Ac 4341 II The Metropolitan Borough of Finsbury FIN 44 ANNUAL REPORT ON THE PUBLIC HEALTH OF FINSBURY for the Year 1963 BY C. O. S. BLYTH BROOKE, M.D., B.S., D.P.H. Medical Officer of Health FINSBURY HEALTH CENTRE, PINE STREET, LONDON, E.C.1. The Metropolitan Borough of Finsbury ANNUAL REPORT ON THE PUBLIC HEALTH OF FINSBURY for the Year 1963 BY C. O. S. BLYTH BROOKE, M.D., B.S., D.P.H. Medical Officer of Health FINSBURY HEALTH CENTRE, PINE STREET, LONDON, E.C.1. HEALTH COMMITTEE Chairman: Councillor A. E. Ley Vice-Chairman: Councillor R.J. Redrupp Alderman C. A. Allen J. P. Councillor Mrs. S. Cliffe Councillor J. Crossley Councillor E.I. Jones Councillor Mrs. A. E. Lamb Councillor J.L. Lee Councillor Mrs. H. Tarr Councillor Mrs. L.C. Trotter Medical Officer of Health: C.O.S. Blyth Brooke, M.D., B.S., D.P.H. Deputy Medical Officer of Health: A.K. Arnold, M.B., B.ch., B.A.O., D. (Obst) R.C.O.G., D.P.H. Public Analyst: J.H.E. Marshall, M.A., F.R.IC. Public Health Inspectors: A.J. Truslove, M.A.P.H.I. (Chief Public Health Inspector) E. Ditchburn, M.A.P.H.I. S.G. Fisher, F.A.P.H.I. L.A. Brittain, M.B.E., T.D. MAPHI. G.A. Buckingham, M.A.P.H.I. R.C. Sanderson, M.A.P.H.I. M.Inst. P.C. M.E.S. Poultney, M.A.P.H.I., M.R. S.H. R.C. Lockwood, M.A.P.H.I. R. A. Cummins, M.A.P.H.I. Senior Meat Inspector and Deputy Chief Public Health Inspector: R.S. Barber, F.A.P.H.I. Student Public Health Inspectors: J.E. Downer B. Gilbey (W.E.F. 30.9.63.) D.Nattress 2 Smoke Control Officer: W.P. Butterick Senior Laboratory Technician: Miss R. Weitz. F.I.M.L.T. Rodent Officer: P. L. Moseley Assistant Rodent Officer: F.J.P. Moody Administrative & Clerical Staffs: A. G. Holmes (Assistant Administrative Officer). J. T. Lindsay(senior Clerical Assistant) Miss J.L. Faulkner. F.W. Haynes. I. Patience. R. Blakeley(Resigned 14.4.63). A. R. Manz (W. E. F. 20.5.63). Miss E. Buhr J. A. Smith Infectious Disease Visitor: Mrs R. Pepper, S.R.N., R.F.H , 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: Miss L. Brailsford. S R.N. Health Centre Caretaker: R. North 3 To the Worshipful the Mayor, Aldermen and Councillors of the Metropolitan Borough of Finsbury. MR. MAYOR, LADIES AND GENTLEMEN, This is the last occasion on which a Medical Officer of Health has the honour to present to you, Mr. Mayor, and your Council, an Annual report on the Health of the Borough of Finsbury, which we in our several capacities have been proud to serve, as by the time the next report for 1964 can be prepared your functions will be superseded by those of the Council of the London Borough of Islington. In presenting this report therefore, it is fitting that I should refer to the many changes and the vast improvement in Public Health which have taken place since the formation of the Borough in 1900. Indeed a revolution has occurred in the physical and social environment, and this has been reflected in the lives and characters of those living or working in the district. Although national and economic changes together with the devastation due to the Second World War have played their part in bringing this about, much credit belongs without doubt to the farseeing policies initiated and pursued with vigour by the Pinsbury Borough Council. I have included a statement of some of the Principal Developments of the Public Health Service by the Metropolitan Borough of Finsbury 1901-1965. I have also included a comparison of some of the main features of the first annual report of the Medical Officer of Health for Finsbury, namely that for 1900, with the corresponding details for 1963 where possible. This latter year was somewhat uneventful but allowed of further consolidation of the work of the Public Health Department. The general health of the population remained good and apart from an extensive outbreak of a mild form of Dysentery, there was no unusual incidence of disease. The birth rate has again fallen slightly to 15.0 and is well below the national average. The illegitimate birthrate rose to 8.4 per cent of the total births having been below 7.4 in recent years and this gives rise to concern regarding infant welfare and social circumstances. The infant mortality rate fell to the phenomenally low level of 10.9 as against the rate of 20.9 for England and Wales. This is particularly happy as the rate for the last two years had been high, although previously between 15 and 16; also there were no illegitimate infant deaths. The death rate was 13.9 which was above the national rate of 12.2 and represents a slight rise on the rate for the previous year, and appears rather more than might have been expected due to an unexpected rise in the loading factor to balance the age constitution of the population introduced by the Registrar-general. There was a further slight increase in the number of deaths from cancer including those from lung cancer, and also from coronary diseases. On the other hand there was a fall in the number of deaths from Bronchitis and Pneumonia and from Cerebral embolism and thrombosis. 4 The number of cases of suicide rose from 3 in 1962 to 8, which is the highest number in recent years and six were below the age of 65. There were no maternal deaths. Very many will regret the passing of the Finsbury Borough Council, but I am convinced that the high reputation it has earned in the field of Public Health, as well as in other directions, will be long remembered. Although I believe we are justifiably proud of the past we must not remain nostalgically absorbed in it, but prepare to facilitate the furtherance of our ideals, not only for the community we now serve, but also for that in the area soon to be united with ours by the Council of the London Borough of Islington. We hope and trust that the health and wellbeing of this wider group of citizens will continue to improve at an ever increasing pace and that the work of the Council will be fruitful in its efforts to bring this about. Each year in my annual report I have acknowledged with pleasure the help given me by successive mayors, chairmen and members of the Committees under whom I have worked, and all members of the council, as well as the loyal co-operation and support of my staff. These expressions of thanks have perforce become somewhat stereotyped in form though made in all sincerity. Again, this year I am very happy to repeat these acknowledgements to you Mr. Mayor and those concerned. This year I take the opportunity to pay a wider tribute, not only to you Mr. Mayor, but to all your predecessors under whom I have had the honour and the pleasure to serve, and the various Chairmen, members of the committees and councils, during the time that I have been in Finsbury. I have throughout been very sensible of the help and support they have given me, and of the confidence they have shown in me. I thank them also for their personal friendship which contributed greatly in enabling me to feel apart of our Borough and to make my days happy. To my staff belongs the credit for developing and maintaining the good name of my department, which I believe it has borne with the Council and public generally. I have had the good fortune to be served by a very large number of most able and loyal assistants in all branches of work, who have given years, and in some cases a lifetime to the service of the people of Finsbury. Although it would be impossible to mention by name the very many who have helped me in this way, I must record the personal debt I owe for the collaboration and support given by Mr. E.Q-Bilham-assistant administrative officer when I first came to Finsbury in 1935-and whose death I had recently to report to your Council, and by Mr. A.G.Holmes who has occupied this post since 1949. To them all I am full of gratitude. I also record my appreciation of the close co-operation and collaboration which I have enjoyed with representatives of voluntary and other organisations in the Borough, as well as with many members of the public. For me the years have gone quickly by having found pleasure in 5 trying to idenity myself with the community in Finsbury and to help it to overcome the many adverse conditions that have prevailed. The plight of so many before, during and immediately after the war, was indeed a sad one but hope for the future was never lost, and I have been very happy to see the greatly improved circumstances that have been brought about in recent years. I am proud of some of my accomplishments, but very conscious of my very many shortcomings, and ways in which I have failed. Finally Mr. Mayor I extend through you my affectionate good wishes for the future of all in Finsbury. I have the honour to be, Your obedient servant, C. O. S. BLYTH BROOKE, Medical Officer of Health. 6 Some of the Principal Developments of the Public Health service by The Metropolitan Borough Council of Finsbury 1900-1965 Former Medical Officers of Health:- 1901-1907. G. Newman, M. D., F. R. S. Edin., D.P.H. Camb. (Later Sir George Newman). 1907-1909. C. Porter, M. D., B.Sc., M.R.C.P., Barrister-at-Law. 1909-1934. A. E. Thomas, M. A., M. D., D. P. H., Barrister-at-Law. 1934-1939. N.D. Dunscombe, M.A., M.B., D.P. H., Barrister-at-Law. Outstanding Reports of the Medical Officer of Health published by the Borough council: 1901. The Housing question in Finsbury. 1902. Bakehouses in Finsbury. 1903. The Milk supply of Finsbury. 1904. Infants Milk Depot. 1906. Infant Mortality in Finsbury. 1929. Housing conditions in Finsbury. 1900 The Voluntary notification of Phthisis initiated by the Clerkenwell vestry was adopted by the Borough council. 1901-1904 An outbreak of anallpox involved many cases in Finsbury. 1904 A lady Sanitary Inspector appointed with duties in connection with infant welfare corresponding to those of a Health Visitor later. An infants Milk Depot was established by a voluntary organisation; this was shortly afterwards taken over by the Borough Council. 1906 A severe epidemic of measles occurred which involved Finsbury and was responsible for 115 deaths. 1907 The Notification of Births Act 1907 was adopted by the Council. 1908 Two rudimentary infant welfare centres were opened as weighing centres, with two lady sanitary Inspectors in attendance. 1909 Two lady Health visitors appointed to work with the lady Sanitary Inspectors. 1910 A special form of reconstituted milk with additional fat and called Finsbury Cream was provided at cost price for wasted and debilitated infants. 7 Dinners were provided for poor nursing and expectant mothers at a cost of 2d. 1915 The first Municipal Maternity and Child Welfare centre was provided by taking a service run by a voluntary organisation in 162 Lever Street. This was transferred to Leage Street in 1929. The provisions made included an ante natal clinic and dinners for expectant and nursing mothers. There were also 7 voluntary centres in the Borough. The midwifery service for the Borough was carefully considered by the council and it was reported that this was carried out by students of St. Bartholomew's Hospital, midwives from the city of London lying-in hospital, and the Royal Maternity Charity, one midwife from the Royal Free Hospital and one from the Board of Guardians, a nurse for difficult cases from the Metropolitan Nursing Association, and monthly nurses from the Maternity Nursing Association. There were also 3 ante-natal clinics available for Finsbury mothers apart from the Municipal clinics already referred to. 1915-1916 The epidemic of cerebrospinal Fever caused a considerable number of cases to occur in Finsbury. 1916 A Tuberculosis Dispensary for Finsbury persons was started in the Royal Chest Hospital, city Road. 1918 The World pandemic of Influenza was responsible for 261 deaths in Finsbury. 1920 Dried milk was sold at cost price to necessitous mothers for infants. 1921 Dinners and/or Dried milk were provided for infants and children under 5, either free or reduced cost, according to an assessment scale. 1922. Zymotic enteritis made notifiable in Finsbury during the summer months (period extended to cover the whole year in 1923). 1923 Measles made notifiable in Finsbury. Agreement made with the Infants Hospital, Vincent Square, for the reservation of cots for Finsbury children needing hospital treatment. 1924 An Assistant Medical Officer of Health for maternity and Child Welfare first appointed. 1927 A new Maternity and child Welfare centre opened in Pine Street. 8 1928 Diphtheria immunization first started by the Council. This fell into abeyance for a short time and then recommended in 1934. 1929 Municipal midwives were first employed. Arrangements were first made by the council for the admission of difficult midwifery cases to hospital. An Obstetric consultant was first appointed by the Council. A service of Home Helps for Nursing Mothers was inauguated. A special child Welfare session was inaugurated for Italian speaking mothers and children. A rat catcher for a period of a few weeks, was first appointed; otherwise only suitable poisons were supplied on request. 1930 Consequent upon the cancellation of National grants to voluntary organisations in connection with Maternity and Child Welfare services, similar grants were made by the Council, and arrangements entered into to secure closer collaboration. Arrangements were made for massage and artificial sunlight for debilitated children. A Day Nursery in 9 Lloyd Square run by a voluntary organisation was taken over by the Council. It was transferred to 42 Baker Street in 1931. Convalescent beds were first retained for sickly Finsbury children under 5. 1931 Tuberculosis Dispensary transferred from Royal chest Hospital to 21 Whiskin Street and full time Tuberculosis Officer and visitor appointed. A scheme for the construction of a Health Centre first promulgated. 1932 Municipal Midwifery service abandoned and special agreement with local hospital entered into for conduct of the service. 1934 Whooping cough made notifiable and vaccine made available to local medical practitioners. An elaborate Health week was held in the Borough. 1936 A routine was established with the co-operation of the Hospitals concerned, for the Wassermann reaction to be carried out in relation to all expectant mothers attending Ante-natal clinics. 9 1938 In conjunction with surrounding Boroughs an obstetric emergency unit was instituted based on St. Bartholomew's Hospital. On October 28th the Finsbury Health centre was opened by Lord Horder G.C.V.O., M.D., F.R.C.P. who said it was a privilege to open such a unique building, through whose portals so many thousands of people would seek and find health and happiness. 1939 The Day Nursery was evacuated first to Berkshire and later transferred to Gloucestershire. 1940 Large numbers of evacuees from Gibralter were disinfested in the Cleansing Station at the Health Centre. 1941 A Comprehensive Shelter Health Service was established. 1943 A rodent control service was established. 1946 Extension of the Domestic Help service to cover the needs of the sick and aged inaugurated. Attention directed to the needs of the elderly, and the duties of the scabies nurse/visitor whose work was rapidly diminishing, extended as a nurse/visitor for the Aged. 1948 Personal Health Services transferred to the London County Council and the Specialist clinic services to the NorthEast Metropolitan Hospital Board. 1949 Holiday schemes for the elderly for a nominal charge inaugurated. The work of voluntary organisations for the care of the elderly co-ordinated and encouraged by the making of grants. 1950 A localised outbreak of Typhoid fever occurred which involved 10 persons all living in one house. 1951 A part time employment scheme for the elderly was inaugurated by the Council jointly with a voluntary organisation. It was taken over by the council in 1964. In 1954 a special workshop was built in Gloucester Way, with funds from various trusts, and opened by the late Lord Horder. Distinguished visitors to the Health Centre and/or the Workshop include:- H.M. Queen Elizabeth the Queen Mother. Lady Louis Mountbatten (later countess Mountbatten) on many occasions. 10 in connection with the employment of St. John auxilliary nurses in the Shelter Health Scheme. Mr. Maisky at that time Russian Ambassador in this country in connection with an 'Aid to Russia' campaign and Exhibition. Dr. Edith summerskill (later Baroness Summerskill) in connection with a pood campaign. A delegation of the 'Supreme Soviet' and the Rt. Hon. Henry Brooke, Esq., when Minister of Housing and Local Government. Sir Geoffrey Hutchinson Chairman of the National Assistance Board. Miss Pat Hornsby Smith M.P., Parliamentary Secretary to the Ministry of Health. THE HEALTH OF FINSBURY 1901 AND 1963 Population. 