541 Ackid:17/9/62 FIN 42 The Metropolitan Borough of Finsbury ANNUAL REPORT ON THE PUBLIC HEALTH OF FINSBURY for the Year 1961 BY C. O. S. BLYTH BROOKE, M.D., B.S., D.P.H. Medical Officer of Health FINSBURY HEALTH CENTRE, PINE STREET, LONDON, E.C.I. The Metropolitan Borough of Finsbury ANNUAL REPORT ON THE PUBLIC HEALTH OF FINSBURY for the Year 1961 BY C. O. S. BLYTH BROOKE, M.D., B.S., D.P.H. Medical Officer of Health FINSBURY HEALTH CENTRE, PINE STREET, LONDON, E.C.I. To the Worshipful the Mayor, Aldermen and Councillors of the Metropolitan Borough of Finsbury. MR. MAYOR, LADIES & GENTLEMEN, I have the honour to present to you my Annual Report for the year 1961. In my last report, that for 1960, I endeavoured to outline the progress of the Health conditions in Finsbury for the past five years, in a continuation of my report for 1955, when I summarised the progress made since the war, and in consequence I dealt with most of the subjects at greater length than usual. I feel it is a mistake however, to scrutinize either the vital statistics or any branch of Public Health too closely from year to year, as considerable fluctuations occur due to chance circumstances of little significance, whereas the trends over several years are of greater importance. On this occasion therefore, my report is rather more brief than usual. I am satisfied the general health of the population has remained good, and that the work carried out by my department has contributed thereto. The Birth rate has fallen very slightly from 17.1 recorded for 1960 to 16.9 for 1961, whereas the rate for the country as a whole, rose to 17.4. The Death rate has risen slightly from 10.1 in 1960 to 10.6 in 1961, but remains well below the National figures which also rose from 11.5 to 12.0. An unhappy feature which it is my duty to record, is that the infant mortality rate, which for the past two years has been extremely low, round and about 15, rose to just under 31. The National rate has been between 21 and 22 in recent years. Nearly all these infant deaths occurred in the first few days of life, and cannot be related to unsatisfactory surroundings. I have been asked by the Ministry to include this year a statement of the early Neonatal and the Perinatal mortality rates which have not previously been included as a routine in the reports of Medical Officers of Health. The latter rate which combines Stillbirths with deaths under one year of age (this is for many purposes of little significance where death takes place just before or just after birth), has been increasingly used in recent years, and a study of these trends should prove useful in the years ahead. 2 The various activities which members of my staff have been engaged upon have been maintained, and have not only been maintained but in small ways have been expanded Those in connection with the care of the elderly have continued to be among the forefront of those in any areas, and I have been privileged to receive many distinguished visitors. Anotable event in the year was the Home Safety Exhibition held in the Town Hall for a week in November. This was most ably organised and arranged by my Deputy Dr Bates with the assistance of many organisations and individuals including members of my staff. It was visited by a fair number of the public, including various school parties and individual children. It is impossible to assess the educational value of such a venture but it might well have directed a number of minds to dangers which they had not appreciated, and reminded others of them. In this way it may have served a very valuable purpose. It is a pleasure to record the help and support that you, Mr Mayor, and members of the Council, have continued to give me, particularly that of the Chairmen and Members of the Committees with which I have been principally concerned. It is also a privilege to be able to express formally, my sincere appreciation for the loyal co-operation and help I have enjoyed from all members of my staff. I have the honour to be Your obedient Servant, C. O. S. BLYTH BROOKE, Medical Officer of Health. 3 HEALTH COMMITTEE Chairman: Councillor C. Payne Vice-Chairman: Councillor A. E. Ley Alderman C.A. Allen, J. P. Councillor A. Ashton „ Mrs. S. Cliffe „ A. A. Goldshaw „ R. J. Redrupp „ J. E. Sellers „ Mrs. L. C. Trotter „ Mrs. B. Wheare Medical Officer of Health: C. O. S. Blyth Brooke, M. D., B. S., D. P.H. Deputy Medical Officer of Health: M.M. Bates, M. A., M. D., B. Chir., D.C.H., D.P.H. Public Analyst: C. Harcourt Wordsworth B. Sc. (to October 1961) J.H.E. Marshall, M.A., F.R.I.C., (from October 1961) 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, F.A.P.H.I. L.A Brittain, M.B.E., T.D., M.A.P.H.I., (w. e. f. 8.5.61) G.A. Buckingham, M.A.P.H.I. (w.e.f. 1.4.61) B.J. English, M.A.P.H.I. (w.e.f. 6.2.61) R.C. Sanderson, M.A.P.H.I., M. Inst. P. C., (w.e.f. 20.3.61) M.G. Illman, M.A.P.H.I., M.R.S.H. J.A. Daniel, M.A.P.H.I. (Resigned 12.2.61) Smoke Control Officer: R. A. Cummins Student Public Health Inspectors: M. E. S. Poultney D. Nattress 4 Senior Meat Inspectors: R.S. Barber, F.A.P.H.I. Senior Laboratory Technician: A.B. Charles, F.I.M.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 F.W. Haynes I. Patience R. Blakeley Miss E. Buhr J.A. Smith 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.F.N. Assistant Nurse Visitor for the Aged: Mrs. C.F. Tennant. S.R.N. (w.e.f. 15.5.61) (Resigned 31.10.61) Health Centre Caretaker: R. North 5 SECTION A PHYSICAL FEATURES AND SOCIAL CONDITIONS GENERAL: Area of the Borough (acres) 587 Population 1961 census 32,989 Population Density 56 Rateable Value 31.3.61 £2,918,330 Product of a penny rate (1960/61) £11,595 General rate (1960/1961) 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 Finsbury suffered the loss of many factories, warehouses and offices, especially in the Eastern part of the Borough and there still exist many bombed sites. Residential property also suffered considerable damage. The rateable value has steadily increased since 1951 when it was £956,228 consequent on rebuilding of war damaged properties and devastated areas. A feature of post war development has been the erection of large blocks of modern flats. 6 PRINCIPAL VITAL STATISTICS Population (Mid year estimate): 33,020 Marriages registered: 232 Live Births: Legitimate - Males 292 Females 276 Total 568 Illegitimate - „ 35 „ 10 „ 45 Total - „ 327 „ 286 „ 613 Birth Rate (Standardized): 16.9 England & Wales 17.4 Stillbirths: Legitimate - Males 5 Females 4 Total 9 Illegitimate - „ - „ „ - Total - „ 5 „ 4 „ 9 Stillbirth Rate: Per 1,000 live & stillbirths 14.4 England & Wales (Per 1,000 live & stillbirths) 18.7 Per 1,000 Population (standardized) 0.24 Deaths: - Males 186 Females 166 Total 352 Death Rate (Standardized): 10.6 England & Wales 12.0 Infant Deaths: 19 Infant Mortality: 30.9 England & Wales 21.4 Early Neonatal Mortality Rate: 26.10 Perinatal Mortality Rate: 40.18 Neonatal Deaths: 17 Neonatal Mortality: 27.7 England & Wales 15.5 Illegitimate Infant Deaths: 2 Illegitimate Infant Mortality: 44.4 Maternal Deaths: 1 Maternal Mortality: 1.6 England & Wales: 0.33 Tuberculosis (all forms) death rate: 0.06 England & Wales 1960 all forms per thousand 0.075 Respiratory 0.068 Other forms 0.007 Area Comparability factors - Births 0.91 Deaths 0.99 7 COMPARATIVE STATISTICS 1957-1961 1957 1958 1959 1960 1956-60 1961 1. Population 34,830 34,960 34,030 33,710 34,480 33,020 2. Birth Rate Per 1,000 Population 20.7 18.0 18.5 19.00 19.2 18.6 3. Sex Ratio Male/Female - - - - 1, 113 - 4. Illegitimate Birth Rate Per 1,000 Population 1.7 1.2 1.3 1.3 1.4 1.3 Per 1,000 Live Births 83 71 72 70 74 73 5. Stillbirth Rate Per 1,000 Population 0.49 0.54 0.38 0.36 0.40 0.27 Per 1,000 Total Births 22 29 20 19 21 14 6. Death Rate Per 1,000 Population 10.0 9.7 11.2 10.0 10.2 10.6 7. Infant Mortality Per 1,000 Live Births 22.1 22.2 15.9 15.6 21.0 30.9 8. Infant Mortality Illegitimate Per 1,000 Illegitimate Live Births - - - - 29 - 9. Neonatal Mortality Per 1,000 Live Births 15 17 8 10.9 16 27.7 10. Maternal Mortality Per 1,000 Total Births - - - 1.5 0.30 1.6 11. Tuberculosis (all forms) Death Rate Per 1,000 Population 0.20 0.20 0.03 0.12 0.15 0.06 Crude Rates have been given in every case A dash indicates that numbers are too small for the calculation of a significant rate POPULATION: A further very slight decline in the population has been recorded. BIRTHS: The Birth rate has fallen very slightly since that recorded in 1960. The proportion of illegitimate births has remained very much the same as in recent years. STILL-BIRTHS: The Still-birth rate has fallen very slightly, and is now just below the National rate. DEATHS: There is a very slight rise in the standardized death rate, but it remains well below the National figure. MATERNAL DEATHS: For the second year in succession, I regret that I must record a maternal death and in consequence the rate is again very high. The death in 1960 was recorded as that of a woman aged 32 from Hepatic Necrosis, due to multiple pregnancy with renal failure and macrocytic anaemia given as contributory factors and that in 1961 as of a woman aged 22 from Acute haemorrhagic necrosis of suprarenal glands due to infected abortion. INFANT MORTALITY: A large number of infant deaths occurred in 1961 following two years when we had been extremely fortunate in having very few such deaths. The rate is recorded as 30.9 as against 21.4 for the whole country. All but two of these occurred in the Neonatal period-that is during the first four weeks of life, - and the neonatal rate of 27.7 is therefore also high All but one of the neonatal deaths occurred in the early neonatal, that is during the first week of life. It should be also noted that two of these deaths were among illegitimate children. The causes of infant deaths are set out in the table, and as in recent years, all over the country, immaturity played a very large part. 9 CAUSES OF DEATH 1961: 1. TUBERCULOSIS RESPIRATORY 2. TUBERCULOSIS OTHER 