4c 439(1) Library BOROUGH OF SOUTHGATE ANNUAL REPORT of the Medical Officer of Health for the Year 1962 J. R. CAMPBELL, M.B., ch.B., D.P.H Deputy Medical Officer of Health 5046 47 BOROUGH OF SOUTHGATE ANNUAL REPORT of the Medical Officer of Health for the Year 1962 J. R. CAMPBELL, m.b., ch.b., d.p.h Deputy Medical Officer of Health TO THE MAYOR, ALDERMEN AND COUNCILLORS OF THE BOROUGH OF SOUTHGATE Mr. Mayor, Ladies and Gentlemen I have the honour to present the Annual Report for the year 1962. The year ended sadly with Dr. Harvey's sudden illness in October which deprived the Borough of his services for the remainder of the year. Dr. Harvey is still not fit to resume duty and his absence is felt particularly at this time when his wisdom and experience would have been so valuable in the planning of the new Borough. I know that he has the warm good wishes of all members of the Council. The vital statistics for 1962 have varied little from those of last year. The birth rate with 947 live births was 14.4 per 1,000 of population. The death rate was 11.6, slightly higher than last year's figure of 10.8 but lower than that for the country as a whole—41.9. One maternal death was reported in 1962. The Infantile Mortality rate, i.e. the number of infants who died during the first year of life per 1,000 live births fell from 16.0 to 14.8, there being 1 death less this year than last. The statistics over the past four years show two trends which are persistent and appear significant. The birth rate has risen annually with one exception from 11.4 in 1958 to 14.4 in 1962. This rising birth rate is taking place generally over the whole country. Less satisfactory and a cause for concern is the trend in the illegitimate birth rate, i.e. the number of illegitimate births 3 expressed as a percentage of the total live births. This rate is showing a widespread general rise, and although this year fortunately the rise in Southgate has been halted, the following figures are significant : 1958 — 2.59 1959 — 3.76 1960 — 4.98 1961 — 5.98 1962 — 4.64 It needs little imagination to picture the problems and distress which must arise from this increasing rate. The number of infectious diseases notified during 1962 was 188 as against 915 last year. There were over 600 fewer cases of measles than in 1961 and 70 fewer cases of dysentery, which largely accounts for the difference in the number of notifications. The Infectious Sickness Rate for the year was 2.62 compared with 12.78 last year. It is of note that the only deaths during the year which were due to notifiable infectious disease were those of five males and one female all adults aged 55 to 65 years. This is a complete and striking reversal of the old high infectious diseases mortality rates which were recorded in the early years of life. One case of nonparalytic poliomyelitis was notified in 1962. Our last notification of diphtheria was in 1947—15 years ago. Notifications of whooping cough were 11, a very satisfactory figure. Health education is a continuous process for the Health Department right through the year. The choice and supply of public posters, library book marks and advice leaflets is constantly under review. The 16mm. projector continues to be put to frequent and excellent use and is a great teaching asset. The problem of Health Education on the dangers of smoking is discussed later in the Report. 4 The Council's programme for dealing with unfit houses has continued in 1962 and reference to this will be found later in the Report. In the provision of new housing accommodation, the Council's new flatlets in Aldermans Hill for old people have proved a great success and further provision is planned on similar lines. In last year's Report, Dr. Harvey made reference to the increasing work devolving upon the Public Health Inspectors. This work continues to build up with the extension of the Smoke Control Areas and additional duties relating to housing. The position will require to be kept under review. Dr. Harvey's combined appointment of Borough Medical Officer of Health and County Area Medical Officer has ensured over the years close integration of those two functions, and similarly the very close and friendly co-operation between the two categories of staff should prove a great asset in the smooth change-over to the new Borough. In conclusion, I owe a debt of gratitude to the members of the Public Health Committee and would express to them my sincere thanks for their support and kindness—an expression in which I know Dr. Harvey would wish to be associated. I find it difficult to express fully my appreciation of the loyalty and support which I have received from Mr. Gooday, and, indeed, every member of the staff of the Public Health Department. Without this, my task in suddenly taking over Dr. Harvey's work would have been difficult indeed. I am, Mr. Mayor, Ladies and Gentlemen Your obedient Servant J. R. CAMPBELL Deputy Medical Officer of Health Town Hall Palmers Green, N.13 5 PUBLIC HEALTH COMMITTEE From 1st January, 1962 to 14th May, 1962 Alderman Richard Prior (Chairman) Alderman H. S. Beardow (Vice-Chairman) Councillor Mrs. H. J. Emsden Councillor P. W. Lansten Councillor G. D. Payne Councillor F. A. Rule Councillor A. V. Stapleton From 22nd May, 1962 to 31st December, 1962 Alderman Richard Prior (Chairman) Alderman H. S. Beardow (Vice-Chairman) Councillor S. C. Jenner Councillor John Lindsay Councillor G. D. Payne Councillor A. V. Stapleton Councillor H. O. Thomas PUBLIC HEALTH STAFF Medical Officer of Health: W. Clunie Harvey, M.D., Ch.B., D.P.H. Deputy Medical Officer of Health: Janet R. Campbell, M.B., Ch.B., D.P.H. Chief Public Health Inspector : A. E. Gooday, M.R.S.H., F.A.P.H.I., Cert. R.S.H. Meat Inspection. Deputy Chief Public Health Inspector: R. L. Burkill, F.A.P.H.I., Cert. R.S.H., Cert. R.S.H. Meat Inspection, Cert. R.S.H. Smoke Inspector. Public Health Inspector : W. Shackcloth, A.R.S.H., M.A.P.H.I., Cert. R.S.H. Meat Inspection. Public Health Inspector : J. C. Noble, M.A.P.H.I., Cert. R.S.H., Cert. R.S.H. Meat Inspection. Public Health Inspector : E. T. Jephcott, M.A.P.H.I., Cert. R.S.H., Cert. R.S.H. Meat Inspection (resigned 4.11.1962). Senior Typist: Miss E. W. Barratt. Clerk: Miss A. G. Alcock (resigned 31.12.62). Miss G. R. Edwards (appointed 3.12.62). Junior Clerk : R. R. Hart. General Assistant: B. Latter. Driver : J. L. Arnold. Rodent Operator : W. Dowsett. 