4367 STE 37 Library 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 1963 Together with the Report of the PUBLIC ANALYST Metropolitan Borough of Stepney. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH For the Year 196 3 Together with the Report of the PUBLIC ANALYST CONTENTS PAGE Public Health and Physical Training & Recreation Committee 1 Introductory 2 Staff 7 Summary of Statistics 8 I. Statistics and Social Conditions of the Area 9 II. General Provision of Health Services 14 III. Sanitary Circumstances 27 IV. Housing 38 V. Food-Inspection and Supervision 41 VI. Infectious and Other Diseases 49 Public Analyst's Report 56 Appendix 59 Index 83 PUBLIC HEALTH COMMITTEE (at 31st December 1963) Ex-Officio: HIS WORSHIP THE MAYOR, Councillor E. W. Hill, J.P. CHAIRMAN: Councillor G.H. Wall VICE-CHAIRMAN; Councillor C. Dimes Aldermen: T. Aylward (Mrs.) A. Elboz (Mrs.) C.F. Woollon Councillors: B. Borman M.J. Durell J. Olley A. Butler (Mrs.) C. Edwards J. Orwell (Mrs.) I.B. Calnan B. Holmes (Miss) E. Ramsay, G.R.Chaney S. Kaufman M.B.E. R. Cockel J. Milrood J. Reardon C. Mudd (Mrs.) M. Sambrook PHYSICAL TRAINING AND RECREATION COMMITTEE (at 31st December 1963) Ex-Officio: HIS WORSHIP THE MAYOR, Councillor E. W. Hill, J.P. CHAIRMAN: (Vacant) 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 J. Olley (Mrs.) I.B. Calnan J. Long P. Roche (Mrs.) C. Edwards (Mrs.) K, O'Connor (Mrs.) M. Sambrook M. O'Leary, J.P. 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 washhouses. PUBLIC CLEANSING COMMITTEE: Collection, removal and disposal of house and trade refuse, and cleansing of highways. WORKS COMMITTEE: Maintenance of sewers, parks, gardens and open spaces. 1 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 and Gentlemen, I have the honour to present to you my Annual Report on the state of the public health in Stepney for the year 1963. Statistics The Registrar-General's estimate of the mid-year population of the Borough was 89,930, a decrease of 550 from last year. The age structure shows a larger proportion of persons in the 'over 65' group than the average for the London County Council area, A corrected death rate per thousand of 15.4 compares with the figure of 12.2 for England and Wales. Live births totalled 1,816 (1,852 in 1962) giving a corrected rate per thousand of 18.4 (England and. Wales rate 18.2); infant mortality rate 24.77; perinatal, mortality rate 32.36; and maternal mortality rate 0.53. Infectious Diseases Local outbreaks of typhoid, probably imported from Switzerland by returning holiday-makers, occurred throughout the country and gave rise to some concern in March. No cases were notified in Stepney at this time. A typhoid carrier working at a local hospital was discovered later during a routine examination and treated at her place of residence outside the Borough. Oral polio vaccine was offered to all members of the Borough staff up to the age of 45 years as recommended under the new schedule of immunisation procedures. Tuberculosis Notifications remain higher than average for the County at 105 pulmonary, 20 non-pulmonary. A special campaign in conjunction with the North-East Metropolitan Regional Hospital Board's Mass Miniature Radiography Unit was undertaken during May and June (see page 52). The improved arrangements made by the Chest Physician by which general practitioners can refer patients for chest X-ray at Mile End Hospital also showed a good response. Over a third of the new cases notified this year were of Asian immigrants. Whether the disease was contracted before they left their homeland, or whether our climate and overcrowded conditions combined with their probable low resistance caused them to be infected here is a matter of conjecture. In any event chest X-ray before they emigrate, or immediately on arrival, should be required with adequate education to 2 encourage them to take advantage of our care and after-care facilities. Housing Much discussion has centred on the extent of the powers available under Part II of the Housing Act 1961, particularly in respect of houses-in-multiple occupation. Despite the built-in limitations of parts of this Act, it has been possible to make a good beginning towards the improvement of these properties. The special Housing section has undertaken a considerable number of inspections at all hours of the day and night to contact owners/occupiers, and check on conditions of occupation. Some 200 houses have been dealt with. (See full report on page 39). A partial approach to dealing with the sub-standard and slum tenement blocks commenced during the year. In a large privately owned tenementdwelling block assistance with rehousing from one section of 22 flats was given by the Borough Council to allow a pilot scheme of conversion in the block, using discretionary grant facilities. Satisfactory agreement by both parties was reached on the proposed new rentals with a concomitant security of tenure. Other similar schemes of co-operation with private landlords have been held up due to a shortage of accommodation available for allocation by the Council to absorb the temporary or permanent overspill arising from these projects. Another large block of 100 flats, heretofore considered sub-standard, has been represented as unfit, without any opposition from the owners on the grounds of unfitness, and the Minister's decision is awaited. As the Borough has approximately 5,000 sub-standard dwelling units in this category, there is a long way yet to go. In some parts of the Borough for example those zoned commerce or light industry, numbers of slum houses remain undealt with partly because action would result in a great loss to the available housing pool with no gain in land for new housing schemes. It is paradoxical that such deplorable areas, particularly in the north-west of the Borough, should remain despite the boom in office and commercial building over the last decade. Surely, controlled 'mixed development' could solve the dilemma and plight of many still living in these sordid conditions. Derelict sites remain with us. The potential public health nuisance is being partly ameliorated by the London County Council's programme of placing temporary mobile homes on sites zoned non-residential whose development is not programmed in the immediate future. Health Education Various lectures have been given by the staff of the Department to persons and organisations in the Borough, including youth groups, schools and hospital nurses. The venereal diseases were discussed at two meetings of community leaders in the Borough. Educational talks have been given at a senior girls' school on this subject. More could be done if trained full-time staff were available for this important function of a public health department. The potential dangers of oil-heaters were publicised by the issue of 3 posters and leaflets in English, as well as in Turkish, Greek and Urdu to include more residents of the Borough at risk. Representations have been made by the Council to the Metropolitan Boroughs' Standing Joint Committee on 'The Oil Heaters Regulations, 1962' pressing for an extension of legislation to make it an offence to sell or possess for sale not only heaters manufactured after 1st June 1962, which do not meet the requirements of the Regulations, but also secondhand heaters irrespective of the date of manufacture which are defective or do not conform to the standards laid down. Old People An interesting project was begun with some local general practitioners to compile 'at risk' registers of old people. Using clerical assistance from this Department, family doctors were helped to survey their lists to provide registers of old people which could be of use to them in their practice and also aid voluntary and statutory agencies in planning homevisiting and other help to those in need. An extension of this work, in association with an adequate visiting service, would go a long way to prevent the insidious onset of physical, mental and social deterioration still to be found with some old people, often necessitating their urgent removal into care. Frozen foods introduced to the meals-on-wheels and club meals services were welcomed as providing a greater choice of menu and flexibility in catering. The small additional cost per meal, as compared with the standard meals, was met by a special subvention granted by the Council. Proposals to extend the meals service to the needy in any age group, including an invalid meals service, await implementation following the reorganisation of the old boundaries previously defining the Invalid Meals Service's sphere of operation. The severe winter caused considerable hardship to many old people who for various reasons were unable to maintain adequate heating of their homes. The Holiday Centre bookings reached a new record with 1,364 for the year, including some 965 old-age pensioners provided for at a lower ratesubsidised charge including free transport to and from Sandgate. Food Supervision Poultry slaughterhouse premises have been kept under strict supervision to minimise the nuisance to the public. Their long-awaited removal to a centralised position outside the Borough seems no nearer fulfilment than it has been for some decades. Closures do occur as development of the areas proceed. Open fronted food shops and market stalls are a familiar part of the scene in the Borough. By modern standards, the potential contamination of food that is possible under these conditions of sale leaves much to be desired. Co-operation of owners of fixed shops to provide protective shop windows is being increasingly encouraged to minimise health risks. The Corporation of the City of London, acting as the public health authority for the Port of London, have submitted proposals to the Ministry 4 of Health to take over responsibility for all duties in respect of foodstuffs both within the curtilage of the Dock walls (as at present) and at the wharfside (at present the responsibility of the District Sanitary Authority). It has been the policy of the Borough Council to oppose these proposals and so continue its existing control over wharves/warehouses which operates satisfactorily. In view of the possible risks to health of pesticide residues in foods, a check on conditions at the point of sale of fruit and vegetables from home and abroad arriving at large wholesale distributing centres in the Borough has been made. Special testing is undertaken by the Borough's appointed Analyst. The tests are complex and expensive - see report on page 41). District Inspections For the first time in 13 years the district inspectors were up to establishment at the end of the year. This improved staffing position results in part from the Council's enlightened attitude on grading of salaries according to qualifications and years of experience. However, lest 'Hubris bring Nemesis' impending retirements in the new year and the increased work resulting from new legislation give no grounds for complacency. Training of public health inspector students continues at maximum level, but until all authorities train a quota of public health inspectors the too common drain of staff trained by larger industrial authorities to more salubrious areas will continue. The severe winter with snow and frost, during the first three months of the year, led to a great increase in the number of complaints received in the Department. An example of new legislation is the Offices, Shops and Railway Premises Act, to become operative on 1st August 1964. One inspector has undertaken preliminary work to premises covered by the Act (reported on page 33). The intention of the Act is welcomed as an extension of the statutory control of environmental conditions to include "white collar" workers, similar to that given for other workers by the Factories Act. To date owners/occupiers have responded favourably when advised on likely factors which will require attention when the regulations laying down standards are issued. To cover this important new responsibility a special inspectorate will be required, necessitating an increase in establishment. Clean Air Order No.5 was made by the Council in December. Some 631 acres out of a total of 1,692 are now covered by Smoke Control Orders. Difficulties have arisen recently with the provision of certain types of solid fuels. As a result, more emphasis on providing alternative approved forms of heating will be necessary. At present schemes are being formulated to ensure the continuance of this very essential long-term preventive health measure to ensure 'Clean Air' for the future. 5 An abstract from the annual report of the Consultant Psychiatrist responsible for psycho-geriatric work at St.Clement's Day Hospital is included in the Report. Interesting developments in community mental health services should follow from the application of lessons learnt there. It would be difficult to present a report today without mentioning the plans for local government proposed in the London Government Act 1963. By this time next year, Stepney will form part of the new Greater London Borough of Tower Hamlets. It is therefore unlikely that a further report on the public health of Stepney will be prepared in this form, and in this place. However, for the sake of the records, some report will need to bu made if only as a 'swan song' for the Public Health Department of Stepney, due to cease functioning on 31st March 1965, after serving the borough since 1901. Whatever the future may hold, and no matter what geographical boundaries are laid down for local government areas, in this part of London there will remain enough work to occupy the minds, and challenge the ideals of all members of councils and their officers with eyes to see. Let us make sure we do not discard the best that was in the old way of things for the new not yet proven. In conclusion, I wish to thank the Chairman and Members of the committees for their support, and the Town Clerk and other Chief Officers of the Council for their help and assistance. To the staff of the Public Health Department and the Assistant Administrative Officer in particular, I extend my gratitude for their willing and loyal service in carrying out the work of the department. I am, Your Worship, Ladies and Gentlemen, Your obedient Servant, R. W. WATTON, Medical Officer of Health. May, 1964. 6 STAFF OF THE PUBLIC HEALTH DEPARTMENT (at 31st December. 1963) MEDICAL OFFICER OF HEALTH: R. W. Watton,M.B.,B.S.,D.P.H.,D.C.H.,D.I.H. Assistant Administrative Officer: E. P. Webber (l,2) Senior Administrative Assistant: M. Pliskin District Public Health Inspector: Disinfestation Inspector: Administrative & Clerical Staff: G, Bethell (l,2) E.J.Edwards (l,2) D.J.Berry W. Cue (l) M. Connell H.S.Davies (1,2) Housing Inspector C.H.Coveley R.W.G.Day (l) W.H.Havrorth (l) W.E.Driscoll H.A.Giddings (1,2) Smoke & Factories Inspector: S.W.Embleton W.E.Hart (1,2) B.Goldston J.J.Keniry (l) S.S.Harris T.C.Mansell (l) G.D.Freeland (1,2,3) E.F.Holt B.L.Nunn (l) D.A.Hunnibal R.W.Scanes (1) Hygiene Offices: A.Jacques G. Wilson (l) Miss M.Guest (4,5,6) Miss R.Levey Miss E. New (5,6) Mrs.D.Millings Food Inspectors: Mrs.M.Munday (T) A.C. Brown(1,2) Technical Assistant: A.C.Brown (1,2) (Smoke Control) Miss A.Sayers S.S.Lowther (1,2) Pupil Public S.Vogler (1, 2) G.A.Moore Health Inspectors: Caretaker & Messenger: Housing Assistants: N.Gray T.W.Harlock W.J. Giardelli G.A.Hensher Relief-Caretaker/Messenger: A.B. Kenirv A.J.Lacey E.H.Vaughan J.W.Meakin Disinfecting Staff: Foreman-Dicinfector: Rodent Investigator; 7 Males J.H.Andrews 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.A.K.Heard 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 22). (T).Temporary. 7 SUMMARY OF STATISTICS, 1963 Area of Borough (acres) Population: 1902.7 Rateable value (1st April) £7,332,038 Mid-year estimate Census, 1961 89,930 Sum represented by a penny rate (1936-64) £28,250 Density of population (persons per acre 50.92 General rate (1963-64) 7/8d in £ Number of inhabited dwellings according to Rate Books 26,405 " " structurally separate dwellings - Census 1961 27,257 " " private households-Census 1961 29,333 Births Total Male Female All Births 1,854 924 930 Live Births-Legitimate 1,564 772 792 Illegitimate 252 129 123 Total; 1,816 901 915 Still Births-Legitimate 35 23 12 Illegitimate 3 - 3 Total; 38 23 15 Deaths All Causes 1,218 704 514 Maternal 1 - 1 Infants under 1 year-Legitimate 38 26 12 Illegitimate 7 4 3 Total: 45 30 15 Rates Live birth rate per 1,000 population 20.19 Death-rate per 1,000 population 13.54 Stillbirth rate per 1,000 total births 20.49 Maternal death rate per 1,000 total births 0.53 Infant death rate (under 1 year) per 1,000 live births 24.77 Legitimate infant death rate per 1,000 legitimate live births 24.29 Illegitimate infant death rate per 1,000 illegitimate live births 27.77 Neo-natal death rate (under 4 weeks) per 1,000 live births 14.86 Early neo-natal death rate (under 1 week) per 1,000 live births 12.21 Perinatal death rate (stillbirths plus deaths under 1 week) per 1,000 total births 32.36 Illegitimate live births per cent of total live births 13.87 Area Comparability Factor - Births 0.91 Deaths 1.14 8 I. STATISTICS AMD 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 l-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 concentrate in 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 include brewing, engineering and the manufacture of furniture. Stepney is also one of the most important wholesaling districts in London. 