Ac 4341 ach'd Fin 39 Metropolitan Borough of Finsbury ANNUAL REPORT ON THE PUBLIC HEALTH OF FINSBURY for the Year 1958 BY C. O. S. BLYTH BROOKE, M.D., B.S., D.P.H. Medical Officer of Health The Metropolitan Borough of Finsbury ANNUAL REPORT ON THE PUBLIC HEALTH OF FINSBURY for the Year 1958 BY C. O. S. BLYTH BROOKE, M.D., B.S., D.P.H. Medical Officer of Health FINSBURY HEALTH CENTRE, PINE STREET, LONDON, E.C.I. 2 To the Mayor, Alderman and Councillors of the Metropolitan Borough of Finsbury MR. MAYOR, LADIES AND GENTLEMEN I have the honour to present my Annual report on the statr of the Public Health in Finsbury for 1958 and again am able to say that generally the health of the community has remained good, and that the health conditions of the Borough have continued to improve. I am somewhat disappointed that the birth rate has fallen from 18.2 (after standardisation) to 15.9 as against 16.4 for the whole Country. On the other hand it is pleasing that the death rate has also fallen; it was 10.1 as against the whole of England rate of 11.7. It was particularly gratifying that the increase in deaths from Cancer of the Lung and from Coronary Diseases has not persisted, and that the figures for this year were approximately the same as for last year, for the former, and shewed an appreciable fall for the latter. I feel I ought to call attention to the high still birth rate this year, the continued high death rate from Tuberculosis and especially the large number of deaths from suicide. More happy was the fact that there were no maternal deaths and no deaths of illegitimate children, and that there were fewer accidental deaths. At no time during the year had infectious diseases given rise to any serious concern, in spite of a few mild cases of Diphtheria which occurred in the Autumn The Hygienic conditions of the Borough and the cleanliness in the handling of food continued to occupy the close attention of the department, and further improvements took place. The Council continued in its efforts to secure clean air for the inhabitants and workers in the Borough to breathe, and provisional approval was given by your Council to the inauguration of the first Smoke Control area in the Borough. The aged continued to be of special concern, and, as in previous years, large numbers of visitors from other parts of the country and from overseas came to see and discuss the services provided here. Work was begun on the Galway Street Clearance Area to which I made reference in my last annual report, and during this year proposals have taken shape for a further major clearance area including King Square. 3 Although I am able to present a happy picture of the health conditions in this Borough, nevertheless it must not be thought that we have anywhere near reached the stage when we may be satisfied that everything has been done on behalf of the citizens, for there unfortunately continues to be much loss of life and of health which might be prevented. I am hopeful that when the future policy of London Govern ment is determined upon much further work may be done. To you Mr, Mayor, I should like to extend in full measure my thanks, and those of my staff, for all your courtesy and friendly help during this past year, as well as the previous years during which you were Chairman of the Health Committee, and also to the Chairman and members of this and other Committees for their generous support. Once again I acknowledge with sincere thanks the loyal help and co operation of my staff for whose efficiency and kindly relations with the public I often am given the thanks really due to them. I have the honour to be Your obedient Servant,, C.O.S. BLYTH BROOKE Medical Officer of Health. 4 HEALTH COMMITTEE Chairman: Councillor J. TROTTER Vice Chairman: Councillor W. J. DAVIES Councillor C.A. ALLEN, J.P. " A. ASHTON " F.J.T. CARLISLE " J. CROSSLEY " D. FIREMAN " MRS. C. GRIFFITHS. " J. E. SELLERS " MRS. L.C. TROTTER Medical Officer of Health: C.O.S. BLYTH BROOKE, M.D., B.S., D.P.H. Deputy Medical Officer of Health: M.M. BATES, M.A. , M.D., B.Chir., D.C.H., D.P.H. (from 7.10.58) Public Analyst: C. HARCOURT WORDSWORTH, B.Sc. Public Health Inspectors: A. J. TRUSLOVE, M.A.P.H.I. (Deputy Chief Public Health Inspector) J. LEWIS, M.R.S.H. E. DITCHBURN, M.A.P.H.I. S.G. FISHER, F.A.P.H.I. A. TREVETHICK, M.A.P.H.I. S. J. CASSIDY. K. PALMER, M. A.P.H.L. (Resigned 31.10.58). J.M. SOUTHWICK M.A.P.H. I. B. G. F. PAYNE, D.F.C., M. A. P. H. I., M. R. S. H., (W. E. F. 4.12.58). Student Public Health Inspector: M.C. ILLMAN. (W. E. F. 1.9.58). Senior Meat Inspector: R.S. BARBER, M.A.F.H.I. 5 Rodent Officer: P.L. MOSELEY Assistant Rodent Officer: P.J.P. MOODY Administrative & Clerical Staff: A.G. HOLMES (Assistant Administrative Officer). J.T. LINDSAY (Senior Clerical Assistant) Miss J.L. FAULKNER. Mrs. A.H. BRADFORD (Resigned 15.11.58) F.W. HAYNES. I. PATIENCE. R. BLAKELEY. Miss E. BUHR (W.E.F. 1.12.58) D. NATTRESS (National Service 10.11.57). M.G. PURDIE (W.E.F. 10.3.58). Infectious Disease Visitor: Mrs. R. PEPPER, S.R.N. Nurse Visitor for the Aged: Mrs. M.I. JONES, S.R.N. (Resigned 12.11.58). Mrs. D. MATTHIE, S.R.N., S.C.M., R.F.N., (W.E.F. 15.12.58). Health Centre Caretaker: E.H. JAMES (Resigned 31.1.58) R. NORTH (W.E.F. 1.2.58). 6 SECTION A PHYSICAL FEATURES AND SOCIAL CONDITIONS General Area of the Borough (acres) 587 Population 1951 census 35,370 Population Density 60 Rateable Value (31.3.58) £2,247,239 Product of a penny rate (1957/1958) £8,881 General rate (1957/1958) 17/4d. Finsbury, one of London's 28 Metropolitan boroughs is situated in Central London. The Borough as a whole is built up and congested and possesses very few open spaces, all of which are small in size. A large part of the Borough, particularly in the South East, is essentially industrial and the day population of the Borough has been estimated as between 150,000 and 200,000. The industries accommodated are very varied and include, besides the clock and watch trade which has been associated with Clerkenwell for many years, the scientific and optical instrument making, jewellery, printing and clothing trades. The residential parts of the Borough are mainly working class in character. During the late war Finsbury suffered the loss of many factories, warehouses and offices, especially in the Eastern part of the Borough, and there still exist many bombed sites. Residential property also suffered considerable damage. The rateable value has steadily increased since 1951 when it was £956,228 consequent on rebuilding of war damaged propertities and of devastated areas. A feature of post war development has been the erection of large blocks of modern flats. 7 PRINCIPAL VITAL STATISTICS Population (Mid year estimate) 34,960 Marriages registered 302 Live Births Legitimate Males 325 Females 260 Total 585 Illegitimate " 23 " 22 " 45 Total " 348 " 282 " 630 Birth Rate (standardized) 15.9 England & Wales. 16.4 Stillbirths Legitimate Males 10 Females 8 Total 18 Illegitimate " " 1 " 1 Total " 10 " 9 " 19 Stillbirth Rate Per 1000 live & stillbirths 29.3 England & Wales (per 1,000 live & stillbirths) 21.6 Per 1,000 Population (standardized) 0.48 Deaths Males 183 Females 157 Total 340 Death Rate (standardized) 10.1 England & Wales. 11.7 Infant Deaths 14 Infant Mortality 22.2 England & Wales 22.5 Neonatal Deaths 11 Neonatal Mortality 17.5 Illegitimate Infant Deaths 1 Illegitimate Infant Mortality 22.2 Maternal Deaths 0 Maternal Mortality 0 England & Wales 1957 0.47 Tuberculosis (all forms) death rate 0.20 England & Wales 1957 0.10 Area comparability factors:- Births 0.88 Deaths 1.04 8 COMPARATIVE STATISTICS 1954-1958 1954 1955 1951-1955 1956 1957 1958 1. Population 35,490 35,100 35,500 34,870 34,830 34,960 2. Birth Rate Per 1,000 Population 19.7 19.7 18.9 p.a. 20.0 20. 7 18.0 3. Sex Ratio Male/Female - - 1,084 - - - 4. Illegitimate Birth Rate Per 1,000 Population 1.3 1.4 1.2 p.a. 1.4 1.7 1.2 Per I 000 Live Births 66 72 66 70 83 71 5. Stillbirth Rate Per 1,000 Population 0.20 0.46 0.36 p.a. 0.26 0.49 0.54 Per 1,000 Total Births 10 23 19 13 22 29 6. Death Rate Per 1,000 Population 8.6 10.2 11.3 p.a. 10. 2 10.0 9.7 7. Infant Mortality Per 1,000 Live Births 30.0 30.3 24 30.1 22.1 22.2 8. Infant Mortality Illegitimate Per 1,000 Illegitimate Live Births - - 27 - - - 9. Neonatal Mortality Per 1,000 Live Births 27 19 17 26 15 17 10. Maternal Mortality Per 1,000 Total Births - - 0.6 - - - 11. Tuberculoais (all forms) Death Rate Per 1,000 Population 0.34 0.42 0.45 p.a. 0.20 0.20 0.20 Crude Fates have been given in every case. A dash indicates that numbers are too small for the calculation of a significant rate. 9 Population It is estimated that there has been little change in the population or in its age structure in recent years. Births The birth rate has fallen by about 2 per thousand of the population from the level maintained during the past few years. The illegitimate birth rates fell to an average figure for recent years from the raised rate in 1957. Stillbirths Unfortunately the stillbirth rates rose again this year, and were considerably higher than the national average. Deaths There was a small but happy fall in the death rate, which even after standardisation is well below that for the country as a whole. Maternal Mortality There were no maternal deaths during the year. Infant Mortality The infant mortality rate remained almost the same as in 1957 and is still just below the rate for England and Wales which fell slightly. Causes of Death There was no further increase in this year in the previously rising number of deaths from cancer of the lung, and in fact a very slight reduction of 3. The total number of deaths from all forms of cancer was again about the same as before. There was a substantial fall in the number of deaths from coronary disease namely from 63 in 1957 to 51 in 1958. Again there were 4 deaths from motor car accidents but the exceptionally unhappy experience of 1957 when there were 10 fatal accidents from other causes was not repeated this year when 2 were recorded. On the other hand there were 9 cases of suicide as against 4 in 1957. 10 CAUSES OF DEATH - 1958 0- 1- 2-4 5-14 15-24 25-44 45-64 65-74 75-84 85 Total M F M F M F • Tuberculosis respiratory 2 3 1 6 • Tuberculosis other 1 1 • Syphilitic disease 3 1 4 . Diptheria - . Whooping Cough - . Meningococcal infections - . Acute Polimyelitis - . Measles - . Other infective and parasitic diseases - • Malignant neoplasm- stomach 2 1 1 1 5 " " lung bronchus 1 12 4 22 3 22 " " Breast 4 2 6 " " uterus 2 2 . Other malignant and lymphatic neoplasms 1 4 9 4 4 5 6 2 35 . Leukaemia, aleukaemia 1 1 2 . Diabetes 1 1 1 3 . Vascular lesions of nervous system 5 3 4 8 8 1 3 32 • Coronary disease, angina 1 18 13 5 5 5 4 51 . Hypertension with heart disease 2 2 1 1 2 1 1 10 . Other heart disease 1 1 4 2 4 7 9 1 4 33 . Other circulatory disease 4 6 1 1 1 13 . Influenza 1 1 . Penumonia 2 1 1 4 2 3 4 1 4 22 . Bronchitis 1 12 7 1 5 5 2 3 36 . Other diseases of respiratory system 2 1 2 1 6 . Ulcer of Stomach and duodenum 2 2 11  0- 1- 2-4 5-14 15-24 25-44 45 64 65-74 75-84 85- Total M F M F M F 27. Gastritis enteritis and diarrhoea 2 1 3 28. Nephritis and nephrosis 1 1 29. Hyperplasia of prostate 1 2 3 30. Pregnancy, childbirth, abortion. - 31. Congenital malform- ations 4 1 1 6 32. Other defined and ill-defined diseases. 7 1 1 3 2 1 1 2 2 20 33. Motor vehicle accidents 1 1 1 1 4 34. All other accidents 1 1 2 35• Suicide 2 6 1 9 36. Homicide & operations of war Total 14 2 1 5 2 13 95 44 36 46 47 11 24 340 Inquests Inquests were held on eighteen residents during the year. The causes of death found were: Road Accidents: (Males 3 and 13) 2 Accidental Falls, excluding industrial: (Females 77 and 61) 2 Accidental: (Male 69 crushed by lorry. Male 7 - crushed by gate upon which he was climbing Female 48 - fractured skull in epileptic seizure) 3 Natural Causes: (Male 63. Female 70) 2 Suicide: (Males 53 and 46. Females 75, 63, 58, 55, 50, 36(2)) 9 Total 18 12 INFANT MORTALITY, 1958 CAUSES OF DEATH Causes of Death 0-1 wk. 1-2 wks. 2-3 wks. 3-4 wks. Total under 4 wks. 1-3 mths. 3-6 mths 6-9 mths. 9-12 mths. Total under 1 yr. Influenza - - - - - 1 - - - 1 Congenital malformation 3 - - - 3 1 - - - 4 Birth injury & other disease of early infancy 1 - - - 1 - - - - 1 Immaturity 5 - - - 5 - - - - 5 Bronchitis & Pneumonia - - - 1 1 - - 1 - 2 Other defined causes 1 - - - 1 - - - - 1 TOTALS 10 - - 1 11 2 - 1 - 14 (In this table the international rules for classification have not been strictly followed). 