AC 4361 ISL 92 1963 II ANNUAL REPORT ON THE HEALTH AND SANITARY CONDITIONS OF THE METROPOLITAN BOROUGH OF ISLINGTON. TO THE MAYOR. ALDERMEN AND COUNCILLORS OF THE METROPOLITAN BOROUGH OF ISLINGTON I am privileged to present the Annual Report on the health and sanitary conditions for the Metropolitan Borough for 1963. For many years past, annual increases have been reported in the total number of births and also in the birth rate, but this sequence was not maintained for 1963. The number of births at 5,717 was fewer by 80 than in 1962 and the birth rate was also lower. It remains to be seen, of course, whether this is just a temporary interruption of the trend or the beginning of a reversal. The last Annual Report summarized some of the information which became available from the Registrar-General's Analysis of the 1961 Census Returns, and reference was made to the highlighting by the Census of the very great housing congestion which is a particular feature of Islington. In these circumstances, any increase in the size of the family inevitably increases housing congestion in many families, and with the very great pressure upon hospital maternity accommodation (approximately 90% of Islington infants are bom in hospital) it is inevitable that mother and infant are returned to their home after a shorter period of confinement in hospital than previously. It is a tribute to the maternity services, hospital, London County Council, and practitioner, and not least, to the mothers themselves, that the infant mortality rate of 19.4 deaths per 1,000 live births should continue to be so low relatively to London and to the country as a whole. This should not be taken as signifying that the risks to infants could not be reduced even further, and to quite a substantial degree. Preventive efforts have not yet accomplished all that they can do in this field, which will constitute one of the Health Service challenges for the new London Borough after 1965. A health risk which affects only a few but is serious and may be the cause of permanent damage is lead poisoning, and details will be found in this Report of three young children who were found to be affected. The source of lead in these cases is quite typical, that is, the children contracted the habit of chewing painted toys, painted cot and other woodwork treated with paint containing lead. It is now understood that paint for internal work is being manufactured with a lead content which is negligible, and the same precautions are taken by reputable toy manufacturers in this country. However, old paintwork on cots, window sills, skirtings, etc. may be covered with a higher lead content paint, particularly undercoatings, and parents whose children have unfortunately contracted a liking for chewing paint should be aware that such a habit could be extremely harmful to the child. Infectious Disease Recent experiences on the possible hazards of introducing smallpox from abroad have shown that this applies principally to those travelling by air from other countries, enabling persons to arrive in this country well within the incubation period and before the onset of symptoms. Control measures were strengthened during the year by the introduction of new regulations in respect of the international certificates of vaccination. Air travellers from or through suspect areas who have refused vaccination may on arrival be isolated up to 14 days from the date of their departure from the infected area. There were no smallpox cases during the year, but certain arrivals from abroad were followed up as in the Report. Experience in 1963 also showed that vigilance for diphtheria is still necessary. A small outbreak affected six children, one of whom was severely ill for a time, but fortunately recovered, and no cases proved fatal. Immunization in infancy with subsequent reinforcement for protection is obviously still the lesson to be borne in mind by parents. There was an exceptionally high incidence of dysentery with a record number of 1, 300 cases reported. About half of these were in children of school age and another third in children under five. In the great majority of these cases, the illness was not of a severe nature and only 47 cases were removed to hospital, some of them on social ii rather than medical grounds. The incidence of dysentery normally increases during the winter months, and it seems probable that the very severe weather in the early part of the year which caused considerable interference with sanitation was a factor which contributed in part at least to a higher than usual dysentery infection. The spread of dysentery within the home and the family will be discouraged by good standards of personal and domestic hygiene and cleanliness. Washing the hands after using the toilet should be a routine habit, and the toilet compartment itself must of course be kept scrupulously clean. It is fully realised that good hygiene standards are not easy to maintain where w.c.s have to be shared by more than one family, and hot water is not on tap. Improved and modernised housing standards should, therefore, make easier the raising of personal hygiene standards, but in the meantime more care and effort are necessary. On the credit side, it is most satisfactory to be able to place on record that for the first time in the history of the borough, there was no case of poliomyelitis during the whole year. There can be little doubt but that mass immunization has been responsible for this dramatic result. Respiratory Diseases Again, on the credit side, the effectiveness of the present methods of treatment of tuberculosis of the lungs is demonstrated by only eight deaths due to this cause the lowest on record - compared with 28 ten years ago. The infection itself unfortunately, has not been conquered to the same degree, and a substantial number of new cases were found in males, mainly in the older age groups, but in women it is unfortunate that the principal incidence falls upon the young and middle-aged adult. Health risks of immigrants have been the subject of discussion for some time and the Report contains some useful and interesting figures of the results of chest x-rays done at the Mass X-Ray Unit under the charge of Dr. G.Z. Brett. Those examined were classified by country of origin, and although the catchment area of the X-Ray Unit is larger than the borough of Islington itself, the findings can be accepted as an indication in regard to immigrants resident in the borough. Persons attending the X-ray Unit may come voluntarily or be referred by doctors, but of those examined, there were three groups not born in this country who were found to have a much higher than average incidence of pulmonary tuberculosis. The highest liability was found in Indians and Pakistanis, followed by those bom in Cyprus and thirdly in Ireland. All these ethnic groups were found to have active tuberculosis rates several times higher than those born in this country. It should be appreciated that these findings do not include information of the length of stay in this oountry, and many cases would have contracted the illness well after their arrival, and therefore would not have been detectable if examined at the time of leaving their country. Pulmonary tuberculosis is still sufficiently prevalent in Islington to create major social and domestic as well as medical problems, even though eventual recovery chances have greatly improved. A similar degree of optimism cannot, unfortunately, be applied to deaths from cancers of the lung and bronchus. Whilst the fatalities due to this cause have not increased, neither have they decreased, and for the last five years, the number of deaths has been remarkably constant each year around 170, of whom between 140 and 150 have been males. The evidence indicting cigarette smoking as a cause of lung cancer which was published in 1962 in the Report of the Royal Cbllege of Physicians, has been strongly reinforced by an extensively documented and thorough report published by the U.S. Public Health Service, which fully supports from American sources all previous reports on cigarette smoking risks. Whilst the publication of these reports appears to have a temporary effect in reducing cigarette sales, the public effect appears to wear off and cigarette consumption rises again. It is significant that among doctors in this country who have been the subject of a special statistical survey and whose cigarette consumption has been reduced more than in any other single group, that their lung cancer risk has also decreased, whereas it has increased in the general population and iii the lesson to be drawn would appear to be obvious. Local authority and Ministry of Health publicity expenditure is relatively small when compared with the many millions of pounds spent by commercial concerns on glamour cigarette advertising through the press, hoardings, and commercial television. This Report also refers to the Advisory Smoking Centre with weekly evening sessions set up to assist those who wish to be helped in giving up the smoking habit. There were also well over 200 deaths from bronchitis. Nearly two-thirds of these deaths were in males, mainly in the late middle and elderly age groups, and investigations have shown that cigarette smoking is a major contributory factor in a large number of bronchitis patients. Clean Air The work being carried out for the reduction of atmospheric pollution by the declaration of further Smoke Control Areas under the Clean Air Act is proceeding at a good pace. Four areas became subject to Smoke Control Orders during the year, and the size of each area has with experience increased since the Clean Air Act became operative. The field work under the Act is being carried out by two whole-time Technical Assistants and two Public Health Inspectors who also have certain other duties in addition, but between them they have made nearly 5,000 primary inspections under the Act and nearly 700 domestic adaptations were completed during the year. Nevertheless, in view of the large number of adaptations to be made in Islington, it is not anticipated that the whole of the present borough will be a Smoke Control Area until around 1970. When the Clean Air Act came into force, it was not anticipated there would be supply problems of suitable cokes for the majority of smokeless solid fuel appliances, since coke is produced as a by-product in the manufacture of gas. Towards the end of the year however, the Ministry of Fuel and Power intimated in a circular that the future production of gas coke would be limited due to anticipated changes when alternative sources of gas become available not dependent upon the treatment of coal. This caused some concern for possible future supplies, but it is understood that alternative solid smokeless fuels are likely to become increasingly available, and the Minister recognised that a greater latitude for alternative forms of space heating and for alternative appliances would have to be allowed. Whilst it would be a matter of the greatest regret if there were delays in the declaration of smoke control areas, it is also probable that adaptation costs will prove to be somewhat higher than in the past, and the cost of suitable alternative solid fuels may also rise. Solid fuel supplies were particularly difficult in the severe cold spell at the beginning of the year, and solid fuel storage is a problem to which no satisfactory answer has yet been found for many families living in multiple occupation houses or even in purpose-built flats. Housing Section D of this Report contains information of the flats erected during the year by the Borough Council, the London County Council and private enterprise, and also mentions that since the end of the war, the Borough and County Council between them have erected well over 7,000 flats. Nevertheless, the majority of Islington residents must continue for many years to come to live in old houses which were not built for, and have not yet been properly adapted to be lived in by several families. The Housing Act 1961 included legislation intended to deal with this problem of houses in multiple occupation and matters which might be dealt with in lettings of this type included defects of natural and artificial lighting, ventilation, water supply, personal washing facilities, space heating, sanitary conveniences, facilities for storing and preparing food, and disposal of waste water. A pilot survey was undertaken by the Department to obtain more information on this problem and on improvement possibilities both statutory and informal. Over 400 flats were surveyed and over 300 informal notices were served. iv The results of this work are set out in detail in the Report, but it will be noted that owing to anticipated difficulties in recovering the cost of works which might have to be carried out in default within the terms of the Act, only 7 formal notices were served. This weakness on the part of the 1961 Act was generally recognised, and it is anticipated that strengthened powers under the Housing Act 1964, dealing with multiple occupation houses, will have a more beneficial effect. Work continued, of course, in connection with unfit houses. A total of 58 houses in Clearance Areas were represented as being unfit and Closing or Demolition Orders were made for a further eight individual houses. In addition, 26 Closing Orders were approved for parts of buildings, the majority of which were basements. The maintenance of elderly houses also comprises a major part of the work of the District Public Health Inspectors. This is done under the provisions of the Public Health (London) Act, and in the details set out in the Report, it will be found that the Department received over 5,000 sanitary complaints during the year, everyone of which of course, necessitated an Inspector's visit. Dampness is a very common cause of complaint, but blocked w. c. s and drains, defective woodwork including floors, defective walls and many other matters had to receive attention. The Inspectors served over 2,000 sanitary notices, but much of the repair work is done voluntarily and without difficulty or undue delay by the owners. The Report, however, also contains a list of 44 cases where the Council was compelled to take legal proceedings in order to effect nuisance abatement. Further proceedings had to be taken in 11 cases, again as set out in the Report, on account of subsequent failure to comply with abatement orders made by the Cburt. Supervision of Food and Food Hygiene All food premises whatever their nature, trading in food, are required to comply with the requirements of the Fbod and Drugs Act and the Fbod Hygiene Regulations, and all such premises are liable to inspection under the Acts by the Department's Inspectors, whose work is summarized in this Report. The number and variety of food premises listed, however, is a measure of the size of the Borough's problem. There are, for example, over 160 butchers, nearly 500 cafes, restaurants, canteens and clubs, approximately 450 grocers and provision merchants, wholesale and retail, over 250 public houses and beer houses, and so on. It is, therefore, obvious that the maintenance of a good standard of hygiene in all these premises must be a matter of personal willingness and acceptance of personal responsibility on the part of the owners and of those who act for them. There is also a responsibility to maintain a good hygiene standard on the part of every person who handles food. The Department's Inspectors inspect food premises and take action if necessary, but the handling of food safely and hygienically requires care and understanding at all times. Although food premises must comply with statutory standards once opened, they are not obliged, except for certain limited classes of foods, to inform the Authority when commencing business, with the result that some premises when first seen are found to be unsuitable in some respects. The Committee and the Council have in the past pressed for prior registration of premises such as restaurants and cafes in order that their suitability could be confirmed before opening. If this were done, it would both ease the work of the Department and be a more satisfactory procedure for conscientious food traders because they would have prior information of the installations considered necessary to comply with the Acts, instead of being required, through insufficient knowledge, to make alterations after opening. The Report contains a summary of legal proceedings which had to be taken in 43 cases for various contraventions and departures from the requirements of the Food Hygiene Regulations and the Fbod and Drugs Act. V Elderly Persons The severe conditions in the early winter of 1963 caused considerable hardships to many, but to elderly persons in particular. The deliveries of solid fuel were delayed, but fortunately it was found possible to improvise a scheme whereby fuel could be delivered in 28 lb. bags to aged or sick residents by the Department's vehicle. This scheme was operated jointly with the Islington Old People's Welfare Council and the firm of coal suppliers which kindly agreed to co-operate. The Islington Work Centre for the elderly, part of the activities of the Old People's Welfare Cbuncil, aided by a borough grant, is now operating at its full capacity and providing employment for close on 100 persons. It provides interests, friends, and beneficial physical activity for many elderly persons who might otherwise be lonely and left to fend for themselves as to how they spend their time, and must be regarded as one of the most valuable old people's activities being conducted in the borough. The problem of obtaining suitable premises in other parts of the borough has hindered further development of Work Centres which would benefit many other elderly but still active persons. The Meals-on-Wheels service initiated many years ago through the Islington Women's Voluntary Service and later expanded through the Old People's Welfare Cbuncil, with Borough Council support, became the direct responsibility of the Public Health Department during the year. The maintenance of the nutrition of homebound persons is considered to be an important preventive measure, and plans were under consideration during the year to extend this service. Work at the Treatment Centre to modernise and improve bathing facilities for elderly and partially infirm persons in particular, in accordance with the scheme mentioned in last year's Report was put into effect during the year, and a sketch plan of the modified premises is included in this Report. The baths include two specially fitted shower compartments with seats. Some elderly persons found taking this kind of bath a new experience, but after initial hesitation in some cases, it can be said that the shower bath is being welcomed and is proving its value to both users and staff. Staff and General A chronic deficiency in the establishment of Public Health Inspectors continued during the year and therefore limited the volume of inspections and visiting which could be done. At the end of the year, Mrs. H. Godkin, Nurse-in-Charge of the Treatment Centre, retired. She was one who regarded her duties not only as an appointment but as an opportunity to give unstinted service to others, and the Council placed the following tribute on record:- Mrs. Godkin has held this position since December, 1945, and since that time has personally treated or helped to treat many elderly persons living in extremely unpleasant physical circumstances, a task which she has always carried out with understanding and great kindliness. Thus she has gained the sympathy and often the friendship of those she treated. Mrs. Godkin's gracious and tactful disposition and preparedness always to do anything to assist or benefit elderly people and to ensure that they lived in comparatively clean and comfortable conditions will be greatly missed and - We therefore recommend - That the Cbuncil do place on record their appreciation of Mrs. Godkin's services and her untiring devotion to the well-being of elderly persons of the Borough." vi I have to thank all members of the Department for their work during the year, but I am pleased again to express my thanks personally to Dr. J.P.J. Burns, Mr. W.C. Bartlett, Mr. H. Plinston, and Mr. E.J. Sharp . I should also like to express appreciation as in previous years, to Dr. Wilfrid G. Harding and his staff in Health Division 3 of the London County Council's health services. Close contact for day-today working purposes is maintained between the respective staffs of the London County Council and this Department at many levels. To the two principal Chairmen, Alderman A.J. Rogers, Public Health Committee and Alderman E.J.W. Bayliss, Housing Committee, whose Committees dealt with the reports of the Medical Officer of Health, I again have to express thanks both to them and to their Committee members for their courtesy and careful consideration of the matters which it has been my duty during the year to place before them. V. FREEMAN, Medical Officer of Health. 1 MEMBERS OF THE PUBLIC HEALTH COMMITTEE (As at 31st December, 1963) MAYOR Councillor GEORGE A. BARNARD, J. P. ALDERMEN HERBERT JAMES LOWTON LYGOE, O. B. E. , J.P., M.S.M., L.C.C. ALBERT JOHN ROGERS Councillors MRS. ZARA BAGNARI MRS. CLARA MARGARET COLEBECK EDWARD CHARLES BADEN FORD HENRY WILLIAM FRANCIS FORD HOWARD GLENNERSTER, B. A. PAUL GRANT HENRY JAMES REID TERENCE CORNELIUS ROONEY LEWIS ROSS MRS. MARGARET MARY SHORT MRS. EMILY MARY SIMMS MRS. DIANA MARGARET STUDDERT SIMPKINS, B. Sc. WALTER SMITH MRS. BRONWEN STRADLING VIVIAN STEWART STRADLING Chairman Alderman ALBERT JOHN ROGERS Vice-Chairman Councillor MRS. EMILY MARY SIMMS STAFF OF THE PUBLIC HEALTH DEPARTMENT, TOWN HALL, ISLINGTON N.1 Medical Officer of Health V. FREEMAN, M.R. C.S., L. R. C.P., D.P.H. Deputy Medical Officer of Health J.P.J. BURNS, M.C., M.B., B. Ch., B. A. O., D.P.H. (Part-time) Public Analyst D. F.H. Button, A.R.C.S., F.R. I.C. Deputy Chief Public Inspector H. Plinston, (b)(c) Chief Public Health Inspector W.C. Bartlett, M.A.P.H.I., M. R. S.H. (b)(c)(d) Supervisory Public Health Inspector J.S. Ashworth, (b) Public Health Inspectors District H. Archibald, (b)(c) A. Aslamidis, (b)(c) J.S. Dripps, (a)(c) C.O. Pox, (a)(c) Miss V.M. Goddard, (b)(c)(f)(g)(h) V.H. Haynes, (b)(c) D. E. Jenkins, (a) E.H. Kerridge, (b)(c)(d) W. S. LeMaitre, (a)(c) N. Lightowlers, (b)(c)(d) A. C, Lochhead, (a)(c) Miss S.H. Prentice, (b) (c) (f) (g) (h) G.S. Vaughan, (b)(c) 2 Public Health Inspectors (contd.) Special Disinfection & Disinfestation Services K.E. Sewell, (b)(c)(d)(e) Factories & Clean Air R. T. Govett, (b)(c)(e) S.E. Muggeridge, (b)(c)(e) Food & Drugs T.E.R. Ware, (b)(c)(Snr.) J. Altoft, (a) (c) F. O. Grady, (a) (c) Housing K.L. Garner, (b)(c) A.R. Kempshall, (a) T, Lawson, (b) G.A. Reid, (b)(c) R.C. Whittaker (b)(c) 6 vacancies Technical Assistants - Clean Air Act, 1956: R.A, Drake J.A. Lane Student Public Health Inspectors: D. King W.R, Knight Chief Clerk: E.J. Sharp Sectional Senior Clerks: w.A. McAdam D.A. Owen C.J. Moore S. Wright Clerical Staff: Miss L.M, Anderson Miss B, Demorais M E MacDermott R.S. Biggs Mrs, E.L. Diffey Miss B, Miller S.A, Bishop A.R. Froud Mrs. S.R. Moody Miss M.I. Cole P. Hardwick B. O. Halloran E.E. Conner L.F.G. Hummerstone P.L.J. Regan Mrs. V.E. Cook Mrs. E.J. Johnson J.J. Thompson Mrs. J.M. Crisp Mrs. C.A. McCausland Mrs, I.M. White Elderly Persons and Infectious Diseases Visitors: Mrs, C.M. Burton (h) Mrs. P. Haxell Mrs. I.D. Milbank (g)(h) Miss H.E. Sharp Miss D. Vernon Treatment Centre, Seven Sisters Road, N.7 F. Seabrook (Superintendent of Laundry and Disinfecting Station) Mrs, H.W. Godkin (Nurse-in-Charge) (h) Mrs. M.J. Newton (Home Visitor) 4 Bathing Attendants 1 Handyman 1 Assistant Driver 1 Stoker Handyman 2 Drivers 1 Ambulance Driver 2 Disinfectors 3 Rodent Control: C. Jackson (Rodent Officer) 3 Rodent Investigators 6 Rodent Operators (a) - Certificate of the Public Health Inspectors' Education Board (b) - Certificate of the Royal Sanitary Institute and the Sanitary Inspectors' Examination Joint Board, or other qualification as a Public Health Inspector approved by the Minister of Health (c) - Certificate of the Royal Society of Health, or the Royal Sanitary Institute (or other approved qualification) in Meat and Other Food Inspection (d) - Certificate of the Royal Society of Health or the Royal Sanitary Institute in Sanitary Science (e) - Certificate of the Royal Society of Health or The Royal Sanitary Institute in Smoke Inspection (f) - Health Visitors Certificate (g) - State Certified Midwife (h) - State Registered Nurse 4 SECTION A GENERAL AND VITAL STATISTICS Area o f the Borough 3,092 acres Population Registrar-General's estimate of civilian population - Mid-year 1963: 227,410 Live Births BIRTHRATE PER 1,000 ESTIMATED RESIDENT POPULATION Totals M. F. Islington England & Wales Unadjusted Area Comparability Facto r Adjusted Legitimate 4,807 2,402 2,405 25.1 0. 