LIBRARY HOR 36 BOROUGH OF HORNSEY. ANNUAL REPORT of the Medical Officer of Health for 1944 R. P. GARROW, M.D., D.P.H. Printed by "The Hornsey Journal," Ltd.. 161, Tottenham Lane. N.8. 2 HEALTH COMMITTEE. Councillor J. L. R. Webb, (Chairman), 11, Wilmer Way, N.14 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. „ J. O. Cave, 10, Wood Vale, N.10. „ S. G. Goulding, Woodlands, Cranley Gardens, n.10. Wm. J. Grimshaw, J.P., '25, Sheldon Avenue, N.6. „ Mrs. M. N. Hill, 16, Bishopswood Road, N.6. „ J. W. Shipp, F.R.San.I., 40, Coleridge Road, N.8. „ L. J. Valette, 80, Tottenham Lane, N.8. „ W. V. Wall, Kilton Lodge, Rowben Close, Totteridge. „ C. wlnkley, 72, Woodside Avenue, N.10. I Councillor H. W. Arnold, 23, Etheldene Avenue, N.10. „ P. Baxter, 51, Lothair Road, N.4. „ F. A. P. Boustred, 26, Lanchester Road, N.6. „ M. W. Burns, 7, Womersley Road, N.'8. „ Mrs. N. C. Clegg, 28, Stormont Road, N.6. „ J. Edwards, 102, Turnpike Lane, N.8. „ G. F. N. Norman, 12, Woodberry Crescent, N.10. „ F. L. pascoe, 23, Dorchester Court, 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 Marian 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., Ch.B., D T.M. & H. tDentist (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 Poods. (Retired 31/7/44). J. H. Jesse, M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Foods. A.R.P.S. (Appointed 1/8/44). †*Sanitary Inspectors and Shops Acts Inspectors, Young Persons Act Inspectors, Factory Act Inspectors J. D. Chance, M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Poods. E. Hundy, M.S.I-A. Cert. R.San.I. Cert. Insp. of Meat and Poods. Cert. San. Science. R. Downes, M.S.I.A. Cert. R.San.I. J. Calderbank, M.S.I.A., A.R.Sant.I. Cert. R.San.I. & S.I.E., Joint Board. Cert. Insp. of Meat and Poods. W. J. Wilson, M.S.I.A. Cert. R.San.I. Cert. Insp. of Meat and Poods. (Appointed 1/12/44). 4 †Chief Clerk E. Cheesman, (On Active Service from 12/3/42). Acting Chief Clerk Miss P. Aylward, tAssistant Clerks N. Smith, (On Active Service from 11/1/40). 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. Miss D. M. Sellman, Miss M. Humphreys. tHealth Visitors Mrs. E. Durnford, H.V. Cert., S.C.M. (Retired 31/8/44). Miss A. Godden, H.V. Cert., S.R.N., S.C.M. Mrs. L. Hatton, H.V. Cert., S.R.N., S.C.M. (Part-time Health Visitor and School Nurse). Miss E. Whimster, H.V. Cert., S.R.N., S.C.M. Miss W. Melhuish, H.V. Cert., S.R.N., S.C.M. Miss E. N. Gibbon, H.V. Cert., S.R.N., S.C.M. (Appointed 1/9/44). fMidwives Miss M. Andrews, s.c.m. Miss L. Hughes, s.c.m. Miss A. C. Matthews, s.c.m. Mrs. K. Thompson, s.c.m. (Transferred to Maternity Home). Miss R. Jones, s.c.m. Miss A. J. Buckeridge, S.C.M., S.R.N. (Teacher's Cert.). (Appointed 1/10/44). Mrs. M. Jamison, s.c.m. (Part-time). fDisinfectors and Mortuary W. H. Lewis, Attendants P. Hall. fMedical Services Motor Driver P. Martin. (On Active Service from 19/2/42). G. Wadsworth. iVeterinary Inspector under F. G. BUxTON, M.r.c.v.s. Diseases of Animal Acts 15, Jackson's Lane, N.6. Note.— † Whole-time Officers. * Officers in respect of whom salary contribution is made under the Public Health Aots 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 on the Public Health for the year ending December 31st, 1944. It is common knowledge to those who read the daily papers and listen to the news over the air that the health of this country has been maintained at a high standard through nearly six years of war. There have been no serious epidemics such as the worldwide pandemic of influenza which followed immediately on the European War of 1914-18, and cost many more lives in four months than were lost in four years of warfare. The chief vital statistics of the Borough seen in comparison with past years in Hornsey and also with the corresponding figures for England and Wales, the 126 County Boroughs and "Great Towns," the 148 Smaller Towns, and London, are set out in Table A. From this comparison it will be seen that the birth rate of 19.08 per 1,000 of population is the highest for a quarter of a century; the infant mortality at 38.39 per 1,000 live births is well below the figures for England and Wales, the Great Towns, the Smaller Towns and London. The death rate of 14.94 is the highest (except 15.16 for 1940) ever recorded, and compares unfavourably with the figures for England and Wales, Great Towns, and Smaller Towns. The explanation of this figure is the high proportion of aged persons in the Borough. On account of the exceptional age-constitution of our population, this figure must remain high. The Minister of Health (Circular 49/45) mentions " certain subjects of current interest in particular," on which observations should be made, e.g., Tuberculosis, Venereal Disease, premature and illegitimate infants and infestation. Tuberculosis and Venereal Disease. These have been referred to in propaganda on public health by various authorities, high and low, as the " black spots " on our otherwise satisfactory vital statistics. I am happy to be able to report that they are amongst the " high lights " of the picture in this Borough. The deaths from tuberculosis in 1944 totalled 42 (39 pulmonary and 3 non-pulmonary), which is the smallest number ever recorded. It is not quite so easy to state the position in regard to the venereal diseases, because they are not notifiable as such. Venereal diseases have, however, repercussions in various directions, which enable a Medical Officer of Health, in close touch with the population, through the Maternity and Child Welfare and School Medical Departments, to become aware of any striking rise or fall in the incidence of V.D. For example, Ophthalmia Neonatorum (inflammation of the eyes of the newborn infant) is notifiable. In its most acute forms it is generally due to gonococcal infection of the infant's eyes, contracted in birth from the mother. The notifications of Ophthalmia Neonatorum totalled 13 in the five years '1940-1944 inclusive, against 28 notified in the five years 1935-1939. Then at the Ante-natal Clinics, where expectant mothers in hundreds (including young ^ women recently in the Forces) are examined periodically, there 6 has been practically no evidence of syphilis, gonorrhoea or softsore. Similarly, the thousands of infants and young children attending the Child Welfare Centres have shown no evidence of syphilitic infection of their parents. Finding it difficult to reconcile this clean local bill of health with the oft-repeated statement that venereal diseases have more than doubled during the war, I obtained the figures of persons attending V.D. Clinics in London and the four contiguous counties for the five years of war and for ten years