FiN 45 The Metropolitan of Finsbury Ac. 4341 ANNUAL REPORT ON THE PUBLIC HEALTH OF FINSBURY for the Year 1964 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 1964 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. Alderman M. Cliffe, M.P. (Deceased August, 1964) Councillor Mrs. S. Cliffe Councillor J. Crossley Councillor E.I. Jones Councillor Mrs. A.E. Lamb 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.I.C. 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., M.A.P.H.I. G.A. Buckingham, M.A.P.H.I. R.C. Sanderson, M.A.P.H.I., M.Inst. P.C. (Resigned 9.2.64). M.E.S. Poultney, M.A.P.H.I., M.R.S.H. (Resigned 29.11.64). R.C. Lockwood, M.A.P.H.I. R.A. Cummins, M.A.P.H.I. (Resigned 1.6.64). D. Nattress, M.A.P.H.I. (W.E.F. 6.7.64). 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 2 Smoke Control Officer: W.P. Butterick (Resigned 19.1.64). P.H. Houghton (W.E.F. 10.2.64). Senior Laboratory Technician: Miss R. Weitz, F.I.M.L.T. Rodent Officer: P.L. Moseley (Resigned 18.9.64). F.J.P. Moody (W.E.F. 9.10.64). Assistant Rodent Officer: F.J.P. Moody (Until 8.10.64). Vacant (From 9.10.64). Administrative & Clerical Staffs: A.J. Holmes (Assistant Administrative Officer) J.T. Lindsay (Senior Clerical Assistant) Miss J.L. Faulkner F.W. Haynes I. Patience (Resigned 25.11.64). A.R. Manz Miss E. Buhr Mrs. E.S. Hill (W.E.F. 15.5.64). J.A. Smith Miss K. Palmer (W.E.F. 17.8.64). Infectious Disease Visitor: Mrs. R. Pepper, S.R.N., R.F.N., B.T.A., Nurse Visitor for the Aged: Mrs. D. Matthie, S.R.N., S.C.M., R.F.N., Assistant Nurse Visitor for the Aged: Miss L. Brailsford, S.R.N. Health Centre Caretaker: R. North Finsbury Workshop Scheme for the Elderly: (W.E.F. 1.4.64). Organiser: Mrs. K. Ferguson, S.R.N. Assistants to Organiser: Mrs. E.F. Slater Mrs. A.M. Pickbourne Miss D.H. Marsh (W.E.F. 13.7.64). 3 Mr. Mayor, Ladies and Gentlemen, I have the honour, Mr. Mayor, to present to you my annual report on the Health of the Metropolitan Borough of Finsbury for the year 1964. This takes a shorter form than usual as for 1963 I prepared a comprehensive report being the last occasion on which the Finsbury Borough Council would be in a position to consider it. The general health of the inhabitants remained good throughout the year, which was not marred by the incidence of any unusual outbreak of disease of any kind. For the fourth year in succession there were no cases of Poliomyelitis. There was a very slight rise in the birth rate to 15.5 but this is still below the national rate. The illegitimate birth rate has remained rather high at 8.3 per cent of the births. There was a happy fall in the death rate to 10.8 which is below the rate for England and Wales. This fall was due to there having been 302 instead of 389 deaths as in 1963. The drop in this number being accounted for by fewer from all the main individual causes (including Cancer of the Lung and Coronary disease) except accidents and suicide from which there were about the same number. Unfortunately there were 2 maternal deaths, both from complications arising during pregnancy. It is also my duty to state that there were rather more infant deaths, nearly all under 4 weeks, and the infant mortality rate rose to 23.0 after a phenomenally low figure in 1963. In general the work continued progressively but as the year advanced it was overshadowed to some extent by the uncertainties in regard to the amalgamation of the Borough with that of Islington. The work on behalf of the elderly by the Council, and the Finsbury Old People's Welfare Committee continued to attract National and International interest. A branch workshop was opened in a reconditioned room in Lever Street. Many of the responsibilities in connection with the workshops, the holiday scheme and the meal services were assumed by the Council on Ist April. Finally, I should like to thank the Worshipful the Mayor and the Chairman, Vice-Chairman and members of the Health Committee, as well as all members of the Council of the former Metropolitan Borough of Finsbury, together with all my staff for their continued sympathetic support and help during the year. I have the honour to be, Your obedient servant, C.O.S. Blyth Brooke, Former Medical Officer of Health, Finsbury. 4 SECTION A Physical Features and Social Conditions General: Area of the Borough (acres). 587 Population 1961 census. 32,887 Population Density. 56 Rateable Value 31.3.64. £9,376,607 Product of a penny rate (1963/64) £36,896 General rate 1963/64. 7/6d 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 Clerk enwell 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 devasted areas. A feature of post war development has been the erection of large blocks of modern flats. PRINCIPAL VITAL STATISTICS Population (Mid year estimate) 32,070 Live Births: Males 267 Females 252 Total 519 Legitimate Total 47 Illegitimate Males 25 Females 22 Total Males 292 Females 274 Total 566 5 Birth Rate (Standardized): Birth Rate (Standardized): 15.5 England and Wales (1963) 18.2 Stillbirths: Legitimate Males 5 Females 4 Total 9 Illegitimate Males — Females — Total — Total Males 5 Females 4 Total 9 Stillbirth Rate: Per 1,000 live and stillbirths. 15.7 England and Wales (Per 1,000 live & stillbirths 1963) 17.3 Per 1,000 Population (standardized). 0.25 Deaths: Males 151 Females 151 Total 302 Death Rate (Standardized): 10.83 10.83 England and Wales (1963). 12.2 Infant Deaths: ... 13 Infant Mortality: 23.0 England and Wales (1963). 20.9 Early Neonatal Mortality Rate: 14.1 Perinatal Mortality Rate: 29.56 Neonatal Deaths: 8 Neonatal Mortality: 14.1 England and Wales (1963). 14.2 Illegitimate Infant Deaths: Nil Illegitimate Infant Mortality: Nil Maternal Deaths: 2 Maternal Mortality: 3.48 England and Wales (1963) 0.28 Tuberculosis (all forms death rate). ... 0.19 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 6 COMPARATIVE STATISTICS 1960 - 1964 1. Population 1964 1960 1956-60 1961 1962 1963 32,540 32,230 33,710 34,480 33,020 32,070 17.6 17.1 17.6 2. Birth Rate per 1,000 Population 18.6 19.00 19.2 - - - - - 3. Sex Ratio Male/Female 1,113 1.3 70 1.4 83 4. Illegitimate Birth Rate per 1,000 Population per 1,000 Live Births 1.3 71 1.4 74 1.3 73 1.4 84 5. Stillbirth Rate per 1,000 Population per 1,000 Total Births 0.36 19 0.40 21 0.27 14 0.28 15 0.31 18 0.28 16 6. Death Rate per 1,000 Population 10.0 10.2 10.6 11.9 12.1 9.4 7. Infant Mortality per 1,000 live Births 15.6 21.0 27.9 10.9 23.0 30.9 8. Infant Mortality per 1,00 Illegitimate Illegitimate Live births - 29 - - - - 7.3 14.1 9. Neonatal Mortality per 1,000 Live Births 10.9 16 27.7 24.44 10. Maternal Mortality per 1,000 Total Births - 3.5 0.30 1.6 - 1.5 11. Tuberculosis (all forms per 1,000 Population Death Rate) 0.12 0.06 0.12 0.06 0.15 0.19 Crude Rates have been given in every case. A dash indicates that numbers are too small for the calculation of a significant rate. INQUESTS: Inquests were held on twenty-two residents during the year. The causes of death found were Road Accidents: Male 41 1 Female — — Accidents from falls, excluding Industrial: Males 74, 41 7weeks 3 Females 72 1 Other Accidents: Males 85, 74, 71, 69, 64, 2 6 Females 73, 67, 41. 3 Suicide: Males 75, 60, 56, 63, 41, 31 6 Female 65 1 Murder: Female 74 1 22 INFANT MORTALITY 1964 - CAUSES OF DEATH Causes of Death 0-1 wk. 1-2 wks. 2-3 wks. 3-4 wks. Total under 4 wks. 1-3 mths. 3-6 mths. 6-9 mths. 9-12 mths. Total under l yr. - - 4 - - 5 Congenital Abnormality 4 - - 1 Birth Injury - 1 1 1 - - - - - - - - Indefinite - - 2 2 - 2 - - - Accidental - - - 2 2 - - - - Gastro- Enteritis - - - 1 1 - - - - - - - - - 1 Haemorrhagic disease of newborn 1 - 1 - - Bronchopneumonia - - 1 - 1 - - - - - TOTALS - 1 8 13 8 3 1 - - - (In this table the international rules for classification have not been strictly followed:—) 8 Maternal Deaths There were two maternal deaths during the year. One in a woman aged 48 from Toxaemia and the other in a woman aged 29 from Peritonitis following Caesarean Section undertaken for Ante-partum haemorrhage. CAUSES OF DEATH 1964 1. Tuberculosis Respiratory 0- 1- 2-4 5-14 25-44 45-64 65-74 M F 75-84 M F 15-24 I BHJh I I 1 3 1 1 2. Tuberculosis Other 3. Syphilitic Disease 4. Diphtheria 5. Whooping Cough 6. Meningococcal Infections 7. Acute Poliomyelitis 8. Measles 9. Other Infective & Parasitic Diseases 10. Malignant Neoplasm — Stomach 3 4 11. Malignant Neoplasm — Lung Bronchus 4 3 4 2 12. Malignant Neoplasm — Breast 1 2 1 13. Malignant Neoplasm — Uterus 1 1 14. Other Malignant & Lymphatic Neoplasms 6 7 7 6 3 1 15. Leukaemia, Aluekaemia 1 1 1 16. Diabetes 1 4 17. Vascular Lesions of Nervous Systems 4 4 6 8 5 12 1_1 I J_1 I L L_1 15 18. Coronary Disease, Angina 2 126 19. Hypertension with Heart Disease 1- 2-4 5-14 15-24 25-44 45-64 65-74 M F 75-84 M F 0- 1 1 1 1 3 2 2 2 7 20. Other Heart Disease 3 1 2 1 21. Other Circulatory Disease 22. Influenza 4 4 1 2 11 1 4 23. Pneumonia 8 2 4 3 24. Bronrhitis 4 25. Other Diseases of Respiratory System 1 26. Ulcer of Stomach & Duodenum 1 1 1 27. Gastritis, Enteritis & Diarrhoea 28. Nephritis & Nephrosis 1 29. Hyperplasia of Prostate 30. Pregnancy, Childbirth, Abortion 2 1 I 31. Congenital Malformations 2 1 1 3 1 2 1 2 3 32. Other Defined and III-defined Diseases 7 33. Motor Vehicle Accidents 1 2 2 3 3 34. All Other Accidents 2 1 2 35. Suicide 3 1 36. Homicide & Operations of War 13 2 1 10 55 60 42 32 55 SECTION B GENERAL PROVISION OF HEALTH SERVICES Health Centre: The Council continued to maintain the Health Centre for the administration of the Public Health Services, and arrangements continued in force for the use by the Regional Hospital Board and the London County Council of those portions of the building which were occupied by services transferred to those bodies under the National Health Service Act 1946. The Council also continued to act as an agent for the Regional Hospital Board in respect of certain services controlled by them. There is no doubt that continued experience has confirmed the view expressed for many years, that the occupation by the Health Department of a separate building of a suitable character to which the public may readily come for help and advice in regard to the numerous health and social problems with which they are often faced, and where some services are available, is of great value. Laboratory: The Laboratory in the Health Centre has been maintained jointly with the Regional Hospital Board since 1948 and undertakes the routine work of the Public Health Department in the control of infectious 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 undertake simple routine pathology on behalf of the Chest Clinic, other clinics in the Health Centre and of Medical Practitioners in the District. A particular feature has been the use made of the facilities for the taking and examination of swabs for the early diagnosis of Whooping Cough. This has been of particular value when the disease has been prevalent. The services of the Laboratory Technician have been available for a limited number of Domiciliary visits when these have been called for. 