AC4366 Checked ??? LET61 Metropolitan Borough of Bethnal Green ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1956 S. A. BOYD, M.D. (Vienna), D.P.H., Medical Officer of Health Gekd by P.C. 23.8.57 MBJ Metropolitan Borough of Bethnal Green ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1956 S. A. BOYD, M.D. (Vienna), D.P.H., 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 Pood 28 Prevalence of, and Control over, Infectious Disease 38 Miscellaneous 42 General Provision of Health Services other than those provided by the Borough Council 44 -3- METROPOLITAN BOROUGH OF BETHNAL GREEN PUBLIC HEALTH COMMITTEE Chairman: Aldennan Mrs. A.M. Slvill Vice-Chalrman: Councillor R.H. Hare Alderman H.J. Stubbs, J.P. " Mrs, B.L. Tate, L.C.C. Councillor E.F. Berry ,, W, Hilllard ,, W.G. Kilbey Councillor R.H. May " J. Orwell " S.C. Russell ,, Mrs. L. Sleigh ,, Miss R. Sleigh Ex-Officio Members: His Worship the Mayor (Councillor W.R. Johnson, J.P.) Councillor G.M. Browne " Miss E.A. Carpenter " J. Docherty " C.F.F. Fleet " G.A.Hadley " A.C. Jacob " R.H. Rosamond " A. Stocks Council's Representatives on the London County Council (Division 5) Health Committee: His Worship the Mayor (Councillor W.R.Johnson, J.P.) and Alderman Mrs. A.M. Sivill -4- STAFF OF PUBLIC HEALTH DEPARTMENT Medical Officer of Health; S.A. BOYD, M.D.(Vienna), D.P.H. Public Health Inspectors Senior Public Health Inspector : F.C. Sharpe ø m Senior Housing Inspector : and Deputy Senior Public : Health 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 (Resigned : May, 1956) : L.G. James ø m : L.A. Folley ø m : W. Johnson ø Administrative and Clerical Staff: Chief Clerk : J.E. Pestell Senior Clerk : S.A. Wright Assistant Clerks : R.F. Marshall : C.W. Foxton : F.S. Frid : Mrs. J.E. Ingrey Junior Clerk : Mrs. L. Payne Other Employees: Disinfectors 4 Female Cleansing Attendant 1 Rodent Operatives 4 ø Certified Public Health Inspector m Certified Meat, etc., Inspector -5- Public Health Department, Town Hall, Bethnal Green, E.2. May, 1957. 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 1956. I commenced service as Medical Officer of Health for Bethnal Green in May, 1956, in succession to Dr. R. Duncan Dewar who had obtained a new appointment with the Borough of Hampstead. Dr. Dewar had held the joint appointment as Medical Officer of Health for the Boroughs of Bethnal Green and Poplar. Upon his resignation, both Councils decided to discontinue the Joint arrangement and I was appointed Medical Officer of Health for this Borough and required to devote 25% of my time to clinic duties for the London County Council. Statistics The Registrar General's estimate of the population at midyear was 52,280, which is a reduction in the previous year's figure of 53,860. The death rate was 10.7 as compared with 10.3 for 1955. The birth rate of 17.3 showed a favourable trend as compared with 15.7 for 1955. The infant mortality rate was 24.0 as compared with 20.1 for 1955. Sanitary Circumstances 21,158 visits were made to premises in the Borough and the 6,686 sanitary defects found resulted in the service of 1,700 intimation notices and 658 nuisance notices. Legal proceedings were necessary in 65 instances. -6- Housing The Intensive work on slum clearance for the five year period 1956-60, in accordance with the agreement reached between this Council and the London County Council, continued throughout the year. Food 1,730 visits were made to food premises in the Borough and 176 notices were served in respect of unsatisfactory conditions. Six summonses taken out against the owners of a bakehouse resulted in the imposition of fines totalling £200, and the award of £15.15s.0d. costs to the Council. Infectious Disease 514 notifications of infectious disease were received as compared with 1,117 for 1955. This decrease was mainly due to the smaller number of cases of Measles. Details 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 administered by the London County Council. I am pleased to have this opportunity of thanking Alderman Mrs. A.M. Slvill, Chairman of the Public Health Committee, and the Members of the Committee for their help and encouragement during the year. I would also like to thank my colleagues in other departments for their willing assistance at all times and my particular thanks are due to Mr. F.C. Sharpe, Senior Public Health Inspector, Mr. J.E. Pestell, Chief Clerk, and all the other members of the staff of the Public Health Department for their loyal assistance and support. "I have the honour to be, Your obedient Servant, S.A. BOYD, Medical Officer of Health. -7- SECTION A STATISTICS OP THE AREA Area 760 acres Population, estimated mid-year 52,280 Number of Dwellings 15,578 Rateable Value £704,170 General Rate 16s. 4d. Sum represented by a penny rate £2,751 EXTRACTS FROM VITAL STATISTICS FOR THE YEAR Males Females Total Live Births: Legitimate 46l 393 854 Illegitimate 30 21 51 Rate per 1,000 estimated population 17.3 Stillbirths: Legitimate 9 10 19 Illegitimate - 2 2 Rate per 1,000 total (live and still) births 17.7 Deaths Death Rate per 1,000 estimated population 10.7 Deaths of Infants under one year of age Legitimate 12 7 19 Illegitimate 1 2 3 Death Rate of Infants under one year of age All Infants per 1,000 live births 24.0 Legitimate infants per 1,000 legitimate live births 22.0 Illegitimate infants per 1,000 illegitimate live births 58.8 During 1956, the population showed a natural increase of 347, that is that there were 347 more births than deaths, but in