AC4366 PRO Region 5 BET 59 Metropolitan Borough of Bethnal Green ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1954 R. DUNCAN DEWAR, B.Sc., M B., Ch. B., D.P.H., Barrister-at-Law, Medical Officer of Health Metropolitan Borough of Bethnal Green ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1954 R. DUNCAN DEWAR, B.Sc., M B., Ch. B., D.P.H., Barrister-at-Law, Medical Officer of Health -2INDEX Page Public Health Committee 3 Staff 4 Statistics of the Area 8 Extracts from Vital Statistics 8 Causes of Death 11 Sanitary Circumstances of the Borough 13 Housing 26 Inspection and Supervision of Food 30 Prevalence of, and Control over, Infectious Disease 38 General Provision of Health Services other than those provided by the Borough Council 43 -3- METROPOLITAN BOROUGH OF BETHNAL GREEN PUBLIC HEALTH COMMITTEE Chairman: Councillor W.R. Johnson Vice-Chairman: Councillor P.A. Hart Alderman A.E. McAuliffe Councillor R.H. Hare " Mrs. B.L. Tate, L.C.C. " F.C. Newman Councillor J. Docherty " F.E. Sanders, J.P. " S. Duncombe " Mrs. A.M. Sivill " Miss E. Gilbert " L.J. Smith Ex-Officio- Members: The Worshipful the Mayor (Alderman H.P. Wilson, J.P.) Councillor G.M. Browne " C.F.F. Fleet " G.A. Hadley " A.C. Jacob " Miss D.W. Morshead " R.H. Rosamond " A. Stocks Council's Representatives on the London County Council (Division 5) Health Committee: Councillor F.E. Sanders, J.P. and Councillor Mrs. A.M. Sivill. -4- STAFF OF PUBLIC HEALTH DEPARTMENT Medical Officer of Health: R. DUNCAN DEWAR, B.Sc., M.B., Ch.B., D.P.H., Barrister-at-Law. Sanitary Inspectors Senior Sanitary Inspector: F.C. Sharpe ø m Senior Housing Inspector: and Deputy Senior Sanitary: Inspector: S.R. Slater ø m Housing Inspector: E.F. Swash ø Sampling Officer and Food: Inspector: G.E. Gould ø m District Inspectors: H.G. Avril ø : J.C. McManus 8 m : S.J. Cassldy ø m : L.G. James ø m : L.A. Folley ø m Administrative and Clerical Staff: Chief Clerk: J.E. Pestell Senior Clerk: S.A. Wright Assistant Clerks: R.F. Marshall : C.W. Foxton : J.J. Parker Junior Clerks: F.S. Frid (H.M. Forces) : Miss L. Driver Other Employees: Attendants 2 Disinfectors 4 Female Cleansing Attendant 1 Rodent Operatives 4 ø Certified Sanitary Inspector m Certified Meat, etc., Inspector -5- Public Health Department, Town Hall, BETHNAL GREEN, E.2. May, 1955. 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 1954. The summer of 1954 was generally cold and wet,but in spite of this there were less deaths than in the previous year and there was a reduction in the number of cases of notifiable infectious disease and from this point of view the year was satisfactory. The matter which probably aroused most public and press comment was the passing of the Housing Repairs and Rents Act of 1954. The Intention of the Act was to preserve existing houses in spite of the increased cost of repairs by allowing the owner to increase the rent in those cases where he had in fact carried out full and proper maintenance and at the same time to lay a duty on the local authority to make proposals for the demolition of all the "slum" properties within their area. Some proposals for slum clearance were submitted to the London County Council as a basis for the next five-year programme before the passing of the Act and further surveys were carried out towards the end of the year with a view to including all the remaining property in the Borough which should be dealt with under clearance procedure. It was anticipated that many owners might serve notices of increase of rent within a very short time of the Act coming into force and that there would consequently be a sudden and large demand for certificates of disrepair. This in fact did not happen, and the 150 or so applications for certificates of disrepair which were received in September were largely from the tenants of two sets of block dwellings where the owners had not fully appreciated their responsibility for putting the property into good repair nor had they appreciated that the issue of the certificate of disrepair would not only deprive them of the increased rent applied for but also of the 40% increase which had been allowed under previous Rent Acts. -6- Some owners and agents expressed the view that the procedure required to increase the rent is so complicated and hedged with difficulties that they were not intending to use the provisions of the Act for this purpose, but there is no doubt that the rents of a considerable number of properties have been raised either strictly in accordance with the Act or by a mutual arrangement between landlord and tenant. The number of applications for certificates of disrepair does not apparently form any basis for the estimation of the number of cases in which the rent has been raised. The Housing Repairs and Rents Act of 1954, does not appear to have been very successful in Bethnal Green in helping to preserve existing houses but this may be partly due to the fact that there is within the Borough a much higher proportion of houses which should be dealt with by demolition, rather than by preservation, than is to be found in other areas. Of the 17,000 inhabited dwellings at the end of 1954, some 2,500 were suitable for immediate demolition and there were many more which, being already about 100 years old, have only a very limited life. The worst living conditions are to be found in block dwellings and given a similar state of dilapidation and lack of amenity the family in a house is far happier than a family in a tenement dwelling or flat. It is consequently disappointing that during 1954 there were only proposals to build flats and no proposals for houses. It is appreciated that in order to maintain the necessary density to provide homes for Bethnal