AC434, Metropolitan Porough of finsburp ANNUAL REPORT ON THE PUBLIC HEALTH OF FINSBURY for the Year 1960 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. sbram t he Metropolitan porough of finsburp ANNUAL REPORT ON THE PUBLIC HEALTH OF FINSBURY for the Year 1960 BY C. O. S. BLYTH BROOKE, M.D., 8.5., D.P.H. Medical Officer of Health FINSBURY HEALTH CENTRE, PINE STREET, LONDON, E.C.I. To the Worshipful the Mayor, Alderman and Councillors of the Metropolitan Borough of Finsbury. MR MAYOR, LADIES AND GENTLEMEN, I have the honour to present to you my annual report for 1960 and in so doing I have tried to continue my report for 1955 in which I outlined the progress in the conditions for Health in Finsbury since the war and in particular during the past five years, by referring to the progress made since then In my report for 1956,, I incorporated a short account abstracted from the first annual report that I had been able to trace, namely that of the Medical Officer of Health for the Vestry of St James for 1856, exactly a hundred years before, to illustrate the remarkable changes that had transformed the District. Even in the past five years, many further changes have been brought about in the outward appearance of the Borough, by the demolition of much slum property, the clearance of sites and by new and renovated buildings of various kinds Not only has this occurred in outward appearances but possibly consequent upon them there has been, I believe,, a subtle change difficult to describe in the character of the Borough VITAL STATISTICS The population has continued to fall and in 1960 was estimated to be 33,710, The Birth Rate has varied slightly with an average of about 17 1 which was the rate for 1960,, whereas the National rate was only 16 1 in 1956 but has gradually risen to an identical rate as that in Finsbury. The Death Rate nas remained well below the National figure and has not varied greatly, for 1960 it was 10.1. In my report for 1957 I was abie to comment on the Registrar General decennial report which shewed Finsbury to have third lowest Infant Mortality Rate in the country for the years 1950 1953 1 am happy to report now that this rate has fallen yet further, and for 1960 only 15 6, and must be among the very lowest, and contrasts with the National rate of 21 7 I have elsewnere in the report referred to certain causes which have been responsible for a proportionately nigh, ana others for a proportionately low, death rate in Finsbury,during the last five years, I should like to mention here three causes of a high death rate, which give rise to disquiet:> 2 (a) Cancer of the Lung responsible for 136 deaths (mostly in men) in Finsbury from 1956 1960 has increased to alarming extent everywhere, but the incidence has been higher in the Borough than in most other places In spite of its recognised association with smoking we unfortunately remain ignorant of its basic causation- (b) Motor Traffic Accidents responsible for 19 deaths Although the problem is not within the normal purview of Public Health, one cannot but be concerned at this wastage of human lives, (c) Suicide responsible for 28 deaths These deaths must surely be evidence of our failure to establish a firm integration of all members of the community and to deal adequately with mental instability in our midst GENERAL HEALTH I am perfectly satisfied that the general health of Finsbury is not only good but better than it has ever been, and at least as good as that which prevails in similar areas, Nevertheless, I regret that no statistical evidence is available to support this view Although no practical and real measure of health may be possible,, yet more information ought to be available about the extent of illnesses and disabilities occurring in the area, for without it Health services are left without a guide as to the directions which their efforts should follow This isthe re1teration of a similar cry 150 years ago, which led to the present system of death registration which is now insufficient for our advanced needs INFECTIOUS DISEASES Diphtheria reappeared in two outbreaks in 1958 ana 1959 respect ively after many years absence from the Borough It however adopted the cloak of a mild infection and would seem again to have been eradicated Finsbury nas been fortunate in that the number of cases of Poliomyelitis have been comparatively few although in some residual disabilities have been marked In spite of a continuing rather nigh death rate from Tuberculosis which may be partly due to extraneous causes, I am satisfied that complete control of this disease, once so rampant, is gradually coming about- Whooping Cough is no longer a serious threat to infant life, though on occasions it has left various chest disabilities in its wake Dysentery and Measles have continued to cause considerable nuisance though the attacks have usually been mild- 3 SPECIAL ACTIVITIES Your council has energetically pursued a policy of slum clearance and redevelopment according to a carefully prepared plan, Unfortunately initial delays occurred in the development of smoke control areas, but before the end of 1960, the first order had been made (although not confirmed by the' Minister) for a considerable part of the South of the Borough abutting on the City Smokeless Zone An intensive campaign was successively carried through in 1956 and 1957 to improve the general standards of cleanliness in the cafes ana restaurants, and to ensure that they complied with the Pood Hygiene regulations. Much concern was expressed in 1960 with the injurious effects of noise on health and ways in which this may be reduced are being sought The services for the elderly established by your Council, or sponsored by it which have received recognition from far and near have been further consolidated and extended. PROGRESS AND THE FUTURE Mr- Mayor, I feel that you may look back over the past few years and together with your council may be happy in the strides that have been made towards establishing healthy surroundings in which the coming generation may have better opportunities to enjoy a full measure of Health, Nevertheless, I feel that we ought to consider carefully the ways in which the health of our community can be further safeguarded and the factors which militate against its more ample fruition. I would suggest that the prevalence of much litter constantly scattered about the Borough, is tending to destroy delight in tidiness, cleanliness and even beauty,, all ingredients of Mental Health; that much noise which could be prevented if its harmful effects were generally appreciated, is retarding mental activity; that the lack of contact with nature due to the cost and difficulty of transport to country places is depriving many of a true understanding of life; and that want of a closer family life and parental responsibility is being conducive to juvenile delinquency. I believe that we ought to seek more intently to educate both young and old in the general principles of health preservation, and the use of leisure as well as to provide better opportunities for recreational pursuits of all kinds, We should also inculcate a greater concern for the welfare of neighbours and eradicate the spirit of snobbish isolationism to be found in all classes. As a background we need a deeper philosophic foundation in the teachings of religion and a firmer sense of our responsibilities, 4 ACKNOWLEDGEMENTS From year to year, Mr, Mayor,, I have made acknowledgement to your predecessors of the help and support given to me by the Council, members of Committees, and their several Chairman: it gives me pleasure to reaffirm my gratitude on this occasion; without that mutual confidence which has existed much less would have been accom plished. I regret that I cannot here express my sense of obligation individually to the many members of my staff, who have given me throughout loyal support; their work has constantly enhanced the reputation of my department. However, I do thank them sincerely I have the honour to be Your obedient Servant, C. 0. S. BLYTH BROOKE, Medical Officer of Health. 5 HEALTH COMMITTEE Chairman: Councillor C. Payne Vice-Chairman: Councillor J Crossley Alderman C. A. Allen, J. P. Councillor A, Ashton W,J. Davies " G.A. Nutkins " R,J. Redrupp J E, Sellers " Mrs L.Co Trotter Mrs. B. Wheare Medical Officer of Health: C. 0, S. Blyth Brooke M. D., B. S., D. P. H. Deputy Medical Officer of Health: M.M. Bates, M.A., M.D„. B. Chir., D.C.H., D.P.H. Public Analyst: C. Harcourt Wordsworth, B, Sc. Public Health Inspectors: A,J. Truslove, M,A.P.H.I. (Chief Public Health Inspector). J. Lewis, M. R. S. H. E, Ditchburn, M.A.P.H.I. S, G. Fisher, PA, P.H.I. J. M. Southwickj M.A.P.H.I. (Resigned 10.4,60). B.G.F. Payne, D.F.C., M.A.P.H.I. M.R.S.H. (Resigned 13,12.60) M. C. Illman, M.A.P.H. 1., M.R.S.H. (W.E.F. 28.7.60). J.A. Daniel, M.A. P. H.I. (W.E.F. 16,6.60). Smoke Control Officer: R A. Cummins. (W.E„F, 29.8.60). Student Public Health Inspectors: M. E. S. Poultney Do Nattress 6 Senior Meat Inspector: R.S. Barber, F.A.P.H.I. Senior Laboratory Technician: A„B. Charles, P.IJ.L.T, 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 P. W, Haynes I. Patience R, Blakeley Miss E. Buhr J. A, Smith. (W.E. P. 30.5.60) M. G. Purdie. (Resigned 6.5.60) Infectious Disease 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.P.N. Health Centre Caretaker: R. North 7 SECTION A PHYSICAL FEATURES AND SOCIAL CONDITIONS GENERAL: Area of the Borough (acres) 587 Population 1951 census 35,370 Population Density 60 Rateable Value (31.3.60) £2,834,927 Product of a penny rate (1959/60) £11,234 General rate (1959/1960) 17/- Finsbury, one of London's 28 Metropolitan Boroughs, is situated in Central London The Borough as a whole is built up and congested and possesses very few open spaces, all of which are small in size. A large part of the Borough, particularly in the South East, is essentially industrial and the day population of the Borough has been estimated as between 150,000 and 200,000 The industries accommodated are very varied and include, besides the clock and watch trade which has been associated with Clerkenwell for many years, the scientific and optical instrument making, jewellery, printing and clothing trades. The residential parts of the Borough are mainly working class in character- During the late war 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 8 PRINCIPAL VITAL STATISTICS Population (Mid year estimate) 33,710 Marriages registered 255 Live Births Legitimate Males 315 Females 282 Total 597 Illegitimate " 24 " 21 " 45 Total 339 303 642 Birth Rate (Standardized) 17.1 England & Wales 17.1 Stillbirths Legitimate Males 5 Females 5 Total 10 " 1 " 1 " 2 Total 6 6 12 Stillbirth Rate: Per 1,000 live & stillbirths 18.3 England & Wales (per 1,000 live & stillbirths) 19.7 Per 1,000 Population (standardized) 0.32 Deaths Males 194 Females 143 Total 337 Death Rate (Standardized) 10.10 England & Wales 11.5 Infant Deaths 10 Infant Mortality 15.6 England & Wales 21.7 Neonatal Deaths 7 Neonatal Mortality 10.9 England & Wales 15.6 Illegitimate Infant Deaths 0 Illegitimate Infant Mortality 0 Maternal Deaths 1 Maternal Mortality 1.5 England & Wales 0.39 Tuberculosis fall forms) death rate 0.12 England & Wales 1959 all forms per thousand. Respiratory 0.07 Other forms 0.008 Area Comparability factors - Births 0.90 Deaths 1.01 COMPARATIVE STATISTICS 1951-1960 1951-1955 1956 1957 1958 1959 1960 1956-1960 35,500 34,870 34,960 18.0 34,030 33,710 34,480 1. Population 34,830 19.00 18.9 pa. 20.0 19.2 18.5 2. Birth Rate Per 1,000 Population 20.7 1,113 - - - 3. Sex Ratio Male/Female 1,084 - 1.7 83 0.49 22 10.0 22.1 - 1.3 1.4 1.3 1.4 1.2 4.Illegitimate Birth Rate Per 1,000 Population Per 1,000 Live Births 1.2 pa. 66 72 70 74 71 70 0.36 0.40 0.38 0.26 0.54 0.36 pa. 20 19 21 13 19 29 10.2 11.2 10.2 9.7 10.0 11.3 pa. 22.2 15.9 15.6 21.0 24 30.1 - - - - 29 - 27 26 8 16 17 17 15 10.9 - - - - 1.5 0.30 0.6 0.12 0.20 0.20 5. Stillbirth Rate Per 1,000 Population Per 1,000 Total Births 6. Death Rate Per 1,000 Population 7. Infant Mortality Per 1,000 Live Births 8. Infant Mortality Illegitimate Per 1,00 Illegitimate Live Births 9. Neonatal Mortality Per 1,00 Live Births 10. Maternal Mortality Per 1,00 Total Births 11. Tuberculosis (all forms) Death Rate Per 1,00 Population 0.03 0.15 0.45 pa. 0.20 Crude Rates have been given in every case. A (fash indicates that numbers are too small for the calculation of a significant rate POPULATION The estimates have shown a slight progressive decline but the census report for 1961 must be awaited before any definite statement can be made. BIRTHS: The birth rate has remained about the same as the national rate, rising slightly with the latter in 1960 The proportion of illegitimate births has risen slightly from 66 to 74 per thousand live births for the period 1956 to 1960 The figure for 1960 was 70: the national rate has been about 50, STILL BIRTHS: The still birth rate has varied slightly but has been about the same as that for the country DEATHS: The death rate has been consistently a little below the national rate and well below it in 1960, MATERNAL DEATHS: There was unfortunately a maternal death in 1960 and the rate is in consequence very high for this year, but there were no maternal deaths from 1956 to 1959 and the rate for the five year period is about average. INFANT MORTALITY: Again in 1960 the infant mortality rate reached a further low record of 15.6 well below the national rate of 21.7, The rate has fallen consistently from 1956 when it was above the national rate. The neonatal rate has fallen at the same time and has reached the very low figures of 8 0 in 1959 and 10.9 in 1960 as against tne national rate of 15,6, The illegitimate infant mortality rate was however slightly higher for the five year period, than for the previous quinquennium, namely 29 as against the previous figure of 27, There were however no deaths of illegitimate infants in 1960 The causes of infant deaths in 1960 are set out in the table given Over the five year period nearly half the deaths were on account of immaturity or associated with, and this remains here as elsewhere one of the gravest problems in the preservation of infant life. The other principal causes were congential malformations and birth injuries. The detailed analysis is little different from that •for the country as a whole 11 CAUSES OF DEATH: The tables of the causes of death for the years 1956 1960 have been analysed and compared with the causes of death generally through out the country for the years 1956-1959 (those for 1960 are not yet available) Owing to the small total number of deaths and the variations from year to year, over reliance must not be placed on the significance of any deductions from them especially as they are too small to allow of comparisons being made of the age of individuals in relation to particular causes of death. There were few discernable trends during the five years though that of slight increase in the deaths from coronary disease and of slight decrease in the deaths from cancer of the breast may be mentioned The earlier increase in the number of deaths from cancer of the lung has not been continued, but the level remains very high in relation to the total number of death from all causes. The table appended gives some details as to deaths from certain causes over the five year period, where these have been either more frequent or less frequent than in the whole country. Where there has been little variation from the national rate and where the number of deaths has been too small for proper comparison, these have been omitted Syphilis has, however, because the proportion is so much greater than elsewhere and leukaemia because the deaths from this cause do not seem to have increased to anything like the same extent. as they have done in other places, although the total numbers in both cases are small. DEATHS 1956-1960 Cause of Death Total Number Rate per million Population Finsbury England & wales (Approximate) A Causes with a high proportion in Finsbury: Tuberculosis - all forms 26 151 100 Syphilis 15 57 25 Cancer of Lung 116 673 400 Bronchitis. Pneumonia & other respiratory diseases 308 1,810 1,300 Suicide 28 163 115 B Causes with a low proportion in Finsbury: Cancer of stomach 42 244 320 Cancer of Breast 22 141 210 Vascular diseases of central nervous system 156 905 1,650 Heart Diseases (excluding coronary disease) 204 1,185 1,900 Circulatory Diseases 61 354 500 Leukaemia 5 29 53 12 INQUESTS Inquests were held on sixteen residents during the year The causes of death found were. Ro ad Accidents:- Males - 63, 23 2 Females - 55 1 Accidents from Falls, excluding industrial:- Males - 51 1 1 Females - 67 Other Accidents:- Males - 69, 67 2 Females - 85, 79, 4 months 3 Open Verdict:- Male - 73 1 Suicide: - Males - 82, 75, 26 3 Females - 71, 35 2 Total 16 INFANT MORTALITY 1960 - CAUSES OF DEATH Total under 1 yr 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 Immaturity 6 - - - 6 - - - - 6 Birth Injury - - 1 - - - 1 - - - Other defined causes 1 - - 1 1 1 - - 3 - 7 - - - 7 2 1 - 10 Totals - (In this table the international rules for classification have not been strictly followed). 