AC 4345 59 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 1961 METROPOLITAN BOROUGH OF CHELSEA PUBLIC HEALTH AND BATHS COMMITTEE (at 31st December, 1961) Chairman: Councillor J.A. Paterson-Morgan, F.L.A.S.,J.P. Vice-Chairman: Councillor A.H. Stevenson. Alderman Miss M. D. Shufeldt Councillor Miss Katharine Acland, O.B.E.,T.D. Councillor Mrs. E.C. Blackett, M.A. Councillor J. Elliott Brooks, L.C.C. Councillor Mrs. G.K. Buxton Councillor J.C. Corder, F.R.I.C.S. Councillor H. Denman Councillor Miss Aimee Gibbings Councillor Mrs. C. Mallet Councillor M. Nadin Councillor Dr. Lucy Wills Ex-Officio Members The Worshipful the Mayor (Councillor J.S. Tatton-Brown, M°A.,J.P.) The Deputy Mayor (Councillor Lady Heath, B.Sc.) Borough Representation on outside Committees and other Organisations concerned with Public Health work. (At 31st December, 1961) Chelsea Deanery Moral Welfare Association: Chelsea Tuberculosis Care Committee: Chelsea Youth Committee: Family Welfare Associations London County Council Divisional Health Committee (Division I): London County Council Divisional Tuberculosis Care Committee (Division I): London and Home Counties Clean Air Advisory Council: National Society for Clean Air: Old People's Welfare Committee: Councillor Mrs. G.K. Buxton Councillor Mrs. G.K. Buxton Mr. D. Laffeaty Mr. J.E. Woolford Miss Mellicent Lyall, M.B.E. Councillor Mrs. G.K. Buxton Councillor A.H. Stevenson Councillor Mrs. G.K. Buxton The Worshipful the Mayor, (Councillor J.S. Tatton-Brown, M.A.,J.P.) Chief Public Health Inspector. The Worshipful the Mayor, (Councillor J.S. Tatton-Brown, M.A.,J.P.) Councillor Mrs. G.K. Buxton. The Worshipful the Mayor, (Councillor J.S. Tatton-Brown, M.A., J.P.,) The Deputy Mayor, (Councillor Lady Heath, B.Sc.) Councillor J.A. Paterson-Morgan, F.L.A.S., J.P. Councillor A.H. Stevenson. Councillor J. Elliott Brooks, L.C.C. Councillor Miss Elisabeth Stockwell. Westminster and Chelsea District Nursing Association: Councillor Miss Aimee Gibbings. STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December, 1961. Medical Officer of Health: J.H. WEIR, M.D.,B.S.,B.Hy.,D.P.H. Deputy Medical Officer of Health: D.J. SHEERBOOM, M.B.,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. T.W. CAMSEY. A.J. WHITE. E.R. YOUNG. (Miss) A.C.C. KAY. Women Public Health Inspectors: (Miss) G.K. READER. Drainage Assistant: E. BOSLEY. Rodent Officers: J.F. COOKE. P. DRURY. Public Health Inspectors' Assistant: F.G. RAWLINGSON. Chief Disinfector: F.w. HILL. Disinfector: R.J. WESTON. Cleansing Station Attendant: (Mrs.) J. LOBBAN. J.C. BRYANT (retired 31.10.1961) Chief Clerk: I.M. THOMSON (promoted 1.11.1961) Clerical Officers: P.M. MARGETTS. H.G. HAMILTON. L.A. POWELL. (Mrs.) W. BAAR (resigned 24.5.1961) (Mrs.) J.M. LEE (commenced duty 23.6.1961) P.D. GRAINGER. (Mrs.) O.M. BURKE. Social Worker: Thos. McLACHLAN, A.C.G.F.C., F.R.I.C.,M.I.Biol. Public Analyst: METROPOLITAN BOROUGH OF CHELSEA TELEPHONE: FLAxman 8101 Public Health Department, Town Hall, King's Road, CHELSEA, S.W.3. June, 1962. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Chelsea. Your Worship, Ladies and Gentlemen, I have pleasure in presenting to you my Annual Report on the health and sanitary circumstances of the Borough of Chelsea during 1961. The mid-year home population of the Borough as estimated by the Registrar-General was 48,490, as against 49,140 for the previous year, thus continuing the steady decline which has been evident since 1950. During the period 1950 - 1961 the population has decreased by 4,000. 663 live births (332 males: 331 females) were registered during the year compared with 697 in 1960, giving a birth rate of 13.7 per 1,000 of the estimated population which is the lowest rate recorded since when it was 13.4. Illegitimate live births numbered 93 or 14.0 per cent of the total live births. The total number of deaths was 725 (330 males: 395 females) 4 less than the figure for the previous year (729) which gives a death rate of 14.9 per 1,000 of the estimated population. Of the 725 deaths recorded, 528 (72.83%) related to persons aged 65 and over. It is interesting to note from the classified Table of Deaths incorporated in this Report that the main causes of death were disease 213; cancer (all forms) 136; vascular lesions of the nervous system 89; whilst pneumonia and bronchitis caused 71 deaths. 37 deaths were attributed to accidents or violence (motor vehicle accidents 10: all other accidents 14: suicide 13) which represents 5.1% of the total deaths recorded. 5 males and 4 females died from pulmonary tuberculosis and one female died from the non-pulmonary form of the disease. Although 10 deaths is the highest number recorded since 1952 it should be noted that 6 of these occurred in persons aged 65 and over. Deaths from cancer of the lung totalled 27 (22 males: 5 females) 3 fewer than in the previous year. 16 of the deaths occurred in persons in the 45 and under 65 age group and the remaining 11 deaths concerned persons aged 65 and over. It is gratifying to note that for the seventh successive year there were no maternal deaths or deaths from causes associated with childbirth. 16 deaths of infants under one year of age were recorded as compared with 12 during the previous year, indicating an infant mortality rate of 24.1 per 1,000 live births. The cause of death in 9 instances was due to prematurity. Of the 16 infant deaths, no fewer than 15 occurred in the first week of life which gives an early neo-natal mortality rate of 22.6 per 1,000 live births. There were 11 still births which, added to these deaths in the first week of life, gives a perinatal mortality rate of 38.5 per 1,000 total live and still births. 652 infectious disease notifications were received during the year an increase of 436 compared with 216 cases reported in 1960. This significant increase was entirely due to the incidence of measles, cases were notified as against 15 for the previous year, which represents 86.5% of the total notifications received. It is particularly pleasing to note that only one case of food poisoning was brought to the attention of the Public Health Department throughout the year. During 1961, the Public Analyst to this authority (Mr. Thomas McLachlan) examined and reported upon 260 samples of food and drugs which were submitted to him for analysis. There were only 8 instances where samples were reported to be adulterated or unsatisfactory and each case was thoroughly investigated and appropriate action taken. A comprehensive account of the work undertaken by your Analyst is incorporated in this Report. Seven complaints were received from residents concerning the sale of food stuffs not being of a satisfactory nature and in one instance it was necessary to resort to legal proceedings. The defendants pleaded guilty to the offence and a fine of £60 was imposed with costs totalling £5. 5s. Od. All food shops and catering premises in the Borough have been visited frequently throughout the year by the Public Health Inspectors to ensure compliance with the requirements of the Food Hygiene Regulations. Considerable time has been spent discussing improved lay-outs in restaurant kitchens and the modernisation of kitchen equipment. In many cases kitchen staffs have been advised on food hygiene problems and health education, in an endeavour to make them realise the importance of their work and the part they play in preparing clean food. Particular attention has been directed to shops where food is pre-packed on the premises to ensure that it is not contaminated before packing, and that staffs have adequate washing facilities conveniently placed to enable them to wash their hands before handling bulk foods. Numerous visits have been made to dining-rooms and shack-bars in public houses to ensure that good standards of hygiene are maintained. Brewers have responded well to requests for the installation of modern equipment to improve existing facilities. The volume of work in connection with the supervision of plumbing and drainage both for new as well as old buildings has increased very considerably throughout the year and the District Public Health Inspectors have been called upon to devote a great deal of time to this important aspect of their work. The large-scale redevelopment now taking place in the Borough such as the Carlton Tower Hotel, Wandon Road Flats, and innumerable other large blocks together with numerous conversions of existing buildings, has necessitated many lengthy discussions and site meetings with owners, architects and builders. The Council and its officers, together with the local voluntary organisations, have continued to show a keen and energetic interest in the welfare of the aged and infirm. The number of elderly persons who have problems or who wish to take advantage of the many facilities which are available is increasing each year. During the year under review 191 new cases were visited by the Social Worker who also undertook 1,886 re-visits to persons already on the register. The closest co-operation is maintained between this Department and the Old People's Welfare Committee, and I am grateful for the invaluable services rendered by the various local voluntary organisations, whose untiring efforts have brought comfort and happiness to many old people and made them realise that they can participate in the life of the community,. Steady progress has been maintained regarding the establishment of Smoke Control Areas within the Borough in accordance with the phased programme approved by the Council in February, 1959° The Council's first Smoke Control Order which covers the whole of Church Ward has been operative since Ist November, i960, and it is most encouraging to report that no serious problems or difficulties have been encountered during the first year of operation. Hans Town Ward is the next Area to be brought under smoke control. The Order for this Area has been confirmed by the Minister of Housing and Local Government and will come into operation on Ist November, 1962. It is with considerable regret that I have to refer to the retirement of my Chief Clerk, Mr. J.C. Bryant, who asked to be superannuated on Ist November last, on the grounds of permanent ill-health. Mr. Bryant, who had completed 32 years service with the Borough Council, was a very capable and conscientious officer. I always found him a most loyal and dependable colleague and Chelsea has greatly benefited by his work over the past 32 years. His early departure into retirement was a personal loss to all his colleagues in the Department. In conclusion, may I express my appreciation and thanks to the Chairman and Members of the Public Health and Baths Committee and other Members of the Council, for the help and support they gave me throughout the year. I am also most grateful for the assistance and co-operation I have always received from the Chief Officers and members of the staffs of other Departments. Finally I would like to extend my sincere thanks to my Deputy, Dr. D.J. Sheerboom, and the members of the staff of the Public Health Department for their loyalty and the efficient manner in which they have carried out their many duties. I am, Your Worship, Ladies and Gentlemen, Your obedient Servant, A.U. Medical Officer of Health. Area of Borough: 659.6 acres General Rate: 17s.4d. in the £ (at 31st March, 1961) Product of a Penny Rate (gross): £7,915 Rateable value of Borough as at 31st March, 1961: £1,963,322 Population: Registrar-General's estimate of the population of the Borough (mid-year 1961): Density of population per acres 48,490 73.51 Number of Dwellings (according to the Rate Books): 16,288 Live Births: Total Male Female Legitimate Illegitimate 570 93 663 290 42 332 280 51 331 Birth rate per 1,000 of estimated population: 13.7 Adjustment of birth rate by area comparability factor (0.76): 10.4 (Birth rate for England and Wales - 17.4) Illegitimate Live Births (per cent of total live births): 14.0 Still Births: Total Male Female Legitimate Illegitimate 9 2 11 6 2 8 3 - 3 Rate per 1,000 live and still births: 16.3 (Still birth rate for England and Wales - 18.7) Total Live and Still Births: 674 Infant Deaths (deaths under one year):- Total Male Female Legitimate Illegitimate 13 3 16 5 1 6 8 2 10 Rate per 1,000 live births: 24.1 GENERAL AND VITAL STATISTICS 1961 GENERAL AND VITAL STATISTICS (Continued) Infant Mortality Rates - Total infant deaths per 1,000 total live births: (infant Mortality rate for England and Wales - 21.4) 24.1 Legitimate infant deaths per 1,000 legitimate live births: Illegitimate infant deaths per 1,000 illegitimate live births: 22.8 32.2 Neo-natal Mortality Rate (deaths under four weeks per 1,000 total live births): 24.1 Early Neo-natal Mortality Rate (deaths under one week per 1,000 total live births): 22.6 Perinatal Mortality Rate (stillbirths and deaths under one week combined per 1,000 total live and still births): 38.5. Maternal Mortality (including abortion): Number of deaths: NIL Rate per 1,000 total live and still births: Deaths: Total 725 Male 330 Female 395 Death rate per 1,000 of estimated population (Males 6.8 Females 8.1): 14.9 Adjustment of death rate by area comparability factor (0.72): 10.7 (Death rate for England and Wales -12.0) Tuberculosis: Deaths from Pulmonary Tuberculosis: 9 Deaths from Non-Pulmonary Tuberculosis: 1 Death rate from Pulmonary Tuberculosis per 1,000 of estimated population: Death rate from Non-Pulmonary Tuberculosis per 1,000 of estimated population: Marriages: Number of marriages solemnised in the Borough during the year: 812 16.7 Marriage rate per 1,000 of estimated population: (Marriage rate for England and Wales - 15.l) - SUMMARY OF VITAL STATISTICS 1952-1961 (inclusive) Year 1952 Registrar-General's Estimate of Population Births Deaths Deaths under One Year Maternal Deaths No.