HOR 35 BOROUGH OF HORNSEY. ANNUAL REPORT OF THE Medical Officer of Health FOR 1943 R. P. GARROW, M.D., D.P.H. Printed by "The Hornsey Journal." Ltd.. 161, Tottenham Lane. N.8. 2 HEALTH COMMITTEE. Alderman J. W. Shipp, F.R.San.I. (Chairman), 40, Coleridge Road, N.8. The Mayor, Alderman H. G. J. Williams, O.B.E., .J.P., 105, The Chine, N.21. Alderman Mrs. C. M. Cave, 10, Wood Vale, N.10. ,, S. G. Goulding, Woodlands, Cranley Gardens, N.10. „ Wm. J. Grimshaw, 25, Sheldon Aenue, N.6. ,, J. W. Rowlands, J.P., 25 Cholmeley Park, N.6 „ L. J. Valette, 59, Allison Road, N.8. ,, W. V. Wall, Kilten Lodge, Rowben Close, Totteridge. ,, C. Winkley, 72, Woodside Avenue, N.10. Councillor H. W. Arnold, 23, Etheldene Avenue, N.10. ,, M. W. Burns, 7, Womersley Road, N.8. ,, Mrs. N. C. Clegg, 28, Stormont Road, N.6. ,, H. Colville, 31, Highpoint, North Hill, N.6. ,, J. Edwards, 102, Turnpike Lane, N.8. ,, Mrs. M. N. Hill, 16, Bishopswood Road, N.6. ,, G. F. N. Norman, 12, Woodberry Crescent. N.10. ,, F. L. Pascoe, 23, Dorchester Court, N.10. ,, F. D. Dew, 101, Turnpike Lane, N.8. ,, J. C. O. Lawrence, 58, Great North Road, N.6. ,, J. L. R. Webb, 11, Wilmer Way, N.14. 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 Marion Lones, b.Sc., m.b., b.s., m.r.c.s., l.r.c.p., d.p.h. †*Assistant Medical Officer of Health, Assistant Medical Officer of Schools and Maternity and Child Welfare Centres Margaret Robinson, M.B., C.H.B., D.T.M. AND H. ‡Obstetric Consultants Dr. A. W. Bourne, 12, Wimpole Street, W.1. Dr. W. Mck. H. McCullagh, 149, Harley Street, W.1. Dr. L. H. W. Williams, 89, Harley Street, W.1. ‡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, Food Decontamination Officer 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. A.R.P.S. J. D. Chance, M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Foods. E. Hundy, M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Foods. Cert. San. Science. R. Downes, M.S.I.A. Cert. R.San.I. ,t J. Calderbank, M.S.I.A., A.R.Sant.I. Cert. R.San.I. & S.I.E. Joint Board. Cert. Insp. of Meat and Foods. (Appointed 1/1/43). 4 †Chief Clerk E. Cheesman. (On Active Service from 12/3/42). †Assistant Clerks N. Smith. (On Active Service from 11/1/40). Miss P. Aylward, W. A. Simons. (On Active Service from 27/10/39). T. Hadley, (On Active Service from 23/8/43). Miss E. A. Smith. (Directed to other Employment, 10/12/43). Miss S. P. Nunn, Miss J. Hughes, Miss M. Chesterman, (Appointed 27/4/43). Miss D. M. Sellman, (Appointed 18/10/43). Miss M. Humphreys, (Appointed 13/12/43). †Health Visitors Mrs. E. Durnford, H.V. Cert., C.M.B. Miss A. Godden, H.V. Cert., S.R.N., C.M.B. Miss W. Melhuish, H.V. Cert., S.R.N., C.M.B. (Appointed 29/3/43). Mrs. L. Hatton, H.V. Cert., S.R.N., C.M.B. (Part-time Health Visitor and School Nurse) Miss E. Whimster, H.V. Cert., S.R.N., C.M.B †Midwives Miss M. Andrews, C.M.B. Mrs. M. Jamison C.M.B. Miss L. Hughes, C.M.B. Miss A. C. Matthews, C.M. Mrs. K. Thompson, C.M.B. Miss R. Jones, C.M.B. (Appointed 1/9/43). †Disinfectors and Mortuary W. H. Lewis. Attendants P. Hall. †Medical Services Motor Driver P. Martin. (On Active Service from 10/2/43) G. Wadsworth, ‡Veterinary Inspector under F. G. Buxton, M.R.C.V.S. Diseases of Animals Acts 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 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 for the year ending December 31st, 1943. Chief Vital Statistics. The death rate of 14.48 per 1,000 of population is about the average since the commencement of the war. The birth rate, on the other hand, has shown a steady increase during the war, and at 18.08 in 1943, is the highest since 1909 with the one exception of 1920, when it was 19.3. The infant mortality rate of 30.4 is the low est except that of 1939, when it was 27.25. One maternal death in 1,414 births, giving a maternal mortality rate of 0.69, is very much lower than in any previous year. For the third year in succession no death occurred from diphtheria. These figures, together with the favourable standards of health found in the routine work of the Maternity and Child Welfare Department and the School Medical Service show that the public health has been maintained at a high level in spite of the storms and stresses of five years of war, in which the Borough has suffered heavy material damage. I have the honour to be, Mr. Mayor. Ladies and Gentlemen, Your obedient servant, R. P. GARROW, Medical Officer of Health 6 STATISTICS FOR 1943. (Section A). SOCIAL AND ECONOMIC STATISTICS. Area (acres) 2,872 ,, (square miles) 4.49 Population (Census 1931) 95,524 Do., Registrar-General's estimate, 1943 78,170 No. of separately-assessed inhabited premises (end of 1943), according to Rate Books 23,545 Rateable value (General Rate) at 31st December £1,058,846 Product of a penny rate £4,150 LIVE BIRTHS. M. F. Total. Legitimate 666 641 1,307 Illegitimate 56 51 107 722 692 1,414 Birth Rate 18.1 (per 1,000 population). STILL-BIRTHS. M. F. Total. Legitimate 21 18 39 Illegitimate 3 1 4 24 19 43 Still-Birth Rate 295 (per 1.000 total live and still births . DEATHS. Males 549 Females 583 Total 1,182 Death Rate 14.8 (per 1,000 population). INFANT DEATHS. M. F. Total. Legitimate 25 13 38 Illegitimate 4 1 5 29 14 43 DEATH RATE OF INFANTS UNDER 1 YEAR OF AGE. All infants per 1,000 live births 30.4 Legitimate infants per 1,000 legitimate live births 29.1 Illegitimate infants per 1,000 illegitimate live births 46.7 DEATHS FROM PUERPERAL CAUSES. Rate per 1,000 Deaths, total (live and still) births England and Wales. Puerperal and post-abortive sepsis 1 0.69 0.39 (excluding abortion) Other maternal causes 0 0 1.45 Total 1 0.69 1.84 DEATHS FROM SPECIAL CAUSES. Deaths from Cancer (all ages) 195 Deaths from Measles (all ages) 2 Deaths from Whooping-Cough (all ages) 2 Deaths from Diarrhœa (under 2 years of age) 8 7 GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA (Section B). The only addition to the General Health services of the Borough during 1943 was the Alexandra Maternity Home, Muswell Hill, further particulars of which are given in the Section on Maternity and Child Welfare Services. The normal hospital, clinic, ambulance, laboratory and nursing services were all maintained as in pre-war years. 