AC 4366 LIBRARY ??? p.42 BET57 Metropolitan Borough of Bethnal Green ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1952 Metropolitan Borough of Bethnal Green ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1952 -2- INDEX Page Public Health Committee 3 Staff 4 Statistics of the Area 8 Extracts from Vital Statistics 8 Causes of Deaths 11 Sanitary Circumstances of the Area 13 Housing 26 Inspection and Supervision of Pood 31 Prevalence and Control over Infectious Diseases 39 General Provision of Health Services other than those provided by the Borough Council 46 -3- METROPOLITAN BOROUGH OF BETHNAL GREEN PUBLIC HEALTH COMMITTEE Chairman: Councillor W.R. Johnson Vice-Chairman: Councillor R.H. Hare Alderman A.E. McAuliffe Councillor J.T. Denman " Miss E.K. Dewsnap " G.A. Hadley " J.S. Mead Councillor F.E. Morgan " F.E. Sanders, J.P. " C. Sleigh " H.J. Stubbs, J.P. " E. Winslow Ex-Officio Members: The Worshipful the Mayor (Councillor Mrs.B.L.Tate, J.P.,L.C,C.) Alderman H.P. Wilson, J.P. Councillor A.G. Clark " C.F.F. Fleet " A. Gilbert " A. Stocks " H.E. Tate, J.P. Council's Representatives on the London County Council (Division 5) Health Committee: Councillors W.R. Johnson and R.H. Hare. -4- STAFF OF PUBLIC HEALTH DEPARTMENT Medical Officer of Health: R. DUNCAN DEWAR, B.Sc., M.B., Ch.B., D.P.H. Sanitary Inspectors: Senior Sanitary Inspector: F.C. Sharpe ø m Housing Inspector: G.S. Freeman ø Food Inspectors: G.E. Gould ø m :S.R. Slater ø m Factory Inspector: E.F. Swash ø District Inspectors: H.G. Avrll ø :W. Johnson ø :L. Foxley ø m :J.C. McManus ø :S.J. Cassldy ø :J.A. Harris ø (Resigned 5.7.52) Administrative and Clerical StaffChief Clerk: J.E. Pestell Senior Clerk: S.A. Wright Assistant Clerks: R.F. Marshall C.W. Foxton J.J. Parker (H.M.Forces) F.S. Frid Mrs. B.L. Burge Junior Clerk: Miss L. Driver Other Employees: Attendants 2 Disinfectors 4 Female Cleansing Attendant 1 Rodent Operatives 2 Drainage Staff 3 ø Certified Sanitary Inspector m Certified Meat, etc., Inspector -5- Public Health Department, Town Hall, BETHNAL GREEN, E.2. June, 1953. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Bethnal Green. Mr. Mayor, Ladles and Gentlemen, I have the honour to submit my Annual Report on the health and sanitary circumstances of the Borough for the year 1952. Bethnal Green is one of the smaller Metropolitan Boroughs with an area of 760 acres. Victoria Park, one of the largest and most beautiful of the London Parks, is mainly within the Borough and there are other smaller open spaces but the remainder of the borough is congested. With a few notable exceptions, the streets are narrow and the houses are in crowded terraces with a minimum of space at the rear and usually none in front. There is a considerable amount of light industry and, with a total of 1,463 factories, the number of factories in proportion to area is probably higher than in any other Metropolitan Borough. At one time Bethnal Green was noted for silk weaving and a number of weavers' houses still exist but the predominant trade at the present time is the manufacture of furniture. There are many very satisfactory factories with modern equipment and with good standards of hygiene but there are also many instances where houses, with or without additions, have been converted to factory use and where conditions leave much to be desired. Very many of the dwelling houses in Bethnal Green were built 80 to 120 years ago and whilst they still provide reasonable accommodation at a modest rent where maintenance has not been neglected, the general fabric of the buildings is now wearing out and the amenities provided are far below the standard which is required at the present day. The problems of public health in Bethnal Green are consequently mainly associated with the crowding and bad arrangement of houses, the lack of adequate lighting and ventilation, lack of modern amenities and the nuisances and disadvantages associated with the intermixture of residential and factory premises. -6- The Council has already done a great deal towards redeveloping areas for modern housing and with the help and co-operation of the London County Council a high proportion of the slum clearance programme for London has been allocated to Bethnal Green. In addition, the London County Council has a large housing programme for the Dorough, but in order to attain a good standard it would be necessary to demolish and re-build approximately three quarters of all the houses in the borough and the process of redevelopment will have to be spread over many years. The number of factories, workshops and commercial premises which are necessarily displaced by redevelopment add considerably to the difficulties and cost. In spite of the basically bad environment in Bethnal Green as compared with most other urban areas, the health of the population as measured by death rates and the incidence of notifiable disease is satisfactory, but if it were possible to obtain a measure of the degree of good health or even an accurate measure of the amount of non-fatal illness it is likely that the picture would be less comforting. The infant mortality rate is somewhat higher than that for the previous year, but with a small population the rate varies considerably and is unreliable as an indication of the degree of child care. Out of approximately 11,000 children between the ages of one and fifteen years there were only 8 deaths but of these, three deaths were due to accidents and the prevention of accidents both on the road and in the home is a matter which deserves as much attention as the other preventive services. At the other end of the scale the welfare of old people has attracted increasing attention. Whilst many children still do their utmost to provide for the happiness and well-being of their aged parents the provision of increasing community services appears, in a minority of cases, to have encouraged people to shed their responsibilities. Many old people in Bethnal Green are living in unsatisfactory circumstances and some were found to be unable to care properly for themselves and were not receiving adequate care from others. In a number of cases it was possible to persuade the old person to enter an institution or hospital and it was not necessary to resort to legal proceedings for this purpose. The London County Council, through the Home Help Service, has done an immense amount of good in providing the necessary care and attention for many of the old people and the voluntary services have done a great deal to provide for those needs which cannot adequately be met by legislation. Difficulties did occur during the year on account of the shortage of accommodation both in -7- hospitals and In London County Council institutions, but the officers in charge of both types of accommodation were at all times most cooperative and helpful in arranging whatever assistance was required. The personal health services are under the control of the London County Council and will consequently be reported upon by the County Council and I have therefore included in this Report merely a summary of the clinics provided in the area together with some figures of attendances, etc., which have been kindly provided by the Divisional Medical Officer, Dr. G.O. Mitchell. I have endeavoured in my Report to summarise the work of the Public Health Department during the year and whilst conditions expressed as figures appear to be satisfactory the actual conditions throughout the Borough are far from ideal and give little grounds for complacency. I would like to express my thanks to the Chairman and the Members of the Public Health Committee for their help and encouragement. My thanks are also due to the officers of the Council for their ready assistance and advice at all times and particularly to my own staff for their loyal support. I have the honour to be, Your obedient Servant, R. DUNCAN DEWAR, Medical Officer of Health. -8- SECTION A STATISTICS OF THE AREA Area 760 acres Population, estimated mid-year 57,040 Number of inhabited houses (at 31st December, 1952) 15,939 Rateable Value £445,556 General Rate 22s.8d