Annual Report of the MEDICAL OFFICER OF HEALTH for the YEAR ENDED 31st DECEMBER, 1956 O. C. DOBSON, M.D., B.S., L.R.C.P., M.R.C.S., D.P.H., B.Hy., D.P.A., Barrister-at-Law. Medical Officer of Health PUBLIC HEALTH COMMITTEE (as : 31st December, 1956) CHAIRMAN: Councillor T. G. CROSS VICE-CHAIRMAN: Councillor Mrs. V. E. J. LEECH Councillor Mrs. L. JOHNSTONE, S.R.N. Councillor Mrs. B. G. REID Councillor H. E. BROMLEY Councillor E. J. W. JACKSON, C.B., MoC., M.A. Councillor L. J. LALLY Councillor H. Y. MAYNARD Councillor P.J. McCULLAGH EX OFFICIO: THE CHAIRMAN OF THE COUNCIL Councillor Mrs. I. J. MARSINGALL-THOMAS, B. A. , Ph.D. (London), F. R. G. S. J. P. THE VICE-CHAIRMAN OF THE COUNCIL Councillor A. Lambert STAFF OF THE PUBLIC HEALTH DEPARTMENT (as at 31st December, 1956) Medical Officer of Health (part time) 0. C. DOBSON M. D. , B.S., L.R.C. P., M.R.C S., D.P. H., BHy., D.P.A., Barrister-at-Law Deputy Medical Officer of Health (part time) SHEILA M. M. NIALL. L.M.S.S.A., D.C.H. Chief Public Health Inspector Shops Inspector & Petroleum Inspector E.H. JENKINS, M.R.S.H., M.A.P.H.I. Deputy Chief Public Health Inspector & Shops Inspector H. C. KELLY, M.A.P.H.I. District Public Health Inspectors and Shops Inspectors L. C. GOULD, M. A.P. H.I. G. A. BUCKINGHAM, M. A.P. H. I. Chief Clerk D. C. A. BENNIE Clerks Mrs. J. F. DIXON Miss P. CRANMER Rodent Officer Miss B. H. DIXON Rodent Operatives A. EVANS D. MOYNIHAN Disinfector and Mortuary Attendant A. COX PUBLIC HEALTH DEPARTMENT 76, HIGH STREET, NORTHWOOD (Telephone Northwood 3198/9) Time of attendance of Medical Officer of Health and Public Health Inspectors: Medical Officer of Health - by appointment. Public Health Inspectors -9a.m. to 10.15 a.m., or by appointment. 1 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1956 June, 1957 To the Chai man and Members of the Rui slip-Northwood Urban District Council: Mr, Chairman, Ladies and Gentlemen, This is a factual report on the work of the Public Health Department during 1956, The year was uneventful and there was no epidemic or other upset to give cause for any anxiety on the public health side, The population of the district reached in mid. 1956 73,930 which was a slight increase over the previous year and it is estimated that there are 21,409 inhabited dwellings. The corrected birth rate of 13,86 and the corrected death rate of 9.27 compare with the national rates of 15.7 and 11.7 respectively. The infant mortality of 15.76 shows a welcome decrease from 22,83 in the previous year. The infant mortality figure is liable to show rather violent changes fromyear to year because the numbers being dealt with are comparatively few and even one infant death more or less can affect the rate quite considerably. Deaths of infants under one year both in this district and nationally have reached the lowest level ever and it is doubtful if much further reduction can be achieved without some further substantial increase in medical knowledge. Reference to the table in the body of the report showing the causes of infant deaths will demonstrate that these infant deaths are occurring from a number of conditions, the causations of which are still obscure. It is therefore difficult to know what preventive measures to adopt until the causes of these conditions are accurately known However, much research is going on into these questions and no doubt some increase in knowledge will result. There is not much to be said about the incidence of infectious disease in the district; 1956 was not a 'measles' year - there were only 273 cases compared with 1,344 in the previous year Measles tends to be epidemic in biennial waves and 1955 was a big year and it is probable that 1957 will be similar. 2 Once again there was no case of diphtheria. This statement has now been repeated for so many years that its significance rather tends to be lost and it becomes one of those things taken for granted. It cannot be too strongly emphasized that diphtheria will only remain absent so long as adequate immunisation of infants and young children is kept up. The absence of diphtheria in the community means that there is no longer the opportunity for any naturally acquired immunity to be produced through constant exposure to the infection, Present day immunity is purely artificial and must be maintained artificially in order to keep the disease at bay. During 1956 there was no case - real or suspected - of smallpox in the district. I make no apology for pointing out once again the nearness of the district to the country's major airport and to the ever present danger of the importation of a case of smallpox through the airport It is therefore wise to point out the advantages of having all infants vaccinated as a precaution against this most fearsome disease. Infant vaccination is a comparatively safe procedure. Once an infant has been vaccinated, re-vaccination at any age becomes simple, whereas a first vaccination in an older person is beset with considerable dangers. Immediate vaccination is our only weapon of defence against smallpox, If a case of smallpox occurred, all persons in contact with the case would need to be vaccinated If they had been done as infants then no problem would arise Further, modern