AC 4366 ??? BET 60 Metropolitan Borough of Bethnal Green ANNUAL REPORT THE MEDICAL OFFICER OF HEALTH FOR THE YEAR R. DUNCAN DEWAR, B.Sc., M.B., Ch. B . D.P.H., Barrister-at-Law, Medical Officer of Health ??? 12.9.56 ??? Metropolitan Borough of Bethnal Green ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1955 R. DUNCAN DEWAR, B.Sc., M.B., Ch. B., D.P.H., Barrister-at-Law, Medical Officer of Health -2- INDEX Page Public Health Committee 3 Staff 4 Statistics of the Area 7 Extracts from Vital Statistics 7 Causes of Death 9 Sanitary Circumstances of the Borough 11 Housing 24 Inspection and Supervision of Food 28 Prevalence of, and Control over, Infectious Disease 36 General Provision of Health Services other than those provided by the Borough Council 40 -3- METROPOLITAN BOROUGH OF BETHHAL GREEN PUBLIC HEALTH COMMITTEE Chairman: Councillor W.R. Johnson Vice-Chairman: Councillor W.G. Kilbey Councillor J. Docherty " Miss E. Gilbert " R.H. Hare " P.A. Hart " R.H. May Councillor P.C. Newman " F.E.Sanders, J.P. " Mrs. A.M. Sivill " Mrs. L. Sleigh " E. Winslow Ex-Officio Members: His Worship the Mayor (Councillor G.A. Hadley, J.P.) Alderman Mrs.B.L.Tate, L.C.C. " H.P. Wilson, J.P. Councillor G.M. Browne " S. Duncombe " C.F.F. Fleet " A.C. Jacob " R.H. Rosamond " A. Stocks Council's Representatives on the London County Council (Division 5) Health Committee: Councillor W.R. Johnson 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. Avrll ø : J.C. McManus ø m (Resigned 14.3.55) : S.J. Cassldy ø m (Resigned 3.4.55) : 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 (Resigned 1.5.55) : F.S. Frid : Mrs. J.E. Ingrey (Commenced : 26.9.55) Junior Clerk : Miss L. Driver Other Employees: 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, 1956. 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 report on the health and sanitary circumstances of the Borough for the year 1955. Although the health of the population generally was satisfactory, the number of cases of infectious disease was considerably more than during the previous year. The total number of cases of poliomyelitis throughout the country was much higher than for some years and Bethnal Green did not escape. Indeed the first indication of an epidemic in the London area was the number of cases which occurred in Bethnal Green and in the adjoining borough of Stepney. During the year also, there was a large number of cases of measles which accounted for three quarters of the total notifications of infectious disease. Throughout 1955 the main emphasis was again on housing and following a survey of the Borough a slum clearance programme was prepared and this, after consultation with the London County Council, was submitted to the Minister in accordance with the provisions of the Housing Repairs and Rents Act, 1954. Some details are given in Section C of the report. The effects of the slum clearance programmes, both of the Borough Council and the London County Council, are now becoming much more apparent to anyone who walks through the Borough. Many fine new dwellings have been erected and are in occupation, others are in course of erection and the demolition of the old houses, particularly in the western half of the Borough, has let air and light into many areas which were previously composed of grim narrow roads and crowded houses. The face of Bethnal Green is changing and although some people may regret the demolition of the historic "old weavers" houses their passing will not, I am sure, be regretted by those who for many years have had to live in them. -6- With the Improvement of the standard of the buildings there is an improvement in the standard of care of the homes and it is evident that the occupiers have spent considerable time, trouble and money, In Improving their living conditions even In those old houses which from a structural point of view have come to the end of their useful lives. It is unfortunate that in a Borough such as Bethnal Green almost all the new dwellings must be flats rather than houses but this Borough is noted for the way in which families remain united and it is hoped that this spirit will persist and will overcome the difficulties of bringing up a family as a family in a flat. A summary of the work of the Public Health Department is given 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 administered by the London County Council. A brief report is also included of the work of the Old People's Welfare Committee which has been supplied by the Secretary of the Committee. I would like to express my thanks to Councillor W.R. Johnson, Chairman of the Public Health Committee,and the Members of the Committee for a great deal of help and encouragement during the year and for the interest which they have taken in the work of the Department. I would also like to thank the other Chief Officers of the Council and their staffs for their willing assistance at