Ac 4341 LIBRARY (1) Fin 27 THE METROPOLITAN BOROUGH OF FINSBURY ANNUAL REFORT on the PUBLIC HEALTH OF FINSBURY for the year 1946 By - C.O.S. BLYTH BROOKE, L.R.C.P., M.R.C.S., D.P.H., Medical officer of Health. Finsbury Health Centre, Pine Street, London, E.C.I. PUBLIC HEALTH COMMITTEE (November,1946) CHAIRMAN: Coun. W. Barrie, M.P.S., VICE-CHAIRMAN: Coun. Miss B.P. Beauchamp. Alderman C.W.E. Drew Councillor Miss K. Beauchamp „ Mrs. M. M. Champion „ Miss N. Cordner-James „ Mrs. E. R. Gannon „ Mrs. F. E. Gilbert „ Mrs. C. Griffiths „ A. A. Harris „ Mrs. A. J. Mahon „ Mrs. O. Pannett „ Mrs. E. Potter „ A. G. Webb „ Miss M. A. Westerman (2) MATERNITY & CHILD WELFARE COMMITTEE (Nov'46) CHAIRMAN: Coun. Mrs .F. E. Gilbert, VICE-CHAIRMAN: Ald. Mrs. V. M. Heaps. Alderman W. L. Prowse Councillor W. Barrie „ Mrs. M. M. Champion „ Mrs. E. F. Drake „ Mrs. E. R. Gannon „ Mrs. C. Griffiths „ A. A. Harris „ W. Kingham „ Mrs. A. J. Mahon „ Mrs. O. Pannett „ Mrs. E. Potter „ Miss G. L. Tutty „ Miss M. A. Westerman STAFF MEDICAL OFFICER OF HEALTH C.O.S. Blyth Brooke, L.R.C.P., M.R.C.S.,D.P.H., (Resumed duties after service with H.M. Forces 1/5/46). ACTING MEDICAL OFFICER OF HEALTH A.B. Stewart, M.D., D.P.H., (1/1/46 - 30/4/46) DEPUTY MEDICAL OFFICER OF HEALTH A.B. Stewart, M.D., D.P.H., (Resigned 31/10/46) W.D.R. Thompson, M.R.C.S., L.R.C.P., D.P.H., Barrister-at-Law (from 1/11/46) ACTING DEPUTY MEDICAL OFFICER R. Woolf, M.B., B.S., M.R.C.S., L.R.C.P., OF HEALTH D.P.H., (1/1/46 - 30/4/46) ASSISTANT MEDICAL OFFICERS OF R. Woolf, M.B., B.S., M.R.C.S., L.R.C.P., HEALTH (TEMPORARY) D.P.H., (1/5/46 - 23/10/46) E. Obermer, M.D., M.R.C.S., L.R.C.P., (Resigned 29/4/46) Part-time. K.M. Lane, B.A., M.R.C.S., L.R.C.P., (part-time) Roza Merzer, (from 17/10/46) PUBLIC ANALYST C. Harcourt Wordsworth, B.Sc., PUBLIC VACCINATORS Dr. R.E. Batson, Dr. R.K. Dadachanji, Dr. G.P. Barua, Dr. R. Sacks VACCINATION OFFICER P.E. Capps (part-time) (Resigned 31/12/46) (3) ADMINISTRATIVE CLERICAL STAFF H. Ward, D.P.A., M.R. San. I. (Assistant Administrative Officer) T.E. Williams,(Senior Clerical Assistant) J. E. McDowell,(Statistical Clerk) Miss W. Freeman, (M. & C.17.Assessment Clerk) R.W. Leach, (P.H. Asessment Clerk - from 16/12/46) Miss J.S. Dodd, (M. & C.W. Clerk) J. W. Field, (Clerk) D.S. Ward, (Clerk - from 11/11/46) Miss J.L. Faulkner, (Shorthand-typist) Miss D. Wall, (Shorthand-typist - from 25/11/46) I.L. Bedford, (Clerk - Dental) (from 15/4/46) J. Lindsay, (Clerk - Sanitary Inspectors) (from 25/11/46) Mrs. G.L. Ranee, (Clerk - Foot Clinic) (from 11/12/46) A.F. Cowan, (Clerk - resigned 26/10/46) E. Mitchell, (Clerk - with H.M. Forces) Miss P. Killick, (Office Junior - resigned 5/10/46) J.B. Higgins, (Office Junior - from 11/11/46) SANITARY INSPECTORS MEAT INSPECTORS M. & C.W. SUPERINTENDENTS M. & C. W. DISPENSER HEALTH VISITORS H.J. Newdick, M.S.I.A., (Senior S.I.) H. Clinton, M.S.I.A., (Food and Drugs) Miss F. Hall, M.S.I.A., R.E. Lay, M.S.I.A., A.J. Truslove, M.S.I.A., J. Lewis, M.S.I.A., W. Keutenius, M.S.I.A., (returned from H.M. Forces 4/2/46) G. Hawthorne, M.S.I.A., (returned from H.M. Forces 1/3/46) T. Penman, M.B.E., M.S.I.A., (Seconded to Ministry of Food) R.S. Barber, M.S.I.A., Mrs. M. Parker (Leage St. M. & C.W. Centre) Miss J.R. Turner (Pine St. M. & C.W. Centre) Miss I. Lloyd (part-time) Miss B.J. Scott, Miss M. Rock, Mrs. G. Hartney, Miss L. Breaman, Miss L.E. Hitchings (Temporary) (resigned 30/4/46) DAY NURSERIES Lloyd Square Banner Street Donegal Street King Square TUBERCULOSIS NURSE & VISITOR SECRETARY OF TUBERCULOSIS CARE COMMITTEE WOMEN'S CLINIC DENTAL CLINIC Panel of Anaesthetists FOOT CLINIC CLEANSING STATION (4) Mrs. M.G. Havers (Matron) Miss M.M. Robson (Deputy Matron) Miss G. Jones, (Matron) (resigned 6/4/46) Miss K. Turner (Deputy Matron to 30/5/46 - Matron from 31/5/46) Miss E.M. Hutchings (Deputy Matron from 1/4/46) Miss E.M. Hutchings (Acting Matron 1/1/46 - 31/3/46) Mrs. M.E. Halliday, (Matron) Miss I. Henry (Deputy Matron - resigned 7/9/46) Mrs. F.R. Rogers (Deputy Matron - from 2/9/46) Miss F.M. Prior. H. Ward, D.P.A., R. Woolf, M.B., B.S., M.R.C.S., L.R.C.P..D.P.H., (Medical Officer in charge to 16/10/46) Margaret Salmond, M.D., M.B., B.S., M.R.C.S., L.R.C.P., F.R.C.S., F.R.C.O.G., M.B.E. (part time Medical Officer in charge from 17/10/46) H. Millett, L.R.C.P., M.R.C.S., L.D.S (part-time Dental Surgeon - resigned 22/11/46) J. W. White, L.D.S., (part-time Dental Surgeon) W.R. Gray, L.D.S., ( -do- ) Mrs. C. Roberts, (Dental Nurse-resigned 27/8/46) Miss F. Wood, (Dental nurse - from 27/8/46 - 12/11/46) Mrs. M.A. Blackwell, (Dental nurse - from 13/11/46) Miss A.E. Phelps, (Clinic Attendant - from 18/11/46) Dr. D. Fairweather Dr. G.P. Barua Dr. A.H. Rowntree Dr. E.F. Rossdale Dr. B.J. Wilton Dr. R.E. Batson A.H. Carter, F.C.Ch.A. (Chiropodist in charge) Miss P.M. Vincent, M.I.S.Ch. (resigned 5/10/46) Miss S.M.P. McKenna, MC. Ch. A. (resigned 19/10/46) R.E. Marchant, (from 18/11/46) W.M. Long, (from 25/11/46) Mrs. R.E. Ross (from 18/11/46) F.L. Lydon, M.B., M.R.C.P., (part-time Consultant - from 4/10/46) Mrs. D.I.M. Lloyd (Nurse in charge) PHYSIOTHERAPY DEPARTMENT R. Leaver, M.R.C.S., L.R.C.P., (part-time Consultant - from 7/10/46) Miss M. Calpen (Physiotherapist in charge - resigned 9/2/46) Miss A.E. Nicholas (Physiotherapist in charge - from 2/5/46) Mrs. I. Aperguis (Assistant Physiotherapist) Miss M. Haslett (Part-time Assistant Physiotherapist) Mrs. A.L. Emmerton (Clinic Attendant) Mrs. E. Cotton (Part-time Assistant Physiotherapist - from 5/9/46) LABORATORY TECHNICIAN Miss P.E. Russenberger RESIDENT ENGINEER AND HEALTH CENTRE KEEPER Mr. F.M. Battle. (6) To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Finsbury. I have the honour to present my first Annual Report of the work of the Public Health Department since my return from military service. For the