A4361 1951 ♦ ANNUAL REPORT ON the HEALTH AND SANITARY CONDITIONS of the METROPOLITAN BOROUGH OF ISLINGTON. ♦ VICTOR FREEMAN, m.r.c.s., l.r.C.p., d.p.h., Medical Officer of Heulth. vail & Co., Ltd., Printers. 170 Farringdon Rood, E.C.i 1 Public Health Department, Town Hall, N.l. To The Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington. In presenting my Eleventh Annual Report on the health of the Metropolitan Borough of Islington for the year ended 31st December, 1951, it is pleasing to be able to record the points at which there has been progress in the public health during the year, and to note the new measures which have come into effect and will contribute to the gradual raising of public health standards. Advances in public health and preventive medicine are not usually spectacular but a review of vital statistics, to take only one aspect, even over a period of a relatively few years, as embodied in the pages of this and previous Annual Reports, will show changes which have beneficially affected the people of Islington to a very substantial degree. Among the most striking improvements in the past few years has been the fall in the infant mortality rate for infants under the age of one year, which is now less than half the pre-war rate, but there are still some young children who die unnecessarily and whose lives might be saved to the benefit of the community. It was commonly said at one time that to save infant lives would mean an increase in the number of sick and weakly children who survived, but we now know that the reverse is true. Experience has shown that all those measures which have contributed to the saving of infant life have also benefited the health of the infants who survived the hazards of the first year. The outlook for the mother has also improved dramatically and the change in the maternal death rate will show how very much safer motherhood has now become, even during the last ten years. The public has come to fear infectious diseases much less than formerly. Diphtheria is now relatively rare, but it will be seen from this report that few as have been the diphtheria cases, nevertheless Islington appears to have had a little more than its proportionate share and that, even one or two deaths from diphtheria a year are unnecessary and avoidable. Diphtheria immunisation for the protection of young children is still a very necessary precaution to be taken by all parents. Deaths from tuberculosis of the lungs are decreasing rapidly and new cases of lung tuberculosis have begun to decrease. This has created, no doubt only temporarily, a somewhat contradictory situation since lengthening the life of the tuberculous person may for the time being help to increase the numbers of tuberculous persons circulating in the community. Precautions must therefore be taken to diminish the risks arising from this, and not least among these precautions is the responsibility of the tuberculous sufferers themselves in the personal care they take not to pass on their infection to others. There is also responsibility on all adult members of the public, particularly parents and even grandparents, to ensure that they do not neglect obtaining medical attention for such symptoms as chronic cough, and that they take full advantage of examination by Mass X-ray Units, if they are fortunate enough to have such a Unit available in the district for long or short periods, 2 It has also been necessary to mention certain matters in the Report which, unfortunately, do not show a beneficial trend, and which may in certain cases give cause for serious concern. One of the most outstanding examples of these matters which give cause for anxiety is the increase over the last few years in the number of deaths due to cancer and malignant growths of the lung. Some of this increase may be due to improvements in the methods of investigation and detection, but there can be little doubt that there is also a very substantial genuine increase in the country as a whole. In Islington lung cancer deaths have approximately doubled since 1946 and it will be noted from the Report that deaths from this cause are now considerably more than those due to tuberculosis of the lungs. There is evidence that lung cancer is related to the effects on the respiratory organs over a long period of smoke and certain chemical substances in the atmosphere. The individual himself may be responsible through heavy tobacco smoking, but this cannot furnish the whole explanation, and since there is a higher rate of lung cancer deaths in large built-up areas with dense populations, it is thought that pollution of the atmosphere by domestic smoke in particular, may also pre-dispose. Motor fumes in the streets of towns might also contribute. The investigation of the possible causes of lung cancer and the determination of those particular chemical compounds which pre-dispose are difficult technical matters. However, should the increase be due, even if only in part, to some factors within our control or possible control, then it is a matter of public health importance that the community shall take the necessary steps through legislation and education to reduce the risks of this menacing disease. Pollution of the atmosphere in all its various forms must be tackled much more seriously and with greater speed and vigour than has been the case so far. Of a less serious nature, but having a high nuisance value from the point of view of public health, are the recorded increases during 1951 of food poisoning and dysentery. Dysentery in particular was exceptionally high, with approximately 1,000 notifications. A reduction in the sickness incidence due to these two causes lies to a considerable extent within the discretion of the members of the public themselves. Personal hygiene on the part of food handlers and the proper training of such food handlers by those responsible, whether traders or otherwise, for the preparation and service of meals; proper methods of food storage, especially refrigerator storage ; the consumption of foods on the day of preparation—all these factors will help in the prevention of food poisoning. Better standards of personal hygiene in the home will help to control the incidence of dysentery. It is not easy, however, to have a high personal standard of hygiene and cleanliness in many of the old-fa6hioned houses of which Islington largely consists. These are usually in multi-family occupation, with no bathroom, single water-closet, a tap on the half-landing as the water supply, and no running warm water. With reference to housing, it was not found possible during 1951 to resume any part of the pre-war slum clearance programme. It was anticipated, however, that a start would be made during 1952 and a provisional slum clearance programme, not on a large scale, was received from the London County Council covering proposals in respect of Islington over the next live years. In the meantime it is abundantly obvious that out-of-date housing must continue to be a principal means of accommodation for Islington residents for many years to come. Sanitary complaints, with such old and congested properties must unavoidably arise frequently, and small owners in particular must find themselves in an increasingly difficult position to carry the financial burden, heavy in many cases, of proper housing maintenance. Sanitary complaints continue to be received and dealt with by the Public Health Department at an average rate of approximately 1,000 a month, and the number of prosecutions under the Public Health (London) Act for failure to comply with Statutory Nuisance Notices, and also the failure to comply with Magistrates' Abatement Orders in a substantial number of instances, is further evidence of the difficulty of the housing and sanitary situation in this Borough. Demolition Orders were made in respect of eleven houses during the year as being unfit and not repairable at reasonable cost. Closing Orders were also made in respect of fifteen underground rooms. A major hygiene problem was tackled during the year in conjunction with the Department of Scientific and Industrial Research and excellent results were obtained in dealing with a major source of blowfly infestation. A good start was also made in the more systematic treatment of old bug-infested housing. Neither of these attacks on insects, which are harmful and may even be dangerous to human beings, could have been contemplated a few years ago before the new insecticides became available. The education of the public in health matters has continued as previously, with the addition of the hiring of a major feature film to be shown immediately following the exhibition of health films. Excellent attendances have been attained, rather contrary to the usual experience when health films alone are the attraction. The problems of old persons continue to receive consideration, and the " Meals-on-Wheels " Service, operated by the W.V.S., with the assistance of a Council grant for providing hot mid-day meals for elderly home-bound persons commenced to function during the year. Apart from the benefit of the meal, the scheme is also useful incidentally in that it is a means by which it is possible to keep in touch with old people so that they may be better advised and assisted in other ways. The provision of extra nourishment to old people is essentially a preventive service which should, if fully implemented, assist in maintaining their health. Although approximately three and a half thousand meals were delivered during the year, the Service must still be regarded to some extent as experimental. It is to be hoped that further expansion will be possible, but this depends to a considerable extent on a sufficiency of voluntary help forthcoming to assist in the transport of meals. On the administrative side, considerable assistance was afforded to me in the latter part of the year, particularly in regard to health publicity and matters affecting the welfare of elderly persons, by the Council's appointment of Dr. Amelia Muriel Ison, as part-time Deputy Medical Officer of Health. As Dr. Ison is otherwise a A Medical Officer of the London County Council this appointment constitutes a useful link between the Borough Council's environmental health services, and the personal health services for which the London County Council is responsible as the Local Health Authority. The Council agreed to the re-designation of the Senior Sanitary Inspector and Deputy Senior Sanitary Inspector, as Chief Sanitary Inspector and Deputy Chief Sanitary Inspector, as being more appropriate to their respective responsibilities; and also agreed to the appointment of a Supervisory Sanitary Inspector, with some supervisory and administrative duties, in view of the considerable establishment of Sanitary Inspectors necessary for this Borough. There have been some staff changes, but on the whole both the Sanitary Inspector and Clerical establishment were fairly well maintained. I have to express my thanks to the staff of the Department for their work during the year, and in particular to Mr. W. C. Bartlett, and Mr. B. J. Ashcroft, Chief, and Deputy Chief Sanitary Inspectors, and to Mr. E. J. Sharp, Chief Clerk. I am also glad again to have the opportunity of expressing my thanks to the Public Health and Housing Committees under their respective Chairmen, Councillor Mrs. F. H. Cantwell, and Councillor D. McArthur Jackson, for their sympathetic consideration in the many matters I have had to report to them during 1951, matters in which it was not always easy or straightforward to arrive at the wisest decision. V. FREEMAN, Medical Officer of Health. 5 MEMBERS OF THE PUBLIC HEALTH COMMITTEE (As at December 1951) Mayor : Alderman A. Baker, J.p. Alderman : Herbert James Lowton Lygoe, J.I'., M.S.M. Councillors : Mrs. Emma Elizabeth Baker Charles Percy Hawkins Ernest James Simmons Mrs. Florence Hilda Cantwell, J.P. Louis Holman Mrs. Edith Agnes Sprigos Mrs. Gladys Dorothy Cantwell Ronald George Lord Ernest David Ward Alfred John Davis Ernest George Kice Edward Albert Willis George Albert Gardner Miss Ruby Seaton Thomas Horace Wright John Robert Goodman Chairman : Councillor Mrs. Florence Hilda Cantwell, J.P. Vice-Chairman : Councillor Mrs. Edith Agnes Spriggs Staff of the Public Health Department, Town Hall, Islington, N.l. (T = Staff on Temporary Establishment) Medical Of ficer of Health : V. Freeman, M.R.C.S., L.R.C.P., D.P.H. Deputy Medical Officer of Health (T. Part-time) : A. M. Ison, M.D., D.P.H. Public Analyst : Chief Sanitary Inspector : D. F. H. Button, A.R.C.S.. F.R.I.C. (ft), (c), (d) W. C. Bartlett Deputy Chief Sanitary Inspector : (6), (e), (e) B. J. Ashcroft Supervisory Sanitary Inspector : (ft) j. S. Ash worth Sanitary Inspectors : (6) J. W. Aiken (ft), (c) A. W. Haydock (ft) A. Moxon (ft), (c) A. A. Aslamidis (ft) D. J. Herrington (ft), (e) F. H. W. Pedrick (ft), (d) C. Broomfield (ft), (c) H. R. Homewood (ft), (c) Miss S. H. Prentice lb), (c) D. J. Davies (ft) D. W. E. Jessett (ft) M. E. Rousell (ft) G. A. Faulkner (ft) A. R. Kempshall (ft) A. K. D. Shuttleworth (ft), (c) K. L. Garner (ft), (c), (d) N. Lightowlers (ft) P. A. Slater (ft), (c) Miss V. M. Goddard (a), (c) S. P. Marks (ft) F. J. B. Taylor (ft), (e) W. B. Goddard (ft) J. H. Meurice (ft), («) A. Watson (ft) D. Harwood (ft) J. D. Miles (2 vacancies) Chief Clerk : E. J. Sharp Clerical Staff: S. A. Bishop P. Hard wick C. J. Moore* W. R. Causton* Miss M. E. Hudson S. C. Nottingham L. J. Cook L. Hummerstone D. A. Owen Mrs. V. E. Cox Mrs. E. J. Johnson R. Pluck C. J. Cridland* W. A. McAdam* P. L. Regan Mrs. O. Easson (T) Mrs. C. A. McCausland Mrs. M. V. Sinclair (T) R. A. Easton Mrs. E. M. Matthews (T) J. Thompson Miss D. Francis H. Mills Mrs. F. Underwood W. H Goody (T) Disinfecting and Bathing Stations, Seven Sisters Road, N.7. W. G. Jollie (F.ngineer-in-Charge) Mrs. H. W. M. Godkin (Nurse-in-Charge) 4 Home Visitors 1 Stoker Handyman 1 Assistant Driver 3 Bathing Attendants 2 Drivers 3 Disinfectors Rodent Control : C. Jackson (Rodent Officer) 3 Rodent Investigators 6 Rodent Operators (a) = Certificate Sanitary Inspectors' Examination Board. (b)=Certificate of the Royal Sanitary Institute and the Sanitary Inspectors' Examination Joint Board, (c) = Royal Institute Meat Inspectors' Certificate. (d)=Royal Sanitary Institute Certificate in Sanitary Science. (f) = Royal Sanitary Institute Smoke Inspectors' Certificate. * =Senior Sectional Clerk, 6 SECTION A. GENERAL AND VITAL STATISTICS. Area of the Borough 3,092 acres. Population. Registrar General's estimate of civilian population, Mid-vear 1951 235,800 Live Births. Birth Rate per 1,000 Estimated Resident Population T otals M. F. Islington London Admin. County England and Wales Legitimate 3,595 1,888 1,707 Illegitimate 285 145 140 3,880 2,033 1,847 16.45 17.8 15.5 Still Births. Legitimate 70 40 30 Rate per 1,000 Total (Live and Still) Births 20.94 Illegitimate 13 7 6 83 47 36 Deaths. Death Rate (Unadjusted) per 1,000 Population Totals M. F. Islington London Admin. County England and Wales 3,131 1,581 1,550 13.28 13.1 12.5 Deaths from Puerperal Causes. Deaths. 