AC 439(1) Hornsey LIBRARY Hor 043 BOROUGH OF HORNSEY REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1951 68623 HOR 043 BOROUGH OF HORNSEY REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1951 MEMBERS OF THE COUNCIL *Alderman T. Tivendale, j.p., Mayor Alderman H. F. Nichols, Deputy Mayor ALDERMEN F. H. Bailey, j.p. H. Hynd, j.p., m.p. *M. W. Burns Miss E. C. McCullough, j.p. Mrs. C. M. Cave G. F. N. Norman *S. G. Goulding G. F. Pallett Wm. J. Grimshaw, j.p. *L. J. Valette COUNCILLORS t*Miss O. R. Anderson *A. M. Kisby (Chairman of Area Health Com.) J. C. O. Lawrence L. A. Bains *Mrs. W. L. Le Messurier Mrs. C. E. Burke-Scott R. G. Leeming t*R. A. Butler, j.p. *J. Lindsey {Chairman of Health Com.) W. Maiden L. G. Capes E. B. C. Mayo F. C. Cave, j.p. *A. H. Morley F. E. Cleary N. Muldoon H. P. Creasy H. L. Norman tW. J. M. Crosland *Miss J. Richardson Mrs. K. M. St. P. Crump *Mrs. L. F. Sutton O. J. R. de Boer R. F. Sutton F. W. Edwards *C. V. Tipping P. F. H. Emery †*Miss M. Toyne *J. F. Ford G. E. Turvey *H. A. Goodwin G. Watson P. Hardiman *R. J. G. Watt *A. S. Kent C. R. Williams * Member of Health Committee at 31st December, 1951. † Member of Area Health Committee at 31st December, 1951. 2 Public Health Department, Town Hall, Hornsey, N.8. His Worship the Mayor, Aldermen and Councillors of the Borough of Hornsey Mr. Mayor, Ladies and Gentlemen, I have the honour to submit this my Annual Report on the health of the Borough for the year ended the 31st December, 1951. The work of your public health department during the year has been full of interest. With other branches of the health and allied services it has contributed to a high standard of health locally, as measured by vital statistics. No complacency can be felt, however, since such figures fail to give a true picture of the degree of positive health enjoyed by individuals which go to make up the community. The heavy use being made of the curative services in Hornsey, as elsewhere, demonstrates the urgent need for greater stress on prevention of disease and education of the public in maintaining healthy standards of living. Your health department has been concerned with these and many other environmental health problems throughout the year; and recorded in the body of this Report. During the year Dr. P. A. Tyser was appointed Deputy County Medical Officer for Cambridgeshire. All who knew Dr. Tyser while he was in Hornsey will wish him well in his new office. To the Chairman, Councillor R. A. Butler, j.p., and members of the Health Committee I wish to record my appreciation of their ready support and encouragement during the year. In commending the work of my colleagues on the staff I must again pay a special tribute to the loyal devotion of Mr. Jesse, the Chief Sanitary Inspector, and for the direct personal assistance given to me at all times by Mr. Davies the Chief Clerk. I am, Your obedient servant, G. Hamilton Hogben, Medical Officer of Health. 1st September, 1952. 3 CONTENTS Section 1.—INFECTIOUS DISEASES AND TUBERCULOSIS Page Infectious Diseases 5 Mass X-Ray 5 Diphtheria Immunisation 7 Laboratory Services 8 Outbreak of dysentery in a Hornsey School 8 Food Poisoning 9 Section 2.—SANITARY INSPECTION Inspection of Shops 11 Rag Flock and other Filling Materials Act 1951 13 Rodent Control 14 Storage of Petroleum 16 The Moselle 17 Section 3.—HOUSING Service of Housing Notices 19 Campsbourne Clearance Area 19 Demolition and Closing Orders 20 Post War Housing Development 21 Section 4.—FOOD Inspection of Food Premises 23 Lectures on Food Hygiene 24 Prosecutions 24 Milk Supply 25 Ice Cream 25 Bakehouses 25 Slaughterhouses 26 Registration of Hawkers of Food and their Storage Premises 26 Registration of Premises for the Manufacturing of Preserved Foods 26 Byelaws— Restrictions on Smoking 26 Water Supply 27 Section 5.—NATIONAL ASSISTANCE ACT Persons in Need of Care and Attention 29 Burial or Cremation of the Dead 30 Section 6.—GENERAL Medical Examination of Staff 31 Area Health Service 31 Area Welfare Service 31 Lunacy and Mental Treatment Acts 31 Ambulance Service 31 Mildura Court Welfare Centre 31 Veterinary Inspection in Hornsey 32 Mothercraft Training Society 34 Open Air Swimming Pool 34 Public Mortuary 35 Section 7.—STATISTICAL TABLES 37 APPENDIX: STATISTICAL REPORT OF THE SCHOOL MEDICAL OFFICER 55 4 SECTION 1. INFECTIOUS DISEASES Since the early days of Public Health administration the incidence of infectious disease has been accepted as a measure of the efficiency of the service. This outlook is changing because the effective control of many infectious diseases is now accepted, and advances in chemotherapy have rendered these diseases less menacing. The incidence of diphtheria has strikingly fallen in recent years and this must be attributed to the large numbers of immunised children in the community. Among diseases more commonly met with in years gone by—puerperal sepsis, pneumonia, scarlet fever and erysipelas—all assume less importance to-day because the serious complications which might follow are now more easily prevented by modern therapy. Freedom from typhoid and cholera has become assured by the present day purity of water supplies and the efficiency of our sewerage systems. The modern use of insecticides such as D.D.T. has limited the risk of spread of infection by fleas or lice and as a result typhus and plague are to-day mainly of historical interest. Smallpox can be effectively dealt with by vaccination which, alas, has fallen off in recent years thus increasing the potential danger to the public by a growing unprotected community. The most important infectious disease in our midst is pulmonary tuberculosis, though hopeful signs of its ultimate control are evident. Tuberculous meningitis at one time almost always fatal in children has been rendered, with the aid of chemotherapy, a curable disease. Pasteurisation of milk has done much to reduce the number of cases of non-pulmonary tuberculosis. Mass miniature radiography is an important weapon in the fight against the spread of tuberculosis and a valuable aid to the detection of early signs of the disease and therefore to the commencement of treatment at a very early stage with the resultant decrease in the time subsequently taken by the patient to return to normal activity. Most of us have natural powers of resistance high enough to overcome any infection we normally meet in mingling with crowds in the streets, public transport vehicles, places of entertainment and elsewhere, but tuberculosis of the lungs is an insidious disease and its early symptoms are vague. Because of the importance of early diagnosis and treatment of unsuspected cases, the Mass X-ray Unit has been made available, free, to the general public. Eight million people have been examined by the 57 mass miniature radiography units in the country. The procedure consists of taking an X-ray photograph which is subsequently examined by an expert, who, if he finds abnormality, communicates the fact in strict confidence to the examinee only. The Mass X-ray Unit from the North West Metropolitan Regional Hospital Board visited Hornsey in March for a period of two weeks. 5 All sessions were attended to capacity and 5,054 persons were x-rayed, 2,897 in organised groups and 2,157 at the public sessions. The Health Department can claim a great measure of credit for the excellent response, as during the few weeks previous the department had sent letters to shops and factories in the Borough and an open letter was published in both of the local newspapers urging the public to accept the facilities offered for x-ray of the chest. The local branch of the Women's Voluntary Service co-operated with the Department in distributing leaflets to private houses in the Borough. The welfare centres and the health visitors also assisted greatly in publicising the visit of the x-ray unit. As a result of the excellent response of the public, arrangements have been made for the unit to spend four weeks in Hornsey during the Autumn of 1952. The numbers examined were as follows:— Male Female Total Number x-rayed 2,196 2,858 5,054 Numbers recalled for large films 55 44 99 Those recalled were dealt with as follows:— Male Female Total No further action 24 22 46 Further advice recommended 16 20 36 Recheck at Unit at later date 12 2 14 Did not attend 3 - 3 55 44 99 School children examined (these figures are included above):— Male Female Total X-rayed356 605 961 Recalled for large films 7 4 11 Those recalled were dealt with as follows:— Male Female Total No further action 4 2 6 Further advice recommended 3 2 5 7 4 11 None of the schoolchildren proved to be active cases. Poliomyelitis, a seriously damaging infectious disease is met only infrequently in epidemic form. Last year three paralytic cases occurred in Hornsey but each was in a mild form and all three made a complete recovery. Whooping cough continues to be a serious disease of early childhood, often associated with respiratory and other complications. Research in recent years supports the value of the use of prophylactic vaccine in preventing this disease. Fifteen cases of puerperal pyrexia were notified during the year. Thirteen of this number were notified after the introduction on the 1st August, 1951, of the new Puerperal Pyrexia Regulations, 1951, which created a change in definition. Now any febrile condition occuring in a woman in whom a temperature of 100° F. or more has 6 occurred within fourteen days after childbirth or miscarriage must be notified. Previously it was necessary for this temperature to be sustained or to reoccur during a period of twenty-four hours. The reason for a change in definition is the possibility of masking symptoms by prompt use of modern drugs. DIPHTHERIA IMMUNISATION Regular sessions for this purpose are held at the Welfare Centres and the parents of children attending the Day Nurseries are also encouraged to allow their children to be immunised. Immunisation in relation to child population:— Number of children at 31st December, 1951, who had completed a course of immunisation at any time before that date:— Age in years at 31/12/51 Under 1 1 2 3 4 5 to 9 10 to 14 Total under 15 Number Immunised 66 805 1,079 1,157 1,445 3,661 408 8,621 Estimated mid-year child population 1951 Children under five 8,430 Children 5-14 10,400 18,830 There was no case of diphtheria in Hornsey during the year. Two persons were admitted to hospital under observation but were found not to suffer from diphtheria. The first was a baby boy of nine months who was diagnosed as suffering from glandular fever; he had completed immunisation a month previously. The other case, a man of fifty-four years, was diagnosed as tonsillitis; he had not been immunised. This was the tenth consecutive year during which there had been no death from diphtheria in Hornsey. The remarkable advance that has been made as the result of diphtheria immunisation may be illustrated by the fact that in Hornsey from the beginning of this century until 1941 there had been at least one death from diphtheria each year. The national immunisation campaign commenced in 1941 but a start had been made in Hornsey in 1936. It should be realised, however, that the freedom of the community from deaths from this cause depends on maintaining a sufficiently high proportion of the child population immunised. The aim is to maintain at least 70 per cent of the child population protected and it cannot be stressed too frequently that babies should be immunised as soon after the age of six months as possible. In Hornsey the proportion of immunised children under the age of fifteen years at the end of the year was approximately 45 per cent. National figures show that in the first forty years of this century over 3,000 deaths of children from diphtheria occurred annually. By 1951 this had fallen to the low figure of 34 in England and Wales. Deaths among immunised children as compared with the non-immunised are estimated as in the proportion of 22:1. Despite the now known advantages of immunisation against diphtheria, and the facilities so readily available, it is regretted that during the past three years there has been a sharp fall in the acceptance rate by the parents of young children. 