Library BOROUGH OF WOOD GREEN ANNUAL REPORT of the Medical Officer of Health for the Year 1961 WM. CLUNIE HARVEY, m.d.,d.p.h. Medical Officer of Health. WooD 43 BOROUGH OF WOOD GREEN ANNUAL REPORT of the Medical Officer of Health for the Year 1961 WM. CLUNIE HARVEY, md.d.p.h Medical Officer of Health. Public Health Department, Town Hall, Wood Green, N. 22. July, 1962. To THE MAYOR ALDERMEN and COUNCILLORS of the BOROUGH OP WOOD GREEN. Mr. Mayor, Ladies and Gentlemen, I beg to present my Annual Report for the year 1961. As Medical Officer of Health for the Borough, I feel that 1 am extremely fortunate in having been able to state in so many Annual Reports that "the year under review was once again uneventful". This has certainly made my yearly survey less exciting and undoubtedly less interesting - than would otherwise have been the case. None the less, it clearly points to the happy position in which Wood Green has found itself for so many years. This has been largely due to the careful planning which has gone into the shaping of the Borough, and to the vigilence which my predecessors as Medical Officers of Health have exercised. Our present duty is equally clear, and could be reduced to the single, time-worn phrase "that which wehave, we hold" This certainly typifies the duty of the Public Health Department, a duty which the Department has always accepted and will continue to accept. The vital statistics for 1961 were again satisfactory, and compare well with those of preceding years. The death rate was 11.3, slightly lower than the figure recorded for the previous year. The birth rate rose from 14, 2 in 1959 and 15.0 in 1960 to 15. 7 in 1961. This rise is very small, perhaps too small to have any real significance. Nevertheless it should be noted. The infantile mortality rate, i.e. the number of infants who died during the first year of life per thousand live births, was 26.8 as against 30, 4 in 1960 and 20.71 in 1959. With such a comparatively small number of births, these figures are useful mainly for comparative purposes. None the less every infant death continues to be scrutinised with the greatest care, to attempt a still greater decrease. There were no deaths from puerperal sepsis; indeed, no deaths took place during childbirth. In point of fact, during the past 10 years only four deaths took place during childbirth, of which none was due to sepsis. This is a highly satisfactory situation, due to a variety of causes better midwifery, better ante-natal care and the almost incredible advances witnessed in the use of antibiotics. The number of infectious diseases notified during 1961 was considerably in advance of those notified during the previous year, 867 as against 229, This was more than due to the fact that 1961 was a "measles year", 763 cases of measles being reported, as against 21 in 1960. The infectious sickness rate for the year therefore showed a corresponding increase, 18.16 as compared with 4,75 during 1960. Since the increase in measles notifications accounted for 3 more than the total increases, these figures have little significance in themselves. More important, much more important, is the fact that the type of infectious disease met with during 1961, indeed since the war, is very much milder on the whole than previously It is also worthy of note that no cases of poliomyelitis were notified during the year, the last case of this particular disease occurring in 1959. The infectious diseases picture will be more fully discussed in the portion of the Annual Report which deals with the prevalence and control of infectious diseases. I will therefore make no further comments at this stage. Year by year, I have stressed the importance of housing as it affects the whole pattern of Public Health: or, to use what is perhaps a better expression in this context, the pattern of preventive medicine. I have often felt that, more than ever as the years go by, pure public health and housing are inseparable. Those authorities which have a "Health & Housing Committee", where matters appertaining to housing as a major problem are dealt with by the Health Committee, are in some respects adopting a wholly logical attitude. As the Council will be aware a good deal of the time of my Inspectors is taken up, not only in dealing with housing queries, e. g. overcrowding, the need for Council housing because of conditions detrimental to the health of one or more members of the family, etc, but also with the abatement of nuisances, most often by the issue of informal notices, and occasionally but only when absolutely necessary - by having to resort to the issuing of statutory notices followed by Court procedure. The Public Health Department considers this to be an integral part of its duty, since problems associated with housing are at the root of so many social evils. It is extremely pleasing to see the work which is being carried out in Wood Green in relation to the erection of new houses and flatlets, especially when this accommodation is being made available for tenants displaced from slum clearance areas. This problem is being vigorously tackled and has already appreciably shrunk in proportion. It is truly pleasant to be able to report that Wood Green has taken energetic steps to deal with housing for the elderly, a problem which grows in intensity year by year. This age group of the population has been neglected for too long. Still more work is required, but it is obvious that Wood Green appreciates the situation-indeed, with a rapidly ageing population such as ours it must do-and means to do what it can to effect amelioration. I cannot let this opportunity pass without reminding the Council that the work which has fallen to the lot of Public Health Inspectors is increasing with a rhythm which is sometimes frightening. Smoke Control-and a great deal of work has been done in this field in Wood Green-food inspections housing itself, have all either been presented as new problems, or as problems which have been considerably magnified. I count myself extremely fortunate that I have an excellent team of Health Inspectors in 4 Wood Green. And this is not only fortunate for me, but is a matter of good fortune for the Council. The Inspectors are keenly alive to the fact that the duties which they perform are closely allied to the continued prosperity of the Borough, that the role which they play should never be under-estimated. The time has almost come when I may have to ask for an additional Inspector. That, however, will be a matter of report to the Staff Committee in due course. Further progress was made in the implementation of the Council's scheme for the control of smoke in the Borough. Wood Green No.3 Smoke Control Order, embracing 1389 dwellings and 58 other premises, came into operation on 1st October, 1961, making a total to date of 3,831 dwellings and 333 other premises now subj ect to Smoke Control Orders. During the year Wood Green No.4 Smoke Control Order relating to 1,660 dwellings and 74 other premises in the Bowes Park Area was submitted for the approval of the Ministry of Housing and Local Government, with the proposal that the order come into operation on 1st October, 