AC. 4367 STE 36 Metropolitan Borough of Stepney ANNUAL REPORT OF THE Medical Officer of Health R.W. WATTON, M.B., B.S., D.P.H., D.C.H. FOR THE YEAR ENDED 1962 Together with the Report of the PUBLIC ANALYST Metropolitan Borough of Stepney. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH For the Year 1962 Together with the REPORT OF THE PUBLIC ANALYST CONTENTS PAGE Public Health and Physical Training & Recreation Committees 1 Introductory 2 Staff 5 Summary of Statistics 6 I, Statistics and Social Conditions of the Area 7 II. General Provision of Health Services 14 III. Sanitary Circumstances 27 IV, Housing 35 V. Food - Inspection and Supervision 39 VI, Infectious and other Diseases 45 Public Analyst's Report 54 Appendix 57 Index 81 1 PUBLIC HEALTH COMMITTEE (at 31st December 1962) EX OFFICIO: Her Worship the Mayor, Councillor (Miss) E. M. Aylward, J.P. CHAIRMAN; Councillor E. W. Hill VICE-CHAIRMAN: Councillor G. H. Wall Alderman T. Aylward Alderman (Mrs.) A, Elboz Councillors; B. Borman C. Dimes C. Mudd G. W. Butcher M. J, Durell J. Olley (Mrs.) I. B. Calnan (Mrs.) C. Edwards (Miss) E. Ramsay, G. R. Chaney B. Holmes M.B.E. R. Cockel S. Kaufman J, Reardon R. J. Connolly J. Milrood (Mrs.) M. Sambrook PHYSICAL TRAINING AND RECREATION COMMITTEE (at 31st December 1962) EX OFFICIO ; Her Worship the Mayor, Councillor (Miss) E. M. Aylward, J.P. CHAIRMAN: Councillor H. Walvisch VICE-CHAIRMAN: Alderman (Mrs.) A. Elboz Aldermen: J. C. Lawder, O.B.E.,J.P. J .O'Connor, J.P. (Mrs.) C.F. Woollon Councillors: G. W. Butcher W. Harris P. Roche (Mrs.) I. B. Calnan (Mrs.) K, O'Connor (Mrs.) M. Sambrook (Mrs.) C, Edwards M. O'Leary, J.P. P. Sullivan J. T. Reilly Other Committees of the Council concerned with Public Health Services HOUSING COMMITTEE: Duties under the Housing Acts other than those delegated to the Public Health Committee. BATHS AND WASHHOUSES COMMITTEE; Management of public slipper baths, swimming baths, and washhousss. PUBLIC CLEANSING COMMITTEE; Collection, removal and disposal of house and trade refuse, and cleansing of highways. WORKS COMITTEE: Maintenance of sewers, parks, gardens and open spaces. METROPOLITAN BOROUGH OF STEPNEY PUBLIC HEALTH DEPARTMENT, 43, White Horse Road, stepney, E.l. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney. Your Worship, Ladies & Gentlemen, I have the honour to present to you my Annual Report on the state of the public health in Stepney for the year 1962. The 1961 Census returns show a decline in the population from 98,858 in 1951 to 92,000 (the estimate of the Registrar-General for 1962 being 90,4.80). Density, i.e. persons per acre, declined from 56 to 51 in the last decade. Structurally separate dwellings occupied increased from 24,895 to 26,524; persons per room declined from an average of 0.94 to 0.86, reflecting some improvement in housing. In the early part of the year outbreaks of Smallpox occurred in a neighbouring county, and elsewhere in the country. This led to many requests from the general public for vaccination by their family doctors and at London County Council clinics. Numerous visits were made by officers of the Department, to keep under surveillance persons arriving from endemic areas abroad and secondary contacts of cases in this country. Housing, in all its facets, continues to occupy a great deal of the time of the Department. Numerous deputations have been sent by the Council to the Ministry of Housing and Local Government and to the London County Council, with additional meetings at officer level to plan a concerted effort to rid the Borough of its existent 'black spots'. There is little doubt what ought to be done in the case of many slum tenement blocks, and other sub-standard properties. However, the shortage of land available for building at a reasonable price thwarts many urgent schemes. Whilst agreeing with a comprehensive development scheme for the area, it is irksome, to say the least, to observe large derelict areas left barren awaiting planned development and meanwhile attracting refuse dumping and caravan squatters. It is the conviction of many that revolutionary methods of building and a rationalisation of the industry, coupled with the will to make a top national priority of the need to provide decent homes for all, could quickly remove the scourge of slums and squalid overcrowded housing. As it is, a depleted public health inspectorate spends an increasing amount of time in an attempt to enforce standards in the worst type of property, often to the detriment of the necessary supervision of property whose useful life could reasonably be extended by maintenance of a reasonable state of repair. 2 The Housing Act 1961, particularly its powers in respect of Houses in Multiple Occupation, has brought a great number of houses in the Borough within the scope of the Department to ensure better standards of management and the provision of additional amenities in these properties. The formation of an expanded housing section in the Department to survey houses in multiple occupation, and assist landlords in their schemes for conversion, is already bearing fruit in a growing number of such houses being regularly inspected to ensure better standards. Management orders are being made, as required. The task is time-consuming, relying as it does on persuasion in the first instance, and because of the absence of any minimum statutory standard of essential amenities written into the standard of fitness. In order that improvements to substandard property might be accelerated in this area the definition of standard of fitness contained in Section 4 of the Housing Act, 1957, should be so amended that a house is deemed to be not suitable for occupation unless reasonable amenities are provided therein. To turn to a more comforting and encouraging aspect of the year's work, services for the care of the aged have been improved. The number of old people supplied with meals at clubs, or at home, continues to increase - thanks to the excellent work of The Stepney Old People's Welfare Association, and the purpose-built kitchen and club of the Women's Voluntary Service. With the decision of the Council to take over, as from April 1st 1963, the financial provision of this service, and using further powers now available, it is hoped to plan the integration of an invalid meals service within the existing old people's meals service. The Council has increased its subsidy to the flourishing Workroom for the Elderly which continues to run under a voluntary committee in premises owned by the Borough Council. The wisdom of setting up a Holiday Centre at Sandgate ensures that 18 Old Age Pensioners weekly can enjoy a cheap holiday away from Stepney under excellent conditions. The remaining 18 places filled as they are in the season by young family groups, maintains an all-age group clientele which is appreciated by most residents. For some time, a survey of old people in the Borough has been discussed. Whilst this has not been possible under statutory authority, young people's groups of different religious affiliations are making door-to-door surveys in selected parts of the area. Their work may not be statistically valid by the standards of a professional social survey yet they have revealed old people in need. At the same time they have acquired an awareness of community problems, knowledge of which is likely to prove more beneficial in terms of human relationships than an arid scientific investigation. The Consultant Chest Physician., Dr. R.M. Orpwood, contributes a general item on Tuberculosis in Stepney, on page 48 of the report. There has been some improvement over the year, but with the added problems that 3 arise in a 'mixed population' further work is required, in selected groups "at risk". A project for 1963 includes special visits by the Mass Radiography Unit to lodging houses, areas showing high infection rates, and also.an experimental once-weekly day visit to a static site in the Borough. The psycho-geriatric ward, day hospital, and club at St.Clement's Hospital continue to flourish. An item taken from the annual report of the Consultant Psychiatrist is included on page 22. Provision of a hostel to care for mentally frail old people is still required in the Borough, as is the need for day clubs in the community to link hospital therapy with ordinary life outside. A discussion on the rising rate of illegitimacy and venereal disease is on page 10. It is hoped that 1963 will bring a concerted effort with other interested statutory and voluntary bodies to reach the vulnerable younger age groups. The policy of declaring smoke control areas, under the Clean Air Act, came under criticism with the 'smog' in December, 1962. Fortunately, the mortality rate attributable to this smog was less than that in a similar incident during 1952. The present schemes to reduce smoke emission by extending smoke control areas were vindicated. Research is required to find methods to reduce the sulphur content in fuels, prior to sale, so that health hazards from oxides of sulphur shall be minimised. Stepney is a challenge. Much has been achieved, particularly in the post-war period, but much remains to be done before the new Stepney can be said to have emerged. In conclusion I express gratitude to the Chairman and Members of Committees for their support. The continued co-operation of the Town Clerk and other Chief Officers of the Council and their staffs are acknowledged. To the staff of the Public Health Department I extend grateful appreciation of their loyal and efficient help at all times. I am, Your Worship, Ladies and Gentlemen, Your obedient servant, R. W. WATTON, Medical Officer of Health. May, 1963. 4 STAFF OF THE PUBLIC HEALTH DEPARTMENT (at 31st December 1962) MEDICAL OFFICER OF HEALTH: R. W. Watton, M.B.,B.S.,D.P.H.,D.C.H. Assistant Administrative Officer: E. P. Webber (1, 2) Senior administrative -Assistant: M. Pliskin District Public Health Inspector: W. Cue (1) R.W.G.Day (l) H.A.Giddings (l, 2) W.E.Hart (l, 2) J.J.Keniry (l) B.L.Nunn (l) D.J.Townshend (l) (T) (4 Vacancies) Food Inspectors: A.O.Brown (l, 2) H.J.Green (l, 2) S.S.Lowther (1, 2) S. Vogler (1, 2) Caretaker & Messenger T.W.Harlock Relief-Caretaker & Messenger: E.H.Vaughan Disinfecting Staff: 8 Males Disinfestation Inspector: E.J.Edwards (l, 2) Housing Inspector: W.H.Haworth (l) Smoke & Factories Inspector: G.D.Freeland (l, 2, 3) Hygiene Officers: Miss A.J.Ballam Miss M.Guest (4, 5, 6) Technical Assistant: (Smoke Control) Vacant Housing Assistants: W.J.Giardelli A.B.Keniry Foreman-Disinfector: W. Sexton Administrative & Clerical Staff: D.J.Berry Miss D, Calnan M.Connell C.H.Coveley W.E.Driscoll S.W.Embleton B.Goldston S.S.Harris E.F.Holt D.A. Hunnibal A.Jacques Miss R.Levey J.W.Meakin Mrs.M.Munday (T) Miss A.Sayers Pupil Public Health Inspectors: N.Gray G.A.Hensher R.W.Scanes Rodent Investigator: S.C.Ludlow Cleansing Station Attendants: Rodent Operatives; 2 Females; 1 Male 3 Males Holiday Centre Staff; Resident Steward; R. Willis Resident Cook; Mrs.N.Willis Resident-Assistant; Mrs.J.Fromling Other Staff - 7 1. Public Health Inspector's Certificate. 2. Meat and Other Foods Inspector's Certificate. 3. Smoke Inspector's Certificate. 4. Health Visitor's Certificate. 5. State Certified Midwife. 6. State Registered Nurse. (Note; For Staff changes during the year see page 26). (T) Temporary. 5 SUMMARY OF STATISTICS, 1962 Area of Borough (in acres) 1902.7 Rateable value (1st April) £2,416,948 Population: Mid-year Estimate 90,480 Sum represented by a Census - 1961 92,000 penny rate (1962-63) £9,600 Density of population (persons per acre) 51.23 General Rate (1962-63) 20/4d in £ Number of inhabited dwellings according to Rate Books 26,004 " " structurally separate dwellings - Census 1961 27,257 " " private households - Census 1961 29,333 BIRTHS Total Male Female All Births 1,888 963 925 Live Births - Legitimate 1,583 799 784 Illegitimate 269 146 123 Total 1,852 945 907 Still Births - Legitimate 30 16 14 Illegitimate 6 2 4 Total 36 18 18 DEATHS All Causes 1,133 655 478 Maternal - - - Infants under 1 Year - Legitimate 29 20 9 Illegitimate 4 1 3 Total 33 21 12 RATES Live birth rate per 1,000 population 20.47 Death rate per 1,000 population 12.52 Still-birth rate per 1,000 total births 19.06 Maternal death rate per 1,000 total births nil Infant death rate (under 1 year) per 1,000 live births 17.82 Legitimate Infant death rate per 1,000 legitimate live births 18.32 Illegitimate Infant death rate per 1,000 illegitimate live births 14.87 Neo-natal death rate (under 4 weeks) per 1,000 live births 12.96 Early neo-natal death rate (under 1 week) per 1,000 live births 11.88 Perinatal death rate (stillbirths + deaths under 1 week) per 1,000 total births 30.72 Illegitimate live births per cent. of total live births 14.31 Area Comparability Factor: Births 0.91 Deaths 1.01 6 1. STATISTICS AND SOCIAL CONDITIONS OF THE AREA General Information The Metropolitan Borough of Stepney is bounded on the west side by the City of London, on the east by the borough of Poplar, on the north by the boroughs of Shoreditch and Bethnal Green and on the south by the River Thames, the river boundary being some 2.39 miles in length. The Borough is roughly rectangular in shape, the length being 2.3 miles, the breadth varying from 1-1½ miles and contains approximately 83 miles of streets. The area of the borough is 1,902 acres and of this the river accounts for 136 acres and inland waters consisting of docks and canals cover 75 acres. Dark blue London Clay is found under the whole Borough at a depth of between 20-30 feet from the surface. Above this level are layers and patches of gravel and sand, brown and yellow clays being found nearer the surface. In some parts of the borough there are layers of "made" ground, the result of earlier habitation, and as is to be expected the flow of subsoil water is towards the river. The area is to a large extent industrial in character, factory premises being spread throughout the Borough but tending to be concentrated towards the western end, with docks and wharves stretching along the whole of the river front which forms the southern boundary. The chief industry of the Borough is the manufacture of clothing of all kinds, and it is estimated that one-third of the tailoring industry of London is carried on in Stepney. Other major industries includebrewing, engineering, and the manufacture of furniture. Stepney is also one of the most important wholesaling districts in London. The Spitalfields Wholesale Fruit and Vegetable Market and the London Fruit Exchange are situated in the Borough. Notable landmarks in the borough include the Tower of London and the Royal Mint. Fifty Years Ago The Annual Report of the Medical Officer of Health for the year 1912 contains the following information; The estimated population was 277,315 and, the birth-rate was reported to be 30.9. The death rate (uncorrected) was 15.3 per 1,000 population and the infant mortality rate 110 per 1,000 births. Among the causes of deaths reported were; Tuberculosis 538, Diarrhoea and enteritis 178, Measles 172, Cancer 232, Premature Births 1840., Whooping Cough 90, Alcoholism 34, Diphtheria 25 and Scarlet Fever 14. 7 Deaths of children under one year included 178 from Diarrhoea and enteritis, 32 from Measles and 51 from Whooping Cough. There were 175 inquests on children under five years of age, 40 deaths being attributed to convulsions, 4-0 to overlying in bed by parents and 12 to burns and scalds. Notifications of infectious diseases included 340 Diphtheria 893 Scarlet Fever; 51 Enteric Fever,and 2,678 Pulmonary Tuberculosis. Of the 1,249 samples of food analysed, 162 (13%) were found to be adulterated, as a result of which 79 prosecutions were taken. 130 samples of milk and 18 samples of butter were found to be adulterated. Of 118 samples of milk taken on Sundays, 15.2% were adulterated. Legal proceedings were taken in 175 instances under the Public Health Act, Food and Drugs Acts and other Acts and Byelaws. The occupiers of 23 food premises were summoned for not keeping their premises in a clean condition. A wholesaler was sent to prison for four months with hard labour for selling for human consumption corned beef which was unsound. Twenty-four pages were devoted to a report by the Medical Officer of Health on proposals suggested for a scheme for the prevention of tuberculosis. Mothers-to-be employed in their own homes frequently worked to within a few hours of confinement and resumed work fourteen days later. A man was kept in custody for eight days after being arrested for failing to appear to answer a summons regarding overcrowding. 17,135 inspections were specially made during the year for the purpose of detecting overcrowding. The Reverend E. Carter, M.A., Vicar of St.Jude's Church, Whitechapel, and his wife, lost their lives when the s.s."Titanic" foundered. There were 32 cowsheds in the Borough licensed for the keeping of 917 cows. The Report of the Borough Engineer and Surveyor stated that the earliest recorded street numbers in London were in Great Prescot Street, Steoney: this was mentioned by Hatton in 1708, and as the street was inhabited by rich foreign merchants it is probable that the system of numbering was introduced from abroad. 14,895 loads of hay and straw were brought into the Whitechapel Hay and Straw Market. 8 9 Census. 