7 LABORATORY SERVICES The Laboratory Services are directed by the Medical Research Council on behalf of the Ministry of Health. Pathological specimens are sent for examination to the Central Public Health Laboratory at Colindale and the Branch Laboratory at Coppetts Wood Hospital, Hornsey. The Public Health Department is a collection centre for specimens submitted by general practitioners and local authorities and supplies of containers are obtainable between 9.0 a.m. and 5.15 p.m. (9 a.m. to 12.30 p.m. on Saturdays). Specimens received in the Public Health Department office are collected on Monday to Friday at 2 p.m. and at 10 a.m. on Saturday by a messenger from the Laboratory Service. Specimens may also be sent direct to the Hornsey Laboratory before 5 p.m. Monday to Friday and 12 noon on Saturdays. The Central Public Health Laboratory maintains a twenty-four-hour emergency service. The assistance of the technical staff attached to the laboratories is also available in connection with outbreaks of infectious diseases at day nurseries and schools and this assistance is extremely valuable in controlling the spread of infection. OUTBREAK OF DYSENTERY IN A HORNSEY SCHOOL On the 26th November, 1951, the health department was notified of an unusually large number of pupils absent from a school in the district and alleged to be suffering from "gastric influenza". In all, some ninety pupils were away that day (the average number of absentees at this time of the year was said to be thirty). One child was admitted to hospital and confirmed to be suffering from dysentery. The assistance of the Public Health Laboratory Service, Colindale, was immediately sought and the school meals service, under the supervision of Dr. Betty Hobbs, exhaustively investigated. The homes of all pupils living in the district, and absent from school, were visited for the purpose of obtaining first-hand clinical histories; and arrangements made for the collection of stool specimens. All medical officers of health in adjacent districts, where pupils were known to live, were notified of the outbreak and the nature of the investigations being carried out. Specimens from the school teaching and school feeding staffs were also arranged. On the 28th November an additional forty absentees among pupils was reported and one member of the teaching staff. On the 29th November the absentee list had reached 217 pupils out of a total of 426 on the roll and five members of the teaching staff, but none of the domestic or school feeding staff had been absent. School meals were suspended and later that day school closure was recommended. By this time sonne dysentery had been identified in specimens submitted from sick pupils. Altogether thirty-nine positive cases occurred. 8 Clinically the attack of diarrhoea was generally mild, lasting forty-eight hours, and in only one case (the child admitted to hospital) was blood found in the motions. As far as could be ascertained the outbreak concerned only those who had taken school meals. No positive conclusion could however be drawn from the facts elicited since symptoms first arose on Sunday, November 25th, though the school mid-day meal on Friday, November 23rd, was suspect. By the time the public health department was first notified on Monday, November 26th, no remains of the meal were available for laboratory analysis. A striking feature of the outbreak was the apparent immunity of the kitchen staff who had exactly the same food as the pupils and teaching staff. In all, some 800 specimens of faeces were examined in Hornsey alone, and throughout the extensive investigations the utmost co-operation was given by all concerned in the endeavour to trace the origin of the outbreak. FOOD POISONING Fourteen cases were notified during the year. Of the confirmed cases. five were due to salmonella typhi-murium and three to salmonella enteriditis. In six cases the cause was said to be unknown. Two cases were admitted to hospital as non-specific enteritis. 9 SECTION 2. SANITARY INSPECTION INSPECTION OF SHOPS In 1949 the Home Office issued the final report of a Committee of Enquiry which was appointed:— (1) To enquire into the provisions of the Shops Acts relating to closing hours (general or local) and to report as soon as possible whether any alterations are desirable. (2) To enquire into and make recommendations as to extending, strengthening or modifying:— (a) The Statutory provisions relating to the health, welfare and safety of employed persons at places of employment other than those regulated under the Factories or Mines and Quarries Acts, and (b) The Statutory regulation of the hours of employment of young persons. (3) To enquire into and make recommendations as to the machinery for enforcing statutory provisions within the scope of (1) and (2) above. The report is in three parts. Part 1 deals with the health, welfare and safety of persons employed in shops and offices, hotels, restaurants and the catering industry, indoor and outdoor entertainment, road and rail transport, agriculture, fishing and shipping, domestic work and certain miscellaneous occupations. Part 2 deals with the hours of employment of juveniles, and Part 3 with administration and enforcement. So far, no new legislation has been enacted to implement any of the recommendations of this Committee, but on the 1st October, 1950, the Shops Act 1950 came into operation. This is purely a consolidation Act and makes no change in the existing law. It repeals and replaces the Shops Acts, 1912-1936, the Retail Meat Dealers' Shops (Sunday Closing) Act 1936, certain sections of the Young Persons (Employment) Act 1938 and Defence Regulations 60 A.B. The local authorities for the purpose of the Shops Act are (outside London) the district council and in certain cases the County Council. With the exceptions mentioned below these local authorities are required to enforce within their district the provisions of the Act and any Regulations or Orders made thereunder, institute proceedings in respect of contraventions and appoint shops inspectors. In Hornsey the Borough Council is the Authority concerned and the duties are undertaken by the Public Health Department, the Sanitary Inspectors being authorised inspectors under the Shops Act. As Section 38 of the Act, relating to the ventilation and temperature of Shops and sanitary conveniences, is enforced by the local sanitary authority as part of its normal public health duties, the inspectors are able to deal with both parts of the Act when carrying out inspections. 11 CLOSING ORDERS RELATING TO SHOPS The local authority has power, under certain conditions, to make local Closing Orders for fixing the hours at which, either throughout the area of the local authority or in any specified part thereof, all shops or shops of any specified class are to be closed for the serving of customers. The authority may also, by order, fix the day on which shops are to be closed for the weekly half-holiday, or may, if satisfied that the majority of the occupiers of shops of any particular class in any area are in favour of being exempted from closing for the weekly half-holiday, either wholly or by fixing as the closing hour instead of one o'clock some other hour not later than two o'clock. Before the order is made the local authority must be satisfied that a majority of the occupiers of such shops are in favour of the exemption, or, in the case of a vote being taken, that at least one half of the votes recorded by the occupiers of the shops within the area of the class in question are in favour of the exemption. The following closing orders are in force in the Borough:— Hornsey Chemists Weekly Half-Holiday Order, dated 20th January, 1913. Provides for the closing of chemists' shops on Thursday at 1 p.m. in all wards except part of Stroud Green Ward lying west of Oakfield Road and Denton Road. Hornsey Dealers in Stationery and Stationers' Sundries Order, dated 19th May, 1913. Exempts retail dealers in these goods in the Crouch End, Central Hornsey, North Harringay, South Harringay and Stroud Green Wards from the provisions of the Act relating to the closing of shops for the weekly half-holiday. Highgate Ward Dealers in Stationery and Stationers' Sundries Order, dated 31st July, 1913. (Applies to Highgate Ward—similar provisions to previous Order). Hornsey Dealers in Books Order, dated 19th January, 1914. Exempts all shops in the Borough in which the sale by retail of books is carried on from closing for the weekly half-holiday. Highgate Grocers, Provision Merchants and Oil and Italian Warehousemen's Weekly Half-Holiday Order, dated 20th April, 1914. Provides for the closing of such shops in Highgate Ward on Thursday at 1 p.m. Hornsey Butchers' Weekly Half-Holiday and Closing Order, dated 22nd March, 1920. Provides for the closing of all butchers' shops (including pork butchers) in the Borough as follows:— Monday, Tuesday and Wednesday at 7 p.m. Thursday (weekly half-holiday) at 1 p.m. Friday and Saturday at 8 p.m. Hornsey Dealers in Motor-cars, Motor-cycles and Cycles Order, dated 24th October, 1938. Exempts all such shops in the Borough from closing for the weekly half-holiday. 12 During the year under review 1,262 visits were paid to shops and, apart from a number of minor infringements, which were dealt with, the provisions of the Shops Act have been well observed. During the year, forty-eight written notices were served and as a result the following defects were remedied. Lighting provided 31 Heating provided 12 Sanitary Accommodation provided 23 Sanitary Accommodation labelled 41 Washing facilities provided 50 Seats for shop assistants 5 Number of shops cleansed 64 Number of shops dealt with 78 RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 This Act which came into operation on 1st November gave local authorities greater power to control the type of filling material used for upholstery and stuffing of bedding, toys, baby carriages, and such other articles as may be prescribed by Regulation. The remaking or reconditioning of any article is excluded from the provisions of the Act. Two kinds of premises are defined in the Act:— Registered premises are those where filling materials of the types listed in Section 33 of the Act are used in manufacturing bedding, toys, baby carriages and other articles of upholstery. Licensed premises are those where rag flock is (a) manufactured or (b) stored for distribution to registered premises. The fee prescribed for licensing and registration is £1 in each case. The local authority must register the premises on receipt of the requisite fee. A licence may be issued after inspection and can be refused (subject to appeal) only where arrangements are unsatisfactory. The Act prohibits the use of prescribed filling materials for such purposes as upholstery etc., on premises which are not registered, and it is made an offence to sell a new article containing dirty material. The Minister of Local Government and Planning has made Regulations under various sections dealing with records, right to having samples tested, standards of cleanliness and has prescribed certain analysts for the purpose of testing samples. The kinds of filling materials, appropriate tests and the method of sampling are also prescribed. The Medical Officer of Health and the sanitary inspectors are expressly made authorised officers for the purposes of the Act and are empowered to enter and inspect registered and licensed premises and to take samples of filling materials found therein. Samples must be submitted to an analyst prescribed in the Rag Flock and Other Filling Materials Regulations, 1951. No licences have been issued and three registrations have been effected under the Act. 13 RODENT CONTROL There are only two kinds of rat in this country, the brown or common rat and the ship or black rat. The first, as its name implies, is much the commoner in most districts and is the only rat found in Hornsey. Coming from treeless plains, it is a burrowing animal which feeds on roots, growing crops and any animal it can kill. It also feeds on any garbage or offal available, doing considerable damage. The rats feed chiefly at night at any place where food is left exposed and accessible; they always try to feed under cover. The extent of the problem of eradication can be judged from the fact that rats breed from the age of six months onwards and produce four or five litters in a year, each of from four to ten young; even larger litters have been recorded. A litter of twenty-three young rats with tie parent rats has been removed from a nest in this borough. Fortunately there is a high mortality among young rats. The urgent need for every effort in extermination is emphasized by their ability to spoil and waste food of all kinds and their wholesale destruction of property. As rats will eat almost anything, even the sick and young of their own kind, it is virtually impossible to starve them out and fecundity assures their survival even if as many as 90 per cent of them are killed at one time. The underlying principle of modern rodent control is to kill off all the rats and mice within the infested area in as short a time as possible, and may consist of poisoning, gassing, or trapping. It has been estimated that, given ideal breeding conditions, a pair of rats can be responsible in the course of a year for as many as 600 progeny, but very few are likely to survive, the others falling victims to disease, attack by other rats and the activities of rodent operators. In every case of infestation by rats and mice, systematic treatment is carried out by using the methods recommended by the Ministry of Agriculture and Fisheries (Infestation Control Division). One rodent operator is employed on this important work under the general supervision of the sanitary inspectors. A careful survey is made in each case to determine the extent of the infestation, the location of runs, living quarters and feeding grounds in order to decide the best baiting points and type of bait to be used having regard to necessary safety precautions. Finally, occupiers are advised as to hygiene and rat proofing of the premises. All baits must be finely divided so that they cannot be carried away and stored by rats and the various bait bases used are sausage rusk, bread rusk, wheat and oatmeal, and various poisons such as zinc phosphide, barium carbonate, arsenic, red squill, a blood coagulant known as "warfarin", and cyanide gas. There are various methods of baiting, the real object of which is to gain the confidence of the rat and overcome that caution so characteristic of its behaviour. This is generally attained on the fourth day when rats are feeding freely and without fear. On the fifth day poison bait is laid. Regular treatment of sewers is an important contribution in the prevention of surface infestation. 