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 1913 contains the following information: The estimated population was 275,300 and the birth-rate was reported to be 29.6. The death rate (uncorrected) was 15.1 per thousand population and the infant mortality rate 112 per thousand births. Among the causes of death reported were; Tuberculosis 572, diarrhoea and enteritis 305, cancer 236, measles 95, premature births 121, whooping cough 26, diphtheria 21, scarlet fever 7, alcoholism 30 and appendicitis 23. 9 Deaths of children under one year included 250 from diarrhoea and enteritis, 23 from measles and 120 from pneumonia. There were 201 inquests on children under five years, 40 deaths being attributed to convulsions, 27 to overlying by parents in bed, and 13 to burns and scalds. Notifications of infectious disease included 423 diphtheria; 784 scarlet fever, 70 enteric fever, and 2,038 new cases of pulmonary tuberculosis. That year all forms of tuberculosis were made notifiable. Of the 1,263 samples of food analysed 146 (11.6%) were found to be adulterated, as a result of which 79 prosecutions were taken. 101 samples of milk and 27 samples of butter were found to be adulterated; and of 110 samples of milk taken on Sundays 14.5% were adulterated. Legal proceedings were taken in 152 instances under the Public Health Act, Food and Drugs Act and other acts and byelaws. An organisation pleaded guilty to selling to the London County Council for the breakfast of necessitous children 90 slices of bread and dripping which were unsound, unwholesome and unfit for human consumption. Inspections numbering 19,131 were made by sanitary inspectors specifically for the purpose of detecting overcrowding. The Borough Engineer and Surveyor reported that 13,477 loads of hay were brought into the Whitechapel Hay and Straw Market, the number declining over the previous years due to mechanical traction. The Hay and Straw Market was held three days a week from early morning until 3 p.m., and at the time of closing a bell was rung to signal the departure of all hay and straw carts. The average cost per horse per working day (including fodder, wages of stablemen, rent, etc.) was 4/8d. Each horse received daily 12 lbs. oats, 24 lbs. hay and clover and during the summer one bundle of greenmeat. The Metropolitan Association for Befriending Young Servants made application to the Council for a small sign to be affixed to a lampstandard directing persons to their newly-acquired offices. Population The Registrar-General's mid-year estimate for 1963 is 89,930. Last year's estimate was 90,480. The density of population is now 50.92 persons per acre. In 1913 it was 156 per acre. During the year there was a natural increase in population of 598; that is there were 598 more births than deaths. The Registrar-General estimates the population to be 550 less than last year, the indication being that 1,148 persons have moved out of the Borough. Births The Council is supplied by the County Council with a weekly return of live births and stillbirths notified to the latter authority, as the local Health Authority, under the National Health Service Act, 1946. 10 The total number of live births registered in the borough during the year was 4,349, and of which 2,751 belonged to other areas. In addition 218 births belonging to Stepney occurred outside the borough, making a total of 1,816 births (901 males; 915 females) to Stepney residents. The live birth rate is 20.19 per 1,000 population. The rate when adjusted by the comparability factor is 18.37, compared with the rate for England and Wales of 18.2, the highest since 1947. Illegitimate live births numbered 252, representing 13.87 per cent of the total live births. Still-births numbered 38, representing a rate of 20.49 per 1,000 total births, compared with 17.3 for the country as a whole. Accidents in the Home Many more deaths occur now throughout the country 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 these. 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 Steoney forms a part. A table summarising these figures over the past four years is given on page 63, from which it will be noted that there is a steady annual increase, the total increase since 1960 being in the order of 17 per cent for all accidents in London as a whole, and 32 per cent for the London County Council Division 5 area. Accidents due to falls have increased in this area by 28 per cent, compared with London's increase of 12 per cent, and the increase in other accidents in the Division is in the order of 42 per cent as against 33 per cent for the County. While the figures may not be fully comprehensive they give a reasonably accurate picture. During the year, the London Ambulance Service removed to hospital 195 Stepney home accident cases, as compared with 155 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 11 persons concerned a special safety-type gas cooker. Attention is also given in the homes of old people to oil heaters, particularly the dripfeed type; advice and assistance is given to enable the old people to have these converted so as to conform with safety standards. Marriages The number of marriages in the Borough during the year was 780, being 16 more than last year. The marriage rate per 1,000 population is 17.3 compared with 16.9 in 1962. Deaths The net number of deaths registered during the year was 1,218, compared with 1,133 last year. The death rate of 13.54 is the highest since 1952. The rate of 13.54 when adjusted by the comparability factor is 15.4, as compared with 12.2 for England and Wales. The principal causes of death were heart disease which accounted for 28 per cent of the total deaths; cancer 20 per cent, and diseases of the respiratory system 22 per cent. Deaths of persons over the age of 65 years amounted to 64 per cent of the total deaths. Details of deaths by cause and age are given in Table I of the appendix, on pages 60 and 6l. Infant Mortality Deaths of infants under one year numbered 4-5, giving a rate of 24.77 per 1,000 live births. The rate for England and Wales is 20.9. The Tables on page 62 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 32.36, compared with 30.72 last year. Neonatal Mortality During the year there were 27 deaths of infants under four weeks of age, representing a neonatal mortality rate of 14.86. Last year, there were 24 neonatal deaths the rate being 12.96. Maternal Mortality There was one maternal death this year. 12 Accidental Deaths The number of deaths due to accidents was 37, or six more than last year. These included 12 due to motor vehicles (three more than in the previous year); 11 in the home; 1 at work and one from drowning. (See Table 2 on page 6l 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 1740 27 127 19 - Total: 1,913 The total number of unemployed at the end of 1962 was 2,164. Claims for Sickness Benefit The numbers of claims made for sickness benefit to the local office of the Ministry of Pensions and National Insurance, covering the E.l postal district, are given below for each month of the year, with comparisons for 1961 and 1962: 1963 1962 1961 January 1,933 2,425 2,604 February 2,414 1,615 2,013 March 1,642 1,470 1,191 April 1,307 1,420 1,388 May 1,081 1,052 1,117 June 1,021 1,072 1,351 July 919 864 994 August 1,110 838 958 September 1,020 1,233 1,365 October 1,091 1,252 1,337 November 1,445 1,237 1,387 December 1,444 1,494 1,548 Total for Year: 16,427 15,972 17,253 Open Spaces There are now 77 acres of parks and open spaces within the Borough, an increase of over 50 per cent in the last ten years. This represents 0.85 of an acre for every 1,000 population. The County of London plan provides for 4 acres within the County per 1,000 population, with an interim standard of 2½ acres. A list of the sites is given on page 81. Comparative Statistics A Table showing vital statistics for the Borough at various years from 1901, is on page 80. 13 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. This year, it was found necessary to apply for only one such Order under this enactment in respect of a woman aged 80 years who was removed to hospital. Voluntary admission to a hospital or institution was obtained for 11 other persons. Two women officers, both State Registered Nurses and one a certificated health visitor, are employed for visiting aged persons in the Borough, and 2,495 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 were as follows:- Number on register at 1st January, 1963 2171 Additions during the year 589 Removals during the year 217 Number on register at 31st December, 1963 2543 The Department continued operating its Laundry service 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 4,611 articles of bed linen 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. 983 baths were given to 74 old people during the year by the Council's Home Bathing service, which was inaugurated in 1950. With a view to ascertaining the magnitude of the problem associated with old people, not already known to this Department's visitors, who might be in need of any of the socio-medical services available to them, a pilot survey commenced tow rd the end of the year of persons aged 70 and over on the lists of seven general practitioners in the Borough. All the old persons on one doctor's list had been visited by the end of the year, and the following results were thrown up by the survey:- 14 W.V.S. LUNCH CLUB, BLAKESLEY STREET (Photo by T. J. Golden) Already known to the Department 28% Already receiving assistance 10% Moved away, died, etc. 13% Found not requiring assistance 69% Found requiring assistance 8% Thus approximately 1 in 13 persons over 70 years of age were found to require some kind of assistance. Had those of pensionable age (men 65, women 6o) been included in the survey doubtless the percentage found to be in need of help would have been appreciably lower. A visiting card was left with those persons not requiring assistance at present to enable them to make contact with the Public Health Department should the need arise. In any event, they will be revisited at intervals as frequently as possible, but at least annually. Liaison is maintained with statutory and voluntary bodies e.g. the Stepney Old People's Welfare Association, London County Council, National Assistance Board, local hospitals and particularly with Dr.C.P.Silver, local Consultant Geriatrician. An example of liaison which exists is that hospitals notify this Department when an old person is about to be discharged so that any welfare services can be arranged beforehand, such as a home help, meals-on-wheels. The Council's contribution to the old people's welfare services in the Borough for the year 1963-4. amounted to £23,500, which included grants for the mobile meals service, old people's holidays, workrooms, administrative expenses of the Stepney Old People's Welfare Association, and grants to various old people's clubs. There are 18 old people's clubs in the Borough, all affiliated to the Stepney Old People's Welfare Association.* One club 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 82} the photograph facing this page was taken at lunch time at one of the clubs. The Metropolitan Boroughs' Standing Joint Committee concurred with the views expressed by the Central Consultative Committee for the Welfare of Old People on the subject of day centres and clubs for the elderly, suggesting that mobile and infirm old people be catered for at the same premises and that in addition to midday meals and social activities it was desirable to provide bathing and chiropody services on the site. The mobile meals service operated by the Stepney Old People's Welfare (*) Hon.Secty., The Stepney Old People's Welfare Association, Liraehouse Town Hall, Commercial Road, E.14. Voluntary visitors are urgently needed and should apply to the Secretary. 15 Association, the Women's Voluntary Service and the Beaumont Hall Settlement increased their deliveries to a weekly average of 924 meals to home-bound old people. Five vehicles are employed in this service. Eight of the old people's clubs which include luncheon clubs among their facilities provided an average of 717 meals every week. To enable the Women's Voluntary Service to supply an additional 100 meals a day from the meals centre in Blakesley Street, proposals were approved for alterations to the premises and for the estimated cost of £2,000 to be met by the Council. A Chiropody service is provided by the Stepney Old People's Welfare Association at clinics situated at four of the old people's clubs in the Borough, and an average of 220 treatments including 90 domiciliary treatments were given each month during the year. Following the conferment of extended powers on local authorities by the National Assistance Act 1948 (Amendment) Act, 1962, in common with other metropolitan borough councils this Council on 1st April took over full financial responsibility for the meals for old people provided in the Borough. Formerly the County Council made up the difference (approximately one-half) between the cost of such meals and the amount paid by the old people themselves. 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 years:- Conference Held At Attended By Central Council for Health Education. London' (January) Medical Officer of Health and Pupil-Public Health Inspector, Mr.G.A.Hensher. Home Safety. London (March) Councillor C.Dimes and Medical Officer of Health. Do. (October) Alderman T.Aylward and Medical Officer of Health. Royal Society of Health. Eastbourne (April) Councillor E.W.Hill and Medical Officer of Health. Central Consultative Committee for Old People. London (June) Councillor C.Dimes and Hygiene Officer Miss E. New. (Contd.) 16 Conference Held At Attended By London Council of Social Service. Oxford (September) Councillor J. Olley. Public Health Inspectors Association. Eastbourne (September) Councillor C.Dimes and Public Health Inspector, Mr.W.E.Hart. Royal Institute of Public Health and Hygiene. Harrogate (September) Councillor G.H.Wall and Medical Officer of Health. National Society for Clean Air. Scarborough (October) Councillor C.Dimes and Public Health Inspector, Mr.G.D.Freeland. Central Council for Disabled. (Oct London October & December) Councillor (Mrs.) C.Edwards and Medical Officer of Health. Deceased Persons Inquests. Inquests on 56 residents of the Borough were held during the year, the verdicts being: 9 deaths due to road accidents, 19 other accidents, 19 suicides, 1 acute alcoholism, 2 misadventure, 1 natural causes, and 5 open verdicts. Burials. Section 50 of the National Assistance Act, 1948, places a duty on the Council to arrange for the burial of any person found dead within the Borough where no private arrangements have been made. 23 such burials took place during the year-22 adults and one stillborn childat a cost of £257, of which £218 was recovered by the end of the year either from the estates of the deceased persons or from liable relatives, or by way of grants made under the National Insurance Act, 1946. Sixteen requests for burial came from H.M.Coroner's Officer, 5 from relatives and 2 from friends of the deceased. Disposal of contents of homes. 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 accommodation for housing purposes as soon as possible. Transport of bodies abroad. From time to time certificates are issued regarding bodies transported abroad, to the effect that the deceased did not die from an infectious disease and that the coffin had been hermetically sealed. One such certificate was issued this year, relating to a body flown to Israel for burial. Free Washing Facilities The Council provides free washing facilities in 16 of the twenty-two public conveniences in the Borough. 