AC 439(1) WEM 37 BOROUGH OF WEMBLEY REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1956 E. GRUNDY, M.D., M.R.C.S., D.P.H., Medical Officer of Health BOROUGH OF WEMBLEY REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1956 E. GRUNDY, M.D., M.R.C.S., D.P.H., Medical Officer of Health HEALTH COMMITTEE (May, 1956) The Mayor—Councillor L. J. SULLIVAN, J.P. The Deputy Mayor—Alderman G. R. MARSHALL Chairman—Councillor F. R. HILL, B.Sc. Vicc-Chairman—Councillor Mrs. NEWLAND Alderman C. H. SMITH, O.B.E., D.L. ; Councillors : M. J. CURLEY, W. R. DUDDEN, P. A. GOFF, N. M. LAMB, Mrs. E. M. LEWIS, E. C. MEREDITH, M.P.S., F.S.M.C., M. G. T. NORTHMORE, W. T. PAVITT, Mrs. E. WYATT STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health: E. GRUNDY, M.D., M.R.C.S., D.P.H. Deputy Medical Officer of Health: Dr. R. HALPERIN Chief Public Health Inspector: R. M. TURNER (a) (b) (c) Deputy Chief Public Health Inspector: H. YOUNG (a) ( b) (c) Public Health Inspectors: C. DUERDEN (a) (b) (c) L. KLUTH (a) (b) (c) G. E. A. REYNOLDS (a) (b) (c) E. POWER (a) (b) (c) (d) A. NICOL (a) (b) Senior Clerk: G. H. HUGHES (a) Second Clerk: A. J. HILL Personal Assistant to Medical Officer of Health: Miss F. H. CARRAN General Clerks: Mrs. H. NIXON R. MARKS (a) Certificate, Royal Sanitary Institute & S.I. Exam. Joint Board. (b) Certificate for Inspectors of Meat and Other Foods. (c) Certificate for Inspectors of Smoke. (d) Certificate, Sanitary Science. 3 BOROUGH OF WEMBLEY ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the Year 1956 To the Mayor, Aldermen and Councillors of the Borough. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit the Annual Report on the Health of the Borough for 1956. This Report has been compiled in the following five chapters, four with a statistical appendix, in which the figures relating to the functions of the Public Health Department have been collected together according to the relevant services. Chapter I VITAL STATISTICS, Page 6, Statistical Appendix A, Pages 7—13. „ II GENERAL HEALTH SERVICES, Pages 14—17, Statistical Appendix B, Page 18. „ III INFECTIOUS DISEASES, Page 19, Statistical Appendix C, Pages 20—25. „ IV ENVIRONMENTAL HYGIENE, FOOD AND WATER, HOUSING, FACTORIES, ETC., Pages 26—39, Statistical Appendix, D, Pages 40—57. „ IV ADMINISTRATION OF THE DEPARTMENT AND STAFF, Pages 58—59. 5 CHAPTER I. VITAL STATISTICS 1. The population of the Borough in mid-1956 was estimated by the Registrar-General to be 128,300 and whilst this is considerably below 131,384 the census figure for 1951 it probably represents the most accurate figure attainable. It is an interesting observation that the population of Wembley and Kingsbury recorded in the census of 1931 was some 65,799, an inter-census increase of 99.7%. Wembley remains the fifth largest County District in Middlesex, those greater, according to population, being Harrow, Ealing, Willesden and Hendon. 2. In 1956 there were recorded 1,492 live births, giving a birth rate of 11.63 per thousand of the estimated population. The number of deaths was 1,160 giving a crude death rate of 9.04 per thousand. When the comparability factor (1.18) is applied the standardised death rate becomes 10.67, an increase on last year's figure but below the national rate of 11.7 per thousand of the population. 3. The infantile mortality rate of 16.76 showed once again a slight drop compared with the figure for the previous year and is below the national rate for England and Wales, yet one feels some comment is not out of place. Prematurity continues to be the main cause of neonatal death and the emergency unit maintained at the Edgware General Hospital is of advantage in cases of prematurity, probably keeping this rate to an absolute minimum. During the year there were two infant deaths as a result of misadventure and, whilst it would be churlish to offer any detailed comments, one cannot help feeling that if such accidents could be avoided it could be nothing but advantageous to the families concerned and to the community generally. 4. During the year two deaths were recorded in adult women from maternal causes. Both of these occurred in hospital and the investigations which take place as a routine in all cases of maternal death revealed that every medical procedure possible seems to have been taken in relation to the two pregnancies. 6 STATISTICAL APPENDIX A. CERTAIN VITAL STATISTICS, 1956 from figures supplied by Registrar-General. (Some comparative 1955 figures within brackets.) Population Total 128,300 Live Births. Male. Female. Total. Live birth rate per 1,000 estimated population. 11.63 Legitimate 758 686 1,444 (1,352) Illegitimate 25 23 48 (45) (10.83) Stillbirths. Legitimate 15 14 29 Rate per 1,000 total (live and still) births 11.86 (11.06) (28) Illegitimate — — — 11.86 (11.06) (1) Stillbirth rate per 1,000 estimated population 0.22 (0.22) Deaths 613 547 1,160 Death rate per 1,000 estimated population — Crude rate 9.04 (1,045) (8.10) Adjusted by Area Comparability Standardised rate 10.67 (8.91) Factor of Registrar-General 1.18 Infantile Mortality. Deaths of infants under one year of age:— Male. Female. Total. Legitimate 17 8 25 (21) 25 Illegitimate — — — (24) (3) 7 Death rate of infants under one year of age :— All infants per 1,000 live births 16.76 (17.18) Legitimate infants per 1,000 legitimate live births 17.31 (15.53) Illegitimate infants per 1,000 live illegitimate births — (66.67) Maternal Mortality. Deaths from Pregnancy, Childbirth, Abortion 2 (1) Maternal mortality rate per 1,000 live births 1.34 (0.72) Maternal mortality rate per 1,000 total (live and still) births 1.31 (0.70) Per 1,000 population. Per 1,000 Live Births. Per 1,000 total births (live and still). Birth rate. Still Birth rate. Death rate. Infantile mortality. Maternal mortality. Maternal mortality. Wembley 11.63 0.22 9.04 16.76 1.34 1.31 England and Wales 15.60 0.37 11.70 23.80 0.57 0.56 London 15.90 0.33 11.70 21.40 — — 160 County Boroughs, etc. 15.60 0.36 11.60 24.00 — — 160 Smaller towns, etc. 15.60 0.36 11.60 24.10 — — Area in acres 6,294 Estimated number of inhabited houses at end of 1956 38,400 Rateable Value, 7th January, 1957 £2,834,465 Estimate of the product of a penny rate 1956/57 £11,350 8 Causes of Deaths during the Year. Causes of Death. Male. Female. 1956. Total.  1. Tuberculosis, respiratory 7 1 8 2. Tuberculosis, other 2 — 2 3. Syphilitic disease 1 1 2 4. Diphtheria — — — 5. Whooping Cough — — — 6. Meningococcal infections — — — 7. Acute poliomyelitis — — — 8. Measles — — — 9. Other infective and parasitic diseases — 1 1 10. Malignant neoplasm, stomach 18 17 35 11. Malignant neoplasm, lung, bronchus 60 10 70 12. Malignant neoplasm, breast — 24 24 13. Malignant neoplasm, uterus — 11 11 14. Other Malignant and Lymphatic neoplasms 74 51 125 15. Leukaemia, aleukaemia 4 — 4 16. Diabetes 2 3 5 17. Vascular lesions of nervous system 50 78 128 18. Coronary disease, angina 127 67 194 19. Hypertension with heart disease 11 11 22 20. Other heart disease 44 87 131 21. Other circulatory disease 25 33 58 22. Influenza 1 4 5 23. Pneumonia 23 28 51 24. Bronchitis 47 28 75 25. Other diseases of respiratory system 8 1 9 26. Ulcer of stomach and duodenum 8 4 12 27. Gastritis, enteritis and diarrhœa 3 2 5 28. Nephritis and nephrosis 9 3 12 29. Hyperplasia of prostate 9 — 9 30. Pregnancy, childbirth, abortion — 2 2 31. Congenital malformations 5 4 9 32. Other defined and ill-defined diseases 46 47 93 33. Motor vehicle accidents 10 6 16 34. All other accidents 13 11 24 35. Suicide 6 12 18 36. Homicide — — — ALL CAUSES 613 547 1,160 9 The Principal Causes of Death. Disease. Total Number of deaths. 1. Heart disease and other diseases of circulatory system (18—21) 405 Vascular lesions of nervous system (17) 128 533 2. Malignant neoplasms (10—14) 265 3. Respiratory diseases:— (a) Influenza (22) 5 (b) Pneumonia (23) 51 (c) Bronchitis (24) 75 (d) Other respiratory diseases (25) 9 140 4. Tuberculosis:— (a) Respiratory system (1) 8 (b) Other forms (2) 2 10 5. Violent deaths:— (a) Suicide (35) 18 (b) Road traffic (33) 16 (c) Other violent causes (34) 24 58 6. Congenital malformations (31) 9 Note: Numbers in brackets are index numbers allocated by Registrar-General for Annual Return of Causes of Deaths. 10  Percentage of total deaths under 1 year. Percentage of total deaths under 50 years. Percentage of deaths taking place in hospitals. 