AC 439(1) Llibbrary BOROUGH OF SOUTHGATE ANNUAL REPORT of the Medical Officer of Health for the Year 1964 JANET R. CAMPBELL, M.B., ch.B., D.P.H Medical Officer of Health SouG 49 BOROUGH OF SOUTHGATE ANNUAL REPORT of the Medical Officer of Health for the Year 1964 JANET R. CAMPBELL, m.b., ch.b., d.p.h 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 1964. This will be my last annual report and the last report for the Borough of Southgate. It is to me a doubly nostalgic occasion because it terminates the very happy association I have enjoyed with Southgate over the past 33 years, first as Assistant School Medical Officer and finally as Medical Officer of Health. On an occasion such as this— in a sense a farewell to the Borough of Southgate— one is irresistably drawn to look back over the years so far as the health records go and this takes us to 1896. Over these 68 years the advance in knowledge and understanding of infections, the saving of infant life and the greatly increased life span are achievements which must have seemed beyond the dreams of the Medical Officers of Health of those early days. I have done a series of graphs to illustrate some of these advances and together with explanatory notes these are to be found on pages 33 to 36 at the end of this report. To return to this year's report, although substantially complete, a few items, e.g. number of illegitimate births, etc., are not yet to hand from the Registrar-General. In 1964 there was a slight regression in the birth rate which rose consistently each year from 1958 to 1963. This year, with 965 live births, the rate per 1.000 population was 13.48 against 15.63 last year. The crude death rate was 11.79 compared with 13.55 in 1963. The corrected death rate for 1964 cannot yet be estimated. Again there were no maternal deaths, the last such death occurring in 1959. The infant mortality rate, i.e. the number of infants who died during the first year of life per 1,000 live births was 15.54. This, although higher than last year, compares very favourably with the figures of 18.7 for the county and 20.9 for England and Wales for 1963. The number of infectious diseases notified was 257 compared with 1,560 last year. Measles notifications were 148 against 1,104, and dysentery notifications 18 against 244 in 1963. 2 Again in 1964 there were no notifications of diphtheria, which now puts the last such notification at a distance of 17 years. Notifications of whooping cough were 50. Tetanus Immunisation of Borough Staff One of the most satisfactory features of our work in 1964 was the immunisation against tetanus of 124 of ithe outdoor staff of the Borough, including the Parks, Buildings, Roads, Sewers and Refuse Collection and Disposal Staffs. This is the first opportunity of such protection that these groups have had and I am particularly pleased that so many have availed themselves of it. My thanks are due to the County Medical Officer for permission to use the facilities and staff of our clinics for this purpose. Health Education Our scheme to hold meetings with parents and staff associations has made good progress. At these meetings we have shown various films for discussion with parents and teachers, and subsequently the School Medical Officers have attended at the schools for the showing of the films and have been available for questions and discussion. This seems to be a reasonable line of progress and has met with a good reception. On every member of the Public Health Department, as I am aware on every one of the Council's Officers, extra duties have fallen in relation to the coming changes in the Borough. The warm help' fulness met with on all sides and from all departments is one of the heartening features in this rather difficult change-over. Once again I wish to express my appreciation of the loyalty and efficiency of every member of the staff of the Public Health Depart' men;t, and would thank especially Dr. Leonora Crawford my Deputy, Mr. Gooday, Chief Public Health Inspector, upon whom I have relied so much, Mr. Burkill, Deputy Chief Public Health Inspector, and Miss Barratt, Senior Typist. Finally I should like very sincerely to thank the Council and especially the Chairman and Members of the Public Health Committee for their part in helping to transform a duty which at first seemed overwhelming into one which I have greatly enjoyed. I am, Mr. Mayor, Ladies and Gentlemen Your obedient Servant JANET R. CAMPBELL Medical Officer of Health Town Hall Palmers Green, N.13 February, 1965 3 PUBLIC HEALTH COMMITTEE From 1st January to 31st December, 1964 Alderman Richard Prior (Chairman) Alderman H. S. Beardow (Vice-chairman) Councillor S. C. Jenner Councillor L. F. Lafitte Councillor G. D. Payne Councillor A. V. Stapleton Councillor H. O. Thomas PUBLIC HEALTH STAFF Medical Officer of Health: Janet R. Campbell, M.B., Ch.B., D.P.H. Deputy Medical Officer of Health: Leonora A. Crawford, M.B., B.S., D.P.H., D.C.