ACL345 1 Mrs Loyne Div 5. B 2 Miss Knorr 3Lrbrary CHE 51 Metropolitan Borough of Chelsea Annual Report of the Medical Officer of Health J. H.WEI R, M.D., B.S., B.Hy., D.P.H. for the year 1953 65890 METROPOLITAN BOROUGH OF CHELSEA REPORT of the Medical Officer of Health for the year 1953 J.H. WEIR, M.D., B.S., BoHy., D.P.H. CONTENTS Page INTRODUCTION 5 SECTION CUE - POPULATION, BIRTHS, DEATHS AND VITAL STATISTICS 8 SECTION TWO - SANITARY INSPECTION OF THE BOROUGH 18 SECTION THREE - GENERAL PROVISION OF HEALTH SERVICES 37 SECTION FOUR - INSPECTION AND SUPERVISION OF FOOD 50 SECTION FIVE - INFECTIOUS AND OTHER DISEASES 65 -1 - METROPOLITAN BOROUGH OF CHELSEA PUBLIC HEATH AND BATHS COMMITTEE. Chairman: Councillor Hannay, J. M.Ch.S. Vice-Chairman: Councillor Lyall, Miss M, M.B.E. Councillor Acland, Miss K. O.B.E. Councillor Duncan, Lt. Col. R.C., C.I.E., M.V.O., O.B.E. " Baxter, Mrs. M. Councillor Gough, A.E. " Beier, E.W. " Henry, Mrs. A.F. " Bifield, W.C., M.M. Mollpy, Miss P.D.J. " Budgett, F.G.P. " Tatton-Brovm, J.S. "Buxton, Mrs. G.K. " Woolford, J.E. u Casserley, C.J. Ex-Offlcio Members Her Worship the Mayor (Councillor Miss M.K. Cook) The Deputy Mayor (Councillor C. Townsend) - 2 - Representation by Members of the Public Health and Baths Committee on outside Committees and other Organisations concerned with Public Health work. Chelsea Cancer Coicmittees Councillor Mrs. G.K. Buxton Chelsea Tuberculosis Care Committees: Councillor Mrs. G.K. Buxton Councillor Miss M. Lyall Farm' iv Welfare Associations: Councillor Miss M. Lyall Invalid Children's Aid Associations Councillor Miss M. Lyall Iondon County Council Diyisional Councillor Miss M. Lyall Health Committee (Division I) London County Council Divisional Tuberculosis Care Committess" Councillor Mrs. G.K. Buxton (Division I) Londen and Home Counties Smoke Councillor J. Hannay Abatement Advisory Councils National Smoks Abatement Societys Councillor J. Hannay Councillor Miss M. lyall Old People's Welfare Committees Councillor J. Hannay Councillor Miss M. Lyall Third Feathers Club Committees Councillor Lt.-Col. R.C. Duncan Westminster and Club Chelsier District Councillor Miss M. Lyall Nursing Associates: - 3 - STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December. 1953. Medical Officer of Healths: J.H. WEIR, M.D., B.S., B.Hy., D.P.H. Deputy Msdical Officer of Healths: W.C. TURNER, M.D., B.S., D.P.H., D.I.H. Chief Sanitary Inspectors: H. HOYLAND, M.R.S.I., M.S.I.A. Deputy Chief Sanitary Inspector BARKER, M.R.S.I., M.S.IJU and Senior Housing Inspectors Housing Inspeetors: H.W. LUDLOW, M.R.S.I., M.S.I.A. E.R. YOUNG, M.R.S.I., M.S.I.A. District Sanitary Inspeetors: J. CAST LEY, H.F. LEAGOCK, M.S.I.A. A.J. WHITE, M.S.I.A. Women Sanitary Inspeetors: (Miss) A.C.C. KAY, M.S.I.A. (Miss) G.K. READER, M.S.I.A. Sanitary Inspectors' Assistant: F.G. RAWLINGSON Drainage Assistant: E. BOSLEY Rodent Officers: J.F.COOK P. DRURY Disinfectors: L.H. BERRY (Chief) F.W. HILL R.J. WESTON Cleansing Station Attendant: (Mrs.) J. LGBBAN - 4 - Clerical Staff: J.C. BRYANT (Chief Clerk) I.M. THOMSON (Senior Clerk) H.G. HAMILTCN (Infectious Diseases Clerk) (Miss) A. PALMER (Shorthand-Typist) L.A. POWELL (General Clerk) R.H. LITCHFIEID (General Clerk) - Returned from National Service 9th November, 1953* P.N. MARGETTS (Junior Clerk - Temporary) Social Worker: (Mrs.) O.M. BURKE Public Analyst: THOMAS McIACHLAN, A.C.G.F.C., F.R.I.C., 4, Hanway Place, London, W.l - 5 - METROPOLITAN BOROUGH OF CHELSEA Public Health Department, Town Hall, King's Road, CHELSEA., S.W.3. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Chelsea. Your Worship, My Lord, Ladies and Gentlemen, I have much pleasure in submitting my annual report for the year ended 31st December, 1953• The report has been compiled in the manner outlined by the Minister of Health in his circular l/54, dated 12th January, 1954. The practice of providing both graphs and tables to illustrate the great advancements made in attaining better standards of health, is continued. The population of the Borough is estimated by the RegistrarGeneral to be 52,150, as compared with 52,140 and 52,490 in 1952 and 1951 respectively. Compared with the return for 1952 a very slight increase is apparen: nevertheless the population is 340 below the estimate for 1951. Military personnel stsioned in the area continue to be included in the population, but no information as to their actual numbers is available. Births. The number of Live Births allocated to Chelsea was 787, and the birth rate was 15. 1. The total was made up by Males 423: Females 364. From an examination of the "Summary of Vital Statistics" on page 10 it would appear that the decline in the number of registered live births has been arrested, an assumption which is supported by the following table in respect of both England and Wales and Chelseas;- Live Births 1951 1952 1953 England and Wales: 679,497 673,559 682,007 Chelsea: 819 787 787 Stillbirths. Thase totalled 16, Males 9: Females 7. Stillbirths 1951 1952 1953 England and Wales: 15,949 15,578 15,639 Chelsea: 20 14 16 Deaths. The death rate increased by 0.5 to 13.3 as compared with 12.8 in 1952, whilst the number of deaths advanced from 669 to 694. 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 - 6 - by the populations. Such differences are well illustrated by (a) Chelsea with its large proportion of residents aged 65 years and over, and (b) the "new" towns which are mainly populated by persons of the lower age groups. In practice however, populations are not so constituted, and the RegistrarGeneral has, therefore, employed a factor known as the "Area Comparability Factor" for each district. This provides for an adjustment 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 (13.3) is multiplied by the factor which is represented by 0.88 so far as Chelsea is concerned, and such an adjustment results in a death rate of 11.7. Maternal Mortality. Three deaths were recorded as having resulted from accidents or diseases associated with pregnancy or childbirth. The last occasion on which a death was attributed to such causes was in 1946• Infant Mortality. Once again the number of deaths of infants under the age of one year has declined. During the year, fifteen deaths, representing a mortality rate of 19.1 occurred. The remarkable fact which emerges from a consideration of the following table is the great opportunity presented for infants to attain to adult life (In 1900, approximately 1 child in 7 failed to reach its first birthday: in 1953 the ratio was 1 to 52). Year Deaths under 1 year of age No. of births registered Rate per 1.000 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 1953 15 787 19 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 consideration with the actual number of deaths and births registered, when it becomes clear that a greater proportionate reduction in the number of deaths has occurred compared with the decline in births. On page 14 appears a table setting out infant mortality rates relevant to some thirteen other countries as compared with England and Wales. Marriages. During the year, 700 marriages were solemnized in the borough. In 1952 and 1951, the figures were 739 and 785 respectively. Infectious Diseases. The number of notifications received during the year was 1,232, an increase of approximately 62 per cent. over the figures for 1952 (765). Measles, Whooping Cough, and Dysentery (all forms) accounted for 86.5 per cent. of the total notifications received. Generally speaking, eighty to ninety per cent. of all persons reaching the age of - 7 - twenty years have had Measles. and of the 1,573 notifications received during the past three years, 97 per cent, related to children between 0 and 15 years. The figures for the past seven years conform to the wellknown biennial periodicity of measles, which also shows a fairly constant phasic pattern within each two-year cycle. Food Poisoning. 23 notifications came to hand during the year. In the two preceding years the figures were 10 and 13. Full details will be found in the section devoted to "Infectious Diseases" • Food and Drugs. The Council's Analyst, Mr. T. McLachlan, examined and reported upon four hundred samples of foods and drugs during 1953. Of this total, twenty seven (6.75 per cent.) were found to be adulterated; in fourteen instances "adulteration" was based an labelling inaccuracies or misdscription. Full details of the work of the Analyst will be found in this report. Food Hyglena. All shops, stalls premises and vehicles concerned with the preparation, storage and sale of food have been under the constant supervision of the Council's Food Inspectors, and these officers readily advise all personnel engaged at such premises as to the maintenance of both adequate and up-to date hygienic conditions. Housing Conditions,. The provision and continuance of satisfactory housing conditions are matters of close attention, and details of work in this connection will be found in the report. Welfare of Old Peopls. Keen interest in and attention to the needs of aged people are paramount features of the work of the Council's officers, and all with whom contact has been made have come to realise that they can continue to enjoy a full part in the life of the community. The increasing scope of this work can be appreciated from the brief summary of persons now eligible for the mssay facilities readily available:- Year Number on Register 1950 106 1951 613 1952 934 1953 1,032 In closing I would like to record my appreciation of the courtesy and consideration shown to me by the Chairmen of Committees and individual members of the Council, the friendly co-operation of all Chief Officers and their staffs and the loyalty of my colleagues in the Public Health Department. I am, Madam Mayor,My Lord, Ladies and Gentlemen, Your obedient Servant, J.H. WEIR, Medical Officer of Health. _ 8 - METROPOLITAN BOROUGH OF CHELSEA ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1953 AREA OF THE BOROUGH: 659.6 acres GENERAL RATE: 1953-54- - 19s .6d. in the £. PRODUCT OF A PENNY RATE: £5,125. RATEABLE VALUE OF BOROUGH AS AT 31st MARCH. 