LIBRARY AC 4355 STPAN 102 Metropolitan Borough of Saint Pancras. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1947 DENNIS H. GEFFEN, m.d., b.s., m.r.c.s., l.r.c.p., d.p.h., Medical Officer of Health. printed by harrison and sons, ltd., st. martin's lane, london (4626/48) Metropolitan Borough of Saint Pancras. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1947 DENNIS H. GEFFEN, m.d., b.s., m.r.c.s., l.r.c.p., d.p.h., Medical Officer of Health. CONTENTS. Introductory 4-8 Committees and Officers 9-11 Section 1.—General Information 12-16 Section 2.—Population, Births and Deaths 17-25 Section 3.—Notifiable Diseases 26-36 Section 4.—Sanitary Circumstances of the Area 37-46 Section 5.—Factories, &c 46-48 Section 6.—Inspection and Supervision of Food 49-53 Section 7.—Maternity and Child Welfare 54-60 Section 8.—Tuberculosis 61-71 3 INDEX. PAGES Acute influenzal pneumonia 27 Acute primary pneumonia 27 Ambulance facilities 14 Analyst, Public 11 Anterior poliomyelitis and polioencephalitis 27 Area of Borough, wards, open spaces 12 Bacteriological examinations 33, 50 Bakehouses 46 Births— illegitimate 23 notification of 18 rates 17 registered live 17 registered still, and rate 17,23,24 Bodies received at mortuary 25 Cerebro-spinal meningitis 28 Chief Officers of the Council 9 Child guidance 59 Child life protection 58 Children, illegitimate, care of 59 Chiropody clinics 59 Cleansing and distinfecting station 33 Cleansing station attendances 35 Clerical staff 10 Climatological summary 16 Committees, members of 9 Condemned food 53 Coroner's court 25 Daily guardians 58 Day nurseries 13, 59 Day nursereis staff 11 Deaths— classification, with age distribution 19 illegitimate 23 infantile, with causes, age and ward distribution 20, 21 infants under 1 year 18, 20 number and rate, all ages 18 puerperal . * 24 tuberculosis 25 Dental treatment 54 Diphtheria 28 Diphtheria immunisation 28 Disinfection 33, 35 District Nursing Associations 56 Dysentery 29 Encephalitis lethargica 29 Enteric or typhoid fever 29 Erysipelas 29 Factory inspectors, visits by 46,47 Food— condemned 53 inspectors, visits by 49 poisoning 30 sampling 50 summonses 52 unsound 53 Foot clinics 59 Foreword by M.O.H. 4 Health visitors 11,54 Health visitors, visits by 54 Home helps 57 Home nursing 56 Hospitals in the Borough 13 Housing applications 45 Icecream 51 Illegitimate children, care of 59 Infantile mortality— causes, age and ward distribution 20 fate 18 causes, since 1939 21 Infectious diseases 27 Inspectors, district, factory, food, housing 10 Inquests 25 Insulin 15 Invalid Children's Aid Association 57 Legal proceedings 38, 52 Malaria 30 Maternal mortality 24 Maternity and child welfare— centres 13 committee members 9 (4626) PAGES Maternity and child welfare—continued. sessions and attendances 55 staff . . 11 Maternity cases—beds 57 Measles 30, 31 Meat and other foods—inspections made 50 Medical staff 10 Midwifery grants 56 Milk- bacteriological examinations 50 licences granted 50 purveyors on register 49 Mortuary and Coroner's court 25 Notifiable diseases 26 Notifications— births 18 infectious diseases 27 Nurseries, day 13, 59 Nursing, home 56 Ophthalmia neonatorum 31 Outworkers 48 Pneumonia 27 Population and Borough statistics 17 Post-mortems 25 Premature infants, care of 58 Public Analyst 11 Public Health— Committee members 9 (Tuberculosis) Regulations, 1925 66 1930 63 Public vaccinators 11 Puerperal fever and pyrexia 31 Rat extermination 36 Sanitary inspectors 10 Sanitary inspectors, visits by 37 Scabies 31 Scarlet fever 32 Smallpox and vaccination 32 Social welfare 15 Staff— clerical 10 maternity and child welfare 11,54 medical 10 nursery 11 tuberculosis 11 Statistics, vital 13, 22 Statistics, vital, from 1918 22 Stillbirths 23 Tuberculosis— artificial pneumothorax 68 boarding out of contacts 71 Care Committee 69 deaths 61,62,65 dental treatment 70 dispensary . . 13 dispensary staff 11 expenditure of Care Committee 71 extra nourishment 70 figures for past 10 years 64 finsen light 68 housing 70 institutional treatment 66 maintenance allowances 70 new cases 61, 66 notifications 64 prevalence and fatality 64 sessions 66 social welfare 69 visits by Health Visitors 68 work carried out, report on 66 work carried out, summary 67 X-ray examinations 68 Typhoid or enteric fever 29 Unsound food 53 Vaccination 32 Vaccinators, public 11 Verminous persons 34 Vital statistics 13, 22 Water 45 Welfare Centres 13 Whooping cough 33 a 2 4 Town Hall, Euston Road, N.W.I. 1th July, 1948. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Saint Pancras. Your Worship, Ladies and Gentlemen, I beg to place before you my annual report upon the conditions of health and sanitation in the Metropolitan Borough of Saint Pancras during the year 1947, this being the fourth annual report it has been my privilege to present. Once again I propose in my opening remarks to call attention to the actual environmental factors which are influencing the health and comfort of the residents of the borough. The coming year will see certain responsibilities in connection with the care of individuals pass from the hands of the borough council, and this has somewhat clouded our appreciation of the primary aim and object of a public health department. This primary object is the preservation of the health of the community by raising the standard of living and by educating the public in the ways of health. The coming into operation of the National Health Service Act on 5th July, 1948, does not take away from the borough council its responsibility for preserving the health of the 136,700 persons who live in the borough. Nor does it relieve the Council's Officers of their responsibility in this respect. It has been the privilege of the Metropolitan borough councils to build up maternity and child welfare, home help and domestic help schemes, and to care for the tuberculous in their own homes. In the provision of these services they have been pioneers, particularly so in St. Pancras, where the first child welfare centre was commenced. It is often the lot of pioneers to tread the hard path and establish in a small way what afterwards becomes a big service, and this has been the lot of St. Pancras in so far as child welfare is concerned. Whilst the pioneer spirit still exists, fresh fields of activity will become apparent, and never was there a time when enterprise was so required as it is to-day, to improve the standard of living of the citizens of large towns that have been subjected to the ravages of war. The finest social services can only achieve effective results if the population they serve is provided with the right environmental background. In due course the country will be provided with an integral hospital service. It will not be sufficient to provide wards where disease can be cured, where the pain of ill-health can be mitigated. It will be essential to find out why hospital beds are filled, and what are the factors in every-day life that create the circumstances that lead to disease. Once again, then, I turn in these opening remarks to a survey of the environmental conditions of St. Pancras, and place before you a survey of the homes in which our residents are living. Housing. The total number of houses and flats in the borough is approximately 24,150. The majority of the houses are occupied by two or more families, for it is estimated that there are over 40,000 separate families living in the borough. Some indication of the condition of these premises can be gauged from the number of complaints received in the course of a year. For the past three years the figures are as follow:— 1945 3,832 1946 5,689 1947 7,550 5 The number is steadily rising. This is not surprising. The majority of the houses in the borough are old and worn out. It is some years since any of them have been replaced by new dwellings. Until such time as we can once more clear away decayed out-moded houses and replace them by modern dwellings, we must expect this rise in the number of complaints, and an increasing amount of work and investigation to make living accommodation free from nuisances which are injurious to health, and as comfortable as possible for those who still have to live in them. The number of complaints indicates that 31 per cent. of the houses in the borough showed some sanitary defect during the course of the year, for the remedy of which the help of the department was required ; and this gives no heed to complaints which were brought direct to landlords or their agents and remedied without the intervention of the Public Health Department. One visit does not suffice to deal with a complaint, as will be noted from the fact that no less than 16,800 visits were paid to deal with complaints alone. In 132 cases a summons had to be taken out in order to secure the abatement of the nuisance. Another indication of the work which has been required to deal with sanitary nuisances is seen from the amount of money sanctioned by licence to carry out work at the instance of the sanitary inspector. Any work exceeding £10 in cost needs a licence. The following figures show how the amount of money needed to cover this work increased during the year :— £ s. d. 26th January 5,903 14 4 28th February 7,404 16 9 28th March 5,121 8 11 25th April 5,973 19 9 30th May 10,729 15 5 27th June 8,633 13 5 25th July 9,071 1 7 29th August 8,132 16 1 27th September 6,803 17 6 31st October 10,170 5 6 30th November 14,145 18 6 31st December 16,016 12 2 £108,107 19 11 If work continues during 1948 at the rate of the last month of the year 1947, it may be anticipated that the amount of money required to deal with the work will be nearly £200,000. This does not take into consideration the many defects which can be remedied at a cost of less than £10, or those cases where a licence was received on the direct request of the owner of the property, or at the instance of the District Surveyor to deal with dangerous structures. The general attitude to-day is that only the most urgent repair work can be carried out, and work considered as urgent is primarily that required to deal with conditions that affect health or are a danger to life. There is an increasing tendency to rely upon the Public Health departments of the country to determine the amount of work which is required in connection with the first category. A very great responsibility rests upon your sanitary inspectors in connection with this work. It is a very serious matter to require owners to carry out work involving nearly £200,000 in the course of one year. This work must be necessary; it must be essential to health. At first sight it might seem unwise to spend so much money on old property, and that it is holding up the provision of new dwellings in the use it entails of labour and materials. Unfortunate as this may be, it is unavoidable. Since 1939 there have been no new houses erected in the borough, ordinary maintenance and repair has been cut to a minimum, and even (4626) a3 6 insanitary conditions have had to be tolerated on account of the war. Damage has resulted from bomb and blast. It is absolutely essential that existing premises shall be rendered fit for human habitation pending the construction of new dwellings and the demolition of existing ones. There are already twelve thousand families on the waiting list for new accommodation, a large proportion of whom are living in totally unsatisfactory conditions. Were it not for the work of the sanitary inspectors this waiting list would be even higher, for quite a large number of applicants for re-housing base their claim upon insanitary conditions. The remedying of these defects often keeps families off the re-housing list, others it provides with tolerable comfort until the Council can find them alternative accommodation. As I see the position today there can be no let-up in work associated with the remedy of insanitary conditions in existing houses. On the other hand it will increase until houses or flats are provided in such number that it will be possible to pull down and destroy for ever unsatisfactory and worn out accommodation. During the course of the year I was asked to advise as to 878 housing applications and to assess the urgency of the case. My recommendations were as follows: A (Urgent priority) 565 B (Urgent priority—less serious) 175 C (General waiting list) 80 D (No special consideration) 58 This somewhat dismal resume of the position should be judged in the light of the Council's housing proposals and schemes in hand. In the early part of 1948, the Council's tenancies were as follows:— On estates 1,204 In requisitioned houses 1,737 In temporary houses 214 In compulsory purchase order houses 51 A total of 3,206 The Council are obviously the biggest property owners in the borough and it is estimated that the number of persons housed by the Council is no less than 12,008—8-78 per cent. of the population of the borough. The early months of 1948, have shown that between 150 and 190 applications for re-housing are received each month. The number re-housed is but a small proportion of the number of applications, and therefore the number on the waiting list, no less than 12,339 in March, 1948, is still increasing. I am indebted to the Housing Department for the following information:— Over 900 houses have been repaired and adapted to suit modern requirements. Twelve flats which were demolished by enemy action have been rebuilt and occupied. In five of the Council's housing schemes, totalling 649 flats, the buildings are actually in course of erection, and in but a few months some will be available for occupation. Amenities include lifts, hot water, smokeless fuel grates, choice of electric or gas power points, facilities for laundry work, private balconies, gardens and play places. Furthermore, twice this number have also been planned and sites acquired ready for the time when consent can be obtained to start building. 7 Maternity and Child Welfare. This is the last complete year for which St. Pancras will be responsible for Maternity and Child Welfare services, and it is therefore pleasing to be able to record a year of high achievement. The number of registered live births was 2,793. This is the highest recorded figure since 1931, when the number was 2,955. I believe that the figure for 1947 still records the effect of demobilisation, marriage and the commencement of family life, for there were indications towards the end of the year that the birth rate was dropping. I anticipate that the number of births in 1948 will be less than in 1947. The infantile mortality rate was 34.0, the lowest ever recorded in St. Pancras. I feel sure that this rate will be a source of gratification to the Council and a fitting reward for its ever present concern for the welfare of the children of the borough, for its pioneer efforts and its enthusiasm. This figure of 34 per thousand is not achieved in a land flowing with milk and honey, nor in a community well housed and provided with open spaces, but in St. Pancras, overcrowded, partially destroyed by enemy action, at a time of scarcity when we are trying to overcome bad environmental conditions resulting from two wars. This figure is achieved during the year when England recorded one of its severest winters. I do not know what is the lowest figure it is possible to obtain ; I certainly do not consider 34.0, as that minimum. I believe it can, and in fact will be, lowered by better environmental conditions, better medical knowledge on the causes of premature birth, injury at birth, and congenital abnormality. Glad as I am to report this low infantile mortality in the last full year of our responsibility, I still do not accept the figure with complacency. The Care of Blind Persons in St. Pancras. The care of individual persons certified as blind rests with the London County Council. The environmental conditions in which they live is part of the responsibility of the St. Pancras Borough Council. It is obvious that many conditions may exist in the premises in which they live, of which, on account of their disability, they are unaware. There are approximately 50 persons certified as blind living in St. Pancras. Of these, three are in hospital and two are in homes for the blind. 