AC 4341 (1) FIN 26 THE METROPOLITAN BOROUGH OF FINSBURY ANNUAL REPORT on the PUBLIC HEALTH OF FINSBURY for the year 1945. By - A.B.STEWART, M.D., D.P.H., Acting Medical Officer of Health (2) METROPOLITAN BOROUGH OF FINSBURY PUBLIC HEALTH COMMITTEE: (Nov. 1945) MATERNITY AND CHILD WELFARE COMMITTEE (Nov. 1945) CHAIRMAN: Coun. W.Barrie, M.P.S. CHAIRMAN: Coun. Mrs. F.E.Gilbert VICE CHAIRMAN: Coun. Mrs. E.F.Drake VICE CHAIRMAN: Coun. Mrs.E.R.Gannon Alderman C.A.Allen Councillor W.Barrie, M.P.S. Councillor Miss B.P.Beauchamp Councillor Miss B.P.Beauchamp Councillor Miss K.Beauchamp Councillor Mrs. M.M.Champion Councillor Mrs. M.M.Champion Councillor Miss N.Cordner-James Councillor Miss N.Cordner-James Councillor Mrs. R.Curtis Councillor Mrs. B.M.Dobb Councillor Mrs. E.R.Gannon Councillor Mrs. F.E.Gilbert Alderman Mrs. V.M.Heaps Councillor Mrs. A.J.Mahon Alderman Mrs. V.M.Heaps Councillor H.J. Hull Councillor Mrs. O.Pannett Councillor Mrs. O.Pannett Councillor Mrs. E.Potter Councillor A.G.Webb Councillor Miss G.L.Tutty Councillor Miss M.A.Westorman Councillor Miss M.A.Vesterman Councillor Mrs. C.Griffiths. STAFF MEDICAL OFFICER OF HEALTH: Җ C.O.S.Blytli Brooke, L.R.C.P., M.R.C.S. ,D.P.H. ACTING MEDICAL OFFICER OF HEALTH: A.B.Stewart, M.D., D.P.H., ACTING DEPUTY MEDICAL OFFICER OF HEALTH: R.Woolf, M.B., B.S., M.R.C.S., L.R.C.P.,D.P.H. ASSISTANT MEDICaL OFFICERS: E.Obermer, M.D., M.R.C.S., L.R.C.P., (parttime from July, 1945) H.Lomas, M.D., M.R.C.S., L.R.C.P.(part-time) K.M.Lane, B.A., M.R.C.S,, L.R.C.P.,(parttime from November, 1945) PUBLIC ANALIST: J.K.Colwell, F.I.C., F.C.S., (part-time) (Died April, 1945) C. Harcourt Wordsworth, B.Sc., (from May, 1945 ) PUBLIC VACCINATIONS: Dr. R.E.Batson Dr. R.K.Dadachanji Dr. G.P. Barua Dr. R.Sacks. VACCINATION OFFICER: P.E.Capps (part-time) CLERICAL STAFF: H.Ward, M.S.I.A., (Chief Clerk) T.E.Williams J.E.McDowell Miss W. Freeman (M.& C.W) Miss J.S.Dodd (M.& C.W) Miss A.Rimel (T.B.Clerk and Lab.Asst) (Resigned 31/5/45) Җ W. Keutenius Җ A.F.Cowan Җ G.Hawthorn Mrs. M.Haynes J.Field E.Mitchell J.E.Newman Mrs. E.K.Dawson (resigned 2/2/45) Miss J.L.Faulkner (from 12/3/45) Miss P.Killick (from 9/7/45) Җ With H.M.Forces. SANITARY INSPECTORS & MEAT INSPECTORS: M.&c C.W.Centre SUPERINTENDENTS: M.&c C.W.DISPENSER: HEALTH VISITORS: DAY NURSERIES: - LLOYD SQUARE. BANNER STREET. DONEGAL STREET. KING SQUARE. TUBERCULOSIS NURSE: SECRETARY OF TUBERCULOSIS CARE COMMITTEE: WOMEN'S CLINIC: DENTAL CLINIC: Anaesthetists: 3. H.J.Nawdick, M.S.I.A.(Senior San.lnspector) H.Clinton, M.S.I.A. Miss P.Hall, M.S.I.A. Mr. R.E.Lay, M.S.I.A Mr. A.J.Truslove, M.S.I.A. Mr. J.Lewis, M.S.I.A. (Temporary) Mr.T.Penman, M.B.E, M.S.I.A. (Meat Insp.- seconded to Ministry of Food) Mr.R.S.Barber, M.S.I.A.(Assistant Meat Inspector) Miss M.Fillingham (Leage St.M.&c C.W.Centre) Miss J.R.Turner (Pine Street M.&c C.W.Centre) Miss I.Lloyd (Part-time) Miss M.Rock Miss L.Breaman (Seconded to Ministry of Heal Mrs. G.Hartney Miss B.J.Scott Miss L.E.Hitchings Mrs. M.G.Havers (Matron) Miss M.M.Robson (Deputy Matron) Miss G.Jones (Matron) Miss K.Turner (Deputy Matron) Miss M.Humphreys (Matron) (Resigned 14/8/45) Mrs. D.Cohen (Matron) (From 20/8/45) Miss (Deputy Matron) Mrs. L.M.Foulger (Matron)(Resigned 28/7/45) Miss M.E.Gardner (Matron)(l/10/45 - 17/11/45| Mrs. (Matron) (From 19/11/45) Miss I.Henry (Deputy Matron) Miss F.M.Prior Mr. H.Ward R. Woolf, M.B., B.S., M.R.C.S., L.R.C.P., D. (Medical Officer in Charge) P.R.Asplet, L.D.S. (Part-time Dental Surgeon (Resigned 13/6/45) H.Millett, L.R.C.P., M.R.C.S., L.D.S., (Part-time Dental Surgeon) J.W.White, L.D.S. (Part-time Dental Surgeon) W.R.Gray, L.D.S., (Part-time Dental Surgeon from 22/10/45) Mrs. C.Roberts (Dental Nurse) Dr. A.Fairweather Dr. G.P.Barua Dr. A.H.Rowntree Dr. E.F.Rossdale Dr. B.J.Wilton Dr. R.E.Batson 4. Mr. A.H.Carter, F.C.Ch.A.(Chiropodist-incharge) FOOT CLINIC: Miss P.M.Vincent, A.l.S.Ch.(Asst.Chiropodist) Miss R.V.Akker, M.C Ch.A.(Asst.Chiropodist) (resigned 30/6/45) Miss S.M.P.McKenna, M.I.S.Ch. (Asst. Chiropodist from 2/7/45) CLEANSING STATION: Mrs. D.I.M.Lloyd (Nurse in Charge) Miss M.Calpen (Nurse in Charge) SOLARIUM: Mrs. I.Aperguis (Asst.Masseuse) Miss M.Haslett (Part-time Asst.Masseuse) Mrs. A.L.Emerton (Solarium Assistant) RESIDENT ENGINEER AND HEALTH CENTRE KEEPER: Mr. F.M.Battle 5. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Finsbury. I have the honour to present the Annual Report of the work of the Public Health Department during 1945, in the continued absence of Dr. C.O.S.Blyth Brooke on military service. The end of the War made it possible for the first steps to be taken towards a return to the normal Working of the department. It will be noted in the statistical section which follows that the population of the borough increased slightly during the year, this being due to inward transfer and not to natural increase. During the year births and deaths were approximately equal due to the abnormal distribution of the population In 1944 preliminary arrangements were made to guarantee payments to foster mothers and to assist in the Moral Welfare work in the borough by contributing to the funds of the local committee. Payment is now being made but so far we have been unable to find suitable women in the borough who are willing to undertake the duties of foster mother. The increase in the number of illegitimate children noted in 1944 has, unfortunately, been maintained in 1945. The shortage of suitable women willing to undertake domestic duties was reflected also in the position regarding Home Helps for Maternity cases and the neW Domestic Help scheme; the present position being that the long established Home Help scheme is being operated with difficulty owing to the staff shortage and that it has been impossible to make a start with the proposed Domestic Help Scheme, although Finsbury approved such a scheme more than a year before