SOUT 29 BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1961 MARGARET A. GLASS, Medical Officer of Health Perry & Routleff Ltd., Printers, Uxbridge and Ealing BOROUGH OF SOUTHALL ANNUAL REPORT OF THE Medical Officer of Health for the Year 1961 MARGARET A GLASS, Medical Officer of Health THE COUNCIL OF THE BOROUGH OF SOUTHALL, 1961 THE WORSHIPFUL THE MAYOR *Councillor J. Barrett, J.P. Deputy Mayor: *Alderman W. H. Hopkins, J.P. Aldermen: *Cavell, Mrs. I., J.P. Douglas, H. C. Love, P. J. *Dane, A. T. *Hopkins, W. H., J.P. Salmon, J. Councillors: *Aspell, T. J. A. *Haigh, J., J.P. Southey, P. G. *Barrett, J., J.P. *Hook, R. E. Steele, T. J. Barton, A. J. *Jones, Mrs. E. W. Ward, E. Day, F. R. *†Lamb, W. G. Ward, J. H., Errington, F. G. *Rockhill, F. R. J. Williams, Mrs. V. G. I. Griffiths, Mrs. M. C. *†sheil, E. J. (Chairman) *†Woodruff, J. A. T. *Members of the Public Health Committee. †Members of the Area Health Committee (Area No. 9). To the Mayor, Aldermen and Councillors of the Borough of Southall. MR. MAYOR, LADIES AND GENTLEMEN, I have the honour to present the 71st Annual Report on the health and circumstances of the population of the Borough of Southall. The year was an unsatisfactory one in some ways. The general standard of health of the people was fair, but a rise in the death rate, a rise in the birth rate and a rise in the infant mortality rate occurred. With regard to the death rate there was a heavy increase in the deaths from circulatory diseases and cancer. A rise in the birth rate in these days means that as the proportion of infants born at home is small, the hospital facilities for maternity are overstrained, and it is noteworthy that twenty-five infant deaths out of a total of twenty-six occurred in hospital. This demand for hospital confinement which arose at first from the difficulty of bearing children in overcrowded houses, has now become socially acceptable for all, and childbirth is now treated as a disease instead of being a part of normal healthy living, with resultant effects on the mental health and security of interrelationship of mothers and children. Apart from an outbreak of measles, infectious disease was not a problem during 1961, nor were dysentery or food poisoning. There was only one death from tuberculosis, but the incidence of this disease does not get less, and the high number of multiple cases suggests that longer periods of hospital isolation and less dependence on home treatment with drugs may be necessary. The section of the Report on Welfare while by no means complete gives some idea of the considerable effort made, and time spent voluntarily, in work in Southall to improve the conditions of those who are handicapped by disability or age from leading a full life. Much work was done by the Inspectors during the year on the surveys for Smoke 1 Control Areas, and to check on houses likely to be in multiple occupation. Emergency public health visits and infectious disease enquiries cannot wait, so it was fortunate that the year was uneventful in these respects when there was so much to be done on house-tohouse visiting. I would like to thank very sincerely everyone who has provided information to be used in this report, and I am happy also to acknowledge with gratitude the loyalty and assistance of all the members of the Public Health Department, not only with the preparation of this report, but at all times. I am, Your Worship, Ladies and Gentlemen, Your obedient Servant, Margaret a. glass Medical Officer of Health. Manor House, Southall. Telephone Numbers: SOU 3621-2. SOU 5060. 2 Acknowledgments to:— The County Medical Officer The County Welfare Officer The County Public Control Officer The Area Medical Officer The Physician Superintendent, St. Bernard's Hospital The Medical Superintendent, Hillingdon Hospital The Medical Officer of Health, Cambridge The Medical Officer of Health, Sheffield The Medical Officer of Health, Westminster Dr. J. T. Nicol Roe, Area Chest Physician Dr. T. M. Pollock, Medical Officer of the Medical Research Council Dr. G. Z. Brett, Medical Officer of Mass X-ray Unit 5A Miss B. J. Butcher, Liaison Officer of Mass X-ray Unit 5A The Borough Education Officer The Officers of the Fuel Research Station The General Practitioners of Southall Secretary-Warden, Community Centre, Southall The Manager, Southall Office of the Ministry of Labour The Youth Employment Officer The Chief Officers of the Council The Organisers of voluntary associations in Southall 3 HEALTH DEPARTMENT STAFF for the year 1961 Medical Officer of Health: Margaret A. Glass, B.Sc., M.B., Ch.B. (Glasgow), D.P.H. (Cantab.). Deputy Medical Officer of Health: Robert L. Lindon, M.R.C.S., L.R.C.P., D.P.H., D.C.H. Public Health Inspection Staff: Chief Public Health Inspector: R. W. McDonald, Cert. S.I.B., Cert. M. & F. Deputy Chief Public Health Inspector: S. Sadler, Cert. S.I.B., Cert. M & F., R.S.I. Smoke Certificate. District Public Health Inspectors: C. H. Wright, Cert. S.I.B., Cert. M. & F., Cert. Smoke Inspector. J. T. Woolford, Cert. S.I.B., Cert. M. & F. P. J. McMahon, Cert. S.I.B., Cert. M. & F. Additional Public Health Inspector: D. A. C. Davis, Cert. S.I.B. (Until 12.3.61). Trainee Public Health Inspector: M. R. Chaudhry, S.I. Cert. (PAK)., A.R.S.H. (From 4.12.61). General Assistant: W. A. J. Hyde. Clerical Staff: Senior Clerk: Mrs. K. Jones. Clerks, Shorthand-Typists: Mrs. K. N. Malam. Miss C. M. Hately. Miss D. P. Swift (From 23.1.61). Interviewing Officer: W. G. V. Hyde. 4 GENERAL STATISTICS AND SOCIAL CONDITIONS OF THE BOROUGH Area (Acres) 2,607.762 Population—1961 Census Year 51,337 Population—Registrar-General's estimate (mid 1961) 52,770 Number of inhabited houses according to the Rate Book at 31st March 1961 14,958 Average number of occupants per house 3.53 Sum produced by a penny rate £4,077 Rateable Value £1,011,332 Southall is a County District, compact in shape, being almost a square, with water boundaries on three sides—the River Brent on part of the east, the Grand Union Canal and the Yeading Brook on the west and the Grand Union Canal on part of the south. The Borough is highly industrial, containing large factories for food processing and engineering, and many smaller factories producing a great variety of semi-finished or finished products. The development of the Borough has been rapid, mainly within the present century, and so there has been little slum clearance to deal with, but there is a good deal of sub-standard housing, i.e. houses without baths or without hot water supply, and some without indoor sanitary accommodation. The problem of multi-occupation of such houses by members of the same family or by different families brings problems of cleanliness and the 5 Parks and Open Spaces controlled by the Council:— Brent Meadow 8.92 acres Cranleigh Play Park 2.00 acres Dormers Wells Housing Site 2.99 acres Dudley Road Island 0.13 acres Durdans Park 22.48 acres Football Ground, Western Road 3.51 acres Frogmore Green 0.35 acres Glade Lane 27.93 acres Havelock Road Open Space 2.22 acres Jubilee Park 11.13 acres Lady Margaret Road 0.25 acres Land at junction of Windmill Lane and Tentelow Lane 0.48 acres Land on west side of Cranleigh Gardens 1.07 acres Lea Road 0.13 acres North Road Island 0.35 acres Norwood Green 7.25 acres Queen's Road 0.13 acres Recreation Ground 18.00 acres Southall Municipal Sports Ground 19.78 acres Southall Park 26.77 acres Swimming Bath Site, Dormers Wells 10.50 acres The Manor House 2.00 acres West Middlesex Golf Course 108.00 acres Western Road 0.17 acres Wolf Fields 3.33 acres Wolf Green 0.18 acres Land to north-west of Kingsbridge Crescent 0.12 acres Land on north side of Spencer Street 0.31 acres 280.48 acres tenance of freedom from infectious disease and from diseases encouraged by faulty hygiene. Areas of land in two neighbouring Boroughs have been used for Southall Council house building because of the shortage of land within the Borough and to assist with the housing needs of the people of Southall, and use is also made of New Town housing. In spite of the seeming increase in multi-occupation of houses it is significant, that in a Census year, when the real count of the people has been taken, the figure for the average number of occupants per house in the Borough has fallen to 3.53. This finding seemed so odd when pressure seems to increase all the time from people living in misery because of overcrowding that it seemed worth-while to tabulate the corresponding figures for the last ten years, and from the table following a steady fall can be seen. Average number of occupants per inhabited house Year Persons 1952 3.84 1953 3.78 1954 3.73 1955 3.62 1956 3.57 1957 3.55 1958 3.52 1959 3.54 1960 3.55 196 3.53 Unemployment has not been a problem in Southall. Figures obtained by courtesy of the Manager of the Southall Employment Exchange and the Youth Employment Officer are as follow:— Men Women Number of persons registered as unemployed at Southall Employment Exchange on 11th December, 1961 177 52 Number of unfilled vacancies as at 6th December, 1961 182 74 Boys Girls Number of persons registered as unemployed at the Youth Employment Office on 11th December, 1961 12 6 Number of unfilled vacancies as at 6th December 1961 36 33 Swimming Bath The Southall Borough Council maintains an outdoor swimming pool in the Recreation Ground, which is one of the public parks, and this pool is used very fully during the summer months. The surface area of the bath is 3,600 square feet (120 feet by 30 feet) cubic capacity 16,500 cubic feet (110,000 gallons). The water is treated by breakpoint chlorination and the normal chlorine content of 1.0 parts per million at the shallow end and 0.7 at the deep end is maintained. During peak periods this is increased to 4.0 parts per million at the shallow end in order to obtain 2.0 parts per million at the deep end. A minimum of three samples of the water are taken daily by the staff of the Baths Superintendent for chlorine and pH reading, and from time to time bacteriological testing is carried out by officers from the Public Health Department. At no time during 1961 was the water found to be unsatisfactory for use by swimmers. As this bath is closed during the winter 6 months it can be fully emptied and repaired, if necessary, and cleansed each year before the spring opening. During 1961 the total number of persons using the bath was 32,726 (29, 242 in 1960). The average number of persons attending per day was 214. The maximum number at any one session was 350. Paddling Pool A paddling pool for young children is available in Cranleigh Gardens Play Park. The capacity of the pool is approximately 15,500 gallons with depth from 1½ inches to 9 inches. The water of the pool is free running and is treated by continuous chlorination for hygiene purposes. Like the swimming bath, this pool was in constant and very full use during the summer of 1961. Bacteriological sampling when carried out gave satisfactory results. School Playing Fields For the physical training, school games and recreation of school children the total acreage of school playing fields in Southall is approximately 22. At present considerable use is also made of the play parks within the Council's public parks and negotiations are still proceeding for the acquisition of three further areas of land suitable for playing fields. 7 VITAL STATISTICS Total Deaths, 719. (Males, 364: Females, 355). Crude Death Rate, 13.63. For extracts from vital statistics and causes of death, see Appendix, Tables I and II. Deaths and Death Rate The death rate, i.e. the number of deaths per 1,000 total population, rose again in 1961 Below is shown the comparative figures for the past nine years. Year Death Rate 1953 13.31 1954 12.16 1955 11.92 1956 12.25 1957 13.02 1958 12.04 1959 12.12 1960 13.15 1961 13.63 The principal causes of death were cancer, coronary disease, heart disease and other diseases of the circulatory system—in that order—but if coronary disease is included amongst the diseases of the circulatory system—this is by far the highest cause. In an ageing population in an era when speed gets ever faster and crises—political, economic, and social—multiply, the stress diseases are bound to take their toll, and cerebral haemorrhages and other sudden arterial breakdowns occur. The figure for cancer deaths has risen steeply in 1961 from 118 to 148 and lung cancer accounted for 44 of these—this latter figure had been falling steadily for the previous three years. There were no deaths from whooping cough, diphtheria, and poliomyelitis, but there were eleven who died from influenza. There was one death from tuberculosis. The number of outside deaths i.e. of Southall residents who died in Hillingdon Hospital, other Middlesex hospitals and hospitals outside the County boundaries, including various London hospitals, was 297 (males 180 and females 117). Deaths of institution inmates (including patients from Southall addresses and from outside areas) number as follows: St. Bernard's Hospital, 285 (males 110 and females 175); Mount Pleasant Hospital, 73 (males 36 and females 37); Southall-Norwood Hospital, 6 (males 4 and females 2); in addition 3 deaths (all male) occurred of persons belonging to other districts. In 1961, six people died as the result of motor vehicle accidents, as compared with nine in 1960. It is regrettable that there has not been a year free from motor vehicle accident deaths since 1954. The total number of deaths from violent causes was recorded as 28 in 1961 as compared with 39 in 1960. To make an approximate allowance for the way in which the sex and age distribution of the local population differs from that of England and Wales as a whole, the crude death rate is multiplied by a comparability factor supplied by the Registrar-General. This, then, gives a comparative death rate of 12.13 compared with the rate for England and Wales as a whole, which was 12.0. For distribution of deaths in the various wards, see Appendix, Table III. Births and Birth Rate. (Figures for 1960 are given in brackets). The total number of live births belonging to the district, whether occurring within or outside the district, was 973 (817). The illegitimate live births were 80 (66). There were 22 stillbirths (11), all legitimate. 8 A rise in the birth rate (live and still) is recorded from 15.58 in 1960 to 18.86 in 1961. The birth rate is the number of births per 1,000 of the total population. Eighty illegitimate live births were registered during 1961. The following table shows the comparative figures for the past 25 years, showing that 1961 has the highest figure recorded during that period. Year No. of IIIegitimate Live Births 1937 38 1938 31 1939 34 1940 31 1941 30 1942 38 1943 39 1944 55 1945 60 1946 56 1947 53 1948 53 1949 39 1950 36 1951 28 1952 26 1953 31 1954 23 1955 21 1956 38 1957 37 1958 42 1959 55 1960 66 1961 80 To make an approximate allowance for the way in which the sex and age distribution of the local population differs from that for England and Wales as a whole, the birth rate is multiplied by a comparability factor supplied by the Registrar-General. The corrected live birth rate was 19.18. The corresponding rate for the whole of England and Wales was 17.4 and this was the highest birth rate since the year 1948. Infant Mortality Infant mortality, i.e. the number of children dying before reaching the age of one year, was greater, the figure for 1961 being the highest since 1953 as can be seen by the graph on page 10. Twenty-six infants died compared with 14 in 1960, giving a rate of 26.72 compared with 17.14 in 1960. Of these 26 deaths, one died at home and 25 in hospital. Twenty-three infants (males 12 and females 11) died within the first four weeks after birth. Table IV gives the causes of infant deaths under the age of one year. Graph A, on page 10 shows the trend of the infant mortality rate since 1900. The corresponding rate for Middlesex County was 20.4 and for England and Wales as a whole was 21.4, the lowest ever recorded in this country. The Southall figure, which has always been among the lowest in the County and below the National rate, shows a deterioration this year—although the figures on which the rate is based are small, i.e. 26 infants died compared with 14 in 1960, still many of these lives need not have been lost since an analysis of the causes of the infant deaths shows that prematurity was the main cause of death, which with proper ante-natal care might have been preventable. 