* Rate Rate No.* Rate No.* Rate No.* 12.8 15.1 669 16 - 52,140 - 787 20 1953 52,150 13.3 15 15.1 694 3 3.7 787 19 734 14.1 1954 15.1 21 2 2.5 52,060 787 27 16.0 25 1955 51,450 14.5 825 - 745 34 16.4 815 16.0 51,070 21 1956 837 - 25 14.6 14.8 1957 750 50,600 - 738 16 22 730 14.5 - 1958 14.8 24 50,190 742 32 - 1959 49,520 726 14.6 14.7 722 12 16 - 49,140 1960 14.2 729 14.8 697 12 17 48,490 725 - 1961 13.7 14.9 - 663 16 24 Averages for the ten years 1952-1961:- Births 750 Deaths 739 Deaths under one year of age 17.8 Maternal Deaths 0.5 * Totals arrived, at after due allowance for inward, and outward transfers. CLASSIFICATION OF DEATHS OF CHELSEA RESIDENTS WITH AGE DISTRIBUTION FOR THE YEAR 1961 1 and under 5 5 and under 15 15 and under 25 Causes of Death at all ages Under 1 year 25 and under 45 45 and under 65 1. Tuberculosis, respiratory 9 - - - - 2 2 - - 2. Tuberculosis other 1 - - - - - 3. Syphilitic disease 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4. Diphtheria 5. Whooping-Cough - - 6. Meningococcal Infections - 7. Acute Poliomyelitis - 8. Measles 1 - 1 - - - 2 9. Other infective and parasitic diseases 2 - - - - - 6 10. Malignant neoplasm, stomach 16 - - - - 1 16 11. Malignant neoplasm, lung, bronchus 27 - - - - - 7 12. Malignant neoplasm, breast 17 - - - - - 2 13. Malignant neoplasm, uterus 5 - - - - - 15 14. Other malignant and lymphatic neoplasms 67 - - 1 1 7 1 4 15. Leukaemia and Aleukaemia - - - - 1 - 4 16. Diabetes - - 1 - - - - - - - - - - - - - 9 17. Vascular lesions of nervous system 89 - 1 28 114 18. Coronary disease, angina 2 - 3 - 19. Hypertension with heart disease 96 5 20. Other heart diseases 2 5 48 21. Other circulatorydiseases - - - - - - - 1 1 - 22. Influenza 6 23. Pneumonia 37 3 - 1 - - - - - - - - 24. Bronchitis 34 3 - - - - - 2 581 1 1 104 Carried Forward 2 17 31 33 6 41 CLASSIFICATION OF DEATHS OF CHELSEA RESIDENTS WITH AGE DISTRIBUTION FOR THE YEAR 1961 Under 1 year 1 and under 5 5 and under 15 25 and under 45 65 and upwards Causes of Death at all ages 15 and under 25 45 and under 65 Brought forward 581 1 - - - - - - 2 17 104 454 1 2 - - - - - - - 6 - - 1 25. Other diseases of respiratory system 4 - - - - 26. Ulcer of stomach and duodenum 3 - - 27. Gastritis, enteritis and diarrhoea - 1 - 5 - - 2 28. Nephritis and nephrosis 8 - - - 29. Hyperplasia of prostate - - - - - 30. Pregnancy, childbirth, abortion - 1 9 2 1 2 31. Congenital malformations 2 1 - - 11 42 71 - 32. Other defined and ill-defined diseases 12 2 4 10 4 - - 33. Motor vehicle accidents 3 4 1 34. All other accidents 14 - 1 - - - 3 1 - - - - 8 35. Suicide 13 3 - - 36. Homicide 1 1 - - TOTALS 11 725 16 3 4 31 132 528 AGE MORTALITY Number of Deaths Percentage of Total Deaths Under one year 2.21 16 1 and under 5 3 0.41 5 and under 15 0.55 4 15 and under 25 11 1.52 25 and under 45 31 4.27 45 and under 65 132 18.21 65 and upwards 528 72.83 CANCER OF THE LUNG AND BRONCHUS - 27 deaths (Males 22 and Females 5) from this cause were recorded during 1961 as compared with thirty deaths (Males 25 and Females 5) in i960. The following table gives details of the deaths of Chelsea residents during the ten years 1952 to 1961:- Year Males Females Totals Percentage of deaths registered 1952 27 6 33 5.0 1953 16 4 20 2.9 1954 7 3.7 20 27 1955 21 8 29 3.5 1956 6 31 25 3.8 1957 16 6 22 2.9 6 28 4.0 1958 22 36 4.9 1959 31 5 1960 25 30 4.2 5 3.7 1961 22 5 27 Totals 225 58 283 - Averages 22.5 5.8 28.3 3.8 It is apparent, therefore, that deaths occur in the ratio of four males to one female. The following summary of deaths for England and Wales during each year from 1952 to 1961 has been prepared from information made available by the Registrar-General:- Year ENGLAND AND WALES Cancer of the Lung and Bronchus Number of Deaths Registered Increase over preceding year 1952 971 14,218 1953 15,132 914 1954 16,331 1,199 1955 17,271 940 914 1956 18,185 933 1957 19,118 1958 691 19,809 1959 21,063 1,254 1960 21,992 929 817 1961 22,809 INFANT MORTALITY Deaths of infants under one year totalled 16 as compared with 12 during 1960, giving a rate of 24 0 1 per 1,000 live births. The infant mortality rate for England and Vales is 21„*f<, The increase in deaths during the year was mainly due to the incidence of prematurity which was returned as 9 as against 2 in the previous year. It will be noted from the following summary that of the 16 deaths recorded, 15 occurred before the age of one week. Cause of Death Under 1 Week 1-2 weeks 2-4 weeks 1-3 months TOTAL M F M F M F M F M F Prematurity 3 6 - - - 3 6 1 Asphyxia - - - - 1 - - 1 Congenital Heart Disease 1 - - - - 1 - - Hydrocephalus - 1 1 - - - Massive infarction of Placenta - 1 - - - Haemolytic disease of the new - - 1 1 1 1 - Cerebral Haemorrhage - - - 1 Haemorrhagic Diathesis - - - - - - - 1 6 9 - 1 6 10 - TOTALS - - - - - - - - - - - - - - - - - - - - - - - - - - - - - INFANT MORTALITY RATES ENGLAND AND WALES AND VARIOUS OTHER COUNTRIES Deaths under 1 year of age per 1,000 live births. Country 1954 1955 1956 1957 1958 1959 1960 22 23 24 England. & Wales 25 35 22 22 17 16 Sweden 19 17 17 15 15 17 21 19 17 17 17 Netherlands 20 20 New Zealand 22 22 19 19 20 20 Australia 22 22 22 21 20 22 20 Denmark 27 25 25 23 22 22 21 26 United. States of America 27 27 26 26 27 26 29 Scotland 31 30 28 28 28 26 33 Republic of Eire 38 37 36 35 32 29 34 France 41 39 36 31 30 27 Italy 53 49 48 50 48 45 44 The above table has been prepared from information made available by the Registrar-General. CREMATION SERVICE In October, 1957? an agreement was entered into with the General Cemetery Company whereby cremation facilities became available at West London Crematorium, Kensal Green, for persons who, at the time of death, resided or were normally resident in the Borough of Chelsea. A reduced standard charge of four guineas applies in such cases and during 1961 arrangements for cremation were made in respect of thirty-one persons. The total number of cremations recorded in Great Britain last year was 224, 464, compared with 204,034 in i960, an increase of 20,4300 The total for 1961 represented 36.45$ of the recorded deaths, compared with 34.71$ for the preceding year. The following table illustrates the progress of cremation in Great -Britain over the past twenty years:- Year No. of Crematoria No. of Cremations Percentage of total Deaths 1942 57 28,518 5.23 1943 58 34,259 6.03 1944 58 39,016 7.00 1945 58 42,963 7.80 1946 50,160 58 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 1960 148 204,034 34.71 1961 224,464 36.45 160 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. Spastic Children, The Centre for 61, Cheyne Walk, S.W.3. 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 Treatment and. research of cerebral palsy in the very young children. Children's Diseases NURSING HOMES Belgravia-Chelsea Nursing Home, 39, Royal Avenue, S.W.3. Private PERSONAL HEALTH SERVICES - London County Council The London County Council is responsible for the day-to-day administration of these services. Division 1 of the County Council comprises the TJoroughs of Chelsea, Fulham, Hammersmith and Kensington 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 1,274 6,236 Attendances at Infant Welfare Sessions HEALTH VISITING Number of visits carried out by Health Visitors Expectant mothers; First visits Total visits 425 927 First visits (including visits paid to premature infants) Total visits Children under 1 year» 1,001 3,181 Children between 1 and 2 years: Total visits 1,594 Children between 2 and 5 years: Total visits 2,396 2 and 5 years: Still births: Total visits 3 School children: Total visits 151 Care of old people: Total visits 18 Care of other people: Total visits 62 Miscellaneous: Total visits 233 Unsuccessful: Total visits 1,^13 No. of children under 5 visited during the year 1,895 No. of households visited during the year 1,531 Foster mothers: Number of registered foster mothers 4 Number of children fostered 3 Diphtheria Immunisation: No. of children who completed a primary course of injections 430 No.of children receiving reinforcing injections 439 Vaccinations: No. of children vaccinated at Violet Melchett Infant Welfare Centre 264 Details of the facilities available at the Violet Melchett Infant Welfare Centre, Flood Street, S.W.3., are as follows CLINICS Monday p.m. (by appointment) Ante-natal and Post-natal: Relaxation and Ante-natal Wednesday: 12 noon to 1 p.m. Exercises: Friday : 2 p.m. to 3 p.m. Mothercraft classes with Demonstrations and Films: Friday at 3 p.m. Infant Welfare: Tuesday & Thursday: 2 to 4 p.m. Wednesday: 10.30 a.m. to 12 noon, at the Community Centre, 385. King's Road. S.W.10. Test feeds: arranged as required Vaccination against Smallpox Tuesday at 10 a.m. Immunisation against Diphtheria, Whooping Cougfr, Tetanus and Polio: Special Toddlers» By appointment on the first Thursday in each month. Dental Clinic (for children only) : Monday 9.30 a.m. (by appointment) Health Visitors are available at the Centre for interview daily from 9 a.m. to 10.15 a.m. and from if.3o 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, Tuesday and Thursday; Friday 9 a.m. to 12.30 p.m{ closed on Saturday. CENTRE FOR SPASTIC CHILDREN The following report on the work of the Centre for Spastic Children has been kindly supplied by The Secretary of the Chelsea and Kensington Hospital Management Committee. The Centre for Spastic Children has continued its excellent work throughout the year at 61, Cheyne Walk, under the control of the Chelsea and Kensington Hospital Management Committee. At the Centre, selected children between the ages of 2 to 7 years, suffering from cerebral palsy are accepted for admission to one of the nursery classrooms where they receive both educational training and therapy. Under regular medical supervision they are given daily physiotherapy, speech therapy, audio-therapy and occupational therapy as necessary, The two nursery classrooms, which can accommodate 15 children in each, were full for most of the year. In addition, the Assessment Unit which provides similar facilities for more backward children had as many as 12 on the roll. With these, plus other children who attend the Centre for various forms of therapy only, the Centre maintained an average of 65 children under treatment throughout the year, including three from overseas. The Hostel, which is maintained by the Friends of the Spastic Centre and which can provide residential facilities for up to six children and, if necessary one or two mothers, was well utilised. Endeavour to improve facilities is constant and the past year has seen an extension of the loop induction system which now enables children with hearing losses to be included in Group activities with normal hearing children in all the classrooms and in the garden, extension of the available playing space in the garden, improved accommodation for occupational thereapy and the provision of a glass verandah in the garden which will enable some children to remain out of doors even in inclement weather. Perhaps the greatest improvement however, was the long awaited start on a hydrotherapy pool which, when completed will prove of tremendous physiotherapeutic value to the children. The clinical work includes, for all cases, routine neurological examination, full psychological, audiological and ophthalmological tests and the making of a clinical film. The Centre now holds a unique collection of nearly 300 films which are priceless for research purposes. The electro-encephalogram department accepts adult patients from a number of hospitals in addition to the children of the Centre and it produces over 500 records each year. In October, 1961, a post-graduate course was again held and lectures and demonstrations on the etiology, pathology and management of cerebral palsy were given to doctors and physiotherapists. Speech, physio and occupational therapy students attended the Centre for special training and in addition large numbers of visitors, professional and lay, visited the Centre from all parts of the world. WELFARE OF OLD PEOPLE. To be aware of elderly persons who have problems and to be able to keep in touch with them is of the utmost importance in providing the help when it is most urgently needed and, in this connection, the Welfare Officer visited 191 new cases during the year and made 1,886 re-visits to the 1,200 old people already on the register. Additional visiting by the British Red Cross Society, the Women's Voluntary Services and the St. John Ambulance Brigade in connection with the delivery of meals, recreation and personal cleansing, is of great value and provides a constant liaison with the Public Health Departments. Grant The Borough Council makes a grant of per annum to the Chelsea Old People's Welfare Committee. Meals on Wheels This service, organised and distributed by the voluntary organisations on five days a week, not only ensures that our more housebound old people are certain of one good meal a day, but provides a valuable link with all services available. Number of meals issued during the year 13,476 Average weekly supply 259 Average number of old persons supplied 67 August 1961, saw the introduction