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: J. C. Noble, M.A.P.H.I., Cert. R.S.H., Cert. R.S.H. Meat Inspection. Public Health Inspector: D. G. Ring, M.A.P.H.I., Cert. P.H.I., Dip Meat and Food Inspection, Dip. Smoke Inspector, P.H.I Education Board. Senior Typist : Miss E. W. Barratt. Clerk : Miss G. R. Edwards. Junior Clerk : G. R. Manley. General Assistant : J. L. Arnold Rodent Operator : W. Dowsett. STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (in acres) 3,765 Registrar'General's Estimate of Resident Civilian Population, 1964 71,580 Number of Inhabited Houses and Flats 1st April, 1964 (excluding Shops assessed' with private dwelling accommodation) 23,367 Effective Rateable Value on 1st April, 1964 £4,309,195 Sum represented by Id. rate (1964-65 Revised Estimate) £17,800 4 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR Live Births 965 Birth Rate per 1,000 of the estimated population 13.48 Still Births 14 Rate per 1,000 live and still births 14.30 Deaths from all causes and at all ages 844 Death Rate per 1,000 of the estimated population 11.79 Deaths from Puerperal Causes — From Puerperal Sepsis — From Other Causes — Maternal Death Rate per 1,000 live and still births — Deaths of Infants under 1 year of age 15 Infant Death Rate All Infants per 1,000 Births 15.54 Deaths from Measles, all ages nil Deaths from Pertussis, all ages nil POPULATION The Registrar-General's estimated population of the Borough at Phe middle of 1964 was 71,580, an increase of 370 as compared with 1963. BIRTHS—BIRTH RATES The total nett births for the year accredited to the district were 965, a decrease of 47 on the preceding year. The birth rate for the year was 13.48 per 1,000 of the population. During the year, the number of births recorded was 121 more than the number of deaths, as compared with 47 more in 1963. 5 MORTALITY General Mortality and Death Rate The nett number of deaths accredited to the district was 844, 11211 less than in 1963. This gives a crude death rate of 11.79 per 1,000 of the population (the rate for 1963 being 10.98). The corrected death rate is not yet available. The Deaths and Death Rates for the past five years have been: Death Rates year Number of Deaths Southgate England & Wales 1960 929 (Corrected) 11.0 11.5 1961 921 ,, 10.8 12.0 1962 1,084 ,, 11.6 11.9 1963 965 ,, 10.98 12.2 1964 844 (Crude) 11.79 — Deaths from bronchitis and cancer of the lung and bronchus totalling 105 were very similar to those of last year which totalled 100. Deaths from diseases of the heart and circulation, however, show a welcome drop from 505 to 428. Infant Mortality Of the 15 infant deaths recorded for Southgate in 1964, 7 did not survive beyond one month and 5 died in the first week. Still Births Fourteen still births were accredited to the Borough in 1964. This is equal to a death rate of 14.30 per 1,000 live and still births, the corresponding figures for 1963 being 11 still births and a rate of 10.75. Maternal Mortality There were no maternal deaths in 1964. Mortality of Persons over the age of 65 Six hundred and ten deaths or 72.271% of the total deaths during the year occurred in persons over the age of 65 years. Of these, 230 died between the ages of 80 and 90, while a further 19 females and 9 males were over 90 years, the oldest being 98. 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. 6 TABLE I Causes of Death during the year 1964 Causes of Death Male Female Total Rates per 1,000 of population All cases (civilians only) 394 450 844 11.79 1. Tuberculosis, Respiratory - 1 1 0.01 2. Tuberculosis, Other — — — — 3. Syphilitic Disease — — — — 4. Diphtheria — — — — 5. Whooping Cough — — — — 6. Meningococcal Infection 1 — 1 0.01 7. Acute Poliomyelitis — — — — 8. Measles - - - — 9. Other Infective and Parasitic Diseases — — — — 10. Malignant Neoplasm—stomach 6 8 14 0.20 11. Malignant Neoplasm, Lung, Bronchus 37 5 42 0.59 12. Malignant Neoplasm, Breast — 18 18 0.25 13. Malignant Neoplasm, Uterus — 1 1 0.01 14. Other malignant and lymphatic Neoplasms 34 38 72 1.01 15. Leukaemia, Aleukaemia 2 4 6 0.08 16. Diabetes 1 2 3 0.04 17. Vascular Lesions of Nervous System 20 61 81 1.13 18. Coronary Disease, Angina 56 36 92 1.28 19. Hypertension with Heart Disease 15 17 32 0.45 20. Other Heart Disease 63 818 151 2.12 21. Other Circulatory Disease 29 43 72 1.01 22. Influenza - — - - 23. Pneumonia 48 51 99 1.38 24. Bronchitis 33 30 63 0.88 25. Other Diseases of Respiratory System 7 8 15 0.21 26. Ulcers of Stomach and Duodenum 1 2 3 0.04 27. Gastritis, Enteritis and Diarrhoea — 2 2 0.03 28. Nephritis and Nephrosis 3 3 6 0.08 29. Hyperplasia of Prostate — — — — 30. Pregnancy, Childbirth, Abortion — — — — 31. Congenital Malformation 4 1 5 0.07 32. Other Defined and Ill-Defined Diseases 23 19 42 0.59 33. Motor Vehicle Accidents 4 1 5 0.07 34. All Other Accidents 2 5 7 0.10 35. Suicide 5 6 11 0.15 36. Homicide — — — — 7 TABLE IA Causes of death during the year 1964, divided into age groups FEMALES Causes of Death Under 1 year 1—4 years 5 —14 years 15—24 years 25—44 years 45—64 years 65—180 years 81—90 years Over 90 years Totals, all ages 1. Tuberculosis, Respiratory - - - - - 1 - - - 1 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 - - - - - - - - - - 10. Malignant Neoplasm, Stomach - - - - - 2 3 3 — 8 11. Malignant Neoplasm, Lung, Bronchus - - - - - 2 1 1 1 5 12. Malignant Neoplasm, Breast - - — - 2 11 4 1 - 18 13. Malignant Neoplasm, Uterus - - - - - - - 1 - 1 14. Other Malignant and Lymphatic Neoplasms - - - - 1 8 18 10 1 38 15. Leukaemia, Aleuksmia - - - - - 1 2 1 - 4 16. Diabetes - - - - - - 1 - 1 2 17. Vascular Lesions of Nervous System - - - - - 5 34 22 - 61 Carried forward - - - - 3 30 63 39 3 1 37 8 TABLE IA—cont. Cause of Death Under 1 year 1—4 years 5 —14 years 15—24 years 2'5—44 years 45—64 years 65—80 years 81—90 years Over 90 years J Totals, all ages Brought forward - - - - 3 30 63 39 3 1 37 18. Coronary Disease, Angina - - - - 1 4 15 16 - 36 19. Hypertension with Heart Disease - - - - - 2 12 3 - 17 20. Other Heart Disease 1 - - - - 5 35 39 8 88 21. Other Circulatory Disease - - - - 1 10 16 15 1 43 22. Influenza - - - - - - - - - - 