14 Normally rats nest near to the source of their food supply and keep to the same runs when travelling around their particular areas. It is frequentiy found that they make their nests underneath chicken houses where there is always a supply of food. They may also be attracted to houses where food is thrown out for the birds. It should be placed on a platform raised on a pole so that rats cannot climb on to it. Chicken houses should be rat-proofed and built on piers at least twelve inches high and the space below the houses must be kept clear, as rubble, timber, etc., dumped there affords cover for rats to nest in. The house mouse also breeds very rapidly, having four or five litters in a year each of five or six young which are able to carry on an independent existence in two weeks and breed at the age of six weeks. Occasionally mice enter houses from the field and gardens during the Autumn when the weather turns colder. Eradication of mice is frequently much more difficult than eradication of rats and various methods of dealing with the problem are used. Extensive research work is being carried out by the Ministry. During the year it has not been necessary to serve any notices under the Prevention of Damage by Pests Act and it has been found that the public as a whole co-operate with the Department. No charge is made for eradication of rats from private dwellings but the cost of work in business premises is recovered from the owner of the business. All costs incurred on eradication of mice are recovered from the occupiers of the properties. Following is a summary of the work carried out during 1951:— Number of properties inspected 390 Number found to be infested with rats— (a) Major (i.e. more than 20 rats) 4 (b) Minor 200 Number treated by the Rodent Operator 194 Number found to be infested with mice 63 Number treated by Rodent Operator 18 Number given advice 45 15 STORAGE OF PETROLEUM Legislation controlling the use of petroleum in this country dates from 1862 when an "Act for the safe keeping of petroleum" was passed. This Act was amended in 1868. Since then further Acts have been passed amending and repealing the earlier Acts until in 1928 the whole of the petroleum legislation was consolidated in the Petroleum (Consolidation) Act, 1928. In 1936 the Petroleum (Transfer of Licences) Act was passed. This provided for the transfer of licences granted under the 1928 Act. The two Acts together are known as the Petroleum (Regulation) Acts, 1928 and 1936, and constitutes the principal legislation controlling the storage of petroleum spirit at the present time. Petroleum is defined as "Petroleum, which when tested in a prescribed manner gives off an inflammable vapour at a temperature of less than 73 degrees Fahrenheit." The Act has also been applied by Order in Council to compositions or mixtures which contain Petroleum Spirit. Such compositions include certain india-rubber solutions, varnishes, quick-dry paint and spraying liquids. The quantity of petroleum stored under licence is 83,755 gallons, 83,245 gallons of which are stored in underground tanks and 510 gallons kept in properly sealed two gallon-cans. The total number of licences issued is seventy-three. All plans relating to new petrol installations are submitted to the Committee for their approval. The construction of new installations has been strictly supervised and tanks and pipe lines for bulk storage installations tested. The tanks are tested before and after installation to a pressure of 10 lbs per square inch and a final test on tank and pipe lines by means of a petrol test. Electrical meter pumps may introduce a hazard due to sparking unless precautions are taken and their construction and installation comply with the regulations of the Council. Petroleum spirit may not be kept without a petroleum spirit licence under the Act except in small quantities and under certain conditions. According to strict interpretation of Section 1 (1) of the Act, petrol lighter fuel contained in gelatine capsules does not come within this exemption, but the Council does not insist on a licence being taken out in these cases providing the total quantity does not exceed three gallons. If the capsules get wet they may become defective and cause leakage. No conflagration occurred on licensed premises during the year and only one case involving petrol was dealt with by the Hornsey Fire Brigade when a pint bottle of petrol was fractured by the heat from a gas stove. Cellulose Spirit Nineteen premises are licensed for the storage of cellulose spirit and the total quantity stored is 1,168 gallons. In addition to petroleum and cellulose, 70 gallons of naptha, 12,000 gallons of bensole and 10 cwts. of carbide of calcium are stored under licence. 16 THE MOSELLE For nearly a century the Moselle has been a source of public health nuisance. In 1866 the Tottenham Board of Health obtained an injunction restraining the Highway Board for the parish of Hornsey from making further sewers or drains which would pollute the stream. For a considerable time previously the sewage for the parish of Hornsey had been carried off by the Moselle and the Highway Board inaugurated a new system by which the sewage of Hornsey was discharged in a body into the Moselle a short distance before the stream reached Tottenham. The Moselle proper originated somewhere in the Muswell Hill Area, and was reinforced in the valley below by a stream from Queen's Wood now concealed in a pipe. This latter can be traced across the Crouch End Playing Fields and, for a short distance there, is still open. The area drained by the Moselle is the southern slopes of Muswell Hill, Queen's Wood, Lower Highgate, Crouch End, Central Hornsey and the Campsbourne. The approximate number of properties in this area is 7,500. The Moselle, which eventually flows untreated into the River Lea, should carry only surface and underground water. Almost all houses in the Moselle drainage area have two systems of drainage and the surface water one which is connected to the Moselle should carry only rain water. Unfortunately it had been found that in the past many houses were connecting waste water and soil fittings into the Moselle and the purity of the effluent was being affected. The situation gradually deteriorated and notices in 1947 regarding the purity of the effluent were served on the Borough of Hornsey by the Lee Conservancy Catchment Board. As a result of the notice a complete check on sewers throughout the entire Moselle surface water drainage system was carried out. Each check was followed by inspections of properties from which it was suspected pollution of the surface water system was occurring and in all 2,819 properties were inspected. These inspections involved checking the front inspection chambers in properties where it was often found that the soil drain was choked and the sewage was leaking into the surface water system. This revealed 291 cases where remedial action was necessary. The dry weather flow of the Moselle was then sampled at six selected points to assist the Council in isolating the pollution. These samples were taken on seven successive weeks and clearly indicated that pollution of the Moselle was not restricted to any one area. After consideration by the Council it was decided that the only real way to solve this pollution problem would be to check individual drainage inlets to every property or building which drained into the Moselle. The work of checking the individual houses was started by the permanent staff of sanitary inspectors. As district inspectors could only devote a certain period of their time to this work it soon became apparent that two additional temporary inspectors would be required to devote their time exclusively to this checking in order that real headway could be made. 17 Appointments were made as from January 1951. After eight months the two temporary inspectors left the district to take up permanent posts and were replaced in October 1951 by one inspector as by then the major portion of the checking had been completed. The following table shows details of work carried out by the end of the year:— Inspections Re-inspections Satisfactory Notices Served Notices Complied with Nov. 1949- 1,301 140 1,047 254 155 Dec. 1950 Jan.— Dec. 1951 5,739 1,287 5,370 369 374 7,040 1,427 6,417 623 529 It is anticipated that this investigation will be completed in 1952 when further samples will be taken and the position reviewed. It is a regretable fact that nearly 9 per cent of the properties in the Moselle area have been found to be either partly or wholly discharging their waste water and sewage into the surface water drainage system, and there is no doubt that a very valuable contribution has already been made towards solving the problem of this pollution. 18 SECTION 3. HOUSING SERVICE OF HOUSING NOTICES The Public Health and Housing Acts were intended to improve health by removing "slum" properties and relief of overcrowding, but since the war factors have arisen which make it difficult to use our legislative powers to the definite advantage of the community. The standard of housing varies from district to district and what constitutes an "unfit" house in one area appears to be tolerated in another. As far as health is concerned we should try to preserve a balance between bad housing and overcrowded conditions. In a district where overcrowding is prevalent then lower structural standards might have to be tolerated temporarily; but as overcrowding is abated an increasing number of houses may be classified as unfit. Ill-health may follow life in a structurally defective house but we must be careful not to exaggerate its effect. In the past, for example, dampness was regarded as a cause of chronic chest conditions or as a cause of rheumatic fever. Though overcrowding may be a contributory cause of these conditions, dampness alone can be responsible for no more than lowering of resistance generally to disease. More insidious therefore is ill-health caused by overcrowding. The trauma it causes may be more emotional than physical; and the bickering between ill-matched relatives in a congested home may aggravate this emotional tension. This is especially so when of long duration; and may give rise to chronic ill-health in later life. Diseases of "stress" such as chronic rheumatism, duodenal ulcer, and coronary thrombosis are today much more common than the infectious diseases prevalent in days gone by. Relief of overcrowding, particularly of more than one family, is the primary housing need today; and an overcrowded family living in a luxury flat may be in an environment potentially more dangerous to health than a family living in a caravan. From the angle of preventive medicine and public health it is the conditions under which people live rather than defects of housing structure which must take priority. CAMPSBOURNE CLEARANCE AREA The first stage commenced in October, 1949, is well in hand and 65 new dwellings are in course of construction. In April 1951 the Council resolved, pursuant to Section 25 of the Housing Act, 1936, that the following properties be included in an area declared to be a Clearance Area for the purpose of the Act:— Nos. 6—56 (even) inclusive, Boyton Road. Nos. 19—25 (odd) inclusive, Boyton Road. Nos. 1 and 3 Eastfield Road. At the same time the Council made a Compulsory Purchase Order under Section 29 of the Act which included all these properties. 