13 CAUSES OF DEATH - 1960 - 0- 1- 2-4 5-14 15-24 25-44 45-64 65-74 75-84 85- Total M F M F M F n n n u 1 2 n n n rt n 1-r 2 1. Tuberculosis respiratory 2 1 2. Tuberculosis, other 1 3. Syphilitic disease 1 - 4. Diphtheria - 5. Whooping Cough - 6. Meningococcal Infections - 7. Acute Poliomyelitis - 8. Measles 1 2 1 - 9 9. Other infective & parasitic diseases 1 2 i 2 1 10. Malignant neoplasm - stomach 5 2 1 19 7 3 11. " " lung bronchus 1 1 1 5 2 12. " " - breast 1 1 1 7 1 13. " " - uterus 12 2 6 6 39 4 14. Other malignant and lymphatic neoplasms 1 7 1 15. Leukaemia, aleukaemia 9 - 12 16. Diabetes 3 2 u 3 45 9 17. Vascular lesions of nervous system 10 7 1 2 7 55 18. Coronary disease, angina 18 10 0- 1- 2-4 5-14 15-24 25-44 45-64 65-74 75-84 85- Total M 6 F M F M F i 6 4 3 2 3 1 1 j 48 1 1 1 rr 4 11 2 5 - n 1 5 19. Hypertension with heart disease 40 20. Other heart disease 2 1 2 1 2 1 2 12 21. Other circulatory disease 1 3 3 1 22. Influenza 3 1 17 23. Pneumonia 1 5 1 6 8 6 29 24. Bronchitis 1 2 1 25. Other diseases of respiratory system 1 1 1 3 26. Ulcer of stomach & Duodenum M 11 - 27. Gastritis, enteritis & diarrhoea 1 3 1 28. Nephritis and nephrosis 1 1 29. Hyperplasia of prostate 5 1 30. Pregnancy, childbirth, abortion 1 1 8 3 31. Congenital malformations 6 2 3 28 32. Other defined and ill-defined diseases 2 2 3 2 3 33. Motor vehicle accidents 1 M 17 1 1 2 12 34. All other accidents U 51 5 u LJ 35. Suicide M 51 36. Homicide & operations of war - 337 10 2 4 71 59 - 2 11 Total 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 continued experience has confirmed the view expressed for many years, that the occupation by the Health Department of a separate building of a suitable character to which the puDlic may readily come for help and advice in regard to the numerous health and social problems with which they are often faced, and where some services are available is of great value 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 bacteriological examination of milk and other ana has operated in close association with the Central Public Heaitn 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 when the disease has Deen prevalent Owing to the deficiency in the establishment of the Public Health Inspector.-, full use of the laboratory has not been made, for the examination of foods This was particularly the case in 1960 The services of the Laboratory Technician have been available for a limited number of Domiciliary visits when these have been called for- The following tables set out the work undertaken in the years 1956 1960 1.6 WORK OF THE PUBLIC HEALTH DEPT. 1956 1957 1958 1959 1960 Ear, Nose & Throat Swabs. 27 9 390 1,193 106 Per Nasal Swabs 165 78 31 31 86 Faeces 1,380 588 2,082 370 1,841 Sputums 261 195 198 226 138 Milk 66 78 59 63 9 Water 8 5 8 14 19 Ice Cream 30 40 19 27 Meat 22 27 7 23 6 Various Foods 6 61 23 5 24 WORK OF THE REGIONAL HOSPITAL BOARD 1956 1957 1958 1959 1960 Bacteriology 90 126 295 214 147 Haematology 322 373 372 482 502 Biochemistry 3 22 159 138 153 TOTAL NUMBER OF DOMICILIARY VISITS 17 31 17 4 12 Note:- Under the heading "Bacteriology" are included:- 1. Pregnancy Tests. 2. W.R. Kahn, PPR & 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. 17 BLOOD TRANSFUSION The Council has continued throughout the past syears to co-operate with the National Blood Transfusion Service by arranging Blood Donation Sessions at the Health Centre The number of sessions held and the number of volunteers has remained fairly constant during the period under review Three sessions were held during 1960 at which 325 donors attended, 289 were bled and 36 were rejected for various reasons INTERNATIONAL CERTIFICATES OF VACCINATION AND INOCULATION. These being an international form of certificate of vaccination and inoculation, require the signature of the medical practitioner issuing the certificate to be authenticated by the Medical Officer of Health In 1960 204 certificates were so authenticated. There has been little variation from year to year of this service. BURIAL OR CREMATION OF THE DEAD Each year arrangements have been made for the burial of a few persons who have died or who have been found dead in the Borough where no suitable funeral arrangements have been made In 1960 three such burials were arranged HEALTH EDUCATION Health Education in 1960 followed very similar lines to that adopted in the previous four years under review, namely by the exhibition of public posters and by the distribution of literature from suitable centres Efforts were made with some success to increase the number of distribution centres by circularising all the voluntary organisations,, churches etc in the Borough asking for their co operation, which was in most cases readily given Healtn 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 Book marks incorporating information on various health education subjects have also been distributed with the co-operation of the Libraries Department, 18 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 111 ELDERLY PERSONS The Council has continued its very active concern and support in connection with all schemes designed to assist in the care of the ageing, towards their better health and to enable them to enjoy their later years Some of these Schemes have been established as part of the Council' s general health services, and others have been encouraged and developed by means of generous grants to voluntary organisations responsible for them, amounting in all to £5„046 during the financial year 1959/60. The work of these organisations has been co ordinated as far as possible by the Pinsbury Old People's Welfare Committee consisting of representatives of most of them and of the Health Committee, and of which I have been privileged to be Honorary Secretary It has operated therefore in very close association with the Services provided by the Council and has received from it financial grants towards its expenses In addition to co ordination it has also undertaken responsibility for the services indicated with the initials F 0 P W C in brackets below a, Visitors, A nurse visitor has been 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 A social worker was appointed in 1957, and an assistant Social worker in 1960 by the Finsbury Old People's Welfare Committee, wren the main duties of aiding all the aged to obtain such benefits as might be available from any source, and to give personal help comfort and friendship wherever possible In this and other ways information has become available as to most of the elderly in need, but occasionally others are found whom had they been known earlier might have been helped (b) Meal Services„ (i) Club meals. Many of the elderly, 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. 19 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 elderly During each year from 1956 to 1960 about 20,000 meals were served in this way except in 1958 when the numbers fell to 17,500. In 1960 the figure was 20, 062 The following centres have been in operation for 3 to 5 days weekly throughout the five years, except where otherwise stated. (i) Women's Voluntary Service, 68 Exmouth Market, E C, 1- (li) British Red Cross Society, Old People's Centre,9 Walmsley St E.Col. (Closed for Meal Services June 1959). (iii) Field Lane Community Centre, Cubitt St., EC 1 in connection with Field Lane Institution, 16 Vine Hill,, EC 1 (iv) Claremont Central Mission, White Lion Street, N 1„ (v) St Clements Hall, Lever Street, E C.l. (Closed in July 1958 because of lack of voluntary help). (vi) Finsbury Mission, Moreland Street, E. C. 1. (Opened early in 1959)„ (v11) British Red Cross Society, Community Centre Priory Green Estate, N 1 (Opened in July 1959 and closed in 1960 because of poor attendance). Mobile Meals Aged persons unable, by reason of sickness and infirmity to attend one of the meal centres have been supplied with a hot meal delivered to their home by the "Invalid Meals of London' 1 Until 1958 this voluntary organisation operated in close association with the Borough Council, and a substantial grant was made to them Since then they have operated independently Their main object is to supply invalid meals to the sick rather than normal meals to those who merely, on account of physical infirmity, are unable to go out Nevertheless many meals have been supplied to such persons The service is however restricted Towards the end of 1960 theFinsbury Old People's Welfare Committee decided to undertake experimentally on a small scale, the delivery of frozen whole meals which only required to be heated in the impervious envelope in which they were delivered by placing it in boiling water in a saucepan for 15 minutes The idea was that this service might be valuable for those not within the purview of the "Invalid Meals of London", but yet were unable to attend a centre or to cater adequately for themselves The service was initiated in the last few days of tne year. 20 (c) Nutritional Supplements (F 0 P V,C,) 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, (d) Sheltered Employment. The scheme inaugurated as an experiment in 1951 to provide sheltered employment for those of the elderly, who are unable to continue in normal employment and yet are able to undertake suitable light work for 2 hours daily has continued to play an important role in the provisions made for this group of the community. It is administered by a special voluntary organisation known as the Finsbury Employment Scheme for the Elderly, and has received generous support from the Council, The Work Centre named "Brooke House" situated at 39/41 Gloucester Way, E,C,I. made possible as a result of a number of generous bene factory,and opened by the late Lord Horder in November 1954, has proved eminently satisfactory in every way. In 1960 a small branch scheme for about 10 persons was opened in the Community Centre on the Priory Green Estate, It is hoped that this will expand 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, 21 (e) Holidays; The Council has continued this service designed to preserve the Health of the elderly by allowing those sufficiently able to do so to benefit from a stay of two weeks in the country or at the seaside Applications were invited by public announcement and through variously interested clubs and societies; such applications were made to the Health Department, Each applicant was required to contribute a small sum towards the cost, normally ten shillings per week, but varied slightly in some cases. Arrangements were then made for the holiday at one or other of the holiday homes run by voluntary organisations A grant was made to each of the homes or to the Finsbury Old People's Welfare Committee, 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 consid erable sum was saved by aged persons Holidays were provided in this way for about 300 persons each year, and in 1960 for 318 comprising 40 married couples, 42 men and 196 women at a total cost to the council of £2,508 Holidays were provided at Ramsgate, Brighton Bognor, Leigh on Sea Clacton Margate and Worthing The Scheme has proved an unqualified success as was evidenced by the large number of appreciation letters received and in other ways I am of the opinion that a holiday benefits considerably the permanent health of the individual, builds up the body for the winter months and is of considerable value socialogically All this apart from the pleasure and enjoyment given to the aged persons at the time (f) Laundry 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 numoer of about 45 to 50 persons have in this way been abled to retain their clothes and bedlinen in a wholesome condition 22 (g) Bathing; Baths have been provided free of charge at the Health Centre to those aged persons who, on account of their condition, cannot use the existing Public Baths. An attendant has been available to help with dressing and undressing and to render assistance if this is necessary In 1960 a bathing attendant was appointed to visit the infirm elderly in their own homes, and there wash and bath them as possible, and according to the circumstances. This has proved a very valuable service and has helped many of the elderly to keep themselves clean, comfortable and respectable. It has also relieved the pressure on the Home Nursing Services which previously undertook these duties for those who might be described as sick. It does not of course, undertake the bathing of those for whom a skilled and trained nurse is required It was found that the attendant could undertake about 20-24 cases each week; in most cases bathing was carried out weekly for those for whom the service was provided (h'j Cleansing; Occasional cleansing services have been provided for those aged persons where their accommodation has been allowed to become so dirty and 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, (i) Chiropody, (1) There has been throughout the five years, a satisfactory chiropody clinic in the Health Centre, administered by the London County Council, which has been available for the elderly as well as for others, (2) A domiciliary Service (F.0.P.W.C.) has been 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, An increasing number of visits have been paid,, from 245 in 1956 to 475 in 1960, and pensioners of all ages up to 96 have received benefit from them, 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, ana do things for themselves, and so retain the independence essential to their mental and physical well being 23 (j) S. OS, Cards (F.O.P.W.C. ): The SOS Card Scheme operated by the Committee in the borough has functioned very successfully as in the past. No use however was made of the Scheme during the years under review 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 it. Clubs; There are a number of clubs for the elderly in the Borough, and most of these have remained available throughout the period under review, The majority of them meet once a week and sometimes more often, and various social activities are organised in connection with them Several are closely associated with religious organisations,, The following may be listed Womens' Voluntary Service, 68 Exmouth Market, E C 1. Clerkenwell & Islington Medical Mission,, Woodbridge Street E. C. 1. Field Lane Community Centre 32 Cubitt Street. W.C.1. Finsbury Mission, Moreland Street, E C 1„ Leysian Mission, 112 City Road E C . Claremont Central Mission, White Lion Street, N.1. British Red Cross Society, Walmsley Street. E. C.l. Priory Green Community Centre N. St, Luke' s Church, Old Street., E.C.1?. St James (Pentonville) Womens Fellowship Pentonville Roaa N. 1. St- James (Clerkenwell) Clerkenwell Close, E CI. Holy Redeemer Church, Exmouth Market, E,C 1„ Sunshine Club, 33 Lloyd Baker Street, W C.l„ Special mention however, should be made of that organised by the British Red Cross Society at 9 Walmsley Street, EC 1 The pren consist of the basement kitchen) ground floor and Ist floor of a medium sized terraced house. These are open most days of the week for club members and other elderly to make use of as they wish thougn in fact the numbers using them have been small„ Towards the end of 1959 the ground floor rooms until then used for a dinner service were reconditioned and opened as a snuggery for the elderly to sit and gossip round the fires, 24 In 1960 a special afternoon meeting was arranged for the house bound elderly and special transport has been arranged for them This provided a valuable amenity for those not normally able to take advantage of facilities and services available for the more active elderly (1) Compulsory Removal It has fortunately been necessary during the five years, in only two cases to use the provisions of its National Assistance Act. or of the Amending Act (under which both Medical Officer of Health and his Deputy are empowered by the Council to act in urgent cases) to secure the compulsory removal of any aged persons These two cases occurred in 1958 and concerned men of 84 and 75 years living alone under very insanitary conditions. In neither case was actual force needed to effect the removal, and in one case it is worthy of record that the man who had refused adamantly the doctor, the nurse and the Medical Officer of Health, was induced to leave voluntarily and happily by the kindly tact and banter of a young constable present to assist in the removal. OTHER ACTIVITIES FOR THE ELDERLY I. Ambulance (TO P V C. . An ambulance was presented to the Finsbury Old People's Welfare Committee through the generosity of the Rotary Club (Finsbury) in 1959 This has been used for the conveyance of the infirm aged to the club already referred to and for other purposes on behalf of the elderly It has also been loaned to other organisations providing recreation for the handicapped In addition, due to the non availability of more suitable transport, it has also been used for the delivery of domicil lary meals 2 Barber and Hairdresser Service i'F.O PIC. In 1956 the Committee inaugurated a Domiciliary Barber service (Haircutting and Shaving) for elderly men who were housebound or bedridden This was essentially a restricted service for men for whom no other arrangements were possible. There was no charge to the elderly and the Committee paid the Barbers' fees In 1960 however, some difficulty was experienced in operating this scheme as the two hairdressers who had been doing the work,, were not able to do so at that time,, and at the present time endeavours are being made to make suitable arrangements with other hairdressers 3 Christmas Parcels I CJ: Many of the elderly have been provided each Christmas with a parcel of groceries and other suitable gifts by the clubs or churches with which they are associated, orby the Finsbury Old People's Welfare Committee which has distributed about 300 each year. 25 4. Coal (F.0.P.1.C): 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 to provide coal to the aged in an emergency. 