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 435 donors attended. 393 were bled and 42 rejected for various reasons. The comparative figures for 1963 were 475 donors, 419 bled and 56 rejected. International Certificates of Vaccination and Inoculation: The International form of certificate of vaccination and inoculation approved since the war, requires the signature of the medical practitioner issuing the certificate to be authenticated by the Medical Officer of Health. 12 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 1964, 234 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 8 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 time for attendance, where advice or treatment of Venereal diseases can be obtained, were renewed as necessary in the Council's Public Conveniences. The Council also continued to co-operate in the Health publicity programme organised by the London County Council Health Division 111. Elderly Persons: The Council has continued its very active concern and support during 1964 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 £10,420 during the financial year 1963/64. The work of these organisations has been co-ordinated as far as possible by the Finsbury 13 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 are 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 others are found whom had they been known earlier might have been 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 1964, 29,114 meals were served from Meal Centres, as against 21,840 in 1963. The following centres were in operation for 3 to 5 days weekly throughout the year: (i) Women's Voluntary Service, 68 Exmouth Market, E.C.1. (ii) Field Lane Community Centre, Cubitt St., E.C.1, in connection with Field Lane Institution, 16 Vine Hill, E.C.1. (iii) Claremont Central Mission, White Lion St., N.1. (iv) Finsbury Mission, Moreland Street, E.C.1. (v) Leysian Mission, 106 Old Street, E.C.1, (from March, 1964). (ii) Mobile Meals: Aged persons unable, by reasons 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. 14 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 themselves. 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 overall 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 the 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). This new service commenced on the Ist July, 1963. 5,063 Domiciliary meals were served during 1964, as compared with 4,941 (3,453 frozen meals and 2,512 cooked meals) for the year 1963. (c) Nutritional Supplements (F.0.P.W.C.) The arrangements continued with Messrs Wander Ltd., Bovril Ltd., Glaxo Ltd., and Horlicks Ltd., whereby "Ovaltine". "Hospital Extract Bovril", "Marmite", "Jaffa Juice", "Complan" and "Horlicks" are supplied to the various organisations represented on the Committee for resale to the aged attending their clubs, at a price considerably less than the normal retail price. These Nutritional Supplements have proved very popular with the aged and considerable quantities have been sold to them. (d) Sheltered Employment: The Scheme inaugurated as an experiment in 1951, to provide sheltered employment for those of the elderly, who are unable to continue in normal employment, and yet are able to undertake suitable light work for 2 hours daily, has continued to play an important role in the provisions made for this group of the community. 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, and during 1964 a further branch for about 20 persons was opened at the Old People's Centre, Lever Street, E.C.1. 15 Some 140 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 Ist 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 various 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 addresses, with whom the Council had made block bookings of accommodation. Preliminary and interim grants were paid by the Council to the holiday homes, and final settlement of the balance owing was made at the end of the season. The Council also paid for all transport provided; and contributions collected from the elderly (in accordance with the assessment scale) were paid into the Borough Treasurer's Department, Holidays were provided in this way for about 398 persons in 1964, comprising 81 men and 317 women of which 40 were married couples, at a total cost to the Council of £4,479. Holidays were provided at Brighton, Bognor, Leigh-on-Sea, Clacton, Margate, Worthing, Chigwell (Essex) and Heme 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 16 and sent to a commercial laundry, returned again on Friday or Saturday of the same week, when they are-re-checked for return to the elderly. 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, the Council inaugurated a domiciliary bathing service, whereby elderly persons can be washed and bathed in their own homes. This has proved a very valuable service, and has helped many of the elderly to keep themselves clean, comfortable, and respectable. It has been found that an attendant can attend about 20 — 24 cases each week. Additional attendants have been appointed as the need has arisen, and during 1964, three attendants were so employed. (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 domestic help, to keep it at least for a time sanitary, once it had been cleansed. (i) Chiropody: (1) There is a satisfactory chiropody clinic in the Health Centre, administered by the London County Council which is available for the elderly as well as for others. (2) A domiciliary service (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. 688 visits were paid in 1964 and pensioners of all ages up to 96 have received benefit from them. This service has proved well justified in so far as it has enabled the aged and infirm to get about at home in reasonable comfort, and do things for themselves, and so retain the independence essential to their mental and physical well-being. (j) S.O.S. Cards (F.O.P.W.C.) The S.O.S Card Scheme operated by the Committee in the Borough has functioned very successfully in the past. No use, however, was made of the Scheme during 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: 17 The following may be listed: Women's Voluntary Service, 68 Exmouth Market, E.C.I. Clerkenwell and Islington Medical Mission, Woodbridge St., E.C.I. Field Lane Community Centre, 32 Cubitt Street, W.C.1. Finsbury Mission, Moreland Street, E.C.1. Leysian Mission, 112 City Road, E.C.1. Claremont Central Mission, White Lion street, N.1. 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.1. Holy Redeemer Church, Exmouth Market, E.C.1. Sunshine Club, 33 Lloyd Baker street, W.C.1. The British Red Cross have a special afternoon meeting arranged each week for the housebound elderly and for which whenever available, special transport has been provided. This club provides 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 1964 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: in February 1964, a new ambulance (purchased by the Borough Council) was delivered, and substantial use was made of it during the year for transporting less active elderly persons to clubs, taking a small number of housebound to Chigwell for their holidays; and other recreational activities. 2. Day Care Service (F.0.P.W.C.) in April, 1963, the Finsbury Old People's Welfare Committee inaugurated a Day 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:— 18 (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 goes 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 time 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, unobstrusive supervision and very personal friendship cannot be given by a centrally 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 1964 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 the 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 1964. 4. Christmas Parcels (F.0.P.W.C.): Many of the elderly have been provided each Christmas with a parcel of groceries and other suitable gifts by the clubs or churches with which they are associated, or by the Finsbury Old People's Welfare Committee, which distributed about 400 in 1964. 19 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 a small number of occasions during 1964 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 aged male living alone. Substantial use has been made of the Scheme. There is no charge to the Aged. 7. Opthalmic Service: As there were many elderly in need of glasses or other ophthalmic treatment who found it too much trouble to make an appointment at a hospital or other clinic, a special arrangement was made in 1956, by the courtesy of Moorfields Eye Hospital whereby appointments could be made on their behalf and for them to be seen with a minimum of waiting in the hospital. A small number of cases were referred during 1964. 