1952 3.16 15.03 44.19 1953 2.67 13.88 34.07 1954 2.42 14.49 50.54 1955 2.30 10.74 49.61 1956 2.16 10.86 50.95 SOME OTHER ESSENTIAL LOCAL STATISTICS. Birth Notifications (as supplied by Area Medical Officer). Notified by. At home. In Hospital. In Nursing Home. Totals. Doctors 2 395 42 439 Midwives 276 819 — 1,095 Parents — — — — Totals 278 1,214 42 1,534 Percentages 18.1 79.1 2.8 100.0 Live births — 1,503 Still births — 31 11 Infantile Mortality. Deaths from stated causes at various ages under one year. Cause of death (extracted from weekly returns of local Registrars, and from inward transfers of RegistrarGeneral). Under 1 week 1 — 2 weeks 2 — 3 weeks 3 — 4 weeks Total under one month 1 — 3 months 3 — 6 months 6 — 9 months 9 — 12 months Total death under 1 year Prematurity 7 — — - 7 - - - - 7 Pneumonia 2 — 1 1 4 - - 1 - 5 Atelectasis 3 1 — — 4 - - — - 4 Intracranial haemorrhage 3 — — — 3 — — — — 3 Hydrocephalus — — — 1 1 — — — — 1 Acute pulmonary oedema — — — 1 1 - - — - 1 Acute gastro enteritis — — — — - 1 - - 1 Myelomeningocele — 1 — — 1 — - — — 1 Misadventure — 1 — — 1 - — 1 2 15 3 1 3 22 — 1 1 1 25 12 Infantile Mortality, 1952-1956 Year. Wembley. England & Wales. 1952 24.33 27.6 1953 20.13 26.8 1954 18.23 25.5 1955 17.18 24.9 1956 16.76 23.8 Infantile mortality during last five years (7,381 live births, 144 deaths under one year): 19.51 Maternal Mortality. Rate per 1,000 total births (live and still), 1952-1956:— Year. Wembley. England & Wales. 1952 0.00 0.72 1953 0.65 0.76 1954 0.66 0.69 1955 0.70 0.64 1956 1.31 0.57 Maternal mortality during last five years (7,531 total births, 5 maternal deaths): 0.66 13 CHAPTER II. GENERAL HEALTH SERVICES. 1. HOSPITALS. The whole of Wembley lies within the area of the North West Metropolitan Regional Hospital Board but hospitals accepting the sick are administered by two Hospital Management Committees, the Central Middlesex Group Hospital Management Committee and the Hendon Group Hospital Management Committee, the two major general hospitals being the Central Middlesex Hospital and the Edgware General Hospital. The Wembley Hospital and the Kingsbury Maternity Hospital are situated in the Borough and these hospitals are under the control of the Governors of Charing Cross Hospital. Infectious diseases are normally accepted at the Neasden Hospital or, in case of necessity, at the Hendon Isolation Hospital. Cases of mental deficiency and mental disease are catered for at Shenley Hospital. Arrangements are made for the admission of tuberculous patients to a variety of hospitals through the three Chest Clinics serving the area. A list of hospitals is included:— Central Middlesex Hospital, Acton Lane, N.W.10. (ELGar 5733.) Edgware General Hospital, Edgware, Middlesex. (EDGware 2381.) Wembley Hospital, Fairview Avenue, Wembley, Middlesex. (WEMbley 3136.) Kingsbury Maternity Hospital, Honeypot Lane, Kingsbury, N.W.9. (COLindale 6309.) Neasden Hospital, Brentfield Road, Neasden, N.W.10. (WILlesden 2251.) Hendon Isolation Hospital, Goldsmith Avenue, Hendon, N.W.9. (COLindale 8182.) Willesden Chest Clinic, Pound Lane, Willesden, N.W.10. (WILlesden 6254.) Harrow Chest Clinic, 199, Station Road, Harrow, Middlesex. (HARrow 1075.) Edgware Chest Clinic, Edgware General Hospital, Edgware, Middlesex. (EDGware 4467/8.) 14 2. AMBULANCE SERVICE. A service of ambulances and sitting case cars is maintained by the Middlesex County Council as Local Health Authority at:— No. 4 Depot. (ELGar 5506.) The accident service is obtained by dialling 999. The authority of a medical practitioner is required for service to be given, except in emergency and accident cases. 3. HEALTH SERVICES. Health Services under Part III of the National Health Service Act, 1946, are provided by the County Council and relevant details in so far as they apply to the borough are included below:— County Medical Officer: A. C. T. Perkins, M.C., M.D., D.P.H., 3, 5 & 7, Old Queen Street, S.W.1. Telephone : TRAfalgar 7799. Area Medical Officer—Area No. 6—Wembley: E. Grundy, M.D., M.R.C.S., D.P.H., Area Health Office, 215, Chevening Road, N.W.6. Telephone: LADbroke 2411. 15 Clinics for Child Health: College Road, Wembley. Telephone No.: ARNold 1336. London Road, Wembley. Telephone No.: WEMbley 1021. Monks Park, Wembley. Telephone No.: WEMbley 4842. One Tree Hill, Bridgewater Road, Alperton. Telephone No.: WEMbley 2435. Perrin Road, Sudbury, Wembley (Orthodontic). Telephone No.: ARNold 2500. Perrin Road, Sudbury, Wembley. Telephone No.: ARNold 6164. Kingsbury Free Church, Slough Lane, Kingsbury, N.W.9 Telephone No.: COLindale 4315. 245, Stag Lane, Kingsbury, N.W.9. Telephone No.: COLindale 6680. 245, Stag Lane, Kingsbury, N.W.9 (Dental). Telephone No.: COLindale 8729. Library Clinic, Stag Lane, Kingsbury, N.W.9. Telephone No.: COLindale 6343. Day Nurseries : Princes Avenue, Kingsbury, N.W.9. Telephone No.: COLindale 4456. Vale Farm, Watford Road, Sudbury, Wembley. Telephone No.: ARNold 3162. Domestic Help. Provided on medical certificate in cases of sickness or maternity by application to the Area Health Office: 215, Chevening Rd., N.W.6. 16 Immunisation and Vaccination. By application to National Health Service practitioners who have entered the Scheme, or by arrangement with the Area Medical Officer : 215, Chevening Road, N.W.6. Telephone No.: LADbroke 2411. Midwifery and Home Nursing. By application to the Area Medical Officer: 215, Chevening Road, N.W.6. Telephone No.: LADbroke 2411. Outside office hours Home Nurses may be contacted in their own homes. School Health Service. Clinics at all the Child Health Clinics. 4. VERMINOUS CONDITIONS. Only 3 cases, 2 adults and 1 child were referred to a Health Centre for treatment more intensive than could be given in the home. The generalisation remains true that infestation is scarcely a Public Health problem in Wembley. The response of the mothers to the advice given through the School Health Services is most gratifying. 5. MORTUARY. The Mortuary which was closed in 1955 has not yet been replaced although plans have been prepared by the Borough Engineer and Surveyor and discussions have taken place with appropriate officers of the Ministry. The Government ban on capital expenditure has, up to now, prevented the Corporation from going ahead with its plans to erect a new Mortuary at the rear of the Town Hall, but there are indications that the Corporation will be able to make some progress in the near future. In the meantime the Harrow Corporation have permitted their Mortuary to be used for the reception of cases from Wembley which in 1956 amounted to 160 bodies. 17 STATISTICAL APPENDIX B. Establishments for Massage and Special Treatment. (a) Members of the Chartered Society of Physiotherapy who have lodged with the Local Authority a certificate signed by two resident medical practitioners that they are suitable persons to carry on such an establishment 4 (b) Licences granted:— New 1 Renewals 17 18 CHAPTER III. INFECTIOUS DISEASES. 1. SERVICES PROVIDED, Notification, investigation, pamphlets issued on the various infectious diseases, exclusion from school of patients and contacts, advice re milk handlers—Disinfection —Hospitalisation generally at Neasden Hospital or Hendon Isolation Hospital, re puerperal pyrexia and ophthalmia neonatorum, Emergency Bed Service, re smallpox as arranged by the Regional Hospital Board — Notification of tuberculosis — Authentication of travellers' inoculation state — Food poisoning notification and investigation — Scabies, arrangements with the Middlesex County Council — Complete bacteriological service available at Central Public Health Laboratory, Colindale, outfits distributed from Public Health Department. 2. There is little to note in this Section for the year, as the absence of any unusual infectious disease and the lack of any major outbreak of notifiable disease have not occasioned serious concern during the year. The incidence of common infections of infancy varies slightly from time to time and the figures in the statistical appendix indicate that the experience in 1956 was not unusual or in any way adverse. One particular incident calls for some comment, although the results could not be regarded as serious. In October five cases were notified from one of the schools in the Borough as suspected aseptic meningitis (? Poliomyelitis), and immediately it became evident that the school could possibly have been a source of infection arrangements were made for the Health Visitor and Assistant School Medical Officer to visit the premises daily, excluding all children showing suspicious symptoms and following up in the home all absentees. An informative letter was sent to practitioners and two days later it was felt prudent to avoid the re-assembly of the eight-year-old group (78 children) at the conclusion of the half-term holiday. The class involved was closed therefore during the possible incubation period of the suspected illness. Fortunately, no further cases occurred although, as can be imagined, the local press, and indeed the national press, commented upon the situation. It was not until some two months later that cultures from the laboratory showed the presence of Poliomyelitis virus from at least three of the children previously excluded. 