17 Crude Spirit Drinking Following representations made by another borough council to the Metropolitan Boroughs' Standing Joint Committee concerning the problems associated with crude spirit drinkers, all metropolitan borough councils were asked to advise on the extent of the problem in their area. The views of the Medical Officer of Health on the matter were endorsed by the Public Health Committee and submitted to the Standing Joint Committee who decided to take no action as only two councils reported any problem. Subsequently one of the councils concerned stated that a useful purpose might be served by a discussion of the matter by representatives of the two councils, and a meeting was arranged for early in 1964.. Health Education The Council co-operated with the London County Council in a campaign to alert the general public and young people in particular to the alarming increase in the incidence of venereal disease. Some 425 specially prepared posters, overprinted with the addresses of the nearest clinics, were posted up by the Department in the sanitary conveniences of public houses, licensed clubs, cafes, dance halls and industrial canteens. A lecture was given at the London Hospital on 5th February by a consultant venereologist and a social worker in a V.D. clinic to invited Stepney persons. On 14th February a combined lecture/film was given by the Medical Officer of Health in conjunction with the Archdeacon of London, under the auspices of the Stepney Youth Committee, at Chapter House, St. Paul's Cathedral. The audience consisted largely of heads of schools and youth club leaders. From this meeting a series of talks on venereal disease was arranged, at the request of the Headmistress of a Girls' Grammar School in the Borough. These took the form of informal instruction on the anatomy and physiology of the sexual functions of the body. Discussions followed on the venereal disear.es, their mode of presentation, and prevention. The moral values implicit in the relationship of sex, marriage and society were brought out in the series. Some extremely interesting 'consumer reports' were forthcoming in essays on the talks written by the pupils. This series of talks will be repeated as health educator, teachers and pupils found the project worthwhile. The view has been expressed that it is unfortunate that a similar approach cannot be made a part of the curricula of all schools desiring to participate. Lectures on the work of the Public Health Department and on environmental hygiene were given to trainee nurses and to other groups of women. The operation of the Council's fourth 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 also were the Council's official notice boards and those affixed to lamp-columns in street markets in the Borough. Each month a different topic is chosen, either to coincide with a national or 18 county campaign or at a time of year when the incidence of a particular health hazard is increased. The occupiers of several large factories, and some chemists shops, accept 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 Libraries. In all, some 3,300 posters and 23,000 leaflets were distributed. In view of the dangers associated with defective and badly maintained oil heaters, warning posters and leaflets were distributed during the winter months. Copies of the posters were printed in Greek and Turkish for the benefit of the non-English reading Cypriots and in Urdu to help the Pakistani and Indian residents of the Borough. In addition a halfpage advertisement was issued in the Christmas edition of a newspaper printed in Urdu on this subject. 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, was circularised to the local general practitioners and hospitals. A special campaign was conducted during the "fireworks" season, warning the public to exercise care in the use of pyrotechnics. Publicity was also given to the Council's Holiday Centre by means of advertisements in the Press, slides shown in local cinemas, and by posters and leaflets. Vacant sites in the Borough were posted up with notices warning the public against depositing rubbish and against the use of land as caravan sites. Other subjects publicised included the relationship between smoking and health; diphtheria immunisation; vaccination against poliomyelitis; food hygiene; influenza; and care of the elderly. Holiday Centre During the year 1,191 Stepney residents spent a holiday at the Council's Holiday Centre-The Manor House, Sandgate, near Folkestone, Kent. This number included 795 aged persons and 140 children. The total number of weekly bookings was 1,364, the highest since the Manor House was opened in 1958. The Holiday Centre is open all the year round and is available to all residents of the Borough, young and old, half the total accommodation being 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 is 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. Less difficulty was 19 experienced this year in getting residents of the Borough to use the facilities for a holiday in the Winter. The intensive publicity measures taken in the autumn as well as personal contact by the department's Hygiene Officers resulted in a considerable improvement in winter bookings. During the year representatives of two metropolitan borough councils, which were contemplating setting up similar holiday centres, visited the Manor House and were shown over the premises. 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 The London Jewish Hospital, Stepney Green. 128 East End Maternity Hospital, Commercial Road. 58 Despite representations made by the Council, the Queen Elizabeth Hospital for Children was closed by the North-East Metropolitan Regional Hospital Board on the 30th April, 1963. 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). Two Citizens' Advice Bureaux were opened to the public on the 18th February; one at Toynbee Hall, Commercial Street, and the other at Dame Colet House, Ben Jonson Road. The Council affords financial support for both offices. 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 43 re Food samples). Investigations were carried out on 297 specimens submitted by the Medical Officer of Health and by general practitioners in the Borough during the year. The specimens comprised: 260 faeces, 26 throat swabs, 10 rectal swabs, and 1 nasal swab. Special Reports Special reports were made by the Medical Officer of Health to the Public Health and/or Housing Committees during the year on the following subjects: Houses in Multiple Occupation, Public Conveniences (conjoint report). Smoke Control Order No.5. 20 Legislation The following Acts, Orders and Regulations affecting the Department were made during the year:- Date Operative Animal Boarding Establishments Act 1963 1.1.64 London Government Act 1963 Various London County Council (General Powers) Act 1963 10.7.63 Offices, Shops and Railway Premises Act 1963 Various Public Lavatories (Turnstiles) Act 1963 31.7.63 London County Council Byelaws for Removal, etc. of Refuse 1963 1.6.63 1.4.63 Bread and Flour Regulations 1963 1.9.64 Ice Cream (Heat Treatment,etc.)(Amendment) Regulations 1963 18.6.63 Liquid Egg (Pasteurisation) Regulations 1963 1.1.64 Meat Inspection Regulations 1963 1.10.63 Milk (Special Designation) Regulations 1963 Various Motor Cycle (Protective Helmets) Regulations 1963 18.11.63 National Assistance (Powers of Inspection) (Amendment) Regulations 1963 1.1.64 Public Health (Aircraft) (Amendment) Regulation 1963 1.8.63 Public Health (Ships) (Amendment) Regulation 1963 1.8.63 Poisons List Order 1963 2.9.63 Poisons Rules 1963 2.9.63 Rivers (Preventions of Pollution) Regulations 1963 1.3.63 Smoke Control Areas (Authorised Fuels) Regulations 1963 29.7.63 Soft Drink Regulations 1963 29.7.63 Other subjects dealt with in Circulars issued by Government Departments included the following:- Ministry of Health: Annual Reports of Medical Officers of Healths Fluoridation of Water Supplies: Incontinence Pads: Poisons Information Service: Port Health Control: Smoking and Health. Ministry of Agriculture, Fisheries and Food: Arsenic in Food Regulations 1959 (Sampling of Brewing Materials): Further loss of ground by the Ship Rat: Official Certificates under the Public Health (Imported Food) Regulations in respect of Bechuanaland, Morocco, and the Federal Republic of Germany. Ministry of Housing and Local Government: Clean Air Act 1956 (Gas Cokes as open fire fuels; Chimney heights; Smoke Control Areas): Design of surface water sewerage systems: Frost damage to pipes: 'Radioactive Substances Act I960: Rivers (Prevention of Pollution) Act 1961: Storm overflows and the disposal of storm sewage: Treatment of derelict land. 21 Home Office: Pharmacy and Poisons Act 1933. 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. Swimming and Slipper Baths Four Swimming Baths are provided by the Council in the Borough. During the year 52,430 swims were taken by adults, and 137,631 by 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 examination and 30 for fhemical analysis. 3 samples showed the presence of b.Coli and 21 samples revealed a low free chlorine content and/or pH value. Appropriate measures were taken following the receipt of each report on these samples. The number of slipper baths taken during the year at the four Council establishments was 205,333, which included 6,208 taken by old age pensioners and three by unemployed persons who were admitted free of charge. The total number of persons admitted to all sections of the Baths and Wash houses Department, including the Laundry, was 432,468. Staff Changes The following staff changes took place during the year:- Commenced duty: Bethell, G.J. Public Health Inspector 21 Dec. Davies, H.S. Public Health Inspector 1 Apr. Heard, Mrs.A.K. Resident-Assistant (Holiday Centre) 1 Jul. Lacey, A.J. Pupil-Public Health Inspector 23 Sept. Mansell, T.C. Public Health Inspector 1 Jul. Moore, G.A. Technical Assistant (Smoke Control) 16 Apr. New, Miss E. Hygiene Officer 30 May Wilson, G. Public Health Inspector 12 Aug. Ceased duty: Ballam, Miss A.J. Hygiene Officer 28 Feb. Fromling, Mrs.J. Resident-Assistant (Holiday Centre) 4 May Green, H.J. Public Health Inspector (Food) 15 Apr. Sexton, W. Foreman-Disinfector 5 Feb. Townsend, D.J. Public Health Inspector 11 Apr. 22 PERSONAL HEALTH SERVICES I am indebted to Dr.A.L.Thrower, Divisional Medical Officer, London County Council, for the following information relating to the work in 1963 of the personal health services administered in the Borough by the County Council: 1. Statistics Infant Welfare Centres Total number of children who attended and who were born in - 1963 1,257 1962 - under 1 979 1962 - over 1 396 1958-1961 836 Infant Welfare Sessions:- Total attendances 19,416 Total medically examined 10,591 Toddlers Sessions:- Total attendances 687 Total medically examined 654. Ante- and Post-Natal Clinics Total attendances Nil (Now dealt with by General Practitioner obstetricians) Health Visiting Number of children visited who were born in - 1963 1,933 1962 2,196 1958-1961 4,221 Number of persons aged 65 and over who were visited 112 Number of mentally disordered persons visited 56 Number of persons visited who were discharged from hospitals (other than mental hospitals) 35 Number of tuberculous households visited 97 Number of infectious households visited (other than T.B.) 73 Total effective visits 19,643 Total unsuccessful visits 4,503 Child Minders (daily guardians) Number of child minders registered - Voluntary 4 Statutory 3 Number of children being minded - by Voluntary minders by Statutory minders 7 Immunisation and Vaccination For details of immunisation and vaccination see pages 50 and 51. 23 Home 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:- Matexnity (including expectant mothers) 7 Tuberculosis 15 Aged and infirm 722 Other cases 204 2. Services Provided Infant Consultation Afternoons 673, Commercial Road Tuesday, Thursday (and Friday 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 Tuesday (morning); Wednesday. 69,East India Dock Road Tuesday, Thursday (and Thursday morning). Ante-Nate 1 673, Commercial Road Wednesday. Vaccination against Smallpox 35, Stepney Green Tuesday. Immunisation against Diphtheria and Whooping Cough 35, Stepney Green Tuesday. (Note: Diphnerin 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 First Tuesday in month. Mary Hughes Centre, Underwood Road First and third Tuesday in month. 673, Commercial Road Monday. Day Nurseries Christian Street. Underwood Road. Voluntary Day Nursery Beaumont Grove (Alice Model Day Nursery). 24 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: "It is extremely disappointing to find that there is a further falling off in the use of this service, chiefly in the referrals by general practitioners. It is hard to believe that the needs of the psychiatrically aged person in this area are being met. One essential step towards this end would be the compilation by practitioners of a register of old people, an aid which is rare, I understand, but which has been recognised elsewhere as worth the time involved and is in course of production by some. Referrals by Old People's Welfare Associations and Mental Welfare Officers have also decreased but this could be attributed to the development of a better awareness that patients should be psychiatrically ill to be admitted and not just social stress problems. This is all to the good but the problem of finding who is at risk because of mental illness seems to be as difficult as ever. It has been suggested that political uncertainty due to the Greater London reorganisation may have inhibited local authority action and if this is so we may hope for improvement in the coming year but there are also other factors. The increase in referrals by psychiatrists is explained by the use being made of the Day Hospital after a stay in Dundee Ward as a further step in the process of rehabilitation. One of the indirect effects of a restricted turnover is seen in the much larger number of patients whom we have allowed to stay on, because they have become largely dependent upon us and to discharge them without alternative support of a suitable kind could be disastrous. "The tendency to have an increasing residue of socially non-viable persons due to the onset of dementia is difficult to avoid and in this context it will be seen that the average age of admission is rather higher. One notes that 20 patients in 1963 as compared with 8 in 1962 had to be maintained throughout the year as being too vulnerable to social stress and isolation to be discharged. Day Centres suited to this type of patient would be helpful, also socalled "Clubs" such as the one now functioning successfully at Trinity Church. The work of our staff has attained as high a standard as before, having gained in fact by experience, and it is sincerely hoped that its endeavours will be more fully utilised in the coming year. "The picture of the in-patient geriatric work continues to be a very satisfactory one. Close integration with the Day Hospital has worked well, contributing to a shorter average length of stay and 25 higher bed occupancy figures as well as a good percentage of patients (74%) discharged home or to a hostel. By making a re-assessment of physiotherapy needs in relation to dormitory space six female beds were added, available on July 1st. , In spite of these, however, it has not been possible to avoid a female waiting list. All male beds on the other hand were not always in use, explaining the rather lower figures for admission and discharges. Advancing dementia played its part, as did physical morbidity, in causing more transfers to long-stay care. On the other hand, there were fewer deaths, in spite of the severe winter. There is a very good therapeutic atmosphere now in which the social and occupational aspects play their part." 26 III. SANITARY CIRCUMSTANCES The District Public Health Inspectors served 2,512 Notices during the year, and in 86 cases legal proceedings were employed to enforce compliance therewith. At the end of the year, the Department was up to full strength in the establishment of District Public Health Inspectors for the first time in 13 years. New legislation passed this year affecting this section of the department included the Animal Boarding Establishments Act, 1963, and the Offices, Shops and Railway Premises Act, 1963. Aspects of the work of the inspectors not covered in the following paragraphs will be found in the statistical appendix, pages 66 to 68. Animal Boarding Establishments Act. 1963 This Act which received the Royal Assent on 31st July 1963, and comes into operation on 1st January 1964, requires boarding establishments for animals to be licensed by the Council on payment of a fee and provides for such conditions as the Council deems necessary to be specified in the licence together with powers of inspection to ascertain whether the conditions are being complied with. There is one such establishment in the Borough. During the year the Council adopted a set of conditions subject to which a licence may be granted, and fixed the licence fee at ten shillings. Certificates of Disrepair (Rent Act. 1957) 1 During the year 8 applications under the Rent Act 1957 were received from tenants for Certificates of Disrepair, four certificates being issued. Clean Air Following the issue at the end of the year of a White Paper on the Minister of Power's reassessment of the probable availability of smokeless fuels during the next decade compared with the likely demand, the Minister of Housing and Local Government in Circular No.69/63 outlined revised arrangements consequentially considered necessary. Open grate gas coke may not be available, whereas there will be plenty of hard coke, so that the installation of heaters capable of burning the latter should be encouraged with the aid of grant on the full expenditure which hitherto was not approved. It is also recommended that householders choosing electric heating should be encouraged to install the storage type of heater,which takes power at off-peak periods, rather than the direct type which gives out heat as soon as switched on and causes peak load supply difficulties. These recommendations will be put into effect in future Smoke Control Orders. 