23. Pneumonia - - - - - 6 21 22 2 51 24. Bronchitis 2 - - 1 1 2 12 11 1 30 25. Other Diseases of Respiratory System 1 - - - - 3 3 1 - 8 26. Ulcers of Stomach and Duodenum - - - - - 1 - 1 - 2 27. Gastritis, Enteritis and Diarrhoea - - - - - - - 2 - 2 28. Nephritis and Nephrosis - - - - - - 1 - 2 3 30. Pregnancy, Childbirth, Abortion - - - - - - - - - - 31. Congenital Malformations - - 1 - - - - - - 1 32. Other Defined and illdefined Diseases 1 - - - 1 3 8 4 2 19 33. Motor Vehicle Accidents - - - 1 - - - - - 1 3!4. All Other Accidents - - - - - 3 2 - - 5 35. Suicide - - - 2 2 - 1 1 - 6 36. Homicide - - - - - - - - - - Totals 5 - 1 4 9 69 189 154 19 450 9 TABLE IB Causes of death during the year 1964, divided into age groups MALES Cause of Death Under 1 year 1—4 years 5—14 years 15—24 years 25—44 years 45—64 years 65—SO years 81—90 years Over 90 years Totals all ages 1. Tuberculosis, Respiratory - - - - - - - - - - 2. Tuberculosis, Other - - - - - - - - - - 3. Syphilitic Disease - - - - - - - - - - 4. Diphtheria - - - - - - - - - - 5. Whooping Cough - - - - - - - - - - 6. Meningococcal Infection - - - - - - 1 - - 1 7. Acute Poliomyelitis - - - - - - - - - - 8. Measles - - - - - - - - - - 9. Other Infective and Parasitic Diseases - - - - - - - - - - 10. Malignant Neoplasm, Stomach - - - - - 2 4 - - 6 11. Malignant Neoplasm, Lung, Bronchus - - - - 2 17 15 3 — 37 14. Other Malignant and Lymphatic Neoplasms - - — — 2 16 10 6 - 34 15. Leukaemia, Aleukaemia - - - - 1 - 1 - - 2 16. Diabetes - - - - - - 1 - - 1 17. Vascular Lesions of Nervous System 1 - — - - 4 10 4 1 20 18. Coronary Disease, Angina - - - - 3 19 28 5 1 56 19. Hypertension with Heart Disease - - - - - 7 6 2 - 15 Carried forward 1 - - - 18 65 76 20 2 172 10 TABLE IB—cont. Causes of Death Under 1 year 1—4 years 5 —14 years 15—24 years 25—44 years 45—64 years 65—180 years 81—90 years Over 90 years Totals all ages Brought forward 1 - - - 8 65 76 20 2 172 20. Other Heart Disease - - 1 1 - 12 26 21 2 63 21. Other Circulatory Diseases - - 1 - - 9 13 6 - 29 2-2. Influenza - - - - - - - - - - 23. Pneumonia - - - - - 6 22 16 4 48 24. Bronchitis 4 1 - - 1 7 10 9 1 33 25. Other Diseases of Respiratory System - - - - - 3 3 1 - 7 26. Ulcers of Stomach and Duodenum - - - - - - 1 - - 1 27. Gastritis, Enteritis and Diarrhoea - - - - - - - - - - 28. Nephritis and Nephrosis - - - - - 1 2 - - 3 29. Hyperplasia of Prostate - - - - - - - - - - 31. Congenital Malformations 3 1 - - - - - - - 4 32. Other Defined and Illdefined Diseases 2 - - 3 1 8 7 2 - 23 33. Motor Vehicle Accidents - - - 1 - 1 2 - - 4 34. All Other Accidents - - - - 2 - - - - 2 35. Suicide - - - - 2 1 1 1 - 5 36. Homicide - - - - - - - - - - T otals 10 2 2 5 14 113 163 76 9 394 11 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 1964 Age FEMALES MALES TOTALS 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 5 0.59 0.07 10 1.18 0.14 15 1.77 0.21 1-5 years — — — 2 0.24 0.03 2 0.24 0.03 5-15 years 1 0.12 0.01 2 0.24 0.03 3 0.36 0.04 15-25 years 4 0.47 0.06 5 0.59 0.07 9 1.06 0.13 25-45 years 9 1.06 0.13 14 1.66 0.19 23 2.72 0.32 45-65 years 69 8.18 0.96 113 1'3.39 1.5.8 182 21.57 2.54 65-75 years 98 11.61 1.37 114 13.51 1.59 212 25.12 2.96 Over 75 years 264 31.218 3.69 134 15.818 1.87 398 47.16 5.56 Totals 450 5331 6.29 394 46.69 5.50 844 100.00 11.79 12 TABLE III INFANTILE MORTALITY 1964: Net 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. Other Tuberculosis - - - - - - - - - - 10. Abdominal Tuberculosis - - - - - - - - - - 11. Meningitis (not Tuberculous) - - - - - - - - - - 12. Convulsions - - - - - - - - - - 13. Laryngitis — - - - - - - - - - 14. Bronchitis - 1 - — 1 1 3 1 - 6 15. Pneumonia 1 — — — 1 — 2 — - 3 16. Diarrhoea - - - - - - - - - - 17. Enteritis - - - - - - - - - - 18. Gastritis - - - - - - - - - - 19. Syphilis - - - - - - - - - - 20. Rickets - - - - - - - - - - 21. Want of attention and Iniury at Birth - - - - - - - - - - 22. Suffocation - - - - - - - - - - 23. Atelectasis - - - - - - - - - - 24. Congenital Malformation 1 1 - - 2 - - - 1 3 25. Premature Birth 3 - - - 3 — - - - 3 26. Atrophy, Debility and Marasmus - - - - - - - - - - 27. Other Causes - - - - - - - - - - Total 5 2 - - 7 1 5 1 1 15 13 TABLE IV Vital statistics of whole district during 1964 and eight preceding years Year Population estimated at Middle of each Year Net Births belonging to the District Net 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 live births 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 71,490 937 13.10 921 12.90 15 16.00 1962 71,370 947 13.30 984 13.80 14 14.80 1963 71,210 1,012 14.21 965 13.55 9 8.89 1964 71,580 965 113.418 1844 11.79 (crude) 15 15.54 14 GENERAL PROVISION OF HEALTH SERVICES Care of the Aged Fortunately the residents of Southgate continue to live as a rule to a ripe old age— and in most cases to an active and happy old age. There are however, a considerable number of elderly people who are lonely and out of touch with the services which are provided1 to help them and it is towards these people that our efforts are especially directed. The Old Peoples Welfare Committee are continually expanding their services and the Centre at Ruth Winston House is of inestimable benefit. The Elderly Persons' Advice Clinics also are being extended so that they will be available to elderly people in the various parts of the Borough. Until recently sessions were held fortnightly at Ruth Winston House. It has now been arranged1 to hold monthly sessions at each of four centres, Ruth Winston House, Green Lanes, N.13; Broomfield