Lcn 96 REPORT OF THE MEDICAL OFFICER OF HEALTH ACKA.BY FOR THE CITY OF LONDON FOR THE YEAR 1970 p- To be presented, 23rd September, 1971. PORT AND CITY OF LONDON HEALTH COMMITTEE (as at 31 st December, 1970) Chairman Henry Duckworth, J.P., Deputy Late Chairman Christopher Selwyn Priestley Rawson, J.P. Aldermen The Rt. Hon. the Lord Mayor Lt.- Col. Sir Ian Frank Bowater, Kt., D.S.O., T.D., D.Sc. Alan Pearce Greenaway Robin Danvers Penrose Gillett, R.D. Lindsay Roberts Ring Commoners Anthony Wallinger Goodinge Ernest Gordon Duffett, T.D. Arthur Patrick Mills Samuel Sheppard, O.B.E. Reginald Hugh Willard Thomas Cuthbert Harrowing, Deputy Dudley Recknell Clack Arthur John Osborn Thomas Ernest Chester Barratt, C.B.E., M.A., LL.B., Deputy Lt.-Col. Charles George Surtees Shill Eric Frederick Wilkins, C.B.E., Deputy Sir Stanley Graham Row I and son, Kt. ,M.B.E.,J.P.,G.L.C. Matthew Henry Oram, T.D., M.A. Dennis Gordon Fisher William Ian Baverstock Brooks Leslie Joseph Walshaw Smith Alan Francis Gordon Stanham, Deputy Henry Wimburn Horlock, M.A. William Harold Wylie-Harris, Deputy Stanley Edward Cohen, C.B.E. Dr. J ames Cope William George Alfred Harries William Samuels, Deputy Percy John Dyter Cyril Edward Baylis David Ivor Evans, T.D., J.P., Deputy Ronald Arthur Ralph Hedderwick Herbert Twyneham Pike, Deputy Sir Thomas Kingsley Collett, Kt., C.B.E., Deputy Lady Donaldson, J .P. STAFF (As at 3 1 st December, 1970) Commenced Service MEDICAL OFFICER OF HEALTH (for the Port and City of London) PRINCIPAL SCHOOL MEDICAL OFFICER AND ACTING CHIEF WELFARE OFFICER (City of London) SWANN, William George, M.D., B.Ch., B.A.O., D.(Obst.), R.C.O.G., D.P.H., B.Sc., D.P.A., F.R.I .P.H.H. Jan. 1964 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. Mar. 1958 MEDICAL OFFICER (for the Port and City of London) DE THIERRY, Albert Edward Lewis, M.A., M.B., B.Chir., D.(Obst.)., R.C.O.G.. D.P.H. Mar. 1967 ASSISTANT MEDICAL OFFICERS STOTT, William, M.B., B.S., D.P.H., F.R.I.P.H.H., F.R.S.H. (Part-time) Aug. 1958 WHITE FRANKLIN, Alfred, M.A., M.B., B.Ch., F.R.C.P. (Child Health Clinic) (part-time) Apr. 1965 DENTAL OFFICER WALLACE, Lionel John, L.D.S., R.C.S. Jun. 1965 PUBLIC ANALYST Dr. H.A.WILLIAMS, Ph.D. (London), M.Chem.A., F.R.I.C., A.C.G.F.C., F.C.G.I., F.R.S.H. Jan. 1968 AGRICULTURAL ANALYST Dr. H.J. HAMENCE, O.B.E., Ph.D., A.C.G.F.C., F.R.I.C. Jul. 1969 DEPUTY AGRICULTURAL ANALYST P.S. HALL, B.Sc., M.Chem.A., F.R.I.C. Jul. 1969 ADMINISTRATIVE STAFF (Port and City of London) R.C. RATLIFF Chief Clerk Mar. 1930 E.V. SMITH Deputy Chief Clerk Oct. 1938 C.W.R. BETTS First Assistant Clerk Apr. 1926 F.B. OSBORN, A.M.R.S.H. Senior Assistant May 1952 R.H. COLLINS, M.R.I.P.H.H., L.M.R.S.H. Senior Assistant Jan. 1963 D.J. FLOOD Senior Assistant Mar. 1963 Mrs. D.M. SHEPHERD Senior Assistant Apr. 1965 S.C. DARLISON Senior Assistant Apr. 1963 D.M. HADDON Senior Assistant Nov 1968 Miss M.L. GURNEY First Class Assistant May 1939 R.G. HEMING First Class Assistant Aug, 1965 R.G. RUTTER First Class Assistant Jul. 1968 R.G. FARRELL First Class Assistant Jul. 1965 J.G. COX First Class Assistant Aug. 1970 Mrs. I.H. HAMBLIN General Grade Assistant Oct. 1957 Miss M.J. GOOLD General Grade Assistant Oct. 1969 Mrs. E.J .A. MORROW General Grade Assistant Mar. 1968 M.L. GORE General Grade Assistant Jun. 1970 Mrs. J.E. GRAHAM General Grade Assistant Jun. 1966 Miss L. MOWBRAY General Grade Assistant Nov. 1970 Miss B. LOVATT Shorthand Typist Nov. 1969 Miss L. SHARMA Shorthand Typist Jul. 1970 Mrs. V.S. POOLE Shorthand Typist Oct. 1970 Mrs. P. LAWSON Copy Typist Aug.1970 A.W. THREADGOLD Senior Asst. (Meat Inspectors' Office) Nov. 1923 E.J. PETERS Clerical Assr. (Meat Inspectors' Office.). Nov. 1935 J.E. CASH Clerical Asst. (Meat Inspectors' Office) Mar. 1954 J.T. HADLEY, A.M.R.S.H. Senior Asst. (Diseases of Animals Act) Jun. 1965 2 ADMINISTRATIVE STAFF (Port and City of London) (Contd.) Commenced Service Mrs. W.A.A. SCHOFIELD Clerical Asst. (Diseases of Animals Act) Aug. 1967 Mrs. J. LYONS Clinic Clerk (Part time) Apr. 1965 H.T. LLOYD Senior Messenger Nov. 1968 J.A. LAMBERT Messenger/Driver Nov. 1968 G.HAMMOND Messenger/Driver Mar. 1968 PUBLIC HEALTH INSPECTION STAFF E. THOMPSON, M.A.P.H.I. Chief Public Health Inspector Sep. 1948 M.J. FLYNN, M.A.P.H.I. Deputy Chief Public Health Inspector Jul. 1951 J.H. RILEY. M.A.P.H.I. Senior Public Health Inspector Aug. 1962 J.B. WELLDON. M.A.P.H.I., A.R.S.H. Senior Public Health Inspector Aug. 1962 H.L. SHEPLEY, M.A.P.H.I. Senior Public Health Inspector May 1964 J .A. HOARE, M.A.P.H.I. Senior Public Health Inspector May 1964 W.J. BAXENDALE Public Health Inspector Jan. 1964 D.F. CORFIELD Public Health Inspector Jun. 1964 D. HITCHCOCK, M.A.P.H.I., M.R.S.H. Public Health Inspector Nov. 1967 T.B. MEANEY, M.A.P.H.I., F.R.S.H. Public Health Inspector Mar. 1968 B.L. NUNN Public Health Inspector Apr. 1968 A.G. WILLIAMS, M.A.P.H.I, Public Health Inspector May 1968 G.L. PAGE, M.A.P.H.I., M.R.S.H. Public Health Inspector Jul. 1968 B.J. DAWSON Public Health Inspector Feb. 1969 M.C.J. ELKINGTON, M.A.P.H.I. Public Health Inspector Feb. 1969 P.G. FAIRBAIRN, M.A.P.H.I. Public Health Inspector Aug. 1969 D.T.W. FREEMAN Technical Assistant Mar. 1968 MEAT INSPECTION STAFF W.R. LEE, M.lnst.M., M.A.P.H.I. Chief Meat Inspector Jul. 1930 S.S. GARRARD, M.A.P.H.I. Deputy Chief Meat Inspector Sep. 1946 W.L. MORRIS, M.lnst.M. Senior Meat Inspector Sep. 1946 K.S. SEYMOUR, M.lnst.M., M.A.P.H.I., M.A .M.I. Senior Meat Inspector Jul. 1935 J.C. WILSON, M.lnst.M., M.A.M.I. Senior Meat Inspector Jan. 1936 J.T. COX, M.A.P.H.I. Meat Inspector Aug. 1954 H. FIELD, M.A.P.H.I. Meat Inspector Aug. 1954 G. GINGELL, A.R.S.H., M.lnst.M., M.A.P.H.I. Meat Inspector Aug. 1954 B.G.F. PAYNE, D.F.C., M.A.P.H.I. Meat Inspector Dec.I960 F.E. ELSEY, M.A.P.H.I. Meat Inspector Jan. 1964 S.A. MONK, M.A.P.H.I. Meat Inspector Oct. 1970 D.R. BERNHARDT Technical Assistant (Authorised) May 1931 R. HUDSON Senior Porter May 1963 HEALTH AND WELFARE SECTION Miss G.L. BENFIELD, S.R.N., S.C.M., H.V., Nursing Admin. P.H. Cert., M.R.S.H. Health and Welfare Officer Apr. 1965 MissM.T. DOWD, R.F.N., S.R.N., C.M.B., Part 1, H.V. Asst. Health and Welfare Officer May 1967 Miss S.M. BERGSTROM, S.R.N., S.C.M., H.V. Asst. Health and Welfare Officer Apr. 1967 Mrs. P.A. MIMMS Clerk/Dental Surgery Assistant Sep. 1965 Miss R. ATKINS Chiropodist (Part time) Jan. 1970 R. JONES Chiropodist (Part time) Apr. 1969 9 Home Helps DISEASES OF ANIMALS ACT G.S. WIGGINS, M.R.C.V.S., F.R.S.H. Veterinary Officer Oct. 1964 J .A. MORRIS, M.R.C.V.S. Veterinary Officer (Part time) Apr. 1967 R.J. HAYHURST, D.F.C. Inspector Oct. 1964 K.W. KING, A.M.R.S.H. Inspector Apr. 1965 V.O. GUBBINS Inspector (Part time) Jul. 1968 RODENT STAFF Commenced Service G.A. MASON Foreman Rodent Operative Dec. 1946 P.M. BERRY Rodent Operative Jun. 1967 J. PEGRAM Rodent Operati ve Sep. 1967 R.C. HARRIS Rodent Operative Dec. 1967 J.E. KIDDY Rodent Operative Sep. 1968 F.H. PRIEST Rodent Operati ve Mar. 1969 MORTUARY AND DISINFECTING STATION F.H. LAWRENCE Superintendent of the City Mortuary and Disinfecting Station May 1936 J.W.T. SUNNICK Disinfection Apparatus Attendant May 1950 MANUAL WORKERS R.H. 1'AN SON (General Duties at Smithfield Market) Feb. 1964 W.T. STEELE (General Duties at Mortuary) Aug. 1958 T.H. POLLEY (General Duties at Mortuary) Feb. 1970 B. DENNIS (General Duties at Smithfield Market) Apr. 1970 E.A. HIGLEY (General Duties at Smithfield Market) Sep. 1967 Mrs. M.M. SHEEHAN (Bath Attendant and Cleaner) Oct. 1962 G.W. JACOBS (General Duties at Mortuary) Dec. 1966 W.H. DALTON (General Duties at Smithfield Market) May 1970 A.J. FREW (General Duties at Smithfield Market) Nov. 1970 4 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON FOR THE YEAR 1970 To the Right Honourable The Lord Mayor, Aldermen and Commons of the City of London in Common Council assembled. GUILDHALL, E.C.2. Telephone: 01-606 3030. My Lord Mayor, Lady and Gentlemen, I have the honour to submit the following report on the work of my Department during the year ending 31st December 1970. I have the honour to be, Lady and Gentlemen, Your Obedient Servant, W.G. SWANN, M.D., B.Sc., Medical Officer of Health, Port and City of London. 5 HOUSING Housing Acts 1. Number of houses which on inspection were considered to be unfit for human habitation:- 3 2. Number of houses in which defects were remedied in consequence of informal action by the Local Authority or their Officers:- NIL 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) 2 (b) NIL 4. Number of notices served during the execution of works:- NIL 5. Number of houses which were rendered fit after service of formal notices:- NIL 6. Number of demolition or closing orders made:- NIL 7. Number of houses in respect of which an undertaking was accepted under subsection (4) of section 16 of the Housing Act, 1957:- NIL 8. Number of houses demolished:- NIL 9. Number of inspections and reinspections of housing accommodation:- 84 During the year under review, because of changes in the legislation and the need to deal comprehensively with requests from owners and occupiers of houses in the City, it has been necessary to pay more attention to the private housing sector in the City. This necessitated 57 inspections of dwelling-houses and resulted in 27 further inspections being carried out. Individual Houses — Part II, Housing Act, 1957 As a result of complaints by occupiers, or on the request of owners as to their condition, the department carried out several inspections. In two cases the owners were informally advised not to re-let for dwelling purposes the premises which had fallen vacant. In the other cases informal action was taken by requiring the owner to carry out remedial work. Clearance Areas — Part III, Housing Act, 1957 Because of concern expressed by the Health Visitors as to the circumstances under which some of the older inhabitants of the City were living, inspections were carried out of the individual houses concerned. The inspections revealed that two blocks of tenement flats were involved and it was decided that these should be dealt with on a more comprehensive basis. A house-to-house inspection was carried out in respect of one of these blocks of flats, which consisted of nine dwellings. On the basis of a report prepared by this department the Court of Common Council subsequently decided to declare a clearance area in respect of this block and agreed that the necessary steps be taken to make a Compulsory Purchase Order. The matter was submitted to the Ministry of Housing and Local Government for confirmation. At the end of the year two objections had been received and unless these are withdrawn a local Public Inquiry will be held. 6 The Housing Act. 1969 - Qualification Certificates Part III of this Act introduced a process for converting controlled tenancies into regulated tenancies upon the granting of a "qualification certificate" by a Local Authority that certain conditions in respect of a property have been met. This enables a landlord to apply to the Rent Officer for the assessment of a fair rent in respect of the dwelling under the Rent Acts. Local Authorities grant such a certificate on being satisfied that the premises are:- (a) Fit for human habitation having regard to the requirements of Section 4 of the Housing Act, 1957. (b) In a good state of repair having regard to its age, character and locality. (c) In possession of all the standard amenities, i.e. bath, wash-hand basin, sink, hot and cold water to these fitments, and a readily accessible W.C. compartment. Seven such applications were received during the course of the year under review. Each was investigated by this department and as a result four applications were granted, two refused, and one was receiving further consideration. The following report has been received from the Housing Manager:- "During the year 233 families were rehoused leaving 495 families on the housing register at the end of December 1970. Good progress was made on the second phase of the Middlesex Street redevelopment and the estate when completed will provide a shopping and residential precinct of 181 flats and 38 shops. A further Old People's Unit comprising 60 units of accommodation and 30 family residential units are under construction on the site of Otto House, Sydenham Hill. Work continues on the redevelopment of the Barbican residential area where 1,700 flats are under construction." EXAMINATION OF WATER SUPPLIES AND SWIMMING BATH WATER The Corporation of London exercise their function with regard to water supply under the Public Health Acts, 1936 and 1961, and the Water Acts of 1945, 1948 and 1955. There is also a provision in the Offices, Shops and Railway Premises Act, 1963, which requires all employers of shop and office workers to ensure that a supply of clean drinking water is available. In the City there are two sources of water supply— (1) From the statutory water authority—in the case of the City, the Metropolitan Water Board, and (2) From deep wells, of which there are I 14 in use, owned by various business houses in in the City. The supply from the Metropolitan Water Board is completely safe and satisfactory when delivered to premises and all examination up to that point is carried out by the Board's own staff. Examination on the premises is carried out by the City Public Health Inspectors, who also ensure that the storage tanks and general supply facilities within the building are satisfactory. The water from the deep wells is both satisfactory in quantity and quality and it is derived from the hard grey chalk substrata about 450 ft. below the City and it is not plumbo-solvent. Water samples for bacteriological examinations are usually taken from the well riser, indicating source quality, and from the drinking taps, indicating storage quality. A total of I I I such samples were taken from premises where there are deep wells. Six samples were found to have a high plate count, which necessitated a further investigation as to the source of contamination. In each case subsequent samples proved to be satisfactory. No Bacterium coli (type I) were isolated. In addition, drinking water was sampled in 26 various business houses in the City and one such sample was found to be unsatisfactory. An investigation indicated that the cause of this unsatisfactory sample was the filthy state of a vending machine from which the water was delivered. This machine was subsequently taken out of commission. Swimming Baths The three swimming baths within the City were visited weekly and bacteriological, chlorine and pH tests were made. A total of 105 bacteriological samples were taken, of which 5 were unsatisfactory. The causes of these unsatisfactory samples were investigated and the subsequent samples proved to be satisfactory. As a result of these investigations it was necessary to close down one of the swimming pools temporarily to enable cleaning and re-chlorination to be carried out. 7 The following table shows details of bacteriological examinations of both drinking water supplies and swimming bath water. Source of Supply Number of Samples Number of Samples giving results above 0 per 100 ml s. Number of Samples giving plate counts above 0 Cols/ml after 24 hours at 37 °C. Col i form Count Bact. Coli. (Type 1) (1) Deep Wells within the City Area 101 2 - 26 (2) Metropolitan Water Board 32 3 - 23 (3) Swimming Pools within the City 109 1 - 43 TOTAL 242 6 - 92 Samples are taken from various sources for chemical analysis when questions of taste, adour and colour are raised. Five such samples were taken and subsequently found satisfactory. The results are tabulated below:- No. Source Supply Use Condition of Water Remarks 1 Drinking Point M.W.B. Drinking Clear, bright, odourless tasteless and pale yellow colour. Bacteriologically satisfactory. Water consistant with M.W.B. supply to City of London. No cause for complaint of Gastro enteritis. 2 Tap M.W.B. Drinking Clear, bright, odourless tasteless, colourless and free from sediment. Water consistant with M.W.B. supply to City of London. 3 Tap M.W.B. Drinking Smal 1 amount of brown sediment. When allowed to stand, clear, colourless odourless and tasteless. Sediment found to be iron hydroxide or rust, not harmful to a consumer. 4 Drinking Point M.W.B. Drinking Clear, bright, free from sediment, odourless and practically colourless. Bacteriologically satisfactory. Water consistant with M.W.B. supply to City of London. 5 Tap M.W.B. Drinking Clear, bright, free from sediment, odourless, tasteless, and practically colourless. Water consistant with M.W.B. supply to City of London. 8 The Metropolitan Water Board have supplied the following Report:- "l.(a) The supply was satisfactory both as to (i) quality, and (ii) quantity throughout 1970. (b) All new and repaired mains are disinfected with chlorine; after a predetermined period of contact the pipes are flushed out and refilled; samples of water are then collected from these treated mains, and the mains are returned to service only after the analytical results are found to be satisfactory. The quality control from these laboratories is carried out by means of daily sampling from sources of supply, from the treatment works or well stations, from the distribution system, and through to the consumer. Any sign of contamination or any other abnormality is immediately investigated. (c) (i) The Board has no record of the number of structurally separate dwellings supplied in your area, but the population supplied direct according to the Registrar-General's estimates at 30th June, 1970, was 4,644 (ii) No houses were permanently supplied by standpipe. (d) No artificial fluoride is being added, and where the fluoride content is indicated in the analyses it represents the naturally occurring fluoride in the water. 