1953: £1,290,102 POPULATIONS: Registrar-General's estimate of the population of the Borough (mid-year, 1953) 52,150 LIVE BIRTHS: Total M F Legitimate Illegitimate 726 61 391 22 335 22 Birth rate per 1,000 of estimated population 15.1 787 423 364 Adjustment of birth rate by area comparability factor 11.4 STILL BIRTHS: 16 9 7 Rate per 1,000 (live and still births) 19.9 DEATHS; 694 302 392 Death rate per 1,000 of estimated population (Males 5.8: Females 7.5) 13.3 Adjustment of death rate by area comparability factor 11.7 EXCESS OF REGISTERED BIRTHS OVER DEATHS: 93 (Males : Females) +121 - 28 ) MATERNAL MORTALITY RATE; (Three deaths associated with pregnancy or childbirth occurred amongst Chelsea residents during the year.) 3.7 DEATH RATE OF INFANTS UNDER ONE YEAR OF AGE: All infants per 1,000 live births 19.1 Legitimate infants per 1,000 legitimate live births 12.4 Illegitimate infants per 1,000 illegitimate live births 98.3 DEATHS FROM TUBERCULOSIS: Pulmonary 4 Other forms Death rate, per 1,000 of estimated population :Pulmonary Tuberculosis: 0.07 - 9 - BIRTH RATES, DEATH RATES, ANALYSIS OF MORTALITY, MATERNAL MORTALITY AND CASE RATES FOR CERTAIN INFECTIOUS DISEASES IN THE YEAR 1953 (Provisional figures based an Quarterly Returns) England and Wales 160 County Boroughs & 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 Live Births 15.5 17.0 15.7 17.5 Still Births ( 0.35 0.43 0.34 0.38 ( 22.4(a) 24.8(a) 21o4(a) 21.0(a) Deaths All Causes 11.4 12.2 11.3 12.5 Typhoid and Paratyphoid 0.00 0.00 - - Whooping Cough 0.01 0.01 0.00 0.00 Diphtheria 0.00 0.00 0.00 - Tuberculosis 0.20 0.24 0.19 0.24 Influenza 0.16 0.15 0.17 0.15 Smallpox 0.00 0.00 0.00 - Acute Poliomyelitis (including polioencephalitis) 0.01 0.01 0.01 0.01 Pneumonia 0.55 0.59 0.52 0.64 Notifications (Corrected) Typhoid Fewer 0.00 0.00 0.00 0.01 Paratyphoid Fever 0.01 0.01 0.01 0.01 Meningococcal infection 0.03 0.04, 0.03 0.03 Scarlet Fever 1.39 1.50 1.44 1.02 Whooping Cough 3.58 3.72 3.38 3.30 Diphtheria 0.01 0.01 0.01 0.00 Erysipelas 0.14 0.14 0.13 0.12 Smallpox 0.00 0.00 0.00 — Msasles 12.36 11.27 12.32 8.09 Pneumonia 0.84 0.92 0.76 0.73 Acute policmyelitis (including Polioencephlitis Paralytic 0.07 0.06 0.06 0.07 Non-paralytic 0.04 0.03 0.04 0.03 Food poisoning 0.24 0.25 0.24 0.38 Puerperal pyrexia 18.23(a) 24.33(a) 12.46(a) 28.61(a) Rates per 1,000 Live Births Deaths All causes under 1 year of age 26.8(b) 30.8 24.3 24.8 Enteritis and diarrhoea under 2 years of age 1.1 1.3 0.9 1.1 (a) Per 1,000 Total (Live and Still) Births. (b) Per 1,000 related live birth. - 10 - SUMMARY OF VITAL STATISTICS 1940 - 1953 (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 51,000 868 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 - - 1953 52,150 787 15.1 694 13.3 15 19 3 3.7 Aver for the seven years 1947-18953:- Births 835 Deaths 640 Deaths under one year of age 24 Maternal Deaths 0.43 + Totals arrived at after due allowance for inward and outward transfers. -11 - DEATHS OF RESIDENTS DURING 1953 AGE AT DEATH Causes of Death At all Ages 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 upwards 1. Tuberculosis, respiratory 4 - - - - 2 1 1 2. Tuberculosis, other - - _ _ — - - - 3. Syphilitic disease 2 =- - _ — - 1 1 4. Diphtheria - - - — - — - - 5. Whooping cough — — — - - - - - 6. Meningococcal infections - - _ _ - - - - 7. Poliomyelitis, actxto - - - — - - - - 8. Measlos - - — — *- — - - 9. Infective and parasitic diseases, other 1 - - - - - 1 - 10. Malignant neoplasm stomach 14 — _ - - 1 3 10 11. Malignant neoplasm, lung, bronchus 20 - - - - - 8 12 12. Malignant neoplasm,breast 11 - _ - - 1 6 4 13. Mal,ignant neoplasm, uterus 8 — — - - 1 2 5 14. Malignant and lymphatic plasms , other 68 - 1 - - 9 18 40 15. Lsukasmis, aleukaemia 7 - _ 1 - - 4 2 16. Disbstes 5 - - - 1 - - 4 17. o Vascular lesion of mervons system 88 - _ — - 3 12 73 18. Coronary disease angins 76 - _ - - 1 12 63 19. Hypertension with heart disease 7 - _ - - - 1 6 20. Heart disease, other 98 - _ - - 2 8 88 21. Circulatory disease, other 59 - - - - - 9 50 22. Influsnza 9 - - - — - 4 4 23. Pheumonia 48 3 1 - 1 " 5 38 24. Bronchitis 40 — — - 1 - 7 32 Carried forward 565 3 2 1 3 21 102 433 - 12 - DEATHS OF RESIDENTS DURING 1953 (Continued) AGE AT DEATH At all Ages 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 forward 565 3 2 1 3 21 102 433 25. Respiratory System, other diseases of 10 - - - - - 7 3 26. Ulcer of stomach and duodenum 6 - - - - - 2 4 27. Gastritis, enteritis, and diarrhoea 2 1 - - - - 1 - 28. Nephritis and nephrosis 7 - -- _ — - 3 4 29. Hyperplasia of prostate 6 - - _ — - - 6 30. Pregnancy, childbirth, abortion 3 - - - - 3 - - 31. Congenital malformations 2 1 - - 1 — - - 32, Other defined and ill-defined diseases 52 9 1 - 2 2 12 26 33. Motor vehicle accidents 7 - - 2 _ _ 2 3 34. All other accidents 19 1 1 - _ 3 6 8 35. Suicide 14 - - - 2 4 7 1 36. Homicide and operations of war 1 - - - - 1 - - TOTALS 694 15 4 3 8 34 142 488 The following summary gives an indication of the vast changes which have taken place in respect of deaths occurring in Chelsea (a) under one year of age, and (b) at 65 years and over:- Year Number of deaths Deaths under 1 year of age Percentage of total deaths Deaths at 65 years and over Percentage of total deaths 1900 1,737 333 19.17 442 25.44 1925 883 64 7.24 433 48.01 1950 638 21 3.29 434 68.02 1951 686 19 2.76 483 70.40 1952 669 16 2.39 470 70.25 1953 694 15 2.16 488 70.31 It is of Interest to note the tendency for the percentages of deaths in the particular age groups above, to become stabilised. 13 INFANT MORTALITY During the year, the deaths of fifteen infants under the age of one year were recorded, representing a death rate of 19.1 per 1,000 live births, as compared with 20.3 and 23.2 in 1952 and 1951 respectively. The infant mortality rates during 1953 for England and Wales, and London were 26.8 and 24.8 respectively. Seventy-three per cent, of the deaths of Chelsea infants occurred under four weeks of age. Deaths were attributed to :- Males Females Asphyxia - 1 Atelectasis 1 - Gastro-enteritis 1 - Inattention at birth 1 1 Intracranial haemorrhage 1 - Malformations, Congenital 2 - Pneumonia 1 2 Prematurity 2 2 Once again it is pleasing to indicate that the death rate of infants under one year of age has decreased, 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 past fifty-three years, as will be appreciated from the following summary:- Year Number of deaths 1900 333 1910 141 1920 73 1930 32 1940 15 1950 21 1951 19 1952 16 1953 15 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. 14 INFANT MORTALTY RATES- ENGLAND AND WALES AND VARIOUS OTHER COUNTRIES Deaths under 1 year of age per 1,000 live births Country 1948 1949 1950 1951 1952 Average for five years ENGLAND AND WALES 34 32 30 30 28 30.8 SCOTLAND 45 41 39 37 35 39.4 NORTHERN IRELAND 46 45 40 41 39 42.2 AUSTRALIA. 28 25 24 25 24 25.2 CANADA 44 43 41 38 38 40.8 CHILE 160 169 153 149 134 153.0 DENMARK 35 34 31 29 29 31.6 FRANCE 51 61 52 51 46 52.2 IRISH REPUBLIC 49 59 45 45 41 47.8 ITALY 70 74 64 67 64 67.8 NETHERLANDS 29 27 25 25 23 25.8 NEW ZEALAND 22 24 23 23 22 22.8 SWEDEN 23 23 20 21 20 21.4 UNITED STATES OF AMERICA. 32 31 29 29 29 30.0 The above table has been prepared from information made available by the Registrar-General. - 15 - SPASTICS Towards the end of the year, the No. 4. (Chelsea) Group Hospital Management Committee indicated that it was their intention to initiate a day centre for spastic children under the age of 5 or 6 years at the Cheyne Hospital for Children in Cheyne Walk. At first it is anticipated that twenty-four children will be accepted, but in the light of experience gained, this number will, it is hoped, be increased. Cerebral palsy, which produces what is known as the "spastic child", has been the subject of recent research. Such a condition, arises from an injury to the brain before, during, or after birth, and may render it difficult for a child to either stand, walk, speak, or use its hands. Until lately this problem was one difficult to cope with in view of the fact that little was known about it, consequently children so affected were deemed to be mentally defective, the tragic implications of whish can be readily appreciated when considering the fact that their intelligence is, in the majority of cases, quite normal. The British Council for the Welfare of Spastics, under the presidency of the Archbishop of Canterbury, is vigourously publicising the sad lot of sufferers, and I feel sure that the action taken in this Borough will certainly bring about a great improvement in the condition of children so afflicted, and in due course help towards the ultimate attainment of a fuller life which, at present, is endangered. The day centre will, it is hoped, be opening in September, 1954. - 16 - ATMOSPHERIC POLLUTION The many and varied problems arising from atmospheric pollution have at all times received the closest possible attention of the Borough Council and its officers. During the period 5th to 8th December, 1952, a very persistent and dense fog occurred. In the first instance it consisted mainly of smoke, but on the latter three days it developed into a very thick water fog which spread well outside the metropolitan area. Greatly increased mortality from certain causes resulted, as evidenced by the following table:— Week ended 1952 London Administrative Country Deaths from: Bronchitis and Pneumonia Diseases of the Heart and Circulatory System November 1st 67 (66) 223 (248) 8th 74 (76) 226 (265) 15th 74 (71 247 (262) 22nd 77 (75) 264 (240) 29th 101 (81) 312 (262) December 6th 121 (86) 318 (236) 13th 872(71) 801 (231) 20th 521 (75) 457 (229) 27th 275 (77) 325 (227) NOTE: The figures in parentheses represent deaths which occurred at corresponding periods during 1953. Without doubt the steady improvements which are resulting from action taken by constituent authorities have been accepted in a co-operative spirit by industrialists and others, and merit some satisfaction. Nevertheless, a considerable contribution to the pollution of the atmosphere is made by the householder who is not as yet prepared to accept other forms of heating as a satisfactory substitute for the open hearth. The melancholy fact that during the week ending 13th December, 1952, 1,673 deaths occurred from causes as set out above, as compared with 302 deaths in a comparable period In 1953, must surely serve to quicken the pulse of public interest in the responsibilities of citizenship. The officers of local authorities are constantly carrying out observations and investigations, and when the existence of nuisances has been substantiated, advice and suggestions to those operating industrial plant sire proffered, and these, in the great majority of cases, have been well received. - 17 - This Council is co-operating with other Metropolitan Boroughs the Department of Scientific and Industrial Research in the establishment of stations for the investigation of atmospheric pollution covering the whole of London, and towards the end of the year a station was established in this area whereat matter collected in an atmospheric deposit gauge is, at regular intervals, removed for analysis. - 18 - SANITARY ADMINISTRATION OF THE BOROUGH SUMMARY OF WORK PERFORMED BY THE SANITARY INSPECTORS DURING THE YEAR 1953. Number of complaints received during the year:- 1,186 INSPECTIONS AND REVISITS : DWELLINGS: House inspected after complaints 4,279 House inspected after Infectious Disease 848 House-to-House inspections 1,212 Underground Rooms 167 Overcrowding and "Permitted Numbers" 177 Visits to obtain information re Housing Application 177 Lodging Houses 14 Inspection of council flats for vermin 112 -- Other visits 78 7,064 FOOD PREMISES: But chers 136 Horseflesh Dealers 8 Fishmongers and Fish Friers 38 General Provision Shops, Including Delicatessen Shops 142 Dairies and General Stores selling Milk 237 Ice Cream Vendors (Premises, Stalls, Vehicles, etc.) 413 Ice Cream Manufacturers 27 Bakehouses and Underground Bakehouses 66 Street Stalls and Barrows 43 Food Delivery Vehicles 7 Food Factories (Mechanical) other than Bakehouses 16 Food Factories (Nca-Mechanieal) other than Bakehouses 3 Hotels, Restaurants and Dining Rooms 763 Premises in connection with Unsound Food 536 Premises in connection with Sampling 200 Other Food Premises 76 2,711 FACTORIES AND OUT WORKERS Factories - other than Food Factories (Mechanical) 232 Factories-other than Food Factories (Non-mechanical) 137 Outworkers 60 Other visits (not classified) 2 431 DRAINAGES Drains tessted - by water 265 Drains tessted - by smoks 124 Drains tessted - by air 71 Drains traced - by colour 45 505 Carried forwards 10,711 19 SUMMARY OF WORK PERFORMED BY THE SANITARY INSPECTORS DURING THE YEAR 1,953 (Continue}). INSPECTIONS AND REVISITS (Continued) Brought forwards 10,711 MISCELLANEOUS : Public Conveniences and Hotel Conveniences accessible from the street 7 Internal Conveniences at Cinemas, Theatres, Hotels, etc 3 Stables and Manure pits 2 Animals poultry and birds 15 Open spaces, highways, allotments, fairgrounds, etc. 161 Office premises 15 Marine Stores and Second-hand Dealers' premises 2 Premises under Pharmacy and Poisons Act, 1933 67 Premises to enforce requirement of shops Act 56 Visits to premises re Voluntary works. 