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: Complaints 1,237 Re-inspections 4,447 Information from builder 169 Special Inspections 298 Drainage 136 Water tests applied (new drains) 27 Smoke and Chemical tests (old drains) 51 Fee Tests 2 Verminous houses 89 Pests 64 Overcrowding surveys 17 Offices (Workplaces) 3 Notifiable Infectious Diseases 400 Scabies 247 Small-pox Contacts - Typhoid 2 Sunday Trading Inspections 234 Shops Acts 66 Cooked Meat Shops 2 Butchers' shops 43 Slaughter-houses 222 Dairies and Milkshops 15 Grocers' shops 131 Bakehouses 18 Fish shops 15 Restaurant kitchens 34 Greengrocers' shops 5 Other food shops 6 Food Inspections 206 Milk Surveys - Rat Infestation Order 43 Factories and outworkers 109 Conveniences 4 Passages - Young Persons Act - Piggeries 25 Petroleum Stores 30 Smoke observations - Surveys (P.N.) 1 Re-Surveys (P.N.) 1 Memo. B.E. & S. 25 8 INSPECTIONS NECESSITATED BY WAR CONDITIONS. Salvage Sacks Sites 930 Survey of Unoccupied Houses 1,741 A.R.P. Posts 4 Air Raid Trench Shelters 495 Fuel and Lighting Order 67 Emergency Feeding Stores 10 A.R.P. Food Stores 1 11,694 NOTICES. The Notices served during the year are as follows: — Under the— Verbal Preliminary Statutory Public Health and Housing Acts 203 588 19 Housing Byelaws — 6 — Shops Acts— — — Factory Acts — - - 203 594 19 SUMMARY OF SANITARY IMPROVEMENTS CARRIED OUT. DRAINAGE. Number of houses and premises redrained 9 Repairs or amendments to existing drains 62 Drains or gullies unstopped or cleansed 51 Manholes provided 10 do. repaired 23 Intercepting traps fixed 2 New gulley traps fixed 31 New soil pipes and ventilating shafts fixed 31 Soil pipes and ventilating shafts repaired 38 Fresh-air inlets provided or repaired 3 WATER-CLOSETS AND SANITARY FITTINGS. New water-closet buildings 4 New water-closet basins fixed 84 Water-closet unstopped, cleansed or repaired 51 New check cisterns fitted to water-closets; existing check cisterns repaired 27 New sinks provided 18 New lavatory basins provided 22 New waste-pipes fixed 43 Waste-pipes trapped, repaired or unstopped 48 Waste-pipes diverted into proper drain 1 Baths provided or made usable 11 Urinals cleansed 1 MISCELLANEOUS. Roofs repaired 242 Eaves guttering renewed, cleansed or repaired 48 Rain-water pipes provided, repaired 62 Damp walls remedied 101 Damp-proof courses inserted 14 Paving of yards repaired 78 Premises structurally repaired 392 Rooms cleansed, distempered or papered 94 Premises disinfested of vermin 130 Drinking-water cisterns repaired, cleansed and covered 44 9 Water supply (additional) provided 1 Windows and skylights provided or made usable 78 Sub-floor ventilation 9 Floors repaired 86 Windowsills repaired 38 Sash cords and fittings repaired 71 Sanitary dustbins provided 53 Accumulations of manure and refuse removed 30 Stoves, ranges and coppers repaired or renewed 42 Sundry items 188 Food stores provided 4 2,375 FACTORIES. DEFECTS REMEDIED Sanitary accommodation—Insufficient 1 Unsuitable or defective 2 Not separate for sexes — Workrooms cleansed or repaired 3 Ventilation improved — Heating provided — 6 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. Fourteen houses have been dealt with under these Byelaws during the year and the following works carried out:— Byelaw. 4 (b) Water supplies — 4 (c) Washing accommodation 2 4 (d) Food stores 12 5 (a) Repairs to drains — 5 (b) Means of carrying off waste water 4 5 (c) Provision of windows - 5 (d) Room ventilation provided - 5 (f) Ventilation to the bedroom and room with cooking apparatus - 5 (g) Staircase repairs — 5 (h) Handrails provided - 18 OTHER HOUSING ACTIVITIES. FAMILIES RE-HOUSED BY THE COUNCIL. — The Council i'e-housed 19 families, representing 84 persons. 10 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) 1,237 (b) Number of inspections made for the purpose 3,062 (2) (a) Number of dwelling-houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 — (b) Number of inspections made for the purpose — (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 487 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 391 3. Action under Statutorxj Powers during the Year-.— A.—Proceedings under Sections 17, 18 and 23 of the Housing Act, 1930:— (1) Number of dwelling-hou-ses 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... B.—Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 19 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: — (a) By owners 19 (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 — (2) Number of dwelling-houses demolished in suance 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 — (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit — 11 1. Homing Act, 1936%. Overcrowding: — (;i) (i) Number of dwellings overcrowded at the end of the year 28 (ii) Number of families dwelling therein 35 (iii) Number of persons dwelling therein 207 (b) Number of new cases of overcrowding reported during the year 1 (c) (i) Number of cases of overcrowding relieved during the year 1 (ii) Number of persons concerned in such cases 8 INSPECTION AND SUPERVISION OF FOOD. (Section E.) FOOD CONDEMNED—1943. Tinned Vegetables 230 lbs. 4 ozs. Tinned Soup 37 lbs. Tinned Jam 81 lbs. 8 ozs. Tinned Marmalade 2 lbs. Tinned Fruit 253 lbs. Tinned Fish 230 lbs. 13 ozs. Tinned Dried Milk 11 lbs. 8 ozs. Tinned Liquid Milk 351 lbs. 2 ozs. Tinned Meat 576 lbs. 2 ozs. Tinned Vegetable Stew 2 lbs. Margarine 39 lbs. 12 ozs. Haricot Beans 14 cwts. 21 lbs Split Peas 41 lbs. Semolina 1 cwt. 2 lbs. Babbits 921bs. Nut Paste 168 lbs. Drinking Chocolate 18 packets Sugar 8 lbs. Dried Fruit 36 lbs. 8 ozs. Cornflakes 41 lbs. Carrots 1 cwt. 15 lbs. Suet 17 lbs. Imported Lamb 3 lbs. Bottled Fish 7 lbs. Broken Biscuits 2 cwts. Golden Syrup 4 lbs. Fish 11 cwts. 23 lbs. Flour 11 lbs. Cheese . 31 lbs. Fish Paste 8 ozs. Meat 146 lbs. 12 ozs. Eggs 2¾ dozen Egg Substitute 12 lbs. 12 ozs. Salt 1 lb. 8 ozs. Boiled Sweets 8 ozs. Pudding Mixture 2 lbs. 8 ozs. Potatoes 2 cwts. Fruit 13 lbs. 8 ozs. Boiled Oats 10 lbs. 582 Horses w ore slaughtered and one Goat and one Pony—2,026| lbs. of meat were condemned, including liver and lungs. * These figures are taken from Departmental records, but owing to changes brought about by war conditions the figures may not Indicate the final position in regard to overcrowding. 12 CLEANSING AND DISINFECTING STATION. Cleansing of infested persons and the disinfection of clothing are important public health measures at all times—but in war it is invariably found that more work of this kind has to be carried out. The possibility of the introduction into this country of louse-borne typhus, and the fact that scabies infestation had already reached epidemic proportions, called urgently for extension of the provisions for cleansing and disinfection. All this work was previously done at the Depot, High Street, Hornsey. Under the new arrangements only male persons are treated at the old Cleansing Depot. Women and children are dealt with at a new Cleansing Station close by the School Clinic at the rear of the Town Hall. Disinfection of clothing is earned out by agreement with the Finchley, Hornsey, Wood Green and Friern Barnet Joint Hospital Committee at the Isolation Hospital, Muswell Hill. All these arrangements are working satisfactorily and assist the staffs of the Public Health, Maternity and Child Welfare and School Medical Departments in combating head lice and improving the general standard of cleanliness. No legal action has been taken under the Scabies Order in 1943. \ INFECTIOUS DISEASES. (Section F.) DIPHTHERIA IMMUNISATION. The following are the numbers of children immunised during 1943: — Under 5 years of age 1,286 Over 5 years of age 534 Total 1,820 VACCINATION. The Public Vaccinators inform me that they performed vaccination of persons in the Borough during 1943 as follows: — Dr. E. Buckler 236 Dr. R. Mackay 495 PREVENTION OF BLINDNESS. (PUBLIC HEALTH ACT, 1925, SECTION 66.) Two cases of ophthalmia neonatorum were notified, both cases being nursed at home. 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. 2 2 0 2 0 0 0 13 TUBERCULOSIS. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS. No occasion has arisen in the course of the year to put these powers into action. There were 974 beds available solely for Middlesex under the Middlesex County Council's scheme for the treatment of Tuberculosis in sanatoria, namely:— Institution Accommodation Type of Case Adults Children M F County Sanatorium, Harefield 192 192 66 Pulmonary—sanatorium 4 4 10 ,, observation County Sanatorium, Clare Hall 206 202 32 ,, sanatorium Danesbury Manor, Welwyn - 60 - „ Victoria Home, Windsor — — 6 Non-pulmonary Patients are also sent to the Middlesex County Council's general hospitals and to numerous other voluntary hospitals and sanatoria. The total number of cases on the Tuberculosis Register at the end of 1943 was 1,028, viz., pulmonary 798, non-pulmonary 230, an increase of 74 on the total for last year. A table showing the history of cases of Tuberculosis during the year will be found on Table F. MORTUARY. Eighty-six bodies were received at the mortuary. DISEASES OF ANIMALS ACTS. 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 1943 as follows: — Inspections made under the Diseases of Animals Acts 26 (Pigs 298) Animals inspected:— Under the Parasitic Mange Order: Horses 2 Under the Swine Fever Order, 1908: Pigs — No action was necessary under the Tuberculosis Order, 1925. Three post-mortem examinations on pigs were carried out during the year. 14 LIST OF TABLES. TABLE A.—Vital Statistics, 1913-1943. TABLE B.—Causes of, and ages at, death in 1943. TABLE C.—Infant Mortality in 1943. Causes of, and ages at, death. TABLE D.—Births, Deaths, Infant Deaths, and Deaths from certain diseases, 1913-43. TABLE E.—Cases of Infectious Disease notified in 1943. TABLE E.—(1) Notification of. and deaths from. Tuberculosis, 1943. ,, (2) Tuberculosis Register, 1943. 15 TABLE A. BOROUGH OP HORNSEY VITAL STATISTICS, 1913-1943. Year. Estimated Mid-Year Population. Birth Rate per 1,000 Population. Death Kate per 1,000 Population. Infant Mortality per 1,000 live Births. 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 13.8 12.7 54.05 Regr.-Gen.'s Estimate. 88,450 1930 88,450 Census. 13.7 11.8 41.35 1931 95,524 11.9 11.2 52.6 Regr.-Gen.'s Estimate 1932 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 1936 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 11.39 11.16 27.25 (b)90,780 1940 77,130 12.82 15.16 49.30 1941 69,730 12.86 13.95 63.20 1942 74,800 16.37 14.13 49.80 1943 78,170 18.08 14.48 30.41 ENGLAND and WALES * (Rates in 1943) 16.5 12.1 49 126 County Boroughs and Great Towns, including London * (Rates in 1943) 18.6 14.2 58 148 Smaller Towns Resident Population 25,000—50,000 at 1931 census * (Rates in 1943) 19.4 12.7 46 London *(Rates in 1943) 15.8 15.0 58 * Rates per 1,000 civilian population. † (a) For calculation of Birth rate. (b) „ „ „ Death rate. or incidence o£ notifiable infectious disease 16 TABLE B —CAUSES OF, AND AGES AT, DEATH, 1943. 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 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2. Cerebro-spinal fever 2 2 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... 2 3. Scarlet Fever 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 4. Whooping cough 2 1 1 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 5. Diphtheria 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 6. Tuberculosis of respiratory system 57 33 24 ... ... ... 1 ... ... 1 2 5 11 3 ... 6 3 8 4 7 2 3 1 ... ... 6 7. Other forms of tuberculosis 5 1 4 ... ... ... ... ... ... ... ... ... 2 1 ... ... 2 ... ... ... ... ... ... ... ... 7 8. Syphilitic diseases 10 8 2 ... ... ... ... ... ... ... ... ... ... ... ... 3 1 1 ... 1 2 ... 2 ... 8 9. Influenza 27 15 12 ... 1 ... ... ... ... ... ... ... ... 1 ... 1 2 ... 1 3 ... 2 1 8 7 9 10. Measles 2 2 0 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10 11. Acute polio-myelitis and polioencephalitis 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11 12. Acute infectious encephalitis 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 13. Cancer of buccal cavity and æsophagus (males only) 4 4 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 ... 13 Cancer of uterus (females) 7 0 7 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 2 ... 2 ... ... ... 2 14. Cancer of stomach and duodenum 27 13 14 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 1 3 1 1 5 6 7 14 15. Cancer of breast 24 0 24 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 4 ... 8 ... 4 ... 7 15 16. Cancer of all other sites 133 83 50 ... ... ... ... ... ... ... 1 ... 1 1 ... 3 4 12 9 23 9 29 18 15 8 16 17. Diabetes 2 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 17 18. Intra cranial vascular lesions 120 46 74 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 4 10 10 17 25 18 35 18 19. Heart disease 274 113 161 ... ... ... ... ... ... ... ... 1 1 1 ... 2 3 10 5 22 19 31 40 46 93 19 20. Other diseases of circ. system 52 23 29 ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 2 4 1 4 4 3 15 17 20 21. Bronchitis 81 41 40 ... 1 ... ... ... ... ... ... ... ... ... ... 1 2 1 2 8 5 12 7 19 23 21 22. Pneumonia 66 25 41 4 3 ... 1 ... 1 ... ... ... ... ... 2 2 1 ... 2 6 4 5 11 8 16 22 23. Other respiratory diseases 10 7 3 1 ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 1 1 ... ... 2 3 ... 23 24. Ulcer of stomach or duodenum 18 13 5 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 2 3 1 7 ... ... 1 24 25. Diarrhœa, under 2 years 8 6 2 6 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 25 26. Appendicitis 4 4 0 ... ... ... ... 2 ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... 26 27. Other digestive diseases 23 9 14 1 1 ... ... ... ... ... ... ... 1 ... ... 2 1 1 ... ... 4 1 ... 4 7 27 28. Nephritis 22 12 10 ... ... ... ... ... ... ... 1 1 1 ... ... ... ... 1 ... 3 2 4 1 4 4 28 29. Puerperal and post-abortive sepsis 1 0 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 29 30. Other maternal causes 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 30 31. Premature birth 6 4 2 4 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 31 32. Con. mal., birth injuries, infantile disease 19 13 6 11 5 ... ... 1 ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 32 33. Suicide 11 6 5 ... ... ... ... ... ... ... ... 1 ... ... 1 2 1 1 ... 1 2 1 1 ... ... 33 34. Road traffic accidents 10 5 5 ... ... ... ... ... ... 1 ... 1 ... ... ... 1 1 1 ... 1 1 ... 2 ... 1 34 35. Other violent causes 16 4 12 ... 1 ... ... ... ... 1 ... ... ... 1 1 ... ... ... ... 1 1 ... 1 1 8 35 36. All other causes 89 55 34 ... ... ... ... 2 ... 1 ... ... ... 2 2 3 2 4 4 7 5 14 6 22 15 36 Totals 1,132 549 583 29 14 0 4 5 2 4 2 9 9 11 20 30 25 51 46 102 81 134 128 174 252 17 TABLE C.—INFANT MORTALITY, 1943. CAUSES OF DEATH. Deaths from stated causes at various Ages under One Year of Age. Total Deaths under One Year. DAYS WEEKS MONTHS Under 1 Day 1-7 1-2 2-3 3-4 1-3 3-6 6-9 9-12 Conditions associated with Pregnancy A Birth Premature Birth 4 2 ... ... ... ... ... ... ... 6 14 Congenital Malformations 2 2 1 ... ... 1 1 ... ... 7 Congenital Debility ... ... ... 1 ... ... ... ... ... 1 Conditions arising from Infection after Birth Whooping Cough ... ... ... ... ... ... 1 ... ... 1 29 Tuberculosis of Meninges ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... 1 ... ... 1 Pneumonia ... ... 1 ... ... 