spite of this the Registrar General estimated that the number of persons resident in the Borough was 1,580 less than in the previous year, showing that some nineteen hundred persons had been rehoused outside the Borough or left for other reasons. -8- The death rate was 10.7 per 1,000 persons as compared with a rate of 10.3 for 1955. Both births and deaths depend to some extent on the proportion; 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 11.0 as compared with 11.7 for England and Wales. The birth rate during 1956 was 17.3 as compared with 15.7 during the previous year. The adjusted rate for comparison with other areas 1s 15.7 which is the same as for England and Wales. The infant mortality rate at 24.0 is above the rate for the previous year and compares with the rate of 23.8 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. 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 894 live births (485 male and 409 female) were notified and in addition there were 21 stillbirths (9 male and 12 female). These figures represent corrected totals after the addition of inward transfers and the deduction 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 All causes M F M F M F M F M F M F M F M F M F 15 9 1 1 2 1 2 2 13 12 88 65 87 76 78 108 286 272 1 Tuberculosis, respiratory 1 I 2 1 4 1 2 Tuberculosis. other 1 1 1 3 - 3 Syphilitic disease 1 - - - - 5 Whooping Cough - - 6 Meningococcal infections - - 7 Acute Poliomyelitis - - 8 Measles - - 9 Other Infective and parasitic diseases - - 10 Malignant neoplasm, stomach 5 2 4 2 1 4 10 8 11 Malignant neoplasm, lung, bronchus 2 11 1 7 2 1 2 19 7 3 3 1 - 7 13 Malignant neoplasm, uterus 1 1 - 2 14 Other malignant and lymphatic neoplasms 1 2 1 10 8 10 7 14 7 36 24 15 Laukaemia, aleukaemia 1 i 3 2 1 3 5 16 Diabetes 1 3 - 4 17 Vascular lesions of nervous system 2 5 7 10 8 28 17 43 18 Coronary disease, angina 2 25 5 17 1? 13 13 57 30 19 Hypertension with heart disease 1 3 1 4 1 8 20 Other heart disease 3 1 9 5 11 4 12 13 32 21 Other circulatory disease 1 1 3 8 3 8 4 6 10 24 22 Influenza 1 1 - 23 Pneumonia 2 2 1 4 4 2 ? 9 6 17 15 24 Bronchitis 2 1 9 1 11 8 13 11 35 21 25 Other diseases of respiratory system 1 1 2 1 1 1 1 4 4 26 Ulcer of stomach and duodenum 1 2 6 1 1 2 10 3 27 Gastritis, enteritis and diarrhoea 1 1 1 1 28 Nephritis and nephrosis 1 1 1 2 1 29 Hyperplasia of prostate 5 5 - 30 Pregnancy, childbirth, abortion - - 31 Congenital malformations 2 2 4 - 32 Other defined and ill-defined diseases 8 6 1 4 6 4 5 1 10 18 27 33 Motor vehicle accidents 1 2 1 1 4 1 34 All other accidents 1 2 3 1 5 2 35 Suicide 1 1 1 l 3 1 6 2 36 Homicide and operations of war -11- SECTION B SANITARY CIRCUMSTANCES OF THE BOROUGH 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 210 cases where wastage of water due to defective pipes or fittings was observed. During the year one new premises was 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 Sanitary Inspection of the Borough The Borough was divided into five public health 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 2,630 complaints of insanitary conditions, defects were found requiring the service of Intimation Notices in 1,700 cases. Of these Statutory Notices were required in 658 instances and legal proceedings were instituted in 65 cases. In addition, 16 notices in accordance with the London County Council (General Powers) Act, 1955, three under Section 26 and thirteen under Section 27, were served. In twelve of these sixteen cases the necessary work was carried out by the Council and the expenses incurred recovered from the owners of the properties. In connection with the supervision of drainage works a total of 2,403 inspections were made during the year. 57 notices in accordance with Section 25 of the London County Council (General Powers) Act, 1955, were served and in sixteen instances the necessary work was carried out by the Council and the expenses incurred recovered from the owners of the properties. -12- TABLE 2 RECORD OF VISITS Notifiable Infectious Diseases 301 Non-notifiable diseases 4 Food Poisoning 2 Complaints as to insanitary conditions 2,630 Aged and Infirm persons 57 Factories 1,182 Mllkshops 233 Other Food Premises 1,631 Outworkers' houses 139 Tenement houses 61 Drainage work 2,403 Smoke observations 76 Enquiries with regard to housing 2,147 Other inspections and special work 2,435 Re-Inspections 7,857 Total 21,158 TABLE 3 SANITARY DEFECTS IN CONNECTION WITH WHICH NOTICES WERE SERVED Dirty and/or dilapidated rooms 1,643 Defective drains and choked w.c.'s 133 Defective and dirty w.c.'s 1,122 Defective water supply 170 Defective paving 76 Defective gutters and rain water pipes 395 Defective roofs 666 Dampness 633 Defective dustbins 80 Smoke Nuisances 1 Other defects 1.767 Total 6,686 -13- Supply of Dustbins In 39 cases during the year notices were served upon the owner in accordance with Section 12 of the London County Council (General Powers) Act, 1954. Legal Proceedings It was found necessary on 65 occasions during the year to take legal proceedings to enforce compliance with the requirements of Notices served. In 23 of these cases Abatement Orders were made by the Justices with the infliction of costs amounting to £60. 7s. 6d. Brief details are set out below. Abatement Orders Premises Offence Result of Proceedings 20, Fuller Street Non-compliance with Nuisance Notice Abatement Order made (7 days) £2. 12s. 6d. costs 96, Toyes Buildings do. Abatement Order made (14 days) £2. 