Ac 43393 TOWER HAMLETS LONDON BOROUGH 1972 ANNUAL REPORT of THE MEDICAL OFFICER OF HEALTH & PRINCIPAL SCHOOL MEDICAL OFFICER London Borough of Tower Hamlets DIRECTORATE OF COMMUNITY SERVICES With the Compliments of the Director & Medical Officer of Health Health Department, 227-233. Commercial Road, Telephone London E1 2BU 01 -790 1818 Tow 8 LONDON BOROUGH OF TOWER HAMLETS ANNUAL REPORT of THE MEDICAL OFFICER OF HEALTH & PRINCIPAL SCHOOL MEDICAL OFFICER 1972 R. W. WATTON M.B., B.S., D.P.H.. D.C.H.. D.I.H. CONTENTS PAGE Health Committee1 Introductory2 Staff 4 Summary of Statistics5 Part I Statistics and Social Conditions of the Area 7 II Prevalence of and Control Over Infectious and Other Diseases 11 III Personal Health Services17 IV Environmental Health Services25 V Miscellaneous Services 11 VI School Health Services 47 VII Appendix of Statistical Tables 51 INDEX 93 HAM TOWER HAMLETS HEALTH AND HOUSING MANAGEMENT COMMITTEE (as at 31st December, 1972) Ex—Officio: The Worshipful the Mayor, Alderman H.F. Rackley Alderman John Orwel l Alderman J.J. Long Councillor E.C. Winter flood CHAIRMAN Councillor D. Kelly VICE-CHAIRMAN Councillor M.J. Durell COUNCILLORS J D. Allen J. Kennedy R. W. Ashkettle I.P. McDougall H.T.E. Brazier J. Milrood H. Conway F.G. Spearing Mrs. L.D. Crook E.G. Walker J. Docherty J.P. R.J. Warner A.P. Hegarty -1- Health Department, 227/233 Commercial Road, London El 2BU To: The Mayor, Aldermen and Councillors of the London Borough of Tower Hamlets Mr. Mayor, Ladies and Gentlemen, I present the annual report on the health of the Borough for 1972. COMMUNICABLE DISEASES Notifications received of infectious diseases showed an increase on last year but this was largely accountable by increased measles notifications. The number of primary notifications of pulmonary tuberculosis was the highest since the formation of the borough in 1965. BIRTH RATE This year's live birth rate of 12.43 births per 1,000 population was the lowest ever and for the first time the "natural increase in population" became a decrease, deaths exceeding births by 230. DOCKLAND DEVELOPMENT Schemes for redevelopment were held up during the year whilst the Dockland Study Team, jointly sponsored by the Greater London Council and the Department of the Environment, continued with its survey of possible options for development. Their full report was to be published early in 1973. Meanwhile the area of London Docks remains very much derelict. The adjacent private development in St. Katharine's Dock proceeded apace with the new hotel. World Trade Centre and Housing schemes under construction or planned for the near future. RE-ORGANISATION OF THE NATIONAL HEALTH SERVICE Following publication of the consultative documents, Green papers I & 11,1972 saw the issue of the 'grey book'. Management Arrangements for the Reorganised National Health Service. This sets out a blue-print for the future, albeit written in management jargon. Courses for medical administrators, and multi-professional courses have been arranged at centres throughout the country at which some of the staff of the health department have attended. After some delay, a Joint Liaison Committee was to be set up in the New year following the definition of the Area for this part of London i.e. comprising the City, Hackney, Newham and Tower Hamlets. Of much interest to this authority, for the future, will be the effectiveness of the links between the appropriate Area and District management of the health services and its own environmental health services and social services department. The question of representation by the local authority on the Area Board, and the strength or weakness, of the Community Health Council for the district are matters of concern. FAMILY PLANNING Discussions were held during the year and reports to committee and Council made on the provision of a free family planning service to residents of the borough. It was agreed -2- to commence this in the municipal year 1973. Continued use will be made of the Family Planning Association and our own clinics, with an extension of facilities to local family doctors. HOUSING Representations of unfit properties in the 1970 • 1975 programme proceeded according to schedule. The majority of unfit tenement blocks has been dealt with. The require a re-orientation to include the use of General Improvement Areas when appropriate however, the present legislation would benefit from stronger compulsory powers, in default. CHEST CLINICS The year saw completion of the integration of the three chest clinics in a based at the London Chest Hospital. A comprehensive service is now given to the whole borough from a newly built annexe to the hospital, including the use of the range of services offered by this specialist hospital. In the penultimate year of the existence of Tower Hamlets as a local health authority, my thanks go to the members of the department who, despite many uncertainties, have given a good year's service to maintain the standards of the past. I hope the changes to come by April 1974 and beyond with the unification of the National Health Service will be evolutionary in nature, and not too traumatic. To the respective chairmen and members of committees for their support in the year, I acknowledge appreciation, as also to the Chief Executive and senior colleagues throughout the borough services. I am Yours faithfu1ly, R W Watton Medical Officer of Health and Principal School Medical Officer May 1973 -3- STAFF OF HEALTH DEPARTMENT (as at 31st December, 1972) DIRECTOR OF COMMUNITY SERVICES AND MEDICAL OFFICER OF HEALTH Dr. R. W. Watton PRINCIPAL MEDICAL OFFICER PRINCIPAL MEDICAL OFFICER Dr. J. Richards Medical Officers 38 (8.3) Dr. K. Winship CO-ORDINATOR, DIRECTORATE OF COMMUNITY SERVICES E P. Webber DEPUTY CHIEF ADMINISTRATIVE OFFICER M. PIiskin SENIOR ADMINISTRATIVE OFFICERS C.H. Drake J. E. Pestell G. R. Williamson Administrative and Clerical Staff 53 (51.5) CHIEF PUBLIC DEPUTY CHIEF PUBLIC HEALTH INSPECTOR Public Health Inspectors 20 HEALTH INSPECTOR H. S. Davies J. J. Keniry Technical Assistants 9 CHIEF DENTAL OFFICER Pupil Public Health Inspectors 8 T. H. H. Murray Dental Officers 4 (3.4) Dental Auxiliaries 2 Dental Surgery Assistants 12 PRINCIPAL NURSING OFFICER ASSISTANT NURSING OFFICER Mrs. D.E. Marrin Mrs. I. E. Nicholls Health and Tuberculosis Visitors Student Health Visitors Clinic and School Nurses 39 (38) 5 26 (21.75) PRINCIPAL SOCIAL WORKER (Acting) Social Workers SUPERVISOR CLEANSING SERVICES (HEALTH SERVICES) 3 Miss M. Y. Lindsey Miss E. New CHIEF CHIROPODIST Chiropodists 10 (3.3) P. Twort NON-MEDICAL SUPERVISOR OF MIDWIVES SUPERINTENDENT OF HOME NURSING Miss I. M. Clarke Miss N. 0. Humphris DEPUTY SUPERINTENDENT OF HOME NURSING Midwives (Agency) 6 Miss P. J. Ribbans District Nurses (inc. Agency) 31 (30.5) HEALTH EDUCATION OFFICER ASSISTANT HEALTH EDUCATION OFFICER (Vacant) Miss M. E. Bush OTHER STAFF 22 (17.0) OTHER MANUAL STAFF 81 (64.5) Total staff of Department 389 (323.25) Note - Numbers in brackets relate to equivalent whole-time -4- SUMMARY OF STATISTICS, 1972 Area of Borough (Acres) 4,876 Rateable Value (1st April 1972) £15,120,962 Population; Mid-year estimate 159,200 Estimated product of a penny rate (1972-3) £ 135,250 Census, 1971 164,948 General Rate (1972-3) Dwelling Houses 100.50 p in £ Census, 1961 205,682 Mixed hereditaments 106, 00 pin £ Density of population (persons per acre) 32.64 Number of inhabited dwellings according to Rate Books at 1st April 1972 61,406 " " structurally separate dwellings - Census 1971 55,545 " " private households - Census 1971 57,465 Births Total Male Female All Births 2,010 1,040 970 Live Births Legitimate 1, 691 872 819 Illegitimate 288 147 141 Total; 1,979 1,019 960 Still Births Legitimate 28 18 10 Illegitimate 3 3 - Total; 31 21 10 Deaths All Causes 2,209 1,177 1,032 Maternal - - - Infants under 1 year Legitimate 44 26 18 Illegitimate 8 2 6 Total: 52 28 24 Rates Live birth-rate per 1,000 population 12.43 Death rate per 1, 000 population 13, 87 Still-birth rate per 1, 000 total births 15.42 Maternal death rate per 1,000 total births 00.00 Infant death rate (under 1 year) per 1,000 live births 26.27 Legitimate infant death rate per 1.000 legitimate live births 26.02 Illegitimate infant death rate per 1, 000 illegitimate live births 27.77 Neo-natal death rate (under 4 weeks)per 1, 000 live births 15.15 Early neo-natal death rate (under 1 week) per 1.000 live births 11.62 Perinatal death rate (still births plus deaths under 1 week) per 1, 000 total births 26.86 Illegitimate live births per cent of total live births 14.55 Area Comparability Factors Births 1.10 Deaths 1.05 -5- -6- PART I STATISTICS AND SOCIAL CONDITIONS OF THE AREA 1. STATISTICS AND SOCIAL CONDITIONS OF THE AREA The borough of Tower Hamlets is bounded on the west side by the City of London, on the east by the Borough of hewham, on the north by the Borough of Hackney and on the south by the River Thames. The river boundary is some seven miles in length along which exist numerous wharves engaged in trans-shipping activities. The area of the borough is 4,876 acres, being approximately four miles long and four miles wide at the most distant points. Mileage of roads covered is 178.5. Some 266 acres cover canals and enclosed docks including the East and West India Docks, and the Millwall Docks. The predominant geological stratum of the Borough is dark blue London clay found at a depth of between 20 and 30 feet from the surface; above this level are layers and patches of gravel and sand with brown and yellow clays found nearer the surface. In some parts of the borough there are layersof made' ground, the result of earlier habitation, and as is to be expected the flow of subsoil water is towards the river. This area is to a large extent industrial in character, factory premises being spread throughout the borougn with light industry tending to concentrate in the western end and heavy industry in the east. One of the chief industries 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 this area. Other major industries include brewing, engineering, the manufacture of furniture and ship repairs. Tower Hamlets is also one of the most important wholesale districts in London. Spitalfields wholesale fruit and vegetable market and the London Fruit Exchange are situated in the borough, and there are many wholesale food depots from which goods are distributed throughout the country. Notable landmarks in the borough include the Tower of London and the Royal Mint. POPULATION The Registrar General's estimated mid-year population of the borough was 159,200, a decrease of 5,450 from last year's figure. The decennial census of the population taken on 25th April 1971 revealed the borough population to be 164,948, a reduction of 40,734 or 19.8% from the 1961 census. It is apparent that the estimated population of the borough during the intercensal years was too great, with the result that birth rates given in Annual neports for those years were too low and the death rates too high. Deaths exceeded live births by 230 so that as the estimated population decrease was 5,450 the net estimated movement of residents out of the borough would normally arount to 5,220 persons. The density of population is 32.64 persons per acre, a reduction of over 9 persons per acre (22%) since 1365. FIFTY YEARS AGO In 1922 the estimated population of the boroughs of Bethnal Green, Poplar and Stepney, which now form the borough of Tower Hamlets, was 536,270. There were 13,400 births and 7,683 deaths. Cases of infectious disease notified in Poplar and Stepney include 56 smallpox, 1,032 scurlet fever, 1,403 diphtheria and 918 pulmonary tuberculosis. There were 124 deaths from measles. 212 from whooping cough 142 from diphtheria and 509 from pulmonary tuberculosis. The Medical Officer of Health for Stepney stated that 15% of the population were aliens and that in one ward of the borough the density of population was 258 persons to the acre. "7" The Chief Health Visitor of Poplar referring to the infant mortality rate of 79 per thousand births as being half that of eleven years ago. stated that she was still of the opinion that an improved midwifery service would do more to decrease these rates than the provision of ante natal clinics. The Stepney Public Analyst reported that the position with regard to the sale of whisky and other spirits was unsatisfactory, the law requiring that they should not be weaker than 35° UP and that 15% of samples taken in England and Wales in 1921 were not satisfactory. He added that themajority of licensees in Stepney exhibiteda notice stating that "to meet the requirements of the Food and Drugs Act all spirits are sold as diluted spirits" and that few persons realised that such a notice would legalise the sale of 1% whisky 99% water. According to the report of the Medical Officer of Health for Bethnal Green a vendor was sentenced to three months imprisonment in default of paying a fine of £50 for selling milk which was 76% deficient in milk fat. LiVE BIRTHS There were 2,625 live births registered in the borough during the year. After correction for place of residence (inward transfers 143, outward transfers 789), the number allocated to the borough was 1,979 comprising 1,019 boys and 960 girls, a decrease of 255 from 1971, giving a crude birth rate of 12,43 per 1,000 population compared with 13,57 last year. When adjusted by the Registrar-General's area comparability factor for the borough, which makes allowances for differences in the age and sex distribution in the population throughout the country, the rate is 13,67 compared with 14.8 (estimated) for England and Wales, a ratio of 0.92 to the national rate. ILLEGITIMATE LIVE BIRTHS The number of illegitimate live births during the year was 288 equivalent to 14,55% of the total live births, compared with 13.69% last year. The comparable figure for England and Wales was 9%. STILLBIRTHS This year stillbirths numbered 31 equivalent to a rate of 15.42 per 1,000 total births, compared with 13.68 in 1971. The rate for England and Wales was 12.0. DEATHS The number of deaths registered - 2,209, shows an increase of 62 over the figure of last year. The death rate was 13.87 and when adjusted by the comparability factor becomes 14.56 as compared with 12.1 for the country as a whole. The largest single cause of death was heart disease, 28% of total deaths, followed by cancer 25% and respiratory condi t ions 20%. The various causesof deaths and distribution by age groups are set out in Table 1. INFANT MORTALITY Deaths during the first year of life numbered 52 equivalent to a rate of 26 . 27 per 1,000 live birthsThe rate for the previous year was 24.17 and 20 . 23 forl970. Fluctuations occur in years in the same decade but generally the downward trend continues: in 1931the comparable rate for the area was 77 per 1,000 live births and in 1921 almost 1 in 10 babies died before their first birthday. The rate forEngland and Wales was 17.0 for 1972. -8- Details of causes of death at various ages under 1 year will be found in the Appendix on page 52. MATERNAL MORTALITY There were no maternal deaths this year. NEO-NATAL MORTALITY During the year there were 30 deaths of infants under 4 weeks representing aneo-natal mortality rate of 15.15, the rate for England and Wales being 12.0. Last year there were 41 deaths giving a rate of 18.35 per 1,000 live births. PERI-NATAL MORTALITY This term is used to describe the combination of still births and deaths in the first week of life expressed as a rate per 1,000 total live and still births. The rate for this year was 26.86 the rate for England and Wales being 22.0. ACCIDENTAL DEATHS Deaths due to accidents numbered 59 (compared with 58 last year) motor vehicles being the cause of 15 deaths. Statistics supplied by the Road Safety Officer will be found on page 52. EXPECTATION OF LIFE The expectation of life at birth, based on the estimated home population and mortality experience over the three years 1968 to 1970, is 68.6 years for a boy and 74.9 for a girl. This is an increase of 0.6 years for males and 1.2 years for females over the figures based on mortality during the years 1957 to 1959. The figures also show that at age 65 a man has a life expectancy of 11.9 years and a woman of 15.8 years. Sixty years ago the expectation of life of a boy at birth was 48.5 years and of a girl 52.4 years. MORBIDITY The number of first claims for sickness benefit are obtained from local offices of the Departments of Health and Social Security and are included for information in a weekly bulletin circulated by the department to all hospitals and general practitioners in the area. The Department's offices are not coterminous with the borough boundaries but rather with postal districts, so that these claims do not relate entirely to borough residents, they cover the E.1., E.2., E.3., and E. 14 postal districts (monthly figures are to be found on page 56. MARRI AGES The number of marriages solemnised in the borough during the year was 1,364, or 42 more than last year, made up as follows:- Register Office 668 Church of Sngland 470 Authorised persons and other denominations 226 The marriage rate per 1,000 population was 17.1 compared with 16.0 last year, -9- PUBLIC RELATIONS Activities of the Health Department are publicised in 'Tower Hamlets News' which is published by the Council and issued to the public after each Council Meeting, Topics to which attention was drawn during the year related to the Cervical Cytology Service, Winter Ailments. Immunisation. Lead pollution. Safety with fireworks. Smoking and health, Going abroad for holidays , Home safety, detai1s of changes in Services provided at Clinic Centres and publicity for the Mass Radiography Unit's weekly Service in the Borough. In addition, the practise of circulating a weekly bulletin to general practitioners and hospitals in the borough giving information on infectious disease, morbidity and relevant topical matters was continued. PUBLIC TRANSPORT Public transport facilities in the borough include eleven District Metropolitan and Tube Railway Stations and 4 Suburban Railway Stations, UNEMPLOYMENT The number of wholly unemployed adult persons registered at the Poplar, Shoreditch and Stepney Employment Exchanges at 7th December totalled 3,345 men and 187 women , or 683 more than last year. It must be borne in mind that the above figures do not apply solely toTower Hamlets re si dents as one does not need to be a resident to register with an unemployment exchange of a particular area. Furthermore, the Shoreditch Exchange figures include the Shoreditch areas of the London Borough of Hackney. Information supplied by the Youth Employment Service shows that unemployed young persons (under 18), numbered 89 boys and 27 girls, compared wi th 1971 figures of 96 and 24 respect ively. OPEN SPACES The amount of parks and open spaces in the borough is now 349.28 acres, equivalent to 2.19 acres per 1,000 population, A list of the sites is given on pages 66 and 67. COMPARATIVE STATISTICS A table showing vital statistics for the area covered by the borough at various years from 1901 is on page 53. HEALTH DEPARTMENT ESTABLISHMENT A list of all Health Departments Establishments showing clinic sessions held and services provided is given in the Appendix on pages 90 and 91„ -10- PART I I PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES II. PREVALENCE OF AND CONTROL OVER INFECTIOUS AND OTHER DISEASES WEATHER CONDITIONS The year began with a mild and changeable January, but cold at the end of the month. A dull and unsettled February was followed by a fine and warm March. Unsettled and cool weather was experienced in April and May, the Spring Bank Holiday being the coldest in London since 1941. June was exceptionally cool - the coldest in London for at least 25 years . The cool weather continued into July, but a fine warm spell arrived at mid-month. It was the driest August in London since 1947 and the coldest September for 20 years. October was another dry month, November having alternate spells of stormy and bright weather. The mean temperature in December was slightly above normal. INFECTIOUS DISEASES - NOTIFICATIONS The number of notified cases of infectious diseases, corrected for revised diagnoses and duplicate notifications, was 980 compared with 619 during the previous year. Liaison is maintained with general practitioners and hospitals in the area by a weekly bulletin which is circulated giving them information on the numbers of