3 1 ... 2 7 Empyema (other respiratory dis.) ... ... ... ... ... ... ... 1 ... 1 Enteritis and Diarrhœa ... ... ... ... ... 2 4 1 ... 7 Bronchitis ... ... ... ... ... ... ... ... 1 1 Other diseases peculiar to first year of life 4 4 ... ... ... ... ... ... ... 8 Other causes ... ... ... ... ... 1 ... 1 ... 2 Influenza ... ... ... ... ... ... ... 1 ... 1 Totals 10 8 2 1 0 7 8 4 3 43 18 TABLE D.—BIRTHS, DEATHS, INFANT DEATHS AND DEATHS FROM CERTAIN DISEASES, 1913-1943. YEAR. Population Total Live Births Total Still 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) 1914 1,529 ... 791 88 1 4 21 1 7 1 82 44 10 1915 1,394 ... 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 1 136 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 1 147 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 1,221 ... 1,128 67 0 13 2 0 7 0 143 58 15 1930 1,209 45 1,047 50 4 0 10 2 4 0 156 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 17 1 44 20 1934 95,306 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 1 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) 96,610 1,101 41 1,014 30 0 2 2 0 4 1 164 51 3 (b) 90,780 1940 77,130 †(a) 933 †(a)39 1,169 46 0 0 3 0 1 0 179 42 7 (b)989 (b)42 1941 69,730 (a)791 (a)26 973 50 2 1 3 0 1 0 145 43 5 (b)897 (b)27 1942 74,800 1,225 30 1,057 61 0 0 2 0 0 0 184 50 10 1943 78,170 1,414 43 1,132 43 2 2 8 0 0 0 195 57 5 * (a) For calculation of Birth rates. †(a) For calculation of Infant and Maternal Mortality Rates. (b) „ „ ,, Death rates. (b) „ „ „ Birth rates. 19 TABLE E.—INFECTIOUS DISEASES NOTIFIED, 1943. DISEASE WARDS AGES Total Admitted to Joint Hospital. Admitted to other Hospitals. Nursed at Home. Highgate Muswell Hill. Crouch Bed Central Hornsey North Haringey South Haringey Stroud Green Finsbury Park. 0— 1 1— 5 515 15— 25 25— 45 45— 65 65 and over Scarlet Fever 14 33 14 60 19 18 52 7 0 58 128 13 13 5 0 217 164 5 48 Diphtheria 23 6 2 3 5 3 1 1 0 5 6 23 8 2 0 44 35 9 0 Pneumonia 7 10 8 35 7 6 20 10 3 20 10 7 16 28 19 103 3 8 92 Erysipelas 1 3 3 3 1 3 2 0 1 0 0 2 9 3 1 16 4 6 6 Puerperal Pyrexia 2 3 5 2 4 1 1 1 0 0 0 5 13 1 0 19 2 17 0 Ophthalmia Neonatorum 0 0 0 2 0 0 0 0 2 0 0 0 0 0 0 2 0 0 2 S.F. and Heart Disease 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 1 0 0 Cerebro-Spinal Meningitis 2 1 0 1 0 1 0 1 0 1 1 1 2 1 0 6 2 3 1 Dysentery 3 2 0 1 1 1 0 1 0 3 0 0 3 0 3 9 1 8 0 Measles 80 168 25 186 96 52 123 56 49 392 320 14 8 2 1 786 12 7 767 Whooping Cough 3 14 2 18 11 9 22 3 10 41 26 5 0 0 0 82 2 1 79 S.F. and Otitis Media 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 Paratyphoid Fever 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 Measles and Pneumonia 1 1 1 4 3 1 0 1 1 6 5 0 0 0 0 12 4 1 7 Poliomyelitis 0 1 0 0 0 0 1 0 0 1 0 1 0 0 0 2 2 0 0 Whooping Cough and Pneumonia 2 1 0 1 0 0 1 0 1 2 2 0 0 0 0 5 3 1 1 Colitis 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 S.F. and Chicken Pox 0 0 0 1 0 0 1 0 0 0 2 0 0 0 0 2 2 0 0 139 243 62 317 148 95 224 81 67 530 501 72 73 42 24 1,309 239 67 1,003 Tuberculosis : Pulmonary 32 33 16 31 16 13 24 12 0 3 7 40 75 43 9 177 Non-Pulmonary 3 3 2 4 2 1 1 6 0 4 7 3 4 2 2 22 Total 174 279 80 352 166 109 249 99 67 537 515 115 152 87 35 1,508 20 Excluding T.B. Admitted to Joint Isolation Hospital 26 39 16 51 26 19 54 10 Other Hospitals 23 12 13 7 7 6 5 2 Nursed at Home 91 162 34 252 67 72 166 69 The following 43 cases were treated at the Isolation Hospital in addition to the above:—Carbuncle 1, Bilateral Peritonsillitis 1, Dyspepsia 2, Acute Pharyngitis 1, Bronchial Catarrh 2, Observation 4, Scabies 2, Mumps 3, Chorea 1, Impetigo Contagiose 1, Post Measles Meninga Encephalitis 1, Peritonsillar Abscess 1, Chicken Pox and Impetigo 1, Acute Catarrhal Tonsillitis 2, Sub-ingual Purulent Blister 1, Follicular Tonsillitis 1, Septic Scabies 1, Mosquito Bite 1, Acute Furmiculosis Pyeloneyshertis 1, Palpebral Urtimia 1, Glandular Feuer 1, Eythemia Mutiforne 1, DDIs. Skin Eruptions 1, Nasal Pharyngitis 1, Tonsillitis 2, Pemphigus 1, Muscular Rheumatism 1, Sore Throat 1, Puepira Rheumatica 1, Febucular 2, Septic Lower Lip 1. 21 TABLE F.—(1) NOTIFICATION OF, AND DEATHS FROM. TUBERCULOSIS, 1943. 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 3 2 2 0 1 0 0 5 — 15 5 2 5 2 1 0 0 0 15—25 18 22 0 3 5 2 0 2 25 - 35 22 24 1 1 3 11 1 0 35 — 45 18 11 1 1 6 3 0 2 45 - 55 18 4 1 1 8 4 0 0 55 — 65 15 6 0 0 7 2 0 0 65 and over 7 2 0 2 3 1 0 0 Totals 103 74 10 12 33 24 1 4 Wards: Highgate 17 15 2 1 Muswell Hill 15 18 2 1 Crouch End 9 7 2 0 Central Hornsey 24 7 1 3 North Haringey 7 9 1 1 South Haringey 6 7 0 1 Stroud Green 17 7 0 1 Finsbury Park 8 4 2 4 Totals 103 74 10 12 22 TABLE F.— (2) TUBERCULOSIS REGISTER, 1943. Pulmonary. Non-Pulmonary. Total. Male. Female. Male. Female. Male. Female. (a) Number of Cases on Register at commencement of 1943 388 342 120 104 508 446 (b) Number of Cases notified for first time during year under Regulations 75 54 9 6 84 60 (c) Cases restored to Register during 1943 7 3 0 1 7 4 (d) Cases added to Register otherwise than by notification under Regulations : (1) Transferred from other districts 14 10 1 1 15 11 (2) From Death Returns 7 7 0 4 7 11 103 74 10 12 113 86 (e) Number of Cases removed from Register during 1943 54 55 6 10 60 65 (f) Number of Cases remaining on Register at end of 1943 437 361 124 106 561 467 Cases removed from the Register shown under (e) are accounted for as follows: — Cured. Removed to another area. Died at Home. Died at Sanatorium or other Institution. Totals. M F M F M F M F M F Pulmonary 7 9 17 18 8 8 22 20 54 55 Non-Pulmonary 0 1 2 4 0 2 4 3 6 10 23 Borough of Hornsey ANNUAL REPORT ON Maternity and Child Welfare Services 1943 24 MATERNITY & CHILD WELFARE COMMITTEE Alderman W. V. Wall, (Chairman), Kilten Lodge, Rowben Close, Totteridge. The Mayor, Alderman H. G. I. Williams, O.B.E.. J.P., 105, The Chine, N .21 Alderman Mrs. C. M. Cave, 10, Wood Vale, N.10. ,, S. G. Goulding, Woodlands, Cranley Gardens, N.10. ,, Wm. J. Grimshaw, 25, Sheldon Avenue, N.6 ,, J. W. Rowlands, J.P., 25 Cholmeley Park, N.6 ,, J. W. Shipp, 40, Coleridge Road, N.8. ,, L. J. Valette, 59, Allison Road, N.8. Councillor H. W. Arnold, 23, Etheldene Avenue, N.10. ,, M. W. Burns, 7, Womersley Road, N.8. „ F. E. Cleary, Oakmead, Waverley Road, N.8. ,, Mrs. N. C. Clegg, 28, Stormont Road, N.6. ,, H. Colville, 31, Highpoint, North Hill, N.6 F. D. Dew, 101, Turnpike Lane, N.8. ,, P. Baxter, 51, Lothair Road, N.4. ,, J. C. O. Lawrence, 58, Great North Road, N.6. ,, Mrs. M. N. Hill, 16, Bishopswood Road, N.6. ,, G. F. N. Norman, 12, Woodberry Crescent, N.10. ,, J. L. R. Webb, 11, Wilmer Way, N.14. Selected. Members: Lady F. O. Dixon, 2, Woodside Avenue, N. 6. Mrs. J. Barrenger, 18, Fordington Road, N.6. 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. 