34 persons are living in their own homes. Of these, 14 are totally blind and 20 partially blind, but their blindness is such that they are not able to do ordinary work for which sight is required. Their ages are as follows : 2 aged 88 7 between 81 and 87 11 „ 70 and 80 8 ,, 60 and 69 4 „ 50 and 59 1 aged 38 1 age not given. Routine visits have been made to all blind persons living at home to see what improvement in their living conditions can be obtained for them and to abate any sanitary nuisances. It was found that 13 of the above blind persons were living alone and 19 with relatives or friends. Two partially blind persons, brother and sister, are living together. Our survey has shown that in 28 cases the general care was considered either satisfactory or fair. In two cases it was unsatisfactory, and in two the surroundings were stated to be poor. Home helps have been offered where necessary, and in 12 cases sanitary defects were found and the appropriate notices served. I am satisfied that this routine survey of the conditions under which blind persons in St. Pancras are living has and will help materially in improving their comfort. (4626) a 4 8 Medical Examinations for Superannuation Purposes. The Council resolved that as from the 1st October, 1947, medical examinations for superannuation purposes should be carried out by the Medical Officer of Health or a member of his medical staff. Since that date 54 persons have been examined for permanent positions in the Council's service and all have been passed as fit. It has been very pleasing to see the excellent condition of the teeth of young entrants, particularly so in those who have served in the armed forces. I have been carrying out superannuation examinations for over twenty years and the improvement that I have seen in this past year is well marked. I think this improvement is largely due to a more equal distribution of those essentials in the diet which are conducive to good teeth and to the care which has resulted from the dental services in the forces. In addition to these 54, I have examined another 29 persons referred to me for a second opinion. In 21 of these cases I have been able to pass the applicant for superannuation purposes ; seven I have failed and one case is to be reviewed shortly. Seven other members of the staff have been examined in connection with retirement or in order that I could give an opinion as to their fitness to carry out the type of work in which they were employed. There remains for me the pleasant task once again of thanking the Council and the Committees I have served for the help and courtesy I have received at all times, and to acknowledge the ever ready co-operation of my colleagues and the unstinted assistance of the staff for whom I am responsible. It is indeed a pleasure to work in a borough where Councillors and Officials alike put forth so much effort and give their Medical Officer of Health so much encouragement in improving the health and happiness of the residents of the district. I beg to remain, Your Worship, Ladies and Gentlemen, Your obedient Servant, DENNIS H. GEFFEN, Medical Officer of Health. 9 Metropolitan Borough of St. Pancras. PUBLIC HEALTH COMMITTEE. November, 1946, to October, 1947. Councillor Mrs. W. Paul (Chairman); Councillor Rev. J. Jones (Vice-Chairman); The Mayor (Councillor F. W. Powe); Aldermen Dr. L. F. Browne and Dr. E. A. Gregg; Councillors Dr. S. G. Dean, Mrs. M. A. Foster, Miss F. L. M. Freeman, Mrs. J. Gregory, C. Haimes, Mrs. L. G. Hume, R. Kane, A. G. Shelley, H. B. Sheridan and R. L. Workman. November, 1947, to October, 1948. Councillor Miss F. L. M. Freeman (Chairman); Councillor Rev. J. Jones (Vice-Chairman); The Mayor (Councillor Mrs. Lilian Bryant); Aldermen Dr. L. F. Browne and Dr. E. A. Gregg; Councillors Dr. S. G. Dean, E. F. Evans, Mrs. M. A. Foster, Mrs. J. Gregory, Mrs. L. G. Hume, Dr. N. Malleson, Mrs. W. Paul, A. G. Shelley, H. B. Sheridan and R. L. Workman. MATERNITY AND CHILD WELFARE COMMITTEE. November, 1946, to October, 1947. Councillor Mrs. D. D. Naftel (Chairman); Councillor Mrs. A. E. Lake (Vice-Chairman); The Mayor (Councillor F. W. Powe); Aldermen Mrs. L. Bartlett and G. Home; Councillors Mrs. L. Bryant, Miss L. M. Chivers, Mrs. K. E. Deacon, Dr. S. G. Dean, Mrs. M. A. Foster, Miss F. L. M. Freeman, Mrs. J. Gregory, Rev. J. Jones, T. B. Moss and T. J. Powney. November, 1947, to October, 1948. Councillor Miss L. M. Chivers (Chairman); Alderman Mrs. L. Bartlett (Vice-Chairman); The Mayor (Councillor Mrs. Lilian Bryant); Alderman G. Home; Councillors Dr. S. G. Dean, Mrs. M. A. Foster, Miss F. L. M. Freeman, Mrs. J. Gregory, Miss E. M. Haworth, Mrs. L. G. Hume, Rev. J. Jones, Dr. N. Malleson, T. B. Moss, A. S. Ruffell and Mrs. J. Young. CHIEF OFFICERS OF THE COUNCIL. Town Clerk and Solicitor R. C. E. Austin, LL.M. Deputy Town Clerk W. F. McKeer. Borough Engineer and Surveyor . C. S. Bainbridge, M.Inst.C.E., F.R.I.C.S., M.I.Mun.E. Borough Librarian F. P. Sinclair, A.L.A. Borough Treasurer and Accountant P. C. Taylor, F.I.A.C. Borough Valuer W. S. Willis, F.R.I.C.S. (Special Rating Diploma). Chief Electrical Engineer R. Lee, M.I.E.E., A.M.I.Mech.E. Housing Manager A. W. Davey, A.I.H. Building Manager A. E. Ullmer. Chief Architect T. Sibthorp, L.R.I.B.A., A.R.I.C.S., A.M.T.P.I. Superintendent Registrar J. M. Lander. 10 STAFF OF THE PUBLIC HEALTH DEPARTMENT at the end of the year 1947. Medical Officer of Health, Administrative Maternity and Child Welfare Officer, Vaccination Officer, and Administrative Tuberculosis Officer : Dennis H. Geffen, M.D., B.S., M.R.C.S., L.R.C.P., D.P.H. Tuberculosis Officer. G. A. Back, B.A., M.B., B.Ch., M.R.C.S., L.R.C.P., D.P.H. Senior Maternity and Child Welfare Officer and Acting Deputy Medical Officer of Health. Susan M. Tracy, L.R.C.P., M.R.C.S., D.P.H. Assistant Medical Officers. Margaret Edge, M.B., Ch.B., D.C.H., C.P.H. Margaret Balfour, M.D., D.P.H. Mary T. D. Paterson, M.B., B.S., D.P.H. Rosemary Davies, M.B., B.S., D.C.H. Chief Sanitary and Housing Inspector. E. W. Winchester. Inspectors of Food and Food Places. (3) S. W. Capel. R. N. Thomas. R. Warren. Inspectors of Factories. (2) J. A. Hoare. I. Williams. Deputy Chief Sanitary and Housing Inspector. W. B. Dykes. District Inspectors (15). B. V. Cryer. H. P. Price. C. A. Engledow. E. S. Rushton. T. H. Hague. W. Shackcloth. J. E. Jones. H. E. Westripp. E. C. J. Kipping. G. K. Wilby. E. F. Kirby. J. H. Willett. S. A. C. Lord. (1 vacancy.) J. Marginson. Clerical Staff (13). V. R. Meurice, Chief Clerk. C. W. Smith (First Clerk). J. F. S. Dove. G. F. Peeling. A. A. Sleet. R. B. M. Lake. S. Morse (Temporary). L. H. Maguire. Miss J. M. White (Temporary D. H. Smith. vice Wisdom). J. J. Wisdom (S.I. Course). (2 vacancies.) Miss B. Pinnock. 11 TUBERCULOSIS DISPENSARY Health Visitors (for Tuberculosis): Miss M. M. Gilpin, Miss W. E. Webb. Nurse, and Secretary to Tuberculosis Care Committee: Mrs. E. Bevan. Clerical: Miss L. M. Davison, Mrs. S. W. Gardner. MATERNITY AND CHILD WELFARE Superintendent Health Visitors (2) Miss B. M. Harris (Ampthill Square). Miss M. Manger (Somers Town). Health Visitors (18). Miss C. O'Leary (Ampthill Square). Miss H. Smith Miss B. M. L. Boxall Miss H. M. Upton (Camden Town). Miss E. B. Bagnall Mrs. B. N. Owen Miss M. Cornall (Kentish Town). Miss E. M. Boyce Miss M. M. Wilson Miss E. M. S. Cox Mrs. S. Payne (Queen's Crescent). Miss M. A. Clarke (Somers Town). Mrs. B. H. Fawcett Miss A. Gundry (South Highgate). (There were 4 vacancies on 31.12.47.) †Temporary. Clerical Staff (3). Miss A. Andrews. Mrs. C. Pearson (Temporary). Miss E. M. Foster. DAY NURSERIES Superintendent Matron: Miss E. M. Butler. Clerk: Miss B. E. Elsy. PUBLIC ANALYST C. Harcourt Wordsworth, B.Sc.(Lond.), F.I.C. PUBLIC VACCINATORS: Ward 1 Dr. N. J. Goodchild.* Ward 2 Dr F. L. Pelly. Ward 3 Ward 4 Dr. J. W. Wigg. Ward 5 Ward 6 Ward 7 Dr. A. E. Tait. Ward 8 Dr. C. H. Alderton. *Resigned 30th November, 1947. Dr. A. J. Clarke appointed. 12 SECTION 1. General Information and Statistical Summary. General. Soil and Situation.—Practically the whole of the borough is situated on London clay. There are a few superficial deposits of gravel in the south and lower Bagshot sands in the extreme north. The altitude varies from 48 feet above Ordnance datum in the south (in the neighbourhood of Ampton Street, King's Cross Road) to 427 feet above Ordnance datum in the north (Pond Square). The borough is about 4 miles long, extending from near Oxford Street in the south to Highgate in the north, and averages about a mile in width. Acres. Area of the borough 2,694 Area of Ward 1 990 Area of Ward 2 162 Area of Ward 3 452 Area of Ward 4 271 Area of Ward 5 342 Area of Ward 6 180 Area of Ward 7 118 Area of Ward 8 179 Area of various public open spaces 530 Regent's Park and Primrose Hill 102 Parliament Hill 184 Kenwood 164 Waterlow Park 29 Disused burial grounds 31 Private square gardens 20 Area of borough highways, excluding footpaths, 28 acres (approx.) Total length of roads about 90 miles Population (1931 Census) 198,133 Population (Registrar General's mid-1947 estimate) . 136,700 Number of persons per acre (estimated average) 50 Rateable value £2,126,768 Product of a penny rate, about £8,450 General rate—14/- in the £ for the year. 13 Summary of Vital Statistics. Net registered live births 2,793 Birth-rate (per 1,000 of estimated population) 20.4 Deaths, all ages . 1,916 Death rate (per 1,000 of estimated population) 14.0 Infantile deaths 95 Infantile death rate (per 1,000 live births) 34.0 Tuberculosis deaths 105 Tuberculosis death rate (per 1,000 of estimated population) *77 Maternity and Child Welfare Centres. Telephone St. Pancras School for Mothers, 1, Ampthill Square, N.W.I EUS 2972 Camden Town Welfare Centre, Barnes House, Camden Road, N.W.I GUL 1667 Kentish Town Welfare Centre, Raglan Street, N.W.5 GUL 1389 North St. Pancras School for Mothers, Queen's Crescent, N.W.5 GUL 2988 Somers Town Welfare Centre, Chamberlain House, Ossulston Street, N.W.I . EUS 2380 South Highgate Welfare Centre, 1, St. Alban's Road, N.W.5 GUL 2008 University College Hospital, Maternity and Child Welfare Department, Huntley Street, W.C.I (for Ward 7—Children) EUS 5050 Tuberculosis Dispensary. Barnes House, Camden Road, N.W.I GUL 2371 Day Nurseries. Telephone Margaret Day Nursery, 42, Phoenix Road, N.W.I EUS 1822 254-256, Camden Road, N.W.I GUL 2910 Coram Gardens Day Nursery, 41, Brunswick Square, W.C.I TER 6054 108, Hampstead Road, N.W.I EUS 3686 Kentish Town Day Nursery, 27, Gospel Oak Grove, N.W.5 GUL 2906 South Highgate Day Nursery, Chester Road, N.19 ARC 4921 Regents Park Day Nursery, 4, Prince Albert Road, N.W.I GUL 4037 Hospitals in the Borough. Telephone British Dental, 146, Camden Road, N.W.I GUL 1977 British Functional Mental and Nervous Disorders, 72, Camden Road, N.W.I . GUL 2041 Elizabeth Garrett Anderson, 144, Euston Road, N.W.I EUS 2501 Hampstead General and N.W. London (Out-patients Department), Bayham Street, N.W.I GUL 1734 14 Hospitals in the Borough—continued. T elephone Highgate, Dartmouth Park Hill, N. 19 ARC 2681 London Foot, 33, Fitzroy Square, W.l MUS 0602 London Skin, 40, Fitzroy Square, W.l MUS 1411 Manor House (Ophthalmic), 324, Gray's Inn Road, W.C.I TER 5121 National Temperance, Hampstead Road, N.W.I EUS 5206 Royal Ear, Huntley Street, W.C.I EUS 5050 Royal Free, Gray's Inn Road, W.C.I TER 4331 Royal National Throat, Nose and Ear, Gray's Inn Road W.C.I TER 4311 St. Pancras, St. Pancras Way, N.W.I EUS 1617 University College, Gower Street, W.C.I EUS 5050 West End Hospital for Nervous Diseases.—Owing to war damage of hospital premises at Gloucester Gate, Regent's Park, N.W.I, temporary wards have been available at Princess Louise Hospital, St. Quintin Avenue, N. Kensington, W.10. Ambulance Facilities. London Ambulance Service (Accident and General). Headquarters : The County Hall, S.E.I. For accidents (in the home or elsewhere) or sudden illness (in streets, public places and places of employment) Dial 999 For maternity cases or very urgent illness in the home WAT 6000 For other cases—illness, infectious diseases, &c WAT 3311 The following restrictions have had to be placed upon the admission of certain types of infectious disease to the London County Council hospitals, owing to the acute shortage of nursing and domestic staff:— Chickenpox, German Measles and Mumps.—Patients will be admitted at the request of the Borough Medical Officer of Health only. No patient will be accepted for admission except on grounds of clinical severity or where home conditions make it impossible to retain the patient at home. Whooping Cough.—Patients will be accepted direct from medical practitioners and will be admitted up to the limit of the available accommodation for this disease. In the event of beds not being available, preference will be given to younger children and children who cannot be cared for at home. Measles.—No patient will be admitted except at the request of the Borough Medical Officer of Health. In the event of beds not being available, children under 3 years of age will be given preference. Scarlet Fever.—This will be dealt with in the same way as chickenpox, German measles and mumps, except that some preference will be given to children under 5 years of age. Enteritis and Dysentery.—Children under two years of age will be accepted direct from medical practitioners and every effort will be made to admit all such patients. Patients over 2 years of age will be dealt with in the same category as chickenpox, German measles and mumps. 15 Social Welfare. L.C.C. Area III/IV—Comprises the Metropolitan Boroughs of Finsbury, Hampstead, Holborn, Islington, St. Marylebone, St. Pancras and Shoreditch. Local Social Welfare Officer (Area III/IV) G. E. Oughton. Local Office: 53, Clerkenwell Road, E.C.I. Area Welfare Officer— Phone: CLE 5871. C. H. Osbourn. District Welfare Officers (for St. Pancras cases). R. J. O'Connell (GUL 2868) District Welfare Station, Bower Cottage, Holmes Road, A. F. Whyman (GUL 2737) N.W.5. H. Williams (WEL 2894) 29, Marylebone Road, N.W.I. W. H. A. Webb (CLE 5871) 53, Clerkenwell Road, E.C.I. After office hours officers are on duty at Old County Hall, Spring Gardens, for dealing with emergency cases. Provision of Insulin. Under powers contained in Section 227 of the Public Health (London) Act, 1936, the Council defrayed the cost of insulin provided for 16 necessitous persons during the year, amounting to £63. 16 Climatological Summary, Year 1947. Station, Camden Square, N.W.I—Lat. 51° 33' N. Long. 0° 08' W. January February March April May June July August September October November December Barometer— Mean Pressure at 32° F. at station mbs. level (Bar. 112 ft. above M.S.L.) 1018.1 1009.2 1003.0 1018.4 1016.2 1015.3 1015.4 1020.6 1019.6 1022.8 1014.5 1016.4 Air Temperature— Mean of— A. Maximum °F. 40.8 33.7 47.2 58.7 68.8 72.2 74.4 80.0 71.2 60.9 51.8 47.1 B. Minimum °F. 31.9 26.7 36.0 43.2 50.1 55.7 59.2 58.8 54.7 46.0 42.0 39.1 Mean of A and B °F. 36.3 30.2 41.6 50.9 59.5 63.9 66.8 69.4 62.9 53.5 46.9 43.1 Difference from average (1906-1935) °F. - 4.0 - 10.3 - 2.1 + 2.6 + 3.1 + 2.9 + 2.5 + 5.7 + 3.9 + 1.6 + 2.8 + 1.6 Mean relative humidity per cent. 86 83 86 70 69 75 75 72 78 42 86 87 Earth temperature at 4 ft. depth °F. 42.9 40.5 39.2 44.2 49.4 55.5 58.5 61.5 60.7 56.4 52.3 47.8 Bright sunshine— Total observed (daily mean) Hr. 0.75 0.30 1.60 5.40 5.90 6.90 5.57 8.93 5.47 2.85 1.65 0.45 Percentage of possible 9 3 14 39 38 42 35 62 43 27 19 6 Percentage of average 81 19 57 128 95 105 90 159 129 110 128 56 Rainfall (rain-gauge level, 110 ft.)— Number of days precipitation 16 10 24 13 14 11 11 3 9 3 11 15 Total fall In. 1.48 1.55 5.76 1.87 0.97 2.74 1.78 0.08 1.40 0.07 1.01 2.27 Percentage of average (1881-1915) 80 93 315 121 55 136 75 4 77 3 43 95 Hour of observation, 9 a.m. (G.M.T.). The readings for Bright Sunshine are those taken at Regent's Park—no readings being recorded at Camden Square. Total rainfall for year, 20.98 inches. 17 SECTION 2. Births and Deaths. STATISTICS FOR THE YEAR 1947. Population. The civilian population, as estimated by the Registrar-General, mid-1947, was:—136,700. Comparable estimates for preceding years are set out on page 22. Registered Live Births. Rate per 1,000 of estimated population. M. F. Total. Legitimate 1,285 1,195 2,480 Illegitimate 146 167 313 1,431 1,362 2,793 20.4 Comparable figures for preceding years are set out on page 22. Registered Still Births Rate per 1,000 Live and Still Girths. M. F. Total. Legitimate 39 23 62 Illegitimate 3 5 8 42 28 70 24.4 Comparable figures for preceding years:— Year. 1939 60 26.7 1940 66 32.8 1941 34 23.2 1942 48 26.2 1943 47 25.0 1944 59 29.9 1945 56 27.8 1946 64 25.0 (4626) b 18 Notification of Births. Under the Public Health (London) Act, 1936, a medical practitioner attending a woman in her confinement is required, within 36 hours, to give notice to the Medical Officer of Health of the occurrence of the birth of a child, alive or dead unless he (or she) has reason to believe that the father of the child, or some other person who either was present at the birth or who was in attendance on the mother within six hours afterwards, has already sent the notification. No fee is payable. This notification is in addition to, and not in substitution for, Registration of Birth, which must be made within 42 days of the birth. Births (live and still) notified as having taken place in St. Pancras 3,296 Less non-residents born in the borough 1,846 1,450 Add St. Pancras residents born outside the borough 1,297 Total St. Pancras births notified 2,747 62 of these were still births, leaving a net figure of 2,685 live births notified in 1947. Note.—The number of notified births in any one year differs from the number of registered births in the same year owing to the difference in time allowed for notification and registration. Deaths—All Ages. Rate per 1,000 of M. F. Total estimated population 1,012 904 1,916 14.0 Comparable figures for preceding years are set out on page 22. Death Rate of Infants under 1 year of age. All infants per 1,000 live births 34 Legitimate infants per 1,000 legitimate live births 30 Illegitimate infants per 1,000 illegitimate live births 61 Comparable figures for preceding years:— Year. All Infants. Legitimate. Illegitimate. 1939 52 46 94 1940 56 52 86 1941 51 52 44 1942 66 59 117 1943 71 66 99 1944 64 57 105 1945 44 40 65 1946 38 37 47 See also tables on pages 22 and 23. [To face page 18 LIVE BIRTH RATE DEATH RATE for the Borough, per 1,000 population. 