AC 434 LoN 91 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON FOR THE YEAR 1965 To be presented 16th February, 1967 STAFF (as at 31st December, 1965) Date of Appointment MEDICAL OFFICER OF HEALTH (for the Port and City of London) SWANN, William George, M.D., B.Ch., B.A.O., D(Obst.) R.C.O.G., D.P.H., .. Jan. 1964 B.Sc., D.P.A., F.R.I.P.H.H. DEPUTY MEDICAL OFFICER OF HEALTH (for the Port and City of London) JONES, Dilwyn Treharne, B.Sc., M.B., B.Ch., D.C.H., D.P.H., D.C.T June 1963 ASSISTANT MEDICAL OFFICERS STOTT. William, M.B., B.S., D.P.H., F.R.I.P.H.H. (Part-time) .. Aug. 1958 WHITE-FRANKLIN, Alfred, M.A., M.B., B.Ch., F.R.C.P., M.R.C.S., Child Welfare Clinic (Part-time) .. Apr. 1965 DENTAL OFFICER WALLACE, Leonard John, L.D.S., R.C.S. June 1965 ADMINISTRATIVE STAFF (Port and City of London) BLUNT, H.F. Chief Clerk May 1924 RATLIFF, R.C. Deputy Chief Clerk March 1930 SMITH, E.V. First Assistant Clerk Oct. 1938 OSBORN, F.B. Senior Assistant May 1952 BETTS, C.W.R. Senior Assistant April 1926 LOTT, R.H. Senior Assistant May 1947 COLLINS, R.H. Senior Assistant Jan. 1963 SHEPHERD, Mrs. D.M. First Class Assistant April 1965 FLOOD, D.J. First Class Assistant March 1963 BALL, F.E. First Class Assistant April 1961 DARLISON, S.C. First Class Assistant April 1964 GURNEY, Miss M.L. First Class Assistant May 1939 MOORE, A.J.G. First Class Assistant April 1964 BROWN, K.B.P. General Grade Assistant April 1964 IIAMBLIN, Miss I.H. General Grade Assistant Oct. 1957 HEMING, R. General Grade Assistant Aug. 1965 MORRIS, T.K. General Grade Assistant Oct. 1965 FARRELL, R.G. General Grade Assistant July 1965 SMITH, A.J. General Grade Assistant Oct. 1965 MILLER, Miss J.E. Shorthand Typist April 1963 SARBUTT, Miss B.K. Shorthand Typist Jan. 1965 WILLIAMS, Miss S. Shorthand Typist March 1965 THREADGOLD, A.W. Senior Assistant (Meat Inspector's Office) Nov. 1923 PETERS, E.J. Clerical Assistant (Meat Inspector's Office) Nov. 1935 CASH, J.E. Clerical Assistant (Meat Inspector's Office) March 1954 KILBY, E.H. Senior Assistant, (Diseases of Animals Act) April 1965 HADLEY, J.T. Clerical Assistant (Diseases of Animals Act) June 1965 FISHER, A.W. Clerical Assistant (Royal Docks Office) March 1964 EASTMAN, C.E.W. Clerical Assistant (Royal Docks Office) July 1965 LYONS, Mrs. J. Clinic Clerk (Part-time) April 1965 WOODS, T.A. Messenger Nov. 1955 MAIN, J. Messenger Oct. 1965 BARNETT, D.C. Messenger/Driver Nov. 1965 PUBLIC HEALTH INSPECTION STAFF CAMPBELL, J.W. Chief Public Health Inspector Sept. 1946 THOMPSON, E. Dep. Chief Public Health Inspector Sept. 1948 FLYNN, M.J. Senior Public Health Inspector July 1951 RILEY, J.H. Senior Public Health Inspector Aug. 1962 WELLDON, J.B. Senior Public Health Inspector Aug. 1962 SIIEPLEY, H.L. Senior Public Health Inspector May 1964 HUDSON, L.A. Public Health Inspector April 1934 BAXENDALE, W.J. Public Health Inspector Jan. 1964 HOARE, J.A. Public Health Inspector May 1964 CORFIELD, D.F. Public Health Inspector June 1964 RENDELL, J.H. Public Health Inspector June 1965 MEAT INSPECTION STAFF THOMPSON, F.E., M.B.E Chief Meat Inspector July 1924 LEE, W.R. Deputy Chief Meat Inspector July 1930 GARRARD, S.S. Senior Meat Inspector Sept. 1946 MORRIS, W.L. Senior Meat Inspector Sept. 1946 SEYMOUR, K.8. Senior Meat Inspector July 1935 WILSON, J.C. Senior Meat Inspector Jan. 1936 COX, J.T. Meat Inspector Aug. 1954 FIELD, H. Meat Inspector Aug. 1954 GINGELL, G. Meat Inspector Aug. 1954 PAYNE, B.G., D.F.C. Meat Inspector Dec. 1960 ELSEY. F.E. Meat Inspector Jan. 1964 BERNHARDT, D.R. 'Authorised Officer' under Food Hygiene Regulations, 1955 May 1931 PREVOST, A.E. Senior Portor Feb. 1926 1 HEALTH AND WELFARE SECTION BENFIELD, Miss G.L. Health and Welfare Officer April 1965 PRESTON, Miss S. Health Visitor April 1965 MIMMS, Mrs. P.A. Dental Surgery Assistant Sept. 1965 JONES, R. 6 HOME HELPS Chiropodist (part-time) July 1965 DISEASES OF ANIMALS ACT WIGGINS, G.S., M.RC.V.S. Veterinary Officer Oct. 1964 HAYHTTRST, R.J. D.F.C. Inspector Oct. 1964 GU3BINS, V.O. Inspector RODENT STAFF April 1965 CARTER, J. Rodent Officer Sept. 1944 MASON, G.A. Foreman Rodent Operative Dec. 1946 TREMAYNE, L.R. Rodent Operative Nov. 1943 CARDY, E.G. Rodent Operative June 1950 MORTUARY AND DISINFECTING STATION LAWRENCE, F.H. Superintendent of the City Mortuary and Disinfecting Station May 1936 SUNNICK, J.W.T. Disinfecting Apparatus Attendant May 1950 SMITH, R.F. Assistant Disinfector March 1965 MANUAL WORKERS PORTBURY, T. (General Duties at Smithfield Market) July 1953 HUDSON, R.H. (General Duties at Smithfield Market) March 1963 I'ANSON, R.H. (General Duties at Smithfield Market) Feb. 1964 STEELE, W.T. (General Duties at Mortuary) Aug. 1958 HADLEY, J.H. (General Duties at Mortuary) Sept. 1962 PEARCE, C.E. (General Duties at Smithfield Market) June 1964 PEARCE, G.R. (General Duties at Smithfield Market) Feb. 1965 SHEENAN, Mrs. M.M. (Bath Attendant and Cleaner) Oct. 1962 PUBLIC ANALYST WILLIAMS, H.A., Ph.D. (Lond), A.C.G.F.C., F.R.I.C., F.R.S.H. Jan. 1958 2 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON FOR THE YEAR 1965 To the Right Honourable The Lord Mayor, Aldermen and Commoners of the Corporation of London. Guildhall. e.c.2. Telephone: MONarch 3030. My Lord Mayor and Gentlemen, I have the honour to submit the following report on the work of ray Department during the year 1965. On 1st April 1965 under the London Government Act 1963 the Corporation became responsible for the provision of Personal Health, Welfare and Children's Services under the National Health Service Acts, National Assistance Acts, Children and Young Persons Acts and associated legislation. The Public Health (London) Act was repealed at the same time by the London Government Act 1963. The Corporation's powers under the Public Health (London) Act 1936 however are replaced by powers under the Public Health Acts of 1936 and 1961 which now, with certain reservations, apply to London Boroughs and the Corporation as they apply elsewhere in England and Wales. These changes required the establishment of a new Health and Welfare Section in the Departs ment. I am grateful to all members of the staff of the department who have carried out extra duties willingly and efficiently, particularly before and during the transitional period. Finally, I should like to express my appreciation of the courtesy and consideration which the Chairman and members of the Port and City of London Health Committee have extended to me during the year. I have the honour to be Your obedient Servant, W. G. SWANN, M.D., B.Sc., Medical Officer of Health, Port and City of London. HOUSING Housing Act, 1957 1. Number of houses which on inspection were considered to be unfit for human habitation:— Two 2. Number of houses in which defects were remedied in consequence of informal action by the Local Authority or their Officers:— Eight 3. Number of representations made to the Local Authority with a view to (a) the serving of notices requiring the execution of works or (b) the making of demolition or closing orders:— (a) None (b)None 4. Number of notices served during the execution of works:— None 5. Number of houses which were rendered fit after service of formal notices:— None 6. Number of demolition or closing orders made:— Two 7. Number of houses in respect of which an undertaking was accepted under subsection (4) of section 16 of the Housing Act, 1957 :- None 8. Number of houses demolished:— None 3 During the year 99 families were rehoused, leaving 386 families on the Housing Register at the end of December 1965. The new Public Services Building, Barbican, was completed and provides a new Fire Station, office accommodation for the Civil Defence and Weights and Measures Departments and for certain sections of the Medical Officer's Department, previously at 20 Golden Lane, and 13 maisonettes. Of the 2,105 flats to be built 1,877 are now under construction, together with a new City of London Girls' School and some commercial accommodation. WATER SUPPLY In addition to the Metropolitan Water Board supply there are 123 artesian wells in use in the City, all are used for domestic or drinking purposes. Most of these wells were constructed between 1890 - 1930 and were bored to depths of between 300 and 650 feet into the hard grey chalk below the impervious strata, yielding many thousands of gallons of clear, sparkling and bacteriologically pure water. Each of these wells is operated by the respective owners or occupiers of the premises in which they are housed and they provide an adequate supply of water for all purposes. When the 1945 - 1948 Water Acts came into force, a restriction was imposed on new borings as the water table was known to be falling, and since that time no new bore holes have been allowed in this area. Disused wells are sometimes brought into operation and improved by means of acidisation. This process enlarges the interstices in the chalk strata and allows the subterranean water freer access and is accompanied by some nuisance to the surrounding users. Systematic bacteriological and chemical examination of water supplies has been undertaken during the year. Samples were drawn from the following sources:— No. of Samples Deep wells 123 M.W.B. drinking water taps 9 Other drinking water taps via storage tanks 11 Swimming baths 17 Total 160 There were no adverse reports on deep well or drinking water supplies. Swimming bath samples were of varying quality, 5 samples not complying with the Ministry of Health's standard. Advice was given by the Officer concerned and subsequent samples were satisfactory. The Metropolitan Water Board have supplied the following information:— "The water was generally of satisfactory quality and quantity during 1965. The supply is derived from two sources in varying and unpredictable proportions, namely, River-Thames derived water from the Thames Valley filtration stations and New River-derived water from the Board's works at Stoke Newington. The average chemical and bacteriological results of analyses carried out on the finished waters from these two sources are set out on the attached sheets. 1 am informed that the permanent population of the City of London is 4,469 and none of the premises are permanently supplied by standpipe. No new sources of supply were installed by the Board during 1965 and there were no extensions to trunk mains, nor were there any changes in the general scheme of supply. During the year some 328 yards of service mains were laid in your area. All new and repaired mains are chlorinated before being brought into use or restored to service, and samples of water from them are tested bacteriologically to ensure that the quality is satisfactory. The Board's waters are not plumbo-solvent. Samples are collected daily at each stage of purification of the water and from the distribution system. Immediate action is taken in respect of any form of contamination or variation in quality." 4 METROPOLITAN WATER BOARD — Water Examination Department BACTERIOLOGICAL RESULTS - YEARLY AVERAGES, 1965 CITY OF LONDON Source of Supply BEFORE TREATMENT AFTER TREATMENT Number of samples Agar plate count per ml. Coliform count Escherichia coli count Agar plate count per ml. Coliform count E. coli count 20-24 hours at 37°C. 3 days at 22°C. Per cent. samples negative in 100 ml. Count per 100 ml. Per cent, samples negative in 100 ml. Count per 100 ml. Number of samples 20-24 hours at 37 °C. 3 days at 22°C. Per cent. samples negative in 100 ml. Per cent. samples negative in 100 ml. All Thames-Derived 3,888 7.3 99.92 100.0 Stoke Newington 257 6.5 100.0 100.0 5 METROPOLITAN WATER BOARD - WATER EXAMINATION DEPARTMENT RESULTS OF THE CHEMICAL EXAMINATION OF RIVERS AND FILTERED WATER STATION FOR 1965 Milligrammes per litre (unless otherwise stated) Description of the Sample Number of Samples Day of the month Ammoniacal Nitrogen Albuminoid Nitrogen Nitrate Nitrogen Oxygen abs. from KMn04 4 hrs at 27° C. B.O.D. 5 days at 20° C. Hardness (total) CaC03 Hardness (noncarbonate CaC03) Magnesium as Mg Chloride as CI Phosphate as P04 Silicate as Si02 Sulphate as S04 Natural Fluoride as F Surfaceactive material as Manoxol OT Turbidity units Colour (Burgess units) PH value Electrical Conductivity (micromhos) (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) (22) (23) All Thames-derived 363 0.049 0.091 4.3 1.20 264 68 4 41 1.9 10 64 0.25 0.10 0.1 15 7.6 560 Stoke Newington 52 0.050 0.068 5.6 0.72 300 66 5 42 1.5 12 60 0.25 0.07 0.1 8 7.8 610 SEWERAGE AND SEWAGE DISPOSAL Sewerage and sewage disposal in the City of London are the responsibility of the City Engineer who has supplied the following information:— "The sewerage system in the City is comprised mainly of ovoid shaped brick sewers, the average internal dimensions being four feet high and two feet eight inches wide, this size being adopted only to provide access for sewermen, as the normal dry weather flow depth of effluent is only about nine inches at an average velocity of two to three feet per second. The Corporation sewers discharge into the Greater London Council intercepting sewers which flow eastwards across the City at a much lower depth to their Northern Outfall Works. The system of sewerage in the City is adequate, with ample margin for diverting flows from sewers during reconstruction and maintenance works." SMOKE NUISANCES City of London (Various Powers) \ct, 1954. Clean Air Act, 1956. During the year 127 complaints of smoke nuisances were received .These were investigated by the Public Health Inspectors and emanated from the following sources. 1. Oil fired furnaces 60 2. Solid fuel furnaces 18 3. Bonfires 27 4. Asphalt 2 The main causes of nuisance in 1 and 2 were inefficient combustion due to poor technical knowledge of the operator and bad maintenance. Bonfire nuisances arose mainly from the disposal of combustible matter on demolition sites and were dealt with under Section 16 of the Clean Air Act, 1956. A satisfactory measure of co-operation was secured in all cases and further action was not required. NOISE Noise control continued to call for considerable attention during the year, again mainly concerned with building operations. Extending the term noise to include vibration and coupling this with the increased use of business machines an additional cause of complaint arose because of interference with the working of delicate office machinery. This is readily understood when it is realised that sheet piling or heavy earth moving operations are often carried out on sites adjacent to occupied premises. Although this would appear to concern machinery efficiency rather than the health of the operator, usually there were elements of both calling for investigation and action. In general in the largest and noisiest operations the most effective relief has been obtained by confining work to periods outside the times of peak office activity and by limiting night work, to the benefit of the resident population. Building operations inside buildings have given rise to repeated complaints and have been the most difficult to control by restricting the working periods. Often specialist sub-contractors are employed who are less used to the noise problem and often they have less facility to deploy labour on other work. 70 complaints were received. Of these 26 involved large projects calling for continuing observations over periods of weeks or months. COMMON LODGING HOUSES There is one mens' common lodging house in the City which is fully occupied nightly. These premises are situated at 116, Middlesex Street and are owned by the Salvation Army Authorities. The premises house some 420 men on 6 floors. There are canteen facilities available in the basement. 