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 and 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 1964. (ii) Wireless Relay Services: The Committee has continued to finance the provisions of a Wireless Relay Service for the use of the 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. The Committee entered into an agreement in 1956, with the two Relay Wireless Companies which cover the greater part of the Borough, whereby 20 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 1964, on an average 14 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.): In 1963, an unknown benefactor financed a scheme for the London Area to provide televisionsets for loan to 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 made available throughout London under the scheme is 1,000 and about 40 Finsbury residents were fortunate enough to be included in the original allocation in 1963. New cases nominated since that time are placed on a central waiting list, and the waiting list is absorbed as and when sets become available due to discontinuation of service to existing cases. 12. Various (F.O.P.W.C.): (i) Co-operation has continued with the London Electricity Board and North Thames Gas Board to have electricity and gas appliances checked for possible defects, and meters lowered where they are 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 1964. 21 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 a satisfactory condition, and are adequately covered. The Metropolitan Water Board give regular information whenever water supplies to any premises are withdrawn, either because the premises have become vacant or because of defects causing waste of water or due to unpaid rates. Investigations are made by the department and, where necessary, action is taken to have the supply reinstated. In 1964 only three instances occurred. There are at present only 3 deep wells known not to be fully sealed in the Borough. These are situate in the premises of 1. Royal London House, Finsbury Square. 2. City Gate House, Finsbury Square. 3. Bovril Ltd., Old Street. The first two premises mentioned are partly in Crown occupation, and samples of the water are periodically examined either by this department or elsewhere on behalf of the Ministry of Works. That on the premises of Bovril Ltd., is not in actual use. During the year 10 samples were taken and examined bacteriologically in the Department and two submitted for chemical analysis to the Public Analyst. In addition, the Metropolitan Water Board examined 8 samples in conjunction with the Department. 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 also 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 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. 22 Apart from careful day-to-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 samples to be sterile. (ii) There is an indoor swimming pool 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 has given rise to concern, though the alkalinity and amount of free chlorine has occasionally been found to be low and complete sterility not maintained. (iii) An additional covered swimming bath was opened in October, 1963, 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. In all, 7 samples of swimming bath water were taken for analysis during the summer months. Public Health Inspectorate: The establishment of Public Health Inspectors was increased by 1 during 1964, to a total of 11, in order to cope with the Offices, Shops and Railway Premises Act. Unhappily three Inspectors left during the year for a variety of reasons, including the attraction of higher salaries. The senior student successfully passed the first Diploma examination of the Public Health Inspectors Education Board and was appointed to the Inspectorial staff. Thus only 7 inspectors remained at the end of the year, and this acute shortage is illustrated in the diminished volume of work carried out in the Department. Sanitary Conditions: I am glad to be able to report once again 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 total number of complaints made to the department during the year was 862 as against 1064 in 1963. By a re-arrangement of the work it has still been possible to investigate most 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. 23 The following table sets out a number of details of the work carried out under this heading in 1964:— Housing damp, dirty — remedied 180 Doors, windows, floors, walls, ceilings, sashcords repaired 267 Watercloset and urinal defects remedied 77 Soil and vent pipe defects remedied 68 Rainwater Pipes cleared, repaired or renewed 77 Waste pipes cleared, repaired or renewed 72 Drains cleared 80 Roofs and gutters repaired 163 Yard or area defects remedied 35 Water Storage tank defects remedied 11 Washhouse defects remedied 2 Water supply to houses reinstated 25 Firegrates renewed or repaired 48 Animal nuisances abated 1 Miscellaneous nuisances abated 66 Dust receptacles renewed or repaired 72 Accumulations of refuse removed 192 Overcrowding cases reported 26 No. of Basement rooms inspected 105 No. of House Inspections 1,545 No. of House-to-House Inspections 96 Total No. of first visits for all purposes 6,631 Total No. of re-visits for all purposes 9,016 No. of Intimation Notices served 411 No. of Nuisance Notices served 62 Legal proceedings under the provision of the Public Health (London) Act 1936, were instituted on 2 occasions in 1964. Details are as set out below:— Date Premises Offence Result 13.1.64. 10 Langton Gate. Failure to comply with a nuisance notice to repair roof. Fined £5 Cost £1 3 Vineyard Walk. Failure to comply with Abatement Order Pined £20 or 28 days imprisonment in default. Costs 28.1.64. £2. 2s. 0d. Urgent Nuisances: During 1964 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. 24 Choked drains. 26 (in 24 cases the drains were cleared by the owners within the 48 hour period. In the remaining 2 instances, 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 remedied by the owner). 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. Eighty-two drainage plans were approved by the Council during 1964, and 2,390 visits were made by the Public Health Inspectors in connection with the supervision of work in progress. The following table is an indication of the extent of the work carried out during the year. Drains laid or amended Soil and vent pipes erected Drains or Soil pipes tested Waste pipes erected 391 452 426 369 Water closets installed Urinals installed 931 121 Lavatory Basins fixed Sinks fixed 1,440 656 Bath and showers installed 440 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 at 88 Old Street, E.C.1, 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. 25 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, again been further extended. The Public Health Inspectors visited and inspected the premises from time to time during the year. Offices, Shops and Railway Premises Act, 1963. The Act which came into operation in August, 1964, contains provisions for securing the Health, Safety and Welfare of persons employed to work in Offices, Shops and Railway Premises. The Act applies to all premises where persons are employed, the only general exclusions are family businesses and premises where self employed persons work. The Act requires that all premises to which the Act applies should be registered. Up to 31st December, registrations in respect of 1,333 premises had been received. Although occupiers of all premises received a reminder regarding registration.it is thought that many registerable premises are still unregistered. Public Health Inspectors of the Department commenced the considerable task of inspection in September, and a streamlined method of registration, inspection and service of notices was devised, and circulars relating to different provisions of the Act were included with each notice, as necessary. The inspection of offices, in particular, was hampered by the shortage of Public Health Inspectors and the failure to appoint a technical assistant. The inspections have revealed that the more common defects, are the absence of supplies of hot running water; staircases without handrails; defects to sanitary conveniences; the lack of clothing accommodation; and the absence of thermometers and first aid boxes. Particular attention was paid to the guarding of food machinery, certain types of which are capable of causing serious injury. 19 machines were discovered without the recommended type of guard and a warning issued in each case. It was found necessary to refer certain questions to the Ministry of Labour for advice in connection with the guarding of gravity feed slicing machines. Consultations also took place with the machine manufacturers, and H.M. Inspector of Factories. In connection with the provisions of the Act relating to the notification of Accidents, 8 notifications were received. However, all the accidents were of a minor nature, and did not require lengthy investigation or special action. One application was received and approved during the year for exemption from the requirement, to provide first aid boxes at premises where 26 a properly staffed first aid room existed, but no other applications for exemption from those provisions of the Act and Regulations in force at 31st December, 1964, were received. The following is a summary of statistics regarding premises in Finsbury subject to the Offices, Shops and Railway Premises Act. REGISTRATIONS AND GENERAL INSPECTIONS: No. of premises registered during 1964 Total No. of registered premises at end of 1964 No. of General inspections 1964 Offices. 