13 SECTION B GENERAL PROVISION OF HEALTH SERVICES Health Centre The Council continued to maintain the Health Centre for the administration of the Public Health Services and arrangements continued in force for the use by the Regional Hospital Board and by the London County Council of those portions of the building which were occupied by services transferred to those bodies under the National Health Service Act 1946. The Council also continued to act as an agent for the Regional Hospital Board in respect of certain services controlled by them. There is no doubt that the Centre continues to be of value to the public not only for the services available but as a place to which they may readily come for help and advice in regard to many health problems. Numerous individual visitors and organised parties both from this country and overseas visited the Health Centre during 1958. All reasonable requests to visit the Health Centre were granted as the exchange of views and information thus afforded is of mutual benefit. Laboratory The laboratory in the Health Centre has been maintained jointly with the Regional Hospital Board since 1948 and undertakes the routine work of the Public Health Department in the control of infectious disease and the bacteriological examination of milk and other food stuffs and has operated in close association with the Central Public Health laboratory service in Colindale. In addition it continues to undertake simple routine pathology on behalf of the Chest Clinic, other clinics in the Health Centre and of medical practitioners in the district. A particular feature has been the large use made of the facilities for the taking and examination of swabs for the early diagnosis of Whooping Cough. This has been of particular value. 14 Work of the Public Health Department Number examined Ear, Nose & Throat swabs for K.L.B. 390 Per & Post-nasal swabs for H. Pertussis 31 Faeces 2,082 Milk 59 Synthetic Cream 2 Ice Cream 19 Fish 4 Meat 7 Vegetables (tinned) 2 Milk (tinned) 1 Spirits & Wines 16 Water 8 Sputa 198 Work of the Regional Hospital Board Bacteriology Haematology Biochemistry Number of Investigations Health Centre Clinics 280 256 102 638 General Practitioners 213 225 57 495 1,133 Note:- Under the heading "Bacteriology" are included:- 1. Pregnancy Tests. 2. W. R. P.P.R. & G.C./C.F.T. The biochemical investigations mainly involved the estimation of:- 1. Serum Cholesterol. 2. Serum Uric Acid. 3. Serum acid & alkaline phosphatase. 4. Liver function tests. Domiciliary visits by technician 17. Blood Transfusion The Council continued to co-operate with the North London Blood Supply Centre of the National Blood Transfusion Service, by arranging Blood Donation Sessions at the Health Centre. Three sessions were held during the year at which 270 donors attended. 238 were bled and 32 rejected for various reasons. 15 International Certificates of Vaccination and Inoculation The international form of certificate of vaccination and inoculation approved since the war requires the signature of the medical practitioner issuing the certificate to be authenticated by the Medical Officer of Health. The purpose of the authentication is to provide proof to health authorities abroad that the signature of the person issuing the certifIcate is that of a registered medical practitioner. In 1958 176 certificates were authenticated no case of an improper signature was discovered and no application in consequence refused. Burial or Cremation of the Dead It is provided by Section 50 of the National Assistance Act, 1948, that the local authority shall arrange burial or cremation in the case of any person who has died or been found dead in the borough in any case where it appears to the authority that no suitable funeral arrangements have been or are being made. During the year four persons were buried or cremated under these provisions. Health Education Health Education in general was continued during the year by the exhibition of public posters and by the distribution of literature from suitable centres. Health Education in general was also carried out throughout the year by all the members of the staff who are in contact with the general public in their homes and businesses The former Empire Marketing Boards were kept posted during the year with special poster sets. Exhibition Stands situated in the entrance hall of the Health Centre were used to display amongst other publicity matter the display sets issued by the Ministry of Health and rodent control publicity issued by the Ministry of Agriculture, Fisheries & Food. Book marks incorporating information on various health education subjects have also been distributed with the co-operation of the Libraries Department. Enamelled panels showing details of hospitals with times for attendance where advice or treatment on Venereal Diseases can be obtained were renewed as necessary in the Council's Public Conveniences. The Council also continued to co operate in the health publicity programme organised by the London County Council Health Division III. It may also be said that the character of the Health Centre building which houses the Public Health Department was designed to inspire the conception of health among the many members of the public who use it for one purpose or another. 16 Aged persons The Council continued as in past years to take a very active interest in work on behalf of old people during 1958. The services available to men over 65 years and women over 60 years included: (i) Laundry Service: This service was continued for the Chronic Sick who were unable by reason of ill health, senility etc, to keep their personal and domestic laundry in a state of cleanliness required to ensure a healthy environment. The articles are collected on Monday disinfected, checked and sent to a commercial laundry, returned again, checked and redelivered on Friday or Saturday of the same week. A varying number of about 45 to 50 persons have in this way been enabled to retain their clothes and bedlinen in a wholesome condition. (ii) Holiday Scheme: The Council continued this service designed to preserve the health of the elderly by allowing those sufficiently able to do so to benefit from a stay of two weeks in the country or at the seaside. Applications were invited by public announcement and through variously interested clubs and societies; such applications were made to the Health Department. Each applicant was required to contribute a small sum towards the cost, normally ten shillings per week but varied slightly in some cases. Arrangements were then made for the holiday at one or other of the holiday homes run by voluntary organisations. A grant was made to each of the homes to cover the cost including the railway or coach fare and their necessary travelling expenses, less that amount which the individual was required to contribute. Arrangements were continued with the co operation of the Red Cross Society and Women's Voluntary Service for those aged persons who so desired to save, through the medium of Savings Stamps, the amount or part of the amount they would be required to contribute towards the cost of the holiday. Stamps were on sale at the Health Centre, Red Cross and Women's Voluntary Service Centres, and in all a considerable sum was saved by aged persons. In this way a holiday was provided during 1958 for 302 persons comprising 34 married couples. 45 men and 189 women at a total cost to the Council of £2,399. Holidays were arranged at Ramsgate, Brighton, Bognor Leigh-on-Sea Clacton. Margate & Worthing. The Scheme proved an unqualified success as was evidenced by the large number of appreciation letters received and in other ways. 17 I am of the opinion that a holiday benefits considerably the permanent health of the individual, builds up the body for the winter months and is of considerable value socialogically. All this apart from the pleasure and enjoyment given to the aged persons at the time. (iii) Meal Services (a) Many of the aged, particularly those who live alone, are apt to take insufficient food, not only because of expense but also because of the difficulty and trouble involved in preparing a satisfactory meal for one. Dinner services, therefore, have been instituted through voluntary associations throughout the Borough. A grant is given to the associations by the Council to cover their expenses and further grants are made by the London County Council and Pinsbury Old People's Welfare Committee to enable the meals to be supplied at a cost of elevenpence per head to the aged. During 1958 a total of 17,497 meals were served from such centres. The centres in operation which are open on 3-5 days a week are: 1. Women's Voluntary Service, 68, Exmouth Market, E.C.1. 2. British Red Cross Society, Old People's Centre, 9, Walmsley Street, E.C.1. 3. Field Lane Institution, 16, Vine Hill, Clerkenwell Road, E.C.1. 4. Claremont Central Mission, White Lion Street, N.1. 5. *St. Clement's Hall, Lever Street. E.C.1. *It is hoped to open a new meal centre at more suitable premises at the Finsbury Mission early in 1959 to replace St. Clements Hall Meal Service which was closed in July 1958 due to lack of voluntary help. (b) Invalid Meals for London: Aged persons, who are unable by reason of sickness and infirmity to attend one of the Meal Centres run by the various voluntary organisations, were supplied with a meal delivered at their home. There is, however, a restricted service and there is often a waiting list of applicants. (iv) Finsbury Employment Scheme for the Elderly This Scheme continued to develop and to expand during the year under review. The Work Centre named "Brooke House" situated at 39/41 Gloucester Way, E.C.1, made possible as a result of a number of generous benefactors, and opened by the late Lord Horder in November 1954, has proved eminently satisfactory in every way. 18 Some 120 elderly persons have undertaken work which has been mostly outwork on behalf of many firms, who have generously co-operated, but some articles have been made for sale to the trade or direct to the public. The elderly employed have been paid a small wage amounting to 10/a week, which is slightly more than the actual value of the labour provided. This Scheme has not only brought joy and happiness to many elderly people but has been of great value in preserving their health of mind and body. It has also attracted intense interest from many parts of the country and from overseas and many bodies are considering inaugurating or have inaugurated similar schemes. (v) Nurse/Visitor: A Nurse/Visitor is employed whose duties involve the regular visiting of aged persons, particularly those living alone, who are likely to be in need of care and attention - Liasion with voluntary organisations - and ascertaining detailed information from applicants for one or more of the Council's services for the aged. (vi) Bathing and Cleansing Service: Baths are provided free of charge at the Health Centre to those aged persons who, on account of their condition cannot use the existing Public Baths. A nurse is in attendance to render assistance, if this should be necessary. Occasional cleansing services were provided for those aged persons where their accommodation has been allowed to become so dirty and unwholesome that it had become beyond their capabilities to get it clean again, although possible able with or without the aid of a domestic help to keep it at least for a time sanitary once it had been cleansed. The Council continued to encourage all voluntary organisations in the borough to extend the services available to the aged for meals and recreation. Grants which were made on the basis of reports made to the Council on the work of each organisation amounted in all to £1,928 in the financial year 1958/59. There were two compulsory removals to suitable premises during 1958 of persons in need of care and attention under Section 47 of the National Assistance Act 1948. Both were in respect of elderly men aged 84 and 75 years respectively. 19 Finsbury Old People's Welfare Committee The work of the voluntary organisations is co-ordinated as far as possible by the Finsbury Old People's Welfare Committee which consists of representatives of most of the bodies who are concerned with the elderly and of which I am privileged to be Hon. Secretary. It operates, therefore, in close association with the services provided by the Council and has received from the latter financial grants each year. Apart from the co ordination of other voluntary bodies it has under its aegis inaugurated the following services. (i) Domiciliary Chiropody Service: This service is provided free of charge for those aged persons who are unable by reason of senility chronic sickness etc to attend personally the Foot Clinic at the Health Centre and has proved of great benefit to the elderly. 346 visits were paid during 1958. The ages of the persons visited ranged, from 63 to 92 years. This service has proved well justified in so far as it has enabled the aged and infirm to get about at home in reasonable comfort and do things for themselves and so retain the independence essential to their mental and physical well being. It is also of interest to record that as in previous years numerous voluntary donations of small amounts were received from aged persons receiving domiciliary chriopody service as an expression of their appreciation of the service provided and the benefits secured. (ii) Mending Scheme for the Aged This Scheme provides in association with the Finsbury Employment Scheme for the Elderly a Mending Service for the aged. There is a definite need for this service which effects repairs to such items of clothing as socks underclothes, etc. and is particularly useful in respect of the male aged living alone. Substantial use was made of the Scheme during the year. There is no charge to the aged. (iii) The Wireless for the Bedridden Society The Committee continued to act as Sponsor in respect of applications received from bedridden or housebound Finsbury aged persons desiring wireless facilities provided by the above Society. 