3. SYPHILITIC DISEASE 4. DIPHTHERIA 5. WHOOPING COUGH 6. MENINGOCOCCAL INFECTIONS 7. ACUTE POLIOMYELITIS 8. MEASLES 9. OTHER INFECTIVE & PARASITIC DISEASES 10. MALIGNANT NEOPLASM-STOMACH 11. „ „ - LUNG BRONCHUS 12. „ „ - BREAST 13. „ „ UTERUS 14. OTHER MALIGNANT & LYMPHATIC NEOPLASMS 15. LEUKAEMIA, ALEUKAEMIA 16. DIABETES 17. VASCULAR LESIONS OF NERVOUS SYSTEM 18. CORONARY DISEASE, ANGINA 19. HYPERTENSION WITH HEART DISEASE 20. OTHER HEART DISEASE 21. OTHER CIRCULATORY DISEASE 22. INFLUENZA 23. PNEUMONIA 24. BRONCHITIS 25. OTHER DISEASES OF RESPIRATORY SYSTEM 26. ULCER OF STOMACH & DUODENUM 27. GASTRITIS, ENTERITIS & DIARRHOEA 28. NEPHRITIS & NEPHROSIS 29. HYPERPLASIA OF PROSTATE 30. PREGNANCY, CHILDBIRTH, ABORTION 31. CONGENITAL MALFORMATIONS 32. OTHER DEFINED AND ILL-DEFINED DISEASES 33. MOTOR VEHICLE ACCIDENTS 34. ALL OTHER ACCIDENTS 35. SUICIDE 36. HOMICIDE & OPERATIONS OF WAR TOTALS: 10 11 INQUESTS: Inquests were held on fourteen residents during the year. The causes of death found were Road Accidents: Males - 41, 20 2 Females - 69 1 Accidents from Falls, excluding Industrial: Males - 51 1 Lack of attention at Birth: Female - 15 minutes 1 Other Accidents: Male - 61 1 Female - 76 1 Open Verdicts: Female - 50 1 Suicide: Males - 68, 26, 25 3 Females - 29, 26 2 Murder: Female - 26 1 14 INFANT MORTALITY 1961-CAUSES OF DEATH Causes of Death 0-1 wk 1-2 wks 2-3 wks 3-4 wks Total under 4 wks 1-3 mths 3-6 mths 6-9 mths 9-12 mths Total under 1 yr IMMATURITY 9 - - - 9 - - - - 9 BIRTH INJURY 2 - - - 2 - - - - 2 OTHER DEFINED CAUSES 3 - - - 3 1 - - - 4 CONGENITAL ABNORMALITY 2 1 - - 3 - - - - 3 BRONCHITIS - - - - - 1 - - - 1 TOTALS: 16 1 - - 17 2 - - - 19 (In this table the international rules for classification have not been strictly followed). 12 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 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 public 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 foodstuffs, and has operated in close association with the Central Public Health Laboratory service in Colindale. In addition it continues to undertake simple routine pathology on behalf of the Chest Clinic, other clinics in the Health Centre, and of medical practitioners in the District. A particular feature has been the 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 been prevalent. The services of the Laboratory Technician have been available for a limited number of Domiciliary visits when these have been called for. The following table sets out the work undertaken in the year 1961. 13 WORK OF THE PUBLIC HEALTH DEPARTMENT Ear, Nose and Throat Swabs 117 Per Nasal Swabs 32 Faeces 1,231 Milk 36 Ice Cream 91 Water 23 Meat 64 Various Foods 25 Sputums 185 WORK OF THE REGIONAL HOSPITAL BOARD Bacteriology 87 Haematology 429 Biochemistry 119 Total Number of Domiciliary Visits 7 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 BLOOD TRANSFUSION: The Council continued to co-operate with the National Blood Transfusion Service, by arranging Blood Donation Sessions at the Health Centre. Four sessions were held during the year at which 420 donors attended. 388 were bled and 32 rejected for various reasons. The comparative figures for 1960 were 325 donors, 289 bled and 36 rejected. 14 INTERNATIONAL CERTIFICATES OF VACCINATION AND INOCULATION: The international form of certificate of vaccination and inoculation approved since the war requires the signature of the medical practitioner issuing the certificate to be authenticated by the Medical Officer of Health. The purpose of the authentication is to provide proof to health authorities abroad that the signature of the person issuing the certificate is that of a registered medical practitioner. In 1961 221 certificates were authenticated, no case of an improper signature was discovered, and no application in consequence refused. BURIAL OR CREMATION OF THE DEAD: It is provided by Section 50 of the National Assistance Act, 1948, that the local authority shall arrange burial or cremation in the case of any person who has died or been found dead in the borough, in any case where it appears to the authority that no suitable funeral arrangements have been or are being made. During the year six persons were buried or cremated under these provisions. HEALTH EDUCATION: Health educational activities were continued during the year by the exhibition of public posters combined with the distribution of literature to suitable centres. Health education in general was also carried out throughout the year by all the members of the staff who are in contact with the general public in their homes and businesses. 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 cooperation of the Libraries Department. Enamelled panels showing details of hospitals with times for attendance, where advice or treatment on Venereal Diseases can be obtained, were renewed as necessary in the Council's Public Conveniences. The Council also continued to co-operate in the Health publicity programme organised by the London County Council Health Division III. 15 "Be Safe in Your Home" Exhibition. The Council held a "Be Safe in Your Home" Exhibition at the Finsbury Town Hall for the period 1st to 7th November 1961 inclusive, which coincided with the National Campaign, to reduce the loss of life and limb caused by home accidents. The Exhibition was opened by the Worshipful the Mayor of Finsbury, Councillor W.C. Comley, J.P. The extensive scope of the Exhibition can be gained by reference to the list of Exhibitors which is as set out below:- 1. Birmingham Corporation. 2. British Red Cross Society. 3. British Standards Institution. 4. Crayleigh Safeguard Products Ltd. 5. Daily Mirror. 6 Emberton, Franck & Tardrew (Architects). 7. Finsbury Borough Council (Hazard House). 8. Lion Stamping Co. Ltd., Oil Heaters. 9. London County Council. 10. London Electricity Board. 11. Luton Home Safety Committee. 12. Metropolitan Police. 13. Ministry of Health. 14. Moorfields Eye Hospital. 15. North London Association of Opticians. 16. North Thames Gas Board. 17. Proban Ltd. 18. The Pyrene Co. Ltd. 19. The Royal Society for the Prevention of Accidents. 20. St. Bartholomew's Hospital (Pharmacist). 21. St. Bartholomew's Hospital (Diagnostic Radiology Dept.). 22. St. John Ambulance Brigade. 23. World Health Organisation. 24. Women's Advisory Council on Solid Fuel. A feature of the Exhibition was the display of posters submitted by School-children in the Borough, to the Home Safety poster competition, the prizes for which were kindly presented by the Worshipful the Mayor of Finsbury. Additional attractions were cookery demonstrations and film shows. An attractive brochure produced in connection with the Exhibition was a useful medium of Health Education, containing as it did authoritative articles on various aspects of home safety. It can be said that the Exhibition was a successful one having regard to its nature, being fairly well attended by the General Public, and being well attended by School-children both individually and in organised school parties. 16 A "Welcome to Citizenship" Exhibition was sponsored for the first time by the Council, with the co-operation of the Staff, and proved highly successful. Each department attempted to show a small proportion of its work, and how it affected the general public, in an endeavour to promote interest by young local government voters in the public affairs of their own Borough. In this, the Health Department played its part, and I am pleased to record that the Department's exhibit, which was arranged mainly by the Chief Public Health Inspector, was voted the best exhibit. ELDERLY PERSONS: The Council has continued its very active concern and support during 1961 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 £7,256 during the financial year 1960/61. The work of these organisations has been co-ordinated as far as possible by the Finsbury 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.O.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, with 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. 17 Dinner services, therefore, have been instituted through voluntary associations throughout the Borough. A grant is given to the associations by the Council to cover their expenses and further grants are made by the London County Council and Finsbury Old People's Welfare Committee, to enable the meals to be supplied at a cost of elevenpence per head to the elderly. During 1961 20,680 meals were served from Meal Centres as against 20,062 in 1960. The following centres were in operation for 3 to 5 days weekly throughout the year: (i) Women's Voluntary Service, 68 Exmouth Market, E.C.1. (ii) Field Lane Community Centre, Cubitt St, E C.1. in connection with Field Lane Institution, 16 Vine Hill, E C 1. (iii) Claremont Central Mission, White Lion Street, N. 1. (iv) Finsbury Mission, Moreland Street, E.C.1. (ii) 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". 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 the Finsbury 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. During 1961, 4,941 such meals were served to elderly persons unable to attend a meal centre. The cost to the elderly was one shilling per meal. (c) Nutritional Supplements (F.O.P.W.C.) The arrangements continued with Messrs Wander Ltd., Messrs Bovril Ltd., and Messrs Marmite Food 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. 18 (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.1. made possible as a result of a number of generous benefactors and opened by the late Lord Horder in November 1954, has proved eminently satisfactory in every way. In 1960 a small branch scheme for about 10 persons was opened in the Community Centre on the Priory Green Estate. It was hoped to expand this branch in 1961 but so far this has not proved possible. Some 120 elderly persons have undertaken work which has been mostly outwork on behalf of many firms, who have generously cooperated, but some articles have been made for sale to the trade or direct to the public. The elderly employed have for some years been paid a small wage amounting to 10/- a week, which is slightly more than the actual value of the labour provided. It was possible towards the end of 1961 to increase this wage to 12/6 per week. 