Green people in Bethnal Green, and for financial reasons, it is necessary that the majority of new dwellings must be flats, but it may well be that in the years to come it will be found that the mental ill-health of the inhabitants has increased. It is well known that a great deal of mental ill-health Is due to unsatisfactory family circumstances and the average flat is not the best place in which to bring up the average family. The work of the Public Health Department is summarised In the report which follows and the Divisional Medical Officer, Dr. G.O. Mitchell, has again kindly supplied me with some particulars of the personal health services which are, of course, the responsibility of the London County Council. -7- I would like to thank the Chairman and Members of the Public Health Committee for their encouragement and support throughout the year. I would also like to thank the Chief Officers of the Council and their staffs for their ready assistance and advice at all times and my own staff in particular for their very loyal help on every occasion. 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 55,530 Number of inhabited houses (at 31st December, 1954) 17,340 Rateable Value £446,579 General Plate 23s. 8d. Sum represented by a penny rate £1,777 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR Males Females Total Live Births: Legitimate 450 442 892 Illegitimate 22 29 51 Rate per 1,000 estimated population 17.0 Stillbirths: Legitimate 12 7 19 Illegitimate - - - Rate per 1,000 total (live and still) births 19.7 Deaths Death Rate per 1,000 estimated population 9.8 Deaths of Infants under one year of age - Legitimate 7 6 13 Illegitimate - 1 1 Death Rate of Infants under one year of age - All infants per 1,000 live births 14.8 Legitimate infants per 1,000 legitimate live births 14.3 Illegitimate infants per 1,000 illegitimate live births 19.6 During 1954, the population showed a natural increase of 396, that is that there were 396 more births than deaths, but in spite of this the Registrar General estimated that the number of persons resident in the Borough was 1,120 loss than in the previous year, showing that some fifteen hundred persons had been rehoused outside the Borough or left for other reasons. -9- The death rate was 9.8 per 1,000 persons as compared with a rate of 10.1 for 1953. Both births and deaths depend to some extent on the proportions of young and old people and of males and females in the area, and in order to make comparisons between one area and another the Registrar General gives Area Comparability Factors which take into account these variations in age and sex. Using this factor the adjusted death rate for Bethnal Green would be 10.4 as compared with 11.3 for England and Wales. The birth rate also showed a favourable trend during 1954, being 17.0 as compared with 15.9 during the previous year. The adjusted rate however still remains below the national level at 14.8 as compared with 15.2 for England and Wales. The infant mortality rate at 14.8 is only fractionally above the rate for the previous year and compares very favourably with the rate of 25.5 for England and Wales which is itself the lowest rate ever recorded in this country. It is, in Bethnal Green however, calculated on a very small number of infant deaths and is consequently subject to large variations from year to year and as an indication of child care the figure should bo used with some caution. The causes of death are shown in Table 1, which follows. There was a general reduction in the number of deaths but there was no significant change in the proportion of deaths attributable to any particular cause. 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 942 live births (470 male and 472 female) were notified and in addition there were 17 stillbirths (10 male and 7 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 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 the following year. -10T A B L E 1 CAUSES OF DEATH (See next page) -11- -12- TABLE 1 CAUSES OF DEATHS Causes of Death Under 1 1 to 5 5 to 15 15 to 25 25 to **5 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 7 7 _ 1 3 2 1 2 19 13 92 56 92 77 71+ 101 288 259 1 Tuberculosis, respiratory _ _ • - - - - 1 - 3 3 1 3 1 1 1 Y 7 2 Tuberculosis, other - - - - - - - - - - - - - - - - - - 3 Syphilitic disease - - - - - - - - - - - - - - - - - - 4 Diphtheria - - - - - - - - - - - - - - - - - - 5 Whooping Cough - - - - - - - - - - - - - - - - - - 6 Meningococcal infections - - - - - - - - - - - - - - - - - - 7 Acute Poliomyelitis - - - - - - - - - - - - - - - - - - 8 Measles - - - - - - - - - - - - - - - - - - 9 Other infective and narasitlc diseases - - - - - - _ _ - - - - - - - - - - 10 Malignant neoplasm, stomach - - - - - - - - - 1 5 2 4 4 - 2 9 9 11 Malignant neoplasm, lung, bronchus - - - - - - - - 1 - 13 2 10 2 4 1 28 5 12 Malignant neoplasm, breast - - - - - - - - - 1 1 6 - 4 - 1 1 12 13 Malignant neoplasm, uterus - - - - - - - - - - - 1 - - - 1 - 2 14 Other malignant and lymphatic neoplasms - - - - 1 1 _ _ 1 1 10 8 16 10 5 13 33 33 15 Leukaemia, aleukaemia - - - - - - - - - - - - - - - - - - l6 Diabetes - - - - - - - - - - - - - - - 4 - 4 17 Vascular lesions of nervous system - - - - - - - - 4 1 2 8 5 14 7 15 18 38 1 18 Coronary disease, angina - - - - - - - - 1 - 17 4 20 11 13 14 51 I 19 Hypertension with heart I _ disease - - - - - - - - 1 - 2 - 2 2 2 5 7 29 | 20 Other heart disease - - - - - - 1 - 1 2 8 4 9 4 11 17 30 7 1 21 Other circulatory disease - - - - - - - - - - 5 4 2 5 6 5 13 27 1 22 Influenza - - - - - - - - - - - - - - - - - 14 I 23 Pneumonia 2 1 - - - - - - 1 - 2 3 2 5 3 5 10 - I 24 Bronchitis - - - - 1 - - - - 2 9 4 7 5 9 5 26 14 1 25 other diseases of L