Ac 4366 II BET 68 Metropolitan Borough of Bethnal Green ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1963 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 1963 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 26 Prevalence of, and Control over, Infectious Disease 38 Miscellaneous 42 General Provision of Health Services other than those provided by the Borough Council 44 - 2 - METROPOLITAN BOROUGH OF BETHNAL GREEN PUBLIC HEALTH COMMITTEE Chairman: Councillor B. A . McCarthy Vice-Chairman: Councillor A. M. Praag Alderman W .E. Hart Councillor D.A . Bales ,, E. Bishop ,, J.R. Callaghan ,, Mrs. D.M. Couling Councillor G.A. Hadley ,, R.H. Hare ,, A.W. Hastings ,, W. Hilliard ,, Miss R. Sleigh Ex-Officio Members: The Worshipful the Mayor (Councillor R.H. Rosamond , J.P.) Alderman G.M. Browne ,, A .C. Jacob ,, Mrs. A.M Sivill Councillor H. Bloom ,, L.A. Coan ,, W.J. Griffiths ,, J. Orwell ,, A. Stocks 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 (retired May, 1963) E.F. Swash ø (appointed June, 1963) Senior Housing Inspector and Deputy Senior Public Health Inspector : S.R. Slater ø m District Inspectors : J.W. Parton ø : D. Thomson ø (left June, 1963) : A . V. Sullivan ø D. Jenner ø m : F.R. Hunter ø : R.E. Williams ø m (commenced September, 1963) Administrative and Clerical Staff, etc. Chief Clerk : J.E. Pestell Senior Clerk : S.A. Wright Assistant Clerks : R.F.Marshall : C.W. Foston : T.E. Oldfield (commenced January, 1963) General Clerk : Mrs. J.E. Ingrey Junior Clerk : F.C. Tulley Housing Assistant : W .G. Kidson (commenced April, 1963) Pupil Public Health : P.J. Barnes Inspectors : D.R. Bower (commenced April, 1963) Health Officer : Mrs. J.M. Harrold , S.R.N., R.F.N. , (commenced March, 1963) Assistant Welfare Officer : Mrs. O. Haga , S .R.N. (commenced October, 1963) Other Employees Disinfectors 3 Female Cleansing Attendant 1 Rodent Operatives 4 ø Certified Public Health Inspector m Certified Meat, etc. Inspector - 4 - ADVance 4831 Public Health Department, Town Hall, Bethnal Green , E.2. June, 1964. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Bethnal Green. Mr. Mayor, Ladies and Gentlemen , I have the honour to report on the health and sanitary circumstances of the Borough for the year 1963. Last year I referred to areas of unfit houses represented during both the previous and present clearance programmes and to the erection of new homes on the sites provided. During the year under review in pursuance of the Council's housing policy progress has again been extensive, resulting in the demolition of a further large number of tenements and houses which had outspent their useful life. Satisfactory housing accommodation does more than anything else to promote and maintain a healthy community. With the exception of "New Towns" there are probably few districts where the average standard of accommodation is as high as in Bethnal Green where approximately half the dwellings are of post war construction with modern facilities. - 5 - I am pleased to have this opportunity of thanking the Chairman and Members of the Public Health Committee for their support and encouragement during the year. I also wish to acknowledge the co-operation of other Chief Officers and their staffs and my particular thanks to my own staff for their loyal and efficient support. I was sorry to lose the capable services of Mr. F .C. Sharpe upon his retirement during the year. Mr. Sharpe had been on the staff of this Public Health Department for 37 years, the last 17 years of which he had held the post of Senior Public Health Inspector, and I wish him a happy retirement. 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 46 ,090 Number of Dwellings 14 ,687 Rateable Value £1 ,088 ,776 General Rate 8s. 10d. Sum represented by a penny rate £9 ,080 VITAL STATISTICS Live Births Number 827 Rate per 1 ,000 population 17.9 Illegitimate Live Births (per cent of total live births) 9.4 Stillbirths: Number 15 Rate per 1 ,000 total live and stillbirths 32 Total live and stillbirths Rate per 1,000 population 18.2 Infant Deaths (deaths under 1 year) 20 Infant Mortality Rates: Total infant deaths per 1 ,000 total live births 24.2 Legitimate infant deaths per 1,000 legitimate live births 24.0 Illegitimate infant deaths per 1,000 illegitimate live births 25.6 Neo-natal Mortality Rate (deaths under 4 weeks per 1,000 total live births) 15.7 Early Neo-natal Mortality Rate (deaths under 1 week per 1 ,000 total live births) 14.5 Perinatal Mortality Rate (stillbirth and deaths under 1 week combined per 1 ,000 total live and stillbirths 32.0 Maternal Mortality (including abortion) Number of deaths Nil Rate per 1,000 total live and stillbirths - Death Rate per 1,000 estimated population 12.2 During 1963 the Registrar General estimated the population as 46,090 which is 140 less than in the previous year. The death rate was 12.2 per 1,000 persons which is the same as for 1962. Both births and deaths depend to some extent on the proportions of young and - 7 - 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 13.3. The birth rate during 1963 was 17.9 which is the same as the previous year. The adjusted rate for comparison with other areas was 16.8. The infant mortality rate was 24.2 which 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 832 live births (422 male and 410 female) were notified and in addition there were 12 stillbirths (8 male and 4 female). - 8 - - 9 - CAUSES OF DEATH Causes of Death Under 4 weeks 4 weeks and under 1 year AGE IN YEARS TOTALS 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75 and over M F M F M F M F M F M F M F M F M F M F M F M F All causes 6 7 7 — 2 2 2 1 1 — 3 1 10 6 28 16 71 35 83 64 83 136 296 268 1 Tuberculosis, respiratory 2 1 3 2 Tuberculosis, other 1 1 1 1 3 Syphilitic disease — — 4 Diphtheria — — 5 Whooping Cough — — 6 Meningococcal infections — — 7 Acute Poliomyelitis — — 8 Measles — — 9 Oiher infective and parasitic disease. — — 10 Malignant