1961 The Report for the County of London on the Census of population taken in 1961, reveals the following information with regard to this Borough. The population has decreased by 6,858 since the last census in 1951, equivalent to a reduction of 0.71% per annum which is the approximate mean for the County. During the intercensal period 1931-51, the population decrease in Stepney was the highest in London, namely 4.05% per annum. The excess of births over deaths for the last ten years would have given an increase of population of 0.69% per annum; the indication is that there was an annual emigration from the Borough of 1.4% of the population. Of the total population of the Borough enumerated in the Census 6,550 resided in hotels, hostels, old people's homes, and other miscellaneous establishments. The number of private households in the Borough has decreased by 635, whilst the number of structurally separate dwellings has increased by 1,629. Of the 26,524 dwellings in the Borough, 10,141 are Local Authority owned. The density of persons per room is 0.86%, as compared with 0.94% for 1951. The percentage of persons at more than 1½ per room is 16.2, the fourth highest in the metropolitan area. Households numbering 5,212, equivalent to 18% of the total, live in shared dwellings. Buildings containing more than one dwelling number 2,076. Households without cold water supply in the dwelling number 232 (0.8%), without hot water supply 15,830 (54.2%), without fixed bath 16,530 (56.6%) and without a water-closet 587 (2.0%). 10,578 households (4.0.4%) have the exclusive use of all the above amenities. The number of persons of pensionable age, that is men over 65 and women over 60, is 12,193, there being 13 persons over 95 years of age. Persons born outside the British Isles number 9,993, including 1,599 West Indians, 905 Indians, 789 Pakistanis, 770 Maltese, 698 Cypriots, 598 Africans and 296 other Asians. 5.9% of the population were born in the Colonies and Commonwealth countries, slightly more than the figure for the County of London which is 5.8%. Population The Registrar-General's mid-year estimate for 1962 is 90,4.80. Last year's estimate was 91,710. The density of population is now 51.23 persons per acre. In 1912 it was 157 per acre. During the year there was a natural increase in population of 719; that is there were 719 more births than deaths. The Registrar-General estimates the population to be 1,230 less than last year, the indication being that 1,949 persons have moved out of the Borough. Births The total number of live births registered in the Borough, during the year, was 4,396 and of this 2,700 belonged to other areas. In addition 156 births belonging to Stepney occurred outside the borough, making a total of 1,852 births (94.5 Males; 907 Females) to Steoney residents. The live birth rate is 20.4-7 per 1,000 population, the highest since 1946. The rate when adjusted by the comparability factor is 18.6 compared with the rate for England and Wales of 18.0, the highest since 1947. Illegitimate live births numbered 269, representing 14.31 per cent of the total live births. Still-births numbered 36, representing a rate of 19.06 per 1,000 total births, compared with 18.1 for the country as a whole. Illegitimate Births The graph (opposite) shows the increase in illegitimate births since 1957 for the London County Council area, and for Stepney. These figures taken with the rising number of cases of venereal disease, perhaps demonstrate changing moral values in our society. Unfortunately, children born out of wedlock show higher morbidity and mortality rates compared with those born into a normal family. Also the social ostracism met by the unmarried mother creates a mental atmosphere which cannot be conducive to the wellbeing of the developing child. As has been said, there are no illegitimate children, only illegitimate mothers and fathers! Whilst to welcome the trend evidenced by the rising illegitimacy rate would be nonsensical, yet there should be no doubt about what to do to help the child involved. This would appear to be an age of transition in respect of moral codes. It behoves the older generation to seek a synthesis of that which is best in the old tradition - particularly in regard to stable family life - with that which is laudable in the new, namely, franker, less hypocritical views on sex. To condemn youth, whilst not providing positive standards for their aspirations, will do nothing to prevent a trend which can prejudice the health of an increasing number of vulnerable babies and children. 10 ILLEGITIMATE BIRTHS Expressed As Percentage of LIVE BIRTHS (STEPNEY - BLACK * LONDON - RED) Accidents in the Home Many more deaths throughout the country occur now from accidents in the home than from road accidents, or from lung tuberculosis, and the public cannot be urged too strongly to see that all possible precautions are taken in the home to minimise them. The powers and duties of the Council under the Home Safety Act, 1961, relating to the dissemination of information and advice for promoting safety in the home and encouraging proper precautions against accidents are exercisable by the Public Health Committee. The means taken to educate the public in this respect are referred to elsewhere in this Report. The County Medical Officer of Health supplies information, which he obtains from the London Ambulance Service, relating to the removal to hospital of home accident cases occurring in London and in the London County Council Health Division 5, of which Stepney forms a part. A table summarising these figures over the past four years is given on page 6l. While the figures may not be fully comprehensive they give a reasonably accurate picture. During the year the London Ambulance Service removed to hospital 155 Stepney home accident cases, as compared with 218 last year. Old people are prone to home accidents and the department's women Hygiene Officers pay great attention to this risk during their visits. For example, where accidents from gas appliances have occurred, or are likely to occur, they have been instrumental in obtaining for the old persons concerned a special safety-type gas cooker. Attention is also given in the homes of old people to oil-heaters, particularly those of the drip-feed type; advice and assistance is given to enable the old people to have these converted so as to conform with safety standards. ferriages The number of marriages in the Borough during the year was 764., being 23 less than last year. The marriage rate per 1,000 population is 16.9 compared with 17.1 in 1961. Deaths The net number of deaths registered during the year was 1,133 compared with 1,208 last year. The death rate of 12.52 compares with 13.13 for 1961. The rate of 12.52 when adjusted by the comparability factor is 12.64, as compared with 11.9 for England and Wales. The principal causes of death were heart disease which accounted for 29 per cent of the total deaths, cancer 19 per cent and diseases of the respiratory system 24 per cent (the highest ever). Deaths of persons over the age of 65 years amounted to 66 per cent of the total deaths. Details of deaths by cause and age are given in Table I of the Appendix, on pages 58 and 59. 11 12 Infant Mortality Deaths of Infants under one year numbered 33, giving a rate of 17.82 per 1,000 live births, the lowest ever recorded -as is the rate (21.4) for England and Wales. The tables on page 60 show the deaths from stated causes at various ages under one year, together with comparative figures over the last five years. Perinatal Mortality The perinatal mortality rate of infants (viz. still-births plus deaths occurring in the first week of life) was 30.72 as compared with 36.78 last year. Neonatal Mortality During the year there were 24 deaths of infants under four weeks old, representing a neonatal mortality rate of ,12.96. Last year there were 32 neonatal deaths, the rate being 17.17. Maternal Mortality There were no maternal deaths during the year. Accidental Deaths The number of deaths due to accidents was 31, or nine less than last year. These included 9 due to motor vehicles (one more than in the previous year); 9 in the home; 1 at work; 1 from drowning, and 11 due to various other causes. (See Table 2 on page 59 relating to Road Accidents.) Unemployment The Ministry of Labour has kindly supplied me with the following information as to the estimated number of persons residing in the Borough who were registered as unemployed at the end of the year Men Boys Women Girls 1,991 25 142 6 Total; 2,164. The total number of unemployed at the end of 1961 was 1,497. Claims for Sickness Benefit The number of claims made for sickness benefit to the local office of the Ministry of Pensions and National Insurance are given below for each month of the year, with comparisons for 1961 1962 1961 January 2,425 2,604 February 1,615 2,013 March 1,470 1,191 April 1,420 1,388 May 1,052 1,117 June 1,072 1,351 July 864 994 August 838 958 September 1,233 1,365 October 1,252 1,337 November 1,237 1,387 December 1,494 1,548 Total for Year 15,972 17,253 Open Spaces There is in the Borough 0.77 of an acre of Parks and. Open Spaces per 1,000 population. A list of the sites is given on page 79. Comparative Statistics A table showing vital statistics for the Borough at various years from 1901, is on page 78. 13 H II. GENERAL PROVISION OF HEALTH SERVICES AGED PERSONS WELFARE The Council is empowered by Section 47 of the National Assistance Act, 1948, as amended by the National Assistance (Amendment) Act, 1951, to make application to a Court of Summary Jurisdiction for an Order for the removal to a hospital or institution of any aged, infirm or physically incapacitated person living in insanitary conditions and who is in need of care and attention. During the year, it was necessary to apply for five Removal Orders and one Extension Order under this enactment in respect of the following persons:- Age. Removed to. Remarks. Miss R.S. 75 Hospital Order for 3 weeks. Extension Order for transfer to Institution (3 months). (Still away). Mr. C.M. 79 Institution Order for 6 weeks. (Still away). Mrs. A.L. 80 Institution Order for 6 weeks. (Still away). Mrs. A.P. 80 Hospital Order for 3 weeks. (Died). Mrs. J.C. 78 Hospital Order for 3 weeks. (Died). In addition to those removed under Magistrate's Orders, admission to a hospital or institution was obtained for 18 other persons. Two women officers, one a State Registered Nurse and certificated Health Visitor, are employed for visiting aged persons in the Borough, and 3,252 visits were made by these officers during the year. A register of all old persons visited is kept in the Department. Amendments made to the Register during the year are as follows Number on Register at 1st January, 1962 2,131 Additions during the year 409 Removals during the year 369 Number on Register at 31st December, 1962 2,171 The Department continued operating its Laundry service (begun in 1951) for the chronic sick who are unable by reason of ill-health, senility, etc. to keep their personal laundry and bed linen in a clean condition. During the year, 343 parcels of laundry were dealt with. In order to prevent injury, or danger of injury, to health, Section 43 of the London County Council (General Powers). Act, 1953, operated by the Borough Council, makes provision for the personal cleansing in their own homes of aged persons who are verminous or otherwise in need of bathing. 910 baths were given to 82 old people during the year by the Council's Home Bathing service, which was inaugurated in 1950. The National Assistance (Amendment) Act 1962 substitutes a new section for Section 31 of the Act of 1943, with the effect of extending previous powers of local authorities under this section so as to enable them (a) to assist voluntary organisations in providing meals or recreation for old people by making a contribution towards the cost thereof; to provide by gift or loan or otherwise, furniture, vehicles or equipment; to permit the use of premises belonging to the local authority; to make available the services of the local authority's staff connected with the premises or vehicles which the organisation is permitted to use, and (b) to provide meals and recreation for old people either directly or through the agency of voluntary organisations and to recover such charges (if any) as the authority may determine, having regard to the cost of the service. The Council's grant for the year 1962-3 to the Stepney Old People's Welfare Association, for allocation as appropriate to the various organisations in the Borough catering for the welfare of old people, amounted to £8,800. There are eighteen old people's clubs in the Borough, all affiliated to the Stepney Old People's Welfare Association.* Three clubs closed during the year and a new one opened. The Council is represented on the Association by the Chairman of the Public Health Committee and other members of the Council and by the Medical Officer of Health. A list of Clubs and the facilities thereat will be found on page 80. A grant of £1,410 was also made to the Workrooms for the Elderly, a voluntary organisation, £410 being in respect of adaptation, rent and rates of premises owned by the Council and made available to the organisation in April this year. (See photograph opposite page 14). There are now five vehicles employed by the various voluntary organisations in delivering meals to old people. The Mobile Meals Service operated by the Stepney Old People's Welfare Association, the Women's Voluntary Service and the Beaumont Hall Settlement stepped up *Hon.Secretary, The Stepney Old People's Welfare Association, St.Katharine's, Butcher Row, Cable Street, E.l. Voluntary visitors are urgently needed and should apply to the Secretary. 15 their deliveries to a weekly average of 923 meals to homebound old people. Eight of the old people's clubs, which include luncheon clubs among their facilities, provided an average of 665 meals each week. A Chiropody service is provided by the Stepney Old People's Welfare Association at clinics situated in five of the old people's clubs in the Borough, and an average of 278 treatments including domiciliary treatments were given each month during the year. This year saw the completion of the first project of the Stepney Old People's Housing Association Ltd., namely the provision of eleven units of accommodation for single and married old persons, and accommodation for a caretaker, obtained by acquisition of the lease and the conversion of Nos.27 and 28 Tredegar Square which were formerly requisitioned by the Council. The Council assisted in the project with an interest free loan of £6,700. As a frontispiece to this report there is a photograph of a former 17th century almshouse chapel in the Borough, opened this year by the County Council as a Rehabilitation Centre for handicapped persons. AMBULANCE FACILITIES The London County Council is responsible under Section 27 of the National Health Service Act, 1946, for the provision of Ambulance transport within the administrative County of London. CONFERENCES The Council was represented at the undermentioned Conferences during the year Conference Held at Attended by Royal Society of Health. Scarborough (April) Cr.E.W.Hill and Medical Officer of Health. Central Consultative Committee for Old People. London (June) Cr.(Mrs.) C.Edwards and Medical Officer of Health. Public Health Inspectors' Association. Southport (September) Cr.H.Walvisch and Public Health Insp. Mr.R.W.Day. National Society for Clean Air. Harrogate (October) Cr.C.Dimes and Public Health Insp.Mr.G.D.Freeland. National Old People's Welfare Council. Eastbourne (March) Cr.H.Walvisch and Asst. Admin.Officer Mr.E.P.Webber. Central Council for Health Education. London (January) Medical Officer of Health and Pupil Public Health Inspector Mr.R.Scanes. 16 (Contd.) Home Safety Conference. Windsor (April) Cr.(Mrs.)C.Edwards and Hygiene Officer Miss M. Guest. Royal Institute of Public Health & Hygiene. Ea stbourne (October) Cr.E.W.Hill and Medical Officer of Health. Employment Fellowship. London (April) Cr.J.Olley and Medical Officer of Health. London Council of Social Service (Race Relations). London (July) Cr.J.Olley and Medical Officer of Health. London Council of Social Service (Partnership in the Arts). London (June) Cr.S.Kaufman and Medical Officer of Health. DECEASED PERSONS Inquests. Inquests were held on 50 residents of the Borough, the verdicts being 7 deaths due to road accidents; 21 other accidents; 15 suicides; 1 acute alcoholism; 1 misadventure; 2 manslaughter; 1 murder and 2 open verdicts. Burials. Section 50 of the National Assistance Act, 1948, places a duty on the Council to arrange for the burial of any persons found dead within the Borough where no private arrangements have been made. 23 such burials took place during the year - 18 adults and 5 children, at a cost of £266 of which sum £129 was recovered by the end of the year either from the estates of the deceased persons, from liable relatives or by way of grants made under the National Insurance Act 1946. 15 requests for burial came from H.M.Coroner's Officer, 7 from relatives and one from a friend of the deceased. It is often necessary where persons living alone have died in the Borough, to dispose of the contents of their homes. This is done in conjunction with relatives of the deceased, or with the Treasury Solicitor where there are no known relatives, and has the effect of releasing the accommodation for housing purposes as soon as possible. FREE WASHING FACILITIES The Council provides free washing facilities in 16 of the twentytwo Public Conveniences in the Borough, with the aim of promoting food hygiene and cleanliness. 17 HEALTH EDUCATION The programme of health education continued throughout the ye.