5. Mending Scheme for the Aged (F,O.P W,C,,: This scheme provides in association with the Finsbury Employment Scheme for the Elderly, a Mending Service for the aged There is a definite need for this service which effects repairs to such items of clothing as socks, underclothes etc, and is particularly useful in respect of the male aged living alone Substantial use had been made of the Scheme, There is no charge to the aged. 6. Ophthalmic Service: As there were many elderly in need of glasses or other ophthalmic treatment who found it too much trouble to make an appointment at a hospital or other clinic, a special arrangement was made in 1956 by the courtesy of Moorfields Eye Hospital whereby appointments could be made on their behalf and for them to be seen with a minimum of waiting in the hospital Each year till 1959 about thirty old persons,, and in 1960 18, had their eyes examined under this Scheme. A few domiciliaiy visits by an optician have also been arranged, where the aged person has been nousebound 7. Outings, Christmas Parties etc. A number of outings in the summer, and parties and visits to a theatre in the winter have been arranged, and given by many organisa tions and individuals interested in the Welfare of the Elderly, as Dy the clubs in the Borough In some cases the arrangements have been made by the Old People's Welfare Committee 8. Patients in Hospitals S Residents in Homes (FOP W C An endeavour has been made to keep in touch with Finsbury old persons in hospital and Welfare Homes, and so help them to feel that they are not forgotten, by sending them birthday ana Cnnstmas cards and by arranging friendly visitors for them This hasish nas however proved difficult and has only been successful to a limited extent 9. Redecoration of Accommodation (F.0.P.W.?, C Through the good offices of an international voluntary organis ation whose members have been willing to give their services, several old people were enabled to have their rooms redecorated in 1957,, '958 and 1960 The cost of materials used and other incidental expenses were borne by the Committee In a number of cases, organisations arranged their own voluntary labour, and the FOP I.C. has born cost of the materials used 26 JO Vueless (F. O„Po W„C„ J; (i) The Wireless for the Bedridden Society The Committee has continued to act as Sponsor in respect of applications received from bedridden or housebound Finsbury aged persons desiring wireless facilities provided by the above Society A number of new cases each year have thus been able to enjoy the sound programmes (ii) Wireless Relay Services, The Committee has continued to finance the provision of a Wireless Relay Service for the use of the hundred and twenty aged persons participating in the Finsbury Employ ment 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. The Committee entered into an agreement in 1956, 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 bed ridden, 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, On an average in 1960 eighteen persons have enjoyed these facilities (either relay or a wireless set where Relay Service does not operate) at any one time 11. various( F.O.P. W.C.): (1) Co operation has continued with the London Electricity Board, and North Thames Gas Board to have electricity and gas appliances checked for possible defects and meters lowered, where they had been placed in places difficult for the elderly to reach (11) Brown walking sticks, foot stools and shopping baskets on wheels have been issued on loan to elderly persons unable to afford them,, where they have been needed (ill) A special news sheet called Finsbury Tidings" was issued and distributed free of charge to elderly persons in December 1960 bearing a Christmas message from the Mayor Arrangements were made for a special service for the elderly in St Paul's Cathedral in 1957, This was attended by nearly 2000 elderly from all parts of the diocese of London 27 SECTION C SAMITRY CIRCUMSTANCES WATER: The Borough is freely supplied with water from trie Metropolitan Water Board As this supply is under continuous control no regular examinations are made of it In many houses and block dwellings, supplies of drinking water as well as water to be used for other domestic purposes, are oDtamcd from storage tanKs Generally speaking it may be said that these tanks are in good general condition and the majority of them are satisfactorily covered, and do not require attention except on rare occasions Prom time to time inspections are carried out to ascertain their condition, mainly on complaint, and if necessary steps are taK&n to enforce cleansing and adequate covering, in accordance with thfl Council's Bye=laws During the course of the 5 year period several samples were taken for bacteriological examination and only one of these, in 1959, was found to be unsatisfactory This was from a tank which had remained unused for a long time, and was only brought into use to feed a W C cistern. The Metropolitan Water Board give regular information whenever water supplied to any premises are withdrawn This may be because the premises have become vacant or because of defects causing waste of water or of unpaid rates. Investigations are made by the department, and where appropriate, action is taken to have the supply reinstated It has occurred on a diminishing number of occasions and In 1960 only seven instances occurred and in each case the supply was restored There are at present only 3 deep wells known not to be fully sealed in the Borough still. These are situate in the premises of 1, Royal London House, F insbury Square 2. City Gate House, Finsbury Square 3, Bovril Ltd , Old Street, The first two premises mentioned are partly in Crown occupation,, and samples of the water are regularly examined either by this depart ment or elsewhere, on behalf of the Ministry of Works That on the premises of Bovril Ltd,, is not in actual use That, until 1960, on the premises of Nicholsons Gin was examined from time to time and found on all occasions to be perfectly satisfactory it was however fully sealed off in 1960, The total number of water samples examined bacteriologically in 1960 was 6, 28 SWIMMING BATHS: (i) The Council maintains two establishments, one in Merlin Street and one in Ironmonger Row, both of which provide in addition, to a large indoor warmed swimming pool, slipper baths and facilities for the washing of clothes That in Ironmonger Row is particularly well equipped in every way, and contains a Turkish Bath section. There is in addition at this establishment, a special childrens pool of limited dimensions and even depth This pool is not greatly used except at fortnightly intervals when a club consisting of members interested in helping spastics and cured cases of poliomyelitis, helps them to recover some degree of movement and to enjoy the freedom possible for them when in water. The pool is specially heated on these occasions, and a very valuable service is rendered in this way. The water is circulated, filtered and chlorinated. Apart from careful day to day control of chlorination by the Baths Superintendent, the regular examination of the water has been carried out by the Laboratory Technician The results have uniformly shown a satisfactory degree of alkalinity and of free chlorine and the sample to be sterile The laundry at the Ironmonger Row establishment where persons may undertake their own washing, was renovated and re-equipped during 1960 to form a very excellent department on modern lines, and is now of a very high standard. (ii) There is an indoor swimming pool open to the public during the summer months at Northampton College The water here is circulated, filtered and chlorinated but the plant in use is somewhat out of date, and detailed control has from time to time been somewhat difficult. Regular chemical control is maintained by the College authorities Chemical and bacteriological examinations have also been made from time to time by the Laboratory Technician none of which have given rise however, to concern though the alkalinity and amount of free chlorine have occasionally been found to be low and complete sterility not maintained. SANITARY CONDITIONS I am happy to be able to report that there has been a continuing improvement during the past 5 years of the prevailing environmental conditions in the homes of the residents This has been consequent for a large part on the disappearance of many of the slum properties It has reflected a diminishing number of complaints made to the department from 1,680 in 1956 to 920 in 1960. In spite of a deficiency in the establishment of Public Health Inspectors it has been possible to investigate all complaints and when these have appeared urgent,without 29 delays Generally speaking, the policy adopted has been to press for the abatement of nuisances by informal action rather than to take legal proceedings In this way it has been possible to preserve better relations with landlords and thus to secure further improvements which could not be enforced In spite of the general improvement referred to there still remains much unfit property deleterious to health in the Borough One matter that has consistently given considerable concern has been the accumulation of refuse in backyards and areas, and on waste ground and difficulties are still found in preventing the dumping of rubbish and its removal, Unwanted articles, furniture or builders refuse which may constitute an eyesore. and not forming a health nuisance in the first place, often tends to encourage the deposit of more obnoxious items by others In a number of cases such items have been represented as unwhole some and have been removed for destruction by the Council, in order to prevent their deposition in unsuitable places. The following table sets out a number of details of the work carried out under this heading in 1960. Houses damp, dirty- remedied. 321 Doors, windows,, floors, walls, ceilings sashcords repaired. 509 Watercloset and urinal defects remedied. 117 Soil and vent pipe defects remedied. 70 Rainwater pipes cleared, repaired or renewed 75 Waste pipes cleared, repaired or renewed 57 Drains cleared. 91 Roofs and gutters repaired. 274 Water storage tank defects remedied. 2 Yard or area defects remedied. 48 Washhouse defects remedied. 8 Water supply to houses re-instated. 12 Water supply laid on to upper storeys of house. 3 Firegrates renewed or repaired. 31 Animal nuisances abated. 2 Miscellaneous nuisances abated. 78 Dust receptacles renewed or repaired. 86 Accumulations of refuse removed. 119 30 Overcrowding cases reported. 32 No. of Basement rooms inspected. 383 No. of House inspections. 1,194 No. of House-to-House inspections. 26 Total No. of first visits for all purposes. 4,910 Total No. of re-visits for all purposes. 7,072 No, of complaints received. 920 No. of Intimation Notices served. 585 No. of Nuisance Notices served. 31 Legal proceedings were instituted on 32 occasions for noncompliance of Nuisance Notices from 1956 to 1959, but in no case was such action necessary in 1960. URGENT NUISANCES' During the 5 year period several urgent matters arose which can now be dealt with under the London County Council (General Powers) Act 1955, In such cases after service of the Notice the Council has arranged for the abatement of the nuisance, and the recovery of the cost. In 1960 3 such notices were served in connection with general matters and 7 in relation to stopped drains. 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. Ninety-nine drainage plans were approved by the Council during 1960 and 1,946 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, ... 150 Soil & Vent pipes erected. ... 157 Drains or Soil pipes tested. ... 227 Waste Pipes erected. ... 228 Waterclosets erected. ... 664 Urinals erected,, ... ... 51 Lavatory Basins fixed. ... 731 Sinks fixed. ... 584 Baths installed. ... ... 376 31 Since the single stack system of drainage was first introduced in 1955 some 13 subsequent applications to use this system have been provided by the Council In each instance the work has basically complied with the recommendations of the Building Research Station and satisfactory syphonic tests have been carried out on completion of the work In all but two instances the installations have been in blocks of new or converted flats Prom time to time it has been considered necessary to open up drams as a matter of urgency and appropriate action has been taken under the Public Health London) Act 1936 0 Such necessity did not arise in 1960, COMMON LODGING HOUSE There is a Common Lodging House for men situated at 88 Old Street„ E.C. I. 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. The conditions in this lodging house are far from satisfactory, although standards of hygiene reasonable in all the circumstances, are maintained A large number of occupants stay there only for a very short period, but probably some 50 to 100,, mostly older men,, maKe the premises their home for a considerable time The number of inmates is too great to allow of any real comfort being given or Welfare work being undertaken by the limited staff During 1958 a survey of the conditions prevailing in this lodging house was carried out by a voluntary organisation with which the Borough Council was associated It is clear from the results of this survey and from other investigations that this place does serve a very useful purpose in helping a number of men who are unable or unsuitable to settle down in ordinary domestic life, but that there are opportunities offered here to which use have never been made, to help them in their many social problems, 12 visits of inspection were made by the Public Health Inspectors during the year„ There has bean no other known lodging houses licensed in the Borough. 32 SHOPS The duty is placed on the Council by the Shops Act 1950 to carry out inspections of retail and wholesale shops and warehouses to ensure that adequate sanitary accommodation is provided and that sufficient means of ventilation and heating are provided and maintained. From 1959,. additional duties in respect of the provision of washing facilities, and facilities for the taking of meals in a shop by employees formerly exercised by the London County Council, were transferred to the Borough Council A register of shops is kept in the department and during the year 159 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 have been 58 certificates of exemption in force granted by the Council allowing use of sanitary accomnodation elsewhere than on the premises owing to restricted space RAG & BONE DEALERS There are no known premises where such trade is carried out, and which would bring them within the scope of the Bye laws in this connection. There were until 1958 7 premises where trade was carried out in rags and waste paper etc, but in three cases such business then ceased, but has continued in the remaining 4 premises These have been inspected from time to time RAG FLOCK: 4 premises in the Borough are licensed for the manufacture or storage of rag flock and 8 premises are registered to use filling materials under the Rag Flock and Other Filling Materials Act 1951. Regular visits have been paid to these premises including 7 inspections in 1960 On all occasions the conditions have been found to be satisfactory 29 samples of filling materials have been taken during the 5 year period including 3 in 1960. One sample in 1956 alleged to be "Woollen felt* failed to meet the standard specified and should have been described as "Rag flock layered*, The matter was taken up with the suppliers., All other samples were found to be satisfactory OFFENSIVE TRADES One business of long standing is licensed by the Council and the conditions have been found to be satisfactory. It is situated in the area adjoining Smithfield Market and is regularly visited. 33 FACTORIES As might be expected from the general increase in mechanisation throughout the country and the demolition of much of the older property in the Borough the number of premises in which power is not used and where in consequence the Council is responsible for health conditions other than the satisfactory state of the sanitary accommodation and the enforcement of the Pood Hygiene Regulations in canteens, has continued to fall considerably from 106 in 1956 to 71 in 1960 The number of factories with power has also fallen but proportionally not to the same extent: from 1,375 in 1956 to 1,321 in 1960 Regular inspections have been made but in 1959 and 1960 these were less frequent owing to the depletion of staff. Generally speaking conditions have been found to be clearly satisfactory. The number of defects which could be dealt with officially under the Factories Act have been 131 in 1956; 186 in 1957; 175 in 1958 80 in 1959 and 76 in 1960 The smaller number in 1959/60 is probably due to fewer inspections It must be remembered that many of the defects enumerated are of a minor or temporary nature such as dirty sanitary accommodation but on the other hand certain unsatisfactory conditions found have been dealt with under the Pood Hygiene Regulations or by persuasion. The official returns for 1960 are as follows:- INSPECTIONS for purposes of provisions as to health (Inspections made by Public Health Inspectors). Premises Number on Register 71 Number of Occupiers prosecuted Written Notices Inspections 8 - (i) Factories in which Sections 1,2,3,4, and 6 are to be enforced by Local Authorities. 