19 As the result of the Order, objections were made by seven persons owning 18 of the properties and the then Minister of Local Government and Planning caused a Public Inquiry to be held by W. Mackintosh Esq., A.R.I.B.A., one of H.M. Inspectors. Evidence was given on behalf of the Council by Councillor Mrs. Sutton as Vice-Chairman of the Housing Committee, the Council's Officers and five of the seven objectors. It was emphasized in the Council's evidence that the Council had reached the final stages of their post-war Housing Schemes and that there was no further land which could be acquired in the Borough for housing purposes. It was further stated that some 74 families, comprising approximately 230 persons, would be affected by the Order and following the confirmation thereof by the Minister 32 properties would be demolished, two- and three-bedroom flats would be erected on the sites thereof and all the persons affected would be rehoused by the Council. After the Inquiry the Inspector examined the properties and in September, 1951, the Order was confirmed by the Minister without modification, subject to a direction being made under Section 42 of the Housing Act, 1936, in respect of No. 1 Eastfield Road being a wellmaintained house. DEMOLITION AND CLOSING ORDERS Housing Act, 1936, Sections 11 and. 12. Two Demolition Orders and two Closing Orders were made during the year, as shown by the following tables. In addition, the Committee considered making Demolition Orders in respect of 22 Haringey Grove and 102 Tottenham Lane but in each case the owner agreed to demolish the property if the Council would rehouse the tenants. The tenants were rehoused and both premises were then demolished by the owners. Demolition Orders Property Council resolution Order made Action taken 25 Church Lane 19th June 22nd June Demolished. 103 Myddelton Road 25th Sept 28th Sept Demolished Closing Orders Property Part affected Council resolution Order made Action taken 8 Boyton Road Two basement rooms, Kitchen/ scullery & passage 23rd Jan. 13th Feb. Rooms closed 72 St. Mary's Road Two basement rooms 18th Dec. 20th Dec. Rooms closed 20 POST-WAR HOUSING DEVELOPMENT I am indebted to the Borough Engineer and Surveyor—Mr. G. A. Pentecost, A.M.I.C.E., M.I.Mun.E., A.M.T.P.I., for the following information. The number of new dwellings completed by the Council and private enterprise together by the end of 1951 amounted to 1,005. Details are as follows:— Year Council Private Total 1946—1950 554 312 866 1951 85 54 139 639 366 1,005 In addition, a further 140 Council dwellings and 91 private houses were under construction at the end of the year. The types of accommodation provided by the Council are as follows:— 1 Bedroom 2 Bedroom 3 Bedroom 4 Bedroom 1 Bedsitting room Totals Flats 44 290 145 15 nil 494 Houses nil 22 74 15 nil 111 Aged Persons' Dwellings nil nil nil nil 34 34 Under construction Flats 8 76 30 nil 26 140 Work is in hand on the construction of sixty-five dwellings and two shops comprising the whole of the first stage of the Campsbourne Redevelopment Scheme and it is anticipated that at least twenty-four dwellings will be ready for occupation during 1952 and the remainder early in 1953. It is hoped to start building work in 1952 on part of the second stage, involving the erection of six flats in Boyton Road in order that this may be completed simultaneously with the scheme in Brook Road. With regard to the completion of the second stage it will be necessary to re-house a total of sixty-six families and for this reason it is not anticipated that work on the construction of the new dwellings on the east side of Boyton Road will be able to start until 1953. It is interesting to note that a new type of dwelling will be under construction during 1952, that is in Ashford Avenue where three-storey blocks are to be erected comprising aged persons dwellings on the ground floor and the equivalent of a three-bedroom house on the second and third floors. Each tenant will be provided with his own small garden at the rear of the premises and it is hoped that this will improve family living conditions. It has been most noticeable that on the majority of 21 Council housing schemes, tenants in flats have been quick to take advantage of window boxes to display flowers, etc. Where these are not available many tenants have constructed their own flower boxes. It is thus evident that this small amenity is very greatly appreciated by the tenants and does appear to emphasise the desire of people to have at least one small piece of garden. During 1945 fifty-nine emergency hutments (Nissen and Uniseco) of the two-year type were erected by the Council but all have now been demolished or vacated except six on the sites of numbers 446-452 Archway Road. This land is to be reserved for highway improvement and open space, and thus it will not be possible to use it for housing purposes. Permanent dwellings have been erected on all the other sites except at Wightman Road and Park Road by Palace Road where it is anticipated that works will be commenced in 1952. Eighty-two temporary bungalows of the ten-year type were erected in 1946 and further representations are to be made to the Ministry for permission to redevelop these sites during 1952 or 1953. It is also interesting to record that twenty-four transfer licences have been issued to enable families in Hornsey to build dwellings for their own occupation outside the borough. It is hoped that during 1952 this scheme can be extended, as 200 applications have already been received, including sixty from persons on the housing waiting list, ten from requisitioned premises and five from tenants of permanent Council dwellings. The Middlesex and County of London Development Plans were published during 1952 and both of these are incapable of fulfilment unless the housing problem is solved. The Middlesex Plan gives a target population of 83,000 for Hornsey, or a reduction of just over 15,000 on the present figures. It is not known when this reduction will take effect but it is estimated that the population in 1971 will be 97,292 (or about 1,000 less than in the borough at present). It is interesting to note that during 1948 and 1949 over 12,000 people or one-eighth of the population left Hornsey and that a similar number entered the area apparently with little or no assistance from the Council in the provision of housing accommodation. These figures are remarkable as they do indicate a movement of population on a scale not generally appreciated. Requisitioned Premises The number of units under requisition at the end of the year was 792, a decrease of forty during the year and eight-nine during the last three years. No. 27 Weston Park was purchased by the Council and converted into three flats. 22 SECTION 4. FOOD INSPECTION OF FOOD PREMISES Every opportunity has been taken during the general inspection of food premises throughout the Borough to discuss with food traders and their staffs the necessary effort required from them to ensure that the clean handling of food becomes a normal business routine and these conversations together with an increasing public discrimination in favour of the better appointed and conducted food shop, appear to be proving that the practice of good food hygiene is good business as well as good public health. The standard of repair, decoration and equipment of the food premises generally throughout the district has continued to improve. Requests from the public health department mostly meet with the active agreement and co-operation of the occupiers of the shops. Constant supplies of hot and cold water, clean towels and soap are available for use by a large majority of food-handlers and efforts are made to ensure that these facilities are used. Adequate cloakroom space for outdoor clothing and staff rooms for meals taken on the premises are provided where required and special clothing for use during working hours is becoming more generally used. Cold storage facilities and screening or covering of exposed food on display are methods which are being encouraged to minimise the risk of food contamination. There is a need for provision to be made for hand washing for those engaged in hawking and delivering food. Catering Establishments There are about 150 premises in the Borough where food is prepared and sold to the public in the form of meals or refreshments, and these premises include restaurants, cafes, snack-bars, mobile refreshment stalls and public houses. Restaurants and cafes are inspected at frequent intervals and generally the standard of cleanliness is good but the premises often require some improvement in the lay-out, equipment and methods of food preparation, in order to attain the standards considered to be desirable. Formal notices requiring repairs, alterations and cleansing have been issued in about 100 instances, and in a number of others alterations of a minor character have been carried out after verbal requests. Generally, both proprietors and staff are co-operative in their attitude and realise the importance of a high standard of hygiene in the preparation and serving of food to the public. The smaller cafes, however, remain a problem owing to their restricted space. Special attention has been directed to the methods of cleansing beer and spirit glasses in public houses. Various tests have shown that the bar rinsing water can be in a highly contaminated condition. The practice of cursorily rinsing dirty glasses during rush periods in public houses has received a great deal of attention from the Brewers' Federation and other 23 interested bodies. The difficulty of providing a suitable sterilising agent which would not impart an objectionable taste, smell, or sediment to the glasses has been solved by the production of quaternary ammonium compounds. These detergents are giving promising results and are now being widely used in public houses. Communal Feeding The increase in the number of food poisoning cases since 1939 has been attributed in part to the extension of the communal feeding arrangements. In Hornsey the school meals service provides about 6,000 lunches per day to school children and teaching staffs; in addition, restaurants and canteens in the Borough provide probably not less than 3,000. LECTURES ON FOOD HYGIENE Preliminary enquiries were made with food traders and their staffs to estimate the response which the Council could expect for a proposed series of lectures to food-handlers on the various aspects of Food Hygiene. Difficulties appear to preclude support at present in that the food traders say that the shortage of staff prevents them from releasing their assistants to attend lectures during normal working hours and the assistants claim that other responsibilities prevent them from giving their own time to attending meetings on this subject. Talks to local organisations have been given to explain the Council's legal powers and responsibilities, the degree of success estimated to have been achieved and the contribution which the housewife as a member of the purchasing public can make in this work. Comments received after these talks appear to indicate a wider appreciation by the public of the difficulties involved, and it is known that many more members of the public are assisting by their own efforts in encouraging the implementation of the Council's programme. PROSECUTIONS The Food and Drugs Act 1938 and other legislation concerned with the hygiene, preparation, storage, handling and sale of food intended for human consumption permits any member of the public to lay information before the Courts on the grounds that food has been sold which is not of the nature, substance or quality demanded or is unfit for human consumption, but persons receiving unsatisfactory food normally bring it to the public health department. Only two prosecutions were taken during the year. The first was in connection with a piece of bandage and lint from a wound which was found embedded in a loaf of bread, and the second case was a bottle of fruit drink which contained paraffin. Proceedings were taken under Sections 3 and 9 of the Food and Drugs Act, 1938 against the shopkeepers. The first firm was fined £7. 5s. Od. and £4. 4s. Od. costs and the second was fined £10 and £10. 10s. Od. costs. 24 MILK SUPPLY The production and processing of milk continues to be a primary responsibility of the Ministry of Agriculture and Fisheries but the local authority is responsible for the inspection of all dairies used for the distribution of milk. In this Borough there are no pasteurisation plants and by the end of the year under review bottling of milk in this area had ceased. The Milk (Special Designations) (Specified Areas) Order 1951 came into operation on 1st October, 1951. This Order makes compulsory the use of special designations for retail sales of milk in certain areas specified in the Schedule of the Order and the whole of Middlesex is one of the areas specified. Five dairy premises were registered during the year. Licences for the sale of special designated milk were granted as follows: New Licences Renewals Dealers Supplementary Dealers Supplementary Pasteurised 1 1 25 9 Tuberculin Tested 11 24 9 Sterilised 4 1 38 9 Accredited - - 1 - On 1st October 1954 the special designation "accredited" will cease to be used. Sixty-five samples of milk sold under special designations were taken in course of delivery or from shops and submitted for bacteriological examination. All were found to be satisfactory. ICE CREAM Thirty-nine samples of ice cream were taken during the year and submitted for bacteriological examination. The results were as follows:— Grade 1 Grade 2 Grade 3 Grade 4 33 5 1 - The grading of the samples of ice cream submitted for bacteriological examination during the year shows a distinct improvement on the comparative figures for 1950. This is due perhaps to the use of specially prepared detergents by most dealers selling loose ice cream. Until recently, a detergent which would remain effective for a reasonable time usually had the disadvantage of transmitting a noticeable smell and taste to the ice cream. The production of the quaternary ammonium compounds, which have neither smell nor taste, has overcome this. BAKEHOUSES The three underground bakehouses in the Borough continue to be in use, as they were certified in September 1949 as suitable for that purpose for a further period of five years. They are inspected frequently to see that suitable hygienic conditions are maintained. Of the other twelve bakehouses in the Borough, one was entirely reconstructed during the year at the cost of about £800 at the time of its acquisition by a new owner and after consultation and advice from members of the public health department. Five other bakehouses have had major repairs including the provision of further sanitary accommodation, hot water supplies and staff accommodation. 