neoplasm, stomach 1 1 7 1 3 1 2 11 5 11 Malignant neoplasm, lung, bronchus 2 5 13 2 7 1 9 36 3 12 Malignant neoplasm, breast 2 4 2 2 2 — 12 13 Malignant neoplasm, uterus 2 — 2 14 Other malignant and lymphatic neoplasms 2 1 3 1 4 4 6 8 9 5 25 18 15 Leukaemia, aleukaemia 1 — 1 16 Diabetes 1 1 1 1 2 2 4 17 Vascular lesions of nervous system 3 4 4 4 10 6 16 17 30 18 Coronary disease, angina 2 1 4 16 6 24 21 14 28 60 56 19 Hypertension with heart disease 1 1 1 2 1 20 Other heart disease 2 2 3 3 2 3 11 13 18 21 21 Other circulatory disease 1 1 2 2 8 7 1 11 12 21 22 Influenza — — 23 Pneumonia 1 3 1 2 1 7 2 7 24 19 29 24 Bronchitis 2 1 3 1 12 4 11 2 17 17 46 24 25 Other diseases of respiratory system — — 26 Ulcer of stomach and duodenum 1 2 1 4 — 27 Gastritis, enteritis and diarrhoea 1 1 — 2 28 Nephritis and Nephrosis 2 1 2 2 3 29 Hyperplasia of prostate — — 30 Pregnancy, childbirth, abortion — — 31 Congenital malformations 2 2 1 2 3 4 32 Other defined and ill-defined diseases 4 3 1 1 1 1 1 1 1 2 2 2 5 4 3 10 19 23 33 Motor vehicle accidents 1 1 1 1 1 4 1 34 All other accidents 1 1 1 2 1 1 2 2 3 9 5 35 Suicide 2 1 1 3 1 36 Homicide and operations of war 1 — 1 - 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 , but following complaints two samples from domestic premises were submitted for chemical analysis and reported upon as satisfactory. Notices were sent to the Board in 79 cases where wastage of water due to defective pipes or fittings was observed. During the year 342 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. Sewerage and Sewage Disposal Arrangements for sewerage and sewage disposal in the Borough are adequate. -11- Sanitary Inspection of the Borough Following the 2,736 complaints of insanitary conditions, defects were found requiring the service of Intimation Notices in 1,320 cases, in accordance with the Public Health (London) Act, 1936. Of these, Statutory Notices were required in 514 instances and legal proceedings were instituted in 44 cases. In addition, 54 notices in accordance with the London County Council (General Powers) Act, 1955, one under Section 26 and fifty-three under Section 27 , were served. Towards the latter part of 1963, greater use was made of Section 27 of the Act in respect of defects of an urgent nature. In cases where there was a failure to remedy the defects within the statutory period, it was intended that the Council should do the works. By the end of the year, this had been found necessary in four instances. In connection with the supervision of drainage works a total of 1,194 inspections were made during the year and an ever increasing amount of time is spent by the Inspectors' in the examination of drawings submitted for proposed new buildings or amendments to existing buildings. Ninety-four notices in accordance with Section 25 of the London County Council (General Powers) Act, 1955, were served. Defects covered related mainly to chokages and defects in drains requiring urgent attention. In 29 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 Bakehouses 102 Baker Shops 98 Butchers 165 Canteens 101 Confectioners 126 Eel & Pie Shops 14 Fish Curers 6 Fried Fish Shops 35 Fruit and Greengrocery 144 Grocers 263 Ice Cream 206 Licensed Premises 253 Milkshops 159 Restaurants 243 Slaughterhouses (Poultry) 3 Street Stalls 330 Miscellaneous Food Premises 174 Infectious Disease 280 Food Poisoning 24 Complaints Investigated 2,736 Aged and/or Infirm persons 118 Factories 1,495 Outworkers 242 Housing Enquiries 300 Houses let in Lodgings 228 Drainage Works 1,194 Rent Act 17 Smoke Observations 183 Shops Act 375 Miscellaneous 3,226 Re-inspections 5,231 Clean Air Act 183 Total 18,254 - 13 - TABLE 3 SANITARY DEFECTS IN CONNECTION WITH WHICH NOTICES WERE SERVED Dirty and/or dilapidated rooms 770 Defective drains and choked w.c.'s 159 Defective and dirty w.c.'s 956 Defective water supply 113 Defective paving 23 Defective gutters and rain water pipes 318 Defective roofs 400 Dampness 337 Defective dustbins 95 Smoke Nuisances 6 Accumulations of refuse 154 Other defects 1,574 Total 4,905 Supply of Dustbins In 19 cases during the year notices were served on Owners of properties in accordance with Section 12 of the London County Council (General Powers) Act, 1954 , requiring the provision of new dustbins. Legal Proceedings It was found necessary on 44 occasions during the year to take legal proceedings to enforce compliance with the requirements of Notices served. In 5 of these cases Abatement Orders were made by the Justices with the infliction of costs amounting to £15. 0s. 0d. Brief details are set out below:- ABATEMENT ORDERS Premises Offence Result of Proceedings 19, Ezra Street Non-compliance with Nuisance Notice Abatement Order made (28 days) £3. 0s. 0d. costs. 217, Grove Road -do- -do- -do- 2/4, Peary Place -do- -do- -do- 43, Strahan Road -do- -do- -do- 19, Wennington Road -do- -do- -do- - 14 - In 1 case, a further summons was taken out for non-compliance with Abatement Order, as follows:- Premises Result of Proceedings 43, Strahan Road Withdrawn. Works done. Costs £2. 2s. 0d. paid. In 38 cases summonses were withdrawn owing to the nuisances being abated prior to the date of hearing, the defendants paying expenses amounting to £52. 