6 STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 3,765 Registrar-General's Estimate of Resident Civilian Population, 1962 71,370 Number of Inhabited Houses and Flats 1st April, 1962 (excluding Shops assessed with private dwelling accommodation) 22,977 Effective Rateable Value on 1st April, 1962 £1,544,088 Sum represented by 1d. rate (1962-63 Revised Estimate) £6,335 7 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR Male Female Total Live Legitimate 474 429 903 Births Illegitimate 18 26 44 492 455 947 Birth Rate per 1,000 of the estimated population 14.4 Still Legitimate 3 6 9 Births Illegitimate — — — 3 6 9 Rate per 1,000 live and still births 9.5 Deaths from all causes and at all ages 984 Death Rate per 1,000 of the estimated population 11.6 Deaths from Puerperal causes 1 From Puerperal Sepsis — From Other Causes 1 Maternal Death Rate per 1,000 live and still births 1.04 Deaths of Infants under 1 year of age: Male Female Total Legitimate 7 6 13 Illegitimate — 1 1 7 7 14 Infant Death Rate: All infants per 1,000 births 14.8 Legitimate—per 1,000 legitimate live births 14.39 Illegitimate—per 1,000 illegitimate live births 22.73 Deaths from Measles, all ages nil Deaths from Pertussis, all ages nil 8 POPULATION The Registrar General's estimated population of the Borough at the middle of 1962 was 71,370, a decrease of 120 as compared with 1961. BIRTHS—BIRTH RATES The nett total births for the year accredited to the district were 947, an increase of ten on the preceding year. Of these, 492 were males and 455 females (18 males and 26 females being illegitimate). The birth rate for the year was 14.4 per 1,000 of the population. The birth rate for England and Wales was 18.0. The births and birth rates for the past five years were as follows Birth Rates Year No. of Births Southgate England and Wales 1958 809 11.4 16.4 1959 851 13.0 16.5 1960 944 14.7 17.1 1961 937 14.14 17.4 1962 947 14.4 18.0 During the year, the number of births recorded was 37 less than the number of deaths, as compared with 16 more in 1961. 9 MORTALITY General Mortality and Death Rate The nett number of deaths accredited to the district was 984, 63 more than in 1961. This gives a crude death rate of 13.8 per 1,000 of the population and a corrected death rate of 11.6 (the rate for 1961 being 10.8). The greatest single cause of this increase was a rise of 20 in the deaths from Coronary Disease and Angina, and of 15 in the deaths of cancer of the lung. There was also a rise of 4 in the deaths from bronchitis. The heavy toll of life from these two group causes could be considerably reduced, but its reduction involves the most difficult of all remedies—the changing of habits that are set and built in to the way of life. Contributory factors in coronary disease are undoubtedly the stress and rush of present-day living. A three-mile walk daily would be an excellent prescription coupled with sensible and moderate eating to prevent increase of weight. It is surely an obvious assumption that the heart can do its job more efficiently without an added load of a stone or more imposed upon it just when it is beginning to age. The following table shows the deaths from cancer of the lung and bronchus and deaths from bronchitis for Southgate over the past ten years:— Deaths from Cancer of the Lung and Bronchus Male Female 1953 20 6 1954 35 6 1955 35 9 1956 28 9 1957 39 9 1958 24 9 1959 43 8 1960 42 5 1961 30 9 1962 45 9 10 Deaths from Bronchitis 1953 34 19 1954 19 11 1955 27 16 1956 21 12 1957 27 14 1958 23 19 1959 37 16 1960 20 14 1961 31 13 1962 35 13 In attempting to prevent the onset of bronchitis and cancer of the lung, we are up against a habit—smoking—which is even more deeply ingrained and difficult to eradicate. Only methods of education that carry conviction will succeed in such an extraordinarily difficult task. The method which succeeded in the great proportion of doctors was a cold statistical survey which showed clearly how many of their colleagues who were smokers were dying of cancer of the lung. If the same precipitous drop could be effected in those to whom children look for example—particularly parents and teachers—the chances of a drop in smoking would materially increase throughout the whole population. Since smoking is comparable to drug addiction, the main effort must be to prevent young people from starting the habit. Addicts may say " This is my business, it concerns my life," but there are few individuals whose life is not precious to someone and whose death does not bring tragedy and irretrievable loss to others. The evidence against smoking is now so- overwhelming that most smokers concede it as a cause of lung cancer and would wish to give it up. Clever advertising is probably the strongest factor in defeating the best resolutions and counter propaganda must be extremely skilful to compete with it. The pipe smoker has much more control over the amount of tobacco he smokes since he is not constantly having a tobacco pouch passed to him by his friends. In face of the tremendous difficulty in eradicating the habit of cigarette smoking, could it at least be replaced by the pipe smoking habit—with attractive pipes for ladies ! And since it is a more mature habit it might even become more attractive to teenagers who want to be " with it." Smokers' clinics have been started up and down the country and their methods and degree of success are being critically studied. 