366 23 OCT 1968 Dap ELS IF7M ackd BET 65 Metropolitan Borough of Bethnal Green ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1960 S. A. BOYD, M.D. (Vienna), D.P.H., Medical Officer of Health Metropolitan Borough of Bethnal Green ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1960 S. A. BOYD, M.D. (Vienna), D.P.H., Medical Officer of Health INDEX Page Public Health Committee 2 Staff 3 Statistics of the Area 6 Vital Statistics 6 Causes of Death 8 Sanitary Circumstances of the Borough 10 Housing 23 Inspection and Supervision of Food 27 Prevalence of, and Control over, Infectious Disease 35 Miscellaneous 39 General Provision of Health Services other than those provided by the Borough Council 42 2 METROPOLITAN BOROUGH OF BETHNAL GREEN PUBLIC HEALTH COMMITTEE Chairman: Alderman W.E. Hart Vice-Chairman: Councillor A.E. Turpin Alderman H. Hooke „ Mrs. A.M. Sivill Councillor E.F. Berry „ Mrs. D. M. Couling „ R.H. Hare Councillor Miss H. Morsman „ Mrs. R.L. Rosamond „ Miss R. Sleigh „ Mrs. L. Sleigh „ A. Stocks Ex-Officio Members: The Worshipful the Mayor (Councillor G.M. Browne, J. P.) Alderman H.J. Stubbs, J.P. Councillor L. A. Coan „ J. Docherty „ G.A. Hadley „ A.C. Jacob „ R.H. May Council's Representatives on the London County Council (Division 5) Health Committee: Alderman Mrs. A.M. Sivill and Councillor Mrs. D. M. Couling. 3 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: W. Johnson ø D.R Waddell ø K.A. Webster (commenced 13th June, 1960) ø m Administrative and Clerical Staff, etc. Chief Clerk: J.E. Pestell Senior Clerk: S,A. Wright Assistant Clerks: R.F. Marshall : C.W. Foxton : F.S. Frid General Clerk: Mrs. J.E, Ingrey Junior Clerk: D. Lacy (commenced 2nd August, 1960) Housing Assistant: F.R. Hunter Pupil Public Health Inspectors: A.V. Sullivan :D. Jenner Other Employees: Disinfectors 3 Female Cleansing Attendant 1 Rodent Operatives 3 ø Certified Public Health Inspector m Certified Meat, etc., Inspector 4 ADVance 4831 Public Health Department, Town Hall, Bethnal Green, E.2. June, 1961. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Bethnal Green. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit my report on the health and sanitary circumstances of the Borough for the year 1960. In studying the causes of death in Bethnal Green one can conclude that having survived the first year of life the chances of reaching the age of 45 are very good indeed. In 1960 in this group, representing a total population of some 30,000 persons, there were 25 deaths. Were they deaths which could have been prevented? The answer to this question is that a number of these deaths could have been avoided because when we examine the 25 deaths we find that 7 were caused by motor vehicle accidents and one was due to another accident. Accident prevention should obviously be extended to over 45 age groups as well because there the sad tale continues with motor vehicle accidents causing 5 deaths and a further 5 deaths arising from other accidents. When we examine the deaths in the age group 45-75 we find that there were 170 male deaths as compared with 117 female deaths. There were more deaths amongst males due to their mode of living which must in some ways be different from that of the females. What can it be? In examining the causes of death in this age group we find deaths caused by cancer of the lung number 25 amongst the males and 5 amongst females; bronchitis, 16 males and 3 females; and coronary disease and angina, 39 males and 16 females. The number of deaths caused by these three diseases accounts for the excess of male over female deaths. Two of the conditions, cancer of the lung and bronchitis, have direct relationship to smoking. There is some connection between smoking and the third, coronary diseases, but here other more important factors enter into consideration such as over-eating, the type of food we take and lack of exercise. As to advice, do not smoke, or if that is impossible, smoke less and encourage the non-smoker to remain one. I am specially considering the young people - your children- in this respect. 5 In connection with the prevention of the coronary diseases our knowledge as yet is scanty, but good advice would be to eat enough but not too much, and to eat more fish and salads and less of the rich, fatty and fried foods and to take adequate exercise. I am pleased to have this opportunity to thank Alderman Mr. W.E. Hart, 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 the other Chief Officers of the Council and their staffs for their willing assistance at all times and my particular thanks are due to my own staff for their loyal assistance and support at all times. I have the honour to be, Your obedient Servant, S.A. BOYD, Medical Officer of Health. 