4345 CHE 57 Metropolitan Borough of Chelsea Annual Report of the Medical Officer of Health J. H.WEIR, M.D., B.S., B.Hy., D.P.H. for the year 1959 - 1 - METROPOLITAN BOROUGH OF CHELSEA PUBLIC HEALTH AND BATHS COMMITTEE (at 31st December. 1959) Chairman: Councillor J.S. Tatton-Brown Vice-Chairman: Councillor J.A. Paterson-Morgan, F.L.A.S., M.R.S.H., J.P. Councillor Mrs. E.C. Blackett, M.A. " J. E. Brooks " Mrs. G.K. Buxton " J.C. Corder, F.R.I.C.S. " H. Denman Councillor Miss Aimee Gibbings " Mrs. C. Mallet " M. Nadin Alderman Miss M.D. Shufeldt Councillor A.H. Stevenson " Dr. L. Wills Ex-Officio Members The Worshipful the Mayor (Councillor Miss Katharine Acland, O.B.E., T.D., J.P.) The Deputy Mayor (Alderman R.A. Lygon, B.A.) - 2 - Representation by Members of the Public Health and Baths Committee on outside Committees and other Organisations concerned with Public Health work. (At 31st December 1959.) Chelsea Deanery Councillor Mrs. G.K. Buxton Moral Welfare Association: Chelsea Tuberculosis Councillor Mrs. G.K. Buxton Care Committee: London County Council Councillor Mrs. G.K. Buxton Divisional Health Committee (Division I): London County Council Councillor Mrs. G.K. Buxton Divisional Tuberculosis Care Committee (Division I); London and Home Counties Councillor J.S. Tatton-Brown Clean Air Advisory Council: National Society for Councillor Mrs. G.K. Buxton Clean Air: Councillor J.S. Tatton-Brown Old People's Welfare Councillor J.A. Paterson-Morgan Committee: Councillor J.S. Tatton-Brown - 3 - STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December. 1959. Medical Officer of Health: J.H. WEIR, M.D., B.S., B.Hy.,D.P.H. Deputy Medical Officer of Health: Hastings E.A. CARSON, M.D.,B.S., D.P.H. Chief Public Health Inspector: H. HOYLAND. Deputy Chief Public Health Inspector and Senior Housing Inspector: S.W. BARKER. Public Health Inspectors: H.F. LEACOCK. H.W. LUDLOW. A.J. WHITE. . E.R. YOUNG. Women Public Health Inspectors: (Miss)A.C.C. KAY. (Miss)K.G. READER. Drainage Assistant: E. BOSLEY. Rodent Officers: J.F. COOKE. P. DRURY. Public Health Inspectors' Assistant: F.G. RAWLINGSON. Chief Disinfector: L.H. BERRY. Disinfectors: F.W. HILL. R.J. WESTON. Cleansing Station Attendant: (Mrs.) J. LOBBAN. Chief Clerk: J.C. BRYANT. Clerical Officers: I.M. THOMSON. H.G. HAMILTON. L.A. POWELL. (Mrs.) W. BAAR. P.M. MARGETTS. P.D. GRAINGER. Social Worker: (Mrs.) O.M. BURKE. Public Analyst: Thos. McLACHLAN, A.C.G.F.C., F.R.I.C.,M.I.Biol. - 4 - METROPOLITAN BOROUGH OF CHELSEA TELEPHONE: Public Health Department, FLAxman 8101 Town Hall, King's Road, CHELSEA, S.W.3. July, 1960. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Chelsea. Your Worship, Ladies and Gentlemen, I have much pleasure in presenting my annual report on the health of the Borough for the year 1959. The Registrar-General estimated the population at 49,520, a decrease of 670 on last year, and so the downward trend which has been apparent since 1950 has steadily continued. The total number of live births recorded was 722 as compared with 742 in 1958, the comparative rates per 1,000 of the population being 14.6 and 14.8 respectively. When the "area comparability factor" is applied, the resultant current rate is 11.1. The number of deaths registered, namely 726, shows very little change from last year when it was 730. The death rate per 1,000 of the population was 14.7, which, after adjustment by the "area comparability factor" becomes 11.0. The "area comparability factor" is a means of making allowance for the differing age and sex distribution of different populations. After application of this factor, the corrected rate more accurately depicts the comparison with other areas. This was the fifth successive year in which none of the deaths recorded was associated with pregnancy or childbirth. Another pleasing factor was the sharp decline in infant mortality, the details of which can be seen in the body of the report. The number of infectious disease notifications received during the year was 613. This shows a significant increase on last year when the figure was 445, and was due to the usual biennial recurrence of measles. The position regarding food poisoning was most satisfactory, only five cases being reported during the year. The important question of accidents in the home came under review during the year. Section 82 of the London County Council (General Powers) Act, 1957, enables a local authority to disseminate information and advice on home safety matters, and reference is made in the body of this report to a Home Safety Campaign which was held in November, - 5 - to coincide with the period chosen by the London County Council for their general campaign throughout London. Under the provisions of the Clean Air Act, 1956, the Council's proposals for establishing its first smoke control area were submitted to the Minister of Housing and Local Government on the 19th November, The detailed surveying of properties in Church Ward and the preparation of estimated costs were carried out by members of the existing staff in the Public Health Department. Full technical details will be found on pages 54 to 57 . Mr. T. McLachlan, the Public Analyst, examined and reported upon four hundred samples of Food and Drugs which were submitted to him during the year by the sampling officers, and in fourteen instances (3½%) he reported that adulteration, labelling inaccuracies or misdescriptions had been found. In all these cases, thorough investigations were pursued to ensure that such offences did not recur. It was found necessary in two instances to resort to legal proceedings when the traders concerned were fined sums, inclusive of costs, of £13. 8s. 0d. and £23. 8s. 0d. respectively. A comprehensive account of the Public Analyst's work throughout the year is included in this report. The Public Health Inspectors have regularly inspected all food premises within the Borough and since the introduction of the Food Hygiene Regulations, 1955, considerable progress has been made in structural improvements in food shops and restaurants. Throughout the year special attention has been paid to the preparation rooms in shops where foodstuffs are weighed and packed for sale in self-service stores. In many cases requests have been made for additional washing facilities to be provided within or adjacent to preparation rooms, so that persons handling unwrapped foods can be encouraged to wash their hands after opening tins, packing cases, cartons, etc. In concluding my report I am pleased to have this opportunity to thank all Members of the Council, and particularly the Chairman and Members of the Public Health and Baths Committee, for their continued support, and I also acknowledge the co-operation and help I have received from the Chief Officers of other Departments. Finally, to all members of the Public Health Department I extend my grateful thanks for their loyalty and the conscientious manner in which they have carried out their duties during the year. I am, Your Worship, Ladies and Gentlemen, Your obedient Servant, Medical Officer of Health. - 6 - METROPOLITAN BOROUGH OF CHELSEA Annual Report of the Medical Officer of Health for the year 1959 Area of the Borough: 659.6 acres General Rate: 17s.8d. in the £ (at 31st March 1959) Product of a Penny Rate (gross) £7,458 Rateable value of Borough as at 31st March. 1959: £1,877,832 Population: Registrar-General's estimate of the population of the Borough (mid-year 1959) 49,520 Density of population per acre: 75.07 Live Births: Total Male Female Legitimate 630 340 290 Birth rate per 1,000 Illegitimate 92 54 38 of estimated 722 394 328 population: 14.6 Adjustment of birth rate by area comparability factor 11.1 Birth rate for England and Wales - 16.5 Still Births: Total Male Female Legitimate 4 1 3 Rate per 1,000 live Illegitimate 1 1 - and still births 6.9 5 2 3 Maternal Mortality: No deaths associated with pregnancy or childbirth have occurred among Chelsea residents since 1954. Deaths: Total Male Female 726 314 412 Death rate per 1,000 of estimated population 14.7 (males 6.3; females 8.3) Adjustment of death rate by area comparability factor 11.0 Death rate for England and Wales - 11.6 7 Annual Report of the Medical Officer of Health for the year 1959 (continued) Deaths and death rates of Infants under One year of age: Total Male Female 12 6 6 All infants per 1,000 live births 16.6 Legitimate infants per 1,000 legitimate live births 15.9 Illegitimate infants per 1,000 illegitimate live births 21.7 Deaths of Infants under four weeks of age: Total Male Female 9 4 5 Death rate of infants under four weeks of age per 1,000 live births 12.5 Tuberculosis: Deaths from Pulmonary Tuberculosis 3 Deaths from non-Pulmonary Tuberculosis Nil Death rate from Pulmonary Tuberculosis per 10,000 of estimated population 0.6 8 It will be seen that the illegitimate births number 92, representing 12.7 per cent of the total live births registered. These may be compared vith the statistics for London Administrative County and England and Wales, which are as follows:- Chelsea London England & Wales (in thousands) Year Births Illeg. % Births Illeg. % Births Illeg. % 1950 829 57 6.875 53,660 3,752 7.0 697 35 5.1 1951 819 53 6.475 52,387 3,597 6.9 677 32 4.8 1952 787 72 9.1 51,443 3,607 7.0 673 32 4.8 1953 787 61 7.75 50,992 3,645 7.1 684 32 4.7 1954 787 78 9.9 50,745 3,615 7.1 673 31 4.7 1955 745 71 9.5 49,826 3,827 7,7 667 31 4.7 1956 837 99 11.8 52,171 4,434 8.5 700 33 5.0 1957 738 105 14.3 52,733 4,686 8.9 723 34 4.7 1958 7 42 98 13.2 54,152 5,343 9.9 740 36 4.9 1959 722 92 12.7 Not yet available The infant mortality rate among illegitimate infants in Chelsea was 21.7, and compares as follows with the rates for London Administrative .County and England and Wales;- Chelsea London England & Wales Year I.M.R. Leg. M.R. Illeg. M.R. I.M.R. Leg. M.R. Illeg. M.R. I.M.R. Leg. M.R. Illeg. M.R. 1950 25.3 23.3 52.6 25.75 24.81 38.33 29.6 29.1 39.4 1951 23.2 23.5 19.0 25.45 24.74 35.03 29.7 29.2. 38.5 1952 20.3 16.8 55.5 23.06 22.30 33.27 27.6 27.2 34.9 1953 19.1 12.4 98.3 23.90 22.96 36.25 26.8 26.5 33.0 1954 26.6 22.6 64.1 20.63 19.86 30.71 25.4 25.1 32.0 1955 33.5 31.1 56.3 23.22 21.96 38.41 24.9 24.6 31.7 1956 25.1 23.0 40.4 21.20 20.89 24.58 23.7 23.5 28.7 1957 21.7 23.7 9.5 22.00 21.04 31.80 23.1 22.8 30.0 1958 32.3 31.1 40.8 22.00 22.07 26.39 23.5 22.0 28.0 1959 16.6 15.9 21.7 Not yet available 9 SUMMARY OF VITAL STATISTICS. 1947-1959 (inclusive) Year Registrar-General's Estimate of Population Births Dea ths Deaths under One Year Maternal Deaths No.¤ Rate No.¤ Rate No.¤ Rate No.¤ Rate 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 1954 52,060 787 15.1 734 14.1 21 27 2 2.5 1955 51,450 745 14.5 825 16.0 25 34 - - 1956 51,070 837 16.4 815 16.0 21 25 - - 1957 50,600 738 14.6 750 14.8 16 22 - - 1958 50,190 742 14.8 730 14.5 24 32 - - 1959 49,520 722 14.6 726 14.7 12 16 - - Averages for the thirteen years 1947-1959:- Births 801 Deaths 697 Deaths under one year of age 22.4 Maternal Deaths 0.38 * Totals arrived at after due allowance for inward and outward transfers. 