register otherwise than by notification under Regulations : (1) Transferred from other districts 7 11 0 0 7 11 (2) Prom Death Returns 4 5 0 0 4 5 (e) Number of Cases removed from Register during 1939 66 61 10 9 76 70 (f) Number of Cases remaining on Register at end of 1939 325 316 103 100 428 416 Cases removed from the Register shown under (e) are accounted for as follows: — Found not to beT.B Cured. Removed to another area. Died at Home. Died at Sanatorium or other Institution. Cases closed by T.B.O. Totals. M F M F M F M F M F M F M F 0 1 6 6 26 31 Pulmonary 9 7 24 16 1 0 66 61 1 0 1 2 7 5 Non-Ptilmonary 11 0 1 0 0 10 9 36 37 TABLE I.—FACTORIES AND WORKPLACES. The following is a summary of the result of inspections made at Factories, and Workplaces during the year, with a list of Outworkers' premises, a copy of which has been forwarded to the Home Office as required. None of the Outworkers' premises was found to be in an unwholesome condition. Premises. (1) Number of Inspections. (2) Written Notices. (3) Prosecutions. (4) Factories 36 3 0 (with mechanical power) Factories 49 3 0 (without mechanical power) Other premises (including works of building and engineering construction but not including outworkers' premises) 37 0 0 Total 122 6 0 DEFECTS FOUND IN FACTORIES AND WORKPLACES. Particulars. (1) Number of Defects. Number of Prosecutions. (5) Found. (2) Remedied. (3) Referred to H.M. Inspector. (4) Want of cleanliness 8 8 - - Overcrowding - - - - Unreasonable temperature 1 1 - - Inadequate ventilation 2 2 - - Ineffective Drainage of floors - - - - Sanitary conveniences insufficient 1 1 - - unsuitable or defective 1 1 - - not separate for sexes - - - Other offences (Not Including offences relating to Homework or offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921 and re-enacted in the Third Schedule to the Factories Act, 1937). - - - - Total 13 13 - - 38 TABLE I.— (contd.). OUTWORKERS, 1939. Nature of Work. <n Premises. Outworkers. Instances. Notices served. Prosecutions. Art Needlework 1 I 0 0 0 Artificial Flowers 2 2 0 0 0 Bead Stringing 1 3 0 0 0 Boots 7 9 0 0 0 Boxes 1 1 0 0 0 Carnival Hats 1 1 0 0 0 Church Needlework 2 2 0 0 0 Druggists' Sundries 1 1 0 0 0 Embroidery 5 5 0 0 0 Handbags 2 2 0 0 0 Jewel Cases 1 1 0 0 0 Machinery 1 1 0 0 0 Photography 1 3 0 0 0 Silk Tassels 2 2 0 0 0 Toys 1 1 0 0 0 Wearing Apparel 91 116 0 0 0 Total 120 151 0 0 0 39 Borough of Ibornsen ANNUAL REPORT ON Maternity and Child Welfare Services 1939 41 MATERNITY & CHILD WELFARE COMMITTEE as at 31st December, 1939. Councillor Mrs. M.N. Hill (Chairman), 16, Bishopswood Road, N.6. The Mayor, Alderman H. G. J. Williams, J.P., 105, The Chine, N.21. Alderman S. G. Goulding, Woodlands, Cranley Gardens, N.10. ,, W. W. Kelland, M.A., 14, Hillside Mansions, N.6. , J. W.Rowlands, J.P., 25, Cholmeley Park, N.O. ,, R. Steeds, 19, Coolhurst Road, N.8. Councillor Mrs. J. H. Barrenger, 18, Fordington Road, N.6. ,, Elliott E. Brooks, 122, Crouch Hill, N.8. ,, Mrs. C. M. Cave, 10, Wood Vale, N.10. ,, J. Edwards, 102, Turnpike Lane, N.8. ,, H. G. R. Griffin, 33, Fordington Road, N.6. ,, W. J. Grimsiiaw, 25, Sheldon Avenue, N.6. ,, G. K. M. Hutchinson, 8, Grosvenor Gardens, N.10. ,, H. Hynd, 12, Addington Road, N.4. ,, G. F. N. Norman, 12, Woodberry Crescent, N.10. ,, V. G. Rkad, 38, Sheldon Avenue, N.6. ,, L. J. Yalette, 59. Allison Road, N.8. ,, W. Y. Wall, 10, Winchester Place, N.6. ,, F. Wilders, 14, Sunimerland Mansions, N.10. Selected Members: Lady F. o. Dixon, 2, Woodside Avenue, N.6. Mrs. H. M. Inward, 99, Pemberton Road, N.4. Mrs. M. King, 45, Wood Vale, N.10. Miss B. I. Smith, 43, Weston Park, N.8. Mrs. B. Walton, "Greenacre," The Green, Ealing, W.5. Miss E. F. Wood, 38, Church Crescent, N.10. 42 MATERNITY HOSPITAL ACCOMMODATION. North Middlesex Hospital,—The maternity admissions from Hornsey to the North Middlesex Hospital numbered 127 in 1039, as compared with 167 in 1938. There is the closest co-operation between the Council's Ante-natal Medical Officers and the obstetric surgeon in charge of the Maternity Department of the Hospital. City of London Maternity Hospital.