AC4345 Che 50 Metropolitan Borougb of Chelsea iipi M Annual Report of the Medical Officer of Health J. H.WEIR, M.D., B.S., B.Hy., D.P.H. for the year 1952 1 METROPOLITAN BOROUGH OF CHEISEA PUBLIC HEALTH AND BATHS COMMITTEE Chairman: Councillor Hannay, J., M.Ch.S. Vice-Chairman: Councillor Williamson, The Hon. Mrs. C. Councillor Acland, Miss K., O.B.E. Councillor Dumin, J.C., A.S.A.A., A.C.A. " Batfes A. " Hulbert-Powell, E.C.L., M.A. " Bifield, W.C., M.M. 11 Iyall, Miss M., M.B.E. 11 Buxton, Mrs. G.K. " Sandilands, F.E.P., M.A. " Casserley, C. " Villiers, C.H., M.C. " Curthoys, J.E. " Woolford, J.E. " Duncan, Lt.-Col. R.C., C.I.E., M.V.O., O.B.E. Ex-Officio Members Her Worship the Mayor (Councillor Miss M.K. Cook) The Deputy Mayor (Alderman Captain R.L. Edwards, R.N., J.P.) 2- Representation by Members of the Public Health and Baths Committee on outside Committees and other Organisations concerned with Public Health work. Chelsea Cancer Committee; Councillor The Hon.Mrs. C. Williamson Chelsea. Pimlico and Belgravia District Nursing Association s Councillor The Hon .Mrs. C. Williamson Chelsea Tuberculosis Care Committees Councillor Mrs. G.K. Buxton Councillor Miss M. Lyall Councillor The Hon.Mrso C. Williamson Family Welfare Association; Councillor Miss M. Lyall Greater London Advisory Council for Smoke Abatements Councillor J. Hannay London County Council Divisional Health Committee (Division I) t Councillor The Hon.Mrs. C. Williamson London County Council Divisional Tuberculosis Care Committee (Division I): Councillor Mrs. G.K. Buxton National Smoke Abatement Society; Councillor J. Hannay Councillor The Hon.Mrs. C. Williamson Old People's Welfare Committees Her Worship the Mayor, Councillor Miss M.K.(bok Councillor J. Hannay Councillor The Hon.Mrs. C. Williamson 3 STAFF OF THE PUBLTfl HKALTH DEPARTMENT at 31st December. 1952. Medical Officer of Health: ' J.H. WEIR, M.D., B.S., B.Hy., D.P.H. Deputy Medical Officer of Health: W.C. TURNER, M.D., B.S., D.P.H., D.I.H. Chief Sanitary Inspector: H. HOYLAND, M.R.S.I., M.S.I.A. Deputy Chief Sanitary Inspector and Senior Housing Inspector: S.W. BARKER, M.R.S.I., M.S.I.A. Housing Inspectors: H.W. LUDLCW, M.S.I.A. E.R. YOUNG, M.R.S.I., M.S.I.A. District Sanitary Inspectors: J. CASTLEY H.F. USACOCK, M.R.S.I., M.S.I.A. A.J. WHITE, M.S.I.A. Women Sanitary Inspectors: (Miss) A.C.C. KAY, M.S.I.A. (Miss) G.K. READER, M.S.I.A. Sanitary Inspectors1 Assistant: F.G. RAWLINGSQN Drainage Assistant: E. BOS LEY Rodent Officer: J.F. COOKE Rodent Operative: P. DRUHY Disinfectors: L.H. BERRY (Chief) F.W. HILL R.J. WESTON Cleansing Station Attendant: (Mrs) J. LOBBAN. Clerical Staff: J.C. BRYANT (Chief Clerk) I.Mo THOMSON (Senior Clerk) J.T. HEALY (Infectious Diseases Clerk) (Miss) A. PALMER (Shorthand-Typist) L.A. PCWELL (General Clerk) N.R. BETTS (General Clerk) M.S. TAYLOR (Office Junior - Temporary) Social Worker: (Mrs) O.M. BURKE Public Analyst: THOMAS McTACHTAN, A.C.G.F.C., F.R.I.C. - 4 - METROPOLITAN BOROUGH OF CHELSEA Public Health Department, Town Hallj, King's Road, CHELSEA. S.W.3. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Chelsea. Your Worship, % Lord, Ladies and Gentlemen, I have much pleasure in submitting my annual report for the year ending 31st December, 1952® The report has been compiled in the manner outlined by the Minister of Health in his circular 42/l951, dated 10th December, 1951® Throughout my report comparative references, both by the use of graphs and tables, will illustrate the great advancements made in achieving better standards of health. The population of the borough is estimated by the RegistrarGeneral to be 52,140, as compared with 52,430 and 52,490 in 1951 and 1950 respectively, representing a decline of 350 over the past two years. Military personnel stationed in the area are included in the population, but no information as to their numbers is available. Births. The number of Live Births allocated to Chelsea was 787 - 406 Males and 38I Females. In 1951, there were 819 births, so that the total has fallen by 32. An examination of the "Summary of Vital Statistics" on page 9 will show how registered live births have steadily declined since the cessation of hostilities.. Stillbirths. These totalled 14 - Males 93 .Females 5. The figures for the preceding two years were as followst — 1951 Males 12 Females 8 - Total 20 1950 Males 12 t Females 12 - Total 24 The applicable Stillbirth rates were 17.5, 23.8, and 28.1 Deaths. The death rate fell by 0.3 to 12.8 as compared with 13.1 in 1951, whilst the number of deaths declined from 686 to 669. If it were possible for the populations of all areas to be similarly constituted as regards the proportions of their sex and age components, their crude death rates (deaths per 1,000 of population) could be accepted as valid comparative measures of the mortalities experienced by the populations# (Obviously Chelsea has a far greater number of residents aged 65 years and over than, for example, Crawley or Harlow, whilst the latter towns will be mainly populated by persons of the lower age groups). In practice, however, populations are not so constituted, and the Registrar-General has therefore employed a factor known as the "Area Comparability Factor" for each district. This provides for an adjustment 5 of the age and sex composition of a particular area to that of England and wales as a whole so that a statistical basis can be established. To obtain the adjusted death rate, the crude death rate is multiplied by the "Area Comparability Factor", and as 0.94 represents the factor so far as Chelsea is concerned, the adjustment results in a death rate of 12.1. It is pleasing to record that no deaths have occurred as a result of accidents or diseases associated with pregnancy or childbirth since 1946. During the period 194-0 - 1946, eleven deaths were attributed to such causes. Infant Mortality. The number of deaths occurring amongst infants under one year of age continues to decline, and during the year under review sixteen deaths, representing a mortality rate of 20.3 were registered. A striking feature of the remarkable reduction in the wastage of infant life is presented by consideration of the following brief summarys- Year Deaths under 1 No. of births Rate per 1.000 year of age. registered. registered births 1900 333 2,245 148 1910 141 1,376 102 . 1920 73 1,392 52 1930 32 799 40 1940 15 428 40 1950 21 829 25 1951 19 819 23 1952 16 787 20 It will be apparent that since 1940 there has been a tendency for the dramatic improvement of the early decades of the century to decline. The rate, however, must be viewed in association with the actua] number of deaths and births registered. Clearly a great proportionate reduction in the number of deaths has occurred compared with the decline in births. Infectious Diseases. The number of notifications received during the year was 785, a decrease of 266 compared with 1,031 in 1951® As was the case in the latter year, Measles played a significant part, 355 cases coming to the knowledge of the Public Health Department, representing 45 per cent of the total notifications. As a general rule, eighty or ninety per cent of all persons attaining to the age of twenty years have had Measles, and of the 1,342 notifications received during the past three years, 97 per cent were in respect of children aged between 0 and 15 years. The figures for the past seven years conform to the well-known biennial periodicity of measles, which also shows a fairly constant phasic pattern within each two-year cycle. Food Poisoning. Ten notifications were received during the year. In 1951 and 1950 the figures were 13 and 122 respectively. 6 Food and Drugs. The Council's Public Analyst, Mr. Thomas McLachlan, examined and reported upon four hundred samples of foods and drugs during 1952. Of this total, nineteen (4.75 per cent) were found to be adulterated; in eight instances "adulteration" was based upon labelling inaccuracies or misdescription,, Food Hygiene, The policy of exercising rigid supervision of all premises concerned with the preparation, storage and sale of food continues at a high levels whilst personnel engaged therein receive, as may be necessary, advice from the Council's Food Inspectors to ensure the maintenance of adequate hygienic standards. Housing Conditionsa The provision and maintenance of satisfactory housing conditions is under constant review, and the various Acts, Orders and Regulations affecting this aspect of Publics Health work are rigidly applied» Welfare of Old People. The aim of providing some measure of happiness and freedom from care is keenly pursued by the Council and its officers, thus helping those who are of advanced age or are infirm to lead a full life, and at the same time giving them a sense of being far from unwanted., The magnitude of this service will be appreciated by a consideration of the following detailss- Year Noo of Old People on Register 1950 106 1951 613 1952 934 A detailed report of the numerous facilities which can be enjoyed by Old People will be found in this report Personally, the year has been one to look back upon with a feeling of appreciation for the friendly support and sympathy I have at all times received from the Chairman and Members of the Public Health and Baths Committee in the consideration of the problems it has been ngr duty to place before them, as well as the courtesy extended to me by both them and members of other Committees., Finally, the loyal and diligent efforts of all officers in the Public Health Department are gratefully acknowledged. I am, Madam Mayor, Lord, Ladies and Gentlemen-, Your1 obedient Servant 9 J.H. WEIR Medical Qffieer of Health 7 METROPOLITAN BOROUGH OF CHET ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1952 POPULATION: Registrar-General's estimate of the population of the Borough (mid-year, 1952) 52,14-0 AREA OF THE BOROUGH: 660 acres LIVE BIRTHS: Total M. F. Legitimate 715 363 352 Birth rate per 1,000 of Illegitimate 72 43 29 estimated population 15.1 787 406 381 Adjustment of birth rate by area comparability factor-. .. Ho2 STILL BIRTHS: 14 9 5 Rate per 1,000 (live and still births) 17.5 DEATHS: 669 325 344 Death rate per 1,000 of estimated population 12.8 (Males 6.2 : Females 6.6) Adjustment of death rate by area comparability factor 12.1 EXCESS OF REGISTERED BIRTHS OVER DEATHS: 118 (Males 81 : Females 37) MATERNAL MORTALITY RATE: NIL (No deaths associated with pregnancy or childbirth have occurred amongst Chelsea residents for the past six years) DEATH RATE OF INFANTS UNDER ONE YEAR OF AGE: All infants per 1,000 live births 20.3 Legitimate infants per 1,000 legitimate live births 16.8 Illegitimate infants per 1,000 illegitimate live births 55®5 DEATHS FROM TUBERCULOSIS: Pulmonary 12 Other forms 3 Death Rates per 1,000 of estimated population:Pulmonary Tuberculosis: 0.23 Non-Pulmonary Tuberculosis: 0.05 8 BIRTH RATES, DEATH RATES, ANALYSIS OF MORTALITY, MATERNAL MORTALITY AND CASE-RATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR 1952 (Provisional figures based on Quarterly Returns) England and Wales 160 County Boroughs and Great Towns (including London) 160 smaller Towns (Resident Population 25,000-50,000 at 1951 Census) London Administrative County Rates per 1,000 Home Population Births 15.3 16.9 15.5 17.6 Still births 0,35 0.43 0.36 0.34 22.6(a) 24.6(a) 23.0(a) 19.2(a) Deaths A11 Causes 11.3 12.1 11.2 12.6 Typhoid and paratyphoid 0.00 0.00 0.00 - Whooping cough '0.00 0.00 0.00 0.00 Diphtheria 0.00 0.00 0.00 0.00 0.24 0.28 0.22 0.31 0.04. 0.04 0.04 0.05 Smallpox 0.00 - - - Acute poliomyelitis cluding polioencephalitis] 0.01 0.01 0.00 0.01 Pneumonia 0.47 0.52 0.43 0.58 Notifications (Corrected) Typhoid fever 0.00 0.00 0.00 0.00 Paratyphoid fever . 0..02 0.02 0.03 0.01 Meningococcal infection 0.03 0.03 0.03 0.02 Scarlet fever 1.53 1.75 1.58 1.56 Whooping cough 2.61 2.7 4 2.57 1.66 0.01 0,01 0.03 0.01 Erysipelas 0.14 0.15 0.12 0.14 0.00 0.00 0.00 - 8.86 10.11 8.49 9.23 Pneumonia 0.72 0.80 0.62 0.57 Acute poliomyelitis 1 (including encephalitis) Paralytic 0.06 0.06 0.06 0.06 Non-paralytic 0.03 0.03 0.02, 0.03 Food poisoning 0.13 0.16 0.11 0.18 Puerperal pyrexia 17.87(a) 23.94(a) 10.22(a) 30.77(a) Deaths Rates per 1,000 Live Births All causes under 1 year of age 27.6(b) 31.2 25.8 23.8 Enteritis and diarrhoea under 2 years of ase 1.1 1.3 0.5 0.7 (a) Per 1,000 Total (Live and Still) Births. (b) Per IjOOO related live births. 