resDlratory system - - - - - - - - - - 3 - 1 - - 2 4 16 1 26 Ulcer of stomach and I duodenum - - - - - - - - - - 3 - 4 1 1 3 8 2 I 27 Gastritis, enteritis and diarrhoea - - - - - - - - - - - - - 1 1 - 1 4 I 28 Nephritis and nephrosis - - - - - - - - - - 1 1 - 2 - 1 1 1 29 Hyperplasia of prostate - - - - - - - - - - - - 1 - 3 - 4 4 I 30 Pregnancy, childbirth, I abortion - - - - - - - - - - - - - - - - - - I 31 Congenital malformations 1 1 - - - - - - - 1 - - 1 - - 1 2 3 1 32 Other defined and ill-defined diseases 4 4 - - 1 - - 1 4 1 5 7 4 3 7 2 25 18 1 33 Motor vehicle accidents - - - 1 - - - - - - - - - 1 1 1 2 1 34 All other accidents - 1 - - - - - - 1 - 2 - 1 - - 2 4 3 1 35 Suicide - - - - - - - - 4 - 1 1 - 3 - - 5 4 1 lo Homicide and operations of war - - - - - 1 - - - - - - - - - - - 1 -13- SECTION B SANITARY CIRCUMSTANCES OF THE BOROUGH (1) Water Supply Water for domestic purposes in the Borough is obtained in all cases from the Metropolitan Water Board. i Bacteriological and chemical examination of the water is carried out at frequent intervals by the Metropolitan Water Board. The results of examination are available to the local authority and they were uniformly satisfactory during 1954. There has been no evidence that the water has a plumbo-solvent action. Notices were sent to the Board in 39 cases where wastage of water due to defective pipes or fittings was observed. During the year 184- new premises were certified as having a proper and sufficient water supply in accordance with Section 95 of the Public Health (London) Act, 1936. In addition to the supply from the Metropolitan Water Board, there are five wells used for purposes other than drinking. These are:- Attached to Council's Public Baths 1 Attached to a hospital 1 Supplementary supply for industrial purposes 3 (2) Sanitary Inspection of the Borough The Borough was divided into five sanitary inspectors'districts and Table 2, which follows, gives a summary of the work of the Inspectors. The major portion of the work was concerned with insanitary conditions. Following the 2,627 complaints of insanitary conditions sanitary defects were found requiring the service of Intimation Notices in 1,878 cases. Of these statutory notices were required in 685 instances and legal proceedings were instituted in 50 cases. The main types of defects found are shown in Table.3. In connection with the supervision of drainage works, a total of 2,417 inspections were made during the year. Fourteen notices were served under Section 40 of the Public Health (London) Act, 1936, and in one instance the necessary work was carried out by the Council, the expenses incurred being recovered from the owner of the property. -14- TABLE 2 RECORD OF VISITS Notifiable Infectious Diseases 402 Non-notifiable diseases 7 Food Poisoning 6 Complaints as to insanitary conditions 2,627 Aged and Infirm persons 29 Factories 686 Milkshops 640 Other Food premises 2,239 Outworkers' houses 279 Tenement houses 165 Drainage work 2,417 Smoke observations 13 Enquiries with regard to housing 2,571 Other inspections and special work 2,507 Re-Inspections 7,905 Total 22,491 -15- (3) Supply of Dustbins The London County Council (General Powers) Act, 1954, came Into operation during the year and Section 12 of this Act removed the doubt as to whether notices requiring the provision of dustbins were to be served either on the owner or the occupier of a house and provided that in all cases they were to be served on the owner. The owner having right of appeal to a court of summary Jurisdiction on the ground that the obligation ought to fall upon the occupier of the house. In the majority of cases an informal letter to the owner has been sufficient to obtain the provision 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 £1, which is somewhat less than the price charged by private traders. In 26 cases during the year notices were served upon the owner in accordance with Section 12 of the London County Council (General Powers) Act, 1954, 15 notices being served under Section 105 of the Public Health (London) Act, 1936, prior to the coming into operation of the London County Council (General Powers) Act, 1954. In no Instance was an appeal lodged. (4) Legal Proceedings It was found necessary on 50 occasions during the year to take legal proceedings to enforce compliance with the requirements of Notices served. In 9 of these cases Abatement Orders were made by the Justices with the infliction of costs amounting to £23.12s.6d. Brief details are set out below. Abatement Orders Premises Offence Result of Proceedings 4, Kerbela Street Non-compliance with Abatement Order made Nuisance Notice (28 days) £2.12.6 costs 2, Code Street do. do. do. 22, Cranberry Street do. do. do. 33, Hollybush Gardens do. do. do. 6l, Driffield Road do. do. do. 167, Vallance Road do. do. do. 22, Code Street do. Abatement Order made (14 days) £2.12.6 costs 10, Sheldon Place do. do. do. 15, Delamere Buildings do. do. do. -16- In the case of 4, Kerbela Street a further summons was taken out for non-compliance with Abatement Order, when the Justices Imposed £5 fine and £2.12s.6d. costs were awarded to the Council. Closing Orders were granted by the Justices in respect of 254, Cambridge Heath Road and 9, Weaver Street. In 38 cases summonses were withdrawn owing to the nuisances being abated prior to the date of hearing, the defendants paying expenses amounting to £58.5s.6d. (5) Housing Repairs and Rents Act, 1954 Details of applications received in accordance with Part II of the Housing Repairs and Rents Act, 1954, for the period 30th August, 1954. to the end of the year, arc as follows:- -17- No.of applications for certificates No.granted No.refused No.of applications for