25 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 1,321 - 406 45 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises). 14 10 - 1,406 TOTAL 441 53 - 34 CASES IN WHICH DEFECTS HERE 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 37 26 4 5 Want of Cleanliness (S. 1) - Overcrowding (S. 2) - 3 2 - 1 Unreasonable temperature (S.3) 3 3 - - - Inadequate ventilation (S.4) 4 3 1 - - Ineffective drainage of floors (S.6) - - - - - 1 - 2 Sanitary Conveniences (S.7). (a) Insufficient 1 - (b) Unsuitable or defective 40 31 - 19 - (c) Not separate for sexes 1 1 - 1 - Other offences against the Act (not including offences relating to Outwork) 15 9 11 2 - TOTAL - 104 76 30 16 35 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 and no formal action has been required in any case for many years, though occasionally by arrangement with the firms concerned, a few articles which might have been in contact with infectious disease have been disinfected or destroyed Nature of Work Section 110 Section 111 No of outworkers in, August list required by Sect. 110( i)(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. 1,284 - - - - - - Household linen 11 23 16 126 - - - - - Umbrellas etc. - - - - Artificial flowers - - - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper - - - - - Brush making 18 - - - - - - - - - - - Feather sorting 10 - - - 57 - - - - Carding etc., of buttons etc. Cosaques, Christmas Crackers, Christmas Stockings, etc. - - - 13 2 1,560 - - - - - - Lampshades TOTAL - - - 36 The information supplied, which it must be remembered does not embrace all forms of outwork, is of use in that it enables some supervision of the home circumstances. A number of Pinsbury firms employing outworkers has fallen during the last five years from 184 in 1956 to 141 in i960, as has the total number of outworkers. It should be noted that the term "Outworker" includes a number of factories which undertake outwork on behalf of other firms and are inspected as factories,, The number of actual home workers in Pinsbury has also fallen from 444 in 1956 to 243 in 1960. The register of outworkers which firms are required to maintain are inspected as part of the routine, during the inspection of the factories concerned, and no formal action has been required in relation to any failure in this matter or in the transmission of returns. The following tables set out the detailed information supplied and the official returns:- The number of firms employing outworkers in 1960 was 141 The number of Finsbury outworkers employed by them was 217 The number of non Finsbury outworkers employed by them was 2,975 The number of Finsbury outworkers employed by firms outside the Borough was. 112 The total number of Finsbury outworkers employed by firms in or outside the Borough was (Of these 86 were firms and 243 homeworkers.) 329 The registers of outworkers which firms are required to maintain are inspected as part of the routine during the inspection of the factories concerned. Number of visits paid to homes - 315. CLEAN AIR: There has undoubtedly been a decrease in the degree of Atmospheric Pollution in London over the past 20 or 30 years, but it remains a contributory cause of much ill health, structural damage and drabness in our surroundings,. The condition of the air in Finsbury and its further pollution from sources within the Borough is probably little different from that in other parts of the Metropolis. 37 On a day in October 1956 continuous observations were made from certain nigh buildings in the Borough throughout the hours of daylight, in order to obtain an overall picture of the size of the smoke problem in the Borough. During the whole day no source within the Borough produced smoke in such quantity or density as to create a serious nuisance, and even the domestic sources seemed to be comparatively low. It was thought however desirable on that occasion to send a written intimation to nine firms whose smoke or whose chimneys were particularly noticeable. Air pollution from Industrial establishments is certainly lessened as a result of improvements to boiler plants that have been carried out by firms or from the result of pressure brought by officers of the department Atmospheric smoke however, has not decreased correspondingly and now probably represents a much greater proportion of the total pollution than before. Much attention has been given to the problems of the prevention of pollution especially since the end of 1956 when the Clean Air Act came into force MEASURE OF ATMOSPHERIC POLLUTION Since the middle of 1953 a station for measuring air pollution has been operated in the Pinsbury Health Centre in conjunction with the Department of Scientific and Industrial Research, and monthly determinations of the soluble and insoluble deposits have been made, together with the es m of the sulphur dioxide content of the air by the lead perioxide candle method. Since March 1955 daily measurement of the smoke and sulphur dioxide by volumetric analysis have also been made. At the beginning of 1960 the monthly estimation of sulphur dioxide by the first method were discontinued as it was found from experience over three years that concordant results were arrived at by this, and the volumetric methods. This is not necessarily the case in all areas as each of the two methods also measures some other impurities There is considerably daily and seasonal variation, due to the weather and no doubt the amount of fuel consumed in the District, but there has been little change in the general level of pollution, as is shown by the accompanying tables which give the findings for 1955 and also for 1959 and i960 There would appear to have been a significant decrease in smoke pollution but on the other hand the soluble deposits in 1959 and to a lesser extent in 1960 have increased but these may have originated in areas very close to the instruments It has been suggested that the demolition of nearby slum property played a part in this increase. 38 METROPOLITAN BOROUGH OF FINSBURY ATMOSPHERIC POLLUTION READINGS EXTRACTED FROM D.S.I.R BULLETINS 1955 S.D. T.D. Smoke S.O.2 Jan Feb Mar April 6.9 May 18.1 June 16.8 July Aug Sept Oct Nov Dec 19.16 9.81 15.06 16.11 7.59 11.3 12.9 16.7 20.6 31.85 16.90 19.68 17.2 27.4 16.6 24.16 24.08 28.8 26.05 34.1 30.74 - - 29 22 16 17 25 63 14 10 57 57 - - 6 6 5 7 13 18 - - 5 16 Total deposit on the Borough of Finsbury during 1955 296.96 tons per sq. mile. Jan 25.28 36.94 51 26 Feb 14.1 21.54 39 24 Mar 20.0 41.0 22 12 April 29.6 38.5 16 11 May 40.3 48.3 8 6 June 41.7 50.0 8 6 July 30.6 37.5 6 4 Aug 49.2 56.6 8 5 Sept 33.8 39.23 8 6 Oct 54.4 65.4 17 10 Nov Dec 1959 20.0 18.3 S.D. 31.1 37 16 25.3 T.D. 23 Smoke 13 S.O. 2 Total deposit on the Borough of Finsbury during 1959 491.41 tons per sq. mile. Jan Feb Mar 13.5 April May June July Aug Sept Oct Nov Dec 1960 25.6 18.1 32.8 23.7 19.6 16.1 59.2 23.8 21.8 19.8 15.0 S.D. 17.8 38.9 31.1 31.5 26.6 28 13 24.4 66.3 32.9 32.1 23.2 28.5 25.3 T.D. 19 12 10 5 4 6 10 16 27 31 18 Smoke 12 16 17 8 8 6 5 5 7 14 18 S.O. 2 Total deposit on the Borough of Finsbury during i960 384.65 tons per sq. mile. S.D. - SOLUBLE DEPOSITS as rates of deposition In tons per sq. mile per month. T.D - TOTAL DEPOSITS as rate of deposition in tons per sq. mile per month. SMOKE - denotes all fine suspended impurity collected by test filter in volumetric apparatus expressed as "milligrams per 100 cubic metre of air". SO - 2 includes all acid producing gasses in the air with the exception of carbon dioxide and is net acidity of the air calculated as sulpher dioxide by the volumetric method expressed as "parts per 100 million of air". 39 A detailed analysis has been made of the daily smoke and sulphur dioxide measurements in relation to the direction of the wind for each month of the years 1956 and 1959 As no continuous records of the strength and direction of wind were made, these being only recorded once daily, the significance of any results would have to be received with great caution. The analysis however, showed no significant relationship and there is therefore no evidence that the air in Finsbury is contaminated from any neighbouring district in particular, Moreover it would appear that the site of the instruments has been satisfactorily selected so as not to be affected by aerial effluents from premises in the vicinity. It may be noted that in 1959 the soluble deposits were considerably higher than in 1955, and they were in fact higher than any other previous years. This may have been due to local circumstances but no definite explanation can be given at this stage. A number of complaints of depositions of fine globules of oil have been made particularly in the Eastern parts of the Borough, and these call for further investigations which are being pursued SMOKE EMISSION: A number of observations have been made each year of the chimneys in Industrial establishments -on 419 occasions in 1960, 119 complaints of smoke (including 19 in 1960) have been investigated. Verbal warnings have been given where appropriate and advice has been given to managements and their staffs,, and on 14 occasions between 1957 and 1959 written notices have been issued when contraventions of the regulations have been observed. FURNACES: 46 formal notifications (including 22 in 1960) have been received of intention to instal industrial furnaces since the coming into force of the Clean Air Act, and prior approval was sought and given in one case to a plan submitted in 1959. SMOKE CONTROL AREAS: In 1957 consideration was given to the establishment of a Smoke Control area, and one of 62.6 acres abutting on the City Corporation Smokeless Zone and extending northwards to Old Street was selected as being the most suitable, A preliminary survey of the proposed area was carried out which revealed that of 820 dwellings, 570 would require conversion of their existing firegrates, Some 250 commercial, industrial and other premises were also contained within the area, 40 Towards the end of 1958 the Council agreed to seek provisional approval to this Finsbury (No.1) Smoke Control area, and this was given by the Ministry of Housing and Local Government during 1959 Owing to staff shortages it was only possible to complete the detailed survey of the area following the appointment of a Smoke Control Officer in July 1960 In October i960 the Council agreed to the making of an Order which was submitted to the Minister for confirmation, and is due to come into force in June 1962 Within the area is a large estate of block dwellings, some eighty years of age comprising 480 flats which the owners have undertaken to modernise within the next few years In view of this, these premises have been specifically excluded from the Order. A second smaller area of 37¼ acres was also surveyed and reported upon before the end of 1960 and the necessary steps taken to make this the subject of an Order In 1959 the Council formulated its programme for smoke control areas for the subsequent five years to cover approximately 311 acres or just over half the Borough, and it is hoped that the initial delays which occurred will now be overcome by an accelerated rate of progress in implementing this programme FUMES FROM VEHICLES ON THE HIGHWAYS; Many persons have been concerned in recent years with the emmission 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 time 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, 41 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 107 such instances including 55 in 1960 have been reported, since this procedure was started in the autumn of 1958, It would seem to me that the procedure adopted which I got from a town in the north of England has been useful though of course in Finsbury such action cannot make more than a minute contribution to the solution. It would seem tnat 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 them selves may be unaware, Acknowledgements often with thanks and details of action taken, are received in most cases VERMINOUS ARTICLES & PREMISES The Disinfestation service continues to provide for the destruction of all types of insects and pests, but especially the Bed Bug, fleas, Beetles and Cockroaches During the five years under review there has been a considerable reduction in the density of cimex infestations, although the actual number of premises infested still remains high, This reduction is undoubtedly due to the extensive Clearance Schemes now in operation The general method of control has been by means of spraying with a 5% solution of D D T or other insecticide, with a follow-up treatment about 14 days later if found necessary. In the more serious cases of Bed Bug the bedding has been removed to the Health Centre for treatment in the steam disinfector. In connection with the re-housing of families it is the practice to have the furniture., effects and rooms sprayed with an insecticide a few days before removal but where a family is to occupy one of the new flats a contractor is employed, and fumigation takes place whilst the furniture is in transit. Section 122 of the Public Health (London) Act 1936, enables the Council on a report from the Medical Officer of Health, to cause to be disinfected or destroyed any article in a house which has been verminous, filthy, dangerous or in an unwholesome condition so that health is affected. During 1960 69 such representations were made under this Section, Most of these representations were in respect of old and filthy articles remaining in rooms after the death of the sole tenant. 42 The work of disinfestation has covered a very wide range of insects etc. and during 1960 a total of 378 premises were treated, including the following:- Bed Bug 152 Cockroaches 24 Beetles (various types) 38 Fleas 8 Flies Ants 14 19 Routine spraying of vacated Council properties 100. SCABIES & OTHER VERMINOUS CONDITIONS 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 October 1959 when the nurse responsible for this work was withdrawn by arrangement with that Council, and the supervision continued by the nurse appointed by the Borough Council, who has undertaken throughout the supervision of the work in connection with cases, other than schoolchildren and such Home Visiting as has been necessary In February 1960 however,, the London Countv Council decided to discontinue the use of this centre,, on account of the small numoer of children from this district required to attend Arrangements were also continued for the treatment of cases on behalf of the Shoreditch Borough Council. The incidence of both scabies and body lice has remained low, although a considerable number of children, mainly dealt with by the London County Council as Education Authority, are found with head lice- Home visiting has only been carried out in connection with the somewhat rare cases of persistent or recurrent infestations in the same family In 1960 the total number of treatments given was For Finsbury cases For Scabies 49 for head lice 83 for body lice 49 For Shoreditch cases " " 18; " " Nil, " " " 1 Nearly all the cases of body lice were casual residents from a common lodging house, some of whom were sent on suspicion only as being infested, 43 PREVENTION OF DAMAGE BY PESTS ACT. 1949: RODENT CONTROL: The control of both rats and mice within the Borough of Finsbury has, over the years, been a major problem and only by continuous inspections and treatments has it been possible to clear or reduce infestations to a minimum. Rattus Norvegious, or Common rat, has been the chief source of trouble in the residential areas and experience proved that defective drainage was responsible for many infestations In these cases repair has been promptly carried out. Rattus rattus, or Ship rat gained a substantial hold in the industrial part of the Borough where, during and shortly after the war it found ideal living conditions in the older type of buildings, especially those with wooden floors. One of the chief difficulties met was to persuade the several occupiers of any one premise to admit the presence of rats and to join in a Block scheme. Whilst powers are given under the Prevention of Damage by Pests Act 1949 to compel, it was considered advisable to adopt persuasive measures The Council, already employing a Rodent Officer, foreman and six rodent operatives, was able to offer the occupiers of infested premises a service with a view to destroying the rats and mice On 11th March 1957 an Assistant Rodent Officer was appointed and his chief duty was to carry out a complete survey and inspection of all business premises throughout the Borough of Finsbury This block by block inspection proved most effective and an astonishing number of infestation of both rats and mice were found, and in many instances the Council were requested to carry out the work of disinfestation. Each treatment was maintained for at least three months and such poisons as Zinc phosphide and Arsenious Oxide were used, followed by semi permanent baits of Warfarin ; and it is fair to comment that the general infestation is now at comparatively low level Following initial treatment of premises, the occupiers in many