3,506 Visits to Owners, Builders and Agents Offices 467 Smoke observations 29 Food poisoning 8 Fumigation of furniture 22 Visits to aged and infirm persons 241 Visits to premises which resulted in "no access" 6 Premises other than dwellings after Infectious Disease 5 Visits to premises Pet Animals Act, 1951 2,000 Premises other than dwellings after Infectious Disease 6 Atmospheric Pollution Recording 60 Premises under Rag Flock and Other Filling Materials Act, 1950 20 Marchandise Marks Act 1 Other Visits 714 7.413 TOTAL: 18,124 - 20 - 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 6 15 113 8 246 24 5 5 422 Passages & Staircases: Walls & Ceilings cleansed and redecorated 1 - 52 4 41 - - - 98 Yard & Area Walls cleansed and redecorated 1 - - _ - - - 1 2 Rooms and Contents cleansed by occupiers - - - - 1 - _ 1 Verminous Rooms disinfested - — 3 4 - - - - 7 Rooms where Food is manufactured, stored or sold 4 1 - - - _ 9 35 49 Plant used in the Production of Food 2 _ - -- - - - - 2 Miscellaneous 3 - - - - - - 1 4 GENERAL REPAIRS: Roofs 1 _ 40 - 107 33 — — 181 Eaves, Gutters - - 8 — 70 15 - - 93 Rain-water pipes - - 7 1 3 3 - - 14 Yard and Areas: Pavings 1 _ 13 2 11 3 — 1 31 Walls rendered or repaired 1 - 27 2 12 4 - 1 47 Rooms; Wall & Ceiling plaster 3 4 110 7 253 33 3 3 416 Passages & Steaircasess Wall and Ceiling plaster 1 - 44 3 38 3 - - 89 Floors 1 — 27 2 40 5 3 2 80 Stair Treads,Banisters & Balustrades — 1 18 — 12 2 - 2 35 Window and Door Frames, fittings and sash cords - - 274 17 340 20 - - 451 Dampness remedied 1 1 31 3 374 45 - - 455 Fireplaces & Fire-ranges repaired - - 61 1 46 14 - - 122 Washing Coppers repaired — — 10 - 2 - - - 12 Natural Ventilation provided or improved - - 23 1 13 9 - - 36 Chimneys and Flues - - 12 1 6 2 - - 21 Natural Lighting provided - - 7 - - - - - 7 Miscellaneous — 1 18 1 42 9 2 1 74 Carried forward 26 23 888 57 1457 224 22 52 2749 - 21 - 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 26 23 888 57 1457 224 22 52 2749 DRAINAGES: Total Reconstructions — - _ _ 11 - - 11 Partial Reconstructions, repairs or alterations - - - - - 9 - - 9 Frontage Drains Reconstructed - 1 _ - 15 2 1 19 Obstructions cleared — 1 - 11 17 - 1 30 Inspection Chambers provided — — - _ 2 33 - - 35 Inspection Chamber coders renewed - — - _ 4 1 _ - 5 Interceptors provided - — - - 2 17 1 - 20 Soil & Ventilation Stacks provided or reconstructed - - 2 - 3 33 - - 38 Soil & Ventilation Stacks repaired — — - _ 4 - _ - 4 Waste & Ventilation Stacks provided or reconstructed - - 2 - 3 46 1 1 53 Waste & Ventilation Stacks repaired — — 3 _ 1 4 _ 1 9 Ant 1-Syphonage Stacks provided or reconstructed - - - - - 20 - - 20 Fresh Air Inlets provided - - — — 2 10 - - 12 Fresh Air Inlets repaired or renewed - - 1 - 8 2 - - 11 Single Sinks provided - - 3 _ — 50 9 1 63 Single Sinks renewed - _ 3 1 1 1 - - 6 Baths provided - - - — _ 110 - _ 110 Baths renewed — — — — _ 1 - _ 1 Wash-hand basins provided 1 - - - - 116 4 2 123 Waste Pipes cleared of obstructions or repaired - - - - 1 - - - 1 Untrapped Waste Pipes provided with traps - - - - 2 1 - - 3 Miscellaneous 2 - 13 - 24 30 - 1 70 Carried forward 29 25 915 58 1540 738 38 59 3402 - 22 - WORKS SUPERVISED BY THE SANITARY INSPECTORS (Continued} FACTORIES ACT, 1937 HOUSING ACT, 1936 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1938 TOTALS N. V. N. ' V. N. V. N. V. Brought forward 29 25 915 58 1540 738 38 59 3402 SANITARY CONVENIENCES: Additional Water Closets provided 1 — - - — 102 - • 103 Water Closet pans renewed - - 2 - 9 8 — - 19 Water Closet pans cleansed - - - - 2 - - - 2 Water Waste preventers renewed or repaired - - 2 - 11 3 - - 16 Water Waste preventers provided 1 - - - - 102 - - 103 Additional Urinals provided — — — — — — 2 - 2 Roofs repaired or renewed - - 2 - 7 4 - - 13 floors repaired or renewed — 1 1 - 4 3 - — 9 Walls & Ceiling plaster cleansed, repaired or redecorated 3 2 27 - 57 7 1 3 100 Natural Ventilation provided or improved - - 12 - 10 9 - - 31 Natural or Artifical Light provided or improved - - - - _ - - 1 1 Ventilated Lobby provided — - 7 - - 2 - _ 9 Miscellaneous - - 11 - 15 6 - 1 33 WATER SUPPLY: Supplies provided to Tenements - - 36 3 4 - - - 43 Taps supplied en main for drinking purpose - - 36 3 - 1 - - 40 Burst Pipes repaired - _ — _ 6 2 - - 8 Cisterns cleansed, covered or repaired - - 2 - 1 - - - 3 MISCELLANEOUS SERVICES PROVIDED: Artificial Lighting to rooms 1 - - — - — — — 1 Heating 1 - - - - - - - 1 Soap & Towels for Staff 1 _ - - - - - - 1 Staff Rest & Changing rooms _ _ _ - - — 1 — 1 Constant Hot Water - - - - - - 3 5 8 Bins, Refuse - - - - 1 - - — 1 Food Cupboards provided - - 44 3 - 1 - - 48 Food Cupboards - Ventilation provided - - 6 - 1 - - - 7 Miscellaneous - - - -- - 1 - -- 1 Carried forward 37 28 1103 67 1668 939 45 69 4006 - 23 - 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 MISCELLANEOUS NUISANCES 37 28 1103 67 1668 989 45 69 4006 ABATED ARISING FROM: Animals or Birds - - - - 2 — - — 2 Offensive accumulations on open land and bomb sites - 3 - - 5 8 - — 16 Poultry - — — - 2 — - - 2 GRAND TOTALS 37 31 1103 67 1677 997 45 69 4026 N = Work carried out under Notice. V = Voluntary work. - 24 - WATER SUPPLY The provision of water for both commercial and domestic users is made by the Metropolitan Water Board. During 1953, no complaints were received in the Public Health Department as to the condition of water supplies. Fourteen samples of water were taken at the Council's Public Baths, and in every instance a satisfactory report was received. As a result of investigations by the Council's Sanitary Inspectors, the following provisions were made:- Supplies to tenements 43 Taps on mains for drinking purposes 40 Burst pipes repaired 8 Cisterns cleansed, covered or repaired 3 - 25 - INSPECTIONS, PROCEEDINGS, etc. Approximate number of houses in the Borough 16,000 PUBLIC HEALTH (LONDON) ACT. 1936 Number of houses inspected on account of complaints or illness 1,719 Number of statutory notices served 123 Number of houses repaired or nuisances remedied 433 HOUSING ACT, 1936 Number of houses inspected - house-to-house (Housing Consolidated Regulations, 1925) 44 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 Housing Act, 1936 Nil Number of houses repaired under Sections 9 and 10 of Housing Act, 1936:- (a) by owners 32 (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 5 (b) Voluntarily Nil Number of houses (wholly or in part) the subject of Closing Orders (excluding underground rooms) Nil 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 22 Number of overcrowded families who have obtained alternative accommodation 31 Number of houses erected by the Borough Council during the year 92 UNDERGROUND ROOMS Number occupied but unfit Nil Number closed or modified occupation approved Nil HOUSES LEI IN LODGINGS Number of houses let in lodgings in the Borough 575 Number of inspections (see in above) - Number of prosecutions Nil Number of complaints remedied under the bye-laws (not included under any other heading 17 - 26 - DETAILS OF NOTICES SERVED DURING THE YEAR UNDER VARIOUS ACTS 1. FACTORIES ACT. 1937 1 2. FOOD AND DRUGS ACT. 1938 3 3. HOUSING ACT, 1936 (a) Section 9 - Repair of Insanitary Houses 38 (b) Byelaws - As to Lodging Houses for the working classes 19 57 4. PUBLIC HEALTH (LONDON) ACT. 1936 (a) Intimation (Arising out, of this items 108 Nuisance Notices were served) 327 (b) Section 40 - Drainage 6 (c) Section 184 - Food Storage 9 5. SHOPS ACT. 1950 Section 38 - Provision of suitable sanitary conveniences and ventilation Nil 6. PREVENTION OF DAMAGE BY PESTS ACT. 1949 Section 4 - Destruction of mice Nil TOTAL 403 Three hundred and ninety-seven notices were complied with during the year of which three hundred and thirty-eight 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. - 27 - HOUSING ACT, 1936 - PART IV - OVERCROWDING New cases investigated and recorded 22 Number of families involved 22 Number of person involved 122 Cases relieved by :- (a) Rehousing Authorities 13 (b) Informal or formal procedure 18 Such actios resulted in 162 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, 48 families were living in overcrowded conditions. Every endeavour is being made to abate the overcrowded conditions. - 28 - APPLICATIONS FOR RE-HOUSING To assist the Council's Property Manager in arriving at a just consideration of the merits of each application received, a "pointing" system was evolved, and became effective in May, 1953. As applicable, points were awarded under the following headings:- Sub-standard accommodations Ill-health (excepting Tuberculosis); Tuberculosis; Overcrowding; and Other circumstances. During the year, 181 applications were referred to the Public Health Department. 139 originated from Chelsea residents, and the remainder from applicants living in other areas. Each case was investigated - 128 in connection with ill-health, including Tuberculosis, and 53 in respect of sub-standard accommodation. By the 31st December, 1953, the position was as follows:- Applicants re-housed by the Borough Council 30 Applicants re-housed by the London County Council Applicants who secured alternative accommodation by their own efforts 11 45 Of this total, 38 of the cases re-accommodated had been dealt with under the heading of "ill-health". The policy of co-operative examination of each housing application under the headings mentioned is proving to be mutually satisfying by virtue of the accelerated period of enquiry and subsequent re-settlement. - 29 - HOUSING REPAIR WORK Early in the year, a comprehensive report was made on the work carried out under the Housing Act during the past five years# In 1947 the Public Health and Housing Committees;, concerned at the housing conditions existing at the western end of the Borough, appointed deputed members to advise on action to secure improvements. The condition of these old, structurally worn houses, lacking essential amenities, had been aggravated by the War. In dealing with housing conditions only two years after the cessation of hostilities, the action of the Council compared favourably with that of other Matropolitan Boroughs# The public were less tolerant of bad. conditions, and the frequent service of notices dealing with nuisances on complaint was failing to arrest deterioration. The deputed members decided that the provisions of the Housing Act, 1936, should be operated to arrest decay and remedy insanitary conditions, and that two additional Sanitary Inspectors should be appointed. Preliminary Work. The deputed members decided that house-tohouse inspections should be made under the Housing Act, 1936, having regard to the future life of the property; that Lodging Houses should be registered, and "underground" rooms should be dealt with after making suitable regulations. The application of the provisions of the Housing Acts to secure the repair and provision of additional conveniences and amenities in old, badly planned and poorly const rusted houses in multiple occupation is beset with difficulties. The cost of making a house fit for habitation under the Housing Act mast be reasonable, and a suitable standard of fitness must be related to the cost of repairs (which have increased by almost 2006 over pre-war costs), the small income due to the control of Rents by the Rent Restrictions Act, and the ability to recover the outlay. The small builder who usually undertakes this type of work is content with a low margin of profit and requires daily supervision, but the effort is worth while when the achievement is considered against the cost of new accommodation for rehousing. Methods Employed. Nine areas were surveyed. Each house therein was inspected in detail, and those found below reasonable standard of fitness but capable of improvement were selected for reconditioning. The aim has been to improve housing conditions, and by prolonging the habitability of dwellings to relieve the housing shortage. The procedure has been design ad to give these properties a life of at least a further ten years. The Inspector decides the respects in which the house is unfit for human habitation, and prepares a specification of works, with measurements of materials required. In addition to external and internal disrepair of