major part of this period I was engaged as a Public Health Officer in the Allied Military Government of Italy, finally occupying the position of Chief Public Health Officer of the disputed territories of Trieste and Venezia Guilia. I returned to duty in May, 1946. I feel that it would be a presumption on my part to comment on the vary satisfactory way in which Dr. Stowart carried out my dutios during my absence, which wore acknowledged by the Council at the time of his resignation, but I can at least refer to the very friendly manner in which he co-operated with me in regard to the taking over and the handing back of the responsibilities and it was with very great regret that I lost his services as deputy towards the end of the year, when he was appointed to the post of Medical Officer of Health of Paddington. Dr. Thompson was appointed by the Council as his successor and took ovor duties on the 1st November. The death of Dr. Lomas who had been associated with the Maternity and Child Wolfare section of the department for many years occurrod during the summer and was felt by all as a great loss. Mr. Capps resigned from the office of Vaccination Officer which ho had held conjointly with a similar appointment from Holborn for many years, at first under the Board of Guardians and later under the Borough Councils. We have all wished him much felicity in his retirement. During the year nearly all the staff who had served with His Majesty's Forces returned again to civilian duties in tho department. The year has been mainly characterized by the beginning of reconstruction after wartime conditions in the face of continuing difficulties in regard to procurement of staff and materials. The birth rate rose very considerably in Finsbury, as in other places, from 12 per 1,000 in 1939 and about 16 per 1,000 in the immediately preceding years, to a figure of over 20. The death rate, which in 1939 was under 14, and which during the war years had reached a figure as high as nearly 20 in 1944, dropped to 15.6. Too much significance should, however, not be attached to these figures because no standardization has been possible to make allowance for the undoubtedly higher average age of the population. The infant mortality rate hat: remained about constant in the last three or four years and the fall experienced in other areas was unfortunately not experienced in this Borough. The main cause of infant mortality has been prematurity. The still birth rate 1 increased from an average figure of rather under 3 to 3.6% of total births. Infectious disease presented no serious features during the year. There were no deaths from Diphtheria and the death rate from Tuberculosis dropped to below 1 per 1,000 for the first time since 1939. (7) Conditions of overcrowding and of deplorable housing generally remained throughout the year unsatisfactory and owing to shortage of labour and materials little progress was made in the reconditioning of property, which has tended during the war years to become in a poorer general state of repair. A sample survey of overcrowding conditions was undertaken towards the end of the year. The activities of the Maternity and Child Welfare section were operated, particularly in the second part of the year, at an increasing pressure on account of the rise in the birth rate. The Women's League of Service, Cynthia Street, found it necessary to end their activities during the year after having given continued service in the Borough for a very long time. Particular mention may be made of the faithful service rendered by their late visitor, Miss Smith, to the mothers and children of the Pontonvillo aroa. During the year the activities of the department were oxtended by the bringing into operation of a Domestic Help Scheme for assistance to the sick in their homes. Unfortunately it has been impossible to extend this as frooly as was wished because of the few persons who were found willing for such omployment In this connection, particular attention was paid to the aged and a scheme of visiting by a member of the staff of the department was initiated. I should like to take this opportunity of thanking the members of the Council and of the Public Health, Maternity and Child Welfare Committees and the staff of my department for the cordial welcome which they accorded me on my return to civilian duties and for the generous support that they gave me in taking on once again the duties of Modical Officer of Health. I have the honour to be Your obedient servant, C.O.S. BLYTH BROOKE Medical Officer of Health. (8) AREA: POPULATION: LIVE-BIRTHS: STILL-BIRTHS: DEATHS: SECTION "A" - VITAL STATISTICS The area of the Borough is 587 acres. The Registrar General's estimate of resident civilian population was 33,400. In 1938 the estimated population was 56,960. The total number of live births belonging to the Borough occurring during 1946 was 687 including 68 illegitimate births, and consisting of 381 males and 306 females, giving a birth rate of 20.6 per 1,000 population. The total number of births during 1945 was 472. The birth rate for England and Wales was 19.1 and for the London Administrative County 21.5, per 1,000 civilian population. The total number of still-births allocatod to the Borough during the year was 26. This figure represents 3.6% of the total births, and .78 per 1,000 civilian population, compared with .54 for London Administrative County and .53 for England and Walos. The total number of deaths belonging to the Borough registered during 1946 was 522, consisting of 286 males and 236 femalos, giving a death rate per 1,000 population of 15.6. The total number of deaths for 1945 was 480. The comparable death ratos in London and England and Wales during 1946 wore 12.7 and 11.5 respectively. COMPARATIVE STATISTICS, 1939 - 1946 I 1939 1940 1941 1942 1943 1944 1945 1946 Population 33,400 55, 110 40,090 30,280 28,420 27,830 26,740 27,990 Birth rate (per 1000 population) 16.9 20.6 12.5 14.3 14.8 15.9 16.7 16.0 Death rate (-do-) 13.6 23.1 17.1 24.7 17.9 17.5 19.9 15.6 Maternal mortality (per 1000 live births) 4.2 0. 