AC 4341 The Metropolitan Borough of Finsburn Fin 4o ANNUAL REPORT ON THE PUBLIC HEALTH OF FINSBURY for the Year 1959 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.1. The Metropolitan Borough Of Finbury ANNUAL REPORT ON THE PUBLIC HEALTH OF FINSBURY for the Year 1959 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.1. 2 To the Mayor, Alderman and Councillors of the Metropolitan Borough of Pinsbury. MR MAYOR, LADIES AND GENTLEMEN, I have the honour to present my Annual Report on the state of the Public Health in Pinsbury for 1959, and as has been my good fortune in recent years again state that the health of the Community has remained good and that the health conditions of the Borough have continued to improve. When considering the vital statistics of a small population such as that of Pinsbury, it must be constantly borne in mind that chance fluctuations occurring from year to year make comparisons difficult and conclusions drawn from them may be of little significance. Nevertheless their study is of interest and if proper allowances are made they may serve to indicate progress towards the ideal of health or ways in which it is being undermined. The birth rate was 16.4 after standardisation which was almost identical with that of the country as a whole. Although the standardised death rate of 11.2 was higher than in the previous year, it was still below the figure of 11.6 for England and Wales as a whole. It is pleasing to relate that the high stillbirth and Tuberculosis death rates for 1958, to which I referred in my last Annual Report, did not persist, the former falling to the average rate for the country and the latter well below it. I am particularly happy to report that the Infant Mortality rate of 15.9 formed a low record for the Borough and was probably one of the lowest in the country. The national rate was 22.0. Unfortunately there was however, one death among illegitimate infants but again in this year there were no maternal deaths. The rising deaths, not only in Pinsbury but throughout the country from all forms of cancer, especially lung cancer and coronary diseases, continue to be matters of serious concern. Again I feel that I ought to draw attention to the high number of cases of suicide which have occurred here as elsewhere, although there are only 7 as against 9 in the previous year. Also to draw attention to the high toll of life by car and other accidents, with 7 deaths from motor vehicles and 15 from other kinds of accidents (including one under 1 year of age) as against 4 and 2 respectively in 1958. 3 Infectious diseases, particularly a mild form of Diphtheria and Dysentery, continued their nuisance value causing considerable dislocation in the affected schools and in a few homes, but no serious concern was felt at any time. It might seem from experience that a new modified form of Diphtheria has arisen but there can be no certainty at present, that it may not revert to the virulent form that was so prevalent up to the war, and still occurs from time to time. The various services on behalf of the elderly were continued as before and again large numbers of visitors from other parts of the country and overseas came to see and discuss these services. The shortage in the number of Public Health Inspectors due to vacancies in Establishment which it has not been possible to fill, have caused difficulties in dealing with the many problems of Clean Air, Food Hygiene etc. A most important event in regard to the future health conditions in the Borough occurred when confirmation was given late in the year to the clearance of the slum properties in King Square and neighbouring streets, and before long it is hoped this area will be transformed to provide good housing on modern standards. It was a great pleasure to the members of my department when Councillor J.Trotter who had been Chairman of the Health Committee for many years and had given them constant encouragements in their work, was elevated to the office of Mayor, and I thank him for his friendly help in both capacities. It is also a pleasure to welcome your elevation Mr. Mayor, for you too have been associated with the Health Services tor many years both as a member of the Council and also in your personal undertakings. May I respectfully give you, the Chairman and members of Health and other committees, my cordial thanks for all the help given. Finally, I should like to say that I have received many compliments on the work of my department, and that these in so far as they have been earned, are entirely due to the keen and loyal work by my staff in my name. It is a pleasure to be able to place this on record and to offer them my genuine thanks. I have the honour to be Your obedient Servant, C.O.S. BLYTH BROOKE, Medical Officer of Health. 4 HEALTH COMMITTEE Chairman: Councillor A.SMITH Vice-Chairman: Councillor J.CROSSLEY Aldernan C. A. ALLEN J.P. Councillor A. ASHTON " W. C. COMLEY " W. J. DAVIES " G.A. NUTKINS " J. E. SELLERS " MRS. L. C. TROTTER " MRS, B. WHEARE 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.B., B.CHIR., D.C.H., D.P.H. 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, PA.P.H,I., A. TREVETHICK, M.A.P.H.I. (Resigned 31.8.59). S. J. CASSIDY, (Resigned 28.6.59). J. M. SOUTHWICK M.A.P.H.I., B.G.P. PAYNE, D.P.C., M.A.P.H.I., M.R.S.H., Smoke Control Investigator: D. NATTRESS. (W. E. P. 16.11.59). Student Public Health Inspectors: M.C. ILLMAN M.E.S. POULTNEY (W.E.F. 5.10.59). Senior Meat Inspector: R.S. BARBER, M.A.P.H.I., Senior Laboratory Technician: A.B. CHARLES A.I.M.L. 5 Rodent Officer: P.L. MOSELEY Assistant Rodent Officer: F.J.P. MOODY Administrative & Clerical Staff: A.G. HOLMES (Assistant Administrative Officer). J.T. LINDSAY (Senior Clerical Assistant). MISS J.L. FAULKNER F.W. HAYNES I. PATIENCE R. BLAKELEY MISS E. BUHR M.G. PURDIE Infectious Diseaae Visitor: MRS. R. PEPPER, S,R.N., R.F.N., B.T.A. Nurse Visitor for the Aged: MRS. D. MATTHIE, S. R. N., S. C. M., R. F. N. Health Centre Caretaker: R.NORTH 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 (31.3.59) £2,364,286 Product of a penny rate (1958/1959) £9,094 General rate (1958/1959) 17/4d Pinsbury, 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 Pinsbury 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 properties 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): 34,030 Marriages registered: 263 Live Births: Legitimate Males 303 Females 280 Total 583 Illegitimate " 23 " 22 " 45 Total " 326 " 302 " 628 Birth Rate (standardized) 16.4 England & Wales 16.5 Stillbirths: Legitimate Males 4 Females 7 Total 11 Illegitimate " 1 " 1 " 2 Total " 5 " 8 " 13 Stillbirth Rate: Per 1,000 live & stillbirths 20.3 England & Wales (per 1,000 live & stillbirths) 20.7 Per 1,000 Population (standardized) 0.34 Deaths: Males 204 Females 169 Total 373 Death Rate (standardized) 11.2 England & Wales 11.6 Infant Deaths: 10 Infant Mortality 15.9 England & Wales 22.0 Neonatal Deaths: 5 Neonatal Mortality: 8.0 Illegitimate Infant Deaths: 1 Illegitimate Infant Mortality: 22.2 Maternal Deaths: 0 Maternal Mortality: 0 England & Wales 0.32 Tuberculosis (all forms) death rate: 0.03 England & Wales 1958 all forms per thousand 0.10 Area Comparability factors - Births 0.89 Deaths 1.02 COMPARATIVE STATISTICS 1955 - 1959 1955 1951-1955 1956 1957 1958 1959 1. Population 35,100 35,500 34,870 34,830 34,960 34,030 2. Birth Rate Per 1,000 Population 19.7 18.9 p.a. 20.0 20.7 18.0 18. 