9— SUMMARY OF VITAL STATISTICS 1940 - 1952 (inclusive) Year Registrar-General's Estimate of Population BIRTHS DEATHS DEATHS UNDER ONE YEAR MATERNAL DEATHS No. * Rate No. * Rate No. * Rate No. * Rate 1940 38,700 428 11.0 851 22.0 15 40 3 7.8 1941 26,470 306 11.6 600 22.7 9 38 - - 1942 27,430 342 12.5 502 18.3 17 50 1 2.8 1943 30,330 459 15.1 554 18.3 32 70 1 2.1 1944 30,990 416 13.4 572 18.4 21 50 1 2.4 1945 35,310 557 15.8 536 15.2 25 45 4 6.9 1946 45,740 816 17.8 550 12.0 36 44 1 1.2 1947 51,000 968 19.0 611 12.0 43 44 - - 1948 50,890 883 17.4 597 11.7 35 40 - - 1949 51,990 875 16.8 588 11.1 23 26 - - 1950 52,490 829 15.8 638 12.2 21 25 - - 1951 52,430 819 15.6 686 13.1 19 23 - - 1952 52,140 787 15.1 669 12.8 16 20 - * Totals arrived at after due allowance for inward and outward transfers. 10 DEATHS OF RESIDENTS DURING 1952 Causes of Death at all Ages AGE AT DEATH Under 1 year 1 and under 5 5 and under 15 15 and under 25 25 and under 45 4i5 and under 65 65 and upwards l. Tuberculosis, respiratory 12 2 8 2 2. Tuberculosis, other 3 _ 3 3. Syphilitic disease 3 1 2 4. Diphtheria - - - - - — - - 5. Whooping cough - - - - - - - _ 6. Meningococcal infections 7. Poliomyelitis, acute 1 1 3. Measles 1 — — 1 — — — — 9. Infective and parasitic diseases,othei 3 1 1 1 10. Malignant neoplasm, stomach 14 2 4 8 11. Malignant neoplasm, lung, bronchus 33 3 4 16 12. Malignant neoplasm, breast 13 3 3 7 13. Malignant neoplasm, uterus 6 2 2 2 14. Malignant and lymphatic neoplasms, other 65 1 4 20 40 15. Leukaemia, aleukemia 2 _ 2 16. Diabetes 5 — - - 1 - — 4 17. Vascular lesions of nervous system 92 1 1 11 79 18. Coronary disease angina 67 1 17 49 19. Hypertension with heart disease 5 1 4 20. Heart disease, other 112 2 1 12 97 21. Circulatory disease,other 47 _ _ _ 8 39 22. Influenza 5 — — — — — 3 2 23. Pneumonia 48 2 2 — 1 2 A 37 24- Bronchitis 30 - - - - 1 A 25 Carried forward 567 3 2 2 6 23 115 416 11 DEATHS OF RESIDENTS DURING 1952 ( Continued) Causes of Death At aH ages AGE AT DEATH Under 1 year 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upward] Brought forwaid 567 3 2 2 6 23 115 416 25. Respiratory • system, other diseases of 7 — — - — — - 7 26. Ulcer of stomach and duodenum 6 — — — 1 — 3 2 27. Gastritis, eritis and diarrhoea 3 — — — — - — 3 28. Nephritis and nephrosis 5 _ — - - 1 3 1 29. Hyperplasia of prostate 10 - - - - - 1 9 30. Pregnancy, childbirth, abortion ' — - — — — - - - 31. Congenital malformations 2 - - - 1 - - 1 32. Defined and ill defined diseases, other 40 10 - 1 1 4 4 20 33. Motor vehicle accidents 3 — — 1 - 1 1 34-. Accidents, all other 19 3 — — 1 3 2 10 35. Suicide 7 - - — 4 2 1 36. Homicide and operations of war — — — — — — — — TOTALS 669 16 2 4 10 36 131 470 The following short summary will show what vast changes have taken place in respect of deaths occurring (a) under one year of age, and (b) at 65 years and overs- Year Number of deaths Deaths under 1 year of age Percentage of total deaths Deaths at 65 years and over Percentage c total death 1900 1,737 333 19.17 442 25.44 1925 883 64 7.2 4 433 48.01 1950 638 21 3.29 434 68.02 1952 669 16 2.39 470 70.25 12 INFANT MORTALITY Sixteen deaths of infants under 1 year of age occurred during the year, representing a death rate of 20,3 per 1,000 live births as compared with 23,2 and 25.3 in 1951 and 1950 respectively,, The infant mortality rates for England and Wales, and London were 27o6 and 23.8 respectively, Seventy-five per cent, of the deaths recorded were in infants under four weeks of age. Deaths were attributed to:- Males° Females. Asphyxia 2 Atelectasis 1 Gastro-enteritis 1 Inattention at birth 1 Pneumonia 1 Prematurity 5 2 Pulmonary haemmorhage 1 Respiratory failure 1 T oxaemia 1 It is of great interest to note that the death rate of infants under the age of one year is the lowest ever obtained in the Borough, but it is far more satisfactory to observe to what a remarkable extent the actual number of deaths in this particular age group has fallen during the last half century, as is indicated in the following summary Year Number of deaths 1900 333 1910 141 1920 73 1930 32 1940 15 1950 21 1951 19 1952 16 In considering the above figures it must be borne in mind that only 428 births of local residents were registered in 1940 which accounts for the low proportion of deaths under one year of age. 1900 1901 1902 1903 1904 1905 1906 ' 1997 1908 1909 / 1910 1911 1912 1913 <^. 1914 1915 1916 1917 \ 1918 / 1919 V. 1920 1921 >— 1922 \ 1923 \ 1924 / 1925 \ 1926 1927 "C 1928 1929 [ 1930 N. 1931 1932 > 1933 / 1934 f 1935 ( 1936 V 1937 1938 J 1939 / 1940 \ 1941 1942 1943 \ 1944 \ 1945 N. 1946 / fc 1947 y/ M 3 | 1948 f o g £ g 1949 / -Ml1950 / $ E i I 1951 / . g 3 Jj 1952 g S a| 1953 K 6 I g 1954 | g 0 P 1955 S S 2 1956 S S I 1957 ^ R p 1958 ___J W59 i960 13 INFANT MORTALITY RATES - ENGLAND AND WALES AND VARIOUS OTHER COUNTRIES Deaths under 1 year of aee oer 1.000 live births Country 1948 1949 1950 1951 Average for 4 yr& ENGLAND AND WALES 34 32 30 30 30.5 SCOTLAND 45 41 39 37 40.5 NORTHERN IRELAND 46 45 40 41 43.0 AUSTRALIA 28 25 24 25 25.5 BELGIUM 50 52 59 66 56.7 CANADA 44 43 41 38 41.5 CHILE 160 169 153 149 157.7 DENMARK 35 34 31 29 32.2 FRANCE 51 61 52 51 53.7 IRISH REPUBLIC 49 59 45 45 49.5 ITALY 70 74 64 67 68.7 NETHERLANDS 29 27 25 25 21.5 NEW ZEALAND 22 24 23 23 23.0 SWEDEN 23 23 20 21 21.7 UNITED STATES OF AMERICA 32 31 29 29 30.2 14 METEOROLOGY - 1952 The f.ll.wing table gives brief details .f temperatures9 rainfall and sunshine during each quarter .f the year, and has been prepared fr.m inf.rmati.n supplied by the Direct.r .f the Mete.r.l.gical Office, based .n data .btained at Kew Observat.ry, Daily Temperatures .f the Air T.tal T.tal Quarter Average .f Average .f Average .f Rainfall Sunshine Highest L.west .f Mean (inches) (h.urs) March 46.1° 36,1° 41.l° 5.14 243.8 June 63.8° 47.6° 55.2° 4.54 624.2 September 68„4° 54.1° 6l.2° 5.57 567.O December 4805° 38„30 43.4° 9.09 220u8 TOTALS 165508 The MARCH quarter opened brightly th.ugh cold; sunshine during January was well above the average, whilst rainfall was moderate. Sunny and dry weather marked the opening .o the JUNE quarter whilst it was the warmest May .f the century; rainfall was below the normal expectation, despite a fall of 3.27 inches in seventy-five minutes over south-western suburbs of the metropolis .n the 19th. June was drier whilst sunshine appreciably exceeded the average in south-eastern England "Mainly dry and rather warm" was expressive of the month of July but taking the SEPTEMBER quarter as aowholes the rainfall was in excess of normal precipitation, whilst sunshine recorded was up to. average, though the month of September was unusually cold. The DECEMBER quarter saw a maintenance of the cold conditions which prevailed in September, with slightly less rain and average sunshine f.r October. November ot. was quite cold, and sunshine was below average and rainfall greater than anticipated., December was notable for a long spell of sm.ke-laden fog, whilst sunshine and rain both exceeded the average. 15 COMMENTS ON THE LONDON FOG. During the period 5th to 8th December, an area of high pressure lay stationary over the Greater London area, and brought with it almost complete calm, a condition which was most conducive to the formation of fog® On the 5th it consisted mainly of smoke, but on the following three days it developed into a very thick water fog which extended outside the London area. The production of a water fog is not necessarily advanced by the existence of smoke; nevertheless such a circumstance may well contribute to the persistency of a fog. A feature of the disastrous occurrence now under consideration was the remarkable variations of smoke concentration noted. On one occasion the highest concentration exceeded the lowest by 14 times. Another indication of the abnormal conditions can be appreciated by a reference to results obtained from the working of an air-conditioning plant at a London building under the control of the Ministry of Works. Filters to the plant were shown to be clogging at a rate of 26 times the normal, and during one four-hours period this rate soared to 54 times the normal. A consideration of the effect these "epidemic" conditions had upon the health of the population is eloquently portrayed by a perusal of the following table which gives details of deaths from certain causes prior to the exceptional conditions, and also for the two weeks following the clearing of the fogo Week ended; London Administrative County 1952 Deaths from: Bronchitis & Diseases of the Heart Pneumonia. & Circulatory System., November 1st 67 223 8th 74 226 15th 74 247 22nd 77 264 29th 101 312 December 6th 121 318 13th 872 801 20th 521 457 27th 275 325 Having regard to the mortality attributable to the exceptional weather, it would seem reasonable to assume that upwards of a million people were more or less seriously affected. It is significant to read that deaths from Bronchitis and Pneumonia in the two weeks following the fog showed increases of 400 per cent and 200 per cent respectively as compared with the figures for the week ending 6th December. The increase in sickness was mainly due to respiratory disease, which was nearly quadrupled, although heart disease also rose to about three times the normal number. Some indication of the increased morbidity - 16 - is given in the new sickness claims under the National Insurance Act for Middlesex and London, which rose to 28,900 for the week ended 16th December as shown in the following tables:- New Sickness Claims (National Insurance) London and Middlesex Week ended: New Claims November 11th 15,100 18th 15,000 25th 17,100 December 2nd 19,000 9th 20,300 16th 28,900 23rd 16,300 30th 11,400 SANITARY CIRCUMSTANCES OF THE AREA - 17 - SANITARY ADMINISTRATION OF THE BOROUGH SUMMARY OF WORK PERFORMED BY THE SANITARY INSPECTORS DURING THE YEAR 1952. Number of complaints received during the year:- 1,140 INSPECTIONS AND REVISITS: DWELLINGS Houses inspected after complaints 4,598 Houses inspected after Infectious Disease 773 House-to-House inspections 2,159 Underground Rooms 230 Overcrowding and "Permitted Numbers" 283 Visits to obtain information re Housing Applications 85 Inspection of Council flats for vermin 107 Other visits 12 8,297 FOOD PREMISES: Butchers 169 Horseflesh Dealers 1 Fishmongers and Fish Friers 56 General Provision Shops, including Delicatessen Shops 208 Dairies and General Stores selling Milk 70 Ice Cream Vendors (Premises, Stalls, Vehicles etc) 126 Ice Cream Manufacturers 301 Bakehouses and Underground Bakehouses 58 Street Stalls and Barrows 51 Food Delivery Vehicles 5 Food Factories (Mechanical) other than Bakehouses 47 Food Factories (Non-mechanical) other than Bakehouses 36 Hotels, Restaurants and Dining Rooms 676 Premises in connection with Unsound Food 793 Premises in connection with Sampling 234 Other Food Premises 163 2,994 FACTORIES AND OUTWORKERS: Factories - other than Food Factories (Mechanical) 273 Factories - other than Food Factories (Non-mechanical) 173 Outworkers 77 Other visits (not classified) 2 525 DRAINAGE: Drains tested - by water 218 Drains tested - by smoke 202 Drains tested - by air 75 Final tests after repair or reconstruction 96 Drains traced by colour 125 716 Carried forward: 12,532 — 18 SUMMARY OF WORK PERFORMED BY THE SANITARY INSPECTORS DURING THE YEAR 1952 (Continued) — ~ INSPECTIONS AND REVISITS (Continued) Brought forward; 12,532 MISCELLANEOUS: Public Conveniences and Hotel Conveniences accessible from the street 12 Internal Conveniences at Cinemas, Theatres, Hotels etc . 