travel regulations demand valid vaccination certificates and of course vaccination is necessary in the case of the armed forces. For all these reasons therefore a proper start in infancy with vaccination is most desirable. Progress has been made during the year in the methods of prevention of certain other infectious diseases; protection against whooping cough by immunisation has been continued and it is possible to confer a degree of immunity against tetanus by the same method. In the latter part of the year a beginning was made in attempting to prevent poliomyelitis by means of a vaccine and a number of children in the 2 to 9 years old group were treated by this method. The vaccination proved to be completely safe and it is probable that this method of attacking poliomyelitis will become an established feature of public health work. New Food Hygiene Regulations came into operation during the year These regulations made the work of the Public Health Department easier, in that they specified certain standards in food premises which had to be reached. Fortunately, most of the food traders and handlers had already been educated in this matter sufficiently to know what standards would be expected of them and the implementation of the regulations as a result proceeded without any great difficulty. This work of supervising food premises is now of course accepted as part of the Public Health Department's routine. 3 The problem of slum clearance in this district is comparatively a small one and, in fact, during the year the majority of houses on which action needs to be taken have already been dealt with. Few districts will have as little to do in slum clearance as this, but it is fortunate that the majority of houses are of comparatively recent building and action needs to be taken only in the case of a few very old properties. I would like to take this opportunity to thank the Chairman and members of the Public Health Committee for their encouragement and support during the year My grateful thanks are also due to the Chief Public Health Inspector and the remainder of the staff of the department for their excellent co-operation and work during the year I am, Your obedient Servant, 0. C. DOBSON, Medical Officer of Health. 4 STATISTICS TOTAL AREA OF DISTRICT 6,583 acres. POPULATION The Registrar-General's estimate of the population for the mid-year: - 1952 1953 1954 1955 1956 71,220 72,130 72,070 72,700 73,930 Population Census, 1951 68,288 Estimated Number of Inhabited Dwellings 21,409 BIRTH RATE NO. OF BIRTHS BIRTH RATE BASIS M. F. TOTAL 1 LIVE BIRTHS Legitimate 519 470 989 13.38 Per 1,000 Registrar- Illegitimate 18 8 26 0.35 General' s Estimated Total 537 478 1,015 13.73 Resident Population STILL BIRTHS - Legitimate 5 5 10 9.7 Per 1,000 total Illegitimate - - - 0.0 (i. e. Live and Still Total 5 5 10 9.7 Births) TOTAL BIRTHS REGISTERED Per 1,000 Registrar- Legitimate 524 475 999 13.51 General' s Estimated Illegitimate 18 8 26 0.35 Resident Population TOTAL 1,025 13.86 5 The following table indicates the ratio of domiciliary and institutional confinements: - LIVE BIRTHS STILLBIRTHS Domiciliary Institutional Domiciliary Institutional 279 736 - 10 The Crude Birth Rate of 13.73 shews a slight increase from the figure of 12.65 for 1955. For the purpose of comparison with other districts or the country as a whole the Corrected Birth Rate is 13.86. The Corrected Birth Rate is obtained by multiplying the Crude Birth Rate by 1.01, the Comparability Factor supplied by the Registrar-General. Birth Rate - England and Wales: 15.7. DEATH RATE TOTAL DEATHS (All Causes) DEATH RATE (per 1,000 Registrar-General's estimated resident population. Male 274 7.3 Female 266 TOTAL 540 The Crude Death Rate of 7.3 shews a slight decrease from the figure of 8 1 for 1955. For the purpose of comparison with other districts or the country as a whole the Corrected Death Rate is 9.27. The Corrected Death Rate is obtained by multiplying the Crude Death Rate by the Comparability Factor, 1,27, Death Rate - England and Wales: 11.7 6 Death Rate of Infants under one year of age Males Females Total Death Rate (per 1,000 Live Births) In total live births 10 6 16 In legitimate live births 10 6 16 15.76 In illegitimate live births - - - The infant mortality rate of 15,76 shews a decrease from the figure of 22,83 for 1955, The following are the causes of and ages at death:- INDER 1 DAY DAYS WEEKS MONTHS TOTAL 2 3 6 1 2 1 5 9 M F Atelectasis 1M 1M - - - - - - - 2 _ Pneumonia - - - 1M 1M 1M - IF 1M 4 1 Prematurity 2M IF IF - - - - - - 2 2 Pyogenic Meningitis - - - - - - 1M - - 1 - Intra Cranial Haemorrhage IF - - - - - - - - - 1 Respiratory Obstruction 1M - - - - - - - - 1 - Congenital Meningomyelocele - - - - - - IF - - - 1 Anoxia IF - - - - - - - - - 1 TOTAL MALES 4 1 - l 1 1 1 - 1 10 - TOTAL FEMALES 2 1 1 - - - 1 1 - - 6 Infant Mortality Kate - England and Wales 23,8 No of Maternal Deaths 1 Maternal Mortality Per 1,000 Total Births 0.98 7 CAUSES OF DEATH The following table shews causes of death as given in the Registrar-General's statistics, CAUSE OF DEATH NUMBER OF DEATHS Male Female Total Tuberculosis, respiratory - 1 1 Tuberculosis, other - 1 1 Syphilitic disease 1 - 1 Diphtheria - - - Whooping