Rui 8 URBAN DISTRICT COUNCIL OF RUISLIP-NORTHWOOD ANNUAL REPORT of the Medical Officer of Health for the year 1938 G. CLARK, M.B., D.P.H., D.T.M. & H. Medical Officer of Health Telephone Northwood With the Bompliments of the Medical Officev of Health to the bouncil Whan Disbict bouncil of Ruislip–Northwood, bouncil offices, Northwood Middx. URBAN DISTRICT COUNCIL OF RUISLIP-NORTHWOOD PUBLIC HEALTH DEPARTMENT. Public Health Officers of the Local Authority. Medical Officer of Health (part time) : G. Clark, M.B., D.P.H., D.T.M. & H. Senior Sanitary Inspector and Shops Inspector: S. P. Bristow, C.R.S.I., M.S.I.A. Sanitary Inspectors : L. C. Gould, Cert. S.I.B., M.S.IA. H. C. Kelly, do. do. Junior Clerk : E. H. Box. Public Health Department and Office— 19, Hallowell Road, Northwood. (Tel. : Northwood 1400, Extension No. 24.) * Time of attendance of Medical Officer of Health and Sanitary Inspectors—Mornings, 9 a.m. to 10 a.m., or by appointment. Maternity and Child Welfare. Medical Officers, Middlesex County Council: Northwood, Eastcote and Ruislip. Medical Officer—Miss C. I. Wright, M.B., B.S., D.P.H. Ruislip Manor Medical Officer—Mrs. A. M. Burn, M.B., Ch.B., D.P.H. South Ruislip Medical Officer—J. R. Tibbies, M.B., Ch.B., D.P.H. 1 Health Visitors and School Nurses. Northwood : Miss M. C. Brimacombe, S.R.N., S.C.M., 43, Hallowell Road, Northwood. ,, Miss N. Smith, S.R.N., S.C.M., 14, Thurlstone Road, South Ruislip. Eastcote : Miss K. S. Martin, S.R.N., S.C.M., 378a, Oxleay Court, Alexandra Avenue, Harrow. Ruislip: Miss N. M. Cooper, S.R.N., S.C.M.,55, Pinner View, Harrow. „ MissR. Coulthard, S.R.N., S.C.M., 9Chestnut Gr've, Sudb'y „ Miss M. E. Hurst, S.R.N., S.C.M., 8a, Bridge St., Pinner. South Ruislip : Miss C. F. Whitbread, S.R.N., S C.M., 6, Meadow Way, Weald Village, Harrow. Midwives. Nurse R. J. Carter, S.C.M., 123, Pavilion Way, Eastcote. (Tel. No. : Pinner 489.) Nurse E. G. Smith, S.R.N., S.C.M., "Eothen," Northwood Road, Harefield (Tel. No. : Harefield 33). Nurse R. E. Temple, S.R.N., S.C.M., 49, Potter Street, Northwood Hills, Northwood. (Tel. No. : Northwood 1475). Registrar of Births and Deaths and Vaccination Officer. Mr. A. W. Finch. Attends at Northwood : Council Offices, Tuesdays, 10 a.m. to 11 a.m., and Fridays, 10 a.m. to 10.45 a.m. Attends at Ruislip : Mrs. Riddles' Shop opposite Church, every Monday, 3 to 3.45 p.m. South Ruislip, St. Paul's Church Room, Torrington Road, Monday 2 to 2.45 p.m. The Head Office of the Registrar of Births and Deaths is at Roman's House, 281, High Street, Uxbridge. Hours of Attendance. Mondays. 9 to 10 a.m. and 5 to 7 p.m. Wednesdays. 9 to 11 a.m. Tuesdays. 4.30 to 5.30 p.m. Thursdays. 9 to 11 a.m. Fridays. 5 to 7 p.m. Saturdays. 9 to 10 a.m. Births and stillbirths are required to be registered within 42 days by the father or mother personally, and deaths within 5 days by the nearest relative. The above is for the registration of births and deaths only, the registration of marriages can only be effected at the office of the Superintendent Registrar, at 38, High Street, Uxbridge. Telephone No. : Uxbridge 1420. PUBLIC ASSISTANCE DEPARTMENT. Relieving Officer. Mr. J. E. Harrison, 252, High Street, Uxbridge (Tel. No.: Uxbridge 26). 2 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, 1938. To the Chairman and Members of the Urban District Council of Ruislip-Northwood. Ladies and Gentlemen, I beg to submit my second annual report. This is the Thirtyfourth Annual Report since the formation of the Urban District, and is in accordance with the instructions contained in the circular of the Ministry of Health dated 25th October, 1938. It contains a record of the work of the Public Health Department for the year 1938. General Characteristics of the District. The Ruislip-Northwood Urban District Council area may be described as follows. It is more or less rectangular about 5J miles long with an average width of 2J miles; situated at the North-West corner of Middlesex, abutting on the Watford Rural District, Hertfordshire, on the North, the Uxbridge Urban District, Middlesex, on the West, Harrow Urban District, Middlesex, on the East. The lowest level is about 109ft. at the South end, rising generally to 365ft. at the North end. The River Pinn flows from East to West through the centre of the District. The Urban District is now divided into four wards, namely : 1. North wood. 2. Eastcote. 3. Ruislip. 4. South Ruislip. The number of Councillors representing these wards is twentyone— Northwood, 8. Eastcote, 4. Ruislip, 7. South Ruislip, 2. 