instances have requested that a continuous service be given as a preventive measure This is arranged and a charge of 8/ per hour mane It is a recognised fact that rats in sewers are a serious menace not only from a disease and pest point of view, but for the amount of damage they cause to the sewer system and surrounding earth works after breaking out„ 44 For a number of years alternate baiting with Zinc phosphide and Arsenious Oxide was carried out twice yearly at all available manholes, but a check made in 1956/57 showed that no substantial reduction was being made in the rat population, for breeding was exceeding those killed, A trial period with three treatments a year followed, but with little effect, for it became apparent that the rats had either become immune to or formed a poison prejudice. Certain parts of the local sewer system were difficult to bait as some extreme points were without manholes, and formed excellent living quarters for rats. However the Borough Engineer arranged for access points to be made in these '■stunt* ends, and so far as completed, have been most useful during sewer treatments. All manholes and side entrances to the sewers have been fitted with baiting trays, some being of a pattern which allows them to be lifted from their fixing, placed aside whilst sewermen are working nearby and replaced at the end of the day without the bait being disturbed. In 1958 it was decided to discontinue the triple treatment of sewers as mentioned, and to poison all possible access points four times during the year with one additional test baiting. For the poison it was recommended that Sodium Fluoroacetate at 0.25% in either damped sausage rusk or course pinhead oatmeal be used. The results have been good and there are signs of a definite decrease in the number of rats in the sewers, and in some instances a clearance has been effected. Much controversy has taken place as to the dangers of using Sodium Fluoroacetate(or "1080" as it is known), but providing those engaged in mixing and depositing the bait follow the directions issued and take the precautions necessary when handling any poison, there is little likelihood of harm coming to them. There is however one definite advantage in its use. It is known to be more toxic than any other recommended poison, and the smallest quantity of "1080" poison bait eaten by a rat is sufficient to kill it, whereas with Warfarin continuous feeding is necessary for several days before sufficient poison to prove fatal is consumed by the rats Bearing in mind the amount of alternative food available to rats in sewers it is possible that the lethal amount of poison bait may never be taken During the past five years only one case of Well's disease has been confirmed and the sewerman in question has made good recovery. In 1956 it was necessary to find new accommodation for the rodent control staff as those then occupied were within a Clearance Area, Alterations and modifications were carried out to the recently closed mortuary at the Health Centre, and these provided up-to-date staff and mixing rooms. The lay-out has from time to time aroused favourable interest and the Ministry of Agriculture Fisheries and Pood (Infestation Control Division) have asked that official visitors to this Country from Denmark and Israel, together with other interested Authorities, be allowed to visit the premises. 45 It is pleasing to record that the co operation of both residents and the trades people within the Borough has been of a very high standard and during the five years under review it has not been necessary to serve any statutory notice or take legal action against any of them under the Prevention of Damage by Pests Act 1949 1955 1960 No. of complaints received: Business Premises 181 78 Domestic Premises 177 481 Additional Infestations found: Business Premises 181 1081 Domestic Premises 261 158 No. of premises treated: Business Premises 362 1159 Domestic Premises 742 345 No of visits made: Business Premises 8961 13344 Domestic Premises 14742 6888 Charges Made £1,393.1.0 £3,945.15.0 PET ANIMALS: There is little trade in the Borough in pet animals Licenses under the Pet Animals Act 1951 have been issued in respect of only 6 premises during the past 5 years, all of which were renewed in 1960. Three were in respect of shops - two in respect of stalls and one in respect of premises used for the breeding and sale of tropical fish largely for export All the premises were inspected during the year and a total of 13 formal visits were made HEATING APPLIANCES: Observations have constantly been made on all shops, warehouses and stalls handling the sale of new and secondhand gas, electric or oil fires to ensure that such appliances were adequately guarded in accordance with the standards laid down Where necessary the prescribed probe weight and burning tests were carried out by the Inspectors. Apart from casual observations 18 formal inspections were made during 1960 In 1957 a summons was issued against a street trader for exposing for sale a secondhand electric fire without a regulation guard The case was however dismissed on the evidence submitted by the defendant to the effect that the fire was not for sale but was in his possession for repair. 46 Also in 1957 a Public Health Inspector was obstructed in the exercise of his powers by a shopkeeper refusing permission for him to undertake the prescribed tests on an oil heater. As a result of a formal warning to the firm concerned, tests were subsequently carried out and the heater was found to be satisfactory. No other formal action has been taken during the 5 year period under review. NUISANCE FROM PIGEONS: Licenses have been granted for catching pigeons in the streets and open spaces, to two firms, both of which were in force in 1960. Enquiries have satisfied the Council as to the means employed by those authorised that they are humane, and that the carcasses unfit for human consumption are not sold for that purpose In 1957 the Council employed a firm of Contractors to abate a nuisance caused by pigeons on certain premises MORTUARY: The Mortuary formerly maintained in the Health Centre for the reception of the bodies of those dying from infectious disease, and other emergency cases, was converted in 1957 for the use of the Rodent Operatives and the storage of their equipment and poisons, as it had not been used for a very long time. The Corporation of London has kindly agreed to make available accommodation at their Golden Lane Mortuary should any emergency arise. HAIRDRSSERS: The Council fixed the Ist February 1956, as the appointed day on which to bring into operation the provisions of the London County Council (General Powers) Act 1954 requiring the registration of persons carrying on the business of Hairdresser or Barber, and the registration of the premises used, and made Bye-laws for the purpose of securing the cleanliness of registered premises including the instruments, towels and equipment used therein, and the cleanliness of the persons employed both in regard to themselves and their clothing In 1960 there were a total of 46 registered premises in the Borough The general standard of cleanliness of the establishments has been improved as a result of the inspections carried out, and the action taken in enforcing the requirements, but there is room for further improvements, In all 42 visits were made to hairdressers and barbers during 1960. DISINFECTION Disinfection is carried out where infectious disease has occurred, and on all occasions when requested wherever considered necessary. 47 The general practice has been to spray the rooms with a diluted formalin, and in the more serious cases, bedding has been removed to the Health Centre for treatment in the steam disinfector„ In April 1959 consideration was given to a memorandum issued by the Ministry of Health on the subject. In consequence it was decided that in such cases as smallpox, typhoid, paratyphoid, poliomyelitis and diphtheria (and any other cases warranting such action) a fumigation with formaldehyde and potassium permanganate would be carried out after the rooms had been sealed. During 1959 some 30 premises, including sections of a London County Council school within this Borough were treated. During 1960 only 3 premises were subjected to this treatment, but spraying was carried out on 191 occasions Disinfection of bedding, clothing and other articles normally by steam, occasionally when more suitable 'by Formalin vapour, has been carried out in the disinfecting station at the Health Centre. Some improvements in the plant were effected in 1959 as well as in the techniques employed. Such disinfection has been carried out in connection with the Infectious Diseases where indicated, some cases of vermin and in some circumstances for mattresses etc, from the hospitals and the Common Lodging House in the Borough, In 1960, 3,557 articles were treated. Disinfection of goods, mainly clothing, has continued to be carried out on behalf of certain export firms in order that they may comply with the requirements of some Commonwealth and Foreign Governments. In 1960 this was undertaken for 44,205 articles, the plant being charged on 175 occasions. 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. No use has been made of this accommodation during the 5 syearsunder review. 48 NOISE Much concern has been felt in recent years as to the harmful effects of noise on those living and working in the Borough, Complaints of particularly objectionable noise have been made from time to time, and efforts have been made to secure reduction of it. In some cases considerable amelioration has been effected, but often difficulties have been encountered. No formal action has been taken under London County Council (General Powers) Act 1957 which provides for noises to be treated as nuisances under the Public Health (London) Act 1936 in certain circumstances, as the restrictions imposed have rendered it in most cases unpracticable Towards the end of 1960 the Noise Abatement Act 1960 which somewhat strengthens the powers to secure abatement of noises which are a nuisance came into force. In 1960 the Council accepted an invitation to become a member of the Noise Abatement Society. The Society aims to eliminate excessive and unnecessary noise from all sources, by means of publicity, pressing for the enforcement of existing laws, and for new bye-laws where existing laws appear inadequate. 49 SECTION D HOUSING GENERAL The estimated number of dwellings in the borough at the end of 1960 was 9.980 (9,497) consisting of 3.079 (3,583) houses, 6.886 (5.866) flats and 15 (48) huts. The houses are mostly privately owned Ownership of the flats is as follows:- Pinsbury Borough Council 2,044 (1,476) London County Council 581 (559) City Corporation 322 (Nil) Metropolitan Police 126 (126) Housing Associations 2,644 (2,463) Private Ownership 1,169 (1,242) The figures in brackets refer to the corresponding estimates for 1955, From these estimates it is seen that the total number of dwellings has remained about the same, but that the number of houses has fallen considerably and the number of flats has however increased As many of the houses which have been demolished were in multi-occupation, the total number of families accommodated has fallen Although the population estimates cannot at the moment be taken as final, there has probably been some fall in the density of population in the Borough, but they themselves have not been considerable. NEW BUILDING The construction of new housing accommodation has continued since 1955 at what may be considered a rapid rate. The following table lists the new properties completed in the 5 year period, those marked with an asterisk having been completed in 1960. By the Finsbury Borough Council: Priory Green Estate (Calshot House 19, Wynford House 85) 104 flats 19-24 Wynyatt Street 12 " Amwell House 12 " Brunswick Close Estate (Wyclif Court 64, Emberton Court 71, Brunswick Court 72) 207 " *Pleydell Estate (Gastigny House 29, Grayson House 99, Galway House 102, Palyn House 5, Radnor House 5) 240 " 575 flats Total 50 By the London County Council: *Percival Estate (Crayle House) 22 flats By the City Corporation: Golden Lane Estate (Bowater House 30, Bayer House 30, Gt. Arthur House 120, Stanley Cohen House 32, Basterfield House 54, *Hatfield House 56) 322 flats By Housing Associations: Peabody Estate (Block D Roscoe St. 24. Fortune House 16, 1-11 Fortune St. 6. Peabody Tower 52, St. Mary Tower 52. Peabody Court 42) 192 flats By Private Owners: Arlington House 19 flats *10, 13/14 & 34/35 Wynyatt Street 14 " *Keen House, Calshot Street 1 1 " Others 6 40 flats Total A Grand Total of 1.151 flats of which 333 were completed in 1960. During the last five years, 45 certificates of Habitation under Section 95 of the Public Health (London) Act 1936, were issued of which ten were issued in 1960. INSPECTIONS: Regular house to house inspections have been carried out during the last five years mainly in connection with plans and proposals for slum clearance Due to the interval in the programme necessitated by the difficulties of rehousing following the representation of the large King Square area, and to the depletion of staff, the number of inspections namely 26„ was however lower in 1960 than in previous years. The tabular statement prepared in accordance with the Housing Consolidated Regulations 1925-32 is as follows:- No of houses considered on inspection to be unfit for human habitation. 23 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. 23 (b) making demolition or closing orders. 51 No. of notices served requiring the execution of repairs No c of houses rendered fit after service of notice No. of demolition or closing orders made 22 No. of houses in respect of which undertakings were accepted ... No. of houses demolished 1 REPAIR OF HOUSES UNDER THE HOUSING ACT: No action has been taken since the war owing to the difficulties involved. CONVERSIONS AND IMPROVEMENTS Comparatively little older property in the Borough has been reconstructed so as to bring it into line with modern standards, and little advantage has been taken of grants available under the Housing Act, The list of the properties in which such improvements have been made in the last five years is given below Those completed in 1960 have been denoted by an asterisk and indication is also given of grants made in each case where this applies B Peabody Buildings R. Block Roscoe Street 10 flats Pensioners Court, Charterhouse 13 A. 29/31 Pentonville Road 5 63/5 Myddelton Square 8 A. 54/5 5 33/5 10 *5/6 5 A 17 Paget Street 3 A 6/7 3 A *15/16 Rawstorne Street 3 A, *53 3 A. 36 Wilmington Square 2 S *8 Northampton Square 1 S *1/24 Rawstorne Buildings 24 A Improvement Grant from finsbury Borough Council. B " " " London County Council. S. Standard Grant for additional amenities from finsbury Borough Council. Two applications for improvement grants were rejected, and in three other cases informal enquiries were not proceeded with. Provisional approval was also given in 1960 to two applications for improvement involving in each instance 12 flats, and one application for a standard grant involving 24 flats. 52 ARTICIAL LIGHTING OF STAIRCASES The artificial lighting of staircases in many blocks of flats in the Borough is on the whole satisfactory. Bye-laws were made by the Council in 1958 under the London County Council (General Powers' Act 1956, requiring the adequate artificial lighting of common staircases in tenement houses and flats. Action was taken in 1959 under the Bye-laws, however, by way of service of a notice on the owner of one tenement house, where no artificial lighting had been provided to the common staircase. Suitable electric lighting was subsequently installed and the notice complied with during the early part of 1960 CERTIFICATES OF DISREPAIR: Inspection of properties are made in connection with all applications to the Council for a certificate of disrepair and for their cancellation Advice is given when requested in regard to the completion of the appropriate form The following is a summary of the action taken during the years 1956-60 and the present position. There was no action taken in 1960, Increase of Rent & Mortgages Interest (Restrictions) Acts. No. of certificates issued 1 No. of certificates revoked 1 Housing Repairs & Rents Act 1954. No. of certificates issued 24 No. of certificates revoked 8 No. of certificates still in operation 16 Rent Act 1957, Applications for certificates 69 Certificates issued 34 Certificates still in force 23 Certificates cancelled 11 Certificates not proceeded with 17 Undertakings accepted 18 Certificates issued as to remedying of defects. (a) issued to tenants 8 (b) issued to landlords (cancellations) 4 (c) Still in force 4 In 1960 there were no applications for certificates, but there was one application for a cancellation under the 1957 Act, which was objected to by the tenant and cancellation was not effected. 