3. The supervision of contacts landing from ship or aeroplane called for routine surveillance of 4 persons regarding smallpox. Constant vigilance must be exercised on persons arriving from infected foreign areas and this supervision must be given with discretion and understanding. International Certificates of vaccination and immunisation were authenticated in respect of 892 residents intending to proceed overseas. 19 21 Notifications of Selected Infectious Diseases according to sex and age as finally diagnosed. Age Group. Scarlet Fever. Whooping Cough. Diphtheria. Measles. Dysentery. Poliomyelitis. gococcal infection. Age Group. Acute pneumonia. Erysipelas Encephalitis Fo0d Poisoning. Typhoid Fever Paratyphoid Fever. Paralytic. Nonpara lytic. Acute infective. Postinfec tious. M. F. M. F. M F. M F. M. F. M F. M. F. M. F. M F. M F. M. F. M. F. M. F. M F. M F. 0 — — 3 2 15 10 0 3 - - 1 1 3 _ _ _ _ 1 — 1 5 3 — — 36 37 — — — — — — — — 5 3 4 — 1 - — 1 — 10 4 — — — - 2 — 3 1 3 — — 43 46 1 1 1 1 — — — — 15 10 8 1 — - — — — 2 2 — — — - 3 5 2 — 5 — — 98 70 — — — — — — — - 45 15 12 3 7 - - - - - 3 1 — 1 - 4 4 5 4 6 — — 84 93 — — — — — — — 65 & over 6 6 - 4 - - - - - - - - - - 5 42 39 21 22 — — 386 341 2 2 2 1 — 2 — - 10 10 19 3 1 — — 8 8 — 2 — 1 — — — — 15 4 — — — — — 1 2 — 2 — — 1 2 — — 25 & over 1 1 - - - - 3 5 1 4 - - - - 1 - All ages 66 70 37 42 Nil 674 612 4 11 3 3 1 4 1 All ages 37 30 4 12 Nil 1 1 13 12 1 — 1 — Monthly incidence of the Infectious Diseases. Disease. January. February. March. April. May. June. July. August. September October. November. December. Total. Scarlet fever 16 11 24 14 14 8 13 1 8 5 14 8 136 Diphtheria - - - - - - - - - - - - Nil Pneumonia 6 14 18 6 5 3 4 — — 3 1 7 67 Erysipelas — 1 3 1 — — 6 1 2 1 — 1 16 Dysentery — 1 — — — 2 2 — — 6 1 3 15 Measles 4 123 428 315 240 81 51 3 1 9 7 24 1286 Whooping cough 5 7 1 2 13 5 7 11 5 2 15 6 79 Paratyphoid fever - - - - - - - - - 1 - - 1 Poliomyelitis :— Paralytic — — — — — — — 1 — 4 — 1 6 Non-Paralytic — — — — — — 1 — 1 3 — — 5 Encephalitis :— Infective - - - - - - - - - - - - Nil Post-Infectious - - - - 1 1 - - - - - - 2 Meningococcal infection - - - - - - - - - - - 1 1 Fo0d poisoning — — 3 1 1 4 2 5 1 6 2 — 25 Winter Respiratory Diseases (October—March). Notifications of primary pneumonia and acute influenzal-pneumonia. Death certificates in which respiratory diseases mentioned. 1952-53 75 210 1953-54 40 / 163 1954-55 56 156 1955-56 57 187 1956-57 30 98 22 Consultations regarding infectious disease, between the Medical Officer of Health and the local Medical Profession continued whereby the considerable experience of the department is placed at the disposal of residents. Non-notifiable Infectious Diseases in School Children. Information obtained from the head teachers:— Disease. January. February. March. April. May. June. July. August. September. October. November. December. Total. Chicken-pox 12 14 57 15 54 52 8 — 2 4 4 2 224 Mumps 2 6 10 3 3 8 6 — 2 16 30 33 119 German measles 5 3 47 41 55 84 23 — 1 2 2 2 265 Tuberculosis. No. of Notifications. Pulmonary. Non-pulmonary. Male. Female. Male. Female. Under one year — — — — 1 to 4 years — 3 — — 5 to 14 years 1 — 1 — 15 to 24 years 6 8 — 1 25 to 34 years 8 5 1 — 35 to 44 years 3 6 — 1 45 to 54 years 10 2 — 1 55 to 64 years 5 2 — 1 65 and over 4 1 1 — Totals 37 27 3 4 23  No. of Deaths. Pulmonary. Non-pulmonary. Male. Female. Male. Female Under one year 1 to 4 years — — — — 5 to 14 years — — — — 15 to 24 years — — — — 25 to 34 years — — — — 35 to 44 years — — — 1 45 to 54 years 2 — — — 55 to 64 years 3 — — — 65 and over — — — — Totals 5 Nil Nil 1 This includes deaths from all causes of cases on the Tuberculosis Register. No. admitted to hospitals No. discharged from hospitals or Sanatoria: or Sanatoria: 24 53 During the year 119 cases removed from register. At 31st December 1,005 names remained on register — 927 pulmonary and 78 non-pulmonary. Of 6 deaths from tuberculosis, all were notified during life (100.00%). Fo0d Poisoning Outbreaks. There was one outbreak of fo0d poisoning involving 20 cases, all of which were mild and of transient duration. 24 Bacteriological Service (at Central Public Health Laboratory). Examinations made. Quarter ending Total for 12 months. 31/3/56. 30/6/56. 30/9/56. 31/12/56. Throat and Nose Swabs. Diphtheria — — - — - Haemolytic Streptococci 45 21 16 28 110 Vincents angina 5 3 2 3 13 Negative 114 77 71 71 333 Faeces. Shigella — 1 12 8 21 Salmonella 7 6 15 2 30 CI. Welchi 1 2 - - 3 E. Coli — 1 — 1 2 Negative 36 46 77 85 244 Urine. Negative - 2 — 1 3 Sputum. T.B. smear - 2 - - 2 Other organisms - - - - - Negative 22 27 18 13 80 Pertussis. Per nasal swab - - - 1 1 Negative 10 4 1 5 20 Blo0d. Paul Bunnel: Positive 1 1 Negative 1 — — — 1 Scabies. Only 2 cases of scabies, both adults, were treated during the year. Laundry for the Incontinent Aged. No. of cases 38 Cost of Laundry £128 9s. lid. 25 CHAPTER IV. ENVIRONMENTAL HYGIENE, FO0d AND WATER, HOUSING, FACTORIES, ETC. 1. SERVICES PROVIDED, Ascertainment, investigation and abatement of nuisances—Scrutiny re sewers and drains—Sanitary circumstances of special premises (Public Houses, Cinemas, Dance Halls)—Co-ordination regarding Local Land Charges, etc., registers— Supervision of fo0d, ascertainment and condemnation of unfit fo0d— Routine peri0dic examination of public water supplies—Middlesex County Council Act, 1950, registration of hawkers of fo0d and premises—Registration under Milk and Dairies Regulations—Supervision under Milk (Special Designations) Regulations—Inspections under the Fo0d Hygiene Regulations, 1955—Inspections and sampling under the Ice Cream (Heat Treatment, etc.) Regulations, 1947 and 1948—Housing, overcrowding, disrepair, ascertainment and action thereon—Issue of Certificates of Disrepair under the Housing Repairs and Rents Act, 1954—Ascertainment and supervision of movable dwellings under Middlesex County Council Act — Supervision of domestic refuse bins—Factories and workplaces and outworkers, supervision regarding smoke—Noise and dust nuisances—Supervision of petroleum storage — Prevention of Damage by Pests Act, 1949, ascertainment of infestations and dealing therewith—Disinfestation of verminous premises — Identification of, and advice on meth0ds of eradicating household pests — Borough bye-laws relevant to P.H. Inspectors, Go0d rule and government and prevention of nuisances, Nuisances, Offensive trades, Slaughterhouses, Ventilation and lighting of stables, Building bye-laws, Public sanitary conveniences, Removal of offensive matter, etc., through the streets, Removal of house refuse. 2. HOUSING. Housing Repairs and Rents Act, 1954. This Act which came into force on the 30th August, 1954, required local authorities to submit to the Minister of Local Government and Planning by 30th August, 1955, proposals for dealing with houses in their areas which appeared to be unfit for human habitation and suitable for demolition. The figures given were to be a broad estimate of the number of houses which could be dealt with in a five-year programme, and could be supplemented later as 26 stances warranted. Wembley is a comparatively new town and consequently has not a large number of houses which should be cleared. A Survey was carried out and 43 houses were included in the figure submitted to the Minister, 39 of which it was thought would be included in Clearance Areas and the remainder dealt with as individually unfit houses. None of the proposed Clearance Areas is large and the sites therefore do not lend themselves to extensive redevelopment. Of the 43 houses listed, 8 have already been demolished by the owners without statutory action being invoked by the Council and 2 have been demolished in accordance with Demolition Orders; 4 were included in a declared Clearance Area but the Minister did not confirm the Order as the owner gave an undertaking to put the houses in a proper state of repair. Although the problem in Wembley is a small one, the rehousing of displaced persons is not easy having regard to the Council's commitments and liabilities for the rehousing of other families. Wembley has practically reached saturation point and there is virtually no land available in the Borough for the erection of more Council houses or flats. During the year 14 applications were received from tenants for certificates in compliance with Section 26 of the Act; 13 certificates were issued and one was refused. In 4 instances landlords applied for revocation of certificates following the execution of the necessary works of repair and these were granted. This part of the Act dealing with certificates has been revoked by the Rent Act, 1957. The new Act formulates a different procedure which will be dealt with in next year's Annual Report. Legal Proceedings. In one instance legal proceedings had to be taken in the Magistrates' Court in respect of repairs which had not been carried out by the owner following the service of a statutory notice under Section 93 of the Public Health Act, 1936. The Court made an order for the work to be carried out in 28 days and fined the defendant £2 0s. 0d. with £1 10s. 0d. costs, plus a witness fee of £1 10s. 0d. The necessary repairs were subsequently carried out by the owner. Details of inspections made, notices served and works carried out at dwelling houses are given in the statistical appendix. 