9 GRAPH A Infant Mortality Rate from 1900 to 1961 10 Premature Infants Seventy-five premature infants were born alive during the year; 63 were born in hospital and of these, 46 were surviving at the end of one month; 12 were born at home and 11 of these were surviving at the end of one month. There were 16 premature still births, all occurring in hospital. These figures are far from pleasing—showing that not only has there been a further rise in the number of premature births—but also of premature still-births, that 10% of the total births (live and still) were prematurely born, and that one third of the premature infants born either were born already dead or lived only a very short time. Comparable figures for the past five years are:— Premature Births Year Born at Home Born in Hospital Births Died within one month Stillbirths Births Died within one month Stillbirths 1957 8 2 - 40 7 6 1958 8 — — 49 8 3 1959 7 - — 48 6 3 1960 15 - 1 45 7 7 1961 12 1 63 17 16 These figures also seem to indicate that a premature infant stands a better chance of surviving if it is born in its own home, though of course, premature births occurring in hospital often happen because of maternal ill-health—thus the premature infant is more likely to be inherently weaker than the premature infant produced at home. The classification of a premature infant is given to a child born prematurely, or which weighs less than 5½ lbs. at birth. The figures for premature births and stillbirths are both showing an upward trend, the corresponding figures in 1960 were 60 premature live births and 8 premature stillbirths. Maternal Morbidity Two cases of puerperal pyrexia were notified direct to the Department during 1961— in addition 35 cases were notified to other authorities, and subsequently reported here— 34 of these occurred in Hillingdon Hospital and one in Hammersmith Hospital. The classification of puerperal pyrexia is "any febrile condition occurring in a woman in whom a temperature of 100.4° Fahrenheit (38° Centigrade) or more has occurred within fourteen days after childbirth or miscarriage". 11 PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES The number of infectious disease cases notified during 1961 was great, because of an epidemic of measles. All other infections were either less or much the same as in 1960— See Tables VI and VII. No cases of diphtheria were notified, but there was one case of acute paralytic poliomyelitis, this however, was not confirmed. Monthly Bulletins of Incidence of Infectious Disease These bulletins were circulated monthly to all general practitioners in the Borough, and, in addition to information with regard to infectious diseases occurring during the previous month, any topical matter, or incident of mutual interest to general practitioners and the Public Health Service, was also included. Measles Measles incidence was very heavy during the year 1961, and there was one death from this cause. The following table shows the trend of notifications during the past ten years. The 1961 outbreak had some uncharacteristic features in that it began slowly in the early part ot the year, built up, but then continued over many months, Poliomyelitis One notification of anterior poliomyelitis was received in 1961—this was subsequently confirmrmed as having been an injury only- traumatic myositis Vaccination against poliomyelitis, which is organised by Middlesex County Health Department. continued throughout 1961, and details are as follows:— Number of persons who had received two injections at any time up to 31st December, 1961 18,445 Age group:— 1943—1960 1933—1942 Born before 1933 and under 40 Others TWO injections during 1961 1,048 394 929 224 THIRD injection during 1961 886 258 1,055 63 Of those previously obtaining two injections, by the end of December, 15,557 had received a third injection. 12 In fact, cases were notihed in every month except December—the peak months being March, April and May. Year No. of Cases Deaths 1952 528 — 1953 931 1 1954 41 — 1955 1,329 — 1956 61 — 1957 674 1 1958 476 — 1959 674 — 1960 12 — 1961 1,042 1 In addition, 3,357 children between the ages of 5 and 12 were given a fourth reinforcing injection during 1961. Influenza Influenza assumed epidemic form in the first three months of 1961, but although it was the cause of absenteeism and overcrowding of hospital beds, the form of the disease was not unduly severe. Eleven deaths were recorded as having been caused by the influenza. Dysentery Sixteen notifications for dysentery were received in 1961. Out of these only one was confirmed bacteriologically as positive for dysentery, the organism being Shigella Flexnerii. Smallpox (Variola) No case of smallpox occurred in Southall during the year. Notifications were received of contacts, three in number, members of the crew of a ship from which a case of suspected smallpox had been removed to hospital. The final diagnosis was that the patient did not have smallpox. In the last days of the year smallpox cases were discovered in England having been brought in by air from Karachi, where an epidemic of this disease had broken out. Surveillance was begun. Vaccination against Smallpox The total figures for vaccination showed a slight rise in 1961 but the percentage of children receiving vaccination during their first year of life went down from 50% in 1960 to 46% in 1961. 1961 Age Group Under 1 year 1-2 years 2 -4 years 5-14 years 15 years and over Total Primary Vaccination 449 52 38 41 75 655 Re-vaccination - — 4 6 119 129 1960 Age Group Under 1 year 1-2 years 2-4 years 5-14 years 15 years and over Total Primary Vaccination 410 44 15 26 39 534 Re-vaccination - — 4 13 132 149 Typhoid Fever A case of this disease was discovered in a boy returned from holiday abroad, he was treated and discharged from hospital free from infection. Scarlet Fever (Scarlatina) The number of notifications received during the year was 27 as compared with 42 for the previous year. There was one secondary case, i.e. occurring within three weeks following the notification of a previous case in the same household. 13 Diphtheria No cases of Dhtheria were notified to the Department. The following information supplied by the Area Medical Officer shows the number of children immunised against diphtheria during the year. Number of Children who completed a full course of Primary Immunisation in Southall during the year Number of Children who were given Secondary or Reinforcing Injection during the year (i.e. having in a previous year received a complete full course) Ages at Date of Final Injection Under 1 1-1 5-14 Total 331 500 153 984 531 The immunisation state of the child population improved slightly during the year, the figures showing an increase on 1960, in particular the number brought for a re-inforcing or booster injection went up from 159 in 1960 to 531 in 1961. Ophthalmia Neonatorum One case of ophthalmia neonatorum was notified during the year. Although the infant was admitted to hospital, the organism found was non-venereal, and the infection cleared up with treatment. Tuberculosis Notifications Pulmonary The number of new cases notified during the year was 74. Other Forms The number of new cases notified during the year was 15. Of the total notifications, which include new cases and inward transfers from other districts, 70 were received from the Uxbridge Chest Clinic; 8 from General Hospitals; 8 from St. Bernard's Hospital; 1 from Hounslow Chest Clinic; 1 from Ealing Chest Clinic and 1 from a General Practitioner. The number of new notifications rose from 71 in 1960 to 89 in 1961. Of the 89, 22 were inward transfers, i.e. they were not resident in Southall at the time of development of the disease and, therefore, the actual figure of new notifications of Southall residents was 67 one of which was subsequently diagnosed as nontuberculous; while in 1960 the number of inward transfers was 24 making the figure for new notifications of Southall residents 47, less one subsequently cancelled. Deaths Tuberculosis of the respiratory system, 1; other forms, nil. For details of new cases notified and deaths in 1961, see Appendix Table VIII, and for the occupation of new cases, see Appendix, Table IX. Although the fact that only one death from tuberculosis was registered during 1961 is one to be welcomed, there was a disturbing rise in the incidence of new disease; notifications rose by nearly 50%. As will be seen on Graph B, notifications of this disease have not yet fallen below pre-war level, although the deadly effect of the disease has continued to drop fairly steadily for the past thirty years. No doubt better methods of diagnosis have ensured that cases are discovered in time for treatment to produce good result, but the statistics raise considerations about the need for more cases to be treated for longer periods in hospitals; domiciliary treatment may be increasing the risk of the development of fresh cases, particularly in overcrowded homes, or where patients are not supervised sufficiently to make sure they are persevering with treatment and observing strict rules of hygiene. 14 Graph B Tuberculosis (All Forms)—Notifications and Deaths from 1930 to 1961 Deaths Notification 15 The amount of tuberculosis amongst Indian residents rose in 1961, comparative figures for the last five years are:— Year New Notifications Number of Indians 1961 67 29 1960 47 13 1959 64 12 1958 57 14 1957 61 10 The analysis of the housing conditions of new cases (of notified patients living in Southall, exclusive of St. Bernard's Hospital notifications) shows in ten cases statutory overcrowding, eight occupied by Indians, and two by families other than Indian. No abatement of the overcrowding had been obtained by the end of 1960. In fourteen instances there were multiple cases, six in English homes, and eight in Indian ones. Statutory overcrowding was confirmed in three of these houses. The number of patients was two in nine cases, three in two cases, but six members were affected in three houses—in each case these were Indian houses. Work on enforcing the standards for houses in multiple occupation should help to reduce this hazard—and longer retention in hospital must be obtained for infectious persons. Of three cases of overcrowding with tuberculosis in 1960, abatement had occurred in all three instances; in one instance of dilapidated housing with tuberculosis, no rehousing had taken place by the end of the year. In the case of overcrowding remaining from 1958—the family has now removed. Management of Tuberculosis For diagnostic purposes, Southall patients are mostly referred either by general practitioners or from hospital doctors to the Uxbridge Chest Clinic, and if tuberculosis is found, treatment and following-up is instituted from that Clinic. The Tuberculosis Visitor calls at the home of a patient and submits a copy of her report to the Public Health Department. Contacts are seen by the Visitor and they have suitable tests, either tuberculin tests or X-rays, or both, at the Chest Clinic. If sanitary defects or overcrowding are reported further visiting is carried out from the Public Health Department. At St. Bernard's Hospital, cases of tuberculosis are isolated in Adelaide Ward, which has 24 male and 24 female beds. One of the doctors from Uxbridge Chest Clinic continues to carry out tuberculin testing and B.C.G. vaccination of members of the nursing staff of the hospital. B.C.G. vaccination B.C.G. vaccination is offered to contacts of cases of tuberculosis, to medical and nursing staffs of tuberculosis wards, and since 1957, as a result of the findings of the Medical Research Council in their Tuberculosis Vaccines Clinical Trial, to children aged 13 and over in Southall schools. Testing with tuberculin is carried out beforehand. The tuberculin test, if positive, shows that infection has occurred at some time during life, and further investigation is undertaken to verify whether this is active, chronic or healed infection, as these all give the same result to the test. When the tuberculin test is negative and in the absence of disease, B.C.G. inoculations are carried out in order to render the individuals tuberculin positive and, therefore, to have immunity to infection by the tuberculous bacillus. 16 Under the B.C.G. vaccination in schools scheme, details are as follows:— Number invited to take part in the scheme Number of consents received Referred to Chest Clinic Number of Children vaccinated with B.C.G. Contacts Positives 1,448 1,235 11 366 717 All testing and vaccinating during 1961 under this scheme was carried out in Southall by the Middlesex County Council Staff. Mass X-ray The mobile Mass X-ray Unit visited certain organised groups in Southall during 1961 and the following numbers were X-rayed:— Ripolin Paints 56 Taylor Woodrow 902 Southall Laundry 82 Featherstone Road School 492 1,532 Only two observation cases of pulmonary tuberculosis were discovered. In addition the Unit visited twice at the A.E.C., Quaker Oats and Wimpey depots as part of a new scheme for the routine X-raying of persons employed in factories over the age of 40. There is now available at the West Middlesex Hospital a static Mass X-ray Unit, the second to be introduced in Middlesex, and while primarily intended for the use of hospital patients, there is an open invitation for any member of the public to attend at any time when the Unit is working, for a check. This is a most useful undertaking and supplements the work done during the visit of the Mobile Unit to Southall. It also saves the need, in most cases, of reference by appointment to the Chest X-ray Clinic for a large film to be taken. 17 Details of work on Southall contacts during 1960 and 1961 at Uxbridge Chest Clinic are as follows:— 1960 Under 1 year 1-4 5-15 Over 15 Total Tuberculin tests—Positive result - 2 26 114 142 Tuberculin tests—Negative result 34 35 51 21 141 B.C.G. given 34 35 51 21 147 B.C.G. given—Babies born in hospital — — - 6 Most of the "over 15" were Indians 1961 Under 1 year 1-4 5-15 Over 15 Total Grand Total Tuberculin tests—Positive result * 2 10 28 40 153 - 2 27 84 113 Tuberculin tests—Negative result * 21 24 16 8 69 110 11 13 11 6 41 B.C.G. given * 21 24 16 8 69 110 11 13 II 6 41 B.C.G. given—Babies born in hospital. 