AC 4345 Library CHE 60 hecl 78.63 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 1962 - 1 - METROPOLITAN BOROUGH OF CHELSEA PUBLIC HEALTH AND BATHS COMMITTEE (at 31st December, 1962) Chairman: Councillor J.A. Paterson-Morgan, F.L.A.S., J.P. Vice-Chairman: Councillor Mrs. C. Mallet. Alderman Miss M.D. Shufeldt Councillor Miss Katharine Acland, O.B.E., T.D. Councillor Mrs. G.K. Buxton Councillor Mrs. D.K. Clowes Councillor J.N. Crichton-Miller Councillor Miss Aimee Gibbings Councillor Miss P.D.J. Molloy Councillor M. Nadin Councillor A.J.S. Pringle Councillor A.H. Stevenson Councillor N.J.P. Wadley, M.C. Councillor T.S. Wood Ex-Officio Members The Worshipful the Mayor (Councillor Vice-Admiral J.W. Durnford, C.B, J.P.) The Deputy Mayor (Councillor John Hannay, M.Ch.S.) - 2 - Borough Representation on outside Committees and other Organisations concerned with Public Health work. (At 31st December. 1962) Chelsea Deanery Moral Welfare Association: Chelsea Chest Care Fund Committee: Chelsea Youth Committee: Family Welfare Association: 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: Third Feathers Club Committee: Westminster and Chelsea District Nursing Association: Councillor Mrs. G.K. Buxton Councillor Mrs. G.K. Buxton Mr. J.E. Woolford (One vacancy) Miss Mellicent Lyall, M.B.E. Councillor Mrs. G.K. Buxton Councillor A.H. Stevenson Councillor Mrs. G.K. Buxton Councillor Mrs. C. Mallet Chief Public Health Inspector Councillor Mrs. G.K. Buxton Councillor Mrs. C. Mallet The Worshipful the Mayor The Deputy Mayor Councillor J.A. Paterson-Morgan, F.L.A.S., J.P. Councillor Mrs. C. Mallet Councillor J. Elliott Brooks, L.C.C. Councillor Miss Elisabeth Stockwell Councillor Miss P.D.J. Molloy Councillor Miss Aimee Gibbings - 3 - STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December. 1962. Medical Officer of Health: Deputy Medical Officer of Health: Chief Public Health Inspector: Deputy Chief Public Health Inspector and Senior Housing Inspector: Public Health Inspectors: Women Public Health Inspectors: Drainage Assistant: Rodent Officers: Public Health Inspectors' Assistant: Chief Disinfector: Disinfector: Cleansing Station Attendant! J.H. WEIR, M.D., B.S., B.Hy., D.P.H. D.J. SHEERBOOM, M.B., B.S., D.P.H. H. HOYLAND. S.W. BARKER. T.W. CAMSEY. H.F. LEACOCK. A.J. WHITE. E.R. YOUNG. (Miss) A.C.C. KAY. (Miss) K.G. READER. E. BOSLEY. J. F. COOKE. P. DRURY. F.G. RAWLINGSON (retired 17.5.1962) A.E. ROTH (commenced duty 12.6.1962) F.W. HILL R.J. WESTON (Mrs.) J. LOBBAN Chief Clerk: Clerical Officers: Social Worker: I.M. THOMSON P.M. MARGETTS H.G. HAMILTON L.A. POWELL (Mrs.) J.M. LEE (resigned 24.6.1962) (Miss) E. DEACON (commenced duty 25.6.1962) P.D. GRAINGER R.A. CLARKE (commenced duty 11.1962) (Mrs.) O.M. BURKE Public Analyst: Thos. McLACHLAN, A.C.G.F.C., F.R.I.C., M.I.Biol. - 4 - METROPOLITAN BOROUGH OF CHELSEA TELEPHONE: Public Health Department, FLAxman 8101 Town Hall, King's Road, CHELSEA, S.W.3. June, 1963. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Chelsea. Your Worship, Ladies and Gentlemen, I have much pleasure in presenting my Annual Report on the health and environmental circumstances of the Borough for the year 1962. The Registrar-General's estimate of the mid-year home population of the Borough was 48,550, an increase of 60 on the previous year's estimate of 48,490. Live births numbered 625 (males 318: females 307), 38 fewer than in 1961 (663), which represents an annual rate of 12.9 Per 1,000 of the estimated population. It is interesting to note that this is the lowest number of Chelsea births registered since 1945 when the total was 557. Illegitimate live births totalled 77 or 12.3 per cent of the total live births registered, 16 less than in 1961 when 93 (14.06%) were recorded. Still births numbered 11, remaining at the previous year's level, giving a rate of 17.3 per 1,000 live and still births. The number of deaths at all ages during the year was 708 (Males 319: females 389), 17 less than the figure for the previous year (725), giving a death rate of l4.6 per 1,000 of the estimated population. 76.27$%of the deaths recorded related to persons aged 65 and over, and 15.68% concerned persons in the 45 and under 65 age group. The principal causes of death were heart disease 230; cancer (all forms) 129} pneumonia and bronchitis 113; and vascular lesions of the nervous system 85. Deaths attributed to accidents and violence totalled 28. Heart disease and cancer continue to cause the highest mortality rates and together (359 deaths) they account for 50.7% of the total number of deaths. if persons died from tuberculosis (2 respiratory and 2 non-respiratory), 6 fewer than in the previous year when there were 10 deaths. Since the end of the war in 1945, there has been a gradual downward trend in the mortality of this disease due to such causes as the advent of new and effective drugs which also allow more extensive surgery to be undertaken; the greater emphasis placed on finding the primary source of infection and of all case contacts and the protection of the latter with B.C.G. vaccination; and finally the big improvement in the general health and social well-being of the nation as a whole. Deaths from cancer of the lung rose from 27 in 1961 to 32 in 1962 (males 22: females 10) and it is of particular interest to note that whilst the number of male deaths equalled the previous year's total (22), female deaths doubled rising from 5 to 10, the highest yet recorded. It is perhaps too early to say whether this is related to the known increase in smoking in women since 1940. During the past ten years the annual number of local residents dying - 5 - from this disease has fluctuated between 20 and 36 but this is to be expected when such small numbers are involved and it is not indicative of a decline in the disease. A study of the death returns for Great Britain over the past nine years shows that the national aspect is totally different and an annual average increase of over 1,000 deaths has been maintained. In March, 1962, the Royal College of Physicians published a report which assessed the evidence about the relationship of smoking and health, and it proved beyond all reasonable doubt that smoking, particularly cigarettes, was a cause of lung cancer, as well as a cause of bronchitis and possibly certain heart and other diseases. A summary of local and national lung cancer deaths is included in this Report. I am very pleased to be able to /report that for the eighth successive year there were no maternal deaths or deaths from causes associated with childbirth. Infantile deaths during 1962 were 16, reaching the same level as in 1961, and indicating an infant mortality rate of 25.6 per 1,000 live births compared with 21.4 for England and Wales. Of the 16 deaths recorded, 7 occurred before the age of one week giving an early neo-natal mortality rate of 11.2 per 1,000 live births. Still births numbered 11 which, added to the 7 deaths occurring in the first week of life, gives a perinatal mortality rate of 28.3 Per 1,000 total live and still births. In the field of infectious disease the most interesting feature was the remarkable decline in measles cases, 63 being notified as against 564 during the previous year, which accounted for the total number of infectious disease notifications received during 1962 being the lowest on record. Only 151 cases were reported compared with 652 in 1961, a decline of 501 cases. 67 Sonne Dysentery cases were notified, an increase of 28, but 59 of these cases concerned outbreaks among residents of an Institution in which the rapid spread of infection is very difficult to control. Only 2 cases of food poisoning were reported throughout the year and both were connected with an extensive outbreak which involved several other London boroughs. The cause of the outbreak was traced to a certain supply of ham which had become infected with Salmonella Bredeney. During January and February, further cases of smallpox entered the country from Pakistan, causing outbreaks in some areas, notably in Bradford and South Wales. Fortunately no case occurred in the Borough but many contacts, persons from infected areas and travellers from Pakistan itself, had to be visited and kept under surveillance. This involved a considerable amount of work for the Inspectors concerned. Supplies of vaccine were also made available to all General Practitioners in the Borough and the staff of the Health Department were all vaccinated as a precaution. Mass vaccination was not offered to the general public as it was felt that this was unjustifiable and would cause unnecessary panic. New cases of tuberculosis which are shown separately from other notifiable.diseases totalled 26, as compared with 21 in the preceding year. 16 of these cases concerned persons aged 25 and under 35, which represents 61.5% of all new cases notified. A detailed review of the incidence and notification of infectious disease will be found in the final section of this Report. Throughout the year 330 samples of food and drugs were examined and reported upon by the Public Analyst and in 18 cases (5.45%) samples were reported to be adulterated or inferior. All adulterations were - 6 - fully investigated and appropriate action was taken where necessary. 12 complaints were received concerning the sale of unsatisfactory foodstuffs and in two instances successful legal proceedings were instituted. The Women Public Health Inspectors have continued to give a great deal of attention to food shops and catering establishments which are kept under constant supervision. Every effort has been made to obtain the highest possible standards regarding structural improvements, modernisation of equipment and hygiene. This necessitated advising owners on all these matters and discussing with staffs points of personal hygiene and food handling. In the majority of cases owners and caterers have been most cooperative and considerable improvements have been achieved. Your District Public Health Inspectors have diligently carried out their many duties in regard to the general supervision of environmental conditions within their districts. The supervision of plumbing and drainage works has again made heavy demands upon their time and this section of their work continues to expand and calls for considerable concentration when dealing with complicated schemes of conversion involving large buildings. The investigation of noise complaints is another aspect of their work which often entails long periods of observation and numerous enquiries before a satisfactory solution can be reached. Work on the establishment of smoke control areas in accordance with the Council's phased programme progressed satisfactorily during the year, and the second Smoke Control Order covering Hans Town Ward became operative on the 1st November. It was intended that the next area to be brought under smoke control should comprise Royal Hospital Ward and part Cheyne Ward, but dealing with part of a ward would have created administrative difficulties in arriving at figures in regard to area, premises, population and assessment of cost. It has been agreed, therefore, to combine the Royal Hospital and Cheyne Wards into one area, and the detailed survey of this area is now in progress. During the year under review the routine work of the Department relating to the care of old people continued to increase and many social and other problems were brought to the attention of tne Council's officers. 213 new cases were added to the Department's register and the Social Worker made a total of 1,604 visits to old and new cases. The frozen meals service, which has now been in operation for well over a year, appears to have proved a very successful venture and is greatly appreciated by the majority of recipients. When this service was first introduced many old people were suspicious of this new system of distributing meals but experience has shown that they now prefer to receive a pre-packed frozen meal which takes only fifteen minutes to prepare and which they can have at a time suitable to themselves. The National Assistance Act, 1948 (Amendment) Act, 1962, which received Royal Assent on the 24th May, extends the previous powers of local authorities to provide meals and recreation for old people. Your Public Health and Baths Committee have welcomed the wider powers now available which will be used whenever necessary. Close liaison and good relations continue to exist between the officers of the Public Health Department, the Old People's Welfare Committee and the local voluntary organisations, and I feel sure that all members of the Council will join with me in thanking the voluntary workers who have so readily given of their time to assist old people in their many and varied problems. - 7 - One particular feature of the past year's work which I feel deserves a special mention concerns health education. During late September an Oil Heater Safety Campaign was conducted throughout the Borough, drawing the attention of the public to the dangers inherent in old models and publicising the need to have heaters examined before the return of wintry conditions. In this connection the Divisional Medical Officer of the London County Council rendered valuable assistance by supplying leaflets and pamphlets, and arranging increased propaganda at the Council's clinics in the Borough during the period of the campaign. A further important step in the field of health education was the Borough Council's action, in response to appeals from the Minister of Health, to approve the carrying out of an extensive "Smoking and Health" campaign warning against the dangers to health of smoking, particularly of cigarettes. As members are aware, this campaign was held very recently during the period 11th to 23rd March, and a full account will be included in my next Annual Report reviewing the work carried out during 1963. Under the provisions contained in the Housing Act, 1961, which came into force at the end of that year, local authorities are given new and greatly strengthened powers to deal with squalid living conditions in houses in multiple occupation. These new powers enable a local authority to apply a code of management to individual houses in which proper standards of management have not been observed; to require the provision of additional facilities and amenities essential to decent living conditions; and to make a direction limiting the number of persons who may live in a house, or part of a house, which is in multiple occupation. The Minister desires that the provisions of the Act should be applied in a reasonable manner and that management orders only be made in regard to particularly difficult properties. It is not anticipated that it will be necessary to invoke these new powers very widely in Chelsea, as it is gratifying to report that in many cases improvements have been carried out and the number of occupiers reduced as a result of informal action by the Public Health Inspectors. I do not recall in recent years having drawn special attention to the work of the rodent staff. This important section of the Department's work engages the full-time services of two Rodent Officers, and in previous years regular campaigns to rid the sewers of rats have been carried out with the assistance of the sewermen, using a variety of bait bases and poisons. This method has proved quite successful in reducing the rat population of the sewers, but during the past year a new method was introduced using a direct poison, Fluoracetamide, which does not involve additional labour as the necessity to prebait was avoided. Reports received from the rodent officers and the sewer workers on the use of this new treatment have been most encouraging and a similar treatment is programmed for 1963. Before concluding I feel I should make a brief reference to the Government Bill which was introduced in the late Autumn containing proposals for the re-organisation of London government. This Bill received its Second Reading on the 12th December and under its provisions the boroughs of Chelsea and Kensington will join to form one of the 12 inner London boroughs which replace the existing metropolitan boroughs. A number of joint meetings at Member and Officer level have taken place during the last few months to discuss future policy concerning the proposed amalgamation of the two authorities. Under the Bill the new combined Borough will still be responsible for all matters related to environmental health, but in - 8 - addition, all the Personal Health Services will be under its control together with some other minor responsibilities. In order that these additional services are maintained at a high level of efficiency there will of necessity be a considerable increase in the numbers of staff for whom new premises will be required. Mr. F.G. Rawlingson, Public Health Inspectors' Assistant, retired on the 17th May, 1962, after completing 42 years service with the Borough Council. He was previously a member of the staff of the Borough Engineer and Surveyor's Department and transferred to the Public Health Department in February, 1946. During the past 16 years he has proved a most reliable and hard-working assistant and all his colleagues wish him well in his retirement. Finally I wish to take this opportunity of thanking the Chairman and Members of the Public Health and Baths Committee and other Members of the Council for their continued help and support during the year. I also greatly appreciate the co-operation and assistance forthcoming from the Chief Officers and staffs of other Departments. I should also like to express my grateful thanks to my own staff for their loyalty and valued assistance throughout the year. I am, Your Worship, Ladies and Gentlemen, Your obedient Servant, Medical Officer of Health. - 9 - GENERAL AND VITAL STATISTICS 1962 Area of Borough: 659.6 acres General Rate: 17s„10d. in the £ (at 31st March, 1962) Product of a Penny Rate (gross): £8,118 Rateable value of Borough as at £1,999,254 31st March. 