1962, The implementation of the scheme to date is noteworthy in two respects, (a) it is one year ahead of the scheduled time, and (b) the transition from coal to smokeless fuels in those areas now controlled has been smoothly carried out, due no doubt to an emphasis on personal relations rather than public relations. I have very little to add to the paragraph on Health Education which appeared in my Annual Report for 1960. As the Council will be aware, I am a frequent contributor to the local press, whenever I consider that an article is required on a subject of topical importance. Here, I would once again wish to thank the Editors of our local press for their unfailing helpfulness and courtesy. Nothing has been of greater help to me over the past years. We also readily accede to any request for a health talk by a local organisation, with or without an accompanying film show. As should be the case, health education in Wood Green is closely bound up with the work carried out by the staff of the Middlesex County Council, so that talks are given by Health Inspectors, Assistant County Medical Officers, Health Visitors, Dr. Campbell, as my deputy, or myself, according to the type of talk required and the special abilities of each section of the staff to undertake these duties. Abundant leaflets, bookmarks, etc. on health matters are available both in the Public Health Department and in the Area Health Office, and also in our Clinics and in our Central and Branch Libraries. When any particular subject calls for the display of posters, this method of propaganda is utilised to the full. Altogether, as I have said so often, the neglect of health education is a major blunder. Fortunately, Wood Green has never fallen into this pitfall. As the Council may be aware, I have been a regular monthly contributor to the magazine "Better Health" since 1948. I like to think that these articles are widely read and that, as the articles are syndicated in many parts of the world, the name of 5 Wood Green is being widely publicised outside this country This may appear in many ways a trivial matter but it still gives me great pleasure to think that so many articles which carry my name and the designation of the three districts for which I act as Medical Officer of Health, are being so widely circulated, Although the vital significance of the connection between smoking and health not only lung cancer but also bronchitis coronary thrombosis and such diseases as gastric ulcers, has only exploded into the public consciousness within thepast few months, this problem has been before us for many years, certainly since the issue of the Registrar General s statistical report which proved conclusively that such a connection did exist. A full report on this subject more properly belongs to the Annual Report for 1962. but I make no apology for mentioning such an extremely important matter. Although actual deaths fro» lung cancer have very substantially and tragically increased in this country since 1940 the local picture is fortunately not so striking as the following tables will show - Deaths from Cancer of the Lung and Bronchus Male Female 1952 19 6 1953 19 2 1954 26 8 1955 26 1 1956 24 2 1957 24 1 1958 30 10 1959 27 8 1960 29 11 1961 33 3 Prom these tables it will be seen that, relatively speaking, deaths arising from cancer and bronchitis have not increased in Wood Green to any substantial extent. This should in no way discourage us from continuing our efforts to discourage smoking, especially among children and young people. As I have said, however, the measures which we are taking and have already taken to achieve this end belong to the Annual Report for 1962. 6 Deaths from Bronchitis Male Female 1952 47 23 1953 30 24 1954 20 10 1955 36 12 1956 27 17 1957 21 7 1958 20 10 1959 24 11 1960 30 9 1961 18 18 It is interesting to note, as a tragic corollary to the deaths from bronchitis, that the year 1952 was particularly severe. This was because that was the year in which "smog" was so prevalent, and when a very great toll was taken among elderly people. I have already remarked on the fact that the Wood Green Public Health Department is extremely fortunate in its staff. I am equally happy to repeat the statement which I made last year, that our relations with the burgesses as a whole are extremely pleasant. We have never abated our efforts to show that our one aim is to help, that red tape and officialdom form no part of our armament, or at least as small a part as is practicable, having regard to control from above. The same remarks apply to the relations between the Public Health Department and general practitioners, which have been extremely cordial since I took up my duties as Medical Officer of Health. Finally, it is again worthy of mention that our relations with the Middlesex County Council have been of the best, and have permitted an integration of work which would otherwise have been quite impossible. In conclusion,I would express my most sincere thanks to the Health and Cleansing, Committee and to the Borough Council for the continued courtesy and assistance which I have come to expect as Medical Officer of Health. I would also express ray grateful thanks to every member of the Public Health Department, and in particular to Dr. Janet Campbell,my Deputy, and to Mr. W. McCauley, my Chief Public Health Inspector. It is truly a fortunate Medical Officer of Health who knows that he has a loyal, conscientious and efficient staff. That, I am very glad to say, has always been my own position. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, W. C. HARVEY, Medical Officer of Health. 7 BOROUGH OF WOOD GREEN HEALTH AND CLEANSING COMMITTEE Councillor C. D. MOSS (Chairman) Councillor C. W. BUCKBY (Vice-Chairman) The Mayor, Alderman R.G.KENDALL J. P. Councillor G CATHLES Alderman J. W. BARNETT Councillor J, A. CATON Councillor Mrs. L. A. ANGELL Councillor E C. HALE Councillor J.D.REED STAFF Medical Officer of Health-WILLIAM CLUNIE HARVEY M. D. D. P. H. Deputy Medical Officer of Health - JANET RUSSELL CAMPBELL M. B. Ch.B., D.P.H. Chief Public Health Inspector-W. McCauley, Cert. R. San. Inst, and San. Insp. Joint Board, Cert. Meat and Food Inspection. Public Health Inspectors - F. JAMES, Cert, R. San. Inst, and San. Insp. Joint Board. Cert. Meat and Food Inspection Cert. R. Soc. of Health. Smoke Inspector. W E. GOODFELLOW Cert. R. San Assoc. of Scotland, Cert. Meat and Food Inspection and Cert. R. Soc. of Health, Smoke Inspector, H. J BAILEY Cert. R. San. Inst, and San. Insp. Joint Board, Cert. Meat and Food Inspection. J. E JONES Cert. R. San. Inst, and Cert. Meat and Food Inspection. Chief Clerk - P V INGRAM General Clerks - Miss J W POPE, Shorthand Typist (Resigned 30. 9.61 ). Mrs, P L ALESWORTH (Commenced duty 9.10.61). R W. SHADBOLT. Rodent Operator - J. HARRIS Disinfector - F. WORKMAN 8 STATISTICS AND SOCIAL CONDITIONS FOR THE AREA Area (acres) 1,606 Population - estimate supplied by the Registrar General 47,750 Number of inhabited houses (end of 1960) according to Rate Books 14,601 Rateable Value (1960) £873,039 Sum represented by a penny rate (estimated) £3,490 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR Total M F Live Births- Legitimate 692 354 338 Birth Rate per Illegitimate 61 32 29 1,000 15.7 Still Births 12 5 7 Rate per 1,000 Births 17. 