floors, walls, ceilings, windows, doors and fireplaces, items such as insufficiency of ventilation and light, defective sanitation, rising and - 30 - penetrating dampness and absence of food stores are among the many dealt with. This inspection takes a considerable time and requires great care in order that legal difficulties may not arise at a later stage in the proceedings. The Inspector has also to prepare an estimate of the cost by pricing each item. The Public Health Committee, on being satisfied that the house can be repaired at reasonable cost, authorises the service of a notice upon the person liable. Every effort is made to get the works carried out by the Landlord. If this fails, the Committee authorises the execution of the necessary work and the recovery of the cost. Tenders are prepared and sent to six builders on the Council's approved list, firms being selected who are known to be able to undertake this work at a reasonable price, and the account is paid by the Council, To avoid the collection of rents, efforts are made by the Borough Treasurer to secure agreement with the owner that he makes quarterly payments to the Council. In all cases the expenses plus interest are recovered in a few years. -Insanitary Basements. In 1947 the deputed members stated that insanitary basements should be dealt with, and during the past five years it has been found that many families are still forced to occupy basements, many of which could be repaired if the Council had regulations prescribing standards of fitness for such rooms. To this end, the Council made Underground Room Regulations on 21st October, and it is anticipated that approval thereto will be confirmed early in the new year. Demolition. Great care has had to be exercised in the making of demolition orders because of the serious shortage of rehousing accommodation. Even so, it has been necessary to make demolition orders in respect of 56 houses, and of these 15 were derelict and unoccupied and a further 12 were the subject of Dangerous Structure Notices served by the London County Council. To date 32 houses have been demolished. With demands upon housing accommodation condition at such a high level, it is regretted that additional properties cannot, for the present, be similarly dealt with. Details of premises repaired under the Housing Act, 1936, are as followss- Area Completed Proceeding Average cost Owner Council Premises Cost Premises Cost Premises Cost £ £ £ £ Dartrey Road 82 8,065 60 3,274 _ 80 Slaidburn Street 49 6,112 2 402 - - 127 Guthrie Street,etc. 17 1,058 — - - — 62 Christchurch Street 30 2,957 2 274 _ — 101 (part of) Stadium Street 8 899 - - 28 4,978 163 Trafalgar and Stewart Houses 6 36 - - 7 616 50 Tetcott Road, etc. 6 696 — — 3 653 150 Cremorne Road 1 77 — — 5 604 114 Lots Road (part of) — _> 8 815 199 19,900 64 3,950 51 7,666 100 - 31 - It will be apparent that for a Total Coat of £31,516 (representing an average expenditure of only £100 per house), 314 houses have been rendered reasonably fit, with an expectation of life of at least ten years. In only 64 was it necessary for the Council to carry out the work at a cost of £3,950 of which approximately £3,450 had been recovered at the end of the year. - 32 - 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 (1) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities :- 102 105 3 (2) Factories not included in (l) in which Section 7 is enforced by the Local Authority :- 204 177 - - (3) Other Premises in which Section + 7 is enforced by the Local Authority 6 2 - - TOTALS 312 284 3 - Notes- Outworkers' premises are not included in (3) 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). - 33 - 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) 15 13 - - - Over crowding (Section 2) - - - - - Unreasonable temperature (Section 3) - - - - - Inadequate ventilation (Section 4) - - - - - Ineffective drainage of floors (Section 6) - - - - - Sanitary Conveniences (Section 7) - - - - - (a) Insufficient - - - - - (b) Unsuitable or defective 9 8 - - - (c) Not separate for sexes 4 3 - - - Other offences against the Act (not including offences relating to Outwork 10 - 10 - - TOTALS 38 24 10 - - - 34 - FACTORIES ACT, 1937 (Continued,) 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. 15 - - - - - Furniture and upholstery 1 - - - - - Curtains and furniture hangings 2 - - - - - Household linen, Making-up etc. 4 - - - - - Jewelry, repairing, etc. 1 - - - - - TOTALS 23 - - - - - 35 LEGAL PROCEEDINGS The institution of legal proceedings, under the Public Health (London) Act, 1936, was necessary in eleven instances. Brief details of results of hearings are set out below. Premises 0ffence Result 0f proceedings 13, Fernshaw R0ad N0n-c0mpliance with Statut0ry N0tice. Abatement 0rder made f0r the w0rk t0 be c0mpleted within 42 days. C0uncil awarded £2. 2s. 0d. c0sts. 2, Birth Terrace N0n-c0mpliance with Statut0ry N0tice. Abatement 0rder made f0r the w0rk t0 be c0mpleted within 42 days. C0uncil awarded £2. 2s. 0d. c0sts. 3, Tetc0tt R0ad N0n-c0mpliance with Statut0ry N0tice. Abatement 0rder made f0r the w0rk t0 be c0mpleted within 4-2 days. C0uncil awarded £2. 2s. 0d. c0sts. 7, Call0w Street N0n-c0mpliance with Statut0ry N0tice. Summ0ns adj0urned sine die w0rk in pr0gress at time 0f hearing. 1, Glebe Place Nan-compliance with Statutory Notice. Abatement Order made f0r the work to be completed within 28 days. C0uncil awarded £2. 2s. 0d. c0sts. 22, Gurrter Gr0ve N0n-compliance with Statutory N0tice. Abatement 0rder made f0r the w0rk t0 be c0mpleted within 28 days. C0uncil awarded £1. 1s. 0d. c0sts. 186, L0ts R0ad N0n-c0mpliance with Statut0ry N0tice. Abatement 0rder made f0r the w0rk t0 be c0mpleted within 42 days. C0uncil awarded £1. 1s. 0d. c0sts. 35, Upcerne R0ad N0n-c0mpliance with Statut0ry N0tice. Abatement 0rder made f0r the w0rk t0 be c0mpleted within 14 days. C0uncil awarded £2. 2s. 0d. c0sts. 35, Upcerne R0ad N0n-c0mpliance with Statutory N0tice. Abatement 0rder made f0r the w0rk t0 be c0mpleted within 21 days. C0uncil awarded £2. 2s. 0d. c0sts. 36 LEGAL PR0CEEDINGS (Continued) Premises Offence Result of proceedings 23, Tetcott Road Non-compliance with Statutory Notice. Abatement order made for the work to be completed within 35 days. Council awarded £2. 2s. 0d. costs. 14, Tadema Road Non-compliance with Statutory Notice. Summons withdraw. - requirements of notice having been complied with at time of hearing. Council awarded £2. 2s. 0d. costs. APPEALS 13, Fernshaw Road Appeal against Abatement order. Appeal dismissed on certain terms endorsed on Counsel's Brief. Appellant ordered to pay to the Council £5. 5s. 0d. t0wards its costs. 13, Fernshaw Road Civil Debt £5. 5s. 0d. order made for payment of £5. 5s. 0d. Council awarded £2. 2s. 0d. costs. 37 NATIONAL ASSISTANCE ACT. 1948. BURIAL OR CREMATION OF THE DEAD (Section 50) The provisions of the above Act require a local authority 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 death occurred in local hospitals or in the homes of residents. Subsequently however, 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 births (or her) maintenance under Section 42(1) of the let, 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 an the Borough Council in a direct sense, as will be seen from the following summary:- Year Interments arranged by Borough Council 1948 (approximately 6 months) 43 1949 25 1950 9 1951 10 1952 9 1953 12 Responsibility for the internent 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. 38 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 act the time of deaths- 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 before 5th July, 1888. A further exception is made in the case of a child wider the age of ten years who was born before 5th July, 1948. Grants as indicated above may only be paid in full to liable relatives; a local authority whilst assuming the role of a "liable relative" will cnly receive three-fifths of an applicable grant, as stipulated by the National Insurance (Death Grant) Regulations, 1949. 39 MEDICAL EXAMINATION During the year, fifty-nine 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 57 proved successful; 1 was referred for re-examination and 1 proved unacceptable for superannuation purposes, PUBLIC MORTUARY FACILITIES No premises for use as a Mortuary exist in the Borough, but excellent facilities are available, under an agreement with Hammersmith Borough Council, act their Mortuary in Fulham Palace Road, W.6. (Telephones RIVerside 1813) which is also adjacent to the Coroner's Court for this area. Details relevant to Chelsea residents are as follows:- Number of Post-Modems carried out without Inquest 192 Number of Post-Mortems carried out with Inquest 55 40 DISINFECTION AND DISETFESTATICN. The following is a summary of the work carried out by the staff of the Council's Disinfecting and Cleansing Centre, 9a, Lots Road, Chelsea, during the past three years. (a) SCABIES. 1951 1952 1953 Treatments were carried out as follow:- ADULTS (Male) Cases 2 4 2 Treatments 2 4 3 ADULTS (Female) Cases 5 5 3 Treatments 13 7 7 CHILDREN Cases 11 3 1 Treatments 17 6 4 In addition to the figures shown above 14 children attending London County Council schools were given 20 treatments.) (b) VERMINOUS CONDITIONS. Details of work in this connection are set out below:- ADULTS (Mala) Cases 3 6 2 Treatments 4 6 2 ADULTS (Female) Cases 221 388 465 Tratments 221 388 465 CHILDREN Cases 111 277 304 Treatments 111 277 304 (365 treatments were given to London County Council school children.) (a) DISINFECTION OF ROOMS AND CONTENTS AFTER INFECTIOUS DISEASE. Number of rooms disinfected 289 337 220 Number of articles disinfected. 2,060 4,373 6,138 Disinfestation of Rooms and Contents. Number of rooms disinfected 430 511 480 Number of articles disinfected. 2,077 1,307 1,615 MISCELLANEOUS DISINFECTION. Number of rooms disinfected 254 242 322 Number of articles disinfected. 1,098 1,572 2,370 41 PET ANIMAL 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 pat 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. 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. 42 PHARMACY AND POISONS AST. 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 49 (47 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 ammonia. 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). 43 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. 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 £1.0s.0d. was received. 44 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 Mica Destruction Act, 1919, the primary duty for the eradication of these particular pasts 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 587 2,131 Number of infestaion found 45 264 Number of treatments undertakes 35 233 Number of pre-baits laid 1,516 Number of poison bailts laid 494 Number of complaints received 318 2. Sewer Maintanances Treatments. No. of pre- baits laid No. of poison baits laid Estimated kill No. 1 Treatment 810 270 2,025 No. 2 Treatment 1,026 342 3,420 45 WELFARE OF OLD PEOPLE The circumstances and conditions peculiar to people of advanced age are under constant investigation by the Council's officers. Understandably, and despite, in many instances, infirmity, it is found that such persons are quite happy if they can stay in their homes surrounded by their private possessions, and to this end efforts are made to ensure their comfort. An annual grant of £350 is made bv the Borough Council 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, 1,032 persons were on the Council's list, as compared with 934 at the end of 1952. Every effort was made to ensure that all needs were mat to the full. 