all times and my particular thanks are due to the members of my own staff for their loyal help at all times. I have the honour to be, Your obedient Servant, R. DUNCAN DEWAR, Medical Officer of Health -7- SECTION A STATISTICS OF THE AREA Area 760 acres Population, estimated mid-year 53,860 Number of inhabited houses (at 31st December, 1955) 16,615 Rateable Value £444,722 General Rate 23s.8d. Sura represented by a penny rate £1,738 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR Males Females Total Live Births: Legitimate 419 385 804 Illegitimate 21 20 41 Rate per 1,000 estimated population 15.7 Stillbirths: Legitimate 5 8 13 Illegitimate — —- — Rate per 1,000 total (live and still) births 15.9 Deaths Death Rate per 1,000 estimated population 10.3 Deaths of Infants under one year of age- Legitimate 12 5 17 Illegitimate — — — Death Rate of Infants under one year of age- All infants per 1,000 live births 20.1 Legitimate infants per 1,000 legitimate live births 21.1 Illegitimate infants per 1,000 illegitimate live births Nil During 1955, the population showed a natural Increase of 282, that Is that there were 282 more births than deaths, but in spite of this the Registrar General estimated that the number of persons resident in the Borough was 1,670 less than In the previous year, showing that some sixteen hundred persons had been rehoused outside the Borough or left for other reasons. -8- The death rate was 10.3 per 1,000 persons as compared with a rate of 9.8 for 1954. 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 10.8 as compared with 11.7 for England and Wales. The birth rate during 1955 was 15.7 as compared with 17.0 during the previous year. The adjusted rate however still remains below the national level at 13.6 as compared with 15.0 for England and Wales. The Infant mortality rate at 20.1 is above the rate for the previous year and compares with the rate of 24.9 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 be 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 J notified to them as the Local Health Authority under the National Health Service Act, 1946. During the year 854 live births (440 male and 4l4 female) were notified and in addition there were 15 stillbirths (6 male and 9 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. -9- -10- TABLE 1 CAUSES OF DEATHS 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 12 5 3 2 2 . 8 8 109 55 83 72 86 108 300 253 1 Tuberculosis,respiratory — — . .. - - - - - 5 - 2 - l - 8 - 2 Tuberculosis, other — _ _ _ - - - - - - - - - - - - 3 Syphilitic disease — — _ - - - - - - 2 - - 2 - 4 Diphtheria — _ 1 - - - - - - - - - - - 1 5 Whooping cough — _ _ . _ _ - •> - - - - - - - - - 6 Meningococcal infections — — - - - - 1 - - - - - - - 1 - 7 Acute Poliomyelitis — _ . - - - - - - - - - - - - 8 Measles — — _ <_ . - - - - - - - - - - - 9 Other infective and Parasitic diseases — — __ _ . - - - 10 Malignant neoplasm, stomach — — _ . - - - - - L_ 2 2 1 - 6 9 11 Malignant neoplasm, lung, bronchus — — 20 5 3 1 - 28 8 12 Malignant neoplasm, breast — — _ - - - - - - 4 - 4 - 2 - 10 13 Malignant neoplasm, uterus — . - - - - - - - - - - - - - 14 Other malignant and lymphatic neoplasms — 1 1 2 9 6 10 11 6 11 26 31 15 Leukaemia, aleukaemia — _ _ _ - - - - - 2 - 1 - - - 3 - 16 Diabetes — 1 - - 2 1 - 1 2 3 17 Vascular lesions of nervous System — 7 8 7 10 12 21 26 1 18 Coronary disease, angina — 1 18 5 11 15 10 6 30 07 19 Hypertension with heart disease - 1 3 5 2 J? 9 .. M 2 20 Other heart disease 1 1 - 2 3 7 7 1 4 9 27 21 41 21 Other circulatory disease — _ _ _ 2 f. 22 Influenza — - - - _ _ _ l _ l 2 ±J, 23 Pneumonia 1 2 1 - 1 - _ 4 2 4 8 15 9 25 22 24 Bronchitis — - - - - 1 _ 17 2 12 6 10 11 40 19 25 Other diseases of respiratory system — 2 1 2 1 5 -*-7 1 26 Ulcer of stomach and duodenum — 1 5 1 3 3 9 4 27 Gastritis, enteritis and diarrhoea — 1 1 2 28 Nephritis and nephrosis — - - - _ _ _ 2 1 1 2 29 Hyperplasia of prostate — - - _ _ 1 5 6 30 Pregnancy, childbirth, abortion — 31 Congenital malformations 5 - - - c= _ _ 1 . 6 11 32 Other defined and ill-defined diseases 4 1 1 1 3 6 2 5 3 9 12 26 33 Motor vehicle accidents - - - - - _ ] l 1 1 34 All other accidents 35 Suicide 1 - - - - - 2 - - - - 3 1 6 1 36 Homicide and operations of war — . _ . 