3 Deaths 538 273 265 Death Rate per 1, 000 11.3 Deaths from Puerperal causes - Rate per 1,000 Births - Deaths of infants under one year of age- All infants 17 Rate per 1,000 live births 26,8 Legitimate 15 Rate per 1,000 legitimate live births 21.68 Illegitimate 2 Rate per 1,000 illegitimate live births 32. 8 Deaths from - Tuberculosis 3 Cancer (all ages) 119 Measles (all ages) - Whooping Cough (all ages) - Diarrhoea (under 2 years of age) - Number of Births notified 753 Number of Births registered in the Borough 180 POPULATION The mid-year estimate of the population supplied by the Registrar General is 47 750 a decrease of 410 from that of the previous year. BIRTHS The number of live births registered during the year was 753 which gives a crude birth rate of 15.7 per 1,000 of population the corrected birth rate being 16.1 the rate for 1960 was 15.7. There were 12 still-births giving a still-birth rate of 17.3 per 1,000 births. In 1960 the still-birth rate was 15 2. 9 MORTALITY General Mortality and Death Rate The net number of deaths accredited to the district was 538. seven less than in 1960. This gives a crude death rate of 11.3 per 1, 000 of the population and a corrected death rate of 10.6 (the rate for 1960 being 11.0). I have already made mention in the introduction to this Report of the established connection between smoking and health. This, I need scarcely say, is reflected in the deaths from cancer of the bronchus and lungs, bronchitis, coronary thrombosis and psycho-somatic diseases such as gastric and duodenal ulcers. I will say nothing more here relating to smoking and health since this is a matter which has received very great publicity during 1962, and should be a matter for more detailed survey in the Annual Report for that year. So far as coronary thrombosis is concerned, diseases of the heart and circulation still make up the largest single cause of mortality in the Borough. Year after year I have made mention of the fact that, although diseases such as coronary thrombosis and lung cancer take an appalling toll of life, particularly the lives of men at the height of their power, "epidemiology" as we know the term is still closely linked with infectious illnesses. This is not to say that, infectious illnesses should not receive careful attention. That is certainly not the case. The fact that most infectious diseases are now mild in nature, especially such diseases as pertussis and scarlet fever, by no means implies that this mildness will continue. None the less the sooner it is realised that such diseases as heart disease call for much more careful study, and until the causes of heart and similar diseases are discovered and the appropriate remedies applied, death rates will continue to be much higher than most of us would like to see. As I have remarked before, there are no conditions actually existing within the Borough which one can point to as contributing to cardiac disease. It is a fact, however, that Wood Green shares with the rest of the country the strain of modern life, which is clearly having an effect upon so many families. The journey which so many of our residents have to take to and from London every day, is presumably a factor which must be taken into account. Finally Wood Green, as a built-up area, even by no means a wholly congested area, leaves its population more vulnerable than the population of rural areas, where the tempo and strain of life are not so hectic, and where incidentally, a smoke-laden atmosphere does not constitute a serious health hazard. Altogether, although many explanations for the increase in cardiac fatalities over the past few years have been advanced, and although a great deal of research is going on in this and other countries, the situation is still far from satisfactory. It is perhaps unfortunate that, although we are continually being pressed to carry out research and investigation the staff of such an area as the Borough of Wood Green finds precious little time to indulge in more than its share of routine work. Sometime in the future, this pattern may be reversed. When it is, it will be all to the good. INQUESTS Twenty-seven inquests were held following the deaths of Wood Green residents during 1961. A further 170 post mortem examinations were carried out without an inquest, 60 of these in the Prince of Wales Hospital which, by arrangement with the Wood Green Borough Council, provides mortuary services. MATERNAL MORTALITY No cases of maternal mortality were reported. INFANT MORTALITY There were 17 deaths of infants under one year of age, which gives an infant death rate of 26 8 per 1, 000 live births, as compared with 22 deaths and a rate of 30.4 in the preceding year. Among the 17 infants who died in Wood Green during 1961 before they had reached the age of twelve months, 14 were under the age of one month. of these, 12 failed to survive, one week, in fact seven died in the first day. Every infant death continues to be carefully scrutinised. STILL-BIRTHS Twelve still-births, 11 legitimate and one illegitimate were accredited to the Borough for 1961. This is equal to a death rate of 17.3 per 1,000 births the corresponding figures for 1960 being 11 still-births with a rate of 15. 2. This rate is slightly higher than that for the previous year, but so little and relating to such a small number of infant deaths that the significance is negligible. The following table shows causes of death at various ages under one year' - Under 1 week j1 to 2 weeks |2 to 3 weeks 3 to 4 weeks Total under 4 weeks 4 weeks and under 3 mths 3 mths and under 6 mths 6 mths and under 9 mths 9 mths and under 12 mths Total deaths under one yr. Prematurity 6 - - - 6 - - - - 6 Congenital Defects 2 - - 1 3 - - - - 3 Atelectasis 1 - - - 1 — - - - 1 Gastro-enteritis - - - - - 1 - - - 1 Intra-cranial Haemorrhage - - - - - - - - - - Capillary Bronchitis 1 - - - 1 2 - - - 3 Asphyxia - - - - - - - - - - Broncho-pneumonia — - - - - - - - - - Other Causes 2 - 1 - 3 - - - - 3 Total 12 - 1 1 14 3 - 17 11 GENERAL PROVISION OF HEALTH SERVICES Care of the Aged Quite apart from the admission to hospital of the aged infirm, there are many problems associated with old age which increasingly demand more and more attention. The Public Health Department is. as always, prepared to help in every possible way. while our Health Visitors, Home Nurses and Home Helps continue to assist the aged by every means within their power. Once again the Old People s Welfare Committee has been able in many ways to assist the statutory services, by providing those little extras which do not lie within the province either of the local authority or of the local health authority. One might mention here the prospect of setting up at least one workshop where elderly persons can be usefully employed. This will provide a truly valuable service, both of clinical and, to a certain degree, of financial benefit. The Clinic for Old Persons which I mentioned in my Annual Report for 1960, and which is being held at the Old People s Centre, was not opened until