ACD 439(1) WILLESDEN WIL 46 Public Health Dept. REPORTS COLLECTION COPY BOROUGH OF WILLESDEN 1950 THE 75th ANNUAL HEALTH REPORT S. LEFF, M.D., D.P.H., Barrister at Law, Medical Officer of Health BOROUGH OF WILLESDEN Health Department, 54, Winchester Avenue, Kilburn, London, N.W.6. September, 1951. To the Mayor, Aldermen and Councillors of the Borough of Willesden. Mr. Mayor, Ladies and Gentlemen, I beg to submit the Annual Report on the health and sanitary circumstances of the Borough for the year 1950. It is with a great deal of pleasure that I can report a general improvement in the health of the people of the Borough. The general death rate, the infant mortality rate, and the cancer and tuberculosis death rates have been reduced. There has also been a general reduction in the infectious disease rates, with the exception of measles, whooping cough, and tuberculosis. There was no epidemic of anterior poliomyelitis during the year (there were only 12 confirmed cases). The infant mortality rate was the lowest on record, but not very much below that of 1948; the illegitimate birth and death rates were higher than usual. The health of the people in the Borough depends upon the living conditions and the standard of the health services. In estimating the extent in the improvement of the health of the people, we must take into consideration what could be done as well as what has been done. In the last Annual Report it was shown that many lives could have been saved if the conditions of living in many wards were raised to those of the wards with the better rates. The improvement of the rates in all wards during the year must be measured against what could have been achieved. It is true that there is usually an interval of time before improvements in the health services and the living conditions cause reductions in the sickness and death rates. Similarly, a deterioration in the living conditions and health services does not immediately produce an increase in these rates. The increase in the tuberculosis case rate and the fall in the birth rate are warning signs that the housing situation in the Borough may seriously affect the health of the people in the future, and the effects of the rising costs of living on the nutrition of the people may be reflected in the rates in the next few years. There has been an improvement in the co-operation between the various health services in the Borough during the year, but they will not be able to give their best work until there is one organisation set up to administer all the health services in the area. The hospital and personal health services, in particular, suffer because they have no intimate contact with the local organisations and, therefore, lack intimate knowledge of local interest and needs; all the health services suffer from the restrictions which prevent their expansion to satisfy the Borough's urgent health needs. Health services gain in vitality in an atmosphere of development and expansion. There has been a further expansion in the work of the local environmental health services, particularly in the repair of houses, in the campaign for clean food, and in better health education. It is a pleasure to record the growing interest that many councillors are taking in this important work. I wish to thank all members of the staff, and particularly the sanitary inspectors and the members of the Health Committee and Borough Council, for their share in the work of improving the health of the people in Willesden during the year 1950. I have the honour to be, Your obedient servant, S. LEFF, Medical Officer of Health. 3 STATISTICS AND SOCIAL CONDITIONS OF AREA. Population, 1950 181,700 Population Census, 1931 184,434 Pre-war population, 1938 187,600 Area of the district in acres 4,634-5 acres Number of inhabited houses 43,286 Rateable value £1,639,484 General rate for the year 17s. 6d. Product of a Id. rate £6,773 VITAL STATISTICS. Live Births : Total Male Female Willesden Borough Council Legitimate 2564 1297 1267 Birth rate per 1,000 of the estimated resident population. Illegitimate 171 91 80 Total 2735 1388 1347 1505 Rate per 1,000 total (live and still) births Still births 63 26 37 22.52 Death rate per 1,000 estimated resident population. Deaths 1775 933 842 9.77 Death Rate of Infants Under One Year of Age : All infants per 1,000 live births 22.67 Legitimate infants per 1,000 legitimate live births 22.23 Illegitimate infants per 1,000 illegitimate live births 35.09 Death Rate of Infants Under Four Weeks of Age : All infants per 1,000 live births 13.16 Legitimate infants per 1,000 legitimate live births 12.88 Illegitimate infants per 1,000 illegitimate live births 17.54 Maternal Mortality : Deaths from puerperal causes— Puerperal sepsis Nil per 1,000 registered total births Other puerperal causes Other maternal causes 2 Total maternal mortality rate 73 per 1,000 registered live births Deaths from : Males Females Total Cancer (all ages) 179 148 327 Measles (all ages) 1 1 2 Whooping cough (all ages) 1 1 2 Diarrhoea (under 2 years of age) - - - 5 Infant Mortality and Still-birth Rates by Wards. Ward No. of persons per Acre, 1948 Combined rate, 1936-39 Combined rate, 1940-45 Reduction 1940-45 compared with 1936-39 (percentages in brackets) Combined rate, 1946-50 Reduction 1946-50 compared with 1940-45 (percentages in brackets) Reduction 1946-50 compared with 1936-39 (percentages in brackets) Still-birth rate, 1946-50 Carlton 160 7611 58.82 17.29 26.27 32.55 49.84 24.07 (23.50) (55.92) (65.48) Harlesden 92 75.88 54.36 21.52 37.11 17.25 38.77 30.11 (28.36) (31.73) (51.09) Willesden Green 94 69.39 49.92 19.47 27.64 22.28 41.75 32.38 (28.05) (44.63) (60.16) Round wood 101 66.29 69.60 +3.31 32.90 36.70 33.39 21.45 (+4.99) (52.72) (50.36) Kilburn 111 64.89 47.93 15.96 31.41 16.52 33.48 29.71 (23.05) (34.46) (51.59) Stone bridge 92 62.62 55.60 7.02 34.72 20.88 27.90 24.69 (11.21) (37.55) (44.55) Manor 74 56.31 38.68 17.63 30.33 8.35 25.98 20.22 (31.30) (21.58) (46.13) Church End 71 47.51 41.10 6.41 28.24 12.86 19.27 27.48 (13.49) (31.28) (40.56) Neasden 51 46.24 47.76 +1.52 14.03 33.73 32.21 17.54 (+3.28) (70.62) (69.65) Cricklewood 55 41.71 48.26 +6.55 21.63 26.63 20.08 21.63 (+15.70) (55.18) (48.14) Kensal Rise 104 40.90 45.13 44.23 19.21 25.92 21.69 18.14 (+10.34) (57.43) (53.03) Mapesbury 54 39.25 52.80 +13.55 18.31 34.49 20.94 21.44 (+34.52) (65.32) (53.35) Brondesbury Park 39 35.22 31.16 4.06 26.41 4.75 8.81 26.41 (11.53) (15.24) (25.01) Whole Borough 78 58.27 51.35 6.92 27.14 24.21 31.13 24.57 (11.87) (47.14) (53.42) GENERAL PROVISION OF HEALTH SERVICES. Public Health Laboratory Service. The work in connection with the examination of specimens is carried out by the Public Health Laboratory Service at the Central Public Health Laboratory, Colindale Avenue, N.W.9, and at their branch laboratory at the Neasden Hospital, Brent field Road, N.W.10. Specimens, swabs from sore throats, faeces from suspected intestinal infections, and cough plates and post-nasal swabs from suspected whooping cough cases, etc., are delivered by private practitioners to the branch laboratory at the Neasden Hospital or to the Health Department, 54, Winchester Avenue, N.W.6, or the Willesden Health Centre, 381, High Road, Willesden, N.W.10, for collection and transfer to the Central Public Health Laboratory. A presumptive report is telephoned to the practitioner on the morning after receipt of the specimen, and is followed by a written report. Samples of milk taken by the Sanitary Inspectors from dealers in the district are also forwarded to the laboratory for examination. During the year 1950, the following work was carried out at the laboratory : Throat/Nose Swabs : Diphtheria bacilli - Hæmolytic