1 6 1 -■ 1 1 8 2 -11- 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. Bacteriological and chemical examination of the water is carried out at frequent Intervals by the Metropolitan Water Board. Notices were sent to the Board in 67 cases where wastage of water due to defective pipes or fittings was observed. During the year 124 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 2,502 complaints of insanitary conditions sanitary defects were found requiring the service of Intimation Notices in 1,754 cases. Of these statutory notices were required in 765 Instances and legal proceedings were instituted in 41 cases. The main types of defects found are shown In Table 3. In connection with the supervision of drainage works, a total of 2,022 Inspections were made during the year. Eight notices were served under Section 40 of the Public Health (London) Act, 1936, and in four instances the necessary work was carried out by the Council, the expenses Incurred being recovered from the owners of the properties. -12TABLE 2 RECORD OF VISITS Notifiable Infectious Diseases 736 Non-notifiable diseases 14 Food Poisoning 7 Complaints as to Insanitary conditions 2,502 Aged and Infirm persons 76 Factories 583 Milkshops 598 Other food promises 2,056 Outworkers' houses 184 Tenement houses 78 Drainage work 2,022 Smoke observations 55 Enquiries with regard to housing 2,402 Other inspections and special work 2,265 Re-Inspections 7,496 Total 21,074 TABLE 3 SANITARY DEFECTS IN CONNECTION WITH WHICH NOTICES WERE SERVED Dirty and/or dilapidated rooms 1,808 Defective drains and choked w.c.'s 206 Defective and dirty w.c.'s 1,007 Defective water supply 82 Defective paving 68 Defective gutters and rain water pipes 378 Defective roofs 718 Dampness 803 Defective dustbins 111 Smoke Nuisances 9 Other defects 2,413 Total 7,603 -13- (3) Supply of Dustbins In 58 cases during the year notices were served upon the owner In accordance with Section 12 of the London County Council (General Powers) Act, 1954. (4) Legal Proceedings It was found necessary on 4l occasions during the year to take legal proceedings to enforce compliance with the requirements of Notices served. In 6 of these cases Abatement Orders were made by the Justices with the infliction of costs amounting to £13.2s.6d. Brief details are set out below. Abatement Orders Premises Offence Result of Proceedings 164, Brick Lane Non-compliance with Nuisance Notice Abatement Order made (28 days) £2.12s.6d.costs 331, Cambridge Heath Road do. do. No costs. 41, St. Jude's Road do. do. £2.12s.6d.costs 35, Hollybush Gardens do. do. do. 80, Buckhurst Street do. do. do. 21, Mace Street do. Abatement Order made (14 days) £2.12s.6d.costs A Closing Order was granted by the Justices in respect of No.5, Peel Grove and £2.12s.6d. costs were awarded to the Council. In 34 cases summonses were withdrawn owing to the nuisances being abated prior to the date of hearing, the defendants paying expenses amounting to £42.10s.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, during the year, are as follows:- -14-  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 under Part II of the 1954 Act. 31 35 3 26 17 4 (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 increases of rent are recoverable under section 2(1)(c) and (d) of the Increase of Rent and Mortgage Interest (Restrictions) Act, 1920. 43 39 4 3 2 1 -15- (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 1,490 and a total of 682 Inspections and reinspections 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:- 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 624 287 20 — 2. Factories not included In (1) in which Section 7 is enforced by the Local Authority 862 395 54 — 3. Other premises in which Section 7 is enforced by the Local Authority 4 — — — TOTALS 1,490 . , 682 74 — TABLE 5 CASKS 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 9 14 - 3 - Overcrowding - - - - - Unreasonable temperature - - - - - Inadequate ventilation 1 - 1 1 - Ineffective drainage of floors - - - - - Sanitary conveniences:- (a) Insufficient 2 1 - - - (b) Unsuitable or defective 109 178 - 12 - (c) Not separate for sexes l - - - - Other offences against the Acts (not including offences relating to outwork) 94 97 1 2 - TOTALS 216 290 2 18 - -l6- -17- OUTWORK SECTION 110 No. of Outworkers in August list required by Section 110 (1) (c) Wearing apparel (Making, etc.) 152 Curtains, Furniture hangings and Household Linen 33 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 29 Artificial flowers (6), Brushes (3), Umbrellas (5) 14 Cosaques, Christmas crackers, Christmas stockings, etc. 18 Button, Carting, etc. 7 Stuffed Toys 15 Total 268 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 133 visits to shops in relation to general sanitation, ventilation and temperature requirements. 15 notices were served in respect of unsatisfactory conditions found to exist. (9) Disinfection and Dlsinfestation The following is a summary of the routine work carried out by the disinfecting staff during the year:- No. of rooms disinfested 715 Articles of clothing, bedding, etc., submitted to steam disinfection 861 Articles disinfected by formalin 407,975 Hospital mattresses, pillows, etc., disinfected 4,696 Number of articles destroyed by request 1,337 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 90 families removing to Borough Council flats were disinfested. -18- (10) Personal Cleansing Station During the year, 23 adults and 2 children had baths for verminous conditions at the Personal Cleansing Station, simultaneous disinfection