before the war. The statistics indicate that, in the depleted civilian population of these five counties, V.D. was lower in incidence during every year of war than in any of the ten years preceding the war, and less than half the incidence in the early thirties—well remembered as the years of economic depression and unemployment following the financial crisis of 1931. Premature and Illegitimate Children. Premature children and infants born under weight naturally receive special care in nursing and feeding by the midwives in domiciliary practice, by the staff of the Alexandra Maternity Home, by the Health Visitors in their home visiting, and by the Medical Officers at the Infant Welfare Centres. Illegitimate infants receive the same care and attention from the staff of the Maternity and Child Welfare Department as do legitimate children and, with the co-operation of voluntary agencies, all the suggestions (a) to (h) in Circular 2866 from the Ministry of Health regarding the care of illegitimate children are in operation in this Borough. Infestation. Adequate facilities exist for dealing with skin infestations— pediculosis and scabies. Adult males found infested are treated by men at the Central Depot, High Street, Hornsey, and women and children have the same treatment from a woman at the Cleansing Station established in Pear Tree Cottage, adjoining the School Clinic at the Town Hall. Immunisation. For the third successive year no death occurred from diphtheria. The diphtheria wards at the Joint Isolation Hospital, Muswell Hill, which serves the needs of Hornsey, Finchley, Wood Green and Friern Barnet (a population of about a quarter of a million), have been closed during the entire year and remain closed. There is now no need to persuade parents to have their children immunised. They have learned from experience that immunisation is a perfectly painless and safe procedure, without unpleasant reactions, and they believe, rightly, that it prevents diphtheria in the great majority of children and is an almost certain protection against a fatal issue from this disease. Therefore they welcome the opportunities for immunisation provided by the Council at the Infant Welfare Centres War-Time Day Nurseries and in the Schools. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, R. P. GARROW, Medical Officer of Health. 7 STATISTICS FOR 1944 (Section A). SOCIAL AND ECONOMIC STATISTICS. Area (acres) 2,872 „ (square miles) 4.49 Population (Census 1931) 95,524 Do., Registrar-General's estimate, 1944 76,440 No. of separately-assessed inhabited premises (end of 1944), according to Rate Books 23,100 Rateable value (General Rate) at 31st December £1,053,685 Product of a penny rate £4,075 LIVE BIRTHS. M. F. Total Legitimate 722 677 1,389 Illegitimate 33 37 70 755 704 1,459 Birth Rate , 19.08 (per 1,000 population). STILL-BIRTHS. M. F. Total Legitimate 18 23 41 Illegitimate 3 0 3 21 23 44 Still-Birth Rate 29.28 (per 1,000 total live and still births). DEATHS. Males 539 Females 603 1,142 Death Rate , 14.94 (per 1,000 population). INFANT DEATHS (under 1 year of age). M. F. Total Legitimate 23 26 49 Illegitimate 6 1 7 29 27 56 DEATH RATE OF INFANTS UNDER 1 YEAR OF AGE. All infants per 1,000 live births 38.39 Legitimate infants per 1,000 legitimate live births 35.27 Illegitimate infants per 1,000 illegitimate live births 100.0 MATERNAL MORTALITY. Deaths. Rate per 1,000 total (live and still) births Puerperal and post-abortive sepsis 1 0.66 Other maternal causes 1 0.66 Total 2 1.32 8 DEATHS FROM SPECIAL CAUSES. Deaths from Cancer (all ages) 172 Deaths from Measles (all ages) 0 Deaths from Whooping-Cough (all ages) 4 Deaths from Diarrhœa (under 2 years of age) 5 GENERAL PROVISION OF HEALTH SERVICES FOR THE AREA (Section B). 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. J. H. Jesse, Chief Sanitary Inspector: Complaints 1,539 Re-inspections 2,703 Information from builder 178 Special Inspections 351 Drainage 260 Water tests applied (new drains) 15 Smoke and Chemical tests (old drains) 53 Fee Tests 1 Verminous houses 77 Pests 29 Overcrowding surveys 2 Overcrowding Re-inspections 3 Notifiable Infectious Diseases 278 Scabies 108 Small-pox Contacts 75 Food Poisoning 5 Sunday Trading Inspections 118 Shops Acts 33 Cooked Meat Shops 2 Butchers' shops 37 Slaughter-Houses 105 Dairies and Milkshops 26 Grocers' shops 98 Bakehouses 19 Fish shops 23 Restaurant kitchens 15 Greengrocers' shops 13 Other food shops 81 Food Inspections 508 Milk Surveys 3 Rat Infestation Order 1,017 Factories and outworkers 48 Conveniences 9 Music and Dancing Licences 9 Petroleum Stores 51 Smoke observations 1 Surveys (Permitted Number) 10 Re-Surveys (Permitted Number) 2 Memo. B. E. & S. 15 9 INSPECTIONS NECESSITATED BY WAR CONDITIONS. Rest Centres 4 Salvage Sack Sites 292 Survey of Unoccupied Houses 680 Landlord & Tenant (War Damage) Amendment Act, 1941 148 Air Raid Shelters 326 Fuel and Lighting Order 56 Food Shops Damaged 2 First Aid Repairs 378 Control of Building Operations (No. 2) Order, 1944 498 Visits re Certificates of Essentiality 97 Building Licences 266 10,667 NOTICES. The Notices served during the year are as follows:— Under the— Verbal Preliminary Statutory Public Health and Housing Acts 167 602 38 Housing Byelaws — 3 — 167 605 38 SUMMARY OF SANITARY IMPROVEMENTS CARRIED OUT. DRAINAGE. Number of houses and premises redrained 2 Repairs or amendments to existing drains 25 Drains or gullies unstopped or cleansed 64 Manholes provided 9 Manholes repaired 14 Intercepting traps fixed 6 New gulley traps fixed 15 New soil pipes and ventilating shafts fixed 6 Soil pipes and ventilating shafts repaired 9 WATER-CLOSETS AND SANITARY FITTINGS. New water-closet buildings 2 New water-closet basins fixed 54 Water-closets unstopped, cleansed or repaired 33 New sinks provided 19 New lavatory basins provided 13 Waste-pipes trapped, repaired or unstopped 42 Waste-pipes diverted into proper drain 8 Baths provided or made usable 1 Urinals cleansed 3 MISCELLANEOUS. Roofs repaired 103 Eaves guttering renewed, cleansed or repaired 51 Rain-water pipes provided, repaired 32 Damp walls remedied 48 Damp-proof courses inserted 6 Paving of yards repaired 14 Premises structurally repaired 211 10 Rooms cleansed, distempered or papered 23 Premises disinfested of vermin 7 Drinking-water cisterns repaired, cleansed and covered 25 Water supply (additional) provided 26 Windows and skylights provided or made usable 25 Sub-floor ventilation 3 Floors repaired 53 Walls and ceilings repaired 141 Windowsills repaired 8 Sash cords and fittings repaired 47 Sanitary dustbins provided 64 Accumulations of manure and refuse removed 11 Stoves, ranges and coppers repaired or renewed 59 Sundry items 50 1,329 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. Five houses have been dealt with under these Byelaws during the year and the following works carried out:— Byelaw. 