AC 4361 1953 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 Health E. G. Ellis & Sons, Willow Street, Chingford. E.4 1 Public Health Department, Town Hall, N.l. To The Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington. I have pleasure in presenting my Thirteenth Annual Report on the health of the Metropolitan Borough of Islington for the year ended 31st December, 1953. There are many features of Public Health that can be regarded as satisfactory and comparing favourably with the best areas in other parts of the Country. There are other features which are not so satisfactory, but Public Health can never be stationary and there is room for progress in all fields. Mention has been made in past Annual Reports over many years of the congested nature of the Borough This has been confirmed by the publication of further information by the Registrar General in his County of Lo don Report giving the results of further analysis of the 1951 Census. Islington is not favoured with large open spaces, and with an average of 76 2 persons to the acre, it is among the half-dozen or so most densely populated Boroughs in the County of London, and there is congestion in every Ward of the Borough. The population figures for the respective Wards are given on page 10 of the Report, and it will be seen that no single Ward can serve as a lung for other parts of the Borough and in every Ward the population density considerably exceeds the average for the County of London. When it is appreciated that this congestion is taking place in housing by far the greater part of which is very out-of-date by modern standards, it will be seen how difficult is the housing problem of the Borough, and how difficult or impossible it is for sufficient new housing to be constructed which will accommodate the present population within the confines of the Borough. The out-of-date character of Islington's houses is shown by the table on page 47 of the Report, where it is mentioned that 59 per cent., nearly 82,000, Islington households have no bath of their own, and another 20 per cent. share a bath. 53 per cent. of Islington households share even a water closet, and it must be obvious that high standards of personal hygiene and personal cleanliness cannot be as easy to maintain in Islington's out-of-date houses as would be the case if the same families occupied separate accommodation, each family with its own bath, water closet and water supply, including running hot water. It says much for the long-continued efforts of the Preventive Health Services, both in the past and the present, and the standards of mothercraft which are now general in the Borough in spite of home drawbacks, that the infant mortality rate should continue at a low level, although the 1953 figure was not quite so favourable as that of the previous year. There is, however, a gap when the child reaches the toddler stage when periodic medical examinations and check-ups would help in improving his health before he enters school. The continued decrease in the deaths from pulmonary tuberculosis is dramatic and satisfactory, but unfortunately the numbers of new cases are not decreasing in 2 the same way. Early seeking of medical advice when there is departure from normal health and vigour, especially in the young adult, would assist in the detection of lung illness at a time when the road to recovery may be shortened. Reference has also been made in the Report to the increase in deaths from cancer of the lung, and to the manner of pollution of the air we breathe, which it is thought may provoke the onset of lung cancer, if it does not actually cause it. This would seem to call for the placing before the public of the facts, as we know them at present, so that the public will request and support preventive action. Television and broadcasting are proving their importance as an educational medium, and lung cancer has also been the subject of discussion in Parliament. While most infections are dimishing, it is regretted that more cases of food poisoning were reported in 1953 than in any previous year. Although most cases of food poisoning are not severely ill and recovery is usually complete within 24 to 48 hours, the consequences might be very serious to the young and the old. In any event, it would seem very desirable to avoid food poisoning and to prevent the occurrence of even a relatively mild sickness. Increasing attention is being paid to the education of the public and all concerned with food handling, and in addition to the regular and routine supervision of food premises and clean food publicity and education which goes on all the time, special efforts were made with the organisation of a successful Food Hygiene Exhibition, with the full co-operation of an important local catering firm, as well as special talks in the Schools, and particular attention to the inclusion of suitable films in the Health Publicity Film Shows. Under the Section dealing with the Supervision of Food, mention will be found of several Orders which came into force during the year. There was probably a greater number of Orders issued on food matters than on any other single section of of the Department's activities. The ending of the control of flour was signalised by the Flour Order, 1953, and the Bread Order, 1953, which gave freedom to the manufacture of National bread, brown bread, whiter bread and wholemeal bread. The importance of bread in the National diet has continued to be recognised by the requirements that calcium must be added to all types of flour except wholemeal, and flours of less than 80 per cent. extraction must have certain specified additions in compensation for the extracted items. The Merchandise Marks Act, 1953, strengthened the law in regard to more correct descriptions being given in the labelling of foods and drugs including proprietary medicines. Dysentery is another intestinal infection over the spread of which we have little control at present. Its spread is thought to be promoted by faulty hygiene, and it is not thought, in general, that it is a food infection although under certain circumstances it could act in this way. The incidence of dysentery in Islington tends to be rather higher than that for London as a whole. It may be that this is related to the sanitary circumstances disclosed above, although up to the present it has not been possible to produce any definite proof. Technical enquiries, however, are proceeding. The particular importance of environmental hygiene in this Borough gives special point to observations in the Report of the Working Party on the Recruitment, 3 Training and Qualification of Sanitary Inspectors which was issued during the year. The Working Party in its Report stated that— " A Sanitary Inspector is a Local Government Officer whose duty it is to secure compliance with certain laws designed to protect the public health. To do this, he needs to have a good working knowledge—in many cases a detailed knowledge—of certain techniques and sciences. The number and variety of these is the outstanding feature of his work. Thus while not himself practising medicine, architecture, engineering, or building, he must know something of all of them, and all this calls for a very special type of training. But first and last he is an executive officer, exercising control over the public in accordance with the law of the land, a control which often touches the pocket of the individual and could in the wrong hands be very galling. It is here that the modern sanitary inspector has developed his own special skill over and above those he borrows from other callings. The public health code is a vast and complicated one and it is the sanitary inspector's function within his own field to translate it into terms intelligible to the common man and so enable him to see clearly what he must do and how he can do it with least inconvenience and expense. The sanitary inspector must needs be familiar with many trades but he must also be master of one—a most important one in a free community—that of interpreting the requirements of the law to the citizen and enlisting his willing co-operation." The Working Party concluded that over the next five years and possibly ten years, 250 Student Sanitary Inspectors should commence their training annually if there is to be anything like a sufficiency of Inspectors in the future. At present the numbers commencing their training in England and Wales are very considerably below this figure. For some years this Council has arranged for the training of two Student Sanitary Inspectors and this scheme has proved beneficial both to the Council and to the Students concerned. The study of the extent and nature of atmospheric pollution is important; if the subject is to be dealt with systematically, more local information is required. In conjunction with the London 6s? Home Counties Smoke Abatement Advisory Council and the Department of Scientific and Industrial Research, which is responsible for collating findings in all areas, three recording and measuring stations were set up in the Borough during the year. These stations measure the rainfall, the soluble and insoluble deposit and sulphur dioxide emissions. The stations are situated respectively at the Town Hall, Community Centre, York Way Court, and the Disinfecting Station, Seven Sisters Road. With regard to health publicity and education, this side of the Department's work is increasing. In addition to the Food Hygiene Exhibition already mentioned, the Department also took part in another Exhibition. Regular evening film shows, including health films are now a constant feature of the Department's work in the autumn, winter and spring months, and special lectures and demonstrations have been arranged for particular groups, including food handlers, students and school children. 1953 was also the first full year for staff specially appointed by the Council towards the end of 1952 to carry out work in connection with the needs of elderly persons. The Report gives a list of 17 cases where the Department had to take Statutory action to safeguard elderly persons against the results of their own weak' ness and inability to manage their own lives, brought about, in the main, by old age. The circumstances in every one of these cases are distressing, but many other elderly persons were brought to the attention of the Department by various 4 individuals and representatives of organisations, who were visited by the Depart ment's officers and helped and advised in many ways. Loneliness is one very important problem with which a large number of old persons have to cope. Friends and relatives have departed and elderly persons and elderly couples may be left alone. Because of infirmity and slowness of movement, they find it difficult to carry out the necessary shopping, preparation of their food and keeping of their homes in reasonably clean condition. This is especially the case if their health is not good, even temporarily. Neighbourly action in helping lonely old people in the various necessary day-to-day tasks could do a good deal to make their lives easier and help them in maintaining their morale and state of health. Visitors from voluntary organisations are doing excellent work by keeping in touch with old people, but the number of voluntary workers does not allow more than a very small proportion to be accomplished of what should be done. Health depends to a great extent upon proper nutrition and this is difficult to achieve for persons who cannot easily leave their homes. Some of them are helped by a mid day meal supplied through the " Meals-on-Wheels " Service, carried out by the W.V.S., with transport provided by the Borough Council and a direct subsidy towards the cost of the meals granted by the L.C.C. Again, this service, while helpful, can only be of limited use because of the insufficiency of voluntary workers to man a more adequate service. Assistance given by the Borough Council in the form of grants towards holidays for old people must also be very helpful physically and mentally, and assists many to go away when a holiday would not have been possible otherwise. The staff of the Public Health Department constitute a Health Service team which, due to the volume of work in the Borough, is one of the largest, if not the largest of the Metropolitan Health Departments. Two important staff changes occurred during the year, Dr. A. M. Ison was succeeded as Part-time Deputy Medical Officer of Health, by Dr. A. L. Thrower, who is also an Assistant Medical Officer of the London County Council, and the vacancy for a Deputy Chief Sanitary Inspector, caused by the resignation of Mr. Ashcroft was filled by the appointment during the year of Mr. H. Plinston. I have pleasure in expressing thanks to Mr. W. C. Bartlett, Chief Sanitary Inspector, and Mr. E. J. Sharp, Chief Clerk, for their continuing valuable services willingly given in all matters affecting the work of the Department, and they also are ably and willingly assisted by all members of the Public Health staff. I again have pleasure in expressing thanks for their sympathetic consideration of the matters placed before them, to the Public Health and Housing Committees, with Alderman H. J. L. Lygoe, J.P., M.S.M., and Councillor F. W. Byrne, as their respective Chairmen. V. FREEMAN, Medical Officer of Health. 5 MEMBERS OF THE PUBLIC HEALTH COMMITTEE (As at December, 1953) Mayor: Councillor C. F. Rogers. Alderman: Herbert James Lowton Lygoe, J.P., M.S.M. Councillors: Ernest John William Bayliss Albert John Rogers Frank Ernest Field Lewis Ross George Albert Gardner Mrs. Agnes Seeley Ernest Charles Gough Mrs. Emily Mary Sims Louis_ Holman Terence Patrick Spriggs William Hunter Mrs. Bronwen Stradling Thomas Gordon Hyland Robert Patrick Walsh William Campbell Lillie Ernest David Ward Chairman: Alderman Herbert James Lowton Lygoe, J.P., M.S.M. Vice-Chairman: Councillor Mrs. Emily Mary Simms STAFF OF THE PUBLIC HEALTH DEPARTMENT, TOWN HALL, ISLINGTON, N.1 (T=Staff on Temporary Establishment). Medical Officer of Health: V. Freeman. M.R.C.S., L.R.C.P., D.P.H. Deputy Medical Officer of Health: A. L. Thrower, M.B.. B.S., M.R.C.S., L.R.C.P., D.P.H., (T. Part-Time.) Public Analyst: Chief Sanitary Inspector: D. F. H. Button, A.R.C.S., F.R.I.C. W. C. Bartlett (b) (c) (d) Deputy Chief Sanitary Inspector: H. Plinston (b) (c) Supervisory Sanitary Inspector: J. S. Ashworth (b) Sanitary Inspectors: (b) J. W. Aiken (b) J. Harris (b)(c) F. H. W. Pedrick (b) (c) A. A. Aslamidis (b) (c) A. W. Haydock (b) (c) (f) (g) (h) Miss S. H. Prentice (b) (d) (e) C. Broomfield (b) (c) H. R. Homewood (b) J. H. R. Roscow (b) (c) (e) D. J. Davies (b) D. W. E. Jessett (b) (c) K. E. Sewell (b) J. Edmunds (b) A. R. Kempshall (b) A. K. D. Shuttleworth (b) D.T.Evans (b) (c) (d) N. Lightowlers (b) U.P.Stanton (b) G. A. Faulkner (b) (c) J. H. Meurice (b) W. T. Stevenson (b) (c) K. L. Garner (b) A. Moxon (b) G. S. Tovey (b) (c) (f) (g) (h) Miss V. M. Goddard Chief Clerk: E. J. Sharp Clerical Staff: R. J. Barker (T) R. A. Easton Mrs. E. M. Matthews (T) S. A. Bishop Miss D. Francis C. J. Moore* W. R. Causton* W. H. Goody (T) S. C. Nottingham E. Connor P. Hardwick D. A. Owen Miss B. Y. Christmas (T) Miss M. E. Hudson P. L. Regan L. J. Cook L. Hummerstone J. Thompson Mrs. V. E. Cox Mrs. E. J. Johnson Mrs. F. Underwood C. J. Cridland* W. A. McAdam* S. Wright Mrs. O. Easson (T) Mrs. C. A. McCausland Old People's Health Officer: Mrs. B. I. Montaut (f) Disinfecting and Bathing Stations, Seven Sisters Road. N.7. W. G. Jollie (Engineer-in-Charge) Mrs. H. W. M. Godkin (Nurse-in-Charge) (f) 3 Home Visitors 1 Stoker Handyman 1 Assistant Driver 2 Bathing Attendants 2 Drivers J Disinfectors (1 vacancy) 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 Sanitary Institute Meat Inspectors' Certificate. (d = Royal Sanitary Institute Certificate in Sanitary Science. (e) = Royal Sanitary Institute Smoke Inspectors' Certificate. (f) = State Registered Nurse. (g) = State Certified Midwife. * = Senior Sectional Clerk. t = On National Service. (h) = Health Visitors' Certificate. 6 SECTION A. GENERAL AND VITAL STATISTICS. Area of the Borough 3,092 acres. Population. Registrar-General's estimate of civilian population, Mid-year 1953 : 233,500 Live Births. Birth Rate per 1,000 Estimated Resident Population London England Admin. and Totals M. F. Islington County Wales Legitimate 3,673 1,908 1,765 Illegitimate 296 137 159 3,969 2,045 1,924 17.0 17.5 15.5 Still Births. Legitimate 86 47 39 Rate per 1,000 Total (Live and Illegitimate 6 4 2 Still) Births 22.66 92 51 41 Deaths. Death Rate (Unadjusted) per 1,000 Population London England Admin. and Totals M. F. Islington County Wales 2,669 1,331 1,338 11.43 12.5 11.4 Deaths from Puerperal Causes. Deaths. Rate per 1,000 Total Births 4 0.99 Death Rate of Infants under One Year of Age. London England Admin. and Islington County Wales All infants per 1,000 live births 24 25 27 Legitimate infants per 1,000 legitimate live births 26 Illegitimate infants per 1,000 illegitimate live births 37 Notification of Births. For year ending 31st December, 1953 3,912 (corrected figure from L.C.C.). Marriages (Provisional figures). Marriages solemnised in the Borough during the year 2,228 7 COMPARATIVE VITAL STATISTICS — 1942 TO 1953. (Compiled from Registrar-General's Returns) 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 Population 233,500 235,300 235,800 238,200 239,580 238,200 236,840 227,160 195,770 188,560 189,970 186,000 Live Births—(Total) 3,969 3,897 3,880 4,091 4,389 4,608 5,577 5,284 3,708 3,826 3,592 3,368 (Illegitimate) — 296 282 285 302 318 331 431 442 438 335 264 251 Birth Rate per 1,000 population 17.0 16.56 16.45 17.17 18.32 19.34 23.55 23.26 18.94 20.29 18.91 18.10 Still Birth Rate per 1,000 births 22.66 17.89 20.94 17.48 19.87 18.94 18.99 22.20 22.41 25.72 24.97 33.29 Deaths 2,669 2,876 3,131 2,760 2,958 2,682 3,053 2,947 2,856 3,057 3,017 2,852 Death rate 11.43 12.22 13.28 11.59 12.35 11.26 12.89 12.97 14.59 16.21 15.88 15.33 Maternal Death rate per 1,000 births 0.99 1.01 0.50 0.72 0.67 0.85 0.70 1.48 0.26 2.03 2.71 2.29 Death rate of Infants under 1 year 24 22 28 29 27 35 32 39 46 48 46 54 Marriage rate per 1,000 population 19.08 17.85 19.17 18.37 18.61 19.67 19.54 20.21 25.00 18.36 18.59 25.30 T.B. Notifications per 1,000 population (all forms) 2.08 2.03 1.77 2.05 2.20 2.25 2.43 2.18 2.81 3.14 3.04 2.30 Death-rates per 1,000 population— Pulmonary T.B. 0.16 0.30 0.30 0.38 0.52 0.66 0.70 0/4 0.80 0.86 0.85 0.93 Diphtheria Nil Nil 0.004 0.004 0.008 Nil 0.004 Nil 0.01 0.01 0.05 0.01 Suicides 0.14 0.076 0.15 0.09 0.12 0.15 0.07 0.11 0.06 0.10 0.08 0.14 Road Traffic Accidents 0.077 0.076 0.11 0.10 0.06 0.08 0.11 0.10 0.07 0.16 0.10 0.16 Other violent causes 0.20 0.22 0.26 0.26 0.25 0.43 0.37 0.45 1.05 1.84 0.38 1.45 8 CLASSIFICATION OF DEATHS WITH AGE DISTRIBUTION (REGISTRAR GENERAL'S RETURNS) Cause of Death Age Groups 0— 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 1 4 21 2 5 2 1 — 28 9 37 1 2. Tuberculosis, Other — — — 2 — — — — 1 — 1 1 — 1 — — 2 4 6 2 3. Syphilitic diseases — — — — — — — — — — 1 — 4 2 3 2 8 4 12 3 4. Diphtheria — — — — — — — — — — — — — — — — — — — 4 5. Whooping Cough — 1 1 — — — — — — — — — — — — — 1 1 2 5 6. Meningococcal Infection 1 — — — — — — — — — — — — — — — 1 2 3 6 7. Acute Poliomyelitis — — — 1 — 1 — 1 — — — — — — — — — 3 3 7 8. Measles — — — — — — — — — — — — — — — — — — — 8 9. Other infective and parasitic diseases 1 — — 1 — — — — 1 1 1 — 2 1 — — 5 3 8 9 10. Malignant neoplasm, stomach — — — — — — — — 1 1 14 6 13 11 13 11 41 29 70 10 11. Malignant neoplasm, lung, bronchus — — — — — — — — 6 1 63 6 39 6 6 6 114 19 133 11 12. Malignant neoplasm, breast — — — — — — — — — 3 — 17 — 9 — 7 — 36 36 12 13. Malignant neoplasm, uterus — — — — — — — — — 2 — 5 — 6 — 3 — 16 16 13 14. Other malignant neoplasms — — — — — — 1 — 3 7 40 30 39 33 42 45 125 115 240 14 15. A-and-Leukaemia — — 1 — — 1 — — 1 3 1 2 3 2 — 1 6 9 15 15 16. Diabetes — — — — — — 1 — 1 — 1 4 3 6 1 4 7 14 21 16 17. Vascular lesions of the nervous system — — — — — — 1 — 2 3 21 33 25 55 49 83 98 174 272 17 18. Coronary disease, Angina — — — — — — — — 15 2 62 16 76 56 52 70 205 144 349 18 19. Hypertension with heart disease — — — — — — — 1 — — 9 7 10 11 10 19 29 38 67 19 20. Other heart disease — — — — — — 1 1 5 7 22 20 27 40 74 168 129 236 365 20 21. Other circulatory disease — — — — — — — — — — 9 7 11 13 23 53 43 73 116 21 22. Influenza — — — — — — — — 1 2 5 2 5 5 5 12 16 21 37 22 23. Pneumonia 9 9 1 1 — — — — 1 2 12 6 16 23 31 44 70 85 155 23 24. Bronchitis 3 3 1 1 — — — — 5 1 48 19 63 26 66 66 186 116 302 24 25. Other disease of the respiratory system — — — — — 1 — — 1 — 5 1 4 4 2 1 12 7 19 25 26. Ulcer of stomach and duodenum — — — — — — — — — — 9 4 15 3 7 12 31 19 50 26 27. Gastritis, enteritis, diarrhoea 