19 CLASSIFICATION OF DEATHS, WITH AGE DISTRIBUTION—1947 Causes of death Ages—Both Sexes Under 1 year 1 and under 5 5 and under 15 15 and under 45 45 and under 65 65 and upwards Totals M F All Causes 95 26 20 173 491 1,111 1,012 904 1. Typhoid and paratyphoid fevers — — — — — — — — 2. Cerebro-spinal fever — — — — — 1 1 — 3. Scarlet fever — 1 — — — — — 1 4. Whooping cough 4 3 — — — — 4 3 5. Diphtheria — 2 — 1 — — 1 2 6. Tuberculosis of respiratory system 1 — — 50 28 17 65 31 7. Other forms of tuberculosis — 1 — 3 2 3 6 3 8. Syphilitic diseases I — — — 10 6 9 8 9. Influenza — 1 — — 3 7 4 7 10. Measles — 2 — — — — 1 1 11. Ac. poliomyelitis and polioencephalitis — — 1 — — — 1 — 12. Ac. infectious encephalitis — — 1 1 — — — 2 13. Cancer—buccal cavity and Oesoph (M); Uterus (F) — — — 3 11 26 16 24 14. Cancer—stomach and duodenum — — — 2 17 21 20 20 15. Cancer—breast — — — 3 12 10 — 25 16. Cancer—all other sites — — — 21 85 131 134 103 17. Diabetes — — — — 1 7 4 4 18. Intracranial vascular lesions — — — 2 38 133 79 94 19. Heart diseases — — — 16 100 331 221 226 20. Other circulatory diseases — — — 1 17 74 44 48 21. Bronchitis 2 1 — 5 50 112 116 54 22. Pneumonia 14 3 1 5 41 85 86 63 23. Other respiratory diseases 1 — 1 — 6 11 9 10 24. Ulcer—stomach or duodenum — — — 7 4 15 20 6 25. Diarrhoea (under 2 years) 13 1 — — — — 8 6 26. Appendicitis — 1 1 1 — 3 2 4 27. Other digestive diseases — 1 — 7 11 9 12 16 28. Nephritis — — 1 2 13 14 16 14 29. Puerperal and post-abortive sepsis — — — 1 — — — 1 30. Other maternal causes — — — — — — — — 31. Premature birth 15 — — — — — 10 5 32. Congenital malformations, birth injury and infant diseases 27 2 1 2 1 1 15 19 33. Suicide — — — 12 11 6 22 7 34. Road traffic accidents — 1 2 5 2 5 7 8 35. Other violent causes 9 1 6 9 6 33 29 35 36. All other causes 8 5 5 14 22 50 50 54 (4626) b 2 20 DEATHS OF INFANTS UNDER 1 YEAR OF AGE—1947 Deaths of infants from stated causes with Age and Ward distribution:— Cause of death Age Deaths in each Ward No address Totals Under 1 day 1 day to 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under 4 weeks 4 weeks and under 3 months 3-6 months 6-9 months 9-12 months Total Deaths under 1 year 1 2 3 4 5 6 7 8 M F M F M F M F M F M F M F M F M F M F Whooping cough — — — — — — 1 2 1 — 4 1 1 — — 1 — — — — — 1 — — — — — — — 3 1 Pulmonary tuberculosis — — — — — — — — 1 — 1 — — — — — 1 — — — — — — — — — — — — 1 Septicaemia — — — — — — 1 — — — 1 — — — — — — — — — — 1 — — — — — — — 1 — Congenita! syphilis — 1 — — — 1 — — — — 1 — — — — — — — — — — — — — — — — — — — 1 Meningitis (pneumococcal) — — — — — — 1 — — — 1 — — — — 1 — — — — — — — — — — — — — 1 — Bronchitis — — — — — — 1 1 — — 2 — — — — — 1 — — — — — — — — 1 — — — 1 1 Broncho—pneumonia — 1 2 1 1 5 2 5 1 — 13 2 1 — — 1 — — — 2 2 2 — — — — — — — 9 4 Pneumonia (unstated) — — — — — — 1 — — — 1 — — — — — — — — — — 1 — — — — — — — 1 — Enteritis — — — — — — 2 6 3 2 13 2 — 2 — — 3 — — — — — — — — — — — — 7 6 Congenital malformations 1 1 1 1 — 4 2 1 1 — 8 1 — 1 — — 1 1 — — 1 1 1 — — 1 — — — 5 3 Premature birth 3 11 1 — — 15 — — — — 15 2 — 1 — 2 2 1 2 4 — — 1 — — — — — — 10 5 Injury at birth 7 2 — — — 9 — — — — 9 — — 1 1 1 2 — — — 2 — 1 — 1 — — — — 2 7 Atelectasis 5 2 — — — 7 — — — — 7 1 2 1 — 2 — — 1 — — — — — — — — — — 4 3 Other diseases peculiar to first year of life 1 — 1 — 1 3 — — — — 3 — — — 1 — — — 1 — 1 — — — — — — — — — 3 Lack of care of new—born 2 — — — — 2 — — — — 2 — — — — — 1 — — — — — — — — — — 1 — 1 1 Other violence — — — — — — 4 3 — — 7 — — — 1 1 1 — — — — — 2 — — — 2 — — 1 6 Other causes 1 — — — — 1 2 3 1 — 7 — 1 1 — 1 — — 2 — — 1 — — — 1 — — 3 4 Totals 20 18 5 2 2 47 17 21 8 2 95 9 7 7 5 10 12 6 7 6 6 7 5 — 1 3 3 1 — 49 46 [To face page 20 LEGITIMATE CHILDREN. INFANTILE DEATH RATE (under the age of 12 months) NEO-NATAL DEATH RATE ( „ „ „ 4 weeks) for the Borough, per 1,000 registered live births. ILLEGITIMATE CHILDREN. INFANTILE DEATH RATE (under the age of 12 months) NEO-NATAL DEATH RATE ( „ „ „ 4 weeks) for the Borough, per 1,000 illegitimate live births. 21 Infantile Mortality, by causes. [####] 1939 1940 1941 1942 1943 1944 1945 1946 1947 Measles — — 1 — 1 — — 1 — Whooping cough 5 — 8 3 1 2 3 — 4 Influenza — — 1 1 1 — — 1 — Cerebro-spinal fever — 1 — — — — — 1 — Syphilis 1 1 — — 1 1 — — 1 T.B — — — 1 — — — — 1 Meningitis — 1 — — 3 1 — 1 1 Convulsions 1 — — 1 — — — — — Bronchitis 3 4 1 6 6 3 1 8 2 Broncho-pneumonia 13 16 — 10 10 20 — 7 13 Lobar pneumonia 2 1 — 1 1 — — — — Pneumonia (not stated) — 1 9 1 2 1 12 — 1 Enteritis and diarrhœa 30 29 9 23 18 20 24 13 13 Congenital debility, sclerema, icterus 3 — 1 — — — — — — Congenital malformations 8 10 7 13 10 13 6 8 8 Premature birth 30 17 19 27 28 25 7 24 15 Injury at birth 4 3 2 3 8 7 4 12 9 Atelectasis 2 5 4 5 8 6 13 11 7 Haemorrhage from umbilicus 1 — — — — — — — — Inattention at birth 1 — — — — — — — — Lack of care of new-born — — — 3 — 1 — — 2 Violence — 9 — 3 — 6 4 3 7 Mikulier's disease — — 1 — — — — — — Maternal toxæmia — — 1 — — — — — — Melæna neonatorum — — 1 — — — — — — Icterus gravis — — 1 — — — — — — Septicaemia — — — — — 1 — — 1 Bacillary dysentery — — — — — 1 — — — Other diseases peculiar to first year of life — — — 8 — 4 2 1 3 Other causes 10 10 8 8 32 11 10 5 7 Totals 114 108 74 117 130 123 86 96 95 (4626) B 3 22 Vital Statistics of Borough of St. Pancras since 1918. Year Population estimated at middle of each year Nett Registered live births belonging to the borough Nett deaths belonging to the borough At all ages Under 1 year of age Under 4 weeks. Number Rate per 1,000 of estimated population Number Rate per 1,000 of estimated population Number Rate per 1,000 nett live births Number Rate per 1,000 nett live births. 1918 196,883 3,318 16.8 3,914 22.3 340 102 98 30 1919 228,585 3,824 16.7 2,930 13.4 336 88 143 37 1920 228,980 5,934 25.4 2,895 12.4 435 73 171 29 1921 212,900 4,764 22.4 2,778 13.0 360 76 135 28 1922 212,500 4,559 21 .5 3,107 14.6 337 74 117 26 1923 214,400 4,348 20.3 2,585 12.1 272 63 129 30 1924 214,600 4,112 18.8 2,848 13.0 303 74 96 23 1925 216,300 3,880 17.9 2,745 12.7 280 72 95 24 1926 216,800 3,612 16.7 2,680 12.4 274 76 98 27 1927 213,200 3,299 15.5 2,621 12.3 205 62 85 26 1928 206,000 3,274 15.9 2,618 12.7 261 80 82 25 1929 204,400 3,170 15.5 3,126 15.3 262 83 95 30 1930 204,400 3,208 15.4 2,478 11.9 194 60 75 23 1931 195,600 2,955 15.1 2,601 13.3 200 68 71 24 1932 194,000 2,684 13.8 2,545 13.1 186 69 64 24 1933 190,900 2,589 13.6 2,608 13.7 151 58 69 27 1934 187,540 2,449 13.1 2,408 12.8 160 65 70 29 1935 185,300 2,466 13.3 2,219 12.0 155 63 60 24 1936 183,900 2,389 13.0 2,478 13.5 190 79 52 22 1937 181,900 2,364 13.0 2,329 12.8 154 65 48 20 1938 179,400 2,433 13.5 2,063 11.5 156 64 57 23 1939 167,300 2,187 12.3 2,170 13.0 114 52 49 22 1940 133,200 1,948 14.6 2,728 20.5 108 56 41 21 1941 103,770 1,434 13.8 2,055 19.8 74 51 39 27 1942 105,900 1,785 16.9 1,730 16.3 117 66 55 31 1943 108,640 1,836 16.9 1,842 17.0 130 71 66 36 1944 105,780 1,914 18.1 2,001 18.9 123 64 52 27 1945 111,400 1,957 17.6 1,806 16.2 86 44 37 19 1946 129,410 2,494 19.3 1,717 13.3 96 38 51 20 1947 136,700 2,793 20.4 1,916 14.0 95 34 47 17 23 Still Births. Illegitimate Births and Deaths of Illegitimate St. Pancras Children. Year. Still Births. Illegitimate Births. Deaths of Illegitimate Children. Neo-Natal. Under 1 year. Number. Rate. Number. Rate. Number. Rate. Number. Rate. (Illegitimates in brackets) per 1,000 births (live and still) per cent. of live births per 1,000 Illegitimate births per 1,000 Illegitimate births 1918 — — 310 9.5 18 57 75 237 1919 — — 302 8.4 17 53 69 216 1920 — — 332 5.6 15 46 68 212 1921 — — 264 5.5 15 58 46 178 1922 — — 254 5.6 7 28 40 157 1923 — — 247 5.7 15 60 44 177 1924 — — 242 5.9 8 33 36 147 1925 — — 243 6.3 10 42 31 129 1926 — — 226 6.3 10 43 31 135 1927 — — 228 6.9 15 65 33 142 1928 — — 238 7.3 17 70 37 152 1929 114 (17) 34.7 246 7.8 8 32 31 123 1930 103 (16) 31.1 269 8.4 12 43 29 105 1931 104 (13) 33.9 245 8.3 12 47 29 114 1932 78 (13) 28.2 214 8.0 10 45 27 121 1933 88 (15) 32.8 227 8.8 17 73 23 99 1934 77 (8) 30.4 239 9.8 14 57 28 114 1935 94 (11) 36.7 218 8.8 11 50 21 95 1936 103 (9) 41.3 233 9.7 12 52 28 120 1937 78 (14) 31.9 221 9.3 10 43 28 121 1938 83 (17) 32.9 282 11.6 9 31 27 94 1939 60 (6) 26.7 265 11.7 Records suspended. 26 94 1940 66 (10) 32.8 197 9.8 17 86 1941 34 (6) 23.2 159 10.8 7 44 1942 48 (8) 26.2 188 10.2 22 117 1943 47 (11) 25.0 274 14.5 27 99 1944 59 (13) 29.9 287 14.5 30 105 1945 56 (13) 27.8 325 16.1 21 65 1946 64 (11) 25.0 297 11.6 14 47 1947 70 (8) 24.4 313 11.2 19 61 (4626) b 4 24 The still birth rate is the number of children born dead, out of every thousand births (live and still). It will be noticed that there has been a satisfactory fall from 1929, when it was 34 .7, to 24.4 in 1947. The number of illegitimate births in the borough has varied from 310 in 1918 to 313 in 1947. It was lowest at 159 in 1941, and highest at 332 in 1920. The percentage of illegitimate births has varied from 5.5 in 1921 to 16.1 in 1945. For 1947 the number of illegitimate births was 313, and the rate was 11.2 per cent. It will be noted that the rate for 1947 was generally less than during the war years 1943.1946. The morals of a country must not be judged by the percentage of children born illegitimate for there are other factors of equal importance. So far as morals are concerned the child bom within less than eight months of marriage was probably conceived before marriage; furthermore, immorality does not always result in conception. An investigation of statistics in England and Wales as a whole has shown that although during the war years the number of children born illegitimate increased, the number born within less than eight months of marriage actually decreased. This was due to the fact that whereas before the war marriage often took place after pregnancy had occurred, circumstances were such during the war that this was not always easy or possible, for a fiance might be in another part of England and Wales, or abroad, and conception thus resulted in an illegitimate birth. Of the greatest interest is the fall in the illegitimate death rate from 237 per thousand in 1918 to 61 in 1947. Deaths from Puerperal Causes. Deaths. Rate per 1,000 Live and Still Births. Sepsis. Other causes. Total. Puerperal Sepsis 1 0.35 Other maternal causes — — 0.35 Comparable figures for preceding years :— Year. 1939 3 1.33 1940 6 2.98 1941 4 2.72 1942 8 4.36 1943 1 0.53 1944 6 3.04 1945 5 2.48 1946 4 1.56 25 Deaths from Tuberculosis—All ages. Death Rate per 1,000 of estimated population. Pulmonary 96 0.70 Other forms 9 0.07 105 Total 0.77 Comparable figures for preceding years :— Year. No. of Deaths. Rate. 1939 130 0.77 1940 160 1.20 1941 123 1.18 1942 147 1.39 1943 117 1.08 1944 128 1.21 1945 127 1.14 1946 98 0.75 Mortuary and Coroner's Court. During 1947, the provision of improved facilities at these premises continued. The major items were the enlargement of the office used by the Coroner's Officers and the provision of a public waiting room by the conversion of unused space in the Mortuary. The following figures show the routine work undertaken with, in brackets, the corresponding figures for 1946: 1. Post-mortems held. (a) St. Pancras cases. (i) Resident or died in St. Pancras 268 (175) (ii) Resident in St. Pancras, died elsewhere 52(56) (iii) Died in St. Pancras, resident elsewhere 175 (77) 495 (308) (b) ex-St. Pancras cases (i.e., both resident and died elsewhere) 525 (518) 1,020 (826) 2. Bodies received for viewing only. (a) St. Pancras cases. (i) Resident and died in St. Pancras 4 (ii) Resident in St. Pancras, died elsewhere 1 (iii) Died in St. Pancras, resident elsewhere 9 14 (b) ex-St. Pancras cases 29 — 43 (32) 3. Total bodies received 1,063 (858) 4. Inquests held 552 (570) 26 SECTION 3. Prevalence of, and Control over, Notifiable Diseases. The undermentioned diseases are compulsorily notifiable in St. Pancras:— A.—Under the Public Health (London) Acts, 1891 and 1936:— Smallpox (Variola). Cholera. Diphtheria and Membranous Croup. Erysipelas. Scarlet Fever (Scarlatina). Typhus Fever. Typhoid Fever. Enteric Fever. Relapsing Fever. Continued Fever. Puerperal Fever. B.—Under Special Regulations made by the Ministry of Health granted under powers contained in the Public Health Acts:— Plague (1900). Cerebro-spinal Fever and Acute Poliomyelitis (1912). Acute Encephalitis Lethargica and Acute Polio-encephalitis (1919). Puerperal Fever and Puerperal Pyrexia (1926, 1928). Ophthalmia Neonatorum (1926, 1928). Tuberculosis (1930). Measles and Whooping Cough (1938). Scabies (1943). And the Infectious Diseases (London) Regulations, 1927 for:— Malaria. Acute Primary Pneumonia. Dysentery. Acute Influenzal Pneumonia. And wherein Enteric Fever is defined to include the Paratyphoid group of fevers. C.—Under a Special Order of the London County Council in 1909:— Glanders Hydrophobia Anthrax " when these occur in man D.—Under Section 17, Food and Drugs Act, 1938:— Food Poisoning. (For information regarding removal to hospital, see "Ambulances," page 14.) 27 Cases Notified. Notifications Comparable totals for 1946 Under 1 1 and over Total for 1947 Acute influenzal and primary pneumonia 9 88 97 123 Anterior poliomyelitis and polioencephalitis 1 35 36 3 Cerebro-spinal meningitis 2 5 7 9 Diphtheria and membranous croup — 41 41 94 Dysentery 19 5 24 92 Enteric or typhoid fever — 2 2 5 Erysipelas 1 37 38 53 Food poisoning — 7 7 9 Malaria — 1 1 7 Measles 56 846 902 1,115 Ophthalmia neonatorum 23 — 23 33 Puerperal fever — 5 5 6 Puerperal pyrexia — 35 35 47 Scabies 8 292 300 699 Scarlatina or scarlet fever 1 123 124 244 Whooping cough 88 396 484 511 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:— Under 1 Over 1 Total Anterior poliomyelitis 1 20 21 Cerebro-spinal meningitis — 1 1 Diphtheria and membranous croup — 20 20 Erysipelas 1 1 2 Measles 3 7 10 Scabies — 1 1 Scarlatina or scarlet fever 1 15 16 Whooping cough 8 11 19 Pneumonia. This disease is a frequent complication of other diseases, such as Measles. When it occurs in that manner it is not notifiable. The notifiable forms of Pneumonia are Acute Primary and Acute Influenzal Pneumonia. There were 62 notifications of the former and 35 of the latter during 1947 (as compared with 80 and 43 respectively for 1946). Anterior Poliomyelitis and Polioencephalitis. England suffered from its worst outbreak of infantile paralysis during 1947, and the epidemic affected St. Pancras in that there were notified 36 cases, of which 15 were subsequently confirmed as being definite cases of the disease. One person died. I was called upon in 28 consultation on a number of occasions to determine as to diagnosis, course of action and prevention of spread of infection. Unfortunately little is known of the infectivity of Anterior Poliomyelitis or Polioencephalitis, the medical names for the two forms of the disease known to the public as infantile paralysis. There is reason to believe, on the one hand, that it may be an infection carried by discharges from the nose, or, on the other hand, that it may be food-borne. There is no vaccine capable of protecting against the disease. Many cases are mild, some almost evanescent and remaining undiagnosed, whilst paralysis does not eventuate in all cases. It must be remembered, however, that persons contracting a mild form of the disease may be equally as capable as those with a severe form of carrying the infection to other persons. Each case was followed up to secure abatement of unsatisfactory environmental conditions where possible, and I advised against the congregation of large numbers of children together, especially for the purpose of competitive sport. It was not found necessary to close any schools or nurseries. Cerebrospinal Meningitis. (Cerebro-Spinal Fever, Meningococcal Meningitis, " Spotted Fever.") Seven cases were notified, and in all but one the diagnoses were confirmed. There was one death. Diphtheria and Diphtheria Immunisation. The immunisation of children is carried out at the Council's Welfare Centres and Day Nurseries, by general practitioners, and also by the London County Council Medical Officers at the day schools. The Council's Health Visitors have been in constant touch with parents of children under school age, for the purpose of securing immunisation. During the year, 2,282 children were recorded as immunised through the various channels mentioned, and the total number of St. Pancras children known to be immunised since the scheme commenced is 14,698. The number of births during the year was 2,793, and therefore it would appear that approximately 81 per cent, of children are being immunised in the borough, in most cases at approximately the age of one year. What has been the effect of this immunisation upon the incidence of diphtheria in the borough? During 1947 the number of cases notified was 41, but as the diagnosis was not confirmed in 20 instances the actual number of cases for the year was 21; by far the lowest figure ever recorded in the borough. Of the children who contracted the disease, seven had been immunised. Three persons died of diphtheria, and not one of these had been immunised. From this it is fair to assume that immunisation generally has been responsible to a great extent for the diminution in the number of persons who are contracting diphtheria in the borough; that those who had been immunised had only mild attacks ; and in particular that fatality in persons immunised was nil. The table and graph that follow show the correlation between immunisation in the borough and the fall in the incidence of diphtheria. DIPHTHERIA. [To face page 28 cases notified numbers immunised 29 1 2 3 4 5 TOTALS IMMUNISED YEAR YEAR BIRTHS NUMBER IMMUNISED AGE AT 31st DEC 1947 AGE AT TIME OF IMMUNISATION 0/1 1/2 2/3 3/4 4/5 5/6 6/7 7/8 8/9 9/10 10/11 11/12 12/13 13/14 14/15 1923 4346 1 24-25 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1924 4112 5 23-24 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1925 3880 9 22-23 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1926 3612 12 21-22 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1927 3299 14 20-21 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1928 3274 18 19-20 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1929 3170 59 18-19 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1930 3208 173 17-18 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1931 2955 223 16-17 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1932 2684 261 15-16 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1933 2589 329 14-15 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1934 2449 478 13-14 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1935 2466 647 12-13 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1936 2389 677 11-12 3 43 60 35 31 23 11 13 5 1 3 2 2 1 — 233 1936 1937 2364 774 10-11 8 113 158 93 82 56 31 35 14 4 8 6 6 3 — 617 1937 1938 2433 859 9-10 4 55 78 46 40 27 15 17 7 2 4 3 3 1 — 302 1938 19391939 2187 956 8- 9 2 29 40 24 21 14 8 9 4 1 2 2 2 — — 158 1939 1940 1948 1237 7-8 1 14 20 12 10 7 4 4 2 1 1 1 1 — — 78 1940 1941 1434 1214 6-7 8 108 151 89 79 53 29 33 14 4 8 6 6 2 — 590 1941 1942 1785 1134 5-6 36 494 691 404 359 242 135 153 63 18 36 27 27 9 — 2694 1942 1943 1836 1095 4.