Sum represented by a penny rate £1,805 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR Males Females Total Live Births: Legitimate 490 452 912 Illegitimate 29 22 51 Rate per 1,000 estimated population 17.4 Stillbirths: Legitimate 9 7 16 Illegitimate - - - Rate per 1,000 total (live and still) births 15.8 Deaths Death Rate per 1,000 estimated population 11.9 Deaths of infants under one year of age - Legitimate 13 16 29 Illegitimate - - - Death Rate of Infants under one year of age - All infants per 1,000 live births 29.2 Legitimate infants per 1,000 legitimate live births 30.8 Illegitimate infants per 1,000 illegitimate live births Nil The population as estimated by the Registrar General is 960 less than that for the previous year and, at the same time, the number of inhabited houses has increased by 112. Throughout the Borough there is an average of 358 persons for every 100 houses. This is a very satisfactory figure and shows that there is comparatively little real overcrowding in houses. The overcrowding which is not disclosed by these figures is the crowding together of the houses themselves rather than the crowding inside the houses. -9- The birth rate, being the number of births registered during the year per 1,000 of the estimated mid-year population, shows an increase of 0.6 over the previous year giving a figure of 17.4. Taking into account the age and sex distribution within the Borough the comparative figure is 16.5 as against 17.6 for London and 15.3 for England and Wales. The death rate of 11.9 is 1.6 below the figure for 1951 and gives a comparative figure of 12.8 as against 12.6 for London and 11.3 for England and Wales. The infant mortality rate, being the deaths of children under the age of 1 year for every 1,000 live births registered, is 29.2 as compared with 23.8 for London and 27.6 for England and Wales. The rate for Bethnal Green is 6.7 above the figure for the previous year but, as a single death can cause a large alteration in the rate, care should be used in drawing any conclusions. The causes of death are shown in Table 1, which follows. There continues to be a rather disquieting rise in the number of deaths from malignant growths of the lung in men, the figure being 44 as compared with 29 for the previous year. The mounting frequency of this cause of death throughout the country and particularly in London during the past few years is still being actively investigated and whilst there can be no doubt that tobacco smoking is one factor causing this increase other factors such as atmospheric pollution are receiving careful consideration. Notification of Births Arrangements continued in operation during the year whereby the London County Council furnished to the Borough Council a weekly return of births (including stillbirths) notified to them as the Local Health Authority under the National Health Service Act, 1946. During the year 1,008 live births (524 male and 484 female) were notified and in addition there were 18 stillbirths (10 male and 8 female). These figures represent corrected totals after the addition of inward transfers and the deletion of outward transfers and the difference between these figures and those set out previously is due to the fact that births must be registered only within 6 weeks and it is not uncommon for a child to be born and notified in one calendar year but not actually registered until after the New Year. -10- TABLE 1 CAUSES OF DEATH (See next page) -11- -12- TABLE 1 CAUSES OF DEATH Causes of Death Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 to 75 75 and " upwards Totals M F M F M F M F M F M F M F M F M F All causes 13 16 3 - 4 1 3 2 12 12 110 65 133 84 98 126 376 306 1 Tuberculosis, respiratory - - - - - - - - 1 3 8 1 3 - 1 2 13 6 2 Tuberculosis, other - - - - - - 1 - --- - - 1 - - - - 1 1 3 Syphilitic disease - - - - - - - - - - - 5 3 - - - 3 5 4 Diphtheria - - - - - - - - - - - - - - - - - - 5 Whooping Cough - - - - - - - - - - - - - - - - - - 6 Meningococcal infections - 1 - - - - - - - - - - - - - - - 1 7 Acute Poliomyelitis - - - - - - - - - - - - - - - - - - 8 Measles - - - - - - - - - - - - - - - - - - 9 Other Infective and parasitic diseases - - - - - - - - 1 - - - - - - - 1 - 10 Malignant neoplasm, stomach - - - - - - - - - 1 3 5 3 2 - 4 6 12 11 Malignant neoplasm, lung, bronchus - - - - - - - - - - 21 1 17 2 6 1 44 4 12 Malignant neoplasm, breast - - - - - - - - - - - 2 - 2 - 6 - 10 13 Malignant neoplasm, uterus - - - - - - - - - - - 1 - 1 _ 2 - 4 14 Other malignant and lymphatic neoplasms - 1 1 - - - - 2 1 - 7 12 16 8 5 8 30 31 15 Leuka - - - - - - - - - - 1 1 - - - 1 1 2 16 diabetes - - - - - - - - - 1 2 1 1 2 - 5 3 9 17 Vascular lesions of nervous system - - - - - - - - - 1 4 8 7 7 7 16 18 32 18 Coronary disease, angina - - - - - - - - 1 - 14 5 16 8 13 13 44 26 19 Hypertension with heart disease - - - - - - - - - 1 - - 1 1 3 1 1 4 3 20 Other heart disease - - - - - - - - 1 3 8 8 13 15 12 23 34 49 21 Other circulatory disease - - - - - - - - - - 2 _ 5 9 9 16 16 25 22 Influenza - - - - - - - - - - - - 1 - 1 - 2 - 23 Pneumonia - - 1 - - - - - 1 - 2 2 9 5 7 8 20 19 24 Bronchitis 1 - 1 - 1 - - - - - 15 5 16 12 14 11 48 28 25 Other diseases of respiratory system - - - - - - - - 2 - 3 2 3 2 2 - 10 4 26 Ulcer of stomach and duodenum - - - - - - - - 1 - 4 1 4 1 1 1 10 3 27 Gastritis, enteritis and diarrhoea - - - - - - - - - - - - - - - - - - 28 Nephritis and nephrosis - - - - - - - - - - 1 - 2 - - - 3 - 29 Hyperplasia of prostate - - - - - - - - - - 1 _ 4 - 7 - 12 - 30 Pregnancy, childbirth, abortion - - - - - - - - - - - - - - - - - - 31 Congenital malformations 2 2 - - - - - - 1 - - - - - - - 3 2 32 Other defined and ill-defined diseases 10 7 - - 1 - - - 1 2 9 4 4 6 8 7 33 26 33 Motor vehicle accidents - - - - - 1 1 - - - - - - 1 1 - 2 2 34 All other accidents - 1 - - 2 - - - - - 1 - 2 - 1 1 6 2 35 Suicide - - - - - - - - 1 - 3 _ 2 - - - 6 - 36 Homicide and operations of war - - - - - - 1 - - - 1 - 1 - - - 3 - -13- SECTION B SANITARY CIRCUMSTANCES OF THE AREA (l) Water Supply The water supply of the Borough is provided by the Metropolitan Water Board and has been satisfactory as regards quality and quantity. Bacteriological examinations and chemical analyses are carried out by the Metropolitan Water Board at frequent intervals. The water is not known to have any plumbo-solvent action. No complaint of contamination was received during the year. Notice was sent to the Metropolitan Water Board of observed waste in 117 cases. There are 5 wells in the Borough, as follows:- Attached to Council's Public Baths 1 Attached to a local hospital 1 Supplementary supply for Industrial purposes 3 During the year 256 new premises were certified as having a proper and sufficient water supply. (2) Sanitary Inspection of the Area Table 2, which follows, gives a summary of the work of the sanitary inspectors. The major portion of the work was concerned with insanitary conditions. It was not found possible nor practicable to re-institute a system of house-to-house inspection and housing inspections were carried out only on complaint followed, of course, by re-inspections where necessary. Following the 3,142 complaints of insanitary conditions sanitary defects were found requiring the service of Intimation Notices in 2,421 cases. Of these statutory notices were required in 1,134 instances and legal proceedings were instituted in 106 cases. The main types of defects found are shown in Table 3. -14- In connection with the supervision of drainage works, a total of 2,010 inspections were made during the year. Only four notices were served under Section 40 of the Public Health (London) Act, 1936, and in two instances the necessary work was carried out by the Borough Council, the expenses being recovered from the owners of the property. It was not found necessary to take legal proceedings for any case of infringement of the Drainage By-laws. The work of the inspectorial staff is necessarily reflected in the work done by the clerical staff and, in addition to the recording and preparation of the notices mentioned above, 2,531 letters were sent