Streptococci 239 Vincent's angina 7 Negative 642 Total 885 Faeces: Shigella 23 Salmonella 20 Protozoa — Negative 259 Total 303 Sputum : T.B. Smear 370 Other organisms — Negative 1399 Total 1769 6 Pertussis: Cough plate - Post-nasal swab Negative - Total 9 Milk : Pasteurised 300 Other Taken from School Taken from Dealers' Premises. Pasteurised Pasteurised. T. T. Pasteurised. Sterilised. No. taken 157 68 20 38 No. satisfactory 149 65 20 32 No. unsatisfactory in respect of Methylene Blue test only and second sample taken 8 3 No. unsatisfactory in respect of turbidity test (sterilised only) - - - 6 No. of second samples satisfactory 8 3 - 6 Ice Cream : 10 Grade 2 Grade 2 3 Grade 3 3 Grade 4 2 Water : Domestic supplies, etc. 7 Satisfactory 7 Unsatisfactory - Swimming pools 86 Satisfactory 86 Unsatisfactory - MISCELLANEOUS 188 TOTAL 3557 Uncleanliness and Scabies. Cases Treated at the Scabies and Lice Treatment Centre, Neasden Hospital. [ No. of new cases treated Total No. of attendances For scabies For lice and nits Total For scabies For lice and nits Total Children under 5 years 36 22 58 120 (7) 22 142 Children 5-14 years 45 213 258 170 (8) 231 401 Adults : Men 31 6 37 297 (14) 84 381 Women 60 65 125 The numbers in the brackets are contacts of scabies who on inspection showed no signs of infection, but nevertheless received treatment. They are not included in the total. 7 Establishments for Massage and Special Treatment. The registration of establishments for massage and special treatment is delegated to the Borough Council in accordance with Part XII of the Middlesex County Council Act, 1944, and the work of inspection of the establishments is performed by the Council's sanitary inspectors. During the year 1950, 23 premises were registered, 5 persons were granted a licence, 17 a renewal of a licence, and 1 received exemption under section 363 of the Act. Health Education. Health education has become very popular in the borough, and lecturers on health are in great demand at clubs, religious organisations, community associations, trade unions, co-operative and political parties, day nurseries and schools. Doctors, health visitors, sanitary inspectors, other chief officers and their deputies, the public relations officer, the chairman of the Area Health Committee and his wife, and many outside lecturers have given invaluable help in this work. Without them, little success could have been achieved, and the public health department and the people of Willesden are very grateful for their assistance. Mothercraft classes and talks by doctors and health visitors are now given at all the health centres. Further, separate meetings of sanitary inspectors, doctors, health visitors and day nursery matrons and their deputies are held regularly, where health educational films are shown, often with the help of outside lecturers. Many interesting discussions have taken place. Health education is thus helping the health worker and the people in the battle against disease. There is nothing spectacular in the results, but the foundation is being laid for a community of people with a clear understanding of how our main enemy, disease, can be defeated. Health Services of the Other Authorities in the Area. The hospital facilities provided by the North-West Metropolitan Regional Hospital Board, and the maternity and child welfare and school health services provided by the Middlesex County Council, remain substantially the same; they are described in the 1948 report. It is interesting to note the position regarding the provision of private beds in hospitals within the district. Under the provisions of the National Health Service Act, 1946, there are, broadly speaking, three types of accommodation available for persons requiring hospital in-patient treatment. Persons admitted to hospital under section 3 of that Act are not required to contribute at all towards the cost of their maintenance and treatment in hospital and the entire expense is met from the National Exchequer. Under section 4 of the National Health Service Act, accommodation is made available in certain hospitals in single rooms or small wards for persons desiring to obtain a measure of privacy and willing to make a contribution towards the cost of their accommodation but unable to pay the full amount of such cost. Regulations were issued subsequent to the passing of the Act under which the charge made to such patients is at the rate of 6/- per day for persons occupying single rooms and at the rate of 3/- per day for accommodation in two-bedded or other small ward accommodation. Under section 5 of the National Health Service Act accommodation in single or other small wards is made available in certain hospitals for persons willing to pay the full cost involved in providing for their maintenance in hospital and also the charges made by the medical practitioners concerned for medical services (normally not being more than 75 guineas for any particular course of treatment) which may be incurred in their treatment. These patients may engage the services of any medical practitioner who carries out duties in the hospitals in the National Health Service, although in practice they usually elect to be treated by consultants engaged at the hospital at which they seek admission. Alternatively, they may pay the hospital authorities for the services of the medical and surgical staff engaged in their treatment. Persons admitted to hospital under section 3 of the Act who need section 4 or 5 accommodation on medical grounds are admitted to such accommodation to the exclusion, if necessary, of persons who have undertaken to pay the charges to which I have referred. Each of the general hospitals administered by the Central Middlesex Hospital Management Committee has both section 4 and section 5 accommodation. The three hospitals concerned are Acton Hospital, Gunnersbury Lane, Action, W.3, Willesden General Hospital, Harlesden Road, N.W.10, and Central Middlesex Hospital, Acton Lane, Park Royal, N.W.10, although it is not anticipated that such accommodation at the latter hospital will come into use until the 1st June, 1951. PREVALENCE OF, AND CONTROL OVER, INFECTIOUS AND OTHER DISEASES. Infectious Diseases—Number of Cases Notified and Confirmed. Number of cases confirmed (number notified in brackets) 1948 1949 1950 Diphtheria 15 (48) 8 (33) 1 (15) Scarlet fever 306 (325) 340 (325) 306 (317) Pneumonia 180 (195) 161 (175) 150 (164) Whooping cough 423 (435) 205 (212) 648 (650) Erysipelas 39 (43) 29 (35) 26 (29) Measles 1281 (1290) 985 (990) 2255 (2280) 8 Other Infectious Diseases Notified During 1950. Disease Number confirmed (number notified in brackets) Typhoid fever 2 (2) Dysentery 19 (30) Malaria - - Poliomyelitis and polio-encephalitis 12 (17) Cerebro-spinal fever 6 (13) No cases of encephalitis lethargica were notified. Measles. 2280 cases were notified in 1950 (2255 confirmed), but a total of 2515 cases came to the notice of the health visitors, 1478 in children under 5 years of age. There was 1 death from measles in a child under year of age. Whooping Cough 650 cases were notified in 1950 (648 confirmed), but a total of 818 came to the notice of the health visitors, 414 in children under the age of 5 years. There were 2 deaths from whooping cough in children under 1 year of age. Pneumonia and Influenza, 164 cases of pneumonia were notified in 1950 (150 confirmed). There were 87 deaths from bronchopneumonia, lobar pneumonia and pneumonia (unspecified), and 13 deaths from influenza. Ophthalmia Neonatorum. 3 cases were notified in 1950, a case rate of 1.10 per 1000 registered live births. There was complete recovery with unimpaired vision in all 3 cases. Puerperal Pyrexia. 