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 1952, the average weekly distribution was 260, a figure which represented the maximum attainable with equipment available. Last year, 10,302 meals were delivered to the homes of old people, an average of 198 per week; of this total, 170 were new cases. Recipients were most appreciative of these meals, which arrived at their homes hot, and were therefore ready for immediate consumption owing to the installation of the "Hotlock" system in each "Meals on Wheels" van. If this service was not in operation, 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 97 persons (86 in 1952) were recommended for the services of 2 qualified chiropodists, receiving 376 treatments, an increase of 7 over the number given in 1952. This facility is in great demand, and there is a waiting list for this valuable domiciliary service. Holidays. Pleasant holidays arranged by the Honorary Secretary of the Chelsea Old People's Welfare Committee were much enjoying by 61 persons, chosen for their special need of a change of air and surroundings, at a minimum cost of £1 per person for 2 weeks' holiday, the main expense being borne by the Chelsea Old. People's Welfare Committee. The majority stayed at homes controlled by the Women's Holiday Fund, and others had a restful stay at the Lloyd Thomas Home of Rest, Highgate. In the latter case, transport was provided to take them to and from their hemes. Library and Shopping facilities are maintained by the British Red Cross Society whose weekly visits are gratefully appreciated by those who are unable to get out or can only do so with great difficulty. The Society also provides escorts, when necessary, for sick persons to proceed for treatment at hospitals. Shopping facilities are also provided by the Women's Voluntary Services. 46 The problem of securing hospital accommodation for the chromic sick continues to be difficult, but the cordial relationship existing has enabled fifty-nine men and woman to gain admission. In sane instances it is pleasing to record that the efforts of hospital rehabilitation departments resulted in a return home to lead normal lives. Institutional care was found to be essential in twenty-seven cases, and it is noteworthy that all responded well to communal life. Nevertheless, the utmost tact and patience are called for before the change of environment is made. Issues of clothing were made when need was established, and 177 persons received benefit in this way during the year. The Women's Voluntary Services and other kind donors 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, fourteen persons were given personal cleaning thirteen rooms were also cleansed, and where necessary, cleared of superfluous items. The Council's Social Worker made 2,006 visits to registered cases either in their own homes or whilst they were undergoing hospital treatment. In conclusion, I would like to express my gratitude to the British Red Cross Society and the Women's Voluntary Services for their unfailing efforts throughout the year, and to other voluntary organisations who have in no small measure contributed to the success of the work on behalf of aged people. 47 HOSPITALS AND NURSING HOMES The Borough is fortunate in possessing excellent facilities for both general and special hospital treatment. A list of the institutions now functioning in this area is as follows:- HOSPITALS TYPE OF INSTITUTION Brompton Hospital, Fulham Road, S.V.3. Chest Diseases Chelsea Hospital for Women, Dovehouse Street, S.W.3. General Granard House, 98, Dovehouse Street, S.W.3. Malignant Disease (Part of Royal Cancer Hospital) Royal Cancer Hospital, Fulham Road, S.W.3. Malignant Disease Royal Hospital, Royal Hospital Road, S.W.3. Home for Pensioners St. George's Home, Milman's Street, S.W.10. Tuberculosis St. Luke's Hospital, Sydney Street, S.W.3. Chronic Sick St. Stephen's Hospital, Fulham Road, S.W.10. General Victoria Hospital for Children, Tite Street, S.W.3. Children's Diseases NURSING HOMES Royal Avenue Nursing Home, 39, Royal Avenue, S.W.3. Private Wilbraham Nursing Home, 3, Wilbraham Place, S.W.1. Private Cheyne Hospital far Children in Cheyne Walk has not been active in Chelsea since the commencement of World War II, having transferred to Sevenoaka, Kent. Normally it dealt with the treatment of children suffering from deep-aeated diseases, who were not eligible for treatment in the general hospitals. Late in 1954, the local Hospital Management Group hope to introduce a day centre, for the care of children afflicted with cerebral palsy. Further information an this subject will be found cm page 15. 48 "PART III" ACCOMMODATION A local authority is required under Section 21 of the National Assistance Act, 1948, 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; and (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 was considered advisable to arrange for the reception of 23 persons in such accommodation, and in every instance admissions were made at King's Mead, Dovehouse Street, It was not necessary for any recourse to legal action to enforce removal as indicated in Section 47 of the above Act, as amended by the National Assistance (Amendment) Act, 1951. Any anxiety as to the safety of belongings whilst such persons are receiving due care and attention is obviated by the fact that the London County Council assume responsibility for their custody. Incidentally reasonable notice is always given to the County authorities when admissions are being sought. 49 MATERNITY AND CHILD WELFARE SERVICES I am indebted to Dr. V.I. Russell, Mrdical 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. WELFARE CENTRES Attendances at Ante-natal and Post-natal sessions 1,303 Attendances at Infant Welfare sessions 9,286 HEALTH VISITING Number of visits carried out by Health Visitors in respect of:— Premature Infants 48 Infants under 1 year 3,101 Children between 1 and 5 years 4,017 Unsuccessful visits. 1,638 Expectant mothers 757 Stillbirths. 6 Infectious Diseases. 240 Miscellaneous 706 10,513 FOSTER MOTHERS Number of registered foster mothers. 8 Number of children fostered. 16 DIPHTHERIA IMMUNISATION Number of children who completed a primary course of Infections 461 Number of children who received reinforcing injections. 277 Number of children vaccinated at Violet Mslchett Infant Welfare Centre 428 50 BYEIAWS FOR THE PROTECTION OF FOOD Considerable work under these Byelaws has been carried out by the Council's Food Inspectors during the year. Occupiers of fourteen food premises received written or verbal cautions referring to inadequate methods for protecting food (sandwiches, cakes, cheeses, meats, etc.) from contamination when exposed for sale. The majority of shopkeepers approached have co-operated promptly, and have fitted glass counter screens or transparent dish covers, but some have so far adopted only temporary measures such as cellophane covers, etc. It is hoped that these will soon be replaced by screens of a permanent nature. One vendor of wet fish has fitted a plate glass window to what was formerly an open shop in order to protect the fish and other foods from dust and dirt from the roadway. Snack bars and restaurants and public houses have been kept under regular observation to ensure that no uncovered food is placed on counters where it may become contaminated by persons sneezing or coughing. Food delivery vans have been inspected at every opportunity, and four firms have been cautioned for unsatisfactory methods of delivery. Suggestions have been made for improving methods of protecting and handling food, and in most cases these have been readily adopted. Frequent inspections and visits to the thirty-four fruit and vegetable shops in the Borough have resulted in displays outside shops being raised to a reasonable and safer height from the ground. A number of occupiers of food premises were found to have omitted to affix notices inside doors of water-closet compartments, stressing the importance of employees washing their hands before handling food. In every case this omission was remedied immediately without the necessity for any further approach. In this connection it may be stated that requests have been made for the provision of washing facilities actually in the water-closet compartments at restaurant kitchens, and these requests have been complied with in nearly every instance, thus ensuring that hand—washing is not neglected. Efforts are continuously being made to maintain a uniform standard throughout the Borough, and it is necessary to regularly carry out work, mainly of an educational nature, to ensure that food traders and their employees fully appreciate their shortcomings when handliag, wrapping, displaying, and delivering food. 51 INSPECTION AND SUPERVISION OF FOOD As required by current legislation, registers are maintained of all persons carrying on trades connected with the manufacture, storage and sale of food. Early in the year, letters and notes in. connection with the "Handling, Wrapping and Delivery of Food" were circulated to traders and their staffs, and generally speaking, this action was much appreciated. The following summary gives details of the types of businesses receiving the attention of the Public Health Department:- Bakehouses 11 Butchers 29 Dairies and Milk Shops 43 Food Factories 4 Fried Fish Primeses 3 Fruit and Vigetables Retailers 34 General Provision Merchants 53 Industrial Canteens 7 + Miscellaneous Premises 30 Public Houses and Hotels 48 Restaurants 144 West Fish Retaillers 9 West and Fried Fish Retailer 1 + Off-licences and bottling stores. As required under Section 14 of the Food and Drugs Act, 1938, or other local acts, the registrations of 98 premises for the storage and sale of Ice Cream, and 32 premises for the sale of Preserved Foods, are effective. 52 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 Satisfactory Unsatisfactory Total Cream Artificial 10 -. 10 Frozen egg 1 - 1 Milk, Cows 23 - 23 'Puregg' 1 - 1 Stewed Steak 3 3 6 Water 14 - 14 TOTALS: 52 3 55 Reference to fifty-three samples of Ice Cream will be found, on page 53• 53 ICE CREAM Fifty-three samples of Ice Cream were submitted to the Public Health Laboratory Service for "Methylene Blue" tests, with the following results:— Grade I 32 Grade II 8 Grade III 6 Grade IV 5 51 The remaining two samples were of coloured ices which did not respond to the test. A consideration of the table set out below will clearly show that good standards are now attaining in respect to Ice Cream. Grading 1951 1952 1953 No. of samples Percentage of total No. of samples Percentage of total No. of samples Percentage of total I 50 83.3 24 70.6 32 62.7 II 7 11.7 5 14.8 8 15.6 III - - 1 2.9 6 11.8 IV 3 5.0 4 11.7 5 9.9 TOTALS: 60 100.0 34 100.0 51 100.0 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 arsas. Ice Cream which received chemical examination by the Public Analyst is commented upon in the section devoted to "Food and Drugs" commencing on page 56• 54 MILK SUPPLY 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 daily 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, 1953, entries in the register were as follows:- (a) Number of registered distributors with premises in the Borough 34 (b) Number of registered distributors other than those included in (a) above 16 (c) Number of premises in Chelsea registered as dairies 1 (d) Number of premises in Chelsea, other than dairies, from which milk is distributed 42 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. 39 supplementary licences were granted in respect of milk sold by retail within the Borough from 16 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 26 34 31 91 Supplementary 12 14 13 39 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 pasteurisation or sterilisation of milk took place in the Borough during the year, such processes having been carried out in other areas. 