early in 1962. The operation of this Clinic therefore falls within the Annual Report for that year, although it may now be said that the Clinic is performing a very useful purpose. One of my Assistant County Medical Officers (Dr. E. Waterhouse), together with a very competent nurse, attend this Clinic every alternate week, since the Clinic alternates on Friday afternoons with the session held in Southgate. At the request of the Local Medical Committee. I attended a session of the Committee in London so that the object of the Clinic might be more fully discussed and the co operation of local general practitioners obtained. The meeting was entirely successful, all the points were mutually agreed upon, and I am extremely happy to be able to report that general practitioners are co-operating with us to the full. It would be foolish to state that the geriatric situation is satisfactory, either in Wood Green, or in North London as a whole. I hasten to add that I invariably obtain what assistance is available from the various hospitals which serve the Area. None the less it is a tragic fact that the admission of the elderly sick to hospital presents an increasingly urgent problem a problem which at the moment seems virtually unsolvable. It is admittedly a fact that the Ministry of Health has issued a ten year Command Plan which visualises the re building and extension of existing hospitals and the provision of new hospitals. If this scheme includes the provision of a great many additional geriatric beds this will be a worth while contribution. Unless however this substantial contribution is forthcoming the gradual ageing of the population of these islands will continue to present a problem a pitiable problem which none of us can afford to neglect 12 Hospitals I need add little to the remarks which I made in recent Annual Reports relating to the hospital services available to the residents of Wood Green In the section which deals with care of the aged, I particularly mention the difficulty which exists relative to the provision of geriatric services. So far as other hospital admissions are concerned, little difficulty exists, except that the admission to hospital of pregnant women presents something more of a problem than was the case a few years ago. This is not so much due to the lack of beds, as to a lack of staff, a difficulty which has tended to increase year by year. Here again, the provision of adequate housing would go very far towards solving this problem. Laboratory Facilities As in past years, the Central Public Health Laboratory Service has been of the greatest assistance to us, not only the Central Laboratory at Colindale, but also the Laboratory housed in Coppetts Wood Hospital, where Mr. McGimpsey is the Bacteriologist. I gratefully acknowledge the assistance afforded throughout the year, and the close co-operation which has continued for so many years between the Public Health Department and the Laboratory Service. NATIONAL ASSISTANCE ACT, 1948 (National Assistance Amendment Act, 1951) SECTION 47;- Removal to suitable premises of persons in need of care and attention. It was not found necessary for the Council to take any action under this Section during 1961. NATIONAL ASSISTANCE ACT, 1948 SECTION 50: - Burial or Cremation of the Dead. There were no burials carried out under this Section during 1961. 13 Summary of the work carried out at the Central Public Health Laboratory for the year as follows - Positive Negative Swabs for Diphtheria bacilli - - Sputa for tubercle bacilli - - Throat and nose swabs 59 Faeces 132 Urine 3 Blood - Others 4 Ice Cream - Water (Swimming Pool) 4 SANITARY SERVICES Inspections Public Health Act, 1936 636 Housing Act, 1957 167 Rag Flock and Other Filling Material Act, 1951 Pet Animals Act. 1951 6 Factories and Outworkers 202 Food preparing Premises 343 General Food Premises 1.207 Shops Act, 1950 186 Smoke Observations 79 Unsound Food 195 Complaints Investigated 376 Interviews with Owners, etc. 96 Revisits to property under notice 610 Infectious Diseases Cases 36 Special enquiries in connection with infectious disease cases 33 Aged and infirm persons 4 Pests Act 278 Clean Air Act 2,619 Miscellaneous 360 Informal Notices Served Shops Act 13 Complied with 9 Food and Drugs Act 26 " " ll Public Health Act 183 " " 184 Housing Act " " Factories Act 3 " " 2 Noise Abatement 1 " " Statutory Notices Served Public Health Act 49 Complied with 57 Housing Act 1 " " 1 Factories Act - " " - Food and Drugs Act 13 " " - M C.C. Act 1 " " 1 Rent Act, 1957 The number of applications for Certificates of Disrepair has shown no appreciable change this year. Set out below is a table showing the number of applications received as compared with the previous year:- 1960 1961 Number of Applications for Certificates of Disrepair (Form I) 21 19 Number of Proposals to Issue Certificates of Disrepair (Form J) 20 17 Number of Certificates of Disrepair issued (Form L) 6 5 14  1960 1961 Number of Applications for Certificates of Disrepair rejected 2 1 Number of Certificates of Disrepair cancelled 5 3 Number of Applications for Cancellation rejected 1 - Number of visits made in connection with above 44 31 Housing Statistics 1. Inspection of dwelling-houses during the year:- (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 364 (b) Number of inspections made for the purpose 803 (2) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation (3) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 1 2. 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 183 3. Action under Statutory Powers during the year - (1) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1957:- (a) Number of dwelling-houses in respect of which notices were served requiring repairs 1 (b) Number of dwelling-houses which were rendered fit after service of formal notices: - (i) By owners 1 (ii) By Local Authority in default of owners (2) Proceedings under Public Health Acts:- (a) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 49 (b) Number of dwelling-houses in which defects were remedied after service of formal notices (i) By owners 57 (ii) By Local Authority in default of owners 15 (3) Proceedings under Sections 11 and 13 of the Housing Act, 1957:- (a) Number of dwelling-houses in respect of which demolition orders were made (b) Number of dwelling-houses demolished in pursuance of demolition orders (4) Proceedings under Section 12 of the Housing Act, 1957 - (a) Number of separate tenements or underground rooms in respect of which closing orders were made (b) Number of separate tenements or underground rooms in respect of which closing orders were determined, the tenement or room having been rendered fit In no instance was it found necessary for legal proceedings to be taken. Housing Applications The task of visiting housing applicants and the preparation of reports on their living conditions has been discontinued, with the exception of certain cases where information is required by the Council's Housing Officer or by Housing Departments of outside districts when a Wood Green resident is an applicant on their Housing List. Several such visits were made by the Public Health Inspectors during the year. In