Ac 4344 Ach.10-10-52 Wed 61 City of Westminister REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1951 ANDREW J. SHINNp, O.B.E., M.D., D.P.H., (LOND.). Medical Officer of Health. LONDON: harrison and sons, ltd., printers to the late king george vi, st. martin's lane, w.c.2. Cits of Mestminster. REPORT OP THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1951 ANDREW J. SHINNIE, O.B.E., M.D., D.P.H., (Lond.). Medical Officer of Health, LONDON: harrison and sons, ltd., printers to the late king george vi, st. martin's lane, w.c.2. CONTENTS. Page Abstracts—Factory Act 31 Aged and Infirm—care of 17 Area of the City 12 Atmospheric Pollution 43 Bacteriological Examinations 17 Births12 British Bed Cross Society 18 Burial or Cremation of the Dead 47 Catering Establishments 32,35 Clean Pood Campaign 32 Closing Orders 25,28 Common Lodging Houses 32 Coroner's Court and Mortuary 48 Deaths 12, 15, 16 Disinfection and Disinl'estation 46 Drainage 23 Dwelling Houses 22 Factories, Workplaces, Shops and other Premises 29 ,, Defects and Nuisances 31 Food, Inspection aud Supervision 32, 34, 36 „ Legal Proceedings 45 ,, Poisoning 39 ,, Shops and Premises 33 „ Unsound 39 Fumigation of Furniture 47 House to House Inspection 29 Houses, number of 12 „ unfit 25 Housing 22, 25 „ Informal and Voluntary Action 25,28 ,, Statistical Summary of 20 years 27 Ice Cream 37 Infantile Mortality 13 Infectious Diseases 13, 14 ,, ,, Certificates 14 International Certificates of Inoculation and Vaccination 19 Introduction 9 Legal Proceedings 45 (6916) A 2 Page Manufactured Meat Products Working Party 32 Medical Attention 18 Medical Inspection of Aliens 19 Medical Research Council14 Milk and Dairies 38 Mobile Meals Service (" Meals on Wheels ") 18 Noise Nuisances 43 Notes on Housing 26 Notices 22, 23, 30, 31, 33, 34, 35, 42, 44 Notices, Statutory 23, 33, 44 Outworkers 30 Overcrowding 26 Pharmacy and Poisons Act 39 Pigeons 42 Poliomyelitis 13, 14 Population 12 Premises 21,22,23, 30 Private Deep Wells 46 Public Health Committee 5 Public Health Staff 6, 7, 8 Rag, Flock and other Filling Materials Act 46 Rateable Value 12 Rat and Mice Repression 42 Rehousing 26 Rodents destroyed 42 Samples, food 34, 36 Sanitary Circumstances 21 Slaughterman's Licences 20 Smallpox 14 Smoke Abatement 44 Staff, Public Health Department 6, 7, 8 Starlings 42 Statistics and Social Conditions 12 Tuberculosis 15, 17 • Underground Rooms 25,29 Unfit Premises 25 Unsound Food 39 Water 46 „ additional supplies to premises 23 Welfare of Old People 17 Westminster Old People's Welfare Association 19 Workplaces, Shops, etc29 5 PUBLIC HEALTH COMMITTEE. The Mayor (ex-officio): Councillor Albert Sciver, J.P., B.Sc., F.R.I.C. The Deputy Mayor (ex-officio): Councillor Wilfred Eric Rice, C.B.E., J.P. Chairman : Councillor C. R. Purnell. Vice-Chairman : Councillor Lt.-Col. H. Norman Edwards, M.B.E. Members: Alderman G. F. Jerdein, D.L. Councillor Dr. T. Anwyl-Davies. „ A. L. Burton. ,, G. F. Davies. , J. C. R. Durran, J.P. J. G. Elsworthy, F.R.I.C.S., F.A.I., M.R.San.I. ,, R. L. Everest, F.R.I.C.S., F.I.Arb. ,, D. E. Havinden. ,, L. E. Johnson. W. Charles Norton, M.B.E., M.C. ,, Miss P. C. Paton Walsh. „ Dr. G. Rewcastle, O.B.E.. (Died 18.2.51.) ,, Mrs. Arthur Rye. ,, Mrs. Francis Storrs. „ The Countess Winterton, 6 STAFF OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health: Andrew J. Shinnie, O.B.E., M.D., D.P.H., &c. Assistant Medical Officer of Health: (jointly for Westminster and Holborn), P. 0. Roads, M.D., D.P.H., &c. Public Analysts: (Part time) F. W. Edwards, F.I.C. T. McLachlan, A.C.G.F.C., F.I.C. Chief Sanitary Inspector: H. E. White. Chief Clerk: W. D. Sambrook. Deputy Chief Sanitary Inspector: (and with special duties relating to Theatres, Cinemas and other places of amusement), W. G. J. Sutton. Sanitary Inspectors: District: A. G. Bates. J. M. Burbridge. W. J. Davies. J. E. Drake. D. W. Saunders. F. E. Siddle (Inspector for Rodent Control). R. F. Stubbs. (To 30.6.51.) W. L. French (Inspector, with special duties relating to the care of old people, for Disinfection, Disinfestation, &c.). 