—An arrangement was entered into as from April 1st, 1937, for the payment of one guinea for each Hornsev mother admitted. During 1939 the number was 74, as compared with 56 in 1938. EMERGENCY MATERNITY UNIT (FLYING SQUAD). The Maternity Department of North Middlesex Hospital has undertaken to provide in cases of urgent necessity (at the request of the doctor or midwife in attendance) a "flying squad"—that is, an ambulance with doctors and nurses and equipment capable of giving immediate treatment in the patient's own home in cases of emergency. Fortunately no ease has arisen for calling the unit since the arrangement was entered into. MIDWIFERY SERVICES. There were 22 Midwives, including the 3 Borough Midwives, notified to the Middlesex County Council as practising in the Borough. 14 of whom reside outside the Borough. The Borough Midwives attended 255 births, in addition to ante-natal clinics held at the Welfare Centres, Town Hall, Wightman Road, Church Road, Highgate, and Coldfall School Clinic. One of the conditions upon which the Council's Midwives accept a case is that the expectant mother shall attend an ante-natal clinic. Two thousand six hundred and sixty-three births have been attended by the Borough Midwives since the appointment of a Midwife was first made in 1922. 43 PUBLIC HEALTH ACT, 1936 (Sec. 203). NOTIFICATION OF BIRTHS. All live births and still births of seven months and over must be notified to the Medical Officer of Health within 36 hours, in addition to being registered within a period of six weeks after birth. The number of births notified under the Acts during 1939 was: — Male. Female. Total. Live births 636 577 1,213 Still births 19 20 39 655 597 1,252 The births were notified: — By doctors ... ... 47 ,, Borough Midwives ... ... 224 ,, other midwives ... ... 308 ,, hospitals ... ... 131 ,, parents ... ... 8 ,, others ... ... 503 1,221 Not notified (from Registrar's return) :— Live births 30 Still births 1 31 1,252 Of this number there were: — Live births. Still births. Occurring in the Borough and transferred to other districts 211 4 Belonging to Hornsey and occurring in Hospitals, Ac., outside the district 543 21 The 1,037 nett number of notified births belonging to Hornsey were divided among the districts of the Centres as follows: — 44 Live Still Births. Births. Total. Town Hall Centre 485 19 504 Wightman Road Centre 249 9 258 Highgate Centre 246 7 253 Coldfall Sub-Centre 22 0 22 1,002 35 1,037 HOME HELPS. The Hornsey Home Helps Society was started in 1930 by members of the Voluntary Committees of the Centres (Hon. Secretary, Mrs. Inward, 99, Pemberton Road, N.4). In spite of the difficulties of this work, steady progress has been made, as shown by the yearly figures: — No. of Helps Mothers Income. Expenditure. Year. on Books. served. £ s. d. £ s. d. 1930 3 4 11 2 0 9 0 0 1931 4 12 38 19 0 37 11 5½ 1932 4 5 21 5 0 16 12 0 1933 5 11 37 9 0 36 6 10 1934 5 14 44 9 6 44 8 2 1935 6 35 125 17 0 127 13 0 1936 8 66 186 11 2 187 12 7 1937 10 93 303 1 0 329 9 8 1938 12 136 566 9 0 501 16 11 1939 16 129 520 19 0 482 19 10 In January the Council decided to make a grant of £200 towards the expenses of the Society for the year ending 31st March, 1940. MILK (MOTHERS & CHILDREN) ORDER, Two thousand three hundred and sixteen applications for milk under this Order were dealt with during the year, of which 2.276 were granted and 40 refused: — ½ pint milk daily free 1 1 pint ,, ,, ,, 1,161 l½pints 1 2 pints ,, ,, ,, 748 2½ pints ,, 2 3 pints ,, ,, ,, 137 1 pint ,, ,, half-price 52 45 2 pints milk daily half-price 48 1lb. dried milk weekly free 29 l½lbs. „ „ „ „ 86 21bs 7 l½lbs. ,, ,, half-price 3 21bs. „ ,, ,, ,, 1 Not granted 40 2,316 The number last year was 2,079. The total of the accounts paid to 31st December amounted to £1.087. MATERNITY AND CHILD WELFARE DENTAL SCHEME. The Dental Scheme for mothers and young children, started in 1928, continues to do good work. The cost of dentures for mothers, in excess of what the mothers are able to pay, was borne by the Voluntary Committees of the Centres until 1936, when it was taken over by the Maternity and Child Welfare Committee. The following is a record for the year of