many cases I receive letters from private doctors pressing the urgency of the need for rehousing a patient on medical grounds. On these occasions I discuss the matter with the Housing Officer and award extra points when I consider the case warrants some priority. Unfortunately the housing situation in Wood Green is so critical that at the moment all new housing accommodation is needed to rehouse people from the clearance areas. Smoke Control Areas Work in the formation of smoke control areas under the Clean Air Act 1956 continues. The Council s Smoke Control Order No. 3 came into operation on 1st October, 1961. This Order relates to an area of 200 acres in extent and comprises 1389 dwellings in the Bounds Green Area. At the close of the year the Council submitted for approval by the Minister of Housing and Local Government Smoke Control Order No. 4 relating to an area embracing 1660 dwellings in the Bowes Park area. It is proposed that the Order come into operation on the 1st October, 1962. During the year a further two volumetric apparatus were set up in the Borough for the measurement of smoke and sulphur dioxide as part of the National Survey by the Department of Scientific and Industrial Research one in Bounds Green Secondary Modern School, the other at Lordship Lane Secondary Modern School, where the daily records are kept during term time by the scholars, under the direction of their respective science masters. During the 16 school holidays these are maintained by the Public Health Inspectors. I should like to take this opportunity to thank the schools concerned for their ready co-operation in this matter. Rodent Control During the year 211 dwellings in the Borough were treated for rat infestation, entailing 1,663 visits. In addition 30 business premises were treated for the presence of rats. A further 55 dwellings and 9 other premises were treated for mice and a total of 448 visits were made. The Council's refuse tip at White Hart Lane was constantly baited with an anti-coagulant bait and several supervisory visits were made to the adjoining Council allotments for evidence of the presence of rats. The sewers were treated on two occasions for the control of rats during the year and 672 manholes were baited. The baiting consisted of two unpoisoned baits on alternate days, followed by a poisoned bait. For the purpose of sewer treatment the Borough is divided into ten small areas and two gangs of two men each occupy just over three weeks in carrying out the treatment. Co-operation is sought from the Borough Engineer s and Surveyor s Department in this connection. Record sheets are kept of each visit and a return made to the Ministry of Agriculture, Fisheries and Food after each treatment. The following is a copy of the results of both treatments:- RODENT OPERATION (1) Twenty-eigth Maintenance Treatment April/May 1961 and (2) Twenty-ninth Maintenance Treatment October/November 1961 No. of Manholes Manholes Showing Pre bait take Complete Pre-bait take Complete Poison take Part Poison take 10th April/ 5 th May 672 347 127 0 315 30th Oct./ 24th Nov. 672 393 218 0 347 17 Ponds and Rubbish Dumps These are regularly inspected with the object of preventing the breeding of insect pests. The pond in White Hart Lane is emptied and cleansed periodically by the Borough Engineer and Surveyors Department whilst that at Alexandra Palace is supervised by the Alexandra Palace Trustees. 18 INSPECTION AND SUPERVISION OF FOOD (a) Food Premises in the Borough Bakers Shops 23 Butchers Shops 38 Cafes and Restaurants 52 Chemists Shops 15 Confectionery and Sweet Shops 69 Dairies and Milk Shops 38 Pried Pish Shops 11 Wet Pish Shops 11 Greengrocers Shops 49 Grocers Shops 82 Public Houses and Off-Licences 41 Food Factories 9 ( b) Food and Drugs Act, 1955, Section 16. There are 11 premises registered for the manufacture of Ice Cream in the district and 150 premises registered for retailing Ice Cream. puring the year 59 visits were paid to these premises. Also 46 premises are registered under this Section for the preparation or manufacture of sausages or potted, pressed pickled or preserved food intended for sale. Visits to these premises during the year numbered 186, (c) Middlesex County Council Act I950o Section II.-Registration of Hawkers of Food. Twenty-nine hawkers of food in the Borough are registered- (d) Meat and Other Foods Condemned The under-mentioned foodstuffs were certified as unfit for human consumption during the year- lb. Tins Meat 786 Meat 819 Fish 131 Pish 225 Salt 18 Fruit 2 492 Raisins 8 Vegetables 641 Cut Peel 10 Tomatoes 188 953 Evaporated & Condensed Milk 207 Cream 38 MISCELLANEOUS ITEMS - Milk 24 Boxes of Sweets 24 Milk Pudding 46 Coffee 42 Soup 97 Jam etc. 111 Spaghetti 12 Cheeses 8 Steak & Kidney 31 Cereals 90 Others 67 Pickles 133 4,887 Sauce 65 Mayonnaise 17 After examination by the Public Health Inspector condemned food is collected by this Department's Van; it is then removed 19 to the Council's Refuse Disposal Plant where it is destroyed by incineration. In some instances food is brought to the Department s offices for examination and the same method of disposal applies (e) Food and Drugs Act, 1955 - Food Hygiene Regulations, 1955. Throughout the year, as in previous years, much attention has been paid to food hygiene. The Public Health Inspectors make frequent visits to food premises within the Borough, primarily to ensure the enforcement of the Pood Hygiene Regulations, and secondly to advise and educate food handlers in the paramount importance of food hygiene. In all 1550 visits were made to food premises, as set out below:- Dairies and Milk Shops 60 Butchers 297 Ice Cream Premises 59 Pried Fish Shops 29 (Registered) Stalls (Registered) 126 Other Pood Premises 979 Pull use has again been made of the propaganda material available, including posters from the Ministry of Health, Ministry of Agriculture, Fisheries and Food, the Central Office of Information and the Central Council for Health Education. 20 FACTORIES AND HOMEWORK 1.Inspections Premises No. on Register Number of Inspections Written Notices Occupiers Prosecuted FACTORIES WITHOUT mechanical power 30 47 - - FACTORIES WITH mechanical power 181 184 - - OTHER PREMISES in which Section 7 is enforced by the local authority 6 6 - - Total 217 237 - - 2. Defects Found Particulars Number of cases in which defects were found Number of cases in which prose cutions were instituted Found Remedied Referred To H.M, Inspector By H.He Inspector Want of cleanliness - - - - - Overcrowding - - - - - Unreasonable temperature - - - - - Inadequate ventilation - - - - - Ineffective drainage of floors - - - - - Sanitary conveniences (a) insufficient - - - - - (b) unsuitable or defective - - - - - (c) not separate for sexes - - - - - Other offences against the Act (not including offences re lating to outwork) - - - - - Total - - - - - 3.Outwork Particulars No. of outworkers in August list No. of cases of default in sending lists to Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions Wearing apparel 99 - - - - - Artificial flowers 1 - - - - - Paper bags 2 - - - - - Brushes 1 - - - - - Christmas crackers 11 - - - - - Lampshades 1 - - - - - Leather goods 2 - - - - - Toys 32 - - - - - Greeting cards 9 - - - - - Total 158 - - - - - 21 Water Supply The whole Borough is in the area supplied by the Metropolitan Water Board and every house has a constant supply. Rag Flock and Other Filling Materials Act 1951 Three premises in the Borough are registered under the above Act. Three samples of feathers were submitted for laboratory examination and were found to be satisfactory. Pet Animals Act 1951 Under the Act seven licences were renewed during the year after the premises had been inspected and found to be satisfactory. Establishments for Massage or Special Treatment Five existing licences under the Middlesex County Council Act, 1950 were renewed during the year Housing The Borough Surveyor has kindly supplied me with the following figures showing the number of dwellings which have been erected or rebuilt during the year. Council dwellings completed - 2 flats New Road 36 maisonettes Winkfield & Acacia Roads 15 flats . Alexandra Park Road Council Droperties in course of construction at end of year - 15 flats Pellatt Grove 8 flats Williams Grove 52 flats Winkfield & Acacia Roads 52 flats Commerce Road Private enterprise properties completed or in course of construction - 46 flats 3 houses. Swimming Baths The figures of attendances at Western Road and Durnsford Road Baths for the past two years are as follows Western Road Baths 1960 1961 Swimming Bath 93.270 90 758 -do- Children (Special sessions) 439 529 Children from Schools 32.296 34.841 Spectators 9.353 7.251 Slipper Baths 33.418 32.891 -do- Old Age Pensioners (free) 3.051 3.479 Steam Bath - 97 22 Durnsford Road Open Air Baths 1960 1961 Adults 18.046 22.732 Children 41.349 47.460 Children from Schools 600 830 Season Ticket Holders 26.576 * Spectators - Adults 6.232 7.098 Children 836 1.467 *Attendances of season ticket holders no longer recorded, Samples of water were taken from both baths. The results of the tests were uniformly satisfactory. There is nothing I can add to the remarks which I have made in previous Annual Reports relating to our Swimming Baths being a means of providing health -giving exercise in the open air. The incidence of Plantar warts (verrucas) among schoolchildren continues to be a matter of concern. Although it is quite obvious that swimming baths are by no means the only way in which verrucas can be spread, it is equally obvious that the wet surrounds of swimming baths provide a means of allowing the virus which causes verrucas to pass from one child to another. I am doing all I can to get the co-operation of teachers and parents in obviating the spread of this infection and the Baths Manager and I have the situation constantly under review. Collection and Disposal of Refuse The Borough Engineer and Surveyor, who is responsible for this service, reports as follows- (a) Household refuse is collected weekly by vehicles operated on the relay system. (b) Trade and special refuse is collected as and when required. Six 12 cubic yard capacity Scammell Containers and two Mechanical Horses are used for collection of household refuse and one Bedford Lorry for trade and special refuse. During the year 1960/61 the total tonnage of refuse collected was 11 921 tons: the income from salvage material amounted to £3.197. The steam raised by the incineration of the refuse is used for space and water heating at Western Road Baths, 23 PREVALENCE AND CONTROL OF INFECTIOUS DISEASES The following table sets out the infectious diseases notified as compared with notifications received during 1960:- 1961 1960 Scarlet Fever 15 38 Diptheria - - Cerebrospinal Fever - - Enteric or Typhoid Fever - - Paratyphoid Fever - - Erysipelas 1 3 Pneumonia 43 28 Acute Poliomyelitis - - Acute Encephalitis - - Puerperal Pyrexia - - Pulmonary Tuberculosis 19 27 Non-pulmonary Tuberculosis 6 3 Malaria - - Measles 763 21 Whooping Cough 13 72 Ophthalmia Neonatorum - - Dysentery 4 34 Food Poisoning 2 3 Smallpox - - Meningoccocal Infection 1 - 867 229 Prom the table set out above, the following facts emerge:- 1. Scarlet Fever notifications fell from 38 in 1960 to 15 in 1961. Once again, as I have so often said before, the type of scarlet fever met with was extremelv mild, so mild that admission to hospital was only necessary when no one remained at home to look after the affected child. 2. For the fourteenth year in succession no case of diphtheria occurred in the Borough. The last death took place approximately 22 years ago. The fact that cases of diphtheria are still occurring in various parts of the country, however, once again means that we dare not relax our precautions. This particularly applies to immunisation, either against diphtheria alone or against diphtheria, pertussis and tetanus combined, The fact that 91.0 percent. of infants under the age of two years are protected against diphtheria, either alone or by the use of the triple antigen is extremely pleasing. Indeed so far as I am aware, this immunisation rate is perhaps the highest in these islands. 3. Measles notifications rose from 21 in 1960 to 763 in 1961. This was to be anticipated, as 1961 was a "measles year". As in the case of scarlet fever, severity was extremely low. 24 4. Pertussis notifications fell from 72 in 1960 to 13 in 1961. As I have remarked before, there is no valid, concrete evidence to prove that immunisation against pertussis, a policy which is actively pursued in Wood Green, is having an appreciable effect on the incidence. Although approximately 89 per cent of children under the age of two have been protected against pertussis by immunisation-and surely this must be having an effect-a few infants still remain unprotected, in spite of the stringent efforts which are made, especially by our Health Visitors, to persuade parents to accept immunisation. This is proved by the faot that, of the 13 cases of pertussis which occurred in 1961, 12 infants had either not been immunised at all or had not completed their course of injections. 5. The incidence of food poisoning and dysentery fell from a combined total of 37 during 1960 to a total of 6 in 1961. The measures which we have taken, particularly the control of dysentery and food poisoning among school children, remains as before, and appears to be satisfactory. Although 6 cases did occur during the year, it must be remembered that dysentery, particularly Sonne dysentery, and food poisoning are now epidemic in this country; a fact which we must regretfully accept. It must also be remembered that these cases have little more than nuisance value, the disease being quickly recovered from and leaving, so far as we are aware, no ill-effects. All cases of dysentery and food poisoning, particularly Salmonella typhimurium infections, are carefully investigated. Where any cause is discovered, the matter is actively pursued even when the original infection took place somewhere outside the Borough. 