^r. Each month a different topic is chosen, either to coincide with a national campaign or at a time of year when the incidence of a particular health hazard increases. The operation of the Council's third Smoke Control Order was given intensive publicity in that part of the Borough covered by the order. The Department's Poster Boards were used to display various posters during the year, as were also the Council's official notice boards and those affixed to lamp columns in street markets in the Borough. The occupiers of several large factories and some chemists' shops accepted posters for display and leaflets for distribution. With the co-operation of the Borough Librarian, bookmarks and leaflets on various health subjects were distributed from the lending section of the borough Libraries. Some 3,000 posters and 21,000 leaflets were distributed. In view of the dangers associated with defective and badly maintained oil heaters, posters and leaflets were distributed in the winter months. Copies of posters were printed in Greek and Turkish for the benefit of non-English speaking Cypriots. The Pakistan High Commissioner's Office was approached for a translation of the posters into Bengali and Urdu to help Pakistani and Indian residents in the borough. A monthly bulletin giving details of the incidence of infectious diseases, and data supplied by the local office of the Ministry of Pensions and National Insurance on persons claiming sick benefit - plus health propaganda material for surgery waiting-rooms, were circulated to local general practitioners and hospitals. In an attempt to put over by more direct means elements of positive health, a course of four weekly lectures on Food Hygiene and practice, supported by films and practical demonstrations, was held at the Public Health Department. These were attended by the food supervisory staffs of local firms undertaking food manufacturing processes or running large workers canteens. The food inspectors in their daily work at such premises endeavour to raise the standards of food hygiene. Lectures and film shows were also given to a local school, to a postgraduate group of social science students, and at a local hospital to a regional meeting of the Royal College of Nursing during the smallpox outbreak in other parts of the country. By invitation of the Medical Officer of Health, City of London, and St.Bartholomew's Hospital, E.C.L, the facilities of the diagnostic clinic for women at the hospital were made available to residents and workers in Stepney, in addition to those working in the City. This clinic aims to detect malignant, or other gynaecological pathological states, at a time when preventive measures can guarantee cure. Perhaps 18 2 per cent (l in 50) of working-class women who have borne children might expect to develop cancer of the womb (cervix) in present conditions. Curative treatment is often possible if the condition is detected at an early stage. Firms employing women in the borough were circularised urging the value of these preventive health investigations for women over the age of 35 years. A pelvic examination and a cervical smear (Papanicolau technique) is undertaken, by appointment, at the clinic. This year the Council became affiliated to the Home Safety Section of the Royal Society for the Prevention of Accidents, advantage being taken of the purchase of publicity material made available by that body which was used in a campaign held during the month of July. Publicity was also given to the Council's Holiday Centre by means of advertisements in the Press, slides shown in local cinemas, posters and leaflets. A campaign on the relationship between smoking and health was also carried out. Vacant sites in the borough were posted up with notices warning the public against depositing rubbish and also against the use of the land as caravan sites. Publicity was given to other subjects including diphtheria immunisation; vaccination against poliomyelitis; food hygiene; influenza, and the care of the elderly. HOLIDAY CENTRE During the year 1,137 Stepney residents spent a holiday at the Council's Holiday Centre, The Manor House, Sandgate, near Folkestone, Kent; this number included 723 aged persons and 14.6 children. The total number of weekly bookings was 1,268. The Holiday Centra is open all the year round and is available to any resident of the Borough, young and old — half the total accommodation is alloted to the latter each week. Coach transport is provided to and from the Manor House and the Public Health Department. The management and control of the Holiday Centre are vested in the Council's Physical Training and Recreation Committee, and the day-to-day administration is the responsibility of the Medical Officer of Health. Difficulty is experienced in getting residents of the Borough to use the facilities for a holiday in the Winter. It is appreciated that because of work and school commitments families with children cannot take advantage of the holiday centre, but one might consider that old people would welcome a winter holiday. The intensive publicity measures taken in the autumn (referred to above) as well as personal contact by the department's Hygiene Officers have resulted in only a slight improvement in winter bookings. 19 HOSPITAL FACILITIES The undermentioned Hospitals are situated in the Borough No.of Beds. The London Hospital, Whitechapel Road 685 Mile End Hospital, Bancroft Road 476 London Jewish Hospital, Stepney Green 128 *Queen Elizabeth Hospital for Children, Glamis Road 44 East End Maternity Hospital, Commercial Road 58 INFORMATION CENTRE The Council operates an Information Service for the public at the Municipal Offices, 227-233, Commercial Road, E.l. (Telephone: STEpney Green 1818). LABORATORY FACILITIES Bacteriological investigations for infectious diseases are carried out on behalf of the Public Health Department by the Regional Hospital Board's Group Laboratory, at Mile End Hospital. (See also page 40 re Food samples). Investigations were carried out on 140 specimens submitted by the Medical Officer of Health and by medical practitioners in the Borough during the year. The specimens comprised 113 faeces, 17 throat swabs and 10 rectal swabs. SPECIAL REPORTS OF MEDICAL OFFICER OF HEALTH Special reports were made to the Public Health and/or Housing Committees during the year on the following subjects Vacant and derelict sites. Houses in Multiple Occupation. Chronic Bronchitis. Air Pollution and diesel fumes. Provision of Meals for Old People. Home Accidents - fires caused by oil heaters. Provision of Sanitary Accommodation in Refreshment Houses. Registration of Ice Cream premises. Stepney Smoke Control Order No.4. *Closed with effect from April 30, 1963. 20 LEGISLATION The following Acts, Orders and Regulations affecting the Department were made during the year:- Date Operative Landlord, and Tenant Act 1962 1.11.62 Local Government Records Act 1962 1.10.62 London County Council (General Powers) Act 1962 1. 8.62 National Assistance Act 194-8 (Amendment) Act 1962 24. 5.62 Town and Country Planning Act 1962 1. 4.63 Abstract of Factories Act Order 1962 7.12.62 Discharge of Radioactive Waste (Extension of Temporary Control) Order 1962 7.12.62 Emulsifiers and Stabilisers in Food Regulations 1962 16.7.62 Factories; The Slaughterhouses Order 1962 7.11.62 The Slaughterhouses (No.l) Regulations 1962 7.11.62 The Slaughterhouses (No.2) Regulations 1962 7.11.62 Food and Drugs (Legal Proceedings) Regulations 1962 27.6.62 Food Hygiene (General) Regulations 1962 1.1.63 Food Standards (Table Jellies)(Amendment and Revocation) Regulations 1962 12.7.62 Housing (Management of Houses in Multiple Occupation) Regulations 1962 22.5.62 Housing (Prescribed Forms)(Amendment) Regulations 1962 24.5.62 Milk and Dairies (Emulsifiers and Stabilisers) Regulations 1962 11.4.62 Milk and Dairies (Legal Proceedings) Regulations 1962 27.6.62 Milk and Dairies (Preservatives) Regulations 1962 26.7.62 Motor Cycles (Protective Helmets)(Amendment) Regulations 1962 30. 6.62 Oil Heaters Regulations 1962 1.6.62 Poisons List Order 1962 31.12.62 Poisons Rules 1962 31.12.62 Preservatives in Food Regulations 1962 26.7.62 Other subjects dealt with in circulars issued by Government Departments, included the following:- Ministry of Health: Annual Reports of Medical Officers of Health; Development of Health and Welfare Services; Co-operation with Voluntary Organisations; Fluoridation of Water Supplies; Smoking and Health. Ministry of Agriculture, Fisheries and Food; Official certificates under the Public Health (Imported Food) Regulations in respect of South Africa, and South-West Africa; Approved Chemical Agents. 21 Ministry of Housing and Local Government: The Clean Air Act 1956; Gypsies; Turistiles in Public Conveniences; Caravan Parks; Houses in Multiple Occupation - Improvement of Houses. Home Office; Pharmacy and Poisons Act 1933; Oil Heaters Regulations 1962. General Register Office; Infectious and Other Notifiable Diseases (Weekly and Quarterly Returns); Transfer of Births, Deaths and Still-Births; Vital Statistics - Annual Reports of Medical Officers of Health. PSYCHO-GERIATRIC SERVICE - ST.CLEMENT'S HOSPITAL The catchment area for the psycho-geriatric services provided at St.Clement's Hospital comprises the boroughs of Bethnal Green, Poplar and Stepney. The Consultant Psychiatrist, Dr.W.M.Ford Robertson, at the Psycho-Geriatric.Day Hospital and Dundee Ward in St.Clement's Hospital, reports:- "As the Day Hospital and Dundee Ward have now evolved as one integrated unit it has seeded appropriate to summarise the results of inpatient care. There was a turnover of about two patients a week in this 22-bedded ward, the average length of stay being 11,5 weeks. During the year the Day Hospital with 24 places had a total of 5,391 attendances - 4,161 females and 1,230 males. The principal diagnostic categories were. - in order of frequency - depressive illness, confusional states, paranoid states and dementia. Practically all those discharged home or to hostels (almost three-quarters of the discharges) were improved. Arrangements were made for many discharged from the ward to attend the Day Hospital, with which they had become familiar through visits during their stay. , Delays of several months, however, were almost invariably experienced before transfer of patients to Long Grove or Part III accommodation could be effected. Most of such patients were found after admission to be demented and unfit to return home. The demand, for beds from the community remains considerable. "During our second year, the capacity of the Day Hospital has been seen in clearer perspective both in its potential and in its limitations. This is, we believe, the result of increased clinical experience, and also better co-operation and understanding from all those in the community whose interest lies in the aged and mentally.ill. There has been no lack of candidates to fill the 24 places with the result that patients have been better selected, which is partly reflected in the increased proportion and imoroved mental state of patients eventually discharged in 1962. Referrals by psychiatrists have been confined to those with undoubted mental illness. Patients from all other sources have been assessed at our Out-Patients Department prior to acceptance. 22 While the rate of admission and the overall distribution of diagnosis have altered little, and the factor of social isolation remains important in nearly every case, the proportion of patients suffering from little more than loneliness has been reduced. "In spite of the encouraging improvement in the discharge figures, by comparison with Day Hospitals for younger patients, the turnover is low and the numbers returned to the community perhaps unimpressive. However, when mental illness is superimposed on ageing, with such factors as social isolation and diminished resistance with greater incapacitation by illness, perhaps our figures cannot be much improved. In the more severely ill patients, Dundee Ward is the place of choice as the first stage of treatment. Later, the Day Hospital is used for rehabilitation. The Day Hospital serves best the convalescent and those whose illness is moderately incapacitating, often insidious in onset and chronic in course. In such cases the Day Hospital supplies an alternative to permanent in-patient treatment. Response is fairly rapid to full-time attendance but reduction may lead to difficulties, and to cut down too much may be to see a return of symptoms. The service given by the Day Hospital, even supposing not more than 50 per cent of its patients are returnable to the community, can also be gauged by those it mahages to keep out of hospital, general or psychiatric, as permanent residents. This is in line with the idea that the aged should be kept in community care as long as possible. Our capacity to do this more effectively, and on a larger scale, will depend on the development of. club facilities in the community of a kind different from those well established for persons without psychiatric disability, usually in the first decade after retirement. This aspect of after-care deserves to receive much more urgent consideration; we ourselves have taken the following steps to develop our own ideas. "Late in the year we formed a social club within the Day Hospital itself which on two afternoons a week is open to any ex-patients living nearby and prepared to attend without provision of transport. The work of the Social Department has been extended but still more has to be done, especially in the community in conjunction with the welfare officers of the Local Authority and Voluntary Associations. Relations with such bodies have been fostered through the bi-monthly meetings of our committee and by the routine forwarding of information about patients to the Medical Officers of' Health and their welfare staffs, as well as to Practitioners, when patients are admitted and discharged. Having been enlarged the membership of the Day Hospital Committee has become more representative and useful." 23 MATERNITY AMD CHILD WELFARE I am indebted to Dr.G.O.Mitchell, Divisional Medical Officer, London County Council, for the following information relating to the personal health services administered in the Borough by the County Council: 1. Statistics Infant Welfare Centres Total number of children who first attended during the year and who on the date of their first attendance were under 1 year of age 1,440 Total number of children who attended: Children born in 1962 1,353 " " 1961 1,275 " " 1957-1960 1,065 Total attendances by children: Under 1 year of age 17,947 1 to 5 years of age 5,293 Ante-Natal and Post-Natal Clinics (excluding Hospital Ante-Natal Clinics) Ante-Natal Consultations: Number of women who attended l6l " " New Cases (included in above) 150 Total attendances 1,154 Post-Natal Consultations: Number of women who attended 64 Health Visitors Number of children (up to 4 years) visited 6,141 " " infants under 1 year of age visited for first time 1,816 Total visits to children under 1 year of age 6,891 " " " aged 1 year but under 2 years 4,216 " " " 2 to 5 years of age 8,895 Number of expectant mothers visited for first time 584 Total visits to expectant mothers 1,138 Child Minders (daily guardians) Number of child minders - Voluntary 14 Statutory 5 Number of children minded - Voluntary Statutory 10 Immunisation and Vaccination For details of immunisation and vaccination see Pages 45 and 47. 24 Domestic Help Service This service, covering the boroughs of Bethnal Green, Poplar and Stepney, is divided into three districts irrespective of borough boundaries, and statistics for each separate borough are not available. However, the number of cases in which help was provided in the 'southern' district (which comprises the Borough of Stepney less the area east of the Canal and two areas north of the east-west line - Whitechapel High Street, Whitechapel Road and Mile End Road), are as follows:- Maternity (including expectant mothers) 3 Tuberculosis 2 Aged and infirm 215 Other cases 43 2. Services Provided Infant Consultation Afternoons. 673, Commercial Road. Tues., Thurs.(and Fri.morning). 17, Rhondda Grove. Monday and Thursday. Mary Hughes Centre, Underwood Road. Monday, Wednesday & Thursday. St.George's Centre, Library Place. Tuesday, Wednesday & Friday. 5, Pier Head, Wapping. Wednesday. 35, Stepney Green. Tues.(morning); Wed. 69, East India Dock Road. Tues. and Thurs. (morning) Ante-Natal and Thursday afternoon. 673, Commercial Road. Wednesday. Vaccination against Smallpox 35, Stepney Green. Tuesday. Immunisation against Diphtheria or Whooping Cough 35, Stepney Green. Tuesday. (Note:- Diphtheria and. Whooping Cough immunisations are also carried out at the Infant Welfare sessions). Inoculation against Poliomyelitis 35, Stepney Green. Tuesday. Toddlers Clinics St.George's Centre, Library Place. 1st Tuesday morning in month. Mary Hughes Centre, Underwood Road. Tuesday. 673, Commercial Road. Monday. Day Nurseries Christian Street; Underwood Road. Voluntary Day Nursery Beaumont Grove (Alice Model Day Nursery). 25 SWIMMING AND SLIPPER BATHS Four Swimming Baths are provided by the Council in the Borough. The Open Air Swimming Bath at Goulston Street was reopened in May after reconstruction. During the year the number of Swims taken amounted to 125,583, comprising 18,204 adults and 107,379 children and juveniles. The water is subjected to a continuous chlorination and filtration process, passing through the filters once every 3½ hours. 