11 In spite of these rather gloomy comments it must be borne in mind that it is only because so many other major causes of death have been eradicated and also that more money is available to spend on cigarettes and a great variety of confectionery that these diseases of the older age groups are rising in importance. With each decade not only are many more infants living to reach their second year, but this second year seems almost like a spring-board to give them a flying start in life so that the loss of life up to the age of 45 is almost negligible. On the basis of the 1962 statistics, of 947 live births 933 babies would survive to reach their second year. In Southgate's total child population from the age of 1 year to 15 years, the total deaths were 5, and between the ages of 15 and 45 they totalled 17. Immunisation has played a very large part in this success story but it requires constant vigilance to ensure that it continues at its present high level. Diphtheria and poliomyelitis are still diseases that could return again as a cause of death and crippling. Infant Mortality Of the 14 infant deaths recorded for Southgate in 1962, 11 did not survive beyond one month. Nine died in the first week and 7 infants died on the first day. These very early deaths are the hardest of all to prevent. Still Births Nine still births, all legitimate, were accredited to the Borough for 1962. This is equal to a death rate of 9.4 live and still births, the corresponding figures for 1961 being 11 still births and a rate of 11.6. Maternal Mortality One maternal death was reported during 1962. Mortality of Persons over the age of 65 Seven hundred and thirty-four deaths, or 74.76 of the total deaths during the year, occurred in persons over the age of 65 years. Of these, 277 died between the ages of 80 and 90, while a further 36 females and 7 males were over the latter age, the oldest being 97. Following the trend of recent years, diseases of the heart and circulation were responsible for more deaths in this age group than any other cause. 12 TABLE I Causes of Death during the Year 1962 Causes of Death Male Female Total Rates per 1,000 of population All cases (civilians only) 475 509 984 13.80 1. Tuberculosis, Respiratory 4 — 4 0.05 2. Tuberculosis, Other — — — — 3. Syphilitic Disease — — — — 4. Diphtheria — — — — 5. Whooping Cough — — — — 6. Meningococcal Infection — — — — 7. Acute Poliomyelitis — — — — 8. Measles — — — — 9. Other Infective and Parasitic Diseases 1 1 2 0.03 10. Malignant Neoplasm—stomach 12 12 24 0.34 11. Malignant Neoplasm, Lung, Bronchus 45 9 54 0.76 12. Malignant Neoplasm, Breast — 19 19 0.26 1 3. Malignant Neoplasm, Uterus — 9 9 0.12 14. Other malignant and lymphatic Neoplasms 53 40 93 1.33 15. Leukaemia, Aleukaemia 1 4 5 0.07 16. Diabetes — 6 6 0.08 17. Vascular Lesions of Nervous System 47 87 134 1.86 18. Coronary Disease, Angina 130 76 206 2.911 19. Hypertension with Heart Disease 4 13 17 0.213 20. Other Heart Disease 39 77 116 1.63 21. Other Circulatory Disease 26 31 57 0.79 22. Influenza 1 — 1 0.02 23. Pneumonia 22 31 53 0.75 24. Bronchitis 35 13 48 0.69 25. Other Diseases of Respiratory System 5 4 9 0.12 26. Ulcers of Stomach and Duodenum 7 7 14 0.19 27. Gastritis, Enteritis and Diarrhoea 1 2 3 0.04 28. Nephritis and Nephrosis 2 3 5 0.07 29. Hyperplasia of Prostate 11 — 11 0.15 30. Pregnancy, Childbirth, Abortion — l l 0.02 31. Congenital Malformation 11 1 2 0.03 32. Other Defined and Ill-Defined Diseases 12 43 55 0.77 33. Motor Vehicle Accidents 3 4 7 0.09 34. All Other Accidents 6 13 19 0.26 35. Suicide 7 3 10 0.14 36. Homicide — — — — 13 TABLE II Deaths from all causes, divided as to sex and certain age groups, and showing a percentage of total deaths and death-rates per 1,000 of population for each age group 1962 FEMALES MALES TOTALS Age No. % of total deaths Rate per 1,000 No. %of total deaths Rate per 1,000 No. % of total deaths Rate per 1,000 0-1 year 7 0.68 0.10 7 0.68 0.10 14 1.28 0.18 1-5 years — — — 1 0.10 0.01 1 0.10 0.01 5-15 years 1 0.10 0.01 3 0.30 0.06 4 0.40 0.07 15-25 years 1 0.10 0.01 12 0.20 0.05 3 0.30 0.06 25-45 years 7 0.68 0.10 7 0.68 0.10 14 1.28 0.18 45-65 years 72 7.22 1.06 143 14.50 2.08 215 21.84 3.16 65-75 years 124 12.70 1.60 1124 12.70 1.60 248 25.42 3.21 Over 75 years 297 30.16 4.15 188 19.20 2.77 485 49.38 6.93 Totals 509 51.64 7.03 475 48.136 6.77 984 100.00 13.80 14 TABLE III INFANTILE MORTALITY 1962 : Nett deaths from stated causes at various periods under one year of age Causes of Death Under 1 week 1—2 weeks 2—3 weeks 3—4 weeks Total under 1 month 1—3 months 3—6 months 6—9 months 9—12 months Total under 1 year 1. Smallpox — — — — — — — — — — 2. Chickenpox — — — — — — — — — — 3. Measles — — — — — — — — — — 4. Scarlet Fever — — — — — — — — — — 5. Pertussis — — — — — — — — — — 6. Diphtheria and Croup — — — — — — — — — — 7. Erysipelas — — — — — — — — — — 8. Tuberculous Meningitis — — — — — — — — — — 9. Abdominal Tuberculosis — — — — — — — — — — 10. Other Tuberculosis — — — — — — — — — — 11. Meningitis (not Tuberculous) — — — — — — — — — — 12. Convulsions — — — — — — — — — — 13. Laryngitis - — — — — — — — — — 14. Bronchitis - - - - - 1 - - - 1 15. Pneumonia - 2 - - 2 - - - - 2 16. Diarrhoea — — — — — — — — — — 17. Enteritis — — — — — — — — — — 18. Gastritis — — — — — — — — — — 19. Syphilis — — — — — — — — — — 20. Rickets — — — — — — — — — — 21. Suffocation 1 - - - — 1 - - - 2 22. Want of Attention and Injury at Birth — — — — — — — — — — 23. Atelectasis 1 — — — 1 — — — — 1 24. Congenital Malformation 1 - - - 1 - - — — 1 25. Premature Birth 4 - - - 4 - - - - 4 26. Atrophy, Debility and Marasmus — — — — — — — — — — 27. Other Causes 2 - - - 2 1 - - - 3 Total 9 2 - - 11 3 - - — 14 15 TABLE IV Vital statistics of whole district during 1962 and eight preceding years Year Population estimated at Middle of each Year Nett Births belonging to the District Nett Deaths belonging to the District At all ages Under 1 year of age Number Rate per 1,000 population Number Rate per 1,000 population Number Rate per 1,000 population 1954 72,290 815 11.30 813 11.20 13 16.00 1955 711,870 776 10.30 809 11.30 15 19.30 1956 71,670 800 11.20 844 11.80 11 13.80 1957 71,250 798 11.20 901 12.60 16 20.10 1958 70,840 809 11.40 943 13.30 17 21.00 1959 70,680 851 12.00 943 13.30 13 15.15 1960 69,880 944 13.50 929 13.30 14 14.80 1961 71,490 957 13.10 9211 12.90 15 16.00 1962 71,370 947 13.30 (crude) 984 13.80 (crude) 14 14.80 14.40 (corrected) 11.60 (corrected) 16 GENERAL PROVISION OF HEALTH SERVICES Care of the Aged The greater expectancy of life, with the increase of the number of aged people in the community creates many very special problems and with these a responsibility which is really that of the whole community. It is in this field probably more than in any other that voluntary effort is so vital. We are extremely fortunate in the work that is done in the Borough by the Old People's Welfare Committee. Many of the problems, however, are brought to the Public Health Department and we are then able to call upon the Health Visitors, Home Nurses, Home Help Organisers and Public Health Inspectors to assess the need so that we can estimate how best to render help. The Retired Persons' Advice Clinic was opened at Ruth Winston House on 30th March. This clinic is held on alternate Friday afternoons and is staffed by one of the County Assistant Medical Officers, together with a member of the Nursing stafF. The sessions are informal and advice is given on health matters and also on hobbies, activities, etc. These are well attended and I believe are fulfilling a very useful function. It seems that there will always be some geriatric problems which are almost insoluble but these additions to the services of the elderly are very welcome. A further great asset is the appoint' ment of a Geriatrician at the North Middlesex Hospital to serve this part of the County. Hospitals Hospital services available to residents of Southgate arte as reported in previous years, but the appointment of a geriatrician referred to in the previous paragraph of this report has closed a very serious gap in the service. Laboratory facilities As in past years, the Central Public Health Laboratory Service has been of the greatest assistance to us, not only the Central Laboratory at Colindale but also the Laboratory housed in 17 Edmonton Town Hall. I gratefully acknowledge the assistance afforded throughout the year, and the close co-operation which has continued for so many years between the Public Health Department and the Laboratory Service. Summary of the work carried out by the Laboratory Service for the year is: Positive Negative Swabs for diphtheria bacilli — 116 Sputa for tubercle bacilli — 36 Throat & Nose 420 Faeces 467 Urine 199 Blood 148 Others 135 Mortuary The mortuary arrangements remain as set out fully in my Report for 1946, with the addition mentioned in the 1960 Annual Report that we now have a firm agreement with Prince of Wales' Hospital to accept Southgate bodies. In 1962, 119 bodies were sent to the mortuary at the Prince of Wales' Hospital. Scabies and Lice Our procedure in regard to the treatment of scabies and infestation by lice remains as set out in previous Annual Reports. During 1962, one person was treated for scabies at the Edmonton Cleansing Station. NATIONAL ASSISTANCE ACT, 1948 Section 47—Removal to suitable premises of persons in need of care and attention No action was taken by the Council in 1962 under this Section. 18 SANITARY SERVICES Summary of Visits Visits re housing defects (Public Health Act, 1936) 2,236 Visits re housing defects (Housing Act, 1957) 512 Visits re drainage and building works 212 Visits re dustbins (Public Health Act, 1936) 41 Visits re housing conditions and overcrowding (applications for housing accommodation) 82 Visits re Rent Act, 1957 17 Visits re food premises (including butchers, bakehouses, confectioners, restaurants, grocers and fish-shops) 1,210 Visits re ice cream sampling 66 Visits re food hawkers 9 Visits re factories 159 Visits re Shops Act, 1950 726 Visits re infectious diseases 770 Visits re Glean Air Act 6,308 Visits re Prevention of Damage by Pests Act, 1949 389 Visits re other matters 3,429 16,166 Service of Notices Informal Notices served re Housing Repairs 379 re Dustbins 17 re Food Premises 91 re Shops and Factories 57 Total Informal Notices served 544 Total Informal Notices complied with 541 Total Statutory Notices served 36 Total Statutory Notices complied with 33 19 Repairs to Houses During the year under review, the Public Health Inspectors have been actively engaged on work in connection with repairs to houses. Their efforts have resulted in repairs being carried out at 432 houses, the repairs varying from those of a major character to minor repairs necessary to abate specific nuisances. The repairs referred to were carried out mainly as a result of informal action. Only in 36 instances was it found necessary to follow-up informal action by the service of Statutory Notices. In one instance, it became necessary for the Council to institute legal proceedings to secure compliance with a Statutory Notice requiring the execution of repairs. A Court Order was obtained and the works were subsequently carried out. Unfit Houses During 1962, further progress was made in the implementation of the Council's programme for dealing with unfit houses. 