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. (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. 19 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. Holidays were provided in this way for about 357 persons in 1961, comprising 46 married couples, 42 men and 223 women at a total cost to the Council of £2,926. Holidays were provided at Ramsgate, Brighton, Bognor, Leigh-on-Sea, Clacton, Margate, Worthing, Chigwell (Essex) and Herne Bay. The Scheme has proved an unqualified success as was evidenced by the large number of appreciative 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 number of about 45 to 50 persons have in this way been able to retain their clothes and bedlinen in a wholesome condition. (g) Bathings: 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. In April 1961 an additional bathing attendant was appointed to cope with the increased demand for the service. 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. 20 (h) Cleansing: Occasional cleansing services have been provided for those aged persons where their accommodation has been allowed to become so dirty and unwholesome that it had become beyond their capabilities to get it clean again, although possibly able with or without the aid of a domestic help, to keep it at least for a time sanitary, once it had been cleansed. (i) Chiropody: (1) There is a satisfactory chiropody clinic in the Health Centre, administered by the London County Council, which is available for the elderly as well as for others. (2) A domiciliary service (F.O.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. 551 visits were paid in 1961 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, and do things for themselves, and so retain the independence essential to their mental and physical well being. (j) S.O.S. Cards (F.O.P.W.C.): The S.0.S. 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 year 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 apractical value also has a comfort value, as many of the aged express the sense of security which possession of the card affords them. (k) 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.1. Claremont Central Mission, White Lion Street, N.1. 21 British Red Cross Society, Walmsley Street, E.C.1. British Red Cross Society, Priory Green Community Centre, N.1. St. Luke's Church, Old Street, E.C.l. St. James (Pentonville) Womens Fellowship, Pentonville Road, N.1. St. James (Clerkenwell) Clerkenwell Close, E.C.1. Holy Redeemer Church, Exmouth Market, E.C.1 Sunshine Club, 33 Lloyd Baker Street, W.C.1. Special mention however, should be made of that organised by the British Red Cross Society at 9 Walmsley Street, E.C.1. The premises consist of the basement (kitchen) ground floor and 1st 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-though in fact the numbers using them have been small. The ground floor rooms are used as a snuggery for the elderly to sit and gossip round the fires. A special afternoon meeting was arranged each week for the housebound 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 was only necessary on one occasion during 1961 to use the provision of the National Assistance Act or of the Amending Act (under which both the Medical Officer of Health and his Deputy are empowered by the Council to act in urgent cases) to secure the compulsory removalof any aged persons. The case in question was a man in his late 70's living alone under insanitary conditions who subsequently settled down in a Welfare Home. OTHER ACTIVITIES FOR THE ELDERLY: 1. Ambulance (F.O.P.W.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 domiciliary meals until November 1961, when it was possible to purchase a more suitable van from a grant received from the Council. 2. Barber and Hairdresser Service (F.O.P.W.C.): The Committee provided 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. 22 Some difficulty however was experienced in operating this scheme as the two hairdressers who had been doing the work, were not able to do so and at the present time endeavours are being made to make suitable arrangements with other hairdressers. This was possible on several occasions during 1961. 3. Christmas Parcels (F.O.P.W.C.): 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, or by the Finsbury Old People's Welfare Committee, which has distributed about 300 each year. 4. Coal (F.O.P.W.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. Extensive use was made of this service in 1961. 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 organisations and individuals interested in the Welfare of the Elderly, as by the clubs in the Borough. In some cases the arrangements have been made by the Old People's Welfare Committee. 8. Patients in Hospitals & Hesidents in Homes (F.O.P.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 Christmas Cards and by arranging friendly visitors for them. This has however proved difficult and has only been successful to a limited extent. 23 24 9. Wireless (F.O.P.W.C.): (i) The Wireless for the Bedridden Society. The Committee has continued to act as Sponsor in respect of applications received from bedridden or housebound Pinsbury aged persons desiring wireless facilities provided by the above Society. A number of new cases have thus been able to enjoy the sound programmes in 1961, (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 Employment Scheme for the Elderly, at "Brooke House", 39/41 Gloucester Way, E.C.I, and at the Women's Voluntary Service Meal Centre in Exmouth Market, E.C.I. 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 person, who, whilst not housebound or bedridden were, in the opinion of the officers, deserving of the provision of wireless facilities and that in such cases the rental should be paid by the Committee In 1961 on an average 19 persons have enjoyed these facilities (either relay or a wireless set where Relay Service does not operate) at any one time, 10. Various (FaO,P.W.C„): (i) 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. (ii) Brown walking sticks, foot stools and shopping baskets on wheels have been issued to elderly persons on loan, unable to afford them, where they have been needed. (iii) A special news sheet called "Pinsbury Tidings" was issued and distributed free of charge to elderly persons on two occasions during 1961. 25 SECTION C SANITARY CIRCUMSTANCES WATER: The Borough is freely supplied with water from the Metropolitan Water Board. As this supply is under continuous control no regular examinations are made of it. All the premises in the Borough have a piped supply of water but, in many houses and block dwellings, supplies of drinking water, as well as water to be used for other domestic purposes, are obtained 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, mainly on complaint, to ascertain their condition, and if necessary steps are taken to enforce cleansing and adequate covering, in accordance with the Council's Bye-laws. The Metropolitan Water Board give regular information whenever water supplies 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 1961 only four 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. These are situate in the premises of 1. Royal London House, Finsbury 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 periodically examined either by this department or elsewhere, on behalf of the Ministry of Works. That on the premises of Bovril Ltd., is not in actual use, The number of water samples examined bacteriologlcally in 1961 was 2. In addition, one sample was submitted to the Public Analyst for chemical analysis where lead poisoning was suspected by a tenant. The water however, was found to be quite satisfactory. 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 (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 chimical 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 to concern, though the alkalinity and amount of free chlorine have occasionally been found to be low and complete sterility not maintained. PUBLIC HEALTH INSPECTORATE; As a result of an enlightened policy adopted by the Council, I am happy to report that the establishment of Public Health Inspectors has been increased to 10 and the Department is now fully staffed in this section. In accordance with previous practice the Council has continued to engage two student Public Health Inspectors, and all past students have been successful in passing the examination It is therefore pleasing to record that during the year the Council's new training scheme was formally approved by the Public Health Inspectors Education Board. Under the Board's plan the ratio of students to Public Health Inspectors may be increased to 3 and there is every likelihood that this will be done in the near future. 26 SANITARY CONDITIONS: I am glad to be able to report that there has been a continuing improvement during the past year 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 920 in 1960 to 832 in 1961. It has been possible to investigate all complaints without delay. 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. 