6 During the year 16 inspections were made which included early morning and late night visits. The premises are kept in a good state of repair, maintenance and decoration being carried out continuously. Bedding is changed weekly or after every user, whichever is the sooner. Insect infestations are dealt with in collaboration with the Superintendent of the City Mortuary and Disinfecting Station. Infested persons are bathed and their clothes disinfected at the Milton Court Cleansing Station. The registration of the Keeper and Deputy Keeper is carried out every 13 months and is renewed subject to satisfactory conditions prevailing at the common lodging house at the end of that period. EXHUMATION OF HUMAN REMAINS IN DISUSED CHURCHYARDS During 1965 in connection with road widening and extensions in lloundsditch six boxes of identifiable human remains and 220 boxes of unidentifiable remains were removed from St. Botolph's Church, Aldgate to the City of London Cemetery, Manor Park, involving thirteen early morning visits by the Public Health Inspector concerned. At St. Giles Church, Cripplegate, in connection with the Barbican Development, 1,537 boxes of human remains were removed by the London Necropolis Co. Ltd., and reinterred at Brookwood Cemetery necessitating 95 early morning visits by the Public Health Inspectors concerned. In accordance with Re-organisation Area Measure, 1944, St. Augustine, Watling Street site was appropriated for use as part of, or in connection with, the Choir School of St. Paul's Cathedral in accordance with a Scheme gazetted on 2nd February, 1954. The removal of 132 boxes of human remains was supervised by a Public Health Inspector and reinterred in Brookwood Cemetery, Woking, Surrey in accordance with the requirements of Section 2(2) of the First Schedule to the 1944 Measure. Further exhumations were deferred until 1966 in accordance with phasing of building operations in connection with the Choir School. OFFICES, SHOPS AND RAILWAY PREMISES ACT 1936 A large part of the inspectors' time has been taken up by advice to architects and others on the requirements of the Act in connection with proposed offices and shops and improvements to those existing. This service, though not obligatory under the Act, is considered most valuable as this is the opportune time to influence occupiers as to the spirit of the Act and thereby attain better conditions. In the advice given to occupiers stress is laid upon providing sufficient lighting; not only sufficient for the task but sufficient to accomplish the task with efficiency and without eye strain. The standard recommended is based on the legal and recommended standards of lighting in various countries and on the better office lighting in the City of London, and is higher than that recommended by the British Illuminating Engineering Society (30 lumens/sq. ft.). (The British Lighting Council infer that a possible statutory standard would be 15 lumens/sq. ft.). Where statutory minimum standards are laid down, these tend to become maximum standards and it is believed that better office lighting will be achieved if no such standard is set. No advice is given about ventilation providing each room has a window opening to the external air, but where mechanical ventilation is required advice is based on a standard of 1000 cu.ft. fresh or artificially purified air/hour/person and it is recommended that heating elements are incorporated in the system. But it was generally found in shops that ventilation was poor. Further advice is given on the general provisions of the Act and OSRI forms are issued for the notification of employment of persons. Where the size of offices warrant the presence of persons suitably qualified in first aid, occupiers are advised that the British Red Cross Society conduct classes at Finsbury Barracks, City Road, E.C.I. Of the points raised on general inspections the following are, perhaps, worth mentioning: — 1. Drinking water taps are generally provided in toilet accommodation. This is not the most suitable position on the grounds of both hygiene and aesthetics but attempts to achieve better siting of such points are as yet disappointing. 7 2. Guarding of Machinery. The small hand operated guillotine is the most common unguarded machine found in offices. Difficulty in obtaining suitable guards for such machines is a common complaint by occupiers and indeed stationers rarely stock such machines with adequate guards. Currently the greatest problem under this section is the guarding of lift wells and dangerous parts of lift machinery in lift motor rooms. The investigation of accidents is time consuming and no major contraventions of the provisions of the Act have as yet been brought to light by such investigations. TABLE A REGISTRATIONS AND GENERAL INSPECTIONS TOTALS Offices 211 6,188 59 Retail shops 112 948 191 Wholesale shops, warehouses 39 762 113 Catering establishments open to the public, canteens 23 508 84 Fuel storage depots Nil Nil Nil (1) (2) (3) (4) Class of premises Numbe r of premises registered during the year Total number of regis tered premises at end of year Number of registered premises receiving a general inspection during the year. TABLE B NUMBER OF VISITS OF ALL KINDS BY INSPECTORS TO REGISTERED PREMISES 3,280 TABLE C ANALYSIS OF PERSONS EMPLOYED IN REGISTERED PREMISES BY WORKPLACE Class of Workplace Number of persons employed (1) (2) Offices 233,159 Retail Shops 4,724 Wholesale departments, warehouses 7,278 Catering establishments open to the public 6,527 Canteens 4,068 Fuel storage depots 12 Total 255,768 Total Males 153,085 Total Females 102,683 8 6 TABLE B-EXEMPTIONS M/c. Line No. . ... Class of premises (1) No. of exemptions current at 31st Dec. (2) No. of exemptions granted or extended during year (3) No. of applications refused or exemptions withdrawn during year (4) No. of eases in cols. (3) and (4) where employees opposed application (5) Appeals to Court against refusal to grant or extend an exemption or against the withdrawal of an exemption No. made (6) No. allowed (7) 1 Offices Part I—Space (Sec. 5(2)) 2 Retail shops 3 Wholesale shops, warehouses 4 Catering establishments open to public, canteens NIL 5 Fuel storage depots Part II—Temperature (Sec. 6) 11 Offices 12 Retail shops 13 Wholesale shops, warehouses 14 Catering establishments open to public, canteens NIL IS Fuel storage depots Part III—Sanitary Conveniences (Sec. 9) 21 Offices 22 Retail shops 23 Wholesale shops, warehouses NIL 24 Catering establishments open to public, canteens 25 Fuel storage depots Part IV—Washing Facilities (Sec. 10) 31 Offices 32 Retail shops 33 Wholesale shops, warehouses 34 Catering establishments open to public, cantecns 35 Fuel storage depots Prosecutions instituted of which the hearing was completed in the year M/c. Line No. Section of Act or title of Regulation or Order No. of persons or companies prosecuted No. of informations laid No. of informations leading to a conviction 1 2 3 4 5 NIL 11 12 13 14 No. of complaints (or summary applications) made under section 22 NIL 15 No. of interim orders granted NIL TABLE F—INSPECTORS 21 22 No. of inspectors appointed under Section 52 (1) or (5) of the Act 15 23 24 25 31 No. of other staff employed for most of their time on work in connection with the Act 2 32 33 34 35 HYGIENE IN HAIRDRESSERS' AND BARBERS' SHOPS The former powers dealing with hygienic conditions in hairdressers and barbers shops contained in the London County Council (General Powers) Act, 1954 have been repealed and these powers are replaced by legislation in the Public Health Act 1961 Section 77. There is no power, at present, to require registration of these premises. During the year 41 inspections were made showing that byelaw requirements are generally being maintained. FACTORIES ACT, 1961 Factory premises have been under such supervision as is necessary, and the following gives details of the work carried out:— PART I OF THE ACT 1.—INSPECTIONS for the purposes of provisions as to health. PREMISES Number on Register Number of Inspections Written notices Occupiers prosecuted (i) F actories in which Sections 1,2,3,4 and 6 are to be enforced by Local Authorities 1,184 (incl. 2 bakehouses and 1,022 kitchens) 1,842 (incl. 2 bakehouses and 1,809 kitchens) 168 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 411 235 19 (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-v.orkers' premises) 6 10 4 TOTAL 1,601 (incl. 2 bakehouses and 1,022 kitchens) 2,087 (incl. 2 bakehouses and 1,809 kitchens) 191 - 2—CASES IN WHICH DEFECTS WERE FOUND (If defects are discovered at the premises on two, three or more separate occasions they are reckoned as two, three or more "cases"). PARTICULARS No. of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of cleanliness (S.l.) 599 * 602 — — — Overcrowding (S.2.) — — — — — Unreasonable temperature (S.3.) 2 — — — — Inadequate ventilation (S.4) 36 * 44 — - — Ineffective drainage of floors (S.6.) — — — — — Sanitary Conveniences (S.7.) (a) insufficient 4 * 5 — — — (b) unsuitable or defective 196 182 — 2 — (c) not separate for sexes 15 2 — — — Other offences against the Act (not including offences relating to Outwork) — — 2 — - TOTAL 838 835 2 2 — *The number of defects remedied is higher than the number of defects found due to a 'carry over' from previous years. 10 PART VIII OF THE ACT Outwork (Sections 133 and 134) Section 133 Section 134 Nature of Work No. of outworkers in August list required by Section 133 (1) (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 Prosecutions 1 2 3 4 5 6 7 Wearing apparel (Making, etc.) 285 — — — — — TOTAL 285 — — — — — OUTWORK AND THE INSPECTION OF OUTWORKERS' PREMISES, ETC. Lists received from City Firms employing outworkers 39 Names and addresses of outworkers resident in the City received from other Authorities 25 Names and addresses of outworkers resident outside the City, employed by City firms, transmitted to other Authorities 285 No case of infectious disease was reported in connection with outworkers' premises in the City. SANITARY CIRCUMSTANCES The general sanitary supervision has been maintained and in this connection 5,390 inspections have been made. As a consequence of these inspections, it was necessary to serve 61 Intimation Notices. Tenement Houses were inspected and the only common lodging house in the City was kept under regular supervision. ATMOSPHERIC POLLUTION At the beginning of 1965 the City Corporation had four stations for the measurement of atmospheric pollution by the volumetric method in operation but the apparatus at the City Mortuary, Golden Lane was taken out of service at the end of June together with the deposit guage and the lead peroxide candle which were sited on the premises. The volumetric apparatus at Cloak Lane Police Station was dismantled in December. It is hoped that these instruments will be resited and put into service again early in 1966. Daily readings are taken at each of the volumetric stations and the information is collated at the central office in Guildhall where the smoke stains are 'read' on a photo-electric reflectometer and forms are completed and returned to the Ministry of Technology, Warren Spring Laboratory at Stevenage where similar information from all over the country is collated. The operators of the volumetric apparatus have again carried out observations and recordings in a most efficient manner and the co-operation of the City Police and the Superintendent of the City Mortuary and Disinfecting Station is greatly appreciated in this connection. The results of the atmospheric pollution investigations carried out by this department are set out in the following tables:— TABLE I - Deposit Guage The rainwater collected at Guildhall was more than the average for the past five years and there was a further increase of insoluble deposits. This increase of insoluble deposits may be due to demolition and rebuilding work which has been carried out in the City. TABLE II - Smoke concentration by the volumetric method. The concentration of smoke recorded during 1965 is less than that recorded in 1964 and is well below the average concentration for the past five years. 11 TABLE HI — Sulphur measurement — by the volumetric and lead peroxide methods. The concentration of sulphur recorded in 1965 was less than that recorded in 1964 and is less than the average concentration for the past five years at Bishopsgate and Snow Hill but slightly more at Cloak Lane. TABLE I — Results obtained in 1965 of the monthly observations of rainfall and deposited matter by means of the deposit gauges. MONTH Rainfall collected in deposit gauge DEPOSITS Equivalent to Insoluble Soluble Total Millimetres inches of rain Millimetres inches of rain Tons per squnre mile STATIONS (see note below) A B A B A B A B January 45 1.76 50 1.98 14.54 14.28 8.98 10.57 23.52 24.85 February 10 0.40 11 0.43 8.21 15.13 5.70 7.65 13.91 22.77 March 39 1.55 43 1.68 15.47 33.11 9.54 15.50 25.01 48.61 April 47 1.86 45 1.76 37.16 33.75 7.85 14.62 45.01 48.37 May 39 1.55 45 1.77 14.31 16.89 5.90 8.06 20.20 24.95 June 39 1.53 45 1.77 12.92 12.58 7.15 7.61 20.07 20.19 July — — 67 2.64 — 16.28 — 10.13 — 26.41 August — — 49 1.93 — 16.86 _ 6.73 — 23.59 September — — 116 4.56 — 14.68 _ 9.93 — 24.61 October — — 17 0.66 — 19.03 — 7.72 — 26.75 November — — 66 2.60 — 19.75 — 11.73 — 31.47 December — — 93 3.65 — 15.94 — 9.25 — 25.19 Averages: 1965 37 1.44 54 2.12 17.10 19.02 7.52 9.96 24.62 28.98 1964 36 1.44 44 1.71 25.91 15.13 14.92 12.49 40.83 27.63 1963 37 1.45 41 1.63 16.30 12.48 16.93 10.07 33.23 22.55 1962 43 1.69 40 1.58 14.80 14.21 9.51 8.49 24.31 22.69 1961 42(a) 1.66(a) 44 1.71 14.02(a 15.08 9.05(a) 7.80 23.05(A) a) 22.88 1960 62 2.46 63 2.49 14.58 12.39 7.55 8.15 22,13 20.55 1960-1964 44 1.74 46 1.82 17.12 13.86 11.59 9.40 28.71 23.26 NOTE: A — Golden Lane B — Guildhall (a) average for 10 months 12 TABLE II — Results obtained in 1965 of the daily observations of the concentration of SMOKE by the volumetric method. MONTH Rainfall collected in deposit gauge at Guildhall Golden Lane POLICE STATIONS Bishopsgate Cloak Lane Snow Hill Equivalent to Monthly Average Monthly Average Monthly Average Monthly Average Millimetres inches of rain Micrograms per cubic metre Micrograms per cubic metre Micrograms per cubic metre Micrograms per cubic metre January 50 1.98 100 124 113 85 February 11 0.43 91 98 115 88 March 43 1.68 98 121 116 91 April 45 1.76 58 58 76 52 May 45 1.77 40 59 58 40 June 45 1.77 30 49 45 32 July 67 2.64 — 45 46 27 August 49 1.93 — 64 53 36 September 116 4.56 — 132 72 56 October 17 0.66 — 138 116 101 November 66 2.60 — 132 98 75 December 93 3.65 — 134 — 84 Average: 1965 54 2.12 70 96 83 64 1964 44 1.71 88 155 113 77 1963 37 1.45 100 183 138 87 1962 43 1.69 84 217 106 77 1961 42(a) 1.66(a) 90 200 100 80 1960 62 2.46 100 160 130 60 1960-1964 46 1.79 92 183 117 76 (a) Average for 10 months TABLE III — Results obtained in 1965 of the measurement of SULPHUR DIOXIDE by the volumetric and lead peroxide methods. MONTH Rainfall collected in deposit gauge at Guildhall POLICE STATIONS LEAD PEROXIDE METHOD Equivalent to Golden Lane Bishopsgate Cloak Lane Snow Hill Golden Lane Finsbury Circus Millimetres inches of rain Monthly Average Monthly Average Monthly Average Monthly Average Mgs, (SO3) per day per 100 sq, cm. MICROGRAMS PER CUBIC METRE January 50 1.98 400 500 510 531 4.81 3.39 February 11 0.43 298 388 550 506 3.61 2.74 March 43 1.68 449 550 548 506 4.76 2.78 April 45 1.76 259 355 337 340 4.05 2.25 May 45 1.77 178 282 213 196 2.08 1.15 June 45 1.77 133 226 180 177 1.82 0.88 July 67 2.64 — 225 157 137 — 0.99 August 49 1.93 285 196 145 — 0.88 September 116 4.56 333 226 179 — 1.12 October 17 0.66 _ 527 479 447 — 2.03 November 66 2.60 _ 471 522 451 — 3.72 December 93 3.65 — 543 — 471 — 2.74 Averages: 1965 54 2.12 286 390 356 341 3.52 2.06 1964 44 1.71 316 448 377 383 3.06 2.27 1963 37 1.45 300 380 381 345 2.92 2.29 1962 43 1.69 284 478 352 340 2.64 2.15 1961 42(a) 1.66(a) 257 458 286 286 3.01 2.10 1960 62 2.46 257 400 372 257 3.22 2.19 1960-1964 46 1.79 ] 283 433 354 322 2.97 2.20 (a) Average for 10 months 13 RODENT CONTROL In compliance with the provisions of the Prevention of Damage by Pests Act 1949, it is the duty of every Local Authority to take such steps as may be necessary to secure as far as practicable that their district is kept free from rats and mice. Compliance with requirements of the Act comprised inspection to ascertain the presence of rats and/or mice, treatment of properties found to be infested, recommendation and supervision of structural and incidental proofing, and three-monthly treatments for the destruction of rats in the City sewers. A total of 2,125 properties were inspected under the Act, the properties varying from comprehensive re-development sites in the course of construction, multi-occupied blocks of offices, riverside food wharves and warehouses, public and private catering establishments, shops and factories to domestic, dwellings. Altogether 534 complaints were received, either by notification or as a result of inspection, and of this total 471 infestations were subject to control measures. In 63 instances no action other than advice was necessary. The total of 471 infestations requiring remedial measures comprised 7 major and 50 minor infestations of rats, and 3 major and 411 minor infestations of mice. Of the rat infestations, 7 major (21/200) and 48 minor (1/20) were of common rat (Rattus Norvegicus) and the remaining 2 minor were of ship (black) rat (Rattus Rattus) nature. The numerical density of the 7 major infestations was sufficient to exclude them from the minor scale, although they were in the main, low