1901 101, 463 1961 32,887 1963 (estimated) 32, 230 Percentage of Population aged Under 5 5-14 15-24 25-64 Over 65 1901 12.1 20.8 20.1 44.1 3.1 1961 8.3 14.1 12.7 53.8 11.1 From these figures it is seen that the population has fallen to a number less than one third of that when the Borough was first constituted and that it now contains a much higher proportion of adults and elderly persons. In fact the total number of those over 65 years of age has increased from 3,161 in 1901 to 3,668 in 1961. Rateable Value 1901 £963,775 1962 £2,981,711 Social class There are no comparable data available for determining any changes which may have taken place in the proportion of the several accepted social class distinctions but it is interesting to note that in 1901 that 7.8 per cent of families kept domestic servants as against 23 for London as a whole. Births Birth Rate 1901 32 1963 15 11 These rates are reasonably comparable as the proportion of women aged 15 to 45 in the population has not altered greatly. Deaths Death Rate 1901-28.7 (This rate is an approximation based on the aged constitution of the population in 1961 and therefore comparable with that for l963. The actual rate for 1901 which applied to the population as constituted at that time was 21.3) Death Rate 1963 13.9 Infant Deaths Infant Mortality Rate 1901 140.6 1963 10.9 The appalling rate for 1901 given above representing 533 actual deaths of infants under 1 includes 20 suffocated by overlaying, between Friday evening and Monday morning, due to the drunken condition of the parents in most, if not all, cases, and 69 from Diarrhoea, mostly in the summer and autumn. No infant deaths from either of these causes has taken place in the last ten years. The saving of infant lives demonstrated by these figures, and of childrens lives referred to below, has been the most striking of all the evidence of the improvement in the health of the population of this country generally, and of this Borough in particular, where the earlier rate was well above the national rate, and in recent years usually below it. Childhood deaths In 1901 there were 371 deaths among children aged from 1 to 15 and in 1963 the corresponding number was 4 and for the same number of children of these ages living in 1901 would have been about 17. Causes of Death Apart from a fall in the number of deaths from each recognised cause (with the exception of cancer and coronary disease), the special feature has been the near elimination as causes of death of Tuberculosis, which was responsible for 270 deaths in 1901, of Alcoholism together with cirrhosis of liver which accounted for 35 deaths, and of the ordinary infectious diseases which were responsible for 182 deaths. Infectious Diseases When the Borough was formed in 1901 many infectious diseases now of little serious import, were rampant and took a heavy toll of life, not only directly but also indirectly, through the complications that were frequent and the aftermath of ill health which they left behind. This is now no longer the case, and normally these diseases have little more than a nuisance value though from time to time they arise as a cause of serious ill health and even of death. 12 The great improvement in housing and social conditions has been the main factor in bringing about this change, but the advance of medical science in prevention and treatment has also played a very considerable part. It cannot however be denied that fortuitous alterations in the character of some infectious diseases for some of them, such as Scarlet Fever and Measles, have become less virulent and some such as Encephalitis lethargica, and the variety of Influenza which appeared in 1918 have come and gone in the intervening years. Throughout historic and probably prehistoric times, there have been similar variations in the incidence and virulence of diseases for reasons which we do not understand, some appearing for the first time, or becoming more virulent for years, and then becoming milder or disappearing altogether. smallpox. There were 88 cases with 10 deaths in 1901 but this was an unusual circumstance at that time, and accounted for by an outbreak which commenced in London in August; a similar outbreak might well occur at the present time. Many pages of report describe the details of this event. Much concern is expressed about the vaccination state of the population. Although the vaccination of infants was at that time compulsory, there was widespread evasion of the requirements, either by the declaration of objection on grounds of conscience, or in other ways. No reliable data were available to the Medical Officer of Health but from the investigation of children in the schools he concluded that from 15 to 25 per cent of them were unvaccinated. There were no cases in 1963. Diphtheria. In 1901 there were 289 cases with 36 deaths and in 1963 there were no cases. It may be noted that the bacteriological examination of swabs for doubtful cases was already undertaken by the Council in 1901, as was also the free issue of Antitoxin for immediate use before a patient could be transferred to hospital, and as a preventive inoculation to contacts. Typhoid Fever. In 1901 there were 65 cases with eleven deaths and in 1963 there were no cases. The Widal blood test was already in 1901 undertaken free on behalf of the council for doubtful cases. Scarlet Fever. In 1901 there were 495 cases with 19 deaths. Owing to the severity of the disease at that time there were almost certainly very many serious and lasting complications in the cases that recovered The Medical Officer of Health reports at length on the investigations regarding 24 of the cases, most of which arose as a result of drinking milk which was eventually traced as coming from a particular farm in Staffordshire, where four of the farmers family were found to be suffering from the disease. In 1963 there were 43 cases all of them mild and transient. 13 Measles. In 1901 there were 49 deaths nearly all below 5 years of age, directly attributable to measles. As measles was not at that time notifiable it was impossible even to guess at the total number of cases. In 1963 there were 398 cases but no deaths. Whooping cough. In 1901 there were 37 deaths all under 5 years of age, directly attributable to Whooping Cough. Like measles being not notifiable at that time there is no evidence available as to its incidence. In 1963 there were 37 cases and no deaths. Enteritis of infants. In 1901 there were 127 deaths and an unknown but very large number of cases. In 1963 there were 26 case, one of which was serious, and resulted in death, which is most unusual these days. Erysipelas. In 1901 there were 95 cases with 4 deaths. In 1963 there were 6 cases none of them serious. Poliomyelitis, meningococcal infections and encephalitis. In 1901 there were no records of any of these diseases having occurred, and in 1963 two cases occurred. In the intervening years however, a considerable number of cases with some deaths occurred. Tuberculosis. In 1901 there were in all 276 deaths from all forms of tuberculosis and there must have been a very large number of cases, many probably unrecognised in the population. The deaths were most numerous in the overcrowded parts of the Borough away from the open spaces. A large number occurred in the same houses. Much concern was felt in regard to this disease but efforts were frustrated in that no sanatoriums were available for treatment, and of course the help that X-rays could give in diagnosis had not been discovered. Methods of prevention that could be adopted were practically confined to education as to infection being spread by spitting, and disinfection, voluntary notification was arranged by the Borough council with the approval of the Local Government Board, but only 70 cases came to the knowledge of the department in this way. Finsbury was the first Metropolitan Borough to introduce this arrangement. Arrangements were made for the pathological examination of sputum for Tubercle Bacilli. In 1963 23 new cases of Tuberculosis were notified and the number of deaths amounted to two. A specialist physician with a clinic in the Health centre with access to pathological and X-ray aids to diagnosis and treatment gave advice wherever needed in the recognition and supervision of the disease, and accommodation in various institutions was readily available when required. 14 Alcoholism. In 1901 there were 13 deaths directly due to alcoholism or delirium trements(of which 7 were women) and many others indirectly attributable to this cause including 22 (13 women) from cirrhosis of the liver. In 1963 there were no deaths directly the result of alcoholism and probably none in which it played a major role and cirrhosis of the liver has all but disappeared. Though the debilitating effects of chronic alcoholism are occasionally encountered, they are of insufficient general importance to be specially mentioned in the Annual Report. Cancer. In 1901 there were only 72 deaths recorded from cancer, whereas in 1963 there were 88 deaths. It must be remembered however that the number of elderly in the Borough has not decreased, and these numbers are broadly comparable without adjustment for the diminished population. Coronary Disease. In 1901 deaths from this cause were so rare that the few that probably occurred were classed generally as from Heart disease, whereas in 1963 there were 77 deaths. Accidents. In 1901 there were 67 deaths from accidents and in 1963 there were 2 deaths from motor vehicle accidents and from other accidents making a total of 14 deaths. Suicide. In 1901 there were 14 cases of suicide all under 65 years of age, and in 1963 8 cases including 2 over 65 years. FOOD Meat In 1901 there were 7 slaughterhouses in the Borough and the second largest dead meat market in London, namely the Extra-corporation meat markets in the vicinity of Smithfield. There were of course no cold meat stores, and the total amount of meat handled in the market area, although very considerable must have been much less than that in 1963. There were a large number of butchers shops and market stalls selling meat in the Borough. Inspection was carried out by a full time meat inspector assisted as necessary by other sanitary inspectors. Surrender of unsound and diseased meat by the owner was accepted by the Council. But if such meat was discovered by the inspector the matter was reported to the Medical Officer of Health, who, if he regarded the case as serious seized the meat and submitted it to the magistrate for condemnation, and reported the fact to the Public Health committee. Co-operation with the trade was sought rather than prosecution, except in the more flagrant cases, nevertheless legal proceedings were instituted in 24 instances. 15 Of these prosecutions 9 were in respect of diseased meat and 15 of unsound meat. 11 of them were taken against firms in or around the central meat market, 9 against shops or stalls in the market streets, and 4 in other butchers shops. Convictions were secured in every case and in three cases prison sentences of 6 months. 6 weeks and one month respectively without option of a fine, were imposed. In 6 cases the fines were of £50 or more in 4' of £25 or more, in 8 of £5 or more and in 3 of less than £5, were imposed. The total amount of meat surrendered was rather more than 30 tons. Milk In 1901 there were 8 licensed cowkeepers with in all, 150 cows. There were 267 registered milk shops who obtained their supply mostly from wholesale dealers(often more than one) who in their turn obtained it from scattered firms in remote parts of the country. These shops were regularly inspected but sterilisation of the vessels and strict cleanliness as we recognise it today was unknown. 252 samples of milk were submitted to the Public Analyst who reported on 56 of them, that they were adulterated. Legal proceedings were instituted in 32 (21 for varying percentages of added water, 2 being of as much as 20 per cent and 11 for abstraction of fat to varying amounts, 1 being for 34 per cent and 2 for 23 per cent.) In addition a prosecution was also undertaken for 'sending a servant out with a milk perambulator and churn' without a name and address on either. Convictions were secured in all cases and small fines imposed. In 1963 there were no cows kept in the Borough and there were 135 registered milk sellers. Although the original source was in the country as before yet all the milk was heat treated and practically all of it bottled by the distributors before arrival in the Borough and vigorous control of its handling at all stages in respect of hygiene was carried out. Tuberculosis in relation to meat and milk. A violent constroversy raged in 1901 as to whether the germ of bovine tuberculosis could infect man, and in July of that year Professor Koch the original discoverer of the germ stated in London that he firmly believed this not to be possible, in spite of increasing evidence to the contrary. The Government immediately set up a Royal commission to enquire into the matter and advised local authorities to continue in the meantime the control of tuberculous milk and meat. There was no break in the measures taken in this Borough which were designed to protect the public from a danger of infection now known to have been great in relation to milk and possibly in regard to meat although in the latter case the germs would probably be killed by cooking. 16 Ice Cream In 1901 there were 89 persons and premises in which ice cream was made were registered, but as registration was not then compulsory the actual number was thought to have been probably greater. Of the total of 89 no fewer than 15 were in the Italian quarter which was said to be open to criticism on the grounds of a varity of insanitary conditions. and the trade appeared to flourish most where these were worst. It is stated that the ingredients and mode of compounding were such as to permit various forms and degrees of pollution. The ice cream was mostly sold by itinerant barrow men. In 1963 there were 3 premises registered for the manufacture of ice cream. These were all suitable as regards hygiene, were regularly inspected and the making of the ice cream as well as the hygienic condition of the equipment and ingredients supervised. There were in addition 155 premises licensed for sale but in nearly all cases the ice cream was delivered and sold adequately wrapped to prevent contamination. Sale was also from itinerant vehicles and these maintained a fair standard of hygiene and were to some extent supervised. Cheese. A most unusual incident is described at some length in the 1901 report namely an outbreak of food poisoning from cheese involving altogether probably some 30 to 40 persons including 4 in Pinsbury, as well as the Medical Officer of Health and the head of the firm of distributors involved, who tested the offending cheese which appeared healthy by eating a portion. The actual maker of the cheese in Holland was traced and he came over to London to study the details. The outbreak was clearly what would now be called, of the toxic type, but the reason for the production of the toxin was never discovered. Butter. In 1901 122 samples of butter were submitted to the Public Analyst and of these 18 were found to be adulterated. In 14 cases a prosecution was undertaken and convictions were secured and fines levied in all but one case which was dismissed. A firm in the Borough in this year imported large quantities of colonial and Danish butter, thoroughly mixed it with milk (8 to 10 quarts per hundredweight) and sold it as 'pure butter' through its 120 branches in the country (none in Finsbury). Various prosecutions and convictions followed, and following an appeal in one case to the High Court, which was dismissed, the firm varied the designation and described it as Pearks Milk blended Butter'. Although this description was possibly even more misleading. its legality was upheld. The Borough Council approached the Board of Agriculture, who in the next year made the regulation that butter must not contain an excess of 16 per cent of water, whereas this product was admitted, and even advertised to contain 24 per cent being described as 'the choicest butter blended daily with full cream English milk, thus acquiring a delicacy of flavour that cannot be obtained in any other butter, and retains about 24 per cent of moisture'. 