10 DEATHS OF RESIDENT DURING 1959 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 3 - - - - - 1 2 2. Tuberculosis, other - - - - - - - - 3. Syphilitic disease 1 - - - - - 1 - 4. Diphtheria - - - - - - - — 5. Whooping Cough - - - - - - - - 6. Meningococcal infections - - - - - - - - 7. Acute Poliomyelitis _ - - - - - - - 3. Measles - - - — — — — — 9. Other infective and parasitic diseases 1 - - - - - - 1 10. Malignantneoplasm stomach 11 - - - - - 3 3 11. Malignant neoplasm lung, bronchus 36 - _ - - 3 16 17 12. Malignant neoplasn breast 16 - _ _ _ 1 6 9 13. Malignant neoplasm uterus 5 - _ - - 2 1 2 14. Other malignant and lymphatic neoplasms 59 - - - 1 4 16 38 15. Leukaemia and Aleukaemia 6 - - - 1 - 1 4 16. Diabetes 1 - - - - - - 1 17. Vascular lesions of nervous system 81 - - - - 1 11 69 18. Coronary disease, angina 103 - - - - 1 25 77 19. Hypertension with heart disease 16 - - - - - 2 14 20. Other heart diseases 100 - - - - 4 6 90 21. Other circulatory diseases 59 - - - 1 1 7 50 22. Influenza 22 - - - - - 3 19 23. Pneumonia 67 3 - - - 1 9 54 24. Bronchitis 30 — — — — - 9 21 Carried forward 617 3 - - 3 18 117 476 11 DEATHS OF RESIDENTS DURING 1959 (Continued) 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 Carried forward 617 3 - - 3 18 117 476 25. Other diseases of respiratorysystem 5 - - - - - - 5 26. Ulcer of stomach and duodenum 6 - - - - - 1 5 27. Gastritis, enteritis and diarrhoea 2 - - - - - - 2 28. Nephritis and nephrosis 4 - _ - - 1 - 3 29. Hyperplasia of prostate 4 - - mm - - — 4 30. Pregnancy, childbirth, abortion - - - - - - - - 31. Congenital malformations 10 2 1 2 1 1 2 1 32. Other defined and ill-defined diseases 46 7 1 - - 1 7 30 33. Motor vehicle accidents 5 _ - - - 1 2 2 34. All other accidents 17 - - - 1 3 - 13 35. Suicide 9 - - - 2 2 5 - 36. Homicide 1 - - - - 1 - - TOTALS 726 12 2 2 7 28 134 541 Consideration of the following table clearly indicates the increase in longevity of residents during the first half of this century. Year No. of Deaths Deaths under 1 yr. of age Percentage of Total deaths Deaths at 65 years and over Percentage of Total deaths 19 00 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 1954 734 21 2.86 547 74.52 1955 825 25 3.03 617 74.78 1956 815 21 2.58 643 78.89 1957 750 16 2.13 575 76.66 1958 730 24 3.28 544 74.52 1959 726 12 1.65 541 74.52 12 ANALYSIS OF DEATHS The percentages of the total deaths attributable to particular causes during the past four years are set out below. The figures in parentheses are to be read in association with those appearing in the main table of deaths shown on the preceding pages. Coding PERCENTAGE 1955 1956 1957 1958 1959 Average for 5 years (1) 0.97 0.12 0.27 0.55 0.41 0.46 (2) 0.12 - - 0.14 - 0.05 (3) 0.48 0.49 0.40 0.27 0.14 0.36 (4) — - - - — — (5) - - - - - - (6) - - 0.13 - - 0.03 (7) 0.24 - - - - 0.05 (8) — — 0.13 0.14 - 0.05 (9) 0.36 0.12 0.40 0.27 0.14 0.26 (10) 1.94 2.21 2.27 2.88 1.51 2.16 (11) 3.51 3.81 2.93 3.84 4.94 3.81 (12) 1.57 2.60 1.73 2.46 2.20 2.11 (13) 0.61 0.86 1.07 0.41 0.69 0.73 (14) 10.93 9.96 9.07 9.04 8.13 9.43 (15) 0.36 0.61 0.40 0.28 0.83 0.50 (16) 0.97 0.73 0.27 0.96 0.14 0.61 (17) 11.88 13.41 14.52 13.42 11.16 12.83 (18) 11.64 10.60 9.73 12.20 14.19 11.67 (19) 1.94 2.21 2.80 2.05 2.20 2.24 (20) 12.73 14.51 15.20 12.60 13.77 13.76 (21) 10.10 8.36 10.13 6.85 8.13 8.71 (22) 0.24 - 0.93 0.96 3.03 1.03 (23) 6.42 7.75 7.20 5.07 9.23 7.13 (24) 4.61 4.80 4.93 6.44 4.13 4.98 (25) 0.40 1.23 0.80 0.82 0.69 0.79 (26) 1.60 1.35 1.07 0.96 0.83 1.16 (27) 0.73 - 0.53 0.41 0.28 0.39 (28) 0.97 0.37 0.70 0.41 0.55 0.60 (29) 0.40 0.61 0.40 0.41 0.55 0.47 (30) - - - - - - (31) 0.73 0.86 0.80 0.96 1.38 0.95 (32) 8.85 9.47 6.80 10.00 6.34 8.29 (33) 1.21 0.61 0.93 0.82 0.69 0.85 (34) 2.30 1.48 1.87 2.19 2.34 2.04 (35) 1.21 0.86 1.50 2.19 1.24 1.40 (36) – 0.24 0.13 - 0.14 0.10 - 13 - CANCER OF THE LUNG AND BRONCHUS Thirty-six deaths (Males 31 and Females 5) from this cause were recorded as compared with twenty-eight (Males 22 and Females 6) in 1958. The following table briefly gives details of the deaths of Chelsea residents during the years 1950 to 1959 (inclusive):- Year Males Females Totals Percentage of Deaths Registered 1950 18 4 22 3.4 1951 16 — 16 2.3 1952 27 6 33 5.0 1953 16 4 20 2.9 1954 20 7 27 3.7 1955 21 8 29 3.5 1956 25 6 31 3.8 1957 16 6 22 2.9 1958 22 6 28 4.0 1959 31 5 36 4.9 Averages 21.2 5.2 26.4 3.6 Over the period shown above 80.3% of the deaths were in respect of males, whilst 19.75% concerned females, i.e. 4 Males to 1 Female. However, the real significance of the increase for the country as a whole can be properly gauged from the following summary of deaths during each year from 1950 until the present times- Year England and Wales Cancer of the Lung and Bronchus Number of Deaths Registered Increase over preceding year 1950 12,241 1,266 1951 13,247 1,006 1952 14,218 971 1953 15,132 914 1954 16,331 1,119 1955 17,271 940 1956 18,185 914 1957 19,118 933 1958 19,809 691 1959 21,063 1,254 14 INFANT MORTALITY It will be seen when compared with 1958 that the number of deaths under this heading has exactly halved, and of this total seventy-five per cent had not attained the age of four weeks. Mortality was attributed to the following causes:- Males Females Broncho Pneumonia 1 2 Asphyxia 1 1 Hyaline Membrane Disease 1 1 Prematurity - 2 Atelectasis 1 - Cerebral Thrombosis 1 - Meningitis 1 - During the ten years 1925 to 1934, 465 infants under the age of one year died, thus giving an annual average of 46.5 for that period. In the years 1950 to 1959, deaths aggregated 190, or an annual average of 19. The sharp fall in the number of deaths under this particular heading was due mainly to the fact that only two instances of prematurity were recorded during the year as compared with nine in 1958. It will be noted that fifty per cent of the total deaths recorded occurred before the age of one week, and in fact none in the period of six months to a year. The actual periods at which mortality was recorded are as follows :- Under 1 week Under 4 weeks 4 weeks to 3 months 3 to 6 months 6 to 12 months Total under 1 year Males 3 1 1 1 — 6 Females 3 2 1 - 6 6 3 2 1 - 12 15 INFANT MORTALITY RATES ENGLAND AND WALES AND VARIOUS OTHER COUNTRIES Deaths under 1 year of age per 1,000 live births. Country 1952 1953 1954 1955 1956 1957 1958 Average for 7 years England & Wales 28 27 25 35 24 23 22 26.3 Sweden 20 19 19 17 17 17 15 17.7 New Zealand 22 20 22 22 19 20 19 20.6 Netherlands 23 22 21 20 19 17 17 19.8 Australia 24 23 22 22 22 21 20 22.0 Denmark 29 27 27 25 25 23 22 25.4 United States of America 29 28 27 27 26 26 27 27.1 Scotland 35 38 31 30 28 29 28 31.3 Republic of Eire 41 39 38 37 36 33 35 37.0 France 46 42 41 39 36 34 31 38.4 Italy 64 59 53 49 48 50 48 53.0 The above table has been prepared from information made available by the Registrar-General. - 16 - HOSPITALS AND NURSING HOMES Excellent facilities for both general and special hospital treatment are available in the Borough, as will be seen from the following lists:- HOSPITALS Brompton Hospital, Fulham Road, S.W.3. Chelsea Hospital for Women, Dovehouse Street, S.W.3. Granard House, 98, Dovehouse Street, S.W.3. (Part of Royal Marsden Hospital) Royal Marsden Hospital, Fulham Road, S.W.3. Royal Hospital, Royal Hospital Road, S.W.3. St. Luke's Hospital, Sydney Street, S.W.3. St. Stephen's Hospital, Fulham Road, S.W.10. Victoria Hospital for Children, Tite Street, S.W.3. TYPE OF INSTITUTION Chest Diseases General Malignant Diseases Malignant Diseases Home for Pensioners Chronic Sick General Children's Diseases NURSING HOMES Belgravia-Chelsea Nursing Home, 39, Royal Avenue, S.W.3. Private - 17 - MATERNITY. CHILD WELFARE AND OTHER SERVICES The London County Council is responsible for the day-to-day administration of these services, with the assistance of the Medical Officers of Health for the Boroughs of Chelsea, Fulham, Hammersmith and Kensington. Division 1 of the County Council comprises the above Boroughs, and Dr. B.E.A. Sharpe, Divisional Medical Officer, has kindly supplied the following information relating to Chelsea:- WELFARE CENTRES Attendances at Ante-natal and Post-natal Sessions 1,457 Attendances at Infant Welfare Sessions 7,642 HEALTH VISITING Number of visits carried out by Health Visitors:- Expectant mothers: First Visits 228 Total Visits 581 Children under First Visits (including 1 year:- visits paid to Premature Infants) 577 Total Visits 2,397 Children between 1 and 2 years: Total Visits 1,322 Children between 2 and 5 years: Total Visits . 2,192 Still Births: Total Visits 11 School Children: Total Visits 80 Care of Old People: Total Visits 10 Care of Other Peoples Total Visits 10 Miscellaneous: Total Visits 470 Unsuccessful: Total Visits 1,239 No. of children under 5 visited during the year 1,422 No. of households visited during the year 1,352 Foster Mothers: Number of registered foster mothers Nil Number of children fostered Nil - 18 - MATERNITY, CHILD WELFARE & OTHER SERVICES (Continued) Diphtheria Immunisations Number of children who completed a primary course of injections 538 Number of children who completed reinforcing injections 516 Vaccination: Number of children vaccinated at Violet Melchett Infant Welfare Centre 423 Details of the facilities available at the Violet Melchett Infant Welfare Centre, Flood Street, S.W.3., are as follows:- CLINICS Ante-natal & Post-natal: Monday p.m. and Friday a.m. (by appointment) Relaxation & Ante-natal Exercises: Wednesday: 12 noon to 1 p.m. Friday: 2 p.m. to 3 p.m. Mothercraft Classes with Demonstrations & Films: Friday at 3 p.m. Infant Welfare: Tuesday & Thursdays 2 to 4 p.m. Wednesdays 10.30 a.m. to 12 noon, at the Community Centre. 358, King's Road. S.W.10. Test Feeds arranged as required. Vaccination against Smallpox Wednesday at 10.30 a.m. by appointment. Immunisation against Diphtheria, Whooping Cough and Tetanus: Tuesday at 10 a.m. Special Toddlers By appointment on the first Thursday in each month. Dental Clinic (for children only) Monday 9.30 a.m. (by appointment) - 19 - MATERNITY. CHILD WELFARE & OTHER SERVICES (Continued) Health Visitors are available at the Centre for interview daily from 9 a.m. to 10.15 a.m. and from 4.30 p.m. to 5 p.m. and during these times may be contacted by telephone (FLAxman 8387). A Welfare Foods Department, whereat National Dried Milk, Orange Juice and Cod Liver Oil may be obtained functions at the above Centre from 1.30 p.m. to 4.45 p.m. (Monday to Friday); closed on Saturday. "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 great need thereof, being need arising in circumstances which could not reasonably have been foreseen, or in such circumstances as the authority may in any particular case determine. One institution - "King's Mead", Dovehouse Street is maintained by the London County Council in the Borough as "Part III" accommodation, and they are, in this particular respect, "the local authority". It was considered essential to arrange for the reception of 7 persons in such accommodation during 1959, and in all cases admissions were made At "King's Mead". Recourse to legal action was, happily, only necessary in one instance to enforce removal to hospital as indicated in Section 47 of the Act, as amended by the National Assistance (Amendment) Act,1951. However, in a small number of the cases concerned, transfers were only effected after considerable persuasion. The London County Council assumes responsibility for the safe custody of the belongings of persons accommodated, thus removing any grounds for anxiety. Reasonable notice is always given to the County authorities of impending removals. 20 WELFARE OF OLD PEOPLE The investigation of the circumstances and living conditions of each aged person, brought to their notice is undertaken by the Borough Council's officers. Every effort is made to ensure their well-being, with due appreciation of the fact that in most instances they prefer to remain in familiar surroundings,, The importance of regular visiting is fully realised, and greatly appreciated by the beneficiaries. At the close of the year 1,147 persons were on the registers of the Public Health Department,, The Borough Council makes a grant of £450 yearly to the Chelsea Old People's Welfare Committee, which is representative of and coordinates the activities of voluntary organisations working in this sphere of public service. It is obviously impossible to refer to all the facilities offered, but the following list illustrates the variety of assistance available for the well-being of those in needs- Provision of Hot Meals. This service is efficiently administered by the Women's Voluntary Services from Monday to Friday in each week. During the year 13,048 meals were delivered, or an average weekly supply of 250. In 1958 the respective figures were 13,474 and 259. The receipt of hot meals at a regular hour was welcomed by all concerned. Chiropody. 157 persons were recommended for this service provided by two qualified chiropodists, and the number of treatments given totalled 500. During the year a clinic was opened entirely for the use of old age pensioners at the Chelsea Community Centre. It is staffed by students from the London County Council's main chiropody clinic in Chelsea. This clinic is very popular and during the year 209 persons were treated, receiving 1,038 treatments. Holidays. The continuance of this scheme provided 96 persons with holidays at the sea or in the country. The majority stayed at homes controlled by the Women's Holiday Fund, whilst others stayed for one or two weeks at the Lloyd Thomas Home of Rest at Highgate. In some instances, transport was provided to convey people to and from holiday centres, and quite frequently escorts travelled to and from railway stations,, Married couples were accommodated at various seaside resorts early or late in the summer at special reduced rates for pensioners offered by the Hotel and Boarding Associations. Library and Shopping Facilities-continued to be maintained by the British Red Cross Society, and the weekly visits by their officers are eagerly awaited by those who are housebound by their disabilities. The Society also provides escorts, when necessary, to accompany persons attending hospital for treatment. Shopping facilities are provided by the Women's Voluntary Services. 