in the major scale. Treatment of these infestations entailed 4,302 visits for operational purposes, and in the application of the control measures 10,572 initial baiting sites were selected for both rats and mice. For the ccntrol of rats 4,896 pre-baits were laid which necessitated the use of 522 poison baits to finalise the treatments. These measures resulted in a minimum estimated kill of 859 rats, and of this number 396 bodies were removed from the sites on completion of the operations. Others were found in several instances following removal of structural or incidental harbourage affording nesting facilities. The use of anti-coagulant rodenticides and other poisons entailed the application of 9,700 baiting-points for the control of mice and 595 bodies were recovered. In 10 instances structural rat-proofing was carried out by owners or occupiers, and in 11 cases defective drainage resulting in common rat infestation was remedied. Incidental rat and mouse proofing in the nature of removal of harbourage provided by unnecessary and undisturbed accumulations has again received unremitting attention. The Common rat infestations were mainly confined to building sites which provide every facility and are therefore conducive to infestation by both species, but bearing in mind the vast amount of re-development completed since 1950, and that now in progress, plus prior demolition, infestation has not reached the degree visualized and expected at the outset of reconstruction. From the time the footings of the sites are completed inspections are made at frequent intervals, and any necessary action taken, and fullest co-operation has at all times been received from the various contractors. The low level of ship (Black) rat infestation gradually obtained since 1951 has been maintained and only 2 minor infestations of this nature were treated during the year. For comparison, in 1947, 643 infestations were treated and of that number 595 infestations were of ship rat character. To illustrate further the diminished degree of rat infestation, numerically and in distribution, the up-to date summary collated from detailed records kept since 1944 is included as useful information. It should be understood that the figure referring to rat infestation is the combined total of ship and common rat infestation, the former comprising until 1957, 90% of infestation. It is also emphasised that the estimated number of rats destroyed is the absolute minimum while the total in the bodies found column is the sum of those removed from premises by the operators, and and does not include any subsequently found on elimination of structural or incidental harbourage. 14 SURFACE PROPERTIES Year INFESTATION TREATED RATS Rats Mice Poison Traps Mice found Initial baiting points Prebaits laid Poison baits laid Mice Warfarin baits No. Major Minor Major Minor Estd. kill Bodies found 1944 320 261 39 13 7 11,388 2,558 423 95 12,784 62,336 8,452 1945 417 241 158 6 12 10,038 2,410 217 164 11,321 60,444 7,926 1946 373 232 101 12 28 8,658 2,767 480 207 14,991 63,244 8,672 1947 705 313 330 19 43 6,969 2,081 454 311 18,226 88,980 11,123 1948 751 260 438 22 31 5,637 1,822 552 263 18,720 98,506 12,066 1949 631 149 395 30 57 5,046 2,113 761 557 23,684 91,792 16,242 1950 846 186 391 109 160 4,369 1,632 605 710 23,737 129,295 17,719 1951 651 82 266 182 121 3,436 1,308 775 833 33,712 124,789 25,291 7,012 1952 616 50 278 152 136 2,877 1,237 514 852 11,320 48,783 5,149 16,800 1953 647 25 238 111 273 1,527 725 241 853 16,045 28,672 2,313 11,634 1954 675 20 219 116 320 1,630 955 91 1,181 16,508 25,339 1,982 16,508 1955 677 10 169 139 359 1,070 595 60 1,540 16,407 19,024 1,222 12,706 1956 661 7 141 124 389 782 459 63 1,644 16,033 10,519 823 12,829 1957 575 7 105 84 379 902 506 45 1,296 11,919 9,769 679 9,895 1958 523 2 54 36 431 343 191 16 1,012 7,645 3,034 336 6,653 1959 545 3 50 25 467 399 162 2 886 8,643 3,835 385 8,593 1960 584 2 66 33 483 634 284 12 916 12,373 5,625 574 10,029 1961 523 2 74 14 433 555 289 _ 726 10,942 5,539 506 9,495 1962 508 8 76 8 416 989 535 659 9,987 7,036 699 9,043 1963 482 3 62 4 413 524 217 676 11,812 4,970 516 10,281 1964 487 5 60 2 420 507 304 704 10,086 5,058 452 9,173 1965 471 7 50 3 411 859 396 — 595 10,572 4,896 522 9,700 12,668 1,875 3,760 1,244 5,789 69,139 23,546 5,311 16,680 327,467 901,485 123,649 160,351 Periodical treatment at 3 monthly intervals for the control of common rats in sewers is a primary factor in the control of this species in surface properties. It is the purpose of these treatments to keep the rat population of the sewers down to the lowest possible level, thereby preventing the infestation of surface properties via defective drainage. During the period under review, four "Direct" poison treatments with Fluoracetamide commonly known as "1081", were applied in March, June, September and December, and an average of 390 sewer manholes distributed over 34 miles of traversable sewers were poison-baited on each occasion except in June. The annual overall test baiting which provides an indication of the results of the previous treatments was applied prior to the June control and a total of 390 manholes were baited, the test baits being left for two days. These baits which in effect act as pre-baits were then examined and where taken replaced by poison bait. The test bait result was 48 "takes" (30 complete, 13 x 3/4 and 5 x 1/2) each bait being 4 ozs and comprising sausage rusk and water in equal parts by weight. Taking into account only the complete takes recorded the summarised result is 7.5% complete "takes" of the total number test baited. The comparable test in 1961 produced 85 "takes" of which 71 were complete which is 17.6% of the total number baited and in the years 1962-1964 the result was 11.6%, 8.9% and 6.7% respectively. Subsequent to the initial eewer treatment in December, 1943, it was the practice to carry out six-monthly controls, comprising a two day pre-bait followed by poison baiting where pre-bait was taken. The poisons alternately used were Zinc Phosphide, arsenious Oxide and Alpha— naphthyl-Thio-urea The recorded result of the initial treatment was 355 pre-bait "takes" from 427 entrances baited of which 185 or 43% were complete "takes" indicating the numerical density and distribution of the rat population of the sewers at that time. Continued six-monthly controls resulted in a gradual reduction of pre-bait "takes" and the recording in the May 1948 treatment was 118"takes" of which 63 or 15.5% werecomplete "takes". From then onwards an upward trend of pre-bait takes was experienced until in December 1950, the pre-bait takes were 225 of which 185 or 45.3% were complete "takes", thus equalling the number obtained in the initial control December, 1943. This result indicated that the use of the above mentioned poisons and six-monthly controls was no longer maintaining the low level of residual rat population and that there was increased distribution over a wider area and a possibility of some poison prejudice. 15 It was considered that in view of the time and effort expended on these control measures drastic action was necessary to secure a further reduction of the residual rat population in the sewers and with the approval of the Ministry of Agriculture, Fisheries and Food, extensive experimental control measures with Sodium Fluoroacetate (1080) and intermediate tests were applied, institutins the "Direct" poison control system at 3 monthly intervals. The first test-baiting result in June 1952 after five controls, with "1080" was 35 "takes" of which 7 or 1.7% were complete. Continued treatments and subsequent tests produced similar results. In 1956, Fluoracetamide (1081) was substituted for "1080" and similar controls and tests were applied until 1960 with equal results, and continued controls since, with annual tests, have maintained the low level of infestation which was believed could be obtained with "1080" and "1081" in combination with "Direct" poisoning at 3 monthly intervals. This system is now standard practice and advocated in the official Handbook on Rodent Control and since adopted by commercial Pest Control firms offering their services to local Authorities. In surface properties these rodenticides have been the major factor in the present low level of rat infestation in general and Ship (Black) rat in particular, and allied to the pre-baiting system of application which, without exception has always been strictly adhered to, has on numerous occasions resulted in complete elimination of infestations of both species with the minimum number of poison baits employed for one night only, and a high body recovery ratio relative to the number of baits. The annual reduction of the number of rat infestations treated and their relative quantative values has followed a similar pattern to the break down in sewers, and a reference to the surface properties summary from 1950 onwards indicates the reduction subsequently achieved since that year when controls with "1080" and "1081" were instituted. Their use over the past fifteen years has shown that when controlled and dispensed by a responsible person, plus a strict observance of the necessary safety precautions in the handling and laying of the made up baits, in suitable and safe environments (which applies equallv to less toxic poisons), a complete clearance can often be made with safety to man and domestic animals. Having detailed at length the history and value of these rodenticides, it is regretted that the Poisons Rules 1965, restricts their use to ships and sewers, the effect of which means greater reliance on Zinc Phosphide and arsenic as acute poisons and Warfarin in the chronic field. While these poisons, as in the past, still have their place in Rodent Control, experience has shown that they have rarely produced the desired high rate of kill and consequent elimination of breeding potential, and the resistance of rats to Warfarin found to exist in parts of this country and on the continent can only add to resultant difficulties. It is the essence of good practice, and should be the aim of every responsible person engaged on Rodent Control to destroy the highest percentage of any infestation quickly and surely and where possible avoid the often slow and painful results of less toxic rodenticides. The restriction, therefore, on the use of "1080" and "1081" can only be considered a retrograde step which must inevitably engender a sense of frustration in personnel engaged for many years on this important facet of Public Health, often carried out in difficult conditions. PIGEON NUISVNCE A firm of pigeon catchers is employed under contract by the City Corporation whose policy is not to exterminate all pigeons but to control their numbers to such proportions as will ensure that the pleasure they give to residents and visitors is not out-weighed by the nuisance they cause. During the year 4,300 pigeons were humanely trapped and killed as compared with 3,800 in 1964. CITY MORTUARY Bodies received 203 'Post Mortem Examinations made 203 Inquest on bodies 40 Inquests held at Holloway Prison Nil Inquests on fires Nil 16 DISINFECTION AND CLEANSING OF VERMINOUS PERSONS, ETC. Export of Clothing, etc. Articles, by weight 4 tons. 14 cwt. No. of articles disinfected 463,721 Cases of horsehair 317 Fees received £2,422 10s. Od. General Disinfection, Infectious Diseases, etc. Premises disinfected after cases of infectious disease 4 Lockers at Post Offices disinfected 18 Verminous premises disinfected 13 Cleansing of Persons:- No. of verminous persons bathed 879 No. of scabious persons bathed 5 No. of articles disinfected 8,840 OBSERVATIONS ON CATERING ESTABLISHMENTS IN THE CITY When considering a year's work in connection with all types of catering establishments undoubtedly there is, at first glance, apparently little difference between the problems and results of one year with those of another. On the other hand catering is similar to many industries. It is not static and it must either progress or deteriorate. At the present time it cannot be contended that progress is being made in the direction of hygiene, the direction from which perforce a local authority must view catering. This observation is not intended to be a condemnation of the whole catering industry, as the people engaged in this trade are themselves only too well aware of the many pressures which militate against them in present circumstances and prevent their achieving optimum standards. The City of London does present an almost intractable problem so far as the caterer is concerned. In so far as he can work normal hours for five days a week it is attractive, but his time of actual trading is confined to approximately fifteen hours each week and with the present low price structure it would appear that many restaurants are no longer a viable financial proposition. This is borne out by the fact that some catering firms which are household' names have, during the past year, voluntarily given up their premises in the "square mile" owing to adverse trading and difficulties associated with staff. It may be questioned why difficulties of trading and finance should concern Public Health Officials especially when statutory powers are available to deal with most contingencies. This may be answered by the assumption which might even be an axiom that when a food business begins to falter the first thing that flies out of the door is hygiene. Commodity prices are not easily cut, the standard charges for rent, rates and fuel are unassailaole and the easiest way for caterers to reduce costs and so solve some of the economics of the situation is to dispense with staff, that is, of course, if they are ever fully staffed in these difficult days. Apart from such circumstances one wonders at times whether the types of employee available are really suited to the work they are expected to carry out. While work such as routine cleaning and washing up is considered to be a simple task, the layout, design and adaptation of some kitchens is so poor as to make these operations unnecessarily difficult. Poor layout and the use of inherently unsuitable premises account for many of the obstacles facing the small caterer and in some instances can be the snare in which the enthusiastic but unwary become enmeshed. It is in such circumstances that powers for registration and prior approval would be advantageous to all concerned. Most emphatically this is not presuming the right to tell a man he must not be in business but it is justifiable to indicate that some premises and the amenities available are basically unsuitable for catering. There are other facets of the food industry where the use of such powers is notconsidered unreasonable and it is illogical to contend that identical arrangements for prior approval cannot be extended to all premises which are intended to be used for catering purposes. As a result of the extensive building operations which have been taking place in the City during recent years, problems have arisen concerning the catering arrangements provided on major building sites. Obviously whatever arrangements are made must be of a temporary nature, often in prefabricated structures where the standard of construction is often below the minimum standards found in normal catering premises. It cannot be gainsaid that as opposed to normal restaurants a considerable amount of dirt and debris are inevitably deposited in the eating areas of these canteens. This presents con siderable cleaning difficulties, although in many instances the building contractors have made quite reasonable arrangements so far as kitchens are concerned. 