25 SLAUGHTERHOUSES The Live Stock (Restriction of Slaughtering) Order, 1940, continued in force and no slaughtering was carried out during the year. No licences to slaughter were issued. REGISTRATION OF HAWKERS OF FOOD AND THEIR STORAGE PREMISES On the 1st June, Section 11 of the Middlesex County Council Act 1950 was brought into operation in the Borough. This Section is an extension of Section 279 of the Middlesex County Council Act 1944 as it requires the registration of hawkers of all food and not only those selling meat, fish, fruit and vegetables. When Section 11 came into operation all persons and premises who were registered under the 1944 Act were deemed to be registered under the new Act. It would appear that the registration of a hawker under the above Act permits him to sell any type of food and the registration of storage premises permits this also. Most hawkers request registration of themselves and the storage premises only for particular types of foodstuffs such as fruit and vegetables etc., and the Council considers the applications purely in the light of these statements since premises suitable for the storage of fruit and vegetables would in most cases not be suitable for the storage of fish, meat and other highly perishable articles. An amendment of Section 11 of the Middlesex County Council Act 1950 would appear to be desirable to allow of the registration of persons and storage premises for restricted types of food only. The following registrations were effected during the year:— Hawkers Storage Under 1944 Act 3 2 Under 1950 Act 3 1 6 3 REGISTRATION OF PREMISES FOR THE MANUFACTURE OF PRESERVED FOODS No registrations were effected under the provisions of Section 14 of the Food and Drugs Act, 1938, for the pickling of meat. The total number of registered premises in the borough is 58. BYELAWS—RESTRICTIONS ON SMOKING On 23rd April 1951 a Byelaw came into force forbidding smoking by persons "whilst handling, wrapping or delivering any food which is not pre-packed or otherwise protected by a suitable cover against the risk of contamination unless, having regard to the nature of the food, such protection is not reasonably necessary." This habit is difficult to control but every effort is made to convince food-handlers of the importance of restricting smoking in food premises. 26 WATER SUPPLY The water supply for Hornsey is provided by the Metropolitan Water Board from two sources:— (a) Water from the New River, treated at the Board's filtration works at Hornsey, and Stoke Newington. (b) River Thames water stored in Littleton Reservoir and treated at the Board's filtration works at Kempton Park. Water is pumped from these works into service reservoirs at Crouch Hill. Samples of water are collected on five days in every week, or more often if required, at each stage of the purification process and tests include physical, chemical and microbiological examination. The water supply to this area is not plumbo-solvent. All new and repaired mains are chlorinated before being restored to use and samples of water from them are tested bacteriologically to ensure that its quality is up to that normally supplied. The water supply is in all cases direct to dwelling houses; none is supplied by means of a stand pipe. The supply has been satisfactory both in quantity and quality during the year. Chemical Examination 250 samples of water were taken for chemical examination from each of the three filtration works and were found to be satisfactory. Bacteriological Results Filtration Works No. of microbes per ml. Colonies counted on agar Bact. coli test Percentage of samples negative to Bact. coli in 100 ml. Bact. coli per 100 ml. No. of after 20-24 hrs. Samples at 37°C. Hornsey 257 36.0 100.0 - Stoke Newington 256 35.6 99.6 0.012 Kempton Park 764 28.2 99.7 0.004 Fluoridation of Water Supply Research has proved that an excess of fluoride above 1.5 parts per million causes mottling of the tooth enamel. Further, that when the fluoride content of drinking water is below 1.0 part per million the rate of dental caries in children increases and where the fluoride is very low or absent the incidence of dental caries is abnormally high. The optimum fluoride content for a water supply is, it is suggested, between 1.0 and 1.5 parts per million. Excess causes mottling, deficiency increases the susceptibility of children's teeth to caries. The fluoride content of the water supplied to Hornsey is 0.2 parts per million. In Hornsey mottling of the enamel is very rare but dental caries in children is common. The question of whether or not fluoride should be added to the public supply is one which must be decided in the future. 27 SECTION 5. NATIONAL ASSISTANCE ACT, 1948. PERSONS IN NEED OF CARE AND ATTENTION The National Assistance (Amendment) Act, 1951, came into force on 1st September, 1951, to enable local authorities to deal without delay with the removal of persons in need of care and attention. It amends Section 47 of the 1948 Act making it possible for the medical officer of health and another registered medical practitioner to apply to a court or a single justice for an order to remove and detain in a home, for a period not exceeding three weeks, any person in need of care and attention under the terms of Section 47. It is not necessary to give seven clear days' notice as under Section 47 of the principal Act. If it is necessary for the person to be detained for a period longer than three weeks the local authority may apply to a court as provided by Section 47 of the 1948 Act and an order may then be made for an extension of the period of detention by not more than three months. The medical officer of health is authorised by the Borough Council to make application direct to the Court or a justice. No person was compulsorily removed to a hospital or other place during the year. It was, however, necessary to investigate many complaints of aged persons living in insanitary conditions who, it was alleged, were not receiving adequate care and attention. Many aged persons are enabled to live alone very happily by the help of other occupants of the house. This may consist of help in bringing home the heavier shopping or by helpful encouragement in the home. Others receive great help from the Home Help Service or by the willing advice and guidance given by the Hornsey Old People's Welfare Committee. Many of the cases referred to the Health Department for action under the National Assistance Act have become beyond the care of neighbours and stubbornly refuse the assistance of the Home Help Service. Occasionally complaints are received which appear to be motivated by the desire of other occupants of the house to obtain more room. The following are brief reports on some of the cases investigated during the year. Case A.—A woman of about 90 years of age, living in one room, who had been known to the Department for many years because it had been necessary on occasions to arrange for her room to be disinfected and cleansed. She was always very truculent and refused to accept the service of a Home Help. A great deal of rubbish was removed from her room and a slight improvement made in the latter part of the year, but her health failed and she suffered from a mild senile dementia. While arrangements were being made to remove her compulsorily she agreed to be admitted to a residential home. Case B.—A woman of 70 years who, it was alleged, lived in insanitary conditions, and caused a nuisance to other occupants by smells from her room. On investigation it was found that the house was fairly clean though she had hoarded old newspapers and magazines and bones for a considerable time. These she agreed to have removed and destroyed. 29 Case C.—A woman of 84 years who had been living alone since the death of her husband, did her own shopping and had domestic help one morning per week. She was quite unable to care for herself and was drinking excessively. Ultimately she agreed to go into a home for old people and now appears happier and more contented. Section 50.—Burial or Cremation of the Dead Arrangements were made for the burial of the bodies of five persons who had died in the borough. One was a newly born male child who had been found in Finsbury Park and the other four were aged women, two of whom lived alone and two in a home for old people. 30 SECTION 6. GENERAL MEDICAL EXAMINATION OF STAFF Twenty-eight persons were medically examined to determine their fitness for acceptance on the permanent staff. Twenty-six were found to be fit. One of the conditions of the new scheme for sickness pay for all employees who come within the scope of the National and Provincial Councils for Non-Trading Services (Manual Workers), which came into operation on the 5th July 1948, is that all new employees be required to submit to a medical examination before the completion of six months service with the Council in order to determine their fitness for admission to the scheme. One hundred and thirteen persons were examined, one hundred and eleven of whom were accepted for the scheme. AREA HEALTH SERVICE The personal health services now under the control of the Middlesex County Council are administered from the Area Health Office, Somerset Road, Tottenham, N.17. Telephone number TOTtenham 4500. AREA WELFARE SERVICE The Welfare Service of the Middlesex County Council is administered in Hornsey by the Area Welfare Officer, 5 Lansdowne Road, Tottenham, N.17. Telephone number TOTtenham 1212, and it is to this officer that enquiries should be directed regarding the admission of persons to residential homes provided by the Middlesex County Council. LUNACY AND MENTAL TREATMENT ACTS The Authorised Officers for the purpose of these Acts have their offices at 5 Lansdowne Road, Tottenham, N.17. Telephone number TOTtenham 1211. AMBULANCE SERVICE Ambulances are on call for urgent cases including maternity cases throughout the day and night. Telephone number MOU: 2222. MILDURA COURT WELFARE CENTRE This centre was officially opened by the Chairman of the County Health Committee (County Alderman Mr. F. E. Harmsworth) on the 31st March 1951. It is incorporated in Mildura Court, a block of flats erected by Hornsey Borough Council, and is on the quietest part of the site. It comprises an entrance hall, waiting hall, weighing room with dressing cubicles and rooms for the doctor, health visitor, toddlers and staff, together with lavatories, testing room, etc. The main rooms have folding partitions so that they may be used separately or thrown into one. An outside pram shelter is also provided. This attractive modern clinic is a welcome addition to the existing maternity and child welfare centres of Hornsey. Accommodation temporarily occupied for clinic purposes at the Campsbourne Institute was vacated in June 1951. 