17 In 1963 4 samples of butter were examined and none were found to be adulterated. Margarine. In 6 cases prosecutions were carried out in 1901 in relation to the non-labelling of margarine on the wrapper in which it was sold. 2 of these cases were however dismissed, and in 2 cases the summonses were withdrawn. No similar contraventions were discovered in 1963. Sampling Generally. 127 other articles of food were sampled in 1901, and 11 were found to be adulterated as follows: Mustard 1; Cocoa 2; Coffee 4; Sugar 1; Rum 1; Whiskey 2; Successful prosecutions were undertaken in 4 cases. In 1963 620 samples were submitted for analysis of which none were unsatisfactory. HOUSING It is recorded that in 1901 there were 9, 280 houses but no blocks of flats were included, as such there must have been about 13,000 separate dwellings. In 1963 it is estimated that the number was 9,262. It would seem that the number of dwellings has not decreased as much as is sometimes thought. A number of blocks of flats which are now regarded as slum property such as Dundee. Corporation and Bartholomew Buildings, were described in 1901 as model dwellings and appear to have been regarded as such. Overcrowding if reckoned by the number of persons per acre was clearly about three times more than at the present time, and if measured by the number of persons living in a given number of rooms, the great improvement since the foundation of Finsbury is shown by the following table:- Number of persons in grossly overcrowded accommodation 1. Families living in One Room 2. 4. 5. 6. 7. 8. 9. 10 or more Total more than 2 in one room 1901 5295 3904 2165 1176 490 88 36 51 13,205=13.1% of Population 1961 75 44 25 6 - - - - 150=0.5% of Population 2. Families living in Two Rooms 5. 6. 7. 8. 9. 10 or more Total more than 4 in 2 rooms 1901 6200 6048 4438 2256 918 29 20,289=20.1% of Population 1961 405 186 28 32 - - 651=2.0% of Population 18 3. Families living in Three Rooms 7. 8. 9. 10 or more Total more than 6 in 3 rooms 1901 3143 2696 1755 1362 8,946=8.8% of Population 1961 154 80 18 10 262=0.9% of Population 4. Families living in Four Rooms 9. 10 or more Total more than 8 in 4 rooms 1901 1089 1207 2,296=2.3% of Population 1961 72 70 142=0.4% of Population Total living in overcrowded conditions set out above:- 1901 44, 736 = 44.2 per cent of Population 1961 1,205 = 3.7 per cent of Population Because of the difficulty of ascertaining the full extent of the overcrowding a midnight inspection of 9 houses in Bastwick Street was undertaken, on one occasion in 1901. It was discovered that in these houses 158 adults and 114 children under ten were sleeping. Some details were given in the report of a sample of ten rooms in each of which 7 or 8 persons were sleeping. Overcrowding is reported in 1963 as still persisting in a number of houses and tenements, but not to anything like the degree that it did in 1901 nor to anything like the same extent. Although the number of cases referred to in the report, namely 28, was certainly considerably below the actual figure, many instances not being known to the Medical Officer of Health, the true figure was not likely to be more than 200, as compared with many times that number in 1901 and examples such as those described with 7 or 8 sleeping in one room were unheard of in 1963. The character of the housing conditions prevailing in 1901 is well set out in the following extract from the report for 1901 A large part of the borough area is covered by warehouses factories workshops or small shops, in immediate proximity to, and often crowded together with, dwelling-houses. The majority of these dwelling-houses are chiefly of two or three storeys, situated in narrow streets and alleys off main thoroughfares. Many of them are small, old cottages showing signs of decay. Such generally contain two rooms, one on the ground floor and one above, the communicating staircase being situated in the ground floor room, into which also the door from the street directly opens. Most of the houses have small back yards. These houses are generally occupied by single families, but in some cases by two, though from this arrangement they are ill-adapted for this purpose. The houses of three storeys are chiefly in the larger thoroughfares. They generally contain an entrance passage and two rooms, one behind 19 the other, on each floor. In nearly all instances such houses are Occupied by members of more than one family, even if the ground floor is used as a shop. The better class houses of this character are rented by one tenant, who sublets. The poorer class houses are let in separate tenements, and there is, as a rule, no responsible caretaker. In the older portions of the Borough both of these kinds of houses are old, worn out, damp, or have no means of ventilation. In one or two quarters such houses exist 'back to back', and without any through ventilation whatever. In these and some other cases it would appear that closure is the only remedy, and for insanitary areas a more or less thorough clearance. Much of this kind of property is held on building leases granted in the first half of last century, and many of them are now falling in. Opportunities for reconstruction are therefore becoming frequent. These conditions of house property have been brought about, in the main by two agencies. In the first place, it may be said that there has been proceeding for a number of years a change of usage more than a change of actual property. Whole streets and squares of houses, formerly occupied by single families, and often good class families, are now occupied as separate dwellings on separate floors. The private house has become a tenement house. There is a common passage and a common staircase, both of which are open to the public, and any considerable degree of privacy is thus destroyed. The passage and staircase act as the ventilating shaft for the foul atmosphere derived from the dwelling rooms opening on to the stair. The history of such a house is a dismal record of degeneration. Year by year the state slowly but surely becomes worse. The house was structurally designed for one family, and is now occupied by four or more families. The sanitary conveniences were also designed for one family, and now provide for four families. The same must be said of the water supply and washhouse accommodation. There can be no doubt that the ill-ventilation and the difficulty of access to the water closet, scullery, washhouse, or dustbin may directly act as causes of ill-health, and undesirable habits. In the second place, another of the general characteristics of house property in the Borough is that the yards in the rear of the houses have, in so many cases, been built over. The condition of things constantly to be observed is this. Between two streets, running parallel, there existed when the houses were first built an open space, subdivided into yards. Thus fresh air was obtainable in the rear as well as in the front of the houses. In the yards were constructed various conveniences for sanitary purposes washing, refuse collection, etc. Thus the house, as a private house, was equipped. But in addition to the invasion of tenants, to which reference has already been made, another change soon came about. The yards became covered in or otherwise built over, generally for workshop premises. Even when such buildings are only small they effectually prevent through ventilation on the ground floor. But so extensive have such buildings become in 20 certain cases, that a large portion of the open space originally existing between the street backs has now been filled in. The houses have thus become, practically speaking, 'back-to-back' houses. Moreover, the immediate proximity of some kinds of workshops to dwelling-houses readily gives rise to nuisance of various kinds. There can be little doubt that it is changes of this kind that have made house property in Finsbury unsatisfactory, and increased overcrowding. Finsbury is at present undergoing a radical change from a residential district into a non-residential commercial district comparable to the City of London. Such a transition acts prejudicially for along period of years on dwelling-house property and overcrowding. The new Borough inherited from the former vestries a number of areas already represented for clearance under the Housing of the Working Classes Act 1890 and earlier Acts. These consisted of(a)5 areas to be dealt with by the London County Council. These covered 4 5/8ths acres with 264 houses in which 1704 persons were living. On the site it was proposed to build accommodation for 2,656 persons, and (b) 6 areas to be dealt with by the Borough council. These included 110 houses in which 859 persons were living. In addition, seven other areas are referred to with 109 houses and 746 residents not as then represented but which ought to be cleared. In 1963 the Borough had a quite different aspect, for commerce and industry had displaced residential accommodation to a very considerable extent and the building of many new blocks of flats had increased the proportion of this type of accommodation to that of houses, the total number of flats being estimated to be 7.210. There were still in 1963 ten areas already represented for clearance and 11 others determined upon to be dealt with by the end of 1965 and these included a substantial area known as the Clarke's Close Estate. But these properties, although unfit, were not to be compared in regard to their insanitary condition and surroundings with those that existed in 1901,and would not at that time have been regarded as unduly unsatisfactory The slums of 1901 were by 1963 past and almost forgotten history. Considerable numbers of properties still existed in the Borough however,which provided most unhappy and unhealthy conditions for those living in them, because of general dilapidation and the sharing of houses between several independent families. They did not however form more than about 10 per cent of the total housing accommodation. During 1901 new Byelaws were framed, passed and confirmed, with respect of Houses let in lodgings. It was then hoped that by the enforcement of requirements set out in them, that the sanitation and cleanliness of the Borough would be advanced. 21 canal Boats. The work of inspection of canal boats and sailing barges occupied a considerable proportion of the time of one sanitary Inspector and during the year 102 boats occupied in all by 207 men, 34 women and 64 children were inspected. No case of infectious disease was discovered but notices were served in four instances as follows:- Defective stove pipe, leaky boat, defective pump and cabin deck head leaky. Slaughterhouses and cowhouses. There is no mention of these in the report for 1901 but that to the clerkenwell Vestry for 1900 refers to 4 slaughterhouses and 5 cowhouses with in all 116 cows in this part of the Borough. (The last slaughterhouse was in use until the beginning of the 2nd World War in 1939, and although I cannot state exactly when cows were last kept in the Borough, I remember seeing two cows on one occasion in a cowhouse in Great Sutton Street since I came to Finsbury in 1935). Factories One sanitary inspector was engaged full time on the inspection of 1.356 factories registered in the Borough and 80 defects were remedied The new Factory and Workshop Act 1901 had already been passed and improvements in the Factories and bakehouses, especially the underground bakehouses, were anticipated when this Act came into force in 1902 Bakehouses There were 78 bakehouses including 46 underground bakehouses in the Borough, and it is recorded that they were mostly old and unsatisfactory most of them having been in use for half a century and some since the beginning of the nineteenth century. Schools Although no details are supplied it is clear that various very careful inspections of the schools were made None were closed during the year for infectious disease. Disinfection. 15.853 articles were disinfected during the year and 2 vans were employed for their collection and redelivery respectively, but whether ordinary steam or superheated steam was used is not clear. 983 rooms were also disinfected the walls having previously been stripped in a few cases During the year a change was made from the use of sulphur fumigation to spraying with formaldehyde. Reception Houses. 72 families with 310 persons were temporarily accommodated in the two reception houses, maintained whilst disinfection of roans was carried out. Mortuaries. The 2 mortuaries were used for the reception of 489 bodies as follows 161 for inquests to be held, 12 because of infectious disease; 9 by orders and 307 for the convenience of relatives SANITARY INSPECTION The following table sets out a summary of the work undertaken in 1901 and in 1963: 22  1901 1963 Number of Inspectors 9 10 Housing damp, dirty remedied 818 270 Doors, windows, floors, walls, ceilings, sashcords repaired 368 411 Watercloset and urinal defects remedied 1,243 176 Soil and vent pipe defects remedied 53 97 Rainwater pipes cleared, repaired or renewed 151 130 Drains cleared and/or repaired 574 212 Roofs and gutters repaired 346 223 Water storage tank defects remedied 211 31 Yard or Area defects remedied 820 44 Washhouse defects remedied 332 1 Water supply to houses reinstated 15 121 Water supply laid on to upper storeys of houses - - Firegrates renewed or repaired - 18 Animal nuisances abated 11 12 Dung or dust receptacles renewed or repaired 381 80 Accumulations of refuse removed 148 200 Miscellaneous nuisances abated 274 83 No. of Basement rooms inspected - 229 Overcrowding cases reported - 51 Number of House Inspections 1,660 Number of House to House inspections 1,746 389 Total number of first visits for all purposes 3,216 7,990 Revisits 14, 883 11,519 Number of Intimation notices served 2,666 515 Number of Nuisance notices served 505 74 Legal proceedings under Public Health (London) Act 1891, byelaws made under it or other legislation dealing with Public Health, were taken in 21 instances (including 3 respecting smoke nuisances) and convictions or orders were obtained in 16 cases and were withdrawn in 5 cases (on payment of costs in 3). 23 SECTION A. Physical Features and social conditions General Area of the Borough (acres). 587 Population 1961 census 32, 887 Population Density 56 Rateable value 31.3.63. £3, 142, 765 Product of a penny rate (1962/63) £12,065 General rate 1962/63 19/2d. Finsbury, one of Londons 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. PRINCIPAL VITAL STATISTICS Population (Mid year estimate) 32,230 Marriages registered 244 Live Births Legitimate -Males 237 Females 267 Total 504 Illegitimate - males 24 Females 22 Total 46. TOTAL - Males 261 Females 289 Total 550 24 Birth Rate (standardized): 15.0 England and wales 18.2 Stillbirths: Legitimate Males 3 Females 5 Total 8 Illegitimate Males 2 Females - Total 2 TOTAL Males 5 Females 5 Total 10 Stillbirth Rate: Per 1,000 live and stillbirths 17.9 England & Wales (Per 1,000 live and stillbirths) 17.3 Per 1,000 Population (standardized) 9.27 Deaths: Males 212 Females 177 Total 38 9 Death Rate (Standardized): 13.9 England and Wales 12.2 Infant Deaths 6 Infant Mortality: 10.91 England & Wales 20.9 Early Neonatal Mortality Rate 7.3 Perinatal Mortality Rate 25.0 Neonatal Deaths: 4 Neonatal Mortality: 7.3 England and wales 14.2 Illegitimate Infant Deaths: Nil Illegitimate Infant Mortality: Nil Maternal Deaths: Nil Maternal Mortality: Nil England and Wales 0.28 Tuberculosis (all forms death rate: 0.06 England and wales 1963 all forms per thousand 0.063 Respiratory 0.056 Other forms 0.007 Area comparability factors Births 0.88 Deaths 1.15 25 COMPARATIVE STATISTICS 1959-196i3 1. Population 1959 1960 1956-60 1961 1962 1963 34,030 33,710 34,480 33,020 32,540 32,230 2. Birth Rate per 1,000 Population 18.5 19.00 19.2 18.6 17.6 17.1 3. sex Ratio Male/Female - - 1, 113 - - - 4. Illegitimate Birth Rate per 1,000 Population 1.3 1.3 1.4 1.3 1.3 1.4 per 1,000 Live Births 72 70 74 73 71 84 5. stillbirth Rate per 1,000 Population 0.38 0.36 0.40 0.27 0.28 0.31 per 1.000 Total Births 20 19 21 14 15 18 6. Death Rate per 1,000 Population 11.2 10.0 10.2 10.6 11.9 12.1 7. Infant Mortality per 1,000 Live Births 15.9 15.6 21.0 30.9 27.9 10.9 8. Infant Mortality Illegitimate per 1,000 Illegitimate Live Births - - 29 - - - 9. Neonatal Mortality per 1,000 Live Births 8 10.9 16 27.7 24.14 7.3 10. Maternal Mortality per 1,000 Total Births - 1.5 0.30 1.6 - -- 11. Tuberculosis (All forms Death Rate per 1,000 Population 0.03 0.12 0.15 0.06 0.12 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. 