27 Provisions for other changes made desirable by the fuel situation and requiring legislation are being made in a Housing Bill at present before Parliament. These include easing the restrictions on grants towards conversions in dwellings erected after the Act came into force; provision for Ministry contributions towards discretionary grants made by local authorities; withholding grant for any class of appliances which it is considered would strain fuel resources; grants towards provision of gas and electric pokers where no other works are involved; and power to approve expenditure retrospectively. The Borough's fourth 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 1963. At the end of the year the Minister's confirmation of Area No.5 was awaited. Area No.4 comprises 157 acres with 2,960 dwellings and 269 commercial, industrial and other premises. A survey of the area revealed that the number of heating appliances in dwellings which were in regular use and which required replacement or adaptation, was 800. There is, in the Public Health Offices, a Smoke Control Exhibition open to the public in which are 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 when the Order comes into operation. Facing this page is a map showing the Smoke Control Areas established in the Borough. Difficulty in obtaining supplies of solid smokeless fuel or indeed any smokeless fuel during the severe winter created many problems, in particular to old people living alone above the first floor of tenement dwellings. Advantage was taken by some traders of the difficulties of delivery by selling at exorbitant prices small quantities of fuel in paper bags. The Council supported a proposition made by a neighbouring borough council that local authorities should be given powers to establish small depots from which to sell solid fuel in emergencies and so obviate the need for consumers having to buy bagged fuel in small quantities at high prices. 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 20 premises. 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. 28 Details of visits and inspections made by the Smoke and Factories Inspector are given on page 69. Consumer Protection Act. 1961 In order to prevent or reduce risk of death or injury, this Act authorises the making of regulations imposing safety requirements relating to any prescribed class of goods. The Oil Heaters Regulations 1962 made under this Act impose such requirements in respect of domestic kerosene burning space-heaters manufactured after 1st June 1962. The Heating Appliances (Fireguards) Regulations 1953 require fireguards of prescribed standards of construction and. fitting to be fitted to gas and electric fires and oil heaters. The prescribed tests were applied to 14 electric, 2 gas and 1 oil appliances, all of which proved satisfactory. Drainage and Sanitary Conveniences Considerable use is made of Section 25(1) of the London County Council (General Powers) Act 1955, whereby a Public Health Inspector can serve a notice requiring an 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 237, the Council executing the work in 69 instances. A Summons taken out for failure to comply with a notice served under Section 40 of the Public Health (London) Act 1936 for the repair of a defective drain, and another for failure to comply with a notice served under the London County Council (Drainage) Byelaws, resulted in fines amounting to £15 with costs of £3.9.0 being 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, and furnish the prescribed particulars with respect to, matters under the Act administered by the Council. Particulars will be found in the appendix, pages 70 and 71. Hairdressers and Barbers Persons shall not carry on the business of barber or hairdresser unless they and their premises are registered by the Council. The number of premises and persons registered at the end of the year were 120 and 132 respectively. Inspections numbering 282 were made during the year to ensure that the Byelaws made by the Council for the conduct of these premises were not infringed. 29 The Council supported representations made by another borough council to the Metropolitan Boroughs Standing Joint Committee, that powers be sought Where by a local authority can refuse to register premises considered unsuitable Legal Proceedings Legal proceedings instituted during the year (other than those relating to food premises), showing penalties imposed, were as follows: No of Summonses Fines Costs £ s d £ s d Factories Act 1961 5 — 3 0 0 Housing Act 1957; Overcrowding in Houses in Multiple Occupation 49 165 0 0 67 16 0 Obstruction of Public Health Inspector 2 35 0 0 8 18 0 Public Health (London) Act 1936: 72 12 0 0 203 6 0 Non-compliance with Nuisance Orders 3 10 0 0 9 0 0 Defective drains (Section 40) 1 5 0 0 3 9 0 Keeping unlicensed Common Lodging House (Section 156) 1 5 0 0 3 7 0 London County Council (Drainage) Byelaws 1 10 0 0 — London County Council (General Powers) Act 1959, Section 22 (Using unlicensed land for siting caravans) 11 49 LO 0 21 2 0 Prevention of Damage by Pests Act 194-9 Section 4 (Rat harbourage) 1 5 0 0 3 13 0 Stepney Borough Council Byelaws: (Yard Paving) 4 15 0 0 10 15 0 (Staircase Lighting) 2 7 0 0 - 1 - - Totals: 153 318 10 0 334 6 0 (Details of other legal proceedings taken will be found on pages 44 to 46) • 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) Hostel for Women, Hopetown Street (Salvation Army) 228 Women The premises are inspected regularly, sometimes in the la to evening? 30 to ensure that the byelaws relating thereto are complied with. Legal proceedings were issued against a person for keeping a common lodging house without a licence. The summons was proved, the defendant being fined £5. Lodging Houses - Seamen Two such premises in the Borough provide accommodation for 388 seamen, as follows:- Sailors Home & Red Ensign Club, Ensign Street and Dock Street. 2A3 Seamen Empire Memorial Hostel, 747, Commercial Road. 145 " Regular inspections, including some at night, are also carried out at these premises. 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; • namely, Tower House and Providence Row Night Refuge. Tower House (formerly known as "Rowton House"), which was opened in 1902, provides accommodation for 694 men and Providence Row Night Refuge for 77 men, women and children. Milk Bottles Attention was given to the problem created by the abandoning of large quantities of empty milk bottles on vacant sites in the Borough and, following discussions at a meeting with various representatives of the dairy trade, with their co-operation satisfactory arrangemements were made for the collection and disposal of abandoned bottles. Motor Cycles (Protective Helmets) Regulations. 196? These Regulations, which came into operation on 18th November 1963, consolidate with amendments former regulations and prescribe British Standards Specifications to which protective helmets must conform when sold or offered for sale. Gale of helmets not conforming with the Standards constitutes an offence under Section 221 of the Road Traffic Act 1960. Five helmets examined at a shop in the Borough were found to conform to the prescribed standards. Noise Abatement Act. 1960 The London County Council (General Powers) Act 1937 made provisions for excessive, unreasonable or unnecessary noise which is injurious or . dangerous to health to be a noise nuisance which may be dealt with summarily under the Public Health (London) Act .1936. The Noise Abatement 31 Act 1960 amended the provisions to 'any noise which is a nuisance' and included vibration within the term. The Act also restricts the operation on the highway of loudspeakers (which includes ice-cream vendors' chimes). The frequency with which complaints of noise nuisance were received this year showed a marked increase. The group giving the greatest cause for complaint were transport contractors depots - particularly where operations are carried on throughout the night. Noises complained of were revving engines, shouting instructions to drivers, loading and unloading. Other complaints referred mainly to industrial processes. Representations made to the proprietors of the firms concerned usually had the desired effect. In one instance, a formal notice under the Act was served. An occupier of a flat was summoned under the Act for committing a noise nuisance to the annoyance of neighbours, the summons being adjourned sine die on an undertaking being given not to commit a further nuisance. Notices Served Notices served during the year under the various Acts and Byelaws, are as follows:- Public Health (London)Act 1936, Section 82 1,824 Do. „ 40 49 Do. „ 106 1 Do. „ 109 22 Factories Act 1961 107 Prevention of Damage by Pests Act 1949 41 London County Council (General Powers) Act 1954 (Dustbins) 78 London County Council (General Powers) Act 1955 (Stopped-up Drains, etc.) 237 Noise Abatement Act 1960 1 Shops Act 1950 23 London County Council (Drainage) Byelaws 46 Do. (Poultry Slaughterhouse) Byelaws 9 Stepney Council (Staircase Lighting) Byelaws 21 Do. (Yard Paving) Byelaws 31 Do. (Hairdressers) Byelaws 22 2,512 Outworkers Employers of outworkers in the Borough in certain specified occupations are required, by the provisions of Section 133 of the Factories Act 196.1, to supply the Council, in February and August each year, with a list 32 of the names and addresses of all persons employed by them as outworkers during the preceding six months. Where the outworker resides in another area, the Council is required to forward details to the local authority for that area. It is an offence to fail to submit lists of outworkers or to give out work to be done in a place which is considered to be injurious to the health of the persons employed therein. No such contraventions were discovered during the year. There are 440 premises on the Register, 22 less than last year. Number of firms in the Borough employing outworkers 88 11 „ outworkers residing in, and employed by firms in, the Borough 184 „ „ outworkers residing outside, and employed by firms in, the Borough 425 „ „ outworkers residing in, and employed by firms outside, the Borough 256 Offensive Businesses There are 19 offensive businesses in the Borough. The Register comprises the following premises:- Dresser of Furskins (l); 34/38, Brodlove Lane Poultry Slaughterhouses (18): 75, Hessel Street 19, Bell Lane* 7, Leyden Street* 28, Burslem Street 10b, Leyden Street* 161, Cannon 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* 21/24, Hessel Street* 10a, Monthope Street 36, Hessel Street 82, Stepney Way (* Establishment Orders on these premises are subject to renewal from time to time.) The premises were inspected on 77 occasions and nine notices served relating to contraventions of the Byelaws. Offices. Shoos and Railway Premises Act. 1963 This Act, which received the Royal Assent on 31st July, makes provision for securing the health, safety and welfare of persons employed in offices, shops and certain railway premises. When the Act comes into operation, those sections of the Shops Act 1950 dealing with arrangements for the health and comfort of shop workers will be repealed. Enforcement duties under the Act are imposed upon local authorities in respect of the majority of the provisions, upon fire authorities for the 33 appropriate provisions and upon H.M. Inspector of Factories in respect of the remainder. In certain types of premises all the provisions are dealt with by the Factory Inspector e.g., Crown properties, factory and railway premises, schools,and premises occupied by local authorities. The duties of the Council under the Act have been placed on the Public Health Inspectors. Although the Act does not come into operation until 1964, one of the district public health inspectors was appointed in September to survey, with the assistance of pupil-public health inspectors, premises in the Borough which are subject to the provisions enforceable by the Council. By the end of the year 1,120 visits to offices and shops had been made to ascertain conditions existing, to advise on the provisions of the Act and likely requirements of the Regulations not yet made so that preparations could be put in hand for the execution of any necessary works. Where contraventions of existing legislation affecting the premises were ascertained appropriate action was taken which included the service by this Inspector of notices under the Shops Act 1950. (See Table on page 67). Pet Animals Act. 1951 There are 5 licensed pet shops in the Borough including stalls in markets. No contraventions were discovered of the conditions subject to which the annual licences are granted by the Council. Pharmacy and Poisons Act. 1933 The sale of certain poisons (chiefly those used for sanitary domestic and horticultural purposes) by persons other than pharmacists is subject to the provisions of this Act and the Rules made thereunder. A person selling such poisons must have his name entered on a List kept by the Council, and must make application annually for re-entry and pay a prescribed fee. Compliance rust be made with the requirements relating to storage, transport, labelling, and containers. There are 53 names on the Council's List, 67 visits to premises being made during the year. Radioactive Substances Act. 1960 As from 1st December 1963 persons who keep or use radioactive materials are, unless exempted, required to register with the Minister of Housing and Local Government and obtain authorisation from him for the accumulation or disposal of radioactive waste. Certificates of registration issued under Section 1 and authorisations under Sections 6 and 7 of the Act were issued by the Minister on four promises in the Borough, namely; the London Hospital Medical College, Queen Mary College, the Royal Mint Refinery and Messrs. Truman, Hanbury & Buxton's Brewery. 34 Bag Flock and Other Filling Materials Act. 1951 This Act, designed to secure the use of clean filling materials in articles which are upholstered, stuffed or lined, requires the licensing or registration (as the case may be) of premises where rag flock is manufactured or stored or filling materials are used Regulations made under the Act prescribe standards of cleanliness for filling materials. Premises registered for the use of filling materials number 13, whilst two premises are licensed for the storage of rag flock. Five samples of filling materials were obtained from registered premises during the year. The Analyst reported excessive chlorine content in a sample of woollen felt, and excessive trash content in one of cotton felt. The vendors were cautioned for the offences. Refuse Disposal The Public Cleansing Officer has kindly supplied the following information on refuse disposed of during the year:- House and Trade Refuse - 37,143 tons Street and Market Refuse - 9,505 tons Where possible refuse collection is carried out in the Borough by means of "Paladin" containers, mainly from blocks of flats. This method was adopted in 1955 since when 950 of these containers have been installed, which involve 2,150 collections per week. The Cleansing Department carried out 24,014 cleansings of 5,093 street gullies by means of mechanical gully emptiers. Rodent Control In accordance with the requirements of the Ministry of Agriculture, Fisheries and Food, statistics on rodent control work for surface infestations carried out by the Department during the year were submitted to the Ministry. In this period 1,669 dwellings and other premises were inspected and 1,101 found to be infested with mice or rats. Treatments were carried out by the department's rodent control staff to 973 properties found to be infested, the charges for servicing business premises amounting to £346. By the implementation of Section 4. of the Prevention of Damage by Pests Act 1949, under which 41 notices were served during the year, it was 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 owner of a vacant site for failing to comply with one such notice, requiring the removal of refuse 35 forming rat harbourage. The summons was proved, the owner being fined £5 and ordered to pay £3.13.0 costs. In consequence of the failure of the owner of another site to comply with a similar notice, the Council exercised its powers to carry out the work in default, the cost of £150 being charged to the owner. Following discussions between the Technical Officer of the Infestation Branch of the Ministry of Agriculture, Fisheries and Food and officers of the Borough Engineer's and Public Health Departments, a reappraisal of sewer rodent control work in the Borough took place. In consequence thereof, and of subsequent recommendations submitted by the Ministry, the work of sewer disinfestation and its administration was varied from 1st April this year, so that instead of disinfestation treatments in sewers being carried out by the Borough Engineer's staff twice annually, using bait prepared by the Public Health Department's staff, a continuous treatment throughout the year is now given by a team of three men (two sewermen and one rodent operative), acting under the supervision of this department's Rodent Investigator. Two treatments were completed between 1st April and 11th November of all the sewer manholes and side entries, numbering 1,603, in the Borough. The efficacy of the treatment is evidenced in that on the first treatment the poison-bait was taken completely in 712 instances compared with 180 on the second treatment, and the number of major surface infestations of common rats was 12 this year compared with 6 last year. A copy of the Return furnished to the Ministry is on pages 64 and 65. 