31 VETERINARY INSPECTION IN HORNSEY by Mr. F. G. BUXTON, M.R.C.V.S., Veterinary Inspector. During the past thirty years while I have been Veterinary Inspector of this Borough the duties have undergone considerable changes. My father, who was the first Veterinary Inspector appointed by the Borough in 1906, retired in 1922. After his retirement I carried on the duties and was formally appointed in 1925. The appointment of a Veterinary Inspector is authorised under the Diseases of Animals Act, 1894, which states (Section 35(i))—"Every Local Authority shall appoint so many inspectors and other officers as the local authority think necessary for the execution and enforcement of this Act. . ." His duties include visiting farms, stables and other places in the Borough at or in which he has information or reason to believe that there are diseased cattle, sheep, goats, swine, horses, dogs or other animals, and make all necessary inspections and examinations. He shall inspect the slaughtering and burial, or removal to the knackers, of diseased cattle, horses and other animals, making post-mortem examinations when necessary. He carries out all the duties required of him in connection with the prosecution of persons for offences under the above-mentioned Acts and any other Acts under which powers are derived, attending before Justices or Magistrates in the Petty Sessional or police courts, or any other Court, when required, and giving evidence in support of summonses or other proceedings relating to matters coming within the scope of his duties. He gives all such notices as may be necessary, and makes all necessary reports, returns and information to the Board of Agriculture, and reports the results of his inspections, inquiries and action taken to the Medical Officer of Health. When I first became the Veterinary Inspector there were in the area a number of dairy cows at Manor Farm, Hornsey Lane Farm, Park Farm and later some in Claremont Road. The milk was sold locally. In addition there were a few kept for the private use of their owners. These required inspection and when necessary testing for tuberculosis; samples of milk taken regularly for examination, and reactors slaughtered and post-mortem examination carried out under the terms of the Tuberculosis Order 1925. Reports were made to the Borough Council and returns to the Ministry of Agriculture on the results of inspections and the action taken in connection with animals suffering from the various notifiable diseases. At the present day only one cow remains in the Borough; it is privately owned and its milk is not sold. The other cow belonging to the same owner died suddenly one night in October, 1950, and the clinical signs upon inspection gave one to suspect anthrax, a notifiable disease. As usual the Ministry took over and, eventually, reported the case as negative. At times, under the Parasitic Mange Order 1911, outbreaks of parasitic mange were reported in horses owned by the various private concerns such as coal companies, job masters as well as private individuals. These 32 were inspected, and scrapings taken for microscopic examination, weekly inspections were made until the animal had recovered or was destroyed. There are now only a few horses in the Borough and this condition is rarely found. Prior to the war and particularly during an outbreak of foot and mouth disease a considerable number of licences were issued for animals coming into the Borough for slaughtering. These were mainly sheep, cattle and pigs, and were all inspected upon arrival and before slaughter. Store pigs coming into this area under licence had to remain at the place of destination for twenty-eight days. This would apply equally to-day. Since the coming of the Live Stock (Restriction of Slaughter) Order, 1940, slaughtering has been restricted and now few licences are issued for animals coming into the Borough. Rabies is fortunately a disease which has been stamped out. Nowadays it occurs in England only in the Quarantine Kennels where dogs brought into the country have to spend six months. As far as I can ascertain, Hornsey has not had a confirmed case, and the last suspected case reported in Hornsey was in March 1921. This was a sable and white collie in Inderwick Road; it proved to be negative. "Newcastle" disease or fowl pest came into this country in 1926 or 1927; it is a notifiable disease under the Fowl Pest Order of 1936. There were several cases reported in the Borough which were inspected and reported to the Ministry of Agriculture, these were mainly among "backyard" poultry and were during the war years and very soon after. In 1939, the Riding Establishment Act came into force and in consequence all riding establishments in the Borough are inspected twice a year, and reports made on the condition of the horses and ponies. In 1952, the Pet Animals Act, 1951, will come into operation on 1st April, after which date no person will be allowed to keep a pet shop except under the authority of a licence issued by the Borough Council. These premises will be inspected and reported upon as a routine on two occasions each year and forthwith on receipt of evidence of contravention of the conditions under which the licences are issued. It is, perhaps, not well known that persons taking pet animals abroad must obtain a veterinary certificate stating that the animal is fit and not in an infectious state and has not been in an "infected area" (i.e. where the existence of foot and mouth disease has been confirmed) for a period which varies according to the country to which it is being sent. Each year approximately twelve certificates are issued in respect of dogs and cats and sometimes racing pigeons and occasionally even budgerigars. Mechanisation of the Council's transport has meant the loss of the May Day Parade when the horses and carts were decorated, and prizes presented by the Mayor to the drivers of the most attractive and best cared for horses and vehicles, taking into consideration the age of the horses and the length of time the driver had looked after the animal. 33 Veterinary Inspections No Licences were issued under the Contagious Diseases of Animals Acts. Five inspections were carried out under the Contagious Diseases of Animals Acts as follows:— Three being for suspected Fowl Pest, totalling 41 fowls. Two for Store Pigs coming to the Borough, totalling 20 porkers. Two inspections were made under the Riding Establishment Act, 1939. The number of horses and ponies inspected was sixteen. No action was necessary under the Tuberculosis Order, 1925. MOTHERCRAFT TRAINING SOCIETY It is with very real regret that I record that Cromwell House, the headquarters of the Mothercraft Training Society, was closed at the end of July. It was founded in 1918 and its chief function was to teach the feeding and rearing of infants according to the principles laid down by Dr. Truby King. Cromwell House was known all over the world and health visitors and others have visited there during their courses of training. Midwives and nurses from all over the country attended demonstrations on infant feeding and courses were arranged for expectant mothers. The Society specialised in dealing with the feeding of "difficult" babies both as in-patients and through their out-patient clinics. They advocated and promoted wherever possible the breast feeding of infants. A training college for nursery nurses was also run by the Society. For over thirty years Cromwell House was financed by voluntary contributions, but greatly increased costs of recent years, coupled with a falling off in contributions, made it necessary for the Society to close. OPEN AIR SWIMMING POOL, PARK ROAD I am indebted to the Borough Engineer and Surveyor for the following information: Break-point chlorination has now been in operation at the Open Air Swimming Pool for over two seasons and the results are considered to be satisfactory. The object of chlorinating swimming pool water is to maintain it in a sterile condition and reduce to a minimum the risk of transmitting water-borne disease or infection. To do this effectively a supply of chlorine must be available in the water so that bacteria may be attacked immediately and ammonia compounds destroyed. The water in the Pool is pumped on to filters which strain out suspended matter and keep the water clear. The chlorine is added on the return journey together with other chemicals. The original system, which was superseded, was that known as marginal chlorination, and the concentration of chlorine was between 0.1 and 0.2 parts per million. In this system the chlorine first combines with the ammonia, with the result that it is a combination of chlorine and ammonia which attacks the bacteria. The action of these compounds is considerably slower than that of a "free residual" chlorine. 34 The break-point system consists of adding enough chlorine to oxidise the products of ammonia so that there is a "reserve" of chlorine immediately available to attack and destroy bacteria. The concentration of chlorine in the water may be from 1 to 5 parts per million. With this system, however, it is very important to control the alkalinity of the pool water within fairly close limits, otherwise conditions may become unpleasant for bathers. The break-point system is of advantage during periods when there is a heavy bathing load, since under the superseded system there was usually insufficient chlorine in the water to form an effective "reserve". No economic system of pumping water can ensure that all parts of the pool water are removed at the same rate, and there is a tendency to create what are known as "dead spots" where the movement is slow. A reserve of free chlorine is very desirable in such circumstances. The water is sampled and tested by the pool attendants about every two hours at the points likely to give the worst results, and during every month a sample is taken and sent for an independent chemical and bacteriological analysis. During the last season the results were very satisfactory. Break-point chlorination is also considered to give water a more inviting and attractive appearance. The statistics for 1951 were as follows:— Total admissions 79,711 No. of season ticket holders—adults 125 children 557 The Pool was opened on Saturday, 28th April, 1951, and closed on Saturday, 29th September, 1951. PUBLIC MORTUARY Under Section 198 of the Public Health Act the local authority may, and if required by the Minister shall, provide a mortuary for the reception of dead bodies before interment; a post-mortem room for the reception of dead bodies during the time required to conduct any post-mortem examination ordered by a coroner or other duly authorised authority; and may make byelaws with respect to the management and charges for the use of any such place provided by them. A local authority or parish council may provide for the interment of any dead body which may be received into their mortuary. There are various regulations regarding the disposal of dead bodies, designed to prevent the spread of infection. If the Medical Officer of Health certifies that it is necessary, a Justice may order the body of any person to be removed to the mortuary and, if he considers it necessary, buried within a stated time. The Medical Officer of Health or other medical practitioner may certify that it is necessary for the body of a person who has died from a notifiable infectious disease to be removed direct from hospital to a mortuary or buried forthwith. These provisions were previously in the Public Health Act, 1875. The Hornsey mortuary and post-mortem room are situated at the Central Depot, Hornsey High Street. During the year ninety-six bodies were admitted and post-mortems carried out on all of them. Inquests were held on ten bodies. 35 SECTION 7. STATISTICAL TABLES There is always need for great care in studying statistical tables, and the temptation to read more into figures than they do, in fact, convey must be avoided. For example, the thoroughness with which the inspection of a Borough is carried out cannot be discovered merely from a study of the number of inspections under any one heading or group of headings. It is obvious, for example, that an inspection of a house with a view to action under Section 9 of the Housing Act must necessitate many hours work whereas a visit in connection with a leaky roof or a blocked flue may take only as many minutes. When comparing the figures for infectious diseases by wards in the Borough the varying populations of the wards should be taken into account. No exact figures are available but the populations of the wards to the nearest hundred are estimated to be as follows:— Hundreds Hundreds Highgate 160 North Haringey 79 Muswell Hill 190 South Haringey 80 Crouch End 82 Stroud Green 162 Central Hornsey 170 Finsbury Park 74 The number of separately assessed inhabited premises is stated as 24,822, an apparent fall since last year of over 2,000 premises. This is due to the fact that lock-up shops, garages and other premises which are separately assessed for rates have been excluded from the figure this year. It will be seen that the infant death rate in Hornsey was 24.1, an increase of 2.9 per thousand. The rate for 126 county boroughs and great towns (which includes the Borough of Hornsey) has also increased by .1 per thousand; the rate for the smaller towns, on the other hand, has fallen by 1.8 per thousand to 27.6. The downward trend in the national figures for infant mortality has continued and the 1951 rate of 29.6 is the lowest ever recorded in this country. Again there was only one maternal death in Hornsey during the year and the rate for the whole of the country once more shows a fall—from 0.87 in 1950 to 0.79. The great increase in the number of notified cases of puerperal pyrexia is due to the change in its definition. This is dealt with more folly in the Section on Infectious Disease. The increase in the number of notifications of dysentery from 10 in 1950 to 132 in 1951 was largely due to the outbreak in a Hornsey school which has been described elsewhere in this report. The area comparability factors for births and deaths allowing for the differing age and sex distribution of the population are: births 0.89 and deaths 0.92. The Hornsey rates multiplied by these factors become 13.08 and 9.67 respectively. 