819 812 38 Retail shops 254 245 217 Wholesale shops, warehouses 147 147 7 Catering establishments open to the public and canteens 113 113 8 Fuel storage depots — — — Total 1,333 1,317 270* * As a result of these inspections, no less than 254 notices were served on occupiers and owners in respect of the 929 items revealed requiring attention. NO. OF VISITS OF ALL KINDS BY INSPECTORS TO REGISTERED PREMISES 413 ANALYSIS OF PERSONS EMPLOYED IN REGISTERED PREMISES BY WORKPLACE Class of Work place No. of persons employed Offices 24,194 Retail Shops 1,316 Wholesale departments, warehouses 3,129 Catering establishments open to the public 676 Fuel storage depots 597 29,912 Males 17,752 Females 12,160 Total 27 Prior to 1st August, 1964, 36 inspections were carried out under the Shops Act 1950 involving the service of 1 notice. Rag and Bone Dealers: There are no known premises where such trade is carried out, which would bring them within the scope of the Bye-Laws in this connection. There are 4 premises where trade is carried on in rags and waste paper etc. Rag Flock: At the end of 1964, 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 the Rag Flock and Other Filling Materials Act 1951. Two visits were paid to these premises in 1964. On each occasion the conditions have been found to be reasonably satisfactory. One sample of filling material was taken during the year and was found to be satisfactory. Offensive Trades: At the end of the year no business was licensed pursuant to Section 140 of the Public Health (London) Act 1936, sanctioning the carrying on of an offensive trade. Factories: The official returns for 1964, 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 3 1 (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority. - 1,141 167 25 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers premises). - NIL 12 12 - 26 Total 1,182 182 28 CASES IN WHICH DEFECTS WERE FOUND PARTICULARS Number of cases in which defects were found Number of cases in which prosecution vere instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of Cleanliness (S.1). 1 1 - 1 - - Overcrowding (S.2). - - - - - Unreasonable Temperature (S.3). - 1 - - 1 Inadequate ventilation (S.4). - 1 - - Ineffective drainage of floors (S.6). - - - - - Sanitary Conveniences (S.7) (a) Insufficent - - - - - 70 (b) Unsuitable or defective 70 13 - - (c) Not separate for sexes 1 2 1 - - Other offences against the Act (not including offences relating to Outwork). - - - - - Total 73 72 1 17 - Outworkers: Many firms arrange for some work to be undertaken as outwork either under contract by other factories or by homeworkers, and in order to check the spread of vermin or infectious disease, information as to such outwork must be supplied in relation to certain classes of work. Because smallpox and scarlet fever, the two diseases considered most likely to spread in this way, are no longer of serious concern, and verminous premises only infrequently discovered, the supervision of outwork has become of less importance than heretofore, and no formal action has been required in any case for many years, though occasionally by arrangement with the firms concerned, a few articles which might have been in contact with infectious diseases have been disinfected or destroyed. 29 OUTWORK Section 110 Section 111 No. of outworkers in August list required by sect. 110 (i)(c). No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions NATURE OF WORKS 973 Wearing apparel Making etc. - - - - - 7 Household linen Umbrellas etc. - - - - - 19 - - - - - 11 Artificial flowers - - - - - The making of boxes or other receptacles or parts there of made wholly or partially of paper 36 - - - - - Brush making 12 - - - - - - 10 Feather sorting - - - - - 32 Carding etc., of buttons etc. - - - - 5 Cosaques, Christmas Crackers, Christmas Stockings etc. - - - - - - - 4 - - Lampshades - 1,109 - - - - - TOTAL: 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 table sets out the detailed information supplied in the official returns. The number of firms employing outworkers in 1964 was 93 The number of Finsbury outworkers employed by them was 130 The number of non-Finsbury outworkers employed by them was 2,029 The number of Finsbury outworkers employed by firms outside the Borough was. 67 The total number of Finsbury outworkers employed by firms in or outside the Borough was (of these 68 were firms and 129 homeworkers) 197 Number of visits paid to homes 225 30 Clean Air: There has undoubtedly been a decrease in the degree of atmospheric pollution in London over the past 20 or 30 years, and in particular since the implementation of the Clean Air Act 1956, 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. 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 was discontinued as it was found from experience over three years that concordant results were arrived at by this, and the volumetric methods. This is not necessarily the case in all areas as each of the two methods also measures some other impurities. There is considerable daily and seasonal variation due to the weather and no doubt the amount of fuel consumed in the district, but there has been little change in the general level of pollution. Smoke Emission: The number of timed observations made during the year of the chimneys in industrial and commercial establishments was 221 and 28 complaints of smoke investigated. Verbal warnings have been given where appropriate and advice has been offered to management and their staffs. On 6 occasions in 1964 written notices were issued when contraventions of the Act or Regulations had been observed. Furnaces: 113 formal notifications (including 26 in 1964) have been received of intention to install 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: During the year, the survey was finalised and a report submitted to Council regarding the fifth area to be dealt with. Subsequently the Minister of Housing and Local Government confirmed the Finsbury (No. 5) Smote Control Order which becomes operative on Ist October, 1965. 31 The conversion of firegrates in the No. 4 Area was completed during 1964. In this connection, 35 notices were served under Section 12 (2) of the Clean Air Act, A start was made on the survey of the sixth area, but owing to the loss of two Public Health Inspectors successively responsible for this work, the Smoke Control Officer's time was increasingly devoted to the implementation of existing Orders. During December, special observations were made in the four areas subject to Smoke Control Orders. In the case of non-residential buildings, emissions of smoke were observed from 12 furnaces, including one hospital. Two of the furnaces were exempt from the Orders; one premises was made the subject of a notice and in another case the National Industrial Fuel Efficiency Service had been consulted. In the other instances, some of the smoke emissions were from oil-fired furnaces and all were of a minor character. Smoke arising from dwellings was observed on 43 occasions. A warning letter was distributed to all the tenants of the flats concerned, as it appeared that, in spite of conversions having been carried out, bituminous coal was still being sold and used in the district. It was also discovered that many new tenants had not been informed of the existence of a Smoke Control Order. The total number of visits paid in connection with smoke control areas during 1964 was as follows:— By Public Health Inspectors 610 By the Smoke Control Officer 2,634 PROGRAMME FOR SMOKE CONTROL AREAS IN FINSBURY Total Premises Area No. Acres 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. 4 103 100 2,466 2,006 29.11.62. 1.10.63. 5 3,070 2,499 19.6.64. 1.10.65. 6 64 1,162 932 7 100 1,620 1,215 8 60 1,568 1,179 587 12,293 9,002 TOTAL: 32 VERMINOUS ARTICLES AND PREMISES: The Council's Disinfestation Service continues to provide for the destruction of all insects and pests, but in particular beg bugs, cockroaches and fleas, etc. In the majority of cases one spraying with a 5% solution of D.D.T. or other insecticide has had the desired effect, and where necessary a follow up treatment has been carried out to ensure success. The slight increase in bed bug, cockroaches and beetles, was without doubt due to the exceptional prolonged summer experienced during 1964. In one particular case a persistent infestation of BLAPS MUCKONATA (1) otherwise known as the cellar or Churchyard beetle, was successfully dealt with by concentrated efforts using a Malathion based insecticide and pressure blower. During 1964, a wide range of pests were dealt with and 397 premises were treated including Bed bug 89 Cockroach 19 Flies 7 Beetles (Various) 34 Ants 16 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 1964, 52 such representations were made and spraying was carried out before any article was removed. The routine spraying was also carried out at 104 Council properties that for various reasons had 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. Home visiting has only been carried out in connection with the somewhat rare cases of persistent or recurrent infestations in the same family. In 1964 the total number of treatments given was:— Scabies Head Lice Body Lice For Finsbury Cases For Shoreditch Cases 52 13 47 6 8 5 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. 33 Prevention of Damage by Pests Act 1949: Rodent Control: The work of Rodent Control within the Borough continues to give satisfactory results. During the year under review RATTUS NORVEGICUS (Common Rat) and mice have been the main cause for complaint, no infestation of RATTUS RATTUS (Ship Rat) has been reported or discovered. The majority of infestations have been on a small scale except in one particular instance where rats had burrowed beneath a dust chute and in this case the rodent control staff carried out an intensive programme which cleared the area of rats. Rats in the sewers of Finsbury still require continuous attention, and the usual quarterly treatments are being carried out to this effect. The Rodent Control Staff comprise a Rodent Officer, Assistant Rodent Officer, Foreman and six operatives who are fully employed treating and maintaining a service at the many business and domestic houses in the Borough, who request assistance in this field. As in previous years both residents and occupiers of business premises within the Borough of Finsbury have been most co-operative in the fight against rodents, and it is gratifying to note that it has not been necessary to issue a Statutory notice or take legal action of any kind under the Prevention of Damage by Pests Act 1949. Number of complaints received Business premises Domestic „ 63 79 Additional Infestations Pound Business „ 1,116 Domestic „ 181 Number of Premises treated Business „ 1,179 Domestic „ 260 Number of Visits made Business „ Domestic „ 13,289 6,115 Charge made to Business premises £4,504 14s. 0d. 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 5 premises during the past year. Two 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 second hand gas, electric or oil fires, to ensure that such appliances were adequately guarded in accordance with the standards laid down. Two official visits were paid during the year by the Public Health Inspectors. 