4 (b) Water supplies 1 4 (e) Cooking accommodation 1 5 (g) Staircase repairs 2 5 (h) Handrails provided 1 5 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) 1,430 (b) Number of inspections made for the purpose 2,594 (2) (a) Number of dwelling-houses (included under sub-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 499 11 2. Remedy of Defects during the Year without service of formed Notices:— Number of detective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers 223 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 — B.—Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 38 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (a) By owners 12 (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 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 — (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 30 (ii) Number of families dwelling therein 37 (iii) Number of persons dwelling therein 216 (b) Number of new cases of overcrowding reported during the year 2 (c) (i) Number of cases of overcrowding relieved during the year 1 (ii) Number of persons concerned in such cases 9 * 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 reeard to overcrowding. 12 INSPECTION AND SUPERVISION OF FOOD. (Section E.) FOOD CONDEMNED—1944. lbs. ozs. lbs. ozs. Tinned Meat 823 10 Biscuits 76 8 Tinned Vegetables 225 12 Tinned Fruit 179 Tinned Dried Milk 46 7 Dripping 18 Tinned Liquid Milk 734 5 Lard 138 4 Tinned Fish 285 5 Flour 2,027 8 Tinned Jam 79 8 Cocoa Butter 672 Tinned Soup 132 10 Extracon 196 Bottled Jam 1,100 Sweetened Chocolate 470 Bottled Marmalade 158 Golden Syrup 58 Tea 208 12 Salad Cream 3 Sugar 4,311 4 Custard Powder 3 Bacon 824 10 Fresh Vegetables 2,128 8 Cooked Meats 127 10 Poultry 82 Margarine 121 10 Spaghetti 25 Butter 52 Cakes 26 Cereals 1,347 Gravy Powders 14 10 Dried Vegetables 1,931 8 Salt 180 4 Cheese 287 11 Spices 3 11 Dried Egg 32 10 Pepper 1 Sauce 24 12 Mustard 9 8 Winkles 56 Vegetarian Foods 11 4 Fresh Meat 835 5 Meat Extracts 13 10 Fresh Fish 3,830 2 Honey 43 Fresh Fruit 948 Sweets 348 4 Cocoa 3,841 Bread 161 Coffee 15 8 Lemonade Powder 7 Cake and Pudding Mixtures 119 Suet 20 8 Benger's Food 40 Marmite 4 Gelatine 2 8 Pickles 252 12 Nut Frying Oil 112 Bottled Milk 2 quarts Dried Fruit 406 4 Fruit Squash 25 bottles Tinned Marmalade 21 Eggs 613 Chocolate Powder 24 Oxo Cubes 44 229 Horses were slaughtered and one Pony. 746¼ lbs. of meat were condemned, including liver and lungs. CLEANSING AND DISINFECTING STATION. Male adults are treated at the Cleansing Station attached to the Central Depot in High Street, Hornsey. Women and children are dealt with at the Cleansing Station close by the School Clinic at the rear of the Town Hall. Disinfection of clothing is carried 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 1944. 13 INFECTIOUS DISEASES. (Section F.) DIPHTHERIA IMMUNISATION. The following are the numbers of children immunised during 1944:— Under 5 years of age 569 Over 5 years of age 52 Total 621 VACCINATION. The Public Vaccinators inform me that they performed vaccination of persons in the Borough during 1944 as follows:— Dr. E. Buckler 286 Dr. R. Mackay 506 PREVENTION OF BLINDNESS. (PUBLIC HEALTH ACT, 1925, SECTION 66.) Four cases of ophthalmia neonatorum were notified, all of which were nursed at home. Cases Vision unimpaired. Vision impaired. Total blindness. Deaths. Removed from district. Notified. Treated At home. In hospital or nursing home. 4 4 0 3 0 0 0 1 TUBERCULOSIS. PUBLIC HEALTH (PREVENTION OF TUBERCULOSIS) REGULATIONS. No occasion has arisen in the course of the year to put these powers into action. The following statement shows the total number of beds for cases of tuberculosis belonging to or reserved for the sole use of the Middlesex County Council at the end of December, 1944, namely:— Institution Accommodation Type of Case Adults Children M F Harefield County 192 192 66 Pulmonary—sanatorium Hospital 4 4 10 „ observation Clare Hall County Hospital 198 222 34 „ sanatorium Danesbury Manor, Welwyn - 60 - „ Victoria Home, Windsor — — 6 Non-pulmonary 14 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 1944 was 1,076, viz., pulmonary 843, non-pulmonary 233, an increase of 48 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. Ninety-two 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 1944, as follows:— Total number of Licences issued under the Contagious Diseases of Animals Acts 0 Inspections made under the Contagious Diseases of Animals Acts 26 (Pigs 261) No action was necessary under the Tuberculosis Order, 1925. One post-mortem examination on a. pig was carried out during the year. 15 LIST OF TABLES. TABLE A.—Vital Statistics, 1914-1944. TABLE B.—Causes of, and ages at, death in 1944. TABLE C.—Infant Mortality in 1944. Causes of, and ages at, death. TABLE D.—Births, Deaths, Infant Deaths, and Deaths from certain diseases, 1915-44. TABLE E.—Cases of Infectious Disease notified in 1944. TABLE F.— (1) Notification of, and deaths from, Tuberculosis, 1944. „ (2) Tuberculosis Register, 1944. 16 TABLE A. BOROUGH OF HORNSEY VITAL STATISTICS, 1914-1944. Year. Estimated Mid-Year Population. Birth Rate per 1,000 Population. Death liate per l.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 Regr.-Gen.'s Estimate. 88,450 13.8 12.7 54.06 1930 88,450 Census. 13.7 11.8 41.38 1931 95,524 Regr -Gen.'s Estimate 11.9 11.2 52.6 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 1944 76,440 19.08 14.94 38.39 ENGLAND and WALES (Rates in 1944) 17.6 11.6 46 126 County Boroughs and Great Towns, including London (Rates in 1944) 20.3 137 52 148 Smaller Towns Resident Population 25,000—50,000 at 1931 census (Rates in 1944) 20.9 12'4 44 London (Adm. County) (Rates in 1944) 15.0 15'7 61 17 TABLE B.—CAUSES OF, AND AGES AT, DEATH, 1944. Total. All Ages. 0 1 2—4 5—14 15-24 25-34 35-44 45-54 55-64 65-74 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 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 3. Scarlet Fever 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 4. Whooping cough 4 2 2 2 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 5. Diphtheria 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 6 Tuberculosis of respiratory system 39 24 15 ... ... ... ... ... ... ... ... 3 1 2 7 6 3 4 ... 8 2 1 2 ... ... 6 7. Other forms of tuberculosis 3 1 2 ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... 7 8. Syphilitic diseases 8 7 1 ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... 