Cough - - - Meningococcal infections - - - Acute Poliomyelitis - - - Measles - - - Other infective and parasitic diseases 1 1 2 Malignant neoplasm, stomach 10 4 14 Malignant neoplasm, lung bronchus 17 2 19 Malignant neoplasm, breast - 15 15 Malignant neoplasm, uterus - 1 1 Other malignant and lymphatic neoplasms 31 39 70 Leukaemia, aleukaemia 3 - 3 Diabetes - - - Vascular lesions of nervous system 22 44 66 Coronary disease, angina 76 42 118 Hypertension with heart disease 3 5 8 Other heart disease 13 34 47 Other circulatory disease 14 14 28 Influenza 1 1 2 Pneumonia 15 14 29 Bronchitis 19 5 24 Other diseases of respiratory system 2 2 4 Ulcer of stomach and duodenum 6 3 9 Gastritis, enteritis and diarrhoea 2 2 4 Nephritis and nephrosis 4 3 7 Hyperplasia of prostate 1 - 1 Pregnancy, childbirth, abortion - 1 1 Congenital malformations 4 1 5 Other defined and ill-defined diseases 20 18 38 Motor vehicle accidents 3 2 5 All other accidents 5 7 12 Suicide 1 4 5 Homicide and operations of war - - - ALL CAUSES 274 266 540 8 INFECTIOUS DISEASES The following table shews the incidence of infectious diseases during 195f and gives comparisons with the previous year. 9 PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASE Classified List of Infectious Diseases Notified DISEASE AGES OF CASES NOTIFIED 1 TOTAI 1956 TOTAL Total Cases Admitted to Hospital DEATHS Under one year 1 to 2 3 to 4 5 to 9 10 to 14 15 to 24 25 and over Age unknowr 1955 1956 1955 1956 1955 Scarlet Fever 2 5 32 6 2 - - 47 41 - - - - Diphtheria - - - - - - - - - - - - - Typhoid Fever - - - - - - - - - - - - - - Paratyphoid 'B' Fever - - - - - - 1 - 1 - - - - - Dysentery - 1 1 1 - - 2 - 5 6 - 3 - - Erysipelas - - - 1 1 1 8 - 11 15 - 1 - - Puerperal Pyrexia - - - - - 9 - 1 10 4 8 4 - - Meningococcal Infection - - 1 - - 1 - - 2 - 2 - - - Ophthalmia Neonatorum - - - - - - - - - 5 - 2 - - Pneumonia 3 1 - 1 - 2 29 1 37 30 10 8 29 24 Smallpox - - - - - - - - - - - - - - Malaria - - - - - - - - - - - - - - Tuberculosis (Pulmonary) SEE TABLE Tuberculosis (Non-Pulmonary) Poliomyelitis (Paralytic) - 1 - - - - - - 1 4 1 4 - - Poliomyelitis (Non-Paralytic) - - - - - 1 2 - 3 5 3 5 - - Acute Encephalitis (Infective) - - - 4 - - - - 4 5 4 5 - - do, (Post Infectious) - - - - - - - - - - - - - - Measles 15 49 58 137 1 5 2 6 273 1344 2 9 - - Whooping Cough 11 3 9 25 1 - - - 49 91 - - - Food Poisoning - - 1 2 2 3 9 - 17 13 7 1 - - TUBERCULOSIS AGE PERIODS NEW CASES NOTIFIED PULMONARY NON PULMONARY Males Females Total Males Females Total 0-1 - - - - - - 1-5 - - - - - - 5-15 2 1 3 - - - 15-25 8 9 17 - - - 25-35 2 5 7 1 - 1 35-45 6 3 9 - - - 45-55 11 5 16 - 1 1 55-65 2 - 2 - - - 65 and up 2 1 3 - - - TOTALS 33 24 57 1 1 2 AGE PERIODS DEATHS PULMONARY NON-PULMONARY Males Females Total Males Females Total 0-1 - - - - - - 1-5 - - - - - - 5-15 - - - - - - 15-25 - _ - - - - 25-35 - - - - _ - 35-45 - - - - _ - 45-55 -_ _ - - -_ -_ 55-65 - - _ _ - - 65 and up - 1 1 - - - TOTALS - 1 1 - 1 - TOTAL NUMBER OF CASES IN REGISTER AT END OF YEAR:- Pulmonary Non-Pulmonary Male Female Male Female TOTAL 340 277 19 35 671 10 TUBERCULOSIS SANATORIA Patients resident in the Urban District of RuislipNorthwood come under the care of the Chest Clinic at Uxbridge, The address is The Chest Clinic, Local County Offices, High Street, Uxbridge. Telephone: Uxbridge 8290 Physician to the Chest Clinic•' J.T. Nicol Roe, M.D., Ch.B . D.P.H. All cases are seen by appointment MASS RADIOGRAPHY In September the Mass Radiography Unit No. 5A paid a visit to this district, operating at the following sites:- Cavendish Pavilion, Eastcote, Council Depot, Pinner Road, Northwood, Ruislip Gardens Infants' School Victoria Hall, Dulverton Road Ruislip Manor, estnead Clinic, South Ruislip, Manori Farm, Ruislip. The following figures show the number of persons X-rayed and those who were recalled for a second examination. It must be emphasised that these further examinations do not always mean infection from Tuberculosis, but may have regard to some other abnormality of the chest or the heart. SUMMARY OF SURVEY Male Female Total Number examined 2438 3310 5748 Number recalled for large films 33 36 69 DISPOSAL OF LARGE FILM CASES (a) No further action 39 (b) To return to Unit for further X-ray (c) Further investigation required (this does not necessarily indicate Tuberculosis) 27 (d) Known cases had or having treatment 2 (e) Failed to return for large films 1 Cases of Pulmonary Tuberculosis - 7 Male, 6 Female, 11 GENERAL PROVISIONS OF HEALTH SERVICES IN THE DISTRICT INFECTIOUS DISEASES HOSPITAL St John's Isolation Hospital is situated at Kingston Lane, Uxbridge Telephone Uxbridge 5120-1 SMALLPOX AND TYPHUS Any suspicious case should be reported to the Medical Officer of Health who will arrange for a smallpox or typhus consultant to confirm diagnosis and will also find accommodation at the appropriate hospital VENEREAL DISEASES Treatment of cases can be obtained at London Hospitals and at Hillingdon Hospital Uxbridge, Times for attendance at the Hillingdon Hospital are as follows Monday, Wednesday Friday 8. 30a. m 6.30 p m Tuesday 8. 