the Dental Clinic for Mothers and Children. Mothers. Children. Clinics held 89 Old cases 432 150 New cases 108 111 Total attendances 540 265 Finished cases 99 164 Attendances for dentures 175 - Dentures provided 40 - Dentures repaired 2 - Teeth extracted 631 194 Fillings done 55 18 Inspections 69 36 Gas cases 44 72 Local injections 107 - Other treatments (dressings, scaling, gum treatment, etc.) 32 199 46 A charge of 7s. 6d. per session is made for the use of the Dental facilities at the School Clinic by the Education Committee, the cost for the service for the year for use of premises, etc., being £15 0s. 0d. ORTHOPAEDICS. The Surgeon attends monthly and the Masseuse four times weekly for the treatment of elementary school children and children under five years. The following are the statistics for the year for children under five: — Surgeon. Masseuse. Sessions held 7 139 Children treated—New cases 39 — Old cases 79 — ,, attendances 118 529 The cost, which is divided proportionately between the Education and Maternity and Child Welfare Committees, was £43 4s. 9d. for the treatment of children under five years for the year to 31st March, 1940. VOLUNTARY COMMITTEES. Valuable assistance to mothers and children attending the Centres has been rendered by the Voluntary Committees during the year in special cases requiring surgical boots, convalescent homes and other forms of treatment. TODDLERS' PLAYROOM AT HIGHGATE. The Toddlers' Playroom, started in November, 1931, under Miss Benn, has a morning session from 9—12 on five days per week (Monday to Friday). There are 23 children between the ages of 2 and 5 years on the roll, who made a total of 2.465 attendances from January to July. Owing to the outbreak of war (following immediately on the termination of the summer holidays), the Playroom remained closed for the remainder of the year. 47 CHILD LIFE PROTECTION. PUBLIC HEALTH ACT, 1936 (Secs. 206—220). The Children Act, 1908, and the Children and Young Persons Acts, 1932 & 1933, have been superseded in the main and incorporated in the Public Health Act, 1936. The work, however, is still carried out by the Health Visitors in their respective areas. Foster-mothers are encouraged to bring the children to the centres for periodical medical examination. The number of requests for foster-mothers is much in excess of the number available and requests are often received from Societies and Authorities outside the Borough. A register of foster-mothers and foster-children is kept by the Medical Officer of Health and at each Centre. The following is a summary of the Register: — Centre— no. 3 No. 1. No. 2. & Sub. Total. No. of foster-mothers on the register: At the beginning of 1939 20 11 10 41 ,, ,, end 19 8 5 32 No. of foster-children on the register: At the beginning of 1939 24 16 31 71 „ end 22 16 5 43 Died during the year — — — — On whom inquests were held during the year — — — — Visits to foster-children: 1st Visits 13 17 9 39 Total Visits 113 137 54 304 No proceedings were taken during the year. 48 MATERNITY STATISTICS. Ante-Natal, Natal and Post-Natal. MATERNITY AND CHILD WELFARE WORK, 1939. Nature of Work. Centres. Totals. No. 1. No. 2. No. 3 and Sub-Centre. Number of sessions held 148 83 99 330 ,, ante-natal sessions held 68 24 26 118 Number of individual Mothers seen by Doctor:— Ante-natal, New cases 253 106 81 440 ,, Old cases 595 287 177 1,059 Post-natal, New cases 47 25 17 89 ,, Old cases 7 3 5 15 902 421 280 1,603 Total attendances of Mothers 1,336 421 280 2,037 Number of babies attending Centres for first time : Under 1 year 413 222 151 786 1 3 years 58 55 49 162 3—5 ,, 43 16 37 96 Number of individual babies on Centre registers: Under 1 year 326 189 119 634 1—5 years 809 352 292 1,453 Babies seen by Doctor 2,896 1524 1,010 5,430 Attendances of babies at medical consultations 3,586 2,032 1,546 7,164 Total attendances of babies at Centres : Under 1 year 5,169 2,571 1,788 9,528 1—3 years 2,714 982 694 4,390 3—5 „ 688 94 273 1,055 Referred to own private doctors 20 4 16 40 Referred to hospitals 9 9 24 42 Visits paid by nurses : — First visits Total visits First visits Total visits First visits