4 * Indians and Pakistanis Dr. J. T. Nicol Roe, Chest Physician, Uxbridge Chest Clinic, reports on the need for continued aggressive action in detecting the new case of pulmonary tuberculosis, for only by so doing and treating this case effectively will diminution of new cases be maintained. Cases in the Southall area showed an increase in 1961 and this was partly linked up with the continued influx of Indians and Pakistanis into the Borough. Wives and children have been arriving in increasing numbers and this has resulted in an increase in disease in females and children. The continued co-operation of local General Practitioners in referring to the Chest Clinic newly arrived Indians and their families for X-rays and/or Tuberculin testing is an essential part of the anti-tuberculosis programme. Patients in the Southall area, as before, are admitted to Harefield Hospital. Dr. Nicol Roe considers it is still a desirable thing for anti-tuberculous drugs to be initiated in hospital, as a certain risk always exists towards the development of sensitivity reactions. Of the Indians and Pakistanis who were referred to the clinic by their general practitioners for X-ray only, the following were skin tested and B.C.G. vaccinated:— Under 1 year 1-4 5-15 Over 15 Total Tested 11 15 41 90 157 Negative 11 13 11 6 41 Positive — 2 27 84 113 Vaccinated 11 13 11 6 41 Of those originally skin tested, 3 failed to return to the clinic for reading of the test. With regard to prevention and early detection of cases, contacts both at home and factory or workshop should have regular X-rays and/or Tuberculin Tests. Full use should continue to be made of the Mass X-ray Unit's visits to the Borough. Cancer It will be seen by the table of causes of death (page 57) that in 1961 148 cases (males 89 and females 59) died from cancer. See Appendix, Table V, for an analysis of cancer deaths since 1936. On page 19 is set out in tabular form a classification of the cancer deaths according to the site of the primary growth and in ages. The total number of deaths from cancer in 1961 rose, being 148 as compared with 118 in 1960 giving the highest death rate for this cause yet recorded. Cancer of the lung in males was the highest individual figure for site of disease and was 40% up on the 1960 figure. Distribution of Infectious Disease Notifications For the incidence of various infectious diseases notified during the year, under age groups and locality, see Appendix, Tables VI and VII. Infectious Disease Visits During the year, the Public Health Inspectors paid 125 visits with reference to cases of infectious disease. In addition, the County Health Visitors did a certain amount of home and school visiting in connection with infectious diseases. 18 CLASSIFICATION OF CANCER DEATHS IN SITES AND AGES Age Groups—Male Site Total Under 10 10—20 20—30 30—40 40—50 50—60 60—70 70—80 80 + '58 '59 '60 '61 '58 '59 '60 '61 '58 '59 '60 '61 '58 '59 '60 '61 '58 '59 '60 '61 '58 '59 60 '61 '58 '59 '60 '61 '58 '59 '6C '61 '58 '59 '60 '61 '58 '59 '60 '61 Lung 33 31 28 9 - - - - - - - - - - - - 3 - - - 2 1 3 3 12 15 11 6 7 8 9 20 8 7 5 10 1 - - - Stomach 16 13 9 3 - - - - - - - - - - - - - - - - - - - - 4 3 1 2 5 5 3 ? 6 5 5 8 1 - - 1 Intestine 13 6 7 6 - - - - - - - - - - - - - - - - 1 1 1 - 2 2 1 1 7 2 3 3 2 - - 2 1 1 2 - Bladder 3 5 — 3 - - - - - - - - - - - - - - - - - - - - 1 2 — — 1 2 — 2 1 1 — 1 - - - - Prostate 4 2 6 9 - - - - - - - - - - - - - - - - - - - - - - 1 2 2 - 2 2 2 1 2 3 - 1 1 2 Other 22 8 20 9 - - - - 1 - - 1 1 - - 2 - 2 - 1 2 3 1 6 2 5 6 3 3 7 4 7 - 1 4 1 1 2 3 Totals 91 65 70 *9 - - - - 1 - - 1 1 - - - 5 - 2 - 4 4 7 4 25 24 19 17 25 20 24 33 26 14 13 28 4 3 5 6 Age Groups—Female Site Total Under 10 10—20 20—30 30—40 40—50 50—60 60—70 70—80 80 + '58 '59 '60 '61 '58 '59 '60 '61 '58 '59 '60 '61 '58 '59 '60 '61 '58 '59 60 '61 '58 '59 '60 '61 '58 '59 '60 '61 '58 '59 '60 '61 '58 '59 '6 0 '61 '58 '59 '60 '61 Breast 10 5 8 5 - - - - - - - - - - - - - - - - - - 2 2 3 1 5 6 - 2 - 3 4 - - 1 3 2 1 3 Lung 5 5 3 5 - - - - - - - - - - - - - - - - - 1 - - 2 - 1 1 - 3 2 3 2 1 - 1 1 - - - Stomach 5 9 6 8 - - - - - - - - - - - - - - - 1 - - - - — 1 1 2 1 2 3 1 2 2 2 1 2 4 — 3 Uterus 1 2 3 4 - - - - - - - - - - - - - - - - - - - - - 1 - 1 1 - - - - 1 3 2 - - - i Intestine 8 11 9 8 - - - - - - - - - - - - - - - - - - 1 1 3 - 1 2 1 3 3 2 3 5 4 2 1 3 — 1 Bladder — 1 — 3 — — — — — — — — — — — — — — — — — — — — - - - - - - - 1 - 1 — — — - - 2 Other 19 17 19 6 - - - 1 - - - - - 1 - - 1 - - - 1 3 1 - 6 6 2 1 3 4 5 3 4 2 7 6 4 1 4 5 Totals 48 50 48 9 - - - 1 - - - - - 1 - - 1 - - 1 1 4 4 3 14 9 10 13 6 14 3 13 15 12 16 13 11 10 5 15 19 Laboratory Work Specimens taken for bacteriological or chemical investigations, in connection particularly with infectious disease cases, are brought daily to the Manor House and transported to the Ealing Public Health Laboratory. The necessary investigations are carried out and results reported simultaneously to the Medical Officer of Health and to the doctor who has submitted the specimen from one of his patients. Details of the work carried out in 1961 are as follow:— Faeces specimens 204 Sputum specimens 5 Blood specimens 20 Urine specimens 49 Swabs (nose, throat and vaginal) 36 Disinfection and Disinfestation In cases of infectious disease, rooms, clothing, etc., were disinfected—-rooms by sealing and fumigating with a formalin preparation; clothing, bedding and other infected articles remaining in the room for disinfection. Lists of premises, articles, etc., disinfected during the year:— Rooms 4 Books 56 Beds 19 Eiderdowns 20 Blankets 40 Pillows 28 Sheets 44 Lists of premises disinfested from vermin during the year:— Bug infestation 28 rooms with beds and bedding Flea infestation 17 rooms Cockroach infestation 15 rooms In addition, 16 wasps nests were destroyed. Smallpox Disinfection In the event of smallpox occurring within the district and disinfection being required on a considerable scale, arrangements have been made whereby this could be carried out. An agreement was made with the North-West Metropolitan Regional Hospital Board whereby in such an event the staff of St. John's Hospital, Uxbridge, would carry out this work. Provision of Antitoxin and Vaccine Lymph The Council provides diphtheria antitoxin free to local practitioners in the district. This antitoxin is obtainable from the Public Health Department during office hours and by direct request to the Medical Officer of Health at other times. In the event of emergency supplies of vaccine lymph being required, they are obtainable at very short notice. Scabies and Lice During 1961, one case of infestation with scabies and one of pediculosis capitis and one of pediculosis corporis were brought to the Public Health Department for cleansing. Baths and treatment were arranged at Hammersmith Cleansing Station by courtesy of Hammersmith Borough Council. Details of head inspections in schools are to be found in Table X page 61. 20 WELFARE General St. John Ambulance Association: The local headquarters of the St. John Ambulance Association are situated at Harrington Road, Southall, and the honorary officers are Dr. Mary Ellis of Lansdowne House, High Street, Harlington, Divisional Surgeon; Miss E. Hobson, 20 Elmfield Road, Southall, Divisional Superintendent, Nursing Division and Mr. W. Adams, 98 Carlyle Avenue, Southall, Divisional Superintendent, Ambulance Division. There are 20 Nursing Members, 4 Officers and 11 Auxiliary Members. The work carried out is as follows:— Home Nursing and Nursing Equipment. The St. John Ambulance Nursing Division has been trained in Home Nursing and First Aid to the Injured. It also lends nursing equipment for use in the home from the Medical Comforts Depot in Hartington Road, open every evening (except Saturdays, Sundays and Bank Holidays) from 7.30 p.m. to 8.30 p.m. for the issue of articles needed by the public. During the year 286 articles were lent under the scheme —the 1960 figure was 370. Welfare—General. The St. John Ambulance Brigade carried out trainings in First Aid and Home Nursing for all who cared to take advantage of the service, also special courses for Civil Defence volunteers and for Scouts and Guides. The members of the Nursing and Ambulance Divisions carried out many other duties including attendance at local cinemas, sports, fairs, Old Folks' Clubs, accompanying old people's group excursions to the seaside, hospital duties, also sick visiting. Members also took part in duties further afield, including London Airport, London theatres, concerts, etc. The amount of voluntary time given to this good work is considerable. During 1961, 852 hours were spent on public duties, and 267 on miscellaneous duties. British Red Cross Society: The Southall Division of the British Red Cross Society continued to increase in membership during 1961, to some 175 members. A second Girls' Cadet Unit was formed which increased weekly. Members are extremely keen on all the work they can assist in, which includes attendance at our Blood Donor sessions. A second Members' Group was also registered in 1961, and the new members of both sexes helped considerably in raising money by holding frequent whistdrives and dances. The Club for Disabled People also showed an increase in membership. Various outings were enjoyed by these people throughout the year. Other activities by the Red Cross included training and instruction in first aid, nursing, maternal and child welfare, medical loan depot, escort duties, visiting, transport for the sick, clerical work and assistance at all Blood Donor sessions, emergency help for disabled ex-Servicemen, first aid duties at the local rugby football ground and the London Royal Festival Hall, and continued participation in the Territorial and Civil Defence excercises at the Hayes training ground. Club for Disabled Persons: A Club, for persons suffering from severe disablement, met fortnightly and was a social and recreational one for people suffering from any physical handicap. Transport was provided by members of the Rotary Club and Round Table for those members who were unable to make their own way to the Club premises, which were at the Southall Community Centre. The membership remained at a figure of 25—the average attendance 21 being about 18. Members make themselves useful to the Community Centre staff in little ways, and this is of considerable therapeutic value. The Hard of Hearing Club: This Club, which was inaugurated in 1955, had another successful year in 1961 and continued to be popular and useful to its members. The membership figure increased by 25% and there was an average weekly attendance of 30—35. The Committee is very energetic and the programmes arranged for the members were varied, interesting and often directly useful in helping them to come to terms with their disability. The Welfare Committee of the Southall Group had numerous calls for services—such as help with hearing aid difficulties. Five members attended the Old Age Pensioners' Holiday at Dymchurch organised by the Welfare Committee of the Middlesex and Surrey League, and the group was represented at the National Conferences of the British Association for the Hard of Hearing. Diabetic Club: The Southall and District Diabetic Club, a Branch of the British Diabetic Association, continued to function throughout 1961. This Club, formed im 1956, aims to enable diabetics, their relatives and friends, and those interested in diabetic welfare, to meet together socially and to hear authoritative talks from speakers who specialise or are particularly interested in diabetes such as doctors and other health experts. Membership by subscription was 61, with a Club Newsletter circulation of 115. The attendance at monthly meetings in the Masons Room of the Holy Trinity Hall averaged 25. The Club has a Committee of 10 members which includes welfare officers and organisers of various fund raising activities in aid of the Research Fund. The Club programme in 1961 included food demonstrations, Norwegian travel and road safety film shows, coach outings, as well as talks by diabetic specialists. Two younger school teenage members attended holiday camps run by the British Diabetic Association during the summer. The Club is a member of the North West Metropolitan Region which consists of 7 Branches in west London, and inter-club visits are organised. Multiple Sclerosis Society: A new Branch of this Society was formed during 1961 to meet the needs of sufferers from this disability in the Boroughs of Southall, Heston and Isleworth, Hayes and Harlington, and Uxbridge. It was named the West Middlesex Branch. The work undertaken by this Society includes the visiting of disabled members in their homes, the organisation of social meetings and the provision of financial help with holidays. Welfare of the Blind and Partially Sighted: The welfare services for the blind and partially-sighted are the responsibility of the County Council under the National Assistance Act, 1948. In 1961, there were resident in the Borough 97 blind and 14 partially-sighted persons. There were 6 partially-sighted children attending Special Schools, and 1 blind child aged 3 years, at home. Sixteen blind persons were in full-time employment. Of these, 3 were in Workshops for the Blind, and 1 was working as a Home Worker. Their earnings were augmented by the County Council. The County Council's Welfare Department provides a Home Teaching service, the object of which is to enable blind and partially-sighted people to lead as full and active lives as their handicap allows, by assisting them in overcoming the effects of their disabilities. The majority of blind persons are either not capable of employment owing to age or infirmity, or for some reason are not available for employment. Amongst the latter arc housewives who may receive instruction in carrying out their household duties from the Home Teachers or in residential courses of social rehabilitation. The Home Teachers visit all blind and partially-sighted persons in their own homes, in hospitals and in residential homes, advise on all problems relating to their welfare and 22 keep them in touch with available social services. They give instruction in Braille and Moon systems of embossed type, and in handcrafts. Deaf-Blind persons also receive the services of a special Home Teacher for the Deaf-Blind. A handcraft class is held fortnightly at the King's Hall Methodist Church, South Road, Southall. Close co-operation is maintained between the County Council and Voluntary Organisations, including the Social Club for the Blind, which holds fortnightly meetings at the Labour Hall, The Broadway, Southall, and the Middlesex Association for the Blind which assists individual necessitous blind people and maintains a holiday home at Littlehampton, two holiday caravans at Lancing, and two Residential Homes for the Blind. The Southall Blind Club has a membership of 32 with an average age of 70 + and transport to Club meetings is carried out by members of Southall Round Table and Inner Wheel. The Club is social and in 1961 also ran two coach outings and a Christmas party. Blind persons are eligible for the loan of a wireless receiver through the British "Wireless for the Blind" Fund, and the County Council has a scheme for assisting blind and partially-sighted persons with the maintenance of wireless sets. Other services are provided by the County Council either directly or through a registered agency and these include facilities for the placement of blind persons in employment, courses of residential rehabilitation, training courses for mothers with blind babies, the supply of embossed literature, special equipment and handcraft materials, assistance in the disposal of handcrafts and assisted holidays for those in need. Welfare of Handicapped Persons other than Blind: Schemes for the welfare of handicapped persons other than blind and partially-sighted which are operated by the County Council's Welfare Department under the National Assistance Act, 1948 provide welfare services for the deaf and dumb and hard-of-hearing, and other persons who are substantially and permanently handicapped by disease, injury or congenital deformity. Services to the deaf and dumb and the hard-of-hearing are provided by appropriate Voluntary Organisations, to which the County Council makes grants in aid. The Borough of Southall forms part of Area 9 which includes also the Boroughs of Brentford & Chiswick and Heston & Isleworth. Two Welfare Visitors and a Homework Organiser are included in the staff which has been provided by the County Council's Welfare Department for carrying out social services required, and who visit those suffering from substantial and permanent handicaps. They work from the local Area Welfare Office and the handicapped persons are visited in their own homes with a view to assisting them to obtain services from statutory or voluntary sources. The County Council supplies aids and appliances not covered by the National Health Service, carries out where necessary adaptations to a house to enable a handicapped person to become more mobile, provides holidays, arranges for the disabled to take part in social activities, including choral and dancing classes, attend handcraft classes, etc. A special coach with an hydraulic hoist to lift wheelchair cases is available for use for social activities etc. Advice and guidance regarding personal problems are given and membership of voluntary organisations catering for particular handicaps is facilitated. The Home Work Organiser endeavours to procure from industry appropriate assembly work and arranges for this to be carried out by handicapped persons at a Work Centre or in their own homes where this is considered to be suitable and of assistance to the individuals concerned. At 31st December, 1961, 112 residents of the Borough were registered as generally handicapped. Alterations to houses to make them more suitable for handicapped persons were made in two houses:— House: Rail by bath provided. Old Persons' Bungalow: Rail at back door, and front and rear steps made more shallow. 