3 General Statistics. Acreage of the District. Northwood Ward 1,979 Acres. Eastcote Ward 1,378 „ Ruislip Ward 1,790 „ South Ruislip Ward 1,437 ,, Total 6,584 „ Number of Inhabited Houses at end of June, 1937 10,994 1938 12,911 Population at the time of the Census, 1901 3,560 1911 6,217 1921 9,113 1931 16,038 Estimated population at end of June, 1934 22,647 1935 28,473 ,, „ ,, „ 1936 35,535 1937 42,986 The Number of Inhabited Houses and estimated Population of the The Registrar General's estimate of the resident population mid 1938, is 40,820 and my estimate is based on the average number of persons per inhabited house as at the census in 1931. viz; 3.91 Rateable Value. Rateable value, March 31st, 1938, £428,978. Sum represented by a Id. Rate, March 31st, 1938, £1,610. Poor Law Relief. The amount of out relief paid in Ruislip Parish during the year ending December 31st, 1938, was £789 14s. 6d. 4 Wards at June, 1938 : Ward No. of inhabited houses Population Northwood 2,921 11,421 Eastcote 2,691 10,521 Ruislip 4,119 16,105 South Ruislip 3,180 12,433 Totals 12,911 50,480 Extracts from Vital Statistics for the Year 1938. Compiled from the figures supplied by the Registrar-General. Births. Births during 1938. M. F. Totals. Legitimate 410 391 801 Illegitimate 9 15 24 Totals 419 406 825 Total Births for 1937 714 5 Stillbirths :— M. F. s. Legitimate 18 17 35 Illegitimate — 1 1 Totals 18 18 36 Birth Rate. Birth Rate per 1,000 of population 20.21 Illegitimate Birth Rate per 1,000 of population .59 Birth Rate for 1933 13.9 „ 1934 15.9 „ 1935 16.3 „ 1936 17.7 „ 1937 19.68 Birth Rate for England and Wales for 1938 15.1 Stillbirth Rate per 1,000 of population .88 „ „ Total Live and Stillbirths 41.81 Deaths. M. F. Total. Deaths during 1938 163 159 322 Death Rate. The Death Rate is 7.9 The Death Rate for 1933 was 8.4 1934 ,, 7.3 1935 ,, 8.2 1936 „ 7.8 1937 „ 8.2 The Death Rate from all causes for the whole of England and Wales for 1938 was 11 6. Infant Mortality. Deaths of Infants under one year of age :— M. F. Totals. Legitimate 17 16 33 Illegitimate 1 — 1 Totals 18 16 34 Infant Mortality Rate per 1,000 births 41.21 Legitimate ,, „ ,, 40.00 ,, „ ,, Live Births 41.19 Illegitimate „ „ Illegitimate Live Births 41.66 The Infant Mortality Rate for 1932 was 23.2 „ ,, ,, 1933 ,, — 49.8 „ „ „ 1934 „ 11.7 „ „ „ 1935 ,, 31.8 „ „ „ 1936 „ 39.4 „ „ „ 1937 ,, 47 61 The Infant Mortality Rate for England and Wales for 1938 53.0 6 (Provisional Figures based on Weekly and Quarterly Returns) England and Wales. 126 County Boro's. and Great Towns including London. 148 Smaller Towns (Resident Populations 25,000 to 50,000 at 1931 Census). London Administrative County. Rates per 1,000 Population. Births : Live 15.1 15.0 15.4 13.4 Still 0.60 0.65 0.60 0.48 Deaths : All Causes 11.6 11.7 11.0 11.4 Typhoid and Paratyphoid fevers 0.00 0.00 0.00 0.00 Smallpox 0.00 — 0.00 — Measles 0.04 0.05 0.03 0.06 Scarlet fever 0.01 0.01 0.01 0.01 Whooping Cough 0.03 0.03 0.02 0.03 Diphtheria 0.07 0.07 0.06 0.05 Influenza 0.11 0.10 0.11 o.os Notifications : Smallpox 0.00 0.00 0.00 — Scarlet fever 2.41 2.60 2.58 2.05 Diphtheria 1.58 1.85 1.53 1.90 Enteric fever 0.03 0.03 0.04 0.05 Erysipelas 0.40 0.46 0.39 0.46 Pneumonia 1.10 1.28 1.98 0.98 Rates per 1,000 Live Births. Deaths under 1 year of age 53 57 51 57 Deaths from Diarrhoea and Enteritis under 2 years of age 5.5 7.8 3.6 13.1 Maternal Mortality : Puerperal Sepsis 0.89 Not available. Others 2.19 Total 3.08 Rates per 1,000 Total Births (i.e., Live and Still). Maternal Mortality : Puerperal Sepsis 0.86 Not available Others 2.11 Total 2.97 Notifications : Puerperal fever 14.42 18.08 12.51 3.53 Puerperal pyrexia 15.46 7 S.D. 55. Birth-ra+es, Death-rates, Analysis of Mortality, Maternal Death-rates, and Case-rates for certain Infectious Diseases in the year 1938. England and Wales, London, 126 Great Towns and 148 I Smaller Towns. Summary of Causas of Death, 1938. Diseases. Disease. Males. Females. Totals. 1. Typhoid and Paratyphoid Fevers _ _ _ 2. Measles — — — 3. Scarlet Fever — — 4. Whooping Cough — — — 5. Diphtheria 1 i 2 6. Influenza — 3 3 7. Encephalitis Lethargiea — — — 8. Cerebro-Spinal Fever — — .— 9. Respiratory Tuberculosis 11 2 13 10. Other Tuberculosis 4 1 5 11. Syphilis 1 — 1 12. General Paralysis of insane, etc. — — — 13. Cancer 18 25 43 14. Diabetes 2 2 4 15. Cerebral haemorrhage, etc. 5 10 15 16. Heart disease 48 32 80 17. Aneurvsm 1 — 1 18. Other circulatory diseases 8 15 23 19. Bronchitis 1 4 5 20. Pneumonia all forms 9 7 16 21. Other respiratory 3 2 5 22. Peptic ulcer 1 — 1 23. Diarrhoea, etc. (under 2 years) 3 2 5 24. Appendicitis 1 1 2 25. Cirrhosis of Liver — — — 26. Other diseases of liver — 3 3 27. Other digestive 3 5 8 28. Nephritis acute and chronic 3 3 6 29. Puerperal sepsis — — — 30. Other puerperal causes — 3 3 31. Congenital debility, Premature birth, etc. 13 11 24 32. Senility 1 3 4 33. Suicide 1 2 3 34. Other violence 10 7 17 35. Other defined diseases 15 15 30 36. Ill defined causes — — — All Causes : Totals 163 159 322 General Provisions of Health Services in the Area. Hospitals. Fever Hospital. The Isolation Hospital is situated outside the district at Hillingdon, Uxbridge. Ruislip-Northwood is one of the four authorities included in the Joint Hospital Board. 