30 cases of puerperal pyrexia were notified during the year (28 confirmed). Food Poisoning. 24 cases of food poisoning were notified during the year (12 confirmed). Tuberculosis. The death rate from tuberculosis has been more than halved in the post-war period, but the case rate has shown an increase; the reduction in the case rate in 1949 was not continued in 1950. The numbers on the register have also more than doubled (see Table 1). It is unlikely that the increase is entirely due to the better detection of cases, since the percentage who were notified more than a year before death is still less than 50 per cent.; and 16 per cent. were not notified at death. The probability is that while there has been a decrease in the number of deaths, largely due to improved treatment at home together with the use of chemotherapy, there has been an actual increase in the number of cases. The Annual Report of 1949 indicates that this increase is probably due to the present conditions of overcrowding in the borough. 9 TUBERCULOSIS. Table 1 Tuberculosis Case and Death Rates (per 1,000 estimated resident population) Cases on Register Year Population No. of New Cases (No. of Deaths in brackets) Case Rates (Death rates in brackets Pulmonary Non-pulmonary All forms Pulmonary Nonpulmonary All forms Pulmonary Nonpulmonary All forms 1936-39— Pre-war Period 1936 190,000 211 47 258 1.11 .168 1.358 655 152 807 (128) (16) (144) (.673) (.084) (.757) 1937 188,030 205 49 254 109 .261 1.351 688 161 849 (119) (14) (133) (.632) (.074) (.707) 1938 187,600 210 56 266 1.119 .298 1.417 691 172 863 (117) (11) (128) (.623) ( 058) (.681) 1939 188,000 250 37 287 1.329 .197 1.526 678 166 844 (108) (12) (120) (.574) ( 063) (.638) Total 753,600 876 189 1,065 1162 .251 1.413 (472) (53) (525) (.626) ( .070) (.696) 1940-45— War period 1940 152,030 204 54 258 1.324 .355 1.697 587 145 732 (105) (16) (121) (.690) (.105) (795) 1941 127,230 217 32 249 1.705 .252 1.957 575 116 691 (79) (15) (94) (.621) (.117) (.738) 1942 138,600 234 47 281 1.688 .339 2.027 369 133 502 (100) (15) (115) (.721) (108) (.829) 1943 144,430 262 51 313 1.814 .353 2.167 734 150 884 (85) (14) (99) (.589) (096) (.685) 1944 139,510 210 23 233 1.505 .165 1.670 815 156 971 (84) (18) (102) (.602) (129) (.731) 1945 161,954 207 45 252 1.278 .277 1.556 927 172 1,099 (81) (16) (97) (.500) (.098) (.598) Total 863,754 1,334 252 1,586 1.544 .292 1.836 (534) (94) (628) (.619) (108) (-727) 1946-49— Post-war period 1946 170,550 255 34 289 1.495 .199 1.694 1,067 180 1,247 (95) (11) (106) (.557) ( .065) (.622) 1947 175,900 253 33 286 1.438 .188 1.626 1,198 191 1,389 (78) (9) (87) (.443) (.051) (.494) 1948 179,900 243 27 270 1.351 .150 1.501 1,293 196 1,489 (80) (11) (91) (.445) (.061) (.506) 1949 181,120 186 22 208 1.026 .121 1.147 1,386 207 1,593 (66) (9) (75) (.364) ( .050) (.414) 1950 181,700 229 29 258 1.260 .159 1.419 1,543 217 1,760 (51) (4) (55) (.280) ( .022) (.302) Total 889,170 1,166 145 1,311 1.311 .163 1.474 (370) (44) (414) (.416) ( .049) (.465) The death rates, the case rates and the numbers on the tuberculosis register, illustrate the development. The pre- and post-war Tuberculosis Rates. As shown in the Annual Report of 1949, there were marked differences in the morbidity and mortality rates of tuberculosis in the different wards because of the differences in their living conditions. The pulmonary case rates for the period 1946-50 in two wards was less than 1, while in three wards it was more than 1.5, and in another three wards more than 1.4. The ward with the lowest pulmonary rate had 0.948, while the highest was 1.706, almost double. Improvements in the living conditions of the people in the wards with the high morbidity and mortality rates would reduce these rates and save a good deal of money which is now being spent on the curative services. 10 Table 2. The pre- and post-war Tuberculosis Rates 1936-39—1946-50 Decrease or Increase in the Rates Death Rate 1946-50 1936-39 1946-50 Ward Pulmonary Rate No. of Pulmonary Cases Combined Rate No. of Nonpulmonary Cases Pulmonary Rate No. of Pulmonary Cases Combined Rate No. of Nonpulmonary Cases Pulmonary Rate Combined Rate All Forms Rate Carlton 1.781 113 2.270 31 1.706 106 1.947 15 -075 -223 39 .627 Kilburn 1.509 92 1.838 20 1.476 103 1.734 17 -033 -104 31 .444 Stonebridge 1.469 79 1.748 15 1.650 104 1.920 17 +.181 +.172 43 .682 Roundwood 1.442 71 1.726 14 1.582 87 1.836 14 +.140 +.110 36 .654 Brondesbury Park 1.262 63 1.583 16 1.332 82 1.430 6 +.070 -153 26 .422 Kensal Rise 1.088 61 1.373 16 1.060 62 1.197 8 -028 -176 37 .632 Cricklewood 1.105 68 1.268 10 1.021 79 1.085 5 -084 -183 25 .323 Church End .971 58 1.239 16 1.432 104 1.652 16 +.461 +.413 26 .358 Neasden 1.004 46 1.157 7 .948 53 1.091 8 -056 -066 33 .590 Willesden Green .958 56 1.112 9 1.224 84 1.370 8 +.266 +.258 28 .408 Harlesden .974 61 1.102 8 1.187 96 1.323 11 +.213 +.221 33 .408 Mapesbury .852 68 1.065 17 1.431 148 1.547 12 +.579 +.482 27 .261 Manor .764 40 .955 10 9.57 58 1.089 8 +.193 + .134 30 .495 Whole Borough 1.162 876 1.413 189 1.311 1,166 1.474 145 +.149 + .061 414 .465 11 Poliomyelitis. During the year 19 Willesden residents were notified as suffering from poliomyelitis, including a late notification on discharge from the London Hospital. Of these 19 cases, 12 were confirmed, 6 persons between the age of 0 and 15 years, and 6 above the age of 15 years. One case was fatal, 5 had severe paralysis, 5 slight paralysis, and one was non-paralytic. A girl aged 17 years was notified as cerebro-spinal meningitis, but was finally diagnosed as poliomyelitis (nonparalytic). The fatal case was a girl of 13 years who was admitted to hospital diagnosed as suffering with appendicitis, but the post-mortem revealed the case as polio-encephalitis. 7 were admitted to Neasden Hospital and 5 to other hospitals, and on discharge 3 were transferred to the Royal National Orthopaedic Hospital at Stanmore and 8 were discharged home, 2 of whom attended the hospital out-patients' department for treatment. Smallpox. There were no cases of smallpox during the year. SANITARY CIRCUMSTANCES OF THE AREA. Water. The Metropolitan Water Board and the Colne Valley Water Company supply Willesden with water of excellent quality. Sewage and Drainage. Most of the sewage of the borough is discharged into the London County Council main sewers, but a small amount from the Park Royal area is discharged into the West Middlesex Main Drainage system. Refuse Disposal. House refuse is collected weekly, and trade refuse as often as neccssary; the trader pays an agreed charge. The refuse is disposed of by controlled tipping at Twyford. The Borough Engineer's department deals with matters relating to the provision of dust-bins. Bathrooms. One in three Willesden families have no bathroom, and one in four have to share with another family. Less than half the Willesden families (41 per cent.) have a bathroom of their own. Water Closets. Approximately one in four families (22 per cent.) share a water closet, but the proportion rises to almost three-quarters (68 per cent.) in dwellings occupied by three or more families. Gardens. Willesden is poorly equipped with public open spaces, 242 acres, compared with an estimated need of 1,313 acres; yet one in four families have no garden at all, and a large number have to share a garden. SWIMMING BATHS. Swimming Bath No. of Samples Taken No. Satisfactory No. Unsatisfactory Granville Road 26 26 — Gladstone Park 33 33 — King Edward's Park 27 27 — These results chow that the break-point chlorination plant installed at Gladstone Park Baths has improved the standard of water purity. Further improvements are required to remedy the unsatisfactory surface drainage and the sanitary and shower bath arrangements (see 1948 Annual Report). 