3.68 2.8 4.4 2.1 2.4 1.5 Death rat e, infants under 1 (-do-) 55.0 33.5 68.0 70.4 64.0 56.0 47.0 54.0 Death rate of illegitimate infants under 1 (per 1000 illeg.live births) 53.6 131.6 167.0 125.0 76.9 83.3 128.0 118.0 Still-births (percentage of total births. 2.7% 2.3% 2.6% 4.0% 4.04% 2.92% 2.51% 3.6% T.B. death rate per 1000 inhabitants (all forms) 1.65 1.07 0.78 1.77 1.72 1.33 1.46 0.96 33 56 Illegitimate births 38 36 39 24 47 68 (9) The following table shows the causos of, and ages at death during the year 1946:- 65- Total all ages. 0- 1- 5- 15- 45- CAUSE OF DEATH - 1. Typhoid and Paratyphoid Fevers - - - - - - 1 - 2. Cerebro-Spinal Fever 1 - - - - 3. Scarlet Fever - - - - - - - 2 - - 4. Whooping Cough 2 - - - - 5. Diphtheria - - - - - - 28 - - 13 6. Tuberculosis of Respiratory System - 14 1 7. Other forms of Tuberculosis 4 - 3 - - 1 - - - - - 5 2 8. Syphilitic Diseases 7 - 9. Influenza 4 - - - 1 3 10. Measles 1 - - 1 - - - - - - 11. Acute Polio-myelitis and Polio- Encephalitis. - - - - 12. Acute Infectious Encephalitis - - - - - - - - 13. Cancer of Buccal Cavity and Œ sophagus and Uterus. 12 - - - 6 6 20 - - 14. Cancer of Stomach & Duodenum - 4 6 10 15. Cancer of Breast - - - - 3 1 4 16. Cancer of all other sites - 3 13 28 45 1 - 17. Diabetes 5 - - - 1 4 - 42 - 18. Intra-Cranial Vascular Lesions - - - 13 29 96 19. Heart Disease 121 - - 2 23 - 18 - 20. Other diseases of circulatory System. - 2 2 14 - 47 - - 16 28 21. Bronchitis 3 - - 22. Pneumonia 49 6 - - 10 33 23. Other respiratory diseases 3 - - - 1 2 - - 2 24. Ulcer of Stomach or Duodenum 10 - - 2 6 25. Diarrhoae under 2 years 4 4 - - - - - 26. Appendicitis - - - - - - - 1 27. Other digestive diseases 11 - - 1 1 8 28. Nephritis 6 - - 1 4 1 - 1 - 29. Puerperal & Post-Abortive Sepsis 1 - - - - 50. Other maternal causes - - - - - - - 6 - - 51. Premature birth 6 - - - 32. Cong.Malf.Birth Injuries. Infant Pis . 14 - 2 1 1 10 - 33. Suicide 4 - - - 2 2 - 5 34. Road Traffic Accidents - - 1 - 2 2 35. Other Violent Causes 11 1 - 1 1 1 7 56. All other causes 37 - - 20 2 7 8 286 20 - 2 23 90 151 M 19 F 236 17 5 1 45 151 522 3 3 42 37 302 Total All Causes 135 10 Section "B" - General Provision Of Health Services Treatment And CLINICS. The attendances at the Various Treatment Contres and Clinics have shovvn a further steady expansion and there wore record attendances in the Dental, Foot,and Woman's Clinics. ATTENDANCES &C. at TREATMENT CENTERS AND CLINICS 1943 1944 1945 1946 No.of sessions. No. of new cases Total No. Atts. No.of Sess- No. of new cases Total No. Atts. No. of sessions. No. of new cases Total No. Atts. No.of Sess ions. No. of new cases Total No. Atts. CLINIC FOOT CLINIC 1195 849 6638 1358 800 8037 1572 701 10244 1774 721 11121 527 4291 979 Clinis 986 4413 4967 5747 327 357 1298 423 1506 529 14567 10032 9122 605 693 497 464 9345 SOLARIUM 499 415 438 321 738 373 295 194 WOMEN'S CLINIC 90 119 59 44 45 52 47 25869 2647 2066 2174 2360 26951 24628 22803 2586 2965 2885 2480 TOTALS As from 1st January, 1946, the charges in the Foot, Women's and Sunlight Clinics to residents and to non-resident employees were increased to a more economic level. The staff in the Foot Clinic was again increased to cope with the additional attendances and part-time consultants were engaged in the Solarium and in the Women's Clinic. The Council's Assessment Scheme was varied to provide for free treatment to all Old , Pensioners who were without other form of income. LABORATORY: As from February, 1246 the Council employed a full-time Laboratory Technician to undertake the work of the moratory, the scope of which was thereby increased. Routine examinations of swabs, sputum, milks, &c., were carried out and the following is a brief summary of the work undertaken No.of throat and nasal swabs examined 357 No.of sputums examined, for T.B 195 Milk samples 257 Pathological specimens examined 38 Ice cream samples 36 Blood Counts 66 Urethral smears 32 Mycelium Investigations (Foot Clinic) 191 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. INQUESTS: Inquests were held on 27 residents during the year, the findings boing as follows: Haemorrhage 1 Cancer 1 Bronchitis 1 Road Accidents 5 Misadventuro 5 Violenco 4 Solf Noglect 1 Peritonitis 1 Unknown 1 Suicido 3 Broncho-pncumonia 4 MATERNAL Mortality: There was one maternal death during the year, giving a matornal mortality rate of 1.5 per 1,000 Total (Livo and Still) Births. INFANTILE MORTALITY: There were 37 deaths amongst infants undor ono year of ago and the infant mortality rate based on 1,000 live births was 54. Of thoso doaths 18 occurrod in the nco-natal period, oight of the infants deaths occurred in illegitimate children and there were 10 deaths due to prematurity. INFANT MORTALITY RATES 1941 1940 1942 1943 1944 1945 1946 55 FINSBURY 68 70 64 56 47 54 68 LONDON 58 53 50 60 61 41 59 ENGLAND & WALES 55 49 49 46 46 43 DEATHS IN RELATION TO DISEASE: During the year there was an increase of 42 in tiie number of deaths from 480 to 522. There were no deaths from Diphtheria, Typhoid or Scarlet Fever during tho year. 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 these deaths occur to a large extent in the 65 years and over group. Of the total of 522 deaths, 302 occurred in the age group of 65 years and over. GRANTS SCHEME: 1,825 dinners were granted free of charge to necessitous mothers and children at tho two Centres, under the provisions of the Council's Maternity and Child Welfare Grants Scheme Tho schomo to provido dinnors for solocted casos who were outsido the incc.no group for froo dinnors was continued. Charges wore made for such cases at the rate of l/3d por dinner for adults and 6d por dinnor for children under 5 years, and a further 5,265 dinners were providod under this scheme. 