17 The fact that some dissatisfaction is indicated with the state of certain City restaurants does not mean that the Inspectors have been inactive during the course of the year under review. On the contrary, the work of continuous inspection and re-inspection has been maintained with unabated energy, but all their efforts have done no more than arrest the rate of decline. Unfortunately there seems to be an impression amongst caterers that they are safe from legal action as long as they remedy dirty and unsatisfactory conditions as and when requested to do so by the local authority. At times caterers appear to be unaware of the fact that by allowing such conditions to exist they automatically render themselves liable to legal sanction. Whilst one has every sympathy with individual managers and proprieters they should understand that notwithstanding the difficulties with which they are contending in order to keep their establishments operative they cannot contract out of their legal responsibilities so far as the maintenance of clean and hygienic conditions are concerned. Having made critical comments on the conditions found in some premises it is not unreasonable to expect critisms that the standards sought are too high, that they are impossible to maintain and that they are unnecessary. This must be refuted categorically since there are really no half measures when handling food and any laxity in this direction must inevitably lead to trouble. Advice and guidance in trying to overcome difficulties associated with hygiene and catering can be offered but the final responsibility must rest with the caterer not to allow adverse conditions to arise. CATERING ESTABLISHMENTS Before establishing a new catering business planning approval must be obtained before premises, new or existing, are adapted for this purpose. In order that the applicants for such approval can be satisfied that the premises are suitable from a public health point of view and that the various statutory requirements can be met, they are referred by the City Planning Officer to your Medical Officer of Health. 73 such applications were received during the year as a consequence of which 221 inspections were made. FOOD AND DRUGS ACT, 1955 It will be seen that the samples purchased by the Sampling Officer constituted a representative cross section of all articles of food in regular use and of 365 samples purchased during the course of the year only 17, or 4.7%, were the subject of an adverse report by the Public Analyst. Three commodities were the principal source of difficulty; pre-packed bacon, sausages and lard. Two samples of sausages were found to contain an excess of fat. After correspondence and discussion with representatives of the manufacturers an assurance was given that the recipes were designed to give a fat free meat content of more than 50% of the total meat. The representations made appear to have had beneficial results as subsequent samples were to be found satisfactory. Difficulty was again experienced with the labelling of lard. Last year it was found that the presence of antioxidants was not disclosed on the label. This irregularity was subsequently rectified but now exception has been taken to the use of the word "Pure" when describing lard containing antioxidants. Representations were again made to the packers and wholesalers who have agreed to amend their labels by omitting the use of the word "Pure". The question of indicating each of the ingredients of pre-packed oacon was taken up with four separate packers and curers who in each case maintained that the ingredients, namely pork, salt and nitrite were an integral part of the final product and that there was, therefore, no contravention of the Labelling of Food Order, 1953. There is some substance in this contention and after legal advice it was decided not to take any further action. The attention of the Ministry of Agriculture, Fisheries and Food was drawn to this matter so that the position could be clarified when new regulations are made. The complaints made by members of the public have enabled useful investigations to be made into the practices followed by various food traders and manufacturers as a result of which a number of weaknesses and deficiences have been located and remedied. ADMINISTRATIVE ACTION REGARDING ADULTERATION OR OTHER IRREGULARITY Article Informal or Formal Sample Nature of adulteration or irregularity Action Apples Frozen Sliced Informal Contained sulphur dioxide, 130 parts per million, the presence of. which was not disclosed on the label: Written representations were made to the retailer who subsequently withdrew from sale his stocks of this commodity. 18 Article Informal or Formal Sample Nature of adulteration or irregularity n Bacon ) Rindless Half ) Gammon ) Informal The samples were pre-packed but the label did not include the appropriate designation of each of the ingredients. The attention of each of the packers of the samples of bacon in question has been drawn to the opinion expressed by the Public Analyst. In each case an opinion contrary to that of the Public Analyst has been expressed, and the packers maintain that they were in fact complying with the provisions of the Labelling of Food Order 1953. On the advice of the Comptroller and City Solicitor it was decided not to take legal action. Sweetcure Bacon Back Bacon ) Streaky Bacon ) • Bacon Roll Informal The specimen contained a mouse dropping. The complainant was interviewed on three occasions regarding the circumstances of this case but refused to give a statement in writing. The investigation gave rise to doubts as to the true facts and further action was considered impracticable. * Beef Hamburger Informal The specimen included part of an insect, identified as the terminal end of a Dermestes Larva. The catering premises from which this beef hamburger was obtained were inspected but there was no indication of any insect infestation, nor could it be determined that the caterer in question was responsible for the presence of the insect in the hamburger. Accordingly, therefore, it was not practicable to take any further action. Beef Steak with Gravy, Canned Informal Contained meat, 63 per cent. The label of the can bore the statement — *Beef content not less than 65%". Stewed steak with Gravy should contain at least 75% of meat. Written representations were made to the importers of this commodity who indicated that importation of this particular brand had been discontinued. *Bread Informal Contained baked in the bread several deposits of brown foreign matter consisting of ordinary fine bakery refuse. This loaf was the subject of a complaint by a customer who purchased the bread in a shop in the City. After investigation this matter was reported to the Port and City of London Health Committee who instructed the Comptroller and City Solicitor to send a warning letter to the bakers in question. * Bread, remnants Informal Contained baked in two of the pieces of bread streaks of foreign black substances consisting of dirty grease containing fine particles of iron. Appropriate representations made to the baker. * Bread, Slices Informal Contained baked in the bread several small dark masses of foreign matter, consisting of dried dough containing iron oxide. Appropriate representations made to the baker. • Brussel Sprouts > Informal The sprouts had deteriorated, being sour and containing small black spots, due to mould and other damage. An investigation indicated that the refrigerated container in the retailers shop was not being maintained at a suitable temperature. Appropriate representations were made to the retailer in question who took the necessary steps to rectify the situation. * Buttered Scone Remnants Informal The specimen contained several fragments of coke on the cut surface of the scone. 19 Investigation indicated that this scone was baked at a bakehouse within the City, and it was possible, therefore, to make a very thorough enquiry into this matter. The bakehouse was operated by gas and no solid fuel of any kind is used on the premises. It was finally ascertained that the foreign matter was derived from a box of imported dried fruit. Written representations were made to the importers of this commodity who in turn pursued the matter with their suppliers in Turkey. 19 Article Informal or Formal Sample Nature of adulteration or irregularity Action "Doctor" Pure Tea Informal Consisted of ordinary tea. The label tended to imply that the tea was medically recommended, and was consequently considered liable to be misleading. Written representations were made to the retailing company who are also responsible for the packing of this commodity. Discussions took place with their representative and an amended label has now been submitted to and approved by this Department. * Doughnut, remains of Informal The specimen contained in the jam filling the carcase of a beetle larva (Terebrionid) and a small lump of earth. Representations made to manufacturers but further action not considered necessary. * Farmhouse Wonderloaf (Sliced) Informal Contained embedded in one of the slices where it had been baked, a small house fly. The matter was taken up with the bakery concerned and the local authority in the area where the bakery is situated. The complainant did not wish to give evidence on behalf of the Corporation of London and it was not possible therefore to take any legal action. * Fragment of glass from a plate of meat Informal The spedimen corresponded to a fragment broken from the rim of a wine glass. This piece of glass was found on a plate of food at a banquet and could have come from a wine glass broken during the meal. After a thorough investigation it was considered that no useful purpose would be achieved by further action. *Ham, Sliced Informal The ham was slightly stale and showed extensive green phosphorescent areas on the surface. It was considered unsuitable for sale. An inspection of the premises from which this ham was sold indicated that there was a quick and constant turnover of ham and other cooked meats and no criticism could be made in their method of storage or of their stock rotation. There was some uncertainty as to the time which had elapsed between the purchase of the ham and the complaint being made to this department. It was not possible, therefore, to take any further action regarding this complaint. Hofferman's Swisson Rye Informal Consisted of processed cheese with caraway seeds. The sample did not consist of, nor contain, rye, and the description was considered incorrect and confusing. Written representations were made to the importers who have agreed to discontinue the importation of this type of cheese; Kipper Fillets Frozen Informal Contained artificial colouring matter (Brown FK) the presence of which was not disclosed on the label as required by the Labelling of Food Order. This matter was investigated last year when the Ministry of Agriculture, Fisheries and Food was informed in writing of the difficulties encountered in dealing with this problem. Accordingly therefore, no further action has been taken at the present time. * "Laidabeille" Informal The label did not conform to the requirements of the Labelling of Food Order. The product was claimed to contain numerous vitamins but the quantities were not stated, and the label did not include a correct statement of ingredients. Correspondence and subsequent discussion with the manufacturers resulted in the label being amended. Mead Informal Consisted of melomel prepared from grape and apple juice fermented with honey, containing Proof Spirit 24 per cent. The term "Mead" was not considered to be an "appropriate designation" and the declaration of fruit basis and strength did not comply with the Labelling of Food Order. Appropriate representations were made to the producers and bottlers of this commodity and as a result suitably amended labels are now in use. 20 Article Informal or Formal Sample Nature of adulteration or irregularity Action * Medicine Informal The medicine contained suspended in it a considerable quantity of dust. This medicine was dispensed by a firm of multiple chemists. Extensive enquiries and subsequent analysis by the Chief Chemist of the firm in question of the remainder of the medicine and the stock from which it was dispensed failed to indicate the cause of the complaint. The complainant was not willing to give evidence on behalf of the C orporation of London and it was not possible, therefore, to take any legal action. Moutarde de Dijon with White Wine Informal Contained no alcohol. Description appeared to be incorrect. Written representations were made to the retailer concerned who agreed to withdraw from sale the outstanding stocks of this commodity. * Orange Drink Informal Contained floating in the drink four dead spider beetles (Ptinidae) and a small curved piece of white plastic. A representative of the firm bottling this commodity was interviewed and appropriate written representations were subsequently made. * Pasteurised milk, carton of Informal Contained a hard, white, elongated piece of plastic material, probably a tailing from the plastic used to strengthen the paper carton. Matter taken up with the Company concerned. No further action necessary. Pork Sausages Informal Contained— Fat 35% Fat Free meat 30% Total meat 65% The proportion of fat in sausages should not exceed 50 per cent of the total meat content. Written representations were made to the manufacturers who have assured this department that their recipes are such as to ensure that the proportion of fat meat is not excessive. Subsequent samples were found to be satisfactory. Pork Sausages Preserved Informal Contained Fat 39% Fat-free meat 30% Total meat 69% The proportion of fat in sausages should not exceed 50 per cent of the total meat content. Written representations were made to the ' manufacturers who gave an assurance that their recipes were arranged to ensure that there would be a proper balance between fat and fat-free meat. Subsequent samples were found to be satisfactory. Pure Lard • Informal Contained butylated hydroxyanisole ) 70 p.p.m. the presence of which ) disclosed on the label but the ) word "PURE" was considered in- ) appropriate as a description of ) lard that contains any admixture. ) Contained butylated hydroxyanisole) 60 p.p.m. the presence of which ) was disclosed on the label but the ) word "PURE" was considered in- ) appropriate as a description of ) lard that contains any admixture. ) Correspondence has taken place with the importers of this commodity who agreed to amend their labels. Pure Lard Informal Pure Lard Informal Conta ined butylated hydroxyanisole, 70 p.p.m. which was disclosed on the label, but the word "PURE" was considered inappropriate as a description of a lard that contained an admixture. Appropriate representations were made to the wholesalers and to the wholesaler packers who have agreed to amend their labels. * Raspberries, Canned Informal Contained a small dead fly (Delia trichodactyla) Written representations were made to the canners of this commodity. * Rose and Vanilla Marshmallows Informal The marshmallows were mouldy and unfit for human consumption. This article of food was the subject of a complaint by a member of the public. After investigations representations were made to the vendor and the manufacturers, but the institution of legal proceedings was considered impracticable as the complainant declined to give evidence on behalf of the Corporation of London. 21 Article Informal or Formal Sample Nature of adulteration nr irregularity Action * Rusks Informal Contained baked in one of the rusks a few particles of dirty brown foreign matter, which was found to consist of rusk discoloured by iron. Written representations were made to the importers of this commodity who pursued the matter with the manufacturers in Holland. * Smdwich, Cheese and Tomato Informal The sandwich was mouldy and unfit for human consumption. Both these sandwiches were purchased by the same person from the same premises. An investigation indicated that these * Sandwich, Ham Informal The ham was stale and unfit for consumption. wiches were several days old when sold and that unsold sandwiches had inadvertently been mixed up with new stock. It has now been arranged that all unsold sandwiches at the end of each day will be destroyed in the waste food disposal unit which has been installed on the premises. *Sandwich, Sslmon Informal The sandwich was stole and had an unpleasant smell indicating decomposition. This sandwich was made from canned salmon and on investigation showed that it had been kept over from the previous day. Appropriate action has been taken to prevent a recurrence of this difficulty. Savoidelice Cheese Informal Consisted of a whole round cheese covered with a thick, somewhat mouldy, coating of grape seeds and wax, the edible part amounting to only 50 per cent of the whole sample. The article was prepacked but did not bear an English name or statement of ingredients on the label. Written representations made to the importers of this commodity. After discussion with their representative it was agreed that an amended label would be prepared. * Soup Informal The soup contained a small dead Spider Beetle of the Ptimidae family. Matter taken up with the retailer. * These samples were examined as a result of complaint by members of the public. 