infectious diseases occurring in the borough during the week, the number of new claims for sickness benefit received at local offices of the Ministry of Social Security in the area, and other relevant information from time to time. A summary of notifications of infectious diseases received during the year will be found on page 56 and a list of diseases notifiable in the borough on page 55. ANTHRAX No case of anthrax was reported during the year. CANCER Of a total of 546 deaths from cancer occurring this year 149 were due to cancer of the lung. The death rate of lung cancer was 0.93 per 1,000 population, an increase of 30% since 1965. CHOLERA No case of cholera was notified during the year. DIPHTHERIA No cases of diphtheria were notified during the year. DYSENTERY Notified cases of dysentery totalled 96, compared with 39 during the previous year. FOOD POISONING Twenty seven cases of food poisoning were notified during the year compared with 68 in 1971. Salmonella typhi-murium was isolated in 6 instances. Other Salmonella organisms isolated included 1 bredeney and 6 agosa. Clostridium welchii was discovered in 2 cases. -11- Two family outbreaks were reported to the Department of Health and Social Security as required by Memorandum 188/Med. INFECTIVE JAUNDICE Notifications of infective jaundice numbered 50 during the year compared with 66 during 1971. MALARIA One case of malaria was notified during the year, in a patient who had recently entered the country from abroad. MEASLES Notified cases of measles totalled 578 during 1972. In the previous year 238 notifications were received. Children vaccinated against the disease during the year numbered 1,551. ACUTE MENINGITIS Two notifications were received during the year, compared with eight in 1971. OPHTHALMIA NEONATORUM No cases were notified during the year. POLIOMYELITIS Once again no cases of poliomyelitis occurred in the borough during the year. Details of vaccination against poliomyelitis will be found on page 57, SCABIES Cases of scabies which came to notice during the year totalled 245 compared with 317 in 1971. Patients and contacts were given medicinal baths and their clothing disinfected at the Council's cleansing station. The number of baths given was 404. Although scabies ceased to be a notifiable disease on 1st April, 1965, by the co-operation of the general practitioners and hospitals information is forwarded to the Health Department of persons suffering from the condition, and arrangements made for follow-up by home visits to ensure that the patients and their contacts receive treatment at the Council's cleansing station. SCARLET FEVER There were 69 confirmed cases notified, compared with 50 during 1971. SMALLPOX No cases of smallpox were notified during the year although the advice of the Medical Officer of Health was sought by general practitioners in some instances where the disease was suspected. Notifications are occasionally 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 Health Department for the necessary period. -12- TYPHOID No cases of typhoid fever were notified during 1972. WHOOPING COUGH There were 13 notifications compared with 54 during 1971. Statistics relating to immunisation are on page 57. TUBERCULOSIS The number of primary notifications of pulmonary tuberculosis received during the year was 123, the highest number since 1965. The notification rate was 0.77 per 1,000 population compared with 0.48 last year. Non-pulmonary cases notified numbered 20. The mortality rate for pulmonary tuberculosis was 10.0 per 100,000 population compared with 4.2 in 1971. Statistical data relating to new cases and deaths will be found on page 58. Public Health (Prevention of Tuberculosis) Regulations, 1925 These Regulations provide that persons suffering from tuberculosis ofthe 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. Mass Radiography The North-East Metropolitan Regional Hospital Board's Unit 6A's weekly session at Toynbee Hall continues to operate. I am indebted to the Medical Director and Organising Secretary for the information given on the work of the Unit which will be found on page 59. B.C.G. Vaccination The numbers of persons vaccinated during the year,under the Council's scheme for the B.C.G. vaccination of susceptible (tuberculin negative) child contacts of known tuberculous patients, diabetic children, thirteen-year old schoolchildren, students at further education establishments and mentally subnormal persons at training centres, are shown in Table 15 on page 59. Other Preventive Measures In addition to the B.C.G. vaccination scheme, other preventive measures include the chest X-ray of all newly appointed staff and a triennial X-ray of those who are likely to work in close and frequent contact with children, staff at the Council's training centres for mentally subnormal persons and tuberculin reactors discovered among thirteen-year old schoolchildren, students and others tested with a view to B.C.G. vaccination. Epidemiological investigations are made among the contacts of cases of tuberculosis notified in children, staff or residents in the Council's establishments. Similar investigations are carried out at secondary schools where the reactor rates disclosed by tuberculin surveys are significantly higher them the average for secondary schools in the area. -13- CHEST CLINICS In conjunction with the North-Fast Metropolitan Regional Hospital Board and the Prompton Hospital, and in accordance with proposals under Section 28 of the National Health Service Act 1946, tuberculosis prevention, care and after-care services for patients living at home are provided at the chest clinic in the borough situated in the London Chest Hospital and staffed by chest physicians, tuberculosis visitors, welfare officers and clerks. Services provided from the Chest Clinic include social work by welfare officers and assistance in cash or kind not available from official sources by chest clinic committees from their voluntary funds; these services are the responsibility of the Social Services Department of the Council. The Stepney Chest Clinic closedon31st March 1972 which completed the centralisat ion by the North-East Metropolitan Regional Hospital Board of the Chest Clinic services of the Borough at the London Chest Hospital. After Care Other services provided by the department for the care and after care of patients and contacts include - boarding-out of child contacts home nursing loan of bedding and nursing equipment and rehousing of selected tuberculous families. Chest Diseases Care Committee Dr. M. Caplin, Consultant Chest Physician to the Chest Clinic of the London Chest Hospital reports:- "The year 1972 was a landmark in the history of the London Chest Hospital. It witnessed the absorption of the work of all the local chest clinics in Tower Hamlets and Hackney into the London Chest Hospital in a new department which has been purpose-built in the grounds of the Hospital. The new building has been much admired and has been designed to provide the comprehensive facilities which to-day are considered necessary for the early diagnosis, treatment and after care of patients suffering from diseases of the chest. Though many patients will have to travel further than before, the increased facilities available will allow for several investigations to be done at the same visit, and so may reduce the number of attendances and the number of journeys patients previously made. Centralisation of the services should also help to bring about a closer linkage with the locsl authority health and welfare services. The absorption, in so short a time, of so many of the patients who previously attended the other chest clinics presented many problems to the staff at the London Chest Hospital. These problems are now gradually being overcome, and I should like to pay a special tribute to those concerned with the tremendous amount of work involved. At the same time as the absorption of the local chest clinics, the Chest Clinic Care Committee at the London Chest Hospital, which has been in existence in one forpnr another for over 50 years has taken on anew shape. Now it has a constitution, has been registered as a charity and has increased its size to include members from the Poplar, Stepney, Metropolitan and Shoreditch Chest Clinic Care Committees. These other Care Committees which have done so much for the patients in Tower Hamlets and Hackney have now all been wound up and their responsibilities assumed by the Chest Clinic Care Committee of the London Ches t Hosp i tal. -14- The pattern of help has now changed over the past year. Tuberculosis, lung cancer and chronic bronchitis are still the main groups which show a need for help beyond that which can be satisfied from statutory sources. The Chest Clinic Care Committee at the London Chest Hospital is fulfilling this important task, and I am grateful to all its members for the part they are playing." HEALTH CONTROL OF IMMIGRANTS During the year 581 advice notes of immigrant arrivals were received in the department from various ports of entry, and succsssful contact was made in 365 instances. Of the remaining 216 some had moved to addresses outside the borough, and details were forwarded to the authority concerned, but the majority were either not known or had never arrived at the address given. One immigrant suffering from tuberculosis was admitted on condition that she reported to the Medical Officer of Health for examination. Arrangements were made for her to attend a Chest Clinic. VENEREAL DISEASE The annual return received from the Venereal Disease Clinic at the London Hospital shows the new cases attending the clinic during the year to be as follows:- Area of Residence Syphilis Gonorrhoea Other Conditions Total (1971) Tower Hamlets 47 422 2,003 2,472 (2 , 497) Other London Boroughs 100 1,123 6,014 7, 237 (6,856) Other Areas 17 110 1,051 1, 178 (1,144) TOTAL 164 1,655 9,068 10,887 ( 10 , 497) Returns received from 7 other hospitals in London of new patients attending their clinics during the year showed that 254 were residents of Tower Hamlets, comprising 4 syphilis 27 gonorrhoea and 223 other venereal conditions. Two welfare officers appointed by the Council work from the Whitechapel Clinic under the direction of Dr. E.M.C. Dunlop, M.D., F.R.C.P., Senior Physician to the Department for tracing contacts and following up defaulters. Dr. Dunlop reports as follows "During 1972 we dealt with 164 new cases of syphilis (1971-197), with 1,655 cases of gonorrhoea (1971-1,891), other genital infections and other conditions totalled 9,068 (1971-8,409). The total of new cases for the year was 10,887 (1971-10,497). It is gratifying that the numbers of cases of both syphi1is and gonorrhoea have declined. The increased use of the Clinic by the community is shown by the rise in the number of cases of other infections, so that total attendances for the year were some 400 greater than for the previous year. Total attendances for Tower Hamlets (2,472) shows little change (1971 - 2,497). There were 47 cases of syphilis (1971-69, 422 of gonorrhoea (1971 - 476) and 2,003 of other conditions (1971 - 1951) Thus for Tower Hamlets as for the total work of the Department, there has been a decline in gonorrhoea and in syphilis, and an increase in the other conditions. The effectivity of contact tracing has contributed materially to this decline in gonorrhoea and syphilis." - 15- COMPENSATION FOR STOPPING EMPLOYMENT Section 41 of the Public Health Act 1961 makes provision for a Medical Officer of Health to request any person to discontinue work with a view to preventing the spread of infectious disease, such person to be compensated for any loss suffered as aconsequence. Three notices under this section were served during the year. -16- PART III PERSONAL HEALTH SERVICES III PERSONAL HEALTH SERVICES The Principal Nursing Officer, Mrs. D.E. Marrin., reports as follows:- " During 1972 10 Health Visitors were appointed and 2 resigned. There were also several changes amongst clinic nurses, but we were up to full establishment from September onwards. Management Courses were attended during the year by an Assistant Nursing Officer, aCentre Superintendent and two Health Visitors. Three Health Visitors attended Field Work Instructor Courses and other Courses were attended by 8 Health Vi si tors. A total of 91 medical students and 344 student nurses were assisted in gaining community experience in the preventive field. Study days included a fairly wide range of topics, embracing family planning, care of the mentally handicapped child, hearing loss in school children, and sexually transmitted diseases. Our staff continue their liaison with general practitioners and further placings in agreement with both medical and nursing staff were attempted, but implementation of the plan produced difficulties. The Urinary Research project was implemented, which will no doubt prove of great assistance to the young child. A vast amount of work has gone into keeping children free from infestation both by Health Visitors and School Nurses and a product containing Malathion has been used in the Borough since February, to help in this much needed side of the preventive field. Keystone vision testing was commenced in September, 1972., amongst various groups of school children and is proving extremely effective in discerning defects." ANTE AND POST-NATAL CLINICS Sessions are conducted in Council clinics by midwives and medical officersfor ante and post-natal examination. In addition four general practitioners undertake ante-natal work for their own patients in Council clinics which are made available to them free of charge and with a domiciliary midwife in attendance (Statistics on page 60) ANTE-NATAL, MOTHERCRAFT AND RELAXATION CLASSES These classes are held by domiciliary midwives and heal th visitors in Council clinics for both institutional and domiciliary booked cases. (Statistics on page 60) ADOPTION AND BOARDING-OUT OF CHILDREN Adoption Persons proposing to adopt children are required to submit medical certificates as to their health before achild is placed with them. These certificates areverified by the Medical Officer of Health before consent is given. Similarly, the medical records of the children to be adopted are scrutinised and the Director of Social Services advised on the child's suitability for adoption. -17- Should the reports reveal any medical defects inheritable disease or handicap in the child- further enquiries are made and- in the case of inheritable disease in the natural parents the prospective parents are interviewed by their own practitioner. Boarding Out The medical examination is given in accordance with the Boarding Out of Children Regulations, 1955, and includes the Wasserman and/or Kahn tests except where the child is over school leaving age or is boarded out in an emergency or in accordance with Part III of the Regulations. Again the results of these medical examinations are scrutinised in the Health Department and the Director of Social Services informed as to their suitability. The following is a summary of the cases dealt with from 1968-1972 Adoption Cases 1972 1971 1970 1969 1968 Children suitable for adoption 14 20 25 33 37 Children suitable for adoption subject to certain conditions - - - - - Children unsuitable for adoption - - - - 1 Couples suitable to adopt children 29 48 23 39 36 Couples unsuitable to adopt children 1 1 - - 1 Boarding Out Cases Children suitable for boarding out 39 34 44 44 33 CERVICAL CYTOLOGY The service for the collection of cervical smears for cytology investigation by hospital authorities continued during the year with sessions in the Council's clinics. In addition, a general practitioner continued holding regular sessions in his surgery, assisted by a member of the staff of the Health Department, and the Family Planning Association continued taking smears at sessions held in Council clinics. Examinations were also carried out at a Centre of employment in the Borough. From these 2,176 examinations were carried out. In addition hospitals in the area read 12,603 slides and although al1 the latter did not refer to borough residents it can be assumed that the majority did. Details will be found on page 60, CONGENITAL DEFECTS Notification of congenital abnormalities under the national scheme recommended by the Ministry of Health in 1963 continued throughout the year. Defects found in stillborn and 1iveborn children within 36 hours of birth were noted on birth notification forms by hospital or domiciliary staff, details of which are as follows:- Number of babies notified as having one or more congenital defects 38 Number of stillbirths and livebirths notified over the same period 2,010 The rate of notification per 1,000 total births was 18.9 compared with 13.7 last year. There are obvious difficulties in assessing the real incidence of congenital defects under such a voluntary scheme, but some help does flow in maintaining observation registers -18- CLiNIC CENTRES There are six clinic centres in the borough, 3 school treatment centres and 7 combined clinic and school treatment centres. Clinic auxiliaries continued during the year to carry out various tasks in the clinic centres, thereby affording more time to the health visiting and nursing staffs to cope with their professional duties. Services provided at each of the Centres are given on pages 90 and 91. CRECHES Children can be placed in creches for an afternoon at eight of the clinic centres by mothers who wish to attend the mothers' club or sewing class at the centre, or who have hospital appointments. Creches also provide facilities for motheistobe relieved of their children for 2 or 3 hours during the day and provide an opportunity for an only child to associate with other children of the same age. No charge is made where the mother is attending a centre activity, but a charge is made of 9p per session if the mother wishes to leave her child whilst she attends to shopping or other domestic duties. ASSESSMENT CLINIC Almost five years ago a combined local authority and hospital assessment clinic was set up for the diagnosis and continuing assessment of infants and children suspected of having a delay in development. The Assessment Clinic is based at the London Hospital Children's Outpatients Department, where a clinic for children with cerebral palsy was already in existence. The clinic functions on one day a week, and although it serves mainly Tower Hamlets, children from neighbouring boroughs are also seen. Children continue to be referred mainly by local authority medical officers, following agreement with the family doctor, and by consultant paediatricians from other hospitals in the borough as more doctors, health visitors and social workers concerned in the care of children realise the value of early assessment, treatment and training of not only physically and mentally handicapped children, but also those children who have a delay in language development due to emotional problems and adverse social and environmental conditions. The staff of the Assessment Clinic consists of a Consultant Paediatrician, aPrincipal Medical Officer of the Health Department, a Psychologist, two Physiotherapists, an Occupational Therapist, a Speech Therapist, a Medical Social Worker, aHealth Visitor and a Nursing Sister. A Social Worker from the Social Services Department was seconded to the Clinic for some time. Apart from the diagnostic assessments, follow up assessments are made to ensure comprehensive continuing care which includes parent guidance, counselling and integration of care and supervision provided by the professional staff concerned. A child with a physical handicap, e.g. cerebral palsy, and his/her parents, receive any necessary help and supervision by the Physiotherapists and Occupational Hierapist, who also obtain special equipment or app1iancesconsidered necessary forthechild. Referral to other departments of the hospital is made for the investigation and treatment of other problems, e.g. dental caries squints, hearing loss and orthopaedic problems. The Principal Medical Officer and the Health Visitor co-ordinate the work of the -19- clinic and health department, ensuring that these children who are placed on the Observation Register, receive continuing support from the coramunity, Any help that can be given by local authority facilities is recommended e.g. attendance at a day nursery, creche or playgroup Social work support is recommended for many fami1ies and special