5 3. Sex Ratio Male/Female - 1,084 - - - - 4. Illegitimate Birth Rate Per 1,000 Population 1.4 1.2 p.a. 1.4 1.7 1.2 1.3 Per 1,000 Live Births 72 66 70 83 71 72 5. Stillbirth Rate Per 1,000 Population 0.46 0.36 p.a. 0.26 0.49 0.54 0.38 Per 1,000 Total Births 23 19 13 22 29 20 6. Death Rate Per 1,000 Population 10.2 11.3 p.a. 10.2 10.0 9.7 11.2 7. Infant Mortality Per 1,000 Live Births 30.3 24 30.1 22.1 22.2 15.9 8. Infant Mortality Illegitimate Per 1,000 Illegitimate Live Births - 27 - - - - 9. Neonatal Mortality Per 1,000 Live Births 19 17 26 15 17 8 10. Maternal Mortality Per 1,000 Total Births - 0.6 - - - - 11. Tuberculosis (all forms) Death Rate Per 1,000 Population 0.42 0.45 p.a. 0.20 0.20 0.20 0.03 Crude Rates 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 was almost identical with that of the country as a whole. The illegitimate birth rate was slightly higher being 1.3 as against 12 the previous year. Still-births: The still-birth rate was lower at 0.38 as against 0.54 in the previous year. Deaths: Although the standardised death rate of 11.2 was higher than in the previous year, it was still below the figure of 11.6 for England & Wales as a whole. Maternal Mortality: There were no maternal deaths during the year. Infant Mortality: The rate of 15.9 formed a low record for the Borough and was probably one of the lowest in the country. Causes of Death: The break that occurred in 1958 of the steady increase in the deaths from cancer of the lung and coronary diseases, was unfortunately temporary only, and there has been a small increase on the 1957 figure for deaths from cancer of the lung and those from coronary diseases were very similar. The number of deaths from other forms of cancer however, remain almost the same. CAUSES OF DEATHS - 1959 0- 1-1 2-4 5-14 15-24 25-44 45-64 65-74 75-84 85- Total M F M F M F 1. Tuberculosis respiratory 1 1 2. Tuberculosis, other - 3. Syphilitic disease 2 1 3 4. Diphtheria - 5. Whooping Cough - 6. Meningococcal Infections - 7. Acute Poliomyelitis - 8. Measles - 9. Other infective and parasitic diseases - 10. Malignant neoplasm - stomach 2 3 1 1 1 8 11. ,, ,, - lung bronchus 3 13 6 3 1 1 27 12. " " breast 3 1 1 1 6 13. " " uterus 3 3 14. Other malignant and lymphatic neoplasms 1 2 6 9 2 9 4 1 34 15. Leukaemia, aleukaemia - 16. Diabetes 1 1 2 17. Vascular lesions of nervous system 1 3 6 5 2 7 2 26 18. Coronary disease, angina 2 20 7 7 6 10 2 7 61 0- 1- 2-4 5-14 15-24 25-44 45-64 65-74 75-84 85- Total M F M F M F 19 Hypertension with heart disease 2 2 3 2 9 20. Other heart disease 8 2 2 5 8 2 27 21. Other circulatory disease 1 1 4 2 4 1 2 15 22. Influenza 1 1 1 1 1 3 8 23 Pneumonia 1 6 5 1 6 7 1 2 29 24. Bronchitis 2 1 8 8 5 4 8 1 1 38 25. Other diseases of respiratory system 1 4 1 1 1 8 26. Ulcer of Stomach & Duodenum 2 2 1 5 27. Gastritis enteritis, and diarrhoea 2 2 28 Nephritis and nephrosis 1 1 2 29 Hyperplasia of prostate 2 2 30. Pregnancy, childbirth abortion - 31 Congenital malformations 3 1 4 32 Other defined and ill defined diseases 3 1 3 6 2 2 2 2 3 24 33 Motor vehicle accidents 1 1 1 1 1 1 1 7 34 All other accidents 1 1 2 3 1 2 3 1 1 15 35 Suicide 2 2 1 2 7 36 Homicide & operations of war - Total 10 1 4 2 16 100 57 39 45 63 11 25 373 12 Inquests: Inquests were held on thirty residents during the year. The causes of death found were: Road Accidents:- Males - 3, 50, 66, 86 4 Females - 44, 70, 81 3 Accidents from Falls, excluding industrial:- Males - 3(2), 46, 62, 82, 83, 86 7 Females - 86 1 Other Accidents:- Males - 1, 52, 70 3 Females - 6 months, 76, 77, 83 4 Natural Causes:- Male,- 52 1 Suicide:- Males - 42, 43, 67 3 Females - 54, 56, 65, 74 4 Total 30 INFANT MORTALITY 1959 - 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. Congenital malformation - - - 2 2 1 - - - 3 Immaturity 3 - - - 3 - - - - 3 Bronchitis & Pneumonia - - - - - 1 - 1 1 3 Home Accidents - - - - - - 1 - - 1 Totals 3 - - 2 5 2 1 1 1 10 (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 1959. 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 foodstuffs, 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. 1,193 Per & Post-nasal swabs for H. Pertussis 31 Faeces 370 Milk 63 Ice Cream 27 Fish 1 Meat 23 Water 14 Bone Meal 4 Synthetic Cream 1 Sputa 226 Work of the Regional Hospital Board Bacteriology Haematology Biochemistry Number of Investigations Health Centre Clinics 50 259 121 430 General Practitioners 164 223 17 404 834 Note:- Under the heading "Bacteriology" are included:- 1. Pregnancy Tests. 2. W.R. Kahn, P.P.R. & G.C./F.T. 3. Salm.-typhi & para typhi agglutinations. the biochemical investigations mainly involved the estimation of:- 1. Serum Cholesterol. 2. Serum Uric Acid. 3. Acid & Alkaline Phosphatase. 4. Liver function tests. 5. Blood Urea. 6. Blood Sugar. Domiciliary visits by technician. 4. 15 Blood Transfusion The Council continued to co-operate with the National Blood Transfusion Service, by arranging Blood Donation Sessions at the Health Centre. Three sessions were held during the year at which 295 donors attended. 259 were bled and 36 rejected for various reasons. 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 authentica tion 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 1959 178 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 seven persons were buried or cremated under these provisions. Health Education: Health Education activities were continued during the year by the exhibition of public posters and by the distribution of literature from suitable centres. In the latter connection efforts were made with some success to increase the number of such 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. Exhibition Stands situated in the entrance hall of the Health Centre were used to display amongst other publicity matter the publicity sets issued by the Ministry of Health. 16 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. Aged Persons: The Council continued as in past years to take a very active interest in work on behalf of old people during 1959. The services available to men over 65 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 ested 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. 17 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 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, and a considerable sum was saved by aged persons. In this way a holiday was provided during 1959 for 308 persons comprising 38 married couples. 48 men and 184 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. I am of the opinion thataholiday 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 Finsbury Old People's Welfare Committee to enable the meals to be supplied at a cost of elevenpence per head to the aged. During 1959 a total of 19,661 meals were served from such centres. The centres in operation which are open on 3-5 days per 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.l. (January to June). 18 3. Field Lane Institution, 16 Vine Hill, Clerkenwell Road, E.C.1. 4. Claremont Central Mission, White Lion Street, N.1. 5. Finsbury Mission, Moreland Street, E.C.1. 6. Priory Green Community Centre, Wynford Road, N.1. (July to December). (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. 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. The Management Committee had the privilege and honour of welcoming Queen Elizabeth the Queen Mother to "Brooke House", the Work Centre of the Scheme on the 12th November, 1959. 19 (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. Liaison 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 possibly 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 £1,460 in the financial year 1959/1960. There were no compulsory removals to suitable premises during 1959 of persons in need of care and attention under Section 47 of the National Assistance Act, 1958. In one case, an elderly woman of age 84 years, a warrant was obtained but fortunately at the last moment she agreed to enter a hospital voluntarily. 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. 20 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. 380 visits were paid during 1959. 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 chiropody 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 Pinsbury 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 Pinsbury aged persons desiring wireless facilities provided by the above Society. (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. and at the Women's Voluntary Service Meal Centre in Exmouth Market, E.C.1. These have been much appreciated by the elderly persons using the Centres. 21 The Committee have 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 1959. 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 Pinsbury persons accommodated in hospital, who are not receiving regular visits from friends and relations. (rii) Nutritional Supplements: The arrangements continued with Messrs Wander Ltd., Messrs Bovril Ltd., and Messrs Marmite Pood Extract Co. Ltd., whereby "Ovaltine", "Hospital Extract Bovril" "Marmite" and "Jaffa Juice" are supplied to the various organisations represented on the Committee for resale to the aged attending their clubs at a price considerably less than the normal retail price. These Nutritional Supplements have proved very popular with the aged and considerable quantities have been sold to them. 22 (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-seven 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 (Hair-cutting and Shaving) for elderly men who are housebound or bedridden 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 outlook, 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. 