34 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 1964, 2 licences were in force. Mortuary: The Corporation of London was so good as to make available mortuary accommodation at their Golden Lane Mortuary for Finsbury infectious and emergency cases. 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 48 registered premises in the Borough. In all 19 visits were made to hairdressers and barbers during 1964. 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 1964, it was not necessary to resort to this kind of treatment, although spraying was carried out on 97 occasions under the following headings:— Suspected Dysentery and Gastro Enteritis 6 Suspected Measles 5 Suspected Scarlet Fever 11 Suspected Whooping Cough 2 Suspected Tuberculosis 5 35 On behalf of St. Marks Hospital Moorfields Eye Hospital Mount Pleasant G.P.O. and Miscellaneous spraying I.D. 68 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, 215 articles were treated. Goods, mostly, clothing, were also disinfected on behalf of certain export firms as follows:— Number of articles 7,250 Number of times disinfecting plant charged 15 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 1964. Noise: Towards the end of 1960 the Noise Abatement Act, which somewhat strengthens the powers to secure abatement of noises which are a nuisance, came into force. During 1964, there were 34 complaints of noise received by the Department. A summary of the complaints indicates the type of premises involved, viz:— Building Sites 7 Factories 15 Shops 3 Domestic 1 Demolition Works 1 Dogs 1 Street Noises 2 Public House and Club 2 Diesel locomotives 1 Steam Generator 1 Several complainants were disturbed by night work at adjoining premises. In most cases, following correspondence with the firms in question some amelioration of the conditions was brought about. 36 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 1964 was 9,540 disregarding uninhabitable properties. The dwellings in the Borough consist of approximately 7,330 flats and 2,210 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 and 1875. 20 Percentage built between 1875 and 1900. 26 Percentage built between 1900 and 1919. 4 Percentage built between 1919 and 1945. 9 Percentage built since 1945. 34 Ownership of the flats is roughly as follows:— Finsbury Borough Council 2,790 London County Council 640 City Corporation 540 Metropolitan Police 130 Housing Associations 1,430 Private Ownership 1,800 NEW BUILDING: The following new dwellings were completed during 1964:— By Finsbury Borough Council Rodney House, O.M. Richards, Estate President House, King Square, Estate 25 flats 94 " 119 flats Private Owners. 8 " Total No. of flats. 127 " During 1964, 7 certificates of Habitation under Section 95 of the Public Health (London) Act 1936 were issued. 37 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 the older property in the Borough has therefore been reconstructed or had the five standard amenities provided. Improvement grants have been made by the London County Council to a certain Housing Trust. 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 insufficent financial inducement generally. For the record, during 1964, the Council approved one application for a standard grant and one for a discretionary grant in respect of private houses. In addition, it approved discretionary grants to enable the owners to modernise a block of 16 flats. The Conversion of the undermentioned properties was completed during the year:— Peabody Estate Block B. 60/62 Myddleton Square Springfield Court. 15 flats 9 „ 25 „ 26 Northampton Square. 1 house Pennybank Chambers (rendered fit by L.C.C. and Closing Orders determined). 16 flats. Repair of Houses under the Housing Acts: No representations were made during 1964. 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 when these have become vacant or been known to be about to become vacant. 38 The table appended summarises the action taken during 1964 and indicates the overall position at the end of the year. Closing and Demolition Orders: Whole Basement Other Houses Rooms Parts No. of representations made. 8 2 — No. still under consideration. 2 12 1 Total No. of undertakings accepted. — — — Demolition Orders made. — — — Such properties since demolished. 1 — — Closing Orders made. 5 2 — Such properties later demolished. 6 2 — Orders later determined. 16 — 1 Total No. of representations lapsed or no action taken. Total No, of properties still subject to 2 3 — (a) Demolition Orders — — — (b) Closing Orders 31 124 4 Inspections: The tabular statement in respect of 1964, 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. 10 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. 10 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. 2 Clearance Areas: Surveys were carried out by Public Health inspectors of Clerkenwell Close and Baron Street areas, which were included in the current Slum Clearance programme. Reports and representations were submitted to the Council and appropriate Orders agreed to. A summary of the position relating to individual unresolved areas is given overpage. 39 Area No. of Houses Year of Order Remarks Herbal Hill 2 1957 Premises vacant; not yet demolished. King Square (No. 2 Area). 292 1958 Redevelopment of housing Estate in progress. (No. 3 Area). 25 1958 Northampton Road 9 1961 Rehousing in progress. Bowling Green Lane 2 1961 C.O. confirmed without modification June, 1963. Benjamin Street 4 Order not Premises acquired by made negotiation. Margery Street 14 1963 C.P.O. confirmed — rehousing commenced. St. Helena Street 9 1963 C.O. confirmed and premises demolished. White Lion St. (No. 1). 4 1963 C.O. confirmed without modification, July, 1964. Pentonville Road 3 - Represented April, 1963. Tenants rehoused. Finsbury Estate 132 — Council property. Certificate of Unfitness issued October, 1963. Rehousing nearly completed and demolition commenced. Clerkenwell Close 10 - Baron Street 14 - Rehousing: Applications for rehousing by the Borough Council are made to the Housing Manager and these have been assessed for some years according to a points scheme. When accompanied by medical certificates to support the application on medical grounds, these have been referred to the Medical Officer of Health. Enquiries are then made by the Nurse/Visitor into the detailed nature of the family health, and the apparent bearing on this of the accommodation in use, and when desirable an inspection is carried out by the Public Health Inspector. These reports are then correlated with the medical certificates, and a degree of medical priority is then allotted. 40 During 1964 applications have been dealt with as follows:— New Cases 96 Cases reconsidered on new medical certificates 111 Cases reconsidered 4 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 1964 was Rehoused by Finsbury Borough Council (original lettings). 50 Rehoused by Finsbury Borough Council from clearance areas etc. 100 Rehoused by London County Council (including clearance areas). 136 Rehoused in New Towns. 8 Rehoused by City Corporation. 5 In addition many transfers within 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 211 families have been recorded, in 78 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 l / 2 or 1 unit, usually caused by natural increase over a period of years. Twenty new cases were noted during 1964. 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 duringthe year. 41 Houses in Multiple occupation: The Council has given serious consideration to the many complex problems arising from the multi-occupation of houses but owing to the serious shortage of staff and other difficulties involved, including the possible displacement of tenants, no formal action was decided upon. The Department however, has continued to press for additional amenities to be provided in individual premises 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. During the winter of 1963/64 a survey of all the blocks of flats in the Borough was carried out by the Public Health Inspectors regarding the artificial lighting of the staircases and landings. Some 52 visits of inspection were actually made in 1964. 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 a certificate of disrepair and for their cancellation. Advice is given when requested in regard to the completion of the appropriate form. The following is a summary of the action taken in recent years, and the present position. Housing Repairs and 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 Certificates issued as to remedying of defects (a) Issued to tenants. 8 (b) Issued to landlords (Cancellations) 6 (c) Still in force. 4 In 1964 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. 42 SECTION E FOOD General: Food Premises: The number of Food Premises in the Borough has not changed greatly since last year. The numbers of various classes of food premises is as follows:- Restaurants, cafes, snack bars 134 Public Houses 99 Off Licensed Premises 10 Licensed Clubs 25 Breweries, Distilleries etc. 8 Factory Canteens 71 Commercial Canteens 45 Dairies & Milk Distributors 124 Ice Cream, Manufacturers 3 Ice Cream Sellers 156 Confectioners (sweets) shops 79 Bakers Shops 21 Bakehouses (a) Basement 6 (b) Above ground 9 Grocery & provisions shops (retail) 57 Provision merchants (wholesale) 11 Greengrocers & fruiterers 24 Cheese importers 3 Fish Shops 2 Fish curers 2 Fried Fish Shops 9 Eel & pie shops 5 Poultry dealers (wholesale) 6 Butchers shops (retail) 39 Wholesale butchers & offal merchants 62 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) 15 Manufacturing wholesale chemists 9 In addition to the above established food premises, there are approximately 132 street market stalls in the three markets dealing in various foodstuffs. Note. In the above list some premises are enumerated in more than one category. 