2.(a) The supply was derived from the following works and pumping stations:- River Thames - derived from Battersea Works New River — derived from Stoke Newington Works No new sources of supply were instituted and there were no changes to the general scheme of supply in your area. The number of samples collected and the bacteriological and chemical analyses of the supply from the above sources after treatment are shown on the attached sheets. (b) On account of their hardness content and alkaline reaction the Board's river and well water supplies are shown to be not plumbo-solvent. It should, however, be appreciated that all types of water pick up varying amounts of metal from the material of water piping particularly when it is newly installed; this applies to copper, zinc, iron and also to lead. 9 10 METROPOLITAN WATER BOARD - WATER EXAMINATION DEPARTMENT AVERAGE RESULTS OF THE CHEMICAL EXAMINATION OF WATER SUPPLIED TO THE CITY OF LONDON FOR 1970. Milligrammes per litre (unless otherwise stated) Description ot the Sample Number of Samples Day of the month Ammoniacal Nitrogen Albuminoid Nitrogen Nitrate Nitrogen Oxygen abs. from KMn04 4 hrs at 2 7° C. B.O.D. 5 days at 20° C. Hardness (total) CaC03 Hardness (noncarbonate) CaC03 Magnesium as Mg Sodium as Na Potassium as K Chloride as CI Phosphate as P04 Silicate as Si02 Sulphate as S04 Natural Fluoride as F Surfaceactive material as Manoxol OT Turbidity units C olour (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) River Thames — Derived 363 0.026 0.083 4.8 1.02 274 79 5 27.7 5.6 40 2.7 9 70 0.20 0.03 0.1 11 7.9 570 Stoke Newington 52 0.008 0.061 5.2 0.61 305 78 5 30.9 4.9 45 1.9 9 71 0.20 0.02 0.0 8 7.9 620 BACTERIOLOGICAL RESULTS - YEARLY AVERAGES. 1970. WATER SUPPLIED TO THE CITY OF LONDON Source of Supply BEFORE TREATMENT AFTER TREATMENT Agar plate count per ml. Col iforrn count Escherichia coli count Number of samples Agar plate count per ml. Col iform count E. coli count Number of samples 20-24 hours at 37°C. 3 days at 22° C. Per cent, samples negative in 100 ml. Count per 1 00 ml. Per cent, samples negative in 100 ml. Count per 100 ml. 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. River Thames — derived 8,259 31.9 37.91 17.3 53.58 4.7 3,710 8.0 99.92 99.97 Stoke Newington 754 39.1 56.76 6.9 75.46 1.7 258 15.3 100.0 100.0 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 4 feet high x 2 feet 8 inches wide, this size being adopted only to provide access for sewermen, as the normal dry weather flow depth of effluent is only about 9 inches at an average velocity of 2 to 3 feet per second. The Corporation sewers discharge into the General London Council intercepting sewers which flow eastwards across the City at a much lower depth to their Beckton Sewage Treatment Works. In my opinion, the system of sewerage in the City is adequate, with ample margin for diverting flows from sewers during reconstruction and maintenance works." NOISE There was an increase in the number of complaints concerning noise in the City, which necessitated 245 visits and 843 re-visits. Most of the complaints arose from demolition and reconstruction operations and in this respect there was a noticeable change in the attitude on the part of contractors towards accepting the need for the reduction of noise caused by the use of pneumatic drills by fitting muffles to the drills at all times. While contractors show this apparent willingness, there are the individual employees who often fetch everyone's efforts to naught by their complete disregard for the necessity to reduce noise. There was an increase in the number of out-of-hours visits made to assess levels of noise created during the quieter hours of the night. These visits were mostly concerned with noise from fans used for the ventilation of large buildings throughout the City and complaints made by the new City residents in the Barbican Estate were in this category. In addition the works of major reconstruction such as Moorgate Station and Cannon Street give rise to much bitterness among residents. While it is appreciated that some work has to be carried out when the railway tracks are out of use, it does appear at times that this is made the excuse to run wild. It must be understood by everyone who contemplates construction work in the City that any form of noisy work at night will inevitably lead to difficulties. While it has been feasible to secure a satisfactory reduction of noise in cases where loudness was the sole criterion of complaint, those problems associated with the irritating quality of some noises have been most intractable. COMMON LODGING HOUSE In recent years various pressure groups have emphasised matters which have stirred a section of the community into action. In the field of housing considerable attention has been drawn to the plight of London's homeless, but here the only sustained appeal is where both parents and children are concerned. The housing aspect of a common lodging house can be seen in the sense that men are forced through various circumstances to live in deprived conditions. If one can compare the general standards of amenity and privacy that are afforded to normal people, the standards at a common lodging house can only be described as being minimal and barely sufficient to keep body and soul together. The extent of the problem is mitigated to a degree by the Salvation Army, who run the hostel. As an organisation with an ideal, they persevere when many would consider an individual to be a hopeless "drop-out." The accommodation is very basic, In the main, large rooms are occupied by beds interspaced with chairs, the numbers involved varying from 84 to 13 persons in a single room. In contrast, a report of some years ago stated that: "They are crammed full of beds fromtop to bottom, until there is no room for any more. Each bed is filled to capacity and may contain as many as four, five and even six lodgers." In those days no attemptwas made to segregate the sick and the healthy, the old and the young, the drunk and the sober. During the year under review there has been a real improvement in conditions generally at the registered common lodging house in Middlesex Street. Regular inspections have been maintained throughout the year and many problems concerning the sanitary arrangements have been dealt with on a personal basis by the public health inspector concerned and the Salvation Army authorities. Much additional benefit has accrued because of the helpful attention of some residents who are employed as a casual labour force, who bear the brunt of the sordid hard work involved. These men, some who have been dutiful for many years, are among to-day's unsung heroes. They carry out tasks that many men would feel insulted even to be asked to do, and yet they execute this work for very little financial gain. Lice infestation at this hostel continues to present problems and difficulties. There was an overall improvement in the level of infestation despite an increase in the number of verminous beds found towards the end of the year. The beds are inspected in the early morning by a public health inspector, as this has been found to be the best time to view the bedding as the beds have just been vacated and are more likely to have vermin easily visible on the sheets. At the end of the year no men had remained in the hostel who had vermin on their bedding and who had received a notice to attend at the cleansing station. Rather than stay and be bathed or risk complaint being made, men opted to leave the hostel. It was therefore unnecessary to request formal action. However, because men do attempt to regain admittance after a while, formal procedure may become necessary. Taking the 84-bed dormitory as an example, an average of eight verminous beds were found during each visit. Some of the migrant hostel dwellers carry the vermin around from place to place. These men act as reservoirs and then infest other men who regularly live in Middlesex House and because of poor clothing and washing habits seem to remain in a fairly constant state of infestation. Because of this, men are being encouraged to attend the Cleansing Station at regular intervals— sometimes at frequently as once a week. Accommodation such as that which exists in Middlesex Street should not be tolerated in the future. This little corner of E. I. could be redeveloped to provide shopping and arcade facilities adjacent to Petticoat Lane, with a multi-storey hostel to accommodate men, situated in a position which would secure the privacy of both commercial and residential sections of the community. OFFICES, SHOPS AND RAILWAY PREMISES ACT 1963 The accelerated progress in securing the general inspection of offices which has been achieved in recent years has been maintained during the year under review, when 2,168 general inspections were made. All aspects of the Act have received attention, but the provision of satisfactory means of ventilation, especially in air-conditioned buildings, is a problem which had continued to demand much time and consideration by the Public Health Inspectors engaged in the enforcement of the Act. As this highly complex technical problem was dealt with at some length in my last Annual Report there is no need for further observations at the present time. The Act was introduced to make "fresh provision for securing the health, safety and welfare of persons employed to work in office or shop premises". As in much comparable modern legislation, many sections give the Minister power to make regulations prescribing various requirements to ensure that the health provisions are implemented in detail. From time to time more new regulations are enacted, for example, arising from the provisions of Section 20 of the Act, the Offices, Shops and Railway Premises (Hoists and Lifts) Regulations, 1968, came into operation on 28th May, 1969. These Regulations place upon the owner of the premises the obligation to ensure that every lift shall be thoroughly examined by a competent person at least once in every period of six months. Each report of the result of every examination made in pursuance of these Regulations must be preserved and kept readily available for inspection by any inspector for two years after the date of the signing of the Report. Further, where the examination indicates that the lift cannot continue to be used with safety unless certain repairs are carried out immediately or within a specified time, the person making the report shall within twenty-eight days of the completion of the examination send a copy of the report to the enforcing authority. In practice it has been found that this six-monthly inspection is not being adhered to. The usual answer gnven is that it is up to the engineer who makes the examination. This means that on 28th May, 1971, many lifts will not have been thoroughly examined four times and that four reports of these examinations will not be available to the enforcing authority by this date. The intention of the Lift Regulation appears to be to secure proper construction and continued maintenance in the interests of safety. When the four reports are available for inspection it will give the inspector a guide as to the degree to which the lift has been properly maintained. The problems which have arisen from an administrative point of view are summarised below. Often the owner does not realise that he is responsible for havingthe lift thoroughly examined every six months. Neither does he appreciate that the report of the examination may have to be forwarded to the enforcing authority at his expense, may be used against him in legal proceedings, and that the competent person who has been directed by him to make the thorough examination may be charged with giving evidence against him by the enforcing authority. 12 In my opinion "a competent person" is one not only qualified in lift engineering butcompetent as a witness in accordance with the procedure laid down in Article 6(3) of the Regulations. In these circumstances for the same firm to be responsible for regular maintenance and subsquently to submit a report after a thorough examination of the same lift is likely to place too great a burden on the loyalties of the staff in question. It is by reason of this interpretation of the Regulations that letters have been addressed to various firms pointing out the problems which could arise where they not only give an examination service but carry out the repairs and maintenance as well. The regulations are clear as to the procedure where the examination shows that the lift cannot continue to be used with safety. Within twenty-eight days a copy of the report must be sent to the enforcing authority. A problem arises as to the interpretation of the requirement: "....shall be preserved and shall be kept readily available for inspection by any inspector." Does this mean on the premises where the lift is situated or within the offices of owner or managing agents away from the said premi ses? In either case to implement the Regulations a visit is required each six months. Where no safety factors are involved it means that unless the inspector actually visits the premises and sees the report there is no knowledge as to the frequency or otherwise of the examinations. In term of man-hours and effort by the Inspectors the definition of "readily available" is of supreme importance. The report ought to be on the premises and preferably fixed within a frame inside the lift for all passengers to see and read. This would ensure that question I (a) on the form prescribed for the report of examination of hoist or lift was properly answered. Often it has been difficult to associate a report with a particular lift when more than one lift is in operation in the same premises. A practical issue not dealt with in the Hoists and Lifts Regulations, 1968. or the main Act of 1963, is the necessity for the lift to be capable of being used at all times. The thorough examination by a competent person may properly show that the lift can be used with safety, but the lift may not work, or work only intermittently! Problems arise where the lift is relied upon to give access to sanitary conveniences, washing facilities and drinking water, at places conveniently accessible to the persons employed, and the lift just does not work. How many flights of stairs should an employee have to climb or descend to constitute "conveniently accessible"? The tendency now is for the construction of multi-storey office blocks where the staircases are designed merely as fire exits Therefore the lift needs to be reliable in use as well as safe to use In the older type of building the lifts often serve ce.tain floors only and the main toilet suites are sometimes one floor above or below the nearest lift access. Experience on regular routine inspections shows the need for fresh publicity concerning the responsibility of employers to notify the enforcing authority that they intend to occupy an office and that they must complete the statutory form of notification (OSR.I). TABLE A REGISTRATION AND GENERAL INSPECTIONS Class of premises Number of premises newly registered during the year Total number of registered premises at end of year Number of registered premises receiving one or more general inspections during the year Offices 428 6723 2168 Retail shops 48 896 157 Wholesale shops, warehouses 5 798 44 Catering establishments open to the publ ic, canteens 4 548 531 Fuel storage depots NIL NIL NIL TOTALS 485 8965 2900 TABLE B NUMBER OF VISITS OF ALL KINDS (INCLUDING GENERAL INSPECTIONS) TO REGISTERED PREMISES 8377 13 TABLE C ANALYSIS BY WORKPLACE OF PERSONS EMPLOYED BY REGISTERED PREMISES AT END OF YEAR Class of workplace Number of persons employed Offices 270184 Retail shops 4940 Wholesale departments, warehouses 5876 Catering establishments open to the public 6718 Canteens 4616 Fuel storage depots NIL T otal 292,334 Total Males 175.393 Total Females 1 16,941 14 15 SUMMARY OF DEFECTS FOUND AND NOTICES SENT 1. Cleanliness Dirty conditions 100 Accumulations of Refuse 6 2 Overcrowding 46 3. T emperature Unreasonable 1 Absence of Thermometer 101 Absence of Warming Facilities . 2 4. Ventilation Inadequate 102 5. Lighting Inadequate 88 6. Sanitary Conveniences Insufficient 11 Unsatisfactory/Defective 100 Not separate for sexes 37 7. Washing Facilities Insufficient 3 Unsatisfactory/Defective 30 No Hot water 20 Soap/Drying facilities 12 8. Drinking Water Inadequate supply 22 Disposable vessels/Rinsing facilities 4 9. Clothing Inadequate accommodation 6 Inadequate drying facilities 10 10. Seating Inadequate 2 II. Floors, Stairs. Passages Unsound construction 21 Obstruction/slipping 38 Handrail (lack of) 43 Protection of Openings 7 12. Machinery Inadequate guarding 73 13. First Aid Inadequate Provision 124 14. Information No Handbookavai lable 138 15. Dangerous Practices 10 16. Miscellaneous 66 1223 16 HYGIENE IN HAIRDRESSING AND BARBERS SHOPS Section 77 of the Public Health Act, 1961, empowers local authorities to make Byelaws dealing with hygienic conditions in Hairdressers' and Barbers' shops. During the year 32 inspections were made. The Greater London Council (General Powers) Act, 1967 requires all persons who wish to carry on the business of a hairdresser or barber to be registered in respect of their premises. During the year, 6 hairdressers and barbers were so registered bringing the total on the Register to 69. 