educational help is required for manychildren FAMILY PLANNING Family Planning sessions conducted on behalf of the Council by the Family Planning Association are held at three of the Council's Clinic Centres 287 sessions being held dur.ng the year. In addition Council sessions staffed by Medical Officers and Health Visitors are operated at a further four clinic centres. The Family Planning Association provide a Domiciliary Service. Preliminary visiting is carried out by the Non-medical Supervisor of Midwives. Thi s year new patients numbered 1,858 , an increase of 487 ove r last year. Statistics on page 6 2 FEEDING DIFFICULTIES Facilities are provided at a centre outside the Borough for in-patient treatment of mothers and babies when breast feeding difficulties are experienced or of babies with dietary prob1ems, It was not found necessary to uti1ise these facilities during the year HEALTH EDUCATION During 1972 the emphasis has remained on health education teaching in schools. The majorityof requests come from secondary schools but the marked lack of knowledge of some elementary health matters, i.e. smoking suggests that health education should be extended to all primary schools to become truly preventative. In addition to the Health Education Officer the Health Visitors have been increasingly involved during the past year in health education work in schools. In April this year a cervical cytology campaign was mounted and with theco-operation of the housing department 16 000 leaflets containing information regarding the "smear test" were distributed with the rent cards to Council tenants. The health visitors reported a moderate rise in the number of attendances at cytology clinic sessions. Two colleges of further education, Walbrook College and the London College of Furniture, requested exhibitions on the subject of smoking this year Display material , exhibits and film shows stimulated interest and discussion among the students, many of whom are heavy smokers Statistics of the work of the section are given on page 89 HEALTH VISITING Health visitors maintain close liaison with the staff of statutory and voluntary bodies, general practitioners and hospitals in the borough. Their visits to expectant mothers and to children under five years of age are shown with other statistics on page 62 Health education work iscarried out by means of personal contact as well as in group sessions held at the clinics. At the request of the paediatricians concerned, health visitors attend out-patients departments athospital s to providealink between hospital and home. The numbers of health visitors including centre superintendents and tuberculosis -20- visitors employed at the beginning and end of the year were 31 and 39 respectively, there being 2 resignations and 10 appointments during the year. Command paper 1973 recommended an establishment for health and tuberculosis visitors, based on a proportion of 0.18 visitors per 1,000 population, which ratio would equate to 29 staff for the current year HOME NURSING One member of the senior staff completed the advanced course of Practical Work Instruction during the year and another completed the basic course. Two State Registered Nurses completed the District Nursing Training Course obtaining the National Certificate. Three State Enrolled Nurses undertook District Nurse Training and were successful in the examination. The following number of pupils from the London Hospital undertook the State Enrolled Nurses' Integrated course of training,23 pupils for 2 days District Nurse training, 22 pupils for 2weeks District Nurse training, 4.pupils for 8 weeks District Nurse training and2for l0 weeks,al l6 being successful in their examination for the National Certificate. Two pilot liaison schemes with general practitioners commenced last year. This year geographical areas of work were abandoned and nurses were allocated groups of doctors with whom they are now working in liaison. A further liaison scheme was commenced late in the year with a third hospital in the borough. Statistics relating to the Home Nursing Services are on page 63. LAUNDRY SERVICE Soiled personal clothing, bed linen etc., is col1ected at 1east twice weekly from the homes of persons who are incontinent, and cleansed and laundered in the department's laundry at Branch Road Cleansing Station. The number of articles laundered showed an increase of 45% over last year. Statistics on page 63. INCONTINENCE PADS Special commercially prepared disposable pads and/or knickers are supplied free in suitable cases for use by incontinent and chronically ill aged persons. Over 55,000 pads plus 50,000 linings were purchased during the year and issued to 281 persons, 14% more persons than last year receiving this service. LOAN OF NURSING EQUIPMENT Artic1es of nursing and sick room equipment are loaned at the request of the general practitioner, district nurse or hospital medico-social worker etc., free of chsrge for an indefinite period, to persons being nursed in their own homes. The Council purchased many items of additional equipment required to meet requests for loans. In addition equipment is loaned by the British Red Cross Society and by the Council's Social Services Department to handicapped persons. Statistics on page 64 MARIE CURIE MEMORIAL FOUNDATION The Council participates in both schemes operated by the Marie Curie Memorial Foundation for the we1fare of persons suffering from cancer who are being nursed in their own homes, namely the Day and Night Nursing Service and the Area Grant Welfare Scheme. -21- Nurses and/or "sitters in" are provided for short periods to patients who live alone and to others to enable relatives to obtain adequate rest periods from the responsibility of nursing Under the Welfare Scheme, grants are made on behalf of th e Foundation towards the cost of hire or supply of special equipment, linen, bedding etc. Five patients received a total of 100 hours under the Day and Night Nursing Service, while a further 26 patients were provided with special equipment. A grant is made by the Council to the Foundation. DOMICILIARY MIDWIFERY SERVICE The Council operates adomiciliary midwifery service under Section 23 of the National Health Service Act 1946 by an arrangement for utilising the services of midwives employed by the London Hospital and by the Nursing Sisters of St John the Divine. In addition the Council directly employs the non medical supervisor of midwives. The joint scheme for training midwivesby the Nursing Sisters of St. John the Divine and the Mile End Hospital, continued during the year. Pupils who completed the course numbered 16 with 4 pup'ls under training at the end of the year The Council pays to the hospital 40 per cent of the expenditure involved under the provisions of the Ministry of Health Circular 8/56 There were 124 home confinements attended by the Midwives Four general practitioners f rom practices in the borough provided ante-natal care with midwives, at four of the Council's clinics. Statistics on page 65 MIDWiVES ACT 1951 The Council is a local supervising authority under the Midwives Act, 1951 supervising functions being carried out by the Council's non medical Supervisor of midwives. The number of midwives who notified during the year their intention to practice as midwives within the borough including these in hospitals,was 130 the number practising at the end of the year being 65. MATERNITY LIAISON COMMITTEES The department is represented on local maternity liaison committees by the Medical Officer of Health or Principal Medical Officer and the non medical supervisor of midwives or the principal nursing officer. As the borough is served by two hospital management committees there are separate maternity liaison committees for each group catchment area VACCINATION AGAINST MEASLES Vaccination against measles for all children up to the age of 15 years continued, 1,551 children being vaccinated during the year including 191 by general practitioners, VACCINATION AGAINST RUBELLA Vaccination against rubella continued to be offered to all girls between their 11th and 14th birthdays The purpose is to ensure that as many girls as possible are offered protection against rubella by vaccination before reaching child-bearing age because of the known association of certain foetal abnormalities wi th rube 11 a infection in pregnancy. During the year 743 girls were vaccinated. OBSERVATION REGISTER At the end of the year, the Observation Register totalled 5,286 persons comprising:- -22- Children under 5 "at risk" 2,256 Children under 5 handicapped 220 Young persons aged 5-21 years handicapped 2,577 Children non-resident but attending schools in the borough 233 The Principal Medical Officer keeps the register under constant review. Further details relating to the register will be found on page 54. A booklet produced by the department sets out details of the services available for the care of handicapped children and young persons provided by the Council,the Inner London Education Authority and by other statutory and voluntary bodies. PHENYLKETONURIA Tests for phenylketonuria are carried out by means of the Guthrie method on all babies. Co-operation is readily given by the hospitals in the borough having maternity wards, both in regard to taking the specimens and the pathological examinations. Arrangements are made with regard to domiciliary births by attending midwives and for health visitors to deal with other babies found not to have been tested. PREMATURE BAB IES Any child weighing 5½lbs (2,500 grammes) or less when born is regarded as premature, and necessary advice and assistance is afforded to mothers with premature babies. Statistics relating to premature births occurring during the year will be found on page 62. RECUPERATIVE HOLIDAYS FOR SCHOOLCHILDREN Unaccompanied school children placed by the Inner London Education Authority on recuperative holidays numbered 394 and 14 schoolchi1dren accompanied by their parents were placed during the year. RESIDENTIAL ESTABLISHMENTS FOR CHILDREN IN CARE The Health Department's visiting medical officers regularly attend at the Social Services Department's residential establishments to examine the children, treat any cases of illness occurring and advise on medical aspects of child welfare, hygiene and the prevention of infection. The department is also responsible for the provision of relief nursing staff as required at these establishments. SURVEYS The department has taken part in a number of surveys during the year in association with various research studies being carried out by the following bodies/authorities:- Department of Health and Social Security National Surveillance of Congenital Rubella Defects Department of Social Medicine, Survey of Childhood Cancers Oxford University Greater London Council Research and Spina Bifida Intel 1igence Unit Medical Research Council Measles British Births Survey Child study St. Pancras Coroner Foundation Study of Infant Deaths -23- DENTAL CARE FOR THE PRIORITY CLASSES Section 22 of the National Health Service Act 1946 puts local authorities under an obligation to provide dental care for children not yet at school and for nursing and expectant mothers. The same dental officers and dental auxiliaries who treat school children in the school health service carry out this part of their work in the same clinics and at the same time as they treat the school children under the school dental service. This arrangement for mixing sessions to enable the family to attend together,has proved popular and is available at every dental surgery. Dental Auxiliaries trained to treat very young children as a speciality attend to the majority of pre-school children. Statistics are on page 61. WELFARE FOODS AND VITAMIN SUPPLEMENTS The distribution of dried milk, cod liver oil, orange juice and vitamin tablets on behalf of the Department of Health and Social Security, continued at the Council's clinic Centres. Issues during the year (value £1,073) included:- National Dried Milk Tins 3,407 Cod Liver Oil bott1es 54 Orange Juice bottles 896 Vitamin Tablets packets 1,413 Vitamin Drops bot11es 5,351 Additionally. various brands of proprietary cereals, dried milk and vitamin preparations recommended by Health Visitors or Medical Officers were available at Clinic Centres, sales of these amounting to £6,550. -24- PART IV ENVIRONMENTAL HEALTH SERVICES IV ENVIRONMENTAL HEALTH SERVICES The Chief Public Health Inspector, Mr. H.S. Davies, reports as follows:FOOD AND DRUGS Imported Food One fifth of imported food samples taken during the year were unsatisfactory, mostly in respect of labelling irregularities In all cases the offences were taken up with the importers and producers. Two parcels of finger turmeric contained excess lead. This is a natural phenomenon, the lead being taken up during the growth of the plant. The turmeric a main ingredient of curry powder,was allowed forward for cleaning and subsequent grinding. Some processed cheese did not meet the requirements of the Cheese Regulations, and was returned to the producing country (Switzerland). Aconsignment of Kachuro, an oriental fruit used as flavouring, contained 8.5%of foreign matter and was destroyed by the importer. Canned Sliced Mangoe claimed to be "brimful of vitamins, virtue and vitality" Whilst a Health Department cannot concern itself with virtue, claims in respect of vitiamins and minerals must be substantiated by the name and amount of the vitamin or mineral on the label. Analysis of Food and Drug Samples 838 samples of food and drugs were submitted for analysis by the Public Analyst, 14 being purchased formally, and 824 informally. Irregular samples ascertained numbered 47. Legal proceedings were instituted in respect of buttered rol1 s spread wi th 98% margarine, minced beef having added preservative, acetic acid not being of the quality demanded, pork pie containing rust and dirt, and pasteurised milk containing mould growth. The resignation of one of the Food Inspectors in mid-November caused a reduction in the total number of samples procured,the remaining Inspector having to concentrate on the examination of imported foodstuffs at a time when his attention would ordinarily be concentrated on retail sales. Matters taken up with manufacturers and importers included fruit salad not having the correct proportions of various fruits; foreign matter in a meat pasty and which proved to be cow hair, vodka witha74.8% deficiency of proof spirit; a drug which showed no expiry date on the packet and which had been prepared before the requirement became statutory although the drug was sti11 efficaceous; fruit yoghourt containing benzoic acid,fresh milk concentrate deficient in milk solids, a new product being test marketed, cottage pie having an unsatisfactory label, the product being withdrawn from sale; fruit chews containing Ponceaux MK, a non-permitted food colour, acetic acid with an unsatisfactory label (concentrations above 15% must have the words DANGEROUS - NOT TO BE USED UNLESS DILUTED in red letters on the label) The absence, inadequacy or improper declaration of ingredients on labels ascertained in 63 samples were also the subjects of correspondence with ascertained or importers. -25- Pie and Mash Shop The improvement effected in the meat content of pies produced in these establishments has not been maintained. Almost two-thirds of the pies sampled were below the minimum meat content of 25 per cent. A decision of the Queens Bench Division has now made the formal sampling of meat pies impossible for practical purposes and until some amending legislation is passed it will be difficult to enforce effectively the requirements of the Regulations. Liquid Egg Pasteurisation There are two plants in the borough where liquid egg is pasteurised. The supply of eggs was even more spasmodic than in the previous year, both plants again operating intermittently. The satisfactory standard of hygiene expected of these plants was maintained. Six samples of egg taken proved satisfactory when subjected to the alphaamylase test. Milk Supply - Samples Thirteen samples were submitted for chemical analysis, al1 being satisfactory The average fat and so1ids-not-fat content of the ordinary milk samples analysed was 3.65 per cent and8.7l per cent respectively, and of the superfatted variety 4.45 per cent and 8.54 per cent. No samples were taken for the purpose of examination for the presence of brucella abortus. Ice Cream There are three premises in the borough registered for the manufacture of ice cream. Inspections were made from time to time under the Ice Cream (Heat Treatment, etc.) Regulations 1959, and no contraventions were found. 28 samples of ice cream obtained in the borough and submitted to the methylene blue reduction test gave the following results:- Grade No. I 17 II 2 III 3 IV 6 Of the unsatisfactory samples (grades III and IV) 8 were manufactured in the borough. In al1 cases investigations were carried out and recommendations made follow up samples being satisfactory. Food Hygiene (General) Regulations 1970. Food Hygiene (Markets, Stalls and Delivery Vehicles) Regulations 1966. Food premises in the borough are subject to frequent inspection by the public health inspectors to ensure that the provisions of the Food Hygiene Regulations are being observed, and a public health inspector visits the borough's Sunday markets each week. There are 3,411 food premises, including stalls, in the area. Notices of requirements served numbered 382 and 250 summonses involvine 42 premises/stalls were heard during the year. -26- Becteriological Examination of Foddstuffs Samp1es submitted for bacteriological examination numbered 117 comprising:- 2 Coconut (dessicated) 27 Ice Cream 1 Custard tart 33 Meats-; prepared and cooked 11 Dried hen egg (pasteurised) 19 Prawns (frozen cooked and peeled) 17 Frozen Ready Meals 1 Sardines 2 Gelatine I Sausage roll 1 Herring in jelly 2 Shellfish Of these the following 23 samples were unsatisfactory: 2 Frozen Ready Meals 5 Prawns (frozen cooked and peeled) 8 Ice Cream 1 Sausage roll 7 Meats - prepared and cooked Unsound Food The following quantities of unsound foodstuffs were disposed of under the Public Health (Imported Food) Regulations and the Public Health Acts: Wharves 95 tons London Fruit Exchange and Spital fields Market 77 tons Other Premises 80 tons TOTAL 252 tons These foods tuffs were delivered to or co11ected by the Council's 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. Condemnation certificates numbering 544 were issued in respect of unsound food in 1972. Unsound Food Etc. -Complaints Complaints made by members of the public as to the alleged unsound condition etc. of foods and which were investigated during the year numbered 32. The complaints referred to- Alleged Unsound Conditions: 1 Blackcurrant Juice, 1 Bread, 1 Cheese, 1 Chicken, 1 Chicken pie, 1 Cod Roe, 1 Ham, 1 Liver Sausage, 1 Pork Luncheon Meat, 1 Potatoes, 1 Raisins, 1 Sausages, 2 Sterilised milk, 1 Toffees, 1 Vienna Sausage, 1 Vinegar. Alleged Dirty Condition and/or foreign Body or Deposit 1 Apple Pie, 1 Blancmange, 3 Bread, 1 Custard, 1 Doughnut, 1 Easter-egg, 1 Fruit Cake, 1 Jam, 1 Milk, 1 Pickles, 1 Pork-pie, 1 Rice, 1 Tea. Food Export Certificates Certificates numbering 98 we re issued in respect of avariety of foodstuffs exported to Argentina, Belgium, Brazil, Canada, Cyprus, Finland, France. -27- West Germany, Greece, Guatemala, Italy, Libya, Madeira. Mexico, Spain, Sweden, and Zai re. Before certificates are issued the foodstuffs destined for export are examined and where necessary samples taken for analysis. Relevant investigation is also made into the methods of production. DISEASES OF ANIMALS The Corporat ion of London, through its veterinary officers and inspectors carried out on an agency basis duties imposed on the Council under the Diseases of Animals Act, 1951 and Performing Animals Act 1925. 