23 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 Senior Medical Officer of St. Matthew's Hospital, and her staff. 24 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. Pour samples of water were taken during 1959 for chemical or bacteriological examination. Three of these samples were found to be satisfactory, and one unsatisfactory. The latter was taken as a result of a complaint of rusty water coming from a tap which has been unused for a long time, and it was found to be due to a dirty tank. This tank was otherwise only used to feed a W.C. cistern, and was cleansed and the tap disconnected, a main supply being readily available. Action was required to be taken by the department in 12 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 these swimming baths is chlorinated and samples were submitted to chemical and bacteriological control on 14 occasions during the year, and were found to be satisfactory. Advice was however given in one case on improvements in the methods of purification employed. 25 Sanitary Conditions: A large proportion of the time of the Public Health Inspectors is spent in investigating environmental conditions 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 311 Doors, windows, floors, walls, ceiling, sashcords repaired 522 Watercloset and urinal defects remedied 147 Soil and vent pipe defects remedied 34 Rainwater pipes cleared, repaired or renewed 57 Waste pipes cleared, repaired or renewed 53 Drains cleared 77 Roofs and gutters repaired 252 Water storage tank defects remedied 9 Yard or area defects remedied 31 Washhouse defects remedied 8 Water supply to houses re-instated 12 Water supply laid on to upper storeys of house 7 Firegrates renewed or repaired 38 Animal nuisances abated 4 Miscellaneous nuisances abated 86 Dust receptacles renewed or repaired 96 Accumulations of refuse removed 90 Verminous or filthy articles destroyed 74 Overcrowding cases reported 22 No. of Basement rooms inspected 126 No. of House inspections 1,317 No. of House-to-House inspections 536 Total No. of First Visits for all purposes 7,798 Total No. of Re-visits for all purposes 7,308 No. of Complaints received 1,419 No. of Intimation Notices served 661 No. of Nuisance Notices served 66 No. of Notices served re Pood Premises 51 26 Legal proceedings were instituted under the Public Health (London) Act 1936 for non-compliance with Nuisance Notices in the undermentioned cases:- Date Premises Offence Results 7. 4. 1959 2 Vineyard Walk. Broken waste pipe,guttering and rainwater pipe. Abatement order (7 days). £2 fine. £1. 11s. 6d costs. 7. 4. 1959 3 Vineyard Walk. Broken stair treads and water pipe. - do - 20.11.1959 47 Wilmington Square. Nuisance from birds and animals kept on premises. Abatement order (28 days). £2 fine. £5.5s.0d costs. Appeal to Quarter Sessions subsequently abandoned; £21 costs to Council. In addition the following legal proceedings were instituted:- 4. 10. 1959 47 Wilmington Square. Obstructing the D.C.P.H.I. in the course of his duties. Dismissed. 4. 10, 1959 47 Wilmington Square. Assaulting the D.C.P.H.I. £2 fine. £2. 2s. 0d. costs. Nuisances Requiring Urgent Abatement: During the year 3 notices were served by the Public Health Inspectors pursuant to Sec.27 of the London County Council(General Powers) Act 1955. In each case the Council arranged for the abatement of the nuisances and recovery of the cost of same. Eight notices were also served under Sec.25 of the same Act requiring the clearing of stopped up drains. In 5 cases the owners themselves arranged for the work to be done and in the other 3 instances the drains were cleared by the Council. Public Health (London) Act 1936-Section 40: Two notices under this section were served during the year in respect of defective drains which were subsequently repaired by the Council. 27 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. Seventy-four drainage plans were approved by the Council during 1959, and 1,010 visits were made by the Public Health Inspectors in connection 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 145 Soil & Vent pipes erected 115 Drains or Soil pipes tested 190 Waste Pipes erected 178 Waterclosets erected 323 Urinals erected 77 Lavatory Basins fixed 518 Sinks fixed 234 Baths installed 71 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. Nine visits of inspection were made during the year by the District Public Health Inspector. 28 During the previous 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 circumstances 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, which commenced in 1958 was continued. Shops: A duty was 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. Prom the 1st January, 1959, Sec.18 of the London County Council(General Powers) Act 1958 transferred to the local authority, the additional duties in respect of the provision of washing facilities, and facilities for the taking of meals in a shop by employees. A register of shops is kept in the department and during the year 47 visits were paid by the Public Health Inspectors. In two 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. 29 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 andother Filling Materials Act 1951. A total of 7 inspections of these premises were made during the year. Five samples of various types of filling materials were taken during the year and submitted to the approved analyst Offensive: Trades One premises is at present licensed by the Council as 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 1959 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 enforced by Local Authorites. 71 29 10 - (ii) Factories not included in(i) in which Section 7 is enforced by the Local Authority 1,324 705 55 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises). 9 7 - - TOTAL 1,404 741 65 - 30 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) 36 27 11 9 - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) 3 2 - - - Inadequate ventilation (S.4) 1 - - 1 - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient 1 1 - - - (b) Unsuitable or defective 47 38 - 26 - (c) Not separate for sexes. 2 1 - 2 - Other offences against the Act (not including offences relating to Outwork). 20 11 15 - - TOTAL 110 80 26 38 -- 31 OUTWORK Nature of Work Section 110 Section 111 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. 1,414 - - - - - Household linen 11 - - - - - Curtain & furniture hangings - - - - - - Furniture and upholstery - - - - - - Fur pulling - - - - - - Umbrellas, etc. 23 - - - - - Artificial flowers 24 - - - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 96 - - - - - Brush making 17 - - - - - Feather sorting 22 - - - - - Carding etc, of buttons etc. 48 - - - - Cosaques. Christmas Crackers, Christmas stockings, etc 14 - - - - - Lampshades 3 - - - - - TOTAL 1,672 - - - - - 32 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 1959 was 154 The number of Pinsbury outworkers employed by them was 241 The number of non Pinsbury outworkers employed by them was 3,405 The number of Finsbury outworkers employed by firms outside the Borough was 87 The total number of Pinsbury outworkers employed by firms in or outside the Borough was 328 Of these 77 were firms and 251 homeworkers. Number of visits paid to homes 324 The registers of outworkers which firms are required to maintain are inspected as part of the routine during the inspection of the factories concerned. 33 Atmospheric Pollution: Section3(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 12 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. One such application was received and approved. The number of complaints received by the department during 1959 in respect of smoke nuisances was 38. All these were investigated. The Public Health Inspectors made a total of 546 timed observations on industrial chimneys, in addition to keeping a general watch on smoke emission from boilers. Written notices were sent to 3 firms whose chimneys were emitting dark smoke contrary to the Dark Smoke(Permitted Periods) Regulations, 1958. 