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 Regi ster Number of Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1,2,3.4 and 6 are to be enforced by Local Authorities 69 (incl. 1 bakehouse) 124 23 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 548 (incl. 2 bakehouses) 32 6 — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 151 1 1 9 — TOTAL 768 167 38 - 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 Referred Number of cases in which prosecutions were instituted Found Remedied To H.M. Inspector by H.M. Inspector Want of cleanliness (S. I.) 13 1 1 - - - Overcrowding (S.2-) — _ _ Unreasonable temperature (S.3.) — — — — — Inadequate ventilation (S.4.) _ — — — Ineffective drainage of floors (S.6.) — — — — — Sanitary Conveniences (S.7.) (a) insufficient 7 6 _ _ _ (b) unsuitable or defective 26 23 _ — _ (c) not separate for sexes 2 7 — — — Other offences against the Act (not including offences relating to Outwork) 33 29 2 8 - TOTAL 81 70 2 8 - 17 Part VIII of the Act Outwork (Sections 133 and 134) ]Nature of Work Section 133 Section 134 No. of outworkers in August list required by Section 133 (1) (c) No. of cases of defau It in sending 1 i sts to the Counci 1 No. of prosecutions for failure to supply li sts No. of i nstances of work in unwholesome premi ses Noti ces served Prosecutions 1 2 3 4 5 6 7 Wearing apparel (Making, etc.) 250 - - - - - TOTAL 250 - - - - - Outwork and the inspection of outworkers' premises etc. Lists received from City Firms employing outworkers 25 Names and addresses of City outworkers received from other Authorities 9 Names and addresses of outworkers resident outside the City, employed by City firms, transmitted to other Authorities. 250 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 21,296 inspections have been made. As a consequence of these inspections, it was necessary to serve 1,812 Intimation Notices. Tenement Houses were inspected and the only common lodging house in the City was kept under regular supervision. ATMOSPHERIC POLLUTION CITY OF LONDON (VARIOUS POWERS) ACT, 1954 CLEAN AIR ACT, 1956 CLEAN AIR ACT, 1968 The above-mentioned Acts provide a broad basis for controlling pollution of the atmosphere in the City and are enforced by the City's Public Health Inspectors, who carried out 1,814 inspections and observations during the year. The following statistics indicate the extent of the work undertaken in this particular field:— 1. Initial inspections — 647 2. Re-inspections — 157 3. Observations made — 1,010 4. Contraventions noted — 37 5. Verbal intimations — 115 6. Notices served — 9 Over the past few years it has been observed that while most areas in the country show a steady decline in the concentration of S02 in the atmosphere, the level in London as a whole does not appear to be declining at the same rate and, indeed, for the City of London it has ceased to fall and over the last year demonstrates a tendency to rise. What is disturbing is that it is unlikely to be a temporary increase, since the trends in redevelopment mean bigger installations and more fuel consumed in the same area. Concern must be expressed over this rising sulphur dioxide concentration in the atmosphere in the City and whatever steps are available ought to be taken to secure its reduction. Users of oil-fired boilers are encouraged to use a fuel oil of less 1% sulphur content and it is felt that if this voluntary method had not been adopted the sulphur dioxide pollution would have been much worse. 18 The implementation of the Chimney Height Regulations, 1968, has proved to be difficult, as the City has its own peculiar problems concerning chimney heights. There is a tendency to view a tall building as being synonymous with a tall chimney and expect thatitwill be justas effecti ve as a tall chimney in the despersal of products of combustion. This is far from the truth, particularly when planning considerations dictate that the stack outlet shall not protrude above the outline of the building it serves or intrude in any way on the skyline. There have been no applications for installations which require a dilution of the flue gases in order to discharge these products at ground level — a point which has been watched with some trepidation since last year, as other forms of pollution could be caused by this practice. The enactment of the 1968 Clean Air Act and subsequent Clean Air (Emmission of Dark smoke) (Exemption) Regulations, 1969, has allowed bonfires to be burnt subject to certain conditions. These provisions have tended to make the prohibition of such bonfires impossible. Measurement of Atmospheric Pollution. These measurements have continued throughout the year at two stations with volumetric apparatus. At these stations 24-hour readings are taken of sulphur dioxide and particulate matter. The results are forwarded to theMinistry of Technology at Warren Spring for computation. Samples of deposited matter have been taken throughout the year at one station and the Corporation's Public Analyst has returned monthly analyses of the samples submitted to him. It is my view that two stations are hardly sufficient to adequately cover the City where concentrations of pollutants can vary quite markedly by reason of very localised conditions. Steps are being considered to improve the coverage in conjunction with Warren Spring Laboratory. TABLE 1 Results obtained in 1970 of the monthly observations of rainfall and deposited matter by means of the deposit gauge at Guildhall. Month Rainfall collected in the deposit gauge Deposited Matter (Tons per square mile) Millimetres Inches Insoluble So1u b1e T otal J anuary 64 2.50 22.10 7.17 29.27 February 46 1.81 20.78 6.10 26.88 March 48 1.90 26.60 8.00 34.61 Apri 1 41 1.62 12.16 4.88 17.04 May 15 0.61 37.06 5.78 42.85 June 8 0.32 19.23 4.88 24.11 July 24 0.94 9.70 4.75 14.27 August 68 2.70 17.91 5.99 23.90 September 24 0.96 14.72 6.10 20.32 October 14 0.55 14.83 7.07 21.89 November 108 4.27 15.00 9.94 24.94 December 28 1.09 16.90 13.06 29.96 Averages 1970 41 1.61 18.92 6.98 25.88 1969 43 1.71 24.48 6.08 30.55 1968 61 2.40 21.36 8.85 30.22 1967 59 2.13 19.33 11.90 31.23 1966 49 1.94 17.85 10.11 27.96 1965 54 2.12 19.02 9.96 28.98 1964 44 1.71 15.13 12.49 27.63 1964-1970 49 1.94 19.44 9.48 28.92 19 TABLE II Monthly summary of the results obtained in 1970 of the daily observations of the concentration of SMOKE by the volumetric method at the Public Services Building and at Snow Hill Police Station. The results obtained by means of the deposit gauge at Guildhall are included for comparison. Month Concentration of Smoke (microgrammes per cubic metre) Rainfall collected in the deposit gauge Public Services Building Snow Hill Police Station Mi 11 imetres Inches J anuary 71 89 64 2.50 February 47 68 46 1.81 March 49 64 48 1.90 April 38 47 41 1.62 May 39 41 15 0.61 June 30 35 8 0.32 July 22 33 24 0.94 August 29 59 68 2.70 September 35 — 24 0.96 October 52 — 14 0.55 November 45 65 108 4.27 December 58 62 28 1.09 Averages 1970 43 45 41 1.61 1969 54 60 43 1.71 1968 51 48 61 2.40 1967 50 50 54 2.13 1966 59 56 49 1.94 1965 70(Golden Lane) 64 54 2.12 1964 88(Golden Lane) 77 44 1.71 1964 - 1970 59 57 49 1.94 TABLE III Monthly summary of the results obtained in 1970 of the measurement of SULPHUR DIOXIDE by the volumetric method, at the Public Services Building and at Snow Hill Police Station. The results obtained by means of the deposit gauge at Guildhall are included for comparison. Month Concentration of SO2 (microgrammes per cubic metre) Rainfall collected in the deposit gauge Public Services Bui Iding Snow Hill Police Station Millimetres Inches January 332 450 64 2.50 February 310 410 46 1.81 March 378 391 48 1.90 April 302 319 41 1.62 May 198 191 15 0.61 June 173 216 8 0.32 July 132 138 24 0.94 August 146 169 68 2.70 September 242 — 24 0.96 October 280 — 14 0.55 November 342 325 108 4.27 December 357 374 28 1.09 Averages 1970 270 249 41 1.61 1969 299 287 43 1.71 1968 277 263 61 2.40 1967 271 292 54 2.13 1966 328 49 1.94 1965 286(Golden Lane) 341 54 2.12 1964 3 l6(Golden Lane) 383 44 1.71 1964-1970 286 306 49 1.94 20 RODENT CONTROL Work involved in implementing the Prevention of Damage by Pests Act, 1949, can be classified under two headings: (a) The inspection of premises and the offer of advice on treatment of premises which are infested. (b) Control work in the sewers. (a) Premises Premises inspected (routine or on complaint) 3,300 Complaints received 1,281 House mouse infestations 922 Rat infestation (minor) 61 Initial baiting sites selected 12,493 Total operational visits 6,341 Efforts were made to establish sources of infestation and advice given and "follow up" visits paid to check on the effectiveness of treatment. (b) Destruction of rat^s in sewers. Two direct treatments were carried out in March and September using Fluorakil and arsenious oxide respectively and involving 369 entrances to the sewers. In June and December, two tests baiting treatments were carried out and where takes were recorded poison baits, using zinc phosphide, were applied. The December operation showed a noticeable decline in the test bait takes compared with the June operation, as follows: — June: : 47 Full Takes 67 Half Takes December: 32 Full Takes 46 Half Takes CITY MORTUARY Bodies received 196 Post Mortem Examinations made 194 Inquests on bodies 31 Inquests held at Holloway Prison NIL Inquests on fires NIL Inquests on Treasure Trove NIL 21 All the sewer treatments were carried out in good dry weather conditions. PIGEON CONTROL The Public Health Act, 1961, gives local authorities permissive power to take steps to abate or mitigate nuisance from pigeons believed to have no owner. On the receipt of a complaint an inspection is made and if conditions which constitute a nuisance are found the details are notified to a pest control firm with which the City Corporation has a contract and which operates generally within the City area. In addition, where a nuisance in City gardens and open spaces occurs the work of the contractor is supplemented by periodic treatments undertaken directly by the staff of this Department in co-operation with the Superintendent of Parks and Gardens. These treatments are all subject to approval by the Regional Pests Officers of the Ministry of Agriculture, Fisheries and Food. As a result of these control measures there has been some reduction within the City in the extent and degree of the nuisance caused by pigeons. DISINFECTION AND CLEANSING OF VERMINOUS PERSONS, ETC. Export of Clothing, etc. Articles, by weight 2-i tons No. of articles disinfected 410,744 No. of operations . 983 Fees received £1 198.1Is.Od. General Disinfection, Infectious Diseases, etc. Cells at Police Stations disinfected 12 Lockers at Post Offices disinfected 13 Verminous premises disinfected 6 Beds and bedding disinfected 2122 Cleansing of Persons No. of verminous persons bathed 1052 No. of persons with scabies bathed 4 No of articles disinfected 10560 OBSERVATIONS ON CATERING ESTABLISHMENTS The caterers in the City are an industrious community — in fact they have to be in order tp survive — and many of the small proprietors consistently work a twelve-hour day. In spite of any criticism that may be made it should be realised that they are providing an essential service to the City workers, often for a very small reward. At the present time the City caterer is overwhelmed by three apparently insuperable problems: namely, staff shortages, continually rising costs, particularly of maintenance, and the resistance of City workers to increasing their expenditure on midday refreshments. Not only is there a continuing staff shortage but the quality of the staff available has deteriorated both in skill and reliability. It is not uncommon for a catering worker to fail to report for duty for no apparent reason, but the caterer would be out of business very quickly if he failed to get the food to his customers on time. The ultimate sanction of dismissal is of little avail because to-day a worker can always find another job speedily, probably the same day without any difficulty. It is fair to say that there are few City caterers who do not struggle, maybe at times ineffectively, to conduct their business in a proper manner and to maintain their premises in a clean and hygienic condition, and there are fewer still who resist the criticisms that are made in the course of routine inspection of their establishments. It is invariably found that the individual City caterer is receptive to constructive suggestions and criticisms, and there is certainly no resentment of the regular demands that are made on them to maintain and improve their premi ses. However, whilst one is fully aware of the difficulties which have to be overcome every day to continue to run an essential service to the community, it is disappointing in some cases to find that a caterer does not seem to be concious of shortcomings and deficiences until they are actually pointed out to him. There are within the City approximately one thousand catering units of every conceivable type and size, varying from the small snack bar with accommodation for about twenty-five customers to the large restaurant and staff canteen serving, perhaps, over one thousand meals each day, and whilst there is the equivalent of four public health inspectors involved almost full time on this work, it is never possible to visit each premises as often as one would wish, notwithstanding the fact that 873 routine general inspections were carried out during the course of the year under review and a further 2,795 re-inspections and miscellaneous inspections were made. The policy of the Department has always been to educate and persuade, even if this often becomes a time-absorbing operation. As the result of the pursuance of this policy legal proceedings were instituted in two cases only. Both prosecutions were successful and fines and costs totalling £408 were imposed. During the year, in addition to innumerable verbal representations, 301 written intimations were sent to City caterers, drawing their attention to a multiplicity of contraventions of the Food Hygiene Regulations. Doubtless this sustained activity has contributed to the substantial improvements which have continued to be made in kitchens and other working areas, both structurally and in the day to day cleaning and maintenance. However, in spite of all the efforts of the caterers and the Public Health Inspectors engaged in this work it would be unrealistic to pretend that there is any general satisfaction on the standard of hygiene in catering premises at the present time and it would seem that it is impossible to improve standards further until the problem of staff shortages has been overcome. 22 It should be emphasised, of course, that there are now within the City a number of truly top-grade quality restaurants where this staff problem is less acute, and in these establishments the standard of food and service available is undoubtedly equal, if not superior, to that of the renowned West End restaurants. It is interesting to record the fact that the "Gold Plate" award by Egon Ronay to the "Restaurant of the Year" was, for the year 1970, won by a restaurant situated within the City of London. Some of the staff restaurants provided by the banks, insurance companies and other institutions are also beyond reproach and provide excellent examples of efficient and hygienically operated catering units. Invariably the many official visitors from overseas who have been afforded the opportunity of making a thorough and detailed inspection of these premises have been favourably impressed by the excellence of the construction, equipment and design and by the high standard of cleanliness and hygiene which is regularly achieved. The co-operation and the facilities afforded by the proprietors and managers to enable such visitors to inspect their restaurants is appreciated by this Department. During the year under review there has been a further reduction in the number of operative restaurants in the City. Some premises have been closed down because of redevelopment, others are being used for alternative purposes, and a few remain empty, presumably in the hope that a would-be caterer of sufficient courage or one ignorant of the inherent difficulties of City catering, will eventually accept a tenancy. Unfortunately, because of the high level of rents in the City there is a tendency for the inferior and cheaper type of premises, for which an alternative use cannot be found, to be adapted for catering purposes. Whilst in some instances it has been possible to persuade an intending caterer not to establish a new business in inherently unsuitable premises, if such advice is not accepted or if this Department is not consulted there is no legal process by which such a basically unsatisfactory development can be prevented. In accordance with normal practice, much time and effort has been devoted to proposed new premises where the prospective tenant has contacted this Department, to ensure that as high a standard as is practicable is secured. Advice and guidance has been given in all such cases and the cotoperation which has been achieved in many instances has been advantageous both to this Department and the caterer. FOOD AND DRUGS ACT, 1955 During the year the work of the Sampling Officer has been directed to samples of food which the housewife would normally buy or be tempted to purchase as a consequence of modern marketing methods. Of the 390 samples purchased only 18 were the subject of adverse reports by the Public Analyst. The irregularities mostly referred to infringements