161 inspections were carried out during the year at poultry slaughterhouses and a further 54 visits were made to premises with holdings for live poultry, 25 pet shops received quarterly visits. In addition, regular visits were made to street markets concerning the sale of poultry and the sale of pet animals. An employee of a pet shop was admitted to hospital suffering from psittacosis and a full inspection of the premises was carried out. All birds on the premises appeared to be healthy Other investigations were carried out in the borough where the patient was resident. An inspection was made of the premises of a firm concerned with the sterilisation of imported horse meat for animal consumption. Conditions were found to be satisfactory. OFFICES, SHOPS AND RAILWAY PREMISES ACT, 1963 Registration The total of registered premises has fallen from the figure of 3,197 for the first year after the amalgamation of the former Metropolitan Boroughs of Bethnal Green, Poplar and Stepney at 31st December 1966, to a total of 2,818 at 31st December, 1972. This reduction is mainly due to the number of premises that have been demolished as part of the housing programme It wi11 be instructive to note how far the total adjusts as redevelopments take place, bearing in mind that the small old convenient corner shop' that has been cleared, is often replaced with a larger more complex unit on the shopping parade of a new estate. Difficulty is still experienced in keeping an accurate check of newly opened premises, and it is usually found necessary to give verbal and written requests to occupiers before registration is effected. Inspection 1,473 general inspections were made during the year and 347 subsequent 'follow up' visits. 580 informal notices were served. Although these figures indicate that a 2 year cycle of general inspection has been achieved, bad conditions are still found in some premises. Particular difficulty in the enforcement of the Act is met in premises occupied by recent immigrants to this country due to language and other factors. Occupiers, however, are generally co-operative, and the threat of legal proceedings is normally sufficient to enforce the carrying out of requirements where no ready -28- response to informal notices is received. Cleanl iness Apart from a few isolated cases, the general standard of cleanliness in registered premises is quite a reasonable one. The use of laminated plastics and other modern methods of finishing internal surfaces in recently converted and newly erected premises, has helped a great deal in this respect. Overcrowd i ng Only five minor cases of overcrowding were dealt with during the year. It is gratifying to note that enforcement of the Act has virtually put an end to the several bad cases of overcrowding which were found during the initial inspections made after the commencement of the Act in 1964. Preventative measures are initiated by making use of the information contained in pians submitted with applications made under the Drainage Bye-laws. Where it appears that a case of overcrowding might occur in a premises that is to be altered or newly occupied, the matter is immediately taken up with the applicant's architect. Temperature Thanks to the relatively mild weather conditions enjoyed in the South East of England in recent winters, complaints with regard to insufficient heating have been kept to a minimum. Difficulty is sometimes experienced in administering this Section of the Act in the many wholesale premises in the Borough, where much of the floor area is taken up with the storage of stock, and is only in occupation by members of the staffs for short periods. Judgement is also necessary to achieve reasonable comfortable conditions for staffs inbutchers' and other food premises, and, at the same time, not to risk spoilage of foodstuffs. Ventilation The task of maintaining adequate ventilation without the loss of security in registered premises continues to be a problem. Shops occupying the ground floors under blocks of flats have been found to be the most frequent victims of 'break-ins' or vandalism, and it is difficult to insistonoptimum conditions to an occupier whose premises have been a recent target for such an attack, The installation of a system of mechanical ventilation is often accepted in these instances, in spite of the fact that it is liable to mechanical failure,or sometimes not switched on. Lighting Offices are generally adequately lit, so too are the serving areas of shops, but this is not always the case in back rooms, stockrooms,.stairs and passages. The acceptable minimum values detailed in the relevant Department of Employment Circular are so low as to preclude legal enforcement, but every effort is made to encourage the provision of lighting in accordance with the desirable values recommended by the Illuminating Engineering Society. Sanitary Conveniences Lack of cleanliness and simple minor lack of maintenance, such as the -29- replacement of a defective light bulb, are the most frequent matters requiring attention, and often, shop staffs are their own worst enemies in this respect. Conveniences are, also, often found to be in use for the storage of goods. This is part of the storage problem met with in so many shops which is referred to under 'Floors, Stairs and Passages' below. Washing Facilities The standard in offices is generally good, but in shops leaves much to be desired. Cleanliness is often lacking, and it is frequently obvious from the condition of the hand basins and water heaters that they have not been in recent use. The fact that the definition of a 'wash basin' in the Washing Faci1ities Regulations 1964 does not preclude the use of a sink in the place of a basin does not help attempts to improve out of date facilities. Accommodation for Clothing So often the only facility provided is a nai1 or hook in a convenient door. The minimum requirement made by Inspectors is provision to enable each member of the staff to hang his or her outdoor clothing to dry separately from the clothing of others on a wet day. In the absence of Regulations prescribing minimum standards, it is not possible to require accommodation that would ensure the safe custody of clothes together with the contents of the pockets. Floors, Stairs and Passages Every effort is made to point out to occupiers the dangers of fire and accident arising from the obstruction of floors, stairs and passages. Usually, the obstruction is only a partial one, but instances have been seen where fire and other exits are completely blocked by boxes and cartons containing goods. These conditions are usually rectified immediately in the presence of the Inspector, but in some cases a subsequent visit will find a similar, if minor, condition existing. Dangerous Machines There is an undoubted improvement in the guarding of dangerous machines, although the removal of guards on food slicing machines by operators is sometimes met with. In these circumstances, it is difficult to refute the usual explanation that the machine is about to be cleansed, and it is left to the Inspector merely to impress on the person concerned the inherent dangers of using an unguarded machine. Accidents A total of 72 accidents were reported during the year, and such action taken as was found to be necessary following investigation. No fatal accidents were reported. The total number of accidents reported annually has remained fairly constant over the past few years, but it is questionable that all accidents involving absence from work for 3 days or more are reported. Every effort -30- Hoists and Lifts A total of 126 notices were served during the year requiring works of repair to be carried out, and generally the provisions of the Regulations are being satisfactorily complied with. Beer crate hoists and hand operated service lifts at almost every public house in the Borough did not meet the requirements of the Regulations, at their commencement, but, after an initial resistance, each of the major brewers have now embarked on a programme of improvement to bring these appliances into compliance with present day standards." CLEAN AIR Notices were given to the Council of proposals to instal furnaces in five premises. Seven applications for prior approval of furnace installations were received and approved. Thirteen applications for chimney height approval were received and approved, subject in some instances to the chimney heights being amended. The whole of the borough is covered by smoke control orders. Approval,for grant purposes was given to the install at ion of 13 heating appliances, the total estimated grants amounting to £199. In addition a discretionary grant of £6.26 in respect of the 30 per cent balance of cost of works of adaptation to heating appliances in the dwelling was approved by the Council on grounds of hardship. HOUSING Slum Clearance During the year 3 Clearance areas were represented involving 141 houses. Two Public Inquiries were held and one Order confirmed . Underground Rooms The closure of basement rooms continued throughout the year. 80 such rooms in 39 premises being closed. Closing and Demolition Orders During the year Closing Orders were made in respect of 16 houses which were unfit for human habitation, and6premises were the subjects of Closing Orders on parts of the premises, amounting to 30 rooms. Undertakings not to relet were accepted in respect of one house and sixteen other rooms. Demo1ition 0rders were made on three houses. Houses in Multiple Occupation The Tower Hamlets (Registration of Houses in Multiple Occupation) Informatory and Regulatory Scheme 1971 The above-mentioned scheme came into force on the 1st January, 1971. Its purpose is to provide a register of certain houses in multiple occupation, to control over-crowding and to encourage 1andlords to instal essential facilities. Many landlords failed to register on the appointed date, and failure to register new houses in multiple occupation is still occurring. -31- It is regretted that the Scheme has its failings, one of which is that occupants who are allowed to take up residence without registration cannot be forced to move out and thus, the landlord profits byhis offence. This practice is on the increase. Under the Scheme landlords who wi sh to increase the number of occupants must obtain permission from the Council who can ask for facilities to be provided. Where it is not possible to provide facilities,a Direction under Section 19 Housing Act 1961, is served on the landlord, but again many landlords are deliberately ignoring the direction and are overcrowding their properties. Although they are prosecuted the excess number of occupants cannot be ejected. At the end of the year 1,244 houses were under surveillance. During the year 7 premises were found to be deficient in means of escape in the case of fire, and it was necessary to serve notices to remedy the deficiencies Management Orders were made in respect of 29 premises and informal notices to remedy conditions caused by neglect of management were served with regard to 108 houses. In 34 cases the conditions were rectified. Summonses served for contraventions of the Management Regulations numbered 67, fines amounting to £513 being imposed. Overcrowding Overcrowding by immigrant landlords is still on the increase. Immigrant males arrive in this country without their families, and having found accommodation which in most cases consists of one or two rooms, arrange for their families to join them and thus overcrowding occurs. Notices in respect of overcrowding under the provisions of Section 90 of the Housing Act 1957, were served in 4 instances. Visits in the 1ate evening continue to be made to check that the notices are being complied with. 35 summonses were issued in respect of contraventions, resulting in fines amounting to £540. Directions to prevent or reduce overcrowding we re served in 72 instances under Section 19 of the Housing Act 1961. Summonses numbering 8 were issued for contravention of the Directions, resulting in fines amounting to £195 being imposed. Owing to the constant change of management of houses in multip1e occupation, notices frequently have to be re-served thus causing a pro longed del ay in getting repairs and fire precautions work carried out and overcrowding abated. Standard and Improvement Grants 64 premises were inspected regarding applications made to the Council for standard or improvement grants. Qualification Certificates The Housing Act 1969, provides for the conversion from rent control to rent regulations of dwellings which satisfy qualifying conditions. Where a house which is subject to a controlled tenancy is in good repair and is provided with the standard amenities, a qualification certificate is issued to the owner which enables him to apply to the rent officer for a fair rent to be registered. During the year 33 such applications were received and 27 approved. -32- Applications for Rehousing At the end of the year, there were 6,224 applications for rehousing on the Council waiting list, 394 more than last year. Tenants of Counci1 dwellings who have applied for transfer to larger or smaller accommodation number 1,307. Preferential Housing on Health Grounds App1ications for preferential housing on health grounds investigated during the year numbered 631. An "urgent' assessment was granted in 60 cases and balancing points were awarded in a further 158. Tenant transfer was supported in the case of 214 tenants of Council dwellings. New Mousing During the year 1,372 new permanent dwellings were completed in the borough; 707 by the Borough Council, 610 by the Greater London Council and 55 by other persons. Details are given on page 70. At the end of the year units of accommodation owned by the Borough Council numbered 15,938 comprising 14,304 erected by the Council, 29 prefabricated bungalows and 1,605 properties acquired. Dwellings in the borough owned by the Greater London Council totalled 26,553 at the end of the year. Local Authority owned dwellings now comprise 76% of the total dwellings in the Borough. FACTORIES Provision is made in Section 153 of the Factories Act 1961 for the Medical Officer of Health to include in his annual report prescribed particulars with respect to matters under the Act administered by the Council. These details are given on pages 71 and 72. A certificate of suitability under Section 70 of the Act con t inues in fo rce in respect of one basement bakehouse in the borough,one having closed duringthe year. HAIRDRESSERS AND BARBERS Premises registered with the Council in accordance with Section 21 of the Greater London (General Powers) Act, 1967 numbered 170 at the end of the year. LABELLING AND ADVERTISING OF MEDICINES By the Medicines Act 1968 (Commencement No. 2) Order 1972, the 1st September was appointed for the coming into operation of certain sections of the Medicines Act 1968 which elaborated and extended, and will in due course replace, the existing provisions in the Food and Drugs Acts relating to misleading labelling and advertisements in respect of drugs and take into account the safeguards introduced by the Act. LEGAL PROCEEDINGS A summary of legal proceedings instituted during the year under various Acts and Regulations following ascertainment of contraventions by the public health inspectors and technical assistants will be found on page 73. -33- PERSONAL CLEANSING STATION A cleansing service for verminous persons and persons suffering from scabies operates at Branch Road Cleansing Station, in addition to the service provided for schoolchildren at school treatment centres. Statistics on page 74. DISINFECTION AND DISINFESTATION These services are provided on site at Branch Road Disinfection Station where teams of operators are also based to deal with infection and infestations at premises. Premises and fomites are disinfected after the occurrence of certain infectious diseases, generally by means of steam under pressure or by formaldehyde. Articles of clothing etc. for export are also dealt with where the country to which the goods are being exported requires an official certificate. A service is provided for the disinfestation of premises infested by insects, etc. including ants, bedbugs, cockroaches, fleas, carpet beetles, woodlice, clovermites, firebrats, spider beetles, silverfish and dermestidae. (Statistics on page 74 ). LICENSING ACT, 1961 Applications for registration of clubs under the Licensing Act 1961 are dealt with by a magistrates court, copies of the applications being sent to the Council for any observations it 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 an d reported during the year numbered 25. LODGING HOUSES - COMMON There are three licensed common lodging houses in the borough, providing accommodation for 769 persons as follows:- Salvation Army Hostel, Garford Street 218 Men Salvation Army Women's Hostel, Hopetown Street 228 Women Salvation Army Hostel, 177, Whitechapel Road 323 Men The premises are inspected regularly including visits made at night to ensure compliance with the byelaws relating thereto. LODGING HOUSES - SEAMEN There are two premises in the borough which provide accommodation for 430 Seamen as follows:- Queen Victoria Seamen"s Home, 121/123, East India Dock Road 187 Seamen Sailors' Home, Dock Street 243 Seamen Regular inspections are carried out at these premises, including visi ts at night. MORTUARY SERVICE The Council's mortuary is situated in Cottage Street, Poplar High Street, -34- and adjoins the coroner's court. The mortuary has accommodation for 15 bodies and serves the Poplar and Stepney areas. Prior to the formation of the borough, Bethnal Green Council had an arrangement with Hackney Council for the use of the latter's mortuary, which arrangement continues in respect of mortuary accommodation for that part of the borough, the cost being shared on a population basis. A total of 640 bodies was received during the year (541 in the Council's mortuary and 99 in Hackney mortuary) including the bodies of 180 persons who were resident in other areas. Other statistics will be found on page 73. OFFENSIVE BUSINESSES There are 17 offensive businesses in the borough as follows:- DRESSER OF FURSKINS (3) 34/38 Brodlove Lane 74 Florida Street *419 Old Ford Road POULTRY SLAUGHTERHOUSES (14) *17 Bell Lane * 10b Leyden Street *19 Bell Lane 13 Leyden Street 107 Bethnal Green Road 15 Leyden Street 28 Burslem Street *7 Lower Hessel Street *14 Hessel Street *115/137 Monier Road 36 Hessel Street *4 Monthope street *7 Leyden Street *6 Monthope Street (*Establishment orders on these premises are subject to renewal from time to time) . A new Slaughterhouse opened during the year at 115/137 Monier Road, wit consequent closing of the premises at 161 Cannon Street Road, 163 Cannon Street Road, 16/18 Cobb Street, 75 Hessel Street, 21/22, Lower Hesse) street and 10 a Monthope Street. MISCELLANEOUS REPORTS BY DISTRICT AND SPECIALIST PUBLIC HEALTH INSPECTORS Some 793 reports were submitted to the Controller of Development and Borough Architect in respect of applications for planning permission under the Town and Country Planning Act, 1962, for redevelopment or change of use. 78 reports in respect of the transfer of publicans' licences under the Licensing Act, 1964, were submitted to the Licensing Justices. OUTWORKERS Employers of outworkers in the borough in certain specified occupations are required by the provisions of section 133 of the Factories Act 1961 to supply the Council, in February and August each year, with a list of the names and addresses of al1 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 outwork to be done in a pi ace which is considered to be injurious to the health of the per sons employed -35- The number of outworkers included in the August list was 735 compared with 1,106 in the corresponding list last year. PET ANIMALS ACT, 1951 There are 66 licensed pet shops in the borough including stalls in markets see also page 28 (Diseases of Animals). 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 provisions of this Act and of 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 must be made with the requirements relating to storage, transport, labelling and containers There are 66 names on the list, 3 being removed from and 2 added to the list during the year. POULTRY PROCESSING AND PACKING The number of poultry processing premises has been reduced from 19 to 14 due to the London Board for Shechita opening a new poultry slaughterhouse in the Borough. 