82 20.6 18.2 Illegitimate 910 477 433 5,717 2,879 2,838 Illegitimate live births per cent of total live births 15.9 Still Births RATE PER 1,000 TOTAL (LIVE AND STILL) BIRTHS Totals M. F. Islington England & Wales Legitimate 78 39 39 17.0 17.0 Illegitimate 21 11 10 99 50 49 Total live and Still Births 5,816 Notifications of Births For the year ended 31st December, 1963 5,577 (corrected figure from L.C.C.) Marriages (Provisional figures) Marriages solemnised in the Borough during the year 2,465 5 Deaths Infant mortality (deaths under 1 year) Total deaths 111 RATE PER 1,000 LIVE BIRTHS Islington England & Wales 19.4 20.9 Legitimate 19.1 Illegitimate26.4 Neonatal mortality rate (deaths under 4 weeks) 14.7 Early neonatal mortality (deaths under 1 week) 12.9 PER 1,000 TOTAL LIVE AND STILL BIRTHS Perinatal mortality (still births and deaths under 1 week combined) 29.7 Maternal deaths (including abortion) Total deaths 1 RATE PER 1,000 LIVE AND STILL BIRTHS 0.17 0.28 All deaths RATE PER 1,000 POPULATION Total M F Islington England & Wales Unadjusted Area Comparability Factor Adjusted 2.671 1,288 1,383 11.7 1.12 13.1 12.2 CLASSIFICATION OF DEATHS WITH AGE DISTRIBUTION (REGISTRAR GENERAL'S RETURNS) Cause of Death AGE GROUPS All Ages Under 4 wks. 4 weeks under 1 year 1- 5- 15- 25- 35- 45- 55- 65- 75 & over M F Total M F M F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 1 Tuberculosis, Respiratory 6 2 8 - - - - - - - - - - - - - 1 1 - 1 1 2 - 2 - 1 2. Tuberculosis, Other - 4 4 - - - - - - - - - - - - - 1 - - - - - 2 - 1 2 3. Syphilitic diseases 3 5 8 - - - - - - - - - - - - - - 1 - 1 - - 1 1 4 3 4. Diphtheria - - - - - . . . . . • . - . - . . _ . . • . . _ . 4 5. Whooping Cough - - - - - - - - - - - - - - - - - - - - - - - - - 5 6. Meningococcal Infection . - - . . . . • - ~ . . - . - - - . . - . - - - - 6 7. Acute Poliomyelitis - - - - - - - - - - - - - - - - - - - - - - - - - 7 8.Measles - - - - - - - - - - - - - - - - - - - - - - - - - 8 9. Other infective and parasitic diseases 3 - 3 - - l - 1 - - - - - - - - - - - 1 - - - _ - 9 10. Malignant neoplasm, stomach 36 20 56 - - - - - - - - - - - - 1 - 5 1 8 6 10 5 12 8 10 11. Malignant neoplasm, lung bronchus 147 20 167 - - - - - - - - - - - - 2 1 18 2 56 4 46 9 25 4 11 12. Malignant neoplasm breast 1 43 44 . . « - - - - . - - - 2 - 4 - 11 _ 12 _ 3 1 11 12 13. Malignant neoplasm uterus - 23 23 - - - - - - - - - 1 - - - 2 - 6 - 5 - 7 - 2 13 14. Other malignant neoplasms 122 121 243 - - - - - - 2 - 2 1 2 3 4 5 13 11 25 16 34 41 40 44 14 15. A-and-Leukaemia 9 6 15 - - - - - 1 - - - - 1 - - 1 1 - 2 - 4 2 1 2 15 16. Diabetesa 11 13 24 - - - - - - - - - - - - - - - 1 3 _ 5 6 3 6 16 17. Vascular lesions of the nervous system 83 159 242 - - - - - - - - - - 2 - - 2 2 6 18 10 22 38 39 103 17 18. Coronary disease, Angina 248 214 462 - - - - - - - - - - - - 8 3 24 10 62 26 70 63 84 112 18 19. Hypertension with heart disease 15 23 38 - - - - - - - - - - - - 1 - 2 1 2 1 1 4 9 17 19 20. Other heart disease 65 153 218 - - - - - - - - 1 - 2 1 3 1 5 8 9 17 14 21 31 105 20 21. Other circulatory disease 63 136 199 - - - - - - - - - - 2 1 1 - 2 2 13 4 14 19 31 110 21 22. Influenza - 6 6 - - - - - - - - - - - - - - - - - - - 1 - 5 22 23.Pneumonia 93 136 229 1 3 4 6 - 1 - - - - 2 - - - 2 3 14 5 19 17 51 101 23 24. Bronchitis 143 87 230 - - 3 2 - - - - - - - - - 2 10 1 35 10 39 9 56 63 24 25. Other disease of the respiratory system 26 7 33 1 - - - - - - - - - - - - - 1 1 9 3 8 2 7 1 25 26 Ulcer of stomach and duodenum 23 9 32 - - - - - - - - - - 1 - - - 1 1 7 3 6 2 8 3 26 27. Gastritis enteritis, diarrhoea 2 9 11 - - - 2 - - - - - - - - - - - 1 2 - - 2 - 4 27 28. Nephritis and Nephrosis 7 7 14 - - - - 1 - - - - - 1 1 2 - - 1 - 1 1 1 2 3 28 29. Hyperplasia of prostate 7 - 7 - - - - - - - - - - - - - - - - - - 3 - 4 - 29 30. Pregnancy, Childbirth and Abortion - 1 1 - - - - - - - - - - - 1 - - - - - - - - - - 30 31. Congenital Malformations 8 9 17 3 4 1 1 - - 1 - 1 - - - - _ - - 2 1 - 2 - 1 31 32 Other defined and ill-defined diseases 80 113 193 36 34 4 1 1 - 1 1 1 - - 1 3 3 3 8 9 12 9 15 13 38 32 33, Motor vehicle accidents 19 13 32 - - - - 1 - 1 1 6 - 2 2 1 1 2 - 1 3 3 3 2 3 33 34. All other accidents 42 30 72 - - 1 - - 1 1 - 6 1 5 1 4 3 5 3 4 3 5 2 11 16 34 35. Suicide 22 13 35 - - - - - - - - 1 1 4 1 5 6 2 2 5 1 4 2 1 - 35 36. Homicide 4 1 5 1 1 1 - - - - - - - 1 - 1 - - - - - - - - - 36 All Causes 1288 1383 2671 42 42 15 12 4 3 6 2 18 4 25 14 36 36 100 80 289 144 319 279 434 767 Totals 2671 84 27 7 8 22 39 72 180 433 598 1201 Percentages 100 3.15 1.01 0.26 0.30 0.82 1.46 2.70 6.74 16.21 22.39 44.96 7 COMPARATIVE VITAL STATISTICS - 1950 TO 1963 (Compilertrora Registrar-General' s Returns) 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 Population 227,410 227,870 227,170 222,940 223,400 225,800 227,800 228,300 228,800 230,500 233,500 235,300 235 800 238,200 Live Births - (Total) 5,717 5,797 5,412 5,195 4,972 4,592 4,582 4,322 3,945 4,063 3,969 3,897 3,880 4,091 (Illegitimate ) 910 910 738 652 557 494 467 402 340 336 296 282 285 302 Birth Rate per 1,000 population (Unadjusted) 25.1 25.4 23.8 23.3 22.3 20.3 20.1 18.9 17.2 17.6 17.0 16.56 16.45 17.17 Still Birth Rate per 1,000 births 17.0 17.1 16.7 19.8 19,52 21.94 19.68 21.51 21.09 19.31 22.66 17.89 20.94 17.48 Deaths 2.671 2,581 2,590 2,466 2,580 2.594 2,457 2,566 2,591 2,425 2,669 2,876 3,131 2,760 Death rate - (Unadjusted) 11.7 11.3 11.4 11.1 11.55 11.49 10.79 11.24 11. 32 10.52 11. 43 12.22 13.28 11.59 Maternal Death rate per 1,000 births 0.17 0.51 1.27 0.19 1.18 1.28 0.64 0.45 0.25 0.48 0.99 1.01 0 .50 0.72 Death fate of Infants under 1 year 19.4 19.1 21.2 21 22 23 21 21 26 17 24 22 28 29 Marriage rate per 1,000 population 21.68 22.05 21.17 21.24 21.51 21.0 20.7 3 21.44 20.95 19.35 19.08 17.85 19.17 18.37 T. B, Notifications per 1,000 population (all forms) 1. 42 1.36 1.46 1.83 1.67 2.13 1.51 1.81 1.97 1.94 2.08 2.03 1.77 2.05 Death-rates per 1,000 population Pulmonary T. B. 0.04 0.06 0.10 0.05 0.10 0.14 0.12 0.15 0.20 0.16 0.16 0.30 0.30 0.38 Neoplasm of Lung, Bronchus & Trachea 0.73 0.73 0.75 0.82 0.77 0.68 0.67 0.62 0.52 0.53 0.57 0.54 0.54 0.54 Suicides 0.15 0.11 0.12 0.13 0.14 0.15 0.11 0.15 0.13 0.13 0.14 0.076 0.15 0.09 Motor Vehicle Accidents 0.14 0.09 0.13 0.15 0.13 0.13 0.092 0.13 0.14 0.082 0.077 0.076 0.11 0.10 All other accidents 0.32 0.26 0.26 0.26 0.25 0.18 0.23 0.22 0.22 0.17 0.20 0.22 0.26 0.26 8 SUMMARY OF INFANT MORTALITY 1963 (Based on Registrar General's Returns) Primary Cause of Death Under 1 day Days Weeks Months 1963 1962 1 - 2 2 - 3 3 - 4 4 - 5 5 - 6 h . 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 Meningococcal Infection Tuberculosis - Lungs Tuberculosis - Other forms Bronchitis 1 2 1 1 5 (4) Pneumonia 1 1 2 2 3 2 2 1 14 (16) Influenza Enteritis and Diarrhoea 1 1 2 (2) Premature Birth 15 2 17 (15) Congenital Malformation, Birth Injury, Atelectasis, Atrophy and Marasmus 35 6 3 3 1 2 1 51 (58) Syphilis Suffocation Overlying (3) Violent Causes 2 1 1 4 (4) Road Traffic Accidents All other causes 5 2 1 2 3 2 1 1 1 18 (9) TOTALS 58 6 5 2 1 5 1 6 5 7 3 5 1 1 1 2 2 111 111 9 COMMENTS ON VITAL STATISTICS Population The Registrar General's estimated mid-year population at 227,410 compares with the 1962 mid-year estimate of 227,870 This would seem to follow the trend shown by the Registrar General's estimates year by year prior to the 1961 Census, of small decreases of population, which had been reversed in 1961 and 1962 Births For the first occasion since 1955, the number of births in 1963 did not exceed those of the previous year The total of 5,717 was only slightly less and the birthrate was only a fractional fall It would, however, be premature to assume that there is likely to be a levelling out, or even that this may be the beginning of a reduction in the birthrate. There may well be local factors and it will be of particular interest to observe the trend in the current and succeeding years. The reduced rate is also affected by an adjustment in the area comparability factor following the processing by the Registrar General of the 1961 figures The 1963 percentage of illegitimate live births to total live births again slightly exceeded the previous year's figure in rising from 15.7 to 15.9. Since almost one in six of all live births have been classified as illegitimate, this must have an important socio-medico significance. It would seem to be desirable to have further studies of the principal population groups which make the largest contribution to the number of illegitimate children born, and to obtain further information of the effects of this situation upon the future welfare of the children concerned Children under 15 years of age The following table (extracted from the Registrar General's Returns) gives the estimate number of children under the age of 15 years in the County of London and in Islington: Under 1 year 1 - 4 Total under 5 5-14 Total under 15 London Admin County 61,600 207,200 268,800 368,100 636,900 Islington 5,660 18,140 23,800 26,200 50,000 Deaths The unadjusted total death rate was only fractionally higher than in 1962, rising from 11.3 to 11.7 The adjusted rate, however, rose from 11.0 to 13.1. This was again due to a marked adjustment in the area comparability factor being made over last year. 10 The following table shows the deaths due to respiratory causes, i.e. influenza, pneumonia and bronchitis, on a monthly distribution: Under 1 year 1-54 55 - 64 65 - 74 75 - Total January 2 3 12 15 35 67 February 4 6 24 16 73 123 March 2 6 17 12 61 98 April 1 - 3 6 13 23 May 2 2 3 4 11 22 June - 1 2 6 18 27 July 1 - 1 5 13 20 August 1 - - 7 4 12 September 4 - 2 5 11 22 October - - 1 6 7 14 November 2 2 5 4 17 30 December 2 4 2 15 23 46 It will be seen that February and March were the months of greatest respiratory risk. More respiratory deaths occurred than in the previous year and the increase was mostly due to an additional number of deaths with pneumonia as the certified cause Although the majority were, as usual, very elderly persons, i.e. over 75, it will be seen also there were rather more deaths in the 55-64 age group in February and March than in the 65-74 age group, and this disproportion did not take place in other months Deaths of infants under one year The infant mortality of 19.4 for 1963 is just fractionally higher than that for the previous year which was the lowest recorded, 50% of all infant deaths occurred within the first 24 hours following birth From one to twelve months the greatest risk to infants was due to respiratory disease, particularly pneumonia. Of a total of 27 infant deaths in the age group one to twelve months, ten were due to pneumonia Maternal Mortality It is a very considerable tribute to the hospitals, the Local Health Authority and the family practitioners that in a total of 5,816 live and still births, there was only one maternal death. This was a fatal issue following instrumental interference and was therefore undoubtedly avoidable. Respiratory Tuberculosis The downward trend of deaths from lung tuberculosis, which was interrupted in 1961 and fortunately resumed in 1962, when the rate dropped from 0.10 per thousand population to 0.06, again fell in 1963 to 0.04 - the lowest recorded The decreased risk of mortality was not, however, combined with a similar fall in the number of cases, commented upon elsewhere in the report, and demonstrates that there is no reason for complacency yet with regard to tuberculosis of the lungs in an area such as Islington. 11 Malignant Growths of Lung and Bronchus From the table given below, it will be seen that the total deaths due to malignant disease of lung and bronchus has remained approximately stationary over the past few years There are still approximately six times as many males as females who died from this cause The majority of men affected are not elderly, but aged 55-65 and not an inconsiderable number are younger still Deaths Male Female Total 1950 115 14 129 1951 104 23 127 19 52 1 07 20 127 1953 114 19 133 1954 98 25 123 1955 103 17 120 1956 119 22 141 1957 127 25 152 1958 130 24 154 1959 145 26 171 1960 156 26 182 1961 141 29 170 1962 144 22 166 1963 147 20 167 Deaths due to cancers of the lung and bronchus are the only group of malignant disease deaths which have increased over the past years Deaths due to other forms of malignant disease have remained stationary or have shown a decrease The principal reason for this difference between lung cancer and other forms is, or should be common knowledge by now. The evidence summarized in the Report of the Royal College of Physicians published in 1962 and accepted by the Ministry of Health for many years namely 90% of all lung cancer cases follow long continued cigarette smoking, has not been contraverted Lung cancer and coronary disease of the heart are the two principal single causes of death in men of middle age The health education problems arising from this are discussed elsewhere in this report The following information has been kindly furnished by Dr Brett, Physician-in Charge, Static X-Ray Unit, Drayton Park, in respect of persons passing through the Unit and found to have primary lung cancer. The figures given include residents outside the Borough as well as Islington residents Male Female Number of cases found 70 9 12 Coronary Disease with Angina Islington deaths due to coronary conditions both in men and women have been analysed and a summary of the mortality of the past 10 years is given below Although there was some fall in the male deaths, the female deaths with certified coronary disease, increased substantially in all age groups, to give the highest total recorded Ages 25 M F 45 M F 65 M F 75 M F Total M F 1954 8 - 57 13 54 51 59 66 178 130 1955 9 1 78 20 70 47 52 79 209 147 1956 4 2 72 2 3 6 2 5 1 80 7 5 218 151 1957 10 2 7 8 2 5 50 49 7 0 95 208 171 1958 7 1 71 21 68 74 66 88 212 184 1959 9 - 97 22 74 62 57 89 237 173 1960 13 - 106 27 91 47 66 89 276 163 1961 14 - 103 17 60 58 64 87 241 162 1962 8 1 100 27 80 55 80 103 268 186 1963 8 3 86 36 70 63 84 112 248 214 Totals 90 10 848 231 679 557 678 883 2295 1681 Accidents The following table gives the deaths from accidents to Islington residents from 1954 onwards:- 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 Motor vehicle accidents 19 33 29 21 30 30 34 29 21 32 Other violent accidents 40 50 51 52 40 55 57 60 59 72 In the following table causes of accidental deaths in 1963 are analysed, in their respective age groups:- Type 0- 1- 5- 15- 25- 45- 65- 75- M F. Total Motor Vehicle Accidents _ 1 2 6 6 6 6 5 19 13 32 Falls - - 1 1 2 3 2 19 18 10 28 Accidental Poisoning (Solid, Liquid Gases and Vapours) - - - 2 4 3 3 6 9 9 18 Drowning - - - - 2 - - - 2 - 2 Fire 1 - - 2 1 3 - 2 3 6 9 Inhalation of Stomach contents, ingestion of food, etc. - - - - - 1 - - - 1 1 Other (Railway Accidents, etc.) - 1 - 2 4 5 2 - 10 4 14 Total 1 2 3 13 19 21 13 32 61 43 104 13 The improvement noted in last year's Annual Report when 21 fatalities due to motor vehicles were recorded, was not maintained, Unfortunately, there was an increase in 1963 in the number of fatalities in all age groups except those over 75, Fatal accidents due to other causes were regrettably at a record total of 72. There was an increase of 9 over the past year in fatal accidents due to falls and an increase of 4 in fatalities due to fire. 14 SECTION B PREVALENCE AND CONTROL OF INFECTIOUS AND OTHER DISEASES Notifiable Infectious Diseases and Deaths during the year 1963 Disease Number of Noti fications Number of Deaths Removed to Hospital Number of Cases returned to Registrar-General after correction of Diagnosis Cases "coming to knowledge" but not Notified Smallpox - (-) - - - - Scarlet Fever 67 (66) - 11 66 8 Diphtheria 16 (-) - 16 6 - Enteric Fever (including Paratyphoid) 1 (5) _ 1 1 - typhus Fever - (-) - - - - Puerperal Pyrexia 232 (230) - 230 232 - Ac. Primary & Influenzal Pneumonia 32 (28) - 5 32 - Ophthalmia Neonatorum 19 (58) - 14 19 - Acute Encephalitis 8 (4) - 8 7 - Meningococcal Infection 8 (8) - 8 7 2 Anthrax (-) - - - - Dysentery 851 (252) 1 47 851 529 Malaria 1 (1) - 1 1 - Erysipelas 11 (17) - 1 11 2 Measles 2229 (1314) - 48 2,211 157 Whooping Cough 185 (51) - 30 185 - Ac. Poliomyelitis (4) - - - - Food Poisoning 103 (67) - 13 91 18 Tuberculosis - Lungs 295 (290) 8 - 227 - Tuberculosis - Other Forms 29 (21) 4 - 27 - Scabies 112 (69) - - 112 240 (Figures in brackets are notifications for 1962) Domiciliary Visiting of Infectious Disease Cases and Contacts - No. of Visits Smallpox 128 Scarlet Fever 74 Diphtheria 272 Enteric Fever (including Typhoid and Paratyphoid) 27 Meningococcal Infection 9 Dysentery 1,632 Malaria 1 Acute Encephalitis 6 Eysipelas 7 Measles 2,498 Whooping Cough 210 Acute Poliomyelitis 8 flood Poisoning 90 Scabies 303 Vermin 148 Ineffective Visits 1,041 Others 27 Total 6,481 15 Smallpox New regulations regarding International Certificates of Vaccination came into force on 1st August, 1963. Travellers arriving by air from locally infected or "endemic" areas, who refuse vaccination, will now, unless they are in transit, be isolated for 14 days from the date of departure from the infected area, or for the length of their stay in this country, whichever is the less If a traveller by air is proceeding within a few days to another country that is party to these regulations, then the Port Health Authority of this other country will be informed by telex or telephone. Whilst the new regulations also apply to sea travellers it is not intended that Port Medical Officers should exercise these powers as a matter of routine, except in relation to infected ships. Of the 21 references for suspected smallpox and supervision of possible smallpox contacts, therefore, 19 of these were arrivals to this country from declared smallpox areas who were reported to be proceeding to addresses in Islington and were not in possession of valid international certificates of vaccination, In accordance with the abovementioned regulations they were all visited and kept under surveillance for the required period of time. Two patients were referred by family practitioners to the Medical Officer of Health or his Deputy as suffering from rashes of a type where it was desirable to exclude smallpox as a possible cause One patient was a 25 year old female Chinese student, who had recently arrived from Singapore on the Liner s. s. "Chusan" It was not thought to be a case of smallpox and subsequent bacteriological examination reports were negative The other patient was a 3½ year old child, who was found to be suffering from chicken-pox The following is the table of successful vaccinations performed over the past sixteen years:- 1st January - 3rd July 1948 1,124 1956 ... ... ... 2,590* 5th July - 31st December 1948 702 1957 ... ... ... 3,624* 1949 1,628 1958 ... ... ... 3,449* 1950 2,307 1959 ... ... ... 2,692* 1951 3,291 1960 ... ... ... 2,753* 1952 2,450 1961 ... ... ... 3,782* 1953 3,055 1962 ... ... ... 32,795 1954 4,052* 1963 ... ... ... l,009** 1955 5,942* (Figures kindly furnished by Divisional Medical Officer, London County Council) * Including Re-vaccinations Group Sessions for Schoolchildren discontinued ** The small number of vaccinations undertaken in 1963 was a direct result of implementing the Ministry of Health, advice regarding the timing of such vaccinations i.e. at 16 - 19 months of age instead of at 5 months. 16 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 Applications for authentication to be dealt with by the Medical Officer of Health numbered 1,355 as against 3,361 for the previous year. The applications comprise requests for authentication of International Certificates of Vaccination and Inoculation against smallpox, cholera, typhoid, etc. and constitute a substantial item of work. The certificates, of course, are required for travel abroad. The fall in the numbers authenticated over the previous year was due to the lifting of the special requirements of several of the European countries, introduced as a result of the outbreaks of smallpox in England and Wales in 1962. 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 The number of cases notified in 1963 was 2,229. This was a continuation of the outbreak mentioned in last year's Annual Report which commenced in October 1962 and reached a peak in January 1963 when 626 cases were notified. The greater majority of cases were relatively mild and uncomplicated, but 48 were referred to hospital There was no instance, fortunately, in which measles led to / death. The following table shows the age-groups of the notified cases during 1963:- Under 1 year 1 - 5 5 years and upwards No. of Notifications in 1963 113 1,349 767 Percentage of total Notifications 5.1 60.5 34.4 No. of Deaths - - • 17 MEASLES - MONTHLY INCIDENCE, 1963 18 Whooping Cough 185 notifications of Whooping Cough were received in 1963. This compares with 51 received in 1962 which was the lowest on record. The age groups are as follows:- Under 1 year 1 - 5 5 years and upwards No. of Notifications in 1963 30 91 64 Percentage of total notifications 16.2 49.2 34.6 No. of Deaths - - - The following chart shows the measles and whooping cough position since 1950 19 Fatality Rates per 1,000 notifications each age group 1954 - 1963) Percentage of notifications (1954 - 1963) Under 1 1-5 5 & upwards Under 1 1-5 5 & upwards Measles 1.22 0.09 0.12 4.0 56.6 39.4 Whooping Cough 2.01 0.56 - 14.4 52.0 33.6 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 19, 203 Completed cases 5,208 ) Primaries 3,579 ) Boosts London (Measles and Whooping Cough) Regulations 1938 Home visiting of measles and whooping cough cases was carried out by the Home visitors as under:- No. of Investigations Measles Whooping Cough No. of Ineffective Visits Re-visits 2,489 210 382 9 Acute Poliomyelitis For the first time on record in the public health history of Islington, there was not a single case of poliomyelitis either reported or confirmed in 1963. This situation, of course, might have been anticipated following the dramatic fall in the poliomyelitis cases over the past few years in particular It is very apparent that it is the successful campaign for inoculation against poliomyelitis, first through the medium of the Salk Vaccine given by injection and more recently, by the Sabin Vaccine given orally, that this successful and most important outcome has resulted Continued immunisation will be necessary to maintain public protection against poliomyelitis During the year discussions took place between the Divisional Medical Officer, the Medical Officer of Health, on co-operative procedure to be taken in the event of the occurrence of a case of poliomyelitis, Immediate steps would be taken to ensure general local immunisation using the oral vaccine, and the public health department staff in such an event would work closely with the London County Council staff in arranging to give appropriate publicity to the necessary measures and to assist with domiciliary visiting. No, Reported No. Confirmed Deaths 1963 _ _ _ 1962 5 2 - 1961 13 1 - 1960 34 15 - 1959 109 60 6 1958 37 10 - 1957 55 25 1 1956 34 13 - 1955 97 56 2 1954 35 12 1 1953 47 17 3 1952 30 15 - 1951 21 8 - 1950 54 31 2 Includes a case notified posthumously and not included in Registrar-General's Tables, • Two cases, with onset in December, 1956, were notified in 1957, and are included in the above returns. Protection against Poliomyelitis Protection against poliomyelitis is given at all Welfare Centres in Islington under arrangements made by the L.C.C. "Open Sessions" are held and attendances at these is not restricted by place of residence, hence it is not possible to give the number of Islington residents who have attended The following figures show the numbers of persons who have been protected at L,C.C. Clinics and by medical practiti rners in 1963 in the whole of the Division comprising the areas of the Boroughs of Finsbury, Holborn and Islington Age Groups 0-4 yrs. 5-19 20-29 Others Total 2nd Salk (injections) 50 20 67 26 163 3rd Salk 46 26 81 17 170 4th Salk 2 10 - - 12 3rd Sabin (Oral) 4, 594 1, 293 617 429 6,933 Reinforcing (Sabin) doses 513 2,408 112 15 3, 048 Diphtheria Cases and Deaths 1932 - 1963 Year Notified Cases Deaths Year Notified Cases Confirmed Cases Deaths Year Notified Cases Confirmed Cases Deaths 1932 601 20 1944 94 38 2 1957 9 1 – 1933 551 33 1945 86 45 3 1958 6 2 . 1934 815 32 1946 137 50 - 1959 48 9 - 1935 760 13 1947 72 19 1 1960 4 - – 1936 583 31 1948 44 7 - 1961 10 4 2 1937 623 20 1949 55 17 2 1962 • - . 1938 595 23 1950 50 19 1 1963 16 6 - 1939 254 10 1951 43 17 1 1940 101 2 1952 23 – . 