Total visits Grand First visits Totals Total visits To expectant mothers 131 168 94 130 85 178 310 476 To infants under one year 473 1,564 501 776 252 739 1,226 3,079 To children aged 1-5 years 116 3,000 34 1,145 42 1,282 192 5,427 Total visits paid by Nurses 720 4,732 629 2,051 379 2,199 1,728 8,982 CHILD LIFE PROTECTION— Visits paid to Foster Children 13 113 17 137 9 54 39 304 RECORD OF WORK OF MUNICIPAL MIDWIVES, 1939. Miss Andrews Mrs. Jameson Miss Hughes Total Confinements attended 128 63 64 255 Ante-natal Clinics attended 72 33 12 117 do. visits 458 290 241 989 Post-natal visits 1,757 1,464 933 4,154 Borough of hornsen ANNUAL REPORT OF THE School Medical Officer FOR THE Year ending December 31st 1939 3 HORNSEY EDUCATION COMMITTEE. List of Members, 31st December, 1939 APPOINTED BY HOBNSEY. Members of the Town Council— Aldermen Mr. W. G. Baurenuer, J.P., 18, Fordingtou Road, Highgate. N.6. Mr. B. H. Jenkinson, 30, Avenue Road, Highgate, N.6. Mr. W. W. Kelland, M.A., (66, Avenue Road, Highgate, N.6. Mr. .J. W. Bowlands, J.P., 25, Cholmeley Park, Highgate, N.6. Councillors Mrs. C. M. Cave, 10, Wood Vale, Muswell Hill, N.10 (Chairman). Mr. H. G. B. Griffin, 33, Fordingtou Road, Highgate, N.G (Vice-Chairman). Mr.W. J. Grimshaw, 25, Sheldon Avenue, Higligate, N.G. Mr. G. K. M. Hutchinson, 8, Grosvenor Gardens, N.10. Mr. D. V. Johnson, 54, Coolhurst Road, Crouch End, N.8. Mr. W. E. Lark, 34, Broadway, N.8. Mr. J. W. Palmer, 30, Crescent Road, Crouch End, N.8. Mr. F. L. Pascoe, 110, Highgate Hill, N.G. Mr. L. J. Valette, 59, Allison Road, Harringay, N.8. Mr. W. V. Wall, 10, Winchester Place, Highgate, N.6. Co-optative Members— Mrs. C. Crowther, 37, Bishop's Road, Highgate, N.6. The Rev. E. S. Duval, M.A., The Rectory, High Street, Hornsey. Mr. F. C. Ellerton, 14. Bancroft Avenue, N.2. Mr. J. H. Ford, M.A., 5, Woodland Gardens, Muswell Hill, N.10. Mrs. A. Holman, J.P., 8, Hornsey Lane, Highgate, N.6. Mrs. G. M. Reid, B.A., 60a, Shepherd's Hill, Highgate, N.6. 4 STAFF OF SCHOOL MEDICAL. SERVICE. School Medical Officer: R. P. Garrow, M.D., D.P.H. Assistant School Medical Officers: Jean Sutherland, M.B., Ch.B., D.P.H., D.C.O.G. (Resigned 15/12/39). Marian Lones, B.Sc., M.B., B.S., D.P.H. (Appointed 9/3/39). Frances Carter, L.D.S., R.C.S. (Eng.). (Engaged in School Dental work in Cambridge for the duration of the War). F. P. M. Clarke, B.A., B.Sc., L.R.C.P., L.R.F.P.S. (Glas.) Orthopaedic Surgeon: H. J. Seddon, F.R.C.S. (Eng.) (Resident Medical Superintendent, Royal National Orthopaedic Hospital, Country Branch, Stanmore). (Resigned, 31/12/39). J. A. Cholmeley. M.B., F.R.C.S. (Eng.). (Appointed 1/1/40). Masseuse: Mrs. Yorke (Royal National Orthopaedic Hospital). Resigned, August, 1939). Mrs. Gouran. (Appointed September, 1939) Nurses : Assistant Clerks: L. Hatton. E.Cooper. W. WHIMSTER. J.WILLMORE. L. M. Oliver. C. Martin. Dentist s Assistant: Clerk: L. Howard. H. M. Croak. Dentists: Winifred M. Hunt, L.D.S. Oculist: J. S. Boden. (Resigned). Dr. Marian Lones. (Appointed 9/3/39). Aurist: 5 To the Chairman and Members of the HORNSEY EDUCATION COMMITTEE. Madam Chairman, Ladies and Gentlemen, I have the honour to submit my Annual Report for the year ending 31st December, 15)39. The Board of Education, recognising the difficult circumstances in which school medical work has been carried on since the outbreak of war, have made drastic alterations in the annual statistical returns asked for, and expressed willingness to accept reports describing changes in the special services brought about by the war. The declaration of a state of war in the first week of September brought the work of the School Medical Service to a standstill by the evacuation of the schoolchildren, the closing of the schools, and the occupation of the School Clinic as a First Aid Post. The cessation of work at the School Clinic was of short duration. Before the end of September it was apparent that there was a demand for the services of the Clinic for school children remaining in the Borough. These were gradually provided until, at the end of the year, all the forms of treatment comprising the normal work of the Olinic were