64-82 (inc.) High Street, N.14 Following a decision by the Council in 1961 to deal with the above-mentioned houses by way of a Clearance Order under the Housing Act, 1957, an objection was lodged by the owners in respect of Nos. 64-68, and a local enquiry was held by the Minister of Housing and Local Government in May. Subsequently in October, the Minister confirmed the Clearance Order in respect of Nos. 70-82. With regard to Nos. 64-68, while agreeing that they were unfit for habitation, the Minister excluded them from the Clearance Order in order to give the owners an opportunity of preparing a scheme for their renovation. 9.19 (odd) Springfield Road, N.11 1.23 (consec.) Upper Park Road, N.11 74.84 (even) High Road, N.11 15.41 (odd) Lower Park Road, N.11 In July, as a result of representations Dr. Harvey made to the Council under the Housing Act, 1957, in respect of the unfitness for habitation of the above-mentioned houses, the Council declared the two areas to be Clearance Areas under Part III of the Act. The Council resolved to acquire by way of a Compulsory Purchase Order those houses which it had not been found possible to acquire by agreement, in order to effect clearance. 20 Rent Act, 1957 The following is a summary of the action taken by the Council during 1962 under the Rent Act, 1957:— Part I—Applications for Certificates of Disrepair (1) Number of applications for certificates nil (2) Number of decisions not to issue certificates nil (3) Number of decisions to issue certificates: (a) in respect of some but not all defects nil (b) in respect of all defects nil (4) Number of undertakings given by landlords under paragraph 5 of the First Schedule nil (5) Number of Certificates issued nil Part II—Applications for Cancellation of Certificates (7) Applications by landlords to Local Authority for cancellation of certificates 3 (8) Objections by tenants to cancellation of certificates nil (9) Decisions by Local Authority to cancel in spite of tenants' objections nil (10) Certificates cancelled by Local Authority 3 Housing Applications Visits by the Public Health Inspectors to applicants for housing accommodation and the preparation of reports as to living conditions have continued in 1962. The number of visits for this purpose was 82, as against 66 in 1961. The close liaison between the Public Health Department and the Housing Department has been maintained in 1962, as in previous years. On many occasions I have been asked by the Town Clerk to advise as to the degree of urgency on medical grounds with reference to particular applications. Food Hygiene Undoubtedly in the past few years, improvement has taken place in food hygiene standards in food premises generally throughout the Borough. To some extent, it is true to say that this has been dictated by modern trends in food trading. It is also true to say, however, that, to an extent, it has resulted from work done by the Public Health Inspectors in implementing the requirements of the Food Hygiene Regulations. 21 During 1962, the Inspectors made 1,210 visits to food premises. Their visits not only served to bring about improvement in the storage, handling and distribution of food together with improve' ments in food premises, but were instrumental in securing the maintenance of such improvements. Arising out of these visits, it was found necessary, in 91 instances, to require the occupiers of food premises to deal with matters which were in contravention of the Food Hygiene Regulations. In all cases, I am pleased to be able to report, the matters were attended to without recourse by the Council to legal proceedings. Legal proceedings, however, were instituted by the Council under the Food ??? Drugs Act, 1955, in respect of the following offences:— Sale of a chocolate cake containing a packet of cigarette papers Sale of eccles cake containing a nail Smoking while handling open food Sale of bread containing part of a rodent Firm fined £100, plus £5 5 s. Od. costs Firm fined £5, plus £5 5s. Od. costs Employee fined £3, plus £3 3s. Od. costs Firm fined £10, plus £5 5s. Od. costs Food Inspection The following is a summary of food surrendered and condemned during the year as unfit for human consumption. The food, all of which was in small quantities, was carefully mixed-in with household refuse at the Council's Refuse Collection Works and disposed of at the controlled tipping site used by the Council:— Fish 6 stone Carcase meat 235 lbs. Offal 229 lbs. Ham (canned) 235 lbs. Ham (cooked) 19 lbs. Canned Meats (various) 80 lbs. Canned Foods (various) 260 cans Frozen Vegetables 96 packets Rabbit 22 lbs. Chicken 37 lbs. Bubble gum 6 cases Spearmint 76 boxes 22 Number and Classes of Food Premises in the Borough Below is a summary of the food premises in the