of frozen meals, which were, to the old people, quite revolutionary and many were suspicious of this new systems These suspicions were quite successfully overcome by bringing as many of the regular recipients as possible by car to a demonstration lunch at the Community Centre which was kindly arranged by Messrs<> Lyons, from whom a weekly delivery of foods is obtained and stored in a deep freeze unit at the Centre. Since the inception of these meals they have become generally appreciated and the variety of dishes has considerably increased. The cost of each meal to the old people is Is. Od. per day and the preparation requires fifteen minutes only in a saucepan of boiling water. Chiropody - Domiciliary Service 168 persons received 648 treatments given by two fully qualified chiropodists working six days a month between them. All applicants are visited and approved by the Welfare Officer before recommending to the British Red Cross Society who administer the service. Chiropody - Old People's Clinic 1,862 treatments were given at the Chelsea Community Centre which is staffed by London County Council chiropody students. This is a twice weekly service and is now free to the pensioners. Holidays These are arranged throughout the Summer in conjunction with the Women's Holiday Fund and Hotel and Boarding House Associations at seaside resorts, particularly Ramsgate, where a small hotel caters almost entirely and very efficiently for old people's holidays. As the result of an appeal by the present Mayor and his predecessor, £200 was allocated to provide old people, who had been ill during the winter months, with a much needed rest that they could not possibly have taken at their own expense. Number of assisted holidays 27 Self-paid holidays 77 Total 104 The more infirm people requiring holidays are referred to the Physically Handicapped Department of the London County Council. Incontinent Laundry This is a twice weekly service carried out in co-operation with the Fulham Borough Council and applications are received from doctors and the District Nursing Association. Number of recipients approved 39 Weight of articles laundered 8,981 Ibs. Provision of this service often discloses the urgent need for fresh beds, mattresses, bedding, mackintosh sheets and clothing, which were supplied by this Department and the voluntary services jointly. Home Personal Cleansing is a voluntary service performed.by a nurse of the St. John Ambulance Brigade who visited a weekly average of eight specially difficult cases during the year. Domiciliary Library and Shopping Services are supplied by the Women's Voluntary Services and the British Red Cross Society to old people on the recommendation of the Welfare Officer. Christmas Parcels The Christmas Dinner Fund Committee collected sufficient money to provide an increased amount of good cheer to old people during Christmas week and deliveries were on an entirely voluntary basis. Number of parcels distributed by the Committee 530 Number distributed by other organisations and private donors 210 Total 740 Old Time Dancing and Arts and Crafts Classes Both these classes are now well established and are self-supporting in that they provide their own materials and outings, and are of considerable therapeutic value to their members. The classes are sponsored by the London County Council who provides the Instructors and charges a small fee of Is. 6d. per term and 2s. Od. per annum respectively. 60 Number attending Dancing Class Number attending Arts and Crafts Class 20 Clothing Issues have been made through the Women's Voluntary Services and the Welfare Officer to 225 persons during the year. Coal (gift) Sums of £100 and £10 donated by the Chelsea Benevolent Society and the Royal Hospital respectively enabled 105 old people to receive two cwts. coal. Preference is given to invalids, rheumatic sufferers and basement dwellers. Accidents in the Home With the object of preventing accidents caused by faulty gas appliances, any such defects discovered by the officers of the Public Health Department are reported to the North Thames Gas Board who visit, inspect and advise on any improvements that are considered necessary, to ensure that all equipment is in good working order. Whenever possible, gas and electric meters are lowered to positions within easy reach with a view to reducing the risks old people take in the home climbing on chairs, steps, etc. Fireguards are supplied by the Old People's Welfare Committee or on application to the London County Council and safety bath mats are also provided. Outings The provision by the British Red Cross Society of a minibus capable of carrying 8 infirm old people has been a means of providing a glimpse of the outside world and companionship to over 100 old people who would otherwise have remained almost completely housebound. This service has helped them to realise that they are not forgotten and can still remain in touch with life around them and which is of tremendous psychological value. Each of the four Clubs held their annual outgoings to the sea and 4 additional invitations from the Women's Institutes and the Rotary Club enabled a further 200 pensioners who were not club members to enjoy a day in the country. Hospital Admissions and Institutional Care Excellent relations exist between this Department and the local hospitals, especially St. Luke's Hospital for the elderly and chronic sick, who admit all patients with the minimum of waiting and whose Almoners are most co-operative over problem cases. Every effort is made by the Old People's Welfare services to maintain old people in their own homes as long as possible with the result that only 15 people were admitted to Homes during the year and in no case was it necessary to take action under statutory powers. However, the following case is indicative of some of the problems which are found when dealing with old people:- Mr and Mrs X (both over 70 years) - It had been necessary to place Mr. X in hospital on two previous occasions but his third admission became necessary to ensure his safety as Mrs X was becoming increasingly senile and had nearly gassed them both on one occasion. The Gas Board was called in and provision of a safety gas burner was advised and installed. A Home Help was asked to visit Mrs. X but unfortunately she was always turned away and in the end it needed a good deal of persuasion before Mrs. X would allow her entry. It was necessary for the Welfare Officer personally to take Mrs. X to the Cleansing Station for regular bathing and also to the Foot Clinic for treatment. She was also supplied with fresh clothing to ensure that she was reasonably clean. Meals were provided but had to be heated by the Home Help or the Welfare Officer to make sure the old lady had one good meal a day. Arrangements were also made to collect Mrs. X's pension every week. In spite of these services, it finally became necessary to persuade Mrs. X to enter a Home, where she is occasionally able to visit her husband in hospital. NATIONAL ASSISTANCE ACTS. 1948/1951. National Assistance Act, - Section 47, and National Assistance (Amendment) Act, 1951 - Section 1. Removal to Hospital and/or Institution of Persons in Need of Care and Attention. During the year no action was necessary under the provisions of the above Acts for the compulsory removal of aged and infirm persons in need of proper care and attention. National Assistance Act, 1948 - Section 21. Provision of "Part III" Accommodation. It is the duty of a local authority, subject to and in accordance with the provisions of Section 21 of the Act, to provide residential accommodation for persons needing care and attention, and temporary accommodation for persons who are in urgent need thereof. The London County Council is, in this particular respect, "the local authority", and such accommodation is provided at "King's Mead", Dovehouse Street. During the year it was necessary to arrange for the admission of fifteen persons to "King's Mead". National Assistance Act, - Section 50. Burial or Cremation of the Dead, Under Section 50 of the above Act the Borough Council is required to arrange for the burial or cremation of any person who has died or who has been found dead in the Borough, if it appears in such cases that no other suitable arrangements can be made. Cremation is not carried out having regard to the many legal, religious, administrative and practical difficulties, and disposal is always by way of interment which obviates any suggestion that the Council has acted in an unauthorised manner. The Borough Council has power to recover from the estate of a deceased person the expenses incurred in carrying out this duty, in so far as these expenses are not covered by a Death Grant under t he National Insurance Scheme. During the year it was necessary to arrange four burials as follows:- Males Females (Aged) 86 years 39 years 90 years Unknown new born child MASS RADIOGRAPHY The Organising Secretary of the South West London Mass X-Ray Service has kindly furnished the following report on the activities of the Service in Chelsea during 1961s = During the year a Mobile Unit of the South West London Mass X-Ray Service visited The Chelsea College of Technology in Manresa Road, where 513 students and staff were examined, and a visit was also made to the College of Aeronautical and Automobile Engineering, where 395 persons were x-rayedo Two visits were made to x-ray staff of John Lewis Clearings and Peter Jones Limited, and a Unit also went to x-ray staff at The Royal Marsden Hospital, and the London Transport Executive, Power Station, (Lots Road). About two hundred men over 45 years of age who live and/or work in Chelsea, are making use of the six-monthly service, which was started three years ago, to provide regular chest x-ray examinations for men in that age group, in an effort to detect more cases of lung cancer, while they are still curableo In connection with this service a Mobile Unit comes twice a year to the junction of King's Road and Manresa Road« It was not possible to arrange for a public Mass X-Ray Centre to be opened in the Borough this year, but many residents of Chelsea found it convenient to attend the South West London Mass X-Ray Centre at Western Hospital, Seagrave Road, Fulham, S.W.6. This Centre is open to everyone over the age of fifteen (irrespective of where they work or live), on Wednesday afternoons and evening between 2.00 p.m. - 4.00 p.m., and 5 p.m. 7.00 p.m., and no appointments are needed for these public sessions. ACCIDENTS IN THE HOME During the year, the London Ambulance Service removed to hospital 111 Chelsea home accident cases. Although it has not been possible to furnish figures showing the various causes of these local accidents the following summary shows that, within the Administrative County of London, the majority of home accidents were due to falls. It will be observed that the total home accident cases during the year was 8,431, of which no less than 6,456 resulted from falls in or about the home, and in 3,037 of these cases the victims were aged 65 and upwards. More deaths result from accidents in the home than from road accidents and thousands of people, mostly elderly men and women and young children, are severely injured and caused unnecessary suffering. Greater efforts should be made to make people more conscious of their responsibility to take all possible precautions to remove the causes of accidents in the home. Summary of Home Accidents reported by the London Ambulance Service within the Administrative County of London during the year 1961. Percentage of Total Accidents Total accidents reported 8,431 Total accidents caused by falls at all ages 6,456 76.5 Total accidents due to other causes at all ages 1,975 23.5 Total accidents caused by falls Under 1 year 53 .06 6.17 1 and under 5 520 456 5.41 5 and under 15 15 and under 25 4.45 375 25 and under 45 754 8.94 45 and under 65 1,261 14.95 65 and upwards 3,037 36.02 ROAD ACCIDENTS The following summary shows the road, traffic accidents which occurred within the Borough during the year. The total number of accidents was 459, causing 549 casualties, 8 of which proved fatal. It is at least gratifying to record, having regard to the very heavy volume of traffic which passes through Chelsea during peak periods, that no children were killed on the roads within the Borough during the year under review. 11 children were, however, seriously injured, and 35 sustained slight injuries. I am indebted to the Town Clerk for making this statistical information available to me for inclusion in my Report. Month No. of Accidents Adults Children Total killed Seriously Injured Slightly Injured killed Seriously Injured Slightly Injured killed Injured January 40 3 8 33 1 4 3 46 - February 33 - 4 28 - 1 2 - 35 March 51 - 5 40 - 1 8 - 54 April - - 1 47 1 6 44 1 51 41 - 1 May 1 4 38 3 3 48 June - 35 - 5 30 1 2 - 38 July 33 42 - - 45 2 1 - - August 36 - 7 38 1 5 - 51 - - September 32 - 6 30 - 3 - 39 - October 41 1 2 39 1 1 1 43 November 28 1 7 25 1 1 1 34 - December 42 44 4 1 8 1 1 57 - TOTALS 459 8 64 431 11 35 8 541 - Accidents per mile of road 13.9 CONFERENCES The Council was officially represented at the undermentioned. -Conferences dealing with matters within the purview of the Public Health and Baths Committee:- Association of Public Health Inspectors Bournemouth 19th to 22nd September National Association of Baths Superintendents Torquay 10th to 13th October National Society for Clean Air 4th to 6th October Brighton Royal Society of Health Blackpool 24th to 28th April CONTRIBUTIONS TO VOLUNTARY ORGANISATIONS The Public Health and Baths Committee recommended payments to the funds of voluntary organisations during as follows £. s. d. 6. 