6 SECTION A STATISTICS OF THE AREA Area 760 acres Population, estimated mid-year 47,580 Number of Dwellings 15,243 Rateable Value £744,242 General Rate 20s.0d. Sum represented by a penny rate £2,837 VITAL STATISTICS Live Births: Number 825 Rate per 1,000 population 17.3 Illegitimate Live Births (per cent of total live births) 7.5 Stillbirths: Number 11 Rate per 1,000 total live and stillbirths 0.23 Total live and stillbirths 17.5 Infant Deaths (deaths under 1 year) 22 Infant Mortality Rates: Total infant deaths per 1,000 total live births 25.6 Legitimate infant deaths per 1,000 legitimate live births 28.8 Illegitimate infant deaths per 1,000 illegitimate live births Nil Neo-natal Mortality Rate (deaths under 4 weeks per 1,000 total live births) 21.8 Early Neo-natal Mortality Rate (deaths under 1 week per 1,000 total live births) 19.4 Perinatal Mortality Rate (stillbirths and deaths under 1 week combined per 1,000 total live and stillbirths 32.3 Maternal Mortality (including abortion) Number of deaths Nil Rate per 1,000 total live and stillbirths - Death Rate per 1,000 estimated population 11.3 During 1960 the Registrar General estimated the population as 47,580 which is 1,380 less than in the previous year. The death rate was 11.3 per 1,000 persons as compared with a rate of 11.6 for 1959. Both births and deaths depend to some extent on the proportions 7 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 11.5 for England and Wales. The birth rate during 1960 was 17.3 as compared with 16.7 during the previous year. The adjusted rate for comparison with other areas is 16.4 as compared with 17.1 for England and Wales. The infant mortality rate was 25.6 as compared with the rate of 21. 9 for England and Wales. 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 864 live births (446 male and 418 female) were notified and in addition there were 10 stillbirths (8 male and 2 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. 8 9 TABLE 1 CAUSES OF DEATH Causes of Death under 1 year 1 to 4 5 to 14 15 to 24 25 to 44 45 to 64 65 to 74 75 and over Totals All causes M F M F M F M F M F M F M F M F M F 18 4 - - 2 2 1 1 8 11 88 51 82 66 83 122 282 257 1 Tuberculosis, respiratory 2 1 1 2 2 Tuberculosis, other 1 - 1 3 Syphilitic disease - - 4 Diphtheria - - 5 Whooping Cough - - 6 Meningococcal infections - - 7 Acute Poliomyelitis - - 8 Measles - - 9 Other infective and parasitic diseases 1 1 - 10 Malignant neoplasm, stomach 6 1 2 4 1 1 9 6 11 Malignant neoplasm, lung, bronchus 1 20 3 5 2 6 2 32 7 12 Malignant neoplasm, breast 4 6 1 2 1 12 13 Malignant neoplasm, uterus 1 2 1 1 - 5 14 Other malignant and lymphatic neoplasms 2 1 12 7 18 6 6 10 38 24 15 Leukaemia, aleukaemia 1 1 1 1 16 Diabetes 1 1 2 - 4 17 Vascular lesions of nervous system 2 5 9 9 11 10 20 24 42 18 Coronary disease, angina 1 2 19 5 20 11 16 19 56 37 19 Hypertension with heart disease 2 3 3 1 6 6 9 20 Other heart disease 1 1 6 4 3 3 6 17 16 25 21 Other circulatory disease 2 1 3 4 1 4 6 9 22 Influenza 1 - 1 23 Pneumonia 2 1 2 4 6 6 16 11 26 24 Bronchitis 1 8 - 8 3 14 8 31 11 25 Other diseases of respiratory system 1 2 3 - 26 Ulcer of stomach and duodenum 1 1 - 27 Gastritis, enteritis and diarrhœa - - 28 Nephritis and nephrosis 2 1 1 5 3 6 29 Hyperplasia of prostate 1 1 - 30 Pregnancy, childbirth, abortion - - 31 Congenital malformations 3 1 3 1 32 Other defined and ill-defined diseases 14 2 2 2 5 2 3 7 7 25 19 33 Motor vehicle accidents 1 1 1 3 1 2 1 1 1 7 5 34 All other accidents 1 1 2 1 1 4 2 35 Suicide 1 1 2 2 2 36 Homicide and operations of war - - 10 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 36 cases where wastage of water due to defective pipes or fittings was observed. During the year 53 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 four wells in use in the Borough. These are as follows:- Attached to Council's Public Baths 1 (not used for domestic purposes) Attached to a hospital 1 (used for all purposes) Supplementary supply for industrial purposes 2 (used for refrigeration purposes only) These wells are sampled at regular intervals. Sanitary Inspection of the Borough Following the 2,037 complaints of insanitary conditions, defects were found requiring the service of Intimation Notices in 1,115 cases. Of these,Statutory Notices were required in 373 instances and legal proceedings were instituted in 22 cases. In addition, 7 notices in accordance with the London County Council (General Powers) Act, 1955, two under Section 26 and five under Section 27, were served. In two 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 2,396 inspections were made during the year. 35 notices in accordance with Section 25 of the London County Council (General Powers) Act, 1955, were served and in eight instances the necessary work was carried out by the Council and the expenses incurred recovered from the owners of the properties. 11 TABLE 2 RECORD OF VISITS Bakehouses 56 Bakers Shops 53 Butchers 189 Canteens 61 Confectioners 94 Eel & Pie Shops 16 Fish Curers 15 Fried Fish Shops 55 Fruit and Greengrocery 91 Grocers 277 Ice Cream 233 Licensed Premises 123 Milkshops 258 Restaurants 333 Slaughterhouses (Poultry) 10 Street Stalls 465 Miscellaneous Food Premises 128 Infectious Disease 446 Food Poisoning 28 Complaints investigated 2,037 Aged and/or infirm persons 132 Factories 1,910 Outworkers 293 Housing Enquiries 468 Houses let in Lodgings 47 Drainage Works 2,396 Rent Act 70 Smoke Observations 50 Shops Act 512 Miscellaneous 1,849 Re-inspections 6,242 Total 18,937 12 TABLE 3 SANITARY DEFECTS IN CONNECTION WITH WHICH NOTICES WERE SERVED Dirty and/or dilapidated rooms 729 Defective drains and choked w.c.'s 128 Defective and dirty w.c.'s 893 Defective water supply 50 Defective paving 50 Defective gutters and rain water pipes 438 Defective roofs 434 Dampness 329 Defective dustbins 72 Smoke Nuisances 10 Accumulations of refuse 106 Other defects 1,184 Total 4,423 Supply of Dustbins In 25 cases during the year notices were served on Owners of properties in accordance with Section 12 of die London