STPM 10 METROPOLITAN BOROUGH OF SAINT PANCRAS ANNUAL REPORT (Abridged) on the HEALTH OF THE BOROUGH for the year 1944 DENNIS H. GEFFEN M.D. , E. S. , D.P.H., M.R.C.S., L.R.C.P., MEDICAL OFFICER OF HEALTH To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Saint Pancras. Your Worship, Ladles and Gentlemen, I have pleasure in presenting to you my first Annual Report upon the conditions of health in the Metropolitan Borough of St. Pancras. In accordance with instructions received from the Ministry of Health this report in in an abridged form and is chiefly a compilation of statistical Information. In that I commenced duties In the middle of October it will be realised that most of the Information contained herein concerns matters that occurred before my appointment, and there have only been months upon which I can speak from personal knowledge. Although this report is for the year 1944 it is nevertheless written In the latter part of 1945 and it is impossible to be unbiased by matters that have arisen in this year marked by peace not only in Europe, but throughout the world, for there can be no excuse now for postponing the planning of those services which are essential to the health of the district. Before the end of 1944 it became apparent to me that one could not expect to see St. Pancras the healthy borough it should be unless it was realised that the paramount need of its citizens was adequate housing, a fact well recognised not only by the Health Committee, but also by the Housing Committee and every member of the Council. So much was this the case that I was asked as one of my first tasks to carry out a survey of the condition of the property in the whole borough. This survey showed that there were approximately 25,500 dwellings of which roughly 18,000 were houses and 7,500 self-contained flats. These dwellings were divided into those which were In such a condition that they should be demolished within 10 years, those that should be demolished within 20 years and 30 years and those with a satisfactory life of over 30 years. No less than 6,000 dwellings were such that they should be demolished on grounds of health and structure within the next 10 years, i.e. nearly one quarter of the property of the borough. Approximately 5,000 had a reasonable life of 10/20 years and 4,500 with a life of 2O/3O years, leaving approximately 10,000 dwellings with a satisfactory life of over 30 years and this Included most of the self-contained flats. This gives some idea of the problem - the primary problem which on grounds of health must receive the consideration of the Council. It would appear that within 20 years over 40% of the borough should be rebuilt. page 2 During this survey an attempt was also made to ascertain the extent to which dwellings could be so converted as to provide healthy accommodation, and by this is meant separate flats or maisonettes consisting of three bedrooms, a living-room, a kltchpn, bathroom and W.C. The figures showed that dealing with houses of a life of over 10 years, suitable conversion could provide 20,000 such units and as an immediate step to relieve unsatisfactory housing in the borough this may be considered to be the quickest method. Admittedly this is but a system of alleviation, but even alleviation is worth while in a borough where many houses ore let in floors to separate families - where two rooms with a water tap on a staircase landing and a gas-cooker outside a room and a W.C. on another floor, sometimes several floors below, often provides all the accommodation for a family of a mother and father and several children. I make no excuse in this report on health conditions in the district by commencing with a review of the housing situation as I have seen it since I became your Medical Officer of Health, St. Pancras Is no new borough to me. I was trained within Its precincts and I learned my midwifery within its small houses. Many years ago I realised that most of the.health services provided for a community will have their value seriously diminished unless the population be adequately housed. The type of house that will be provided, or alternately that is required, is a matter of interest and accordingly, a survey was requested which should show what, generally, are the desires of the St. Pancras citizens. Do they work in the borough or outside; do they wish to live in the borough or outside; do they want a house Or a flat; what is the size of family; how many rooms do they need; and how are individual