10s. 0d. Factories, Workshops and Workplaces The provisions of the Factories Act, 1961 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, 1961, 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 1,247 and a total of 1,569 inspections and re-inspections were made during the year. 94 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 Act, 1961 during the year:- - 15 - TABLE 4 INSPECTIONS FOR THE PURPOSE OF PROVISIONS AS TO HEALTH Premise 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 443 493 78 - 2. Factories not included in (1) in which Section 7 is enforced by the Local Authority 798 1,057 212 - 3. Other premises in which Section 7 is enforced by the Local Authority 6 19 2 - TOTALS 1,247 1,569 292 - - 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 45 87 2 3 - Overcrowding - - - - - Unreasonable temperature 1 - 1 - - Inadequate ventilation 1 1 - - - Ineffective drainage of floors - - - - - Sanitary conveniences:- (a) Insufficient 3 2 - - - (b) Unsuitable or defective 461 529 - 3 - (c) Not separate for sexes - - - - - Other offences against the Acts (not including offences relating to outwork) 181 242 4 - - TOTALS 692 861 7 6 - It must be remembered that the totals in columns "defects found" and "defects remedied" differ because those found towards the end of the year are not remedied until the early part of the following year. The number of defects remedied therefore may well be in excess of those found. This is true of 1963 because at the end of 1962 there was an excess of defects found over those remedied. - 17 - OUTWORK Outworkers (Section 133 (1) (c)) Twice yearly , February and August, the Factories Act, 1961, 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 372 names of outworkers which appeared on the employers lists received in August, 107 were given as residing within the Borough; in addition, 94 names of outworkers residing in Bethnal Green were forwarded from other Councils. The outworkers notified by Bethnal Green employers are drawn from a very large area; many live in outer London districts, e.g. Bexley, Caterham, Uxbridge, Barnet, Hornchurch, while some are resident in such distant places as Bath, Birmingham, Chard, Glasgow, Spalding and Bury-St.Edmunds. The outworkers resident in Bethnal Green, notified by other boroughs were, with but one exception, employed by firms in Metropolitan Boroughs north of the Thames. Number of Outworkers in August lists required by Section 133(1)(c) Wearing apparel (making etc.) 117 Curtains and furniture hangings 21 Brushes 2 Boxes 48 Lampshades 4 Christmas Crackers etc. 7 Artificial Flowers, Umbrellas 2 201 Section 133. There was no case of default in sending lists to the Council. Section 134. 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 sanitary conveniences attached thereto. During the year 323 visits were made to shops and 46 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 1,092 Articles of clothing, bedding, etc. submitted to steam disinfection 808 Articles disinfected by formalin 746 Hospital mattresses, pillows, etc. disinfected 9 ,437 Number of articles destroyed by request 2,126 Notwithstanding the Council's facilities to collect free of charge any unwanted bedding , furniture , or other bulky domestic articles upon request, the dumping of such articles on open sites in the Borough continues and many visits were made by the Disinfecting Staff to disinfest them prior to removal. The rooms, furniture and bedding of 310 families being rehoused by the Borough Council were disinfested. Personal Cleansing Station During the year, 20 persons had baths for verminous conditions at the Personal Cleansing Station, simultaneous disinfection of clothing being carried out. In addition, 22 persons 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 375 occasions. 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- This service continued to expand during the year particularly during the latter part when a regular twice-weekly collection of soiled articles was ensured Thirteen cases were on the register at the end of 1963 and 2 ,423 items of laundry were collected , cleansed and returned during the year. Prevention of Damage by Pests Act, 1949 During the year, 285 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. Eight notices under section 4 (1) of the Act were served. Systematic baiting and poisoning was carried out by the Rodent Operatives, 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. National Assistance Act, 1948 Under Section 47 of the National Assistance Act, 1948, as amended by the National Assistance (Amendments) 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 seven cases to use the powers of the Act:- Six of the cases were of aged and infirm persons who were unable to care for themselves and were not receiving from other persons proper care and attention. In addition , they were all in urgent need of hospital treatment for various conditions. They all refused to enter hospital and , in their own interests , there was no alternative but to apply for removal orders which were granted by the Magistrate. The other case was in respect of a woman aged 59 years , who was suffering from diabetes and who was unable to devote to herself, and was not receiving from other persons, proper care and attention. She also refused to enter hospital and after thorough enquiry and consideration had shown it necessary in her own interests , application was made for a removai order which was granted by the Magistrate. -20- Old People's Welfare 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, meals-on-wheels , chiropody , holidays and outings, etc. During the year, the Council appointed two State Registered Nurses to the staff of the Public Health Department. In addition , an Assistant Visitor on the staff of the Old People's Welfare Committee also came under the control of the Medical Officer of Health. These members of the staff carry out the statutory duties of the Council with regard to aged and infirm persons and are responsible to the Medical Officer of Health for providing such detailed supervision of infirm persons as he may direct, with particular reference to those who are homehound and even confined to bed. There is close liaison with the Old People's Welfare Committee , the London County Council, the National Assistance Board , medical practitioners, hospitals , etc, etc , for the provision of any necessary services required by old people in this Borough. It is estimated that there are some 8,000 aged persons in Bethnal Green. A record of all old people in the Borough is being compiled and an initial visit made to assess need, if any, and to assist with any problems. At many of