1962: Population: Registrar-General's estimate of the population of the Borough (mid-year 1962): 48,550 Density of population per acre: 73.6 Number of Dwellings (according to the Rate Books): 16,566 Live Births: Total Male Female Legitimate 548 279 269 Birth rate per 1,000 Illegitimate 77 39 38 of estimated 625 318 307 population: 12,9 Adjustment of birth rate by area comparability factor (0.76) : 9.8 (Birth rate for England and Wales - 18.0) Illegitimate Live Births (per cent of total live births): 12.3 Still Births: Total Male Female Legitimate 9 5 4 Rate per 1,000 live Illegitimate 2 2 and still births: 17.3 11 5 6 (Still birth rate for England and Wales - 18.l) Total Live and Still Births: 636 Infant Deaths (deaths under one year):- Total Male Female Legitimate 10 5 5 Rate per 1,000 Illegitimate 6 4 2 live births: 25.6 16 9 7 - 10 - GENERAL AND VITAL STATISTICS (Continued) Infant Mortality Rates - Total infant deaths per 1,000 total live births: 25.6 (Infant Mortality rate for England and Wales 21.4) Legitimate infant deaths per 1,000 legitimate live births: 18.2 Illegitimate infant deaths per 1,000 illegitimate live births: 77.9 Neo-natal Mortality Rate (deaths under four weeks per 1,000 total live births): 17.6 Early Neo-natal Mortality Rate (deaths under one week per 1,000 total live births): 11.2 Perinatal Mortality Rate (stillbirths and deaths under one week combined per 1,000 total live and still births): 28.3 Maternal Mortality (including abortion): Number of deaths NIL Rate per 1,000 total live and still births: Deaths: Total Male Female 708 319 389 Death rate per 1,000 of estimated population (Males 6.6 Females 8.0): 14.6 Adjustment of death rate by area comparability factor (0.67): 9.8 (Death rate for England and Wales - 11.9) Tuberculosis: Deaths from Pulmonary Tuberculosis: 2 Deaths from Non-Pulmonary Tuberculosis: 2 Death rate from Pulmonary Tuberculosis per 1,000 of estimated population: 0.041 Death rate from Non-Pulmonary Tuberculosis per 1,000 of estimated population: 0.041 Marriages: Number of marriages solemnised in the Borough during the year: 830 Marriage rate per 1,000 of estimated population: 17.1 - 11 - SUMMARY OF VITAL STATISTICS 1953-1962 (inclusive) Year Registrar-General's Estimate of Population Births Deaths Deaths under One Year Maternal Deaths No.* Rate No.* Rate No.* Rate No.* Rate 1953 52,150 787 15·1 694 13·3 15 19 3 3·7 1954 52,060 787 15·1 734 14·1 21 27 2 2·5 1955 51,450 745 14·5 825 16·0 25 34 - - 1956 51,070 837 16·4 815 16·0 21 25 - - 1957 50,600 738 14·6 750 14·8 16 22 - - 1958 50,190 742 14·8 730 14·5 24 32 - - 1959 49,520 722 14·6 726 14·7 12 16 - - 1960 49,140 697 14·2 729 14·8 12 17 - - 1961 48,490 663 13·7 725 14·9 16 24 - - 1962 48,550 625 12·9 708 14·6 16 25 - - Averages for the ten years 1953-1962:- Births 734 Deaths 743 Deaths under one year of age 17.8 Maternal Deaths 0.5 * Totals arrived at after due allowance for inward and outward transfers. - 12 - CLASSIFICATION OP DEATHS OF CHELSEA RESIDENTS WITH AGE DISTRIBUTION FOR THE YEAR 1962 Causes of Death At all ages Under 1 year 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards 1. Tuberculosis, respiratory 2 - - - - 1 - 1 2. Tuberculosis other 2 — — — — — — 2 3. Syphilitic disease - - - - - - - - 4. Diphtheria - - - — - - • — 5. Whooping Cough - — - - — • • — 6. Meningococcal Infections 1 1 • - - - - - 7. Acute Poliomyelitis - - - - - - - - 8. Measles - - - - - - - - 9. Other infective and parasitic diseases — • - "" - - - - 10. Malignant neoplasm, stomach 14 - - - - - 3 11 11. Malignant neoplasm, lung, bronchus 32 - - - - 2 10 20 12. Malignant neoplasm, breast 6 - • - — "" 2 4 13. Malignant neoplasm, uterus 8 — — — — - 4 4 14. Other malignant and lymphatic neoplasms 63 - - - 1 5 16 41 15. Leukaemia and Aleukaemia 6 - l - 1 - 2 2 16. Diabetes 4 - - - - 1 1 2 17. Vascular lesions of nervous system 85 - - - - 1 14 70 18. Coronary disease, angina 112 - - - 1 1 19 91 19. Hypertension with heart disease 8 - - - - - - 8 20. Other heart diseases 110 - — — 1 4 4 101 21. Other circulatory diseases 35 - — — - - 7 28 22. Influenza 4 - - - - - 1 3 23. Pneumonia 69 5 - 1 - - 3 60 24. Bronchitis 44 - - - - - 7 37 Carried Forward 605 6 1 1 4 15 93 485 - 13 - CLASSIFICATION OF DEATHS OF CHELSEA RESIDENTS WITH AGE DISTRIBUTION FOR THE YEAR 1962 Causes of Death At all ages Under 1 year 1 and under 5 5 and under 15 15 and under 25 25 and under 45 45 and under 65 65 and upwards Brought forward 605 6 1 1 4 15 93 485 25. Other diseases of respiratory system 8 - - - - 1 2 5 26. Ulcer of stomach and duodenum 4 - - - — - - 4 27. Gastritis, enteritis and diarrhoea 2 - - - 1 - - 1 28. Nephritis and nephrosis — - - — — - - - 29. Hyperplasia of prostate 2 - - — — - — 2 30. Pregnancy, childbirth, abortion - - - - - - - - 31. Congenital malformations 11 3 - 5 1 1 - 1 32. Other defined and ill-defined diseases 48 7 1 1 - - 9 30 33. Motor vehicle accidents 3 - - - - 1 - 2 34.. All other accidents 14 - - 1 1 1 1 10 35. Suicide 11 - - - 1 - 6 - 36. Homicide - - - - - - - - TOTALS 708 16 2 8 8 23 111 540 AGE MORTALITY Number of Deaths Percentage of Total Deaths Under one year 16 2·26 1 and under 5 2 0·28 5 and under 15 8 1·13 15 and under 25 8 1·13 25 and under 45 23 3·25 45 and under 65 111 15·68 65 and upwards 540 76·27 - 14 - INFANT MORTALITY 16 deaths of infants under one year of age were recorded during 1962, the same as for the previous year, giving a rate of 25.6 per 1,000 live births. The infant mortality rate for England and Wales was 21.4. It will be observed from the following summary that of the 16 deaths recorded, 11 occurred before the age of four weeks, which gives a neonatal mortality rate of 17.6, and 7 infants died before the age of one week indicating an early neo-natal mortality rate of 11.2. Cause of Death Under 1 Week 1-2 weeks 2 - 4 weeks 1-7 months TOTAL M F M F M F M F M F Microcephaly - - 1 - - - - - 1 - Pulmonary Haemorrhage 2 - - - - - - - 2 - Broncho Pneumonia - 1 - - - 1 2 1 2 3 Prematurity 1 2 - - - - - - 1 2 Cerebral Haemorrhage 1 - - - - - - - 1 - Haemolytic Disease - - - - - - 1 - 1 - Congenital Heart Disease - - 1 - - - - - 1 - Meningococcal Septicaemia - - - - - - - 1 - 1 Oesophageal Atresia - - - - - 1 - - - 1 TOTALS 4 3 2 - - 2 3 2 9 7 - 15 - CANCER OF THE LUNG AND BRONCHUS During the year under review 32 deaths (Males 22 and Females 10) were recorded as against 27 deaths (Males 22 and Females 5) in the preceding year. The following table has been prepared to show the deaths of Chelsea residents from lung cancer, compared with deaths caused by tuberculosis, during the ten year period 1953 to 1962:- CANCER OF THE LUNG AND BRONCHUS TUBERCULOSIS Year Males Females Total Males Females Total 1953 16 4 20 3 1 4 1954 20 7 27 6 3 9 1955 21 8 29 5 4 9 1956 25 6 31 1 - 1 1957 16 6 22 1 1 2 1958 22 6 28 2 3 5 1959 31 5 36 3 - 3 1960 25 5 30 - 2 2 1961 22 5 27 5 5 10 1962 22 10 32 3 1 4 TOTALS 220 62 282 29 20 49 It will be observed therefore, that during the past ten years over five times as many residents died from lung cancer as from tuberculosis. It may be significant that the female figures are the highest yet recorded and twice those of the past three years. It is commonly believed that the seeds of lung cancer may be sown by cigarette smoking over a considerable time dating back many years before the final activation. It is possible that this increase reflects the increase of cigarette smoking among women during the past 20-25 years. Although since 1953, the yearly total of Chelsea lung cancer deaths has varied very little, resulting in an annual average of 28, the local figures do not give a true picture of the position over the Country as a whole. The national aspect is quite different as will be seen from the following summary of deaths for Great Britain since 1954 — Year GREAT BRITAIN Cancer of the Lung and Bronchus Number of Deaths Registered Increase over preceding year 1954 18,076 1,233 1955 19,001 925 1956 20,080 1,079 1957 21,109 1,029 1958 22,046 937 1959 23,393 1,347 1960 24,412 1,019 1961 25,288 876 1962 26,383 1,095 - 16 - These figures show that since 1954 lung cancer deaths in Great Britain have risen steadily, maintaining an annual average increaae of over 1,000. In the past nine years 199,788 deaths have occurred from this disease - many more than those who die from accidental deaths on the roads or in the home. In March 1962, the Royal College of Physicians published a Report on "Smoking and Health". This Report assessed the evidence about the relationship of smoking and health and concludes that cigarette smoking is a cause of lung cancer and bronchitis, and probably contributes to the development of coronary heart disease and various other less common diseases. One of the principal recommendations contained in the Report was that there should be more education of the public, especially school children, concerning the hazards of smoking. In this connection, the Minister of Health in Circular No. 6/62, asked all Local Health Authorities to take the necessary steps to achieve a general discouragement of smoking by using all their channels of health education to make the conclusions of the Report widely known, and to bring home to the public the dangers to health of smoking, particularly cigarettes. The Minister expressed the hope that all authorities would engage in this work immediately. The Borough Council at its meeting in October last, approved a recommendation from the Public Health and Baths Committee authorising the Medical Officer of Health to conduct a local "Smoking and Health" Campaign directed to the public at large, and to be synchronised if possible with similar campaigns held by the London County Council and the Ministry of Health. 17 SUICIDE The following table shows the number of suicides in the Borough over the last 10 years, a number which has remained fairly constant:- 1953 14 1954 9 1955 10 1956 7 1957 11 1958 16 1959 9 1960 18 1961 13 1962 11 Total 118 In 1962 there were 11 which is 1.6% of all causes of death, and which was in fact, together with those due to accidents, the fourth largest cause following after those due to Cancer, Diseases of the Heart and Blood Vessels and Chest Diseases. It accounted for more deaths than Tuberculosis, Poliomyelitis, Measles, Whooping Cough and Diphtheria and Smallpox all grouped together, and to this total must be added the number of attempted suicides which is probably at least twice as many again. The passing of the Suicide Act, 1961, an Act about which many people are unaware, now means that an attempt to commit suicide is no longer a criminal offence. Whether this will in any way increase the numbers attempting suicide is probably most unlikely,but the actual figures for attempted suicide may well rise as both Coroners and also hospital doctors will be less inclined to shield the diagnosis now that the legal stigma has been removed. There are many reasons why a person may wish to end his life and of course a high percentage of those attempting suicide really have no intention of actually dying but rely on someone saving them in time and then gaining solace from the increased attention that they receive during and after their recovery. Recent work has shown however that suicides may be divided roughly into the following classes: those due to some sudden shock or bereavement; those due to true mental illness, most commonly of a depressive nature; old people suffering from loneliness together with an actual or imagined disease; and, finally, a group which is becoming more appreciated, namely those who commit suicide when suffering from some ordinary physical illness not necessarily of a serious nature. Prevention is indeed difficult, but if the possibility of suicide were born in mind by everyone dealing with a person showing signs of depression, or if families took more notice if one of their members showed signs of an unexplained emotional abnormality and if more could be done to dispel loneliness and boredom in old age, then probably many attempts could be prevented and the patient put under suitable medical care. Probably many of us know of suicides, who might never have taken their lives if they had been able to discuss their problems (real or imaginary) with someone they could trust. Sympathetic listening and a little time spent with them could quite probably have prevented many such tragedies, which involve not only the person concerned but also his family and friends. 18 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 Boroughs 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 lf466 Attendances at Infant Welfare Sessions 6,908 HEALTH VISITING Number of visits carried out by Health Visitors:- Expectant mothers: First visits 391 Total visits 862 Children under 1 year: First visits (including visits paid to premature infants) 801 Total visits 2,769 Children between Total visits 1,457 1 and 2 years: Children between Total visits 2,332 2 and 5 years: Still births: Total visits 3 School children: Total visits 109 Care of old people: Total visits 22 Care of other people: Total visits 44 Miscellaneous: Total visits 239 Unsuccessful: Total visits 1,457 No. of children under 5 visited during the year 1,754 No. of households visited during the year l,244 Foster mothers; child minders and private day nurseries at end of year: Number of foster mothers 3 Number of children fostered 3 Number of voluntarily registered child minders 18 Number of children minded 13 Number of registered private day nurseries 3 Number of children attending 68 19 Diphtheria Immunisation: No. of children who completed a primary course of injections 351 No. of children receiving reinforcing injections 928 Vaccinations: No. of children vaccinated at Violet Melchett Infant Welfare Centre 411 Details of the facilities available at the Violet Melchett Infant Welfare Centre, Flood Street, S.W.3., are as follows:- CLINICS Ante-natal and Post-natal: Monday p.m. (by appointment) Relaxation and Ante-natal Monday 6 p.m. to 7 p.m. Exercises: Friday 2 p.m. to 3 p.m. (followed by parentcraft) Parentcraft 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 Cough, 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) Children's Creche: Wednesday & Friday 9.30 a.m. to 12 noon. Health Visitors are available at the Centre for interview daily from 9 a.m. to 10.15 a.m. and from 4.30 p.m. to 5 p.m. and during these times may be contacted by telephone (FLAxman 8387). A Welfare Foods Department, whereat National Dried Milk, Orange Juice and Cod Liver Oil may be obtained, functions at the above Centre from 1.30 p.m. to p.m. Monday, Tuesday and Thursday; Friday 9 a.m. to 12.30 p.m., closed on Saturday. 20 MASS RADIOGRAPHY I am grateful to the Organising Secretary of the South West London Mass X-Ray Service who has kindly supplied the following report on the activities of the Service in Chelsea during 1962:- A number of visits were made to the Borough by mobile Mass X-Ray Units of the South West London Service during the year under review. These included the annual visit to the Chelsea College of Technology where nearly five hundred students and staff were x-rayed. The College of St. Mark and St. John was also visited in conjunction with the London County Council's B.C.G. innoculation scheme, so that all the positive re-actors to the tuberculin skin tests could be x-rayed. Two visits were paid to John Lewis Clearings (Peter Jones Ltd), and to Messrs. Foster Wheeler, and one to the Power Generating Station at Lots Road. Two hundred and fifty men in the over forty-five years of age group who live and/or work in Chelsea, are making use of the six monthly service which was started in 1958 to provide regular chest x-ray examinations for this section of the population, in an effort to detect more cases of lung cancer, at the earlier stages of the disease. In connection with this service the mobile Unit came to a site in Britten Street in May, and to one in Manresa Road in November. Owing to difficulties in obtaining suitable accommodation, it was not possible to open a temporary public Mass X-Ray Centre, but many residents of Chelsea found it convenient to come to the Central Mass X-Ray Centre, at the Western Hospital, Seagrave Road, S.W.6. This centre is open all the year round to everyone over the age of fifteen, irrespective of where they work or live, on Wednesday afternoons and evenings between 2-4 p.m. and 5-7 p.m. No appointments are needed for these public sessions, but ante-natal patients, and children between the ages of 6 and 8 years referred by a clinic or general practitioner are x-rayed at other times, and are required to make an appointment beforehand. Children 8 to 14 years old can be brought to the public sessions, provided they have an x-ray request form from a general practitioner. In 1962, 15,000 people were x-rayed at this centre. The three units of the South West London Mass X-Ray Service, which covers the boroughs of Battersea, Chelsea, Fulham, Lambeth, Wandsworth and Westminster carried out 99,000 mass x-ray examinations during the year under review, as a result of which 317 cases were referred to chest clinics with radiological abnormalities suggestive of clinically significant tuberculosis, and 111 cases were referred which were suggestive of neoplasm requiring further investigation. In addition 253 other examinees were discovered to have significant abnormalities. 