available—minor ailments, dental, eye, orthopaedic, aural, etc. The work has been considerably hampered by the dual occupation of the premises by School Medical and First Aid Post staffs. The building, designed for school medical work and answering admirably all the demands of this work upon it, is unsuitable for the reception and treatment of casualties in any considerable numbers. In the interest of both services it is hoped that alternative accommodation of a more suitable nature will soon be available as a First Aid Post. Evacuation. The Borough of Hornsey is one of the areas in the outer ring of London which are included with the Administrative County of London as the Metropolitan Evacuation Area. Nearly one-lialf of the elementary school population of the Borough was conveyed by train to reception areas in the counties of 6 Hertfordshire, Bedfordshire, Huntingdonshire, Cambridge ami the Isle of Ely. This mass movement of children from town to country was carried out without any major accident, thanks to the efficiency of the transport arrangements and the superintendence of the children by their teachers, assisted by voluntary workers. It is doubtful whether the social and family life of this country has ever been so profoundly affected by any single measure. The autumn weather was excellent and a great majority of the children took kindly to their new surroundings. There has, however, been a constant tendency for evacuated children to return to their homes in the Borough. Uncleanliness. Evacuation has been the means of calling public attention to some medical problems which Elementary Education Authorities have been dealing with for many years. The first and most important of these is the problem of personal cleanliness. This is a matter to which close attention has been paid in Hornsey by frequent inspections by the school nurses, the use of the Cleansing Centre, as required, and the provision in some of the schools of facilities for hot baths and sprays for the boys and girls. I am happy to be able to report that in visiting the schools throughout the reception counties I saw and heard very little of uncleanliness amongst the Hornsey school children. Bedwetting. Another problem which is always with us is the problem of nocturnal eneuresis, or bedwetting. Like its sister complaints, stammering and nail-biting, it is probably on the increase. It is a manifestation of nerve strain in highly-strung children. It is not surprising, therefore, that the condition should be determinated or aggravated by separation of the children from home and parents. Some of the cases responded to intelligent treatment and care by the billet mother, others have been accommodated in hostels in the reception areas and some have returned home. General Healii of Evacuated Children. A concensus of opinion amongst the teachers who accompanied the children is that there has been a general all-round 7 improvement in the health of the children evacuated. Tn some cases, the improvement has been striking. Several factors have no doubt contributed to this result— e.g., the greater freedom and exercise available in the country, more regular hours in going to bed at night and the change of diet. Provision of Milk. Immediately on the partial re-opening of schools in the Borough arrangements were made for the children to have milk in school on payment or, in necessitous cases, free. Changes in Staff. Medical Staff.—Early in 1939 Dr. Marian Lones was appointed whole-time Assistant Medical Officer of Health for Maternity and Child Welfare and Assistant School Medical Officer to replace the part-time officers, Dr. Muriel Radford and Dr. J. S. Boden. Dr. Jean Sutherland, Deputy Medical Officer of Health and Assistant School Medical Officer since 1933, resigned hi December, 1939, to take up an appointment on the medical staff of the Ministry of Health. I wish to pay tribute to the excellent work she has done during the seven years she has been in Hornsey. This vacancy has not been filled on account of the uncertainty as to the course of the war and therefore as to the numbers of mothers and children remaining in the Borough. Early in 1940 part-time medical assistance to the extent of six sessions per week has been approved by the Council. Orthopaedic Staff.