2 3 — — — — 1 — — — — 2 — 3 — 5 3 13 16 27 28. Nephritis and Nephrosis — — 1 — — — 1 — 2 2 2 4 — 1 2 3 8 10 18 28 29. Hyperplasia of prostrate — — — — — — — — — — 2 — 6 — 6 — 14 — 14 29 30. Pregnancv, Childbirth and Abortion — — — — — — — 1 — 3 — — — — — — — 4 4 30 31. Congenital Malformations 6 0 1 — — — — — — 1 1 2 — 1 — — 8 9 17 31 32. Other defined and ill-defined diseases 27 23 2 1 1 2 3 — 2 5 15 13 11 13 17 31 78 88 166 32 33. Motor vehicle accidents — — — 1 — 1 1 — 3 — 2 2 2 3 1 2 9 9 18 33 34. All other accidents 2 1 3 1 — — 1 1 3 1 4 3 3 3 10 10 26 20 46 34 35. Suicide — — — — — — — 1 5 1 12 3 6 — 2 3 25 8 33 35 36. Homicide — — — — — — 1 — — — 1 — 1 — — — 3 — 3 36 All Causes 51 45 11 11 1 6 12 7 60 52 384 217 389 339 423 661 1,331 1,338 2,669 96 22 7 19 112 601 728 1084 2,669 Totals Percentages 3.6 0.82 0.26 0.71 4.20 22 2 27.28 40.61 100 9 SUMMARY OF INFANT MORTALITY 1953 (Based on Registrar General's Returns) Primary Cause of Death Under 1 day Days Weeks Months 1953 (1952) 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 (—) Whooping Cough 1 1 (1) Meningococcal Infection 1 1 (—) Tuberculosis—Lungs (—) Tuberculosis—Other forms (—) Bronchitis 1 1 1 2 1 6 (6) Pneumonia 2 1 2 1 1 3 2 1 1 2 1 1 18 (16) Influenza (—) Enteritis and Diarrhoea 1 1 1 1 1 5 (2) Premature Birth 20 6 1 2 1 29 (24) Congenital Malformation, Birth Injury, Atelectasis Atrophy and Marasmus 19 5 1 1 1 2 2 1 32 (—) (—) (29) Syphilis (—) Suffocation Overlying 1 1 (—) Violent Causes 1 1 2 (—) Road Traffic Accidents (—) All Other Causes 1 1 (11) Totals 42 11 2 2 3 — 1 2 1 3 6 3 4 4 3 2 2 3 1 1 —— 96 (88) 10 COUNTY OF LONDON REPORT CENSUS, 1951 Acreage, Population and Persons per Acre : Acreage Population Persons per Acre 1931 1951 County of London 74,850 4,397,003 3,347,982 44.7 Islington (Metropolitan Borough) 3,092 321,795 234,632 76.2 Wards— No. 1 Tufnell 412 33,409 30,239 73.4 No. 2 Upper Holloway 299 32,874 24,942 83.4 No. 3 Tollington 316 31,005 25,623 81.1 No. 4 Lower Holloway 407 38,327 27,787 68.3 No. 5 Highbury 415 32,247 25,307 61.0 No. 6 Mildmay 331 26,933 23,284 70.3 No. 7 Thornhill 178 29,452 15,558 87.4 No. 8 Barnsbury 138 21,356 13,209 95.7 No. 9 St. Mary 150 19,016 13,585 90.6 No. 10 Canonbury 290 29,269 20,181 69.6 No. 11 St. Peter 156 27,907 15,917 102.0 Percentage Distribution of Population by Age : 0—4 5—14 15—44 45—64 65 & over County of London 8.1 11.5 45.3 24.0 11.1 Islington 8.5 12.0 45.5 22.9 11.1 COMMENTS ON VITAL STATISTICS CENSUS, 1951—County of London Report, received 1953. Distribution of Population within the Borough. It will be noted from the extracted figures from the Registrar-General's County Report that the population density for the Borough of 76.2 persons per acre compares very unfavourably with the average of 44.7 for the County of London. The Census thus confirmed that Islington is one of the most densely populated areas of London, and whilst some boroughs have quite considerable variations of population density from Ward to Ward, there is a very high density in Islington in every Ward. The most congested Ward is St. Peter, with a density of 102 persons per acre, followed by Barnsbury with a figure of 95.7. However, the Registrar-General's table also shows that even the present population congestion is considerably less, in most Wards, than in 1931. From the table of Population Distribution by Age, it will be noted that 11.1 per cent. are over the age of 65, which is equivalent to 26,050 at the time of the Census. Births. As was noted in last year's Report, the birth-rate has again increased, although slightly, and this would appear to be in accordance with the National trend, which seems to reverse the post-war fall in the birth-rate down to 1951. The proportion of births classified as illegitimate remains fairly constant at 7.5 per cent. of all the 1953 births. Principal Causes of Death. The general death-rate at 11.4 is a reduction on the death-rates for the previous two years, and the principal factors which have contributed to this fall are mentioned below. 11 Infants under One Tear. The infant mortality rate of 24 per thousand, although a little higher than the previous year, still represents a low risk for infants. The low rate may be taken as a further testimony to the standard of maternal care exercised by mothers in Islington in spite of many unfavourable housing and sanitary circumstances, and to the assistance given by the Personal Health Services of the Local Health Authority, the Hospital and General Practitioner services in the Borough. The Islington infant mortality rate of 24, compares not unfavourably with the corresponding figure of 25 for the County of London and 27 for the whole of England and Wales. Even with this low rate, however, there is still room for improvement. Of the total of 96 infant deaths, 42 occurred within 24 hours of birth, and 61 within seven days. These deaths it is difficult to avoid, but something can be done by mothers themselves, especially when expectant, in seeing that they come under the care of a doctor or midwife as early as possible in pregnancy, and that they carefully follow the advice given, especially in regard to work, diet and rest. They should not hesitate to consult a doctor immediately there is any depar ture, or apparent departure, from normal health, including normal pregnancy. Of the 29 infants who died between the ages of one and twelve months, five deaths were due to bronchitis, eight to pneumonia and five to enteritis and diarrhoea. It is highly probable that the great majority of these deaths were avoidable, and a considerable responsibility rests on parents to ensure that their young infants have early medical or nursing attention as soon as there is any departure from good health or if there is any failure of normal progress. There are many facilities in the Borough for obtaining advice without charge on the healthy up-bringing of infants, and it is the duty of parents, fathers as well as mothers, to see that they obtain and follow such advice. • Deaths from Other Causes. Respiratory Tuberculosis. It is pleasing to record that there is again a very considerable drop in the number of deaths from respiratory tuberculosis, the total, numbering 37 for the year, being the lowest on record and comparing with 71 for the previous year. Of the total of 37, 28 were males, 21 of whom were aged 45 to 65 years. Malignant Growths of Lung and Bronchus. The following table will show how deaths are tending, if anything, to increase:— Deaths Male Female Total 1950 115 14 129 1951 104 23 127 1952 107 20 127 1953 114 19 133 It was only a few years ago that the number of deaths from tuberculosis of the lungs considerably exceeded those due to cancer of the lungs, the reverse is now very much the case. Of the 114 male deaths during the year 63, or 55 per cent., were aged 45 to 65. The possible causes contributing to the high proportion of lung cancer deaths were mentioned in last year's Report. Whilst the cause of lung cancer is not known, it is thought that one of the principal factors contributing to the increase is heavy cigarette smoking (25 or more a day) continued for many years (10 or more). Cigarette smoking seems to present a greater risk than pipe smoking. Large built-up areas also have a higher lung cancer rate than smaller 12 built-up and rural areas, and it is therefore thought that atmospheric pollution may also be another contributory factor in the increase in lung cancer. The lastmentioned factor would not, however, explain the very much greater risk, five or six to one, for the male as compared with the female. That heavy cigarette smoking increases the risk as a view which has now considerable authoritative and official support both in this country and in the United States of America. In our present state of knowledge, the later in life the adolescent or young adult postpones taking to cigarette smoking, the better will be his chances of avoiding a health calamity of this kind. Other Forms of Cancer. Deaths from all other forms of cancer, male and female, showed a diminution on previous years. Diseases of the Heart and Circulatory System. Diseases from causes of this nature were considerably less in 1953 as compared with 1952, and this reduction made a substantial contribution to the lower death-rate for the year. Diseases of the Respiratory System. Deaths due to pneumonia and bronchitis were much the same as previously. Accidents. The following table gives the deaths from accidents in Islington from 1949 onwards :— 1949 1950 1951 1952 1953 Motor vehicle accidents 14 24 26 18 18 Other violent accidents 60 61 61 48 46 The Report of the Standing Interdepartmental Committee on Accidents in the Home, issued with Home Office Circular 106/1953, stated that the majority of accident victims are young children and old people, more than 25% being under 15 and more than 50% over 65. More children under 15 died from home accidents than from any single infectious disease ; between the ages of one and five years a fatal accident in the home is the third largest cause of death. The following table shows the Islington accident deaths (excluding road accidents) according to age groups and sex :— Under 1 yr. 1-5 5-15 15-45 45-65 Over 65 yrs. All Ages Male Female 1949 5 1 2 13 10 29 60 36 24 1950 2 4 — 8 4 43 61 27 34 1951 2 5 5 6 8 35 61 26 35 1952 — — 2 9 13 24 48 33 15 1953 3 4 — 6 7 26 46 26 20 There is no information regarding the number of non-fatal accidents in the home, but it is obvious that the annual toll of injury and death represents a considerable financial as well as human loss. It is to be regretted that Home Safety Committees have not been encouraged and have not been organised as have Road Safety Committees. Suicides. Suicide deaths, at 33, showed a considerable increase for some unknown reason, as compared with the suicide deaths, at 18, for 1952. There was an increase of only one for the females who committed suicide, but the number of males increased from 11 to 25 and of these 12, or practically half, were aged 45 to 65. 13 SECTION B. PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES. Notifiable Infectious Diseases and Deaths during the year 1953. Disease Number of Notifications Number of Deaths Removed to Hospital Number of Cases returned to RegistrarGeneral after correction of Diagnosis Cases "coming to knowledge" but not Notified Smallpox - (-) - - - - Scarlet Fever 250 (474) — 70 244 13 Diphtheria 12 (23) — 12 1 — Enteric Fever (including Paratyphoid) 1 (2) 1 - - Typhus Fever — (-) — — — — Puerperal Pyrexia 192 (385) — 173 189 17 Ac. Primary & Influenzal Pneumonia 322 (246) 7 4 330 - Ophthalmia Neonatorum 27 (26) — 19 26 — Acute Encephalitis 1 (1) — 1 1 — Meningococcal Infection 8 (10) 3 8 3 6 Anthrax — (—) — — — — Dysentery 372 (216) — 103 344 34 Malaria 5 (1) — 2 5 — Erysipelas 48 (33) 1 10 48 3 Measles 2,541 (2,885) — 130 2,642 50 Whooping Cough 1,188 (504) 2 154 1,169 26 Ac. Poliomyelitis 34 (20) 3 34 16 2 Ac. Polioencephalitis — (-) — — — — Food Poisoning 243 (62) — 10 239 10 Tuberculosis—Lung 450 (433) 28 —, — — Tuberculosis—Other Forms 35 (55) 9 — — — Scabies 25 (31) — — 25 - (Figures in brackets are notifications for 1952.) Investigations made in respect of Infectious Diseases cases, contacts, etc., by the Sanitary Inspectors and Home Visitors during the year as under:— Smallpox 16 Erysipelas 46 Scarlet Fever 267 Measles 2,612 Diphtheria 18 Whooping Cough 1,163 Enteric Fever (including Paratyphoid) 6 Acute Poliomyelitis & Polioencephalitis 63 Typhus — Food Poisoning 98 Meningococcal Infection 23 Scabies 76 Dysentery 400 Vermin 422 Malaria 1 Enteritis — Pneumonia — Ineffective Visits 946 Total 6,157 Smallpox. No cases of smallpox were recorded, but visits were paid to ten smallpox contacts who landed at Southampton from a ship in which a case had occurred and were now living at an address in this Borough. On investigation they were found to be in good health, but precautionary action was taken in notifying Medical Officers of districts subsequently visited by members of this family. In three other cases visits were paid by the Medical Officer of Health to suspect cases on requests by general practitioners. These cases were not confirmed, but such measures constitute part of the precautions which have to be taken when the 14 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 1952 2,450 1953 3,055 (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. The number of applications for authentication continued to increase rapidly, and during the year the Medical Officer of Health dealt with 347 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. Measles. In 1952 I reported that there had been 2,885 notifications of measles, the second highest recorded figure in the history of the Borough. The figure for 1953 was not far short of this at 2,541. The majority of the cases were a continuation of the second outbreak which began in the Autumn of 1952. The outbreak remained at a continuously high level until the end of February, and the number of notifications decreased slowly from the beginning of March to the beginning of June, when very few cases were recorded. From then onwards measles continued at an exceptionally low level right to the end of 1953. Taking the autumn/winter outbreak, 1952/53 as a whole, there were 3,408 notifications of measles from October, 1952, to May, 1953, inclusive. The following table shows the age-groups of the notified cases during 1953:— Under 1 year 1—5 years 5 years and upwards No. of Notifications in 1953 128 1,531 882 Percentage of total notifications 5.0 60.3 34.7 No. of Deaths - - - It was only in the most exceptional circumstances that measles cases were removed to hospital. 15 Whooping Cough. Whooping Cough in 1953 showed a substantial increase, at 1,188 notifications, as compared with 564 for 1952. The distribution of whooping cough cases according to their ages was as follows:— Under 1 year 1—5 years 5 years and upwards No. of Notifications in 1953 128 618 442 Percentage of total notifications 10.8 52.0 37.2 No. of Deaths 1 1 — Fatality Rates (per thousand) 7.8 1.62 — Fatality Rates per 1,000 notifications each age group Percentage of notifications (1944—1953) (1944—1953) Under 1 1—5 5 & upwards Under 1 1—5 5 & upwards Measles 6.17 0.54 — 5.2 59.0 35.8 Whooping Cough 38.9 2.31 — 13.1 59.3 27.6 16 Over the ten-year period 59.3 per cent. of all cases of whooping cough and 59 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 5,308 Completed cases 1,691 London (Measles and Whooping Cough) Regulations, 1938. Home visiting of measles and whooping cough cases was carried out by the Home Visitors as under :— of Investigations No. of Ineffective Measles Whooping Cough Visits Re-visits 2,597 1,157 603 11 Acute Poliomyelitis and Polioencephalitis There were slightly more confirmed cases in 1953, but the total number was not large. Three of the cases of poliomyelitis during the year had fatal results. The cases reported for each of six years are set out as under :— No. Reported No. CONFIRMED 1953 47 17 1952 30 15 1951 21 8 1950 54 31 1949 88 62 1948 11 9 (a) Onset dates Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. 19531 — — — 2 26 231—— 1952- - — — — — 1 — 2 8 — 2 1 1 1951- - 1 — — 1 1 2— 21 — — — 1950 - - 1 — 1 — 2 2 10 10 1 2 2 — 1949 - - - - - - - - 9 6 171 8 8 4 1948 - - - 1 — 2 — 1 — 2 — 1 1 1 (b) Under 1 yr. 1 — 5 — 15 — 25 and over 1953 ..... ..... ..... ..... 6 5 3 3 1952 ..... ..... .... 15 4 5 1951 - — 2 2 2 2 1950 .... .... 1 11 12 4 3 1949 ..... - 3 35 17 2 5 1948 .... .... — 2 5 1 1 (c) Deaths—1953—3 (4 years ; 15 years ; 24 years). 1952—Nil. 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). 1948—Nil. 17 Diphtheria Cases and Deaths—1927-1953 Year Notified Cases Deaths Year Notified Cases Deaths Year Notified Cases Confirmed Cases Deaths 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 1952 23 1935 760 13 1944 94 2 1953 12 1 — Corrected Notifications England and Wales London Islington 1944 23.199 758 38 1945 18,596 801 45 1946 11,986 747 50 1947 5,609 451 '19 1948 3,575 335 7 1949 1,881 221 17 1950 962 81 19 1951 699 30 17 1952 101 5 — 1953 267 13 1 In 1953 I was able to report that for the first time on record there had been no case of diphtheria, and of course, no deaths from this cause in the Borough. Although there was one confirmed case reported in 1953, this was not, strictly speaking, a case, but a contact who was a carrier, remaining in good health. It could therefore be said, strictly, that 1953 was the second successive year when no children or other person became ill through contracting diphtheria. This happy outcome, as compared with previous years up to very recently, must be ascribed to widespread immunisation. It will be seen from the table given that although a considerable number of Islington children are immunised every year, there still remains many whose parents do not now appear to think that immunisation is a necessary procedure for the protection of health. These parents should realise that there is still a risk from diphtheria, that it still remains a dangerous disease when it does occur, and that a general disregard of diphtheria immunisation might well bring back the risks of former years. If this should occur, parents of non-immunised children might well be the first to deplore and regret their failure to obtain this safeguard. The following table, shown in the 1952 report, is repeated to emphasise the relative risks of diphtheria in children immunised and not immunised. 18 Diphtheria Cases and Immunisation state 1947-1953 (inclusive) Immunised Non-Immunised Unknown Total Deaths Age Groups 0—5 5—15 15 + Age Groups 0—5 5—15 15 + 1953 — — 1 « 1 Nil 1952 — — 1951 1 2 — 8 5 1 — 17 7 years—Not immunised 1950 — 5 — 3 7 4 — 19 7 years—Not immunised 1949 1 3 — 2 8 3 — 17 4 years 6 years Not immunised 1948 1 2 1 1 — 2 — 7 Nil 1947 — 5 1 2 4 5 2 19 16 years—Not immunised Totals 3 17 2 16 24 16 2 80 5 deaths (None immunised) 22 56 No. of Islington Children Immunised against Diphtheria—1939-1953 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 525 89 3,261 5,734 6,321 3,165 3,688 3,425 4,563 5,387 3,185 2,604 3,073 3,019 2,654 Diphtheria Immunisation. Dr. B. E. Sharpe, Divisional Medical Officer, London County Council, has kindly supplied the following figures in respect of Islington children for the current year. Dr. B. E. Sharpe, Divisional Medical Officer, London County Council, has kindly supplied the following figures in respect of Islington children for the current year. Estimated proportion of Children Immunised at 31.12.53 Under 5 yrs. 54.7% 5—15 yrs. 95.6% Total Attendance at all Clinics 7,639 Sessions Held 321 Average Attendance 23.8 Number of Children who received Full Course of Immunising— Injections:— Under 5 years 2,439 5—15 years 215 Boosting Injections 2,079 Schick testing was discontinued in 1953. Information as in previous reports is, therefore, no longer available. Food Poisoning Number of notifications received 1947 7 1948 10 1949 55 1950 104 1951 148 1952 58 1953 243 It will be noted from the above table that more notifications of food poisoning were received in 1953 than in any previous year. 19 In accordance with Circular 2/50 of the Ministry of Health, the following table summarises the outbreaks of food poisoning and the character of each outbreak. Date No. of Notifications No. of persons served No. of cases reported No. of deaths Foods involved and Organisms responsible 1. 28.2.53 17 17 17 — Re-heated Rabbit. — Probably Staphylococcus Aureus CoagulasePositive. 2. 5.7.53 120 970 301 — Unknown. 3. 13.7.53 — 159 14 — Irish Stew.—Probably CI. Welchii possibly supplemented by Staphylococcal Coagulase-Positive. 4. 13.7.53 — 241 24 do. do. 5. 14.7.53 1 170 25 — Milk Pudding, Potato and Cabbage. Staphylococcal Coagulase- Positive. 6. 14.7.53 1 120 22 — do. do. 7. 5.8.53 — 70 16 Undetermined but possibly Sausages.—Undetermined. 8. 6.9.53 1 37 8 — Tongue or Spam served in sandwiches.—Undetermined. 9. 27.9.53 4 6 4 — Duck Eggs.—Salmonella Typhimurium. Further details of these outbreaks are as under :— 1. This outbreak occurred at a hospital ; rabbit which was prepared on one day was not all consumed and was re-heated and served again the following day. The rabbit was found to be infected with Staphylococcus Aureus, CoagulasePositive, and the same organism was recovered from an infected finger-nail-bed of one of the kitchen staff. It therefore appears probable that in the course of food handling by this particular member of the staff, the organism was transferred from the infected finger to the food, and the organisms increased by the time the food was served to an extent whereby food poisoning symptoms were caused. 