of clothing being carried out. In addition, 17 adults and 5 children received treatment for Scabies at the Station. Sanitary Inspectors visit and advise in all cases of Scabies and in those cases where verminous 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 seven occasions. (11) Prevention of Damage by Pests Act, 1949 During the year, 152 complaints of Infestation by rats or mice 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. Seven notices under section 4(1) of the Act was served. Systematic baiting and poisoning was carried out by the Rodent Operatives on 452 occasions with satisfactory results. In accordance with the suggestion of the Ministry of Agriculture, Fisheries and Food, all sewers under the control of the Council were baited twice during the year, involving a total of 1,303 manholes. Positive results were obtained in 543 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. In the following three cases it was necessary to use the powers under the Act:- -19- 1. Mrs. P., aged about 90 years, was found to be suffering from malnutrition, debility and chronic arthritis of legs and was living in insanitary conditions. Because of her age and physical incapacity she was unable to devote to herself,and was not receiving from other persons, proper care and attention. Attempts were made to persuade Mrs. P. to enter hospital voluntarily but as she refused there was no alternative but, in her own interests, to apply to a Magistrate for a removal order which was granted. 2. Mr. B., aged about 86 years, was found to be infirm and physically incapacitated and living in insanitary conditions. He was unable to look after himself and had no assistance from other persons. Mr. B. refused to enter an institution and, in his own interests, there was no alternative but to apply for a removal order which, however, was refused by the Magistrate. Shortly after the application for compulsory removal Mr. B. voluntarily consented to enter an institution and this was arranged. 3. Mrs. M., aged 70 years, was found to be suffering from cerebral thrombosis and was aged, infirm and physically incapacitated. Arrangements were made by her medical practitioner for her removal to hospital but she refused to go and in her own interests application was made for a removal order which was granted by the Magistrate. Although application to a Court was only made in the three cases mentioned above there were 150 other cases brought to the notice of the Department where aged persons were in need of care and attention. It was possible in a number of cases to provide the necessary care for these old people in their own homes and the Home Help Service provided by the London County Council was particularly helpful In this way. In other cases where it was not possible to make satisfactory provision in their own homes the old people were persuaded to enter a hospital or an institution. Mention should be made of the medical staffs of St. Matthew's Hospital and Bethnal Green Hospital and the Admittance Officers of the London County Council's Southern Grove Lodge who invariably showed the utmost kindness, sympathy and understanding In dealing with these distressing cases. Their help has at all times materially eased the problems and difficulties of the Public Health Department in this work. -20 Since 1948 there has been In existence In the Borough an Old People's Welfare Committee, comprising representatives of the Bethnal Green Borough Council and the various local organisations and social settlements. Beginning as it did with the formation of one club for old people, other clubs have been established and there are now nine clubs under the Committee's control, having a total membership of over 850. The Committee is also fully cognizant of the needs of old people apart from the amenities afforded by clubs. A chiropody scheme is in operation, whereby old people may receive foot treatment at the chiropody clinic, or in the case of the homebound, have foot treatment in their own homes. Great importance is also attached to the necessity for ensuring that old people have the opportunity of obtaining hot meals, and a meals-on-wheels service is operated on four days per week. There is also a holiday scheme in operation whereby old people, who are members of clubs or organisations, may enjoy a well-earned rest in beautiful country surroundings at the Council's Holiday Centre at Redbourn, near St. Albans, Hertfordshire. The plight of the lonely and homebound old people has not been forgotten, and although this is the biggest physical task of all, in as much as there is an estimated total population of 7,500 old persons living in the Borough, a scheme of regular visiting of the infirm and aged sick is in full operation. Bethnal Green is known to have one of the highest proportions of aged people among its residents in any of the London Boroughs, and the size of