12s. 6d. costs 112, do. do. do. do. 9, Nelson Gardens do. do. do. 15, Mace Street do. do. do. 70, Teesdale Street do. do. do. 123, Roman Road do. Abatement Order made (21 days) £2. 12s. 6d. costs Yard next 55, Haverfield Road do. Abatement Order made (28 days) £2. 12s. 6d. costs 9, Paradise Row do. do. do. 135. Toyes Buildings do. do. do. 123, do. do. do. do. 124, do. do. do. do. 137. do. do. do. do. 101, do. do. do. do. 119, do. do. do. do. 4, Peel Grove do. do. do. 100, St.Peter's Avenue do. do. do. Linden Buildings do. do. do. 64, Fuller Street do. do. do. 125/127, Brick Lane do. do. do. 69, Sewardstone Road do. do. do. 5. Vyner Street do. do. do. Toyes Buildings do. Abatement Order made (56 days)£2. 12s. 6d. costs -14- In 3 cases, a further summons was taken out for non-compliance with Abatement Order, as follows:- Premises Result of Proceedings Toyes Buildings £25 fine, £2. 12s. 6d. costs 20, Fuller Street Withdrawn on payment of £l. lls. 6d. costs 100, St. Peter's Avenue Withdrawn on payment of £2. 2s. 0d. costs In 38 cases summonses were withdrawn owing to the nuisances being abated prior to the date of hearing, the defendants paying expenses amounting to £55. 13s. 0d. In one Instance the Justices adjourned the case sine die. 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:- -15-  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. 2 2 - 47 40 5 (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. 21 14 1 1 - - -l6- Factories, Workshops and Workplaces The provisions of the Factories Acts, 1937 and 1948 are administered by H.M. Inspector of Factories of the Ministry of Labour and National Service, in conjunction with the local sanitary authority. Close co-operation is maintained between the two, and defaults found in the course of visits to factories are notified between one and the other according to the body responsible for remedial measures. The principal duties of the sanitary authority are the enforcement of Sections 1, 2, 3. 4, 6 and 7 of the Factories Act, 1937, insofar as non-power factories are concerned, and Section 7 only in respect of power factories. The requirements of these sections may be summarised as follows:- Section 1 Every factory to be kept clean, and free from any effluvia arising from any drain, sanitary convenience or nuisance, and lays down the frequency with which cleansing must be undertaken. Section 2 A factory shall not be so overcrowded as to cause risk of injury to health of the persons employed therein. Section 3 Effective provision to be made for securing and maintaining a reasonable temperature in each work-room. Section 4 Effective and suitable provision for securing and maintaining adequate ventilation of each work-room, and for rendering harmless all fumes, dust and other impurities generated in the course of any work. Section 6 Effective drainage of floors where wet processes are carried on. -17- Section 7 Provision of sufficient and suitable sanitary conveniences, properly lighted, with separate accommodation for the sexes. Factories and Workplaces in this Borough carrying on a variety of trades number 1,486, and a total of 833 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 625 302 33 - 2. Factories not included in (1) in which Section 7 is enforced by the Local Authority 857 529 79 - 3. Other premises in which Section 7 is enforced by the Local Authority 4 2 - - TOTALS 1,486 833 112 - -18- 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 39 38 1 2 - Overcrowding - •- • - - Unreasonable temperature - 1 - - - Inadequate ventilation - 2 - 1 - Ineffective drainage of floors - - - - - Sanitary conveniences:- (a) Insufficient 1 1 - 1 - (b) Unsuitable or defective 132 118 1 5 - (c) Not separate for sexes 2 2 - - - Other offences against the Acts (not including offences relating to outwork) 117 99 5 1 - TOTALS 291 261 7 10 - -19- OUTWORK Outworkers (Section 110(1)(c)) Twice yearly, February and August, the Factories Act, 1937> requires all employers of outworkers in the Borough to forward to the Local Authority a list giving the names and addresses of all persons employed by them in homework during the previous six months. Of the 769 names of outworkers which appeared on the lists thus received, 226 were given as residing within the Borough; In addition 349 names of outworkers residing in Bethnal Green were forwarded from other boroughs. These figures are approximately double the number of individual workers as in the majority of cases the same people are notified in February and August. Particulars of those persons not resident in the Borough are forwarded to the Boroughs concerned. It may be of interest to mention that some of the homeworkers resident in Bethnal Green are employed by firms whose places of business are as far away as Leeds, Luton and Windsor, and local firms have sent in lists containing outworkers resident in Axminster, Eastbourne, Heckington (Lines.) and Bathavon (Somerset). The following information of classes of work and numbers of outworkers employed thereon, being Bethnal Green residents, is in respect of the August lists, received from employers in the Borough, and from other boroughs:- Number of Outworkers in August list required by Section 110(1)(c) Wearing apparel (making, etc.) 170 Curtains, Furniture hangings and Household Linen 26 Brushes 50 Boxes 20 Buttons, etc., Carding 19 Artificial Flowers 5 Christmas Crackers (1), Umbrellas (4), Feather Sorting (2) 7 Stuffed Toys 16 Total 313 —20— 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. Shops Acts During the year the Public Health Inspectors paid 170 visits to shops in relation to general sanitation, ventilation and temperature requirements. 