21 CENTRE FOR SPASTIC CHILDREN - 6l/62. Cheyne Walk. The Secretary of the Chelsea and Kensington Hospital Management Committee has kindly supplied the following report on the work of the Centre for Spastic Children during 1962. The Centre for Spastic Children, which is a specialised unit for the treatment of young patients with cerebral palsy and which forms part of the Chelsea and Kensington Hospital Group, has continued its work throughout the year, and some added facilities have now increased its scope and value. In addition to the two nursery classes for children from 2 to 7 years of age, a Special Care Unit has been formed to cater for cerebral palsied children who are considered to be ineducable but trainable and who benefit from being in a group with other children with similar disabilities for whom all the treatment and training facilities of the Centre are available. The age range of this group has been extended upwards to 11 years and fifteen children can be accepted at any one time into this unit. The London County Council is largely responsible for the running costs of the Special Care Unit, assisted by the Friends of the Centre, who themselves paid for the complete adaptation and equipping of the accommodation for its use. The Assessment Unit in which up to eight children may attend for short periods of assessment, also continues to function. In addition to those children who attend for the whole of each school day, a number of babies and some older children attend two or three times a week for therapy. The Hostel which is run and financed by the Friends of the Centre can house six or seven weekly boarders and has a Mother and Child unit for short stay visits. All of this accommodation was well used during the year. The Hydrotherapy Pool which was provided through the generosity of Richard Hearne and which, at the time of its completion, formed the seventh of "Mr. Pastry's Pools for Spastics", has been in use almost daily since March, 1962. It is an extremely popular form of treatment with the children as well as being most beneficial to them. Clinical work undertaken at the Centre includes for all cases routine neurological examination, full psychological, audiological and ophthalmological tests, and the making of a clinical film. The electro-encephalogical department also plays its part in the routine assessment of each spastic child and in addition accepts adult and child patients from many other hospitals, producing about 700 records each year. 22 The electro-myography department is also in fairly constant use both for investigatory work on neurological cases and for research purposes. Preparations began in the latter part of 1962 for a six weeks postregistration course for physiotherapists, occupational therapists and speech therapists, which was scheduled to begin in February 1963, and applications for places on the course have been received from many countries. It is hoped to hold such courses twice yearly in the future. Many visitors, both professional and lay, are shown round the Centre in the course of a year, including a number of parties from medical, nursing and therapy schools. In addition several of the training schools for speech and occupational therapy send third-year students to do part of their training at the Centre under the senior therapist of the appropriate department. 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 needed, and in this connection, the Welfare Officer visited 213 new cases during the year and made 1,391 re-visits to the 1,280 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 liasion with the Public Health Department. Grant The Borough Council makes a grant of £450 per annum to the Chelsea Old People's Welfare Committee. Meals on Wheels. This service, as usual, has been efficiently administered by the Women's Voluntary Services and distributed by the voluntary organisations on five days a week. It not only ensures that housebound old people are certain of one meal a day, but provides a valuable link with all services available. Number of meals issued during the year 13,952 Average weekly supply 268 Average number of old people supplied 70 As mentioned in my Annual Report for 1961, frozen meals are now supplied. This scheme has been running for sixteen months to everyone's satisfaction. To cover the weekend, voluntary helpers take homemade soup to old people just out of hospital or too ill to eat solid food. This excellent 23 idea has worked extremely well and does ensure that ill or fragile old people are visited regularly. Chiropody - Domiciliary Service 168 persons received 673 treatments given by two qualified chiropodists working six days a month between them. All applicants are approved by the Welfare Officer before informing the British Red Cross Society who administer the service. Chiropody - Old People's Clinic 1,689 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 free to the pensioners. Holidays Throughout the Summer, holidays are arranged with the Women's Holiday Fund and Hotel and Boarding House Associations at seaside resorts, particularly Ramsgate, where a small hotel caters almost entirely for old people. During two weeks in June and one in September, the hotel was occupied entirely by Chelsea residents. To avoid undue strain, each party was taken by coach direct from the Town Hall to the hotel. Number of assisted holidays 29 Self-paid holidays 29 58 The more infirm people requiring holidays are referred to the Physically Handicapped Department of the London County Council. Incontinent Laundry. This twice weekly service is carried out in co-operation with the Fulham Borough Council. During the year, 37 persons have so benefited and some 7,757 lbs of soiled articles laundered. Provision of this service often discloses the urgent need for fresh beds, bedding 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 six 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 on the recommendation of the Welfare Officer. 24 Christmas Parcels The Christmas Dinner Fund Committee collected sufficient money to provide 625 housebound and lonely old folk with a Christmas parcel. In addition to this number it is known that over 300 other pensioners received some form of parcel or gift. Coal (gift) During the year various sums totalling £224 were received by the Old People's Welfare Committee and this enabled 160 old people to receive two cwts of fuel. Preference is given to invalids, rheumatic sufferers and basement dwellers. Accidents in the Home In preventing accidents, which may be caused by faulty gas appliances, any defects are referred to the North Thames Gas Board, who inspect and advise on any improvements that may be needed. Whenever possible, gas and electric meters are lowered so reducing the risks old people take in the home climbing chairs, 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 supplied. Old Time Dancing and Arts and Crafts Classes. Both these classes are still very well attended and are of considerable therapeutic value to their members. These classes are sponsored by the London County Council who provides the Instructors and charges a small fee of 1s. 6d. per term and 2s. 0d. per annum respectively. Number attending Dancing Class 60 Number attending Arts and Crafts Class 26 Clothing Issues have been made through the Women's Voluntary Services and the Welfare Officer to 196 persons during the year. Hospital Admissions and Institutional Care Difficulty in securing accommodation for the chronic sick continues but as excellent relations exist between this Department and the local hospitals, patients are admitted with the minimum of delay. Every effort is made by the Old People's Welfare Services to maintain old people in their homes as long as possible with the result that only 19 people were admitted to Homes during the year and in only one case was it necessary to take action under statutory powers. 25 Outings Each of the four clubs held their annual outings to the sea and 2 additional invitations from the Women's Institutes enabled 58 pensioners who were not club members to enjoy a day in the country. The British Red Cross Society, by providing a minibus capable of carrying 8 infirm old people, have, during the year, taken over 100 pensioners for trips to the country. The Chelsea Christmas Dinner Fund had a surplus of money following the Christmas parcel distribution and decided to use this by providing a days free outing for 350 pensioners. Arrangements were made for 9 full coaches to leave Chelsea on 18th June for Windsor where the old people boarded 2 launches and made a trip to Marlow and back, having both lunch and tea on board. On returning to Windsor coaches brought them back to Chelsea. 26 NATIONAL ASSISTANCE ACTS. 1948/l962. (a) National Assistance Act, 1948 - 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 action was only necessary in one instance under the provisions of the above Acts for the compulsory removal of aged and infirm persons in need of proper care and attention. The case in question concerned an old lady aged 88 years who was living alone in insanitary conditions and was suffering from the effects of self-neglect and malnutrition. (b) 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 considered necessary to arrange for the reception of nineteen persons in such accommodation and all but three of these admissions were made at "King's Mead". (c) National Assistance Act. 1948 - Section 31 and National Assistance Act. 1948 (Amendment) Act, 1962. Provision of Meals and Recreation for Old People. The National Assistance Act, 1948 (Amendment) Act, 1962, received Royal Assent on 24th May, and it substitutes a new section for Section 31 of the 1948 Act which extends the previous powers of local authorities so as to enable them:- (a) to assist voluntary organisations to provide meals or recreation for old people by making contributions to the cost of the service; to provide, by gift or loan or otherwise, furniture, vehicles or equipment; to permit the use of premises belonging to the local authority; to make available the services of local authority staff connected with the premises or vehicles which the organisation is permitted to use; (b) to provide meals and recreation for old people, either directly or through the agency of voluntary organisations, and to recover such charges (if any) as the authority may determine, having regard to the cost of the service. 27 NATIONAL ASSISTANCE ACTS. 1948/1962 (Continued) The Public Health and. Baths Committee have welcomed the wider powers now available which will be used whenever needed, and provision has been made in the annual estimates for 1963/64 to increase the Council's grant to the Chelsea Old People's Welfare Committee to meet the increased cost of the "Meals on Wheels" service, and to help towards financing other services - for example, domiciliary chiropody and holidays at the seaside. (d) National Assistance Act. 198 - 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 the National Insurance Scheme. During the year seven burials were arranged by the Council's Contractor as follows:- Males Females (Aged) 7 weeks 35 years (unknown woman) 50 years 60 years 80 years 73 years 86 years 28 ACCIDENTS IN THE HOME 91 Chelsea home accident cases were removed to hospital during the year by the London Ambulance Service as compared with 111 for the previous year. It has not been possible to obtain detailed figures showing the various causes of these local accidents, but the following summaries have been prepared from information made available by the County Medical Officer of Health, relating to home accident cases within the Administrative County of London which were removed to hospital by the London Ambulance Service. Falls in or about the home continue to cause by far the highest accident rate, particularly among elderly persons. It will be seen that of a total of 8,607 accident cases reported during the year no less than 6,565 (76.3%) were due to falls, and in 3,045 cases (35.4%) the victims were aged 65 and over. Summaries of Home Accidents reported by the London Ambulance Service within the Administrative County of London during the year 1962. Percentage of Total Accidents Total accidents reported 8,607 Total accidents caused by falls at all ages 6,565 76.3 Total accidents due to other causes at all ages 2,042 23.7 Total accidents caused by falls:- Under 1 year 55 0.6 1 and under 5 541 6.3 5 and under 15 494 5.7 15 and under 25 382 25 and under 756 8.8. 45 and Tinder 65 1,292 15.0 65 and upwards 3,045 35.4 29 ACCIDENTS IN THE HOME - CAUSES Cause of accident Male Female Total FALL On stairs 334 664 998 From ladder 59 42 101 From chair 39 110 149 Outside (i.e., windows, balconies, roofs, etc.) 122 76 198 In garden 92 127 219 In bath 12 11 23 From one level to another,(i.e., tables, boxes, beds, etc.) 158 276 434 On same level (i.e., in room, over objects) 215 536 751 Unspecified 1,198 2,494 3,692 Sub-total 2,229 4,336 6,565 HIT BY OBJECT 107 114 221 COOKING STOVE (saucepans, water, fats, etc.) 49 87 136 TEAPOT 31 22 53 OTHER BOILING WATER 90 89 179 ELECTRIC SHOCK 14 8 22 POISONING (including foreign objects) 175 165 34O GASSING 75 117 192 KNIFE-LIKE WOUNDS (including spikes and cuts from glass) 163 163 326 FIRES 83 102 185 WINDOWS (trapping) 4 25 29 SUFFOCATION 13 18 31 NOT SPECIFIED 135 193 328 TOTAL 3,168 5,439 8,607 30 ROAD ACCIDENTS During 1962, 452 road traffic accidents occurred within the Borough, causing 542 casualties, 5 of which proved fatal. These figures are slightly lower than for the previous year when 459 accidents caused 549 casualties resulting in 8 deaths. It is again pleasing to record that there were no fatal accidents involving children on the roads in Chelsea during the year under review. 5 children were, however, seriously injured, and 38 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 Adult Children Total Killed Seriously Injured Slightly Injured Killed Seriously Injured Slightly Injured Killed Injured January 40 - 4 35 - - 5 - 44 February 32 - 5 40 - - 3 - 48 March 34 - 5 31 - - 2 - 38 April 28 - 2 26 - - 3 - 31 May 49 - 3 54 - - 7 - 64 June 41 2 8 36 - - 2 2 46 July 39 - 5 40 - - 4 - 49 August 35 1 1 42 - 3 2 1 48 September 39 - 7 28 - 2 5 - 42 October 35 2 6 29 - - 1 2 36 November 45 - 4 44 - - 3 - 51 December 35 - 4 35 - - 1 - 40 TOTALS 452 5 54 440 - 5 38 5 537 Accidents per mile of road 13.7. 