2 Rate per 1,000 Total 0.50 Births. Death Rate of Infants Under One Year of Age. Islington London Admin. County England and Wales All infants per 1,000 live births 28 26 29 Legitimate infants per 1,000 legitimate live births 29 Illegitimate infants per 1,000 illegitimate live births 14 Notification of Births. For year ending 31st December, 1951 3,851 (corrected figure from L.C.C.) Marriages (Provisional figures). Marriages solemnised in the Borough during the year 2,260 L COMPARATIVE VITAL STATISTICS 1940 TO 1951. (Compiled from Registrar General's Returns) 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 Population 235,800 238,200 239,580 238,200 236,840 227,160 195,770 188,560 189,970 186,000 183,470 224,110 L.ive Births—(total) 3,880 4,091 4,389 4,608 5,577 5,284 3,708 3,826 3,592 3,368 2,986 3,850 (illegitimate) 285 302 318 331 431 442 438 335 264 251 214 272 Birth Rate per 1,000 population 16.45 17.17 18.32 19.34 23.55 23.26 18.94 20,29 18.91 18.10 16.27 17.18 Still Birth Rate per 1,000 births 20.94 17.48 19.87 18.94 18.99 22.20 22.41 25.72 24.97 33.29 26.72 32 17 Deaths 3,131 2,760 2,958 2,682 3,053 2,947 2,856 3,057 3,017 2,852 3,508 4,143 Death rate 13.28 11.59 12.35 11.26 12.89 12.97 14.59 16.21 15.88 15.33 19.12 18.48 Maternal Death rate per 1,000 births 0.50 0.72 0.67 0.85 0.70 1.48 0.26 2.03 2.71 2.29 3.02 1 59 Death rate of infants under 1 year 28 29 27 35 32 39 46 48 46 54 59 47 Marriage rate per 1,000 population 19.17 18.37 18.61 19.67 19.54 20.21 25.00 18.36 18.59 25.30 28.07 32.92 T.B. Notifications per 1,000 population (all forms) 1.77 2.05 2.20 2.25 2.43 2.18 2.81 3.14 3.04 2.30 3.00 2.10 Death-rates per 1,000 population Pulmonary T.B 0.30 0.38 0.52 0.66 0.70 0.64 0.80 0.86 0.85 0.93 1.20 0.84 Diphtheria 0.004 0.004 0.008 Nil 0.004 Nil 0.01 0.01 0.05 0.01 0.06 0.09 Suicides 0.15 0.09 0.12 0.15 0.07 0.11 0.06 0.10 0.08 0.14 0.14 0. J 7 Road Traffic Accidents 0.11 0.10 0.06 0.08 0.11 0.10 0.07 0.16 0.10 0.16 0.14 0.14 Other violent causes 0.26 0.26 0.25 0.43 0.37 0.45 1.05 1.84 0.38 1.45 1.74 2.38 8 CLASSIFICATION OF DEATHS WITH AGE DISTRIBUTION (REGISTRAR GENERAL'S RETURNS). Age Groups Cause of Death 9— 1 — 5- 15- 25- 45— 65— 75— All Ages M. F. M. F. M. F. M. F. M. F- M. F. M. F. M. F. M. F. Total 1. Tuberculosis, Respiratory 1 I 2 7 7 25 9 8 1 6 9 48 21 69 2. Tuberculosis, Other _ 1 1 - 1 - 2 - 1 1 - - - - 5 2 7 3. Syphilitic diseases — — — — - - - - 4 4 2 1 - 9 6 7 13 4. Diphtheria - - - 1 - - - - - - - - - - - - - 1 5. Whooping Cough - - - - - - - - - - - - - - 6. Meningococcal Infection 1 - 1 - - - - - - - - - - - - - - 9 7. Acute Poliomyelitis - - - - - - - - - - - - - - - - - - 8. Measles ] 1 1 - - - - - - - - - - - - 2 1 3 9. Other infective and parasitic diseases - - - - - - - - 2 - 4 - - 1 - - 6 1 7 10. Malignant neoplasm, stomach - - - - - - - - 3 - 18 10 17 11 10 19 48 40 88 11. Malignant neoplasm, lung, bronchus - - 7 3 50 9 34 7 13 4 104 23 127 12. Malignant neoplasm, breast - - - 3 - 15 - I 4 - 4 - 36 36 13. Malignant neoplasm, uterus _ - - - - 3 - 13 - 5 - 5 - 26 26 14. Other malignant neoplasms 1 1 - 1 7 10 46 40 66 37 61 51 181 140 321 15. A- and -Leukaemia 1 1 - - - - - - 3 2 1 - 2 4 6 10 1 6. Diabetes - - - - - 1 - - - - - 1 2 3 3 6 5 11 16 17. Vascular lesions of the nervous - - - - - - - - 1 2 24 21 37 44 70 108 132 175 307 18. Coronary disease, Angina - - - - - - - - 8 - 62 21 70 40 58 108 198 141 339 19. Hvpertension with heart disease - - - - - - - - - - 12 13 30 28 34 52 76 93 169 20. Other heart disease . - - - - - 5 10 28 32 40 55 100 208 173 305 478 21. Other circulatory disease - - - - - - - - 1 5 7 18 23 16 41 39 72 111 22. Influenza 2 - - - - - - - 2 6 1 6 7 6 20 20 30 50 23. Pneumonia 5 4 - 2 - - - - 4 - 19 5 21 20 28 43 80 74 154 24. Bronchitis 3 5 1 - - - - 2 I 58 11 61 43 44 73 168 134 302 25. Other disease of the respiratory system - - 1 - - - - - 1 - 6 2 5 4 4 1 17 7 24 26. Ulcer of stomach and duodenum — - - 2 - 9 1 14 3 8 33 11 44 27. Gastritis, enteritis, diarrhoea 2 — — — — — 2 - - 3 3 2 7 5 12 28. Nephritis and Nephrosis — — 1 - 2 2 7 1 2 2 2 1 14 6 20 29. Hyperplasia of prostate - - - - - - - - - 8 - 13 - 13 30. Pregnancy, Childbirth and Abortion — _ * - - 2 - - - - - - - 2 2 31. Congenital Malformations 5 10 1 - - 2 2 - - - - - 8 12 20 32. Other defined and ill-defined diseases 52 16 1 5 1 2 - 5 10 32 16 11 28 21 37 125 112 237 33. Motor vehicle accidents 1 - 1 - ] - 1 2 8 - 3 1 1 4 2 1 18 8 26 34. All other accidents - 2 1 4 4 1 2 - 3 1 5 3 4 7 7 17 26 35 61 35. Suicide — — — — - 1 1 6 - 8 8 7 3 1 - 23 12 35 36. Homicide — — —* — — — 1 - — — — — — - 1 — 1 All Causes 72 38 9 15 8 3 9 6 76 59 436 248 466 395 505 786 1,581 1,550 3,131 Totals Percentages 110 3.52 24 0.77 11 0.35 15 0.48 135 4.31 684 21.84 861 27.50 1,291 41.23 3,131 100 9 SUMMARY OF INFANT MORTALITY 1951. (Based on Registrar General's Returns) Primary Cause of Death Under 1 day Days Weeks Months 1951 (1950) 1-2 2—3 3—4 4—5 5—6 6-7 1-2 2—3 3—4 1—2 2-3 3-4 4—5 5-6 6-7 7—8 8—9 9—10 10—11 11—12 Totals Totals Measles 1 1 (—) Whooping Cough — (—) Cerebro Spinal Fever — (-) Tuberculosis—Lungs 1 1 (1) Tuberculosis—Other forms — (i) Bronchitis 2 1 3 1 1 8 (2) Pneumonia 2 2 1 1 ] 1 2 1 2 1 5 1 1 21 (22) Influenza 2 2 (—) Knteritis and Diarrhoea 1 1 2 (3) Premature Birth 8 7 1 16 (30) Congenital Malformation,Birth Injury, Atelectasis Atrophy and Marasmus 22 6 3 4 1 1 2 2 1 1 1 2 1 47 (47) Syphilis — (-) Suffocation Overlying — (—) Violent Causes 1 1 2 (—) Road Traffic Accidents 1 1 (—) All Other Cases 1 2 1 1 1 1 1 8 (13) Totals 33 15 6 5 2 3 — 4 2 5 6 8 5 4 3 3 — 4 — —- 1 109 (119) COMMENTS ON VITAL STATISTICS. Births. The birth-rate continued to fall from the post-war peak in 1947 of 23.55 per thousand population to 16.45 for 1951. 7.93 per cent, of the 1951 births were classified as illegitimate. The proportion of illegitimate births has remained fairly steady at approximately 7 per cent, since 1949. 10 Principal Causes o( Death. The death rate of 13.28 per thousand population was the highest recorded rate in post-war years, as can be noted from the table on page 7. This was in accordance with the general rise in the 1951 death rate for the County of London, and also a somewhat smaller increase for the whole Country. The details of the increases are discussed below. Infants under one year. The infant.mprtality rate, 28 per thousand live births, varied little from last year (29), and it is the third successive year with an infant mortality rate of under 30. As mentioned in the Annual Report for 1950, it must be regarded as evidence of the greatly improved personal standards of infant care and knowledge applied by mothers. Such care appears to be more important for infant survival than general environmental and housing conditions, which cannot be regarded as satisfactory or as greatly improved over pre-war conditions when the infant mortality rate was much higher. The importance of the care taken by each mother is further demonstrated by the extraordinarily low figure of 14 for the illegitimate death rate. The total number of illegitimate births of course is relatively small, but the remarkable reduction in the illegitimate infant mortality risk over the past few years has been regular and consistent, as shown in the following table (rates per 1,000 illegitimate live births) :— 1951 14 1948 39 1950 23 1947 39 1949 35 1946 68 Of the 1951 total of 109 infant deaths, 33 occurred within twenty-four hours of birth, and 64 within the first seven days. This is regarded as the most difficult group in which obvious preventive measures can be taken, the principal requirements being even greater care and medical attention during pregnancy. Of the small balance of deaths numbering 34 which occurred during the period from one to twelve months, 16 were due to the respiratory infections, i.e., bronchitis and pneumonia, and all of these respiratory deaths occurred not later than the seventh month. Most, if not all, of these deaths should be preventable without difficulty, and each such death should therefore be regarded as an unnecessary tragedy. Deaths from other Causes. Respiratory Tuberculosis. Deaths from this cause continued to decrease, although there was still a substantial group of 69. It is particularly satisfactory that the largest decrease in the number of deaths due to tuberculosis is in the age group between fifteen and forty-five years, with only 17 deaths as against 30 for 1950. Pulmonary tuberculosis has always been the greatest single cause of death for this age-group but 1951 is the first year in which this did not occur. Malignant Growths of Lung and Bronchus. These figures were not given separately by the Registrar Genera] prior to 1950 and it is not therefore possible to make exact comparisons with previous years. From an investigation of the department's records, however, it would appear that there has been a considerable increase since 1946. It will be noted that males are affected to a very much greater degree than females—in the proportion of more than four to one for 1951. There is evidence that the increase is connected with the increase in heavy tobacco smoking, particularly of cigarettes, but this may not be the only factor, and atmospheric pollution by smoke is also under suspicion. If social factors are in part responsible 11 lor the increase of malignant growths of the lung, then it should be possible to deal with such factors as preventable, and there is an opportunity here for valuable work to be done. Other Malignant Neoplasms. Other malignant neoplasms showed a considerable increase over the previous year, being 321 deaths as against 265 in 1950. The increase was mainly in those aged 65 and upwards. Diseases of the Heart and Circulatory System. Deaths due to these groups showed considerable increases over 1950 and constitute the principal reason for the total increase in deaths for the year. Here again, there is probably much scope for further enquiry into the cause and prevention of these types of illness. There was also a considerable increase over 1950 in the deaths due to bronchitis, and to a lesser degree, to influenza and pneumonia. Accidents. Accidents, apart from motor accidents, accounted for 61 deaths, of which 35 were in persons over the age of sixty-five years. Twelve accident deaths were under the age of 15, and again it should be possible to do much more to reduce the toll from these clearly preventable causes. SECTION B. PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES. Notifiable Infectious Diseases and Deaths during the year 1951. disease Number ol Notifications Number of Deaths Removed to Hospital Number of Cases returned to Registrar General after correction of Diagnosis Cases " coming to knowledge " but not Notified Smallpox (1! - - - - Scarlet Fever 382 (288) —. 104 372 16 Diphtheria 43 (50) 1 42 17 1 Enteric Fever (including Paratyphoid) 2 (7) 1 1 1 - Typhus Fever — (-) - - - - Puerperal Pyrexia 106 (38) - 84 103 35 Ac. Primary & Influenzal Pneumonia 127 (129) 12 1 128 - Ophthalmia Neonatorum 3 (21) - 3 3 _ Acute Encepha litis - (3) 2 - - - Meningococcal 1 nfection 9 (14) - 8 6 - Anthrax - (—) - - - - Dysentery 995 (133) - 124 928 117 Malaria 1 (1) - - 1 - Erysipelas 62 (42) - 15 62 1 Measles 3,199(2,464) 3 107 3,179 45 Whooping Cough 1,068 (772) - 96 4,050 30 Ac. Poliomyelitis 12 (39) - 9 10 Ac. Polioencephalitis - (—) - - - - Food Poisoning 150 (104) - - 148 16 Tuberculosis—Lung 375 (446) 70 - Not Returned - Tuberculosis—Other Forms 43 (43) 8 - do. - Scabies 33 (36) - - 33 85 (Figures in brackets are notifications for 1950) 12 Investigations made in respect of infectious Diseases cases, contacts and etc., by the Sanitary Inspectors and Home Visitors during the year as under :— Smallpox 112 Erysipelas 55 Scarlet Fever 398 Measles 3,230 Diphtheria 69 Whooping Cough 1,033 Enteric Fever (including Paratyphoid) 17 Acute Poliomyelitis & Polioencephalitis 32 Typhus — Food poisoning 101 Meningococcal Infection 15 Scabies 130 Dysentery 793 Vermin 1,010 Malaria 1 Enteritis 17 Ineffective Visits 1,302 Total 8,375 Smallpox. No cases of smallpox were recorded, but visits were paid to 44 smallpox contacts who lived permanently or temporarily in the Borough and who had been in contact, in one instance, with cases which had occurred in an area outside the Borough and, in two other instances, in ships which had passed through the Far East. In a number of other cases visits were paid by the Medical Officer of Health or Deputy Medical Officer of Health to suspect cases on a request by the general practitioner. These cases were not confirmed but such measures constitute part of the precautions which have to be taken when the slightest suspicion of smallpox has arisen. Useful help can now also be given by the Virus Research Department of the Central Public Health Laboratory, Colindale, which has undertaken the examination of pathological specimens in suitable cases. Successful vaccinations :— 1947 3,345 1st January—3rd July, 1948 1,124 5th July—31st December, 1948 702 1949 1,628 1950 2,307 1951 3,291 (Figures from 1948 onwards kindly furnished by Divisional Medical Officer, London County Council.) The Vaccination Acts were rescinded under the National Health Service Act, 1946, as from 5th July, 1948. Certificates of Vaccination and Inoculation—Authentication-Ministry of Health Circular 60/48. During the year the Medical Officer of Health dealt with 77 requests for authentication of International Certificates of Vaccination and Inoculation against smallpox, cholera, typhoid, etc. Measles and Whooping Cough. Measles and Whooping Cough became generally notifiable in London at the end of 1939. Prior to this there was only a limited notification. The number of measles notifications, 3,199 for the year, is the highest recorded in the Borough for any one year. A sharp increase in the measles notifications began in October, 1950, and the notifications increased each month to January, 1951, 879 being notified in this month. Notifications continued at a high level until about 13 the middle of 1951, when the measles cases decreased rapidly and remained low for the rest of the year. Children of different ages were affected as shown in the following table :— Measles, 1951. 5 vears and Under 1 year I—5 years upwards No. of Notifications 166 2,038 995 Percentage of total notifications 5.2 63.7 31.1 No. of Deaths 1 2 — Fatality Rates (per thousand) 6.0 0.98 — It was only in the most exceptional circumstances that measles cases were removed to hospital. Whooping Cough, 1951. The notifications of whooping cough, 1,068, were also higher than the total for 1950 (772). The distribution of whooping cough notifications according to their ages was as follows :— 5 years and Under 1 year 1 —5 years upwards No. of Notifications 96 627 345 Percentage of total notifications 9 58.7 32.3 No. of Deaths — — — It will be noted that 9 per cent, of whooping cough cases were under the age of one year and this is a particularly distressing illness for infants. Fortunately there were no deaths due to whooping cough during the year, but nevertheless both whooping cough and measles may be responsible for long continued respiratory catarrh which may be debilitating to the child for a very considerable period. It is therefore to be expected that many parents will desire to take advantage of whooping cough inoculation, although the benefit from this cannot be so certain at present as in the case of protection against diphtheria. 14 The following chart shows the measles and whooping cough position since 1942 Fatality Rates per 1 ,000 notifications each age group Percentage of notifications (1942—1951) (1942—1951) Under 1 1—5 5 & upwards Under 1 1—5 5 & upwards Measles 8.14 0 .86 — 5.6 58.3 36.1 Whooping Cough 58.55 4.19 — 13.1 61.0 25.9 Over the ten-year period 61 per cent, of all cases of whooping cough and 58.3 per cent, of all cases of measles were in children one to five years of age. Whooping Cough Prophylaxis. Whooping cough immunisation is carried out in the Local Health Authority Clinics and by general practitioners. The Divisional Medical Officer has kindly made available the following information in regard to Islington children :— Whooping cough Prophylaxis Total attendances 934 Completed cases 191 15 London (Measles and Whooping Cough) Regulations, 1938. Home visiting of measles and whooping cough cases was carried out by the Home Visitors as under : — No. of Investigations. No. of Ineffective Measles IVhooping Cough Visits Re-visits 3,226 1,022 614 15 Acute Poliomyelitis and Polioencephalitis. 1951 was fortunately a year with very little poliomyelitis. In general poliomyelitis is associated with long spells of warm, sunny weather and in this respect 1951, particularly the second half, was a poor year. This may have had an effect upon the incidence of poliomyelitis, but our information on this matter at present is too incomplete to dogmatise. The cases reported for each of four years are set out as under:- No. of Cases reported 1951 21 No. of CONFIRMED cases 1950 54 1949 88 1947 52 1951 8 1950 31 1949 62 1947 22 (a) Jan. Feb. Mar Apr May June July Aug. Sept. Oct. Nov. Dec 1951 1 - - 1 1 2 — 2 1 — — 1950 1 - 1 — 2 2 10 10 1 2 2 — 1949 — — — — — — 9 6 17 18 8 4 1947 - - 1 1 - 1 2 6 4 4 3 - (b) Under 1 yr. I — 5— 15— 25 and over 1951 - 2 2 2 2 1950 1 11 12 4 3 1949 3 35 17 2 5 1947 1 6 5 7 3 (r) Deaths—1951—Nil. 1950-2 (6 years 12 years). The onset of the disease of the 6-year-old was in 1949. 1949—2 (2 years 26 years). 