the task can be measured from the fact that old people number one eighth of the total population of the Borough. Nevertheless, the Committee is ever anxious to pursue further schemes in the welfare of the aged, and a laundry scheme for the elderly is being considered. Much of the work of the Committee could not have been achieved without considerable financial help, and in this connection the Bethnal Green Borough Council has responded most generously to requests from the Committee for such assistance. -21- (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, 14 burials were arranged by the Department at a cost of. £123.l6s.6d. of which £58.5s.6d. was recovered up to the end of the year, and a further £9.19s.0d. In respect of burials carried out before the period under review. (14) Mortuary The arrangement between the boroughs of Poplar, Shoreditch and Bethnal Green whereby the Poplar Mortuary Is the main mortuary for use by the three boroughs with the Bethnal Green Mortuary being maintained as a reserve for use In emergencies is working satisfactorily. The number of Bethnal Green bodies received at the Poplar Mortuary was 106. 105 post-mortems were carried out and 16 inquests held. (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. 78 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. -22- During 1955, the names of 50 persons were retained 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. There are no premises in the Borough where rag flock or other filling materials are manufactured but 44 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 Green 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 19 licences were granted in respect of shops and 55 licences in respect of stalls. 17 warning letters were sent in connection with various infringements of the Act. (19) Atmospheric Pollution During the year, a station for the monthly measurement of deposited matter and of sulphur dioxide was installed on the roof of a building at one of the Council's Depots. The apparatus used is in two parts, one instrument being a deposit gauge for the measurement of ash and grit, etc., in the atmosphere and the other a lead peroxide instrument by which the amount of sulphur dioxide is measured. The results obtained since the operation of the instruments are as follows:- -23- Month Rainfall In mms. Insoluble deposits In tons per square mile Soluble deposits In tons per square mile S.O.2 In mgs. per day per 100 square cms. June 49 13.5 7.4 1.3 July 19 9.4 4.4 1.0 Aug. 24 10.0 5.2 1.3 Sept. 49 10.2 8.4 1.7 Oct. 65 12.5 13.3 3.0 Nov. 11 13.2 8.2 3.5 Dec. 40 16.4 12.3 4.4 In addition, a second station for recording the dally measurement of pollution by sulphur dioxide and of smoke was installed at the Town Hall. The results obtained from the instruments at the two stations are communicated to the Department of Scientific and Industrial Research. (20) Hairdressers and Barbers During the year, in accordance with Section 18 of the London County Council (General Powers) Act, 1954, 51 premises and the persons carrying on the businesses of hairdressers or barbers thereat were registered after the "appointed day" of 1st October, 1955. Bye-laws made by the Council for the purpose of securing the cleanliness of the premises, instruments and persons employed, etc., were confirmed and came into operation on the 1st November, 1955. -24- SECTION C HOUSING Clearance Areas (Section 25 Housing Act, 1936) Areas which were represented or were the subject of Public Inquiry during the year were as follows:- Peel Grove (Bethnal Green Borough Council) Chilton Street (London County Council) Menotti Street " " " Poyser Street " " " During the year agreement was reached between the London County Council and the Borough Council on the slum clearance programme for the 5 year period (1956-60). The estimated number of unfit houses to be dealt with during this period is 2,434. Demolition of Insanitary Houses (Section 11 Housing Act, 1936) Having regard to the effect of demolition upon adjoining property, Closing Orders were made upon ten 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 (Section 12 Housing Act, 1936) Following official representation 6 Closing Orders were made during the year prohibiting the use for human habitation of twelve rooms. Overdrowding (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 1954 6l4 New cases reported during 1955 26 Total 640 Overcrowding abated during 1955 179 On register at end of 1955 461 -25- Equiv. Families Adults Rehoused by London County Council 17 83½ Rehoused by Bethnal Green Borough Council 4 15½ Removed from register:- No longer overcrowded by reason of altered circumstances 2 12½ Removed, mostly without trace 148 762 Removed, premises demolished 8 47 Total 179. 