192 visits were made to these premises. The total number of birds processed is not accurately known due to the absence of a statutory requirement on traders to furnish this information. It is estimated that about 2,000,000 birds are slaughtered for the Kosher trade and about 1,000,000 for Muslims and for other requirements. In the former case the birds are mainly first grade young hens and cockerels and in the latter poor quality hens and kosher rejects. In both instances there is a small seasonal percentage of turkeys, ducks and geese. The European Economic Community's requirements for the siaughter of poultry are welcomed but there is some doubt whether the retail trade in live birds at a slaughterhouse for immediate slaughter and take-away by the purchaser will come within the scope of the regulations. There is already an exemption for "producer to consumer" trade but it is thought that the "retailer of livebirds to the consumer" trade is unique to this district, and since it accounts for about 1,000,000 poor quality birds per year over which there appears to be no control, it can only be hoped that the Minister of Agriculture, Fisheries and Food will have regard to it when Regulations are made.The "producer to consumer" exemption is an "escape clause" made with the best intention but is open to abuse. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 This Act, designed to secure the use of clean filling material sin articles which are upho1stered, stuffedor 1ined, requires the licensing or registration, as the case may be, of premises where rag flock is manufactured or stored or filling materials used. Regulations made under the Act prescribe standards of cleanliness for filling materials. 12 samples of filling materials were obtained from registered premises during the year and submitted to the prescribed Analyst for examination. All of these samples proved satisfactory. -36- REFRESHMENT HOUSES In connection with the provisions of Section 89 of the Public Health Act, 1936 and Section 80 of the Public Health Act, 1961 relating to sanitary conveniences in refreshment houses, 6 notices were served during the year requiring the provision of sanitary accommodation to comply with the Council's s t andards. REFUSE DISPOSAL The Cleansing Officer of the Council has kindly supplied some statistics relating to refuse disposal for the year, given on page 79. RENT ACT, 1968 No applications under the Rent Act 1968 were received for certificates of disrepair during the year. 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. Inthisperiod out of 3,969 dwel1ings and other premises requiring inspection 2,323 were found to be infested with mice or rats compared with 3,668 last year. Treatments were carried out by the department's rodent control staff in 2,323 properties the charges for servicing business premises amounting to £921. Statistics are given on page 76. SEWERAGE The arrangement in the area for sewerage and sewage disposal are satisfactory. The planned programme of reconstruction of defective sewers is proceeding. SWIMMING BATHS The water in the seven public swimming baths in the Borough and in the Bath at the Council's Hornchurch Children's Home is sampled at monthly intervals by the Scientific Department of the Greater London Counci1 on this Counci1's behalf. A total of 136 samples taken during the year proved satisfactory. Seven were unsatisfactory and appropriate action taken. In addition 59 samples were taken from nine school swimming baths in the borough, 6 samples being unsatisfactory. VACANT SITES The development of some sites for open space and car parking has prevented recurring misuse of cleared and fenced sites and is a policy which should be encouraged on a temporary basis. Of the 93 sites which came to notice during the year 56 were cleared of rubbish and fenced by the end of the year. A further 63 from the previous year were also d^alt with. -37- Ownership of the sites dealt with was as follows:- Sites requiring Sites dealt action with Greater London Council 69 45 Borough Council 14 3 Private Ownership 10 8 In 10 cases where the owners were not traced or who defaulted the work was carried out by the Council's contractor, and the cost made a charge on the 1and.. WATER SUPPLY The domestic water supply in the borough is supplied by the Metropolitan Water Board. The supply to the area is derived from the Rivers Thames and Lea, and is not piumbo-so1vent. Daily samples of the water are subjected for quality control to regular routine chemical and bacteriological examination at the Board's laboratories. The water supply to the borough has been satisfactory both in quality and quantity during 1972. No artificial fluoride was added and where fluoride is indicated in the analyses it represents the naturally occuring fluoride in the water. Immediate action is taken in respect of any form of contamination revealed by inspection or analysis. All new and repaired mains are disinfected with chlorine and the water subsequently checked as to quality, before the structures are restored to service. No houses are permanently supplied by standpipe. There are 18 deep wells in the borough in use. The Metropolitan Water Board was notified on 33 occasions where wastage of water was taking place. Notifications were received from the Board on 48 occasions of intention towithdraw the supp1y frompremises becauseof non-payment of rates. In October 1965 the Council resolved in favour of fluoridation of the water supply. However, in this respect councils in the Greater London area do not have overall control of the water supplied to their boroughs which is provided by the Metropolitan and other Water Boards. Section 23 of the Greater London Council (General Powers) Act 1967 empowers the Council to carry out work and recover the reasonable expenses incurred thereby to secure that the supply of water to a building is restored by the statutory water undertakers where such supply has been disconnected by reason of the defective state of the supply pipes etc. The Medical Officer of Health is authorised by the Council to exercise its powers under this enactment in appropriate cases. WORKS iN DEFAULT Works were carried out by the Council on 38 occssions during the year in default of persons on whom notices were served requiring the execution of works. They comprised 28 instances of failure to comply with notices served under Section 17, Public Health Act, 1961 regarding choked drains, and 10 instances of failure to comply with notices served under Section 4 of the Prevention of -38- Damage by Pests Act, 1949 for clearance of refuse from sites and erection of corrugated steel fencing. STATISTICS Tables 30 to 50 of the Appendix give additional statistical information of the environmental health services -39- -40- PART V MISCELLANEOUS SERVICES V. MISCELLANEOUS SERVICES ACCIDENTS IN THE HOME 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 Health Committee. Health education for the prevention of home accidents has continued throughout the year, with particular reference both to those groups at greatest risk and to the most prevalent causes. Inquests were held during the year on 19 fatalities in the borough arising from accidents which occurred in the home, including 6 from falls, 5 from poisoning, 2 from carbon monoxide and 1 from burns Many children were admitted to hospital or treated as out patients after swallowing medicines in tablet or capsule form. Special publicity is arranged each year regarding home accident prevention including the necessity for preventing medicines and other dangerous materials from being accessible to children and for precautions to be taken during the "Firework season". AMBULANCE FACILITIES The Greater London Council is responsible under Section 27 of the National Health Service Act 1946 for the provision of ambulance transport in the area. ARTIFICIAL KIDNEY MACHINES During the year the Council undertook the work, and bore the cost, of carrying out necessary adaptations including plumbing, electricity and water supplies to three more dwellings in the borough where renal dialysis machines were being installed, two by St. Bartholomews Hospital and one by the London Hospital. The cost of adaptation was £1,400. AUTHENTICATION OF INTERNATIONAL CERTIFICATES OF VACCINATION AND INOCULATION Persons proceeding abroad are required in certain countries to produce acertificate of recent successful vaccination and/or inoculation, and in addition the signature of the vaccinating dcrctor must be verified by the Medical Officer of Health of the district. During the year 6,848 signatures on certificates were verified as those of medical practitioners practising in the borough and the certificates endorsed accordingly, BLIND AND PARTIALLY SIGHTED PERSONS For the purpose of the Council's scheme for providing welfare services under the National Assistance Act 1948 for the blind and partially sighted, it is necessary to arrange medical exanmnations in connection with the certification of such persons. The department arranged 74 examinations by a consultant ophthalmologist during the year, and certificates accepted f rom other 1ocal authorities, hospitals and private ophthalmologists numbered 68 Transport to the clinic for examination is arranged for these persons where necessary 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 Burials undertaken during the year numbered 57 (Statistics on page 78) CHIROPODY Treatment is provided free to old persons in receipt of retirement pensions, expectant mothers, school children and the physically handicapped. -41- Foot clinics are held at 9 of the Health Department's establishments, and at 2 other establishments, providing a total of 42 sessions each week by the Chief Chiropodist, a ful1 time Senior chiropodist and nine part-time chiropodists. For those unable to attend clinics, 7 of the chiropodists visit their homes to give treatment. The purpose designed clinic for "transport" cases i.e. those with limited physical capabilities operated on four days each week throughout the year. The number of treatments carried out in Council clinics and in Social Services Homes for the Elderly are set out in Table 19 CONFERENCES Conferences attended by members of the Council and/or officers of the department are summarised on pages 80 and 81 DECEASED PERSONS Inquests Inquests were held on 92 residents of the borough during the year, the verdicts being 19 deaths due to road accidents. 26 other accidents, 9 suicide, 12 misadventure, 20 open verdicts, 1 natural causes, 1 chronic alcoholism. 2 murder. 1 manslaughter and 1 neglect, Transport of bodies abroad From time to time certificates are issued regarding bodies being transported abroad to the effect that the deceased had not died from an infectious disease and that the coffins were hermetically sealed. Seventeen such certificates were issued this year, relating to 16 bodies flown to Israel and 1 to France. HOMF. BATHING Aged persons who are bedfast or homebound are given bed baths and, where the person is sufficiently agile, complete baths in their own homes by the Council's bathing at tendants. This service is of increasing assistance in relieving the district nurses of as much non-nursing duty as possible (Statistics on page 63.) HOSPITAL FACILITIES The undermentioned hospitals are situated within the borough- No. of Beds Bethnal Green Hospital, Cambridge Heath Road, E.2. 308 London Hospital, Whitechapel Road, E.l. 719 London Chest Hospital, Victoria Park. E.2. 142 London Jewish Hospital, Stepney Green, E.l. 128 Mildmay Mission Hospital, Austin Street, E,2, 70 London Hospital (Mile End) Bancroft Road. E.l. 410 Poplar Hospital, East India Dock Road, E.14. 107 Queen Elizabeth Hospital for Children, Hackney Road E.2. 146 St, Andrew's Hospital Devons Road E.3. 365 London Hospital (St. Clement's) Bow Road. E.3. 128 -42- LABORATORY FACILITIES Bacteriological investigations for infectious diseases are carried out on behalf of the health department by the Public Health Laboratory Service (directed by the Medical Research Council for the Department of Health and Social Security) at County Hall, S.E.I. Investigations carried out by the Laboratory on specimens submitted by the department totalled 567. comprising 566 faeces and 1 serum Bacteriological investigations on 120 food samples were carried out during the year. LEGISLATION The following acts, orders and regulations affecting the department were made during the year:- Acts of Parliament Date made Date Operative Agriculture (Miscellaneous Provisions Act 1972 9. 8.72 1. 1.74 Criminal Justice Act 1972 26.10.72 1. 1.73 Deposit of Poisonous Waste Act 1972 30. 3.72 30. 3.72 Employment Medical Advisory Service Act 1972 11. 5.72 1. 2.73 Greater London Council (General Powers)Act 1972 9. 8.72 9. 8.72 Poisons Act 1972 9. 8.72 9. 8 72 Orders and Regulations Bread and Flour (Amendment) Regulations 1972 13. 9.72 1.11.72 Building Regulations 1972 Deposit of Poisonous Waste (Notification of 29. 2.72 1. 6.72 Removal or Deposit) Regulations 1372 6. 7.72 3. 8.72 Fire Precautions Act 1971 (Commencement No. 1 ) Order 1972 21. 2.72 20. 3.72 Fire Precautions (Hotels and Boarding Houses) Order 1972 21. 2.72 1. 6.72 Food (Control of Irradiation) (Amendment) Regulations 1972 16. 2.72 1. 4.72 Housing (Prescribed Forms) Regulations 1972 21. 2.72 1. 5.72 Labelling of Food (Amendment) Regulations 1972 10.10.72 8.11.72) 5. 1.76) Lead in Food (Amendment) Regulations 1972 30.11.72 1. 1.73 Local Authorities (Goods and Services) (Public Bodies) Order 1972 5. 6.72 3. 7.72 Live Poultry (Restrictions) Amendment Order 1972 Medicines Act 1968 (Commencement No. 2) 7. 9.72 29. 9.72 Order 1972 Milk (Special Designation) (Amendment) 16. 8.72 1. 9.72 Regulations 19 72 National Health Service lQuali f icat ion of Health Visitors) Regulations 1972 25. 7.72 25 11.72 1.10.72 1. 1.73 Smoke Control Areas (Exempted Fireplaces) Order 1972 21 3.72 18. 4.72 Smoke Control Areas (Exempted Fireplaces) No- 2 ) Order 1972 26. 7.72 3. 8.72 The Heavy Goods Vehicles (Drivers' Licences) (Amendment) Regulations 1972 12 12.72 18. 1. 73 -43- C i rcu1ars Circulars on other matters relevant to the functions of the department and issued by the various Government Departments during the year included those relating to the following subjects Analysis of Rain Potable and Waste Waters Capital Programme 1972-3 Compensation Blight and Rehousing; De sign Bulletin 22 New Housing in a cleared area Design Bulletin 25 . The Estate Outside the Dwelling reactions of residents to aspects of Building Layouts Development involving the use of storage in Bulk of Hazardous Material Food Hygiene Code of Practice Hygiene in Microwave Cooking Health Visitor Training Academic Year 1973 74 Heating for Elderly People in Winter Homeless Single Persons in need of care and support Local Authorities Socia1 Services 10 year Deve1opment PI an 1973-83- Review of Waste Disposal Facilities Sites for Gypsy Caravans Solid Fuel Supplies - Priority Consumers Sunlight and Daylight Planning Criteria and Design of Buildings Traffic and the Environments Training of District Nurses Vaccination against Rubella for Women of Chi1d bearing age Vasectomy Volume 2 of the River Pollution Survey 1970 of England and Wales Water Charges. MEDICAL EXAMINATION OF STAFF The department's medical officers undertake for the Council the medical examination of new entrants to the Council's service, of staff and employees absent due to sickness exceeding one month, of employees considered for participation in the Sick Pay Scheme and for extension of service beyond the age of 65 years, as well as assessments for gratuities and other reasons as required. Examinations or assessments carried out during the year numbered 1,654 (details on page 68 ) RADIOACTIVE SUBSTANCES Persons who keep or use radioactive materials unless exempted are required under the provisions of the Radioactive Substances Act 1960 to register with the Department of the Environment and to obtain authority for the accumulation or disposal of radioactive waste. The Department has issued 14 registration certificates with respect to premises in the borough. REFRESHER COURSES Refresher and training courses attended by staff during the year are listed on pages 82 to 84. REMOVAL OF PERSONS IN NEED OF CARE AND ATTENTION 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 justice of the Peace for an Order for the removal to hospital or institution of any aged, infirm or physically incapacitated person living in insanitary conditions, and who is in need of care and attention. It was found necessary this year to apply for Removal Orders under this enactment in respect of 12 persons, 11 of whom were removed to hospital and 1 to a Welfare home. -44- STAFF CHANGES Appointments and resignations of members of the staff numbered 66 and73 respectively, as fol1ows:- Appointments Resignations Administrative and Clerical 10 12 Dental Staff 11 14 Medical Officers 2 2 Nursing Staff: Health Visiting 14 13 Clinic and School 12 9 District Nurse 7 7 Public Health Inspectors and Pupils 2 2 Social Workers 1 1 M i see 11aneous 7 13 TOTAL 66 73 TRAINING etc. FOR STUDENTS As part of their training and studies, student nurses, medical students and others need to make visits of observation to local Health Authority establishments and to spend time with certain field staff. Students accepted during the year numbered 464 comprising:- 48 Student Nurses London Hospital, Community Option period. 296 Student Nurses London, Mile End, Bethnal Green, St. Andrews, London Jewish and Great Ormond Street Hospitals. 91 Medical Students London and Middlesex Hospitals. 12 Degree and Integrated Nursing Degree Course Nurse-Health-Visitor Course Students 10 Student Health Visitors Polytechnic of North London, North East London Polytechnic and Polytechnic of the South Bank 1 Community Liaison Officer London Hospital 1 Psychiatric Nurse St. Clements Hospital 2 Occupational Therapy Students London Hospital 2 Visiting Nursing Students U.S.A. 1 Student District Nurse Tutors' Course. -45- -46- PART VI REPORT OF THE PRINCIPAL SCHOOL MEDICAL OFFICER ON THE SCHOOL HEALTH SERVICE VI REPORT OF THE PRINCIPAL SCHOOL MEDICAL OFFICER ON THE SCHOOL HEALTH SERVICE The Inner London Education Authority is responsible for the School Health Service, but by virtue of an agreement by Section 32 of the London Government Act. 1963, there is joint use by the Authority and the Council of professional staff premises and equipment. The Medical Officer of Health is the Principal School t'edical Officer of the Inner London Education Authority for the area of the borough and is responsible to that Authority for the day to day running of the Service. As in previous years close liaison with the Medical Adviser and his central staff has maintained an effective service. At local divisional level, Mr, Peirce and his staff have been ever willing to continue good working relationships. SCHOOLS AND SCHOOL ROLLS Pupils on school rolls numbered 30.679 at the end of the year, at tending 98 maintained schools in the borough which include four schools for the educationally subnormal, two for the maladjusted one for delicate children, and one for the physically handicapped. There are no direct grant or independent schools included in the School Health Service. The registers were as follows:- Type of School 'No. of Schools Pupi1s Primary 63 17,751 Secondary 20 11,304 Nursery 7 714 Special 8 910 MEDICAL INSPECTION OF SCHOOLCHILDREN Routine Medical Examinations These are carried out by medical officers of the department assisted by school nurses. Where further examinations are found to be required children are referred to special clinics, e.g. vision hearing dental, child guidance and special investigation clinics, etc. Non-routine Medical Examinations These examinations are carried out for various reasons, e.g. prior to departure on school journeys for ascertainment of suitability for ordinary school and at the request of the head teacher, educational welfare officer, schoo1 nurse, pa rent or medical officer. Attendances for treatment of scabies at the bathing centres decreased from 205 last year to 180 in 1972. A combined approach with the co operation of local schools, general practitioners and the borough cleansing station staff continued during the year toensure where possible that all known cases, and their family and other contacts are given a complete course of treatment. -47- HANDICAPPED PUPILS Every possible care is given to ensure that any child with a handicap which might affect his or her educational attainment is kept under careful review and consideration, whether he or she is in an ordinary school or a special school, and a register of all handicapped children is maintained to ensure no child is lost sight of when he/she moves from school to school or borough to borough Tower Hamlets children placed in special schools are as follows:- Handicap No at Day Schools No at Boarding Schools Blind - 6 Partially sighted 20 - Deaf 5 3 Partially hearing 48 4 Educationally subnormal 496 114 Epi1ept i c - 1 Maladjusted 93 77 Physically handicapped 85 12 De1icate 111 20 Multiple