County Council (General Powers) Act, 1954. Legal Proceedings It was found necessary on 22 occasions during the year to take legal proceedings to enforce compliance with the requirements of Notices served. In 8 of these cases Abatement Orders were made by the Justices with the infliction of costs amounting to £24.0s.0d. Brief details are set out below:- ABATEMENT ORDERS Premises Offence Result of Proceedings 162, Sewardstone Road Non-compliance With Nuisance Notice Abatement Order made (14 days) £3.0s.0d. costs do. do. Abatement Order made (28 days) £3.0s.0d. costs 8, Pedley Street do. do. do. 172, Vallance Road do. do. do. 4, Falcon Buildings do. do. do. 13 Premises Offence Result of Proceedings 14, Hunslett Street Non-compliance with Nuisance Notice Abatement Order made (28 days) £3.0s.0d. costs 15, Wood Close do. do. do. Leslie House do. do. do. In 1 case, a further summons was taken out for non-compliance with Abatement Order, as follows:- Premises Result of Proceedings 16, St. Peter's Close Withdrawn, £2.2s.0d. costs In 13 cases summonses were withdrawn owing to the nuisances being abated prior to the date of hearing, the defendants paying expenses amounting to £25.4s.0d. Rent Act, 1957 During the year, the following applications were received in accordance with the First Schedule of the Act. Part 1 - Applications for Certificates of Disrepair (1) Number of applications for certificates 6 (2) Number of decisions not to issue certificates Nil (3) Number of decisions to issue certificates 6 (a) in respect of some but not all defects 2 (b) in respect of all defects 4 (4) Number of undertakings given by landlords under paragraph 5 of the First Schedule 4 (5) Number of undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule 2 (6) Number of certificates issued 4 14 Part 11 - Applications for Cancellation of Certificates (7) Applications by landlords to Local Authority for cancellation of certificates 9 (8) Objections by tenants to cancellation of certificates Nil (9) Decisions by Local Authority to cancel in spite of tenants' objection Nil (10) Certificates cancelled by Local Authority 12 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. Factories and Workplaces in this Borough carrying on a variety of trades number 1,252 and a total of 1,775 inspections and re-inspections were made during the year. 111 investigations 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:- 15 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 453 623 71 - 2. Factories not included in (1) in which Section 7 is enforced by the Local Authority 793 1,149 194 - 3. Other premises in which Section 7 is enforced by the Local Authority 6 3 - - TOTALS 1,252 1,775 265 - 16 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 26 19 - - - Overcrowding - - - - - Unreasonable temperature - - - - - Inadequate ventilation 1 - - - - Ineffective drainage of floors 1 - - - - Sanitary conveniences:- (a) Insufficient 1 - - 1 - (b) Unsuitable or defective 483 435 - 6 - (c) Not separate for sexes - 1 - - - Other offences against the Acts (not including offences relating to outwork) 192 191 2 - - TOTALS 704 646 2 7 - 17 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 431 names of outworkers which appeared on the employers lists received in August, 106 were given as residing within the Borough; in addition 129 names of outworkers residing in Bethnal Green were forwarded from other Councils. 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 Authorities:- Number of Outworkers in August list required by Section 110(l)(c) Wearing apparel (making, etc.) 139 Curtains and Furniture hangings 23 Brushes 4 Boxes 45 Buttons, etc., Carding 10 Artificial Flowers 3 Christmas Crackers, etc. 5 Umbrellas 4 Stuffed Toys 2 235 Section 110. There was no case of default in sending lists to the Council. Section 111. There was no instance of work being carried on in unwholesome premises. Shops Acts The Borough Council has power to require, in any shop in which persons are employed, suitable and sufficient lighting, washing facilities and facilities for the taking of meals and is responsible for ventilation and temperature of shops and their sanitary conveniences. During the year, 348 visits were made to shops and 18 notices 'Were served in respect of unsatisfactory conditions found to exist. 18 Disinfection and Disinfestation The following is a summary of the routine work carried out by the disinfecting staff during the year:- Number of rooms disinfested 775 Articles of clothing, bedding, etc. submitted to steam disinfection 649 Articles disinfected by formalin 2,449 Hospital mattresses, pillows, etc. disinfected 6,556 Number of articles destroyed by request 1,890 In addition, on 2 occasions rubbish which had been dumped on open sites, etc., was sprayed with insecticide prior to removal. The furniture and bedding of 120 families removing to Borough Council flats were disinfested. Personal Cleansing Station During the year, 47 adults had baths for verminous conditions at the Personal Cleansing Station, simultaneous disinfection of clothing being carried out. In addition, 21 adults and 6 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. 