27 notices were served in respect of unsatisfactory conditions found to exist. Disinfection and Disinfestation The following is a summary of the routine work carried out by the disinfecting staff during the years- No. of rooms disinfested 538 Articles of clothing, bedding, etc., submitted to steam disinfection 1,084 Articles disinfected by formalin 962 Hospital mattresses, pillows, etc., disinfected 3,863 Number of articles destroyed by request 2,004 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 19 families removing to Borough Council flats were disinfested. Personal Cleansing Station During the year, 16 adults and 1 child had baths for verminous conditions at the Personal Cleansing Station, simultaneous disinfection of clothing being carried out. In addition, 8 adults and 4 children received treatment for Scabies at the Station. Public Health Inspectors visit and advise in all cases of Scabies and in those cases where verminous conditions persistently recur. -21- 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 thirteen occasions. Prevention of Damage by Pests Act, 1949 During the year, 123 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 rodent operatives under the supervision of the Public Health Inspectors. Three notices under section 4(1) of the Act were served. Systematic baiting and poisoning was carried out by the Rodent Operatives on 370 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 1,326 manholes. Positive results were obtained in 540 instances. 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 i11, 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:- 1. Mrs. S:, aged about 83 years, was found to be infirm and physically incapacitated and living in Insanitary conditions. 2. Mrs. P., aged about 59 years, was found to be suffering from myocardial degeneration, bronchitis, persistent diarrhoea and was infirm and living in insanitary conditions. 3. Mrs. L., aged about 75 years, was found to be suffering from senility aggravated by chronic alcoholism, malnutrition and living in insanitary conditions. -22- In each of these cases, the persons concerned were unable to devote to themselves, and were not receiving from other persons, proper care and attention. They refused to enter a hospital, or a suitable institution, voluntarily and, in their own interests, there was no alternative but to apply for removal orders. These were granted, Mrs. S. being removed and detained in an Institution for six weeks, Mrs. P. removed and detained in a hospital for three weeks and Mrs. L. removed and detained in an institution for three weeks. Both of the old ladles settled down quite happily in the institution to which they were admitted, and expressed no desire to leave. Mrs. P. was in urgent need of hospital treatment and at the end of the year was still an in-patient. During the year, 53 other cases were brought to the notice of the Department where aged persons were in need of attention. It was possible in a number of these to provide necessary care for these old people in their own homes and the Home Help service provided by the London County Council was again helpful in this connection. 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. The Old People's Welfare Committee, comprising representatives of the Council and the various local organisations and social settlements, continued to provide all possible assistance to old people in the Borough by the provision of clubs, home visitation, meals-on-wheels service, chiropody service, holidays and outings, etc. Offensive Trades There are four premises in the Borough registered for the purpose of carrying on offensive trades. One being the business of fur skin dresser, two poultry slaughterhouses and one animal slaughterhouse. 55 visits of inspection were made to these premises. 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 -23- 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 45 premises are registered for the use of such materials in the trades conducted therein. 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 53 licences in respect of stalls. 10 warning letters were sent in connection with various infringements of the Act. Atmospheric Pollution A station for the monthly measurement of deposited matter and of sulphur dioxide is 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. In addition, a second station for recording the daily measurement of pollution by sulphur dioxide and of smoke is 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. Hairdressers and Barbers Section 18 of the London County Council (General Powers) Act, 1954, requires the registration of premises and the persons carrying on the business of hairdressers or barbers thereat. At the end of the year, 52 premises were registered and 59 inspections were made to them during the year. -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:- Cranbrook Street (Bethnal Green Borough Council) Buxton Street (London County Council) Newllng Street " " " Colllngwood Street ,, ,, " Demolition of Insanitary Houses (Section 11 Housing Act, 1936) Having regard to the effect of demolition upon adjoining property, Closing Orders were made upon eight 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. 