30 a. m 7 00 p m. Thursday 8.00 a.m. - 6 30 p.m Saturday 8 00 a. m. 12 noon HOSPITALS Hillingdon Hospital, Hillingdon, Uxbridge. General and Maternity For admission, applications should be made to the Medical Director Telephone Uxbridge 8282 Northwood, Pinner, and District Hospital, Pinner Road, Northwood Telephone Northwood 567 Mount Vernon Hospital, Rickmansworth Road, Northwood TelephoneNorthwood 3281 St Vincent's Orthopaedic Hospital, Eastcote, TelephonePinner 50 For admission application should be made by the doctor in attendance 12 REGISTRAR OF BIRTHS AND DEATHS Mrs. J. R. Stanley, Middlesex County Council The Head Office of the Registrar of Births and Deaths is 266, Field End Road, Eastcote Telephone: Field End 9222. Hours of attendance: Monday 9.30 a. m .- 12.30 p.m. Tuesday 10.00 a.m. - 12.30 p.m. 2.00 p.m. - 4 30 p.m. 5.00 p m - 7.00 p.m Wednesday 10.00 a m - 12,30 p.m. Thursday 10,00 a.m - 12 30 p.m Friday 10.00 a.m. - 12 30 p m 2.00 p.m. - 4.30 p.m. Saturday 9.00 a. m.- 11.00 a m Births and stillbirths are required to be registered within 42 days by the father or mother personally, and deaths within five days by the nearest relative. The registration of marriages can only be effected at the office of the Superintendent Registrar at 7, Lyon Road, Harrow Telephone: Harrow 6135 MENTAL HEALTH SERVICE The Mental Welfare Officers (Duly Authorised), No. 8 Area, Area Office, Local County Offices, Uxbridge, (Telephone- Uxbridge 8290) are as follows:- Mr, A. G. Ash, 69, Helen Avenue, Feltham. (Feltham 2096) Mr L. R. Bradbury, 45, Falling Lane, Yiewsley. (West Drayton 2930) Urgent Night Calls If an Authorised Officer is urgently required to deal with a case at night-time, the nearest Ambulance Station should be contacted (by dialling 999 or '0' and asking for 'Ambulance'), and asked to send an Ambulance for the Authorised Officer on call. The Ambulance Service will know which Authorised Officer will be on call for the night 13 NATIONAL ASSISTANCE BOARD Under the National Assistance Act, 1948, the National Assistance Board are responsible for granting cash assistance to persons in need The Board's Office for this District is at Colhum House, Bakers Road, Uxbridge. Telephone Uxbridge 8601 SCHOOLS The Middlesex County Council is the Education Authority for both Primary and Secondary education. Private Schools have been regularly supervised by this Department to ensure compliance with the public health regulations, AMBULANCE FACILITIES Calls by telephone for use of ambulance should be made at all times to Northwood 1110 or 1220 and Ruislip 2223, or by using the 999 or s0' facilities and asking operator for the Ambulance Service, LABORATORY FACILITIES Bacteriological examinations are carried out by the Public Health Laboratory Service, Central Public Health Laboratory, Colindale Avenue, Colindale, London N I 9. Telephone: Colindde 7041, Medical Practitioners can leave swabs and specimens in receiving boxes provided at the following places in the Urban District. These specimens will be collected daily by the Messenger The Laboratory request that all specimens be left for collection, and not forwarded by post. Address Position of Receiving oOX NORTHWOOD: Public Health Office, Inside general office, 76, High Street EASTCOTE: Eastcote House, High In vestibule, inside Road (back entrance) back entrance, RUISLIP Fire Station, In main vehicle shed, Eastcote Road on wall left-hand side of doors, NATIONAL ASSISTANCE ACT, 1948, SECTION 47 There was no official action taken by the Council under the above Section of the National Assistance Act, 1948, in respect of the removal to institutions of persons in need of care and attention, A few persons, however, were accommodated by voluntary arrangement and with the co-operation of the County Welfare Officer 14 MATERNITY AND CHILD WELFARE The Middlesex County Council as the Local Health Authority is responsible for all services concerned with the care of Mothers and Children and the other services set out in Part III of the National Health Service Act, 1946 For this purpose the County has been divided into ten administrative areas The Urban District of Ruislip-Northwood, together with the Borough of Uxbridge, and the Urban Districts of Hayes and Harlington, and Yiewsley and West Drayton, form Local Area No, 8. Dr. 0 C Dobson, M D. , D P H,, D P A , Barrister-at-Law, is the Area Medical Officer and all services mentioned below are now administered from the Area Health Office at the County Offices, Uxbridge. Particulars regarding any of these services can be obtained on enquiry at that office or at any one of the Clinics listed below CLINICS AND SCHOOL TREATMENT CENTRES Sessions are held at the following premises for the regular supervision of the health of infants and children up to five years of age, NORTHWOOD Ryefield Court, Ryefield Crescent Monday, 1 30 p.m Tuesday, 1,30 p.m EASTCOTE Eastcote House, High Road Monday, 1.30 p.m Wednesday, 9 30 a m Cavendish Pavilion Each Thursday in month except the last at 9.30 a.m., and each Thursday at 1.30 p.m. RUISLIP Manor Farm Thursday, 9 30 a.m. and 1.30 p.m. RUISLIP GARDENS Mobile Clinic, Sidmouth Drive Pavilion Monday, 1.30 p.m. RUISLIP MANOR The Welfare Centre, Lady Bankes School, Dawlish Drive Wednesday, 1.30 p.m. Friday, 1,30 p.m, SOUTH RUISLIP Westmead Tuesday, 1.30 p.m. Thursday, 1,30 p.m, 15 ANTE-NATAL