25 MATERNITY AND CHILD WELFARE CENTRES. The four centres at which Maternity and Child Welfare work is carried out are situated— No. 1 Centre at the rear of the Town Hall, Crouch End, N.8. No. 2 Centre at Burgoyne Hall. Burgoyne Boad, Harringay, N.4. No. 3 Centre at Church Road. Highgate, N.6. No. 4 Centre at Coldfall Avenue, Muswell Hill, N.10. The volume of work done is set out in Tabular form in this report. At No. 1 Centre the numbers attending increased so that new sessions had to be arranged. There are now five sessions per week of childwelfare and three sessions weekly of ante-natal work. The pram shelter was inadequate (this was extended in 1944 and is now satisfactory). At No. 2 Centre also the increased number of mothers and children was met by the provision of extra sessions. Here (also in 1944) a further step was taken towards completing the adaptation of what was a Church Hall to the functions of a Health Centre, with the most pleasing results. A new development in the work of Burgoyne Hall Centre is the appointment of a Psychologist, Miss Ruth Thomas, to advise the mothers on the problems of behaviour in infancy and childhood. No. 3 Centre at Church Boad, Highgate, has been out of action for three months (during 1944) as a result of enemy action, but has undergone repairs and is working normally again. No. 4 Centre at Coldfall Avenue, Muswell Hill, has been a matter of concern to the Committee for some years. Started sixteen years ago, when Coldfall School was built, it was originally intended to be merely a sub-centre for the treatment of minor ailments in school children; but there has gradually developed at it all the work of a Maternity and Child Welfare Centre and School Clinic combined. The premises are quite inadequate for these purposes and for the numbers attending, and search has been made for suitable premises more centrally situated for the Muswell Hill area. The unused Electricity Showrooms in Fortis Green have been placed at our disposal and the work of adaptation was proceeding in 1944 when the building was severely damaged by enemy action. It is hoped that in the near future this work may be resumed and that the result will be a much better centre more conveniently situated for the mothers of the Muswell Hill area. The Need for New Centres. For some time the Maternity and Child Welfare Committee have had under consideration the question of additional Centres to save mothers from the longer journeys required by some of them in attending the present Centres. Search is being made in Central Hornsey and in the Finsbury Park-Stroud Green area for suitable premises. As to the quality of the work of the Centres and of the staffs of Health Visitors, Midwives and Voluntary Workers connected with them, the vital statistics bear testimony. The infant mortality rate of 30 and maternal mortality rate of 0.69 per 1,000 births represent health standards for maternity and infant life equal to those of the oft-quoted figures of Oslo, Denmark, Holland and New Zealand. They are an achievement of which any health authority may be proud. 26 Clinic Services Available for Children Under Five. Infants and children under five in attendance at the four Centres are eligible for all the various forms of treatment given to school children at the School Clinic, namely, the treatment of minor ailments, defective vision and squint, ear, nose and throat troubles, dental attention and orthopædic treatment. In these matters there is close co-operation between the Centres and the Clinic. Expectant and Nursing Mothers receive dental treatment. MATERNITY HOSPITAL ACCOMMODATION. Expectant mothers attending the Ante-natal Clinics have a wide choice in regard to attendance in child birth—they may book with one of the Borough midwives who attend every session of Ante-natal Clinics or engage a private midwife or doctor; or go to a private maternity home; or arrange for admission to one of the Maternity Hospitals of the Metropolis or to a Maternity Department of a General Hospital in London. There is an increasing demand for confinement away from home and there is a shortage of available maternity beds for normal cases. The majority of hospital cases go to the North Middlesex Hospital, which took 127 in 1941, 159 in 1942 and 170 in 1943. For some ten years the Maternity and Child Welfare Committee has endeavoured to secure suitable Maternity Home accommodation in the Borough. Success came in 1943, when Miss Brain retired from her work at the Alexandra Park Nursing Home and the Council purchased this property for the purpose of a Municipal Maternity Home. The Alexandra Maternity Home is situated on a corner site of about three-quarters of an acre at the crossing of Alexandra Park Road and Muswell Avenue. It is conveniently placed on a bus route and is easily accessible from all parts of the Borough. The present buildings have accommodation for 22 beds and an isolation bed, and the site has an unbuilt frontage of over 100 feet on Alexandra ParkRoad. The Home is capable of extension to 40 or 60 or even 80 beds in the future if the development of the Health Services called for a larger maternity unit in this area. Maternity Bed Policy. The acquisition of a local Maternity Home is, in my opinion, the most important step forward which the Maternity Committee has taken for many years. It anticipates two important Reports which have appeared lately on the Maternity Services, namely— 1. The Report of the London Maternity Services (Voluntary Organisations) Joint Committee November, 1943 (a Committee of very experienced obstetricians practising in the London area). 2. Report on a "National Maternity Service" by the Royal College of Obstetricians and Gynaecologists, May, 1944. For the last twelve years official policy in regard to Maternity bed provision has been based on the final report of the Departmental Committee on Maternal Mortality and Morbidity (1932). This report recommended— "(iv) That in the interests of economy, as well as to facilitate specialist treatment of non-obstetric conditions associated with pregnancy and child-birth, new maternity accommodation should, where practicable, be associated with general hospitals." 27 This recommendation and the policy based on it are to a large extent responsible for the shortage of maternity beds. The Reports of the London Maternity Services Joint Committee in 1943 and of the Royal College of Obstetricians and Gynæcologists, 1944, take another view and recommend Maternity Units large and small, separate or associated with hospitass, according to the needs of the area. It is hoped that these recent influential reports may so modify the official outlook on this question that the Alexandra Maternity Home will have a long and useful life in the service of this Borough with the whole-hearted approval and co-operation of the Ministry of Health and Middlesex County Council. The Alexandra Maternity Home opened on October 1st, 1943, and received 22 patients in the three months up to December 31st. In 1944 the number of occupied beds had reached 17 when the flyingbomb phase of aerial war began and evacuations from London took place. The Home remained open for those mothers who, in spite of the dangers from the air, wished to remain near their homes. The Obstetric Surgeon to the Home is Dr. J. R. Harris and the Matron is Miss G. M. Howell, S.R.N., S.C.M. Dr. Mathias resigned from her duties as Ante-natal Medical Officer at No. 1 Centre (Town Hall) on her retiring from practice in this district. Dr. Harris accepted an invitation to take this work and also the Ante-natal Clinic at No. 4 Centre (Coldfall). Thus one-half of the