20 (iv) Wireless Relay Services The Committee continued to finance the provision of a Wireless Relay Service for the use of the hundred and twenty aged persons participating in the Finsbury Employment Scheme for the Elderly at "Brooke House". 39/41 Gloucester Way, E.C.1, at the Women's Voluntary Service Meal Centre in Exmouth Market E.C.1, and at the St. Clement's Meal Centre, Lever Street, E.C.1. (until July 1958). These have been much appreciated by the elderly persons using the Centres. During the year the Committee entered into an agreement with the two Relay Wireless Companies which cover the greater part of the borough, whereby relay wireless facilities are provided for elderly persons at a reduced rental the Committee to be responsible for ensuring that each aged person has a current Wireless Receiving Licence. It was agreed that the service should initially be restricted to a maximum of twenty aged persons, who, whilst not housebound or bedridden, were in the opinion of the officers, deserving of the provision of wireless facilities and that in such cases the rental should be paid by the Committee. At the end of the year eighteen persons were enjoying such facilities (either relay or a wireless set where Relay Service does not operate). (v) S.O.S. Card Scheme: The S.O.S. Card Scheme operated by the Committee in the borough has functioned very successfully in the past. No use, however, was made of the Scheme during 1958. The purpose of the Scheme is to enable old people living alone to contact someone outside their home in an emergency. The Scheme besides having a practical value also has a comfort value, as many of the aged express the sense of security which possession of the card affords them. (vi) Visiting of the aged in Hospital: Arrangements have been made for members of the voluntary organisations represented on the Committee to visit Finsbury persons accommodated in hospital who are not receiving regular visits from friends and relations. (vii) Nutritional Supplements: The arrangements continued with Messrs Wander Ltd., Messrs Bovril Ltd., and Messrs Marmite Food Extract Co. Ltd., whereby "Ovaltine". "Hospital Extract", "Bovril" and "Marmite" are supplied to the various 21 organisations represented on the Committee for resale to the aged attending their clubs at a price considerably less than the normal retail price. These arrangements were extended in April 1958 to include the provision of "Jaffa Juice" which has proved equally popular to the other Supplements provided. (viii) Ophthalmic Service: The Committee being of the opinion that there was a considerable need for a special Ophthalmic Service for elderly people, there being many who were in need of glasses or other treatment but who found it too much trouble to make an appointment at a hospital or other clinic, approached Moorfields Eye Hospital with a view to special arrangements being made. Twenty nine elderly persons received ophthalmic treatment in this way in the period under review. (ix) Coal: The Committee is registered in the Licensed Merchants Register in relation to the district of Finsbury as a licensed merchant to furnish supplies of coal in quantities not exceeding 28 lbs This coal is stored at the Health Centre and the service was used on numerous occasions during the year to provide coal to the aged in an emergency. (x) Barber Service: The Committee during the year continued to provide a Barber Service (Haircutting and Shaving) for elderly men who are housebound or bed ridden and for whom it is not possible to make alternative arrangements. (xi) Social Worker: The Committee were enabled by reason of financial assistance received from a local charity to employ a full time Social Worker whose duties in brief are to aid the aged and sick poor to obtain such benefits as may be available from any source, whether voluntary or statutory, in the course of such work to give personal help, comfort and friendship as may be possible. One of the main reasons for the appointment was the fact that the Committee knew of the existence in the borough of many aged persons whom it had not been possible to contact personally, but who were often, due to their independent out look, in the greatest need. It is this type of case the Committee now hope to ferret out and ascertain their needs. It should be noted that as well as the services outlined above operated by or in close relation to the Council the following services provided by the London County Council are available: 22 1. Domestic Help Service. 2. A Chiropody Clinic in the Health Centre. Further, a Physiotherapy Clinic provided by the Hospital Management Committee is available in the Health Centre. I should once again like to express my thanks and appreciation of the medical services rendered to the aged persons of Finsbury by the general practitioners in the district and their close co-operation with me and officers of my department, and to Dr. Stern the Medical Superintendent of St. Matthew's Hospital, and her staff. 23 SECTION C SANITARY CIRCUMSTANCES Water Apart from 3 business premises which obtain certain supplies from deep wells, the whole of the borough is supplied with water by the Metropolitan Water Board. Regular examinations of water are therefore considered to be unnecessary. In many houses and block dwellings supplies of drinking water are obtained from storage tanks and inspections of these are made, usually following complaint, to ascertain their condition and, if necessary enforce cleansing and adequate covering of the tanks in accordance with the Council's Bye-Laws. Six samples of water were taken during 1958 for chemical or bacteriological examination. All proved satisfactory. Action was required to be taken by the department in 16 instances following the withdrawal of the water supply by the Metropolitan Water Board or as the result of defects caused to the supply pipes by frost. In each case the supply was restored. Swimming Baths Two establishments are maintained by the Council one in Merlin Street and the other in Ironmonger Row. Both are of modern construction and in addition to an indoor swimming pool, slipper baths and facilities for washing clothes are provided. The Ironmonger Row establishment also possesses a Turkish Bath and a special Children's Pool. An indoor Swimming Pool is also open to the public at the Northampton College during the summer months. The water at all these Swimming Baths is chlorinated and continues to be subject to chemical and bacteriological control. Ornamental and Paddling Pools Complaints were received in respect of the condition of a paddling pool and an ornamental pool on different housing estates in the Borough. The former was drained to prevent nuisance arising from children and dogs playing therein; the latter was stocked with fish and the owners cleared the pool of excessive weed and algae. 24 Sanitary Conditions A large proportion of the time of the Public Health Inspectors is spent in investigating environmental condition in the homes of the inhabitants of the borough. All complaints made by tenants and others were investigated and the following table gives details of action taken by the Inspectors and nuisances abated under the Public Health (London) Act 1936. Houses damp, dirty remedied 367 Doors, windows, floors, walls, ceilings, sashcords repaired 754 Watercloset and urinal defects remedied 167 Soil and vent pipe defects remedied 59 Rainwater pipes cleared, repaired or renewed 88 Waste pipes cleared, repaired or renewed 64 Drains cleared 101 Roofs and gutters repaired 339 Water storage tank defects remedied 8 Yard or area defects remedied 35 Washhouse defects remedied 13 Water supply to houses re-instated 16 Water supply laid on to upper storeys of house 6 Firegrates renewed or repaired 65 Animal nuisances abated 6 Miscellaneous nuisances abated 105 Dust receptacles renewed or repaired 76 Accumulations of refuse removed 99 Verminous or filthy articles destroyed 68 Overcrowding cases reported 44 No. of Basement Rooms inspected 272 No. of House inspections 1,457 No. of House-to-House inspections 420 Total No. of First Visits for all purposes 6,698 Total No. of Re-visits for all purposes 8,789 No. of Complaints received 1,520 No. of Intimation Notices served 718 25 No. of Nuisance Notices served 129 No. of Notices served re Food Premises 73 Legal proceedings were instituted under the Public Health (London) Act 1936 for non-compliance with Nuisance Notices in the undermentioned cases:- Date Premises Offence Result 27.2.58 27 Culpeper Street Defective area guard) rails 10/- fine £2/2/0 costs. 27.2.58 27 Culpeper Street Damp walls etc. 10/- fine 19.5.58 39 Whiskin Street Damp walls etc. Abatement order (28 days). £2/0/0 fine. £1/1/0 costs. 8/6d. Court Fee. 19.5.58 17 Meredith Street Damp walls etc. Ditto 19.5.58 18 Meredith Street Rotted floor boards etc. Ditto 7.10.58 16 Wynyatt Street Leaking roof Abatement order (14 days). £3/0/0 fine. £2/2/0 costs. 14/6d.Court Fee. 7.10.58 31 Wynyatt Street Leaking roof Ditto 16.12.58 16 Wynyatt Street Non-compliance with Abatement Order £1/0/0 fine. £2/2/0 costs. 16.12.58 31 Wynyatt Street Ditto Ditto 16.12.58 5 Wynyatt Street Leaking roof Summons dismissed. Notice complied with £2/2/0 costs. 16.12.58 7 Wynyatt Street Leaking roof Ditto 16.12.58 25 Wynyatt Street Leaking roof Ditto 16.12.58 29 Wynyatt Street Leaking skylight Ditto 26 Nuisances Requiring Urgent Abatement During the year 5 notices were served by the Public Health Inspectors pursuant to Sec. 27 of the London County Council (General Powers) Act 1955. In 2 cases the necessary work was done by the owners. In the remainder, the Council arranged for the abatement of the nuisances and recovery of the cost of same. Public Health (London) Act 1936 Section 40. One notice under this, section was served during the year in respect of a defective drain which was subsequently repaired by the Council. Drainage Work Extensive rebuilding and alteration to existing industrial commercial and residential properties has been going on since the war and continues to take place. This necessitates numerous visits to building sites and discussions relating to compliance by building contractors with the London County Council Drainage and W. C. Bye Laws. Forty-five drainage plans were approved by the Council during 1958, and 1,817 visits were made by the Public Health Inspectors in connect ion with the supervision of work in progress. The following table is an indication of the extent of the work carried out during the year. Drains laid or amended 142 Soil and Vent pipes erected 123 Drains or Soil pipes tested 185 Waste Pipes erected 268 Waterclosets erected 462 Urinals erected 104 Lavatory Basins fixed 627 Sinks fixed 442 Baths installed 171 Common Lodging House There is a Common Lodging House for men situated at 88 Old Street, E.C.1. which is owned and maintained by the Salvation Army. The premises are licensed for 313 inmates on the basis of the standards laid down by the London County Council prior to the transfer of functions in 1933. Separate quarters are provided for the Deputy Keeper and staff but, generally, the common sleeping rooms are on the upper floors, the kitchen dining room and office are on the ground floor and the washing facilities and lockers are in the basement. The main sanitary accommodation is situated in the ground floor yard but additional toilet facilities are also provided on each bedroom floor. 