30 samples were taken during the year for bacteriological and 30 for chemical analyses. Four samples showed the presence of b.Coli while some revealed a low free chlorine content and/or pH value. The number of Slipper Baths taken during the year at the four Council establishments was 161,105, which included 5,745 by old age pensioners and six by unemployed persons who were admitted free of charge. The total number of persons admitted to all sections of the Baths and Washhouses Department, including the Laundry, was 325,453. STAFF CHANGES The following staff changes took place during the year Commenced duty: M. Connell General Clerk 3 Sept. W.D.Giardelli Housing Assistant 3 Dec. T.W. Harlock Caretaker and Messenger 19 May G.A. Hensher Pupil Public Health Inspector 24 Sept. D.J. Townshend Public Health Inspector (Temporary) 1 Oct. Dr. R.W. Watton Medical Officer of Health 22 Jan. Ceased duty: A.N. Cook Caretaker and Messenger 23 Apr. W.T. Gardiner Public Health Inspector 31 Dec. J.H. King General Clerk 18 May Dr. F.R.O'Shiel Medical Officer of Health 21 Jan. L. Rajigah Public Health Inspector (Temporary) 5 Jan. 26 III. SANITARY CIRCUMSTANCES The District Public Health Inspectors served 2,308 Notices during the year, and in 4-6 cases legal proceedings were employed to enforce compliance therewith. At the end of the year, the Department was still four below the establishment of District Inspectors. Aspects of the work of the inspectors not covered in the following paragraphs will be found in the statistical appendix, pages 64. to 66. Certificates of Disrepair (Rent Act. 1957) During the year, 29 applications under the Rent Act 1957 were received from tenants for Certificates of Disrepair, 13 certificates being issued. The Council exercised its right under paragraph 5 of the First Schedule to the Act in refusing to accept undertakings from landlords in respect of eight premises. Clean Air The Borough's third Smoke Control Order made under the Clean Air Act, 1956, was confirmed by the Minister of Housing and Local Government in March and came into operation on 1st October, 1962. At the end of the year the Minister's confirmation of Area No.4 was awaited. Area No.3 is one of 90 acres and comprises 1,914 dwellings and 145 commercial, industrial and other premises. A survey of the area revealed that the.number of appliances in dwellings which were in regular use, and which required replacement or adaptation, was 670. There is, in the Public Health Offices, a Smoke Control Exhibition always open to the public in which is displayed various types of approved space heating and cooking appliances and authorised fuels. Arrangements are also made with the Solid Smokeless Fuels Federation for their Demonstration Van to tour each smoke control area for a week, immediately prior to the date the Order comes into operation. Facing the next page is a Map showing the Smoke Control Areas established in the Borough. Under the provisions of Section 3(3) of the Clean Air Act, 1956, furnaces may not be installed in buildings unless notice of proposal to install has been given to the Council. Notices were given to the Council of proposal to install furnaces in 30 premises. Persons who installed furnaces in two premises without giving the requisite notice were cautioned. 27 Measurements of air pollution are taken regularly in the Borough by means of lead peroxide instruments which give monthly records of the concentration of sulphur in the air, and also by combined smoke filters and volumetric sulphur dioxide apparatus which afford daily readings. The use of deposit gauges which gave records of soluble and insoluble matter deposited was discontinued after November this year. Details of visits and inspections made by the Smoke and Factories Inspector are given on page 67. Drainage and Sanitary Conveniences Considerable use is being made of Section 25(1) of the London County Council (General Powers) Act, 1955, whereby a Public Health Inspector can serve a notice requiring the owner to clear an obstructed drain within 48 hours, and if the notice is not complied with during that time the Council may themselves execute the work and recover the cost from the person responsible. Notices under this section served during the year numbered 263, the Council having executed the work in 51 instances. Seven summonses were taken out for failure to comply with notices served under Section 40 of the Public Health (London) Act, 1936, for the repair of defective drains, and two for failure to comply with notices served under the London County Council (Drainage) Byelaws. Fines amounting to £15 with costs of £25.14.0d were imposed. Factories Under Section 153 of the Factories Act, 1961, the Medical Officer of Health is required among other things to report to the Council in his annual report specifically on the administration of, and furnish the prescribed particulars with respect to, matters under the Act administered by the Council. The particulars referred to will be found in the Appendix, pages 68 and 69. Hairdressers Hairdressers and barbers premises registered by the Council under Section 18 of the London County Council (General Powers) Act, 1954, number 127. The Council supported representations made to the Metropolitan Boroughs' Standing Joint Committee by another metropolitan borough, that local authorities should be enabled to exercise a greater degree of control over premises and to refuse registration where it is considered that the premises are unsuitable for use as a hairdressing establishment. 28 Legal Proceedings Legal proceedings instituted during the year (other than those relating to food premises), showing penalties imposed, were as follows:- Act or Byelaw No. of Summonses Fines Costs £ s d £ s d Public Health (London) Act 1936: Nuisance Orders 23 — 66. 6. 0 Non-compliance with Nuisance Orders 2 45. 0. 0 5. 0. 0 Defective drains (Section 40) 7 11. 0. 0 21. 14. 0 Insufficient W.C. accommodation (Section 105) • 1 5. 0. 0 3. 13. 0 Keeping swine in unfit place (Section 119) 1 3. 9. 0 London County Council (Drainage) Byelaws 2 4. 0. 0 4. 0. 0 London County Council (General Powers) Act 1959, Section 22 (Using unlicensed land for siting caravans) 5 17. 0. 0 4. 3. 0 London County Council (General Powers) Acts 1951-54 (Dustbins) 1 2. 0. 0 1. 10. 0 Prevention of Damage by Pests Act 1949 Section 4 (Rat harbourage) 3 12. 0. 0 1. 0. 0 Stepney Borough Council Byelaws (Yard paving) 1 1. 0. 0. - 46 97 0. 0 110. 15. 0 (Details of other legal proceedings taken will be found on pages 35 & 41). Radioactivity With the increasing use in the industrial, medical and scientific fields of ionising radiations and materials containing radioactive substances, attention is being given to this modern hazard. One of the Public Health Inspectors has attended a course of background training on radiological health and safety as recommended by the Ministry of Health in Circular 31/61. There is also liaison between the Council and a research laboratory in the Borough regarding the disposal of radioactive wastes. 29 Notices Served Notices served during the year under the various Acts and Byelaws are as follows:- Intimation Notices. Statutory Notices. Public Health (London) Act 1936s Section 82 126 1,296 " " 40 — 67 " " 105 — 10 " " 109 — 18 " " 119 - 1 Factories Act 1961 65 — Prevention of Damage by Pests Act 1949, Section 4 - 71 London County Council (General Powers) Act 1954 (Dustbins) - 308 London County Council (General Powers) Act 1955 (Stopped-up Drains), etc. - 263 London County Council (General Powers) Act 1955 (Water Supply) - 2 Noise Abatement Act 1960 — 2 Shops Act 1950 — 4 London County Council (Drainage) Byelaws — 30 London County Council (Poultry Slaughterhouse) Byelaws - 4 London County Council (Seamen's Lodging House) Byelaws 1 Stepney Council (Staircase Lighting) Byelaws - 18 Stepney Council (Storage Cisterns) Byelaws - 5 Stepney Council (Yard Paving) Byelaws - 4 Stepney Council (Hairdressers) Byelaws - 13 192 2,116 Refuse Disposal The Public Cleansing Officer has kindly supplied the following information on refuse disposed of during the year House and Trade refuse 37,095 Tons Street and Market refuse 9,454 " Where possible refuse collection is carried out by means of "Paladin" containers, mainly from blocks of flats, throughout the borough. This method was adopted in 1955 since when 732 of these containers have been installed. The Cleansing Department carried out 26,511 cleansings of 5,131 street gullies by means of mechanical gully emptiers. 30 Lodging Houses - Common There are three common lodging houses in the Borough, providing accommodation for 726 persons as follows 10-22, Johnson Street (Church Army) 175 men 177, Whitechapel Road (Salvation Army) 323 " Hostel for Women, Hopetown Street (Salvation Army) 228 women Another dormitory at 177, Whitechapel Road was brought into use during the year, increasing the accommodation by 23 beds. At the invitation of the Salvation Army, members of the Public Health Committee carried out a tour of inspection of this lodging house. Lodging Houses - Seamen Two such premises in the Borough provide accommodation for 388 seamen as follows:- Sailors' Home & Red Ensign Club, Ensign Street & Dock Street 243 seamen Empire Memorial Hostel, 747, Commercial Road 145 " Accommodation was re-opened during the year at the Empire Memorial Hostel increasing the facilities available to seamen by 43. Lodging Houses - Other In addition to the licensed common and seamen's lodging houses, there are two other premises in the Borough which provide lodgings but which are not subject to licensing or registration, viz: Tower House and Providence Row Night Refuge. Tower House (formerly known as "Rowton House"), which'was opened in 1902, orovides accommodation for 694 men and Providence Row Night Refuge for 77 men, women and children. Outworkers There are 462 premises on the Register, 134 less than last year. Number of firms in the Borough employing outworkers 93 " " outworkers residing in, and employed by firms in, the Borough 201 " " outworkers residing outside, and employed by firms in, the Borough 562 " " outworkers residing in, and employed by firms outside, the Borough 261 31 Offensive Businesses There are nineteen offensive businesses in the Borough. The register comprises the following premises:- Dresser of Furskins (1): 34/38, Brodlove Lane. Poultry Slaughterhouses (18): 19, Bell Lane* 7, Leyden Street* 28, Burslem Street 10b, Leyden Street* 161, Gannon Street Road 13, Leyden Street 163, Cannon Street Road* 15, Leyden-Street 16/18, Cobb Street 7, Lower Hessel Street* 14, Hessel Street* 4, Monthope Street* 21/22, Hessel Street* 6, Monthope Street* 36, Hessel Street 10a, Monthope Street 75, Hessel Street 82, Stepney Way. (*Establishment Orders of these premises are subject to renewal from time to time by the Council.) Half the poultry slaughterhouses in the Borough were established before the function of granting Establishment Orders was transferred from the County Council to the Borough Council. The orders for such premises not being renewable annually, the Borough Council have no powers to impose conditions regarding, for example, the hours during which slaughtering and delivery of poultry may take place. In the absence of such conditions nuisances have arisen from noise, particularly, in the early morning. The Council during the year made representations to the Secretary of State, the London County Council and the Metropolitan Boroughs' Standing Joint Committee urging that powers be conferred upon the Council to permit them to review all establishment orders annually, and to impose conditions. Representations were also made to the appropriate authority expressing the Council's hope that everything may be done to expedite the establishment of a centralised poultry slaughterhouse. Rodent Control In accordance with the requirements of the Ministry of Agriculture, Fisheries and Food, statistics on Rodent Control work carried out by the Department during the year were submitted to the Ministry. During this period 2,421 dwellings and other premises were inspected, and 1,027 were found to be infested with mice or rats. Treatments were carried out by the Department's rodent control staff to 839 properties found to be infested, the charges made for servicing business premises amounting to £401. 32 By the implementation of Section 4 of the Prevention of Damage by Pests Act 1949, it has been found possible to clear bombed sites of refuse which would otherwise act as possible harbourage for rats and other vermin. Moreover under the same section which permits specified works to be carried out, it has been possible to require sites to be fenced in by the owners. Legal proceedings were taken against the owners of three properties for failing to comply with notices served under Section 4 of the Prevention of Damage by Pests Act, requiring the removal of rat harbourage and the prevention of deposition of further harbourage by the erection of a closed fence or wall around the sites. The summonses were proved, fines totalling £12 with costs of £1 being imposed, A copy of the return furnished to the Ministry is on pages 62 & 63. The Council carries out on behalf of the Stepney Group Hospital Management Committee any necessary treatments for rodent infestation at Hospitals and other premises in the Borough, which come under the control of that Committee. Shops The number of premises in the Borough covered by the provisions of the Shops Act 1950, is 3,134. Certificates were granted during the year under Section 38(6) of the Act in respect of two premises exempting them from compliance with sanitary accommodation provisions. Water Supply The whole of the Borough is supplied with water by the Metropolitan Water Board, which is the authority responsible for its purity. The quantity and quality of water supplied by the.Board during the year have been satisfactory. All the premises in the Borough are supplied individually direct from the public water mains. The number of instances where the water supply to premises was repaired or reinstated, following action taken by the Department, totalled 140, and the Metropolitan Water Board was notified on 40 occasions where wastage of water was taking place. During the year, 24 notices were received from the Metropolitan Water Board of withdrawal of water supply: in six premises for nonpayment of rates and in 18 because of defects in the service. 33 Water Certificates Water certificates as to new dwellings having a proper and oufficient supply of water, were issued under the provisions of the Public Health (London) Act, 1936, in respect of 743 dwellings. Wells Bacteriological and chemical analyses of water from the four deep wells in use industrially in the Borough are made periodically and the results reported to this Department. All were reported as satisfactory. Work executed by the Council in default of Owners Work was carried out by the Council at the following premises in default of the owners, from whom the stated costs incurred were recoverable Rat harbourage removed and preventive measures taken (Section L. Prevention of Damage by Pests Act 1949). £. s d Sites - 12, Black Lion Yard 20. 5. 7 Brenton/Camdenhurst Streets 291. 0. 0 138, Buxton Street 19. 7. 8 140, Buxton Street 19. 1. 7 33, Cable Street 76. 0. 0 58, Turners Road 165.19.10 Dustbins supplied (Section 12. London County Council (General Powers') Act 1954). 35 Premises (62 bins) 141. 4. 3 Stopped-up Drains cleared (Section 25(l), London County Council (General Powers) Act 1955). 51 Premises 166.16. 4 Workplaces There are known to be 552 workplaces in the area (other than those premises covered by the Factories Act, 1961). 34 IV. HOUSING Clearance Areas During the year two clearance areas, involving 149 houses, were declared by the Borough Council. Demolition Orders The Council made demolition orders in respect of three premises during the year. As a result of appeals, one order was quashed, and closing orders were substituted for the remaining two demolition orders. An appeal against a Closing Order made by the Council was dismissed. Overcrowding During the year 57 cases of alleged overcrowding were investigated, 32 of which were confirmed and referred to the London County Council. Twenty overcrowded families were rehoused by the London County Council and 8 by the Borough Council. The Register of overcrowded premises was reviewed during the year. It was found, following a survey, that for reasons such as children . having married or obtained other accommodation, removals, etc., the register was reduced from 355 to 183. Underground Rooms There are approximately 1,500 underground rooms in the Borough used for living or sleeping purposes, of which 1,450 are unfit. During the year, 7 rooms were closed and Closing Orders on three rooms were determined. A summons issued for the occupation of an underground room in contravention of a closing order resulted in the owner being fined £4 with £3.3.0 costs. Town & Country Planning (Housing Accommodation') Direction. 1952 Under this Order the Borough Council is consulted by the London County Council (the Planning Authority) before applications are determined for planning permission for development involving change of user of premises from use as a dwelling. Investigations of 22 such applications were carried out during the year. Applications for Rehousing At the end of the year, there were 2,472 applications for rehousing on the Housing Manager's register. These included the tenants of 154 Council dwellings who desired larger or smaller accommodation. 