22 FOOD AND DRUGS ACT 1955, AND FOOD REGULATIONS Samples submitted for Analysis. Article Informal Article Informal Almonds, Ground 1 Margarine 11 Bacon 8 " Corn Oil 1 Batter Mixture 1 Marmalade 1 Biscuits 5 Meat 3 Brawn 1 Meat Pie 3 Bread 8 Meat, Canned 19 Butter 4 Milk 41 Butter, Peanut 2 Milk, Canned 8 Cereal 1 Mincemeat 5 Cheese 18 Mustard 2 Cheese Spread 5 Oil, Vegetable 5 Chocolate Drink 3 Pastes — Coffee 7 Meat 1 Coffee Concentrate 2 Pate Truffe 1 Cream, Dairy 5 Pate de Foie 1 Confectionery 10 Pastry 3 Curry Powder 3 Pepper 2 Curried Meat 4 Rice 1 Dressing, Vegetable 2 Salt 1 Drinks, Blackcurrant 1 Sauces 8 Drinks, Fruit 14 Sausages 30 Dripping, Beef 1 Sausage Rolls 1 Drugs 3 Soups 4 Fish, Canned 5 Spaghetti 2 Flavouring 1 Spices 1 Flour 7 Spirits 6 Frozen prepacked — Suet 3 Fish 6 Sugar 5 Fruit 1 Tea 5 Meat 2 Tomatoes, Canned 7 Vegetables 5 Tomato Paste 3 Fruits — Dried 8 Vegetables, Canned 3 Fresh 3 Vegetables, Dehydrated 2 Glace 1 Vinegar 2 Fruit Pie 1 Wine 3 Gelatine 1 Herbs 2 Honey 2 Jam 2 Jelly Crystals 1 Lard 13 Lemon Curd 1 TOTALS 365 ANALYTICAL EXAMINATIONS (Other than Food and Drugs Act) Albumen 1 Ham 2 Bacon Roll 1 Hamburger 1 Biscuits 1 Jelly l Bread 4 Meat Pie 1 Canned Fish 5 Medicine 1 Canned Fruit 7 Milk 2 Canned Fruit Juice 2 Mixed Peel 3 Canned Meat 4 Onion Powder 5 Canned Tomatoes 6 Paper, Wrapping 2 Canned Vegetables 3 Peanuts 1 Chicken Cutlet 1 Peppers 1 Chicken & Ham Pie 1 Sandwiches 3 Confectionery 2 Scone 1 Fertiliser 2 Soup 1 Fish Gravy 1 Teas 1386 Frozen Foods 1 Toy Tool Kit (Plastic) 1 Fruit, Dried 55 Water, Drinking 1 Fruit, Drink 2 Water, Swimming Bath 1 Fruit, Fresh 3 1,516 23 BACTERIOLOGIC AL EXAMINATIONS Albumen, Granular or Flake 71 Albumen, Powdered 243 Beef 2 Blood 1 Canned Sliced Carrot 1 Faeces 10 Pork 2 Water (including 20 from Swimming Baths) 163 Whole Egg Powder 8 501 FOOD AND DRUGS ACT, 1955 (Section 16) This Section provides for registration of premises for the sale, manufacture for saleor storage of ice cream, or the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale. The following table shows the types of business carried on:— Nature of Business for which registered Sale and storage of pre-packed ice cream 76 Manufacture, sale and storage of ice cream 3 Selecting and sorting of sausage casings 8 Preparation and cooking of jellied eels and shellfish 13 Cooking of Hams 1 Manufacture of sausages, dripping and cooked meats and brining of meat 28 Cooking, smoking and canning of meat products 9 Manufacture of pies 1 Sale of cooked meats 1 140 This has required the registration of 132 premises. FLAVOURINGS "Dr. H. Amphlett Williams, the Public Analyst for the City of London, has contributed the following:— In view of a trend in public taste towards highly flavoured, as well as highly coloured, foods and drinks, more attention has recently been devoted to the chemical constituents of artificial flavourings. Tests are applied in particular to ascertain the nature of the solvents used, which form the principal constituents of flavouring essences, following the earlier use of methylated spirits and, more recently, ethylene glycol, which has a toxicity similar to that of methyl alcohol and has been banned in U.S.A. following several deaths from drinking anti-freeze fluids. Of passing interest was the detection of substantial quantities of coumarin in three samples of imported "Pure Vanilla Extract" submitted in 1965. Coumarin has a powerful taste, inferior in character to vanilla but three times as strong and has been used in the past to reduce the cost of vanilla essences. It is a hepatic and renal poison and a cumulative anti-coagulant, forming the base from which the rat poison Warfarin has been developed; and its use in flavouring has been banned in U.S.A., Canada and on the Continent. It is not yet specifically prohibited in this country, although its use was discontinued by British essence manufacturers on advice from the Ministry of Health, and is now recommended by the Food Standards Committee to be prohibited by Regulation. A large part of one of the consignments had apparently been delivered to some premises in the Midlands while the rather difficult analysis was being completed and the Health Authorities there were accordingly informed. The presence and proportion of coumarin was confirmed by the analysts concerned on samples of the Vanilla Extract taken from the premises, but the consignment was released, subject to relabelling, on the grounds that there was no evidence that its use would be harmful. This action seems to be founded on the view that any chemical, provided it is not specifically prohibited by Regulation, may be added to food unless it can be proved in a Court of Law that the food is thereby rendered injurious to health." 24 PHARMACY AND POISONS ACT, 1933 This Act provides for registration by the Local Authority of persons not already registered in respect of poisons in Part I of the Poisons List who desire to sell poisons included in Part II. Part I of the Poisons List includes the more dangerous poisons such as strychnine — which may be sold only by Pharmacists registered by the Pharmaceutical Society of Great Britain, whereas Part II includes the less dangerous poisons such as phenols, hair dyes, etc. 60 firms were registered under this Act, 55 of which were re-registrations. Two infringements were noted. 51 inspections were made in connection with the administration of the Act. PHARMACY AND MEDICINES ACT, 1941 This act has continued to have the attention of the Inspector. It aims to protect tne public from misleading claims by advertisements or by labels on medicine bottles. 21 inspections were made and no contraventions came under the notice of the Inspector. FERTILISERS AND FEEDING STUFFS ACT, 1926 This Act requires sellers of certain specified fertilisers and feeding stuffs for cattle or poultry to furnish purchasers with a statutory statement indicating the name under which the article is sold and the amount, if any, of certain scheduled ingredients. 20 inspections were made. No contraventions were noted. ITINERANT FOOD VENDORS Constant inspections of barrows and of itinerant food vendors have been maintained and no difficulty has been experienced in connection with this class of trade. AGRICULTURE PRODUCE (GRADING & MARKING) ACTS, 1928-1931 Regulations madeunder these Acts prescribe designations referred to as "Grade designations" indicating the quality of certain articles of agricultural or fishery produce. Such regulations contain definitions of the quality indicated by every "grade designation" thereby prescribed and specify a "grade designation mark" to represent each "grade designation". The Acts also stipulate that all "preserved" eggs shall be so marked before being offered for sale and that all premises used for the cold storage of chemical storage of eggs shall be registered with the local authority. There are no firms so registered in the City of London. No difficulty was experienced in the administration of these Acts. MERCHANDISE MARKS ACT, 1926 This Act prohibits the importation of certain foodstuffs unless they bear marks indicating the "country of origin" or whether they are of "Foreign" or "Empire" origin. No difficulty has been experienced in the administration of this Act. FISH INSPECTION Inspection of fish in the City of London is carried out by officers of the Worshipful the Fishmongers' Company. The Fishmeters returns indicated as follows:— Deliveries at or near Billingsgate Market (including shell fish) Weight of Fish Condemned Condemnation Rate 88,136 tons 265 tons 0.30% 25 MEAT AND FOOD INSPECTION - SMITIIFIELD MARKET During the year, 1965, 338,982 tons of meat, poultry, etc., were delivered into Smithfield Market, a decrease of 15,106 tons compared with 1964. This was mainly due to a shortage in Yugoslavian beef, a better market being found elsewhere. The new Meat Regulations which came into force on 1st October, 1963, have been extended and come fully into operation on 1st October, 1966, this extension was due to there not being sufficient meat inspectors to cover 100% inspection in the country. In last year's report, it was emphasised that the use of rubber stamps on meat was not suitable, due to moisture the markings became illegible. It will be noted that of the 1,440 diseased items which were stamped by local authorities 35% of the stamped markings were illegible, and out of a total of 1,760 diseased items 18% were not stamped by local authorities. 530 licensed porters of the Market were notified of the City Corporation's offer to give antetetanus injections. 57 porters took advantage of this offer. In July Mr. W.R. Lee was invited to give a lecture on poultry diseases to the Public Health Inspectors, South Western Centre Week End School, Exeter, Devon. 80 attended. In October Messrs. W.R. Lee and K.S. Seymour were invited to give a similar lecture to the North Eastern Centre, held at Bradford when 175 attended. 26 27 Table showing the amount of meat surrendered to or seized by Meat Inspectors in the City of London for DISEASED Condition, 1965. Country January lbs February lbs March lbs April lbs May lbs June lbs July lbs August lbs September lbs October lbs November lbs December lbs TOTAL 1965 lbs TOTAL 1964 lbs Argentine 143 539 32 31 288 17 129 31 68 268 158 1,704 2,161 Australia 29 66 11 106 59 Eire 83 224 90 202 240 197 526 1,134 806 1,077 1,438 6,017 1,321 France 203 Great Britain 10,423 12,299 15,230 7,981 8,346 9,977 11,262 9,309 12,135 9,474 8,988 15,559 130,983 171,836 Holland 14 41 34 89 New Zealand 6 15 27 12 13 34 11 44 7 22 25 216 1,055 Rhodesia 76 144 111 56 194 39 99 39 758 742 S. Africa 25 25 65 Sweden 54 10 50 114 219 Uruguay 26 Yugoslavia 103 7 110 304 1965 10,738 12,614 15,900 8,406 8,785 10,458 11,543 10,202 13,346 10,469 10,406 17,255 140,122 - 1964 16,691 14,972 12,379 18,840 12,397 12,280 14,343 10,477 17,672 17,091 15,666 15,183 - 177,991 28 Table showing the amount of meat surrendered to or seized by Meat Inspectors in the City of London for UNSOUND condition, 1965. January lbs. February lbs. March lbs. April lbs. May lbs. June lbs. July lbs. August lbs. September lbs. October lbs. November lbs. December lbs. TOTAL 1965 lbs. TOTAL 1964 lbs. Argentine 5,357 16,130 24,848 38,912 10,792 6,488 3,721 19,215 26,036 7,520 3,811 20,097 182,927 250,122 Australia 416 28 207 15 121 60 10,349 192 137 612 160 12,297 2,925 Bechuanaland 220 20 240 Brazil 22 22 83 Canada 11 11 270 292 Chile 9 Denmark 93 14 15 15 15 152 274 Eire 334 170 211 625 549 750 4,634 676 692 623 388 1,214 10,866 5,892 France 32 32 8,542 Great Britain 10,652 6,421 8,891 10,359 16,637 19,248 22,966 21,906 23,893 21,623 9,189 10,955 182,739 216,022 Holland 26 30 55 175 400 585 520 141 718 44 2,694 2,957 Hungary 54 54 New Zealand 376 523 3,316 4,039 65 1,440 978 10,924 15,388 14,831 13,440 1,593 66,913 6,971 Poland 62 2,327 211 903 7,651 2,908 365 198 176 84 791 15,676 623 Rhodesia 14 83 288 157 237 66 22 139 62 165 311 238 1,782 2,229 S. Africa 175 Sweden 136 136 156 Uruguay 5,553 4,172 814 56 286 1,173 37 16 12 12,119 33,700 Various 340 340 Yugoslavia 2,155 450 1,044 379 19,024 64,752 20,09??? 75 2,973 384 62 111,389 297,449 1965 25,087 28,299 41,162 55,577 48,559 101,206 66,539 55,086 69,646 46,478 27,906 35,125 600,670 - 1964 39,865 46,238 24,837 37,905 61,871 110,467 162,994 153,185 119,494 34,223 22,226 14,824 828,129 29 Table showing the amount of various food products (EXCLUDING MEAT) surrendered to or seized by Meat Inspectors in the City of London for UNSOUND condition, 1965 Commodity January lbs February lbs March lbs April lbs May Ins June lbs July lbs August lbs September lbs October lbs November lbs December lbs TOTAL 1965 lbs TOTAL 1964 lbs Tinned Meat 1,038 524 1,356 1,555 1,194 1,162 935 1,122 3,690 1,209 . 2,990 1,482 18,257 11,572 Other Tinned Goods 3,084 1,437 515 468 581 2,244 819 1,070 384 1,078 1,574 2,593 15,847 14,333 Poultry & Feathered Game 9,801 7,975 6.079 4,355 13,589 8,993 23,889 14,511 20,340 8,019 8,090 25,806 151,447 119,940 Rabbits and Hares 238 490 758 574 202 354 2,008 95 193 1,171 156 340 6,579 4,286 Offal 8,063 5,691 12,616 5,514 9,280 14,366 11,490 14,619 14,345 17,202 10,283 7,618 131,087 146,994 Butter 7 Cheese 24 24 48 Frozen Foods (Various) 507 2,488 1,250 4,245 626 Horse Meat 49 49 Fish 207 1965 22,731 18,629 21,324 12,466 24,846 27,119 39,141 31,441 38,952 28,728 23,093 39,089 327,559 - 1964 23,311 19,843 12,042 13,222 19,246 20,933 39,214 29,680 36,895 23,863 24,088 35,628 - 297,965 30 Total number of items stamped and passed by local authorities but condemned for diseased condition on arrival at Smithfield Market. Total number of items NOT stamped by local authorities but condemned for diseased condition on arrival at Smithfield Market. MEAT INSPECTION REGULATIONS 1963 (MARKING OF MEAT) Beef Mutton Pork Veal Bodies Qrs. Pes. Car Pes. Car. Pes. Car. Pes. V. N v. N. V. N. V. N. V. N. V. N. V. N. V. N. V. N. 3 1 1 1 113 2 28 5 136 34 290 736 87 1 2 2 128 5 1 33 8 49 72 22 2 5 1 1 1 241 2 33 6 169 42 339 808 109 2 1 2 1 1 . 1 1 84 2 12 3 35 12 72 226 46 1 1 1 Number of items included in above table on which local authority stamp was illegible. Key to leadings Qrs. = Quarters Pes. = Pieces Car. = Carcases V. =. Visible (i.e. Diseased condition could have been visibly detected at time of slaughter.) N. = Not visible (i.e. Diseased condition could not have been detected until mert was cut into smaller portions./ United Kingdom meat pitched at Smithfield Market 1964 137,742 tons 1965 130,432 tons United Kingdom meat condemned for diseased condition at Smithfield Market 79 ton 11 cwt. 3qr. 4 lb. =0.06% 61 ton 17 cwt. 0 qr. 18 lb. =0.05% MEAT INSPECTION Tons Cwts. Qrs. Lbs. Meat etc., delivered at Smithfield Market 338,982 - - - Meat etc., surrendered to Inspectors at Smithfield Market 457 7 1 20 Meat etc., surrendered to Inspectors at Leadenhall Market & City Shops 9 2 3 7 Meat etc., surrendered to Inspectors at Cold Stores 10 8 2 12 Number of Eggs (Various) surrendered 1,608 Number of Exportation Certificates issued 38 Number of demonstrations and lectures given 127 Number of attendances by students 1,297 Number of samples sent for bacteriological examination 37 Number of samples sent for pathological examination 2 Number of samples taken for Government Chemist investigation 99 FOOD INSPECTION Foodstuffs, in addition to meat, condemned as unfit for human consumption as a result of the inspection of food landed at Riverside Wharves and in grocers shops, cafes, restaurants, etc., amounted to 94 tons 18 cwts. 3 qrs. 24 lbs. which was disposed of as follows:— Tons Cwts. Qrs. . Lbs. Released for Manufacture 7 3 0 8 Disposed of to Contractors 9 10 3 25 Destroyed 60 17 2 11 Re-exported 17 7 1 8 8 cwts. 2 qrs. 0 lbs. of food were placed under stop and subsequently dealt with under supervision of other local authorities. FOOD HYGIENE (General) REGULATIONS, 1960 and 1962. Transport and Handling of Meat at Smithfield Market. The stalls in Smithfield Market have been maintained to a good standard of cleanliness. Any defects have been remedied, and necessary repairs have been carried out promptly. Defective equipment has been replaced immediately. The carrier company vans have been maintained to a good standard of cleanliness. Private butchers vans have been well maintained but the standard of cleanliness of vehicles used by some cafe and restaurant proprietors is still below standard. The second floor of the new Fish, Fruit and Vegetable market, which was opened during the year, has been devoted entirely to the parking of barrows used by the market porters. This area is served by a battery of four lifts and features an automatic truck washing machine. This section will accommodate approximately 1,000 market workers each with a personal heated locker. There is changing, toilet and washing accommodation equipped with shower baths and electric shaving points. This is under the direction of the Market Superintendent and his staff. During the year 477 infringements were noted and suitable warnings were given including 261 in writing as listed below. Successful legal proceedings were taken against 3 persons for smoking whilst handling food and against 4 persons for not wearing protective clothing whilst carrying meat Infringements Warning Letters Prosecutions 75 in connection with clothing 64 3 21 in connection with containers 13 — 58 in connection with hats 52 1 43 in connection with meat contamination 25 — 105 in regard to premises and equipment 8 — 46 were incidents of smoking whilst handling food. 43 3 51 regarding trucks 5 — 77 regarding vans and cars 51 — 1 in respect of a wound dressing which was not waterproof — — 31 The seven prosecutions resulted in the defendants being fined a total of £63 and they were ordered to pay a total of 16 guineas costs. There are estimated to be some 7,000 persons using Smithfield Market daily, which figure includes:— approximately 600 porters licensed by the Superintendent of the Market, including some 120 freelance porters popularly known as "bummarees". some 200 pitchers who arrive at the Market with the various meat vans, unload the vehicles and leave the Market again on the vans. tenants' staffs, buyers and their staffs. there are 357 stalls on the Market occupied by approximately 110 tenants. NATIONAL HEALTH SERVICE ACT, 1946. PART III. NOTIFICATION OF BIRTHS, PUBLIC HEALTH ACT, 1936 and PUBLIC HEALTH (Notification of Births) ACT, 1965 Total number of births occurring in the City in 1965 was 684. The Notifications of births to women resident in the City in 1965 were as follows:— Domiciliary Hospitals & Nursing Homes Total Live Births 1 17 18 Still Births Nil 2 2 NATIONAL HEALTH SERVICE ACT, 1946. SECTION 22 CARE OF MOTHERS AND YOUNG CHILDREN Centres & Clinics During the period from 1. 