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 173 occasions, as compared with 32 during 1959. This is a complicated and difficult service but one which is most worth while and for which the homebound and often disabled persons concerned are very thankful. Laundry Service for Incontinent Persons The arrangement with Hackney Borough Council for the laundering of articles of bed linen and personal clothing from incontinent persons continued during the year. 19 During the year 577 articles belonging to nine persons were collected, laundered and returned. Prevention of Damage by Pests Act, 1949 During the year, 257 complaints of infestation by rats or mice were received and in most cases of rat infestation 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 at 322 domestic premises and at 205 business premises, 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 1,311 manholes. Positive results were obtained in 586 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 ill, infirm or incapacitated persons who are not receiving proper care and attention. During the year under review it was found necessary in three cases to use the powers of the Act:- One of these cases was in respect of a woman aged 75 years, who was infirm and physically incapacitated and living in insanitary conditions. She was unable to devote to herself and was not receiving from other persons, proper care and attention. She refused to enter a suitable institution and, in her own interest, there was no alternative but to apply for a removal order, which was granted by the Magistrate. The two other cases were in respect of women aged 73 and 89 years who were infirm and physically incapacitated and living in insanitary conditions. They were also in need of urgent hospital treatment but refused to enter hospital voluntarily and, in their own interests, there was no alternative but to apply for removal orders which were granted by the Magistrate. 20 During the year 21 other cases of aged persons in need of attention were brought to the notice of the Department. 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 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 two premises in the Borough carrying on offensive trades, one being the business of a fur skin dresser and the other a poultry slaughterhouse. 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 26 premises are registered for the use of such materials in the trades conducted therein. Pet Animals Act. 1951 The operation of this Act is very important in Bethnal Green on account of the well known 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. During the year 12 licences for the sale of pet animals were granted in respect of shops and 51 licences in respect of stalls. Three warning letters were sent in connection with various infringements of the Act. 21 Clean Air Act, 1956 In accordance with the Council's proposed programme of smoke control orders for the Borough, the Minister of Housing and Local Government duly confirmed during the year the Council's first Order which came into operation on 1st December, 1960. On receipt of the confirmation every householder in the Area whose premises had fireplaces where conversions were considered necessary was invited to submit estimates of the cost of the works required. Inspections followed the receipt of these estimates and tenants were in due course notified of the Council's approval to the proposed works of adaptation and the amount of grant payable on satisfactory completion of the work. Subsequent visits were made when claims were submitted for payment of the grants. The operative date of the Order was widely publicised so that all householders and business premises in the Area were made aware that the emission of smoke from chimneys in the Zone after 1st December, 1960, might constitute an offence under the Clean Air Act of 1956. Notices under Section 12 (2) of the Act were served where necessary. Preliminary action was taken in the Spring of 1960 to introduce the Council's: No.2 Smoke Control Order. The Order was made by the Council in November and at the end of the year the Minister's confirmation was awaited. There are over 2,500 householders in this area and it is expected that this Order will become operative later in 1961, Tenants have co-operated well and there is no doubt that the implementation of the Council's Clean Air policy is meeting with goodwill and approval. 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. 22 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, 51 premises were registered and 123 inspections were made to them during the year. - 23 - SECTION C HOUSING Clearance Areas Properties included in areas scheduled for slum clearance during the period 1956-1960 have been dealt with and discussions took place during the year between this Council and the London County Council upon the programme for 1961-65. With the demolition and clearance of properties in areas zoned for industrial purposes, sites have become available for the segregation of industrial premises from residential property. Many new factories have been erected in the Borough which by modern methods of production have secured a marked improvement in the exclusion of noise and dust. The following clearance areas were confirmed by the Minister of Housing and Local Government during the year:- Great Eastern Buildings 28 flats (Bethnal Green Borough Council) Grimsby Street 9 houses - ditto - Eckersley Street) Pedley Street ) 15 houses (London County Council) Demolition/Closing of Unfit Houses Having regard to the effect of demolition upon adjoining property, Closing