2. This outbreak occurred in an Institution in the Borough, but it was not possible to identify any particular organism, either from the patients, or from food samples of items consumed shortly before the outbreak. 3 & 4. These were School outbreaks at two Schools, the mid-day meal for both of them being prepared in the kitchens of one School only. The organism responsible was thought to be Clostridium Welchii, which may be present in connection with meat, or meat preparations, and the food course thought to be responsible was Irish stew. 5 & 6. This outbreak occurred in children and staff of two other Schools, where again the mid-day meal was prepared at one of them. The outbreak was probably of Staphylococcal origin, Coagulase-Positive. These germs were found in considerable numbers in the milk pudding, but organisms may also have been present in the meat pudding which was served as the first course, of which, unfortunately, no samples were available. 7. The organisms could not be identified in this case, which was an outbreak in a small hospital in the Borough, but the suspected item of food consumed was sausages. 20 8. The outbreak in this case occurred in members of a coach party travelling to a seaside resort. Tongue and spam sandwiches were eaten at 11 a.m., and within 2—4 hours members of the party were taken ill with fairly severe symptoms of sickness and diarrhœa. Eight persons were kept overnight at the hospital in the seaside resort, others were less severely ill. All hospital patients were discharged the following morning, and recovery was rapid in all cases. The meats for the sandwiches were cooked two days before the outing and were kept at room temperature until made up into sandwiches. There was, therefore, ample time for the germs to multiply, and since the meats were kept for two days at room temperature the conditions were no doubt favourable for the rapid growth of food poisoning organisms. 9. This was a domestic outbreak occurring in a single family. It is very probable that infected duck eggs were the cause of the illness in this case, taken in the form of fried duck eggs. The campaign for safer food is dealt with in the Health Publicity section of this Report. Dysentery Whereas I had to report in 1951 that 995 notifications of dysentery had been received during the year, the highest number to be recorded, this position, fortunately, did not continue. The dysentery cases notified in 1953 numbered 372. The routine arrangements previously reported for the follow-up of dysentery cases and their contacts continued to be followed. All notified cases were visited by a Sanitary Inspector or Infectious Disease visitor, and arrangements made, unless otherwise desired by the General Practitioner attending, for examination of stool specimens at the Archway Group Laboratory, except in those cases where the patient was attending hospital. Of the 372 notified cases, 280 were confirmed as suffering from Shigella Sonnei. 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. The Deputy Medical Officer of Health is available at the Public Health Department, Seven Sisters Road, for the examination of complicated cases of scabies or special cases referred by General Practitioners. 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 10 43 Number of baths given 51 Number of treatments — 50 L.C.C. Children Number treated 32 434 Number of baths given 68* — Number of treatments — 436 Adults Number treated 45 87 Number of baths given 102* — Number of treatments — 96 * Baths were also given to 7 Scabies Contacts and 105 Special Cleansing Cases. 21 Scabies Clinic: Number of Clinics held 27 Number of cases attended 78 Adults 30 Children under 5 years 12 School children 36 78 Diagnosis of cases— Scabies 56 Other conditions 22 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 64 6 48 118 Vermin 397 9 198 604 Tuberculosis. The rates per thousand population for new cases of pulmonary tuberculosis for the last six years have been :— 1948—2.34; 1949—2.39; 1950—2.07; 1951—1.87; 1952—2.16; 1953—2.34. 546 new cases of pulmonary tuberculosis were added to the Register during the year, as against 518 in 1952. Whilst the dramatic fall in the death rate from this cause (recorded on page 11) is gratifying, the fact that there is no room for complacency with regard to tuberculosis is demonstrated by the failure of any decrease in the number of new cases. There is, if anything, a tendency for the new cases to increase ; it is difficult to say how many of the new cases would have been discovered and notified during the year without the continued presence of the Mass X-Ray Unit of the North West Metropolitan Regional Hospital Board. No doubt some cases would have come to light, but possibly at a later stage when the disease was more fully developed. The value of Mass X-Ray examination lies, as mentioned in last year's Report, in the probable diminution of the no doubt very considerable reservoir of unknown cases who contribute to the transmission of the disease to others. The combined effect of the increased discovery of cases and the reduction in the death rate, indicating that patients with tuberculosis are living longer, means that the total pool of tuberculous people in the Borough has increased and this is shown in the continued increase in the number of cases of tuberculosis registered in the Department, and on the registers of the Chest Clinic. Of the 207 new cases of tuberculosis of the lungs in women, 124 were between the ages of 15 and 35 ; probably the most difficult and disheartening age-group in which this illness can be contracted. Of the 339 new cases of lung tuberculosis in men, 49 were aged 15 to 25, and 75 aged 25 to 35 ; again extremely serious from the point of view of career, family responsibility and earning capacity. 22 New Cases and Mortality during 1953 Ages New Cases Deaths Respiratory Non-Respiratory Respiratory Non-Respiratory M. F. M. F. M. F. M. F. 0— 1 2 —. — — — 1— 7 13 1 2 1 — 2 5— 14 15 3 2 — 15— 49 56 7 3 1 — 25— 75 68 5 7 1 2 35— 51 26 3 5 2 1 45— 52 11 1 2 7 1 2 55— 49 6 2 1 15 1 65 and upwards 31 10 — 3 8 2 — 1 Total for all ages 339 207 22 25 31 10 3 3 593 47 Rates per 1,000 population— New cases—pulmonary 2.34 non-pulmonary 0.20 Deaths— pulmonary 0.17 non-pulmonary 0.02 Public Health (Tuberculosis) Regulations, 1952 Although information in regard to the coming and going of tuberculous patients under these Regulations is not as complete as it was under the Tuberculosis Regulations, 1930, every effort is made to confirm the correctness of the Register still maintained in the Department. The total number of cases on the Register of the Department, as at 31st December, 1953 was :— Pulmonary— Males 1,351 Females 1,126 Non-Pulmonary—Males 150 Females 175 2,802 The corresponding figures for previous years are :— 1948 2,401 1949 2,490 1950 2,368 1951 2,404 1952 2,575 Chest Clinics The Chest Clinics of the Regional Hospital Board continue to function at the Royal Northern and Royal Chest Hospitals, with Dr. J. Wallace Craig as Physician to the Clinics. Cases on Chest Clinic Registers Pulmonary Non-Pulmonary Total Grand Total Adults Children Adults Children Adults Children Number of definite cases of tuberculosis on Chest Clinic Registers N. S. M. F. M. F. M. F. M. F. M. F. M. F. 638 600 64 41 45 59 6 10 683 659 70 51 1,463 601 470 48 55 30 56 8 7 631 526 56 62 1,275 at 31st December, 1953 1239 1070 112 96 75 115 14 17 1314 1185 126 113 2,738 23 The corresponding figures for previous years are :— 1949 2,127 1950 2,238 1951 2,443 1952 2,575 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 Health 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 19 patients ; others have been referred to various organisations for assistance. I am indebted to Dr. B. E. A. Sharpe, Divisional Medical Officer, London County Council, for the 1953 figures in connection with vaccination, diphtheria and whooping cough inoculations, and chest clinics. Tuberculosis—Mass X-Ray Unit of the North West Metropolitan Regional Hospital Board The Static Mass X-Ray Unit at 32 Drayton Park, continued to function during the year. At the end of the Unit's first working year 1952/53, approximately 20,000 Islington persons had been examined. The proportion of pulmonary tuberculosis cases found has been high relative to the expectation in London. There is no doubt that a considerable number of persons are now undergoing treatment as a result of a visit to the Unit who would otherwise have delayed considerably in obtaining medical advice. It has therefore been found possible to institute treatment much earlier in many cases with consequent benefit to the patient, a shorter period of treatment, and better hope of ultimate cure. Further, the early detection and treatment of such persons has also benefited those with whom the patients are in contact, since many of them would otherwise have been infectious cases to those around them. In order to attract further attention to the work of the Unit, the Regional Hospital Board, in conjunction with the Borough Council, arranged for the holding of a Tuberculosis Conference in the Town Hall, which was opened by His Worship the Mayor. The Chair was taken by Alderman Lygoe, and the principal speakers were Mr. Maurice Hackett, Chairman of the Tuberculosis Committee of the Regional Board, and Dr. G. Z. Brett, of the Mass X'Ray Unit. A considerable number of representatives of varied local interests were present. There is no doubt that the Mass X-Ray Unit has carried out a public health function of the utmost importance and interest to the Borough. Bacteriological Examinations As from 1st December, 1953, arrangements were made for the examination of all bacteriological specimens submitted to the Public Health Department, to be carried out by The Public Health Laboratory Service, The County Hall, S.E.1. 24 This transfer of bacteriological work brought to an end the arrangements for the examination of public health bacteriological specimens by the Royal Institute of Public Health and Hygiene which had been in force for over thirty years. The Council paid testimony to the fact that for the whole of this period the services of the Royal Institute have been available to the Medical Officer of Health and to Practitioners in the Borough for the examination of specimens for seven days a week at all times. The Council formally thanked the Institute for their services. The re-arrangement was necessitated by the setting up of the Public Health Laboratory Service within the County of London area. The transfer of work has in no way affected the continuation of a high standard of service to the Public Health Department and to Practitioners in the Borough. Examinations carried out by The Royal Institute of Public Health and Hygiene, and the Public Health Laboratory Service: — Total Swabs (Diphtheria) 192 Sputum (Tuberculosis) 54 Faeces (Typhoid) 2 Btood (Typhoid) — Faeces (Dysentery) 1,466 Faeces (Food poisoning) 73 Swabs (Streptococci) 34 Food (Food poisoning) 59 Swabs (Pertussis) — Smears (Variola) 2 Scrapings (Variola) — Total 1,882 SECTION C SANITARY CIRCUMSTANCES OF THE AREA (In conjunction with Mr. W. C. Bartlett, Chief Sanitary Inspector). Although the position relative to the majority of the houses in the Borough remains the same as in previous years, particularly in respect of age and disrepair, the situation appears to have been a little easier during the year under review. Consequent upon the free limit being raised to £500, notices served under the Public Health (London) Act, 1936, have received more prompt attention where the owners had a genuine desire to maintain their property in a reasonable nuisance-free condition. This situation is reflected in the decrease in the number of complaints, in the number of applications for certificates of disrepair, in the number of prosecutions for non-compliance with statutory notices and with abatement orders. Many owners, however, still found that property was uneconomic and abandoned it, or asked the Council to take appropriate action under the Housing Act, 1936. Having regard to the number of existing hostels in the Borough, and the fact that this type of accommodation is increasing, representation was made to the Minister of Housing and Local Government to approve draft byelaws for hostels, but such approval was not granted. Consequent upon 1953 being Coronation Year, the large influx of visitors to the Borough caused every available space to be utilised temporarily for living accommodation. In one case, application was made for permission to use a large warehouse as accommodation for 50 Iraqis during the Coronation period. Upon investigation, however, it was found that the space afforded by the warehouse was only sufficient to accommodate half the proposed number. 25 The Company concerned were most co-operative, and eventually decided to provide more suitable accommodation elsewhere. The Council decided to support a recommendation that the London County Council be asked to include in their next General Powers Bill appropriate provision to enable Metropolitan Borough Councils and the City of London to register and control barbers' and hairdressers' shops, and to make byelaws for the purpose of securing hygienic conditions. Such legislation is both necessary and desirable, particularly in a Borough such as Islington where a considerable number of such premises exists. Consequent upon the Heating Appliances (Fireguards) Act, 1952 (Commence' ment) Order, 1953, the statute of last year came into operation in March. In addition, the Secretary of State issued Regulations under the Act during the year. These Re2ulations require fireguards to be fitted to gas fires, electric fires and all heaters which are so designed that they are suitable for use in residential premises and are of such type that without a guard there is a likelihood of injury by burning. Standards of construction and fitting of guards, and the tests employed in ascertaining which guards comply with these standards, are set out in the Regulations. Heating appliances other than imported appliances manufactured before the 1st October, 1953, and not fitted with the requisite guards may be sold or let until the end of September, 1954. Summary of Work done by District Sanitary Inspectors. During the year 48,430 inspections or revisits were made by the District Sanitary Inspectors. In connection with visits to dwelling-houses, 58,522 inspections or re-inspections of separate lettings were made. Routine Inspections, etc. Houses Inspected (on complaint, etc.) 8,550 do. Separate Lettings in above 14,838 Inspections re Schools 4 do. Licensed Premises 29 do. Hairdressers 2 do. Child Life Protection 5 do. Stables, Manure Pits 3 do. Courts, Mews 6 do. Food Salvage Containers 484 do. Rag and Bone Dealers 2 do. Bombed Sites 360 do. Derelict Buildings 106 do. A.R.P. Shelters, Static Water Tanks 71 do. Fairgrounds, Caravans . 6 Nuisances dealt with by Notice 13,128 do. informally 1,363 Houses Reinspected 23,876 do. Separate Lettings in above 40,958 Other revisits 631 Notices Served—Intimation 4,631 do. Statutory 3,197 Notices Complied with—Intimation 2,860 do. Statutory 3,118 do. By Local Authority in default 14 26 Routine Inspections, etc.—continued Land Charge Enquiries dealt with 5,683 Requisitioned Properties—Inspected 148 do. Separate Lettings in above 257 do. Reinspected 191 do. Separate Lettings in above 312 National Assistance Act (Section 47).—Aged and Infirm Persons Cases Investigated 82 Cases Revisited 175 (See also Section on Services for Elderly Persons). Housing Acts. Sections 57/62, etc.—Inspections and Revisits 775 Survey of Areas—Preliminary Investigations 882 Sections 9, 11, 12, etc 1,111 do. Separate Lettings in above 1,145 Miscellaneous. Other Visits or Inspections not specified above 2,849 Non-effective Visits 7,481 Total Nuisances and Contraventions Reported (all sources) 14,760 *Food ii Drugs Act, etc.—Week End (Saturday—Sunday) Duty. Retail Shops and Food Purveyors Inspected 79 Street Markets Visited 217 Barrows, Stalls Inspected 305 * See also Section E. Rent and Mortgage Interest Restrictions Acts, 1920 to 1939. Certificates of Disrepair. Applications brought forward from 1952 4 Applications in 1953 29 Total 33 Certificates issued in 1953 25 Applications refused in 1953 8 Balance to 1954 0 Total 33 Clearance Certificates. Applications brought forward from 1952 4 Applications in 1953 21 Total 25 Certificates issued in 1953 16 Applications refused in 1953 7 Balance to 1954 2 Total 25 27 Improvements effected as a result of Service of Notices under the Public Health (London) Act. 1. Brickwork—walls repaired or rebuilt 32 2. Drains cleared, repaired, etc 394 3. Dampness remedied 3,598 4. Fireplaces and ranges repaired/renewed 780 5. Floors repaired 683 6. Flues repaired 360 7. Internal walls repaired 2,065 8. Ceilings repaired 1,331 9. Rainwater pipes/gutters repaired 569 10. Roofs repaired 1,881 11. Rooms cleansed 531 12. Sinks provided 62 13. Soil pipes repaired and renewed 42 14. Staircases or passages cleansed 188 15. Staircases repaired 207 16. Waste pipes repaired 262 17. Water Closet Apartments cleansed 84 18. Water Closet Pans and Traps renewed 116 19. Water Closets—flushing apparatus repaired or renewed 191 20. Water Closets—general repairs 499 21. Water supply provided 59 22. Water service pipes repaired 76 23. Window cords renewed 2,151 24. Windows repaired or renewed 979 25. Miscellaneous improvements 1,354 Total 18,494 Total number of houses improved 4,652 Total number of separate lettings improved 5,610 Total number of nuisances abated 16,026 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 £1,977. Issue of Licences. In January of this year, the free limit was raised to £500, so that licences were required only for expenditure above this amount. The cost of the work carried out to secure the abatement of nuisances at respective properties was well within this figure, and therefore no licences were issued in respect of notices served by this Department. The Government, later in the year, decided to raise the ceiling to £1,000 as and from the 1st January next year. 28 Legal Proceedings. Public Health (London) Act, 1936. Failure to comply with Statutory Notices contrary to Section 82 (No. of Cases: 169). Date Address Magistrate's Decision 15.1.53 10 Andover Road Ordered to abate within 28 days. do. 2 College Cross Defendant to pay £l1s. costs. do. 11a Ockendon Road Ordered to abate with 28 days. Defendant to pay £1 1s. costs. do. 47 Magdala Road Ordered to abate within 14 days. Defendant to pay £1 1s. costs. do. 67 Playford Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 56 Landseer Road Ordered to abate within 28 days. Defendant to pay 10/6d. costs. do. 17 Ella Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 17 Shaftesbury Road Ordered to abate within 14 days. Defendant to pay 10s. 6d. costs. do. 69 Outram Street Ordered to abate within 28 days. do. 46 Caledonian Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 15 Baxter Road Defendant to pay £l 1s. costs. do. 17 Bishop's Grove Defendant to pay £l 1s. costs. do. 43 Ireton Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. 26.1.53 8 Comus Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 242 Tufnell Park Road Ordered to abate within 21 days. Defendant to pay £1 1s. costs. 12.2.53 41 Loraine Road Ordered to abate within 28 days. do. 80 Moray Road Ordered to abate within 7 days. do. 109 Durham Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 3 Goodwin Street Ordered to abate within 70 days. Defendant to pay £1 1s. costs. do. 57 Evershot Road Ordered to abate within 14 days. Defendant to pay £1 1s. costs. do. 92 Gifford Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 67 Havelock Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 55 Outram Street Ordered to abate within 28 days. Defendant to pay £l 1s. costs. do. 109 Offord Road Ordered to abate within 14 days. Defendant to pay £1 1s. costs. do. 167 Barnsbury Road Ordered to abate within 14 days. Defendant to pay £1 1s. costs. do. 40 Loraine Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. 36 Corbyn Street Defendant to pay £1 1s. costs. 24 Copenhagen Street Defendant to pay £1 1s. costs. 29 Cloudesley Road Defendant to pay £l 1s. costs. 22 Harecourt Road Defendant to pay £11s. costs. 12.3.53 48 Bride Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 38 Bride Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. 82 Tollington Way Ordered to abate within 56 days. 1 Grosvenor Avenue Ordered to abate within 7 days. do. 9 Luard Street Ordered to abate within 7 days. Defendant to pay £1 1s. costs. 402 Hornsey Road Defendant to pay £1 1s. costs. 