17. 6. Central Council for Health Education Chelsea Old People's Welfare Committee 450. -. -. London and Home Counties Clean Air Advisory Council 2. 2. -. 8. 8. National Society for Clean Air -. Royal Society for the Prevention of Accidents 2. 2. -. PUBLIC MORTUARY FACILITIES The Borough Council has not maintained mortuary premises for many years, but under an agreement made with Hammersmith Borough Council adequate arrangements are available at their Mortuary in Fulham Palace Road which is also adjacent to the Coroner's Court. During post-mortems were carried out in respect of Chelsea residents. MEDICAL EXAMINATIONS Sixty medical examinations were carried out during the year on members or prospective members of the staff. Three persons were found to be unfit. SANITARY ADMINISTRATION The work of the Public Health Inspectors and other members of the outdoor staff covers an ever widening field as the following pages illustrate., With limited space it is impossible to refer in any detail to all aspects of their work, a great deal of which is carried out without resorting to statutory measures. To an even lesser degree has it been necessary to institute legal proceedings,, Despite the fact that some 713 complaints were made to the Public Health Department during the year and a considerable number of routine inspections of all types of premises were carried out, in only four cases were legal proceedings instituted., The remainder were successfully dealt with by informal action* LEGAL PROCEEDINGS - Public Health (London) Act. 1936 - Statutory Nuisances Resort to legal proceedings was only necessary in the three undermentioned cases :— Premises 69, Blantyre Street Offence Non-compliance with Statutory Notice. Public Health (London) Act, 1936 - Sect. 82 and Fifth Schedule. Result of Proceedings Summons withdrawn - requirements of Notice complied with at time of hearing. Council awarded £lo 11s. 6do costs. 75, Blantyre Street Summons withdrawn - requirements of Notice complied with at time of hearing. -ditto- Council awarded £1. 11s. 6d. costs. 96, Oakley Street -ditto- Summons adjourned sine die by consent - work in progress but not completed at time of hearing. Notes Details of proceedings under the Pood and Drugs Act, 1955 appear on page 46 . GENERAL SUMMARY OF THE WORK OF THE PUBLIC HEALTH INSPECTORS INSPECTIONS AND RE-VISITS - DWELLINGS: After complaints 2,077 After infectious disease 169 House-to-house, underground rooms and overcrowding 371 Miscellaneous-unclassified 147 2,764 FOOD PREMISES: Butchers 469 Fishmongers and Fish Friers 84 General Provision Shops and Dairies 245 Ice Cream Vendors 238 Bakehouses and Factories 104 Street Traders 84 Hotels, Restaurants and Dining Rooms 1,380 Premises in connection with unsound food and food sampling 236 Unclassified premises 99 2,939 FACTORIES AND OUTWORKERS: Factories other than Food Factories 480 Outworkers 8 488 MISCELLANEOUS: Animals, poultry and birds and Pet Animals Act, 1951 19 Open spaces and highways 62 Office premises 23 Merchandise Marks Acts 52 Premises re Pharmacy and Poisons and Shops Act 351 Premises re voluntary works 5,989 Visits to owners, agents and builders' offices 235 Food Poisoning 2 Visits to aged and infirm persons 132 Visits resulting in "no access" 858 other visits 1,159 Clean Air Act, 1956 including smoke observations and atmospheric pollution recording 9,144 Verminous persons 13 18,039 PREMISES FOR THE TESTING OF DRAINS BY: Air 147 46 Smoke Water 616 809 Total 25,039 REPAIRS AND INSTALLATIONS SUPERVISED INCLUDING. BOTH VOLUNTARY WORK (V) AND WORK AS THE RESULT OF THE-SERVICE OF NOTICE (N) UNDER VARIOUS ACTS. CLEANSING AND REDECORATING V. N. Rooms, passages and. staircases 26 40 GENERAL REPAIRS Roofs, gutters and. rainwater pipes Yard and area pavings 30 - 1 - Walls and ceilings 3 70 Floors, staircases, window and door frames Fireplaces and chimney flues 2 72 6 - Dampness remedied Miscellaneous 72 - 7 - DRAINAGE AND SANITARY CONVENIENCES Total and partial reconstructions including frontages 30 9 Obstructions cleared 21 - Inspection chambers and covers provided 29 - Interceptors provided 13 - Soil, ventilation and waste stacks constructed and repaired 115 3 Waterclosets and waste water preventers repaired and renewed 678 12 Sinks provided or renewed 334 4 625 Baths provided - Wash-hand basins provided or renewed 705 2 2 Waste pipes cleared or repaired 2 Miscellaneous 9 - WATER SUPPLY Supplies provided to tenements - 1 Taps supplied on main for drinking purposes Burst.pipes repaired - - 14 - Cisterns cleansed, covered or repaired 1 - Totals carried forward 2562 376 REPAIRS AND INSTALLATIONS SUPERVISED INCLUDING BOTH VOLUNTARY WORK (V) AND WORK AS THE RESULT OF THE SERVICE OF NOTICE (N) UNDER VARIOUS ACTS. MISCELLANEOUS PROVISIONS V. N. Brought forward 2562 376 Soap and towels for staff - - Staff rest and changing rooms - - Constant hot water 2 3 Refuse bins 15 - 4 Covered display and counter screens provided - 9 Natural and mechanical ventilation 2 Natural and artificial lighting 1 - Removal of offensive accumulations on open land and bomb sites 2 15 TOTALS 2568 423 GRAND TOTAL ... 2991 Note: Included in this table are 177 dwelling houses repaired as a result of the service of Notices. NOTICES SERVED Public Health (London) Act, 1936. 168 Intimation Nuisance 42 Section 40 - Drainage 7 L.C.C. (General Powers) Act, 1954. Section 12 - Provision of dustbins - Intimation 7 Section 12 - Provision of dustbins - Statutory Notices 1 L.C.C. (General Powers) Act, 1955. Section 25 - Stopped up drains 11 Factories Act, 1937. Health - general provisions 22 Food and Drugs Act, 1955. Defects at Food Premises 25 Shops Act, 1950. Sanitary Conveniences and Ventilation 6 Clean Air Act, 1956. Adaptation of Fireplaces 3 TOTAL 292 NOTICES COMPLIED 240 notices were complied with during the year of which 169 were served under the Public Health (London) Act, 1936. WATER SUPPLY The whole of the water for human consumption and domestic purposes is supplied direct from the mains of the Metropolitan Water Board. Excellent co-operation exists between the officers of the Board and those of the Public Health Department. Any samples of water obtained on either routine check or as a result of complaint are submitted to the Board who carry out the necessary analysis and advise on the result. Two such samples were submitted during the year and the result of the analysis in both cases showed that the water was of satisfactory hygienic quality and fit for human consumption. Further valuable information is received from the Board prior to the discontinuance of water supplies by reason of either defects in service pipes or the non-payment of water rate, enabling the Public Health Inspectors in many cases to provide for continuity of service, 15 such cases were reported during the year. In addition, Ik supplies were repaired, 2 water storage cisterns cleansed and provided with proper covers, 1 tenement provided with independent supplies and 1 dwelling provided with drinking water direct from the rising main. PUBLIC BATHS The Public Baths were opened in 1907 and comprise two swimming pools, one 100' x 30' having a capacity of some 100,000 gallons of water, the second pool is somewhat smaller 97' x 27' with a capacity of 90,000 gallons and, in addition, there are 45 personal baths (27 for men and 18 for women). Despite improvements the use of the personal baths is gradually declining. This however is not unsatisfactory in that it reflects the number of additional baths being provided in domestic premises. The supply of water is obtained from a deep well situated beneath the baths and the water used in the swimming pools is treated by chlorination and continuous filtration. Twenty-six samples of water were taken from baths, pools and sources of supply, for bacteriological examination, all of which were reported upon as satisfactory. Considerable works have been carried out in the past few years to improve the facilities which are available at the Public Baths. These include the dressing accommodation in the large pool, baths surrounds, diving stage, pre-cleansing in the large pool and the modernisation of chlorination plant to ensure the efficient sterilisation of water contained in the swimming pools. The boiler plant has been Converted to oil firing and new hot water calorifiers have been installed. Constant endeavours are being made to modernise the existing facilities and a comprehensive scheme is envisaged to provide for improvements to the ladies personal baths including the adaptation of baths for the special use of elderly persons, new changing accommodation in the small pool, and it is hoped that in the near future the large pool may be floored over to provide recreational space for youth activities. It is pleasing to record, that only two complaints, both of a minor nature, were brought to the attention of the Public Health Department throughout the year. These concerned, the overchlorination of the water in the swimming pools. The complaints were registered at the time of the change-over from marginal chlorination to "break point" chlorination and during this period there were slight teething troubles in bringing the new purification plant into service. During the year the total attendances at the private baths and the swimming pools were 25,157 and 79,204 respectively but these figures are exclusive of attendances in respect of Season Ticket Holders, L.C.C. Scholars and Clubs. DRAINAGE The supervision of drainage work being carried, out in connection with the erection of new buildings, conversion of existing structures, or required as a result of the service of notice, is the responsibility of the Public Health Inspectors,, During the year 123 applications were received for single systems and a further 38 for premises drained in combination. To avoid delays in progress of works it has always been the practice to approve works in principle where possible and submit to the appropriate Committee for ratification,. Similar action is taken where schemes are amended in progress „ Drainage is a section of the work of the Public Health Department which is rapidly expanding., It is an exacting and responsible duty as may be illustrated by such buildings as Carlton Tower Hotel, Wandon Road Flats, the Supermarket and Plats in King's Road and other large blocks particularly in the Hans Town Ward, together with numerous individual houses being erected throughout the Borough, with the most difficult work always being that associated with conversions. However, excellent relations are maintained in practically all cases with owners, architects and builders. TOWN AND COUNTRY PLANNING Close liaison exists with the Town Clerk's and the Borough Engineer's departments, and all applications being dealt with by either the London County Council or the Chelsea Borough Council are referred immediately to the Public Health Department. This co-operation is very valuable as it enables the Public Health Inspectors to become aware of any proposals affecting work which ultimately will come under their supervision., It then becomes possible to notify the applicant directly or through one of the other departments of the Health Department's requirements By this means those concerned are spared much waste of time and money. During the year 482 applications were referred to the Public Health Department. LAND CHARGES ACT. 1925 Enquiries as to any outstanding notices, orders or charges were dealt with in respect of premises. NOISE ABATEMENT - Noise Abatement Act, 1960 Complaints relating to noise and vibration (other than caused by aircraft) may now be dealt with under this Act which has extended the powers previously contained in the London County Council (General Powers) Act, 1937. A noise has no longer necessarily to be injurious or dangerous to health. Previously under common law action could be taken by any ten householders directly affected but under the new Act this is now reduced to three. The Act stipulates that a "noise or vibration which is a nuisance shall be a statutory nuisance" and subject to the remedies available under the Public Health Act. The difficulty is in proving the nuisance. There are so many subjective and objective factors in the assessment of noise which can vary in so many particulars and in its effect on people. Just as one man's meat is another man's poison so one man's euphony is another's cacophony. Some people appear incapable of existing without background noise. Others either don't appear to notice or else are not annoyed by noises which drive others frantic. As for example the people who are insensitive to noises created by themselves or their possessions - their children, their animals, their wireless or television, even their smoker's cough. Again, people can be intensely annoyed by faintly audible sounds while the much louder sounds of aircraft, trains or traffic pass unheeded. This very brief mention of some of the simpler aspects of the large and complicated problem of noise will, it is hoped, give an indication of the difficulty of establishing what constitutes a noise nuisance. Even then a further legal obstacle has still to be overcome. As the law stands it is a defence to