the official scheme was suggested by the Ministry of Health. One of the first moves towards normal working after the War was the re-establishment of the Maternity and Child Welfare Centre in Pine Street. In consequence the Reception Flat became available for its proper function and the temporary premises in Whiskin Street were vacated. The disbandment of the Civil Defence Service freed the parttime Rodent Operatives and four of them were appointed to full-time posts to operate the scheme for rat repression, In order to encourage dealers to sell designated milk the Council decided during the year to issue licences without payment of the customary fee. A full-time laboratory technician was appointed for the first time with a view to intensifying the laboratory control of milk. Finsbury experienced its first visit of the L.C.C.Mass Radiography Unit during the year and details of the work can be found in the Tuberculosis section of the report. The gratifying lowering of the infant mortality of last year has not been maintained. In all 26 infants under the age of one year died in 1945. 19 died in the first month of life, the other 8 dying between the age of 1 month and 1 year. rematurity continues to be an important factor and the measures introduced in 1944 to save premature infants continue in use. A considerable epidemic of Measles occurred during the year - 364 cases in all. By arrangement with the London County Council only such cases as suffered from complications or were inadequately housed or, for other social reason, could not be nursed at home, were admitted to the sorely-taxed Infectious Diseases Hospitals. It is a reflection of prevailing conditions in Finsbury that it was found necessary to admit no less than 87 cases of Measles to Hospital. It is unnecessary to stress the grave Housing position, particularly as the demobilisation of the Armed Forces is bound to add appreciably to the problem. It is perhaps pertinent at this point to mention that apart from the cases brought to immediate notice, there were literally hundreds of cases known to the Health Department prior to 1945 waiting patiently for rehousing; cases of tuberculosis in overcrowded conditions, cases of heart disease living on second and third floors, cases of the newly-married living with relatives in an atmosphere of friction, apart from those living in premises already earmarked for demolition. The question of priority amongst the various hardship cases is one which requires careful consideration. These introductory remarks are not intended to be exhaustive, matters of interest being discussed Glsewhere in the report in the appropriate sections. In this, my last report as Acting Medical Officer of Health, I cannot close without expressing my grateful thanks to the members of the Public Health and Maternity and Child Welfare Committees for their most generous support not only in this year, but in tiro other years during which I have held the post. It would net have been possible for me to carry out the duties of Medical Officer of Health as well as those of clinical Tuberculosis Officer without such support along with the wholehearted endeavours of the staff, during th 23 diffiecult years. I have the honour to be, Your obedient servant, A .B.STEWART Acting Me ddcal Officer of Health 7. SECTION "A" VITAL STATISTICS AREA: POPULATION: BIRTHS: STILL-BIRTHS: DEATHS: The area of the Borough is 587 acres. The Registrar General's estimate of resident civilian population was 27,990. In 1938 the estimated population was 56,960. The total number of live births belonging to the Borough occurring during 1945 was 472, including 56 illegitimate births, and consisting of 238 males and 234 females, giving a birth rate of 16.9 per 1,000 population. The total number of births during 1944 was 427. The birth rate for England and Wales was 16.1 and for the London Administrative County 15.7, per 1,000 civilian population. The total number of still-births allocated to the Borough during the year was 13. This figure represents 2.7% of the total births, and .47 per 1,000 civilian population, compared with .40 for London Administrative County and .46 for England and Wales. The total number of deaths belonging to the Borough registered during 1945 was 480, consisting of 247 males and 233 females, giving a death rate per 1,000 population of 17,1. The total number of deaths for 1944 was 533. COMPARATIVE STATISTICS, 1938 - 1945: 1938 1939 1940 1941 1942 1943 1944 1945 Population 56 ,960 55,110 40,090 30,280 28,420 27,830 26,740 27,990 Birth rate (per 1000 population) 13.0 12.5 14.3 14.8 15.9 16.7 16.0 16.9 Death rate(-do) 12.9 17.1 13.6 23.1 24.7 17.9 17.5 19.9 Maternal Mortality (per 1000 live births) 4.05 0 3.68 2.8 4.4 2.1 2.4 4.2 Death rate, infants under 1 (-do-) 73. 33.5 68. 70.4 64. 56. 47. 55. Death rate of illegitimate infants under 1 (per 1000 illeg. live births) 51. 131.6 167. 125. 53.6 76.9 83.3 128. Still births (percentage of total births. 4.9 2.3 2.6 4.0 4.04 2.92 2.51 2.7 T.B. Death rate per 1000 inhabitants (all forms) 0.67 0.78 1.77 1.65 1.72 1.33 1.46 1.07 Illegitimate births 39. 38. 36. 33. 39. 24. 47. 56. 9 The following table shows the causes of, and ages at death during the year 1945:- Total all ages 1- 15- 45- 65- CAUSE OF DEATH 0- 5- - 1. Typhoid and Paratyphoid Fevers - - - - - - - - - - - - - 2. Cerebro-Spinal Fever - - - - - 5. Scarlet Fever - - 1 2 1 - - - 4. Whooping Cough - - 5. Diphtheria - - - - - - 6. Tuberculosis of Respiratory System 28 - - 10 14 3 1 - - 2 2 7. Other forms of Tuberculosis - - - - 2 8. Syphilitic Diseases 2 - - - - - 1 - 1 9. Influenza - - - 10. Measles - - - - - - - 11. Acute Polio-Myelitis and Polio- Encephalitis. - - - - - - - - - 12. Acute Infectious Encephalitis - - - - - 13. Cancer of Buccal Cavity and (Esophagus and Uterus 14 4 10 - - - - 2 9 14. Cancer of Stomach & Duodenum 11 - - - - - - 15. Cancer of Breast 5 1 3 1 - 16. Cancer of all other sites - 1 3 21 24 49 - 17. Diabetes 1 - - - - 1 - - 18. Intra-Cranial Vascular Lesions 38 1 13 24 - - 19. Heart Disease - 19 97 121 - 1 4 20. Other Diseases of Circulatory System. 