4. 65 the Metropolitan District Nursing Association provided a district nursing and domiciliary midwifery service to the City and the London Borough of Camden. Following information that the latter borough had made proposals to take over direct administration of the district nursing and midwifery services in that area, arrangements were made for the Association to continue to operate a service in the City only as from 1st October, 1965 with a Superintendent and 2 or 3 Nurse/Midwifes, the rest of the staff on the Association being transferred to Camden. The number of domiciliary confinements in the City is small, but provision has been made for ante and post natal clinic facilities to be available at Milton Court clinic. The Child Welfare Clinic is held twice weekly at St. Bartholomew's Hospital. The staff consists of a part-time clinic clerk who issues welfare foods and a health visitor who carries out health education, and conducts mothercraft classes and tests for phenylketonuria and early signs of deafness. Dr. A. White Franklin the Paediatrician of the hospital is Medical Officer. He reports that "despite absence of adequate playing space for them in the City, the children continue to look extremely well and to grow well. A high proportion attend for the full course of immunisation." It is hoped, in due course, to move this Clinic to the Milton Court premises although thanks must be extended to the Governors of St. Bartholomew's for the facilities available to the Corporation on behalf of City residents. During the nine months there were 543 attendances at the Clinic and of these 196 children were medically examined. An 'at risk' register is maintained of all children under 5 years of age who for any reason are considered to be 'at risk' and at the end of the year there were two names on it. Dental Services — See Dental Officers report. Day Nurseries There is no nursery or creche in the City where mothers can leave children whilst shopping or working. 32 Several enquiries were received during the period for places in day nurseries and arrangements were made with voluntary nurseries in adjacent boroughs for the children of working mothers to be placed and maintenance guaranteed by the Corporation. However in each case the mother withdrew having been able to make other arrangements for the child/children to be cared for by relatives. It is appropriate here to mention the Nurseries and Child Minders Regulations Act, 1948. During the period there were no enquiries for services or registration under this Act and very few are expected. However, advertisements were inserted in appropriate newspapers to draw the attention of persons to the requirements of the Act. Unmarried Mothers and their Children The care of such persons and their placement in homes is the responsibility of the Health and Welfare Officer in conjunction with voluntary moral welfare bodies. No cases were referred to the department up to 31st December, although Moral Welfare bodies dealt with 17 city worker cases. The Corporation would deal with any arising, either under the National Health Service Act 1946 or the National Assistance Act, 1948, whichever was more appropriate to the circumstances of the case. Fireguards Where necessary fireguards will be lent to necessitous families with children under 12 years of age and also to necessitous elderly, handicapped or blind persons. NATIONAL HEALTH SERVICE ACT 1946 SECTION 23 Midwives Service As mentioned previously the Metropolitan District Nursing Association provides these services in the City. Emergency services for night and weekend calls are organised on a rota basis but by cooperation with the Whittington Hospital patients only have one number to telephone. Living accommodation for staff is provided in Corporation property in the City's Golden Lane Estate where necessary. The authorities of the Inner and Middle Temples have requested the Corporation to provide midwifery services in their areas and this has been agreed. Under the London Government Act, 1963 the Temples, which administratively are within the City, are their own health and welfare authorities. At the end of the year no Order had been made regulating the provision of services in the Temples. During the nine months under review the Metropolitan District Nursing Association dealt with one domiciliary confinement and one early discharge of mother and baby from hospital. Midwives Act, 1951 The Corporation is the Supervising Authority for the City of London which includes St. Bartholomew's Hospital. 13 midwives notified their intention to practice. NATIONAL HEALTH SERVICE ACT 1946 SECTION 24 Health Visiting At 1st April one Health Visitor was transferred from the London County Council or re-transferred to the Corporation as she had, in fact, been employed by the Corporation prior to 1948. The Health and Welfare Officer is also a qualified Health Visitor and hence the service can proceed during holidays and ill-health but it is obvious that this is unsatisfactory in view of the other demands on the time of the Health and Welfare Officer and arrangements are tn hand for the appointment of a Health Visitor/Social Worker. This will enable more routine visiting of elderly persons to be undertaken and free the Health and Welfare Officer for more responsible tasks in connection with her varied duties. During this period the health visitor made 190 effective and 65 unsuccessful home visits. NATIONAL HEALTH SERVICE ACT 1946 SECTION 25 Home Nursing At present the home nursing service is undertaken by the Metropolitan District Nursing Association. It is proposed to continue this arrangement and to expand the work. The functions of the Home Nurse will be not only to carry out clinical treatments as instructed by the General 33 Practitioner but also to carry out simple physiotherapy, to instruct the patient and his relatives in the best method of nursing and feeding and in general to see that the most efficient methods are brought to bear so that the patient is made as mobile and as comfortable as possible and that the inevitable loneliness of the home-bound patient living alone is reduced to a minimum. Between 1st April and 31st December the number of nursing visits was as follows:— Total No. of nursing visits made 1,699 No. to persons between 5 and 64 392 No. to persons 65 and over 1,307 It is interesting to note that no visits were made to children under 5 years of age. The authorities of the Inner and Middle Temples have requested the Corporation to provide nursing services within their areas on an agency basis and this has been agreed. The number of persons requiring injections has fallen but the staff are spending more time with patients with long term illnesses. No. of visits for injections only 485 No. of visits for other treatments 1,214 No. of patients at 1st April 17 No. of new medical patients 20 No. of new surgical patients 4 No. of patients discharged 24 No. of patients at 31st December 17 The staff of the Metropolitan District Nursing Association attend a weekly session at the surgery of a firm of general practitioners who supply medical practitioner services to most of the City residents. It is difficult to foresee any expansion of this service to other General Practitioners in view of the large number of doctors on the periphery of the City but who have only a small number of residents who are on their books. Loan of home nursing equipment Small items of equipment are issued on loan by the City of London Branch of the British Red Cross Society whilst larger items of equipment such as wheelchairs, hoists and pulleys have been purchased and issued by the department. No charge is made for this service. NATIONAL HEALTH SERVICE ACT 1946 SECTION 26 Vaccination and Immunisation Vaccinations against smallpox, diphtheria, whooping cough, poliomyelitis, tetanus and tuberculosis continue in the child welfare clinics and schools. Diphtheria/Whooping Cough/Tetanus Immunisation The number of children immunised at the clinic at St. Bartholomew's Hospital was as follows Children bom in years 1965 1964 1963 1962 1961 1960 1958 1957 1950 Total No. of children known to have completed a full course of primary immunisition in the 63 - - - - - - - 9 Authorities area up to 31.12.65. Smallpox 250 trainee ambulance drivers for the Greater London Council training school in Bishopsgate were vaccinated by Corporation staff at clinic sessions. 13 children were vaccinated at the clinic at St. Bartholomew's and 33 adult travellers were vaccinated. T.A.B. 12 members of the staff received this treatment. 34 NATIONAL HEALTH SERVICE ACT 1946 SECTION 28 PREVENTION OF ILLNESS, CARE AND AFTERCARE Tuberculosis The City of London Chest Clinic is at St. Bartholomew's Hospital. The medical and nursing staff is supplied by the hospital, whilst the Corporation supplies the Tuberculosis Health Visitor. During the period under review the Tuberculosis Health Visitor made 31 effective and 9 unsuccessful visits. Mass Miniature Radiography Premises have been made available at Milton Court for a permanent Mass Miniature Radiography Unit of the North East Metropolitan Regional Hospital Board to be established. B.C.G. Vaccination B.C.G. Vaccination is carried out at the Chest Clinic except for school children who are seen at School. The City of London School, the City of London School for Girls, and Sir John Cass School were visited for this purpose and 134 children were tested and subsequently inoculated as necessary. It is hoped to extend the scope of this service to cover other schools in the City and also places of further education offering facilities to young adults. Hostels for Ambulant Tuberculous Men Three men were in such hostels at 31st December 1965 and maintenance was guaranteed by the Corporation. Care Committee There is no Care Committee in the City as a result of negligible demand. At the end of the year there were 48 persons on the T.B. Register, but 15 of these were from the Salvation Army Hostel, most of them not living there regularly and often not traceable after a short while. These men present a continual intractable problem and constant visiting and education is essential to avoid serious trouble at the hostel. Many of the men refuse treatment or discontinue it at a stage rendering themselves liable to become drug resistant. Meals for invalid and sick persons Arrangements have been made with the Luncheon Room Committee of the Corporation of London Staff Association for individual diet meals to be available for delivery by departmental transport. Further details' will be found in the section dealing with Welfare. Recuperative Holidays Three such holidays for adults were arranged during this period. Chiropody There is a growing and continuous demand for this service and a direct service was commenced on 19th July. The service is bedevilled by the current lack of chiropodists and the need to offer both domiciliary and clinic treatments on a sessional basis presents problems of its own although the Corporation provided new equipment and facilities at Milton Court. Figures for the period are as follows:— No. of domiciliary treatments by chiropodists on sessional basis 92 No. of clinic treatments by chiropodist on sessional basis 6 Pads for Incontinent Persons Full use is made of the general encouragement from the Ministry of Health to issue such pads where appropriate. No charge is made for this service which greatly helps not only the person being nursed or otherwise in need of them but also his family and those nursing him. Supplies of prophylactics etc. Yellow Fever Vaccine On 1st April the Corporation took over from the London County Council the provision of the supply of Yellow Fever vaccine to the designated Centre at Unilever House and also, as the Corporation is the Port Health Authority for London the supply of vaccine to the Shipping Federation at their King George V Dock Medical Centre. During the year this latter service was extended to include the Shipping Federation Centre at Tilbury Docks. During the nine months 3,978 doses of vaccine were issued. 2,654 persons were vaccinated. 35 Oral Poliomyelitis Vaccine In accordance with Ministry requirements, poliomyelitis vaccine was supplied to the Medical Department of Unilever Ltd., St. Bartholomew's Hospital, The Church Missionary Society and to medical practitioners within the City who requested it. 16 children received doses at the Child Welfare Clinic, 20 girls at the City of London Girls School completed the course, and in all some 2,700 doses were distributed. Tetanus Vaccine Through arrangements made with Professor Shooter at St. Bartholomew's Hospital and the Superintendent of Smithfield Market Tetanus Vaccine was offered to meat porters at Smithfield all of whom were though to be at special risk. The result was disappointing: No. of porters offered vaccine 530 No. of porters accepting offer 57 No. of persons completing full course 45 Venereal Disease Contact Tracing Arrangements have been made with the consultant venereologist at St. Bartholomew's Hospital Treatment Centre for the Health and Welfare Officer to act as intermediary in respect of contact tracing in other local authority areas and to help with any contact tracing in the City. A male public health inspector is also available if necessary. Health Education The fact that the daytime population of the City is so huge makes for a unique opportunity to offer health education to a vast variety of people. Regular supplies of Health Education material are sent to nearly two dozen interested bodies in the City and it is hoped to expand this steadily in addition to giving talks and showing films. Regular lectures are already given by the Health Visitor and the Health and Welfare Officer to students of the City Day College and nurses at London Hospital and it is intended to extend the service to other centres of education within the City. Family Planning Rent free premises are given to the Family Planning Association at Milton Court where one lunch time and one evening session were held each week for City workers and residents. Where appropriate the Corporation underwrites the cost of supplies and treatment for City residents referred on medical grounds. SECTION 28 NATIONAL HEALTH SERVICE ACT 1946 AND MENTAL HEALTH ACT 1959 The Medical Officer of Health for the London Borough of Tower Hamlets provides mental health services in the City on an Agency basis. In all, 25 persons were admitted to hospital under the provisions of the Act. Whenever necessary, mental welfare officers attend Courts at the Mansion House and at Guildhall, and assist with cases for whom a court order for hospital admission is being sought, and also with cases who are at court, for other purposes when the need for possible hospital admission under the'Act arises. Six patients have been seen at these courts. The assistance of a mental welfare officer was sought by the City Police on three occasions, to deal with mentally disordered persons who were found in public places, and a similar case was dealt with at the request of the British Railway police. Eight domiciliary visits were made at the request of the Medical Officer of Health, general practitioners and the police, with a view to possible compulsory action, or to assess a patient's mental state. Eleven patients in St. Bartholomew's Hospital who are residents of other areas have been attended, and arrangements made for transfer to hospitals more appropriite to their home address. Visits have been made by the Mental Welfare Officers to the Salvation Army Hostel in Middlesex Street, with a view to providing community care. It often happens that patients referred by hospitals and other agencies cannot be contacted, because they fail to arrive at the Hostel. At the end of the