2 Animals, poultry and birds 2 Open spaces, highways, allotments, fairgrounds etc 108 Office premises 1 Marine Stores and Second-hand Dealers' premises 2 Premises under Pharmacy and Poisons Act, 1933 71 Premises to enforce requirements of Shops Act 133 Visits to premises re Voluntary works 3,417 Visits to Owners, Builders and Agents Offices 448 Smoke observations 14 Food poisoning 21 Fumigations of furniture 28 Visits to aged and infirm persons 257 Visits to Verminous Persons 19 Visits to premises which resulted in "no access" 1,573 Premises other than dwellings after Infectious Disease 34 Other visits 887 7,029 TOTAL: 19,561 -19 WORKS SUPERVISED BY THE SANITARY INSPECTORS FACTORIES ACT, 1937 HOUSING ACT, 1936 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1938 TOTAL N. v. N. V. N. V. N. V. [/##] CLEANSING: Rooms: Walls & Ceilings cleansed and redecorated - 5 183 2 304 30 2 3 529 Passages & Staircases: Walls & Ceilings cleansed - - 77 1 56 4 - - 138 Yard & Area Walls cleansed and redecorated - - - - 4 - - - 4 Verminous Rooms disinfested - - 11 - 9 5 - - 25 Rooms where Food is manufactured, stored or sold - - - - - - - 13 13 Miscellaneous - - - - 1 - - - 1 GENERAL REPAIRS: Roofs 2 - 50 2 116 15 - - 185 Eaves, Gutters — 1 17 - 58 3 - - 79 Rain-water pipes - - 24 - 26 1 - - 51 Yard & Area: Pavings - - 24 - 17 1 - - 4 Walls rendered or repaired - — 34 - 20 1 - - 55 Rooms: Walls & Ceiling plaster — - 205 — 342 35 1 3 586 Passages & Staircases: Wall and Ceiling plaster - - 61 - 59 5 - - 125 Floors - - 74 - 55 6 - 1 136 Stair Treads, Banisters and Balustrades - - 37 - 19 - - - 56 Window and Door Frames, fittings and sash cords. - - 407 2 187 20 - - 616 Dampness remedied — — 31 1 378 28 - — 438 Fireplaces & Fire-ranges repaired - - 75 - 78 9 - - 162 Washing Coppers repaired - - 15 - - - - - 15 Natural Ventilation provided or improved 1 1 24 - 17 4 - - 47 Chimneys & Flues — — 40 - 9 1 — — 50 Miscellaneous 2 1 12 - 59 4 - 2 80 Carried Forward 5 8 1401 8 1814 172 3 22 3433 WORKS SUPERVISED BY THE SANITARY INSPECTORS (Continued) FACTORIES ACT, 1937 HOUSING ACT, 1936 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1938 TOTAL N. V. N. V. N. V. N. V. Brought Forward 5 8 1401 8 1814 172 3 22 3433 DRAINAGE: Total Reconstruction — — — — 3 10 - - 13 Partial Reconstruction, repairs or alterations - - 1 - - 7 - - 8 Frontage Drains Reconstructed. - - - - 18 7 1 - 26 Obstructions cleared — 1 - - 18 5 - - 24 Inspection Chambers provided - - - 1 3 33 - - 37 Inspection Chamber covers renewed - - 3 - 3 - - - 6 Interceptors provided - - - - 8 11 1 - 20 Soil &Ventilation Stacks provided or reconstructed - — - - 2 31 - - 33 Soil & Ventilation Stacks repaired - - - - 9 - - - 9 Waste &Ventilation Stacks - - - provided or reconstructed - - 11 - 7 57 - - 75 Waste & Ventilation Stacks repaired - - - - 19 6 - - 25 Anti-Syphonage Stacks provided or reconstructed - - - - - 20 - - 20 Ant i-Syphonage Stacks repaired or renewed - - - - - 3 - - 3 Fresh Air Inlets provided - - - - 2 14 - - 16 Fresh Air Inlets repaired or renewed - - 7 - 13 - - - 20 Single Sinks provided - - 7 - 5 58 - 1 71 Single Sinks renewed - - 10 - 7 2 1 - 20 Double Sinks provided - - - - - 3 - - 3 Double Sinks renewed - - - - - 1 - - 1 Baths provided - - - - - 63 - - 63 Wash-hand basins provided — - - - - 90 - 1 91 Wash-hand basins renewed - - - - - 1 - - 1 Waste pipes cleared of obstructions or repaired - - - - 1 - - - 1 Untrapped Waste pipes provided with traps - 1 - - 13 - — - 14 - - 2 - 29 60 - 1 92 Carried Forward 5 10 1442 9 1974 654 6 25 4125 - 20 - - 21 - WORKS SUPERVISED BY THE SANITARY INSPECTORS (Continued) FACTORIES ACT, 1937 HOUSING ACT, 1936 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1938 TOTAL Brought Forward N. V. N. V. N. V. N. V. 5 10 1442 9 197-4 654 6 25 4125 SANITARY CONVENIENCES: Additional Water Closets provided - - - - 1 75 - - 76 Water Closet pans renewed - - 2 — 16 4 — - 22 Water Closet pans cleansed - — 1 - 10 - - - 11 Water Waste preventers renewed or repaired - - 4 - 12 8 - - 24 Water Waste preventers provided - - - - 1 81 - - 82 Roofs repaired or renewed — - 4 — 4 — - - 8 Floors repaired or renewed - - 4 - 3 2 - _ 9 Walls and Ceiling plaster cleansed, repaired or redecorated - 5 40 - 72 4 - 4 125 Natural Ventilation provided or improved - 2 7 - 7 13 - - 29 Natural or Artificial Light provided or improved - - - - 2 - - - 2 Ventilated Lobby provided — — - — — 1 1 — 2 Miscellaneous — 1 17 — 45 6 - - 69 WATER SUPPLY: Supplies provided to Tenements - - 5 - 9 - - - 14 Taps supplied on main for drinking purposes 1 - 11 - 6 - - - 18 Burst Pipes repaired - - 1 — 7 — _ — 8 Cisterns cleansed, covered or repaired - - - - 6 4 - - 10 Miscellaneous - - - - 1 - - - 1 Carried Forward 6 18 1538 9 2176 852 7 29 4635 - 22 - WORKS SUPERVISED BY THE SANITARY INSPECTORS (Continued) FACTORIES ACT, 1937 HOUSING ACT, 1936 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1938 TOTAL Brought Forward N. V. N. V. N. V. N. V. 4635 6 18 1538 9 2176 852 7 29 MISCELLANEOUS SERVICES PROVIDED: Constant Hot Water — - - — - - — 2 2 Food Cupboards Ventilation provided - - 10 - 1 - - - 11 Food Cupboards provided - - 44 - - - - - 44 Miscellaneous - - - - 1 - 2 - 3 MISCELLANEOUS NUISANCES ABATED, ARISING FROM: Offensive accumulations on open land and bomb sites 2 - 5 - 17 3 - - 27 Emissions of excessive noise - - - - - 1 - - 1 Trees, Obstructions from light and air - - - - 1 1 - - 2 GRAND TOTALS 8 18 1597 9 2196 857 9 31 4725 N = Work carried out under Notice. V = Voluntary works. - 23 - INSPECTIONS. PROCEEDINGS, etc. Total number of houses in the Borough 15,800 (approx) PUBLIC HEALTH (LONDON) ACT. 1936 +Number of houses inspected on account of complaints or illness 1,796 Number of statutory notices served 365 Number of houses repaired or nuisances remedied 411 HOUSING ACT. 1936 Number of houses inspected - house-to-house (Housing Consolidated Regulations, 1925) 138 Number of houses included by representations by the Medical Officer of Health under Section 25 of Housing Act, 1936 Nil Number of houses demolished following representation by Medical Officer of Health under Section 25 of the Housing Act 1936 Nil Number of houses repaired under Sections 9 and 10 of Housing Act, 1936:- (a) by owners 31 (b) by local authority in default of owners Nil Number of houses demolished (a) in pursuance of orders under Section 11 of the Housing Act, 1936 20 (b) voluntarily 10 Number of houses (wholly or in part) the subject of Closing Orders (excluding underground rooms) 1 Number of Closing Orders determined (i.e. houses made fit) Nil OVERCROWDING (HOUSING ACT. 1936) Number of families found to be living in overcrowded conditions 13 Number of overcrowded families who have obtained alternative accommodation 9 Number of houses erected by the Borough Council for working classes during the year 105 UNDERGROUND ROOMS Number occupied but unfit Number closed or modified occupation approved Nil HOUSES LET IN LODGINGS Number of houses let in lodgings in the Borough 575 Number of inspections (see + above) Nil Number of prosecutions Nil Number of complaints remedied under the bye-laws (not included under any other heading 30 24. HOUSING ACT. 1936. PART IV - OVERCROWDING New cases investigated and recorded 13 Number of families involved 13 Number of persons involved 70 Cases relieved by: (a) Rehousing Authorities 5 (b) Informal or formal procedure 4 Such action resulted in 44 persons being adequately housed. There has been no recurrence of overcrowding at any premises in which the efforts of the local authority had brought about an abatement of such a condition. At the end of the year, fifty-four families were living in overcrowded conditions. Every endeavour is being made to abate the overcrowded conditions. - 25 - * FACTORIES ACT, 1937 Under Section 128 of the above Act, a Medical Officer of Health is required to report annually as to the administration of Factories, Workshops, and Workplaces in his district. The following three tables indicate the work carried out by the Sanitary Inspectors during the year. 1. INSPECTION OF FACTORIES. WORKSHOPS. AND WORKPLACES. Premises Number on Register Number of Inspections Written Notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities: 107 102 2 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority: 200 196 - - (iii) Other Premises in which Section 7+ is enforced by the Local Authority - - - - TOTALS: 307 298 2 - Note: Outworkers premises are not included in (iii) above. +i.e.Electrical Stations - Section 103(1)), Institutions (Section 104) and sites of Building Operations and Works of Engineering Construction (Sections 107 and 108 ). 26 FACTORIES ACT. 1937 (continued) 2. CASES IN WHICH DEFECTS WERE FOUND. Particulars Number of cases in which Defects were found Number of Cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (Section l) 5 5 - - - Overcrowding (Section 2) - - - - - Unreasonable temperature (Section 3) - - - - - Inadequate ventilation (Section 4) 1 1 - - - Ineffective drainage of floors - - - - - (Section 6) Sanitary Conveniences: - - - - - (Section 7) (a) Insufficient 1 1 - - - (b) Unsuitable or defective. 10 9 - 1 - (c) Not separate for sexes. 7 3 - - - Other offences against the Act (not including offences relating to Outwork) 6 - 6 — - TOTALS 30 19 6 1 - OUTWORK (Sections 110 and 111) Nature of Work No. of Outworkers in August List required by Section 110 (l)(c) No. of Cases of default in sending List to the Council No. of Prosecutions for failure to supply Lists No. of instances of work in unwholesome premises Notices served Prosecutions Wearing Apparel Making, etc. 13 1 - - - - Curtains and furniture hangings 4 - - - - - Furniture and upholstery 1 - - - - - Chocolates and sweetmeats 15 - - - - - Lampshades 1 - - - - - TOTALS; 34 1 - - - - -27- FACTORIES ACT. 1937 (continued) — 28 The institution of legal proceedings, under the Public Health (London) Act, 1936, was necessary in fifteen instances. Brief details of results of hearings are set out below. Premises Offence Result of Proceedings 29a, Cremorne Road Non-compliance with Statutory Notice. Summons withdrawn requirements of notice complied with at time of hearing. 8, Blantyre Street Non-compliance with Statutory Notice. Summons withdrawn requirements of notice complied with at time of hearing. Council awarded £l. l1s. 6d. costs. 23, Luna Street Non-compliance with Statutory Notice. Summons adjourned sine diework in progress at time of hearing. 13, Fernshaw Road Non-compliance with Statutory Notice. Summons adjourned sine die work in progress at time of hearing. 73y Blantyre Street Non-compliance with Statutory Notice,, Three Abatement Orders made for the works to be completed within 56 days. Council awarded £3. 3s. 0d. costs. 36, Edith Grove Non-compliance with Statutory Notice. Abatement Order made for work to be completed within 35 days. 37, Edith Grove Non-compliance with Statutory Notice. Abatement Order made for work to be completed within 35 days. Council awarded £1. 1s. 0d. costs. 31, Gertrude Street Non-compliance with Abatement Order. Defendant fined £15.15s.0do Council awarded £5.5s.0d. Costs. 31,Burnaby Street Non-compliance with Statutory Notice. Summons adjourned sine die work in progress at time of hearing. 17, Callow Street Non-compliance with Statutory Notice. Abatement Order made for work to be completed within 28 days. Council awarded £2. 2s. 0d. costs. LEGAL PROCEEDINGS - 29 - LEGAL PROCEEDINGS (Continued) Premises Offence Result of Proceedings 23, Gertrude Street Non-compliance with Statutory Notice. Abatement Order made for work to be completed within 56 days. Council awarded £2. 2s. 0d. costs. 17, Callow Street Non-compliance with Abatement Order. Penalty Summons Defendant fined £14.6s.0d. Council awarded £ 2.2s.0d. Costs. 87, Edith Grove Non-compliance with Statutory Notice. Abatement Order made for work to be completed within 42 days. Council awarded £2. 2s. 0d. costs. 96, Edith Grove Non-compliance with Statutory Notice. Summons withdrawn - work in progress at time of hearing. 3, Tetcott Road Non-compliance with Statutory Notice. Summons adjourned sine die work in progress at time of hearing. - 30 - DETAILS OF NOTICES SERVED DURING THR YEAR UNDER VARIOUS ACTS l. FACTORIES ACT. 1937 Health - General Provisions 2 2. FOOD AND DRUGS ACT. 1938 Section 13 - Defects at Food Premises 3 3. HOUSING ACT. 1936 (a) Section 9 - Repair of Insanitary Houses 48 (b) Byelaws - As to Lodging Houses for the Working Classes 78 4. PUBLIC HEALTH (LONDON) ACT. 1936 (a) Intimation 353 (Arising out of this item, 171 Nuisance Notices were served) (b) Section 40-Drainage 8 (c) Section I84 Food Storage 4 5. SHOPS ACT, Section 10 - Provision of suitable sanitary conveniences and ventilation 2 6. PREVENTION OF DAMAGE BY PESTS ACT. 1949 Section 4 - Destruction of mice 1 TOTAL 451 Four hundred and sixty-three notices were complied with during the year, of which four hundred and eleven were served under the Public Health (London) Act, 1936. RENT AND MORTGAGE INTEREST RESTRICTIONS ACTS One certificate was issued in accordance with the provisions of the above Acts. — 31 NATIONAL ASSISTANCE ACT. 1948. BURIAL OR CREMATION OF THE DEAD In accordance with the provisions of the above Act, the Borough Council is required to make arrangements for the burial or cremation of the body of any person in respect of whom no other suitable action can be taken. This responsibility has been operative since 5th July, 1948, on which date the National Health Service Act, 1946, came into force. In the early stages, the Borough Council dealt with all interments of the nature indicated above, whether they died in hospitals or in their own homes. However, in March, 1949, the Minister of Health reconsidered the application of this particular section of the National Assistance Act, and decided that Hospital Committees and Boards should arrange and pay for the burial or cremation of patients dying in hospitals under the following circumstances: (a) Relatives not being traced; (b) Relatives being traced, but who were not, immediately before a patient's death, liable