78 Tollington Way Ordered to abate within 56 days. do. 17 Barnsbury Grove Ordered to abate within 28 days. Defendant to pay £l 1s. costs. do. 40 Bride Street Ordered to abate within 28 days. Defendant to pay £l 1s. costs. do. 10 Islington Park Street Ordered to abate within 28 days. 12 Islington Park Street Ordered to abate within 28 days. do. 14 Islington Park Street Ordered to abate within 28 days. do. 49 College Cross Ordered to abate within 28 days. do. 48 Grovedale Road Ordered to abate within 28 days. 29 Public Health (London) Act, 1936. Failure to comply with Statutory Notices contrary to Section 82 (No. of Cases: 169).—contd. Date Address Magistrate's Decision  12.3.53 5 Annette Road Ordered to abate within 28 days. do. 92 Rhodes Street Ordered to abate within 28 days. Defendant to pay £1 1s. costs. 23.4.53 107 Georges Road Ordered to abate within 14 days. do. 20 Keystone Crescent Fined £1. Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 19 Hollingsworth Street Fined £1. Ordered to abate within 7 days. Defendant to pay £l 1s. costs. do. 64 Bride Street Fined £1. Ordered to abate within 21 days. Defendant to pay £l 1s. costs. do. 9 Dillon Place Ordered to abate within 21 days. Defendant to to pay 10/6d. costs. do. 22 Hornsey Rise Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 55 Berriman Road Fined £1. Ordered to abate within 28 days. Defendant to pay £l 1s. costs. do. 7 Annette Road Fined £1. Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 25 Bavaria Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 62 Gladsmir Road Defendant to pay £1 1s. costs. do. 58 Rhodes Street Defendant to pay £l 1s. costs. do. 16 Marriott Road Defendant to pay £1 1s. costs. do. Fined £1. Defendant to pay £1 1s. costs. do. 93 Tollington Way (b) Fined £1. Defendant to pay £1 1s. costs. do. Fined £1. Defendant to pay £1 1s. costs. do. Fined £1. Defendant to pay £1 1s. costs. do. 111 Hornsey Road Fined £1. Defendant to pay £1 1s. costs. do. 60 Landsrer Road Defendant to pay £1 1s. costs. do. 20 Northampton Grove Fined £1. Defendant to pay £l 1s. costs. do. .23 Charlesworth Street Fined £1. Defendant to pay £l 1s. costs. do. 69 Bride Street Fined £1. Defendant to pay £1 1s. costs. do. 10 Lough Road Fined £1. Defendant to pay £1 1s. costs. do. 10 Rhodes Street Fined £1. Defendant to pay £ls. costs. do. Fined £1. Defendant to pay £1 1s. costs. do. 43 Hilldrop Road Fined £1. Defendant to pay £1 1s. costs. 21.5.53 1 Fortnam Road Fined £1. Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 4 Carville Street Fined £1. Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 53 Havelock Street Fined £1. Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 5 Christie Street Fined £1. Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 8 Copenhagen Street Fined £1. Ordered to abate within 14 days. Defendant to pay £1 1s. costs. do. 26 Tilloch Street Fined £l. Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 22 Bemerton Street Fined £1. Ordered to abate within 21 days. Defendant to pay £1 1s. costs. do. 10 Huntingdon Street (a) Fined £1. Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 10 Huntingdon Street (b) Fined £l. Ordered to abate within 28 days. do. 10 Monnery Road Fined £1. Ordered to abate within 21 days. do. 27 Warrender Road Fined £1. Ordered to abate within 28 days. do. 7 Ward Road Fined £l. Ordered to abate within 28 days. do. 431a Hornsey Road Adjourned sine die. do. 34 Rupert Road Fined £1. Ordered to abate within 35 days. Defendant to pay £1 1s. costs. do. 12 Ward Road Fined £l. Ordered to abate within 28 days. do. 80 Moray Road Fined £1. Ordered to abate within 28 days. do. 34 Fairmead Road Ordered to abate within 28 days. Defendant to pay £1 5s. costs. do. 17 Bredgar Road Ordered to abate within 28 days. Defendant to pay £1 5s. costs. do. 39 Theberton Street Fined £1. Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 67 Cloudesley Road Fined £1. Ordered to abate within 14 days. Defendant to pay £1 1s. costs. 30 Public Health (London) Act. 1936. Failure to comply with Statutory Notices contrary to Section 82 (J^o. of Cases : 169).—contd. Date Address Magistrate's Decision 21.5.53 6 Stanmore Street Fined £1. Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 43 Oldershaw Road Ordered to abate within 28 days. Defendant to pay £1 5s. costs. do. 46 Westbourne Road Ordered to abate within 28 days. Defendant to pay £l 5s. costs. do. 35 Culpeper Street Ordered to abate within 14 days. Defendant to pay £l 5s. costs. do. 58 Hazellville Road Fined £l. Ordered to abate within 7 days. Defendant to pay £1 1s. costs. do. 8 Ormond Road 15 Benwell Mansions Ordered to abate within 7 days. Defendant to pay £1 5s. costs. Defendant to pay £1 5s. costs. do. 1-28 Clarence Terrace Fined £1. Defendant to pay £1 1s. costs. do. 48 Brooksby Street Fined £1. Defendant to pay £1 1s. costs. do. 7 Copenhagen Street Fined £1. Defendant to pay £1 1s. costs. do. 33 Lyon Street Fined £1. Ordered to abate within 28 days. Defendant to pay £1 1s. costs. do. 173 Offord Road Defendant to pay £1 5s. costs. 25.6.53 35 Mild may Road Ordered to abate within 7 days. Defendant to pay £1 13s. 6d. costs. do. 112 Grosvenor Avenue Adjourned sine die. do. 93 Bemerton Street Fined £1. Ordered to abate within 28 days. Defendant to pay £1 9s. 6d. costs. do. 31 Lyon Street Fined £10. Ordered to abate within 21 days. Defendant to pay £1 1s. costs. do. 11 Roman Way (a) Ordered to abate within 28 days. Defendant to pay £1 18s. 6d. costs. do. 11 Roman Way (b) Fined £1. Ordered to abate within 28 days. Defendant to pay £l 14s. 6d. costs. do. 13 Shaftesbury Road Fined £1. Ordered to abate within 28 days. Defendant to pay £1 9s. 6d. costs. do. 3 Baxter Grove Fined £10. Ordered to abate within 14 days. Defendant to pay 8s. 6d. costs. 16 Chalfont Road Fined £1. Defendant to pay £1 1s. costs. do. 2a Warrender Road Fined 15s. Od. Defendant to pay £1 1s. costs. 85 Cornwallis Road Fined £1. Defendant to pay £l 1s. costs. 23.7.5 J 550 Caledonian Road Ordered to abate within 7 days. Defendant to pay £1 13s. 6d. costs. do. 125 Fonthill Road Ordered to abate within 56 days. Defendant to pay £1 13s. 6d. costs do. 166 Liverpool Road Ordered to abate within 28 days. Defendant to pay 12s. 6d. costs. do. 9 Rupert Road Ordered to abate within 28 days. Defendant to pay £l 3s. costs. do. 8 Story Street Ordered to abate within 28 days. Defendant to pay £l 13s. 6d. costs. do. 42 Arthur Road Ordered to abate within 21 days. Defendant to pay £l 3s. costs. do. 39 Florence Street Ordered to abate within 14 days. Defendant to pay £2 2s. 6d. costs. do. 34 Rupert Road Adjourned sine die. do. 14 Berriman Road Adjourned sine die. do. 19 Newington Green Defendant to pay £1 9s. costs. do. 3 5 Bardolph Road Fined £1. Defendant to pay £1 1s. costs. do. J 8 Halton Road Fined £1. Defendant to pay £1 1s. costs. 3.9.53 65 Ferntower Road Ordered to abate within 14 days. Defendant to pay £1 13s. 6d. costs. do. 43 St. Thomas Road Defendant to pay £l 5s. costs. do. 18 Williamson Street Defendant to pay £1 5s. costs. do. 95 Tabley Road Defendant to pay £1 9s. costs. do. 29 Pleshey Road Defendant to pay £1 5s. costs. do. 11 Huntingdon Street Ordered to abate within 28 days. Defendant to pay £1 13s. 6d. costs. do. 131 St. Thomas Road Ordered to abate within 7 days. Defendant to pay £1 13s. 6d. costs. do. 13 Warrender Road Ordered to abate within 21 days. Defendant to do. 17 Ella Road Ordered to abate within 28 days. Defendant to pay £1 13s. 6d. costs. 31 Public Health (London) Act, 1936. Failure to comply with Statutory Notices contrary to Section 82 (No. of Cases: 169).—contd. Date Address Magistrate's Decision 3.9.53 88 Rhodes Street Ordered to abate within 21 days. Defendant to pay £2 3s. 6d. costs. do. 8 Parkhurst Road Ordered to abate within 28 days. Defendant to pay £1 13s. 6d. costs. 8.10.53 9 Boxworth Grove Ordered to abate within 28 days. Fined £2. Defendant to pay £1 14s. 6d. costs. do. 13 Boxworth Grove Ordered to abate within 7 days. Defendant to pay £2 2s. 6d. costs. do. 15 Gifford Street Defendant to pay £1 5s. costs. do. 67 Regina Road Ordered to abate within 28 days. Fined £2. Defendant to pay £l 9s. 6d. costs. do. 1 Newhall Street Ordered to abate within 21 days. Fined £1. Defendant to pay £l 9s. 6d. costs. do. 70 Durham Road Ordered to abate within 28 days. Defendant to pay 12s. 6d. costs. do. 72 Durham Road Ordered to abate within 28 days. Defendant to pay 12s. 6d. costs. do. 74 Durham Road Ordered to abate within 28 days. Defendant, to pay 12s. 6d. costs. do. 79 Durham Road Ordered to abate within 28 days. Defendant to pay 12s. 6d. costs. do. 83 Durham Road Ordered to abate within 28 days. Defendant to pay 12s. 6d. costs. do. 43 Hollingsworth Street Ordered to abate within 28 days. Fined £1. Defendant to pay £1 9s. 6d. costs. do. 58 Landseer Road Defendant to pay £1 9s. costs. do. 86 Gifford Street Defendant to pay £l 5s. costs. 5.11.53 230 Sussex Way Ordered to abate within 28 days. Defendant to pay £1 13s. 6d. costs. do. 68 Lough Road Ordered to abate within 14 days. Defendant to pay £1 13s. 6d. costs. do. 12 Hornsey Street Ordered to abate within 7 days. Defendant to pay £2 3s. 6d. costs. do. 45 Sonning Street Ordered to abate within 28 days. Defendant to pay £2 3s. 6d. costs. do. 3 Northampton Grove Ordered to abate within 14 days. Defendant to pay £2 3s. 6d. costs. do. 222 York Way Ordered to abate within 28 days. Defendant to pay £ l 13s. 6d. costs. do. 105 Georges Road Ordered to abate within 28 days. Defendant to pay £1 13s. 6d. costs. do. 1 Francis Terrace Ordered to abate within 28 days. Defendant to pay £1 7s. costs. do. 370 Camden Road Ordered to abate within 28 days. Defendant to pay £1 13s. 6d. costs. do. 67 Regina Road Defendant to pay 4s. Od. costs. do. 10 Instow Place Defendant to pay £l 5s. costs. 10.12.53 37a Lowman Road Fined £3. Ordered to abate within 14 days. Defendant to pay £1 15s. 6d. costs. do. 9 Belitha Villas Defendant to pay £1 5s. costs. do. 175 Offord Road Ordered to abate within 21 days. Defendant to pay £l 13s. 6d. costs. do. 3 Lonsdale Place Fined £1. Ordered to abate within 28 days. Defendant to pay £1 9s. 6d. costs. do. 36 Islington Park Street Defendant to pay £1 5s. costs. do. 107 Georges Road Fined £5. Defendant to pay £l 9s. 6d. costs. Ordered to abate within 28 days. do. 194 Liverpool Road Fined £1. Ordered to abate within 14 days. Defendant to pay £1 9s. 6d. costs. do. 42 Blundell Street Fined £3. Ordered to abate within 28 days. Defendant to pay £1 15s. 6d. costs. 32 Public Health (London) Act, 1936. Failure to comply with Magistrate's Abatement Order (No. of Cases: 47). Date Address Magistrate's Decision 15.1.53 52 Mackenzie Road Fined £20. Defendant to pay £2 2s. costs. 12.2.53 8 Rheidol Terrace Defendant to pay £1 1s. costs. do. 45 Hornsey Rise Gardens Fined £5. Defendant to pay £1 1s. costs. do. 25 Offord Road Fined £4. Defendant to pay £1 1s. costs. do. 173 Offord Road Fined £5. Defendant to pay £1 1s. costs. do. 221 Hornsey Road Fined £3. Defendant to pay £1 1s. costs. do. 80 Moray Road Fined £5. Defendant to pay £1 1s. costs. 23.4.53 16 Northampton Grove Fined £2. Defendant to pay £l 1s. costs. do. 18 Halton Road Adjourned sine die. do. 11 Ockendon Road (a) Fined £l. Defendant to pay 10s. 6d. costs. do. 11 Ockendon Road (b) Fined £1. Defendant to pay 10s. 6d. costs. do. 25 Marlborough Road (a) Fined £l. Defendant to pay £1 1s. costs. do. 25 Marlborough Road (b) Fined £l. Defendant to pay £1 1s. costs. do. 107 Georges Road Fined 10s. Defendant to pay £1 1s. costs. do. 46 Caledonian Road Fined £2. Defendant to pay £1 1s. costs. do. 17 Shaftesbury Road Fined £2. Defendant to pay £1 1s. costs. do. 7 Jackson Road Defendant to pay £1 1s. costs. do. 28 Halton Road Adjourned sine die. 21.5.53 41 Loraine Road Fined £l. do. 80 Moray Road Fined £5. do. 80 Moray Road Fined £10. do. 1 Fortnam Road Fined £10. Defendant to pay £1 1s. costs. do. 45 Hornsey Rise Gardens Fined £10. Defendant to pay £11s. costs. do. 13 Comus Road Fined £5. do. 92 Gifford Street Fined £1. Defendant to pay £1 1s. costs. do. 41 Loraine Road Fined £1. Defendant to pay £l 1s. costs. 23.7.53 55 Berriman Road Fined £5. Adjourned sine die. do. 55 Ou'ram Street Fined £2. Defendant to pay £1 9s. 6d. costs. 3.9.53 92 Gifford Street Fined £20. Defendant to pay £l 1s. costs. do. 48 Grovedale Road Defendant to pay £1 5s. costs. do. 7 Annette Road Fined £3. Defendant to pay £1 1s. costs. do. 80 Moray Road (a) Fined £5. do. 80 Moray Road (b) Fined £30. do. 80 Moray Road (c) Fined £50. do. 21 Aubert Park Adjourned sine die. do. 109 Durham Road Fined £10. Defendant to pay £1 1s. costs. do. 17 Shaftesbury Road Fined £25. Defendant to pay £1 1s. costs. do. 8 Comus Road Fined £3. Defendant to pay £1 1s. costs. 8.10.53 43 Oldershaw Road Fined £2. Defendant to pay £1 1s. costs. do. 41 Loraine Road Fined £2. Defendant to pay £1 1s. costs. do. 5 Christie Street Fined £2. Defendant to pay £1 1s. costs. do. 41 Loraine Road (Sec. 95) Discharged Absolutely. Defendant to pay £1 5s costs. do. 31 Lyon Street Fined £3. Defendant to pay £1 1s. costs. do. 26 Tilloch Street Fined £3. Defendant to pay £1 1s. costs. 10.12.53 7 Annette Road Fined £10. Defendant to pay £1 1s. costs. do. 42 Arthur Road Fined £10. Defendant to pay £1 1s. costs. L.C.C. Byelaws (No. of Cases : 1) Date Offence Magistrate's Decision 12.2.53 Byelaws as to Lodging Houses. Failure to comply with Byelaw 13 (a) of the above Byelaws in respect of nuisances exist ing at the following property: 58 Lough Road — Fined 10s. 0d. 33 Disinfection and Disinfestation. 892 rooms were disinfected after cases of infectious or other disease. A total of 1,540 rooms were treated for vermin, of which 486 were disinfested free of charge. The majority of free cases were on behalf of elderly or infirm persons. The Council make a charge of 7s. 6d. for the first room, and 5s. Od. for every additional room treated for verminous conditions. The furniture and bedding of families moving to new Council dwellings were treated in situ with a preparation of D.D.T. before removal and again when families took up residence in the new accommodation. The effects of 224 families were so treated as a precautionary measure. In addition, 23 treatments for flies were carried out on static water tanks, bombed sites, etc. The export of second-hand stockings, etc., continued during the year, and these were treated at the factory with formalin, under the supervision of the Sanitary Inspector, to meet the requirements of the South African Authorities. The Sanitary Inspector paid 161 visits to the factory to supervise the treatment of 1,209 bales of stockings or other materials for export to that country. Static water tanks, air-raid shelters, bombed sites, etc. The Department continued to receive complaints concerning the tipping of refuse, accumulation of water, and other nuisances in static water tanks or on bombed or vacant sites. Organic and other refuse such as bedding, etc., was removed by the Cleansing Superintendent upon requests forwarded by this Department. The co-operation of the London Fire Brigade continued to be available to pump out stagnant water from static water tanks. Details of the action taken are as follows :— Visits to bombed sites 360 Visits to air-raid shelters and static water tanks 71 Vacant land cleansed 15 Vacant land enclosed 2 Derelict buildings enclosed 3 Static water tanks cleansed 10 Blowfly Infestation. As in previous years, the treatment with D.D.T. of the sidings at Ashburton Grove Refuse Disposal Depot continued throughout the summer months, commencing on the 10th June. This consisted of dusting with D.D.T. powder the large area of railway track, the broken bottle pit, the surrounding green areas and any other areas when necessary, if the circumstances required it at the time. 34 The site was visited by Mr. A. A. Green of the Pest Infestation Laboratory, D.S.I.R., in order to collect blowfly larvae for experimental purposes. During his visit, he carried out a short but very gratifying inspection. In a communication received from him, it was stated that a heavy infestation of larvae was being brought into the Depot, but there was every indication that the control was just as good as when the treatment first started. The high level of control achieved gave rise to two very satisfying observations : (1) the application of the treatment is both thorough and efficient ; (2) the treatment remains effective. It is evident that although blowfly larvae are being introduced in very large numbers into the Depot, an extremely small number develop to the adult blowfly stage, and get away from this area. The work done must make a major difference to the blowfly population in and around the Borough. Thanks are again due to the Cleansing Superintendent, and to the representatives of the D.S.I.R. for their Co-operation, and the assistance which continues to be afforded in order that the treatment may be carried out satisfactorily. During the season, 22 cwt. of D.D.T. powder was used and a total number of 165 hours worked by Disinfestor on this treatment. The Minister of Food, in Circular No. 12/53, issued in June, drew attention of Local Authorities to the fact that recent work on the life history of the various kinds of blowfly—blue-bottles and green-bottles—shows that many of the methods of control which are appropriate to houseflies are ineffective for blowflies. The circular draws attention to the habits and life history of blowflies, and gives advice on the steps which should be taken at food premises and refuse disposal works in order to prevent the presence of blowflies. It would appear that this circular has been issued by the Ministry consequent upon the work carried out by Officers of the D.S.I.R. at the Metropolitan Cattle Market and Ashburton Grove Depots respectively. Steam Disinfection,. 114,030 articles of clothing or bedding were subjected to steam disinfection at the Disinfecting Station (99,300 for clothing contractors). Atmospheric Pollution. Public Health (London) Act, 1936—Part V. Emission of Smoke. The fact that public interest concerning emission of smoke from factory chimneys has been aroused is reflected in the increased number of complaints received during the year under review, and the resulting increase in the number of observations and inspections which were made by the Sanitary Inspectors concerned. The statutory provisions set out in the Public Health (London) Act, 1936, do not affect the emission of smoke from domestic premises, and as it is estimated that at least 50% of the total smoke emission in a Borough such as Islington arises from 35 this source, it is considered that legislation should be made in the near future which would provide effective means for dealing with this problem. In addit on the existing statutory powers fall far short of those necessary to maintain a satisfactory atmospheric standard. Compulsory notification to the Local Authority of any boiler or furnace installation (new or replacement) is recommended. Approval of the Local Authority should be obtained as to the type of boiler or furnace to be installed, and the prior submission of plans and specifications should be made obligatory. This would enable consideration to be given to the adequacy of building construction and suitability of furnaces, boilers, etc., to minimise possible smoke nuisances. The Inspectors of this Department investigate all complaints of smoke nuisance, and interview both the managers and the stokers personally. Practical advice is given on the spot and the staff concerned shown how the furnace can be operated without creating a smoke nuisance. It is generally found that the representatives of the Companies concerned are co-operative, but, where nuisances constantly occur, they are usually caused by the human element and the lack of suitable fuel. During the year the Department co-operated with St. Pancras, when it was proposed to erect a refuse destructor of considerable size in the St. Pancras area near the border of this Borough. The Chief Sanitary Inspectors of the respective Departments together interviewed the Engineer having control of this project, when the possibilities of a serious smoke nuisance occurring, which would affect both Boroughs, were stressed. Having regard to all the implications, the implementation of this scheme has been deferred for the time being. A scheme was also submitted for a refuse destructor to be erected in the Finsbury Park area of this Borough, but again representatives of the Company concerned were interviewed and attention drawn to the possible pollution of the atmosphere which would result from its use. Upon investigation it was found more economical for this Borough's Cleansing Department to remove the trade refuse periodically and therefore the proposed scheme was not implemented. Whilst Municipal flats are provided with a grate suitable for burning smokeless fuel, the majority of domestic premises are not so equipped. Difficulty has been experienced by householders during the year in obtaining sufficient supplies of smokeless fuel, which is more expensive and requires increased storage space. Until the supply of smokeless fuel improves and the householder can obtain it at an economic price, it will not be easy to persuade occupants of domestic premises to use this fuel exclusively. Arrangements were made by the Northampton Polytechnic for a two-sessional course for stokers, but as the majority of firms in this Borough employ only one stoker, difficulty is experienced in releasing staff at any time during the day. Attendance at an evening course has not proved popular with stokers, and therefore the Inspectors have found that the best method is, when complaints are investigated, to interview the staff concerned and demonstrate the firing of the boilers in such a manner as to cause no nuisance. This takes considerable time, but this is time well spent since the stoker can be shown, with the same fuel and boilers, that it is possible to stoke the furnaces efficiently. 