houses occupied ? This survey is at present being carried out. It will not, of course, Include the whole borough; it will be a sample survey, but should give some indication of ,vhat type of housing is required and possibly enable us to estimate the number of individual families in the borough who are entitled to separate housing accommodation. There is but little doubt that the healthiest type of home for a family is that which provides a separate house with a garden. In St. Pancras this may be economically impracticable but if this be so it, nevertheless, is an indication that the space in flats must approximate to that provided in individual houses for.those who live in less crowded areas where land is of lower monetary value. It might indeed be argued that on grounds of health, flat dwellers need even more space than those provided with Individual houses. Page 3 Towards ttfe end of the year I also commenced an inspection of certain areas of the borough which it was considered might be suitable fir representation to the Council as clearance areas under part 3 of the Housing Act of 1936. As housing proceeds apace it is essential that steps shall be taken to secure that slums are not allowed to exist side by side with healthy new housing development - to breed an unhealthy discontented population. Housing must be associated with the eradication of slums. During the month of Novenber an outbreak of foodpoisoning occurred which involved 123 persons. The source of trouble was noon discovered and the outbreak controlled. The illness in no case was serious, recovery being rapid. There were no fatalities. The increase in the number of illegitimate children in the country has caused concern and each welfare authority has been asked to give the matter particular consideration. A scheme was devised for London as a whole following upon deliberations of the Metropolitan Boroughs Standing Joint Committee. It was advised there should be an increased contribution to the various voluntary associations dealing with this problem and that there should be a unified payment to mothers prepared to foster illegitimate children. This payment was determined at 17/6d per week for a child under a year and 15/- thereafter until the child attained the age of 5 years. Payment may be made direct to the foster mother by the local authority, recovery in part or whole being made from the child's natural mother on a basis agreed throughout the county. St. Pancras has adopted this scheme. The trouble, however, lies in inability to find foster mothers and this not only for illegitimate children, but for other children whose mothers are unable to look after them themselves. It is generally agreed that the legislation covering the care of foster children is unsatisfactory at the present moment. Any woman may receive a foster child for gain provided she gives prior notification to the local authority. If the local authority is not satisfied its remedy is to apply to a magistrate to have the child removed to a place of safety or that it be returned to its mother. There is no doubt that it is advisable that prospective foster mothers should not be allowed to accept children until they have received the consent of the local authority following upon satisfactory investigations concerning the person and her home and it is hoped that the Government Committee considering the care of children looked after away from their parents will give, this matter primary consideration. The nurseries of the borough are called "war-time nurseries" and there is fear, therefore, that they may soon page 4. cease to function. The eight war-time nurseries together with four admitting children 2/5 years at the L.C.C. Rest Centres, provided accommodation for 597 children a day. At the time of writing this report, however, the waiting list for our nurseries is over 300. There has been considerable argument as to the need and the value of nurseries for children under 2 or 3 years of age. I would like to deal with only one of the many arguments which has been put forth against such provision, namely that the best place for a child of tender years ia at home with its mother. This may be so, provided that the mother has reasonable knowledge of the care of children, sufficient money to provide for their welfare and above all accommodation in which they can grow up to be healthy citizens. This argument is not tenable for one moment where life is lived by a large family in two or even three tenement