of the Labelling of Food Orders, but two were the subject of summonses, both for selling food unfit for human consumption. The labelling infringements were resolved after consultation with the manufacturers and packers concerned. Particular attention was again paid to the sampling of "made-up" foods such as mince meat, pies, and sausages of all kinds, and it is interesting to note that the above-mentioned summonses were the result of the Sampling Officer having purchased this kind of food early on a Monday morning as soon as the premises opened for business. By this means, also, it is possible to obtain an indication of the freshness or otherwise of food offered for sale after a long weekend when most food premises are closed. Eighteen were formal samples of milk purchased from milk roundsmen in the City area and from restaurants, and on examination by the Public Analyst were found to be satisfactory in all respects. Two were formal samples of draught beer purchased from separate public houses in the City area and these, too, on examination proved satisfactory. FOOD COMPLAINTS During the year under review there was an increase in the number of complaints concerning food sold in an unsound condition or food containing extraneous material. Court proceedings were instituted in 13 cases and fines and costs were imposed totalling £410. The complaints investigated related to the following: — I. Severe mould growths, staleness and unsoundness which affected the following articles: — (a) Strawberries (b) Scotch Egg (c) Chops (d) Liver and Bacon Croquettes 23 (e) Apple Pie (f) Pork Pie (g) Sausage Roll (h) Meat Pies (i) Gooseberry Pie (j) Cottage Cheese (k) Buns (I) Chicken (m) Corned Beef 2. Extraneous objects discovered in food included: — (a) glass in a sandwich 3. Insectsdiscovered in food included: — (a) larvae in packets of biscuits (b) dead fly in cake (c) unidentified insect in carton of yoghurt (d) live larvae in packets of potato crisps 4. Rodent contamination in: — (a) biscuits which were partly eaten by mice. The overwhelming majority of complaints concerned foods which were mouldy, stale, putrefied or otherwise unfit. Have the standards of manufacture or sale deteriorated or is the public more critical in relation to food quality? Certainly marked changes in food processing, presentation, sales techniques and the generally good standard of hygiene in most City premises have created a climate whereby customers expect to find uniformity of quality. At the same time, with increased factory processing and pre-packaging it has become increasingly difficult for the consumer to examine the quality and freshness of the food which he is buying, and reliance must be placed on labelling and on the implied warranty that the goods are of merchantable quality. During the investigation of some cases, the Public Health Inspectors found that perishable goods were being sold long afterthe expiry date shown by the manufacturers' codes on the packets. In one case a fruit pie was more than two months out of date and in a very objectionable condition when opened by the purchaser. The system of coding used by manufacturers on perishable foods leaves much to be desired. In many instances codes are not fully understood by retailers and caterers and are a complete mystery to consumers, if indeed, they are aware of them at all. Most manufacturers interviewed by the Public Health Inspectors took great pains to show that staleness or the lack of freshness of their goods could not occur prior to delivery to retail premises because their system of coding and control was almost foolproof. The implication is that all complaints of mould, staleness and other abnormalities of age must necessarily be due to lack of proper stock control by the retailer. Investigations have shown that the system of control employed by most manufacturers is weak during the delivery period and that so long as the present system of sales and deliveries is continued on an incentive bonus and commission basis there will be a risk in the chain of supply that goods out of code or near the end of their last day of freshness will find their way into retail outlets among fresh deliveries. Most retailers and operators of food businesses purchase their supplies from well-known sources and rely on the good name of their suppliers to ensure that only good quality, fresh food is delivered to them. Since, however, manufacturers cannot guarantee this beyond the gates of their own factories, caterers within the City should examine all goods as they are delivered to their premises, and perishable foods should be marked with the date of delivery. Complaints of mould, putrefaction or staleness may arise from failure of the shopkeeper to ensure proper stock rotation, but it may well be that the supplier is at fault, and unless the retailer can accurately show the date of receipt of goods he is at a serious disadvantage in proving warranty. In the final analysis the consumer has a right to expect good, clean, wholesome food presented openly and preferably with a clear date indication of its freshness. NATURE OF ADULTERATION OR IRREGULARITY Article Nature of adulteration or irregularity Action *Bread Sliced Loaf Contained baked in the bread a small quantity of brown foreign matter, which consisted of baked dough discoloured by rust. Appropriate representations were made to the bakers concerned who instigated an investigation Action has been taken to prevent further contamination. 24 Arli cle Nature of Adulteration or irregularity Action *Biscuits Digestive Part of the wrapping of the packet and the biscuits underneath were damaged, having apparently been gnawed by a rodent. Legal proceedings were instituted against the retailer who was fined £5.00 and ordered to pay £10.00 costs. *Buns Buttered The buns contained excessive foreign matter, viz. a small stone, a splinter of wood, part of an iron staple and a piece of woody stem. Legal proceedings were instituted against the firm of bakers concerned who were fined £25.00 and ordered to pay £12.00 costs. Cream Cakes The cakes contained imitation cream, made from emulsified fat, sugar and water. A letter of caution was sent to the retailer and the matter has been satisfactorily resolved. Cream Cakes Assorted The cakes contained imitation cream, made from emulsified fat, sugar and water. A letter of warning was sent to the retailer concerned. Cream Doughnuts Contained imitation cream made from emulsified fat, sugar and water. The cakes were mistakenly marked by a shop assistant. The proprietor has taken steps to ensure that all cakes are correctly labelled in future. *Doughnut Consisted of a cream doughnut showing a greyish discoloration of which a complaint had been made. The discoloration was caused by the presence of particles of scorched flour in the coating of frying oil. Investigation revealed that no further action was necessary. *Apple Pie Consisted of a slice of a Dutch Apple Pie. It bore a large growth of green mould on the apple filling and was unfit for consumption. Legal proceedings were instituted against the Caterer who was fined £25.00 and ordered to pay £10.00 costs. *Apricot Pie Consisted of a broken apricot pie which was mouldy throughout and was unfit for consumption. A letter of warning was sent to the Caterer concerned. *Gooseberry Pie The pie was in an advanced state of decomposition, being covered by green, orange and other mould growths, and the fruit filling being unrecognisable. Unfit for human consumption. Legal proceedings were instituted against the Caterer who was fined £10.00 and ordered to pay £10.00 costs. Plain Chocolate Consisted of milk chocolate substitute, made from sugar, hardened palm kernel oil, cocoa and skimmed milk powder Plain chocolate is made from sugar, cocoa and cocoa butter anc does not contain other vegetable fats. Investigation revealed that no further action was necessary. *Cheese The specimen, which had a very strong smell, was in poor condition and contained abnormal growths of bacteria and moulds. A lette. ot caution was sent to the Wholesaler who supplied the cheese. Advice was also given to the Caterer concerned as to future storage of foil wrapped cheese. *Cheese Danish Blue The cheese had had a strong smell, and brown growths with a slimy exudate were noticeable on the surface when the foil wrapping was removed. It was putrescent and unsuitable for sale. A letter of caution was sent to the Wholesaler concerned. Further samples obtained from the Importer have proved satisfactory *Cheese Cottage with Chives The cheese had deteriorated, having an unpleasant smell and being affected by growths of red yeast. A letter of warning was sent to the caterer concerned. *Cheese Cottage with Chives The cheese had deteriorated, having an unpleasant smell and being affected by mould. A letter of warning was sent to the Caterer concerned. *Cheese Cottage The cheese had deteriorated. It was partly covered by an abnormal fungal growth and was unsuitable for sale. Legal proceedings were instituted against the Caterer who was found guilty of negligence and fined £20.00 and ordered to pay £12.00 costs. 25 Arti cte Nature of Adulteration or Irregularity Action *Cheese Cottage The cheese had deteriorated, having a putrid smell due to fungal growth. A letter of warning was sent to the Caterer concerned. Cheese Low Fat Soft Contained only 9.3% fat instead of not less than 10% as required by the Cheese Regulations. Representations were made to the importers regarding the low fat content of the cheese. All stocks have been withdrawn from sale. *Cheese Soft The cheese was putrid and unfit for human consumption. Fortyeight live maggots of the Lesser Housefly were found in it. A letter of warning was sent to the Caterer concerned. Crowdie and Cream. Fresh Natural Cheese Consisted of a medium fat soft cheese containing Sorbic acid 600 parts per million. The supplier of the cheese has been requested to ensure that future supplies meet the requirements of the Labelling of Food Order. *Insect found in Bilberry Flavoured Yoghurt The specimen consisted of the Strawberry Seed Beetle, Harpalus rufipes. It was dead, badly mutilated and impregnated with Bilberry Juice. A letter of warning was sent to the Supplier of the yoghurt by the Corporation's Legal Officer. *Cheese Sandwiches The sandwiches were not consider ed reasonably fresh. They had a stale, sour smell and the Chedda Cheese bore patches of blue mould. A letter of caution was sent to the Caterer concerned. i *Cheese Sandwich Biscuits One of the packets contained among the biscuits six cast larval skins and one live pupa of a species of Dermestid beetle. A letter of warning was sent to the Manufacturer of the biscuits by the Corporation's Legal Officer. *Pickle Sandwich Containing Glass The specimen consisted of a small fragment of Crown Glass weighing 0.324 gram and of a character consistent with having originated from the broken neck of a 1 gallon pickle jar. Legal proceedings were instituted against the Caterer who was fined £15.00 and ordered to pay £10.00 costs. *Salmon Sandwich The specimen had a very unpleasant putrid odour and was unfit for consumption. A letter of warning was sent to the Retailer concerned. *Egg and Tomato Sandwich The sandwich had an unpleasant smell, which was traced to the egg being tainted. A letter of warning was sent to the Cafe Proprietor. Stewed Steak with Gravy, Canned Contained meat, 70%. This article should have a meat content of not less than 75%. A letter of caution was sent to the Retailer concerned. *Steak and Kidney Puddings One of the three puddings had an objectionable musty smell and bore on the upper surface of the pastry two large growths of mould (Penicillium). A letter of caution was sent to the Retailer concerned. Shepherds Pie Contained, in the layer of mashed potato, Sulphur dioxide, 50 parts per million, the presence of which was not disclosed on the label. A letter was sent to the Suppliers of the Food requesting them to ensure that future supplies conform with the Labelling of Food Order. English Lamb Chops The chops had an objectionable putrid smell and were unsound and unfit for consumption. Legal proceedings were instituted against the retailer who was fined £35.00 and ordered to pay £6.00 costs. Liver and Bacon Croquette The sample was stale and unsound, each of the six croquettes having two or more small growths of mould. Legal proceedings were instituted against the Retailer who was fined £35.00 and ordered to pay £6.00 costs. *Chicken The specimen was mouldy and unfit for human consumption. A letter of warning was sent to the Retailer concerned by the Corporation's Legal Officer. *Steak and Kidney Pie Contained on the pastry top a growth of green mould and was unfit for consumption. A letter of warning was sent to the retailer concerned. 26 Arti cle Nature of Adulteration or Irregularity Action *Steak and Kidney Pie Contained on the upper crust a growth of black mould and on the inside between the pastry and the filling several growths of white mould. Unsuitable for consumption. A letter of warning was sent to the Retailer concerned. *Portion of Pork Pie Contained on the meat under the pastry top a large growth of green mould and was unfit for consumption. Legal proceedings were instituted against the Caterer who was fined £20.00 and ordered to pay £ 12.00 costs. *Portion of Meat Pie Mouldy and unfit for human consumption. Legal proceedings were instituted against the Caterer who was fined £20.00 and ordered to pay £12.00 costs. Small unwrapped Pork Pies The pies were stale and had been attacked by mould. Legal proceedings were instituted against the Caterer who was fined £20.00 and ordered to pay £8.00 costs. Meat Pies Comprised 3 meat pasties, the average weight of which was 4.83 ozs. and the meat content '/j oz, or 10.3% of the pasties. Any meat pie or pasty should have a meat content of not less than 25%. or, if its weight does not exceed SVi ozs. of at least 1 oz. This foodstuff was wrongly labelled. Representations have been made to the supplier and the product is now correctly labelled as a cornish pasty. *Sausage Roll The sausage filling was covered by growths of green and black moulds and the sample was unfit for human consumption. Legal proceedings were instituted against the Caterer who was fined £15.00 and ordered to pay £12.00 costs. *Sausage Roll The sausage filling was covered by growths of green and black moulds and the sample was unfit for human consumption. Legal proceedings were instituted against the Caterer who was fined £15.00 and ordered to pay £12.00. *Scotch Egg Stale and unfit for consumption, the meat covering having an objectionable smell of decomposition. Legal proceedings were instituted against the Caterer who was fined £15.00 and ordered to pay £5.50 costs. * Part of a Scotch Egg Somewhat stale and unsuitable for sale. A letter of caution was sent to the Retailer concerned. Scotch Egg Stale and unsuitable for sale. A letter of caution was sent to the Caterer concerned. *Corned Beef. Canned The interior of the two cans were corroded and the corned beef had an unpleasant, sulphide smell and taste. It was partly discoloured and had deteriorated through overlong storage. Legal proceedings were instituted against the Retailer who was fined £25.00 and ordered to pay £20.00 costs. Grapes The grapes had deteriorated, six out of the forty four in the package (i.e. 13%) having extensive patches of brown rot and mildew and being unfit for consumption. A letter of warning was sent to the retailer concerned by the Corporation's Legal Officer. Oranges The sample was unfit for consumption, two of the four oranges being rotten and the other two, brown shrivelled and softening. A letter of warning was sent to the retailer concerned by the Corporation's Legal Officer. *Strawberries The specimen was mouldy and unfit for consumption. Legal proceedings were instituted against the Proprietor of the shop, who was fined £15.00 and ordered to pay £7.35 costs. Carrots Contained tin, 360 parts per million. Tin excessive. Representations were made to the supplier of the carrots who withdrew the whole consignment from sale. 27 Article Nature of Adulteration or Irregularity Action 'Yeoman' Consisted of Mashed Potato Mix, inadequately labelled, the common or usual name of the food not being specified. The manufacturers, of this product were informed that it was incorrectly labelled. New Labels have now been supplied which conform with the Labelling of Food Regulations. Creamed Potatoes The sample consisted of a dry mixture of cooked and powdered potatoes containing no cream, butter or milk. The description "Creamed Potatoes" was considered inappropriate when applied to a product which contained no cream and was not even of a creamy consistency. The manufacturer of this product was informed that it was incorrectly labelled. New labels have now been supplied which conform with the Labelling of Food Order. *Chips The potato chips included several particles of other cooked foods, comprising — 1 piece of bread from a cut slice, 2 particles of ham, 3 pieces of ham fat, 6 small particles of salmon. A letter of warning was sent to the Caterer concerned by the Corporation's Legal Officer. De Dijon Moutarde Contained sulphur dioxide, 110 parts per million, the presence of which was not disclosed on the label. A letter was sent to the suppliers of the food requesting them to ensure that future supplies conform with the Labelling of Food Order. Vinegar Contained ten small dead flies identified as Drosophila funebris, the Vinegar Fly. A letter of caution was sent to the Company concerned. Medium Dry Wine Consisted of a golden coloured wine of 24° proof. The description did not appear to constitute an "appropriate designation" as required by the Labelling of Food Order. A letter was sent to the Company concerned requesting them to ensure that future supplies conform with the Labelling of Food Order. "Bio-Strath" The preparation was recommended as a aid in the trea'ment of illness and convalescence, and to contain vitamins and minerals of which a large number were specified on the label. Determinations of six of these constituent: however, showed that the daily dosage amounted to far less than the normal bodily requirement of such vitamins and minerals, the fractions ranging from 1/200th to l/20th, and the label was consequently considered misleading. On the advice of the Corporation's Legal Officer it was decided that it was impracticable to initiate legal proceedings. All the samples were of an informal nature and those marked *were examined as a result of a complaint by members of the Public. 