36 Where it is possible for the staff to be released to attend lectures, this is encouraged. Number of complaints received during year 51 Number of observations made 257 Number of inspections and revisits 312 Number of notices served 5 Number of notices complied with 2 Recording of Atmospheric Pollution. Consequent upon the dense fog which enveloped the London area during the 5th—8th December, 1952, inclusive, the public have become more atmospheric pollution-minded, particularly having regard to the increase in the number of deaths which occurred during this period from bronchitis, pneumonia and other forms of respiratory diseases. In order to assist in the investigation into atmospheric pollution, this Council acceded to a request from the London and Home Counties Smoke Abatement Advisory Council and arranged for the measuring and recording of atmospheric pollution in the Borough. As a result, three measuring and recording stations were set up, each having a deposit gauge and a lead peroxide instrument to provide the necessary readings. These stations are situated on the Town Hall roof, the roof of the Community Centre, York Way Court, and at the Disinfecting Station, Seven Sisters Road, and operated from the 1st July of this year. A summary of the observations at the above three Stations for the six months ending the 31st December is as follows . Month Site Rainfall in Inches (Tons per square mile) Mg.of S03/day collected by 100 sq. cm. of Batch A Lead-Peroxide. (Louvered Box) Insoluble Deposit Soluble Deposits Total Solids July 1 2 3 3.43 3.90 4.57 7.02 13.24 9.91 7.56 10.62 6.96 14.58 23.86 16.87 1.15 1.74 0.63 August 1 2 3 2.01 2.13 2.21 4.74 8.05 7.23 5.80 4.15 5.68 10.54 12.20 12.91 1.48 1.71 0.74 September 1 2 3 1.54 1.62 1.73 9.94 13.46 11.24 6.43 7.89 6.50 16.37 21.35 17.74 3.74 2.11 0.91 October 1 2 3 2.20 2.25 2.29 7.49 13.12 9.84 9.25 9.31 7.79 16.74 22.43 17.63 2.36 2.34 1.72 November 1 2 3 1.42 1.50 1.46 9.31 11.60 11.54 6.96 7.33 5.61 16.27 18.93 17.15 4.97 2.51 4.72 December 1 2 3 0.59 0.63 0.67 8.82 20.38 11.44 † † 8.35 † † 19.79 3.19 4.05 3.02 † Figures for water-soluble matter for Sites 1 &2 not available. Key to Sites : 1. Town Hall. 2. York Way. 3. Disinfecting Station. 37 The Council was also very concerned with the menace of fumes caused by the extension of the use of diesel oil engines, and faulty maintenance of these, particularly as so many of the major roads in the Borough are used by heavily laden diesel engine vehicles, the fumes from which are undoubtedly a contributory cause of atmospheric pollution. Requisitioned Properties. This department has drawn the attention of the Council's Housing Manager to any nuisances or major difficulties arising from the occupation of requisitioned properties, in order to secure the premises being reasonably nuisance-free. The number of requisitioned properties on 1st January, 1953, was 1,362, and 67 were derequisitioned during the year. Details of the action taken during the year are as follows :— Outstanding at end of 1952 85 Referred to Housing Department during 1953 170 Premises where nuisances were abated during 1953 176 Outstanding at end of 1953 79 WORK OF SANITARY INSPECTORS ADMINISTERING FACTORIES ACT, 1937, FOOD AND DRUGS ACT, 1938, AND OTHER RELEVANT ACTS. Inspections and Re-Visits. 5,867 inspections and 4,403 re-visits were made by the Inspectors. These are summarised as follows :— Inspections Revisits Coffee and dining rooms, hotel and restaurant kitchens and refreshment rooms 973 636 Stalls (Refreshment and Food) 163 20 Factories (Mechanical) 1,328 1,316 Factories (Non-mechanical) 211 172 Factories (Public Health (London) Act, 1936) 1,350 1,287 Fish curers 57 45 Fishmongers 11 14 Fried Fish Shops 134 32 Noise Nuisances 40 43 Outworkers 73 70 Provision Shops 392 197 Special Inspections (Food licences) 42 — Bakehouses (Level) 196 119 Confectioners 198 87 Food Factories 11 4 Fruiterers/Greengrocers 432 222 Preserved food premises 256 139 5,867 4,403 (Sec separate section for underground bakehouses and offensive trades.) 38 Defects, nuisances or contraventions found. Nuisances and Notices. (a) Factories Act, 1937. Number of contraventions found 675 Number of contraventions remedied 663 Notices served 208 Notices complied with 189 (b) Food and Drugs Act, 1938. Number of contraventions found 1,465 Number of contraventions remedied 1,558 Notices served 191 Notices complied with 206 (c) Public Health (London) Act, 1936. Number of contraventions found 430 Number of contraventions remedied 418 Notices served 178 Notices complied with 147 (d) Shops Act, 1950. Number of inspections under this Act 653 Number of revisits 84 Number of exemption certificates applied for 1 Number of certificates granted — Complaints received. Number of complaints (General) 390 Number of complaints (Home Office) 20 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). 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 321 211 13 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 1,747 1,342 195 — (iii) Other Premises in which Section 7 is enforced by the Local Authority* (excluding out-workers' premises) — — — — Total 2,068 1,553 208 — 39 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) 18 — 1 3 — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — 1 — — Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7)— (a) Insufficient 17 5 — 1 — (b) Unsuitable or defective 616 656 — 20 — (c) Not separate for sexes 19 2 — 1 — Other offences against the Act (not including offences relating to Outwork) 4 — — — 2 Total 674 663 2 25 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). 40 Outwork. (Sections 110 and 111). Nature of Work (1) Section 110 Section 111 No. of outworkers in August list required by Sec. 110(1) (c) (3) No. of cases of default in sending lists to the Council (4) No. of prosecutions for failure to supply lists (5) No. of instances of work in unwhole- some premises (6) Notices served (7) Prosecuitions (8) Wearing apparel Making, etc. Cleaning and washing 1,126 — — — — — Making of Files 16 — — — — — Brass and brass articles 3 — — — — — Umbrellas, etc 3 — — — — — Artificial flowers 174 — — — — — Paper bags 17 — — — — — The making of boxes or other receptacles or parts thereof made wholly or partially of paper 103 — — — — — Brush making 17 — — — — Feather sorting 55 — — — — — Carding, etc., of buttons etc 21 — — Stuffed toys 42 — — — —- — Basket making 3 — — — — — Cosaques, Christmas crackers, Christmas stockings, etc. 6 — — — — — Textile weaving 10 — — — — — Lampshades 15 — — — — — Chocolates and sweetmeats 26 — — — — — Total 1,637 — — — — — Factories Act, 1937—Section 54. Underground Bakehouses. Certificates of Suitability, as required by Section 54 of the Factories Act, 1937, continued to be in force in respect of 23 underground bakehouses, at the following addresses :— 52 Balls Pond Road, N.l 76 Caledonian Road, N.l 299 Caledonian Road, N.l 8 Danbury Street, N.l 68 Essex Road, N.l 350 Essex Road, N.l 483 Liverpool Road, N.7 121 Packington Street, N.l 52 Stanmore Street, N.l 14 Upper Street, N.l 102 Upper Street, N.l 54 Archway Road, N. 84 Ashbrook Road, N. 146 Blackstock Road, N. 3 Card well Terrace, N. 144 Elthorne Road, N. 132 Holloway Road, N. 27 Hornsey Rise, N. 7 Junction Road, N. 59 Junction Road, N. 239 Junction Road N. 77 Newington Green Road, N. 123 Newington Green Road, N. 41 Underground Bakehouses—continued. In addition the following, although still on the register, discontinued to be used during the year :— 487 Hornsey Road, N. 398 Essex Road, N.l. Details relative to the existing bakehouses are as follows :— Number of routine inspections 125 Number of re-visits 55 Number of notices served 10 Number of notices complied with 11 Legal Proceedings. Factories Act, 1937—Failure to comply with Section 54 (Certificate of Suitability). Date Address Magistrate's Decision 7.9.53 266 St. Paul's Road Defendant found Guilty. Discharged absolutely. Public Health (London) Act, 1936. London County Council (General Powers) Act, 1937. Noise Nuisances. Details of the action taken in respect of complaints received of alleged noise nuisances during the year are as follows :— Number of complaints of noise nuisance 36 Number of inspections 40 Number of revisits 43 Number of notices served 1 As a result of a petition being received concerning noise made at a depot in the Finsbury Park Station area, where it was alleged that a nuisance was created when boxes of fish were unloaded from railway waggons into lorries, by the use of ironclad trollies which were wheeled over concrete and by the shouts of the employees, it was necessary to keep the premises under observation from 12 midnight to 7 a.m. on two occasions. Action taken by the Sanitary Inspector resulted in a mitigation of the nuisances complained of, the firm concerned being most co-operative. As a result of action taken, no further complaints have been received. 42 Public Health (London) Act, 1936. Offensive Trades. Details of the respective offensive trades in the Borough are as follows :— (a) 2 Tripe Boilers: 14/18, Market Road—Messrs. J. L. Henson (Wholesale) Ltd. 22/24, Vale Royal—Messrs. Edmund Martin Ltd. (b) 1 Knacker: 18/20, Vale Royal—Messrs. Harrison Barber 6s? Co. Ltd. (c) 1 Fur S\in Dresser: 24, Bracey Street—Messrs. J. & A. Fischer Ltd. (d) 7 Gut Scrapers : 3, Old Slaughterhouses—Casings Ltd. 4, Old Slaughterhouses—Home Killed Meat Association Ltd. 12, Old Slaughterhouses—Universal Casings Co. Ltd. 13, Old Slaughterhouses—Messrs. Morris 6? Co. (Meat Importers) Ltd. 15, Old Slaughterhouses—Messrs. Wm. Menzies Ltd. (Established anew.) 5 Tileyard Road—Messrs. C. Edwards 6? Son Ltd. Tileyard Road—Messrs. Tracey 6? Co. Ltd. (e) 2 Fat Melters: 4, Old Slaughterhouses—Home Killed Meat Association Ltd. 16, Old Slaughterhouses—Messrs. Wm. Menzies Ltd. 38 inspections were made of the above premises and appropriate action taken where necessary. (/) 1 Slaughterer: 180, York Way—Messrs. Harrison Barber 6? Co. Ltd. This slaughterhouse was the subject of 176 inspections or visits, either for the examination of horses carcasses for human consumption, in respect of which the Company had given notice to this Department, or in order to secure compliance with the relative statutes or byelaws, etc. The owners of 4 private slaughterhouses renewed their licences, but none of these premises was used during the year under review due to the Government's scheme of centralised slaughtering. Shops Art, 1950—Applications for Exemption. There was one application received for exemption from the provisions of Section 38 relative to the provision of suitable and sufficient sanitary conveniences. This application was refused. 43 Pharmacy and Poisons Acts, 1933/1941. No. of Listed sellers of Part II poisons other than registered pharmacists 197 No. of visits and inspections 101 No. of initial registrations during year 6 No. of samples taken 1 No. of samples unsatisfactory 0 Certain amendments to the Poisons List and the Poisons Rules were made during the year by virtue of the Poisons List Order, 1953, and the Poisons Rules, which came into operation on 1st September. The Poisons List Order added certain substances to the poisons list, and the third schedule set out the complete list of poisons included in the Order on the date of its coming into operation. The Poisons Rules imposed, inter alia, appropriate requirements and restrictions on the sale of the substances now added to the Poisons List by the aforementioned Order. Rag Flock and other Filling Materials Act, 1951. Number of premises on Register (Section 2 for Upholstery) 32 Number of Licences issued (under Section 7 for the storage of Rag Flock) 1 Number of samples taken—Satisfactory 3 Unsatisfactory 1 Diseases of Animals Acts. No action was necessary by this Department under these Acts which are administered by the London County Council. Pet Animals Act, 1951. Number of licences issued during year 23 44 Prevention of Damage by Pests Act, 1949. The following is a summary of the work carried out by the Rodent Control Section during the year :— Notices Served : 7 Intimations and 7 Statutory Notices. Type of Property Local Authority Premises Dwelling Houses Business Premises Total 1. Complaints received (including repeats) 37 1,208 189 1,434 2. Number of properties inspected as a result of: (a) Notification (initial complaint only) (a) 29 992 167 1,188 (b) Block Survey (b) — 674 39 713 3. Number of properties found to be infested by rats (including 10 ship rats) 11 507 90 608 4. Number of properties found to be infested by mice 3 380 33 416 5. Re-visits by Investigators * 1,684 3,483 229 5,396 6. Non-effective visits by Investigators 1 167 5 173 7. Number of infested properties treated (new jobs commenced) 14 870 126 1,010 8. Continuation or post-bait treatment * 1,443 2,348 246 4,037 9. Visits by Operators * 4,958 11,063 956 16,977 10. Still being baited at end of year — 59 2 61 11. Completed during the year 1,247 1,995 220 3,462 12. Number of Business Agreements dealt with : 106. 13. Members of the Rodent Staff assisted in the operation of smoke machine in respect of 178 drainage tests carried out by Sanitary Inspectors. * Includes the baiting of manholes for sewer maintenance treatments 17/18. NOTE :—For the purpose of completing Sections 2, 3, 4 and 7, each property is entered once only in respect of inspections, infestations and treatments. As provided for under the Prevention of Damage by Pests Act, 1949, all domestic premises are treated free of any charge. A charge, however, has to be made in respect of business premises. A variation in the charge was made in April of this year, when an inclusive charge of 9s. Od. per hour became effective, and this arrangement has so far proved satisfactory. In the event of the treatment costing less than the amount assessed, a refund is made to the responsible person, but should it be necessary to extend the treatment beyond the cost allowed, a further assessment and charge are made in order that the work may be completed. As indicated in the above table, the percentage of ship rat infestations was 0.976% of the total infested premises found. Difficult cases continue to be met, and it is only by persistent efforts and patience that these are brought to a satisfactory conclusion. In the case of one requisitioned property, rats infested the first storey intermittently over a period of some years. Drains were relaid or repaired on adjoining property and a number of smoke tests were applied to the drain of this particular house, but with negative results. It finally became necessary for the Council to open up the ground and expose the outlet drain, which was relaid upon being found defective. No further complaints have been received, and no takes were recorded upon the premises being post-baited. 45 Another interesting case was the existence of rats in one of the public gardens in the Borough. Upon tracing the run, a disused unsealed interceptor was found ; the chamber had been filled loosely with large pieces of York stone, making it very easy for rats to climb to the top of the manhole and escape above ground. This was remedied by emptying the chamber and fixing a proper frame and cover. Another hole was traced and revealed a disused, defective drain connected to the sewer. This was sealed off and filled in. No further rat nuisance has occurred. Investigations at a house in the Borough showed that it had two completely separate drains, one running at the side and the other under the house. Rats were escaping from the drains under the premises, and upon these being sealed and filled in with lime, no further trouble has occurred. Another case revealed the fact that two water closets discharged into a leadlined box approximately 18 ins. x 12 ins. x 18 ins , the untrapped outlet of which was connected to the head of the house drain. Upon re-draining, the premises became rat-free. Four hospitals in the Borough were inspected quarterly for rodents, and any necessary action taken by the appropriate Group Hospital Management Committee. With the co-operation of the Superintendent of the Metropolitan Cattle Market, the drains within the curtilage of the Market area were baited twice during the year and found rat-free. Four Workable Area Committee Meetings were attended by representatives from this Department during the year. Sewer Treatments. Two routine sewer treatments were carried out during the year, in connection with which the co-operation of the Borough Engineer and his staff was appreciated. Details of the treatment are as follows :— Treatment No. Manholes Bodies Seen Percentage of Poison Takes Baited Showing Complete Takes Showing pre-bait Takes Showing No Takes CT PT NT 17 773 223 439 334 5 1.83% 90.43% 7.74% 18 803 331 506 297 26 4.54% 92.69% 2.77% Water Supplies. The Metropolitan Water Board continues to be the responsible authority for the supply of water to this Borough. Two samples of water from the main supply were taken for chemical and bacteriological examination, both of which were reported to be satisfactory. Public Health (London) Act, 1936—Section 95. (1) Water supplies to tenement houses. 52 notices were served under this section requiring the provision of water supplies to tenement houses. 59 water supplies were provided. 5 prosecutions were taken for failure to comply with statutory notices, details of which are as follows: 46 Date Address Magistrate's Decision 15.1.53 14 Tollington Place Ordered to abate within 28 days. Defendant to pay £1 1s. costs. 15.1.53 41 Loraine Road Ordered to abate within 28 days. Defendant to pay £1 1s. costs. 21.5.53 17 Barnsbury Street Fined' £1. Ordered to abate within 28 days. Defendant to pay £l 1s. costs. 25.6.53 12 Chalfont Road Fined £2. Ordered to abate within 14 days. Defendant to pay £1 9s. 6d. costs. 3.9.53 376 Camden Road Defendant to pay £1 5s. costs. A number of complaints was received as a result of action taken by the Metropolitan Water Board in cutting off water supplies to houses with burst or faulty water service pipes. These cases proved difficult for this Department to deal with adequately, and it was decided to ask the Metropolitan Water Board to exercise their statutory powers in such cases. These powers permit the Board to carry out the work to defective water fittings upon the expiration of the period allowed in the notice, and to recover the expense incurred. At the end of the year, this matter was still under consideration by the Board. (2). 