rooms. Whatever may be the pros and cons elsewhere, I have no hesitation in stating that nurseries are essential in St. Pancras now and until such time as we have dealt with our housing problem. Whether children are healthier at home with their parents than in a nursery, or not, is an argument that may be of Importance elsewhere, but in St. Pancras it is reasonable to expect that the health of a child whose mother has to work and who lives in unsatisfactory housing conditions will improve as a result of admission to a well run, well staffed, nursery. During the course of the year I have also had to consider the plight of elderly persons unable to care for themselves. StT Pancras contains a large number of these persons living alone with but few, if any relatives or friends to care for them or help them. It is possible to apply to a magistrate for an order for their admission for three months to an Institution. Unfortunately, if the order is not obeyed, there is no power to enforce it except that anyone obstructing the execution of the order is liable to a fine, a remedy which is useless in the case of aged persons who have no means of paying the fine and for whom imprisonment in default thereof, is unthinkable. In future considerations of housing in the borough attention should be paid to the proper care and attention of these aged and infirm persons who although no longer able to look after themselves, need care and attention of a kind somewhat different from that provided in an Institution, a care and attention which must be given without infringement of liberty or their capacity to go out by themselves and to visit those friends they still have. The statistics I have placed before you in this report show comparisons from 1939 onwards. Although our population has diminished considerably there has been such an increase in. the birth rate that the number of births during 1944 was only 273 less than in 1939 when the population was over 60,000 more. page 5. This must be an indication that if the population of St. Pancras increases with the return of our men and women from the services there will be an additional need for an intensification of Maternity and Child Welfare services. The infantile mortality rate has fallen from 71 per thousand in 1943 to 64 in 1944, but in 1939 it was only 52. It is hardly for me after so short a period to comment on the health of the borough compared to its standard before and during the war, but I know I am Justified in saying that for an area that has suffered so badly from war damage as St. Pancras and where housing conditions are so bad, it is at least surprising and indeed a source of congratulation that by and large the health of the district has been maintained at a standard comparable with that throughout the country. I know I Join with every member of the Council in looking forward to. years of peace in which v/e shall see the growth, of first class health services in the borough and I believe that now Is the time when land should be chosen and a plan agreed for the future. The health of a district depends largely upon the kindness and enthusiasm of its general practitioners, to whom in the first place it is customary for the public to go with their fears of disease and their problems of health. It is only fitting that in this report there should be an acknowledgment of the services that the general practitioners of St. Pancras have rendered in this past year and in particular during the war years when they helped not only at our Centres and Clinics but at our First Aid Posts and our Shelters. Their availability at all times in years of strain and over-work Is deserving of the deepest gratitude of the borough. For their welcome to me and their co-operation I am also deeply grateful. I would ask the members of the Health Committee and of the Council generally, to accept my sincere thanks for the cordial welcome they have given me to the borough and for the courtesy I have received from them. I would also extend the same thanks to my colleagues for their assistance and co-operation. Lastly, this report would not be complete without acknowledging the help of my staff, so much appreciated In the difficult task of commencing my duties. I an, your Worship, Ladies and Gentlemen, Your obedient servant, DENNIS H. GEFFEN Medical Officer of Health. page 6 STATISTICS FOR THE YEAR 1944 POPULATION The civilian population, as estimated by the Registrar General, in the middle of the year was:- 105,780 The following