26 INQUESTS: Inquests were held on twenty-four residents during the year. The causes of death found were Road Accidents: Male 63 1 Female 60 1 Accidents from Falls, excluding Industrial: Males 21 1 Females 80 , 66 , 57 3 Other Accidents: Males 56, 38 2 Females 70, 67, 55, 48, 48, 47 6 Suicide: Males 69, 68, 59, 43. 34, 33, 23 7 Female 27 1 Murder: Female 74 1 Self Neglect: Female 72 1 24 INFANT MORTALITY 1963 -CAUSES OF DEATH Causes of Death 0-1 wk 1-2 wks 2-3 wks 3-4 wks Total under 4 mths 1-3 wths 3-6 mths 6-9 mths 9-12 mths Total under 1 yr. IMMATURITY 3 - - • 3 - - - - 3 PNEUMONIA - • - - - 1 1 - - 2 CONGENITAL ABNORMALITY 1 - - - 1 - - - - 1 BRONCHITIS - - - -- - - - - - - TOTALS 4 - - - 4 1 1 - - 6 (In this table the international rules for classification have not been strictly followed). 27. CAUSES OF DEATH 1963: 1. Tuberculosis Respiratory 0- 1- 2-4 5 -14 15-24 25-44 45-64 65-74 75-84 85- Total M F M F M F 2 2 2. Tuberculosis Other - 3. Syphilitic Disease 2 1 - 3 4. Diphtheria - 5. Whooping cough - 6. Meningococcal Infections - 7. Acute Poliomyelitis - 8. Measles - 9. Other Infective & Parasitic Diseases 1 1 10. Malignant Neoplasm - stomach 9 1 2 1 1 14 11. Malignant Neoplasm - Lung Bronchus 17 6 - 4 1 1 - 29 12. Malignant Neoplasm - Breast 5 - 1 - 1 7 13. Malignant Neoplasm - 1 - 2 3 14. Other Malignant & Lymphatic Neoplasms 1 2 12 4 7 1 4 2 2 35 15. Leukaemia, Aleukaemia 1 1 2 16. Diabetes 1 - 1 1 1 4 17. Vascular Lesions of Nervous systems 1 7 4 5 7 3 - 2 29 18. Coronary Disease, Angina 23 .5 6 3 15 2 3 77 19. Hypertension with Heart disease 0- 1- 2-4 5-14 15-24 25-44 45-64 65- 74 75-84 85- Total M F Af F M F - 3 3 20. Other Heart Disease 3 3 2 3 3 4 2 6 26 21. Other circulatory Disease 3 3 6 6 3 21 22. Influenza - 23. Pneumonia 1 5 5 4 10 6 3 5 39 24. Bronchitis 4 12 - 4 7 - 2 29 25. Other Diseases of Respiratory system 3 1 - 2 - 6 26. Ulcer of stomach & Duodenum 1 - 1 2 1 5 27. Gastritis, Enteritis & Diarrhoea - 28. Nephritis & Nephrosis 1 1 29. Hyperplasia of Prostate - 30. Pregnancy, childbirth Abortion - 31. congenital Malformations 2 1 3 32. Other Defined and I11 Defined Diseases 4 3 5 2 6 - 4 - 3 27 33. Motor vehicle Accidents 2 2 34. All Other Accidents 1 6 - 3 1 1 12 3E. Suicide 1 4 1 2 -- 8 36. Homicide & Operations of war - 1 1 Totals 6 - -- 2 2 14 115 58 46 55 56 10 25 389 28. 29, SECTION B. GENERAL PROVISION OP 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 diseases 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 continued to under take 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. 30 BLOOD TRANSFUSIONS 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 475 donors attended 419 were bled and 56 rejected for various reasons. The comparative figures for 1962 were 465 donors,434 bled and 31 rejected. INTERNATIONAL CERTIFICATES OF VACCINATION AND INOCULATION: The International form of certificate of vaccination and innoculation 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 1963 147 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 had 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 10 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 co-operation of the Libraries Department. Enamelled panels showing details of hospitals with times for attendance, where advice or treatment on Venereal diseases can be obtained,were renewed as necessary in the Council's public Conveniences. The Council also continued to co-operate in the Health publicity prograjnme organised by the London County Council Health Division III. 31. ELDERLY PERSONS: The Council has continued its very active concern and support during 1963 in connection with all schemes designed to assist in the case 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 £11,190 during the financial year 1962/63. 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 and Assistant Nurse Visitor have been employed whose duties involve the regular visiting of aged persons, particularly those living alone, who arc likely to be in need of care and attention The main duties of the staff of the Finsbury Old People's Welfare Committee are to aid 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 othersare found whom had they been known earlier might have bee n helped. The staff consists of a Social Worker and two Assistant Social Workers (b) Meal Services (i) club Meals: Many of the elderly, particularly those who live alone, are apt to take insufficient food, not only because of expense but also because of the difficulty and trouble involved in preparing a satisfactory meal for one. Dinner services, therefore, have been instituted through voluntary associations throughout the Borough. A grant is given to the associations by the Council to cover their expenses and further grants are made by the Finsbury Borough 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 1963 21,840 meals were served from Meal Centres, as against 20,608 in 1962. The following centres were in operation for 3 to 3 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, S.C.1. 32. (iii) Claremont Central Mission, White Lion St. 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 are 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 themselvds. The cost to the elderly was one shilling per meal. Early in 1963 intimation was received from the National Catering Organisation from whom frozen meals were purchased,that it was intended, due to the insufficiency of the demand, to discontinue the supply of such frozen meals as from the end of June 1963. Every effort was made through the medium of various central organisations to ascertain the potential over-all demand for such frozen meals with a view to representation being made to the firm to ensure continuation of supply. Unfortunately the overall demand at that time was not such as to warrant the firm altering the decision which they had already made to discontinue the provision of such frozen meals. The Council therefore decided to provide a Domiciliary meals service using fresh cooked meals from the Caterer who provides for the normal meal service. (The caterer prepares such meals in the kitchens attached to the Finsbury Town Hall. The Domiciliary meals service using fresh cooked meals, commenced on the 1st July 1963, and during the period July to December 1963, 2,512 such meals were served, which altogether with the frozen meals provided for the period January to June 1963 (namely 3,453) makes a total number of Domiciliary meals supplied during 1963 5,965 as against 4,941 such meals in 1962. (c) Nutritional Supplements (F.O.P.W.C.) The arrangements continued with Messrs. Wander Ltd., Eovril Ltd., Marmite Food Extract Co., Ltd., Glaxo Ltd., and Horlicks Ltd..whereby 'Ovaltine' 'Hospital Extract Bovril' , 'Marmite' , 'Jaffa Juice' , 'Complan' and Horlicks' are supplied to the various organisations 33. represented on the Committee for resale to the aged attending their clubs, at a price considerably less than the normal retail price. These Nutritional Supplements have proved very popular with the aged and considerable quantities have been sold to them. (d) Sheltered Employment: The scheme inaugurated as an experiment in 1951, to provide sheltered employment of 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 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 co-operated, but some articles have been made for sale to the trade or direct to the public. The elderly employed are paid a small wage amounting to 12/6d. a week, which is slightly more than the actual value of the labour provided. This Scheme has not only brought joy and happiness to many elderly people but has been of great value in preserving their health of mind and body. It has also attracted intense interest from many parts of the country and from overseas, and many bodies are considering inaugurating, or have inaugurated, similar schemes. As a result of the passing of the National Assistance (Amendment) Act 1962, the Borough Council resolved that as from the 1st April 1964 the Finsbury Employment Scheme for the Elderly should be run directly by the Council instead of as previously by Grant aid through the Voluntary Organisation at present administering it. (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. 34. 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 401 persons in 1963, comprising 106 men and 295 women of which 32 Were married couples, at a total cost to the Council of £3,953 Holidays were provided at 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 bed linen in a wholesome condition. (g) Bathing: Baths have been provided free of charge at the Health Centre to those aged persons who, on account of their condition, cannot use the existing Public Baths. An attendant has been available to help with dressing and undressing and to render assistance if this is necessary. In 1960 a bathing attendant was appointed to visit the infirm elderly in their own homes, and there wash and bath them as possible, and according to the circumstances. This has proved a very valuable service and has helped many of the elderly to keep themselves clean, comfortable and respectable 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. (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 has 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. 35. (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 (P. 0. P. W. C.) has been provided free of charge for those aged persons who are unable, by reason of senility, chronic sickness etc., to attend personally the Foot Clinic at the Health Centre, and has proved of great benefit to the Elderly. 707 visits were paid in 1963 and pensioners of all agesupto 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.0.S. Cards (F.0.P.W.C): The S.0-S. Card Scheme operated by the Committee in the Borough has functioned very successfully in the past. No use, however, was made of the Scheme during 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 a practical value also has a comfort value, as many of the aged express the sense of security which possession of the card affords them (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 lists d Women's 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.I Pinsbury Mission, Moreland street, E.C.I. Leysian Mission, 112 City Road, E.C 1 Claremont Central Mission, White Lion Street, N.1. British Red Cross Society, Old People's Centre, Lever St., E.C. 1. British Red Cross Society, Priory Green Community Centre, N.1. St. Luke's Church, Old Street, E C 1. St. James (Pentonville) Womens Fellowship, Pentonville Road, N. 1. St James (Clerkenwell) clerkenwell close, E.C.I. Holy Redeemer Church, Exmouth Market, E.C.1. Sunshine Club, 33 Lloyd Baker Street, W.C.I. 36. The Club organised by the British Red Cross Society at 9 Walmsley Street E C 1 which was open most days of the week for club members and other elderly to make use of as they wished and the ground floor room used as a snuggery for the elderly to sit and gossip round the fires, were closed in September 1963 Due to the fact that the Council had acquired premises at the junction of Lever Street and Dingley Place,the British Red Cross Club was able to move their activities from Walmsley Street to the Old People's Centre in Lever St., on the 28th September 1963 The British Red Cross were also able to continue the special afternoon meeting arranged each week for the housebound elderly and for which whenever available, special transport has been provided. These clubs provide 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 not necessary during 1963 to use the provisions 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 removal of any aged persons OTHER ACTIVITIES FOR THE ELDERLY 1. (Ambulance F.O.P.W.C): The Finsbury Old people's Welfare Committee were presented through the generosity of the Rotary Club of Finsbury, in 1959.with a secondhand ambulance This vehicle was used extensively for the conveyance of the aged and infirm and also loaned to other organisations providing recreation for the handicapped and the elderly. In 1962 the ambulance had to be taken out of use due to the nonavailability of spare parts I am happy to be able to say that the Council have now resolved to purchase an ambulance for use in providing recreation to the elderly, and it is anticipated that delivery will be effected early in the New Year. 2. Day Care Service (F.O.P.W.C.): In April 1963 the Finsbury Old People's Welfare Committee inaugurated aDay Care Service based on a belief that there is a considerable group of elderly people who, because of mild confusion, forgetfulness or physical disability, are unfit to be left alone for long periods; who do not wish, or cannot, go into a Home; who cannot be helped much by treatment in hospital (and if admitted might block a bed for a long time for somebody who could respond to treatment) and for whom the existing domiciliary services, statutory or voluntary, do not fully meet the need Needs The elderly who have the need for this service are those who are very aged, suffering from ill health physical disability or confusion, often bedbound, housebound, unable or afraid to go out on their own and who either live alone or are left alone for long periods. These people fall broadly into the following groups - 37. (i) cared for by relatives or friend who needs occasional relief; (ii) cared for by younger relatives out at work all day; (iii) living entirely alone, (iv) in hospital and able to return home only if care is provided. All these need more help and supervision than is available, and could be helped by the following services:- (a) Day Care Service. A sitter-in gœs in for a regular period each week and is paid for the actual time he or she stays, to enable a relative or friend to get a break. Such a service meets the need of most in category (i). Continuous care of a sick and aged person over a long period can be most exhausting, and if relief is not given, the relative or friend can break down and this may result in two people having to be cared for. (b) Good Neighbour Service. This provides for those for whom a 'Sitter-in' is not practical or necessary, Many of the people live in one room or in accommodation not suitable for another person to sit in for a long time. Also somebody sitting and talking can be pleasant for a short time, but too long can be a burden on both. These people really need a friend or neighbour who can 'pop in' regularly (particularly on days when there is no Home Help) to see they are alright, have not fallen or become ill, to call the doctor or health officer if necessary, to get in shopping, see they have food to eat, and get a light meal (especially at times when no Meals on Wheels are provided), to attend to fires and check safety of heaters and gas; and to give the kind of friendship and help one might expect of a relative if he or she were available This regular daily care,unobtrusive supervision and very personal friendship cannot be given by acentrally placed worker with a large number of people to attend to. A 'Good Neighbour' pops in from time to time as arranged, and is paid for a service, rather than time spent; though naturally this is taken into account. The service which is still in its infancy has operated very satisfactorily during 1963, and has without doubt done much to meet the needs set out above, in respect of the small number of cases in which the Social Workers and others have considered the provision of the Day Care Service desirable. 3. 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. Very substantial use was made of this service during 1963. 4. Christmas Parcels (F.O.P.W.C): Many of the elderly have been provided each Christmas with a parcel of groceries and other suitable 38. 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. 5. 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. the coal is stored at the Health Centre and the service was used on numerous occasions to provide coal to the aged in an emergency. 6. 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 has been made of the Scheme. There is no charge to the aged. 7. Ophthalmic Service: As there was 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 1963. 8. 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, 9. Patients in Hospitals & Residents 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. 10. 