37 SOCIAL AND ECONOMIC STATISTICS Area (acres) 2,872 Area of Parks and Open Spaces (acres) 329 Population : Census 1931 95,524 Census 1951 98,134 Registrar General's estimate at 30 June, 1951 98,890 Number of separately assessed inhabited premises according to Rate Books 24,822 Rateable value (General Rate) £1,072,443 Product of a penny rate £4,370 VITAL STATISTICS LIVE BIRTHS M F Total Legitimate 737 641 1,378 Illegitimate 34 39 73 771 680 1,451 Birth Rate (per 1,000 population) Hornsey 14.7 England and Wales 15.5 126 County Boroughs and Great Towns including London 17.3 148 Smaller Towns 16.7 London Administrative County 17.8 STILL BIRTHS M F Total Legitimate 15 14 29 Illegitimate 1 1 2 16 15 31 Still-birth Rate (per 1.000 population) Hornsey 0.31 England and Wales 0.36 126 County Boroughs and Great Towns including London 0.45 148 Smaller Towns 0.38 London Administrative County 0.37 INFANT DEATHS (under 1 year of age) M F Total Legitimate 23 10 33 Illegitimate 1 1 2 24 11 35 38 Comparable Infant Death Rates (per 1,000 live births) Hornsey 24.1 England and Wales 29.6 126 County Boroughs and Great Towns including London 33.9 148 Smaller Towns 27.6 London Administrative County 26.4 Neo -Natal Deaths (under 4 weeks of age) M F Total Legitimate 21 6 27 Illegitimate 1 - 1 22 6 28 MATERNAL DEATH RATES (per 1,000 total live and still-births) Hornsey (one death only) 0.67 England and Wales 0.79 DEATHS FROM ALL CAUSES Males 495 Females 652 1,147 Death Rate (per 1,000 population) Hornsey 11.6 England and Wales 12.5 126 County Boroughs and Great Towns including London 13.4 148 Smaller Towns 12.5 London Administrative County 13.1 NOTIFICATIONS OF PUERPERAL PYREXIA Number of Notifications 15 Puerperal Pyrexia Rate (per 1,000 total live still-births) Hornsey 10.33 England and Wales 10.66 126 County Boroughs and Great Towns including London 13.77 148 Smaller Towns 8.08 London Administrative County 14.90 39 40 DEATHS OF HORNSEY RESIDENTS Classified according to ages and age groups Under 1 1 to 2 2 to 4 5 to 14 15 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 and over Totals M . . . . 1 2 3 1 3 2 12 20 1 Tuberculosis, respiratory F . . . 1 . 4 1 . 1 1 . 8 M . . 1 . . . . . . . . 1 1 2 Tuberculosis, other F . . . . . . . . . . . . M . . . . . . . . . 2 1 3 4 3 Syphilitic disease F . . . . . . . . . . 1 1 4 Diphtheria 5 Whooping Cough 6 Meningococcal infections NIL 7 Acute poliomyelitis 8 Measles M . . . . . . . . . . 2 2 3 9 Other infective and parasitic diseases F 1 . . . . . . . . . . 1 M . . . . . . 1 4 3 4 4 16 33 10 Malignant neoplasm, stomach F . . . . . . . 1 4 3 9 17 M . . . . . . 2 3 12 11 . 28 38 11 Malignant neoplasm, lung, bronchus F . . . . . . 1 1 2 3 3 10 M . . . . . . . . . 1 . 1 22 12 Malignant neoplasm, breast F . . . . . . 2 1 4 8 6 21 M . . . . . . . . . . . . 14 13 Malignant neoplasm, uterus F . . . . . . 1 5 2 2 4 14 M . . . . 2 . 1 3 2 18 17 43 100 14 Other malignant & lymphatic neoplasms F . . . . . . 3 6 16 20 12 57 41 Deaths of Hornsey Residents—continued Under 1 1 to 2 2 to 4 5 to 14 15 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 and over Totals M . . . . . . . . . 1 . 1 6 15 Leukaemia, aleukaemia F . . . 1 . . . . . 3 1 5 M . . . . . . . . . . 1 1 6 16 Diabetes F . . . . . . . . 1 1 3 5 M . . . . . . 1 2 6 12 24 45 143 17 Vascular lesions of nervous system F . . . . . . 1 3 8 27 59 98 M . . . . . . 3 6 15 21 32 77 140 18 Coronary disease, angina F . . . . . . . 2 6 21 34 63 M . . . . . . . . 4 6 5 15 48 19 Hypertension with heart disease F . . . . . . . 1 2 10 20 33 M . . . . . 1 . 3 2 10 39 55 162 20 Other heart disease F . . . . . . 4 4 4 19 76 107 M . . . . . . . 1 2 6 8 17 40 21 Other circulatory disease F . . . . . . 1 . 2 9 11 23 M . . . . . . . 2 5 4 1 12 30 22 Influenza F . . . . . . 1 1 2 4 10 18 M 1 . . . . . . 1 4 7 9 22 58 23 Pneumonia F 1 . . . 1 . . 1 1 13 19 36 M . . . . . . 1 3 16 17 11 48 24 Bronchitis 77 F . . . . . . 1 . 2 6 20 29 M . . . . . . . . 1 2 . 3 25 Other diseases of respiratory system 9 F . . . . . . . 1 . 1 4 6 42 Deaths of Hornsey Residents—continued Under 1 1 to 2 2 to 4 5 to 14 15 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 and over Totals M . . . . . . 1 1 3 1 6 12 14 26 Ulcer of stomach and duodenum F . . . . . . . . . 1 1 2 M . . . . . . . . . 1 1 2 3 27 Gastritis, enteritis and diarrhoea F . . . . . 1 . . . . . 1 M . . . 1 . . 1 . . 1 . 3 9 28 Nephritis and nephrosis F . . . . 1 . 1 . 2 1 1 6 M . . . . . . . . . 1 4 5 5 29 Hyperplasia of prostate F . . . . . . . . . . . . M . . . . . . .. . . . . . 1 30 Pregnancy, childbirth, abortion F . . . . . 1 . . . . . 1 M 5 2 . . . . . . . . . 7 13 31 Congenital malformations F 4 . . 1 . . . 1 . . . 6 M 18 . . . 1 1 . . 5 5 11 41 96 32 Other defined and ill-defined diseases F 4 . 1 . . 2 4 2 7 8 27 55 M . . . 1 . 1 1 1 . . . 4 10 33 Motor vehicle accidents F . . 1 . . 1 . . 1 1 2 6 M . . 1 . 1 . 1 . 1 1 1 6 21 34 All other accidents F 1 . . . . . 1 . 1 1 11 15 M . . . . . 1 2 2 4 2 2 13 20 35 Suicide F . . . . . 1 . 1 3 2 . 7 M . . . . . . . . . . . . 1 36 Homicide and operations of war F . . . . 1 . . . . . . 1 M 24 2 2 2 5 6 18 33 88 136 179 495 F 11 . 2 3 3 10 22 32 70 165 334 652 TOTALS 35 2 4 5 8 16 40 65 158 301 513 1,147 43 INFANT DEATHS CAUSES BY AGE GROUPS AND SEXES Under 1 Day 1—6 Days 1 Week 2 Weeks 3 Weeks Total Under 1 Month 1—2 Months 3—5 Months 6—8 Months 9—11 Months Totals M F M F M F M F M F M F M F M F M F M F M F Pneumonia . . 1 . . . . . . . 1 . . 1 1. . . . . . 2 1 Post-natal asphyxia and atelectasis 1 . 2 . . . . . . . 3 . . . . . . . . . 3 . Congenital malformations 1 . 1 . 2 1 . 2 1 . 5 3 . . . 1 . . . . 5 4 Prematurity, immaturity 2 1 1 2 . . . . . . 3 3 . . . . . . . . 3 3 Injury at birth 5 . 5 . . . . . . . 10 . . . . . . . . . 10 . All other causes . . . . . . . . . . . . . . . 2 . . 1 1 1 3 TOTALS 9 1 10 2 2 1 . 2 1 . 22 6 . 1 1 3 . . 1 1 24 11 44 NOTIFICATION OF INFECTIOUS DISEASE BY AGE AND SEX AGE IN YEARS Scarlet fever Whooping cough Acute Poliomyelitis Measles Ophthalmia neonatorum Meningococcal infection Paralytic Non-paralytic M F M F M F M F M F M F M F Under 1 - - 12 7 - - - - 23 25 1 - 1 - 1—2 7 3 33 28 - - - - 158 129 - - - - 3—4 15 14 45 49 - 1 - - 218 180 - - - - 5—9 49 53 42 44 1 - 2 - 289 285 - - - - 10—14 5 8 2 2 1 - - - 7 5 - - - - 15—24 1 1 - - - - - - 7 7 - - - - 25 and over - 1 2 3 - - - - 6 6 - - - - TOTALS 77 80 136 133 2 1 2 - 708 637 1 - 1 - 157 269 3 2 1,345 1 1 AGE IN YEARS Acute pneumonia Dysentery Erysipelas Typhoid fever Food poisoning Puerperal pyrexia Paratyphoid fever Malaria M F M F M F M F M F M F M F M F Under 5 3 6 12 13 - - - - - 1 - - 1 - - - 5—14 1 2 12 35 1 - - - - 1 - - - - - - 15—44 10 10 7 46 3 2 - 1 4 2 - 15 - - 1 - 45—64 16 12 3 2 3 3 - - 3 2 - - - - - - 65 and ove 5 20 - 2 3 3 - - - 1 - - - - - - TOTALS 35 50 34 98 10 8 - 1 7 7 - 15 1 - 1 - 85 132 18 1 14 15 1 1 The infant with opthalmia neonatorum was treated in hospital and the vision was unimpaired. No case of diphtheria was notified. 45 NOTIFICATION OF INFECTIOUS DISEASE BY WARDS High gate Muswell Hill Crouch End Central Hornsey North Haringey South Haringey Stroud Green Finsbury Park Totals Scarlet fever 20 25 10 32 23 21 19 7 157 Whooping cough 18 52 14 47 47 11 52 28 269 Paralytic - 1 - - - 1 1 - 3 Non-paralytic - - 1 - 1 - - - 2 Measles 122 290 144 197 108 72 269 143 1,345 Acute pneumonia 5 10 3 11 17 9 17 13 85 Dysentery 13 23 16 24 18 5 22 11 132 Erysipelas 1 2 3 4 2 - 3 3 18 Meningococcal infection 1 - - - - - - - 1 Food poisoning 5 2 - 1 4 - 2 - 14 Puerperal pyrexia 3 1 1 2 2 2 2 2 15 Typhoid fever - - - - - - 1 - 1 Paratyphoid fevers - - - - 1 - - - 1 Malaria - - - - 1 - - - 1 Ophthalmia neonatorum... - - 1 - - - - - 1 TOTALS 188 406 193 318 224 121 388 207 2,045 46 TUBERCULOSIS The total number of cases on the Tuberculosis Register at the end of 1951 was 848, viz., pulmonary 746, non-pulmonary 102. TUBERCULOSIS REGISTER Pulmonary Non-Pulmonary Total Male Female Male Female Male Female (a) Number of Cases on Register at commencement of year 420 335 59 48 479 383 (b) Number of Cases notified for first time during year under Regulations 47 35 4 3 51 38 (c) Cases restored to Register 3 2 - - 3 2 (d) Cases added to Register otherwise than by notification under Regulations (1) Transferred from other Districts 32 21 - 3 32 24 (2) From Death Returns - 1 - - - 1 (e) Number of Cases removed from Register 81 69 7 8 88 77 (f) Number of Cases remaining on Register at end of year 421 325 56 46 477 371 Cases removed from the Register shown under (e) are accounted for as follows :— Found not to be T.B. Recovered Removed to another area Died at home Died at Sanatorium or other Institution Now Diagnosed as Pulmonary T.B. TOTAL M F M F M F M F M F M F M F PULMONARY 2 2 4 7 56 50 8 3 11 7 - - 81 69 NON-PULMONARY 1 - - 1 4 7 1 - - - 1 - 7 8 PUBLIC HEALTH LABORATORY SERVICE BACTERIOLOGICAL EXAMINATIONS Throat and Nose Swabs Diphtheria bacilli - Hæmolytic streptococci 105 Vincents angina 23 Negative 227 355 Faeces Shigella 302 Salmonella 14 Protoza 1 Negative 877 1,194 Sputum Tubercular smear - Other organisms 7 Negative 51 58 Pertussis Cough Plates - Postnasal swabs 1 Negative 13 14 Milk Ice cream 52 Pasteurized 57 Other 11 120 Miscellaneous 751 2,492 47 SANITARY INSPECTION Inspections made during the year were as follows:— Food Food Premises (See table on next page) 935 Registration of Hawkers 27 Infectious Diseases Notifiable Infectious Diseases 310 Smallpox contacts 20 Food Poisoning 30 Scabies and Verminous Persons 1 Dysentery 276 Sanitary Inspections Complaints 1,782 Drainage 482 Water Tests applied 59 Smoke and Chemical Tests 58 Rodent Control 183 Surveys (Permitted numbers) 62 Overcrowding conditions 55 Building Licences 66 Shops Acts 1,262 Factories 235 Outworkers 340 Cinemas, Halls, etc., Renewal of Music and Dancing Licences 30 Rent Restrictions Acts 1 Moselle Pollution 5,739 Smoke Observations 32 Stables and Urinals 1 Verminous conditions 13 Pests 28 Under Rag, Flock etc. Act, 1951 12 Other Reasons 325 Housing Housing Inspections (See table on page 50) 2,188 Camps bourne Clearance Area 31 Others Petroleum Stores 154 Re-inspections Moselle Pollution 1,287 For all other purposes 6,933 TOTAL VISITS 22,957 48 FOOD PREMISES Inspections of food premises were made during the year as follows:— Butchers' Shops 106 Restaurants, Cafes, etc. 174 Grocers' Shops 278 Bakehouses 112 Fish Shops 35 Milkshops 27 Greengrocers' Shops 20 Confectioners 44 Cooked Meat Shops 14 Ice Cream Premises 53 Public Houses 70 Horse Flesh Butchers 2 Total Inspections Made—935 The following is a list of food condemned as unfit for human consumption. Wherever possible this was disposed of as salvage:— Cwts. lbs. Cwts. lbs. Canned Vegetables 3 81 Rabbits 1 88 Canned Fruit 8 109 Bacon - 80 Canned Fruit Juice - 71 Pickles - 7 Canned Meat 25 17 Chocolate Spread - 13 Canned Fish 3 110 Paste - 32 Canned Soup 1 17 Mincemeat - 4 Canned Marmalade - 51 Pudding Mixture - 4 Canned Jam - 70 Xmas Pudding - 12 Canned Tomato Paste - 61 Potato Powder - 30 Dried Fruit 3 9 Onion Powder - 5 Cheese 1 32 Meat Extract - 2 Butter - 35 Sourcrout - 3 Artificial Cream - 32 Molasses - 5 Tea 3 13 Cherries - 9 Cereals 1 35 Sweets - 41 Meat 11 55 Biscuits 1 110 Fish 6 107 Malt & Cod Liver Oil - 10 Poultry - 11 Canned Milk 340 pints Total Food Condemned—79 cwts. 67 lbs. and 340 pints of Milk 338 visits were made to food premises in connection with condemnation. 49 HOUSING INSPECTIONS 1.—Inspection of Dwelling-houses during the year:— (a) (1) Total number of dwelling-houses inspected for housing defects under Public Health or Housing Acts 2,011 (2) Number of inspections made for the purpose 2,188 (b) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for habitation 667 2.—Housing Act, 1936:— (a) Houses demolished as a result of formal procedure under Section 11 7 (b) Houses demolished as a result of informal notices preliminary to formal procedure under Section 11 2 (c) Parts of buildings closed (Section 12) 5 (d) Houses made fit as a result of informal notices preliminary to formal procedure under Sections 9 to 12 2 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. Eight houses have been dealt with under these Byelaws during the year and the following work carried out:— 4 (a) Closet Accommodation 1 4 (b) Water Supply 11 4 (c) Washing Accommodation 6 4 (d) Food Stores 5 5 (b) Means of carrying off waste water 4 NOTICES The Notices served during the year were as follows:— Verbal Preliminary Statutory Public Health and Housing Acts 137 1,408 203 Housing Byelaws - 1 1 Shops Acts 9 48 - Food and Drugs Act - 90 - Factories Act 4 1 - M.C.C. Act, 1950 - - 1 150 1,548 205 50 FACTORIES ACT, 1937 The following tables show the work carried out by the Sanitary Inspector under this Act:— 1. Inspections of Factories Premises Number of Inspections Written Notices Prosecutions Factories with Mechanical Power .. 