1947—3 (10 months 5 years; 24 years). Diphtheria. DIPHTHERIA—CASES AND DEATHS—1926 —1951. Year Notified Cases Deaths Year Notified Cases Deaths Year Notified Cases Confirmed Cases Deaths 1926 743 31 1935 760 13 1944 94 38 2 1927 720 25 1936 583 31 1945 86 45 3 1928 760 25 1937 623 20 1946 137 50 1929 1.008 34 1938 595 23 1947 72 19 1 1930 1.248 42 1939 254 10 1948 44 7 - 1931 714 15 1940 101 2 1949 55 17 2 1932 601 20 1941 174 11 1950 50 19 1 1933 551 33 1942 201 2 1951 43 17 1 1934 815 32 1943 188 9 16 Tt will be noted from the above table that there were 17 cases of diphtheria in the Borough during the year, after correction of diagnosis, and one death. The number of cases of diphtheria is, of course, low as compared with the number who contracted the disease in pre-war years. Nevertheless it will also be noted that there were 19 cases in 1947 and only 7 cases in 1948. In fact, apart from 1948, the number of cases from 1947 onwards disappointingly remained approximately constant. For the purposes of comparison a table has been constructed of the corrected notifications for England and Wales, London and Islington since 1944. DIPHTHERIA CORRECTED NOTIFICATIONS England and Wales London London percentage of England and Wales Islington Islington percentage of London 1944 23,199 758 3.27 38 5.01 1945 18,596 801 4.31 45 5.62 1946 11,986 747 6.23 50 6.69 1947 5,609 451 8.04 19 4.21 1948 3,575 335 9.37 7 2.09 1949 1.881 221 11.75 17 7.69 1950 962 81 8.42 19 23.5 1951 699 30 4.29 17 56.7 Populations : (1951) Percentage—Islington of London 7.02 „ London of England and Wales 7.67 It will be apparent from this table that the percentage of corrected cases in the County of London as compared with England and Wales increased gradually to a maximum in 1949 and reached a figure which was substantially above the proportion of population of London to England and Wales, but the London percentage dropped to a low figure in 1951. Islington, however, occupies a different relative position to London. It will be noted that up to 1948 the Islington percentages of corrected diphtheria cases were consistently lower than the corresponding population percentages in relation to London, and in 1948 there was the remarkably low total of only 7 cases, or 2 per cent, of all London cases. In 1949, the Islington cases increased to 17, or 7.69 per cent, of London cases, but in 1950 and 1951 the London cases fell rapidly whilst the number of Islington cases remained almost constant. The position therefore arose that in 1950 Islington supplied 23.5 per cent, of all London cases and in 1951 it supplied 56.7 per cent., or over half of all the cases of diphtheria in London! On examination of the cases, it appears that in 1949 there were five cases in one family; in 1950 there were again five cases in one family; and in 1951 there were four cases in one family, two cases in a second family, and three cases in a third family. Consecutive large family or group notifications of this character are somewhat unusual and have tended to swell the figures. However, even allowing for this factor, there were still more single diphtheria cases proportionately in Islington in 1951 and 1950 than in the County of London. Islington Outbreaks in 1951. Four members of one family aged two years, three years, fourteen months and twenty-five years respectively, contracted diphtheria about the same time. None 17 was immunised and all eventually recovered. Towards the end of the year there was another outbreak with more tragic consequences. The family involved comprised parents and six children, the eldest nine years old ; the first patient in the family was a seven-year-old boy who was sent into hospital severely ill ; two days later an eight-year-old sister also began to sicken from diphtheria and in another two days a younger sister, five years old, contracted the same illness. The seven-year-old boy unfortunately died within a few days. The eight-year-old sister was also in danger of her life for a time, but recovered after a long illness, the younger sister bad a less severe attack. None of these children was immunised. In the next-door house another child, aged 4|, also sickened about the same time and was diagnosed as a mild case of diphtheria. Three weeks later the elder brother of this child was removed to hospital as a case of diphtheria. Neither of these children was immunised. It is obvious from these outbreaks that diphtheria can still be a source of tragic risk when children are not immunised. Diphtheria and Immunisation. The diphtheria risks for the non-immunised child, as shown in the above report of 1951 outbreaks, are demonstrated more conclusively if the cases are taken over a period of years. From the table below showing the relative diphtheria risks in recent years to immunised and non-immunised children, there seems no reason to doubt that if higher immunisation rates could have been achieved, there would have been fewer cases of diphtheria in Islington in 1950 and 1951. Immunised Non-Immunised Unknown Total Deaths Age Groups Age Groups 0-5 5—15 15+ 0—5 5—15 15 + 1951 1 2 - 8 5 1 - 17 7 vears—Not immunised 1950 — 5 — 3 7 4 10 7 vears—Not immunised 1949 1 3 — 2 8 3 — 17 4 years Not immunised (i years 1948 1 2> 1 1 2 7 Nil 1947 — 5 1 2 4 5 2 19 10 years—Not immunised Totals 3 17 2 16 24 15 2 70 5 deaths (None immunised) 22 55 In comparing diphtheria in immunised and non-immunised children over the five-year period 1947-51, it is probable that over the period, slightly more than half the children under five were in an immunised state, and at least three quarters of the school children. The 24 non-immunised school children who contracted diphtheria, therefore, belong to a group numbering not more than one third of the immunised school children. It therefore seems that over this period, a non-immunised child was about five times more liable to contract diphtheria than an immunised child. Further, of the 79 Islington children who have had diphtheria over the past five years, five have died, and none of these five was immunised. Tliis is in agreement with all previous extensive experience of immunisation in Islington. It has not been possible, in spite of careful records having been kept (although these cannot be quite complete) to trace the death from diphtheria of any child immunised in the Borough who has satisfactorily completed an immunisation course since 1930, I8 With regard to the immunised children who contracted diphtheria, examination of the records shows that in nearly all cases immunisation had been completed three, four or five years previously, and a booster injection at about school entry age might have diminished the subsequent risk still further. The main conclusion to be drawn from this examination is that it would be very premature at this stage to relax our efforts to attain maximum immunisation of children in Islington, and parents who do-not have their children immunised early in life take on a very serious responsibility. No. OF ISLINGTON CHILDREN IMMUNISED AGAINST DIPHTHERIA 1937-1951. 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 281 1,078 525 89 3,261 5,734 6,321 3,165 3,688 3,425 4,563 5,387 3,185 2.604 3,073 Diphtheria Immunisation. Dr. A. B. Stewart, Divisional Medical Officer, London County Council, has kindly supplied the following figures in respect of Islington children for the current year. Under 5 yrs. 5—15 yrs. Estimated proportion of Children Immunised at 31.12.51 56% 95% Total Attendance at all Clinics 12,047 Sessionsheld 362 Average Attendance 33 Number of Children who received Full Course of Immunising— Injections :— Under 5 years 2,723 5—15 years 350 Number of children who were Primary Schick Tested with negative result and therefore did not require immunisation 48 Number of children re-tested with a negative result 489 Number of children Post Schick Tested with a negative result 1.809 Boosting Injections 839 Food Poisoning. 148 cases of food poisoning were notified during the year. The great increase each year in the notifications of food poisoning is shown by the following figures:— Number of notifications received. 1947 7 1948 10 1949 55 1950 104 1951 148 How far this represents a true increase in the amount of food poisoning it is difficult to say, since there is no doubt there is a greater awareness of the possibility of food poisoning both by the public and medical practitioners. As far as is known, none of the notified cases in 1951 suffered from the illness in a dangerous form. In spite of the great increase in the number of notifications it is still probable, however, that there is much mild food poisoning which is not reported because the symptoms do not warrant the patient's attendance for medical advice, 19 In accordance with Circular 2/50 of the Ministry of Health, the following table is given listing the principal outbreaks of food poisoning during the year:— Date No. of Notifications No. of persons served No. of cases reported No. of deaths Food involved and Organisms responsible 2·2·51 14 300+ 14 - Beef stew—unascertainable 1·3·51 - 345 9 - Stewed steak—unascertainable 30·3·51 9 720 11 - Fried fish—unascertainable 11·10·51 1 300 21 - Braised steak—CI. Welchii 24·10·51 - 100 30 - Meat pudding—CI. Welchii It will be noted that in all the above outbreaks the foods thought to be responsible in each case were meat and fish dishes. The most effective preventive measure for outbreaks of this nature is the consumption of all food soon after preparation. It is inadvisable to prepare food, especially meat and fish dishes, a day prior to the food being served—and this procedure is all the more risky in the absence of a refrigerator for storage. Dysentery. The notifications of dysentery in 1951 numbered 995, the highest to be recorded in any one year. In view of the great increase in the number of cases which began to be apparent from December, 1950, onwards, a special enquiry was undertaken in each case and the results carefully recorded and summarised. The great increase in the number of notifications of dysentery continued almost throughout the year, reaching a maximum of 177 in March. Well over 100 cases were also recorded for each of the months of April, May and June, but notifications decreased to 53 in July and gradually fell towards the end of the year to 25 in December. In addition to those cases notified a number of others were discovered during the course of the investigation so that the total number recorded was over 1,100. The notification of dysentery was exceptionally high in Islington—approximately 23 per cent, of all the London cases for the year being notified from this Borough. All cases notified were visited by a Sanitary Inspector or Infectious Disease Visitor and wherever possible, and this occurred in the great majority of cases, examination of stool specimens was arranged with the Archway Group Laboratory for confirmation or otherwise of diagnosis, unless the patient was already attending a Hospital. A diagnosis of dysentery due to Bacillus Sonne was confirmed in 574 cases, and in the early months of the outbreak approximately two-thirds of the cases were confirmed. At the commencement of the outbreak young children at the various day nurseries in the Borough were mainly affected, due no doubt to the accidental introduction of a child carrying the organism, but later families and school children began to be affected. There was close collaboration throughout the year between the Public Health Department and general practitioners, the Archway Group Laboratory, and the Divisional Health organisation of the London County Council. Nearly 50 per cent, of those affected were under the age of five years, with slightly more boys than girls. Over the age of fifteen 213 females were notified as against 89 males, and this is thought to be due to the fact that when a child is ill, it is the elder sister or the mother, or even the grandmother, who undertakes most of the nursing of the child and is, therefore, most likely to be infected through contact with the infectious sick child, 20 There was no evidence in this outbreak that dysentery was spread by food infection, nevertheless all precautions were taken since spread in this manner could not be altogether ruled out. Fourteen cases of dysentery actually occurred in food handlers, that is persons concerned with handling food in food establishments outside their own homes. There were also 61 persons found to be handling food who were contacts, and it was considered advisable in these cases for temporary discontinuance of their work until the risk of their spreading infection unknowingly was no longer present. Where necessary, a certificate was issued enabling a person excluded as a contact, on the advice of the Medical Officer of Health, to claim National Health Insurance benefit on production of the certificate. Very few of the cases were severely ill and no deaths occurred due to dysentery. The great majority were nursed at home and recovered within a fairly short time without complications. In a smaller number of cases, owing to special circumstances, admission to Hospital was arranged. Scabies and Vermin. The number of cases of scabies treated continues to decrease. Benzyl benzoate continues to be the treatment of choice for scabies and proprietory 2 per cent. D.D.T. emulsion for the treatment of verminous heads. Both of these preparations have given extremely satisfactory results for their respective purposes. Complicated cases of scabies and special cases referred by the general practitioners continue to be seen by the Council's consulting dermatologist, Dr. Marre, at the Scabies Clinic, which is held weekly. Treatment for scabies and vermin was carried out at the Public Health Department, Seven Sisters Road (Cleansing Station), as under:— Scabies Vermin Children under 5 years Number treated 18 93 Number of baths given 40 — Number of treatments — 94 L.C.C. Children Number treated 42 864 Number of baths given 180* — Number of treatments — 869 Adults Number treated 70 164 Number of baths given 188* — Number of treatments — 182 Scabies Clinic : A consultant dermatologist is in attendance. Number of Clinics held 52 Number of cases attended 261 Adults 126 Children under 5 years 53 Schoolchildren 82 Diagnosis of cases— 261 Scabies 162 Other conditions 99 Home Visiting. Follow-up home visiting for cases of scabies and vermin was carried out by the Home Visitors of the Cleansing Station as under:— Families Visited Revisits Ineffective Visits Total Scabies 129 1 77 207 Vermin 988* 12 567 1,567 * One case was treated at home, * Baths were given to 21 Scabies and 6 Infectious disease Contacts. 21 Tuberculosis. The rates per thousand population for new cases of pulmonary tuberculosis for the last five years have been— 1947—2·18; 1948—2·34; 1949—2·39; 1950—2·07 ; 1951—1·87. Although there were unfortunately 441 new cases of pulmonary tuberculosis added during the year, there is some satisfaction in the fact that the notification rate for new cases has decreased for the second year in succession since 1949, whereas prior to this there had been continual increases. It may appear contradictory, however, that the total number of cases of tuberculosis on the Register has increased to 2,404 from the corresponding figure of 2,368 for last year. The explanation would appear to be that tuberculosis patients, owing to modern methods of treatment, now have a better expectation of life than previously, as shown by the more spectacular fall in the pulmonary tuberculosis death rate. Therefore, even though the rate for new cases is now falling slightly, the total number of persons suffering from tuberculosis may continue to increase. The importance of this point is that unless the greatest personal precautions are taken, and care exercised by the patients themselves, there may be a temporarily increased possibility of spread through the greater number of patients with positive sputa. There is, therefore, no room for complacency in dealing with this problem. It will be noted from the table of new cases below that out of a total of 220 new cases of tuberculosis of the lungs in women, no less than 146 were between the ages of 15 and 35. This is particularly tragic since this is the period of life when the young woman is either earning her living or looking after a home, possibly with young children. New cases among males were more evenly distributed, but the greatest number in any ten-year period was 56 between the ages of 25 and 35. It is gratifying that the proposal of the North-west Metropolitan Regional Hospital Board, reported in the Annual Report for 1950, to establish a Static Mass Radiography Unit for the Borough almost reached fruition during the year and was actually opened to the public in the early part of 1952. Apart from the value of such a Unit to persons who may be found to be suffering from tuberculosis at an early stage, and the greatly improved prospects of ultimate cure through early detection— there will also be the additional value that such persons who may unknowingly be the means of infecting others will, by accepting early treatment, automatically diminish the possibility of the infection being passed on to others. New Cases and Mortality during 1951. Ages New Cases Deaths Inspiratory Non - Respiratory Respiratory Non - Respiratory M. F. M. F. M. F. M. #] 0— 2 - 1 — 1— 3 12 2 4 — — 1 1 5— 13 9 5 3 — — — 15— 39 78 3 11 1 2 1 — 25— 56 68 3 4 4 3 — — 35— 36 26 - 4 3 4 2 — 45— 26 14 - 3 8 4 — 1 55— 30 11 2 1 17 4 1 — 65 and upwards 16 2 4 - 15 4 1 — Total for all ages 221 220 10 30 49 21 6 2 490 78 22 Rate par 1,000 population— New cases—pulmonary 1.87 non-pulmonary 0.22 Deaths— pulmonary 0.30 non-pulmonary 0.03 Public Health (Tuberculosis) Regulations 1930. The total number of cases of tuberculosis on the Register as at 31st December 1951, was— Pulmonary— Males 1,125 Females 998 Non-Pulmonary—Males 124 Females 157 2,404 Tuberculosis Dispensaries. The Tuberculosis Dispensaries of the Regional Hospital Board continue to function at the Royal Northern and Royal Chest Hospitals, with Dr. J. Wallace Craig