55 UNSOUND FOOD Whan it has been established that food is unsound, it is surrendered to the Council's Officers, removed from the premises and the necessary certificates issued. The food is subsequently disposed of via the Council's refuse disposal service, but prior to such action it is treated with carbolic acid. Approximately 7,640 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 1950-1953 (inclusive) are set out in the following tables:- UNSOUND FOOD SURRENDERED TO THE COUNCIL'S FOOD INSPECTORS DURING THE YEARS 1950-1953 (INCLUSIVE) Commodity 1950 lbs. 1951 lbs. 1952 lbs. 1953 lbs. Biscuits - - - 505 Bread — — — 144 Cereals 307 _ — 139 Fish, fresh 1,096 327 117 174 Fish, tinned 415 402 88 - Fruit, dried 194 - — - Fruit, tinned 1,666 2,184 1,723 2,157 Fruit juices 326 165 98 — Ham, tinned — 3,775 - - Meat, fresh 713 - 1,326 1,621 Meat, tinned 2,111 830 - 1,239 Milk, tinned 371 241 95 - Pickles, Sauces, etc 343 — - - Preserves - Jams Marmalade, etc. 245 77 123 182 Sausages - 300 858 435 Soups 201 132 40 93 Vegetables 881 709 1,127 436 Aggregates of all foods condemned annually 9,721 9,788 8,192 7,64.0 Average for the four years = 8,335 lbs. 56 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Chelsea. Madam Mayor, Ladies and Gentlemen, During the year 1953, 4-00 samples of foods and drugs were examined under the Food and Drugs Act. Ctf these 178 were taken formally and 222 informally. The number adulterated or incorrectly labelled was 27, or 6.75 per cent. 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 Percentage adulteration Compositional Labelling Milk 207 0 (0%) 0 (056) Other foods 188 15 (8. Q6) 10 (5.36) Drugs 5 0 (056) 2 (4056) In general the food situation throughout the country is now improving rapidly and, whilst the public need the protection of the Food and Drugs Acts as much as ever to protect them from skilful sophistication, there is little doubt that many inferior products will disappear or be forced to improve in order to meet the natural competition of other foods. With the reappearance of proprietary products, however, the shelf life of foods in shops will tend to be prolonged and greater care will have to be devoted to the keeping properties of food on storage. A portion of a sliced loaf of bread was sent for analysis owing to black marks running through it. The marks were caused by fungus due to improper and dirty packing conditions, showing that there was considerable carelessness in the Bakery. No traces of iron or mineral oil could be found. A local resident had the unfortunate experience of being served in a restaurant with a sausage containing a large piece of gristle. On making a complaint he was served with a meat pie in which there was present a piece of bristle long. Your analyst suspected that the piece of bristle was from a brush used in the bakehouse and this was found to be correct. Investigation showed that the manufacturer of the sausages did nob run his meat through a mincer, but used a bowl cutter only and that insufficient care was employed in subsequent examination. As the complainant had thought the piece of gristle was part of a mouse, it was disturbing to find a piece of bristle in the meat pie served in exchange. A sample labelled "Puregg" contained eggs, skim milk and salt and the name was therefore considered misleading. The percentage of skim milk was nob inconsiderable and some of the egg protein and fat were coagulated and not readily emulsified with the remainder of the constituents making it unsuitable for ~ertain culinary jobs. The manufacturers explained later that this was very old stock, and they did not intend to manufacture any further supplies. 57 Foreign matter taken from a sample of canned peas was examined and found to consist of animal excrement probably derived from a rabbit# Some potted sardines and potted anchovies were found to contain hexamine# Hexamine is a compound of ammonia and formaldehyde and formaldehyde is prohibited as a preservative in this country,, though its use is permitted in Germany from which countiy these two samples emanated# Adverse comments were made on three samples of tomato paste and one of tomato pulp# Cfae sample of tomato paste contained at least 330parts per million of tin, whereas the maximum quantity suggested by the Ministry of Food is 250 parts per million# The second sample contained 254- parts per million of tin# This product had been condemned by another authority, and the middleman's stock had been surrendered# The product had been bought by the packers to fulfil a commitment and was nob their own preparation# They promised to avoid a recurrence of this trouble. The third sample did not have the appearance of tomato paste and contained several pieces of plum and cherry stones© It was eventually ascertained that the product was a fruit puree manufactured in Czechoslovakia normally intended for consumption on the home market and that inadvertently a few tins had been incorrectly labelled and exported as tomato paste# The tomato pulp was stated to contain nob less than 32 per cent of dry matter after deducting saltj, whereas It was found to contain only 29#3 per cent so that it was 8#4 per cent deficient in total solid matter# A sample of Guava Cheese claimed to be "rich in Vitamins C, B, and A,® bub failed to comply with the requirements of the Labelling of Food Order in that the quantities of vitamins present were not given# A product must not be described as being rich in vitamins unless the normal quantity consumed in one day contains act least the fall daily requirement of the vitamins claimed and the claim "rich in vitamins11 was unwarranted o Some pineapple juice was examined and found to possess a very musty flavour# In the opinion of your analyst this was du® to tb§ juice having been mouldy befor® being treated with a large quantity of sulphur dioxide. Some canned peaches delivered to a hospital wer® submitted owing to the complaint that the peaches were salty0 The sample was fbuad to ccertain o05 per cent of saltj, about ten times the quantity normally present in tinned peaches# It seemed possible that the peaches might been treated with brine to prevent mouldlnessj or that they might fea^e been grown near the sea coast and been covered with dried sea spray# It was later stated that the peaches had in fact been covered with a dilute brine after peeling and before canning, in order to prevent oxidation with brown discolouration# The fruit had not been sufficiently washed afterwards# ^ tin of Lime Juice examined was found to be badly stained and the lime juice contained 145 parts per million of tin, but in view of the Report of the Ministry of Food Metallic Contamination Sub-Committee this sample could cnly be reported as inferior# 58 A can of Turtle Soup with Sherry contained alcohol of proof strength 0.58 per cent, equivalent to 1,6 per cent of Sherry. lour analyst was of the opinion that the quantity of sherry was insufficient to affect the flavour of the Soup to any appreciable extent and that the label was misleading. It was later found that the production of the soup had ceased and no more would be packed under the existing label. Some canned Cream of Shrimp Soup contained only 9.7 per cent of total solid matter and 3.1 per cent of fat. Cream Soup must contain not less than 4- per cent of fat and not less than 10 per cent of total solid matter. It was eventually agreed that the firm would not import any more of this product at the present time, and if at any time they wished to alter this decision they would take adviea csi the label. A number of samples had misleading labels or were incorrectly labelled* Some canned Cream was stated on the label to contain sugar in order to enhance the full rich flavour, without making a correct disclosure of the ingredients as "Cream, Sugar". Agreement regarding the labelling of this product was eventually reached. A sample of Ice Cream Mix was labelled as containing "minor ingredients" which were not described. This label was also corrected. A sample of Invalid Jelly was examined and found to have a good gelatine content, but the word "colour" was not included in the declaration of ingredients. It was later found that the manufacture of this produce had been discontinued for some years. A Fish and Vegetable Paste Mixture was found to contain pieces of tomato and salt the presence of which constituents was not declared. A Cocktail Savoury contained 23.7 per cent of salt of which about 20 per cent was added salt, but this was not declared on the label. New labels were eventually printed. A sample of Continental Mustard containing tomato was examined without this ingredient being disclosed on the label. The other ingredients were stated correctly and th© importers eventually promised to see that all future shipments were correctly labelled. A vegetarian nut preparation was found to be wrongly labelled as it was stated to contain "sweetened vegetable fat", but this must be declared as vegetable fat and sugar. The disclosure of other ingredients would also have to be placed in their correct order. The manufacturers agreed to have fresh labels printed. Some Rye Slices were described on the label as "A Tasty and Nutritious Food rich in Vitamins", but in reality rye contains thiamine or vitamin Bl, but does not contain any other vitamins. The labels were eventually corrected. A sample of Cough Mixture and a Cough Syrup were both correctly prepared but the formulae on the labels were incorrectly described according to the requirements of the Pharmacy and Medicines Act. 59 The following items of legislation or proposed legislation were introduced during the year:- The most important of these was the Food and Drugs Bill, which had its first reading in the House of Lords in November• This Bill is primarily a consolidating bill and will enable a large volume of Emergency legislation to be made permanent. It will also tidy up some of the law under the existing Food and Drugs Acts, 1938 - 1950. Unless an Act of this nature were passed it would be difficult to retain a considerable number of Statutory Orders introduced by the Minister of Food during and since the war. Unlike much of the temporary legislation of the last few years a considerable amount of thought is being given to this Bill and all interested parties should find an opportunity to have their views expressed in me or other of the Houses of Parliament. The Labelling of Food Order, 1953, was largely a re-enactment of the previous Labelling of Food Order, but it released what are commmly known as biscuits from the necessity of declaring their ingredients. It permits the labels of intoxicating liquors to be printed either with a light block print an a dark background or the reverse, it permits the additicn of emulsifying salts and edible starch merely to be defined as such when added to stated foods, and it allows preparations specified in the British Pharmacopoeia or the British Pharmaceutical Codex to be sold without a declaration of composition. Qq the other hand it requires french coffee and Vienna coffee to be labelled "coffee and chicory mixture" or "coffee with fig seasoning" in substantially as conspicuous wording as "french coffee™ or 'Viennese coffee". It also prohibits the sale of solutions containing more than 15% of acetic acid by anyone other than a pharmacist or an authorised seller of poisons unless the labels are marked "Dangerous - not to be used udess diluted" together with the relevant wording showing the concentration, of acetic acid present. The Cream and Use of Milk (Revocation) Order, 1953» enabled home produced cheese and cream to come on to the market again by removing restrictions ess. manufacture and sale. It also permits the use of milk to the manufacture of bread, biscuits, pastries, cakes, ice-cream and confectionery geaerally. The Food Standards (Ice Cream) Order, 1953$ re-enacted the Food Standards (Ice Cream) Order, 1951, and re-introduced the minimum fat cosateofe ©f sugar 1Q£, and milk-s olidsHiot-fat 7.5$. Seventy five per cent of the sugar must be sucrose, i.e., cane or