1941 174 11 1953 12 1 - 1942 201 2 1954 6 1 - 1943 188 9 1955 9 1 - 1956 8 2 - 21 Corrected Notifications Year 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 1954 176 8 1 1955 169 17 1 1956 63 11 2 1957 40 4 1 1958 79 38 2 1959 103 75 9 1960 53 18 - 1961 52 28 4 1962 19 - - 1963 33 14 6 Whilst I was able to report in 1962 that there was not a single case of diphtheria in Islington, 1963, unfortunately, did not maintain this clear record, when 6 cases and 7 carriers were finally confirmed The first case was an 8 year old Islington boy attending Vittoria School, who developed a sore throat and was subsequently admitted to hospital and found to have diphtheria in a fairly severe form. The discovery of this case immediately set in motion the very detailed procedure agreed between the health departments of the County Council and the Borough Councils for dealing with such events. Household and family contacts were visited and nose and throat swabs taken and the same procedure applied to school children Family practiti aiers in Islington and local hospitals were also warned of the occurrence of a case of diphtheria. Within a few days after the finding of the first case, mainly as a result of the examination and observations of possible contacts, a further five cases of diphtheria, all mild or very mild, were admitted to hospital, together with seven children who were also admitted to hospital as symptomless carriers of the diphtheria germ. Of the six cases, four were children attending the Vittoria School, one at Charles Lamb School and the other child attended the Tudor School, Of the seven carriers, six were Vittoria children and one attended the Charles Lamb School, Children attending the Tudor and Charles Lamb Schools were followed up on account of family or school contact with children attending the Vittoria School In spite of enquiries, it was not possible to trace the source of infection of the first case, but it most gratifying to record that the very exhaustive tracing of contacts, bacteriological examinations and isolation in hospital of those found to be harbouring the germ whether as cases or carriers, together with the immunisation of those at special risk succeeded in the early limitation of any possible spread. 22 Diphtheria Immunisation, 1963 Dr.. Wilfrid G„ Harding, Divisional Medical Officer, London County Council, has kindly supplied the following figures in respect of Islington for the current year. As immunity tends to wane with the passage of time, the Immunity Index relates only to children who have been inoculated during the last 5 years by general practitioners, and in L.C.C. Welfare Centres and Schools. This is consonant with the Immunity Index given by the Ministry of Health. Age at 31.12,63 i.e. born in year Under 1 1963 1 - 4 1962 - 59 Last complete course (whether primary or boost) 1959 - 63 2,603 14,449 Mid-year population 5,660 18. 140 Immunity Index 46 69.7 Food Poisoning Number of notifications received 1947 7 1948 10 1949 55 1950 104 1951 148 1952 58 1953 243 1954 104 1955 294 1956 141 1957 150 1958 183 1959 164 1960 131 1961 119 1962 67 1963 103 It will be seen from the above that there was a rise in the number of notifications of food poisoning over last year, comprising isolated and family cases. It is, however very gratifying to record that there were no outbreaks during the year to be reported to the Ministry of Health in accordance with Memo. 188/Med. of the Ministry of Health, Although it is the first year since 1952 that this has occurred, there is no justification for any relaxation in vigilance, for food poisoning is a disease which is directly related to cleanliness, food hygiene and health education. 23 Lead Poisoning The following 3 references of lead poisoning were received during the year. In the first case information was received from the Divisional Medical Officer, L.C.C., Health Division III regarding a child who was under treatment at the Hospital for Sick Children and who, it had been discovered, had a blood lead level which was twice the normal. A domiciliary visit was carried out by the Public Health Inspector, who reported that the only apparent incriminating item was a favourite toy, a metal motor car, which had been painted red and white. It was stated that the boy continually licked this car The toy motor car was therefore examined by the Public Analyst, who subsequently reported that the red paint had an appreciable lead content In the next case information was received from the Hospital for Sick Children regarding a child who was under treatment there, and who, it had been discovered, had a raised blood lead leveL A domiciliary visit was carried out by the Public Health Inspector who reported that the baby was in the habit of sucking the headboard and sides of her cot and was also eating other articles - dirt lying around both inside and outside the house which could have been contaminated by paint. This habit had been going on for some considerable time A partition on the ground floor had recently been painted and the Inspector took samples of paint scrapings both from the cot and from the partition in the room These specimens were sent to the Public Analyst who reported that whilst the paint from the cot contained only negligible amounts of lead, the paint from the partition contained 34 per cent lead On the third case, information was received from the Divisional Medical Officer, LC.Co, Health Division III, of a child who had been admitted to Whittington Hospital with a diagnosis of Lead Poisoning A domiciliary visit was carried out by the Public Health Inspector who reported that the child had been biting on the cot, window sills and pieces of clothing The mother had recently repainted the cot and window sills Hie Inspector obtained a sample of paint from the child's cot, and two from the window sills - one of the fresh pink paint and one of the older green paint. Two further samples of paint were obtained from paint tins. One sample of the fresh pink paint scrapings f-cm the window sill showed appreciable lead content and, it was thought, may have been derived from previous painting or from an undercoat. The Paediatrician, Whittington Hospital and the Divisional Medical Officer, London County Council, Health Division III were informed. 24 Typhoid and Paratyphoid Fever There was one confirmed case of Typhoid Fever in the Borough during the year. This was a female aged 35 years who was admitted to an Isolation Hospital and was found to be suffering from typhoid fever. She discharged herself, as a typhoid carrier, against medical advice although subsequently submitting 6 negative faecal and urine specimens She had been on holiday in Italy for 3 months and returned to England not feeling well. It is presumed that the infection was contracted abroad. Family and other contacts were kept under close observation, 3 of these contacts were engaged on food handling duties in other Boroughs. The Medical Officers of Health of the Boroughs concerned were kept fully informed of all developments. Routine bacteriological examinations from all contacts proved negative for typhoid. Information was received in early March from the Chief Medical Officer of the Ministry of Health of cases of Typhoid Fever reported among persons who had recently returned to England from Switzerland Each of the persons concerned had stayed in Zermatt during the second half of February No cases were reported amongst Islington residents but investigations were made after the receipt of information of an Islington child who had been in contact with a nurse who was a confirmed case of Typhoid and had recently returned from Zermatt, Reports were also received of an Islington Doctor and Nurses from Whittington Hospital and one other Islington resident who had also recently returned from Zermatt The attention of all Medical Practitioners was drawn to the possibility of typhoid fever as an explanation of illness in any recent Zermatt traveller A comnunication on this subject was also addressed to all those responsible for Catering and Food Handling Staffs in the Borough Information was received from the Royal Northern Hospital of 3 Islington contacts of a confirmed case of Typhoid in Bedfordshire. A routine domiciliary visit was made and results of bacteriological tests proved satisfactory Information on the case was requested from the Medical Officer of Health of the Borough concerned Subsequently a reply was received confirming the Typhoid Fever, and stating that the infection was not a local one but was, in fact, acquired abroad The Medical Officer of Health Southampton reported that 4 Islington residents were contacts of a suspected case of Typhoid Fever on the s s "Flandre" which arrived at Southampton on 24th June. Domiciliary investigations were made and all faecal and urine specimens examined were negative One of the contacts could not be traced and the Medical Officer of Health, Southampton was informed. ' "Reports of a further 7 contacts (2 isolated and 5 in one family) of Typhoid Fever were also investigated during the year 25 Paratyphoid "B'' Fever A Birmingham young lady who was a member of a Holiday tour to Alghero, Sardinia, was taken ill and admitted to hospital as a confirmed case of Paratyphoid ™B" Fever. 3 Islington families who were members of the same tour were kept under observation. Routine bacteriological examinations proved negative Chinese Bulked Egg Paratyphoid B Type Taunton In a communication received from the Ministry of Health, information was given concerning three outbreaks of Paratyphoid B type Taunton which had occurred in the provinces since the middle of March This outbreak was similar to one which occurred in Edinburgh at the end of last year and continued until the beginning of 1963. Approximately half the original cases occurred in young people and were associated with cream pastries or cakes These were usually traced to a bakery in which Chinese Bulked Egg products were known to have been used at the relevant time In sampling the Chinese Egg products at Bakeries associated with the above outbreaks. Paratyphoid type B was not found and a casual association not proved, but precautions in the case of Chinese Bulked Egg seemed desirable. Stocks in cold stores from suspected shipments were held and the importers and distributors took steps to recall any unused stocks. Hie Minister advised that a check of the use of this product in bakeries was advisable and that general practitioners be advised to be on the alert. All the general practitioners in the Borough were informed accordingly and all the bakeries in the Borough inspected Only in one case was Chinese Egg found A sample was forwarded to the Bacteriologist who reported that organisms of the Salmonella group were not isolated Typhus Information was received in late June of a Doctor who had arrived by plane from India and had been in contact with a case of Typhus Fever, Domiciliary enquiries proved to be satisfactory and, as the quarantine period was complete, no further action was taken Dysentery The incidence of Dysentery in 1963 (1,378 cases) showed a sharp rise over 1962 (369 cases). Indeed, this figure is the highest ever recorded in Islington for this disease. From the detailed analysis it will be noted that 455 cases (33%) were under 5 years and 662 cases (48%) aged 5-15 years. Hie infecting organism in nearly all cases is Shigella sonnei and the illness is fortunately rarely severe or dangerous. This age distribution is explained by the character of the occurrences. Some schoolchildren in a school in the north of the Borough were affected in early December 1962, and in addition to the children, a kitchen meals helper was also found to be carrying the organism. Subsequently, children at a number of other schools were also affected, and cases were reported from four Day Nurseries 26 An additional factor of some interest in the investigation of the spread of the outbreak was the very severe winter experienced at the time. Several of the older schools had lavatories, wash basins etc., frozen up. One school in particular, with a large number of dysentery cases, had to be closed for several days. All cases were visited by the Infectious Diseases Visitors and, whenever possible, examination of the stool specimens were arranged with the Public Health Laboratory, County Hall, S.E. 1. As mentioned elsewhere in the report, 8,582 specimens were sent during the year, for Dysentery alone. It will be seen from the dysentery table on page 27 that, arising out of these enquiries 33 dysentery cases were found to be employed as food handlers and 137 were food handlers who were direct or indirect contacts of dysentery cases. An interesting factor that emerges from these tables year by year, is of a steady falling off intheuunber of cases that are being formally notified by medical practitioners. This is clearly demonstrated in the following figures:- Year % of Cases Notified 1951 90 1954 89 1960 78 1963 62 27 DYSENTERY IN ISLINGTON - 1963 Month 1963 No. of Cases Notified Coming to knowledge Confi rmed Cases Sex AGE GROUPS Cases employed as food handlers Food Handler Contacts Water Closet Accommodation 0- 1- 5- 15- 2 5- 45- 65- Same family Separate family Separate Shared January 78 43 35 69 M 2 14 20 2 7 1 - 1 13 5 40 38 F - 9 16 2 5 - - February 339 245 94 275 M 5 44 107 5 18 3 4 12 45 15 201 138 F 5 28 85 3 24 6 2 March 207 89 118 180 M . 27 73 6 9 5 - 6 20 6 136 71 F - 30 33 6 12 6 - April 148 79 69 140 M 3 38 17 1 5 1 - 4 12 8 66 82 F 1 34 26 1 12 4 5 May 166 124 42 143 M 3 19 39 1 6 . . 5 11 - 91 75 F 3 25 42 11 14 1 2 June 161 99 62 147 M 1 28 39 1 6 - - - 6 - 91 70 F 4 20 53 2 6 - 1 July 164 94 70 143 M 1 26 33 2 3 2 . - 21 - 100 64 F 5 32 45 3 9 1 2 August 38 18 20 31 M - 9 3 - 4 1 - 4 9 - 26 12 F - 7 6 3 2 3 - September 15 6 9 11 M 2 3 3 - - - - - - - 8 7 F 1 3 2 1 - - - October 36 32 4 24 M 3 10 5 - - - - 1 - - 15 21 F 1 4 5 - 5 2 1 November 15 9 6 11 M . 1 1 1 - - • - - - 9 6 F i 2 5 1 2 - 1 December 11 11 - 8 M 1 1 1 1 2 - _ - - - 6 5 F - - 3 - 1 1 - TOTAL 1378 849 529 1182 M 21 219 341 20 61 13 4 33 137 34 789 589 F 21 194 321 33 92 24 14 TUBERCULOSIS 1963 PRIMARY NOTIFICATION OF PULMONARY CASE 29 Tuberculosis The number of deaths from Tuberculosis of the lungs fell fran 13 in 1962 to 8 in 1963, the lowest total on record. New cases amongst females rose by 40% and comprised an increase in all the age groups from 5 to 45 years inclusive. In males, there was a 14% fall over the previous year, with the decrease in all the age groups from 15 years upwards, New Cases and Mortality during 1963 NEW CASES DEATHS Respiratory Non-Respi ratory Respi ratory Non-Respi ratory Male Female Male Female Male Female Male Female 0 1 1 – – – – – – 1 2 4 – – – – – - 5 8 11 – 1 – - – - 15 14 21 – – – - – • 25 31 21 4 7 – – – - 35 29 19 – 4 – 1 – 1 45 21 6 1 2 1 - – - 55 20 4 1 – 1 1 – - 65 and upwards 16 5 – – 4 - – 3 Total for all ages 142 92 12 17 6 2 – 4 263 12 Rates per 1,000 population: New cases : pulmonary 1.03 . non-pulmonary 0.13 Deaths : pulmonary 0.04 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 ns 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, 1963, was:- Pulmonary Males 1,454 Females 1,100 Non-Pulmonary Males 140 Females 168 2,862 30 The corresponding figures for previous years are:- 1962 2.912 1961 2,978 1960 3,034 1959 3,074 1958 3,172 1957 3,168 1956 3,048 1955 2,945 1954 2,922 1953 2,862 1952 2,575 1951 2,404 1950 2,368 Islington Chest Clinic, Whittington Hospital St. Pancras Chest Clinic, Margaret Street, St. Marylebone Mass X/Ray Unit of the North-Rest Metropolitan Regional Hospital Boards 32 Drayton Park, N. 5 The Borough is well and conveniently served by the above centres to which patients may be referred, or where persons may attend for examination. Cases on Chest Clinic Registers Number of definite cases of tuberculosis on Chest Clinic Register as at 31st December 1963 Pulmonary Non-Pulmonary Total Adults Qiildren Adults Children Adults Children M F M F M F M F M F M F Islington C.C. 1146 761 60 60 56 83 3 11 1202 844 63 71 St. Pancras C. C. 119 72 8 12 5 6 124 78 8 12 1265 833 68 72 61 89 3 11 1326 922 71 83 Grand Total 2, 402 The corresponding figures for previous years are:- 1962 2,415 1961 2,450 1960 2,497 1959 2, 564 1958 2,735 1957 2,818 1956 2,772 1955 2,751 1954 2,851 1953 2,738 1952 2,575 1951 2 443 1950 2, 238 31 The Islington X Ray Centre Dr. G. Z. Brett, Physician-in-Charge of the Static X-Ray Unit at Drayton Park has kindly agreed to the following inclusion from his report which reviews the work of the Unit for 1963. The Centre was officially opened in February 1952= It was originally intended to provide X-Ray facilities for all those living and working in the Borough of Islington. Within a year, however, practitioners in many neighbouring boroughs were also making use of the facilities of the Centre, The following is extracted from Dr. Brett's annual report: Static X-Ray Centre TABLE A ISLINGTON NON- ISLINGTON TOTAL Men Women Men Women No. x-rayed 6, 441 6,013 8,179 7,716 28, 349 No. of Cases 72 26 49 19 166 Rate per 1,000 10. 1 4.3 6.0 2. 4 5,8 TOTAL 7.8 4,3 5.8 An analysis as under has been done of British born and other ethnic groups who attended the Static Centre in Islington. The highest incidence of Tuberculosis was: found in Cypriot and Irish bom men. The increase in Tuberculosis among West Indian men observed in 1961 and 1962 was confirmed also in 1963 On the whole the non-British born formed about 25% of all examinees and yielded about 45% of active Tuberculosis. TABLE B No. x-rayed No.:of Cases Rate per 1, 000 Men Womien Men Women Men Women British-born 110,736 10, 339 62 27 5.8 2.6 Irish 955 1,020 19 4 19.9 3.9 Cypriots 408 294 9 2 22.0 6.8 West Indians 952 827 8 2 8.4 2,3 Indians ) Pakistanis ) . 323 200 10 2 30,0 20.0 Africans 466 194 6 2 13,0 10.0 Others 783 852 7 6 9.0 7.0 Total Non-British born 3,887 3,387 59 18 15.0 5.3 32 Tuberculosis Care Committee The London County Council is responsible for care and after care work under Section 28 of the National Health Service Act, 1946, but the Islington Tuberculosis Care Committee remains in being, working in conjunction with the Islington Chest Clinic, and Members of the Borough Council and the Medical Officer of Health serve on this Committee. The Tuberculosis Care Committee is able to assist patients in many ways, including the provision of extra nourishment, while loans of beds, bedding and medical appliances were made to 3 patients from the L, C. C, loan stock, others were referred to various organisations for assistance. The Care Committee administers an occupational therapy service with occupational therapists employed by the L.C.C. The following figures show the service being provided in a typical week: No. of sessions of instructions in homes during a week 20 No. of patients receiving instruction at home 50 Scabies and Vermin As will be seen from the following table there are still a considerable number of Scabies and also vermin infestations. In fact, there was quite a steep rise in the numbers treated for scabies in 1963 - 369 compared with 161 the previous year, There was rather more than twice the number of children under 5, nearly three times the number of schoolchildren and twice the number of adults who were treated. The numbers treated for vermin infestations, however, were at 239 rather fewer than the previous year's total of 273 These conditions continue to be dealt with at the Council's Treatment Centre and are of course closely related to personal hygiene. It is evident that the standard of hygiene and personal cleanliness in some homes leaves something to be desired, although it should be remembered that approximately one half of the houses in Islington are still without a bath and a similar scarcity applies to wash basins with hot and cold running water for personal washing, apart from the use of the kitchen sink washing, apart from the use of the kitchen sink. This, combined with the high proportion of congested family accommodation in the Borough, makes the attainment of a reasonable standard of hygiene much more difficult than it need be. Scabies Vermin Children under 5 years - Number treated 59 11 Number of baths given 127 . Number of treatments - 11 L.C.C. Children Number treated Number treated 122 153 Number of baths given 304 - Number of treatments - 156 Adults Number treated Number treated 188 75 Number of baths given 417 - Number of treatments - 84 In addition 3 Special Baths were given 33 Home Visiting Scabi es Families Visited Revisits Ineffective Visits Total 159 10 134 303 Vermin 111 1 43 155 Bacteriological Examinations The number of specimens sent to the Public Health Laboratory, County Hall, S.E.I, for bacteriological examination was 9,839. This was over 2,500 more than 1958 when a record of 7,221 specimens were sent. In both years the majority of the specimens were fæcal and arose out of the various dysentery outbreaks. The incidence of dysentery is commented upon elsewhere in the report, but it is interesting to note that, in dealing with these specimens, both the Infectious Diseases Section and the Public Health Laboratory came very near to saturation point. Specimens were sent at the rate of up to 1,600 per month Examinations carried out Total Swabs (Diphtheria) 845 Sputum (Tuberculosis) 12 Faeces & Urine (Enteric Fever) 124 Blood (Enteric Fever) - Faeces (Food Poisoning) 186 Food (Food poisoning) 1 Faeces (Dysentery) 8,582 Faeces (Poliomyelitis) - Swabs (Streptococci) 47 Swabs (Pertussis) - Swabs (Influenza) • Vesicle Fluid scrapings (Variola) 1 Other specimens 41 TOTAL 9,839 (I am indebted to Dr. Wilfrid G. Harding, Divisional Medical Officer, London County Council, for the 1963 figures in connection with vaccination, diphtheria and whooping cough inoculations, and chest clinics.) 