as Chest Physician-in-charge. Cases on Dispensary Registers. Pulmonary Non-Pulmonary Total Grand Total Adults Children Adults Children Adults Children Number of definite cases of tuberculosis on Dispensary Registers N. M. F. M. F. M. F. M. F. M. F. M. F. 569 573 50 33 41 55 9 15 610 628 59 48 1,345 S. 503 415 48 49 27 33 13 10 530 448 61 5fl 1,098 at 3lst December, 1951 1072 988 98 82 68 88 25 1140 1076 120 107 2,443 Tuberculosis Care Committees. Although the responsibility for care work has passed under the National Health Service Act, 1946, to the London County Council as the local health authority, the Islington Tuberculosis Care Committee remains in being, working in conjunction with the Islington Chest Clinics at the Royal Northern and Royal Chest Hospitals, and members of the Borough Council and the Medical Officer of Health serve on the Islington Tuberculosis Care Committee and the Divisional Care Committee for the co-ordination of care work in the three Boroughs of Islington, Finsbury and Holborn. Loans of bedding or medical appliances were made to 37 patients ; others have been referred to various organisations for assistance. I am indebted to Dr. A. B. Stewart, Divisional Medical Officer, London County Council, for the 1951 figures in connection with vaccination, diphtheria and whooping cough inoculations, and tuberculosis dispensaries. Bacteriological Examinations. Total Swabs (Diphtheria) 308 Sputum (Tuberculosis) ·68 Faeces (Typhoid) - Blood (Typhoid) - Faeces (Dysentery) 3,585 Faeces (Food poisoning) 99 Swabs (Streptococci) 46 Food (Food poisoning) 25 Swabs (Pertussis) 2 Smears (Variola) 2 Scrapings (Variola) 1 Total 4,136 23 SECTION C SANITARY CIRCUMSTANCES IN THE AREA. During the year under review, the position relative to the maintenance of domestic property continued to cause concern, and more owners found houses uneconomic. In certain cases notices served under the Public Health (London) Act, 1936, were not complied with although abatement orders had been obtained and, in some instances, the owners were proceeded against for non-compliance with such orders. It then became necessary for the Council to implement Housing Act procedure, resulting in the demolition or closing of the whole or part of the houses concerned. In some cases the owners undertook not to re-let until the part concerned or the whole house was made fit for human habitation. Whilst this procedure involved the re-housing of the existing tenants, it did preserve housing accommodation. In other cases, in order to obviate hardship being caused to the occupants, the Council carried out work of an urgent nature although the prospects of being reimbursed were remote. In one case where the basement of a shop owned by the Council was found to be used as a bakehouse contrary to Section 54 of the Factories Act, 1937, legal proceedings were instituted. Upon receipt of an undertaking to transfer the bakehouse to the ground floor, the case was adjourned by the Magistrate until January, 1952. In another case where a notice had been served under Section 54 of the Factories Act, 1937, specifying that the existing certificate of suitability would cease on a certain date, an appeal was lodged and the Magistrate adjourned the case sine die. The Council during the year approved the purchase of a number of Elsan closets which could be loaned to householders, in approved cases, where drainage work was being carried out which necessitated the system being out of action for some time. This scheme proved beneficial in many instances. By virtue of Defence Regulation 62 (B), which came into force in 1940, the provisions of Section 119 of the Public Health (London) Act, 1936, relative to the keeping of swine in any premises within 40 yards of a street or public place, were suspended. On the 1st July, 1951, the Defence Regulations (No.1) Order, which revoked Defence Regulation 62 (B) in so far as it concerned England and Wales, became operative ; thus the situation reverted to that which prevailed pre-war. Section 12 of the Allotments Act, 1950, however, makes a similar provision in respect of hens or rabbits which can still be kept otherwise than by way of trade or business in any place or land, provided no nuisance is caused and they are not kept in such a manner as to be prejudicial to health. The Pet Animals Act, 1951, which was passed during this year, but which comes into force on the 1st April, 1952, provides for the annual licensing of all pet shops. The Rag Flock and Other Filling Materials Act, 1951, which came into force on the 1st November, repealed the Rag Flock Acts, 1911 and 1928, and Section 136 of the Public Health (London) Act, 1936. This important Act requires, inter alia, the registration of premises where filling materials are used, and the licensing of premises where Rag Flock is manufactured or kept. 24 In addition, the Rivers (Prevention of Pollution) Act, 1951, and the Prevention of Damage by Pests (Shipping) Order, 1951, were passed and came into force during the year. The L.C.C. (General Powers) Act, 1951, came into force immediately upon its receiving royal assent on the 1st of August of this year. This Act drastically amended the procedure to be carried out under certain sections of the Public Health (London) Act and substituted for Section 286 a new section dealing with appeals, and added Section 286a. By virtue of this amendment, a person upon whom a notice is served has the right of appeal to a Court of summary jurisdiction on certain grounds, and the notice must specify the provisions of Section 286 and 286a, setting out the grounds of appeal, and the procedure to be adopted. The Public Health Departmant is affected directly by the amendments to the Sections dealing with drainage and sanitary conveniences, and whilst the position relative to the right of appeal is clarified, difficulty has been experienced and hardship caused by virtue of the fact that a notice in respect of a stopped drain stipulates that the owner, or person concerned, has the right of appeal within twenty-one days. This fact can sterilize any action which may be taken in default, until the expiration of this period, and should an appeal be lodged, action is further postponed. Summary of Work done by District Sanitary Inspectors. During the year 52,773 inspections or revisits were made by the District Sanitary Inspectors. In connection with visits to dwelling-houses 57,692 inspections or reinspections of separate lettings were made. Routine Inspections, etc. Houses Inspected (On complaint, etc.) 10,703 do. Separate Lettings in above 16,342 Inspections re Schools 18 do. Licensed Premises 27 do. Hairdressers 2 do. Child Life Protection 6 do. Stables, Manure Pits 5 do. Courts, Mews 4 do. Food Salvage Containers 865 do. Rag and Bone Dealers 4 do. Bombed Sites 121 do. Derelict Buildings 186 do. A.R.P. Shelters, Static Water Tanks 78 do. Fairgrounds, Caravans 2 Nuisances dealt with by Notice 21,898 do. informally 997 Houses Reinspected 25,628 do. Separate Lettings in above 38,790 Other revisits 660 Notices Served—Intimation 6,811 do. Statutory 6,850 Notices Complied with—Intimation 5,034 do. Statutory 5,717 do. By Local Authority in default 89 Land Charge Enquiries dealt with 3,782 25 Requisitioned Properties—Inspected 233 do. Separate Lettings in above 299 do. Reinspected 419 do. Separate Lettings in above 539 National Assistance Act (Section 47).—Aged and Infirm Persons. Cases Investigated 192 Cases revisited 367 Housing Acts. Sections 57/62, etc.—Inspections and Revisits 876 Survey of Areas—Preliminary Investigations 415 Sections 9, 11, 12, etc. 752 do. Separate Lettings in above 801 M iscellaneous. Other Visits or Inspections not specified above 3,362 Non-effective Visits 7,380 Total Nuisances and Contraventions Reported (All sources) 23,386 *Food & Drugs Act, etc.—Week End [Saturday—Sunday) Duty. Retail Shops and Food Purveyors Inspected 110 Street Markets Visited 179 Barrows, Stalls Inspected 178 *See also Section E. Rent and Mortgage Interest Restrictions Acts, 1920 to 1939. Certificates of Disrepair. Applications brought forward from 1950 1 Applications in 1951 86 Total 87 Certificates issued in 1951 82 Applications refused in 1951 4 Balance to 1952 1 Total 87 Clearance Certificates. Applications brought forward from 1950 5 Applications in 1951 55 Total 60 Certificates issued in 1951 42 Applications refused in 1951 17 Balance to 1952 1 Total 60 Public Health (London) Act, 1936—Sections 40 and 109. Consequent upon Notices served by the Sanitary Inspectors under Sections 40 and 109 respectively, of the Public Health (London) Act, 1936, the Council, in pursuance of their powers under this Act to carry out urgent sanitary and drainage work in default, executed work amounting to a total of £1,165. 26 Issue of Licences. The Licensing Officer has provided the following information in respect of the total number of Licences issued for the years 1950 and 1951, together with details of the number of Licences issued in respect of Statutory Notices served by this Department, and the value of the Licences issued is submitted. The total percentage of Licences issued in respect of Statutory Notices was 21 per cent, of the total allocation. No. of Value of l.icences No. of Licences Value of Licences Statutory issued against issued issued Notices issued Statutory Notices £ s. d. £ s. d. 1950 2,823 628,498 13 0 693 135,639 2 5 1951 2,692 628,498 1 11 619 : 132,549 1 II Prosecutions. Public Health (London) Act, 1936 (260 Cases). Failure to comply with Statutory Notices contrary to Section 82. Date Address Magistrate's Decision 5.1.51 27 Barnsbury Street Defendant ordered to pay £3 3s. costs. 11.1.51 5 Thornhill Crescent Defendant ordered to pay £1 1s. costs. do. 100 Offord Road Ordered to abate within 28 days. do. 11 Huntingdon Street Defendant ordered to pay £1 1s. costs. do. 50 Blundell Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 48 Blundell Street Ordered to abate within 28 days. Defendant to pav £1 1s. costs. do. 31 Pemberton Terrace Ordered to abate within 28 days. do. 31 Lowman Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 76 May ton Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 48 Queen Margarets Grove Defendant ordered to pay £ 1 1s. costs. do. 103 Grosvenor Avenue Defendant ordered to pav £ 1 1s. costs. 17.1.51 88 Whadcoat Street (a) Case dismissed. Plaintiffs ordered to pay 20s. costs. do. 88 Whadcoat Street (b) Ordered to abate within 2 days. Defendant to pay £2 2s. costs. do. 88 Whadcoat Street (c) Ordered to abate within 2 days. Defendant to pay £2 2s. costs. (If owner as in (b) above these costs not to be charged). 18.1.51 48 Kingsdown Road Ordered to abate within 56 days. Defendant to pay 20s. costs. do. 10 Boxworth Grove Defendant ordered to pay 20s. costs. 8.2.51 3 Thornhill Crescent Defendant ordered to pay £1 1s. costs. do. 3 Carville Street (a) Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 3 Carville Street (6) Ordered to abate within 21 days. Defendant to pay £1 1s. costs. do. 4 Carville Street Ordered to abate within 28 days. Defendant to pay £ 1 1s costs. do. 87 Andover Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 50 Ferntower Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 29 Goodinge Road Ordered to abate within 28 days. Defendant topay £1 1s. costs. do. 58 Mackenzie Road Ordered to abate within 28 days. do. 3 Pyrland Road Ordered to abate within 42 days. do. 179 Barnsbury Road Ordered to abate within 21 days. Defendant to pay £1 1s. costs. do. 69 Stroud Green Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 12 Gifford Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 21 Corinth Road Ordered to abate within 28 days. do. 41 Lennox Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 54 Baxter Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. 27 Public Health (London) Act, 1930 (260 Cases). Failure to comply with Statutory Notices contrary to Section 82. Date Address Magistrate's Decision 8.2.51 52 Mackenzie Road Ordered to abate within 42 days. do. 81a Hungerford Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 116 St. Johns Way Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 99 Cornwallis Road Ordered to abate within 28 days. do. 7 Ellenborongh Road Ordered to abate within 28 days Defendant to pay £1 1s. costs. do. 56 Bingfield Street Ordered to abate within 28 days. do. 18 Corporation Street Ordered to abate within 28 days. 13.2 61 26 Brewery Road Ordered to abate within 28 days. 8.3.51 6 Hollingsworth Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 67 Cleveland Road Ordered to abate within 28 days. do. 88 Elthorne Road Defendant ordered to pay £ 1 1s. costs. do. 29 Cloudesley Road (a) Defendant ordered to pay 10s. costs. do. 29 Cloudesley Road (b) Defendant ordered to pay £ 1 1s. costs. do. 23 Ferntower Road Defendant ordered to pay 10s. costs. do. 21 Barnsburv Grove Ordered to abate within 28 days. do. 52 Wharfdale Road Ordered to abate within 28 days. Defendant to pay 10s. costs. do. 48 Elizabeth Avenue (a) Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 48 Elizabeth Avenue (b) Ordered to abate within 28 days. Defendant to pay £ 1 1s. costs. do. 48 Elizabeth Avenue (c) Ordered to abate within 28 days. do. 3 Elizabeth Avenue Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 52 St. Pauls Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 36 Charlesworth Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 26 1 Hillmarton Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 74 Thornhill Road Defendant ordered to pay £1 1s. costs 15.3.51 81 Cornwallis Road Fined 40s Detendant ordered to pay £1 1s. costs. 10.4.51 5 Medina Road Ordered to abate within 28 days. do. 32 Almorah Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 98 Elmore Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 13 Elmore Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 82 Elmore Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 42 Ponder Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 28 Brewery Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs do. 2 Mavville Street Defendant to pay £1 1s. costs. do. 96 Prebend Street Ordered to abate within 28 days. do. 10 Coleman Fields Ordered to abate within 28 days. do. 49 Balfe Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 39 Balfe Street Ordered to abate within 14 days. Defendant to pay £1 1s. costs. do. 86 Morton Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 102 Northchurch Road Defendant to pay £1 1s. costs. do. 52 Pooles Park Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 50 Pooles Park Ordered to abate within 28 days. Defendant to pay £1 1s costs. do. 7 Payford Road Ordered to abate within 14 days. Defendant to pay £1 1s. costs. do. 27a Pemberton Gardens Ordered to abate within 28 days. Defendant to pay £1 1s. costs do. 126 Copenhagen Street Defendant to pay £1 costs. do. 62 Lough Road Defendant to pay £1 costs 24.5.51 76 Lough Road Defendant to pay £1 costs. do. 26 Durham Road (a) Defendant to pay £1 1s. costs do. 26 Durham Road (b) Defendant to pay £1 1s. costs. do. 3 Northampton Grove Defendant to pay £1 1s. costs do 49Arlington Avenue Defendant topay £1 1s. costs 28 Public Health (London) Act,1936 (260 Cases). Failure to comply with Statutory Notices contrary to Section 82. Date Address Magistrate's Decision 24.5.5l 36 Ponder Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 31 Alexander Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. Flat 4, 7 Highbury Grange Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 29 Arthur Road Ordered to abate within 28 days. Defendant to pay 10s. 6d. costs. do. 41 Loraine Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 57 Muriel Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 120 Highbury New Park Ordered to abate within 28 days. Defendant to pay £1 1s. costs. 