43 Inspection of the above food businesses has been carried out formally and informally at frequent periods. The total number of visits made during 1964 was 4701 to premises and 2038 to stalls. The inspection of street traders storage premises involved 34 visits during the year. FOOD HYGIENE The standard obtained through constant supervision and personal contact reported last year has been maintained but it must be emphasised that in many cases it is only by constant visiting that serious contraventions of the Food Hygiene (General) Regulations, 1960 have been avoided. Experience has shown that, due to the human element, the tendency to do things contrary to the spirit of the Regulations is ever present and in order to prevent these tendencies from becoming habits numerous informal visits are sometimes necessary. Employers and employees have, generally speaking, shown a willingness in ensuring that the main provisions of the regulations are complied with. The regulation regarding smoking is still the cause of discussion, due to the fact that no prohibition is imposed on customers using the premises and stalls to which this restriction applies. The administration of the 'no smoking' rule is made very difficult in street markets by reason of the fact that masses of people congregate in these areas during the busy hours, many of whom are observed to be not too careful with regard to the disposal of cigarette ash. In spite of this, it is gratifying to be able to report that a considerable improvement in this matter has been achieved by personal contacts with food handlers and not through the medium of the Courts. STREET TRADING: During the year a more intensive supervision has been made in this branch of food supervision in the Borough. In two of the street markets. Traders Associations are established and this undoubtedly leads to a greater exchange of views. This, it is felt, must eventually be to the benefit of the consumer regarding the provision of cleaner food. The question of the personal hygiene of street traders dealing in foodstuffs continues to be a matter of concern, and undoubtedly this question will have to be given serious thought in the future, and the provision of suitably placed personal washing points in street markets should be given a high priority in any future planning of the street markets in the Borough. One other aspect which reacts adversely to any attempt at improving hygienic conditions in the street markets is the question of accumulations of trade waste during service hours. It is felt that a more satisfactory approach could be made to the traders if a system of centralised trade refuse collection points were introduced. 44 CATERING ESTABLISHMENTS: Many improvements in planning and design have been carried out in establishments operating in the Borough during the past year. The advantage of registration or licensing which helped in the satisfactory layout of catering establishments during the Great War has been lost by reason of the repeal of the Orders issued by the appropriate Ministry. However, by constant observation a degree of supervision is attained in respect of premises before they open for service to the public. The tendency to carry out food preparation in rooms from which the customer is prohibited is one that is deprecated and suggestions have been made that customers should, if they wish, be permitted to inspect the preparation rooms at reasonable hours, and thus assure themselves that conditions are satisfactory. The public can undoubtedly assist in attaining a cleaner food supply by reporting any flagrant contravention to the department and secondly by refraining from dealing with the offending trader. Although the upkeep, maintenance, cleanliness of the premises and personal handling of food is the responsibility of the owner of the food business, and no provision being made in the Regulations for the service of Statutory Notices, an intimation of any defects observed on inspection is made in writing to the owner and this has been found to have the desired effect in having the defects or unhygienic practices remedied. BACTERIOLOGY OF FOOD: During the year 321 samples of food and 35 swabs were examined in the laboratory at the Health Centre. The samples were as follows:- Cream (artificial). Cream (fresh) 4 4 Egg (liquid) Ice Cream 8 78 Meats (pre-cooked) from cafes 61 „ shops 69 „ manufacturers 30 160 Meats (raw) Milk 19 40 Shell fish 4 4 Miscellaneous 321 The creams (artificial and fresh); the liquid eggs; the milks and the shell fish were found to be satisfactory. The ice cream samples were mainly from the two manufacturers within the Borough and were most satisfactory when sampling was carried out at short intervals. The manufacturers are located in a busy market and as their equipment is inevitably exposed to high aerial contamination, it is understandable that during peak periods they have difficulty in maintaining a bacteriological Grade 1 commodity. 45 Considerable attention has been devoted to pre-cooked foods as it is thought that with the exception of the few firms with a national reputation for hygiene, many food handlers have not yet been educated to the dangers that can result from unclean habits. PRE-COOKED MEATS: The 61 samples from cafes were from 16 premises with small kitchens and minimum good food storage accommodation and included lamb, beef, ham, chicken and pork. They were primarily tested for the presence of the pathogenic organisms and it is encouraging to report that in all cases the result was negative. Total counts however were not so satisfactory, especially if the commodity was more than 24 hours old. In many cases the storage was limited to a refrigerator many of which were not being used or maintained correctly, the most common faults being:- (a) Failure to store correctly (e.g. placing raw meat on top shelves). and (b) Failure to use a sterilant when cleansing. The 69 samples from provision shops were mainly of ham, corned beef, brawn, jellied veal, liver sausage and brisket and were mostly from premises where the hygiene was suspect. As anticipated total counts tended to be high due in many cases to excessive handling and the failure to use and maintain properly cleansed equipment. It is encouraging to note the increased tendency to pre-pack sliced ham, etc. and it is hoped the time is not far distant when it will be compulsory for all pre-cooked meats exposed for sale by retail to be pre-packed in a properly maintained preparation room. The samples from manufacturers were of ham, brisket and tongue and results showed the desirability and necessity of sampling from a manufacturer's unopened pack, as in several cases the results were not at first as satisfactory as might have been expected. Liquid Egg: On the 1st January 1964 the Liquid Egg (Pasteurisation) Regulations came into force. The effect of these Regulations was to make it an offence to use as an ingredient in the preparation of food intended for sale for human consumption, liquid egg which does not satisfy the requirements of Part 1 of the Schedule to the Regulations. Provision is made for the sampling of products and during the year 8 samples were procured from bakers and confectioners. All the samples satisfied the requirements of the Regulations. There are no egg pasteurisation plants in the Borough. QUALITY OF FOOD AND ITS DESCRIPTION: Informal sampling has been carried out during the year in respect of a great variety of foodstuffs. Generally, reports on these samples have been satisfactory, although with the increase in legislation governing the composition of certain foods and the labelling of same, certain minor difficulties have been reported. 46 During the year there has been a marked increase in the packaging of foodstuffs treated by the Accelerated Freeze Drying (AFD) method of food preservation. This has resulted in leaving increased refrigerated space available for more perishable foodstuffs. Some concern is still experienced regarding the storage of cooked meats exposed for sale; unfortunately legal requirements are not as stringent as many would wish, but attempts have been made to ensure that the storage of this type of highly perishable food is such that the risk of contamination is reduced to a minimum. During the year, 620 samples were submitted to the Public Analyst as under:- Milk 8 Cream, Condensed Milk, etc. 12 Butter, Margarine, Fats 26 Cheese 18 Sausages 57 Meat & Fish products 135 Soups 4 Sauces & Vinegars etc. 16 Condiments, spices, flavourings 36 Gelatine, jellies etc. 13 Dried fruit 20 Jams & Preserves 37 Cake & pudding mixtures 17 Flour 5 Cereals 19 Coffee, cocoa, tea extracts 19 Non-alcoholic drinks 18 Canned fruit & vegetables 15 Fresh fruit & vegetables 7 Bread & Cakes 30 Sugar Confectionery 37 Restaurant meals & snacks 34 Deep freeze foods 8 Dehydrated foods 11 Medicines 3 Powders 1 Tablets 10 Ointments & Lotions 4 Reports in respect of unsatisfactory samples were received in respect of 11 samples as follows:— 1. Cooking oil — inadequately labelled. 2. Buttered rolls — fatty portion not butter 3. Beef sausages — sour when received. 4. Buttered rolls - fatty portion not butter 5. Buttered rolls — fatty portion not butter 6. Buttered rolls - fatty portion mixture of butter and margarine. 7. Buttered rolls — fatty portion not butter. 8. Stewed steak (open can) — discolouration of lean meat. 47 9. Olives — mouldy. 10. Figs — maggot infested. 11. Bread (sliced) - containing dirt. Action taken in respect of these samples as follows:- 1. The principal of the firm manufacturing this product was interviewed, and a letter received from him stated that steps were being taken to cause the labels to comply with the requirements of the Labelling of Food Order. 2,4,5,6 & 7. Formal samples were taken of these products, and in one case, where the formal sample was reported to be unsatisfactory, legal proceedings were instituted. 3. Legal proceedings were instituted in this case and the report of the hearing will be found elsewhere in the report. 8. The sample was examined and it was reported that a possible cause for the discolouration was due to an insufficiency of nitrate during processing. 9. The stock of the premises from which the purchase was made was examined. No evidence of mould was observed in respect of this stock. 