9 13 22 - - - - 21. Bronchitis 47 2 1 17 27 - - 1 22. Pneumonia 23 6 2 - 5 9 23. Other Respiratory Diseases 3 - - - 1 2 - - 5 8 - - 1 2 24. Ulcer of Stomach or Duodenum 1 1 - - - - 25. Diarrhoae under 2 years - - - - - - - 26. Appendicitis - 7 - - - - 2 27. Other Digestive Diseases 3 - 1 6 11 - - 4 28. Nephritis 2 - - 29. Puerperal & Post-Abortive Sepsis 2 - - - - - 30. Other Maternal Causes - - - - - 6 31. Premature Birth 6 - - - - - 32. Cong. Malf. Birth Injuries, Infant Dis. 9 8 1 - - - - 33. Suicide - - - - - - - 34. Road Traffic Accidents 1 3 4 - - - - 35. Other Violent Causes 31 1 1 1 6 11 11 2 6 8 15 36. All other causes 32 1 - M 247 11 2 5 24 81 124 134 F 233 15 3 2 18 61 142 258 Total All Causes 480 126 5 7 42 9 SECTION "B" - GENERAL PROVISION OF HEALTH SERVICES TREATMENT CENTRES AND CLINICS. The attendances at the Various Treatment Centres and Clinics have shown a steady expansion since their inception and there were record attendances in the Dental and Foot Clinics. ATTENDANCES &C. at TREATMENT CENTRES AND CLINICS CLINIC 1942 1943 1944 1945 No. of sessions. No.of new cases Total No. Atts. No. of sessions. No. of new cases Total No. Atts. No.of sessions. No. of new cases Total No. Atts. No.of sessions. No. of new eases Total No. Atts. FOOT CLINIC 833 4600 1195 849 6638 1358 800 1572 10244 8037 701 655 4967 327 357 DENTAL CLINIC. 312 3858 986 979 4291 423 1298 907 4413 499 529 9122 473 13154 415 772 693 14567 10032 438 497 SOLARIUM 49 52 295 45 373 44 WOMEN'S CLINIC 502 47 119 90 186 321 1667 22114 2647 25869 2174 2360 22803 2586 24628 TOTALS 2520 2066 2480 The Council approved a scheme for the treatment of staff members at the various clinics in the Health Centre. It was decided also to contract with local firms to treat their employees provided that this work did not interfere with the facilities available for residents. In order to allow the chiropodists to devote more time to professional work clerical assistance was provided in the Foot Clinic and an additional chiropodists chair and equipment were ordered. LABORATORY: Routine examinations of swabs, sputum, milks, &c., have continued to be carried out at the Laboratory in the Health Centre and the following is a brief summary of the work undertaken - No.of throat and nasal swabs examined 392 No.of sputums examined for T.B 150 Milk samples 71 Pathological specimens examined 48 The Council continued the arrangement whereby special examinations are undertaken at the Archway Group Laboratories by the L.C.C.Group Pathologist, Doctor J.M.Alston. 10 INQUESTS: Inquests were held on 19 residents during the year, the findings being as follows: Bronchitis 1 Road accidents Misadventure Violence 4 2 9 Self Neglect Heart Failure Miscarriage 1 1 1 MATERNAL MORTALITY There were two maternal deaths during the year, giving a maternal mortality rate of 4.1 per 1,000 Total (Live and Still) Births. INFANTILE MORTALITY: There were 26 deaths amongst infants under one year of age and the infant mortality rate based on 1,000 live births was 55. The following are comparative infant mortality rates; INFANT MORTALITY RATES 1940 1941 1942 1943 1944 1945 68 70 64 56 47 55 FINSBURY 50 68 60 58 61 53 LONDON 49 46 55 ENGLAND & WALES 59 49 46 DEATHS IN RELATION TO DISEASE: During the year there was a decrease of 53 in the number of deaths from 533 to 480, There were no deaths from Diphtheria, Measles, Typhoid or Scarlet Fever during the The deaths from Cancer, Heart Disease, Bronchitis and Intra cranial Vascular lesions form a high proportion of the total deaths, and it is to be noted that those deaths occur to a large extent in the 65 years and over group. Heart Disease, Intracranial Vascular lesions and Bronchitis are frequently concomitant with senile changes in the aged. There has a substantial reduction in the deaths due to tuberculosis. GRANTS SCHEME 1,075 dinners were granted free of charge to necessitous mothers and children at the two Centres, under the provisions of the Council's Maternity and Child Welfare Grants Scheme, The scheme to provide dinners for selected cases who were outside the income group for free dinners was continued. Charges were made for such cases at the rate of l/3d. per dinner for adults and 6d per dinner for children under 5 years, and a further 4138 dinners were provided under this scheme. 133 lbs.of Dried Milk were also issued to necessitous persons free of charge; 26 lbs. were issued at half cost, and 2,353 lbs at cost price. 11 MUNICIPAL WELFARE CENTRES: The attendances at the two Municipal Maternity and Child Welfare Centres are briefly outlined in the following table and a comparison is shown with the figures which obtained in 1944: LEAGE STREET PINE STREET 1944 1945 1944 1945 Mothers, Individual 138 180 115 102 Mothers, Attendances 329 242 174 106 Children (1-5 yrs) Individual 441 449 221 242 Children (1-5 yrs) Attendances 2,153 2,328 1,236 1,169 Babies, Individual 377 390 157 192 Babies, Attendances 2,700 3,729 1,272 1,552 PRIORITY DOCKETS FOR EXPECTANT MOTHERS: In accordance with the Ministry of Health Circular 154/44, arrangements wore continued through the Maternity and Child Welfare Services for the issue of priority dockets to enable expectant mothers, being confined at home, to obtain a supply of utility sheets. During the year 212 dockets were issued. HEALTH VISITING: The regular visitation of expectant mothers and children under five years was continued by the Health Visitors and during the year a total of 10,049 visits were made by the Council Staff in addition to visits made by the officers from certain Voluntary Centres in the borough. The following special cases