35 Preferential Housing on health grounds Thirteen of the 25 cases investigated were found to come within the Council's Points Scheme. Caravans Although not many caravans find their way into the Borough to park on derelict sites, the few that do arrive cause no little concern because of inadequate environmental hygiene conditions (see photograph). The metropolis cannot offer these facilities for this type of dwelling. Water is obtained by buckets from nearby residents, refuse is disposed of by distribution over the site around the caravan, and pail closets are often emptied into the sewer via the nearest street gully. To employ the processes of the available laws in order to move caravans off unsuitable sites is an arduous and tardy procedure. The first difficulty occurs in serving a summons - the owner or occupier of the caravan invariably and. coincidentally is absent when the Warrant Officer calls. The next hope (often a vain one) is that he will appear at Court to answer the summons. After a lengthy period - often as long as six months - the summons is heard, complaint proven and the defendant perhaps fined £1. In effect, he can live at a rent of £1 for six months and, in consaquence, often stays on the site awaiting a further summons, or may condescend to move his caravan on to a derelict site in the next street. There is no provision for the Court to order the removal of the caravan. The time spent by officers of the Council to hatch this egg is out of all proportion to the result achieved. In order to prevent nuisances arising from misuse of open sites there should be legislation to compel the person who demolishes any premises to enclose the site by a suitable wall, not chain link fencing or chestnut paling, before he leaves the site. Summonses numbering 11 were taken out against caravanners who contravened Section 22 of the London County Council (General Powers) Act, 1959, by stationing their caravans on land which was not licensed for the purpose. Five summonses were heard, resulting in fines of £17 with costs of £4.3.0d. Houses in Multiple Occupation Part II of the Housing Act, 1961, extends the powers given to local authorities under Sections 36 and 90 of the Housing Act, 1957, to deal with houses in multiple occupation. Although the Act itself came into operation on 24th November 1961, the Regulations made thereunder, namely, the Housing (Management of Houses in Multiple Occupation) Regulations 1962, did not come into force until 22nd May 1962. 36 The Caravan problem. Photo T. J. Golden Briefly the new powers are: (l) to make good neglect of proper standards of management; (2) to require the execution of works necessary to provide minimum facilities and amenities; (3) to increase the penalties for failure to abate overcrowding; (4.) to apply a direction to a house in multiple occupation limiting the number of persons who may live therein, and (5) to enable a local authority to carry out works in default. The administrative work necessary to implement the provisions of this legislation is voluminous, and the time required to deal effectively with premises is not less lengthy because of the rather complicated procedure laid down and the right of persons affected to appeal at every stage of the proceedings. There are several thousand houses in multiple occupation, formerly known as houses let in lodgings, in the Borough. (The definition of a house in multiple occupation is one which is let in lodgings or occupied by more than one family). The Council agreed with a recommendation that, in the first instance attention be given to those premises occupied by three or more families and that action under Section 90 of the Housing Act, 1957, relating to overcrowding caused by single male persons be taken against the owner/occupier of the premises. It was also agreed that action requiring the provision of essential facilities and amenities, such as sinks, baths, hot water supply, etc., be confined to those premises which had an expectation of at least 15 years life. A problem to be considered is the availability of labour, direct or otherwise, to carry out the necessary works on behalf of the Council in default of the person on whom notice is served. Another difficulty arises in the rehousing of the overspill, whether temporary or permanent, occasioned by the installation of these facilities. The Act provides for specifications of works to be included in notices served: because of the amount of work this involves and the acute shortage of public health inspectors, the Council at the end of the year appointed two officers, with practical building experience, as Housing Assistants to draw up specifications and carry out inspections under the supervision of the Public Health Inspector (Housing). The Council also adopted a set of standards to be applied in connection with the provision of additional services and facilities, and agreed with the recommendation of the Minister that informal approach be made, in the first instance, to persons owning or managing these premises. By the end of the year 222 houses had been inspected and detailed reports submitted. Informal approach regarding the absence of proper standards of management and the need for provision of essential facilities, was made in respect of 21 premises; action was taken with regard to overcrowding in 17 premises, and notices of intention to make management orders were served in three instances. This work is now continuing at a faster rate. 37 Standard Grants and Improvement Grants In conjunction with officers of the Borough Engineer and Surveyor's Department, the Housing Inspector inspected 16 premises regarding which applications had been made to the Council for standard or improvement grants. New Housing During the year, 770 new dwellings were completed in the Borough; 258 by the Borough Council, 489 by the County Council and 23 by private enterprise. (See Appendix, page 77). A total of 8,428 new permanent dwellings have now been constructed in the Borough since the war; 5,515 by the London County Council, 2,617 by the Borough Council, 69 by the Corporation of London and 227 by private enterprise. At the end of the year units of accommodation owned by the Council numbered 4,351, comprising 3,927 erected by the Council and 424 formerly requisitioned and other premises purchased. A photograph of part of the Borough Council's Clichy Estate appears opposite this page. The Estate was so named after the Borough's "twintown" of Clichy-la-Garenne, a suburb of Paris. Statistics A summary of inspections made by the Housing Inspector is given on page 67, and further Housing statistics will be found on pages 70 & 71. 38 V. INSPECTION MP SUPERVISION OF FOOD At the beginning of the year some newspapers gave publicity to stories of children in various parts of the country having been taken ill following consumption of imported sweets consisting of toffee contained in an ordinary cockle shell. Four samples were taken from confectioners in the Borough but no pathogenic organisms found. Milk vending machines in the Borough received regular attention, samples being frequently taken both for chemical analysis and for bacteriological examination. As part of the Christmas trade, sweets described as "Chocolate Whisky Bottles containing genuine whisky" appeared in several shops in the Borough. Samples taken contained approximately only 20% proof spirit instead of 65%. Following discussion with the importers, a satisfactory label and description was agreed. Towards the end of the year swabs were taken of prepacked poultry at pre-packing premises in the Borough and of cut poultry exposed for sale in retail butcher and poultry shops. Gutting tables were also swabbed. Of 83 swabs submitted for bacteriological examination for the presence of salmonella organisms, 5 were found positive (including one from a gutting table). Swabbing of poultry is being continued and measures to be taken to reduce the risk of salmonella cross infection are under active consideration. Any steps which reduce the reservoir of those salmonellae organisms liable to infect the general public are to the benefit of the public health. Perhaps, more emphasis in this field is desirable when it is known that 'food poisoning' outbreaks continue at a high rate in this country. Sampling of desiccated coconut and of imported egg products continues at the wharves and results show that improvement is being maintained consequent upon the policy of detention and sampling of all consignments. The same can be said of tea imports, sampled and analysed for excessive lead. More consignments of all these commodities are now found to be satisfactory, which suggests that the action of the Riparian and Port Health Authorities has resulted in more careful production and handling in the exporting countries. Licensing Act. 1961 This Act gives local authorities powers to inspect restaurants, residential hostels, and the like, in respect of which applications are made to the licensing justices for the grant of licences to enable intoxicating liquor to be sold therein. Similar powers are conferred on local authorities as regards licensed clubs together with the right to object on one or more specific grounds when applications for registration, or renewal thereof, come before the licensing justices. The Council authorised the Public Health Inspectors to inspect these premises, and reports are made as to their suitability and convenience for the purpose, having regard to their character, condition, size and nature. Where the Council objects to the granting of a licence, in consequence of the report of the Public Health Inspector, it is necessary for the inspector concerned to attend 39 before the Magistrates at the hearing of the application. Reports on 35 applications were made during the year. Bacteriological Examination of Foodstuffs Samples submitted for bacteriological examination numbered 1,161. These comprised 827 samples of desiccated coconut, 151 imported dried and frozen egg, egg albumen, spray, crystals, etc., 26 ice cream, 38 tuberculin tested (pasteurised) milk, 16 pasteurised milk, 14 sterilised milk, 1 cooked salt beef, 4 sugar confection in sea-shells, 1 ice cream lolly, and 83 swabs taken from poultry premises. Six samples of dried egg albumen crystals and one egg albumen sample were found to contain various salmonella organisms and the packages were detained under the Public Health (Imported Food) Regulations for re-export or heat treatment. Six samples of desiccated coconut contained salmonellae and were released for either sterilisation under supervision, or for re-export for processing. Two tuberculin tested (pasteurised) milk, samples failed the Methylene Blue Test, repeat samples being satisfactory. Five swabs taken from poultry premises were positive to salmonellae. Towards the end of 1961 illness occurred among 300 boys at a Naval Training establishment in Suffolk, alleged to have been caused by eating raw apples contaminated with an organic phosphorous insecticide to an amount equivalent to 10 parts per million. The apples were supplied by a wholesaler in Spitalfields Market, in this Borough, who obtained them from a farm in Kent. Exhaustive investigations were carried out and subsequent reports failed to substantiate the alleged cause of the outbreak of diarrhoea and vomiting. Bakehouses and Bakers Shoos A. summons was issued against the proprietor of a baker's shop for selling cake containing a foreign body. A fine of £10 with costs of £5.5.0d was imposed. Chemical Sampling of Foodstuffs Samples submitted for analysis to the Public Analyst numbered 412 for the year. The Report of the Public Analyst appears on pages 54-56. Export Certificates 94 certificates were issued in respect of the examination of a variety of foodstuffs exported to the United States, South America, Canada, Sweden^ Italy, Malta, Israel, Spain and Kuwait. Before issuing these certificates an inspection of the foodstuffs to be exported is carried out, and on occasion samples are taken for analysis. Where necessary investigation is made into the method of production. 40 Grocers Shop Legal proceedings taken against a grocer for selling an article of confectionery which was unfit for human consumption resulted in the imposition of a fine of £10 with £5. 5. 0d costs. Ice Cream There are 22 premises in the Borough registered for the manufacture of Ice Cream, but only two were used for this purpose during the year. Inspections were made from time to time under the Ice Cream (Heat Treatment, etc.) Regulations, 1959, and no contravention of the regulations found. 17 samples of Ice Cream submitted for chemical analysis showed an average fat content of 9.97 per cent. 26 samples were subjected to the Methylene Blue reduction test, with the following results Manufactured in Borough outside Borough Total Grade I 5 (3) 10 (12) 15 (15) "II 2 (1) 3(2) 5(3) "III 2 (3) - ( -) 2 3) " IV 1 (1) 3 (- ) 4 (1 ) (The figures in parenthesis are those for 1961.) The three unsatisfactory samples (Grades III and IV), manufactured in the Borough, were taken from two firms. Advice was given on production methods and subsequent samples taken proved satisfactory. The three Grade IV samples manufactured outside the Borough were obtained from the same retailer: the local authority concerned was notified. Legal Proceedings Summonses dealt with by the Public Health Inspectors (Food) during the year were as follows:- No. of Summonses Fines Costs Food and Drugs Act, 1955. 4 (3 premises) £12. 0. Od £16. 5. Od Food Hygiene (General) Regulations, 1960. 8 (l premises) 8. 0. Od 3. 3. Od £20. 0. Od £19. 8. 0d 41 Cautionary Letters On instructions of the Public Health Committee, cautionary letters were issued in respect of the following contraventions:- Sale of bread loaf containing a piece of metal. Sale of bread loaf containing a piece of string. Sale of pork sausages deficient in meat. Sale of pork sausages deficient in meat and containing excess quantity of preservative. Failing to screen properly a fish stall. Milk Samples Milk samples taken and submitted for chemical analysis during the year numbered 82, including nine taken at hospitals, schools and day nurseries in the Borough. The average fat and solids-not-fat contents of ordinary milk samples analysed were 3.62 and 8.55 per cent, respectively, while those of the super-fatted variety were 4.40 and 8.89 per cent. Poulterers' Premises Eight summonses issued against the proprietor of a poultry shop for contravention of the Food Hygiene Regulations resulted in the person being fined £8 with £3.3.0d costs. Bacteriological examination was carried out on 83 swabs taken from preparation tables, utensils, etc., in poulterers' premises. 5 of the samples were found to be positive to salm'onellae. Public Health-(Imported Food) Regulations. 1937-48 181 Detention Notices and 314 Release Notices were served under, the Regulations. These affected a variety of foodstuffs including butter, cereals, chillies, cocoa., cocoa-butter, coconut, coffee, dried fruit, egg powder, ginger, ground nuts, gum tragacanth, honey, lard, assorted canned goods, offals, senna pods, spices, sugar and tea. Two consignments of meat and animal casings, which arrived unaccompanied by the official certificates, were subsequently released on production of the certificates. 140 carcases of mutton, representing a 5 per cent. examination, were examined for casoous lymphadenitis by the cutting of the lymphatic nodes. All the carcases examined were found to be free from disease. Sanitary Accommodation in Refreshment Houses. Inns. &c. Section 25 of the London County Council (General Powers) Act, 1959, enables a metropolitan borough council to require the provision of sanitary conveniences at inns, refreshment houses, etc. Following the making of this legislation doubt arose as to the interpretation of the phrase "refreshment house". Accordingly the 42 County Council promoted legislation defining a refreshment house as anybuilding in which food or drink is sold to, and consumed by, the public. This definition was included in Section 25 of the London County Council (General Powers) Act, 1962. During the year the Council adopted a set of standards for sanitary conveniences to be applied in connection with the provisions of the Act. The provision of washing facilities was originally included in the 1959 Bill but was deleted during its passage through Parliament. This Council supported the views of the Metropolitan Boroughs' Standing Joint Committee that the County Council should be asked to make a further approach to Parliament on the matter. Sausages (Meat Content) Analysis of 19 samples of pork sausages and 4 samples of beef sausages showed the average meat content to be 69.5 per cent, and 64.75 per cent, respectively. Two formal samples of pork sausages taken were found to be deficient in meat and the vendors were cautioned. Unsound Food The following quantities of unsound foodstuffs were disposed of during the year under the Public Health (Imported Food) Regulations, 1937-48, and the Public Health (London) Act, 1936:- Tons cwts. Wharves 110 7 London Fruit Exchange and Spitalfields Market 99 9 Bishopsgate Goods Station - 11 do, (Train Ferry) - 17 Other Premises 70 16 Total: 282 tons 0 cwts. Approximately 96 tons of unsound food was allowed to be used for chemical or animal feeding piu'poses, or for manufacturing purposes other than for human consumption, the remainder being delivered to, or collected by., the Public Cleansing Department, at whose riverside depot it was mixed with household refuse, under the supervision of the Public Cleansing Officer, and removed by barge to a controlled tipping site in Essex. Approximately 2,250 condemnation certificates in respect of unsound food were issued in 1962. 