27 Eighteen visits of inspection were made during the year by the District Public Health Inspector. During the year considerable interest was displayed in the conditions in this Common Lodging House and the circumstances relating to those making use of it. The Calouste Gulbenkian Trust agreed to finance an investigation into the needs of these men, and the circumstance that led to them to reside temporarily or permanently in it with a view to considering any assistance which could be given to them. This survey undertaken by the London Council of Social Service in association with the Borough Council, was commenced in September. Shops A duty is placed on the Council by the Shops Act 1950 to carry out inspections of retail and wholesale shops and warehouses to ensure that adequate sanitary accommodation is provided and that sufficient means of ventilation and heating are provided and maintained. A register of shops is kept in the department and during the year 200 visits were paid by the Public Health Inspectors. In 5 instances notices were served on the occupiers requiring various matters to be dealt with. There are a number of exemption certificates in force which have been granted by the Council in the past, allowing the use of sanitary accommodation elsewhere than on the premises owing to restricted space. The construction of many new shops and the modernisation of others has had the effect of raising the standards of shops generally. Rag and Bone Dealers There are 4 premises in the borough dealing in rags waste paper, metal and similar articles. As none of them deal in bones they do not fall within the scope of the London County Council Bye Law in respect of Rag and Bone Dealers. Four visits were paid to such premises during the year however, and no nuisances were observed. Rag Flock Four premises in the Borough are licensed for the manufacture or storage of rag flock and 8 premises registered to use filling materials under the Rag Flock and Other Filling Materials Act 1951. Regular inspections of these premises were made during the year with a total of 11 visits. Five samples of various, types of filling materials were taken during the year and submitted to the approved analyst. All these passed the cleanliness standard. 28 Offensive Trades One premises is at present licensed by the Council at, an offensive trade for the processing of raw tripes. This is situated in Eagle Court in the area adjoining Smithfield Market and is regularly visited by the Senior Meat Inspector. Factories. The statistics for 1958 are as follows INSPECTIONS for purposes of provisions as to health (Inspections made by Public Health Inspectors). Premises Number of Register Number of Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be en forced by Local Authorities 76 45 12 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 1,344 968 71 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out workers' premises). 8 6 - - TOTAL 1,428 1,019 83 - 29 CASES IN WHICH DEFECTS WERE FOUND Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of Cleanliness (S.1) 50 41 2 4 - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) 7 6 - - - Inadequate ventilat2 ion (S.4) 1 - 1 - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient - - - - - (b) Unsuitable or defective 85 78 - 24 - (c) Not separate for sexes 1 1 - 1 - Other offences against the Act (not including offences relating to Outwork) 31 6 25 - - TOTAL 175 132 28 29 - 30 OUTWORK Section 110 Section 111 Nature of Work No of out workers in August list required by Sect. 110(1)(c) No of cases of default in sending lists to the Council No of prosecutions for failure to supply lists No. of instances of work In unwholesome premises Notices Served Prosecutions Wearing apparel Making etc 1,610 - - - - - Household linen 12 - - - - - Curtain & furniture hangings - - - - - - Furniture and upholstery - - - - - - Pur pulling - - - - - - Umbrellas, etc 21 - - - - - Artificial flowers 17 - - - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 88 - - - - - Brush making 14 - - - - - Feather sorting 21 - - - - - Carding, etc. of buttons etc 58 - - - - - Cosaques, Christmas Crackers, Christmas stockings etc 43 - - - - - Lampshades 51 - - - - - TOTAL 1,935 - - - - - 31 Outworkers Many firms arrange for some work to be undertaken as outwork either under contract by other factories or by homeworkers and, in order to check the spread of vermin or infectious disease, information as to such outwork must be supplied in relation to certain classes of work. Because smallpox and scarlet fever, the two diseases considered most likely to be spread in this way, are no longer of serious concern and verminous premises only infrequently discovered, the supervision of outwork has become of less importance than heretofore. Nevertheless the information supplied, which it must be remembered does not embrace all forms of outwork, is still of use in that it enables some supervision of the home circumstances. A proportion of the homes have been visited each year and the conditions are on the whole satisfactory, and no evidence has been found of children being required to spend long hours on this type of work or of it being carried out by groups of persons working in unhygienic ill ventilated and ill lit rooms as occurred frequently at one time. The rate of pay for outwork may not be good but it often provides occupation for those who for one reason or another are unable to go out to work and eases financial stresses. The number of firms employing outworkers in 1957 was 164 The number of Finsbury outworkers employed by them was 370 The number of non Finsbury outworkers employed by them was 4,419 The number of Finsbury outworkers employed by firms outside the Borough was 90 The total number of Finsbury outworkers employed by firms in or outside the Borough was 460 Of these 78 were firms and 382 homeworkers. Number of visits paid to homes 335 The registers of outworkers which firms are required to maintain are inspected as part of the routine during the inspection of the factories concerned. 32 Atmospheric Pollution Section 3 (i) of the Clean Air Act requires a person proposing to instal industrial and other large furnaces to give notice of intention to the local authority and eleven such notices were received during the year. The Section also provides for the optional submission of plans and specifications of such furnaces whereby prior approval may be given by the local authority. The number of complaints received by the department during 1958 in respect of smoke nuisances was 34. All these were investigated. The Public Health Inspectors made a total of 586 timed observations on industrial chimneys, in addition to keeping a general watch on smoke emission from boilers. Written intimation notices were sent to 6 firms whose chimneys were emitting smoke in such quantities as to be a nuisance which in two instances were followed up with Nuisance Notices. Air pollution from industrial chimneys appears to have lessened during recent years, as a result of improvements to boiler plants carried out by firms and other institutions in the main because of pressure by officers of the department. Smoke Control Area Consideration of the proposal to establish a Smoke Control Area under the Clean Air Act 1956 previously reported upon was resumed, and towards the end of the year the Council agreed to seek provisional approval from the Ministry of Housing and Local Government. The Area, to be known as the Finsbury (No.1) Smoke Control Area, comprises 62.6 acres in extent and contains an estimated number of 820 dwellings of which 570 will probably require conversion of their existing heating appliances. Some 220 commercial and industrial premises are included in the Area and 20 of these are known to require modification or change of their boiler plants. Measurement of Pollution The Council continues to co operate with the Department of Scientific & Industrial Research in the daily measurement of the amount of smoke and free sulphur dioxide in the atmosphere and the monthly measurement of deposits and sulphur dioxide content by the lead peroxide method. 33 Fumes from Vehicles on the Highway Many persons have been concerned in recent years with the emission of black and oily fumes from vehicles on the roads, such emissions being observed by no means infrequently. It is nearly always due either to lack of maintenance, defects or maladjustments in the engine, or to wilful interference by the drivers of the setting (even when this is sealed to prevent it being tampered with), in order to allow the vehicles to acquire a quicker rate of acceleration, especially when going up hill, for it is at such times when the load on the engine is greatest, and the engine defective, that the emission is most likely to occur. These fumes are both filthy and oily, very unpleasant and a nuisance, and at times even a danger as they may obscure vision. It is also possible, though admittedly not proven, that they are by nature cancer producing. Although the nuisance in Finsbury is probably not as great as in some other areas, as we have no long steep hills in the Borough, yet because considerable nuisances have been reported, we asked the Public Health Inspectors in December 1957, to make a note of the registration number, and when possible the name and address of the owner of every vehicle seen to be discharging noisome fumes. When the name of the owner was not known, I was able to obtain this through the co-operation of the London County Council. When these reports were presented to me I wrote a friendly letter to the owner calling his attention to the occurrence and asking for his co-operation to prevent a continuance of it. i report now the results of the instances which occurred, during 1958. for the information of your Committee. In all, 16 such instances were reported to me. Letters of thanks (in some cases effusive) were received in *(Of these in six cases it was stated that a defect had been found in the pump, and the other four stated the engine would be checked). 10 cases A plain statement that the vehicles was checked but special investigation would be made. 1 case A friendly statement that the matter could not be understood as everything possible was done to prevent such emissions. 1 case A plain statement that the matter was receiving attention. 1 case 34 No reply (In one of these cases a definite enquiry elicited the information that a defect had been found in the vehicle and it had been attended to). 3 cases * Note - This included London Transport Executive and British Road Services. It would seem to me that the procedure adopted which I got from a town in the north of England, has been useful, though of course in Finsbury such action cannot make more than a minute contribution to the solution. It would seem that it served a useful purpose in at least 12 out of the 16 cases and that owners of vehicles are, on the whole, co operative and anxious to avoid the creation of nuisances and glad to have information from a reliable source of the condition of their vehicles, or conduct of their drivers, as the case may be, of which they themselves may be unaware. Verminous Premises and Articles The Disinfestation service provides for the eradication of all insect pests including ants, bugs, fleas (human and animal), cockroaches, beetles, moths and other insects. During the year 154 infested premises were treated and an additional 204 were sprayed as a precautionary measure, making a total of 358 premises treated. The usual method of control has been by using a spray of 5 per cent D.D.T. or similar insecticide, leaving a residual film, with a follow up treatment some 14 days later if found necessary. As a routine measure of control of vermin disinfestation is carried out in the case of tenants moving into the Council's Housing Estates (other than Post War). Here the normal routine is for the old accommodation of the prospective tenant to be sprayed as already described some days before removal and at the same time similar action is taken at the proposed new residence. In serious cases, on the day of removal bedding is collected steam disinfested at the Health Centre and returned same day to the new address. In the case of removal to Post War Estates, the Council has entered into arrangements whereby the furniture and effects are subject to treatment with hydrogen cyanide gas whilst in transit. 35 Section 122 of the Public Health (London) Act, 1936 enables the Council, on a report from the Medical Officer of Health that any articles in a house in the borough are in such a verminous, filthy, dangerous or unwholesome condition that health is affected or endangered thereby, to cause the articles to be cleansed, disinfected or destroyed. 58 such representations were made in 1958. Cleansing of Verminous Persons The Borough Council continued the operation of the Bathing Centre in the Health Centre for the treatment of verminous conditions, including Scabies, and arrangements whereby school children were treated on behalf of the London County Council under the supervision of a nurse appointed by them. At other times the work was carried out under the supervision of the nurse appointed by the Council, who also undertook the Home Visiting when this was necessary. Arrangements were also continued during the year by which cases were treated on behalf of the Shoreditch Borough Council. Body lice have been dealt with by means of a hot bath during which the clothing is steam disinfected and then powdered with D.D.T. Head lice have been dealt with by the usual method of washing and combing the hair together with the use of Suleo, a preparation containing D.D.T. Scabies has been treated by painting the body after a hot bath with Benzyl Benzoate on the first attendance following by a further hot bath on the next day and the application of calamine lotion. The clothes are not normally disinfected. Scarcely any recurrences have taken place. Vermin Scabies Total Total number of treatments given to Finsbury cases (other than school children) 70 44 114 Total number of treatments given to Shoreditch cases (other than school children). 