Orders were made upon eight premises in accordance with Section 17 of the Housing Act, 1957, in lieu of making Demolition Orders. Closing of Unfit parts of Buildings Following official representation 15 Closing Orders were made during the year under Section 18 of the Housing Act, 1957, prohibiting the use for human habitation of the rooms concerned. Overcrowding (Housing Act, 1957) Details of overcrowding in the Borough, and of cases where overcrowding was abated, are as follows:- - 24 - No. of cases On register at end of 1959 173 New cases reported during 1960 10 Total 183 Overcrowding abated during 1960 14 On register at end of 1960 169 Families Equiv. Adults Rehoused by London County Council 8 36½ Rehoused by Bethnal Green Borough Council 6 25½ Rehoused Privately - - Section 9, Housing Act, 1957 During the year 109 premises were inspected and detailed specifications prepared of works required to be carried out to render the dwellings in all respects reasonably fit for human habitation, in accordance with Section 9 of the Housing Act, 1957, to enforce all essential repairs providing this could be done at reasonable cost. Action was taken in the first instance by sending letters to owners enclosing two copies of the specification and informing them that the Council would shortly be giving consideration to exercising their powers under Section 9 and asking if they were prepared to execute the works, in which case statutory procedure would not be necessary. In nearly every case a prompt acknowledgement was forthcoming requesting time to consider and to obtain builders' estimates, and subsequently an undertaking from the owner to carry out work was received, in some instances after a prior discussion on the matter. It had been the intention to allow the owners two months for consideration after which the authority of the Public Health Committee would have been sought for service of Section 9 notices but in one instance only was this found necessary as the responses of the owners were most surprisingly favourable. At the end of the year on a substantial number of the properties the work had been completed or was in progress and for the remainder a definite promise to carry out the work had been received. The following legal proceedings were taken during the year: - 25 - Housing Act, 1957 Permitting basement rooms to be used in contravention of Closing Order. Defendant was find £10, with £2. 6s. 0d. costs. Permitting basement room to be used in contravention of Closing Order. The summons was dismissed. New Housing During the year new housing accommodation was provided as shown below:- Names of Premises Provided by Number of dwellings Waring House London County Council 5 Ramsey Street do. 48 Total 53 Housing Statistics Inspection of Dwelling Houses during the year:- Total number of dwellings in the Borough 15,243 Number of initial visits to dwelling houses on complaint 2,037 Number of dwelling houses inspected with a view to action under Part II of the Housing Act, 1957 294 Number of dwelling houses visited for any other reason 5,550 Total number of re-inspections for any of the reasons set out above 6,242 Number of unfit or defective houses made fit or repaired as a result of informal action 1,077 Action under Statutory Powers Public Health (London) Act. 1936 Number of houses in which defects were remedied after service of formal notices. - (a) By Owners 453 (b) By Local Authority in default of Owners 8 - 26 - Houses Let in Lodgings (Housing Act, 1957) Houses made fit for occupation by number of families accommodated (Section 36) 1 Overcrowding abated (Section 36) 2 cases Demolition and Closing Orders (Housing Act, 1957) Closing Orders made in lieu of Demolition Orders (Section 17) 8 houses Parts of buildings closed by Closing Orders (Section 18):- (i) Underground rooms 5 (ii) Other rooms 10 Undertaking not to use parts of a building for human habitation accepted 1 room Re-Housing Programme The following statement shows the number of families and persons accommodated by the Housing Committee during the year:- Premises Families Persons In Council flats, maisonettes and conversions 78 78 209 At the end of the year there were approximately 1,847 applications for re-housing outstanding. - 27 - SECTION D INSPECTION AND SUPERVISION OF FOOD 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 (General) Regulations, 1959, inspections made thereat and notices served. TABLE 6 INSPECTION OF FOOD PREMISES Type Number in Borough Number Registered Visits Notices served Bakehouses 19 - 59 8 Bakers Shops 18 - 19 2 Butchers 44 37 167 26 Canteens 38 - 47 4 Confectioners 55 - 87 6 Eel and Pie Shops 9 9 17 1 Fish Curers 7 7 18 7 Fried Fish Shops 11 11 43 2 Fruiterers/Greengrocers 47 - 76 6 Grocers 68 3 161 13 Ice Cream Premises 142 142 233 12 Licenced Premises 125 - 151 17 Milkshops and Dairies 95 95 225 23 Miscellaneous 35 2 61 3 Other Fish Premises 10 2 22 7 Poultry Slaughterhouses 1 - 9 2 Restaurants 73 - 274 53 School Meals Kitchens 17 - 15 - Street Stalls 217 - 153 11 Totals 1,031 308 1,837 203 During the year legal proceedings in respect of food premises were taken as follows:- Food and Drugs Act, 1955 Selling meat pies which contained mice excreta. Defendants were fined £10, with £5.0s.0d. costs. - 28 - Selling chicken and veal pies which were found to contain green mould. Defendants were fined £10, with £2.0s.0d. costs. Unlawfully