table shows the varying population during the preceding five years - 1939 167,300 1942 - 105,900 1940 133,200 1943 - 108,640 1941 103,770 1944 - 105,780 LIVE BIRTHS M F TOTAL RATE per 1,000 of estimated population Legitimate 870 757 1627 Illegitimate 146 287 1016 898 1914 18.1 Year 1939 2187 12.3 1940 1948 14.6 Comparable figures for preceding five years 1941 1434 13.8 1942 1785 16.9 1943 1836 16.9 1944 1914 18.1 STILL BIRTHS M F TOTAL RATE per 1,000 Live and Still Births Legitimate 24 22 46 Illegitimate 9 4 13 12 26 52 29.9 Year 1939 60 26.7 1940 66 32.8 Comparable figures for preceding five years - 1941 34 23.2 1942 48 26.2 1943 47 25.0 1944 59 29.9 DEATHS - All Apres M F TOTAL Death Rate per 1,000 of estimated population 1096 905 2001 18.9 Year 1939 2170 13.0 1940 2728 20.5 Comparable figures for preceding five years - 1941 2055 19.8 1942 1730 16.3 1943 1842 17.0 1944 2001 18.9 Page 7 DEATHS FROM PUERPERAL CAUSES Deaths RATE per 1,000 Live and Still Births TOTAL Puerperal Sepsis 2 Sepsis 1 Other causes Other puerperal causes 4 1.01 2.03 3.04 Year 1939 3 l.33 1940 6 2.98 Comparable figures 1941 4 2.72 for preceding five 1942 8 4.36 years 1943 1 0.53 1944 6 3.04 DEATH RATE OF INFANTS UNDER 1 YEAR OF AGE All infanta per 1,000 live births 64 Legitimate Infants per 1,000 legitimate live birth3 57 Illegitimate infants per 1,000 Illegitimate live births 105 Year All Infants Legitimate Illegitimate 1939 46 54 1940 56 52 Comparable rates 1941 51 52 44 for preceding 1942 66 59 117 five years - 1943 71 66 99 1944 64 57 105 DEATHS FROM TUBERCULOSIS - All Acea Death Rate per 1,000 of estimated population Pulmonary 115 1.09 Other forma 13 0.12 128 Total 1.21 Year No.of Deaths TOTAL 1939 130 0.77 1940 160 1.20 Comparable figures 1941 123 1.18 for preceding five 1942 147 1.39 years - 1943 117 1.08 1944 123 1.21 NOTIFICATIONS OF BIRTHS The number of births notified as having taken place in the Borough during 1944 was 2,165. The number of births of non-residents equalled, 1,264, and information was received in respect of 799 births occuring outside the Borough. page 8 CLASSIFICATION OF DEATHS, WITH AGE DISTRIBUTION Causes of death Ages - Both Sexes Under 1 year 1 and under 5 5 and under 15 5 and undeb45 45 and under 65 65 and upwards Totals M F ALL CAUSES 123 21 25 222 584 1026 1O96 905 1. Typhoid & paratyphoid . . 1 . . . 1 . 2. Cerebro-spinal fever . . . 1 . . 1 . 3.carlet fever . . . . . . . 4. Whooping cough 2 4 . . . . 4 2 5. Diphtheria . 1 1 . . . 2 . 6.Tuberculosis of respiratory system . . 1 48 51 15 76 39 7. Other forms of Tuberculosis . 2 2 7 2 . 6 7 8. Syphilitic diseases . . . 1 9 3 9 5 9. Influenza . . . 1 3 7 4 7 10. Measles . . . . . . . . 11.Ac.poliomyelitis & polioencephalitis . . . . . . . . 12. Ac. Infectious encephalitis . . . 1 1 . 2 . 13. Cancer - buccal cavity and Oesoph (M); Uterus (F) . . . 4 11 20 23 12 14. Cancer - stomach & duodenum . • . 8 25 23 40 16 15.Cancer - breast . • . 2 12 7 . 21 l6.Cancer - all other sites . 1 . 7 92 82 109 73 17. Diabetes . . . . 4 3 5 2 18. Intracranial vascular lesions . . . 3 36 103 67 75 19. Heart diseases . . . 13 99 346 220 238 20. Other circulatory diseases . • . 2 16 48 39 27 21. Bronchitis 3 1 . 2 43 109 99 59 22. Pneumonia 21 2 . 5 29 80 77 60 23. Other respiratory diseasee 1 1 . 1 5 8 9 7 24. Ulcer - stomach or duodenum . . . 3 19 12 31 3 25. Diarrhoea (under 2 years) 20 2 . . . . 13 9 26. Appendicitis • 1 . 1 2 4 7 1 27. Other digestive diseases • 1 1 . . 7 13 25 17 29 28. Nephritis • . . 5 12 10 15 12 29. Puerperal & post-abortive sepsis • . . 2 . . . 2 30. Other maternal causes . . . 4 . . . 4 31. Premature birth 25 . . . . . 15 10 32. Congenital malformations, birth injury & infant diseases 30 . . 1 3 1 17 18 33. Suicide • . . 5 8 3 12 4 34. Road traffic accidents • . 2 . 4 2 6 2 35. Other violent causes 7 2 16 77 54 50 103 103 36. All other causes 12 4 2 11 31 65 67 58 page 9 Infant Mortality Deaths from stated causes with Ward distribution Cause of Death 1 2 3 4 5 6 7 8 No address Totals Whooping cough 1 1 2 Septicaemia l 1 Badsillary dysentery 1 1 Congenital syphilis 1 1 Meningitis 1 1 Bronchitis l 2 3 Broncho-pneumonia 2 3 5 1 2 2 1 4 20 Pneumonia (not stated) 1 1 Enteritis 8 3 7 1 1 20 Congenital malformation 2 2 3 2 1 3 13 Premature birth 5 8 1 4 2 5 25 Injury at birth 4 1 1 1 7 Atelectasis 4 1 1 6 Other diseases peculiar to 1st year of life 2 2 4 Lack of care of newborn 1 Other violence 1 2 1 1 1 6 Other causes 1 2 3 2 2 1 11 Totals 27 13 33 6 8 11 7 16 2 123 Maternal