43 Unsound Food. &c. - Complaints Complaints made by members of the public as to alleged unsound condition, etc., of food, and which were investigated during the year, numbered 28. The complaints referred to the following Alleged unsound condition. Bacon 1, bread rolls 3, carrots 1, cheese toasties 1, cream soda 1, faggots 1, meat 1, peanuts 1, scampi 1, scones 1. Alleged dirty condition and/or foreign body or deposit. Biscuits 1, bread and rolls 5, cheesecake 1, currants 1, doughnuts 1, lemonade 1, milk 1, minced meat 1, salami 1, saveloys 1, sausage rolls 1. Alleged adulteration. Milk 1. Zeebrugge-Harwich Train Ferry 284 midnight or early morning visits and 166 other visits were made to Bishopsgate Goods Station for the purpose of examining 8,718 trucks of foodstuffs arriving from the following countries Austria 4 Trucks. Holland 5 Trucks. Belgium 397 " Hungary 425 " Bulgaria 40 " Italy 4346 " Channel Islands 1 " Roumania 65 " Congo 19 " Spain 1 " Denmark 15 " Sweden 7 " France 1 " Switzerland 17 Germany 20 " Yugoslavia 3335 " Greece 20 " The weight of the foodstuffs examined was 78,730 tons, comprising 42,592 tons of fresh fruit and vegetables, 16,457 tons chilled and frozen meat and offals, 11,396 tons preserved meats and sausages, etc., 5,411 tons bacon, 1,972 tons butter, 126 tons confectionery, 261 tons preserved fruits and vegetables, 121 tons eggs, 194 tons horsemeat, 90 tons cheese, and 110 tons miscellaneous foodstuffs. Foodstuffs found to be unsound, and which were stopped and destroyed, amounted to 17 cwts. 44 VI. PREVALENCE OF. AND CONTROL OVER INFECTIOUS AND OTHER DISEASES Weather Conditions January was wet but very sunny and had a mean temperature a little above average with sleet and snow on three days. February was very dry and sunny, with sleet and snow on five days. March was exceptionally cold, very frosty and with sleet or snow on ten days. April was rather cold with average rainfall, whilst May was cool, dull and rather dry. June was dry with rather more than average sunshine, but from then on the summer was dull, cool and, with the exception of August, wet. October was dry and very sunny, November too being dry but with less than average sunshine. December generally was cold and sunny, with fog from the 3rd to 7th. Snow fell on Boxing Day and presaged a period of frost lasting well into 1963 when many weather records were broken. Notifications The number of notified cases of infectious diseases (corrected for revised diagnoses and duplicate notifications) during the year was 772, the lowest ever recorded. Table 14. on page 74 shows cases notified together with comparative figures over the last ten years. A list of diseases which are notifiable in the County of London is shown in Table 16 on page 76. Cancer The number of deaths from cancer during the year was 214 (22 less than last year). Deaths from lung cancer numbered 66, which is 13 less than in 1961. The male death rate from lung cancer in England and Wales increased from 567 per million population in 1952 to 895 in 1962, the female death rate increasing from 98 to 146 during the same period. The graphs facing the following page show the increase in the rates of deaths from lung cancer since 1951, compared with the rates of deaths from cancer of all sites where little change hns occurred. Diphtheria No notifications of Diphtheria were received for the second year in succession and none was received in the whole County, the first time since records were kept. 45 The number of Stepney children immunised at London Gounty Council clinics, during the last 5 years, is as follows:- 1962 1961 1960 1959 1258 Completed primary courses:- Children under 5 years 982 1,424 1,302 1,330 1,106 " 5-15 years 208 489 437 318 420 Children given reinforcing injection 1,725 2,858 1,389 940 1,372 Seventeen swabs were forwarded by general practitioners to the Mile End Group Laboratory where bacteriological examinations are carried out on. behalf of the Borough Council. Dysentery There was a decrease in the incidence of Sonne Dysentery, 31 cases being notified compared with 48 cases last year. Enteric Fever No cases of Enteric Fever were notified during the year. Erysipelas During the year, 4 notifications were received (compared with 119 in 1936). Food Poisoning There were 8 cases of Food Poisoning notified in the Borough during the year. Salmonella organisms were isolated in two cases. A Report of the Public Health Laboratory Service on Food Poisoning in England and Wales during 1961 states that the picture differs little from that of previous years. The total reported incidence has fallen gradually over the last six years and the number of fatal cases has fallen. A disturbing feature is the increased prominence of incidents due to Salmonellae other than salmonella typhi-murium, which show both a relative increase in recent years and an absolute increase over 1960. Malaria One case of Malaria was notified. Measles Notifications of Measles in the Borough numbered 438, compared with 1,906 last year. There were no deaths from the disease. Notifications received towards the end of the year showed evidence of the beginning of the biennial epidemic. Meningococcal Infection No notifications were received during the year. 46 CANCER DEATHS 1951-1962 Rates Per 10,000 Population Ophthalmia Neonatorum One case, in a resident of the Borough, was notified during the year. Poliomyelitis Three notifications of Poliomyelitis were received, the diagnosis being confirmed in one paralytic case. Vaccination against poliomyelitis is carried out by the Divisional Health Department of the London County Council and is available to all persons up to the age of 40. Puerperal Pyrexia There were 15 notifications during the year compared with 87 in 1961. Of these, six were residents of the Borough. Scabies Scabies is still notifiable under the County of London (Scabies) Regulations, 1943. The number of cases formally notified was 33 compared with 50 last year. 73 scabies patients and contacts were treated by medicinal baths at Branch Road Treatment Centre and their clothing disinfested, viz:- Males Females Children 34 19 20 The number of baths given totalled 106. Scarlet Fever There were 24 cases notified and no deaths from the disease. Smallpox No cases of Smallpox were notified during the year and it was not necessary to take action under the Public Health (Smallpox) Regulations. The occurrence of a case of Smallpox in a metropolitan borough at the end of 1961 and another at the beginning of 1962 led to a heavy demand for vaccination, 600,000 persons being vaccinated in. London, 250,000 of them for the. first time. Frequent notifications are received from Port and Airport Authorities of persons coming into the Borough who may have been in contact with smallpox. Observation is kept on such persons by officers of the Public Health Department for the necessary period. The number of children successfully vaccinated or revaccinated against smallpox at London County Council clinics, during the year, was 8,533. 47 Certificates were issued in respect of 115 consignments of rags and waste material exported to Spain and Italy to the effect that the area was free from smallpox and yellow fever. Tuberculosis I am indebted to Dr.R.M.Orpwood, M.R.C.S.,L.R.C,D.P.H., Chest Physician at the Stepney Chest Clinic, for the following report on Tuberculosis in the Borough:- "One of the commonest mistakes today in relation to the study of the progress made against infectious disease is the view, quite frequently quoted, that Tuberculosis has already been conquered and need no longer be considered a serious problem. "It is true that the number of people who die from this disease has been markedly reduced in the whole country (a reduction in which Stepney has shared). This has been due mainly to improved methods of treatment, new drugs, etc. In the number of fresh cases diagnosed, however, the reduction has not been so marked. It should be noted that the death rate in England and Wales between 1950 and 1960 dropped by over 80%, but the notification rate over the same period dropped by only 25%. This fact can give no cause for complacency or lessening of effort. A similar drop in the number of fresh cases of Tuberculosis in Stepney diagnosed for the first time has been slow to show itself in recent years, mainly because of the relatively unchanged proportion of new cases discovered amongst specialised groups of population commonly found in Stepney and similar areas, e.g. lodging house inmates, vagrants, immigrants from overseas, etc. For several years the latter group has formed about a quarter to a fifth of the total new cases in Stepney. This proportion, however, is showing signs of decreasing and the position may be expected to improve in this respect during the next 5 to 10 years, provided no large scale immigration without adequate medical safeguards is resumed. "During 1962 the use of all the well-established methods of detection of this disease has been pursued. The Stepney Chest Clinic, which is under the control of the Stepney Group Hospital Management Committee, remains, apart from its other functions in the diagnosis and treatment of non-tuberculous chest conditions, the centre of the attack on Tuberculosis. "The facilities for the examination of any suspected case of tuberculosis continue to be available for patients referred by general practitioners, or by other medical departments in Hospitals and the School Medical Service. The family "contacts" are seen at regular intervals as they form a group which are specially liable to contract this disease. Fewer contacts are found at the. present time to have tuberculosis mainly because of the efficacy of B.C.G. (anti-T.B.) vaccination; the latter is available at the Chest Clinic for this specialised group. 48 "Routine surveys by the London County Council medical staff at schools in connection with B.C.G. for school-leavers frequently discover a few cases of childrsn who show evidence of T.B. infection. Although usually such children show no evidence of actual disease, as a precaution they are regularly X-rayed at the Chest Clinic over a period of 2 years at least as a safeguard. "In 1962 we had operating for the first time a new scheme for X-ray facilities through the Chest Clinic, open to all general practitioners: this is already proving a valuable form of case discovery and has great potentialities for the future. "Tuberculosis cannot be regarded as being beaten until the last case has been diagnosed and successfully treated, and clearly we have soma way to go before this stage is reached. The oresence of even a handful of infectious cases can be a potential source of danger. Tuberculosis has sometimes been referred to as the "sleeping dragon" and may still give us some unpleasant surprises. Compared with 25 years ago the position is very good but continued effort is still called for to complete the filial eradication of this monster." As shown in the graph facing page 50 there was a consistent decline over the last five years in the morbidity rate for the Borough. The mortality rate does not demonstrate a fall during this period. However, dealing with such small numbers, this may not be statistically valid; national figures show that mortality has decreased to a considerably greater extent than morbidity (as discussed in the report of the Chest Physician above). The male death rate for Pulmonary Tuberculosis in England and Wales decreased from 304 in 1952 to 93 in 1962, and the female death rate from 128 to 28 per million population. Analysis of data (Table I, page 50) indicates the large number of notified cases from common lodging houses, seamen's lodging houses, and from the immigrant population in the Borough. Notifications of immigrants have remained constant, or have slightly increased, whilst the other groups show a decrease. Hence the percentage of cases per year increased from 22 per cent in 1958 to 37 per cent in 1962 for immigrants. Most of these persons, of Asiatic origin, congregate in some of the worst areas of the borough living under grossly overcrowded conditions which further increases the chance of cross-infection. As reported in the Housing section, a limited policy was approved by the Council to abate these grossly overcrowded tenancies - particularly in respect of single males who often occupy upwards of four persons to a room for sleeping purposes. The arrangements made with the High Commissioners of Malta and Cyprus continue whereby reports on conditions at proposed addresses of would-be immigrants from those countries are supplied by the Department. A recommendation made by the Borough Council that such a scheme should be applied to other countries was supported by the Metropolitan Boroughs' Standing Joint Committee. A compulsory health check including a 49 routine chest X-ray of all immigrants would be more salutary to help reduce this increasing reservoir of infection arising from our 'open-door' policy. The age groups commonly affected amongst immigrants are those under 45 years, principally males (see Table II). This is in contradistinction to the incidence in the native-born tubercular cases where the dangerous 'carriers' are chiefly found in the post-50 years ago group. PULMONARY TUBERCULOSIS - 1958/1962 Table I - Notifications 1958 1959 1960 1961 1962 No. of Cases notified 136 135 110 99 91 No. of Cases in Common Lodging Houses 21 12 11 14 10 No. of Cases in Seamen's Lodging Houses 4 1 1 4 1 No. of Immigrant Cases 31 38 20 26 34 Percentage of Immigrant Cases to Total 23% 28% 18% 26% 37% Table II - Notifications among Immigrants Ages: 0 1 2 5 10 15 20 25 35 45 55 65 75 Total M. - 1 2 3 2 - 9 44 25 24 13 2 1 126 F. 1 2 - 3 1 2 5 6 1 1 1 - - 23 1 3 2 6 3 2 14 50 26 25 14 2 1 149 The number of primary notifications of Pulmonary Tuberculosis received, during the year, was 91 compared with 99 last year, and the number of non-pulmonary cases notified was 9, the same as in the previous year. The mortality rate for the year for pulmonary tuberculosis was 13 and for non-pulmonary nil per 100,000 of the population, compared with 12 and nil respectively for 1961. (For details of register and notifications see page 75). 115 visits were paid by the Public Health Inspectors to the homes of persons suffering from tuberculosis and appropriate action taken where public health nuisances were found to exist. 50 PULMONARY TUBERCULOSIS MORBIDITY + MORTALITY Rates Per 100,000 Population Public Health (Prevention of Tuberculosis) Regulations. 1925 These regulations provide that persons suffering from Tuberculosis of the respiratory tract shall not be employed in the handling of milk or milk receptacles. Power is given to the Council to cause such persons to discontinue their employment. It was not found necessary to take action under the regulations during the year. Tuberculosis Care Committee The Tuberculosis Care Committee on which voluntary and official bodies are represented, and whose meetings are attended by the Medical Officer of Health, continues to supply help to Tuberculous persons and to relatives who require assistande which cannot be obtained from official sources or where urgency or special circumstances indicate that the voluntary sources of the Care Committee are preferable. During the year assistance was given to needy persons by way of grants towards clothing, fuel, removal expenses, holidays, and fares for relatives visiting patients in hospital. The Care Committee again provided a day's coach outing to the seaside in the summer as well as Christmas gifts to 45 patients ill at home. Funds raised through the Annual Christmas Seal Sale were supplemented by donations from various organisations, for which the Care Committee is most grateful. Help was also obtained from appropriate sources for patients who were attending the Chest Clinic suffering from lung cancer. Whooping Cough Confirmed cases notified during the year numbered 18, the lowest ever recorded - as it was for the London area as a whole. There were no deaths from the disease. Infectious Disease Contacts Where a person is precluded from continuing at work by reason of being a carrier or having been in contact with an infectious disease, benefits under the National Insurance Act 1946 are paid only on the production of a certificate from the Medical Officer of Health. It was not found necessary to issue any certificates during the year. Authentication of International Certificates of Vaccination and Inoculation Persons proceeding abroad are required in certain countries to produce a certificate of recent successful vaccination and inoculation, and in addition the signature of the vaccinating doctor must be verified 51 by the Medical Officer of Health of the district. During the year, signatures on 4,001 certificates were verified as those of medical practitioners practising in Stepney and the certificates endorsed accordingly. Venereal Disease Attendances at special clinics for these diseases have shown an increase over the last 10 years. New Stepney cases attending clinics during the last three-quarters of 1962 for treatment and observation are shown in the following table. Separating the native-born from the immigrant population an interesting pattern emerges. approximately two-thirds of the males but only one-tenth of the females attending are of immigrant origin. Thus, it would appear that unattached immigrant males are acquiring the disease from white consorts, who form by far the largest fraction of the reservoir of infection, as demonstrated by the fact that nine-tenths of those attending clinics are nativeborn women. Age Groups:- Under 16 16 17 18-19 20-24 25-29 30 and over Total Indigenous M. - - 6 9 68 64 156 303 F. - 1 12 47 106 49 72 287 Immigrant M. 2 - 2 14 125 152 278 573 F. — 2 2 4 7 2 12 29 Totals: M. 2 - 8 23 193 216 434 876 F. - 3 14 51 113 51 84 316 National figures show a similar upward trend. Particularly, gonorrhoea in the 'teenage' female is increasingly common. This group appears to be a vulnerable one, and requires special attention by health education methods to dispel any ignorance of the risks associated with promiscuous sexual behaviour. To this end, a number of meetings have been held in the Borough at which leaders of the local community, teachers, and youth club workers have been given an outline of these diseases and how they affect the community's health. It is hoped to plan a large-scale campaign in 1963 to reach youth club members and school-age groups. There are certain difficulties with health education schemes in a subject so associated with taboos and repression. Perhaps if sex education in its widest sense of fitting the person for life were paramount, sex education would fit into its rightful place therein. 