out by the department concerning insanitary conditions and a further 933 letters concerned housing and other public health matters. One of the main difficulties encountered is in dealing reasonably with those properties which are old and worn out and which are scheduled, either under a Borough Council or a County Council plan, for acquisition and demolition during the next few years. It Is both unreasonable and uneconomic to insist on major repairs and then shortly afterwards to pull the property down and in fact a great deal of public money has been wasted in paying for War Damage repairs to property which has since been demolished. Whilst repairs were being paid for out of public money by the War Damage Commission, owners were willing and even anxious to comply with nuisance notices but now that a high proportion of damage attributable to enemy action has been repaired and the full cost has to be met by the owner, if an extensive notice is served the owner frequently applies to the Court for a closing order on the grounds that the cost of repairs is unreasonable. The order is usually granted because it can be shown that the expenditure is quite uneconomic. This practice is likely to persist whilst the absurd position continues to be that a new Council flat is worth say £2,000 whereas an old house, giving the same or greater accommodation but without some of the amenities, even if put into excellent repair is worth little more than the ground it is built upon. The Public Health Department, however, is not concerned with economics but with maintaining reasonable conditions in which people can live and, in practice, an endeavour is made to keep the repairs required by a sanitary notice within such limits that the owner is not provoked into applying for a closing order, and in spite of what has been said above many owners have carried out extensive repairs when it was obviously uneconomic to do so. -15- TABLE 2 RECORD OF VISITS Notifiable Infectious Diseases 637 Non-notifiable diseases 76 Food Poisoning 5 Complaints as to insanitary conditions 3,142 Aged and Infirm persons 17 Factories 685 Milkshops 520 Other Food premises 2,655 Outworkers' houses 576 Tenement houses 61 Drainage work 2,010 Smoke observations 2 Enquiries with regard to housing 649 Other inspections and special work 2,910 Re-inspections 10,659 Total 24,604 TABLE 3 SANITARY DEFECTS IN CONNECTION WITH WHICH NOTICES WERE SERVED Dirty rooms 3,997 Defective drains and choked W.C.'s 276 Defective and dirty W.C.'s 1,371 Defective water supply 132 Defective paving 130 Defective gutters and rain water pipes 551 Defective roofs 1,079 Dampness 1,636 Defective dustbins 181 Other defects 4,849 Total 14,202 -l6- (3) Supply of Dustbins It has been the practice for many years in Bethnal Green for the owner of the house to supply the dustbin and it is only during recent times when the price of bins has increased and the ownership of property has become increasingly uneconomic that there have been objections to the continuance of this practice. In the great majority of cases an informal notice to the owner has been sufficient to obtain the supply of a new dustbin and this has probably been assisted by the fact that the Borough Council has been able to supply a standard bin for 17/6d (now increased to £1) which is somewhat less than the price charged by private traders. In only nine cases during the year was it necessary for the Council to consider the service of a notice under Section 105 of the Public Health (London) Act, 1936, and in consideration of all the circumstances notice was served on the owner in six cases and on the occupier in the remaining three. In no case was an appeal lodged. (4) Legal Proceedings It was found necessary on 106 occasions during the year to take legal proceedings to enforce compliance with the requirements of Notices served. In 21 of these cases Abatement Orders were made by the Magistrate with the infliction of costs amounting to £68.5s.0d. and in addition, in three instances, for non-compliance with Abatement Orders the Magistrate imposed fine and costs totalling £15. 5s. 0d. Brief details are set out below. Abatement Orders Premises Offence Result of Proceedings 26, Lanfranc Road Non-compliance with Nuisance Notice Abatement (28 days) Order made £3.3.0 costs 265, Brick Lane do. do. £6.6.0 costs 30, Burnside Street do. do. £3.3.0 costs 28, Morpeth Street do. do. do. 14, Swanfield Street do. do. do. 85, Warner Place do. do. do. 1, Squirries Street do. do. do. Squirries Street do. do. do. 27, St.Peter's Avenue do. do. do. 12, Brierly Street do. do. do. 35, Wennington Road do. do. do. 3, Felix Street do. do. £2.2.0 costs -17- Abatement Orders (continued) Premises Offence Result of Proceedings 24, Morpeth Street Non-compliance with Abatement Order made Nuisance Notice (28 days) £3.3.0 costs 25, Morpeth Street do. do. do. 16, Gosset Street do. do. do. 22, Code Street do. do. do. 90. St. Peter's Avenue do. do. do. 2, Kenllworth Road do. do. do. 51. Hemming Street do. do. do. 90. Collingwood Street do. do. do. 79. Cyprus Street do. Abatement Order made Atlas Works, Viaduct Place. Non-compliance with Abatement Order (56 days) £3.3.0 costs £10 fine £3.3.0 costs 39. St. Jude's Road do. Withdrawn. Works done. No costs. 265. Brick Lane do. Withdrawn. Works done. £2.2.0 costs paid Closing Orders were made by the Magistrate in 11 cases and Costs amounting to £25.4s.Od. were awarded to the Council. In addition, one Closing Order, made In 1951, was revoked by the Magistrate and £3.3s.Od. costs were paid to the Council. Brief details are set out below. Closing Orders Premises Offence Result of Proceedings 4, Victoria Place, The Oval. Non-compliance with Nuisance Notice Closing Order granted £3.3.0 costs 47, Mowlem Street do. do. do. 25, Vyner Street do. do. do. 10, Hollybush Place do. do. No costs 12, Hollybush Place do. do. do. 4, Wellington Row do. do. £3.3.0 costs 8, Crossland Square do. do. do. 352, Hackney Road do. do. do. 8, Chance Street do. do. No costs 30, Wennlngton Road do. do. £3.3.0 costs 31, Clarkson Street do. do. do. 17, St. Peter's Avenue Proceedings for revocation of Closing Order made 13.7.51 Closing Order revoked £3.3.0 costs paid -18- In 70 cases summonses were withdrawn owing to the nuisances being abated prior to the date of hearing, the defendants paying expenses amounting to £113. 8s. 0d. (5) Rent and Mortgage Interest (Restrictions) Acts During the year the number of certificates of disrepair issued to tenants was 35, and certificates of fitness were granted on application of property owners in 17 cases. (6) Swimming Baths 23 samples of water were taken during the year from the Council's Public Swimming Baths and submitted for bacteriological examination and chemical analysis. The reports showed that the water consistently maintained a high degree of purity. (7) Factories, Workshops and Workplaces Factories and Workplaces in this Borough carrying on a variety of trades number 1,463 and a total of 982 inspections and re-inspections were made during the year. This small number of inspections was due to shortage of inspectorial staff, the Factory Inspector being engaged on district work. In addition to the above, a number of visits were made in regard to drainage and applications under the Town and Country Planning Act, 1947. The following Tables give details of work carried out under the Factories Acts, 1937 and 1948, during the year:- -19- TABLE 4 INSPECTIONS FOR THE PURPOSE OF PROVISIONS AS TO HEALTH (including inspections made by Sanitary Inspectors) Premises Number on Register Number of Inspections Written notices Occupiers prosecuted 1. Factories in which Sections 1,2,3,4 and 6 are to be enforced by Local Authorities 622 349 49 - 2. Factories not included in (1) in which Section 7 is enforced by the Local Authority 838 633 119 3. Other premises in which Section 7 is enforced by the Local Authority 3 - - - TOTAL 1,463 982 168 - -20- TABLE 5 CASES IN WHICH DEFECTS WERE POUND Particulars No. of Cases in which Defects were Found No. of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness 57 51 - 4 - Overcrowding - - - - - Unreasonable temperature - - - - - Inadequate ventilation 2 1 1 1 - Ineffective drainage of floors 3 2 - - - Sanitary conveniences:- (a) Insufficient 2 4 - - - (b) Unsuitable or defective 279 162 - 59 - (c) Not separate for sexes 5 4 - 5 - Other offences against the Acts (not including offences relating to outwork) 127 91 6 4 - TOTAL 475 315 10 73 - -21- OUTWORK SECTION 110 No. of Outworkers In August list required by Section 110 (1) (o) Wearing apparel (Making, etc. Cleaning and washing) 76 Curtains and Furniture hangings 84 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 41 Brush making 14 Chocolates and sweetmeats 121 Cosaques, Christmas crackers, Christmas stockings, etc. 28 Total 364 Section 110. There was no case of default in sending list to the Council. Section 111. There was no instance of work being carried on in unwholesome premises. (8) Shops Acts During the year the Sanitary Inspectors paid 139 visits to shops in relation to general sanitation, ventilation and temperature requirements. 