28 PROSECUTIONS FOOD AND DRUGS ACT 1955 Article Section Fine Costs Unfit Strawberries Section 8 £15 £7.35 Mouldy Scotch Egg Section 2 £15 £5.50 Unsound Lamb Chops Section 8 (1) (a) £35 £6 Mouldy Liver & Bacon Section 2 £35 £6 Croquettes Glass in Sandwich Sections 2,113 (3) £15 £10 Rodent damaged biscuits Section 2 £5 £10 Mouldy Apple Pie Section 2 £25 £10 Unfit Pork Pie Section 8 (1) (a) £20 £12 Unfit Hot Sausage Rolls Section 8 (1) (a) £30 £24 Unfit Meat Pie Section 8 (1) (a) £20 £12 Unfit Gooseberry Pie Section 8 (1) (a) £10 £10 Mouldy Cottage Cheese Section 2 £20 £12 Unsound Pork Pies Section 8 (1) (a) £20 £8 Fly in Cake Section 2 £20 £8 Foreign matter in buns Sections 2,113 (3) £25 £12 Unwholesome Canned Section 2 £25 £20 Corned Beef Unsatisfactory condition of Restaurant Food Hygiene (General) Regulations I960 £15 £5.50 Unsatisfactory condition of Restaurant Food Hygiene (General) Regulations I960 £345 £8 Unsatisfactory condition of Restaurant Food Hygiene (General) Regulations I960 £80 £39 29 FOOD AND DRUGS ACT 1955 AND FOOD REGULATIONS Samples purchased and submitted for Analysis Article Informal Formal Article Informal Formal Bacon A Jam and Preserves 4 Beer 2 Jelly 1 Bio-Strath 1 Liver Sausage 2 Black Pudding 2 Macaroni 1 Biscuits 6 Meat, canned, fresh, frozen, pasties, pies, pudding 35 Bread and Butter (slices 1 Bread and Rolls 8 Meat Products and prepacked 27 Bread and Rolls (part baked) 1 Meatless Steaks in Gravy 1 Bread Crumbs 1 Milk, canned, fresh, dried 8 18 Butter 3 Mousse 2 Butter Milk 1 Mustard 1 Cabbage 1 Paella, pkt. 1 Cakes and Pastries 24 Pasta 1 Cakes and Pudding Mix 1 Pastes and Pates 4 Cheese 10 Peanuts 1 Cheese Spread, Grated 3 Pickles 1 Chicken and Curry 1 Porridge, canned 3 Chicken, cooked and fried and barbecued 3 Potato, canned, crisps, instant 8 Chicken croquettes, pies and portions 8 Radishes 1 Raspberry Fool 1 Chilli powder 1 Rolls, filled 5 Chocolate Dessert 1 Salad 2 Chocolate, Malt Drink 2 Salad Dressing 1 Christmas Pudding 1 Sandwiches 8 Coffee, instant 2 Sauces 9 Cocoa 1 Sausages, bottled, canned, smoked 11 Confectionery 9 Cornish Pasties 6 Sausage rolls 9 Cream, Dairy Canned 6 Scotch Eggs 11 Curry 1 Soups 2 Custard Powder 1 Spices and Herbs 3 Danish Caviar 1 Sponge Pudding 1 Faggots 2 Tea 5 Fish, cakes, canned, shell, frozen, potted, smoked, spread, prepacked 13 Tomato Juice 1 Tomatoes, canned 2 Trifle 1 Vegetables, canned 3 Fruit, canned, dried, drinks, fresh, fillings juices, pies 40 Vinegar 1 Wines 7 Yoghurts 8 Hamburgers 1 Honey 2 TOTALS 362 20 30 Other Samples submitted for Analysis Arti cle Informal Formal Article Informal Formal Biscuits 8 Meat, canned, fresh, puddings and pies, pasties, products 16 Bread 1 Butter 2 Fruit, canned, dried, fresh, fillings, pies, pre-packed 17 Cakes and Pastries 3 Cakes and Pudding mix 2 Fruit, drinks, juices 2 Cereals 4 Rice and Custard Pudding 1 Cheese 7 Rolls and Sandwiches 6 Chips 1 Sauces 1 Chicken portions 1 Sausage Rolls 2 Chicken croquettes 1 Scotch Eggs A Chocolate syrup 1 Snai Is 1 Coffee, Roasted 1 Soup and Soup Balls 2 Coffee, Instant 1 Spices 2 Coffee-Mate 1 Stuffed goose Liver 1 Condiments 1 Tea 475 Confectionery (Flour) 2 Tomatoes, canned, puree 2 Cottage Cheese 7 Vegetables, canned, instant 2 Dried Orange Peel 1 Vinegar 1 Fish, canned 6 Wheat, cream of 1 Fresh Chestnut puree 1 Yoghurt 1 Macaroni Cheese 1 Water r Maple syrup 1 Fertilizers 2 Mushrooms, dried 1 Dust from Chimney of Great Eastern Hotel, Bishopsgate 1 Mustard 4 TOTAL 604 Bacteriological Examinations Cream Bun 1 Egg Albumen 29 Milk 2 Corned Beef 1 Curried Beef 1 Steak and Kidney Pie 1 Chi 1 led Meat 1 Roast Beef 1 Faecal Specimens 77 Vomit 1 Scotch Egg 2 Sausage Rolls 1 Spit Roast 1 Minced Meat 1 Pork Pie 1 Garlic Sausage 1 Water (including 103 from swimming baths) 242 TOTAL 364 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 22 tons 15 cwt 0 qrs 14 lbs which was disposed of as follows:- Ton Cwts Qrs Lbs Destroyed 13 18 3 19 Disposed of to Contractors 5 15 3 21 Released for Manufacture 3 0 0 0 Re-exported 1 2 13 cwt I qr 16 lbs of food detained at City Wharves was released under the supervision of the Local Authority. FOOD AND DRUGS ACT 1955 (SECTION 16) The Section provides for registration of premises for the sale, manufacture for sale or 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 - Brining of Meat 16 Boiling of Shellfish 5 Cooking of Meats and Poultry 9 Cooking of Meats and Poultry for resale 5 Manufacture of Dripping 8 Manufacture of Ice Cream 2 Manufacture of Pies 2 Manufacture of Sausages 10 Pickling and bottling of Shellfish 3 Preparation and bleaching of tripe 1 Preparation of Jellied Eels and Shellfish 8 Preparation of Poultry 2 Sale and storage of Pre-packed Ice Cream 51 Selecting and testing Sausage Casings 4 Sale of Ice Cream/Pre-packed 30 Cooking of pre-packed Frozen Pies 1 TOTAL 157 PHARMACY AND POISONS ACT, 1933 This Act provides that every local authority shall keep a list of persons who, not being entitled to sell poisons included in Part I of the Poisons List, are, subject to the provisions of this Act, to be entitled to sell poisons included in Part II of the Poisons List (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 less dangerous poisons such as Phenols, hair dyes, etc.) A local authority may refuse to enter in, or may remove from, the list the name of any person who fails to pay the fees prescribed by rules or who in the opinion of the authority is, for any sufficient reason, relating either to him personally or to his premises, not fit to be on the list. Fifty firms are registered under this Act. During the year 43 inspections were made in connection with the administration of the Act, in consequence of which five contraventions of a minor nature were noted and effectively dealt with. 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. Ten inspections were made in connection with the administration of the Act. One contravention was noted and effectively dealt with. FISH INSPECTION Inspection of fish in the City of London is carried out by officers of the Worshipful the Fishmongers' Company. The Fishmongers returns indicated as follows:- Deliveries at or near Billingsgate Market (including shellfish) Weight of Fish condemned Condemnation Rate 76,560 tons 205 tons 0.26% MEAT AND FOOD INSPECTION - SMITHFIELD MARKET Meat, Poultry and Other Foods delivered at Smithfield Market:- 1970 287,444 tons 1969 316.718 tons The difference of 29,274 tons in the above figures is roughly balanced by the drop in tonnage on meat from South America delivered at Smithfield. 1970 1969 Argentine 16,096 tons Argentine 38,376 tons Uruguay 10 Uruguay 7,524 Other S/Am. Countries 5,726 Other S/Am. Countries 6,134 21,832 tons 52,034 tons The replacement of bone in beef by cuts of boneless beef is responsible for this, also for great changes in some sections of the market and accounts for the lower total of South American meat surrendered for unsound condition. Cooled or chilled meat which developed spoilage in transit forms the bulk of unsound meat surrendered. The meat from Finland surrendered in January, however, was not a fresh import, but came from a United Kingdom Cold Store. Meat Inspection Regulations, 1963 These Regulations apply to meat slaughtered in England and Wales. Deliveries of meat from these sources to Smithfield during 1970 were as follows: (1969 figures in parenthesis). Beef and Veal Mutton and Lamb Pork Tons 24,194 (18,447) 14,895 (14,509) 39,985 (41,424) 23 tons II cwts I qr 20 lbs was surrendered for disease and amounted to 0.030% (0.038%) of deliveries. Local Authorities continued to be notified of significant losses by reason of disease from carcases bearing their legible inspection stamps and close liaison was maintained on matters concerning the Meat Inspection Regulations. 85% of mutton carcases, 34% of pork carcases, and 77% of veal carcases surrendered for diseased condition carried inspection stamps which were illegible. Some of these carcases, particularly sheep and young calves, would have been moist and difficult to stamp legibly because of their condition. These figures, therefore, cannot be related to the stamping of normal, sound carcases, but no doubt the legibility of stamps would often be improved if more time was available for drying off before stamping. Poultry Inspection There are no premises in the City of London which are used for the processing of live poultry. Smithfield supplies come in the main from processing stations in the United Kingdom, while small quantities may be sent from farm and other premises. Poultry inspection in the City of London consist of the scrutiny and examination of uneviscerated carcases from all sources; eviscerated carcases are hard frozen and cannot be examined for disease. Carcases of 500 young and 500 adult birds taken at random from poultry condemned at Smithfield were the subject of a paper "Pathological Findings in Condemned Chickens" by P.A. Papasolomontos, E.C. Appleby and O.Y. Mayor (Veterinary Record (1969) 85.17). One of the conclusions reached was (quote) "Lesions of respiratory systems and serous surfaces were found in almost 50% of young birds. Lesions of the alimentary system, including tuberculosis, and of the reproductive tract, especially ovarian carcinoma, were common in the older birds." The picture of disease found remains fairly constant, but Marek's disease was more frequently found in 1970 and towards the end of the year there were some condemnations of poultry in which the evidence of disease led to suspicion of Fowl Pest. Information concerning two sources was passed to the Ministry of Agriculture, Fisheries and Food. 33 Imported Food Regulations, 1968. Imported meat in containers notified as unexamined at the Port of Entry for the purpose of these Regulations was examined on arrival at Smithfield. The supply of information by the Smithfield FreightOffice of British Rail is greatly appreciated. It is particularly valuable in tracing containers which do not arrive in Smithfield and where the notifications therefore have to be passed on. Communications from Port Health Authorities, particularly at weekends have been helped by the installation of a recording machine. Official notifications concerning 4,059 containers from the Republic of Eire were received during the year. Sampl ing Samples sent for bacteriological examination 30 Samples sent for histological examination 1 Samples collected for Government Chemist I 35 (Pesticide Research) Educational Mounted specimens loaned to Local Authority Health Exhibitions 50 Morbid specimens were provided for 5 Public Health Examinations in London. Acknowledgement is made of the co-operation of the Department of Pathology, Royal Veterinary College, with whom a mutually beneficial arrangement provides them with pathological specimens of poultry and the Meat Inspectors with pathological reports when requested. Ten such reports were received during the year. Exports Number of exportation certificates issued 5 TABLE SHOWING THE AMOUNT OF MEAT, POULTRY AND OTHER FOODS SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON, 1970 Smithfield Market Leadenhall Market and City Shops Cold Stores Total T C Q L T C Q L T C Q L T C Q L Meat (Diseased) 28 12 l 6 1 8 1 12 28 12 3 26 Meat (Unsound) 179 19 0 II 1 1 1 0 1 3 14 0 24 182 4 1 20 Offal 48 5 1 25 1 2 12 19 1 20 49 6 2 1 Poultry & Feathered Game 49 17 0 5 3 6 2 10 4 0 2 53 7 2 17 Rabbits & Hares 1 18 3 7 3 20 1 19 2 27 Tinned Meat 4 0 2 17 3 3 4 4 4 1 21 Other Tinned Goods 3 13 1 23 12 1 4 4 5 2 27 Frozen Fish 15 3 5 15 3 5 1970 317 2 2 15 5 16 2 15 1 18 0 2 324 17 1 4 1969 374 2 2 26 3 8 2 12 6 3 18 377 18 1 0 34 35 TABLE SHOWING THE AMOUNT OF MEAT SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR DISEASED CONDITION. 1970. Country of Origin January February March Apri 1 May June July August September October November December 1970 1969 lbs lbs lbs lbs lbs l bs lbs lbs lbs lbs lbs lbs lbs lbs Australia 69 69 Denmark 15 15 15 Eire 754 229 536 565 104 232 609 244 714 412 473 250 5,122 12,838 England and Wales 6,194 4,650 5,812 5,764 4,104 3,870 3,924 4,316 4,478 3,954 3,391 2,331 52,788 62,820 Finland 17 324 191 120 93 126 83 954 1,462 New Zealand 18 40 4 10 33 1 1 21 137 59 N. Ireland 46 5 20 35 30 77 1 31 16 360 462 Poland 18 14 32 91 Scotland 579 624 470 917 115 429 362 259 104 199 192 237 4,487 3,649 S. Africa 29 40 69 - Sweden 18 8 16 42 27 1 1 1 - Yugoslavia 30 30 221 Other Countries 550 1970 7,527 5,625 7,182 7,516 4,470 4,653 5,101 4,894 5,401 4,763 4,208 2,834 64,174 - 1969 7,996 4,842 10,071 7,568 6,689 7,288 7,536 6,279 6,716 6,652 5,668 4,862 - 82,167 36 TABLE SHOWING THE AMOUNT OF MEAT SURRENDERED TO OR SEIZED BY MEAT INSPECTORS IN THE CITY OF LONDON FOR UNSOUND CONDITION, 1970. Country of Origin January February March April May June July August September October November December 1970 1969 lbs lbs lbs lbs lbs lbs lbs lbs lbs lbs lbs lbs lbs l bs Argentine 1,617 4,304 5,278 3,772 2,083 3,335 2,524 2,117 5,806 4,840 3,493 6,022 45,191 108,813 Australia 180 128 425 54 360 124 1,271 381 Brazi 1 32 44 80 22 178 5,693 Denmark 24 26 60 110 1,524 Eire 5,013 4,898 3,319 5,526 3,703 5,761 5,533 7,456 9,402 5,61 3 6,431 6,007 68,662 69,108 England and Wales 5,753 4,741 4,951 6,107 12,264 24,058 31.516 19,691 30,787 5,376 14,709 5,053 165,006 175.001 Finland 16,784 12 400 563 13 11,505 44,182 73,459 1 ,974 France 260 132 64 456 781 New Zealand 27 153 222 241 674 61 275 465 1 14 73 334 525 3,164 3,381 N. Ireland 144 564 36 124 76 20 489 836 1,237 444 495 92 4,557 2,214 Poland 76 16 268 790 47 1,197 70,201 Scotland 1,415 924 698 443 8,156 902 1,469 4,684 6,097 2,313 528 922 28,551 31,009 S. Africa 8 303 404 315 4,842 54 1, 137 98 7,161 1 ,419 Sweden 126 100 17 32 1 ,732 2,007 231 U.S.A. 36 60 368 464 - U ruguay - 55,120 Yugoslavia 743 383 394 289 133 216 293 3,121 550 320 6,442 14.591 Other Countries 300 300 345 1970 31,636 16,159 1 5,729 17,631 28,046 50,770 42,179 39,915 55.788 62,910 26,598 20,815 408,176 - 1969 73,853 16,105 17,162 24,603 25,043 32,850 142,734 56,804 45,761 48,185 1 3,327 45,359 - 541,786 FOOD HYGIENE - SMITHFIELD MARKET The Food Hygiene (General) Regulations, I960 Around Smithfield, in Leadenhall Market and in the City including Billingsgate area there are 32 businesses dealing in meat, poultry and game which are subjected to regular routine visits by the Meat Inspectors, Number of Premises 32 Number of premises fitted to comply with Regulation 1632 Number of premises to which Regulation 19 applies 31 Number of premises fitted to comply with Regulation 19 30 The Food Hygiene (Markets, Stalls & Delivery) Vehicles Regulations, 1966 These Regulations are enforced in Smithfield Market which at the 31st December 1970 comprised of 331 stalls occupied by 11 I tenants. Each business is equipped with washing facilities required by Regulations 16 and 18 of these Regulations. Co-operative efforts to improve hygiene by all concerned were noticably rewarding, but problems inherent in old market buiIdings, which are also public,remain to be overcome. Continuous changes make any estimation of numbers of manual workers engaged in the market unreliable, there are however 388 porters licensed by the Clerk and Superintendent who are self employed or employed by meat firms and meat carriers. A good standard of cleanliness of vehicles has been maintained both by the market carrier companies and private butchers and any structural defects have been carried out promptly. There is still an ever increasing number of vehicles used by cafeand small restaurant owners for transporting their own meat which do not conform to the Hygiene Regulations. The cleanliness of these vehicles is often below desirable standards. Where these are observed attention is given to educate the owner in the requirements of the Regulations, and the help of Local Authorities is sought to ensure that vehicles are clean and hygienic on their next visit to the market. The supply of clean protective clothing is becoming more difficult. During the year the only laundry, hire and repair service firm has shut its collection Depot in the market and only account customers are now served by delivery and collection vehicles to firms on the market. This has deprived the self employed porters and pitchers of laundry facilities which in the past had proved very successful and there appears to be no laundry prepared to take over this service. The Food Hygiene (Docks, Carriers, etc.) Regulations, I960 One large riverside cold store at Blackfriars was closed down. There are now 4 Public Cold Stores where meat deliveries are handled and where these Regulations are enforced. Check inspection for caseous lymphadenitis of samples from 40 consignments of frozen mutton carcases in these cold stores were made during the year. DISEASES OF ANIMALS ACT 1950 & ASSOCIATED ACTS Mr. G.S. Wiggins, M.R.C.V.S., Veterinary Officer for the City of London, has submitted the following report:- "Under the terms of the London Government Act 1963, the Corporation of London is the authority for the administration of the Diseases of Animals Act 1950, in regard to the importation of animals, for the whole of Greater London. The remainder of the functions under the Diseases of Animals Act and Associated Acts are the responisbility of the individual London Boroughs, but the Corporation carries out duties for 17 London Boroughs on an agency basis. 