676 lbs of Dried Milk were also issued to nocossitous persons free of charge; 64 lbs. woro issuod at half cost, and 7,898 lbs at cost prico. Tho figuros of Driod Milk issuos show moro than a throo-fold incroaso on those which obtained in 1945. (12) MUNICIPAL WELEFARE 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 1945: LEAGE STREET PINE STREET 1945 1946 1946 1945 Mothers, Individual 180 140 102 103 Mothers, Attendances 242 169 106 116 Children (1-5 years) Individual 449 385 242 319 Children (1-5 years) Attendances 2,328 2,402 1,169 1,596 Babies, Individual 390 470 192 273 Babies, Attendances 4,387 3,729 1,552 2,241 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 mothors, being confined at home, to obtain a supply of utility sheets. During the year 371 dockets were issued. HEALTH VISITING: The regular visitation of expectant mothers and children under five years was continued by the Health Visiters and during the year a total of 11,327 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 16 ) Prematurity Died - 5 1 ) Satisfactory - 43 Marasmus Illegitimacy 41 ) Removed to other 12 ) areas - 10 Twins Poor progress 10 ) Still special at 7 ) end of year - 31 Poor care 1 ) T.B.contact Anaemia 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 CHILD WELFARE CLINICS HELD. INSTITUTION No. of ATTENDANCES City of London Maternity Hospital 105 484 Clarement Contral Mission 95 391 1,009 Maternity Nursing Association 101 The Women's League of Service ceased to function in Finsbury during the year and the Annual Grant was discontinued. (13) NURSERIES: Four day nursorios were in operation in the Borough until 1/4/46 when Donogal Street was transfered to the London County Council leaving three nurseries serving the borough with places for 155 children. The following table shows the average daily attendances: JAN. FEB, MAR. APL. MAY. JUN. JUL. AUG. SEP. OCT. NOV. DEC. i i King Square 31 34 32 33 33 31 30 28 24 21 34 32 Lloyd Square 51 47 42 56 59 52 56 55 49 57 58 56 Donegal Street 48 57 63 - - - - - - - - - Banner Street 28 39 41 34 33 27 42 48 48 49 52 51 Total 158 177 178 123 125 110 128 131 121 127 144 139 HOME NURSING: The arrangements with the Metropolitan District Nursing Assn. 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 home, was continued throughout 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. 1,593 bottles of Cod Liver Oil, 12,073 bottles of orange juice and 408 Cod Liver Oil Capsules were issued during the year, through the two Municipal Centres. MIDWIFERY: Under the Council's Midwifery arrangements as detailed in previous annual reports the following numbers of patients were admitted to the various hospitals. (a) St. Bartholomews Hospital 97 (b) The City of London Maternity Hospital 33 (c) The University College Hospital 3 Co-operation was maintained between the Hospitals concerned and the Matornity and Child Wolfaro Department. Attondancos at ante-natal clinics are notifiod and ante-natal visits are made by our Health Visitors. Tho Council also made uso of the L.C.C. Emergency Maternity Homes which are situated in the country and which were formerly part of the evacuation scheme. 45 Finsbury mothers were delivered in these homes. The following table shows the attendances at the various ante-natal and postnatal clinics: Health Centre City of Lon. Mat. Hosp. Royal Northern Hospital. St. Barts Hospital. Maternity Nursing Assn. Ante Natal 284 284 1,642 2,929 1,642 Post Natal 33 18 32 (14) CARE OF PREMATURE INFANTS: In accordance with recommendations contained in Ministry of Hoalth circular 20/44..(a) a space is provided on the Birth Notification forms for recording the weight of babies of 5½ 1bs or less; (b) a supply of equipment is kept in stock for premature infants nursed at homo; (c) a panel of Home Helps is available and (d) the Health Visitors regard premature births as 'special cases , necessitating more froquoent visiting. During tho yoar 40 births woro notified where the birth weight was 5½ 1bs.or less; of these 18 were nursed entiroly at homo and survived at tho end of ono month. HOME & DOMESTIC HELPS: The Council provides a service of Home Helps during the post-natal and ante-natal period- for domiciliary cases. 50 cases were attended during the year. At the ond of the year the panel of Home Helps consisted of 3 regular persons. The staff shortage for this work continued and as a result the Council agreed during the year to the employment on a short-term basis of suitable porsons nominatod by tho Mothors thomselvcs. The scheme has worked well and became increasingly popular. Towards the latter end of the year the Council, in a limited way, was able to give practical application to tho rocommondations of tho Ministry of Health under Circular 179/44 regarding the provision of Domestic Helps to the sick and infirm as apart from the Maternity Home Help Service. 