these initial visits it is found that the aged persons concerned are not in need of any assistance and, indeed, it is often found that they are still working. These cases are to be visited yearly. On the other hand, many instances were found during the year where aged persons were in need of help and, in some cases in urgent need of care and attention. These latter were usually homebound and lived alone without relatives or friends to visit them and were often unaware of the many services available to them. In addition to the Home Bathing Service and the Laundry Service for Incontinent Persons, mentioned elsewhere in this report, a Library Service for Homebound Aged Persons is now in operation with the kind co-operation of the Council's Public Libraries Department and students from Queen Mary's College. The Council has also recently given approval for a Day Care Service for the Aged and Infirm whereby it is proposed to arrange visits by "Good Neighbours" to suitable cases when they will provide companionship, prepare a light meal and undertake other tasks for the comfort and welfare of the aged person concerned. This service will be provided to those homebound aged persons who live alone and who are frail, confused, sick or handicapped , and who need more help than the existing domiciliary services, either voluntary or statutory, can provide. It is hoped that these visits will give the lonely old person the comfort and security of knowing that there is at least one person upon whom they can rely. A small payment will be made to the "Good Neighbour" for her services. -21- 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. Twelve inspections were made in 1963 , three notices being served. 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 23 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 9 licences for the sale of pet animals were granted in respect of shops and 48 licences in respect of stalls. Common Lodging Houses There are no Common Lodging Houses in the Borough. Clean Air At the end of 1962 it was anticipated that the Council's last two Smoke Control Orders would be confirmed in 1963 and that the whole of the Borough would be subject to control from November of that year. Unfortunately by the end of 1963 there was still a portion of the Borough not subject to such control. Of the two outstanding Orders submitted the Minister of Housing and Local Government confirmed No.5. Thus the outstanding western portion of the Borough became a Smokeless Zone. -22- In the case of Order No.4 , a large industrial undertaking within the area made an objection to the Order. The Council was not prepared to give exemption in this case, particularly as there was a history of dark smoke emissions giving cause for offence. A number of meetings have been held between the objectors and representatives of the Council with a view to the installation and proper use of equipment leading to the total elimination of smoke. At the close of the year, these matters were still under discussion and this one remaining part of Bethnal Green will therefore not be smoke-free until 1964. Fireplace conversions were carried out to meet the requirements of the Council's Smoke Control Order No.5 and this became operative from November, 1963. Emissions of smoke which are seen coming from chimneys in premises already included in Smoke Control Orders lead to investigations at the premises. If the heating appliance causing the smoke needs converting a notice under Section 12(2) of the Clean Air Act is served. In those cases where coal is being used , particularly on converted appliances, preliminary warning letters are sent to the offenders. The severe winter of 1963 saw some temporary shortages of solid smokeless fuels in the Borough but generally supplies are sufficient although not always of the type most in demand. In the case of elderly tenants , emergency fuel supply arrangements were made by the Old People's Welfare section. Information gathered during the year shows a trend away from the use of solid fuels towards gas and electricity for heating. This is particularly so where married couples are both at work and require quick means of heating in the evenings. The number of visits made by Public Health Inspectors in connection with the application of the Clean Air Act are shown in Table 2 of this report. It is interesting to note that of the 183 "smoke observations" also listed in Table 2, fifty-three were "timed". That is, the length of time of each smoke emission from a chimney was noted and the density of the smoke recorded according to the Ringelmann scale. A further 1,487 visits were made by other staff in connection with estimates submitted for fireplace conversions and later to check the completed works. Two further atmospheric pollution measuring stations planned at the end of 1962 were set up in 1963. One is situated on the roof of the Town Hall and one at the Council's Public Baths in Cheshire Street. This gives the Council a total of three such stations. Daily records are taken in respect of the smoke filters and sulphur dioxide content. This information is passed to the Warren Spring Laboratory who co-ordinate the observations and in due course make their findings available to Local Authorities. 