Borough, classified under type of business:— Bakers and Confectioners 30 Butchers 55 Grocery and Provisions 110 Fruit and Greengrocery 60 Wet Fish 14 Fried Fish 7 Restaurants and cafes (including school canteens, works canteens, clubs, etc.) 118 Confectionery and sweets 81 475 In the Borough there are 331 premises registered under Section 16 of the Food and Drugs Act, 1955, 236 in respect of ice cream and 95 in respect of preserved foods. Under the provisions of the Middlesex County Council Act, 1950, relating to hawkers of food and their premises, there were 98 hawkers on the register at the end of 1962. Of these, 24 have storage premises in the Borough and 74 have their storage premises in other areas. Post-Mortem Inspection of Animals No slaughtering of animals took place in the Borough during 1962. Ice Cream Sampling During the year under review, 48 samples of ice cream were obtained and submitted to the Public Health Laboratory for bacteriological examination. The results were:— Grade 1 39 „ 2 7 „ 5 1 4 1 48 23 Generally these results are good. The sample which gave the Grade 3 result was taken from a restaurant and that which gave the Grade 4 result was taken from an itinerant vendor. In each case the matter was taken up with the firm concerned and the method of distribution checked. Subsequent samples proved satisfactory. Establishments for Massage or Special Treatment Under the Middlesex County Council Act, 1944, sixteen licences were renewed in respect of establishments for massage, chiropody or similar treatment. Pet Animals Act, 1951 Five licences were granted by the Council during 1962 under the above-mentioned Act in respect of pet animal shops in the Borough. Swimming Bath The figures for attendances at the Barrowell Green Open Air Swimming Bath for the past two years were:— 1962 1961 Adults (Mixed and Spectators) 7,235 11,970 Children (Mixed and Spectators) 23,679 30,987 From Schools 2,774 5,672 Season Tickets 5,834 8,672 39,522 57,301 Costumes, etc., hired 24 44 The arrangements whereby samples of the water from the swimming bath are taken at regular intervals has been continued. The results of the samples taken during 1962 were uniformly satisfactory. A notice continues to be posted at the Bath informing the public of the result of these samples. Prevention of Damage by Pests Act, 1949 During 1962, 362 complaints of rats and mice were received and dealt with, as against 398 in 1961. In May 1962, a baiting and poisoning treatment was carried out by the Borough Engineer's Department in the Council's soil sewers. 527 manholes were baited. The poison bait used for this treatment was pinhead oatmeal plus warfarin. In 38 of the manholes baited, complete or part takes of bait were noted. 24 In October 1962, a further baiting and poisoning treatment was carried out in the Council's soil sewers. On this occasion, 530 manholes were baited with pinhead oatmeal plus warfarin. In 40 of the manholes baited, complete or part takes of bait were noted. All work in the sewers was carried out in accordance with the recommendations of the Ministry of Agriculture, Fisheries and Food. Public Conveniences Sixteen public conveniences are available in the Borough, situated as follows:— Broomtfield Park (3) Arnos Park Bramley Sports Ground Oakwood Park Tottenhall Sports Ground North Circular Road, Palmers Green Triangle, Palmers Green Fords Grove, Winchmore Hill "Cherry Tree" Hotel, The Green, N.14 " Crown," Chase Side, N.14 " White Hart," Chase Road, N.14 " King's Head," Wades Hill, N.21 " Orange Tree," Highfield Road, N.21 Grovelands Park Conveniences provided by London Transport Executive at Southgate and Oakwood Underground Stations are also available to the public. All public conveniences in the district are inspected by members of the Public Health Department staff. This inspection includes conveniences provided for the use of the public in public houses and hotels. Defects are brought to the notice of the Borough Surveyor's Department or are notified to the proprietors of the premises in which the public conveniences are situated. Water Supply The water supply of the district, which is almost entirely supplied by the Metropolitan Water Board, remains satisfactory in quality and quantity. The supply is from high pressure mains. All the houses in the district are provided with direct pipe supply. It was not considered necessary to carry out any bacteriological or chemical examinations of drinking water during the year. There is no evidence of any plumbo-solvent action in the water. 25 Refuse Collection and Disposal The Borough Engineer and Surveyor reports that a weekly collection service was maintained throughout the year. The quantity of refuse dealt with at the Refuse Disposal Works, Barrowell Green, amounted to 21,669 tons, an increase of 716 tons over the previous year. During the year, 237 collections of garden refuse were carried out. Some householders may still not be aware that for a nominal charge, the Borough Engineer will also arrange for the removal of bulky items of refuse (furniture, etc.) which the refuse collectors are not required to collect in the course of their normal duties. The sale of salvage recovered from refuse realised an income of £15,153. Tonnages of the various materials were as follows:— tons Waste Paper 1,326 Non-ferrous metals 3 Rags 28 Tins 510 Bottles 5 Carpet 25 Scrap Iron 94 Gullet 18 Miscellaneous items 22 Street Cleansing The normal frequency of sweeping the streets in the Borough was as follows:— miles At least once daily 6 Three times weekly 12 Twice weekly 60 Once weekly 6 Allotment