1 ... ... 3 ... 2 ... 8 9. Influenza 8 6 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 2 1 2 1 9 10. Measles 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10 11. Acute polio-myelitis and polio encephalitis 0 0 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11 12. Acute infectious encephalitis 1 1 0 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 12 13 Cancer of buccal cavity and oesophagus (males only) 11 11 0 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 2 ... 2 ... 4 ... 13 Caucer of uterus (females) 10 0 10 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 ... ... ... 4 ... 2 14. Cancer of stomach and duodenum 21 10 11 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 6 6 3 1 2 14 15. Cancer of breast 15 0 15 ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 3 ... 1 ... 3 ... 5 15 16. Cancer of all other sites 115 52 63 ... ... ... ... ... ... ... ... ... ... ... 1 2 1 5 8 16 13 18 22 11 18 16 17. Diabetes 5 2 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 1 ... 1 17 18. Intra cranial vascular lesions 136 54 82 ... ... ... ... ... ... ... ... ... ... ... 1 1 1 4 5 7 9 23 33 19 33 18 19 Heart disease 269 128 141 ... ... ... ... ... ... ... ... ... 1 3 1 1 5 7 3 29 12 35 44 53 75 19 20. Other diseases of circ. system 51 31 20 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 2 2 2 9 5 18 10 20 21. Bronchitis 60 31 29 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 3 4 3 11 4 14 19 21 22. Pneumonia 47 21 26 3 5 ... ... ... ... ... ... ... ... 1 1 ... 1 1 3 2 2 9 7 5 7 22 23 Other respiratory diseases 10 1 9 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 1 1 6 23 24 Ulcer of stomach or duodenum 16 10 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 1 2 1 ... 4 3 ... 24 25. Diarrhœa, under 2 years 5 2 3 2 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 25 26 Appendicitis 2 0 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 26 27. Other digestive diseases 26 13 13 ... 2 ... ... ... ... ... ... ... ... 1 ... ... ... 4 ... 3 2 2 5 3 4 27 28. Nephritis 28 15 13 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 3 4 4 5 6 4 28 29. Puerperal and post abortive sepsis 1 0 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 29 30. Other maternal causes 1 0 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 30 31. Premature birth 13 10 3 10 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 31 32. Con. mal., birth injuries, ile disease 23 10 13 9 10 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 1 ... ... ... 32 33. Suicide 3 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... 33 34. Road traffic accidents 7 5 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 ... ... 1 1 2 ... 34 35. Other violent causes 131 50 81 ... 1 ... ... 1 1 ... 1 7 4 5 8 9 14 11 9 6 6 7 10 4 27 35 36. All other causes 73 40 33 3 2 ... 1 ... ... ... ... 2 ... 1 1 2 1 1 3 3 4 9 4 19 17 36 Totals 1,142 539 603 29 27 0 2 2 1 0 1 12 7 16 20 25 35 51 46 91 72 146 160 167 232 18 TABLE C.—INFANT MORTALITY, 1944. 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 Day Under 1 Week 1 2 3 1-2 3-5 6-8 9-11 Conditions associated with Pregnancy & Birth Premature Birth 6 6 1 ... ... ... ... ... ... 13 27 Congenital Malformations 1 4 3 1 ... ... ... ... ... 9 Congenital Debility ... ... ... 1 ... 1 ... ... ... 2 Injury at Birth 1 1 ... ... ... 1 ... ... ... 3 Conditions arising from Infection after Birth Varicella ... ... ... ... ... ... 1 ... ... 1 29 Whooping Cough ... ... ... ... ... ... 1 2 ... 3 Meningitis (non-meningoc) ... ... ... ... ... ... 1 ... ... 1 Pneumonia ... ... ... ... 1 2 2 3 ... 8 Hernia Intestinal Obstruction ... ... ... ... ... ... ... 2 ... 2 Enteritis and Diarrhœa ... ... ... ... ... 1 3 1 ... 5 Other diseases peculiar to first year of life 1 4 ... ... ... ... ... ... ... 5 Other causes ... ... ... ... ... 1 1 ... 2 4 Totals 9 15 4 2 1 6 9 8 2 56 19 TABLE D.—BIRTHS. DEATHS, INFANT DEATHS AND DEATHS FROM CERTAIN DISEASES. 1915-1944. 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) 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 0 171 44 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 0 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 74,80C 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 1944 76,440 1,459 44 1,112 56 0 4 5 0 0 0 172 39 3 * (a) For calculation of Birth rates. „ (a). For calculation of Infant and Maternal Mortality Rates, (b) „ „ „ Death rates. (b) „ „ „ Birth rates. 20 TABLE E.—INFECTIOUS DISEASES NOTIFIED, 1944. DISEASE WARDS AGES Total Admitted to Joint Hospital. Admitted to other Hospitals. Nursed at Home. Highgate Muswell Hill. Crouch End Central Hornaey North Haringey South Haringey Stroud Green Finsbury Park. 0- 1 15 515 1525 2545 4565 65 and over Scarlet Fever 17 20 10 57 21 4 27 4 2 49 92 12 4 1 0 160 115 1 44 Diphtheria 8 3 2 0 4 3 1 0 0 4 6 8 3 0 0 21 21 0 0 Pneumonia 4 5 8 9 8 2 4 1 1 3 3 6 4 15 9 1 1 2 38 Erysipelas 3 7 1 8 1 0 2 0 1 1 0 0 12 5 3 22 12 1 9 Puerperal Pyrexia 2 1 0 1 0 0 0 0 0 0 0 1 3 0 0 4 0 4 0 Ophthalmia Neonatorum 1 0 1 0 0 1 1 0 4 0 0 0 0 0 0 4 0 0 4 Cerebro-Spinal Meningitis 1 1 0 0 0 0 0 0 1 0 0 1 0 0 0 2 1 1 0 Dysentery 3 4 0 1 1 0 0 0 1 3 2 0 1 1 1 9 2 4 3 Measles 2 8 17 71 47 43 21 6 14 97 88 11 3 2 0 215 18 0 197 Whooping Cough 12 52 5 36 32 21 31 8 38 104 52 0 1 2 0 197 9 3 185 Encephalitis 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 Malaria 0 0 0 0 1 0 1 0 0 0 0 1 0 1 0 2 0 0 2 Total 54 101 44 183 115 74 88 19 62 261 244 40 31 27 13 678 179 17 482 Admitted to Joint Isolation Hospital 28 28 15 55 23 6 20 4 Other Hospitals 5 5 0 1 2 0 4 0 Nursed at Home 21 68 29 127 90 68 64 15 Excluding T.B. There were 90 natients suffering from diseases other than infectious diseases treated at the Isolation Hospital in addition to the above. 21 TABLE F.— (1) NOTIFICATION OF, AND DEATHS FROM, TUBERCULOSIS. 1944. AGE PHRIODS. New Cases. Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M F M F M F M F Years 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 2- 4 8 2 0 1 0 0 1 0 5-14 3 1 5 0 0 0 0 0 15-24 19 22 3 3 3 1 0 0 25-34 15 28 2 0 2 7 0 0 35-44 38 9 0 0 6 3 0 1 45-54 10 2 0 0 4 0 0 0 55-64 10 2 0 0 8 2 0 1 65 and over 1 1 0 0 1 2 0 0 Totals 85 67 10 4 24 15 1 2 Wards : Highgate 9 10 0 0 Muswell Hill 17 18 3 1 Crouch End 7 4 0 1 Central Hornsey 15 7 2 0 North Haringey 13 11 2 0 South Haringey 4 3 0 1 Stroud Green 15 7 3 1 Finsbury Park 5 7 0 0 Totals 85 67 10 4 22 TABLE F.