-5 20 442 430 183 174 149 171 150 108 118 99 79 90 75 12 2300 1943 1944 19 14 1103 3-4 10 349 332 79 64 61 65 64 32 27 18 20 21 20 10 1172 1944 •945 1957 1351 2-3 30 836 514 189 73 66 28 24 10 8 4 5 3 3 2 1794 1945 1946 2494 1272 1-2 205 1216 191 151 93 92 97 101 100 72 60 48 28 19 5 2478 1946 1947 2793 797 0-1 797 1067 105 66 61 42 38 28 21 20 21 11 3 2 — 2282 1947 TOTALS 14698 — 1124 4766 2770 1371 1087 831 632 631 380 276 264 210 192 135 29 Dysentery. 24 cases were notified during the year, all of which were St. Pancras residents, as compared with 92 for 1946. Bacteriological examinations were made in 20 cases, and all other cases were diagnosed clinically. There were two outbreaks in an institution in the borough—one of 4 cases (Flexner) and one of 13 cases (Sonne). Encephalitis Lethargica. No cases were notified during the year, and no deaths occurred. Enteric or Typhoid Fever. There were no deaths. Two cases of typhoid were notified during the year, one of which was not a St. Pancras resident. Erysipelas. 38 cases were notified, two subsequently not confirmed, and no deaths occurred; as compared with 53 cases and no deaths during the previous year. 30 Food Poisoning. Food Poisoning and suspected Food Poisoning are notifiable by Section 17 of the Food and Drugs Act, 1938. Seven notifications were received during the year. There was no death. Malaria. One case was notified and there was no death. Measles. Particulars of the cases, deaths and incidence and mortality rates of Measles since 1926 are given in the following table:— Estimated population Year Cases Deaths Under 1 year Over 1 year Total Incidence rate per 1,000 population Under 1 year 1-5 years 5-15 years Adults Total Mortality rate per 1,000 cases 216,800 1926 260 3,474 3,734 17.2 25 38 2 - 65 17.4 213,200 1927 40 377 417 1.9 - 5 - - 5 12.0 206,000 1928 234 3,642 3,876 18.8 30 87 10 - 127 32.7 204,400 1929 28 563 591 30 - 4 3 - 7 11.8 204,400 1930 179 3,297 3,476 171 3 26 2 - 31 8.9 195,600 1931 31 399 430 2.2 1 1 - - 2 4.7 194,000 1932 135 2,730 2,865 14.8 6 21 - - 27 9.4 190,900 1933 38 399 437 2.2 - 4 - - 4 9.2 187,540 1934 195 3,443 3,638 19.4 8 23 1 - 32 8.8 185,300 1935 23 97 120 0.6 - 1 - - 1 8.3 183,900 1936 180 2,795 2,975 16.2 3 12 2 - 17 5.7 181,900 1937 28 610 638 3.5 - 1 - - 1 1.5 179,400 1938 166 2,171 2,337 13.0 5 6 1 - 12 5.1 167,300 1939 14 71 85 0.5 - - - - - - 133,200 1940 20 265 285 2.1 — 1 - - 1 3.5 103,770 1941 45 571 616 5.9 1 - 1 - 2 3.2 105,900 1942 91 1,401 1,492 14.1 - - - - - - 108,640 1943 89 993 1,082 9.9 1 3 - - 4 3.7 105,780 1944 50 748 798 7.5 - - - - - - 111,400 1945 71 954 1,025 9.2 - - 1 - 1 1.0 129,410 1946 74 1,041 1,115 8.6 1 1 — - 2 1.8 136,700 1947 56 846 902 6.6 - 2 - - 2 2.2 31 MEASLES—Mortality rate per 1,000 cases. Ophthalmia Neonatorum. The number of cases notified was 23, of which 16 were St. Pancras residents. All these cases recovered satisfactorily. The remaining seven cases were ex-St. Pancras residents but were in-patients of St. Pancras hospitals when the disease occurred. In addition 54 cases of mild inflammation of the eyes were reported. Puerperal Pyrexia and Puerperal Fever. In 1947 there were 35 notifications of Puerperal Pyrexia and five notifications of Puerperal Fever. Scabies. 300 cases were notified (as compared with 699 in 1946, 887 in 1945, and 931 in 1944) and a further 57 cases came to the notice of the Department. In only one case was the diagnosis not confirmed, and all were visited. 32 Scarlet Fever. The number of cases notified was 124 as compared with 244 during the previous year. Sixteen cases were not subsequently confirmed. The actual number of cases was therefore 108. One death occurred. Return Cases.—This term is applied to cases of Scarlet Fever which occur in a house within 28 days of the return from hospital of a previous case. There was only one such case during the year. Multiple cases in one house—that is, several cases occurring more or less together—are not as frequent as one might expect. In 3 families there were two such cases. Cases of scarlet fever are not admitted to hospital, except at the request of the Medical Officer of Health on grounds of clinical severity or where home conditions make it impossible to retain the patient at home. Some preference may be given to children under 5 years of age. Smallpox and Vaccination. There was no case of smallpox in the borough during the year 1947, though I was called upon to give a second opinion on several occasions where the diagnosis was doubtful. The primary duty of the Vaccination Officer is to secure the vaccination of St. Pancras children, whether born in the borough or outside, but the duties also consist in securing that appropriate information regarding ex-St. Pancras children born in the borough is conveyed to Vaccination Officers of other districts, to secure that the benefits of vaccination are conferred under the Vaccination Acts. The following table gives particulars as regards vaccination in respect of children whose births were registered in the Borough of St. Pancras from 1st January to 31st December, 1946. Figures for 1947 are not yet available. Number Percentage of Births registered North SouthEast Southwest Whole Borough North SouthEast Southwest Whole Borough Births registered 478 1,336 1,391 3,205 100.0 100.0 100.0 100.0 Successfully vaccinated 283 797 878 1,958 59.2 59.6 63.1 61.1 Died, unvaccinated 13 38 47 98 2.7 2.8 3.4 3.1 Had smallpox — — — — — — — — Insusceptible of vaccination 1 2 6 9 — 0.1 0.4 0.2 Received certificate of conscientious objection 105 182 190 477 21.9 13.6 13.6 14.9 Postponed by medical certificate 10 5 10 25 2.1 0.4 0.7 0.8 Moved to known address in other districts 19 253 198 470 3.9 18.9 14.2 14.6 Lost sight of by removal 20 19 24 63 4.2 1.4 1.7 1.9 Unvaccinated and not accounted for in previous columns 27 40 38 105 5.6 2.9 2.7 3.2 GRAPH A. All Births, including Inward Transferred Births. BIRTHS 4229 3848 3404 2294 1498 2327 3128 3015 3422 4215 VACCINATIONS 1970 1936 1446 858 666 1319 1836 1705 1973 2695 EXEMPTIONS 1217 1214 952 460 284 44 3 555 412 507 532 PERCENT OF BIRTHS VACCINATED 465 503 424 374 444 555 586 565 576 640 [To face page 82 GRAPH B. Inward Transferred Births only. This graph and the figures relate to vaccinations of inward transfers only, i.e., children born in hospitals in other boroughs, but resident in St. Pancras. It will be noted that 71 per cent. were vaccinated. 33 The following are comparable percentages of successful vaccinations :— 1940 33.4 1941 43.6 1942 54.7 1943 57.2 1944 55.5 1945 55.5 1946 61.1 It will be seen that the total number of children born in the borough during 1946 was 3,205, a figure which includes not only births of St. Pancras residents, but of persons living in other boroughs who entered hospitals in the borough for their confinement. Of these, 1,958 were vaccinated, a percentage of 61.1. The number of St. Pancras births was 3,125, of which 1,860 were vaccinated, a percentage of 59.5. Whooping Cough. 484 cases were notified by medical practitioners, as compared with 511 for 1946, and 19 were not subsequently confirmed. An additional 82 cases came to the notice of the department and were visited. There were seven deaths. Bacteriological Examinations. To aid in diagnosis and to detect contact or carrier cases, the borough council provides bacteriological diagnosis free of charge in connection with certain diseases. This work is carried out under contract by the Royal Institute of Public Health and Hygiene, 23, Queen Square W.C.I. Positive Negative Total Diphtheria bacilli 4 380 384 Tubercle bacilli 7 99 106 Dysentery — 4 4 Hæmolytic Streptococci 1 1 2 Totals 12 484 496 CLEANSING, DISINFECTING AND RODENT CONTROL. In April, 1947, the work of cleansing, disinfection and rodent control was transferred from Camley Street, N.W.I, to the Public Health Department Annexe, Prospect Terrace, W.C.I (Tel. No. Terminus 8567). The new premises, converted from bomb-damaged flats and slipper baths, provide much better facilities for the treatment of scabies and vermin, and the modem equipment has increased the speed and efficiency of the disinfection of contaminated articles. Although a marked improvement on the old Cleansing and Disinfecting Station, it must be emphasised that the Annexe is the conversion of an existing building undertaken in difficult times, and the provision of purpose-built premises should be the aim of the future. (4626) c 34 It will be seen from the following table of attendances that the number of scabies treatments is less than half that of 1946:— Cleansing. The number of attendances during the year was as follows:— (1) Scabies. Men Women Children under 5 Schoolchildren Total 1947 Total 1946 St. Pancras 402 642 179 877 2,100 4,790 Ex St. Pancras 72 42 29 180 323 673 No fixed abode — — — — — 4 Totals 474 684 208 1,057 2,423 5,467 (2) Verminous Conditions. Men Women Children under 5 Schoolchildren Total 1947 Total 1946 Head lice St. Pancras 8 52 32 1,648 1,740 1,866 Ex St. Pancras 1 3 4 528 536 631 No fixed abode — — — — — 5 Body lice St. Pancras 419 16 — — 435 897 Ex St. Pancras 21 2 — — 23 28 No fixed abode 33 — — — 33 44 Totals 482 73 36 2,176 2,767 3,471 The majority of the children included in the above tables were brought by school officers of the London County Council under powers conferred upon them by the Education Act, 1944. Payment is made by the London County Council at the rate of two shillings per child in respect of verminous conditions, and one shilling per bath for those suffering from scabies. 35 Attendances at Cleansing Station. Total Attendances. Scabies. Vermin. Year. Scabies. Vermin. Totals. 1932 1,706 5,576 7,282 1933 1,731 5,037 6,768 1934 2,256 5,908 8,164 1935 2,051 5,944 7,995 1936 3,197 5,893 9,090 1937 2,427 5,693 8,120 1938 3,924 5,290 9,214 1939 2,081 3,879 5,960 1940 1,591 3,002 4,593 1941 2,049 4,091 6,140 1942 7,089 2,870 9,959 1943 9,152 3,033 12,185 1944 6,171 3,416 9,587 1945 6,301 2,977 9,278 1946 5,467 3,471 8,938 1947 2,423 2,767 5,190 Disinfection. Figures set out below show the number of houses, rooms, etc., dealt with after infectious diseases or following complaints of vermin:— Number of Cases Number of Houses Sprayed and Fumigated Number of Rooms and Contents Rooms only Contents only Cerebro-spinal meningitis 10 10 6 3 2 Diphtheria 52 51 55 1 2 Dysentery 8 8 7 2 1 Enteric fever 3 3 5 — — Erysipelas 30 30 13 7 11 Measles 46 46 3 6 40 Poliomyelitis 32 32 32 4 — Puerperal fever 2 2 2 — — Scabies 35 35 — — 35 Scarlet fever 112 112 101 16 3 Tuberculosis 148 148 142 16 11 Vermin 685 696 19 1,391 45 Other diseases 339 339 18 29 299 Whooping cough 6 6 — — 6 Chicken Pox 1 1 — 1 — (4626) c 2 36 Rodent Control. During 1947, the special scheme of the Ministry of Food was operated in St. Pancras. This entailed the inspection and treatment area by area of the whole Borough. In parts predominantly commercial, every building, open space and bomb site was examined by the Investigators; elsewhere visits were made to all business premises, to dwelling houses where complaints had been received in the past and to "typical" dwelling houses. No unexpected information was received from this survey, but the results of the "block treatment" which followed were very satisfactory. So far as rats in private dwellings are concerned, it can be said that in the majority of cases the infestations are linked with defective drains or sewers. The work of the Rodent Operatives, especially in sewers, no doubt keeps these infestations to a minimum, but re-infestation is always likely. Frequently it is impossible to locate the exact position of the defect, or even the drain concerned, or to prove that a defect exists. The intention in 1948, is to concentrate on rats in relation to drainage. The number of operatives employed varied, but averaged 10. A little over 10,000 investigations were made and 1,211 premises were treated. In a few additional cases the occupiers of business premises employed private pest control companies who co-operated in the time and method of treatment used by the Council in other parts of the area receiving attention. 710 complaints of rats were made to my department and 578 notices were served. Every manhole in the Council's sewers was treated twice during the year—in March and November. Treatment consisted on both occasions of pre-baiting for two days with sausage rusk and poisoning on the third day by adding zinc phosphide. On the first occasion there were complete takes of poison in 155 manholes, part-takes in 227 and no takes in 16. This indicated a kill of 5,360 rats. The corresponding figures for the second treatment were— complete takes 213, part-takes 164, no takes 13—indicating a kill of 5,900 rats. 37 SECTION 4. Sanitary Circumstances of the Area. Summary of Work carried out by District Sanitary Inspectors during 1947. Complaints received 7,550 On complaint— Whole house inspections 14 Part of house inspections 7,580 Part of house re-inspections 16,800 Infectious Diseases— Investigations 626 Inspections 22 Re-inspections 56 Smoke observations 37 Mews and stable yards 31 Shops Act inspections 1 Protection of food by-laws 6 Pharmacy and Poisons Act— First inspections 11 Subsequent inspections 3 Verminous persons 36 Housing applications 1,253 Other inspections 1,673 Housing Acts and Regulations— Inspections 2 Re-inspections 3 Houses let in lodgings— Inspections 2 Overcrowding Regulations— Inspections 3 Underground rooms 110 Drainage— Under notice 1,858 Voluntary 3,378 New buildings 334 Police Court 119 Rent Restrictions Acts 72 Ineffective visits 3,334 Rag Flock Act 1 Offensive and regulated trades 10 Total 37,375 Notices served— Rent Acts 47 Others 5,713 (4626) c 3 38 Legal Proceedings. The following prosecutions were undertaken during 1947 in respect of general sanitary work:— Date of Hearing. Address. Offence. Result of Proceedings, Court and Magistrate. PUBLIC HEALTH (LONDON) ACT, 1936. 1.1.47 34, Acton Street Staircase, watercloset, 1st floor front and back, second floor front and back, and top floor rooms, walls and ceilings dirty and plaster defective Premises being sold. Summons adjourned sine die. Mr. Frank Powell, Clerkenwell. Do. 19, Wicklow Street Main and scullery roofs defective. Defective grate in ground floor front room. Defective ceilings to first floor, front and back rooms. Badly fitted windows in ground and first floor back rooms. Defective reveals to yard door Work commenced. Summons adjourned sine die. Costs £2 2s. Mr. Frank Powell, Clerkenwell. Do. 2, Barclay Street Defective roof. (Previous summons adjourned on 15.10.46 for work to be completed) Adjourned 28 days. Costs £2 2s. Mr. Frank Powell, Clerkenwell. Do. 22, Barclay Street Defective roof - Work in progress. Summons adjourned 28 days. Costs £2 2s. Mr. Frank Powell, Clerkenwell. 16.1.47 20, Mornington Crescent Hopper defective to rainwater pipe. Accumulation at rear dangerous to health Adjourned sine die. Mr. Ivan Snell, Marylebone. 27.1.47 39, Hadley Street Defective watercloset pan and trap Nuisance abated. Summons withdrawn. Costs £2 2s. Mr. Ronald Powell, Marylebone. 29.1.47 48, Highgate Road Front eaves gutter defective Undertaking given to remedy as soon as weather permits. Adjourned sine die. Costs £2 2s. Mr. Frank Powell, Clerkenwell. 4.2.47 51, Chalk Farm Road Absence of water supply to watercloset cistern Order to abate nuisance within 14 days. Costs £2 2s. Mr. Ronald Powell, Marylebone. 12.2.47 61, Doynton Street Failing to comply with Abatement Order requiring the repair of defective main roof Order complied with. Summons withdrawn. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 40, Raydon Street Defective dustbin Nuisance abated. Summons withdrawn. Costs £1 ls. Mr. Bertram Reece, Clerkenwell. Do. 22, Barclay Street Defective roof Nuisance abated. Summons withdrawn. Mr. Bertram Reece, Clerkenwell. 4.3.47 73, Falkland Road Main roof leaking Work to commence when weather permits. Summons adjourned sine die. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. 12.3.47 2, Barclay Street Defective roof Summons adjourned sine die. Mr. Frank Powell, Clerkenwell. Do. 40, Raydon Street Main roof defective Summons adjourned sine die. Costs £2 2s. Mr. Frank Powell, Clerkenwell. 39 Date of Hearing. Address. Offence. Result of Proceedings, Court and Magistrate. PUBLIC HEALTH (LONDON) ACT, 1936—cont. 26.3.47 51, Chalk Farm Road Failing to comply with Abatement Order to supply water to w.c. cistern Fined 40s. Costs £2 2s. Mr. Ronald Powell, Marylebone. 27.3.47 72, Highgate Road Torn and hanging wall and ceiling paper Nuisance abated. Summons withdrawn. Costs £2 2s. Mr. Frank Powell, Clerkenwell. 3.4.47 39, Chester Road Damp walls, ceiling plaster loose Adjourned sine die. Undertaking given to complete repairs within 28 days of granting of licence. Costs £4 4s. Mr. Frank Powell, Clerkenwell. Do. Do. Ceiling defective in basement passage 8.4.47 44, Lulot Street Back addition roof leaking Order made to abate nuisance within 14 days. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 48, Lulot Street Damp walls. Roof leaking. Gutter fallen. Ceiling and wall plaster loose 14 days' Abatement Order made. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 58, Lulot Street Ceiling plaster fallen. Mantelshelf loose 14 days' Abatement Order made. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. Do. Main and back addition roofs defective. Wall paper loose, ceiling defective 14 days' Abatement Order made. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. 21.4.47 13, Dartmouth Park Road Main roof leaking Work done. Summons withdrawn. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. 23.4.47 10, Lancing Street Drain choked. An occupied house without sufficient supply of water 7 days' Abatement Order made. Costs £1 1s. Mr. Blake Odgers, Clerkenwell. Do. 18, Lancing Street Burst water service pipe Work done. Summons dismissed under P. of O. Act. Costs £1 1s. Mr. Blake Odgers, Clerkenwell. 28.4.47 2, Barclay Street Defective wall plaster 28 days' Order. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 7, Barclay Street Defective roof. Defective wall and ceiling plaster 28 days' Order. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 15, Barclay Street Defective main and wash-house roofs. Defective rainwater pipe. Defective ceiling plaster 28 days' Order. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 16, Barclay Street Defective roofs. Guttering missing. Defective rainwater pipe. Defective flooring Work done. Summons dismissed under P. of O. Act. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. Do. 45, Barclay Street Verminous rooms Fined £5. Mr. Bertram Reece, Clerkenwell. Do. 46, Barclay Street Defective roof 28 days' Order. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 47, Barclay Street Defective roof 28 days' Order. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 50, Barclay Street Defective roof. Defective ceiling plaster 28 days' Order. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 60, Barclay Street Dirty passage walls and ceiling 28 days' Order. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. (4626) C 4 40 Date of Hearing. Address. Offence. Result of Proceedings, Court and Magistrate. PUBLIC HEALTH (LONDON) ACT, 1936-cont. 28.4.47 61, Barclay Street Defective roof. Defective ceiling plaster 28 days' Order. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 65, Barclay Street Roof defective. Vent pipe access plate missing. Rainwater pipe missing 28 days' Order. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 45, Barclay Street Roofs defective. Plaster defective 28 days' Order. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 67, Barclay Street Defective roof. Defective wall plaster. Defective mantelpiece and fireplace jambs 28 days' Order. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. 30.4.47 55, Albert Street Defective dustbin Nuisance abated. Summons withdrawn. Costs £2 2s. Mr. Sandbach, K.C., Marylebone. Do. 12, Jamestown Road An occupied house without a sufficient supply of water on top floor Summons dismissed owing to Statutory Notice having been served on person other than the owner. Mr. Sandbach, K.C., Marylebone. Do. 37, Jamestown Road Accumulation of builder's rubbish in yard Nuisance abated. Summons withdrawn. Costs £2 2s. Mr. Sandbach, K.C., Marylebone. Do. 15, Kingstown Street Flooring defective. Absence of firegrate Fined £2. 21 days' Order. Costs £1 1s. Mr. Sandbach, K.C., Marylebone. Do. 27, Kingstown Street Roof and gutter defective. Wall plaster defective. Window sill defective Fined £2. 21 days' Order. Costs £1 1s. Mr. Sandbach, K.C., Marylebone. 14.5.47 109, Gaisford Street Defective ceiling and wall plaster Work done. Summons dismissed under P. of O. Act. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. Do. 64, Patshull Road Walls damp and plaster defective 14 days' Order. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. Do. 117, Gaisford Street Defective w.c. pan 14 days' Order. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. Do. 26, Wrotham Road Defective roof. Dampness. Defective guttering. Dirty walls and ceiling Adjourned sine die. Work since done and Costs £2 2s. received. Mr. Bertram Reece, Clerkenwell. Do. 29, Wrotham Road Defective roof. Dampness. Defective plaster. Defective kitchen range Adjourned sine die. Work since done and Costs £2 2s. received. Mr. Bertram Reece, Clerkenwell. Do. 87, Islip Street Defective roof Adjourned sine die. Work since done and Costs £2 2s. received. Mr. Bertram Reece, Clerkenwell. 21.5.47 99, Fortess Road Yard w.c. fitting defective 7 days' Order. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. Do. 31, Leverton Street Defective roof and guttering Adjourned sine die as Defendants ceased to be owners. Mr. Bertram Reece, Clerkenwell. 41 Date of Hearing. Address. Offence. Result of Proceedings, Court and Magistrate. PUBLIC HEALTH (LONDON) ACT. 1936—cont. 21.5.47 27, York Rise Damp walls. Sink waste pipe untrapped. W.c. fitting leaking. Manhole cover broken. Defective wall and ceiling plaster. Sash weights out of adjustment Work in progress. Adjourned sine die. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. 23.5.47 61, Arlington Road Dirty walls and ceilings. Dampness. Roof defective. Guttering defective. Wall plaster defective Work done. Summons withdrawn. Costs £1 1s. Mr. Ronald Powell, Marylebone. 27.5.47 128, Royal College Street Defective w.c. pan Work done. Summons withdrawn. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. 10.6.47 85, York Way Defective roofs. Defective ceilings Work done. Summonses withdrawn. Costs £4 4s. Mr. Bertram Reece, Clerkenwell. Do. Do. Defective wall plaster 24.6.47 195, Hampstead Road Choked drain 14 days' Order. Costs £3 3s. Mr. Ivan Snell, Marylebone. 22.7.47 9, Doughty Mews Defective roof and damp walls Work in progress. Adjourned sine die. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. 19.8.47 11, St. Martin's Close Defective rain-water pipe, plaster, flooring, glazing and flue pipe Work done. Summons withdrawn. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 53, Pratt Street Defective roof, plaster and ceiling boarding; defective flooring and range; untrapped sink; absence of water supply to first and top floors. 28 days' order. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. 16.9.47 46, Acton Street No water supply to top floor rooms 28 days' order. Costs £2 2s. Mr. Frank Powell, Clerkenwell. Do. 1, Lancing Street Burst water service pipe in basement Work done. Summons withdrawn. Costs £1 1s. Mr. Frank Powell, Clerkenwell. Do. 4, Lancing Street Defective wall and ceiling plaster Work in progress. Adjourned sine die. Costs £1 1s. Mr. Frank Powell, Clerkenwell. Do. 9, Lancing Street Defective roof Work done. Awaiting test. Adjourned sine die. Costs £1 1s. Mr. Frank Powell. Clerkenwell. Do. 18, Lancing Street Wall and ceiling plaster defective; fireplace jambs and mantelpiece loose; communicating door missing Written undertaking received. Adjourned sine die. Costs £1 1s. Mr. Frank Powell, Clerkenwell. 6.10.47 21, Bertram Street Main roof leaking Work done. Adjourned sine die. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 89, Cromer Street Water supply defective. Accumulation of rubbish Work done. Summons withdrawn. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. Flat 1a, 89, Cromer Street Front basement room walls damp Work done. Summons withdrawn. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. Do. 1, Lancing Street Defective roof, rain-water pipe, grate, fireplace, wall and ceiling plaster Work in hand. Summons withdrawn. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 2, Lancing Street Defective roof, ceiling plaster and grate Work in hand. Summons withdrawn. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. 13.10.47 70, Lulot Street Main drain stopped Work carried out by Borough Council. Dismissed under Probation of Offenders' Act. Costs £2 2s. Mr. Frank Powell, Clerkenwell. 42 Date of Hearing. Address. Offence. Result of Proceedings, Court and Magistrate. PUBLIC HEALTH (LONDON) ACT, 1936—cont. 13.10.47 48, Falkland Road Dampness and defective plaster Work completed. Summons withdrawn. No costs either side. Mr. Frank Powell, Clerkenwell. Do. 58, Raydon Street Ceiling plaster fallen Work completed. Summons withdrawn. Costs £2 2s. Mr. Frank Powell, Clerkenwell. 15.10.47 95, Weedington Road Defective water supply pipe 7 days' Order. Costs £2 2s. Mr. H. F. R. Sturge, Marylebone. Do. 179, Gloucester Avenue Defective water fittings, flooring, plaster. Insanitary stone sink 21 days' Order. Costs £2 2s. Mr. H. F. R. Sturge, Marylebone. Do. 21, Prince of Wales Road Defective main roof. Damp walls 21 days' Order. Costs £2 2s. Mr. H. F. R. Sturge, Marylebone. 22.10.47 223, Camden Road Defective main roof and ceiling plaster. Adjourned sine die. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. Do. 111, Chalton Street Dirty walls and ceiling. Main roof defective Work in progress. Summons withdrawn. No costs. Mr. Bertram Reece, Clerkenwell. Do. 53, Gaisford Street Damp walls. Defective wall plaster Adjourned sine die. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. 12.11.47 14, St. Leonards Square Defective ceiling plaster, grate, sink waste pipe, yard surface, main roof 21 days' Order. Costs £2 2s. Mr. Ivan Snell, Marylebone. 24.11.47 29, Healey Street Dampness. Defective roof. Smoke nuisance. Dirty walls and ceilings Work completed. Summons withdrawn. Costs £2 2s. Mr. Ivan Snell, Marylebone. Do. 22, Hawley Road Defective w.c. roof, plaster, manhole cover. Drain interceptor cap missing. Dampness: Street door weatherboard required Work completed. Summons withdrawn. Costs £3 3s. Mr. Ivan Snell, Marylebone. Do. 20, Egbert Place Dirty walls and ceilings. Defective roof and plaster. Displaced window frames Adjourned sine die. Mr. Ivan Snell, Marylebone. 26.11.47 13, Drummond Street Defective roof gutter, w.c. flush joint, waste pipe from sink, wall plaster, jambs. Accumulation dangerous to health 28 days' Order. Mr. Bertram Reece, Clerkenwell. Do. Do. Overcrowding of basement front room 28 days' Order. Mr. Bertram Reece, Clerkenwell. Do. 15, Drummond Street Defective roofs and w.c. flush joint 28 days' Order. Mr. Bertram Reece, Clerkenwell. Do. Do. Water closet stopped Work completed. Summons withdrawn. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. 27.11.47 65, Bartholomew Road Without proper and sufficient supply of water 28 days' Order. Mr. T. F. Davies, Clerkenwell. 18.12.47 20, Elm Road Dampness: defective gutter, dustbin, plaster Work in progress. Summons withdrawn. Costs £5 5s. Mr. T. F. Davies, Clerkenwell. HOUSING ACT, 1936. L.C.C. Lodging-house Byelaws. 21.4.47 17, Evangelist Road Defective sash cords Work in progress. Summons adjourned sine die. Costs £3 3s. Mr. Bertram Reece, Clerkenwell. Do. Do. Walls damp. Roof defective. Ceiling paper torn 43 Date of Hearing. Address. Offence. Result of Proceedings, Court and Magistrate. HOUSING ACT, 1936—cont. L.C.C. Lodging-house Byelaws—cont. 28.4.47 2, Barclay Street Defective sashcords, glazing, parting-slips, etc. Fined £2. Mr. Bertram Reece, Clerkenwell. Do. 45, Barclay Street Defective sashcords Fined £2. Mr. Bertram Reece, Clerkenwell. Do. 46, Barclay Street Defective window-frame. Missing baluster rails. Dirty and defective walls and ceilings Fined £2. Mr. Bertram Reece, Clerkenwell. Do. 67, Barclay Street Defective stair-treads. Dirty walls and ceilings Fined £2. Mr. Bertram Reece, Clerkenwell. 21.5.47 23, Churchill Road Dirty walls and ceiling Work in progress. Adjourned sine die. Costs £2 2s. Mr. Bertram Reece, Clerkenwell. 10.6.47 85, York Way Failure to cleanse walls and ceilings See under Public Health (London) Act, 1936. 19.8.47 53, Pratt Street Defective sashcords, dirty walls and ceilings Fined £2. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. 16.9.47 4, Lancing Street Failure to cleanse rooms, passages and staircases Work in progress. Adjourned sine die. Costs £1 1s. Mr. Frank Powell, Clerkenwell. Do. 18,Lancing Street Defective sashcords, parting slips, beading, glazing, dirty walls and ceilings. Written undertaking received. Adjourned sine die. Costs £1 1s. Mr. Frank Powell, Clerkenwell. 6.10.47 1, Lancing Street Failure to cleanse walls and ceilings Work in hand. Summons withdrawn. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. Do. 2, Lancing Street Failure to cleanse walls and ceilings Work in hand. Summons withdrawn. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. Do. 2, Lancing Street Failure to remedy defective sashcords Work in hand. Summons withdrawn. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. Do. Flat 1, 89, Cromer Street Failure to cleanse walls and ceiling; remedy defective wall plaster Work done. Summons withdrawn. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. 13.10.47 48, Falkland Road Failing to cleanse ceilings See P.H. (Lond.) Act, 1936. Do. 58, Raydon Street Failing to cleanse ceiling and frieze See P.H. (Lond.) Act, 1936. 21.11.47 179, Gloucester Avenue Failing to cleanse walls and ceiling of basement w.c. compartment Fined £2. Costs £2 2s. Mr. Ronald Powell, Marylebone. 24.11.47 22, Hawley Road Failing to ease windows See under P.H. (Lond.) Act, 1936. Do. Do. Defective stairs See under P.H. (Lond.) Act, 1936. 26.11.47 13,Drummond Street Defective sashcords Fined 25s. Mr. Bertram Reece, Clerkenwell. Do. Do. Defective plaster Fined 25s. Mr. Bertram Reece, Clerkenwell. Do. Do. Dirty walls and ceilings Fined 25s. Mr. Bertram Reece, Clerkenwell. Do. 15, Drummond Street Defective sashcords and putties Fined 25s. Mr. Bertram Reece, Clerkenwell. Do. Do. Defective plaster and stair treads Fined 25s. Mr. Bertram Reece, Clerkenwell. Do. Do. Dirty walls and ceilings to w.c. apartments Fined 25s. Mr. Bertram Reece, Clerkenwell. 18.12.47 20, Elm Road Defective glazing See under P.H. (Lond.) Act, 1936. Do. Do. Dirty walls and ceilings See under P.H. (Lond.) Act, 1936. 44 Date of Hearing. Address. Offence. Result of Proceedings, Court and Magistrate. PUBLIC HEALTH (LONDON) ACT, 1891. L.C.C. Bye-laws with respect to Water-closets, Ash-pits, etc. 12.3.47 61, Doynton Street Absence of dustbin Dustbin provided. Summons withdrawn. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. 30.4.47 55, Albert Street Insufficient dustbin accommodation See under P.H. (Lond.) Act, 1936. Do. 39, Regents Park Road Insufficient dustbin accommodation Fined £1. Costs £1 1s. Mr. Sandbach, K.C., Marylebone. 21.5.47 193, Dartmouth Park Hill Insufficient dustbin accommodation Nuisance abated. Dismissed under P. of O. Act. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. Do. 27, York Rise Defective w.c. ceiling Work in progress. Adjourned sine die. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. Do. Do. Defective w.c. seat Work in progress. Adjourned sine die. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. 19.8.47 53, Pratt Street Insufficient dustbin accommodation Fined £2 2s. Mr. Bertram Reece, Clerkenwell. 6.10.47 1, Lancing Street Defective wall plaster to w.c. apartment Work in hand. Summons withdrawn. Costs £1 1s. Mr. Bertram Reece, Clerkenwell. 26.11.47 13, Drummond Street Defective door to w.c. apartment Fined 25s. Costs £5 5s. Mr. Bertram Reece, Clerkenwell. Do. 15, Drummond Street Defective w.c. doors and water waste preventers Fined 25s. Mr. Bertram Reece, Clerkenwell. 18.12.47 20, Elm Road Failing to provide additional portable metal dustbin See under P.H. (Lond.) Act, 1936. PUBLIC HEALTH (LONDON) ACT, 1891. Vestry Bye laws. 30.4.47 27, Kingstown Street Yard paving defective Fined £2. Costs £1 1s. Mr. Sandbach, K.C., Marylebone. METROPOLIS MANAGEMENT ACT, 1855, AND METROPOLIS MANAGEMENT ACTS AMENDMENT (BYELAWS) ACT, 1899. L.C.C. Drainage Byelaws. 12.3.47 48, BurghleyRoad Carrying out sanitary work in a manner contrary to the bye laws Summons adjourned sine die. Costs £2 2s. Mr. Frank Powell, Clerkenwell. 