3 35 38 Total number of treatments given to school children (all the school children treated were not resident in Finsbury; a proportion being from adjacent boroughs). 710 78 788 Total number of home visits paid 1 36 Prevention of Damage by Pests Act, 1949 Rodent Control For the work of rodent control, this Council employs a Rodent Officer, Assistant Rodent Officer, Foreman and six operatives. During the year under review an extensive and systematic "Block" inspection of business premises has been carried out. This revealed many infestations of both rats and mice. Consequently the amount of work has increased and many occupiers of business premises have requested that maintenance treatments be given even after the infestation has been cleared. The presence of rattus rattus (Ship Rat) is still noticed in parts of the Borough but there has been a marked reduction in the density of infestations. In conjunction with the Borough Engineers Dept. the treatment of sewers has been carried out on three occasions since April 1958. and on the recommendation of the Ministry of Agriculture, Fisheries & Food, sodium fluoroacetate (1080) has been used. The results have so far been good and the treatments have undoubtedly reduced the size of infestations of rattus norvegicus (common rat), both above and below the surface. During May 1958 members of the Finnish Public Health & Sanitary Inspectors Association were paying a visit to this Country and, following a request from the Infestation Central Division of the Ministry ,of Agriculture, Fisheries and Food. it was a pleasure to welcome them to this Borough, when it was possible for them to see all aspects of the British methods of rodent control from the keeping of records to the visiting of both surface and sewer treatments. The co-operation of the general public throughout the Borough has been good and it has not been necessary to serve any notice in connection with matters under this Act. No. of complaints received Business premises 52 Domestic premises 211 Additional Infestations found Business premises 902 Domestic premises 109 No. of premises treated Business premises 954 Domestic premises 320 Total number of visits to Business premises 17,862 Domestic premises 6,975 37 Pet Animals The Pet Animals Act, 1951 requires that all premises, including shops and stalls, where pets are sold, shall be licensed annually by the local authority. Seven licenses were issued by the Council during 1958 viz. 3 in respect of shops, 3 in respect of stalls and 1 in respect of premises used for the breeding and sale of tropical fish. Except for the latter the amount of trade in pet animals and birds is comparatively small and no difficulties have arisen in connection with the implementation of the Act. All the premises were inspected during the year, a total of 12 formal visits being made. Heating Appliances The Heating Appliances (Fireguards) Act 1952 and the Regulations made thereunder are enforced by the Health Department. Inspections were made of shops, warehouses and stalls known to be selling new or second-hand gas, electric or oil fires to ensure that such appliances were adequately guarded in accordance with the standards laid down in the Regulations. Where necessary the prescribed probe, weight and burning tests were carried out by the Inspectors. Apart from many casual inspections 46 official visits were made under the Act during 1958. Reception House The portion of the Health Centre which had in the past been maintained by the Council as a Reception House (for persons who could not remain in their own rooms whilst these were being cleansed after infectious disease, or who had no alternative accommodation in which to reside during housing repairs) continued to be used, by agreement with the North East Metropolitan Regional Hospital Board, for the purpose of accommodating the administrative side of the Mass Radiography Unit. The Islington Borough Council has kindly agreed to provide accommodation for Finsbury residents at their Reception House as and when the occasion should arise. Disinfection Disinfection is carried out in all cases after infectious disease has occurred when it is considered necessary, and in other cases on request, generally after advice has been given that it would be advisable for it to be carried out. 38 During the year it was carried out in the following instances for the reasons set out:- Suspected Diphtheria 30 " Scarlet Fever 37 " Poliomyelitis 5 " Dysentery & Gastro enteritis 64 " Measles 30 " Whooping Cough 11 Tuberculosis 16 Scabies 2 On behalf of St. Marks & other hospitals 20 Miscellaneous 20 235 Bedding and clothing were brought to the Disinfecting Station in the Health Centre in these cases, and disinfected with steam. In all including the cases where this was carried out for the control of vermin. 5,180 articles were treated. Goods, mostly clothing, were also disinfected on behalf of certain export firms as follows. Number of articles 56,109 Number of times disinfecting plant charged 151¾ Nuisance from Pigeons In order to control the number of pigeons in the Borough, licenses have been granted for catching them in the streets and open spaces, as they are liable to become a public nuisance and to do much damage. Enquiries are made as to the means employed by those authorized, to ensure that they are humane and as to disposal of the carcasses to ensure that birds unfit for human consumption are not sold for this purpose. During 1958 two licenses were in force. Mortuary The Corporation of London was so good as to make available mortuary accommodation at their Golden Lane Mortuary for Finsbury infectious and emergency cases. 39 Hairdressers Under the London County Council (General Powers) Act 1954. power was given to Borough Councils to require the registration of persons carrying on the business of a hairdresser or barber and the registration of the premises and the Council fixed the 1st February 1956 as the appointed day on which the provisions of the Act came into force in Finsbury. In accordance with the Act the Council made byelaws for the purpose of securing the cleanliness of registered premises including the instruments, towels and equipment used therein and also the cleanliness of persons employed in such premises in regard both to themselves and their clothing. These were based on the model agreed by the Metropolitan Boroughs and were confirmed by the Ministry of Housing & Local Government. A total of 45 premises have been registered under the Act. In all 69 visits were made to hairdressers and barbers during 1958. 40 SECTION D HOUSING General The estimated number of dwellings in the borough at the end of 1958 was 9,857 consisting of 3,293 houses. 6,523 flats and 41 huts. The houses are almost entirely privately owned. Ownership of the flats is as follows - Finsbury Borough Council 1,811 London County Council 559 City Corporation 266 Metropolitan Police 126 Housing Associations 2,644 Private ownership 1,117 New Accommodation The housing construction programme of the Council and other housing authorities has continued to make progress during the year and I am pleased to report the erection and occupation of the following 227 new flats during 1958. By the Finsbury Borough Council: Amwell House, Holford Square 12 flats Wyclif Court Brunswick Close Estate. 64 flats Emberton Court 71 flats Brunswick Court 72 flats By Private Owners: 54/55 Myddelton Square (conversion) 5 flats Others 3 flats Six certificates of habitation under Section 95 of the Public Health (London) Act 1936 were issued during 1958 in connection with new or converted premises which included the above mentioned blocks of flats. In addition plans were well advanced in connection with the redevelopment of the extensive Galway Street Clearance Area, and preparatory work on the site has commenced. 41 Basement Rooms Steps are taken as and when necessary to prevent the re-occupation of unsatisfactory basement rooms by making Closing Orders. When information is received of the pending rehousing of families living in basements, inspection of the premises is carried out to ascertain whether the rooms could be made to comply substantially with the Housing Act standards at reasonable expense. If not, an official Representation is made to the Council and in most cases a Closing Order results. Premises subject to a Closing Order are inspected annually for the purpose of ascertaining whether any infringement of the Order has occurred. A total of 272 inspections of basement rooms were made for all purposes during the year and the following is a summary of action taken:- Premises Rooms No. of closing orders in force on 1st Jan. 1958 113 190 No. of representations under consideration on 1st January 1958 82 156 No. of representations made during 1958 18 32 No. of representations under consideration on 31st December 1958 80 153 No. of undertakings accepted - - No. of closing orders made during 1958 21 40 No. of closing orders determined during 1958 4 6 No. of closing orders in force on 31st Dec.1958 129 222 Unfit Parts of Houses (other than Easement Rooms) From time to time it has become necessary to take action in spect of a few individual rooms in houses still regarded technically as fit for habitation where these have for one reason or another deteriorated in condition beyond reasonable possibility of being rendered fit. Premises Rooms No. of closing orders in force on 1st Jan. 1958 4 8 No. of representations under consideration on 1st January 1958 6 11 No. of representations made during 1958 1 2 42  Premises Rooms No. of representations under consideration on 31st December 1958 6 11 No. of undertakings accepted during 1958 - - No. of closing orders made during 1958 1 2 No. of closing orders determined during 1958 - - Repair of Houses under Sections 9 and 10 Housing Act 1957. No action has been taken since the war under these Sections. Individual Unfit Houses & Flats Chiefly because of rehousing difficulties, action to secure the demolition or closure of individual unfit houses has been restricted to a comparatively small number of very bad houses including certain unoccupied premises. Since the war Demolition or Closing Orders have been made in respect of 167 premises. The following was the position at the end of 1958. No. of closing orders in force on 1st Jan. 1958 32 No. of representations under consideration on 1st Jan. 1958 36 No. of representations made during 1958 3 No. of representations under consideration at 31st Dec. 1958 3 No. of closing orders made during 1958 35 No. of demolition orders made during 1958 1 No. of premises subject to demolition orders demolished during 1958 - No. of premises subject to closing orders demolished during 1958 18 No. of closing orders determined during 1958 as a result of reconstruction 4 No. of closing orders in force on 31st December 1958 45 Tabular Statement prepared in accordance with the Housing Consolidated Regulations 1925-1932 No. of houses considered on inspection to be unfit for human habitation 22 No. of houses wherein defects were remedied by informal action - 43 No. of representations made with a view to: - (a) serving notices requiring the execution of work - (b) making demolition or closing orders 22 No. of notices served requiring the execution of repairs - No. of houses rendered fit after service of notice - No. of demolition or closing orders made 58 No. of houses in respect of which undertakings were accepted - No. of houses demolished - Slum Clearance The position obtaining at the end of the year in respect of individual Clearance Areas is summarised below:- 1. Ironmonger Passage Lizard Street - 3 premises These premises were demolished during the year. 2. St. James Row - 8 premises Three of the houses were demolished. 3. Galway Street - 168 premises Rehousing of the tenants on this large area was completed and the site practically cleared by the end of 1958. 4. Herbal Hill/Herbal Place - 7 premises As a result of the Council's Clearance Order, a public enquiry was held on the 11th November 1958. 5. Field Place - 7 premises. This order was confirmed without modification on the 11th August 1958. 6. Medcalf Place - 15 premises This order was confirmed without modification on the 18th November 1958. 7. King Square (No.l) Area - 26 premises Following objections to the Council's Clearance Order, a public enquiry was held by the Ministry on the 8th October 1958. 44 8. King Square (No.2) Area - 292 premises This very large area' was surveyed and represented and a Clearance Order agreed to by the Council. 9. King Square (No.3) Area - 25 premises This area was inspected and represented and a Clearance Order agreed to by the Council. 