27 applications were received for water certificates, and 27 certificates were issued in respect of 451 separate dwellings. The annual examination of the known 28 bore holes or wells in the Borough was carried out. 19 of these have been abandoned and effectively sealed, leaving 9 capable of being used. It was found, however, that 2 of these were temporarily out of commission. Samples of water for chemical and bacteriological examinations were taken from the wells in use, and the results showed that no exception could be taken to their continued use for domestic or washing purposes, although in one case there was slight contamination. The owners of this well were informed that chlorination should be carried out. In no case is any of the water used for dietetic purposes. Details of samples taken are given as under :— Satisfactory Unsatisfactory Chemical Bacteriological Chemical Bacteriological Chemical Bacteriological 7 7 7 6 — 1 Swimming Bath Water. The number of samples of swimming bath water taken during the year is as follows :— Satisfactory Unsatisfactory Chemical Bacteriological Chemical Bacteriological Chemical Bacteriological 14 14 14 13 — 1 In addition, two samples of subsoil water were taken and four samples from the lake at Riverside walk. 47 SECTION D HOUSING (In conjunction with Mr. W. C. Bartlett, Chief Sanitary Inspector). It is common knowledge that the greater part of the habitable accommodation in Islington is in the form of multi storey tenement occupation in old-fashioned houses of the early Victorian period, or of even earlier construction. This position has been confirmed in the Registrar-General's County of London Report, compiled from the 1951 Census returns :— Number of Private Households 81,793 Percentage of Households sharing % Piped Water Supply 42 Cooking Stove 7 Kitchen Sink 22 Water Closet 53 Fixed Bath 20 Percentage of Households without Fixed Bath 59 Action under Section 9 of the Housing Act, 1936, not having been resumed during the year, the service of notices was continued and the necessary follow-up action taken to secure that dwellings in the Borough were nuisance-free. The opinions of tenants and other members of the public may differ from those of the Inspectors, as to what is a nuisance under the Public Health (London) Act, 1936, and, in the absence of a statutory definition, recourse has to be made to case law, which is by no means conclusive. In a High Court of Justice in October this year, it was upheld that walls and ceilings, although dirty, flaking and in need of decorative repair, were not a nuisance, no dampness or vermin being present. In a Borough such as Islington, where the majority of property is reaching its centenary, and a number have well passed that age, difficulty is being experienced in maintaining the properties in a reasonable state. Many houses are structurally sound, but uneconomic due to the high cost of labour and material. This fact is supported by the findings of the Committee of Inquiry into the Cost of House Maintenance, the report of which was issued in April of this year. From this report it will be seen that, taking 1939 as 100, the index figure for the cost of maintaining a house in good tenantable repair is 316. In arriving at this conclusion, the Committee states its wish to emphasise that this index gives their estimate of the cost of doing today the same amount of maintenance work as was done in 1939. No account has been taken of any changes in cost which might be due to : (a) increasing age of houses, and therefore the need to incur more expenditure on repair of the structure and the replacement of sanitary and heating eqiupment; 48 (b) any changes in the incidence of expenditure due to the need to make good the deterioration which took place during the war years ; (c) changes between 1939 and 1953 in the frequency or extent of painting and decoration. A very desirable amendment to Seciton 11 of the Housing Act, 1936, was made by the Local Government (Miscellaneous Provisions) Act, 1953, whereby a local authority can, in lieu of making a demolition order, make a closing Order prohibiting the use of a house for any other purpose than a purpose approved by the authority. This is particularly beneficial when the property concerned forms part of a terrace, and demolition would possibly render the adjoining properties unsafe, and in any case necessitate the shoring and weatherproofing of the exposed walls. The revocation of Defence Regulation 68 C.A., whereby it was an offence in certain circumstances to use living accommodation for business purposes, led to action—as far as possible—being taken under the Town and Country Planning (Housing Accommodation) Direction Order, 1952. A slum clearance programme of areas proposed to be dealt with during 19561960 was approved by the Council, but in view of the possibility of the Housing Repairs and Rents Bill being placed on the statute book in the near future, this scheme may have to be reviewed. Considerable and increasing numbers of Cypriots have arrived in the Borough and the co-operation of the Commissioner on behalf of the Cyprus Government is appreciated. Notice of the intended arrival to particular addresses in the Borough is given by the Commissioner, and is always followed up by visits to the premises concerned by the Sanitary Inspectors of this Department. Details of the proposed living conditions are obtained, and particularly as to whether additional persons would cause overcrowding under the Housing Act, 1936, or whether any other special adverse sanitary circumstances would occur. By this method it is possible to exercise some form of control, but since persons are not restricted once they have been allowed to enter the country, it is not possible for this Department to exercise complete supervision or control once they are resident in the Borough ; in fact it has been found that immigrants arriving at an approved address often do not stay, but move to other accommodation in respect of which this Department has no information. During the year 311 notifications were received from the Commissioner, of which 243 were acceptable on housing grounds in the first place. 56 applications could not be recommended as overcrowding would have resulted. In 6 further cases which could not be recommended in the first instance, it was later found possible, by a rearrangement or additional accommodation being found in the home premises, to approve the applications. In 8 cases, however, it was necessary to draw the attention of the Commissioner to the fact that there was already serious over crowding at addresses in which immigrants intended to live. The 311 applications refer to 459 persons comprising : 155 Male adults 185 Female adults 119 Children 49 Of the 243 cases accepted, there were included 380 persons comprising : 127 Male adults 160 Female adults 93 Children Since approximately a quarter of all the persons concerned are children, it is obvious that proper schooling is a problem to be solved in respect of children over the age of five years. Re-housing. Number of dwellings erected by this Council during year 234 Number of dwellings in the course of erection at end of year by this Council 467 Number of new applications (L.C.C.) referred to this Department during year 1,225 Number of above families in respect of whom over crowding forms have been issued 163 Number of above families not living in overcrowded conditions 94 Number of overcrowded families re-housed by the Islington Borough Council during the year 319 Number of overcrowded families re-housed by the London County Council during the year 110 In addition, a number of families have been rehoused from sites acquired for redevelopment in connection with the Council's Housing Schemes. Further families have been rehoused from properties in respect of which Closing or Demolition Orders have been made. Number of applications referred to the Department from the Commissioner, Cyprus Government, for acceptance of immigrants from Cyprus 318 Number of letters sent concerning housing conditions during the year 2,755 50 During the year the following action was taken under the Housing Act, 1936 :— Number of Dwellings Section represented 9 — 11 (unfit houses) 4 11 (as amended by Local Government (Miscellaneous Provisions) Act, 1953) 3 12 (parts of buildings) 3 12 (underground rooms) 32 Total 42 Resulting from these and previous representations and like proceedings during the year the following action was taken :— Section Action Number of Dwellings 11 Undertakings accepted 3 11 (As amended by Local Government (Miscellaneous Provisions) Act, 1953)—Closing orders 4 12 Closing orders made 23 (46 underground rooms) 12 Undertakings accepted 8 (This figure includes 15 basement rooms) 12 Undertakings accepted (parts of buildings) 1 (This figure includes 3 rooms) Total 39 Dwellings upon which Closing Orders have been substituted under the Local Government (Miscellaneous Provisions) Act, 1953, where Demolition Orders made under Section 11 were in operation 4 11 Undertakings cancelled upon completion of the necessary work 1 12 Closing orders determined upon completion of the necessary work 3 Licences authorising temporary overcrowding. Four licences were granted under Section 61 of the Housing Act, 1936, authorising overcrowding ; 1 for a period of five months, 2 for a period of six months and 1 for a period of one year. In 2 cases these constituted renewals of licences which had expired. One application for a licence was not granted. The total number of dwellings affected was therefore 5. 51 Housing Act, 1936. Prosecutions. Date Address Magistrate's Decision 25.6.53 4 Bemerton Street Failing to comply with Section 14 of the above Act. Fined £1. Defendant to pay £1 1s. costs. 25.6.53 4 Bemerton Street Failing to comply with Section 14 of the above Act. Defendant discharged on payment of 4s. costs. SECTION E SUPERVISION OF FOOD (In conjunction with Mr. W. C. Bartlett, Chief Sanitary Inspector) The Government, being aware of the necessity for improved legislation relating to food and food premises, issued a Bill during the year under review in which certain material amendments to the Food and Drugs Act, 1938, are proposed. In the main, proprietors of food factories and shops in the Borough will welcome any effort which will result in cleaner and safer food being sold to the public. In order to acquaint the public and, in particular, food handlers, with the equipment and practices necessary to promote hygiene in catering establishments, the Ministry of Food issued a handbook entitled " Clean Food." This booklet should receive wide publicity, for it sets out in simple and readable language the points to which attention must be paid by those engaged in the food industry, particularly catering, in order to ensure a satisfactory standard of hygiene. The handbook should be available to every person engaged in the catering industry. The findings of the Inter-Departmental Committee on Meat Inspection, whose report was issued in 1951, received recognition by the issue of Memo. 3/Meat, which supersedes Memo. 62/Foods which was issued by the Ministry of Health over thirty years ago. This memorandum contains the methods and criteria of meat inspection recommended by the Ministry of Food for adoption by local authorities and their officers. The recommendations are divided into four sections : Part I—giving general guidance for authorised Officers, occupiers of slaughterhouses and slaughtermen. Part II—dealing with ante-mortem inspection. Part III—dealing with post-mortem inspection. Part IV—action to be taken when evidence of disease is found. Upon implementation, Memo. 3/Meat will ensure that the inspection of meat, including the inspection of animals prior to slaughter, will be carried out efficiently and prevent diseased or unsatisfactory meat being passed on to the consumer either direct from the retailer or through the medium of manufactured meat products. 52 The control of flour ended in August, the Minister of Food thereby implementing the final steps in the Government's proposals as outlined in a white paper published earlier in the year. Arising out of the de-control of flour, the Minister issued the Flour Order, 1953, and the Bread Order, 1953, as a result of which the housewife will be able to obtain National bread, brown bread, whiter bread and wholemeal bread. By virtue of these Orders, calcium must be added to all types of flour except wholemeal flour, produced from the whole of the wheat grain without any additions. Also, certain specified nutrients must be restored to all flours of less than 80 per cent. extraction. Several other Statutory Instruments affecting food were issued during the year, including the following :— 1. Labelling of Food Order, 1953—which re-enacted in a consolidated and revised form the Labelling of Food Order, 1950. Certain new provisions have been introduced, among which are the following :— (i) biscuits and flour confectionery to be defined for the purpose of exemption ; (ii) it is now necessary for retailers who pre-pack food consisting of two or more ingredients on the premises where it is to be sold, to declare on or after 1st July, 1953, the ingredients on labels ; (iii) it is now necessary to specify the ingredients of beef and pork sausages and sausage-meat and home canned fruit and vegetables. 2. Offals in Meat Products Order, 1953—this Order protects the consumer consequent upon the fact that it prohibits the inclusion of certain specified offals which are unsuitable in meat products which are not or which have not been canned. 3. Food Standards (Preserves) Order, 1953—by virtue of this Order, the distinction between fresh fruit and full fruit jam has been abolished. 4. Transfer of Functions (Slaughterhouses and Knackers' Yards) Order, 1953— this Order came into operation on 1st January, this year, as a result of which certain statutory powers and duties relating to slaughterhouses and knackers yards or otherwise relating to the slaughter of animals were transferred to the Ministry of Food. 5. Food Standards (Soft Drinks) Order, 1953—amongst the principal changes brought about by the issue of this Order are :— (a) certain medicated and glucose beverages are exempt ; (b) the standards, with certain modifications, apply to soft drinks for consumption by diabetics. 6. The Artificial Sweeteners in Food Order, 1953. 7. The Food Standards (Saccharin Tablets) Order, 1953. 53 8. The Canning of Food and Feeding Stuffs and Home-Canned Fruit and Vegetables (Revocation) Order, 1953—by virtue of this Order, it is no longer necessary to declare ingredients on labels given in respect of canned fruit and canned vegetables. 9. The Merchandise Marks Act, 1953—this statute, which comes into operation on 31st January, 1954, strengthens the law against misleading and false trade descriptions, by including " misleading" trade descriptions, and a provision relative to " quality " as well as description of " fitness for purpose, strength, performance or behaviour " of an article. Manufacturers of food and drugs will need to reconsider the wording of their advertisements and labels—for no exemption is given in favour of what has up to the present been legitimate, although exaggerated. Manufacturers of proprietary medicines, and particularly those who manufacture special brands of infants' and invalids' foods, will need to exercise great care if they are to comply with these new conditions. It must also be remembered that the new Act increases the maximum fine at Petty Sessions, for a first offence under Section 2 of the Act of 1887, to £100. The inspection of food and food premises continued during the year, and a number of complaints were received of alleged foreign matter in food, including :— A staple in cake. A beetle in loaf. Matchstick in bread. Nail in loaf. Enamel in tin of stewed steak. Piece of metal in sausage. Glass in milk and in pickles. Button in mince tart. Mould in meat pie and apple turnover. Maggotty toffee. Dirty milk bottles. In the majority of cases, the evidence was not sufficient to justify statutory action being taken. Food and Drugs Act, 1938. Number of food premises in the area, and type of business. Bakehouses—level 35 —basement 25 Food factories 41 Fish friers 73 Fish curers 33 54 Fish depot 1 Cafes and restaurants 303 Public houses (catering) 213 Canteens and clubs 131 Coffee stalls 9 Off-licences selling food 35 Greengrocers 200 Grocers 288 Confectionery 185 Chemists 52 Fish shops 16 Continental Butchers 2 Food stalls (street traders) 83 Food storage premises for street traders 97 Bakers retail shops 37 Butchers 146 Preserved Food Premises Registered under Section 14(1 )(b) of the Food and Drugs Act, 1938. (Included in foregoing list.) Total No. of Preserved Food Premises 212 No. of Butchers 93 No. of Grocery and provision shops 84 No. of General shops 10 No. of Cafes 1 No. of Bakers, etc. (meat pies) 7 No. of Food Factories 13 No. of Cooked meat shops 4 Total No. of visits made by Inspectors to Preserved Food premises 334 Legal Proceedings. Details of the action taken by the Council under the Food and Drugs Act, 1938, are as follows :— Date Offence Magistrate's Decision 2.3.53 Selling food, namely a small Dundee Cake which was not of the quality demanded contrary to the above Act at: — 24 Caledonian Road Fined £5. Defendant to pay £1 2s. costs. 23.3.53 Offences under Stction 13 in connection with 66/68 Andover Road. Failing to keep the floor in a proper state of repair. Failing to keep the walls in a proper state of repair. Fined 40s. Defendant to pay 10s. 6d. costs. Fined 40s. Defendant to pay 10s. 6d. costs. 55 Date Offence Magistrate's Decision 23.3.53 Failing to keep the ceiling in a proper state of repair. Fined 20s. Defendant to pay 10s. 6d. costs. Failing to keep the window in a proper state of repair. Fined 20s. Defendant to pay 10s. 6d. costs. Failing to keep the doors in a proper state of repair. Fined 20s. Defendant to pay 10s. 6d. costs. Failing to keep clean the walls Fined 40s. Defendant to pay 10s. 6d. costs. Failing to keep clean the ceiling Fined 40s. Defendant to pay 10s. 6d. costs. Failing to keep clean the floor Fined 40s. Defendant to pay 10s. 6d. costs. Allowing refuse or filth to accumulate in a room of the said premises Fined £5. Defendant to pay £1 1s. costs. Failing to ensure that cleanliness was observed by person employed in the said room in regard to apparatus and utensils therein. Fined £3. Defendant to pay £1 1s. costs. Unsound Food. The total amount of food condemned during the year was :— 43 tons, 9 cwts., 2 qrs., 1 stone, 12 lbs., 8 ozs. details of which are given in the following table :— Tons Cwts. Qtrs. Stones Lbs. Ozs. Tinned Goods 39 7 — — 3 4 Pish — 8 2 1 7 — Meat 1 — 3 — 13 12 Others 2 13 — 1 2 8 Total 43 9 2 1 12 8 Number of condemnation certificates issued was 1,750. Most of the above food was condemned upon request by the respective owners. Condemned food received from traders is taken to the Council's refuse disposal depot at Ashburton Grove awaiting conveyance, under supervision, to the refuse tip. Small quantities of food which may be subject of complaint by householders are surrendered to the Inspector, who ensures that there is no possibility of use for human consumption. Food such as cereals are disposed of for animal feeding, under supervision, and if the food is conveyed to another borough, the Medical Officer of Health for that borough is informed accordingly in order that he may arrange for the supervision of its ultimate disposal. Where possible all other condemned food is dyed in order to make it impossible for it to be re'sold or used for human consumption. Condemned meat is used for animal feeding or industrial purposes. 56 Sampling. 922 samples (373 formal, 549 informal) were submitted to the Public Analyst for examination. Of these, 28 (or 3.04 per cent.) were adulterated as shown in the following summary :— Formal Informal * Milk 1 *Glycerine, Lemon & Honey 1 *Lemon Butter 1 Milk 5 Lemon Curd 2 Bread 4 Meat Extract (Canned) 1 Tomato Soup (Canned) 1 Beef Sausages 1 * Lemon Butter 1 Mince Tart 1 Meat Pie 1 Whipping Compound 1 Apple Turnover 1 Toffee 1 Jelly Crystals 1 Codeine Phosphate Tablets 1 Lobelline Lozenges 1 Pearl Barley 1 Glace Cherries 1 Totals 4 24 * Incorrect or Misleading Label. Meat and Other Foods. The Metropolitan Cattle Market, which is owned by the Corporation of the City of London, is under the control of the Ministry of Food. No visits by Officers of this Department were therefore necessary for the purpose of inspecting home killed or imported meat. In accordance with the requirements of the Public Health (Meat) Regulations, 1924/52, 166 notices were received during the year in respect of the intended slaughter of horses for human consumption Details of action taken are as follows :— Number of horses slaughtered 213 Number of carcasses inspected 213 Weight of horse-flesh condemned 30 lbs. Description of horse-flesh condemned liver Twelve of the above carcasses were exported to Holland. Slaughter of Animals Act, 1933. Slaughtermen's Licences. During the year 1 new licence was issued, making a total of 25 in force. 57 Inspection of Refreshment and Coffee Stalls. Eleven evening inspections of refreshment and coffee stalls were carried out by Sanitary Inspectors. No complaints relative to such stalls were received during the year, and the conditions found to exist at the time of the Inspectors' visits were generally 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. Lavatory Jan. Feb. Mar. Apr. May Jun. July Aug. Sep. Oct. Nov. Dec. Approx. weekly average through -out year Archway— Men 35 17 20 21 32 34 39 44 47 38 29 30 32 Women 24 28 24 28 28 30 21 30 31 34 34 32 29 Finsbury Pk.— Men 82 84 79 83 116 67 82 77 82 81 77 82 83 Women 8 8 10 11 18 12 8 15 13 4 6 7 10 ParkhurstRd.— Men 43 36 44 42 50 51 52 53 50 41 42 40 45 Women 7 8 9 11 9 15 14 14 18 15 16 13 12 Highbury— Men 24 25 27 27 26 28 28 33 34 32 34 30 29 Women 7 8 6 3 11 21 11 8 11 11 9 11 10 Offord Rd.— Men 12 13 10 10 7 10 8 8 15 14 12 11 11 Women 2 2 4 4 5 4 6 4 4 3 3 2 4 High St.— Men 33 43 47 43 41 45 49 39 38 49 32 36 41 Islington Gr.