AND POST NATAL CLINICS Any expectant mother may obtain advice and medical supervision of pregnancy at the following Centres In addition. Relaxation Exercise Classes are held at Northwood and Eastcote House Clinics for cases specially recommended An appointment for post-natal examination can be obtained on request at any of these Clinics NORTHWOOD Ryefield Court, Ryefield Crescent Wednesday, 1.30 p.m. EASTCOTE Eastcote House, High Road Wednesday, 1 30 p.m. Second and Fourth Wednesdays in month, Midwives only session, RUISLIP GARDENS Mobile Clinic, Sidmouth Drive Pavilion 2.30 p m (Midwives only session) First and Third Thursdays in month. RUISLIP MANOR The Welfare Centre, Lady Bankes School, Dawlish Drive, Thursday, 1 30 p m Second and Fourth Thursdays in month Midwives only session, SOUTH RUISLIP Westmead Monday, 1,30 p m (Midwives only session) First and Third Tuesdays in month at 9 30 a m. SCHOOL CLINICS Sessions are held as under, exclusively for school children : NORTHWOOD Ryefield Court, Ryefield Crescent Tuesdays, 9,30 a m RUISLIP MANOR The Clinic, Lady Bankes School, Dawlish Drive Fridays, 9,30 am RUISLIP Manor Farm Tuesdays, 9 30 a m. SOUTH RUISLIP Westmead Fridays, 9,30 a m. 16 DENTAL CLINICS Dental treatment is available for school children, expectant and nursing mothers and children under five years. Appointments are made only through the School Medical or Infant Welfare Services HEALTH VISITING This service makes available practical advice on all matters relating to the health of the family. Qualified Health Visitors (who are also the School Nurses) are in attendance at clinic sessions and also visit homes where there are babies and young children. DOMICILIARY MIDWIVES The following midwives are employed by the County Council to attend mothers throughout pregnancy and confinement Under the terms of the National Health Service Act, this service is now provided without charge. Telephone No. Miss M. E. Ball, S. R. N, S C M 69, Addison Way, Northwood Northwood 56 Miss A. M. Shepherd, S. R. N., S.C M 118, Shenley Avenue Ruislip Ruislip 4673 Miss G. G. Burnard, S. R. N., S. C. M. 2, Whitebutts Road, South Ruislip Ruislip 6125 Miss 0. H. Hutchinson, S.R.N,, S. C. M. 30a, Salisbury Road, Eastcote Ruislip 5151 HOME NURSING The District Nursing Associations no longer function and under the National Health Service Act, 1946, their work has been taken over by the County Council. The following Home Nurses cover the Ruislip-Northwood District. Telephone No. Miss E. M. Pool, S.R.N, S. C. M. 6, Cheyne Court, High St., Ruislip Ruislip 3480 Miss E. Bright, S. R. N. Flat 4, Sunnyside, Joel St., Eastcote Pinner 2274 Miss E. Davies, S. R. N. , S. C. M. 35, Meadow Way, Eastcote Pinner 3407 Miss M. Prior, S. R. N., S. C. M. Sanguhar, Elgood Avenue, Northwood Northwood 1544 17 PRIVATE MIDWIVES AND PRIVATE MATERNITY NURSING HOMES The names and addresses of private midwives and private maternity nursing homes can be supplied on application to this office DIPHTHERIA IMMUNISATION Provision for immunisation is made under the National Health Service Act, 1946, and is the responsibility of the County Council IMMUNISATION DURING 1956 AGE NO. OF CHILDREN WHO COMPLETED A FULL COURSE OF PRIMARY IMMUNISATION NO. OF CHILDREN WHO RECEIVED A SECONDARY (REINFORCING) INJECTION Diphtheria only Combined Diphtheria and Whooping Cough Whooping Cough only Diphtheria only Combined Diphtheria and Whooping Cough Whooping Cough only Under 1 5 473 — — — — 1 13 218 1 — — — 2-4 10 57 1 10 44 — 5-14 17 11 6 127 332 1 15 & Over — — — — — — TOTALS 45 759 8 137 376 1 18 This service is administered from the Area Health Office, and the following sessions are held:- NORTHWOOD CLINIC, Ryefield Court, Ryefield Crescent. First Tuesday in each month, at 10.30 a.m. MANOR FARM CLINIC Ruislip. Third Tuesday in each month, at 10.30 a.m. RUISLIP MANOR CLINIC, Dawlish Drive Last Friday in each month, at 10.30 a.m. CAVENDISH PAVILION, Eastcote Last Thursday in each month at 10 a.m. EASTCOTE HOUSE, High Road, Eastcote. First Thursday in each month, at 10 a.m. MOBILE CLINIC, Sidmouth Drive Pavilion, Ruislip Gardens. Stand 3rd Thursday in each month, at 1.30 p.m. WESTMEAD, South Ruislip. Second & Fourth Tuesday in each month at 10 a.m. Under the National Health Service Act, 1946 Diphtheria Prophylactic may be obtained from the Public Health Department on application by Medical Practitioners who have signified their willingness to carry out immunisation under the Act. VACCINATION The Vaccination Acts have been repealed. Vaccination against smallpox is performed on request, without charge, by doctors who have signified their willingness to carry out this work under the National Health Service Act 1946. In addition, in certain cases, vaccination can be carried out at the County Council's clinics. The vaccination of all healthy infants between 4-6 months of age is recommended. During the year the following vaccinations were undertaken:- AGE VACCINATION RE-VACCINATION Under 1 650 — 1 20 — 2-4 19 ??? 