12 SANITARY SECTION. Staff. The authorised establishment of Sanitary Inspectors is one Chief Sanitary Inspector, one Deputy Chief Sanitary Inspector and 17 District Sanitary Inspectors. During the year, one Sanitary Inspector resigned and the vacancy was filled by the appointment of a qualified Pupil Sanitary Inspector. The authorised establishment of pupil sanitary inspectors is 6, and during the year there were 5 on the staff, which included a qualified plumber, who was previously an employee of the Council. The Rodent Officer and 4 operatives were employed in the destruction of rats and mice in dwelling houses, factories and other industrial buildings and on bombed sites and waste lands. Two labourers are employed on vermin disinfestation, drain testing, and general duties. SANITARY INSPECTION OF THE AREA. Inspections : 1950 1949 Number of dwelling houses inspected for housing defects (under P.H.A or H. A. 1936) : Number of premises inspected on complaint 5441 5971 Number of premises inspected in connection with infectious disease 4 10 Houses inspected—house-to-house—Housing Act, 1936 220 106 Number of dwelling houses—own observation 196 186 5861 6273 Number of inspections made for the purpose 33900 32771 Periodic Inspections : 1950 1949 Slaughterhouses—number registered 1 2 Number of inspections made 10 - Common lodging houses—number registered under Bye-laws 1 1 Number of inspections made 45 26 Offensive trades—number of premises in district 4 4 Number of inspections made 4 7 Factories—with mechanical power—number of inspections 851 1331 Notices served 181 58 Without mechanical power—number of inspections 153 122 Notices served 31 12 Work places-other than out-workers—number of inspections 10 22 Notices served 3 1 Homeworkers and outworkers 208 22 Inspection of food premises: Baker 256 150 Bread and confectionery 209 Dairy 116 298 Butcher 744 1578 Grocer and general store 1745 Fishmonger and fish-fryer 435 400 Cafe and Restaurant 1139 778 Greengrocer and fruiterer 710 278 Ice Cream and sweet shop 748 352 Food stall 162 117 Public House 151 - Works Canteen 125 - Food factory 136 1 Any other food premises 87 - Total periodic inspections 8044 5481 1950 1949 Total periodic inspections 8044 5481 For certificates under the Rent Acts 68 53 Public House urinals 240 122 Mews and stables 72 80 Miscellaneous 1249 848 Under Circular 2845 - 88 Smoke observations 122 218 Verminous rooms—number of primary inspections 234 174 Number of re-inspections 326 262 Total number of inspections and re-inspections 44255 40097 13 Action taken by the service of notices under Public Health and Housing Acts : 1950 1949 Number of Intimation Notices served 3113 3521 Number of Intimation Notices complied with 2848 2827 Number of Statutory Notices served (Public Health Act, 1936) 1804 1703 Number of Statutory Notices complied with (Public Health Act, 1936) 1658 1372 Number of Statutory Notices served (Housing Act, 1936) 95 39 Number of Statutory Notices complied with (Housing Act, 1936) 67 30 Number of cases of non-compliance with Statutory Notices referred to Town Clerk (Section 93, Public Health Act, 1936 383 424 Number of cases referred to the Borough Engineer for work to be carried out in default of owners *177 105 *126 work carried out by Borough Engineer, remaining 51 by owners. Action taken by Town Clerk on cases referred to him during the year—Section 93, Public Health Act, 1936: Cases completed (by informal action) 257 308 Work in hand 15 9 Court orders obtained 49 53 Summonses issued — 1 Summonses withdrawn—notices complied with 41 30 Notices withdrawn—re-served 21 20 Work done by agreement—Section 275, Public Health Act, 1936 — 3 383 424 Rent and Mortgage Interest (Restrictions) Acts: 73 94 Number of applications granted 66 72 Number of applications refused (work done) 6 21 Number of applications withdrawn 1 1 SUMMARY OF NUISANCES ABATED AND IMPROVEMENTS EFFECTED. Water Supply and Water Service. 1950 1949 Cisterns—new one provided 34 48 cleansed, repaired, covered, etc 133 142 draw taps placed on mains 14 26 Drainage and Sewerage of Existing Buildings. Water closets—number of W. C. s substituted for dry receptacles repaired, supplied with water or otherwise improved 627 550 additional closets constructed 26 46 Drains—water closets aerially disconnected from sculleries, living rooms and bedrooms 11 5 examined, tested, exposed, etc. 495 621 unstopped, repaired, trapped, etc 547 685 new soil pipes or vent shafts fixed 59 66 disconnecting traps or chambers inserted 61 79 reconstructed 39 66 new manhole covers 94 113 Cesspools—rendered impervious, emptied, etc., abolished and drain connecting to sewer — 2 Existing soil pipes or vent shafts repaired 201 205 Overcrowding (under Public Health Acts) 8 9 Smoke 13 18 Accumulation of refuse 124 117 Foul ditches, ponds, etc., and stagnant water 5 7 Fowls, pigs and other animals 20 55 Dampness 2108 2240 Yard and forecourts paved, repaved or repaired 265 222 Walls and ceilings cleansed 6995 5329 Verminous rooms disinfested 458 288 Leaky roof made watertight 2013 1900 Additional ventilation provided under floors 139 165 Dilapidated plaster repaired 5593 4664 Flooring and other woodwork repaired 2625 2057 Damp-proof courses inserted 97 173 Water supply reinstated 59 69 Wash-house floors repaired or repaved 66 45 Fireplaces and stoves repaired 1347 1279 Decayed brickwork repaired and repointed 779 646 Sinks provided or replaced 182 181 Additional light and ventilation provided to staircase 11 15 Larders or food cupboards ventilated or provided 21 22 Gutters and/or rainwater pipes repaired or renewed 1655 1717 New sash cords and glass provided to doors and windows 3954 3064 Miscellaneous 997 834 Total number of nuisances abated 31875 27770 14 Overcrowding. Licences to permit temporary overcrowding in excess of the permitted number— Section 61, Housing Act, 1936 : 1950 1949 Number of licences issued 6 3 Housing Act, 1936—Sections 11 and 12. Closing Orders made: 18, College Parade—underground room 1 4 Demolition Orders made: 19, Grosvenor Gardens; Albert Cottage, Neville Road; 1, Avenue Road; 2, Rupert Road; 4, Rupert Road; 7, Rupert Road; 14, Victoria Villas; 32, Connaught Road 8 6 Albert Cottage, Neville Road, was demolished in December, 1950, and the tenants were rehoused by the Council. There was an appeal against the order in the case of 32, Connaught Road, and the date of hearing was January 12th, 1951. At the end of the year tenants in six houses where demolition orders were made were still waiting to be rehoused by the Council. Three properties with demolition orders dating from 1949 were demolished during the year, 195, 197, and 199, Cambridge Road. HOUSING. The Housing (Standards of Fitness) Sub-committee continued the work of improving the conditions in privately owned houses in the area by action under the Public Health Act, 1936, and the Housing Act, 1936. Houses continued to be inspected as a result of tenants' complaints, which were almost equal to the number of the previous year. The number of landlords who did not carry out the work of the repair notices under the Public Health and Housing Acts increased : the number of court cases also increased. The general work of the committee was described in the Annual Report for 1949. The lack of homes in the district hinders the work of the committee in the closure and demolition of slum property, since the tenants have no other place to go to. Tenants have had to remain for some time in houses scheduled for demolition, and their living conditions in the meantime have become much worse; the committee could only enforce action for serious nuisances, e.g., leaking roofs, drainage defects, etc. Many houses in the district are becoming slum property, and it is doubtful whether the repeated patching of these houses is the most economical in the long run; the building of new houses may cost more at first, but it would save a lot of money on repairs and on the treatment of those whose health is affected by living in slum conditions. There are no accurate figures of present day overcrowding in the area, but it is unlikely that there has been any marked improvement, since the increase in population has kept pace with the increases in housing accommodation. 