House, Broomfield Park, N.13; Combined Clinic, Bowes Road, N.ll; and de Bohun Clinic, Green Road, N.14. These Advice Clinics will be attended by Dr. O'Callaghan, together with a member of the nursing staff. Laundry Service for Aged Incontinent Persons This service was set up in Wood Green in 1963 to serve the Boroughs of Wood Green and Southgate and the Urban District of Friern Barnet. It is an excellent example of co-operation between three local authorities, all of whom have this service closely at heart. With the coming changes other arrangements have had to be made and as from 1st March laundry for Southgate will be dealt with at Colindale Isolation Hospital. St. Ann's Hospital, Tottenham, however, hope quite soon to be able to accept Southgate laundry, together with that for Edmonton. I am grateful to the three councils and to the officers, particularly of the Engineer's Department in Wood Green, who have made the scheme work so smoothly and efficiently and also to Mrs. Mitchell, the Area Home Help Organiser, for the extra work she has willingly put into this service. Chiropody Service Southgate is very fortunate in retaining the services of Mr. Rockman, the whole-time chiropodist appointed by the County to Area 2. He will continue to hold sessions at de Bohun Clinic and also to carry out domiciliary work. 15 Hospitals The general hospital services available to the people of South' gate continue in the main as in previous years. The acute shortage is in maternity beds, and the scheme for "planned early discharge" must inevitably continue until the shortage is met. In all these cases a very careful investigation is made to ensure that the home is a suitable one to which the mother may safely return 48 hours after her confinement in hospital. Laboratory Facilities I would again record my appreciation and thanks to the staff of the Public Heallth Laboratory Service both at Cblindale and at Edmonton for their unfailing assistance during the year. I feel that we are very highly privileged in having available their expert advice to call upon at any time. Summary of the work carried out by the Laboratory Service for the year is : Positive Negative S'wabs for diphtheria bacilli — 92 Sputa for tubercle bacilli — 17 Throat and Nose 220 Faeces 693 Urine 148 Blood 69 Others 90 Mortuary The mortuary arrangements remain as set out fully in the Annual 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 1964, 107 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 in previous years. In cases requiring treatment at a Cleansing Station, it is our practice to arrange with the Medical Officer of Health of Edmonton for treatment to be carried out at the Edmonton Cleansing Station. During 1964, three persons were treated for scabies at the Edmonton Cleansing Station. 16 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 1964 under this Section. SANITARY SERVICES Summary of Visits Visits re housing defects (Public Health Act, 1936) 1 873 Visits re housing defects (Housing Act 1957-61) 256 Visits re drainage and building works 98 Visits re dustbins (Public Health Act, 1936 15 Visits re housing conditions and overcrowding (applications for housing accommodation) 46 Visits re Rent Act, 1957 24 Visits re food premises (including butchers, bakehouses, confectioners, restaurants, grocers and fish-shops) 1,150 Visits re ice cream sampling 15 Visits re factories 2C8 Visits re Shops Act, 1950 106 Visits re infectious diseases 536 Visits re Clean Air Act 3,011 Visits re Prevention of Damage by Pests Act, 1949 190 Visits re other matters 3,192 10,720 Service of Notices Informal Notices served re Housing Repairs 342 re Dustbins 4 re Food Premises 47 re Shops and Factories 30 Total Informal Notices served 423 Total Statutory Notices served 31 Total Statutory Notices complied with 31 17 Repairs toi 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 378 houses, the repairs varying from those of a major character to minor repairs to abate specific nuisances. The repairs referred to were carried out mainly as a result of informal action. Only in 31 instances was it found necessary to follow-up informal action by the service of Statutory Notices. In three instances it became necessary for the Council to institute legal proceedings to secure compliance with Statutory Notices requiring the execution of repairs. Court Orders were obtained and the works were subsequently carried out. Unfit Houses During 1964, further progress was made in the implementation of the Council's programme for dealing with unfit houses. 9-19 Springfield Road, N-11 1-23 (consecutive) Upper Park Road, N-ll 74-84 (even) High Road, N-l 1 15-41 (odd) Lower Park Road, N-H Confirmation of the Council's Compulsory Purchase O'rder in respect of two areas declared by the Council to be Clearance Areas under Part III of the Housing Act, 1957, and comprising the above-mentioned unfit properties, was received on 25th May, 1964. At the close of the year, the majority of the tenants had been re-housed and demolition of the properties was well in progress. 