6. No case of poliomyelitis was notified during 1961. As in the case of immunisation against diphtheria, our programme of vaccination against poliomyelitis is something of which I think we can be justly proud, more than 83.6% percent. of Wood Green children under the age of two years having been protected against poliomyelitis by vaccination. As will be known, we are now using the Sabin vaccine, a method of oral vaccination which has superceded the giving of Salk vaccine by injection. Sabin vaccine is administered by mouth, the method of administration varying according to the age of the person concerned. It'need scarcely be said that this method is proving extremely popular as after-effects are virtually nil and the disadvantage of a prick eliminated. It is important to remember that several outbreaks of poliomyelitis have recently occurred within Great Britain, one at least being extensive. This proves that the virus is still with us and requires careful supervision. As in previous years we have co-operated with the Central Public Health Laboratory, Colindale, in obtaining specimens from children who have not been in known contact with poliomyelitis, so that their stools can be examined. 25 7. Twenty-five cases of tuberculosis were notified during 1961, as against 31 in 1960 (28 pulmonary and 3 non-puimonary). The Mass Radiography Unit did not visit Wood Green during 1961, but is scheduled to visit the Borough in 1962. A broad classification of the cases of tuberculosis notified during the past five years in relation to employment was:- 1957 1958 1959 1960 1961 Clerical 4 5 4 5 5 Manual Labour 3 2 10 2 1 Housewives 3 9 3 3 3 Factory Workers 3 2 8 11 2 Children 1 - 3 3 1 Professional classes 3 2 3 1 1 Domestic Service 1 1 1 - - Nurses - - - 1 - Shop Assistants 2 3 3 1 1 Armed Forces - - 1 - - Retired Persons - - 3 1 3 Unclassified 5 8 5 2 9 25 33 43 30 25 Our scheme for the B. C. G. vaccination of school children is actively continuing and is working extremely well. This work is undertaken by the School Health Service. DISINFECTION AND DISINFESTATION The number of articles dealt with at the Disinfection Station was as follows:- Articles disinfected 8 Articles destroyed 58 and 1 cat and 1 dog 9 rooms were disinfected on account of infectious disease. 13 premises were disinfested on account of the presence of vermin, which involved the disinfestation of 37 rooms. 72 premises were treated for infestations of cockroaches, wasps, ants, flies, bluebottles, fleas, beetles and maggots, woodworm, woodlice, moths, bees and silverfish. 64 library books were brought to the Department during the year for disinfection on account of being in contact with cases of infectious disease. 26 27 APPENDIX 1 TABLE 1 Vital Statistics of Wood Green 1941-1961 Year Population Estimated to middle of each year Nett Births belonging to the District Nett Deaths belonging to the District Under 1 year of Age At all Ages Total No Rate per 1,000 population Illegitimate NO. Total No. Rate per 1,000 live births Illegitimate No. Rate per 1,000 illegitimate births No. Rate per 1,000 population (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) 1941 43,870 523 11.9 25 16 31 0 - 589 13.4 1942 44,840 704 15.7 29 25 37 1 34 573 12.7 1943 44,710 756 16.8 37 31 41 0 - 553 12.3 1944 44,060 824 18.7 46 26 31 5 108 564 12.8 1945 44,940 694 15.9 47 19 27 1 21 616 13.7 1946 50,680 986 19.4 48 34 34 2 42 629 12.4 1947 52,290 1,066 20.3 41 30 28 1 24 649 12.4 1948 53,080 805 15.1 21 23 28 2 95 520 9.8 1949 52,780 719 13.6 33 18 25 0 - 631 11.9 1950 52,710 677 12.8 25 17 25 1 40 630 11.9 1951 52,400 653 12.4 15 21 32 1 67 715 13.6 1952 52,080 654 12.5 33 14 21 2 60 602 11.5 1953 51,470 600 11.6 23 17 28 3 130 517 10.04 1954 51,090 564 11.03 25 15 26 0 - 533 10.4 1955 50,610 592 11.7 17 14 23.6 1 58.8 519 10.3 1956 50,100 578 11.5 20 10 17.3 1 50.3 537 10.7 1957 49,500 655 13.2 28 11 16.8 1 35.7 585 9.6 1958 49,100 635 12.9 37 13 26.62 1 27.09 573 11.3 1959 48,520 640 14.1 36 14 20.71 2 55.56 604 12.4 1960 48,160 724 15.0 46 22 30.4 - - 555 11.5 1961 47,750 753 15.7 61 17 26.8 2 32.8 548 11.5 28 TABLE II INFECTIOUS DISEASES FOR THE PAST 25 YEARS Year Diphtheria Scarlet Fever Enteric or Typhoid Fever Pulmonary Tuberculosis Nonpulmonary Tuberculosis Measles Pertussis Poliomyelitis †N *D †N *D †N *D †N *D †N *D †N *D †N *D †N *D 1937 46 3 72 1 2 - 49 24 8 2 1 5 2 - 1938 63 2 92 - 1 - 59 21 10 7 3 - 1 - 1939 24 1 63 - - - 45 26 6 2 - 1 2 - 1940 26 - 61 - 7 - 55 22 10 4 89 - 24 2 - 1941 42 - 51 - 2 - 57 26 7 4 401 2 192 1 1 - 1942 22 - 87 - - - 69 30 4 4 361 2 95 1 1 - 1943 26 - 155 - - - 43 22 3 3 356 - 106 1 - - 1944 9 - 51 - - - 44 20 5 4 232 - 134 1 1 - 1945 2 - 62 - 2 - 56 27 7 4 172 - 117 - 2 - 1946 7 - 73 - 1 - 76 22 10 3 346 - 89 - - 1 1947 10 - 46 - - - 52 17 10 5 410 2 171 - 2 - 1948 - - 69 - - - 65 21 9 5 408 - 174 - 5 1 1949 - - 71 - 2 - 68 19 9 - 678 - 46 - 6 1 1950 - - 99 - 1 - 57 10 6 2 421 - 376 1 4 - 1951 - - 196 - 1 - 50 13 5 2 434 - 127 1 1 - 1952 - - 93 - - - 36 5 4 1 449 - 89 - 3 - 1953 - - 66 - - - 64 5 7 2 778 - 202 - 6 2 1954 - - 61 - - - 73 6 8 1 29 - 80 - 1 - 1955 - - 26 - - - 51 6 5 1 635 - 28 1 4 1956 - - 17 - - - 30 1 7 1 27 - 37 - 5 - 1957 - - 22 - - - 26 6 5 1 876 - 95 - 6 - 1958 - - 77 - 1 - 29 5 3 - 421 - 40 - 2 1 1959 - - 28 - - - 30 1 3 - 169 - 16 - 7 1 1960 - - 38 - - - 27 1 3 - 21 - 72 - - - 1961 - - 15 - - - 19 2 6 1 763 - 13 - - - /-Notifications *D - Deaths 29 TABLE III INFECTIOUS DISEASES NOTIFIED DURING THE YEAR 1961 Notifiable Disease Cases Notified in Whole Borough Total Cases Notified in each Ward Total Cases removed to Hospital or Sanatorium Total Deaths At Ages - Years All Ages Under 1 year 1 to 5 years 5 to 10 years 10 to 15 years 15 to 20 years 20 to 25 years 25 to 35 years 35 to 45 years 45 to 55 years 55 to 65 years 65 and upwards AlexandraBowes Town Hall Noel Park Scarlet Fever 15 - 2 10 - 2 - - - 1 - - - 4 11 4 - Diptheria - - - - - - - - - - - - - - - - - Cerebro Spinal Fever - - - - - - - - - - - - - - - - - Enteric Fever - - - - - - - - - - - - - - - - - Para-typhoid Fever - - - - - - - - - - - - - - - - - Erysipelas 1 - - - - - - - - - - 1 - - 1 1 - Pneumonia 43 1 3 3 1 2 2 3 7 5 6 10 8 10 25 12 2 Acute Poliomyelitis - - - - - - - - - - - - - - - - - Polio-Encephalitie - - - - - - - - - - - - - - - - - Puerperal Pyrexia - - - - - - - - - - - - - - - - - Pulm Tuberculosis 19 - - - - 2 3 6 3 1 4 - 6 8 5 10 3 Non-Pulm Tuberculosis 6 - l - - - 1 1 1 - 1 1 1 4 1 3 2 Malaria - - - - - - - - - - - - - - - - - Chickenpox - - - - - - - - - - - - - - - - - Measles 763 13 369 354 23 - 1 2 - - - - 337 271 154 - - Whooping Cough 13 1 10 2 - - - - - - - - 8 4 1 - - Ophthalmia Neonatorum - - - - - - - - - - - - - - - - - Dysentary 4 - 2 - - - - 2 - - - - - 2 2 3 - Food Poisoning 2 - 1 - - - - 1 - - - - 1 1 - 1 - Meningoccocal Infection 1 - - - - - - 1 - - - - - - 1 1 - Totals 867 15 388 369 24 6 7 16 11 7 11 12 361 304 201 35 7 TABLE IV Causes of death during the year 1961 Causes of Death Male Female Tuberculosis, respiratory 2 - Tuberculosis, other 1 - Syphilitic disease - 1 Diphtheria - - Whooping Cough - - Meningococcal infections - - Acute Poliomyelitis - - Measles - - Other infective and parasitic diseases - - Malignant neoplasm, stomach 11 5 Malignant neoplasm, lung, bronchus 33 3 Malignant neoplasm, uterus, - 11 Malignant neoplasm, breast, - 4 Other Malignant and lymphatic neoplasms 26 26 Leukaemia, aleukaemia 2 3 Diabetes 1 - Vascular lesions of nervous