92½ In addition, two cases recommended on health grounds were found to have removed from the Borough. New Housing During the year new housing accommodation was provided as shown below Name of Premises Provided by No. of flats Burrand House London County Council 12 Dundas House ” ” ” 14 O'Brien House Borough Council 60 Pepys House ” ” 38 Total 124 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 16,615 1. Inspection of Dwellinghouses during the year:- (1) (a) Total number of dwelllnghouses Inspected for housing defects (under Public Health and Housing Acts) 4,887 (b) Number cf inspections made for the purpose 12,383 (2)(a) Number of dwellinghouses included under subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 276 (b) Number of inspections made for the purposes 1,782 -26- (3) Number of dwelllnghouses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 14 (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 2,634 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 1,192 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 1,820 (2) Number of dwelllnghouses in which defects were remedied after service of formal notice:- (1) By Owners 586 (ii) By Local Authority in default of Owners 4 (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 1 (2) Number of dwellinghouses which were rendered fit after service of formal notices:- (i) By Owners 1 (ii) By Local Authority In default of Owners (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936:- (1) Number of dwelllnghouses in respect of which Demolition Orders were made (2) Number of dwellinghouses demolished in pursuance of Demolition Orders (3) Number of houses closed (Local Government (Miscellaneous Provisions) Act, 1953) 10 (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 12 -27- (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 205 (2) Number of dwellinghouses demolished as a result of Clearance Area procedure 5 Re-Housing Programme The following statement shows the number of families and persons accommodated by the Housing Committee to the 31st December, 1955:- Premises Families Persons Council flats 103 103 318 Requisitioned properties 19 19 57 Total 122 122 375 At the end of the year there were approximately 2,597 applications for re-housing outstanding. -28- SECTION D INSPECTION AND SUPERVISION OF FOOD (a) Milk Supply (1) Inspection of Premises A total of 424 visits were made In 1955 to dairies and other premises in the Borough used in connection with the distribution of milk and in 15 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 1955 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 14 Distributors (a) Inside the Borough 107 (b) Outside the Borough 28 Number of Licences issued under Milk (Special Designation) (Pasturised and Sterilised Milk) Regulations, 1949, and Milk (Special Designation) (Raw Milk) Regulations, 1949 Sterllised Pasteurised Tuberculin Tested Dealers' Licences 120 79 35 Dealers 1 Supplementary Licences 23 21 20 Totals 143 100 55 -29- (3) Milk Sampling During 1955, 44 Informal samples of milk were submitted to the Public Analyst for examination, all of which were reported as genuine. In addition, 62 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. cested Phosphatase test Methylene Blue test Turbidity test Passed Failed Passed Failed Void Passed Failed Pasteurised 40 40 - 36 - 4 - - Sterilised 20 - - - - - 20 - Tuberculin Tested (Pasteurised) 2 2 - 2 - - - - Totals 62 42 - 38 _ 4 20 - 17 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 2,154 visits paid to shops, stalls and other premises where food is sold, prepared for sale or stored, a total of 92 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:- -30- TABLE 7 INSPECTION OF FOOD PREMISES Type Number in Borough Number Registered Inspections Notices served Ice Cream 156 156 435 2 Mllkshops and Dairies 121 121 424 15 Butchers 47 38 260 1 Fried Fish Shops 15 15 80 1 Fish Curers 9 8 31 4 Eel and Pie Shops 9 8 27 - Miscellaneous 26 6 6l 2 Offal Dealers 5 5 18 - Other Fish Premises 7 2 25 - Restaurants 96 - 149 15 Licensed Premises 138 - 129 31 Greengrocers 57 - 40 8 Grocers 57 - 75 2 Bakehouses 27 - 39 6 Confectioners 34 - 23 - Canteens 34 - 9 1 Bakers' shops 10 - 9 3 Poultry Slaughterhouses 3 - 66 - Cattle Slaughterhouse 1 - 15 - Street Stalls 225 - 239 1 Totals 1, 077 359 2,154 92 -31- (e) Unsound Food During the year under review the Food Inspector examined and took appropriate action in relation to unsound food on 115 occasions. Details of the food together with quantities are set out below:- Quantity Tons Cwts. lbs. Pickllng Onions 19 5 - Salami 1 15 - Cucumbers in Brine 1 3 64 Horseradish Roots 19 - Meat - Tinned 7 71 " - Carcase 4 106 Cheese 3 96 William Pears 2 16 Chinese Liquid Egg 1 20 Oxtails 33 Butter 5 24 2 75 Other Foodstuffs Prunes 576 tins Fruit 311 tins Vegetables 76 tins, 9 Jars Milk 15 tins Soup 12 tins Fish 11 tins Various 16 Jars, 4 bottles, 1 tin Eggs 1,600 Condemned Food is collected by Council and destroyed or, where suitable, used for animal food. (f) Food and Drugs Act Mr. A.E. Parkes, F.R.I.C., F.C.S., of No.