obstructing Public Health Inspector from carrying out proper inspection of food premises. Defendant was fined £3. Food Hygiene Regulations, 1955 Not refraining from the use of tobacco while handling open food in a food room in which there was open food. Defendant was fined £5, with £1.0s.0d. costs. Not refraining from the use of tobacco while in a food room in which there was open food. Defendant was fined £5, with £1.0s.0d. costs. Permitting cakes on food stall to be displayed for sale on the ground on the public footway so as to involve a risk of contamination. Defendant was fined £2, with £1.0s.0d. costs. Failing to provide suitable screening at the sides and back of shellfish stall in such a manner as to prevent any mud, filth or other contaminating substance from being deposited upon any fish thereon. Defendant was fined £2, with 10s.0d. costs. Food Hygiene (General) Regulations, 1960 Summonses were taken out against an occupier of food premises in respect of the undermentioned offences:- (i) Failing to maintain sanitary convenience in efficient order. (ii) F ailing to maintain in prominent and suitable position near sanitary convenience at food premises a clearly legible notice requesting users to wash their hands after using convenience. (iii) Failing to provide suitable and sufficient wash hand basin for use of all persons engaged in handling of food on or about premises in position conveniently accessible to such persons. - 29 - (iv) F ailing to maintain in efficient working order sink provided for washing food and equipment used in food business. (v) Failing to keep kitchen floor clean and in such good order, repair and condition as to enable it to be effectively cleaned. The Justices imposed fines totalling £25 and awarded £3.0s.0d. costs to the Council. Other legal proceedings were as follows:- Milk and Dairies (General) Regulations, 1959 Failing to ensure that a bottle used for containing milk, immediately before use, was in a state of thorough cleanliness. Defendants were fined £5, with £3.3s.0d. costs. Regulation No. Particulars No. of contraventions 8 Food insufficiently protected from risk of contamination 13 9 Persons to refrain from smoking whilst engaged in handling food 1 12 Soil drainage system not properly constructed 1 14 Sanitary conveniences either not kept clean or unsuitable 22 15 Lack of proper water supply to food premises 1 16 Inadequate handwashing facilities or insufficient suitable water supply or no proper water supply 5 18 No proper storage accommodation for staff clothing 12 19 Inadequate facilities for washing equipment 3 21 Ventilation to food rooms not suitable or insufficient 1 23 Food rooms in unclean, unsuitable or defective condition 30 24 Unnecessary accumulations of refuse 19 27 No suitable covered receptacle for waste 9 Milk Supply (1) Inspection of Premises A total of 225 visits were made in 1960, to premises in the Borough used in connection with the distribution of milk and in 23 instances appropriate action was taken to deal with unsatisfactory conditions which were found to exist. - 30 - (2) Registration and Licensing Details of premises on the register at the end of 1960, and the number of licences issued during the year under the Milk (Special Designation) Regulations, 1949 to 1954, are set out as follows:- Number of Premises on Register at end of year Dairies 10 Distributors (a) Inside the Borough 85 (b) Outside the Borough 27 Number of Licences issued under Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 to 1953 and Milk (Special Designation) (Raw Milk) Regulations, 1949 to 1954 Sterilised Pasteurised Tuberculin Tested Dealers' Licences 91 70 44 Dealers' Supplementary Licences 26 24 23 Totals 117 94 67 (3) Milk Sampling During 1960, 20 informal samples of milk were submitted to the Public Analyst for examination, all of which were reported as genuine. In addition, 16 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 15 15 . 15 . . Tuberculin Tested (Pasteurised) 1 1 - 1 - - Total 16 16 - 16 - - 20 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. - 31 - Unsound Food During the year under review the Food Inspector examined and took appropriate action in relation to unsound food on 50 occasions. Details of the food together with quantities are set out as follows:- Quantity Tons Cwts Lbs Argentine Frozen Horsemeat 25 14 10 Meat - Tinned 1 10 2½ " Carcase 2 28¾ Wheat Gluten 13 - Walnuts 4 - French Frozen Egg White 3 24 Prunes 3 - Pears 2 32 Fish 1 84 Chickens 1 55 Lard 28 Flour 22 Dried Broad Beans 17½ Oats 5 28 15 84¾ Other Foodstuffs Fruit 450 tins Vegetables 74 " Milk 14 ,, Soup 8 ,, Biscuits 204 packets Various 5 ,, 6 tins Food and Drugs Act Mr. H. A. Parkes, B.Sc., F.R. I. C. of 161 Bow Road, E.3, is Public Analyst for the Borough. Out of a total of 167 samples (4 formal and 163 informal) examined by the Public Analyst during 1960, 9 samples were found to be adulterated, 2 formal and 7 informal. - 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 Culinary Powders and Mixtures - - - 34 33 1 34 Drugs - - - 4 4 - 4 Flour - - - 4 4 - 4 Luncheon Sausage 1 - 1 5 4 1 6 Meat and Fish Paste - - - 6 6 - 6 Milk - - - 20 20 - 20 Sausages - - - 7 7 - 7 Sweet Confectionery - - - 4 4 - 4 Various 3 2 1 79 74 5 82 Total 4 2 2 163 156 7 167 - 33 - TABLE 9 Action taken in regard to samples reported by the Public Analyst to be not genuine. Sample No. Article