27 The following table sets out a number of details of the work carried out under this heading in 1961. Houses damp, dirty - remedied 326 Doors, windows, floors, walls, ceilings, sashcords repaired 605 Watercloset and urinal defects remedied 141 Soil and vent pipe defects remedied 73 Rainwater pipes cleared, repaired or renewed 77 Waste pipes cleared, repaired or renewed 93 Drains cleared 200 Roofs and gutters repaired 282 Water storage tank defects remedied 20 Yard or area defects remedied 40 Washhouse defects remedied 5 Water supply to houses reinstated 4 Water supply laid on to upper storeys of house 3 Firegrates renewed or repaired 31 Animal nuisances abated 9 Miscellaneous nuisances abated 131 Dust receptacles renewed or repaired 67 Accumulations of refuse removed 251 Overcrowding cases reported 47 No. of Basement rooms inspected 227 No. of House inspections 999 No. of House-to-House inspections 19 Total No of first visits for all purposes 5,886 Total No. of re-visits for all purposes 9124 No. of Intimation Notices served 546 No. of Nuisance Notices served 64 No. of Recurring Nuisance Notices served 3 Legal proceedings were instituted on 1 occasion for non-compliance with a Nuisance Notice in 1961, in respect of a leaking roof at No, 48 Wynyatt Street. As however the necessary work was carried out prior to the Court hearing, the summons was withdrawn, URGENT NUISANCES: During the year 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 1961 4 such notices were served in connection with general matters and 6 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 Seventy-eight drainage plans were approved by the Council during 1961 and 2,117 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 352 Soil & Vent pipes erected 234 Drains or Soil pipes tested 430 Waste Pipes erected 214 Waterclosets erected 499 Urinals erected 91 Lavatory Basins fixed 532 Sinks fixed 296 Baths installed 128 Since the single stack system of drainage was first introduced in 1955 some 18 applications to use this system, including 5 in 1961, have been approved by the Council. In each instance the work has basically complied with the recommendations of the Building Research Station and satisfactorily syphonic tests have been carried out on completion of the work. 28 COMMON LODGING HOUSE: There is only one Common Lodging House known in the Borough, namely that for men situated at 88 Old Street, E. C.l. which is owned and maintained by the Salvation Army, The premises were licensed for 313 inmates on the basis of the standard laid down by the London County Council, prior to the transfer of functions in 1933, at the beginning of the year. Separate quarters are provided for the Deputy Keeper and staff, but the common sleeping rooms are large dormitories on the upper floors, the kitchen, dining room and office being on the ground floor, and the washing facilities and lockers 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 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 serves a useful purpose in helping a number of men who are unable or unsuitable to settle down in ordinary domestic life, but there are opportunities offered here to help them in their many social problems, of which advantage has never been made. Many visits of inspection were made by the Medical Officer of Health and Public Health Inspectors during the year. It is apparent that the building as it at present exists, has been so crowded as to prevent any reasonable degree of comfort or convenience for those using it, and that their mental and physical health might well thereby be endangered. The Council gave much detailed consideration as to the renewal of the licence which fell due towards the end of the year. In view of the undertaking given by the owners to effect a number of improvements, it was finally agreed to renew the licence for a total of 275 men, thus reducing the number of residents permitted from the 313 previously allowed. 29 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. Prom 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 382 visits were paid by the Public Health Inspectors. In 9 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 accommodation elsewhere than on the premises owing to restricted space. RAG AND 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 are 4 premises where trade is carried on in rags and waste paper etc. These have been inspected from time to time. RAG FLOCK: Following a revision of the register, at the end of 1961, 4 premises in the Borough were licensed for the manufacture or storage of rag flock and 6 premises were registered to use filling materials under the Rag Flock and Other Filling Materials Act 1951. Regular visits have been paid to these premises including 15 inspections in 1961. On all occasions the conditions have been found to be reasonably satisfactory. Nine samples of filling materials were taken during the year All were found to be satisfactory. OFFENSIVE TRADES: At the end of the year no business was licenced pursuant to Section 140 of the Public Health (London) Act 1936, sanctioning the carrying on of an offensive trade. 30 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 since the war and there are now only 50 non-power factories,in the Borough. The number of factories with power has also fallen but proportionally not to the same extent, there being some 1,234 at the end of 1961. Regular inspections have been considerably increased because of the improved staff situation. Generally speaking conditions have been found to be satisfactory. 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 in accordance with the Act and Regulations. The official returns for 1961 are as follows:- INSPECTIONS for purposes of provisions as to health (Inspections made by Public Health Inspectors) Premises Number on Register Number of Inspections Written Notices Occupiers prosecuted (i) Factories in which Sections 1,2,3,4 and 6 are to be enforced by Local Authorities. 50 100 7 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority. 1, 234 1,455 68 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers premises). 17 14 - - Total: 1,301 1,569 75 - 31 CASES IN WHICH DEFECTS WERE FOUND Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Refe To H.M. Inspector rred By H.M. Inspector Want of Cleanliness (S. 1) 52 41 12 8 - Overcrowding (S.2) - - - 1 - Unreasonable Temperature (S.3) 1 1 - - - Inadequate ventilation (S.4) 10 8 - - - Ineffective drainage of floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient 1 1 - 1 - (b) Unsuitable or defective 33 27 - 14 - (c) Not separate for sexes 1 1 - 1 - Other offences against the Act (not including offences relating to Outwork) 32 21 23 9 - Total: 130 100 35 34 - 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 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. 32 OUTWORK 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. 1,205 - - - - - Household linen 13 - - - - - Umbrellas etc. 16 - - - - - Artificial flowers 16 - - - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 116 - - - - - Brush making 16 - - - - - Feather sorting 20 - - - - - Carding etc. of buttons etc. 67 - - - - - Cosaques, Christmas crackers, Christmas stockings, etc. 10 - - - - - Lampshades 2 - - - - - Total: 1,481 - - - - - 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. The following tables set out the detailed information supplied in the official returns; - The number of firms employing outworkers in 1961 was 125 The number of Finsbury outworkers employed by them was 211 The number of non Finsbury outworkers employed by them was 2,983 The number of Finsbury outworkers employed by firms outside the Borough was 93 The total number of Finsbury outworkers employed by firms in or outside the Borough was (of these 75 were firms and 229 homeworkers) 304 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 - 285 33 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 Pinsbury and its further pollution from sources within the Borough is probably little different from that in other parts of the Metropolis. 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 estimation of the sulphur dioxide content of the air by the lead peroxide 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 considerable 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. SMOKE EMISSION: The number of timed observations made during the year of the chimneys in Industrial establishments was 310 and 32 complaints of smoke investigated. Verbal warnings have been given where appropriate and advice has been offered to managements and their staffs. On 5 occasions in 1961 written notices were issued when contraventions of the Act or Regulations had been observed. 34 FURNACES: Sixty-five formal notifications (including 18 in 1961) 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: Progress was made during the year regarding the making of Smoke Control Orders. The Finsbury (No.l) and (No.2) Smoke Control Orders were made by the Council and confirmed by the Minister of Housing and Local Government during the year. Action is now being taken to implement these two Orders. A report was submitted to the Council towards the end of the year regarding proposals for a third area and the necessary formalities are being proceeded with in regard to the making of an Order. The programme of Smoke Control Areas in Finsbury was revised in December 1961. Originally, ten to 15 years was envisaged as being necessary to deal with the whole Borough. The Council has now agreed to a greatly accelerated programme which, if it is found possible to adhere to, the Borough should be completely covered by Smoke Control areas by 1967. Details are set out below: - PROGRAMME FOR SMOKE CONTROL AREAS IN FINSBURY Area No. Acres Total Premises Dwellings Date of Order Date of Operation 1 66 623 362 29/3/61 1/6/62 2 37 438 30 31/7/61 1/9/62 3 57 1,346 779 1/6/63* 4 103 2,466 2,006 1/10/63* 5 100 3,070 2,499 1/10/64* 6 64 1,162 932 1/10/65* 7 100 1,620 1,215 1/10/66* 8 60 1,568 1,179 1/10/67* Total 587 12,293 9,002 * Proposed 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. 