—(2) TUBERCULOSIS REGISTER, 1944. Pulmonary. Non-Pulmonary Total. Male. Female. Male. Female. Male. Female. (a) Number of Cases on Register at commencement of 1944 437 361 124 106 561 467 (b) Number of Cases notified for first time during year under Regulations 61 36 8 4 69 40 (c) Cases restored to Register during 1944 4 5 2 0 6 6 (d) Cases added to Register otherwise than by notification under Regulations : (1) Transferred from other districts 11 21 0 0 11 21 (2) From Death Returns 9 5 0 0 9 5 85 67 10 4 95 71 (e) Number of Cases removed from Register during 1944 63 44 7 4 70 48 (f) Number of Cases remaining on Register at end of 1944 459 384 127 106 586 490 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 6 6 29 22 13 4 15 12 63 44 Non-Pulmonary 3 0 3 4 0 0 1 0 7 4 23 Borough of Hornsey ANNUAL REPORT ON Maternity and Child Welfare Services 1944 24 MATERNITY & CHILD WELFARE COMMITTEE. Councillor H. W. Arnold (Chairman), 23, Etheldene Avenue, N.10. 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, J.P., 25, Sheldon Avenue, N.6. „ Mrs. M. N. Hill, 16, Bishopswood Road, N.6. „ J. W. Shipp, F.R.San.I., 40 Coleridge Road, N.8. „ L. J. Valette, 80, Tottenham Lane, N.8. „ W. V. Wall, Kilton Lodge, Rowben Close, Totteridge. Councillor P. Baxter, 51, Lothair Road, N.4. „ F. A. P. Boustred, 26, Lanchester Road, N.6. „ M. W. Burns, 7, Womersley Road, N.8. „ F. E. Cleary, 9, Waverley 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. „ J. C. O. Lawrence, 58, Great North Road, N.6. „ G. F. N. Norman, 12, Woodberry Crescent, N.10. „ J. L. R. Webb, 11, Wilmer Way, N.14. Selected Members: Mrs. G. Bradfield, 80, Etheldene Avenue, N.10. Lady F. O. Dixon, 2, Woodside Avenue, N.6. Mrs. M. King, 45, Wood Vale, N.10. Miss B. I. Smith, 43, Weston Park, N.8. Mrs. M. A. Vautier, 20, Dorchester Court, N.10. Mrs. B. Walton, Greenacre, The Green, Ealing, W.5. 25 To the Chairman and Members of the Maternity and Child Welfare Committee. Mr. Chairman, Ladies and Gentlemen, I have the honour to report on the work of the Maternity and Child Welfare Department for 1944—an ever-expanding and increasingly important section of public health or preventive medicine. The figures relating to the four Centres, the Alexandra Maternity Home, the War-Time Day Nurseries, the work of the Domiciliary Midwives and the Health Visitors are given in the following pages. The exceptionally large number of births (1,588 in 1944 as compared with an average of 1,200 in pre-war years), has meant pressure of work everywhere and some conjestion at the centres. Measures for the further expansion and improvement of the service ha\ie received the Committee's attention, e.g. (1)—Extension of the Town Hall Centre in accordance with plans now being prepared by the Borough Engineer. (2)—Completion of the work of adaptation of Burgoyne Hall, Harringay, by conversion of the present air-raid shelter into a doctor's room and waiting room; also the provision of a new front elevation. (3)—Better premises for the Highgate Centre. No suitable building or site has been found so far. (4)—Adaptation of the Electricity Showrooms, Fortis Green, to take the place of the small, out of the way, and entirely inadequate Centre at Coldfall Avenue. This work was in progress—indeed, nearing completion—when the buildings and adaptations were severely damagad by enemy action. Bomb damage has been repaired so far as the original building is concerned. The alterations and adaptations for the Maternity and Child Welfare work involve very little in the way of labour or materials. (5)—The establishment of a new Centre in Central Hornsey —at " Stonecroft," 100, Priory Road, or at " Ladywell," Church Lane. The latter is the more central and convenient site. Temporary buildings in the grounds of "Ladywell" would meet thj immediate needs. (6)—The establishment of a new Centre to serve the Stroud Green—Finsbury Park area of the Borough. Here again, temporary or prefabricated buildings on a blitzed site would serve until a permanent centre is provided as an integral part of the housing development. (7)—The provision of additional beds at the Alexandra Maternity Home, Muswell Hill, N.10, which cannot cope with the number of mothers making application for admission. In view of the prospective high birth rate in 1945, as estimated by the exceptional numbers of expectant mothers now attending the ante-natal clinics, this matter is urgent. (8)—The appointment of an additional Health Visitor. Items 4 and 7 are the most urgent requirements and it is hoped that, in spite of the difficulties of the times in regard to building labour and materials, they may be started forthwith and completed within a few months. 26 ALEXANDRA MATERNITY HOME. Alexandra Maternity Home is now recognised by the Central Midwives' Board as a Part II Training School, which means that we may appoint eight pupil midwives at a time from candidates who are already State Registered Nurses and who have passed the Part I examination of the Board. Four of these pupils will work for three months at the Maternity Home and three months attached to one of the Council's Disrict Midwives. They also attend the Ante-Natal Clinics conducted by Dr. Harris, Obstetric Surgeon at the Home. It is unnecessary for me to emphasise the influence these new developments will have in raising the whole standard of the Maternity service in the Borough. I am, Your obedient servant, R. P. GARROW. Medical Officer of Health. 27 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; 1944. Male. Female. Total. Live births 832 711 1,543 Still births 21 24 45 853 735 1,588 The births were notified:— By doctors 12 „ Borough Midwives 362 „ Alexandra Maternity Home 201 „ Other Midwives 302 „ Hospitals 171 „ Others 515 1,563 Not notified (information extracted from Registrar's returns) :— Live births 23 Still births 2 25 1,588 Of this number there were:— Live births Still births. Occurring in the Borough and transferred to other districts 186 9 Belonging to Hornsey and occurring in Hospitals, etc., outside the distric 664 22 The 1,393 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 .. 600 18 618 Burgoyne Road Centre 300 6 306 Church Road Centre 212 5 217 Coldfall Centre 244 8 252 1,356 37 1,393 Births attended by Borough Midwives:— Miss Andrews 113 Miss Hughes 61 Miss Matthews 87 Mrs. Thompson 28 Miss Jones 63 Miss Buckeridge 9 Mrs. Jamison 1 362 28 HOME HELPS. The Hornsey Home Helps Society was started in 1930 by members of the Voluntary Committees of the Centres. The splendid v^ork done for fifteen 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. The following is a brief report of the work carried out by the Society during 1944:— Number of cases attended (of which 126 paid full fee and 58 part-fee) 184 Number of Home Helps employed— Full time 5 Part time 5 CHILD LIFE PROTECTION. PUBLIC HEALTH ACT, 1936 (Sees. 