10. Donegal Street Area - 45 premises An inspection was carried out and a presentation made to the Council on 1st December 1958 of this area which included houses previously represented in Cynthia Street; the latter Order was rescinded. 11. Buxton Buildings - 28 premises These flats were included in the agreed slum clearance programme but on grounds of expediency each individual flat was made the subject of a closing order representation. As a result of the extensive action taken during the year with the exception of 2 houses, representations have now been made in respect of all the properties scheduled in the 1956/60 programme agreed between the Council and the London County Council. Inspections The year 1958 was one of intense activity by the Department in the matter of slum clearance. As indicated above, three areas were subjected to detailed surveys by the Public Health (Housing) Inspectors and were represented under the Housing Act 1957. Of all the areas so far represented to the Council under the Housing Acts, the combined King Square Area is by far the largest in extent and contains more houses than any other area previously dealt with by the Department. In all, a total of 420 house to house inspections were made during the year. Overcrowding It is difficult to estimate the extent of overcrowding in the borough - either overcrowding based on the purely legal standard or what may well be considered to be overcrowding of families living in cramped conditions necessitating the use of kitchens as bedrooms but not legally overcrowded. At the beginning of 1957 a register was 45 started of overcrowded families, coming to the notice of the Department. During that period details of some 68 families have been recorded, in 16 of which the overcrowding was subsequently abated by rehousing. At the end of the year there were 52 cases on the register. Generally speaking however, serious overcrowding is much reduced and the majority of cases coming to the notice of the department are invariably overcrowded to the extent of ½ to 1 unit. Fortyfour such families were reported to the appropriate authority during 1958. Seven new instances of wilful overcrowding came to light during the year. In each case strongly worded letters were sent to the landlord and tenant, and in three instances the overcrowding was subsequently abated. In the remaining four cases because conditions were considered not to be sufficiently serious, or on humanitarian grounds, it was decided not to institute legal proceedings. Rehousing Applications for rehousing by the Borough Council are made to the Housing Manager and these have been assessed for some years according to a points scheme. When accompanied by medical certificates to support the application on medical grounds these have been referred to the Medical Officer of Health. Enquiries are then made by the Nurse/Visitor into the detailed nature of the family health, and the apparent bearing on this of the accommodation in use and when desirable, an inspection is carried out by the Public Health Inspector. These reports are then correlated with the medical certificates, and a degree of medical priority is then allotted. During the year applications were dealt with as follows - New cases 230 Cases reconsidered on new medical certificates 136 Cases reconsidered 20 Applications for rehousing by the London County Council are made to that body. Reports are then frequently asked for and supplied in regard to the existing overcrowding and sanitary defects. If accompanied by medical certificates further information is given on request to the Divisional Medical Officer of the London County Council who is responsible for allocating priorities on medical grounds. The approximate number of families rehoused during the year was:- Rehoused by Finsbury Borough Council 39 Rehoused from Clearance Areas by Finsbury Borough Council 180 Rehoused by London County Council 61 Rehoused in new towns 6 46 In addition 12 families on the Council's Housing list were rehoused by the City Corporation. Rent Act 1957 - Certificates of Disrepair So far as the Department is concerned, inspections have been made by the Public Health Inspectors in connection with all applications to the Council by tenants for a Certificate of Disrepair and for advice in completing the appropriate forms required by the Act. and latterly, to check repairs in respect of applications for the cancellation of certificates. Details for 1958 are set out in the following table:- No. of applications for Certificates of Disrepair 37 No. of decisions not to issue Certificates 4 No. of decisions to issue Certificates (a) in respect of some defects 12 (b) in respect of all defects 6 No. of Undertakings given by Landlords 9 No. of Undertakings refused Nil No. of Certificates issued 17 No. of applications by landlords for cancellation of certificates 6 No. of objections by tenants to cancellation of certificates 2 No. of decisions to cancel certificates in spite of objection 1 No. of certificates cancelled 2 No. of applications for certificates as to the remedying of defects (a) from Tenants 2 (b) from Landlords 6 No. of such Certificates issued to:- (a) to Tenants 2 (b) to Landlords 5 Improvement Grants Property owners in the borough have taken little advantage of the financial assistance available under the Housing Acts whereby improvements can be effected to sub-standard houses at the discretion of the Council. 47 Two formal applications only were received by the Council during the year in respect of proposed works of improvement. In each case, however, the application was rejected in view of the fact that the premises as a whole were not being dealt with. 48 SECTION E FOOD Food Premises The number of known food premises in the borough at the end of the year was as follows - Restaurants, cafes and snack bars 165 Public Houses 124 Off licence premises (retail & shops)9 Factory canteens 73 Commercial canteens Apppox. 50 Dairies and milk distributors etc 138 Ice Cream sellers 150 Confectioners (sweets) shops 75 Bakers shops 24 Bakehouses (i) Basement 7 16 (ii) Above ground 9. Grocers & provision shops (retail) 40 Provision merchants (wholesale) 13 Cheese importers (wholesale) 3 Greengrocers & fruiterers 22 Fish shops 3 Fish curers 3 Fried fish shops 9 Eel & pie shops 6 Poultry dealers (wholesale) 4 Butchers shops (retail) 37 Wholesale butchers & offal dealers 24 Wholesale horseflesh dealer 1 Bacon factories 8 Sausage factories 3 Sausage casing merchants 6 49 Meat extract factory 1 Public cold stores 6 Chemists shops (retail) 18 Manufacturing & wholesale chemists 9 In addition there are 160 street market stalls dealing in various foodstuffs. The total number of visits paid to all food premises during 1958 was 3,632 and to food stalls 6,037. Food Hygiene Regulations Work has continued during the year in connection with the implementation of the Pood Hygiene Regulations in restaurants, cafes and snack bars. Visits by the Public Health (Pood) Inspectors have resulted in obtaining compliance with the requirements of the Regulations to a large degree in this type of premises in the Borough, although concern has been expressed by many occupiers at the expense involved, in view of the insecurity of their tenure of the premises, due to expired leases and short tenancies. Generally speaking the occupiers of this type of business has been found to be co-operative and it is hoped that by further visits a clearer view of the need for Hygiene in the Handling, Storage and Preparation of food will be instilled into all persons engaged in this business. The total number of visits made to restaurants cafes and snack bars during the year was 1,595. These included visits to discuss proposed works with Contractors and others as well as to supervise improvements in progress. At the end of the year the position was as follows:- Total number originally recorded 1957 165 Premises subsequently opened 1 166 Number of premises closed 13 Number of premises in Clearance Areas (unsatisfactory) 1 Number of premises consider to be satisfactory 144 Number where work was still in progress 7 *Premises where work had not been done 1 166 *Details of this cafe were submitted to the Council for consideration, who authorised legal proceedings, but the premises were subsequently closed down, after the end of the year under review. 50 Adulteration of Food In 1958 a total of 620 samples of foods and drugs were submitted to the Public Analyst. Of these four were formal and the remainder were informal samples. Details are appended. No. of Samples Obtained Foods Milk 106 Cream & Condensed Milk 13 Ice Cream 5 Cheese 15 Sausages 17 Meat & Fish Products 120 Soups 11 Sauces. Vinegar etc. 24 Condiments, spices & flavourings 41 Jams & Preserves 19 Jellies & Gelatine 7 Dried Fruit 25 Cake & Pudding Mixtures 30 Fresh Fruit & Vegetables 1 Flour 5 Cereals 4 Coffee. Cocoa, Tea & Extracts 15 Non alcholic drinks 21 Canned fruit and vegetables 42 Cakes & Bread 11 Sugar Confectionery 48 Restaurant Meals & Snacks 2 Drugs Medicines 18 Powders 2 Tablets 9 Ointments, lotions 9 620 51 Informal samples of honey and borax, and glycerine of borax were found to be deficient in borax. Formal samples were purchased with a similar result and a letter was sent to the manufacturer requesting a greater care in the preparation of these products. A formal sample of Chocolate Coconut Tea squares was submitted for analysis after a complaint had been received that the sweets had a strong bitter taste. Examination showed that the goods were stale, and the stock was surrendered and destroyed. Food Complaints 22 complaints were received from members of the public during the year in respect of alleged unsound or adultered food purchased from shops in the Borough. In every case an investigation was carried out and a report submitted to the Health Committee. Legal proceedings were recommended in four instances all of which were successful. In the remaining cases, actions appropriate to the circumstances were taken. Legal Proceedings The Council instituted legal proceedings under Section 2 of the Food & Drugs Act 1955 as under:- Date Premises Offence Result 18. 3. 58 54. Rawstorne Street Non-brewed condiment deficient in acetic acid content Dismissed Costs £2.2.0 7. 10. 58 31.Chapel Market Selling bread not of the nature and substance demanded (mouldy) Fined £10 Costs £8. 18. 6d 7. 10.58 25. Exmouth Market Selling bread not of the nature and substance demanded (mouldy) Warranty pleaded Case dismissed Symmons issued against manufacturer as under 7. 10.58 25 Exmouth Market Selling bread not of the nature and substance demanded (mouldy) Fined £10 4. 12. 58 43. Chapel Market Foreign body (screw) in loaf of bread Fined £10 Costs £3. 13. 0d 52 Bacteriological Examination of Food The pathological laboratory in the Health Centre was used whenever possible during the year for the routine examination of various types of food and whenever suspicion of contamination or possible danger to public health arose. During the past year several types of foodstuffs have been submitted for bacteriological examination in addition to the usual routine examination of milk and ice cream, as indicated in the following list:- Canned Hams 5 Canned Stewed Steak 5 Canned Luncheon Meat 2 Canned Anchovies 6 Canned Garden Peas 2 Custard 2 Gravy 2 Roast Lamb 1 Steak & Kidney Pie 1 Stewed Steak 1 Pilchard Sandwiches 1 Wines & Spirits 16 44 Canned Hams Inspection and examination of this type of canned food has continued and although the position has improved it has been considered necessary to submit samples for bacteriological examination. In some of the samples submitted Cl.Welchii was isolated and it was generally found that the types of organisms isolated suggested careless handling and insufficient sterilization at the time of manufacture, or storage under unsuitable conditions. Canned Anchovies in Salt Several samples of this class of canned food (unprocessed) were submitted for bacteriological examination. In some of the samples C1. Welchii were isolated. Satisfactory arrangements were made for the disposal of these foodstuffs. Wines and Spirits A consignment of wines and spirits was received in the Borough which had been stored in a cellar which had been flooded with crude sewage. As a result of exhaustive examinations it was decided that no 53 serious infection by pathogenic organisms had taken place and after negotiations with the owners some of the goods were destroyed and the remainder released for consumption. Milk The regular sampling of milk for chemical analysis and bacteriological examination has continued to be carried out from shops, milk depots, roundsmen, schools and day nurseries. The number of routine inspections of dairies and milk shops during 1958 involved 261 visits. Summary No. of dairies on register at end of 1958 9 No. of distributors on register at end of 1958 129 No. of transfers approved during 1958 2 No. of new applications approved during 1958 5 No. of premises removed from register during 1958 4 Designated Milk Licences issued Dealers Supplementary Tuberculin 55 28 Pasteurised 73 28 Sterilized 76 31 Quality of Milk No. of samples submitted to Public Analyst 106 No. of samples reported as adultered Nil Average fat content of all milk samples 3.9% Average non-fatty solids content 8.6% No. of samples submitted for bacteriological examination 65 No. reported as satisfactory 65 Channel Island Milk Since the introduction of the statutory standard for Channel Island milk, samples have been taken throughout the year and the average for all these samples were as under:- Fat content 4.7% Non-fatty solids 9.06% 54 Ice Cream Although 22 premises are still registered for the manufacture of ice-cream the number where manufacturing actually took place during the year was 2. At one of these, the product is subjected to freezing only following delivery in bulk after pasteurisation from a factory outside the borough. At the other establishment used at present for the manufacture of ice-cream the mixture is subjected to pasteurisation at a temperature of 150°F for 30 minutes. The standard of ice cream from a Chemical and Bacteriological standpoint has generally been satisfactory. The number of visits paid to ice-cream premises by the Public Health (Food) Inspectors during 1958 was 70. Summary of Premises No. of premises registered for manufacture 22 No. of premises registered for storage & sale 126 No. of premises registered for storage only . 