35 In general the destruction is by spraying with a 5% solution of D.D.T. or other insecticide, with a follow-up treatment of some 14 days later if necessary. Where bedding is found to be heavily infested this is removed to the Health Centre for treatment in the steam disinfector. The Clearance schemes in operation locally have done much to reduce bug infestations, and in connection with rehousing of the families, it has been the practice to disinfest the furniture and effects shortly before removal, either by spraying or by fumigation during 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 cleansed, disinfected or destroyed any article in a house which has become verminous, filthy, dangerous or in an unwholesome condition, so that health is affected. During 1961, 56 such representations were made under this Section, most of them being in connection with articles found in rooms following the death or removal to hospital of the sole occupant. Disinfestation has covered a wide range of pests, and during 1961 402 premises were treated. They include the following:- Bed Bugs 145 Cockroaches 12 Beetles (various) 37 Fleas 3 Flies 13 Ants 15 Routine spraying of vacated Council properties 138 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 arrangements 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 County Council decided to discontinue the use of this centre, on account of the small number of children from this district required to attend. 36 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 1961 the total number of treatments given was: For Pinsbury cases: Scabies Head Lice Body Lice 50 9 30 For Shoreditch cases: 18 0 0 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. PREVENTION OF DAMAGE BY PESTS ACT 1949: Rodent Control: As in previous years the work of rodent control has continued as a large scale operation within the Borough of Pinsbury and the result is gratifying, for without doubt the rat population has been considerable reduced. During the past twelve months Rattus Norvegicus (or Common rat) has been the chief cause for complaint, but no serious infestation has been found. By concentrated efforts the presence of Rattus rattus (or Ship Rat) has been almost eliminated, and no large infestation remains. The Council employs a Rodent Officer, an Assistant Rodent Officer, foreman and six operatives and through the extensive Block Control Scheme operated, this staff is fully engaged. Rats in the sewers continue to be a problem, but the quarterly. use of Sodium fluoroacetate (1080) has been most effective, and in general the size of infestation has been reduced, with total clearance effected in some parts. During the year under review it has not been necessary to serve a statutory notice or take legal proceedings under the Prevention of Damage by Pests Act, and it is pleasing to record that both residents and the occupiers of business premises within this Borough have been extremely co-operative in all matters concerning both rats and mice. 37 Number of complaints received - Business premises 70 Private Dwellings 133 Additional infestations found - Business premises 1,168 Private Dwellings 213 Number of premises treated - Business premises 1,238 Private Dwellings 346 Number of visits made - Business premises 14,071 Private Dwellings 7,516 Charges made to Business premises - £4,317 14s. 0do PET ANIMALS: There is little trade in the Borough in pet animals. Licences under the Pet Animals Act, 1951 have been re-issued in respect of 6 premises during the past year. 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 12 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 24 formal inspections were made during I960, NUISANCE FROM PIGEONS: In order to control the number of pigeons in the Borough, licences have been granted for catching them in the streets and open spaces, as they are liable to become a public nuisance and to do much damage. Enquiries are made as to the means employed by those authorized, to ensure that they are humane and as to disposal of the carcasses to ensure that birds unfit for human consumption are not sold for this purpose. During 1961 3 licences were in force. MORTUARY: The Corporation of London was so good as to make available mortuary accommodation at their Golden Lane Mortuary for Pinsbury infectious and emergency cases. 38 HAIRDRESSERS: The Council fixed the 1st 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. At the end of the year there was a total of 46 registered premises in the Borough As a result of a special survey carried out, action was taken where necessary to enforce the requirements of the Bye-laws, but there is still room for further improvements. In all 111 visits were made to hairdressers and barbers during 1961. DISINFECTION: Disinfection is carried out where infectious disease has occurred; upon request or when such action isconsidered necessary. The usual method is to spray the rooms and contents with diluted formalin, and in some instances the bedding etc, is removed to the Health Centre for treatment in the steam disinfectors. In the more serious cases of infection fumigation of the premises is carried out by using a maxture of formaldehyde and potassium permanganate after the rooms have been totally sealed. However, during the year 1961 only two premises required this type of fumigation whilst 179 sprayings were carried out as shown below. Suspected Dysentery & Gastro-enteritis 17 Suspected Measles 19 Suspected Scarlet Fever 55 Suspected Whooping Cough 11 Miscellaneous I.D. 38 Tuberculosis 5 Scabies 1 On behalf of St. Marks & other hospitals 33 179 Bedding and clothing were brought to the Disinfecting Station in the Health Centre in these cases, and disinfected with steam. In all including the cases where this was carried out for the control of vermin 993 articles were treated. 39 Goods, mostly clothing, were also disinfected on behalf of certain export firms as follows:- Number of articles 34,201 Number of times disinfecting plant charged 112% 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 Pinsbury residents at their Reception House as and when the occasion should arise. No use has been made of this accommodation during 1961. NOISE; No formal action has been taken under the London County Council (General Powers) Act, 1937whlch 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. 40 SECTION D HOUSING GENERAL: The estimated number of dwellings in the Borough at the end of 1961 was 9,864 consisting of 2,885 houses, 6,976 flats and 3 huts. The houses are mostly privately owned. Ownership of the flats is as follows:- Pinsbury Borough Council 2,054 London County Council 581 City Corporation 394 Metropolitan Police 126 Housing Associations 2,644 Private Ownership 1,177 Over the years the number of houses has fallen but the number of flats has considerably increased. NEW BUILDING: The following new flats were completed during 1961, the number being less than in recent years:- By the City Corporation: Cullum Welch House, Golden Lane Estate 72 flats By Private Owners Baron Close, Baron Street 6 flats Caretakers Flat, Jewin Welsh Presbyterian Church, Fann Street 1 flat Caretakers Flat, City-Gate House, Finsbury Square 1 flat Total 80 flats During last year, 8 certificates of Habitation under Section 95 of the Public Health (London) Act 1936, were issued. INSPECTIONS: 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 7 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 41 (b) making demolition or closing orders 7 No. of notices served requiring the execution of repairs No. of houses rendered fit after service of notice No. of demolition or closing orders made 18* No. of houses in respect of which undertakings were accepted No. of houses demolished 1 (* including premises represented prior to 1,1 61) 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 conversion of the undermentioned properties was completed during the year. 2-5 Paget Street (by discretionary grant) 12 flats 33 -34 Northampton Square (by Pinsbury Borough Council) 5 flats One application for a standard grant was withdrawn, and in one other case an informal enquiry was not proceeded with. ARTIFICIAL LIGHTING OF STAIRCASES: 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. The artificial lighting of staircases in the many blocks of flats in the Borough is on the whole satisfactory. 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 in recent years, and the present position. There was very little action taken in 1961. 42 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 70 Certificates issued 34 Certificates still in force 22 Certificates cancelled 12 Certificates not proceeded with 17 Undertakings Accepted 19 Certificates issued as to remedying of defects (a) Issued to tenants 8 (b) Issued to landlords (Cancellations) 5 (c) Still in force 4 In 1961 there was 1 application for a certificate, in respect of which an undertaking was subsequently accepted, and there was 1 application for a cancellation under the 1957 Act. 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 has become 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 1961 and indicates the overall position at the end of the year. CLOSING AND DEMOLITION ORDERS: Whole Houses Basement Rooms Other Parts No, of representations made 4 3 - No. still under consideration 3 14 1 Total No. of undertakings accepted - - - Demolition Orders made - - - Properties demolished during 1961 1 - - 43  Whole Houses Basement Rooms Other Parts Closing Orders made 4 14 - Such properties later demolished 3 6 - Orders later determined 1 2 - Total No. of representations lapsed or no action taken - 14 2 Total No, of properties still subject to (a) Demolition orders 2 - - (b) Closing Orders 46 139 5 CLEARANCE AREAS: During 1961 a considerable amount of rehousing was undertaken by the Council of tenants living in clearance areas, which were represented in the 1956 60 programme. As a result, demolition of the unfit houses in the King Square Areas was commenced and at the end of the year some 184 had been demolished, Plans had been agreed for the redevelopment of the area. The programme for 1961-65 which had been agreed with the London County Council was formally approved by the Minister of Housing & Local Government during the year. This allows for a total of 287 houses to be dealt with by Pinsbury Borough Council and 324 by the London County Council during the 5 years. As a result, surveys were carried out and official representations made in respect of the Northampton Road and Bowling Green Lane Areas, and Clearance Orders subsequently made by the Council. A summary of the position relating to individual undemolished areas is given below:- Area No. of Houses Year of Order Remarks St, James Row 8 1953 One house still remaining Herbal Hill 2 1957 Rehousing effected Field Place 7 1957 Rehousing completed Medcalf Place 15 1957 Not yet demolished King Square No. 1. Area 26 1957 Premises demolished No. 2. Area 292 1958 Rehousing in progress and 158 houses demolished No. 3 Area 25 1958 Rehousing commenced Donegal Street 42 1959 Rehousing commenced Northampton Road 9 1961 Clearance Order made Bowling Green Lane 2 1961 Clearance Order made 44 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 135 families have been recorded, in 40 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. One bad instance of wilful overcrowding came to light during the year, and strongly worded letters were sent to the landlord and tenant, as a result of which some amelioration of the overcrowding was secured by members of the family sleeping out at relatives. 