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 Town Burgoyne Church Hall Hall Road Coldfall Total No. of foster-mothers on register: At the beginning of 1944 14 5 3 3 25 „ „ end „ „ 12 3 1 2 18 No. of foster-children on register: At the beginning of 1944 27 16 4 6 53 „ „ end „ „ 24 8 2 4 38 Died during the year — — — — 0 On whom inquest were held during the year — — — — 0 Visits to foster-children: 1st Visits 10 23 1 1 35 Total Visits 100 153 35 24 312 No proceedings were taken during the year. 29 MATERNITY AND CHILD WELFARE DENTAL SCHEME. The following is a report on the work carried out during the year by the Dental Surgeons in connection with the Maternity and Child Welfare Dental Scheme for children under five years of age:— Inspections 98 Old cases 30 New cases 68 Attendances 235 Finished cases 68 Teeth extracted 62 Teeth filled 136 General anaesthetics 29 Local anaesthetics 6 Other treatments (silver nitrate dressings, scalings, gum treatments, etc.) 277 The following work was carried out in connection with the Dental Scheme for expectant mothers, by the Dental Surgeon, Mr. Creeke. Attendances 566 New cases 139 Examinations 143 Extractions 474 (172 under local anaesthetic, 302 under gas). General anaesthetics 1 Fillings 175 Dressings 81 Scalings 42 Attendances for dentures 114 Dentures provided— Upper and lower 21 Single dentures 8 Dentures repaired 1 Finished cases 73 30 MATERNITY STATISTICS. Ante-Natal, Natal and Post-Natal. MATERNITY AND CHILD WELFARE WORK, 1944. Nature of Work. Centres. Totals. Town Hall Burgoyne Hall Church Road Coldfall Number of Children's sessions held 234 91 103 55 483 ,, ante-natal sessions held 133 56 40 45 274 Number of individual Mothers seen by Doctor:— Ante-natal, New cases 456 172 162 108 898 ,, Old cases 1,836 602 349 404 3,191 Post-natal. New cases 66 68 55 4 193 ,, Old cases 10 0 0 37 47 2.368 842 566 553 4,329 Total attendances of Mothers 2,889 828 613 704 5,034 Number of babies attending Centres for first time : Under 1 year 552 269 220 184 1,225 1—3 years 48 16 78 26 163 3—5 „ 12 8 22 6 48 Number of individual babies on Centre registers at end of 1944 1,445 683 470 325 2,923 Babies seen by Doctor 3,989 1,903 571 605 7,068 Attendances of babies at medical consultations 6,682 4,441 726 605 12,454 Total attendances of babies at Centres : Under 1 year 7,148 3,345 1,804 1,756 14,053 1—3 years 3,221 925 442 330 4,918 3-5 „ 527 171 101 48 847 Referred to own private doctors 21 6 15 41 83 Referred to hospitals 61 15 37 37 150 Visits paid by nurses:— Firat visits Total visits First visits Total visits First visits Total visits First Visits Total visits Grand First visits Totals Total visit To expectant mothers 98 179 65 85 33 98 50 65 246 427 To infants under one year 592 1,786 179 371 213 1,139 196 467 1,180 3,763 To children aged 1-5 years 363 2,812 137 447 35 556 22 431 557 4,246 Total visits 1,053 4,777 381 903 281 1,793 268 963 1,983 8.436 CHILD LIRE PROTECTION— Visits paid to Foster Children 10 100 23 153 1 35 1 24 35 312 RECORD OF WORK OF MUNICIPAL MIDWIVES, 1944. Midwife Confinements attended Ante-natal Clinics attended Ante-natal visits Post-natal visits Miss Andrews 115 42 462 1,428 Miss Hughes 74 75 207 1,091 Miss Matthews 81 41 238 999 Mrs. Thompson 27 26 108 371 Miss Jones 60 48 279 1,002 Miss Buckeridge 8 17 25 128 Mrs. Jamison — - — 1,143 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 Ladywell 27, Church Lane, N .8 Mountview 8938 74 6/4/1942 Miss Stewart Queen's Lodge 40-42, Great North Road, N.6 Mountview 5339 80 27/6/1942 Mils 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 Cletnence House 24, Queen's Aveuue, N.10 Tudor 6730 50 24/1/1944 Mrs. Bawcomb 33 Borough of Hornsey ANNUAL REPORT OF THE School Medical Officer FOR 1944 R. P. GARROW, M.D., D.P.H. 34 HORNSEY EDUCATION COMMITTEE. List of Members, 31st December, 1944 Members of the Town Council:— Alderman Mrs. C. M. Cave, 10, Wood Vale, N.10. Mr. Alderman Wm. J. Grimshaw, J.P., 25, Sheldon Avenue, N.6. Mr. Alderman J. W. Palmer, 30, Crescent Road, N.8. Mr .Alderman J. W. Rowlands, J.P., 25, Cholmeley Park, N.6. Mr. Alderman L. J. Valette, 80, Tottenham Lane, N.8. Mr. Alderman W. V. Wall, Kilton Lodge, Rowben Close, Totteridge. Mr. Councillor W. J. Baker, 7, Woollaston Road, N.4. 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 W. E. Lark, 27, Avenue Road, N.6. Mr. Councillor H. McGlennon, St. Just, Oxendonwood Road, Nr. Farnborough. Mr. Councillor H. Norman, 14, Elder Avenue, N.8. Mr. Councillor D. J. Treharne, 89, Tollington Park, N.4. Selected Members:— Rev. E. S. Duval, M.A., The Rectory, High Street, N.8. Mrs. A. Holman, J.P., 8, Hornsey Lane, N.6. Councillor Mrs G. M. Reid, B.A., 60a, Shepherd's Hill, N.6. Mrs. C. Crowther, 10a, Hampstead Lane, N.6. Mrs. J. I. Grimshaw, 25, Sheldon Avenue, N.6. Miss J. M. bolton, 20, Grand Avenue, N.10. Rev. J. Crowlesmith, 4, Tetherdown, N.10. Director of Education: R. E. BRETTLE, M.A., D.Phil. 35 Staff of School Medical Services (December, 1944). School Medical Officer R. P. GARROW, M.D., D.P.H. Deputy School Medical Officer Marian Lones, B.Sc., M B.. B.S., M.R.C.S.. L.R.C.P.. D.P.H. Assistant School Medical Officers Margaret Robinson, M.B., Ch.B., D.T.M. & H. Jasmine Taylor, M.B., B.Ch., B.A.O., D.P.H. Dentists Winifred M. Hunt, l.d.s. Dorothy Young, l.d.s. Frances Carter, L.D.S., R.C.S. (Eng.). (Engaged in School Dental Work In Cambridge tor the duration of the War.). Oculist Dr. Marian Lones. Aurist F. P. M. Clarke, B.A., B.Sc., L.R.C.P., L.R.F.P.S. (Glas). Orthopedic 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) Orthoptist Miss S. D. Price. Speech Therapist Miss E. Richnell. Educational Psychologist Miss M. Kent. Nurses L. M. Oliver. L. Hatton. C. Martin. Dental Attendants L. Howard. E. S. Smith. Clerk H. Cavalier. Assistant Clerk J. Wilmore. (Directed to Industry under National Service Acts, 20/12/42). J. Porter. 