handicaps - 4 TOTALS 858 241 INFECTIOUS DISEASE IN SCHOOLS Of the 980 cases of infectious disease notified 356 or 36% related to school-chi1dren. In addition 1,318 notifications were made by head teachers of pupi1s absent from school on account of infectious and other illnesses Where the notifications from any particular schoo1 war rant further investigation special visits are made and any necessary investigations carried out including the taking of specimens for bacteriological examination to ascertain the sources of and contain, the outbreak. ENVIRONMENTAL HYGIENE IN SCHOOLS Each school in the borough is visited annually by public health inspectors for environmental hygiene inspection and results of their findings are reported to the Medical Adviser of the Inner London Education Authority. Visits are also made to schools by public health inspectors in connection with enquiries and investigations concerning infectious diseases. MINOR AILMENTS CLINICS Children suffering from minor ailments may be referred to minor ailments clinics where they are seen by a nurse and the appropriate treatment given. A doctor attends one of these c1inics where vaccination and immunisation is also given. There are 8 such clinics situated in school treatment centres in the borough. Attendances this year totalled 17,305, compared with 19,819 last year. -48- VACCINATION AND IMMUNISATION RECORDS OF SCHOOLCHILDREN The percentage of school children on school rolls immunised and vaccinated is as fol1ows. D.phthena Tetanus Poliomyelitis 85.9 83.57 86.2 B. C. G. VACCINATION The arrangements continued during t he year fo rvaccinating 13 year old school children against tuberculosis using B.C.G.. 1,279 children being vaccinated. PART TIME EMPLOYMENT OF SCHOOLCHILDREN It is a requirement of the Children and Young Persons Act 1933/Education Act 1944 where children wish to take up part-time employment such as delivering newspapers, etc., that they be medically examined to ensure that they are fit for the proposed employment. All children examined for this purpose during the year were found fit for the employment p roposed. DEAF AND PART I ALLY-HEAR ING CHILDREN Children under 5 suspected of hearing loss are tested by the clinic medical officer at clinic centres. School children are normally tested during their firstyear at school Where such a loss is confirmed or there is any doubt, the child is referred to an audiology clinic and seen by a teacher of the deaf and re-tested by a nurse audio-metrician. Action taken includes referral to hospital for treatment, or for the issue of a hearing aid. or keeping the child under observation where the loss is slight. Children may be recommended to attend a partially hearing unit in one of the primary schools in the Borough. There are no special schools for deaf children in the borough, children having to go to a school in Is 1ington. EDUCATIONALLY SUBNORMAL CHILDREN From the 1st April 1971, under the Education (Handicapped Children) Act 1970. the provision for notifying a child as unsuitable for education at school ceased, and the provisions of Section 34 of the Education Act 1944 regarding special educational treatment apply to such children. The Education Act 1944 makes provision for the statutory examination of children who may require special educational treatment and for review examinations of such children. Children examined for these purposes during the year by specially qualified medical officers numbered 80. There are four schools in the borough for the education of these children who are medically examined each year HEALTH EDUCATION IN SCHOOLS Liaison with various schools in the borough continued to give good results Teaching staff show more interest in the work of the Health Department and appreciate the need for health education -49- Health education sessions held at schools numbered 235 during the year attended by 5.084 pupils EDUCATION (MILK) ACT 1971 From the commencement of the autumn term 1971 this Act of Parliament restricted Education Authorities from providing school milk other than to children under 7 years of age, children attending special schools and children in primary schools for whom the school medical officer certified that such provision was necessary on medical grounds. Following the adoption of a resolution by this Council that expenditure be incurred under the provision of section 6 of the Local Government (Financial Provisions) Act 1963 for the provision of free milk to schoolchildren resident in the borough in the age group 7 to 11 years these children continue to receive school milk hitherto provided by the Inner London Education Authority. SCHOOL DENTAL SERVICE The Principal School Dental Officer (Mr T .H. H. Murray) reports as follows "There are 8 dental clinics in the borough providing dental suites with a total of 13 surgeries one surgery being used exclusively for orthodontics. All premises are provided with up-to- date equipment. Inability to keep the number of dental officers up to establishment dui.ng 1972 resulted in a falling off of the amount of dental treatment being offered The position now seems to be more stable and it is expected that it will improve Forward planning includes new dental surgeries in a health centre in Watney Street for 1976." STATIST ICS Statistics relating to the School Health Service will be found on pages 85 to 89 -50- PART V I I APPENDIX OF STATISTICAL TABLES TABLE I TOTAL DEATHS BY CAUSE AND AGE OF TOWER HAMLETS RESIDENTS - 1972 (Registrar-General's Return) Cause of Death ALL AGES AGE GROUP TOTAL M F -1 1- 5- 15- 25- 35- 45- 55- 65- 75- Enteritis and other diarrhoeal diseases 1 - 1 1 - - - - - - - - - Tuberculosis of respiratory system 14 10 4 - - - - - 2 1 1 6 4 Late effects of respiratory tuberculosis 2 1 1 - - - - - - - 1 - 1 Other tuberculosis 2 2 - - - - - - - - 1 1 - Meningococcal infection 1 - 1 - - 1 - - - - - - - Syphilis and its sequealae 1 - 1 - - - - - - - - 1 - Other infective and parasitic diseases 4 1 3 3 - - - - - - 1 - - Malignant neoplasm-buccal cavity, etc. 9 7 2 - - - - - - - 3 2 4 Malignant neoplasm-oesophagus 10 7 3 4 - 6 Malignant neoplasm-stomach 70 48 22 - - - - 1 1 5 17 24 22 Malignant neoplasm-intestine 57 29 28 - - - - - 2 5 15 14 21 Malignant neoplasm-larynx 5 5 - - - - - - - - 2 2 1 Malignant neoplasm-lung, bronchus 149 116 33 - - - - - 2 13 48 50 36 Malignant neoplasm-breast 57 - 57 - - - - - 4 14 18 10 11 Malignant neoplasm-uterus 17 - 17 - - - - - 1 3 1 6 6 Malignant neoplasm-prostate 20 20 - - - - - - - - 1 7 12 Leukaemia 9 3 6 - 1 1 1 1 - 1 1 1 2 Other malignant neoplssms 143 77 66 - - 1 2 2 3 20 27 52 36 Benign and unspecified neoplasms 2 1 1 - - 1 - - - - 1 - - Diabetes mellitus 22 10 12 - - - - - - 2 5 7 8 A vitaminoses. etc. 2 2 - - - - - - - 1 - - 1 Other endocrine etc. diseases 5 4 1 2 - - - - - 1 1 - 1 Anaemias 9 3 6 - 1 - - - - - 1 2 5 Other diseases of blood etc. 2 1 1 - - - - - - - - 1 1 Mental disorders 7 6 1 - - - - - 1 2 1 1 2 Meningitis 1 1 - - - - - - - - 1 - - Other diseases of nervous system 17 8 9 - 1 1 1 1 2 2 2 4 3 Chronic rheumatic heart disease 24 10 14 - - - - - 2 1 10 6 5 Hypertensive disease 20 4 16 - - - - - 1 2 2 5 10 Ishaemic heart disease 498 292 206 - - - - - 8 45 105 171 169 Other forms of heart disease 93 37 56 - - - - - - 2 6 24 61 Cerebrovascular disease 178 77 101 - - - - 1 2 9 14 59 93 Other diseases of circulatory system 84 25 59 - - - - - - 2 6 20 56 Influenza 12 6 6 - - - - - - 2 1 6 3 Pneumonia 226 92 134 2 1 - - 3 4 4 14 45 153 Bronchitis and Emphysema 170 126 44 - - - - - 3 9 27 61 70 Asthma 2 2 - - - - - - - - 1 1 - Other diseases of respiratory system 25 16 9 3 - - - - 1 2 3 5 11 Peptic ulcer 9 6 3 - - - - - - 1 - 3 5 Appendicitis 1 1 - - - - - - - 1 - - - Intestinal obstruction and hernia 16 5 11 1 - - - - - - 2 4 9 Cirrhosis of liver 6 2 4 - - - - - - 1 5 - - Other diseases of digestive system 24 11 13 - - - - 1 - 1 2 6 14 Nephritis and nephrosis 13 7 6 - - - - - 2 4 3 1 3 Hyperplasia of prostate 5 5 - - - - - - - - - 2 3 Other diseases, genito-urinary system 15 5 10 1 - - - - 1 2 3 1 7 Diseases of the skin, subcutaneous tissue 5 2 3 - - - - - - - 1 - 4 Diseases of musculo-skeletal system 6 - 6 - - - - - - - - 2 4 Congenital anomalies 14 6 8 7 2 2 - - - 1 - 1 1 Birth injury, difficult labour, etc. 18 9 9 18 - - - - - - - - - Other causes of perinatal mortality 5 3 2 5 - - - - - - - - - Symptoms and ill defined conditions 17 7 10 6 1 - - - - - 2 3 5 Motor vehicle accidents 15 11 4 - 1 1 3 2 - 1 1 5 1 All other accidents 44 27 17 2 3 4 3 1 5 9 4 4 9 Suicide and self-inflicted injuries 9 8 1 - - - 1 1 1 2 1 1 2 All other external causes 17 13 4 1 - - 2 3 1 4 2 4 - Males 1,177 28 5 4 10 14 33 118 236 386 343 Females 1,032 24 6 8 3 3 16 57 132 245 538 GRAND TOTAL 2 209 52 11 12 13 17 49 175 368 631 881 -51- TABLE 2 SUMMARY OF ROAD ACCIDENTS OCCURRING IN THE BOROUGH Pedestrians Motor Cyclists Pedal Cyclists Other Road Users Total 1972 killed 13 - 1 5 19 injured 592 121 70 939 1,722 1971 killed 13 1 3 5 22 injured 587 178 75 857 1,697 TABLE 3 INFANT MORTALITY Deaths from stated causes at various ages under 1 year complied from local death returns) AGE PERIODS Total Deaths under 1 year Per Cent of Total Under 24 hours 1-6 days Weeks Months 1- 2- 3- 1- 4- 7- 10- Respiratory Distress Syndrome 2 3 1 - 1 - - - - 7 (7) 14.3 Bronchitis - - - - - - 1 - - 1 (4) 2.0 Pneumonia - 1 - 1 1 - 5 1 - 9 (5) 18.4 Congenital Malformations - - - 1 1 1 2 - - 5 (7) 10.2 Premature Birth 1 2 - 1 - - - - - 4 (15) 8.2 Asphyxia, Atelectasis 1 - - - - - - - - 1 (3) 2.0 Birth Injuries - - - - - - - - - - (1) - Other Causes 3 4 1 2 2 8 - 1 1 22 (13) 44.9 TOTALS: 7 10 2 5 5 9 8 2 1 49 (55) 100.0 (*Figures in parenthesis denote corresponding deaths in 1971) TABLE 4 INFANT MORTALITY Comparative table showing deaths of infants at various ages under 1 year Year Under 24 hours 1-6 days 1-4 weeks Total under 4 weeks 1 - 12 months Total under 1 year Percentage deaths under 4 weeks of total Infant deaths 1968 20 18 11 49 19 68 72 1969 11 13 4 28 15 43 65 1970 16 13 4 33 16 49 67 1971 25 10 6 41 14 55 74 1972 7 10 12 29 20 49 59 -52- -es- COMPARATIVE VITAL STATISTICS Year Population Live Births Deaths Deaths under 1 year Maternal Deaths Cancer Deaths (all forms ) Tuberculosis Deaths (all forms) No. Rate* No. Rate* No. * Rate* No. * Rate* No. Rate* No. Rate* 1901 597,106 21, 515 36.0 12, 143 20.3 N/A N/A 420 0.7 1,670 2.8 1911 570,429 17,461 30.6 10.272 18.0 2, 664 152.5 51 2.9 506 0.8 1, 223 2.1 1921 530, 656 13,283 25.0 6, 863 12. 9 1,219 91.8 29 2.1 571 1.1 751 1.4 1931 491,300 8, 585 17.5 6,286 12.7 685 79.8 26 2.9 692 1.4 565 1.1 1941 174, 520 2, 607 14.9 6, 733 21.4 117 44.8 5 1.8 399 2.2 272 1.5 1951 229,118 4,092 17.8 3,083 13.4 101 24.7 5 1.2 531 2.3 90 0.4 1961 204, 340 4, 037 19.7 2,484 12.1 95 23.5 5 1.2 480 2.3 25 0.1 1962 204, 050 4, 086 20.0 2,474 12.1 79 19.3 0 0 503 2.5 24 0.1 1963 203,850 3, 988 19.6 2, 531 12.4 96 24.1 2 0.5 510 2.5 24 0.1 1964 206,080 4, 026 19.5 2,256 10.9 92 22.8 1 0.2 523 2.5 12 0.05 1965 204, 560 3, 867 18.9 2,280 11.1 76 19.6 0 0 529 2.6 21 0.1 1966 202, 560 3,703 18.3 2,245 11.1 62 16.7 0 0 481 2.4 22 0.1 1967 198, 230 3, 262 16.4 2,130 10.7 56 17.2 1 0.3 539 2.7 18 0. 1 1968 192,250 2, 875 15.0 2,382 12.4 69 24.0 0 0 539 2.8 18 0.1 1969 188, 080 2, 612 13.9 2,315 12.3 46 17.6 2 0.8 493 2.6 15 0.1 1970 182,260 2,471 13.6 2,170 11.9 50 20.2 1 0.4 537 2. 9 17 0.1 1971 164, 650 2,234 13.6 2,147 13.0 54 24.2 0 0 567 3.4 9 0. 05 1972 159,200 1, 979 12.4 2,209 13.9 52 26.3 0 0 546 3.4 18 0.1 * per 1, 000 population * * per 1, 000 total births N.A.-Not available NOTE: Figures prior to 1965 relate to those of the former Metropolitan Boroughs of Bethnal Green, Poplar and Stepney. TABLE 6 OBSERVATION REGISTER (i) Observation Register (Children under 5 years) No. on Register on 1st January 2, 789 3,736 No. added during year 947 No. removed during year - died 21 - moved away 358 - no longer at risk 839 - transferred to ages 5-21 register 42 1,260 Total on Register at 31st December 2,476 No. of above total suffering from handicaps 220 Year of birth of those on Register at 31st December 1972 765 1971 650 1970 438 1969 360 1968 263 2, 476 (ii) Observation Register (5-21 years) Total on Register at 31st December 2, 577 (iii) Handicaps of children and young persons on Observation Register 0-4 years 5-21 years Educationally subnormal - 805 Severely subnormal - 127 Physically handicapped 134 557 Mentally retarded 33 - Maladjusted - 280 Blind (Registered) ) - 5 Visual defects ) 5 72 Speech defects (requiring special or other school) 16 23 Epileptic 7 115 Deaf and partially hearing 11 195 Delicate (including diabetic) - 137 Multiple handicaps 14 261 Total: 220 2, 577 In addition there are 233 children suffering from handicaps attending schools in the Borough, but living outside the Borough. -54- TABLE 7 DISEASES NOTIFIABLE IN THE BOROUGH Disease Authority for Notification Statutory Instrument No. Acute Encephalitis Health Services and Public Health Act 1968 (Section 56) 1968/1366 Acute Meningitis -do- -do- -do- Acute Poliomyelitis -do- -do- -do- Anthrax -do- -do- -do- Cholera -do- (Section 48) - Diphtheria -do- (Section 56) 1968/1366 Dysentery (Amoebic) -do- -do- -do- Dysentery (Bacillary) -do- -do- -do- Food Poisoning -do- (Section 48) - Infective Jaundice -do- (Section 56) 1968/1366 Leprosy -do- -do- -do- Leptospirosis -do- -do- -do- Malaria - do- -do- -do- Measles -do- -do- -do- Ophthalmia Neonatorum -do- -do- -do- Paratyphoid fever -do- -do- -do- Plague -do- (Section 48) - Relapsing fever -do- -do- - Scarlet fever -do- (Section 56) 1968/1366 Smallpox -do- (Section 48) - Tetanus -do- (Section 56) 1968/1366 Tuberculosis -do- -do- -do- Typhoid fever -do- -do- -do- Typhus -do- (Section 48) - Whooping Cough -do- (Section 56) 1968/1366 Yellow fever -do- -do- -do- -55- TABLE 8 INFECTIOUS DISEASE NOTIFICATIONS Corrected Notifications Removed to Hospital Notified in 1971 Notified in 1970 Acute Encephalitis Infective - - - - Post - infectious - - - - Acute Meningitis 2 2 8 2 Acute Poliomyelitis Paralytic - - - - N on-para lytic - - - - Anthrax - - - - Cholera - - - - Diphtheria - - - - Dysentery 96 5 39 36 Food Poisoning 27 6 68 82 Infective Jaundice 50 22 66 127 Leptospirosis 1 1 - - Malaria 1 1 - - Measles 578 20 238 1,063 Ophthalmia Neonatorum - - - 2 Plague - - - - Relapsing Fever - - - - Scarlet Fever 69 3 50 48 Smallpox - - - - Tetanus - - - - Tuberculosis Pulmonary 123 76 101 Non-pulmonary 20 18 17 Typhoid Fever - - 2 3 Whooping Cough 13 2 54 138 Yellow Fever - - TOTALS: 980 62 619 1, 619 TABLE 9 MORBIDITY - First Claims for Sickness Benefit The number of claims made to local offices of the Department of Health and Social Security covering postal districts E. 1., E. 2., E. 3., and E. 14., were as follows;- 1972 1971 1970 1972 1971 1970 January 4,753 5, 074 6, 432 July 2, 823 2,371 2, 557 February 3,107 2,603 3, 670 August 2,094 2, 698 2, 607 March 2,766 3, 892 4, 074 September 3, 015 2, 383 3,410 April 3, 003 2,350 3,447 October 2, 939 2, 704 3,265 May 2,336 3,050 2, 710 November 3,370 3,457 3,145 June 2,442 2,387 2, 934 December 4, 609 2, 718 3,406 TOTALS: 37,257 35, 687 41, 657 -56- TABLE 10 VACCINATION AND IMMUNISATION Children vaccinated/immunised Others aged T O T A L Year of birth 1972 1971 1970 1969 196568 Under 16 Over 16 Diphtheria 675 1,048 108 58 126 108 - 2,123 Re-inforcing - 368 1,087 308 1,331 327 5 3,426 Tetanus 675 1,048 108 58 130 175 8 2,202 Re- inforcing Dose - 368 1,087 309 1,364 596 150 3,874 Whooping Cough 668 1,029 91 12 9 - - 1,809 Re-inforcing Dose - 356 1, 042 150 46 5 - 1,599 Poliomyelitis 677 1,046 108 61 130 118 2 2, 142 Re-i nforcing Dose - 369 1,087 286 1,382 633 49 3,806 Measles 1 1,136 259 65 79 11 - 1, 551 Rubella _ - 743 - 743 Diphtheria immunisation of children under 5 Children under 5 immunised during 1968/72 9, 227 Estimated population under 5 as at 30th June 1972 10,400 Percentage protected 88.7 Vaccinations/immunisations (all ages) carried out at clinics/general practitioners surgeries At Council Clinics By General Practitioners "Jo Primary by General Practitioners Primary Reinforcing Primary Reinforcing Diphtheria 1,885 2, 971 238 455 11.21 Tetanus 1, 906 3, 160 296 714 13. 44 Whooping Cough 1, 585 1,390 224 209 12.38 Poliomyelitis 1, 917 3,325 225 481 10.50 Measles 1,360 - 191 - 12.31 Rubella 707 36 4. 84 -57- TABLE 1i TUBERCULOSIS - NEW CASES AND DEATHS 1972 New Cases and Deaths; Primary notifications of 123 pulmonary and 20 non-pulmonary cases were received; 10 other cases came to light via death returns from Registrars. Pulmonary tuberculosis (including late effects) accounted for 16 deaths, there being 2 deaths from non-pulmonary tuberculosis. Age distribution of new cases and deaths is as follows;- -1 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 55- 75- Total (all ages) (a) New Cases Pulmonary M - - - 4 1 10 3 12 18 15 14 10 7 94 F 1 1 4 6 1 2 3 5 1 3 - 2 - 29 Non-Pulmonary M - - 1 - - 2 1 3 - 2 - - 1 10 F - - - 1 1 1 - 4 1 1 - ■ 1 10 (b) Deaths Pulmonary M - - - - - - - - 1 1 - 5 4 11 F - - - - - - - - 1 - 2 1 1 5 Non-Pulmonary M - - - - - - - ■ - - 1 1 - 2 F - TABLE 12 TUBERCULOSIS - VARIATIONS IN REGISTER Pulmonary Non-Pulmonary Total Males Females Males Females Cases No. Cases notified during 1972 94 29 10 10 143 Other cases added to register 20 3 1 - 24 No. cases removed from register 70 39 3 3 115 Remaining on register at 31st December 589 328 35 46 998 -58- TABLE 13 TUBERCULOSIS - CARE AND AFTER CARE Home Care and Treatment Patients receiving attention by home nurses 2 Work of Tuberculosis Visitors No. of tuberculous households visited 1,140 No. of visits to above and to contacts 6,623 No. ofunsuccessful visits 499 Children No.child contacts boarded out during year Nil No. child contacts boarded out for segregation durinpB. C.G. Vaccination Nil TABLE 14 MASS RADIOGRAPHY - Unit 6A Mobile Surveys No. of factories, sites, etc. visited 8 Persons x-rayed - Males 1,252 - Females 186 - Total 1,438 Mo. referred for further investigation 29 Toynbee Hall- Weekly session Persons x-rayed - Males 2, 955 - Females 2,010 - Total 4, 965 No. referred for further investigation 124 No. found requiring immediate treatment for tuberculosis 9 -do- Clinic supervision 20 No. found suffering from lung cancer 7 TABLE 15 TUBERCULIN TEST 4ND B C G. VACCINATION Contacts Schoolchildren and Students Total No. of skin tests 202 1,508 1,710 No. found positive 63 107 170 No. found negative 139 1,279 1,418 No. vaccinated 136 1,279 1,415 -59- TABLE16 ANTE AND POST NATAL SERVICES No. Ante and Post Natal Sessions Held by: Medical Officers - Midwives 45 No. women attending for ante natal examination 48 No. women attending for post natal examination 35 Total attendances 348 No. General Practitioners holding sessions in Council clinics 4 Mothercraft and Relaxation Classes; No. women attending (a) Institutionally booked 41 (b) Domiciliary booked 4 No. attendances 211 No. sessions held by Health Visitors 48 TABLE 17 CHILD WELFARE CENTRES No. premises at end of year 14 No. sessions during year held by: Medical Officers 224 Health Visitors 73 Sessional General Practitioners 1,512 Hospital medical staff 52 Total Sessions; 1, 861 No. ch ildren attending - bom this year 1, 676 - born last year 1, 984 - born 1967/70 2,771 No. attendances of children of all ages 32, 132 Average attendance per session 17.2 TABLE-18 CERVICAL CYTOLOGY Premises Number Sessions Examinations Council Clinics 3 193 1,491 General Practitioners Surgeries 1 30 104 Family Planning Clinics 3 287 581 Other Slides read in Hospital Laboratories Submitted By G. P's Hospital Other Hospitals St. Andrew's Hospital 118 775 108 Mile End Hospital 1,383 1, 995 649 London Hospital 7,575 (Ressidents of all areas) -60- TABLE 19 CHIROPODY Treated at Clinics Domiciliary Treatment New patients during year 807 113 Total patients at end of year 3,457 679 Treatments - children 80 - - expectant mothers - - - physically and mentally handicapped 51 - - aged persons 13,230 3, 037 No. of chiropodists employed 11 No. of clinic sessions held 1, 980 No. of patients treated per clinic session 7.0 Percentage of total patients receiving domiciliary treatment 16.4 No. of sessions held in Old Peoples' Homes 121 Total No. of treatments; 16, 398 TABLE 20 DENTAL TREATMENT FOR EXPECTANT AND NURSING MOTHERS Expectant Mothers Children Persons examined 43 506 No. requiring and offered treatment 43 486 Visits during the year 181 1, 569 Courses of completed treatment 43 334 Teeth extracted 18 4 Teeth filled 104 967 Emergencies treated 8 102 General anaesthetics given - - No. patients x-rayed 38 1 No. patients treated by scaling etc. 43 304 Dentures - full 2 - - partial 3 2 No. of sessions for treatment 197 -do- for health education 9 No. of treatment Centres at end of year 8 -61- TABLE 21 FAMILY PLANNING SERVICE Attendances at Sessions held at Clinics in the borough during the year. Premises New Cases Old Patients Total Patients Total Visits No. of Sessions. Council Clinics St. Georges 180 - 180 650 76 Island 189 - 189 804 74 Greenwood 269 - 269 903 96 Leopold Street 426 - 426 1, 542 102 Family Planning Asso ciation Clinics Domiciliary Service 76 - 76 - - Underwood Road 452 766 1,218 2,545 171 Wapping 25 47 72 193 24 Wellington Way 241 346 587 1, 400 92 Totals 1, 858 1,159 3,017 8, 037 635 1971 Statistics 1,371 1,201 2,662 7, 103 572 TABLE 22 HEALTH VISITING No. Visited No. of Visits Children bom this year 2,050 ) 34, 974 " " under 5 7,533 ) Aged persons 561 1,756 Mentally disordered persons 59 620 Tuberculous households 12 48 Households on account of other infectious diseases 34 111 Other Cases 2,785 3,618 Visits to expectant and nursing mothers - 2, 058 Total effective visits 43,185 Unsuccessful visits 8,416 TABLE 23 PREMATURE BIRTHS Born in Hospital Born at Home or in Nursing Home 1972 1971 1970 1969 1972 1971 1970 1969 No. of Births 156 166 211 211 7 10 9 5 Died within 24 hours 5 18 11 8 2 1 - Died within 1/28 days 10 7 8 11 - - 1 Premature still births 18 20 23 17 2 2 -62- TABLE 24 HOME BATHING Persons serviced during the year: Male 106 Female 316 Total 422 Ffe rsons receiving service at end of year: Male 73 Female 202 Total 275 Total baths given during year 7, 321 TABLE 25 HOME NURSING Number of patients nursed during year 3,632 Number aged under 5 91 Number aged over 65 1, 935 Number of visits during year 87. 