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, 53 premises were registered and 87 inspections were made to them during the year. 17 notices were served in respect of unsatisfactory conditions. -23- SECTION C HOUSING Clearance Areas During the period under review representation of unfit properties included in the agreed clearance programme continued. Five areas were representedMiddleton Street, Cambridge Buildings Darling Row , Holly Mansions, Pollard Street and Fountain Street. These areas contained 333 houses occupied by 1,094 persons. Owners of properties in the Middleton Street, Darling Row and Pollard Street Clearance Areas objected to the Council's proposals and Public Inquiries were held at the Town Hall. The Minister of Housing and Local Government confirmed Orders made in respect of Tuscan Street, Pollard Street (Nos. 1, 2 and 4 Areas), Holly Mansions, and Nos. 3 and 5, Mansford Street Areas. Closing of Unfit Houses Thirty closing orders were made during the year under Section 17 of the Housing Act, 1957. Forty-six closing orders were made under Section 18 of the Act in respect of parts of buildings found to be unfit for habitation. Housing Act, 1957 , Section 9 Inspection of dwellings capable of being made fit at a reasonable cost continued throughout the year. Housing Act, 1961 The survey of houses in multiple occupation in the Borough commenced at the end of 1962 was continued. Fifty-two dwellings comprising 218 lettings had received visits by 31st December, 1963. In 36 cases Management Orders under Section 12 of the Act were made. These were later followed by the service of informal notices indicating the amenities lacking in the premises. This approach resulted in some response from Owners but in the main the essential facilities required in dwellings have not been provided. -24- There are difficulties in the implementation of this Section of the Act for not only are owners disinclined to carry out works, some tenants do not wish for improvements which they feel might lead to rent increases. Alternatively, the use of rooms for provision of essential amenities can lead to partial loss of accommodation for tenants and possibly eviction. Overcrowding (Housing Act, 1957) Details of overcrowding in the Borough, and of cases where overcrowding was abated, are as follows:- No. of cases On register at end of 1962 123 New cases reported during 1963 1 Total 124 Overcrowding abated during 1963 14 On register at end of 1963 110 Families Equiv. Adults Rehoused 13 58½ Removed without trace 1 3 Details of overcrowded families on the department's records are reviewed from time to time and divided into "seriously" and "less seriously" overcrowded categories. The most urgent cases in the first category are referred to the Housing Committee for consideration for rehousing. In addition, one family who had been referred to the London County Council on medical grounds was rehoused. New Housing During the year new housing accommodation was provided as shown below:- Name of Premises Provided by Number of Dwellings Briggs House London County Council 24 Chambord House -do- 16 Gowan House -do- 24 Kirton Gardens -do- 39 Strickland House -do- 24 Doric House Bethnal Green Borough Council 28 Holman House -do- 48 Puteaux House -do- 60 Stubbs House -do- 16 Tate House -do- 16 Thomas Hollywood House -do- 47 342 -25- In addition mobile homes were erected to provide temporary accommodation. These are placed on sites in the Borough which are not scheduled for immediate use for other purposes. Housing Statistics Inspection of Dwelling Houses during the year:- Total number of dwellings in the Borough 14,687 Number of initial visits to dwelling houses on complaint 2,736 Number of dwelling houses inspected with a view to action under Part II of the Housing Act, 1957 2,298 Number of dwelling houses visited for any other reason 6,096 Total number of re-inspections for any of the reasons set out above 5,231 Number of unfit or defective houses made fit or repaired as a result of informal action 1,218 Action under Statutory Powers Public Health (London) Act, 1936 Number of houses in which defects were remedied after service of formal notice:- (a) By Owners 653 (b) By Local Authority in default of Owners 33 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 310 310 842 At the end of the year there were approximately 1,429 applications for re-housing outstanding. -26- 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 16 - 75 3 Bakers Shops 18 - 40 2 Butchers 39 34 151 15 Canteens 46 - 28 2 Confectioners 63 - 83 7 Eel and Pie Shops 9 9 6 3 Fish Curers 3 3 4 1 Fish Premises (Other) 10 - 14 4 Fried Fish Shops 10 10 21 2 Fruiterers/Greengrocers 45 - 89 10 Grocers 66 3 213 23 Ice Cream Premises 134 134 301 14 Licensed Premises 125 - 250 62 Milkshops and Dairies 88 88 242 14 Miscellaneous 37 - 64 8 Poultry Slaughterhouses 1 - 8 3 Preserved Food 3 3 4 - Restaurants 69 - 214 38 Schools Meals Kitchens 22 - 19 1 Street Stalls 198 - 83 5 Wholesale Food 10 - 35 4 Totals 1,012 284 1,944 221 -27- During the year legal proceedings in respect of food premises were taken as follows:- Food and Drugs Act, 1955 Selling a loaf of bread which contained a metal screw. Defendants were fined £10, with £3. 3s. 0d. costs. Selling a loaf of bread which contained a portion of a cigarette. Defendant was fined £10, with £2. 2s. 0d. costs. Selling a currant bun which contained a brass labelling pin. Defendant was fined £10 , with £3. 3s. 0d. costs. Having in possession for purpose of preparation for sale four 17-lb tins of anchovies intended for but unfit for human consumption. Defendant was fined £10, with £3. 3s. 0d. cost. Having in possession for the purpose of sale 9 lbs. dried broad beans intended for but unfit for human consumption. Defendant was fined £5 , with £1. 0s. 0d. costs. Food Hygiene (General) Regulations, 1960 Allowing mice excreta to accumulate in vicinity of scales used for weighing cereals in a food room. Defendants were fined £20 , with £5. 0s. 0d. costs. Carrying on a food business at premises the use of which because of the condition thereof exposed food to the risk of contamination. Defendants were fined £10. Carrying on a food business at premises the use of which because of the condition thereof exposed food to the risk of contamination. Defendants were fined £5 , with £2. 2s. 0d. costs. -28- Failing at street market stall to take all such steps as were reasonably necessary to protect unwrapped sweets from risk of contamination. Defendant was fined £2, with £1. 