27 Overcrowding. The number of cases of overcrowding known to the Health Department has shown a steady decrease during the past nine years, as the following figures indicate. Year. Number of Cases of overcrowding on Register. Total Number of Cases of overcrowding relieved during the year. Number of Cases of overcrowding relieved during the year by removal to unknown addresses. 1948 602 307 22 1949 558 268 86 1950 516 133 6 1951 517 52 9 1952 456 102 2 1953 424 52 3 1954 303 133 95 1955 204 108 102 1956 169 47 42 Household Pests. The number of bug-infested houses has shown a marked decrease in recent years and only 19 cases were recorded during 1956. With the advent of D.D.T. and B.H.C. which with their derivatives remain toxic to insects for long peri0ds after their application, the coniroi of insects has become a much easier problem. Fleas which in years past were quite a common pest are now very rarely encountered Despite this great decrease in the prevalence of insects parasitic tc man the Department receives many enquiries with respect to othei pests as to their identification and control. In most cases the Department is able to indentify the species but in cases of doubt the Entymologists at the Natural History Museum at South Kensington have readily given their advice. The commonest household pest; which form the subject of enquiries nowadays are carpet beetles, silvei fish, ants, furniture beetles and scavanger beetles. It is also quite common to find that insects normally found in gardens and which do no real harm indoors have invaded the house and given cause for 28 anxious concern to occupiers. The identification of such insects, advice on control and the assurance that they are harmless afford considerable relief to house occupiers. Rats and mice are dealt with later in this Report. 3. WATER SUPPLY. The water supply of the Borough which is provided by the Colne Valley Water Co., except for a small area in the southern end of the district supplied by the Rickmans worth and Uxbridge Valley Water Co., remained satisfactory iii quality and quantity. The supply is pumped from deep wells ir„ the chalk outside the Borough boundaries. All of the samples taker, from piped supplies were reported as satisfactory. No tendency to plumbo solvent action has been detected. All dwelling houses in the Borough are provided with a mains water supply. There is a number of private wells in the Borough all in con nection with industrial undertakings, but in no instance is the watei from these sources used for drinking. The Council have continued to express their concern at the hardness of the public water supplies which have a total hardness range from 238—266 parts per million. Whilst there would not appear to be evidence of prejudicial effects to health from such hard water its detrimental effects on boilers and hot water systems are well-known. 4. SWIMMING POOLS. The two outdoor Swimming Pools have continued to be a source of enjoyment and healthy recreation. " Breakpoint" chlorination or superchlorination which was installed just prior to the 1951 season has made it possible to maintain a sparkling clear water, together with a minimum risk of infection. Attendances at the Pools during the year were:— Kingsbury 75,478 Vale Farm, Wembley 65,815 These attendances are little more than half those recorded for the preceding year, which is perhaps a sad reflection on the kind of weather which prevailed through most of the summer season. 29 5. FO0d HYGIENE. The Fo0d and Drugs Act, 1955, came into operation on the 1st January, 1956. It is described as an Act to consolidate the Fo0d and Drugs Act, 1938, the Fo0d and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, and the Fo0d and Drugs Amendment Act, 1954, together with certain other enactmencs amending and supplementing Part V of the Act of 1938, in relation to slaughterhouses and knackers' yards. All the older Acts are repealed by the new Act. One important feature of the Act is the power of the Minister Under Section 13 to make regulations as to fo0d hygiene. After a go0d deal of consultation with representatives of both local authorities and the fo0d trade, the Fo0d Hygiene Regulations, 1955, were made and came into operation on the 1st January, 1956, except for certain regulations which did not become operative until the 1st July, 1956. These Regulations are a great advance on any powers previously possessed by local authorities relating to fo0d hygiene. The main object of the Regulations is to reduce the incidence of fo0d poisoning and there is no doubt that the studied observance of the Regulations by all persons engaged in the fo0d trades could attain this end. A large number of inspections of fo0d premises has been made including school canteens and of all premises belonging to the Corporation where refreshments are sold to the public. The Health Committee was authorised by the Council to explore fully the implications and implementation of the new Regulations so that standards could be laid down which, while they were to be applied in the first instance to Corporation properties, would also act as a guide in all other cases so far as they were applicable. In the first place the Town Clerk submitted to the Committee a comprehensive report on the legal requirements of the Regulations and this was followed by a joint report of the Medical Officer of Health, the Borough Engineer and the Chief Public Health Inspector, on the requirements to bring all Corporation property up to the requisite standard, the advantages and disadvantages of materials used in kitchen equipment, e.g., stainless steel, glazed stoneware, galvanised iron, vitreous enamel, plastics, teak, etc., together with alternative estimates of costs. Experience shows that stainless steel is one of the best materials where continuous and heavy use is to be expected, and despite its higher initial cost is 30 probably the most economical in the long run, and this was borne in mind in appropriate cases. After careful consideration of all the circumstances the Health Committee made recommendations to the various Committees controlling Corporation property and in all instances these were adopted and the Council made appropriate provision in the estimates for the improvements to be carried out. During recent times there has been a great advance in the design and choice of materials in the manufacture of kitchen fixtures and fittings and of other equipment used in connection with fo0d trades. For example, m0dern stainless steel sinks combined with drainers made in a single steel pressing have many advantages over the glazed stoneware sink provided with a fitted wo0den draining board which soon became saturated, worn and sometimes decayed with crevices which were incapable of proper cleansing. 6. LEGAL PROCEEDINGS IN CONNECTION WITH FO0d. Legal proceedings were necessary in the following instances:— A loaf of bread containing black foreign matter—defendants fined £2 10s. 0d. and £1 3s. 0d. costs, plus two witness fees of £1 0s. 0d. each. A loaf of bread containing a piece of oily fabric—defendants fined £2 0s. 0d. and £1 2s. 0d. costs, plus a witness fee of £1 0s. 0d. A half pound of currants containing cat excrement—defendants fined £5 0s. 0d. and £2 2s. 0d. costs, plus a witness fee of £1 0s. 0d. In four other cases of articles of fo0d containing foreign matter warnings were issued. 