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. Shoos Act. 1950 The number of premises in the Borough covered by the provisions of the Shops Act 1950, is 3,211. Under certain sections of this Act the Council is empowered to ensure that in shops where people are employed suitable sanitary conveniences, means of temperature, ventilation and lighting are provided and maintained, as well as facilities for washing and for taking meals. Where sanitary or washing facilities cannot be provided on the premises but are otherwise conveniently available, the Council may grant certificates of exemption from these provisions. A temporary certificate of exemption, granted in 1962 in respect of a shop premises, was extended for a further period of six months pending completion of rebuilding. 36 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 reinstated or repaired, following action taken by the department, totalled 264. and the Metropolitan Water Board was notified on 21 occasions where wastage of water took place. During the year, 28 notices were received from the Metropolitan Water Board of withdrawal of water supply; in 20 premises for nonpayment of rates and in 8 because of defects in the service. The Council expressed itself in favour, in common with all other metropolitan borough councils, of the Metropolitan Water Board being asked to introduce fluorides into the water supply. Water Certificates Water certificates as to new dwellings having a proper and sufficient supply of water were issued under the provisions of the Public Health (London) Act 1936, in respect of 826 dwellings. Wells Bacteriological aid chemical analysis 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 in default of owners, from whom the costs incurred were recoverable, as follows:- Rat harbourage removed and preventive measures taken (Section 4, Prevention of Damage by Pests Act 1949): Site of 3 premises £150. 0. 0. Dustbins supplied (Section 12, London County Council (General Powers) Act 1954): 23 premises (32 bins) £67.11.8. Stopped-up drains cleared (Section 25(1), London County Council (General Powers) Act 1955); 69 premises £230.16.9. Defective drains repaired (Section 4-0, Public Health (London) Act 1936): 2 premises £24-6.15.9. 37 IV. HOUSING Clearance Areas During the year two Clearance Areas, involving ten houses, were declared by the Borough Council. Closing and Demolition Orders The Council made a Demolition Order in respect of a disused factory used for dwelling purposes. On appeal, a Closing Order was substituted for the demolition order. Appeals lodged against the refusal by the Council to permit three basement flats - the subject of closing orders to be used for storage purposes were dismissed. Overcrowding During the year 28 cases of alleged overcrowding in dwellings were investigated, 24 of which were confirmed and referred to the London County Council. Overcrowding in houses-in-multiple occupation is. referred to later in the Report. Fifteen overcrowded families were rehoused by the London County Council and five by the Borough Council. The Register of overcrowded premises was reduced during the year from 183 to 174 families. Underground Rooms There are approximately 1,350 underground rooms in the borough used for living or sleeping purposes, of which 1,300 are unfit. During the year seven rooms were closed. Town ?nd 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 20 such applications were carried out during the year. Applications for Rehousing At the end of the year, there were 2,614 applications for rehousing on the Housing Manager's register. These included the tenants of 184 Council dwellings who desired larger or smaller accommodation. Preferential Housing on health grounds Applications for preferential housing on health grounds investigated during the year, numbered 54. 38 LONDON COUNTY COUNCIL MOBILE HOMES (Photo by T, J. Golden) Mobile Dwellings (including Caravans) During the year site .licences for 183 Mobile Dwellings erected by the London County Council, were granted under the provisions of Section 22 of the London County Council (General Powers) Act, 1959. The licences are issued for a period of three years, subject to further application on a year-to-year basis. (See photograph facing page 38). The Council agreed, following a recommendation of the Public Health Committee, that in future vacant sites in Council development areas be fenced with corrugated iron instead of chestnut paling, which experience had proved was soon damaged allowing lorry drivers to fly-tip refuse on to the site and caravan dwellers to occupy them. Summonses numbering 18 were taken out against caravanners who contravened this section by stationing their caravans on land which was not licensed for the purpose. Eleven summonses were heard, resulting in fines of £49.10.0 with costs of £21.2.0. A summons brought against the owner of a fairground under the Council's Pleasure Fair Byelaws was dismissed, the Magistrate finding the case not proven. Houses in Multiple Occupation A large proportion of the time and effort of officers in the department's Housing section was devoted this year to use of the Council's powers under the provisions of Part II of the Housing Act 1961 and Regulations made thereunder. Despite the lengthy procedure involved in making Management Orders, it was found possible to make Orders affecting 71 premises and to serve notices of intention to make orders in respect of 60 other houses. An appeal lodged against the making of one management order was subsequently withdrawn. Necessary works to remedy conditions caused by neglect of management were completed in 37 houses -in one case by the Council in default, and were in hand in many other premises at the end of the year. In all, 193 houses were being dealt with by formal or informal action at the end of the year. Following action being taken under the provisions of Part II. of the Housing Act .1961, notices to quit were served in some cases on occupants of lodgings. This caused some concern to the Council, and a reference was submitted to the Metropolitan Boroughs' Standing Joint Committee with a view to representations being made to the Minister of Housing and Local Government to introduce legislation to afford a reasonable measure of protection to tenants and their families. Subsequently, this was brought to the attention of the Member of Parliament for the constituency with the request that he take up the matter in connection with the Housing Bill now before Parliament. The Housing Assistants were asked to give evidence on certain facts to the Rent Tribunal in several cases where it was alleged that exorbitant rents were being charged to occupiers of houses-in-multiple occupation. Notices numbering 45 were served under the provision of Section 90 of the Housing Act 1957 for permitting overcrowding in houses-in-multiple occupation. 49 Summonses were issued in respect of 21 premises for contravention of notices, resulting in fines of £165 with costs of £67.16.0 being imposed. Many visits in the late evening and early hours of the morning are necessary to check that these notices are being complied with. The provisions of Section 19 of the Housing Act 1961, relating to the making of directions to prevent or reduce overcrowding, are also being implemented. Standard Grants and Improvements In conjunction with officers of the Borough Engineer and Surveyor's Department, the Housing Inspector inspected 12 premises, regarding which applications had been made to the Council for standard or improvement grants. Part of a block of dwellings, erected in 1887, were modernised by the owners with financial aid from the Council. Owners of other blocks of flats are preparing similar schemes. New Housing During the year 826 new permanent dwellings were completed in the Boroughs 115 by the Borough Council, 705 by the County Council, and six by private enterprise. (See appendix, page 79). A total of 9,256 new permanent dwellings have now been constructed in the Borough since the war; 6,220 by the London County Council, 2,732 by the Borough Council, 69 by the Corporation of London, and 233 by private enterprise. A photograph of some 17-storey blocKS recently erected, facing this page, illustrates Stepney's changing skyline. At the end of the year units of accommodation owned by the Council numbered 4,439, comprising 4,030 erected by the Council and 409 formerly requisitioned and other premises purchased. Statistics A Summary of inspections made by the Housing Inspector is given on page 69 and further Housing statistics will be found on pages 72 and 73. 40 LONDON COUNTY COUNCIL STIFFORD ESTATE (Photo by L.C.C.) V. INSPECTION AND SUPERVISION OF FOOD The Port of London Health Authority made representations to the Minister of Health during the year concerning the boundaries of that Authority and its functions in relation to imported food, and contended that it should have the powers of a food and drugs authority throughout the area of the Port of London, Several meetings of officers of the riparian authorities took place to consider these representations by the Port Health Authority for extension of powers, and a meeting called by the Minister of Health of all the interested parties was also attended late in the year. The matter was still under consideration at the end of the year. The Food Standards Committee which advises the Minister of Agriculture, Fisheries and Food and the Minister of Health on the exercise of their powers under the Food and Drugs Acts to control the composition, description, labelling and advertising of food for the protection of the consumer, issued a report during the year recommending that standards of minimum meat content should be laid down for meat pies and meat and vegetable pies. Other reports published by the Committee were concerned with the Antioxidant in Food Regulations 1958 and the Emulsifiers and Stabilisers in Food Regulations 1962. The Minister of Agriculture, Fisheries and Food gave notice that it was proposed to make regulations under the Food and Drugs Act 1955 to prohibit the addition of certain specific chemicals to raw or unprocessed meat; it was also stated that the Food Standards Committee had been asked to examine the leakage of chemicals from food containers, packing materials and pointing into the food. The Council supported representations made by another borough council to the Metropolitan Boroughs' Standing Joint Committee to seek powers for the compulsory registration of all premises where food is handled. The sampling of glucose and invert sugar ceased to be carried out by H.M. Customs and Excise on 1st October this year, from which date it became the duty of the Food and Drugs Authority. The Food Hygiene (General) Regulations 1962, which prohibits the peeling of onions undertaken in connection with a food business on domestic premises, came into operation on .1st January this year. Pesticide Residues in Food The post-war era has seen a large increase in the use of man-made chemicals both as antibiotics in therapy against disease and as insecticides, rodenticides and fungicides. It cannot be denied that immediate benefit to man ensues from the exhibition of these artificial agents; . however a warning note has been sounded by ecologists working in many scientific disciplines. To upset the balance of nature in one field 41 42 always produces repercussions elsewhere - often to the disadvantage of man. Further, these chemical agents, whilst controlling insect or slug populations, are taken up in the 'food chains' later to be absorbed byother animals and also by man. The cumulative result of these minute doses can be assessed only after many years. As is known from other work, deleterious effects may follow such prolonged exposure. Recent surveys demonstrate that chlorinated hydro-carbons - D.D.T. is one are stored largely in the body fat and the average concentrations estimated post-mortem are rising year by year. Another sequel to the extermination of slugs and insects is to deny normal predators, such as birds, access to their food reservoirs - hence it is alleged that 'no birds sing' in many woods of our country. The advantages accruing from the use of chemicals having been acknowledged, and the point taken that some warnings are over-dramatised, it would seem that more care and supervision is essential to guard the public health. Stringent provisions exist to combat other risks, for example by restricting the use of certain colouring matters in food, and, based on the same rationale, restrictions are now to be enforced in respect of some chlorinated hydro-carbons. Alternative forms of biological control include the release of radiation-sterilised males into insect communities, or odour attractants, to concentrate insects for ease of disposal. These appear to have a lesser health hazard and their adoption is encouraged. The Ministry of Agriculture, Fisheries and Food, amongst others, undertakes the testing of foodstuffs for pesticide residues. This Council, as a food and drugs authority, also has a responsibility particularly with the large wholesale fruit and vegetable market within its boundaries. Over the year, a selection of home and foreign grown produce obtained at the point of sale was sent for testing by the appointed analyst to determine the degree of contamination with pesticide residues and all were found to be satisfactory. The tests are expensive and time-consuming, involving a special study of the effects on colonies of a selected breed of flies exposed to the washed-off residues. Home oroduce examined included cabbages, peas, carrots, cauliflowers, plums and tomatoes; the foreign produce consisting of Spanish onions, melons, grapes, pomegranates, and French and Tasmanian apples. Mould in Tomato Paste It was agreed at a joint meeting of the Port Health Authority and the Riparian authorities that imports of tomato paste, Particularly from Italy, should contain not more than 60 percent of fields oositive by the Howard Mould Count, especially as there seems to be a strong relationship between high mould counts and the presence of excessive fragments of rotten tomato in the paste. The limit of 60 percent was to be applied until the 1963 crops were canned, when a limit of 50 percent would be f ixed. LIQUID EGG PASTEURISING PLANT (Photo by T.J. Golden) In Stepney, 23 samples of tomato paste and 8 samples of canned tomatoes examined were found to come below the limit of 50 per cent of fields positive. All imports of tomato paste are automatically detained at the wharves for sampling. Liquid Egg Pasteurisation The Borough lost its only milk pasteurising establishment during the year, and gained its first egg pasteurising plant. A firm of egg merchants, anticipating the coming into operation of the Liquid Egg (Pasteurisation) Regulations 1963, installed an egg pasteurising plant in a factory designed and erected for the purpose, where half a million eggs are being pasteurised daily. Illustrations of the process are shown opposite pages 42 and 44. The stainless steel equipment is simple in design and easy to operate, and does not need dismantling for cleansing purposes. Fifty women are employed in an air-conditioned, insect-proof room, breaking the eggs one by one, smelling them and looking for defects such as bloodspots, etc. Those which are unsatisfactory are rejected, the sound eggs falling into stainless steel containers. Each container of eggs is checked by a supervisor before being emptied into the bulk holder serving the pasteuriser. The liquid egg is then passed through a stainless steel filter so as to separate membranes, pieces of shell, etc., and after pasteurisation is conveyed either to tankers, each holding 2,000 gallons, or into 28-1b. tins. Any surplus is fed into a large sealed stainless steel holding tank. Desiccated Coconut Considerable quantities of desiccated coconut arrive at wharves in the Borough from Ceylon. In addition to being sampled for food poisoning organisms, the coconut is examined for condition. During the year, 211 bags and/or cases were detained and of these 41 were destroyed, 94 were released for sorting and reconditioning and. 76 released for oil extraction. Bacteriological examination of foodstuffs Samples submitted for bacteriological examination numbered 1,008. These comprised 480 samples of desiccatod coconut, 277 imported dried and frozen egg, egg albumen spray and crystals, 10 baker's albumen (substitute milk protein), 7 ice cream, 3 ice cream lollies, .1 gravy, 1 apricot jam, 1 milk pudding, 30 tuberculin tested (pasteurised) milk, 10 pasteurised milk, 10 sterilised milk, 1 sultanas, and 177 swabs taken from poultry premises. 