23 Residents of the Borough needing any of the County Welfare Services briefly referred to in this Report should apply to the Area Welfare Officer, at the Local County Offices, Great West Road, Brentford. Nutrition of school children: The following figures kindly supplied by the Divisional Education Officer give the details of milk and meals acceptance in the various schools in the Borough. The percentage of children having milk in schools was as follows:— School 1959 1960 1961 Primary 97% 96% 96% Secondary Modern 85% 72% 73% Technical 83.3% 75% 67% Grammar 41.1% 39% 53% Talbot Special 92.5% 83.5% 87% The percentage of meals served to daily attendances:— School Average % of Attendance taking meals Autumn Term A verage Number taking meals Average Attendance 1961 1960 1961 1960 1961 1960 Primary Schools: Beaconsfield Road Junior Mixed 40 44 118 108 294 244 Beaconsfield Road Infants' 42 48 82 76 196 157 Clifton Road Junior Mixed 46 42 67 67 146 161 Clifton Road Infants' 43 45 51 44 119 97 Dormers Wells Junior Mixed 61 55 124 115 203 209 Dormers Wells Infants' 66 58 89 89 134 153 Featherstone Road Junior Mixed 41 35 118 102 289 288 Featherstone Road Infants' 45 43 103 92 228 212 George Tomlinson Junior Mixed 65 64 141 150 216 235 George Tomlinson Infants' 50 50 58 59 115 117 Lady Margaret Junior Mixed 55 51 161 163 291 319 Lady Margaret Infants' 42 44 91 85 215 192 North Road Junior Mixed & Infants' 55 58 213 214 384 369 St. Anselm's R.C. 77 75 302 284 393 380 Tudor Road Junior Mixed 47 44 146 151 312 343 Tudor Road Infants' 35 38 70 87 201 228 Secondary Schools: Southall Grammar 57 50 343 318 597 630 Dormers Wells Boys' 37 39 203 221 549 573 Dormers Wells Girls' 56 58 287 327 513 560 Featherstone Road Boys' 44 45 273 266 615 588 Western Road Girls' 45 50 198 216 437 436 Grammar/Technical * 37 35 126 126 339 361 Special Schools: Talbot Road 97 98 204 192 210 195 * Dudley Road Annexe only 24 It is interesting and pleasing to report an annual increase in the percentage of children taking school meals:— Year Summer Term Autumn Term 1958 40.79 43.69 1959 41.63 46.51 1960 44.84 50.67 1961 46.36 50.95 Old People The needs of 25 special cases of old people living in difficult circumstances were investigated during 1961, and what happened to them is recorded in the following list:— Admitted to hospital 4 Admitted to old people's home 1 Remaining at home 20 (a) Home Help provided 2 (b) Home Help and District Nurse and meals provided 1 (c) Home Help and meals provided 1 (d) Home Help and visiting 1 (e) Adaptation to house awaited 1 (f) Awaiting housing for old people 11 (including three couples) (g) No Action required 2 (h) Hospital transport arranged 1 The difficulties of the old persons recorded on this list were brought to the notice of the Public Health Department staff either by medical practitioners, interested relations, neighbours or friends, or following complaint by one or other of the statutory authorities. The County Council has the duty, under the National Assistance Act, 1948, of providing residential accommodation for aged and infirm persons in need of care and attention which is not otherwise available to them; and it can do this by providing its own Homes or by arrangements with recognised Voluntary Organisations. The County Council's Welfare Department administers the County Homes, and the number of persons admitted to such homes from the Borough in 1961 was 22, one of whom was brought to our attention first in the year 1953, one in 1956, one in 1958, and one in 1961. It has been ascertained from the Area Medical Officer that 456 Southall people were given Home Help during the year, and of these 391 consisted of chronic sick or aged persons, and of 712 persons who were assisted by the Home Nurses, 391 were of age 65 or over, 159 male and 232 female. Many voluntary associations contributed to provide Christmas parcels or special comforts for old people. Meals on Wheels Service: During the year mid-day meals on four days per week were provided for house-bound old people in need of the service. In 1961, 13,154 meals were delivered, an increase of 2,217 over the 1960 figure. One hundred and fifty-seven old persons were assisted by means of this scheme during the year. The maximum number of old people receiving the meals on any one day was 77, so that both vans were working to capacity on many occasions. Special Christmas dinners (frozen pack) were delivered to 84 people and also to them went 84 special parcels to cover the Christmas period when meals were not being delivered. 25 Chiropody Service for Old People: This service was continued throughout 1961. Five local chiropodists gave their services at cheap rates for Old Age Pensioners. In 1961, Middlesex County Officers were empowered to proceed with a scheme for the increase in the provision of chiropody as part of the County Health Services, and 56 patients had attention during the year at the Northcote Avenue Clinic, of whom a proportion were elderly persons. The County Council was able also to offer financial assistance to voluntary organisations providing chiropody, and the Southall Old Peoples' Welfare Committee treated 858 under this scheme. Holidays for Old People: The holiday scheme whereby old people get a seaside holiday during off season months of May and September, at reduced rates, continued during 1961 and was operated by the various Old People's Clubs in the Borough. In addition, the Southall Old People's Welfare Association sent 40 old age pensioners for one week's free holiday by the sea. Two day outings were arranged by this Association for 39 elderly housebound. Clubs for Old People: Old Age Pensioners Federation—Southall No. 1 Branch: This Club had a membership of 180 and met once a week for social purposes, attendances being high during the summer months but not so good during the winter. Seaside outings were arranged on three occasions during the summer also. St. Anselm's "Over Sixties" Club: Formed in 1956 with only a few people, had a membership in 1961 of 145. The Club met weekly on Tuesdays and had an average attendance of between 100 and 120. The meeting was social with entertainment and refreshments. Four free outings were arranged to the seaside and a birthday party, a Christmas party and a visit to a Christmas Pantomime, were arranged during the year. The members of this Club are visited when sick. The Silverthreads Group: This Club had a membership of 120, meeting once a week on Thursdays at the Community Centre, with an average attendance of 90. The Club is a social one, and entertainment was provided for the members each week. There were two coach outings, a birthday party, a Christmas party and a harvest festival also arranged. The Darby and Joan Club: This Club met weekly and had a membership in 1961 of 66 with an average attendance at each meeting of about 50. The meetings were social, entertainment being provided and refreshments. Summer outings and Christmas parties were arranged. This Club also encouraged the doing of handicrafts by its members. The Allenby Old Age Pensioners Club: This Club met weekly on Wednesdays, had a membership of 120 with an average attendance of about 100. The Club is social and entertainment and refreshments were provided at each meeting. Five seaside outings were arranged by this Club, the organiser of which takes a special pride in the fact that the Club is entirely self-supporting. The United Old Folks Club: The average attendance at this Club was 180—200. Meetings were once a week on Mondays and these were social with entertainment provided. The members had three free outings to the seaside, 164 persons going on each occasion. Fifty-two members went to Hunstanton for two weeks' holiday, six of these were paid for out of Club funds, the rest paid for their board and lodging themselves. Transport and trips were, however, 26 provided free for all. A Christmas party, Christmas parcels and gifts for the sick were also provided from this Club and a free pantomime outing. St. John's Old Folks Club: This is a social Club with entertainments and outings and the average attendance at the weekly meetings was 43. Other Services: A service for the provision of cheap laundry and a cheap boot and shoe service are available for old age pensioners. The North Thames Gas Board offers a free service of inspection of the gas appliances and service pipes in houses of old age pensioners living alone. The reason for this is to reduce the risk of gas poisoning, a frequent cause of home accidents and fatalities in old people. The offer includes free replacement of faulty pipes and the free repair of faulty appliances. To take advantage of this offer, lists of old people living alone are submitted from the Public Health Department and in due course the homes of the person nominated on the lists are visited by the Gas Board Officers. Fresh lists continued to be supplied from time to time. A visiting library service for old people who were housebound was started early in 1959—operated by the Southall Old People's Welfare Committee, and with distribution assisted by various young people's groups. This has proved to be a very successful scheme, not only because the elderly obtain reading material without effort, but because the voluntary visitors who include young people from the Girl Guides, give pleasure by their interest in the old people. Southall Association for the Occupation of the Elderly: The Work Centre for the Elderly situated in the Municipal Sports Ground, and maintained by a voluntary association supported in part by Middlesex County Council and Southall Borough Council, continued to operate throughout 1961. Various types of simple work were carried out by the old people in quite a satisfactory way, indeed, as the firms supplying the work were expected to pay the proper rate for work, it was essential that the work should be completed to their satisfaction. The number of workers at the end of the year was 50, and various types of work were carried out, carding buttons, trimming and stamping of metal bolts, trimming of rubber, sorting of porcelain fittings, etc., and the old people could be put on the jobs which were most suited to their capabilities. Any old age pensioner is eligible to apply for work under this scheme and once taken on is kept on whether his or her output can be considered significant or not. It is realised by the workers that a flat rate of 10/- per week for a ten hour week is certainly much less than the younger healthy pensioner would be able to obtain in the labour market, but they also realise that as they grow older or ill and less able to do very much work this wage will continue the same. The scheme can never become self-supporting, but it is showing great benefits in the social and even physical well-being of the people who are working. There is a very happy atmosphere in the work rooms. Cups of tea are provided during the morning and afternoon sessions. National Assistance Act, 1948, section 47: National Assistance (Amendment) Act, 1951; No case was dealt with under these powers during 1961. 27 HEALTH EDUCATION Throughout the year, person to person propaganda continued. Every home visited, every social contact of the staff of the Public Health Department results in some item of health information or advice on good healthy living being given, and it is important that advice should be repeated over and over again, particularly if it has been sought by the questioner. The whole purpose of the Public Health Department of a Council is to endeavour to provide an environment in which optimum health can be attained by everybody and to teach the public then to live in this good environment in a good way so that disease disaster and crippling injury may not cause the doctors' surgeries to be full, and hospital waiting-rooms and beds to be occupied. There is still too much talk of more and better hospitals instead of fewer and healthier patients. Hospitals are necessary evils but should always be considered as such, and it is a wonderful thing that children's hospitals, tuberculosis hospitals and infectious disease hospitals throughout the country have become derelict from lack of patients and that the surgical specialists for these patients have had to turn to other specialties or do general medical or preventive work. Health education by poster and leaflet publicity begins to fail of its effect because of the pressure of trade advertising, and the ears and eyes of the general public are becoming resistant to bombardments of propaganda on any subject at all, so that health education must be subtle and continuous. At a Seminar held by the Central Council for Health Education in the early part of 1961 this subject—Mass Media in Health Education—was discussed very thoroughly and it seemed to be generally agreed that television still was a most powerful force for putting over health education. In this Borough, all the mass methods are used at varying times and in varying ways. Posters on topical subjects are displayed on many noticeboards thoughout the town, these posters being changed from time to time. In 1961 special emphasis was laid on two subjects, Home Safety and the Prevention of Litter. The Royal Society for the Prevention of Accidents was having a campaign for some months about the prevention of accidents from burns and scalds, and the local publicity was timed with the Society's regional and national publicity. The dropping of waste paper and cigarette ends has seemed to many people to have little connection with public health but in fact, of course, this is far from the case and still, in spite of publicity, in spite of the risk of incurring a penalty in the Court, day after day the streets are seen to be littered with food bags, cores and skins of fruit, sweet papers and cigarette ends all or any of which may at the start or later contain food poisoning or other dangerous germs. Children often pick up these dropped articles which may have a bright and attractive shining surface and so a chain of infection can be established straight away. During the period when anti-litter posters and other publicity on the subject, including press publicity, were being distributed in Southall, a competition was organised amongst school children who invented and drew or painted anti-litter posters, some with slogans and some without. These posters were done in class. The best went forward for judging and the prize winners' posters were first displayed in the Town Hall Council Chamber and later in the shop windows of a number of local traders. Small prizes were awarded for the best entries which indeed showed very much the inventiveness and power of observation amongst the children who were all of primary school age. It is to be hoped also that the fact of doing this work will have registered a life-long recollection that to drop discarded articles in the street is a bad thing to do. 28 ACCIDENTAL DEATHS The number who died as a result of accident other than motor vehicle accident was lower—14 in 1961 compared with 24 in 1960. Six of the accidental deaths were the result of accident in the home, and three happened in hospital. Six elderly persons died from the consequences of falls, three from accidents at home and three from accidents in hospital. Two persons were found drowned; one died from septic poisoning following a comparatively trivial crushing injury, one man at work was struck by a falling object, one was asphyxiated in a fire at home, one died from coal gas poisoning at home, and one by inhalation of vomit at home. A child died following a blow at play. There were eight suicides, three swallowed drugs, one drowned, and four died from gas poisoning, the ages of these varied from 29 to 66. 