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. Measurement of Pollution: The Council continued to co-operate with the Department of Scientific & Industrial Research in the daily measurements 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. Smoke Control Area: During the year provisional approval was given by the Ministry of Housing and Local Government in respect of the Finsbury(No 1) Smoke Control Area. This 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. The official survey was commenced towards the end of the year. 34 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 Motor Taxation Officer of the appropriate authority. 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. In all, 36 such instances were reported to me. 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 Pinsbury such action cannot make more than a minute contribution to the solution. It would seem that it served a useful purpose in most 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. Verminouse Premises and Articles: The Disinfestation service provides for the destruction of all insects and pests including bugs, fleas, cockroaches, beetles and moths. 35 During the year 357 infested premises have been treated and a further 94 sprayed as a precautionary measure, making the total of 451 premises dealt with. The general method of control has been by using 5% D.D.T or similar insecticide, and where necessary a follow-up treatment has been given about 14 days later. In serious cases the bedding has been conveyed to the Health Centre to receive treatment in the steam disinfector. Measures have been taken to control vermin when tenants are moving into this Council's properties. The normal routine has been for the old accommodation and the effects of the prospective tenant to be sprayed a few days before removal, and a similar treatment given to the proposed new accommodation. In cases of a removal to Post War Estates the Council has an arrangement with Contractors whereby the furniture and effects are fumigated with poison gas during transit. 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. 74 such representations were made during the year 1959 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. The arrangements whereby school children were treated on behalf of the London County Council under the supervision of a nurse appointed by them continued until 2nd October 1959, when the nurse responsible for this work was withdrawn by arrangement with the London County Council and the work undertaken by the staff of the Council. 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. 36 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 followed 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) 48 11 65 Total number of treatments given to Shoreditch cases(other than school children) 8 13 21 Total number of treatments given to school children(all the school children treated were not resident in Finsbury; a proportion being from adjacent boroughs) 511 68 579 Total number of home visits paid Nil 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 Rodent operatives. During the year a large number of inspections under this Act have been carried out and it is pleasing to note that no serious rat infestation has either been found or reported. Many of the previously infested business premises have been cleared, but a large percentage of the occupiers have requested that a continuance of the service should be given to prevent re-infestation taking place. The presence of Rattus rattus(Ship rat) is still found in parts of the Borough, but there has been a marked reduction in the numbers and the size of the infestations. 37 In conjunction with the Borough Engineer's Dept., the treatment of sewers has been carried out four times during the past 12 months. On each occasion sodium fluoroacetate(1080) has been used to poison the rats. Again a marked reduction in the number of rats in the sewers has been noticed. One case of Weil's disease was reported, but it is pleasing to note that the sewerman concerned is making good recovery. The co-operation of the general public in so far as rodents are concerned has been good, and it has not been necessary to serve any notice in connection with matters under this Act. Number of complaints received Business premises 52 Domestic premises 193 Additional Infestations found Business premises 982 Domestic premises 160 Number of premises treated Business premises 1,034 Domestic premises 353 Total number of visits to Business premises 14,626 Domestic premises 8,904 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. Six licenses were issued by the Council during 1959 viz, 3 in respect of shops, 2 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 5 formal visits being made. Heating Appliances: The Heating Appliances(Firequards) Act 1952 and the Regulations made thereunder are enforced by the Health Dept. 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 appliences 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. 38 Apart from many casual inspections 9 official visits were made under the Act during 1959. 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. In the past it has been the practice other than in the more exceptional cases, i.e., smallpox, typhus etc., to spray the rooms and contents with diluted formalin, but in April 1959 consideration was given to a memorandum issued by the Ministry of Health as to improved uses of formaldehyde in fumigation. Consequently it was decided that in such cases as smallpox, typhoid, paratyphoid, poliomyelitis and diphtheria, together with any other case where such methods were deemed advisable, to carry out a fumigation of the infected rooms with a mixture of formaldehyde and potassium permanganate, after a thorough sealing had been carried out. Between May and December 1959, 30 premises, including two whole sections of a London County Council School, were so treated. During the year disinfection was carried out in the following instances for the reasons set out:- Suspected Diphtheria 60 Scarlet Fever 73 " Poliomyelitis 7 " Dysentery & Gastro enteritis 20 Measles 59 " Whooping Cough 2 Tuberculosis 7 Scabies 1 On behalf of St. Marks & other hospitals 30 Miscellaneous I.D. 38 297 39 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 4,204 articles were treated. Goods, mostly clothing, were also disinfected on behalf of certain export firms as follows: Number of articles 22,930 Number of times disinfecting plant charged 72¾ Nuisance from Pigeons: In order to control the number of pigeons in the Borough, licences 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 1959 two licences were in force. Mortuary: The Corporation of London was so good as to make available mortuary accommodation at their Golden Lane Mortuary for Fisbury infectious and emergency cases. 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. There is a total of 46 registered premises at present in existence in the Borough. In all 42 visits were made to hairdressers and barbers during 1959. 40 SECTION D HOUSING General: The estimated number of dwellings in the borough at the end of 1959 was 9,745 consisting of 3,179 houses, 6,548 flats and 18 huts. The houses are mostly privately owned. Ownership of the flats is as follows:- Finsbury Borough Council 1,807 London County Council 559 City Corporation 266 Metropolitan Police 126 Housing Associations 2,644 Private Ownership 1,146 New Accommodation: The following flats were constructed during 1959:- By the Pinsbury Borough Council Nil By Private Owners: 33/35 Myddelton Square(conversion) 10 flats Arlington House, Arlington Way 19 flats Two certificates of habitation under Section 95 of the Public Health(London) Act 1936 were issued during 1959 in connection with the new or converted premises mentioned above. In addition, the redevelopment of the extensive Galway Street Clearance Area, was well under way at the end of the year. Housing Act 1957: 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. 41 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 126 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. 1959. 129 222 No. of representations under consideration on 1st Jan. 1959 80 153 No. of representations made during 1959. 10 19 No. of representations under consideration on 31st Dec. 1959. 71 137 No. of undertakings accepted 2 3 No. of closing Orders made during 1959. 17 32 No. of closing orders determined during 1959. 3 5 No. of closing orders in force on 31st Dec. 1959. 142 248 Unfit Parts of Houses(other than Basement Rooms): From time to time it has become necessary to take action in respect 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 Booms No. of closing orders in force on 1st Jan. 1959.5 10 No. of representations under consideration on 1st J an. 1959. 