28.6.51 30 Ellington Street Defendant to pay £1 1s. costs. do. 30 Belitha Villas Defendant to pay £1 1s. costs. do. 23 Ponder Street Defendant to pay £1 1s. costs. do. 98 Elmore Street Defendant to pay £1 1s costs. do. 48 Burder Road Defendant to pay £1 1s. costs. do. 23 Burder Road (a) Defendant to pay £1 s. costs. do. 23 Burder Road (b) Defendant to pay £1 1s. costs. do. 25 Burder Road Defendant to pay £1 1s. costs. do. 94 Frederica Street Defendants to pav £1 1s. costs. do. 84 Roman Way (a) Withdrawn. £1 1s. costs awarded against the Council. do. 84 Roman Way (b) Withdrawn. £11s. costs awarded against the Council. do. 69 Cleveland Road Defendant to pav £1 1s. costs. do. 237 Caledonian Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 2 Stanmore Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 68 Goodinge Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 44 Queen Margarets Grove Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 2 Highbury Quadrant Ordered to abate within 28 days. do. 94 Mildmay Road Ordered to abate within 14 davs. do. 96 Elmore Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 88 Elmore Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 32 Mildmay Grove Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 70 Elmore Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 43 Elmore Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 27 Pemberton Gardens Ordered to abate within 28 days. Defendant to pav£1 1s. costs. do. 43 Girldestone Road Ordered to abate within 28 davs. do. 24 Burder Road Ordered to abate within 7 days. Defendant to pav £1 1s. costs. do. 48 Ponder Street (a) Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 48 Ponder Street (b) Ordered to abate within 28 days. Defendant to pay £1 1s. costs do. 9 Hungerford Road Ordered to abate within 28 days. do. 28 Charlesworth Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 222 York Way (a) Ordered to abate within 6 weeks. do. 222 York Way (b) Ordered to abate within 6 weeks. do. 16 Nailour Street Ordered to abate within 28 days. do. 23 Blundell Street Ordered to abate within 28 days. do. 45 Blundell Street Ordered to abate within 28 days. do. 9 Freeling Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 44 Queen Margarets Grove Ordered to abate within 28 days. Defendant to pav £1 1s. costs. do. 23 Mitford Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 25 Mitford Road Ordered to abate within 28 days. Defendant to pav £1 1s. costs. do. 8 Lambton Road Ordered to abate within 6 weeks. 29 Public Health (London) Act, 1936 (260Cases). Failure to comply with Statutory Notices contrary to Section 82. Date Address Magistrate's Decision 26.7.51 31, Lowraan Road (Stat. Notice dated 27.3.51) Ordered to abate within 7 days. Defendant to pay £1 1s. costs. do. 31 Lowman Road (Stat. Notice dated 29.1.51) Ordered to abate within 21 days. Defendant to pay £1 1s costs. do. 35 Boleyn Road Case withdrawn. Defendant to pay £1 1s. costs. do. 33 Boleyn Road Case withdrawn. Defendant to pay £1 1s. costs. do. 44 Luard Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 16 Medina Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 6 Aubert Road Ordered to abate within 14 days. Defendant to pay £1 1s costs. do. 31 Lyon Street Ordered to abate within 28 days. do. 99 Andover Road Case withdrawn. Defendant to pay £1 1s. costs. do. 7 Grange House, Highbury Grange. Case withdrawn. Defendant to pay £1 1s costs. do. 13 Wolsey Road Case withdrawn. Defendant to pay £1 1s. costs do. 50 Pemberton Gardens Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 5 Medina Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. 6.9.51 29 Almorah Road Ordered to abate within 14 days. Defendant to pay £1 1s. costs. do. 36 Almorah Road Ordered to abate within 14 days. Defendant to pay £1 1s. costs. do. 34 Almorah Road Ordered to abate within 14 days. Defendant to pay £1 1s. costs. do. 3 Carville Street Ordered to abate within 14 days. Defendant to pay £1 1s. costs. do. 4 Pemberton Gardens Ordered to abate within 28 days Defendant to pay £2 2s. costs. do. 115 Georges Road Case withdrawn. Defendant to pay £1 1s. costs. do. 21 Rupert Road Ordered to abate within 28 days. Defendant to pay £2 2s. costs. do. 9 Elton Street Ordered to abate within 21 days. Defendant to pay £1 1s. costs. do. 52 Pooles Park Ordered to abate within 21 days. Defendant to pay £2 2s. costs do. 19 Ellenborough Road Case withdrawn. Defendant to pay £1 1s. costs. do. 24 Barnsbury Street Ordered to abate within 28 days. do. 50 Brooksby Street Case withdrawn. Defendant to pay £1 1s. costs. do. 184 Liverpool Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 24 Andover Road Ordered to abate within 21 days. do. 221 Hornsey Road Ordered to abate within 21 days. Defendant to pay £1 1s. costs. do. 23 Wheelwright Street Ordered to abate within 28 days. do. 6 Oldershaw Road Ordered to abate within 28 days. do. 36 Northdown Street Ordered to abate within 14 days. Defendant to pay £2 2s. costs. 4.10.51 7 Ellenborough Road Defendant to pay £1 1s. costs. do. 11 Belitha Villas Ordered to abate within 42 days. Defendant to pay £1 1s. costs. do. 85 Richmond Avenue Defendant to pay £1 1s. costs. do. 93 Frederica Street Ordered to abate within 28 days. do. 47 Eburne Road Defendant to pay £1 1s. costs. do. 86 Pooles Park Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 88 Pooles Park Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 110 Essex Road (a) Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 110 Essex Road (b) Ordered to abate within 28 days. do. 12 Fulbrook Road Defendant to pay £1 1s. costs. do. 385 Hornsey Road Defendant to pay £1 1s. costs. do. 9 Basire Street Ordered to abate within 14 days. 8.11.51 2 Stanmore Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 34 Lyon Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do 69 Pembroke Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs do. 52 Mackenzie Road Defendant ordered to pay £1 1s. costs. do. 33 Ellington Street Ordered to abate within 28 days. Defendant to pay 10s. 6d. costs. 30 Public Health (London) Act, 1936 (260 Cases). Failure to comply with Statutory Notices contrary to Section 82. Date Address Magistrate's Decision 8.11.51 21 Westbourne Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 217 Junction Road Ordered to abate within 14 days. Defendant to pay £1 1s. costs. do. 6 Dagmar House defendant ordered to pay £1 1s. costs. do. 170 Liverpool Road Defendant ordered to pay £1 1s. costs. do 165 Hemingford Road Ordered to abate within 21 days. Defendant to pay £1 1s. costs. do. 11 Huntingdon Street Ordered to abate within 14 days. Defendant to pay £1 1s. costs. 6.12.51 24 Comus Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 9 Hanley Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 49 Blundell Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 60 Goodinge Road (a) Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 60 Goodinge Road (6) Ordered to abate within 28 days. do. 50 Hemingford Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 31 Offord Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 12 Ellenborough Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 26 Durham Road Defendant ordered to pay £1 1s. costs. do. 153a Highbury New Park Defendant ordered to pay £1 1s. costs. do. 119 Grosvenor Avenue. . Defendant ordered to pay £1 1s. costs. Public Health (London) Act, 1936. Failure to comply with Magistrate's Abatement Order. 9.2.51 54 Mackenzie Road Fined £5. Defendant to pay £2 2s. costs. do. 50 Mackenzie Road Fined £2. Defendant to pay £2 2s. costs. 15.2.51 15 Cathcart Hill Fined £10. Defendant ordered to pay £ 1 1s. costs. do. 29 North Road Fined £10. Defendant ordered to pay £1 1s. costs. do. 22 Nailour Street Fined £3. Defendant ordered to pay £1 1s. costs. 22.2.51 82 Andover Road Defendant discharged under the Criminal Justice Act. Ordered to pay £1 1s. costs. 24.5.51 50 Blundell Street Fined £2. Defendant ordered to pay £1 1s. costs. do. 48 Blundell Street Defendant to pay £1 1s. costs. do. 54 Baxter Road Fined £2. Defendant to pay within 28 days. 6.6.51 5 Ellenborough Road Fined 20s. Defendant ordered to pay £2 2s. costs. 28.6.51 99 Cornwallis Road Fined £5. Defendant to pay £1 1s. costs. do. 31 Pemberton Terrace Fined £5. Defendant to pay £1 1s. costs. do. 52 Pooles Park Fined £2. Defendant to pay £1 1s. costs. do. 50 Pooles Park Fined £2. Defendant to pay £1 1s costs 26.7.51 21 Barnsbury Grove Fined £3. Defendant given 14 days to pay. 30.7.51 36 Almorah Road Fined £3. do. 34 Almorah Road Fined £3. do. 32 Almonrah Road Fined £3. do. 29 Almorah Road Fined £3 do. 98 Elmore Street Fined £3. do. 96 Elmore Street Fined £3. do 94 Elmore Street Fined £3. do. 80 Elmore Street Fined £3. do. 43 Elmore Street Fined £3. do 58 Elmore Street Fined /3. do 1 Cleveland Road (Stat. Notice dated 30.6.50) Fined £3. do. 1 Cleveland Road (Stat. Notice dated 10.7.50) Fined £3. do. 23 Elmore Street Fined £3. do. 10 Elmore Street Fined £3. Defendant to pay £15 15s. costs. do. 24 Cleveland Road Fined £3. do. 37 Elmore Street (Stat. Notice dated 3.7.50) Fined £3. do. 37 Elmore Street (Stat. Notice dated 2.8.50) Fined £3. do. 41 Elmore Street Fined £3. do 62 Elmore Street Fined £3. 6.9.51 50 Pooles Park Fined £5. Defendant to pay £2. 2s. costs. do. 52 Pooles Park Fined £10. Defendant to pay £2. 2s. costs. 31 Public Health (London) Act, 1936 Failure to comply with Magistrate's Abatement Order. Date Address Magistrate's Decision 4.10.51 48 Elizabeth Avenue (a) Fined £5. Defendant to pay £1 1s. costs. do. 48 Elizabeth Avenue (b) Fined £5. Defendant to pay £1 1s. costs. do. 48 Elizabeth Avenue (c) Fined £3. Defendant to pay £1 1s costs. do. 52 Wharfdale Road Fined £5. Defendant to pay £1 1s. costs. do. 31 Lowman Road (a) Fined £6. Defendant to pay £1 1s. costs. do. 31 Lowman Road (b) Fined 40s. Defendant to pay £1 1s. costs. do. 31 Lowman Road (c) Fined 20s. Defendent to pay £1 1s. costs. 8. 11.51 237 Caledonian Road Fined £5. Defendant to pay £2 2s. costs. do. 52 Mackenzie Road Fined £3. Defendant to pay £ 1 1s. costs. do. 21 Barnsbury Grove Fined £5. Defendant to pay £1 1s. costs. do. 48 Ponder Street (a) Defendant ordered to pay £2 2s. costs. do. 48 Ponder Street (b) Fined £3. Defendant to pay £1 1s. costs. do. 52 Pooles Park Fined £10. Defendant to pay £2 2s. costs. do. 50 Pooles Park Fined £10. Defendant to pay £2 2s. costs. do. 56 Bingfield Street Fined £2. Defendant to pay £1 1s. costs. 6. 12.51 36 Charlesworth Street Defendant ordered to pay £1 1s. costs. do. 54 Baxter Road Fined £2. Defendant to pay £1 1s. costs Payment to be made within 14 days. do. 16 Nailour Street Fined £2. Defendant to pay £1 1s. costs. do. 23 Blundell Street Fined £2. Defendant to pay £1 1s. costs. do. 45 Blundell Street Fined £2. Defendant to pay £1 1s costs. do. 52 Pooles Park Fined £2. Defendant to pay £1 1s. costs. 10.12.51 30 Freeling Street Defendant ordered to pay £1 1s. costs. L.C.C. Bye-Laws. Date of Hearing Offence Result of Proceedings 13.2.51 Failure to comply with the provisions of:— Bye-Law 12 of the L.C.C. (Drainage) Bye-Laws, 1934, re 77 Frederica Street. Defendants fined £1. Council awarded £1 1s. costs. 8.3.51 Bye-Law 22 as to Lodging Houses for the Working Classes re 39 Huntingdon Street. Work completed. Council awarded £1 1s. costs. 24.5.51 Bye-Law 13 (a) of the Bye-Laws as to Lodging Houses for Working Classes, re 57, Fonthill Road. Defendant Fined 10s. 6.9.51 Bye-Law 14 (e) of the Bye-Laws as to Lodging Houses for Working Classes re 11 Belitha Villas Defendant lined £2. Council awarded £1 1s. costs. 6.9.51 Sec. 12 of the L.C.C. (Drainage) ByeLaws, 1934, re 40 Frederica Street Summons withdrawn 8.11.51 Sec. 12 of the L.C.C. (Drainage) ByeLaws, 1934, re 40 Frederica Street. Case withdrawn. Public Health (London) Ac!, 1936. Failure to comply with Statutory Notices contrary to Section 95. 8.3.51 5 Napier Terrace Ordered to abate within 28 days, pay £1 1s. costs. Defendant to 15.3.51 81 Cornwallis Road Fined 20s. Defendant ordered to pay £1 1s. costs. 19.4.51 86 Morton Road Ordered to abate within 28 days. do. 42 Ponder Street Ordered to abate within 28 days. do. 33 Halse Street Ordered to abate within 28 days, pay £1 1s. costs. Defendant to 24.5.51 10 Halse Street Ordered to abate within 14 days, pay £1 1s. costs. Defendant to 28.6.51 11 Halse Street Ordered to abate within 14 days, pay £1 1s. costs. Defendant to 6.9.51 21 Ward Road Ordered to abate within 21 days, pay £2 2s. costs. Defendant to 6. 12.51 16 Hale Street Defendant ordered to pav £1 1s. cosrs. 32 Disinfection and Disinfestation. The free treatment of rooms and furniture with D.D.T. in recommended cases continued and the number so treated was 461, most of these being on behalf of elderly or infirm persons. A total of 1,635 rooms were disinfested of vermin. During the vear, 1,063 rooms were disinfected after cases of infectious or other diseases. The precautionary spraying of furniture and bedding of families moving to new Council dwellings was continued, and the effects of 120 families were so treated. Cleansing of Verminous Houses Block Disinfestation Scheme. The scheme for systematic block disinfestation approved by the Council in 1950 was implemented during the current year. The scheme was based upon systematic house-to-house and street-by-street inspection, and disinfestation if necessary, in addition to the customary procedure of individual treatment upon complaint, or treatment arising out of casual inspection for other purposes. Charges for treatment offered were at the rate of 7s. 6d. for the first room and 5s. for each additional room. Owing to the great amount of other disinfestation work, it was not possible to implement the scheme to the full extent as originally contemplated. The mode of operation of the scheme was as follows 1. Target Area. An area was selected which it was thought probable would contain a relatively high proportion of infested houses. 2. Visits. Every house in the selected area was visited by the designated Infestation Inspector. Satisfactory inspection on account of no access, or for other reasons, was not possible in a substantial proportion of houses. 3. Delivery of Explanatory Letters. Having ascertained which houses showed signs of infestation, appropriate letters were delivered personally to the occupier, so that the accompanying explanatory talk would assist in obtaining agreement to operate the scheme on a voluntary basis. 4. Disinfestation. This was carried out using 5 per cent. D.D.T. Kerosene spray and 10 per cent. D.D.T. powder. Operators were trained by the specialist Infestation Inspector and personally supervised by him until good proficiency was obtained. 5. Re-Visits. All houses were re-visited where no answer was obtained on the first visit. 6. Re-Inspection of Premises after Disinfestation. It was not practicable within the time to re-visit all treated premises, but a considerable proportion was re-visited and no re-infestations found. 33 7. While the majority of tenants were helpful, re-visits were necessary several times in some cases. It was found necessary to serve Sanitary Notices in some instances. General Observations. Of the 494 houses inspected 147, or approximately 30 per cent., were found to have evidence of vermin infestation. It is doubtful whether more than a very small proportion of these would have come to the notice of the Department by complaint in the absence of the scheme. Apart from this, disinfestation in adjoining houses is much more useful than disinfestation in scattered lettings. In addition certain other infestations were also brought to light, such as a very heavy cockroach infestation which was dealt with separately. Within its limitations, the scheme has proved useful and its continuance was approved. Ashburton Grove Depot—Blowfly Infestation. The infestation of Ashburton Grove Depot and the adjoining railway property has been a serious and regularly recurring summer problem, and during the year under review the Council carried out extensive measures in conjunction with representatives of the Department of Scientific and Industrial Research with a view to finding out the best method of combating this fly nuisance. The blowflies and blowfly maggots are brought in with the refuse from four Boroughs, and the maggots complete their life cycle at the Depot to the extent of millions or tens of millions every season. It, therefore, became a major problem to break the cycle of reproduction at some stage. Experience proved that it was difficult to kill maggots directly in adequate numbers, the principal maggot infestations being in the soil between and immediately adjacent to the railway tracks. Therefore no attempt was made to deal directly with maggots. The technique adopted, therefore, was aimed at covering the whole of the ground with insecticide and keeping it covered by repeated treatments in such quantities as would ensure that whenever the maggots emerged from the ground and hatched into flies there would be sufficient insecticide to be picked up to ensure that the vast majority of newly hatched flies would die from the effects. Arrangements were made with the D.S.I.R. for representatives of that Department to be allocated certain areas for experimental purposes, and it was therefore necessary that these should be carefully avoided by the Council's operators. The insecticide used by the latter consisted of 5 per cent. D.D.T. in powder form, sprayed by powder-blowers which were hand operated. Areas only lightly infested were treated less frequently than the heavily infested portions. One of the Sanitary Inspectors was deputed to supervise this work, and was assisted by two operators. With regard to the frequency of dusting, daily treatment was carried out on one loading bay and the sites used for depositing fish and fruit boxes and broken glass, twice-weekly treatments being carried out on the railway tracks taking much-infested waggons based outside the D.S.I.R. special treatment areas, treatments once-weekly on further tracks, and occasional treatment in certain other areas. During June, the infestation was relatively light, but at the beginning of July the number of flies showed a marked increase, and heavy maggot infestation became 34 more obvious on certain track areas. Certain variations of treatment were made on occasions as the effectiveness of the treatment became apparent during July. The results obtained proved highly satisfactory and the experiment was well worth while. By arrangement with D.S.I.R., future observations will be made in order to ascertain the effect of this treatment in relation to the over-wintering of flies. Thanks are due for the co-operation ,of the Cleansing Superintendent and the representatives of the D.S.I.R. and for all the assistance given in order that the above treatment could be carried out satisfactorily. Treatment of Salvage Bins. Arrangements were made during the year in conjunction with the Cleansing Department, for the treatment with D.D.T. of 50 kitchen waste bins. 11 was proposed to compare the results with a similar number of untreated bins in an adjoining area. It was impossible to commence this work until August, and it was found that heavy infestations of salvage bins were very rare, both in the treated and untreated bins. A few bins were found to be more regularly infested than others, and whether or not the treatment which was being carried out at Ashburton Grove Depot at the same time affected the number of flies found in the bins cannot be proved, but may be regarded as a distinct possibility. Steam Disinfection. 