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 accommo dation 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. 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. 45 During 1961 applications have been dealt with as follows • New Cases 71 Cases reconsidered on new medical certificates 46 Cases reconsidered 2 The number of families rehoused during 1961 was:- Rehoused by Finsbury Borough Council (original lettings) 9 Rehoused by Finsbury Borough Council from clearance areas etc. 160 Rehoused by London County Council (including clearance areas) 95 Rehoused in New Towns 38 In addition many transfers within Council property took place, in order to make the best use of existing accommodation. LEGAL PROCEEDINGS: Legal Act 1957 proceedings in respect of contraventions of the Housing were instituted during the year as follows:- Date Premises Offence Result 19.5.61 268 City Road Obstructing P. H. I. Fined £1 Costs £3 3s. 0d. 11.7.61 15 Culpeper St. Permitting use of basement rooms in contravention of Closing Order Fined £5 Costs £2 12s. 6d. 4.12 61 - do. - - do - Fined £10 Costs £2 12s. 6d. 11.7 61 - do - Occupying basement rooms in contravention of Closing Order Fined £5 Costs £2 12s. 6d. 4.12.61 - do. - - do. - Fined £10 Costs £2 12s. 6d. 1L 7. 61 20 Culpeper St. Permitting use of basement room in contravention of Closing Order Fined £3 Costs £3 3s. Od 11.7.61 20 Culpeper St. Occupying basement room in contravention of Closing Order Not proceeded with. 46 SECTION E FOOD GENERAL: FOOD PREMISES: The number of food premises in the Borough remain comparatively constant apart from those premises closed by reason of clearance areas, and in the case of registered Ice-Cream manufacturers, a reduction has been caused by the removal from the register of those sellers who have discontinued to trade in this commodity. The number of those known in the Borough now are:- Restaurants cafes and snack bars 156 Public Houses 110 Off-licence premises (retail & shops) 11 Breweries, Distilleries etc. 12 Factory Canteens 78 Commercial Canteens 50 Dairies and milk distributors 131 Ice-cream manufacturers 3 Ice-Cream sellers 159 Confectioners (sweets) shops 74 Bakers shops 75 Bakehouses (i) Basement 7 (ii) Above ground 9 Grocers and provision shops (retail) 57 Provision merchants (wholesale) 12 Cheese importers (wholesale) 3 Greengrocers & fruiterers 22 Fish shops 7 Fish curers 2 Fried fish shops 8 Eel & pie shops 5 Poultry dealers (wholesale) 3 Butchers shops (retail) 39 Wholesale butchers and offal dealers 42 Wholesale horseflesh dealers 1 Bacon factories 7 Sausage factories 2 Sausage casing merchants 3 Meat extract factory 1 Public cold stores 6 Chemist shops (retail) 16 Manufacturing wholesale chemists 9 47 In addition there are some 180 street market stalls dealing in various foodstuffs. N.B Some premises are enumerated in more than one category. These business concerns have been inspected periodically both formally and informally. The total number of visits paid during 1961 was 3,827 to premises and 2,989 to stalls. FOOD HYGIENE: Work in connection with food hygiene continues to exercise the attention of the inspectors. The increase in the establishment has enabled more attention to be paid to this important item. Numerous inspections of restaurants and cafes have been made, some being visited on several occasions, where the conditions warranted such action. Towards the end of the year a series of lecture/demonstration/ discussion groups was arranged, for selected groups of food handlers. These were held either at the Health Centre, or at the premises concerned, where the number of employees justified this. The question of attaining the complete co-operation of food handlers in this matter is still requiring earnest thought; the process is slow but it is believed that definite progress can be reported. Problems met with include the difficulty of impressing the employees of the need for personal cleanliness at all times, together with the need to refrain from smoking. Some tests were made during the year of the temperatures at which the various foodstuffs for immediate consumption were kept in canteens and restaurants. Generally these were found to comply with the requirements of the Pood Hygiene (General) Regulations 1960. BACTERIOLOGY OF FOOD: The improvement in the staffing situation enabled more attention to be given to this branch of the work, priority being given to Ice-Cream from manufacturers within the Borough, and Minced Beef from retail butchers. The samples taken in 1961 were:- Artificial Cream 4 Butter 1 Canned Meats 5 Coconut 3 Cornish Pasties etc. 5 Eggs 6 Ice-Cream 78 Ice-Cream (Soft) 5 Lollies 10 Meat Products 2 Milk 38 Minced Beef 63 Shellfish 1 Total 221 48 artificial cream: These samples were taken from Bakeries and found to be satisfactory. It had been noticed that a confectioner was in the habit of selling day-old eclairs cheaply, and a sample revealed that the number of organisms present exceeded 10 million per gramme. Further samples were taken to determine the initial number of organisms in fresh eclairs, and also to ascertain more accurately the effect of 24 hours storage. The results showed a very rapid deterioration and the confectioner agreed to discontinue selling stale eclairs. ice-cream: The majority of the samples were from the two principal manufacturers and although the early samples were unsatisfactory, improved methods of cleaning and sterilisation of equipment, constant supervision and regular sampling, raised the standard to Grade I. The manufacturers were co-operative and the more recent samples indicated that asatisfactory standard is being maintained. MINCED BEEF: Samples were taken from all the various butchers and many showed very heavy counts of Bacteria In addition to individual action a circular letter was sent to all butchers drawing attention to the need for a high standard of cleanliness, and the desirability of sterilising mincing machines, scales, knives, trays, counters, etc. quality of food and its description: Routine sampling of foods and of drugs has continued. Some reports of adulteration or of misleading description on the labels have been received and necessary action taken. Formal sampling has only been undertaken when an informal sample has been reported unsatisfactory. In 1961, 623 samples were submitted to the Public Analyst as under:- Foods No. of samples submitted Milk 50 Cream & Condensed milk 13 Butter, margarine & fats 25 Cheese 12 Sausages 11 Meat & Fish products 128 Soups 9 49 Foods No. of samples submitted Sauces, vinegar etc. 10 Condiments, spices & flavourings 66 Jams & preserves 13 Jellies & Gelatine 13 Dried Fruit 11 Cake & Pudding mixtures 27 Fresh fruit & Vegetables 2 Cereals 18 Coffee, Cocoa, Tea & Extracts 23 Non-Alcoholic drinks 33 Alcoholic drinks 1 Canned fruit & vegetables 69 Cakes & Bread 30 Sugar Confectionery 22 Restaurant meals or snacks 2 DRUGS Medicines 13 Powders 4 Tablets 11 Ointments, lotions 7 623 During the year reports of unsatisfactory samples were received in respect of nineteen samples. Pour of these were in regard to Faggots, manufactured in the Borough. The reports stated that the majority of samples contained various percentages of S. 02, which preservative is not permitted in this class of meat product. Investigations were carried out and samples of the ingredients were examined. Eventually it was established that the adulteration was due to negligence on the part of an employee, and further samples were found to be satisfactory. Some of the remainder of the other unsatisfactory samples were in respect of samples of food purchased by the general public, who considered that the food was not of the generally accepted standard. complaints of food: Members of the public continue to bring specimens of food to the public health department, in respect of which they consider they have grounds for complaint. During the year eighteen complaints have been received. The majority of these complaints were justified and full investigations were carried out by the food inspectors. 