0s. 0d. costs. Summonses were taken out against occupiers of food premises in respect of the undermentioned offences, and the Justices imposed fines and awarded costs to the Council as follows:- 1. (i) Carrying on a food business at premises the use of which because of the condition thereof exposed food to the risk of contamination. (ii) Failing to keep clean a chopping block used for chopping meat in the retail food shop. (iii) Failing to provide a suitable and sufficient wash-hand basin for the use of all persons engaged in the handling of food on or about the premises in a position conveniently accessible to such persons. (iv) Failing to keep clean the flooring of the retail food shop. Total fines £70. Costs £5. 5s. 0d. 2. (i) Failing to keep the floor in the foodshop in such good order, repair and condition as to enable it to be effectively cleaned. (ii) Failing to keep clean the walls and ceiling of the foodshop. (iii) Failing to keep clean the walls and ceiling of cellar used as a food room for storage of food. Total fines £30. Costs £3. 0s. 0d. 3. (i) Allowing newspapers to come into contact with meat patties being prepared for human consumption in the kitchen. (ii) Failing to keep the kitchen floor clean. (iii) Failing to keep clean the flooring behind counter used for service of food in the restaurant. Total fines £20. Costs£l. 0s. 0d. -29- 4. (i) Failing to keep clean and in efficient working order the sanitary convenience regularly used in connection with the food premises. (ii) Failing to keep clean the walls , floors , ceilings and woodwork of the ground floor food store. Total fines £20. Costs £2. 0s. 0d. Labelling of Food Order, 1953 Selling from street market stall tins of oxtail soup which were unlabelled. Defendant was fined £2 , with £1. 0s. 0d. costs. Food Hygiene (General Regulations), 1960 Continuing the Council's policy of improving and maintaining higher standards of hygiene and cleanliness in the many food shops and stalls in the Borough, the Food Hygiene (General) Regulations of 1960 were extensively applied. Fifty-seven notices under the Regulations were served in respect of the following contraventions. Regulation No. Particulars No. of contraventions 5 Food business carried on at premises where conditions might expose food to risk of contamination. 5 6 Equipment used in food preparation not kept clean or in good order. 31 8 Person engaged in handling food failing to prevent it being exposed to risk of contamination. 26 9 Persons engaged in handling food either not personally clean or indulging in the use of tobacco 3 10 Use of unsuitable wrapping material liable to lead to food contamination 1 -30- Regulation No. Particulars No. of contraventions 14 Sanitary conveniences either not clean or unsuitable or lacking "hand-washing" notices. 52 15 Proper supply of water either lacking or insufficient. 5 16 Inadequate hand-washing facilities or such facilities not maintained in clean and proper state. 17 17 First aid materials either lacking or insufficient. 11 18 Accommodation for storage of staff clothing either lacking or insufficient. 5 19 Inadequate facilities for washing food and equipment. 14 21 Unsuitable or insufficient means of ventilation to food rooms 2 23 Food rooms in unclean , unsuitable or defective condition. 135 24 Accumulations of refuse or waste material in food rooms 22 26 Food stall not kept in clean and proper condition 1 27 Food stalls without suitable covered receptacles for waste or lacking adequate screening 10 28 Food stalls without adequate personal cleansing facilities. 2 -31- Milk Supply (1) Inspection of Premises A total of 242 visits were made in 1963 to premises in the Borough used in connection with the distribution of milk and in 14 instances appropriate action was taken to deal with unsatisfactory conditions which were found to exist. (2) Registration and Licensing Licences issued in 1961 under the Milk (Special Designation) Regulations, 1960 continued in force in 1963 except for 5 new licences issued where changes of distributors occurred. Number of Premises on Register at end of year Dairies 10 Distributors 78 (3) Milk Sampling During 1963, 27 samples of milk (3 formal and 24 informal) were submitted to the Public Analyst for examination, all of which were reported as genuine. In addition, 31 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 Pasteurised Tuberculin Tested 16 16 - 16 - (Pasteurised) 15 15 - 15 - Totals 31 31 - 31 - 24 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. Unsound Food During the year under review the Public Health Inspectors examined and took appropriate action in relation to unsound food on 51 occasions. Details of the food together with quantities are set out as follows:- During the year under review the Public Health Inspectors examined and took appropriate action in relation to unsound food on 51 occasions. Details of the food together with quantities are set out as follows:- -32- Quantity Tons Cwts. Lbs. Meat-Tinned 2 76 " - Carcase 1 84 Potatoes 4 1 - Dried Milk Powder 40 Chestnuts 14½ Various 9½ 4 6 - Other Foodstuffs Frozen Foods 545 packets Vegetables 215 tins Fruit 62 " Fish 54 " Soup 18 " Soft Drinks 31 bottles Various 33 tins, 8 cartons , 6 packets , 3 bottles In addition, the following quantities of unsound food were seized at food premises in the Borough, condemned and destroyed:- Apples 641¾lbs. Anchovies 68 lbs. Dried Broad Beans 9 lbs. After a fire at premises adjoining a food shop in the Borough, 585 containers and 9 lbs. of sweet confectionery were surrendered, condemned and destroyed. Food and Drugs Act During the year, Mr. W.B. Chapman , B.Sc. , F.R.I.C. was appointed to the post of Public Analyst for the Borough and Mr. J.H. Barker, B.Sc., F.R.I.C., was appointed Deputy Public Analyst. Both these officers are on the staff of the Scientific Branch of the London County Council. Out of a total of 237 samples (31 formal and 206 informal) examined by the Public Analyst during 1963, 27 samples were found to be adulterated or irregular, 4 formal and 23 informal. -33- TABLE 8 SUMMARY OF ANALYST'S REPORTS ARTICLE SAMPLES TAKEN FORMALLY SAMPLES TAKEN INFORMALLY Total number of samples taken No. taken Genuine Adulterated or Irregular No. taken Genuine Adulterated or Irregular Canned preparations 1 1 - 38 32 6 39 Cocoa and Coffee preparations 3 2 1 6 2 4 9 Dried Fruit and Vegetables 1 - 1 8 6 2 9 Drugs 4 4 - 5 4 1 9 Fish and Meat preparations 2 1 1 24 22 2 26 Milk 3 3 - 24 24 - 27 Pickles and Sauces 2 1 1 10 8 2 12 Soft Drinks 7 7 - 8 7 1 15 Sugar and Sugar Confectionery 1 1 - 26 25 1 27 Various 7 7 - 57 53 4 64 Total 31 27 4 206 183 23 237 -34- TABLE 9 Action taken in regard to samples reported by the Public Analyst to be not genuine. Sample No. Article Result of Analysis Action 25 Minced Beef Contained 320 parts per million of sulphur dioxide preservative Letter of caution. 