52 Verminous Persons The number of lice-infested persons bathed and whose clothing was disinfested at the Council's Cleansing Station, is as follows Males Females Children 301 16 2 - Total: 319. The number of baths and treatments given amounted to 328. Disinfection Premises disinfected after infectious disease numbered 23, which included nine for pulmonary tuberculosis. 7,363 articles of clothing and bedding were steam disinfected, including 245 articles for export for which five certificates were issued. Formaldehyde disinfection of 85,048 articles of clothing and 25 tons of rags for export was also carried out, during the year, for which 77 certificates were issued. The charges for export and other disinfections carried out amounted to £49. Disinfestation (bed bugs and other insect pests) The following is a summary of insect disinfestation work carried out by the Public Health Inspector (Disinfestation) General inspections for vermin 1,082 Attempted visits 125 Number of premises found verminous. 319 " " revisits 65 " " miscellaneous visits 182 " " premises treated 359 Treatments referred to above included those for infestations of cockroaches, beetles, ants, silverfish, and the like. In addition disinfestation of the furniture and effects of families rehoused by the London County Council, was carried out on 14 occasions. The Council continues to carry out on behalf of the Stepney Group Hospital Management Committee any necessary work of disinfestation at hospitals and other premises in the Borough coming within the control of that Committee. 53 SUMMARY OF PUBLIC ANALYST'S QUARTERLY REPORTS for the Year 1962 The following is a summary of the reports submitted each quarter of the year in compliance with Section 99 of the Food and Drugs Act 1955 by the Council's Public Analyst, Mr.D.F.H.Button, A.R.C.S.,F.R.I.C., of Southwark Health Services Department, Walworth Road, S.E.17. A copy of each quarterly report is submitted to the Minister of Agriculture, Fisheries and Food in accordance with the same section of the Act. During the year, 412 sampler were submitted for analysis, 45 of which were purchased or taken formally and 367 informally. The samples are classified as follows:- 19 Alcoholic Spirits 1 Ice Cream Powder 1 Analgesic. Tablets 1 Indigestion Tablets 1 Aspirin Tablets 2 Liqueur Chocolates 2 Bicarbonate of Soda 1 Lolly Syrup 1 Blackcurrant Syrup 11 Margarine 2 Blancmange Powder 12 Meat, canned 1 Boracic Ointment 5 Meat and Vegetables, canned 1 Bread Roll 2 Meat Pies 14 Butter 1 Meat Pudding, canned 2 Castor Oil 82 Milk 7 Chewing Gum 1 Olives in brine 1 Chillies 1 Non-brewed. Condiment 9 Coffee and Coffee Beans 1 Onion Sauce Cubes 1 Condensed Milk 1 Pudding Mixture 2 Cooking Fat 1 Sauce 4 Desiccated Coconut 3 Sago 5 Fish, canned 23 Sausages 1 Fish Paste 1 Soft Drink 1 Fish, potted 2 Soup, bottled 1 Epsom Salts 25 Soup, canned 3 Fruit 2 Soup Tablets 5 Fruit Juice 12 Sugar 39 Fruit, dried 3 Sugar Confectionery 3 Fruit Drinks 1 Sulphur Ointment 4 Fruit Squashes 2 Table Jelly 1 Gelatine 52 Tea 1 Glauber Salts 1 Tomato Concentrate 1 Ground Ginger 1 Tonic Tablets 8 Ice Lollies 2 Toothpaste 16 Ice Cream 2 Vinegar 54 Of the samples analysed, 3 formal and 36 informal were found to be unsatisfactory, as follows:- Article Formal or Informal Nature of irregularity Remarks Barbados Sugar (6 samples) Informal Contained prohibited colouring (Rhodamine B). Detained at Wharf. Dried Apricots (7 samples) Informal Contained Sulphur Dioxide in amounts Varying from 2500-3800 parts per million. Part released for dried fruit salad mixture, part reexported. Dried Apricots (8 samples) Informal In poor condition. Released for sauce making. Pearl Sago (3 samples) Informal Unpleasant odour and contaminated with mould. Re-exported for animal food. Orange Juice (3 samples) Informal Old stock - unfit for human consumption. Destroyed. Non-brewed Condiment Informal Contained lead - 11 parts per million. Formal sample to be taken. Chocolate Whisky Bottles Informal Incorrect description. Manufacturers agreed to alter description. Do. Formal Glauber Salts Informal Effloresced. Further samples unobtainable stock exhausted. Pork Sausages Informal. 7.5% deficient in meat. (See following Formal sample). Do. Formal 20% deficient in meat. Cautionary letter sent. Do. Informal Contained 620 parts per million Sulphur Dioxide. (See following Formal simple). Do. Forma1 Contained 520 parts per million Sulphur Dioxide, 26% deficient in meat. Cautionary letter sent. Coffee Beans (2 samples) Informal Contaminated with mould growth. Re-exported. Bread Roll Informal Complaint of foreign body. Charred dough No action. Ice Lolly Informal Unsatisfactory labelling. New labels provided. 55 Milk. 82 samples of milk were examined during the year, the average composition being 3.62 per cent Fat and 8.55 per cent Non-fat Solids. The average composition of samples taken over the past ten years, is as follows:- Year Number of Samples Examined Milk Fat, per cent. (Legal minimum standard 3.0) Non-fat Solids, per cent. (Legal minimum standard 8.50) 1953 201 3.54 8.72 1954 87 3.50 8.56 1955 84 3.53 8.54 1956 92 3.52 8.53 1957 110 3.58 8.54 1958 93 3.73 8.56 1959 102 3.67 8.58 1960 70 3.60 8.59 1961 100 3.67 8.55 1962 82 3.62 8.55 56 APPENDIX of STATISTICAL TABLES 57 58 Table I TOTAL DEATHS BY CAUSE AND AGE OF STEPNEY RESIDENTS - 1962 (Registrar-General's Return) CAUSE OF DEATH ALL AGES Age Groups Total M F -1 1- 5- 15- 25- 45- 65- 75- 1 Tuberculosis - Respiratory 12 7 5 - - - - 2 5 3 2 2 " - Other - - - - - — — — — - - 3 Syphilitic Disease 5 3 2 - - - - 1 1 1 2 4 Diphtheria - - - - - - - - - — — 5 Whooping Cough - - - - - - - - - — — 6 Meningococcal Infection 2 2 - 1 1 - - - - — - 7 Acute Poliomyelitis - - - - - - - - - — — 8 Measles - - - - - - — — — - - 9 Other Infective and Parasitic Diseases 2 1 1 - — - — 1 - 1 - 10 Malignant Neoplasm - Stomach 31 18 13 - - — — 3 8 10 10 11 " " - Lung, Bronchus 66 55 11 — - — — 1 34 24 7 12 " " - Breast 10 - 10 — — — — — 5 4 1 13 " " - Uterus 4 - 4 - - - - — 3 1 - 14 " " - Other 95 50 45 - - 1 1 5 35 25 28 15 Leukaemia, Aleukaemia 8 4 4 — — 1 — 1 4 — 2 16 Diabetes 13 3 10 — - — — — 2 5 6 17 Vascular Lesions of Nervous System 80 38 42 — - — — 2 19 26 33 18 Coronary Disease, Angina 206 126 80 - - - - 5 59 73 69 19 Hypertension with Heart Disease 22 9 13 - - - - - 4 8 10 20 Other Heart Disease 105 50 55 - - - 1 4 20 15 65 21 Other Circulatory Diseases 51 24 27 - - - - - 7 14 30 22 Influenza 8 5 3 - — - - — 1 2 5 23 Pneumonia 122 68 54 4 2 - - — 15 25 76 24 Bronchitis 128 97 31 2 — - — 2 30 34 60 25 Other Diseases of Respiratory System 16 11 5 1 - - - - 4 5 6 26 Ulcer of Stomach and Duodenum 12 8 4 - - — - — 3 1 8 27 Gastritis, Enteritis and Diarrhoea 3 1 2 1 - - - — — - 2 28 Nephritis and Nephrosis 5 3 2 — — — — 1 3 1 — (Contd.) 59 . Table 1- Continued. CAUSE OF DEATH ALL AGES Age Groups Total M F -1 1- 5- 15- 25- 45- 65- 75- 29 Hyperplasia of Prostate 1 1 - - - - - - - - 1 30 Pregnancy, childbirth, abortion - - — — — - - - - - - 31 Congenital malformations 7 5 2 3 1 — 1 1 - - 1 32 Other defined and ill-defined diseases 71 35 36 21 — - - 5 11 12 22 33 Motor vehicle accidents 9 6 3 — 1 - 1 2 1 2 2 34 All other accidents 22 13 9 - 1 — 1 1 5 4 10 35 Suicide 14 10 4 — — — 2 4 7 1 - 36 Homicide and operations of war 3 2 1 - - - - 2 1 - - Males 655 - 21 5 - 6 33 204 172 214 Females - 478 12 1 2 1 10 83 125 244 GRAND TOTAL 1 133 33 6 2 7 43 287 297 458 Table 2 COMPARATIVE TABLE OF ROAD ACCIDENTS OCCURRING IN THE BOROUGH YEAR Children under 7 years Children 7-14 years Adults TOTALS Killed Injured Killed Injured Killed Injured Killed Injured 1958 - 70 - 75 14 896 14 1,041 1959 - 59 - 68 8 930 8 1,057 1960 - 69 2 62 11 894 13 1,025 1961 - 88 - 73 8 919 8 1,080 1962 1 71 - 85 16 999 17 1,155 1962 Pedestrians Motor Cyclists Pedal Cyclists Drivers Other Road Users TOTAL Killed 13 1 - 1 2 17 Injured 388 160 88 172 347 1,155 6o Table 3 INFANT MORTALITY, 1962 Deaths from stated causes at various ages under 1 Year (compiled from Local Death Returns) CAUSE OF DEATH AGE PERIODS Total * Deaths under 1 Year Per Cent of Total Under 24 hours 1-6 days Total under 1 wk. Weeks Total under 4 wks. Months 1- 2- 3- 1- 4- 7- 10- Bronchitis - - - - - - - - 2 - - 2 (-) 6.1 Pneumonia - — — - - - - 1 1 - 2 4 (7) 12.1 Gastro-Enteritis - - - - - - - - 1 - - 1 (1) 3.0 Congenital Malformations 1 1 2 1 - - 3 1 - - - 4 (3) 12.1 Premature Birth 7 5 12 - 1 - 13 - - - - 13 (21) 39.4 Asphyxia, Atelectasis 2 1 3 - - - 3 - — — — 3 (4) 9.2 Birth Injuries - 1 1 - - - 1 - - - - 1 (2) 3.0 Umbilical Hernia 1 - 1 - - - 1 - - - - 1 (1) 3.0 Meningococcal Infection - - - - - - - 1 1 - - 2 (-) 6.1 Hydrocephalus and Meningo-myelocele - - - - - - - - - 1 - 1 (-) 3.0 Vascular lesions of nervous system - 1 1 - - - 1 - - - — 1 (-) 3.0 Totals 11 9 20 1 1 1 22 3 5 1 2 33 (40) 100.0 * Figures in parentheses denote corresponding deaths in 1961. + Includes deaths from other causes. Table 4 Comparative Table showing Deaths of Infants at various ages under 1 Year Year Under 24 hours 1-6 days 1-4 weeks Total under 4 weeks 1-12 months Total under 1 Year Percentage Deaths under 4 weeks of Total Infant Deaths 1958 13 7 1 21 15 36 58 1959 17 11 4 32 13 45 71 1960 8 6 5 19 13 32 57 1961 25 4 2 31 9 40 77 1962 11 9 2 22 11 33 66 61 Table 5 HOME ACCIDENT CASES REPORTED BY THE LONDON AMBULANCE SERVICE Accidents due to Falls 1962 1961 1960 1959 London Divn.5 London Divn.5 London Divn.5 London Divn.5 On stairs 998 57 1119 65 1221 69 1175 42 From ladder 101 2 111 4 113 1 134 2 From chair 149 8 174 15 199 7 237 15 Outside (i.e. windows,balconies,roofs,etc.) 198 10 217 12 234 4 300 21 In garden 219 4 227 11 251 8 305 4 In bath 23 2 15 2 18 1 27 1 From one level to another (i.e. tables, boxes, beds, etc.) 434 20 412 15 348 19 386 28 On same level (i.e. in room, over objects) 751 31 920 40 888 32 1004 47 Unspecified 3692 164 3261 170 2868 162 2369 124 Total due to Falls 6565 298 6456 334 6140 303 5937 284 Other Accidents Hit by object 221 12 202 j 5 184 8 172 13 Scalding from - teapot 53 2 45 1 53 4 55 4 objects on cooking stove 136 5 123 4 108 1 125 3 Other boiling water 179 8 151 6 129 1 134 6 Electric shock 22 2 39 3 26 3 26 2 Poisoning (including foreign objects) 340 10 338 12 318 15 255 11 Gassing 192 17 165 14 137 12 188 23 Knife-like wounds (including spikes and cuts from glass) 326 13 337 24 321 11 327 11 Fires 185 8 178 16 141 11 128 15 Windows (trapping) 29 2 42 - 47 2 34 1 Suffocation 31 2 18 2 17 1 21 3 Unspecified 328 14 337 19 326 25 412 22 Total Other Accidents 2042 95 1975 106 1807 94 1877 114 TOTAL - ALL ACCIDENTS 8607 393 8431 440 7947 397 7814 398 Table 6 RODENT CONTROL TYPE OF PROPERTY Local Authority Dwelling Houses (inc.Council Houses) All Other (including Business Premises) TOTAL No. of properties in Area 41 26,156 7,604 33,801 No. of properties inspected as result of notification 3 729 234 966 No. of such properties found to be infested by:- Common rat Major — 6 5 11 Minor - 347 91 438 Ship rat Major - - 1 1 Minor - 2 7 9 House mouse Major 3 37 61 101 Minor - 240 74 314 No. of properties inspected in course of survey under the Act - 855 526 1,381 No. of such properties found to be infested by:- Common rat Major — - - - Minor - 32 7 39 Ship rat Major — - - - Minor - - - - House mouse Major — - 5 5 Minor - 10 33 43 No. of properties otherwise inspected - 69 5 74 No. of such properties found to be infested by:- Common rat Major — 1 - 1 Minor - 35 5 40 Ship rat Major — — - - Minor - - - — House mouse Major - 2 - 2 Minor - 23 - 23 62 Table 6 - Continued. Local Authority Dwelling Houses (inc.Council Houses) All Other (including Business Premises) TOTAL Total inspections carried outincluding re-inspections 3 1,715 793 2,511 No. of infested properties treated 3 724 112 839 Total treatments carried outincluding re-treatments 3 786 140 929 No. of notices served under Section 4 of the Act: (a) Treatment - - - - (b) Structural Work (i.e. Proofing) - 27 44 71 No. of cases in which default action taken following Section 4 Notice - - 4 4 Legal Proceedings - 2 1 3 No, of "Block" control schemes carried out Nil Sewers - Maintenance Treatments I am informed by the Borough Engineer and Surveyor that two treatments for the destruction of rats in sewers were carried out during the year. 63 Table 7 SUMMARY OF WORK OF DISTRICT PUBLIC HEALTH INSPECTORS No. of Premises Inspections Notices Served Legal Proceedings Taken Registered and Licensed Premises Hairdressers and Barbers 127 141 13 - Rag Flock Premises 18 8 — — Pet Shops 4 - — — Offensive Businesses 19 61 4 — Pharmacy and Poisons Premises 66 86 - - Common Lodging Houses 3 7 - - Seamen's Lodging Houses 2 11 1 - Factories, Shoos, &c. Mechanical Factories 2,074 165 65 — Non-mechanical Factories 152 4 — - Other Factories 125 4 - — Outworkers 455 6 - - Shops 3,134 28 4 - Workplaces 552 1 1 1 Other Visits and Inspections Complaints and Nuisances 5,466 ) 1,832 35 House-to-House and Houses in Multiple Occupation ) 1,168 ) Disrepair Certificates 159 - - Drainage 4,657 388 10 Infectious Disease and Contacts 305 - - Markets (Weekend Inspections) 18 — - Miscellaneous visits and inspections 1,616 - - Revisits 4,585 — - Attempted visits 1,153 — - Total 19,649 2,308 46 6 4 Table 7 - Continued. Rent Act. 1957 - Certificates of Disrepair 1.- Applications for Disrepair Certificates 29 Notices of proposal to issue Certificates 29 Undertaking accepted 12 Undertakings refused 8 Certificates issued 13 2.- Applications for cancellation of Disrepair Certificates 20 Cancellations issued 11 Cancellations refused 9 3.- Applications for certificates as to remedying of defects Tenant. Landlord 3 7 Certificates issued- all defects remedied — 4 Certificates issued- some defects remedied 3 3 Complaints Number received at Office 3,376 Dangerous Structures Number of premises notified to District Surveyor 70 Drains Number tested with smoke 892 " found defective 85 ¨ of plans on which observations submitted 140 Land Charges Number of premises reported upon 3,275 Public Houses Number of premises reported on to Licensing Justices 51 Wastage of Water Number of premises notified to Metropolitan Water Board 40 65 Table 8 SUMMARY OF REPAIRS, &c. Carried out under the supervision of District Public Health Inspectors during the Year. Dampness in rooms remedied 670 Premises where - New drains constructed 250 Drains reconstructed 120 Existing drains repaired 230 Drain obstructions cleared 406 Dustbins provided 468 Dwelling-rooms, passages and staircase walls and ceilings repaired 504 Factories; New W.Cs provided 20 Sanitary accommodation repaired 117 Other defects remedied 8 Floors repaired 271 Fireplaces' and Coppers repaired or renewed 65 Gullies, manholes provided or repaired 293 Light and ventilation improved or provided to rooms and staircases 71 Roofs, gutters, rainwater pipes renewed or repaired 877 Rubbish accumulations removed 223 Sinks, baths and lavatory basins fitted 1,091 Soil and vent pipes provided or repaired 285 Staircases - treads, etc. repaired 95 Ventilation (underfloor) provided to rooms 2 Waste pipes provided or repaired 322 Water-closets and urinals: New provided 548 Compartments cleansed, repaired 247 Obstructions cleared 109 Flush apparatus repaired 243 Pans and traps fixed 365 Water supply: Cisterns cleansed, repaired 36 Defective supply or fittings remedied 101 Extra supply provided 4 Windows repaired 644 Yards and areas cleansed or paving repaired 113 Miscellaneous repairs 232 66 Table 9 SUMMARY OF WORK OF THE PUBLIC HEALTH INSPECTOR (SMOKE & FACTORIES) AND TECHNICAL ASSISTANT Clean Air Act, 1956 No. of visits to premises re Smoke Control Areas 689 premises visited on complaint of Smoke Nuisance 58 " notices served re Smoke Nuisances (Section 16) 2 Smoke observations 247 applications for prior approval (Sec. 3(2)) received 4 " notices of proposal to install (Sec. 3(3))received 30 " contraventions of Section 3(3) ascertained 2 " notices served under Section 12(2) (adaptations) 327 Factories Act. 1961 No. of visits to Mechanical Factories 113 " " " Non-mechanical Factories 3 notices served 18 matters referred to H.M. Inspector of Factories 9 Table 10 SUMMARY OF INSPECTIONS MADE BY THE HOUSING INSPECTOR Complaints 69 Caravan Sites 400 Houses in Multiple Occupation 104 Housing Act, 1957 - Section 16 33 " " - Section 17 18 Immigrant Enquiries for Malta Government 26 Improvement Grants and Standard Grants 16 Miscellaneous Inspections 308 Overcrowding 37 "Permitted Numbers" under the Housing Act 215 Premises inspected - Compulsory Purchase Orders 138 Premises situated in Clearance Areas 211 Town Planning 38 Underground Rooms 201 67 Table 11 PRESCRIBED PARTICULARS ON THE ADMINISTRATION OF THE FACTORIES ACT. 1961 1.- Inspections for purposes of provisions as to health Type of Factory No. on Register Inspections Written Notices Factories without mechanical power 152 4 - Factories with mechanical power 2,074 165 65 Other Premises under the Act (Electrical Stations, Institutions, and sites of building operations and works of engineering and construction) 125 4 - Total 2,351 173 65 2.- Cases in which Defects were found Particulars Found Remedied Referred to H.M. Inspector by H.M. Inspector Want of cleanliness 7 3 4 1 Overcrowding - - - - Unreasonable temperature 1 - 1 - Inadequate ventilation 1 - 1 - Ineffective drainage of floors - - - - Sanitary Conveniences: (a) insufficient 3 3 - 1 (b) unsuitable or defective 95 95 — 13 (c) not separate for sexes 28 28 - 8 Other offences against the Act (Not including those relating to outwork) 14 1 13 - Total. 