25 of the egg samples were found to contain various salmonella organisms and the packages were detained under the Public Health (Imported) Food Regulations for re-export. Three samples of desiccated coconut contained salmonellae, the consignments being released for heat treatment wider supervision. 43 Food Hygiene (General) Regulations. 1960 Inspections of food premises by the Public Health Inspectors (Food) to ensure that the provisions of the Food Hygiene Regulations were being observed, numbered 3,906 during the year. Notices served requiring works to be done to comply with the Regulations totalled 354. No applications were made during the year for certificates exempting premises from complying with any of the provisions of the Regulations. Bakehouses and Bakers Shops Summonses issued against the proprietors of two bakers shops for selling bread containing foreign bodies, resulted in fines of £12 with costs of £8.13.0 being imposed. Catering Establishments There are 924 catering establishments in the Borough, including industrial canteens. The proprietor of a café was fined £15 with costs of £3.7.0 for selling buttered rolls, the "butter" consisting of margarine. Chemical sampling of foodstuffs Samples submitted for analysis to the Public Analyst numbered 380 for the year. The Report of the Public Analyst appears on pages 56 to 58. Export Certificates 115 certificates were issued in respect of the examination of a variety of foodstuffs exported to Canada, Denmark, Germany, Holland, Israel, Italy, Lebanon, South America, Spain, Sweden, Switzerland and the United States. Before certificates are issued an inspection of the foodstuffs for export is carried out, and on occasion samples are taken for analysis. Where necessary investigation is made into the method of production. Grocers Shops Legal proceedings taken against a grocer for selling a meat pie which was unfit for human consumption resulted in a fine of £10 with £5.5.0 costs. Another grocer was summoned for selling non-brewed condiment containing an excessive amount of lead, and was also fined £10 with £5.5.0 costs. Ice Cream There are 21 premises in the Borough registered for the manufacture of ice cream but only three 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 contraventions were found. Sixteen samples of ice cream submitted for chemical analysis showed an average fat content of 10.1 per cent. 44 BREAKING EGGS FOR PASTEURISATION (Photo by T. J. Golden) 7 samples were subjected to the Methylene Blue reduction test, with the following results:- Manufactured In Borough: Outside Borough Total Grade 1 5 (5) - (10) 5 (15) " II 2 (2) - (3) 2 (5) " III — (2) - ( -) - (2) " IV - (1) - (3) - (4) (Figures in parenthesis are for 1962) 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 6 £49. 0. 0. £23. 10. 0. Food Hygiene (General) Regulations 1960 2 (same premises) 4. 0. 0. 2. 0. 0. £53. 0. 0. £25. 10. 0. Cautionary Letters On the instructions of the Public Health Committee, cautionary letters were issued in respect of the following contraventions:- Sale of bread loaf containing resinous matter and charred dough. " bread loaf containing rodent droppings. " sweet lolly containing a metal bolt. " minced meat containing excess quantity of preservative. Failing to provide hot water for glass washing at a soft drinks stall. Margarine - Vitamin A Four samples of margarine analysed for vitamins A and D content were found to conform to the accepted standards. Licensing Act. 1961 Applications for the registration of clubs under the Act are dealt with by the Magistrates' Court, copies of the applications being sent to the Council for any observations they may wish to make. Public Health Inspectors visit the premises to report on their suitability as regards the requirements of public health and food and drugs legislation. Premises inspected and reported on during the year numbered 31. 45 Milk Samples Milk samples submitted for chemical analysis during the year numbered 54, including 18 taken at hospitals, schools and day nurseries in the Borough. The average fat and solids-not-fat contents of ordinary milk samples analysed were 3.70 and 8.53 per cent respectively, while those of the super-fatted variety were 4.70 and 8.84 per cent. Butchers and Poulterers Premises Bacteriological examination was carried out on 177 swabs taken from preparation tables, utensils, etc. in poulterers premises, with negative results. Two persons employed in a poulterer's shop were summoned under the Food Hygiene Regulations for smoking in a food room. Each was fined £2 with £1 costs. The sale of minced meat containing sulphur dioxide preservative in a butcher shop led to the institution of legal proceedings, the vendor being fined £2 with £1 costs. Public Health (Imported Food) Regulations. 1937-19A8 260 Detention Notices and 391 Release Notices were served under the Regulations. These affected a variety of foodstuffs including agar-agar, animal casings, cocoa, coconut, coffee, dried fruit, egg powder, ginger, gum tragacanth, lard, senna pods, spices, sugar and tea. Four consignments of animal casings, which arrived unaccompanied by the official certificates, were subsequently released on production of the certificates. A fifth consignment was re-exported. Sausages (Meat content) Analysis of 9 samples of pork sausages and 5 samples of beef sausages showed the average meat content to be 75.9 per cent and 65.8 per cent, respectively. 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 126 18 London Fruit Exchange and Spitalfields Market 106 10 Bishopsgate Goods Station 2 1 Do. (Train Ferry) 1 5 Other premises 37 8 Total: 274 2 46 About 80 tons of unsound food was allowed to be used for chemical or animal feeding purposes, 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 supervision, and removed by barge to a controlled tipping site in Essex. Approximately 1,500 Condemnation Certificates in respect of unsound food were issued in 1963. Unsound Food. Etc. - Complaints Complaints made by members of the public as to the alleged unsound condition, etc. of food, and which were investigated during the year, numbered 43. The complaints referred to:- Alleged unsound condition; Apricot jam 1, bread 3, cake 1, chicken 1, confectionery 2, corned beef 1, eggs 2, fruit and vegetables 1, liver sausage 2, meat 1, meat pies 3, meat and vegetable dinners 2, potatoes 1, salmon (canned) 1, tea 1. Alleged dirty condition and/or foreign body or deposit: Biscuits 1, bread 9, confectionery 1, dates 1, baby food 1, lobster balls 1, meat 1, peas 1, sultana roll 1, general foodstuffs 1. Not of nature or substance demanded: Chow mien 1, fish 1. Zeebrugge-Harwich Train Ferry 255 midnight or early morning visits and 79 other visits were made to Bishopsgate Goods Station for the purpose of examining 5,944 trucks of foodstuffs arriving from the following countries:- Austria 1 Trucks Mexico 20 Trucks Belgium 361 " New Zealand 1 " Bulgaria 1 " Roumania 124 " Canary Islands 6 " South Africa 1 " Denmark 14 " Spain 4 " France 8 " Sweden 1 " Germany 14 " Switzerland 20 " Holland 7 " Turkey 1 " Hungary 551 " U.S.A. 3 " Italy 3,367 " Yugoslavia 1,439 " The weight of the foodstuffs examined was 60,953 tons comprising: 38,795 tons fresh fruit and vegetables; 4,570 tons chilled and frozen 47 meat and offals; 10,543 tons canned meats and sausages, etc.; 3,413 tons bacon; 385 tons preserved fruits and vegetables; 2,872 tons butter, cheese and eggs; 55 tons biscuits and confectionery; 100 tons beef and pork lungs and hog and sheep casings; 76 tons pea flour; 32 tons assorted nuts; 31 tons fish; 31 tons wheaten flour; 26 tons crisp bread; 14. tons canned soups; 10 tons cooked poultry. Foodstuffs found to be unsound, and which were stopped and destroyed, amounted to 25 cwts. Yugo-Slav Chilled Beef There has been a big improvement in the condition of Yugoslav chilled beef arriving at Bishopsgate Goods Station via the ZeebruggeHarwich train ferry and, during the year, only 8 trucks of meat arrived out of condition. These were released for trimming, etc. under supervision at Smithfield Market. Betting and Gaming Act. 1960 Under the provisions of this Act, the Council issues permits in respect of amusements with orizes, applications for licences being referred to this Department for reports as to suitability of the premises, which are usually food premises. During the year 29 premises were inspected. Sanitary Accommodation in Refreshment Houses A notice was served (and complied with) on the proprietor of a cafe under the provisions of Section 25 of the London County Council (General Powers) Act, 1957, requiring the provision of sanitary accommodation in the premises for use of customers. 48 VI. PREVALENCE OF. AND CONTROL OVER INFECTIOUS AND OTHER DISEASES Weather Conditions January was exceptionally cold, in fact it was the coldest January in London since 1838. Snow lay throughout the month and there were ice floes on the Thames near London Bridge. February continued very cold, with snow or sleet falling on 20 days. Temperatures in March reverted to norma1, with much rain, April being typically changeable. May too was changeable and rather cool. It was the dullest and wettest June since 1958 but the Whit sun weekend was the sunniest for 14 years. July was dry and warmed up towards the end of the month. August and September including the Bank Holiday had dull, cold weather. A dry October with normal temperatures preceded one of the mildest Novembers on record, with fog on four days. The driest year for 10 years concluded, with a dry and rather cold December. Notifications The number of notified cases of infectious diseases (corrected for revised diagnosis and duplicate notifications) during the year, was 1,564. Table 15 on page 76 shows cases notified together with comparative figures over the last 10 years. A list of diseases which are notifiable in the County of London is shown in Table 18 on page 78. Liaison is maintained with general practitioners and hospitals in the area, and a monthly bulletin is circulated to them giving information of infectious diseases occurring in the Borough during the month, the number of claimants for sickness benefit obtained from the local National Health Insurance Office, and other relevant information from time to time. Cancer The number of deaths from cancer during the year was 240. Deaths from lung cancer numbered 71, being five more than in 1962. The male death rate from lung cancer in England and Wales increased from 567 per million population in 1952 to 908 in 1963, the female death rate being increased from 98 to 152 in the same period. The main conclusions of a United States Public Health Service Report on smoking and lung cancer correspond closely to the Report of the Royal College of Physicians, though couched in some respects in stronger terms. The former Report states that "Cigarette smoking is causally related to lung cancer in men: the magnitude of the effect of cigarette smoking far outweighs all other factors." The Children and Young Persons Act 1963, which comes into force on 1st February 1964., increases tenfold or more the penalties for selling 49 tobacco or cigarette papers to persons apparently under 16 years of age, the maximum fines now being £25 for the first offence, £50 for the second and £100 for the third and subsequent offences. Diphtheria One notification of diphtheria was received but was not confirmed. The number of Stepney children immunised at London County Council clinics, during the last 5 years, is as follows:- 1262 1962 1961 1960 1959 Completed primary course:- Children under 5 years 1,062 982 1,424 1,302 1,330 Children 5-15 years 335 208 489 437 318 Children given reinforcing injection 1,926 1,725 2,858 1,389 940 Swabs forwarded by general practitioners to the Mile End Group Laboratory, where bacteriological examinations are carried out on behalf of the Borough Council, numbered 26. Dysentery Notifications of cases of dysentery numbered 4-0, compared with 31 cases last year. Enteric Fever No cases of enteric fever were notified during the year. Erysipelas During the year 8 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 typhi-murium was isolated in one case. Malaria One case of malaria was notified. Measles Although 1963 was an epidemic year, notifications numbered only 1,012 compared with 1,906 in the previous epidemic year of 1961. Meningococcal Infection Three notifications were received during the year, and were was one daeth 50 Ophthalmia Neonatorum No cases of ophthalmia neonatorum were notified this year, the first time ever. Poliomyelitis No notifications of poliomyelitis were received. 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 52 notifications during the year, compared with 15 in 1962. Of these 16 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 compared with 33 last year. Sixty-eight scabies patients and contacts were treated by medicinal baths at the Branch Road treatment centre and their clothing disinfested, viz:- Males Females Children 26 19 23 The number of baths given totalled 85. Scarlet Fever There were 31 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. Notifications are frequently 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 under 15 years successfully vaccinated or revaccinated against smallpox at London County Council clinics, during the year, was 189. Tuberculosis The number of primary notifications of pulmonary tuberculosis received during the year was 105 compared with 91 last year, and the 51 number of non-pulmonary cases was 20 compared with 9 in 1962. The mortality rate for the year for pulmonary tuberculosis was 12 and for non-pulmonary nil per 100,000 of the population, compared with 5.6 and 0.7 respectively for England and Wales. (For details of register and notifications see page 77), It would appear that, judging from the names and addresses of persons notified as suffering from tuberculosis, 48 of the total notifications of 125 (38%) related to immigrants, mainly of Asian origin. The precise number of immigrants at risk is not known, but taking into account the Table in the Registrar-General's Report on the 1961 Census, which deals with the birthplace of residents of the Borough, the notification rate in Stepney among Asian and Middle-East immigrants is in the order of 12 per 1,000 compared with 0.9 in the remainder of the population. As stated in last year's Report, I am firmly of the opinion that a routine chest X-ray at or before the time of entry to the country of all immigrants is essential if we are to eradicate the disease from our shores. However, instead of positive measures being adopted in a forward approach, back-pedalling seems to be the order of the day. To illustrate, the High Commissioners for Malta and Cyprus have now ceased to enquire of the Council regarding housing accommodation in the Borough proposed to be used by intending immigrants from their countries. The Council suggested to the Metropolitan Boroughs' Standing Joint Committee that an endeavour should be made to extend this practice to all Commonwealth countries. The Committee took up the point with the Commonwealth Relations Office who felt that the suggestion was not practicable because the Commonwealth High Commissioners would not be aware of the intentions of their numerous nationals in this country to move into new accommodation in a particular area. Again, a pregnant woman with three children aged 5, 4 and 1 year, who were all in need of medical attention, landed at London Airport from Pakistan to proceed to a house-in-multiple occupation in the Borough, whose occupier had already been warned for permitting overcrowding in the premises. A Mass Radiography Unit of the North-East Metropolitan Regional Hospital Board carried out a survey in the Borough during May and June. Visits were paid to odging-housss and to various sites in the Borough, and the Unit was set up each Friday for 8 weeks at the Municipal Offices. Out of a total number of 5,901 persons X-rayed, 10 cases of tuberculosis were discovered, which required immediate treatment, and a further two which required close clinical supervision. In addition six persons X-rayed were found to be suffering from lung cancer. Significant cases of tuberculosis amounted to 2 per 1,000 persons X-rayed, the national figure being 1.4. per 1,000. The mobile survey of visits to various sites gave a figure of 1.7 52 significant cases of tuberculosis discovered per 1,000 persons X-rayed, whilst the weekly 'static' survey produced 3.4 cases per 1,000. 135 visits were made 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. 