prove that "the best practicable means have been used for preventing and for counteracting the effect of the noise or vibration". Section 2 of the Act deals with the operation of loudspeakers on the highway and with certain exceptions loudspeakers shall not be used between 9 p.m. and 8 a.m. for any purpose or at any time for the purpose of advertising any entertainment, trade or business. Perhaps it is unfortunate that this restriction cannot be applied at all times to personal transistor type radios. The use of musical chimes to advertise the sale of ice-cream is permissible but restricted to the hours between Noon and 7 p.m. Thirty-three complaints were received regarding extract fans in restaurants and commercial premises: mechanical grab on building site: early morning delivery of milk: loud gas works siren: use of circular saws: use of electric drills: motor car repairs: workshop repairs: noisy tenants in flats: jazz band in coffee bars dancings humming caused by ice-cream generators customers singing and shouting in late-night coffee barss high-pitched whistling from chimney cowl and humming caused by food refrigerators. No cases were considered suitable for legal action by the Council and no proceedings were instituted by private individuals. Since the passing of the Act people have become very noise conscious and many complaints included in the list referred to above have been dealt with and remedies effected with the co-operation of the various concerns affected, but on the other hand there are complaints as to the banging of car doors, and the loud talk of customers leaving late night restaurants, etc.., which are difficult if not impossible to deal witho PET ANIMALS ACT, 1951. Under Section 1, no person shall keep a Pet Shop unless licensed by the Council. Two renewal applications from licence holders were received and approved. Several inspections were made of the premises and at all times the stock was well cared for and maintained in accordance with the conditions specified in the licence. FOULING OF PAVEMENTS BY DOGS This is a subject which provides the majority of irate complainants and this is very understandable, for the fouling of footwear and consequently car and domestic floor coverings is in itself extremely annoying. Added to this is the public health risk from flies transporting infection from exposed deposits to uncovered food supplies. Unfortunately, it is a difficult problem to deal with owing to the lack of understanding on the part of many dog lovers, the difficulty in obtaining detailed information as to the offenders, and not least the reluctance of complainants to attend at legal proceedings in support of their complaints. Leaflets have in the past been posted on the standards of street lights, but owing to exposure to the weather and despoliation, they have often had but a short life. The Council are now affixing notices of a more permanent nature, and publicising as much as possible the results of successful prosecutions. The Council's Bye-law provides that (l) No person being in charge of a dog in any street or public place and having the dog on a lead shall allow or permit such dog to deposit its excrement upon the public footway. (2) Any person offending against this "bye-law shall be liable on summary conviction to a fine not exceeding forty shillings. No prosecutions were undertaken during the year. RENT ACT. 1957 For the third, successive year no applications were received or certificates issued in accordance with the provisions of the above Act. HOUSING ACT. 1957 - PART IV - OVERCROWDING Every effort is made to find alternative accommodation for overcrowded families so far as local conditions and circumstances will allow, and apart from any official action that can be taken by either the Borough Council or the London County Council, all possible channels sure explored to effect abatement by informal procedure. In all cases where overcrowding is abated warning letters are sent to the owners of the premises drawing their attention to the provisions of the Housing Acts. The following summary shows the number of cases relieved during the year and the extent of overcrowding in the Borough at 31st December, 1961:- New cases investigated and recorded 10 Number of families involved 12 65 Number of persons involved Cases relieved by:- (a) Rehousing Authorities 1 (b) Informal or formal procedure 2 Such action resulted in twenty-five persons being adequately housed. Cases on register at 31st December, 1961. 32 Number of persons involved. 193 NEW HOUSING Number of new dwellings completed during the year:- (a) by the Borough Council 60 (b) by other persons 36 APPLICATIONS FOR RE-HOUSING - Awarding of Points. 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 headingss- Substandard accommodation; 111-health (excepting Tuberculosis); Tuberculosis; Overcrowdings; and Other circumstances During the year, 20 applications were referred to the Public Health Department, 17 originated from Chelsea residents and the remainder from applicants living in another area. Each case was investigated - 19 in connection with ill-health including tuberculosis, and one in respect of sub-standard accommodation, bringing the total number of cases since May, 1953, to 351 residents and 98 non-residents. The cases of one licensee in requisitioned premises and nine tenants in Council premises were also referred to this Department during the year for an opinion or pointing on medical grounds. A total of 350 such cases have been dealt with since 1955. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 During the year thirteen samples of various filling materials were taken and submitted to the Chilton Research Laboratories, High Wycombe, and in each case the Analyst issued a satisfactory certificate„ Six premises are registered for the use of filling materials to which this Act applies, but there are no premises in the where rag flock is manufactured,, FACTORIES ACT. 1937. Under Section 128(3) 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:- 1. INSPECTIONS OF FACTORIES. WORKSHOPS AND WORKPLACES. Number of Premises Number on Register Inspections Written Notices Occupiers Prosecuted (l) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities: 62 140 1 - (2) Factories not included in (l) in which Section 7 is enforced by Local Authorities: 381 11 - 192 (3) Other premises in which Section 7 is enforced by Local Authorities * 48 48 - - TOTAL 302 569 12 - NOTE:- Outworkers' premises are not included in (3) above. i.e. Electrical Stations - Section 103 (1). Institutions - Section 104, and sites of Building Operations and Works of Engineering Construction - Sections 107 and 108. 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 1) - - 2 - - Overcrowding (Section 2) 1 1 - 1 - Unreasonable Temperature (Section 3) 5 4 - 1 1 Inadequate Ventilation (Section 4) 1 1 - 1 - Ineffective drainage of floors (Section 6) - - - - - Sanitary- Conveniences (Section 7) (a) Insufficient - - - - - 20 (b) Unsuitable or defective 10 2 - - (c) Not separate for sexes - - - - - Other offences against the Act (not including Outworkers) 1 - - - - TOTAL 30 16 - 5 - FACTORIES ACT. 1937 (Continued) OUTWORK Sections 110 and 111 Notices served Prosecutions tions Nature of Work No.of Outworkers in August list as required by Section 110 (l)(c) No. of Cases of default in sending Lists to the Council No. of Prosecutions for failure to supply Lists No. of instances of work in unwholesome premises Wearing Apparel making etc. - - - - - 7 Household Linen - - - - - - Curtains and furniture hangings - - - 3 - - Furniture and Upholstery - - - - - - Stuffed Toys - - - - - - Lampshades - - - - - - - Jewellery 4 - - - - - TOTALS 14 - - - - FOOD HYGIENE All food shops and catering premises in the Borough have been visited frequently throughout the year. The number of restaurants continues to increase and in nearly all cases the prospective owners have sought and accepted the advice of the Public Health Inspectors concerned before commencing to plan the kitchens &c. The standard of kitchen equipment is improving steadily, and it has been found that the majority of the owners of catering premises have modernised the kitchens in a co-operative manner, and have, on occasions, improved the lay-out and facilities to a degree far in excess of that stipulated in the Food Hygiene Regulations. Considerable time is spent discussing food and health education with kitchen staffs, in an endeavour to make them realise the importance of their work and the part they play in the preparation of clean, safe food. It has been found from experience that careless, unhygienic practices and bacteria, and that even the most modern kitchen appliances are useless if the staff fail to keep themselves and their equipment in a clean and hygienic conditiono Difficulty has been experienced during recent years with regard to bacterial contamination of loose ice-cream served in restaurants, and many managements have been persuaded to change over to wrapped varieties, i.e., either wrapped "family" blocks, or even wrapped individual portions,. With regard to food shops, the trend towards self-service continues. It has been noted with interest that an increasing number of manufacturers are producing sweets and confectionery either individually wrapped or in packets, and it is not uncommon to find that some sweet-shops have no unwrapped sweets whatsoever* This is very satisfactory from the food hygiene point of view as the risk of contamination is considerably reduced. As with restaurants, a large amount of the time spent on each visit to food shops is now taken up with instructions in clean food handling and cleansing of the premises„ There is a very common tendency for the shop itself to look smart and inviting while the store-rooms and staff accommodation may often be dirty and neglected, and the singes and wash-basins either mis-used or so placed that they cannot be used for the appropriate purpose. Particular attention is paid to shops where food is pre-packed on the premises, to ensure that it is not contaminated before or during packing, and that staffs have adequate washing facilities in a convenient position to enable them to wash their hands after opening tins, packing cases, &c and before handling bulk food such as butter, cheese, sides of bacon and cooked meats. Several smaller provision shops closed during the year, as did the Borough's only ice-cream factory. With the exception of a large Supermarket and a Danish pastry shop, no new food shops have been opened, and it is interesting to note that where sites are redeveloped the new shops are rarely opened as food shops. INSPECTION AND SUPERVISION OF FOOD Registers are maintained of all premises connected, with the manufacture, storage and sale of food. The following summary gives details of the type of businesses receiving the special attention of the Public Health Inspectors :- 88.k6h.0U56 8 000 oee 000 000 6 Blltch6rS 000 o o o 000 000 26 Horse-flesh butcher 1 Food Factories (flour-mills, bottling-stores) 6 Milk Retailers (including dairies) 59 General Provision Merchants (not selling milk) 22 Fruit and vegetable retailers 26 Hotels and Public Houses, Clubs, Restaurants, ( Dining Rooms, Canteens and miscellaneous 193 catering establishments ( Fried fish premises 2 Wet fish retailers 8 Miscellaneous premises (Bread and cake shops, sweets and confectionery shops, ice-cream Store) 53 Ice Cream Premises Section 16 (1) (a) of the Food and Drugs Act, 1955, provides for the registration of premises used for the sale, or the manufacture for the purpose of sale, of ice-cream, or the storage of ice-cream intended for sale. At the end of the year the number of premises registered was 116» Preserved Food Premises Section 16 (l) (b) of the Food and Drugs Act, 1955, provides for the registration of premises used for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale o Thirty-three premises were registered at the end of the year. PUBLIC HOUSES Public houses come within the scope of the Food Hygiene (General) Regulations, 1960, as premises where food and drink are sold. A large number of the Chelsea public houses have dining-rooms and snack-bars, and numerous visits were paid to ensure that good standards of hygiene are maintained. Various brewers have responded to requests for new, modern equipment for washing glasses, cutlery and crockery, and have also installed adequate hand-washing facilities for both staff and customers. Most of the public houses in the are now provided with adequate sanitary accommodation and wash-hand basins for both male and female customers. LEGAL PROCEEDINGS - FOOD AND DRUGS ACT, 1955 - UNSATISFACTORY PURCHASES, Seven complaints were received during the year concerning the sale of the undermentioned foodstuffss- Presence of foreign matter in a bottle of milk. Sale of mouldy chocolate gateau. Sale of bacon infested with maggots (2 complaints concerning two shops). Presence of foreign matter in a cheese-cake. Presence of string in a cottage loaf. Sale of contaminated lemon juice. The various adulterations were fully investigated and reported to the Public Health and Baths Committee. In five of these cases, legal difficulties or mitigating circumstances negatived the institution of legal proceedings and where appropriate warning letters were sent to the firms concerned. With regard to the case of the bacon infested with maggots, the Committee took a very serious view of this offence and authorised legal action. The complainant purchased bacon from a store and when reaching home found it to be infested with maggots. Returning immediately to the shop the bacon was exchanged for another -J-lb., which was also found to be contaminated with maggots. The defendants pleaded guilty to the offence and a fine of £60 was imposed with costs totalling £5. 