21 Difficulty in securing hospital accommodation for the chronic sick continues, but happy relationships have been maintained between the Council's officers and hospital authorities from whom willing co-operation and assistance has been received. It is pleasing to record that the patient efforts of hospital rehabilitation departments have resulted in many people being able to resume normal home life. Institutional care became necessary for 7 persons, all of whom settled down quite readily to a communal life. The Women's Voluntary Services and other kind donors have continued to distribute much needed clothing to recommended cases, and 241 persons were so helped in this manner during the year as compared with 266 in 1958. The National Assistance Board also gives every sympathy to persons in distress, and makes grants which ensure the securing of essential items. Many people were found to be in enfeebled conditions, and unable to care for themselves. Personal cleansing was arranged and at the same time their rooms were cleansed and superfluous items disposed of. A laundry service has been inaugurated by the Council with the valued co-operation of Fulham Borough Council. Soiled linen is collected twice weekly from the homes of incontinent persons, and delivered to Fulham's Disinfecting Station where it is laundered and later collected for return to those using the scheme. During the year the service was provided for 19 persons, and some 3,967 pounds of bedding, etc., were laundered. Christmas Dinners. Through the kindness of voluntary subscribers and a working committee, sufficient funds were secured to provide 500 housebound and lonely old folk with a two-course Xmas dinner, a miniature bottle of brandy, sweets, biscuits, and "a shilling for the, gas". The entire distribution was carried out on Christmas Eve. The Council's Social Worker made 1,494 visits to cases on the Council's registers. In a number of cases visits were made to people whilst they were in hospital. Many visits were of a protracted nature, often necessitating further enquiries, investigation or negotiations which cannot be adequately represented in a statistical statement. Old Time Dancing Classes were held on one afternoon each week with the services of a fully qualified teacher and pianist supplied and paid for by the London County Council. A fee of l/6d per term is paid by each old person who attends. Membership of the class has now reached 62 and all members say that they look forward to this one afternoon when they can thoroughly enjoy themselves and at the same time derive great benefit from dancing. Outings. During the year outings were arranged to the country through the kindness of various Women's Institutes and the Chelsea Rotarians. These outings catered for 30 to 60 old people and were 22 confined to non-club members. Every effort is made by the Welfare Officer to ensure that only the lonely or those who seldom go out are invited, and on all these occasions tea and entertainment is provided. A PROPOSED DAY HOSPITAL FOR THE CHRONIC AND ELDERLY SICK. A gift of £25,000 from the King Edward's Hospital Fund for London has enabled the South West Metropolitan Regional Hospital Board and the Chelsea Group Hospital Management Committee to undertake the construction of a Day Hospital for the chronic and elderly sick. It is proposed that this new building will be erected within the grounds of St. Luke's Hospital. The objects of this new centre will be to shorten the stay and facilitate the discharge of the elderly and chronic sick from general and geriatric hospitals, and to give the patients in this category the opportunity of remaining at home for as long as possible. The hospital will be suitable for patients who require prolonged physical treatment but who eventually become fit enough to discharge. It will also be of great value to those who will never be in the position of managing fully without hospital supervision but who could be discharged provided they received treatment and care during the day. 23 ACCIDENTS IN THE HOME - HOME SAFETY CAMPAIGN At their meeting on the 16th June, 1959, the Public Health and Baths Committee deputed three members to consider as to the possible action which the Council could take to initiate home safety propaganda with an estimate of the cost involved. The Deputed Members reported back to the Committee that in their opinion a Chelsea Home Safety Campaign under the direction of the Medical Officer of health should be held during November, and it was suggested that this should coincide with the period chosen by the London Country Council (2nd to 8th November) for their general campaign throughout London. They were also of the opinion that the leaflet "Household Code" produced by the Kensington Borough Council would, with a few minor amendments, be the best vehicle for the dissemination of information. This action was approved by the Council at its meeting on the 29th July, and arrangements were made for the printing of 20,000 leaflets of "The Household Code" at a cost of approximately £62. 0. 0d. In addition, 10,000 bookmarks of a varied nature, 100 various coloured posters and between eleven and twelve thousand instructive pamphlets, brochures and leaflets were secured free of charge from the London County Council. Distribution of literature was mainly carried out by members of the Public Health Department and the staff of the Public Library gave valuable assistance by issuing bookmarks to borrowers. In addition, managing agents of large blocks of flats and dwellings were most cooperative in complying with requests that their maintenance staffs assist in the distribution of literature. As far as possible, distribution was carried out during the last two weeks of October to ensure the fullest possible publicity immediately prior to the London County Council's general campaign. It is to be hoped that this concentrated campaign will have resulted in householders becoming more conscious of their responsibility to make greater efforts to remove the causes of accidents in the home. 24 BOROUGH CREMATION SERVICE The Borough Council, in October 1957, entered into an agreement with the General Cemetery Company whereby a reduced standard charge of four guineas would apply for each Chelsea resident in respect of whom cremation was carried out at the Kensal Green Crematorium. During the past year these arrangements were made for twenty-four persons. In Great Britain the total number of cremations recorded last year was 190,819, an increase of over 10,000 in the figure for 1958. The total for 1959 represented 32.30% of the recorded deaths as compared with 30.58% for the preceding year. It will be seen from the following table that since 1952 the number of crematoria established in the country has more than doubled. The last few years also show a steady increase in the percentage of the total deaths cremated. The Progress of Cremation in Great Britain Year No. of Crematoria No. of Cremations Percentage of Deaths 1946 58 50,160 8.90 1947 58 61,160 10.47 1948 58 64,290 12.10 1949 58 79,607 13.86 1950 58 89,557 15.63 1951 59 107,161 17.43 1952 63 107,699 19.27 1953 68 116,728 20.76 1954 74 125,521 22.29 1955 82 141,353 24.37 1956 99 153,238 26.27 1957 108 163,358 28.36 1958 120 180,075 30.58 1959 131 190,819 32.30 25 SPASTIC CHILDREN A treatment centre for spastic children was established in 1955 at 61, Cheyne Walk, under the authority of the No. 4 (Chelsea) Group Hospital Management Committee. The Centre is continuing to widen its activities and through the past year has received patients from as far afield as Turkey, Portugal and Spain. The pattern of examination and investigation has remained much the same as in 1958 with audiometric and ophthalmological examinations being carried out on every patient. The number of cases examined has now reached three hundred and the current number of children attending regularly is sixty-seven, of whom thirty-two attend daily either in the two classrooms or an assessment class. The Medical Committee is now developing research work and for the last eighteen months a sub-committee has met and evolved some research schemes, many of which are now in hand. This year a spacious schoolroom has been erected for the senior children, and by arrangement with the education authorities concerned the upper age limit of the children in class has been raised to seven years. The hostel has continued to prove a very considerable asset to the work of the Centre. Six children can be accommodated weekly from Monday to Friday, and in addition a mother and child can be lodged there for a fortnight's treatment, training and advice. 26 MEDICAL EXAMINATIONS Thirty-seven prospective members of the staff were examined to determine their fitness to enter the Council's service and superannuation scheme, and two medical examinations were carried out on behalf of other local authorities, making a total of thirty-nine for the year. NATIONAL ASSISTANCE ACT. 1948. Section 50 of the National Assistance Act, 1948, places responsibility upon a local authority to arrange the burial or cremation of any person in respect of whom no other suitable arrangements can be made. The Borough Council does not, however, arrange for cremations to be carried out. In some instances it has not always been possible to trace any surviving relatives, although every possible line of enquiry has been fully pursued, but there is always the possibility that a member of the deceased's family might ultimately be contacted and who would not express approval to cremation having been performed. During the year it was necessary to arrange four interments as follows:- (Aged) Males Females 81 Years 75 Years 42 " 55 " 27 MASS RADIOGRAPHY A Mobile Unit of the South West London Mass X-Ray Service visited the Chenil Galleries, King's Road, from 9th to 21st April, 1959. During this visit 4,233 people were x-rayed, of whom seven were referred with radiological abnormalities suggestive of clinically significant tuberculosis, and a further seven were referred with radiological abnormalities suggestive of neoplasm requiring further study. Included in the above total were 350 men in the over 45 age group who are participating in the six-monthly service for the detection of lung cancer. During November, a Mobile Unit made the annual visit to the Chelsea Polytechnic in Manresa Road. The Mass X-Ray Centre at the Western Hospital, Seagrave Road, Fulham, S.W.6. is open, without appointment, every Wednesday between 2.0 p.m. - 4.0 p.m., and 5.0 p.m. - 7.0 p.m., and is used by many Chelsea residents. PUBLIC MORTUARY FACILITIES. A public mortuary has not been in existence within the Borough for some years. An agreement has been effected with the Hammersmith Borough Council whereby excellent facilities are available at their mortuary in Fulham Palace Road. During 1959, one hundred and ninety-five post-mortems were carried out in respect of Chelsea residents. 28 SANITARY ADMINISTRATION OF THE BOROUGH SUMMARY OF THE WORK PERFORMED BY THE PUBLIC HEALTH INSPECTORS DURING THE YEAR 1959. Number of complaints received during the year 821 INSPECTIONS AND RE-VISITS. DWELLINGS. Inspections after complaints 2,430 Inspections after infectious disease 813 House-to-House inspections 438 Underground Rooms 155 Overcrowding and "Permitted Numbers" 126 Other Visits 42 4,011 FOOD PREMISES: Butchers 281 Fishmongers and Fish Friers 77 General Provision Shops 21 Dairies 161 Ice Cream Vendors 230 Ice Cream Manufacturers 9 Bakehouses 48 Street Stalls and Barrows 80 Food Factories (Mechanical) 14 Food Factories (Non-mechanical) 1 Hotels, Restaurants and Dining Rooms 1,065 Premises in connection with unsound food 154 Premises in connection with food sampling 206 Other food premises 158 2,505 FACTORIES AND OUTWORKERS: Factories other than Food Factories (Mechanical) 294 Factories other than Food Factories (Non-mechanical) 115 Outworkers 26 435 DRAINAGE: Drains tested: (a) by water 657 (b) by smoke 103 (c) by air 130 890 Carried forward 7,841 29 SANITARY ADMINISTRATION OF THE BOROUGH SUMMARY OF THE WORK PERFORMED BY THE PUBLIC HEALTH INSPECTORS DURING THE YEAR 1959 Brought forward 7,841 INSPECTIONS AND RE-VISITS (Continued) MISCELLANEOUS: Animals, Poultry and Birds 14 Open spaces and highways 70 Office Premises 8 Premises re Pharmacy and Poisons 13 Premises to enforce requirements of Shops Act 331 Premises re Voluntary Works 5,330 Visits to owners, agents and builders' offices 210 Smoke Observations 216 Food Poisoning 5 Visits to aged infirm persons 55 Premises under Pet Animals Act, 1951 7 Atmospheric Pollution Recording 263 Visits resulting in "No Access" 826 Other visits 1,196 Clean Air 2,721 Premises under Rag Flock Act, 1950 9 Inspections after infectious disease other than dwellings 56 11,330 19,171 30 WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS FACTORIES ACT, 1937 HOUSING ACT, 1957 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1955 TOTAL CLEANSING: N. V. N. V. N. V. N. V. Rooms: Walls & Ceilings cleansed and redecorated 6 — 6 — 4 — — 1 17 Passages & Staircases: Walls & Ceilings cleansed & redecorated — — — — — — 5 1 6 Yard & Area Walls cleansed & colourwashed — — — — — — 1 — 1 Rooms where Food is manufactured, stored or sold — — — — — — 63 19 82 Miscellaneous — — — — — — 1 — 1 GENERAL IMPROVEMENTS AND REPAIRS: Roofs 1 — 1 — 50 1 — — 53 Eaves, Gutters — — 1 — 22 — — — 23 Rain-water pipes — — — — 12 — — — 12 Yard and Area: Pavings — — 1 — 5 _ — — 6 Walls rendered or repaired — — 1 — 19 — — — 20 Rooms: Wall & Ceiling plaster 3 — 3 — 108 — 5 1 120 Passages & Staircases: Wall & Ceiling plaster — — 3 — 17 _ _ — 20 Floors 1 — — — 22 1 12 2 38 Stair Treads, Banisters & Balustrades 1 — — 26 _ _ _ 27 Window & Door Frames, fittings & sash cords 1 — 12 — 200 3 — — 216 Dampness remedied 1 — 1 — 174 — — — 176 Fireplaces & Fire-ranges repaired — — 2 — 28 — — — 30 Natural Ventilation provided or improved 5 — 1 — 1 1 2 — 10 Chimneys & Flues — — 1 — 2 — — — 3 Natural Lighting provided or improved 2 — — — — — 1 — 3 Miscellaneous — — — — 28 — — — 28 Carried forward 21 33 718 6 90 24 892 31 WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS (Continued) FACTORIES ACT, 1937 HOUSING ACT, 1957 PUBLIC HEALTH (LONDON) ACT, 1936 FOOD & DRUGS ACT, 1955 TOTAL Brought forward N. V. N. V. N. V. No V . 