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 Finsbury 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 1963. (ii) Wireless Relay Services: The Committee has continued to Finance the provisions of a Wireless Relay Service for the use of the hundred and twenty aged persons participating in the Finsbury Employment Scheme for the elderly at "Brooke House', 39/41 Gloucester Way, E.C.1. and at the Women's Voluntary Service Meal Centre in Exmouth Market, E.C.1. These have been much appreciated by the elderly persons using the Centres. 39. 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 minimum of twenty aged persons, who, whilst not housebound or bedridden were, in the opinion of the officers, deserving of the provision of wireless facilities and that in such cases the rental should be paid by the Committee. In 1963 on an average 17 persons have enjoyed these facilities Either relay or a wireless set where Relay service does not operate) at any one time 11. Television(F.O.P.W.C):An unknown benefactor has financed a scheme for the London Area to provide television sets for loan housebound elderly persons. The Scheme provides for rented sets to be installed and all expenses, including the annual licence fee, would be met from a fund he has set up. It has been agreed that the sets shall only be sought for old people who are: - (a) mainly confined to their homes apart from any old people's welfare activities arranged for them; (b) managing on an income which is around the current N.A.B. allowance level, (c) have no T V. set available to them and would like one; and (d) may fairly be expected to get recreational benefit from an installation. The total number of sets to be made available in London under the scheme would be 1,000. The Finsbury Old People's Welfare Committee submitted 40 nominations of elderly persons within the above category, and television sets have been provided to such nominees. 12. Various (F.O.P.M.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 were situated 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 "Finsbury Tidings' was issued and distributed free of charge to elderly persons on two occasions during 1963. 40. 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. During the year a survey was made of all the major blocks of flats known to have storage tanks for supplying drinking water Samples of water were taken and, where necessary, cleaning and sterilisation and adequate covering of the tanks was enforced in accordance with the Council's Bye-laws. The very extreme wintry conditions experienced during the early part of 1963 were found to have caused an excessive number of burst pipes and those buildings having water tanks in exposed positions on the roof suffered more than most from frost damage. In many instances whole runs of water service pipe had to be renewed 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 1963 only three instances occurred and in each case the supply was restored. There are at present only 3deep 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 bacteriologically in 1963 was 35. Of these 4 samples were taken from deep wells and 31 from private 41. dwellings supplied from water storage tanks The well water was also submitted to the Public Analyst for chemical analysis, and found to be highly satisfactory In the case of the bacteriological examinations, several were initially found to be bad, but following the cleaning and sterilisation of the tanks referred to above, subsequent results were 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 dayrto-day control of chlorination by the Baths Superintendent,the occasional 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 chemical control is maintained by the College authorities. Chemical and bacteriological examinations have also been made from time to time by the Laboratory Technician none of which have given rise to concern, though the alkalinity and amount of free chlorine have occasionally been found to be low and complete sterility not maintained. (iii) An additional covered swimming bath was opened in October on the Golden Lane Estate, owned by the City Corporation, mainly for the use of residents of the estate, but which is also available to the general public, including schoolchildren. Public Health Inspectorate: I am happy to report that up to the end of the year, the Department remained fully staffed in this section, with an establishment of 10 Public Health Inspectors. In accordance with previous practice the Council has continued to engage student Public Health Inspectors. 42. Sanitary Conditions: I am glad to be able to report that there has been a steady 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 unfit properties. The trend, as indicated by the diminishing number of complaints in recent years, was halted in 1963. The total number of complaints made to the department during the year was 1064 as against 735 in 1962. This is most certainly accounted for by reason of the excessively bad weather that obtained during the winter months. 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. The following table sets out a number of details of the work carried out under this heading in 1963: Housing damp, dirty - remedied 270 Doors, windows, floors, walls, ceilings, sashcords repaired 411 Watercloset and urinal defects remedied 176 Soil and vent pipe defects remedied 97 Rainwater pipes cleared, repaired or renewed 130 Waste pipes cleared, repaired or renewed 131 Drains cleared 212 Roofs and gutters repaired 223 Yard or area defects remedied 44 Water storage tank defects remedied 31 Washhouse defects remedied 1 Water supply to houses reinstated 121 Firegrates renewed or repaired 18 Animal nuisances abated 12 Miscellaneous nuisances abated 83 Dust receptacles renewed or repaired 80 Accumulations of refuse removed 200 Overcrowding cases reported 51 No. of Basement rooms inspected 229 No. of House inspections 1,660 No. of House-to-House Inspections 389 Total No. of first visits for all purposes 7,990 Total No. of re-visits for all purposes 11,519 No. of Intimation Notices served 525 No. of Nuisance Notices served 74 Legal proceedings were instituted on 4 occasions in 1963 for noncompliance with notices. Details are as set out below:- 43. Date Premises Offence Result 26.6.63. 3 Vineyard Walk Failure to comply Pined £5. Costs with a Nuisance £1.5.6. Notice. Abatement Order- 28 days. 24.10.63. Farringdon Rd. Bldgs.Five summonses. Fined £2 on each Non-compliance with summons. Costs Notices in accord- £2.2.0. (one ance with LCC (Gen. summons only) Powers) Act 1954 Sec 12. requiring the provision of dustbins (Paladin containers). 13.11.63. 178 Central Street Failure to comply with Fined 10/- Costs a Nuisance Notice. 10/- Abatement Order - 7 days 13.11.63. 3 Vineyard Walk do. Fined £10. Costs £1. Urgent Nuisances: During 1963 the following urgent matters were dealt with as prescribed by the London County Council (General Powers) Act 1955 by the service of notices on the persons responsible. Choked drains 9 (in 8 cases the drains were cleared by the owners within the 48 hour period. In the remaining instance the work was carried out by the Council and charged to the owner). Other urgent defects 1 (this was a leaking water service pipe and was remided by the Council and made a charge on the property). Drainage Work: Extensive rebuilding and alteration of existing industrial, commercial and residential properties has been going on since the war and continues to take place. This necessitates numerous visits to building sites and discussions relating to compliance by building contractors with the London County Council Drainage and W.C. Bye-Laws. Seventy-four drainage plans were approved by the Council during 1963. and 2,993 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. 44 Drains laid or amended 487 Soil and Vent pipes erected 364 Drains or Soil pipes tested 565 Waste Pipes erected 346 Water closets installed 754 Urinals installed 136 Lavatory Basins fixed 875 Sinks fixed 476 Baths and showers installed 376 Petrol Interceptors built 1 The revised Drainage Bye-Laws made by the London County Council came into force on the 1st May 1962. They were necessary because of recent advances in the technique of design and construction, and the use of modern materials in drainage work. The new Bye-Laws allow the use of the 'single stack' system, and this is being used extensively in connection with tall blocks of flats. It calls for greater care in approving installations of this type. Common Lodging Houses: There is only one Common Lodging House known in the Borough, namely that for men situated at88 Old Street, E.C.I, which is owned and maintained by the Salvation Army. The premises were licensed for 275 inmates. 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. Detailed consideration was given in 1961 to this lodging house and the number of men for whom the licence was renewed was reduced from 313. During 1962 a number of improvements were effected by the owners but as it was understood that the premises would be closed during 1963, no action was taken to secure more elaborate modernisation of the facilities provided. The licence has, however, since been further extended. The Public Health Inspectors visited and inspected the premises from time to time during the year. Shops: The duty is placed on the Council by the Shops Act 1950 to carry out inspections of retail and wholesale shops and warehouses to ensure that adequate sanitary accommodation is provided and that sufficient means of ventilation and heating are provided and maintained. From 1959, additional duties in respect of the provision of washing facilities, and facilities for the taking of meals in a shop 45. by employees formerly exercised by the London County Council, were transferred to the Borough Council. A register of shops is kept in the Department with records of 1115 premises, and during the year 177 visits were paid by the Public Health Inspectors. In one instance a notice was served on the occupiers requiring various matters to be dealt with. There are 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 premisee where trade is carried on in rags and waste paper etc. Rag Flock: At the end of 1963, 2 premises in the Borough were licensed for the manufacture or storage of rag flock,and 6 premises were registered to use filling materials under theRag Flock and Other Filling Materials Act 1951. Regular visits have been paid to these premises including 5 inspections in 1963. On all occasions the conditions have been found to be reasonably satisfactory. Two samples of filling materials were taken during the year which 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. 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 Food Hygiene Regulations in canteens, has continued to fall considerably since the war and there are now only 29 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 1,174 at the end of 1963. Generally speaking, conditions have been found to be satisfactory. It must be remembered that many of the defects found are of aminor or temporary nature, such as dirty sanitary accommodation, and are often dealt with informally. On the other hand, certain unsatisfactory conditions found have been dealt with in accordance with the Act and Regulations: 46. The official returns for 1963 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, & 6 are to be enforced by Local Authorities. 29 60 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority. 1,174 911 69 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers prenises'. 26 26 1 - TOTAL 1,229 997 70 Nil CASES IN WHICH DEFECTS WERE FOUND Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.K. Inspector Want of Cleanliness (S.1). 2 - 2 - _ Overcrowding (S.2). - - - - - Unreasonable Temperature (S.3) - - - - - Inadequate ventilation (S.4) 1 _ 1 - - Ineffective drainage of floors (S. 6) _ _ _ _ _ Sanitary Conveniences (S. 7) (a) Insufficient 7 8 - - - (b) Unsuitable or defective 98 101 _ 9 _ (c) Not separate for sexes 5 5 - 3 - Other offences against the Act (not including offences relating to Outwork) 22 _ 22 _ _ TOTAL 135 114 25 12 - 47. 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 or 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 formany years though occasionally by arrangement with the firms concerned, a few articles which might have been in contact with infectious diseases have been disinfected or destroyed. OUTWORK Nature of Work Section 110 Scction 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. 1147 - - - - - Household linen 12 - - - - - Umbrellas etc. 9 - - - - - Artificial flowers 18 - - - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 39 - - - - - Brush making 14 - - - - - Feather sorting 16 - - - - - Carding etc. of buttons etc. 54 - - - - - Cosaques. Christmas Crackers, Christmas Stockings etc. 5 - - - - - Lampshades 2 - - - - - Total 1316 - - - - - 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 1963 was 107 The number of Pinsbury outworkers employed by them was 166 The number of non-Finsbury outworkers employed by them was 2,790 48. The number of Finsbury outworkers employed by firms outside the Borough was 82 The total number of Finsbury outworkers employed by firms in or outside the Borough was 248 (of these 75 were firms and 173 homeworkers) The registers of outworkers which firms are required to maintain are inspected as part of the routine during the inspections of the factories concerned. Number of visits paid to homes 174 Clean Air: There has undoubtedly been a decrease in the degree of Atmospheric Pollution in London over the past 20 or 30 years, but it remains a contributory cause of much ill health, structural damage and drabness in our surroundings. The condition of the air in Finsbury and its further pollution from sources within the Borough is probably little different from that in other parts of the Metropolis. Air pollution from Industrial establishments iscertainly 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 Finsbury 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 measurements 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 49. chimneys in Industrial establishments was 523 and 30 complaints of smoke investigated. Verbal warnings have been given where appropriate and advice has been offered to management and their staffs. On 9 occasions in 1963 written notices were issued when contraventions of the Act or Regulations had been observed. Furnaces: Eighty-seven formal notifications (including 8 in 1963) 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 Two further Smoke control Orders came into operation during 1963, viz, the Pinsbury (No.3) Smoke Control Order on 1st July, and the Pinsbury (No.4) Smoke Control Order on 1st October 1963. At the end of the year, a total area of 263 acres was subject to Orders, although the conversion of many grates in the No.4 Area had not been completed. To cover this situation, 98 notices had been served in accordance with Section 12(2) of the Clean Air Act. Owing to staff difficulties, it became apparent by the end of the year, that it would not be possible to complete the survey of the proposed Area No.5. in time to adhere to the scheduled programme, particularly as on the 17th December Circular No. 69/63 was issued by the Minister of Housing &Local Government which entailed are-examination of the whole situation. It appears, therefore,that it will not be practical for the whole Borough to be covered by Smoke Control Orders by 1967, as was envisaged. The total number of visits paid in connection with smoke control areas during 1963 was as follows:- By the Public Health Inspector 1,509 By the Smoke Control Officer 2,113 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 4.4.62. 1.7.63. 4 103 2,466 2,006 29.11.62. 1.10.63. 5 100 3,070 2, 499 6 64 1,162 932 7 100 1,620 1,215 8 60 1,568 1,179 Total 587 12,293 9,002 50. Verminous Articles & Premises: The Council's Disinfestation service continues to provide for the destruction of all insects and pests, but in particular bed bugs,cockroaches, fleas etc. Usually it is sufficient to spray with a 5% solution of D, D.T. or other insecticide with a follow-up treatment about 14 days later if required. Badly infested bedding is removed for treatment in the steam disinfector at the Health Centre. The re-housing programme in operation locally, and the continuous low temperatures during 1963, reduced by approximately 30% the number of bed bug infestations dealt with as compared with 1962. As a precautionary measure spraying is carried out to the furniture and effects shortly before removal but in certain cases a fumigation is done during the time the goods are being transported to the new address. 