966 TABLE 26 LAUNDERING FOR AGED AND INCONTINENT No. of articles cleansed and laundered during year 74,129 No. of collections made during year 6,318 No. of persons who received service during year 173 No. of persons receiving service at end of year . 92 TABLE 27 RECUPERATIVE HOLIDAYS Category No. for whom holiday arranged Accompanied children: At School 14 Pre- school - Unaccompanied children: Placed by Inner London Education At School Authority: 394 Pre-school - Total 408 -63- TABLE 28 LOAN OF NURSING EQUIPMENT AND FIREGUARDS Nursing equipment and fireguards loaned, by the Council, free of charge to residents of the boroueh during the vear were as follows-- Article S!o, on loan at 1/1/72 No. loaned during year No. returned during year No. on loan at 31/12/72 Air rings 26 19 18 27 Back rests 21 22 22 21 Beds - Air - - - - Bed cradles 19 17 10 26 Beds - Hospital 9 8 8 9 Bed pans 31 29 29 31 Bottles 38 38 34 42 Cups, feeding - 2 2 - Commodes - Chair 183 121 133 171 Commodes - Stool 10 6 8 8 Crutches, Elbow 4 4 4 4 Cushions, sani - - - - Cushions - Sponge - - - - Fracture boards 20 5 3 22 Hoists - Penrhyn 2 2 4 - Mattresses - ordinary 1 4 3 2 Mattresses - Dunlopillo 10 4 5 9 Sheets - rubber 33 40 25 48 Walking frames 27 15 12 30 Walking frames - wheeled 1 - - 1 Walking frames - Zimmer adjustable 1 1 - 2 Walking sticks - tripod 19 9 11 17 Walking sticks - Quadruped 3 - 2 1 Water Closet Seats inflatable 5 - - 5 TOTALS: 463 346 333 476 OTHER EQUIPMENT LOANED Fireguards 573 45 3 615 -64- TABLE 29 DOMICILIARY M IDWIFERY Category Midwives of the Nursing Sisters of St. John the Divine District Nurses Midwives of the London Hospital Total Home Confinements 1972 92 - 32 124 1971 85 - 57 142 1970 118 - 76 194 1969 112 - 121 233 1968 119 - 151 270 1967 146 - 202 348 Early Discharges 1972 112 133 164 409 1971 77 148 132 357 1970 75 198 68 341 1969 48 117 60 225 1968 53 93 43 189 1967 59 52 111 -65- TABLE 30 PARKS AND OPEN SPACES IN THE BOROUGH (a) Administered by Borough Council Location Area in Acres Abbott Road .103 Albert Square Gardens .660 Alfred Street .160 All Saints (Poplar) 1.060 Allen Gardens 1.690 Alton Street 3.000 Arbour Square .660 Arnold Circus .072 Bartlett Park 11.570 Bazeley Street .303 Beaumont Square 1.000 Bethnal Green Gardens 11.970 Blackwall Tunnel Commemoration Park 1. 830 Blair Street .680 Bromley 1.520 Cable Street/Schoolhouse Lane .177 Carlton Square 1. 950 Christchurch (Spitalfields) 1.250 Claredale Estate .569 Club Row .073 Dee Street .449 Ford Square .400 Ford Street .090 Furze Green 1. 930 Gale Street .240 Glaucus Street .700 Globe Road .079 Gosling Gardens 2.500 Grove Hall Park 4. 500 Holy Trinity, Morgan Street .680 Ion Square 2.500 Island Gardens 3.000 Jodrell Road .105 King Edward Memorial 8.500 Kings ley Hall .133 -66- TABLE 30 (Continued) PARKS AND OPEN SPACES IN THE BOROUGH (Continued) (a) Administered by Borough Council (continued) Location Area in Acres Kirkwall Place . 123 Langdon Park 2.610 Mallon (Commercial Street) .190 Meath Gardens 10. 540 Mile End .500 Millwall Park 13.500 Newby Place .490 Peel Grove 1.118 Pelter Street . 122 Poplar 4.409 Prescot Street .230 Roche lie Street .073 Ropewalk Gardens 1.510 St. Bartholomew's (Bethnal Green) .447 St. George's-in-the-East , 2.250 St. James's (Bethnal Green) 2.000 St. James's (Ratcliffe) 2.500 St. John's Parish 2.500 St. Mary's Churchyard 1.260 St. Matthew's (Bethnal Green) 2.065 Shandy Park 3.180 Sidney Square .330 Sir John McDougall Gardens 6.320 Stepney Churchyard 6.960 Stepney Green 6.920 Swanfield Street .227 Swedenborg Square .670 Trafalgar Square .600 Tredegar Square 1.240 The Triangle, Columbia Road .066 Trinity Gardens 1. 030 Trinity Square 1.230 Tunnel (Blackwall) .857 Vallance Road 1.690 Wakefield(Tower Hill) .060 Wapping Gardens 3.560 Waterside Gardens 1. 920 Weavers Fields 15,120 Wick Lane Promenade 1.500 Wyvis Street .257 York Square .200 168.477 (b) Administered by Greater London Council Location Brickfield Gardens 5. 730 Burdett Gardens 4.140 King George's Field, East London Stadium 15.930 Limehouse Churchyard 2.000 Victoria Park 148. 500 Tower Hamlets Cemetery Gardens 4.500 180.800 349.277 -67- TABLE 31 MEDICAL EXAMINATIONS OF COUNCIL STAFF (a) Medical Examinations Number New appointees 25 Transfers to permanent staff 25 Entry to Council's Sick Pay Scheme 15 Sickness absence exceeding one month 328 Extension of service beyond 65 years of age 39 Reviews, heavy goods vehicle drivers, etc. 70 Student Teachers 89 Examinations arranged with other Authorities 1 Total 592 Abortive appointments 176 (b) Medical Assessments For entry to Sick Pay Scheme 388 New appointees 445 Transfers to permanent staff 226 LOLA Staff 3 1,062 TABLE 32 D ISEASES OF ANIMALS ACTS Kosher Poulterers and Poultry Slaughter houses Inspections for cleanliness and fowl pest control 161 Street Markets Inspection re sale of animals and observations on movements of live poultry 54 Pet Shops Visits 100 TABLE 33 VISITS BY PUBLIC HEALTH INSPECTOR (CLEAN AIR) To premises regarding complaints 177 Smoke Control Orders 237 for smoke observations 345 regarding installation of boilers and Chimneys 113 routine boiler inspections 74 No. of notices served under Sec. 12(2) Clean Air Act ... 3 " Sec. 16 -do- -68- TABLE 34 SUMMARY OF PUBLIC ANALYST'S QUARTERLY REPORTS The following is a summary of the samples analysed and included in reports submitted each quarter of the year by the Council's Public Analyst in compliance with Section 99 of the Food and Drugs Act, 1955. A copy of each quarterly report is submitted to the Minister of Agriculture, Fisheries and Food in accordance with the Act. During the year 838 samples were submitted for analysis, as follows;- 4 Ale (Canned 1 Lager (canned) 13 Baby foods 8 Margarine 1 Beer(canned) 44 Meat and meat preparations 4 Biscuits 39 Meat pies and sausage rolls 1 Brandy 45 Meat products (canned) 10 Bread 22 Milk 4 Bread and Butter 10 Milk preparations 10 Butter 3 Miscellaneous samples 16 Cereals and starch products 23 Nuts and nut preparations 11 Cheese and cheese preparations 21 Oils fats and fatty foods 44 Cocoa and chocolate preparations 18 Pickles and sauces 9 Coffee and coffee preparations 3 Rum 5 Cream 7 Salad cream 43 Drugs 31 Sausages and other meat products 6 Eggs and Egg Products 11 Soft drinks 33 Fish and fish preparations 18 Soup and soup mixes 1 Flavourings 41 Spices and condiments 16 Flour and flour products 1 Stout 31 Flour confectionery 9 Sugars, syrups, etc. 3 Food additives 29 Suger confectionery 86 Fruit and fruit preparations 16 Table jelly preparations 1 Gin 14 Tea 3 Gravy preparations 29 Vegetables and vegetable preparations 4 Herbs and herb preparations 10 Vinegar and acetic acid 1 Ice cream 4 Vodka 4 Ice lollies 2 Whisky 15 Jam and preserves -69- TABLE 35 HOUSING INSPECTORS AND TECHNICAL ASSISTANTS VISITS AND NOTICES VISITS Housing Act, 1957 (Sections 16, 17 and 18) 360 Slum Clearance 1, 934 Overcrowding 56 Town Planning applications 68 Houses in Multiple Occupation 6, 655 Preferential re-housing 553 Sites 3,079 Qualification Certificates 80 Improvement Grants 27 Miscellaneous 558 TOTAL 13, 370 NOTICES, ORDERS, ETC. HOUSING ACTS 1957-64 Informal Notices 108 Requiring Additional Services (Section 15) 1 Management Orders made 29 Intention to make directions 71 Directions made (Section 19) 72 Directions revoked 1 Overcrowding (Section 90 Housing Act, 1957) 4 Means of Escape in Case of Fire (Section 16) 7 No. Registered Part I Registration Scheme 72 No. Registered Part II Registration Scheme 2 No. Registered : Registration Scheme,. Subject to conditions 10 TABLE 36 DWELLINGS ERECTED DURING i 972 (a) By Borough Council Daring House 360 Roman Road 11 Diamond House 380 Roman Road 21 Imperial House 120 Grove Road 12 Ivanhoe House 130 Grove Road 19 Lefevre Walk 1 - 182 182 Patrick Connolly Gardens 29 - 33, 35 - 111 81 Portia Way 22 - 76 (even) 28 Teviot Street 164 - 506 (even) 172 Wager Street 69 - 187, 72 - 154 102 William Guy Gardens 1-59 59 Wren House Gernon Road 20 707 (b) By Greater London Council Cornwood Drive Exmouth Estate 66 Brodbury House Holland Estate 6 Gelston Point Watney Market Estate 95 Gough Grove Lansbury Estate 38 Jossiline Court Ranwell Estate 64 Kedleston Walk Hollybush Gardens Estate 58 Musbury Street Exmouth Estate 48 Ollerton Green Locton Estate 56 Robin Hood Gardens Robin Hood Gardens Estate 110 St. Stephen's Road Ranwell Estate 54 West Arbour Street Exmouth Street 15 610 (c) By Others Abbeyfield House Old Ford Road 7 Regent Square Old Ford 48 55 TOTAL 1,372 -70- TABLE 37 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 W ritten Notices Factories without mechanical power 106 22 - Factories with mechanical power 1,672 1,639 118 Other premises under the Act (Electrical stations, institutions, and sites of building operations and works of engineering and construction) _ 78 7 Total 1, 856 1,668 118 2. Cases in which defects were found Particulars Referred Found Remedied To H. M. inspector by H. M. inspector Want of cleanliness - - - - Overcrowding - - - - Unreasonable temperature - - - - Inadequate ventilation - - - - Ineffective drainage of floors - - - - Sanitary conveniences: (a) Insufficient 5 5 - - (b) unsuitable or defective 215 196 - 9 (c) not separate for sexes 10 5 - 1 Other offences against the Act (not including those relating to outwork) 28 8 2 - Total 258 214 2 10 -71- TABLE 38 PART VI1i 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. of prosecutions for failure to supply lists to the Coun cil Wearing apparel: Making etc. 623 - - Cleaning and washing ~ ~ ~ Household linen - - - Lace, lace curtains and nets - - - Curtains and furniture hangings - - - Furniture and upholstery 5 - - Electro-plate 19 - - File making - - - Brass and brass articles 2 - - Fur pulling - - - Iron and steel cables and chains - - - Iron and steel anchors and Grapnels - - - Cart gear - - - Locks, latches and keys - - - Umbrellas, etc. 3 - - Artificial flowers 3 - - Nets (other than wire nets) - - - Tents - - - Sacks - - - Racquet and tennis balls - - - Paper bags - - - Making of boxes and other receptacles or parts thereof made wholly or partially of paper 75 - - Brush making 3 - - Pea Picking - - - Feather sorting - - - Carding, etc. of buttons, etc. - - - Stuffed toys - - - Basket making - - - Chocolates and sweetmeats - - - Cosaques, Christmas stockings - - - Textile weaving - - - Lampshades 2 - - Total; 735 - - Section 134, There were no instances of work found in unwholesome premises. -72- TABLE 39 LEGAL PROCEEDINGS INSTITUTED DURING THE YEAR No. of Summonses Fines £ Costs £ Housing Act, 1961: Houses in Multiple Occupation: Contravention of Direction 8 195 50 Contravention of Regulations 67 513 72 Means of escape from fire not provided 1 100 5 Housing Acts, 1961/69: Contravention of Tower Hamlets (Registration of Houses in Multiple Occupation) Informatory and Regulatory Scheme, 1971 33 479 108 Housing Act, 1957: Overcrowding in Houses in Multiple Occupation 35 540 94 Contraventions of Closing Orders 11 85 35 Public Health Act, 1936: Nuisance Orders 24 - 88 Non-compliance with Nuisance Orders 1 - 4 Public Health (Recurring Nuisances) Act, 1969 4* 16 - Clean Air Act, 1956 2 20 10 Food and Drugs Act, 1955 25 685 175 Food Hygiene (General) Regulations 1970 96 586 104 Food Hygiene (Markets, Stalls and Delivery Vehicles) Regulations 1966 154 833 221 Offices Shops and Railway Premises Act, 1963 1 5 - Prevention of Damage by Pests Act, 1949 2 25 10 Byelaws as to Artificial Lighting of Common Staircases in Tenement Houses and Flats 1 10 4 Total; 465 4,092 980 ★ Prohibition Orders obtained in 2 cases TABLE 40 MORTUARY SERVICE Tower Hamlets Mortuary Hackney Mortuary Total Bodies received 541 99 640 Post - mortems only 463 91 554 Inquests 73 8 81 Deposit only 5 - 5 -73- TABLE-41 CLEANSING STATION Persons treated for scabies Men 69 Women 53 School children 95 Children under 5 28 Total; 245 No. treatments given 418 Persons treated for verminous conditions Men 585 Women 52 School children 622 Children under 5 87 Total 1,346 TABLE 42 DISINFECTING STATION Disinfection: No. of dwellings disinfected for infectious diseases 72 No. of dwellings disinfected for other reasons 301 No. of rooms involved 408 No. of articles disinfected by steam 4, 044 No. of articles disinfected by formaldehyde 614 Np. of premises other than dwellings disinfected 139 Disinfestation: No. of dwellings disinfested for bed bugs 449 for other vermin 143 No. of rooms involved 3,601 No. of other premises and sites disinfested 728 No. of articles disinfested by steam 15, 458 No. of articles disinfested by formaldehyde 1,538 Drainage: No. of premises where drains tested 100 No. found defective 35 -74- TABLE 43 OFFICES, SHOPS AND RAILWAY PREMISES ACT, 1963 Type of Premises Registered during year Total No. of Registered Premises at end of year Registered Premises receiving general inspections during year Persons employed Offices 72 1, 016 411 16,460 Retail Shops 49 1,015 478 4,157 Wholesale Shops 41 533 330 4, 885 Catering establishments/ Staff Canteens 23 233 254 1,525 Fuel Storage Depots - 1 - 5 Total 185 2, 818 1,473 27,032 ( Males 18, 022) ( Females 9,010) Other visits to registered premise a . 847 Visits to non-registered premises 564 Informal Notices served Offices, Shops and Railway Premises Act, 1963 524 Notification of Employment of Persons Order, 1964 56 Lifts and Hoists Regulations 1968 126 Accidents notified - Causes Machinery Non-power driven machinery or relevant part in motion 1 Transport: Vehicle in motion not moved by power 1 Vehicle in motion moved by power 4 Fire and Explosion 1 Hand Tools 4 Falls of persons: On or from fixed stairs 5 On or from ladders or step ladders 3 Other falls from one level to another 5 Falls on the same level 10 Stepping on orstriking against object or person 2 Handling Goods (not otherwise classifiable) 27 Struck by falling object 3 Not otherwise specified 6 Total 72 -75- TABLE 44 RODENT CONTROL Properties inspected Number inspected Number found to be infested by Rats Mice On complaint 2,518 641 1, 614 Otherwise 1,455 20 48 .Total; 3, 973 661 1, 662 Properties treated by Council (including 323 business premises) 2, 323 Visits by Rodent Operatives • 13, 743 Notices served under Section 4 of the Act (a) treatment - (b) structural (proofing work 46 Cases where default action taken following service of notice 10 Number of "Block Control" schemes carried out 37 Sewer Treatments No. of Manholes No. Treated 4, 155 14, 594 -76- TABLE 45 VISITS BY PUBLIC HEALTH INSPECTORS Type of Premises No. Visits or inspections Registered and Licensed Premises Common Lodging Houses 3 28 Fur Skin Dressers 3 3 Hairdressers 170 108 Ice-Cream 360 256 Massage Establishments 3 5 Milk Distributors 249 236 Pet Shops and Stalls 66 102 Pharmacy and Poisons 66 76 Poultry Slaughterhouses 20 192 Prepared Food - Meat 100 77 - Fish 73 76 Rag Flock 31 25 Seamen's Lodging Houses 2 4 Dwellings No. of visits on complaint ) 6,717 No. of visits for drainage ) 61, 406 3,398 No. of revisits ) 6,421 No. of other visits 1,590 Other Premises Bakehouses 34 89 Baker Shops and Stalls 84 166 Butcher Shops and Stalls 163 282 Canteens and Clubs 626 221 Chemists 53 22 Confectionery Shops and Stalls 344 292 Fish Shops and Stalls 120 126 Greengrocers and Fruiterers Shops and Stalls 492 410 Grocers Shops and Stalls 354 454 Hospitals, Institutions and Day Nurseries 39 10 Public Houses 439 693 Poultry Shops and Stalls 105 85 Restaurants, Cafes and Stalls 547 764 School Meal Centres 138 90 Wholesale Food Depots, Markets and Wharves 143 1, 430 Other Food Premises 152 137 Food Delivery Vehicles - 25 Factories (Mechanical) 1, 672 1,639 Factories (Non-Mechanical) 106 22 Factories (other) 78 7 Outworkers 735 687 Schools 101 171 Drainage Works - 1, 996 29,131 There are 3, 345 food premises including stalls in the Borough, some of the premises listed above are included under more than one trade category. / -77- table 46 miscellaneous work of public health inspectors Rent Act 1968 - Certificates of Disrepair Applications for disrepair certificates Applications for cancellation of disrepair certificates Complaints Number received at Office 6,700 Dangerous Structures Number of premises notified to District Surveyor 63 Drainage Plans Number of plans on which observations submitted to Director of Technical Services 280 Land Charges Number of premises reported upon to Chief Executive 1, 984 Town Planning Applications No. of premises reported upon to Borough Architect and Planning Officer 793 Public Houses Number of premises reported upon to Licensing Justices 78 Licensed Clubs No. of premises reported upon to the Chief Officer of Public Control 25 table 47 burials undertaken Under Section 50, National Assistance Act 1948 Number of Adults 52 Number of Children 5 Number of Stillborn - Total Cost £1,497 Burials requested by - Coroner 38 - Relatives 16 - Others 3 -78- TABLE 48 NOTICES SERVED BY DISTRICT PUBLIC HEALTH INSPECTORS Factories Act 1961 118 Food Hygiene (General) Regulations 1970 349 Food Hygiene (Markets, Stalls, and Delivery Vehicles) Regulations 1966 33 Hairdressers and Barbers Byelaws 5 Informal Notices to Local Authority Housing Departments 2, 002 Prevention of Damage by Pests Act 1949 46 Public Health Act, 1936, Section 39 5 -do- 44 1 -do- 45 1 -do- 48 - -do- 75 14 -dcr- 89 6 - do- 93 732 Public Health Act, 1961, Section 17 92 Staircase Lighting Byelaws 8 Total; 3,412 TABLE 49 OUTWORKERS Firms in the borough employing outworkers 452 Outworkers residing in, and employed by firms in the borough 542 Outworkers residing outside the borough employed by firms in the borough 1,452 Outworkers residing in the borough employed by firms outside the borough 193 Total outworkers in the borough 735 TABLE 50 REFUSE DISPOSAL Home and trade refuse 73, 568 tons Street and market collections 14, 302 tons No. of bulk containers in use 3,594 No. of bulk trailers in use 46 No. of street gulleys cleansed 13,356 -79- TABLE 51 CONFERENCES Conference Venue Dates Representatives Association of British Adoption Agencies London 25th October Principal Medical Officer Association of Public Health Inspectors Councillor Mrs. Couling Councillor Mrs. Crook (1) Annual Conference Blackpool 18th - 22nd September Chief Public Health Inspector (2) Future Organisation and Management of Environmental Health Service London 13th June Councillor Main Public Health Inspector Association of Sea and Airport Health Authorities London 28th - 30th June Councillor Tuson Associate Medical Officer of Health British Dental Association Swansea 10th - 14th July Chief Dental Officer Health Visitors' Association Scarborough 2nd - 4th November Councillor Downes Principal Nursing Officer Inner London Education Authority - Health Education London 14th November Assistant Health Education