29 ROAD SAFETY Seven persons (6 adults, 1 child) were killed in street accidents in Southall during 1961. Details are as follows:— Persons Killed Type of Road User Cause of accident Age Sex Public Service Vehicle Passenger Double-decker Motor Bus travelling south when passenger on the bus and standing on the platform fell off into the roadway 16 F Pedestrian Two pedestrians crossing road from south to north (40 yards east of a pedestrian crossing) when vehicle travelling east collided with both. The driver had apparently sounded his horn, the pedestrians hesitated and as the car moved forward again they started to move again and the driver braked but skidded into them. 65 F Motor Cyclist Solo Motor Cyclist travelling west apparently lost control and collided with bus stop standard 26 M Motor Cyclist Vehicle 1 travelling east overtook vehicle 2 on a left-hand bend, then hit vehicle 3 and then hit vehicle 4 which was travelling west. Rider of vehicle 1 was then hit by vehicle 2. 18 M (Vehicle 1—Solo Motor Cyclist Vehicle 2—Scooter Vehicle 3—Pedal Cyclist Vehicle 4—Lorry) Pedal Cyclist Pedal Cyclist rode from east kerb to west kerb across the path of a south-bound Private Motor Car and was knocked to the ground 12½ M Pedestrian Light Goods Vehicle facing south in Lady Margaret Road waiting to turn right into Cranleigh Gardens. Private Motor Car travelling south overtook on nearside and pedestrian stepped from east kerb of Lady Margaret Road and was knocked down by Private Motor Car 78 F Pedestrian Vehicle 1 (Private Motor Car) was travelling south. Vehicle 2 (Milk Float) was stationary against west kerb and Vehicle 3 (Private Motor Car) stationary against east kerb. Pedestrian ran across road from behind vehicle 3 and was struck by Vehicle 1 and knocked into Vehicle 2. 86 F 30 Persons Injured Adult School Age Under 5 Serious Slight Serious Slight Serious Slight Pedestrians 13 Total 66 53 6 Total 36 30 — — Pedal Cyclists 11 Total 94 83 6 Total 35 29 — — Private Motor Car Drivers 2 Total 45 43 — — — — Private Motor Car Passengers 5 Total 42 37 1 Total 6 5 — — Motor Cyclists 10 Total 70 60 — — — Scooter and Moped Riders 4 Total 35 31 — — — — Drivers of other vehicles 1 Total 11 10 — — — — The year showed a very bad rise in the motor vehicle accident figures for Southall. The total of persons killed or injured was increased by 62 over that of 1960, a boy cyclist was killed, and the number of children injured was up from 37 in 1960 to 82 in 1961. Of the seven dying as a result of motor accidents in Southall three were Southall residents and this included the 12 year old boy; three other Southall residents died as a result of motor accidents received when they were away from home. 31 Persons Injured (continued). Passengers in/on other vehicles 3 Total 38 35 Total 4 4 — — Equestrienne — — Total 1 1 Summary Persons killed 6 Adults 1 Child Persons injured Serious: 49 Adults 13 Children Slight: 352 Adults 69 Children 401 Adults 82 Children SANITARY CIRCUMSTANCES OF THE BOROUGH Water Supply and Water Services Water is supplied to nearly the whole of the district by the South-West Suburban Water Company. The Metropolitan Water Board supplies a small area in the southern part of the district, and the Rickmansworth & Uxbridge Valley Water Company a small area in the northern part. The supply is satisfactory, both in quality and quantity. Reports on sampling carried out by the Metropolitan Water Board are issued from time to time. All inhabited houses are supplied from public water mains and there are no standpipes in use on mains. Under Section 35, Middlesex County Council Act, 1956, provision is made for immediate action to be taken by the Local Authority to restore a water supply which has been cut off for some default. One sample of shallow well water from an allotment site was taken and found to be contaminated too much for it to be used for the purpose of watering growing plants to be used for food. A faulty sample from the water supply of a private dwelling was the subject of much investigation and work had to be carried out on the drainage system to secure improvement. Sewerage Middlesex County Council provides the facilities for purification of sewage from the Borough at the Mogden Sewage Works. The amount of congestion occurring in the drains and sewers of the Borough, partly as a result of increase in the number of houses and shops, partly due to the fact that improved knowledge of hygiene results in an increased use of water for cleanliness meant that problems have arisen of overcharging of sewers, and of flooding during periods of heavy rain. Measures to relieve this have had to be taken, and the latest position with regard to these improvements is as follows:— Surface water drainage was installed in parts of Dormer Wells Lane and Tentelow Lane not previously served by surface water sewers and the risk of flooding in these roads is reduced. Work was in progress throughout the year on the Southern Soil Relief Sewer. This scheme will be completed during 1962. British Waterways installed a septic tank to deal with sewage from the cottages at Bulls Bridge and only two pail closets remain at these cottages. The only other pail closets emptied by the Council are two at "Springdale". There are two cesspools emptied by the Council's gully emptier—one at "Springdale" and one at Wyke Green. Sanitary Inspection of the District The total number of inspections of premises made during the year by the Public Health Inspectors was 8,457. Table XI gives an analysis of the number and nature of such inspections. There was a considerable rise in the amount of visits carried out under the Clean Air Act (Smoke Control Areas) requirements. The progress of this work is speeding up as the difficult early problems have gradually been overcome and a routine of survey, enquiry, report and assessment established. These visits served multiple purposes, as any sanitary defects in the houses visited would be brought to the notice of a health inspector calling even though the purpose of his call was specific. The 1961 figure of 3,081 inspections in connection with the Clean Air Act compares with 2,484 in 1960 and 1,708 in 1959. An unpleasant feature of the Sanitary Inspection figures is the rise in the number of visits required in connection with vermin, both as regards disinfestation and as regards rats and mice control. Market There is a market, part open, part covered, in the High Street where a weekly horse 32 and cattle sale was held on Wednesdays and a general sale of market produce and goods was held on Saturdays. Special attention was paid regularly to the hygienic provisions and maintenance there. In addition, travelling fairs and circuses spend periods in the Borough, three to four times a year, and require supervision. School Sanitation, Ventilation and Lighting Schemes for the improvement of sanitary conditions in Southall schools made progress during the year as follows:— Featherstone Road Junior Mixed—Conversion of one classroom, to twelve water closets for girls and eleven washbasins, one drinking fountain, hot and cold water to the washbasins, completed in September, 1961. Featherstone Road Infants —New sanitation being provided. Work in progress. Western Road Girls —Scheme in progress of modernising toilets—in alteration of junior school to senior school. Bad arrangement in the Canteen at Lady Margaret Road School was brought to the notice of the Education Authority during 1961, but at the end of the year the work desirable to meet the requirements of the Food and Drugs (Hygiene) Regulations had not been completed. The Borough Council provides the number of dustbins required for the removal of school refuse. Eradication of Bed Bugs and Fleas Statistics for the year:— (a) Number of Council houses (1) found to be infested 5 Total 14 (2) disinfested during the year 5 (b) Number of other houses (1) found to be infested 9 (2) disinfested during the year 9 In June reports were received of a 'plague of fleas' in a group of houses in the southern side of the Borough near the canal. Eighteen houses were visited and treatment for fleas given for 14 rooms. Canal Boats Southall is not a registration authority for Canal Boats. Inspections are carried out in the Boroughs having mooring depots for these boats as a routine procedure and only rarely is there need for interference by any officer of Southall—no report was necessary during 1961. Mortuary and Post-Mortem Room The mortuary, situated in Havelock Road, provides adequate accommodation for the Borough but is little used. No bodies were deposited in the mortuary during the year. One hundred and two bodies were deposited in the mortuary at Acton and fifty-seven bodies in the mortuary at Uxbridge, for post-mortem purposes and coroner's inquest if necessary. 33 Factories Act, 1937 The following tables give details of the work done in connection with the factories and outworkers in the Borough:— Inspections Factory Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 12 3 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 175 89 - - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) - - - - Totals 187 92 — — Defects Found Particulars Number of cases in which defects were found Found Remedied Referred Number of cases in which Prosecutions were instituted To H.M. Inspector By H.M. Inspector Want of cleanliness - - — - - Overcrowding - — — — — Unreasonable temperature - — — — — Inadequate ventilation - — — — — Ineffective drainage of floors — — — — — Sanitary Conveniences— (a) Insufficient - — — — — (b) Unsuitable or defective 6 6 — — — (c) Not separate for sexes — — — — — Other offences against the Act (not including offences relating to outwork). - - — — — Totals 6 6 — — — 34 Outworkers Nature of Work Section 110 Section 111 No.of outworkers in August List required by Section 110 (1) (c) No. of Cases of Default in sending Lists to the Council No. of Prosecutions for failure to supply Lists No. of Instances of Work in Unwholesome Premises Notices Served Prosecutions Wearing Apparel—Making . . 20 - - - - - Stuffed Toys 1 — — — — — Artificial Flowers 1 — — — — — Totals 22 — — — — — The Rag Flock and Other Filling Materials Act, 1951 There are no premises in the Borough subject to registration or licence under this Act. Premises where upholstery is reconditioned and secondhand articles sold are included in the list of general inspections. 35 HOUSING Of the 83 houses included in the provisional programme of slum clearance submitted to the Minister of Health in 1955, 19 still remain to be dealt with. A further five years programme of 72 houses was approved by the Ministry of Housing and Local Government on the 17th August, 1961. During 1961 one house was closed by undertaking to use by way of business only and four almshouses were demolished on the operation of demolition orders. Improvement Grants (Housing Act, 1949, as amended by the Housing (Financial Provisions) Act, 1958). Thirty-eight applications were received and thirty-eight were approved for grant for property improvement. The improvements in standards of housing resulting from the use of this type of grant and from the repair conditions by which increased rents can be obtained under the Rent Act, 1957, make a useful, although very slow, advance in the attainment of good environmental conditions for healthy living. In all up to the end of 1961 only 117 of these applications have been approved. Certificates of Disrepair (Rent Act, 1957) During the year 9 applications were received, 9 proposals to issue certificates were approved. Two certificates of revocation of the disrepair certificate were approved. Overcrowding More visits were required in 1961 to be paid for estimation of overcrowding and fourteen cases of new overcrowding were confirmed. Thirty-nine cases of overcrowding were relieved during the year. The number remaining on the Department's register of overcrowding at the end of the year was 35 dwellings, which is a decrease of twenty-five on last year's figure. For further details see Table XII, page 63. Rehousing of Applicants for Council Dwellings Council Housing within the Borough The number of families obtaining Council accommodation for the first time in 1961 was 59. Twenty-three old age pensioners, or pension age married couples, were moved into old people's dwellings. New Town Housing The total number of families removing to New or Expanded Towns: 25 families nominated under the Industrial Selection Scheme up to April, 1956 (since when the Council has had to pay subsidy for every family moving from this Borough to New or Expanded Towns). In addition 50 families who had found their own accommodation in one of the New Towns were subsequently accepted as Council nominees. The total number of families who have moved to New or Expanded Towns since that date is a further 260, forty-five families having been rehoused in this way during 1961. Modernisation of Council Houses There were 426 houses, built between 1930 and 1936, which still had old ranges with hot water supply, except where the tenents themselves installed modern fireplaces. Fiftynine of these ranges were replaced by the Council during 1961, making a total of 289 modernised up to the 31st December, 1961. Two houses purchased by the Council were improved by the provision of bathrooms. Houses Let in Lodgings At the end of the year 249 houses had been ascertained to be in multiple occupation. 