34 SECTION C SANITARY CIRCUMSTANCES OF TllE AREA (In conjunction with Mr, W„C Bartlett, Chief Public Health Inspector) During the year under review, the number of Public Health Inspectors engaged in the Department was under strength and although vacancies were repeatedly advertised several positions still remained un-filled at the end of the year A Student Scheme, which had been suspended, was resumed and a second Student Public Health Inspector was engaged early in the year, The unusual wintry conditions which commenced on Boxing Day the previous year continued with increased severity. On some days the temperature was as low as - 8.9° C Blocks of municipal and privately owned flats were severely affected due to the build-up of ice in the soil and waste pipes, Where necessary, Elsan Closets together with a quantity of fluid were loaned to tenants and this service was much appreciated, Where sanitary blocks were situated in the school yard, great difficulty was experienced by the Education Authority in maintaining them in good working order and in certain cases this was impossible - the conveniences being out of order during the whole period. The freeze-up also affected the hygienic conditions of food premises Lack of water and frozen waste pipes gave the proprietors every reason for their premises being sub-standard. Patrons came in with dirt and ice from the street on their boots and with the absence of water, it was difficult to keep the floors clean Cuts in the electrical and gas supplies did not help and the shop keepers worked under very difficult conditions The position was temporarily aggravated by the unavoidable delay in the refuse and pigswill collection. The demand for oil heaters considerably increased with the result that most shop keepers sold out, A certain amount of hardship was experienced due to the delay in deliveries of fuel and this was particularly severe in the case of elderly, infirm or sick persons. Where electrical or gas heating was used to supplement solid fuel, the situation was worsened by supply cuts or reduced current. The maximum capacity for solid fuel for families in multi-occupied houses is generally about 5 cwts When this is used up, delay in future deliveries means that tanants are without until further supplies are available In order to assist, a scheme was adopted whereby solid fuel in 28 lb bags was delivered upon payment to aged or sick residents in the Borough Where water supplies were frozen, the Metropolitan Water Board erected stand pipes in the vicinity of the dwellings: affected, The fact that so many properties were without water supply caused the Minister oi Housing and Local Government to issue Circular 65/63 in which he referred to the widespread damage and inconvenience caused. Enclosed with this circular was one addressed to Water Undertakers in which the Minister indicated his great concern over the damage and discomfort caused by frozen pipes In the wholly abnormal conditions a certain amount of damage was probably unavoidable but in his opinion, there was evidence of inadequate protection even against a normal winter many of the reasonable precautions against frost rests on the householder The conditions 35 which arose due to frozen water services could, in many cases, have been avoided. Much of the inconvenience was caused because the service pipes were inadequately protected and water closets were situated outside. Tenants should be aware of the position of the stop-cock and ensure that it is in working order. Taps should not be allowed to drip and a little salt placed in water closet and gully traps would have prevented the water content from freezing In increasing measure, it is found that the homes of aged or infirm persons require cleansing. In certain circumstances, the conditions are such that it has been found necessary to obtain volunteers from the Disinfecting Staff to undertake this work The City of London (Various Powers) Act, 1963, came into force during the year by virtue of which the Metropolitan Cattle Market and Abattoir was closed at the end of the year under review. Hie site is to be re-developed for housing, open space and educational purposes. Although slaughtering will stop at the end of this year, ancillary trades will continue for a while. The transfer of this site from the City Corporation to the London County Council will take effect from the 1st January, 1964, Another Statute which will affect the work of the Department is the Offices, Shops and Railway Premises Act, 1963, and which is based on the report of the Gowers Committee of 1949. The Act not only applies to rooms in which people work but covers other parts of the premises occupied together with an office or shop for the purpose of the activities carried on therein. Thus stairs, passages, landings, storerooms, entrances, exits and yards may be included The Act also applies to canteens which cater wholly or mainly for the people employed in the respective premises Anyone intending to employ people in offices, shops or railway premises will be required to notify the appropriate Authority and all existing premises will have to be registered. In addition to the above legislation, the Animal Boarding Establishments Act, 1963, was passed and becomes operative on the 1st January next year; The language iroblem presents difficulties with some immigrant groups in explaining hygiene requirements. It is not easy to "get across" to many what is required by the laws of this country and why, Interpreters, whilst normally helpful can sometimes get the words mixed up. During an inspection of an exceptionally clean hairdressing establishment, the Inspector, speaking through an interpreter sought to convey to the proprietor the need for sterilising his equipment. The proprietor turned on the Inspector because he thought that he was complaining about the dirty conditions of his business, Housing conditions and accommodation of immigrants often present difficulties. Overcrowding, lack of security of tenure and high rents are amongst the problems that create and encourage social problems, Many live in fear of eviction. In June, owing to torrential rain, a number of basements were flooded causing inconvenience and hardship to a number of families. Where possible, arrangements were made for floor coverings and carpets to be removed, dried and returned to the owners. In addition, disinfectant fluid was distributed where necessary. This service was much appreciated by the residents concerned. On three occasions during the year, two Inspectors carried out joint inspections during the night. The Inspectors performing this duty visit premises the subject of noise complaints, refreshment houses, clubs, food factories (on night shifts), coffee stalls and inspect vehicles used for the transport of meat. The presence of Inspectors during the night has a salutary effect upon food handlers, The Inspectors endeavour .to 36 secure compliance with the Pood Hygiene Regulatiens and other relevant legislation at all times. This duty is not an easy one but complaints regarding noise and other nuisances can be investigated and often brought to a successful conclusion. During the year approval was granted to certain Inspectors to attend training which enabled them to obtain the Diplomas of the Royal Society of Health in Meat Inspection and Smoke Inspection respectively. Two Inspectors were permitted to attend a Radiological Course at Slough College. The Council granted leave without pay to one Public Health Inspector to enable him to attend a full-time course at London University from October 1963 until June 1964, for the purpose of taking the Diploma in Content and Method of Health Education. 37 Summary of Work done by District Public Health Inspectors (i) Inspections Houses/flats inspected under Public Health (London) Act, 1936 6 , 38? Sepnrate lettings 13,062 Revisits Houses/flats 13,505 Separate lettings 28,2 13 (ii) Other inspections and visits Miscellaneous 4, 100 Prevention of Damage by Pests Act, 1949 133 Infectious Diseases 492 National Assistance Acts, 1948 and 1951 (Aged & Infirm) 120 Factories Act, 1961 - Outworkers 91 Pet Animals Act, 1951 41 Consumer Protection Act, 1961, and Regulations 15 Noise Nuisances 92 Food Premises 272 Housing Act, 1961 (Houses in Multiple occupation) 1,040 Non-effective visits 3,962 (Hi) Nuisances and Notices Notices served - Public Health (London) Act, 1936 (a) Intimation 4,218 (b) Statutory 2,159 Notices complied with - Public Health (London) Act, 1936 (a) Intimation 1,884 (b) Statutory 895 Nuisances found 6,383 Nuisances abated 7,468 Number of houses improved 3,45.2 Separate letting in above 3, 450 Total number of improvements to dwelling houses 6,985 (iv) Legal Proceedings Informations prepared 101 Abatement Orders made by Magistrate 39 Abatement Orders complied with 1 Further Proceedings for disobedience of Abatement Orders 8 (v) Drainage Plans examined 464 Examinations and Tests 260 (vi) Complaints Outstanding (at end of 1962) 209 Received during the year 5,075 plus 425 repeated complaints Dealt with during year 5,067 Outstanding (at end of 1963) 217 (vii) Land Charges Act, 1925 Enquiries received 3,898 Properties involved 4,776 Investigations 4,776 38 (viii) Rent Act, 1957 Applications for Certificates of Disrepair (1) Number of applications for certificates during 1963 7 Number of applications brought forward from 1962 Number of applications carried forward to 1964 1 Total number of applications receiving attention 1963 7 (2) Number of decisions not to issue certificates 2 Number of Undertakings on Form 'K' accepted 1 (3) Number of decisions to issue certificates 4 (a) in respect of some but not all defects 1 (b) in respect of all defects 3 (4) Number of Undertakings given by landlords under paragraph 5 of the First Schedule 1 (5) Number of Undertakings refused by Local Authority under proviso to paragraph 5 of the First Schedule - (6) Number of certificates issued where undertakings not accepted Applications for Cancellation of Certificates (7) Applications by landlords to Local Authority for cancellation of certificates 17 Number of applications brought forward from 1962 1 Number of applications carried forward to 1964 1 Total number of applications receiving attention 1963 18 (8) Objections by tenants to cancellation of certificates 5 (9) Decisions by Local Authority to cancel in spite of tenant's objection 3 (10) Certificates cancelled by Local Authority 16 Applications by Overseas Companies for Certificates of Repair Applications received Certificates issued (ix) Improvements effected as a result of Service of Notices under the Public Health (London) Act, 1936 1. Brickwork walis repaired or rebuilt 7 2. Drains cleared, repaired, etc 500 3. Dampness reniedied 366 4. Fireplaces and ranges repaired/renewed 72 5. Floors repaired 257 6. Flues repaired 28 7. Internal walls repaired 749 8. Ceilings repaired 631 9. Rainwater pipes/gutters repai red/renewed 279 10. Roofs repaired 56 4 11. Rooms cleansed 20 12. Sinks provided/renewed 55 13. Soil pipes repaired and renewed 72 14. Staircase or passages cleansed 5 15 Staircase repaired 125 16. Waste pipes repaired/renewed 238 17. Water Closet Apartments cleansed 5 18. Water Closet Pans and Traps renewed 128 19. Water Closets - flushing apparatus repaired or renewed 94 20. Water Closets - general repairs 381 21. Water supplies provided 18 22. Water service pipes repaired 252 23. Window sash cords renewed 618 24. Windows repaired or renewed 544 25. Miscellaneous improvements 977 Total 6,985 39 Public Health (London) Act, 1936 - Sections 40 and 109 London County Council (General Powers) Act, 1955, Sections 25, 26 and 27 Work required to be done for Drains, Sanitary Conveniences and Premises (a) Consequent upon Notices served by the Public Health Inspectors, the Council, in pursuance of their powers under the above Acts carried out works in default to a total cost of £2117 3s. 6d. This amount is apportioned as follows "nder the respective Acts and Sections:- £ s. d. Public Health (London) Act, 1936, Section 40 1375 16 9 Public Health (London) Act, 1936, Section 109 122 0 6 London County Council (General Powers) Act, 1955, Section 25 486 8 6 London County Council (General Powers) Act, 1955, Section 26 - London County Council (General Powers) Act, 1955, Section 27 132 17 9 ■ 12117 3 6 As mentioned in last year's annual report, the Council adopted a scheme which resulted in an improved public service whereby the cost of clearing stopped drains carried out by the Council was remitted if less than £2. This has prevented occupants of the affected properties from inconvenience and the nuisances have been abated with the minimum delay. The number of stopped drains reported .was 283 and the number cleared without charge was 138. Legal Proceedings Public Health (London) Act, 1936 Failure to comply with Statutory Notices contrary to Section 82 Date Address Magistrate's Decision (1) 1.1.63 299 City Road Fined £2.0.0. Defendant to pay £2.0.0. costs (2) 1.1.63 24 Bromfield Street Ordered abatement within 14 days. Fined £5.0.0. Defendant to pay £3.0.0. costs. (3) 1.1.63 7 Crossley Street Fined £2.0.0. Defendant to pay £2.0.0. costs (4) 1.1.63 42 Liverpool Road Ordered abatement within 14 days. Fined £5.0.0. Defendant to pay £2.10.0. costs. (5) 1.1.63 46 Barnsbury Street Ordered abatement within 28 days. Absolute discharge. Defendant to pay £2.0.0. costs. (6) 1.1.63 1 Bromfield Street Ordered abatement within 14 days. Fined £5.0.0. Defendant to pay £2.10.0. costs. (7) 5.2.63 41 Colebrook Row Ordered abatement within 7 days. Fined £2.0.0. Defendant to pay £2.0.0. costs. (8) 5.3.63 2 Bromfield Street Ordered abatement within 14 days. Fined £5j0.0. Defendant to pay £3.0.0. costs. (9) 5.3.63 19 Haverstock Street Ordered abatement within 28 days. Fined £5.0.0. Defendant to pay £3.0.0. costs. (10) 2.4.63 12 Dagmar House, Dagmar Terrace Ordered abatement within 14 days. Fined £2.0.0. Defendant to pay £2.0.0. costs. (11) 2.4.63 10 Bromfield Street Ordered abatement within 28 days. Fined £2.0.0. Defendant to pay £2.0.0. costs. (12) 2.4.63 38 Thane Villas Ordered abatement within 14 days. Fined £2.0.0. Defendant to pay £2.0.0. costs. 40 Date Address Magistrate's Decision (13) 2.4.63 5 Layton Road Ordered abatement within 14 days. Fined 13.0.0. Defendant to pay £2.0.0. costs. (14) 2.4.63 61 Cross Street Ordered abatement within 7 days. Fined £2.0.0. Defendant to pay £2.0.0. coats. (15) 2.4.63 16 Haverstock Street Ordered abatement within 28 days. Fined £2.0.0. Defendant to pay £2.0.0. costs. (16) 7.5.63 31 Yonge Park Ordered abatement within 14 days. Absolute discharge. Defendant to pay £2.0.0. costs. (17) 7.5.63 31 Haverstock Street Fined £2.0.0. Defendant to pay £2.0.0. costs. (18) 7.5.63 24 Haverstock Street Ordered abatement within 28 days. Fined £2.0.0. Defendant to pay £2.0.0. costs. (19) 7.5.63 32 Story Street Absolute discharge. Defendant to pay £2.0.0. costs. (20) 4.6.63 35 Ebume Road Ordered abatement within 28 days. Absolute discharge. Defendant to pay £2.0.0. costs. (21) 2.7.63 58 Barnsbury Street Ordered abatement within 14 days. Fined £3.0.0. Defendant to pay £2.0.0. costs; (22) 2.7.63 25 Parkfield Street Ordered abatement within 7 days. Fined £2.0.0. Defendant to pay £2.0.0. costs. (23) 2.7.63 56 Barnsbury Street Ordered abatement within 14 days. Fined £3.0.0. Defendant to pay £2.0.0. costs. (24) 2.7.63 21 Haverstock Street Ordered abatement within 28 days. Fined £3.0.0. Defendant to pay £2.0.0. costs. (25) 2.7.63 78 Thornhill Road Ordered abatement within 7 days. Fined £3.0.0. Defendant to pay £2.0.0. costs. (26) 2.7,63 14 Haverstock Street Ordered abatement within 28 days. Fined £3.0.0. Defendant to pay £2.0.0. costs. (27) 2.7.63 8 Haverstock Street Ordered abatement within 28 days. Fined £3.0.0. Defendant to pay £2.0.0. costs. (28) 2.7.63 32 Haverstock Street Ordered abatement within 28 days. Fined £3.0.0. Defendant to pay £2.0.0. costs. (29) 2.7.63 25 Crown Mansions Ordered abatement within 7 days. Fined £3.0.0. Defendant to pay £2.0.0. costs. (30) 2.7.63 85 Englefield Road Ordered abatement «athin 14 days. Absolute discharge. Defendant to pay £2.0.0. costs. (31) 15.8.63 162 Barnsbury Road Absolute discharge. Defendant to pay £2.0.0. costs. (32) 15.8.63 7 Haverstock Street Ordered abatement within 21 days. Absolute discharge. Defendant to pay £2.0.0. costs. (33) 15.8.63) 18 Bromfield Street Absolute discharge. Defendant to pay £2.0.0. costs. (34) 3.9.63 56 Colebrook Row Nuisance abated. Defendant to pay £2.0.0. costs. (35) 1.10.63 7 Athelatane Road Fined £2.0.0. Defendant to pay £2.0.0. costs. (36) 1.10.63 1 Bromfield Street Ordered abatement within 14 days. Absolute discharge. Defendant to pay £2.0.0. costs.' (37) 1.10.63 49 St. Peters Street Ordered abatement within 28 days. Absolute discharge. Defendant to pay £2.0.0. costs. (38) 1.10.63 25 Pooles Park Ordered abatement within 28 days. Absolute discharge. Defendant to pay £2.0.0. costs. (39) 1.10.63 31 Pooles Park Ordered abatement within 21 days. Fined £1.0.0. Defendant to pay £2.0.0. costs. (40) 1.10.63 21 Macdonald Road Ordered abatement within 14 days. Absolute discharge. Defendant to pay £2.0.0. costs. (41) 1.10.63 42 Liverpool Road Ordered abatement within 21 days. Jined £2.0.0. Defendant to pay £2.0.0. costs. (42) 1.10.63 75 Cornwallis Read Ordered abatement within 14 days. Information withdrawn. Defendant to pay £1.0.0. costs. (43) 3.12.63 48 Mildmay Road Premises vacant, summons withdrawn. (44) 17.12.63 65 Pyrland Road Ordered abatement within 21 days or. items 1 and 2. Fined £5.0.0. Defendant to pay £4.0.0. costs. Failure to comply with Magistrate's Abatement Order Date Address Magistrate's Decision (1) 26.3.63 1 Bromfield Street Absolute discharge. Defendant to pay £2.0.0. costs (2) 2.4.63 24 Bromfield Street Fined £2.0.0. Defendant to pay £2.0.0. costs. (3) 2.4.63 46 Barnsbury Street Fined £3.0.0. Defendant to pay £2.0.0. costs. (4) 2.7.63 19 Haverstock Street Fined £25.0.0. Defendant to pay £2.0.0. costs. (5) 2.7.63 61 Cross Street Fined £10.0.0, Defendant to pay £2.0.0. costs. (6) 3.9.63 24 Bromfield Street Case dismissed, (7) 1.10.63 35 Eburne Bead Fined £10,0,0. Defendant to pay £2,0.0, costs, (8) 3.12.63 7 Haverstock Street Fined £10.0,0 Defendant to pay £3,0.0. costs. (9) 3. 12.63 14 Haverstock Street Fined £20,0.0, Defendant to pay £3,0.0. costs. (10) 3.12.63 21 Haverstock Street Fined £20.0.0. Defendant to pay £3.0.0. costs. (11) 3.12.63 32 Haverstock Street Fined £10.0.0. Defendant to pay £4,0.0, costs. Disinfection and Disinfestation (a) General Number of roans disinfected after cases of infectious disease ... 246 Number of rooms treated for vermin ... 739 Number of rooms included in the above figure treated for vermin (free of charge) 114 (The majority of free cases were carried out on behalf of elderly or infirm persons or persons of limited means) The department also undertook the disinfection of wards in a number of hospitals upon request for co-operation in the control of hospital infection In addition the routine disinfection of pillows and woollen blankets from a hospital in the Borough continued for the purpose of reducing the likelihood of infection, particularly of staphylococcal infection, 1,803 bags containing blankets and pillows were disinfected in accordance with an agreed procedure 37 visits were paid by the Public Health Inspector to a factory to supervise the treatment of 4,110 bales of clothing and other material for export. The total weight of bales treated was 98 tons 12 cwts. In addition 10 oven loads were steam disinfected at the Treatment Centre for the Company concerned (b) Steam Disinfection 4,581 articles of clothing or bedding were steam disinfected (c) Fly and other Infestations Anti-Fly Treatment at Ashburton Grove Depot commenced on 22nd May and continued during the summer months, The evidence of infestation was slight. The Council's Housing Estates were treated for red clover mite, complaints having been received from eleven blocks of flats during the season Seven estates were treated; in the remaining four, natural abatement occurred. 41 42 Five wasp nests were destroyed and eight infestations of bees were dealt with. The nests of bees comprising t»o of "Bumble Bees'" and six of "Rogue Honey Bees" having no value to Bee Keepers were destroyed In last year's report was recorded details of a large infestation of Narcerdes Melanura (Wood Beetle) in a block of Council flats and adjoining property. Although it was dealt with at the time, a re»-infestation occurred during the present year. It is considered that these beetles are encouraged by the presence of a quantity of old wood probably left over from the previous buildings on the site and which was deposited underneath the garden soil. (d) Static water tanks - Air-raid shelters - Bomb damaged sites, etc. The nuisance arising from the tipping of refuse on vacant sites is decreasing due to re development. The deposit of refuse and the accumulation of water in static water tanks still present a problem. Although the Cleansing Superintendent, upon application from the Public Health Inspectors, arranges for the removal of the refuse by his department, and the stagnant water is pumped out by the London Fire Brigade, it is not long before further complaints are received due to refuse again being deposited and the partial filling of tht tanks with rainwater. Notices are displayed where possible drawing the attention of the public to the fact that the depositing of refuse on war damaged sites is an offence. Visits paid to bomb damaged sites 206 Visits to air-raid shelters and static water tanks 70 Inspections of derelict buildings 129 The placing of abandoned vehicles on vacant sites in the Borough is increasing and the co-operatiai of the Cleansing Superintendent is sought by the Public Health Inspectors for their removal. Complaints are frequently received in respect of derelict buildings. Such buildings being dangerous can become a health hazard by the deposit of all kinds of refuse, there is often difficulty in tracing owners and, in certain cases, the Council has to remove the refuse itself. Caravan sites and control of Development Act, 1960 Caravans Applications for approval to site caravans in the Borough were given in certain cases. In one case, caravans appeared on vacant land but these were quickly removed following a visit paid by an Inspector. Atmospheric Pollution Clean Air Act, 1956 During the year the following legislation and circulars were issued by the Minister of Housing and Local Government:- 1. : Circular No. 7/631 relating to:- (i) Gas cokes as open fire fuels; 43 (ii) Delivery of coal in smoke control areas (iii) Advice on oil-burning appliances 2, Memorandum on chimney heights and Circular 25/63 relating thereto, 3, The Smoke Control Areas (Authorised Fuels) Regulations, 1963 by virtue of which fluidised char binderless briquettes manufactured by the National Coal Board were declared to be authorised fuel for the purposes of the Clean Air Act, 1956, This fuel is retailed under the name of "Homefire", Circular 54/63 was also issued by the Ministry and related to the issue of the above order, 4, Circular 69/63 was issued by the Ministry and referred to the publication by the Minister of Power of a White Paper entitled "Domestic Fuel Supplies and the Clean Air Policy", The Government's intention to encourage and take vigorous action against urban smoke pollution remains Due, however, to the technological changes in the gas industry there will be little further increase in the future production of gas coke and some re-shaping of current arrangements has become necessary, It is anticipated that there will be sufficient coke manufactured to meet the requirements of existing smdce control areas but the production of gas coke is already beginning to decline It follows, therefore, that open grate gas coke can no longer be regarded as the main replacement for raw coal in future smoke controlled areas The Minister recognises that the initial effect of the changed fuel position may be to make it more difficult for Local Authorities to establish further smoke control areas From now on a greater change in householders' heating arrangements will often be necessary, and greater efforts may well have to be made to persuade householders of the need for the change Householders will still have a wide choice of appliances and fuels: for most people the cost of fuel need be little, if at all greater: and more money will often be payable to the householder by way of grant and heating standards will be improved It is considered that there will continue to be a sufficient supply of hard coke, In view of this, the Minister considers that the installations of openable stoves, under-floor draught open fires or fixed gas, electric storage or oil heaters should now be regarded as "reasonably necessary" works and that the full expenditure on such installations subject to certain conditions - should rank for grant. During the year-four Smoke Control Orders came into operation and two were confirmed by the Minister which will not become operative until next year. The size of the areas being surveyed are now approximately 100 acres compared with the original area of approximately 25/50 acres The increase in size results in a comparable increase in the amount of work involved The number of premises surveyed and the number of adaptations carried out with all the relevant approval of the claims submitted and checking to ensure that the work has been done satisfactorily, has caused considerable increase in work both in regard to the Inspectors as well as the clerical staff. The difficulty of the availability of smokeless fuel is continually being met with, The sale of pre-packed smokeless fuel by retailers such as greengrocers, ironmongers and hardware stores etc, is increasing, This method is not economical as far as the purchaser is concerned, the comparative cost being often increased by more than 50%, This is regarded as unsatisfactory to Old Age Pensioners who often purchase their fuel in this manner and can ill afford the extra cost. 44 SMOKE CONTROL AREAS Revised phased programme North Islington Canonbuiy Kings Cross 1959/60 No. 1 Operative Date 1st Sept 1960 No. 1 Operative Date 1st Sept. 1960 No. 1 Operative Date 1st Dec. 1963 1960/61 No. 2 II M 1st Jan. 1962 No. 2 M 1st Jan. 1962 1961/62 No. 3 II II 1st Sept. 1962 No. 3 II 1st Sept. 1962 No, 4 II II 1st Dec. 1962 1962/63 No. 5 II II 1st June 1963 No. 4 M II 1st Dec. 1962 No. 6 II II 1st Dec. 1963 No. 5 M 1st June 1963 1963/64 No. 7 II II 1st Dec. 1964 No. 6 II 1st Dec. 1964 1964/65 No. 8 No. 7 No. 9 No. 8 1965/66 No. 10 No. 9 No. 10 45 With the increase in the number of immigrants extreme difficulty is often experienced to ensure that the requirements of the Clean Air Act are fully understood by owners and occupiers. Nuisances from smoke are often caused by demolition contractors who burn timber and other waste on the site All cases brought to the notice of the Inspectors have been effectively dealt with. Complaints were received of smoke emission from two hospitals in the Borough and observations were continuing at the end of the year. With regard to one, the Hospital Authorities who are themselves anxious to do everything possible to abate the nuisance, called in the National Industrial Fuel Efficiency Service whose representatives met the Inspector on the site and submitted recommendations to the Hospital Board which are receiving attention. It is appreciated that the boiler cannot be closed down because it would mean shutting the hospital and as it provides a greater part of the hospital services for the Boroughs of Islington, St, Pancras and Hornsey this is clearly impossible. Number of applications received for prior approval by local authority as to plans and specifications for new furnaces (Section 3(2)) 10 Number of applications for prior approval granted re above 10 Inspections 1, 835 Re-visits 1,982 Complaints received 59 Smoke observations 227 Contraventions found 69 Adaptations completed (domestic) 674 Notices served 104 Notices complied with 85 Prosecutions 1 The following is a summary of work undertaken by Technical Assistants under the Clean Air Act, 1956. Inspections 3,537 Re-visits and other calls 2,272 Non-effective visits 2,075 Miscellaneous visits 167 Legal Proceedings Clean Air Act, 1956 Date Address: Offence Magistrate's Decision (1) 5.3.63 John Petronzio (Clock Cases)Ltd, Paramount Works, Tyndale Place, Upper Street Smoke emitted from a chimney contrary to Section 11(2) and thus liable to penalty under Secti <n 27(2) Fined £5.0.0, Defendant to pay £3.0.0, costs, 46 Recording of Atmospheric Pollution The recording of atmosphericppllution is carried out at two stations within the Borough viz, at the Town Hall and at the Treatment Centre, Seven Sisters Road The concentrations of sulphur dioxide and smoke in the atmosphere are recorded daily and the findings are sent to the Warren Springs Laboratory for collation and comparison with other Metropolitan areas in order that an overall picture may be obtained for the whole of London, An automatic sequential smoke sampler has been installed at the Town Hall by means of which smoke recordings can be taken for one, three or twenty-four hours respectively. This instrument is used in conjunction with D, S.LR and by its use the periods during which smdte is at its greatest during the day or night can be ascertained. A. summary of the recordings from the Borough Cbuncil sites is set out in the following tables:- Monthly Deposits recorded by the Deposit Gauges and Sulphur-Dioxide by the Lead-Peroxide Method Month Si te No. 