1970 was the fifth year in which agency arrangements were in operation and visits of inspection were made to various premises including riding establishments, animal boarding establishments, pet shops, kosher and other butchers and poulterers, slaughterhouses, farms, piggeries, theatres, circuses, poultry and cattle shows, research laboratories etc. The total number of premises which the Corporation undertook to visit was 741 and 2084 visits of inspection were carried out. 37 The work carried out under these Acts and Orders included the following:Psittacosis or Ornothosis Order, 1953 A case of psittacosis occured in November in the London Borough of Richmond upon Thames. The bird concerned was an imported dove, one of a consignment of twelve from Germany. The bird died and tests proved positive for psittacosis. Restrictions were placed on the remaining birds. These were examined after the usual period and as they had remained healthy restrictions were lifted. The relevant medical authorities and Ministry were informed. Another case of this disease occurred in November in the Royal Borough of Kensington and Chelsea. In this case three parrots died over a period of 4 weeks. The carcase of the first bird to die was disposed of but the other two were sent to a laboratory where tests proved positive for psittacosis. The pet shop from which the birds came was visited and all cages,utensils etc., were thoroughly cleaned and disinfected. The owner of the shop and his staff received advice from the Medical Officer of Health of Royal Borough of Kensington & Chelsea. There were nine other parrots at the shop and the owner was informed that these should not be sold until permission was given. The shop was re-visited in December and as all the birds were in good health permission was given for the birds to be disposed of. Fowl Pest Order, 1938 An epidemic of fowl pest began in August in the County of Essex and by December had spread to some 40 counties in England and Wales. Eight outbreaks occurred in the Corporation's agency area and restrictions were placed on 13 other farms which were exposed to infection. At the request of the Ministry of Agriculture, Fisheries and Food, Officers visited premises where poultry is slaughtered or sold concerning the disposal of waste materials and the cleansing and disinfecting of vehicles used for the conveyance of poultry. The correct disposal of viscera etc., is necessary in preventing the spread of disease and this problemwas heightened by the strike of dustmen, road cleaners, etc., which occurred during the outbreak. The Ministry requested the department to deal with one outbreak which occurred in the London Borough of Lewisham. The cleansing and disinfecting of the premises and destruction of the diseased carcases were carried out and the necessary forms issued. Riding Establishments Act, 1964 Under the provisions of this Act, Veterinary inspection must be carried out of riding establishments at least once per year. Such inspections were made at 40 establishments in eleven London Boroughs Also, a number of investigations and enquiries were made concerning complaints from members of the public and the R.S.P.C.A. Pet Animals Act, 1951 Visits of inspection were made to 97 pet shops in seven London Boroughs and to the pet shop in the City of London. Recommendations were submitted concerning the re-licensing of these shops. Visits were also made concerning complaints from the public. Club Row, the Sunday morning market which specialises in the sale of pet animals was visited regularly and a problem which was particularly encountered was that of un-licenced vendors selling animals. The prevention of this practice is difficult in that Officers have to obtain absolute proof that a sale took place. Several persons were warned about this practice and the co-operation of Officers of the Police and the London Borough of Tower Hamlets is greatly appreciated in this respect. The London Borough of Islington has now asked the department to commence the inspection of pet shops in that Borough, Animal Boarding Establishments Act, 1963 28 animal boarding establishments were visited on behalf of four London Boroughs and reports were submitted concerning the re-licencing of these establishments, The service was also used in a consultative capacity and to investigate complaints. Live Poultry (Restrictions) Order, 1957 Two licences were issued under the terms of this Order, to enable the holding of poultry exhibitions at the Dagenham Town Show and Carnival and the International Poultry Show. Inspections were carried out to ensure that the terms and conditions of theOrder were conformed to. At the request of the Ministry of Agriculture, Fisheries and Food, no further licences have been issued due to the epidemic of fowl pest. 38 39 Performing Animals (Regulation) Act, 1925 Five certificates of registration were issued under the terms of this Act. Visits were made to television studios concerning the use of animals in productions and to a circus which appeared at Clapham Common and Bromley Common A certificate of registration was issued to Thames Television Limited to enable them to use performing animals in their productions and the studios were visited and the provisions of the Act explained to the Secretary of the Company, The department will be notified when animals are to be used so that inspections may be carried out. Regulation Movement of Swine Order, 1959 Under the terms of this Order animals moved under the authority of a licence to premises other than a bacon factory or a slaughterhouse must be kept on the premises, separate from other animals, for a period of 28 days. During the year 352 licences were received and verified. This service was carried out on behalf of the London Boroughs of Bromley, Bexley and Greenwich. Post Mortems Frequent requests were received for Officers to carry out post mortem examinations on animals which arrived dead or died at slaughterhouses or were found dead on farms, public highways etc. 39 such examinations were carried out of which 33 were pigs, 5 sheep and I calf. Acts and Orders, 1970 The following Acts and Orders, affecting the work of the department, come into operation during the year. Slaughter of Poultry Act, 1967 This Act, which came into operation on 1st January, states that every local authority must maintain a register of all premises in its area where turkeys or domestic fowls are stunned before slaughter. The Act makes provisions for the humane slaughter of poultry which are set out therein and also makes provision for the prevention of cruelty to birds awaiting slaughter. Fowl Pest (Infected Areas) Special Orders, No. I, 2 and 3 Special Order No. I declared parts of Essex to be infected areas and Order Nos.2 and 3 extended these areas to eight other counties. These areas became subject to the provisions of the Fowl Pest (Infected Areas Restriction) Order 1956 which include a prohibition against the movement of poultry out of, within or into an infected area except under licence. Diseases of Animals (Approved Disinfectants) Order, 1970 This Order, which came into operation of 17th September, sets out lists of disinfectants approved by the Minister in relation to Orders under the Diseases of Animals Act 1950 dealing with Foot and Mouth Disease, Fowl Pest and Tuberculosis and other Orders requiring the use of an approved disinfectant. I would once again like to take this opportunity of expressing my appreciation of the staff of this department who have shown the greatest co-operation and helpfulness to all concerned during the year." PERSONAL HEALTH SERVICES IN THE CITY (Comparable figures for 1969 are given in brackets where appropriate) The total number of births occurring in the City (St. Bartholomew's Hospital and domiciliary births) was 915 (913). Births (to City Residents) 1969 1970 Hospital Live Births 22 23 Domiciliary Live Births 1 NIL Number of these born with congenital malformations NIL NIL Stillbirths NIL NIL 40 NATIONAL HEALTH SERVICE ACT, 1946 (as amended by the Health Services and Public Health Act, 1968) The Corporation of London is responsible for services as set out in Sections 21 to 29 (excluding Section 27) of the National Health Service Act, 1946. The Greater London Council is responsible for the administration of all ambulance services within the Greater London area under Section 27 of the Act. SECTION 21 - HEALTH CENTRES There are no such Centres in the City of London. SECTION 22 - CARE OF MOTHERS AND YOUNG CHILDREN There were no (NIL) notified cases of congenital defects recorded during the year either to City residents or to non-City residents. Infant Deaths 1969 / 970 Stillbirths NIL NIL Neo Natal NIL NIL Perinatal NIL NIL Others under 5 years NIL NIL Maternal Deaths 1969 1970 NIL NIL Child Health Clinic Clinic Attendance of Children under 5 years. 1969 1970 Attendances 419 421 Medical Examinations 165 169 Hearing Tests 7 8 Phenylketonuria Tests 15 3 Dr. A. White Franklin, the Paediatrician, has reported as follows: "The work of the Infant Welfare Clinic continues with little change. The standard quadruple immunisation procedures are well accepted by the Mothers, and fortunately have not caused any complications. Smallpox vaccination, now performed during the second year of life, is also popular. Measles immunisation is being carried out in the second year. On the whole, the parents are well informed about the management of their infants and accept their responsibilities well. Many have attended the usual Ante-Natal Classes in the Maternity Departments, so that they are emotionally well-prepared. The At-Risk Register is still maintained, although modifications are expected since in general the results from the Register are not justifying the technique. Relatively new is the "abused baby" register. This is intended to draw special attention to the possibility that parents have harmed their babies because of some unresolved psychological problems of their own. Recent study of this problem shows it to be a real one, but if the index of suspicion becomes too high, the relationship of confidence between the Mother and her baby's Doctor may be harmed. Much more study is required before the best method of handling this problem can be planned." Vaccinations and Immunisations at Child Health Clinic 1969 1970 Diptheria/Tetanus/Whooping Cough 21 12 Poliomyelitis 15 10 Smallpox 11 9 Measles 2 3 At Risk Register 1969 1970 Children under 5 years of age 4 1 41 Day Nurseries 1969 1970 Kingsway Creche City children in attendance at end of year 4 3 City children on waiting list NIL NIL Other Nurseries City children in attendance at end of year 2 NIL City children on waiting list NIL NIL Registered Child Minders 1969 1970 Application for registration NIL NIL Unmarried Mothers and their Children The Diocesan Moral Welfare Worker has advised and assisted 13 (8) cases during the year. Only two of these were City residents. There was one referral to Corporation staff during the year. Welfare Foods The sale of Welfare Foods continues at the Child Health Clinic, St. Bartholomew's Hospital and at the Health Department Office. SECTION 23 - MIDWIFERY SERVICE The Metropolitan District Nursing Association continued to provide domiciliary midwifery services in the City. No request for midwifery services within the Temples was made. 1969 1970 Home confinements attended I 0 Planned early discharge from hospital 2 2 Emergency cases attended 0 I The midwives attend, on a one day per week rota, St. Bartholomew's Hospital maternity department where they attended three deliveries. Midwives Act, 1951 The Corporation, as a supervising Authority for the City of London, received 34 (26) notifications from midwives of intentions to practise during the year. SECTION 24 - HEALTH VISITING 1969 1970 Home Visits to children under 5 years Successful visits 545 290 Unsuccessful visits 119 47 The promotion of healthy living, advice on the care and upbringing of children and information on the welfare services available has continued as part of the functions of the Health and Welfare Officers. The families are met in their own homes and in the Child Health Clinic at St. Bartholomews Hospital. Testing for the detection of phenylketonuria and hearing ability screening being part of the procedures used to eliminate poor health factors. Elderly handicapped people and the aged chronic sick receive many supportive services which enable them to remain in their own homes. These two groups require the utmost collaboration with family doctors, hospital services, social workers and voluntary organizations. It is the role of the Health and Welfare Officers to supply that link in maintaining the elderly, helping them achieve active healthy living as long as possible within their own environment. The Health Department has received one student health visitor for a period of training, student nurses from Great Ormond Street Hospital for observation visits and other observers from health and social work agencies. Health Education either individually or to groups, progresses steadily, every opportunity being taken to provide information and knowledge not only for the resident community but for the daily working population as well. 42 Tuberculosis Health Visiting There has been a slight increase in the volume of work during the year partly due to the contact tracing in shops and offices and the follow-up visits required to check on the men staying in the Middlesex Street hostel. Home visits to City residents attending the Chest Clinic at St. Bartholomew's Hospital have been made to provide support and supervision and to ensure satisfactory progress. 1969 1970 Cases notified (residents) 1 5 Home visits, Old and new cases 52 92 Shops and office contact tracing No. of investigations 71 6 (involving 75 persons) SECTION 25 - HOME NURSING The Metropolitan District Nursing Association continued to provide home nursing services in the City. There were 5 (I) requests to attend patients who live within the Temples and 7 (0) requests to attend patients who live within the Barbican area. Approximately 662/3%(75%) of visits made were to persons aged 65 years and over. Details of visits are as follows:- 1969 1970 Visits to children under the age of 5 years 4 0 Visits to age group 5 to 64 940 1305 Visits to persons aged 65 and over 2505 2352 Total visits 3449 3657 Type of Nursing Care and Treatment 1969 1970 Injections only 765 908 Injection plus other treatment 16 15 Nursing care and treatment 2668 2734 Totals. 3449 3657 Number of patients being attended at the end of year 20 20 The District Nursing Staff received 28 night calls during the year. SECTION 26 - VACCINATION AND IMMUNISATION (See School Health Section for vaccinations and immunisations of school children) Adults Children under five years Smallpox 50 (63) M (II) Poliomyelitis NIL 10 (12) (primary courses and booster doses) Diptheria/Whooping Cough/Tetanus NIL 12 (17) (primary courses and booster doses) In accordance with Ministry of Health instructions that smallpox vaccine should be distributed to medical practitioners by the Local Authority in whose area they practise, arrangements were made, commencing in June 1967, for the vaccine to be distributed to City doctors. During 1970, 5336 (6099) doses have been issued to private doctors, general practitioners, St. Bartholomew's Hospital, the medical department of Unilever and various City business houses. Vaccine is also issued for the vaccination of trainee ambulance drivers at a City centre. Poliomyelitis vaccine is also issued at the request of St. Bartholomew's Hospital. Unilever Ltd., and City medical practitioners, In all, 3200 (2933) doses were issued. SECTION 27 - AMBULANCE SERVICE The Greater London Council are responsible for the ambulance service in the Greater London area. 43 SECTION 28 - PREVENTION OF ILLNESS, CARE AND AFTERCARE City of London Chest Clinic Dr. Neville C. Oswald, the Chest Physician, has reported as follows:- "During 1970, 12 City Residents with Pulmonary Tuberculosis have been kept under regular supervision. Eight were carried over from 1969, three previously notified came into the Salvation Army Hostel and one (a Syrian) was referred from Health Control, Heathrow Airport. Of the 12 patients, two were infectious and admitted to Hospital, five close contacts of Tuberculosis are under observation, four school children with positive tuberculous skin tests are also seen reguarly. During 1970, six City Workers were found to have active Pulmonary Tuberculosis, none of whom resided in the City. This led to the radiological examination in the Clinic of 75 contacts, of whom 20 had second examinations. There are 12 City Residents with non-tuberculosis respiratory diseases, who are seen regularly in the Clinic." Mass Miniature Radiography A Mass Miniature Radiography Unit of the North East Metropolitan Regional Hospital Board is established at Milton Court. Dr. R. Shoulman, the Director of the Unit reports as follows:- "Introduction During the year under review Unit 6D continued to serve the City of London and operated for the greater part at Public Services Building, Milton Court, E.C.2., where 45,601 persons were X-rayed. The Unit also visited four large organisations where a further 7,164 examinations were made. For the year the overall total amounted to 52,765. Since the Unit commenced operating in May, 1950, it has X-rayed well over one million individuals. Up to the end of 1970, the totals examined were as follows:- 751,564 males and 488,394 females, making a grand total of 1,239,958. Unit Results Tuberculosis. During 1970, tuberculous infection was detected in 370 examinees, of these 362 were healed lesions requiring no further action. 