199 Chase Road, N.14 In October, 1964, the Council made a Closing Order in respect of this house under Part II of the Housing Act, 1957, on the grounds that it was unfit for habitation and incapable at reasonable expense of being made so fit. The tenant vacated the property and it was subsequently demolished voluntarily by the owner. Rent Act, 1957 The following is a summary of the action taken by the Council during 1964 under the Rent Act, 1957:— Part I—Applications for Certificates of Disrepair (1) Number of applications for certificates 2 (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 2 18 (4) Number of Undertakings given by landlords under paragraph 5 of the First Schedule 2 (5) Number of Certificates issued nil Part II—Applications for Cancellation of Certificates (6) Applications by landlords to Local Authority for cancellation of certificates nil (7) Objections by tenants to cancellation of Certificates nil (8) Decisions by Local Authority to cancel in spite of tenants' objections nil (9) Certificates cancelled by Local Authority 3 Housing Applications The staff of the Public Health Department work in close liaison with that of the Housing Department. I myself have frequent meetings with Miss Grey to review and discuss cases regarding medical priority. The Public Health Inspectors also are often called upon to visit housing applicants in order to make a report on their living conditions. The number cvf visits for this purpose was 46 as against 83 in 1963. Food Hygiene As in previous years, considerable attention has been given by the Public Health Inspectors to the storage, distribution and sale of food at the various food premises in the Borough. For this purpose, the Inspectors made 1,150 visits to food premises during 1964. Generally speaking, the standard of food hygiene maintained by the food traders is good. Arising out of these visits, however, it was found necessary in 47 instances to require the occupiers of food premises to remedy 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 and Drugs Act 1955, in respect of the following offences: Sale of loaf containing portion of Firm fined £15 plus adhesive bandage costs Sale of loaf containing piece of Firm fined £20 .plus adhesive tape costs Sale of loaf containing a metal screw Firm fined £50 plus costs 19 Sale of iced bun containing part of a Firm fined £10 plus wasp costs Sale of loaf containing a common Firm fined £10 plus house-fly costs Legal proceedings were also instituted by the Council under the Milk and Dairies (General) Regulations 1959 in respect of milk bottles not being properly cleansed prior to filling : Milk bottle with cement adhering to Firm fined £10 plus the inside costs Milk bottle having pupara: of the fruit Firm fined £10 plus fly adhering to the inside costs Food Inspection The following is a summary of food surrendered and condemned during the year as unfit for human consumption. The food, most of which was in comparatively 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 92 lbs Carcase meat 847 lbs Offal 115 lbs Ham (canned) 570 lbs Ham (cooked) 12 lbs Canned Meats (various) 24 lbs Canned Foods (various) 123 cans Frozen Foods—Vegetables 340 lbs Meat 174 lbs Fish 185 lbs Miscellaneous 144 lbs Nuts 84 lbs Ice cream 3,369 packets Cheese 262 lbs 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 32 Butchers 54 Grocery and Provisions 117 Fruit and Greengrocery 59 20 In the Borough there are 335 premises registered under Section 16 of the Food and Drugs Act 1955, 240 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 101 hawkers on the register at the end of 1964. Of these, 26 have storage premises in the Borough and 75 have their storage premises in other areas. Post-Mortem Inspection of Animals No slaughtering of animals took place in the Borough during 1964. Wet Fish 14 Fried Fish 7 Restaurants and cafes (including school canteens, works canteens, clubs, etc.) 119 Confectionery and sweets 94 496 Ice Cream Sampling During the year under review, 15 samples of ice cream were obtained and submitted to the Public Health Laboratory for bacteriological examination. The results were: Grade 1 13 „ 2 2 „ 3 - 4 — 15 Generally these results are good. The samples which gave the Grade 2 results were pre-packed and were obtained from two retail shops in the Borough. The opportunity was taken by the Public Health Inspectors to direct the attention of the manufacturers to the results and to check the method of distribution of the retailers. Establishments for Massage or Special Treatment Under the Middlesex County Council Act, 1944, fourteen licences were renewed and two new licences were granted in respect of establishments for massage, chiropody or special treatment. 21 Pet Animals Act, 1951 Five licences were granted by the Coundil during 1964 under the above-mentioned Act in respect of pet an'imal shops in the Borough. Swimming Bath The figures for attendances at the Barrowell Green Open Air Swimming Bath for the past two years were: 1964 1963 Adults (Mixed and Spectators) 20,905 1 l,8l6 Children (Mixed and Spectators) 35,040 19,809 From Schools 4,216 3,056 Season Tickets 4,197 3,938 64,358 38,619 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 1964 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 1964, 358 complaints of rats and mice were received and dealt with, as against 458 in 1963. In April, a baiting and poisoriing treatment was carried out by the Borough Engineer's Department in the Council's soil sewers. 