21 — 33 — 718 6 90 24 892 DRAINAGES Total Reconstructions — — — — — 12 — — 12 Partial Reconstructions, repairs or alterations — — — — — 8 — — 8 Frontage Drains Reconstructed — — — — 9 3 — — 12 Obstructions cleared — 1 — — 35 — — — 50 Inspection Chambers provided — 1 — — — 34 — — 35 Inspection Chamber covers renewed — — — — 5 — — — 5 Interceptors provided — — — — 1 15 — — 16 Soil & Ventilation Stacks provided or reconstructed — — — — 1 59 — 1 61 Soil & Ventilation Stacks repaired — — — — 4 1 — — 5 Waste & Ventilation Stacks provided or reconstructed — — — — 1 60 — — 61 Waste & Ventilation Stacks repaired — — — — 1 — — — 1 Fresh Air Inlets provided — — — — — 19 — — 19 Fresh Air Inlets repaired or renewed — — — — 7 2 2 — 11 Single Sinks provided — 3 — — — 214 4 12 233 Single Sinks renewed — — — — 5 1 3 — 9 Double Sinks provided — — — — — — — 2 2 Baths provided — — — — — 223 — — 223 Wash-hand basins provided — 4 — — — 254 3 5 266 Wash-hand basins renewed — — — — — 3 — — 3 Waste Pipes cleared of obstructions or repaired — — — — 1 — — — 1 Untrapped waste pipes provided with traps — — — — 1 — — — 1 Miscellaneous — 2 — — 13 5 3 — 23 Carried forward 21 11 33 — 802 933 105 44 1949 - 32 - WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS (Continued) FACTORIES ACT, 1937. HOUSING ACT, 1957. PUBLIC HEALTH (LONDON) ACT, 1936. FOOD & DRUGS ACT, 1955. TOTAL. Brought forward N. V. N. V. N. V. N. V. 1949 21 11 33 — 802 933 105 44 SANITARY CONVENIENCES Additional Water Closets provided - 5 - - 4 257 - 5 271 Water Closet pans renewed — - - — 2 2 1 — 5 Water Closet pans cleansed - - - - — - 1 - 1 Water Waste preventers renewed or repaired - - - - 8 1 - _ 9 Water Waste preventers provided - 5 - - 4 257 - 5 271 Urinals repaired 1 2 — — — - - - 3 Roofs repaired or renewed 1 - - - 2 - - _ 3 Floors repaired or renewed - — - - - - 1 - 1 Walls & Ceiling plaster cleansed, repaired or redecorated 9 - 1 - 18 - 14 2 44 Natural Ventilation provided or improved 3 - - - - - - _ 3 Natural or Articifial Light provided or improved 6 1 - - - - 1 - 8 Ventilated Lobby provided — — _ — — — 5 - 5 Miscellaneous 4 - 1 - 11 - - - 16 WATER SUPPLY: Supplies provided to Tenaments - - 1 - 1 - - - 2 Taps supplied on main for drinking purposes - - 1 - - - - - 1 Burst Pipes repaired - — — — 7 - - - 7 Cisterns cleansed,covered or repaired — - - - 1 1 - - 2 Carried forward 45 24 37 - 860 1451 128 56 2601 - 33 - WORKS SUPERVISED BY THE PUBLIC HEALTH INSPECTORS (Continued) FACTORIES ACT, 1937. HOUSING ACT, 1957 PUBLIC HEALTH . (LONDON) ACT, 1936. FOOD & DRUGS ACT, 1955. TOTAL Brought forverd N. V. N. V. N. V. N. V. 2601 45 24 37 - 860 1451 128 56 MISCELLANEOUS SERVICES PROVIDED: Heating - - - - - — — 1 1 Soap & Towels for staff - - - - - - 2 - 2 Staff Rest & Changing rooms - — — — _ — 1 4 5 Constant Hot Water — — _ — — _ 15 4 19 Bins, refuse - - - - 13 2 - - 15 Covered Display & Counter Screens provided — — — — — — 2 2 4 MISCELLANEOUS NUISANCES ABATED. ARISING FROM: Offensive accumulations on open land & boob sites - - - - 11 1 - - 12 GRAND TOTALS 45 24 37 — 884 1454 148 67 2659 N = Work carried out under Notice. V = Voluntary Works. - 34 - INSPECTIONS. PROCEEDINGS. ETC. Total number of houses in the Borough 16,245 (approx.) PUBLIC HEALTH (LONDON) ACT, 1936, Number of houses inspected on account of complaints or illness 1,302 Number of statutory notices served 36 Number of intimation notices served 146 Number of houses repaired or nuisances remedied 202 WATER SUPPLY. The provision of water for both commercial and domestic users is made by the Metropolitan Water Board. During the year two complaints regarding the unsatisfactory condition of the water supply were received. Both complaints were referred to the Water Board and in the first instance the owners of the property were advised to clean the water fittings within the flat, in order that any fears that the occupier may have concerning the water be allayed, and in the second case samples of water were taken from the tap, results of which showed that the water was of satisfactory hygienic quality and fit for human consumption. As a result of investigation by the Counci's Public Health Inspectors the following provisions were made:- Supplies to tenements 2 Taps on main for drinking purposes 1 Cisterns cleansed, covered or repaired 7 Burst pipes repaired 11 PUBLIC BATHS AND SWIMMING POOLS. These facilities are available at premises situate in Chelsea Manor Street, adjacent to the Town Hall. During the year 30 samples of water were taken from baths, pools and sources of supply, for bacteriological examination, and apart from one sample adversely reported on because of its low chlorine content residual - the result of minor breakdown of the chlorine plant - the water was found to be in a satisfactory condition. - 35 - DETAILS OF NOTICES SERVED DURING THE YEAR 1. PUBLIC HEALTH (LONDON! ACT. 1936 (a) Intimation 136 (b) Nuisance Notices 20 (c) Section 40 - Drainage 10 L.C.C. (General Powers) Act, 1954 (a) Section 12 - Provision of dustbins - Intimations 10 (b) Section 12 - Provision of dustbins - Statutory Notices 2 L.C.C. (General Powers) Act. 1955 Section 25 - Stopped up drains 4 2. FACTORIES ACT, 1937. Health - general provisions 24 3. FOOD AND DRUGS ACT. 1955 Defects at food premises 34 4. SHOPS ACT. 1950 Provision of suitable sanitary conveniences and ventilation 20 TOTAL 260 DETAILS OF NOTICES COMPLIED WITH DURING THE YEAR. Two hundred and ninety-one notices were complied with during the year of which two hundred and one were served under the Public Health (London) Act, 1936. RENT ACT. 1957 No Certificates were issued during the year in accordance with the provisions of the above Act. - 36 - HOUSING ACT. 1957 - PART IV - OVERCROWDING New cases investigated and recorded 1 Number of families involved 1 Number of persons involved 3 Cases relieved by:- (a) Rehousing Authorities 1 (b) Informal or formal procedure NIL Such action resulted in 7 persons being adequately housed. Cases on register at 31st December, 1959 26 Number of persons involved 154 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 accommodation; Ill-health (excepting Tuberculosis); Tuberculosis; Overcrowding; and Other circumstances. During the year, 9 applications were referred to the Public Health Department, 8 originated from Chelsea residents and the remaining one from an applicant living in another area. Each case was investigated - 4 in connection with ill-health including tuberculosis, and 5 in respect of sub-standard accommodation, bringing the total number of cases since May 1953, to 330 residents and 94 non-residents. Points scheme for allocation of permanent accommodation The cases of 14 licensees in requisitioned premises were also referred to this Department during the year for pointing on medical grounds under the above scheme. Since 1955, a total of 320 cases have been dealt with under this heading. NEW HOUSING Number of houses erected by the Borough Council during the year - 4. - 37 - 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 Public Health Inspectors during the year:- l. 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: 70 116 9 - (2) Factories not included in (1) in which Section 7 is enforced by Local Authorities? 222 365 14 (3) Other premises in which Section 7 is enforced by Local Authorities? - - - - TOTALS 292 481 23 - NOTE:- Outworkers' premises are not included in (3) above. i.e. Electrical Stations - Section 103 (l), Institutions - Section 104, and sites of Building Operations and Works of Engineering Construction - Sections 107 and 108. - 38 - FACTORIES ACT. 1937 (Continued) 2. CASES IN WHICH DEFECTS WERE FOUND Particulars Number of cases in which Defects were found Prosecutions Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of Cleanliness (Section l) 6 4 _ 4 - Overcrowding (Section 2) - - - - - Unreasonable Temperature (Section 3) 2 - - 1 - Inadequate Ventilation (Section 4) - - - - - Ineffective drainage of floors (Section 6) - - - - - Sanitary Conveniences (Section 7) (a) Insufficient 1 — - - - (b) Qnsuitable or defective 59 36 _ 5 - (c) Not separate for sexes 1 1 - 1 - Other offences against the Act (not including Outworkers) 1 1 _ - - TOTAL 70 42 - 11 - - 39 - FACTORIES ACT, 1937 (Continued) OUTWORK Sections 110 and 111 Nature of Work No. of Outworkers in August List as 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 Prosecu tions Wearing Apparel making etc, 9 - - - - - Household Linen - - - - - - Curtains and furniture hangings 2 - - - - - Furniture and Upholstery - - - - - - Stuffed Toys l - - - - - Lampshades 4 - - - - - TOTALS 16 - - - - - - 40 - FOOD HYGIENE Since the introduction of the Food Hygiene Regulations, 1955, considerable progress has been made in structural improvements in food premises. A large number of food shops and restaurant kitchens have been completely reconstructed following notices from the Public Health Inspectors and, in addition, other shopkeepers and restaurant proprietors have voluntarily modernised their premises and in nearly all cases have sought and accepted the advice of the Inspectors before the alterations started Several provision shops have followed the modern trend of self-service, and although this method ensures that almost all goods are wrapped and the majority displayed under refrigeration, special attention has now to be paid to the preparation rooms where the foodstuffs are weighed and packed. This has sometimes meant requests for additional washing facilities to be provided within or adjacent to the preparation room so that persons handling unwrapped butter, cheese and cooked meats can be encouraged to wash after opening tins, packing-cases and cartons, As a result of the improved conditions in shops and kitchens, the Inspectors are now able to devote more time to educating food handlers in good hygienic practices, and during 1959 this was carried a stage further by means of a course of food hygiene lectures to hospital kitchen staffs at the request of the No. 4 (Chelsea) Group Hospital Management Committee This course was conducted by the St. John Ambulance Brigade who invited the Medical Officer of Health and four of the Public Health Inspectors to give lectures and carry out the verbal examination at the end of the course. With the advent of automatic food and milk vending machines and conversions to self-service stores, the pattern of the food retail business appears to be changing and it has been noted with interest during the year that e number of food premises, the majority of them small family businesses, have closed down and the premises have either been re-opened for other purposes, or remain unoccupied, in some cases awaiting redevelopment of the site. On the other hand, only on four occasions has the reverse happened, where premises used for various other businesses have been converted to food shops or restaurants. Examples of the changes which occurred during 1959 are given on the following page. - 41 - Former Business Now used as: 1. Fishmonger Antiques 2. Fishmonger Redevelopment of site, 3. Fried Fish Office 4. Butcher Redevelopment of site. 5. Greengrocer Redevelopment of site. 6. Greengrocer Travel agency 7. Grocer Florist 8. Grocer Private occupation. 9. Bread and Cakes Ladies fashions. 10. (Bread, cakes) Not yet relet. (Bakehouse ) 11. Sweets, tobacco. Antiques 12. Restaurant Builders' offices. 13. Restaurant Not yet relet. 14. Restaurant Sale of antiques. 15. Chemist Bread and cakes. 16. Chemist Bread and cakes. 