31 notices were served in respect of unsatisfactory conditions found to exist. (9) Disinfection and Disinfestation The following is a summary of the routine work carried out by the disinfecting staff during the year:- No. of rooms disinfested 742 Articles of clothing, bedding, etc., submitted to steam disinfection 20,075 Articles disinfected by formalin 300,494 Hospital mattresses, pillows, etc., disinfected 7,826 Number of articles destroyed by request 431 In addition, all bombed sites, static water tanks and stables in the borough were sprayed with insecticide as preventive measures against flies and mosquitoes during the summer months. The furniture of 95 families removing to Borough Council flats was disinfested by means of hydrocyanic acid by arrangement with 22. contractors in course of transit from the previous homes, the bedding being treated by steam at the Disinfecting Station at the same time. (10) Personal Cleansing Station During the year, 24 adults and 6 children had baths for verminous conditions at the Personal Cleansing Station, simultaneous disinfection of clothing being carried out. The majority of adults concerned were men from a Common Lodging House. In addition, 6 adults and two children received treatment for Scabies at the Station. During the year, the Public Health Committee approved the removal of one bath, the space to be utilized for other purposes. Sanitary Inspectors visit and advise in all cases of Scabies and in those cases where verminous conditions persistently recur. (11) Prevention of Damage by Pests Act, 1949 This Act gives power to the Council to require action to be taken to eradicate infestations of rats and mice, and to prevent infestations. All complaints concerning infestations are investigated and, where necessary, action taken to set traps or lay bait. No charges for this service are made in respect of dwellinghouses but the cost is charged in full in respect of business premises. During the year, 165 complaints of infestations were received and in most cases smoke tests of the drainage of the premises affected were carried out by the Drainage Staff under the supervision of the Sanitary Inspectors. Systematic baiting and poisoning was carried out by the Rodent Operatives on 398 premises with satisfactory results. In accordance with the suggestion of the Ministry of Agriculture and Fisheries, all sewers under the control of the Council were baited twice during the year, involving a total of 1,328 manholes. Positive results were obtained in 554 instances. (12) National Assistance Act, 1948 Under Section 47 of the National Assistance Act, 1948, as amended by the National Assistance (Amendment) Act, 1951. provision is made whereby a court of summary jurisdiction may make an order for the removal of ill, infirm or incapacitated persons who are not receiving proper care and attention. -23- Whilst this provision is very necessary in order to deal with unusual and very difficult cases it is one which should be resorted to only when all else has failed. Some persons feel very keenly that they should not be treated in, what appears to them, a manner which is used for criminals, merely because they are old or helpless and do not exhibit a passion for cleanliness. A number of cases came to the notice of the Public Health Department where it was suggested that conditions would justify action under this section. Mostly they were old people living alone but there were some cases of elderly married couples. On investigation it was found that some of these people were unaware of the facilities provided by the London County Council under the Home Help Service and the provision of a Home Help solved most of the difficulties. Some of those that were aware of the service required considerable persuasion to overcome their pride and sense of Independence to allow a stranger to enter their homes. In some cases it appeared that medical treatment was what was mainly required, in others, an old peoples home or institution appeared to be the only reasonable solution and apart from the difficulty of obtaining a chronic sick bed or a place in an institution it was frequently necessary to overcome the objection to entering what is still regarded by many old people as the "workhouse" or the "infirmary". In a few instances it was possible to arrange for adequate care to be provided by friends or relatives. In all cases it was possible to arrange matters by persuasion and it was unnecessary to resort to legal proceedings. (13) Burial of the Dead In accordance with Section 50 of the National Assistance Act,1948, the Council is responsible for the burial or cremation of the body of any person who had died or been found dead within the Borough, and where no private arrangements are being made for the disposal of the body. Authority is given to recover from the estate of the deceased person, or from any person who, under the Act, was liable to maintain the deceased immediately prior to his/her death, the expenses incurred in carrying out the duty, in so far as these expenses are not covered by any grant under the National Insurance Act, 1946. During the year, 11 burials were arranged by the Department at a cost of £82. 14s. 6d., £55. 0s. 6d. being recovered up to the end of the year. -24- (14) Mortuary The Council's Mortuary at St. Matthew's Row continued to serve both Shoreditch and Bethnal Green Boroughs. During the year 275 bodies were received there and 262 post-mortem examinations were made. The arrangement for the use of the Mortuary by Shoreditch came into force when the Shoreditch mortuary was destroyed by enemy action. The arrangement provides that the Mortuary Attendant shall be employed and paid by the Shoreditch Borough Council and that the Bethnal Green Borough Council shall maintain the Mortuary premises and equipment. The Mortuary is not satisfactory in all respects. It is an old building which does not lend itself to easy modernisation and there is no provision for refrigeration. Proposals for alternative arrangements are under consideration. (15) Offensive Trades There are five premises in the Borough registered for the purpose of carrying on offensive trades. One being the business of a fur skin dresser and four poultry slaughterhouses. During the year, 88 visits of inspection were made to these premises. One premises previously licensed for the slaughter of cattle or horses has not been in use since 1939- (16) Pharmacy and Poisons Act, 1933 The provisions of the Act and the Poisons Rules relating to the sale of poisons specified in Part II of the Poisons List were administered during the year. During the year, the names of 56 persons (46 retentions and 10 new applications) were entered on the Council's list of Persons entitled to sell Part II Poisons. All applications are investigated to ensure compliance with the Act and Poisons Rules. (17) Rag Flock and Other Filling Materials Act, 1951 This Act provides for the licensing by the local authority of all premises used for the manufacture and/or storage of filling materials to which the Act applies, and for