530 manholes were baited. The poison bait used for this treatment was pinhead oatmeal plus warfarin. In 26 of the man-holes baited, complete or part takes of bait were noted. In October, 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 22 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 & Food. 22 Public Conveniences Sixteen public conveniences are available in the Borough, situated as follows: Broomfield Park (3) Arnos Park Bramley Sports Ground Oakwood Park Tottenhall Sports Ground North Circular Road, Palmers Green Triangle, Palmers Green High Road, New Southgate, N.l1 Fords Grove, Winchmore Hill "Cherry Tree" Hotel, The Green, 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. Refuse Collection and Disposal A weekly collection service was maintained throughout the year. The quantity of refuse from all sources dealt w'ith at the Refuse Disposal Works, Barrowell Green, N.21, amounted to 22,855 tons, an increase of 82 tons over the previous year. The number of speciall collections of garden refuse, furniture, etc., carried out during the year was 1,948. 23 The abandonment of vehicles within the Borough has not, so far, become the problem in Southgate that it has in many areas. 20 such vehicles were removed by the Council during 1964. Many owners no longer wanting their vehicles have, fortunately, sought the advice of the Council regarding disposal. In cases in which the owner has been a resident of the Borough, the Council has made available a free disposal service on delivery of the vehicle at the Refuse Disposal Works. The sale of salvage recovered from the refuse realised an income of £16,349. This is an increase of £810 over the previous year. Tonnages of materials salvaged were as follows:— tons Waste Paper 1,459 Scrap Metals 523 Rags 25 Bottles 3 Carpet 23 Gullet 71 Miscellaneous 20 Street Cleansing The normal frequency of sweeping of streets in the Borough was as follows:— miles At least once daily 6 Three times weekly 12 Twice weekly 60 Once weekly 6 Control of weed growths on pavements, etc., throughout the Borough was effected by the application of chemical weed killer. During the year 11,262 gully cleansings were carried out. Fumes and Noise During 1964, 13 complaints were received from residents concerning alleged nuisances from fumes arising in one instance from industrial premises and in seven instances from domestic premises. In the case of the industrial premises, observations were made and steps taken to obtain the co-operation of the firm concerned, with the result that the nuisances were abated. In the case of the domestic premises, the complaints concerned fumes arising from oil-fired central heating installations. Each complaint was investigated by the Public Health Inspectors and the occupiers advised upon remedial action. Twenty complaints were received from residents concerning alleged nuisances from noise. The noises arose from various sources 24 including noisy dogs, noisy refrigerator, panel beating and industrial noise. Informal action taken by the Inspectors resulted in the noises ceasing or being reduced in extent. Air Pollution During the year under review, no contraventions of the Dark Smoke (Permitted Periods) Regulations were observed on any of the industrial premises in the Borough. With regard to pollution from domestic premises, further progress was made in the implementation of the Council's programme in respect of Smoke Control Orders. The Council's No. 4 Smoke Control Order carne into operation on 1st October. The area covered was 4417 acres containing 1,674 dwellings, 5 industrial premises, 75 commercial and 11 other premises, and extended the area already covered by the Council's Nos. 1, 2 and 3 Orders. In this connection, as in previous years, much time and considerable effort were entailed during the greater part of the year in dealing with numerous applications from residents for financial grants under the Clean Air Act, 1956, towards the conversion or adaptation of their fireplaces to enable them to avoid contravening the Order by emitting smoke from their premises. All applications were examined individually, advice given to applicants on their choice of fuel appliance, information as to the amount of grant to which they were entitled, and in each case the conversions and adaptations inspected to ensure that they were carried out to the satisfaction of the Council. A further step in the implementation of the Council's programme was the preliminary work done in the early part of the year in respect of the Council's No. 5 Smoke Control Order. This culminated in June in the submission of the requisite information by the Council to the Ministry of Housing and Local Government for confirmation of the Order. The Minister's confirmation was received on 2ilSt September. Between this date and the end of the year, many residents took advantage of the relatively mild winter and following submission of and approval to their applications for grant aid, put in hand the work of converting or adapting their fireplaces to enable them to conform to the Order. The date of operation of the Order is fixed at 1st November, 1965. The smoothness With which the Council's programme for Smoke Control Areas has progressed in the years 1959-1964, is due, in my View, largely to realisation on the part of residents that the reduction of atmospheric pollution in the Borough is a worth-while public health measure. Also, I feel, it is due in no small degree to the efficiency with which the work has been carried through by the staff generally and in particular by Mr. R. L. Burkill, Deputy Chief Public Health Inspector. 