8 The general maintenance charges of the Uxbridge Joint Hospital are based on the production of the rates according to the rateable value of the Constituent Authorities. The four Local Authorities included in the Joint Hospital Board are :— Representatives. Uxbridge Urban District Council 4 Ruislip-Northwood Urban District Council 5 Hayes and Harlington Urban District Council 3 Yiewsley and West Drayton Urban District Council 2 The accommodation provided at the Hospital is :— Nos. 1 and 2 Blocks, Scarlet Fever, about 50 Beds and Cots. No. 3 Block, Diphtheria, about 20 Beds and Cots. No. 4 Block, Observation Wards, about 12 Beds and Cots. Smallpox Hospital. The Middlesex County Council have contracted with the London County Council to provide the necessary transport and accommodation for cases of smallpox. In the event of any medical practitioner in the district having a suspicious case he should communicate per telephone to me a follows :— To the Council Offices— Telephone No. : Northwood 1400, Extension 24. On Week-days from 9 a.m. to 5.30 p.m. On Saturdays from 9 a.m. to 12.30 p.m. Arrangements will then be made if necessary to obtain the assistance of an expert to help in the diagnosis of the case with the least possible delay. 9 The North-wood, Pinner and District Hospital (Northwood War Memorial), Pinner Road, Northwood. This Hospital is maintained entirely by voluntary subscriptions and is not subsidized by the Local Authority. (H.S.A. and H.S.F. Vouchers are accepted.) The accommodation now provided is as follows :— Public Wards : Private Wards : Women's Ward, 12 beds. Five Single Roi ms Men's Ward, 8 beds. Two Double Rooms (4 beds). Children's Ward, 6 beds. One Observation Room Kitchen. Administrative Quarters. Operating Theatre. X-Ray Room. There is generally a waiting list for the Private Wards. For further information apply to Secretary, Mr. H. M. Maskell at the Hospital. Tel. : Northwood 567. Tuberculosis Sanatoria. Provided and maintained by the Middlesex County Council. Tuberculosis Dispensary. The Tuberculosis Dispensary is provided by the Middlesex County Council. Medical Officer : Dr. A. S. Hall, M.A., M.B., B.Ch., M.R.C.P. Address : Redhill County Hospital, Edgware. Telephone No.: Edgware 3406. Clinic Address : 53, Greenhill Crescent, Harrow. Telephone No. : Harrow 1820. Hours of Attendance : Mondays, 10.30 a.m. Tuesdays, 10.30 a.m. (Contacts) Thursdays, 2.30 p.m. Second and fourth Wednesdays in each month at 6 p.m. 10 Maternity Hospitals. The North wood, Pinner and District Hospital will admit cases to private wards for operative midwifery. Patients seeking admission to Hillingdon County Hospital need no longer make application to the Relieving Officer. Admission is arranged by the Medical Superintendent, and any necessary inquiries into financial circumstances are carried out through the Almoner at the Hospital. The Middlesex County Council have made arrangements whereby Medical Practitioners may obtain advice by telephone in cases of difficult labour, and if considered desirable the Obstetric Surgeon will either visit the patient in her home or make arrangements for the admission of the case to Hillingdon County Hospital. Medical Practitioners desirous of using this service should telephone Uxbridge 1782. Hillingdon County Hospital, Uxbridge. Telephone No. : Uxbridge 1782. Medical Practitioners can obtain admission for urgent cases by making application direct to the Medical Superintendent by telephone (see above). Medical practitioners should make a practice of leaving a note at the patient's home, giving particulars of the illness of the patient in order that the note may accompany the patient to the Hospital. Relatives should be informed that they must attend at the Almoner's Office at the Hospital in order to give necessary information with regard to means, etc. For non-urgent cases instructions should be given that they should apply to the Almoner at the Hospital, and should take with them a note giving the reason for the recommendation and any particulars which may be considered likely to be of assistance to the Hospital Staff. It is no longer necessary to apply to the Relieving Officer. Maternity Homes. Miss B. Powell-Jenkins, Athene Nursing Home, West Hatch Manor, Ruislip. Telephone No. : Ruislip 659. Miss F. M. C. Jackson, Resthaven, The Drive, Northwood. Telephone No. Northwood 564. Miss A. I. Serginson, Restholme, Brickwall Lane, Ruislip. Telephone No. : Ruislip 185. 