17. Dressmaker Restaurant 18. Electrician Coffee bar - 42 - SHOPS ACT 1950. Health and Welfare Provisions In the past responsibility for enforcement of the section of the above-mentioned Act dealing with the health and comfort of shop workers has been divided between the London County Council and the local Council, but as from 1st January, 1959, the London County Council's powers and duties in this respect were transferred to the Metropolitan Boroughs, making them responsible for the following: 1. Washing facilities 2. Sanitary conveniences 3. Lighting 4. Temperature 5. Facilities for taking meals Taking into consideration the extensive shopping frontages of Sloane Street, King's Road and Fulham Road, these extra duties necessitated a considerable number of inspections and, in all 331 visits were made and 20 notices served. - 43 - INSPECTION AND SUPERVISION OF FOOD Registers are maintained of all premises connected with the manufacture, storage, and sale of food. Traders and their staffs are kept well informed of the latest methods adopted for the hygienic handling, wrapping and delivery of food, and the great majority are appreciative of such advice. The following summary gives details of the type of businesses receiving the special attention of the Public Health Inspectors Bakehouses 6 Butchers 25 Horse-flesh butcher 1 Food Factories (flour mills, bottling stores, ice cream factory) 8 Milk Retailers (including dairies) 54 General provision merchants (not selling milk) 34 Fruit and vegetable retailers 30 Hotels and Public Houses ) Restaurants, Dining Rooms,Canteens) Fried fish premises 3 Wet fish retailers 8 Wet and dry fish retailer 1 Miscellaneous premises (Bread and cake shops, sweets and confectionery shops, ice cream store) 56 As required under Section 16 of the Food and Drugs Act, 1955, 121 premises are registered for the storage and sale of Ice Cream, and 33 premises for the sale of Preserved Food. - 44- LEGAL PROCEEDINGS - Food and Drugs Act, 1955. During the year a number of complaints were received regarding the sale of foodstuffs not being of a satisfactory nature, but in only two instances was it deemed necessary to institute legal proceedings under Section 2 of the Food and Drugs Act, 1955 (person who sells any food or drug which is not of the nature, substance, or quality demanded by the purchaser shall be guilty of an offence). The first case concerned the sale of skinless pork sausages which were sour and mouldy and the defendants were found guilty of the offence and a fine of £5 was imposed with costs totalling £8. 8s. 0d. In the second case the defendants were found guilty of the offence of selling an article of food, namely a mouldy sausage roll which was not of the quality demanded, A fine of £15 was imposed with costs totalling £8, 8s. 0d. BACTERIOLOGY During 1959, 83 samples were submitted for examination to the Bacteriological Laboratory of the Public Health Service, London County Councilo These comprised 38 water and milk specimens (water 30 and milk 8) - all of which were found satisfactory - and 45 ice cream specimens graded by the Laboratory as follows:- Grade I: 25 Grade II: 10 Grade II: 6 Grade IV: 4 45 UNDERGROUND BAKEHOUSES During the year the quinquennial review of underground bakehouses took place, and the three remaining underground bakehouses in the Borough were granted certificates of suitability under the Factories Act 1937. It is interesting to note that within the past ten years the number of underground or basement bakehouses has been reduced from 11 to 3, either by reason of voluntary closing or because the Council has refused to renew the certificates of suitability. Of the 3 remaining, one is in property which is included in an L.C.C. school development scheme, and the occupier of one of the others proposes to reconstruct the bakehouse above ground within the near future. - 45 - MILK SUPPLY Under the Milk and Dairies (General)Regulations, 1959, a local authority is required to keep a register of all persons carrying on the trade of milk distributor, and of all premises used as dairies (other than dairy farms) in their district, and to remove from the register the name of any person who ceases to trade as a milk distributor, and of any premises which cease to be used as dairy premiseso On the 31st December, 1959, entries in the register were as follows:- (a) Number of registered distributors with premises in the Borough 46 (b) Number of premises in the Borough, other than dairies from which milk is distributed 53 (c) Number of premises in the Borough registered as dairies 1 (d) Number of registered distributors other than those included in (a) above 16 During the year 130 applications were received, and principal licences were granted under the Milk (Special Designation) (Raw Milk) Regulations, 1949 to 1954, and the Milk (Special Designation) (Pasteurised and Sterilised) Milk Regulations, 194-9 to 1953, authorising the use of special designations in relation to milk sold at, or from premises within the Borough. 55 supplementary licences were granted in respect of milk sold by retail within the Borough from 22 premises not situated in the area of this authority. Details of licences granted were as follows:- Type of Licence Tuberculin Tested Pasteurised Sterilised Total Principal 39 49 42 130 Supplementary 17 19 19 55 All retailers selling milk within the Borough have been licensed to use special designations in accordance with the provisions of the Milk (Special Designations) (Specified Areas) Order, 1951, which came into force on 1st October, 1951 for the whole of the County of London. - 46 - PET ANIMALS ACT. 1951. During the year three licences were applied for and granted and in each case a fee of 10/- was paid. Each shop was regularly visited throughout the year to ensure that all animals were being cared for and maintained in accordance with the conditions attaching to the licence. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951. Eleven premises in the Borough, used for upholstering and similar processes, have been registered since the Act came into force on 1st November, 1951. There are no premises in the Borough where rag flock is manufactured. PHARMACY AND POISONS ACT. 1933. The number of listed sellers of Part II Poisons, on the Council's register was 45. All applications are investigated to ensure that records are properly maintained, labelling efficiently performed, storage accommodation adequate, and that sales are only made by employees nominated on the application forms. In every instance it was found that the requirements of the Act and the Poisons Rules were being complied with, whilst it was apparent that all concerned were fully aware of their particular responsibilites. 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 Gommittee each Spring, and when approval has been given, appropriate entries are made for a period of twelve months (1st May to 30th April). - 47 - STREET TRADING - Licensed and Unlicensed Stall-holders. Traders are licensed annually to operate from established sites in the Borough in accordance with the provisions of Part IV of the London County Council (General Powers) Act, 1947, and providing requirements are fully observed, licences are renewed on receipt of applications. A number of licensees are concerned with the retailing of food, and in such instances the Council's Public Health Inspectors are particularly attentive to the conditions prevailing at storage accommodation, whilst steps are taken to ensure that all equipment is hygienically maintained. The practice of smoking while handling food has been considerably reduced as a result of the verbal and written warnings issued by the Public Health Inspectors throughout the year. It is desirable that food displays should not be sited too near pavement surfaces, and it is stressed, under the Food Hygiene Regulations, 1955, that the permitted minimum height of such displays is 18" from ground level. Street trading from licensed sites in this Borough is carried out as follows:- Fruit and vegetables 14 Refreshments (at coffee stalls) 3 Flowers 10 Newspapers 6 In addition there are 3 stalls which are sited on private forecourts. These are : Fruit and vegetables 1 Shellfish 1 Clothing 1 Eighty visits were made to stalls during the year. The institution of legal proceedings in respect of unsatisfactory conditions was not necessary. - 48 - RODENT CONTROL - The Prevention of Damage by Pests Act, 1949. The following are details of work carried out during the year by the Rodent Officers in connection with the destruction of rats and mice: 1. Treatment of Business and Private Premises. Business Premises Private Premises Number of visits 336 3,380 Number of infestations found 45 284 Number of treatments undertaken 36 281 Number of pre-baits laid 2 ,500 Number of poison baits laid 732 Number of complaints received 342 2. Sewer Maintenance Treatments. No. of prebaits laid No. of poison baits laid No. 1 Trea tment 1,415 451 No. 2 Treatment 1,240 311 There has been excellent co-operation from owners and occupiers of premises where treatments have been carried out It is interesting to record that a large number of rat infestations have been traced to defective frontage drains, this being the section of drain between the interceptor and the sewer, and such infestations have been completely eradicated on reconstruction or repair of the defective drain. - 49 - UNSOUND FOOD When it has been established that food is unfit for human consumption, it is surrendered to the Council's Public Health Inspectors, removed from the premises, and the necessary surrender certificates issued, the food being subsequently disposed of via the Council' s refuse disposal service, after suitable treatment with liquid carbolic. Approximately 2,290 pounds of unsound or diseased food were surrendered to and destroyed by the Council's Public Health Inspectors during the year, and for the purpose of comparison, details of the foods which have largely contributed to the annual totals during the years 1956 - 1959 (inclusive) are set out in the following tables:- UNSOUND FOOD SURRENDERED TO THE COUNCIL'S FOOD INSPECTORS DURING THE YEARS 1956 - 1959 (INCLUSIVE). Commodity 1956 lbs. 1957 lbs. 1958 lbs. 1959 lbs. Cake 37 Cheese 86 33 44 46 Currants — 102 — — Fish, Tinned 66 11 — 114 Fish, Fresh — — — 43 Flour — — — 80 Fruit, Tinned 829 482 421 380 Fruit, juices 60 46 31 46 Fruit, Fresh — — — 120 Fruit, dried — — 25 — Ice Cream — — — 99 Meat, Fresh 1,287 853 815 281 Meat, Tinned 310 520 910 635 Milk, Tinned 33 28 — 30 Potatoes — — 208 — Preserves - Jams, — — — — Marmalade, etc. 45 21 — 20 Sausages — 23 — — Soups — 16 16 30 Vegetables 214 410 125 328 Aggregates of all foods condemned annually 3,296 2,661 2,780 2,290 Average for the four years - 2,757 lbs. - 50 - DISINFECTION AND DISINFESTATION SUMMARY OF WORK CARRIED OUT BY THE COUNCIL'S DISINFECTING STAFF DURING THE YEAR 1959. Under an arrangement with the London County Council, schoolchildren are treated at the Cleansing Station for Scabies and Verminous conditions. SCABIES CASES TREATED Chelsea Residents 12 L.C.C. School children 8 VERMINOUS CONDITIONS. Adults 175 Children 65 L.C .C. School children 125 DISINFECTION OF ROOMS AND CONTENTS. CLOTHING ETC. Number of Rooms Disinfected 219 Number of Articles Disinfected 2,188 DISINFESTATION OF ROOMS AND CONTENTS. Number of Rooms Disinfested 502 Number of Articles Disinfested 1,897 - 51 - ATMOSPHERIC POLLUTION RECoRDING The Council maintain two measurement and recording stations. The readings are submitted to the Department of Scientific and Industrial Research, who issue monthly bulletins indicating the national picture as regards atmospheric pollution. The stations are situated at the Chelsea Polytechnic, Manresa Road, and the Chenil Galleries, King's Road. Chelsea Polytechnic The apparatus situated on this station consists of a standard deposit gauge for collecting the amount of soluble and insoluble deposits, and a lead peroxide apparatus for measuring the sulphur content of the air. The deposited matter is collected at the end of each month and forwarded to The Royal Institute of Public Health and Hygiene for analysis. The following tables show the results obtained from this station during the year :- Month 1959 Days Exposed Rainfall (ins.) Total Deposits for perioc in tons per sq. mile Deposits per day in tons per sq, mile (average} Soluble Insoluble Total Soluble Insoluble Total January 32 2.03 11.35 15.54 26.89 .355 .486 .841 February 25 0.04 5.74 10.27 16.01 .230 .411 .6a March 33 1.69 8.66 15.44 24.10 .262 .468 .730 April 30 2.09 8.97 10J20 19.17 .299 .340 .639 May 31 0.51 3.94 5.42 9.36 .127 .175 .302 June 30 0.79 4.92 10.79 15.71 .164 .360 .524 July 30 1.21 6.41 7.69 14.10 .214 .256 .470 August 32 1.33 4.37 4.38 8.75 .136 .137 .273 September 30 0.06 5.04 11.10 16.14 .168 .370 .538 October 32 1.62 8.83 11.29 20.12 .276 .353 .629 November 29 2.20 8.95 12.53 21.48 .309 .432 .741 December 31 2.68 9.86 12.04 21.90 .318 .388 .706 Totals 365 16.25 87.04 126.69 213.73 — — — - 52 - Estimation of Atmospheric Sulphur Milligrams of Sulphur Trioxide per Day. Month Days Exposed Chelsea Polytechnic January 32 6.58 February 25 5. 66 March 33 3.91 April 30 3.31 May 31 2.55 June 30 2.10 July 30 1.73 August 32 1.61 September 30 2.51 October 32 3.14 November 29 4. 51 December 31 3.82 Average for year: 3.45 Chenil Galleries This station measures the amount of smoke suspended in the air and the sulphur dioxide content of the atmosphere. The apparatus consists of a smoke filter and a hydrogen peroxide bubbler. Readings are taken daily by an officer of the Public Health Department and the results are averaged to produce figures for each month. All information obtained from these readings is forwarded to the Fuel Research Station for correlation with the results obtained from other sites throughout the country. 