5s. Od. ANNUAL REPORT OF THE PUBLIC ANALYST for the year ended 31at December,l96l. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Chelsea, Your Worship, Ladies and Gentlemen, During the year 1961, 260 samples only of food, of which 100 were samples of milk and 160 samples of food other than milk, were submitted for examination. At the present time the general standard of food sold to the public is very good, but it is doubtful whether too high a standard will be maintained if the number of samples taken is reduced too far. The incidence of adulteration may be classified as follows:- Number of samples Number of samples examined adulterated, etc. 100 2 Milk Other foods 160 6 Drugs - - The suppliers of milk sold in the borough maintained the high standard of quality that has existed for many years and more difficulty is found in London at the present time due to the improper washing of dirty bottles than to the actual quality of milk sold. Of the 100 samples of milk submitted during the year 46 were of good quality and contained 3.8 per cent or more of milk fat, 51 were of fair quality in that they contained between 3.3 and 3.8 per cent of milk fat, and only 3 were reported as of poor quality because the milk fat was less than 3.3 per cent. No sample of milk was found to be adulterated when purchased by the sampling officers. Complaints were received about two further samples of milk. In the first case a slug had been found in the milk, but your analyst was of the opinion that this had gained access to the jug into which the milk had been emptied and had not been present in-the milk in the bottle as sold. Had the slug been present initially it could not have failed to have been attacked by the alkaline washing solution used for bottle washing. The milk itself was a pasteurised milk and had been passed through a strainer in the pasteurising process. After pasteurisation it had run directly into the bottles as they emerged from the washing and drying process. The slug, moreover, showed no signs of having been attacked by alkali. In the second case the bottle contained a piece of cement or concrete, which had not been dislodged during the washing process and indicated not only had inspection at the dairy, but also the purpose for which the bottle had been employed earlier on a building site. A sample of margarine contained 16.1 per cent of water, whereas the maximum permitted quantity is 16.0 per cent. Before this last war butter and margarine seldom contained more than about per cent of water, now they seldom contain less than 15.5 per cent and, as a result, the legal maximum tends to be exceeded periodically. A home made lemon curd was of very good quality and, as it complied with the requirements of the Pood Standards (Preserves) Order, 1953, it was unnecessary for it to bear any declaration of ingredients. Unfortunately the manufacturer was so anxious to tell the purchaser about the excellence of his product that he not only listed the ingredients used, but listed them in the wrong order giving the impression that fresh eggs instead of sugar were the principal constituent. Complaint was received about the brownish-orange colour of some lemon juice, of which the can showed definite signs of corrosion o. The complaint juice contained 36O parts per million of iron and 33 parts per million of tin, whereas a control sample contained only 8 parts per million of iron and 0.7 parts per million of tin. The discoloration and unpleasant taste resulted, therefore, from the corrosion of the tinplate of the can. Two further complaints were received due to the decomposition of foods. In the one case a chocolate gateau was mouldy and the conclusion reached by your analyst was that it had been made and placed in its greaseproof lined container before it had had time to cool. The complaint was received during the hot part of the summer and there was little doubt that the warm weather had assisted in the growth of the mould. The second case concerned some pickled herring fillets. These had been purchased in March and kept till June before opening with the result that they were inedible. These pickled fish products are called "semi-preserves" on the continent because they are not sterile, and are liable to ferment if kept for any length of time without refrigerated conditions. At the "same time these particular herrings had been smoked before being preserved and your analyst was of the opinion that had the smoking been properly carried out the fillets would have kept almost indefinitely. The last complaint was one which caused considerable enquiry. The remains of a cheese cake were submitted, because parts of it had been eaten by two people, both of whom had immediately vomited* The cake possessed an intensely bitter taste and as it appeared that there might have been some sinister intent behind this contamination the matter was placed in the hands of the police. Besides the bitter taste there were many pieces of animal hair and other dirt present, but no information was forthcoming at first on this point. The police analyst reported the presence of 3 grains of sodium amytal in the portion of the Cake submitted to him, but this would not account for the vomiting caused to the two people who consumed portions. The police were satisfied that there could have been no sinister attempt on the consumers, so handed the matter back to the Council. The manufacturers of the cake were equally convinced that the amytal could not have gained access in their bakery, nor would sodium amytal alone have caused the vomiting. The vomiting was probably caused by the fact that sodium amytal is often prescribed in admixture with ipecacuanha alkaloids, these alkaloids being added to cause vomiting if taken in excess and therefore to help stop drug addiction. There is, therefore, the possibility that someone in the bakery might have been trying to take a large dose of tablets, and finding them most unpleasant, had spat them out between the cake base and the filling or someone might have been playing a practical joke on the consumers. This cannot be known. The origin of the various pieces of animal hair and dirt was found to have arisen from the consumers of the cake having been at work in a furriers at the time of the event. They found the cake so revolting that they threw the uneaten portions on the floor before gathering them again to submit to the Council's Inspectors, but it did not occur to them that this aspect of "the case might complicate matters and should have been mentioned. Food Legislation. The year little change in food legislation, although proposals were made for such changes. The Lead in Pood Regulations, brought into force the proposals made by the Food Standards Committee in 1959. The maximum quantity of lead permitted in a ready-to-drink non-alcoholic beverage is 0.2 parts per million and for other foods 2.0 parts per million with the exception of certain foods. These are divided into two classes, those for which a larger amount of lead will be permitted for a limited time only and those which contain larger quantities of lead naturally and can never be kept to the low limit proposed for ordinary foods. Such foods include apples, pears, concentrated fruit juices and tomato puree or paste, fish and canned fish, raw sugars, including liquid or solid glucose, cocoa powder, tea, yeast and yeast products, dried onions, herbs, ground spices, flavourings, and pectin. The quantity permitted in these foods is based on the amounts likely to be present from natural causes. The Labelling of Food (Amendment) Regulations, 1961, exempts wines prepared from preserved or concentrated grape juice from declaring the fruit juice from which they have been prepared, even though they have not been obtained from the fermentation of the freshly expressed juice. The Ministers of Agriculture, Fisheries and Food? Healths and Scotland, and the Home Secretary have asked the Food Standards Committee to undertake a review of the existing labelling of food provisions of the Labelling of Food Order and other food regulations relating to labelling and the Food Standards Committee have asked for the views of any interested parties. The Food Standards Committee issued a supplementary Report on Preservatives in Food together with Proposals for new Regulations. The problem of preservatives, food additives, and similar substances is becoming so complex that one cannot but- sympathise with any committee advising a Government at the present time. In the opinion of your analyst, moreover, the time has now arrived when no country of importance can afford to make laws governing such additions without considering carefully the existing and possible legislation of other countries of similar development,. Your analyst will be the opening speaker next September at an International Symposium called to explore the matter of food regulations„ In the meantime one can only consider legislation as it affects this country and agree that the Committee have made a brave attempt to cope with the position as it is. It is unfortunate that many substances, such as salt, glycerin, propylene glycol, acetic acid, and others .should not be defined as preservatives, when they are the most efficient and commonest preservatives in use. When advising the Government on legislation the Committee have also to consider the possibility of its implementation and one can only state that many experts are in grave doubt about the implementation of food legislation now and in the future. It is suggested that -sulphur dioxide and benzoic acid shall continue as permitted preservatives for certain foods and it is interesting to note that it is suggested that sulphur dioxide shall be recognised as a preservative in unfermented grape juice to be used for sacramental purposes, provided that not more than 70 parts per million are employed, while ordinary fruit juices to be used for other purposes may contain up to 350 parts per million. As an alternative 2,000 partsper million of benzoic acid, or methyl- or propyl-p. hydroxybenzoate may be employed. The existing regulations have caused immense difficulties owing to an uncertainty, which was never intended. Methyl- or propyl-p.hydroxybenzoate will be permitted also in liquid coffee or tea extracts, drinking chocolate concentrate, pickles and sauces, tomato pulp, or liquid rennet. Here it is noted that liquid tea extract is given official notice for the first time in proposed British legislation and that permission will be given to use a preservative in a drinking chocolate concentrate, but there is no mention of chocolate syrups used on a very large scale for pouring over ice-creams, puddings, etc. By definition these last are not flavouring syrups because they are not to be diluted with milk or water to make a drink with a distinctive flavour nor can they be described as flavouring emulsions. It is proposed that bread shall be permitted to contain up to 3,ooo parts per million, i.e. 0.3 per cent of propionic acid and that flour confectionery shall be permitted 1,000 parts per million of either propionic acid or sorbic acid. Sorbic acid and nisin are to be permitted in cheese and nisin is also to be permitted in canned foods. Benzoic acid or sorbic acid are to be permitted in solutions of permitted food colours or in silicone anti-foam emulsions. It will be difficult for an analyst to say whether a trace of sorbic acid in a food has been introduced by reason of the inclusion of a small amount of a silicone anti-foaming agent. Sodium nitrate and nitrite are accepted as preservatives in cured meats and in Gouda and Edam type cheese. Orthophenylphenol may be employed as a preservative on apples, pears, pineapples, peaches, melons, and citrus fruit, but no such permission is extended to apricots, or to fruit such as Avocardo pears, which belong to the laurel family and are quite distinct from ordinary pears. Citrus fruits may also contain diphenyl. The food pattern of civilised countries is changing so rapidly at the present time that one wonders for how long such legislation can be effective. In support of the earlier note on the necessity for international collaboration in food legislation it may be mentioned that during the year the World Health Organisation issued a press report to the effect that boric acid may be added for all countries except Germany and the United States. Great Britain has forbidden its use since 1925. At the same time it may be mentioned that F.A.O. is now bringing out a series of monographs dealing with the legal position of food additives in various countries, each monograph being written by an acknowledged expert of the country concerned. The monograph on food additives in Great Britain was the second to be issued in the series. Proposals have teen issued by the Food Standards Committee for Soft Drinks Regulations. Your analyst is greatly concerned that at the present time manufacturers of soft drinks can add vitamins or other ingredients to make them resemble official nutritional products and describe them by the official titles so long as letters