146 new housing units were built (including 46 rebuilt after war damage) and the waiting list of applicants for houses has increased from 8,372 to 9,426. OVERCROWDING. Housing Act, 1936. It is impossible to give accurate figures of the overcrowding in the borough without a general survev of the housing accommodation. The Housing Department has, however, supplied some figures based mainly on the statements of applicants for new houses. (a) (i) Number of dwellings overcrowded at end of year 1,500 (ii) Number of families dwelling therein 1,500 (iii) Number of persons dwelling therein 5,250 (b) Number of new cases of overcrowding reported during the year 323 (c) (i) Number of cases of overcrowding relieved during the year 126 (ii) Number of persons concerned in such cases 633 (d) Cases in which dwelling houses have again become overcrowded after the local authority have taken steps for the abatement of overcrowding No information (e) (i) Number of Council houses found to be overcrowded at end of year 153 (ii) Number of families dwelling therein 222 (iii) Number of persons dwelling therein 1,293 (f) Number of cases of overcrowding in Council houses relieved during the year No information HOUSING. Houses erected by private enterprise 4 (In addition 46 were rebuilt after war damage). Houses erected by Local Authority Flats erected by Local Authority 96 Total number of applicants on Council's waiting list at December 31st, 1950 9,426 15 SMOKE NUISANCE. The number of complaints of smoke nuisances slightly decreased in 1950, but the dust and sulphur fumes from Power Stations continued to be a source of nuisance to those living near the stations. The main reduction in smoke nuisances from the ordinary industrial boiler installations has been effected by co-operation between the Sanitary Inspectors and the Technical Officers of the Ministry of Fuel and Power. Excessive smoke emission from boiler plants is due to the working of the plant above its rated capacity, the lack of skill in the operators, or the use of unsuitable fuel. Sanitary Inspectors have given guidance on the best methods of stoking, but some firms still think that any untrained person can do the skilled job of stoking. The Coal Allocations Division of the Ministry of Fuel and Power have been asked to supply better fuel where it is unsuitable, and although they cannot always arrange for better fuel, there has been an improvement in the supplies in 1950. The number of complaints of smoke, grit and sulphur emitted from the three Power Stations in the borough has decreased, but this is not necessarily due to an actual decrease in the nuisance. The Sanitary Inspectors observed less evidence of smoke and grit nuisance; probably due to the reduction in use of the older power stations as new power stations are added to the grid system. Further research is, however, required on the best methods of reducing the sulphur nuisance, and particularly how far the cost of gas washing plants is compensated by the improvement in the atmosphere near power stations, with the consequent saving of money on linen, cleaning, and the health of the people. Many local authorities throughout the country have placed instruments near power stations to measure the amount of atmospheric pollution. The Willesden Council have agreed to carry out tests in this area. There will be some delay before the actual measurements can begin as the necessary apparatus is in very short supply. The Department of Industrial and Scientific Research (Fuel Research) have very kindly offered to assist in these measurement operations with scientific and technical advice. BOMBED SITES. The Council have a programme to clear up these sites to prevent the recurrence of nuisance. A number of bombed sites have now been fenced in, been built on, or converted into public recreation grounds, and the Health Department continue to deal with the nuisances on the other sites, e.g., by clearing away refuse, getting rid of rats, etc. DISINFESTATION. The sanitary inspectors inspect verminous premises and supervise the work of the disinfectors employed by the Council. Furniture of tenants moving into new Council dwellings is disinfested by contractors; bedding materials are disinfested at the steam disinfector at the Neasden Hospital. (a) Disinfestation of verminous premises : Number of primary inspections of verminous premises by sanitary inspectors 234 Number of re-inspections of verminous premises by sanitary inspectors 326 Total number of properties dealt with by disinfestors 300 Number of private premises supervised by sanitary inspectors 234 Number of Council properties supervised by Housing Department 66 *Number of verminous rooms disinfested under Council's Scheme 458 Number of verminous rooms disinfested by owners 25 Total number of verminous rooms disinfested 483 *Some rooms are treated more than once. (b) Disinfestation of possessions of tenants moving into new Council dwellings : {arranged by Housing Department after 1.4.1950.) Number of furniture disinfestations 24 Number of premises disinfested by H.C.N. — (c) Number of loads of bedding disinfested at Neasden Hospital 38 (d) Miscellaneous disinfestations: Number of treatments for beetle infestations in canteens, etc 14 Number of treatments for housefly infestations 2 Number of treatments for ant infestation 10 RODENT CONTROL. Rodent control has been carried out at the following properties :— 1950 1949 Total number of premises treated 799 628 New agreements 19 19 Renewal of agreements 69 60 Business premises 120 81 Borough Council properties 22 16 Private dwellings 569 452 The cost of disinfestation at business premises is recovered from the occupiers, and amounted to £705 12s. 4d. The service is free to occupiers of private dwellings, but the Borough Council recovers 50 per cent. of the cost in grant aid according to the terms of Circular No. N.S.19. The total cost in 1950 was £554 7s. 1d. The work of rat disinfestation in the sewers is carried out by the Borough Engineer's Department. Where outbreaks of rats have been detected in defective drains and nests of rats are suspected in the sewage system, co-operation has been obtained from the Engineer's Department in deciding whether to break open pavements. There has been an overall increase in the work of disinfestation in this section over last year and 171 more premises have been treated, 48 at business premises, 6 at Borough Council properties, and 117 at private dwellings. 