ante-natal work at the Council's Centres is done by the Obstetric Surgeon at the Maternity Home. 28 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. SUMMARY OF BIRTHS NOTIFIED, 1943. Male Female. Total. Live births 732 710 1,442 Still births 23 23 46 755 733 1,488 The births were notified:— By doctors 14 ,, Borough Midwives 437 ,, Other Midwives 331 ,, Hospitals 170 ,. Others 512 1,464 Un-notified (from Registrar's returns): Live births 21 Still births 3 24 1,488 Of this number there were:— Live births Still births. Occurring in the Borough and transferred to other districts 175 3 Belonging to Hornsey and occurring in Hospitals, etc., outside the district 654 32 The 1,310 nett number of notified births belonging to Hornsey were divided among the districts of the Centres as follows:— Live Births. Still Births. Total Town Hall Centre 576 14 590 Burgoyne Road Centren 254 10 264 Church Road Centre 246 11 257 Coldfall Sub-Centre 191 8 199 1,267 43 1,310 Births attended by Borough Midwives:— Miss Andrews 159 Miss Hughes 90 Miss Matthews 102 Mrs. Thompson 69 Miss Jones 17 437 29 HOME HELPS. The Hornsey Home Helps Society was started in 1930 by members of the Voluntary Committees of the Centres. The splendid work done for thirteen years has been recognised by the Council, which in 1943 approved a more adequate financial provision and appointed Mrs. Inward. Hon. Secretary of the Society, to be Superintendent of Home Helps. CHILD LIFE PROTECTION. PUBLIC HEALTH ACT, 1936 (Secs. 206—220). Regular visits are paid by the Health Visitors to the homes of foster-mothers in their respective areas, and 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. 1 No, 2 No. 3 No. 4 Total No. of foster-mothers on the register: At the beginning of 1943 15 7 7 1 30 „ „ end 14 5 3 3 25 No. of foster-children on the register: At the beginning of 1943 32 16 14 1 63 ,, ,, end ,, ,, 27 16 4 6 53 Hied during the year - - - -1 On whom inquests were held during the year - - - - 0 . Visits to foster-children: 1st Visits 7 9 8 5 29 Total Visits 118 77 53 30 278 No proceedings were taken during the year. 30 MATERNITY STATISTICS. Ante-Natal, Natal and Post-Natal. MATERNITY AND CHILD WELFARE WORK. 1943. Nature of Work. Centres. Totals. No. 1. No. 2. No. 3. No. 4. Number of Children's sessions held 246 127 126 76 575 ,, ante-natal sessions held 150 60 50 22 282 Number of individual Mothers seen by Doctor:— Ante natal, New cases 408 208 188 69 873 ,, Old cases 1,429 719 587 253 2,988 Post-natal. New cases 97 54 47 3 201 „ Old cases 19 7 14 19 59 1,953 988 836 344 4,121 Total attendances of Mothers 2,897 1,030 928 379 5,234 Number of babies attending Centres for first time: Under 1 year 526 572 226 126 1,450 1 3 years 75 150 38 17 280 3—5 „ 26 22 19 9 76 Number of individual babies on Centre registers at end of 1943 1,445 720 542 266 2,973 Babies seen by Doctor 4,561 2,645 869 541 8,616 Attendances of babies at medical consultations 5,951 6,879 1,299 550 14,679 Total attendances of babies at Centres: Under 1 year 9,493 5,002 2,677 1,907 19,079 1—3 years 4,139 1,775 759 244 6,917 3—5 „ 654 303 164 60 1,181 Referred to own private doctors 23 16 11 32 82 Referred to hospitals 109 22 39 21 191 Visits paid by nurses:— First visits Total visits First visits Total visits First visits Total visits First Visits Total Visits Grand First visits Totals Total visits To expectant mothers 83 153 60 77 56 180 33 59 232 469 To infants under one year 603 2,218 203 393 275 907 179 306 1,260 3,824 To children aged 1-5 years 94 2,789 98 359 45 452 17 132 254 3,732 Total visits 780 5,160 361 829 376 1,539 229 497 1,746 8,025 CHILD LIFE PROTECTION— Visits paid to Foster Children 7 118 9 77 8 53 5 30 29 278 RECORD OF WORK OF MUNICIPAL MIDWIVES, 1943. Miss Andrews Miss Hughes Mist Matthews Mrs. Thompson Mrs. Jamison Miss Jones Total Confinements attended 164 109 109 61 — 21 464 Ante-natal Clinics attended 74 69 45 50 — 29 267 do. visits 659 283 222 184 — 91 1,439 Post-natal visits 1,859 1,453 1,489 924 1,547 275 7,547 31 WAR-TIME DAY NURSERIES. The following are some particulars relating to the War-time Day Nurseries in the Borough:— Name Address and Telephone Number Number of Children accommodated Date of Opening Matron Lady well 27, Church Lane, N .8 Mountview 8938 80 6/4/1942 Miss Stewart Queen's Lodge 40-42, Great North Road, N.6 Mountview 5339 74 27/6/1942 Miss Harper Red Gables 113, Crouch Hill, N.8 Mountview 7553 46 20/7/1942 Mrs Ryder Vincent House 68-70, Hampden Road, N.8 Mountview 9077 56 22/3/1943 Miss Brindle Clemence House 24, Queen's Avenue. N.10 Tudor 6730 50 To be opened early 1944 Mrs Bawcomb Stonecroft 100, Priory Road, N.8 63 To be opened in 1944 — The health of children and staffs in the War-time day Nurseries has been good, and the training of Probationers has been specially successful. Eleven Probationers have sat the examination for the Nursery Nurses' Diploma. All have passed and five have gained distinction. Credit for this is due to the excellent course of lectures and demonstrations which the Probationers have had at the Northwestern Polytechnic, to the great interest in the teaching taken by the Matrons and Medical Officers at the Nurseries and to the Probationers themselves for their keen and intelligent interest in the work. 38 Borough of Hornsey ANNUAL REPORT OF THE School Medical Officer FOR THE Year ending December 31st 1943 34 HORNSEY EDUCATION COMMITTEE. List of Members, 31st December, 1943 Members of the Town Council:— Alderman Mrs. C. M. Gave, 10, Wood Vale, N.10. Mr. Alderman W. J. Grimshaw, 25, Sheldon Avenue, N.6. Mr. Alderman J. W. Rowlands, J.P., 25, Cholmeley Park, N.6. Mr. Alderman L. J. Valette, 59, Allison Road, N.8. Mr. Alderman W. V. Wall, Kilten Lodge. Rowben Close, N.20. Mr. Alderman J. W. Palmer, 30, Crescent Road, N.8. Mr. Councillor M. W. Burns, 7. Womersley Road, N.8. Mr. Councillor H. Hynd, J.P., 12, Addington Road, N.4. Mr. Councillor D. V. Johnson, 54, Coolhurst Road, N.8. Mr. Councillor H. F. Nicholls, 163, Park Road, N.8. Mr. Councillor D. J. Treharne, 89, Tollington Park, N.4. Mr. Councillor W. J. Baker, 7, Woollaston Road, N.4. Mr. Councillor H. Norman, 14, Elder Avenue, N.8. Co-optative Members:— Rev. E. S. Duval, M.A., The Rectory, High Street, N.8.. Mrs. A. Holman, J.P., 8, Hornsey Lane, N.6. Mrs. G. M. Reid, B.A., 60a. Shepherd's Hill, X.6. Mrs. C. Crowther, 10a, Hampstead Lane, N.6. Mrs. J. I. Grimshaw, 25, Sheldon Avenue, N.6. Miss J. M. C. Bolton, 20, Grand Avenue, N.10. Director of Education: R. E. BRETTLE, M.A., D.Phil. 35 STAFF OF SCHOOL MEDICAL SERVICES. (December, 1943). School Medical Officer: R. P. Garrow, M.D., D.P.H. Deputy School Medical Officer: Marian Lonks, B.Sc., M B., B.S , M.R.C.S., L.R.C.P., D.P.H. Assistant School Medical Officer: Margaret Robinson, M.B., Ch.B., D.T.M. & H. Dentists. Winifred M. Hunt, L.D.S. Frances Carter, L.D.S., R.C.S. (Eng.). (Engaged in School Dental work in Cambridge for the duration of the War). Dorothy Young, L.D.S. Oculist: Dr. Marian Lones. Aurist: F. P. M. Clarke, B.A., B.Sc., L.R.C.P., L.R.F.P.S. (Glas.). Orthopædic Surgeon: J. A. Cholmeley, M.B., F.R.C.S. (Eng.). (Resident Medical Superintendent, Royal National Orthopaedic Hospital, Country