4 Domestic Holps were engaged on part-time duties to assist in 4 urgont casos at a net cost to tho Council of £46.7s.4d. HOSPITAL TREATMENT: The arrangements between the Council and the Elizabeth Garrott 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 four children to Hospital under these arrangements. Other admissions during tho year wore made to tho Royal Free Hospital, Queen Elizabeth's Hospital for Children, Archway Hospital and Charing Cross Hospital. EAR, NOSE AND THROAT HOSPITALS: An arrangement is in force for the removal of tonsil.; and adenoids with (1) The Royal Free Hospital, (2) Central London Ear, Nose and Throat Hospital and (3) Queen Elizabeth's Hospital for Children. The waiting list at these hospitals is however so great that in order to avoid delay children were referred to Archway, St.Bartholomews or Gt.Ormond Stroot Hospitals. Eight cases were dealt within this way. PUERTO .L FEVER AND PUERPERAL PYREXIA: During 1946 thoro were three cases of puerperal pyrexia and three cases of puerperal fever notifiod in Finsbury, nono of which provod fatal. This gives a rate per 1,000 Live and Still Births of 8.4 as compared with 8.5 for England and Wales, and 9.68 for the London Administrativo County. Ophthalmla Nronsyotum: The number of casos of Ophthalmia Neonatorum notifiod was six. Three of these cases were treated at home and three in hospital. In no case was there impairment of vision. CONVALConvalescent Treatment: Tho Council continued their arrangomonts 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 20. In addition, children woro referred for convaloscnce through the Invalid Children's Aid Association, under which arrangement 37 further children completed convalescence during 1946. The need for convalescent provision greatly exceeded the accommodation available Arrangements were made during the year with the Women's Holiday Fund to provide a fortnight's holiday in approved cases. 12 mothers and 13 children were sent away under these arrangoments. (15) POST NATAL CLINIC: A post-natal clinic was inaugurated at the Health Centre during the year. FOSTER PARENTS: At the end of 1946 th-• | registered foster mother in the borough. ILLEGITIMATE CHILDREN: The Council contribute annual sum of £101 towards the improvement of the services of voluntary organisations for Moral Welfard in London, and is suitably represented on the Council of 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 Homo, BLOOD TRANSFUSION SERVICE: The Council agrced to co-oporate with the North London Blood Supply Dopot by arranging blood donation sessions at tho Health Contro. 20 SECTION "C" -SANITARY CIRCUMSTANCES Tho following is a summary of work undertaken by the Sanitary Inspectors during 1946 - Houses, damp, dirty or remedied 738 Doors, windows, floors, walls, ceilings, sashcords repaired 714 Overcrowding cases abated in other than Registered Houses 21 Illegal occupation of undergroundrooms 1 Water closet defects remedied 406 Water closets erected 152 Urinal defects remedied 8 Urinals erected 7 Soil pipo and ventilating shaft defects remedied 39 Solil pipo and ventilating shafts erected 40 Yard defects remedied 136 Waste pipe defects remedied 103 Waste pipes erected 112 Water cistern defects remedied 55 Accumulations of rubbish or manure removed 117 Dung or dust receptacles repairod or renewed 111 Drains relaid, amended or sealed 111 Drains cleared or tested 210 Rain water pipes cleared, repaired or renewed 87 Water supply to houses reinstated 9 Roofs and gutters repaired 441 Area defects remedied 45 Wash-house defects remedied 126 Animal nuisances abated 5 Infectious Disease Investigations 170 Stables cleansed or repaired 2 Smoko observations 93 Water supply laid on to uppor storeys of house 18 Miscellaneous nuisances abated 246 Common Lodging Houses (visits) 31 Butchers Stalls, etc. (visits) 4085 Street Traders Storage (visits) 173 Old & Infirm Verminous Persons - No.of inspections 120 Shops - Inspections 115 Shops - No.of notices 11 Public Houses cleansed or repaired 5 Public Houses - No.of inspections 50 Public Conveniences - Inspections 504 Registered Housos - visits of inspection 854 -do- - overcrowding cases abatod 2 -do- - cleansed 157 -do- Intimation (cleansing) notices served 157 -do- -Statutory (cleansing) notices served 1 First visits (complaints, casual visits) 8628 Re-visits 7885 Intimation Notices served 1233 Statutory Notices served 32 17 Canal Boats inspected 6 House inspections 1827 House to house inspections 119 Piggeries - No.of inspections 13 Complaints received 1369 Verminous prem1ses cleansed by Borough Council - Council property 64 Other property 163 RECEPTION HOUSE: 14 persons used the Reception House during 1946 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. VERMINOUS PREMISES: During the year 207 premises were found to be verminous and disinfestation measures were carried out. In addition the treatment of the accommodation and furniture of new entrants to the Council's dwellings was systematically performed. Greater use was made of D.D.T. in place of cyanide in the disinfestation of furniture. 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. 1721 treatments were given during the year to L.C.C. school-children and 1558 treatments to adults and pre-school children. Home visiting of scabies cases and contacts was continued and the Nurse-incharge of the Cleansing Station made 404 home visits during the year. In October a Consultant Skin Specialist was appointed to give advice and to hold sessions from time to time as required. SHOPS: The number of inspections made under the Shops Act, 1934 during 1946 was 115. 11 notices were served for contraventions. RAG FLOCK: The number of samples of Rag Flock taken during the year was 7, all of which proved satisfactory. CANAL BOATS: The total number of canal boats inspected during the year was 45, none of which carried any offensive cargo. Contravention of statutory requirements had taken place in 16 instances. There was no discovery or notification of infectious disease. The number of children on the boats was 34, of whom 20 were of school age. 42 visits in addition were paid by the Health Visitors. AGED AND INFIRM PERSONS: No application for compulsory removal to hospital was made during the year. persons known to the Department to be living alone are visited periodically to ensure that institutional treatment or care is obtained if necessary. It was arranged for one of the Council's nurses to spend a portion of her time in visiting Aged and Infirm persons. STREET TRADERS: At the and of 1946, 231 persons wore liconsod to engage in Street Trading within the Borough. 