6 required occasional supervision only and 2 (both males) had significant lesions requiring treatment, giving the lowest incidence rate ever recorded, i.e. .064 for males and nil for females, an overall rate of .038 per 1,000 examined Lung Cancer. 6 cases of carcinoma of the bronchus were discovered, all males, giving a rate of 1.90 per 10,000 examined. Of the 52,765 persons X-rayed on miniature film, 147 were referred for further investigation, a rate of 2.78 perl,000 examinees.Other chest conditions were detected in fair numbers,as in previous years. General Comments This will be the last Annual Report on the workings of the Unit as it is to cease operations at the end of February, 1971, in accordance with arrangements made by the Regional Hosp ital Board and the Department of Health. I cannot let this opportunity pass without expressing my grateful thanks to the members of the Unit staff, who all managed to carry out their duties as efficiently as ever with the shadow of closure hanging over them. At the time of preparing this Report, alternative positions have been secured or offered for all except the Organising Secretary. During the months of January and February, 1971, the Unit X-rayed 6,244 persons, of whom 25 were referred for further investigation, but by the time the results are known the Unit will have completely disbanded, but we can report that during the life of the Unit a grand total of 1,246,202 individuals were examined, and undoubtedly this Unit has played a significant role in the control of active tuberculosis. I wish to pay tribute to Dr. W.G. Swann, Medical Officer of Health for the City of London for the ready co-operation given, and to thank the Thames Group Hospital Management Committee and the Regional Hospital Board for their advice and assistance." 44 Special Hostels for Tuberculous Men 1969 1970 Men resident during the year 4 5 Loan of Nursing Aids 1969 1970 Supplied by Health Department 44 63 Supplied by British Red Cross Society — City Branch 2 6 The number of aids loaned to City residents are still increasing year by year. There is no doubt that the elderly infirm and those with chronic illnesses find the use of walking aids, wheelchairs, commodes, back-rests and other aids a great help in maintaining some measure of independence. The aids are also particularly appreciated by supporting relatives. Chiropody Service The following reports have been received from Mr. R. Jones, M.Ch.S., S.R.Ch., and Miss R. Atkins, M.Ch.S., respectively "From January to December 1970, 415 treatments were given to patients at Gravel Lane Clinic. Each patient was seen on average once a month and all the patients were in the 70 plus age group and suffered with the usual Chiropodial ailments of the aged such as bad callosities, corns and painful bunion joints. The number of Diabetic patients seen had not increased during the year. Patients with the exception of 3 only missed appointments due to sickness or weather conditions. With missed appointments the patient could not understand that due to previous bookings another appointment could not be given immediately, although they were seen on emergencies if sepsis was present. All of the patients were very appreciative of the treatment given and in my opinion if we can keep these old people mobile for several more years the Clinic is doing a very good job." "The Chiropody Service continued to functionas intheprevious year, except that in AprilChiropody treatment became free to all patients. Persons treated are those over retirement age and those physically handicapped. Chiropody treatment as arranged by The Health Department falls into four categories:Milton Court A Chiropody Clinic is run here once a month. Usually six to eight patients are seen at a session, and during the year about 83 treatments were given. Salvation Army Hostel A clinic is held here about every two months. At the beginning of the year the number of men attending was decreasing, but by the end of 1970 five men regularly attended for much needed treatment. It is very surprising that the men do not make more use of this service. I understand that many of the men are not old enough to be eligible, and the necessity to have to wash their feet deters others from applying! Seven sessions were held during the year, and 29 treatments were given. Domiciliary Visits This service is only for Housebound patients or those too infirm to go to the clinic. There are about 30 people who are treated in their home, and during the year about 150 treatments were given. Sir John Cass's Foundation School During the year nearly every child in the school had a foot inspection. This included a "general chat" on Feet, Footwear, Hygiene and Posture, given to them as a group, and then an examination of each child. After this any necessary treatment is given The children are told report any foot problems they may have at any time during the year. The children at the school are very Chiropody conscious, and even know how to pronounce Chiropody correctly! They are 45 aware of shoe sizes and the correct type of footwear that they should be wearing. I impress on them to be measured for new footwear, because in many cases they are wearing shoes that are too small for them. At the end of the summer term, the senior class were all given a pamphlet on Foot Health, and advice on the care of their feet, when they left this school at the end of the Summer Term to go to one that possibly may not have a similar Chiropody Service. About 315 children were seen during the year and about 35 required further treatment. I would like to thank The Health and Welfare Department, The Brigadier and his Staff at the Hostel, and Mr. Jarvis and his Secretary at the School,for their kindness,help, and co-operation towards me, which had helped in the smooth running or this service and my pleasure in doing the work." Recuperative Holidays 1969 1970 Adults NIL 1 Children NIL NIL Pads for Incontinent Persons No charge is made for this service, which greatly helps not only the individual concerned, but also the family and those providing nursing care. Incontinent Laundry Service (Public Health Act, 1936) 1969 1970 Persons receiving service at end of year 13 15 Items washed 5481 3745 Patients supplied with Incontinence Pads at end of the year 3 3 Arrangements have been made with the London Borough of Tower Hamlets for items to be laundered at their premises. A twice weekly collection and delivery service is operated by Corporation transport. Yellow Fever Vaccination The Corporation continued to supply yellow fever vaccine to the designated centre at Unilever House. As the Corporation is also the Port Health Authority for the Port of London arrangements have also been made for distribution to the Shipping Federation Medical Centre at King George V Dock and at Tilbury Dock. During the year 3098 (4460) doses of vaccine were distributed. International Certificates of Vaccination against Smallpox 1969 1970 No. authenticated 2964 3237 No. returned as doctor did not practise in the City 20 43 V.D. Contact Tracing 1969 1970 Requests received for assistance in follow up City cases: NIL NIL Non City cases: 9 14 Health Education Subject Audience No. of Lectures Attendances Health and Welfare Services Guides ) 7 129 Nurses ) Police Sergeants ) Baby Care Ante-natal Mothers 12 195 Place of Sexual Relationship in School Children 12 98 Society Weight Control General Public An estimated I 500 people attended the exhibition during the three days "Good Health" General Public Four lunch-time lectures by St. Barth- Work of Health olomew's Hospital staff. Flowmeter Department study (2,500 took part in this). 46 There was a reduction in the number of special talks given to small groups in 1970, but it was decided to produce two exhibitions and a series of talks for both City workers and City residents. These were organised and achieved considerable success. The first Exhibition was held in April, 1970, its purpose being to demonstrate the work of the Port and City Health Services. Four Lunch Time Talks were given by consultant medical staff of St. Bartholomew's Hospital at the Guildhall at weekly intervals. The topics were Cervical Cytology, Weight Control, Air Pollution and Coronary Thrombosis. Audiences of approximately 150 people attended each of these talks and many questions were asked in the lively discussion periods. The Exhibition Hall situated at the rear of the Guildhall was the site of the exhibition. Entitled "Good Health" it portrayed in photographs and by other forms of visual aids, the control of communicable disease, the prevention of importation of unwholesome foods, the safeguarding of hygiene both in the Port and City itself, reduction of air pollution, noise control and varying aspects of the personal health and welfare services. It is estimated that well over 2,500 people attended. The second exhibition was held in September, 1970, and consisted of the Health Education Council Mobile Unit placed outside the Royal Exchange. Inside the building, films were shown during the lunch hours and posters and leaflets were on display, the theme being ''WeightControl". In spite of wet weather, an estimated number of over 1,500 people attended during the three days; a similar number watched the films. The following report has been received from Professor P.J. Lawther, M.B., F.R.C.P., Director of the Medical Research Council's Air Pollution Unit:- "At the Health Exhibition in April, 1970 the Medical Research Council Air Pollution Unit carried out a survey of Peak Expiratory Flow (PEF) in relation to smoking habits and residential history. A team of three workers from the Unit, together with one from the Health Department, attended each lunchtime and people visiting the exhibition were invited to answer a few questions about date and place of birth, area of residence and smoking habits. They were then weighed and measured and asked to blow five times into a peak flow meter. Tables of "standard" values were on display, so that the subjects could check that their results were within the normal range. The few subjects with very low values were given a note of their own results and advised to see their physician. Over 2,500 people had their peak flow measured during the five weeks of the exhibition, and the survey was continued in further lunchtime sessions at the College of Further Education, in Bunhill Row. The results from a final total of 2891 subjects were punched onto cards for analysis by computer. It has been possible to examine the relationship between peak flow, height and age thoroughly, and the results may be used to provide revised "standards" against which to compare clinical results. The tabulations of height and weight obtained in this survey are also of interest in their own right, and the results are being compared with those from other studies of working populations. The proportion of smokers in this sample was smaller than in the general population of the United Kingdom, particularly among middle-aged men, and there was a tendency for peak flow to decline more rapidly with age among continuing smokers than among others. More detailed analyses of the results in relation to smoking and area of residence are still in progress, and the results will be published in due course." Family Planning Rent free premises are provided for the Family Planning Association at Milton Court where three lunch-time and one evening sessions are held each week for City Workers and residents. The Corporation continues to underwrite the cost of consultations and supplies to married women residents referred on medical grounds. Following the National Health Service (Family Planning) Act, 1967, the Corporation also underwrites the cost of consultations to married women residents or other residents who seek advice on social grounds. The Corporation has also agreed to give a grant to the Family Planning Association. The Association has submitted the following report on their work in the City:- "1970 has again been a busy one for the family planning clinic at which more patients were seen than during the previous year. 1480 (1315 in 1969) patients made 4102 visits (3759 in 1969) and 609 (642 in 1969) were new to FPA clinics. The number of City residents attending was 61. It is encouraging to note that the number of established patients continues to increase and we feel sure that the number of new patients attending has been kept at this figure because unfortunately it has not been possible to extend the number of lunch time sessions. Many of the people attending these latter sessions live quite a distance from the City and find it a great help to be able to go to a clinic in their lunch break. All sessions are in fact working to capacity and extra daytime sessions are badly needed to cope with the increased number of people wishing to use the clinic. 205 sessions were held during this year, 24 more than last year. 47 The medical staff find those attending the clinic welcome the opportunity to discuss not only the question of contraception but other related problems and are happy to help wherever possible. The Branch continues to hold special sessions for those with marital difficulties and during the year several couples from the City clinic have received help at these sessions. 720 cervical smears were taken during the year and we are happy to report that all were negative. We are grateful for the opporunity to provide this service in the City which has enabled us to help so many couples this year." Well-Women's Clinic The clinic, set up in 1958 with Corporation funds, is established at St. Bartholomew's Hospital. The following report on the work of the clinic during 1970 has been received from Mr. D.K. Williams, F.R.C.S., M.R.C.O.G. "Total number of attendances: 443 Abnormal smears Inflammatory changes 41 Atrophic changes 26 Class IV — Carcinoma in situ 1 Clinical Findings: 1. Cervical erosions 28 Cervical polyps 20 2. Vaginitis: Trichomonal vaginitis 3 Monilial vaginitis 7 Atrophic vaginitis 14 3. Uterine fibroids 22 4. Uterine prolapse 5 5. Benign Ovarian cysts 3 6. Breast lumps 5 (Follow-up revealed: Benign cysts 2 Cystic hyperplasia 1 Diffuse nodularity - normal post-natal changes 1 7. Thyroid enlargement 1 8. Pregnancy I' Bank of England cervical smear scheme The following report on the work of the clinic during the year has been received from Dr. I.D. MacDonald, M.D.:- "In January 1970, I said that the first series of examinations had been completed and the clinic was temporarily closed. It re-opened in November to start the second series and offer tests to ladies who had joined the Staff more recently. Ten cases are usually seen each week and the smears are sent to the Cytology Laboratory at St. Bartholomew's.81 were examined during the latter part of the year. There were no positives. A number of minor gynaecological disorders were reported to general practitioners." Domiciliary Physiotherapy The Metropolitan District Nursing Association continued to employ a sessional domiciliary physiotherapist to treat, under general practitioners or hospital supervision, those persons who are usefully benefitting from this type of service which may not be provided by a local authority under the Act. 1969 1970 Number of patients treated during the year 12 18 Visits made to treat patients, visit doctors and clinics 257 288 3 of the patients attended live in the Barbican area. 48 MENTAL HEALTH ACT, 1959 and NATIONAL HEALTH SERVICE ACT, 1946 Mental Health Services Mental Health services in the City are provided on an agency basis by the London Borough of Tower Hamlets and the following information has been given by Dr. R.W. Watton, Medical Officer of Health of that Borough:- City Courts Eight patients seen at Court by a Mental Welfare Officer and escorted to Psychiatric Hospital. St. Bartholomew's Twenty patients visited at request of hospital doctors and dealt with pursuant to the provisions of the Mental Health Act, 1959. British Transport Police One patient referred for Mental Health action, several requests for advice and guidance duly given. City Offices One patient visited and dealt with under Mental Health Act, 1959. Other requests for for advice and guidance were received from various agencies and help duly given. Samaritans Two patients referred for action and hospital out-patient appointments were made. Other requests for advice and guidance were received and duly given. Visited in Private Addresses Six patients (referred by various agencies) were visited in their homes for investigation, action under the Mental Health Act, 1959 or follow-up. Tower Hamlets Day Centre for Mentally III and Psycho-geriatric