to his (or her) maintenance under section 42(1) of the Act, and are not willing to undertake the arrangement of burial or cremation; and (c) Relatives not being able to obtain a death grant under the National Insurance Act, 1946, and unable to accept financial responsibility for burial or cremation expenses. This decision by the Minister of Health greatly eased the financial burden on the Borough Council in a direct sense, as will be seen from the following summary: Borough Council 1948 (approximately 6 months) 43 1949 25 1950 9 1951 10 1952 9 - 32 - Responsibility for the interment or cremation of the great majority of persons who die in hospitals is, therefore, not falling upon a local authority, as is evidenced by the foregoing figures.. This Council deals with such cases as may be referred to them by hospital authorities owing to the failure of liable relatives to assume their responsibilities, whilst the necessary arrangements are always made in respect of persons dying in their own homes when it is obvious that exhaustive enquiries for next of kin have proved unavailing. Under the Second Schedule of Part II of the National Insurance Act, 1946, appear details of Death Grants payable, subject of course, to the fulfilment of certain provisions and the fact that either the deceased person or a legally liable relative has made a qualifying number of contributions to National Insurance. A grant is obtainable when the deceased person was at the time of death Grant (a) under the age of three years £ 4 (b) between three and six years £ 6 (c) between six and eighteen years £10 (d) over the age of eighteen years £20 A grant cannot be secured in the case of a man born before 5th July 1883, or a woman born before 5th July, 1888. A further exception is made in the case of a child under the age of ten years who was born before 5th July, 1948. Section 50 of the National Assistance Act, 1948, provides that "an authority may recover from the estate of the deceased person or from any other person who for the purposes of this Act was liable to maintain the deceased person immediately before his (or her) death, expenses incurred". In the great majority of cases it has been found that the estates of deceased persons whose burials have been carried out by the Council have proved of little value. On the other hand, on the few occasions when the effects of a deceased person have realised more than the funeral expenses, the balance of the estate is transferred to Her Majesty's Treasury. A local authority is committed to the following procedure, for which it does not receive any reimbursement:- (i) the removal of the deceased from his or her home address to a mortuary or undertaker's chapel; (ii) the prosecution of enquiries to establish the existences or otherwise, of next-of-kin (which at times involves recourse to the despatch of telegrams or the making of long-distance telephone calls;) (iii) the listing of effects, and their subsequent transfer to store pending developments, and (iv) the preparation of considerable correspondence before a particular case can be finally settled. - 33 - Subject to certain provisions, the death grant payable in respect of a person aged over eighteen years if £20. 0s. 0d, but if his interment is carried out by a local authority, the latter can only receive three-fifths, i.e. £12. 0s. 0d. of the death grant. (Reference* The National Insurance (Death Grant) Regulations, 1949.) Surely, if a definite death grant is laid down as a contributor's right, assuming that his contributions to National Insurance have been fully maintained a local authority in assuming the role of a "liable relative" should receive the full death grant (£20). Shortly after the interment of a person through official channels, an undertaker will submit an account therefore Assuming his charge total £15. 0s. 0d, the Council are immediately faced with a deficit of £3. 0s. 0d. because they will only receive a payment of £12. 0s. 0d. from the Ministry of National Insurance.In addition to this, cognisance must be taken of expenditure connected with the performing of items (i) to (iv) above. The payment of the scheduled grant in full by the Ministry of National Insurance to a local authority would obviate any financial loss by the latter, and at the same time remove the possible existence of a feeling that although a person has been fully insured throughout his working life, he is, after all, to be given a funeral partly at the expense of disinterested persons. Many people of advanced age gain some measure of comfort from the knowledge that they will in the passage of time be laid to rest clear of any obligation to others. - 34 - MEDICAL EXAMINATIONS During the year, forty-four examinations were carried out to ascertain whether persons appointed to fill positions in the Council's employment were fit for admission to the authority's superannuation scheme. As a result of the examinations 42 proved successful; 1 was referred for re-examination; and 1 proved unacceptable for superannuation purposes. PUBLIC MORTUARY FACILITIES For some years past no premises have been maintained as a Mortuary in this Borough, but under an agreement made with Hammersmith Borough Council adequate arrangements exist at that authority's mortuary in Fulham Palace Road, W.6, premises which are, incidentally, adjacent to the Coroner's Court for this area. The following information is relevant to Chelsea residents:- Number of Post-Mortems carried out without Inquest 190 Number of Post-Mortems carried out with Inquest 34 - 35 - DISINFECTION AND DISINFESTATION The following is a summary of the work carried out by the Council's staff at the Disinfecting Station and Cleansing Centre, 9a, Lots Road, S.W.10. during the past three years 1950. 1951. 1952. (a) SCABIES Treatments were carried out as follows:- Adults(Males) Cases 3 2 4 Treatments 4 2 4 Adults(Female) Cases 11 5 5 Treatments 29 13 7 Children Cases 10 11 3 Treatments 24 17 6 (In addition to figures shown above, 7 children attending London County Council schools were given 12 treatments) (b) VERMINOUS CONDITIONS Details of work in this connection are set out belows:Adults (Males) Cases 6 3 6 Treatments 10 4 6 Adults (Females) Cases 90 221 388 Treatments 90 221 388 Children Cases 66 111 277 Treatments 66 111 277 (312 treatments were also given to London County Council school children) (c) DISINFECTION OF ROOMS AND CONTENTS AFTER INFECTIOUS DISEASE Number of rooms disinfected 268 289 337 Number of articles disinfected 2,881 2,060 4,373 - 36 - DISINFECTION AND DISINFSTATION (Continued) 1950. 1951. 1952. (d) DIS INFESTATION OF ROOMS AND CONTENTS Number of rooms disinfested 533 430 511 Number of articles disinfested. 2,202 2,077 1,307 (e) MISCELIANEOUS DISINFECTION Number of rooms disinfected 210 254 242 Number of articles disinfected 1,433 1,098 1,572 - 37 - PET ANIMALS ACT. 1951, The Pet Animals Act, 1951, which came into operation on the 1st April,1952, provides for a system of licensing and inspection by local authorities of pet shops, the main purpose being the enforcement of the Protection of Animals Acts in their application to the business of selling pets. Under section 1 of the Act, no person may keep a pet shop unless he obtains a licence from the local authority, on payment of a fee not exceeding ten shillings. In deciding whether to grant a licence, the local authority is required to have regard to the need for securing that there will be provided accommodation suitable as regards size, temperature, lighting, ventilation and cleanliness; that there will be an adequate supply of suitable food and drink; that the animals will not be sold at too early an age; that all reasonable precautions will be taken to prevent the spread of infectious diseases; and that appropriate steps will be taken in case of fire or other emergency. The local authority has, however, a discretion to withhold a licence on other grounds, and is given power to specify in the licence such conditions as they think necessary or expedient in a particular case.Any person aggrieved by the refusal of the local authority to grant such a licence or by the conditions imposed in the licence may appeal to a court of summary jurisdiction It is made an offence under section 2 to sell animals as pets in any part of a street or public place,, except at a stall or a barrow in a market, and it is laid down in section 3 that it shall be an offence to sell pets to children under twelve years of age. Under section 4 a local authority may authorise in writing any of its officers or any veterinary surgeon or veterinary practitioner to inspect any premises in respect of which a licence has been granted. This would also include inspection of any animals found on the premises. Section 5 deals with the penalties for offences under the Act and disqualifications The penalty for an offence under any provision of the Act, other than section is a fine not exceeding £25 or imprisonment for a term not exceeding three months, or both. The penalty for an offence under section 4 is a fine not exceeding £25. Where a person is convicted of an offence under the Act, or under the protection of Animals Act, 1911, the court may cancel any licence held by him under the Act and may disqualify him from keeping a pet shop for such period as the court thinks fit„ Section 7 provides that references in the Act to the keeping of a pet shop shall be construed as references to the carrying on, in premises of any nature (including a private dwelling), of a business of selling animals as pets and as including references to the keeping of animals with a view to their being sold in the course of such a business, subject to provisions exempting persons who keep or sell pedigree animals bred by them, or the offspring of an animal kept as a pet. During the year two persons were licensed to keep pet shops in the borough and in each case a fee of ten shillings was paid. - 38 - PHARMACY AND POISONS ACT. 1933. The provisions of the Act and the Poisons Rules relating to the retailing of poisons specified in Part II of the Poisons List were administered throughout the year. The number of listed sellers placed on the Council's register was 50 (48 retentions and 2 new applications). All applications are investigated to ensure that records are properly maintained, labelling efficiently performed, storage accommodation is adequate, and that sales are only made by employees nominated on application forms., In every instance it was found that the requirements of the Act and Poisons Rules were being complied with, whilst subsequent enquiries revealed that all concerned were well aware of their responsibilities in such matters. As a general rule the poisons retailed were insecticides, rodent exterminants, hair dyes, and household ammoniac Applications for inclusion and/or retention in the Council's register are considered by the Public Health and Baths Committee each Spring. When approval has been expressed to applications, appropriate entries are made for a period of twelve months (1st May to 30th April). 39 RAG FLOCK AND OTHER FILLING MATERIALS ACT,1951 The Rag Flock and Other Filling Materials Act, 1951, came into force on 1st November, 1951, and brought about the repeal of:- The Rag Flock Acts of 1911 and 1928, and Section 136 of the Public Health (London) Act, 1936. The new Act represents a consolidation of the 1911 and 1928 Acts, and extends control to a large number of filling materials in order to ensure the cleanliness of same. "Rag Flock" means flock which has been produced wholly or partly by tearing up spun or woven or knitted or felted materials, whether old or new, but does not include flock obtained wholly in the processes of the scouring, milling or finishing of newly-woven or newly-knitted or newlyfitted fabrics.. It is the duty of a local authority to 8- (i) Secure registration of premises used for upholstering and similar processes; (ii) Issue licences in respect of premises used for the manufacture, or for storing, of rag flock; (iii) Arrange periodic inspection of all registered and licensed premises, inspection of premises where it is believed filling materials, etc., are held for sale or offered or exposed for sale, inspection of premises believed to be subject to registration, and premises where it is believed that rag flock is manufactured or kept, etc; (iv) Ensure that occupiers of registered and licensed premises keep proper records relating to filling materials and rag flock; (v) Arrange for the taking of samples of filling materials by an authorised officer, and for testing by an Analyst prescribed by regulations, or by the Public Analyst; and (vi) Take proceedings for offences under the Act. Nine premises in the Borough, used for upholstering and similar processes, have been registered since the Act came into force and in each case a fee of £1. 