53 UNFIT HOUSES AND PARTS OF HOUSES: There are still many unfit houses and parts of houses in the Borough although their number is steadily diminishing. Owing to the difficulties in relation to rehousing, it has not been practicable to secure demolition or closure of any but those in the worst condition. From time to time it bacame necessary to take action to secure closure of a few individual rooms (other than basements) in houses where these could not be made fit at a reasonable cost. Steps have been taken to secure closure of unsatisfactory basement rooms usually when these have become vacant or been known to be about to become vacant. The table appended summarizes the action taken during the period 1956-1960, the figures in brackets referring to action taken in 1960. CLOSING AND DEMOLITION ORDERS: Whole Houses Basement Rooms Other Parts No. of representations made. 82 (5) 101 (17) 7 (1) No still under considerations. 3 15 - Total No. of undertakings accepted. - J 12 (1) - Demolition Orders made. 7 (2) - - - - Such properties since demolished. 4 (1) Closing Orders made. 80 (10) 83 (11) 3 (1) Such properties later demolished. 54 5 (29) 20 (20) 3 (3) Orders later determined (-) 16 (4) - Total No of representations lapsed or no action taken. - 3 46 60 6 Total No of properties still subject to (a) Demolition Orders, 134 5 (b) Closing Orders. 54 CLEARANCE AREAS During the five years under review, a very great deal of clearance in relation to the size of the Borough was initiated, and carried through by the Borough Council. The remaining part of the programme agreed for 1951-1955 was completed as well as the whole of that for 1956-1960 A provisional programme for 1961-65 was also submitted. Two large areas have been, or are being, dealt with, namely Galway Street (314 acres) which provided space for the development of modern blocks of flats already in occupation, and Kings Square Nos, 1.2 and 3 areas (over 11 acres) where redevelopment will be possible. The individual areas dealt with were: 1. Faulkner's Alley. 2 1953 Demolition completed 1956. *2. Macclesfield Place. 19 1953 1957 *3. St, James Row. 8 1953 One house still remaining. *4. James Gardens, Frys Bldgs. 25 1955 Demolition completed 1957. 5. Ironmonger Passage, Lizard Street. 3 1955 " " 1958. *6. Galway Street. 168 1955 " " 1958. 7. Cynthia Street. 8 1956 Order rescinded 1958 and area included in Donegal St area, see below. 8. Buxton Buildings. 28 1957 Dealt with by way of Closing Orders on all flats individually Demolition completed in 1960. *9. Herbal Hill, Herbal Place. 7 1957 Order only confirmed for two premises by Minister which are still standing. Closing orders were made on remaining properties. 10. Field Place. 7 1957 7 Rehousing of tenants not completed 11. Medcalf Place. 15 1957 " " " " " *12. King Square " " " " " No.1 Area. 26 1957 " " " " " No.2 " 292 1958 " " " " " No.3 " 25 1958 " " " " " *13. Donegal Street 42 1959 " " " " " Official enquiries were held on behalf of the Minister of Housing and Local Government, in connection with Areas marked by an asterisk * „ 55 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 113 families have been recorded, in 35 of which the overcrowding was subsequently abated by rehousing, Generally speaking however, serious overcrowding is much reduced, and the majority of cases coming to the notice of the department are only overcrowded to the extent of ½ to 1 unit. Three 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* These reports are then correlated with the medical certificates, and a degree of medical priority is then allotted. During the five years applications have been dealt with as follows:- New cases. 870 (80) Cases reconsidered on new medical certificates. 566 (55) Cases reconsidered. 66 (3) (The figures in brackets are those for 1960), Applications for rehousing by the London County Council are made to that body. Reports are sometimes asked for and supplied in regard to the existing overcrowding and sanitary defects. A very limited number are granted medical priority allocated by the County Medical Officer of Health. 56 The approximate number of families rehoused during the five years was:- Rehoused by Finsbury Borough Council (original lettings). 182 (21) Rehoused by Finsbury Borough Council from clearances areas, etc. 285 (56) Rehoused by London County Council (including clearance areas). 497 (87) Rehoused in New Towns, 72 (11) Rehoused by City Corporation. 37 (1) (The figures in brackets are those for 1960), In addition many transfers within Council property took place, in order to make the best use of existing accommodation, and some were rehoused by private owners. LEGAL PROCEEDINGS: In only one case were legal proceedings instituted for alleged offences against the Housing Acts, and that was in 1959 in respect of the use of basement rooms in contravention of a Closing Order. The summons was adjourned sine die to enable the owner to complete works to render the rooms fit. 57 SECTION E FOOD GENERAL: POOD PREMISES: There has been little variation in recent years in the number of food premises in the Borough apart from some increase in those selling ice-cream. The numbers of those known in the Borough now are: Restaurants, cafes and snack bars. 155 Public Houses. 120 Off-licence premises (retail & shops) 11 Breweries, Distilleries, etc. 13 Factory canteens. 75 Commercial canteens 50 Dairies and milk distributors etc. 128 Ice-Cream Sellers. 170 Confectioners (sweets) shops 75 Bakers shops 24 Bakehouses (i) Basement 7 ) (ii) Above ground 9 16 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. 1 58 Sausage casing. 3 Meat extract factory. 1 Public cold stores. 6 Chemists shops (retail). 18 Manufacturing & wholesale chemists. 9 In addition there are 176 street market stalls dealing in various foodstuffs. N.B. Some premises are enumerated in more than one category These business concerns have been inspected from time to time. both formally and informally. The total number of visits paid during 1960 was 3,340 to premises and 2,828 to stalls. FOOD HYGIENE This five year period has seen the gradual implementation of the Pood Hygiene Regulations 1955 which came into force on 1st January 1956 In the first two or three years emphasis was laid on the rest aurants and cafe"s in the Borough, and many improvements were as a result, effected, as well as unsatisfactory conditions eliminated Shortage of Public Health Inspectors has prevented further systematic action in regard to other types of premises, but nevertheless some progress has been made in securing conformity with requirements The objectionable habit of smoking whilst handling food, unfort unately is still common and its eradication is proving difficult In general, I think it may be said that the prevailing standards of cleanliness in the handling of food, though not as good as those desired, compare favourably with those in other similar areas, They are certainly better than they were a few years ago BACTERIOLOGY OF FOOD: Samples of various foodstuffs have been taken for bacteriological examination, but owing to staffing difficulties this has not been carried out as frequently as might be of advantage particularly has this been the case in 1960. However, particular attention was given in this year to the risk of contamination of synthetic cream products The nature of the samples taken in 1960 was: Milk 9 Meat Products 6 Cream cakes 21 Dessicated coconut 1 In no case were pathogenic organisms discovered. 59 QUALITY OP FOOD AND ITS DESCRIPTION: Routine sampling of foods and of drugs has continued, but the instances of adulteration or of misleading description have been very few. For this reason formal sampling has only been practised when an informal sample has proved unsatisfactory, or for some other special reason. In 1960 630 samples (including 3 formal samples) were submitted to the Public Analyst as follows:- Foods No. of samples obtained: Milk 46 Cream & Condensed Milk 15 Butter, margarine & fats 16 Ice-Cream 4 Cheese 15 Sausages 7 Meat & Fish products 128 Soups 6 Sauces, Vinegar etc. 30 34 Condiments, spices & flavourings Jams & preserves 26 Jellies & Gelatine 13 Dried Fruit 18 Cake & Pudding Mixtures 34 Fresh Fruit & Vegetables 1 Cereals 24 Coffee, Cocoa, Tea & Extracts 21 Non-alcholic drinks 19 Canned fruit and vegetables 68 Cakes & Bread 25 Sugar Confectionery 38 Restaurant Meals or Snacks 2 Drugs: Medicines 18 Powders 5 Tablets 9 Ointments, lotions, 8 630 60 From 1956 to 1959 adverse reports on informal samples followed by similar reports on repeat samples taken formally, led to prosecutions in relation to Vinegar (2), non brewed condiment, Friars Balsam and Buttered Rolls, No prosecutions followed such action in 1960. In other cases, the repeat formal sample was found to be satisfactory there was no remaining similar food of which a formal sample could be taken, a warning was given or the offence, if any was regarded as too trivial to warrant action. The total number of adverse reports in 1960 was 4 and comments were included in regard to a few other samples. COMPLAINTS OF FOOD: Each year a number of complaints were received from members of the public in respect of food purchased in the orough which was alleged to be unfit or unsatisfactory. In i960 16 such complaints were made. There was considerable substance in the majority of these com plaints though a few were trivial. In some cases the complainants were unwilling to give evidence or if willing, this did not seem to be sufficiently strong to warrant legal proceedings. Each case was however carefully investigated, and appropriate action taken. In 1960 one prosecution for selling a mouldy chicken pie was undertaken. The complainant was in each case thanked for their co operation and informed as to the action taken PARTICULAR FOODS AND TYPES OF FOOD PREMISES: Street Market Stalls There are four market streets situated at Chapel Market, Exmouth Market, Whitecross Street and Farringdon Road, A total of 623 stalls were licensed by the Council at the end of i960 of which 176 were licensed for the sale of Although there has been a small increase in the number of stalls licensed since 1956 the number on which food is sold has fallen from 197 which were then licensed. A daily inspection and a rota of weekend inspections of street markets has been operated. Although it was anticipated that the stall holders would have made an attempt to comply with the Regulations, experience has shown that no serious thought has been given to the matter and that no attempt has been made by the majority of stall holders selling un protected foodstuffs to provide washing facilities Offences with regard to smoking are still numerous, and it is hoped that when a full staff is available that a concentrated effort will be made to improve conditions. 61 The siting of stalls for the sale of foodstuffs requires investigation with a view to reducing the risk of contamination of food. The system of issuing licenses to stall holders 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 has undoubtedly prevented undesirable conditions being commenced. MILK: Almost all sales of milk in the Borough consists of Bottled milks and in consequence problems in relation to the details of the handling and treatment of them have been practically eliminated. Sampling for chemical and bacteriological examination has continued in order to provide a check on suppliers from other areas. In this connection special attention has been given to that sold to Day Nurseries and Schools Inspection of premises from which milk is sold have also continued and in 1960 276 such inspections were made Apart from the introduction of milk vending machines (from which samples were also taken) in the last few years, there has been little change in the details in regard to the registration, licensing, and the chemical composition summarized in the following table. No of Dairies on register at end of year 9 No. of Distributors Premises at end of year 119 No- of Designated Milk Licenses issued during year. Dealers Supplementary Tuberculin tested 57 24 Pasteurised 75 24 Sterilized 74 27 Satisfactory Unsatisfactory No of samples submitted to Public Analyst. 46 NIL No of samples submitted for Bacteriological examination 58 NIL All Milk C.I. Milk Average fat content. 3.8% 4.23% Average non-fatty solids content. 8.74% 9.01% 62 ICE CREAM: There have been only 3 premises in the Borough where ice-cream has been manufactured in the last five years, One of these was given up for production in 1956. Of the remaining 2, one is used only for freezing following delivery in bulk of the material after pasteurization in another area. Reference has already been made elsewhere to an increase in the number of premises from which ice-cream is now sold. In addition a number of itinerant vendors ply their trade in the Borough. The standard of ice-cream has generally been satisfactory and samples have been taken regularly both for chemical and bacteriological examination until 1960, when, owing to shortage of staff, no samples were taken. Number of Premises registered for manufacture: 22 storage & sale: 148 MEAT: storage only: 2 In the vicinity of the Smithfield Meat Market there are a considerable number of wholesale butchers and offal shops, bacon and provision warehouses, wholesale game, poultry and rabbit shops and Public Cold Air Stores. During the past few years there has been an increase in the number of wholesale shops in this area, some of these being completely new buildings. Most of these wholesale butchers shops trade in meat of a very low quality i.e. old bulls, cow, sow and mutton carcasses which are chiefly used in the sausage and manufacturing trade. It is due to the high percentage of disease and other conditions of these carcasses that a rigid inspection is maintained, to make sure that meat unfit for human consumption is not passed on to the public. Possibly due to the strict examination for Caseous Lymphadenitis in recent years and to the fact that thousands of carcasses were condemned for this disease, the incidence of this disease in imported carcasses of mutton and lamb is steadily decreasing. Consignments of Scandinavian and European offals and tinned hams continue to be imported in increasing numbers and condemnations have taken place on several occasions. The collection of unsound meat and other foodstuffs continues to be collected very satisfactorily by Messrs Henson and Burbidge Ltd., Matusa Works, Beckton who render down this meat etc, for technical tallow and fertilizers. 63 During the last five years a 100% examination of certain imported beef livers was carried out for aparasitic infection, the Echinococcus Granulosus, commonly known as "Hydatid Disease", and the result is as set out below. Beef Livers examined for Echinococcus Cysts. Examined Condemned No. Weight 6162 bags 13,457 beef 120,066 lbs 5117 cartons 27 cases livers Representations by the Council were made to the Ministry of Health and Ministry of Agriculture, Fisheries & food, but the position has not improved as these diseased livers are still being imported into this country. During the past five years 977 certificates (239 in 1960), were issued for the export of meat bacon, sausage casings and meat extract. and it has been noticed that there has been an increasing demand for these export certificates. Due to the opening of more wholesale butchers shops and offal premises there has been an increase in the amount of meat and offal which has been condemned for disease and other conditions. There are no licenced slaughterhouses in the Borough and no slaughtering has taken place since the war. The retail butchers shops and stalls have been regularly inspected with regard to the condition of the meat which appears to be fairly satisfactory. REGISTERED FOOD PREMISES The following types of business are carried on in premises registered for the manufacture of sausages or potted, pressed, pickied or preserved foods. Sausage Manufacturing 31 Sausage Smoking 1 Meat Pickling 39 Offal Cooking 5 4 Cooked meats or pie making Ham boiling 12 Bacon curing & smoking 3 Fish curing 3 Shellfish cooking 2 Jellied Eels 2 Meat Extraction 1 64 Total number of premises registered on December 31st 1960 was 73. Meat Pickling is invariably done at wholesale and retail butchers shops, at most of which sausages are also manufactured. There is in addition one wholesale sausage factory in the Borough, The cooking of meat offal and pies is done mostly at premises that specialise in that type of trade, and this also applies to jellied eels. Large quantities of bacon are smoked at the establishments registered for that purpose and the smoking of fish is also carried out locally. Two retailers cook their own supplies of shellfish. One large firm is engaged in manufacturing and bottling meat extract. These premises are regularly inspected and in 1960 177 visits were paid to them. There has been little variation in the amount of business carried on in the past five years. The conditions as regard the hygienic methods employed in the handling of the food have been reasonably satisfactory, and have been subject to general and continuing improvement. In 1959 it was however found necessary to cancel the registration of one sausage manufacturing establishment after the occupier had failed to take advantage of the opportunity that was offered to him to remedy the unsatisfactory condition of the premises. In 1960 he recommenced the manufacture of sausages despite the cancellation and legal proceedings leading to a conviction were instituted BAKEHOUSES: At the end of 1960 there were 7 underground and 9 other bakehouses in use in the Borough. In the 1958 quinquennial survey four certificates of suitability were refused for underground bakehouses previously in use. On the other hand 5 new bakehouses on the ground floor level have been brought into use. The conditions both for hygiene in the preparation of break and cakes and for the health of those employed have in the main improved considerably. Nevertheless it was found necessary to prosecute the occupiers of an underground bakehouse in 1960 for using the premises when in a very dirty condition. The bakehouses have been regularly visited and 70 inspections were made in 1960. 