52,986 articles of clothing or bedding were subjected to steam disinfection at the Disinfecting Station (43,990 for clothing contractors). In addition, 121 tons, 12 cwt. 2 qtrs. of material was disinfected for clothing contractors. Public Health (London) Act, 1936—Emission of Smoke. The Council appointed two representatives to serve on the London and Home Counties Smoke Abatement Advisory Council for this year. The position relative to the abatement of smoke nuisances showed an improvement from last year. The factory proprietors and staffs continued to co-operate as much as possible, and there was a decrease in the number of complaints received and the notices required to be served. The Ministry of Fuel and Power continued to assist wherever possible, and thanks are due to the Ministry for the facilities which they have placed at the disposal of the Council in order that complaints of smoke nuisances may be kept to a minimum. Number of complaints received during year 29 Number of observations made 139 Number of inspections and re-visits157 Number of notices served 5 Number of notices complied with 3 WORK OF SANITARY INSPECTORS ADMINISTERING FACTORIES ACT, 1937, FOOD AND DRUGS ACT, 1938, AND OTHER RELEVANT ACTS. Inspections and Re-Visits. 5,825 inspections and 5,120 re-visits were made by the Inspectors, These are summarised as follows;— 35  Inspections Revisits Coffee and dining rooms, hotel and restaurant kitchens and refreshment rooms 1,279 1,047 Stalls (Refreshment and Food) 130 60 Factories (Mechanical) 1,235 1,320 Factories (Non-mechanical) 208 203 Factories (Public Health (London) Act, 1936) 1,228 1,328 Fish curers 33 33 Fish mongers 66 15 Fried Fish Shops 164 83 Noise Nuisances 26 32 Outworkers 305 228 Provisions Shops 286 183 Special Inspections (Food licences) 22 — Bakehouses (Level) 162 127 Confectioners 142 46 Food Factories 14 9 Fruiterers/Greengrocers 271 184 Markets 4 3 Preserved food premises 250 219 5,825 5,120 (See separate section for underground bakehouses and offensive trades.) Defects, nuisances or contraventions found. Nuisances and Notices. (a) Factories Act, 1937. Number of contraventions found 996 Number of contraventions remedied 1,121 Notices served 163 Notices complied with 194 (b) Food and Drugs Act, 1938. Number of contraventions found 2,115 Number of contraventions remedied 2,399 Notices served 361 Notices complied with 417 (c) Public Health (London) Act, 1936. Number of contraventions found 542 Number of contraventions remedied 736 Notices served 235 Notices complied with 264 (d) Shops Act, 1950. Number of inspections under this Act 471 Number of revisits 160 Number of exemption certificates applied for 3 Number of certificates granted 1 Complaints received. Number of complaints (General) 232 Number of complaints (Home Office) 17 Factories Act, 1937. Prescribed particulars on the administration of the Factories Act, 1937. 1.—Inspections for purposes of provisions as to health (including inspections made by Sanitary Inspectors). 36 Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities.. 359 208 20 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 1691 1,265 293 - (iii) Other Premises in which Section 7 is enforced by the Local Authority* (excluding out-workers' premises) - - - Total 2,050 1,473 313 - 2.—Cases in which Defects were Found. Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l) 4 11 - Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — — — Inadequate ventilation (S.4.) 2 1 — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7)— (a) Insufficient 30 25 — - — (6) Unsuitable or defective 944 973 — - — (c) Not separate for sexes 3 10 — — — Other offences against the Act (not including offences relating to Outwork) 12 107 — — — Total 985 1,127 — 2 — * i.e. Electrical Stations (Section 103(1)), Institutions. (Section 104) and sites of Building Operations and Works of Engineering Construction (Sections 107 and 108). 37 Outwork. (Sections 110 and 111). Nature of Work Section 110 Section 111 No. of outworkers in August list required by Sec. 110 (1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions (1) (3) (4) (5) (6) (7) (8) Making, etc. Wearing Cleaning and apparel washing 714 — — - — — Household linen 2 — — — — - Lace, lace curtains and nets 1 - - - - - Curtains and furniture hangings 1 - - - - - Furniture and Uphols- tery 1 - - — — - Electro-plate 1 - - — — - Brass and brass articles 1 - - — — - Umbrellas, etc. 7 - - — — - Artificial flowers 96 - - — — - Paper bags 11 - - - — - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 86 - - - - - Brush making 9 - - — - - Feather sorting 59 - - — - Carding, etc., of buttons, etc. 20 - - — — - Stuffed toys 81 - - — — - Basket making. . 2 - - — — - Cosaques, Christmas crackers, Christmas stockings, etc. 81 - - - - - Textile weaving 5 - - — — - Lampshades 21 - - — — - Total 1,199 - - — — - Factories Act, 1937—Section 7. Sanitary Conveniences. During the year, three applications were received and approved for exemption in respect of the provision of sanitary conveniences, fn addition, one existing approval was determined. Underground Bakehouses. Certificates of suitability continued to be in force pursuant to Section 54 of the Factories Act, 1937, in respect of 31 underground bakehouses. This is a decrease of two since the previous year. Details relative to the existing bakehouses are as follows:— Number of routine inspections 126 Number of re-visits 86 Number of notices served 26 Number of notices complied with 12 38 The two underground bakehouses which have been closed during the year were replaced by a modern level bakery in another part of the Borough. This action reflects credit upon the Company concerned, who have been able to construct up-to-date premises, which satisfy a very high standard of hygiene. Legal Proceedings. Date of Hearing Details of Case Result of Proceedings 12.12.51 An appeal against the Council's decision not to grant an extension of the certificate of suitability re basement bakehouse at 14, Upper Street Hearing adjourned sine die Public Health (London) Act, 1936, L.C.C. (General Powers) Act, 1937, Noise Nuisance. Following complaints being received of alleged noise nuisances, the following action resulted. Number of Inspections 26 Number of Re-visits 32 In one particular case, complaints were received in respect of a noise nuisance occurring at a bakery during night operations due to the loading and unloading of vehicles, the starting of engines, and the throwing of cake trays on to the road from the vehicles concerned. In order to investigate this complaint, it was necessary for the Sanitary Inspector to pay visits and keep the premises under observation from 12 midnight until 3 a.m. The complaint was not substantiated, for the Company and its staff make every effort to minimise noise and no further complaints have been received in respect of these particular premises. Public Health (London) Act, 1936. Offensive Trades. The number of respective offensive trades in the Borough is as follows:— (a) 3 tripe boilers. (b) 1 knacker. (c) 1 fur skin dresser. (d) 6 gut scrapers. (e) 1 fat melter. In addition, the Council approved the establishment of the business of a fat melter or fat extractor at 16, Old Slaughterhouses, Metropolitan Cattle Market, during the year. 263 inspections and visits were made and appropriate action taken where necessary. Shops Act, 1950—Applications for Exemption. There were three applications received for exemption from the provisions of Section 38 relative to the provision of suitable and sufficient sanitary conveniences, and one Certificate of Exemption was issuecl, 30 Pharmacy and Poisons Acts, 1933 41. Number of listed sellers of Part 11 poisons, other than registered pharmacists 201 Number of visits and inspections 67 Number of initial registrations during the year 13 Number of samples taken 4 Number of samples unsatisfactory Nil Arising from a visit paid to a cafe in the Borough in 1950, when the Sanitary Inspector saw a card on which were a number of packets labelled and advertised as "thoroughly recommended by doctors, chemists and nurses, etc.," a sample was submitted to the Public Analyst. It was reported that the contents were aspirin, but that the packets which contained the tablets were not labelled with the proper designation of the contents as required by Section 11 of the Pharmacy and Medicines Act, 1941. Upon the case being heard at the North London Police Court, the defendant was discharged absolutely on payment of £4 4s. costs. The Prevention of Damage by Pests Act, 1949. Details of the work performed by the Rodent Control Section are given as follows:— Number of complaints received 1,584 Number of investigations carried out 3,649 Number of infestations found 2,338 (Comprising 144 business premises, 5 local authority premises, 2,189 dwellings) Number of premises baited 2,303 Number of smoke tests carried out to drains 177 Treatments carried out:— Dwellings 2,189 with 15,020 baits being laid Local Authority premises 5 with 20 baits being laid Business premises 109 with 1,015 baits being laid Post-bait treatments in respect of dwellings and business premises 3,124 with 16,590 baits being laid 5,427 32,645 Number of agreements sent out 124 Number of agreements returned 109 Percentage of ship rats : 0.8 per cent. of the infestations found It is the practice of a number of business firms to deal with their premises by means of their own staff or servicing firms, and where this procedure is adopted, the premises are kept under supervision to ensure that the treatment is satisfactory. During the year, the Prevention of Damage by Pests (Shipping) Order, 1951, came into force, and this Council is affected by virtue of the fact that a portion of the Regent's Canal passes through the Borough. Difficulty continued to be experienced in ridding bombed sites of rats, this being due to a number of causes. It has been found that unsealed outlets of drains situated under these sites is a frequent source of rat trouble. It is also difficult to bait such areas with poison having regard to the easy access to these sites by animals, children and birds. Completely satisfactory results are obtained only when the site is redeveloped. 40 Arising out of an inspection of a baker's shop it was found that the premises were heavily infested by rats. 36 baits were laid, complete takes of bait and poison being obtained. Subsequent post-baiting proved that the infestation was cleared by this single treatment, which is an unusual result considering that in this case the premises were infested by ship rats. Further test-baiting was carried out by representatives of the Ministry of Agriculture and Fisheries which substantiated the fact that the treatment was successful. The firm in question was, however, summoned under Section 3 of the Prevention of Damage by Pests Act, 1949, for failing to give notice on two separate occasions that the premises were rat infested. The Defendant was fined £2 and the Council awarded £2 2s. costs on each of the two summonses. Legal proceedings were also instituted against this Company under the Food and Drugs Act, 1938, details of which are given on page 45. The fact that it is often difficult to trace the source of access to premises by rats is borne out by the experience tl at the Rodent Control Section had at one particular house, where it was necessary for 87 visits to be paid over a total period of some years, and for at least 3 smoke tests to be applied to the drain in order to find the source. Fventually a defective drain was found in the front of the premises, and upon this being repaired, no further trouble has occurred. In another case, a heavy infestation of rats was dealt with in 1948 when a defective drain was relaid. No further trouble was experienced until this year when upon a complaint being received, poison bait was laid as a result of which 131 rats were removed from under the floor by the Rodent Operator. It was eventually found that the disused gully branch connected to the sewer had not been sealed. After the sealing of this opening, no further trouble was experienced. Sewer Treatments. Treatments in respect of the Council's sewers were carried out on two occasions during the year, and in this connection the co-operation of the Borough Engineer and his staff was appreciated. 21st May to 31st May, 1951. Manholes Baited Pre-Bait Bodies seen Percentage of poison takes Estimated kill Complete takes Takes No Takes CTs PTs NT 752 283 462 290 11 10.5% 83.2% 6.3% 4,335 3rd December to 13th December, 1951. Manholes Baited Pre-Bait Bodies seen Percentage of poison takes Estimated kill Complete takes Takes No. Takes CTs PTs NT 773 292 519 254 11 5.78% 87.22% 7% 4,567 41 Water Supplies. The Metropolitan Water Board is responsible for the supply of water to this Borough, and samples were taken for chemical and bacteriological examination as detailed below, all of which were reported to be satisfactory. The co-operation of the Metropolitan Water Board and its Officers is appreciated. There are 28 bore holes or wells known to exist in the Borough, 18 of which have been abandoned and effectively sealed. Of he remaining 10, 6 were temporarily out of commission during the year. Samples of the water for chemical and bacteriological examinations were taken from the 4 at present in use, and from the results obtained, no exception could be taken to the use of the water for domestic or washing purposes. None of the water from this source is used for dietetic purposes, and it is therefore considered that the position relative to underground water in the Borough is satisfactory. The following samples were taken:— Mains Supply. Satisfactory U nsatisfactory Chemical Bacteriological Chemical Bacteriological Chemical Bacteriological 4 5 4 5 — — Well Water. Satisfactory Unsatisfactory Chemical Bacteriological Chemical Bacteriological Chemical Bacteriological 6 7 6 7 — — Swimming Bath Water. Satisfactory U nsatisfactory Chemical Bacteriological Chemical Bacteriological Chemical Bacteriological 3 3 3 3 — — Requisitioned Property. Requisitioned property continued to be inspected in order to ensure, wherever practicable, compliance with the statutory requirements. In a number of cases it was considered that the properties were uneconomic and the approval of the Ministry was obtained for their de-requisition. The number of requisitioned properties existing on 1st January was l,436 and the number taken out of requisition during the year was 67. SECTION D. HOUSING. The situation relative to the repair and maintenance of the housing in the Borough continued to cause considerable concern to the Council, the majority of dwellings in Islington being old, and having suffered considerably from the effects of war-time conditions. 