revocation of certificates* No.granted No.refused (a) Dwelling-houses which have been the subject of a notice of repairs increase of rent 187 17^ 2 3 2 under Part II of the 1954 Act. (b) Dwelling-houses which have not been the subject of a notice of repairs increase of rent under the 1954 Act but in respect of which permitted 13 12 - - increases of rent are recoverable under section 2(1) (c) and (d) of the Increase of Rent and Mortgage Interest (Restrictions) Act, 1920. * Including applications for revocation of sanitary certificates issued under the pre-1954 Act procedure but still in force at 30th August, 1954. -18- During the year under review and prior to the coming Into operation of the above Act, 6 certificates of disrepair were Issued to tenants and 3 certificates of fitness were granted to owners under the Rent Acts. (6) Swimming Baths 24 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 1,475 and a total of 755 inspections and relnspectlons were made during the year. 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 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 631 274 30 - 2. Factories not Included in (1) In which Section 7 is enforced by the Local Authority 841 478 81 1 3. Other premises in which Section 7 is enforced by the Local Authority 3 3 1 - TOTALS 1,475 755 112 1 Factories Act, 1937 Legal proceedings were taken against the occupiers of a factory in respect of sanitary convenience having communication with workroom without intervening ventilated space, when the defendants were discharged conditionally and £5.5s.0d. costs were awarded to the Council. -20- TABLE 5 CASES IN WHICH DEFECTS WERE FOUND 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 30 51 - 2 - Overcrowding - - - - - Unreasonable temperature - - - - - Inadequate ventilation 2 4 1 - - Ineffective drainage of floors - - - - - Sanitary conveniences:- (a) Insufficient - 3 - - - (b) Unsuitable or defective 205 167 - 9 - (c) Not separate for sexes 4 6 - 3 - Other offences against the Acts (not including offences relating to outwork) 100 91 2 2 1 TOTALS 341 322 3 16 1 -21- OUTWORK SECTION 110 No. of Outworkers In August list required by Section 110 (1) (c) Wearing apparel (Making, etc. Cleaning and washing) 167 Curtains and Furniture hangings 29 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 30 Artificial flowers, Brushes, etc. 10 Cosaques, Christmas crackers, Christmas stockings, etc. 13 Total 249 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 249 visits to shops in relation to general sanitation, ventilation and temperature requirements. 28 notices were served in respect of unsatisfactory conditions found to exist. (9) Disinfection and Dlsinfesr-atlon The following is a summary of the routine work carried out by the disinfecting staff during the year:- Nq. of rooms dlsinfested 700 Articles of clothing, bedding, etc., submitted to steam disinfection 2,305 Articles disinfected by formalin 616,758 Hospital mattresses, pillows, etc., disinfected 4,313 Number of articles destroyed by request 839 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 and bedding of 70 families removing to Borough Council flats were dlsinfested. -22- (10) Personal Cleansing Station During the year, 21 adults and 1 child had baths for verminous conditions at the Personal Cleansing Station, simultaneous disinfection of clothing being cabled out. The majority of adults concerned were men from a Common Lodging House. In addition, 11 adults and 4 children received treatment for Scabies at the Station. Sanitary Inspectors visit and advise in all cases of Scabies and in those cases where veruinous conditions persistently recur. During the year the mobile bathing equipment for the cleansing, by consent, of aged persons in their own homes where the persons concerned are so enfeebled as not to be able to attend at the Personal Cleansing Station was used on eight occasions. (11) Prevention of Damage by Posts Act, 1949 During the year, 189 complaints of infestation by rats or mice were received and in most cases smoke tests of the drainage of the premises affected were carried cut by the Drainage Staff under the supervision of the Sanitary Inspectors. One notice under section 4(1) of the Act was served. Systematic baiting and poisoning was carried out by the Rodent Operatives on 4l2 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 1,268 manholes. Positive results were obtained in 540 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 maji make an order for the removal of ill, infirm or incapacitated persons who are not receiving proper care and attention. -23- Whllst 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. 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 eases 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. In some cases it was possible to arrange voluntary admission to hospital or other suitable place. In a few Instances arrangements were made for adequate care to be provided by friends or relatives. In no instances was it necessary 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, 10 burials were arranged by the Department at a cost of £77. 9s. 6d. of which £45. 1s. 10d. was recovered up to the end of the year, and a further £2. 3s. 6d. in respect of burials carried out before the period under review. (14) Mortuary During the year, an arrangement between the boroughs of Poplar, Shoreditch and Bethnal Green came into operation whereby the Poplar Mortuary became the main mortuary for use by the three boroughs with the Bethnal Green Mortuary being maintained as a reserve for use in emergencies. This arrangement is working most satisfactorily. The number of Bethnal Green bodies received at the Poplar Mortuary was 121. 