65 LICENCED PREMISES: There were 156 licensed premises at the end of 1960 there having been little change in this number over the past few years; of this number 120 were public houses, the majority of which also carry on a catering business Considerable improvement in the general standards has been effected in recent years and is still continuing Reports on the hygienic condition of the accommodation and the toilet facilities, are submitted in connection with the transfer of licenses Routine inspections are also carried out from time to time. In 1960 141 inspections in all were made, 56 of them were for the preparation of the reports referred to VARIOUS FOODS: (a) Canned Hams: In 1957 it was noted that a considerable weight of canned hams imported from the continent was found to be unsound, and a number of samples have subsequently been submitted for bacteriological examination. In some cases CI, melchii were isolated. The condition of this type of goods has since improved but requires constant supervision, especially in view of the fact that much of this type of product is used for the preparation of sandwiches and liable to be a source of food poisoning outbreaks if unsuitably stored on retail premises. (b) Canned Anchovies in salt: Several samples of a consignment of canned anchovies {unprocessed) were examined bacteriologlcally in 1958 and CI Welchii were isolated in several, Satisfactory methods were then found for its disposal. (c) Wines and Spirits: A consignment of wines and spirits was received in the Borough in 1957, This had been stored in a cellar which had been flooded elsewhere with crude sewage, After exhaustive examinations and negotiations with the owner, part was destroyed and the remainder released for consumption. poisons: A register of sellers of Poisons listed in Part II of the Pharmacy and Poisons Act 1933 is kept, In 1956 there were 44 applications for inclusion but in 1960 the number had fallen to 36. The premises concerned were visited from time to time to ensure that the regulations were complied with. 66 UNSOUND FOOD & FOOD POISONING: No formal seizure and condemnation of food has been necessary for many years. There has been little evidence of attempts by traders to sell unwholesome food, in fact it is they who usually notify the department of suspected food in their possession. Voluntary surrender of food is accepted and certificates are issued accordingly. The amount of food dealt with in this way has varied little and remains comparatively high because certain multiple stores have their warehouses in finsbury to which doubtful food is returned from branches elsewhere, and the large amount of meat dealt with in the Smithfield area. Small quantities of unsound food are incinerated where facilities exist, but otherwise is removed as trade refuse or by the contractors referred to under Meat. A total of 149 visits were made in this connection in 1960 apart from those connected with meat inspection and 751 certificates were issued. The total quantities of unsound food surrendered during 1960 were. Lbs. Meat (diseased) 44,696 38,211 Meat (unsound) Meat Products 8,832 Bacon 5,199 Offals (diseased & unsound) 60,399 Poultry 3,982 Game 475 Rabbits 318 Canned Foods 19,241 Bottle fruits & pickles 6 Dried fruit 89 Preserves 39 Cheese 4,846 Fruit & Vegetables 40 FISH 208 Cereals 59 Miscellaneous 1,608 Butter 20 Frozen Foods 5,624 Lard 24 Eggs 300 194,216 lbs. 86.70 tons. 67 FOOD POISONING: During the past five years a continual succession of individual cases of food poisoning have been reported, as well as a few small family outbreaks. These included a small outbreak in a school which involved 12 children and two teachers in 1958, and one involving 28 persons in a residential hostel in 1960, The total number of cases involved in this way was 33 in 1956 9 in 1957, 46 in 1958; 29 in 1959 and 73 in 1960. All cases during this and previous years were investigated as far as possible, and all reasonable precautionary action was taken, but in many cases information was received too late for this to be effective. The following summary of the 5 year period indicates the number of cases for which particular organisms were probably responsible. SALM. Typhi-murium. 16 " Thompson. 4 " Enteriditis. 2 " Newport. 2 " Derby. 2 " Anatum. 1 " Heidelberg. 1 " Stanleyville, 1 " Brandenberg. 1 C. Welchii. 30* *including 28 in the outbreak in 1960 described below. In no case was the food responsible definitely ascertained though a large number of articles were suspected. Although the number of cases may seem large in relation to the population in finsbury they do not in my opinion, constitute any increase from previous experience and nearly all the cases were very mild, with early symptoms of some temporary Diarrhoea, with occasionally some nausea or vomiting. All recovered quickly in 24 hours. The large number reported may well be due to the happy relations of the Health Department with the members of the public and the doctors who have given information in regard to cases which in other circumstances they might not have done. This view is expressed in spite of the knowledge that there has been some increase generally in the country in regard to the incidence of food poisoning. 68 On the whole, whilst completely satisfied that food conditions are satisfactory, probably more so than at any other time, since the war, when some spread of Salmonellosis took place from which the country has not yet recovered, nevertheless it is clear that constant supervision is imperative. It may be noted that no case has been traced in this Borough during these five years, as aresult of infection directly or indirectly from frozen eggs, or from dessicated coconut which elsewhere have been a source of considerable concern. Bacteriological examinations of a number of foodstuffs have been made. As stated above 73 cases were notified during 1960, and there were no deaths. In one family outbreak involving two cases the agent identified was Salmonella Enteriditis and in the outbreak in the hostel with 28 cases the agent was thought to be Co Welchii. There were six other small family outbreaks involving 17 individuals. where the agent was not identified. Of the remaining individual cases the only agents identified were in one case Salmonella Brandenburg, in two cases Salmonella Typhi murium and two cases Salmonella Enteriditis.The food suspected included Oranges; doughnuts; veal & ham pie; mushrooms; ice lollies; jellied eels; salmon salad; reheated chop; chicken; tinned pink salmon; cream buns. LEGAL PROCEEDINGS: Since 1955 legal proceedings have been taken in respect of 22 cases under the Food & Drugs Act or the Food Hygiene Regulations and these are summarized below. A conviction was secured in all but one case, that for selling a mouldy apple turnover. A summary of these is:- Mouldy foodstuffs 5 Foreign bodies not necessarily associated with faulty hygiene such as nails 6 Foreign bodies usually associated with faulty hygiene such as flies 4 Quality of vinegar or nonbrewed condiment 3 Margarine used in "buttered" rolls 1 Unhygienic conditions in bakehouses 1 Sale of milk from unregistered premises 1 Manufacture of sausages on unregistered premises 1 69 Details of legal proceedings instituted in 1960 are:- Date Premises Offence Under Food Hygiene Regulations 1955: 24.3.60 6 Barnsbury Road 26.4.60 337 St. John St. Under Section 16(1) Food & Drugs Act 1955: 26.4.60 337 St. John Street Under Section 2 Food & Drugs Act 1955. 26.1.60 23 Exmouth Market 5.9.60 2a Chapel Market Thirteen contraventions in respect of conditions in basement bakehouse. Eleven contraventions in respect of conditions in sausage factory. Using unregistered premises for the preparation of sausages for sale. Selling non-brewed condiment 10% deficient in Acetic Acid. Selling a mouldy chicken pie. Result Pined £50 on first summons. Fined £5 on remaining 12 summons Total £110, Costs £5.5s. 0d. Summons withdrawn on ceasing to use premises. Fined £10. Costs £5.55. 0d. Fined £5. Costs £5. 5s. 0d. Fined £20. Costs £10.10s.0d. 70 SECTION F INFECTIOUS DISEASES GENERAL: Although many infectious diseases are still prevalent especially among children, they have not been responsible, apart from Polio myelitis, for any deaths or, to any material extent, prolonged ill health or disability during the five years under review. Most diseases have been mild and even Diphtheria which re-appeared in the Borough in 1958 and 1959 adopted the character of a mild disease. Dysentery in the Nurseries and Schools was often troublesome to eradicate. Tuberculosis has now, fortunately, been displaced from its importance as a fearsome social evil. All cases are visited by the Nurse Visitor, and general advice has been given on the precautions that need to be taken in its control letters from the Medical Officer of Health setting out some of the principle points being delivered by her. Detailed enquiries are made as well as arrangements for the examination of contacts, and their exclusion as well as the patient from school or work where appropriate. In the occasional case where it may be desirable to exclude a contact from work the appropriate certificate under the National Insurance Act is given. These visits are of considerable value in limiting the spread of infections, and are in the main, greatly appreciated both by the Doctors and the patients or their parents. In some cases where it may appear to the Visitor that further medical treatment is necessary, the calling in of medical advice has been recommended. In 1960 2,132 visits were paid by the Nurse Visitor. The following table shows the incidence of notifiable diseases in 1960. Dysentery All Ages Under 1 yr 1-4 yrs 5-14 yrs 15-24 yrs 25-44 yrs 45-64 yrs 65- Cases treated in Hosp. 6 9 23 1 33 52 5 190 94 - 1 1 2 Erysipelas 4 - - - - 1 - - 1 - - Encephalitis - - 1 2 10 17 7 Food Poinsoning 73 1 10 24 4 15 5 10 - - - 6 - - Gastro-Enteritis (under 2 yrs) - - - 1 - 1 Malaria Measles 1 - - 120 254 121 27 12 - 1 - - 71 Meningococcal Infections All Ages Under 1 yr 1-4 yrs 5-14 yrs 15-24 yrs 25-44 yrs 45-64 yrs 65- Cases treated In Hosp. 2 - - 1 1 - - 2 - 2 2 - - 2 Paratyphoid - 8 - - 10 45 16 41 Pneumonia (Acute Primary) - 3 5 - 3 - 2 2 1 5 5 Pneumonia (Acute Influenzal) - - - - 1 - - 1 - - - Poliomyelitis (Paralytic) 1 1 4 3 - - - Puerperal Pyrexia - - 25 4 1 - Scabies 4 2 14 - 19 - - - Scarlet Fever 46 21 1 - - 24 - Tuberculosis (Pulmonary) 30 - 1 - 9 6 - 2 13 - - Tuberculosis (Other forms) 1 6 4 - - - - 40 22 1 - 31 79 Whooping Cough 15 1 - Total 783 261 291 42 71 46 24 171 48 DIPHTHERIA: There were two outbreaks of Diphtheria which occurred in the 5 year period, which may or may not have had any connection. The first was in 1958 and involved three schools and a few house contacts of the children concerned and involved 12 cases and 18 carriers. None of the cases were seriously ill. The second outbreak was in 1959 and involved one school in this Borough and one school in Islington. There were 50 cases and 30 carriers, and one child and one adult were seriously ill but both recovered satisfactorily. The full accounts of these two outbreaks were given in the Annual reports for 1958 and 1959 respectively. There was no knowledge of any case or carrier in the years 1956 and 1957 nor in 1960. DYSENTERY Outbreaks in the schools and nurseries in the Borough, have continued to occur throughout the period under review. In general there were very few cases of serious illness but a considerable degree of discomfort resulted in some instances and the presence of the disease has led to much minor social disturbance and concern. There has been a tendency for the infection to spread in the Homes to other members of the families involved. It is probable that it is in this way that the infection spreads from one institution to another 72 In 1956 there were 203 cases; 1957 120 cases; 1958 320 cases; 1959 45 cases and in 1960 190 cases. Of the cases in 1960, 97 were bacteriologically confirmed, 58 were diagnosed on clinical grounds alone without bacteriological confirmation, and in 35 symptoms were absent or so very mild and indefinite that they could be described as carriers only. All the infections in this year were due to Shigella Sonnei with the exception of three cases in one family where the organism was of the flexner type. The cases in 1960 involved two schools and one nursery. ENCEPHALITIS: In 1957 two elderly women developed this condition and died. There was no known connection between these cases nor was their cause discovered. In 1958 there was one case of Encephalitis following Influenza. and in 1960 one nurse from a hospital in the Borough developed this condition, the primary nature of the infection remaining undiscovered. In both cases recovery was complete. ENTERIC FEVER (PARATYPHOID) : There were no cases in the years 1956 to 1959, but in 1960 two cases were discovered in children, two boys aged 8 and 11 years respectively who were admitted to hospital for other conditions,and there found to be suffering from paratyphoid 'B' . All the contacts were carefully watched and examined, and the patients were further watched on their final discharge from hospital. In the case of one boy, the second specimen examined after discharge was found to be positive, but further examinations afterwards found to be negative. ENTERIC FEVER (TYPHOID): In 1956 there was one case of Phage E Typhoid which was contracted whilst on holiday in Spain. In 1959 there was one case of a woman aged 21 who was found,, when admitted to hospital for another condition, to be suffering from Typhoid. These individuals and their contacts were kept under strict supervision for a long period, and it is believed that no carriers have developed as a result of these attacks. There was no information in 1960 with regard to any cases or contacts. It is interesting to note that in the latter year 14 cases of simple sore throats were either referred by their doctors or attended the laboratory for swab examination, because of the concern felt by them or their parents by reason of the earlier outbreaks. 73 ERYSIPELAS: A few cases, including four in 1960, have been notified in each year The cases however, have not been serious, and recovery was rapid and complete in each case. CHICKEN POX: Chicken pox has occurred throughout the five year period being rather more prevalent in 1957 and 1960 than in the other years. In 1960 there were 121 cases which came to the knowledge of the department, and in none of these cases were there any complications. GASTRO- ENTERITIS (over 2 years): A few cases were reported to the department each year including 7 in 1960 All these cases were investigated and no specific infection was discovered, nor did the cases appear to be connected with any particular food GASTRO- ENTERITIS (under 2 years): A number of such cases have been notified each year. 28 in 1956, 30 m 1957. 15 in 1958, 18 in 1959 and 15 in 1960, Of the latter 10 were very mild and none really ill. 6 were admitted to hospital. This condition, at one time considered a serious threat to young individuals has now become of little significance. All the cases were investigated fully, but no infective organism was connected with. or other cause discovered HEPATITIS (Infective): Two cases came to the knowledge of the department in 1957 and three in 1960, and none in the other years GLANDULAR FEVER Three cases came to the notice of the department in 1956, one in 1957 and one in 1959 and none in the other years. MALARIA In 1956 and again in 1960 one case of Malaria was notified. In each case the patient had returned from abroad recently and was removed to hospital for treatment. 74 MEASLES: A considerable number of cases of measles have occurred each year the highest figure being in 1959 when there were 585 cases In general a certain number of the cases were moderately severe, a few very severe but the majority mild. In 1960 there were 254 cases, 27 of whom were treated in hospital, 114 were described as moderately severe 140 as mild, but apart from one of broncho-pneumonia and one of acute bronchitis, there were no complications and recovery was satisfactory in all. MENINGOCOCCAL INFECTION: In 1956 there were two cases of meningitis, in 1959 one case of Septicaemia, and in 1960 two babies, both of whom had meningitis. All recovered completely. MUMPS: Mumps continued throughout the period without any great variation in its incidence. In 1960 77 cases came to the knowledge of the department and there were no complications in any of these cases OPHTHALMIA NEONATORUM: Prom 1956 to 1959 a few cases were notified, each year, but in 1960 there were no cases. The cases were investigated by the Officers of the London County Council and none were serious PNEUMONIA (Acute Primary): Each year there have been from 40 to 90 cases of Pneumonia (primary) notified, nearly all of whom have been satisfactorily treated in hospital. The highest incidence was in 1958 when there were 89 cases,: in 1960 there were 45 cases. PNEUMONIA (Acute Influenzal): A few cases have been notified each year, the highest number being in 1957 when Influenza occurred in epidemic form in the country Apart from the 14 cases of Influenzal Pneumonia notified in that year 120 cases of influenza came to the knowledge of the Department There was no evidence in other years of any undue incidence of Influenzal Pneumonia or Influenza In 1960 5 cases of pneumonia were notified all of whom were treated in hospital. 