16 INSPECTION AND SUPERVISION OF FOOD. Unsound Food. Section 10 of the Food and Drugs Act, 1938, makes provision for the examination of food and the seizure of unsound food. The food trader usually calls in the sanitary inspector when he suspects that he has been supplied with unsound food, because he can obtain a credit note from the supplier if the sanitary inspector condemns the consignment as unfit for human consumption. It is disappointing to see so much unsound food when there are general shortages of food. Some of this food could have been saved if more care were taken in its production. Examples of careless preparation of food during the year are a rusty nail in bread, paper in bread, string in bread, glass in a small cake, and dirt in bottles of milk. The public can help by informing the Public Health Department of the sale of any unsound food. The Middlesex County Council supervise food adulteration, and this is another example of duplication of work. An intimate knowledge of food traders in the district helps in the discovery of both unsound and adulterated food, and consequently these duties should be carried out by one authority. Food Unfit foe Human Consumption. Meat: 1950 1949 1948 1938 Bacon 175 lbs. 101 lbs. 284 lbs. 295 lbs. 1020 lbs. in 1937 Cooked 84 lbs. 77 lbs. 269 lbs. - Tinned 1589 tins 1520 tins 2799 tins 965 tins Raw 3936 lbs. 4968 lbs. 2488 lbs. 262 lbs. Fish: Tinned 1405 tins 1584 tins 4084 tins - Raw 3022 lbs. 4349 lbs. 7165 lbs. 222 lbs. (wet and dried) Vegetables : Tinned 3795 tins 3271 tins 4166 tins - Raw 203 lbs. - — - Fruit: Tinned 2695 tins 1813 tins 2892 tins - Raw 867 lbs. 279 lbs. 1359 lbs. 111 lbs. Bread, flour, cereals, etc 176 lbs. 8774 lbs. 1936 lbs. - Preserves 932 lbs. 689 lbs. 3889 lbs. - Cheese 145 lbs. 409 lbs. 101 lbs. - Butter and fats 103 lbs. 11 lbs. 53 lbs. - Eggs 2393 2737 4254 - Tinned milk 5108 tins 5071 tins 3896 tins - Soups 340 tins 269 tins, 1248 packets 462 tins - Miscellaneous: Tomato pulp 93 tons, 1429 lbs. Mayonnaise 25 bottles Sauce 51 bottles Spaghetti 200 tins Poultry 426 lbs. Pickles 110 bottles Fruit juice 311 bottles Coffee 256 bottles Dried fruit 1104 lbs. Liquid egg 120 lbs. Semolina 27 packets Pudding mixtures 4 packets Christmas puddings 252 Fish paste 73 bottles Sausages 64 lbs. Processed cheese 3 packets Steak pies 5 Ovaltine 2 tins Sandwich spread 3 tins Sweets 116 lbs. Pastry mixture 330 packets Sweet fat 19 packets Gravy powder 24 packets Mincemeat 2 tins Tomato chutney 7 jars Nescafe 7 tins Honey 1 lb. Sugar 9 lbs. Mint sauce 100 bottles Vinegar 36 bottles Suet 16 lbs. Syrup 29 tins Fruit cake 80 lbs. Chocolate 28 lbs. 17 FOOD AND DRUGS ACT, 1938—SECTION 14. Ice Cream Premises Registered : Manufacture Storage for Sale Number of premises registered at December 31st, 1949 19 198 Number of premises registered during the year 1950 — 51 Total number of premises registered at December 31st, 1950 19 249 Food Poisoning. Twelve notifications of food poisoning were received and 2 mild outbreaks were reported in 1950, but despite many investigations no particular food was found responsible. The two outbreaks occurred in a large factory at Park Royal and in a local hospital; 40 people were affected in each outbreak. The menu supplied by the factory canteen was varied, and it was impossible to identify the food which was the cause of the outbreak. Bacteriological examination of the stools of all affected persons gave negative results. Chicken was the food suspected in the hospital outbreak, but all bacteriological results were negative, although it is possible that the portions eaten were infected. The symptoms were mild and all bacteriological examinations of stools were negative. Food is often contaminated in the home by unsatisfactory methods of storing, preparing and serving. At the present time, the facilities for storing, cooking, and serving food in many homes are very poor, and bad housing conditions are thus often responsible for increasing the risks of food poisoning. Many families are living in one or two-room flats which are not provided with a well-ventilated larder. Special attention has, therefore, been given to the provision of properly ventilated food stores when Housing Act notices have been served. Lack of adequate washing facilities in the home makes it difficult to maintain a satisfactory standard of personal cleanliness; dirty cooking utensils, dirty plates and dirty food are not always due to lax and careless habits : they are often due to the absence of wash basins, sinks and hot water. This makes it almost impossible for even the most conscientious to maintain reasonable hygienic standards in the preparation and service of food in the home. The improvement in housing conditions with the provision of adequate washing facilities is an essential step in the prevention of ill health caused by infected food. Clean Food Campaign. Willesden Hygienic Food Committee formed in May, 1948, was renamed the Willesden Clean Food Guild on 26th July, 1950. The Guild expanded the work of securing, as far as possible, the highest standard of cleanliness in the handling, preparation and storage of food. Education is the keynote to the activities of the Guild, for the trader, for the food handling employee, and for the housewife. The Codes of Practice drawn up in 1949 applied to all those in the food trades who are entitled to display the Guild's clean food certificate. The certificate is renewable annually, and is liable to be withdrawn. At the end of 1949, 263 of 1,400 traders in the borough had applied for registration, 195 had been approved for certificates, and the remaining 68 deferred or refused. The Committee decided to cancel the payment of the 10/- fee payable on application, and all the traders were again invited to join. Another 135 traders applied for registration and 107 certificates were issued and 28 were deferred or refused. The number of traders enrolled as members of the Guild is not high, but the proportion is higher than in other districts. TABLE I. Statement of Applications for Registration Received to 31.12.50. During 1949 During 1950 Totals Number of applications received 263 135 398 Number of premises registered and certificates issued 195 107 302 Number of applications deferred or refused 68 28 96 Premises Registered in Connection With the Manufacture of Preserved Food, etc. The registration of Dremises for the sale and storage of preserved food was granted in one case. Milk and Dairies Regulations, 1949. Number of dairymen on register (premises in Willesden) 124 Number of premises 142 Number of dairymen selling milk in Willesden from premises outside Willesden (supplementary licences) 10 Number of licences issued: Premises in Willesden Premises outside Willesden Pasteurised milk 76 9 Sterilised milk 81 10 Tuberculin tested milk (heat treated milk not subject to licensing) 58 9 Total number of licences issued 215 28 Number of inspections made 288 18 TABLE II. Summary. Trade No. in Borough Applications Received Certificates Issued Deferred or Refused Baker 38 12 4 8 Bread and Confectionery 38 7 5 2 Butcher 114 42 34 8 Cafe or Restaurant 150 62 37 25 Dairy 13 5 5 — Fishmonger or Fish-fryer 61 18 9 9 Greengrocer and Fruiterer 127 14 12 2 Grocer and General Store 315 149 123 26 Ice Cream and Sweets 181 49 35 14 Works Canteen 110 32 30 2 Food Factory 14 8 8 — Totals 1161 398 302 96 The Guild also provide glass membership plaques which can be fixed to traders' windows on the payment of a charge to cover expenses. In March, 1950, the Byelaws for the Handling, Wrapping and Delivery of Food and Sale of Food in the Open Air, which were adopted by the Council on 22nd November, 1949, came into force. These byelaws prescribe for the improvement of hygienic food handling by employees in mobile canteens, barrows, etc., and for the exclusion of disease carriers from food handling. They extend the provisions of section 13 of the Food and Drugs Act, 1938, but the provision of water for barrows is still not clearly defined. Even the Catering Trade Working Party in their report on " Hygiene in Catering Establishments " have not asked for wash basins with running hot water. They merely recommend " wash basins " with an " adequate " supply of both hot and cold water. Catering establishments situated in country districts remote from piped water supply, drainage and heating services, could