Result of Analysis Action 49 Pickled Red Cabbage Contained a slimy deposit of living bacteria Further sample takengenuine 52 Dried Broad Beans Contained grubs and eggs Remaining stock destroyed 76 Luncheon Sausage Contained 176 parts per million of sulphur dioxide preservative Further sample takensee No.88 88 Luncheon Sausage Contained 132 parts per million of sulphur dioxide preservative Further sample takengenuine 102 Mineral Water "TIZER" Contaminated with white spirit Letter of caution 121 Faggots Contained 124 parts per million of sulphur dioxide preservative Further sample taken see No. 125 125 Faggots Contained 84 parts per million of sulphur dioxide preservative Verbal caution 129 Sweetened Pudding Mixture Contained living larvae and portions of cocoon Further sample taken genuine 130 Minced Beef (canned) Had a very objectionable smell Further sample taken genuine - 34 - 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. Frozen Egg During the year 4 samples of frozen egg, contaminated by Salmonella organisms, were submitted for bacteriological examination after pasteurisation and satisfactory reports were received thereon. The pasteurisation plant concerned is installed at a large local firm of provision merchants and I have given permission for regular consignments of contaminated frozen egg to be processed thereat under my supervision. Ice Cream During the year, 20 applications for registration for the sale of ice cream were approved and 30 premises were removed from the register upon ceasing the sale of ice cream. At the end of the year there were 142 registered premises in the Borough. 233 inspections of these premises were made during the year and in 12 instances notices were served concerning insanitary conditions. 19 samples of ice cream were submitted to the Methylene Blue test and graded as follows:- Grade 1 13 Grade 2 3 Grade 3 1 Grade 4 2 Each of the three samples graded 3 and 4 were followed immediately by further samples being taken from the two manufacturers concerned; these samples were reported as Grade 1. Food Poisoning Notifications (corrected) totalled seventeen. Salmonella organisms were isolated in six instances but the source of infection in each case was undiscovered. - 35 - There were no deaths. Milk in Schools The arrangements for sampling milk at London County Council Schools continued during the year, A total of 20 samples were submitted for examination, all of which satisfied the prescribed tests. SECTION E PREVALENCE OF, AND CONTROL OVER, INFECTIOUS DISEASE The total number of notifications of infectious disease, excluding Food Poisoning, during 1960 was 340 as compared with 342 in 1958 and 897 in 1959. The four confirmed cases of poliomyelitis were non-paralytic. There were no cases of Diphtheria. The number of cases of other diseases notified is shown in Table 10 which follows, and requires no special comment. - 36 - 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 and over Scarlet Fever _ 3 8 1 - - - 12 11 2 Puerperal Pyrexia - - - - 3 1 - - 4 4 - Ophthalmia Neonatorum 2 - - - - - - - 2 2 1 Erysipelas - - - - - 2 - 2 4 4 3 Meningococcal Infection 1 - 1 1 - - - - 3 2 3 Acute Encephalitis _ _ _ 1 _ _ _ - 1 1 1 Acute Poliomyelitis - 2 2 1 - - - - 5 4 5 Acute Pneumonia - 1 - 1 - 1 1 - 4 4 - Dysentery 7 12 6 11 1 6 1 - 44 43 9 Measles 1 21 16 8 1 - - - 47 47 9 Whooping Cough 23 49 33 60 - - - - 165 164 22 Scabies - 1 2 5 3 1 1 . 13 13 _ Pulmonary Tuberculosis - 1 - 1 3 14 9 6 34 34 - Meninges and C.N.S. - - - - - - - - - - - Other forms - - - - 1 1 - - 2 2 " TOTALS 34 87 63 97 13 26 12 8 340 335 55 - 37 - Tuberculosis During the year formal notifications (corrected) under the Public Health (Tuberculosis) Regulations, 1952, were received in respect of 34 cases of respiratory tuberculosis and 2 non-respiratory as compared with 39 respiratory cases and three non-respiratory cases for the previous year. The following table gives details of the age and sex incidence of these cases:- TABLE 11 Age Periods Primary Notifications 0 - 1 - 2 - 5 - 10 - 15- 20- 25- 35- 45- 55- 65- 75- Total Respiratory males - 1 - 1 - 1 - 5 5 3 4 6 - 26 Respiratory Females - - - - - - 2 4 - 1 1 - - 8 Non-respiratory males - - - - - - - - - - - - - - Non-respiratory females - - - - - - 1 1 - - - - - 2 In addition to the above, information was received of 22 other cases by transfers from other areas. There were 4 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 1959, variations which have taken place during the year, and the number of cases remaining on the Register on the 31st December, 1960. - 38 - TABLE 12 Pulmonary N on-Pulmonary Total Males Females Males Females No. of cases on register 1.1.60 360 286 47 59 752 No. of cases notified during 1960 26 8 - 2 36 Other cases added to register during 1960 11 5 2 4 22 No.of cases removed from register during 1960 397 299 49 65 810 40 25 2 6 73 Remaining on register 31.12.60 357 274 47 59 737 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 require a contact or carrier of infectious disease to stay away from work and during the year under review one such certificate was issued. - 39 - 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 £56.9s.0d. of which £49.18s.0d. was recovered up to the end of the year. Mortuary The arrangement between the boroughs of Hackney, Shoreditch, Stoke Newington and Bethnal Green whereby the Hackney Mortuary receives bodies from these districts continued during the year. The cost of the Mortuary is borne on a population basis by the four authorities. 