0. 0. was received. - 40 - RODENT CONTROL. The prevention of Damage by Pests Act, 1949, which became operative on 31st March, 1950 is more advantageous to a local authority in dealing with rodents than the Rats and Mice Destruction Act, 1919, which has been repealed. The new Act empowers a local authority to take all practicable measures to rid its area of rats and mice. Under the provisions of the Rats and Mice Destruction Act, 1919, the primary duty for the eradication of these particular pests rested upon the individual occupier. With the advent of this new legislation, an occupier is guilty of an offence if he fails to destroy rodents, or use his best endeavours to prevent infestation,, There has always been co-operative action between owners, occupiers and the local authority in this borough. Details of work carried out in this connection during the year are as follows:- 1. Treatment of Business and Private Premises. Business Premises Private Premises Number of visits made 468 1215 Number of infestations found. 37 259 Number of treatments undertaken 29 222 Number of pre-baits laid 1,753 Number of poison baits laid 489 Number of complaints received 300 2. Sewer Maintenance Treatments. No, of Prebaits laid No. of poison baits laid Estimated kill No. 1 Treatment 964 311 2,910 No. 2 Treatment 964 242 2,142 - 41 UNDERGROUND ROOMS During the latter part of 1951, a survey of Underground rooms was undertaken,. This was completed early this yearThe survey was carried out because of the need for an improvement in the condition of the large number of occupied underground rooms in the Borough, with a view to improving the health and living conditions of the occupants, whilst the absence of a definite policy for dealing with underground rooms was holding up action under Section 9 of the Housing Act, 1936, to obtain repair of insanitary houses containing underground rooms.. Statutory Powers for dealing with underground rooms are provided by Sections 132 to 134 of the Publie Health (London) Act, 1936, and Section 12 of the Housing Act, 1936» There are a number of differences in the requirements of the Public Health and Housing Acts in relation to underground roomsThe most important difference is that whereas the Public Health Acts deal only with underground rooms which are separately occupied, the Housing Act and the regulations made thereunder apply to all underground rooms whether occupied separately or in combination with other room. The question of the separate occupation of underground rooms has proved a stumbling block in the past because changes in the letting of such accommodation have been sufficient to take rooms outside the scope of the Public Health Acts. The Housing Act requirements are more definite in their application and simpler to operate. Draft Underground Room Regulations have been submitted to the Ministry of Housing and Local Government for considerations, and approval for their operation is awaited. The following table gives details of the underground rooms examined during the course of the survey, together with appropriate references thereto:- CLASSIFICATION OF UNDERGROUND ROOMS No. of properties Estimated number CATEGORIES - NUMBER OF ROOMS with of underground rooms underground rooms A B D E F 4,667 10,369 60 1,413 5,565 1,543 1,428 360 - 42 - In the above Table rooms have been divided into the following categories:- A. Basement rooms not being underground rooms. UNDERGROUND ROOMS B, Fit for human habitation, i.e. comply with Underground Room regulations. C. Unfit - compliance with regulations could be effected at reasonable cost. D. Unfit - compliance with regulations could be effected, but at unreasonable cost. E. Unfit - Could not be made to comply with regulations. F. Unfit - Although structural considerations would make compliance in all respects impossible, they could nevertheless, be made to satisfy essential requirements. 43 - WELFARE OF OLD PEOPLE The Borough Council shews a keen interest in the circumstances and conditions under which elderly people are living.The great majority of them, despite infirmity, much prefer to remain in their own homes, and every effort is therefore made to ensure their happiness. An annual grant of £350 is made to the Chelsea Old People's Welfare Committee which is representative of and co-ordinates the activities of voluntary organisations engaged in this sphere of public service. At the close of the year, 885 persons were on the Council's list. When it is considered that the respective totals for 1951 and 1950 were 613 and 106, it will be apparent that the Council is endeavouring to make certain that the enjoyment of facilities of every conceivable nature is fully realised. The following brief comments will give some indication of the wide variety of services available:- Provision of Hot Meals. This service is efficiently administered by the Women's Voluntary Services from Monday to Thursday in each week. In 1951, the average weekly distribution was 220, a figure which represented the maximum attainable with equipment then available. Last year 10,725 meals were delivered to the homes of old people, or, on an average, 260 per week. Recipients were most appreciative of this arrangement, and if it was not operative it is quite certain that a high percentage of those now enjoying hot meals would merely consume what would be considered as "make-do" meals. Chiropody. 86 persons (34 in 1951) took advantage of the availability of a qualified chiropodist, and received 369 treatments, an increase of 141 over the number given in 1951. Holidays. Pleasant holidays arranged by the Honorary Secretary of the Chelsea Old People's Welfare Committee were much enjoyed by 65 old people. The majority stayed at homes controlled by the Women's Holiday Fund; others had a restful stay at the Lloyd Thomas Home. Highgate. Library and Shopping facilities are maintained by the British Red Cross Society, whose efforts are gratefully acknowledged by those who can only go out and about with difficulty. The Society also provides escorts when it is necessary for sick persons to proceed for treatment at hospitals. The problem of securing hospital accommodation for the chronic sick continues to be difficulty but the cordial relationship existing has enabled fifty-seven men and women to gain admission. In some instances it is pleasing to record that the efforts of hospital rehabilitation departments resulted in a return home to lead a normal life. 44 Institutional care was found to be essential in eighteen cases, and it is noteworthy that all responded well to a communal life. Nevertheless the utmost tact and patience are called for before the change of environment is made; in three instances it was necessary to effect compulsory removal to a suitable institution under the National Assistance Acts, 1948-195l. Issues of clothing were made when need was established, and 213 persons received benefit in this way during the year.The Women"s Voluntary Services and other kind donors have materially helped in the provision of many items, whilst the National Assistance Board, in making grants, enabled many people to be provided with bedding, and in some cases, beds. Owing to their enfeebled condition, eighteen persons were given personal cleansing; ten rooms were also cleaned and where necessary cleared of superfluous items. It is not possible to make detailed reference to the many opportunities offered in the desire to make the sick and/or elderly aware of that fact that they are always considered an integral part of the community. Briefly, arrangements are made for the provision of . Domestic and Home Helpsa membership of Clubs, advice in connection with applications for Housing, Pensions, Dental and Ophthalmic treatment, and, in fact, for assistance in connections with numerous other minor and major problems which would otherwise only result in perplexity,, The Council's Social Worker made l,702 visits to registered cases either in their own homes or whilst they were undergoing hospital treatment. In conclusion I have much pleasure in expressing my gratitude to the British Red Cross Society and the Women's Voluntary Services for their unfailing efforts throughout the year, and other voluntary organisations who have in no small measure contributed to the contentment of those now of advanced age. - 45 - HOSPITAL SERVICES The Borough is fortunate in possessing excellent facilities for both general and special hospital treatmente A list of the institutions now functioning in this area is as follows:- Name and Addregg.of Institution. HOSPITALS etc. St. Luke's Hospital,Sydney Street, S.W.3. St. Stephen's Hospital, 369, Fulham Road, S.W.10. Brompton Hospital, Fulham Road, S.W.3. Chelsea Hospital for Women, Dovehouse Street, S.W.3. Royal Cancer Hospital, Fulham Road, S.W.3. Granard House, 98, Dovehouse Street, S.W.3. (Part of Royal Cancer Hospital) St. George's Home, Milman's Street, S.W.l0. Victoria Hospital for Children, Tite Street, S.W.3. Royal Hospital, Royal Hospital Road. S.W.3. Type Institution Chronic Sick General Chest Diseases General Malignant Disease Malignant Disease Tuberculosis Children's Diseases Home for Pensioners NURSING HOMES The Royal Avenue Nursing Home, Private 39, Royal Avenue, S.W.3. The Wilbraham Nursing Home, Private 3, Wilbraham Place, S.W.1. 46 "PART III'' ACCOMMODATION In accordance with the requirements of the National Assistance Act, 1948, a local authority is required, under section 21 of the above Act, to provide - (a) residential accommodation for persons who by reason of age, infirmity or any other circumstances are in need of care and attention which is not available to them; (b) temporary accommodation for persons who are in urgent need thereof, being need arising in circumstances which could not reasonably have been foreseen or in such other circumstances as the authority may in any particular case determine. The London County Council are, for the purposes of this Act, the "local authority", and they maintain two institutions as "Part III" accommodation in this Borough, namely: 367, Fulham Road, S.W.10, and King's Mead, Dovehouse Street, S.W.3. During the year it became desirable to arrange for the reception of 18 persons in such accommodation, and in only three instances was it necessary to take legal action to enforce removal in accordance with section 47 of the National Assistance Act, 1948, as amended by the National Assistance (Amendment) Act, 1951. In all cases admissions were secured at King's Mead, Dovehouse Street. During the absence of persons from their own homes in institutions of this nature, their belongings become the responsibility of the Welfare Department of the London County Council who are, as far as is possible, given reasonable notice of the intended transfers. 47 MATERNITY AND CHIID WELFARE SERVICES, I am indebted to Dr. V.I. Russell, Medical Officer for Division I of the London County Council (which comprises the Boroughs of Chelsea, Fulham, Hammersmith, and Kensington) for information relating to the above services, which have been the responsibility of the London County Council since 5th July, 1948, on which day the National Health Service Act, 1946, became operative. WELFARE CENTRES Attendances at Ante-Natal and Post-Natal Sessions 1,448 Attendances at Infant Welfare Sessions 9,704 H.EA;LTH VISITING Number of visits carried out by Health Visitors in respect of:- Premature Infants 21 Infants under 1 year 2,518 Children between 1 & 5 years 5,079 Unsuccessful visits 1,578 Expectant mothers 816 Stillbirths 8 Infectious Diseases 108 Miscellaneous 493 10,621 FOSTER MOTHERS Number of registered foster mothers 8 Number of children fostered 20 DIPHTHERIA IMMUNISATION Number of children who completed a primary Course of injections 533 Number of children who received reinforcing injections 282 VACCINATIONS Number of children vaccinated at Violet Melchett Infant Welfare Centre, Flood Walk, Chelsea 417 48 BACTERIOLOGICAL EXAMINATIONS During the year, fifty-five examinations were carried out for bacteriological findings, details of which are set out in the following summary:- Article Reported upon as Unsatisfactory Satisfactory Total Cream, Artificial - 3 3 Cream, Goats - 2 2 Lollies, Ice - 5 5 Milk, Cows - 10 10 Milk, Goats 1 2 3 Water - 32 32 TOTALS: 1 54 55 Reference to thirty-six samples of Ice Cream will be found on page 49. 