holders again provided an outlet for the many hundreds of lorry loads of leaves collected from the streets during the autumn. During the year, the Council entered into agreement with a contractor for the provision of 250 litter bins, free of cost to the Council, some of the bins to display advertisements. This is a substantial increase in the number of litter bins hitherto sited in the Borough, and it is hoped that the public will make good use of them. 26 It is worthy of mention that the Litter Act, 1958, makes it a punishable offence for any person to cause litter in a public place. During the year 13,396 street gully cleansings were carried out. Fumes and Noise During 1962, three complaints were received from residents concerning alleged nuisances from fumes from industrial premises. Each complaint was investigated by the Public Health Inspectors, observations were made and steps taken to obtain the co-operation of the firms concerned, with the result that the nuisances were abated. Fifteen complaints were received from residents concerning alleged nuisances from noise. These included such varied noises as practising on drums in a house, noise from a pump operating day and night on a road site, and noise associated with industrial premises. Informal action resulted in the noises ceasing or being reduced in extent. In the latter part of the year, the Public Health Committee had under consideration complaints from residents living in the vicinity of the Metal Box Factory concerning noise and fumes. Air Pollution During the year under review, thirty-two observations were made by the Public Health Inspectors in connection with emission of smoke from industrial premises. No contravention of the Dark Smoke (Permitted Periods) Regulations was observed. With regard to domestic premises, preliminary work in connection with the Council's Third Smoke Control Order, an extension of the No. 1 and No. 2 Orders and covering an additional 392 acres and containing 2,034 dwellings, 55 commercial premises and 6 other premises, was completed in the first part of the year. The date of operation of the Order was fixed at 1st October, 1963. The Order was confirmed by the Ministry of Housing and Local Government on 16th August, 1962. Conversions and adaptations of fuel appliances, carried out by residents to enable them to avoid contravention of the Order, had commenced by the close of the year. In addition, the preliminary work on the Council's fourth Smoke Control Area had also been commenced by the end of the year. 27 FACTORIES ACT, 1961 Details of work carried out during the year 1962 1. INSPECTIONS for purposes of provisions as to health (including Inspections made by Public Health Inspectors). 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 33 41 — — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 174 118 — — (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) — — — — Total 207 159 — — 2. Cases in which DEFECTS were found. (If defects are discovered at the premises on 2, 3 or more separate occasions, they should be reckoned as 2, 3 or more cases.) Particulars No. of cases in which defects were found Number of cases in which prosecutions were instituted Found Referred Remedied To H.M. Inspector By H.M. Inspector | Want of Cleanliness (S.l) 5 5 — — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate Ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7) — — — — — (a) Insufficient — — — — — (b) Unsuitable or defective 6 6 — — — (c) Not separate for sexes — — — — — Other offences against the Act (not including offences relating to Outwork) — — — — — Total 11 11 — — — 28 29 OUTWORK—(Sections 133 and 134) Nature of Work Section 133 Section 134 Number of Outworkers in August list required by Section 133(1) (c) Number of cases of default in sending lists to the Council Number of prosecutions for failure to supply lists Number of instances of work in unwhole some premises Notices served Prosecutions Wearing Apparel 73 — — — — — Making of boxes or other receptacles or parts thereof made wholly or partially of paper 3 — — — — Carding etc. of buttons 10 — — — — — Cosaques, Christmas crackers, stockings, etc. 4 — — — — — Lampshades 1 — — — — — Furrier 1 — — — — — Total 92 — — — — — PREVALENCE AND CONTROL OF INFECTIOUS DISEASES From the table of infectious diseases set out on page 33, it will be seen that 188 cases of infectious disease were notified during the year against 915 in 1961. The Infectious Sickness Rate for the year was therefore 2.62 as compared with 12.79 during the previous year. The following table sets out the infectious diseases notified during 1962, as compared with the notifications received during 1961:— 1962 1961 Scarlet fever 14 21 Pertussis 11 6 Measles 98 733 Pneumonia 3 23 Poliomyelitis (non-paralytic) 1 — Dysentery 17 88 Encephalitis — 1 Food Poisoning 27 13 Erysipelas — 2 Puerperal Pyrexia 1 — Tuberculosis 16 28 188 915 From the table set out above, the following facts emerge :— 1. Scarlet fever notifications totalled 14 in 1962, a drop of 7 on the 1961 figures. 