—At the end of the year Mr. H. J. Seddon, Orthopaedic Surgeon, resigned on leaving his position as Resident Medical Superintendent, Royal National Orthopaedic Hospital, Stanmore, to take the Chair in Orthopaedic Surgery in the University of Oxford. In August, 1939, Mrs. Yorke, Orthopaedic Masseuse, was transferred to another district and her place was taken by Mrs. Gouran. Dental Staff.—The pre-war dental staff consisted of one whole-time dentist (Miss W. M. Hunt) and one half-time dentist 8 (Miss F. M. Carter). The latter is now engaged in whole-time dental work amongst evacuated school children in one of the reception areas (Cambridge Borough). Nursing Staff.—Three of the normal staff of four school nurses went with evacuated children into reception areas (Cambridge, Hertfordshire and Bedfordshire). The nurse at Cambridge was recalled at the end of four weeks as her services were required for children remaining in the Borough. Present Position (1940). There is unfortunately a constant tendency for the evacuated children to return to the Borough. Already about two-thirds of the elementary school population are in attendance at school. With a staff depleted to the extent of five sessions per week medical, six sessions per week dental, nurses at half strength and the accommodation at the School Clinic cramped by its dual function of School Treatment Centre and First Aid Post, the service is not working at full efficiency. The uncertainty of the future renders this inevitable. I am grateful to the staff for their loyal co-operation in making the best of difficult circumstances, to the teachers for their constant co-operation and help, and to the parents of the children, to whom the greatest credit is due for the very high standard of cleanliness and health in the schools. I am, Ladies and Gentlemen, Your obedient servant, R. P. GARROW, School Medical Officer. 9 TABLE I. MEDICAL INSPECTIONS OF CHILDREN ATTENDING PUBLIC ELEMENTARY SCHOOLS. (a)—Routine Medical Inspections. Number of inspections in the prescribed Groups— Entrants 394 Second Age Group 979 Third Age Group 231 Total 1,604 Number of other Routine Inspections 154 Grand Total 1,758 (b)—Other Inspections. Number of Special Inspections and Re-Inspections 3,851 TABLE II. CLASSIFICATION OF THE NUTRITION OF CHILDREN INSPECTED DURING THE YEAR IN THE ROUTINE AGE GROUPS UP TO 31st AUGUST, 1939. AGE GROUPS Number of Children Inspected. A (Excellent) B (Normal) C (Slightly sub-normal) D (Bad) No % No. % No. % No % Entrants 394 117 30% 261 66% 16 4% - - Second Age group 979 308 32% 619 63% 52 6% - - Third Age-Group 231 96 41% 115 50% 20 9% - - Other Routine Inspections 154 69 45% 74 48% 11 7% - - TOTAL 1,758 590 33% 1,009 61% 99 6% - - 10 TABLE III. BLIND CHILDREN. At a Public Elementary School. At another Institution. At no School or Institution. 0 2 0 DEAF CHILDREN. At a Public Elementary School. At another Institution. At no School or Institution. 0 6 0 TABLE IV. TREATMENT TABLES. Group I.—Minor Ailments (excluding Uncleanliness, for which see Table VI.). DISEASE OR DEFECT. Number of Defects treated or under treatment during the year. Under the Authority's Scheme Otherwise. Total. (1) (2) (3) (4) Skin— Ringworm-Scalp— (i) X-Ray Treatment. If none, indicate by dash - - - (ii) Other Treatment - - - Ringworm-Body 7 - 7 Scabies 26 - 26 Impetigo 28 - 28 Other Skin Disease 101 - 101 Minor Eve Defects (External and other, but excluding cases falling in Group II). 56 - 56 Minor Ear Defects 53 - 53 Miscellaneous {e.g., minor injuries, bruises, sores, chilblains, etc.) 410 - 410 Total 681 - 681 11 Group II.—Defective Vision and Squint (excluding Minor Eye Defects treated as Minor Aliments—Group I.). Number of Defects dealt with Under the Authority's Scheme Otherwise. Total. Errors of Refraction (including Squint) 398 - 398 Other Defect or Disease of the Eyes (excluding those recorded in Group 1.) 83 - 83 Total 481 - 481 Under the Authority's Scheme. Otherwise. Total. No. of Children for whom spectacles were (a) Prescribed 331 - 331 (b) Obtained 322 - 322 Group III.