16.4.47 14, Chalk Farm Road Installing sink without notice Summons dismissed. Mr. Ronald Powell, Marylebone. Do. Do. Installing w.c. pan and trap without notice Fined 10s. Costs £1 1s. Mr. Ronald Powell, Marylebone. Do. Do. Installing w.c. pan and trap in a manner contrary to Byelaws Fined £2. Mr. Ronald Powell, Marylebone. 16.6.47 43, Argyle Square Carrying out drainage work contrary to Byelaws £3 3s. Costs. Mr. Frank Powell, Clerkenwell. Do. Do. Carrying out drainage work without depositing plans £3 3s. Costs. Mr. Frank Powell, Clerkenwell. Do. Do. Carrying out drainage work without giving notice Not dealt with separately. Do, Do. Installing waste pipes without ventilating the traps Do. Do. Do. Installing lavatory basin with waste pipe discharging into hopper head Do. 20.10.47 48, Burghley Road Installing a water supply and sink and means of carrying off waste water from the top floor in a manner contrary to the Byelaws Costs £2 2s. Mr. Hopkins, Clerkenwell. 45 Date of Hearing. Address. Offence. Result of Proceedings, Court and Magistrate. DEFENCE (GENERAL) REGULATIONS, 1939. Scabies Order, 1941. 3.3.47 – Failing to present himself at Camley Street Clinic to be cleansed from vermin Defendant died. Summons withdrawn. Mr. Ronald Powell, Marylebone PUBLIC HEALTH (LONDON) ACT, 1936—SECTION 136. Rag Flock Regulations, 1912. 1.9.47 – Selling rag flock which did not comply with- the prescribed standard of cleanliness Case dismissed. Magistrate not satisfied that the substance was rag flock. Mr. Ronald Powell, Marylebone. Housing. A number of re-housing applications were dealt with by having such premises inspected and the prescribed form forwarded to the London County Council. The number of applications referred by the borough to the London County Council for information as to overcrowding was 509, and 76 on account of tuberculosis in the family. Water. The bulk of the water supply in the borough is provided by the Metropolitan Water Board, and has been satisfactory in quality and quantity. The Water Act, 1945, makes provision for the conservation and proper use of water resources and supplies. Local authorities and statutory water undertakers may be required to carry out surveys of the existing consumption, the demand for water supplies and of the water resources in, or available for, their area. They may also be asked to prepare an estimate of their future requirements and to formulate proposals to meet them. Regulations known as the Water Abstraction Regulations, 1947, have been made under Section 6 of the main Act and require any person who abstracts water from an underground source to keep records if the plant is capable of yielding at least 20,000 or 50,000 gallons of water per day, the figure depending on the part of the country where the well is situated. The records must give the following information:— (i) The quantity of water abstracted each day; (ii) The rest and the level after pumping (i.e., the pumping level) at some time in the month of October in each year; (iii) Certified copies of the analyses of the water. These records are to be maintained over a period of five years. In addition to the well, which is available if necessary to augment the water supply to the Council's swimming bath at Prince of Wales Road, there are four commercial concerns in the borough which draw their water supply from wells situated on their own premises. These firms have been notified of their responsibility in keeping records as required by the Water Abstraction Regulations, 1947. 46 During the past two years, in the winter and summer months, samples of water have been taken from these wells for chemical and bacteriological examination and also of water pumped from wells situated outside the borough to various points on the railway system centred on Euston Station, and appropriate action has been taken when recommended by the Public Analyst. Samples of water have also been taken regularly from the Council's swimming baths at Plender Street and Prince of Wales Road, and following the receipt of unsatisfactory reports from the Public Analyst in respect of the former, the Medical Officer of Health recommended that the use of this swimming bath should be discontinued. The Plender Street swimming baths are not now in use. Following the recent outbreak of infantile paralysis the Council directed that the water at the Prince of Wales Road baths should be examined at monthly intervals. The Public Analyst's reports indicated that the water was satisfactory. SECTION 5. Factories and Bakehouses. Particulars of inspections and other work carried out by the two Factory Inspectors during 1947 are given in the following table:— Totals Number of visits to— Factories (with mechanical power) 1,746 Factories (without mechanical power) 544 Workplaces 258 Restaurant kitchens 787 Scabies and verminous cases 78 Other visits 541 Total 3,954 Notices served relating to— Factories (with mechanical power) 176 Factories (without mechanical power) 51 Workplaces 19 Bakehouses 57 Restaurants 40 Total 343* *{ 293 were served under the Factories Act, 1937. {10 ,, ,, Public Health (London) Act, 1936. { 40 (Restaurants) under the Food and Drugs Act, 1938. 47 Factories Act, 1937. The following particulars are furnished in accordance with Section 128(3) of the above Act, with respect to matters under Part I and Part VIII:— Part I of the Act. 1. Inspections, etc. Premises Number on Register. Number of Inspections. Written Notices. Occupiers Prosecuted. (i) Non-power factories, in which Sections 1, 2, 3, 4 and 6 are enforced by Local Authorities 382 544 109 Nil. (ii) Power factories in which Section 7 only is enforced by the Local Authority 1,361 1,746 165 Nil. (iii) Other Premises, excluding out-workers' premises 420 799 19 Nil. Totals †2,163 3,089 293* Nil. * Not including 10 notices served under Public Health (London) Act, 1936. † Does NOT include 341 unoccupied premises formerly used for commercial purposes. 2. Cases in which defects were found. Particulars. Found. Remedied. Referred. Number of prosecutions. To H.M. Inspector. By H.M. Inspector. Want of cleanliness (S. 1) 84 84 6 3 — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) 1 1 — 1 — Inadequate ventilation (S.4) 2 2 — 2 — . Ineffective drainage of floors (S.6) — — — — — Sanitary Conveniences (S.7)— (a) Insufficient 4 4 — 2 — (b) Unsuitable or defective 181 181 — 28 — (c) Not separate for sexes 5 5 — 1 — Other offences against the Act (not including offences relating to Outwork) 16 16 — — — Totals 293 293 6 37 — 48 Part VIII of the Act. Outworkers. In certain industries specified in the Act, if work is given out by employers or contractors to be done by workers in their own homes, lists containing the names and addresses of such workers must be forwarded to the Local Authority, with the object of preventing work being carried out in premises which are insanitary or in which infectious disease is present. The following table gives the number and type of such premises in the borough, and the nature of the work carried out:— Wearing apparel— Making, etc. 371 Cleaning and washing 5 Household linen 8 Curtains and furniture hangings 2 Furniture and upholstery 3 Electro-plate 9 Fur pulling 1 Umbrellas, etc. 2 Artificial flowers 3 Paper bags 2 The making of boxes or other receptacles or parts thereof made wholly or partially of paper 7 Brush making 23 Feather sorting 4 Stuffed toys 131 Chocolates and sweetmeats 3 Cosaques, Christmas crackers, Christmas stockings, etc. 2 Lampshades 1 Total 577 There were no instances of default in sending lists to the Council, nor was legal action taken in any case. 49 SECTION 6. Inspection and Supervision of Food. The work of food inspection was carried out by two inspectors from the beginning of the year until the 3rd November, after which one addition was made to this staff. Particulars of the inspections and other work carried out by these officers during 1947 are given in the following table:— Number of visits to— Milkshops 149 Dairies 503 Ice cream premise 704 Slaughterhouses 9 Butchers' shops and meat stalls 899 Prepared meat premises 369 Fishmongers' shops 153 Fried fish shops 101 Fish curers' premises 23 Other premises where food and drugs are sold 993 Market streets and places 956 Railway goods yards, warehouses, etc. 146 Attendances at Police Court 34 Re-inspections after Intimation Notices 20 Other visits 597 Total 5,656* * These visits do not include visits made for the purpose of taking samples. Number of samples taken— Formal 402 Informal 398 Bacteriological 206 Total 1,006 Unsound Foods. Surrenders 441 Seizures 1 Milk Supply. Number of purveyors on the Register at the end of the year were:— Dairies 134 Itinerant purveyors 69 For sale of milk in sealed containers only 188 For sale of cream and artificial cream 9 (4626) d 50 The Inspectors made 652 visits, and 315 formal samples were taken and submitted for analysis. Milk (Special Designations) Regulations, 1936 to 1946. The number of licences granted during 1947 were:— Licences. Supplementary. To sell Tuberculin Tested milk 48 6 To sell Pasteurised milk 62 8 To pasteurise milk 1 — Meat and Other Foods. (i) Public Health (Meat) Regulations, 1924. Periodical visits of inspection were made as follows:— Butchers' Shops and Meat Stalls 899 Prepared Meat premises 369 (ii) Inspection of other premises where food is prepared or offered for sale. The Food Inspectors have continued to keep all such premises under regular and frequent observation, the following inspections being made for this purpose:— Ice cream 704 Fishmongers 153 Fried fish 101 Others 993 Food Sampling. A total of 800 samples (402 formal and 398 informal) were sent for analysis, of which 4 formal and 10 informal were found to be adulterated. Bacteriological Examination of Samples of Milk and Ice Cream. In addition to the ordinary samples of food submitted to the Public Analyst for chemical examination, I have to report that a total of 201 samples of milk and ice cream were procured by the Food Inspectors and submitted to the Royal Institute of Public Health and Hygiene for bacteriological examination. 1. Milk. A total of 100 samples of milk were taken from the London County Council schools and institutions, day nurseries and dairies to ascertain whether they complied with the Milk (Special Designations) Regulations, 1936 to 1946, together with the Heat Treated (Prescribed Tests) Order, 1944. The samples were subjected to the Phosphatase Test (which indicates the efficiency of the method of heat treatment) and the Methylene Blue Test indicating the keeping quality of the milk. All the samples complied with the Phosphatase Test. In regard to the Methylene Blue Test, 89 samples proved to be satisfactory and 11 unsatisfactory. The unsatisfactory samples were taken during the hot weather months of the year. Appropriate action was taken in each case and a "follow up" sample invariably showed that the fault had been put right. Eleven of the above-mentioned samples were taken from the one pasteurising plant in the borough, and all of these samples complied with the two above-mentioned tests. 51 Bacteriological Samples—Milk, 1947. T.T. (Past) Past. Ster. H.T. Totals Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory Satisfactory Unsatisfactory L.C.C. Schools and Institutions — — 36 5 – – 2 1 38 6 Day Nurseries — — 4 — — — 6 4 10 4 Dairies 11 1 26 — 3 — 1 — 41 1 Totals 11 1 66 5 3 — 9 5 89 11 2. Ice Cream. A total of 101 samples of ice cream were submitted for examination. Broadly, the results of these examinations were that 57 could be regarded as satisfactory and 44 unsatisfactory. It must be remembered that there is no legal standard for the bacteriological quality of ice cream. The Ice Cream (Heat Treatment, etc.) Regulations came into force on the first day of May this year, and in connection therewith the Minister of Health (in circular 69/47) stated that he was still not satisfied that there was any test, the reliability of which was sufficiently established to justify its use as a statutory test, non-compliance with which would constitute an offence. The Minister, however, drew attention to a form of methylene blue test adopted for testing ice cream. This proposed provisional test suggested four grades—1, 2, 3, and 4 and it was suggested that if, out of the four grades recommended ice cream consistently failed to reach grades 1 or 2 it would be reasonable to regard this as indicating defects of manufacture or of handling which called for further investigation. As from the 1st May, 1947, a total of 76 samples of ice cream were submitted for examination by the methylene blue test the results of which were as follows:— Grade I 17 }Satisfactory. „ II 14 } „ III 23 }Unsatisfactory. „ IV 22 } Total 76 Too much importance must not be given to these figures, as the test is only a provisional one. Where a sample was graded 3 or 4 a visit to the premises was made and everything possible was done to ascertain where the trouble was, and to give advice as to bringing about an improvement. In this connection manufacturers were only too anxious to co-operate with the authority in trying to place a wholesome product on the market. In some cases a check examination for B. Coli was made in addition to the methylene blue test, and in a few instances of samples of ice cream placed only in grade III it was reported (4626) D 2 52 that B. Coli was absent in 1 m.l. or present only in 0.1 m.l. (which must be regarded as satisfactory). It is difficult to reconcile the two conflicting reports on the same samples, and it is for this reason, no doubt, that the test is regarded only as a provisional one. The explanation is, perhaps, that the methylene blue test varies according to the type and activity of the bacteria rather than their number. The ice cream vendors and manufacturers in the borough are not only aware of the interest which your officials are taking in securing purity of ice cream, but are co-operating with them in their work and I consider this to be a state of affairs which presages well for the future. I would add that in spite of the many difficulties encountered, many improvements have been made both in equipment and premises during the year under review, the benefits of which are not reflected in this year's results inasmuch as many of them were not made until the end of the year. It is hoped, therefore, that the results of 1948, will show a marked improvement on 1947. There were also two samples of synthetic bakery filling cream taken from a very large manufacturer of this product in the borough. Both samples were reported to be very satisfactory from a bacteriological point of view. Legal Proceedings. The following prosecutions were undertaken during 1947 in respect of food and drugs:— Food and Drugs Act, 1938. Date of Hearing. Offence. Result of Proceedings, Court and Magistrate. 15.4.47 Selling apple tonic wine deficient in proof spirit by 12.9 per cent. of the amount stated on the label Fined £10. Costs £10 10s. Mr. Bertram Reece, Clerkenwell. 21.4.47 Exposing for sale two hen carcases intended for but unfit for human consumption Fined £4. Costs £1 1s. Mr. Ronald Powell, Marylebone. Do. Selling a hen carcase intended for but unfit for human consumption Case not dealt with separately. Mr. Ronald Powell, Marylebone. 10.6.47 Selling beef sausages containing only 28 per cent. of meat Fined £2. Costs £5. Mr. Powell, Clerkenwell. 16.6.47 Selling flour intended for but unfit for human consumption Fined £3. Costs £5 5s. Mr. Powell, Clerkenwell. 11.8.47 Failing to prevent the risk of contamination of ice cream Case not dealt with separately. Mr. Paul Bennett, V.C., Marlborough Street. Do. Storing ice cream at unregistered premises Fined £25. Costs £5 5s. Mr. Paul Bennett, V.C., Marlborough Street. 6.10.47 Selling split peas intended for but unfit for human consumption Fined £5. Costs £4 4s. Mr. Bertram Reece, Clerkenwell. 13.10.47 Non-brewed vinegar deficient in acetic acid to the extent of at least 59.5 per cent. Dismissed under Probation of Offenders' Act. Costs £2 2s. Mr. Frank Powell, Clerkenwell. 5.11.47 Failing to take all such steps as might be reasonably necessary to prevent risk of contamination of food in the bakehouse and flour loft Summons withdrawn. Mr. Paul Bennett, V.C., Marlborough Street. Do. Bun intended for but unfit for human consumption Fined £5. Costs £5 5s. Mr. Paul Bennett, V.C., Marlborough Street. 10.11.47 Selling stout intended for but unfit for human consumption Dismissed under Probation of Offenders Act. Costs £2 2s. Mr. Ivan Snell, Marylebone. 27.11.47 Selling loaf of bread intended for, but unfit for human consumption Fined 40s. Costs £3 3s. Mr. T. F. Davies, Clerkenwell. Do. Failing to take all such steps as might be reasonably necessary to prevent risk of contamination of food Fined 40s. Mr. T. F. Davies, Clerkenwell. 