31 OIL HEATER SAFETY CAMPAIGN In recent years there has been a considerable number of accidents involving paraffin oil heaters. These accidents have caused loss of life, serious injury to elderly people and young children and severe damage to property. In view of the concern which has been expressed at the increasing number of this type of accident, regulations have been made under the provisions of the Consumer Protection Act, 1961. These regulations came into force on the 1st June, 1962, and impose safety measures on the sale of all new and secondhand paraffin heaters. In brief they require warning notices to be borne by oil heaters against (i) using petrol as a fuel: (ii) carrying the heater when alight: (iii) using the heater in unventilated places: (iv) using the heater when it may be exposed to draughts: (v) placing the heater where it may be knocked over; and they prescribe certain standards of construction, design and performance with which all domestic oil heaters not designed for use with a flue manufactured after 1st June, 1962, and sold or held for the purpose of selling must comply. There are certain permitted exceptions, and provisions as to inspection, testing and enforcement are conferred upon local authorities at the expense of the local authority. Local authorities have had their attention drawn to the fact that, despite press, radio and television publicity, there has been little demand from the public to have their heaters examined, and where necessary modified. It has been stated that there may be 3½ million heaters, often in daily use, which in many ways do not comply with present day safety standards. In view, therefore, of the dangers inherent in old models, and in order to publicise the need to have heaters examined, the Council at its meeting on the 18th April, 1962, approved a recommendation from the Public Health and Baths Committee authorising the Medical Officer of Health to conduct an Oil Heater Safety Campaign throughout the Borough during the late summer. The campaign was held during the week commencing Monday, 24th September, when various leaflets published by the London County Council and the Fire Protection Association were distributed widely throughout the Borough to Old People's Clubs, large firms, offices, welfare organisations, hospitals and large blocks of flats. Distribution of literature was carried out entirely by the staff of the Public Health Department and valuable assistance was given by the staff of the Public Library who issued bookmarks specially printed for the campaign. The Honorary Secretary of the Chelsea Old People's Welfare Committee kindly arranged for all old people receiving meals-onwheels to receive copies of the leaflets, and large posters were displayed in prominent places all over the Borough. Two small displays were sited at the front and rear entrances of the Town Hall and a further display was arranged in the main entrance of the Public Library. The London County Council also assisted by increasing their propaganda during the period of the campaign at their clinics in the Borough and the local Press co-operated by publishing a letter from the Chairman of the Public Health and Baths Committee. 32 BOROUGH CREMATION SERVICE The Borough Council, in October, 1957, entered into an agreement with the General Cemetery Company whereby cremation facilities became available at the 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 1962 arrangements for cremation were made in respect of fifty persons. The following table shows the number of cremations carried out in respect of Chelsea residents during the five years this scheme has been operative:- Year No. of Cremations Percentage of total recorded Deaths 1958 33 4.5 1959 24 3.3 1960 26 3.5 1961 31 4.3 1962 50 7.0 The progress of cremation in Great Britain and Northern Ireland during 1962 was well maintained and 240,589 cremations were carried out, compared with 224,553 in 1961. In terms of recorded deaths, these figures represent 38.70% compared with 36.20% for the preceding year. PUBLIC MORTUARY FACILITIES AND CORONER'S COURT There are no mortuary premises situate within the Borough but, under an agreement made with the Hammersmith Borough Council, excellent facilities are available at their Mortuary in Fulham Palace Road, W.6., which is also adjacent to the Coroner's Court for this area. During 1962, 281 postmortems were performed in respect of Chelsea residents. MEDICAL EXAMINATIONS During the year, sixty-nine examinations were carried out on the Council's employees and new entrants to the superannuation scheme. As a result of the examinations, sixty-five proved successful, three were referred for re-examination within twelve months and one proved unacceptable for superannuation purposes. 33 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 list:- 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. NURSING HOMES Belgravia-Chelsea Nursing Home, 39, Royal Avenue, 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 Private 34 CONFERENCES The Council was officially represented at the undermentioned Conferences dealing with matters within the purview of the Public Health and Baths Committees- Association of Public Health Inspectors Southport 11th to 14th September Central Consultative Committee on the Welfare of Old People London 25th June Institute of Baths Management Brighton 2nd to 5th October National Society for Clean Air Harrogate 9th to 12th October Royal Society of Health Scarborough 9th to 13th April CONTRIBUTIONS TO VOLUNTARY ORGANISATIONS The Public Health and Baths Committee recommended payments to the funds of voluntary organisations during 1962, as follows:- £. s. d. Central Council for Health Education 6. 17. 6. Chelsea Old People's Welfare Committee 1,121. 16. 3.* London and Home Counties Clean Air Advisory Council 2. 2. 0. National Society for Clean Air 8. 8. 0. Royal Society for the Prevention of Accidents 2. 2. 0. xIn addition to the usual grant of £450 per annum, the Council approved expenditure amounting to £671.16.3d. for the purchase and erection of a portable wooden hut in the yard of the Chelsea Community Centre. The hut is being used for the storage and preparation for delivery of meals for old people and as an office for the Honorary Secretary of the Old People's Welfare Committee. 35 SANITARY ADMINISTRATION OF THE BOROUGH. The following section of the Report (pages 35 to 71 ) is devoted to the work of the Public Health Inspectors together with other associated officers. The Borough is divided into three areas east, central and west - each being the responsibility of one Inspector. In addition, the Deputy Chief Public Health Inspector and one other Inspector are engaged on duties concerned with the establishment of smoke control areas under the provisions of the Clean Air Act, 1956. Two Women Inspectors deal with the inspection and supervision of shops and food premises including food shops, food factories, canteens, restaurants, clubs, public houses, stalls, mobile ice-cream vendors, etc. They also undertake the sampling of articles of food, investigations in connection with food poisoning and infectious disease, and dealing with recording of atmospheric pollution. The majority of the work of the Inspectors has been carried out without recourse to statutory measures. Experience has proved that in Chelsea, with such differing sections of the community, the informal approach in the first instance to many of the day-to-day problems, has invariably brought about both speedy and acceptable solutions. In many no formal action could in fact have been taken; in others formal approach by letter and notice would have been inclined to have the reverse effect - delaying a solution by much protracted correspondence. In support of this statement it will be seen from the report that although 759 complaints were made to the Department and 17,843 inspections and re-visits made to all types of premises, it was only necessary to institute legal proceedings in 13 cases, and of these, 10 cases related to one owner. 36 LEGAL PROCEEDINGS - Public Health (London) Act. 1936 - Statutory Nuisances. During the year it was necessary to institute proceedings in twelve instances. Brief details of results of hearings are set out below:- Premises Offence Result of Proceedings 24, Meek Street Non-compliance with Statutory Notice. Abatement Order made for work to be completed within 28 days. Council awarded £2. 2s. 0d. costs. 11, Edith Grove -do- Abatement Order made for work to be completed within 21 days. Council awarded £2. 2s. 0d. costs. 2, Tetcott Road -do- Abatement Order made for work to be completed within 28 days. Council awarded £2. 2s. 0d. costs. 4, Tetcott Road -do- Abatement Order made for work to be completed within 21 days. Council awarded £2. 2s. 0d. costs. 24, Meek Street Non-compliance with Nuisance Orders. Defendant fined £5. 0s. 0d. Council awarded £2. 2s. 0d. costs. 11, Edith Grove -do- Defendant fined £5. 0s. 0d. Council awarded £2. 2s. 0d. costs. 24, Meek Street -do- Defendant fined £10. 0s. 0d. Council awarded £2. 2s. 0d. costs. 2, Tetcott Road -do- Defendant fined £5. 0s. 0d. Council awarded £2. 2s. 0d. costs. 4, Tetcott Road -do- Defendant fined £5. 0s. 0d. Council awarded £2. 2s. 0d. costs. 24, Meek Street -do- Defendant fined £20. 0s. 0d. Council awarded £2. 2s. 0d. costs. 2, Tetcott Road -do- Defendant fined £15. 0s. 0d. Council awarded £2. 2s. 0d. costs. 4, Tetcott Road -do- Defendant fined £15. 0s. 0d. Council awarded £2. 2s. 0d. costs. Note: Details of proceedings under the Food and Drugs Act, 1955 appear on Page 53. 37 GENERAL SUMMARY OF THE WORK OF THE PUBLIC HEALTH INSPECTORS INSPECTIONS AND RE-VISITSDWELLINGS: After complaints 1,673 After infectious disease 258 House-to-house, underground rooms and overcrowding 521 Miscellaneous unclassified 220 2,672 FOOD PREMISES: Butchers 350 Fishmongers and Fish Friers 71 General Provision Shops and Dairies 211 Ice Cream Vendors 180 Bakehouses and Factories 78 Street Traders 221 Hotels, Restaurants and Dining Rooms 1,031 Premises in connection with unsound food and food sampling 195 Unclassified premises 94 2,431 FACTORIES AND OUTWORKERS: Factories other than Food Factories 465 Outworkers 8 473 MISCELLANEOUS: Animals, poultry and birds and Pet Animals Act, 1951 21 Open spaces and highways 100 Office premises 10 Merchandise Marks Act 130 Premises re Pharmacy and Poisons and Shops Act 325 Premises re voluntary works 6,875 Visits to owners, agents and builders' offices 217 Food poisoning 22 Visits to aged and infirm persons 67 Visits resulting in "no access" 797 Other visits 1,333 Clean Air Act, 1956 including smoke observations and atmospheric pollution recording 1,630 Verminous persons 28 11,555 PREMISES FOR THE TESTING OF DRAINS BY: Air 153 Smoke 41 Water 518 712 TOTAL 17,843 - 38 - REPAIRS AND INSTALLATIONS SUPERVISED INCLUDING BOTH VOLUNTARY WORK (V) AND WORK AS THE RESULT OF THE SERVICE OP NOTICE (N) UNDER VARIOUS ACTS. CLEANSING AND REDECORATING V. N.  Rooms, passages and staircases 14 66 GENERAL REPAIRS Roofs, gutters and rainwater pipes 29 58 Yard and area pavings - 2 Walls and ceilings 1 124 Floors, staircases, window and door frames 3 106 Fireplaces and chimney flues - 6 Dampness remedied - 100 Miscellaneous 4 4 DRAINAGE AND SANITARY CONVENIENCES Total and partial reconstructions including frontages 8 15 Obstructions cleared 5 17 Inspection chambers and covers provided - 6 Interceptors provided 1 6 Soil, ventilation and waste stacks constructed and repaired 51 10 Waterclosets and waste water preventers repaired and renewed 422 69 Sinks provided or renewed 295 21 Baths provided 406 30 Wash-hand basins provided or renewed 433 54 Waste pipes cleared or repaired 5 1 Urinals repaired 9 - Miscellaneous 5 7 WATER SUPPLY Supplies provided to tenements - - Taps supplied on main for drinking purposes - 2 Burst pipes repaired - 8 Cisterns cleansed, covered or repaired - - Totals carried forward 1,691 712 - 39 - REPAIRS AND INSTALLATIONS SUPERVISED INCLUDING BOTH VOLUNTARY WORK(V) AND WORK AS THE RESULT OF THE SERVICE OF NOTICE (N) UNDER VARIOUS ACTS. V. N.  MISCELLANEOUS PROVISIONS Brought forward 1,691 712 Soap and towels for staff - - Staff rest and changing rooms - - Constant hot water - 2 Refuse bins - 15 Covered display and counter screens provided _ 5 Natural and mechanical ventilation - 12 Natural and artificial lighting - 2 Removal of offensive accumulations on open land and bomb sites - 12 Totals 1,691 760 Grand Total 2,451 Note: Included in this table are 143 dwelling houses repaired as a result of the service of Notices. - 40 - NOTICES SERVED Public Health (London) Act, 1936. Intimation 121 Nuisance 35 Section 40-Drainage 11 L.C.C. (General Powers) Act, 1954. Section 12-Provision of dustbins - Intimation 8 Section 12-Provision of dustbins - Statutory Notices 1 L.C.C. (General Powers) Act,1955. Section 25-Stopped up drains 3 Factories Act, 1961. Health-general provisions 4 Food and Drugs Act, 1955. Defects at Food Premises 17 Shops Act, 1950. Sanitary Conveniences and Ventilation - Clean Air Act, 1956. Adaptation of Fireplaces 26 TOTAL 226 NOTICES COMPLIED 223 notices were complied with during the year of which 171 were served under the Public Health (London) Act, 1936. - 41 - WATER SUPPLY - METROPOLITAN WATER BOARD Water for human consumption is, with one exception, supplied from the mains of the Metropolitan Water Board. With four exceptions, the same source supplies water for purposes other than human consumption. Samples of water submitted for analysis were in all cases satisfactory and no complaints have been made in respect of unsatisfactory condition of supplies. Samples for analysis are in all cases submitted to the laboratory of the Metropolitan water Board and certificates giving the result of the analysis are submitted to the Public Health Department. The continued co-operation of the officers of the Board, particularly in respect of proposals to discontinue supplying water to premises because of defects in the supply service or the non-payment of water rate, enabled the Public Health Inspectors to provide for continuity of supply in all but two of the sixteen cases referred to the Department. A further eight supplies were repaired at the direct request of the Inspectors without requesting assistance from the Board. WATER SUPPLY - WELLS There are seven wells in existence in the Borough. One some 600 feet deep supplies water for both drinking and domestic purposes to a large block of flats. Two approximately 780 feet in depth provide water for industrial use, another 400 feet deep provides a supply for fire-fighting purposes, the water being lifted to a large roof storage tank. A further one of a depth of feet supplies the water to the Council's swimming pools, and the remaining two at a depth of 600 feet are not in use, but held in reserve for use in industrial washing. 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 38 personal baths (27 for men and 11 for women). 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. Thirty-three samples of water were taken from baths, pools and sources of supply, for bacteriological examination, all of which were reported upon as satisfactory. During recent years considerable works have been carried out to improve the facilities at the Public Baths including the dressing accommodation in the large pool, baths surrounds, diving stage, precleansing in the large pool, ladies personal baths, 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. The modernisation of existing facilities at the Public Baths was carried a stage further during the past year when the dressing boxes surrounding the small swimming pool were removed and new accommodation for both sexes was constructed in adjacent rooms. Bathers are now allocated a locker with a numbered disc where their clothes, etc. are locked-up whilst they are swimming, and only the Baths Attendant has - 42 - the master-key to open the lockers. Pre-cleansing showers and foot baths are provided for all bathers before they can enter the pool. Arrangements have been made for the large pool to be closed during the winter months when a sprung floor will be laid covering the whole area and an agreement has been concluded with the London County Council for that Authority to rent the accommodation so provided as an indoor sports centre for youth clubs. One complaint was brought to the attention of the Public Health Department during the year concerning a child who experienced irritation to the eyes after swimming in the small pool. The complaint was fully investigated but there appeared to be no obvious explanation relating to the chlorination of the water which had actually been routine tested for chlorine on the morning in question and the reading was normal. 