36 The relevant sections of the Public Health Act, 1936 were applied as fully as possible to the conditions where deterioration of hygiene standards occurred. The Housing Act, 1961, came into force on the 24th November, 1961, affording a measure of new control. The Council immediately commenced consideration of new standards to be applied in 1962. Middlesex County Council Act, 1944—Section 345 The caravan site at the junction of Regina Road and Pluckington Place continued to be used as the winter quarters of a member of the Showmen's Guild. One family still occupied a caravan near the Grand Union Canal, at Bull's Bridge. New Housing The following details have been supplied by the Borough Engineer, outlining the complete amount of house building for Southall since the end of the war. Built by Southall Borough Council During the Year 1961 Since the End of the War (including 1961) Within the Borough Outside the Borough Within the Borough Outside the Borough Old People's Dwellings 34 — 117 12 Houses — — 330 136 Flats — — 390 144 Prefabricated Houses - — 299 - Twenty-one of the temporary prefabricated bungalows have now been demolished and the tenants transferred to permanent housing leaving 278 still standing. Built by Private Enterprise During the Year 1961 Since the end of the War (including 1961) Within the Borough Outside the Borough Within the Borough Outside the Borough Old People's Dwellings — - 20 - Houses 11 — 298 — Flats 6 — 106 - Prefabricated Houses — — — — 37 HYGIENE OF FOOD Food Poisoning Four notifications of food poisoning were received during 1961. All of these were confirmed bacteriologically as being due to infection with the organism Salmonella Typhi Murium. On the 22nd December, information was received from the Medical Officer of a large local factory that twenty-four persons appeared to be suffering from food poisoning after eating a canteen meal. Five hundred persons took this meal and during the next day and the day following a total of 39 persons were reported as having symptoms of gastro-enteritis. Faeces specimens from six of the seven affected persons whose homes were in Southall revealed no pathogenic organisms. Samples were taken of turkey, stuffing, pork, ham and gravy and all of these gave positive cultures of Staphylococcus Aureus. Vegetables gave negative results. Personal Hygiene The free washing facilities in the public conveniences, which were brought into operation in September, 1950, continued to be available throughout 1961. During that period 7,600 paper towels were issued free, and also 3,898 linen towels, which were provided at a cost of 2d. per person. Milk The Milk (Special Designation) Regulations, 1960 transferred licensing to the food and drugs authority which for this area is the Middlesex County Council, (See report of Public Control Officer, pages 39, 40 and 41). Thirty-two distributors of bottled milk were registered under the Milk and Dairies (General) Regulations, 1959. Ice Cream The Ice Cream (Heat Treatment, etc.) Regulations, 1947-1952. As there were no manufacturers in the Borough, temperature control observations, as laid down in these Regulations, were not required. Routine work was carried out under Article 4 of the 1947 Regulations to check the conservation of ice-cream in cinemas. Food Sampling The bacteriological analyses of 218 food samples, taken during the year, were carried out by the Public Health Laboratory Service. One hundred and fifty-eight of these specimens were ice-cream samples, covering ten makes of ice-cream, and following bacteriological analyses the ice-creams were graded as follows:— Excellent 109 Satisfactory 43 Doubtful — Unsatisfactory 6 These ice-cream figures were very much improved on those for 1960, and as our local control is much more strict than elsewhere, being based on a bacterial count rather than the rough chemical one, which is sufficient for statutory requirements, this is very satisfactory. Forty-two samples were taken of imatation cream. The results of these were all satisfactory. 38 Other samples taken:— Turkey Unsatisfactory Pork Unsatisfactory Ham Unsatisfactory Gravy Unsatisfactory Stuffing Unsatisfactory Brussels-Sprouts Satisfactory Custard Satisfactory Peas Satisfactory Apple Satisfactory Baked Potato Satisfactory Boiled Potato Satisfactory Christmas Pudding Satisfactory Cranberry Sauce Satisfactory Mince Tart Satisfactory Dessicated Coconut Unsatisfactory Ice Lolly Satisfactory Rinse water of ice-cream server (2) Both samples satisfactory The first fourteen samples were taken in connection with the food poisoning outbreak at a local factory and a report on this is to be found on page 38. The only other unsatisfactory result was from dessicated coconut—no food poisoning organisms were found, but advice was given regarding the desirability of cooking coconut before using. Satisfactory communication has been maintained during the year with the County Public Control Department, and the report on the work carried out in Southall by the staff of that Department is as follows:— Article Total Samples Taken Unsatisfactory Milk (new) 26 — Milk (various) 14 2 Arrowroot 3 — Butter 13 1 Cakes and Biscuits 3 1 Cream 11 — Drugs 4 — Fish 17 1 Fruit (fresh) 16 2 Fruit (canned) 3 — Ice-Cream 8 — Liver and offal 6 — Margarine 2 — Meat 23 3 Preserves 2 — Sausages 6 2 Soft Drinks 2 — Spirits 9 1 Vegetables 10 — Vinegar and Non-Brewed Condiment 12 2 Miscellaneous 2 — Total 192 15 39 Milk and Butter One sample of milk which was found to be unsatisfactory contained a considerable amount of foreign matter consisting of mould spores with some hyphae in a base of congealed milk. After full investigation the dairy was sent a strong letter of caution. The other sample of milk was a third-of-a-pint bottle for consumption by a scholar at a school and the milk contained part of a metal foil cap. The cap was sterile. A letter of caution was sent to the dairy concerned. A sample of butter which was procured from a retail shop was found to contain 16.5% of water which is slightly in excess of the statutory limit. It proved impossible to obtain further samples as this particular brand of butter had been withdrawn by the manufacturers. In the circumstances no further action was taken. Biscuits Packeted biscuits were found on sale in Southall described as "Bourbon with real chocolate filling". The filling was found not to be "real" chocolate but a soft filling which had chocolate as one of its ingredients. The manufacturer, when the matter was drawn to his attention altered the description to"Bourbon biscuits with genuine chocolate cream filling". Fish A cafe sold in "fried plaice and chips" a dab. Further samples taken at a later date were satisfactory. No action was taken therefore in respect of the original sample. Fruit An official caution was sent to a greengrocer who sold as "Newtown" apples Lavine apples which were of Italian origin. The Newtown is a more highly prized apple. Meat and Meat Products A butcher sold minced beef which contained the preservative sulphur dioxide. Further samples taken from the same butcher were found to be free of preservative and no action was taken in respect of the incorrect sample. Another butcher who sold minced beef containing sulphur dioxide was prosecuted. He was given an absolute discharge. An official caution was sent to the same butcher in respect of undeclared preservative in sausages. An official caution was sent to two other butchers in Southall in respect of the sale of sausages which in each case contained undeclared preservative. Spirits A sample of gin procured from licensed premises was found to be 32.5 U.P. To be genuine the gin should have been 30 U.P. Follow-up samples were satisfactory and for this reason no action was taken in respect of the original adulterated sample. Vinegar An official caution was sent to a greengrocer who sold vinegar deficient in acetic acid. The deficiency was caused by a long period of storage in the retail shop. In respect of a sample of vinegar which on analysis was found to be a solution of dilute acetic acid (commonly known as non-brewed condiment) another greengrocer was prosecuted and was fined £5.5.0d. and ordered to pay £5.5.0d. towards the costs. Merchandise Marks Acts, 1887-1953. Inspections were carried out under the above Acts to ensure that the requirements of the various Marking Orders relating to the indication of origin of imported foodstuffs are applied. Inspections were made at 201 premises and a total of 669 displays were examined. Minor breaches of the Orders were dealt with by verbal warning. One infringement was reported. This was a case in which three joints 40 of beef were described by means of a ticket in the window as "Scotch". The beef was identified by an officer of the Department as of Yugoslav origin. The butcher was prosecuted and was fined £10 on each of three summonses. Safe Milk. From the 1st January, 1961 the County Council became the licensing authority for the issue of licences to dealers with premises within its area and 44 such licences were issued in respect of the sale of milk to which the special designations "pasteurised", "sterilised" and "tuberculin tested" could be applied. The period for which these licences were granted has been extended from one year to five years. Fifty-eight samples of milk were obtained to test that heat treatment and subsequent storage were properly carried out. One was not satisfactory, in that it failed the methylene blue test. This was found to be due to unsatisfactory storage at the retail shop. The prescribed notice of warning was sent to the shopkeeper. Forty-four inspections of premises were made to ensure proper compliance with the Milk (Special Designation) Regulations, 1960. Eight samples of raw milk were procured in Southall and tested for the presence of tubercle bacilli. None was found to be infected. Labelling of Food Order, 1953. The Labelling of Food Order requires prepacked food to be marked with the name and address of the packer or labeller or to bear a registered trade mark; to be marked with its common or usual name and to bear a statement of ingredients if the food consists of more than one ingredient. It also controls the manner in which the presence of vitamins and minerals is disclosed. In the Borough of Southall a total of 69 premises were visited and 226 items of food were examined for compliance with the Order. One infringement was disclosed. In this case ice lolly crystals were on sale without a statement of ingredients. The manufacturer was sent a letter of caution. Labelling and Advertising Infringements. In addition to the detail given above, a considerable volume of work was done in the period under review, which did not arise from samples procured in the Borough of Southall, but which had the effect of protecting the residents in each county district. The matters dealt with were in respect of nationally retailed articles of food. Several manufacturers were required to designate the ingredients on labels of Instant Coffee. As a result of a complaint of the taste of a soft drink, investigations made in the Department showed that there was phenolic contamination which arose from a chemical reaction between chlorinated water and the phenol formaldehyde stopper. The manufacturer has modified the ingredients of this product to prevent the chemical reaction. The manufacturer of a non-alcoholic wine was challenged on the ground that the description was a contradiction in terms, and the label was amended to 'non-alcoholic beverage'. The importer of a slimming food was challenged on claims made in advertising literature as to the Vitamin concentration, and the literature was corrected. A manufacturer's claim of slimming properties for "reducing perles" was challenged and the product withdrawn. The claim relied on the presence of purgatives and bladderwrack. The slimming claims made for a lemon juice in a television advertisement were modified after the manufacturer had been challenged as to the efficiency of the product as a slimming agent. Modifications to the labels of several brands of canned chicken were secured, where it was not apparent from the label that the contents of the cans were not solely chicken, but chicken in jelly or broth. Meat Inspections No slaughtering of meat is carried on in Southall. 41 Food Premises—Inspection The number of food premises in the Borough, by type of business, is shown as follows Shops 337 Greengrocers 51 Grocers 115 Confectioners 96 Fish Fryers 11 Bakers 17 Butchers 35 Fishmongers 12 Catering Establishments (including Canteens) 131 Food Factories 19 487 Premises required to be registered are as follows:— Food & Drugs Act, 1955, Section 16. Fish Curing 6 Manufacture of Sausages or Preserved Food 32 Manufacture of Ice-Cream — Sale only of Ice-Cream 157 Manufacture and Sale of Iced-Lollies — Middlesex County Council Act, 1950, Section 11 Premises of Street Traders 9 The following table shows the quantity of food examined and the disposal of condemned food. Total Inspected (lbs.) Sound Unsound Total (lbs.) Stock (lbs.) Production (lbs.) Consumption (lbs.) Total (lbs.) Animal Feeding (lbs.) By Products (lbs.) Destruction (lbs.) Canned 2.069½ - — - — 2,069½ 113½ — 1,955¾ Raw 5,450 — — — — 5,450 — — 5,450 Totals 7,519½ — — — — 7.519½ 113½ — 7,405½ 42 Food Hygiene Food & Drugs Act, 1955 Food Hygiene Regulations, 1955-1956 The general standard of food premises in the Borough is good and visits to all premises are carried out from time to time to secure that the standard is maintained. Contraventions Found Remedied Articles/Equipment not kept clean 8 8 Articles/Equipment not in good order 2 2 Containers not protected from contamination — — Food so placed as to involve risk of contamination 2 4 Food placed within 18 inches of ground and not adequately protected 6 6 Waterclosets not kept clean and in efficient order 2 4 Insufficient lighting and ventilation to waterclosets 4 4 Absence of "Wash your hands" notices in waterclosets 2 2 Absence of suitable and sufficient wash hand basins 2 5 Absence of hot water at a suitably controlled temperature over wash hand basins 5 5 Absence of soap, nail brushes, clean towels, etc., near wash hand basins 2 2 Absence of First-aid materials 4 5 Absence of suitable and sufficient sinks for the washing of food and equipment - 1 Absence of hot water at a suitably controlled temperature over sink - - Absence of soap, clean cloths, etc., at sink 3 5 Absence of suitable and sufficient ventilation in food rooms — — Walls, floors, etc. not kept clean 2 6 Walls, floors, etc. not kept in good order 5 3 Covered receptacle for refuse not provided 2 4 Accumulations of refuse, etc. 2 4 Rodent infestations 9 8 Miscellaneous 2 2 Totals 64 80 These figures are very encouraging as they show a 30 % drop on faults found and a 20 % rise on faults remedied when compared with the previous years figures—a sign of the growing consciousness of the value of clean hygienic circumstances in the handling of food. No pressure was needed or enforcement by law to get this good result. No prosecutions were taken under Section 2 of the Food & Drugs Act. 1955, 43 Unsound Food The following table shows items of unsound food which were investigated during the year, and the action taken. Subject of Enquiry Action Metal in Toffee Prosecution. £25.0.0 Fine £ 5.5.0 Costs Beetle in loaf Warning Letter Blowfly eggs on Luncheon Meat Prosecution under Food Hygiene (General) Regulations following inspection of shop. £25.0.0. Fine. £5.5.0. Costs Beetle in Loaf Warning Letter Mould on Crumpets Warning Letter Discoloured Chocolate Warning Letter There was a prosecution against a hawker of 'hot dogs' for contraventions of the Food Hygiene (General) Regulations, 1960, and failure to register as a hawker of food under the Middlesex County Council Act, 1950. Fines of £42.0.0. with £5.5.0. costs were imposed. In addition, the County Public Control Department (see page 40) issued warnings in the cases of:— (1) a sample of milk containing mould. (2) a bottle of school milk containing a metal foil cap. 44 ATMOSPHERIC POLLUTION The amount of smoke, grit and sulphur dioxide in the atmosphere over the Borough of Southall continued to be recorded during the year 1961 at the five sites at which recordings have been carried out for previous years. In addition, the station which was established in 1959 at the Manor House, for the estimation of smoke and sulphur dioxide pollution by the volumetric method, whereby air is drawn through two filters, one dry and one liquid, continuously and the amount of atmospheric pollution calculated every 24 hours from the matter deposited on the filter, and from the amount of sulphur taken up by the liquid, continued to operate during 1961. For 1961 results see page 46. The results obtained from the five sites, i.e. Recreation Ground and Railway Allotments—lead peroxide method, Hortus Cemetery, New Primary School, Railway Allotments —deposit gauges, are tabulated on page 50 and graphs prepared from the figures on the table are to be found on pages 47, 48 and 49. Comparison of ten years' averages at Hortus Cemetery. Total solids deposited:— 1952 11.93 1957 10.66 1953 10.67 1958 13.83 1954 14.30 1959 13.04 1955 16.94 1960 10.30 1956 12.93 1961 10.86 Comparisons with three other places, i.e. Westminster, Cambridge and Sheffield, still show that Southall is atmospherically much less impure all the year round than a highly industrial area, but the Borough is included in a large ring round and including London itself designated as a black area for atmospheric pollution under the Clean Air Act, 1956. Alterations in plant, fuels and instrumentation have continued to effect an improvement in the level of industrial smoke emissions. No routine smoke observations have been made during the year. Instead the practice is now followed of informal visits to premises where the amount of smoke emitted appears to be unnecessary, even though this may not amount to a statutory nuisance. A warning letter was sent by the Council in one case where an emission of black smoke infringed the Dark Smoke (Permitted Periods) Regulations, 1958. Eighteen complaints of nuisance from smoke were received. These mainly concerned emissions from small incinerators and indiscriminate burning of refuse. In 14 cases the nuisance was confirmed and eventually remedied. In 4 cases the nuisance was not confirmed. Smoke Control Areas Smoke Control Order No. 2 became operative on the 1st May, 1961. This covers 879 dwellings, 67 commercial premises, 6 industrial premises and 16 other premises. At the end of the year approval of adaptation in 412 houses had been given. Smoke Control Order No. 3 was made and confirmed during the year to become operative on 1st July, 1962. This covers 1,073 dwellings, 84 commercial premises, 14 industrial premises and 10 other premises. In addition the survey of Smoke Control Area No. 4 was commenced. There were two instances in Smoke Control Area No. 2 where smoke from the burning of coal was emitted after the Order came into operation. In both cases the offenders were new tenants who had no knowledge of the restrictions. The co-operation of merchants in avoiding deliveries of coal in smoke control areas would help in such cases. Acid Smuts from oil-burning chimneys A firm referred to in the last annual report as having a chimney emitting acid smuts during the winter months from an oil fired central heating boiler, agreed during the year to replace their metal stacks with stacks specially designed to prevent this nuisance. 