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20
Middlesex Hospital and another 20 male beds in Neasden Hospital. Since November, 1952, 10 male beds
used previously for females in Neasden Hospital have been used for males. In addition, a number of beds
(approximately 50) are available in the chest hospitals of the North.West Metropolitan Regional Hospital
Board. As a result of the improvement in the bed situation and domiciliary treatment, the waiting list has
been reduced to a few days only.
Preventing the Spread of the Disease
The reduction of overcrowding in homes, schools, factories, transport and places of recreation and
amusement will help to prevent the spread of the disease. It is also important to remove the chronic infective
cases from industry and provide sheltered workshops where they can earn their living without risk to
others, particularly susceptible adolescents. The improvement in hospital facilities has resulted in the early
removal of infective cases from the community. Finally, the improvement in health education and a knowledge
of hygiene has permitted the treatment of cases in the home without placing mftmbers of the family
at risk. Health visitors, home nurses and home helps have played a very important part in this, and it is
probably true to say that where suitable precautions are taken, contacts in homes where a known case of
tuberculosis is treated are safer than some members of the public who repeatedly come in contact with
unknown cases.
There has been a change of the method of assessment in home help cases which has affected some of
them adversely. The chest physician commented on them as follows : "Receipt of the high assessments also
give the patients a severe mental jolt just at a time when efforts have been made by the clinic staff to relieve
anxiety following the diagnosis of a serious illness". Arrangements have now been made for appeals to be
dealt with promptly to avoid patients being alarmed by a notice of a high assessment.
Administration
Monthly meetings are held with the chest physician, the welfare officer, the superintendent of health
visitors, midwives and home nurses, the home help organiser and the chief sanitary inspector, where measures
which will help individual cases are discussed, together with suggestions for improvement of the scheme as a
whole in the area. Arrangements are now being made to trace contacts of infective cases in factories and to
encourage factory managers to employ non.infectious ex.tuberculosis patients on the recommendation of
both the chest physician and the medical officer of health.
This has been a most interesting and eventful year in the battle against tuberculosis and it has shown
conclusively that the co.operation of a team of health workers who are actually doing the work produces
increasingly satisfactory results, and that one unit of administration would make things run even more
smoothly.
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
The Borough Engineer's department deals with the provision of dust.bins.
House refuse is collected weekly; trade refuse as often as required at an agreed charge. The refuse
is disposed of by controlled tipping at Twyford.
Household Arrangements
The Registrar General has published an analysis of a 1% sample of the Census 1951.
Shared Dwellings and Overcrowding
Willesden figures reveal a much higher proportion of households in shared dwellings (6 out of 10)
as compared with the average in England and Wales (about 2 out of 10) and Greater London (about 4 out
of 10). It is even higher than that in the County of London (5 out of 10).
The number of persons per room (0.85) is higher than, that in England and Wales and London; the
percentage of persons living more than two per room (5 76) is almost three times the average in England
and Wales and London, and the improvement in Willesden comparing 1951 with 1931 is much less.
Bathrooms
The proportion of households without a fixed bath (6 out of 10) is higher than that in England and
Wales, Greater London and the County of Middlesex (all about 4 out of 10), but it is slightly less than
that in the County of London. This is doubtless due to the greater age of the property in the County of
London and Willesden.
Water Closets
The number of households without a water closet (about 2 out of 10) is only slightly higher
than that in England and Wales and the County of Middlesex, and slightly lower than that in Greater London
and the County of London; in Willesden the proportion rises almost to three.quarters (68 per cent.) in
dwellings occupied by three or more families.