beet sugar, and the other 25% may be invest sugar or sugars derived from the hydrolysis of starch. The Milk (Great Britain) Order, 1953* replaced with amendmenta the Milk (Control and Maximum Prices) Order, 1951> and from the public? analysts' point of view the essential factor in this Order is the permission to sell Channel Islands and South Devon milk containing less than 4- per cent of fat under their own names, so long as the prices charged are only those permitted for other milks in the same categories, i.e., as ordinary milk, Tuberculin Tested milk, or Tuberculin Tested Farm Battled Milk. The Public Health (Condensed Milk) (Amendment) Regulations, 1953s re-enacted the provisions of Regulation 60 CAA of the Defence (General) Regulations and permits the sale of full cream unsweetened condensed milk imported by the Minister containing not less than 7.S$ of fat and net less than 25.5% of all milk solids including fat. - 60 - The Flour Order, 1953, and the Bread Order, 1953, allow some relaxation in the control of flour and bread. Any flour, other than that obtained by the grinding of the whole wheat, must have prepared chalk added to it at the rate of 14 oz. per 280 lb, sack, and all flour of an extraction rate of less than 80% is required to have added to it iron, vitamin Bl, and nicotinic acid in sufficient quantity to ensure a minimum stated quantity of each. The Bread Order permits the sale of breads other than National Bread, so long as National Bread is available for sale when other varieties are sold. Mention was made in the report last year of the number of Meat Orders introduced. The Canned Corned Meat (Prices) Order, 1953, and its amending Order, and the Offals in Meat Products Order, 1953, removed all controls on meat products other than the prohibition of the use of certain offals in the composition of uncooked open meat products for sale for human consumption and the control of the retail price of canned corned meat. During the year there were three Orders relating to the use of oils and fats in foods:- The Oils and Fats Order, 1953, The Oils and Fats (Amendment) Order, 1953, and The Oils and Fats (No.2) Order, 1953. These Orders relate primarily to the oils which may be sold with or without a licence from the Minister of Food, but whereas the first Order laid down standards for dripping and for horsefat for edible purposes, these standards were revoked by the repeal of the Order and the promulgation of the No. 2 Order. In many ways it is to be regretted that, when standards of quality, such as those relating to the quantity of free fatty acids in fats and oils, have once been introduced, they are not carried forward in some way in later Orders. The Public Health (Preservatives etc. in Food) (Amendment) Regulations, 1953, and the amending Order brought into permanent legislation the permission to employ diphenyl for the treatment of wrappers for citrus fruits. The Regulations also allow the use of sulphur dioxide as a preservative for certain dried vegetables, and, for a limited period, the continuance of the addition of borax to margarine. During the year the Food Standards Committee by its Preservatives Committee issued a Report regarding the addition of anti-oxidants to foods. This Report stated that there is no objection to the continuation of the use of certain antioxidants in the preparation of foods, such as ascorbic acid (Vitamin C), lecithin (a natural substance generally associated with fat in foods, especially in yolk of egg), tocopherols (vitamin E present especially in the germ portions of seeds), and citric and tartaric acids, all of which are naturally occurring products and therefore not considered as preservatives in the legal sense of the word. The Committee also considered that iso-ascorbic acid may be considered as similar to ascorbic acid. The Committee recommended, however, something new to British, though not to foreign, law-the legalisation of two other anti-oxidants, namely propyl gallate not exceeding 0.01% and butylated hydroxyanisole not exceeding 0.02%, the use of both of which is permitted in the United States and in Canada. The Committee expressed the opinion, however, that no additions should be made to butter and that a periodic review should be made of the necessity to use any antioxidants or to permit the use of others, not so far allowed. The Food Standards (Preserves) Order, 1953, replaced the earlier Food Standards (Preserves) Order, as modified in 1950, which had been in force since 1944, i.e., since one of the worst periods of the war. It abolished the distinction between fresh fruit and full fruit jams and modified the quantity of fruit required to be - 61 - present in various jams. The main provisions remain, however, unaltered. Arising from the effects of this Order it is interesting to note that various manufacturers have endeavoured recently to place on the market various types of fruit flavoured spread analogous to lemon curd. Lemon cheese or lemon curd has been known for many years and shortly before the outbreak of the last war orange curd appeared on the market. The Food Standards (Preserves) Order makes provision for orange and lemon curds by requiring fruit curds to contain 4 parts of fat, 0.33 part of citric aciid, and 0.125 part of oil of lemon or 0.25 part of oil of orange, together with a certain quantity of egg and the soluble solid matter not less than 65 per cent. It will be appreciated that the stipulation that a fruit curd must contain either lemon or orange oil renders it almost impossible to market products such as banana or apricot curd without inventing a fresh description for them. The Saccharin Order, which had been in force in various forms since early in the war was revoked aid a new Artificial Sweeteners in Food Order, 1953, introduced. This new Order prohibits the use of any artificial sweeteners in food other than saccharin, and results from doubts as to the harmlessness of dulcin and the believed harmful effects of P.4.000. The Soft Drinks Order was revoked during the year and the Food Standards (Soft Drinks) Order, 1953, introduced to take its place. The chief effects of the new Order are to make provision for medicated and glucose beverages, which had hitherto been manufactured since the outbreak of the last war under licence, the application of minimum standards to drinks for diabetics and to ginger beer and herbal and botanical beers, the omission of specific reference to non-alcoholic wine, non-alcoholic cider and non-alcoholic perry, which are now considered to fall under the heading of "any other description of soft drink containing fruit juice". The Order similarly makes allowance for soft drinks made from whole fresh oranges. This Order may give rise to questions of interpretation and legality. The High Court decided that there can be no such thing as "Non-brewed vinegar" because vinegar must be the product of double fermentation and many people believe that there can, therefore, be no such things as "non-alcoholic wines, non-alcoholic cider, and non-alcoholic perry". The term "non-alcoholic wine" has been used for many years, but nonalcoholic cider and. nonalcoholic perry have not even the custom of long use to support them. Similarly there would appear to have been considerable confusion regarding the names by which drinks made from whole orange should be described and how much orange should be contained therein, but this point is one to be settled in the future. I have the honour to be, Madam Mayor, Ladies and Gentlemen, Your obedient servant, THOMAS McLACHIAN, A.C.G.F.C., F.R.I.C., Public Analyst. 62 Taken Formally Adulterated Taken Informally Adulterated Total Samples Analysed Total Samples Adulterated Beans and Pork 1 0 0 0 1 0 Boiled Beef and Carrots 1 0 0 0 1 0 Bran Flakes 1 0 0 0 1 0 Bread 0 0 1 1 1 1 Cake Flour 0 0 1 0 1 0 Cake and Pudding Mixture 0 0 1 0 1 0 Capers 0 0 1 0 1 0 Cashews and Almonds 0 0 1 0 1 0 Cheese 2 0 0 0 2 0 Cheese, cream 0 0 1 0 1 0 Cheese, Guava 0 0 1 1 1 1 Cheese, Milk 0 0 1 0 1 0 Cheese, Processed 1 0 0 0 1 0 Cheese, Soft 1 0 0 0 1 0 Chicken, processed 1 0 0 0 1 0 Chicken, vol-au-vent 0 0 1 0 1 0 Cocktail Savoury 0 0 1 1 1 1 Cocktail Savoury Biscuits 1 0 0 0 1 0 Coffee and Chicory 0 0 1 0 1 0 Coffee Dandelion 0 0 1 0 1 0 Coffee Fig 0 0 1 0 1 0 Coffee Soluble 0 0 1 0 1 0 Confectionery 2 0 0 0 2 0 Cream 0 0 1 0 1 0 Cream, canned 0 0 1 1 1 1 Cream, clotted 0 0 1 0 1 0 Cucumber, sliced 0 0 1 0 1 0 Curd, lemon 0 0 1 0 1 0 Custard Powder 1 0 0 0 1 0 Cutlet, Chicken 1 0 0 0 1 0 Cutlet, Turkey 1 0 0 0 1 0 Dripping 0 0 10 1 0 Egg Product 1 1 0 0 1 1 Fish Cakes 1 0 1 0 2 0 Fish, canned 3 0 3 0 6 0 Fish Pasta 1 0 0 0 1 0 Fish Potted 0 0 4 2 4 2 Fish and Vegetables Mixed, battled 0 0 1 1 1 1 Flour confectionery 1 0 0 0 1 0 Food Thickener 0 0 1 0 1 0 Fruit, canned 1 0 2 1 3 1 Fruit, glace 1 0 0 0 1 0 Fruit Juice 0 0 10 2 10 2 Grape Jelly Preserve 1 0 0 0 1 0 Carried forward 24 1 42 10 66 11 63 Taken Formally Adulterated Taken Informally Adulterated Total Samples Analysed Total Samples Adulterated Brought forward 24 1 42 10 66 11 Herbss Bayleaves dried 1 0 0 0 1 0 Sage dried 1 0 0 0 1 0 Honey 1 0 1 0 2 0 Horseradish 0 0 1 0 1 0 Horseradish Cream 0 0 1 0 1 0 Ice Cream Mix 0 0 1 1 1 1 Jelly, Aspic 1 0 0 0 1 0 Jelly Cream 1 0 0 0 1 0 Jelly Invalid 1 1 0 0 1 1 Linseed Whole 0 0 1 0 1 0 Macaroni and Egg Product 0 0 1 0 1 0 Marmalade 1 0 0 0 1 0 Marzipan 0 0 1 0 1 0 Mayonnaise 0 0 1 0 1 0 Meat 0 0 2 0 2 0 Meat, canned 3 0 3 0 6 0 Meat cubes 1 0 0 0 1 0 feat Extract 1 0 1 0 2 0 Meat Pate 1 0 0 0 1 0 Meat Pie 2 0 2 1 4 1 Meat Pudding 0 0 2 0 2 0 feat Padding, canned 1 0 0 0 1 0 Milk 91 0 116 0 207 0 Minced Goose, canned 1 0 0 0 1 0 Mint Jelly 1 0 1 0 2 0 Molasses 0 0 1 0 1 0 Mousse, lemon. 1 0 0 0 1 0 Mushrooms, canned 1 0 1 0 2 0 Mushrooms, dried 0 0 1 0 1 0 Mustard 1 0 1 0 2 0 Must ard, continental 0 0 1 0 1 0 Mustard and Tomato 0 0 1 1 1 1 Omlette Mix 1 0 0 0 1 0 Onions, dried 0 0 1 0 1 0 Onions, pickled 1 0 0 0 1 0 Paste, meat 1 0 0 0 1 0 Pastry 1 0 0 0 1 0 Pate de foie 0 0 1 0 1 0 Peanut Butter 0 0 1 0 1 0 Peas, canned 0 0 1 1 1 1 Pectin Preparation 0 0 1 0 1 0 Peppers, red 1 0 0 0 1 0 Carried forward 141 2 188 14 329 16 - 64 - Taken Formally Adulterated Takes Informally Adulterated Total Samples Analysed Total Samples Adulterated Brought forward 141 2 188 14 329 16 Pepper, white 0 0 1 0 1 0 Pickles 3 0 1 0 4 0 Pickled Lemons 0 0 1 0 1 0 Ravioli 1 0 0 0 1 0 Rye Bread 1 1 0 0 1 1 Salt, celery 1 0 0 0 1 0 ,, garlic 0 0 1 0 1 0 ,, onion 0 0 1 0 1 0 Sauce 1 0 2 0 3 0 Sauce, sweet 1 0 0 0 1 0 Sausages 1 0 2 1 3 1 Sausages, canned 1 0 0 0 1 0 Sausage, liver 1 0 0 0 1 0 Soft Drink, lemonade powder 1 0 0 0 1 0 Soup, bottled 1 0 0 0 1 0 Soup, canned 5 2 1 0 6 2 Soup cubes 0 0 1 0 1 0 Soup Powder 1 0 3 0 4 0 Soup tablet 0 0 1 0 1 0 Spirits: Brandy 1 0 0 0 1 0 Gin 1 0 0 0 1 0 Rum 2 0 0 0 2 0 Whisky 2 0 0 0 2 0 Spread, savoury 6 0 1 0 7 0 Spread, sweet 0 0 1 0 1 0 Stout 0 0 1 0 1 Sweet Corn 1 0 0 0 1 0 Sweetbread Paste 1 0 0 0 1 0 Tomatoes, canned 0 0 1 0 1 0 Tomato Juice 0 0 1 0 1 0 Tomato Juice Cocktail 0 0 1 0 1 0 Tomato Paste 1 1 3 2 4 3 Tomato Pulp 1 0 1 1 2 1 Vegetable Salad 1 0 0 0 1 0 Vegetarian Nut product 0 0 1 1 1 1 Vinegar 1 0 0 0 1 0 Welsh Rarebit 0 0 2 0 2 0 Drugss Cough Syrup 0 0 1 1 1 1 Cough Mixture 0 0 1 1 1 1 Liquorice Powder 0 0 1 0 1 0 Phenacetin and Caffiene Tabs. 0 0 10 1 0 Throat Tablets 0 0 1 0 1 0 TOTAL 178 6 222 21 400 27 - 65 - INFECTIOUS DISEASES NOTIFICATIONS. The following table shows the total (corrected) number of cases of Infectious Diseases received during the year. Disease Under 1 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 yrs. and over TOTALS  Dysentery 1 2 3 3 2 - - 11 Dysentery (Flexner) 1 - - - - - - 1 Dysentery (Sonne) 29 118 55 10 20 6 10 248 Erysipelas - - - - - 2 2 4 Food Poisoning - - - 1 1 6 15 23 Malaria - 1 - - - - - 1 Measles 32 285 213 9 8 1 1 549 Meningococcal Infection _ 2 1 1 _ _ — 4 Ophthalmia Neonatorum 2 _ _ - - — — 2 Paratyphoid Fever _ - 1 _ — _ — 1 Pneumonia: Ac. Influenzal - - - - 2 6 5 13 Ac. Primary - 2 3 1 4 3 3 16 Poliomyelitis: Paralytic — 1 — 1 — — — 2 Non-Paralytic - 1 - - 2 - — 3 Puerperal Pyrexia _ _ - 12 17 - - 29 Scabies - 2 6 3 8 - - 19 Scarlet Fever - 14 34 - 1 - - 49 Whooping Cough 16 159 80 1 1 - - 257 TOTALS 81 587 396 42 66 24 36 1,232 - 66 - SUMMARY OF NOTIFICATIONS OF INFECTIOUS DISEASES RECEIVED DURING THE YEARS 1949-1953 (inclusive) Disease 194-9 1950 1951 1952 1953 Average for five years  Diphtheria 1 - - - - 0.2 Dysentery 10 117 95 139 260 124 Erysipelas 9 6 7 5 4 6 Food Poisoning 6 122 13 10 23 35 Malaria - - 1 - 1 0.4 Measles 302 318 669 355 549 438 Paratyphoid Fever 1 1 3 1 1 1 Pneumonia: • Ac. Influenzal 20 17 16 - 13 13 Ac. Primary 10 8 5 16 16 11 Poliomyelitis: Paralytic 11 1 — 12 2 5 Non-Paralytic 3 2 1 2 3 2 Puerperal Pyrexia 1 10 7 67 29 23 Scabies 13 10 8 6 19 11 Scarlet Fever 37 55 29 61 49 46 Typhoid - - 1 - - 0.2 Whooping Cough 123 170 174 87 257 162 - 67 - DIPHTHERIA. It is most gratifying that for the fourth year in succession no cases of Diphtheria occurred amongs residents in the Borough, Notifications received and confirmed during 1948 and 1949 were 2 and 1 respectively, and only one death has occurred during the past fourteen years. Set out below are details of notifications of and deaths from Diphtheria from 1900 to 1950. 