6 11 No. of representations made during 1959. 2 5 No. of representations under consideration on 31st Dec. 1959 6 11 No. of undertakings accepted during 1959. No. of closing orders made during 1959. 2 5 No. of closing orders determined during 1959. 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 house. 42 including certain unoccupied premises. Since the war Demolition or Closing Orders had been made in respect of 188 premises. The following was the position at the end of 1959:- No. of closing orders in force on 1st Jan. 1959 45 No. of representations under consideration on 1st Jan. 1959. 3 No. of representations made during 1959. 29 No. of representations under consideration at 31st Dec. 1959 11 No. of closing orders made during 1959. 21 No. of demolition orders made during 1959 - No. of premises subject to demolition orders demolished during 1959 - No. of premises subject to closing orders demolished during 1959 1 No. of closing orders determined during 1959 as a result of reconstruction - No. of closing orders in force on 31st Dec. 1959 65 Repair of Houses under Section 9 and 10: No action has been taken since the war under these Sections. Tabular Statement prepared in accordance with the Housing Consolidated Regulations 1925-1932. No. of houses considered on inspection to be unfit for human habitation. 41 No. of houses wherein defects were remedied by informal action. - No. of representations made with a view to:- (a) serving notices requiring the execution of work. - (b) making demolition or closing orders 41 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 40 No. of houses in respect of which undertakings were accepted. 1 No. of houses demolished 1 43 Legal Proceedings: During the year proceedings were instituted against the owner of No. 278, City Road in respect of the use of the basement rooms in contravention of a Closing Order. The summons was adjourned sine die to enable the owner to complete the work required to render the rooms fit for human habitation Clearance Areas: The position obtaining at the end of the year in respect of individual Clearance Areas is summarised below:- 1. St. James Row-8 premises: Five houses still remained to be cleared. 2. Galway Street-168 premises: Redevelopment of this area was in active progress. 3. Herbal Hill/Herbal Place-7 premises: The Clearance Order was confirmed by the Minister in respect of 2 premises. Action under Part II was recommended for the others which was subsequently taken. 4. Field Place-7 premises: The rehousing of the tenants had not yet been commenced. 5. Medcalf Place-15 premises: The rehousing of the tenants had not yet been commenced. 6. King Square(No.l) Area-26 premises: The Council's Clearance Order, was confirmed with one modification. 7. King Square(No.2) Area-292 premises 8. King Square(No.3) Area-25 premises A public enquiry was held in May and these Compulsory Purchase Orders were subsequently confirmed by the Minister with modification. 9. Donegal Street Area -42 premises: An inspection was carried out and a representation made to the Council in June 1959 of this area, and a Clearance Order was made by the Council. 10. 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, and rehousing of the tenants by the London County Council was carried out at the end of the year. 44 As a result of the extensive action taken during the last four years, 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: In all, a total of 536 house to house inspections were made during the year mainly by the two Inspectors engaged on resurveying the King Square areas. 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. 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 started of overcrowded families, coming to the notice of the Department. Since then details of some 78 families have been recorded, in 20 of which the overcrowding was subsequently abated by rehousing. At the end of the year there were 58 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. Pour 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 each instance the overcrowding was subsequently abated. 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. 45 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 118 Cases reconsidered on new medical certificates 91 Cases reconsidered 2 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 (original lettings) 7 Rehoused by Finsbury Borough Council from clearances areas 5 Rehoused by Finsbury Borough Council from requisitioned property 31 Rehoused by London County Council (including clearances areas) 191 Rehoused in New Towns 23 Rehoused by City Corporation 5 In addition many transfers within Council property took place, in order to make the best use of existing accommodation. 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 1959 are set out in the following table:- No. of applications for Certificates of Disrepair. 1 No. of decisions not to issue Certificates. Nil 46 No. of decisions to issue Certificates:- (a) in respect of some defects. 1 (b) in respect of all defects. Nil No. of Undertakings given by Landlords. Nil No. of Undertakings refused. Nil No, of Certificates issued. 1 No. of applications by landlords for cancellation of certificates. 3 No. of objections by tenants to cancellation of certificates. 1 No, of decisions to cancel certificates in spite of objection. Nil No. of certificates cancelled. 2 No. of applications for certificates as to the remedy of defects: (a) from Tenants. 2 (b) from Landlords 5 No. of such Certificates issued: (a) to Tenants. 2 (b) to Landlords. 5 Certificates of Disrepair issued pursuant to Housing Repairs & Rents Act 1954: No. Applications by landlords for cancellation of certificates. 5 No. of objections by tenants to cancellation of certificates. 3 No. of decisions to cancel certificates in spite of objection. Nil No. of certificates cancelled. 2 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. One formal application only was received by the Council during the year in respect of proposed works of improvement, which was approved. Outline applications or informal enquiries were made with regard to 8 other premises. Two applications for "standard grants" were received but were subsequently withdrawn. 47 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 159 Public Houses 124 Off-licence premises(retail & shops) 10 Breweries, Distilleries, etc. 13 Factory canteens 78 Commercial canteens approx. 50 Dairies and milk distributors etc. 134 Ice Cream sellers 162 Confectioners(sweets) shops 75 Bakers shops 24 Bakehouses(i) Basement 7 16 (ii) Above ground 9 Grocers & provision shops(retail) 42 Provision merchants(wholesale) 12 Cheese importers(wholesale) 3 Greengrocers & fruiterers 22 Fish shops 3 Fish curers 3 Fried fish shops 9 Eel & pie shops 6 Poultry dealers(wholesale) 3 Butchers shops(retail) 37 Wholesale butchers & offal dealers 35 Wholesale horseflesh dealer 1 Bacon factories 7 Sausage factories 2 Sausage casing merchants 3 Meat extract factory 1 48 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 1959 was 3,012 and to food stalls 4,352. Food Hygiene Regulations: Experience has shown that constant supervision of restaurants, cafes and snack bars is necessary in order to ensure that the basic principles of the Regulations are being complied with at all times. Education by means of personal contact with persons engaged in food preparation and handling especially with regard to personal hygiene and general cleanliness of premises and equipment, has been found to be the most effective method of obtaining some measure of compliance. Undoubtedly the majority of the owners of this type of food business are willing to co-operate in the administration of the Regulations, but they are often hampered by the nomadic type of person available for employment in their business, which does not permit them to instil into their employees the need for personal and general cleanliness. Many of the eating establishments in the Borough are structurally old and unfortunately the terms of the tenancy, in many cases, does not encourage the expenditure of large sums of money in improvements and modern equipment; this naturally adds to the need for more thorough inspection and supervision. The total number of visits made to restaurants, cafes and snack bars during the year was 1,930. Adulteration of Food: In 1959 a total of 620 samples of foods and drugs were submitted to the Public Analyst. Of these, six were formal and the remainder were informal samples. 