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A number of such cases came to notice in 1943. Some were eventually persuaded to go into hospital or
institution, some became so ill that they were removed to hospital, some died. Three cases were dealt with under
Section 64 of the Middlesex County Council (General Powers) Act, 1938, and were removed by order of the Court to
institutions of the Middlesex County Council.
One was a man of 85 years, deaf and with considerable impairment of sight, one a man of 87 years, crippled,
weak and ill, and one a woman of 87 years who appeared to have lost all interest in the tidiness and cleanliness of her
surroundings. In each case they lived alone, their rooms were incredibly dirty and untidy and they were unable to
devote to themselves proper care and attention. In the interests of their health and for the prevention of serious
nuisance to other persons residing in the same premises it was necessary to remove them to suitable institutions. In
such cases a renewal of the order has to be applied for in respect of each period of three months during which the
patient needs to be detained in the institution.
In the case of the man of 85 years the order was renewed twice and then the Middlesex County Council took
over responsibility for the patient as a public assistance case. The man of 87 died a week after admission to the
institution.. In the case of the woman of 87 the medical officer of the institution reported at the end of the first three
months that she had improved physically and mentally and was fit to be discharged but should not live alone. In these
circumstances it was not possible to apply for a further order to detain her. Her subsequent fate was left with her
relatives and is so far unknown.
The above patients deeply resented removal from their homes and life-long associations and it appears to me
rather inhuman to have to deal with old people in this way. The Local Authority should be enabled to make arrangements
for a system of domestic help and personal care for the aged in their own homes and for the establishment of
suitably designed and fitted houses and flats where the aged could be accommodated if it were unsuitable for them to
remain in their own homes. It might be desirable to establish groups of small houses for 1 and 2 old people per
house, two storey blocks of service flats with restaurant and caretaker's quarters on the upper storey and lift, and
to take and suitably adapt and fit ground floors in ordinary houses in various parts of the district. Accommodation
should also be available for elderly people for short stays whilst their own homes are cleaned or redecorated. One
elderly lady was accommodated in such circumstances at the Municipal Hospital for a period in 1943, but this
arrangement would not always be possible.
THE SCHOOL MEDICAL SERVICE.
On 28th August, 1942 the Board of Education issued Circular 1604 revising the arrangements to be made for
the medical inspection of school children. Only two routine inspections are now required instead of three—(i) on or
as soon as possible after admission to school; (ii) in the last year of school life—but increased attention is required
to be paid to the children by the School Nurses.
These revised arrangements came into operation on the reopening of the Stonebridge Health Centre in
November, 1942.
During 1943, 4,296 children were medically inspected at routine inspections and 19,479 at special inspections
and re-inspections.
Scabies.—See report on Uncleanliness and Scabies on pages 9 to 11.
Uncleanliness.—(a) Willesden.—During 1943 cleanliness inspections were carried out in the schools on
493 occasions. The total number of examinations and re-examinations made during the year was 38,385.
See report on Uncleanliness and Scabies on pages 9 to 11.
(b) Reception Areas.—In the Annual Reports for 1940-1942 the results of cleanliness inspections made by
the Willesden Council's Health Visitors in reception areas from 20th April, 1940, to 2nd January, 1943, were shown.
The results of cleanliness inspections made by the Willesden Council's Health Visitors in reception areas
during 1943 are as follows:—