7. ATMOSPHERIC POLLUTION. The Clean Air Act, 1956, received the Royal Assent on the 5th July, 1956, but did not come into operation immediately. The Act provided that it should come into operation on the "appointed day" to be fixed by the Minister of Housing and Local Government. Most of it came into operation on the 31st December, 1956, but there is a number of important sections for which the "appointed day" has still to be 31 determined, which include the following :—Prohibition of dark smoke from chimneys; Grit and dust from furnaces; Abatement of smoke nuisances other than smoke from a private dwelling and other than dark smoke which is dealt with under Section 1 of the Act; Prohibition of dark smoke from railway engines and vessels (ships). Section 3 requires all new furnaces (except furnaces of domestic boilers with a maximum heating capacity of less than fifty-five thousand British Thermal Units per hour) to be capable of being operated continuously without emitting smoke when burning fuel of a type for which they were designed and persons proposing to install new furnaces must give notice of intention to the local authority. It is not necessary to submit plans or specifications when giving notice but a person proposing to install a new furnace may do so and if the plans and specifications are approved by the local authority the furnace is deemed to comply with the requirements of Section 3(1) of the Act. It does not, however, give exemption from proceedings for a contravention of any other part of the Act. Section 10 empowers local authorities to reject plans of new buildings (other than residences, shops or offices) unless they are satisfied that the height of any chimney shown on the plans will be sufficient to prevent, so far as practicable, the smoke, grit, dust or gases from becoming prejudicial to health or a nuisance having regard to (a) the purpose of the chimney; (b) the position and description of buildings near thereto; (c) the levels of neighbouring ground; and (d) any other matters requiring consideration in the circumstances. The section does not, however, apply to the erection or extension of a generating station as defined in the Electricity (Supply) Act, 1919, other than a private generating station as so defined. Section 17 provides that virtually all forms of air pollution from premises controlled under the Alkali, etc., Works Regulation Act, 1906, will be subject to control under that Act by the Alkali Inspectorate appointed by the Minister of Housing and Local Government. Local authorities can, however, take proceedings for certain offences but only with the consent of the Minister. In addition, the Minister may, on the application of a local authority, make an order removing the whole or part of any premises controlled under the Alkali Act from the ambit of Section 17(1) if he is satisfied in all the circumstances it is expedient so to do. This in effect would 3 transfer to the local authority powers for dealing with dark smoke, grit and dust, Smoke Control Areas and smoke nuisance which would otherwise be dealt with by the Alkali Inspectorate. Section 21 enables the local authority to grant exemption, wholly or to a limited extent, from certain provisions of the Act to any person for the purpose of carrying out investigations or research relevant to the problem of the pollution of air. The exemption is subject to such conditions and for such period as may be specified in the notice. Any person who has applied to the local authority for an exemption and is dissatisfied with the decision of the local authority may appeal to the Minister who may, if he thinks fit, grant or vary a notice of exemption. Whereas Crown premises and ships were previously exempt from the provisions of "smoke laws" the new Act provides that local authorities can report infringements to the responsible Minister, and it then becomes his duty to inquire into the circumstances and if his inquiry reveals that there is cause for complaint, to employ all practicable means for preventing or minimising the emission of smoke, grit or dust or for abating the nuisance and preventing a recurrence thereof, as the case may be. Section 23 authorises the appointment by the Minister of Housing and Local Government of a Consultative Council to be called the " Clean Air Council," for the purposes of keeping under review the progress made in abating the pollution of the air in England and Wales and obtaining the advice of persons having special knowledge, experience or responsibility in regard to prevention of pollution of the air. Building byelaws may require the provision in new buildings of such arrangements for heating or cooking as are calculated to prevent so far as practicable the emission of smoke. The Council have already decided to make such a byelaw which is in the following form :— There shall be provided in a new building (except in so far as heating is provided by furnaces to which Section 3 of the Clean Air Act, 1956, applies) only such appliances for heating or cooking as are suitably designed for burning any of the following fuels, namely:— (a) gas, (b) electricity, (c) coke, or anthracite, 33 or are appliances of a description exempted conditionally or unconditionally from the provisions of Section 11 of the Clean Air Act, 1956 (which relates to smoke control areas) by any order for the time being in force under Sub-section (4) of that Section. Powers are given to local authorities to undertake or contribute towards the cost of investigations and research relevant to the problem of the pollution of air and to arrange for publicity in various forms to be given to the subject. Smoke Control Areas. Prior to the passing of the Clean Air Act, 1956, a local authority could only institute a "smokeless zone" by promoting a private Act and therefore comparatively few authorities possessed the necessary powers. But the present Act makes it possible for any local authority to define "Smoke Control Areas." Broadly speaking the effect of a Smoke Control Order, which must be approved by the Minister of Housing and Local Government, is to prohibit entirely the emission of smoke from chimneys in the area but the provisions of the Act are flexible and allow for adaptation to local circumstances. Specified buildings or classes of buildings or specified fireplaces or classes of fireplaces may be exempted from the Order. The Smoke Control Areas (Exempted Fireplaces) Order, 1957, provides that in England and Wales fireplaces specially designed or adapted for combustion of liquid fuel shall, provided that they are so installed, maintained and operated as to minimise the emission of smoke, be exempted from the provisions of Section 11 of the Clean Air Act, 1956 (which relates to Smoke Control Areas). The Smoke Control Areas (Authorised Fuels) Regulations, 1956, which came into force on the 31st December, 1956, define the fuels to be used; these fuels are anthracite, briquetted fuels carbonised in the process of manufacture, coke, electricity, gas, low temperature carbonisation fuels and low volatile steam coals. If the owner or occupier of a private dwelling which is in or will be in a Smoke Control Area has to incur expenditure in adapting his heating arrangements, he is entitled to a grant from the local authority of at least seven-tenths of the approved cost subject to the work being done to the satisfaction of the local authority. No grant is payable in respect 34 of a dwelling which was built as or converted to a dwelling after 5th July, 1956. Of the seven-tenths grant payable by the local authority, four-sevenths of this is repayable to the local authority as Exchequer Grant. Only expenditure incurred after the confirmation of an Order and approved by the local authority attracts a grant apd whilst a local authority may pay more than the stipulated amount (seven-tenths) no corresponding increase in Exchequer Grant will be forthcoming. In the case of readily removable appliances provided by the tenant, the grant is one-half of the normal amount (i.e., seventwentieths) payable initially and the other half becomes payable after the lapse of two years from the coming into operation of the Smoke Control Order and then only if the appliance has not been removed. The second instalment is payable to the person then occupying the dwelling. Grants are payable only in respect of private dwellings, except that local authorities may make grants, as they think fit, towards adaptations to fireplaces in churches, chapels, buildings used by charities, etc., where they will be within a Smoke Control Area, but no Exchequer Grant is payable in these cases. When a Smoke Control Order has become operative a local authority may serve a statutory notice upon the owner or occupier requiring the carrying out of adaptations in or in connection with a dwelling to avoid contraventions of the Order, and in default the local authority may themselves carry out the necessary work. A grant is payable in respect of approved work carried out under notice, or if the work is carried out in default, only three-tenths of the cost is recoverable from the person on whom the notice was served. The Ministry of Housing and Local Government has issued a most useful memorandum on Smoke Control Areas which goes a long way towards clearing up many doubts and difficulties which exercised the minds of Councillors and Officers when the Act was first published. This memorandum suggests that areas which are wholly or predominantly industrial should not be included in Smoke Control Areas and that careful thought would need to be given to areas of mixed development. It is recognised that whilst industrial smoke can be reduced substantially by efficient methods of combustion, the prohibition of smoke entirely