11 Midwives. Middlesex County Council. Nurse R. J. Carter, 123, Pavilion Way, Eastcote. Telephone No. : Pinner 489. Nurse E. G. Smith, Eothen, Northwood Road, Harefield. Telephone No. : Harefield 33. Nurse R. E. Temple, 49, Potter Street, Northwood Hills, Northwood. Telephone No. : Northwood 1475. Ruislip Nursing Association. Nurse P. C. Lane, S.R.N., S.C.M., 6, Cheyne Court, High Street, Ruislip. Nurse E. L. Loynes, S.R.N., S.C.M., 6, Cheyne Court, High Street, Ruislip. Telephone No. : Ruislip 3480. Midwives in Private Practice. Nurse E. Collins, 56, Mount Park Road, Eastcote. Nurse A. E. Geenan, 142, Victoria Road, Ruislip Manor. Nurse C. Harman, 1, Hatherleigh Road, Ruislip Manor. Nurse M. G. Hunter, Hope Villa, 221, Victoria Road, Ruislip Manor. Nurse F. M. C. Jackson, Resthaven Nursing Home, The Drive, Northwood. Nurse B. Powell-Jenkins, Athene Nursing Home, West Hatch Manor, Ruislip. Nurse A. Serginson, Restholme Nursing Home, 29, Brickwall Lane, Ruislip. Nurse D. A. Shepherd-Hoskings, 6, Woodville Gardens, Ruislip. Nurse M. J. Urie, 26, Torcross Road, Ruislip Manor. Nurse L. Whitehead, Elsinore, West Hatch Manor, Ruislip. Nurse A. F. Young, 90, West End Road, Ruislip. Venereal Diseases Treatment Centres. Arrangements have been made by the Middlesex County Council with the principal London Hospitals for the treatment of these cases. Information as to times of attendances can be obtained from the Medical Officer of Health. Nursing of Infectious Diseases. No special arrangements are made. 12 Professional Nursing in the Home. General Nursing. The Queen's Institute of District Nursing. District Nurses: Northwood District: Nurse M. C. Steven, S.R.N., S.C.M.. Address : 25, Hallowell Road, Northwood. Telephone No. : Northwood 1544. Ruislip and South Ruislip : Nurse L. Duckworth, S.R.N., S.C.M. Nurse P. C. Lane, S.R.N., S.C.M. Nurse E. E. Loynes, S.R.N., S.C.M. Address : 6, Cheyne Court, High Street, Ruislip. Telephone No. : Ruislip 3480. Church Army Nurses. Northwood.—Holy Trinity Parish, Sister N. A. Holmes, 168, Hallowell Road, Northwood. Emmanuel Parish, Sister A. Cooper, 121, High Street, Northwood. Eastcote—-A Nurse maintained by the Eastcote Nursing Association visits in Eastcote. Name and address : Nurse A. E. Locke, c/c Miss Joel, Fore Street, Eastcote. Telephone : Ruislip 2340. Ruislip.—The following Nurse is working in the neighbourhood : Nurse D. A. Shepherd-Hoskings, 2, Brickwall Lane, Ruislip. Telephone No. : Ruislip 2374. British Red Cross Society. Middlesex Branch. Ruislip-Northwood Division. Voluntary Aid Detachments Nos. 114 and 116. During the year classes and examinations were held in First Aid and Home Nursing, these classes will continue during 1939. The members of the detachments are still doing a large amount of voluntary work at the local hospitals, clinics, and assistance has been rendered in urgent cases in the home. Medical practitioners, nurses, and persons interested should communicate with the Divisional Honorary Secretary, Mr. S. P. Bristow, 6, Rofant Road, Northwood, Telephone : Northwood 1403, who will be pleased to give any further information concerning the activities of the Society. 13 Infectious Diseases. Disease. Total Cases Notified. Cases admitted to Hospital. Total Deaths. Smallpox — — — Scarlet Fever 136 107 — Diphtheria 40 37 2 Paratyphoid 2 —- — Typhoid 2 1 — Dysentery 1 — — Ophthalmia Neonatorum 1 — — Acute Poliomyelitis 1 — — Puerperal Pyrexia 4 — — Pneumonia 30 — — Erysipelas 16 — — Totals 233 145 2 The Case Rate of Infectious diseases per 1,000 of population :— Ruislip-Northwood Urban District. England and Wales. No. of Cases. Case Rate. Case Rate. Smallpox 0 0.00 0.00 Scarlet Fever 136 3.33 2.41 Diphtheria 40 0.98 1.58 Paratyphoid 2 0.05 0.03 Typhoid 2 0.05 Erysipelas 16 0.39 0 40 Pneumonia 30 0.73 0.10 The Rate for Puerperal Pyrexia is calculated in relation to the number of births registered and not in relation to the population. Ruislip-Northwood Urban District England and Wales Number of Cases Case Rate Case Rate Puerperal Pyrexia 4 4.64 14.42 i.e., Live and Still Births. 14 Number of women dying in, or in consequence of, child-birth From Puerperal Sepsis Nil. From Other Puerperal Causes 3 Ophthalmia Neonatorum Cases V ision unimpaired Vision impaired Total Blindness Deaths Notified Treated At Home In Hospital 1 1 (Born in Hospital) Tuberculosis. New Cases and Mortality during 1938. Age Periods. New Cases. Deaths. Pulmonary. Nov-Pul. Pulmonary. Non-Pul. M. F. M. F. M. F. M. F. 1 5 1 1 10 2 1 15 20 2 1 2 25 2 1 1 35 6 5 2 2 45 7 3 4 2 55 5 2 65 2 1 upwards 1 1 1 Totals 26 9 4 3 10 6 15 Infectious Disease Cases Admitted during 1938. During 1938 the following number of cases were admitted to the Hospital : District Scarlet Fever Diphtheria Observation Suspected Typhoid Erysipelas 9 TOTALS Uxbridge U.D.C 72 67 1 — — — — — — 140 Ruislip-Northwood U.D.C. i 07 37 — 1 — — — — — 145 Hayes and Harlington U.D.C 71 22 — .