7 Housing: C. F. Brockett (Inspector in Charge). J. W. Baxter. A. R. Cook (from 9.7.51). J. J. Coveney (to 15.5.51). J. W. M. Meston (from 16.7.51). Food: J. J. Coveney (from 16.fl.51). P. A. Lloyd. H. D. Luke (to 15.5.51). Catering Establishments: J. H. Brownlee. M. J. Flynn (to 30.6.51). R. F. Stubbs (from 1.7.51). Atmospheric Pollution: R. Roper. Women's Factories: Miss C. Hughesdon. Clerical Staff: J. W. Anderson (to 4.5.51). G. Lyness (temporary). R. L. Booker. L. J. Nunn. C. E. Clark. J. M. Shotbolt. A. H. Cole. B. Shrensky (from 1.9.51). A. R. Cook (to 8.7.51). W. E. F. Simmons. P. Cox (temporary). W. H. Smith. Mrs. P. M. Crump (nee Illman). E. A. Taylor. W. F. C. King. E. W. Tyler. D. Levitton, B, S, Weaver. 8 Coroner's Court and Mortuary. Superintendent: A. W. Nicholls. 1st Mortician: L. M. Swanston. Morticians: S. J. Buckingham (from 10.12.51). C. H. Lorraine (to 4.12.51). N. J. Marchant (to 24.2.51). S. E. Salisbury (from 17.12.51). Miss E. S. Dunford (S.R.N.). Mrs. E. Williamson (Cleaner). Disinfecting Staff: N. Heathcote (Foreman). G. Lawrence. L. C. Clarke. J. A. Lovelock. C. J. Daniels. J. Shillingford. J. R. Doyle (Motor Driver). Miss H. MacWilliam (S.R.N.). Miss I. M. Newman (Woman Attendant). Rodent Staff: Rodent Officer: J. W. Brown. H. J. Felstead (Foreman). J. J. Devine. H. Brown. G. Murray. D. G. Cadlock. F. C. Smellie. A. C. Dale (to 30.7.51). J. Vidal. Assistants in the Department: A. Murkiii Assistantts to Sanitary Inspectors. J.Byworh Messengers. J.W.Spooner 9 To the Right Worshipful The Mayor, Aldermen, and Councillors of the City of Westminster. Mr. Mayor, Ladies and Gentlemen, Annual Report for 1951. I beg to present my twenty-seventh Annual Report on the health and sanitary conditions of the City of Westminster. This Report is prepared in accordance with Ministry of Health Circular 42/51. The Circular indicates generally the matters on which the Minister would wish information, e.g., the nature and extent of any outbreaks of food poisoning. The year 1951, after a cold and wet spring followed by a summer rather deficient in sunshine may have had some effect in increasing the deaths from such respiratory conditions as pneumonia and influenzal pneumonia and bronchitis where the number of deaths rose from 92 to 138. There were 19 separate outbreaks of food poisoning, ten of which were instances concerning single individuals. In investigating these outbreaks it is the endeavour to reconcile the type of infective organism recoverable from the suspected food with that from the sufferer and with that from any person known to have prepared or handled the food suspected. In many instances the three lines of inquiry cannot be joined up in a final conclusion. It may be that none of the food suspected remains unconsumed, or less frequently no pathogenic organisms are traceable in those who handled the food. In most cases, however, organisms capable of causing food poisoning are recovered from the persons affected. Sometimes two of the three lines of inquiry seem to achieve a common result as for instance when none of the food consumed is available but the same type of organism is found in the patient and in the suspected food handler, and it can reasonably be assumed that here is an instance of cause and effect. In others where a contaminating organism is found in the food and recovered from the patient, likewise a reasonable assumption of cause and effect can be made. But where nothing can be recovered from the suspected food handler or the specimen of food itself shows no pathogenic organisms, investigations become most disappointing for they involve long and patient effort by those engaged on an inquiry, including the bacteriologist. From the details of some of the outbreaks outlined on page 39 it may be noted that in only seven of them were the results of investigations in any degree definitive. This is in no way surprising in view of the absence of