36 To the Chairman and Members of the Hornsey Education Committee. Mr. Chairman, Ladies and Gentlemen, I have the honour to submit my Annual Report on the work of the School Medical Services for the year ending December 31st, 1944. This is the sixteenth annual report which I have been privileged to present, and it is the last, as the authority to which it is addressed ceased to exist with the coming into force of the new Education Act on the 1st of April, 1945. And so ends an epoch in Education in this country lasting nearly a quarter of a century between the Education Acts of 1921 and 1944. It has been a period of social amelioration probably without parallel in our history, and it may be claimed that the school medical service has been one of the most powerful influences in effecting the improvement. The statistics for 1944 are furnished in the usual tables required by the Ministry of Education, and it is unnecessary for me to write at length on this work with which members of the Committee have kept in such close touch in the schools, at the clinic, and in Committee. The scope of the service has never been confined to the bare official requirements of the Ministry, but has been steadily expanded to cover every medical requirement of school children, with the exception of domiciliary medical attendance,, which is proscribed by the Education Acts. Routine Medical Inspection. - This is carried out in all schools on four age groups each year, namely entrants (age 5), intermediates (age 8), scholarships (age 11) and leavers (age 14). Special Medical Inspections. A medical examination is available to any school child at any time at the request of the Head Teacher, or of the parents through the Head Teacher. Special examinations are undertaken at the clinic or at the school according to the wish of the parent or teacher. If a general medical examination suggests that the opinion of a specialist is necessary or desirable, arrangements are made for this to be carried out by the School Aurist, School Oculist, Dentist, Orthopaedic Surgeon, Speech Therapist, etc., or if the parent desires the opinion of a Hospital Physician or Surgeon this has always been freely available by the kindness of the staffs of the Voluntary Hospitals or the County Hospital. Dental Inspection and Treatment. Dental inspection of all the children is carried out at all the schools—and dental treatment is available for all the children at the school clinic whose parents accept it. This treatment is becoming more and more conservative and to a less extent toothextraction. The " Dental State " in the schools has undergone remarkable improvement in recent years—partly, no doubt, on account of improved nutrition but largely as a result of increased dental attention. 37 Orthodontics. Special cases of irregularity of teeth are referred to the Dental Hospitals or Eastman Dental Clinic for orthodontic treatment. Refractions, Squint and Eye Diseases. The Deputy School Medical Officer, Dr. Marian Lones, is school oculist and carries out all the refraction work and ordering of glasses. Orthoptics. A recent extension of the eye work is the appointment of an Orthoptist—a specialist in the training of the muscles of the eye to cure or prevent squint. School Aurist and Rhinologist. Dr. F. P. M. Clarke sees all cases referred to him by the school medical officers—children suffering from deafness, eardischarge, rhinitis, tonsillitis, recurrent colds in head, catarrh, etc. These are treated by the most modern methods—ionisation, diastolisation, tonsil-suction, replacement, etc. Cleanliness, Minor Ailments, Skin Diseases. The school nurses wage a constant campaign in the schools against the pediculus capititis, impetigo, scabies, sores and other conditions of the skin. Ample facilities are available at the school clinic and in the adjoining cleansing centre at " Pear Tree Cottage " for dealing with these conditions. Orthopædics. The arrangement with the Royal National Orthopaedic Hospital provides the school children with an orthopaedic specialist, Mr. J. A. Cholmeley, the medical superintendent of Stanmore Hospital (the Country branch of the Royal National Orthopaedic Hospital), who visits the clinic monthly and prescribes treatment which is carried out on four sessions a week by the Orthopaedic Masseuse or Physiotherapist (Mrs. Yorke). Cases requiring operation or special treatment are admitted to Stanmore Hospital. Stammering and other Defects of Speech. Stammering and other speech difficulties are dealt with at the School Clinic on four sessions a week by Miss Richnell, the Speech Therapist. Psychological Investigation and Treatment. This work is often referred to as "Child Guidance," and a child guidance team consists of a Psychiatrist, a Psychologist and a Psychiatric Social Worker. Their work is to deal with difficult children or " problem children." Although no child guidance team, as such, has been appointed in Hornsey, it has been recognised for many years that Psychological medicine is a very large part—at least half— of school medicine, and that every medical officer doing work for 38 school children should be sufficiently versed in the methods of psychological medicine to deal with difficult children, to measure intelligence, to distinguish between the various degrees of mental retardation and deficiency, and to advise on the educational, social and medical requirements of such children. This indeed is the most interesting and useful branch of school medical work—but it is very time-absorbing. It has been greatly assisted in the last year by the appointment of an Educational Psychologist, Miss Kent. Nutrition. As school milk and meals extend their influence, and education in proper diet becomes general, the word " malnutrition," in common use ten or a dozen years ago, ceases to have a sinister social significance. The present position is that every child is as well fed as its neighbour, and if he is not so fat, the reason is that his metabolism differs. In bidding farewell to the old order, and welcoming the new, I desire to acknowledge with gratitude the excellent work of my colleagues in the school medical departments—Doctors, Dentists, Nurses, Clerks and Specialists; the great assistance we have always had from the Director of Education and his staff; the whole-hearted co-operation of the Teaching Staffs of the schools (without whose help a school medical service cannot function); the support received from the School Care Committees; and the keen interest of the Education Committee in everything pertaining to the welfare of the school children. I have the honour to be. Ladies and Gentlemen, Your obedient servant, R. P. GARROW. School Medical Officer. 39 MINISTRY OF EDUCATION. MEDICAL INSPECTION AND TREATMENT RETURNS. Year ended 31st December, 1944. TABLE I. MEDICAL INSPECTIONS OF CHILDREN ATTENDING PUBLIC ELEMENTARY SCHOOLS. A.—ROUTINE MEDICAL INSPECTIONS. (1) No. of Inspections:—Entrants, 655; Second Age Group, 909; Third Age Group, 492 Total 2,056 (2) No. of other Routine Inspections 26 Grand Total 2,082 B.—OTHER INSPECTIONS. No. of Special Inspections and Re-inspections 1,967 TABLE II. CLASSIFICATION OF THE NUTRITION OF CHILDREN INSPECTED DURING THE YEAR IN THE ROUTINE AGE GROUPS. Number of Children Inspected. A (Excellent) B (Kormal) c (Slightly sub-normal) D (Bad) No. % No. % No. % No. #] 2,082 1,039 49.9 1,035 49.7 8 0.38 0 0 40 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 4,043 GROUP II.