53 Unsound Food Condemned and Destroyed. During the year 1947, the undermentioned unsound or diseased food was surrendered by the owners and dealt with by the Food Inspectors. Wherever possible the food was used for cattle feeding. Articles. Quantity. Articles. Quantity. Apple Pulp 9 galls + 38 lbs. Lobsters 20 lb. Bacon 23 lbs. Macaroni 48 lbs. Beef 1,922 lbs. Margarine 1½ lbs. Biscuits 38 lbs. Meat Pies 1,113 Black Pudding 1 carton. Mussels 5 cwt. Bread 389 loaves. Mutton 5 lbs. Bread Pudding 67 portions. Onions 6 half bags. Brisket of Beef 4 lbs. Oranges 374 lb. Broccoli 18 bags. Ovaltine 22 lb. Brussel Sprouts 290 bags. Ox-Tongue 48 lb. „ Tops 94 „ Parsley 15 bags. Butter l½ lbs. Parsnips 64 bags. Butter beans 212 lbs. Pearl Barley 2,742 lbs. Cabbages 10 bags. Pears 203 boxes. Cake 133 lbs. Peas 39 lbs. Cakes 70 Pickles 49 jars, 10 cartons Cake Mixture 55 lbs. Pigeons 30 lbs. Calves Heads 24 lbs. Pigs plucks 112 lbs. Canned Food 8,475 tins. „ kidneys 20 lbs. Cauliflowers 191 bags. Pork Luncheon Meat 17 lbs. Celery 360 Rolls. Pork Pies 190 lbs. Cereals 13 lbs. Pork Roll 3 lbs. Cheese 10½ lbs. Porridge Oats 5 cwts. Cherries 20 cases. Potatoes 377 cwt. + 233 bags Chestnuts 21 lbs. Prunes 155 lbs. Chicken 2.l3½ lbs. + 7 crates. Rabbits 120 lbs. + 4 sacks Chocolate 33¾ lbs. +5 crates. ,, beans 36 lbs. Rice Substitute 31 lbs. Cocoa 21 lbs. Rolled Oats 19 lbs. Confectionery 17 lbs. Sausages 534 lbs. Corned Beef 1,822 lbs. Sausage Meat 28 lbs. Crumpets 750 Semolina 42 lbs. Dates 352½ lbs. Shredded Suet 20 lbs. Ducks 1 crate. Shrimps 3 cases. Eggs 255 Soft Drink (cone) 1 Gall. Egg Powder 1½ lbs. Soup Powder 35 cartons. Fish 3,195 stone. Strawberries 5 crates. Fishcakes 105 Sugar 286 lbs. Flaked Barley 73 lbs. Swedes 400 bags. Flour 227 lbs. "Swephat" 112 lbs. Galantine 12½ lbs. Syrup 8 lbs. Gherkins 463 lbs. Tangerines 50 boxes. Ham 18 lbs. Tarts 70 Hares 1 carton. Tea ¾ lb. Ice Cream Powder 300 lbs. Tomatoes 40 lbs. Jam 344 lbs. Tripe 25 lbs. Lamb 13 1b. Turkey 14 lbs. Lettuces 172 crates. Veal and Ham Pie 72 lbs. (4626) d 3 54 SECTION 7. Maternity and Child Welfare. Health Visitors. The number of Health Visitors employed at the end of the year— (a) by the Council, 17. (b) by the University College Hospital, 2 (equivalent to half of the whole time service of one Health Visitor). The following table gives the total number of visits made by the above mentioned Health Visitors during 1946 and 1947:— Council's Visitors University College Hospital Visitors Total 1946 1947 1946 1947 1946 1947 To Expectant mothers 3,685 2,431 159 180 3,844 2,611 To Post natal 834 736 96 78 930 814 To Children 22,935 19,507 1,345 1,222 24,280 20,729 To Child life protection 345 367 73 53 418 420 To Infectious diseases, etc. 1,739 1,491 41 48 1,780 1,539 To Other visits 1,447 1,247 14 22 1,461 1,269 Totals 30,985 25,779 1,728 1,603 32,713 27,382 Dental Treatment. Ampthill Square Camden Town Sessions 36 93 Attendances— Mothers 220 1,226 Children 140 231 The Borough Council made a contribution during the year of £136 12s. 6d. towards the total cost of £273 5s. 0d. for dentures supplied to Nursing and Expectant Mothers. 55 (4626) Maternity and Child Welfare Centres—Sessions and Attendances. Centres St. Pancras School for Mothers (Ampthill Square) Camden Town Kentish Town North St. Pancras School for Mothers (Queen's Crescent) Somers Town South Highgate Totals for Council's Centres University College Hospital Grand Totals 1947 1946 1947 1946 1947 1946 1947 1946 1947 1946 1947 1946 1947 1946 1947 1946 1947 1946 Ante-natal sessions 60 45 107 78 94 91 101 90 50 43 51 50 463 397 203 203 666 600 First attendances 243 216 398 390 314 401 394 466 625 207 109 189 2,083 1,869 397 506 2,480 2,375 Subsequent attendances 908 774 1,887 1,410 1,597 1,397 1,926 1,389 706 572 618 694 7,642 6,236 3,682 3,670 11,324 9,906 Post-natal sessions 1 — 21 24 — — — — — — — 22 24 — — 22 24 First attendances 8 — 273 333 4 — 12 — — — — — 297 333 — — 297 333 Subsequent attendances 1 — 16 — — 1 — — — — — 18 — — 18 Infant Sessions 99 99 203 241 151 151 153 153 129 102 100 102 835 848 102 103 937 951 *First attendances, age 0-1 255 193 534 396 470 367 471 398 332 287 203 204 2,265 1,845 89 79 2 354 1,924 Subsequent attendances, age 0-1 2,964 2,254 6,578 4,640 6,325 5,180 5,526 4,317 4,754 3,523 3,249 3,214 29,396 23,128 802 651 30,198 23,779 *First attendances, age 1-5 31 35 61 83 32 47 24 37 31 45 12 35 191 282 19 20 210 302 Subsequent attendances, age 1-5 972 1,330 1,863 1,886 1,765 1,840 1,003 1,205 1,685 1,438 1,545 1,752 8,833 9,451 382 331 9,215 9,782 Total attendances 4,222 3,812 9,036 7,005 8,592 7,434 7,024 5,957 6,802 5,293 5,009 5,205 40,685 34,706 1,292 1,081 41,977 35,787 Dental Clinic sessions 36 37 93 91 — — — — — — — — 129 128 — — 129 128 Attendances— Mothers 220 337 1,226 1,304 — — — — — — — — 1,446 1,641 — — 1,446 1,641 Children 140 102 231 213 — — — — — — — — 371 315 — — 371 315 Massage sessions 91 92 102 102 91 85 97 99 92 93 92 94 565 565 — — 565 565 Massage attendances 296 458 795 811 418 416 650 657 587 630 616 670 3,362 3,642 — — 3,362 3,642 Gynæcological clinics— First attendances — — — — 159 164 — — — — — — 159 164 — — 159 164 Subsequent attendances — — — — 296 436 — — — — — — 296 436 — — 296 436 Dinners— Mothers 2,347 2,809 — — — — — — — — — — 2,347 2,809 — — 2,347 2,809 Children 2,464 2,467 — — — — — — — — — — 2,464 2,467 — — 2,464 2,467 * Excluding transfers from other centres. 56 Professional Nursing in Necessitous Homes. This is provided by the staff of the following three District Nursing Associations:— Hampstead District Nursing Association, 3, Pond Street, N.W.3. Metropolitan District Nursing Association, 31, Bedford Place, Bloomsbury Square, W.C.1. North London (Islington) Nursing Association, 6 and 7, Canonbury Place, N.l. The Borough Council has an arrangement with these Associations for the home nursing, at the request of the medical practitioner in attendance, of cases of Measles, Whooping Cough, Ophthalmia Neonatorum, Pemphigus Neonatorum, Infective Enteritis, Acute Primary and Acute Influenzal Pneumonia. Arrangements are also in force with the Metropolitan District Nursing Association, for the home nursing of cases of Puerperal Fever and Puerperal Pyrexia. Payment for this nursing is included in the following block grants made by the Council:— District Nursing Association Under the Maternity and Child Welfare Scheme Under the Influenzal Pneumonia Regulations Total Block Grant £ s. £ s. £ Hampstead 20 0 10 0 30 Metropolitan 187 10 62 10 250 North London 15 0 10 0 25 Totals 222 10 82 10 305 The following table gives the number of cases and the number of visits during the past year:— District Nursing Association No. of Cases No. of Visits Hampstead 71 737 Metropolitan 117 1,105 North London 27 290 Totals 215 2,132 Midwifery Grants. By arrangement with University College Hospital assistance is accorded to the hospital where a St. Pancras mother is accepted for her confinement and is unable to pay the sum of £3 per week. This assistance is a maximum of £1 per patient admitted to the hospital, and is granted only in approved necessitous cases. During 1947 there were 40 cases. An agreed sum of £7 7s. per call is also paid to this hospital in respect of the use of an Emergency Obstetric Unit which was called upon on four occasions during the year. 57 Provision of Beds for Maternity Cases. By arrangement with the London County Council eight maternity beds are available for St. Pancras cases at the University College Hospital. These beds are filled by cases referred to the hospital by the Borough Council, and the London County Council pay an agreed sum for their retention. 188 cases were accommodated during 1947. Invalid Children's Aid Association. Under this scheme assistance is rendered towards the cost of convalescence of St. Pancras children under the age of 5 years, with a maximum of 70 cases per annum. The financial arrangements provide for a payment of 75 per cent. of the amount outstanding after allowing for any payments by parents. During 1947, 42 children were so assisted at a cost to the Council of £410 8s. 2d. Home and Domestic Helps. In May the Council authorised the employment of a maximum of ten home and domestic helps, but it was not found possible to obtain this number of persons. Towards the end of the year conditions of employment were improved and publicity was given to the need for increasing the value of this service; and at the time of writing this report the Council has in its employ 35 full-time home helps and ten part-time. The scale of charge is as follows, but in St. Pancras it is very seldom found that the full payment is made:— Scale of Assessment. From the gross income of the applicant or husband there is to be deducted rent and rates up to 30s. and compulsory insurance, then personal allowance of 15s. for each adult included and 7s. 6d. for each dependent child; children and other members of the family living at home (and earning) not to be counted as members of the family for the purpose of the scale and their incomes to be omitted. Members of the Forces to be included in number of family but their personal allowance to be excluded from the family income. The net remaining income to be assessed accordingly and the weekly payment to be made by the applicant to consist of:— One-third of the first £ of net income; One-half of the second and third £ of net income; Two-thirds of remainder of net income. (In no case shall the assessment exceed the cost of the domestic help provided. Minimum amount to be recovered, 1s.). The Home Help service is one which needs very careful supervision if it is to be entirely successful, and it has been necessary to increase the staff to make this possible. In due course it is hoped that the home help will be regarded as a permanent established servant of a local health authority and that before being employed she will be trained in practical and scientific housewifery. 158 cases were cared for under this scheme during the year. 58 Care of Premature Infants. Doctors and nurses notifying births of children have been requested to inform the Medical Officer of Health of the weight of the child at birth, and in most cases they have cooperated in this respect. Prematurity to-day is not deemed to exist in accordance with the date of birth of the child as compared with expected time of confinement. What matters more is not whether a child has been born one month or two months before the expected time, but its weight at birth, and babies are considered to be premature when their birth weight is 5½ lb. or less. Children who were designated as premature in accordance with the above were visited frequently by the Council's Health Visitors, who submitted monthly reports to the Medical Officer of Health until such time as the infant weighed 8 lb. The following table gives particulars in respect of 1947:— Where born Number Born Died in 24 hours Died between 24 hours and 1 month Survived At home 23 4 2 17 In hospital 97 6 8 83 Totals 120 10 10 100 Child Life Protection. This is governed by Part XIII of the Public Health (London) Act, 1936. The duties comprise the supervision of the health and well-being of all children who are under the care of foster mothers until such children reach the age of nine years. A register of foster mothers must be kept with a list of children under their care, and the Local Authority may fix a maximum number of nurse-infants who may be kept in any dwelling. Records must also be kept with regard to removals, deaths, offences against the Act, etc. When premises are registered for the first time, a report should be obtained as regards suitability and sanitary condition. The District Sanitary Inspectors inspect and report on the condition of the homes for registration purposes, the clerical staff of the Public Health Department keep the necessary records, and the Health Visitors at the various Welfare Centres carry out the duties of inspecting and supervising the homes, the health and well-being of the children, giving any necessary advice, and reporting contraventions of the Act. During the course of the year 15 women notified their intention to accept foster children, and these notifications were in respect of 38 children under 9 years of age received during the year, the number at the end of the year being 20. The Council's permanent Health Visitors are also designated Infant Life Protection Visitors, and in the course of supervision they paid 420 visits. Daily Guardians. At the end of the year there were 9 persons having the care of 10 children under this scheme, and the total number of visits made by the Council's Health Visitors during the year was 66. 59 Care of Illegitimate Children. A block grant of £217 was paid to the Standing Joint Committee in respect of five voluntary societies who make arrangements for the care of the unmarried mother and her child. In no case was the Council asked to make a contribution towards the cost of caring for an illegitimate child placed with a foster mother in the district. Child Guidance. An arrangement was made during the year with the Great Ormond Street Hospital, for children recommended by the Council to receive treatment at the hospital's child guidance clinic. Foot Clinics. Clinics for chiropody treatment were provided, starting in August, at Somers Town and South Highgate Welfare centres. Treatment is limited to children and expectant and nursing mothers, and as a result attendances have been low. Application has been made to the Ministry of Health for permission to extend the service to all female residents of the borough. Day Nurseries. There are seven day nurseries in the Borough, controlled by the Council, as follows:— Day Nursery Accommodation Margaret Day Nursery, 42, Phoenix Road, N.W.1 70 254-256, Camden Road, N.W.1 85 Coram Gardens Day Nursery, 40, Brunswick Square, W.C.1 54 108, Hampstead Road, N.W.1 80 Kentish Town Day Nursery, 27, Gospel Oak Grove, N.W.5 55 *Peckwater Street Day Nursery, Kentish Town, N.W.5 70 South Highgate Day Nursery, Chester Road, N.19 45 Regent's Park Day Nursery, 4, Prince Albert Road, N.W.1 52 * This nursery was closed down in May. Priority for the admission of a child to a day nursery is generally granted when the mother is the sole or main wage earner of the family, such as a widow, divorced or deserted mother, or where there is a husband who through sickness is unable to support his family. Semi-priority is granted to mothers who are State Registered Nurses wishing to do hospital work. All priority applications must be supported by Health Visitors' reports, and no child is admitted to a nursery under the priority scheme unless such a report has been obtained. When vacancies at a particular nursery are not expected for a considerable time, priority cases may be offered places at other nurseries where vacancies exist, provided the alternative nursery is reasonably near to the child's home. Mothers who accept these vacancies are later given the opportunity of transferring the child to the nursery originally applied for, if they so wish. Children on the ordinary waiting list are offered vacancies at a nursery only when there are no priority cases in their particular age group on the waiting list for that or a nearby nursery. In actual practice such children are not often admitted. 60 The numbers on the waiting lists for the St. Pancras nurseries total nearly 1,000. Of these, 50 are definitely priority cases and a further 20 are doubtful priority cases awaiting Health Visitors' reports. Incidentally, the number of priority applications has increased considerably of late, and voluntary welfare organisations as well as the welfare centres are constantly making application on behalf of special cases. 500 children were admitted to St. Pancras day nurseries during 1947, and approximately 350 of these were priority cases. Now the nurseries are full, vacancies are rare, and go generally to priority cases only. In view of the long waiting list and the large number of urgent priority cases, consideration has at various times been given to the method of selecting children for admission to day nurseries and investigations were made during the year at two of the nurseries for the purpose of ascertaining the social conditions of children in attendance. The position was found to be as follows: (a) Places at these nurseries—107. (b) In order to compensate for absenteeism and to secure the use of the nurseries to full capacity, allocation is made to roughly 20 per cent. above the complement, which means that 130 children were on the register, of which: 33 were illegitimate. 21 had parents who were separated or divorced. 14 had widowed mothers. 14 had fathers who were invalids unable to work full time. 8 were children of staff at the nurseries. 3 had mothers who married after the child was admitted. 3 were admitted on account of the mother's poor health. 2 had fathers in only temporary employment or unemployed a long time. 2 (sisters) had a father completely irresponsible and lazy. Wife had reported him three times for neglect. 1 had mother who was a State Registered Nurse. 1 had father in prison. 1 child was very backward, and home conditions most unsatisfactory. 103 This left only 27 children, out of a total of 130, who had been admitted from the nonpriority waiting list. It will be seen from the above that the nurseries are filling a very urgent need in the borough. 