76 other people had used the small pool that morning but no further complaints were received. During the financial year 1st April, 1962 to 31st March, 1963, the total attendances at the private baths and the swimming pools were 31,549 and 130,148 respectively but these figures are exclusive of attendances in respect of swimming galas. My thanks are due to the Borough Engineer and Surveyor for supplying this information. DRAINAGE The Public Health Inspectors supervise the whole of the drainage work carried out in the Borough apart from frontage drains. These are the sections of drain from the curtilage of the building to the connection with the sewer, laid under the highway and supervised by the staff of the Borough Engineer and Surveyor. Some of the drainage work is required by statutory notice, but the greater amount is in respect of works of conversion and erection of new buildings. This section of the work of the department continues to expand, and in view of the ever developing trends in building, together with increasing heights, it is a very exacting and responsible duty, calling for considerable thought and patience, particularly when dealing with complicated schemes of conversion. However, in the majority of cases good relations are maintained with owners, architects and builders, although there are many occasions when materials and schemes have to be refused or amended when falling short of the required standard. Time is a valuable factor and to avoid delays in progress of works, it is the practice to approve schemes in principle where possible and submit them to the appropriate Committee for ratification, similar action being taken to schemes amended in progress, and such amendments are many. When considering schemes for approval the Inspector is not only concerned with whether or not the proposals meet the requirements of the Bye-laws, he also calls attention to any shortcomings and suggests any obvious simplifications or improvements. This approach is a considerable factor in the co-operation which exists with architects and builders. - 43 - During the year 189 applications were received for the drainage of premises and of this total 47 were in respect of combined schemes affecting two or more separate premises, being an increase of 28 and 9 respectively over last year. TOWN AND COUNTRY PUNNING Close liaison continues to exist with both the Town Clerk's and the Borough Engineer's Departments regarding all applications to either the London County Council or the Chelsea Borough Council referred to us for observations. The observations are then passed to the applicant either direct or through the other department concerned, thus ensuring that the person responsible for carrying out any accepted scheme is fully aware of the various requirements of the Public Health Department before any work is commenced. In certain cases our requirements indicate the unsuitability of the proposals and a scheme may be abandoned or amended, but all concerned are spared much waste of time and perhaps money, and the Inspectorate ensure that any development which takes place is in accord with the relevant Acts and Bye-laws. During the year 565 applications were referred to the Public Health Department, an increase of 83 over last year. LAND CHARGES The number of enquiries dealt with was 1319. These concerned outstanding statutory or informal notices, combined drainage orders, smoke control orders, certificates of disrepair etc., with, in some cases, additional enquiries regarding restrictions on the use of underground rooms and the suitability of premises for specific purposes-such as catering establishments. NOISE ABATEMENT 38 complaints were received regarding a variety of noises ranging from the hardly discernible squeak from a revolving chimney cowl to works of demolition on a building site. All complaints were investigated, some noises were completely eliminated, considerable numbers were reduced in intensity but in a small number of cases little if any improvement could be effected. In no case was legal proceedings by the Council necessary. In the few cases where complainants were not satisfied with the action of the officers, their rights under private action were explained to them in some detail, but in only one instance did a complainant avail himself of those rights. I would again emphasise the difficulties in dealing with complaints in this field and the patience required of the Public Health Inspectors and various other persons concerned, for since the coming into operation of the Noise Abatement Act, I960, the public have become very noise conscious and whilst many of the complaints refer to noise of quite considerable volume, others are in respect of matters of such a minor nature as to be almost frivolous, yet all receive thorough investigation. - 44 - A nuisance from noise is a matter very difficult to assess, for that which is a nuisance to one person, may not be a nuisance to his neighbour, pass unnoticed, or even be a pleasure. Cases do occur from densely occupied areas, or large blocks of flats where only one person complains, yet conditions are identical for his neighbours. A very close watch is kept on all new or converted premises to try and prevent the siting of plant or equipment in positions likely to give rise to complaints of noise from nearby residents, this is of particular importance where ventilating systems are concerned, many in connection with restaurant kitchens, but powers are limited and advice is not always accepted. FOULING OF PAVEMENTS BY DOGS This is still the subject of complaint from many irate ratepayers, yet there is no easy solution for this problem is in the main caused by the lack of understanding of many dog lovers, no doubt for the most part unintentional. Complainants in many cases either cannot or do not wish to obtain the name of the person in charge of the offending dog, and often have no desire to appear in Court to give evidence. However, two prosecutions were undertaken and as much publicity as possible given to these proceedings. In view of the short life of many of the notices posted on lamp standards warning against fouling of footways, notices of a more permanent nature are now being fitted. The Council's Bye-law provides that- (1) 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. RENT ACT, 1957. For the fourth successive year no applications were received or certificates issued in accordance with the provisions of the above Act. HOUSING ACT, 1957-PART IV - OVERCROWDING Apart from any official action taken by the Borough Council or the London County Council to provide alternative accommodation for overcrowded families, all other possible channels are explored to effect an abatement by informal procedure and many unrecorded cases have been abated during the year, often in respect of occupants of houses in multiple occupation - 45 - by reason of proposed directives under the Housing Act, 1961. In every case where overcrowding has been abated letters of warning against recurrence are sent to all owners or persons in charge of the premises concerned. The following summary shows the number of cases relieved during the year and the extent of overcrowding in the Borough at 31st December, 1962:- New cases investigated and recorded 7 Number of families involved 7 Number of persons involved 34 Cases relieved by:- (a) Rehousing Authorities 1 (b) Informal or formal procedure 17 Such action resulted in one hundred and two persons being adequately housed. Cases on register at 31st December, 1962 22 Number of persons involved 125 NEW HOUSING Number of new dwellings completed during the year:- (a) by the Borough Council NIL (b) by other persons (private) 64 HOUSING ACT, 1961 This Act came into force on the 24th November, 1961, its sections being divided into three parts. Part II is of particular importance to the Public Health Department as it contains amendments to the Housing Act, 1957 which particularly affect houses in multiple occupation previously known as houses let in lodgings and occupied by more than one family. Councils are given new and considerably strengthened powers to deal with squalid conditions existing in such premises and to enforce proper standards of management. The new powers under Part II are divided into five groups:- (l) Imposition of Management Orders on houses in multiple occupation which fall very much below a proper standard of management. This entails the enforcement of Regulations prescribed by the Minister. - 46- (2) Power to require the provision of reasonable and sufficient facilities and. amenities to permit of a decent standard of living, these include water supply, washing arrangements, drainage, water closets, food storage, preparation and cooking, sinks and disposal of waste water, lighting, ventilation and space heating. (3) Provision of means of escape in case of fire. (4) Power to carry out work in default and recover the cost. (5) Power for Local Authority to make a "direction" fixing the number of persons who may occupy a house, to prevent overoccupation. It is the desire of the Minister that the provisions of this Act should be applied in a reasonable manner and Management Orders only made in regard to particularly difficult properties. To date, no Management Orders have been made in Chelsea, but improvements have in many cases been carried out on the informal approach of the Public Health Inspector, in other cases the number of occupiers have been reduced. However it is probable that more formal action will have to be taken in the ensuing years. There are two significant defects in the new Act, the first is the cumbersome administrative procedure which is especially complicated in connection with the enforcement of the requirements of section 16 with regard to fire escape. There is hope of some simplification in the near future. The second defect concerns work required by notice. As there is no provision for penalties for noncompliance, work must be carried out in default, and the cost can only be recovered by way of civil debt from the person on whom the notice is served. In previous Acts it was a charge against the property. Should major works be involved (or even a large number of minor works) and the respective persons served with notices prove financially unsound there is a serious possibility of a Local Authority being involved in heavy financial loss. No doubt practice will highlight this defect and possibly bring about the necessary amendment. UNDERGROUND ROOMS The invitation from the Ministry of Housing and Local Government to revise the existing regulations on the basis of the revised model regulations issued by the Ministry has not yet been accepted, the existing regulations continuing to be administered in a reasonable manner with careful consideration given to premises which are within reasonable distance of compliance. The present policy in Chelsea is to deal with all unoccupied basements if possible before they are let or relet as dwelling accommodation, many such premises come to the notice of the Public Health Inspectors on receipt of copies of Town Planning applications. Site meetings follow and where possible the underground rooms are made to comply with the requirements, or are put to alternative use. Very - 47 - few cases call for the making of Closing Orders. Only in exceptional cases are Closing Orders made in respect of premises occupied for living purposes, and in these cases the Order is made to prevent the premises being relet when the existing tenant is provided with other accommodation. In a large number of cases works to make underground rooms comply are carried out as a result of informal action. Only in two cases was it found necessary to serve Closing Orders and neither of the premises concerned were occupied. 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 headings:- Sub-standard accommodation; Ill-health (excepting Tuberculosis); Tuberculosis; Overcrowding; and Other circumstances During the year, applications were referred to the Public Health Department, 34 originated from Chelsea residents and the remainder from applicants living in another area. Each case was investigated-40 in connection with ill-health including tuberculosis, and two in respect of sub-standard accommodation, bringing the total number of cases since May, 1953, to 385 residents and 106 non-residents. Nineteen tenants in Council premises were also referred to this Department during the year for an opinion or pointing on medical grounds. A total of 369 such cases have been dealt with since 1955. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1961 At the end of the year six premises were registered where filling material is used but there are no premises in the Borough where rag flock is manufactured. PET ANIMALS ACT, 1951 Under Section 1 of the Act, no person shall keep a Pet Shop unless licensed by the Borough Council. Two renewal applications from licence holders were received and approved. Regular 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. - 48 - FACTORIES ACT, 1961. Under Section 153(l) 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 years:- 1. INSPECTIONS OF FACTORIES, WORKSHOPS AND WORKPLACES. Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted  (l) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities: 54 124 1 - (2) Factories not included in (l) in which Section 7 is enforced by Local Authorities: 181 388 3 - (3) Other premises in which Section 7 is enforced by Local Authorities * 31 31 - - TOTAL 266 543 4 - NOTE:- Outworkers' premises are not included in (3) above. * i.e. Electrical Stations - Section 123 (l), Institutions-Section 124, and sites of Building Operations and Works of Engineering Construction-Section 127. - 49- FACTORIES ACT. 1961 (Continued) 2. CASES IN WHICH DEFECTS WERE FOUND Particulars Number of cases in which Defects were found Prosecutions  Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of Cleanliness (Section l) 5 5 - -. - Overcrowding (Section 2) - - - - - Unreasonable Temperature (Section 3) 5 3 - - - Inadequate Ventilation (Section 4) - - - - - Ineffective drainage of floors (Section 6) - - - - - Sanitary Conveniences (Section 7) (a) Insufficient - - - - - (b) Unsuitable or defective 19 16 - 3 - (c) Not separate for sexes - - - - - Other offences against the Act (not including Outworkers) - - -- - - TOTAL 29 24 - 3 - - 50 - FACTORIES ACT. 1961 (Continued) OUTWORK Sections 133 and 134 Nature of Work No. of Outworkers in August list as required by Section 133 (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 Notices served Prosecu tions  Wearing Apparel making etc. 5 - - - - - Household Linen - - - - - - Curtains and furniture hangings 1 - - - - - Furniture and Upholstery - - - - - - Stuffed Toys - - - - - - Lampshades l - - - - - Jewellery l - - - - - TOTALS 8 - - - - - - 51 - FOOD HYGIENE Food shops and catering establishments continue to absorb a great deal of the time of the two women Public Health Inspectors, by reason of the need for added supervision due to staff shortages in the kitchens of food restaurants and coffee bars etc. With few exceptions most caterers seriously endeavour to maintain a high standard of hygiene and cleanliness in respect of both staff and premises, and over the year very few complaints have been received. Nevertheless, the Inspectors must of necessity spend a large amount of time talking to staff on points of personal hygiene and food handling, as there is a constant changing of staff particularly kitchen hands, porters and persons engaged on washing crockery and utensils. By and large the effort is rewarding for the response is good and very little resentment has been shown by employees and even less by employers. There is very often a language difficulty, chiefly in regard to Oriental type restaurants, but usually in the absence of the proprietor at least one person can be found with sufficient knowledge of English to interpret the Inspector's instructions. Considerable improvements have been carried out to many existing establishments both as regards structure and equipment, and a continuous effort is being made to obtain higher standards, a fairly simple matter with new or newly adapted premises, but at times difficult in existing establishments where space is limited. Again emphasis is placed on the co-operation of the majority of owners. The complaint always to the fore in catering premises, and one that I am afraid will always be with us in Chelsea, is that of escaping cooking odours. A great deal of time is spent endeavouring to improve systems of ventilation. The most frequent cause of trouble is due to the position of flue discharge. The closely built up area of Chelsea with its different building heights makes this a difficult problem, further aggravated by the lack of local authority powers. These odours may not constitute a public health nuisance, although they may be of great annoyance to occupiers of neighbouring premises. In many cases they are certainly an amenity nuisance but there is no official action the Inspector can take; a fact that the complainant frequently has difficulty in understanding. A large amount of time was spent dealing with this particular form of complaint and with the co-operation of all concerned considerable improvement was achieved. Prepacking and wrapping of food for display for sale is gaining in popularity and although this reduces the amount of supervision required at sales counter level, increased attention has to be paid to inspecting those parts of the premises where subdividing and packing of food takes place. Much progress has again been made with modernisation of Public Houses including the provision of better catering equipment, installation of modern and often additional sanitary arrangements, together with abolition of some of the very unsatisfactory outdoor urinals. In all cases the brewers have been most co-operative. - 52 - INSPECTION AND SUPERVISION OF FOOD A record is kept by means of a register of all premises connected with the manufacture, storage and sale of food. The number of premises remains reasonably static, the only variations during the year worthy of mention were the reduction of premises retailing milk from 59 to 55, and of general provision shops not selling milk where the reduction is from 22 to 16. These reductions are all in respect of small traders, which is indicative of the present trend to shop at large stores and Supermarkets., The other variation is an upward trend in the number of catering establishments of various types, the increase being from 193 to 218. The following table classifies the types of food premises, all of which are subject to regular routine inspectiont:- Bakehouses 7 Butchers 27 Horse-flesh butcher 1 Food Factories (flour-mills, bottling-stores) 5 Milk Retailers (including dairies) 55 General Provision Merchants (not selling milk) 16 Fruit and vegetable retailers 26 Hotels and Public Houses, Clubs, Restaurants,) Dining Rooms, Canteens and miscellaneous) catering establishments) 218 Fried fish premises 2 Wet fish retailers 8 Miscellaneous premises (bread and cake shops, sweets and confectionery shops, ice-cream stores) 52 Ice-Cream Premises Section 16 (l) (a) of the Food and Drugs Act, 1955, provides for the registration of premises used for the sale, manufacture, and storage for sale of ice-cream. At the end of the year the premises so registered numbered 109 a drop of 7 registrations over the year. Only one manufacturing premise exists in the Borough, this being a catering establishment; there is one large depot which is a holding unit only for a large manufacturer with premises outside the Borough, and apart from restaurants making use of loose ice-cream in connection with the service of meals there are only two retailers of loose icecream. It is the policy of the Public Health Inspectors to encourage as far as possible the sale of only pre-packed ice-cream. There are no soft ice-cream making machines sited in Chelsea, but these are now appearing on the vehicles of itinerant traders, and in view of the greater possibility of contamination of this form of ice-cream careful observation is kept on these traders and the number of samples taken in this field will be considerably increased in 1963. - 53 - 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. 