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 Deposit Total Solids January 1 1.58 6.19 8.58 14.77 3.11 ” 2 1.46 10.54 7.99 18.53 5.16 February 1 0.59 10.30 9.01 19.31 2.97 ” 2 0. 32 15.84 6.44 22.28 4.55 March 1 2.66 31.39 9,31 40.70 2.03 ” 2 1.50 15.50 3.89 19.39 4.07 April 1 2.12 15.14 9.60 24.74 1. 36 ” 2 1.79 22.08 9.43 31.51 2.72 May 1 1.85 12.45 7.49 19.94 0.55 ” 2 1.81 8.32 3.96 12.28 1.82 June 1 2.40 14.21 4.67 18.88 0.48 ” 2 2.21 12.48 3.99 16.47 0.93 July 1 1.22 9.18 6.62 15.80 0.60 ” 2 0.95 7.35 3.15 10.50 1.22 August 1 3.90 8,31 13.84 22.15 0.60 ” 2 3.07 11.01 7.32 18.33 1.13 September 1 1.69 7.85 7.88 15.73 0.72 ” 2 1.42 5.70 6.68 12. 38 1.68 October 1 1.54 9.94 3.77 13.71 1. 42 ” 2 1.42 12.08 6.18 18.26 2.42 November 1 4,57 8.61 3.97 12.58 1.86 ” 2 4. 22 11.78 10.74 22.52 4.0 December 1 0.71 7.12 2.55 9.67 2.06 ” 2 0.63 9,8? 3.76 13.63 4.36 These sites are situated at the following places in the Borough;- 1, Town Hall roof 2. Treatment Centre, at seven Sisters Road Concentration of Smoke and Sulphur Dioxide recorded by the Volumetric Method at the two stations in the Borough Station Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Smoke (micrograms per cubic metre) Public Health Office Town Hall Monthly average 323,51 281,60 152.45 115.36 58.09 34.34 38.77 40.83 90.53 76.67 167.36 196.19 Highest recording 1112 493 325 226 195 72 88 100 276 192 512 380 Shelter House Treatment Centre Monthly average 346.61 284.96 169.32 129.9 73.32 44.53 36.38 38.77 72.23 106.06 169.96 252.19 Highest recording 1128 522 405 267 199 132 88 92 132 172 524 492 SULPHUR DIOXIDE (Micrograms per cubic metre) Public Health Office Town Hall Monthly average 460.41 439.07 289.61 217.70 131.74 96.26 116.61 107.54 146.03 223. 58 292.23 388. 16 Highest recording 2187 936 686 472 262 415 407 227 446 511 682 646 Shelter House Treatment Centre Monthly average 434.09 285.78 205.8 139.76 86.12 70.26 79.77 61.48 100.43 226.74 278.63 364. 90 Highest recording 1747 640 542 260 171 207 326 113 365 367 597 585 48 Work of Public Health Inspectors Administering Factories Act, 1961, and other legislation Factories Act, 1961 Number of inspections 1,065 Number of re-visits 544 Notices served 100 Prosecutions instituted Defects found 405 Defects remedied 381 _Defects referred to H.M . Inspectors 14 Defects referred by H.M. Inspectors 4 Complaints received 9 Notices complied with 66 Public Health (London) Act, 1936 Factories visited 17 6 Contraventions found 79 Contraventions remedied 62 Notices served 37 Notices complied with 30 PART I OF THE ACT Prescribed Particulars on the Administration of the Factories Act, 1961 1. Inspections for the purposes of provisions as to health (including inspections made by Public Health Inspectors. Number of Premises Number on Register Inspections Written Notices Occupiers prosecuted (l) (2) (3) (4) (5) (i) Factories in which Sections 1,2, 3, 4 and 6 are to be enforced by Local Authorities 213 125 6 - (ii) Factories not included in (i) in which Section 7 is enforced by the L^cal Authority 1768 883 82 - (iii) Other Premises in which Section 7 is enforced by the Local Authority* (excluding outworkers premises) 42 57 12 - TOTAL 2023 1065 100 - * i.e. Electrical Stations (Section 123(1)), Institutions (Section 124 sites of Building Operations and Works of Engineering Construction (Section 127), Slaughterhouses, (Section 175( 1)(d) and (e)) and Railway Running Sheds (Section 175(2) and (10)). 49 2. Cases in which Defects were Pound 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 (1) (2) (3) (4) (5) (6) Want of cleanliness (S. 1) 2 2 3 - - Overcrowding (S. 2) - - 1 - - Unreasonable temperature (S. 3) - - 1 - - Inadequate ventilation (S. 4) 1 - 4 - - Ineffective drainage of floors (S. 6) . . - - - Sanitary Convenience (S.7) (a) Insufficient 5 1 1 . (b) Unsuitable or defective 393 378 3 3 - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to Outwork) 4 1 1 - - TOTAL 405 381 14 4 - PART VIII OF THE ACT Outwork (Sections 133 and 134) SECTION 133 SECTTCN 134 No. of outworkers in August list required by Sec. No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply li sts No. of instances of work in unwholesome premises Notices served Prosecutions (1) (2) (3) (4) (5) (6) (7) Wearing ) Making apparel ) etc., Cleaning and Washing 459 - - - - - Household linen 2 - - - - - Lace, lace curtains and nets - - - - - - Curtains and furniture - - - - - hangings 4 + - - - - Furniture and upholstery 4 - - - - - Electro-plate -- - - - - - File making - - - - - - Brass and brass articles 10 - - - - - cont/... 50 SECTION 133 SECTION 134 No. of out workers in August list required by Sec. 133(1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions Fur pulling - - - - - - Iron and steel cables and - - - - - - chains - - - - - - Iron and Steel anchors and - - - - - - grapnels - - - - - - Cart gear - - - - - - Locks, latches and keys - - - - - - Umbrellas, etc. 5 - - - - - Artificial flowers 37 - - - - - Nets, other than wire nets - - - - - - Tents - - - - - - Sacks - - - - - - Racquet and tennis balls - - - - - - Paper bags - - - - - - The making of boxes or other receptacles or parts thereof made wholly or partially of paper 93 - - - - - Brush making 9 - - - - - Pea picking - - - - - - Feather sorting - - - - - - Carding, etc., of buttons etc. 5 - - - - - Stuffed toys 11 - - - - - Basket making - - - - - - Qiocolates and sweetmeats - - - - - - Cosaques, Christmas stockings, etc. 50 - - - - - Textile weaving 1 - - - - - Lampshades 6 - - - - - TOTAL 696 - - - - - 51 Factories Act, 1961, Section 70 Basement Bakehouses Certificates of suitability, as required by Section 70 of the Factories Act, 1961, continued to be in force in respect of eight basement bakehouses at the following addresses;- 76 Caledonian Road 7 Junction Road 54 Archway Road 59 Junction Road 146 Blackstock Road 77 Newington Green Road 3 Cardwell Terrace 123 Newington Green Road In accordance with the requirements of Section 70, the quinquennial inspection of basement bakehouses commenced during the year, In the case of one basement bakehouse, a prosecution was taken under the Food Hygiene (General) Regulations, 1960, and is reported on page 73 , The Proprietor was fined £75, and ordered to pay £6 costs. Public Health (London) Act 1936 London County Council (General Powers) Act, 1937 Noise Abatement Act, 1960 - Noise Nuisance Complaints were received during the year of noise arising from the use of power machines in domestic premises, from wireless, amplifiers, juke boxes and noisy parties. ; Complaints were also received arising out of motor repairs being carried out on the highwayc With the co-operation of the Police, this was discontinued, A compressor used in connect! en with main sewerage work caused annoyance to residents in the vicinity, Arrangements were made to enclose the compressor within a wooden structure thus reducing the noise level - no further complaints were received from this source As mentioned in the foreword to this report, two Inspectors were engaged on three occasions during the year on night duty, During the period of duty, investigations were made into noise complaints arising from the use of machinery, licensed clubs, refreshment houses and other sources, The fact that the.Inspectors are on duty after normal working hours enables many complaints to be finalised., A number of complaints were received by the Department arising out of the parking of heavy vehicles in certain parts of the Borough Hie "rewing-up' of engines in the early hours of the moming is a source of annoyance to the neighbourhood In certain cases, observations were kept during the week-end, Work on the new '"Victoria Underground"' line has commenced and some complaints have already been received of noise nuisance due to the working of machinery and other causes, these being taken up with the appropriate Authority. One factory caused a nuisance to the residents of a block of flats from the use of a "Cyclone1" exhaust system. This has been dealt with satisfactorily, the factory manager being most co-operative and no further complaints have been received 52 The majority of complaints are satisfactorily disposed of voluntarily, an interview by the Inspector being sufficient to secure an abatement of the nuisance, Number of complaints received 134 Number of inspections 30fi Number of confirmed cases abated 197 Public Health (London) Act, 1936 (Part IV) Offensive Trades Complaints were received of a smell nuisance from one gut scraping premises, After a number of visits the nuisance was abated and has not recurred. Upon investigation of another complaint of smell nuisance, the Public Health Inspector found that the basement of a butcher's shop was being used for the purpose of fat melting. The average quantity of fat rendered per week was about 13 - 14 cwt. The nuisance of smell was confirmed and the attention of the Manager was drawn to the fact that the business of a fat melter is governed by the requirements of the Public Health (London) Act, 1936, which prohibits the establishment of such a business without the approval of the Local Authority. A communication was also forwarded to the Company concerned who immediately took action and ceased production. Details of the respective offensive trades in the Borough are as follows:- (a) Tripe Boiler 26/40 Vale Royal, Messrs J L Henson Ltd (b) Knacker 18/20, Vale Royal - Messrs, Harrison Barber & Co Ltd. (c) Fur Skin Dresser 24 Bracey Street - Messrs, J. & A, Fischer Ltd, (d) Gut Scraperp: 13, Old Slaughterhouses - Messrs Armour & Co, Ltd. 15, Old Slaughterhouses - Messrs, Wm Menzies Ltd, Tileyard Road - Messrs Tracey & Co, Ltd. (e) Fat Melters 16 Old Slaughterhouses - Messrs, Wm Menzies Ltd 26/40 Vale Royal - Messrs. J.L, Henson Ltd, (f) Slaughterer: 180, York Way - Messrs, Harrison Barber & Co, Ltd, This slaughterhouse was the subject of 384 visits for the inspection of meat, (g) The Council approved the issue of a licence under Section 145 in respect of the receiving of carcasses of dead horses for human consumption at 14/16, Vale Royal - Messrs, Harrison Barber & Co. Ltd Upon the closure of the Metropolitan Cattle Market, it is anticipated that the ancilliary trades within the market area will ultimately cease to exist, 53 The number of inspections, etc, of offensive trades premises were:- Inspections Re-visits Total Tripe Boilers 7 20 27 Knacker 3 22 25 Fur Skin Dresser 4 3 7 Gut Scrapers 10 53 63 Fat Melter 2 21 23 Licensed Slaughterhouse 6 23 29 Diseases of Animals Act, 1935-1950 Anthrax Order 1938 No action was required to be taken under this legislation during the year, Pharmacy and Poisons Act, 1933 During the year the Poisons List Order 1963 and the Poisons Rules 1963 were made by the Home Secretary UieOrders added inter alia certain substances to the Poisons list' and Rules Number of listed sellers of Part 2 Poisons other than Pharmacists 145 Number of initial registrations during the year 13 Number of visits and inspections 44 Number of samples taken 17 Number of samples satisfactory 17 Rag Flock and other Filling Materials Act 1951 Number of premises on register (Section 2, for Upholstery) 51 Number of Licences issued (under Section 7 for the Storage of Rag Flock) . Nil Number of inspections and visits 33 Number of samples taken 3 Number of samples satisfactory 3 Consumer Protection Act 1961 Oil Heater Regulations 1962 Dua to economy in the price of fuel, a considerable number of people use oil for heating and cooking purposes This is particularly evident in the case of immigrants The danger associated with the use of oil heaters has been stressed from time to time Number of complaints received 6 Number of inspections 15 Number of appliances tested 27 54 London County Council (General Powers) Act, 1954 Hairdressers and Barbers Number of Gentlemen's Hairdressers 91 Number of Ladies' Hairdressers 107 Number of Ladies' and Gentlemen's Hairdressers 16 Number of premises where hairdressing ceased 3 Number of Establishments situated in basements 4 Number of Establishments situated in dwelling houses 3 Number of Establishments where no assistants are employed 65 Number of Inspections and visits 253 Shops Act, 1950 Number of applications received for Certificates of Exemption Nil Number of Exemption Certificates issued Nil Number of inspections and visits 1,580 Prevention of Damage by Pests Act, 1949 An increase in the number of complaints received is recorded including a large increase in initial mice complaints. There were no recorded ship rat infestations and in this connection, reference is made to Technical Circular No.6 issued by the Minister of Agriculture, Fisheries and Fbod, in which the loss of ground by the ship rat in the United Kingdom during the period 1956 - 1961 is outlined. The Ministry points out that it is clear that, as predicted, the status of the ship rat in Britain has further diminished and the species is on the way to losing its permanent foothold in the United Kingdom. Forty-five investigations were traced to defective drains and eleven were caused by disused or unsealed drains. One was traced to a defective sewer vent. The situation regarding municipal housing estates continues to improve but two in particular required the attention of the Rodent Section for some time. In the first case, after extensive investigations, 4 disused drains were found to be the cause. In addition, it appeared that inadequate precautions had been taken when laying the drains to prevent rats entering by the rodding eye. Upon these receiving attention, no further infestation has been reported. The second case related to an estate in respect of which complaints had been received. Before this case could be successfully finished, 24 dwellings, two churches and 4 vacant sites had to be inspected. A case which was the subject of press publicity was investigated and 4 disused unsealed water closet pans were found to have allowed entry of rat into empty premises. Upon sealing these traps, the rat nuisance immediately ceased. Two meetings of the No.1 Workable Area Committee were attended by the Chief Public Health Inspector as Chairman and the Rodent Officer. The second took place at the Infestation Control Laboratories of the Ministry at .Tolworth, when members were conducted over the various sections and the work carried on explained. Thanks are due to the Director and his staff for a most interesting and informative visit. 55 In Technical Circular No. 8 of the Minister of Agriculture, Fisheries and Pood, investigation into sewer rat harbourage and building works was considered. It is in the building and re-construction of drains and sewers and during demolition that most sewer rat harbourage is created. This may be prevented by strict supervision of such work to ensure that a suitable standard is reached. In particular, disused house drains should be filled with concrete right up to the sewer or, better still, they should be grubbed-up and the sewer connection sealed. It is of increasing importance to-day when progress is being made in clearing sewers of rats, not merely to avoid creating new harbourage but to prevent rats from entering sewers. The Animals (Cruel Poisons) Regulations, 1963 which came into force in October prohibits inter alia the destruction of rodents by the use of phosphorus, red squill and strychnine. (a) The following is a summary of the work carried out during the year.. Type of Property Local Au tho ri ty Premises Dwelling Houses Business Premises Total 1. Complaints received (including repeats) 26 1016 156 1198 2. Number of properties inspected as a result of (a) Notification 25 843 137 1005 (initial complaint only) (b) Block survey 20 575 77 672 3. Number of properties found to be infested by rats (including Nil ship rats) 17 469 51 537 4. Number of properties found to be infested by mice 7 528 65 600 5. Re-visits by Investigators 71 3414 47 3532 6. Non-effective visits by Investigators 7 806 45 858 7. Number of infested properties treated (new jobs commenced) 38 958 103 1099 8. Continuation or post-bait treatment 128 3338 47 3 3939 9. Visits by Operators 213 10731 662 11606 10. Still being baited at end of 2 67 9 78 11. Completed during the 45 1261 122 1428 12. Number of Business Agreements dealt with 61 13. Members of the Rodent Staff assisted in the operation of the smoke machine in respect of 144 drainage tests carried out Dy Sanitary Inspectors. NOTE: For the purpose of completing Sections 2,3,4 & 7, each property is entered once only in respect of inspections, infestations and treatments. 56 (b) Sewer Treatments Fbur sewer treatments were carried out with the use of flouroacetamide 1081 including a test bait prior to the first treatment; details are as follows:- Number of Manholes in Borough Prebait laid 4th & 11th March 1910. Manholes Manholes showing Baited Not Baited Complete Takes Prebait Taken No Takes 839 769 70 349 646 123 Direct Poison, Flouroacetamide laid 7th & 14th March 1963 10th June 19«i.i ; 30th Sept. 1963 9th Dec, 63 Manholes Baited Not Baited Baited Not Baited Baited Not Baited Baited Not Baited 648 191 796 58 799 56 783 73 The co-operation of the Borough Engineer and his staff is appreciated. Water Supplies The Metropolitan Water Board continues to be the responsible Authority for the supply of water to Islington, The supply is satisfactory both in regard to quality and quantity Two samples were taken from the mains supply for bacteriological examination and one for chemical analysis, and were found to be satisfactory. In regard to one block of privately owned dwellings, a report was received of a contamination of the drinking water due to a disinfectant or similar liquid being poured into the storage tank In conjunction with the Metropolitan Water Board, immediate steps were taken to cleanse the cistern and connected service pipes, The person who did the act was subsequently traced and dealt with by the Police There are 47,310 dwellings in the Borough supplied directly from water mains which serve a population of 228833, Public Health (London) Act, 1936 - Section 95 1 45 Applications were received for Water Certificates and 45 Certificates were issued in respect of 359 dwellings 2 64 Notices were served under this Section requiring the provision of water supplies to tenement houses Eighteen water supplies were provided and 109 were improved during the year 57 (a) Well Water. Of the 28 bore holes or wells known to exist in the Borough 19 continue to be unused being effectively sealed. Six of the remaining wells are out of use. Three samples were taken for bacteriological examination and three for chemical analysis respectively, the results indicating that the water could not be considered free from pollution in one case. As the water from these sources is used solely for industrial purposes, no objection was raised to its use. (b) Water Supplies - Miscellaneous One sample of sub-soil water was taken for chemical analysis The result indicated gross sewage contamination. (c) Swimming Bath Water 82 samples were taken for bacteriological examination and all but three were reported as being satisfactory 14 samples were taken for chemical analysis and a satisfactory report was received in each case By courtesy of the Chief Superintendent and Engineer of Baths and Wash-Houses, the following information is included in this year's Report. 'There are eight swimming pools at present under the control of the Council and included is the newly reconstructed and modernised Hornsey Road Baths establishment, which will re-open early next year. This pool has been built to national standards,and is one of the finest pools in the country with up-to-date amenities. A modern boiler house has also been installed with electronically controlled equipment and machinery to ensure that the building and water will be maintained at the required'temperature. The Metropolitan Water Board supply the water for this bath The method of treatment for purification is by chemical dosage: alumina ferric is the coagulant used to fulfil the function of forming a film on sand Soda ash is the alkaline salt to counteract acidity A pH value of between 7.4 and 7.6 has proved most satisfactory to the swimmers using these baths Aeration is maintained by means of an air compressor. Sterilisation: Chlorine gas is used a residual of 0,5 to 0,75 p.p m being strictly adhered to. In the summer months when heavy loads are to be expected, it is kept at 0.75 p.p.m. The frequency of changing the bath's water is governed by the flow through the filters which in the case of these establishments is approximately once every four hours In the summer months when the baths are open for 12 to 14 hours daily, a complete turnover of three times per day is necessary." Eight samples of the water at Highbury Fields Open Air Swimming Pool, which is controlled by the London County Council, were taken during the summer season for bacteriological examination. :The results, included in the figures given at the head 58 of this section, were satisfactory and the London County Council were informed accordingly. Three samples of the water were taken for chemical analysis. These are included in the total above, were satisfactory and the London County Council were informed. Two samples of water (included in the figures given above) were taken from the Paddling Pool in Highbury Fields, for bacteriological examination. This pool is also controlled by the London County Council who were informed of the results in both cases. Common Lodging Houses There are no licensed Common Lodging Houses in the Borough. 59 SECTION D HOUSING vln conjunction with Mr. W C. Bartlett, Chief Public Health Inspector; Housing Act 1957 - P'rt III The Minister of Housing and Local Government confirmed an order in relation to the following area - Nos, 3, 4 5, 6 7, 8, 9. 10 and 11 Lonsdale Place. (9 houses) The undermentioned areas were represented to the Council Haverstock Street. Nos, 5. 6, 7, 8, 9, 13, 14, 15, 16. 17 18, 19 20, 21, 24, 25; 26, 27 , 28. 29, 30 31 and 32. Remington Street. Nos 1, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 18, 19, 20 22 , 26 27, 28 29 and 31. Coombs Street Nos. 5, 6. 