2 No. of new registrations during 1958 5 Summary of Samples No. of samples submitted to Public Analyst 13 No. reported as adulterated NIL No. of bacteriological samples taken 21 No. reported as fully satisfactory 14 No. reported as unsatisfactory 4 No. reported as indeterminate 3 Meat Inspection In the neighbourhood of the Smithfield Meat Market there is a considerable number of wholesale butchers and offal shops bacon factories wholesale bacon and provision warehouses, poultry, game and rabbit shops, and Public Cold Air Stores all of which are regularly inspected by the meat inspector. Several of the wholesale butchers shop trade in old cow and bull carcases beef which is used for manufacturing purposes. Due to the nature of these carcases a rigid inspection was maintained to ensure that diseased carcases were not passed on to the public. A systematic examination of imported frozen carcases of mutton and lamb was made for Caseous Lymphadenitis in the Public Cold Air Stores. 55 Consignments of Continental and Scandinavian offals and tinned hams continued to be imported into the Borough and condemnations of these took place on several occasions. The collection of unsound meat and other foodstuffs continues to be collected satisfactorily by the contractors. Messrs Henson and Burbidge, Matusa Works, Beckton, who render down the foodstuffs for technical purposes only. During the year 242 certificates were issued for the export of meat bacon and meat essence. Several of these certificates were issued for the export of boneless and bone-in quarters of cow beef to Italy. Germany and Bermuda. A total of 1,115 visits were made to the retail butchers shops and stalls in the borough. During the course of the year the meat inspector examined 1,033 bags of New Zealand Beef Livers and 620 bags of Uruguayan Beef Livers for a parasitic hydatis cyst, -the Echinococcus Granulosus. Each bag. containing about 6-8 livers was slightly defrosted and two or three incisions were made into the substance of every liver. In several Uruguayan beef livers as many as 10 cysts were counted in each liver. Those livers which contained the hydatis cysts were condemned. A tabular table in regard to the examination is set out below. BEEF LIVERS examined for Echinococcus cysts Country of Origin Examined Condemned Percentage Number Weight Number Weight New Zealand 1033 bags. 88683 892 10102 12.7% Uruguay 620 bags. 52532 3914 18448 35.2% Representations by the Council were made to the Secretaries of the Ministry of Health and Ministry of Agriculture. Fisheries and Food, and in September a communication was received from the Agricultural Branch of the New Zealand Government, that the exportation of infected livers would be prohibited from New Zealand. Bakehouses The year 1958 was the fourth of the quinquennial periods since the enactment of the Factories Act which requires the standard of suitability of basement bakehouses, to be reviewed. Detailed inspections were made of the 11 basement bakehouses in the Borough and schedules of works were prepared and served. As a result of this survey 4 basement bakehouses have now closed and the remaining 7 have satisfied the requirements of the Council and certificates of suitability have been granted. 56 In addition there are 9 other bakehouses in use in Pinsbury. A total of 233 visits were paid during 1958. Registered Food Premises In addition to ice-cream premises, the number of premises registered under Section 16 of the Food & Drugs Act. 1955 for the manufacture of sausages, or potted, pressed, pickled or preserved food is 74. The various types of business carried on at these premises are as follows:- Sausage manufacturing 32 Sausage smoking 1 Meat pickling 39 Offal Cooking 5 Cooked meats & pie making 4 Ham boiling 11 Bacon curing & smoking 3 Fish curing 3 Shellfish cooking 2 Jellied eels 2 Meat extraction 1 A total of 287 visits were paid by the Inspectors during 1958. In some instances more than one type of business is carried on at the same premises. For example meat pickling is invariably done at retail and wholesale butchers shops, at most of which sausages arc also manufactured. There are however. 3 wholesale sausage factories in the Borough. The cooking of meat offal and pies is done mostly at premises that specialise in that type of trade, this also applies to jellied eels. The number of premises at which the boiling of hams has decreased since the war small provision merchants having ceased to cook their own hams, preferring to sell pre-cooked or canned hams. Large quantities of bacon are smoked at the establishments in the borough registered for that purpose. The smoking of fish is also carried out locally and in addition two retailers cook their own supplies of shellfish. One large firm has a factory in the borough for manufacturing and bottling meat extract. The conditions under which the above types of food preparation and preservation are carried out in the Borough are reasonably satis factory. Improvements have been effected during the year, and constant supervision is being maintained. 57 Street Markets There are four market streets situated at Chapel Market, Exmouth Market, Whitecross Street and Farringdon Road. A total of 590 stalls were licenced by the Council at the end of 1958 of which 160 were licensed for the sale of foodstuffs. A rota of week-end inspections of street markets operates, and including the daily visits, a total of 6,037 inspections were made. The difficulties of effectively administering the Food Hygiene Regulations in so far as they affect market stalls in open streets, are being given earnest consideration and it is hoped that by a system of co-operation with the traders and the strength of public opinion on this matter that a gradual improvement will be obtained and maintained. The system adopted of issuing licences to stallholders for the sale of foodstuffs subject to the approval of the conditions of sale and storage by the Public Health Department, is working well, and shows promise of an improvement in conditions generally. Licensed Premises and Public Houses Finsbury has 146 licensed premises, all but 22 of which are public houses. The number of inspections carried out during the year was 193 of which 68 were visits in connection with the transfer of licenses and other matters, under the Licensing Act 1953. These inspections are also used for the investigations of matters requiring remedy under the Public Health (London) Act or Food Hygiene Regulations. During 1958, 22 premises were reported improved through action by the Public Health (Food) Inspectors. Pharmacy & Poisons Act 1933 A list of sellers of Part II Poisons under the Act is kept by the Council. In 1958 37 applications for names to be placed on the list were approved. Inspections continue to be made in connection with this Act. Fortunately no cases have been reported during the year which warranted legal proceedings. Unsound Food No formal seizure and condemnation of food under Section 9 of the Food & Drugs Act 1955 was necessary during the year. The system adopted of encouraging traders to notify the department when they are in possession of any suspected unsound food has now become the accepted method, and in every case voluntary surrender of the unsound food is readily agreed to by the trader. The amount of food dealt with remains at a high figure because apart from the individual traders certain multiple stores have their warehouses situated in Finsbury to which all doubtful tins are returned from the retail shops for sorting and inspection. 58 Similarly, large quantities of foodstuffs are handled by the British Transport Commission which has depots in the Borough and the Pood Inspectors are frequently called in to adjudicate on food that has been damaged or contaminated in course of transit. A total of 187 visits were made by the Pood Inspectors during the year in connection with the examination of unsound food and 1,038 condemnations certificates were issued. These figures exclude any reference to meat inspection. Details of the unsound food surrendered during the year are as follows:- lbs. Meat (diseased) 16,129 Meat (unsound) 39,302 Meat products 17,895 Bacon 21,673 Offals (diseased & unsound) 51,454 Poultry 5,601 Game 195 Rabbits 1,714 Canned foods 57,077 Dried fruit 5 Confectioner 89 Cheese 3,304 Fats 24 Preserves 35 Cereals 849 Eggs - Chestnuts 281 Yeast 2,128 Miscellaneous 3,843 Total 221,598 98. 46 tons. 59 Food Poisoning There were 46 individual cases notified during the year, of which 6 were due to Salmonella Typhi-murium. 1 was due to Salmonella Derby. 1 was due to Salmonella Heidelberg. The distribution of cases throughout the year was as follows:- Jan. 0 Feb. 4 No organisms identified. Mar. 1 April 5 -1 case Sal, Typhi Murium. May. 2 -1 case Sal. Typhi-Murium. June 7 July 5 Aug. 0 Sept. 6 -1 case Sal. Typhi murium. Oct. 3 Nov. 9 -1 case Sal. Heidelberg. 1 case Sal. Derby. Dec 4 3 cases Sal. Typhi Murium in same family. The following individual cases were investigated and the possible cause identified:- April. Stewed Apple & Ham -Sal. Typhi-murium isolated. April. Vegetable Pie -No organisms detected. April. Corned Beef -No organisms detected. June. Brown Ale -No organisms detected. June. Contact with outbreak at Cliftonville - No organisms detected. Small Outbreak in School In February there was a small outbreak in a school involving two teachers and twelve children. The symptoms were abdominal pain and diarrhoea and mild vomiting. There was a rapid recovery. Bacteriological Examination gave the following results Roast Lamb. - Amoebic sporing bacilli and micrococci. Gravy - Large gram + bacilli, some resembled C1. Welchii. Culture resembled Amoebic bacilli. Custard - Gram + Cocci. 60 Faecal specimens from the 2 adults-Clostridium Welchii on culture. Many of the children were resident in other boroughs. The practice of pre-cooking in some large canteens is one to be deprecated. Investigation has shown that the risk of contamination may be very great, and may be the cause of many cases of Food Poisoning. This system of food preparation is discouraged in communal canteens in the Borough whenever the occasion arises to point out the dangers involved. 61 SECTION F INFECTIOUS DISEASES General All cases notified were visited by the Infectious Diseases Nurse/ Visitor and energetic measures taken wherever indicated to ensure adequate minimization of danger of infection to others. The number of visits made by the Infectious Diseases Nurse/Visitor in 1958 was 3,223. The following table shows the incidence of notifiable diseases in 1958:- All Ages Under 1 yr. 1-4 yrs. 5-14 yrs. 15-24 yrs. 25-44 yrs. 45-64 yrs. 65- Cases treated in Hosp. Acute Pneumonia 93 5 14 10 3 19 24 18 83 Diphtheria 30 1 6 22 - 1 - - 29 Dysentery 320 15 111 121 9 57 6 1 83 Encephalitis 1 - - - - 1 - - 1 Erysipelas 3 - - - 1 - 1 1 1 Food Poisoning 46 - 9 8 5 12 9 3 4 Gastro-Enteritis (under 2 yrs) 15 10 5 _ _ _ _ - 11 Measles 233 15 129 86 3 - - - 30 Ophthalmia Neonatorum 7 7 - - - • - - 4 Poliomyelitis (Paralytic) 1 - 1 - - - - - 1 Puerperal Pyrexia 1 - - - - 1 - - • Scabies 25 - 3 13 4 5 - 3 Scarlet Fever 40 1 13 26 - - - - 26 Tuberculosis (Pulmonary) 24 - 2 - 7 6 7 2 - Tuberculosis (NonPulmonary) 5 . _ _ 1 2 2 - _ Whooping Cough 29 4 14 11 - - - 10 Total 873 58 307 297 32 102 47 25 203 62 Diphtheria A small outbreak of 48 cases occurred during the last quarter of 1958. Of these 30 were notified in the Borough of Finsbury. The outbreak occurred in 2 phases 30th September-24th October, and 10th November-3rd December 1958, and children at three schools were affected. The first cases, 2 mothers, were confirmed on September 30th, and energetic measures were taken at once to confine the spread of the disease. The infectious disease visitor immediately visited the homes of the children to ascertain:- 1. The school attended, if any. 2. The history of the illness. 