25 FACTORIES ACT, 1961 Details of work carried out during the year 1964 1. INSPECTIONS for purposes of provisions as to health (including Inspections made by Public Health Inspectors). Premises Number on Register Number of Inspections W ritten Notices Occupiers Prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 29 21 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 168 187 - - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers premises) - - - - T otal 197 208 - - 2. Cases in which DEFECTS were found. (If the ddfects are discovered at the premises on 2, 3 or 4 more separate occasions, they should 'be reckoned as 2, 3 or more cases.) Particulars Found No. of cases in which defects were found Number of cases in which prosecutions were instituted Remedied Referred To H.M. Inspector By H.M. Inspector Want of Cleanliness (S.l) 4 4 — 1 — Overcrowding (S.2) — — — - — Unreasonable temperature (S.3) 1 1 — - — Inadequate Ventilation (S.4) - - - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient 1 1 — - — (b) Unsuitable or defective 3 3 - - - (c) Not separate for sexes — — — - — Other offences against the Act (not including offences relating to Outwork) - - - - - Total 9 9 - 1 — 26 OUTWORK—(Sections 133 and 134) Nature of Work Section 133 Section 134 Number of Outworkers in August list required by Section 133(l)(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 unwholesome premises Notices served Prosecutions Wearing Apparel 60 - - - - - Making of boxes or other receptacles or parts thereof made wholly or partially of paper 2 - - - - - Carding etc. of buttons 20 — — — — — Painting of toys, etc 3 — — — — — Fancy goods 1 — — — — — Making of paper bags 1 — — — — — Furrier 1 — — — — — Handbags 3 — — — — — Jewel and Instrument-case maker 1 — — — — — Electrical Components 1 — — — — — Cotton Bag Maker 3 — — — — — Plastic Goods 1 — — — — — Total 97 — — — — — 27 PREVALENCE AND CONTROL OF INFECTIOUS DISEASES The picture regarding infectious diseases for 1964 is a particularly satisfactory one. It will be seen from the table set out on page 31 that 257 cases of infectious disease were notified cfuring the year, as against 1,560 in 1963. The Infectious Sickness Rate for the year was therefore 3.59 as compared with 20.18 during 1963. The following table sets out the infectious diseases notified during 1964, as compared with the notifications received during 1963:— 1964 1963 Scarlet fever 11 20 Pertussis 50 72 Measles 148 1,164 Pneumonia 7 24 Dysentery 18 244 Food Poisoning 10 11 Puerperal Pyrexia 4 1 Erysipelas — 6 Typhoid — 2 Meningococcal Infection 1 — Tuberculosis 8 16 257 1,560 From the table set out above, the following facts emerge:— 1. Scarlet fever notifications totalled 11,9 fewer than last year. 2. There were again no cases of diphtheria. The last notification was 17 years ago. 3. Measles notifications fell from 1,164 to 148. 4. Pertussis notifications were 50, 22 less than in 1963. 5. There were no outbreaks of dysentery this year, and the total notifications were 18. 6. Again no cases of poliomyelitis were notified. 7. Only half the number of cases of tuberculosis were notified, 8 this year compared with 16 last year. 28 The distribution of these cases among the various wards was as follows:— North-east North-west Middle South 3 — 2 3 A broad classification of the cases of tuberculosis notified during the past five years in relation to employment was:— 1960 1961 1962 1963 1964 Clerical 3 7 5 1 1 Housewives 4 3 3 3 2 Children 5 — — 2 — Manual labour 1 — 2 1 — Factory Workers 4 1 — — — Professional Classes 4 1 1 1 — Armed Forces 1 1 — — — Domestic Service - - - - - Food Trades - — — — 1 Students 1 — — — — Shop Assistants 1 — — 1 — Nurses 1 — — — — Non-manual trades other than food 1 3 - - - Teachers — 1 — — 1 Unclassified 2 11 5 7 3 28 28 16 16 8 IMMUNISATION AND VACCINATION IN THE CONTROL OF INFECTIOUS DISEASE The following table gives a rough estimate of the extent to which the population of Southgate is protected by immunisation from the various infectious diseases. This is based on our knowledge of the rate of immunisation obtaining in children from infancy to fifteen years of age, covering the period from 1935 to the present elate. (The figures do not however take account of movement of population into or out of the Borough). 29 Disease Age Range of population of Southgate estimated to possess useful protection conferred by vaccination or immunisation Diphtheria From infancy to approximately age 40 During 1964, 92% of children reaching the age of 2 years had been immunised Whooping Cough From infancy to age 40 Tetanus From infancy to age 20 Plus 124 of staff of Southgate Borough Council Smallpox From infancy to approximately 10 years— very fully protected, and to perhaps 15 or 20 years fairly fully protected. Vary ing numbers in ages beyond this. During 1964, 78% of children reaching the age of 2 years had been successfully vaccinated Poliomyelitis From infancy to age 25 years—very fully protected, and also to a lesser extent up to age 50 or over Tuberculosis Ages 13-24 very fully protected. This is the group who have received B.C.G. vaccination in school. The consent rate to B.C.G. vaccination for 1964 was 80.3% Measles 115 children aged 1 to 2 years were vaccinated during 1964 under the Research scheme of the Medical Research Council. 1965 is expected to be an epidemic year for measles and this will test the efficacy of the vaccine in these 115 children whose parents volunteered to take part in the trial 30 NOTIFICATIONS OF INFECTIOUS DISEASES, 1964 Disease Jan.— March April— June JulySept. Oct.