Mortality All causes - per 1,000 live and still births 3.04 page 10 PROVISION OF HEALTH SERVICE3 IN THE BOROUGH Treatment Centres and Clinics Expectant Mothers Children Total consultations Total Attendances Consultations Consultations Under 1 1—5 Totall St.Pancras School for Mothers (Ampthill Square) 24 265 149 2021 1047 3068 Camden Town - 60 935 250 3253 1624 4377 Kentish Town - 85 1008 549 41PM • 1629 5757 North St.Pancras School fur Mothers (Queens Crescent) 76 852 150 3945 973 4918 Scmers Town - 15 194 1 128 1997 1l55 3132 South Highgate - 12 143 103 2610 1353 3963 University College Hospital - 203 2596 103 382 241 623 Royal Free Hospital 148 509 97 87 25 112 Totals 623 6502 1129 18,423 8027 26,450 Artificial Light treatment (south Highgate Centre)* - - 83 111 11554 I665 Dental Treatment Ampthill Square Camden Town* Sessions Attendances - Mothers Children 29 225 81 83 818 151 The Borough Council also made a contribution, during the year of £113. Us. towards the total cost of 233.2s. for aentures supplied to Nursing and Expectant Mothers. Gynaecological Clinic Sessions are held weekly, and during The year there were 297 attendances, of which 126 new cases received attention. Page 11 Health Visitors The total number of visits made by Health Visitors are as follows:- Council's U.C.Hospital TOTAL To Expectant mothers 3,677 92 3,769 Post-Natal 801 14 815 Children 18,347 883 19,230 Child Life Protection 187 26 213 Infectious diseases &c. 1,335 24 1,409 Other visits 2,454 61 2,515 23,851 1,100 24,951 Nursing In the Home The following District Nursing Associations undertake the nursing of cases of illness occuring in expectant and nursing Mothers and children under 5 year3 of age. An annual block grant is made to each Association in respect of nursing for certain specified diseases:- Block Grant Number of Cases Visits Hainpstead Metropolitan North London £ 30 250 25 53 113 28 194 747 1,498 157 2,4.02 Invalid Chlldrens' Aid Association Under this Scheme, assistance was rendered towards the cost of convalescence of St. Pancras children under the age of 5 year?, with a maximum of 50 cases. The financial arrangements provided for 8 payment of 75f° of the nett deficit outstanding after allowing for any payments by parents. During 1S44 - 27 children were so dealt with. Home Helps This Scheme was operated with the assistance of an Annual Grant of £2^0 from the Borough Council, for use in maternity cases only. The number of applications for assistance was 74 of which 42 were given help - 37 for maternity cases and 5 for 3icknes3. The balance of 32 cases for assistance were dealt with in various ways such as by arrangements made by or on behalf of the applicant or by admission to a Hospital. page 12 Midwifery Grants By arrangements with certain Hospitals, assistance is accorded to expectant mothers by the Council's payment of £1 per case to the Hospital admitting the patient. This financial assistance is only granted in approved necessitous cases. Provision Is also made to the University College Hospital by a payment of an agreed sum in respect of the use of an Emergency Obstretric Unit. Provision of Beds for Maternity Cases The London County Council made arrangements for a small number of beds to be available fcr St. Pancras cases in two of the London Hospitals. The University (jollege Hospital providing 8, and the Westminster Hospital 5. Dally Guardians At the end of the year there were 8 persons having the care of children under this Scheme, and the total number of visits made were. 130. Payments to the Guardian for the care of children are made by the Ministry of Labour through the local Labour Exchanges, after the Borough Council has approved such Guardian and supplied the necessary particulars on prescribed Forms to the Labour Exchange. Wartime Day Nurseries There were eight of these Nurseries in the Borough admitting children 0 to 5 years, and four others admitting children aged 2 to 5 years and sited at the London County Council Rest Centres. These Nurseries provided accommodation for a total of 597 children, Plphtherla Immunisation THef immunisation of children is carried out by general practitioners; at the Council's Welfare Centres and Wartime Day Nurseries, also by the London County Council Medical Officers at their day schools. During the year 1,172 children were recorded as immunised through the various channels mentioned, and the complete total of St, Pancras children of all ages immunised since the Scheme commenced, amount to 