7 8, 9 13 14 15 16 and 17 City Garden Row Nos 11 and 13 A total of 58 houses Hie Council however deferred action on this representation pending examination of an offer to repair properties in the Area to the standard of the Housing Act, 1957, and the Housing Act, 196i, where applicable Miranda Road. Nos. 1, 3, 5 and 7 - a total of 4 houses. This representation was withdrawn upon the Council being informed that the London County Council were negotiating to purchase these properties with a view to demolition in connection with a comprehensive redevelopment of the immediate area. Close liaison has been maintained with the London County Council in res sect of areas represented by that Authority under Part III of the Housing Act, 1957, and supporting evidence given at public inquiries Housing Act 1961 During the year, the survey of houses in multiple occupation continued, These inspections again confirmed that the old type of 3 or 4 storey properties are frequently changing hands and subsequently being let in multiple occupation to persons of differing nationalities, habits and customs Hie sharing of sanitary conveniences and facilities for the preparation and cooking of food and for the disposal of waste water, creates a social problem. Blocks of flats falling mithin the definition of Section 21 and comprising a total 413 flats, were surveyed Proposals with regard to improvement works prepared by the Public Health Inspectors, vere considered by the Public Health Committee and the owners requested to give consideration to carry out these proposals 60 Only seven formal notices were served during the year under Section 15 due to / difficulties anticipated by the Council in recovering the cost of works which might have to be carried out in default. At the end of the year 1 of these notices had been complied with. 325 informal notices were served upon the persons in control of individual premises together with extracts from the Landlord and Tenant Act 1962, and a summary compiled by the Public Health Inspector concerned showing the additional facilities and amenities required in each property having regard to the state of occupation. During the year the following improvements were carried out informally in 38 properties involving 157 lettings. Natural and Artificial Lighting: Natural 10 Artificial 10 Ventilation: 12 Water Supply: 27 Personal Washing Facilities Hot Water over Sink or Lavatory Basin 85 Baths 24 Showers 1 Drainage and Sanitary Conveniences: Water Closets 7 Facilities for:- Storage of Pood 34 Preparation and Cboking of Pood 9 Disposal of Waste Water (Sink) 17 Space Heating: 40 As many of the tenants of houses in multiple occupation are at work during the day time, Inspectors of necessity have had to visit during evening hours. It is quite evident that control of this type of property demands such visits outside normal hours of duty, Public Health (London) Act, 1936 Closing orders were made under this Act a considerable time ago in respect of two houses in the Borough. One property was demolished and in the second case upon application by the Owner to the North London Magistrate the Order was determined this year, evidence being given by the Inspector that the house was now fit for habitation Miscellaneous During the year 24 Closing Orders made in respect of whole houses and 31 Closing Orders made in respect of parts of buildings were determined upon the owners carrying out works to render the premises fit for human habitation. In many cases, these properties were brought up to a higher standard than the requirements of Section 4 of the Housing Act, 1957, and baths and separate water closet accommodation provided. 61 It is not generally realised that the making fit of a house subject to a Closing Order or Undertaking entails many interviews, discussions and consultations with owners, architects and builders as to the Council s requirements Arising from these discussions, the guidance and advice of Inspectors is sought in many other instances where the work envisaged is of a voluntary nature. In connection with the Council'' s House Purchase Scheme, where the house concerned is let in multiple occupation, the Council requires the applicant to bring the property up to the Council" s standard Code of Practice formulated under Section 15 of the Housing Act, 1961 The property in question is visited by an Inspector to ascertain which service or amenities are lacking. Whilst the necessary works are being carried out the Inspector is required to visit on many occasions to ensure that the Cbuncil s requirements are satisfied, During the year several properties were dealt with under Section 9 of the Housing Act, 1957, and in this connection the Housing Inspectors prepare specifications of works required and also supervise the work whilst in progress It is apparent from the experience gained in the repair of these properties that any large scale programme under Section 9, would in many instances require the provision of temporary accommodation for some of the tenants living in the affected houses Here again, attention is drawn to the increasing number of owners, architects and surveyors who have approached the Department for advice on the Cbuncil's requirements, not only where Closing Orders are in force as previously mentioned, but also on a voluntary basis where conversion work is to proceed Many of these consultations on site whilst adding to the work of the Housing Inspectors, nevertheless serve an extremely useful purpose in securing a uigher class of repair and improvement than might otherwise have been obtained. During the year conversion work in connection with a block of tenement flats was in progress and special attention had to be paid to the construction of trunking in order to secure effective ventilation before a certificate under Section 5 (1), Housing Act, 1957 could be granted in respect of the back to back type of flats This work was oompieted and was the last of ten blocks on the estate to be converted with each flat enjoying its own separate amenities Prom time to time subsequent reinspections of some of the flats in the above blocks have been carried out and the adaptations have considerably improved living conditions Several discussions took place with the Architects concerned with the proposed redevelopment of another estate Effective through ventilation was required in several back to back flats The number of houses and flats erected in the Borough during the year was Borough Council 97 43 Repair/Conversion London County Council 321 Private Enterprise (Inc 24 - City of London Corporation) 134 Flats ♦ 13 houses The number of municipal flats and houses erected since the war is Borough Council 4,062 + 43 Repair/Conversion London County Council 3,281 + 29 rebuilds from war damage The total number of dwellings (i=e flats and houses separately assessed) in the Borough at the end of the year was 47.310 62 HOUSING ACT, 1957 During the year the following actions were taken: Section 5 (Prohibition of back to back houses) No. of certificates issued 2 Section 9 (Repair of insanitary houses) Inspections 11 Visits 57 Notices served 5 Section 16 (Individual unfit houses) Inspections, Visits and Re-visits 1,259 Houses represented 14 Undertakings accepted 1 Undertakings cancelled upon completion of work 1 Section 17 (Individual unfit houses) Closing Orders made 7 Demolition Orders made 1 Houses demolished 78 Section 18 (Parts of buildings including basement rooms) Inspection, Visits and Revisits (a) Basement Rooms 1,713 (b) Other parts of buildings 96 Representations made (a) Basement Rooms 16 (b) Other parts of buildings 10 Closing Orders (a) Basement rooms 14 (b) Other parts of buildings 11 Undertakings accepted (Basement Rooms) 1 Undertakings cancelled or part cancelled upon completion of work (basement rooms 3-other parts 2) 5 Section 24 (Individual Unfit houses) Demolition Orders revoked 3 Section 27 Closing Orders determined or part-determined upon completion of work in respect of - (a) Whole houses 24 (b) Basement rooms 28 (c) Other parts of buildings 3 Section 90 (Houses let in lodgings - overcrowding) Inspections and Revisits 48 Reports to Committee 2 Overcrowding abated Section 42 (Clearance Areas) Inspections 95 Re-visits 315 Housing Consolidated Amencknent Regulations, 1932 (House to House Inspecticns) Number of inspections 43 83 Housing (Financial Provisions) Act, 1958 Improvement Grants Inspections, Re-visits 158 House Purchase (By Individuals) Inspections and re-visits 163 Town and Country Planning (Housing Accommodation) Direction 1952 In accordance with this direction the Council is consulted by the London Cbunty Council before consideration is given to applications received for a change of user from a dwelling to another purpose. In this connection investigations were carried out by this Department. Licences Authorising Temporary Overcrowding No licences were issued during the year. Repair Conversion Visits 6 Council Purchase Visits 40 Housing Act, 1961 - Sections 12/21 Number of Inspections of individual houses 446 Number of Inspections of flats 413 Number of Managements Orders made 8 Number of Management Orders revoked Number of informal notices (Section 15) served 325 Number of formal notices (Section 15) served 7 Number of formal notices (Section 15) complied with 1 Number of Direction Orders (Section 19) made 2 Housing Act, 1961 Failure to comply with the Housing (Management of houses in Multiple Occupation) Regulations, 1962 Date Address Magistrate's Decision (1) 17.12.63 65 Bride Street Fined £10. 0. Od, on one summons £3.0.0. costs. Remaining seven summonses marked "no separate penalty". 64 SECTION E SUPERVISION OF FOOD During the year the following legislation was made which had inter alia the effects indicated - The Meat Inspection Regulations. 1963' ■A These replaced previous Regulations and require that all carcasses of animals slaughtered for human consumption shall not be removed from the place of slaughter until inspected and if passed as fit marked with a prescribed mark Local Authorities can now make a charge for inspection The Milk (Special Designation) Regulations 1963 These re-enact with amendments the Milk (Special Designation) Regulations, 1960, On and after the 1st October, 1964, the designation "untreated" replaces "Tuberculin Tested", The "Methylene Blue" test replaces the "Clot-on-Boiling" test The Liquid Egg (Pasteurisation) Regulations 1963 The pasteurisation of liquid egg to be used in food intended for human consumption is now required in certain cases. The method of pasteurisation and the test tcbe satisfied is prescribed. The Bread and Flour Regulations 1963 These impose requirements as to the labelling and advertising of specific kinds of bread and impose restrictions on claims that any bread, biscuits, rusks or cereal breakfast food is starch-reduced or can aid slimming and prohibits claims that any of these foods have specific weight reducing properties The Ice Cream (Heat Treatment Etc ) (Amendment) Regulations 1963 The addition of sugar to sterilized or pasteurized mixtures used in the manufacture of ice cream is now allowed. The Soft Drink Regulations 1963 These Regulations implement some but not all of the recommendations of the Fbod Standards Committee in its report on Soft Drinks They come into operation in July next year. The Merchandise Marks (Imported Goods) (Raw Cucumbers) Order 1963 This Order requires an indication of origin to be applied to imported raw cucumbers other than gherkins The Minister of Agriculture, Fisheries and Food in Circular FSH 12/63 drew the attention of Food and Drugs Authorities to the fact that after 1st October 1963 H.M, Customs and Excise will discontinue sampling glucose and invert sugar in brewing materials for arsenic Sampling in future will fall within the general enforcement responsibilities of these Authorities. 65 Approval was given for one Inspector to attend a Refresher Course in Meat Inspection given by the Food Commodities Department cf the College for the Distributive Trades. The Course was held during the evenings and consisted of 18 lectures/ demonstrations. Approval was also given for two Inspectors engaged in duties under the Food and Drugs Act to visit a large Ice Cream Manufacturing and Distributing Depot, In order to secure compliance with the Pood and Drugs Act, 1955 and the Hygiene Regulations made thereunder, night inspections were carried out by Inspectors. During the course of these duties, inspections were made of refreshment houses, night clubs and vehicles used for the transport of meat and the delivery of milk, bread, etc., to retailers. Any necessary action was taken. Cbmplaints of alleged unfitness were received in respect of the following- Ants in cake Black substance in bread Cbntaminated dates Dirty bottle of cream Discolouratiai of tinned pork luncheon meat Fly in loaf of bread Fbreign substance in loaf of bread Foam rubber in bottle of milk Fbreign substance in bun Glass in milk bottle * Glass in tinned salmon Hair in meat and vegetable pie Horse Chestnut in bottle of milk Lead in angelica * With regard to this complaint the glass" was found to be crystals of struvite a substance which can be mistaken for glass but which occurs naturally at times in canned salmon, A quantity of tomato puree, olives, pickled pigs-ears, beans etc., fcund to be unfit at an address in the Borough, were seized by the Inspector and an Order obtained from the Magistrate for its destruction - a prosecuticn followed Details of the prosecutions taken in respect of the above complaints and other action by the Inspector appears on pages 69 - 73 Maggots in chocolate wafer bar Mould in birthday cake Mould in bread (3) Mould in Cornish pasty Mould in Party pork pie Mould in meat party pie Mould in apple pies (3) Mouldy skinless pork sausages Mouldy steak and kidney pie Sacking in bread Tin of corned beef - decomposed String in loaf of bread Rancid butter Wire in bread Hie standard of hygiene in food undertakings is normally at a satisfactory level but the Council is concerned about the conditions which exist in the remainder of cafes and restaurants and which are not providing the standard of cleanliness and hygiene which the public are entitled to expect. In a report submitted by the Public Health Committee to the Council, it was stated that regular inspections of food premises are made and when, as a result of such inspections or when such matters are brought to the Committee s attention by complaint, investigations are made, warnings given and if there is no satisfactory improvement, proceedings are instituted. 66 The Committee was, however, handicapped because in the absence of any obligation for the registratim of restaurants, cafes or other places where food may be consumed on the premises, the Department may learn of the existence of such an establishment only after it has been open for some time It was considered that these premises should be registered with the local authority and that the names of the proprietors should be included in the registration It was not considered that there was anything inherently difficult about such registration: indeed, on the 31st March, 1962, 1,923 cafes and restaurants had voluntarily registered themselves with the London County Council within the whole of the London area to obtain refreshment house licences which would enable them to keep open between the hours of 10 p m. and 5 a.m. The Council stated that it was not prepared to tolerate a minority of dirty and unhygienic cafes, restaurants or food premises and the strongest measures will be taken to see that they are brought up to the standard required by the Food Hygiene (General) Regulations. The Council asked the Metropolitan Boroughs" Standing Joint Cbmmittee to consider the submission of representations to the Ministers af Health and Agriculture, Fisheries and Pood jointly with a view to legislation being promoted to effect the registration of such food premises. This was done and the Metropolitan Boroughs' Standing Joint Committee submitted a recommendation to the Minister of Agriculture, Fisheries and Pood accordingly. The Public Analyst requested co-operation in extending the sampling and analysing of drugs under the Fbod and Drugs Act 1955 in order to keep pace with modern development in medicine This was agreed upon and appropriate arrangements were made Many immigrants coming into the Borough are engaged in food preparation and handling. The language difficulty is real and constant supervision is necessary The education of such food handlers is a slow and tedious business A letter with an explanatory booklet was sent to all food traders in the Borough, This was followed up by a series of inspecti <ns and visits by the Inspectors Where improvements in the standard of hygiene have been achieved, this is seldom maintained unless the Inspector is able to devote the necessary time to secure satisfactory follow-up, An example of the attitude of some towards the standard expected in this country arose when a complaint was received that soft drinks were being manufactured in a private house. Investigations showed that in a house occupied by immigrants, one tenant was, in fact, producing a cordial on a commercial scale The mixture was being boiled on the domestic gas stove on the landing in 4 gallon cans which had originally contained liquid detergent After boiling, the cordial was taken into the small kitchen (used by the whole family) and filtered through muslin into an empty 50 gallon oil drum from which it was ladled as required by means of a jug into a galvanized dustbin set up on the kitchen table, A brass tap had been fixed in the side of the dustbin which was used to draw off the cordial through a plastic funnel into bottles filled individually by hand, Samples of the materials which were used in the manufacture of the cordials were taken and the report'of the Public Analyst indicated that some of the colouring matters used were included in the prohibited list. These colouring matters were obtained privately from Jamaica The producer of the cordial was co-operative and 67 manufacturing ceased immediately. It is felt that if the registrati en of food undertakings were obligatory, this case may not even have commenced The number of Fish and Chip shops in the Borough is increasing. Those constructed during the year are of a high standard both in regard to premises and hygiene. Included in the cases brought to the notice of the department and investigated by the Inspectors are the following - A complaint was received alleging a strong disinfectant flavour in some lamb chops purchased in the Borough It was found tnat these were part of a consignment which had been stored in the hold of a ship previously used to carry chemicals. The taint from these chemicals had affected the whole consignment of meat which had been widely distributed before it could be withdrawn Another case arose due to a Canteen Manager reporting cases of illness occurring amongst persons who had eaten a meal in the Canteen the previous day. Everything pointed to minced beef, a sample of which was sent to the Public Analyst who, upon examination, reported a high concentration of nicotinic acid The symptoms of the sufferers appeared to be consistent with an overdose of nicotinic acid It was then found th3t a red meat" dusting powder containing nicotinic and ascorbic acids had been used on the meat in Question, This case is one of many which occurred at the same time and gave rise to questions being asked in Parliament A third case resulted in the condemnation of many tons of foodstuff due to an attempt to import from the Continent peeled potatoes which by the addition of an antifrost preparation and a preservative, it was hoped would remain in a good condition for possibly three weeks. This proved not to be the case and many tons of potatoes were condemned due to the appearance of slime, yeast and mould In one of the supermarkets in the Borough slabs of what appeared to he chocolate in cellophane were displayed for sale Upon analysis the sample contained 31 per cent of fat of which not less than 50 per cent, ns palm kernel or coconut oil It was considered that it was not what is normally known as "chocolate" the fat in which should consist exclusively of cacao-butter, together with butter-fat in the case of milk chocolate. As no label or wording appeared on the wrapper, it was considered that the public may be mislead. The Company concerned co-operated and withdrew the sale of this particular pack Food and Drugs Act 1S55 Nurrber of food "revises in the area ?nd ty>8 of business Bakehouses - level 24 - basement 8 Bakers' retail shops 49 Butchers 163 Continental Cafes and Restaurants' 306 Canteens and Clubs 144 Chemists 50 Coffee stalls 1 Continental Food Shops 58 Fish shops 33 " curers 23 " depot 1 friers 52 <33 Continued. Food factories 35 Food stalls 86 Food storage premises for street traders 48 Greengrocers and Fruiterers 176 Grocers and Provision merchants retailers 426 " " " wholesalers 23 Licensed Clubs 27 Off Licences 108 Public Houses 245 Beerhouses 12 Sugar and chocolate confectionery 344 Milk machines 27 Food machines 12 Preserved Food Premises Registered »jider Section 16 (1) (b) of the Food and Drugs Act, 1955 Included in foregoing list) Total No. of Preserved Food Premises 174 No, of Butchers 120 No. of Grocery and provision shops 39 No. of Food Factories 11 No. of Cooked meat shops 1 No. of Jellied F.el s and Pie Shops 2 No. of Bakers (meat pies) 1 Total No. of inspections and visits made by Inspectors to Preserved Food Premises 80 Details of the inspections etc. by the Inspectors are piven below: Bakehouses - level 150 " • basement 69 Bakers (bread and cake shops) 98 Butchers 190 Chemists 2 Confectioners 149 Fried fish shops 148 Fish curcrs 81 Fishmongers 13 Greengrocers & Fruiterers 119 Grocery & Provisions 775 Wholesale Food Stores and Depots 370 Markets 41 Food Storage for Street traders 1 Other Food Premises 136 Vehicles 77 Stalls 37 Public Houses and Off Licences 12 Bestauranf , Eating Houses and Canteens 906 Meat inspections at Licensed Slaughterhouse 383 Food examinations (other) 271 Ice Cream premises 179 Preserved Food Premises 80 Dairies (milk distributor) 149 Contraventions found 291 Contraventions remedied 207 69 Continued. Notices served (Food and Drugs Act) 114 Notices complied with (Food and Drugs Act) 69 Infectious diseases 28 Food poisoning enquiries 23 General Legal proceedings • attendances at Court 40 Miscellaneous 701 Legal Proceedings Details of the action taken by the Council under the Fbod and Drugs Act, 1955, and the Fbod Hygiene Regulations made thereunder are as follows:- Date 0ffence Magistrate's Decision (1) 19.2.63 Sections 2(1), 113(3) Selling food, namely a steak and kidney pie not of the quality demanded at 21 Canonbury Lane Fined £1.0.0. on first summons. Fined £1.0.0. on second summons. Defendant to pay £5.5.0. costs. (2) 19.2.63 Section 2(1). Selling food, namely % lb raisins not of the quality demanded at 509 Hornsey Road Fined £5. 0.0 Defendant to pay £5.0.0. costs, (3) 19.2.63 Sections 2(1), 113(3). Selling food, namely a pork pie not of the quality demanded at 620 Holloway Road. Fined £3.0.0. Defendant to pay £3.0.0. costs (4) 5.3.63 Sections 2(1), 113(3). Selling food, namely a loaf not of the quality demanded and delivered to a private address Fined £5.0.0. Defendant to pay £3.0.0. costs (5) 5.3.63 Sections 2(1), 113(3). Selling food namely ginger bread not of the duality demanded delivered to a private address. Fined £3,0.0 Defendant to pay £3.0.0. costs. (6) 2.4.63 Food Hygiene (General) Regulations, I960 Sections 5, 33(2a) Carrying on a food business in insanitary premises thus exposing food to the risk of con-animation at 36 Essex Road Fined £20.0.0. Defendant to pay £3.0.0 costs. (7) 4.6.63 Sections 16(1) (b), 16(2). Using the premises for the manufacture of sausages, the said premises not being registered; at 16 Durham Road. Fined £50.0.0. Defendant to pay £2.0.0. costs (8) 4.6.63 Food Hygiene (General) Regulations, 1960 Sections 16(4), 33 Failing to keep a wash-hand basin in an efficient working order for the use of persons engaged in handling food at 139 Highbury New Park, Fined £5,0 0. on first summons Fined £5.0.0, on second summons, Defendant to pay £3 costs. (9) 4.6.63 Food Hygiene {General) Regulations, 1960 Sections 5, 33 (2a) Carrying on a food business in insanitary premises thus exposing food to the risk of contamination at 145/146 Upper Street Fined £25.0.0. Defendant to pay £3.0,0. costs Subsequent appeal at Qiarter Sessions on 5.7.63 dismissed Defendant to pay £15,15.0 costs. 70 Date Offence Magistrate's Decision (10) 4.6.63 Food Hygiene (General) Regulations, 1960. Section 33(1) Failing to keep clean a vehicle (134 CYE), used in the course of a food business, in New North Road. Fined £10.0. Defendant to pay £3.0.0. costs. (11) 4.6.63 Food Hygiene (General) Regulations, 1960. Sections 5, 33(2a) Carrying on a food business in insanitary premises thus exposing food to the riskof contamination at 361 New North Road. Fined £40.0.0. Defendant to pay £3.0.0. costs. (12) 4.6.63 Food Hygiene (General) Regulations, 1960. Sections 5, 33(2a) Carrying on a food business, in insanitary premises thus exposing food to the risk of contamination at 1A Camden Walk Fined £5.0.0. Defendant to pay £3.0.0. costs. (13) 2.7.63 Food Hygiene (General) Regulations, 1960. Sections 5, 33 (2a) Carrying on a food business in insanitary premises thus exposing food to the risk of contamination at 110 Upper Street. Fined £15.0.0. Defendant to pay £3.0.0. costs. (14) 2.7.63 Section 2(1) Selling food, namely a wholemeal loaf not of the quality demanded at 487 Hornsey Road. Fined £5.0.0. Defendant to pay £1.0.0. costs. (15) 24.7.63 Food Hygiene (General) Regulations, 1960. Sections 5, 44, 33. 