Branch, Stanmore). Masseuse: Mrs. Yorke. (Royal National Orthopaedic Hospital). Nurses: Clerk: L. Hatton. H. Cavalier. L. M. Oliver. Assistant Clerk; C. Martin. J. wilmore. (Directed to Industry under National Service Acts, 20/12/42) Dental Attendants: L. Howard. E. S. Smith 36 To the Chairman and Members of the HORNSEY EDUCATIONAL COMMITTEE. Mr. Chairman, Ladies and Gentlemen, I have the honour to submit my Annual Report on the work of the School Medical Service for the year ending December 31st, 1943. Routine medical inspection of four age groups of children has been carried out in all departments of the elementary schools. The full range of clinic treatment of minor ailments, medical consultations, eye, ear, nose and throat, orthopædic and dental sessions have been maintained and there has been added in 1944 an "orthoptic scheme," that is, arrangements for the treatment of squint and associated defects of vision and of muscle balance of the eyes. The work is summarised in the statistical tables at the end of this report, figures which represent a very high standard of health and hygiene in the elementary school population. For example: Nutrition. There is no such thing as malnutrition amongst the children to-day. The rare case here and there of a child with "slightly subnormal nutrition" is explained on physiological grounds because it must be recognised that there are occasional children who, in spite of good food, rest and every care, fail to achieve a reasonable standard of nutrition. Malnutrition from lack of food has been abolished by rationing, ample school milk supplies in the morning and afternoon and excellent school dinners. Cleanliness. The number of individual children found "unclean" (and this means the discovery of even one or two nits in the hair) was 239 in 20,461 inspections made by the school nurses in the course of the year. These inspections are made without previous notice. Less than 4 per cent, of uncleanliness is the lowest ever recorded and has been achieved by the persistent endeavours of the teaching staffs aided bv the nurses to secure personal cleanliness amongst the children. Dental State. The neglected mouth so commonly seen at medical and dental inspection ten or more years ago is becoming rarer. Parents are taking a more intelligent interest in this important factor in health—and the result is a rising proportion of children who accept continuous dental attention during school life and leave school with sound and clean mouths. It is the duty of the School Medical Service to keep up a continuous survey of the school population from every angle affecting their physical and mental health—a duty in which it has the close co-operation of the parents and teachers. In this survey there is evidence of a definite upward trend which has been accelerated during the war, so that to-day, after five years of war, the findings of medical inspection are more favourable in all the important respects than in pre-war days. These findings were fully confirmed by the results of medical inspection for evacuation from " flying bombs " in 1944, when about half the elementary school population came under review. I have the honour to be, Ladies and Gentlemen, Your obedient servant, R. P. GARROW, School Medical Officer. 37 BOARD OF EDUCATION. MEDICAL INSPECTION AND TREATMENT RETURNS.* Year ended 31st December. 1943. TABLE I. MEDICAL INSPECTIONS OF CHILDREN ATTENDING PUBLIC ELEMENTARY SCHOOLS. A.—ROUTINE MEDICAL INSPECTIONS. (1) No. of Inspections:—Entrants, 1,084; Second Age Group, 980; Third Age Group, 174 Total 2,238 (2) No. of other Routine Inspections 19 Grand Total 2,257 B —OTHER INSPECTIONS. No. of Special Inspections and Re-inspections 2,545 TABLE II. CLASSIFICATION OF THE NUTRITION OF CHILDREN INSPECTED DURING THE YEAR IN THE ROUTINE AGE GROUPS. Number of Children Inspected. A (Excellent) B (Normal) C (Slightly sub normal) D (Bad) No % No. % No. % No. % 2,257 1,100 48 1,150 51 7 3 0 0 The Authority are asked to refer to the Form for 1940 for notes in connection with these Tables. 38 TABLE III. GROUP I.—Treatment of Minor Ailments (excluding Uncleanliness) Total number of defects treated or under treatment during the year under the Authority's Scheme 3,543 GROUP II.—Treatment of Defective Vision and Squint. Errors of Refraction (including Squint) 230 Other Defect or Disease of the Eyes excluding those recorded in Group 1) 309 Total 539 Under the Authority's Scheme No. of Children for whom spectacles were (a) Prescribed 277 (b) Obtained 221 GROUP III.—Treatment of Defects of Nose and Throat. Received Operative Treatment 1 Received other forms of Treatment 472 Total Number Treated 473 39 TABLE IV. DENTAL INSPECTION AND TREATMENT. (1) Number of children inspected by the Dentist— (6) Fillings— Permanent Teeth 4,157 (a) Routine age-groups 4,130 Temporary Teeth 241 (b) Specials 771 Total 4,398 (c) Total (Routine and Specials 4,901 (7) Extractions— Permanent Teeth 429 (2) Number found to require treatment 4,167 Temporary Teeth 3,120 Total 3,549 (3) Number actually treated 2,702 (4) Attendances made by children for treatment 4,724 (8) Administration of general anaesthetics for extractions 729 (5) Half-days devoted to— (9) Other Operations- Inspection 53 Permanent Teeth 478 Treatment 654 Temporary Teeth 2,788 Total 707 Total 3,266 TABLE V. VERMINOUS CONDITIONS. (i) Average number of visits per School made during the year by the School Nurses or other authorised persons 34 (ii) Total number of examinations of children in the Schools by School Nurses or other authorised persons 20,461 (iii) Number of individual children found unclean 239 =just under 4% (iv) Number of individual children cleansed under Section 87 (2) and (3) of the Education Act, 1921 2 (v) Number of cases in which legal proceedings were taken:— (a) Under the Education Act, 1921 — (b) Under School; Attendance Byelaws — TABLE VI. BLIND AND DEAF CHILDREN. Number of totally or almost totally blind and deaf children who are not at present receiving education suitable for their special needs. The return should relate to all such children, including evacuees resident In the Authority's area:— 1 At a Public Elementary School. 2 At an Institution other than a Special School. 3 At no School or Institution. Blind Children 1 1 1 Deaf Children 0 0 0 40 TABLE VII. SCHOOL MEDICAL AND DENTAL STAFF. Name of Officer. Proportion of whole time devoted to— School Medical Service. Public Health. S.M.O. R. P. Garrow, M.D., D.P.H 15/40 25/40 A.S.M.Os.— Marian Lones, B.Sc., M.B., B.S., M.B.C.S., L.R.C.P., D.P.H 6/11 5/11 Margaret. Robinson, M B., Ch.B., D.T.M 2/11 9/11 Dr. Jasmine Taylor, M.B., Ch.B., B.A.O., D.P.H. £50 + £25 £50+ £25 Senior Dentist—Miss W. M. Hunt, L.D.S. Whole-time — Dentists—Miss D. Young, L.D.S. Whole-time — SCHOOL NURSING STAFF (excluding Specialist Nurses, such as Orthopædic Nurses) No. of Officers. Aggregate of time given to S.M.S. work in terms whole-time Officers. School Nurses 3 Whole-time S.M.S. District Nurses — — Nursing Assistants - — Dental Attendants 2 Whole-time S.M.S. 41 ANNUAL REPORT OF THE ORGANISERS OF PHYSICAL EDUCATION FOR THE YEAR ENDED 31st DECEMBER, 1943.