year five men were actually receiving community care, but they moved away before any constructive support could be achieved and all trace was lost. 36 Regarding community care for the mentally subnormal one young City resident attends a junior training centre, whilst she and another young person are visited regularly at home. At the end of the year three patients were being maintained in residential hostels at the Corporation's expense. NATIONAL HEALTH SERVICE ACT 1946 SECTION 29 Domestic Help Service On 1st April one part-time home help was transferred to the Corporation with a case load of 6 persons. The service was developed under the control of the Health and Welfare Officer until at 1st October 1965 it was handed over to the Superintendent of the Metropolitan District Nursing Association to organise. There was at that time one full-time and 8 part-time home helps servicing some 56 cases and this was the position at the end of the year. The service is given primarily to the elderly and physically handicapped but two mothers received help during the post natal period. PUBLIC HEALTH ACT 1936 SECTION 84 Laundry Service Arrangements have been made with the London Borough of Tower Hamlets whereby the soiled linen of incontinent persons can be laundered. Corporation transport is used to make a twice weekly collection and delivery. At the end of the year five persons were receiving the service. EDUCATION ACT, 1944 School Health Service and School Dental Service This is operated in conjunction with the Inner London Education Authority in so far as the one local education authority School in the City is concerned (Sir John Cass). During the year 1965 the following school medical inspections were carried out. Routine 202 children inspected Special 73 children inspected Re-inspections 156 children inspected Comprehensive health survey 539 children inspected Sessions at Dental Centres 44 New cases given appointments 151 New cases attended by appointment 40 On treatment cases given appointments 40 Emergency attendance 1 Total attendances 74 1st inspections carried out at school 277 1st inspections carried out at clinic 1 Percentage requiring treatment 46.8% Dental Officer - whole-time equivalent 0.1 Forms One of the problems associated with the take over of services on 1st April was the provision of all the necessary forms. Supplies of specimen forms sent by the London County Council had to be thoroughly investigated and reprinted as necessary by the Corporation's own printing department. The fact that on the appointed day all the forms were ready says much for the efficiency of that department. REPORT OF THE DENTAL OFFICER, CITY OF LONDON A Dental Officer and a dental surgery assistant were appointed for the first time by the Corporation as a result of its assumption of responsibility as the Local Health Authority for the City. Although the appointment was taken up in July it was not until October that treatment could commence due to several delays in completion of the installation of various supply services in the Public Services Building. Examination and treatment is required statutorily to be available for:- (a) Pupils at l.L.E.A. Schools. — Education Act 1944. (b) Children under school age, expectant mothers and mothers with a child under one year of age. — National Health Service Act 1946 Section 22. 37 In addition to the above, treatment is available for all those who wish to take advantage of the service and who are:— (1) Employees of the Corporation (2) Students at the City of London School, City of London School for Girls or the Guildhall School of Music and Drama. The latter treatment is provided under the National Health Service and this scheme is primarily intended to assist those who would otherwise have to spend long hours away from home and study in order to obtain dental attention. Three months is not a long time in which to assess the dental state of those examined, but even so, one factor emerged at once which gave cause for alarm and some despondency, this was the amount of dental decay, treated and untreated, in the teeth of five year olds attending school for the first time. The only redeeming feature was that a good proportion of the decayed teeth had been restored with fillings. What is the cause of this tremendous amount of tooth destruction in such young children? At first sight it was thought to be mostly due to the present day very high consumption of confectionery, ices and sweet drinks and of course a large proportion was, in fact, very possibly due to this cause. However the presence of a substantial incidence of cavities in the front deciduous, or first, teeth, gave the impression towards the end of the period under review that a considerable percentage of the decay seen might be due to the habit, in certain areas, of giving very small children concentrated orange juice and vitamin syrups in dummy feeders, so that the teeth are exposed to a constant flow of concentrated syrupy liquids. The fact that this type and amount of decay in five year olds is not seen in all sectors of the community lends support to this impression. The incidence of dental caries is far too high to accept with any degree of equanimity, and measures to combat this must be seriously considered, and if possible implemented. These are:— (a) A reduction in the consumption of sweets and sticky carbohydrates between meals; human nature and mass-media advertising being what they are, this is a long uphill task. (b) An increased use of detergent foods to combat the effects of sweets etc. (c) An improvement in oral hygiene by means of tooth brushing and rinsing. All these can only be achieved by dental health education and although a good start has been made in this field, much more remains to be done. From the experience of some millions of people in other parts of the world - in some cases for up to twenty years, it is apparent that the situation could be much improved by adjustment of the fluoride content of drinking water to the ideal level. This appears to make the enamel of the growing teeth much more resistant to decay, a resistance which remains in some degree throughout life. On this account the Dental Officer hopes that children will not much longer be denied the benefits of fluoridation which could relieve them of so much pain and disfigurement. Adults. Again the period under review is too short to allow one to draw any conclusions, except perhaps to say that while there appears to be no considerable reduction in the amount of decay, the awareness of the need to have teeth restored and replaced by means of filling and other techniques has improved enormously as compared with 1939 and again with 1948. This indicates that the large amount of money and dental man-hours spent since the commencement of the National Health Service are showing some results. These results are an indication only of the colossal amount of treatment required to repair the ravages of dental decay. When the same amount of time, money and energy, or even a small part of it, are spent on prevention we shall certainly see a reduction in dental disease. WELFARE SERVICES NATIONAL ASSISTANCE ACT 1948 PART III. Section 21 (i) (a) This section relates to the provision of Residential Accommodation for persons who by reason of age, infirmity or other circumstances are in need of care and attention which is not otherwise available to them. In making such provision, the Act specifically precludes the Corporation from providing health services which are specialist services or services of a kind normally provided only on admission to a hospital. The Corporation has 15 beds at 'Hillside' 129 St. Johns Way, N.19. on a 'sharing' basis with other boroughs; the owning borough is the London Borough of Islington. Use is also made of beds in homes managed by voluntary societies. The questionnaire and follow up work by the Health and Welfare Officer has, however, shown that this provision is likely to be inadequate, and, in any case, 'Hillside' is scheduled for run down and closure in 1973 the allocation of beds to the City reducing annually until that time. The Corporation has under consideration its own arrangements to provide residential accommodation for its own people. 38 One of the associated problems is the fact that there is a Salvation Array Hostel in the City from which many applications are received from residents for admission to residential accommodation under Part IIII of the Act. Many of the men have inadequate personalities and would not easily fit into the normal small home whereas a large home, such as 'Hillside' can absorb a high proportion of them without undue interference with the other residents. Consideration is being given to the provision of accommodation solely for such men. It is realised that not all of the residents of the Hostel come into this category and arrangements have been made for admittance to voluntary homes more suited to the needs of these other residents. At 31st December, 1965 the position was as follows: Males Females Persons in 'Hillside' 5 8 Persons in voluntary homes 7 4 Section 21 (i) (b) Temporary accommodation for Homeless Families The need continues for the Corporation to have available temporary accommodation for homeless persons. There have been no cases of families in need 'arising in circumstances which could not reasonably have been foreseen' which is what the Act requires to be covered. Temporary accommodation is provided under agency arrangements with the London Borough of Hackney at Morning Lane Reception Centre and Lambert Road Hostel. During the 9 months the following cases were dealt with:— 6 Families (totalling 19 persons) 3 other persons Total: 22 persons (12 of whom were children). Of the six families mentioned above only one was accepted as a City case and subsequently rehoused. This was a family returned from abroad. Five of the six families referred to were housed at Morning Lane or Lambert Road whilst enquiries were made of them. Apart from the family accepted all others were found to be the responsibility of other welfare authorities and arrangements made to return them to their home area. Each local authority to whose area they were returned was notified of the circumstances. There are four large rail termini in the City at which cases will always arise, apart from those occurring where the boundary of an adjoining borough is not clearly defined. In addition vagrants present a further problem but these are normally referred to the appropriate hostels or the National Assistance Board Reception Centre in Camberwell. Temporary Accommodation for Persons arising from a Peace-time Emergency At the 'changeover' Southern Grove Lodge was designated for use by the City for this purpose but it is realised that this is not feasible and alternative arrangements are in hand. WELFARE SERVICES FOR THE HANDICAPPED SECTIONS 29 AND 30. NATIONAL ASSISTANCE ACT, 1948 At the 1st April there were three physically handicapped, five blind and one partially sighted persons on the register. Following follow up visits as a result of replies to the questionnaire sent to all residents and normal visiting services there were 102 persons on the register at the end of the year. This illustrates the advantage of a more personal service possible in a small area and the problems which the London County Council must have faced in trying to cover the whole of what is now the Inner London area. Home visiting of the blind and partially sighted is covered by agency arrangements with Tower Hamlets Welfare Department but cases are known to the Health and Welfare Officer and, where appropriate, they are also visited. In April, 1965 there were four registered blind persons and no registered partially sighted persons in the City of London. Periodic visits have been made to all these blind people and services which are especially applicable to them, for example, pastimes, clubs and summer holidays for the blind, have been discussed with them to see if they were interested in these schemes. 39 All registered blind persons are entitled to certain concessions; these include a special bus pass entitling the blind person and guide to travel on (red) London buses for one fare only, a free wireless set which, in this area, is supplied by the Metropolitan Society for Blind, and a wireless licence exemption certificate, supplied by the Corporation, entitling a blind person to obtain a free wireless licence from the post office. A blind person may, subject to income, be entitled to a supplementary blind pension payable through the National Assistance Board. Other schemes exist for younger people to enable them to undertake social and industrial rehabilitation and training for further employment, but at the moment there are no registered blind persons in the City to whom this applies. Four applications were completed for blind or partially sighted registration and three people were subsequently examined by the ophthalmologist but none was registered. The purpose of registration is to allow a person with sight difficulties to have the welfare services available under the National Assistance Act, 1948 (Section 29), if he so requires. The number of persons on the general register at the end of the year can be analysed as follows;— 16 16-61 65 & over Total Males Nil 10 20 30 Females Nil 10 62 72 The primary work of assessing and sorting cases to determine need and which specialist services need to be brought into use is the responsibility of the Health and Welfare Officer but a Health Visitor/Social Worker will be appointed to take over most of the follow up work. Arrangements have been made for elderly and handicapped persons to be taken to the 'Mermaid theatre where places were made available to them by kind permission of Mr. Bernard Miles and use is also made of the Social Club at St. Matthew's Hospital. Holidays for the Physically Handicapped The finding of places in holiday homes for such persons is undertaken by the Health and Welfare Officer. In practice such cases as have arisen have been found to be more suitably dealt with as 'recuperative holidays' on medical recommendation but it is realised that this will not always be so and use will be made of the provisions of the Scheme for services for the Physically Handicapped should the need arise. Sheltered Employment for the 'Handicapped and Elderly'. There is very little demand for this at present but further follow up visits to the elderly and handicapped may reveal a need in which case use will be made of the provisions of the various Handicapped Persons Schemes and arrangements made with other authorities or voluntary bodies. Eventually it is proposed to provide accommodation suitable for this purpose in a new Health Centre. Day Centres and Clubs The City of London Old Peoples Welfare Association provide club facilities for elderly residents of the Corporation's Middlesex Street Estate but it is difficult for other elderly City residents to reach and make use of the facilities which are intended primarily for use of Corporation tenants and provided under the Housing Acts. Section 31 Meals-on-Wheels Service As from July 1965 this service has operated from the Guildhall Office with individual diet meals served by arrangement with the Staff Association Luncheon Room Committee to whom thanks are due. From its inception until the end of the year 312 meals were served. Bank Holidays and weekends remain a problem in that no meals can be served but in the former case this is to a certain extent overcome by the provision of cans of soup which the individual can heat and serve. The possibility of frozen cooked meals which only need reheating is being looked into. Where appropriate arrangements have been made for people to receive meals from the Kosher Meals-on-Wheels Service. 