173 visits woro made to the places of storage where foodstuffs were sold. During the year the Council exercised its powers under the Food and Drugs Act for enforcing the exhibition by Street Food Vendors of their names and addresses, on vehicles, barrows, etc. (18) COMMON LODGING HOUSES: There is one Common Lodging House in the Borough, licensed for 348 beds, situate at No. 88 Old Street, and the number of visits made by the Sanitary Inspector was 31. HOUSES LET IN LODGINGS: At the end of the year there were 488 houses on the Register. These were regularly inspected and cleansing notices were served in accordance with the bye-laws but rigid enforcement was impossible owing to the difficulties prevailing in obtaining labour and materials. RAG & BONE DEALERS: There are 10 premises within the Borough in which the business of Rag and Bone Dealer is carried on. 23 visits were made to these premises. SMOKE EMISSION: Ten complaints were received during the year regarding excessive smoke emission. 93 smoke observations were made. MORTUARY: 5 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 1946. Diphtheria 15 Measles 314 Vermin and Scabies 255 Scarlet Fever 80 Tuberculosis 16 Whooping Cough 32 Miscellaneous 84 By request 121 A total number of 11,204 articles were disinfected, being chiefly pillows, mattresses, bolsters, sheets, blankets and wearing apparel. In addition 797,158 articles were disinfected prior to Export and fees charged for this work amounted to £948. Fees for export disinfection work were increased during the year from 20/- to 30/- for each charge of the disinfector. OFFENSIVE TRADES: The following are licenced offensive trade premises: (a) Messrs. Henson, 187 Whitecross Street, E.C.I. (b) Messrs. F.& W.Warman, Ltd., 5 Eagle Court, E.C.I. (c) Messrs. T.Kendon & Sons, Charterhouse Mews, E.C.I. (d) Messrs. Reubens, Ltd., 71/73 St. John Street. Regular visits were made in respect of these premises during the year. OUTWORKERS: No. of Finsbury firms employing outworkers at the end of August 1946 184 Total number of outworkers employed by Finsbury firms 3326 Number of outworkers resident in Finsbury 449 49 FACTORIES ACT, 1937: The number of factories on the register at the end of 1946 was 2,158 comprising 1,297 power factories and 861 non-power factories. 175 firms were added to and 71 removed from the register during the year. The following is a summary of defects found:- NUMBER OF DEFECTS FACTORIES FACTORIES TOTAL (POWER) (NON-POWER) Refuse accummulation or absence Of dustbin 4 1 5 Roof leaky 11 1 12 Dampness and dilapidations 3 10 13 Sanitary Conveniences - defective 16 4 20 " " - dirty 15 6 21 " " - not separated for sexes or insufficient 6 1 7 " " - with no artificial light or unlabelled 54 13 67 " " - absence of intervening vontilated space 35 2 37 " " - unsuitable and insufficient ventilation 62 1 63 Water fittings or waste pipes defective 9 2 11 Thermomoter absent - 2 2 29 notices of complaint and 176 notices of occupation were received from H.M. Factory Inspector. 29 notices were sent to the Factory Inspector regarding the following matters:- Abstract absent 15 New occupation, notification 14 LADY SANITARY INSPECTOR'S WORK: The following is a summary of visits made by the Lady Sanitary Inspector - Factories 1522 Outworkers premises (Sub-contractors) 71 Outworkers premises (domestic) 601 Number of Intimation Notices served 96 Number of Statutory Notices served 0 RAT REPRESSION: No.of complaints and requests for treatment received - 244. No.of additional premises found infested - 123. No.of houses treated - 203. No.of other premises treated - 214. No.of visits made by ratcatchers to houses - 2,476 and to other premises - 434. Steady progress in the treatment of infested premises has been made during the year with the same number of staff as in the latter half of 1945. Treatment continued basically on block control lines, although many individual premises were treated in addition to those undergoing intensive systematic treatment. In an endeavour to obtain an intensification of effort on the part of all local authorities, the Ministry of Food issued Circular N.S.12 dated 10th May, 1946. This circular had as its object the systematic block treatment of the whole of the accepting authorities' area (20) during the fiscal year 1946/7 and provided a special scheme whereby private dwellings could be given treatment without cost to the occupier, the Ministry contributing 60% and the Council 40% of the cost, subject to an approved comprehensive scheme being in operation. It was submitted that a comprehensive campaign was already in progress in Finsbury, and this was accepted by the Ministry, but "intensification of effort" was desired, and, on agreeing to engage additional operators and to make spot check surveys of the area already covered, Finsbury's programme was finally accepted as an approved scheme in November. An extension of time was granted until June 1947, but we were unable to recruit the additional operators needed until after the end of 1946. Circular N.S.11 issued by the Ministry of Food dealt with the treatment of rats in sewers, providing for partial reimbursement of the cost by the Ministry provided two maintenance treatments were completed during the financial year. Two treatments of the Council's sewers were carried out during the year, and although the record of bait takes suggests the rat population remains higher than one would wish, it is considerably lower than it was before regular treatments commenced. HOUSING - SECTION "D" INSPECTIONS: Hereundor 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) 3485 (b) Number of inspections made for the purpose 3833 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 119 (b) No.of inspections made for the purpose 143 (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 