necessitated frequent visits by the Health Visitors:- Nature of Case No.of cases Results Prematurity 7 ) Died - 3 Marasmus 2 ) Satisfactory -24 Illegitimacy 23 ) Removed to other Twins 15 ) areas - 5 Poor Progress 2 ) Still special at Underweight 1 ) end of year - 21, Unsatisfactory enviroment 1 ) Mentally Backward 1 ) Gastro Enteritis 1 ) VOLUNTARY CENTRES: The Council has continued grants to the undermentioned Voluntary Centres, and a brief outline of the work carried out at these Centres is shown below: No. of MEETINGS HELD No. of ATTENDANCES INSTITUTION City of London Maternity Hospital 282 (Finsbury) 290 Claremont Central Mission 92 489 Maternity Nursing Association 305 1888 Women's League of Service 41 862 12 NURSERIES: The Finsbury Evacuated Nursery at Bown Hill Farm, Woodchester, Gloucester, was disbanded during the year, the children returning to London. Four Wartime Nurseries were in operation in the borough during the year. The following table shows the average daily attendances: JAN. FEB. APR. MAY. JUN. JUL. SEP. OCT. NOV. AUG. DEC. MAR. 20 28 31 31 King Square 26 27 22 27 29 31 33 34 45 55 58 54 54 Lloyd Square 37 42 53 54 59 51 62 38 53 58 49 53 46 Donegal Street 53 41 43 59 56 50 47 16 40 46 45 41 39 43 35 Banner Street 26 37 36 119 142 147 154 174 186 194 173 183 184 166 189 Total It is regrettable to have to repeat the complaints of former years regarding the difficulty in obtaining both nursery and domestic staff for the nurseries. our limited residential accommodation has proved a handicap in obtaining probationers who are willing to come from the country if residence can be provided. The attendance figures show improvement in spite of quarantine from time to time following infectious diseas HOME NURSING: The arrangements with the Metropolitan District Nursing Association to undertake the nursing of cases of illness occurring in expectant and nursing mothers and the nursing of children under five years of age suffering frOm any illness at homo, was continued throughout the year. EVACUATION: Arrangements wore made through the Borough Council for the evacuation of 5 children under 5 years and 56 Expectant Mothers, during the year. NATIONAL MILK AND VITAMINS SCHEME: The Municipal and Voluntary Centres continued to operate as distributing points for vitamin products and national dried milk. MIDWIFERY: Under the Council's Midwifery arrangements as detailed in previous annual reports the following numbers of patients wero admitted to the various hospitals. (a) St. Bartholomews Hospital 71 (b) The Royal Northern Hospital 1 (c) The City of London Maternity Hosp.. 21 (inc.l4 Evacuations) (d) The University College Hospital ... 5 Co-operation was maintained between the Hospitals concerned and the Maternity and Child Welfare Department. Attendances at ante-natal clinic are notified and ante-natal visits are made by our Health Visitors. 13 CARE OF PREMATURE INFANTS: The arrangements outlined in the 1944 Report remain in operation. It should be noted that the six infants who died of prematurity did so within a very short time of birth before the question of nursing care arose. During the year 32 births were notified where the birth weight was 5½r lbs or less, 24 of which were in respect of premature births. Of these, 11 were born at home, 8 being nursed entirely at home. Of the 11 babies born at home, 10 survived at the end of one month. HOME HELPS: The Council provides a service of Home Helps during the post natal and ante-natal period for domiciliary cases. The Home Help Service has been maintained and has worked satisfactorily. 60 applications for this service were received during the year. At the end of the year the panel of Home Helps consisted of 5 persons. The staff shortage for this work has already been noted. HOSPITAL TREATMENT: The arrangement between the Council and the Elizabeth Garrett Anderson Hospital for the retention of one cot has persisted throughout the year and has worked very satisfactorily. Arrangements were made during the year for the admission of eight children to Hospital under the Council's arrangements. EAR. NOSE AND THROAT HOSPITALS: The Royal Free Hospital has continued to admit Finshury children requiring tonsillectomy. Similar arrangements exist with the Central London Ear, Nose and Throat Hospital and Archway Hospital. Mr.Milloy F.R.C.S., Medical Superintendent of Archway Hospital, continued to accept cases from Finsbury for operation at short notice as he has done in the past. PUERPERAL FEVER AND PUERPERAL PYREXIA: During 1945 there were five cases of puerperal pyrexia and throe cases of puerperal fever notified in Finsbury. This gives a rate per 1,000 Live and Still births of 16.5 as compared with 9.93 for England and Wales, and 15.87 for the London Administrative County. OPHTHALMIA NEONATORUM: The number of cases of Opthalmia Neonatorum notified was two. One of those cases was treated at home and one in hospital. In neither case was there impairment of vision. CONVALESCENT TREATMENT: The Council continued their arrangements with the Dedisham Convalescent Home where two cots are retained and with the Noel Home, Letchworth where four cots are retained. The number of children admitted to these homes during the year was 21. In addition, children were referred for convalescence through the Invalid Children's Aid Association, which dealt with 11 cases during the year. 14 The London Council of Social Service found it necessary to close Grand Street House, Worplesdon Hill, Surrey, and the Council were thus deprived of the valuable service which Grand Street House rendered; many finsbu ry mother children, havin genefitted by a restful holiday there. . ' It is hoped that it will be possible to make suitable arrangements for convalescence with a similar organisation in the near future. FOSTER PARENTS: At the end of 1945 there were two registered foster mothers in the Borough. INFANT DEATHS: There wore 26 infant deaths in Finsbury during 1945, and the mortality rate based on 1,000 live births was 55. The neo-natal deaths i.e., oocuring within the first twenty-eight days, numbered 19, and the deaths of children from one month to one year was 7. ILLEGITIMATE CHILDREN: TheCouncil now contribute an annual sum of £101 towards the improvement of the services of voluntary organisations for Moral Wolfare in London, and is suitably represented on the councilof Moral Welfare. The Health Visitors pay frequent visits to illegitimate cases and work in collaboration with the Moral Welfare Worker of the Local Organisation at St. Faith's Home. The increased number of illegitimate births in 1945 has already been noted. 