Two patients in regular attendance at the close of the year. Both commenced attendance in 1967. One was accepted for residence in Rawson House, Booth House, Whitechapel in March 1969. Two patients were in regular attendance at the beginning of the year but one was admitted to Hospital at the end of January and the other was also admitted to hospital after two months stay in a residential hostel. Other patients for whom arrangements were made during the year failed to attend. A Social Club operates on Monday and Wednesday evenings for patients and their relatives or friends. Light meals and snacks are provided. The programme of entertainment and activities, feature Bingo, Records, Table Tennis, Darts, Billiards, Film Shows, etc. A quiet room is set apart for those patients who prefer such an environment. Outings are arranged when finances permit. Other facilities available at the Centre are:- (1) Personal interview at the centre by disablement resettlement Officer. (2) Full time services of Social Worker at least 2 days a week for consultation; assessment, employment placement, etc. (3) Laundry facilities. (4) Services of government training centre, hairdressers — (male) by kind permission of the manager, men's hair being cut free of charge once in three weeks. (5) Emergency clothing replaced. (6) Daily newspapers, small library and "Centre View" — the centre's own magazine. Reactivation by Social activities of Day Centre patients is an integral part of the centre policy and extra to the normal day time industrial work and training undertaken. This work ranges from assembling and packing skipping ropes, paint boxes, egg cups, chess sets, etc. etc. Each worker receives an ex-gratia payment. Mid-day meals and light refreshments are served and a minimal charge made. 49 The centre also provides separate facilities for the attendance of psycho-geriatric patients on five days a week. These patients are collected and returned to their homes in transport provided by the Council, an escort is also provided. These elderly patients have, in most instances, attended the psycho-geriatric unit at St. Clement's Hospital, and not any longer requiring nursing attention, are well able to fit into the centre routine. An occupational therapist is in attendance for all elderly patients. An incidental object of the day centre is to provide some relief to relatives from the care of mentally ill persons. Salvation Army Hostel Four patients seen as new referrals. These patients were not previously known to Mental Health in this area:- One patient referred by the Citizens Advice Bureau was admitted informally to St. Clement's Hospital after an out-patient appointment to which he was escorted by a Mental Welfare Officer. One patient came to the office seeking help. A few days before, he had been admitted to Guy's Hospital, suffering from the effects of an overdose of drugs. As he was willing to return to Guy's an out-patient appointment was made for him with a possibility of admission. Two patients were referred by a General Practitioner and were accepted for Community Care. One is being regularly visited by a Mental Health Social Worker. The other has since left the di strict. Psychiatric Recuperative Holidays Three patients had holidays during the year. Maintained in Hostels by Tower Hamlets Council One patient was admitted to a Residential Hostel during the year but was admitted to hospital after a stay of two months. Mentally subnormal in Community Care Two patients regularly seen by a Mental Health Social Worker. One patient does not attend a Training Centre as home training given. This was agreed prior to the patient moving into the City from Middlesex. One patient attended the Whitechapel Training Centre throughout the year until moving into Essex to live with a sister after the death of the mother. 50 Admission to Hospital pursuant to Mental Health Act 1959 Courts Section 29 Section 25 Section 26 Section 5 (Informal) Sec. 60 Sec.25 6 2 4 19 (Excluding Court Cases) 1 1 Admission to Hospital pursuant to Mental Health Act, 1959 — (Address from which admitted) St. Bartholomews Hospital Private Addresses Salvation Army Hostel City Offices Section 29 Section 25 Section 29 Section 25 Informal Section 29 2 1 8 1 1 1 1 Long Grove Hospital: One patient admitted under Section 25 was retained there under Section 26 for treatment. SUPPLEMENTARY INFORMATION PATIENTS IN COMMUNITY CARE PSYCHIATRIC OUT-PATIENT APPOINTMENTS MADE NUMBER OF DOMICILIARY VISITS BY "APPROVED" DOCTORS ARRANGED NUMBER OF VISITS TO NEW REFERRALS (NOT INCLUDING COURTS) NUMBER OF VISITS TO KNOWN CLIENTS PRIVATE ADDRESS S.A. HOSTEL PRIVATE ADDRESS S.A. HOSTEL PRIVATE ADDRESS S.A. HOSTEL PRIVATE ADDRESS S.A. HOSTEL PRIVATE ADDRESS S.A. HOSTEL S.N. M.I. S.N. M.I. S.N. M.I. S.N. M.I. S.N. M.I. S.N. M.I. S.N. M.I. S.N. M.I. S.N. M.I. S.N. 1 3 NIL 2 NIL 1 NIL 5 NIL NIL NIL 6 NIL 4 NIL 60 75 84 NIL 51 SECTION 29 - DOMESTIC HELP There were 13 (16) new cases, 8 (II) chronic sick, 6 (7) under 65 years of age, nil (I) family help, nil (2) maternity cases and 5 (2) others. 12 (24) cases were removed for various reasons. 4 (4) full-time and 3 (4) part-time home helps were in employment at 31st December. Number of clients in receipt of service 53 (52). All applicants for service had their needs met even during periods of staff shortage due to holidays, sickness and resignations. During April a course of 'in-service' training was attended by all home-helps who found the course interesting and beneficial. In order to carry out assessment of need and ensure smooth running of the service 314 (362) visits were paid by the Metropolitan District Nursing Association Superintendent and Nursing Staff. The full charge for the service remains at 10/9d per hour. Of the 53 clients receiving service 46 received free service, 5 paid the full charge and 2were assessed to pay a reduced sum. EDUCATION ACT. 1944 SCHOOL HEALTH SERVICE The general standard of health at the Sir John Cass Foundation School is good and a high level of hygiene is maintained. During the year the following school medical inspections were carried out:- Routine 73 (67) children inspected Special 18 (8) children inspected Re-inspection 62 (87) children inspected Comprehensive Health Survey 217 (223) children inspected Selective Survey 31 (55) children inspected The Comprehensive and Selective inspections are conducted by the School Nurse. The general standard of hygiene amongst the school children was good, and no head nor body infestation occurred during the year. Home visits were made to the City parents to follow up matters arising from the medical inspections. School Dental Service. (The statistics given here complement the Dental Officer's Report) 1969 1970 Sessions at Dental Centre 59 53 New cases attended by appointment 195 147 On treatment cases given appointments 203 206 Emergency attendances 1 1 Total attendances 398 353 1 st inspections carried out at school 191 233 1st inspections carried out at clinic 2 1 Percentage requiring treatment 34.3 54.7 Dental Officer — whole time equivalent 0.1 0.1 Special Clinics A clinic is held at the Sir John Cass's Foundation School from time to time for those pupils who have been examined at school medical inspections for whom further investigation is felt to be necessary. During 1969, 4 (7) such clinics were held, and 18 (30) children examined. Audiometry 52 (41) children were tested during the year at the school. Vaccination and Immunisation of School Children 1969 1970 Poliomyelitis 36 33 B.C.G. School children and Students tested 242 632 No. vaccinated 103 407 Diphtheria/T etanus 49 47 52 Infectious Diseases Reported from Schools 1969 1970 Chickenpox 21 3 Measles - 15 Mumps 2 1 Impetigo 1 - Conjunctivitis - - Whooping Cough - - German Measles - 4 Tonsilitis 2 - Cerebo-Spinal Meningitis - 1 Chiropody Service in School (See Report under Section 28 National Health Service). REPORT OF THE DENTAL OFFICER, CITY OF LONDON "The year has continued to show the trend noticed last year, which indicated that in all sectors and age groups seen in the dental section, a certain plateau of oral health has been reached. (This situation applied up to Autumn 1970, for the reason mentioned below). There was even an overall slight reduction in treatment needed. This was not so much due to a reduction in dental decay, as to treatment overtaking the disease. In the Autumn it was announced that increased charges for dental treatment under theNational Health Services were to be introduced and this precipitated an ever increasing demand for treatment, which by the end of the year was putting a considerable strain on the dental facilities which could be offered. Indeed some mouths were seen which had last been inspected some 10-20 years previously and presumably the owners wanted to redress the previous failure to take advantage of N.H.S. dentistry, before the charges were increased. It is perhaps unwise to forecast the impact of these increased charges, but it seems likely that there will be a falling off in demand from those who need treatment most and, considerable apprehension must be felt about the effect of reducing the age of exemption from charges, from 21 to 18. It is during these years that young people often have a predisposition to dental decay and gum problems. It is also the time when the young person has to think of routine dental inspections for him or herself, rather than having a parental reminder to do so, and having to pay for it is not going to encourage care of the mouth. Older persons who find they have let a visit to the dentist get overdue, may well let things go on still longer, and perhaps beyond repair. School Dental Service; Inner London Education Authority Pre-School Children School Entrants Infants Juniors All these showed a slight reduction in treatment required, although as mentioned above it was mostly a case, of treatment catching up with dental disease. As before — those children, seen in the School Dental Service, who live in the City, still, for the most part, present with the worst mouths. The only way to alter this situation is for their parents to be meticulous in arranging for 2 or 3 visits to the dentist per annum. Dental Health Education Following School re-buiIding compietion, it has again been possible to renew group dental health education and the I.L.E.A. dental health education pays regular visits to the school, which supplements individual instruction given in the dental chair, and helps to keep the subject constantly ' before the chiIdren. F luoridation Increasing the level of fluoridation in drinking water to an acceptable level could transform the dental scene in this country, as has been shown in those areas where it has been tried. However, whilst the process is gradually spreading across the world, it has not happened here in London, one of the world's largest cities, and until it does, the failure to do so will be reflected in the discomfort of dental disease and its mounting cost to the community. 53 It may well be that the more time consuming, more costly, and less affective method of topical fluoridation will have to be offered to children to give them at least some benefit of fluoridation, and at the same time partially salve the conscience of a previous generation in not giving them water fluoridation. St. Bartholomew's Hospital This report would be far from complete without a tribute to the tremendous assistance always so courteously and skilfully given by the staff of the Dental Department, and indeed, by all departments, at the Hospital." CORPORATION STAFF Ophthalmic Optician Service Since March 1959, a firm of Ophthalmic Opticians have been operating a weekly eye testing service for members of the staff. This service is operated under the National Health Service, and examinations are therefore free, although charges are made, in the usual way, for the dispensing of prescriptions. Examinations carried out during the year are shown in the following table:- Total examinations carried out 68 Number of staff who had not previously had an eye test 15 Visual defects found and corrected 10 Re-examinations of persons already using spectacles 53 Further correction needed and carried out 40 Medical Examinations During the year, 700 medical examinations have been carried out, as shown in the following table:- Reoson for Examination Result Male Female Total Admission to Superannuation Scheme Fit Unfit Deferred 273 134 407 7 0 7 6 6 12 Referred for excessive sick absenteeism Fit for duty Still unfit Unfit for further service 14 1 15 17 1 18 7 3 10 Staff over 65 years of age continuing in employment Fit to continue Unfit to continue 89 43 132 0 0 0 Special examinations Exemption from parking meter fees Monument employees 85 14 99 Temporary appointments Fitness to drive heavy goods vehicles (Cleansing Staff) TOTALS 498 202 700 54 STATISTICAL INFORMATION Area - 678 acres (including the Temple and foreshore) Population — Census 1961, 4,711; Estimated mid-year 1970, 4,780. Annual Rateable Value — as at 1st April, 1970, £49,687 ,481 Annual Sum Received from Penny General Rate — L205,000. VITAL STATISTICS COMPILED FROM REGISTRAR GENERAL 'S RETURN 1969 1970 Live Births Number 27 23 Rate per 1,000 population 6.2 4.8 Illegitimate Live Births Number 1 2 Illegitimate live births per cent of total live births 3.7 8.7 Stillbirths Number NIL NIL Rate per 1,000 total live and still births NIL NIL Total Live and Still Births 27 23 Infant Deaths (deaths under 1 year) NIL NIL Infant Mortality Rates Total infant deaths per 1,000 total live births NIL NIL Legitimate infant deaths per 1,000 legitimate live births NIL NIL Illegitimate infant deaths per 1,000 illegitimate live births NIL NIL Neo-Natal Mortality Rate (deaths under 4 weeks per 1,000 total live births) NIL NIL Early Neo-Natal Mortality Rate (deaths under 1 week per 1,000 total live births' Perinatal Mortality Rate (stillbirths and deaths under 1 week combined per NIL NIL 1,000 total live and stillbirths) NIL NIL Maternal Mortality (including abortion) Number NIL NIL Rate per 1,000 total live and stillbirths NIL NIL Deaths (all ages) Number 38 50 Rate per 1,000 resident population 8.73 10.46 55 NUMBERS OF DEATHS BY CAUSE, SEX AND AGE GROUPS (Statistics supplied by the General Register Office on Form S.D.25) CAUSES OF DEATH Sex All Ages Under 4 weeks 4 weeks & under 1 year AGE IN YEARS 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75 and over B19(4) Malignant Neoplasm, Intestine M 1 - - - - - - - - 1 - - F 3 - - - - - - - 1 - 1 1 Bl 9(7) Malignant Neoplasm, Breast M - - - - - - - - - - _ _ F 2 - - - - - - - - 1 1 - B 19(10) Leukaemia .. M 2 - _ - - 1 1 - - - - - F 2 - - - - - - - 1 1 - ~ B I9(11) Other Malignant Neoplasms M 3 _ _ _ _ - _ - - 2 1 - F 2 * - - - - - 1 1 - - B 2I Diabetes Mellitus M - - - - - - - - - - - - F 1 - - - - - - - - - 1 - B 26 Chronic Rheumatic Heart Disease M - - - - - - - - - - - - F 1 - - - - - - - 1 - - - B 27 Hypertensive Disease .. M _ - - - - - - - - - - - F 1 - - - - - - - " - 1 - B 28 Ischaemic Heart Disease M 8 - - _ - - _ 1 2 4 1 - F 4 - - - - - - - 1 - 1 2 -B 29 Other Forms of Heart Disease M 1 - - - - - - - - 1 - - F - - - - - - - - - - - B 30 Cerebrovascular Disease M 4 - _ - - - - - - 2 - 2 F 2 - - - - - - - - 1 - 1 B 32 Pneumonia M 2 - - - - - - - 1 1 - - F 1 " - - - - - - - - 1 B 33(1) Bronchitis and Emphysema M 3 - _ - - _ _ 1 1 - _ 1 F - - - - - - - - - - - - B 34 Peptic Ulcer M 1 - - - - - - - - 1 - - F - - - - - - - - - - - - B 36 Intestinal Obstruction and Hernia M 1 - - - - - - - - - 1 - F - - - - - - - - - - - - B 46(8) Other Diseases of Digestive System M 1 - - - - - - - - - 1 - F 1 - - - - - - - - 1 - - B 46(9) Other Diseases, Genitourinary System M - - - - - - - - - - - - F 1 - - - - 1 - - - - - - BE 48 All Other Accidents M • - - _ . _ - - - - F 1 - - - - - - - 1 - - - BE 49 Suicide and Self-inflicted Injuries M 1 - - - - - - - - 1 - - F - - - - - - - - - - - - TOTAL ALL CAUSES M 28 _ - - - 1 1 2 4 13 4 3 F 22 - - - - 1 - - 6 5 5 5 56 INFECTIOUS DISEASES City Residents Non-Residents Total 1969 1970 1969 1970 1969 1970 Dysentery — Shigella sonne 3 3 4 2 7 5 Food Poisoning 6 3 12 6 18 9 Infective Hepatitis 1 0 0 4 1 4 Measles 3 5 0 6 3 11 Meningitis 0 1 3 1 3 2 Malaria 0 0 1 1 1 1 Tuberculosis Pulmonary 2 5 15 8 17 13 Tuberculosis — other 0 0 8 6 8 6 Whooping Cough 0 1 0 0 0 1 TOTAL 15 18 43 34 58 52 NEW LEGISLATION DURING THE YEAR The following enactments, which affect the work of the Department, were made during the year:- Agriculture Act I 970. Cheese Regulations 1970. Children and Young Persons (Planning Areas) Order 1970. Children and Young Persons Act 1969 (Commencement No 3) Order 1970. Chronically Sick and Disabled Persons Act 1970 Diseases of Animals (Approved Disinfectants) Order 1970 Education (Handicapped Children) Act 1970. Fertilizers and Feeding Stuffs (Amendment) Regulations 1970, Fertilizers and Feeding Stuffs Regulations 1970. Food Hygiene (General) Regulations 1970. Importation of Dogs and Cats (Amendment) (No. I) Order 1970. Importation of Dogs and Cats (Amendment) (No. 3) Order 1970. Labelling of Food Regulations 1970. Local Authority Social Services Act 1970. Local Authority Social Services Act 1970 (Commencement No. I) Order 1970. London Government Order 1970. Poisons List Order 1970. Poisons Rules 1970. Smoke Control Areas (Authorised Fuels) Regulations 1970 Smoke Control Areas (Authorised Fuels) (No. 2) Regulations 1970. Smoke Control (Exempted Fireplaces) (No. 2) Order 1970. Soft Drinks (Amendment) Regulations 1970. PUBLICATIONS (1) Handbook of Poultry Inspection. (2) Clean Food Handling