—Treatment of Defects of Nose and Throat. Number of Defects. Received Operative Treatment. Total. Received other forms of Treatment. Total number treated. Under the Authority's Scheme, in Clinic or Hospital (see note b). By Private Practitioner or Hospital, apart from the Authority's Scheme. (1) (2) (3) (4) (5) (i) (ii) (iii) (iv) (i) (ii) (iii) (iv) (i) (ii) (iii) (iv) - - - - - - - - - - - - 191 191 (i) Tonsils only. (ii) Adenoids only. (iii) Tonsils and Adenoids, (iv) Other defects of the nose and throat. 12 Group IV.—Orthopaedic and Postural Defects. Under the Authority's Scheme. (1) Otherwise. (2) Total number treated. Residential treatment with education. (1) Residential treatment without education. (2) Non-residential treatment at an orthopaedic clinic. (3) Residential treatment with education. (1) Residential treatment without education. (2) Non-residential treatment at an orthopaedic clinic. (3) Number of children treated. 1 3 130 - - - 134 TABLE V.—DENTAL INSPECTION AND TREATMENT. (1) Number of children inspected by the Dentist: — (a) Routine age-groups : AGE 5 6 7 8 9 10 11 12 13 14 15 TOTAL Number 82 220 260 219 363 252 284 229 176 140 35 2,260 (b) Specials 663 (c) Total (Routine and Specials) 2,923 (2) Number found to require treatment 2,775 (3) Number, actually treated 1,948 (4) Attendances made by children for treatment 4,000 (5) Half-days devoted to:— (7) Extractions:— Inspection 20 Permanent Teeth 459 Treatment 543 Temporary Teeth 2,809 Total 563 Total 3,268 (8) Administrations of general anaesthetics for extractions 695 (6) Fillings (see note above): (9) Other Operations: — Permanent Teeth 3,233 Permanent Teeth 132 Temporary Teeth 258 Temporary Teeth 2,328 Total 3,491 Total 2,460 TABLE VI.—UNCLEANLINESS AND VERMINOUS CONDITIONS. (I.) Average number of visits per school made during the year by the School Nurses 32 (ii.) Total number of examinations of children in the Schools by School Nurses 8,416 (iii.) Number of individual children found unclean 201 (iv.) Number of individual children cleansed under Section 87 (2) and (3) of the Education Act, 1921 161 (v.) Number of cases in which legal proceedings were taken : — (a) Under the Education Act, 1921 — (b) Under School Attendance Byelaws — 13 REPORT OF PHYSICAL TRAINING ORGANISER. During the year under review encouraging progress in Physical Education was evident in the Borough until the outbreak of war in September resulted in the temporary closing of schools. Teachers responded to the invitations to attend courses in: — (1) Physical Training for Infants—Women. (2) Physical Training for Juniors—Women. (3) Class Instruction in Land Drill and Water Practice for Swimming—Men. (4) Class Instruction in Land Drill and Water Practice for Swimming—Women. In addition, a Demonstration of Physical Training, Games and Swimming Films was given. Following on Course 4, eight women teachers attended a class for Awards of the Amateur Swimming Association, and the Royal Life-Saving Society. Unfortunately, the war broke out before the examinations were taken. Physical Training. The indications are that, during the past two years, and particularly during the year in question, the teachers generally have shown greater interest in, and enthusiasm for, Physical Training and its allied subjects in the schools, with a resultant higher standard of work by the children. These improvements are probably the result of: — (1) The various Training Courses held for Teachers in 1938 and 1939. (2) The regular visits paid to the schools by the Organisers, during which teachers are helped and advised individually and, quite frequently, demonstrations are given by the Organisers to one or more teachers. (3) The provision of new gymnasia and better facilities generally for Physical Training in some schools. 