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 that health is affected. During 1963, 35 such representations were made and spraying was carried out before any article was removed. During 1963 a wide range of pests was dealt with and 330 premises were treated, including the following: Bed Bug 76 Cockroaches 10 Beetles (varied) 19 Flies 11 Ants 21 The routine spraying was also carried out at 169 Council properties which had for some reason become vacant. Scabies and 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. Arrangements were also continued for the treatment of cases on behalf of the Shoreditch Borough Council. The evidence 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, were 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. 51. In 1963 the total number of treatments given was: Scabies Head Lice Body Lice For Finsbury Cases 56 11 40 For Shoreditch Cases 28 11 11 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: The work of rodent control within the Borough continues to give pleasing results and shows a considerable reduction in the rat population. During the year under review Rattus Norvegicus (Common Rat) and mice have been the cause of the trouble, and there is not one recorded instance of the presence of Rattus Rattus (Ship Rat). Most infestations have been small but two reasonably large pockets of rats were found,and with the use of anti-coagulants these have been successfully cleared up. Rats in the sewers of Finsbury have required continuous attention and treatments have been carried out quarterly by placing baits containing sodium fluoroacetate in all available manholes and access points. The staff for this work comprises a Rodent Officer, an Assistant Rodent Officer, foreman and six operators. All are fully employed, especially in view of the number of contracts held in connection with such work at business premises. Both residents and occupiers of business premises within this Borough have been most co-operative in the matter of rodent control and it is gratifying to note that it has not been necessary to issue one statutory notice or take legal action of any kind against anyone under the Prevention of Damage by Pests Act 1949. Number of complaints received Business premises. 61 Domestic Premises. 90 Additional Infestations found Business Premises 1159 Domestic Premises 199 Number of premises treated Business Premises 1220 Domestic Premises 289 Number of visits made Business Premises 13382 Domestic premises 6063 Charges made to Business premises £4. 488. 17s. 0d. 52. 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. 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. Nineteen visits were paid during the year by the Public Health Inspectors, and the appropriate tests carried out where necessary. Nuisance from Pigeons: In order to control the number of pigeons in the Borough,licenses have been granted for catching them in the streets and open spaces, as they are liable to become a public nuisance and to do much damage, Enquiries are made as to the means employed by those authorised, 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 1963, 2 licences were in force. In December the Health Committee gave consideration to the destruction of pigeons in a block of dwellings but practical difficulties prevented the employment of a contractor to reduce their numbers. 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. 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 47 registered premises in the Borough. A special survey of hairdressers' premises was carried out during the year and action taken where necexsary to enforce the requirements of the Bye-Laws. In all 49 visits were made to hair dressers and barbers during 1963. 53. Disinfection: Disinfection is carried out at premises where an infectious disease has occurred, upon request, or when such action is deemed desirable as a precautionary measure. In some cases infected rooms and the contents are sprayed with a formalin solution and if necessary bedding etc. is conveyed to the Health Centre for treatment in the steam disinfector. Where the more serious types of infection have been present, arrangements are made to seal the infected rooms, and fumigate with a mixture of formaldehyde and potassium permanganate. During 1963 it was not neceesary to resort to this kind of treatment, although spraying was carried out on 142 occasions under the following headings: Suspected Dysentery and Gastro Enteritis 34 Suspected Measles 16 Suspected Scarlet Fever 24 Suspected Whooping Cough 8 Suspected Tuberculosis 5 On behalf of St. Marks Hospital) Moorfields Eye Hospital) Mount Pleasant G.P.0. and) Miscellaneous spraying I.D) 55 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, 527 articles were treated. Goods,mostly clothing, were also disinfected on behalf of certain export firms as follows:- Number of articles 5,223 Number of times disinfecting plant charged 27 Reception House: The portion of the Health Centre which had, in the past, been maintained by the Council as a Reception House (for persons who could not remain in their own rooms whilst these were being cleansed after infectious disease, or who had no alternative accommodation in which to reside during housing repairs) continued to be used, by agreement with the North East Metropolitan Regional Hospital Board, for the purpose of accommodating the administrative side of the Mass Radiography Unit. The Islington Borough Council has kindly agreed to provide accommodation for Finsbury residents at their Reception House as and when the occasion should arise. No use has been made of this accommodation during 1963. 54. Noise: Towards the end of 1960 the Noise Abatement Act 1960 which somewhat strengthens the powers to secure abagement of noises which are a nuisance came into force. During 1963 there were 33 complaints of noise received by the Department - a considerable increase over previous years, probably due to press publicity regarding the Noise abatement Act. A summary of the complaints indicates the type of premises involved, viz: Building Sites 7 Factories 14 Shops 2 Domestic 5 Demolition Works 1 Dogs 2 Street Noises 1 Public House 1 Several complainants were disturbed by night work at adjoining premises In most cases, following correspondence with the firms in question, in each instance some amelioration of the conditions was brought about The complaints regarding private dwellings were mainly in respect of private disagreements between tenants relating to radios etc. and record players. 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. 55 SECTION D. HOUSING General: According to the data provided by the Registrar General, the total number of structurally separate dwellings occupied at the time of the census in April 1961 was 9,262. Taking into account the numbers of premises demolished and those newly erected or converted since that date, it is estimated that the total number of dwellings in the Borough at the end of 1963 was 9,602 disregarding empty properties. The dwellings in the Borough consist of approximately 7,210 flats and 2,390 houses. The proportion of flats has increased considerably in recent years following the demolition of many unfit houses and the erection of flats on the sites. As a matter of interest, the age of the dwellings has been estimated as follows:- Percentage built before 1850 7 Percentage built between 1850 & 1875 20 Percentage built between 1875 & 1900 26 Percentage built between 1900 & 1919 4 Percentage built between 1919 & 1945 9 Percentage built since 1945 34 Ownership of the flats is roughly as follows:- Finsbury Borough Council 2,300 London County Council 620 City Corporation 540 Metropolitan Police 130 Housing Associations 1,830 Private Ownership 1,790 NEW BUILDING The following new dwellings were completed during 1963:- By Finsbury Borough Council Charles Simmons House, Margery Street 16 flats Barnabas House) King Square Estate 36 flats Macclesfield House) 65 flats Rahere House) 95 flats By London county Council Anchor House, Wenlake Estate 20 flats Total No. of flats 232 flats 56 During 1963, 7 certificates of Habitation under Section 95 of the Public Health (London) Act 1936 were issued. Conversions and Improvements: Since the inception of the improvement and standard grants schemes, only two major property owning companies have taken the opportunity of improving their dwellings with the aid of Council grants. Practically all the grants in the two categories have been made to these two owners. Comparatively little of theolder property inthe Borough has therefore been reconstructed or had the five standard amenities provided. It is known that improvement grants have been made by the London County Council to a certain Housing Trust. Following the Circular from the Minister of Housing and Local Government in the latter part of 1962, the Council considered how best to encourage the improvement of houses. As a result, a suitable letter was sent in March 1963 to the 28 largest property owners in the Borough offering assistance by way of grant for the purpose of improving dwellings A copy of the Ministry's pamphlet was enclosed which describes the two types of grant - discretionary and standard. An offer was made to supply further information or discuss the implications of the Scheme in relation to any particular property, In May, letters were sent to some 17 other owners, including a few owner/occupiers, of individual houses in the Borough, which it was believed were suitable for improvement. The response to these efforts was most disappointing and I am at a loss to suggest any further steps that could profitably be undertaken to encourage owners to avail themselves of the Grants Scheme. The main difficulties preventing greater use of the grants scheme appear to be over-occupation of premises, lack of room for additional amenities, refusal of tenants to accept improvements, the inability of landlords to decant tenants in order to carry out improvements, the lack of capital particularly of owners of individual houses, and insufficient financial inducement generally, For the record, during 1963, the Council approved one application for a standard grant and one for a discretionary grant in respect of private houses. In addition, it approved both standard and discretionary grants to enable the owners to modernise a block of 35 flats. The Conversion of the undermentioned properties was completed during the year:- Peabody Estate Blocks, N.S.T. & V. 93 flats 28/29 Myddelton square. 5 flats 10/14 Hermit Street. 9 flats 57 Repair of Houses under the Housing Acts: No representations were made during 1963. Unfit Houses and Parts of Houses: There are still many unfit houses and parts of houses in the Borough that cannot be repaired at reasonable cost, 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 summarises the action taken during 1963 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 2 2 - No. still under consideration 2 15 1 Total No. of undertakings accepted - - - Demolition Orders made 1 - - Such properties since demolished - - - Closing Orders made 5 1 - Such properties later demolished 1 2 - Orders later determined - 6 - Total No. of representations lapsed or no action taken _ 1 - Total No. of properties still subject to (a) Demolition Orders 1 - - (b) Closing Orders 48 124 5 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 4 No. of houses wherein defects were remedied by informal action - No. of representations made with a view to:- (a) serving notices requiring the execution of work - (b) making demolition or closing orders 4 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 7* No. of houses in respect of which undertakings were accepted - No. of houses demolished (* including premises represented prior to 1.1.63). 58 Clearance Areas: Surveys were carried out by the Housing Inspector of White Lion Street (No.1) and Pentonville Road areas, which were included in the agreed Slum clearance programme. Reports and representations were submitted to the Council and appropriate Orders agreed to. In addition,a survey was carried out by thePublic Health Inspectors of the former Clarke's Close Estate, owned by the Council, and subsequently renamed the Finsbury Estate. The majority of these dwellings were included in the 1961-65 slum clearance programme. As a result of the survey, a certificate of unfitness was issued in respect of 132 dwellings in the area. Rehousing of the tenants was commenced towards the latter part of the year, prior to the demolition of the properties and the redevelopment of the site mainly for residential purposes. A summary of the position relating to individual areas is given below: Area No. of Houses Year of Order Remarks Herbal Hill 2 1957 Premises vacant, not yet demolished. Field Place 7 1957 Demolition completed. King Square ( (No. 2 Area) 292 1958 Rehousing nearly completed and most houses demolished. (No. 3 Area) 25 1958 Rehousing in progress. Northampton Road 9 1961 C.P.O. confirmed without modification June 1963. Bowling Green Lane 2 1961 C.O. confirmed without modification. June 1963. Benjamin street 4 Order not made Negotiations proceeding for acquisition Margery street 14 1963 C.P.O. made. Public inquiry held December 1963. St. Helena street 9 1963 C.O. submitted for confirmation. November 1963. White Lion St. (No.1) 4 1963 C.O. made November 1963. Pentonville Road 3 - Represented April 1963 Finsbury Estate 132 ~ Council property. Certificate of unfitness issued October 1963. Rehousing: Applications for rehousing by the Borough Council are made to the Housing Manager and these have been assessed for some years according to apoints scheme. When accompanied by medical certificates to support the application on medical grounds, these have been referred to the Medical Officer of Health. Enquiries are then made by the Nurse/Visitor into the detailed nature of the family health, and the apparent bearing on this of the accommodation in use, and when desirable an inspection is carried out by the Public Health Inspector. 59 These reports are then correlated with the medical certificates, and a degree of medical priority is then allotted. During 1963 applications have been dealt with as follows:- New cases. 94 Cases reconsidered on new medical certificates 91 Cases reconsidered 3 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. The number of families rehoused during 1963 was Rehoused by Finsbury Borough Council (original lettings) 41 Rehoused by Finsbury Borough Council from clearance areas etc. 246 Rehoused by London County Council (including clearance areas) 197 Rehoused in New Towns 19 Rehoused by City Corporation 3 In addition many transfers within the Council property took place, in order to make the best use of existing accommodation and prevent under occupation. 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 191 families have been recorded, in 56 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 of 1 unit, usually caused by natural increase over a period of years. Twenty,eight new cases were noted during 1963. It is the policy to send strongly worded letters, threatening prosecution to owners and tenants of dwellings where recent wilful overcrowding has come to light. No prosecutions were undertaken during the year. 60 Houses in Multiple Occupation: On two occasions during 1963 reports were submitted to the Council of pilot surveys of houses in multi-occupation carried out by the Public Health Inspectors. The houses surveyed were samples of different types of property which came within the category which could be dealt with under Part II of the Act. In assessing the amenities lacking, regard was paid in the reports to the standards suggested by the Metropolitan Boroughs' Standing Joint Committee in conjunction with the number of families occupying particular premises. The Council gave very serious consideration to the many complex problems arising from the multi-occupation of houses but owing to the difficulties involved, including the possible displacement of tenants and the probability of new legislation affecting the situation, no formal action was decided upon. The Department, however, has continued to press for additional amenities to be provided where reasonably possible, on an informal basis. 