1) Carrying on a food business in insanitary premises thus exposing food to the risk of contamination. Fined total of £25.0.0. on all three summonses. 2) Failing to supply for the wash-hand basin an adequate supply of either hot or cold water, or of hot water at a suitable temperature. Defendant to pay £6 costs. 3) Failing to keep clean a sanitary convenience regularly used in connection with food premises at 76 Holloway Road (16) 24.7.63 Food Hygiene (General) Regulations, 1960. Sections 5, 6(2), 33. 1) Failing to ensure that containers for food for use in a food business, were protected and kept free from contamination. Fined total of £31.0.0. on both summonses. Defendant to pay £4 costs. 2) Carrying on a food business in insanitary premises thus exposing food to the risk of contamination at 479 Liverpool Road. (17) 24.7.63 Food Hygiene (General) Regulations, 1960. Sections 5, 33. Carrying on a food business in insanitary premises thus exposing food to the risk of contamination at 33 Essex Road. Fined £20.0.0. Defendant to pay £3.0.0. costs (18) 24.7.63 Food Hygiene (General) Regulations, 1960. 1) Regulations 5, 33 (2a) Carrying on a food business in insanitary premises thus exposing food to the risk of contamination. Fined £25.0.0. on first summons Defendant to pay £5.0.0, costs Second summons dismissed. 2) Regulations 9(c), 33. Smoking whilst being engaged in handling food and in a room where there was open food, at 364 Caledonian Road. t 71 Date Offence Magistrate's Decision (19) 24.7.63 Food Hygiene (General) Regulations, 1960 1) Regulations 14(2), 33 Failing to keep clean a room containing a sani tary-convenience, 2) Regulations 5 33 Carrying on a food business in insanitary premises thus exposing iood to the risk of contamination 3) Regulations 16(1), 33, Failing to provide wash-hand basin for persons engaged in handling food at* 96/98 Mackenzie Road, Fined £25.0.0, on first summons. Defendant to pay . £2.0.0. costs. Fined £3.0.0. on second summons Defendant to pay £2.0.0. costs, Fined £2.0,0. on third summons Defendant to pay £2.0.0, costs. (20) 24.7*63 Food Hygiene (General) Regulations, 1960 1) Regulation 33. Failing to provide suitable locker accommodation for persons engaged in handling food 2) Regulations 5, 33 Carrying on a food business in insanitary premises thus exposing food to the risk of contamination 1) Regulations 14(2), 33. Failing to keep clean a room containing a sanitary convenience regularly used by persons engaged in handling food, at 123 Upper street. Fined a total of £25,0,0. on three summonses, Defendant to pay 15,0.0, costs (21) 15.8.63 Food Hygiene (General) Regulations, 1960 1) Regulations 16(3), 33, Carrying on a food business in insanitary premises thus exposing looa to tne risk of contamination at 157 Seven Sisters Road, 2) Regulations 16(3), 33 Carrying on a food business in insanitary premises thus exposing food to the risk of contamination at 159 Seven Sisters Road 3) Regulations 16(2), 33, Failing to provide and maintain a supply of water for a wash-hand basin at 139 seven Sisters Road, 4) Regulations 16(1)(b), 16(2). Using the rear yard of unregistered premises for the manufacture of sausages at 159 Seven Sisters Road 5) Regulations 5 33 Carrying on a food business in the rear var ol insanitary premises thus exposing food to the risk of contamination at 159 Seven Sisters Road, 6) Regulations 16(3), 33. railing to provide an adequate supply of nail brushes and clean towels at 157 Seven Sisters Road, Fined £25.0.0, on first summons. Defendant to pay £3 0.0, costs. Fined £25.0.0. on second summons Defendant to pay £3.0.0, costs. Dismissed - case not proved on third summons, Dismissed - case not proved, on fourth summons, i Dismissed - case not proved on fifth summons, Dismissed - case not proved on sixth summons. (22) 3.9.63 Sections 2(1), 113(3). Selling food namely a loaf of bread not of the quality demanded at 350 Holloway Road Case dismissed £10,10.0. costs paid to defendants. (23) 26.8.63 Section 2, Selling food, namely a quantity of chocolate biscuits not of the quality demanded at 118 Seven Sisters Road Fined £5.0.0, Defendant to pay £3.0,0. costs. (24) 1.10.63 Food Hygiene (General) Regulations, 1960 1) Regulatiu.is 28(1), 33. Failing to provide clean towels anda supply ol water lor use in connection with a catering business. Fined £2.0.0° Defendant to pay £1,0,0, costs 72 Date Offence Magistrate's Decision (24)1. 10.63 cont. 2) Regulations 26(1), 33. Failing to keep clean a vehicle used in the course of a food business tor the transport of food; the vehicle in both cases being registered number 448 JMH Second summons dismissed. (25) 1.10.63 Food Hygiene (General) Regulations, 1960 1) Regulations 28(1), 33. Failing to provide clean towels, and a supply of water for use in connection with a catering business, 2) Regulations 26(1), 33. Failing to keep clean a vehicle used in the course of a food business for the transport of food; the vehicle in both cases being registered number 448 JMH, Fined £2.0.0. Defendant to pay £1.0.0. costs. Second summons dismissed. (26) 1.10.63 Food Hygiene (General) Regulations, 1960 1) Regulations 16(3), 33. Failing to provide an adequate supply of soap, nail brushes and clean towels lor persons engaged in handling food, 2) Regulations 14, 33. Failing to keep clean a room which contained a sanitary convenience regularly used by persons engaged in handling food. 3) Regulations 5 33. Carrying on a food business in insanitary premises thus exposing food to the risk of contamination at 58 Yorl' ' ay, Fined £10.0.0. on first summons. Defendant to pay £3.0.0, costs. Fined £10.0.0. on second summons. Fined £10.0.0. on third summons. Defendant allowed 28 days to pay. Ordered to serve three months imprisonment in case of default. (27) 1.10.63 Section 2(1). Selling food, namely a cake not of the quality demanded at 487 Hornsey Road. Absolute discharge. Defendant to pay £1.0.0. costs. (28) 1.10.63 Section 2(1) Selling food, namely a bottle of cream not of the quality demanded at 24 Tavistock Terrace Fined £5,0.0. Defendant to pay 10s. Od. costs. (29) 1.10.63 Section 2(1) Selling food, namely a loaf of bread not of the quality demanded at 246 Hornsey Road, Fined £5.0.0, Defendant to pay £1.0.0. costs. (30) 5.11.63 Section 2(1). Selling food, namely sausages not of the quality demanded at 524 Hornsey Road Fined £1.0.0. Defendant to pay £2.0.0. costs. (31) 5.11.63 Section 2(1). Selling food, namely a pie not of the quality demanded at 476 Holloway Road Fined £5.0.0. Defendant to pay £3.0.0, costs. Subsequent appeal to Quarter Session on 20.1.64 dismissed. Council awarded 20 guineas costs (32) 5.11.63 Food Hygiene (General) Regulations, 1960 1) Regulations 26(1), 33. Failing to keep in good order and. repair a vehicle, in order that it may be efiectivelv cleaned; used in connection with a food business for the transport of food, 2) Regulations 28(1), 33. Failing to provide and maintain an.adequate supply of water for use in connection with a catering business carried on from a vehicle registered number 5831 TR Fined £5.0.0. on first summons. Defendant to pay £2.0.0. costs, Fined £5.0.0, on second summons. Defendant to pay £2.0.0. costs. (33) 5.11.63 Food Hygiene (General) Regulations, 1960 Regulations 5, 33 (2) (a) Failing to pay Islington Borough Council costs of £.15. 15.0. imposed on 5.7,63, on dismissal of appeal against conviction of 4.6.63, Fined £20.0.0. Defendant to pay £3.0.0, costs. 73 Date Offence Magistrate's Decision (34) 5.11.63 Section 8(1) (a) Having for the purpose of sale, certain foods intended for, but unfit for human consumption at 364 Caledonian ft>ad Fined £3.0.0. Defendant to pay £2.0.0. costs. (35) 5.11.63 Food Hygiene (General) Regulations, 1960 1) Regulations 16(1), 33. Failing to provide and maintain suitable and sufficient wash-hand basins for the use of persons engaged in handling food at 19 Sheringham Road. Fined £2.0.0. on first summons. Defendant to pay £3.0.0. costs, 2) Regulations 5, 33. Carrying on a food business in insanitary premises thus exposing food to the risk of contamination at 19 Sheringham Road. Fined £5.0.0. on second summons. (36) 5.11.63 Food Hygiene (General) Regulations, 1960 1) Regidations 16(1), 33. Failing to provide and maintain suitable and sufficient wash-hand basins for the use of persons engaged in handling food. 2) Regulations 5, 33. Fined £5.0.0. on first summons. Defendant to pay £3.0.0. costs. Carrying on a food business in insanitary premises thus exposing food to the risk of contamination at 69 Axminster Road, Fined £5.0.0. on second summons. (37) 5.11.63 Section 2(1) Selling food; namely an apple pie not of the quality demanded at 16 Westboume Road, Summons dismissed. No costs awarded, (38) 3.12.63 Section 2(1) Selling food, namely a loaf of bread not of the quality demanded at Tufnell Park Road Fined £10.0.0. Defendant to pay £1.0.0. costs. (39) 3.12.63 Section 2(1) Selling food namely three pies not of the quality demanded ay 218 St Paul's Road Summons dismissed. No costs awarded. (40) 3.12.63 Food Hygiene (General) Regulations, 1960 Regulations 5, 33, 34. Carry on a food business in insanitary premises thus exposing food to the risk of contamination at 31/33 Highgate Hill. Fined £10.0.0. Defendant to pay £3.0.0. costs. (41) 3.12.63 Section 2(1) Selling fqod namely a pork pie, not of the quality demanded at 166 Copenhagen Street. Fined £10.0.0. Defendant to pay £3.0.0, costs. (42) 17.12.63 Food Hygiene (General) Regulations, 1960 1) Regulations 14,33.34. Failing to keep clean a sanitary conveniencein food premises. 2) Regulation 5 Carrying on a food business in insanitary premises thus exposing lood to the risk of contamination. 3) Regulation 19 Tai ling to provide an adequate supply of hot or cold water for washing food and equipment used in a food business at 54 Archway Road. Fined £7 5,0.0. on first summons. Defendant to pay £6.0.0. costs. Second and third summonses marked*No separate penalty". (43) 17.12.63 Section 2(1). Selling food, namely a loaf of bread, not of the quality demanded at 119/123 Newington Green Road. Fined £25.0.0. Defendant to pay £4,0.0. costs. 74 Unsound Food During the year 62 complaints of unsound food were received. The total amount of food condemned was:- Description Tons Cwts. Qtrs. Lbs. Tinned goods 10 17 2 15 Meat 13 4 1 7 Fish 17 6 2 11 Poultry — 9 — 18 Others 2 11 1 15 TOTAL 44 9 — 10 1,601 condemnation certificates were issued, and 440 inspections were necessary in connection with this work. Condemned food received from traders is either taken to the Council's refuse disposal depot at Ashburton Grove, awaiting conveyance, under supervision, to the refuse tip or 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. Sampling 1963 648 samples (9 formal and 639 informal) were sent to the Public Analyst for examination. Forty of these samples, or 6.17% were subject to adverse reports as shown in the summary below. It should be noted however, that with regard to these adverse reports that a number relates to samples not taken during routine sampling, but were the subject of a complaint. Formal Creme Doughnuts 1 Informal Angelica 1 Ice Cream Lolly 1 Apple Pie 1 Lamb 4 Beer 1 Lamb chops 1 Bread 6 Milk 1 Bun 1 Minced Beef 1 Canned Cooking Butter 1 Olive Oil 1 Canned Pears 2 Peeled Potatoes 2 Canned Pork Luncheon Meat 1 Pickled Onions 1 Canned Sterilised Cream 1 Rose-pink Colouring 2 Chocolate 1 sausages 1 Coconut Sweets 1 Sherbet 1 Creme Doughnuts 1 Steak and Kidney 1 Coffee 1 Strawberry Cordial 1 Dates 1 Tahin (Spread) 1 Pleat and Other Foods No visits by officers of this department were made during the year for the purpose of inspecting home killed or imported meat at the Metropolitan Cattle Market. 75 In accordance with the requirements of the Public Health (Meat) Regulations, 1924/52 and the Meat Inspection Regulations 1963, , notices were received during the year in respect of the intended slaughter of animals for human consumption. Details of action taken are as follows:- Cattle Excluding Cows Cows Calves Sheep and Lambs Pigs Horses Number killed (if known) 272 1,495 85 38 — 541 Number inspected 272 1,495 85 38 — 541 All diseases except Tuberculosis & Cysticerci Whole carcases condemned 8 85 — 6 — — Carcases of which some part or organ was condemned 42 765 2 2 — 46 Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 18.38 56.86 2. 35 21.05 — 8.5 Tuberculosis only Whole carcases condemned — — — — — — Carcases of which some part or organ was condemned — — — — — — Percentage of the number inspected affected with tuberculosis — — — — — — Cysticercosis Carcases of which some part or organ was condemned — 3 — — — — Carcases submitted to treatment by refrigeration — — — — — — Generalised and totally condemned — — — — — — All diseased or unfit meat was disposed of for use as knacker's meat or in the manufacture of animal feeding preparations. Of the 541 horses slaughtered for human consumption, the majority were intended for export. Slaughter of Animals Act, 1958 Slaughtermen's Licences During the year ten Licences were renewed and were current at 31st December. 76 Export Certificates-Food 17 Export Certificates were issued, The food consists mainly of tinned and bottled meats (Boneless chicken, ox tongue, ham etc), soups, pate and ham spreads. The majority of the food went to U.S.A(6) and Canada (5). Other countries were Malta (3), Spain (l), Australia (1) and New Zealand (1). merchandise Marks Act, 1887/1953 Agricultural Produce (Grading and Marking) Act, 1928/31 Details of the Inspections carried out by the Inspectors are as follows:- Merchandise Marks Acts Inspections 978 Contraventions found 60 Agricultural Produce (Grading and Marking) Acts Inspections — Contraventions found — Licensed Clubs Number of Applications received 7 Number of Applications objected to 1 Number of visits to Licensed Clubs 13 Inspection of Refreshment and Coffee Stalls Evening inspections of refreshment and coffee stalls were carried out by Public Health Inspectors as found necessary. 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. Traders are becoming more aware of these facilities, the number of persons taking advantage of them being on the increase. Convenience Jan. Feb. Mar. Apr. May. June. Jul. Aug. Sept. Oct. Nov. Dec. Approx. weekly average throughout year Finsbury Park Men 40 44 52 89 72 92 81 90 92 79 73 68 73 Women 33 37 41 54 47 51 35 43 41 34 31 30 40 Parkhurst Road Men 70 81 94 131 152 159 94 97 86 110 106 99 106 Women 67 79 92 121 157 172 79 82 71 80 82 76 96 Archway Men 52 55 62 91 98 110 90 85 84 86 80 82 81 Women 40 48 50 62 47 87 37 39 35 81 76 59 55 77 continued. Convenience Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Approx. weekly average th roughout year Highbury Men 27 39 56 67 81 86 58 60 49 42 41 39 54 Women 22 29 47 42 34 59 43 46 38 33 32 36 38 Offord Road Men — — — — Closed for repairs — — — — — Women — — — — — — — — — High Street Men 52 61 74 72 56 62 82 95 87 98 94 91 77 Islington Green Women 17 18 23 41 27 37 27 31 23 29 28 30 28 420 491 591 770 771 915 626 668 606 672 643 610 Ice Cream Ice Cream (Heat Treatment, etc. ) Regulations, 1959 Supervision of the Manufacture and Distribution of Ice Cream During the year 124 visits were paid to ice cream premises and vehicles. The number of premises registered; (a) for manufacture, sale and storage 15 (b) for sale and storage . 398 (c) for sale only 160 (d) for storage only 572 575 Bacteriological Examination (a) Ice Cream Ninety nine samples of ice cream were sent for bacteriological examination and following Methylene Blue tests were graded as follows:- Grade I 54 including 7 of soft ice cream Grade II 19 " 5 - " - Grade III 11 "8,, Grade IV 15 "6 , 99 26 Samples falling within Grades I or II are considered satisfactory. (b) Lollies Number sampled Satisfactory Unsatisfactory Cream Lollies — — — Plain Lollies 5 5 — 2. Chemical Examination Ice Cream 31 30 1 Ice Lollies 9 9 — 78 Details of 28 samples of ice cream (included in above figure) examined for fat content are as under:- 6% 7% 8% 9% 10% 11% 12% 13% 14% 2 3 1 9 2 4 2 3 1 One sample was 4.6% fat content and was thus 8% deficient. Milk Samples 1. Bacteriological Examination Class of Milk Results Phosphatase Methylene Blue Turbidity Biological Total number of Samples Pasteurised Satisfactory 49 49 — — 49 Unsatisfactory — — — — Sterilised Satisfactory — — 10 — 10 Unsatisfactory — — — — Tuberculin Tested (Pasteurised) Satisfactory 36 34 — — 36 Unsatisfactory — 2 — — Tuberculin. Tested (Raw Milk) Satisfactory — 1 — — 2 Unsatisfactory — 1 — — TOTAL 97 In addition to above two samples of Pasteurised Goat's milk were taken. Both passed Phosphatase and Methylene Blue tests 2. Chemical Examination Details of samples submitted Satisfactory Unsatisfactory Total Formal — — — Informal 168 1 169 — 169 Milk (Special Designation) Regulations. 1960 Number of Licences in force 381 Milk and Dairies (General) Regulations, 1959 Number of Dairies registered in the Borough 11 Number of Distributors registered in the Borough 363 79 SECTION F MISCELLANEOUS SERVICES HEALTH PUBLICITY AND HEALTH EDUCATION Home Safety Act, 1961 The above Act, which came into operation on 18th May, 1961, empowers the Councils of Cbunty Districts and Metropolitan Boroughs to promote home safety by giving information and advice on the prevention of accidents in the home, and to contribute to national and local non-profit making organisations whose activities include the promotion of home safety. The Islington Home Safety Committee was first set up in 1958 under the L.C.C. (General Powers) Act 1957. Islington Borough Home Safety Committee Membership, as at 31st December, 1963. Honorary President: His Worship the Mayor, Councillor G.A. Barnard, J.P. Chairman : Alderman A.J. Rogers Vice-Chairman : Mr. J. Capsey Honorary Secretary : Dr. V. Freeman Councillor L.T. Goombs : Islington Borough Council - Estates Committee " Councillor Mrs. E.J. Walker " " Housing Committee Councillor H.J. Reid " " " Public Health Committee Dr. Wilfrid G. Harding London County Council Health Division 3 Mr. S.R. Butcher " " " Housing Department Chief Officer's representative " " " Fire Brigade Councillor Mrs. E. E. Bull, L. C. C. North London Group Hospital Management Committee Dr. D. K. Robinson North London Group Hospital Management Committee Mr. J. Capsey North London Group Hospital Management Committee Mr. W.J. Palmer North London Group Hospital Management Committee Dr. E. Colin-Russ Local Medical Committee for the County of London Miss D. E. Church Islington Old People's Welfare Council Mr. E.L. Kennedy-Wilson North Thames Gas Board Mr. L.C. Atkins London Electricity Board Mr. D.J. Cooper London Master Builders' Association Mrs. A. Griffiths Islington Trades Cbuncil (1953) Miss B. Naish Royal Society for the Prevention of Accidents 80 Home Safety The Home Safety Committee during the year arranged for the production and distribution of a second volume of the handbook "Sense about Safety" . This included material compiled from the substance of a series of talks given by experts to the Committee and was commented upon favourably in a leading article in a local newspaper. Talks as under were given to the Home Safety Committee:- Dr. J.P. Burns, Deputy Medical Officer of Health spoke on "Home Accident Emergencies and First Aid" . This talk was subsequently summarized in the weekly bulletin sent to all medical practitioners in the Borough. Mr. H. Daile, F.B.O.A. gave a talk on "Good Vision and Safety" . He mentioned that of 164 people screened at the Islington "Safety in the Home" Exhibition in 1960, 87 were found to have sight below the accepted standard, 55 in one eye and 32 in both eyes. These findings must be an indication of widespread visual defects. Mr. W. C. Bartlett, Chief Public Health Inspector gave a talk on the subject of "Buy for Safety" which was related to the campaign of the Royal Society for the Prevention of Accidents during this year. The Home Safety Committee also discussed the high incidence of fires caused by oil heaters, especially in accommodation occupied by immigrants, not all of whom could read the instructions for using these heaters, A programme of lectures for the National Hospital Reserve held at Whittington Hospital included a session on 'Accidents in the Home' , in which the Medical Officer of Health was invited to take part. Area Managers of the National Assistance Board, co-operated in the distribution of pension book wallets, overprinted with home safety advice, which were purchased on the recommendation of the Home Safety Committee, A member of the Public Health Committee suggested in connection with the foregoing that similar arrangements might be implemented for the mothers of young children by the distribution of suitably printed advice on family allowance book wallets. 6,000 such wallets were purchased from the Royal Society for the Prevention of Accidents and were overprinted with home safety advice. By arrangement with the Divisional Medical Officer of the London County Council, the majority were distributed through Welfare Centres in the Borough. Home Accident Cases reported by the London Ambulance Service London County Islington No. of cases Rate per 10, 000 population No. of cases Rate per 10,000 population Year ended 30.9.59 7708 24.1 654 29.3 " " 30.9.60 7757 24.3 588 26.4 " " 30.9.61 8341 26.1 700 31.4 " " 30.9.62 8558 26.9 650 28.5 " " 30.9.63 9330 29.3 752 33.1 81 Smoking and Health The London County Council Health Education Unit operating in the Borough for a period of three weeks from 30th September to 18th October, 1963, was mainly engaged each day with showing films and giving talks to schools in regard to smoking and health Altogether, 37 lectures and film shows were given at 18 schools to over 6,000 school children These were very successful An invitation, however, to a number of large firms and organisations in the Borough met with a disappointing result, as only very few showed interest and accepted. A session for members of the Borough Council's staff was held at the Town Hall on Friday, 18th October, 1963. Two films were shown and a talk given, and questions which followed indicated the keen interest of those who managed to attend. Similar sessions took place for the benefit of Post Office staff and members of a Youth Club Thanks are due to Dr Harding, Divisional Medical Officer of the London County Council, for arranging the visit, to the two members of the team operating the Unit and to Mr. Wales, Divisional Educational Officer, for his help with respect to the sessions at schools During the year, bill posting sites in the Borough were posted with crown posters on this subject supplied by the Ministry of Health, In addition, 12,000 bookmarks were sent to the Borough Librarian who kindly arranged for their distribution in the Public Libraries and suitable literature was also made available in the two publicity stands of the Public Health Department in the Town Hall The Advisory Smoking Centre continued to function at 32, Drayton Park, N 5., where those who wished to give up the smoking habit met together in a group therapy course or undertook an individual course Sessions at this Centre are earned out under joint arrangements of the Divisional Medical Officer of the London County Council, the Chest Physician of the Islington Chest Clinic, Dr Wallace Craig and the Medical Officer of Health. Conferences and Courses The following conferences and courses were attended during the year by members of the Public Health Committee and Officers of the Department:- Conference or Course Dates Attended by Study Course-Air Pollution Its Effect on Society University of London, Dept. of Extra Mural Studies, St Bartholomews Medical College 6 Wednesday lectures commencing 13th February 1963 Medical and Public Health Inspector staff. Greater London & Middx. Home Safety (Area 10) Conference on Home Safety & Accident Prevention 16th March Chief Public Health Inspector. British Pest Control Conference 1963 of Industrial Pest Control lst-3rd April Disinfecting Services Officer (Public Health Inspector). 82 Conference or Course Dates Attended by Association of Public Health Inspectors Week-End School, Folkestone. 5th-7th April 3 Public Health Inspectors, Royal Society of Health Conference 29th April 3rd May Councillor Mrs. C.M. Colebeck and Medical Officer of Health. Summer School for Public Health Administration, Association of Public Health Lay Administrators. 11th-14th September Chief Clerk. Association of Public Health Inspectors Conference, Eastbourne. 