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 1949-1953 were 0.2 and Nil respectively. Immunisation 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. Details of services provided during the year will be found on the following page. - 68 - DIPHTHERIA IMMUNISATION This work has continued throughout the year, bub owing to the fact that poliomyelitis cases had increased somewhat, the London County Council applied restrictions in regard to Immunisation during the summer months, the period at which the incidence of poliomyelitis is at its greatest. During the week ending 19th July, 1952, 4 paralytic and 2 non-paralytic cases of poliomyelitis were notified, whilst in a comparable period in July 1953, the figures were 17 and 10 respectively for the London area. The following table gives information as to work carried out during the year in respect to children resident in the Borough:- A. No. of children who completed a full course of Primary Immunisation in the authority's area (including temporary residents AGE at date of final injection (as regards A) or of reinforcing injection (as regards B) Under 1 1 2 3 4 5 to 9 10 to 14 Total  128 164 67 14 14 74 - 461 B. No. of children who received a secondary (reinforcing) injection (i.e. subsequently to primary immunisation at an earlier age) - - - l 41 209 26 277 The Registrar-General has estimated the population of Chelsea to be as follows:- Under one year of age 790 Between one and four years of age 2,720 Between five and fourteen years of age 4.600 8,110 The percentage of the child population between the years 0 to 15 benefitting from Immunisation was approximately 51 as compared with 65 in 1952. The difficulties experienced as outlined above have undoubtedly greatly contributed to the falling-off in the numbers of children presenting themselves for this facility. - 69 - FOOD POISONING Twenty-three cases were notified as compared with 10 in 1952, and 13 in 1951. 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 2 1 20 23 Outbreaks (other than family outbreaks) due to identified agents:- Total Outbreaks 1 (Clostridium welchii) Total Cases: 20 Family Outbreaks due to identified agents:- NIL Outbreaks (other than family outbreaks) of undiscovered cause:- NIL Family Outbreaks of undiscovered cause:NIL Single Cases:— Agent identified: 2 Unknown causes: 1 (Salmonella typhi-murium 2) Total Cases: 3 - 70 - MEASLES Five hundred and forty-nine notifications of Measles were received in the Public Health Department during 1953, as compared with 355 and 669 in 1952 and 1951 respectively. POLIOMYELITIS Thirteen notifications of Poliomyelitis came to hand, only five of which were subsequently confirmed; three of the cases were of a nonparalytic type. In 1952 there were 14 confirmed cases, and in 1951 one confirmed case. SCARLET FEVER Forty-nine notifications of Scarlet Fever were received in the Public Health Department during 1953, as compared with 61 in 1952. DYSENTERY During 1953, two hundred and sixty notifications were submitted as compared with 139 in 1952 and 95 in 1951. It must be stressed that 80% of 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. - 71 - 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 eleven contacts who had travelled to addresses in the Borough, and all were given advice on the precautionary action they should take. The following table briefly sets out the incidence of this disease during the last fifty-four years. Notifications received Deaths  1900 2 1 1901 5 1 1902 38 7 1903 6 - 1904-1919 _ _ 1920 1 — 1921-1927 - - 1928 1 - 1929-1953 - - The annual averages of notifications received and the death rate for the period under rerview are, therefore, 0.98 and 0.16 respectively. There has been only one serious outbreak of Smallpox during the 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 follows:- CHELSEA 5.8 Kensington 6.4 Fulham 7.4 Paddington 9.2 Hammersmith 12.3 Westminster 18.5 County of London 20.6 - 72 - 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 1953 the Zymotic Death Rate for Chelsea was 0.03 per 1,000 of the population. In 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 1953 only two deaths occurred from a Zymotic disease (Diarrhoea), a total of two hundred and nineteen were recorded in 1900. The numbers of deaths at other periods during the past fifty-three years 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 - 73 - TUBERCULOSIS 134 cases of Pulmonary Tuberculosis were notified during the year. These were made up of 100 primary notifications, 26 "inward transfers", and 8 from other sources. There were also 10 non-pulmonary cases, of which 7 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 1963. PULMONARY NON -PULMONARY TOTAL CASES M. F. M. F. (a) Number of cases remaining on register at 1st January, 1953 205 197 6 21 429 (b) Number of new cases notified. 63 37 2 5 107 (c) Number of cases restored to register. 3 5 2 - 10 (d) Other cases added. 15 11 - 1 27 (e) Removals 49 49 3 4 105 (f) Cases remaining on Register at 31st December, 1953 237 201 7 23 468 - 74 - (A) NEW CASES OF TUBERCULOSIS 1953 (B) DEATHS FROM TUBERCULOSIS 1953 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 45 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 7 6 - 6 2 11 13 9 5 3 - 63 Pulmonary F - 4 3 3 1 3 5 7 8 3 - - - 37 Non- Pulmonary M - _ 1 - - - - 1 - - - - - 2 Non- Pulmonary F - - 1 - - 1 - 2 - - 1 - - 5 (B) DEATHS Pulmonary M - - - - - - - 2 1 - 1 1 1 6 Pulmonary F - - - - - - - - 1 2 - - 2 5 Non- Pulmonary M - - - - - - - - - - - - - Nil Non— Pulmonary F - - - - - - - - - - - - - Nil -75 - ANNUAL REPORT CHELSA TUBERCULOSIS DIPENSARY, BROMPTON HOSPITAL, S.W.3. 1950 1951 1952 1953  Population served by Dispensary 51,990 52,490 52,140 52,150 Number of notified cases in Borough at end of year 425 411 429 440 Number of these who have failed to attend at Dispensary during the year - - - 156 Total attendances during year 1,823 1,834 2,123 1,899 Total new patients seen 377 389 504 526 Number of these who were contacts 163 170 252 285 Number of contacts found to be tuberculous 1 1 7 18 Number of cases newly notified to Madical Officer of Health (i.e. excluding Inward transfers) 78 72 99 107 Number of cases diagnosed as tuberculous (for the first time) at the Dispensary during the year 21 24 25 39 Number of X-rays 1,137 1,301 1,373 1,464 Number of Patients who received refills during the year 29 47 35 20 Number of Patients who received "Special treatment" at home during the year 11 12 30 42 Number of Patients given B.C.G. 11 15 11 12 Number of home visits by medical staff. 14 31 48 53 Number of visits paid by Dispensary Nurse. 1,866 2,167 2,436 2,573 2,297 2,460 2,529 2,633 Number of visits paid by Dispensary Almoner 301 137 163 104 Number of Clinic Sessions per week. 2 2 2 2 Until September, 1953, Child contacts were frequently referred for supervision to the Children's Contact Investigation Department, Brompton Hospital; any necessary follow-up work was done by the Dispensary's Staff but figures relating to these attendances were not Included in this list, except for B.C.G. vaccinations. - 76 - MASS RADIOGRAPHY Throughout the year, vigorous efforts have been maintained in the fight against Tuberculosis, and in particular reference to Chelsea, the following campaigns were conducted:- (1) 15th to 18th September (inclusive) at St. John's Mission Hall, World's End. On request a special campaign was made in the World's End area. This was preceded by a house-to-house distribution of leaflets, and whilst the X-ray examinations were being made, a loud-speaker van toured the streets to publicise the facilities available. 621 persons submitted themselves for X-ray, of which 5 were found to have radiologically significant lesions, probably tuberculous and requiring investigation. All were referred to chest clinics. Those referred represented 0.8 per cent. of the total examined, and although the rate is generally 0.5 per cent. no special significance is attached to such a figure. (2) 21st September to 8th October (inclusive) Chenil Galleries. King's Road. 4,032 persons (1,897 men and 2,135 women) attended for x-ray examinations, as compared with 4,784 in 1952. However, if the attendance (621) at St. John's Mission Hall is added to that at Chenil Galleries (4.,032) the total is 4,653, or a "falling—off" of approximately 3 per cent as compared with that for 1952. 9 men and 12 women were found to have radiologically significant lesions, and they were referred to chest clinics. In addition 2 men and 2 women were found to have lesions probably of no clinical significance, and these were requested to submit for further examination at a later date. The rate of those so referred was 0.52 of the total; this represents the over-all rate of discovery of significant lesions in the south-western area of the metropolis. The Mobile X-Ray Unit visited several industrial premises, business houses, and an educational centre in the Borough. Arrangements are already in hand for a Mobile Unit to operate at Chenil Galleries next summer. I N D E X Subject Fage(s) Aged and Infirm Persons, Welfare of 5, 45 - 46 Analyst, Public - Report of 56 - 64 Atmospheric Pollution 16-17 Bacteriological Examinations 52 Births 5, 6, 8 - 10 Child Welfare 49 Committee, Publie Health and Baths: Members 1 Representation elsewhere by Members 2 Deaths 8 - 14 Diphtheria Immunisation 4-9, 68 Disinfection and Disinfestation 40 Factories Act, 1937 32 - 34 Food: Adulterated 56 - 64 Byelaws 50 Hygiene 7, 50 - 51 Poisoning 69 Unsound 55 Health Visiting 49 Hospitals 47 Housing 18-31 Ice Cream. 53, 58 Infant Mortality 6, 13 - 14 Infectious Diseases 65 - 75 Introduction 5-7 Legal Proceedings 35-36 Mass Radiography 76 Maternal Mortality 6, 8 - 10 Medical Examinations 39 Milk 54, 56, 59, 63 Mortuary, Public 39 National Assistance Act, 1948: Burials 37 - 38 "Park III" Accommodation 48 Nursing Homes 47 Outworkers 34 Overcrowding 25, 27, 28 Subject Page(s) "Part III" Accommodation 4-8 Pet Animals. 41 Population 5, 8, 10 Poisons, Sale of 4-2 Pollution, Atmospheric 16-17 Public Analyst, Report of 56-64 Radiography, Mass 76 Rag Flock 43 Rodent Control 44 Sanitaiy Inspectors, Work of 18-36 Spastics 15, 47 Staff of Public Health Department 3-4 Stillbirths 5, 8 Tuberculosis 8, 73-76 Vaccination. 49 Vital Statistics 8-10 Water Supply 24 Welfare Centre, Attendances at 49 Welfare of Aged and Infirm Persons 5, 45-46 Zymotic Diseases 72