42 Owners continued to find that certain houses are uneconomic, and notices served under the Public Health (London) Act, 1936, did not always result in the work being carried out in order to keep such premises free from nuisance. In certain instances where owners have abandoned property, legal proceedings did not always result in the abatement of nuisances, even where prosecutions have been taken out for failing to comply with an abatement order. It is then necessary to consider the representation of such property under Section 11 or 12 of the Housing Act, 1936, for closure or demolition as appropriate. Numerous examples of such cases could be given, but those of 3 contiguous properties are typical, details of which are as follows:— (1) (2) (3) £ £ £ Estimated cost of works required at each house 770 605 572 War Damage repairs 303 228 261 Improvements 17 17 17 £1,090 £850 £850 The estimated cost of demolition, clearing the site, erecting, shoring and rendering exposed flank walls—£450. The Council's Valuers' Valuation for the freehold in the open market after the execution of the works at the above-mentioned cost with the statutory tenancies continuing £300 £300 £225 It will be obvious that such properties fall outside the provisions of Section 9 of the Housing Act, 1936, and can only be dealt with by demolition procedure. Such cases could be multiplied, and in view of the condition of properties in the Borough, it is anticipated that the housing situation in Islington will deteriorate for some time to come. Much of the property should be cleared and the sites redeveloped, but owing to the general housing situation it has not been possible to initiate slum clearance procedure on a major scale. Agreement has, however, been reached with the London County Council in respect of a slum clearance programme extending over a number of years. Certain of the Sanitary Inspectors were engaged during the year on a survey of Whadcoat Street, and preliminary steps were taken with a view to representing that portion of the street situated between Biggerstaff Street and Lennox Road under Part III of the Housing Act, 1936, as a clearance area. The total number of houses is 38, occupied by 87 families with a total of 271 occupants. Re-housing. The number of new applications (L.C.C.) referred to this Department during year 1,726 The number of above families living in overcrowded conditions 522 The number of above families not living in overcrowded conditions 246 43 The number of overcrowded families re-housed by the L.C.C. during year 284 The number of overcrowded families re-housed by the Islington Borough Council during year 139 (In addition, a number of families have been re-housed from sites acquired for redevelopment in connection with the Council's Housing Schemes. Further families have been re-housed from properties in respect of which Closing or Demolition Orders have been made.) The total number of letters sent concerning housing conditions during year 2,699 The number of dwellings erected by this Council during year 198 The number of dwellings in the course of erection at end of year by this Council 320 During the year the following action was taken under the Housing Act, 1936:— Section Number of Dwellings represented 9 1 11 (unfit houses) 34 12 (parts of buildings) — 12 (underground rooms) 16 Total 51 Resulting from these and previous representations and like proceedings during the year the following action was taken:— Section Action Number of Dwellings 11 Demolition orders 10 11 Undertakings accepted 1 12 Closing orders made 7 (15 underground rooms) 12 Undertakings accepted 5 (This figure includes 12 basement rooms). 12 Closing order made 1 (Fart of dwelling) Total 24 Sec. 11 Sec. 12 Undertaking cancelled upon completion of the necessary work 1 5 Number of dwellings erected by the Council during the year ... ... 198 Licences Authorising Temporary Overcrowding. Four licences were granted under Section 61 of the Housing Act, 1936, authorising overcrowding; one for a period of six months and three for a period of one year. In two cases these constituted renewals of licences which had expired, and the total number of dwellings affected was, therefore, two. Hostels. In Islington, as in other Metropolitan Boroughs, there are a number of hostels where it has been found that the conditions existing were unsatisfactory from certain aspects, e.g., an excess number of beds in a common sleeping room 44 or dormitory, inadequate sanitary accommodation, etc. These hostels, however, fall outside of existing legislation and such premises do not comprise common lodging houses and do not come within the scope of the Lodging House or Tenement House Byelaws. These hostels vary in size, some apparently having no more than six lodgers, and others up to fifty. There are a number which are occupied by lodgers of both sexes. Certain hostels appear to cater particularly for Colonial residents and trainees from West Africa, and others provide for Irish labourers. It is considered desirable in the interests of public health that there should be a greater measure of control and supervision over hostels in the Borough. SECTION E. SUPERVISION OF FOOD. Complaints continue to be received in respect of "foreign" bodies in food, the majority of which are bona fide. Following complaints received and the observations of the Inspectors concerned, it was considered that horse-flesh was being prepared for human consumption and sold in a number of restaurants and other catering establishments in the Borough in contravention of Section 38 of the Food and Drugs Act, 1938. In two cases the proprietors were successfully prosecuted. In the circumstances, the Council circularised all catering establishments and butchers in the area, drawing attention to the provision of the appropriate section of the Food and Drugs Act. The Report of the Catering Trades Working Party on hygiene in catering establishments was issued during the year by the Ministry of Food. The Working Party was appointed by the Ministry in November, 1948, to make recommendations as to the observance of sanitary and cleanly conditions in the catering trade. The findings and recommendations of the Working Party are important, and it is hoped that the Minister of Food will in due course issue directions to local Food and Drugs Authorities which will be based on recommendations included in this report. It is felt that such directions will substantially support the work of the respective authorities and eventually ensure that food is prepared, stored and sold under more hygienic conditions. Coupled with any such directions from the Ministry of Food should be a scheme for the education of personnel engaged in the catering industry, for it has been found that the personal supervision of the Sanitary Inspector is more effective than a set of rules which may only be respected during the Inspector's visit or whilst the employee is under supervision. The report of the Inter-Departmental Committee of Meat Inspection was also issued by the Ministry of Food during the year under review. The terms of reference applicable to this Committee included: "(i) to review the memorandum on a system of meat inspection known as Memo. 62/Foods; (ii) to consider whether Memo. 62/Foods, revised as necessary, should be given statutory authority in new Food Regulations superseding the Public Health (Meat) Regulations, 1924 to 1948, for England and Wales and corresponding legislation for Scotland; 45 (iii) to consider whether ins ection of home-killed meat at the place of slaughter can be made compulsory in England and Wales as it already is in Scotland, and whether this requires any further statutory authority ; (iv) to consider whether the Public Health (Meat) Regulations, 1924 to 1948, require revision in any other respects; (v) to consider the qualifications of those at present engaged in meat inspection and the qualifications which should be required of those so engaged and the facilities for their training; (vi) to consider the existing requirements, and methods of operation, as regards imported meat under the Public Health (Imported Food) Regulations, 1937 and 1948; and to make recommendations to the Minister of Food." In this connection, concern is felt in respect of the transport of meat from the markets to the retailers. The construction and the interior of the bodies of vehicles used in the transport of meat leave much to be desired, and do not lend themselves in many instances to the clean, hygienic handling of this commodity. It is impossible at present, owing to the supply position, to replace the existing unsatisfactory vans by more modern ones, but it is hoped that as the situation eases, the older vehicles will cease to operate. Following an application for the issue of export certificates to the U.S.A. of meat and meat products manufactured by a firm in the Borough, arrangements were • made by the Council for the Medical Officer of Health to act as certifying officer for the purpose of issuing such certificates. Food and Drugs Act, 1938. Prosecutions. Details of the action taken by the Council under the Food and Drugs Act, 1938, are as follows:— Date of Hearing Offence Result of Proceedings 1951 March 15 Selling food, namely rice, not of the quality demanded contrary to Sec. 3 of the Act. Not separately dealt with (see next case) March 15 Selling food, namely rice, not of the quality demanded, contrary to Sec. 9 of the Act. Defendant lined £5. Council awarded £2 2s. 0d. costs. March 15 Selling food, namely toffee, unfit for human consumption contrary to Sec. 3 of the Act. Not separately dealt with (see next case) March 15 Selling food, namely toffee, unfit for human consumption, contrary to Sec. 9 of the Act. Defendant fined £5. Council awarded £2 2s. 0d. costs. April 18 *Failing to prevent risk of contamination of food on 22.1.51. Defendant fined £15. Council awarded £5 5s. 0d. costs. April 18 *Failing to prevent risk of contamination of food on 2.2.51. Defendant fined £15. Council awarded £5 5s. 0d. costs. April 18 Possessing horseflesh for sale without exhibiting the necessary notice. Defendant fined £3. Council awarded £2 2s. 0d. costs. April 18 Sale of meat which was not of the nature demanded. Case not separately dealt with (see above) April 18 Selling food, namely bread, not of the nature demanded, contrary to Sec. 3 of the Act. Defendant discharged absolutely. Council awarded £3 3s. 0d. costs. 46 Date of Hearing Offence Result of Proceedings April 18 Selling food, namely bread, intended for, but unfit for, human consumption, contrary to Sec. 9 of the Act. Not separately dealt with (see case above' May 18 Selling Food, namely ground cinnamon, not of the quality demanded. Defendant fined {1. Council awarded £2 2s. 0d. costs. May 23 Selling food, namely meat, not of the nature demanded, contrary to Sec. 3 of the Act. Case dismissed.(see next case) May 23 Possessing horseflesh for sale without exhibiting the necessary notice. Defendant fined £5. Council awarded £5 5s 0d. costs. Aug. 3 Selling food, namely wafer biscuits and cornets, unfit for human consumption. Council awarded £4 4s.0d. costs. Aug. 3 Selling food, namely an Eccles cake, not of the quality demanded. Council awarded £5 5s. 0d. costs. * Action in regard to premises in question also taken under Prevention of Damage by Pests Act, 1949. Unsound Food. The total amount of food condemned during the year was:— 64 tons, 1 cwt., 1 qr., 11 lbs. details of which are given in the following table:— Tons Cwts. Qtrs Stones | Lbs. Ozs. Tinned Goods 57 9 2 - 3 - Fish 1 2 - 1 13 — Meat - 4 2 - - 4 Others 5 4 3 - 8 12 Total 64 1 1 - 11 - Number of condemnation certificates issued was 2,010. Most of the above food was condemned upon request by the respective owners Sampling. 861 samples (254 formal, 607 informal) were submitted to the Public Analyst for examination. Of these 26 (or 3 per cent.) were adulterated as shown in the following summarv:— Formal Beef sausages 1 Ground Cinnamon 1 Curry Powder 1 Beef 2 Milk 4 Tonic Wine 1 Anti-Gastric Mixture 1 11 Informal Roast Meat 1 Bread 3 Ground Cinnamon 1 Curry Powder 1 Cream Cake 1 Tonic Wine 1 Anti-Gastric Mixture 1 Banbury Cake 1 Wafer Biscuits 1 Canned Cherries 2 Chocolate Cake 1 Christmas Pudding 1 15 47 Of the formal samples, the four adulterated milk samples were deficient in fat; the beef sausages were 24 per cent. deficient in meat ; ground cinnamon and curry powder contained an excess of lead, 200 and 16 parts per million respectively; the two beef samples were found on ex mination to be horseflesh, while the tonic wine contained no tonic ingredient. The Anti-Gastric Mixture was not labelled with a statement of the ingredients. Meat and Other Foods. The owners of 4 private slaughterhouses renewed their licences. Owing to the Government scheme of centralised slaughtering, none of these premises was used during the year. The Metropolitan Cattle Market, which is under the control of the Ministry of Food, was visited on seven occasions by the Sanitary Inspector for the purpose of inspecting imported and other meat. One slaughterhouse for horses was licensed. Slaughtermen's Licences. 18 renewals of existing licences and 2 new licences were issued during the year. Inspection of Refreshment and Coffee Stalls. The evening inspection of refreshment and coffee stalls, which are usually open after normal working hours, was continued and during the year the Inspectors carried out eight inspections. The general conditions prevailing at these stalls continued to be satisfactory. Free Washing Facilities in Public Conveniences. The Council continued to provide free washing facilities in public conveniences in order to encourage cleanliness amongst food handlers and, particularly, street traders who have no convenient personal facilities. The following table given through the courtesy of the Cleansing Superintendent provides details of the weekly average number of persons who availed themselves of the Council's facilities, and it is encouraging to note that in the main, the number of persons taking advantage of these facilities has increased from last year. Lavatory Jan Feb. Mar. Apr. May Jun. July Aug. Sep. Oct. Nov. Dec. Approx. weekly average through out year Archway Rd.— Men 37 43 34 36 33 59 58 52 45 46 37 32 43 Women 26 20 22 24 45 45 45 34 27 32 29 21 31 FinsburvPk.— Men 36 34 45 48 60 64 72 63 75 72 62 68 58 Women 2 4 15 4 9 12 24 28 12 9 8 9 11 ParkhurstRd.— Men 34 34 40 42 45 34 40 32 44 38 32 38 38 Women 15 8 13 12 13 8 17 17 17 16 16 17 14 Highbury Men 19 18 16 19 28 23 28 35 27 35 25 25 25 Women 1 1 6 3 7 4 4 2 2 1 5 6 4 Offord Rd.— Men 9 12 10 10 9 14 18 24 28 18 16 10 15 Women 2 4 3 3 3 3 4 3 3 4 4 4 3 High St.— Men 24 21 18 22 24 23 33 27 22 28 29 15 26 Islington Gr.— Women 6 4 7 10 7 7 9 4 10 10 8 7 7 211 203 229 233 283 296 352 321 312 309 271 272 - 48 ICE CREAM. Ice Cream (Heat Treatment, etc.) Regulations, 1947-51. Supervision of the Manufacture and Distribution of Ice-Cream. On March 1st of this year, the Ice Cream (Heat Treatment, etc.) Amendment Regulations, 1951, came into force by virtue of which the installation of thermometers as required by Regulation 3 (b) (iv) became obligatory. This is a welcome addition to the previous existing requirements, the implementation of which should prove of great assistance to the manufacturers of ice cream and to the Inspectors concerned in ensuring that a satisfactory product is distributed. The Council is now able to require such indicating and recording thermometers as it is considered requisite for indicating and recording the temperatures to or at which the mixture is raised, kept or reduced, and the records of any such thermometers are required to be preserved for a period of not less than one month. Another welcome addition is the Food Standards (Ice-Cream) Order, 1951, which also became operative on 1st March. This Order provides that Ice Cream shall not contain less than 5 per cent. fat, 10 per cent. sugar and 7½ per cent. milk solids other than fat. Ice cream containing any fruit, fruit pulp or fruit puree shall either conform to the standard aforementioned or, alternatively, the total content of fat, sugar and milk solids other than fat shall be not less than 25 per cent. of the ice cream, including the fruit, fruit pulp or fruit puree, and such a total content of fat, sugar and milk solids other than fat shall include not less than 1½ per cent. fat, 10 per cent. sugar and 2 per cent. milk solids other than fat. The Minister of Food states that it is intended that the standard shall apply to any products (including those supplied in catering establishments) which are sold as "ice cream" or "ices" including products where either of these descriptions is qualified by the mention of a flavour, such as "coffee ice." The standard is not intended to apply to water ices sold as such, or to " ice lollies." The Minister, however, regards the standard as an interim one which he proposes progressively to improve as supplies of ingredients become more plentiful. From samples taken subsequent to the Order coming into force, it has been observed that much of the ice cream sold in the Borough is above the standards prescribed in the Order. During the year 443 visits were paid to ice cream premises. The number of premises registered:— (a) For the manufacture/sale/storage 92 (b) For sale and storage 151 (c) For sale only 236 (d) For storage only 5 484 Bacteriological Examination. 