10. The stock at the premises from which the purchase was made was examined and slight evidence of infestation by maggot was observed. The whole of the stock was surrendered and destroyed. 11. Investigation established that this dirt came from the baking machinery and in view of this report no further action was deemed desirable. An appropriate letter was sent to the complainant. COMPLAINTS BY THE PUBLIC: During the year, 29 complaints were recorded in the department in respect of foodstuffs purchased by the complainants. The co-operation of the public is one that is appreciated because it enables the officers responsible, to obtain a greater degree of supervision than would be possible by means of routine inspections. In some cases investigation has shown that the condition of the food is the result of lack of supervision on the part of the retailer in respect of the efficient rotation of stock or sometimes due to loading of deep freeze cabinets, above the recommended 'load line'. This matter is always emphasised when inspection of grocery and provision shops is carried out. Although the increase in the number of complaints compared with last year is 15, various interpretations could be made regarding this increase but analysis of the complaints suggests that the general public are becoming more particular in the composition and quality of food they purchase. A summary of the complaints and some details concerning them are given overpage:— 48 Foreign Bodies: Eight complaints were received in respect of foreign bodies in foodstuffs as under:- Plastic in sausage. Glass in marmalade. Black spots in salmon. Cigarette ash in pork pie. String in bread. Dirt in bread. Plastic in bread roll. Bristle in bread. In all the above cases exhaustive enquiries were made and it was decided in the light of evidence available that no legal proceedings could be instituted. In every case the complainant was thanked for bringing the matter to the attention of the department. Unsound food: Twelve cases of food alleged to be unsound were reported during the year by the general public as under:- Butter mildew. Sausages unsound. Canned stewed steak black. Mouldy steak & kidney pie. Mouldy pork pie. Mouldy bread. Meat pie, mouldy. Black mould on bread. Mouldy pork luncheon meat. Discoloured corned beef. Dark stains in corned beef. Unsound hen. Several of these complaints were found on investigation to be due to bad management on the part of the shopkeeper. Interviews were held with the offenders and it is hoped that more care will be exercised in future. In two cases it was decided that the evidence was sufficient to warrant proceedings being instituted; details of these cases are reported elsewhere in the report. Insects in food: Six complaints were received of insects in food as under:- Beetle in cheese roll. Cockroach in meat pie. Maggots in bacon. Maggots in pork. Maggots in nut milk chocolate. Beetles in packeted potato chips. It is believed that the increase in the number of these complaints may be due to the warm weather during the summer months. 49 Taste: Three complaints regarding unusual taste in food were received during the year as under:- Corned beef - salty. Fresh steak - tangy. Smell of disinfectant in non-alcholic drink. None of these cases was considered serious enough to warrant legal proceedings and in every case the supplier and the complainant were interviewed and satisfactory arrangements made between them. PARTICULAR FOODS AND TYPES OF FOOD PREMISES IN THE BOROUGH: Stalls: Supervision of stalls used for the sale of foodstuffs continues to require constant supervision. As previously reported, the effective disposal of trade waste continues to hinder the work of the department in attempting to improve conditions. Milk: No changes in conditions have occurred in respect of the milk supply in the Borough. No. of Dairies on register at end of year 9 No. of distribution premises at end of year 115 No. of designation milk licenses issued during the year. Tuberculin tested 2 Pasteurized 13 Sterilized 10 Untreated 29 Satisfactory Unsatisfactory No. of samples submitted to Public Analyst. 8 NIL. No. of samples submitted for Bacteriological examination 40 NIL. All milk Channel Island Average fat content. 3.75 4.5 Average non-fatty solids content 8.56 8.92 Ice Cream: Number of premises registered for manufacturer 3 Number of premises registered for sale & storage 154 Number of premises registered for storage only 2 Meat Inspection: The boundary of the Finsbury Borough Council is adjacent to the Smithfield Meat Market, and in this particular area there are a large number of wholesale butchers and offal shops, bacon and provision warehouses, poultry, game and rabbit shops. Some of these wholesale butchers trade in meat of a low quality, e.g. old cows, bulls, sheep, sow and boar carcases, which are mostly 'boned-out' for use in the manufacturing trade. The area inspector is engaged full time in seeing that these carcases are examined to see that no diseased meat is passed on to the public. 50 A slight increase in the amount of meat consigned to the Borough has been noticed and one or two more wholesale butchers shops have opened during the year. Consignments of Scandinavian Offals and Continental Offals continue to be consigned and often condemnations of these have taken place. The collection of unsound meat and other foodstuffs continues to be satisfactorily collected by Messrs Henson and Burbidge Ltd., Matusa Works, Beckton, who render down this unsound food for technical purposes. During the year the meat inspector carried out a 100% examination of Argentine Beef Livers, for a parasitic disease (Echinococcus) and the result was as follows: Examined Condemned Weight 3,392 cartons Beef Livers. 2,654 Beef Livers 26,726 lbs. The percentage of Beef Livers found to be diseased was approximately 14.9%. During the course of the year 258 certificates were issued for the export of meat. There are no licensed Slaughterhouses in the Borough. The retail butchers shops have been regularly inspected with regard to disease and other conditions, which appeared to be fairly satisfactory. REGISTERED FOOD PREMISES: The undermentioned types of businesses are required to be registered by the Council in accordance with the requirements of the Food & Drugs Act 1955. The number at present registered is 76 comprising the following:- Sausage manufacturers 33 Sausage smoking 1 Meat Pickling 40 Offal cooking 5 Cooked meats or pie making 4 Bacon curing & smoking 3 Ham boiling 12 Fish curing 3 Shell fish cooking 2 Jellied eels 2 Meat Extract 1 Note: A number of businesses are registered for more than one type of manufacture. These premises have been inspected regularly and during 1964, 129 visits have been made. 51 Bakehouses. There are 7 underground and 9 above ground bakehouses in the Borough. The general standard is satisfactory and during the year 146 visits were made. Licensed Premises: The number of premises licensed under the Licensing Act, 1953 for the sale of intoxicating liquor in the Borough is 128. Of this number, 99 are operated as Public Houses. During the year 271 inspections have been made and advantage has been taken of transfers, to have improvements carried out where necessary. Licensed restaurants in the Borough now number 9 and in every new application, the opportunity is taken to have the sanitary accommodation improved in the premises. The introduction of the Licensing Act 1961 has resulted in applications being made for the establishment of 25 clubs in the Borough. Supervision of these premises has been maintained and no adverse reports have been received. UNSOUND FOOD: No formal seizure of food, other than meat, was deemed necessary during the year, the co-operation between the department and the trade over the past few years has been maintained. During the year 86 visits were made apart from those connected with meat inspection and 628 certificates were issued in connection with the voluntary surrender of unsound food. Meat (diseased) 27,417 lbs. Meat (unsound) 18,941 „ Meat products 3,121 „ Bacon 11,340 „ Offals (diseased & unsound) 53,888 „ Poultry 10,244 „ Fish 60 „ Game 214 „ Canned goods 11,749 „ Cereals 6 „ Cheese 672 „ Fruit & vegetables 2,150 „ Dried Fruit 48 „ Confectionery 120 „ Preserves 21 „ Fats 224 „ Miscellaneous 9,507 „ Total = 66 tons 16 cwts 3 qrs 6 lbs. 52 LEGAL PROCEEDINGS: During the year 1964, legal proceedings under the Food & Drugs Act 1955 were instituted in 5 cases as follows:- Date Premises Offence Result 16th April 88 Farringdon Road. Cockroach in roll supplied to cafe. Fined £ 5 Costs £10. 20th Aug. 107 Whitecross Street. Fined £10 Costs £10. Buttered rolls not of the nature and substance demanded. 20th Aug. 74 Chapel Market. Insect in meat pie. Fined £5 Costs £21. 8th Oct. 49 Corporation Row. Sale of mouldy bread. Fined £1 Costs £1. 8th Oct. 55 Exmouth Market. Sale of unsound sausages. Fined £10 Costs £10. 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 1964 there were 29 applications for inclusion in the register and all the premises concerned were visited regarding compliance with the Regulations as to labelling etc. FOOD POISONINGS: 43 Cases were notified, 1 of which was a suspected dysentery:- 10 were due to Salmonella Typhi-Murium. 2 „ „ „ „ Brandenburg. 1 „ „ „ „ Reading. 3 „ „ „ Staphylococcus. The last three cases (i.e. due to Staphylococcus) occurred in members of the same family and were traced to reheated beef. 53 SECTION F INFECTIOUS DISEASES General: The general incidence of Infectious Disease throughout the year was very low. For the 4th year in succession there were no cases of Poliomyelitis. In 1964, 993 visits were paid by the Nurse Visitor. 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 245 11 117 107 5 4 1 11 - Dysentery 75 2 21 26 4 17 5 3 - Food Poisoning 42 3 7 10 9 11 2 5 - Scarlet Fever 20 8 12 - 4 - - - - Whooping Cough 15 5 7 2 - 1 3 - - Gastro Enteritis 18 10 8 6 - - - - - Ac. Prim. Pneumonia 44 4 1 3 1 3 16 16 41 Erysipelas - 11 - 3 6 2 3 - - Ophthalmia Neonatorum - - 1 1 1 - - - - Meningococcal Infections - - - - - - - - - - Scabies 26 3 6 7 5 - 5 - - Encephalitis - - - - - - - - T.B. (Pulmonary) 22 2 1 4 7 8 - - - - - T.B. (Otherforms) - 1 - - - 1 - 520 36 172 168 18 47 51 28 77 Total 54 Diphtheria. There were no Cases or contacts during 1964. Dysentery: There were 75 notified cases. 