5-14 16 25 15 and over 21 246 TOTALS 726 277 19 HOME HELP SERVICE Help can be provided in cases where an emergency arises in the home, and in cases of confinement taking place at home. Payment for this service is assessed according to income. Further details of this service may be obtained from the Area Health Office, County Offices, Uxbridge. DAY NURSERIES Forms of application for admission can be obtained from the Nurseries or from the Area Health Office, HighStreet, Uxbridge. Parents are charged a daily fee according to the total family income. 20 REPORT OF THE CHIEF PUBLIC HEALTH INSPECTOR 1. SUMMARY OF INSPECTIONS FOR THE YEAR ENDED 31ST DECEMBER, 1956 Five thousand six hundred and twenty-six inspections were made by the Public Health Inspectors during the year 1956 in respect of the following matters:- Public Health Act Houses inspected for nuisances and repairs (1st inspection) 335 Houses re-inspected 676 Verminous premises 5 Other Insect Infestations 76 Ponds, ditches, watercourses 45 Caravans 20 Gypsy Encampments 221 Yards, passages, car parks 143 Animals, pigs, poultry 48 Dustbins 74 Accumulations of refuse 123 Drains inspected 866 Drains tested 85 Other nuisances 20 Infectious Diseases Enquiries 148 Food and Drugs Act Restaurants and Cafes 139 Industrial Canteens 25 Licensed Premises 10 Butchers® Shops 141 Fish shops 70 Fried Fish shops 21 Green-grocers 89 Grocers 228 Bakers 37 Bakehouses 15 Milk Distribution Premises 33 Ice cream shops, premises and vehicles 73 Confectioners Shops 37 Cooked meat shops 24 Food Hawkers 8 Food Hawkers Storage Premises 2 Unsound Food 143 Total carried forward 3,980 21 Total brought forward 3,980 Samp1ing Ice cream samples 69 Water samples (Domestic) 2 Water samples (Swimming Pools) 82 Other foods 3 Housing Acts Inspections for repairs 49 Inspections for alleged overcrowding 6 Inspections for measuring 1 Housing Repairs and Rents Act Certificates of Disrepair 19 Factories Act Inspections and enquiries (mechanical power) 133 Inspections and enquiries (non-mechanical power) 25 Smoke Abatement Observations and Visits 4 Petroleum Acts Inspections and enquiries 93 Testing of Petroleum Tanks 65 Shops Act Inspections and enquiries . 195 Observations - Closing Hours 26 Miscellaneous Schools and School Canteens 64 Public Conveniences 42 Rodent Control 72 Requisitioned property and Council Houses 26 Hairdressers 56 Visits and interviews with owners and builders ??? Bathing establishments 8 M.C.C. entertainment licences 13 Sports pavilions 12 Aged and Infirm Persons 7 Pet Shops 16 Miscellaneous visits 87 Ineffectual visits 189 5,626 22 Number of inspections made by Rodent Control Staff 4,467 Informal notices served 313 Statutory Notices served 24 Nuisances abated 261 2. COMPLAITS One thousand four hundred and seven complaints were received in 1956 regarding the following matters:- Defective drains and sanitary fittings 480 Defective water fittings and pipes 30 Defective or dirty walls and ceilings 4 Defective roofs and gutters 13 Defective fireplaces and flues 13 Defective doors and windows 5 Defective sinks, baths and wash basins 4 Defective floors 5 Defective dustbins 9 Dampness 28 Other housing defects 25 Infestation by vermin (bed bugs and fleas) 5 Infestation by insects (including ants mosquitoes flies, wasps etc.) 168 Infestation by rats and mice 439 Accumulation of refuse and manure 21 Animals kept in such a state as to be a nuisance 5 Gypsy Encampments 22 Insanitary conditions of ponds and ditches 3 Unsatisfactory housing conditions and overcrowding 3 Obnoxious smells 32 Nuisance caused by excessive noise 4 Unsound food 48 Insanitary state of yards and gardens 7 Miscellaneous nuisances 34 1,407 3. SUMMARY OF SANITARY IMPROVEMENTS AND REPAIRS CARRIED OUT Roofs repaired 24 Gutters and rain-water pipes repaired 28 Damp walls remedied 38 Wall and ceiling plaster repaired 45 23 Water waste preventors repaired or renewed 9 W.C. pans renewed 20 W.C. pans cleansed 4 Provision of intervening ventilated spaces to W.C.'s 1 Water tanks pipes and fittings renewed or repaired 57 Rooms cleansed or re-decorated 57 Floors repaired 20 fresh air inlets repaired 6 Dry Rot remedied 11 Brickwork re pointed and repaired 14 Doors repaired 4 Windows repaired 25 Sinks baths and basins repaired or provided 10 Cullies renewed 22 Waste pipes cleared or repaired 16 Firegrates renewed or repaired 11 Chimney flues and stacks repaired 26 Manhole covers renewed 38 Soil pipes renewed or repaired 17 Yard paving re-laid or repaired 6 Dustbins provided 28 Drains cleared 376 Drains repaired or re-laid 80 Accumulations of refuse removed 40 Miscellaneous repairs 31 4. 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) 335 (b) Number of inspections made for the purpose 725 (2) (a) Number of dwelling houses (included in sub-head (1) above) which were inspected and recorded under the Housing (Consolidated) Regulations, 1925 and 1932 Nil (b) Number of inspections made for the purpose Nil (3) Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 3 2. ???edy 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 276 24 3. Action under Statutory Powers (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 rendered 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 24 (2) Number of dwelling houses in which defects were remedied after service of formal notices: (a) By owners 21 (b) By Local Authority in default of owners Nil 4. (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 as a result of informal procedure under Section 11, Housing Act, 1936 1 (3) Number of dwelling houses in respect of which Closing Orders were made under SubSection (4) of Section 11 of the Housing Act, 1936 as amended by Sub-Section (1) of Section 3 of the Housing Act, 1949 (premises of architectural or historical interest) 3 5. HOUSING REPAIRS AND RENTS ACT, 1954 Applications received for Certificates of Disrepair 8 Applications withdrawn 3 Applications refused — Certificates granted 5 Certificates of Revocation granted to owners 6 25 6, FACTORIES The following tables shew the number of inspections made, defects found, and the result of action taken:- (a) Inspections PREMISES No. on Register NUMBER OF 1nspections Written Notices Occupiers prosecuted 1. Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authority 21 24 — — 2. Factories not included in 1 in which Sec. 7 is enforced by Local Authority 126 131 — — 3. Other premises in which Sec. 7 is enforced by the Local Authority (excluding outworkers' premises) 5 3 — — TOTAL 152 158 — — (b) Defects found in Factories Number of cases in which defects were found Number of cases in which Prosecutions were instituted Found Remedied Referred to H.M. 1nspector by H.M. 1nspector Want of cleanliness (S.l) 4 2 3 — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7) (a) Insufficient 1 1 — — — (b) Unsuitable or defective 8 7 — — — (c) Not separate for sexes — — — — — Other offences (not including offences relating to home work) 2 2 — — — TOTAL 15 12 3 — — 26 7. OUTWORKERS There are 54 outworkers in this District engaged in the following work:- Making of wearing apparel 28 Curtains and furniture hangings 4 Artificial flowers 4 Stuffed toys 3 Making of boxes 1 Carding 1 Cosaques Christmas crackers, etc. 13 Total 54 All premises have been inspected and found satisfactory 8. OFFENSIVE TRADER There are no offensive trades established in this District 9. DRAINAGE AND SEWERAGE The District is drained by separate soil and surface water systems. The surface water sewers are discharged into the various natural streams and watercourses whilst the soil sewers discharge into the main sewers of the West Middlesex Sewerage System. 10. WATER SUPPLY The water supply for the Ruislip-Northwood area is provided by the Colne Valley Water Company. All dwellings in the area are now served by a piped water supply and the supply during the year has been satisfactory both in quantity and quality. Reports are received monthly from the Colne Valley Water Co. as to the chemical and bacteriological examination of samples of water and these have proved satisfactory. The average hardness of samples of water taken during the year is:- Total hardness 22.8 Permanent hardness 5.7 Temporary hardness 17.1 All new and repaired mains are chlorinated before being restored to use and samples of water from them are tested bacteriologically to ensure the purity of the water. 27 11. SWIMMING POOLS Ruislip Lido Forty-five samples of water were obtained and submitted to the Central Health Laboratory Colindale, all of which were satisfactory. Private Swimming Pools Private swimming pools in the District were regularly inspected and samples obtained, all of which were satisfactory. 12. FOOD HYGIENE REGULATIONS. 1955 (a) These regulations came into force on the 1st January, 1956. Certain Sections under these regulations however with reference to the provision of sinks, hot and cold water supplies, accommodation for clothing etc., did not come into force until the 1st July, 1956 Food shops restaurants and premises where food is prepared, stored or sold have been frequently inspected and the following works were carried out in accordance with these regulations during the period 1.7.56 to 31.12.56 Sinks provided 37 Hot water provided 15 Accommodation for Clothing 5 (b) Inspection of Food Premises. Type of Premises No. in District Visits made. Restaurants and Cafes 23 139 Industrial Canteens 14 25 School Canteens 24 61 Ice Cream Premises 94 73 Licensed Premises 23 10 Milk Distribution Premises 10 33 Preserved Food Premises 43 24 Bakehouses 6 15 Bakers 22 37 Butchers 33 141 Grocers 65 228 Wet Fish Premises 12 70 Fried Fish Premises 6 21 Confectioners 45 37 Greengrocers 34 89 Food Hawkers Premises 5 2 TOTALS 459 1,005 13. MEAT AND OTHER FOODS There are no slaughterhouses or wholesale meat depots in this District 28 The following items of foodstuffs amounting to 1 ton 7 cwts. 3 qrs. 11¼ lbs., were examined in retail shops as a result of complaints from the shopkeepers or the public, and were condemned:- 1,020 lbs. Meat 407¾ lbs. Tinned Meat 131 lbs. Offal 17 lbs. Sausages 27¾ lbs. Poultry 10 lbs. Rabbit 56 lbs. Dried Fruit 515¼ lbs. Tinned Fruit 33¾ lbs. Tinned Fruit Juice 95 lbs. Soup 18 lbs. Pickles Sauces etc. 239½ lbs. Tinned Vegetables 351 lbs. Fish 17¼ lbs. Tinned Fish 113¾ lbs. Tinned Milk 54 lb. Cheese 1¾ lbs. Cereals 6 lbs. Marmalade 1½ lbs. Jam 1¼ lbs. Tinned Pudding 6 lbs. Confectionery ½ lb. Coffee 64 lbs. Flour 1 lb. Miscellaneous Items 14. FOOD AND DRUGS ACT, 1955 The following details of samples taken by the County Sampling Officers under the above Act within the RuislipNorthwood Urban District during the period 1.4.55 to 31.3.56 have