be excluded from the general provisions, but those in built-up areas should be required to provide wash basins with running hot water. An increasing number of traders, however, recognise the need for better washing facilities for their employees, and are providing them. A survey which was carried out of all the food premises in the borough (Table III) revealed a large number of breaches of the Bye-laws and the Food and Drugs Act; work was carried out to bring most of these premises up to standard. Much of the work outstanding at the end of the year has now been carried out without statutory action, but the Council is taking court action against a number of traders. The standard of food hygiene in the borough has improved greatly and is still improving. The work of food hygiene education and propaganda was expanded during the year; film shows have been arranged for traders, women's organisations, schools, food factories, dairies, and industrial canteens, and film-strip lectures were carried out in a large number of places where food is prepared. This work has increased during 1951, and the co-operation of employers and works and canteen managers is making it possible for all food premises to be visited and for all food handlers to receive the latest information on clean food handling. TABLE III. Report on Inspection of Food Premises During the Year Ended 31.12.50. Details of inspection of premises : No. of premises inspected during the year 1796 No. of premises unsatisfactory on 31.12.49 152 No. of premises found to be unsatisfactory during the year 596 Total number of premises unsatisfactory 748 Number of re-visits during the year 4967 Total number of visits made during the year 6763 No. of premises made satisfactory during the year 399 Total number of premises still unsatisfactory on 31.12.50 349 19 Details of Defects Found. Defects outstanding at 31.12.49 Defects found during the year Total defects Defects remedied during the year Defects still outstanding Lighting and ventilation 8 39 47 28 19 Constant hot water not provided 85 350 435 173 262 Inadequate refuse storage 13 65 78 57 21 Insufficient sanitary accommodation 8 30 38 14 24 Inadequate storage 4 41 45 24 21 Defective walls and ceilings 68 233 301 206 95 Dirty walls and ceilings 112 435 547 350 197 Dirty hand towels 8 50 58 48 10 Generally bad conditions 9 49 58 40 18 Any other defects 69 397 466 283 183 Totals 884 1689 2073 1223 850 REPORT ON FACTORY INSPECTION. The number of inspections carried out in Willesden factories is shown in Table I. Since the last Annual Report the number of factories on the register has increased from 771 to 874, mainly due to the fact that a large number of butchers and bakers, etc., use small electric motors for their work, e.g., with sausage machines, etc., and consequently their premises become mechanical factories subject to the jurisdiction of H.M. Inspector of Factories; many of these premises had not been entered on the register of factories kept by the local authority. The local authority has the following duties in non-mechanical factories : cleanliness, overcrowding, temperature, ventilation, drainage of floors where wet processes are carried out, and sanitary accommodation. Its duties in mechanical factories are confined to sanitary accommodation. The local authority has no power to deal with lighting of premises, welfare provisions, dangerous or unsuitable premises, but they are responsible for means of escape in case of fire, and this is carried out by the Borough Surveyor. H.M. Inspector of Factories supervises all factories and reports to the local authority any infringement which comes under its control. This leads to a duplication of inspections : a visit from the factory inspector is followed shortly afterwards by a visit from the sanitary inspector; this is often resented by the factory owner. The local authority could easily undertake the supervision of the health and welfare of the workers in industry, and the factory inspector could supervise the safety of machinery, the working hours for young persons, and other matters not directly affecting the health of factory employees. There were 78 non-mechanical and 796 mechanical factories in Willesden at the end of the year, and there were many changes of manufacture, particularly in the smaller factory; 52 factories were closed down or removed from the district and 51 new factories established. There is a big demand for factory premises in the area. There has been a general improvement in the conditions of work in the smaller factories in converted premises, that are often unsatisfactory. Underground Rooms Used as Factories. At the end of the year 16 underground rooms were in use as factories, and all but 3 are used in conjunction with other premises above ground. There has been an improvement in the condition of these premises, and two basements which have been redecorated and repaired are now in good condition. Outworkers and Homeworkers. It is the duty of all factory occupiers to send to the district council during the months of February and August in each year a list showing the names and addresses of all persons directly employed by them outside the factory during the past six months. The sanitary inspectors visit these premises to see that they are kept in a good condition. Where the work or premises are dangerous or injurious to health, the district council may give notice to the occupier of the factory or to any contractor, and the occupier or the contractor commits an offence if work is carried out in that place ten days after the receipt of the notice. There are 872 outworkers on the register and 678 visits were made to their premises, one notice was served for a minor matter and this was immediately attended to. 20 TABLE I. Number of Factories in the Borough. Non-mechanical 78 Mechanical 796 Total 874 Number of Inspections Carried Out During the Year. Non-mechanical factories 153 Mechanical factories 851 Total 1004 Number of Factories Found Unsatisfactory and Notices Served. Non-mechanical 18 Mechanical 117 Total 135 Non-mechanical Mechanical Total Number of factories added to list 4 48 52 Number of factories deleted from list 2 49 51 Defects Found and Remedied in Non-mechanical Factories. Character of Defect No. found Outstanding 1949 Remedied Outstanding 1950 Want of cleanliness 17 3 16 4 Overcrowding — — — — Unreasonable temperature 1 — 1 — Inadequate ventilation 4 — 4 — Ineffective drainage of floors 2 1 3 — Sanitary conveniences- Insufficient 4 1 3 2 Unsuitable or defective 13 1 11 3 Not separate for sexes 1 — 1 1 Defects Found and Remedied in Mechanical Factories. Character of Defect No. found Outstanding 1949 Remedied Outstanding 1950 Sanitary accommodation— Insufficient 10 1 9 2 Unsuitable or defective 106 — 99 7 Not separate for sexes 3 2 4 1 Noise. Residents made several complaints about noise from factories during the year and with two exceptions it has been possible to remove the causes. There are two main factors to account for the complaints. First, many factories are now working late hours in conformity with the export drive, and, secondly, new machines causing a greater amount of noise and vibration have been installed, and parts of old machines have become worn out and have not been replaced. The public have become more conscious of the effects of noise and vibration, and although they expect some intermittent noise in industrial areas—noise of traffic, noise from radio sets and their neighbours, etc.—they have found the constant noise and vibration from some factories unbearable, especially when it has disturbed their sleep. 