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. Towards the end of 1963 asurvey of all the blocks of flats in the Borough was commenced by the Public Health Inspectors regarding the artificial lighting of the staircases and landings. Some 114 visits of inspections were made. It was found that the standard of lighting was reasonably good and in only a few instances was it necessary to request owners to carry out modifications or effect repairs to the existing installations. Certificates of Disrepair: Inspection of properties are made in connection with all applications to the Council for acertificate of disrepair and for their cancellation. Advice is given when requested i n regard to the completion of the appropriate form. The following is a summary of the action taken in recent years, and the present position. Housing Repairs & Rents Acts 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 61 Certificates issued as to remedying of defects (a) Issued to tenants 8 (b) Issued to landlords (Cancellations) 6 (c) Still in force 4 In 1963 there were no applications for a certificate. Legal Proceedings: No Legal proceedings in respect of contraventions of the Housing Acts were instituted during the year. 62 SECTION E FOOD General: Food Premises: There has been no great change in the number of Food Premises established in the Borough. The numbers of the various classes of food premises is as follows:- Restaurants, cafes, snack bars 135 Public Houses 106 Off-Licence premises 11 Licensed clubs 22 Breweries, Distilleries etc. 11 Factory Canteens 75 Commercial Canteens 28 Dairies & milk distributors 135 Ice cream manufacturers 3 Ice Cream sellers 157 Confectioners (sweets) shops 74 Bakers shops 21 Bakehouses (i) Basement 6 (ii) Above ground 9 Grocers & provision shops (retail) 58 Provision merchants (wholesale) 11 Greengrocers & fruiterers 22 Cheese importers 3 Fish shops 2 Fish curers 2 Fried fish shops 8 Eel & pie shops 5 Poultry dealers (wholesale) 6 Butchers shops (retail) 38 Wholesale butchers & offal dealers 46 Wholesale horseflesh dealers 1 Bacon factories 7 Sausage factories 2 Sausage casing merchants 3 Meat Extract factory 1 Public cold stores 6 Soft drinks manufacturer 1 Chemists shops (retail) 16 Manufacturing wholesale chemists 9 63 In addition to the above food premises, there are approximately 180 street market stalls dealing in various foodstuffs. Note: In the above list some premises are enumerated in more than one category. The above type of business establishments have been inspected periodically both formally and informally. The total number of visits paid during 1963 was 4,684 to premises, and 2,507 to stalls. Inspection of street traders storage premises involved 136 visits during the year. FOOD HYGIENE. It is believed that the constant supervision and personal contact with employees in the food businesses in the Borough has done much to ensure compliance with the Food Hygiene (General) Regulations 1960,but experience has shown that owing to the various nationalities engaged in catering particularly, and due to the nomadic nature of some of the types of workers, this constant supervision must be maintained. Generally speaking the employers and employees welcome these visits and having been told why certain requirements are necessary, do their best to carry out instructions. The structural conditions of the food business is in general satisfactory and periodic redecoration and maintenance, is in the majority of cases carried out when necessary. The 'No Smoking' requirements of the Regulations is one which, through persistent supervision,has now been accepted generally by food traders although some improvement in the position may be attributed to the National anti-smoking campaign, it is felt that this betterment is in the main due to the work of the Department. The old fashioned tendency to carry out food preparation behind almost locked doors is one that is fast disappearing, and in many cases food preparation and food handling is carried out within the view of the customer. BACTERIOLOGY OF FOOD. During the year 143 samples of food were submitted to the Health Centre's Laboratory:- Cooked Meats 15 Cream (Synthetic) 3 Ice Cream 41 Milk 25 Sausages 34 Sausage Meat 16 Meat for Sausages 9 143 The milk and synthetic creams were found to be satisfactory. The ice-cream samples were mainly from the manufacturers within the Borough and although satisfactory shewed the need for constant supervision, especially with the increased sales of the soft variety. 64 The Cooked Meats were, as reported upon last year, frequently found to have heavy counts and emphasises the importance of reducing handling to a minimum and for a strict supervision and frequent check of the premises. The sausage samples represented 17 brands and consisted of 24 pork, 5 beef and 5 mixed meats. Twenty-seven of the samples were from local cafes and seven from a local manufacturer. Twenty-three samples were raw, two samples were cooked and nine samples were divided into two, half the sample being raw and the remainder cooked. Twenty-six samples were without protective covering and eight were in their original pack. The cooked samples had either been boiled for 5 minutes or grilled for approximately & - 34 of an hour. RESULTS Total Count The number of viable organisms in the raw samples varied from 70,00060,000,000/gm. 7 pre-packed samples had a count between 70,000 - 1,200,000/gm. 1 pre-packed sample had a count of 9,800,000/gm. 11 unpacked samples had a count between 400,000 - 10,000,000/gm. 13 unpacked samples had a count of 10,000,000 - 60,000,000/gm. THE TOTAL COUNT IN COOKED SAMPLES VARIED FROM 1,000 - 100,000/gm- One sample contained 5,200,000 viable organisms per gm. This high total count was found to be due to heat resistant aerobic spore bearers. COLIFORMS Coliforms were found in all the raw samples. Faecal Coli were found in 28 samples of which six were pre-packed. No Faecal Coli were found in 2 samples. Both were pre-packed. NO COLIFORM OR FAECAL COLI WERE FOUND IN THE COOKED SAMPLES. NO SAMPLE, RAW OR COOKED, CONTAINED SALMONELLA, STAPHYLOCOCCI OR CL. WELCHII. RAW MEAT INGREDIENT Nine samples of raw meat used in the manufacture were collected from three local sausage manufacturers. Also one sample of high quality beef from a local butcher. These shewed the following results:- Total Viable Count 2 samples of beef had a count of 250,000 and 700,000 per gm. 2 samples of pork had a count of 1,000,000 & 7,200,000 per gm. 1 samples of pork belly had a count of 22,000,000 per gm. 1 sample of mutton had a count of 1,200,000 per gm. 2 samples of mixed meat cuttings had a count of 1,200,000 & 2,000,000 per gm. 1 sample of lamb had a count of more than 80,000,000 per gm. 65 THE HIGH QUALITY STEAK HAD A TOTAL VIABLE COUNT OF 400,000 PER CM. COLIFORMS Conforms were found in all samples, including the high quality steak. NO SALMONELLA, STAPHYLOCOCCI OR CL. WELCHII WERE POUND IN ANY OP THE TEN SAMPLES. The conclusion was that the bacterialogical condition of sausages depends largely upon the bacteriological condition of the raw meat and that cooking appears to reduce considerably the number of organisms and to eliminate coliforms and faecal coli. In addition to sampling, 272 swabs were taken from 131 articles in contact with food preparation involving:- Beverage Dispensing Machine 1 Cafes 20 Grocers 1 Ham Factories 2 Sausage Manufacturers 1 Sausage Casing Factory 1 RESULTS OF SWABBING Article No. Faecal Coli Vielchii Coagulase Positive Staphylococci Salmonellae Equipment 65 6 2 1 - Refrigerators 82 5 4 - - Table Tops 68 4 4 3 - Draining Boards 23 - - - - Sinks 14 - - - - TOTALS 272 15 10 4 - The general conclusion is that apart from the firms with a well deserved National reputation for cleanliness, many food premises have a low standard of hygiene. This is often due to ignorance, but frequent advice is tending to bring about an overall improvement. Quality of Food and its description: Informal sampling has been carried out during the year in respect of a great variety of foodstuffs. The general quality of the foodstuffs samples was reported as satisfactory; a few adverse reports were received chiefly in connection with the description of the article. During the year 620 samples were submitted to the Public Analyst as under:- 66 Milk 24 Cream, Condensed Milk etc. 11 Butter, Margarine, Pats 22 Cheese 16 Ice Cream 12 Sausages 22 Meat & Pish Products 147 Soups 9 Sauces, Vinegars, etc. 21 Condiments, spices, flavourings 21 Gelatine, Jellies etc. 15 James, Preserves 26 Dried fruit 29 Cake & pudding mixtures 16 Flour 4 Cereals 12 Coffee, cocoa, tea extracts 18 Non Alcoholic drinks 7 Alcoholic drinks 11 Canned fruit & vegetables 48 Fresh fruit & vegetables 42 Bread & Cakes 31 Sugar Confectionery 21 Restaurant Meals & Snacks 7 Deep freeze foods 1 Medicines 7 Powders 3 Tablets 4 Ointments & Lotions 13 Reports in respect of unsatisfactory samples were received in respect of nine samples as follows:- 1. Excess moisture in Margarine (1) 2. Cream slices (2) 3. Cream doughnuts (2) 4. Borax & Honey (2) 5. Tincture of Iodine (2) Action taken in respect of these samples as follows:- 1. A communication was addressed, to the suppliers and in view of the fact that the article was manufactured outside the United Kingdom, a letter was also sent to the Ministry of Health for their information 2 & The adverse reports in respect of these informal samples were due 3 to the fact that they did not contain dairy creem. Further investigation showed that an appropriate notice was exhibited at the place of purchase 67 4 & Informal samples of these medicinal products were purchased and 5 reported as unsatisfactory owing to an excess of borax in the borax and honey, and an excess of iodine in the tincture of iodine Subsequently formal samples were taken, these were also found to be in excess of the same constituent parts. Owing to a misinterpretation of the legal formalities at the time of purchase required in respect of prepacked goods, it was not possible to take proceedings However, letters were sent to the manufacturers pointing out the contravention and an assurance was received from them promising more diligence in future. COMPLAINTS BY THE PUBLIC During the year 14 complaints were received from the public concerning unsatisfactory conditions in connection with foodstuffs. This shows a decrease over last year of 13 complaints, and it is hoped that this is an indication of more care being taken by the manufacturer. Often these complaints cause considerable thought and investigation, and in some cases the cause is obscure and in a few instances unable to trace Every encouragement is given to the public to report cases where they consider their complaint is justified, and although in many instances the complainant does not wish to be involved in legal proceedings, everyone is thanked for their co-operation in reporting these matters A detailed summary is given showing the type and variety of complaints received Foreign bodies in Foods (3) Piece of plastic in wrapped fruit cake String in a biscuit Dirt in a milk bottle In these cases the usual procedure is to make exhaustive enquiries from both the seller and the manufacturer, and requesting them to submit their observations for the consideration of the Council. In none of the above cases was it decided after investigation that legal proceedings should be instituted but letters were sent to all concerned in the manufacture and distribution of the articles expressing the grave concern with which the Council viewed these complaints Diseased meat (half leg of Pork) This complaint was in respect of a deep seated abscess in the musculature of the leg The expert opinion was that it could not have been detected until the incision was made. In this case the complainant was reimbursed and no further action deemed necessary 68 Mouldy article of food (1). (Sliced Brown Loaf) The evidence available in this case was not definite enough to warrant the Council considering legal proceedings, there being some doubt regarding the possible date of purchase and delivery to the shop. Unsatisfactory condition of Foodstuffs (9) * Canned Salmon * Canned Pork Luncheon Meat * Canned Chopped Ham Loaf * Canned Corned Mutton Bacon (stale) Bacon Sandwich (sour) Vermicelli (discoloured) * Canned Milk (Bitter Taste) Meat Pie The articles marked with an asterisk (*) were packed in countries outside the United Kingdom, and this necessitated forwarding details to the Embassies concerned. Investigation has shown that some of these goods may have been 'bankrupt stock' but in the absence of a readily recognisable date code, it is not possible to verify quickly the age of the goods. In none of these cases was legal action taken. The remaining complaints were investigated and after due consideration were not considered suitable for legal action. In connection with the complaint regarding stale Bacon, it was observed during enquiries at the premises where the sale was made,that a serious contravention of the Pood Hygiene (General) Regulations had taken place on the premises. Legal proceedings were instituted in respect of this contravention, and the result is reported elsewhere in this report. Particular Foods and types of food premises in the Borough STALLS No marked improvement in conditions so far as the pood Hygiene (General) Regulations 1960 has been effected during the past year. This is not due to any lack of supervision on the part of this Department but experience has shown that the three street markets in the Borough have been established for many years, and in several cases have been in the hands of the same family for many years, with the result that habits have now become custom, and it is a state of affairs very difficult to break. However by sheer persistance and regular inspections it could be fairly reported that some slight improvement is being attained; an example of this is in respect of smoking, which has shown a definite decrease on the part of persons engaged in the handling of foodstuffs in the market. The effective disposal of waste material during the hours of operation of the market, is one that is still giving concern. 69 MILK The milk supply in the Borough is principally in the hands of three large distributors; the previous satisfactory condition has been maintained, andno special action has been required by the Department during the year. No. of Dairies on register at end of year 9 No. of Distribution Premises at end of year 126 No. of Designated milk licences issued during the year: Tuberculin Tested 4 Pasteurised 3 Sterilized 3 No. of samples submitted to Public Analyst Satisfactory Unsatisfactory 24 Nil No. of samples submitted for Bacteriological examination 25 Nil All milk C.I. Milk Average fat content 3.70 4.27 Average non-fatty solids content 8.62 8.93 ICE CREAM Number of Premises registered for manufacture 3 do. storage and sale 155 do. 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, poultry, game and rabbit shops. Most of these wholesale butchers trade in meat of a low quality principally carcases of old cows, bulls, sheep, sow and boars, which are 'boned out' for use in the manufacturing trade. It is due to the high percentage of disease and other conditions of these carcases,that a rigid inspection is maintained to make sure that meat unfit for human consumption is not passed on to the Public. Larger quantities of meat and offals are consigned to the Borough and more wholesale butcher premises have opened during the year. Consignments of Scandinavian and European offals and tinned hams are continually being consigned, and condemnation of some of these have taken place on several occasions. The collection of unsound meat and other foodstuffs continue to be satisfactorily collected by the Council,s contractor Messrs. Henson & Burbidge Ltd., Matusa Works, Beckton, who render it down for technical purposes. 