the registration of certain premises where such materials are used in upholstering, stuffing or lining of bedding, toys, baby carriages, etc. -25- There are no premises in the Borough where rag flock or other filling materials are manufactured but 40 premises are registered for the use of such materials in the trades conducted therein. During the year, one sample of rag flock and one sample of coir fibre were submitted for examination, both of which were reported by the prescribed analyst as satisfactory. (18) Pet Animals Act, 1951 This Act, which came into operation on the 1st April, 1952, provides for the regulation of the sale of animals. As from the operative date, no person may keep a pet shop except under the authority of a licence granted by the Borough Council and the Act lays down the conditions under which a licence is granted, which Include accommodation for the animals, the feeding thereof, their age at sale, steps to be taken in regard to infectious disease and in case of fire or other emergency. The Act prohibits the sale of animals as pets in any part of a street or public place except at a stall or barrow In a market and it prohibits the sale of pets to children under 12 years of age. The Act presented particular difficulties in this Borough because of the unique dog market in "Club Row" where trading in dogs on Sunday mornings had been carried on for a considerable number of years, particularly by persons parading in the market with one or more pet animals for sale. Notwithstanding all the difficulties, it was possible by means of posters, visits by the Sanitary Inspectors, and the excellent co-operation of the Police and the Royal Society for the Prevention of Cruelty to Animals to bring to the attention of all persons trading in the market the provisions of the Act and, in the maln^to prevent illegal trading and to improve conditions under which pet animals are sold. During the year, 20 licences were granted in respect of pet shops and 56 licences in respect of stalls. It was necessary on three occasions to take legal proceedings against offenders under the Act, the Magistrate inflicting fine and costs totalling £3.1s.0d. in one case, in another the defendant was discharged and in the third case it was not possible to effect service of the summons on the defendant. In addition, 40 warnings (33 written and 7 verbal) were given in connection with various infringements of the Act. -26- SECTION C HOUSING Clearance Areas (Section 25 Housing Act, 1936) During the year, as a result of official representations, or other Information, the Council declared the following areas to be clearance areas Type of Order made No. of Premises Included In Area Unfit Surrounded by or adjoining area and necessary for satisfactory development Arllne Street Area Compulsory Purchase Order 98 52 Ernest Place Area Clearance Order 8 Kirkwall Place Area Compulsory Purchase Orders 28 17 Columbia Road Area Clearance Orders 10 The Orders were in each instance confirmed by the Minister of Housing and Local Government and in the case of Arllne Street Area confirmation followed the holding of a local Inquiry. Other Areas Two further areas were surveyed during the year, namely, the Whitby Street Area and the Shacklewell Street Area, and reports were submitted to the Council. In the former, action under Section 11 of the Housing Act, 1936, was decided upon and, in the latter, the Council's views were forwarded to the London County Council as the premises were in a larger area being dealt with by that Authority. Demolition of Insanitary Houses (Section 11 Housing Act, 1936) As a result of official representations 3 Demolition Orders were made by the Council during the year, and one undertaking was accepted that premises would not be used for human habitation. Five premises were demolished as a result of Demolition Orders made previous to the year under review. -27- Closing of Unfit parts of Buildings (Section 12 Housing Act, 1936) Following official representations, 3 Closing Orders were made by the Council during the year prohibiting the use for human habitation of seven rooms - four of the rooms being underground rooms. Repair of Unfit Houses (Section 9 Housing Act, 1936) In the period prior to that covered by this Report, 197 notices were served requiring the person having control of a block of flats to execute specified works in order to render such premises fit for human habitation. The owner failed to comply with the notices and the Council itself decided to attend to the works. Difficulties arising from the owner's war damage claims delayed matters but a contract was entered into with a local builder in December, 1952, in respect of 73 of the premises and works were commenced on the 8th December, 1952. Section 9 of the Housing Act, 1936, is used extensively by some Councils and rarely, if ever, by others. Experience in this instance has been disappointing. It was unfortunate that war damage claims and repairs added very considerably to the unavoidable delays with the result that the work required by the Council only commenced some two years after the inspection of the premises and this fact led to further difficulties since, with the lapse of time, conditions in the premises had deteriorated. This method of obtaining repairs and maintenance of property throws a considerably greater amount of work on the Public Health Department and other departments of the Council than the more usual procedure under the Public Health (London) Act, 1936, and It would appear that whilst Section 9 procedure may have been very suitable in 1936 and may still be the method of choice in individual cases it is not generally satisfactory for dealing with present day conditions. Improvement of Houses (Housing Act, 1949) The conversion of 25 out-dated flats into 15 flats with modern amenities was completed during the year for the Peabody Donation Fund with financial assistance under Section 31 of the Act. -28- Overcrowdlng (Housing Act, 1936) Details of overcrowding In the Borough, and of cases where overcrowding was abated, are given below:- No. of cases On register at end of 1951 672 New cases reported during 1952 68 Total 740 Overcrowding abated during 1952 72 On register at end of 1952 668 Families Equiv. adults Rehoused by London County Council 44 212 Rehoused by Bethnal Green Borough Council 17 82 Rehoused privately 1 3 Removed from register:- No longer overcrowded by reason of altered circumstances 2 5 Removed, mostly without trace 8 32 Total 72 344 New Housing During the year new housing accommodation was provided as shown below:- Name of Premises Provided by:- No. of flats Goodrich House London County Council 17 Cleland House „ 17 Rosebery House „ 27 Priam House Conversion of playrooms „ 1 Achilles House „ 1 Ajax House „ 1 Hector House „ 1 Paris House „ 1 Sankey House „ 20 Pomeroy House „ 12 Sidney House „ 66 Chater House Borough Council 36 Margaret Bondfield House „ 9 Ayrton Gould House „ 45 219/221 Bethnal Green Road Private Owner 2 Total 256 -29- Houslng Statistics General details with regard to Inspection of dwelling houses are submitted in the following tabular form:- Total number of houses In the Borough 15,939 1. Inspection of Dwelllnghouses during the year:- (1)(a) Total number of dwelllnghouses Inspected for housing defects (under Public Health and Housing Acts) 4,270 (b) Number of inspections made for the purpose 14,211 (2)(a) Number of dwelllnghouses (included under subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 76 (b) Number of inspections made for the purpose 1.595 (3) Number of dwelllnghouses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 4 (4) Number of dwelllnghouses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 3,l48 2. Remedy of defects during the year without service of Formal Notices:- Number of dwelllnghouses rendered fit in consequence of informal action by the Local Authority or their Officers 828 3. Action under Statutory Powers during the Year:- (a) Proceedings under Public Health Acts:- (1) Number of dwelllnghouses in respect of which notices were served requiring defects to be remedied 