53 Atmospheric Pollution Recording (Continued) The following table shows the results obtained from this station during the year:- VOLUMETRIC ANALYSIS - SMOKE and S02 Month Average daily total Smoke mg/100 m3 S02 p.p.100 m. January 62 30.5 February 54 23.9 March 23 11.4 April 34 11.3 May 16 9.1 June 10 8.0 July 14 5.2 August 16 6.8 September - - October 37 8.8 November 38 10.4 December 25 12.0 - 54 - CLEAN AIR ACT. 1956 THE CHELSEA (CHURCH WARD) SMOKE CONTROL ORDER. 1959. The Council, at its meeting on the 28th January, 1959, agreed in principle to make Church Ward a Smoke Control Area, as a first step towards the development of Chelsea as a Clean Air Zone, and the Town Clerk was authorised to supply the Minister of Housing and Local Government with all necessary particulars of the Council's proposals, in order to obtain his consent to a detailed survey of the Ward being under taken,. Church Ward is bounded on the north by the centre of Fulham Road, on the east by the centres of Draycott Avenue, Whitehead's Grove and Markham Street, on the south by the centre of King's Road, and on the west by the centre of Old Church Street; it is almost 93 acres in extent and contains 3,948 domestic dwellings with approximately 9,300 inhabitants,. Although this Ward is the second smallest in the Borough in area, it is sufficiently large to have some practical effect on atmospheric pollution as it is the most densely populated, and is the Ward with the largest number of small residential units. It also includes 196 commercial premises, 14. industrial premises, institutions, churches, schools and, most importantly, four hospitals - St. Luke's, Chelsea Hospital for Women, the Royal Marsden and the Brompton Hospital, (A map of the Ward appears on Page 58 ). Upon receipt of the Minister's approval in principle to the carrying out of a detailed house-to-house survey and his provisional approval to the Council's proposals, it was possible to commence this survey on 6th April, Despite the fact that the Public Health Department was one short of its establishment of Public Health Inspectors, in the interests of economy and in view of the Minister's decision to waive the need for a preliminary survey it was decided to attempt the survey with the existing staff, the detailed survey to be undertaken by the Deputy Chief Public Health Inspector and one other Inspector who had been engaged on housing repair and renovation work in West Chelsea, The consequential substantial increase in the volume of clerical work in the Department by reason of recording, correspondence and the checking of approved accounts was also undertaken by the existing staff. Progress was steadily maintained throughout the summer months and by the end of September the major part of the survey had been carried out. It had been possible to accelerate the progress of the survey by utilising the part-time services of a District Public Health Inspector, During October and early November, the Inspectors dealt with outstanding queries and re-visited those premises where previous access had not been possible due mainly to owners and occupiers being away on holiday or absent for business reasons. The general reaction of the residents of Church Ward to the Council's proposal to make a Smoke Control Order was most encouraging, and practically all were readily in agreement that it was a worth while effort if it resulted finally in achieving a smoke - 55 - free borough. A circular letter had been sent to all residents in the Area explaining the provisions of the Act, informing them that they would be visited by an Inspector from the Public Health Department on a certain date at a given time, and asking them to co-operate as much as possible with this officer. The purpose of the Inspector's visit was to ascertain the number and cost of fireplaces to be adapted or replaced, together with the amount of smokeless fuel required annually. The Council is required to repay to the owner or occupier 7/l0ths of the approved reasonable expenditure incurred in the adaptations carried out on domestic premises within a Smoke Control Area, 4/l6ths being recoverable by the Council from the Exchequer, the remaining 3/l0ths is borne by the owner or occupier (unless the Council decide otherwise in any case of hardship, but in that event no Exchequer contribution is recoverable in respect of this fraction). Thus the cost of conversion or replacement of unsatisfactory fireplaces is to be borne as follows:- Owner or Occupier 30% Council 30% Exchequer 40% The cost of installation will be judged reasonable if it corresponds broadly with the cost of appliances installed in houses provided by local authorities. Expenditure on works of adaptation or conversion must be approved by the Council if it is to qualify for grant and such expenditure must be incurred after the confirmation of the Order but before its coming into operation. No grant is payable by the Exchequer or the local authority in the case of commerical and industrial premises. In the case of its own properties, the Council will bear 60% of the cost, but a proportion not exceeding 30% of such cost may be passed on to the tenants by way of increase in rent. Included within the Ward are the 124 flats of Pond House and New Pond House, where the heating appliances will require some form of adaptation, and there will also be those units of accommodation in requisitioned premises remaining in the Council's possession after March, I960. An approach was made to the Regional Director of the Ministry of Power, to ascertain whether therewere any unexpected difficulties concerning supplies of smokeless fuels to the area, and the Council was informed that reasonably adequate supplies would be available when the Order comes into operation. As a result of the detailed information obtained from the houseto-house survey, the Council, at its meeting on 18th November, 1959, made a Smoke Control Order, to come into operation on 1st November, I960. The Order was submitted to the Minister of Housing and Local Government for confirmation on 19th November, together with the following Schedule of Estimated Costs of Adapting and Replacing Fireplaces?- - 56 - 1. No. of dwellings 3,948 2. No. of existing appliances requiring replacement or adaptation - (i) Open Fires 1,951 (ii) Open fires with boilers 3 (iii) Combination grates and solid fuel cookers (without boilers) 8 (iv) Combination grates and solid fuel cookers (with boilers) 16 (v) Washboilers 144 3. Number and Costs of New Appliances Required? New Appliances Open Fires Gas or Electric Fires Open Fires with Boilers Combination Grates and Cookers (with boilers) Wash Boilers Totals No.of Appliances 1,811 8 1 16 16 1,852 Total cost of Appliances £ £8,149. 10s. 0d„ £80 £11 £560 £104 £8904. I0s. 0d. Total cost of other works attributable to installation of new appliances £ £17,090. 7s. 0d. £64.16. £18 £275.4. £48 £17496. 7s. 0d. 4. Cost of other work not attributable to installation of new appliances Provision of gas and electric points - 270 £ 1,557.13. TOTAL ESTIMATED COST OF WORKS £ 27,958.10. Total estimated claim for Exchequer contribution £ 11,183. 8. Total estimated Council contribution £ 8,387.11. - 57 - Certain buildings in the London County Council redevelopment area (Dovehouse Street/King's Road/Manresa Road) are due for demolition near to 1st November, I960, the date on which the Council has requested the Order to become operative, and these have accordingly been exempted from the provisions of the Order. This exemption will apply only for so long as the present buildings remain standing and any new buildings erected on the sites will come within the terms of the Order. 58 CLEAN AIR ACT, 1956 CHURCH WARD SMOKE CONTROL AREA CHELSEA CHURSH WARD SMOKE CONTROL AREA The Area is bounded on the north by the centre of Fulham Road, on the east by centres of Fulham Road, on the east by the centres of Draycott Avenue, Whitehead's Grove and Markham Street, on the south by the centre of king's Road, and on the west by the centre of Old church Street. - 59 - SMOKE CONTROL AREA PROGRAMME The Public Health and Baths Committee reported to the Council at its February meeting the terms of Circular No. 5/59 received from the Ministry of Housing and Local Government, which asked local authorities in "black areas" to consider their domestic smoke problems as a whole, and to decide on the number of Smoke Control Orders needed, in what order of priority they should be made, and how many years it would take to finish the job. The Minister also asked local authorities to submit a phased programme for establishing Smoke Control Areas over the next five years. As it ves anticipated that the Church Ward Smoke Control Order would become operative on 1st November, 1960, the Committee informed the Council that future areas should be established in the following order - Hans Town Ward to become operative during 1962, Royal Hospital and part Cheyne Wards during 1964, the rest of Cheyne Ward and the whole of South Stanley Ward during 1966 and North Stanley Ward during 1968. The Minister of Housing and Local Government was informed accordingly. This is the logical sequence for carrying out the work, as it deals in the first place with the border areas, of Kensington and Westminster who it is hoped will be taking similar action, and it leaves until the last the Wards of North and South Stanley where considerable conversion and redevelopment is taking place, and will continue during the next few years, resulting in a reduction of the number of premises which will require attention under the provisions of any Smoke Control Order. EPIDEMIOLOGY Incidence and Notification of Infectious Disease - 60 - The undermentioned diseases are notifiable to the Medical Officer of Health by general practitioners Anthrax Meningococcal Infection Cholera Ophthalmia Neonatorum Continued Fever Plague Diphtheria Pneumonia, Acute Influenzal Dysentery Pneumonia, Acute Primary Encephalitis, Acute Poliomyelitis, Acute Enteric (Typhoid or Puerperal Pyrexia Paratyphoid) Fever Erysipelas Relapsing Fever Food Poisoning (or Scabies Suspected Food Poisoning) Glanders Scarlatina or Scarlet Fever Hydrophobia Smallpox Leprosy Tuberculosis Malaria Typhus Fever Measles Whooping Cough Membranous Croup - 61 - NOTIFICATIONS, The following table shows the total (corrected) number of cases of Infectious Diseases received during the year. Disease Under 1 year 1 and under 5 yrs 5 and under 15 yrs 15 and under 25 yrs 25 and under 45 yrs 45 and under 65 yrs 65 yrs and over TOTAL Dysentery. — — — — 1 — — 1 Dysentery (Sonne) 7 23 16 7 8 — — 61 Erys ipelas — — — — — 1 — 1 Food Poisoning — — - 1 3 1 — — 5 Measles 6 222 177 4 4 3 — 416 Meningococcal Infection 2 — — — — — — 2 Pneumonia s AcoInfluenzal — — — — 1 — 8 9 AcoPrimary — — 1 1 — 3 4 9 Poliomyelitis s Paralytic — 1 — . — — 1 — 2 Non-paralytic — 1 — — — — — 1 Puerperal Pyrexia — — — 19 17 — — 36 Scabies — 2 1 — 3 — — 6 Scarlet Fever — 12 18 1 — — — 31 Whooping Cough 3 18 9 2 — 1 — 33 TOTALS 18 279 223 37 35 9 12 613 - 62 - SUMMARY OF NOTIFICATIONS OF INFECTIOUS DISEASES RECEIVED DURING THE YEARS 1955 - 1959 (inclusive) Disease 1955 1956 1957 1958 1959 Average for five years Diphtheria 2 — — — — 0.4 Dysentery 216 349 71 111 62 161.8 Erysipelas 4 5 3 1 1 2.8 Food Poisoning 27 85 13 7 5 27.4 Measles 736 183 406 217 416 391.6 Meningococcal Infection 2 3 1 1 2 1.8 Ophthalmia "Neona torun 1 — — — — 0.2 Paratyphoid Fever 2 — — — — 0.4 Pneumonia: Ac. Influenzal 6 12 19 4 9 10.0 AcoPrimary 18 24 24 11 9 17.2 Poliomyelitis x Paralytic 2 8 3 3 2 3.6 Non-paralytic 4 6 — — 1 2.2 Puerperal Pyrexia 57 63 31 46 36 46.6 Scabies 12 15 8 6 6 9.4 Scarlet Fever 43 38 34 16 31 32.4 Typhoid Fever — — — 2 — 0.4 Whooping Cough 85 72 69 20 33 55.8 - 63 - DYSENTERY During 1959, sixty-two notifications were submitted as compared with 111 in 1958, and 71 in 1957. Thirty-two of the sufferers were residents of an institution 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. PUERPERAL PYREXIA Puerperal Pyrexia means a febrile condition in a woman in whom a temperature of 100.4° Fahrenheit (38° Centigrade) or more has occurred within fourteen days after childbirth or miscarriage. Thirty-six cases were notified during the year, all of which occurred in hospital. Twenty-nine notifications referred to patients residing outside the Borough. Herewith is a brief summary of the actual causes of the above casess 2 cases were due' to genital tract infection, 6 to breast involvement, 9 urinary tract infection, 2 respiratory tract infection, 1 kidney infection, 2 associated with Caesarean section, and causes not known 14. Four other cases were brought to the notice of this Department by other local authorities; these concerned Chelsea residents whose confinements took place in hospitals in their areas. MEASLES Four hundred and sixteen notifications of Measles were received during 1959, as compared with 216 and 406 in 1958 and 1957 respectively. SCARLET FEVER Thirty-one notifications of Scarlet Fever were