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 1955 46l New cases reported during 1956 13 Total 474 Overcrowding abated during 1956 16 On register at end of 1956 Families Equiv. Adults Rehoused by London County Council 13 55 Rehoused by Bethnal Green Borough Council 2 19½ Removed from register:- No longer overcrowded by reason of altered circumstances - - Removed, mostly without trace 1 4 Removed, premises demolished - - Totals 16 78½ -25- Housing Act, 1936 The following legal proceedings were taken during the year:- Causing or permitting overcrowding at a dwelling-house. Defendant was fined £3, with £5. 5s. 0d. costs. Permitting a dwelling-house to be occupied as a factory in contravention of a written undertaking to relet for storage purposes only. Defendant was fined £15. with £2. 12s. 6d. costs. Permitting a room of a dwelling-house to be used for living purposes in contravention of a Closing Order made in 1955. Defendant was fined £10, with £2. 2s. 0d. costs. Housing Repairs and Rents Act, 1954 During the year, four houses each of which were let in lodgings or occupied by members of more than one family were found to be accommodating an excessive number of persons having regard to the rooms available. Notices prescribed by Section 12 of the Act, specifying the maximum number of persons permitted to occupy each room as sleeping accommodation at any one time, were served upon the responsible persons. The standard adopted was In accordance with the Fifth Schedule of the Housing Act, 1936. Housing Statistics General details with regard to inspection of dwelling-houses are submitted in the following tabular form. Total number of dwellings in the Borough 15,578 1. Inspection of Dwellinghouses during the year:- (1) (a) Total number of dwellinghouses inspected for housing defects (under Public Health and Housing Acts) 4,102 (b) Number of inspections made for the purpose 12,124 (2) (a) Number of dwellinghouses (Included under subhead (1) above which were inspected and recorded under the Housing Consolidated Regulations, 1925 42 (b) Number of inspections made for the purposes 389 -26- (3) Number of dwelllnghouses found to be in a state so dangerous or injurious to health as to be unfit for human habitation .. 17 (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 2,633 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 1,281 3. Action under Statutory Powers during the Year:- (a) Proceedings under Public Health Acts:- (1) Number of dwelllnghouses in respect of which notices were served requiring defects to be remedied 1,812 (2) Number of dwelllnghouses in which defects were remedied after service of formal notice:- (i) By Owners 706 (ii) By Local Authority in default of Owners 28 (b) Proceedings under Sections9 , 10 and 16 of the Housing Act, 1936:- (1) Number of dwellinghouses in respect of which notices were served requiring repairs - (2) Number of dwelllnghouses which were rendered fit after service of formal notices:- (i) By Owners (ii) By Local Authority in default of Owners (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 (3) Number of houses closed (Local Government (Miscellaneous Provisions) Act, 1953) 8 (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 - 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 379 (2) Number of dwellinghouses demolished as a result of Clearance Area procedure 7 Re-Housing Programme The following statement shows the number of families and persons accommodated by the Housing Committee to the 31st December, 1956:- Premises Families Persons Council flats 19 19 70 Requisitioned properties 2 2 7 Total 21 21 77 At the end of the year there were approximately 2,467 applications for re-housing outstanding. 28 SECTION D INSPECTION AND SUPERVISION OF POOD The Food and Drugs Act, 1955, together with the Food Hygiene Regulations, 1955, made under the Act, came into operation on 1st January, 1956. The Act repeals the Food and Drugs Amendment Act, 1954, and consolidates it with the Food and Drugs Act, 1938, the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, and certain other enactments amend and supplement Part V of the 1938 Act in relation to slaughterhouses and knacker's yards. Some of the more important changes in the law which are of concern to enforcing authorities are as follows:- Food and Drugs Act, 1955 1. Provides that the probable cumulative effects of consuming food injurious to health should be taken into consideration. 2. Former defences relating to patent and proprietary articles have been removed. 3. Allows authorised officers to examine and detain containers and vehicles excepting the detention of vehicles belonging to certain transport undertakings. 4. Gives power to a Court to disqualify a caterer convicted of a serious offence against the Food Hygiene Regulations. 5. Certain modifications have been made in the registration procedure. The time limit for attendance following the service of a notice cancelling or refusing registration is increased from seven to twenty-one days, and the applicant may be legally represented. 6. Contains new provisions as to description of cream substitutes. 7. Important changes in the procedure for sampling and analysis. 8. Penalties have been increased. 9. Changes in the conditions for the acceptance of a warranty as a defence. 