24th-27th September. Chairman, Alderman A.J. Rogers, and Chief Public Health Inspector. National Home Safety Conference 1963, Royal Society for the Prevention of Accidents 10th-11th October Councillor L. Ross and Medical Officer of Health. Radiological Protection Course, Slough College, Slough, Bucks. Tuesdays, four occasions, commencing 5th November Deputy Chief Public Health Inspector and Senior Food Inspector. Pood Commodities Department of the College for the Distributive Trades, Refresher Course. 18 lectures demonstrations commencing 12th November 1963. 1 Inspector. General Regular publicity by means of leaflets and posters, according to season and topicality, together with the distribution of 1,000 copies per month of "Better Health" mainly through the Islington Public Libraries, and the provision of "Family Doctor" for reading, continued throughout the year. We are also indebted to the Public Libraries Department for public health and other publicity during the year. In their monthly bulletins as well as printing extracts from my annual report for the previous year, space was devoted to items on nuisances by dogs, rodent infestation, derelict sites, services for elderly persons, sale of solid smokeless fuels in emergencies by local authorities, food hygiene, fluoridation of water, etc. and "snippets" were reported upon from Council agendas on public health topics. SERVICES FOR ELDERLY PERSONS Various services for elderly persons are provided both directly by the Council through the Public Health Department and indirectly by voluntary organisations, The Borough Council continued to give financial assistance to the Islington Old People's Welfare Council and the Women's Voluntary Service under the provisions of Section 31 of the National Assistance Act, 1948, which authorises local authorities to make contributions to the funds of voluntary organisations, whose activities include the provision of recreation or meals for old people. In the 1962 Annual Report, mention was made of 83 the National Assistance Act 1948 (Amendment) Act 1962 which gives local authorities power to make direct arrangements, and following the submission of a comprehensive review to the Public Health Committee with the object of further co-ordinating and extending the services as far as possible, the responsibility for the provision of meals to elderly persons was transferred to the Borough Council from the 1st April, 1963, As mentioned in previous Reports, the Borough, largely through the Public Health Department, effects liaison with voluntary organisations as well as other statutory authorities, assisting old people in one form or another, In the voluntary sphere, acknowledgments are again due to Miss D E Church, the Honorary Secretary, and the members of the Islington Old People's Welfare Council and to Mrs, E. MacGregor, M.B. E., Centre Organiser of the Women's Voluntary Service and her colleagues. Visiting of Elderly Persons The greater part of the organised and systematic visiting of elderly persons is carried out by members of the Public Health Department, who visit for the purposes of the Public Health, L.C. C. (General Powers) and National Assistance Acts. The Elderly Persons Register maintained in the Department comprised, at the end of the year, a total of 3,046 persons over 65 years of age. The Department's Visitors called on 621 new cases during the year and re-visits totalled 4,715. They made 3,608 references during the year to persons or organisations outside the Department and, in present circumstances, it is most unlikely that this kind of help could have been given in any other way, in the absence of the Department's own staff. These references covered requests for provision of meals and home help services, welfare home or hospital admission. National Assistance or grants and introductions to clubs, Work Centre, and associations dealing with blind and handicapped persons, registrations with medical practitioners, and help in contacting relatives, Gas and Electricity undertakings were notified of defective appliances and recommendations were made to the London County Council for the provision of fireguards in an additional 19 cases, 141 cases were also recommended for home nursing equipment supplied through the County Council. The Borough Council's grant to the Old People's Welfare Council for the year, utilised mainly for the provision of meals, holidays, and part-time employment for the elderly, totalled £8,805. Public Health (London) Act 1936. Section 122 Cleansing and Laundry Service Heavy demands continue to be made on the disinfecting and laundry unit at the Treatment Centre. Islington residents: No. of recipients approved 173 No. of washings carried out 2,613 No. of articles cleansed 27,004 84 Home for Confirmed Invalids, Highbury Terrace The weight of laundry dealt with during the year was 3 tons 1 cwt. 1 qtr. 6½ lbs. Aged Pilgrims' Friend Society Home, Hazellville Road Recommendations are received from the Matron for inmates of the nursing home wing who are incontinent. The weight of laundry dealt with was 3 tons 0 cwts. 0qtrs. 25½ lbs Holborn Borough Council The agreement whereby clothing and bedclothes of incontinent elderly persons in Holborn Borough can be dealt with at the Islington laundry has continued During the year 817 washings, comprising 9,218 articles, were carried out on behalf of 56 recipients Stoke Newington Borough Council A similar agreement was entered into, as with Holborn Borough Council, During the year 375 washings, comprising 3,330 articles, were carried out on behalf of 14 recipients. Corporation of London Washings 58 Articles 770 London County Council (General Powers) Act 1953 Section 43 Cleansing of Elderly Persons The service of the bathing of elderly persons must be closely associated with the laundry service mentioned above, Home bathing may be carried out by the Department's own staff in the person's home if he or she is homebound. Alternatively, bathing may be done at the Treatment Centre, Seven Sisters Road, and those who can leave their home but would have difficulties with public transport can be taken to the Centre in the Department's own specially-designed vehicle 274 persons were thus assisted by the Department's nursing and bathing staff, and this entailed 996 home visits and 454 baths given at the Treatment Centre, All this work is carried out under the Supervision of the Nurse-in Charge at the Centre. Work on the scheme for the modernisation of the baths at the Treatment Centre mentioned in the previous Report, was commenced during the year. When completed, the improvements in the Centre will include the provision of two shower compartments fitted with seats and side supports as well as two slipper baths also fitted with special supports. Special attention will also be paid to non-slip flooring and various other minor improvements have been included which, when completed, will make available good hygiene facilities not only for elderly persons, but also for others, including schoolchildren who may require treatment. The finish and colouring scheme will be attractive and cleanlooking without appearing too clinical. 86 National Assistance Acts, 1948 and 1951 It was necessary to invoke the procedure for the removal to suitable premises without delay in respect of one elderly person, in accordance with the provisions of the National Assistance (Amendment) Act, 1951. An order under subsection (3) of section forty-seven of the National 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 sub-section (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. Details of the statutory action taken are given in the following statement which has been compiled in the form required by the Ministry of Health. Aged and Infirm-Action taken under Statutory Powers Case No. Name and Age Reason for Council's Action Period Named in Order Type of Accommodation to which removed Ultimate Result (1) (2) (3) (4) (5) 1 Mrs. F. 78 years This elderly German lady was brought to the attention of the Public Health Department in August 1962, as a person who was aged and might require assistance at a later date. At that time, her home conditions were reasonable She spoke very little English, lived alone and had no relatives in the United Kingdom. She managed her own affairs, but was inclined to be rather vague and forgetful, and had got into some financial difficulties which necessitated a visit to Court. At that time, the National Assistance Board was asked to help her, She was not registered with a Medical Practitioner and the Department arranged for her to be allocated to a Doctor's list. In January, 1963, her living conditions deteriorated rapidly and, as the weather was intensely cold at that time, her Medical Practitioner was consulted as she refused to eat and would not get out of bed, A period of stay in a welfare home was recommended, but she refused to go voluntarily, and she was compulsorily removed under an Order granted by a Justice of the Peace Within a few days, Not exceeding three weeks Geriatric Hospital Still a patient in a Mental Hospital 87 cont. Reason for Council's Action she left the Home without leave, and was later found wandering in the streets by Police and removed to a General Hospital. Her mental condition deteriorated considerably, and she was transferred to a Mental Hospital Fortunately, in relatively very few cases is it necessary to apply for a Court Order for removal of elderly people under the National Assistance Acts. The following are just a few examples of the ways in which the Department's health officers are able to take action or ameliorate conditions on a basis of voluntary co-operation. Mr. M. (77 years); Miss M, (82 years) These two elderly persons- a brother and sister-came to the notice of the Public Health Department in January, 1963, following a complaint that they were living in very dirty circumstances. A visit was made by the Public Health Inspector and Health Officer and they were offered accommodation in a Welfare Home. However, they refused the offer and arrangements were made for special cleansing of their home by members of the Public Health Department, A home-help was provided. They were referred to the National Assistance Board for additional finance. New clothing was provided for Mr. M., and the laundry and home bathing services were arranged for him. Eventually, in June, 1963, Mr. M., who was becoming an increasing burden on his sister, agreed to go into a Welfare Home; Miss M. refused to accompany him. However, soon after her brother's entry into a Home her condition also deteriorated. She had lost interest in her home, and was not preparing or accepting meals. Finally, she also agreed to enter a Welfare Home at the end of November, 1963. They were both resident in the Home at the end of the year. Mr. H. (89 years): Mrs. H. (78 years) Mrs. H. was discharged from hospital in 1956, following an abdominal operation, and a request was made to the department for a home-help. This was arranged, and a visit was made by the Health Officer. Mr. H., her husband, was a difficult person and the Health Officer called on several occasions to arrange for holidays and to assist them with their domestic difficulties. In 1959, Mr. H. was admitted to a Mental Hospital for a short time. Upon discharge, domestic difficulties again became evident, and by the end of 1962 domestic and financial troubles were really pressing. Mr. H. refused to enter a Welfare Home. At that time he became incontinent, and home bathing and laundry services were arranged, but this added to the difficulty of the domestic situation. In early January, 1963, Mrs. H. refused to look after the household any longer and retired to her bed. Arrangements were made for Mr, H. to return to the Mental Hospital Welfare services were immediately provided for Mrs. H., but these proved insufficient and she was admitted to hospital for short periods during January and May, 1963. Following her second admission, she went for convalescence, and returned home in Mid-August, 1963, when the domiciliary services were reinstated. In the meantime, Mr. H. died, and soon after her return home a letter was received stating that Mrs. H. had remarried and had gone to live in another area. 88 National Assistance Act 1948. Section 31 National Assistance Act 1948 (Amendment) Act 1962 'Meals-on-Wheels' and Lunch Clubs As mentioned at the commencement of this section of the Annual Report, the Women's Voluntary Service and the Islington Old People's Welfare Council were responsible for meals-on-wheels deliveries to the 31st March 1963, from which date the service including staff, was transferred to the Department. It was found possible during the year to deliver on an additional day each week. The meals supplied during the year were as follows:- Meals-on-Wheels From 1st January to 31st March, 1963: Women's Voluntary Service 1,743 Islington Old People's Welfare Council 1,448 From 1st April to 31st December 1963: Supplied directly by Council Services 13,718 21,486 meals cooked by NALGO, Town Hall Canteen. Total Number of Meals-on-Wheels: 16,909 Lunch Clubs Gifford Hall Mission 3,445 Caxton House Settlement 1,132 A lunch club at St. Giles Christian Mission, Bride Street, N. 7, also produced 1,957 meals with the help of their own voluntary workers and Council grant-aid Another lunch club, situated in the Borough of Finsbury at Claremont Central Mission, White Lion Street, also caters for Islington residents and receives a £50 grant from this Council. As mentioned above, it was found possible during the year to provide for a limited increase of meals. The Committee also approved in principle the extension of the service in the near future, which would entail the purchase of additional transport. Holidays for Elderly Persons Assisted holidays were again much in demand, and 515 elderly people were able to enjoy a holiday through the Borough Council's grant-aided scheme, which is administered by the Old People's Welfare Council. A sum of £2,750 was earmarked to meet costs which pensioners could not be expected to pay. Most holidaymakers, however, were able to pay some of their expenses and Miss Church. Honorary Secretary of the Welfare Council, arranged to collect small weekly sums to suit the convenience of the savers. Parcels for Elderly Persons The Borough Council authorised the expenditure of £100 on Christmas gift parcels, and it was possible to make a distribution to about a hundred elderly folk. The health officers recommended suitable recipients and delivery was arranged by the Islington Old People's Welfare Council. 89 Islington Work Centre for the Elderly This is another social venture which has now become firmly established in Islington. Numbers attending the sessions have increased and the workroom is usually full to capacity, providing part-time employment for between 90 and 95 persons, each working five half-day sessions per week. The Centre is sited at the Elizabeth Whitelaw Reid Club, Cloudesley Street, N.1., and Miss K. D. Lane, Centre Organiser, is responsible for the day-to-day business, while the Centre is run under the direction of a Sub-Committee of the Old People's Welfare Cbuncil. Generally speaking, sufficient out-work was provided by application to local firms, and the old people were able to reach a high standard of efficiency in carrying out the various tasks. As well as giving them an added interest, a small monetary reward and an opportunity of meeting other elderly folk, the Work Centre is fulfilling a valuable purpose in helping to maintain in these retired people a sense of usefulness in the community Chiropody The financial responsibility for this service, has now passed to the London County Council, but the local administration and appointments system are dealt with by the Islington Old People's Welfare Council, who run 9 weekly sessions and make appointments for approximately 70 persons each week. In addition 231 infirm persons received treatment in their own homes. 90 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, Cramley Street, N.W. 1., after that date. ISLINGTON CREMATORIUM The Medical Referee or the Deputy Medical Referee certified a total of 732 applications for cremation at the Council's Crematorium, East Finchley. MATERNITY AND CHILD WELFARE SERVICES The London County Council, as the Local Health Authority, is responsible for the Maternity and Child Welfare Services, the Home Help Service and a Chiropody service in the Borough, which, together with the Boroughs of Finsbury and Holborn, constitute Division 3. I am indebted to Dr Wilfrid G. Harding, Divisional Medical Officer, for the information given below in respect of these services:- Total Attendances at Maternity & Child Welfare Centres 0-1 58,792 1-2 7,140 2-5 3,572 Special Toddlers' Clinics 3, 311 Ante-Natal and Post-Natal Combined 14,957 Foster Mothers The table of foster-mothers and foster-children registered under the Childrens Act, 1958, is as follows:- 31 .12 .1963 Number of persons fostering children 12 Number of foster-children being cared for 14 L C C. Day Nurseries and Child Minders At present there are 3 Day Nurseries open in Islington:- Scholefield Road 60 places Canonbury Place 67 places Mitford Road 67 places 194 There are also 50 places for Islington children in Springdale Day Nursery (Stoke Newington). In addition there were at the end of the year 92 child minders registered voluntarily under the L.C.C. scheme and 151 children were being minded. 91 Nurseries and Child Minders Regulation Act, 1948 At the end of the year there were 103 children being minded by 19 child minders registered by the L.C.C. under the provisions of the Nurseries and Child Minders Regulation Act, 1948. There was also one private day nursery registered under the Act providing 25 places. Chiropody Clinics Clinics are provided at East Islington Welfare Centre at Drayton Park, South Islington Welfare Centre at Clephane Road and at the Junction Road Congregational Church for' priority cases'- the aged, expectant mothers and the physically handicapped. During the year the total attendances at these clinics were as follows:- East Centre 4,719 South Centre 3, 578 Junction Road 338 Many Islington residents attend the main foot clinic at Pine street at Finsbury where the total attendances were 15,216. Home Helps The home help area is administered from three area offices in the Division. Each of the three areas covers part of Islington and together cover the whole Borough. The total number of households in the Division receiving home helps on 31st December, 1963 was 1,623. Maternity and Child Welfare Centres- The days and times of sessions are as follows:- CENTRE Ante-Natal & Post Natal Children's Toddlers Dental Diphtheria Immunisation Poliomyelitis Inoculation Smallpox Vaccination North Islington Infant Welfare Centre, (Voluntary) Mon, 2 p.m. Wed. 2p.m. ( 2nd in Mth. ) Wed, 2 p.m Wed. 2 p.m. Wed. 2 p.m. 6-9 Manor Gardens,N.7 Tues. ) Wed, ) 10 a.m. Thurs) Mon, to Frid. 2 p.m. Thurs. 10 a.m. (1st in Mth. ) Thurs)9. 30 a. m, Frid, )& 1. 30p.n Frid. 10 a.m Frid. 10 a.m. Frid 10 a.m. Wed 2 p.m. (mi dwives) Thurs. 2 p.m. (4th week) Frid. 2 p.m. North Branch Clinic- Blythe Mansions, Hornsey Rise, N. 19 Frid, 10 a.m. 2 p.m (mi dwives) Mon. 2 p.m. Tues. 2 p.m Thurs. 2 p m, (3rd in Mth.) Mon 2 p.m Tues. 2 p.m Mon. 2 p.m. Tues. 2 p.m. Mon. 2p.m. Tues. 2 p.m. North Branch Clinic- Co-operative Hall, 129, Seven Sisters Road, N,7 Mon. 2 p.m. Wed. 2 p.m. Frid, 2 p.m. (1st in Mth,) Mon. 2 p. m Wed. 2 p.m Mon. 2 p.m. Wed. 2 p.m. Mon. 2 p.m. Wed. 2 p.m. Archway M & C. W, Centre- Congregational Church, Junction Road, N. 19 Tues, 10 a m. Thurs. 10 a m. & 2 p. m. Mon« 9. 30 a.m ( 2n d & 4 th wk s) Tues. 10 a.m Thurs. 10 a.m & 2 p.m Tues. 10 a.m. Thurs. 10 a.m. & 2 p.m. Tues. 10 a.m. Thurs. 10 a.m. & 2 p.m. West Islington Welfare Centre, 42 & 44, Richmond Avenue, N. 1 Tues. 10 a.m. Thurs, 10 a.m. & 2 p.m. (midwives) Mon ) Tues. ) o _ _ Wed. ) 2 P m* Frid. ) Frid. 10 a.m. Wed. 10 a.m. Mon. 11 a.m Wed. 10 a.m Mon. 11 a.m. Wed. 10 a. m. Mon. 11 a.m. Wed. 10 a.m. West Branch Clinic, Tenants' Clubroom, Hilldrop Estate, N.7 Frid. 10 a.m 2 p.m (midwives) Mon. ) Tues. ) n Wed. ) 1 P-m Thurs) Tues. 11 a.m. Mon. ) Tues. ) 0 Wed ) 2 p'm Thurs) Mon. ) Tues. ) « Wed. ) 2 p m Thurs) Mon. ) Tues.) 0 Wed ) 2 p-m" Thurs) South Islington Welfare Centre 6 Clephane Road, Essex Road, N. 1 Mon. 10 a.m. Tues. ) 2 p.m Thurs )(midwives) Frid. 10 a.m. Mon. 2 p.m. Tues. 10 a m. Wed 10 a.m. & 2 p.m. Frid. 2 p,m Hiurs„ 10 a„m Thurs. 10 a.m. Thurs. 10 a.m. South Branch Clinic, Union Chapel Compton Avenue, N. 1 Tues. ) 1. 30 p m Thurs) Tues, )i Thurs)1"30 P"m Tues. ) t on tl 11. 30 p. m IhursJ r Tues. ), Thurs)1-30 P-m" East Islington Welfare Centre, 32 Drayton Park, N.5 Mon 10 a.m., Wed. 2 p.m. (midwives) & 5.30-6.30p.m Thurs. 2 p.m. Frid. 10 a.m. Tues. 2 p.m. Wed, 10 a m Frid. 2 p m. Tues. 10 a.m. Mon. 2 p.m Mon. 2 p.m. Mon. 2p.m. East Branch Clinic 6 Hurlock Street, N,5 Tues. ) Wed. ) 2 p.m. Thurs) Tues. ) Wed. ) 2 p.m Thurs) Tues. ) Wed, ) 2 p.m. Thurs) Tues. ) Wed. ) 2 p.m Thurs) 92 INDEX Accidents 7,12-13,80 Acute Encephalitis 14 Acute Poliomyelitis 14, 19-20 Aged and infirm Persons 41,82-89 Ante-Natal Clinics 92 Anthrax 14 Atmospheric Pollution 42-7 Bacteriological Examination 33,77,78 Births 4,7,9 Blow-Fly Infestation 41 Cancer - Lung 11 Certificates of Disrepair 38 Chemical Examinations 77,78 Child Minders 90-91 Child Welfare Centres 90,92 Chiropody 89,90 Clean Air Act, 1956 42 -7 Cleansing, Elderly Persons 83-84 Closing Orders 60-1,62 Consumer Protection Act, 1961 37 , 53 Coronary Disease with Angina 12 Crematorium 90 Day Nurseries 90 Deaths 5,6,7, 8,-9-l3, 14-20, 29 Dental Clinics 92 Diphtheria 14, 20-22 Diphtheria Immunisation 22,92 Disinfection 41-2 Disinfestation 41-2 Disinfestation of Sewers 56 Dysentery 14, 25-7 Elderly Persons, Services for 41,82-89 Encephalitis, Acute 14 Enteric Fever 14,24-5 Erysipelas 14 Export Certificates 76 Factories Act 37 , 48-51 Fly Infestation 41 Food and Drugs Act 67-74 Food Hygiene Regulations 69-73 Food - Inspection and Supervision 37 , 64-78 Food - New Legislation 64 Food Poisoning 14, 22 Food Sampling 74,77,78 Food, Unsound 65,74 Foot Clinics 89,90 Poster Mothers and Children 90 Hairdressers & Barbers 54 Health Publicity and Health Education 79-78 Holidays for Elderly Persons 88 Home Helps 90 Home Safety committee 79-80 Home Visiting 33 Housing 37, 59-63 Ice Cream 77 Illegitimate Infants - Births and Deaths 4,9 improvement Grants 63 Infant Mortality 5,8,10 Infectious Diseases 14-33,37, 41 Influenza, Pneumonia and Bronchitis 10,14 Inoculation, etc. Certificates 16 Laundry Services 83-84 Lead Poisoning, 23 Legal Proceedings 37,39-41, 45,63,69-73 Live Births 4,7,9 L. C. C. (General Powers) Acts, 39,54 M & C, W. Services 90-92 Malaria 14 Management Orders 63 Marriages 4,7 Mass X-ray 11,31 Maternal Mortality 5,7,10 "Meals on Wheels" 88 Measles 14, 16-17,18,19 Meat 74-75 Meningococcal Infection 14 Merchandise Marks 76 Metropolitan Cattle Market 74 Milk 78 Milk and Dairies Regulations 78 Milk (Special Designations) 78 Miscellaneous Services 79-92 Mortuary 90 Multiple Occupation, Houses in 59-60 National Assistance Acts 37,86-89 Neoplasms, Malignant 7, ll Noise Abatement Act, 1960 51-2 Noise Nuisance 37,51-2 Nurseries - Day 90 Offensive Trades 52-3 Ophthalmia Neonatorum 14 Outworkers 37,49-50 Overcrowding 63 Pet Animals Act 37 Pharmacy and Poisons Actg, etc. 53 eumonia 10,14 Poliomyelitis 14,19-20 Poliomyelitis,Protection Against 19,20,92 Population 4,7,9 Post-Natal Clinics 92 Premature Infants 8 Preserved Food Premises 68,69 Prevention of Damage by Pests Act and Order 37 , 54-6 Public Health Committee 1 Public Health Inspectors - District Work 37-41 Public Health Inspectors - Special Work 48-54 Public Health (London) Act Improvements effected 37-38 Public Health (London) Act, Sections 40 and 109 39 Public Health Officers 1- 3 Public Health (Tuberculosis) Regulations 1952 29-30 Publicity 81-82 Puerperal Pyrexia 14 Rag Flock and Other Filling Materials Act 53 Rats and Mice 54-6 Refreshment and Coffee Stalls 76 Rent Act, 1957 38 Respiratory Infections 10 Sampling 74, 77,78 Sanitary Circumstances 34-58 Scabies 14, 32-3 Scarlet Fever 14 Sewer Treatments 56 Shops Ac;, 1950 54 Slum Clearance Areas 59 Smallpox 14,15-16 Smoke 42-7 Snake Control Areas 43-4 Smoking and Health 11,81 Staff 1-3 Static Water Tanks, etc 42 Statistics - General & Vital 4-13 Still-Births 4,7 Swimming Baths 57 Toddlers' Clinics 90,92 Town & Country Planning 63 Treatment Centre 32,84-85 Tuberculosis 7,10,14,29-32 Tuberculosis - Beds and Bedding 32 Tuberculosis - Care Committee 32 Tuberculosis - Chest Clinics 30 Tuberculosis - Deaths 7,14,29 Tuberculosis Notifications 7, 1, 29 Typhoid Fever 14,24-5 Underground Bakehouses 51,67 Vaccination 15-16,19,92 Vermin 14, 32-3,41 Washing Facilities, Free 76-7 Water Supplies 56-8 Welfare Centres 90,92 Whooping Cough 14,16,18-19 Work Centre for the Elderly 89 Washing Facilities, Free 76-7 Water Supplies 56-8 Welfare Centres 90,92 Whooping Cough 14,16,18-19 Work Centre for the Elderly 89