— 2 — — 95 Yiewsley and West Drayton U.D.C 70 19 — — — — — — — 89 Totals 320 145 i 1 2 1 — — 469 Additional and Special Cases : From Hillingdon Institution, etc., chargeable to Middlesex C.C 2 1 — — — — — — — 3 Royal Air Force Chargeable against Royal Air Force 5 — — — — — — — — 5 Southall Norwood Boro' Council: Chargeable against Southall Norwood Boro' Council 1 — — — — — — — 1 Total 7 2 — — — — — — — 9 Deaths in Hospital : District. Uxbridge U.D.C — 3 — — — — — — — 3 Ruislip-Northwood U.D.C — 2 — — — — — — — 2 Hayes and Harlington U.D.C. — — — — — — — — — — Yiewsley and West Drayton U.D.C 1 — — — — — — 1 Middlesex County Council — — — — — — — — — — Totals — 6 — — — — — — — 6 Deaths Percentage : Year 1936—.958 (8 in 626 cases). Year 1937—1.291 (7 in 542 cases). Year 1938—1.464 (6 in 478 cases). Mortuary. During the year there were 22 admissions to the Mortuary at the Depot, Pinner Road, Northwood. Appli cation for use of the Mortuary to be made to The Public Health Department, 19, Hallowell Rd., Northwood. Telephone No. : Northwood 1400, Extension 24. Or after office hours to:— Mr. J. Ferguson, 133, Brixham Crescent, Ruislip Manor. 16 Ambulance Facilities. Infectious Cases. A Motor Ambulance is provided by the Uxbridge Joint Hospital Board for the removal of infectious cases, bedding and clothing. Non-Infectious Cases. Regulations. The Council's Ambulances will be available for use in case of accident or other sudden or urgent disability and the use of an Ambulance cannot be reserved in advance. An Ambulance shall not in any case be used for a removal to a place distant more than 30 miles by road from the Council Offices, Oaklands Gate, Northwood. The Council will not in any circumstances be liable for delay in the removal or for the non-removal of private cases. The Council will also not be liable for damage, loss or injury to any patient or to any person accompanying such patient. If an Ambulance is required for the removal of maternity cases, the patient must be accompanied by some responsible person in charge of the patient in addition to the Driver and Attendant. The Ambulance will be in sole charge of a driver provided by the Council. Hire of Ambulance. Telephone : Calls by telephone should be given as follows : 8 a.m. to 5.30 p.m. Mondays to Fridays Saturdays 8 a.m. to 12.30 p.m. Northwood 1110. At other times Northwood 995, Scale of Charges. (a) Use of Ambulance in case of Accident or Sudden Illness in a public place in the district No charge. (b) Use of Ambulance for private calls, for conveyance of persons to and from places within the District, or to the Hillingdon Hospital or Uxbridge Cottage Hospital (including waiting time and, if required, the services of an Attendant) 7/6, unless the charge calculated on Scale (c) is less than this charge. 17 (c) For other calls:- For first 12 miles 1/3 per mile or part thereof. For additional miles 1 /- per mile or part thereof. Waiting Charge 4/- per hour or 1/- per quarter of an hour or part thereof. For extra man (if required) 2/- per hour, or 6d. per quarter of an hour or part thereof. Any incidental charges such as washing of blankets, etc. Actual cost to the Council. There are now two ambulances available which is ample for the needs of the district. With respect to cases of persons to be removed to Hillingdon County Hospital, in all but very urgent or accident cases the Ambulance of the County Authorities should be arranged for by application direct to the Hospital. Laboratory Facilities. Bacteriological examinations are carried out by the Clinical Research Association for the District Council. Diphtheria Antitoxin. The arrangement made for the supply of Diphtheria Antitoxin by the chemists is as follows:— Northwood : Mr. H. B. Sharman, 31, Green Lane. Eastcote : Mr. T. T. Johnson, 7, Field End Parade. Ruislip : Mr. I. AP. Vychan Jones, 64, High Street. Mr. A. C. Dungworth, 56, Victoria Road. Antitoxin will be supplied by the above chemists, free to medical practitioners, for patients who are unable to pay for the supply, provided that their doctor gives a certificate to the chemist to that effect. Diphtheria Immunisation. The immunisation scheme inaugurated in 1937 has been carried on and a steady if somewhat slow response has been forthcoming. The Clinics have been held in the morning at: Northwood : 19, Hallowell Road. Eastcote : Eastcote House, High Road. Ruislip : Manor Farm, High Street. South Ruislip : Lady Bankes School, Dawlish Drive, Ruislip Manor. 18 The numbers treated up to the end of the year were as follows: Applications received 578 Children received three doses 538 Of those who have had the complete course 391 have been Schick Tested and 45 were found to be reactors. All reactors receive a further injection of 1.5 c.c.s. of T.A.M. and are subsequently re-tested. In connection with the Diphtheria Immunisation Scheme I should like to place on record my appreciaton of the help given by the Officers and Members of the Ruislip Northwood Division of the British Red Cross Society who have been of great assistance to me. All applications for immunisation are to be made on consent cards to be obtained from the Welfare Centres, Health Visitors, Schools and the Public Health Department. Clinics and Treatment Centres. Maternity and Child Welfare. There are five Welfare Centres holding meetings weekly; the Medical Officer attends each week, and two Ante Natal Clinics are held weekly. Welfare Centres. Locality and Address Day Time Medical Officer. Northwood— Methodist Assembly Room, Hallowell Road Tuesday 2.30 p.m. Dr. C. I. Wright. Eastcote— Eastcote House, High Road Wed. 2.30 p.m. Do. Ruislip— Manor Farm, High Street Mon. & Thurs. 