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 311 samples (14 formal and 297 informal) examined by the Public Analyst during 1955, 1 formal sample and 9 informal samples were found to be adulterated. -32- 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 Ale and Beer - - - 8 8 - 8 Culinary Powders - - - 4l 39 2 41 Drugs - - - 30 29 1 30 Ice Cream 2 1 1 10 9 1 12 Meat and Fish Paste - - - 20 20 - 20 Milk - - - - 44 - 44 Sweot Confectionery - - - 11 10 1 11 Whisky 12 12 - - - - 12 Various - - - 133 129 - 133 Totals 14 13 1 297 288 9 311 -33TABLE 9 Action taken In regard to samples reported by the Public Analyst to be not genuine. Sample No. Article Result of Analysis Action 9 Ground Cinnamon Contained approximately 1.0 per cent of ginger starch Letter of caution 17 Baking Powder 26.2 per cent deficient in available carbon dioxide Letter of caution 88 Pea Flour Infested with weevil Remaining stock destroyed 96 Scone Contaminated with rat excrement Letter of caution 156 Solution of Acetic Acid Incorrectly labelled Labelling of Food Order,1953, complied with by manufacturer after attention having been drawn to incorrect label 234 Ice Cream 10.0 per cent deficient In fat Formal sample 239 Ice Cream 2.0 per cent deficient In fat Letter of caution 241 Spirit of Sal Volatile 0.58 per cent deficient in free ammonia and O.36 per cent deficient In ammonia carbonate Letter of caution 297 Cake Fat in cream filling rancid - spots of green mould on cake portion Letter of caution 298 French Liquor Flavoured Chocolates In moist condition growth of green mould Purchased from stall - unable to trace vendor -34- (g) 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. (h) Ice-Cream During the year, 7 applications for registration for the sale of ice-cream were approved and 16 premises were removed from the register upon ceasing the sale of Ice-cream. At the end of the year there were 156 premises in the Borough registered for the sale of ice-cream and 435 inspections of these premises were made during the year. In 2 instances notices were served concerning insanitary conditions. 25 samples of ice-cream were submitted to the Methylene Blue test and graded as follows:- Grade .1 .. 19 Grade 2 .. 6 (1) Food Poisoning Twenty-two notifications were received, 12 of which were confirmed bacteriologically, the organism in each instance being of the Salmonella group. Foods suspected included soup, fried fish, meat, sausages and tinned salmon, but in only two cases was any portion of suspected food available for bacteriological examination, both of which were submitted for examination but no pathogenic organisms were isolated. There were no deaths. (J) Clean Food Campaign The efforts of the Department for an improved standard of hygiene in all matters relating to the manufacture, handling, storage or distribution of food were continued during the year. Desirable -35- improvements were obtained without recourse to official action but it was necesssary on 27 occasions to serve notices under Section 13 of the Pood and Drugs Act, 1938. Eighteen notices being served on occupiers and nine on owners of food premises. In addition, 19 letters were sent giving warnings against infringements of the Act. At the beginning of the summer a letter was sent to all food traders reminding them of the need for especial precautions in connection with those foods which are particularly liable to contamination such as cooked meat and cream products. They were also reminded of the provisions of the Bye-laws for the Protection of Pood made by the London County Council under Section 15 of the aforementioned Act. Towards the end of the year the Council co-operated with neighbouring boroughs in the holding of a pilot pictorial exhibition and Invitations to attend were sent to food traders in the Borough. (k) 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. (1) Milk at Nurseries Two samples of milk submitted for examination passed the necessary tests. -36- SECTION E PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASE The total number of notifications of infectious disease, excluding Food Poisoning, during 1955 was 1,117 as compared with 624 in 1954. The Increase was mainly due to the larger number of cases of measles. This disease accounted for nearly 74% of all notifications. There was one case of diphtheria during the year. The child concerned, aged 8 years, had not been immunised and died. 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. Fourteen notifications of poliomyelitis were received during the year and in twelve cases the diagnosis was confirmed, only one of these being non-paralytic. 