121 post-mortems were carried out and 18 inquests held. -24- (15) Offensive Trades There are five premises in the Borough registered for the purpose of carrying on offensive trades. One being the business of fur skin dresser, three poultry slaughterhouses and one animal slaughterhouse, which had not been in use since 1939, had its licence renewed during the year. 73 visits of inspection were made to these premises. (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 1954, the names of 50 persons (47 retentions and 3 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. Six samples of disinfectants were taken during the year following upon information from the Medical Superintendent of a local hospital that several young children had recently been brought to his hospital with symptoms of poisoning caused by drinking disinfectant. The Public Analyst reported these disinfectants to contain from 2 to 4 per cent Chloroxylenols in soap solution and that, although labelled "non-poisonous", they would cause illness if taken internally by a child or adult. Owing to the attractive appearance of these disinfectant fluids the Ministry of Health was informed of the Public Analyst's report and. that it would not appear unreasonable to have the warning "Not to be taken" added to the labels. The matter was duly taken up by the Ministry of Health with the British Disinfectant Manufacturers' Association. (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 43 premises are registered for the use of such materials in the trades conducted therein. (18) Pet Animals Act, 1951 The operation of this Act Is probably of more importance in Bethnal Greon than in any other London borough on account of the Sunday morning dog market which has been held in Bethnal Green for many years and which serves both vendors and purchasers throughout the whole of the County of London and even beyond. The conditions under which all pet animals are sold have improved very much indeed since the Act was introduced. During the year 21 licences were granted in respect of shops and 58 licences in respect of stalls. Two summonses were taken out against offenders under the Act. In one case the Magistrate imposed £4 fine and £l.ls.0d. costs, and the other case was dismissed. Also three warning letters were sent in connection with various infringements of the Act. -26- SECTION C HOUSING Clearance Areas (Sec. 25 Housing Act, 1936) Areas which were represented or were the subject of Public Inquiry during the year were as follows:- Claredale Street (Bethnal Green Borough Council) Arllne Street (No.2) (" " " " ) Peel Grove (" " " ") Viaduct Street (London County Council) Satchwell Road ( " " " ) Following the survey made In 1951, a further survey of unfit premises was made during 1954, and eleven areas involving 491 premises were found to be suitable for representation during the 1956-60 period. Detailed reports on each area were submitted, together with maps, and recommendations were made in regard to order of priority for each area. The areas concerned covered 15½ acres containing 634 families and consisting of 2,107 persons. Repair of Unfit Houses (Sec. 9 Housing Act, 1936) Informal action was taken in regard to a number of premises, including a block of flats, which required specified works to be carried out to render the premises fit for human habitation. The owners co-operated in carrying out the repairs and so avoided the necessity of formal action having to be taken. Demolition of Insanitary Houses (Sec. 11 Housing Act, 1936) Four premises were demolished as a result of Demolition Orders made previous to the year under review. Having regard to the effect of demolition upon adjoining property, Closing Orders were made upon four premises in accordance with Section 10 of the Local Government (Miscellaneous Provisions) Act, 1953, in lieu of making Demolition Orders under Section 11 of the Housing Act, 1936. Closing of Unfit parts of Buildings (Sec.12 Housing Act, 1936) Following official representation one Closing Order was made during the year prohibiting the use for human habitation of a basement room in a block of flats. -27- Overcrowding (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 1953 651 New cases reported during 1954 63 Total 714 Overcrowding abated during 1954 100 On register at end of 1954 6l4 Families Equiv. Adults Rehoused by London County Council 33 158½ Rehoused by Bethnal Green Borough Council 19 114½ Removed from register:- No longer overcrowded by reason of altered circumstances 1 5½ Removed, mostly without trace 47 225½ Total 100 504 In addition, three cases recommended on health grounds were re-housed. New Housing During the year new housing accommodation was provided as shown below:- Name of Premises Provided by No.of flats Minister's House, Pott Street Private 1 No.13, Victoria Park Square do. 5 Mark House London County Council 60 Monkbretton House do. 8 Hume House do. 8 Beckwith House do. 12 Taplow Buildings (reconstructed) do. 30 School House, Teesdale Street do. 1 Barnes House do. 34 Susan Lawrence House Borough Council 9 William Fenn House do. 16 Total 184 -28- Housing Statistics General details with regards to inspection of dwelling houses are submitted in the following tabular form:- Total number of houses in the Borough 17,340 1. Inspection of Dwellinghouses during the year:- (1)(a) Total number of dwellinghouses inspected for housing defects (under Public Health and Housing Acts) 4,922 (b) Number of inspections made for the purpose 13,104 (2)(a) Number of dwellinghouses (included under subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 486 (b) Number of inspections made for the purpose 2,070 (3) Number of dwellinghouses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 