135 samples of ice cream were sent for bacteriological examination. 49 The gradings of those submitted to the Methylene Blue Test were reported to be as follows: Grade I 49 Grade II 37 Grade III 27 Grade IV 20 133 Samples graded in I and II of the Methylene Blue Test are considered satisfactory but samples graded in III and IV unsatisfactory. The remaining two samples were satisfactory. In addition 42 samples of Ice Lollies were examined bacteriologically and all were reported to be satisfactory. Chemical Examination. 12 samples of Ice Cream were submitted for chemical analysis, none of which was reported to be unsatisfactory. The fat contents of these samples were as follows:— Fat Content Less Than— 7% 8% 9% 10% 11% 12% 16% 1 2 2 4 1 1 1 2 Ice Lolly samples were also submitted for chemical analysis and no objection could be taken to the results obtained. MILK. The Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, came into operation on 1st January this year. Pursuant to Section 23 of this Act, the Minister of Food issued the Milk (Special Designations) (Specified Areas) Order, 1951, which came into force on 1st October. From this date it became illegal for any person to sell by retail for human consumption any milk other than milk which may be sold as specially designated milk in accordance with the provisions of the respective regulations, 1949, and all retailers selling milk in the areas specified, whether or not their premises are situated in any such area, are required to be licensed by this Council to use a special designation in relation to the milk sold by them. All milk therefore, now sold by retail in the Borough must be special designated milk, namely sterilised, pasteurised, tuberculin tested or accredited milk from a single herd. In the past, premises where loose milk was sold or bottled were registered as Dairies, but consequent upon the introduction of milk in sealed containers, many of the original dairies ceased to trade in loose milk. In view of this fact, the majority of dairy registrations have been cancelled, and re-registered as distributors. The number of dairies in the Borough at the beginning of the year was 121, but on the 31st December there were only 45 dairies on the register. 50 Cream. The Food Standards (Cream) Order, 1951, which came into force on the 30th April, provides a standard for cream. As and from that date, no cream, whether described as cream, single cream, pouring cream, coffee cream, fruit cream or as any other description of cream, shall contain less than 18 per cent. by weight of milk fat ; no sterilised cream shall contain less than 23 per cent. by weight of milk fat ; and no double cream or thick cream shall contain less than 48 per cent. by weight of milk fat. This Order applies equally to home-produced or imported cream and includes cream sold by catering establishments. The Cream Order, 1951, however, prohibited the manufacture of fresh and sterilised cream after June 30th, and the sale of cream and the serving of cream by catering establishments after July 2nd. Milk Samples. The total number of samples taken during 1951 was 672. Samples submitted for Chemical Analysis:— Genuine A dullerated Total Formal 241 4 245 Informal 112 — 112 Grand Total 357 Samples submitted for Bacteriological Examination:— Class of Milk Results Phosphatase Methylene blue Turbidity Total No. of Samples Pasteurised Satisfactory 230 *221 - 235 Unsatisfactory 6 12 Sterilised Satisfactory - - 62 65 Unsatisfactory — — 3 Tuberculin Tested Satisfactory 15 15 15 (Pasteurised) Unsatisfactory — Total 315 * 2 Samples not sent for Methylene Blue Test. During the year 8 animal inoculations were carried out for tuberculosis tests. All were negative. The milks tested were:— Tuberculin Tested Raw 1 Pasteurised 7 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, and Milk (Special Designation) (Raw Milk) Regulations, 1949. The number of dairies and milk shops inspected 155 The following licences were granted:— 51 Pasteurising Establishment 1 Pasteurised 192 Pasteurised (supplementary) 22 Tuberculin Tested 105 Tuberculin Tested (supplementary) 21 Sterilised 248 Sterilised (supplementary) 23 Accredited (supplementary) Nil 612 Milk and Dairies Regulations, 1949. Number of Dairies Registered in the Borough 45 Number of Distributors registered in the Borough 351 Number of Registered Distributors dealing from registered premises outside the Borough 24 Number of Pasteurisers 1 Summary of visits by Inspectors. Dairies—Routine Inspections 103 Miscellaneous visits 521 Milkshops—(Milk sold in sealed containers only)— Routine Inspections 147 Miscellaneous visits 232 Vehicles Inspected 117 Dairies and Milkshops—Inspections re special designated milk 155 Total number of inspections and miscellaneous visits 1,275 Number of Notices served lfi Diseases of Animals Acts. During the year under review, there occurred an outbreak of foot and mouth disease which brought this Borough within the infected area. As the Authority for the administration of the Diseases of Animals Act is the L.C.C., the work of this Department was not affected. SECTION F—MISCELLANEOUS SERVICES. Health Publicity. The campaign of health publicity was continued throughout the year by means of display of posters at, and distribution of leaflets from, various Council buildings throughout the Borough. Further film shows were also organised—6 throughout the year in different parts of the Borough—and in order to encourage the attendance of the general public at these shows, the Public Health Committee agreed to the booking of a feature film to supplement each programme. This venture has achieved great success and since its introduction the film shows have attracted capacity audiences. On each occasion the programme has been introduced by a member of the Public Health Committee and the audience addressed by the Medical Officer of Health or his Deputy. 52 During the year a number of talks on health subjects were given by the Deputy Medical Officer of Health to local organisations. Health Films Exhibited. The Good Housewife in her Kitchen. Defeat Diphtheria. Stanley Takes a Trip. Why Won't Tommy Eat ? Here's Health. The Nose Has It. Unwanted Guests. Your Children and You. Old Wives' Tales. Teeth are to keep. Your Children's Meals. Your Very Good Health. Unseen Enemy. Insects as Carriers of Disease. Your Children's Sleep. Cleanliness Brings Health. Transmission of Disease. Behind the Menu. National Assistance Act, 1948, Section 47. The authority of the Public Health Committee was obtained in five instances under this Section for Court proceedings to be instituted, as necessary, with a view to Orders being made for the detention and maintenance in suitable premises for periods not exceeding three months in regard to persons who (a) were suffering from grave chronic disease, or being aged, infirm or physically incapacitated were living in insanitary conditions and (b) were unable to devote to themselves, and were not receiving from any other persons proper care and attention. In only one instance, however, was it necessary to obtain an Order from the Court (after giving interested parties seven clear days' notice); the other cases being dealt With by voluntary admission to a Welfare Home, or being subject to a postponement action. Details of the Court case are as follows:— Name Reasons for Council's Action Period named in Court Order Type of accommodation to which Removed Ultimate Result Mrs. H. (86 years) Mrs. H., a registered blind person, was living in most insanitary conditions and although she had also a blind daughter, aged 66, residing with her, offers of home-help assistance or accommodation in a L.C.C. welfare home were refused. Not more than three months L.C.C. Welfare Home in the Borough. Mrs. H. was removed to this home on an Order under Section 47 of this Act. The blind daughter accompanied her mother at her own request. In addition to the above I found it necessary personally to invoke the procedure for an immediate removal to be effected, upon certification by a Magistrate, under the powers contained in the National Assistance (Amendment) Act, 1951. 53 The details are as follows :- Name Reasons for Council's Action Period Named in Court Order Type of accommodation to which Removed Ultimate Result Mrs. M. (84 years) Mrs. M. lived alone in a house which was her own property. A friend did shopping. Although seriously ill, Mrs. M. would not leave home for reasons of sentiment. The premises were insanitary and there was also a considerable risk of fire owing to extensive accumulations of paper and miscellaneous articles about the house. Three weeks Local General Hospital. After hospital treatment this patient went to a convalescent home in the Hospital Group She liked the surroundings and was reluctant to leave to enter a private home for aged persons. The number of old people who were brought to the notice of the Public Health Department during the year as being in possible need of attention and assistance was very much greater—192 cases of old persons having been investigated by the Officers of the Department, and 367 repeat visits were paid. It will therefore be seen that although only a very small proportion of old persons had eventually to be dealt with under Section 47 of the National Assistance Act, the amount of work done by the Department arising out of alleged unsatisfactory conditions of old people was quite considerable. National Assistance Act, 1948, Section 31. Under this Section of the Act, which permits local authorities to make contributions to the funds of any voluntary organisation whose activities include the provision of recreation or meals for old people, the Council last year approved a grant to the Women's Voluntary Services to enable the W.V.S. to set up a "Meals-on-Wheels" service. Hot mid-day meals were to be supplied on the recommendation of the Medical Officer of Health, after enquiry, for old people, and particularly those having difficulty in leaving their own homes to get a meal or make purchases of provisions. Information regarding possible recipients was obtained from many sources, including Medical practitioners, District Nursing and Family Welfare Association workers, National Assistance and Local Health Department Officers, and Voluntary Organisations. During the year, which was the first operative year for this service, the number of meals supplied, etc., are given in the following table:— Total number of names brought to the notice of the Department 456 Number recommended to W.V.S. 355 Number of meals delivered during the year 3,532 Weekly average 68 The Council also gave some assistance to old people's Clubs for the provision of meals on the Clubs' premises. Public Mortuary. By agreement with the St. Pancras Borough Council the use of the Council's Mortuary was discontinued as and from 31st March, 1949, all bodies being received at the St. Pancras Mortuary, Camley Street, N.W.1, after that date. 54 Islington Crematorium. There were 180 cremations during the year at the Council's Crematorium. East Finchley, all of which were certified by the Medical Referee or Deputy Medical Referee. The Crematorium was closed for three months for repairs. Maternity and Child Welfare Services. The Maternity and Child Welfare Services are, of course, the responsibility of the London County Council as the Local Health Authority. Islington is included in Division 3 of the L.C.C. Services and I am indebted to Dr. A. B. Stewart, Divisional Medical Officer for the information given below in respect of these services:— Welfare Centres. Welfare Centre Children's Ante-Natal and Post-Natal Immunisation Dental Vaccination North Islington V oluntary Welfare Centre, 6-9, Manor Gardens, N.7. Mon. to Fri. 1.45 p.m. Wed. 1.45 p.m. Thes Thurs.} 9.3. am Tues. 9 a.m. & 2.45 p.m. Tues. 11.15 a.m. North Branch Clinic. Blythe Mansions, Hornsey Rise, N.19. Fri. 1.45 p.m. Mon. 1.45 p.m. North Branch Clinic. Newcourt Church Hall, Tollington Pk., N.4. Wed. 1.45 p.m. West Islington Welfare Centre. 42 ft 44. Richmond Avenue, N.1. Mon., Wed. & Fri. 1.30 p.m. Tues. 9.45 a.m. Tues. 1.30 p.m. Thurs. 9.45 a.m. W ed. 10.30 a.m. Fri. 9.30 a.m. West Branch Clinic, St. Luke's Mission Hall, Goodinge Road, N.7. Thurs. 11 a.m. & 1.30 p.m South Islington Welfare Centre, Tibberton Square, Essex Road, N.1. Mon. 1.30 p.m. Wed. 1.30 p.m. Thurs. 9.30 a.m. & 1.30 p.m Mon. 9.3o a.m. Fri. 9.30 a.m. & 1.30 p.m. 10.0 a.m. Tues. and 2.0 p.m. South Branch Clinic, Union Chapel, Compton Avenue, N.1. Mon. 1.30 p.m. Tues. 9.30 a.m. Tues. 2.0 p.m. South Branch Clinic, Mildmay Sunray Clinic, Mildmay Memorial Hospital, Newington Green, N.l. Tues. 9.30 a.m. & 1.30 p.m. Thurs. 1.30 p.m. East Islington Welfare Centre, 32, Drayton Park, N.5. Tues. 9.30 a.m. & 1.30 p.m. Fri. 1.30 p.m. Mon. 9.0 a.m. Wed. 9.30 a.m. & 1.30 pm. Mon. 2.0 p.m. Fri, 10.0 a.m. Mom 2.0 p.m. East Branch Clinic, Congregational Church Hall, Highbury Quadrant, N.5. Thurs. 9.30 a.m. & 1.30 p.m. Total Attendances at Infant Welfare Centres. Infants North South East West 0-1 years 14,059 12,693 9,972 9,776 1-2 years 2,565 3,104 1,193 1,767 2-5 years 2,316 1,657 794 1,125 Ante-N'atal and post-Natal combined 3,049 1,482 2,124 2,02.5 Child Life Protection. The table of foster-mothers and foster-children being cared for is as follows : 31.12.51 Number of persons on register prepared to receiv e children 42 Number of foster-children being cared for 53 55 Day Nurseries. At the beginning of 1951 there were 7 Day Nurseries in operation. The number of child places was 427. At present there are 7 Day Nurseries open: Scholefield Road 05 places Clephane Road 60 ,, Plimsoll Road 40 „ Pembroke Street 50 „ Canonbury Place 70 „ Windsor Street 68 „ Mitford Hoad 68 ,, 427 56 INDEX. page Acute Polioencephalitis 11, 12, 15 Acute Poliomyelitis 8, 11, 12, 15 Aged and Infirm Persons 52-53 Ante-Natal Clinics 54 Bacteriological Examinations 22, 48-49, 50 Births 6,,9 Blow Fly Infestation 33-34 Cerebro-Spinal Fever 9 Chemical Examinations 49,50 Child Life Protection 24,54 Child Welfare Centres 54 Cleansing Station 20 Crematorium 54 Day Nurseries 55 Deaths 6-11, 13, 14, 15 Defence Regulations 23 Dental Clinics 54 Diphtheria 7, 8, 11, 12, 15-18, 22 Diphtheria Immunisation 17-18. 54 Diseases of Animals Acts 51 Disinfection 32, 34 Disinfestation 32-34 do. Block Scheme 32-33 Disinfestation of Sewers 40 Dysentery 11, 12. 19-20, 22 Encephalitis Lethargica 11 Enteric Fever 11, 12 Erysipelas 11, 12 Factories Act—Complaints 35, 36 Factories Act—Contraventions 23, 35, 36 Factories Act—Inspections 34, 35, 36, 37 Factories Act—Notices served 35,36 Film Publicity 51-52 Food and Drugs Act 25, 34, 35, 44-51 Food—Inspection & Supervision 34, 35, 37-38, 44-51 Food Poisoning 11, 12, 18-19, 22 Food Sampling 46-47, 50 Food, Unsound 46 Foster Mothers and Children 54 Health Publicity 51-52 Home Visiting—Scabies and Vermin 20 Hostels 43-44 Housing 23, 25, 41-44 Ice Cream 48-49 Illegitimate Births and Deaths 6, 7, 10 Infant Mortality 6, 7, 9, 10 Infectious Diseases 8, 11-22, 32 Licences 26 Live Births 6, 7 L.C.C. (General Powers) Acts 24, 38 M. & C. W. Services 54-55 Malaria 11,12 Marriages 6, 7 Mass X-Ray 21 Maternal Mortality 6,7,8 "Meals on Wheels" 53 Measles 8, 9, 11, 12-15 Meat 47 Meningococcal Infection 8, 12 Milk and Cream 49-51 page Milk and Dairies Regulations 51 Milk (Special Designations) 49, 50-51 Mortuary 53 National Assistance Act 25, 52-53 Neoplasms, Malignant 8. 10-11 Noise Nuisance 35, 38 Nurseries—Day 55 Offensive Trades 38 Ophthalmia Neonatorum 11 Outworkers 37 Overcrowding 43 Pet Animals Act 23 Pharmacy & Poisons Acts 39 Pneumonia 8,9, 10, 11 Polioencephalitis 11, 12, 15 Poliomyelitis 8, 11, 12. 15 Population 6 Post-Natal Clinics 55 Premature Infants 9 Prevention of Damage by Pests Act and Orders 24, 39-40 Prosecutions 26-31, 38, 39, 45-46 Public Health Committee 5 Public Health (London) Act, Sections 40 and 109 25 Public Health Officers 5 Puerperal Pyrexia 11 Rag Flock and Other Filling Materials Act, 1951 23 Rats & Mice 24, 39-40 Refreshment and Coffee Stalls 35.47 Rent Restriction Acts (Certificates) 25 Requisitioned Property 25, 41 Rivers (Prevention of Pollution) Act, 1951 24 Salvage Bins—Treatment 34 Sampling 46-47, 50 Sanitary Circumstances 23-41 Sanitary Inspection—District Work 24-25 Sanitary Inspection—Special Work 34-39,41 Scabies 11, 12, 20 Scarlet Fever 11, 12.22 Sewer Treatments 40 Shops Acts 38 Slaughtermen's Licences 47 Smallpox 11. 12, 22 Smoke 34 Staff 5 Statistics—General 6 Statistics—Vital 6-11 Still-Births 6 Swimming Baths 41 Tuberculosis—Beds and Bedding 22 Tuberculosis—Care Committee 22 Tuberculosis—Deaths 7, 8, 9, 10, 11, 21, Tuberculosis—Dispensaries 22 Tuberculosis—Notifications 7, 11, 21-22 Typhoid Fever 11, 22 Underground Bakehouses 37-38 Vaccination 12 Vermin 12, 32 Washing Facilities, Free 47 Water Supplies 41 Welfare Centres 54 Whooping Cough 8, 9, 11, 12-15, 22