— Women 8 12 9 11 14 12 13 11 15 13 12 16 12 285 284 289 294 357 329 331 336 358 335 306 310 Ice-Cream. Ice-Cream (Heat Treatment, etc.) Regulations, 1947-51. Supervision of the Manufacture and Distribution of Ice-Cream. The Food Standards (Ice-Cream) (Amendment) Order, 1953, which came into operation on 1st June, restored the standard for ice-cream to that which prevailed prior to 7th July, 1952. The minimum standard generally for ice-cream is now 5% fat, 10% sugar, 7½% milk solids other than fat. During the year 501 visits were paid to ice-cream premises. Number of premises registered :— (a) for manufacture, sale and storage 87 (b) for sale and storage 173 (c) for sale only 242 (d) for storage only 7 509 58 Bacteriological Examinations. 149 samples of ice-cream were sent for bacteriological examination. The gradings of those submitted to the methylene blue test were reported to be as follows :— Grade I 100 Grade II 32 Grade III 4 Grade IV 6 142 The samples graded in I and II of the methylene blue test are considered satisfactory, and samples graded III or IV unsatisfactory. Of the remaining 7 samples not submitted to the methylene blue test, 3 were found to be unsatisfactory. 11 ice lollies were examined bacteriologically, and all were reported to be satisfactory. 4 milky lollies were submitted for bacteriological examination, 1 of which was found to contain faecal coli. Difficulty was experienced in respect of ice-cream produced at one factory in the Borough where samples, although reported as falling in Grades I and II, were found to contain faecal coli, thus indicating that care was not being taken by the employees in regard to personal hygiene. Other samples from the same factory falling in Grades III and IV also had faecal coli. This situation was brought to the notice of the Company concerned, and by co-operation with the Sanitary Inspector, an ice-cream of satisfactory standard, without the presence of faecal organisms, was ultimately produced. Chemical Examinations. 107 samples of ice-cream and 5 ice lollies were submitted for chemical analysis, none of which was reported to be unsatisfactory. The ice lollies were also reported to be free from metallic contamination. From the following table, which gives details of the respective fat contents of the ice-cream samples, it will be observed that all were satisfactory, in fact the majority were well above standard :—- Fat Content Less Than— 6% 7% 8% 9% 10% 11% 12% 13% 14% 15% 16% 1 2 5 12 23 22 29 7 3 2 1 59 Milk. During the year, the Ministry of Agriculture and Fisheries issued the report of the Working Party on Quality Milk Production, the main points of which can be summarised as follows :— (1) there has been some deterioration in the compositional quality of milk in England and Wales, the decline in " solids-not-fat" being more marked than that in fat ; (2) much of this decline took place during the war and is due to the feeding difficulties then experienced ; (3) efforts have been made to improve the compositional quality and the decline appears to have been arrested in recent years, at least in some parts of the country. There are, however, still many producers who continue to produce poor milk and these producers must be encouraged to improve ; (4) the introduction of a scheme for payment for milk on the basis of compositional quality could not be recommended, but instead producers and distributors should co-operate with the assistance of Government Departments and the Research Institutes in an effort to improve the compositional quality of milk, beginning with the poorest ; (5) those concerned should as soon as possible pay as much attention to solidsnot-fat records as they already do to fat records ; (6) more research is needed into all factors affecting the composition of milk ; (7) the necessary foundation for progress is the maintenance of continuous records of compositional quality for all breeds and for all parts of the country ; (8) Food and Drugs Authorities should not initiate a prosecution for the addition of water to milk unless they have obtained an unfavourable result from applying the Freezing Point Test. Milk Samples. The total number of samples taken during 1953 was 744. Samples submitted for Chemical Analysis:— Genuine Adulterated Total Formal 309 1 310 Informal 147 5 152 Total 462 60 Samples submitted for Bacteriological Examination :— Class of Milk Results Phosphatase Methylene blue Turbidity Total No. of Samples Pasteurised Satisfactory Unsatisfactory 247 — 243 *4 — — 247 Sterilised Satisfactory Unsatisfactory — — — — 23 — 23 Tuberculin Tested (Pasteurised) Satisfactory Unsatisfactory 9 — 9 — — — 9 Total 279 * In relation to 3 of these samples the shade temperature exceeded 65° F. During the year 3 animal innoculations were carried out for tuberculosis tests. The milks were tuberculin tested raw milks and the results were negative, no evidence of tuberculosis being observed after eight weeks. 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 41 The following licences were granted :— Pasteurised 230 Pasteurised (supplementary) 18 Tuberculin Tested 132 Tuberculin Tested (supplementary) 17 Sterilised 294 Sterilised (supplementary) 20 711 Milk and Dairies Regulations, 1949. Number of Dairies Registered in the Borough 28 Number of Distributors registered in the Borough 272 Number of Registered Distributors dealing from registered premises outside the Borough 24 61 Summary of visits by Inspectors. Dairies—Routine Inspections 32 Miscellaneous visits 125 Milkshops—(Milk sold in sealed containers only)— Routine Inspections 266 Miscellaneous visits 121 Vehicles Inspected 74 Dairies and Milkshops—Inspections re special designated milk 41 Total number of inspections and miscellaneous visits 659 Number of Notices served 5 SECTION F—MISCELLANEOUS SERVICES HEALTH PUBLICITY During the year various activities were undertaken in the field of Health Publicity. Exhibitions Food Hygiene. This Exhibition and associated demonstrations, constituting the first of their kind in the Borough, were held during February at a large Restaurant—and the success of this venture was made possible in no small measure by the generous co-operation and free facilities provided by the firm concerned. The demonstrations, which included a food hygiene talk, illustrated by filmstrips, followed by invited questions to a Question Panel, and then a tour of the Exhibition and of the Restaurant's kitchens and bakery, took place on the afternoons of 24th and 26th February. Those invited to the demonstrations consisted in the main of invited staffs and management of those concerned with catering and food preparation in restaurants, canteens, etc. Personnel included restaurant and canteen staffs of hospitals, London County Council Meals Services, including School Meals Service, and commercial establishments. Also present at the demonstrations were members of the Council, representatives of the Ministry of Food and Central Council for Health Education and some Medical Officers, Sanitary Inspectors and other senior staff of adjacent Borough Councils and the London County Council. The proceeding at each of the afternoon demonstrations were opened respectively by His Worship the Mayor of Islington, and by Dr. Eric Fletcher, M.P. The hall was filled on each occasion and it is estimated that approximately four hundred people attended the demonstrations. In addition, some five hundred school children in organised parties visited the Exhibition and large numbers of the general public were also attracted. 62 In addition to the original exhibits organised by the Public Health Department, stands and demonstrations were provided by seven commercial concerns, mainly local, and also the Central Council for Health Education, the Central Public Health Laboratory, Colindale, the Public Health Department of the Hackney Borough Council, and the Mass Radiography Unit, 32, Drayton Park. The enthusiasm of those attending the demonstrations, and the expressions of interest by those people, including members of the public, attending the Exhibition, indicated the great success of this venture, a success which, in no small part, was also due to the many bodies and individuals who so readily and efficiently contributed to its organisation. Home Life and Industries. During September the Islington Chamber of Commerce organised an Exhibition under this title, and the Public Health Department accepted an invitation to hire a stand. The Exhibition was open to the public from 26th September to 3rd October, and the Department's stand dealt with the subjects of atmospheric pollution and food hygiene. The inset plates show photographs of two sections of this stand. Film Shows. Three years ago this Department introduced a scheme for attracting the general public to health publicity film shows by the inclusion in the programme of a fulllength feature film. This particular activity has proved so successful that it has become a regular feature of the Department's health publicity programme. Again this year the film shows have played to large audiences, and this method of health propaganda can be recommended to, and has in fact already attracted the attention of, other Sanitary Authorities. During the year ten Shows were held, the programme on each occasion being introduced by a member of the Public Health Committee, and the films being preceded by a short talk by the Medical Officer of Health or his Deputy. The Council's Director of Entertainments organised regular Film Shows of general interest in the Town Hall during the autumn and winter and his invitation to include a health film was accepted on eight occasions. The health films exhibited were provided by— Central Film Library. National Film Board of Canada Gaumont-British Film Division Imperial Chemical Industries United States Information Service. and were entitled— " A Modern Guide to Health " " A New Beginning " " Another Case of Food Poisoning " " Behind the Menu " " Control of Bacteria in Food " " Defeat Tuberculosis " " Defence against Invasion " " Every Five Minutes " " Footsteps to Beauty " " His Fighting Chance " " Life Blood " " Mary's Birthday " " Old Wives' Tales " " Our Normal Day " " Surprise Attack " " The Nose Has It " " Unwanted Guests " " Wanted for Life " " Your Children's Ears " " Your Children's Meals " " Your Children's Sleep " " Your Children's Teeth." 63 Lectures with Films or Filmstrips. Lectures to Food Handlers. A series of six lectures for food handlers was held during the year. The programmes were arranged to consist of— Lecture, illustrated by film strips ; Address by Medical Officer of Health, or Deputy ; Address by Chief Sanitary Inspector ; Question Time. It is estimated that the lectures were attended by some 300 persons representing a variety of catering establishments. Lectures to School Children. In response to a request from the Divisional Medical Officer, London County Council, talks were given by Mr. Shuttleworth, Sanitary Inspector, to senior children in schools. The subject concerned was food hygiene, with particular reference to milk. Fifteen lectures were given, illustrated with films, and it is estimated that a total of 1,300 children attended. Lectures to Students. In conjunction with the Northern Polytechnic Authorities, arrangements were made for students to be given instruction in certain aspects of Public Health. This included an inspection of old and new housing, food sampling procedure, a visit to a restaurant and, with the co-operation of the Cleansing Superintendent, an inspection of Ashburton Grove Depot, and also a general talk on Public Health Administration and procedure. The students concerned were attending a Dietitians' Course at the Polytechnic. Pamphlets and Posters. The official journal of the Central Council for Health Education, " Better Health " has again been supplied free of charge this year to the public. Many health topics have been covered by the leaflets which have been distributed through the various offices at the Town Hall and the Public Libraries. Posters are used as widely as possible in the various Council establishments to draw attention to current matters of health interest. In November the Ministry of Health drew attention to a coloured wall-sheet (30 ins. x 40 ins.) which they had prepared. The wall-sheet was produced in connection with the Clean Food Campaign and shows some of the ways in which food can become contaminated through faulty " hand hygiene ". One hundred copies of the sheet were obtained from the Ministry for use by this Department, and arrangements made for them to be delivered to the large food preparing establishments in the Borough, together with a letter from the Medical Officer of Health. At the time of delivery the Sanitary Inspector gave advice on the best use of the wall-sheets. 64 SERVICES FOR ELDERLY PERSONS Review of the work of the Old People's Health Officer. The Old People's Health Officer, Mrs. Montaut, who took up her duties with the Council on 30th October, 1952, was given the assistance of other staff during the year on a part'time basis in the visiting of elderly persons. • According to the 1951 Census the number of old people—i.e. males and females over the age of 65 in this Borough, consists of 9,800 men and 16,200 women ; which is 26,000 out of a total Census population of 235,600 or over 11%. It is estimated that for the Country as a whole, 12 1/2% of old people live alone and if this figure is applicable to Islington, there would be approximately 3,250 old persons living by themselves. There are many reasons for believing that the number of such persons is greater in a Borough of the character of Islington. Many difficult cases have to be dealt with, as will be seen, in part, by those listed in respect of whom Statutory action had to be taken. There are, however, other difficult cases in which no Statutory action was taken, and the following is an example illustrating some of the circumstances in which old people may suddenly find themselves. A telephone call was received in the Department stating that an old man living in Popham Street had been without attention for a fortnight, had probably taken very little, if any, food and was probably seriously ill. The Department's visitor called and spoke to an elderly man through the door, but the person apparently fell off the bed while speaking and was rendered unconscious. The person appeared to have rolled against the door, and the visitor was therefore unable to open it for fear of causing injury. The Department informed the Police of the circumstances. A Sanitary Inspector and Police Officer together forced through a window and the old man was found lying on the floor unconscious. An ambulance was called by the Police and removal to hospital effected, but the person died the following day. Number of New Cases visited 871 Total number of re-visits 1,772 Cases compulsorily removed under Magistrate's Order 16 References to other Authorities and Voluntary Associations, re Home Help, National Assistance, Meals-onWheels, etc. 1,250 The Health Officer maintains close touch with the London County Council Divisional Staff, especially in respect of Home-help assistance, with the National Assistance Board, with the Duly Authorised Officer of the London County Council, with the Welfare Officer at " Hillside," as may be appropriate. She also attends meetings of voluntary committees connected with the welfare of the old persons, old persons clubs, etc., and is steadily building up a valuable register of old persons dealt with through the Department. 65 National Assistance Acts, 1948 and 1951—Section 47. Authority for proceedings under Section 47 of the National Assistance Act, 1948, was obtained during the year from the Public Health Committee in 25 cases. " The following provisions of this section shall have effect for the purposes of securing the necessary care and attention for persons who— (a) are suffering from grave chronic disease or, being aged, infirm or physically incapacitated, are living in insanitary conditions, and (b) are unable to devote to themselves, and are not receiving from other persons, proper care and attention . . . the court may, if satisfied on oral evidence of the allegations in the certificate, and that it is expedient so to do, order the removal of the person to whom the application relates, by such officer of the appropriate authority as may be specified in the order, to a suitable hospital or other place in, or wthin convenient distance of, the area of the appropriate authority, and his detention and maintenance therein : Provided that the court shall not order the removal of a person to any premises, unless either the person managing the premises has been heard in the proceedings or seven clear days' notice has been given to him of the intended application and of the time and place at which it is proposed to be made." The result of action taken may be summarised as follows :— Court proceedings instituted 14 Removal to hospital or welfare home on a voluntary basis 8 Conditions improved to such an extent as to render court action unnecessary 3 25 In addition, two further cases were taken to Court with Committee approval obtained the previous year, and in one instance it was found expedient to invoke the procedure for the removal of persons to suitable premises without delay (and without giving interested parties seven days' notice) in accordance with the provisions of the National Assistance (Amendment) Act, 1951. " An order under subsection (3) of section forty-seven of the Rational Assistance Act, 1948, for the removal of any such person as is mentioned in subsection (1) of that section may be made without the notice required by subsection (7) of that section if it is certified by the medical officer of health and another registered medical practitioner that in their opinion it is necessary in the interests of that person to remove him without delay." From the foregoing it will be observed that statutory powers were instituted in 17 instances, and I give details of these in the following statement which has been compiled in the form required by the Ministry of Health :— 66 Aged and Infirm-Action taken under Statutory Powers Name and Age Reasons for Council's Action Period Named in Court Order Type of accommodation to which removed Ultimate Result (1) (2) (3) (4) (5) (1) Mrs. B. (69 years) This lady was cared for by a male lodger, also aged, whose brother wished him to leave his lodgings in what was virtually a hovel and live in better surroundings on the south coast. Mrs. B. suffered from heart trouble and arthritis of hip joints following a fractured pelvis in 1949. The lodger, although under no obligation, did not want to leave Islington until the future well-being of his landlady was safeguarded. Early on the day of the Court proceedings, he was persuaded to go away with his brother. Subsequently an Order was made for Mrs. B.'s removal to suitable premises and maintenance there for a limited period. Later, on the same day, the Magistrate received a letter from Mrs. B. which resulted in action under the terms of the Order being held in abeyance for one week to give Mrs. B. an opportunity of attending Court in person. Before the end of week she met with an accident by falling out of bed and was removed to hospital. This fact was duly reported to Magistrate. Mrs. B. subsequently improved in health and was transferred to a Welfare Home. ♦ (2) Miss F. (87 years) This old lady lived alone in one basement room and was without relatives. The unfortunate conditions under which she was living were brought to our notice by the principal tenant who was worried about Miss F. living in perpetual darkness with candles the only means of lighting. The home was in a bad state with piles of rubbish and rags and an overpowering odour odour of dirt and decay. Miss F. was clad in rags, unable to cleanse herself and there was no evidence of food or cooking utensils. When removal to a Welfare Home took place, on an Order, she was suffering from senility, atheroma and malnutrition. Not exceeding six weeks Welfare Home Settled down as a voluntary patient in due course. 