8,144 SmaJ 1-pox and Vaccina~lon The number of births dealt with by the Vaccination Officer during 1943 totalled 1,698 of which number 971(57.2%) were successfully vaccinated. Figures for 1944 are not yet available. Comparable percentages of vaccinations for 1939, 1940, 1941 and 1942 were 41.8%; 33.4%; 43.6% and 54.7% respectively. Page 12 SANITARY CIRCUMSTANCES IN THE BOROUGH Work carried out by Sanitary Inspectors Vicing and Inspections, including re-inspections, to a total of 27,407 were made by 15 of the staff. Of this figure 4,958 were made by the 2 Food Inspectors and 6,473 by the 2 Factory Inspectors. A total of 1,473 Intimation Notices, including 317 by the Factory Inspectors; 435 Statutory Notices and 7 Notices under the Rent Restriction Act were served during the year. No Notices were served under the Shops Act. Under the Public Health (London) Act 193& there were 9 prosecutions in respect of general sanitary work, and 2 under the London County Council By-Laws made under the Housing Act (Section 6). The removal to a home or Institution of certain aged, diseased or infirm persons is authorised under Section 224 of the Public Health (London) Act of 1936. During the year 1 person (male) was so dealt with. Work in connection with first-aid repairs to war damaged houses was continued in this Department to 31st May 1944, following which date the duties Involved were transferred to the Highways, Sewers & Public Works Department. The transfer included the services of the Housing Inspector and 1 Sanitary Inspector together with the staff of Technical Assistants. During the period January to May a total of 10,585 visits, including 919 first visits, were made. Infectious Diseases Notifications Comparable totals for 1943 Under 1 1 & Over Total Acute Influenzal pneumonia 2 32 34 44 Acute primary pneumonia 6 83 89 79 Anterior poliomyelitis & polioencephalitis _ _ _ 3 Cerebro-spinal meningitis _ 10 10 5 Diphtheria & Membranous group 1 57 58 99 Dysentery 11 45 56 31 Encephalitis lethargica _ 2 2 _ Enteric or typhoid fever _ 1 1 2 Erysipelas 2 54 56 72 Food poisoning — 3 3 15 Malaria _ 2 2 1 Measles 50 748 798 1082 Ophthalmia neonatorum 6 6 12 Puerperal fever _ 16 16 6 Puerperal pyrexia _ 27 27 32 Scabies 11 920 931 546 x Scarlatina or Scarlet fever 2 182 184 408 Smallpox — — _ — Whooping cough 97 478 575 439 X represents 5 months only page 14 Infectious Diseases - Continued It .was subsequently ascertained that the following notifications which are included in the preceding table, were not regarded as cases of the disease as originally diagnosed - Cerebro-spinal meningitis Diphthoria & membranous group Dysentery Measles Scarlatina or Scarlet Fever Whooping cough Under 1 - 1 3 3 2 6 Over 1 2 23 9 21 29 5 TOTAL 2 24 12 24 31 11 Cleansing Station number of attendances at the Camley Street Cleansing station show a decrease as against figures for the preceding year, the years totals being as follows - SCABIES Men Women Children under 5 School Children TOTAL St.Pancras 444 686 263 702 2,095 Ex St.Pancras 15 49 - 208 272 459 735 263 910 2,367 In order to assist with the treatment of scabies cases, arrangements were made with the Middlesex, Royal Free and University College Hospitals, and the persons attending were - Middlesex Royal Free University College TOTAL 395 6 355 757 VERMIN Men Women Children under 5 School Children TOTAL St.Pancras 1014 189 69 1635 2,907 Ex St.Pancras 50 19 _ 440 509 1O64 208 69 2075 3,416 The number of Head Cleansings included in the foregoing figures were - Men Women Children under 5 School Children TOTAL St. Pancras - 185 68 1635 1, 888 Ex St.Pancras - 18 - 440 458 - 203 68 2075 2,346 page 15 Disinfection and Dlslnfestatlon The number of articles dealt with or destroyed at Camley Street on account of verminous conditions and infectious diseases were - Destroyed 182 Disinfected or Dislnfested 13,131 of which 2,478 were A.R.P. Figures set out below show the number of Houses, Rooms, &c. dealt with after infectious diseases or following complaints of vermin - Number of cases Number of 1 houses No. of rooms 'sprayed or fumigated A. R. P. premises sprayed or fumigated Cerebro-spinal meningitis 11 11 15 - Diphtheria 53 53 41 2 Dysentery 33 33 29 1 Enteric fever - - - - Erysipelas 52 51 49 Measles 34 11 15 3 Pneumonia 3 - - - Polio-myelitis - — - - Puerperal fever 8 8 8 - Puerperal pyrexia - - - - Scabies 64 28 2 1 Scarlet fever 314 186 169 3 Tuberculosis 101 95 92 - Vermin 484 297 518 14 4 Other diseases 151 28 63 page 16 