system 30 36 Coronary disease, angina 50 38 Hypertension with heart disease 4 5 Other heart diseases 22 40 Oilier circulatory disease 9 21 Influenza 2 2 Pneumonia 14 17 Bronchitis 18 18 Other diseases of respiratory system 3 - Ulcer of stomach and duodenum 2 2 Gastritis, enteritis and diarrhoea 1 1 Nephritis and nephrosis 1 3 Hyperplasia of prostate 2 - Pregnancy childbirth, abortion - - Congenital malformations 3 2 Other defined and ill-defined diseases 24 18 Motor vehicle accidents 5 2 All other accidents 3 5 Suicide 4 2 Homicide and operations of war - - Total 273 265 30 TABLE IVA Males Causes of Death All Ages Under 1 1 to 2 2 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 and over Tuberculosis, respiratory 2 - - - - - - - - - 1 1 Tuberculosis, other 1 - - - - - - - - - - 1 Syphilitic disease - - - - - - - - - - - - Diphtheria - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - Meningococcal Infections - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - Measles - - - - - - - - - - - - Other infective and parasitic diseases - - - - - - - - - - - - Malignant neoplasm stomach 11 - - - - - - 1 - 5 2 3 Malignant neoplasm lung bronchus 33 - - - - - - 1 4 11 10 7 Malignant neoplasm breast - - - - - - - - - - - - Other malignant and lymphatic neoplasms 26 - - - - - - 1 3 7 7 8 Leukaemia, aleukaemia 2 - - - - - - - - 2 - - Diabetes 1 - - - - - - - 1 - - - Vascular lesions of nervous system 30 - - - - - 1 3 3 7 7 9 Coronary disease angina 50 - - - - - - - 5 6 15 24 Hypertension with heart disease 4 - - - - - - 1 1 - - 2 Other heart diseases 22 - - - - - - - 4 3 - 15 Other circulatory diseases 9 - - - - - - - - - 3 6 Influenza 2 - - - - - - - - - 1 1 Pneumonia 14 - - - - - - - 3 4 4 3 Bronchitis 18 2 - - - - - - - 1 9 6 Other diseases of respiratory system 34 - - - - - - - 2 1 - - Ulcer of stomach' and duodenum 2 - - - - - - - - 1 - 1 Gastritis Enteritis and Diarrhoea 1 1 - - - - - - - - - - Nephritis and nephrosis 1 - - - - - - - - 1 - - Hyperplasia of prostate 2 - - - - - - - - - - 2 Totals carried forward 234 3 - - - - 1 7 26 49 59 89 31 TABLE IVA (Cont'd) Males Causes of Death All Ages Under 1 1 to 2 2 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 and over brought forward 234 3 - - - - 1 7 26 49 59 89 Congenital malformations 3 3 - - - - - - - - - - Other defined and illdefined diseases 24 5 - - 1 1 - - 2 3 6 6 Motor vehicle accidents 5 - - - - 2 1 - 1 - 1 - All other accidents 3 - - - - - - - 1 - 9 - Suicide 4 - - - - - - - 2 1 1 - Homicide and operations of war - - - - - - - - - - - - Totals 273 11 - - 1 3 2 7 32 53 69 95 32 TABLE IVB Females Causes of Death All Ages Under 1 1 to 2 2 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 and over Tuberculosis, respiratory - - - - - - - - - - - - Tuberculosis, other - - - - - - - - - - - - Syphilitic disease 1 - - - - - - - - - - 1 Diptheria - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - Meningococcal infections - - - - - - - - - - - - Acute Poliomyelitis - - - - - - - - - - - - Measles - - - - - - - - - - - - Other infective and parasitic diseases - - - - - - - - - - - - Malignant neoplasm, stomach 5 - - - - - - 1 1 - 1 2 Malignant neoplasm, lung, bronchus 3 - - - - - - - 1 - 1 1 Malignant neoplasm, breast 11 - - - - - - - 3 1 2 5 Malignant neoplasm, uterus 4 - - - - - - - - - 1 3 Other malignant and lymphatic neoplasms 26 - - - - - 1 - 7 5 8 5 Leukaemia, aleukaemia 3 - - 1 - - - - - 2 - - Diabetes - - - - - - - - - - - - Vascular lesions of nervous system 36 - - - - - - - 3 3 8 22 Coronary disease, angina 38 - - - - - - - 2 8 12 16 Hypertension with heart disease 5 - - - - - - - - 1 2 2 Other heart diseases 40 - - - - - - 1 1 6 13 19 Other circulatory diseases 21 - - - - - - - 1 2 3 15 Influenza 2 - - - - - - - - - - 2 Pneumonia 17 - - - - - - 1 - 4 6 6 Bronchitis 18 1 - - - - - - - 2 2 13 Other diseases of respiratory system - - - - - - - - - - - - Ulcer of stomach and duodenum 2 - - - - - - - - - - 2 Gastritis, Enteritis and Diarrhoe 1 - - - - - - - - - - 1 Nephritis and nephrosis 3 - - - - - - - - - - 3 Totals carried forward 236 1 - 1 - - 1 3 19 34 59 118 33 TABLE IVB (Cont'd ) Females Causes of Death All Ages Under 1 1 to 2 2 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 and over Brought forward 236 1 - 1 - - 1 3 19 34 59 118 Pregnancy, Childbirth Abortion - - - - - - - - - - - - Congenital Malformations 2 2 - - - - - - - - - - Other defined and illdefined diseases 18 3 - - - - - 1 2 1 6 5 Motor vehicle accidents 2 - - - - - - - - - 1 1 All other accidents 5 - - - - - - - - - 1 4 Suicide 2 - - - - - - - 2 - - - Homicide and operations of war - - - - - - - - - - - - Totals 265 6 - 1 - - 1 4 23 35 67 128 34 TABLE V TUBERCULOSIS Tuberculosis Register Pulmonary Non Pulmonary Total M. P. M. P. No. of cases on Register at end of 1960 309 231 14 46 600 New cases notified during 1961 13 6 3 3 25 Transfers from other Districts 19 8 1 2 30 No. of cases removed from Register 37 19 3 4 63 No. of cases on Register at end of 1961 304 227 15 47 593 New Cases and Mortality during 1961 Age Periods New Cases Deaths Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. 0 - - - - - - - - 1 - - 2 - - - - - 5 - 1 - 1 - - - - 15 3 3 . 3 - - - - 25 9 3 - 3 - - - - 35 7 - 1 2 - - - - 45 5 2 - - - - - - 55 4 - 1 - - - - - 65 and upwards 3 1 - 1 2 - 1 - Totals 31 10 4 10 2 - 1 - Above includes transfers (30) from other districts. 35 APPENDIX 2 Mi seellaneous (a) Letters to Doctors Letters on the following subjects were circulated to Wood Green practitioners in 1961, some under my signature as Medical Officer of Health, others either as Area Medical Officer or District School Medical Officer:- January 16th Poliomyelitis Vaccination January 20th Tetanus Immunisation March Laundry Service for Old People April 18th Chiropody Service April 18th Polio Vaccination-4th injections May 23 rd Penicillin-free Poliomyelitis Vaccine August August Holiday arrangements August 11th Poliomyelitis Vaccine Supplies October 25th Sabin Polio Vaccine November 2nd Sabin Vaccine and Salk Vaccine November Changes in Midwifery Staff November 24th Retired Persons Advice Clinics December Christmas Holiday Arrangements and Marie Curie Foundation Scheme It has been our consistent practice to keep general practitioners in touch with recent developments in the field of preventive medicine, so that integration can be achieved. This policy is showing useful dividends. (b) Medical Examinations During 1961 64 medical examinations were carried out 23 of these were in respect of entrants to the Council's employ for acceptance into the Superannuation Scheme, 12 in respect of workmen already in the Council's employ for acceptance into the Superannuation Scheme and 29 in respect of workmen for acceptance into the Sickness Pay Scheme. In addition, 33 medical reports were issued relating to employees absent from duty for more than a short period through sickness. These reports were obtained from the family doctor with whom we have the most happy relations, or from a hospital. (c) Additional Reports to Health Committee January - Annual Conference of the Central Council for Health Education. December - Conference of Association of Public Health Inspectors. 36