from industrial furnaces fired by bituminous coal would necessitate a change of fuel. To do this on a large scale would make impossible demands upon the supply of smokeless 35 fuels. The available smokeless fuels will be needed, and can be used to better advantage, for the prevention of domestic smoke. It would appear unlikely, therefore, that the Minister would agree to an Order being made in respect of an area of mixed development if a local authority sought to make it entirely smokeless. A possible alternative would be to include the industries concerned in a Smoke Control Area but to exempt them from the terms of the Order if their furnaces were equipped with efficient mechanical stokers designed and operated so as to minimise the emission of smoke. This would have the effect of preventing undue smoke without increasing the demand for smokeless fuels. It is reasonable to suppose, however, that owners and occupiers of commercial and residential premises in the area might well raise strong objections to their own property having to conform to an Order whilst industrial premises in the same area were exempt. The availability of adequate supplies of smokeless fuels is another aspect of the subject which requires careful consideration. Although supplies are increasing, very much more will be needed if the Clean Air Campaign is to go forward ; the magnitude of the task can be realised when one considers that 44,769 tons of house coal were sold by Wembley merchants in 1956. Much of the solid smokeless fuel now available is coke and whilst it is an excellent fuel in many ways, particularly for closed stoves and boilers, it is not readily acceptable to all householders for use on open fires. The low temperature carbonisation fuels sold under proprietary names and the more recendy introduced re-active cokes are likely to be more acceptable to the public, except for the price, but they are not in plentiful supply. In comparison with gas coke, they are more easily ignited, burn with a short bright flame, and can be kept going with a shallower fuel bed. Some of the more active smokeless fuels can be used on the older type of appliances but modern grates with controlled air supply will burn them more efficiently. The Council has given preliminary consideration to the institution of a Smoke Control Area but up to the moment one has not been defined. The Council are corporate members of the National Smoke Abatement Society and the Council's representatives on this body are Alderman C. H. Smith, O.B.E., D.L., and the Chief Public Health 36 Inspector. Alderman Smith was elected Chairman of the SouthEastern Division of the Society for the second year in succession and he contributed a paper under the title " Local Authorities, the Beaver Report and the Government Clean Air Biil" at the Society's Annual Conference at Bournemouth. The Conference received a better press than any previous ones, which is perhaps because Atmospheric Pollution is arousing more general interest than ever before. 8. INDUSTRIAL NUISANCES. The Council have continued to be faced with problems of this nature, particularly with regard to noise and to some extent with effluvia. In general it can be said that noise in those cases where factories have to work a night shift gives rise to more complaints. This is readily understandable in spite of the fact that the noise level may actually be less at night than during the daytime. In one instance the firm concerned have taken steps to eliminate night work and in another case it has been made possible to discontinue the use, at night, of an air compressor which was in fairly close proximity to houses. To give yet another example, the housing of an extraction plant was found to be loose and giving rise to a "drumming" noise; when this was attended to the unnecessary noise was eliminated. Of course, all noise nuisances are not as easily overcome as the instance quoted ; in fact, some are almost intractable short of the processes carried on being moved to another site altogether. Problems in connection with effluvia are frequently very difficult to solve but there are several comparatively new methods of approach which show promise. There is now an oxy-catalyst on the market which is capable of oxidising fumes, provided there are oxidizable fumes present in sufficient quantities in the flue gases or air to be treated. Ultra violet light can also be used in a similar manner but care must be taken in its application to see that workers are not exposed to the rays and the lamps must therefore be properly sited or shielded to this end. Another method of approach is by the use of a modern deodorant which blends with the effluvia to be eliminated and neutralises it. All of these methods seem to be in the hands of specialist firms and in next year's report it may be possible to give details of the application of one of these methods to local problems. 37 9. SEWERAGE AND DRAINAGE. The Preston Park scheme prepared by the Borough Engineer and Surveyor for the relief of surface water and sewage flooding was commenced in 1956 and completed in 1957. The scheme has also eliminated a number of sewage overflows into the surface water system. A similar scheme is being prepared for the North Kingsbury area to prevent sewage flooding and eliminate overflows. Work on the surface water system in the Stag Lane area is about to commence. Two cesspools remain in the district, both of which receive only drainage from sports pavilions which are too remote from sewers for the premises to be connected. All dwelling houses are provided with water closets connected to the Council's sewers. 10. RODENT CONTROL. The Rodent Control Service which is confined to dealing with infestations by rats and mice has continued to operate during the year under review. A staff of three "Ministry trained" assistants has performed the necessary work. The Department was without the service of one assistant (Mr. M. Hill) during a part of the year, owing to illness which regrettably terminated in his death. This employee had rendered the Corporation 25 years' loyal and conscientious service, 12 of which were in the Public Health Department, and this opportunity is taken to record an appreciation of his work. No charge is made to householders in respect of treatment at private dwelling houses but in all other cases a charge is made on a time and materials basis. 685 premises were satisfactorily treated by the Council and 6 premises were known to have been treated privately. The following details of sewer treatment have been provided by the Borough Engineer and Surveyor. In February/March, 1956, a 10% test bait of sewer manholes was carried out. 449 manholes were baited and there were 20 partial "takes." In the treatment which followed 170 manholes were baited when there was one complete "take" and 47 partial "takes." The corresponding figures for the 21st Maintenance Treatment carried out in November, 1956, were— manholes baited 153, complete " takes " 1, partial " takes " 57. 38 No new developments in poisoning technique were introduced during the year and Warfarin has continued to produce good results. 11. PUBLIC CLEANSING. The Director of Public Cleansing has kindly supplied the following information :— Refuse Collection. House and Trade refuse is collected weekly, with the exception that refuse from certain blocks of flats is collected twice weekly. The amount of refuse collected during the year was 28,000 tons. The separate collection of waste paper from business premises free of charge has been maintained. The amount collected from this source during the year was 847 tons. Refuse Disposal. Refuse is disposed of by a Separation and Incineration Plant which has handled 28,350 tons. Salvage materials amounting to 3,272 tons were sold for £18,286. Waste Food Plant. The amount of kitchen waste collected in Wembley was 2,239 tons, which was processed and sold as concentrated kitchen waste for animal feeding. Street Cleansing. The new system of street sweeping by the use of pedestrian controlled electric trucks, each with an operator and four street orderlies, continues to give a frequency of sweeping of at least once every seven days. Public Conveniences. The increase in use of the free washing facilities at the two staffed Conveniences in the Borough has been maintained during the year. 39 STATISTICAL APPENDIX D. Number of complaints received and investigated 2,453 Visits made by Public Health Inspectors 22,883 (a) Dwelling Houses:— Visits under Public Health Acts 5,744 Visits under Housing Acts 77 Visits re overcrowding 112 Visits to bug infested premises 22 Visits re other vermin (excluding rats and mice, see below) 54 Visits re cases of infectious disease 468 Visits to cases of food poisoning 45 (b) General Environmental Public Health:— Drains and sewers