31 Dried Broad Beans Mould and insect damage Prosecution; Fine £5, Costs £1 Remainder of stock seized. 39 Canned Steak and Kidney Pudding Contained piece of foreign offal heavily contaminated with copper and lead Letter of caution Further samples were examined and shown to be satisfactory. 62 Medicated Cough Drops Wet and sticky. Taste and odour of chloroxylenol disinfectant Stock examined and part surrendered. 119a Sliced Bread Contained portion of cardboard label baked in loaf Verbal caution. Greater care to be taken in future. 133 Cream Slices Filling consisted of imitation cream No descriptive label no action. 134 Dried Broad Beans Insect infestation Letter of caution. 135 Minced Meat Contained 32 parts per million of sulphur dioxide preservative Verbal caution. -35- TABLE 9 (continued) Sample No. Article Result of Analysis Action 143 Milk Chocolate Drops Milk fat and cocoa butter absent or present in trace amounts only Further sample takensee No. 191. 147 Milk Chocolate Drops (Covered) Milk fat and cocoa butter absent or present in trace amounts only Further sample takensee No. 191. 172 Chocolate Buttons Fat consisted principally of fat other than cocoa fat Further samples to be taken. 191 Milk Chocolate Drops Contained only small amounts of milk and cocoa fat Further samples to be taken. 195 Tomato Paste Contained 240 parts per million of copper on direct tomato solids Further samples to be taken. 204 Orange Squash Mould present-due to dirty bottle Verbal caution. Fault in procedure in capping bottles to be remedied forthwith. With regard to 13 irregular samples, the label in each case failed to comply with the requirements of the Labelling of Food Order, 1953. All these irregularities have been dealt with satisfactorily. -36- Ice Cream During the year 16 applications for registration for the sale of ice cream were approved and 15 premises were removed from the register upon ceasing the sale of ice cream. At the end of the year there were 134 registered premises in the Borough. 301 inspections of these premises were made during the year and in 14 instances notices were served concerning insanitary conditions. 66 samples of ice cream were submitted to the Methylene Blue test and graded as follows:- Grade 1 26 Grade 2 11 Grade 3 11 Grade 4 18 Two samples graded 3 and two samples graded 4 were followed immediate by further samples from the retailers and manufacturer concerned; these samples were reported as satisfactory. In the case of 25 samples graded 3 and 4, the four retailers concerned have ceased the manufacture and/or sale of ice cream. Food Poisoning Number of notifications (corrected) 13 Cases otherwise ascertained 2 Salmonella infection (not food borne) 2 In no case was the source of infection definitely established. -37- There were two family outbreaks (included in the above figures) involving four persons in each; one of these outbreaks was thought to be due to the consumption of re-heated meat: The other outbreak was possibly due to the use of bi-carbonate of soda in spring greens served to children for the first time; four children in family (six years and under) were the only persons affected. It is unfortunate that several notifications were received too late for investigations to be of value. In one instance the patient was unco-operative. Other foods suspected were whelks and custard; no portion of suspected foods remained. No pathogenic organisms were isolated from faecal specimens taken from notified cases. There were no removals to hospital and no deaths. Milk in Schools The arrangements for sampling milk at London County Council Schools continued during the year. A total of 24 samples were submitted for examination, all of which satisfied the prescribed tests. 38 SECTION E PREVALENCE OF , AND CONTROL OVER , INFECTIOUS DISEASE The total number of notifications of infectious disease , excluding Food Poisoning, during 1963 was 442 as compared with 662 in 1962 and 1 ,068 in 1961. The number of cases of diseases notified is shown in Table 10 which follows, and requires no special comment. TABLE 10 INFECTIOUS DISEASE DISEASE NOTIFICATIONS Total Notified Corrected Figures Removal 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 1 2 6 8 - - - - 17 16 3 Erysipelas - - - - - 1 1 2 4 4 - Meningococcal Infection 1 1 - - - - - - 2 2 2 Acute Encephalitis - - - 1 - - - - 1 1 1 Acute Pneumonia - 1 - - - 3 - 1 5 5 - Dysentery 3 7 4 11 - 6 1 - 32 32 11 Measles 8 91 75 64 - - - - 238 238 24 Whooping Cough 14 20 22 45 - - - - 101 98 21 Scabies - - - 5 - 1 1 - 7 7 - Pulmonary Tuberculosis 1 2 - 3 4 9 9 4 32 32 Meninges and C. N. S. - - - - - - - - - - Other forms - - - - 1 2 - - 3 3 Totals 28 124 107 137 5 22 12 7 442 438 62 40 Tuberculosis During the year formal notifications (corrected) under the Public Health (Tuberculosis) Regulations , 1952 , were received in respect of 32 cases of respiratory tuberculosis and three non-respiratory as compared with 20 respiratory cases and six non-respiratory cases for the previous year:- The following table gives details of the age and sex incidence of these cases:- TABLE 11 Primarv Not ficat cms Age Periods 0 - 1 - 2 - 5 - 10- 15 - 20 - 25 - 35 - 45 - 55 - 65 - 75 - Total Respiratory males - - 1 - 1 1 1 3 1 6 1 3 1 19 Respiratory Females 1 1 - 2 - 1 1 5 - 1 1 - - 13 Non-respiratory males - - - - - 1 - - 2 - - - - 3 Non-respiratory females - - - - - - - - - - - - - - In addition to the above, information was received of 23 other cases by transfers from other areas. There were 5 deaths during the year certified as being due to tuberculosis and deaths accounted for 11 removals from the Register. Twelve other cases were removed as cured the remaining 38 cases taken off die register were transfers to other areas. The following table shows the number of cases on the Tuberculosis Register at the end of 1962 , variation; which have taken place during the year, and the number of cases remaining on the Register on the 31st December, 1963. 