— Dec. Totals Scarlet Fever 6 1 2 2 11 Pertussis 9 27 7 7 50 Poliomyelitis, paralytic — — — — — Poliomyelitis, non-paralytic — — — — — Measles 4 13 39 92 148 Pneumonia 3 3 — 1 7 Dysentery 9 2 3 4 18 Meningococcal Infection — — 1 — 1 Food Poisoning — 2 7 1 10 Puerperal Pyrexia 2 1 1 — 4 Erysipelas — — - — — Typhoid — — - — — Tuberculosis, pulmonary 1 2 2 2 7 non-pulmonary — 1 — — 1 Totals 34 52 62 109 257 REGISTER OF TUBERCULOSIS CASES Pulmonary NonPulmonary total M. F. M. F. Cases on Register at 1.1.64 225 175 23 26 449 Cases notified for the first time in 1964 4 3 — 1 8 Cases Restored to Register — 1 — — 1 Other Cases Added 8 8 1 — 17 Cases Removed from Register 37 18 2 3 61 Cases Remaining on Register at 31.12.64 200 169 22 24 414 31 TUBERCULOSIS, 1964 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 - - - - - - - 20-25 years 2 1 1 - - - - - 25-35 years 3 5 — 1 — — — — 35-45 years 2 2 - - - - - - 45-55 years 2 3 — — — 1 — — 55-65 years 1 — — — 1 — — — Over 65 years 1 — — — 5 — — — Unknown - - - - - - - - Total 12 11 1 1 6 1 — — * These figures include all cases previously notified and noted by the Tuberculosis Officer and others as having removed into the district. 32 INCIDENCE AND DEATHS FROM DIPHTHERIA Although the death rate was comparatively small in relation to the large number of cases, diphtheria is a crippling disease and leaves a trail of damage to heart, etc., in its wake. The population today is approximately seven times that of 1890, and but for immunisation the cases of diphtheria might also be seven times greater in today's population, giving a five-year figure of almost 1,000 cases. The dramatic fall, which started in 1936, was the result of a tremendous immunisation campaign which grew in momentum until by the 1940's practically every child up to school-leaving age had been immunised. It is a matter of great satisfaction that, in this Borough, even today there is no falling off in the immunisation rate for diphtheria. INFANT AND EARLY NEO-NATAL MORTALITY These rates over the years are completely comparable, since they are in all cases rates per 1,000 births. The graph shows that, out of 1,000 babies born now, 100 are saved who would have died just over 60 years ago. The remarkable feature of the graph is the contrast between the almost dramatic fall in the total infant mortality rate, and the relatively small reduction in loss of life during the first seven days of life. This "hard core" of deaths is accounted for by congenital defects, birth injury and prematurity. Intensive research is proceeding into factors, e.g., drugs, virus infections, etc., which could produce damage to the developing child, particularly during the first three months of pregnancy. There is a clear case for strict control of all drugs administered to women of child-bearing age and for the giving of Gamma globulin to every expectant mother exposed to a virus infection. In addition, a great effort must be made to obtain hospital admission for every mother starting in premature labour so that the child so greatly at risk shall have special skill immediately at hand, and means available to provide an atmosphere of the right temperature and humidity. PERCENTAGE OF ANNUAL TOTAL DEATHS OCCURRING UNDER THE AGE OF ONE YEAR AND OVER THE AGE OF 65 This is a very interesting graph, showing the increasing age and life-span of the population of Southgate, taken at approximately five-yearly intervals from 1895 to 1964. Today less than two out of 100 deaths in the Borough are of babies under a year, and 70-75 out of 100 deaths are now in people over the age of 65. In 1895 a third of the total deaths were in infants, and only 23 out of 100 who died had reached the age of 65. The killing diseases of infancy then were chiefly the diarrhoeal diseases and pneumonia which were no respectors of class or persons. Few families of any size had not suffered such a loss. A factor not shown in this graph, is the present phenomenally low death rate between the ages of one and 65. This means that having survived the first year of life, there is now a very great expectation of living to 65 years or more. In the early days, not only was there a high infantile death rate, but the loss of young lives from tuberculosis and other infections meant that possibly only half of the babies born lived to maturity. Of tremendous importance to the nation is this survival to maturity of 90 to 95% of children in contrast to the survival of only approximately 50% prior to 1900. When one considers that Sir Winston Churchill, born 90 years ago, was a premature infant and greatly "at risk," one realises how manv great men and women must have been lost to the nation Surely it is a heartening thought that, whatever potential for greatness exists in the nation, it now has the opportunity to mature and declare itself. APPENDIX I (a) Letters to Doctors Letters on the following subjects were circulated to Southgate practitioners in 1964, under my signature either as Medical Officer of Health or as Area Medical Officer:— 13th March Collection of Laboratory specimens 4th May Incontinence Pads 7th May Collection of Laboratory specimens 2nd July Tetanus Immunisation of Staff 14th July Collection of Laboratory specimens 14th September Greater London Boroughs 14th September Home Nursing, Midwifery and Home Help Services 15th December Collection of Laboratory specimens (b) Medical Examinations During 1964, 51 medical examinations were carried out in respect of the new entrants to the Council's service. In addition to these medical examinations, a considerable number of medical reports were obtained from family doctors and hospital consultants concerning employees absent from duty through sickness for more than a short period. Once again, it is a pleasure to acknowledge the courtesy and co-operation which I receive on all occasions from the General Practitioners in Southgate. +