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 1960, the names of 39 persons were retained on, and three persons added to 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. Swimming Baths There are two indoor swimming baths at the Council's Public Baths in Old Ford Road, E.2. One is a large pool 100' by 40' which contains 120,000 gallons of water. (This pool is used for mixed bathing and is converted to a Public Hall during the winter months). The other pool measures 75' by 35" and contains 80,000 gallons of water. - 40 - The water for both these swimming pools is obtained from the Metropolitan Water Board and only needs to be changed annually. The method of purification is by continuous circulation with a 3½ hour turn-over, with the water passing through pressurised sand filters where pollution added by the bathers is removed. The water is chemically treated and efficiently sterilised by chlorinating equipment. Three samples of water were taking during the year from these pools and submitted for chemical analysis. The reports showed that the water consistently maintained a high degree of purity. There is also a swimming bath, and open air one, in Victoria Park which is provided and maintained by the London County Council. The water for this pool is supplied by the Metropolitan Water Board and its method of treatment is by pumping in free chlorine from steel cylinders at the rate of 5 lbs. per hour under normal bathing conditions increasing to 8 lbs. per hour when the number of bathers increases to 1,000 or over. Pumping capacity is at the rate of 240,000 gallons per hour and the capacity of the pool approximately 650,000 gallons. Complete water change takes place not less than once every five hours. Rapid filtration, continuous chlorination and aeration keep the water clear, sparkling and attractive in appearance and of a good bacterial purity. The water is changed annually and periodic chemical and bacteriological examinations are carried out by the London County Council. Medical Examination of Council's Staff The Medical Officer of Health carried out the following medical examinations of members of the Council's staff:- Appointments and inclusion within Superannuation Scheme 70 Inclusion within Sick Pay Schemes 77 Absent through illness for over one month 86 Others 18 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 - 41 - 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 225 premises were dealt with during the year. - 42 - SECTION G GENERAL PROVISION OF HEALTH SERVICES OTHER THAN THOSE PROVIDED BY THE BOROUGH COUNCIL 1. (a) Laboratory Facilities Bacteriological examinations are carried out by the Public Health Laboratory Service (directed by the Medical Research Council for the Ministry of Health) at the laboratory, County Hall, S.E.1. This laboratory is available for both medical and sanitary bacteriology. A stock of specimen outfits is maintained at the Public Health Department and these are issued to medical practitioners upon request. (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 1960. 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 301 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 is associated with the Queen Elizabeth Hospital for Children, and has a complement of 40 beds. - 43 - 3. Personal Health Services The following information regarding the operation of the personal health services in the Borough during 1960, 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. Maternity and Child Welfare Centres Greenwood, Peel Grove, E.2. Rochelle, Club Row, E.2. School Treatment Centres:- Bethnal Green School Treatment Centre, Lyte Street, E.2. Rochelle Street Treatment Centre, Rochelle School, E.2. Foot Clinic Bethnal Green School Treatment Centre, Lyte Street, E.2. (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 one year of age 621 Total No.of children who attended during the year and who were born in:- (i) 1960 558 (ii) 1959 366 (iii) 1955-58 294 Total attendances by children Under 1 year of age 6,781 1-5 years of age 1,620 - 44 - (2) Ante-natal and Post-natal clinics Ante-natal consultations:- No. of women who attended during year 242 No. of new cases included above 195 Total attendances 1,232 No. of women who attended for post-natal consultations 96 (3) Health Visitors No. of children (aged 0-4 inc.) visited during year 3,442 No. of children under one year of age visited for the first time 720 Total visits to children under 1 year of age 4,118 Total visits to children aged 1 year and under 2 years 2,333 Total visits to children aged 2 years and under 5 years 5,083 No. of expectant mothers visited 347 Total visits to expectant mothers 761 (4) Care of Expectant Mothers No. of premature live births 66 No. of such infants who died within 28 days of birth 8 (5) Child Minders (Daily Guardians) No. of Child Minders - Statutory Voluntary 23 No. of children minded - Statutory Voluntary 20 (6) Diphtheria Immunisation No. of children who completed a full course of primary immunisation:- under 5 years of age 773 5 to 15 years of age 131 No. of children given a reinforcing injection 745 (7) Vaccination No. of children successfully vaccinated or re-vaccinated 379 - 45 - (8) 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 23 20 992 56