14 This latter improvement has also resulted in considerable improvement with regard to changing of clothing for Physical Training, both on the part of the teachers and children. Present accommodation in some of the schools, however, does not permit of extensive changing of garments, but it has been found that where enthusiasm is present to overcome difficulties, the removal of superfluous garments forms a fairly good substitute for complete changing and invariably results in improvement both in spirit and performance. Swimming. It is to be regretted that Swimming is still not taken systematically as a class subject in all schools. The lack of covered Swimming Baths in the Borough makes it impossible for every child of suitable age to be taught swimming annually, but many children never receive swimming lessons at all during their school life. Until further facilities for swimming instruction are available this gap in the physical training scheme will remain. It is gratifying to report that the Committee had considered a schetne whereby two dressing-rooms were to be provided and other improvements effected at the Mattison Road Bath. The war prevented this scheme from being put into operation. Had it been carried through, conditions would then have existed whereby the water could have been used by consecutive classes with no waste of time. The number of classes using the bath would then have been increased by 100 per cent. It is hoped that the Committee will be able to sanction the carrying out of this scheme at an early date. Some schools send classes of children to baths outside the Borough and express appreciation of the facilities provided at the Islington Swimming Baths, Hornsey Road, and the Wood Green Swimming Baths, Western Boad. It is worthy of note that a number of teachers also take children after school hours to these baths. Organised Games. A beginning was made with regard to the provision of games stores at the Playing Fields. Stores were equipped at Redston 15 Road and Rokesly Central and placed in the charge of the respective groundsmen. The fact that the games equipment was no longer carried to and from school and was under the care of one person was a great advantage and resulted in considerable economy of apparatus and time. The introduction of the scheme was welcomed, and it was hoped that it would be extended to other fields had peace conditions prevailed. The variety and amount of apparatus on the spot enables the teachers to plan the games lessons so that more children are constantly employed and a greater variety of games and games' practices are taught. Methodical planning of the ground markings also provided for a greater number of children to be usefully employed on the ground at the same time. In view, therefore, of the gradual improvements which were being planned and effected both in conditions and standard of achievement, it was particularly disappointing that the outbreak of war caused a complete cessation of Physical Education in the schools for almost the remainder of the year. For those schools which were evacuated the facilities were generally far inferior to those which exist within the Borough, but visits to the reception areas proved that the teachers were carrying on to the best of their ability under difficult conditions. At home, too, as the schools were gradually re-opened, physical activities were quickly resumed, though on a somewhat limited scale. It has been a matter of great satisfaction to know that, notwithstanding the setbacks experienced both at home and in the reception areas, the claims and value of Physical Education have been realised. Head Teachers and other responsible teachers have made an effort to give a reasonable allotment of time to the various branches of the subject in spite of the difficulties experienced through restricted accommodation, distribution of staff, and shorter school hours. 16 Evening Classes. Adult recreative classes were seriously affected by the fact that the Middlesex County Council discontinued payment for teachers and pianists. Notwithstanding this decision, and the inconveniences of the black-out, two evening classes wore held for women. Mr. MaRR. On the 18th October Mr. Marr was released from his duties to join His Majesty's Army. He spent a short time at the Army School of Physical Training at Aldershot and then went on to train non-commissioned officers and men. FLORENCE E. BREESE, Organiser of Physical Training.