32 premises were registered at the end of the year. LEGAL PROCEEDINGS - FOOD AND DRUGS ACT, 1955UNSATISFACTORY PURCHASES. During 1962, twelve complaints were brought to the attention of the Public Health Department concerning the sale of the undermentioned foodstuffs which were not of a satisfactory nature:- (a) Sale of mouldy crumpets. (b) Excess water content of a sample of pure English butter. (c) Portion of a small beetle adherent to the outer crust of a bread roll. (d) Sale of mouldy and sour steakburgers. (e) Presence of a piece of parchment paper with Chinese writing thereon in a bottle of milk. (f) Complaint alleging the presence of a strip of adhesive plaster in a fresh salad. (g) Sale of almond ring contaminated with mice droppings. (h) Sale of mouldy sliced brown loaf. (i) Presence of a bottle cap in a bottle of milk. (j) Sale of bread roll with foreign matter adhering to base. (k) Sale of packet of Crispbread infested with maggots. (l) Sale of mouldy pork pie. All the aforementioned adulterations were thoroughly investigated and reported to the Public Health and Baths Committee. In case (b), the excess water content was very small and the Committee decided to take no action, and in regard to case (f), as the complainant was unable to produce any evidence to substantiate his complaint no further action could be taken in the matter. In cases (a) (c) (d) (h) (i) (j) (k) and (l), legal difficulties or mitigating circumstances negatived the institution of legal proceedings and warning letters were sent to the firms concerned. Concerning case (e), the Committee authorised the institution of legal proceedings and the defendant Company pleaded guilty to the offence. A fine of £2. 0s. 0d. was imposed with costs totalling £2. 2s. 0d. With reference to case (g), the Committee were prepared to resort to legal action having regard to the gravity of the offence but, in view of the fact that the Hammersmith Borough Council, within whose area the bakery is situate, had previously intimated that they were instituting legal proceedings against the firm for allowing a mice infestation on the bakery premises, it was decided not to recommend any further proceedings. As a result of the action taken by the Public Health Committee of the Hammersmith Borough Council, the defendants were fined £10. 0. 0d. with costs totalling £5. 5s. 0d. - 54 - ANNUAL REPORT OF THE PUBLIC ANALYST for the year ended 31st December, 1962. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Chelsea. Your Worship, Ladies and Gentlemen, During the year 1962, 330 samples of food, of which 108 samples of milk and 222 samples of food other than milk were submitted for examination. 325 samples were taken informally and 5 samples formally. Adverse comments were made against 18 samples and the incidence of adulteration or incorrect labelling may be classified as follows:- Number of samples examined Number of samples adulterated, etc.  Milk 108 - Other Foods 222 18 Two milk bottles were submitted for examination. One contained a milk bottle cap which had been pushed inside the bottle. The bottle had been washed in the washing machine and the milk was satisfactory both microbiologically and chemically, though naturally unsightly. The other bottle contained a residue due to micro-organisms. In this case the complainant stated that she had washed the bottle repeatedly and, therefore, your analyst could do nothing further in the matter, for it was impossible to state who had introduced the bacteria. Some butter contained l6.4 per cent of water and, as the maximum permitted quantity is 16 per cent, it contained 2.6 per cent excess water. The manufacturers stated that this was an unusual case probably due to the fact that in blended butters the moisture content varies to some extent due to uneven distribution. Your analyst is of the opinion that the real trouble is due to the fact that manufacturers are endeavouring to work to the legal limit of 16 per cent and occasionally exceed it. Several complaints were received regarding bread. A sliced loaf contained some burnt farinaceous matter, probably from baking tins or trays. The first interior slice of a sliced brown loaf was mouldy. The bakery concerned thought the loaf was probably three days old when the mould was first showing, but it could have been less than this if the bread had been kept in a warm place. The remainder was satisfactory. A piece of adherent matter on a bread roll, thought to be chewing gum, was in reality a piece of plaster of Paris, probably from the ceiling or wall of the bakery, which must have fallen on the roll while on the travelling belt during manufacture and before baking. That the plaster was on the roll before it was baked was proved by the fact that the glazing mixture had run over the top of, and underneath the roll, enclosing part of the plaster between the bread and the layer of dried glazing film. Half a bread roll - 55 - contained the posterior portion of a beetle adhering to the outer crust. The beetle appeared to have been attached to the roll before baking. A wholemeal loaf contained a piece of hard white flour due to the flour having been wetted and dried before being embedded in the bread. An almond ring cake showed several pieces of mouse droppings embedded in the covering icing layer. Inside the almond ring contained a large number of pieces of burnt cereal matter, probably derived from dirty baking tins. Both the manufacture of this almond ring and its storage had been most unsatisfactory. A home made marmalade contained only 62.3 per cent of soluble solids as sucrose, whereas the Food Standards (Preserves) Order, 1953, requires not less than 68.5 per cent. With 62 per cent only of soluble solids, this product would not keep indefinitely and it was already beginning to crystallize. An increasing number of jams and preserves are appearing on the market at the present time which do not conform to the legal standard for soluble solids, but which contain more than the legal minimum of fruit. Many small manufacturers of so-called health products make these jams and many imported jams do not comply with our regulations, which are believed by them to be faulty. A packet of frozen steakburgers, which had been placed in a refrigerator, on opening appeared limp and possessed a slightly offensive smell and a white fluffy growth. Microbiological examination showed a total count of 8,847,000 bacteria per gram growing at 37°C. and 24,000,000 bacteria per gram growing at 27°C. while the fluffy growth was due to a mucor mould which was sporing. These steakburgers must, therefore, have been defrozen for some period and had probably reached atmospheric temperature for 3 or 4 days during their existence. Complaint was made regarding some corned beef showing black marks. This foreign material consisted of mottled black skin which was rather thick and probably came from the interior of the mouth of an ox or a cow or from some similar interior/exterior membrane, but not from the alimentary canal generally. The meat filling of a pork pie was mouldy. The mould was a mucor type and was present in two distinct colours, the old growth was black and at least a week old, while the newer growth was white. Some beef suet contained only 79 per cent of fat and was, therefore, 4.8 per cent deficient in fat. The Pood Standards (Suet) Order, 1952, requires shredded suet to contain not less than 83 per cent of fat. Three cans of salmon steaks, one opened, were submitted because a complainant alleged that the contents of the opened can had caused violent stomach pains and severe diarrhoea. The lacquer had separated from the side of the complaint can and the can was slightly rusted. The salmon contained 20 parts per million of iron and 7.4 parts per million of tin, but this was insufficient to have caused the symptoms shown by the complainant. The sample was reported as inferior. The other two cans submitted contained excellent canned salmon, but the lacquer was again absent from a considerable portion of the tin-plate, and it was thought the cans had been coated with - 56 - lacquer which was too thin, or the tin-plate may have been oily when the lacquer was applied. It was doubtful whether this had caused the digestive trouble. The lacquer of some cans of rhubarb had separated in large patches and considerable corrosion had occurred. The rhubarb in one of the cans contained 356 parts per million of tin and 9.8 parts per million of iron and the contents of another can contained 190 parts per million of tin. The purchaser of some chile powder complained that it was not of the usual quality and was a dark colour. This was submitted together with an unopened tin and the two samples were found to be similar. They were not what would be called chile powder in this country, but consisted of a mixture of ground spices compounded on the lines of curry powder. The powder was safe to use, but was misdescribed and, moreover, it did not comply with the requirements of our Labelling of Food Order, inasmuch as the first Schedule, Table A item 3(a) only exempts spices from the description of their ingredients when they consist of a single ingredient. Food Legislation During the year the most important item of food legislation was the introduction of the Preservatives in Food Regulations, 1962, together with its subsidiary The Milk and Dairies (Preservatives) Regulations. The Preservatives Regulations follow the lines foreshadowed in the Report of which a precis was given last year so that there is little object in repeating the information. The number of preservatives permitted in foods has been increased to twelve, but in no case are more than three defined preservatives permitted to be used for any specified food. A recommendation by the Food Standards Committee that nisin should be permitted as a preservative for cheese has not been adopted in spite of a common belief that it may now be used. The chief item of interest, which had not been foreseen, was that no provision has been made for an expiry date for the sale of pickles and sauces containing benzoic acid as a preservative, so that, theoretically, the sale of thousands of bottles and jars of such products became illegal overnight and have remained so. The Emulsifiers and Stabilisers in Food Regulations, 1962, together with the Milk and Dairies (Emulsifiers and Stabilisers) Regulations, 1962, follow very nearly the lines suggested in the Report of the Food Standards Committee in 1961. The main difference is that definitions have been introduced in these regulations, which will fail to satisfy everyone. Thus an emulsifier is described as a substance which is capable of aiding the formation of a uniform dispersion of two or more immiscible substances and, in the opinion of your analyst, this is a natural definition which is long overdue, but many authorities believe that an emulsion must be a suspension of one liquid in another. Similarly mixtures have been on the market for many years now called by the simple name glyceryl monostearate. Henceforth these fixtures of indefinite composition become partial glycerol esters, which in fact they are, although they often contain free stearic acid. On the other hand, the term interesterification, not mentioned in the Draft Regulations, has now been employed to mean the polymerisation which takes place when castor oil is heated, whereas the word is known internationally - 57 - among chemists to mean a re-arrangement of fatty acid groups within a fat, which is quite a different thing. The Pre-Packed Food (Weights and Measures: Marking) (Amendment) Regulations, 1962, the Pood and Drugs (Legal Proceedings) Regulations, 1962, and the Milk and Dairies (Legal Proceedings) Regulations, 1962, enable Local Authorities, when taking proceedings for infringements of certain orders, to take action against persons other than the vendor, if they are thought to be responsible, thus making action under all food and drugs regulations similar to other infringements of the Act. It will be noted that the Minister has introduced the custom of bringing in statutory regulations for foods generally, and for milk separately. This is at times unfortunate as it implies, for example, that substances declared not to be preservatives, emulsifiers, or stabilisers within the meaning of the regulations may be added to milk. It remains to be seen how the courts will interpret these Regulations, if called upon to do so. Certain manufacturers have always resented the idea of Food Standards Orders on the grounds that they restrict initiative and the Ministry has shown a tendency to reduce the number of such orders to a minimum, so long as the public are adequately protected. With this end in view the Food Standards (Table Jellies) (Amendment and Revocation) Regulations, 1962, revoke the existing standards for table jellies and table jelly crystals, but require manufacturers to label them in accordance with the provisions of the Labelling of Food Order. During the year the Food Standards Committee of the Ministry issued four Reports dealing with:- (1) Canned Meat. (2) Hard, Soft and Cream Cheeses. (3) Dried Milk, and (4) Mineral Oil in Food. The Report on Canned Meat endeavours to make all canned meat products fall into one of ten different categories for meat content and thus to prevent manufacturers lowering the recognised meat content of a product by giving it a slightly different name. The proposed groups are:- Canned meat 95 per cent, Canned minced meat 90 per cent, Canned meat with jelly 80 per cent, Canned meat with gravy 75 per cent, Canned meat with sauce 65 per cent, Canned meat with cereal 80 per cent, Meat loaf 6$ per cent, Meat loaf with stuffing 50 per cent, Canned meat with vegetables 35 per cent, Canned meat with pastry 45 per cent, Canned meat puddings 35 per cent, Canned meat pies 25 per cent, Canned sausage $0 per cent, Canned pork sausage 65 per cent. Any other canned meat product 35 per cent. In general this is a very satisfactory grouping, though it would be difficult to bring products such as canned raviolis containing meat into the category of canned meat with pastry. Similarly one already finds certain manufacturers flavouring stews with onion and claiming, therefore, that the product falls within the definition of canned meat with vegetables, which is not the intention of the report. Probably the most - 58 - contentious proposal in the report is that of the proposed limit of 30 per cent for fat in canned pork products, other than bacon, sausages, and chops, which should be allowed to contain 50 per cento Danish manufacturers suggested that pork luncheon meats and similar products should be allowed to contain 50 per cent of their meat content as fat. Your analyst has examined many hundreds of samples of pork luncheon meat and finds that an average fat content is 38 per cent, a figure with which Danish manufacturers inform him they would be content, Another report, which is to be welcomed, is that on the composition of Hard, Soft and Cream Cheeses. One of the difficulties concerned with standards for cheese is that of reconciling the water and fat contents. This has been very successfully dealt with in the report by suggesting that the maximum moisture content of most hard cheese should be 40 per cent, but that 42 per cent should be allowed in Derby, Leicester or Blue Stilton, 44 per cent in Cheshire, Gloucester or