2. It is now 15 years since the last case of diphtheria was notified in the Borough and 20 years since this was a cause of death. Outbreaks of diphtheria still occur from time to time in different parts of England and Wales but if we can succeed in keeping our immunisation rate at its present very high level, we should certainly avoid any danger of such an outbreak in Southgate. The fact that 96.9% of infants under 2 years of age are protected against diphtheria is very gratifying. The great majority of these immunisations are combined in the triple antigen giving protection against whooping cough and tetanus as well. 3. Measles notifications fell from 733 in 1961 to 98 this year. The type of infection was again very mild. 30 4. Pertussis notifications were 11 this year—although 5 more than last year, still a very satisfactory figure. Although it is difficult in any one Borough to show statistic ally the effect of whooping cough vaccination, recently published figures are of great interest. These show that for England and Wales in 1960 and 1961 the total deaths from whooping cough were 64, and of these 64 deaths, only 1 occurred in a completely vaccinated child—a child aged 2 years who suffered from epilepsy. Although the death rate from pertussis is low, it is such a distressing disease that every child should be protected from it so far as is possible. 5. The incidence of food poisoning and dysentery fell from a combined total of 101 in 1961 to 44 in 1962. All cases of dysentery and food poisoning, particularly Salmonella typhi-murium infections, are carefully investigated and are fully followed-up wherever the source of infection may lie. Although such a marked fall in cases this year is very satisfactory this rate is extremely variable and there is by no means any general reduction throughout the country in these infections. One case of poliomyelitis was notified in 1962. This was nonparalytic and the patient, a little girl aged 2 years, made a good recovery. This child had commenced a course of poliomyelitis immunisation and her third injection was not yet due when she developed poliomyelitis. It may be that her partial immunisation accounted for the mildness of the attack and the complete recovery. All her home contacts accepted poliomyelitis vaccination and no further cases arose. The rate of poliomyelitis immunisation for Southgate children continues at a satisfactorily high level. 7. Sixteen cases of tuberculosis were notified in 1962, 12 fewer than during 1961. No visit was paid to Southgate by the Mass Radiography Unit in 1962. I would state, however, that the Unit has since made a visit to the Borough. 31 The distribution of cases of tuberculosis notified among the various wards was as follows:— North-east North-west Middle South 3 2 5 6 A broad classification of the cases of tuberculosis notified during the past five years in relation to employment was:— 1958 1959 1960 1961 1962 Clerical 3 3 3 7 5 Housewives — 3 4 3 3 Children 1 — 5 — — Manual labour 3 — 1 — 2 Factory Workers 3 — 4 1 — Professional Glasses 2 1 4 1 1 Armed Forces — — 1 1 — Domestic Service 1 — — — — Food Trades — 1 — — — Students — 2 1 — — Shop Assistants 1 — 1 — — Nurses — — 1 — — Non-manual trades other than food 4 5 1 3 _ Teachers — 3 — 1 — Unclassified 12 7 2 11 5 30 25 28 28 16 Our scheme for the B.C.G. vaccination of school children is actively continuing and is working extremely well. This work is undertaken by the School Health Service. 32 NOTIFICATION OF INFECTIOUS DISEASES, 1962 Disease Jan.— March April— June JulySept. Oct.— Dec. Totals Scarlet Fever 1 3 1 9 14 Pertussis 2 8 11 11 Poliomyelitis, paralytic — — — — — Poliomyelitis, non-paralytic — — 1 — 11 Measles 4 5 31 58 98 Pneumonia 1 2 3 Dysentery — 3 5 9 17 Food Poisoning 12 2 1 12 27 Puerperal Pyrexia —. — — 1 1 Tuberculosis, pulmonary — 2 7 5 14 non-pulmonary — — 2 — 2 Totals 20 25 49 94 188 REGISTER OF TUBERCULOSIS CASES Pulmonary NonPulmonary Totals M. F. M. F. Cases on Register at 1.1.62 247 195 22 25 489 Cases notified for the first time in 1962 10 4 — 2 16 Cases Restored to Register 2 1 — — 3 Other Cases Added 7 113 1 — 21 Cases Removed from Register 31 21 1 2 55 Cases Remaining on Register at 31.12.62 235 192 22 25 474 TUBERCULOSIS, 1962 Age *New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary M. F. M. F. M. F. M. F. Under 1 year — — — — — — — — 1- 5 years — — — — — — — — 5-10 years — — — — — — — — 10-15 years — — — — — — — — 15-20 years 1 2 — — — — — — 20-25 years — 5 — 1 — — — — 25-35 years 6 2 1 1 — — — — 35-45 years 2 3 — — 1 — — — 45-55 years 4 2 — — — — — — 55-65 years 4 — — — 4 — — — Over 65 years 2 1 — — 3 — — — Unknown — — — — — — — — Total 19 15 1 2 8 — — — * These figures include all cases previously notified and noted by the Tuberculosis Officer and others as having removed into the district. 33 APPENDIX I (a) Letters to Doctors Letters on the following subjects were circulated to Southgate practitioners in 1962, some under signature of Medical Officer of Health others either as Area Medical Officer or District School Medical Officer:— 26th February Ante-Natal Record Cards 21st March Oral Polio Vaccine 23rd March Laboratory Specimen—Saturday Closing 26th March Laboratory Specimen—Saturday Closing 12th April Collection of Laboratory specimens 7th May Polio Vaccination 5th June Collection of Laboratory Specimens 19th July Collection of Laboratory Specimens 7th August Prevention of Accidents in the Home 10th August Oral Polio Vaccine 15 th October Domiciliary Midwifery Service 23rd October Poliomyelitis Vaccine 25th October Plantar Warts (Verrucas) 6th November Vaccines for Immunisation 11th December Collection of Laboratory Specimens (b) Medical Examinations During 1962, 57 medical examinations were carried out in respect of the new entrants to the Council's service. In addition to these medical examinations, quite a number of medical reports were obtained on employees absent from duty for more than a short period through sickness. These reports were obtained from the family doctor with whom, as has already been said, we have the most happy relations, or from a hospital. 34