49 ICE CREAM Thirty-six samples of Ice Cream were submitted to the Public Health Laboratory Service for "Methylene Blue" tests, with the following results Grade I 24 Grade II 5 Grade III 1 Grade IV 4 34 The remaining two samples were of coloured ices which did not respond to the test. A consideration pf the table set out below will clearly show that very good standards are now attaining in respect to Ice Cream. Grading 1950 1951 1952 No. of samples Percentage of total No. of samples Percentage of total No. of samples Percentage of total I 63 59.4 50 83.3 24 70.6 II 27 25.5 7 11.7 5 14.8 III 13 12.3 - - 1 2.9 IV 3 2.8 3 5.0 4 11.7 TOTALS: 106 100.0 60 100.0 34 100.0 As recently as 1949 the percentage of samples of Ice Cream graded I and II was only 42.9, whilst in the same year those included in Grades II and 17 aggregated 57.1 (Grades I and II are considered "satisfactory;Grades III and IV - "unsatisfactory"). Traders whose products have been adversely reported upon are notified of the findings, whilst Medical Officers of Health are advised similarly concerning Ice Cream manufactured in their areas. Ice Cream which received chemical examination by the Public Analyst is commented upon in the section devoted to "Food and Drugs" commencing on page 58. MILK SUPPLE 50 Under the Milk and Dairies Regulations, 1949, a local authority is required to keep a register of all persons carrying on the trade of milk distributor, and of all premises used as dairies (other than dairy farms) in their district, and to remove from the register the name of any person who ceases to trade as a milk distributor, and of any premise which ceases to be used as a dairy premise. On the 31st December, 1952, entries in the register were as follows:- (a) Number of registered distributors with premises in the Borough 35 (b) Number of registered distributors other than those included in (a) above 15 (c) Number of premises in Chelsea registered as dairies 1 (d) Number of premises in Chelsea, other than dairies, from which milk is distributed 43 During the year, 91 applications were received, and principal licences were granted under the Milk (Special Designation) (Raw Milk) Regulations, 1949, and the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, authorising the use of special designations in relation to milk sold at or from premises within the Borough. 37 supplementary licences were granted in respect of milk sold by retail within the Borough from 15 premises not situate in the area of this authority. Details of licences granted were as follows:- Type of Licence Tuberculin Tested Pasteurised Sterilised TOTALS Principal 25 34 32 91 Supplementary 11 13 13 37 On the 1st October, 1951, the Milk (Special Designations) (Specified Areas) Order, 1951, came into force for the whole of the County of London. After this date it was illegal for any person to sell by retail for human consumption any milk other than milk which may be sold as specially designated milk in accordance with the provisions of the Milk (Special Designation) (Raw Milk) Regulations, 1949, and the Milk: (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, and it was necessary for all retailers selling milk in the area specified (whether or not their premises were situated in such area) to be licensed by the appropriate authority to use a special designation in relation to milk. All retailers selling milk within the Borough have now been licensed to use special designations,. No pasterurisation or sterilisation of milk took place in the Borough during the year, such processes having been carried out in other areas. UNSOUND FOOD - 51 - Approximately 8,192 pounds of unsound or diseased food were surrendered to and destroyed by the Council's Food Inspectors during the year, and for the purposes of comparison, details of the foods which have largely contributed to the annual totals during the years 1949 - 1952 (inclusive) are set out in the following table:- UNSOUND FOOD SURRENDERED TO THE COUNCIL'S FOOD INSPECTORS DURING THE YEARS 1949 - 1952 (inclusive) Commodity: 1949 lbs. 1950 lbs. 1951 lbs. 1952 lbs. Cereals - 307 - - Fish, fresh 1,475 1,096 327 117 Fish, tinned 102 415 402 88 Fruit, dried — 194 - - Fruit, fresh 240 — — — Fruit, tinned 313 1,666 2,184 1,723 Fruit juices 321 326 165 98 Ham, tinned — — 3,775 - Locust beans 705 — - — Meat, fresh 249 713 - 1,326 Meat, tinned 922 2,111 830 — Milk, tinned 618 371 241 95 Pickles, Sauces,etc 144 343 - - Preserves - Jams, Marmalades, etc 259 245 77 123 Rabbits 301 — — — Salad Cream 392 — — — Sausages _ — 300 858 Soups 270 201 132 40 Tomato juice 268 — - — Vegetables 349 881 709 1,l27 Aggregates of all foods condemned annually <>. «„ 8,017 9,721 9,788 8,192 Average for the four years Approximately 8,930 pounds. 52 UNSOUND FOOD (continued) It will be appreciated that an infinite variety of commodities of small aggregate weights have been excluded from the foregoing table; nevertheless, in not a few cases considerable work of investigation is entailed. A typical instance concerned tinned hams which were brought to the notice of the Public Health Department during 1951. By the end of the summer some twelve hundred pounds of tinned ham had been condemned as unfit for human consumption.The hams had been imported from most of the European countries,and an interesting feature was the varying nature of defect in different tins.Samples were submitted to the Central Public Health Laboratories for examination, which revealed that most of the tins examined contained bacteria, and it seemed, in many instances, that the pickle used for curing had not retarded the multiplication of such organisms. The Ministries of Food and Health were acquainted with the wastage of food which was occurring, and these authorities communicated with the countries concerned, the trade, and individual canners.In addition to verbal advice given to traders in this Borough, a circular letter was addressed to all local firms concerned in the sale of tinned hams. Attention was drawn to the position, and advice given with regard to storage, whilst it was also indicated that the services and knowledge of the officers of the Public Health Department were available to all concerned. As a result of the action outlined, the quantity of this particular foodstuff surrendered for condemnation subsequently showed a marked decrease. Foods which as a result of action under the Food and Drugs Act, 1938, are found to be adulterated, will be commented upon in the Public Analyst's report commencing on page 53. WATER Responsibility for the supplies of water to commercial and domestic premises is vested in the Metropolitan Water Board.Examinations of thirty-two samples of water were made during the year, and in all cases a satisfactory report was received. Five of the samples were secured at private premises; the remainder were obtained from sources of supply at the Public Baths. As a result of investigations made by the Sanitary Inspectors, the following provisions were made:- Supplies to tenements 14 Taps on mains for drinking purposes 18 Burst pipes repaired 8 Cisterns cleansed, covered or repaired 10 53 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Chelsea. Madam Mayor, Indies and Gentlemen, During the year 1952, 400 samples of foods and drugs were examined under the Food and Drugs Act. of these, 189 were taken formally and 211 informally. The number of samples adulterated or incorrectly labelled was 19, or 4.75 per cent, this figure being very similar to the one reported last year. No samples of milk examined during the year were found to be adulterated. The incidence of adulteration may be classified as follows:- Number of samples examined Number reported against. Chemical. Labelling and misdescription. Milk 200 - ( 0% ) (0% ) Other Foods 177 7 ( 3.9%) 5 ( 2.8%) Drugg 23 4 (17.4%) 3 (13.2%) A sample of Ice Cream was reported as adulterated because it contained only 2.6 per cent of fat. Although the Food Standards (Ice Cream) (Amendment) Order,1952, specifies a minimum of 4 per cent fat, ice cream on the average contains about 8 to 10 per cent. A sample of Cold Ice Cream Mix was reported adulterated as the label included "minor ingredients and these minor ingredients must be described. Some Gruyere cheese was examined and found to contain excess alkali. Under the Cheese Order emulsifying salts may be added to cheese in order to process it, and in this case an excess of alkali had been employed with the result that bacterial growth had commenced with the formation of gas. The hydrogen ion concentration was between 7 and 7.5 whereas it should have been in the neighbourhood of about 5-6. your analyst considered that this cheese was unfit for sale, though it could not be said that the actual sample submitted was unsafe for consumption. A sample of Milk Soup Powder was examined and reported adulterated as it was found to contain not more than 25 per cent of Full Cream Milk Powder instead of 34 per cent as stated in the formula given on the label. A sample of canned meat was described as Ham Loaf instead of Pork Loaf No attempt had been made to cure the meat before canning. Some Pork Sausages were found to contain only 62 per cent of meat and were, therefore, 4 per cent deficient in meat calculated as pork sausages. A sample of Tomato Puree contained only 8 per cent of total solid matter and your analyst is of the opinion that this sample was not tomato puree but tomato pulp. Tomato puree consists of concentrated tomato pulp and does not include unconcentrated pulp. Another sample of tomato puree was reported as inferior because the manufacturers claimed Tomato Solids 28 to 30 per cent, whereas only 26.6 per cent could be found on examination. 54 Owing to a complaint that primes were coming into the country coated with sodium silicate which was causing gastric disturbances, a sample submitted was examined by your analyst. The sample appeared to be coated with a minute quantity of sodium silicate which gave them a polished appearance, but the amount was insignificant and would not cause any gastric disturbance. A pineapple drink was badly fermosted and contained a large number of yeasts and bacteria, the sugar being reduced to 0.4 lbs.per gallon. It was unfit for sale and failed to comply with the Soft Drinks Order. A tin of caviare and some appetitsild rings contained hexamine. Hexamine is a compound of ammonia and formaldehyde and formaldehyde is prohibited as a preservative in food in this country though its use is permitted in Germany from where these two samples emanated. The label on a tin of Seaweed and Sarsaparilla tablets was misleading within the meaning of Section 6 of the Food and Drugs Act as it stated the ingredients to be Ext. Fuci and Ext. Sarsae.The extracts are not recognised in the British Pharmacopoeia or the British Pharmaceutical Codex nor do they appear in any recognised book of drugs. The formula was incorrectly given on the label of a sample of Embrocation,, This liniment was also claimed to be useful for the alleviation of rheumatoid arthritis and this contravenes the Code of Ethics of the Pharmaceutical Society. The composition of a sample of effervescent Health Salts was incorrectly described, but as the product was being taken off the market there was no necessity for any action in the matter. Four samples of so-called vitamin tablets were submitted and in nearly every case it was found that the vitamins,probably present originally, had deteriorated on keeping,, One of the samples was not labelled at all although it obviously contained a mixture of many vitamin concentrates. It is doubtful whether any good purpose is served by these products being sold indiscriminately to the public since the average person is incapable of judging which vitamins they lack in their diet, but it is impossible to interfere with this type of trade and the wisdom of any attempt to do so may be disputed. During the year several items of legislation or recommendations of Committees of the Ministry of Food were issued, which are of general interest to the public from the point of view of quality. No less than three separate Meat Products Orders were introduced. These orders were of particular interests, in that they were issued primarily as enforcement orders and not as standards under the Food and Drugs Act. For this reason Local Authorities and public analysts were not informed either in advance or at the time of their issue by the Minister, but it is probable that it is the standards, rather that the prices, which will eventually be resurrected from their ashes, even the last order having been revoked in 1953. The first order, S.l. 1952, No.507, removed the restriction on the use of soya flour in sausages, but permitted the inclusion of not more than 6 per cent. of skim milk powder in such products, the