16 SECTION "C" - SANITARY CIRCUMSTANCES Summary of inspections made by Sanitary Inspectors - Total number of first visits 6916 Total number of re-visits 4326 Shops Act Inspections 102 Visits to verminous premises 115 House to House inspections 38 House inspections 1225 Infectious Disease Investigations 90 Investigation of complaints 813 Visits to houses let in lodgings 620 Visits to Butchers Shops and Stalls 3765 Visits to Public Sanitary Conveniences 444 Street Traders' Premises Inspected 67 DRAINAGE: The number of drainage plans deposited and approved during theyear was 5. The following is a summary of the work done:- Water closet defects remedied 180 Water Closets erected 40 Urinal defects remedied 1 Urinals erected 0 Soil pipe and ventilating shaft defects remedied 19 Soil pipe and ventilating shafts erected 11 Waste pipe defects remedied 62 Waste pipes erected 17 Drains re-laid or amended and sealed 50 Drains cleared or tested 133 Rain water pipes cleared, repaired or renewed 49 COMPLAINTS: The total number of complaints received was 813 NOTICES SERVED: The following numbers of notices were served requiring the abatement of nuisances and the remedying of defects:- Number of Intimation Notices 547 Number of Statutory Notices 5 RECEPTION HOUSE: There was no occasion during 1945 for the occupation of the Reception House for the special purpose for which it was provided. The arrangement was kept in force whereby Holborn residents were to use the Reception House if the need arose. 16 ERADICATION OF BUGS In the case of 18 Council flats and 97 other houses, bugs were found and remedial measures were taken. Arrangements were also made in the case of 6 new entrants to the Council's flats for routine disinfestation of their furniture by means of cyanide gas by arrangement with the Islington Borough Council. CLEANSING OF VERMINOUS PERSONS: The London County Council continued to utilize the Cleansing Station for the treatment of school-children during mornings only, the afternoons being reserved for dealing with Finsbury adults and pre-school children. 3,275 treatments were given during the year to L.C.C. school-children and 1,677 treatments to all other cases. Homo visiting of scabies cases and contacts was continued and the Nurse-in-charge of the Cleansing Station made 330 home visits during the year. SHOPS: The number of inspections made under the Shops Act, 1934 during 1945 was 102. RAG FLOCK: The number of samples of Rag Flock taken during the year was 2. CANAL BOATS : The total number of canal boats inspected during the year was 71, none of which carried any offensive cargo. Contravention of statutory requirements had taken place in 14 instances. There was no discovery or notification of infectious disease. The number of children on the boats 39, of whom 23 were of school age. AGED AND INFIRM PERSONS: No application for compulsory removal to hospital was made during the year. Aged persons known to the Department to be living alone are visited periodically to ensure that institutional treatment or care is obtained if necessary. There were at the end of the year 12 perrons on the register kept for the purpose, to whom 91 visits were made. STREET TRADERS: 67 visits were made to the premises of street traders dealing in foodstuffs. COMMON LODGING HOUSES: There is one Common Lodging House in the Borough, situate at No.BB Old Street, and the number of visits made by the Sanitary Inspector was 20. HOUSES LET IN LODGINGS: At the end of the year there were 488 houses on the Register and 620 visits were made in connection with the Houses Let in Lodgings Byelaws. MORTUARY: 86 Bodies were received at the mortuary attached to the Health Centre premises. DISINFECTION: The following table gives particulars of the disinfection work carried out during 1945. Diphtheria 32 Measles 316 Vermin and Scabies 189 Scarlet Fever 53 Tuberculosis 15 Whooping Cough 39 Miscellaneous 94 By request 119 A total number of 11,809 articles were disinfected, being chiefly pillows, mattresses, bolsters, sheets, blankets and wearing apparel. In addition 211,737 articles were disinfected prior to Export and fees charged for this work amounted to £340. 0s. 0d. OFFENSIVE TRADES: The following are licences offensive trade premises (a) Messrs. Henson, 187 Whitecross Street, E.C.1. (b) Messrs. F.& W. Warman, Ltd., 5 Eagle Court, E.C.1. (c) Messrs. T. Kendon & Sons, Charterhouse Mews, E.C.1. In addition Messrs. Reubens of St. John Street, were licensed during the year for the purpose of trading in rabbit skins. 310 visits were made in respect of these premises during the year. OUTWORKERS: No.of Finsbury firms employing outworders at the end of Aug.1945 176 Total number of outworkers employed by Finsbury firms 1430 Number of outworkers resident in Finsbury 237 FACTORIES ACT, 1937: During the year 1,035 first visits and 1,259 re-visits were made to factories and 142 intimation notices were served requiring the remedy of defects found. The following is a summary of defects found NUMBER OF DEFECTS FACTORIES (POWER) FACTORIES (NON-POWER) TOTAL Refuse accumulation or absence of dustbin. 