received in the Public Health Department during 1959, as compared with 16 in 1958. SMALLPOX No case of Smallpox has been notified to this Department as having occurred in the Borough since 1928, and there have been no deaths from this disease for over fifty years. Information was received during the year regarding one contact who had travelled to an address in the Borough, and he was given advice on the precautionary action that should be taken. - 64 - DIPHTHERIA No notifications were received during the year. Two cases were confirmed in 1955, being the only cases since 1949, and there have been no deaths for fourteen years. Immunisation has played a major part towards 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 page 18. POLIOMYELITIS Five notifications of poliomyelitis were received and three were subsequently confirmed; one of the cases was of a non-paralytic type. One of the paralytic cases, a male of 3 years, had received three injections against poliomyelitis and although all the bacteriological tests proved negative, the hospital regarded and notified the case as poliomyelitis in view of the paralysis. All the cases were discharged from hospital after making a satisfactory recovery. Vaccination against poliomyelitis was commenced by the London County Council in 1956, and was only available to children in certain age groups, but as the supply of vaccine improved, the Ministry of Health extended the programme and the following persons are now eligible s- All persons six months to 40 years of age. Expectant mothers. General medical practitioners and ambulance staff and the families of such persons. Staff of hospitals where poliomyelitis is treated during the infectious stage, and the families of such staff. Medical Officers of Health, Public Health Inspectors and Disinfectors. WHOOPING COUGH Thirty-three cases were notified during the year against 20 in 1958. - 65 - FOOD POISONING Five cases were notified as compared with 7 in 1958 and 13 in 1957 A summary of all cases occurring during the year under review is set out in identical form to that supplied to the Ministry of Health. ANNUAL RETURN OF FOOD POISONING FOOD POISONING NOTIFICATIONS (CORRECTED^ AS RETURNED TO REGISTRAR GENERAL. First Quarter Nil Second Quarter Nil Third Quarter 3 Fourth Quarter 2 Total 5 CASSS OTHERWISE ASCERTAINED„ First Quarter Nil Second Quarter Nil Third Quarter Nil Fourth Quarter 1 Total 1 FATAL CASES. First Quarter Nil Second Quarter Nil Third Quarter Nil Fourth Quarter Nil Total Nil PARTICULARS OF OUTBREAKS No. of outbreaks No. of cases Total No. of cases Family outbreaks Other outbreaks Notified Otherwise ascertained Salmonella typhiaiuriu — 1 2 — 2 Agent not identified 1 — 2 1 3 SINGLE CASES No. of cases Total No. of cases Notified Otherwise ascertained Salmonella typthimurium 1 — 1 - 66 - FOOD POISONING Family Outbreaks (l) Three Casas This outbreak affected a father, mother and one daughter aged 5 years. All had diarrhoea and vomiting (not severe). Faecal specimens were submitted for bacteriological examination and were reported negative in all cases. The food causing the illness was thought to be a tin of pork luncheon meat. The preparation of all food consumed by the family is done at home, and the only member of the family not affected was a daughter aged 1 year, who did not share the meal in question and remained quite well. Other Outbreaks (1) Two Cases Two males aged 15 years were involved in this outbreak. They were members of a party of German Students on a short exchange visit to this Country and who were staying in Chelsea. During their visit the party went on a sightseeing tour of London and all had lunch at the same restaurant, but the two youths in question still feeling hungry, purchased and ate some corned beef sandwiches at a coffee stall situated outside this Borough. All the party had the same to eat with the exception of the corned beef sandwiches. The two persons concerned had diarrhoea and vomiting, one so severe that he was removed to hospital. Salmonella typhimurium was isolated in both cases and the remaining members of the party stayed quite well during the rest of their stay. Single Cases (1) This referred to a female aged 24., who was admitted to hospital with acute gastro-enteritis and was afterwards notified as suffering from food poisoning (salmonella typhimurium). On enquiry it was found that the patient was one of a number of people affected in a restaurant outside Chelsea. - 67 - SALMONELLOSIS 16 cases of salmonella infection were brought to the notice of this Department during the past twelve months. These are cases which have symptoms, and although a food poisoning organism is isolated from the faecal specimens, food is not considered to be the vehicle of the infection, which is caused through case-to-case contact or by cross infection. A summary of these cases is now supplied annually to the Ministry of Health as instructed in the revised memorandum on Food Poisoning. A copy of this year's return is submitted below. SALMONELLA INFECTION. NOT FOOD BORNE. Salmonella (type) Outbreaks No. of cases Single Cases Total No. of cases (outbreaks) and single cases) Family Other (Outbreaks) Typhimurium - 1 6 8 14 Newport - - - 1 1 Infantis and Anaturn - - - 1 1 - 68 - NOTIFICATIONS OF INFECTIOUS DISEASE BY WARDS North Stanley South Stanley Cheyne Church Hans Town Royal Hospital TOTALS Dysentery 1 - - - - - 1 Dysentery (Sonne) 12 15 1 32 - 1 61 Erysipelas - - - 1 - - 1 Food Poisoning 2 2 1 - - - 5 Measles 65 80 66 84 47 74 416 Meningococcal Infection - - 2 — - - 2 Pneumonia: Acute Influenzal 1 2 - 6 - - 9 Acute Primary - 1 2 1 3 2 9 Poliomyelitis: Paralytic - - 1 - 1 - 2 Non-paralytic 1 — — — — — 1 Puerperal Pyrexia 36 - - - - - 36 Scabies - 2 - 3 1 - 6 Scarlet Fever 2 4 10 6 7 2 31 Typhoid Fever - - - - - - - Whooping Cough 5 4 8 7 3 6 33 TOTALS 125 110 91 140 62 85 613 69 TUBSRCULOSIS 69 cases of Pulmonary Tuberculosis were notified during the year. These were made up of 35 primary notifications, 26 "invard transfers" and 8 from other sources. There were also 3 non-pulmonary cases, all being primary notifications. The accompanying tables present details of cases at present on the Tuberculosis Register. VARIATIONS IN REGISTER DURING 1959. PULMONARY NON-PULMONARY TOTAL CASES M. F. M. F. (a) Number of cases remaining on register at 1st January, 1959 211 173 16 31 431 (b) Number of new cases notified 21 15 1 2 39 (c) Number of cases restored to register 4 3 - - 7 (d) Inward Transfers 18 8 - - 26 Removals (e) Outward Transfers 26 18 1 1 46 (f) Cases recovered 14 12 - 1 27 (g) Cases gone abroad 1 1 - - 2 (h) Cases lost sight of 4 2 - - 6 (i) Deaths 9 3 - - 12 (j) Cases remaining on the Register at 31st December, 1959. 200 163 16 31 410 70 (A) NEW CASES OF TUBERCULOSIS 1959 (B) DEATHS OF TUBERCULOSIS CASES 1959 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 TOTAL (all ages) (A) NEW CASES Pulmonary M - - - - - - 3 4 3 3 3 5 - 21 Pulmonary F - - - - - 1 - 11 1 - 2 - - 15 Non- Pulmonary M _ - - - - - - 1 - - - - - 1 Non- Pulmonary F - - - - - - - 1 - - 1 - - 2 (B) DEATHS Pulmonary M - - - - - - - - - - 3 5 1 9 Pulmonary F - - - - - - - - - 1 - 1 1 3 Non- Pulmonary M - - - - - - - - - - - - - Nil Non- Pulmonary F - - - - - - - - - - - - - Nil - 71 - CHELSEA TUBERCULOSIS DISPENSARY. BROMPTON HOSPITAL. S.W.3. 1956 1957 1958 1959 Population served by Dispensary 51,070 50,600 50,190 49,520 Number of notified cases in Borough at end of year 468 441 431 411 Number of these who at present do not attend Dispensary 115 96 96 92 Total attendances during year 1,984 1,594 1,453 1,526 Total new patients seen 149 190 168 164 Number of these who were contacts 106 91 80 72 Number of contacts found to be tuberculous - 2 - 4 Number of cases newly notified to Medical Officer of Health (i.e. excluding inward transfers) 43 51 52 39 Number of cases diagnosed as tuberculous (for the first time) at the Dispensary 18 20 26 25 Number of X-rays 1,417 1,250 1,140 1,041 Number of Patients who received "Special treatment" at home during the year 30 6 4 2 Number of Patients given B.C.G. 65 80 75 79 Number of home visits by medical staff 50 25 1 - Number of visits paid by Dispensary Nurse 2,027 1,798 1,627 1,613 Number of Clinic Sessions per week 2 2 2 2 - 72 - ZYMOTIC DISEASES An examination of statistics provided by the Registrar-General for the year 1959 showed that two deaths were attributable to "Gastritis, enteritis and diarrhoea," representing a death rate of 0.04 per 1,000 of the population. Formerly the term "zymotic" was applied to "epidemic or contagious" ailments but later became limited to such diseases as cholera, diarrhoea, diphtheria, measles, scarlet fever, smallpox, typhoid fever and typhus fever. Mortality from these infections has declined to a remarkable extent since the beginning of the century, as will be seen from the following summary:- Year Number of deaths 1900 219 1905 98 1910 66 1915 76 1920 41 1925 29 1930 22 1935 17 1940 1 1945 6 1950 3 1955 6 1956 - 1957 5 1958 4 1959 2 - 73 - BACTERIOLOGICAL EXAMINATIONS All bacteriological examinations are carried out at the Public Health Laboratory at County Hall under its Director, Dr. A.J.H. Tomlinson. No charge is made to the Council for these examinations and during the year 1203 were made as follows:- Throat Nose Swabs Vincent's organisms found 1 Haemolytic Streptococci found 11 Staphylococcus aureus found 1 Pneumococci found 1 Candida albicans found 1 Micrococci found 1 Coliform found 2 Negative results 48 Gum Swabs Vincent's organisms found 1 Ear Swabs Heavy growth of diphtheroids found 1 Mixed growth of micrococci and diphtheroids found 1 Pseudomonas pyocyanea found 1 Eye Swabs Amorphous debris found 2 Boil Swabs Staphylococcus aureus found 1 Faeces Shigella sonnei found 133 Salmonella typhimurium found 13 Pathogenic Bact. coli 026 found 4 Pathogenic Bact. coli 027 found 3 Pathogenic Bact. coli 055 found 5 Pathogenic Bact. coli 0111 found 5 Pathogenic Bact. coli 0119 found 7 Negative results 960 589 faecal specimens which are included in the foregoing were arranged and collected by this Department with the approval and co-operation of local medical practitioners and school authorities. The Public Health Department has an arrangement with Chelsea Doctors, whereby specimens left at the office by 3 p.m. Mondays to Fridays and 11 a.m. on Saturdays are delivered by hand to the Laboratories the same day. This service is used extensively. ANNUAL REPORT of the PUBLIC ANALYST for the year ended 31st December, 1959. THOMAS McLACHLAN, A.C.G.F.C., F.R.I.C., M.I.Biol. - 74 - To the Mayor, Aldermen and Councillors of The Metropolitan Borough of Chelsea. Your Worship, Ladies and Gentlemen, During the year 1959, 400 samples of food and drugs were examined, 35 of which were taken formally and 365 informally. Adverse comments were made against 14 samples and the incidence of adulteration or incorrect labelling may be classified as follows:- Number of samples examined. Number of samples adulterated. Milk 200 1 Other food 200 13 A sample of milk submitted as a complaint, contained 9 per cent of total solid matter and 0.14 per cent of free alkali calculated as caustic soda. It therefore contained approximately 25 per cent of detergent solution and 75 per cent of milk. Two cut loaves were mouldy when purchased due to being sold when they were no longer fresh. The hot summer no doubt made it difficult for bakers selling cut loaves, but some of them could exercise greater care than they would appear to have done. Some slices of white bread contained pieces composed of gear oil mixed with very fine metal resulting from oil dropped from the shafting employed in the bakery. Judging by the large number of this type of complaint bakers should pay more attention to the lay-out of their machinery. Several currant bun loaves were examined during the year and found to contain widely varying quantities of fruit or currants, one containing only 4.8 per cent of fruit was reported as inferior. Some bakers were co-operative when suggestions were made to them that the quantity of fruit should be increased. Bun or currant loaves are not bought regularly, but for special occasions only, and therefore are not subject to the same critical inspection by the ordinary housewife as would be, for example, an ordinary loaf, but she should be able to expect a reasonable quantity of fruit in a bun loaf. The manufacturers of a health drink, which appeared on the market with a considerable flourish of publicity, endeavoured to create the impression that it possessed medicinal properties, whilst evading the restrictions of the Pharmacy and Medicines Act, 1941. As the result of pressure from this and other local authorities they agreed to modify their label and the claims they were making. In the opinion of your analyst a soft drink, called a "Blackcurrant Vitamin C Drink", is not an ordinary soft drink if it is sold essentially as a Vitamin C rather than as an ordinary blackcurrant beverage. One sample was very