29 Food Hygiene Regulations, 1955 These Regulations, most of which came into operation on 1st January, 1956, modified and extended the hygiene requirements of Section 13 of the Pood and Drugs Act, 1938, and included a number of provisions affecting stalls and vehicles and also certain general requirements that apply wherever food is handled. The Regulations apply whether or not there is any question of sale. They apply to the supply of food in the course of a business, which includes canteens, clubs, schools and other institutions as well as undertakings carried on by public and local authorities. The principal extensions of the previous law relate to the following:- (i) Specific requirements designed to prevent the contamination of food. (ii) Provision of sinks and other facilities for washing food and equipment. (iii) The provision of a constant supply of hot water for sinks, wash basins, etc., in food premises and of a supply of hot water on stalls and vehicles. (iv) Restrictions on the preparation and packing of food in or about domestic premises. (v) The conditions under which certain foods that provide a particularly favourable medium for food poisoning organisms are to be kept in food premises. (vi) The requirement to provide vehicles used for the transport of meat with duckboards and separate receptacles for offal, and, where the vehicles are not enclosed, a covering supported by a frame or poles. (vii) The circumstances in which persons carrying meat are required to wear overalls and head coverings. The attention of all food traders in the Borough was directed to the coming into operation of the Pood Hygiene Regulations and they were provided with a summary of some of the main provisions. They were also advised to obtain a copy of the Regulations so as to be fully aware of their obligations. In applying the Regulations during the year, many desirable improvements were obtained without recourse to official action but it was necessary on 23 occasions to serve notices for non-compliance with various requirements. 30 The following table gives the number of food premises in the Borough, by type of business, the number registered under Section 16 of the Food and Drugs Act, 1955, or the Milk and Dairies Regulations, 1949-1954, inspections made thereat and notices served. TABLE 6 INSPECTION OP FOOD PREMISES Type Number in Borough Number Registered Inspections Notices served Bakehouses 23 - 75 10 Bakers Shops 12 - 30 6 Butchers 46 39 256 24 Canteens 41 - 20 1 Cattle Slaughterhouses 1 - 7 - Confectioners 51 - 46 3 Eel and Pie Shops 10 8 15 1 Fish Curers 9 8 22 8 Fried Fish Shops 14 14 28 2 Fruiterers/Greengrocers 52 - 36 5 Grocers 61 3 100 15 Ice Cream Premises 162 162 177 16 Licenced Premises 140 - 138 23 Milkshops and Dairies 116 116 233 13 Miscellaneous 29 4 77 11 Other Fish Premises 15 - 41 10 Poultry Slaughterhouses 2 - 48 1 Restaurants 90 - 159 26 Street Stalls 224 - 222 1 Totals 1,098 354 1,730 176 During the year, legal proceedings were taken as follows:- Public Health (London) Act, 1936 Establishing without consent of the sanitary authority an offensive business, to wit, slaughtering of poultry. Defendant was given a conditional discharge and £3.3s.Od. costs were awarded to the Council. 31 Food and Drugs Act, 1955. Food Hygiene Regulations, 1955. Six summonses were taken out at the same time against the owners of a bakehouse, one under the Food and Drugs Act an five under the Food Hygiene Regulations, in respect of the undermentioned offences:- (i) Having in possession for the purpose of preparation for sale 35 lbs. of meal intended for but unfit for human consumption. (ii) Allowing filth to accumulate in room wherein food was stored. (iii) Falling to keep clean the equipment with which food comes into contact in pastry room. (iv) Falling to keep clean the floor and walls of bakehouse. (v) Depositing rubbish and allowing filth to accumulate in front basement wherein flour was stored. (vi) Allowing filth to accumulate in store cupboard under basement stairs which contained food. The Magistrate Imposed a fine in each case, totalling £200, and awarded £15.15s.0d. costs to the Council. Milk Supply (1) Inspection of Premises A total of 233 visits were made in 1956, to dairies and other premises in the Borough used in connection with the distribution of milk and in 13 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 1956 and the number of licences issued during the year under the Milk (Special Designation) Regulations, 1949, are set out as follows:- 32 Number of Premises on Register at end of year Dairies 14 Distributors:- (a) Inside the Borough 116 (b) Outside the Borough 29 Number of Licences issued under Milk (Special Designation)(Pasteurised and Sterilised Milk) Regulations, 1949, and Milk (Special Designation) (Raw Milk) Regulations, 1949 Sterilised Pasteurised Tuberculin Tested Dealers' Licences 106 71 32 Dealers' Supplementary Licences 25 23 22 Totals 131 94 54 (3) Milk Sampling During 1956, 38 informal samples of milk were submitted to the Public Analyst for examination, all of which were reported as genuine. In addition, 21 samples of heat treated milk were submitted to tests, the results of which are set out in Table 7. TABLE 7 Class of Milk No. tested Phosphatase test Methylene Blue test Passed Failed Passed Failed Void Pasteurised 21 21 - 17 1 3 13 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. 