50 Generally,, the less serious of the complaints were due to negligence on the part of employees, or the result of the increase in automation in the food industry, which, whilst reducing the errors of human element, also reduces the personal supervision of the food being processed. In four cases it was decided to take legal proceedings against the vendors. Particulars of these cases are listed elsewhere in the report. In every case where justifiable complaints are made the complainants are thanked for their co-operation and notified of the result of the action taken. particular foods and types of food premises: Street Market Stalls: There are four market streets at Chapel Market, Exmouth Market, Whitecross Street and Farringdon Road. A total of 708 stalls were licensed by the Council, of which 180 were licensed for the sale of foodstuffs. Daily inspections combined with a rota of weekend inspection continues to maintain a fairly satisfactory standard of hygiene. Stallholders generally do not appear to give sufficient thought to the Pood Hygiene (General) Regulations 1960, although it is noticed that there has been a reduction in the number of wilful cases of smoking whilst handling foodstuffs. Consideration has been given to the method of refuse collection whilst the markets are in operation, and it is hoped that by next year an improved system will be in operation. Inter-departmental discussions have also taken place regarding the siting of stalls for the sale of foodstuffs, with a view to reducing the risk of contamination of the food. The Department continues to approve the storage facilities and conditions of sale prior to licences being granted. MILK: No serious complaints have been received during the year. The bulk of the milk supply is confined to approximately four wholesale suppliers, and practically all the milk sold in the Borough is in sealed bottles. There has not been any appreciable increase in the number of milk vending machines. Samples have been taken, all of which were reported as satisfactory. 51 No. of Dairies on register at end of year 9 No. of Distribution Premises at end of year 122 No. of Designated Milk Licences issued during year: Tuberculin tested 52 Pasteurised 73 Sterilized 70 No. of samples submitted to Public Analyst NO. of samples submitted for Bacteriological examination Average fat content Average non-fatty solids content Satisfactory 50 38 All Milk 3.63 8.73 Unsatisfactory Nil Nil C.I. Milk 4.5 9.10 ice-cream: The Register maintained under Sec, 16 of the Food & Drugs Act 1955 was extensively revised during 1961, and many smaller premises at which ice-cream was previously manufactured, but where production has now ceased, were removed from the Register by the procedure authorised. As a result there are now only 3 premises in the Borough where ice-cream is manufactured. One is used solely for freezing the product following delivery in bulk of the material after pasteurisation in another area. This method gives rise to a certain amount of trouble, and has required detailed investigation in order to ascertain the point at which contamination occured. Numerous samples of ice-cream have been regularly taken for chemical and bacteriological examination, and the standard of ice cream generally has been satisfactory. Recently a new type of ice-cream, namely soft ice-cream, has been introduced into the Borough. This method of manufacture will require constant supervision owing to the numerous parts of the machine which come into contact with the ice-cream necessitating thorough cleansing and sterilization at the end of each day. The position at the end of 1961 was:- Number of premises registered for manufacture 3 Storage and sale 159 Storage only 2 meat inspection: In the neighbourhood 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. 52 Several of these wholesale butchers shops carry on a trade for which this part of Finsbury is well known, that is the wholesale dealing in old cow, bull, sheep, sow and boar carcasses which are mostly used in the manufacturing trade. A close watch and a rigid inspection is maintained on these old carcasses to ensure that no diseased meat is passed on to the public. Due to the opening of more wholesale butchers shops coupled with the fact that more meat is being consigned to the Borough, there has been an increase in the amount of meat which has been destroyed for disease and other conditions. Approximately 20 tons more were destroyed this year than in 1960 and 40 tons more than in 1959. Also during the course of the year 686 quarters of beef were found to be diseased or unsound and destroyed. Consignments of Scandinavian and Continental offals and canned hams continue to be imported into the Borough and condemnation of these have taken place from time to time. The collection of unsound meat and other foods continues to be collected satisfactorily by the Council's contractor Messrs. Henson & Burbidge Ltd., Matusa Works, Beckton who render down the foodstuffs for technical purposes. During the year 235 certificates were issued for the export of meat, bacon and meat extracts. During the course of the year the meat inspector carried out a 100% examination of 2,236 cartons and 640 bags Argentine Beef Livers for a parasitic disease and the result being as follows:- Beef Livers examined for Hydatid' Disease (Echinococcus) Examined Destroyed 2236 cartons Beef Livers No,1621 Beef Livers wt.14171 lbs 14% 640 bags Beef Livers 503 Beef Livers wt. 4640 lbs 11.4% There are no licensed slaughterhouses 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 undermentioned types of business are carried on in premises registered for the manufacture of sausages or potted, pressed, pickled or preserved food, in accordance with the requirements of the Pood & Drugs Act, 1955. One premises was added to the register during 1961, making a total of 74. 53 Sausage manufacturing 32 Sausage smoking 1 Meat Pickling 39 Offal Cooking 5 Cooked meats or pie making 4 Ham boiling 12 Bacon curing and smoking 3 Pish curing 3 Shellfish cooking 2 Jellied eels 2 Meat Extraction 1 These premises are regularly inspected and during the year 1961, 258 visits were made, Considerable improvements have been carried out in a large sausage and meat preserving factory, and this can now be regarded as complying with modern standards. Works of modernisation are also in progress in other types of food premises, particularly butchers establishments. BAKEHOUSES: There are seven underground and nine other bakehouses in the Borough. In practically every case they are conducted satisfactorily although one of the basement bakehouses has required constant supervision. During the year 131 visits were paid to bakehouses. LICENSED PREMISES: There are 150 premises licensed under the 1953 Act for the sale of intoxicating liquor in the Borough, of which 110 are operated as public houses, the majority of which carry on a catering business. Routine inspections were carried out during 1961, and advantage was taken when transfers of licences were being made, to inspect the premises to request necessary repairs and redecoration. UNSOUND FOOD: No formal seizure has been necessary during the year. The cooperation of the trade, established over many years, in connection with the surrender of unfit foodstuffs, continues satisfactorily, and results in a good relationship with the various trades concerned. A total of 126 visits were made in this connection, apart from those connected with meat inspection, and 757 certificates were issued. 54 The total quantities of unsound food surrendered during 1961 were:- lbs. lbs. Meat (diseased) 62,888 Bottle fruits Meat (unsound) 57,482 or pickles 1 Meat products 3,402 Dried fruit 11 Bacon 10, 543 Preserves 20 Offals (diseased & unsound) 56,709 Cheese 4,145 Poultry 3,800 Fruit & Vegetables 1,714 Game 451 Confectionery 52 Rabbits 359 Biscuits 450 Canned Foods 20,825 Miscellaneous 1,683 Frozen foods 19,850 Total 244, 385 = 109 tons 2 cwts 1 lb. food poisoning: There were 28 individual cases notified during the year of which 10 were due to Salmonella Typhi-Murium 1 was due to Salmonella Enteriditis In 17 cases it was not possible to identify the responsible agent. legal proceedings: During 1961 legal proceedings were taken in 5 cases in respect of offences under the Pood & Drugs Act. These are summarised below:- Under Section 2 Food & Drugs Act 1955: Date Premises Offence Result 6.3.61 183 Whitecross Street Selling bread containing a foreign body (piece of fabric) Fined £2 0s.0d Costs £5 5s.0d 13.6.61 35/39 Exmouth Market Selling a mouldy sausage roll Fined £3 3s.0d Costs £3 13s.0d 11.7.61 72 White Lion Street Selling bread roll containing a foreign body (cigarette) Fined £25 0s.0d Costs £3 8s. Od 4.9.61 52 Old Street Selling a mouldy steak & kidney pie Fined £2 0s.Od Costs £3 3s.Od 24.10.61 1 Cowcross St. Selling a cake containing a foreign body (stone) Fined £5 0s.Od Costs £17 0s.Od 55 SECTION F INFECTIOUS DISEASES GENERAL: No serious outbreaks of infectious diseases occured during the year, and there were no cases of Poliomyelitis. There were a number of cases of Dysentery, mostly in connection with day nurseries and also a considerable number of cases of Measles. The instance of these diseases continued to be a considerable nuisance in nurseries and schools, but otherwise of little importance. A number of cases of Scarlet Fever occurred, none of which were in themselves serious, but they served to warn of the continued prevalence of the responsible organism which is capable of causing other more serious conditions. As neither Infective Hepatitis or Rubella (German Measles) are notifiable, no exact information as to the number of cases occurring is available, but from the number of cases reported, it is clear that these diseases occurred in almost epidemic proportion. In no case was Rubella reported in any woman in early pregnancy nor was any contact discovered who was known to be in that condition. 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 1961, 1,987 visits were paid by the Nurse Visitor. 56 The following table shows the incidence of notifiable diseases in 1961. All Ages Under 1 yr. 1-4 yrs 5-14 yrs 15-24 yrs 25-44 yrs 45-64 yrs 65yrs Cases treated in hosp Dysentery 81 8 23 28 4 14 4 - 15 Erysipelas 10 - - - 2 1 6 1 3 Food Poisoning 28 3 6 4 2 10 - 3 5 Gastro-Enteritis (Under 2 yrs) 26 14 12 - - - - - 7 Measles 413 25 255 128 3 2 - - 29 Meningococcal Infections 1 1 - - - - - - 1 Ophthalmia Neonatorum 3 3 - - - - - - 2 Pneumonia (Acute Primary) 53 2 2 3 6 2 21 17 48 Scabies 40 - 4 12 10 10 3 1 - Scarlet Fever 73 - 23 47 1 2 - - 37 T.B. (Pulmonary) 34 - - 2 5 8 12 7 - T.B. (Other forms) 3 - - - - 3 - - - Whooping Cough 28 3 14 - 11 - - - 16 Total 793 59 339 224 44 52 46 29 163 DIPHTHERIA: At the beginning of the year a resident of this Borough attended a school in another Borough where there were some positive cases of Diphtheria. Swabs were taken of the family and all had 3 negative Nose and Throat swabs. There were no further cases or contacts during 1961. DYSENTERY: There were 81 cases notified. Of these 44 were clinical cases with positive bacteriological findings. 