11 (4) Number of dwellinghouses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 2,806 2. Remedy of defects during the year without service of Formal Notices:- Number of dwellinghouses rendered fit in consequence of informal action by the Local Authority or their Officers 858 3. Action under Statutory Powers during the Year:- (a) Proceedings under Public Health Acts:- (1) Number of dwellinghouses in respect of which notices were served requiring defects to be remedied 1,933 2) Number of dwellinghouses in which defects were remedied after service of formal notice:- (1) By Owners 572 (ii) By Local Authority in default of Owners 1 (b) Proceedings under Section 9, 10 and 16 of the Housing Act, 1936:- (1) Number of dwellinghouses in respect of which notices were served requiring repairs (2) Number of dwellinghouses which were rendered fit after service of formal notices:- (i) By Owners - (ii) By Local Authority in default of Owners 126 -29- (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936:- (1) Number of dwellinghouses in respect of which Demolition Orders were made - (2) Number of dwellinghouses demolished in pursuance of Demolition Orders 4 (3) Number of houses closed (Local Government (Miscellaneous Provisions) Act, 1953)4 (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 1 (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 dwellinghouses included in Clearance Areas 213 (2) Number of dwellinghouses demolished as a result of Clearance Area procedure 105 Re-Housing Programme The following statement shows the number of families and persons accommodated by the Housing Committee to the 31st December, 1954:- Premises Families Persons Council flats 70 70 279 Requisitioned properties 53 53 166 Total 123 123 445 At the end of the year there were approximately 2,472 applications for re-housing outstanding. -30- SECTI0N D INSPECTION AND SUPERVISION OF FOOD (a) Milk Supply (1) Inspection of Premises A total of 46l visits were made in 1954, to dairies and other premises in the Borough used in connection with the distribution of milk and in 24 instances appropriate action was taken to deal with unsatisfactory conditions which were found to exist. (2) Registration and Licensing Details of premises on the register at the end of 1954 and the number of licences issued during the year under the Milk (Special Designation) Regulations, 1949, are set out below:- Number of Premises on Register at end of year Dairies 15 Distributors:- (a) Inside the Borough 117 (b) Outside the Borough 28 Number of Licenees isaued under Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations. 1949. and Milk (Special Designation) (Raw Milk) Regulations. 1949 Sterilised Pasteurised Tuberculin Accredited* Tested Dealers' Licences 123 79 35 15 Dealers' Supplementary Licences 28 24 22 2 Totals 151 103 57 17 * Designation not applicable after 1.10.54. -31- (3) Milk Sampling During 1954, 56 informal samples of milk were submitted to the Public Analyst for examination, all of which were reported as genuine, In addition, 63 samples of heat treated milk were submitted to tests, the results of which are set out in Table 6. TABLE 6 Class of Milk No. tested Phosphatase test Methylene Blue test Turbidity test Passed Failed Passed Failed Void Passed Failed Pasteurised 48 46 2 41 1 6 - - Sterilised 13 - - - - 13 - Tuberculin Tested (Pasteurised) 2 2 - 2 - - - - Total 63 48 2 43 1 6 13 - 27 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 2,495 visits paid to shops, stalls and other premises where food is sold, prepared for sale or stored, a total of 238 notices were served in relation to unsatisfactory conditions found to exist in such premises within the Borough. Further details are given in the following table;- -32- TABLE 7 INSPECTION OF FOOD PREMISES Type Number in Borough Number Registered Inspections Notices Served Ice Cream 165 165 526 11 Milkshops and Dairies 132 132 46l 24 Butchers 48 41 288 4 Fried Fish Shops 14 14 53 1 Fish Curers 9 8 36 4 Eel and Pie Shops 9 8 31 1 Miscellaneous 24 6 74 4 Offal Dealers 5 5 16 5 Other Fish Premises 9 2 35 4 Restaurants 99 - 220 71 Licensed Premises 140 - 148 26 Greengrocers 58 - 73 18 Grocers 47 - 100 22 Bakehouses 27 - 76 29 Confectioners 36 - 46 8 Factory Canteens 30 - 25 2 Bakers' Shops 10 - 21 3 Poultry Slaughterhouses 3 - 60 - Cattle 1 - 11 - Street Stalls 221 - 195 1 Totals 1,087 381 2,495 238 (c) Unsound Pood During the year under review the Food Inspector examined and took appropriate action in relation to unsound food on 140 occasions. Details of the food together with quantities are set out below:- Tons Quantity Cwts. lbs. Continental Sausages 4 7 59 Polish Sauerkraut 1 10 - Meat - Tinned 16 110 " - Carcase 15 37¾ Italian Gherkins 2 106 Frozen Eggs 2 54 Fish 1 70 Bacon 1 12 Various 34½ 7 18 35¼ -33- Other Foodstuffs Prunes in Syrup 1,488 tins Fruit 496 tins Vegetables 92 tins, 8 Jars Milk 64 tins Fish 21 tins, 3 boxes Various 15 tins, 1 bottle Meat Pies 14 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 and Mr. H.A. Parkes, B.Sc., F.R.I.C., is Deputy Public Analyst. Out of a total of 316 samples (11 formal and 305 informal) examined by the Public Analyst during 1954, 9 of the informal samples were found to be adulterated. 