41 TABLE 12 No.of cases on register 1.1.63 Pulmonary Non-Pulmonary Total Males Females Males Females 336 248 46 54 684 No. of cases notified during 1963 19 13 3 - 35 Other cases added to register during 1963 13 8 2 - 23 368 269 51 54 742 No. of cases removed from register during 1963 37 19 2 3 61 Remaining on register 31.12.63 331 250 49 51 681 Contacts or Carriers of Infectious Disease 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. During the year under review two such certificates were issued 42 SECTION F MISCELLANEOUS Health Education Health education propaganda during the year included the display of suitable posters and the issue of literature including the monthly distribution of copies of the Central Council for Health Education publication "Better Health". In addition , a float was entered in the Borough Carnival which directed attention to food hygiene. 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 16 burials were arranged by the Department at a cost of £129. 0s. Od. of which £109. 16s. 3d. 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 1963 , the names of 40 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. 43 Consumer Protection Act, 1961 Heating Appliances (Fireguards) Regulations, 1953 Legal proceedings were taken during the year in respect of the following:- (i) Possessing for the purpose of selling on a street market stall a portable electric fire which was not fitted with a guard. (ii) Possessing for the purpose of selling on a street market stall two portable electric fires with guards which did not comply with the standards prescribed by the Regulations. Total fines £2. Costs £1. 0s. 0d. Swimming Baths Seven samples of water were taken during the year from the swimming baths at the Council's Public Baths and submitted for chemical analysis. Two samples were also taken from the open-air swimming pool in Victoria Park which is maintained by the London County Council. All the samples were reported by the Public Analyst as being in a satisfactory condition. 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 84 Inclusion within Sick Pay Schemes 69 Absent through illness for over one month 50 Others 22 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 are provided to the Town Clerk in respect of applications under the above Act. Enquiries in respect of 372 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 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 1963 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 a branch at Banstead) 232 ★ These figures do not necessarily represent beds staffed and in use. The London Chest Hospital designated a Teaching Hospital and under th control of a Board of Governors, is also situated within the Borough and the Tuberculo: 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. 45 3. Personal Health Services The following information regarding the operation of the personal health services in the Borough during 1963 , has been furnished by Dr. A .L. Thrower, 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 Street, E. 2. Foot Clinic Bethnal Green School Treatment Centre , Lyte Street, E.2. (b) Statistics Infant Welfare and Toddlers Sessions 1. Total number of children who attended during the year and who were born in (i) 1963 576 (ii) 1962 - under 1 337 1962 - over 1 98 (iii) 1958 - 1961 403 Infant Welfare Sessions 2. Total attendances 7 ,375 3. Total medically examined 3 ,299 46 Toddlers Sessions 1. Total attendances 368 2. Total medically examined 357 Ante and post natal clinics Total attendances 1 ,347 Health Visiting 1. Number of children visited who were born in:- 1963 663 1962 688 1958 - 61 1 ,563 2. Number of persons aged 65 and over who were visited 55 3. Number of mentally disordered persons visited 6 4. Number of persons visited who were discharged from hospital (other than mental hospital) 69 5. Number of tuberculous households visited 32 6. Number of infectious households visited (other than TB) 29 7 . Total effective visits 7 ,617 8. Total unsuccessful visits 2 ,400 Births (to residents) 1. Number of premature live births during the year 62 2. Number of such infants who died within 28 days of birth 5 47 Child minders 1 . Number of voluntary child minders registered and receiving fees at 31st December , 1963 14 2 . Number of statutorily registered minders at 31st December, 1963 - 3 . Number of children being minded (i) by voluntary minders 16 (ii) by statutory minders - Diphtheria Immunisation 1 . Number of children who completed a full course of primary immunisation and who at the date of the final injection were:(a) under 5 years 593 (b) aged 5 years and under 15 years (immunised in schools and centres and by general practitioners) 102 2. . Number of children given reinforcing injections 880 Vaccination 1. . Number of children vaccinated and revaccinated (all ages under 15) 56 Home Help Service Number of cases provided with home help service:- Maternity T.B. 65 plus Others (under 65) Total Northern District Office (Bethnal Green and part of Stepney and City of London) 6 23 832 195 1,056 Eastern District Office (Poplar and part of Stepney and Bethnal Green) 24 12 941 135 1 ,112