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 eases 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 no certificates were issued. -37- TABLE 10 INFECTIOUS DISEASE DISEASE NOTIFICATIONS Total j notified Corrected figures Removed 1 to Hospital 0-1 year 1-2 years 3 - ^ years 5 -1* years 15-24 years 25-44 years 45-64 years 65 - years Diphtheria - - - 2 - 1 - - 3 1 3 Scarlet Fever - 8 6 16 - 1 - - 31 28 10 Puerperal Pyrexia - - - - 2 3 - - 5 5 1 Ophthalmia Neonatorum 3 - - - - - - - 3 3 - Meningococcal Infection - - - - - 1 - - 1 1 Acute Encephalitis - 1 - - - - - - 1 1 1 Acute Poliomyelitis - 2 3 3 2 4 - - 14 12 14 Acute Pneumonia - - 1 - - 1 2 1 5 5 I Paratyphoid "B" - - - 1 - 1 - - 2 2 2 Dysentery 6 11 12 17 5 9 2 3 65 65 12 Measles 30 228 273 290 2 3 - - 826 324 31 Whooping Cough 10 18 31 34 - 1 - - 94 94 15 Scabies - - 1 5 1 6 3 - 16 16 2 Pulmonary Tuberculosis - 1 1 2 9 14 15 4 46 46 Meninges and C.N.S. - - - - - - - - - - Other forms — 1 - - l 2 - 1 5 5 TOTALS 49 270 328 370 22 47 22 9 1,117 1,108 93 -38- Tuberculosis During the year formal notifications under the Public Health (Tuberculosis) Regulations, 1952, were received in respect of 46 cases of respiratory tuberculosis and 5 non-respiratory cases, as compared with 64 and 8 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 ­ ­ 1 l 1 2 3 2 3 4 8 2 ­ 27 Respiratory females ­ 1 ­ ­ ­ 2 2 6 3 2 1 1 1 19 Non-respiratory males ­ ­ 1 ­ ­ ­ ­ ­1­ ­ ­ ­ 1 ­ 3 Non-respiratory females ­ - ­ - ­ 1 - 1 - - - ­ - 2 In addition to the above, information was received of 34 other cases by transfers from other areas. There were 8 deaths during the year certified as being due to Tuberculosis. The following table shows the number of cases on the Tuberculosis Register at the end of 1954, variations which have taken place during the year, and the number of cases remaining on the Register on the 31st December, 1955. -39- TABLE 12 Pulmonary Non-Pulmonary Total Males Males Females No. of cases on register 1.1.55 4ll 312 70 70 863 No. of cases notified during 1955 27 19 3 2 51 Other cases added to register during 1955 20 11 3 34 458 342 73 75 948 No. of cases removed from register during 1955 43 25 4 6 78 Remaining on register 31. 12. 55. 415 317 69 69 870 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 9.00 12.00 Wednesday 9.00 12.00 5.30 - 6.30 ” 2.60 4.00 (Refills) Thursday 9.00 12.00 ” 2.00 4.00 [Refills) Friday 9.00 12.00 ” 1.30 2.30 (b.c.g) Saturday 9.00 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. During the year, 5 half-pint tins of disinfectant were issued to tuberculous persons for use in sputum flasks and for the soaking of handkerchiefs. -40- 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 1955. 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 309 Mildmay Mission Hospital 56 Queen Elizabeth Hospital for Children (with branches at Shadwell and Banstead) 287 * 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. -41- 3. Personal Health Services The following information regarding the operation of the personal health services in the Borough during 1955. has been furnished by Dr. G.O. Mitchell, Divisional Medical Officer (Division 5) London County Council. (a) Services Available Day Nurseries Pritchards Road, E.2. University House, Sugar Loaf Walk, E.2. Greenwood Maternity and Child Welfare Centre, Peel Grove, E.2, 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 644 1-5 years of age 47 Total No.of children who attended and who were born in:- (i) 1955 584 (ii) 1954 344 (iii) 1953-50 276 Total attendances by children:- Under 1 year of age 6,859 1-5 years of age 1,251 -42- (2) Ante-natal and Post-natal clinics Ante-natal consultations:- No.of women who attended for the first time 511 No.of women who attended 414 Total attendances 1.895 Post-natal consultations No.of women who attended 95 (3) Health Visitors No. of infants under one year of age visited for the first time 852 Total visits to children under 1 year of age 5,670 Total visits to children aged 1 year but under the age of 2 years 3.286 Total visits to children aged over 2 years but under 5 years 5.843 No.of expectant mothers visited 445 Total visits to expectant mothers 931 (4) Infant Life Protection No. on register, 1st January, 1955 Poster mothers 3 Poster children 3 No. on register, 31st December, 1955 Foster mothers 5 Foster children 7 (5) Child Minders (Daily Guardians) No. of Child Minders - Statutory Voluntary 22 No. of children minded - Statutory - Voluntary 22 (6) Care of Premature Infants No. of premature births during the year 60 No. of such children who died within 28 days of birth 3 -43- (7) Diphtheria Immunisation No. of children who completed a full course of primary immunisation:- Under 5 years of age 311 5 to 14 years of age 81 No. of children who were given a secondary or reinforcing injection 519 (8) Vaccination No. of children successfully vaccinated or re-vaccinated 269 (9) Domestic Help Service Domestic help was provided as follows:- Maternity cases T.B. cases Aged and Infirm cases Other cases Northern District Office - covering Bethnal Green and parts of Stepney and City of London 33 32 848 100