32 were clinical cases with positive stools. 29 were clinical cases with negative stools. and 14 were symptomless excretors who were contacts of the clinical cases. Only two cases had to be admitted to hospital. There were no deaths. Encephalitis: In November, a male child, aged 7 years, was admitted to hospital as a suspected meningitis. The diagnosis was not confirmed. Enteric Fever (Typhoid): There were no cases or contacts during 1964. Enteric Fever (Para-Typhoid): There were no cases or contacts. Erysipelas: 11 cases occurred, 4 of which were admitted to hospital. 5 of the cases were mild and the other 6 were moderately severe. There were no deaths. Chickenpox: Of the 59 cases which occurred in the Borough, none was severe and there were no complications. Gastro-Enteritis (over 2 years): There were 6 cases, 3 of which were admitted to hospital. No organisms were isolated from the stools and no contact could be traced between the cases. Gastro-Enteritis (Under 2 years): 21 cases were notified 3 of which were withdrawn leaving a final total of 18. Of these, 6 were removed to hospital. There were no deaths from this cause in 1964, although a baby who was admitted to hospital with gastro-enteritis in December 1963 died in 1964. Glandular Fever: There were 3 cases; 1 adult and 2 children. All were admitted to hospital. No contact could be traced between these cases and the source of the infection could not be discovered. Malaria: No cases or contacts were reported. Measles: 246 cases were notified, one of which was withdrawn leaving a final total of 245 notified cases. In addition, 7 unnotified cases were discovered by the Infectious Disease Visitor. 10 cases were removed to hospital. 127 cases were moderately severe and 118 were mild. 4 cases were complicated by bronchopneumonia and 9 by bronchitis. Meningococcal Infection: There were no cases or contacts. Aseptic Meningitis: There was one case in a male aged 25 years. He was removed to hospital where he made a good recovery. The contacts were kept under surveillance and they all remained well. Pneumiococcal Meningitis: No cases occurred. 55 Mumps: There were 136 known cases. All did well and there were no complications. Ophthalmia Neonatorum: 2 cases occurred. 1 was a resident in the Borough, and the other was a hospital case. Both made satisfactory progress and there was no blindness. Pneumonia (Acute Primary & Influenzal): There were 43 acute primary pneumonias and 1 influenzal pneumonia making a total of 44 cases. All were severe and 39 cases were removed to hospital. There were no deaths. Poliomyelitis: In May, an adult male was removed to hospital as a suspected acute poliomyelitis but was subsequently found to be a case of rheumatic fever. Puerperal Pyrexia: 5 residents of the Borough developed Puerperal Pyrexia while in hospital. There were no deaths. Rubella: There were 30 known cases and so far as could be ascertained, no case came in contact with any woman in early pregnancy. There were no complications. Scabies: 26 cases were notified during the year. Scarlet Fever: 22 cases were notified, 2 of which were withdrawn leaving a final total of 20. 6 cases were removed to hospital. All were mild and there were no complications. Smallpox: 2 residents of the Borough while on a cruise, visited an area where smallpox is endemic. Both these residents and their contacts were kept under supervision. They all remained well. Whooping Cough: There were 15 cases, 3 of which were admitted to hospital. 5 were moderately severe. There were no complications. Tuberculosis: In 1964 23 new notifications were received, and their age and sex distribution was as follows:- 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total. 15 M. F. - 1 1 1 1 - 2 2 1 - 4 4 4 - - - - - 1 - - - Pulmonary. 7 0 M. F. - - - - - - - - - - - - - 1 - - - - - - - - Non-Pulmonary. 1 Totals. 1 1 1 3 2 3 4 8 23 - - - The non-pulmonary was a case of Cervical Nodes. The notification rate of all forms of T.B. was 7.1 per 10,000 as against 4.1 for the whole country (1963). The total number of cases remaining on the Register after adjustment for deaths and transfers were, on the 31st December 1964:- 56 COMPARATIVE STATISTICS 1960 - 1964 1. Population 1960 1956-60 1961 1962 1963 1964 32,540 33,710 34,480 33,020 32,230 17.1 32,070 18.6 19.00 17.6 2. Birth Rate per 1,000 Population 19.2 17.6 - - - - 1,113 3. Sex Ratio Male/Female - 1.3 70 1.3 73 1.3 71 1.4 83 4. Illegitimate Birth Rate per 1,000 Population per 1,000 Live Births 1.4 74 1.4 84 0.28 16 0.36 19 0.27 14 5. Stillbirth Rate per 1,000 Population per 1,000 Total Births 0.40 21 0.28 15 0.31 18 10.0 11.9 10.6 9.4 6. Death Rate per 1,000 Population 10.2 12.1 15.6 30.9 27.9 23.0 21.0 7. Infant Mortality per 1,000 live Births 10.9 8. Infant Mortality Illegitimate per 1,00 Illegitimate Live births - 29 - - - - 27.7 1.6 10.9 16 7.3 14.1 9. Neonatal Mortality per 1,000 Live Births 24.44 - 3.5 - 10. Maternal Mortality per 1,000 Total Births 1.5 0.30 11. Tuberculosis (all forms Death Rate) per 1,000 Population 0.15 0.12 0.06 0.12 0.06 0.19 Crude Rates have been given in every case. A dash indicates that numbers are too small for the calculation of a significant rate. Males Females Total Pulmonary. 130 99 229 Non-Pulmonary. 14 10 24 Totals. 144 109 253 There were 12 deaths during 1964 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 six were as follows:- (a) from Pulmonary Tuberculosis M. 66,67,69 F. 54,67,84 (b) from Non-Pulmonary Tuberculosis Nil. Nil. The death rate was 18 per 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. Finsbury Chest Clinic: (Information kindly provided by Dr. W.D.R. Thompson, Chest Physician). During the year 1964 the total number of attendances at the Chest Clinic was 2,210. Of this total, 423 attendances were made by contacts of notified cases of tuberculosis. The number of new cases of Tuberculosis taken on the Clinic Register during the year amounted to 20 (all pulmonary), and in addition a further 12 notified cases were transferred into the Borough. The total number of notified cases shown on the Clinic Register at 31st December 1964 amounted to 258: this figure includes 16 Non-Respiratory cases. The previous year's total was 260. During the year there were 11 deaths of notified cases (6 males and 5 females) i.e. 2 higher than in 1963. The London County Council Tuberculosis Health Visitor, seconded to the Chest Clinic, made 783 visits to homes in the Borough during the year. B.C.G. Clinic: During the year the B.C.G. Clinic carried out 140 Heaf skin tests, and 18 contacts received B.C.G. vaccination. Mass Radiography Unit 6D: (Information kindly provided by Dr.W.D.R.Thompson, Chest Physician). During 1964 the Mass Radiography Unit examined 40,172 males and 24,189 females making a total of 64,361. Up to the end of 1964 the Unit has examined 891,996 persons since it commenced operations in May 1950. One hundred and seventy cases were referred to Chest Clinics, Hospitals, etc, for further investigation and so far (end of March 1965) 46 57 with tuberculous lesions have been reported, as well as 15 cases of carcinoma of the lung. Pinal diagnosis are awaited from 28 cases. Clinics generally record sputum findings. For the larger part of the year the Unit operated at the Mass Radiography Centre, 20 Golden Lane, although from time to time it was anticipated that it would move to its new accommodation in the Public Services Building in Moor Lane, but so far the building has not been completed. This uncertainty has affected the Unit's planning and correspondingly the attendances. During its mobile period the Unit visited such organisations as the Bank of England, Mount Pleasant Post Office and the Finsbury Health Centre (by kind permission of the Public Health Committee of the Borough of Finsbury). The Unit operated at the Health Centre from 14th July to 27th August during which period it concentrated upon firms in the northern portion of the Borough and firms in the Ludgate Circus area, as direct transport facilities are available for the latter. It should be pointed out that firms in the southern section of the Borough are conveniently situated to the Mass Radiography Centre at Golden Lane. Handbills giving details of the Public Sessions, at which no appointments were necessary, were issued as well as posters. The undermentioned Table summarises the results of the Finsbury Survey:- Total Number of firms circulated. 1418 Number of Participating firms. 385 Males Females Total Total number X-rayed 4856 2607 7463 No previous X-ray 989 747 1736 Recalled for Large films 56 19 75 Referred to Chest Clinics for further investigation 16 4 20 Significant Cases of tuberculosis 3 2 5 Carcinoma of the Lung 1 1 - 1 - 1 Special Heart conditions (One result is still awaited) General Practitioners have used the services of the Unit for their patients for whom special facilities are offered. 58 APPENDIX 'A' LIST OF SPECIAL REPORTS SUBMITTED TO THE HEALTH COMMITTEE BY THE MEDICAL OFFICER OF HEALTH DURING 1964 January Mid-day Meal Service for the Aged (1963). Christmas 1963 — Old People's Welfare. February Proposed Finsbury (No. 5) Smoke Control Area — Interim Report. May Proposed Finsbury (No. 5) Smoke Control Area. June 71st Health Congress — Torquay — 27th April to 1st May 1964. September Mid-day Meals Service for the Aged (Jan to June 1964). Progress Report — Finsbury Employment Scheme for the Elderly October Absences Through Sickness — Manual Staff. Aged Persons — Holiday Scheme 1964. Review of Manual Staff. Annual Conference of the Association of Public Health Inspectors. Conference of Royal Institute of Public Health & Hygiene, at Folkestone, Kent, October 7th - 9th 1964. December Offices, Shops & Railway Premises Act 1963. & 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 1964 June Representation — Clerkenwell Close Area. Representation — Baron Street Area. 59