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. Committeg The Tuberculosis Care Committee decided at their meeting in March to extend the scope of their activities to include those patients attending the Chest Clinic who suffer from non-tuberculous chest diseases, and for this reason the name has been changed to "Stepney Chest Clinic Care Committee." The needs of the patients suffering from tuberculosis continue to be the Committee's main concern, but where hardship is caused through other chest conditions the same help will be available. Grants were made during the year for fares to visit patients in hospital, removal expenses, clothing, rent arrears and other emergency needs. In several cases help was given with the cost of electricity or fuel bills, where these were exceptionally heavy owing to illnes and the severe winter. The Committee provided a coach outing to Brighton for 30 patients in the summer, and at Christmas-time gifts were made to 50 patients ill at home. Whoooing Cough Confirmed cases notified during the year numbered 113. 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 194-6 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, 53 and in addition the signature of the vaccinating doctor must be verified by the Medical Officer of Health of the district. During the year, 979 signatures on certificates were verified as those of medical practitioners practising in Stepney and the certificates accordingly endorsed. Venereal Discuses The number of new cases attending the venereal disease clinic, domiciled in Stepney, shows a disquieting rise over a period of nine months this year compared with the same period in 1962 - an increase of 20 per cent in men and 38 per cent in women. New patients attending the clinic in the Borough for treatment during the last threequarters of 1963, with comparative figures for .1962, are given in the following Table:- MALES FEMALES Age April-December % April-December % Groups 1963 1962 Increase 1963 1962 Increase -16 4 2 100 11 - 16 1 - — 1 3 — 17 4 8 — 20 14 43 18/19 45 23 96 58 51 14 20/24 190 193 — 113 113 — 25/29 273 216 26 110 51 116 30 + 537 434 24 124 84 48 Totals: 1,054 876 20 437 316 38 Analysis of this Table demonstrates that the over-all rise is by no means attributable only to the young. The figures for the groups 17 years and under are too small to allow statistical verification but those for the age groups 25/29, and over 30 years, do show increases ranging from 24 to 116 per cent over last year's comparable data. The preventive approach is best concentrated on the younger age groups. Particularly,'health and sex education of the adolescent are of paramount importance in combatting this menace to the nation's health. Reference is made on page 18 to such measures taken by this Council although the part played by a sanitary authority which is not a health or education authority is somewhat limited. 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 236 21 3 Total: 260 The number of baths and treatments given amounted to 264.. 54 Disinfection Premises disinfected after infectious disease numbered 21, which included 7 for pulmonary tuberculosis. 5,269 articles of clothing and bedding were steam disinfected. Formaldehyde disinfection of 1,694. articles of clothing and 15 tons of rags for export was also carried out during the year, for which eight certificates were issued. The charges for export and other disinfections carried out amounted to £36. Disinfestation (bed bugs and other insect pests) The following is a summary of insect disinfestation work carried out by the Public Health Inspector (Disinfestation)1- General inspections for vermin 1,005 Attempted visits 117 Number of premises found verminous 429 " " revisits 64. " " miscellaneous visits 172 " " premises treated 586 Treatments referred to above included infestations for ants, bed bugs, cockroaches, fleas, flies, carpet beetles, spider beetles, woodlice, woodworm, clovermite, firebrats, larder beetles and silverfish. In addition, disinfestation of the furniture and effects of families rehoused by the London County Council was carried out on 21 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. Destruction of filthy or verminous articles Action was taken on four occasions during the year under Section 122 of the Public Health (London) Act, 1936, for the destruction of filthy or verminous articles removed from dwellings in the Borough. 55 SUMMARY OF PUBLIC ANALYST'S QUARTERLY REPORTS For the Year 1963 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 Deportment, Walworth Rosd, 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, 380 samples were submitted for analysis, 36 of which were purchased or taken formally and 344 informally. The samples are classified as follows:- 19 Alcoholic Spirits 1 Jailful 4 Beer, canned 1 Jelly Powder 5 Bread 1 Khus Khus 1 Bread Mix 2 Lard 25 Butter 2 Lime Cordial 3 Buttered Rolls 5 Margarine 1 Buttered Slices 3 Meat, canned 1 Cake 26 Meat, minced 3 Cake Decorations 54. Milk 1 Candied Peel 1 Mint in Vinegar 1 Cheese Sauce 1 Moong Beans 1 Cheese Spread 1 Mushrooms, canned 1 Choledyl Tablets 2 Non-brewed Condiment 3 Coffee Beans 1 Nutmeg 5 Condensed Milk 1 Olive Oil 2 Cooking Fat 1 Paan Leaves 1 Cornflour 1 Peanut Butter 1 Cream 1 Piriton Tablets 1 Curry Powder 1 Red Peppers,canned 1 Epsom Salts 2 Rice 2 Fennel Seed 1 Rose Hip Syrup 1 Ferraplex Tablets 12 Sausages 1 Fish, canned 3 Saveloys 1 Fish Paste 2 Smoked Salmon 2 Flavouring Essences 10 Soup, canned 7 Fruit 2 Soup Tablets 5 Fruit, dried 1 Suet 16 Fruit, canned 1 Sugar Confectionery 2 Fruit Drinks 66 Tea 3 Fruit Squashes 1 Tofranil Tablets 1 Ghee 23 Tomato Paste 1 Glauber Salts 2 Toothpaste 1 Ground Adoo 1 Turtle Meat, canned 1 Herb and Spice Mixture 5 Vegetables 16 Ice Cream 2 Vinegar 56 Of the samples analysed, 5 formal and 25 informal were found to be unsatisfactory as follows:- Article Formal or Informal Nature of irregularity Remarks Bread Informal Contained foreign matter. Vendor cautioned. Do. (2 samples) " Contained charred and soiled dough. No action. Do. " Contained mouldy and soiled dough. Vendor cautioned. Bread Roll " Contained foreign matter. Do. Butter " Contained 16.6% water. Formal sample satisfactory. Buttered Rolls Formal Spread with margarine. Vendor fined £15 with £3.7.0 costs. Do. " Do. Legal proceedings pending. Canned Mushrooms Informal Cans blown, contents decomposed. Analysed for cause of blowing: Importer informed. Coffee Beans Mouldy. Re-exported. Dried Apricots (5 samples) . " Contained sulphur dioxide in amounts varying from 2800-3900 parts p/million. Released for use in dried fruit salad mixture. Fluoride Toothpaste " Not labelled with active ingredient. Manufacturers gave undertaking to amend label. Minced Meat (2 samples) " Contained sulphur dioxide, 700 and 3000 parts per million. See following Formal samples. Minced Meat Formal Contained sulphur dioxide, 4350 parts per million. Vendor fined £2 with £1 costs. Do. " Contained sulphur dioxide, 600 parts per million. Vendor cautioned. 57 (Contd., Article Formal or Informal Nature of irregularity Remarks Non-brewed Condiment Forma1 Contained lead - 20 parts per million. Manufacturers fined £10 with £5.5.0 costs. Tea (3 samples) Informal Foreign odour. Released for industrial use only. Do. (2 samples) " Contained lead - 13 and 20 parts per million. ' Formal samples unobta inable. (Business given up stock exhausted). Do. " Contained lead - 20 parts per million. Formal sample satisfactory. Do. (3 samples) " Contaminated with hydrocarbon oil. Destroyed, or released for use under supervision. Milk. Milk samples submitted for chemical analysis numbered 54, including two of the superfatted variety. The average fat and non-fat solids content of the ordinary milk samples were 3.70 and 8.53 per cent respectively, whilst for the superfatted variety the composition was 4.70 and 8.84 per cent. The average composition of ordinary milk samples taken over the past 10 years, is as follows:- Year No. of Samples Examined Milk Fat % (Legal minimum standard 3.00) Non-fat Solids % (Legal minimum standard 8.50) 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 1963 52 3.70 8.53 58 APPENDIX of STATISTICAL TAB L E S 59 60 Table I TOTAL DEATHS BY CAUSE AND AGE OF STEPNEY RESIDENTS - 1963 (Registrar-General's Return) CAUSE OF DEATH ALL AGES Age Groups Total M F -1 1- 5- 15- 25- 35- 45- 55- 65- 75- 1 Tuberculosis-Respiratory 11 8 3 - - - - - 3 3 3 2 - 2 „ - Other - - - - - - - - - - - - - 3 Syphilitic Disease 4 1 3 - - - - - - - 2 1 1 4 Diphtheria — — - — — — — - - — - - - 5 Whooping Cough - - - - - - - - - - - - — 6 Meningococcal Infection 1 - 1 - 1 - - - - - - - - 7 Acute Poliomyelitis - - - - - - - - - - - - - 8 Measles - - - - - - - - - — — - — 9 Other Infective and Parasitic Diseases - - - - - - - - - — — - - 10 Malignant Neoplasm - Stomach 29 17 12 - - — - 1 - 3 10 8 7 11 „ - Lung, Bronchus 71 66 5 - - - - - 2 13 19 24 13 12 „ - Breast 21 - 21 - - - - - 2 3 8 4 4 13 " - Uterus 10 - 10 - - - - - 1 4 3 1 1 14. „ - Other 105 55 50 - - 3 - 1 1 13 26 38 23 15 Leukaemia, Aleukaemia 4 1 3 - - - 1 - - - 1 1 1 16 Diabetes 20 12 - - 1 - - 1 1 3 10 4 17 Vascular Lesions of Nervous System 112 48 64 - - - - 2 3 4 12 40 51 18 Coronary Disease, Angina 203 128 75 - - - - - 7 15 48 73 60 19 Hypertension with Heart Disease 28 15 13 - - - - - - 1 2 11 14 20 Other Heart Disease 110 55 55 - - - 1 2 2 8 9 32 56 21 Other Circulatory Diseases 59 30 29 - - - - 1 2 3 12 20 21 22 Influenza 10 4 6 - - - - - 1 - - 1 8 23 Pneumonia 98 52 46 10 - - 1 1 1 6 7 20 52 24. Bronchitis 136 99 37 2 - - - — - 5 17 47 65 25 Other Diseases of Respiratory System 22 18 4 - - - - - 1 1 6 2 12 26 Ulcer of Stomach and Duodenum 6 6 1 — — — - - - - — 2 4 27 Gastritis, Enteritis and Diarrhoea 4 1 3 1 - - - - - — - - 3 28 Nephritis and Nephrosis 8 6 2 - - - - 2 3 1 1 - 1 61 Table X (Continued) CAUSE OF DEATH all ages Age Groups Total M F -1 1- 5- 15- 25- 35- 45- 55- 65- 75- 29 Hyperplasia of Prostate 6 6 - - - - - - - 1 - - 5 30 Pregnancy, childbirth, abortion 1 - 1 - - - - 1 - - - - — 31 Congenital malformations 14 7 7 10 - 1 - - 1 — 2 - — 32 Other defined and ill-defined diseases 68 38 30 21 1 3 1 6 1 5 4 13 13 33 Motor vehicle accidents 12 7 5 - - — 3 — 1 — 2 2 4 34 All other accidents 25 18 7 1 2 1 1 2 — 3 7 4 4 35 Suicide 20 10 10 - - 1 2 5 5 5 2 - 36 Homicide and operations of war — — - - - - - - - - - - Males .. 704 - 30 3 3 4 13 27 62 144 221 197 Females .. - 514 15 1 6 5 8 11 36 65 137 230 GRAND TOTAL: 1,218 45 4 9 9 21 38 98 209 358 427 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 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 1963 - 57 - 88 12 932 12 1,077 1963 Pedestrians Motor Cyclists Pedal Cyclists Driver Other Road Users Total Killed 10 1 - - 1 12 Injured 333 159 106 153 326 1,077 62 Table 3 INFANT MORTALITY, 1963 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 - - - - - - - 1 1 - 1 3 (2) 7.5 Pneumonia - - - 1 - - 1 1 2 2 - 6 (4) 15.0 Gastro-enteritis - - - - - - 1 — — - 1 (1) 2.5 Congenital Malformations 1 1 2 - - 2 4 1 — 1 — 6 (4) 15.0 Premature Birth 13 2 15 — — — 15 - — — — 15 (13) 37.5 Asphyxia, Atelectasis 3 2 5 - - - 5 1 — — — 6 (3) 15.0 Meningococcal Infection - - - - - ~ — — 1 — — 1 (2) 2.5 Vascular lesions of nervous system - - - - 1 1 2 - - - — 2 (1) 5.0 Totals: 17 5 22 1 1 3 27 5 4 3 1 40 (33)+ 100.0 *Figures in parenthesis denote corresponding deaths in 1962. +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 ntage Deaths under 4 weeks of Total Infant Deaths 1959 17 11 4 32 13 45 71 1960 8 6 5 19 13 3.2 57 1961 25 4 2 31 9 40 77 1962 11 9 2 22 11 33 66 1963 17 5 5 27 13 40 67 63 Table 5 HOME ACCIDENT CASES REPORTED BY THE LONDON AMBULANCE SERVICE Accidents due to Falls 1963 1962 1961 1960 London Divn.5 London Divn.5 London Divn.5 London Divn.5 On stairs 961 73 998 57 1119 65 1221 69 From ladder 102 1 101 2 111 4 113 1 From chair 132 13 149 8 174 15 199 7 Outside (i.e. window, balcony, roof, etc.) 233 13 198 10 217 12 234 4 In garden 174 4 219 4 227 11 251 8 In bath 23 1 23 2 15 2 18 1 From one level to another (i.e. table, box, bed, etc.) 400 21 434 20 412 15 348 19 On same level (i.e. in room, over objects) 866 56 751 31 920 40 888 32 Unspecified 4009 207 3692 164 3261 170 2868 162 Total due to Falls: 6900 389 6565 298 6456 334 6140 303 Other Accidents Hit by object 189 9 221 12 202 5 184 8 Scalding from - teapot 140 7 53 2 45 1 53 4 - objects on cooking stove 52 - 136 5 123 4 108 1 Other boiling water 194 5 179 8 151 6 129 1 Electric shock 43 - 22 2 39 3 26 3 Poisoning (including foreign objects) 393 18 340 10 338 12 318 15 Gassing 294 30 192 17 165 14 137 12 Knife-like wounds (including spikes and cuts from glass) 319 27 326 13 337 24 321 11 Fires 267 14 185 8 178 16 141 11 Windows (trapping) 36 - 29 2 42 — 47 2 Suffocation 45 2 31 2 18 2 17 1 Unspecified 436 22 328 14 337 19 326 25 Total Other Accidents: 2408 134 2042 95 1975 106 1807 94 TOTAL - ALL ACCIDENTS 9308 523 8607 393 8431 440 7947 397 Table 6 RODENT CONTROL TYPE OF PROPERTY TOTAL Local Authority Duelling Houses (inc.Council Houses) All Other (including Business Premises) No. of properties in Area 41 26,307 7,598 33,946 No. of properties inspected as result of notification 2 699 205 906 No. of such properties found to be infested by:- Common rat Major — 2 3 5 Minor 1 314 84 399 Ship rat Major - - 2 2 Minor - - 1 1 House mouse Major 1 18 46 65 Minor - 355 47 402 No. of properties inspected in course of under the act - 430 227 657 No. of such properties found to be infested by:- Common rat Major — — 1 1 Minor - 62 10 72 Ship rat Major - - 1 1 Minor - - - - House mouse Major - 1 8 9 Minor - 34 11 45 No. of properties otherwise inspected - 96 10 106 No. of such properties found to be infested by:- Common rat Major - - - - Minor - 39 7 46 Ship rat Major - — — - Minor - - 1 1 House mouse Major - - - - Minor - 47 5 52 64 Table 6 (Contd.) Local Authority Dwelling Houses (inc.Council Houses) All Other (including Business Premises) TOTAL Total inspections carried out including re-inspections 2 1,316 473 1,791 No. of infested properties treated by Council 2 850 121 973 Total treatments carried out including re-treatments 2 981 240 1,223 No. of notices served under Section 3 of the Act:(a) Treatment (b) Structural Work (i.e. Proofing) — 14 25 39 No. of cases in which default action taken following Section 4 notice - - 1 1 Legal Proceedings - - 1 1 No. of "Block" control schemes carried out Nil Sewers - Maintenance Treatments Two complete treatments, comprising pre-baiting and poison baiting, using fluoroacetamide, were given to all sewer manholes and side entrances between 1st April and 11th November. Details are as follows:- Period Pre-Bait Poison Bait No. of Manholes Complete ‘Takes’ Partial ‘Takes’ No. of Manholes Complete ‘Takes’ Partial ‘Takes’ April 1 to July 31 1,592 1,189 283 1,472 712 738 August 1 to November 11 1,603 345 660 1,005 180 670 65 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 120 282 22 - Rag Flock Premises 15 31 - - Pet Shops 5 3 - - Offensive Businesses 19 77 9 - Pharmacy and Poisons Premises 53 67 - - Common Lodging Houses 3 - - 1 Seamen's Lodging Houses 2 13 - - Factories. Shoos. Etc. Mechanical Factories 2088 438 107 1 Non-mechanical Factories 150 14 - - Other Factories 125 15 - - Outworkers 440 7 - - Shops 3211 254 23 - Workplaces 912 10 - - Other Visits and Inspections Complaints and Nuisances 5811) House-to-house and Houses in Multiple Occupation ) 563) 1996 82 Disrepair Certificates 97 - - Drainage 4347 355 2 Infectious Disease and Contacts 210 - - Markets (weekend inspections) 32 - - Miscellaneous visits and inspections 1919 - — Revisits 6835 - — Attempted visits 1429 - - Totals: 2,465 2,512 86 66 Table 7 (Contd.) Rent Act. 1957: Certificates of Disrepair 1.- Applications for Disrepair Certificates 8 Notices of proposal to issue Certificates 7 Undertakings accepted 2 " refused - Certificates issued 4 2,- Applications for cancellation of Disrepair Certificates 3 Cancellations issued 3 " refused - 3.