204 - NIL Factories without Mechanical Power 31 1 TOTALS 235 1 NIL 2. Defects found Particulars No. of defects Found Remedied Referred to H.M. Inspector Number of defects in respect of which Prosecutions were instituted. Want of Cleanliness 5 5 Overcrowding - - Unreasonable Temperature 4 4 Inadequate ventilation 5 5 Ineffective drainage of floors - - NIL NIL Sanitary Conveniences (a) insufficient 6 6 (b) unsuitable or defective 12 12 (b) not separate for sexes 11 11 Other offences - - TOTALS 43 43 NIL NIL There are 182 Outworkers on the register engaged in the following occupations:— Wearing apparel 136 Household linen 2 Curtains and furniture hangings 1 Brass and brass articles 1 Iron and steel cables and grapnels 1 Umbrellas, etc. 2 Artificial flowers 13 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 14 Brush making 1 Feather sorting 2 Carding, etc. of buttons, etc. 1 Stuffed toys 5 Cosaques, Christmas crackers, Christmas stockings,etc. 2 Textile weaving 1 340 visits were paid to outworkers' premises during the year. 51 52 LEGAL PROCEEDINGS Date of Hearing Premises Section of Public Health Act, 1936, or Byelaw Defects Result of Proceedings 21st Feb. 502, Archway Road, N.6 92/93 Roofs and dampness. Summons withdrawn. Work completed. 21st Feb. 10 Northwood Road, N.6 92/93 Roofs, severe dampness and general general defects. Adjourned 14 days. Withdrawn later on completion of work. 21st Feb. 2 Winchester Road, N.6 92/93 Rain-water pipes and gutters—roof— severe dampness. Court Order for execution of work within 21 days and £2 2s. costs. Work completed. 21st Feb. 129 Archway Road, N.6 39 92/93 Soil pipe and vent shaft defective. Roofs, severe dampness, general defects. Court Order for execution of work within 28 days and £2 2s. costs. Work completed. 25th April 32 Muswell Hill, N.10 39 Surface water gullies and drains defective and obstructed, rainwater pipe defective. 92/93 Eaves guttering, dampness, and general defects. Adjourned 28 days. Withdrawn later on completion of work. 25th April 38 Upper Tollington Park, N.4 92/93 Wall and ceiling plaster and general defects. Court Order for execution of work within 2 months and £1 1s. costs. Work completed. 9th May and 29th Aug. 84 Oakfield Road, N.4 92/93 Roofs, ceilings, dampness and flooring. Court Order for execution of work within 28 days and £4 4s. costs. Not complied with. Further hearing on 29th August. Fine of £5 for non-compliance with a daily penalty of 40/- from 12th September and £2 2s. costs. Work in progress 30th August. Completed 26th September. 6th June 26 Coolhurst Road, N.8 92/93 Roof, wall and ceiling plaster, dampness. Adjourned sine die as work in hand. Work completed. 13th June 144 Nelson Road, N.8 92/93 Wall and ceiling plaster, absence of chimney pot. Adjourned 42 days. Subsequently withdrawn on completion of work. 13th June 94 Weston Park, N.8 92/93 Main and back addition roofs. Adjourned 42 days. Subsequently withdrawn on completion of work. 53 LEGAL PROCEEDINGS—continued. Date of Hearing Premises Section of Public Health Act, 1936 or Byelaw Defects Result of Proceedings 19th Sept. 483 Archway Road, N.6 Byelaws Clause 4(b) Clause 5(b) 92/93 Absence of convenient supply of water for domestic use. Absence of efficient means of carrying off waste water from tap. Roofs, severe dampness. Adjourned 28 days. Subsequently withdrawn on completion of work. 19th Sept. 100 Myddelton Road, N.8 92/93 Roofs, dampness, wall and ceiling plaster, general defects. Adjourned 18 days. Later adjourned sine die as work in hand. Work completed. 19th Sept. 96 Uplands Road, N.8 92/93 Joint of flush-pipe and water-closet pan; dampness; displaced window frame. Adjourned 7 days. Subsequently withdrawn on completion of work. 31st Oct. 7 Ossian Road, N.4 92/93 Main and back addition roofs. Adjourned 14 days. Subsequently withdrawn on completion of work. 31st Oct. 67 Lothair Road, N.4 92/93 Back addition roof, wall and ceiling plaster, dry rot in floors. Court Order for execution of work within 28 days, and £2 2s. costs. Work completed. 14th Nov. 92 Lausanne Road, N.8 92/93 Roofs, wall and ceiling plaster and dampness. Adjourned 14 days as work in hand. Subsequently withdrawn on completion of work. 14th Nov. 34 Marquis Road, N.8 92/93 Ground floor front bay and dampness of walls. Adjourned 21 days. Subsequently withdrawn on completion of work. SUMMARY OF SANITARY IMPROVEMENTS EFFECTED Drainage Number of houses and premises redrained 10 Repairs or amendments to existing drains 446 Drains or gullies unstopped or cleansed 393 Manholes provided or repaired 178 Intercepting traps fixed 23 Soil and Vents repaired or renewed 56 Water- Closet and Sanitary Fittings Water-closet buildings provided or repaired 15 Water-closet pans provided or renewed 65 Water-closets unstopped, cleansed or repaired 35 Flushing cisterns provided or repaired 31 New sinks provided 68 New lavatory basins provided 43 Waste pipe trapped, repaired or unstopped 187 Baths provided or made usable 11 Urinals cleansed 1 Miscellaneous Roofs repaired 441 Rain-water gutters, renewed or repaired 236 Rain-water pipes provided or repaired 125 Dampness remedied 213 Damp-proof courses provided 18 Yard paving provided or repaired 55 Rooms cleansed 691 Rooms disinfested of vermin 5 Walls and ceilings repaired 1,411 Floors repaired 209 Sub-floor ventilation provided 10 Windows, doors, skylights, sashcords and fittings repaired 496 Window-sills repaired 66 Water cisterns repaired, cleansed or covered 13 Water supply pipes repaired 11 Stoves, Ranges, Coppers renewed or repaired 123 Flues and Chimneys repaired 35 Accumulation of Refuse removed 5 Dustbins provided 50 Food Stores provided 23 Miscellaneous items 111 54 APPENDIX Statistical Report of the School Medical Officer for the Year 1951 PERIODIC MEDICAL INSPECTION Period Medical Inspections Other periodic inspections Entrants Second age group Third age group Total 900 644 377 1,291 567 Other Inspections Special inspections Re-inspections 1,326 1,247 CLASSIFICATION OF THE GENERAL CONDITIONS OF PUPILS Age Groups No. of pupils inspected A (Good) B (Fair) C (Poor) No. % No. % No. % Entrants 900 440 48.9 442 49.1 18 2.0 Second Age Group 644 359 55.8 279 43.3 6 .9 Third Age Group 377 219 58.1 157 41.6 1 .3 Other periodic inspections 567 257 45.3 306 53.9 4 .8 TOTAL 2,488 1,275 51.2 1,184 47.6 29 1.2 55 DEFECTS FOUND BY MEDICAL INSPECTION Defect or Disease Periodic Inspections Special Inspections No. of defects No. of Defects 1. 2. 1. 2. Skin 2 7 15 15 Eyes a. Vision 81 12 2 2 b. Squint 3 19 - - c. Other 2 5 3 6 Ears a. Hearing 6 6 - - b. Otitis media 2 3 - 1 c. Other 7 7 8 10 Nose and Throat 45 45 26 5 Speech 3 9 - - Cervical Glands - 22 - 1 Heart and Circulation - 9 2 - Lungs 1 20 - - Developmental— a. Hernia - - - - b. Other - - 9 9 Orthopaedic— a. Posture 19 27 - 3 b. Flat foot 18 8 - - c. Other 32 29 17 26 Nervous System— a. Epilepsy - 2 - - b. Other 1 6 - - Psychological— a. Development - 16 1 10 b. Stability - 13 - 15 Other 18 54 1,003 559 1. Requiring treatment. 2. Requiring to be kept under observation but not requiring treatment. 56 PUPILS FOUND TO REQUIRE TREATMENT Number of individual pupils found at periodic medical inspection to require treatment (excluding dental disease and infestation with vermin). Group For defective vision (excluding squint) For any of the other conditions recorded Total individual pupils Entrants 5 76 77 Second Age Group 37 38 72 Third Age Group 21 20 39 Total (prescribed groups) 63 134 188 Other periodic inspections 18 23 37 GRAND TOTAL 81 157 225 MINOR AILMENTS Number of cases treated or under treatment during the year by the Authority Otherwise (a) Diseases of the Skin (excluding uncleanliness) Ringworm—(i) Scalp - - (ii) Body 5 - Impetigo 19 - Other skin diseases 30 - TOTAL 54 - (6) Other treatment given not covered by other Tables. Number of cases treated by the Authority Otherwise Miscellaneous minor ailments 1,497 107 Developmental 3 - TOTAL 1,500 107 57 EVE DISEASES, DEFECTIVE VISION AND SQUINT Number of cases dealt with by the Authority Otherwise External and other, excluding errors of refraction and squint 106 - Errors of Refraction (including squint) 785 14 TOTAL 891 14 Number of pupils for whom spectacles were— (a) Prescribed 529* -* (6) Obtained 502† -† * Including cases dealt with under arrangement with the Supplementary Ophthalmic Services. † Known to be incomplete as glasses supplied direct to patients by National Health Service Opticians. DISEASES AND DEFECTS OF EAR, NOSE AND THROAT Number of cases treated by the Authority Otherwise Received operative treatment (a) for diseases of the ear - - (b) for adenoids and chronic tonsillitis - 7 (c) for other nose and throat conditions - - Received other forms of treatment 215 5 TOTAL 215 12 Orthopaedic and Postural Defects Treated in Orthopaedic Clinic— New Cases 395 Under treatment at end of year 395 Total attendances 2,148 Treated otherwise 12 Child Guidance and Speech Therapy Child Speech Guidance Therapy Number of pupils treated by the Authority 55 126 58 DENTAL INSPECTIONS AND TREATMENT AGE GROUPS No. inspected (i) No. found to require treatment (ii) No. referred for treatment at the County Council's Dental Clinics (iii) Under 5+ - - - 5—16 and over - - - Specials 1,599 1,577 1,569 TOTALS 1,599 1,577 1,569 iv. Number of pupils commenced treatment 1,549 iva. Number of pupils treatment completed 1,232 v. Number of attendances made by pupils for treatment 3,759 vi. Number of appointments not kept 504 vii. Number of half days devoted to (a) Inspection - (b) Treatment 644 viii. Fillings—Permanent Teeth 2,085 Temporary Teeth 560 Total 2,645 ix. Number of teeth filled—Permanent Teeth 1,634 Temporary Teeth 544 Total 2,178 x. Extractions—Permanent Teeth 231 Permanent Teeth for Orthodenture 99 Total Permanent Teeth 330 Temporary Teeth 1,995 Total 2,325 xi. Anaesthetics—(a) General 630 (b) Local 656 (c) Regional 21 Total 1,307 xii. Other operations—(a) Permanent Teeth 789 (b) Temporary Teeth 2,514 Total 3,303 59 SPECIAL DENTAL TREATMENT UNDERTAKEN BY DENTAL OFFICERS Number of impressions, etc. 6 Number of dentures fitted ... 3 Number of radiographs (a) at Dental Clinics 9 (6) at Hospitals - INFESTATION WITH VERMIN Total number of examinations 32,598 Total number of pupils found to be infested 126 Total number of individual pupils found to be infested for the first time during current year 107 EMPLOYMENT OF CHILDREN AND YOUNG PERSONS 1. Number of children medically examined in order to ascertain whether they were physically fit to undertake employment of a light nature outside school hours 60 2. Number of instances in which the state of health was found to be such that certificates were withheld - 3. Number of children examined as to fitness to take part in entertainments 15 4. Number of cases in which certificates to take part in entertainments were withheld - EDUCATION ACT 1944—Sections 57(3), 57(4) and 57(5) Cases dealt with under Section 57, Education Act 1944:— Sub-Section 3 5 Sub-Section 4 1 Sub-Section 5 3 Cases de-notified under Section 8, Education (Miscellaneous Provisions) Act 1948: MEDICAL EXAMINATION OF TEACHERS (a) Number of Teachers examined as to fitness for appointment 13 60 COUNTY COUNCIL DAY SPECIAL SCHOOLS Vale Road School for Physically Handicapped Children New recommendations received during year 2 Children admitted during year 2 In attendance on last day of year 6 On waiting list on last day of year - Tottenham School for the Deaf New recommendations received during year 1 Children admitted during year - In attendance on last day of year 6 On waiting list on last day of year 5 CHIROPODY BOYS GIRLS AGES 0-5 5-10 10-15 Total 0-5 5-10 10-15 Total Attendances : First 1 9 36 46 - 19 76 95 Subsequent 1 15 139 155 - 58 369 427 Conditions—Cases treated at Clinic Flat feet - - 2 2 - - 4 4 Callosity - 2 1 3 - - 3 3 Corns 1 4 11 16 - 1 25 26 Excessive perspiration - - 9 9 - - - - Foot wart - 2 27 29 - 17 61 78 Ingrowing Nail - 1 10 11 - - 2 2 Valgus Feet - - - - - - 1 1 Hallux Valgus - - - - - 1 3 4 Infected Bullae - - - - - - 3 3 Ingrowing Bullae - - - - - - 1 1 Painful Heel - - 1 1 - - - - Conditions—Cases referred to Orthopaedic Clinic Valgus Feet - - 1 1 - 1 4 5 Hallux Valgus - - - - - 1 - 1 Fractured Navicular - - - - - - 1 1 61 62 HANDICAPPED PUPILS CATEGORY ASCERTAINMENT DISTRIBUTION (as at last day of year) No. of ascertained Cases known 1st day of Year No. of New Cases ascertained during Year No. of ascertained Cases known last day of Year In Special Day Schools In Special Residential Schools In Maintained Primary and Secondary Schools In Independent Schools Not at School TOTAL B G B G B G B G B G B G B G B G B G Blind Pupils 2 - - - 1 - - - 1 - - - - - - - 1 - Partially Sighted Pupils 1 4 - - - 3 - 3 - - - - - - - - - 3 Deaf Pupils 1 1 - - 1 1 - 1 1 - - - - - - - 1 1 Partially Deaf Pupils 6 3 - 1 6 4 3 3 1 - - 1 - - 2 - 6 4 Delicate Pupils 15 19 19 14 11 13 - 1 6 8 5 4 - - - - 11 13 Diabetic Pupils - - - - - - - - - - - - - - - - - - Educationally Sub-Normal Pupils 25 17 8 3 35 17 22 10 3 - 7 6 1 - 2 1 35 13 Epileptic Pupils - 4 2 - 2 2 - - 1 - 1 2 - - - - 2 2 Maladjusted Pupils 39 12 8 4 45 15 - - 3 4 42 11 - - - - 45 15 Physically Handicapped Pupils 3 5 3 1 3 4 3 4 - - - - - - - - 3 4 Pupils with Speech Defects 80 33 38 8 82 33 - - - - 77 31 1 - 4 2 82 33 Pupils with Multiple Defects 1 - 1 - 2 - - - 1 - - - - - 1 - 2 - TOTALS 173 98 79 31 188 92 28 22 17 12 132 55 2 - 9 3 188 92 GRAND TOTALS 271 110 280 50 29 187 2 12 280 Children not ascertained as H.P. but recommended convalescence in Holiday Home or Camp School during Quarter ended 31st December, 1951. B G 35 26 PRINTED BY ROBERTS & NEWTON LTD. LONDON. N. 8.