45 Volumetric Method The daily mean concentration of smoke and sulphur dioxide is measured by volumetric apparatus in the Manor House. The gauge faces west and a main road in a built up area of residential and commercial premises. The term "smoke" is used to denote all fine suspended impurity collected by the test filter and expressed as milligrams per 100 cubic metres. The term "sulphur dioxide" includes all acid producing gases in the air with the exception of carbon dioxide and is the net acidity of the air calculated until March 1961 as sulphur dioxide and expressed as parts per 100 million parts of air, but from April 1961 the method of calculation was altered by the officers of the Fuel Research Station and from that time the calculation was in microgrammes per cubic metre of air, so comparison with previous years is not possible—only the figures for the final nine months follow:— SMOKE Microgrammes per cubic metre SULPHUR DIOXIDE Microgrammes per cubic metre Monthly Average Highest Daily Average Monthly Average Highest Daily Average April 10 77 128 257 May 40 70 82 137 June 34 90 76 166 July Apparatus not in operation August 25 70 61 177 September 53 110 181 532 October 33 180 129 277 November 137 372 246 841 December 236 646 415 994 46 Graph C Atmospheric Pollution by Sulphur Oxides (Lead Peroxide Method) 47 Graph D Atmospheric Pollution Estimation—Deposit Gauges at Hortus Cemetery, Railway Allotments and New Primary School Total Solids, Soluble or Insoluble (Tons per square mile per month). 48 Graph E Atmospheric Pollution by Sulphur Oxides Determined by the Lead Peroxide Method Comparison with Other Districts These figures are printed with the permission of the Authorities concerned. 49 Atmospheric Pollution Estimation Month of Year Sulphur Trioxide Lead Peroxide Method, Milligrams per day per 100 sq. cms. DEPOSIT GAUGES Rainfall in mms. Tons per Square Mile per Month Soluble Insoluble Total Recreation Ground Railway Allotments Hortus Cemetery Dormers Wells School Railway Allotments Hortus Cemetery Dormers Wells School Railway Allotments Hortus Cemetery Dormers Wells School Railway Allotments Hortus Cemetery Dormers Wells School Railway Allotments 1960 1961 1960 1961 1960 1961 1960 1961 I960 1961 1960 1961 1960 1961 1960 1961 1960 1961 1960 1961 1960 1961 1960 1961 1960 1961 1960 1961 January 3.36 2.29 3.89 2.69 44.0 63.0 38.0 56.0 45.0 57.8 5.94 3.93 2.73 3.49 2.85 3.85 7.06 4.91 3.36 3.46 10.35 10.9 13.0 8.84 6.09 6.95 13.20 14.75 February 2.44 1.99 3.51 2.89 49.0 54.8 42.0 50.2 4/.0 50.8 1.25 1.73 5.60 1.46 — 2.95 5.65 4.56 3.36 3.97 11.45 10.2 6.9 6.29 8.96 5.43 — 12.97 March 3.43 2.26 3.71 2.58 3.7 3.0 28.0 2.0 38.0 1.0 4.0 3.62 4.46 3.94 6.30 4.10 4.0 4.18 4.04 1.98 16.5 7.41 8.0 7.80 8.50 5.92 22.8 11.51 April 0.74 1.68 1.50 2.76 10.5 54.4 4.54 51.7 13.6 53.2 7.0 4.83 3.24 7.93 8.10 5.35 8.95 7 43 2.82 6.05 7.9 14.71 10.95 12.36 6.06 13.98 16.0 20.06 May 1.50 0.97 1.93 1.36 49.0 13.0 37.0 5.0 47.0 12.0 4.56 3.41 4.56 2.96 6.30 3.72 8.60 7.84 5.64 2.88 10.43 8.91 13.16 11.25 10.20 5.84 16.73 12.62 June 1.04 0.83 1.60 1.07 21.0 32.0 29.0 16.0 29.0 31.0 3.5 4.68 3.20 4.59 4.20 7.45 5.10 8.54 7.5 3.42 11.7 15.80 8.60 13.22 10.70 8.01 15.9 23.25 July 0.43 1.09 1.35 0.80 72.19 21.8 68.8 — 74.91 23.2 3.65 2.77 4.59 2.33 4.36 3.26 3.36 7.36 3.75 3.05 13.1 10.39 7.01 10.13 8.34 5.38 17.46 13.65 August 0.48 0.69 1.23 1.03 56.2 48.6 59.3 43.1 68.5 53.0 3.60 4.59 4.30 3.57 3.70 4.22 9.20 5.24 3.74 4.74 10.1 6.76 12.8 9.83 8.04 8.31 13.8 10.98 September 1.40 1.26 2.01 2.46 86.6 60.0 83.6 52.0 89.0 59.0 4.80 5.06 4.88 5.32 5.30 6.48 6.04 5.08 3.18 3.54 8.74 26.05 10.84 10.14 8.06 8.86 14.04 32.53 October 2.10 1.9 2.64 2.33 158.0 53.0 135.4 46.0 137.0 50.0 10.6 3.58 7.66 4.14 8.65 4.86 4.7 8.76 3.94 2.76 9.9 12.19 15.3 12.34 11.60 6.90 18.60 17.06 November 1.61 2.3 3.18 2.67 91.0 55.0 83.0 53.0 88.6 56.0 5.3 8.02 6.02 2.67 6.12 7.46 2.32 5.66 2.68 3.66 12.48 6.62 7.62 12.68 8.70 6.33 18.60 14.08 December 2.66 3.2 2.72 3.41 41.0 72.0 47.0 73.0 46.0 73.0 — 9.12 4.96 9.98 10.63 10.92 2.36 6.36 5.40 3.84 2.62 23.92 9.52 15.48 10.36 13.82 12.65 34.84 Average for year 1.76 1.69 2.43 2.17 56.84 44.21 56.3 37.33 6.3 43.33 4.4 4.61 4.68 4.37 6.04 5.39 5.61 6.33 4.11 3.61 10.43 12.82 10.3 10.86 8.8 7.98 16.34 18.19 50 MISCELLANEOUS Noise Nuisance Twenty complaints of factory noise were received during the year. Twelve were remedied. One was not confirmed. Seven still remained unabated at the end of the year. Byelaws of Good Rule and Government give control of noisy animals. In 1960 a new Act for the control of noise became law—this was "The Noise Abatement Act, 1960". As the number of complaints brought was five times as great as in 1960, it seems that at least the Act has made the public more noise conscious. The complaints varied from the over-loud playing of a juke box to an industrial noise coming from premises in a neighbouring Borough. Rodent Control The following table gives details of work carried out in accordance with the policy of the Council, as outlined in previous reports. Total notifications of Rats and Mice Confirmed Non-Confirmed 182 182 — Business and Industrial 13 premises treated Domestic 169 „ „ Rats found and cleared in 107 „ Mice ,, ,, ,, ,, 75 ,, Total number of visits in 1961—1,102. Sewers Total number of manholes baited 52 Number of poison takes 9 No takes 43 Some improvement in the figures for rat infestation is shown in the 1961 figures for sewer infestation if the percentage of takes is to be taken as an index. But rats and mice will never cease to be a public health problem so long as the dirty habits of throwing about food remains and wrappings, in streets and houses, and the spilling of food material about and inside factories continues. Pet Animals Act, 1951 Six establishments were licensed during the year. The number of animals kept in each case was small and conditions have remained satisfactory. Administration of the Shops Acts Routine visiting of shops in connection with the Shops Acts Regulations continued. River Pollution Inspection of the rivers and canal of Southall during the year did not give evidence of any individual site of pollution in Southall on which action could be taken. Sampling of river water from the Brent at various stations in the County is carried out several times a year by officers of the Middlesex County Council. No premises were found during 1961 to be discharging poluting effluent into the river or canal. 51 Establishments for Massage and Special Treatment Six establishments were inspected for licence under this heading and all were found satisfactory for the purpose which was intended. Details are as follows:— Purpose No. of Licences Chiropody only 2 Massage, Chiropody and Electrical Treatment 4 Medical Examination of Borough Council Employees During 1961 a total of 79 medical examinations were carried out on applicants for Borough Council employment or members of the Borough Council staff. These examinations were carried out with regard to suitability for employment on the Council's permanent staff, for entry into the Sickness Pay Scheme, or for review after prolonged periods of sick leave. A survey of sickness absence amongst Borough Council staff during the year is shown in the table below, and the comparable statistics for the two previous years. Amongst the outdoor staff fewer people had sick leave, but the length of sickness was greater. Members of Indoor Establishment Year Staff Total Requiring Sick Leave Total days sick leave Percentage requiring sick leave 1961 165 89 1,187 54 1960 154 74 888 48 1959 157 93 1,295 59 Members of Outdoor Establishment Year Staff Total (Part-time and Full-time) Requiring sick leave Total days sick leave Percentage requiring sick leave 1961 281 127 4,561 45 1960 278 153 4.077½ 55 1959 282 206 5.509½ 73 Nuclear Radiation The increased production, transport, and use of radioactive material means that a new public health problem can arise. It has become apparent that some method of control is necessary and that a local authority requires to be informed of all possible sources of radiation within its district. Radioactive isotopes are used in industry, in hospitals and in technical schools and colleges, and it is important that as much information as possible should be available as to the precautions taken in the use of the substances, and what, if anything, has to be done about waste products. The total use in Southall is said to be still extremely minute. The Metropolitan Water Board now gives, with its monthly report on the state of the water coming into public supply, a short notice of the radio activity as estimated by the Board's Laboratory Staff, and also records the reports of the Atomic Energy Authority on the radio active content of outfalls into the Thames from the Nuclear reactors. The Radio Active Substances Act (1960) provided for the central registration and control of the keeping and use of radio active materials and the disposal of radio active waste, and enabled the central authority to notify local authorities of the existence of registered premises within their boundaries. No notifications of this nature have yet been received in the Public Health Department. 52 HEALTH SERVICES PROVIDED BY OTHER AUTHORITIES Norh-West Metropolitan Regional Hospital Board Through the Uxbridge Group Management Committee this authority maintains two hospitals in Southall, the Southall-Norwood Hospital (28 beds) for treatment of general medical and surgical cases and casualties, and Mount Pleasant Hospital (59 beds) for the treatment of geriatric cases. St. Bernard's Hospital is managed by its own Committee and is for the reception of cases of mental and nervous disorders; it has 2,507 beds and takes patients from an extensive area comprising parts of Berkshire, Buckinghamshire and Middlesex, including the Borough of Southall. Informal, temporary and compulsorily certified patients of all types are admitted, and all modern forms of treatment are carried out. Patients are now admitted informally (under the Mental Health Act, 1959) and Informal and Compulsory became the sole categories of admissions after 1st November, 1960. Other hospitals outside the Borough which are used to a considerable extent by patients from Southall are Hillingdon Hospital, West Middlesex Hospital and King Edward Memorial Hospital, Ealing. Southall cases of infectious disease mainly enter St. John's Hospital, Uxbridge, which also has facilities for the treatment of geriatric cases. The greatest number attend Hillingdon, which has all the facilities of an acute general hospital, a geriatric section and a maternity wing, either as outpatients, or as inpatients; in 1961 1,562 Southall residents had inpatient treatment in Hillingdon compared with 1,452 in 1960. 1,170 maternity mothers and babies were discharged from Hillingdon Hospital—compared with 807 in 1960. In 1961 16.42% of all the patients treated to a conclusion in Hillingdon Hospital came from Southall. The Uxbridge Chest Clinic is the regional centre to which residents of the Borough of Southall may be referred regarding chest disorders. It is also the regional centre for the diagnosis, treatment, aftercare and prevention of tuberculosis (both pulmonary and nonpulmonary). Persons may be referred there by their own doctors, from Clinics, etc. Special "X-ray only" Clinics are available without appointment, otherwise persons are seen by appointment. There are male and female beds under the surveillance of clinic physicians at:— (1) Harefield Hospital for the treatment of pulmonary tuberculosis; and at (2) Hillingdon Hospital for the treatment of other chest disorders, and (3) Adelaide Ward of St. Bernard's Hospital—24 male and 24 female beds—for tuberculous patients—pulmonary and non-pulmonary. County Council of Middlesex—Health Department The County Council of Middlesex is the Local Health Authority under the National Health Service Act, 1946, and provides the following services in the Borough, which are operated through the Area Health Office, 92 Bath Road, Hounslow. (a) Care of Mothers and Young Children Ante-Natal Clinics Jubilee Gardens Centre, Northcote Infant Welfare Clinics Avenue Clinic and 13 King Street. Diphtheria, Whooping Cough and Tetanus Immunisation, Smallpox and Poliomyelitis Vaccination Clinics Jubilee Gardens Centre and 13 KingStreet Ultra Violet Light Clinic Northcote Avenue Clinic Priority Dental Service for Expectant and Nursing Mothers and Children Under School Age Northcote Avenue Clime and 13 King Street. 