61 SECTION 8. Tuberculosis. Particulars of all new cases of Tuberculosis and of all deaths from this disease during 1947 are given in the following table in the form required by the Ministry of Health:— Age Periods New Cases Deaths Pulmonary Non-Pulmonary Pulmonary Non-Pulmonary M. F. M. F. M. F. M. F. 0-1 year — — 1 — — 1 — — 1-5 years 5 — 3 1 — — 1 — 5-15 years 6 7 5 1 — — — — 15-25 years 25 41 3 3 7 3 — — 25-35 years 33 24 3 4 17 11 1 — 35-45 years 21 15 — 3 8 4 1 1 45-55 years 12 2 — 2 13 4 1 1 55-65 years 25 4 1 2 8 3 — — 65 and upwards 6 2 2 2 12 5 2 1 Totals 133 95 18 18 65 31 6 3 The total number of Primary notifications was 264; in addition to these, 18 cases, which had not been notified, came to knowledge by means of special death reports, and 79 cases by transfer from other districts. The total number of new cases during the year from all sources was therefore 361, equal to a notification rate of 2.64 per 1,000 of population, compared with 355 new cases during the previous year. The deaths from all forms of Tuberculosis during the year numbered 105, equal to a death rate of 0.77 per 1,000 of population, whereas the total number of deaths in the previous year was 98. It will be noted that, out of a total of 105 deaths from Tuberculosis, 15 (being 14 per cent.) were of cases which were notified only at death. 62 Death from tuberculosis before notification may be due to:—(1) Sudden death of a person who has not consulted a doctor since tuberculosis has developed. (2) Sudden death of a person who has been notified elsewhere but has not consulted a doctor since arrival in the Borough. (3) Difficulty in diagnosis before death. (4) The doctor being under an erroneous impression that the case has been notified in the Borough previously. When necessary a communication is sent to the certifying practitioner asking for an explanation of the circumstances under which formal notification was not made. No case occurred in which it appeared to be desirable to institute proceedings for deliberate or wilful neglect to comply with the regulations. The interval elapsing between notification and death is an indication of the efficiency of notification. In the following table the deaths from tuberculosis (from 1st January to 31st December) are classified according to this interval:— Tuberculosis Deaths, 1947.* Time of Notification Pulmonary Non-Pulmonary Total Percentage Male Female Male Female 1947— Discovered on death 8 6 1 — 15 14.5 Six months or less before death 12 4 2 2 20 19.4 Remainder — — — — — — 1947 Total 20 10 3 2 35 33.9 1946 17 7 — 1 25 24.3 1945 2 2 — — 4 3.9 1944 3 2 — — 5 4.9 1943 5 1 — — 6 5.8 1942-1938 13 5 — — 18 17.5 Before 1938 5 5 — — 10 9.7 Total 65 32 3 3 103 100.0 *Note.— This table is compiled from all deaths from tuberculosis known to have occurred in St. Pancras during the year under review, but the total does not as a rule correspond exactly with the total obtained from the Registrar-General and shown in the preceding table because a few deaths may be allocated by him to the previous or subsequent year. 63 Public Health (Tuberculosis) Regulations, 1930. The number of cases of Tuberculosis notified and those which came to knowledge by means of death reports and transfers from other districts are given in the following tables:— Age Periods Number of Notifications on Form A Primary Notifications Total Notifications (i.e., including cases previously notified by other Doctors). 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Total Pulmonary— Males — 5 5 1 14 11 33 21 12 25 6 133 145 Females — — 5 2 25 16 24 15 2 4 2 95 99 Non-pulmonary— Males 1 3 4 1 1 2 3 — — 1 2 18 19 Females — 1 1 1 2 1 4 3 2 2 2 18 19 Totals 1 9 15 5 42 30 64 39 16 32 12 265 282* * Exclusive of 24 "Lost sight of" cases returned. Age Periods Information obtained from Special Death Reports, by Transfer from other districts, and by Posthumous Notifications 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Total Pulmonary— Males — — — 1 1 6 23 7 11 9 6 64 Females 1 1 — — 2 1 11 6 2 1 3 28 Non-pulmonary— Males — -— — — — 1 — — 1 — 1 3 Females — — — — 1 — 1 — — — — 2 Totals 1 1 — 1 4 8 35 13 14 10 10 97 64 The following table gives particulars as to the prevalence and fatality of this disease during the past 10 years:— Year Estimated Population Notifications Deaths Notification Rate per 1,000 population Death Rate per 1,000 population Pulmonary Other forms All forms Pulmonary Other forms All forms Pulmonary Other forms All forms Pulmonary Other forms All forms 1938 179,400 301 64 365 121 12 133 1.67 0.35 2.02 0.67 0.06 0.74 1939 167,300 310 44 354 118 12 130 1.87 0.26 2.13 0.70 0.07 0.77 1940 133,200 292 45 337 144 16 160 2.19 0.33 2.52 1.08 0.12 1.20 1941 103,770 283 40 323 113 10 123 2.72 0.38 3.10 1.08 0.09 1.17 1942 105,900 274 42 316 134 13 147 2.58 0.39 2.97 1.26 0.12 1.38 1943 108,640 273 44 317 111 6 117 2.51 0.40 2.91 1.02 0.05 1.07 1944 105,780 320 38 358 115 13 128 3.02 0.35 3.37 1.08 0.09 1.17 1945 111,400 298 39 337 117 10 127 2.67 0.35 3.02 1.05 0.08 1.13 1946 129,410 308 47 355 92 6 98 2.45 0.36 2.81 0.71 0.04 0.75 1947 136,700 320 41 361 96 9 105 2.34 0.30 2.64 0.70 0.07 0.77 Notification Register. This is kept at the Dispensary. The following table gives the information for the year ended 31st December, 1947, in the prescribed form:— Pulmonary Non-Pulmonary Total Number of cases on the Register at the commencement of the year 1947 1,012 159 1,171 Number of new cases during the year 343 42 385 1,355 201 1,556 Number of cases removed from the Register during the year (from death or other causes) 286 45 331 Number of cases remaining on the Register at the end of the year 1,069 156 1,225 65 (4626) Deaths from Tuberculosis of St. Pancras residents during 1947, the deaths in each ward and those occurring in the Hospitals of the Borough and elsewhere. Under 1 year 1-2 years 2-5 years 5-10 years 10-15 years 15-20 years 20-25 years 25-35 years 35-45 years 45-55 years 55-65 years 65-75 years 75 years upwards Wards No address Total Not in Institutions St. Pancras Hospitals Other London Hospitals Hospitals outside London I II III IV V VI VII VIII Resident NonResident M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F M IF M F M F M F M F M F M F M F | M F M F M F M F M F M F All Forms – 1 – – 1 – – – – - 3 - 4 3 18 11 9 5 14 5 8 3 11 4 3 2 9 11 3 2 16 5 9 1 6 3 7 3 3 2 16 6 2 1 71 34 20 9 26 102 40 10 Respiratory System – 1 - - - - - - - - 3 - 4 3 17 11 8 4 13 4 8 3 10 3 2 2 9 9 1 1 15 5 9 1 3 7 3 2 2 15 6 2 1 65 31 19 8 24 73 36 9 Central Nervous System – – - - 1 - - - - - - - - - - - - - - - - - 1 - - - - - 1 - - - - - - - - - - - 1 - - - 2 - - - - 14 2 - Intestines and Peritoneum - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6 - - Vertebral Column - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — 2 — — Other Bones and Joints - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — — — — Skin and Subcutaneous Cellular Tissue - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — — — Lymphatic System - - - - - - - - - - - - - - - - - - - - - - - 1 1 - - - 1 1 - - - - - - - - - - - - - - 1 1 1 - 1 — — — Genito Urinary System - - - - - - - - - - - - - - - - - 1 - - - - - - - - - 1 - - - - - - - - - - - - - - - - - 1 - - 1 2 — — Adrenals - - - - - - - - - - - - - - - - - - 1 - - - - - - - - - - - 1 - - - - - - - - - - - - - 1 - - - — — — 1 Other Sites - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — 1 — — Disseminated Acute - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — — — — ,, Chronic - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — — — — „ not d i stinguishable - - - - - - - - - - - - - - 1 - 1 - - 1 - - - - - - - 1 - - - - - - 1 - - - - - - - - - 2 1 - 1 — 4 2 — 66 Public Health (Prevention of Tuberculosis) Regulations, 1925. These regulations make it possible to require that an individual suffering from tuberculosis shall discontinue employment in the milk trade. No formal action was necessary during the year. Tuberculosis Dispensary. Tuberculosis Officer, Dr. G. A. Back. Address and telephone number of Dispensary Barnes House, Camden Road, N.W.1. Gulliver 2371. The following are the times of the sessions at the Dispensary:— Monday 11 a.m. — — Tuesday — 2 p.m. — Wednesday 11 a.m. — — Thursday — 2 p.m. 7 p.m. (Patients at work only) Friday — 2 p.m. — Saturday 11 a.m. (School children only) — — Report on the Work carried out at the Tuberculosis Dispensary. New Patients and Contacts. There has been a slight increase in the number of notifications since last year and the number of new cases dealt with at the Dispensary shows a further increase due to the larger number of patients sent for diagnosis. The number of new contacts attending has increased from 233 to 354. The total number of contacts of the 361 cases notified during the year was 637 and of these 48 per cent. had been examined at the Dispensary and 13 per cent. elsewhere by the end of March, 1948. Institutional Treatment. This is provided by the London County Council in sanatoria, special hospitals and in the tuberculosis wards of their general hospitals. Application for admission is made as a rule on the appropriate form by the Tuberculosis Officer or the resident staff of the voluntary hospitals, but in emergency patients may be admitted by application to the County M.O.H. by telephone. Altogether 324 applications were accepted. Of these 156 were admissions to General Hospitals, 151 to sanatoria, and 17 to various hospitals for observation for diagnosis. 67 (4626) The following table gives a summary of the work carried out at the Tuberculosis Dispensary during the year:— Diagnosis Pulmonary Non-Pulmonary Total Grand Total Adults Children Adults Children Adults Children M. F. M. F. M. F. M. F. M. F. M. F. A.— New cases examined during the year (excluding contacts)— (a) Definitely tuberculous 108 75 11 10 5 14 8 1 113 89 19 11 232 (b) Diagnosis not completed — — — — — — — — 23 28 3 1 55 (c) Non-tuberculous — — — — — — — — 171 231 39 41 482 B.— Contacts examined during the year— (a) Definitely tuberculous — 1 — — — — — — — 1 — — 1 (b) Diagnosis not completed — — — — — — — — 4 15 7 6 32 (c) Non-tuberculous — — — — — — — — 86 116 52 67 321 C.— Cases written off the Dispensary Register as— (a) Recovered 12 13 3 1 3 2 1 3 15 15 4 4 38 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) — — — — — — — — 274 368 92 109 843 D.— Number of Cases on Dispensary Register on 31st December— (a) Definitely tuberculous 468 260 54 36 39 38 37 12 507 298 91 48 944 (b) Diagnosis not completed — — — — — — — — 46 66 13 8 133 e 2 1. Number of cases on Dispensary Register on 1st January 978 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 103 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 176 4. Cases written off during the year as Dead (all causes) 70 5. Number of attendances at the Dispensary (including Contacts) 5,055 6. Number of consultations with medical practitioners— (а) Personal 3 (b) Other 548 7. Number of visits by Tuberculosis Officer to homes (including personal consultations) 10 8. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes 2,040 9. Number of— (а) Specimens of sputum, etc., examined 607 (b) X-ray examinations made in connection with Dispensary work* 1,619 10. Number of "Recovered " cases restored to Dispensary Register, and included in A (a) and A (b) above 2 11. Number of "T.B. plus" cases on Dispensary Register on 31st December 484 * NOT including those made for A.P. refills. 68 Artificial Pneumothorax Treatment. This work is carried out at various voluntary and London County Council hospitals for patients who have been discharged from hospitals and sanatoria, at a cost to the Borough Council of 10s. 6d. per refill, and by the Tuberculosis Officer when he visits Highgate Hospital, without charge to the Borough Council. The total number of refills given during the year was 2,382 and of these 296 were carried out at Brompton Hospital, 1,381 at University College Hospital, 535 at Highgate Hospital, and 170 at other hospitals. Light Treatment. Finsen Light Treatment for lupus is provided usually at the London Hospital and at University College Hospital at a cost to the Borough Council of 5s. per attendance. No attendances were made at the London Hospital and none at University College Hospital during the year. X-Ray Examinations. These are carried out at the Archway Hospital and at Highgate Hospital. The charge is 2s. 6d. per film and the reports are made by the visiting Radiologist or by the Tuberculosis Officer when he visits the hospital. Of the 1,619 examinations made during the year 881 were made at Highgate Hospital. The total number of films made was 1,771. Home visits by Tuberculosis Visitors. These visits were made in order to (i) verify notifications; (ii) investigate the home conditions and report on overcrowding, sanitary defects, need for financial assistance, etc.; and (iii) give instructions in the prevention of tuberculosis and to invite contacts and patients to attend the Dispensary. The particulars of these visits are as follows:— Number of Visits under P.h. (Tub.) Regulations Number of Visits for Dispensary Purposes Total Visits Miss Gilpin 198 999 1,197 Miss Webb 136 1,041 1,177 2,364 G. A. Back, Tuberculosis Officer. 69 St. Pancras Tuberculosis Care Committee. List of Members. 1.—Representatives of the Borough Council. Councillor Mrs. L. Bryant. Councillor Mrs. M. A. Foster. Councillor Miss F. L. M. Freeman. Councillor Mrs. J. Gregory. Councillor Mrs. G. L. Hume. Councillor J. E. Davies. Councillor J. H. Gore. Councillor C. T. E. Fisher. Councillor T. B. Moss. Councillor T. J. Redman. Councillor H. B. Sheridan. 2.—Representatives of other bodies interested in the Welfare of Tuberculous Patients. Miss Ball, L.C.C. Schools Care Committee. Dr. Polhill, L.C.C. (School) Divisional M.O. The Superintendent, Metropolitan District Nursing Association. The Superintendent, North London Nursing Association. Dr. C. L. Mason, London Panel Committee. Councillor A. J. Trott, j.p., Social Welfare. Almoners of the following Hospitals:— Royal Free Hospital. Middlesex Hospital. Elizabeth Garrett Anderson Hospital. National Temperance Hospital. Hampstead General Hospital. University College Hospital. 3.—Ex-officio Members. Dr. D. H. Geffen. Dr. G. A. Back. Mrs. E. Bevan, Secretary. The Care Committee held nine meetings during the year, and the work carried out by or reported to them is indicated in the following summary. Social Welfare. All patients and their families who appear to be eligible are referred to the Social Welfare Department. In January, 1936, the London County Council asked that, for an experimental period, all such patients and suitable contacts who appeared to be in need of extra nourishment in addition to or in substitution for their ordinary diet, should be recommended for it by the Tuberculosis Officer. The recommendations have been renewed quarterly and reported to the Care Committee for approval. During the year 67 quarterly recommendations were made in respect of 32 patients. As a rule, 7s. 6d. per week is allowed above the usual scale. 70 Unemployment Assistance Board. When a patient or the person on whom a patient is dependent is in receipt of unemployment assistance benefit the Unemployment Assistance Board is asked to supply extra nourishment. During the year 26 quarterly recommendations were made in respect of 14 patients. Extra Nourishment provided by the Borough Council. The Council may provide an allowance of 6s. per week for extra nourishment to necessitous patients who are not in receipt of social welfare on the recommendations of the Tuberculosis Officer. The recommendations are reported to the Care Committee and during the year amounted to:— Number of patients recommended 112 Total cost £603 18s. 6d. Dental Treatment. Financial assistance for obtaining dental treatment may be provided by the Council for suitable patients recommended by the Tuberculosis Officer and approved by the Care Committee. The figures for 1947 were:— Number of patients 14 Amount paid by Borough Council £41 14s. 9d. Housing. When necessary, recommendations for better housing accommodation on the Borough Council and London County Council Estates are made to the Housing Department by the Tuberculosis Officer and are reported to the Care Committee. The figures for 1947 were:— Number of families recommended 128 Number of families rehoused— (a) By Borough Council 9 (b) By London County Council 19 (c) Found accommodation not on Councils' Estates 8 Maintenance Allowances. 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 1st January to 31st December, 1947:— Standard Allowance only Standard and Discretionary Standard and Special Standard and Discretionary and Special Special Allowance only Discretionary and Special only Discretionary only Refused Allowance Total 69 33 2 — 5 — — 13 *132 * In addition 1,315 re-assessments of these and previous cases have been made. Comparable figures for 1946:— 80 29 — — 18 — — 10 137 71 Boarding Out of Contacts. Since 1925 the London County Council has made arrangements to board out for varying periods the following types of children:— (a) Children living in heavily infected and overcrowded homes. (b) Children about to be discharged from institutions where they have had treatment for tuberculosis, in cases where their homes are unsuitable. (c) "Weakly" children living under conditions likely to subject them to infection. (d) Children whose mothers are having institutional treatment for tuberculosis. The arrangements are made by the Invalid Children's Aid Association on behalf of the London County Council, and the number accepted and reported to the Care Committee during 1947 was 22. Miscellaneous. During the year the Care Committee incurred an expenditure of £254 14s. 4d. on clothing, coal, removals, furniture and pocket money for patients. Seal Sales. The Care Committee again took part in this scheme for raising funds and from this and other sources obtained an income of £397 7s. 2d.