49 Details are appended. Foods: No. of Samples obtained Milk 30 Cream & Condensed Milk 26 Butter, margarine & fats 9 Cheese 13 Sausages 7 Meat & Pish Products 125 Soups 12 Sauces, Vinegar, etc. 23 Condiments, spices & flavourings 56 Jams & Preserves 21 Jellies & Gelatine 18 Dried Fruit 29 Cake & Pudding Mixtures 27 Fresh Fruit & Vegetables 2 Cereals 12 Coffee, Cocoa, Tea & Extracts 12 Non-alcholic drinks 38 Canned fruit and vegetables 44 Cakes & Bread 26 Sugar Confectionery 41 Drugs: Medicines 21 Powders 5 Tablets 11 Ointments, lotions 12 620 Food Complaints: Twenty-three complaints were received from members of the public during the year in respect of alleged unsound or adulterated 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 three of which were successful. In the remaining cases, actions appropriate to the circumstances were taken. 50 Legal Proceedings The Council instituted legal proceedings during the year as follows: - Date Premises Offence Result Under Section 2 of the Food & Drugs Act 1955, 25. 6.59 65 Amwell Street Selling sausage containing a domestic fly.. Fine £l Costs £l 6s Od. 2. 7.59 68 Chapel Market Selling a mouldy apple turnover. Case dismissed. 2. 7.59 68 Chapel Market Selling a coffee cup cake containing a foreign body (piece of tile) Pine £3 Costs £2 2s Od. 15.10.59 22 Lizard Street Selling bread containing part of human nail., Case proved. Defendant discharged unconditionally., Costs £7 7s Od. Under Section of the Food & Drues Act 1055. Pine £10 Costs £2 12s 6d.. 20. 8.59 52 Old Street Selling designated milk from unregistered premises., 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 lists: - Brawn 1 Cooked meats 5 Fish cakes 1 Canned Hams 4 Ice Cream Ingredients 8 Kippers 1 Meat Pies 3 Minced Beef 1 Sausages 7 Skinless Chicken 2 33 51 Ice Cream Ingredients: A complaint was received from an adjoining Borough regarding a sample of ice cream alleged to have been manufactured in Finsbury and stated to be contaminated with B.Coli (Faecal). The method of manufacture was closely examined and samples submitted of all the ingredients used in the process. As a result certain recommendations were made which it is hoped will prevent further complaints. Sausages: Samples of the various Continental types of Sausages were submitted for examination and no adverse reports were received, Canned Hams: Inspection and examination of this type of canned food has continued. The position with regard to canned hams has improved, but owing to the potential danger in respect of the use of suspect cans for the preparation of sandwiches and other uncooked meals, close attention must continue to be paid to the canned hams. Milk: 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 1959 involved 231 visits. Summary: No. of dairies on register at end of 1959. 9 No. of distributors on register at end of 1959 125 No. of transfers approved during 1959. 8 No. of new applications approved during 1959 6 No. of premises removed from register during 1959. 10 Designated Milk Licences issued: Dealers Supplementary Tuberculin 58 25 Pasteurised 76 25 Sterilized 78 29 52 Quality of Milk: No of samples submitted to Public Analyst 30 No. of samples reported as adulterated Nil Average fat content of all milk samples 3.7% Average non-fatty solids content 8.72% No. of samples submitted for bacteriological examination 58 No. reported as satisfactory 58 Channel Island Milk: Since the introduction of the statutory standard for Channel Island Milk, samples have been taken during the year and the average for all these samples were as under:- Pat content 4.4% Non-fatty solids 9.06% 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 150ºF for 30 minutes. The standard of ice cream has generally been satisfactory. The number of visits paid to ice-cream premises by the Public Health (Food) Inspectors during 1959 was 55. Summary of Premises: No, of premises registered for manufacture. 22 No. of premises registered for storage & sale. 138 No. of premises registered for storage only. 2 No. of new registrations during 1959. 12 Summary of Samples: No. of bacteriological samples taken. 19 No. reported as fully satisfactory. 12 No. reported as unsatisfactory. 4 No. reported as indeterminate. 3 53 Meat Inspection; In the vicinity of the Smithfield Meat Market London, E C 1 there are a considerable number of wholesale butchers and offal shops, bacon and provision warehouses, wholesale game, poultry and rabbit shops, all of which are regularly inspected by the meat inspector. Several of these wholesale butcher shops deal in old cow. bull and sow carcasses, which are used in the manufacturing trade for sausages, pies etc. Several new premises have been opened during the course of the year, and due to the nature of this business a rigid inspection is maintained to ensure that diseased carcasses are not passed on to the public. A systematic examination of imported frozen carcasses of mutton and lamb was made for Caseous Lymphadenitis in the Public Cold Air Stores. Consignments of Continental and Scandinavian offals and tinned hams continue to be imported into the Borough and these are regularly inspected for disease and unsoundness. The collect ion of unsound meat and other foodstuffs continued to be collected very satisfactorily by Messrs Henson and Burbidge Ltd., Matusa Works, Beckton, who render down this condemned foodstuff for technical purposes, such as tallow and fertilizers. During the year 215 certificates were issued for the export of meat, bacon, sausages, meat essence etc, A total of 1,048 visits were made to the retail butchers shops and stalls in the Borough, A further consignment of 373 bags of Uruguayan Beef Livers were examined for hydatid cysts, - Echinococcus Granulosus and 648 Beef Livers were found to be parasitic and condemned approx imately 15% of the consignment. Bakehouses: As a result of the 1958 quinquennial survey, 4 basement bakehouses have now been closed and the remaining 7 have satisfied the requirements of the Council and certificates of suitability were granted at the beginning of the year. In addition there are 9 other bakehouses in use in Finsbury A total of 107 visits were paid during 1959. 54 Registered Food Premises: In addition to ice-cream premises, the number of premises registered under Section 16 of the Pood & Drugs Act 1955 for the manufacture of sausages, or potted pressed, pickled or preserved foods is 72. The various types of business carried on at these premises are as follows: - Sausage Manufacturing 31 Sausage Smoking 1 Meat Pickling 39 Offal Cooking 5 Cooked meats or 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 103 visits were paid by the Inspectors during 1959, Unfortunately it was found necessary to take action in respect of a sausage manufacturing establishment under Section 19 of the Pood & Drugs Act 1955, which provides for cancellation of the registration of premises used for specific purposes which fail to conform with the requirements of the Act. The occupier was given ample opportunity to render the premises satisfactory, but failed to carry out the necessary works and eventually appeared before the appropriate Committee, and was later informed that it had been decided to cancel the registration in respect of the premises in question. No appeal was made by the defendant. The general conditions under which the types of food preparation and preservation are carried out in the Borough, are reasonably satisfactory. Improvements have been effected during the year, and constant supervision is being maintained. Street Markets: There are four market streets situated at Chapel Market, Exmouth Market, Whitecross Street and Farringdon Road, A total of 590 stalls were licensed by the Council at the end of 1959 of which 160 were licensed for the sale of foodstuffs, A rota of week-end inspections of street markets operates and a total of 4,342 inspections were made including daily visits. 