149 130 19 23 Prosecutions There were no prosecutions taken this year under the Act. 68 Table 11 - Continued. Part VIII of the Act - OUTWORK Section 133. Nature of Work No. Outworkers in August list No. Cases of default in sending lists to the Council No. Prosecutions for failure to supplylists Wearing Apparel Making, etc. 445 — - Cleaning and washing - - - Household linen — - — Lace, lace curtains and nets — - - Curtains and furniture hangings — — — Furniture and upholstery — — — Electro-plate - - — File making - - — Brass and brass articles — — — Fur pulling — — — Iron and steel cables and chains — — — Iron and steel anchors and grapnels — — — Cart gear - - - Locks, latches and keys - - - Umbrellas, etc. 2 — - Artificial flowers - — — Nets (other than wire nets) - - - Tents - - - Sacks - - - Racquet and tennis balls - - - Paper bags 1 - - Making of boxes or other receptacles or parts thereof made wholly or partially of paper 12 - - Brush making - - - Pea picking - - - Feather sorting - - - Carding, etc. of buttons, etc. - - — Stuffed toys 1 - - Basket making - - - Chocolate and sweetmeats - - - Cosaques, Christmas stockings 1 - - Textile weaving - - - Lampshades - - - Total 462 - - Section 134. There were no instances of work found in unwholesome premises. 69 Table 12 HOUSING STATISTICS 1.- Inspection of dwelling houses during the year:- (l) (a) Dwelling houses inspected for housing defects (under Public Health or Housing Acts) 4,131 (b) Inspections made for the purpose 13,085 (2) (a) Dwelling houses inspected and recorded under the Housing Consolidated Regulations, 1925 251 (b) Inspections made for the purpose 276 (3) Dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 3 (4) Dwelling houses found not to be in all respects reasonably fit for habitation 1,259 2.- Remedy of defects during the year without service of formal Notices Dwelling houses rendered fit in consequence of informal action by the Local Authority or their officers 119 3.- Action under Statutory Powers during the year (a) Proceedings under Sections 9, 10 and 12 of the Housing Act, 1957:- Dwelling houses in respect of which notices were served requiring repairs nil (b) Proceedings under Public Health Acts (l) Dwelling houses in respect of which notices were served requiring defects to be remedied 1,140 (2) Dwelling houses in which defects were remedied after service of formal notices:- (i) By owners 1,050 (ii) By Local Authority in default of owners 90 70 Table 12 - Continued. (c) Proceedings under Section 17 of the Housing Act, 1957 (l) Dwelling houses in respect of which Demolition Orders were made 3 (2) Dwelling houses demolished in pursuance of Demolition Orders 5 (3) Closing Orders made 3 (d) Proceedings under Section 18 of the Housing Act, 1957:- (l) Separate tenements or underground rooms in respect of which Closing Orders were made 9 (2) Closing Orders determined, the tenements or rooms having been rendered fit (Section 27) 3 (e) Proceedings under Section 28 of the Housing Act, 1957:- Demolition Orders substituted, for Closing Orders nil (f) Proceedings under Section 42 of the Housing Act, 1957:- (l) Number of houses included by Representation by the Medical Officer of Health 149 (2) Number of houses demolished in pursuance of Representations nil Housing Act, 1957: Part IV - Overcrowding:- (i) Number of overcrowded families on Register at the beginning of the year 355 (ii) Number of new cases encountered during the year 32 (iii) Number of cases relieved during the year (Review of Register) 204 (iv) Number of overcrowded families on Register at the end of the year 183 71 Table 13 SUMMARY OF WORK OF PUBLIC HEALTH INSPECTORS (FOOD) No. Visits or Inspections Notices Legal Proceedings Registered Premises Milk Distributors; Dairies 9 236 2 - Other 221 Licences issued to persons under the Milk (Special Designation) Regulations, 1960 230 Ice Cream Premises; Sale 292 223 6 - Manufacture 22 Storage only 1 Prepared Food Premises; Meat 68 229 38 - Fish 36 Other Premises Bakehouses 34 346 10 1 Bakers shops ... ... ... 58 Butchers shops and stalls 98 269 69 1 Catering establishments 986 1,952 140 - Fish shops and stalls 119 174 28 - Greengrocers and fruiterers 620 638 26 - Grocers (wholesale and retail) 345 1,027 37 1 Public Houses and Off-Licences 240 143 5 - Poultry dealers (excluding butchers) 74 179 47 1 Railway Depots 4 453 - - Wharves 45 760 20 - Miscellaneous Food Premises 331 754 16 - Meat Vehicles - 127 5 - Re-Visits - 949 - - Total 8,459 449 4 There are 2,893 Food Premises, including stalls, in the Borough. Some of the premises listed above are included under more than one trade category. (Contd.) 72 Table 13- Continued. Reason for Visit Food Hygiene (General) Regulations, 1960 3,975 Surrender of Unsound Food 573 Merchandise Marks Act 101 Public Health (Meat) Regulations 367 Food Standards Orders 30 Labelling of Food. Orders 37 Byelaws:Fish Curing and Fish Frying 88 Agriculture Produce Grading and Marking Acts 26 Pharmacy and Medicines Act, 1941 25 Sampling 391 Complaints 147 Shops Act 111 Samples of food taken during the year for chemical and bacteriological examination numbered 1,573. Summonses taken out numbered 12 and related to four premises in the Borough; 8 summonses related to failure to keep the premises clean; 2 to confectionery containing maggots, one to sausages deficient in meat and one to a foreign body in a scone. ANALYSIS OF WORKS CARRIED OUT IN FOOD PREMISES Lavatory basins installed 46 Premises where Hot and cold water supply installed 63 " " Washing facilities for staff improved 80 " " Walls, ceilings, floors and. windows cleansed 311 " " Ventilation provided or improved 15 " " Natural lighting improved 2 Sinks provided 20 Food storage accommodation provided 9 Refrigerators installed or repaired 11 Floors renewed or repaired 28 Shop-fronts improved 5 Protective covers provided for displayed 18 Refuse bins provided 44 Miscellaneous 458 73 74 Table 14 NOTIFICATION OF INFECTIOUS DISEASES DISEASE 1962 1952-61 CORRECTED NOTIFICATIONS Notifications Admitted to Hospital Corrected Total 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 Ac.Encephalitis: Infective 1 1 1 - — — : — 1 1 3 2 1 - Post-infectious. - — — 1 1 — — - - - - - 1 Ac.Poliomyelitis: Paralytic 2 1 1 - 1 6 3 7 2 27 3 5 6 Non-paralytic 1 1 -- - - 1 -- 3 1 17 — 2 3 Diphtheria - - - - 1 2 1 - 1 - 1 1 — Dysentery 33 15 31 48 140 87 145 34 115 147 117 67 71 Enteric Fever - - - 1 1 2 1 1 5 1 1 1 2 Erysipelas 4 2 4 13 5 13 6 13 8 11 11 9 24 Food Poisoning 10 2 10 24 19 8 69 8 22 18 23 12 14 Malaria 1 1 1 - - - 2 2 - 1 2 2 1 Measles 443 30 438 1898 55 1344 199 1398 574 1834 144 655 1284 Membranous Croup - - - - - -- - - - - - - - Mening. Infection. - 2 - 2 2 2 3 6 5 5 6 8 3 Oph. Neonatorum 1 1 1 1 2 1 5 7 3 20 10 24 24 Pneumonia 95 - 95 117 81 131 90 77 79 54 65 78 63 Puerperal Pyrexia. 15 15 15 87 100 58 26 44 63 134 163 98 96 Scabies 33 — 33 50 61 49 53 51 43 39 29 22 28 Scarlet Fever 24 7 24 53 24 59 97 46 34 26 60 75 208 Smallpox - - - - - - - - - - - - - Tuberculosis: Pulmonary 108 - 91 99 110 135 136 120 116 149 160 167 137 Non-pulmonary 11 - 9 9 9 14 9 18 11 23 23 13 12 Whooping Cough 18 4 18 31 223 76 36 76 235 147 125 249 156 TOTALS: 800 82 772 2434 835 1988 881 1912 1318 2656 945 1489 2133 Table 15 TUBERCULOSIS - NEW CASES AND DEATHS New Cases: 96 pulmonary cases were notified, being 91 primary notifications and 5 from Death Returns. 10 non-pulmonary cases were notified, 9 being primary notifications and 1 from Death Returns. Deaths: 12 persons died from pulmonary tuberculosis. There were no deaths from non-pulmonary tuberculosis. Age Distribution of new cases and deaths is as follows:- -1 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total (All ages) (a) New Cases (Primary Notifications) Pulmonary M — 1 2 3 - 2 1 19 10 14 8 3 1 64 F - 1 1 1 1 2 2 9 5 2 2 1 - 27 Non-Pulmonary M — — — 1 — - - 3 1 — - - - 5 F - 1 - - - - - 2 1 - - - - 4 (b) Deaths Pulmonary M - - - - - - - - - 1 4 1 1 7 F - - - ~ - - - 1 1 - - 2 1 5 Non-Pulmonary M — — - - - - - - - - - - - - F - - - - - - - - - - - - - - TUBERCULOSIS - VARIATIONS IN REGISTER Pulmonary NonPulmonary Total Cases M F M F (a) Cases on Register at l/l/62 776 349 84 86 1,295 (b) New Cases 64 27 5 4 100 (c) Cases restored to Register 8 8 1 - 17 (d) Other cases added 45 15 3 - 63 (e) Removals 146 58 13 11 228 (f) Cases remaining on Register at 31/12/62 747 1 341 80 79 1,247 75 Table 16 DISEASES NOTIFIABLE IN LONDON Disease Authority for Notification Acute Encephalitis P.H.Act, 1936 (S.143); SI.1949/2259. " Influenzal Pneumonia P.H.Act,1936 (S.143); SI.1953/299. " Primary Pneumonia P.H.Act,1936 (S.143); SI.1953/299. " Poliomyelitis P.H.Act,1936 (S.143); SI.1949/2259. Anthrax P.H.(L)Act,1936 (S.305); SI.1960/1989. Chicken Pox (Notifiable in Port of London only). Cholera P.H.(L)Act,1936 (S.192 & 304). Diphtheria P.H.(L)Act,1936 (S.192 & 304). Dysentery P.H.Act,1936 (S.143); SI.1953/299. Enteric Fever (including Typhoid, and Paratyphoid) P.H.(L)Act,1936 (S.192 & 304); SI.1953/299. Erysipelas P.H.(L)Act,1936 (S.192 & 304). Food Poisoning F.& D. Act, 1955 (S. 26). German Measles (Notifiable in Port of London only). Leprosy * P.H.Act,1936 (S.143); SI.1951/1036. Malaria P.H.Act,1936 (S.143); SI.1953/299. Measles P.H.(L)Act,1936 (S.192); SRO.1938/1100; SRO.1940/205 and SI.1948/420. Membranous Croup P.H.(L)Act,1936 (S.192 & 304). Meningococcal Infection P.H.Act,1936 (S.143); SI.1949/2259. Ophthalmia Neonatorum L.C.C.Order,1910; P.H.(L)Act,1936 (S.192 & 305); SRO.1926/971 & 1937/35; SRO.1928/419. Plague P.H.Act,1936 (S.143); LGB.Reg.,1900. Puerperal Pyrexia P.H.Act,1936 (S.143); SI.1951/1081 and si.1954/1691. Relapsing Fever P.H.(L)Act,1936 (S.192 & 304). Scabies P.H.Act,1936 (S.143); SRO.1943/1016. Scarlet Fever P.H.(L)Act,1936 (S.192 & 304). Smallpox P.H.(L)Act,1936 (S.192 & 304). Tuberculosis P.H.Act,1936 (S.143); SI.1952/704. Typhus Fever P.H.(L)Act,193& (S.192 & 304). Whooping Cough P.H.(L)Act,1936 (S.192); SRO.1938/1100 and 1940/205; SI.1948/420. Yellow Fever (Notifiable in Port of London only). Zymotic Enteritis or Summer diarrhoea (Notifiable in 9 Metropolitan boroughs only - not notifiable in Stepney). * Notifiable to the Ministry of Health. + Notifiable to the County Medical Officer of Health for London. 76 77 Table 17 DWELLINGS ERECTED DURING 1962 Address No. of Dwellings (a) BY BOROUGH COUNCIL. Burley House 51 Charles Auffrey House 41 Clichy House 24 Dagobert House 40 Le Boisseau House 12 Moore House 27 Odette Duval House 52 Paymel House 11 258 (b) BY LONDON COUNTY COUNCIL. Ashpark House 18 Ambrose House 10 Beckley House 44 Burley House 51 Carpenter House 16 Chapman Street 20 Chudleigh Street 36 Davenant House 14 Durham Row 9 Key Close 34 Midhurst House 28 Morris Street 18 Norton House 21 Pevensey House 26 Rhodeswell Road 5 Robinson House 18 Vawdrey Close 18 Wickford Street 8 Withy House 81 Wyllen Clase 14 489 (c) OTHER. 10, Brick Lane 1 201-217, Commercial Road 18 327A, Mile End Road 1 22, Mount Terrace 1 27-28, Tredegar Square 2 23 Total 770 78 Table 18 COMPARATIVE VITAL STATISTICS Year Popula- tion Live Births Deaths Deaths under 1 Year Materna1 Deaths Cancer Deaths Tuberculosis Deaths (All forms) No. Rate* No. Rater* No. Rate+ No. Rate+ No. Rate* No. Rate* 1901 298,600 11,052 37.0 6,217 20.8 1,817 165 17 1.5 211 0.7 865 2.8 1911 (C) 279,560 8,464 30.2 4,854 17.3 1,261 148 24 2.8 236 0.8 647 2.3 1921 (c) 249,657 6,169 24.7 3,244 12.9 550 89 10 1.6 263 1.0 346 1.3 1931 (C) 225,238 4,010 17.8 2,958 13.1 313 78 9 2.1 342 1.5 254 1.1 1941 74,780 1,164 15.5 1,883 25.1 64 79 3 3.5 203 2.7 145 1.9 1942 71,980 1,271 17.6 1,243 17.2 66 52 5 3.7 171 2.3 85 1.8 1943 72,920 1,371 18.8 1,368 18.7 73 53 3 2.1 188 2.5 107 1.4 1944 73,030 1,306 17.8 1,425 19.5 77 56 0 0.0 185 2.5 96 1.3 1945 77,610 1,442 18.5 1,469 18.9 81 56 4 2.6 201 2. 5 110 1.4 1946 94,800 2,147 22.6 1,399 14.7 110 51 4 1.8 198 2.1 81 0.8 1947 100,020 2,184 21.8 1,419 14.1 82 37 2 0.8 229 2.2 99 0.9 1948 99,470 2,077 20.2 1,228 12.3 59 28 0 0.0 239 2.3 75 0.7 1949 100,550 1,830 18.1 1,339 13.3 59 32 1 0.5 255 2.5 71 0.7 1950 99,730 1,845 18.5 1,255 12.5 49 26 2 1.0 244 2.4 56 0.5 1951 (c) 98,858 1,846 18.7 1,364 13.8 39 21 0 0.0 232 2.3 49 0.4 1952 99,000 1,894 19.1 1,371 13.8 35 18 6 3.0 241 2.4 50 0.5 1953 98,570 1,919 19.5 1,187 12.0 75 39 1 0.5 237 2.4 43 0.4 1954 97,900 1,851 18.9 1,126 11.5 41 22 1 0,5 261 2.6 36 0.3 1955 98,180 1,826 18.5 1,183 12.0 42 23 2 1.0 247 2.5 20 0.2 1956 98,160 1,909 19.4 1,186 12.1 43 22 0 0.0 234 2.4 17 0.2 1957 97,810 1,853 18.9 1,214 12.4 45 24 1 0.5 249 2.5 20 0.2 1958 96,360 1,818 18.9 1,161 12.0 36 20 2 1.0 221 2.3 16 0.2 1959 94,900 1,811 19.1 1,246 13.1 45 24 0 0.0 242 2.5 17 0.2 1960 93,850 1,714 18.3 1,037 11.0 32 18 2 1.1 213 2.3 8 0.1 1961 (C) 92,000 1,863 20.3 1,208 13.1 41 22 1 0.5 236 2.5 11 0.1 1962 90,480 1,852 20.5 1,133 12.5 33 19 0 0.0 214 2.3 12 0.1 (C) Census. * per 1,000 population. + per 1,000 total births. Table 19 OPEN SPACES WITHIN THE BOROUGH Location Acreage MAINTAINED BY BOROUGH COUNCIL. Albert Square Gardens 0.66 Arbour Square Gardens 0.66 Beaumont Square Gardens 1.00 Carlton Square Gardens 0.75 Christchurch Gardens, Spitalfields 1.25 Ford Square Gardens 0.40 Kingward Street Playground 0.13 Mallon Gardens, Commercial Street 0.19 Mile End Gardens 0.50 St.George-in-the-East Churchyard 2.25 St.George's Gardens 0.75 St.James's Gardens, Ratcliffe 2.00 Sidney Square Gardens 0.33 Stepney Green Gardens including Clock Tower space. 1.50 Swedenborg Square Playground 0.67 Trafalgar Gardens 0.60 Tredegar Square Playground 1.24 Trinity Square Gardens 1.23 Vallance Road Recreation Ground 1.19 Wakefield Gardens 0.06 York Square Gardens 0.20 17.56 MAINTAINED BY LONDON COUNTY COUNCIL. Allen Gardens 1.26 Bethnal Green Gardens Extension 1.60 Brickfield Gardens 5.73 Diggon Street Playground 0.13 King Edward VII Memorial Park 8.50 King George's Playing Fields (part) 13.75 Liraehouse Churchyard 2.00 Rope Walk Gardens, Christian Street 1.51 Shandy Park 3.18 Stepney Churchyard 9.75 Wapping Gardens 3.45 Waterside Gardens 1.92 52.78 Total (acres) 70.34 These Open Spaces represent 4.16% of the area of the Borough, which is 1,691 acres exclusive of the area covered by the river, docks and canals. 79 Table 20 Social Clubs (including Lunch Clubs and Chiropody Clinics) affiliated to The Stepney Old People's Welfare Association +* Beaumont Hall Old Age Pensioners' Club, Beaumont Hall, 2 Beaumont Grove, E.l. Thursday, 1.30-3.30 p.m. + Berner Friendship Club for Jewish Pensioners, Berner Street, E.l. The Bernhard Baron Settlement, Tuesday, 2-4 p.m. +* Brady Friendship Club for Jewish Pen Hanbury Street, E.l. The Brady Settlement, Wednesday, 2-4.30 p.m. Commercial Road Companionship Club, 351-353 Commercial Road, E.l. Tues., Wed. & Thurs. 6-9 p.m. + Dame Colet House, 29 Ben Jonson Road, E.l. Tues. & Fri. Noon to 2 p.m. "Golden Age" Club, the Labour Party Hall, Stepney Green, E.l. Monday, 7-9 p.m. Holy Trinity Club, Holy Trinity Church Hall, Morgan Street, E.3. Alternate Tuesdays, 7-9 p.m. Jewish Blind Society, East End Club, 241 Mile End Road, E.l. Wednesday, 2-4.30 p.m. S.A.L.O.P. Club, St.Anne's Institute, Three Colt Street, E.14. Tuesday, 7-9 p.m. + St.Dunstan's Club, Haileybury Boys' Club Hall, Ben Jonson Road, E.l. Wednesday, 2-4 p.m. * St.George's Club for Pensioners, St. 181 The Highway, E.l. George's Mission Hall, Friday, 2-4.30 p.m. * St.Katharine's Club for Pensioners, Butcher Row, Ratcliffe, E.14. The Royal Foundation of St.Katharine, Monday 2-4 p.m., Thursday 7-9 p.m. Stepney Friendship Club, East London Synagogue Hall, Rectory Square, E.l. Tuesday, 7-9.30 p.m. +* Toynbee Veterans' Club, Toynbee Hall, 28 Commercial Street, E.l. Tues. & Thurs. 2-4.30 p.m. The Vaughan Pensioners' Club, Johnso Street, E.l. Thursday, 2-4 p.m. +* W.V.S. Darby and Joan All-Day Club, Blakesley Street, E.l. Mon. to Fri., 11 a.m. to 4.30 p.m + W.V.S. Darby and Joan Club, Burdett Estate, St.Paul's Way, E.3. Tues. 11-1 p.m., Fri. Noon to 4 p.m. Zekeinim Club for Jewish Pensioners, Adler Street, E.l. Jewish Institute, Adler House, Monday to Thursday, 2-5 p.m. + also Lunch Club. * also Chiropody Clinic. 80 INDE Page No. Accidents - Home 11, 12, 61 "Road 12, 59 Aged Persons 3, 14 Analyst's Report 54 Area of Borough 6 Bacteriological Examinations of Foodstuffs 40 Bakehouses 40, 72 Births 6, 10 Cancer 45 Caravans 36 Catering Establishments 72 Census 1961 2, 9 Chiropody Clinics 16, 80 Clean Air 27, 67 Clearance Areas 35 Common Lodging Houses 31, 64 Complaints of Nuisances 27, 64 Conferences 16 Deaths 6, 11, 17, 58 Diphtheria 45 Disinfection and Disinfestation 53 Drainage 28, 64, 65 Dysentery 46 Factories 28, 64, 67, 68 Fifty Years Ago 7 Food - Unsound 44 "Inspection and supervision 39, 72 Poisoning 46 Free Washing Facilities 17 General Information 7 Hairdressers and Barbers Premises 28 Health Education 18 Health Services, General provision of 14 Holiday Centre 19 Home Bathing 15 Hospital Facilities 20 Houses in Multiple Occupation 3, 36 Houses - Number in Borough 6 Housing 2, 35 Housing Statistics 67, 70, 71 Ice Cream 41, 72 Illegitimate Births 4, 6, 10 Infant Mortality 6, 12, 60 Infectious Diseases 45, 74, 76 Information Centre 20 Inquests 17 Laboratory Facilities 20 81 Page No. Legal Proceedings 29, 35, 41 Legislation 21 Marriages 11 Maternal Mortality 6, 12 Maternity and Child Welfare 24 Measles 46 Milk Supply 42 Mobile Meals Service 15 National Assistance Act, 1948 14, 15 Neonatal Mortality 6, 12 Notices Served 30 Offensive Businesses 32 Old People's Welfare Association 15 Open Spaces 13, 79 Outworkers 31, 69 Overcrowding 35 Perinatal Mortality 6, 12 Physical Training and Recreation Committee 1 Poliomyelitis 47 Population 6, 9, 10 Poultry Slaughterhouses 32 Psycho-Geriatric' Service 4, 22 Public Health Committee 1 Public Health Inspectors (District) - Summary of Inspections 64 " " " Return of Sanitary Work 65 Radioactivity 29 Refuse Disposal 30 Rent Act, 1957 27, 65 Rodent Control 32, 62 Sanitary Circumstances 27 Scarlet Fever 47 Seamen's Lodging Houses 31 Shops 33, 64 Smoke Control Areas 4, 27 Smallpox 2, 47 Social Conditions of Area 7 Staff 5, 26 Statistics, Summary of 6,78 Still-births 6 Swimming Baths 26 Tuberculosis 3, 48, 75 Underground Rooms 35 Unemployment 12 Venereal Disease 4, 52 Vital Statistics 6, 78 Water Supply 33 Weather Conditions 45 Workrooms for the Elderly 15 82