10 1 11 Roof leaky 6 2 8 Ceiling broken 1 1 2 Sanitary Conveniences - defective 25 3 28 " " - dirty 27 10 37 " " - not separated or insufficient 6 2 8 " " - unlabelled 39 7 46 " " - with no artificial light 47 6 6 53 " " unsuitable 67 73 Staircase dirty 0 0 2 2 Insufficient ventilation of workrooms 3 3 Water fittings leaky 14 2 16 Workrooms dirty 1 14 15 Yard walls dirty 3 1 4 r 18 23 notices of complaint were received from the Homo Office. 24 notices were sent to the Home Office regarding the following matters:- Abstract absent 13 New occupation, notification 11 LADY SANITARY INSPECTOR'S WORK: The following, is a summary of visits made by the Lady Sanitary Inspector - Factories 2294 Outworkers premises (Sub-Contractors) 82 Outworkers premises (domestic) 722 Public Health complaints 23 Public Sanitary conveniences 84 TOTAL 3205 142 Number of Intimation Notices served Number of Statutory Notices served 0 RAT REPRESSION: No.of complaints and requests for treatment received - 356. No.of additional premises found infested - 116. No.of houses treated - 106. No.of other premises treated - 227. No.of visits made by ratcatchers, to houses - 2,179 and to other premises - 6,553. ORGANISATION: A major change in the organisation was made necessary by the disbanding of the Light Rescue Service at the close of hostilities in Europe. Instead of the part-time employment of six Light Rescue men, four of the men were engaged on a full-time basis, one as foreman, so enabling Mr, Lay to devote more time to his normal duties as a district Sanitary Inspector, whilst maintaining the direction of the rodent control campaign. Close contact with the Ministry of Food technical and research sections was continued throughout the year. BLOCK CONTROL: Systematic block control continued and further progress was made in the campaign to reduce the rat population. SEWER TREATMENT: In view of the apparent large rat population that had developed in the long interval between the "Directed" treatments and the first maintenance treatment, the Council agreed to an additional treatment being carried out in March. The routine treatment was made in June, but the intended December treatment was deferred at the request of the responsible Ministry of Food Officer, until January, 1946, when neighbouring boroughs would be operating fit the same time. It is not now possible to give reliable estimates of the number of rats killed by these treatments, but the sewermen state that the rat population in the Councils sewers is now much reduced. 19. HOUSING - SECTION "D" INSPECTIONS: Hereunder will be found particulars of inspections carried out and action taken during the year:- (A) (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 2166 (b) Number of inspections made for the purpose 2382 (2) (a) Number of dwelling-houses (included under subhead (1) above) which inspected and recorded under the Housing Consolidated Regulations,l925 38 (b) Number of inspections made for the purpose 46 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 0 (4) Number of dwelling houses (exclusive of those referred to under the preceding, sub-head) found not to be in all respects reasonably fit for human habitation 547 (B) Number of dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers (C) Action under Statutory Powers during the year. - (a) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:- (1) Number of dwelling-houses in respect of which notices were served requiring repairs - (2) Number of dwelling-houses which were rendered fit after service of formal notices - (a) By Owners - (b) By Local Authority in default of Owners - (b) Proceedings under Public Health acts:- (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 547 (2) Number of dwelling-houses in which defects were remedied after service of formal notice - (a) By owners 547 (b) By Local Authority in default of owners - (c) Proceedings under Sections 11 and 15 of the Housing Act, 1936. (1) Number of dwelling-houses in respect of which demolition orders were made - (2) Number of dwelling-housed demolished in pursuance of demolition orders - (d) Proceedings under Section 12 of the Housing, Act, 1936. (1) Number of separate tenements or underground rooms in respect of which closing orders were made - (2) Number of separate tenements or underground rooms in respect of which closing orders were determined, the tenement or room having been rendered fit - 20. HOUSING APPLICATIONS: 30 families were rehoused during 1945, 6 in Borough Council Flats and 24 by the London County Council. BUSACO STREET AND SADLER STREET AREAS: The property on these proposed rehousing sites was inspected regarding the occupancies and condition of the properties, and a report submitted to the Housing Committee. BASTWICK STREET. A report on certain property in Bastwick Street was submitted to the Housing Committee, recommending closure and demolition. SECTION "E" - INSPECTION AND SUPERVISION OF FOOD AND DRUGS analysis of Milk: During the year 36 samples of milk were submitted to the Public Analyst. No samples were found to be adulterated. Bacteriological Examination of Milk: 102 samples of Designated Milk and 88 samples of Ordinary Milk were submitted for bacteriological examination. Milk Shops and Dairies: Number of applications for registration approved 8 Number of purveyors on the register at the end of 1945 111 Number of purveyors removed from the Register during the year 13 Number of purveyors on the register at the end of 1944 116 Number of visits of inspection carried out 410 Number of notices served for cleansing and repairs to dairy premises 2 Milk (Special De signations) Regulations 1936-1944. Number of applications for licences received - (a) Tuberculin Tested Milk - Dealers 7 (b) Pasteurised Milk - Dealers 32 (c) Pasteurisers 1 (d) Supplementary Licences 8 (e) Number of samples taken for examination 102 21. Milk in