55 An attempt was made during the year to obtain the co-operation of the stall holders in respect of one of the street markets, but it has not at the moment shown to have much effect, and unless some improvement is evident in the near future, it will be necessary to exercise more stringent measures to obtain compliance with the Regulations. The chief concern is in connection with smoking and the provision of facilities for the personal cleansing of the stallholders* 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 159 licensed premises, all but 35 of which are public houses. The number of inspections carried out during the year was 126 of which 72 were visits in connection with the transfer of licenses and other matters, under the licensing Act 1953. These inspections are also used for the investigation of matters requiring remedy under the Public Health (London) Act 1936 The majority of the public houses also carry out a considerable catering business and attempts have been made to improve the arrangements in respect of the preparation and handling of food at these establishments in accordance with the requirements of the Pood Hygiene Regulations 1955. Pharmacy and Poisons Act 1933: A list of sellers of Part II Poisons under the Act is kept by the Council. In 1959 36 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 procedure laid down under Section 180 (8) of the Public Health (London) Act 1936 of notifying 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 56 A total of 149 visits were made by the Pood Inspectors during the year in connection with the examination of unsound food and 734 certificates were issued in respect of foodstuffs considered unsound. These figures exclude any reference to meat inspection the details of which are contained in a separate part of the report. Details of the unsound food surrendered during the year are as follows:- 1 bs. Meat (diseased). 24,170 Meat (unsound). 15,451 Meat Products. 7,973 Bacon. 8,219 Offals (diseased & unsound). 51,690 Poultry. 7,736 Game. 554 Rabbits. 219 Canned Foods. 34,700 Dried fruit. 154 Confectionery. 2 Cheese. 6,266 Fats. 80 Preserves. - Cereals. 461 Eggs . 36 Fruit & Vegetables. 293 Fish. 102 Miscellaneous. 1,554 Total 159,660 71.27 tons. 57 Food Poisoning: There were 29 individual cases notified during the year, of which 2 were due to Salmonella Newport. 2 were due to Salmonella Thompson. 1 was due to Salmonella Typhi-Murium. The distribution of cases throughout the year was as follows Jan. 0 No organisms identified. Feb. Mar. 1 Apr. 4 2 cases Sal. Newport. May 5 2 cases Sal. Thompson. June 1 July ° 1 case Sal. Typhi-Murium. Aug. 9 Sept 2 Oct. 3 No organisms identified. Nov. 0 Dec, 3 The following individual cases were investigated and the possible cause identified. February - Pork No organisms detected. April Candy Floss No organisms detected. April - Fish Sal. Newport isolated. April - Spam Sal. Newport isolated. August - Shrimps No organisms detected. September - Chicken No organisms detected. 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 58 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 1959 was 2,064. The following table shows the incidence of notifiable diseases in 1959. Cases treated in Hosp. 74 49 12 3 2 13 70 1 - 2 1 - - 33 - 1 3 264 65- 29 - - 1 3 - - - - - - 2 - 1 - - 36 45-64 yrs. 17 1 3 4 6 - - - - - - 1 - 14 - - 46 25-44 yrs. 11 - 9 1 6 - 1 - - - - - 1 1 10 - - 40 15-24 yrs. 7 1 4 - 4 - - - - - - 1 5 - 1 1 - 24 5-14 yrs. 1 43 17 - 3 - 220 1 - - 1 - 8 45 _ - 6 345 1-4 yrs. 8 5 12 - 5 7 334 - - 2 - - - 23 - - 8 404 Under 1 yr. 2 - - 1 2 11 30 - 1 - - - - 7 - - 3 50 All Ages 75 50 45 7 29 18 585 1 1 2 1 1 17 69 26 1 17 945 Acute Pneumonia Diphtheria Dysentery Erysipelas Food Poisoning Gastro-Enteritis (under 2 yrs). Measles Meningococcal Infection Ophthalmia Neonatorum Poliomyelitis (Paralytic) Poliomyelitis (Non-Paralytic) Puerperal Pyrexia Scabies Scarlet Fever Tuberculosis (Pulmonary) Typhoid Whooping Cough Total 59 Diphtheria: In all 50 cases were notified during the year and 30 carriers were discovered. The infection followed the same pattern as in the previous year causing mild symptoms in some cases and none in others, making it impossible to distinguish accurately between true cases of diphtheria and carriers who were either healthy or had some other mild illness. There was only one serious case and no deaths. One sporadic nasal carrier was discovered in a boy aged 5 who was staying with relatives in Pinsbury, whilst his mother was in hospital with a Diphtheritic infection, but was normally resident elsewhere in London. He was admitted to hospital and did not return to this Borough, A considerable outbreak in one of the schools in the Borough occurred in the summer. The majority of the cases occurred before the school holidays and by the time these took place it was hoped that the infection had been completely eliminated. Unfortunately however a few more cases and carriers were discovered when the school re-opened, including 6 carriers who were involved before the holidays (3 of these had been regarded as cases of Diphtheria and 3 as carriers, and all had had 3 negative swab examinations before the holidays). It was not clear whether these incidents arose because the organism had persisted intermittently throughout, or because re-infection had occurred. As on the previous occasion the Divisional Medical Officer of the London County Council by agreement, undertook the responsibility for the routine swabbing of all school contacts. All school absentees and all contacts including, where known, the playmates of all those found to be harbouring the causative organisms were followed up and swabbed by the Borough Council staff, as were those carriers treated at home. During this outbreak 64 individuals in all were found to have Diphtheria or to be carriers, in addition to 1 case of Diphtheria and 8 carriers found among children who attended the school, though resident in neighbouring boroughs. Of the 64 individuals concerned 43 including 2 adults were regarded as cases of Diphtheria, and 21 including 3 adults were regarded as carriers. The only serious case was that of the adult aged 16 who had been immunised and had had a booster injection. 60 In the late autumn a further outbreak occurred in an Islington school which may or may not have been connected with the outbreak already recorded. This involved 15 Pinsbury residents of whom 6 children were regarded as cases and 4 adults and 5 children were regarded as carriers. It is interesting to note that 8 of these persons were members of one family. All the cases of diphtheria and the carriers were treated in hospital with the exception of one case already recovering and 6 adult carriers, and 1 child carrier, where special circumstances were considered to render this unnecessary and arrangements were made for treatment to be given by the General Practitioners concerned. The immunisation state of the individuals concerned is given in the following table:- Cases of Diphtheria Carriers Children Adults Children Adults Fully immunized with Booster 10 1 6 . Fully immunized with full course. 17 - 10 - Total immunized 27 1 16 - Partly immunized or immunization doubtful 14 - 3 - Non-immunized. 6 1 4 7 47 2 23 7 The Organism isolated from a number of individuals Was fully investigated and found to be a toxigenic variety of Coryne Bacterium diphtheriae mitis. Smallpox There were no cases or contacts reported. Enteric Fever (1) Typhoid: There was 1 case notified in a female aged 21. After an indefinite illness she was admitted to hospital as a case of septic abortion. She did not respond to treatment, and on investigation was found to be suffering from typhoid. She made a Satisfactory recovery and specimens taken at three-monthly inter-" yals remained negative. The family and contacts were placed under supervision and specimens from them were examined and no spread of the disease occurred. The source of the infection was not discovered. 61 Enteric Fever (11) Paratyphoid; There were no cases or contacts reported. Malaria: There were no cases or contacts reported. Meningococcal Infection: One case of Septicaemia was notified in a girl aged 9 years. She made a good recovery. The family was placed under supervision and no other cases arose. Acute and Post Infective Encephalitis: There were no cases or contacts reported. Acute Poliomyelitis: 3 cases were notified - 2 paralytic and 1 non-paralytic. The details of these cases were as follows:- 1. A boy aged 1 year 9 months who developed paralysis of the left leg in the early summer. He was treated in hospital but recovered and made good progress with, however, some residual weakness. 2. A girl aged 4 who developed severe paralysis involving arms, legs, chest, back also in early summer. She was treated in hospital and placed in a respirator for about 5 weeks. She made very slow progress and remained in hospital till the end of the year, but had recovered little movement. 