2.30 p.m. Do. Ruislip Manor— Lady Bankes Council School, Dawlish Drive Mon., Wed. & Friday 2.30 p.m. Dr. A. M. Burn. Ruislip South— Legion Hall, West End Road Tues. 2.30 p.m. Dr. J. R. Tibbies 19 20 Ante Natal Clinics. Locality and Address. Day. Time. Medical Officer. Northwood— Methodist Assembly Room, Hallowell Road N.B.—Second and fourth Fridays. Midwives Clinic [only. First and third Friday in month. 2 p.m. Dr. C. I. Wright. Ruislip Manor— (only. Lady Banks Council School, Dawlish Drive Thursday 2 p.m. Dr. A. M. Burn. Attendances at Maternity and Child Welfare Centres. Number of Sessions held. Total No. of Attendances. Expectant Mothers. Mothers Infants Children New Old New Old New Old New Old Northwood 51 6042 2 27 89 2782 94 1914 10 1124 Eastcote 52 6477 1 151 2910 09 1829 58 1419 Ruislip 61 7707 12 4 152 3662 108 2025 67 1677 RuislipManor 143 18177 5 57 324 8479 293 5300 118 3601 Ruislip S. 51 3787 7 14 118 1622 86 1158 44 738 Attendances at Ante Natal Clinic. Sessions held Total attendances Expectant Mothers Postnatal. New Old Northwcod 16 147 35 106 6 - - - - - RuislipManor 52 781 254 506 21  Northwood. Eastcote. Ruislip. Ruislip Manor. Ruislip South. Highest attendance 161 183 211* 276 103 Lowest attendance 48 11 14 28 29 Average attendance (Mothers) 57 59 63 62 35 Average attendance (Children) 62 66 64 65 39 Home Visits by Health Visitors. First Visits Re- Visits. Expectant Mothers. Babies under 1 year. Children 1 to 5. Foster Children Expectant Mothers. Babies under 1 year. Children 1 to 5. Foster Children. No. of Homes visited. Northwood 12 113 8 — 34 355 388 16 876 Eastcote 31 143 29 — 14 302 526 3 1066 Ruislip 11 93 14 — 25 156 128 1 529 Ruislip Manor 31 222 22 7 17 238 294 9 749 Ruislip South 27 157 22 5 28 161 326 16 696 Cases attended by Midwives. Nurses R. J. Carter, E. G. Smith and R. E. Temple, County Council Midwives in the Ruislip-Northwood area, appointed under the Midwives Act 1936, carried out the following work during the year:— Confinements attended. Ante-Natal Visits Nursing Visits. 100 783 1788 The County Council's Health Visitors attend the following Welfare Centres : Northwood: Miss M. C. Brimacombe and Miss N. Smith. Eastcote: Miss K. Martin. Ruislip: Miss M. E. Hurst and Miss K. Martin. Ruislip Manor: Miss N. M. Cooper and Miss R. Coulthard. South Ruislip: Miss C. F. Whitbread and Miss R. Coulthard. *Christmas 21 School Clinics. School Clinics are held under the Management of the Middlesex County Council as follows:— Locality and Address. Day & Time. Medical Officer. School Nurse. Northwood— Junior School, Pinner Road Tuesdays 9.30 a.m. Dr. C. I. Wright Miss M. C. Brimacombe Ruislip Manor— Lady Bankes Council School, Dawlish Drive Fridays 9.30 a.m. Do. Miss N. M. Cooper. ADOPTIVE ACTS. The following Acts have been adopted to the extent indicated : Act. Extent of Adoption. Public Health Acts Amendment Act, 1890 The whole. Private Street Works Act, 1892 The whole. Public Health Acts Amendment Act, 1907 Parts II., III., IV*., VI.† and Section 95 Small Dwellings Acquisition Acts, 18991923. The whole. Local Government and Other Officers' Superannuation Act, 1922 The whole. Public Health Act, 1925 PartB II., III., IV., and V., except Section 44 (Part III.); Subject to the conditions that Sections 52 and 54 (Part V.) are not in force in the area covered by No. 1 Town Planning Scheme Restriction of Ribbon Development Act, 1935 Sections 2 (2) and 1 (1) of this Act have been applied to a portion of Field End Road, Eastcote. * Subject to amendments in Sections 25, 27, 35, 38, and 59. t Subject to an amendment in Section 76. BYE-LAWS AND REGULATIONS. Bye-Laws are in force in relation to : 1. New Streets and Buildings. 2. Slaughterhouses. 3. Houses Let in Lodgings. 4. Removal of Snow. 5. Offensive Trades. 6. Cemeteries. 7. Recreation Grounds. 8. Collection of Refuse. Regulations have been made with respect to: (a) Cemeteries. (b) Drainage of Buildings. (c) Management of Golf Course. 