2,434 (2) Number of dwelllnghouses in which defects were remedied after service of formal notice:- (i) By Owners 2,845 (11) By Local Authority in default of Owners 3 (b) Proceedings under Sections 9,10 and 16 of the Housing Act, 1936:- (1) Number of dwelllnghouses In respect of which notices were served requiring repairs (2) Number of dwelllnghouses which were rendered fit after service of formal notices:- (i) By Owners (ii) By Local Authority in default of Owners -30- (c) Proceedings under Section 11 and 13 of the Housing Act, 1936:- (1) Number of dwelllnghouses In respect of which Demolition Orders were made 4 (2) Number of dwelllnghouses demolished In pursuance of Demolition Orders 5 (d) Proceedings under Section 12 of the Housing Act, 1936:- (1) Number of rooms in separate tenements or underground rooms in respect of which Closing Orders were made 7 (2) Number of separate tenements or underground rooms In respect of which Closing Orders were determined, the tenement or room having been rendered fit (e) Proceedings under Section 25 of the Housing Act, 1936:- (1) Number of dwelllnghouses Included In Clearance Areas 52 (2) Number of dwelllnghouses demolished as a result of Clearance Area procedure Re-Housing Programme The following statement shows the number of families and persons accommodated by the Housing Committee to the 31st December, 1952:- Premises Families Persons Councll flats 108 108 316 Requisitioned properties 45 45 153 Total 153 153 469 At the end of the year there were approximately 2,690 applications for re-housing outstanding. -31- SECTION D INSPECTION AND SUPERVISION OF FOOD (a) Milk Supply (l) Inspection of Premises A total of 520 visits were made in 1952 to dairies and other premises in the Borough used in connection with the distribution of milk and in 31 instances appropriate action was taken to deal with unsatisfactory conditions which were found to exist. It was necessar on one occasion to take legal proceedings against the occupier of a milk premises for allowing refuse and filth to accumulate In the sho the Magistrate Inflicting fine and costs amounting to £15.5s.Od. (2) Registration and Licensing Details of premises on the register at the end of 1952 and the number of licences issued during the year under the Milk (Special Designation) Regulations, 19^9> are set out below:- Number of Premises on Register at end of year Dairies 17 Distributors (a) Inside the Borough 112 (b) Outside the Borough 23 Number of Licences Issued under Milk (Special Designation)(Pasteurised and Sterilised Milk) Regulations, 19^9, and Milk (Special Designation) (Raw Milk) Regulations, 1949 Sterilised Pasteurised Tuberculin Accredited Tested Dealers' Licences 121 79 33 11 Dealers' Supplementary Licences 21 18 17 1 Totals 142 97 50 12 One Dealer's (Pasteuriser's) Licence was Issued during the year and is included In above figures. -32- (3) Milk Sampling During 1952 a total of 18 formal and 77 Informal samples of milk were submitted to the Public Analyst for examination, all of which were reported as genuine. In addition, 100 samples of heat treated milk were submitted to tests, the result of which are set out in Table 6. TABLE 6 Class of Milk No. tested Phosphatase test Meth.Blue test Turbidity test Passed Failed Passed Failed Passed Failed Pasteurised 72 72 - 72 - - - Sterilised 28 - - - - 28 - Total 100 72 - 72 - 28 - 21 samples of milk were submitted to test for presence of chlorates as an indication of the efficiency of bottle washing. All were found to be free from same. (b) Meat and Other Foods Arising out of the 2,136 visits paid to shops, stalls and other premises where food is sold, prepared for sale or stored, a total of 83 notices were served in relation to unsatisfactory conditions found to exist in such premises within the Borough. It was necessary on one occasion to take legal proceedings against the occupier of a food premises for allowing refuse and filth to accumulate in the shop, the Magistrate inflicting fine and costs amounting to £10.5s.0d. In addition, legal proceedings were taken against a licensee of a public house for wilfully obstructing the Sampling Officer by refusing to serve him with whisky, for the purpose of analysis, from a bottle of whisky which was exposed for sale, the Magistrate Inflicting fine and costs amounting to £9. 6s. Od. Further details are given in the following table:- -33- TABLE 7 INSPECTION OF FOOD PREMISES Type and Number of Premises Inspections Notices Served Milkshops (129) 520 31 Poultry Slaughterers (4) 86 2 Butchers (50) 262 1 Fried Fish Shops (19) 53 1 Fish Curers (10) 22 - Public Houses (Licensed Premises) (135) 85 2 Restaurants (108) 301 11 Factory Canteens (19) 5 - Bakehouses (28) 96 10 Ice-Cream Premises (151) 369 16 Grocers (62) 106 4 Greengrocers (48) 46 3 Other Food Premises (63) 185 2 Total 2,136 83 In addition to the above, there are 168 street stalls from which food is sold. (c) Unsound Food During the year under review Food Inspectors examined and took appropriate action in relation to unsound food on 219 occasions. Details of the food together with quantities are set out below:- Description of Article Quantity Tons Cwts. lbs Continental Sausages 17 34 Meat - Tinned 16 83 " - Carcase 7 60 Vegetables 13 47 Dried Fruit 8 6 Confectionery 4 91½ Fish 2 70 Sugar 1 5 Chickens 83 Bacon 54½ Cheese 54 Various 53½ 3 13 81½ -34- Other Foodstuffs Baby Foods 2931 tins Fish 2151 tins, 20 jars Fruit 1384 tins, 29 jars Vegetables 349 tins Milk 280 tins Various 80 tins, 113 jars. 14 packets, 11 bottles Condemned Food is collected by Council and destroyed or, where suitable, used for animal food. (d) Food and Drugs Act Mr. A.E. Parkes, F.R.I.C., F.C.S., of l6l. Bow Road, E.3.,is Public Analyst for the Borough. During the year, the Council approved the appointment of Mr. H.A. Parkes, B.Sc., F.R.I.C.,.as Deputy Public Analyst. Out of a total of 360 samples (54 formal and 306 informal) examined by the Public Analyst during 1952, 4 of the formal samples and 6 of the informal samples were found to be adulterated. -35- TABLE 8 SUMMARY OF ANALYST'S REPORTS ARTICLE SAMPLES TAKEN FORMALLY SAMPLES TAKEN INFORMALLY Total number of samples taken No. taken Genuine Adulterated No. taken Genuine Adulterated Confectionery _ - - 21 21 - 21 Culinary Powders - - - 26 26 - 26 Drugs - - - 36 35 1 36 Flour - - - 11 11 - 11 Ice Cream 2 2 - 60 58 2 62 Milk 18 18 - 77 77 - 95 Vinegar 16 13 3 4 3 1 20 Whisky 12 11 1 - - - 12 Various 6 6 - 71 69 2 77 TOTAL 54 50 4 306 300 6 360 -36- TABLE 9 Action taken in regard to samples reported by the Public Analyst to be not genuine. Sample No. Article Result of Analysis Action Result 3 Bronchial Cough Lozenges 75 per cent mineral matter None. No more in stock - 55 Meat Soup 8 per cent deficient in meat None. No legal standard - 82 Meat Soup 20 per cent deficient in meat None. No legal standard - 163 Acetic Acid 47 per cent deficient in acid Formal Sample No. 174 - 174 Acetic Acid 47 per cent deficient in acid Legal proceedings Acquitted. £7-7-0 Costs against Manufacturer 198 Non-Brewed Condiment 7.5 per cent deficient in acetic acid Letter of caution "" 213 Ice Cream 44 per cent deficient in fat Formal Sample Genuine - 218 Ice Cream 17.5 per cent deficient in fat Formal Sample Genuine - 234 Non-Brewed Condiment 15 per cent deficient in acid Formal Sample Genuine - 357 Whisky 37.9 degrees under proof Legal Proceedings Absolute discharge. Costs £6.6.0 (e) Preservatives in Food The routine practice under which all samples of milk, butter, Jiargarine and cheese submitted to the Public Analyst, are examined for the presence of a preservative was continued throughout the year and in no instance was a preservative found to be present. -37- (f) Ice-Cream During the year, 27 applications for registration for the sale of ice-cream were approved. Three applications were refused on the grounds that other articles were being sold or handled in the shop which would increase the danger of contamination of the ice-cream and it was not possible or not practicable to place partitions in the shop or to use other means of avoiding this danger. The type of trade which commonly causes this difficulty is that of greengrocer where the handling of root vegetables unavoidably causes dirt and dust, and this is particularly so where a single shop assistant necessarily handles both commodities. At the end of the year there were 151 premises in the Borough registered for the sale of ice-cream and 369 inspections of these premises were made during the year. In 16 instances notices were served concerning insanitary conditions. 