34 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 1 Adulterated Ale and Beer - - - 16 16 - 16 Culinary Powders - - - 29 29 - 29 Drugs - - - 22 22 - 22 Ice Cream - - - 16 15 1 16 Meat and Fish Paste - - - 14 14 - 14 Milk - - - 56 56 - 56 Sweet Confectionery - - - 16 15 1 16 Whisky 11 11 - - - - 11 Various - - - 136 129 7 136 TOTAL 11 11 - 305 296 9 316 -35- TABLE 9 Action taken in regard to samples reported by the Public Analyst to be not genuine Sample No. Article Result of Analysis Action 53 Diluted Acetic Incorrectly labelled Letter of caution 69 Garden Mint in Vinegar Growth of mould on surface Sales withdrawn 128 Butterscotch 2.15 per cent deficient in butter-fat Letter of caution 130 Haricot Beans Infested with weevil Stock destroyed 152 Oranges Contained 10 parts per million of thiourea Letter of caution 186 Shredded Suet 1.0 per cent deficient in fat Letter of caution 206 Thyme Contained an excessive amount of sand, viz. 7.2 per cent Letter of caution 216 Meat Pie Inside of pie covered with growth of mould Remaining stock surrendered 249 Ice Cream 2.0 per cent deficient in fat Letter of caution (e) Preservatives in Food The routine practice under which all samples of milk, butter, margarine 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. -36- (f) Ice-Cream During the year, 27 applications for registration for the sale of ice-cream were approved and 28 premises were removed from the register upon ceasing the sale of ice-cream. On one occasion a summons was taken out against a retailer for selling ice-cream at premises not registered for that purpose, and was withdrawn on payment by the defendant of £l.lls.6d. expenses. At the end of the year there were 165 premises in the Borough registered for the sale of ice-cream and 526 inspections of these premises were made during the year. In 11 instances notices were served concerning insanitary conditions. 20 samples of ice-cream were submitted to the Methylene Blue test and graded as follows:-. Grade 1 12 Grade 2 8 (g) Food Poisoning Ten (corrected) notifications were received. There was one family outbreak of Food Poisoning during the year and in each of the six cases concerned Salmonella typhi-murium was identified: this agent was also found in three other cases notified and in one further case the cause was unknown. Foods suspected included soup, fried fish, beef fat and bacon, but in no case was any portion of suspected food available for bacteriological examination. 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 were intensified, as a result of the reorganisation of the work of the sanitary inspectors during the year. Although many desirable improvements were obtained without recourse to official action, it was necessary on 134 occasions to serve notices under Section 13 of the Food and Drugs Act, 1938, 103 notices being served on occupiers and 31 on owners of food premises. On two occasions legal proceedings were taken in respect of dirty conditions at food premises. In one case fines amounting to £25 with £2.12s.6d. costs were inflicted, and in the other case fines amounting to £6 with £2.12s.6d. costs. -37- During the year, the attention of the Council was directed to the basically unsuitable practice of the sale of foodstuffs from footway stalls outside shop premises in the Borough and was recommended, after reasonable warning had been given to the shopkeepers concerned, not to renew street trading footway licences for the sale of foodstuffs. The Council has decided that current footway licences for the sale of meat and such other unwrapped foodstuffs as are not usually cleansed by the purchaser prior to consumption will not be renewed on expiration in December, 1955. (i) Milk in Schools The arrangements for sampling milk at London County Council Schools continued without variation. A total of 17 samples were submitted for examination, all of which satisfied the prescribed tests with the exception of two samples which failed to pass the Phosphatase test for heat treated milk. (j) Milk at Nurseries Three samples of milk submitted for examination passed the necessary tests. -38- SECTION E PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASE The total number of notifications of infectious disease during 1954 was 624 as compared with 1,229 in 1953. The decrease was mainly due to the smaller number of cases of measles and whooping cough. These two diseases accounted for more than 68% of all notifications. There were no cases of diphtheria during the year. It should be remembered that during the 10 years before the war, when there was little or no immunisation carried out, the average number of cases per year was well over 300. If immunisation Is not maintained a recurrence of this disease on the previous scale could happen. The greater part of the actual immunisation of infants and school children is carried out by officers of the London County Council and details of the work done is given in Section F of this report. Five cases of suspected poliomyelitis were notified during the year and in three cases the diagnosis was confirmed. 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. Contacts or Carriers of Infectious Disease - Sickness Benefit Circular 115/48 of the Ministry of Health empowers the Medical Officer of Health to issue certificates to persons who have been in contact with or who are carriers of infectious disease, thus enabling them to claim sickness benefit under the National Insurance Acts, when he deems it necessary to exclude such persons from work. It is only exceptionally that it is necessary to require a contact or carrier of infectious disease to stay away from work and during the year under review only two certificates were issued. -39- TABLE 10 INFECTIOUS DISEASE DISEASE 0-1 year NOTIFICATIONS Total notified Corrected figures Removed to Hospital 1-2 years 3 - 4 years 5-14 years 15-24 years 25-44 years 45-64 years 65 - years Diphtheria - - 1 1 - - _ _ 2 - 2 Scarlet Fever - 5 11 18 2 1 - - 37 35 13 Puerperal Pyrexia - - - - - 2 - - 2 2 - Ophthalmia Neonatorum 9 - - - - - - - 9 9 2 Erysipelas - - - - - 3 2 2 7 6 3 Meningococcal Infection l - - - - - - - 1 1 1 Acute Poliomyelitis - l 3 - 1 - - - 5 3 5 Acute Pneumonia - - - - - 1 1 - 2 2 - Dysentery l 12 10 10 5 7 1 1 47 43 12 Measles 14 71 115 138 2 - - - 340 337 29 Whooping Cough 11 21 22 34 - 1 - - 89 88 10 Scabies - 1 1 3 2 3 1 - 11 11 - Pulmonary Tuberculosis - 2 - 4 13 19 20 6 64 64 - Meninges and C.N.S. - - - - 1 - - - 1 1 - Other forms - - - - 3 2 2 - 7 7 - TOTALS 36 113 163 208 29 39 27 9 624 609 77 In addition to the above, four notifications of Malaria were received: the disease had occurred in National Servicemen recently returned from abroad where the disease was stated to have been contracted. -40- Tuberculosis During the year formal notifications under the Public Health (Tuberculosis) Regulations, 1952, were received in respect of 64 cases of respiratory tuberculosis and 8 non-respiratory cases, as compared with 64 and 4 cases respectively far the previous year. The following table gives details of the age and sex incidence of these eases:- TABLE 11 Primary Notifications Age periods 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total Respiratory males - 2 - 1 l 3 1 7 1 10 6 3 - 35 Respiratory females - - - - 2 3 6 10 1 2 2 2 l 29 Non-respiratory, males - - - - - - 2 - 1 - 1 - - 4 Non-respiratory, females - - - - - - 2 1 - 1 - - - 4 In addition to the above, information was received of 32 other cases from the following sources:- Local Death Returns 1 Registrar General's Death Returns (transferable deaths) Posthumous notifications Transfers from other areas 31 There were 14 deaths during the year certified as being due to Tuberculosis. -41- TABLE 12 The following table shows the number of cases on the Tuberculosis Register at the end of 1953. variations which have taken place during the year, and the number of cases remaining on the Register on the 31st December, 1954. Pulmonary Non-Pulmonary Total Males Females Males Females No. of cases on register 31. 12. 53 405 302 71 68 846 No. of cases notified during 1954 35 29 4 4 72 Other cases added to register during 1954 15 13 1 2 31 Cases transferred from Nonpulmonary to Pulmonary - - - - - 455 344 76 74 949 No. of cases removed from register during 1954 44 32 6 4 86 Cases transferred to Pulmonary from Non-pulmonary - - - - - Remaining on register 31. 12. 54 411 312 70 70 863 The following Information concerning the Tuberculosis Dispensary at the London Chest Hospital, E.2., has been furnished by the Tuberculosis Officer, Dr. M. Caplin:- Times 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 -42- 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. During the year,46½ pint tins of disinfectant were issued to tuberculous persons for use in sputum flasks and for the soaking of handkerchiefs. -43- 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 the laboratory, Room 617, County Hall, S.E.I. (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, 1946, continued to provide this service during 1954. 2. Hospitals The following Hospitals in the Borough continued to be administered by the North East Metropolitan Regional Hospital Board:- Total bed complement ø Bethnal Green Hospital 310 Mildmay Mission Hospital 56 Queen Elizabeth Hospital for Children (with branches at Shadwell and Banstead) 287 ø 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. -44- 3. Personal Health Services The following Information regarding the operation of the personal health services in the Borough during 1954, 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. Pritchards Road, E.2. University House, Sugar Loaf Walk, E.2. Maternity and Child Welfare Centre, Cornwall Avenue, E.2. (Services transferred to the Greenwood Maternity and Child Welfare Centre, Peel Grove, E.2. (adjoining Town Hall), April, 1955) School Treatment Centres:- Bethnal Green School Treatment Centre, Lyte Street, E.2. Rochelle Street Treatment Centre, Rochelle Street School, E.2. Foot Clinic:- Bethnal Green School Treatment Centre, Lyte Street, E.2. Monday and Tuesday afternoons - 2-5 p.m. (b) Statistics (1) Infant Welfare Centre 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 662 1-5 years of age 124 Total No. of children who attended and who were born in:- (i) 1954 612 (ii) 1953 347 (iii) 1952-49 346 Total attendances by children:- Under 1 year of age 6,987 1-5 years of age 1,235 -45- (2) Ante-natal and Post—natal clinics Ante-natal consultations:- No. of women who attended for the first time 376 No. of women who attended 474 Total attendances 2,248 Post-natal consultations:- No. of women who attended 115 (3) Health Visitors No. of infants under one year of age visited for the first time 908 Total visits to children under 1 year of age 6,065 Total visits to children aged 1 year but under the age of 2 years 3,405 Total visits to children aged over 2 years but under 5 years 6,389 No. of expectant mothers visited 465 Total visits to expectant mothers 899 (4) Infant Life Protection No. on register, 1st January, 1954 Poster mothers 1 Poster children 1 No. on register, 31st December, 1954 Poster mothers 3 Foster children 3 (5) Child Minders (Daily Guardians) No. of Child Minders - Statutory - Voluntary 26 No. of children minded - Statutory - Voluntary 25 (6) Care of Premature Infants No. of premature births during the year 63 No. of deaths under 1 month 7 -46- (7) Diphtheria Immunisation No. of children who completed a full course of primary immunisation:- Under 5 years of age 608 5 to 14 years of age 269 No. of children who were given a secondary or reinforcing injection 708 (8) Vaccination No. of children successfully vaccinated or re-vaccinated 213 (9) Domestic Help Service Domestic help was provided as follows:- Maternity cases T.3. cases Aged and Infirm cases Other cases Northern District Office - covering Bethnal Green and parts of Stepney and City of London 32 35 791 95