milk powder to count as 60 per cent of its weight of meat. For the first time minimum quantities were laid down for the meat content of many meat products. As a result of this order the general methods for the - 55 - analysis of these meat products were reviewed in detail by public analysts and manufacturers. Later in the year this order was replaced fay the Meat Products (No.2) Order, 1952. From the public health standpoint the chief amendments introduced were the removal of the permission to use milk powder or fat of vegetable origin in place of part of the meat and to include tinned soups as meat products. Owing to various difficulties in applying this order a third order was introduced at the end of the year revoking all standards other than those for sausages. To the layman it may appear that there has been a considerable amount of wasted legislation, much of which has caused considerable discussion and argument„ There appears little doubt, however, that whilst numerous standards put forward and eventually withdrawn had been issued without sufficient consultation with all interested parties, many members of the trade and analysts will employ these standards as a basis for commercial and other purposes, and that they may again be issued at some future date when we have more knowledge regarding their application. The Food Standards (Fish Paste) Order, 1951, which came into effect for retail sales on 7th March, requires fish paste to contain not less than 70 per cent of fish after all waste has been eliminated. Fish varies considerably in composition and public analysts are endeavouring to discover methods of analysis which can be used for its enforcement, The Food Standards (Meat Paste) Order 1951, came into effect for retail sales on 7th March,, This order fixes a standard of not less than 55 per cent of meat in meat paste. The Milk (Control and Maximum Prices) (Great Britain) (Amendment No.4) Order, 1951, which came into effect on the 1st January, 1952, included both Jersey and Guernsey milk as Channel Island milk. The Food Standards (Coffee Mixtures) Order, 1952, requires coffee and chicory mixtures, including French coffee, to be mixtures of coffee and chicory only and to contain at least 51 per cent of coffee,, It further requires coffee with fig flavour or fig seasoning, including Viennese coffee, to be a mixture of coffee with figs only and to contain at least 85 per cent of coffee. This is the first time that there has been any standard for coffee and fig mixtures in this country. The Food Standards (Edible Gelatine) Order, 1951, which came into force on the 1st February, 1952, requires a 3 per cent solution of gelatine, unless labelled otherwise, to form a jelly at 60°F., to contain not more than 3.25 per cent of ash, and not more than specified traces of arsenic, lead, copper, or zinc. - 56 - The Food Standards (Ice Cream) (Amendment) Order, 1952, reduced the minimum fat content of ice cream from 5 per cent to 4 per cent and milk solids other than fat to 5 per cent. The Food Standards (Ice Cream)Order, 1951? had required ice cream to contain not less than 5 per cent of fat and 7.5 per cent of milk solids other than fat.Previous to the last war reputable manufacturers included about 12 per cent of milk fat in ice cream. The Food Standards (Suet) Order, 1952, requires Block Suet to contain not less than 99 per cent by weight of beef suet. It also requires Shredded Suet to be free from fibrous tissue and to contain not less than 83 per cent of beef fat, the permitted diluent being farinaceous material,, The Oils and Fats Order, 1952, although re-Issued as a fresh order, introduced no fresh standards for oils and fats. ' lead in Foods. At the end of 1951 the Ministry of Food circulated a Report and Recommendations designed to limit the amount of lead in various foods, and comment was invited from interested people. The proposals put forward were generally those which were expected, bub one of the chief obstacles in the way of promulgation of final standards at the present time is the difficulty of finding satisfactory methods for the exact determination of minute quantities of this element,, The maximum amounts of lead suggested vary from 0.2 parts per million in ready-to-drmk beverages other than beer and cider to 20 parts in colourings or 10 parts in herbs, spices, flavourings and liquid pectin,. Jam and Marmalade. Revised standards were suggested by the Food Standards Committee for certain jams, although these are still left as short term standards and may be revised when conditions improve. The fruit content for full-fruit standard jams is generally still below the pre-war full-fruit standards of the Food Manufacturers' Federation, but is an improvement on the standards adopted in the Food Standards (Preserves) Order.1944. the case of blackcurrant, loganberry, and raspberry jams? the quantities of fruit being increased from 22%, 25% and 25% to 30% in each case. The minimum percentage of fruit in damson jam is, however. reduced from 38% to 35% Liqueur Chocolates.During the year the Ministry of Food consulted the home trade regarding the use of the term "liqueur chocolates" as a description for chocolate confectionery containing liquid centres, which contained non-spirituous flavoured syrup. It was arranged that the words "imitation liqueur chocolates" followed immediately by the word "non-alcoholic" would be used for the description of this confectionery in the future and that the word "non-alcoholic" should be in substantially the same size type as the other descriptive words. The Minister also drew attention to the fact that the majority of these products are imported from abroad and that he had been unable to hold discussions with the manufacturers. Since very few confectioners hold licences for the sale of alcoholic liquors it is illegal for them to sell real liquer chocolates. - 57 - t During the year the Minister of Food withdrew the Labelling of Food Advisory Service which had been operating very successfully for some years.. Whilst this service had no legislative power it provided most useful liaison between food manufacturers and packers on the one hand and Local Authorities on the other. Any manufacturer seeking advice was given the benefit of the experience of the legal and chemical advisers of the Minister and most manufacturers having been given this advice, accepted it loyally. From the point of view of the public analyst the service was invaluable because, whenever he was in doubt regarding the description or labelling of any product he had only to contact the Ministry to know whether the matter had received the approval of the Ministry and, if so, whether the Ministry had been informed correctly of the composition of the food. With the disappearance of this service every public analyst will be obliged to express his own opinion regarding the labelling of a product and its composition in regard to such label. In the event of the Local Authority supporting the public analyst it will have to be decided whether the matter is one which should be discussed amicably with the manufacturer or whether legal action should be taken. It is thus seen that the advice and opinion of one central advisory service is being replaced by some three hundred and fifty critics, who will not necessarily all be of the same opinion. The increase in eventual cost will be enormous and cannot but cause irritation to reputable manufacturers. I have the honour to be, Madam Mayor, Ladies and Gentlemen, Your obedient servant, THOMAS McLACHLAN, A.C.G.F.C., F.R.I„C„ Public Analyst. 58 Taken Formally Adulterated Taken Informally Adulterated Total Samples Analysed Total Samples Adulterated Aspic Jelly . 1 0 0 0 1 0 Baking Powder 0 0 1 0 1 0 Barley, Pearl 1 0 0 0 1 0 Beef Tea 0 0 1 0 10 Breadcrumbs 1 0 0 0 1 0 Breakfast Food 1 0 0 0 1 0 Butter 1 0 0 0 1 0 Cake Mixture 4 0 4 0 Caviare 1 1 0 0 1 1 Cheese, Gruyere 0 0 1 1 1 1 Cheese, Parmesian 1 0 0 0 1 0 Chicken, potted 1 0 0 0 10 Chicken Vol au Vent 0 0 1 0 1 0 Chocolate Beverage 2 0 0 0 2 0 Coconut 1 0 0 0 1 0 Coffee 1 0 0 0 1 0 Coffee Essence 1 0 0 0 1 0 Coffee and Chicory Essence 0 0 1 0 1 0 Coffee and Chicory Extract 0 0 1 0 1 0 Confectionery 0 0 2 0 2 0 Cream, Cashew Nut 1 0 0 0 1 0 Cream, synthetic 0 0 1 0 1 0 Cream of Tartar 1 0 0 0 1 0 Curried Nut Meat 1 0 0 0 1 0 Curry Paste 0 0 1 0 1 0 Curry Powder 0 0 1 0 1 0 Egg Macaroni 1 0 0 0 1 0 Essence, Anchovies 0 0 1 0 1 0 Fish, bottled 0 0 2 1 2 1 Fish, canned 3 0 9 0 12 0 Fish Cake 1 0 0 0 1 0 Fish Paste 1 0 0 0 1 0 Flour S.R. 1 0 0 0 1 0 Fritter Mixture 1 0 0 0 1 0 Fruit, dried 0 0 1 1 1 Fruit, Figs, minced 0 0 1 0 1 0 Fruit Juice 0 0 4 0 4 0 Fruitarian Sandwich 1 0 0 0 1 0 Gravy Cubes 1 0 0 0 1 0 Glucose 0 0 1 0 1 0 Herbs 1 0 0 0 1 0 Honey 0 0 1 0 1 0 Ice Cream 1 0 9 1 10 1 Ice Cream Mix 1 1 0 0 1 1 Ice Lolly 0 0 4 0 4 0 Icing 0 0 1 0 1 0 Jam 1 0 0 0 1 0 Carried forward 34 2 45 4 79 6 59 Taken Formally Adulterated Taken Adulterated Total Saroles Total Samples Adulterated Brought forward 34 2 45 4 79 6 Jelly 1 0 10 2 0 Macaronia, vitaminised 1 0 0 0 1 0 Marzipan 1 0 0 0 1 0 Meat, canned 2 0 4 1 6 1 Meat Extract 0 0 1 0 1 0 Meat Paste 0 0 2 0 2 0 Meat Pie 0 0 3 0 3 0 Meringue Mix 1 0 1 0 2 0 Milk 93 0 107 0 200 0 Molasses 0 0 2 0 2 0 Mushrooms, canned 1 0 1 0 2 0 Oatmeal 2 0 0 0 2 0 Pastry Mix 0 0 1 0 1 0 Pate do Foi 0 0 2 0 2 0 Puree de Foi Gras 0 0 1 0 1 0 Peas, canned 0 0 1 0 1 0 Pea Malange 0 0 1 0 1 0 Peas, split 1 0 0 0 1 0 Peas Pudding 0 0 1 0 1 0 Pectin Preparation 0 0 1 0 1 0 Pepper, white 0 0 3 0 3 0 Potato Farina 1 0 0 0 1 0 Rice 1 0 0 0 1 0 Salt, cooking 1 0 0 0 1 0 Sauce 5 0 1 0 6 0 Sausages 4 0 7 1 11 1 Sausage Roll 1 0 0 0 1 0 Savoury Flakes 0 0 1 0 1 0 Soft Drink 0 0 1 1 1 1 Soup, canned 2 0 2 0 4 0 Soup, powder 3 1 0 0 3 1 Spices 4 0 0 0 4 0 Spirits : Brandy 1 0 0 0 1 0 Gin 2 0 0 0 2 0 Rum 2 0 0 0 2 0 Whisky 2 0 0 0 2 0 Spread, savoury 0 0 10 1 0 Stuffing 0 0 2 0 2 0 Suet 2 0 0 0 2 0 Tapioca 1 0 0 0 1 0 Tomatoes, canned 10 0 0 1 0 Tomato Concentrate 0 0 1 0 1 0 Tomato Juice Cocktail 0 0 1 0 1 0 Tomato Puree 1 1 3 1 4 2 Trifle Preparation 0 0 1 0 1 0 Vegetables: Cocktail Onions 1 0 0 0 1 0 Carried forward 172 4 199 8 371 12 - 60 - Takes Formally Adulterated Taken Informally Adulterated Total Samples Analysed Total Samples Adulterated Brought forward 172 4 199 8 371 12 Vegetable and Macaroni Casserole 10 0 0 1 0 Vinegar 1 0 0 0 1 0 Welsh Rarebit 10 2 0 3 0 Yeast 1 0 0 0 1 0 Drugs: Aspirin Tablets 10 0 0 1 0 Calamine Ointment 1 0 0 0 1 0 Camphor Spirit 10 0 0 1 0 Chlorophyll Tablets 0 0 10 1 0 Embrocation 0 0 11 1 1 Epsom Salts 1 0 0 0 1 0 Glauber Salts 10 0 0 1 0 Halibut Oil Capsules 1 0 0 0 1 0 Health Salts 11 0 0 1 1 Hydrogen Peroxide 1 0 0 0 1 0 Magnesia 1 0 0 0 1 0 Peppermint, Spirit of 10 0 0 10 Potassium Chlorate 1 0 0 0 1 0 Seaweed & Sarsaparilla Tablets 0 0 11 1 1 Sulphur Tablets 10 0 0 1 0 Tonic 0 0 10 1 0 Tonic Vegetable Concentrate 0 0 10 1 0 Vitamin Tablets 0 0 5 4 5 4 Vitamin Yeast Tablets 1 0 0 0 1 0 TOTAL 189 5 211 14 400 19 INFECTIOUS DISEASES Review — 61 INFECTIOUS DISEASES NOTIFICATIONS. The following table shows the total (corrected) number of cases of Infectious Diseases received during the year. Disease Under 1 year 1 and under 5 yrs. 5 and under 15 yrs. 15 and under 25 yrs. 25 and under 45 yrs. 45 and under 65 yrs. 65 an d and over. TOTALS Scarlet Fever - 21 39 1 - - - 61 Whooping Cough 13 43 30 - 1 - - 87 Poliomyelitis: Paralytic - 5 2 2 2 1 - 12 Non-paralytic — 1 - - 1 - - 2 Measles 24 212 113 3 2 1 - 355 Pneumonia: Ac.Primary - 3 2 2 2 5 2 16 Dysentery 14 47 6 1 - - - 68 Dysentery (Flexner) - 4 - - 1 — — 5 Dysentery (Sonne) 11 50 4 - 1 - _ 66 Paratyphoid Fever - — - 1 — — _ 1 Erysipelas - - 1 - - 4 - 5 Food Poisoning - 5 1 1 2 1 - 10 Puerperal Pyrexia - - - 25 42 - — 67 Scabies - _ 1 3 2 - - 6 Meningococcal Infection — 1 - — — — — 1 Ophthalmia Neonatorum 3 - - - - - - 3 TOTALS 65 392 199 39 56 12 2 765 62 SUMMARY OF NOT IFICAT IONS OF INFECTIOUS DISEASES RECEIVED DURING THE YEARS 1948 - 1952 (inclusive) Disease 1948 1949 " 1950 1951 1952 Average for five years Scarlet Fever 66 37 55 29 61 49 Whooping Cough 230 123 170 174 87 157 Poliomyelitis: Paralytic 1 11 1 - 12 5 Non-Paralyt ic 1 3 2 1 2 2 Measles 404 302 318 669 355 409 Pneumonias Aco Influenzal - 20 17 16 - 10 Aco Primary 14 10 8 5 16 10 Dysentery 31 10 117 95 139 78 Paratyphoid Fever 1 1 1 3 1 1 Erysipelas 7 9 6 7 5 7 Food Poisoning 4 6 122 13 10 31 Puerperal Pyrexia 8 1 10 7 67 18 Scabies 35 13 10 8 6 14 Typhoid 1 - - 1 - 0o4 Malaria _ - - 1 - 0o2 Diphtheria 2 1 - - - 0o6 63 DIPHTHERIA It is most gratifying that for the third year in succession no cases of Diphtheria occurred amongst residents in the Borough. Two notifications were received, but these were finally diagnosed as "acute tonsilitis". Notifications received and confirmed during 1948 and 1949 were 2 and 1 respectively, and only one death has occurred during the past thirteen years. Set out below are details of notifications of and deaths from Diphtheria from 1900 to 1951. Year Cases Deaths 1900 179 18 +1901-1910 108.3 9.7 +1911-1920 84.3 6.1 +1921-1930 133.7 6.2 +1931-1940 93.7 3.2 +1941-1950 10.6 0.1 + Averages over periods of ten years. The very sharp decline in the incidence of Diphtheria during the period 1941-1950 is. to some extent, attributable to the outbreak of hostilities prior to the commencement of this particular decade, with the consequent evacuation of children to safer areas, but it must be borne in mind that by mid 1947 the population (51,000) was again approaching pre-war levels. The average numbers of cases and deaths for the five years 1948-1952 were 0.6 and Nil respectively. Immunisation which is commented upon elsewhere, has played a major part in, from a statistical point of view, the present excellent position; nevertheless it is constantly necessary to publicise the efficacy of such a service. 