* During the year under review the work of the Organisers has heen concerned chiefly in following up and developing the experiments undertaken during 1942. War-time conditions have made it difficult to establish new methods and new schemes on extensive lines. The Organisers consider that probably the most important part of their work has been in assisting teachers to modify and adapt their work to suit the present staffing arrangements and war-time conditions. This work has, of necessity, been carried out in the schools individually and has most frequently taken the form of demonstrations given to one or more teachers with a complete class or a specially selected group of children. This type of work has been carried on both inside and outside the normal school hours. Although this individual approach is most valuable at the present time, and is much appreciated in the schools, it is evident that it is a slower method and less comprehensive than the peace-time procedure of conducting courses for large groups of teachers concerned with a particular age group or a specific branch of the subject, e.g., organised games for Junior Boys. In spite of the many difficulties, of which not the least is the shortage of shoes, suitable clothing and apparatus, it is gratifying to report that in some cases there is an obvious improvement in the standard attained. In both the Senior Boys' and Girls' Departments more advanced and intensive work with apparatus is being attempted. Dancing. A scheme of Dancing was issued to the schools following two courses conducted for Teachers. It is hoped that this will result in dancing lessons being included more regularly in the school curriculum. Playing Fields. The increased demand for the use of Playing Fields by both Schools and Youth Organisations has continued. This extensive use of the pitches on every week day, including Saturday, gives little opportunity for recovery from the excessive wear and tear to which they are subjected. The size and shape of the fields prohibits fullsized pitches being marked out, and also prevents the position of pitches being varied to rest the ground. The additional area secured by the Committee at the Crouch End Playing Fields is now in use. Work is proceeding in the preparation of the extension to the Newlands Playing Field. There is still a need for more and larger playing fields and parks in order to cater adequately for all school-children and for all adults who wish to participate in outdoor physical activities. It is hoped, therefore, that in planning for post-war Educational Reconstruction in Hornsey the Committee will give consideration to the provision of additional open spaces for recreation and games, for it is evident that sufficient acreage is not available at the present time. * Note.—The Annual Report of the Organisers of Physical Education is appended to the Annual Report of the School Medical Officer at the request of the Minister of Education. 42 Organised Games. With regard to the Organised Games lessons, it is now felt that most teachers are more familiar with intensive training methods, making use of the maximum amount of apparatus and catering for all pupils during the lesson. This has greatly increased the interest and enthusiasm of the children. Organised Games out of school hours, including Saturday mornings, have been re-introduced for the first time since the outbreak of war. Athletics. As foreshadowed in the Annual Report for 1942, an Athletics Scheme on the "All-in" principle was issued to the schools in the Spring of 1943. The Scheme was originally intended for children in Senior Schools, but such was the enthusiasm of the Junior Schools' staffs that almost every school Sports Day in the Borough was conducted on this principle. It was particularly gratifying to the Organisers on these occasions to see every child, with the exception of those medically unfit, taking part in and enjoying the School Sports. It is hoped that in future seasons the full application of the Scheme will also result in the regular coaching and training of each child over a period leading up to the Sports Day. Swimming. The number of children who could benefit from swimming instruction has again been limited owing to the continued closure of Mattison Road Bath. Less accommodation was available in 1943 than in previous years for Hornsey school-children at Western Road Bath, Wood Green. Some classes attended at the Hornsey Open Air Pool and some children from two schools were catered for at Hornsey Road Bath. Islington. The inclusive total of 8,397 attendances throughout the season represents approximately 466 children only who received regular swimming instruction. The need for indoor swimming baths designed for instruction purposes is urgent, and it is hoped that Postwar Planning Schemes will include the provision of more than one such bath. It is understood that the Mattison Road Bath will be available for use by the schools in 1944. Gymnasia Floors. The gymnasia floors at the Campsbourne, and North and South Harringay Schools have been washed and treated with a special Scandinavian varnish during the season. Apart from preserving the maple floors, -this treatment has improved the surface by making it non-skid as well as more hygienic. Similar treatment is to be carried out at Highgate Council School. Secondary Schools. The secondary schools have been visited at regular intervals and demonstration lessons have been given to the men teachers who are endeavouring to carry on the work of the Physical Training Specialists now enlisted in H.M. Forces. Head and assistant masters and mistresses have expressed their appreciation of the advice and assistance given during these visits. 43 Teachers' Courses. A Lecture-demonstration Course for Men Teachers and for Women Teachers interested in Junior and Senior Boys' work, was held during the Spring Term. Forty-nine teachers, including twelve head teachers, attended the course. The demonstrations were given by children from six schools, and showed progressive work from the lowest Junior to the top Senior Class. The demonstrations were of two types: (a) a complete lesson, (b) an analysis. A second course of Dancing was held for women teachers. Evening Classes. Physical Education is being carried out regularly and systematically in all the Pre-Service Organisations. Efforts have been made to interest youth members from the voluntary Organisations in Physical Education, but results have not been encouraging. The shortage of suitable and well-qualified leaders is acute, and it is difficult to establish classes. The regular flow of young men and women into the Services has resulted in a continuing change of personnel in the classes which has tended to interrupt progressive training. Six evening classes have been in operation during the season. Holidays at Home. At the Open Air Pool a Splash Night was organised particularly for children and youths. Boys and girls competed from all Departments where swimming had been taught. In spite of showery weather demonstrations of Physical Training were given by Senior Boys and Girls. All these efforts were appreciated by the parents and friends in attendance. ' (Sgd.) JOHN B. MARK, FLORENCE E. BIRKBY, Organisers of Physical Education.