Rat Extermination During 1944 a considerable amount of successful work was undertaken in connection with the extermination of rats, and the Scheme has proved popular, both among business firms and the occupiers of private dwellings. One sewer treatment was given in which approximately 3,000 rats were killed, It would appear from the demand made by the pubic for assistance in rat extermination that this is a service of the Council which has come to stop and even increase. Housing Work under the Housing Act 1936 was suspended owing to the War, but a number of re-housing applications were dealt with by having such promts inspected and the appropriate prescribed form forwarded to the London County Council. The number of applicants for re-housing owing to overcrowding were lb, and because of tuberculosis in the family - 23. Mortuary The number of cases dealt with at the Camley Street Mortuary during the year were:- Bodies received Inquests Post-Mortems St. Pancras 222 104 221 Ex St.Pancras 391 367 38b No Address _34 21 28 647 X 422 635 X Includes 320 Ex St.Pancras cases living and dying out of the Borough and on which 316 Inquests were held. Page 17 INSPECTION AND SUPERVISION OF FOOD Milk Supply Number of premises at the end of the year on the Register were:- Dairies 144 Itinerant purveyors 64 Sealed containers only 200 The Inspectona made 794 visits and 300 formal samples were taken and submitted for analysis. Milk (Special Peslunation,3) Regulations 19?b to 1943 The number of licences granted during 1944 were:- Licences SupdIementary Tuberculin Tested 20 6 Accredited 1 — pasteurised 50 9 Heat and Other Food9 (1) Public Health (Meat) Regulations 1924 Periodical visits of inspection were made as follows:- Slaughter Houses 11 Meat Depots 273 Butchers' Shops & Meat Stalls 683 Prepared Meat premises 396 (ii) Inspection of ether premises where focd is Prepared or offered for sale Tiie Food inspectors have continued to keep all such premises under regular and frequent cbssrvation, 778 inspections being made for thic purpose, Adulterations & prosecutions A total of 800 samples (399 formal and 401 informal) were sent for analysis, of which 11 formal and 10 Informal were found to be adulterated. Prosecutions in 6 cases were undertaken under the Food & Drugs Act 1938 - 3 in respect of Milk and 3 for other adulterated foods. page 18 TUBERCULOSIS Tuberculosis Dispensary The number of definite cases of tuberculosis on the Dispensary Register at the end of the year was: — Pulmonary Non-Pulmonary TOTALS Adults Children Adults Children Adults Children M F M F M F M F M F M F 403 243 39 17 39 30 33 17 442 281 72 34 Total attendances 3,405 Visits by Tuberculosis Visitors 2,435 X-Ray Examinations 853 Sputum Examinations 473 A.P.Refills 2,045 Admissions to Institutions 363 NEW CASES DEATHS Pulmonary NonPulmooary Pulmonary NonPulmonary M F M F M F M F PrUmary Notifitations 156 105 16 18 Death Reports 10 3 3 . Transfers 26 20 1 1 J Other sources . . . . AGES 0 1 . . . . 1 6 1 1 2 . . . 2 5 9 5 7 4 . 1 1 1 15 34 61 3 6 4 11 1 3 25 46 23 3 3 8 9 . 1 35 20 20 1 1 8 8 2 I 45 31 11 1 . 20 5 1 . 55 36 3 3 1 24 2 1 . 65 and upwards 110 4 . 1 12 3 • . TOTALS - •192 128 19 19 76 39 6 7 Comparable figures for 19435- 167 105 24 20 80 31 2 4 Notification Register on 31st December 1944 Pulmonary 913 Non-Pulmonary 154 Comparable figures for 1943:- 834 148 Page 19 Maintenance Allowance These allowances were Introduced in July 1943. The following table shows the number of new patients assessed and the type of allowance (if any) granted from January 1st to December JIbX 1944 - Standard Allowance only Standard and Discretionary Standard and Special Standard and Discretlonary and Spe Speclv. 1 Allowance only Discret1onary and _ PpciUi omv Discre tionary only RefU3ed Allowance TOTAL $ Includes 4 adjourned for more information o2 24 2 1 - 20 — — 22 X 150 Comparable figures for 1943 - 61 32 - 31 - 29 - 155 X In addition 1,129 re-assessments of these and previous cases have been made. TUberculosls Care Committee Income from Seal Sales and other sources - £186. 2.3d. expenditure on clothing, coal, removals, pocket money &c. for patients - £169.10. 3d; Extra Nourishment (provided by the Borough Council) cost £435' 19. 3d; The number of patients - 78. Dental treatment (provided by the Council) cost £28. 11. 6d., the number patients so provided being 5. BACTERIOLOGICAL EXAMINATIONS Positive Negative TOTAL Diphtheria bacilli 6 346 352 Tubercle bacilli 6 95 101 Others - 12 12 12 453 465