40 VITAL STATISTICS - BIRTHS In press reports on the high illegitimate birth rates in 1965 in certain London Boroughs and the methods being undertaken to overcome this by way of health education and family planning advice, it was said that the authority with the highest rate was the City with 21.8% and the statistics produced by the Registrar General on form S.D. 52 supported this statement. As examined superficially, this was a disturbing state of affairs. It was decided to check the Registrar General's figures against records in the Health Department. Table 'A' sets out the position as it appeared at the time. TABLE 'A' Live Births Males Legitimate Illegitimate Totals Registrar General's figures as on S.D. 52 14 4 18 Corporation figures from departmental records 14 1 15 Live Births Females Legitimate Illegitimate Totals Registrar General's figures as on S.D. 52 11 3 14 Corporation figures from departmental records 7 3 10 Totals All Births Illegitimate Births Registrar General's figure 32 7 Corporation figure 25 4 Illegitimate births as percentage of total births Registrar General's figure 21.8% Corporation figure 16.0% Enquiries were made of the Registrar General's office as to the apparent discrepancy and information received from there gave detailed information in respect of 29 children (against a departmental figure of 25) and these are shown in Table 'B' TABLE 'B' Males Legitimate Illegitimate Totals 14 1 15 Females Legitimate Illegitimate Total 9 3 12 Grand Total:— 27 (plus 2 illegitimate births assigned on confidential information and for which no further information was given.) The remaining three births were presumed to relate to registrations outside the London area and could not be traced in the time and with the facilities available. Table 'C' sets this out. TABLE 'C' Revised Figures — Live Births Males Totals Legitimate Illegitimate Registrar General's figures accompanied by addresses. 14 1 15 Births assigned on confidential information – 2 2 Births presumed to relate to registrations outside London area – 1 1 Totals 14 4 18* 41 Females Legitimate Illegitimate Totals Registrar General's figures accompanied by addresses. 9 3 12 Births assigned on confidential information – – – Births presumed to relate to registrations outside London area 2 — 2 Totals 11 3 14 * * These figures accord with the form S.D. 52. It would appear from the information disclosed that the illegitimate live births were not all to genuine City residents but included three to women who gave City addresses as their home addresses but which were, in fact, accommodation addresses. The Illegitimate Birth Rate for the City is, therefore, 12Vi%. The one illegitimate birth of the three untraced cases is presumed to be similar, but as the birth notification cards were not received from the areas in which babies were born, it is not possible to be sure on this point. I am grateful to the Registrar General for the time and effort spent by his staff in helping this investigation. Whilst it is recognised that women giving birth to illegitimate children should be protected by anonymity, it must be appreciated that this may give a grossly distorted borough figure, especially where the number of births is small. MASS RADIOGRAPHY The close liaison between the staffs of the Mass Miniature Radiography Unit and the Corporation has continued and I am grateful to Dr. W.D.R. Thompson, Medical Director of the Unit for the following report:— Introduction 1965 was an eventful year for this Unit. After several postponements it commenced operations on 23rd July in the accommodation provided, without charge, by the Corporation of London in its new Public Services Building, Milton Court, Milton Street, E.C.2. About two months previously the Unit had to vacate the Golden Lane premises as these were being demolished in connection with the Barbican Development scheme. Fortunately temporary accommodation was found on the premises of "The Observer" in Tudor Street when the opportunity was taken of examining over one hundred firms in the Fleet Street area. We are most grateful to the Directors of "The Observer" for offering us this accommodation. During 1965 the Unit was more static than usual for besides "The Observer" Survey the only firm visited was British Petroleum Company. Unit Results During 1965 the Unit examined 39,273 males and 22,926 females, making a total of 62,199. This somewhat lower total came about partly from "teething troubles" arising from the move into the Public Services Building, and partly to the Unit's deliberate concentration upon small firms. Up to the end of 1965 the Unit has examined 576,712 males and 377,483 females — making a grand total of 954,195 since it commenced operations in May 1950. Fifty-three cases (38 male and 15 female) with significant tuberculous lesions have been discovered which gives an overall rate of .852 per 1,000 examinees. The rate of significant cases for men was .968 and for women it was .654. This denotes about fifty per cent increase in the male incident and 21.8% increase in females. Twenty cases of carcinoma of the lung (17 males and 3 females) were discovered during the year. Doctors' Referrals Doctors in our zone have been constantly advised of the services of the Unit. Doctors' referrals have produced an incidence rate of 6.622 per 1,000 examinees. It must be borne in mind 42 that the vast majority of volunteers attending our Unit come from places far beyond the London area, e.g., Margate, Ipswich, Weybridge, Amersham, Reading, Bedford, Eastbourne, Southampton, Bletchley and Worthing, and are registered with doctors in their town of residence. The doctors would automatically refer their patients to the Mass Radiography Units and Chest Clinics in their area. This would account for the small number of Doctors' referrals examined by our Unit. Medical Procedure Abnormal cases have been first referred to the examinee's doctor for subsequent attention by the appropriate Chest Clinic. Eight cases with a positive sputum have been reported of which four were male and four female. Cases not within the scope of a Chest Clinic have been referred to St. Bartholomew's Hospital. The willing co-operation shown by Dr. Neville C. Oswald and Dr. Graham Hayward is gratefully acknowledged. WELL-WOMEN'S CLINIC This clinic, set up with City Corporation funds in 1958, is now well established, and it is a source of justifiable satisfaction that, at a time when the Ministry of Health is recommending Local Health Authorities and Hospital Boards to take action, the Corporation of London and St. Bartholomew's Hospital can claim eight years of first class work in this important field. The following report has been received from the hospital on the work of the clinic during 1965:- "During the year 582 patients were seen and it is encouraging that we now see a wider range of social groups. As you know, when the clinic began there was a particular demand by professional women particularly journalists and school teachers for cervical screening. During 1965 there has been a much larger demand from patients with large families, many of whom are working in clerical or domestic jobs in the City. Three patients were detected with a carcinoma of the cervix in its p'e-invasive stage and these were treated by total obdominal hysterectomy. As in previous years we have found quite a large number of other non-malignant gynaecological abnormalities, for example there were fifteen patients with trichomonas vaginitis. Eighteen patients had uterine myomata and in three hysterectomy was performed. Three other patients had a benign ovarian tumour which was removed. Nine patients were admitted for removal of cervical polypi and it was of interest to note that two patients were found to have a double uterus although they did not require treatment." CORPORATION STAFF Mass Miniature Radiography A permanent Mass Radiography Unit is operated by the North East Metropolitan Regional Hospital Board in premises in the City which are owned by the Corporation. Members of the Staff are encouraged to take voluntary advantage of the facilities provided thus for biennial X-ray of the chest. For obvious reasons no attempt is made to compile official statistics but it is known that a large percentage of Corporation employees take advantage of this opportunity for a regular "check-up". Medical Emergencies The arrangement which has been made with a firm of medical practitioners in the City to be on call for emergencies at Guildhall was implemented on five occasions during the year. This emergency service was instituted because the Medical Officer of Health from the nature of his duties may often be unavailable to answer urgent calls. Ophthalmic Optician Service Since the beginning of March, 1959, a firm of Ophthalmic Opticians have been operating an eye testing service for members of the staff. A weekly session is held in the Medical suite of the Guildhall Office Block. This service is operated under the National Health Service, and examinations are free although charges are made for the dispensing of prescriptions. 43 During the year 126 members of the staff had their eyes tested, 34 of these had not previously had an eye test under the National Health Service, and 26 were found to have visual defects which required correction and were supplied with spectacles. 92 had been examined previously and were already using spectacles. Of these 74 needed further correction and appropriate lenses were fitted to existing frames or to new frames of the patient's choice. Medical Examinations During the year 664 persons were medically examined. The distribution by Departments and the reason for medical examinations are shown in Table 3. 414 persons were medically examined for admission to the Superannuation Scheme; 14 were rejected as unfit and 5 were deferred. The clinical conditions causing rejection are shown in Table 1. 40 persons were medically examined owing to prolonged absence on sick leave. At the time of examination, 19 were reported as fit for duty, 14 were reported unfit for duty, and 7 were reported unfit for further service. The clinical conditions causing unfitness are shown in Table 2. 85 persons who had reached retirement age were medically examined and 83 were reported as fit to continue in the Corporation's service for a further 12 months. 20 persons were medically examined for temporary appointments 5 were examined to verify the nature of a disability and 6 medical examinations were carried out in respect of employees at the Monument. In addition 100 persons were examined in connection with applications for exemption from parking fees. 6 candidates for teaching and canteen posts were X-rayed and all were reported as showing no abnormality of the lungs. TABLE 1 Conditions excluding candidates from the Superannuation Scheme Disease Males Females Addison's Disease 1 Albuminuria 1 — Arthritis, severe 1 — Bronchitis 1 — Defective vision 1 — Hypertension 4 1 Kidney Disease 1 — Meniere's Disease 1 — Mentally unstable 1 — Paralysis 1 — Totals 13 1 TABLE 2 Conditions leading to Premature Retirement Arteriosclerotic dementia 1 Bronchitis and emphysema 1 — Bronchitis and valvular disease of the heart 1 — Cerebral thrombosis 1 — Mental Depression, severe 1 — Polyneuritis 1 — Post operative disability of both feet 1 — Totals 7 - 44 TABLE 3 MEDICAL EXAMINATIONS DEPARTMENT ADMISSION TO SUPERANNUATION SCHEME REFERRED FOR EXCESSIVE SICK ABSENTEEISM OR RETIREMENT OVER 65 YEARS OF AGE Fit Unfit Deferred TOTAL Fit for Duty Still Unfit Unfit for further service TOTAL Fit Unfit TOTAL SPECIAL M F M F M F M F M F M F M F M F M F M F M F M F Architect 29 16 29 16 2 1 3 3 3 " (works) 3 3 Accountant Auditor 2 2 Billingsgate Market 4 4 Cemetery 10 4 1 11 4 3 1 3 l Central Criminal 13 2 13 2 3 3 Court Chamberlain 5 2 5 2 1 1 Cleansing 4 4 3 7 1 1 11 1 16 13 2 18 13 1 Comptroller & City Solicitor 5 5 2 7 5 1 Engineer 6 1 1 7 1 1 2 Epping Forest 5 5 1 1 1 Hallkeeper 3 3 1 1 2 6 1 6 1 Housing 19 11 2 21 11 1 1 6 2 6 4 5 Library 13 4 13 4 London Central 5 2 7 1 Market Medical Officer of Health 23 6 1 24 6 1 1 2 4 1 7 Police 25 56 3 1 1 1 29 58 2 2 6 3 6 3 1 Printing and Stationery 2 1 2 1 1 1 Rating & Rate Accounts 4 3 1 5 3 1 1 84 8 Records 1 1 Remembrancer 1 1 Schools — Boys 7 2 7 2 1 1 3 3 — Free mens 4 7 4 7 — Girls 3 3 — Music & Drama 6 9 1 — 1 7 10 Secondary 1 1 Spitalfields Market 12 12 Surveyor 14 1 14 1 2 1 2 1 1 Tower Bridge 5 5 3 3 6 4 4 Town Clerk 3 7 3 7 8 Weights & Measurers 3 3 1 1 West Ham Park & other open spaces 18 1 19 6 1 7 2 2 253 142 13 1 3 2 269 145 18 1 13 1 7 — 38 2 50 33 2 — 52 32 105 20 45 STATISTICAL INFORMATION Area - 678 acres (including the Temple and foreshore Population - Census 1961, 4,711. Estimated mid-year 1965, 4,600 Annual Rateable Value - As at 31st March, 1965, £44,270.901. Annual Sum received from Penny General Rate — £175,704 Live Births Number 32 Rate per 1,000 population 6.96 Illegitimate Live Births per cent of total live births 21.88 Stillbirths Number 4 Rate per 1,000 total live and still births 111,11 Total Live and Still Births 36 Infant Deaths (deaths under 1 year) 1 Infant Mortality Rates Total infant deaths per 1,000 total live births 31.25 Legitimate infant deaths per 1,000 legitimate live births Nil Illegitimate infant deaths per 1,000 illegitimate live births 142.86 Neo-natal Mortality Rate (deaths under 4 weeks per 1,000 total live births) 31.25 Early Neo-natal Mortality Rate (deaths under 1 week per 1,000 total live births) 31.25 Perinatal Mortality Rate (stillbirths and deaths under 1 week combined per 1,000 total live and still births) 138.88 Maternal Mortality (including abortion) Number of deaths Nil Rate per 1,000 total live and still births Nil Deaths, all ages 53 Death rate per 1,000 resident population 11.52 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1965 CAUSES OF DEATH NETT DEATHS AT THE SUBJOINED AGES OF "RESIDENTS" WHETHER OCCURRING WITHIN OR WITHOUT THE DISTRICT ALL AGES Under 4 weeks 4 weeks and under 1 year 1 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 35 years 35 and under 45 years 45 and under 55 years 55 and under 65 years 65 and under 75 years 7 5 and upwards 1 2 3 4 5 6 7 8 9 10 11 12 13 All Causes 53 1 _ _ - _ 4 9 22 6 11 1. Tuberculosis, respiratory M — — — — — — — — — — — - F — - - - - - - - - - - - 2. Tuberculosis, other forms M — — — — — — — — — — — — F — — — - - - - - - - — - 3. Syphilitic disease M — — — — — — — — — — - - F — — — — — — — — — — — — 4. Diphtheria M — - - - - - — - - - - - F — — — - — - - - — — — — 5. Whooping Cough M — — — — — - - — - - — - F — — — — — — — — — — — — 6. Meningococcal infections M _ — _ _ _ — — _ — — — F — — — — — — — — — — — — 7. Acute poliomyelitis M _ _ — — — — — — — — — F - — — — - - - - - - — - 8. Measles M — — — — — — — — — — — F - - - - - - - - - - - - 9. Other infective and parasitic disease M F — — — — — — — — — — — — 10. Malignant neoplasm-stomach M — — — — — — — — — — — — F — — — — — — — — — — — — 11. Malignant neoplasm-lung, Bronchus M 2 — — — 1 — 1 F 1 — — — — — — — — 1 — — 12. Malignant neoplasm-breast M — — — — — — - - - — - - F — — — — — — — — — — — — 13. Malignant neoplasm-uterus F 1 — — — — — — — 1 — - - 14. Other malignant and lymphatic neoplasms M 6 — 1 4 1 F 4 — — — — — — — — 4 — — 15. Leukaemia, aleukaemia M — — — — — — — — — — — — F — — — — — — — — — — — — 16. Diabetes M — — — — — — — — — — — — F — — — — — — — — — — — — 17. Vascular lesions of nervous system M 4 — — 1 1 — — 2 F 2 — — 1 1 — — 18. Coronary disease, angina M 11 — — — — — — 1 1 4 1 4 F 1 — — — — — - — — 1 — — 19. Hypertension with heart disease M — — — — _ __ F — — — — — — _ _ — — — 20. Other heart disease M 2 — — — — — — — 2 — — F — — — — — — — — — — - - 21. Other circulatory disease M 3 — — — — — — — - - 2 1 F 1 — — — — — — — — — — 1 22. Influenza M — — — _ — — — — F — — — — — — — — - — — - 23. Pneumonia M 3 — — — — — — — 1 1 — 1 F 1 — — — — — — — - - — 1 24. Bronchitis M 3 — — — - — — — 1 2 — — F — — — - - — - — — — — 25. Other diseases of respiratory system M — — — — — — — — — — — F — — - — - — - — — — — 26. Ulcer of Stomach and duodenum M — — — — — — - - - - - - F — — — — — — — — — — — 27. Gastritis, enteritis and diarrhoea M — — — — — — — — — — — — F — — — — — — - — - — - - 28. Nephritis and nephrosis M — — — — - — — — - - - F — — — — — — — — — — — — 29. Hyperplasia of prostate M — — — — — F — — — — — - - - - - - - 30. Pregnancy, childbirth, abortion F - - - - - - - - - - - 31. Congenital malformations M — — — — — — — — — — — F — — — — — — - — — — — - 32. Other defined and ill-defined diseases M 1 — — — — — — — 1 — — F 4 1 - - - — - 1 1 — 1 33. Motor Vehicle Accidents M - - - - - - — - - - - — F — — — — — — — — — — — — 34. All other accidents M 2 — — — — — — 1 — 1 - - F 1 — — — — — — — — — 1 — 35. Suicide M — — — — — — — - - - - - F — — — — — — — — — — — — 36. Homicide and operations of war M — - - - — - - - - - - - F — - — — — — — — — — — — TOTALS M 37 — — — — — 4 6 14 5 8 F 16 1 — — — — — — 3 8 1 3 47 INFECTIOUS DISEASE Notifications received:— Total cases notified Dysentery 5 Measles 16 Puerperal Pyrexia 4 Pulmonary Tuberculosis 7 Total 32 NEW LEGISLATION DURING THE YEAR The following enactments, which affect the work of the department, were made during the year:- Cheese Regulations 1965 Dried Milk Regulations 1965 Milk (Special Designations) (Amendment) Regulations 1965 Poisons List Order 1965 Poisons Rules 1965 Rag Flock and Other Filling Materials Regulations 1965 School Health Service Amending Regulations 1965 48