8 were symptomless cases, 29 were moderately severe clinical cases with negative bacteriological findings; and in all 15 cases were removed to hospital. ENCEPHALITIS: There were no cases or contacts of this infection during 1961. 57 ENTERIC FEVER (PARATYPHOID): There were no cases or contacts of Paratyphoid Fever during 1961. ENTERIC FEVER (TYPHOID): There were no cases or contacts of Typhoid Fever during 1961. ERYSIPELAS: There were ten notified cases of Erysipelas during the year. Six of these were moderately severe, and four mild. Five cases were removed to hospital. There were no deaths. The parts affected were Facial 8, Legs 2. CHICKEN POX: Chicken Pox has occurred in 33 known cases during 1961. None were severe,, and all made satisfactory progress, There were no complications. GASTROENTERITIS (over 2 years): There were 5 known cases of Gastro-Enteritis during 1961. No organisms were isolated in specimens, and there was no contact between the cases. All made very satisfactory progress. GASTRO-ENTERITIS (under 2 years): There were 26 cases notified of which 8 were moderately severe, and 18 mild cases. No organisms were isolated in the faeces. 7 cases were removed to hospital, and all made a good recovery. INFECTIVE HEPATITIS: During 1961 67 cases of Infective Hepatitis came to the notice of this Department. Of these 20 were adults. All were quite ill, and the infection was spread over the Borough. They all made slow but satisfactory progress. There were no deaths. GLANDULAR FEVER: There were two known cases during 1961. No known contact between the cases. Both were removed to hospital, and made satisfactory progress. MALARIA: There were no cases of Malaria in the Borough during 1961. 58 MEASLES: There were 413 cases notified during the year. Of these 224 were moderately severe and the other 189 mild cases, 29 cases were removed to hospital. Complications occurred in 17 cases (four brought on Pneumodia and thirteen Bronchitis). All made a satisfactory recovery. MENINGOCOCCAL INFECTION: One case only was notified during 1961, that of a female child aged 6 months. The onset was sudden and severe. The child was removed to hospital and made a very good recovery. Contacts were kept under supervision and all remained well. MUMPS: There were 38 known cases of Mumps, All were mild and made satisfactory progress. There were no complications. OPHTHALMIA NEONATORUM: 3 cases were notified during 1961. All responded well to treatment and no cases of blindness resulted. PNEUMONIA (Acute Primary): 46 cases were notified in 1961. All were severe cases and all recovered and there were no deaths. PNEUMONIA (Acute Influenzal): 7 cases of acute Influenzal Pneumonia occurred during 1961. No deaths occurred and although all were severe all made a satisfactory recovery. POLIOMYELITIS: During 1961 3 persons were admitted to hospital as possible cases of Acute Poliomyelitis, but were not confirmed. At the beginning of the year there were 4 residents of this Borough who were in contact with a confirmed case. These were kept under supervision and remained well. PUERPERAL PYREXIA: During 1961 7 residents of this Borough developed Puerperal Pyrexia whilst in hospital. All made very satisfactory progress and there were no deaths. 59 RUBELIA: During 1961 there were 87 cases of Rubella. All were mild; there was no contact with any early pregnancy. All made very good progress, and there were no complications. SCABIES: 40 cases were notified during the year. The incidence of Scabies was at a low level and was not of any consequence. SCARLET FEVER: There were 73 notified cases of which two were moderately severe, and the remainder mild. 38 cases were removed to hospital and there were no deaths. All made a satisfactory recovery except that in two instances there were complications of cervical adenitis. SMALLPOX: At the end of the year there was a contact of a confirmed case of Smallpox. The contact was vaccinated, and remained well. No further contacts. TONSILLITIS: During 1961, 32 cases of Tonsillitis came to the notice of this Department, Swabs were taken and all were negative. All made satisfactory progress. WHOOPING COUGH: 28 cases of Whooping Cough were notified during 1961 of which 15 were moderately severe and 13 mild. 16 cases were removed to hospital. There were no deaths and in five cases there were complications (Bronchitis 4 and Collapse of Right Lung 1). TUBERCULOSIS: In 1961 37 new notifications were received, and their age and sex distribution was as follows:- Pulmonary 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total M 1 3 3 3 3 3 5 21 F 2 1 1 1 4 2 2 13 Non-Pulmonary M 1 1 F 2 2 Totals - 2 1 4 7 4 7 5 7 37 60 The non-pulmonary cases included 1 foot and sternum, 1 kidney and 1 endometrium. The notification rate of all forms of T.B. was 11.2 per 10,000 as against 11.2 for the whole country (1960). The total number of cases remaining on the Register after adjustment for deaths and transfers were, on the 31st December, 1961: Males Females Total Pulmonary 146 110 256 Non-Pulmonary 12 9 21 158 119 277 There were 6 deaths during 1961 of persons previously notified as suffering from Tuberculosis, and not removed from the register on the grounds of arrest of the disease, but four of these were from other causes; the remaining two were as follows:- (a) from Pulmonary Tuberculosis:- A male of 70 resident in a Common Lodging House in the Borough. (b) from Non-Pulmonary Tuberculosis:- A female of 45 from miliary tuberculosis, associated with intestinal disease. The death rate was 6 per 100,000 of the population, as against the national rate of 7.5 (1960). 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. MASS RADIOGRAPHY UNIT 6D: During 1961 the Mass Radiography Unit examined 43,004 males and 23,569 females - making a total of 66,573. Up to the end of 1961 the Unit has examined 692,037 persons since it commenced operations in May 1950. One hundred and eighty cases were referred to Chest Clincis, hospitals, etc., for further investigation and so far (March 1962) forty-two cases with a significant tuberculous lesion have been reported as well as fourteen cases of carcinoma of the lung. Pinal diagnoses are awaited from thirty-one cases. Clinics generally record their sputum findings. For the larger part of the year under review, the Unit operated at the Mass Radiography Centre, 20 Golden Lane, E.C.l., and for the remaining period visited firms and organisations including a stay at the Geffrye Museum, Kingsland Road, E.2. when the Unit concentrated upon Shoreditch firms not easily accessible to Golden Lane. 61 General practitioners have continued to send their patients to the Unit with beneficial results. Anyone wishing to obtain information on the Mass Radiography Service should communicate with the Organising Secretary, Mass Radiography Unit 6D, Pinsbury Health Centre, Pine Street, E.C.l. (Tel. No. TERminus 0031, Ext. 9). (Information kindly provided by Dr. W.D.R. Thompson, Chest Physician). FINSBURY CHEST CLINIC: (Information kindly provided by Dr. W.D.R. Thompson, Chest Physician). During the year 1961 a total of 2,151 patients were seen in the Chest Clinic. Of this total 211 attended for the first time as contacts of notified cases, and a further 185 were re-examined as routine contact checks. The number of new cases of tuberculosis taken on the Clinic register during the year amounted to 34, of which 33 were pulmonary and 1 non-pulmonary, 16 of these pulmonary cases proved to be infectious. In addition to these cases a further 13 notified cases (all pulmonary) were transferred into the Borough from other clinics and hospitals. The number of notified cases shown on the Clinic register at 31st December, 1961 was as follows:- Respiratory Won- Respiratory Totals Grand Total Men Women Children Men Women Children Men Women Children 144 104 11 8 7 2 152 111 13 276 The previous year's total was 271. During 1961 there were 4 deaths (3 males and 1 female), 6 lower than 1960. Of the cases removed from the register during 1961, a total of 3 were recovered, 19 were transferred out to other areas, and the remaining 16 cases were removed from the register as "Diagnosis not confirmed" (2), and "lost sight of" (14). The total number of cases X-rayed during the year was 1,141. The London County Council Tuberculosis Health Visitors, seconded to the Chest Clinic, made 723 visits to homes in the Borough during the year. 62 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: Some difficulties were experienced this year in connection with the London County Council's arrangements for the Tuberculosis Health Visitor nursing staff. 63 APPENDIX "A" LIST OF SPECIAL REPORTS SUBMITTED TO THE HEALTH COMMITTEE BY THE MEDICAL OFFICER OF HEALTH DURING 1961. January Mid-day Meal Services for the Aged 1960. February Report on a Survey of the Non-Power Factories in the Borough. March International Conference on Social Work. June Finsbury (No. 2) Smoke Control Area. Public Health Inspectors - Establishment. October Mid-day Meals Service. Report on Finsbury Employment Scheme for the Elderly. Absences through sickness - Manual staff. Review of Manual Staff. November Clean Air Conference - Brighton. Aged Persons Holiday Scheme 1961. Report on Annual Conference of the Association of Public Health Inspectors 1961. Refuse Collection - Removal of Household Lumber. Clean Air Act 1956 - Proposed Finsbury (No.3) Smoke Control Area. December Suicides in the five years 1956/61. Grants - Voluntary Organisations. Programme for Smoke Control Areas in Finsbury. & 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 1961. October Representation - Bowling Green Lane Area. Representation - Northampton Row Area. 64