66 samples of ice-cream were submitted to the Methylene Blue test and graded as follows Grade 1 20 Grade 2 21 Grade 3 7 Grade 4 18 (g) Food Poisoning There were no outbreaks of food poisoning during the year. 6 (corrected) notifications were received, the Illness alleged to be due In one case to the consumption of a meat pie, a portion of which was submitted for bacteriological examination and reported satisfactory. In one case Salmonella typhi-murium was identified and in five cases the cause was unknown. There were no deaths. (h) Clean Food Campaign The efforts of the Department for an Improved standard of hygiene in all matters relating to the manufacture, handling, storage and distribution of food have continued throughout the year. Practically all the food premises in the Borough were visited and although it was necessary on 20 occasions to send notices under Section 13 of the Food and Drugs Act, 1938, it was possible through the co-operative relationship between the occupiers and the Department to secure many desirable improvements without recourse to official action. -38- In accordance with the recommendation of the Minister of Health, suitable notices requesting customers not to bring dogs into food shops, restaurants, etc., were distributed to most of such premises in the Borough and the occupiers requested to display the notices in their shops, (l) By-laws for the Protection of Food These By-laws made under Section 15 of the Food and Drug Act,1938, by the London County Council for securing the observance of sanitary and cleanly conditions and practices in connection with the handling, wrapping and delivery of food sold or intended for sale for human consumption, and in connection with the sale or exposure for sale in the open air of food Intended for human consumption, came into operation on the 3rd November, 1952. The occupants of all food premises, including stalls, in the Borough (numbering some 1,000 persons) were provided with a brief summary of the main provisions of the By-laws. This was followed by personal visits by the Food Inspectors to advise and discuss any special difficulties arising out of compliance with the By-laws. (J) Milk in Schools The arrangements for sampling milk at L.C.C. Schools continued without variation. A total of 36 samples were submitted for examination, all of which satisfied the prescribed tests. (k) Milk at Nurseries Three samples of milk submitted for examination passed the necessary tests. -39- SECTION E PREVALENCE OF, AMD CONTROL OVER, INFECTIOUS DISEASE The total number of notifications of infectious diseases during 1952 was 1,080 as compared with 2,063 in 1951- This reduction was due to the smaller number of cases of Measles and Whooping Cough although even during 1952 these two diseases accounted for more than 60# of the total notifications. Methods of control of Measles are at present unsatisfactory in that the material is scarce and expensive and it is impracticable to prevent or modify cases as a routine procedure. An attack gives protection against further attacks in the great majority of cases and the incidence of the disease in urban areas is modified mainly by the proportion of susceptible children in the population. It is consequently possible to give a forecast of the number of cases likely to occur but this can hardly be described as a method of control. Fortunately the majority of the serious consequences of Measles are due to secondary infections which can now be controlled by the sulphonamide group of drugs or antibiotics such as penicillin. Whooping Cough is almost equally difficult to control. Immunisation is advocated by many and whilst the results are by no means as sure or as effective as in the case of diphtheria immunisation there is considerable evidence that, if the disease is contracted, the attack is likely to be less serious. Whooping Cough, unlike most of the other common fevers, frequently attacks very young infants and the deaths from this disease occur very largely during the first year of life. In order to save life, immunisation must consequently be carried out at a very early age. This form of protection against Whooping Cough is not widely practised in Bethnal Green but it is anticipated that when a more effective Immunising agent is produced the procedure will become more popular. Two cases of Diphtheria occurred during the year and in both cases the patients recovered. This may be regarded as satisfactory when compared with the large numbers of cases and deaths before the War but it is by no means satisfactory when it is remembered that these two cases could have been prevented. The outstanding success of the diphtheria immunisation campaign during the past ten years with the diminishing number of cases and deaths has provoked such selfcongratulatory statements that the general public have lost the sense of urgency which was apparent some years ago. The attitude adopted by -40- many people is that whilst it is still a very good thing for their neighbours to have their children immunised, it does not matter so much as it did about their own children, especially if this may cause trouble or inconvenience. It cannot be stressed too strongly that whilst there is a large number of children unprotected against diphtheria there is a real danger, not merely of individual cases,but of a serious outbreak of the disease. In this connection, credit should be given to the officers of the London County Council who are mainly responsible for immunisation and who have increased the numbers of children immunised by approximately 10# over the numbers in the previous year. The number of cases of Scarlet Fever was larger than for the previous year, the majority of cases occurring in children of school age. The disease is now a very mild complaint and its character has entirely changed from the dangerous and often fatal type which was prevalent at the beginning of this century. Moreover, treatment with modern drugs is very effective and there was no indication that any case was of a serious nature during 1952. There were only two cases of Poliomyelitis during the year and in neither case was there any paralysis. The number of cases of other diseases notified is shown in Table 10, which follows, and requires no special comment. The arrangement whereby any variation in the original diagnosis is notified by the Hospital Authorities continued in operation during the year, and Table 10 which gives details of cases notified has again been prepared with a column showing the corrected figures for each disease after taking into consideration the latest information supplied by Hospitals. -41- TABLE 10 INFECTIOUS DISEASE DISEASE NOTIFICATIONS Total Notified Corrected figures Removed to Hospital Under 1 year 1-2 years 3-4 years 5-14 years 15-24 years 25-44 years 45-64 years 65 and upwards Diphtheria - 1 1 3 1 1 - . 