67 Name and Age (1) Reasons for Council's Action (2) Period Named in Court Order (3) Type of accommodation to which removed (4) Ultimate Result (5) (3) Mr. M. (86 years) This aged person was suffering from ill-nourishment, failing memory, high degree of deafness and was too frail to care for himself. The case was brought to our notice by a brother who was unable to assist as he himself was aged. The home was pitifully neglected with a filthy and greasy bed and an accumulation of rubbish. There was a danger of fire and a filthy smell emanated from the room occupied in a basement. Sec. 47 proceedings, as in all other instances, were only instituted as an extreme measure as Mr. M. refused to go away to a Welfare Home. Alter this took place the basement was closed under the relative provisions of the Housing Act, 1936. Not exceeding six weeks Welfare Home Deceased within one month after admission. (4) Miss P. (74 years) This old lady, who said she had no one in the world, was suffering from bronchitis and malnutrition when the sanitary inspector reported on conditions in the home. She had to rely on neighbours to get her food and at Christmas time only had jellied eels. Candles were used for lighting and in consequence there was a danger of fire. Owing to the stench from her room, people in the house insisted on the front door being kept open. Miss P. refused to leave her home in a ground floor room, which was in a filthy condition. Not exceeding six weeks Welfare Home Subsequently remained in Home as a voluntary patient. (5) Mrs. H. (75 years) Court proceedings were instituted as the landlady was going into hospital and this would leave Mrs. H. ill alone in the house. A married daughter said "I am not in a position to assist her at all and feel the action the Islington Borough Council is taking is in her best interests." This aged person, at the time of removal, was suffering from hypertension, chronic gastritis and underfeeding, and was unable to shop, cook or cleanse her room or person. Her room was cluttered with rubbish, milk bottles, tins and junk. Not exceeding six weeks Welfare Home Subsequently settled down in Home on a voluntary basis. 68 Name and Age (1) Reasons for Council's Action (2) Period Named in Court Order (3) Type of accommodation to which removed (4) Ultimate Result (5) caying food was on the table and her personal clothing was malodorous. The room was too dirty for a home help to operate and the patient's doctor agreed that statutory proceedings should be taken. (6) Mrs. F. (80 years) This case was brought to the notice of the Department by the patient's doctor as a possible Sec. 47 case, with the approval of relatives. A son said" we all agree that what the Council are doing with our mother is for her own good as she definitely refuses to co-operate with any of us or do anything for herself." Mrs. F. sat or lay in her room all day and depended upon spasmodic family visits for food. This aged person, at time of removal, was suffering from atheroma, osteo-arthritis and her bedclothes consisted of bundles of rags. The room occupied was insanitary with a putrid odour. Not exceeding six weeks Welfare Home Deceased during this period. (7) Mrs. C. (80 years) The principal tenant of the house in which Mrs. C. occupied two rooms, complained to this Department of this aged person's neglected state. It was reported that offers of help from relatives had been refused, as well as those of the home help. It was obvious conditions could not have remained as they were with the patient suffering from advanced osteo-arthritis, senility and deafness. Sec. 47 proceeding were therefore taken as she would not leave home. Not exceeding six weeks Welfare Home Patient subsequently settled down. (8) Mrs. S. (83 years) With the co-operation of the patient's medical adviser, and at the urgent request of the patient's brother, action was taken under the provisions of the Amendment Act, 1951. This old lady, who was suffering from malnutrition, cerebral thrombosis and hemiplegia, lived alone in a top floor room and was alone all day. Action was taken in view of her refusal to go away, as constant medical attention and supervision in the home were necessary. Not exceeding three weeks General Hospital Patient stayed as a voluntary patient and was subsequently transferred to Part III accommodation in a country district. 69 Name and Age (1) Reasons for Council's Action (2) Period Named in Court Order (3) Type of accommodation to which removed (4) Ultimate Result (5) (9) Mrs. S. (84 years) The bad state of Mrs. S. was brought to our notice by a friend who stated this aged person was ill, dirty and had had no food for a week and was without a fire in her room. The only other occupants of the house were an old man of 73, his daughter, who was out at work all day and a crippled woman. Mrs. S. sat on a chair all day and was obviously unable to care for herself. Care could not be given by other occupants of the house. Clothing consisted of rags, and the one room occupied, together with some of the contents, were filthy and infested with vermin. When removed Mrs. S. was suffering from arterio-sclerosis and senility. Relatives could not be traced. Sec. 47 proceedings were therefore taken as she refused to go away. Not exceeding six weeks L.C.C. Welfare Home Patient content to remain in Home as voluntary patient. (10) Miss B. (70 years) Having fallen down in the street on a number of occasions, Miss B. was taken home by ambulance after treatment at hospital. Miss B. had no known relatives and her plight was brought to our notice by another tenant in the house. The one room occupied on the top floor was insanitary and verminous. The floor was cluttered with filthy rubbish; neither table nor chair was provided. Heating and cooking was by oil stove. Oil was spilled on the floor with consequent fire risk. This aged person had a habit of emptying toilet pail down sink on landing used for washing-up by a couple in an adjoining room. When removed under an Order, Miss B. was suffering from arterio-sclerosis and mental senility. Not exceeding six weeks L.C.C. Welfare Home An improvement took place in health from proper feeding and attention during that six weeks. On return home, however, co-operation was not given as Home Help was refused. Re-visits are made from time to time by the Health Officer. (11) Mr. G. (73 years) The condition of Mr. G. and his room was brought to notice by the sanitary inspector. A dirty basement room was occupied without cooking or heating facilities. Mr. G. was in a verminous state and spent most of the day in bed surrounded by accumulation of rags, bones, Not exceeding six weeks L.C.C. Welfare Home With proper feeding and attention, improved in health and at end of six weeks decided to seek accommodation elsewhere, returning to this particular Home when so disposed. 70 Name and Age (1) Reasons for Council's Action (2) Period Named in Court Order (3) Type of accommodation to which removed (4) Ultimate Result (5) bottles, etc. There was little room around bed to move about, and it was quite impossible for home help to operate. Only known relative in America and Mr. G. did not remember address. When removed, Mr. G. was suffering from senility and underfeeding. Sec. 47 proceedings took place as this aged person refused to go away. There was no other means available to secure his future wellbeing. (12) Mrs. S. (67 years) Mrs. S.'s home was under review over a year before Court action taken. A son expressed anxiety about welfare of mother and in consequence Notice was served concerning the abatement of a nuisance arising from dampness in one of the rooms occupied. Urgent request was also made to L.C.C. for home help but this service refused by Mrs. S. Mrs. S. was incontinent and was suffering from chronic bronchitis. She did her own shopping but frequently lost money and purchases, and was incapable of cleaning room or person. This aged person lived with daughter who had two sons of school age. All four slept in two beds in one of three neglected rooms. Family agreed to Section 47 proceedings. Not exceeding six weeks L.C.C. Welfare Home Settled down as voluntary patient at end of six weeks. (13) Mr. Y. (93 years) As in other cases of aged persons living alone without relatives, in bad home conditions, the other occupants of premises were worried about Mr. Y., who had a habit of emptying slops down rainwater pipe outside window. This caused a bad stench and complaints were received from a family on the lower floor who had two children. Mr. Y. was in poor state physically and unable to cleanse himself or his room. He was too infirm to attend hospital and was unable to bandage his ulcerated leg. The room, bedding and clothes were in a dirty condition and a foul odour came from his room. Home help Not exceeding six weeks Welfare Home Subsequently settled down in Home on a voluntary basis. 71 Name and Age (1) Reasons for Council's Action (2) Period Named in Court Order (3) Type of accommodation to which removed (4) Ultimate Result (5) • was refused after an attempt to supply this. When removal took place, Mr. Y. was found to be suffering from atheroma, osteo-arthritis, œdematous and ulcerated right leg, fractured ribs, poor eyesight and partial deafness. The patient's doctor agreed with action taken by the Council. (14) Miss C. (70 years) As a result of a complaint received from a tenant in the house, the Health Officer visited Miss C. There was an accumulation of newspapers, paper bags and junk from floor to ceiling. The one room was practically in complete darkness as a mattress was put up at the window. All available wall space was covered with mirrors, pictures and calendars. Nothing had been thrown away for years and the stench was overpowering. Statutory proceedings took place with the agreement of a relative. Not exceeding six weeks Welfare Home With co-operation of owner, room was decorated and a new fireplace installed. The Council's Cleansing Dept. removed large quantities of rubbish in presence of a brother. The National Assistance Board made an allowance for purchase of curtains and floor coverings. (Since discharge, visitors have found difficulty in getting Miss C.'s co-operation in further endeavours to improve her wellbeing.) (15) Mr. R. (94 years) The son of Mr. R. although suffering from ill-health and awaiting sanatorium treatment, did what he could to care for his father who was totally deaf, double incontinent, had an unsteady gait, and could not go out-of-doors unaccompanied. A poor state of hygiene was evident in the home and the bed was in an unclean state. The condition of Mr. R. prevented the attendance of a home help and a fire risk was present through this aged person's habit of sitting over an open gas ring. In view of his persistent refusal to leave his home, Sec. 47 action was put into operation with the complete agreement of the general practitioner concerned. The son also approved of the Council placing the facts before the Court. Not exceeding six weeks Welfare Home Subsequently settled down in in Home on a voluntary basis. 72 Name and Age (1) Reasons for Council's Action (2) Named in Court Order (3) Type of accommodation to which removed (4) Ultimate Result (5) (16) Mrs. B. (78 years) This case was first brought to our notice by the Home Help Organiser, who reported that home helps would not stay here as conditions were too squallid. As a last resort, Sec. 47 proceedings were instituted, with the agreement of the nearest relatives. The patient's doctor also approved of this course of action. Mrs. B. was unable to cleanse herself or her room and was living in insanitary conditions. At the time of removal she was suffering from senility and hypertension. Not exceeding six weeks Welfare Home The Magistrate subsequently granted an extension of not more than three months to the period indicated in the original Order. During this latter three months Mrs. B. decided to remain in a Home as a voluntary inmate. (17) Miss N. (83 years) The National Assistance Board first brought to our notice that Miss N. was unfit to look after herself and room. It was reported that she showed signs of senility, was filthy dirty and dressed in rags, and was refused admission by some shopkeepers to their premises. A grant for the provision of bedding was made by the National Assistance Board after disinfestation work had been carried out by this Department, and Miss N. herself made an effort to clean up and keep the home tidier. This was short-lived, however, for when the Home Help Organiser called about providing a Home Help, the home was again in a filthy state. Miss N. was also in a state of selfneglect. Consequent upon this aged person's repeated refusal to leave her home, Sec. 47 proceedings were commenced. When removal took place, she was suffering from senility with some mental confusion, and osteo-arthritis. She could not remember where her relatives were. Mot exceeding six weeks L.C.C. Welfare Home On admission to this Home, an authority was given voluntarily by Miss N. for the disposal of her effects. Subsequently settled down. 73 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 in 1950 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. The number of meals supplied, etc., during the year, is given in the following table:- Total number of names brought to the notice of the Department 871 Number recommended to W.V.S 102 Number of meals delivered during the year 5,814 Weekly average 111 The Council gave considerable assistance to old people's Clubs for the provision of meals on the Clubs' premises, and also contributed to old people's voluntary organisations, including Clubs, to assist with holidays for old people and crockery, furniture, games, etc., for the Clubs. Cleansing of Elderly Persons. London County Council (General Powers) Act, 1953-Section 43. This section states that where any aged person is verminous, or is for any other reason in need of cleansing in order to prevent injury or the danger of injury to health, and is so enfeebled that he is unable to avail himself of Cleansing Station facilities or to cleanse himself properly, the Authority may arrange for him to be cleansed free of charge at his residence or other suitable place, and may provide equipment as necessary for carrying this out. It is not uncommon to find that self-neglected elderly persons have become vermin infested, certainly the majority of such persons are not in a very good state of personal cleanliness. Arrangements were made in accordance with this Section for the Council's visiting nursing staff to provide such a personal cleansing service at home on request. The domestic circumstances in which such personal cleansing may have to be done are often unfavourable, as is shown by the following example. A request was received from an elderly male person, aged 79, to have a bed bath at home, since he was too frail to go out and attend the Public Baths. His wife was aged 72, and this couple occupied rooms on the third floor. The water supply and sanitary convenience were on the ground floor and water had to be 74 carried up and down several flights of stairs. Medical attention was not required, and the services of a District Nurse were not called for in this case. Arrangements were made for a bed bath to be given at home. It is considered that this Section will prove a very useful hygienic measure. 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. ISLINGTON CREMATORIUM The Medical Referee or the Deputy Medical Referee certified a total of 304 applications for cremation at the Council's Crematorium, East Finchley. 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. B. E. A. Sharpe, 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 Voluntary Welfare Centre, 6·9, Manor Gardens, N.7. Mon. to Fri. 1.45 p.m. Wed. Tues. Thurs. 1.45 p.m. 9.30 a.m. Wed. 2.0 p.m. Tues. 9 a.m. and 2.45 p.m. Wed. 2.0 p.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. Archway M. & C.W. Centre Congregational Church, Junction Road, N.19. Thurs. 1.45 p.m. West Islington Welfare Centre, 42 & 44, Richmond Avenue, N.l. Mon., Wed. & Fri. 1.30 p.m. Tues. Tues. Thurs. 9.45 a.m. 1.30 p.m. 9.45 a.m. Wed. 10.30 a.m. Wed. 10.30 p.m. West Branch Clinic St. Luke's Mission Hall, Goodinge Rd., N.7. Thurs. 9.30 a.m. & 1.30p.m. South Islington Welfare Centre, 6 Clephane Road, Essex Road, N.l. Mon. 1.30 p.m. Wed. 1.30 p.m. Thurs. 9.30 a.m. & 1.30 p.m. Mon. Fri. Tues. 9.30 a.m. 9.30 a.m. 1.30 p.m. Tues. Fri. 10 a.m. 2.0 p.m. Wed. 2.0 p.m. South Branch Clinic Union Chapel, Compton Avenue, N.l. Mon. 1.30 p.m. Tues. 9.30 a.m. South Branch Clinic Mildmay Sunray Clinic, Mildmay Memorial Hospital, Newington Green, N.l. Tuea. 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. Wed. 9.0 a.m. 1.30 p.m. Mon. Fri. 2.0 p.m. 10.0 a.m. Mon. 3.0 p.m. East Branch Clinic Congregational Church Hall, Highbury Quadrant, N.5. Thurs. 9.30 a.m. & 1.30 p.m. 75 Total Attendances at Infant Welfare Centres. Infants North South East West 0-1 years 14,961 12,027 7,416 8,260 1-2 years 2,681 1,793 1,209 1,259 2-5 years 2,161 1,117 871 825 Ante-Natal and Post-Natal combined 3,656 1,745 1,355 1,842 Child: Life Protection. The table of foster-mothers and foster-children being cared for is as follows : 31,12,53 Number of persons on register prepared to receive children 31 Number of foster-children being cared for 39 Day Nurseries. At the beginning of 1953 there were 6 Day Nurseries in operation. The number of child places was 377. Clephane Road Nursery closed in February, 1953, and the children were transferred to a 50 place nursery opened in February in Springdale Road, N.16 (Stoke Newington). At present there are 5 Day Nurseries open in Islington:- Scholefield Road 65 places Plimsoll Road 46 „ Canonbury Place 70 „ Windsor Street 68 „ Mitford Road 68 „ 317 76 INDEX Accidents 7. 8. 9. 12 Acute Encephalitis 13 Acute Poliomyelitis 8, 13, 16 Aged and Infirm Persons 26, 33, 64-74 Ante-Natal Clinics 74, 75 Bacteriological Examinations 23-24, 45, 46, 58, 60 Births 6, 7, 10 Blow-Fly Infestation 33-34 Census 1951 10, 47, 64 Cerebro-Spinal Fever 9 Chemical Examinations 45, 46, 58, 59 Child Life Protection 25, 75 Child Welfare Centres 18, 74-75 Cleansing Station 20-21 Crematorium 74 Day Nurseries 75 Deaths 6,7,8,9,10-12,13,15,16,17,18 Dental Clinics 74 Diphtheria 7, 8, 13, 17-18, 24 Diphtheria Immunisation 17-18, 74 Diseases of Animal Acts 43 Disinfection 33, 34 Disinfestation 33 Disinfestation of Sewers 45 Dysentery 13, 20, 24 Encephalitis, Acute 13 Enteric Fever 13 Erysipelas 13 Exhibitions 61-62 Export Certificates 33 Factories Act—Complaints 39 Factories Act—Contraventions 38 Factories Act—Inspections 37-38 Factories Act—Notices served 38 Film Publicity 61-63 Fog and Smoke 34-37 Food and Drugs Act 37, 38, 53-56 Food—Inspection and Supervision 26, 37-38, Food—New legislation 52-53 Food Poisoning 13, 18-20, 24 Food Sampling 56, 58, 59-60 Food Unsound 55 Foster Mothers and Children 75 Health Publicity 61-63 Heating Appliances (Fireguards) Act, 1952 25 Home Visiting—Scabies and Vermin 21 Hostels 24-25 Housing 26, 47-51 Ice Cream 57-58 Illegitimate Births and Deaths 6, 7, 10 Immigrants 48-49 Infant Mortality 6, 7, 9, 11 Infectious Diseases 13-24 Influenza, Pneumonia and Bronchitis 8, 9, 12 Inoculation, etc.—Certificates 14 Lectures 63 Legal Proceedings 28-32, 41, 46, 51, 54-55, 66-72 Licences 24, 27, 37, 43, 60 Live Births 6 Local Government (Miscellaneous Provisions) Act, 1953 48 L.C.C. (General Powers) Acts 41, 73-74 M. E C.W. Services 74-75 Malaria 13 Marriages 6, 7 Mass X-Ray 21, 23 Maternal Mortality 6, 7, 8 " Meals on Wheels " 73 Measles 8, 9, 13, 14-16 Meat 56 Meningoccal Infection 8, 13 Merchandise Marks Act, 1887 53 Metropolitan Cattle Market 56 Milk and Cream 59-61 Milk and Dairies Regulations 60 Milk (Special Designations) 60 Miscellaneous Services 61-75 Mortuary 74 National Asistance Acts 26, 65-73 Neoplasms, Malignant 8, 11-12 Noise Nuisance 37, 41 Nurseries—Day 75 Offensive Trades 42 Ophthalmia Neonatorum 13 Outworkers 37, 40 Overcrowding 48, 50 Pet Animals Act 43 Pharmacy and Poisons Acts, etc 43 Pneumonia 8, 9, 13 Poliomyelitis 8, 13, 16 Population 6, 7, 10 Post-Natal Clinics 74, 75 Premature Infants 9 Prevention of Damage by Pests Act and Orders 44-45 Prosecutions 28-32, 41, 46, 51, 54-55 Public Hea'th Committee 5 Public Health (London) Act—Improvements effected 27 Public Health (London) Act, Sections 40 and 109 27 Public Health Officers 5 Public Health (Tuberculosis) Regulations, 1952 22 Puerperal Pyrexia6, 13 Rag Flock and Other Filling Materials Act 43 Rats and Mice 44-45 Refreshment and Coffee Stalls57 Rent Restrictions Acts (Certificates) 24, 26 Requisitioned Property26, 37 Sampling 46, 56, 58, 59-60 Sanitary Circumstances 24-46 Sanitary Inspection—District Work 25-37 Sanitary Inspection— Special Work 37-43, 45-46 Scabies 13, 20-21 Scarlet Fever 13, 24 Sewer Treatments Shops Act 38, 42 S'aughtermen's Licences 56 Slum Clearance 48 Smallpox 13-14 Smoke 34-37 Staff 5 Static Water Tanks25, 33 Statistics—General 6 Statistics—Vital 6, 7, 10-12 Still-Births 6, 7 Swimming Baths 46 Tuberculosis—Beds and Bedding 23 Tuberculosis—Care Committee 23 Tuberculosis—Deaths 7, 8, 9, 11-13, 22 Tuberculosis—Chest Clinics 22-23 Tuberculosis Notifications 7, 13, 21-23 Typhoid Fever 13, 24 Underground Bakehouses 40-41 Vaccination 14, 74 Vermin 13, 20-21, 33 Washing Facilities, Free 57 Water Supplies 45-46 Welfare Centres 18, 74-75 Whooping Cough 8, 9, 13, 14-16, 24