similar to the Blackcurrant Syrup of the - 75 - British Pharmaceutical Codex and was sold primarily for flavouring milk. The large quantity of sugar present would make it unpalatable for use as an ordinary cordial. This was a case where the manufacturers were at complete variance with your analyst, but where it would be difficult to foretell the results of a legal action and the Town Clerk therefore advised that it would be unwise to press the matter. This case is typical of many that arise from the abolition of the Labelling Advisory Service of the Ministry of Food. Some Grape and Blackcurrant Juice contained added flavouring not declared on the label. The manufacturers agreed to amend the label to include "and flavouring". A preserve labelled as "Ginger and Apple Preserve" should have been called "Apple and Ginger Preserve", since the ginger was only present in small quantity to add flavour. A sample of Marmalade, which was very thin and runny, contained only 64.9 per cent of total solid matter. The Food Standards (Preserves) Order 1953, permits marmalade to contain 65 per cent of total solid matter where the marmalade is hermetically sealed, but this sample was so liquid in addition to the deficiency in solid matter that it was reported as inferior. The manufacturers thought it had been run through the pipes after cleaning thereby picking up water, and agreed that it should not have been sold in this condition. The meat portion of a sausage roll contained large patches of mould growth of a fruiting penicillium species. It was at least ten days old when received. Two samples of Frozen Skinless Pork Sausages were reported as adulterated because they were sour, and the surface of the sausages showed several areas covered with mould growth. Your analyst heard a rumour to the effect that luncheon meats from a particular country contain dried milk powder, which is not declared as an ingredient. It is not illegal to add dried milk powder to a luncheon meat, but if it is present its presence must be declared among the other ingredients. A few years ago it became common on the continent to add emulsifying salts to luncheon meats and not to declare their presence because it was thought that British public analysts would be unable to detect their presence. This proved to be incorrect and the presence of emulsifying salts is now generally declared when they are used, but many manufacturers believe that they can make a better product without their use. Your analyst believes that he has found out what is now being added to luncheon meats and hopes in due course to be able to stop this practice. A special report on these additives and another on Soup Powder Mixes were submitted to the Medical Officer of Health. New Legislation. Food Standards and Reports. Four Food Regulations, one draft Regulation and three Food Standards Committee Reports have been issued during the year. - 76 - Whilst this is no large amount of legislation or proposed legislation, most of it is important and, in view of the controversial nature of the Reports it is perhaps well that the Food Standards Committee have pondered over their appearance. Arsenic in Food. The Arsenic in Food Regulations, 1959, have now been issued. The Royal Commission on Arsenic Poisoning met 1901 - 1903, and issued a First Report in 1901 and a Final Report in 1903. The full reports with evidence occupied 780 foolscap pages, but as no real standards were laid down for foods generally, it was necessary to rely on recommendations, which have been amended slightly from time to time, leaving the position unsatisfactory. The present Regulations prescribe a standard maximum arsenic content, expressed as arsenic, of 1 part per million in foods generally, with modifications down to 0.1 part per million for soft drinks up to 5.0 parts per million for spices, colourings and certain other substances used in small quantity. Perhaps one may be allowed to express the hope that other regulations regarding lead and similar metals will follow soon. Lead in Food. During the year the Ministers responsible issued a draft for Lead in Food Regulations, which has not yet been implemented. The proposal is that approximately twice as much lead as arsenic should be permitted in foods, and is on the whole very reasonable, though your analyst cannot see why cider should be permitted to contain 1 part per million of lead, whilst perry may only contain 0.2 parts per million. Condensed Milk. The Condensed Milk Regulations, 1959, consolidate and amend the Public Health (Condensed Milk) Regulations 1923 to 1953 and now provide for the sale of half cream sweetened or unsweetened condensed milk, with the proviso that it shall be labelled to the effect that it should not be used for babies except under medical advice. The regulations further lay down revised methods for the labelling of any type of condensed milk in order to make clear whether the food is prepared from full cream, half cream, or machineskimmed milk, whether it is sweetened or unsweetened, and what are the equivalent pints contained in each tin. Ice Cream. Three regulations came into force during the year which affect the composition and quality of ice cream. The Food Standards (Ice Cream) Order, 1959, prohibits the use of artificial sweeteners in ice cream and, having done so, rescinds the requirement for a minimum quantity of sugar. The fat and milk solids-not-fat contents of ice cream remain as before, though if all the fat is derived from milk, such ice cream may be described as Dairy Ice-Cream, Dairy Cream Ice, or Cream Ice. Provision is now made for Milk Ices, which contain - 77 - not less than 2½ per cent of milk fat and not less than 7 per cent of milk solids other than fat. Parev (kosher) ice remains as before. Whilst this regulation makes no provision regarding the labelling of ice cream made with fat other than milk fat the Labelling of Food (Amendment) Regulations, 1959, prohibits the use of any illustration suggestive of butter, cream or milk or anything connected with the dairy unless all the fat in the ice cream is derived from milk, other than that present in egg or a flavouring substance, though it is permissible to state that the ice cream contains skimmed milk solids. Any ice cream made with fat other than milk fat must be labelled to the effect that it "contains non-milk fat". Since standards are no longer made under the Emergency Regulations, in order to allow for the modification in labelling of ice cream, the wording of the principal Order has been changed slightly. The Ice Cream (Heat Treatment, etc.) Regulations 1959, now permit a sterilisation process other than pasteurisation to be employed and, provided that the whole process is kept sterile, the conditions affecting cooling have been relaxed. The Methylene Blue Test is maintained for the bacteriological control of the quality of ice cream. Fluorine in Food. The original Fluorine in Food Order, 1947, was brought into operation on account of the difficulty of obtaining suitable qualities of phosphates for baking powders. Now that conditions are normal the Minister has decided to allow a maximum quantity of 3 parts per million of fluorine in self-raising and similar flours, 15 parts per million in phosphate-containing baking powders, and 30 parts per million of the acidic phosphate content of any other food. This amendment will require more care in analytical control, but it is to be welcomed. Preservatives in Food. Without doubt the most important report or statutory instrument issued by the Ministry during the year was that on Preservatives in Food. The report itself is controversial and it is better merely to summarise the conclusions. Sulphur dioxide will remain the chief preservative permitted and it is suggested that this may be used in wines, beer, cider and perry, soft drinks, fruit juices, vinegar, dried fruit, fruit and fruit pulp, crystallised, glace, candied and syruped fruit, raw peeled potatoes or dehydrated potatoes, other dehydrated vegetables, sausages and butchers' minced meat, prepared starches and sugar syrups derived therefrom as well as other sugar, jams, gelatine and pectin, pickles and sauces and dry root ginger. Benzoic acid could be used as an alternative or with sulphur dioxide in soft drinks and fruit juice products. Either benzoic acid or a para-hydroxybenzoic acid ester could be used in unfermented grape juice used for sacramental purposes, liquid rennet, liquid coffee extract, flavouring syrups, and drinking chocolate concentrates. It is further suggested that propionic acid, sorbic acid, nisin, diphenyl, or ortho-phenylphenol should be used in very special circumstances. - 78 - Report on Soft Drinks. The Food Standards Committee issued a Report on Soft Drinks, early in the year, but it has not yet been implemented by a Regulation. The Committee recommend that soft drinks should be sweetened entirely by sugar and that artificial sweeteners, such as saccharin should be prohibited. They also recommend that manufacturers should be obliged to state the quantity of fruit juice present in drinks reputed to contain it, and finally they recommend that no soft drink contains sufficient carbohydrate to justify any claims relating to energy value. Other minor suggestions are put forward, but the three mentioned above are those which are likely to be discussed before its implementation. Milk Bread. In October the Food Standards Committee issued a report on the composition of milk bread in which they stated that the Committee were divided on what should be contained in milk bread and by what description a loaf containing separated milk solids should be known. The majority view of the Committee was that bread containing not less than 4.2 per cent of milk solids not fat should be sold as milk bread. The Committee generally were of the opinion that the presence of milk fat does not greatly affect the nutritive value of bread, so that the consumer is not prejudiced by the use of separated milk powder. I am, Your Worship, Ladies and Gentlemen, Your obedient Servant, THOMAS McLACHLAN, A.C.G.F.C.,F.R.I.C.,M.I.Bial Public Analyst. - 79 - Artical Taken Informally Taken Formally Total Analysed Adulterated etc. Bread 13 13 5 Butter 17 17 Chicken 1 1 Dessert Powder 1 1 Fish, canned 7 7 Fish Paste 9 9 Fish, Potted, Shrimps 1 1 Flour 10 10 Fruit, canned 2 2 Fruit Juice 1 1 1 Ice Cream 4 4 Jam 17 17 Jelly 1 1 Lard 1 1 Margarine 15 15 Margarine, Kosher 1 1 Marmalade 13 13 1 Meat, canned 10 10 Meat Paste 12 12 Milk 180 20 200 1 Milk Shake Syrup 2 2 Pate, Chicken Liver 1 1 Preserve, Ginger & Apple 1 1 1 Sausages, frozen 2 2 2 Sausage, Liver 3 3 Sausage, Polony 1 1 Sausage Rolls 1 1 1 Soft Drinks 22 22 2 Spirits 15 15 Suet, shredded 6 6 Vinegar 10 10 TOTALS 365 35 400 14 INDEX Subject. Page (s) Accidents in the Home 23 Analyst Public - Report of 74-79 Atmospheric Pollution - Recording Stations 51-53 Bacteriological Examinations 44 and 73 Bakehouses - Underground 44 Baths and Swimming Pools 34 Births 6 Burials - Sect. 50, National Assistance Act, 1948 26 Cancer of the Lung and Bronchus 13 Clean Air Act, 1956:- Church Ward Smoke Control Order 54-58 Smoke Control Area Programme 59 Committee, Public Health and Baths:- Members 1 Representation elsewhere by Members 2 Cremation Service 24 Deaths 6— 13 -Diphtheria 64 Diphtheria Immunisation 18 Disinfection and Disinfestation 50 Dysentery 63 Epidemiology 60 — 72 Factories Act, 1937 37-39 Food & Drugs Act, 1955 - Legal Proceedings 44 Food:- Hygiene 40-41 Inspection and Supervision of Premises 43 Poisoning 65-67 Unsound 49 Home Accidents 23 Hospitals 16 Day Hospital for Chronic Sick 22 Housing Act, 1957- Overcrowding 36 Housing - Applications for Re-housing 36 Infant Mortality 14-15 Infectious Diseases 60-72 Inspections and works carried out 28-33 Introduction 4 — 5 Legal Proceedings 44 Subject Page (s) Mass Radiography 27 Maternity and Child Welfare 17-19 Measles 63 Medical Examination of Staff 26 Milk Supply 45 Mortuary facilities 27 National Assistance Act, 1948 - Sect. 50, Burials 26 Notices - Service of 35 Old People, Welfare of 20-22 Overcrowding 36 Outworkers 39 "Part III" Accommodation 19 Pet AnimaIs Act, 1951 46 Pharmacy and Poisons Act, 1933 46 Poliomyelitis 64 Public Analyst - Report of 74-79 Public Health and baths Committees- Members 1 Representation elsewhere by Members 2 Public Health Department - Staff of 3 Public Health Inspectors - Work of 28-59 Puerperal pyrexia 63 Rag Flock and Other Filling Materials Act, 1951 46 Rent Act, 1957 35 Rodent Control 48 Scar1et Fever 63 Shops Act, 1950 42 Smoke Control:- Church Ward Smoke Control Order 54-58 Smoke Control Area Programme 59 Spastic Children 25 Staffs:- Medical Examination of 26 Public Health Department 3 Statistics:- Births, Deaths, Stillbirths, Illegitimate births, population, etc. 6-9 Street Trading 47 Tuberculosis 69-71 Underground Bakehouses 44 Unsound Food 49 Vaccination 18 Subject Page (s) Water supply 34 Welfare of Old People 20-22 Whooping Cough 64 Zymotic Diseases 72