been kindly furnished by Mr. John A, 0' Keefe, Chief Officer, Public Control Department, Middlesex County Council. ARTICLE TOTAL SAMPLES PROCURED UNSATISFACTORY Milk, various 87 — Butter 10 — Cakes 12 1 Cooked Meat 7 — Cooking Oil 9 — Cream 20 1 Drugs 9 — Fruit canned 8 — Ice Cream 13 — Jelly 2 — Margarine 4 — Meat and neat products 18 — Sausages etc. 23 — Sweets 8 — Vinegar 12 — Wines and spirits 12 — Miscellaneous 10 — TOTALS 264 2 29 The following information is given with reference to the unsatisfactory samples. Cakes: A sample of cream doughnuts contained preservative Follow up samples were genuine and no further action was taken. Cream: A tin of sterilised cream was deficient in fat further samples proved to be genuine and no further action was taken. The Pood and Drugs Act 1955 in section 47, contains new provisions concerning the descriptions which can be applied to certain substances which resemble cream in appearance but are not cream. This has necessitated the making of many inspection visits and the giving of advice to all traders likely to be concerned to ensure that they were fully aware of these new requirements. Merchandise Marks Acts, 1887-1926, and Defence (Sale of Food) Regulations, 1943: 132 inspections of shops were undertaken to ensure that the Marking Orders relating to certain imported foodstuffs made under the Merchandise Marks Act 1926 were complied with 433 separate displays of meat apples, tomatoes, poultry butter and dried fruit were examined Verbal cautions were given in respect of minor infringements not being found so serious as to warrant more stringent action A greengrocer displayed for sale imported apples not marked with an indication of origin He was prosecuted under the Merchandise Marks Acts and fined £1 0 0d For falsely describing Winter Nelis Pears as William Pears he was also summoned under the Defence Regulations fined £3 0 0d and ordered to pay £3 3 0d costs. The Labelling of Food Order. 1953 This Order requires that in general, prepacked foods shall bear on the label a clear statement of the designation of the food and in the case of compound foods the ingredients It also requires that the name and address of the packer or labeller appears At 50 premises 138 articles of pre-packed food were examined No proceedings were taken in respect of any of the infringements detected and manufacturers took immediate steps to correct unsatisfactory labels as soon as their attention was drawn to them. False or Misleading Descriptions A considerable amount of work is carried out each year in scrutinising advertisements and the labelling of pre packed food and taking such action as is possible to secure satisfactory amendments in those cases where a label or advertisement contains a false or misleading description of the food to which it relates This work is of benefit to all districts of Middlesex irrespective of where the offending advertisement or label is discovered and during the year under review corrective action has been taken in respect of cherry wine, biscuits chocolate Easter eggs flour and sugar confectionery, imitation caviare blackcurrant punch, fruit juice drinks and creme de menthe. Safe Milk In addition nine samples of raw milk were procured in your district and submitted to test for the presence of tubercle bacilli None was found contaminated. 30 15. MILK (SPECIAL RESIGNATION) REGULATIONS, 1949 Thirty nine Dealers Licences and twenty nine Supplementary Licences were granted under the Milk (Special Designation) (Raw Milk) Regulations 1949 and the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949. Samples of milk are for examination taken by the Middlesex County Council who are the Food and Drugs Authority in this area 16. ICE CREAM There are in the District ninety four premises registered for the sale of ice cream and one for the manufacture of ice cream. Forty seven samples were taken during the year for examination by the Methylene Blue Test These were placed in the following grades. Grade I 38 Grade III 1 Grade II 6 Grade IV 2 Samples of ice cream for Chemical Analysis are taken by the sampling officers of the Middlesex County Council. 17. PET SHOPS There are 8 premises licensed under the Pet Animals Act. 1951. They were visited and inspected during the year and found to be maintained in a satisfactory condition. 18. FOOD POISONING There was no serious outbreak of food poisoning in this District during 1956. 19. DISINFECTION AND DISINFESTATION 21 premises were disinfected after cases of infectious disease. 4 loads of bedding were disinfected in the Council's steam disinfector. 8 premises were treated for insect infestation. 7 loads of bedding and articles were destroyed. 78 wasp nests were destroyed. Pools ditches and stagnant water were treated to control the breeding of mosquitoes. 20. MORTUARY During the year fifteen bodies were received in the public mortuary at Pinner Road Council Depot. 21. RODENT CONTROL During the twelve months ended 31st December, 1956, the following work was carried out by the Rodent Staff under the Prevention of Damage by Pests Act, 1949:- 31 Visits by Rodent Officer and Operatives 4,467 Premises Disinfested 556 Complaints received 439 Estimated kill for year 1,452 32