21 The public have one of two remedies for the abatement of noise nuisance : as private persons they may apply to the court for an injunction to abate the noise; this, however, may be an expensive procedure, and they usually adopt the alternative of asking the local authority to take action under the Middlesex County Council Act of 1944. Section 313 of this Act gives the local authority power to deal with noise as a statutory nuisance, except in the case of a railway company, the Transport Board or any statutory undertaking. To constitute a nuisance, the noise must be excessive or unreasonable, and must be injurious or dangerous to health. It has not been easy to determine in any particular case whether a noise was injurious or dangerous to health, but guiding principles have been if the noise has unduly disturbed sleep or caused a marked amount of vibration in the living rooms. Difficulties have arisen where the person complaining has been of a nervous temperament and therefore more susceptible to noise, but fortunately there have been other factors in these cases which helped to make the final decision. The decision that the noise is a nuisance, is only the first step in the proceedings, since the person charged has a good defence if he can show that he has taken the best practicable means to prevent or mitigate the nuisance, taking into consideration the cost and other relevant factors. To determine whether the best practicable means have been taken, requires an expert knowledge of machinery, of the production of noise and vibration, and of the means required to mitigate them. The Council called in a recognised consultant to one of the factories, and he prepared a scheme which included alterations to the factory building and removal of heavy noisy machinery away from the adjoining houses. The management decided to remove this machinery to another factory outside the borough. The introduction of double sash windows lessened the noise in another factory, but not sufficient to stop the complaints of nearby residents. Factory premises in closely built up residential areas are unsatisfactory, and control of such development is now provided under the Town and Country Planning Act. SECTION 47, NATIONAL ASSISTANCE ACT, 1948. Details of Cases Dealt With During the Year 1950. 1. Mrs. J. W. (aged 82 years). Mrs. W. occupied two rooms which were in a very insanitary condition. She was continually falling about and was suffering from hallucinations. At the time she was interviewed, she had a broken wrist due to a fall. She was not incontinent, but often fouled the carpet, the bed, or her clothes. Her food was provided by neighbours. A court order was obtained on the 20th April, 1950, for her removal to Redhill House for a period of three months, and she was admitted on the 5th May, 1950. She became bed-ridden in August, 1950, and died in January, 1951. 2. Mrs. L. M. F. W. (aged 75 years). Mrs. W. was living with her husband and was always in an extremely filthy condition, since she had severe incontinence; there were pools of urine in the hall and in the room used by Mrs. W. as a bedroom. The house was in a filthy condition, Mrs. W. was not fully clothed, and a bottle of milk was the only food seen in the house. A court order was obtained on the 1st June, 1950, for her admission to Redhill House for a period of three months and she was admitted on the 3rd June, 1950, and died on the 15th June, 1950. 3. Mrs. V. (aged 87 years). Mrs. Y. occupied a room which was in a very dirty insanitary condition. The only food supply was two portions of bread, half bottle of milk, a small portion of butter and a piece of dried up fried fish. She had no heating at all, despite the extremely cold weather. She was entirely dependent upon neighbours for assistance, and upon a home help who came two or three times a week. A court order was obtained on the 18th December, 1950, for her admission within 28 days to Redhill House for a period of three months. She was admitted to the Central Middlesex Hospital on the 27th December, 1950, under section 20 of the Lunacy Act, and died in Shenley Hospital on the 13th January, 1951. 4. Mrs. S. (aged 84 years). Mrs. S. occupied a room which was kept reasonably clean, but had no heating. Her food supply was a little margarine, sugar and milk. She was infirm, suffering from paralysis agitans and partial loss of sight, but she was able to walk about. A court order was obtained on the 11th December, 1950, for her admission to the Central Middlesex Hospital for a period of three months, and she was admitted on the 12th December, 1950, and died in Shenley Hospital on 6th January, 1951. The four old people who had to be dealt with under section 47 of the National Assistance Act, 1948, reveal the very bad living conditions of some old people. It is still very difficult to find enough hostel accommodation for the old people who are either alone and cannot manage or are so feeble as to be a very heavy burden on relatives. The hospital bed accommodation improved during the year and there was little difficulty in obtaining admission for old people who required hospital treatment. Much preventive work can be carried out by voluntary organisations in establishing clubs for old people, in frequent visiting of old people in their homes, in helping them with their shopping and, above all, in removing the feeling that they are no longer wanted. It is also essential to build more homes and hostels for old people and thus help them to retain their physical and mental powers to the end. Most old people can look after themselves or can be cared for by relatives. Preventive work, though costly, can avoid a big expenditure on treating old people in hospital. Local authority services for old people in the home, even including services like chiropody, need not cost more than £2 10s. Od. to £3 0s. 0d. per week, whereas hospital treatment costs about £10 per week. 22 Burial of Destitute Dead. During the year arrangements have been made for the burial of 11 persons in accordance with section 50 of the National Assistance Act, 1948. Public Mortuary. During 1950 bodies were deposited at the Mortuary as follows:— From Willesden From Acton Total Post-mortems 381 14 395 Post-mortems and inquests 77 4 81 Adjourned inquests 8 1 9 Accommodations Nil Nil Nil Licensing of Hawkers. In December, 1950, the Council fixed April 1st, 1951, as the date when hawkers of food and premises used by them for storage accommodation become liable for registration under section 11 of the Middlesex County Council Act 1950. Common Lodging Houses. In December, 1950, the keeper of the common lodging house at 1 and 2 Malvern Gardens stated that he could not carry out works required under the Public Health Act and the bye-laws to render the premises fit. The licence was, therefore, renewed for a period of six months only; the future use of the premises is still under consideration. Slaughterhouse Licences. During the year two applications for the renewal of slaughterhouse licences were received, and one was granted. In the other case the premises needed repairs before a licence could be issued. The owners were willing to carry out the repairs, but the Council were not satisfied that the site of the premises was suitable for a slaughterhouse. Visit of Health Inspectors From Irish Republic. During the year, the Ministry of Food arranged for three health inspectors from the Irish Republic to pay a short visit to local authorities in England to study the enforcement of food hygiene and the supervision of food premises. Arrangements were made for one of the inspectors to visit Willesden, and he saw the work of food hygiene and the supervision of food premises. The Minister of Food expressed his thanks to the authority at the end of the visit.