64 DIPHTHERIA IMMUNISAT ION - 1952 Number of children, at 31st December, 1952, who had comeleted a course of Immunisation at anv time before that date (i.e. at any time since 1st January, 1938). Age at 31st December, 1952. Under 1 1 2 3 4 5 to 9 10 to 14 i.e., Born in year 1952 1951 1950 1949 1948 1943-1947 1938-1942 Number immunised 32 351 383 460 486 2,299 1,266 Total under 15 years of age 5,277 The Registrar-General has estimated the child population of Chelsea to be 8,080, made up as follows:- Children under five years of age 3,590 Children between 5 and 14 years 4,490 8,080 The percentage of the child population between the years 0 to 15 years which benefited from the advantages of Immunisation was approximately 65 (63 in 1951), whilst the precentages for the age groups 0-5 and 5-14- were 47(4.7) and 79(75) respectively. The rates in parentheses are applicable to 1951. As was the case last year, it is apparent that full advantage is not being taken of this worthy facility. To obviate the possibility of an outbreak of Diphtheria it is considered that at least 80 out of every 100 children should receive immunisation, and the London County Council, who are responsible for this service are actively engaged in publicising the dangers which could arise if parents allowed themselves to be lulled into a sense of false security. 65 FOOD POISONING The number of cases of Food Poisoning has shown yet another decrease. These totalled 10 as compared with 13 in 1951, and 122 in 1950. A summary of all cases occurring during the year under review is set out below in identical form to that supplied to the Ministry of Health. ANNUAL REPORT OF FOOD POISONING NOTIFICATIONS Notifications of the occurrence of Food Poisoning were received as follows:- First Quarter Second Quarter Third Quarter Fourth Quarter Total NIL 1 5 4 10 Outbreaks (other than family outbreaks) due to identified agents:- NIL Family Outbreaks due to identified agents:- NIL Outbreaks (other than family outbreaks) of undiscovered cause:- NIL Family outbreaks of undiscovered cause:- Total Outbreaks 1 Total Cases: 2 Single Casess- Agent identified: 6 Unknown causes: 2 (Salmonella typhi-murium 2) (Salmonella Aertrycke 3) (Salmonella Newport 1) Total Cases: 8 66 MEASLES Three hundred and fifty-five notifications of Measles were received in the Public Health Department during 1952, as compared with 669 and 318 in 1951 and 1950 respectively,, POLIOMYELITIS Fourteen notifications of Poliomyelitis came to hand, all of which were subsequently confirmed; one of the cases was of a nonparalytic type. Of the paralytic cases, a girl aged 5 years died two days after admission to hospital. In 1951 there was one confirmed case, and in 1950 three confirmed cases. Sixty-one notifications of Scarlet Fever were received in the Public Health Department during 1952, as compared with 29 in 1951o DYSENTERY During 1952, one hundred and thirty-nine notifications were submitted as compared with 95 in 1951, and 117 in 1950. It must be stressed that all the sufferers were residents of institutions not controlled by this authority., The premises concerned were such that it was difficult to prevent the spread of infection among the particular type of inmates. Nevertheless the Borough Council has been at great pains to bring about the eradication of the incidence of dysentery. 67 SMALLPOX No case of Smallpox has been notified to the Public Health Department as having occurred in the Borough since 1928. Information was received regarding fourteen contacts who had travelled to addresses in the Borough, and all were given advice as to the precautionaryaction they should take. The following table briefly sets out the incidence of this disease during the last fifty-three years. Notifications received Deaths 1900 2 1 1901 5 1 1902 38 7 1903 6 - 1904 - 1919 - - 1920 1 - 1921 - 1927 - — 1928 1 - 1929 - 1952 - — The annual average of notifications received and the death rate for the period under review are, therefore, 1.0 and 0.17 respectively. There has been only one serious outbreak of Smallpox during this century. This occurred in 1902, when 47 cases came to the knowledge of the Medical Officer of Health, but only 38 were actually notified. During that particular year, 7,797 cases were notified in the County of London, and case rates per 10,000 of population in this and adjacent Boroughs, were as followsi- CHELSEA 5.3 Kensington 6.4 Fulham 7.4 Paddington 9.2 Hammersmith 12.3 Westminster 18.5 County of London 20.6 68 ZYMOTIC DISEASES The term 'Zymotic' was at one time applied to numerous diseases which were considered to be "epidemic, endemic and contagious". However, in the light of existing conditions, it is applicable to such diseases as cholera, diarrhoea, diphtheria, measles, scarlet fever, smallpox, typhoid and typhus fevers. In 1952 the Zymotic Death Rate in this borough was 0.02 per 1,000 of the population. 3n 1900 the rate was 2.26. It is far more significant when rates are translated into actual figures as will be appreciated from the fact that whilst in 1952 only one death occurred from a Zymotic disease (Measles), a total of two hundred and nineteen were recorded in 1900. The numbers of deaths at other periods during the last halfcentury were as follows:- Year Number 1905 98 1910 66 1915 76 1920 41 1925 29 1930 22 1935 17 1940 1 1945 6 1950 3 69 TUBERCULOSIS 131 cases of Pulmonary Tuberculosis were notified during the year. These were made up of 83 primary notifications, 39 "inward transfers", 4 from death returns, and 5 from other sources. There were also 11 nonpulmonary cases, of which 8 were primary notifications, 1 "inward transfer", and 2 from other sources. The accompanying tables present details of cases at present on the Tuberculosis Register. VARIATIONS IN REGISTER DURING 1952 PULMONARY NON-PULMONARY TOTAL CASES M. F. M. F. (a) Number of cases remaining on register at 1st January, 1952 192 193 7 19 411 (b) Number of new cases notified 48 42 3 6 99 (c) Number of cases restored to register 1 - 1 - 2 (d) Other cases added 28 12 - 1 41 (e) Removals 66 48 5 5 124 (f) Cases remaining on register at 31st December, 1952 203 199 6 21 429 70 (A) NEW CASES OF TUBERCULOSIS 1952 (B) DEATHS FROM TUBERCULOSIS 1952 Under 1 year 1 and under 2 years 2 and under 5 years 5 and under 10 years 10 and under 15 years 15 and under 20 years 20 and under 25 years 25 and under 35 years 35 and under 45 years 4-5 and under 55 years 55 and under 65 years 65 and under 75 years 75 years and upwards TOTALS (all ages) (A) NEW CASES Pulmonary M - 1 1 3 - 3 6 23 14 11 8 6 1 77 Pulmonary F 1 - 1 3 1 4 8 19 7 3 5 1 1 54 NonPulmonary M - - 3 - - - - 1 - - - - - 4 NonPulmonary F - - - - 1 - 1 1 2 1 - 1 - 7 DEATHS (B) Pulmonary M — - — - — - - - - 2 4 1 1 8 Pulmonary F - - - - - - - - 2 - - 1 1 4 NonPulmonary M - - - - - - - - - 1 - - - 1 NonPulmonary F - - - - _ - 1 - 1 - - - 2 71 ANNUAL REPORT. CHELSEA TUBERCULOSIS DISPENSARY. BROMPTON HOSPITAL. S.W.3. 1949 1950 1951 1952 Population served by Dispensary 50,890 51,990 52,490 52,430 Number of notified cases in Borough at end of year 415 425 411 429 Number of these who have never attended the dispensary 262 284. 279 294 Total attendance during year 1,979 1,823 1,834 2,123 Total new patients seen ... 363 377 389 504 Number of these who were contacts 106 163 170 252 Number of contacts found to be tuberculous 1 1 1 7 Number of cases newly notified to Medical Officer of Health (i.e. excluding inward transfers) Number of cases diagnosed as tuberculous (for the first time) at the Dispensary during the 67 78 72 99 year 15 21 24 25 Number of X-rays. 1,084 1,137 1,301 1,373 Number of Sputum examinations 179 265 311 313 Number of Mantoux tests 59 201 199 271 Number of Patients who received refills during year app. 15 29 47 35 Number of Patients who received "special treatment" at home during year - 11 12 30 Number of patients given B.C.G. - 11 15 11 Number of home visits by medical Staff - 14 31 48 Number of visits paid by Dispensary Nurse 2,004) 2,391 1,866) 2,167 2,436) 2,573 2,297), 2,460 Number of visits paid by Dispensary Almoner ... ... ) 387) ) 301) ) 137) ) 163) Number of Clinic Sessions per week 2 2 2 2 Child contacts are frequently referred for supervision to the Children's Contact Investigation Department, Brompton Hospitalj anynecessary follow up work is done by the Dispensary's staff but figures relating to these attendances are not included in this list, except for B.C.G. vaccination So This does not include 66 child contacts who were patch-tested at one of the London County Council Institutions. 72 MASS RADIOGRAPHY In connection with the national drive to combat Tuberculosis, X-ray Units visit every possible area from time to time., During the year under review, a Mobile Unit visited an Educational Centre where 606 persons were examined,, During the period 3rd to 23rd September, similar facilities were available to the general public at the Chenil Galleries, adjacent to the Town Hall. As a result of examinations made, the following data has been compiled:- Results of examinations Male Female Total Number satisfactory 2,142 2,583 4,725 Number unsatisfactory and referred to their private doctors:(a) Probably tuberculous 20 18 38 (b) Non-tuberculous 2 — 2 Number of persons who failed to attend for further examination 5 14 19 2,169 2,615 4,784 A Mobile Unit will again be located at the Chenil Galleries during the summer of 1953. INDEX A Page Analyst, Public, Report of 53 - 60 B Bacteriological Examinations 48 - 49 Burial of the Dead (National Assistance Act, 194-8) 31 - 33 C Committee, Public Health and Baths 1 Committee, Representations by Members on other Organisations 2 D Deaths of Residents 10-11 Diphtheria 63 Diphtheria Immunisation 47 & 64 Disinfection and Disinfestation 35 & 36 Dysentery 66 E Examinations of Officers, Medical 34 F Factories Act, 1937 25 - 27,30 Fog, December 1952, Comments on the London 15 & 16 Food Poisoning 65 Food, Unsound 51 & 52 Foods and Drugs, Analyses of 53 - 60 Foster Mothers 47 G General and Vital Statistics 7-9 H Hospital Services 45 Houses Let-in-Lodgings 23 I Infantile Mortality 12-13 Infectious Diseases 61. - 72 Institutional Care 46 Introduction 4-6 L Legal Proceedings 28 - 29 M Page Mass Radiography 72 Maternity and Child Welfare Services 47 Measles 66 Medical Examinations of Officers 34 Milk, Supply of 50 Meteorology 14 N National Assistance Act, 1948 - Burial of the Dead 31 — 33 Notices, Service of Factories Act, 1937 30 Food & Drugs Act, 1938 30 Housing Act, 1936 23 St 30 Prevention of Damage by Pests Act, 1949 30 & 40 Public Health Act, 1936 23 & 30 Shops Act, 1934 30 O Old People, Welfare of 43 & 44 Overcrowdixig 23 & 24 P "Part III" (L.C.C.) Accommodation 46 Pests Act, 1949, Prevention of Damage by 30 & 40 Pet Animals Act, 1951 - Registrations under 37 Pharmacy & Poisons Act, 1933 - Registrations under 38 R Rag Flock, &c, Act, 1951 - Registrations under 39 Rent & Mortgage Interest Restrictions Acts - Certificats under 30 Rodent Control 30 & 4-0 S Sanitary Inspectors, Visits and Re-inspect ions by 17 & 18 " " , Works supervised by 19-22 Scarlet Fever 66 Smallpox 67 Staff of Public Health Department 3 Statistics, General and Vital 7-9 T Tuberculosis 69 - 72 Tuberculosis Dispensary, Ifork of 71 U Underground Rooms 23,41 & 42 Unsound Food 51 & 52 V Page Vaccination 47 Verminous Conditions 35 & 36 Verminous Premises 35 & 36 Vital Statistics 7-9 W Water Supply 52 Welfare of Old People 43 & 44 X X-Ray (Mass Radiography) 72 Z Zymotic Diseases 68