inspected 2,691 Drain and Sewer Test applied 126 Cesspools, etc 2 Urinals, latrines, chemical closets 51 Stables, manure pits, etc. 19 Piggeries (number on register at end of year 2) 44 Ditches and streams 441 Open spaces, etc. 343 Yards 1,854 Public conveniences 113 Tents, vans and sheds 9 Factories—Mechanical 1,736 „ —Non-mechanical 18 Workplaces 378 Outworkers 211 Smoke observations—half hourly 327 „ „ —casual 2,338 „ „ —visits to plant 128 Cinemas, Dance Halls, Public Houses, etc 136 Hairdressers (number of establishments on register at end of year 92) 68 Schools (number of private schools 19) 120 Markets 1" Rats and Mice 136 40 Swimming baths—visits 16 „ „ —Water examination 2 re Certificates of disrepair 26 Mortuary 19 Refuse Tips 22 (c) Food, including milk, meat, water:— Number of dairies registered at end of year 13 Number of distributors of milk registered, with premises in the Borough selling milk in properly closed and unopened receptacles 72 Number of distributors of milk registered whose premises are outside the Borough 22 Number of dairies (included above) where milk is bottled 1 Inspection visits made to:— Meat shops, stalls, etc. (number on register at end of year 83) 537 Slaughterhouse 111 Cowsheds 4 Dairies and milk shops—visits 113 „ „ „ „ —milk samples taken 8 Fried fish shops (number on register at end of year 13) 89 Bakehouses (number on register at end of year 15) 129 Ice cream premises (number on register at end of year 213) 120 Ice cream—samples taken 19 Fishmongers and poulterers (number on register at end of year 29) 226 Greengrocers and fruiterers (number on register at end of year 97) 272 Grocers, etc. (number on register at end of year 261) 628 41 Restaurants, cafes, etc. (number on register at end of year 104) 473 Street vendors, hawkers, etc. (number on register at end of year 79) 49 Other food premises 256 Water supply—visits 143 „ „ —samples taken 8 (d) Other visits and inspections:— Massage establishments, etc 39 Certificates lodged by Members of the Chartered Society of Physiotherapy 4 New Licences granted 1 Licences renewed 17 Noise nuisances 346 Dust nuisances 77 Effluvia nuisances 124 Petroleum stores 503 Miscellaneous 465 Number of verbal notices served 159 Number of written notices served 374 „ „ „ „ complied with 57 Number of statutory notices served 62 Nuisances abated and improvements effected. (a) Dwelling Houses:— Roofs repaired 195 External walls and chimney stacks repaired 70 Gutters and spouts repaired or renewed 110 Damp-proof courses provided 16 Dampness remedied 221 Yards paved or repaired 35 Internal walls and ceilings repaired 154 Doors repaired or renewed 28 Windows repaired or renewed 48 Floors repaired or renewed 57 Sub floor vent. provided or improved 6 42 Rooms cleansed or redecorated 138 Passages and staircases redecorated 67 Staircases repaired 6 Fireplaces and flues repaired or renewed 37 Cooking stoves repaired or renewed 2 Wash coppers repaired or renewed 1 Sinks and washbasins provided or renewed 20 Waste pipes repaired or renewed 48 Food stores provided or improved 1 Dustbins provided or renewed 25 Water supply improved or reinstated 91 W.C. walls, etc., cleansed 17 W.C. pans cleansed 9 W.C. pans repaired or renewed 31 W.C. structures repaired or renewed 4 W.C. lighting and ventilation improved 5 W.C. flush pipe joints repaired 42 Additional W.C.'s provided 1 (b) General Environmental Public Health:— Drains cleansed from obstruction 1,141 Drains repaired or renewed 104 New drains provided 13 New inspection chambers provided 37 Inspection chambers repaired 42 Soil pipes and vent. shafts repaired 22 W.C.'s repaired 16 W.C.'s cleansed 5 Cesspools emptied — Urinals and latrines—cleansed or emptied 5 Stables, manure pits—cleansed 4 „ „ „ —repaired 2 Piggeries cleansed or limewashed 8 Pigsties repaired 4 Animal nuisances abated 7 Offensive accumulations removed 54 Ditches and streams—cleansed 16 „ „ „ —pollution remedied 8 43 Smoke nuisances abated 27 Improvements in boiler plant or fuel effected 12 Cinemas, Dance Halls, etc. — contraventions remedied 7 Hairdressers—contraventions remedied 1 Tents, Vans and Sheds—nuisance abated 1 „ „ „ ,, —Removed 1 Schools—sanitary conditions improved 3 „ —urinals and W.C's cleansed or repaired 2 Markets—contraventions remedied 3 Noise nuisances abated 20 Dust nuisances abated 2 Effluvia nuisances abated 4 Petroleum—contraventions remedied 31 (c) Eradication of bed bugs:— (i) Number of Council houses:— Found to be infested and subsequently dis- infested 7 (ii) Number of other houses:— Found to be infested and subsequently dis- infested 12 (i) by hydrogen cyanide — (ii) by liquid insecticides 12 Other vermin eradicated (not including rats and mice) 21 Verminous articles destroyed 9 (d) Meat and other Food Premises:— Meat shops, stalls, etc.—premises cleansed 46 „ „ „ „ —other contraventions remedied 24 Dairies—cleansed and distempered or painted 6 „ —premises repaired 4 „ —other contraventions remedied 4 Bakehouses — cleansed and distempered or painted 13 „ —sanitary conditions improved „ —other contraventions remedied 44 Ice cream premises—cleansed and distempered or painted 6 „ „ „ —sanitary conditions improved 3 Fried fish shops—cleansed and distempered or painted 8 „ „ „ —sanitary conditions improved 1 „ „ „ —other contraventions remedied 1 Fishmongers, etc., contraventions remedied 14 Grocers, etc., contraventions remedied 43 Greengrocers, etc., contraventions remedied 39 Restaurants, Cafes, etc., contraventions remedied 51 Street hawkers, contraventions remedied 5 Other food premises, contraventions remedied 14 3,435 45 Unsound Food Surrendered:— 1,358 1/2 lbs. Beef. 7 tins Crab. 1,968 lbs. Pork. 14 tins Salmon. 22 lbs. Sausages. 16 tins Herring. 28 lbs. Melt. 1 tin Tuna. 80 lbs. Liver. 3 tins Roes. 44 lbs. Veal. 12 tins Shrimps. 31 1/4 lbs. Lamb. 1 tin Brisling. 155 lbs. Kidneys. 3,215 tins Fruit. 301/2 lbs. Ham. 3 lbs. Raisins. 5 lbs. Chicken. 6 1/4 lbs. Grapes. 26 lbs. Duck. 41 tins Fruit Juice. 33 1/2 stone Cod. 9 tins Jam. 6 stone Plaice. 5 jars Jam. 14 1/2 stone Prawns. 16 tins Marmalade. 13 stone Halibut. 410 tins Vegetables. 7 stone Skate. 4 jars Pickles. 7 stone Haddock. 1 jar Pickled Onions. 13 1/2 stone Whiting. 124 tins Tomato Paste. 24 stone Dog Fish. 45 tins Tomato Juice. 51 tins Corned Beef. 7 bottles Tomato Sauce. 20 tins Veal. 2 cartons Pepper. 99 tins Ham. 9 tins Soup. 21 tins Beef. 2 pkts. Cereals. 35 tins Stewed Steak. 49 tins Evaporated Milk. 38 tins Pork. 2 tins Cream. 18 tins Tongue. 1 tin Skimmed Milk. 59 tins Luncheon Meat. 163 lbs. Cheese. 300 tins Chicken. 71 lbs. Margarine 44 tins Kidney. 2 tins Spaghetti. 10 tins Sausages. 1 tin Ravioli. 1 tin Liver. 1 carton Chocolate Spread. 17 tins Sardines. 1 Gateau. 24 tins Pilchards. 8 tins Eggs. 46 Slaughterhouse. There is one private Slaughterhouse licensed in the Borough. This was discontinued during the War and was brought back into operation in 1952. Particulars of inspections, etc., are as follows:— Carcases Inspected and Condemned. Cattle, excluding Cows. Cows. Calves. Sheep and Lambs. Pigs. Number killed 75 - 23 416 26 Number inspected 75 — 23 416 26 All diseases except tuberculosis and cysticerci:— Whole carcases condemned - - - - - Carcases of which some part or organ was condemned 3 - - - - Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 4 - - - - Tuberculosis only:— Whole carcases condemned - - - - - Carcases of which some part or organ was condemned - - - - - Percentage of the number inspected affected with tuberculosis - - - - - Cysticercosis:— Carcases of which some part or organ was condemned - - - - - Carcases submitted to treatment by refrigeration - - - - - Generalised and totally condemned - - - - - 47 Inspection of dwelling-houses during the year:— (a) (i) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 2,924 (ii) Number of inspections made for the purpose 6,009 (b) (i) Number of dwelling-houses (included under sub-head (i) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925/1932 13 (ii) Number of inspections made for the purpose 31 (c) Number of dwelling-houses found not to be in all respects reasonably fit for human habitation 2,028 Remedy of defects during the year without service of formal notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 2,071 Action under statutory powers during the year:— (a) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:— (i) Number of dwelling-houses in respect of which notices were served requiring repairs None (ii) Number of dwelling-houses which were rendered fit after service of formal notices:— (1) by owners (2) by Local Authority in default of None owners (b) Proceedings under Public Health Acts:— (i) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 57 (ii) Number of dwelling-houses in which defects were remedied after service of formal