53 (b) Midwifery Service Certified Midwives are employed, foi attendance on women in their homes in the Borough during childbirth. (c) Health Visitors Health Visitors are employed to undertake home visiting for the purpose of giving advice on the care of young children, to persons suffering from illness, to expectant and nursing mothers, to the elderly, and on the measures necessary to prevent the spread of infection. (The Health Visitors also act as school nurses). (d) Home Nursing and Nursing Equipment Home Nurses are employed to undertake the nursing of persons in their own homes, at the request of general practitioners and hospitals. Where nursing equipment is required for use in the home, it is available on loan, through the British Red Cross Society. (For details, see page 21). (e) Vaccination and Immunisation In addition to the vaccination and immunisation of infants and young children carried out at the clinics already referred to, vaccination and immunisation against the diseases mentioned on the previous page are carried out by most general practitioners. (/) Prevention of Illness, Care and After Care The County Council's scheme includes provision for the admission of suitable cases to recognised recuperative homes. (Such cases should not be in need of medical or nursing care). The Care and after care of tuberculous persons is dealt with through the Welfare Officer at the Chest Clinic. (g) Home Helps Home Help for householders where this is required owing to the presence of a person who is ill, lying in, an expectant mother, mental defective, aged, or of a child not over compulsory school age within the meaning of the Education Act, 1944, is provided under the County Council's scheme. (h) Ambulance Service A County Ambulance Service is provided for the removal to hospital, where necessary, of accident and sickness cases. There is an Ambulance Station situated in Southall beside the Town Hall, and the Sick Removal Service operates from the Depot in Hanwell. (i) Mental Health Service The Mental Health Service deals with persons suffering from mental illness. (j) School Health Service Medical inspection and dental inspection of school children are arranged by the County Council through the Southall Divisional Executive. Medical treatment and dental treatment are provided by the County Council in the Borough as follows:— Minor ailments treatment Northcote Avenue Clinic and 13 King Street Orthopaedic treatment Northcote Avenue Clinic Ophthalmic treatment Northcote Avenue Clinic Physiotherapy Northcote Avenue Clinic and Jubilee Gardens Centre Ultra Violet Light treatment Northcote Avenue Clinic 54 55 Speech Therapy 13 King Street, Talbot Road School and Jubilee Gardens Centre Dental treatment Northcote Avenue Clinic and 13 King Street Diphtheria, Tetanus and Whooping Cough Immunisation, Smallpox and Poliomyehtis Vaccination Jubilee Gardens Centre and 13 King Street (k) Chiropody Service Since January, 1961, the County Council has provided a Chiropody Service at the Northcote Avenue Clinic where expectant mothers, elderly persons and physically handicapped persons may receive treatment. County Council of Middlesex—Children's Department The County Council, through the Children's Department, is also concerned in caring for children deprived of a normal home life. Area Children's Officers have been appointed to deal locally with such cases as they arise, and operate from the Middlesex County Offices, Great West Road, Brentford. APPENDICES EXTRACTS FROM VITAL STATISTICS Table I Total Male Female Comparative Figures for 1960 Live Births—Legitimate 893 450 443 751 Illegitimate 80 43 37 66 Stillbirths— Legitimate 22 14 8 11 Illegitimate — — — — Deaths 719 364 355 699 Crude birth rate (live and stillbirths) per 1,000 of the estimated population 18.86 15.58 Corrected birth rate (live births only) per 1,000 of the estimated population 19.18 15.98 Stillbirth rate per 1,000 total (live and still) births 22.11 13.29 Crude death rate per 1,000 of the civilian population 13.63 13.15 Corrected death rate per 1,000 of the civilian population 12.13 12.10 Deaths from Puerperal Causes (Heading 30 of the Registrar-General's Short List):— Rate per 1,000 total Deaths (live and still) births No. 30. Pregnancy, Childbirth, Abortion 1.21 Death rate of infants under 1 year of age:— All infants per 1,000 live births 26.72 17.14 Legitimate infants per 1,000 legitimate live births 25.76 17.31 Illegitimate infants per 1,000 illegitimate live births 37.5 15.15 Deaths from cancer (all ages) 148 118 Deaths from measles (all ages) 1 — Deaths from whooping cough (all ages) — — Deaths from diarrhoea, etc. (under 2 years of age) — - 56 Table II Causes of Death, 1961 Male Female Total 1961 1960 1. Tuberculosis, respiratory - 1 1 5 2. Tuberculosis, other — — - - 3. Syphilitic disease — — — 3 4. Diphtheria — — — - 5. Whooping cough — — — - 6. Meningococcal infections — — — - 7. Acute poliomyelitis — — — - 8. Measles 1 — 1 - 9. Other infective and parasitic diseases 1 1 2 - 10/15. Cancer (all forms) 89 59 148 118 16. Diabetes — 4 4 6 17. Vascular lesions of nervous system 35 33 68 85 18. Coronary disease, angina 71 47 118 156 19/20. Heart disease 41 70 111 111 21. Other circulatory disease 15 22 37 30 22. Influenza 6 5 11 - 23. Pneumonia 18 43 61 53 24. Bronchitis 29 11 40 27 25. Other diseases of respiratory system 5 2 7 4 26. Ulcer of stomach and duodenum 3 2 5 5 27. Gastritis, enteritis and diarrhoea — 4 4 4 28. Nephritis and nephrosis 2 1 3 3 29. Hyperplasia of prostate 5 — 5 2 30. Pregnancy, childbirth, abortion — — - 1 31. Congenital malformations 2 3 5 1 32. Other defined and ill-defined diseases 28 32 60 46 33. Motor vehicle accidents 4 2 6 9 34. All other accidents 5 9 14 24 35. Suicide 4 4 8 6 36. Homicide and operations of war — — — — Total Deaths 364 355 719 699 Table III Deaths in wards Ward Male Female Total Waxlow Manor 46 26 72 Northcote 42 32 74 Hambrough 43 28 71 Dormers Wells 117 179 296 Glebe 55 38 93 Norwood Green 61 52 113 Total 364 355 719 57 Table IV Causes of Death Under One Year of Age Certified Causes of Death Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under 4 weeks 1-3 months 3-6 months 6-9 months 9-12 months Total deaths under 1 year Atelectesis 1 - - - 1 - - - - 1 Birth Injury 3 - - - 3 - - - - 3 Bronchitis, pneumonia, etc. - - - - — 1 - - - 1 Cerebrospinal infections - - - - - - - 1 — 1 Congenital malformations and congenital heart disease 3 1 - - 4 1 - - - 5 Gastro-enteritis - - - - - - - - - - Haemorrhagic diseases of newborn - - - - - - - - - - Prematurity 14 1 - - 15 — - - - 15 Peritonitis - - - - - - - - - - Violence - - - - - - - - - - Total 21 2 - - 23 2 - 1 - 26 Live Births. Legitimate 893 Infants Deaths. Legitimate 23 Illegitimate 80 Illegitimate 3 Table V Deaths from Cancer Year Male Female Total Estimated population Rate per 1,000 population 1936 22 30 52 49,550 1.05 1937 42 28 70 51,560 1.35 1938 27 30 57 52,400 0.51 1939 33 41 74 52,430 1.41 1940 28 36 64 51,670 1.23 1941 34 37 71 50,280 1.41 1942 34 38 72 50,350 1.43 1943 51 46 97 49,730 1.95 1944 37 32 69 48,970 1.41 1945 39 44 83 49,880 1.88 1946 40 54 94 54,440 1.64 1947 45 32 77 56,240 1.36 1948 48 36 84 56,130 1.49 1949 46 54 100 56,350 1.77 1950 52 38 90 56,310 1.60 1951 48 46 94 55,620 1.69 1952 46 49 95 55,430 2.01 1952 including long stay hospital deaths 54 57 111 1953 63 57 120 54,910 2.19 1954 72 43 115 54,440 2.11 1955 60 49 109 53,840 2.02 1956 67 65 132 53,220 2.48 1957 58 55 113 53.000 2.13 1958 91 48 139 52,830 2.63 1959 65 50 115 52,900 2.17 1960 70 48 118 53,150 2.22 1961 89 59 148 52,770 2.80 58 Table VI Notifiable Diseases During the Year 1961 (Other than Tuberculosis) Disease Ages Total cases notified Deaths Under 1 year 1 to 2 2 to 3 3 to 4 4 to 5 5 to 10 10 to 15 15 to 25 25 to 35 35 to 45 45 to 65 65 and over Dysentery - 4 1 1 - 2 - 2 4 1 - - 15 - Acute Infective Encephalitis - - - - - 1 1 1 - - - - 3 - Erysipelas - - - - 1 - - - 1 - 5 - 7 - Food Poisoning - - - - - — - 2 1 - 1 - 4 - Measles 41 78 125 126 149 502 13 5 1 2 - - 1,042 1* Meningococcal Infection 1 — - — 1 - — — — - - — 2 - Ophthalmia Neonatorum 1 - - - - - - - - - - - 1 — Pneumonia 1 - 1 - - 1 1 1 3 2 5 8 23 3 Poliomyelitis Acute Paralytic - - 1 - - - - - - - - - 1 - Puerperal Pyrexia - - - - - - - - 2 - - - 2 - Scarlet Fever - - 1 2 5 17 2 27 - Typhoid Fever - - - - - - 1 - - - - - 1 - Whooping Cough 3 2 1 - 1 1 - - - - - - 8 - Total 47 84 130 129 159 524 18 11 12 5 11 8 1,136 4 Dysentery 14 cases Pathological investigation gave negative results. 1 case Specimen not provided. 1 case Originally notified as suspected dysentery confirmed Shigella Flexner. Food Poisoning 4 cases Confirmed Salmonella Typhi Murium. Poliomyelitis Acute Paralytic 1 case Confirmed Traumatic Myositis Measles * Death of non-notified case. The number of cases of infectious diseases (including Tuberculosis) notified during the year, according to the locality, is shown below:— Table VII Diseases Total Waxlow Manor Northcote Hambrough Dormers Wells Glebe Norwood Green Total Deaths Dysentery 15 7 2 - 2 2 2 - Acute Infective Encephalitis 3 - 2 - 1 - - - Erysipelas 7 - 1 1 1 3 1 - Food Poisoning 4 2 — - - - 2 - Measles 1,042 167 119 144 87 244 281 1* Meningococcal Infection 2 - 1 - - 1 - - Ophthalmia Neonatorum 1 — - - - 1 — - Pneumonia 23 2 6 2 6 1 6 3 Poliomyelitis Acute Paralytic 1 - - - 1 - - - Puerperal Pyrexia 2 1 - - 1 - - - Scarlet Fever 27 3 2 1 8 10 3 - Typhoid Fever 1 - - - - - 1 - Whooping Cough 8 — 1 4 3 — - - Tuberculosis 89 3 15 22 21 10 18 1 Total 1,225 185 149 174 131 272 314 5 Dysentery 14 cases Pathological investigation gave negative results. 1 case Specimen not provided. 1 case Originally notified as suspected dysentery confirmed Shigella Flexner. Food Poisoning 4 cases Confirmed Salmonella Typhi Murium. Poliomyelitis Acute Paralytic 1 case Confirmed Traumatic Myositis Measles *Death of non-notified case. 59 Table VIII Tuberculosis Notifications—Ages and Classifications Age Periods New Cases Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary Male Female Male Female Male Female Male Female 0-1 - - - - - - - - 1-5 2 2 — - - - - — 5-10 - 9 - 1 - - - - 10-15 6 1 — - - - - - 15-25 3 4 2 1 - - - - 25-35 10 5 3 3 - - - - 35-45 4 5 3 — - - - - 45-65 13 2 1 - - - - - 65 + 7 1 1 - - 1 - - Total 45 29 10 5 " 1 - - Table IX The occupation of the new cases are as follows:— Occupation Pulmonary Non-Pulmonary Male Female Male Female Bakery Worker - - 1 - Carpenter - - 1 - Capstan Operator 1 - - — Clerk 2 - - - Dairy Foreman 1 - - - Dairy Manager 1 - - - Die Caster 1 - - - Domestic Help - 1 - - Electric Polisher 1 - - — Factory Hand 2 - 1 - Fitter 2 - - - Hairdresser - - 1 - Housewife - 10 - 3 Interior Decorator - - 1 - Labourer 2 - - - Laundry Worker 1 - - - Local Government Officer 1 - - - Lorry Driver 2 - - - Machinist 1 - - 1 Machine Worker - - 1 - Mental Patient 7 5 - - Mining Engineer 1 - - - Packer 1 - - - Paint Filler 1 - - - Park Keeper 1 - - - Piano Works Foreman 1 - - - Pre-Schoolchild 2 1 - - Rate Fixer 1 - - - Refuse Collector 1 - - - Retired 2 - 1 - Schoolchild 7 11 - 1 Staff Controller - - 1 - Unknown 2 1 2 - Total 45 29 10 5 60 Table X Examinations for Verminous Conditions and Children Found to be Verminous Attending Maintained Schools in Southall During 1961 and 1960 School Total number of examinations Total instances of infestation among pupils Number of individual pupils in respect of whom cleansing notices were issued Number of individual pupils in respect of whom cleansing orders were issued 1961 1960 1961 1960 1961 1960 1961 1960 Beaconsfield Road, J.M 903 721 5 5 4 5 1 3 Beaconsfield Road I. 1,185 695 6 5 5 3 4 1 Clifton Road, J.M. 504 691 - - — - - — Clifton Road, I. 401 453 - - - - - — Dormers Wells, J.M. 447 677 2 2 2 2 2 2 Dormers Wells, I 466 468 1 2 1 1 1 - *Dormers Wells, S.B. — - — - — — - — *Dormers Wells, S.G. - - — - - - - - Featherstone Road, J.M 1,202 1,186 2 2 2 1 1 - Featherstone Road, I. 863 905 — — — - — — George Tomlinson, J.M. 614 777 5 1 2 - - - George Tomlinson, I. 356 373 - - - - - - Featherstone Road S.B. 460 - — - - - — — Lady Margaret, J.M. 1,145 1,349 1 - 1 - - - Lady Margaret, I .. 674 881 — 1 - - - - North Road J.M. & I 1,141 1,201 5 14 5 11 4 9 St. Anselm's R.C.M. 1,147 1,680 3 28 1 20 - 14 Talbot Road Mixed 294 220 4 — 3 - 2 - Tudor Road, J.M. 710 1,438 4 7 2 7 1 4 Tudor Road, I 494 950 4 6 2 4 2 2 Western Road, S.G. 1,040 481 9 4 8 4 6 1 Total 14,046 15,146 51 77 38 58 24 36 * Not Inspected 61 Table XI Sanitary Inspections—Classification of Visits Houses, Public Health Act, 1936 3,106 Houses, Housing and Rent Acts, 1936—1957 460 Overcrowding 307 Disinfestation 183 Clean Air Act, 1956 3,081 Smoke Observations 31 Moveable Dwellings 25 Shops Act, 1950 32 Food Shops 351 Fried Fish 5 Cafes, etc 57 Factories (Mechanical) 89 Factories (Non-Mechanical) 2 Outworkers 28 Food Factories 45 Bakehouses 12 Dairies and Milkshops, Farms 5 Water Sampling 6 Ice-Cream Sampling 172 Other Food Sampling 36 Schools 4 Infectious Diseases 125 Stables and Piggeries 11 Markets—Saturday and General 13 Pet Animals Act, 1951 7 Rats and Mice 264 Total 8,457 62 63 Table XII HOUSING—GENERAL Statistics Housing Act, 1936—Overcrowding: (a) (1) Number of dwellings overcrowded at the end of the year 35 (2) Number of families dwelling therein 44 (3) Number of persons dwelling therein 188 (b) Number of new cases of overcrowding reported during the year 14 (c) (1) Number of cases of overcrowding relieved during the year 39 (2) Number of persons concerned in such cases 185 (d) Particulars of any case in which dwelling-houses have again become overcrowded after the local authority have taken steps for the abatement of overcrowding - (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report - INDEX Page Accidents 8,29,57 Ambulance Service 54 Anti-Litter 28 Antitoxin 20 Area of Borough 5 Atmospheric Pollution 45-50 B.C.G. Vaccination 16-18 Bed Bugs 33 Births and Birth Rate 1,8,9,56,58 Blind and partially sighted 22,23 British Red Cross Society 21,54 Bulletin of infectious disease 12 Canal boats 33 Cancer 1,8,18,19,56-58 Caravans 37 Care and after care 54 Catering establishments 42, 62 Cattle market 32, 33,62 Causes of death 56, 57 Certificates of Disrepair and Revocation 36 Chest Clinic 16,18,53 Children's Welfare 55 Chiropody 26, 52, 55 Circulatory disease 1,8,57 Clean Air Act 32,45,62 Clinics 53-55 Club for Disabled Persons 21,22 Coronary Disease 8, 57 Deafness 23 Deaths and death rate 1,8, 29-31, 56-58,60 Deaths from accident 29-31 Deaths in wards 57 Demolition 36 Diabetic Club 22 Diphtheria 8,12,14,57 Disinfection 20 Dysentery 1,13,59 Employees' medical examinations 52 Factories Act, 1937 34,35,62 First Aid 21 Food & Drugs Act 39-42 Food hygiene 43,44 Food inspection 42 Food poisoning 1,38,39,59 Food sampling 38,39,62 Food shops 43,62 Free washing facilities 38 Graphs .. 10,14,15,45,47-49 Handicapped persons 23 Hard of Hearing 22,23 Health education 28 Health visitors 54 Page Heart disease 8,57 Holidays for old people . 26 Home accidents 29 Home help 25,54 Home nursing .. 25, 54 Hospital services 53-55 Houses let in lodgings .. 2,5,16,36,37 Houses—number inhabited 5 Housing .. .. .. 5,6,16,36,37,63 Housing—Repairs and Rents Act 36 Hygiene of food 38-44 Hygiene—personal .. 38 Ice-cream sampling 38,62 Immunisation 14,53-55 Improvement grants 36 Indian immigrants 2, 16-18,36,37 Infant mortality 1,9,10, 56, 58 Infectious diseases, prevalence and control of 1,12-20,59,62 Influenza 8,13,57 Inspection and supervision of food 42 Inspection of sanitary accommodation in factories 34 Laboratory facilities and work 20 Lice 20 Markets 32, 33,62 Massage, establishments for 52 Maternal morbidity 11 Maternity and Child Welfare 53-55 Meals on Wheels 25 Measles 1,12,56,57,59 Meat and other foods 41 Medical examinations 52 Mental health 54 Middlesex County Council Services 53-55 Midwifery service 54 Milk 38,41 Miscellaneous 51, 52 Mortuary 33 Motor Vehicle Accidents 8, 30, 31, 57 Multiple Sclerosis 22 National Assistance Act, S.47 27 Noise nuisance 51 Nuclear Radiation 52 Nursing equipment 54 Nutrition 24,25 Old People's Clubs 26, 27 Old People's Welfare 25-27 Ophthalmia neonatorum 14,59 Outworkers 35,62 Overcrowding 16, 36, 62,63 Paddling Pool 7 INDEX—continued Page Parks and Open Spaces 5 Personal hygiene 38 Pet Animals Act 51,62 Physical features of the district 5-7 Playing Fields 7 Pneumonia 57,59 Poliomyelitis 8,12,13,57,59 Population 5 Premature infants 9,11,58 Public Control Department 39-41,44 Public Health Committee 1 Public Health Inspectors 1,18,32 Puerperal pyrexia 11,59 Rag, Flock and Other Materials Filling Act 35 Rateable value 5 Rats and mice 51,62 Rehousing 36 Respiratory diseases 57 River pollution 51 Road Safety 30,31 St. John Ambulance Service 21 Sanitary circumstances. . 32-35 Sanitary inspection 32,62 Sanitation in schools .. 33 Scabies 20 Scarlet fever 13,59 School Medical Service 54, 55 School Meals and Milk 24,25 Page School playing fields 7 Sewerage 32 Shops Acts 51,62 Slum Clearance 36 Smallpox 13,20 Smoke Control Areas 1,2,32,45 Smoke pollution 45,46 Southall Association for the Occupation of the Elderly 27 Staff 4,52 Statistics—General and Vital .. 8-11,56 Stillbirths .11 Street traders 42 Sulphur dioxide pollution 45,46 Swimming bath 6,7 Tuberculosis 1,8,14-18,57,59,60 Typhoid Fever 13,59 Unemployment 6 Vaccination 13,53-55 Vaccine lymph 20 Verminous persons 20,61 Vital statistics 8-11,56 Volumetric machine 45,46 Water supply and services 32 Welfare1,21-27 Whooping cough .. 8,56, 57, 59 X-Rays 16-18