—Treatment of Defective Vision and Squint. Under the Authority's Scheme Errors of Refraction (including squint) 597 Other defect or disease of the eyes (excluding those recorded in Group 1) 31 Total 628 No. of Children for whom spectacles were (a) Prescribed 222 (b) Obtained 183 GROUP III.—Treatment of Defects of Nose and Throat. Under the Authority's Scheme Received Operative Treatment 0 Received other forms of Treatment 301 Total Number Treated 301 41 TABLE IV. DENTAL INSPECTION AND TREATMENT. (1) Number of children inspected (6) Fillings— (a) Routine age-groups 3,370 Permanent Teeth 3,513 (b) Specials 690 Temporary Teeth 284 Total 3797 (c) Total (Routine and Specials 4.060 (7) Extractions— Permanent Teeth 332 (2) Number found to require treatment 3,347 Temporary Teeth 2,793 (3) Number actually treated 2,557 Total 3,125 (4) Attendances made by children for treatment 3,868 (8) Administration of general anaesthetics for extractions 723 (5) Half-days devoted to— (9) Other Operations— Inspection 49 Permanent Teeth 359 Treatment 621 Temporary Teeth 3,258 Total 670 Total 3,617 TABLE V. VERMINOUS CONDITIONS. (i) Average number of visits per school made during the year by the School Nurses or other authorised persons 36 (ii) Total number of examinations of children in the schools by School Nurses or other authorised persons 18,317 (iii) Number of individual children found unclean 153 (iv) Number of individual children cleansed under Section 87 (2) and (3) of the Education Act, 1921 1 (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 the present time 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 0 0 1 Deaf Children 0 0 0 42 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 25 A.S.M.Os.— 40 40 Marian Lones. B.Sc., M B., B.S., M.R.C.S., L.R.C.P., 6 5 D.P.H. 11 11 Margaret Robinson, M.B., Ch.B., D.T.M. & H. 2 9 Dr. Jasmine Taylor, M.B., Ch.B., B.A.O., D.P.H. 11 11 Senior Dentist—Miss W. M. Hunt, L.D.S. Whole-time — Dentist—Miss D. Young, L.D.S. Whole-time — SCHOOL NURSING STAFF. (excluding Specialist Nurses, such as Orthopaedic Nurses). No. of Officers. Aggregate of time given to S.M.S. work in terms of whole-time Officers. School Nurses 3 Whole-time District Nurses — — Nursing Assistants — — Dental Attendants 2 Whole-time 43 Report of Speech Therapist for 1944. During 1944, a total of 61 children attended Speech Therapy Clinics. Of these 47 received treatment at the School Clinic and 14 received treatment at the Coldfall Centre. In the course of the year:— (a) 10 children have been discharged, cured; (b) 2 have been discharged, as further progress seemed unlikely; (c) 6 have left school. Three were much improved. The others had made some progress; (d) 10 have ceased to attend owing to evacuation but will be re-admitted on their return; (e) 6 have been very irregular in attendance and no estimate of their progress can be made. Of the remaining 27 who require a further course of treatment; (a) 11 are much improved; (b) 10 shew some progress; (c) 6 have attended only for a very short period. There are 3 children on the waiting list at present, but these will be admitted immediately after the holiday. Another 3 children have been interviewed but, on being found unsuitable for immediate clinical treatment, the parents were given advice as to home treatment. Parents of the younger children are invited to be present during treatment in order that they may correctly supervise home practice. Their co-operation has, on the whole, been very good. Every school has been visited at least once during the year. Head Teachers then reported on progress of children already attending the clinic and a number of new cases were examined. E. RICHNELL, Speech Therapist. 44 Annual Report of the Organisers of Physical Education for tl. Year ended 31st December, 1944. During the year under review, Physical Education has been considerably upset by the development of the war. The recurrence of various forms of air attack led to further evacuation of school children, and the consequent disorganisation of school life affected the normal progress of Physical Education in the schools. Once again, therefore, the work of the Organisers lay chiefly in advisory and supervisory visits. The frequent changes in teaching staff and class organisation, because of evacuation, made it impossible to develop the schemes of Physical Education on their broadest lines, but it is greatly to the credit of head and assistant teachers that some form of physical activity was continued regularly in the schools. At the beginning of the summer it was thought that further efforts could be made to foster the development of Swimming and Athletics. A one-day Lecture-Demonstration Course in Swimming was arranged for men and women teachers, and conducted by Mr. W. Downing of the Southgate School of Swimming. The co-operation of the Head Teachers in releasing members of staff for this purpose during school hours was greatly appreciated. The Course was an excellent one of its type, but those who attended it were prevented from experimenting with what they had learned, owing to the flying-bombs. These attacks also caused the cancellation of all School Sports programmes. It is to be regretted that there has been a further loss of men teachers by delayed call-up and transfers to other schools. It is hoped that in the near future conditions will be such that Service men may return, and additional men be appointed to the area. In connection with the latter, it should be remembered that men with specialist qualifications in Physical Education will be required in Hornsey to be responsible for the work in Secondary Schools of all types. In considering the more immediate future, plans are being made to hold a Training Course in Physical Education during school hours, on a more ambitious scale than has been possible so far during the war years. It is only by such courses that the necessary material can be given to those who most require it, in particular branches of the subject. A class of youths and boys from Crouch End School gave a demonstration of Vaulting and Agility work at the Annual Holiday Course of the Ling Physical Education Association. It is commendable that the classes in Evening Institutes and Clubs were continued, although on a much reduced scale. The Organisers look forward to the time when they will be in a position to report a development in this branch of their work. An area course for leaders of Recreative Physical Training was held in the Summer term, and attended by nine Youths from Hornsey. JOHN B. MARR. FLORENCE E. BIRKBY. Organisers of Physical Traimv