Double Gloucester, 46 per cent in Caerphilly, Wensleydale or White Stilton, 48 per cent in Lancashire cheese. After allowing for this moisture the milk fat on the dry matter should be not less than 48 per cento It is further proposed that cheeses of foreign origin should conform to the standards for the named cheese laid down in the country of origin of the particular variety. The standards proposed for cream cheese are 45 per cent of milk fat and for double cream cheese, 65 per cento The standard suggested for soft cheese is a minimum of 20 per cent milk fat and 60 per cent water. Other proposals are put forward for medium fat soft cheese, skimmed milk soft cheese, full fat curd cheese, and medium fat curd cheese. Most of the proposals are excellent, but one would have liked to see some mention made of the so-called "cottage cheese" of which a considerable amount is sold, but presumably this would have to be described either as "medium fat curd cheese" or "skimmed milk soft cheese". It is not proposed to relate the fat content of cheeses to the dry matter except in the case of hard cheese. The report on Dried milk is intended largely to bring our present regulations into line with the proposals of F.A.O. and is, therefore, to be welcomed, even if one is not entirely in agreement, because it will make for a general simplification of international trade. It is suggested that dried milk should contain not less than 26 per cent of milk fat and not more than 5 per cent of moisture, and that partly dried skimmed milk powder should contain not less the 1.5 per cent of milk fat nor more than 5 per cent of moisture with the proviso that when sold in containers of 10 lbs. or less, the fat content should be declared and the product labelled as at present to the effect that it is not to be used for babies except on medical advice. Dried Machine-skimmed Milk would have to be labelled as unfit for babies. It is suggested in the report on the use of Mineral oil in Food that generally no alteration should be made to existing regulations, but that the sealing of eggs and of the rind of whole pressed cheeses should be permitted and, what is more important, that any paraffin wax or paraffin oil used for food purposes should be at least of B.P. quality. It would be useful if this last provision could be extended to apply to packing materials in which fruit is packed, since apples are frequently contaminated with paraffin due, possibly, to the use of paraffin on packing material round the fruit, though it is impossible to state definitely whether or not the apples have been polished with paraffin. - 59 - Although the Hygiene Regulations already cover the sale of milk, milk drinks and similar beverages from automatic machines, it may not be out of place to mention that special legislation may eventually be needed for their more effective control. Members of your analyst's staff have, on more than one occasion, bought chocolate milk drinks from automatic machines and have found them to be mouldy on opening. Unfortunately such purchases are generally made some distance from one's home and it is, therefore, difficult to make complaints. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, THOMAS McLACHLAN, A.C.G.F.C., F.R.I.C., M.I.Biol. Public Analyst. Note: A table showing the various samples submitted for analysis appears on the next page. - 60 -  Article Taken Formally Taken Informally Total Analysed Number Adulterated etc.  Bread 5 5 5 Butter 31 31 1 Butter Milk Beverage 1 1 Cake 1 1 1 Chicken, minced 3 3 Cider 1 1 Fish, canned 6 6 1 Fish Paste 19 19 Fish Spread, Crab 2 2 Flour 1 1 Flour, Self Raising 5 5 Fruit, canned 1 1 1 Fruit Juice 5 5 Honey 1 1 Jam 21 21 Jelly, Redcurrant 1 1 Lemon Curd 1 1 Margarine 20 20 Marmalade 21 21 1 Meat, canned 1 1 1 Meat, frozen 1 1 1 Meat Paste 20 20 Meat Pie 1 1 1 Milk 108 108 Milk Bottle 2 2 2 Milk Shake Syrup 1 1 Paté 6 6 Rum Butter 1 1 Sausages 3 3 Soft Drinks 15 15 Spices 3 3 2 Spirits 4 4 Suet, shredded 5 5 1 Turkey, minced 2 2 Vinegar 11 11 5 325 330 18 - 61 - 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 3,595 lbs. was surrendered to the Public Health Inspectors:- Commodity Weight - lbs Bread and cereals 57 Butter and cream 17 Cakes 154 Cheese 891 Fish, fresh 113 Fish, tinned 315 Fruit, tinned 124 Ice cream 26 Jam 70 Meat, fresh 769 Meat, tinned 566 Poultry 72 Soups and purees 38 Sugar 32 Vegetables, fresh 44 Vegetables, tinned 300 Miscellaneous foods 7 TOTAL 3,595 lbs BACTERIOLOGY The bacteriological examination of samples is carried out by the Public Health Laboratory Service. No charge is made to the Council for this service and during the year the following samples were submitted for examination:- Water 29 Ice Cream 22 Milk 4 Fruit Slices 1 Ham/Pork 7 63 All were reported upon as satisfactory with the exception of some ham and pork samples which were submitted for examination in connection with an outbreak of Salmonella Bredeney referred to under Food Poisoning. - 62 - THE MILK (SPECIAL DESIGNATION) REGULATIONS, I960 The above-mentioned. Regulations which replace and consolidate previous Regulations made between 1949 and 1954, came into force on the 1st October, I960. One of the principal changes brought about by the new Regulations is to extend the period for which a dealer's licence is granted from one to five years, and the licence will be renewable for subsequent quinquennial periods. The following table shows the number of dealers' licences in force at the 31st December, 19621:- Tuberculin Tested 47 Pasteurised 53 Sterilised 40 DAIRIES AND MILK DISTRIBUTORS At the 31st December, 1962, there were 48 registered distributors with premises in the Borough and 55 premises within the Borough from which milk is distributed representing a reduction from 49 and 58 respectively. One premise was registered as a dairy. STREET TRADING Traders are licensed annually to operate from designated sites in accordance with the provisions of Part II of the London County Council (General Powers) Act, 1947. Renewal applications are granted provided the applicant has fully observed the requirements of the licence throughout the previous period. New applicants have to submit their vehicles for examination and, in addition, all storage facilities must be inspected. In many cases both vehicles and food are stored in another Borough and in such cases a report is obtained from this Borough as to suitability before a licence is considered. The two main problems in respect of stallholders are (i) smoking, and (ii) displaying or unloading of food too near the ground where there is risk of fouling by dogs. Constant observation is kept on stalls by all Public Health Inspectors who are frequently passing during the daily routine work. 221 special inspections were made of stalls during the year, this is in addition to visits in this and other Boroughs to the premises where food for the stalls is stored, and the unrecorded casual visits by Inspectors in passing. Street trading from licensed sites in this Borough is carried out as follows:- Fruit and vegetables 14 Refreshments (at coffee stalls) 3 Flowers11 Newspapers 6 - 63 - In addition, there are 3 stalls which are sited on private forecourts as unders:- Fruit and vegetables 1 Shellfish 1 Clothing 1 SHOPS ACT, 1950 Regular inspections were carried out as required by Section 38 in regard to the provision of ventilation, lighting, reasonable temperature, adequate and suitable sanitary conveniences and washing facilities for the staff concerned, and the provision for the taking of meals on the premises should this be necessary. Various improvements were carried out during the year but in no case was it necessary to serve a notice. LICENSING ACT. 1961 From the 1st November, 1961, new types of licences were required for the sale of alcoholic drinks in restaurants, private hotels, guest houses, etc., and from the 1st March, 1962, more stringent controls were introduced in respect of clubs selling intoxicating liquor. Copies of both classes of application to the Justices for licences are referred to the Public Health Department and the premises concerned are inspected by the Public Health Inspector. Objection can be raised to the grant or renewal of a licence if the premises are found to be not suitable or convenient for the proposed use having regard to their character and condition. In practice the main objections likely to be raised would arise from breaches of the Food Hygiene Regulations or from insufficient or improperly sited sanitary accommodation for the use of patrons. No grounds for objection have arisen. Appropriate accommodation has been provided in connection with newly constructed or adapted premises, and in the case of existing establishments previously licensed, additional accommodation has been provided whenever structurally possible, or alternatively other premises have been acquired. PHARMACY AND POISONS ACT, 1933 42 persons entitled to sell poisons included in Part II of the Poisons List were entered on the Council's Register at the 31st December, 1962. 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 infringements were reported during the year. RODENT CONTROL - The Prevention of Damage by Pests Act. 1949. The destruction of rats and mice has fully engaged the two rodent officers throughout the year. There has been a noticeable drop in the - 64 - number of surface infestations by rats, this is due directly to the system of testing drains at premises where rats are seen to gain access from below ground, in many cases the drain is found defective, and after repair or reconstruction the rats are completely eradicated and reinfestation rarely occurs. It can safely be stated that the majority of rat infestations in Chelsea are the result of defective drains, although this year has shown an increase of complaints traced to rats escaping from sites where buildings have been or are being demolished, and no effective steps taken by the contractor to seal off the disused drains. In previous years poisoning campaigns to rid the sewers of rats have been carried out at six monthly intervals with the assistance of the sewermen of the Borough Engineer's Department using a variety of both bait bases and poisons. Results have been rewarding and the rat population of the sewers has been controlled at a low level. However this year it was decided to change this method and use direct poison, Fluoracetamide. This involved four treatments over the year but being a direct treatment did not involve additional labour as the necessity to prebait was avoided. The first three direct poisoning applications took place in April, July and October. The fourth treatment due in December had a prior unpoisoned bait test to check by the amount of bait uptake the success or otherwise of the previous three treatments. The test baits were laid according to plan, but unfortunately owing to weather conditions and the impossibility of removing manhole covers by reason of ice and snow, only a small proportion of checks could be made and the final poisoning campaign could not be carried out. However where checks were made there were very few bait takes recorded and in view of this information together with the reports of sewer workers and rodent officers I have every reason to believe the new treatment an unqualified success. A similar treatment is programmed for 1963, and given more reasonable weather conditions it should be possible to give a more factual result than in the present year. Details of work carried out by the Rodent Officers during the year 1962. 1. Treatment of Business and Private Premises (Rats and Mice) Business Premises Private Premises Number of visits 426 2,384 Number of infestations found 33 202 Number of treatments undertaken 24 194 Number of pre-baits laid 2,000 Number of poison baits laid 585 Number of complaints received 256 2. Sewer Maintenance Treatments (Rats) No. of poison baits laid Poison used No. 1 Treatment 480 Fluoracetamide No. 2 Treatment 480 Fluoracetamide No. 3 Treatment 480 Fluoracetamide No. of test baits laid No. 4 Treatment-Test baiting with sausage rusk 480 - 65 - PIGEONS A local authority is empowered by Section 121 of the Public Health (London) Act, 1936, to seize and destroy pigeons believed to be ownerless where they congregate in numbers in excess of that considered reasonable. In past years the Council both trapped pigeons by the use of direct staff, or made use of suitable self-employed pigeon catchers to operate on highways and open spaces, no charge was made for this service, but allocations of pigeon food were made to the catcher. At the direction of the Public Health Committee both methods were discontinued some years ago. In these circumstances and having regard to the strongly divided public opinion on the subject, the only action that can be taken on complaints of pigeon nuisances is to advise the persons concerned of firms undertaking either the destruction of the birds or the proofing of buildings with one or other of the proved harmless bird repellents. Feeding of pigeons is strongly discouraged and all complaints are investigated, the persons responsible being approached and informed of the nuisance being caused to adjacent properties by filth and noise, which would not exist if not encouraged by feeding, and that the birds will certainly not starve if left to find their own source of food. Improvements are often effected by these discouraging talks. There is no doubt that pigeons in large numbers are not acceptable in built-up areas and a reduction in numbers would be beneficial in every respect, but the days of the free service of the pigeon catcher are past. - 66 - DISINFECTION AND DISINFESTATION The Disinfecting Station and Personal Cleansing Centre is situated at 9A, Lots Road, but the duties of the personnel extend beyond this limited field. The two disinfectors and the two vehicles are used for various duties in connection with the testing of drains and conveying equipment to and from the sites, assisting with food sampling and delivering samples to the Bacteriological, Chemical and Pathological Laboratories. They also undertake the collection and removal of the effects of deceased persons under Section 50 of the National Assistance Act, 1948; the collection and delivery of the laundry of incontinent persons; the collection and destruction of verminous bedding and furniture etc., and in addition, both the disinfectors and the woman cleansing centre attendant give occasional assisted baths to old persons at the Disinfecting Station. The following is a summary of specific work of disinfection and disinfestation carried out:- SCABIES CASES TREATED Chelsea Residents 4 L.C.C. Schoolchildren - VERMINOUS CONDITIONS Adults 37 Children 14 L.C.C. Schoolchildren - DISINFECTION OF ROOMS AND CONTENTS, CLOTHING, ETC. Number of rooms disinfected 305 Number of articles disinfected 813 DISINFESTATION OF ROOMS AND CONTENTS Number of rooms disinfested 294 Number of articles disinfested 2415 - 67 - 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 year:- Month 1962 Days Exposed Rainfall (ins.) Total Deposits for period in tons per sq. mile Deposits per day in tons per sq. mile (av) Soluble Insoluble Total Soluble In soluble Total January 31 2.50 8.74 16.39 25.13 .281 .528 .809 February 28 0.36 3.25 4.47 7.72 .116 .159 .275 March 32 1.39 7.40 10.84 18.24 .231 .338 .569 April 30 1.62 6.12 8.86 14.98 .204 .295 .499 May 31 1.14 6.21 12.63 18.84 .200 .407 .607 June 31 0.42 3.76 9.25 13.01 .121 .298 .419 July 29 3.24 5.97 10.13 16.10 .206 .342 .548 August 30 1.75 4.92 8.70 13.62 .164 .290 .454 September 31 2.98 4.91 12.75 17.66 .158 .411 .569 October 31 1.65 8.33 10.66 18.99 .268 .343 .611 November 29 1.60 5.89 6.87 12.76 .203 .236 .439 December 32 1.37 7.71 8.69 16.40 .240 .271 .511 TOTALS 365 20.02 73.21 120.24 193.45 - - - - 68 - Estimation of Atmospheric Sulphur Milligrams of Sulphur Trioxide per Day. Month Days Exposed Chelsea Polytechnic January 31 4.37 February 28 3.58 March 32 3.77 April 30 2.87 May 31 1.83 June 31 1.77 July 29 1.76 August 30 1.34 September 31 1.66 October 31 3.46 November 29 4.06 December 32 5.83 Average for year:- 3.02 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. - 69 - ATMOSPHERIC POLLUTION RECORDING (Continued) The following table shows the results obtained from this station during the year:- VOLUMETRIC ANALYSIS - SMOKE AND SO2 Month Average daily total Microgrammes per cubic metre Smoke SO2 January 193 430 February 138 323 March 172 469 April 58 266 May 53 212 June 45 180 July 43 171 August 25 139 September 74 132 October 195 334 November 211 405 December 473 * 1057 * The large increase in this figure was due to the dense and persistent fog which settled over London in December from the third to the seventh. Concentrations of sulphur dioxide reached a level similar to or slightly higher than in 1952, but pollution by smoke was distinctly lower. The emission of smoke has been reduced over the last few years by the creation of smoke control areas and an increasing trend by the public in the use