Officer Institute of Petroleum Lead in the Environment London 27th January Associate Medical Officer of Health Institute of Shops Acts Administration Weymouth 3rd - 5th October Councillor Downes Councillor Negus Chief Officer of Public Control Public Health Inspector London Boroughs' Training Committee Working with Battered Babies London 4th October and 7th December Principal Medical Officer National Society for Clean Air Scarborough 16th - 20th October Councillor Allen Councillor J. O'Connor Public Hea 1th Inspector -80- TABLE 51 (Continued) CONFERENCES (Continued) Conference Venue Date Representatives North East London Polytechnic Assessment of Mental Handicap London 4th May Health Visitor Royal College of Nursing Support of Family with Handicapped Child London 16th May School Nurse Royal Institute of Public Health and Hygiene Folkestone 3rd - 6th October Alderman Long Principal Medical Officer Royal Society of Health (1) Contraception or Abortion London 10th February Councillor White Non-Medical Supervisor of Mid- wives (2) Controls and Procedures for Importation of Meat London p. m. 16th March Councillor Kennedy Public Health Inspector (3) Annual Conference Eastbourne 24th - 28th April Councillor Phillips Principal Medical Officer (4) Hunter Report London 27th July Councillor Kelly Director of Community Services and Medical Officer of Health (5) International Conference on Health and Social Services. Isle of Man 4th - 8th September Alderman Orwell (S) Councillor Hill Director of Community Services and Medical Officer of Health Assistant Director of Social Services Royal Society for Prevention of Accidents Home Safety in Retirement London 27th September Health Visitor -81- TABLE 52 REFRESHER AND TRAINING COURSES Courses attended by staff during the year were as follows:- Course Venue Dates Attended by Action on Smoking and Health "Stop them Starting" London 1st June Assistant Health Education Officer Association of Public Health Inspectors (1) Annual Week-end Seminar Canterbury 24th-26th March 2 Public Health Inspectors (2) Clean Food Symposium London 30th June-1st July Public Health Inspector Chiswick Polytechnic London 13th-24th March Health Visitor First Line Management 19th-30th June County Council of Essex Home Improvements Course Theydon Bois. Essex 13th - 15th November Public Health Inspector Family Planning Association Nurses Theoretical Training London 31st January - Health Visitor 1st February London 10th- 12th July Health Visitor 2nd - 4thOctobei Health Visitor London 27th - 29th November Health Visitor Visual Aids Display London a, m, 8th December Centre Superintendent Friendship Week Meeting on Sick and Handicapped Teenagers London 17 th May Social Worker (Health Services) Inner London Education A uthority Oxford 28th June 7th July School Nurse Health Visitors Association Refresher Course National Association of Mental Health Course for Medical Officers on Mentally Subnormal Children London 4 th - 29th September Sessional Medical Officer Institute of Health Education "Education about Drugs, Alcohol and Tobacco" London p. m. 14th July Assistant Health Education Officei Institute for Research into Mental Retardation "Content of Education for Pre-School Mentally Handicapped Child" London evening of 14th July Principal Medical Officer and various members of nursing staff. -82- TABLE 52 (Continued) REFRESHER AND TRAINING COURSES (Continued) Course Venue Dates Attended by North East Metropolitan Regional Hospital Board, Middle Management Course Buckhurst Hill Essex 7th - 8th February Deputy Superintendent Home Nursing North East London Polytechnic, (I) Residential Course for Assessors of Supervised Practise Theydon Bois Essex 31st January 4th February 30th Oct-3rdNov Health Visitor (II) Services on Concern for Bereaved London 26th October Health Visitor (III) Fieldwork Instructors' Course London 30 days during 1972/73 Health Visitor Polytechnic of North London, (I) Initial Practical Work Instructors Course London 19th June 1st July 2 Senior District Nurses (II) Advanced Practical Work Instructors' Course London 25th September - 6th October Senior District Nurse (III) Fieldwork Instructors' Course London 30 days during 1972/73 2 Health Visitors Queens Institute of District Nursing. S.E.N. Refresher Course London 7th - 11th February Distric t N urse Royal College of Midwives Approved Refresher Course Exeter 20th-26th August Non-Medical Supervisor of Midwives Royal College of Nursing (I) Middle Management Appreciation London 10th-21st April Superintendent of Home Nursing Assistant Nursing Officer (II) First Line Management South East London Technical College London lst-26th May Health Visitor (I) Course on New Fire Legislation London 19th, 26 th June, 3rd July Public Health Inspector (II) Course on Lifts and Hoists London 14th, 21st, 28th, November, 5th, 12th December Public Health Inspector Stoke Mandeville Hospital Study Day on Paediatric Neurology and Developmental Medicine Buckinghamshire 17th November Principal Medical Officer Teachers' Advisory Council on Alcoholism Drug Education and Health Education Council Course York 26th-29th July Health Education Officer Thames Polytechnic First Line Management Course London 9th-20th Oct. 27th November 1st December Centre Superintendent University of London Griffiths Extension Course London 23rd February, 1st, 8th, 15th, 22nd March Senior Medical Officer Westair Dynamics Ltd., Demonstration on Condensation Wey bridge p. m. 28th November Public Health Inspector -83- TABLE 52 (Cont inued) REFRESHER AND TRAINING COURSES (Continued) Course Venue Dates Attended by Internal Courses 1. Written Communications 18th - 19th Jan Administrative Assistant (2) Basic Supervision 8th - lOthFeb. Supervisor of Buildings Leading R0 dent Operative Leading Driver/Disinfector (3) Standing Orders p. m. 5th Dec. Co-Ordinator King Edward Hospital Building Fund, Drug Dependency Division London 20th July Health Education Officer Lansbury Institute, Pre-School Playgroup Leaders' Course London Day release (1 day per wk.) for 1 year commencing January 1972 Clinic Auxiliary London Boroughs Management Services Unit (I) Work Appreciation for Professional and London a, 21st-22nd June Senior Administrative Assistant Administrative Staff „ b. 18th-19th July Administrative Assistant (II) Work Simplification in the Office „ p. m. 19th June Administrative Assistant (III) Filing and Records „ 4th-5th July Administrative Assistant London Boroughs Training Committee (I) Seminar on Loss of Hearing/Screening for Deafness „ 11th - 12th January Centre Superintendent Health Visitor (II) Study Day on Needs of Recently Discharged Hospital Patients „ 25th January Senior District Nurse (III) Study Days on Multiple Sclerosis „ 27th April & 26th June District Nurse (IV) Introductory Course for Clinic Nurses „ 4th, 5th, 11th, 12 th, 1,8th, 19th May 2 Clinic Nurses (V) Study Day for District Nurses on Care of Feet. „ 15th November Senior District Nurse (VI) Study Day on Venereal Disease „ 20th November Welfare Officer (V.D.) (VII) Changing Role of the Health Visitor „ p.m. 27th November Centre Superintendent Assistant Health Education Officer (VIII) Health Education in Schools „ 7th-8th Dec. School Nursing Sister National Nursing Staff Committee Top Line Management Course York 6th February to 4th March. Principal Nursing Officer Newham School of Community Nursing S. R. N. Refresher Course London 6th - 10th November 2 District Nurses -84- TABLF 53 SCHOOL HEALTH STATISTICS Pupils on School Rolls (May 1972) Under 5 years - full time 1, 228 part-time 1, 640 Infants 6, 591 Junior 9, 873 Seniors 10, 976 Special 922 31,230 Recuperative Holiday Homes Number of schoolchildren (including Nursery schoolchildren) admitted during the year 408 Health Surveys N o. examined Occasions vermin found Percentage (a) Comprehensive 21,943 902 4, 11 (b) Selective 16,751 1, 521 9. 08 No. of individual pupils found verminous ... 1.116 Percentage of school roll ... 3.57 Vermin - occasions advice and/or shampoo given ... 1,860 - occasions attendance at bathing center ... 563 (c) Communicable disease - No. examined for ... 869 Routine Audiometer Testing No. of children given screening test 3, 707 No. failing screening test and given pure tone test 279 No. failing pure tone test and referred to Otologist 173 School Medical Treatment Clinic No. of premises Sessions in year New Cases Attendances Audiology 1 84 202 549 Bathing 2 576* 788 1, 622 Minor Ailments - Medical Officer 1 39 287 ) 17,305 - Nurse 8 740 1,026 j Ophthalmic 4 245 1,471 3,094 Orthoptic 1 72 54 174 Special investigation 3 202 160 1,565 * includes also adult sessions -85- TABLE 53 (Continued) Defects treated at School Treatment Centres and Hospital Ciinics Errors of refraction and squint 838 Other eye defects 66 Spectacles ordered 788 Athlete's foot 24 Verrucae 269 Ringworm - body 5 Impetigo 12 Other skin diseases 195 Eye diseases 51 Ear diseases 40 Miscellaneous lacerations etc. 717 Orthopaedic and postural defects (treated at schools) B. C. G. Vaccination - Schoolchildren Number of schools visited 18 Number of 13 - year old children offered test 1, 981 Number of consents received 1. 927 Number of children tested 1,508 Number of positive reactors 107 Number of children vaccinated 1,279 Infectious and Other Diseases notified by Schools Disease Nc . of Notifications Chickenpox 298 Dysentery, Diarrhoea 34 German Measles 208 Glandular Fever 4 Impetigo 28 Influenza 31 Jaundice 10 Measles 167 Meningitis 2 Mumps 382 Ophthalmic conjunctivitis 6 Ringworm 16 Scabies 11 Scarlet Fever 51 Tonsillitis 60 Tuberculosis 1 Whooping Cough 9 1,318 (Number notified last year 618) -86-- TAB LE 53 (Conti nued ) SCHOOL HEALTH STATISTICS School Dental Service Number of half day sessions devoted to Treatment 3, 938. 6 -do- Inspections in Schools 201.3 -do- Dental Health Education 444.2 Total 4, 584.1 Inspections Pupils first inspected at school 16, 378 Pupils first inspected at clinic 5, 116 Percentage requiring treatment 59.8 Pupils reinspected 1,413 Percentage requiring treatment 81.7 Treatment Sessions (average per session in brackets) New cases attended 6,291 (1.5) On-treatment cases attended 14, 157 (3.4) Emergencies 1, 119 (0.3) Total attendances: 21, 567 Treatment given (average per session in brackets) Fillings in permanent teeth 6,719(1.6) Fillings in temporary teeth 8,017 (1.9) Extraction of permanent teeth 332 (0. 09) Extraction of temporary teeth 1, 036 (0.2) Other operations 13, 046 (3.1) Orthodontic treatment New cases commenced in year 72 Number of removable appliances fitted 73 Number of fixed appliances fitted 21 -87- TABLE 53 (Cont i nued) SCHOOL HEALTH STATISTICS Routine Medical Inspections Number of children inspected 12, 223 Percentage of total inspected 39.8 Percentage referred for treatment of defects 20.6 Percentage referred for treatment of defects other than vision 12.1 Percentage whose physical condition not satisfactory 0.2 Non-routine Medical Inspections Re-inspections 3,833 Employment certificates 77 School journeys 1,755 Recuperative holidays - before holiday 229 Boarding Schools for the Delicate before Departure 4 Handicapped pupils - statutory examinations 136 - periodic special defect examination 329 Research investigation and enquiries 4 2,534 Specials: at request of Head Teacher - special book 79 - others 472 School Nurse - after health survey 59 - others 104 Divisional Officer (Education) 35 (District Care Organiser or Care Committee ) 45 Parent 77 School Medical Officer 88 959 All other non-routine inspections (including inspections specifically for provision of free milk) 64 7,390 Routine Visions Tests Number of boys tested 5,888 Number of girls tested 5,201 -88- TABLE 53 (C ont i n ued) DEFECTS ASCERTAINED AT ROUTINE MEDICAL INSPECTIONS Number of children noted for treatment or observation expressed as a rate per 1, 000 inspected; Defects Treatment Observation Skin 18. 00 10. 55 Eyes - Vision 100.79 48.11 - Squint 14.24 5.32 - Other 2.45 0. 98 Ears - Hearing 9.33 4. 34 - Otitis Media 3.93 3.93 - Other 2.70 2.29 Nose and throat 7.53 20.21 Speech 5.81 7.61 Lymphatic Glands 1.72 3.35 Heart - Congenital 2.78 1. 88 - Acquired 0.49 2.13 Lungs - Bronchitis 1. 96 2.54 - Asthma 8.10 2.70 - Other 1. 88 1.39 Development - Hernia 1.55 2. 05 - Other 2.78 6.38 Orthopaedic - Posture 2. 86 2. 95 - Feet 5. 07 7.61 - Other 4.66 2.62 Nervous System - Epilepsy 2. 86 0.57 - Other 0.74 0. 90 Psychological - Development 7.44 4.17 - Stability 2.70 7.36 A bdomen 1. 06 0.82 Other - Debility 2.70 0.41 - Enuresis 12.60 12. 03 - Obesity 10.14 17.43 - Other 12.11 3.68 TABLE 54 HEALTH EDUCATION ACTIVITIES Discussion groups or talks on the following subjects were arranged during the year; Subject No. of Occasions Persons Participating General Health Subjects - Schools 225 4,448 - Other 94 1,444 Mothercraft 229 1, 892 Cancer Prevention 24 303 Psychoprophylaxis 42 192 TOTAL 614 8,279 Films or filmstrips were shown on 119 of the above occasions. Posters on health subjects are displayed on poster sites and in clinics and public buildings throughout the borough, the topic being changed in accordance with a monthly programme. The distribution of leaflets is planned to coincide with the poster displays and topical health education activities. During the year 4, 023 posters were exhibited and 49, 573 leaflets distributed (including 16, 000 cytology leaflets, distributed with rent cards). -89- TABLE 55 HEALTH DEPARTMENT ESTABLISHMENTS Particulars of Clinics held and Services Provided as at 31st December, 1972 (a) CLINICS AND SCHOOL TREATMENT CENTRES Address Clinics and other activities held Clinic and School Treatment Centre, Club Row, E.2. Infant Welfare, Minor Ailments, Toddlers, Vaccination and Immunisation. Clinic Centre, 673, Commercial Road, E. 14. Infant Welfare, Occasional Creches, Toddlers, Mothers' Club, Vaccination and Immunisation. Clinic Centre, 1-2 Newmill House, Empson Street, E. 3. Infant Welfare, Toddlers, Dressmaking Class, Mothers' Club and Creche. Vaccination and Immunisation. Clinic and School Treatment Centre, Leopold Street, E. 3. Dental, Infant Welfare, Minor Ailments, Special Investigation, Toddlers, Vaccination and Immunisation, Vision, G. P. Obstetrician, Auditory Training, Orthoptic, Family Planning, Clinic Centre, Library Place, Cable Street, E.l. Chiropody, Infant Welfare, Toddlers, Family Planning, Vaccination and Immunisation. Clinic Centre, Peel Grove, E. 2. Ante-Natal, Infant Welfare, Occasional Creches. Toddlers, Vaccination and Immunisation. Cervical Cytology Psychoprophylaxis, Dressmaking, Keep fit Class, G. P. Obstetrician. Mothers' Club, Post-Natal. Family Planning. Clinic and School Treatment Centre, 32 Riverside Mansions, E.l. Infant Welfare, Minor Ailments, Family Planning, Vaccination and Immunisation. Clinic Centre, 35 Stepney Green, E. 1. Chiropody, Infant Welfare, Toddlers, Vaccination and Immunisation, Mothers' Club. Clinic and School Treatment Centre, Roserton Street, E. 14. Ante-Natal, Chiropody, Dental, Infant Welfare, Occasional Creches, Toddlers, Mothers' Club, Cervical Cytology, Dressmaking, Family Planning, Vaccination and Immunisation. Clinic Centre, Tiller Road Baths, E. 14. Infant Welfare, Toddlers, Vaccination and Immunisation. -90- TABLE 55 (Cont inued ) (a) CLINICS AND SCHOOL TREATMENT CENTRES (cont'd) Address Clinics and other activities held Clinic and School Treatment Centre, Ruston Street, E. 3. Chiropody, Dental, Infant Welfare, Occasional Creches, Toddlers, Vision. Dressmaking, Special Advisory, Speech Therapy, Vaccination and Immunisation. Clinic Centre, 1-2 Wigram House, Wades Place, E. 14. Infant Welfare, Toddlers, Speech Therapy, Chiropody, Vaccination and Immunisation. Clinic and School Treatment Centre, Wellington Way, E. 3. Dental, Infant Welfare, Occasional Creches, Toddlers, Vaccination and Immunisation, G. P. Obstetrician, Cervical Cytology, Dressmaking. Family Planning, Cookery Class. Chiropody. Clinic and School Treatment Centre, Underwood Road, E. 1. Chiropody, Dental, Infant Welfare, Minor Ailments, Special Investigation, Toddlers, Vaccination and Immunisation, Family Planning, Occasional Creches. Sewing Class. School Treatment Centre, 3-4 Phillips House, Coventry Cross, E. 3. Dental, Minor Ailments, Special Investigations. School Treatment Centre, Bernhard Baron Settlement, Henriques Street, E. 1. Dental, Minor Ailments, Vaccination and Immunisation. Vision. School Treatment Centre, Wadeson Street, E. 2. Audiology, Chiropody, Dental,Minor Ailments, Vision. Mission House, (Nursing Sisters of St. John the Divine) Lodore Street, E. 14. Ante-Natal, Post-Natal. London Chest Hospital, Victoria Park, E.2. Chest Clinic. -91- * * * * * * * * * -92- INDEX A Page Hos. „ Accidental Deaths 9 Accidents in the Home 41 Adoption and Boarding Out 17 Ambulance Facilities 41 Analysis of Food and Drug Samples 25,69 Ante-Natal Clinics 17, 60 Anthrax 11 A rea of Borough 5 Artificial Kidney Machines 41 B Bacteriological Examination - Food 27 B. C. G. Vaccination 13,49,59 Births 5,8 Blind, Partially Sighted 41 Burials 41,78 C Cancer 11 Cervical Cytology 18,60 Chest Clinics 3,14 Chief Public Health Inspector's Report 25 Child Welfare Clinics 60 Chiropody 41,61 Cholera 11 Circulars - Ministry ,.. 44 Clean Air 31,68 Cleansing Station 34,74 Clinic Centres . 19 Common Lodging Houses 34 Comparative Statistics 10,53 Conferences and Courses 42,44,80,82 Congenital Defects 18 Creches 19 D Deaf Children 49 Deaths 5,8,51 Dental Services 24,50,61 Developmental Assessment Clinic 19 -93- D (Cont'd) Page Nos„ Diphtheria 11 Diseases of Animals 28,68 Diseases - Notifiable 55 Disinfection/Disinfestation 34,74 Dockland Development 2 Dysentery 11 E Educationally Sub-Normal Children 49 Employment of Schoolchildren 49 Environmental Health Services 25 Establishments 90t 91 Expectation of Life 9 F Factories 33,71 Family Planning 2,20,62 Fifty Years Ago 7 Food and Drugs 25 Food Hygiene 26 Food - Imported 25 Food - Unsound 27 Food Poisoning 11 H & I Hairdressers 33 Handicapped Pupils 48 Health Committee 1 Health Education 20,49,89 Health Visiting 20,62 Home Bathing 42,63 Home Nursing 21,63 Hospital Facilities 42 Houses in Multiple Occupation 31 Housing 3,31,70 Hygiene in Schools 48 Ice-Cream 26 Immunisation 49,57 Incontinence Pads 21 Infant Mortality 8,52 -94- II & I (Cont'd) Page Hos Infectious Diseases 11,48,55,56 Infective Jaundice 12 Inquests 42 L Laboratory Facilities 43 Laundry Service 21,63 Legal Proceedings 33,73 Legislation 43 Licensing Act, 1961 34 Loan of Nursing Equipment 21,64 Lodging Houses 34 M Malaria Marie Curie Memorial Foundation 21 Marriages 9 Mass Radiography 13,59 Maternal Mortality 9 Measles 12,22 Medical Inspection of Schoolchildren 47 Meningitis 12 Midwifery 22,65 Milk Supply 26 Minor Ailments Clinics 48,90,91 Miscellaneous Services 41 Morbidity 9,56 Mortuary 34,73 N Neo-Natal Mortality 9 New Houses 33,70 Notices Served by Public Health Inspectors 79 Nursing Equipment - Loan of 21,64 0 Observation Register 22,54 Offensive Businesses 35 Offices, Shops and Railway Premises 28,75 Open Spaces 10,66,67 Ophthalmia Neonatorum 12 Outwork and Outworkers 35,72,79 -95- P Page Nos= Partially Hearing Children 49 Partially Sighted Persons 41 Peri-Natal Mortality 9 Personal Health Services 17 Pet Animals Act 36 Pharmacy and Poisons Act . 36 Phenylketonuria 23 Poliomyelitis 12,57 Population 7 Post Natal Clinics 60 Poultry Processing and Packing 36 Premature Babies 23,62 Principal Nursing Officer's Report 17 Principal School Medical Officer's Report 47 Public Analyst's Quarterly Reports 69 Public Health Inspectors - Visits 68,70,77,78 Public Relations 10 Public Transport 10 R Radioactive Substances 44 Rag Flock etc. Act 36 Recuperative Holidays 23 Refreshment Houses 37 Refuse Disposal 37,79 Removal of Persons in Need of Care 44 Renal Dialysis 41 Rent Act 37 Re-organisation National Health Service Residential Establishments for Children in Care 23 Road Accidents 52 Rodent Control 37,76 Rubella 22 S Scabies 12 Scarlet Fever 12 School Dental Service 50 School Health Service 47,85^89 -96- S (Cont'd) Page Nos. Seamen's Lodging Houses 34 Sewerage 37 Slum Clearance 31 Smallpox 12 Social Conditions of the Area 7 Staff 4,44,45,68 Statistics and Social Conditions 7 Statistics - Summary 5 Students - Training of 45 Surveys 23 Swimming Baths 37 T T uberculosis 13.58 Typhoid 13 U Underground Rooms 31 Unemployment 1° V Vacant Sites 37 Vaccination 49,57 Veneral Diseases 15 W Water Supply ' 38 Weather Conditions 11 Welfare Foods 24 Whooping Cough 13,57 Works in Default 38 -97- * * * * * * * * * -98-