75 POLIOMYELITIS: During these five years there were 13 definite cases of Polio myelitis:- two in 1956; five in 1957 (one of these cases was notified in another area where he had proceeded for about a week); two in 1958; three in 1959 and one in 1960, All but one of the cases, a child of 8 with non-paralytic disease in 1959, were below the age of 5. one being under 12 months This incidence is well below the National & Regional average, and it is specially to be noted that no adult cases occurred In spite of intensive investigation no relationship was discovered between any of the cases and any other known case elsewhere, except that it seemed probable afterwards that a playmate of one child had recently recovered from a mild non-paralytic attack. One case of a girl of 4 had a very severe attack in 1958 involving arms legs, back and chest, and was nursed in a respirator for a considerable time, spent 18 months in hospital, but is now able to go about in a wheeled chair, and attend a residential school. Three cases recovered completely, but for some leg weakness for which a caliper is now worn. Two recovered completely but for some weakness of facial muscles. Two have moved out of the district one with paralysis of the back and right leg making very slow progress, and one believed to have made a complete recovery. The remaining four cases two of them non paralytic, have made complete recoveries. The child of 8 in 1959 without paralysis was the only case who had had two injections of Poliomyelitis Vaccine. The girl of 4 with widespread paralysis had her first injection 10 days before the onset of the disease i. e during the incubation and too late to give any protection, None of the other cases had received any vaccine The case in 1960 was that of a girl aged 16 months who had some bulbar paralysis including the left side of the face Recovery was complete except for some weakness of the face muscles already referred to. 76 IMMUNISATION AGAINST POLIOMYELITIS (Information kindly provided by Dr.W. G.Harding. M. R.C.S., L.R.C.P., D.P.H. Divisional Medical Officer of Health, L.C.C. Division III). The following table summarises the development of the national immunisation programme:- May and June 1956 December 1956 to March 1957 June 1957 to December 1957 January 1958 September 1958 January 1959 February 1960 Children of all ages "registered" for inoculation but Ministry chose children born in certain months of 1947-54 for inoculation. Supplies of vaccine were limited. Further months chosen by Ministry. Inoculation extended to all who had registered born 1947-56. Age range extended to include those born 1944-57 and priority groups added (expectant mothers, general practitioners and their families, London Ambulance Service personnel and their families Young people bom 1933 or later included. Third injections started - not less than 7 months after the second injection Scheme extended to include those born before 1933 but not yet 40. In Division 3 which comprises the Metropolitan Boroughs of Finsbury, Holborn and Islington, the bulk of immunisations was carried out in the maternity and child welfare centres, and in the schools. These activities for which special additional sessions were introduced in all child welfare centres including Leage Street and Pine Street, were supplemented by the efforts of general practitioners in the area, as well as by ad hoc activities organised by the Divisional Health Office in consultation with the three Borough Medical Officers of Health. Thus lunch-time sessions, intended primarily for young office workers in Finsbury and Holborn and not restricted to residents in these boroughs, were instituted in the Divisional Health Office. 53 Clerkenwell Road, (serving primarily Finsbury) and Holborn Town Hall in 1958, and later in the Kingsway Hall. In spite of these conveniently located and timed arrangements the response was initially disappointing The trafic death of Jeff Hall, the Birmingham footballer, produced a striking change; on 16th April 1959 no less than 1,112 first injections were given during one lunch-time session at 53 Clerkenwell Road, 77 All firms in finsbury and Holborn were circulated, and in addition to the activities on the London County Council's premises, and in the surgeries of family doctors the offer of sending a mobile vaccination team if 5 or more volunteers for vaccination could be found was readily accepted by a number of firms. This idea was further developed by taking into commission in September 1959 a mobile immunisation clinic, converted from an obsolete school bus, which visited popular street sites, housing estates etc, traffic conditions permitting,and in which a total of 6,659 injections were given up to 31st December 1960, Total numbers immunised in Division 3 were as follows:- Year immunised 2nd injection 3rd injection 1956 1,057 - - 1957 7,205 1958 19,093 65 1959 46,033 33,188 1960 Total 19,352 30,848 92,740 64,101 The age distribution was as follows:- Age Group 2nd injection 3rd injection Adults born before 1945 49,537 31,725 School children now aged 5-15 born in:- 1946 3,267 2,872 1947 3,263 2,401 1948 2,815 2,133 1949 2,773 2,160 1950 2,767 2,152 1951 2,619 2,028 1952 3,020 2,237 1953 2,988 2,288 1954 3,240 2,446 1955 3,002 2,381 Total 29,754 Total 23,098 Estimated total number of children resident in the Divisional Area 5-15 yrs 35,230. Under 5 born in:- 1956 3,299 2,599 1957 3,568 2,882 1958 3,323 2,699 1959 2,745 1,098 - 1960 514 Total 13,449 Total 9,278 Estimated total number of children under 5 resident in the Divisional Area 24,200, Total 92.740 Total 64.101 NOTE: No comparison with total population possible as a large number were resident elsewhere, but working in the District. 78 PUERPERAL PYREXIA: One case was notified in 1956; 22 in 1957; 7 in 1958; 1 in 1959. In 1960 there were 7 cases notified of Finsbury residents in various hospitals, and 4 cases within the Borough. The cases were investigated by the Officers of the London County Council, and none were serious. RUBELLA: A number of cases have been reported each year, the highest number being 45 in 1957 and in 1960 there were 15 cases so reported. Enquiries are made in connection with each case to ascertain whether any contact with any women in early pregnancy was likely to occur, and if so to endeavour to prevent it. SCABIES: The incidence of Scabies has continued at a low level, and has not been of any concern, and in 1960 25 cases were notified. SCARLET FEVER: The incidence of this disease has continued unchanged. Each year there have been between 25 and 70 cases notified, but few have shown any degree of severity. About half of these cases have usually been treated in hospital. In 1960 there were 46 cases, with 19 treated in hospital; one of these developed cervical adenitis and recovery was complete in this and other cases. SMALLPOX: There were no cases of Smallpox during the 5 year period. In 1957 eleven contacts of a possible case in another area, and in 1960 two contacts of a modified case, also from another area, were kept under observations for the appropriate period All such persons had been vaccinated. TUBERCULOSIS: The past five years have shown a further fall in the number of notifications of and deaths from Tuberculosis, but they still remain slightly above National rates. This may not however, necessarily reflect a higher incidence in the Borough than elsewhere In regard to notifications, the rate depends on the criteria adopted in diagnosis, and as regards deaths by the allocation to the area of cases which had not developed the disease here and may not have lived for more than a very short time in the Borough. 79 One striking change that has occurred over the past 20 years, has been the rarity of deaths in recent years of those under 45, and another is the few cases of Tuberculosis in an infectious state now living at home, and therefore a source of potential danger to the community. On a recent analysis only 8 such cases were known, whereas not so many years ago there must have been many times this number. In 1960 36 new notifications were received, and their age and sex distribution was as follows:- Pulmonary M F Non-Pulmonary Totals M F 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total n M □ 24 7 1 1 1 2 5 6 5 5 1 2 1 2 1 M □ n LI 1 2 1 2 3 □ 2 7 6 7 7 6 36 The non-pulmonary cases included three cervical glands, one pelvis and one rectum. The notification rate of all forms of T.B. was 10.7 per 10,000 as against 6.0 for the whole country (1959). The total number of cases remaining on the Register after adjustment for deaths and transfers were, on the 31st December 1960. Males Females Total Pulmonary 148 102 250 Non-pulmonary ... 10 6 16 158 10S 266 The details of each case were obtained by the Tuberculosis Visitor, and by the kind co-operation of the London County Council made available to the Public Health Department and any preventive measures possible co-ordinated in this way. There were 4 deaths during 1960 as follows:- (a) from pulmonary Tuberculosis:- (1) A Male aged 52 who was notified six weeks before he died. (2) A Male aged 52 from a Common Lodging House in the Borough but who was not notified before his death, in the Hospital to which he was admitted. (b) from Non-pulmonary Tuberculosis:- (1) A Male aged 52 (A Cypriot) who died from a Tuberculer spine and was not notified prior to death. (2) A Female aged 42 who died of Tuberculer spine and was not notified prior to death. 80 The average death rate from all forms of Tuberculosis in Finsbury for the past five years was 15 per 100,000 of the population, the average for the whole country being about 10.0. For 1960 the rate was 12 as against the national of 8.5 (1959). I should like to acknowledge the willing co-operation and facilities in the interchange of information, which has been provided by the Chest Physician Dr. W.D.R.Thompson, and his staff WHOOPING COUGH: Whooping cough has continued throughout the period under review the highest incidence having been in 1956, when there were 146 cases and six of whom were very severe and 84 moderately severe In 1957 there were 47 cases; in 1958 29 cases; in 1959 17 cases and in 1960 79 cases, of which 46 were regarded as moderately severe, and 33 as mild. These figures include two adults, one of whom had previously suffered from the disease in childhood. 5 cases of Bronchitis and one of Broncho-pneumonia occurred as complications but otherwise progress was satisfactory. MASS RADIOGRAPHY UNIT 6D: A mass radiography unit has continued to operate in the district during the whole of the period 1956-1960. There has been little variation from year to year in the number of persons examined, or of those found to be suffering from Pulmonary Tuberculosis In 1956 a number of Public Sessions were held in the Health Centre at which no appointments were required, but the response was not great From 1958 cases referred by General Practitioners have been examined without appointment, and considerable use has been made of this facility. The Medical Director of the Unit - Dr. W. D.R.Thompson, has kindly provided me with the following summary of its activities during 1960. During 1960 the Mass Radiography Unit examined 37,948 males and 26,408 females making a total of 64,356 which was somewhat lower than the average for the past few years Up to the end of 1960 the Unit has examined 625,464 persons since it commenced operations in May 1950 Sixty-three cases with significant tuberculous lesions have been discovered during the year, as well as twenty cases of carcinoma of the lung. All clinics have recorded their sputum findings and twenty cases had a positive sputum 81 The Unit functioned at the Mass Radiography Centre, 20 Golden Lane E.C.I for about seven months in the year, and during the remaining months it visited firms and organisations which included a co operative Survey at the Finsbury Health Centre, by kind permission of the Public Health Committee of the Borough of Finsbury when nearly four hundred firms participated and 4,004 men and 2,546 women were X-rayed. The Unit also participated in the Special Campaign at Stepney arranged during October/November 1960. During the year under review nearly three thousand new firms were advised of the Mass Radiography Service and produced satisfactory results. General Practitioners have continued to use the Unit's services and such cases have produced an incident rate of 23.08 per 1,000 examined. Anyone wishing to obtain information on the Mass Radiography Service should communicate with the Organising Secretary. Mass Radiography Unit 6D, Finsbury Health Centre, Pine Street, E.C.I. (Tel, No. TERminus 0031 Ext.9)." FINSBURY CHEST CLINIC: Information kindly provided by Dr.W.D.R.Thompson, Chest Physician). During the year 1960 a total of 2,147 patients were seen in the Chest Clinic Of this total, 124 attended for the first time as contacts of notified cases, and a further 150 were re examined as routine contact checks. The number of new cases of tuberculosis taken on the clinic register during the year amounted to 38, of which 33 were pulmonary and 5 non pulmonary. 25 of these pulmonary cases proved to be infectious.In addition to these cases a further 21 notified cases (20 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 31st December 1960 was as follows:- Respiratory Non respiratory Totals Grand Total M W Ch. M W Ch M W Ch 143 100 12 8 6 2 151 106 14 271 The previous years total was 269. During 1960 there were 10 deaths (males), 5 higher than 1959. 82 Of the cases removed from the register during 1960, a total of 10 were recovered, 35 were transferred out to other areas, and the remaining 2 cases were removed from the register as "diagnosis not confirmed" (1)„ and "lost sight of" (1), The total number of cases x-rayed during the year was 1,201. The London County Council Tuberculosis Health Visitors, seconded to the Chest Clinic, made 365 visits to homes in the borough during the year. Each case was visited with a 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 STAFFING ARRANGEMENTS Staff consists of the Chest Physician, a whole time clerk, a radiographer, and nursing and social welfare personnel Laboratory facilities are also available. Miss F.M.Prior retired at the end of 1959 after 30 years out standing service in the Borough and at present she carries out the duties of radiographer. The Nursing arrangements provided by the London County Council during 1960 have, for a number of reasons, been without continuity. the Clinic being allocated more than half a dozen temporary persons As a result there has been a deterioration in the standard of work and the number of home visits fell considerably No Social Worker could be secured in spite of advertising and other measures. Miss R.A.Bennett, a trainee Health Visitor was appointed on November 14th 1960 for seven sessions a week, on the understanding that she would be available for emergencies as they arose It is proposed to appoint Miss A Phelps at the beginning of 1961 to act as the Social Worker and Secretary of the Tuberculosis Care Committee, for 3 sessions a week This has one advantage in that she is normally in the Health Centre and can be seen when necessary. These arrangements are not ideal in a clinic of this nature, it being considered by the Chest Physician that it is more satisfactory to have one whole time person appointed as Health Visitor and Social Worker, who would then be available for patients at all times, instead of the present arrangements of two part-time persons 83 APPENDIX "A" List of special reports submitted to the HEALTH COMMITTEE by the Medical Officer of Health during 1960. January 11th Midday Meal Services for the Elderly 1959. February 8th Grants Voluntary Organisations. March 14th Accidents in the Home. Report on the Importation of Swedish Pig Carcasses Radiation Hazards in the Distribution and Use of Luminising Compounds, Malaria. World Health Day 7th April 1960. June 13th Social Workers' Conference. Atmospheric Pollution, 67th Health Congress Royal Society of Health. October 10th Mid-day Meal Services for the Aged. Jan-June 1960. Finsbury Employment Scheme for the Elderly Ist April 1959 to 31st March 1960. Conference Health & Social Wellbeing 1961. Manual Staff Reduction of Working Hours Review of Manual Staff. Public Health Inspection Nursing Staff Absence through Sickness Manual Staff Holiday Scheme 1961. November 7th Procedure for the Establishment of Smoke Control Areas. Clean Air Act 1956. Proposed Finsbury (No.1) Smoke Control Area Clean Air Conference Harrogate October 5th/7th 1960 December 5th Home Safety Exhibition. National Safety Congress. October 1960. Finsbury (No.2) Smoke Control Area Grants Voluntary Organisations & Monthly Report & Statistical Report for each month. APPENDIX "B" List of Special Reports submitted to the HOUSING COMMITTEE by the Medical Officer of Health during 1960. December Fireguards in Council Property. 84