of smokeless forms of heating. - 70 - CLEAN AIR ACT, 1956 SMOKE CONTROL ORDERS The Chelsea No. 2 (Hans Town Ward) Smoke Control Order, 1962. The Hans Town Ward Smoke Control Order was made by the Council at its meeting on the 24th January, 1962. This Order was confirmed, without modification, by the Ministry of Housing and Local Government on the 2nd April, 1962, with the 1st November, 1962 as the operative date. The area covered by the Order comprises approximately 110.6 acres and there are an estimated 8,620 residents. The detailed house-to-house survey was undertaken in 1961. It revealed that this area contains 3,489 dwellings, 11 industrial premises and 296 commercial premises with 29 other premises including schools, churches and religious establishments. Upon receipt of the Minister's confirmation a circular letter was sent to all householders in the area where fireplaces required adaptation or replacement, notifying them accordingly and advising as to the procedure for obtaining grant. By the end of the year three hundred applications for approval of work for grant purposes had been received. In accordance with the provisions of Section 12(2) of the Clean Air Act, 1956, 26 notices were served requiring works of adaptation to fireplaces which were considered reasonably necessary to avoid contravention of Section 11 of the Act. Cheyne Ward and Royal Hospital Ward Smoke Control Area The Council at its meeting on the 19th December, 1962 agreed in principle to making Cheyne Ward and Royal Hospital Ward its third Smoke Control Area. In accordance with the planned programme dealing with the whole of the Borough the next area comprised Royal Hospital Ward with only part of Cheyne Ward. After consideration it has been decided that dealing with part of a ward would create difficulty in arriving at statistics in regard to area, premises, population and assessment of cost and that it would be preferable to deal with the two Wards in their entirety as one area. The simplification of administration by this procedure together with some extension of time being provided to deal with the additional premises involved, will result in a saving of time in completion of the overall programme. These two Wards cover a little over 300 acres and contain 5,376 dwellings accommodating approximately 16,654 persons. In addition there are 672 commercial premises, 18 industrial premises, 9 educational establishments, 2 hospitals and 28 other premises including 8 churches. - 71 - It can be assumed from previous experience that of the 5,376 domestic premises involved approximately one-half of these will be already equipped with appliances capable of burning smokeless fuel but accurate figures cannot be given until completion of the detailed survey which will be carried out next year. Maps of the Hans Town Ward and the Royal Hospital and Cheyne Wards Smoke Control Areas appear on the following pages. CLEAN AIR ACT. 1956 CHEYNE WARD AND ROYAL HOSPITAL WARD SMOKE CONTROL AREA THE CHELSEA (CHEYNE WARD AND ROYAL HOSPITAL WARD) SMOKE CONTROL AREA The Area is bounded on the west by the centre of Old Church Street; on the north-west by the centres of King's Road, Markham Street and Elystan Street; on the north by the centres of Whitehead's Grove, Cadogan Street, Cadogan Gardens and Ellis Street, then a line extending through to the centre of the northern end of Eaton Terrace; on the east by the centres of Eaton Terrace, Cliveden Place, Bourne Street, Whittaker Street, Holbein Place, Pimlico Road and Chelsea Bridge Road; on the south by the Chelsea Embankment. CLEAN AIR ACT. 1956 HANS TOWN 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 Place, Basil Street, Hooper's Court, Brompton Road and Knightsbridge; 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, Cadogan Gardens and Cadogan Street; and on the south-west by the centre of Draycott Avenue. EPIDEMIOLOGY Incidence and Notification of Infectious Disease - 72 - NOTIFIABLE DISEASES The undermentioned diseases are notifiable to the Medical Officer of Health by general practitioners:- Anthrax Ophthalmia Neonatorum Cholera Plague Continued Fever Pneumonia, Acute Influenzal Diphtheria Pneumonia, Acute Primary Dysentery Poliomyelitis, Acute Encephalitis, Acute Puerperal Pyrexia Enteric (Typhoid or Relapsing Fever Paratyphoid) Fever Erysipelas Scabies Food Poisoning (or Scarlatina or Suspected Food Scarlet Fever Poisoning) * Leprosy Smallpox Malaria Tuberculosis Measles Typhus Fever Membranous Group Whooping Cough Meningococcal Infection * To be notified to: Chief Medical Officer, Ministry of Health. 73 NOTIFICATIONS. The following table shows the total (corrected) number of oases 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 and and over TOTAL Dysentery (Sonne) 12 25 3 16 11 - - 67 Food Poisoning - - - 2 - - - 2 Measles 11 35 13 3 1 - - 63 Meningococcal Infection 1 - - • - - - 1 Pneumonia: Ac.Influenzal - - — - - 1 - 1 Poliomyelitist Paralytio - - - - 1 - - 1 Non-paralytic - - - - - - - - Puerperal pyrexia - - - 3 - - - 3 Scabies - - - 1 2 - - 3 Scarlet Fever - 2 1 - - - - 3 Typhoid Fever - - 1 - - - - 1 Whooping Cough - 3 2 - - 1 - 6 TOTALS 24 65 20 25 15 2 - 151 74 SUMMARY OF NOTIFICATIONS OF INFECTIOUS DISEASES RECEIVED DURING THE YEARS 1958-1962 (inclusive) Disease 1958 1959 1960 1961 1962 Average for five years Dysentery 111 62 69 39 67 69.6 Erysipelas 1 1 3 3 - 1.6 Food Poisoning 7 5 15 1 2 6.0 Measles 217 4l6 15 564 63 255.0 Meningococcal Infection 1 2 3 2 1 1.8 Pneumonia: Ac.Influenzal 4 9 4 5 1 4.6 Ac. Primary 11 9 2 3 - 5.0 Poliomyelitis: Paralytic 3 2 1 1 1 1.6 Non-paralytic — 1 - — — 0.2 Puerperal Pyrexia 46 36 19 4 3 21.6 Scabies 6 6 3 2 3 4.0 Scarlet Fever 16 31 20 4 3 l4.8 Typhoid Fever 2 - - - 1 0.6 Whooping Cough 20 33 62 24 6 29.0 75 DIPHTHERIA No notifications were received during the year. Two cases were notified in 1955, being the only cases since 1949, whilst there have been no deaths for seventeen 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 l9. DYSENTERY During 1962, sixty-seven notifications were submitted compared with 39 in 1961 and 69 in 1960. Of this total, 59 were in an Institution in the Borough. MEASLES Sixty-three notifications were received during 1962, as compared with 564 in 1961. SCARLET FEVER Three notifications were received during the year. The character and frequency of this disease has undergone a dramatic change during the century. Not only is it much less frequent i.e. 204 cases were notified in 1902, but the disease itself is now usually only a very mild one. WHOOPING COUGH Six cases were notified during the year against 2k in 1961. This is the lowest figure for many years and may well be related to the increasing use of the vaccine which is given by both general practitioners and by all London County Council Infant Welfare Clinics. FOOD POISONING During the year quite an extensive outbreak occurred which involved many London Boroughs. In all 254 persons were infected but fortunately only 2 of these were Chelsea residents. The outbreak was finally found to be due to ham which had become infected with Salmonella bredeney. Other than this there were 4 individual cases reported, for whom no food could be incriminated. 76 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. During the early part of the year, imported cases of smallpox occurred which resulted in a number of smallpox cases being notified in various parts of the country. As a result of this a watch was kept on all travellers entering this country from the Par East. On arrival, 61 such travellers gave Chelsea as their forwarding address but of this total only 40 could be traced and kept under observation for the surveillance period. They all remained quite well. The remaining 21 were unable to be found, due in most cases to fictitious addresses and this does show how easy it can be for an infected person to spread the disease before they can be finally contacted and kept under surveillance. POLIOMYELITIS One notification concerning a Chelsea resident was notified and confirmed during the year which was of a paralytic type. There were no deaths from this disease. During the month of May, oral (Sabin) vaccine was made available to clinics and general practitioners as well as the original Salk type. Prom information received it appears that oral vaccine is proving more popular and if the trend continues it is hoped that the level of immunity already obtained in the Borough will increase still further. INTERNATIONAL CERTIFICATES In order to prevent the spread of infectious diseases, certain countries require visitors to be vaccinated against specified diseases under the International Sanitary Regulations. International Certificates have been prescribed for smallpox, yellow fever and cholera. Vaccination against yellow fever, must, for international and technical reasons, be done only at specific centres, but vaccination against any other disease, other than yellow fever, can be done by a person's own doctor. When completed by the medical practitioner, the certificates must be authenticated by the Medical Officer of Health. During the year, 1,976 of these certificates were authenticated in Chelsea. 77 ENTERIC FEVER. During the year there was one case of Typhoid Fever, the first since 1958, which concerned a young girl. She was at no time seriously ill and was treated on routine lines in hospital. She was allowed to be discharged after 6 negative specimens. Very full investigations were carried out as to the possible source of infection but they all proved negative. ERYSIPELAS For the first time in many years no cases of Erysipelas were notified. PUERPERAL PYREXIA Puerperal Pyrexia means a febrile condition in a woman in whom a temperature of 100.4° Fahrenheit (38° Centigrade) or more has occurred within fourteen days after childbirth or miscarriage. Three cases were notified during the year and all occurred in hospital. One of the notifications referred to a patient residing outside the Borough. The following table shows the causes of pyrexia in the notified cases:- Cause No. of cases Rubella 1 Respiratory infection 1 Cause unknown 1 Total 3 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 area. 78 TUBERCULOSIS Summary of Notifications during the period from 1st January, 1962 to the 31st December, 1962. Formal Notifications AGE PERIODS Number of Primary Notifications of new cases of tuberculosis 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75+ Total (all ages) Respiratory,Males - - - - - - - 5 6 1 1 2 2 17 Respiratory,Females - - - - 1 - 1 3 1 - 1 1 - 8 Non-respiratory, Males - - - - - - - 1 - - - - - 1 Non-respiratory, Females - - - — - - - - - - - - - Nil Number of deaths from tuberculosis - 4 Number of cases remaining on Register - 321 CASES NOTIFIED AND DEATHS FOR THE PREVIOUS TEN YEARS Year Pulmonary Non-Pulmonary Total No. of Deaths Number of Cases on Register at the end of each year.  1953 100 7 107 4 468 1954 54 9 63 9 471 1955 40 7 47 9 425 1956 35 4 39 1 464 1957 42 5 47 2 44l 1958 4l 7 48 5 43l 1959 35 3 38 3 4l0 1960 25 2 27 2 362 1961 19 2 21 10 358 1962 25 1 26 4 321 Average number of cases for the ten years - 46.3 Average number of deaths for the ten years - 4.9 79 CHELSEA TUBERCULOSIS DISPENSARY, BROMPTON 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:- 1959 1960 1961 1962 Population served by Dispensary Number of notified cases in 49,520 49,140 48,490 48,550 Borough at end of year 411 361 358 321 Number of these who at present do not attend Dispensary 92 185 152 120 Total attendances during year 1,526 1,278 1,144 1,119 Total new patients seen 164 180 161 114 Number of these who were contacts 72 92 80 84 Number of contacts found to be tuberculous 4 - 1 - Number of cases newly notified to Medical Officer of Health (i.e. excluding inward transfers) 39 29 27 30 Number of cases diagnosed as tuberculous (for the first time) at the Dispensary 25 5 4 2 Number of X-rays 1,041 925 824 843 Number of Patients who received "Special treatment" at home during the year 2 - 1 1 Number of Patients given B.C.G. 79 88 52 28 Number of home visits by medical staff - 3 2 - Number of visits paid by Dispensary Nurse 1,613 1,250 1,121 973 Number of Clinic Sessions per week 2 2 2 lж ж + one extra session every month. 80 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 1211 were made as follows :— Throat/Nose Swabs Staphylococcus aureus found 1 Haemolytic Streptococci found 12 Monilia found 1 Coagulase Staphylococci found 1 Negative results 74 Faeces Poliovirus type I found 11 Poliovirus type II found 2 Poliovirus type I and III found 1 Poliovirus type II and III found 1 Shigella sonnei found 99 Salmonella bredeney found 13 Salmonella typhimurium found 4 Salmonella Stanley found 4 Staphylococcus aureus found 1 Pathogenic Bact. coli 0111 found 2 Negative results 980 Ulcer Swabs Haemolytic Streptococci found 1 Foodstuffs Salmonella bredeney found 1 Negative results 2 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 Subject Page (s) Abatement of Nuisances - Legal Proceedings 36 Accidentss:- Home 28 — 29 Road 30 Analyst Public - Report of 54 - 60 Area of Borough 9 Atmospheric Pollution - Recording Stations 67 - 69 Bacteriological Examinations 61 and 80 Baths and Swimming Pools 41 - 42 Births 9 Burials - Sect. 50 National Assistance Act, 1948 27 Campaign - Oil Heater Safety 31 Cancer - Lung and Bronchus 15-16 Chelsea Tuberculosis Dispensary 79 Clean Air Act, 1956:- Smoke Control Orders 70-71 Atmospheric Pollution Recording 67-69 Committee, Public Health and Baths :- Members 1 Representation elsewhere by Members 2 Conferences - Council representation at 34 Contributions to Voluntary Organisations 34 Cremation - Local service and progress 32 Deaths 9—16 Diphtheria 19 and 75 Diseases, Infectious 72-80 Disinfection/Disinfestation 66 Drainage works 42-43 Dogs - Fouling of pavements by 44 Dwellings - Number in Borough 9 Dysentery 75 Early neo-natal mortality rate 10 Enteric Fever 77 Epidemiology 72—80 Erysipelas 77 Factories Act, 1961 48 — 50 Food and Drugs Act, 1955:- Bacteriology 6l Hygiene 51 Ice-cream Premises 52 Inspection and supervision of premises 52-53 Legal Proceedings 53 Preserved Food Premises 53 Public Analyst's Report 54-60 Street Trading 62-63 Food Poisoning 75 Food — Unsound 61 Fouling of pavements by dogs 44 Subject Page (s) General Rate 9 General and. Vital Statistics 9 - 11 Health Education - Oil Heater Safety Campaign 31 Health - Personal Services 18-19 Home Accidents 23-29 Hospitals, list of 33 Housing Act, 1957:— Overcrowding 44-45 Applications for re-housing 47 Housing Act, 1961 45-46 Housing, New - Local Authority and Private 45 Infant Mortality 9 - 11; 14 Infectious diseases 72 — 80 Inspections and works carried out 37-39 International Certificates of Vaccination 76 Introduction 4 — 8 Land Charges - Enquiries 43 Legal Proceedings:— Pood and Drugs Act, 1955 53 Statutory Nuisances 36 L.C.C. - Personal Health Services 18-19 Licensing Act, 1961 63 Lung Cancer 15-16 Marriages 10 Mass Radiography 20 Maternal Mortality 10 Meals and Recreation for Old People - National Assistance Act, 1948 26 Measles 75 Medical Examination of Staff 32 Milk - Licensing and Supply 62 Mortuary Facilities 32 National Assistance Act, 1948:- Section 21 - Part III Accommodation 26 Section 31 - Provision of Meals and Recreation for Old People 26 Section 47 - Removal to Hospital/institution 26 Section 50 - Burial of the Dead 27 Neo-natal Mortality Rate 10 Noise Abatement 43 — 44 Notices - Service of 40 Notifiable Diseases 72 Notification of Infectious Diseases 73-74 Oil Heater Safety Campaign 31 Old People's Welfare 22-25 Overcrowding 45 Outworkers 50 Subject Page (s) Part III Accommodation - National Assistance Act, 1948 26 Perinatal Mortality Rate 10 Personal Health Services - L.C.C. 18 - 19 Pet Animals Act, 1951 47 Pharmacy and. Poisons Act, 1933 63 Pigeons - Destruction of 65 Poisoning, Food 75 Poliomyelitis 76 Population 9 Public Analyst - Report of 54-60 Public Baths and Swimming Pools 41-42 Public Health and Baths Committee:- Members 1 Representation elsewhere by Members 2 Representation at Conferences by Members 34 Public Health Department - Staff of 3 Public Health Inspectors - Work of 35-71 Public Houses 51 Public Mortuary Facilities 32 Puerperal Pyrexia 77 Rag Flock and Other Filling Materials Act, 1951 47 Rateable value of Borough 9 Rent Act, 1957 44 Road Accidents 30 Rodent Control 63 - 64 Sanitary Administration of Borough 35-71 Scarlet Fever 75 Shops Act,1950 63 Smallpox 76 Smoke Control Orders 70-71 Spastic Children 21 - 22 Staff:- Medical Examination of 32 Public Health Department 3 Statistics:- General and Vital 9 — 11 Births, Deaths, Infant Mortality, Marriages Population, Stillbirths, etc. 9-16 Street Trading 62 - 63 Still births 9 Suicides 17 Town and Country Planning - Applications 43 Tuberculosis 10; 78 - 79 Underground Rooms 46-47 Unsound Food 61 Subject Page (s) Vaccination 19 Vaccination - International Certificates of 76 Vital Statistics 9-11 Voluntary Organisations - Contributions to 34 Water Supply 41 Welfare of Old People 22-25 Whooping Cough 75