notices:— (1) by owners 49 (2) by Local Authority in default of owners 13 48 (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936:— (i) Number of dwelling-houses in respect of which Demolition Orders were made 1 (ii) Number of dwelling-houses demolished in pursuance of Demolition Orders 1 (d) Proceedings under Section 12 of the Housing Act, 1936:— (i) Number of separate tenements or underground rooms in respect of which Closing Orders were made (ii) Number of separate tenements or under- None ground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit Overcrowding. (a) Certificates issued to landlords, giving the mitted number of persons who may occupy a house 25 (b) Number of dwellings recorded as overcrowded at the end of the year 169 Number of families dwelling therein 191 Number of persons dwelling therein 867 (c) Number of new cases of overcrowding reported during the year 12 (d) (i) Number of cases of overcrowding relieved during the year 47 (1) by removals of sub-tenants/lodgers, members of family 3 (2) by removal of families to other known addresses (not overcrowded) 2 (3) by removal to unknown addresses 41 49 (4) rehoused by Council (included also in (2) above):— In requisitioned premises — In Council houses 2 In temporary bungalows — (ii) Number of persons concerned in such cases 240 (e) Cases in which dwelling-houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding 1 New Houses. The Borough Engineer and Surveyor has kindly supplied the following information:— Number of new houses and flats erected during the year: (a) Total, including numbers given in (b) below: (1) by the Local Authority 12 (2) by other bodies or persons 12 (b) With State Assistance under the Housing Acts: (1) by the Local Authority 91 (2) by other bodies or persons None 50 Factories. Number of factory premises — 518. Premises. Number of:— Inspections. Written Notices. Occupiers Prosecuted. Factories with mech. power 1,736 3 - Factories without mech. power 18 — — Other Premises — — — Totals 1,754 3 — Defects found. Particulars. No. of defects :— Found. Remedied. Referred to H.M. Inspector. Referred by H.M Inspector. Want of cleanliness 1 1 - - Overcrowding — — — — Unreasonable temperature — — — — Inadequate ventilation — — — — Ineffective drainage of floors 2 2 — — Sanitary Conveniences:— Insufficient 2 1 — 1 Unsuitable or defective 6 5 — 4 Not separate for the sexes — — — — Other offences 4 4 — — Totals 15 13 - 5 51 Outworkers. Number on register at end of year 518 Nature of work:— Making, repairing of:— Wearing apparel 358 Lace, lace curtains, nets 6 Furniture hangings, curtains 3 Brass and brass articles 10 Artificial flowers 3 Making of boxes or other receptacles or parts thereof, etc., of paper 14 Carding of buttons 10 Stuffed toys 8 Cosaques, Christmas crackers, Christmas stockings, etc. 88 Lampshades 15 Feather sorting Sacks 1 Offices. Number on the register — 333. 52 Shops Act, 1950, Section 38. The Senior Shops Inspector has supplied the following statistics relating to the arrangements for the health and comfort of shop workers, made in accordance with the provisions of the Shops Act:— Number of inspection visits 1,484 Section 38 (1) (b)—temperature:— Number of shops in which a reasonable temperature was not maintained 101 Section 38 (2)—sanitary conveniences:— Number of shops in which sanitary conveniences were not suitable and sufficient 24 Number of certificates of exemption granted Nil Section 38 (4)—washing facilities:— Number of shops in which washing facilities were not suitable and sufficient 6 Number of certificates of exemption granted Nil Section 38 (5)—facilities for meals:— Number of shops in which facilities provided were not suitable and sufficient 2 Disinfection of Premises and Articles. Disinfections for:— Infectious diseases 168 Cancer 4 Vermin (routine protection from) 38 Miscellaneous 34 244 53 Articles disinfected or destroyed :— Disinfected. Destroyed. Bedding and bedclothing 1,162 107 Wearing apparel (including 608 articles for abroad) 717 12 Carpets, rugs, cushions, curtains 11 3 Others 77 2 1,967 124 The Prevention of Damage by Pests Act, 1949. Work carried out 1/4/56 to 31/3/57:— Rats. Mice. (1) Number of premises visited 1,992 135 (2) Number of visits by Public Health Inspectors 366 (3) Number of visits by Rodent Control Assistants 5,793 728 (4) Number of premises which received treatment by Rodent Control Assistants 562 123 (5) Number of premises satisfactorily treated privately 4 2 (6) Number of Council premises (included in (4) ) 23 9 54 Milk (Special Designations) Orders. Licences issued. Dealers. Supplementary. Tuberculin tested 27 20 Pasteurised 27 19 Sterilised 38 22 Samples of designated milk taken. No. of samples taken. No. not satisfactory. Pasteurised 4 — Tuberculin tested — — T.T. (Pasteurised) 2 — Sterilised 2 — 8 - Laboratory Examinations re Food, Milk and Water. Examinations made Quarter ending Total for 12 months 31.3.56 30.6.56 30.9.56 31.12.56 Water - 2 6 2 10 Milk — 4 4 — 8 Ice Cream — — 19 — 19 Other Foods 4 4 4 - 12 55 Food and Drags Act, 1938. The Middlesex County Council are the Authority for the administration of this Act, and the Chief Officer of the Public Control Department has supplied the following particulars of sampling in Wembley during 1956:— Article. No. taken. Unsatisfactory. Milk, various 80 2 Milk, new 80 17 Arrowroot 4 — Butter 30 — Cakes 12 1 Cooked Meats 21 — Cream 33 — Drugs 34 — Fish 18 1 Fish products 11 — Fruit Squash 7 — Ground Almonds 3 — Ice Cream 22 — Marzipan 2 — Margarine 19 — Meat 28 — Meat products 16 — Miscellaneous 9 — Pepper 2 — Preserves 5 — Sausages, etc. 10 — Sweets 8 — Tomato Juice 2 — Vinegar 19 2 Wines and Spirits 15 — 490 23 56 Bye-laws in force throughout the Borough—December, 1956. Relating to the following matters:— Offensive Trades. Hairdressers' Premises. New Streets. Slaughterhouses. Licensed Establishments for Massage and Special Treatment. Removal through Streets of Offensive Matter. Deposit of Litter. Removal of House Refuse. Public Conveniences. Nuisances. Good Rule and Government. Ventilation and Lighting of Stables. Pleasure Grounds. Sale of Contraceptives in Slot Machines. Handling, Wrapping and Delivery of Food. Cycling on Footpaths. Buildings. Emission of Smoke. Spitting. Sale of Coal and Coke (M.C.C.). Employment Agencies (M.C.C.). Employment of Children (M.C.C.). 57 CHAPTER V. ADMINISTRATION, STAFF. During the year your Medical Officers acted professionally for the Council in performing 49 clinical examinations of actual or prospective staff and have provided a number of special reports to the various Committees of the Council. This helps in securing a medically sound personnel for all the activities of the Council and enables special consideration to be given to any unusual incidence of sickness, thereby maintaining a standard of efficiency difficult without such a service. In the Department itself during the year under review the incidence of sickness was very high. This sick absence was occasioned by severe medical and surgical incidents of a non-recurring character, but nevertheless entailing considerable absence from duty during the year. Those remaining on duty consequently were required to devote themselves very conscientiously to their duties, in order to maintain the standard within the Department, and I take the opportunity of thanking the whole of the staff for their conscientious efforts, particularly during this year. It is very appropriate to draw attention to the new designation of members of the Inspectorate. The change of name of these officers brings their title "Public Health Inspector" more into line with the duties they now perform. I think it will be agreed that they have largely ceased to be sanitary police and are occupied on health education in association with their inspections, rather than on securing punishment for those who transgress in some minor way. The Council, during the year, considered the possibility of paid pupillage in the Public Health Inspectorate, but came to the conclusion that the moment was not opportune for commencing this particular activity which is likely to assist in recruitment to the inspectorate of the country. At the end of the year the threat of petrol rationing foretells a possible curtailment of mobility in the future, but this will be met optimistically and with goodwill in the New Year. 58 In conclusion, I would express my thanks and appreciation to all members of the Council, especially those who serve on the Health Committee, and particularly the Chairman, for the admirable way in which they have directed the policy of the Department during the year. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, E. GRUNDY, Medical Officer of Health. 59 Printed by HENDON PRINTING WORKS LTD. 42-44 Victoria Road, London, N.W.4 Tel.: SUNnyhill 1004 & 3006