such as B.P., or B.P.c. are not used. Blackcurrant syrups fall into this category, but so far, the Ministry has refused to take any action, though now that even broadcasting has drawn attention to the matter the situation may be changed. Similarly certain drinks need not comply with the requirements of the Regulations for sugar content if there is a clear and conspicuous description in writing indicating to the purchaser that the drink has been prepared, for consumption by persons suffering from diabetes. Products have been creeping on to the market recently which claim the protection of this proviso, but which are intended for slimming purposes and are not expected to be used primarily by diabetics. Even the names of the products suggest that they are intended for slimming. Another provision which your analyst would like to see introduced is one to prevent claims such as "made from such and such fruit" for a product, which complies with the requirement of the order to the extent that it contains 2 pounds of potable fruit and 4.5 pounds of sugar in 10 gallons, i.e. 100 lbs. of final drink, over 93 per cent of the drink being therefore added water. Following the issue towards the end of 1960 of the "Food Standards Committee Report on Bread and Flour", proposals for regulations were issued during 1961. Probably the most interesting point in these proposed regulations at the present time, in view of the interest taken in slimming, is that it shall be an offence to make any sort of claim, whether by inference or otherwise, that a bread, rusk, biscuit, or cereal food may be used as a slimming aid unless there is a clear statement indicating that it may only be so used if it forms part of a diet in which the total intake of calories is controlled. The Food Standards Committee were also asked to review the use of solvents and flavouring agents used in foods. Apart from water the number of solvents employed is confined to a small number of chemical liquids, but the number of chemicals employed for flavouring is very large. Proposals were also made for regulations to control the use of Emulsifiers and Stabilisers in Food. One of the difficulties of British law is that if the use of a substance is generally recognised as suitable and safe for a particular purpose it ceases to be such a substance by legal definition, and these proposed regulations are no exception to this rule. Thus under the Labelling of Food Order sodium citrate, sodium tartrate, and sodium phosphates may be described generically as "Emulsifying Salts", but under the proposed regulations they are not to be considered as Emulsifiers" or "stabilisers". It is hardly surprising that exporters from other countries complain that it is difficult to understand British law. I am, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, THOMAS McLACHLAN, A.C.G.F.C.,F.R.I.C.,M.I.Bi01, Public Analyst. Article Number examined Number adulterated Informal Formal Total Formal Informal Total 20 Butter 20 Cake 2 2 2 2 Chicken, minced 2 2 Fish, canned 4 4 1 1 Fish paste 13 13 Fish pate 2 2 Flour 6 6 Fruit, dried 12 12 Fruit juice 1 1 1 1 Ice cream 1 1 Jam 17 17 Jelly preserves 3 3 Lemon curd 2 2 1 1 Margarine 13 13 1 1 17 Marmalade 17 Meat paste 11 11 Milk 100 100 Milk, foreign bodies 2 2 2 2 Pate of Pheasant 1 1 Sausage, liver 2 2 Soft drinks 2 2 Spread, chicken 1 1 Spirits 16 16 0 Suet, shredded 3 3 Turkey, canned 1 1 Turkey, minced 1 1 Vinegar 5 5 I ————— 244 16 260 8 8 UNSOUND FOOD Food unfit for human consumption is surrendered, to the Council's Public Health Inspectors, removed from the premises and destroyed. During the year the following unsound food totalling 1,704 lbs. was surrendered to the Public Health Inspectors:- Commodity Weight - 1bs Fish, tinned 46 Fish, fresh 66 Flour 46 Fruit, tinned 119 Meat, fresh 798 Meat, tinned 386 Preserves, jam, marmalade, etc. 95 Vegetables, tinned 131 Miscellaneous foods 17 TOTAL 1,704 lbs BACTERIOLOGY The bacteriological examination of samples is carried out by the Bacteriological Laboratory of the Public Health Laboratory Service, London County Council. The following samples were submitted during the year : Ice Cream 33 Water 26 Milk 11 Brisket of beef 1 Pâtés 7 Ice Lolly 1 TOTAL 79 All were found satisfactory with the exception of 5 ice-cream samples and in these cases full investigations were carried out at the vendor's premises. These investigations resulted in improved conditions of handling and subsequent samples all proved satisfactory. THE MILK (SPECIAL DESIGNATION) REGULATIONS. 1960. The above-mentioned Regulations which replace and consolidate previous Regulations made between and came into force on the Ist October, i960. The main changes brought about by the new Regulations which operate as from Ist January, 1961, are as follows:- (i) Dealers' licences will be issued by the food and drugs authority for the area in which are situated the premises at or from which the milk is to be sold. (ii) Dealers licences no longer restrict sales to the area of the licensing authority and supplementary licences are therefore discontinued. (iii) A Dealers' (pre-packed milk) licence is introduced which authorises in a single form of licence, the use of any or all of the appropriate special designations where milk is obtained by the licensed dealer prepacked, i.e. in the container in which it is to be delivered to the consumer, or is pasteurised or sterilised by the dealer. (iv) Dealers' licences issued on or after Ist January, 1961, will be valid for five years from that date, and will be renewable for subsequent quinquennial periods. The number of licences granted in accordance with these Regulations for the five year period ending 31st December, was as follows:- Dealers' (pre-packed milk) licence permitting all three kinds of specially designated milk 37 Dealers' (pre-packed milk) licence for Pasteurised and Sterilised milk 4 Dealers' (pre-packed milk) licence for Tuberculin Tested and Pasteurised milk 12 Dealers' (pre-packed milk) licence for Pasteurised milk 4 Dealers' (pre-packed milk) licence for Sterilised milk 1 Dealers' (pre-packed milk) licence for Tuberculin Tested milk 1 DAIRIES AND MILK DISTRIBUTORS At the 31st December, 1961, there were registered distributors with premises in the Borough and 58 premises within the Borough from which milk is distributed. One premise was registered as a dairy . STREET TRADING - Licensed and Unlicensed Stall-holders All 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 <> The licensees concerned with the retailing of food receive particular attention from the Public Health Inspectors in connection with the suitability of storage accommodation and the hygienic condition of equipment. Many warnings, both verbal and written, have been given to stall-holders regarding the practice of smoking whilst handling food with satisfactory results. To prevent contamination, particularly by dogs, food displays must be sited at least 18" above street or pavement level. A great deal of difficulty is experienced in this respect particularly during periods of loading and unloading. This problem is by no means confined to street traders, it is equally prevalent with open-fronted shops. 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-four visits were made to stalls throughout the year. SHOPS ACT, 1950 - Health and Welfare Provisions Metropolitan Borough Councils are responsible for the enforcement of certain sections of the Shops Act, 1950 9 which relate to health and welfare provisions, namely:s- 1. Washing facilities 2. Sanitary conveniences 3. Lighting 4.Temperature and ventilation 5. Facilities for taking meals With the extensive shopping frontages of Sloane Street, King f s Road and Fulham Road these duties necessitate an ever increasing number of inspections in view of the many new and altered premises. Difficulties have been encountered with traders modernising shops and shop-fronts, the present-day trend being towards a solid armour-plate glass front with no provision for ventilation. A considerable amount of time was spent in detailed examination of such schemes and adequate ventilation was provided either by a modification of the proposed shopfront or by other natural or mechanical ventilation within the shop. PHARMACY AND POISONS ACT, 1933 The number of listed sellers of Part II Poisons on the Council's Register at 31st December, 1961, was All premises were inspected as to their suitability, and to ensure that records were properly maintained, labelling efficiently performed, and that sales are only made by employees nominated on the application forms. No action was necessary in respect of any offences under the Act. RODENT CONTROL - The Prevention of Damage by Pests Act, 1949 The destruction of rats and mice is one of the important aspects of the work of the Public Health Department and these duties are carried out by two Rodent Officers who work in close co-operation with the Public Health Inspectors. It is pleasing to report that an excellent relationship has existed between the Counoil's officers and the owners or occupiers of premises where treatments have- been carried out. All complaints of infestations received in the Department are dealt with expeditiously and the initial inspection is made by the Rodent Officer as soon as possible after receipt of the complaint, especially where rats are concerned. Two sewer campaigns were carried out during the year (in the Spring and Autumn) and valuable assistance was rendered by the sewermen of the Borough Engineer and Surveyor's Department. It is evident by the consistent bait takes that these campaigns were fully justified resulting in the reduction of the rat population in the sewers to the lowest possible level. It is, in practice, impossible to completely free the sewers of rats, but it is at least possible to control their numbers. Large numbers of rat infestations during the past few years have been traced to defective frontage drains (the section of drain between the interceptor and the sewer), and such infestations have been completely eradicated on the reconstruction or repair of the defective drains. Details of work carried out by the Rodent Officers during the year 1961. 1. Treatment of Business and Private Premises Business Premises Private Premises 465 2,960 Number of visits Number of infestations found 36 233 Number of treatments undertaken 33 226 Number of pre-baits laid 2,167 Number of poison baits laid 628 Number of complaints received 282 2. Sewer Maintenance Treatments No. of prebaits laid No. of poison baits laid 1,370 436 No. 1 Treatment No. 2 Treatment 1,195 296 DISINFECTION AND DISINFESTATION The Disinfecting Station and Personal Cleansing Centre is situated at 9A, Lots Road. During the year the following work was carried out by the Disinfecting Staff:- SCABIES CASES TREATED Chelsea Residents 4 L.C.C. Schoolchildren 3 VERMINOUS CONDITIONS Adults 74 Children 9 L.C.C. Schoolchildren 22 DISINFECTION OF ROOMS AND CONTENTS. CLOTHING ETC. 226 Number of Rooms Disinfected 1,232 Number of Articles Disinfected DISINFESTATION OF ROOMS AND CONTENTS Number of Rooms Disinfested 337 Number of Articles Disinfested 2,597 ATMOSPHERIC POLLUTION RECORDING The Council maintains 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 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 years:- Month 1961 Days Exposed Rainfall (ins.) Total Deposits for period in tons per mile Deposits per day in tons per sq. mile (av) Soluble Insoluble Total Soluble Insoluble Total January 33 2.28 5.24 13.09 18.33 .158 .396 .554 February 28 1.95 4.79 11.94 16.73 .171 .426 .597 4.26 14.65 .146 .651 March 29 0.05 18.91 .505 April 32 2.25 8.80 15.34 24.14 .275 .479 .754 5.41 .174 May 31 0.85 1.71 3.70 .055 .119 June 29 1.24 4.42 12.66 17.08 .152 .436 .588 1.49 12.24 .048 .443 July 31 1.28 13.73 .395 August 31 2.82 4.92 5.66 10.58 .158 .182 .340 September 32 1.99 7.21 12.14 19.35 .225 .393 .618 October 28 2.15 8.96 9.51 18.47 .320 .339 .659 November 30 2.16 7.26 9.88 17.14 .242 .329 .571 2.74 14.23 22.66 .459 December 31 8.43 .271 .730 21.76 TOTALS 365 67.49 135.04 202.53 - - - Estimation of Atmospheric Sulphur Milligrams of Sulphur Trioxide per Day. Chelsea Polytechnic Month Days Exposed January 33 3.70 February 28 3.42 March 29 3.19 April 32 3.02 May 31 1.92 1.44 June 29 July 31 .99 August 31 1.30 September 32 2.42 October 28 3.62 November 30 5.05 December 31 5.04 Average for year :- 2.92 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. Atmospheric Pollution Recording (Continued) The following table shows the results obtained from this station during the years:- VOLUMETRIC ANALYSIS - SMOKE AND SO2 Month Average daily total Milligrammes per 100 Cubic Metres Microgrammes per cubic metre Smoke SO2 January 24 288 February 12 289 March 17 387 April 9 312 May 5 183 June 5 172 July 5 117 August 6 136 September 11 199 October 11 217 November 19 347 34 December 442 CLEAN AIR ACT, 1953 - SMOKE CONTROL ORDERS THE CHELSEA (HANS TOWN WARD) SMOKE CONTROL AREA In November, 1960, the Council decided to make Hans Town Ward its second Smoke Control Area in accordance with the programme for the whole borough becoming a smokeless area by 1968. The Town Clerk was authorised to supply the Minister of Housing and Local Government with all necessary particulars of the Council's proposals for Hans Town Ward in order to obtain his consent to a detailed survey of that Ward being undertaken.. The Minister's consent was contained in Circular No. l/ 