33 Slaughterhouse The number of animals killed at the licensed slaughterhouse in the Borough during the year was as follows:- Lambs 9 No carcases or offal were condemned. Unsound Pood During the year under review the Pood Inspector examined and took appropriate action in relation to unsound food on 79 occasions. Details of the food together with quantities are set out below:- Quantity Tons Cwts. lbs. Meat - Tinned 8 26 " - Carcase 5 2 Onions 6 — Peaches 3 104 Tomatoes 2 28 Dried Peas 1 - Chocolate 109 Cheese 96 Meal 74 Various 2 72 1 11 63 Other Foodstuffs Chickens 15 Fruit 237 tins, 1 jar Fish 205 tins Vegetables 198 tins Milk 38 tins Jam 29 tins, 24 Jars Soup 15 tins Sauce 50 bottles Various 12 Jars, 10 packets, 4 boxes, 1 tin, 1 bottle 34 In addition, 7 cwt. 22 lbs. of various tinned foodstuffs was seized at a food shop in the Borough, condemned and destroyed. Condemned food is collected by Council and destroyed or, where suitable, used for animal food. Food and Drugs Act Mr. A.E. Parkes, F.R.I.C., P.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 258 informal samples examined by the Public Analyst during 1956, 6 samples were found to be adulterated. 35 TABLE 8 SUMMARY OF ANALYST'S REPORTS ARTICLE SAMPLES TAKEN FORMALLY SAMPLES TAKEN INFORMALLY Total number of samples taken No. taken Genuine Adulterated No. taken Genuine Adulterated Culinary Powders - - - 40 38 2 40 Drugs - - - 23 23 - 23 Ice Cream - - - 9 9 - 9 Meat and Fish Paste - - - 20 20 - 20 Milk - - - 38 38 - 38 Sweet Confectionery - - - 10 10 - 10 Various - - - 118 114 4 118 Totals - - - 258 252 6 258 36 TABLE 9 Action taken in regard to samples reported by the Public Analyst to be not genuine. Sample No. Article Result of Analysis Action 48 Pickling Spice Infested with mites Stock withdrawn by wholesaler 70 Gravy Powder Infested with maggots Remaining stock destroyed 139 Parsley Mouldy do. 183 Tapioca Contained 140 parts per million of sulphur dioxide preservative in excess of amount permitted Letter of caution 217 Meal Contained mouse excreta and was infested with larvae £50 fine 251 Military Pickle Contained Jute fibres mixed with vegetable constituents Letter of caution 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. 37 Ice Cream During the year, 12 applications for registration for the sale of ice cream were approved and 6 premises were removed from the register upon ceasing the sale of ice cream. One application was refused on the grounds that potatoes and other dusty root crops were sold at the premises concerned. At the end of the year there were 162 registered premises in the Borough, 6 for manufacture, 155 for sale, and one for storage. 177 inspections of these premises were made during the year and in 16 instances notices were served concerning insanitary conditions. 14 samples of ice cream were submitted to the Methylene Blue test and graded as follows:- Grade 1 1 Grade 2 3 Grade 3 7 Grade 1 3 Where samples of ice cream made at premises in the Borough receive unsatisfactory reports, the methods of manufacture and handling are examined and improvements suggested as necessary. When the place of manufacture is in another area the Local Authority concerned is informed. Food Poisoning Seven notifications were received, 5 of which were confirmed bacteriologlcally, the organism in each instance being of the Salmonella group. Poods suspected were cream cake, meat pie and scallops; no portion of suspected food was available for bacteriological examination, and in four of the cases no particular food was suspected. There were no deaths. Milk in Schools The arrangements for sampling milk at London County Council Schools continued without variation. A total of 13 samples were submitted for examination, all of which satisfied the prescribed tests. 38 SECTION E PREVALENCE OF, AND CONTROL OYER, INFECTIOUS DISEASE The total number of notifications of infectious disease, excluding Food Poisoning, during 1956 was 514, as compared with 1,117 in 1955. The decrease was mainly due to the smaller number of cases of measles. Measles accounted for nearly 50% of all notifications and Whooping Cough for 28%. Six notifications of poliomyelitis were received during the year and In five cases the diagnosis was confirmed, all of these being 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 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 one certificate was issued. 39 TABLE 10 INFECTIOUS DISEASE DISEASE NOTIFICATIONS Total Notified Corrected figures Removed to Hospital 0-1 year 1-2 years 3-4 years 5-14 years 15-24 years 25-44 years 45-64 years 65 - years Diphtheria - - - 3 - 1 - - 4 - 4 Scarlet Fever - 3 6 15 2 3 - - 29 27 13 Puerperal Pyrexia - - - - - 1 - - 1 1 - Ophthalmia Neonatorum - - - - - - - - - - - Erysipelas - - - - - 1 2 1 4 4 - Meningococcal Infection 1 - - - - 1 - - 2 1 2 Acute Encephalitis - - - 1 - - - - 1 1 1 Acute Poliomyelitis - 2 - 3 1 - - - 6 5 6 Acute Pneumonia - - - 2 3 1 - 2 8 8 4 Paratyphoid "B" - 1 - 2 - - - - 3 3 2 Dysentery 1 6 5 10 1 3 - 2 28 25 8 Measles 10 71 66 58 - - - - 205 204 21 Whooping Cough 17 34 43 51 - - - - 145 145 10 Scabies - - - 7 - 3 2 1 13 13 - Pulmonary Tuberculosis 1 - - 5 17 16 19 3 61 60 Meninges and C.N.S. - - - - - - - - - - Other forms - - - - 1 3 - - 4 4 TOTALS 30 117 120 157 25 33 23 9 514 501 71 40 Tuberculosis During the year formal notifications (corrected) under the Public Health (Tuberculosis) Regulations, 1952, were received in respect of 60 cases of respiratory tuberculosis and 4 non-respiratory cases, as compared with 46 and 5 cases respectively for the previous year. The following table gives details of the age and sex Incidence of these casess:- TABLE 11 Primary Notifications Age periods 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total Respiratory males - - - - - 7 2 3 4 7 7 2 1 33 Respiratory females 1 - - 4 1 2 5 7 2 3 2 - - 27 Non-respiratory males - - - - - - - - - - - - - Non—respiratory females - - - - - - 1 2 1 - - - - 4 In addition to the above, information was received of 20 other cases by transfers from other areas, and 2 by death returns from Local Registrar. 