7 2 7 Scarlet Fever 1 9 55 116 5 2 - - 188 185 75 Puerperal Pyrexia - - - _ 4 4 _ - 8 8 _ Ophthalmia Neonatorum 18 _ - - - _ _ - 18 18 - Erysipelas - _ - - - 3 11 4 18 18 11 Meningococcal Infection - _ - 1 3 - _ _ 4 1 4 Acute Poliomyelitis - - _ 1 1 - - - 2 2 2 Acute Pneumonia l l 3 2 1 6 11 7 32 32 10 Dysentery 3 12 19 12 3 5 4 - 58 55 10 Measles 19 65 217 250 2 5 - - 558 551 32 Whooping Cough 15 26 37 20 - - - - 98 95 20 Scabies - l _ 3 2 4 - - 10 10 - Pulmonary Tuberculosis - - - 4 21 32 10 4 71 71 - Other forms of Tuberculosis - - 1 - 3 3 1 - 8 8 - TOTAL 57 115 333 412 46 65 37 15 1080 1056 171 -42- Tuberculosis The Public Health (Tuberculosis) Regulations, 1952, came Into operation on the 1st May, 1952 and revoked the Public Health (Tuberculosis) Regulations, 1930, and made similar provision for the notification of tuberculosis modified to accord with the structure and administration of the services being provided under the National Health Service Acts. They provide for the notification to the Medical Officer of Health of all cases of tuberculosis arising in the Borough but no longer require him to keep a register of tuberculosis notifications although the Minister of Health urged that the Medical Officer of Health should continue to do so. The following Information concerning the Tuberculosis Dispensary at the London Chest Hospital, E.2., has been furnished by the Tuberculosis Officer, Dr. M. Caplin:- Tlmes of Clinics Monday 10.00 12.00 Wednesday 10.00 12.00 5.00 6.30 " 2.00 3.30 (Refills) Thursday 10.00 12.00 " 2.00 3.30 (Refills) Friday 10.00 12.00 " 1.30 2.30 (B.C.G.) Saturday 10.00 12.00 Patients requiring institutional treatment can be admitted to any of the sanatoria, or hospitals dealing with tuberculosis, under the North East Metropolitan Regional Hospital Board. In addition, patients with certain types of the disease can be admitted to the London Chest Hospital or to the Country Branch at Arlesey near Letchworth. Although the waiting period for admission has improved considerably, home treatment Is still carried out in a large number of cases during the period of waiting. This has helped considerably In initiating healing and preventing the spread of the disease, and so reduces the actual time spent in sanatorium. Whenever admission becomes a matter of emergency or urgency no real difficulty is encountered in arranging hospital admission. -43- During the year formal notifications under the Regulations were received in respect of 71 cases of respiratory tuberculosis and 8 non-respiratory cases as compared with 82 and 9 cases respectively for the previous year. The following table gives details of the age and sex Incidence of these cases:- TABLE 11 Primary Notifications Age periods 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total Respiratory males - - - 2 - 7 4 9 3 4 4 4 - 37 Respiratory females - - - 1 1 3 7 15 5 . 2 - _ 34 Non-respiratory, males - - 1 - - l 1 - - 1 - - - 4 Non-respiratory, females - - _ _ _ l _ 3 - _ - - - 4 In addition to the above, information was received of 35 other cases from the following sources Local Death Returns 4 Registrar General's Death Returns (transferable deaths) 4 Posthumous notifications Transfers from other areas 27 There were 21 deaths during the year certified as being due to Tuberculosis. -44- TABLE 12 The following table shows the number of cases on the Tuberculosis Register at the end of 1951, variations which have taken place during the year, and the number of cases remaining on the Register on the 31st December, 1952. Pulmonary Non-pulmonary Total Males Females Males Females No. of cases on register 31. 12. 51 381 298 77 71 827 No. of cases notified during 1952 37 34 4 4 79 Other cases added to register during 1952 14 10 1 2 27 Cases transferred from Nonpulmonary to Pulmonary - _ - - _ 432 342 82 77 933 No. of cases removed from register during 1952 44 53 10 9 116 Cases transferred to Pulmonary from Non-pulmonary - - - - - Remaining on register 31. 12. 52 388 289 72 68 817 Mass Radiography In connection with the national drive to combat Tuberculosis, Mobile X-Ray Units visit every possible area from time to time. During the year a Mobile Unit was based in the Borough and the following details of the resulting Survey have been furnished by the Medical Director of the Mass Radiography Unit 6b. Males Females Total Number of Attendances 2,285 1.722 4,007 Number passed as normal 2,150 1,649 3,799 Number with Inactive Tuberculosis 55 30 85 Number with Active Tuberculosis6 2 8 Number with other abnormalities 74 41 115 -45- There were thus 8 cases of active Pulmonary Tuberculosis disclosed by the Survey giving an Incidence rate of approximately 2 per 1,000 examinations made. This compares very favourably with the National figures for Mass Radiography which Is nearer 4 per 1,000. The Incidence was greater In the male than In the female examinees; the respective ratios being 2.62 and 1.10 per 1,000. All necessary action was taken at the time In respect of all cases, both tuberculous and non-tuberculous, requiring further medical attention. -46- SECTION F GENERAL PROVISION OF HEALTH SERVICES OTHER THAN THOSE PROVIDED BY THE BOROUGH COUNCIL 1. (a) Laboratory Facilities The bacteriological work of the Borough was carried out as part of the National scheme by the Public Health Laboratory Service (directed by the Medical Research Council for the Ministry of Health) at 134, Denmark Hill, S.E.5. (b) Ambulance Facilities The London County Council which undertook responsibility for the provision of ambulance transport within the administrative County of London on the coming Into force of the National Health Service Act, 19^6, continued to provide this service during 1952. 2. Hospitals The following Hospitals In the Borough continued to be administered by the North East Metropolitan Regional Hospital Board:- Total bed complement Bethnal Green Hospital 313 Mlldmay Mission Hospital 56 Queen Elizabeth Hospital for Children (with branches at Shadwell and Banstead) 317 These figures do not necessarily represent beds staffed and In use. The London Chest Hospital designated a Teaching Hospital and under the control of a Board of Governors, Is also situated within the Borough and the Tuberculosis Dispensary established at this Hospital, which serves Bethnal Green and part of the Borough of Hackney, continued to function during the year. The Little Folks Home at Bexhill, which is associated with the Queen Elizabeth Hospital for Children, has a complement of 40 beds. -47- 3 . Personal Health Services The following Information regarding the operation of the personal health services In the Borough during 1952 has been furnished by Dr. G.O. Mitchell, Divisional Medical Officer (Division 5) London. County Council. (a) Services Available Day Nurseries:- Columbia Market, Columbia Road, E.2. Prltchards Road, E.2. University House, Sugar Loaf Walk, E.2. Maternity and Child Welfare Centre Cornwall Avenue, E.2. School Treatment Centre:- Bethnal Green Treatment Centre Lyte Street, E.2. Bathing Centre:- Stewart Headlam Somerford Street, E.2. Chest Clinic:- London Chest Hospital E.2, (b) Statistics (1) Infant Welfare Centres. Total No. of children who first attended during the year and who on the date of their first attendance were:Under 1 year of age 757 1-5 years of age 133 Total No. of children who attended and who at the end of the year were:Under 1 year of age 621 1-5 years of age 781 -48- Total attendances by children:- Under 1 year of age 8,037 1-5 years of age 1,580 (2) Ante-natal and Post-natal clinics. Ante-natal consultations:- No. of women who attended for the first time 396 No. of women who attended 532 Total attendances 2,48l Post-natal consultations:- No. of women who attended 97 (3) Health Visitors No. of infants under one year of age visited for the first time 943 Total visits to Infants under 1 year of age 6,666 Total visits to children 1 to 5 years of age 7,489 No. of expectant mothers visited 348 Total visits to expectant mothers 626 (4) Infant Life Protection No. on register, 1st. Jan. 1952 Foster mothers 3 Foster children 2 No. on register, 31st Dec.1952 Foster mothers 2 Foster children 1 (5) Child Minders (Daily Guardians) No. of Daily Guardians - Statutory - Voluntary 11 No. of children minded - Statutory - Voluntary 8 (6) Care of Premature Infants No. of premature births during the year 72 No. of deaths under 1 month 14 -49- (7) Diphtheria Immunisation No. of children who completed a full course of primary immunisation:- Under 5 years of age 645 5 to 14 years of age 198 No. of children who were given a secondary or re-lnforclng Injection 823 (8) Vaccination No. of children successfully vaccinated or re-vacclnated 213 (9) Domestic Help Service Domestic help was provided as follows Maternity T.B. Other cases cases cases Northern District Office covering Bethnal Green and parts of Stepney and City of London 16 21 653