22 Water Supply. The whole of the district is supplied by the Colne Valley Water Company, with the exception of the following: Cottages in Field End Road, South Ruislip 4 Cottage, Rayson's Hill, Eastcote 1 Total 5 Drainage and Sewerage. The whole of the soil sewers in the Council's area discharge into the sewers of the West Middlesex Drainage Scheme. Collection and Disposal of House Refuse. Controlled tipping on the Council's Refuse Dump off Field End Road, Eastcote, is still in progress and is proving a very satisfactory method of disposal. The weekly collection of refuse is carried out by six Karrier motor dust vans. Trade Refuse. Regulations for the collection of Trade Refuse in the district by the Council are briefly summarized as follows: 1. Council will collect and dispose of trade refuse from shops and business premises with the exception of offal. 2. Where house and shop are jointly occupied one bin per week will be collected free. 3. Schedule of charges: Each dust bin 6d. per week. Per load 7 /6 Per half load 4/- Schools. All the Schools in the Urban District are under the management of the Middlesex County Council. 23 Housing. The Council have provided the following houses Northwood. Pinner Road Site, 1919-1920 114 „ „ „ during 1925 12 „ „ „ during 1926 28 Townsend Way during 1930 12 ,, ,, during 1931 70 Total for Northwood 236 Eastcote. Coteford Close, 1919-1920 34 Wiltshire Lane, 1926 20 Wiltshire Lane, 1927 20 Total for Eastcote 74 Ruislip. Clack Village, 1919-1920 59 Reservoir Road, 1919-1920 22 St. Martin's Lane, 1929 12 Breakspear Road, 1929 18 Total for Ruislip 111 Northwood Cemetery Cottage, prior to 1914 1 Northwood Depot Cottages, 1927 4 Ruislip Sewage Works Cottage, prior to 1914 1 Ruislip Sewage Works Cottages, 1927 2 8 Haste Hill Golf Course Cottage 1 Eastcote Recreation Ground Cottage 1 Bessing by Road Recreation Ground Cottage 1 Haydon Hall Lodge 1 4 Total 433 24 Caravans. During the year there were a large number of gipsy caravans throughout the district, and many complaints were received; and it was found necessary for the Council to take action and remove the vans on several occasions. Milk Supply. The Milk and Dairies Order, 1926. The following are Registered:— Retail Purveyors 29 Wholesale Traders and Producers 10 Dairies 12 Cowsheds 10 Retail Purveyors from outside district 11 Milk (Special Designations) Order, 1936. The following licences were granted for the sale of:— "T.T." Milk 7 Pasteurised Milk 15 Do. Producers 1 The following supplementary licences were granted for the sale of:— "T.T." Milk 6 Pasteurised Milk 7 In addition to the above licences one farm in the district is producing and selling "T.T." milk and two farms producing and selling "Accredited" milk. Meat and Food Inspections. There are two slaughterhouses in the district. Killing takes place three days per week at each slaughterhouse. Slaughterhouses. Public Slaughterhouses Nil Registered do. 2 Licensed do. Nil They are kept clean but their situations are not suitable. 25 Bakehouses. Fourteen in number, these are kept in a satisfactory condition. Food Shops and Stores. Visits are paid to premises where food is prepared, stored and sold. Sale of Food and Drugs Act, Etc. This is administered by the Middlesex County Council. Shops Acts, 1912-1936. During the year inspections, enquiries and special observations were carried out under the above Acts, and proprietors were warned for minor offences. Swimming Baths and Pools. There is only one public bathing place in the Urban District, viz. : Ruislip Reservoir, Ruislip Common, this bathing establishment has a Club House and Cafe, it is frequently visited; the premises are kept in excellent condition. Verminous Premises and the Eradication of Bed Bugs. During the year four houses were found to be bug infested to the following extent: Council Houses Private Houses A. A Trace — — B. Medium 1 2 C. Serious — — D. Doubtful 1 — Total 2 2 26 Treatment. At the two council houses spraying was carried out by the Council and the tenants with vermicide and so far no further complaints have been received. In the case of the 2 private houses, Two Cases. B. One fumigated with Cimex. One cleansed by Occupier with aid of powder. In addition to the above one private house was reported infested with fleas, and was successfully dealt with by the owner. Sanitary Inspection of District. Premises inspected on complaint 328 Premises inspected for nuisances, etc., under Public Health Acts 402 Premises inspected re infectious disease 278 Premises inspected re non-notifiable disease, etc. 9 Inspection and enquiry into cases of contact with smallpox and other diseases 6 Premises under periodical inspection, about 100 Visits to Cowsheds 39 „ Dairies 26 „ Bakehouses 46 „ Offensive Trades 17 „ Slaughterhouses 332 „ Private Slaughtering — „ Factories 129 „ Food Shops 58 „ Shops, Shops Acts 175 ,, Tents, Vans and Sheds 92 Council Houses Inspected 239 27 Sanitary Work. Drains inspected 424 Drains tested 17 Drains unstopped 222 Drains flushed and cleansed 42 Drains repaired 45 Drains re-constructed or part re-constructed 11 Premises disinfected after illness or infectious disease, etc. 159 Clothing and bedding disinfected after illness or infectious disease, etc. 123 Refuse removal complaints 5 New Sanitary Dustbins provided by Owners 161 New Sanitary Dustbins provided by Council (proceedings taken and costs recovered) Nil Number of Statutory Notices served 9 Number of Informal Notices 262 Legal Proceedings Cases — Methods of Disinfection. House Disinfection.