- Applications for Certificates as to Tcnant Landlord remedying of defects 1 10 Certificates issued - all defects remedied - 5 " " , - some defects remedied 1 4 Complaints Number received at Office 3,295 Dangerous Structures Number of premises notified to District Surveyor 73 Drains Number tested with smoke 783 " found defective 71 " plans on which observations submitted 188 Land Charges Number of premises reported upon 2,437 Public Houses Number of premises reported upon to Licensing Justices 44 Wastage of Water Number of premises notified to Metropolitan Water Board 21 Table 8 SUMMARY OF WORK OF THE PUBLIC HEALTH INSPECTOR (OFFICES & SHOPS) (September-December) Visits to Offices 451 „ „ Shops 669 „ „ Factories (Mechanical) 311 " " (Non-mechanical) 21 Referrals to H.M. Inspector of Factories 10 Notices served under Shops Act, 1950 90 " " " Factories Act, 1961 22 Informal notification under offices, Shops and Railway Premises Act, 1963 296 67 Table 9 SUMMARY OF REPAIRS Etc. CARRIED OUT UNDER THE SUPERVISION OF DISTRICT PUBLIC HEALTH INSPECTORS Dampness in rooms remedied 616 Premises where - New drains constructed 149 Drains reconstructed 27 Existing drains repaired 128 Drain obstructions cleared 326 Dustbins provided 110 Dwelling-rooms, passages, and staircase walls and ceilings repaired 488 Factories: New water-closets provided 5 Sanitary accommodation repaired 174 Other defects remedied 5 Floors repaired 237 Fireplaces and coppers repaired or renewed 50 Gullies, manholes provided or repaired 330 Light and ventilation improved or provided to rooms and. staircases 34 Roofs, gutters, rain-water pipes renewed or repaired 1,044 Rubbish accumulations removed 195 Sinks, baths and lavatory basins fitted 1,187 Soil and vent pipes provided or repaired 277 Staircases: treads, etc. repaired 75 Ventilation (under-floor) provided to rooms 3 Waste pipes provided or repaired 443 Water-closets and urinals: New provided 364 Compartments cleansed, repaired 320 Obstructions cleared 76 Flush apparatus repaired 241 Pans and traps fixed 392 Water supply: Cisterns cleansed, repaired 24 Defective supply or fittings remedied 264 Extra supply provided 16 Windows repaired 516 Yards and areas cleansed or paving repaired 91 Miscellaneous repairs 214 68 Table 10 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 1,494 " premises visited on complaint of Smoke nuisance 76 " notices served re Smoke nuisances (Section 16) 4 " Smoke observations 218 " applications for prior approval received (Sec. 3(2) 3 " notices of proposal to install received (Sec. 3(3) 12 " notices served under Section 12(2) - Adaptations 191 Factories Act. 1961 No. of visits to Mechanical Factories 61 " " Non-mechanical Factories 3 " notices served 9 " matters referred to H.M. Inspector of Factories 1 Table 11 SUMMARY OF WORK OF THE HOUSING INSPECTOR AND TECHNICAL ASSISTANTS Complaints 55 Sites, including Caravan sites 260 Housing Act 1957, Section 16 21 " Section 17 5 Improvement Grants and Standard Grants 12 Miscellaneous Inspections 246 Overcrowding 28 "Permitted Numbers" under the Housing Act 25 Premises inspected - Compulsory Purchase Orders 25 Premises situated in Clearance Areas 278 Town Planning applications 33 Underground Rooms 251 Houses in Multiple Occupation:- Number inspected 460 Informal notices served 193 Notices served of Intention to make Management Orders 140 Management Orders made 71 Notices served - Section .14, Housing Act 1961 11 Notices served of Intention to make Direction - Section 19 6 Directions made - Section 19 4 Notices served for Overcrowding - Sec. 90, Housing Act 1957 45 69 Table 12 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 150 17 1 Factories with mechanical power 2,083 499 97 Other Premises under the Act (Electrical Stations, Institutions, and sites of building operations and works of engineering and construction) 157 - - . Total 2,395 531 98 2. Cases in which Defects were found Particulars Found Remedied Referred to H.M. Inspector by H.M. Inspector Want of cleanliness 1 1 - 1 Overcrowding - - - - Unreasonable temperature - - - - Inadequate ventilation - - - - Ineffective drainage of floors - - - - Sanitary Conveniences: (a) insufficient 2 2 - 6 (b) unsuitable or defective 104 104 - 32 (c) not separate for sexes 7 7 - 9 Other offences against the Act (not including those relating to outwork) 9 - 9 - Total 123 114 9 48 3. Prosecutions Five summonses were issued against the proprietor of a factory for failing to maintain and keep clean sanitary conveniences and for absence of artificial lighting or indication for sexes. 70 Table 12 (Contd.) Part VIII of the Act - OUTWORK Section 133. Nature of Work No. of Outworkers in August List No. Cases of default in sending lists to the Council No. Prosecutions for failure to supply lists Wearing Apparel: Making, etc. 436 - - Cleaning and washing - - - Household linen - - - Lace, lace curtains and nets - - - Curtains and furniture hangings - - - Furniture and uphoistery - - - 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 1 - - Nets (other than wire nets) — - - Tents - - - Sacks - - — Racquet and Tennis balls - - - Paper bags - " - Making of boxes or other receptacles or parts thereof made wholly or partially of paper - - - Brush making - - - Pea picking - - - Feather sorting - - - Carding, etc. of buttons, etc. - - - Stuffed toys 1 - - Basket making - - - Chocolates and sweetmeats - - - Cosaques, Christmas stockings - -- - Textile weaving - - - Lampshades - - - Total: 440 - - Section 134. There were no instances of work found in unwholesome premises. 71 Table 13 HOUSING STATISTICS 1.- Inspection of dwelling houses during the year:- (1) (a) Dwelling houses inspected for housing defects (under Public Health or Housing Acts) 4,332 (b) Inspections made for the purpose 14,533 (2) (a) Dwelling houses inspected and recorded under the Housing Consolidated Regulations, 1925 nil (b) Inspections made for the purpose nil (3) Dwelling houses found to be in a state so dangerous or injurious to health as to. be unfit for human habitation 2 (4) Dwelling houses found not to be in all respects reasonably fit for habitation 1,534 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 248 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;- (1) Dwelling houses in respect of which notices were served requiring defects to be remedied 1,286 (2) Dwelling houses in which defects were remedied after service of formal notices (i) By owners 1,190 (ii) By Local Authority in default of owners 96 72 Table 13 (Contd.) (c) Proceedings under Section 17 of the Housing Act, 1957:- (1) Dwelling houses in respect of which Demolition Orders were made 1 (2) Dwelling houses demolished in pursuance of Demolition Orders 1 (3) Closing Orders made 1 (d) Proceedings under Section 18 of the Housing Act, 1957:- (l) Separate tenements or underground rooms in respect of which Closing Orders were made 7 (2) Closing Orders determined, the tenements or rooms having been rendered fit (Section 27) 2 (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 10 (2) Number of houses demolished in pursuance of Representations 61 4.- Housing Act, 1957: Part IV - Overcrowding:- (i) Number of overcrowded families on Register at the beginning of the year 183 (ii) Number of new cases encountered during the year (iii) Number of cases relieved during the year 33 (iv) Number of overcrowded families on Register at the end of the year 174 73 Table 14. SUMMARY OF WORK OF PUBLIC HEALTH INSPECTORS (FOOD) Type of Premises No. Visits or Inspections Notices Legal Proceedings Registered Premises Milk Distributors: Dairies 7 158 3 - Other 216 Licences in force under the Milk (Special Designation) Regulations, 1963 218 Ice Cream Premises: Sale 288 125 2 - Manufacture 21 Storage only 1 Prepared Food Premises: Meat 66 232 16 - Fish 34 Other Premises Bakehouses 32 287 16 2 Baker Shops 55 Butcher Shops and Stalls 98 253 48 1 Catering Establishments 924 1910 133 1 Fish Shops and Stalls 109 163 35 __ Greengrocers and Fruiterers 582 439 7 Grocers (Wholesale and Retail) 355 841 28 2 Public Houses and Off-Licences 235 131 6 - Poultry Dealers (excluding Butchers) 70 164 40 1 Railway Depots 4 335 — - Wharves 45 959 6 - Miscellaneous Food Premises 332 665 17 - Meat Vehicles - 147 - - Revisits — 877 - — Total ... 7,686 357 7 There are 2,791 food premises including stalls in the Borough. Some of the premises listed above are included under more than one trade category. 74 Table 14 (Contd.) Reasons for Visits or Inspections Food Hygiene (General) Regulations, 1960 3906 Surrender of Unsound Food 607 Merchandise Marks Act 149 Public Health (Meat) Regulations 316 Food Standards Orders 71 Labelling of Food Orders 72 Byelaws: Fish Curing and Fish Frying 103 Agriculture Produce Grading and Marking Acts 70 Pharmacy and Medicines Act, 1941 70 Sampling 297 Complaints 269 Shops Act 95 Samples of food taken during the year for chemical and bacteriological examination totalled 1,400. Summonses taken out numbered 8 affecting seven premises in the Borough: 2 summonses related to smoking in food premises; 2 to the sale of bread containing foreign bodies; one to minced meat containing excess preservative; one to non-brewed condiment containing excess lead; one to buttered rolls, the 'butter' consisting of margarine, and one to the sale of a meat pie which was unfit for human consumption. Analysis of Works carried out in Food Premises Lavatory basins installed 56 Premises where hot and cold water supply installed 61 " washing facilities for staff improved 6l " walls, ceilings, floors and windows cleansed 339 " natural lighting improved 17 " ventilation provided or improved 26 Sinks provided 13 Food storage accommodation provided 11 Refrigerators installed or repaired 10 Floors renewed or repaired 31 Shop-fronts improved 13 Protective covers provided for displayed food 15 Refuse bins provided 46 Miscellaneous 452 75 76 Table 15 NOTIFICATION OF INFECTIOUS DISEASES DISEASE 1963 1953-62 CORRECTED NOTIFICATIONS Notifications Admitted to Hospital Corrected Total 1962 1961 I960 1959 1958 1957 1956 1955 1954 1953 Ac.Encephalitis: Infective - - - 1 - - - - - 1 3 2 1 Post Infectious - 1 - - 1 1 - - - - - - - Ac.Poliomyelitis: Paralytic - - - 1 — 1 6 3 7 2 27 3 5 Non-paralytic — — - - - - 1 - 3 1 17 — 2 Diphtheria 1 2 — — — 1 2 1 — 1 — 1 1 Dysentery 40 14 40 31 48 140 87 145 34 115 147 117 67 Enteric Fever - - - - 1 1 2 1 1 5 1 1 1 Erysipelas 8 - 8 4 13 5 13 6 13 8 11 11 9 Food Poisoning 8 1 8 10 24 19 8 69 8 22 18 23 12 Malaria 1 1 1 1 - — — 2 2 — 1 2 2 Measles 1017 37 1012 438 1898 55 1344 199 1398 574 1834 144 655 Membranous Croup — — — — — — — — — — — — — Mening.Infection 3 3 3 - 2 2 2 3 6 5 5 6 8 Oph. Neonatorum - - - 1 1 2 1 5 7 3 20 10 24 Pneumonia 128 12 127 95 117 81 131 90 77 79 54 65 78 Puerperal Pyrexia 52 49 52 15 87 100 58 26 44 63 134 163 98 Scabies 44 1 44 33 50 61 49 53 51 43 39 29 22 Scarlet Fever 31 9 31 24 53 24 59 97 46 34 26 60 75 Smallpox - - - - - - - - - - - - - Tuberculosis: Pulmonarv 127 --- 105 91 99 110 135 136 120 116 149 160 167 Non-pulmonary 21 --- 20 9 9 9 14 9 18 11 23 23 13 Whooping Cough 113 10 113 18 31 223 76 36 76 235 147 125 249 TOTALS 1594 140 1564 772 2434 835 1988 881 1912 1318 2656 945 1489 Table 16 TUBERCULOSIS - NEW CASES AND DEATHS New Cases: 116 pulmonary cases were notified, being 105 primary notifications and 11 from Death Returns. 20 non-pulmonary cases were notified, all being primary notifications. Deaths; 11 persons died from pulmonary tuberculosis. There were no deaths from non-pulrionary 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. - 2 - 2 - 3 5 24 14 10 13 3 3 79 F. - - i 1 - 1 1 14 4 2 3 - - 26 Non-pulmonary M. - 1 - 1 1 2 2 2 4 - 1 - 1 14 F. - - - 1 - 1 1 2 - - - 1 - 6 (b) Deaths Pulmonary M. - - - - - - - - 2 1 3 2 - 8 F. - - - - - - - - 1 2 - - - 3 Non-Pulmonary M. - - - - - - - - - - - - - - F. - - - - - - - - - - - - - - Table 17 TUBERCULOSIS - VARIATIONS IN REGISTER Pulmonary NonPulmonary Total Cases M. F. M. F. (a) Cases on Register at 1/1/63 747 341 80 79 1,247 (b) New Cases 79 26 13 6 124 (c) Cases restored to Register 9 7 2 - 18 (d) Other cases added 57 30 4 - 91 (e) Removals 132 70 8 7 217 (f) Cases remaining on Register at 31/12/63 760 334 91 78 1,263 77 Table 18 DISEASES NOTIFIABLE IN STEPNEY 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. 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). *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)5 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, 1928/419 and 1937/35. 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 (Sol43); SI.1952/704. Typhus Fever P.H.(L)Act,1936 (S.192 & 304) Whooping Cough P.H.(L)Act,1936 (S.192); SRO.1938/1100 and 1940/205; SI.1948/420. *Notifiable to the Chief Medical Officer, Ministry of Health. +Notifiable to the County Medical Officer of Health for London. 78 Table 19 DWELLINGS ERECTED DURING 1963 Address No. of Dwellings (a) By BOROUGH COUNCIL Callahan Cottages, 11a, b and c 3 Dagobert House, 41-50 10 Louise de Marillac House, 1-46 46 St.Vincent de Paul House, 1-12 12 Sambrook House, 1-16 16 Stuttle House, 1-28 28 115 (b) By LONDON COUNTY COUNCIL Avis Square, 1-31 31 Bigland Street, 20-50, 62-88 30 Brancaster House, 1-8 8 Burley House, 1-44 44 Chapman Street, 1-20 20 Halliday House, 1-29 29 Jamaica Street, 131-177 24 Latham House, 1-97 97 Litcham House, 1-12 12 Longnor Road, 2-108 54 Moody Street 42 Pauline House, 1-73 73 Redmans Road, 73-103 16 Robinson House, 10-21, 31-42 24 Solander Gardens, 40-78 39 Stepney Green, 20-58, 62-128 54 Tinsley Road, 1-63 32 Troon House, 1-53 53 Walton House, 1-5, 14-20, 29-30 14 Whatman House, 1-8 8 Whitehorse Lane, Schoolkeeper's House 1 705 (c) OTHER Mile End Road, 193-7 3 Rhondda Grove, 18 3 6 Total: 826 79 Table 20 COMPARATIVE VITAL STATISTICS Year Population Live Births . Deaths Deaths under 1 Year Maternal Deaths Cancer Deaths Tuberculosis Deaths (All forms) No. Rate* No. Rate* 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 r y 71,980 1,271 17.6 1.243 17.2 66 52 5 3.7 171 2.3 85 1.8 1943 1944 72,920 73,030 1,371 1,306 18.8 17.8 1,368 1,425 18.7 19.5 73 77 53 56 3 0 2.1 0.0 188 185 2.5 2.5 107 96 1.4 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 1963 89,930 1,816 20.2 1,218 13.5 45 24 1 0.5 240 2.6 11 0.1 (C) Census. *per 1,000 population. + per 1,000 total births. 80 Table 21 PARKS AND 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 1.09 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 Fields 14.91 Limehouse Churchyard 2.00 Rope Walk Gardens, Christian Street .. 1.51 Shandy Park 3.18 Stepney Churchyard 9.75 Stepney Green 5.29 Wapping Gardens 3.56 Waterside Gardens 1.92 59.17 TOTAL (acres) 76.73 These Parks and Open Spaces represent 4.53% of the area of the Borough,which is 1,691 acres, exclusive of the area covered by the river, docks and canals. 81 Table 22 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, The Bernhard Baron Settlement, Henriques Street, E.l. Tuesday, 2-4 p.m. +Brady Friendship Club for Jewish Pensioners, The Brady Settlement, Hanbury Street, E,l. Wednesday, 2 - 4.30 p.m. +Dame Colet House, 29 Ben Jonson Road, E.l. Tues. & Fri., Noon - 2 p.m. "Golden Age" dub, 348 Commercial Road, E.l. Monday, 7-9 p.m. Lichfield Hall 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. +John Knox All-day Club for the Infirm, The Manse, Stepney Way, E.l. Wednesday, 11 a.m. -4 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.George's Mission Hall, 181 The Highway, E.l. Friday, 2 - 4.30 p.m. *St.Katharine's Club for Pensioners, The Royal Foundation of St.Katharine, Butcher Row, Ratcliffe, E.14. Mon. 2-4 p.m., Thur. 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.1. Tues.-Fri. 11.30a.m.-4.30p.m. The Vaughan Pensioners' Club, Johnson Street, E.l. Thursday, 2-4 p.m. *+W.V.S. Darby and Joan All-day Club, Blakesley Street, E.l. Mon.-Fri., 11 a.m.- 4.30 p.m. +W.V.S. Darby and Joan Club, Burdett Estate, St.Paul's Way, E.3. Wed.& Fri., 11 a.m.- 4.30 p.m. Zekeinim Club for Jewish Pensioners, Jewish Institute, Adler House, Adler Street, E.l. Mon.-Thur., 2 - 5 p.m. +Also Lunch Club *Also Chiropody Clinic. 82 INDEX PAGE Accidents - Home 11, 13, 63 " - Road 13, 17, 61 Aged Persons 4, 14 Analyst's Report 56 Animal Boarding Establishments 27 Area of Borough 8 Bacteriological Examinations of Foodstuffs 43 Bakehouses 44, 74 Births 8, 10 Cancer 49 Caravans 39 Catering Establishments 44, 74 Census 196l 8 Chiropody Clinics 15, 82 Clean Air 5, 27, 69 Clearance Areas 38 Common Lodging Houses 30 Complaints of Nuisances 27, 66 Conferences 16 Crude Spirit Drinking 18 Deaths 8, 12, 17, 60 Diphtheria 50 Disinfection and Disinfestation 55 Drainage 29, 67 Dysentery 50 Factories 29, 66, 69, 70 Fifty-Years Ago 9 Food - Unsound 46 " - Inspection and supervision 4, 41, 74 " - Poisoning 50 Free Washing Facilities 17 General Information 9 Hairdressers and Barbers Premises 29 Health Education 3, 18 Health Services, General provision of 14 Holiday Centre 19 Home Bathing 14 Hospital Facilities 20 Houses in Multiple Occupation 3, 39 Houses - Number in Borough 8 Housing 3, 38 Housing Statistics 69, 72 Ice Cream 44, 74 Illegitimate Births 8, 11 Infant Mortality 8,12, 62 Infectious Diseases 2, 49, 76, 78 Information Centre 20 Inquests 17 laboratory Facilities 20 83 PAGE Legal Proceedings 30, 4.5, 70 Legislation 21 Marriages 12 Maternal Mortality 8, 12 Maternity and Child Welfare - 23 Measles - 50 Milk Supply 31, 46 Mobile Dwellings 39 Mobile Meals Service 15 National Assistance Act, 1948 14, 17 Neonatal Mortality 8, 12 Noise Abatement 31 Notices Served 32 Offensive Businesses 33 Offices 33 Old People's Welfare Association 14, 15 Open Space 13, 81 Outworkers 32, 70 Overcrowding 38 Perinatal Mortality 8, 12 Physical Training and Recreation Committee 1 Poliomyelitis 51 Population 8, 10 Poultry Slaughterhouses 33 Psycho-Geriatric Service 6, 25 Public Health Committee 1 Public Health Inspectors (District) - Summary of Inspections 5, 66 " - Return of Sanitary Work 66, 67 Radioactivity 34 Refuse Disposal 35 Rent Act, 1957 27, 67 Rodent Control 35, 64. Sanitary Circumstances 27 Scarlet Fever 51 Seamen's Lodging Houses 31 Shops 33, 36, 66 Smoke Control Areas 5, 27 Smallpox 51 Social Conditions of Area 9 Staff 7, 22 Statistics, Summary of 2, 8, 80 Still-births 8, 10 Swimming Baths 22 Tuberculosis 2, 51, 77 Underground Rooms 38 Unemployment 13 Venereal Disease 18, 54 Vital Statistics 8, 80 Water Supply 37 Weather Conditions 49 Workrooms for the Elderly 15 84