61, dated l6th January, 1961, which informed local authorities that as considerable experience had now been gained of the operation of the provisions of the Clean Air Act relating to Smoke Control Areas, the Minister did not consider that there was any longer a general need for proposals to be referred to him before Smoke Control Orders were formally submitted for his approval, and he did not wish to comment on any proposals at present before him. Hans Town Ward is approximately 110.6 acres in extent and it is estimated that there are 8,620 residents within the area. The detailed house-to-house survey of the Ward was undertaken during the year and completed in late December. The survey revealed that this area contains dwellings, 11 industrial premises and 296 commercial premises. In addition there are 29 other premises which includes schools, churches and religious establishments, etc. As a result of the detailed information obtained, it appears that 1,101 appliances will require to be adapted or replaced, in order to avoid contravention of the provisions of Section 11 of the Clean Air Act, 1956, and the necessary steps were taken to enable the Council, at its meeting on January, 1962, to consider making a Smoke Control Order to become operative on Ist November, 1962. Maps of the Church Ward and the Hans Town Ward Smoke Control Areas appear on the following pages. CLEAN AIR ACT, 1956 HANS TCTN WARD SMOKE CONTROL AREA THE CHELSEA (HANS TOWN WARD ) SMOKE CONTROL AREA The Area is bounded on the north-west by the centres of Walton Street, Walton Flace, Basil Street, Hooper's Court, Brompton Road and Knightabridge; on the east by the centres of William Street, the east carriageway of Lowndes Square, Lowndes Street, the west carriageway of Chesham Place, Chesham Street, Eaton Place and West Eaton Place; on the south by the centres of Ellis Street, Cadofran Gardens and Cadogan Street; and on the south-west by the centre of Draycott Avenue. CLEAN AIR ACT. 19% CHURCH WARD SmOKE CONTROL AREA CHELSEA CHURCH WARD SMOKE CONTROL AREA The Area 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. EPIDEMIOLOGY Incidence and Notification of Infectious Disease NOTIFIABLE DISEASES The undermentioned diseases are notifiable to the Medical Officer of Health by general practitioners:- Anthrax Cholera Continued Fever Diphtheria Dysentery Encephalitis, Acute Enteric (Typhoid or Paratyphoid) Fever Erysipelas Pood Poisoning (or Suspected Food Poisoning) Leprosy Malaria Measles Membranous Croup Meningococcal Infection Ophthalmia Neonatorum Plague Pneumonia, Acute Influenzal Pneumonia, Acute Primary Poliomyelitis, Acute Puerperal Pyrexia Relapsing Fever Scabies Scarlatina or Scarlet Fever Smallpox Tuberculosis Typhus Fever Whooping Cough 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 (Sonne) 6 3 6 17 1 1 5 39 - - 2 Erysipelas 1 3 - - - - 1 - Food Poisoning - 1 - - - 4 228 Measles 37 288 6 1 - 564 - - - Meningococcal Infection 1 1 2 - - 3 - - Pneumonia: Ac. Influenzal 2 5 - - - Ac. Primary 1 - - 2 - 3 - - 1 - Poliomyelitis: Paralytic - 1 - - - - - Non-paralytic - - - - - - - - Puerperal Pyrexia 2 - 2 4 - - - - - - Scabies 1 1 2 - - 1 - - 4 Scarlet Fever 3 - - - 11 - - Whooping Cough 11 24 2 - - 652 TOTALS 46 322 244 9 13 8 10 SUMMARY OF NOTIFICATIONS OF INFECTIOUS DISEASES RECEIVED DURING THE YEARS 1957 - 1961 (inclusive) Average for five years 1960 1961 Disease 1957 71 3 13 1958 1959 Dysentery 111 62 39 70.4 69 2.2 Erysipelas 1 1 3 3 8.2 Food Poisoning 7 5 15 1 323.6 406 416 564 Measles 217 15 1.8 Meningococcal Infection 1 1 2 3 2 8.2 19 Pneumonia: Ac. Influenzal 4 9 4 5 24 9.8 Ac. Primary 11 9 2 3 2.0 Poliomyelitis: Paralytic 3 3 2 1 1 Non-paralytic - 1 .2 - - - 27.2 Puerperal Pyrexia 31 46 36 4 19 8 5.0 6 6 Scabies 3 2 34 21.0 Scarlet Fever 16 31 20 4 0.4 - Typhoid Fever 2 - - - 41.6 Whooping Cough 69 20 33 62 24 DIPHTHERIA No notification was received during the year» Two cases were confirmed in 1955, being the only cases since whilst there have been no deaths for sixteen 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 o DYSENTERY During 19619 thirty-nine notifications were submitted compared with 69 in 1960, and 62 in 1959- MEASLES Five hundred and sixty-four notifications were received during as compared with 1$ in i960, due to the usual "biennial recurrence of this disease» SCARLET FEVER Four notifications of scarlet fever were received in the Public Health Department during the year, as compared with 20 in 19600 POLIOMYELITIS One notification of poliomyelitis was received, which was of a paralytic type and referred to a child residing outside this Borough whose case was diagnosed in a Chelsea hospital,, Vaccination has continued to be provided during the year by the LOCOCO and by General Practitioners, to the usual age groups, namely six months to kO yearso Unfortunately, during the latter half of the year the supply of vaccine was in short supply and so some restriction had to be placed on the groups of persons vaccinated,. This did not, however, affect infants or expectant mothers» During the coming year the Ministry hope to be able to supply the oral (Sabin) vaccine as well as the original Salk type and it is to be hoped that the level of immunity in the Borough will rise still further. 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 three contacts who had travelled to addresses in the Borough They were kept under observation for the surveillance period and remai2814quite we. 260149 One case of smallpox occurred in a neighbouring borough during the Christmas period, and this department was asked to keep one contact under surveillance at his place of employment. He was seen every day, and kept perfectly well. PUERPERAL PYREXIA Puerperal pyrexia means a febrile condition in a woman in whom a temperature of 100 (3£P Centigrade) or more has occurred within fourteen days after childbirth or miscarriage,, Four cases were notified during the year and all occurred in hospital. Three of the notifications referred to patients residing outside the Borough. The actual cause in one case was due to urinary tract infection, but in the three remaining cases the cause was not known. Two 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. WHOOPING COUGH Twenty-four cases were notified during the year against 62 in 1960. FOOD POISONING One case was notified as compared with 15in 1960 and 5 in 1959 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 Second Quarter Third Quarter Fourth Quarter Total Nil 1 Nil Nil 1 CASES OTHERWISE ASCERTAINED. First Quarter Second Quarter Third Quarter Fourth Quarter Total Nil Nil Nil Nil Nil SYMPTOMLESS EXCRETERS. First Quarter Second Quarter Third Quarter Fourth Quarter Total Nil Nil Nil Nil Nil FATAL CASES. First Quarter Second Quarter Third Quarter Fourth Quarter Total Nil Nil Nil Nil Nil PARTICULARS OF OUTBREAKS. Nil PARTICULARS OF SINGLE CASES. Agent not identified 1. SALMONELLA INFECTIONS, NOT FOOD-BORNE No. of cases Total No. of cases (out breaks and single cases) Outbreaks Salmonella Single Cases Family Other outbreaks - Typhimurium 2 2 - - TUBERCULOSIS Summary of Notifications during the period from the Ist January, 1961, to the 31s December, 1961. Formal Notifications Number of Primary Notifications of new cases of tuberculosis AGE PERIODS Total (all ages) 20- 0- 1- 2- 5- 10- 15- 25- 35- 45- 55- 65- 75+ - - - - 2 - - 3 1 2 2 - 10 Respiratory, Males - - - 1 - - 1 2 1 1 1 1 9 Respiratory, Females 1 - Non-Respiratory, Males - - - - - ­ ­ ­ ­ ­ ­ Nil - ­ Non-Respiratory, Females ­ 1 ­ ­ ­ ­ 1 ­ ­ 2 ­ ­ ­ ­ Number of deaths from tuberculosis - 10 Number of cases remaining on Register - 358 CASES NOTIFIED AND DEATHS FOR THE PREVIOUS TEN YEARS Number of Cases on Register at the end of each year. Year Pulmonary Non-Pulmonary Total No. of Deaths 1952 8 91 429 83 15 1953 100 7 107 4 468 1954 54 9 63 471 9 1955 40 7 47 9 425 1956 35 4 39 1 464 42 1957 5 47 2 441 1958 41 7 48 5 431 1959 35 3 38 3 410 1960 25 2 27 2 362 1961 19 358 2 21 10 Average number of cases for the ten years - 52.s Average number of deaths for the ten years - 6 CHELSEA TUBERCULOSIS DISPENSARY,, BEOMPTON HOSPITAL The following statistics relating to the work of the Chelsea Tuberculosis Dispensary during the past four years have been supplied by the courtesy of the Secretary:- 1958 1959 1960 1961 Population served by Dispensary Number of notified cases in 50,190 49,520 49,140 48,490 431 411 361 Borough at end of year 358 Number of these who at present do not attend Dispensary 96 92 185 152 Total attendances during year 1,453 168 1,526 164 1,278 1,144 Total new patients seen 180 161 Number of these who were contacts 80 72 92 80 Number of contacts found to be tuberculous 4 1 - - Number of cases newly notified to Medical Officer of Health (i.e.. excluding inward transfers) 52 39 29 27 Number of cases diagnosed as tuberculous (for the first time) at the Dispensary 26 25 5 4 1,140 1,041 824 Number of X-rays 925 Number of Patients who received "Special treatment" at home during the year 4 75 2 79 1 52 Number of Patients given B.C.G. - 88 Number of home visits by medical staff 1 - 3 2 Number of visits paid by Dispensary Nurse 1,627 1,613 1,250 1,121 Number of Clinic Sessions per week 2 2 2 2 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 made made as follows :- Throat/Nose Swabs Vincent's organisms found 2 Haemolytic Streptococci found 25 Staphylococcus aureus found 6 Pneumococci found 1 Monilia found 2 Coliforms foundo 1 Normal throat flora found 2 Negative results 79 Faeces Salmonella typhimurium found 3 Shigella sonnei found 54 Pathogenic Bact. coli 026 found 1 Pathogenic Bact.coli 055 found 1 Pathogenic Bact.coli 0111 found 8 Pathogenic Bact. coli 0119 found 6 Pathogenic Bact. coli 0127 found 1 Cysts of Entamoeba Histolytica found 1 Taenia Ova found 1 Negative results 1225 Gum Swabs Negative results 1 Foodstuffs Small growth of Staphylococcus aureus found. 1 Negative results 19 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. INDEX Page(s) Subject, Abatement of Nuisances - Legal Proceedings ... ... Accidents:- 30 Home 26 Road 27 Analyst Public - Report of 47 - 52 Area of Borough 7 Atmospheric Pollution - Recording Stations 59 - 61 Bacteriological Examinations 53 and 71 Baths and Swimming Pools 35-36 Births 7 Burials - Sect. 50, National Assistance Act, 1948 24 Cancer - Lung and Bronchus 12 Chelsea Tuberculosis Dispensary 70 Clean Air Act, 1956: — Smoke Control Orders 62 Atmospheric Pollution Recording 59-61 Committee, Public Health and Baths:- Members 1 Representation elsewhere by Members 2 Conferences - Council representation at 28 Contributions to Voluntary Organisations 28 Cremation - Local service and progress of 15 7 —14 Deaths Diphtheria 18 and 66 Dißinfection/Disinfestation 58 Drainage works 36 Dogs - Fouling of pavements by 38 Dwellings - Number in Borough 7 Dysentery 66 Early neo-natal mortality rate 8 Epidemiology . 63-71 Factories Act $ 1937 41-43 Food and Drugs Act, 195:- Bacteriology 53 Hygiene 44 Ice-Cream premises 45 Inspection and supervision of premises 45 Legal Proceedings 46 Preserved Food premises 45 68 Food Poisoning Food - Unsound 53 Fouling of pavements by dogs 38 General Rate 7 General and Vital Statistics 7-9 Subject Page (s) Health - Personal Services 17 Home Accidents 26 Hospitals - List of 16 Housing Act, 1957:- Overcrowding 39 Applications for re-housing 4O Housing, New - Local Authority and Private 39 Infant Mortslity 7-9; 13 - 14 Infectious diseases 63-71 Inspections and works carried out 31-33 Introduction 4 — 6 Land Charges - Enquiries 37 Legal Proceedingss- Food and Drug 3 Act, 1955 46 Statutory Nuisances 30 L.C.C. - Personal Health Services 17-18 Marriages 8 Mass Radiography 25 Maternal Mortality 8 Measles 66 Medical Examination of Staff 29 Milk - Supply and Licensing 54 Mortuary Facilities 29 National Assistance Act, 1948:- Section 21 - Part 111 Accommodation 24 Section 47 - Removal to Hospital/institution 24 Section 50 - Burial of the Dead 24 Neo-natal Mortality Rate 8 Noise Abatement Act, 1960 37-38 Notices - Service of 34 Notifiable Diseases 63 Notification of Infectious Diseases 64-65 Old People, Welfare of 20-23 Overcrowding 39 Outworkers 43 Part III Accommodation - National Assistance Act,1948 0.. 24 Perinatal Mortality Rate 8 Personal Health Services - L.C.C. 17-18 Pet Animals Act, 1951 - Licences 38 Pharmacy and Poisons Act, 1933 - Inclusions in Register 56 Poliomyelitis 66 Population 7 Public Analyst - Report of 47-52 Public Baths and Swimming Pools 35-36 Page(s) Subject Public Health and Baths Committee:- Members 1 Representation elsewhere by Members 2 Representation at Conferences by Members 28 Public Health Department - Staff of 3 Public Health Inspectors - Work of 30 - 62 Public Houses 45 Public Mortuary, Facilities 29 Puerperal Pyrexia 67 Rag Flock and Other Filling Materials Act, 1951 40 Rateable value of Borough 7 Rent Act, 1957 39 Road Accidents 27 Rodent Control 57 Sanitary Administration of Borough 30 - 62 66 Scarlet Fever Shops Act 9 1950 55 - 56 Smallpox 67 Smoke Control Orders 62 Spastic Children 19 Staff:- Medical Examination 0f 29 Public Health Department 3 Statisticsi- General and V xtal 7-9 Births, Deaths, Infant Mortality, Marriages, Population, Stillbirths, etc. 7-14 Street Trading 55 Stillbirths 7 Town and Country Planning - Applications 36 85; 69 -70 Tuberculosis Unsound Food 53 Vaccination 18 Vital Statistics 7-9 Voluntary Organisations - Contributions to 28 Water Supply 35 Welfare of Old People 20-23 Whooping Cough 67