3. All close contacts and to exclude them from school pending bacteriological reports. 4. The immunization history of each child. The Divisional Medical Officer of London County Council, Health Division Three was consulted and it was agreed that he should be responsible for the swabbing of children in school, and that the Borough Medical Officer should be responsible for all children absent from school, and for the swabbing of all contacts in the houses of any children proving to be carriers as a result of school swabbing. Bacteriological examination showed that the causative organism was a virulent strain of Coryne bacterium diptheriae. On October 5th a fresh case occurred, unconnected with the previous ones. Again all close contacts and class contacts were swabbed, and all carriers were removed to hospital. Child contacts with negative swabs, who had never been immunized were given simultaneous active and passive immunization. The second phase began with the discovery of a fresh case on November 10th 1958, and the routine measures were again undertaken. No direct connection has been found between the cases occurring in the first and second phases. In all these were 30 cases with positive nose or throat swabs. One girl 6 years old was ill, probably with a clinical attack of true diphtheria. She had never been immunized. Twelve children were mildly ill. It is not certain whether these were cases of diphtheria or carriers, ill from some other cause. Of these six had been fully immunized and two more partially immunized. 63 The following table sets out the number of notified cases of and deaths from Diphtheria during the years 1939 to 1958. Year No. of Cases Notified Deaths 1939 58 2 1940 27 2 1941 35 0 1942 19 1 1943 24 2 1944 10 0 1945 13 0 1946 6 0 1947 6 1 1948 1 0 1949 0 0 1950 1 (adult non-resid). 0 1951 0 0 1952 1 0 1953/57 0 0 1958 30 0 As reference to the above table shows, there has not been a comparable number of notified cases of diphtheria since the early 1940's. And although in the present incident all the cases but one were very mild, and many were symptomless carriers, it serves as a reminder that the disease is endemic, and is only held in check by a high acceptance rate of immunization in infancy, re-enforced by booster doses during school life. The outbreak was quickly brought under control by the energetic measures of all concerned, and is being followed up by an intensive campaign for immunization. Smallpox There were no cases or contacts. Enteric Fever (1) Typhoid There were no cases or contacts. 64 Enteric Fever (ii) Paratyphoid There were no cases or contacts. Meningococcal Infection There were no cases or contacts. Post Infective Encephalitis There was one notified case in a male aged 30, following an attack of Influenza. He was seriously ill, but made a slow recovery with no after effects. Acute Poliomyelitis There was one notified case of Paralytic Poliomelitis. This was in a child of 4½ years. The paralysis affected the left side of the face, left arm and left leg. She is making slow but satisfactory progress. Opthalmia Neonatorum There were 7 notified cases. None was severe and all responded to treatment. Puerperal Pyrexia There was one notified case, and 13 cases which developed in hospital in non-borough residents. There were no deaths, and all made satisfactory progress. Erysipelas There were three notified cases, all facial. 2 were moderately severe and 1 was mild. 1 was removed to hospital. All responded to treatment and recovered. Scarlet Fever There were 40 notified cases, 37 of these were very mild and 3 were moderately severe. 22 were removed to hospital. 1 case developed the complication of right cervical adenitis, but all made a satisfactory recovery. Measles There were 233 notified cases which is below the average. 126 were moderately severe and 107 were mild. 19 cases were removed to hospital. All made satisfactory progress. Complications Bronchopneumonia 2. bronchitis 3. 65 Whooping Cough There were 29 notified cases-a low total. 18 cases were moderately severe. There were no complications and no deaths. Acute primary and Influenzal Pneumonias There were 93 notified cases of these pneumonias. 4 were severe cases of Influenzal Pneumonia. Of the 89 Acute Primary Pneumonias 63 were moderately severe and 26 were severe. 83 were removed to hospital. There were no deaths. This was the largest number for many years, and cases continued well into the second quarter. Scabies 25 cases were notified during the year. Dysentery There were 320 cases notified. Of these:- 172 were clinical cases with positive bacteriological findings. 104 were symptomless cases with positive bacteriological findings. 44 were clinical cases with negative bacteriological findings. In all 76 cases were removed to hospital. An outbreak in one school affected 67 children, and in another school 36 children. An outbreak in a nursery affected 11 children. In connection with these outbreaks, 61 adults were infected, probably by their children. All made satisfactory recovery. There were no deaths. Gastroenteritis (under 2 years) There were 15 cases notified of whom 12 were removed to hospital. 4 were moderately severe and 11 were mild. All responded well to treatment. There were no deaths. DISEASES NOT NOTIFIABLE IN FINSBURY The following information was received from Local General Practitioners and other sources. Gastro enteritis (over 2 years) 3 cases, none were severe and there were no known contacts. 66 Mumps 56 cases. No complications. Rubella 14 cases. There were no known contacts with any early pregnancies. Chickenpox 76 cases. No complications. Infective Hepatitis None. Glandular Fever None. Influenza None. Food Poisoning Please see Section 'E' - Food. Tuberculosis The total number of new cases entered in the register during the year was 44. The distribution by sex and age and according as to whether the case was of Pulmonary or Non-pulmonary Tuberculosis, was 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65+ Total Pulmonary M - 1 - 1 1 2 4 2 5 7 2 25 F - 1 - - 1 4 - 3 2 2 1 14 Non Pulmonary M - - - _ . - 1 - 2 - - 3 F - - - - - - 1 1 - - - 2 TOTAL - 0 2 0 1 2 6 6 6 9 9 3 44 These figures do not necessarily correspond, due to technical reasons, with those shown in the report of the Chest Pysician. 67 The Non-pulmonary cases include:- 1 Right inguinal gland: 1 Lumbar Spine; 1 Peritoneum; 2 Kidneys. The notification rate for all forms of tuberculosis was 12.58 per 10,000. The total number of cases remaining on the register after adjustment for deaths and transfers was. on 31st December 1958. Males Femal es Total Pulmonary 143 108 251 Non-Pulmonary 10 8 18 153 116 269 The full details of each case obtained by the Tuberculosis Visitor were, by kind co-operation of the London County Council, made available to and any preventive measures possible co-ordinated with those of the Borough Council. There were six deaths from pulmonary tuberculosis as follows:- Males. 45, 47, 64, 70. Females: 40, 79. There was one death from non-pulmonary tuberculosis a female aged 79 years. I should like to acknowledge the willing co-operation and facilities for the interchange of information which have been provided by the Chest Physician, Dr. W.D.R. Thompson, and his staff. Finsbury Chest Clinic (Information kindly provided by Dr. W.D.R. Thompson, Chest Physician). During the year 1958 a total of 1,612 patients were seen in the Chest Clinic. Of this total. 98 attended for the first time as contacts of notified cases, and a further 48 were re examined as routine contact checks. The number of new cases of tuberculosis taken on the clinic register during the year amounted to 27, of which 20 were pulmonary and 7 non-pulmonary. Of the pulmonary cases 10 proved to be infectious. In addition to these cases a further 24 notified cases (all pulmonary) were transferred into the borough from other clinics and hospitals. 68 The number of notified cases shown on the clinic register at the 3lst December 1958 was as follows:- Respiratory Non-respiratory Totals Grand Total M. W. Ch. M. W. Ch.. M. W. Ch. 132 102 20 6 6 4 138 108 24 270 The previous year's total was 271. During 1958 there were 8 deaths (6 males and 2 females), 1 higher than 1957. Of the cases removed from the register during 1958, a total of 17 were recovered. 25 were transferred out to other areas, and the remaining 2 were removed as "lost sight of" and "diagnosis not confirmed". The total number of cases x-rayed during the year was 1,388. The London County Council Tuberculosis Health Visitor, seconded to the Chest Clinic, made 1,103 visits to homes in the borough during the year. Each case was visited with the view to tracing the source of infection, and advising on the prevention of the disease spreading, and on giving any other assistance where necessary. Disinfection was carried out by the Finsbury Borough Council in a number of cases at the request of the Chest Physician. Mass Radiography Unit 6D (Information kindly provided by Dr. W.D.R. Rhompson Medical Director). Since the Mass Radiography Unit 6D commenced its operations in May 1950 it has examined (up to the end of 1958) 288,413 males and 205,585 females, making a total of 493,998. During 1958 the Unit examined 39,943 males and 28.016 females. Men and women are now X rayed during the same Session. As all the diagnoses have not been received from the Chet Clinics the final number of active cases of tuberculosis during 1958 is not at present, available, but at the end of April 1959 some 65 active cases of tuberculosis and thirteen cases of carcinoma of the lung had been reported. 69 For about nine months in the year the Unit has operated at the Mass Radiography Centre, 20 Golden Lane, E.C.1. During its mobile period the Unit visited several firms and organisations within its zone including a special survey in Finsbury when the Unit functioned in the Finsbury Health Centre, Pine Street by kind permission of the Public Health Committee of the Borough of Finsbury. We take this opportunity of thanking the Medical Officer of Health and his staff for their helpfulness during the Survey. Over seven hundred firms were circulated and about two hundred and thirty firms participated in this Survey which took place from 19th June to 10th July. Also included in this Survey were firms in the Ludgate Circus area as there is a direct facility to the Health Centre. The Public Sessions, for which no appointments were necessary, arranged during this Survey were not too well attended. The total number of people X-rayed was 4,738. Two cases of active tuberculosis and eight cases of inactive tuberculous lesions were discovered, as well as one case of carcinoma of the lung. At the beginning of 1958 the Unit introduced a new procedure for doctor's referrals by means of which doctor's patients could attend the Mass Radiography Centre without a prior appointment. All doctors in the Borough were informed and given a supply of the specially designed forms. The response from general practioners has been gratifying. The Mass Radiography Service is free, reliable and confidential and the Organising Secretary of the Unit, at the Finsbury Health Centre, Pine Street, E.C.1. (Tel. No. TERminus 0031 Ext.9), will be pleased to send full details of the Service to firms and individuals who may be interested. 70 APPENDIX "A" List of special reports submitted to the Health Committee by the Medical Officer of Health during 1958:- January 13th. Artificial Lighting of Common Staircases. Smoke Control Area. March 10th Mid-day meal Services for the Aged-1957. June 9th Conference Report R.S.H. Eastbourne, 28th April- 2nd May 1958. July 14th Registrar General. Decennial Report 1950-1953 Commonwealth Chest Conference N. A. P. T. l-4th July. October 13th Closure of Royal Free Hospital. Finsbury Employment Scheme. Progress Report and Financial Statement 1957/1958. Review of Manual Staff. Mid-day Meal Service for the Aged (Jan.- June 1958). Absences through Sickness (Five year statement). November 10th Aged Persons Holiday Scheme 1958. Annual Conference of the National Society for Clean Air 1-3rd Oct. 1958. Association of Public Health Inspectors. Blackpool 16th 19th September 1958. Proposal to form Home Safety Committee. December 4th Loneliness. & Monthly Report & Statistical Report for each month. 71 APPENDIX "B" List of special reports submitted to the Housing Committees by the Medical Officer of Health during 1958 January 6th (Report on Medcalf Place Area. (Report on Field Place Area. July 7th (Report on Medcalf Place Area. (Revised) (Report on King Square (No.2) Area. November 10th Report on King Square (No.3) Area. December 1st Report on Donegal Street Area.