—Walls are sprayed with 5 per cent. Lysoform. The rooms are then sealed up and fumigated with Formalin. After twelve hours the rooms are opened and soap and disinfecting solution is provided. The work is personally supervised by the Sanitary Inspectors. Ditches, Water Courses and Ponds of Stagnant Water. The water courses have been cleaned out and sprayed. Rentokil Solution is used for spraying ponds, etc. Information as regards spraying private watercourses, etc., will be given at this office. 28 Meat Inspection. Carcases Inspected and Condemned. Cattle exclud'g Cows. Cows Calves. Sheep &c Lambs Pigs Number Killed 12 — 88 985 468 Number Inspected 12 — 88 985 468 All diseases except Tuberculosis. Whole carcases condemned — — — — 1 Carcases of which some part or organ was condemned 1 — — 6 4 Percentage of the number inspected affected with disease other than Tuberculosis 8.33 - - 0.61 1.06 Tuberculosis only. Whole carcases condemned — — — — — Carcases of which some part or organ was condemned 2 — — — 10 Percentage of the number inspected affected with Tuberculosis 16.66 - - - 2.12 Housing Statistics. Number of New Houses erected during the year, i.e., Houses, Bungalows and Flats: (а) Total (including numbers given separately under (b) 2,246 (b) (i) By the Local Authority Nil (ii) By other Local Authorities Nil (iii) By other bodies and persons Nil Housing. 1. Inspection of Dwelling-houses during the Year:— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 174 (b) Number of inspections made for the purpose 633 (2) (a) Number of dwelling-houses (included under head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 40 (6) Number of inspections made for the purpose 100 29 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 3 2. Remedy of Defects during the Year without Service of formal Notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 3 3. Action under Statutory Powers during the Year:— (a) Proceedings under sections 9, 10 and 16 of the Housing Act, 1936: (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were dered fit after service of formal notices:— (a) By owners Nil (b) By local authority in default of owners Nil (b) Proceedings under Public Health Acts: (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 9 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (а) By owners 9 (b) By local authority in default of owners Nil (c) Proceedings under sections 11 and 13 of the Housing Act, 1936: (1) Number of dwelling-houses in respect of which Demolition Orders were made Nil (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (d) Proceedings under section 12 of the Housing Act, 1936 : (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made Nil 30 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Nil 4. Housing Act, 1936, Part IV. Overcrowding: (a) (i) Number of Dwellings overcrowded at the end of the year 3 (ii) Number of families dwelling therein 5 (iii) Number of persons dwelling therein 27 (b) Number of new cases of overcrowding reported during the year 4 (c) (i) Number of cases of overcrowding relieved during the year 4 (ii) Number of persons concerned in such cases 28 (d) Particulars of any cases in which dwelling houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil (e) Any other particulars with respect to ing conditions upon which the Medical Officer of Health may consider it desirable to report Nil Factories. There are 57 Factories with mechanical power and 44 Factories without mechanical power. 1.—Inspection of Factories, including Inspections made by Sanitary Inspectors. Premises. (1) Number of Inspections (2) Written Notices. (3) Occupiers Prosecuted (4) Factories with mechanical power 82 3 - Factories without mechanical power 47 2 - Other Premises under the Act (including works of building and engineering construction but not including outworkers' premises Total 129 5 — 31 2.—Defects found in Factories. Particulars. (1) No. of Defects. No. of defects in respect to which Prosecutions were instituted (5) Found. (2) Remedied (3) Referred to H.M. Inspector. (4) Want of cleanliness (S.1.) 2 2 Overcrowding (S.2.) Unreasonable temperature (S.3.) Inadequate ventilation (S.4.) Ineffective drainage of floors (S.6.) Sanitary Conveniences insufficient unsuitable or defective 1 1 not separate for sexes Other offences (not including offenses relating to Home Work or offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921, and re-enacted in the Third Schedule to the Factories Act, 1937.) 2 2 Total 5 5 — — I am, Your obedient Servant, G. CLARK, M.B., D.P.H., D.T.M. & H. Medical Officer of Health. 32 RAWLINSONS (R.P.W) NORTHWOOD