1233 (B) Number of dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 22 (C) Action under Statutory Powers during the year (a) Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936:- (1) Number of dwellings-houses in respect of which notices were served requiring repairs 0 (21) (2) Number of dwelling-houses which were rendered fit after service of formal notices 0 (a) By Owners 0 (b) By Local Authority in default of Owners 0 (b) Proceedings under Public Health Acts:- (1) Number or dwelling -houses in respect of which notices were served requiring defects to be remedied 1984 (2) Number of dwelling houses in which defects were remedied after service of formal notice - (a) By Owners 1979 (b) By Local Authority in default of owners 5 (c) Proceedings under Sections 11 and 13 of the Housing Act, 1936. (1) Number of dwelling-houses in respect of which demolition orders were made 0 (2) Number of dwelling-houses demolished in pursuance of demolition orders 0 (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 0 (2) Number Of separate tenements or underground rooms in respect of which closing orders were determined, the tenement or room having been rendered fit 0 OVERCROWDING: During 1946 a 'sample' survey of domestic premises was carried out involving a visit to about 10% of the available accommodation in the Borough, as a result of this survey it was estimated that approximately 1,480 families (comprising about 5,000 persons) were living in overcrowded conditions. REHOUSING: 213 families consisting of 794 persons were rehoused by the Council in premises requisitioned for the purpose. 17 families were accommodated in the Council's flats and 48 families were rehoused by the London County Council. SECTION "E" INSPECTION AND SUPERVISION OF FOOD AND DRUGS FOOD STALLS, VEHICLES, ETC: In order to facilitate the investigation of complaints relating to uncleanly condition of food stalls etc, the Council decided by resolution to apply section 16(i) of the Food and Drugs Act, 1938, which requires vendors vendors of display their names and addresses on all stalls, carts, barrows, etc, from which the Food is sold. Analysis of Milk: During the year 43 samples of milk were submitted to the Public Analyst. 2 samples were found to be adulterated. Bacteriological Examination of Milk: 224 samples of Designated Milk and 74 samples of Ordinary Milk were submitted for bacteriological examination. (22) Milk Shops and Dairies: Number of applications for registration approved 8 Number of purveyors on the register at the end of 1946 115 Number of purveyors removed from the Register during the year 4 Number of purveyors on the register at the end of 1945 111 Number of visits of inspection carried out 355 Milk (Special Designations) Rogulations 1936-1944. Number of applications for licences received - (a) Tuberculin Tested Milk - Dealers 7 (b) Pasteurised Milk - Dealers 36 (c) Pasteurisers 1 (d) Supplementary Licences 8 (e) Number of samples taken for examination 298 To encourage the small trader to deal in Special Designated Milks, the Council docidcd to continuo to waivo tho paynont of liconco foos. Of tho samples takon, 20 provod unsatisfactory and apprcpriato action was takon with satisfactory results. Mill: in Schools: 14 samples of milk delivered to tho Schools wore taken during the year and submitted for bacteriological examination. All the samples proved satisfactory. Feed Poisoning: During the year there were 2 isolated cases of Food Poisoning notified under the Food and Drugs, Act, 1938, amongst Finsbury residents. Bakehouses: There were 23 bakehouses in use in the Borough at the end of the year, of which 17 were basement promises. In all the bakehouses machinery is used. 121 visits of inspection were made during the year. Adulteration of Food: The total number of samples taken in 1946 under the Food and Drugs act, 1938, was 739 of which 11 were formal samples and 728 informal. 11 informal and 4 formal samples were found to be adulterated, the latter referring to Mustard deficient in allyl isothiocyanata. In one case legal proceedings were instituted and in the other cases warnings were issued on Voluntary surrender of stocks required. Pharmacy and Poisons Act, 1933: 45 applicants were approved during the year by the Council as Listed Sellers of Poisons and 115 visits were made. 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 1946 there were 85 registrations for the manufacture, sale or storage of Ice-cream. 192 visits of inspection were made and 36 samples of ice-cream were submitted for bacteriological examination with the following results - Very satisfactory - 17; Satisfactory - 6; Unsatisfactory - 13. (23) Registered Food Premises: The following is a summary of Registered Food Premises in the Borough at the end of 1946 - Manufacture of Ice-cream 32 Storage and Sale of Ice-cream 46 Fried Fish Shops 12 Butchers Shops and Stalls 51 Other promises 28 Total 169 289 visits were made to these promises during the year. 