Schools: Ten samples of milk delivered to the Schools were taken during the year and submitted for bacteriological examination. Food Poisoning: During the year there were no cases notified under the Food and Drugs, Act, 1938, amongst Finsbury residents. Bakehouses: There were 22 bakehouses in use in the Borough at the end of the year, of which 17 were basement premises, In all the bakehouses machinery is used. 84 visits of inspection were made during the year and six notices were served for cleansing and other matters. Adulteration of Food: The total number of samples taken in 1945 under the Food and Drugs Act, 1938, was 750 of which 26 were formal samples and 724 informal samples. The following table gives full information with regard to the formal samples submitted to the Council's Public Analyst. NAME OF ARTICLE GENUINE ADULTERATED TOTAL Milk 23 23 - Gin 1 1 - Baking Powder 1 1 - Compound Mustard 1 1 - Pharmacy and Poisons Act, 1933. The work under this Act has continued to be carried out by Mr. Clinton and 39 applicants were approved during the year by the Council as Listed Sellers of Poisons and 91 visits were made. No contravention of the Act or Rules was observed. Salvage Division (Ministry of Food) Examination of foodstuffs have again been carried out in co-operation with the Minister of Food's Salvage Officers. The examinations were necessitated as the result of damage and from loss of labels etc. to packages during transport. Ice-cream: During the year the sale of ice-cream was small in comparison to the quantities sold in pre-rationing days. In a large number of shops registered for the making, storage and sale of ice cream, no trading was done because the electrical freozers installed required an overhaul which the manufacturers were unable to carry out; whilst many shops registered for the sale and storage of ice cream were unable to trade as they relied upon the large manufacturers for their supplies, which, owing to the restrictions on ingredients could not be obtained. 22. Unsound Food: The work of meat inspection in the area of the Smithfield Meat Market continues, since the secondment of Mr. Penman to the Ministry of Food, to be carried out by Mr. R.S. Barber the Assistant Meat Inspector. Regular inspections of the meat and offal consigned to the various wholesale butchers and offal shops were carried out and were also made of the various bacon factories, wholesale bacon and provision warehouses and Public Cold Air Stores. Visits and inspections of the retail butchers shops in the Borough were also carried out. In February 1945, the London Wholesale Meat Supply Association Ltd., an executive department of the Ministry of Food, opened a boning depot at 24, St. John Street, to supply London and the suburbs with meat for manufacturing purposes. Due to the particular class of carcases consigned to this depot, a detailed examination of all meat arriving here is required and is constantly under the supervision of the meat inspector. Summary of Foodstuffs seized by or surrendered to the Meat Inspector during 1945. Diseased or unsound meat 31,537 lbs. Diseased or unsound offal and other foodstuffs 25,271 lbs. Total 54,808 The number of carcases of Mutton and Lamb found to be affected with Caseous Lymphadentis was 49. Representations were made by the Council to the Ministry of Health and Ministry of Food regarding the frequency of Caseous Lymphadenitis in imported mutton. Officials of both Ministries attended Meat Stores in the Borough to note Mr. Barber's findings. Slaughterhouses: The slaughterhouse owned by Mr. J.A. Mobbs, 14 Penton Street was closed down on the outbreak of the war. No animals were slaughtered there during 1945. Disposal of Condemned Meat: The disposal of condemned foodstuffs is now performed by the Sheppey Glue and Chemical Works, Ltd., 34 Ceylon Street, S.W.8. 24. Smallpox and Vaccination: No cases of small-pox occurred in the Borough during 1945. The following is a summary of proceeding under the Vaccination Acts, 1897 to 1898. Number of Finsbury birth notifications received from Registrar 214 122 Number of Certificates of Vaccination received Number of deaths before Vaccination 10 22 Postponements of medical certificate Number of certificates of insusceptibility - Number of notices to other Vaccination Officers re non-resident cases 34 Number of addresses not traced 53 Number of Finsbury babies not vaccinated within Statutory period of four months 29 643 Number of personal visits made during the year Cases notified from other Boroughs for enquiry 188 Certificates of exemption granted after declaration 21 Scarlet Fever: The number of cases of scarlet fever notified during 1945 was 48, of which 34 were removed to Hospital, the average length of stay in Hospital being 30 days. There were no deaths from this disease. Routine visits to patients following discharge were continued. Diphtheria: 13 cases of diphtheria were notified there being no deaths. All the cases were removed to Hospital and the average length of stay was 51 days. The following table shows the cases notified during the last ten years and the number of deaths. Year No. of cases notified No. of deaths 1936 126 4 1937 107 2 1938 101 3 1939 58 2 1940 27 2 1941 35 - 1942 19 1 1943 24 2 1944 10 - 1945 13 - Efforts were continued during the year to secure a greater degree of immunisation in the child population by means of further propaganda and intensive visits by the Health Visitors and Sanitary Inspectors. The method of intensive visiting has been reported in detail elsewhere (Medical Officer - 15th April, 1944, page 125) It was estimated that by the end of 1945, approximately 51.3% of the child population under five years of age had been immunised against diphtheria. The number of children of this ago group immunised during the year was 460. 