70 During the year 276 certificates were issued forthe export of meat, bacon and other meat products. The 100% examination of imported Beef Livers continues, and 827 cartons of Beef Livers were inspected, and 653 beef livers were found to be effected with Echinococcus parasites, i.e. Hydatid disease. This shows that approximately 12%of these imported livers were diseased. There are no licenced slaughterhouses in the Borough and no slaughtering has taken place since the war. The retail butchers ships and stalls have been regularly inspected, with regard to the condition of the meat, which appears to be fairly satisfactory. REGISTERED FOOD PREMISES: Section 16 of the Food & Drugs Act 1955, requires the undermentioned types of businesses namely those used for the manufacture of Sausages, potted, pressed,pickled or preserved food, shall be registered by the Council. The number of premises at present registered is 76 comprising the following:- Sausage manufacture 33 Sausage smoking 1 Meat Pickling 40 Offal Cooking 5 Cooked meats or pie making 4 Bacon curing and smoking 3 Ham boiling 12 Fish curing 3 Shell fish cooking 2 Jellied eels 2 Meat extraction 1 and a number of businesses are registered for more than one type of manufacture. Regular inspections have been made to these businesses and during 1963, 263 such visits were made. Bakehouses There are 7 underground and 9 above ground bakehouses in the Borough. The general standard is satisfactory and during the year 233 visits were made. This year has been one in which the quinquinnial inspection of basement bakehouses was required under Section 70. Factories Act 1961. The Council must carry out an examination in respect of basement bakehouses with regard to their suitability in connection with construction, height, light ventilation and any hygienic respect. Generally the examination showed that in the majority of cases the premises had been 71 maintained in a satisfactory condition, and that subject to the carrying out of minor repairs, registration was effected for another five years in all cases except one; in this case the examination was not carried out due to the fact that the operators had decided to discontinue the use of the basement for baking purposes. Licensed Premises There are 117 premises licensed under the 1953 Act for the sale of intoxicating liquor in the Borough, 106 of these are operated as Public Houses, and the remainder are off licencss The majority of the Public Houses also carry on a catering business. During the year 191 inspections were carried out, and on the occasion of transfers of licences being notified advantage was taken of this to have defects remedied and improvements carried out. There are 4 licensed restaurants in the Borough and advantage is again taken at the time of the application to improve the sanitary accommodation at these premises. Since the introduction of the Licensing Act 1961, club premises wishing to sell intoxicating liquor are required to be registered by the Justices. There are 22 such clubs in the Borough, the majority being run in conjunction with staff canteens. Regular supervision is maintained in respect of these establishments Unsound Food No formal seizure of food other than meat was deemed necessary during the year. The trade in general have maintained their close cooperation with the department and the good relationship built up over the years has resulted in the work of the department in this connection being eased. During the year 116 visits were made, apart from those connected with meat inspection and 679 certificates were issued in connection with the voluntary surrender of unsound food other than meat. The total quantities of unsound food surrendered during 1963 were:- Meat (diseased) 45,043 lbs. Meat (unsound) 94,148 lbs. Meat products 2,602 lbs. Bacon 15,271 lbs. Offals(diseased & unsound) 44,078 Poultry 8,627 Pish 604 lbs. Game 822 Rabbits 1,358 Canned Foods 11, 194 lbs. Cereals 7,734 lbs. Cheese 8,763 lbs. Fruit & Vegetables 3,672 Miscellaneous 3.589 lbs. Total 110 tons. 13 cwts 1 qr 21 lbs. 72 Food Poisoning: There were 30 individual cases notified during the year of which 6 were due to Salmonella Typhi-Murium 1 was due to Salmonella Newport 1 was due to Salmonella Senfentenberg In 22 cases it was not possible to identify the responsible agent LEGAL PROCEEDINGS! During 1963 only one prosecution in respect of foodstuffs was instituted under the Pood & Drugs Act. The result was as follows:- Date Premises Offence Result 15.4.63. 53 Exmouth Market Mice Excreta in Bacon Store Fined £2 Costs £1 POISONS: The Pharmacy and Poisons Act 1933 requires the Council to keep a register of persons selling those Poisons enumerated in Part II of the Act During 1963 there were 30 applications for inclusion in the register and all the premises concerned were visited regarding compliance with the Regulations as to labelling etc. 73 SECTION F INFECTIOUS DISEASES General: The general incidence of Infections throughout the year was low apart from a considerable outbreak of a mild form of Dysentery which, however, did not give rise to any serious concern. For the third year in succession there were no cases of poliomyelitis. There were no cases of Smallpox either at the time of outbreak in other centres or at any other time during the year. 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 1963, 2,360 visits were paid by the Nurse Visitor. The following table shows the incidence of notifiable diseases in 1963:- All Ages Under 1 yr 1-4 yrs 5- 14 yrs 15-24 yrs 25-44 yrs 45-64 yrs 65- Cases Treated in Hospital Measles 398 20 231 140 4 3 25 Dysentery 318 3 91 145 10 59 8 2 25 Pood Poisoning 30 6 6 4 6 5 3 5 Scarlet Fever 43 11 26 3 3 14 Whooping Cough 37 5 19 13 10 Gastro Enteritis 26 16 10 11 AcPneum onia 47 1 4 4 2 4 13 19 34 Erysipelas 6 5 1 2 Ophthalmia Ne onatorum 4 4 2 74  All Ages Under 1 yr 1-4 yrs 5-14 yrs 15-24 yrs 25-44 yrs 45-64 yrs 65- Cases Treated in Hospital Men ingococcal Infections 1 1 1 Scabies 24 2 1 3 5 8 2 3 Encephalitis 1 1 1 T.B.(Pulmonary) 19 1 1 9 6 2 T. B.(Other Forms) 4 1 1 2 958 53 374 338 29 93 41 30 130 Diphtheria: No actual cases of Diphtheria occurred in the borough in 1963. However, during the last quarter of the year 8 schoolchildren became contacts of a confirmed case. Nose and throat swabs were taken from these 8 children and from their family contacts. All the swabs were negative and none of the contacts (direct or indirect) developed the disease. Dysentery: There were 318 notified cases. 236 were clinical cases with positive stools; 52 were clinical cases with negative stools, and 30 were symptomless excretors who were contacts of clinical cases. Out of the total of 318 notified cases,only 23 had to be admitted to hospital. There were no deaths. Encephalitis: No cases were reported in 1963. (The case recorded in the above table occurred in the last days of 1962, but was not notified until January 1963). Enteric Fever (Typhoid): In March, a resident of the Borough was taken seriously ill with typhoid whilst on holiday abroad. He has been kept under supervision since his return to Finsbury, and all bacteriological specimens taken so far have been negative for typhoid bacilli. In May, 5 borough residents became contacts of a confirmed case of typhoid (a merchant seaman who developed the disease in Ceylon). All 5 contacts were kept under supervision - they all remained well and all bacteriological tests were negative. Enteric Fever (PARA typhoid) There were no cases or contacts. Erysipelas: Of the 7 cases notified, one was withdrawn leaving a final total of 6. All were mild cases and made satisfactory progress. 75 Chicken Pox: Of the 25 cases which occurred in the Borough,none was severe and there were no complications. Gastro-Enteritis: (over 2 years) There were 15 cases, 3 of which were admitted to hospital. None were severe and there were no deaths. Gastro-Enteritis: (Under 2 years) Out of the 28 cases notified, 2 were withdrawn leaving a final total of 26. Of these, 15 were removed to hospital and two were still in-patients at the end of the year. There were no deaths from this cause in 1963 although one child who developed gastro-enteritis in 1963 died from its effects in 1964. Glandular Fever: There were 5 cases - 3 adults and two children. No contact could be traced between the cases. All made good progress. Infective Hepatitis: There were three cases. All made satisfactory progress. Malaria: No contacts or cases were reported. Measles: Of the 398 notified cases, 22 were removed to hospital. 265 were moderately severe cases and 133 were mild. 6 cases were complicated by broncho-pneumonia, 12 by bronchitis and 1 by otitis media. There were no deaths. Meningococcal Infection: Only one case occurred. This was in a male child aged 8 months. The attack was a severe one and the child had to be admitted to hospital He was still an in-patient at the end of the year. Aseptic Meningitis: There was one case - in a girl aged 7 years. She was admitted to hospital where she made good progress. The contacts were kept under surveillance and they all remained well. Pneumococcal Meningitis: In May, a female aged 26 was taken to hospital as a suspect case. The diagnosis was subsequently confirmed The patient made a full recovery. 76 In December an elderly lady of 74 developed a sever pneumococcal Meningitis and was removed to hospital where she died Mumps: 29 cases occurred. None were severe and there were no complications. Opthalmia Neonatorum: 4 cases occurred; two of these were residents of the Borough, and 2 were hospital cases. All recovered and there was no blindness. Pneumonia (Acute Primary & Influenzal): 48 cases were notified, one of which was withdrawn leaving a final total of 47. Of these 46 were primary pneumonias and 1 was influenzal. All 47 made satisfactory progress and there were no deaths. Poliomyelitis: There were no cases or contacts. Puerperal Pyrexia: 9 Residents of the borough developed Puerperal Pyrexia while in hospital There were no deaths Rubella: There were 8 cases and as far as could be ascertained, no case came in contact with any woman in early pregnancy. None were severe and there were no complications. Scabies: 24 cases were notified during the year. Scarlet Fever 44 cases were notified, 1 of which was withdrawn leaving a final total of 43, and 13 of these were removed to hospital 42 cases were mild One was moderately severe and complicated by bilaterial cervical adenitis There were no deaths. Smallpox: Although there were no cases of smallpox in Finsbury during 1963, two persons from a smallpox area entered the Borough in the month of August Both had refused vaccination at the Airport but were successfully vaccinated on arrival in Finsbury. Whooping Cough: There were 37 cases, 10 of which were admitted to Hospital 22 cases were moderately severe. 15 were mild and 3 were complicated by Bronchitis 77 Tuberculosis: In 1963 23 new notifications were received, and their age and sex distribution was as follows:- Pulmonary M 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total - 1 - 1 - - 4 2 2 3 1 14 F - - - - - - 2 1 1 - 1 5 Non-Pulmonary M - 1 - - - 1 1 1 - - - 4 P - - - - - - - - - - - 0 TOTALS - 2 - 1 - 1 7 4 3 3 2 23 The non-pulmonary cases included 1 neck, 1 adenitis, 1 Pericarditis, 1 Urinary. The notification rate of all forms of T.B. was 7.1 per 10,000 as against 4.1 for the whole country (1962). The total number of cases remaining on the Register after adjustment for deaths and transfers were, on the 31st December 1963: Males Females Total Pulmonary 128 105 233 Non-Pulmonary 15 9 24 143 114 257 There were 8 deaths during 1963 of persons previously notified as suffering from Tuberculosis, and not removed from the register on the grounds of arrest of the disease, but six of these were from other causes; the remaining two were as follows:- (a) from Pulmonary Tuberculosis M.59. P.52. (b) from Non-Pulmonary Tuberculosis Nil The death rate was 6per 100,000 of the population, as against the National rate of 6.3 (1963). 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 1963 the Mass Radiography Unit examined 44,200 males and 23,636 females, making a total of 67,836. Up to the end of 1963 the Unit has examined 827,635 persons since it commenced operations in May 1950. One hundred and sixty-three cases were referred to Chest Clinics, hospitals,etc.for further investigation and so far (June 1964) thirtyfive cases with a significant tuberculous lesion have been reported. There have been sixteen cases (all male) of carcinoma of the lung. Final diagnosis is awaited from one case. Clinics generally record their sputum findings. 78 For the larger part of the year the Unit operated at the Mass Radiography Centre, 20 Golden Lane, E.C.1. During its mobile period the Unit visited various firms and organisations which, in turn, were generally co-operative efforts. Thus when the Unit was centred on the 'Evening Standard' premises the staffs from over eighty firms in the vicinity participated. To offer firms in Shoreditch a convenient centre for Chest X-ray examination the Unit was sited at the Geffrye Museum in Kingsland Road, London, E.2. for some weeks. General practitioners in the Borough of Finsbury have continued to use the facilities offered by the Unit. Anyone wishing to obtain information on the Mass Radiography Service should communicate with the organising Secretary, Mass Radiography Unit 6D, Finsbury Health Centre,Pine Street,E.C.1. (Tel. No. TERminus 0031, Ext.9). (Information kindly provided by Dr. V.D.R. Thompson, Chest Physician). Finsbury Chest Clinic: (Information kindly provided by Dr. W.d.R. Thompson, Chest Physician). During the year 1963 the total number of attendances at the Chest Clinic was 2,431. Of this total, 558 attendances were made by contacts of notified cases of tuberculosis; 208 contacts attending for the first time. The number of new cases of tuberculosis taken on the Clinic Register during the year amounted to 20, of which 19 cases were pulmonary and 1 non-pulmonary; 9 of these pulmonary cases proved to be infectious. In addition to these cases a further 16 notified cases (15 pulmonary and lnon-pulmonary)were transferred into the Borough from other clinics and hospitals. The number of notified cases shown on the Clinic Register at 31st December 1963 was as follows:- Respiratory Non-Respiratory Totals Grand Total Men Women Children Men Women Children Men Women Children 122 108 13 7 7 3 129 115 16 260 The previous year's total was 259. During 1963 there were 9 deaths of notified cases (7 males and 2 females), 4 lower than in 1962. A total of 35 cases were removed from the Register during 1963; 9 cases on account of death, 20 cases transferred out to other areas, and the remaining 6 cases removed from the Register as 'lost sight of'. The total number of cases X-rayed during the year was 975. The London County Council Tuberculosis Health Visitor,seconded to the Chest Clinic, made 704 visits to homes in the Borough during the 79 year Each case was visited with a view to tracing the source of infection,and advising on the prevention of the disease spreading, and on giving any other assistance where necessary. Disinfection was carried out by the Finsbury Borough Council in a number of cases at the request of the Chest Physician. B.C.G. Clinic: During the year the B.C.G. Clinic carried out 151 Heaf skin tests, on child contacts mainly, and 31 contacts were considered suitable for B.C.G. vaccination. Staffing arrangements: Miss A.Phelps who was appointed in September 1962 to act as Health Visitor in addition to the duties of Social Worker and Secretary of the Tuberculosis Car Committee, continued in these capacities during 1963. 80 APPENDIX 'A' LIST OF SPECIAL REPORTS SUBMITTED TO THE HEALTH COMMITTEE BY THE MEDICAL OFFICER OF HEALTH DURING 1963 January Mid day Meal Servies for the Aged (1962). Houses in Multiple Occupation February Census 1961 - Preliminary Report Grants - Voluntary Organisations March Conference on Water Fluoridation held at National Film Theatre, on 24th January 1963. Conference - Central Council for Health Education for Medical Officers of Health. World Health Day. May Census 1961 - Abstracts from Reports The 70th Health Congress of the Royal Society of Health. July Underground Bakehouses - Factories Act 1961. Mid-day Meal Services for the Aged. (Jan to June 1963). Conference of the Central Consultative Committee on the Welfare of old people. October Progress Report - Finsbury Employment scheme for the Elderly. Sixth International Congress of Gerontology - Copenhagen. Review of Manual Staff. Absences Through Sickness - Manual Staff. Aged Persons - Holiday Scheme 1963. November Public Health Conference - Harrogate. Report on Annual Conference of Association of public Health Inspectors. Report on Clean Air Conference. Report of the RoSPA National Home Safety Conference. December Houses in Multiple Occupation. Grants to Voluntary Organisations. & Monthly Report & Statistical Report for each month. APPENDIX 'B' LIST OF SPECIAL REPORTS SUBMITTED TO THE HOUSING COMMITTEE BY THE MEDICAL OFFICER OF HEALTH DURING 1963 January Representation - St Helena Street Area. February Census 1961 - Preliminary Report. Houses in Multiple Occupation. March Representation White Lion Street (No.1) Area. May Representation - Pentonville Road Area. October Improvement of Houses M. of Housing & L.C. Circ. 42/62. 81