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The decision that the noise is a nuisance, is only the first step in the proceedings, because 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. Fortunately,
the firms affected have been very co-operative and two welcomed the advice of a technical expert called in by
the Council. One firm made fairly extensive and costly alterations and the nuisance was abated to the
satisfaction of everyone concerned. The second firm had not completed the work required by the end of the
year, but some improvement had been made. With the considerable invasion of factory premises in the
residential areas in Willesden, an increase in the number of complaints is expected, but it is hoped that the
co-operation which has been received will continue to the benefit of all parties.
Persons in Need of Care and Attention—National Assistance Act, 1948, Section 47:
There was an increase in the number of persons who were referred to the department requiring special
care and attention. This was due to the increase in the proportion of old persons in the population and to the
fact that relatives who were handicapped by overcrowded living conditions found it difficult to look after them.
Local authorities responsible for housing have few houses suitable for the aged, and the special care
and attention which some of them require, e.g., those who are doubly incontinent, can only be given in special
homes or hostels, or in hospitals. There was an acute shortage of accommodation in these institutions during
the year, and many relatives, doctors, and voluntary organisations applied to the Medical Officer of Health
for assistance. Wherever possible, the special care and attention was given in the person's home by district
nurses and home helps with the assistance of health visitors and general practitioners. Nevertheless, there are
many aged in the Borough who require institutional treatment, but there is no accommodation for them.
Section 47 of the National Assistance Act provides for the Borough Council to make application to the
Court to obtain the removal to an institution of any person who is living in insanitary conditions and is not
receiving proper care and attention. Owing to the shortage of accommodation in homes, hostels, and hospitals,
Section 47 of the Act has not been operated as often as required. The Regional Hospital Board have the
responsibility for providing accommodation in hospitals, and the local health authority in homes and hostels.
There has been a close liaison with the Hospital Management Committee and most of the difficulties with
regard to hospital admission have been overcome since the appointment of a geriatric physician. Excellent
working arrangements have been maintained with the local welfare department, but accommodation in hostels
for the aged and infirm has become more difficult to obtain.
The border-line cases requiring admission present the most difficulties because of the opposing interests
of the authorities concerned. Where there is some doubt as to whether an old person is sick or merely aged
and infirm, the hospital and local authorities vie with one another in trying to pass the responsibility. The
same applies to where an old person's condition alters and a transfer of institution is required. Before the change
in administration there could be no dispute, because the local authority was responsible for both types of institution—hospital
and hostel.
In a few cases the persons died in their homes before Section 47 could be implemented and several of
the people who were admitted voluntarily to hospital died within a fortnight of admission.
It has been suggested that it would be preferable to leave these people to die in peace in their homes,
but they were living under appalling conditions and they would have starved to death if they had not received
attention. One person died of starvation within 48 hours of admission to hospital and another person was found
collapsed on the floor; he had not had any food for three days. An increase in the general interest of neighbours
in their fellow citizens would prevent such disasters, but the first essential is to increase the number of homes
for aged persons.
Many attempts were made during the year to start a "Meals on Wheels" service, as this would not
only benefit the old people, but would save a considerable amount of money in expenditure on the home help
service, because the home helpsspend a large part of their time shopping and cooking meals for old people. Although
the Borough Council was willing to supply the meals through the Civic Restaurant Service and even give
assistance in obtaining suitable vehicles, it was impossible to organise a service as there were not sufficient
voluntary helpers to run it. The Borough Council have no statutory powers to organise a service themselves,
but may assist financially voluntary workers who are prepared to organise a service.
During the year 1948, the necessary Court Order was obtained in one case: a woman of 86 who was
removed to Redhill House in March, 1949. She was sleeping on two chairs in most insanitary conditions and
was dependent for food on scraps and cups of tea sent in by neighbours. The matter was urgent, as the
neighbours had indicated that they would withdraw the little assistance they were giving if the authority took
no action. The County Council reported that there was no accommodation available, but the Court declared
that an emergency existed, and made an order for her immediate admission to Redhill House.
Burial of the Destitute Dead
The duty placed on the Council under Section 50 of the National Assistance Act, 1948, with regard
to the burial of destitute dead was varied by the issue of Ministry of Health Circular 13 /49 on March 1st, 1949,
in which the Ministry of Health asked that hospital management Committees and Boards of Governors of
Teaching Hospitals should exercise their powers in the case of:
(a) Deceased patients whose relatives cannot be traced;
(b) Those whose relatives are traceable but were not, immediately before the patient's death,
liable for his maintenance under Section 42 (1) of the National Assistance Act and are not
willing to arrange for the burial; and
(c) Those whose relatives are unable to obtain a death grant under the National Insurance Act,
1946, and cannot otherwise afford to arrange for burial.