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. Regular inspections of the meat and offal consigned to the various wholesale butchers and offal shops and to the depot of the London Wholesale Meat Supply Association were carried out and were also made of the various bacon factories, wholesale bacon and provision warehouses and Fublic Cold Air Stores. Visits and inspections of the retail butchers shops in the borough were also carried out. Summary of Foodstuffs seized by or surrendered to the Meat Inspector during 1946. Diseased or unsound meat 40,236 lbs. Diseased or unsound offal and other foodstuffs 37,559 lbs. Total 77,795 lbs. The number of carcases of Mutton and Lamb found to be affected with Casoous Lymphadontis was 188. Slaughterhouses: The slaughterhouse owned by Mr.J.A.Mobbe, 14 Penton Street was closed down on the outbreak of the War. No animals were slaughtered there during 1946. (24) SECTION "F" - INFECTIOUS AND OTHER DISEASES Notifications of Infectious Disease: The following table shows the notifiable cases of Infectious Disease during 1946, 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 Remvls. to Hosp. Acute Influenzal Pneumonia 2 - 1 - 1 - - - - Acute Primary Pneumonia 33 5 3 2 1 5 7 10 - - 3 Cerebro-spinal Meningitis 5 3 1 1 - - - 6 Diphtheria (Inc.Mem.Croup) 6 - 3 2 1 - - - 2 7 Dysentery 8 - 2 4 - - - Erysipelas 5 8 15 - 1 1 6 2 - Typhoid 1 1 1 - - - - - - Measles 226 1 80 373 16 124 6 - - 7 - 2 Ophthalmia Neonatorum 7 - - - - - - 2 3 Puerperal Fever 3 1 - - - - Puerperal Pyrexia 3 2 1 1 - - - - - Searlet Fever 44 71 1 21 46 3 - - - 24 - Pulmonary Tuberculosis 72 6 4 13 21 4 - Other forms of Tuberculosis 5 3 4 1 - 17 4 - - - 13 Whooping Cough 42 6 25 11 - - - 2 2 Food Poisoning 2 - - - - - - Poliomyelitis 1 1 - 1 - - - - - Scabies 272 5 23 139 36 48 19 2 - Malaria 3 4 1 - - - - - - 937 319 339 67 18 41 96 57 TOTALS 171 Notification Rates (Comparative Table) per 1,000 population. I Finsbury Eng land 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 .03 .01 .01 .01 .01 Paratyphoid Fever .02 .00 .02 .01 .01 Cerebro-spinal fever .15 .05 .05 .04 .06 Scarlet Fever 2.13 1.51 1.42 1.38 1.33 Whooping Cough 2.22 1.26 2.28 2.48 2.05 Diphtheria .18 .28 .32 .31 .24 Erysipelas .27 .45 .2 .25 .22 .00 Smallpox .00 .00 .00 .00 Measles 7.35 11.17 3.92 4.73 3.70 Pneumonia .75 1.05 .89 1.02 .74 (25) Smallpox and Vaccination: No cases of small-pox occurred in the Borough during 1946. The following is a summary of proceedings under the Vaccination Acts, 1867 to 1898. Number of Finsbury birth notifications received from Registrar 377 Number of Certificates of Primary Vaccination received 144 Postponements by medical certificate 17 Number of Finsbury babies not vaccinated with period of four months 140 Number of personal visits made during the year 630 Certificates of exemption granted after declaration 41 Scarlet Fever: The number of cases of scarlet fever notified during 1946 was 71, of which 44 were removed to Hospital. There were no deaths from this disease. Routine visits to patients following discharge were continued. Diphthoria: 6 cases of diphtheria were notified there being no deaths. All the cases were removed to Hospital. Of those six cases, five had not been immunised. 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 1937 107 2 1938 101 3 1939 58 2 1940 27 2 1941 35 - 1942 19 1 1943 24 2 1944 10 - 1945 13 - - 1946 6 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. It was estimated that by the end of 1946, approximately 48% of the child population under five years of age had been immunised against diphthoria. The number of children of this age group immunised during the year was 421. Whooping Cough: Notifications of whooping cough numbered 42, and there were 2 deaths. Prophylactic treatment has been continued in conjunction with diphtheria prophylaxis. Measles: There was one death directly attributable to measles during the year. Of the 373 cases which occurred 80 were removed to hospital, partly on medical and partly on social grounds. Special visits were paid to all cases nursed at home. (26) Typhoid: There was one notification during the year. Provision of Insulin: By virtue of Section 227of the Public Health (London) Act, 1936, the borough continued to bear the cost of treatment of diabetes in the case of necessitous persons. 5 persons received assistance during the year at a cost to the Council of £28. 6s. 3d. Tuberculosis: The total number of now cases of tuberculosis, both pulmonary and non-pulmonary, ontered in the Register in 1946 was 89. The age period details were as follows: 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- all ages. Males Pulmonary - 4 - 2 2 1 5 5 7 9 3 38 Females Pulmonary - 2 1 1 4 6 8 6 4 1 1 34 Males Non-pulmonary - 1 - 3 2 1 2 1 - - - 10 Females Non-pulmonary - 3 1 1 - - 1 - - 1 - 7 Total - 10 2 7 8 8 16 12 11 11 4 89 The number of cases removed from the Register during the year was 91 and those remaining on the Register of Notifications at the 31st December, 1946, were as follows: nm Males Females Total Pulmonary 390 234 156 Non-pulmonary 50 46 96 486 I I I ♦ I I 202 284 The following is a summary of the Tuberculosis Dispensary work in 1946:- Number of cases on Dispensary Register - Pulmonary 342 Non-pulmonary 67 Total 409 Sputum positive Cases 188 Sputum Negative Cas es 154 Cases notified from services 5 New Cases examined (other than contacts). Pulmonary Non-pulmonary. Total 59 70 (a) Definitely Tuberculous 11 (b) Diagnosis not completed 9 9 - (c) Non-Tuborculous 217 217 296 - (27) Contacts: Pulmonary Non-pulmonary Total 5 (a) Definitely Tuberculous 4 1 (b) Diagnosis not completed 2 2 - (c) Non-tuberculous. 149 149 - 156 Cases Written Off: (a) Recovered (b) Diagnosis not confirmed 5 2 7 Number of attendances at Dispensary 2815 Visits made by Tuberculosis Visitor 826 Home visits by Tuberculosis Officer 22 Specimons of sputum examined 191 Number of patients attending for artificial pneumothorax refills 56 Number of refills given 591 X-RAY DEPARTMENT: Details of the work in the X-ray department during 1946, are as follows: Chest cases: Large films used 977 Small films used 166 Screen examinations 1307 Other cases: Doctor's cases 29 Sunlight Clinic 10 Tuberculosis Maintenance Allowances Sc heme: 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 20 new applications were dealt with. In addition to new cases, 248 cases were presented to the Assessment Officer for review. The total cash allowances paid out during the year was £2,208. PROVISION OF EXTRA NOURISHMENT: The Borough Council has continued to provide extra nourishment for certain types of tuberculous cases. 81 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.