23. SECTION "F" - INFECTIOUS AND OTHER DISEASES Notifications of Infectious Disease: The following table shows the notifiable cases of Infectious Disease during 1945, in various age groups and indicates the total number of cases removed to Hospital: All ages. Under 1 yr. 1 - 5 yrs. 5 - 15 yrs. 15- 25 yrs. 25 - 45 yrs. 45 - 65 yrs. 65+ Total Rmvls. to Hosp. Acute Influenzal Pneumonia 1 1 - 1 - - - - - - Acute Primary Pneumonia 25 8 2 1 2 11 - - Cerebro-spinal Meningitis 5 2 3 1 - - - - - Diphtheria (Inc. Mem. Croup) 13 3 6 3 1 13 - - - 12 1 1 2 1 16 Dysentery 17 - - Erysipelas 7 2 3 2 5 - - - - Typhoid - - - - - - - - - Measles 364 23 224 110 5 2 87 - - 2 2 1 Ophthalmia Neonatorum - - - - - - Puerperal Fever 3 3 2 - - - - - - Puerperal Pyrexia 5 - 5 2 - - - - - 2 11 31 4 34 Scarlet Fever 48 - - - Pulmonary Tuberculosis 87 - 5 8 22 32 17 3 - 1 4 4 4 1 Other forms of Tuberculosis 14 - - - 13 Whooping Cough 49 5 30 1 17 - - - Zymotic Enteritis - - - - - - - - - - Polio-Myelitis - - - - - - - - 3 Scabies 198 22 43 51 56 19 4 - 38 TOTALS 838 319 218 90 110 42 21 178 Notification Rates (Comparative Table) per 1,000 population. Finsbury England and Wales 126 C.B's & great towns including London 148 smaller towns. Res. population 25,000 to 50,000 at 1931 census London Adm. County Typhoid Fever 0.00 0.01 0.01 0.01 0.01 Paratyphoid fever 0.00 0.01 0.00 0.01 0.00 Cerebro-spinal fever 0.18 0.05 0.05 0.05 0.06 Scarlet Fever 1.71 1.89 2.02 2.03 1.57 Whooping Cough 1.75 1.64 1.65 1.47 1.25 Diphtheria 0.46 0.46 0.52 0.56 0.31 Erysipelas 0.25 0.25 0.28 0.24 0.31 Smallpox 0.00 0.00 0.00 0.00 0.00 Measles 13.00 11.67 10.89 11.19 9.03 Pneumonia 0.93 0.87 1.03 0.72 0.78 Whooping Cough: 25. Notifications of whooping cough numbered 49, and there were no deaths. Prophylactic treatment has been continued in conjunction with diphtheria prophylaxis. Measles: There were no deaths from measles during the year. Of the 364 cases which occurred 87 were removed to hospital, partly on medical and partly on social grounds. Special visits were paid to all cases nursed at home. Typhoid: There were no notifications during the year. Provision of Insulin: By virtue of Section 227 of the Public Health (London) Act, 1936, the borough continued to bear the cost of treatment of diabetes in the case of necessitous persons. 4 persons received assistance during the year at a cost to the Council of £11. 3s. 8d. Tuberculosis: The total number of now cases of tuberculosis, both pulmonary and non-pulmonary, entered in the Register in 1945 was 101. The age period details were as follows: *" 1- . ■'' '• f 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total all. ages Males Pulmonary - 4 4 1 4 3 9 7 10 5 2 49 1 12 4 1 1 Females Pulmonary 1 2 5 10 1 38 - - Males Non-pulmonary Females Non-pulmonary 1 1 1 2 - 1 - 1 6 - - - - 3 - - - - 2 2 8 - - Total - 6 6 6 13 13 22 14 12 6 3 101 Of the above cases 28 ware brought to notice otherwise than by formal notification. The number of cases removed from the Register during the year was 97 and those remaining on the Register of Notifications at the 31st December, 1945, were as follows: Males Females Total Pulmonary 235 164 399 Non-pulmonary 45 44 89 280 208 488 The following is a summary of the Tuberculosis Dispensary work in 1945:- Number of cases on Dispensary Register- Pulmonary 357 Non-pulmonary 65 Total 422 26. Sputum Positive Cases 174 Sputum Negative Cases 183 Cases notified from Services 13 New Cases examined (other than contacts). Pulmonary Non-pulmonary. Total (a) Definitely Tuberculous 70 6 76 (b) Diagnosis not completed 22 22 - (c) Non-Tuberculous 190 190 - 288 Contacts: (a) Definitely Tuberculous 6 6 - (b) Diagnosis not completed 2 2 - (c) Non-Tuberculous 131 131 - 139 Cases Written Off: (a) Recovered 9 (b) Diagnosis not confirmed - 9 Number of attendances at Dispensary 2870 Visits made by Tuberculosis Visitor 966 Number of X-ray examination and screenings 2462 Home Visits by Tuberculosis Officer 11 Specimens of sputum examined 150 Number of patients attending for artificial pneumothorax refills 46 Number of refills given 530 X-RAY DEPARTMENT: Details of the work in the X-ray department during 1945, are as follows:- Chest cases: Large films used 832 Small films used 104 Screen examinations 1475 Other cases: Doctor's cases 37 Sunlight Clinic 6 Day Nursery and other staff 8 27. Tuberculosis Maintenance Allowances Scheme: The scheme for the provision of maintenance allowances in certain cases, for the dependants of patients who have to give up remunerative work in order to undergo treatment, and to persons who, though having no dependants, are still in need of allowances during institutional or home treatment, continued to operate smoothly during the year. The Council's T.B. Dispensary machinery is used for the institution of the necessary enquiries and for the presenting of the applications weekly to the Tuberculosis Assessment Officer. During the year 28 new applications were dealt with. In addition to new cases, 296 cases were presented to the Assessment Officer for review. The total cash allowances paid out during the year was £2,315. PROVISION OF EXTRA NOURISHMENT: The Borough Council has continued to provide extra nourishment for certain types of tuberculosis cases. 58 persons were granted extra nourishment during the year. The arrangements in the Chest Clinic have remained unaltered during the year. The cordial relationship between the Care Committee Secretary, Mr. Ward, and the Chest Clinic staff has proved invaluable in the work connected with the Maintenance Allowances Scheme. MINIATURE MASS RADIOGRAPHY: During the year the London County Council Mass Radiography Unit was utilised for the examination of 1451 persons who were employed at various firms and organisations in Finsbury. Of this total, 41 (2.82%) we re referred for large films and 17 (1.17%) of these were referred to general practitioners as probable Tuberculous cases.