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 1955, variations which have taken place during the year, and the number of cases remaining on the Register on the 31st December, 1956. 41 TABLE 12 Pulmonary Non-Pulmonary Total Males Females Males Females No. of cases on register 1.1.56 415 317 69 69 870 No. of cases notified during 1956 33 27 - 4 64 Other cases added to register during 1956 10 8 1 1 20 458 352 70 74 954 No. of cases removed from register during 1956 34 22 6 6 68 Remaining on register 31.12.56 424 330 64 68 886 42 SECTION F MISCELLANEOUS 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, 9 burials were arranged by the Department at a cost of £68. 1s. Od., of which £57. 14s. 4d. was recovered up to the end of the year, and a further £48. 15s. 0d. in respect of burials carried out before the period under review. Mortuary The arrangement between the boroughs of Poplar, Shoreditch and Bethnal Green whereby the Poplar Mortuary was the main mortuary for use by the three boroughs with the Bethnal Green Mortuary being maintained as a reserve for use in emergencies was discontinued during the year because of the reconstitutlon of Coroner's districts. A similar arrangement has now been made between the boroughs of Hackney, Shoreditch, Stoke Newington and Bethnal Green for the use of Hackney's mortuary. 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 1956, the names of 40 persons were retained on and one person added to the Council's list of Persons entitled to sell Part II Poisons. 43 All applications are investigated to ensure compliance with the Act and Poisons Rules. Swimming Baths 22 samples of water were taken during the year from the Council's Swimming Baths and submitted for bacteriological examination and chemical analysis. The reports showed that the water consistently maintained a high degree of purity. Medical Examination of Council's Staff From August the Medical Officer of Health became responsible for certain services in connection with the medical examination of members of the Council's staff. The following examinations were carried out:- Appointments and inclusion within Superannuation Scheme 14 Inclusion within J.I.C. Sick Pay Scheme 30 Absent through illnes3 for over one month 24 Others 8 International Certificates of Vaccination and Inoculation Arrangements continued during the year for the authentication by the Medical Officer of Health of Certificates of Vaccination and Inoculation. These certificates are required by persons proceeding abroad from this country and the purpose of the authentication is to provide information to health authorities abroad that the signature of the person issuing the certificate is that of a registered medical practitioner. Land Charges Act, 1925 Information concerning sanitary notices and Orders outstanding on premises in the Borough and also details of drainage systems is provided to the Town Clerk in respect of applications under the above Act. Enquiries in respect of 370 premises were dealt with during the year. 44 SECTION G 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.l. (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 1956. 2. Hospitals The following Hospitals in the Borough continued to be administered by the North East Metropolitan Regional Hospital Board:- Total bed complement x Bethnal Green Hospital 309 Mildmay Mission Hospital 56 Queen Elizabeth Hospital for Children (with branches at Shadwell and Banstead) 287 x 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. 45 3. Personal Health Services The following Information regarding the operation of the personal health services In the Borough during 1956, 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 Prove, 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 679 1-5 years of age 60 Total No. of children who attended and who were born in:- (i) 1956 551 (ii) 1955 341 (iii) 1954-51 276 Total attendances by children:- Under 1 year of age 7,040 1-5 years of age 1,356 46 (2) Ante-natal and Post-natal clinics Ante-natal consultations:- No. of women who attended during year 396 No. of new cases included in above 327 Total attendances 2,362 No. of women who attended for post-natal consultations 151 (3) Health Visitors No. of children visited during year 5,228 No. of children under one year of age visited for the first time 1,081 Total visits to children under 1 year of age 6,935 Total visits to children aged 1 year and under 2 years 4,317 Total visits to children aged 2 years and under 5 years 7,370 No. of expectant mothers visited 596 Total visits to expectant mothers 1,367 (4) Infant Life Protection No. on register at end of year:- Foster mothers 4 Foster children 5 (5) Child Minders (Daily Guardians) No. of Child Minders - Statutory - Voluntary 22 No. of children minded - Statutory - Voluntary 20 (6) Care of Premature Infants No. of premature live births during the year 57 No. of such children who died within 28 days of birth 10 47 (7) Diphtheria Immunisation No. of children who completed a full course of primary immunisation:- Under 5 years of age 868 5 to 14 years of age 269 No. of children given a reinforcing injection 1,132 (8) Vaccination No. of children successfully vaccinated or re-vaccinated 261 (9) Home Help Service Home help was provided as follows:- Maternity T.B. Aged and Chronic Sick Others Northern District Office-covering Bethnal Green and parts of Stepney and City of London 48 32 828 94