3. A boy aged 8 developed a moderately severe attack but without paralysis in the early summer. He was treated in hospital and recovery was complete. No contact between any of these cases, or between cases Nos. 1 and 3 and any other known case was discovered. Case No.2 attended a school which a child contact of a fatal case also attended. This latter child was later discovered to have the virus present in the stools. Both were in the same class. Ophthalmia Neonatorum: There was 1 notified case which was not severe and made a good recovery. Puerperal Pyrexia: There was 1 notified case. In addition 16 cases were reported which developed among Finsbury residents in hospitals outside the borough. There were no deaths, and all made satisfactory progress. 62 Erysipelas: There were 7 cases notified. The parts affected were:- Pace 5 Leg 1 Ankle 1. Three were moderately severe, and four were mild. Three cases were removed to hospital* All made a satisfactory recovery. Scarlet Fever: There were 69 notified cases. Five were moderately severe and 64 were mild. 31 cases were removed to hospital. There were no complications and all made a satisfactory recovery. Measles: There were 585 cases notified and in addition five cases were otherwise reported giving a total of 590. Of these 436 occurred in the first Quarter. In all 5 cases were severe and 315 moderately severe. 52 cases were removed to hospital. Complications occurred in 18 cases (6 of Pneumonia and 12 of Bronchitis), but all made a satisfactory recovery. Whooping Cough: There were 17 cases notified. 10 were moderately severe and 7 mild. Two cases were removed to hospital. There were no complications or deaths, and all made a satisfactory recovery. Acute Primary and Influenzal Pneumonias. There were 75 notified cases of these pneumonias, 65 were of acute primary pneumonia and 10 of acute influenzal pneumonia. 19 were severe and 56 moderately severe. 74 were removed to hospital and 1 was nursed at home. There were 3 deaths - all acute influenzal pneumonia cases. Scabies: 17 cases were notified during the year. Dysentery: There were 45 cases notified. Of these 13 were clinical cases with positive bacteriological findings, 14 were symptonless cases with positive bacteriological findings, 18 were moderately severe clinical cases with negative bacteriological findings. In all 11 cases were removed to hospital. 63 Gastro-Enteritis. (Under 2 years): There were 18 cases notified; 9 were moderately severe and 9 were mild. 11 were removed to hospital, and all made a good recovery. Diseases not Notifiable in Finsbury: The following information was received from Local General Practitioners and other sources. Gastro-enteritis (over 2 years): There were 9 cases reported. No organisms were isolated in any case. Rubella: There were 11 cases reported. No contact with any woman in early pregnancy was discovered. Mumps: There were 45 cases reported. No complications occurred in these cases. Chlcbenpox: There were 70 cases reported. Glandular Fever: 1 case in a girl aged 6 years, who made a satisfactory recovery. No contact with any other case was discovered. Infective Hepatitis: No cases or contacts were reported. Influenza: No cases were reported. Food Poisoning: Please see Section "E' - Food. 64 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 M---11119377231 Pulmonary F--1--12321111 M - - - - - - - - - - - - Non-Pulmonary F - - - - - - - - - - - Total - - 1 1 2 2 12 6 9 8 3 44 These figures do not necessarily correspond, due to technical reasons with those shown in the report of the Chest Physician. The Non-pulmonary cases include:- 1 Right shoulder; 1 Pelvis. The notification rate for all forms of tuberculosis was 12.92 per 10,000. The total number of cases remaining on the register after adjustment for deaths and transfers was, on 31st December, 1959. Mal es Females Total Pulmonary 143 104 247 Non-Pulmonary 10 6 16 l53 110 263 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 was one death from pulmonary tuberculosis as follows:A male aged 48. There were no deaths from non-pulmonary tuberculosis. 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. 65 Finsbury Chest Clinic: (Information kindly provided by Dr. W.D.R. Thompson, Chest Physician). During the year 1959 a total of 2,088 patients were seen in the Chest Clinic. Of this total, 122 attended for the first time as contacts of notified cases, and a further 108 were re-examined as routine contact checks. The number of new cases of tuberculosis taken on the clinic register during the year, amounted to 25, all of which were pulmonary. 9 of these pulmonary cases proved to be infectious. In addition to these cases a further 15 notified cases (14 pulmonary, 1 non-pulmonary) were transferred into the borough from other clinics and hospitals. The number of notified cases shown on the clinic register at Ihe 31st December, 1959 was as follows:- Respiratory Non-Respiratory Totals Grand Total M W Ch M W Ch M W Ch 140 99 15 7 5 3 147 104 18 269 The previous year's total was 270. During 1959 there were 5 deaths (males), 3 lower than 1958. Of the cases removed from the register during 1959, a total of 9 were recovered. 23 were transferred out to other areas, and the remaining 4 were removed as "diagnosis not confirmed". The total number of cases X-rayed during the year was 1,539. The London County Council Tuberculosis Health Visitor, seconded to the Chest Clinic, made 1,009 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. 66 Mass Radiography Unit 6D: (Information kindly provided by Dr. W.D.R, Thompson, Medical Director). During 1959 the Mass Radiography Unit examined 42,996 males and 24,114 females - making a total of 67,110, Up to the end of 1959 the Unit has examined 561,108 persons since it commenced operations in May 1960. 66 cases of significant tuberculosis have been discovered during the year under review as well as 14 cases of carcinoma of the lung. All clinics have recorded their sputum findings and 22 cases had a positive sputum. The Unit has functioned at the Mass Radiography Centre, 20 Golden Lane, E.C.I, for about nine months in the year, and during the remaining months it visited firms, etc, within its zone, vis. the City of London, and the Metropolitan Boroughs of Finsbury and Shoreditch, Of the firms examined during 1959 many were small and new firms for it has long been the practice of this Unit not to overlook the smaller firms. Since the introduction of our new procedure the number of doctors' referrals has greatly increased and the service is greatly appreciated by those general practitioners who use it. The function of a Mass Radiography Unit is to discover tuberculosis and other chest ailments while in the early stages when more easily curable. Examinees, other than doctor's referrals, attend the Unit by prior appointment as being of great convenience to all concerned, and are informed of the result of their examination. The service is free, reliable and confidential, and is available to all those (above the age of 15) who are either working or living within the Unit's zone. Pull information can be obtained from the Organising Secretary, Mass Radiography Unit 6D, Finsbury Health Centre, Pine Street, E C 1. (Tel. TERminus 0031 Ext 9). 67 APPENDIX "A" List of Special Reports submitted to the Health Committee by the Medical Officer of Health during 1959. January 12th Underground Bake houses - Factories Act 1937. Grants - Voluntary Organisations, February 9th Smoke from Vehicles on the Highway Midday Meal Service for the Aged 1958 April 13th Smoke Control Areas. June 8th Smoke Control Areas. 66th Annual Conference (Harrogate April 1959) Royal Society of Health. July 13th "Health Museum", October 12th Progress Report & Financial Statement of Finsbury Employment Scheme for the Elderly. Midday Meal Services for the Aged. Transport - Elderly Persons. Conference 1960. "Social & other needs in Finsbury". November 9th Review of Manual Staff. Absences through Sickness - Manual Staff. Aged Persons Holiday Scheme 1959 Annual Conference. Association of Public Health Inspectors. Fluoridation of Public Water Supplies Clean Air Conference, London 20th 23rd October 1959. November 23rd The National Safety Congress 1959 Accidents in the Home. & Monthly Report and Statistical Report for each month APPENDIX "B" List of Special Reports submitted to the Housing Committee by the Medical Officer of Health during 1959, July 6th Donegal Street Area - revised representation.