remainders of food consumed and the transitory infectivity of suspected human conveyors. The incidence of other notifiable infectious disease was low. There were no cases of Diphtheria, the very first year in the history of the City when none has been notified. Immunization against this very insidious and mortal disease was begun in 1925, Westminster being the second sanitary authority in London to introduce this preventive measure— Holborn was the first. Very few authorities throughout the country, with the exception of Scottish towns, had adopted it before 1930. Its use (6916) a 3 10 became widespread during the war when there was much massing of children for evacuation, and crowding in shelters. The clear and persuasive broadcasts of Sir Wilson Jameson, then Chief Medical Officer of the Ministry of Health, were largely responsible for the general adopt ion of immunization. In the country generally in 1925 there were 47,684 cases of Diphtheria notified and 2,774 deaths; in 1938 65,008 notified cases and 2,931 deaths; in 1946 11,601 notified and 455 deaths. The provisional figures for 1951 are 699 notified cases and 34 deaths. Much attention has been given to german measles and whooping cough. As regards the former it is because of the alleged influence on malformations of the child when the mother is infected during the first three months of pregnancy. Whooping cough remains still an infection of high incidence among young children leading sometimes to serious consequent respiratory complications. Some useful work has been done in cooperation with the Westminster Children's Hospital in furthering preventive measures among contacts by means of chemical antibiotics. As in 1950 there was one death from whooping cough in infants of under one year of age. There were 1,018 notifications of measles but no deaths. The Registrar General's mid-year estimate of population at 30th June 1951 was 100,000 all ages, a slight decline throughout on the estimate for 1950. When the Registrar General published his preliminary report of the Census in 1951, the persons enumerated were 98,895. The birth rate at 12-35 has risen from 11-9 last year, but this is due to the decline in total population as estimated by the Registrar General. The actual number of births has fallen from 1,251 to 1,235, the fall among illegitimate births being most notable. Infantile mortality was 34 per 1,000 births compared with 35.17 last year but there was a greater mortality among illegitimate infants. The general death rate at 11.87 compares with 10.16 in 1950. As already mentioned more citizens died of respiratory diseases but deaths from cancer were fewer, 241 in 1950 compared with 232 in 1951. Cancer of the lung however claimed more victims, 42 as compared with 35 in 1950, the increase being confined to males. There are some grounds for believing that cancer of the lung and air passages is more common in industrial areas subjected to considerable atmospheric pollution, for in some areas in these islands where the country is largely agricultural, cancer of the lung seems to be considerably less common. There were no deaths from confinements or conditions associated with childbirth. As regards notifications of infectious disease, there was, as expected, a much larger incidence of notified cases of measles, 1,018 compared with 356 in 1950, and 685 in 1949. In spite of this large incidence there were no deaths from measles. There were four cases of poliomyelitis and polioencephalitis and no deaths. Tuberculosis shows a small increase in the total number of cases notified, but slightly fewer deaths. The recent tuberculosis regulations have rather shifted the responsibilities of the local sanitary authorities and placed them on the local health authority, the London County Council. The net result is that notification as an instrument of engaging the services of the local sanitary authority on behalf of the patient has been restricted. In this Report the various activities of the department are reported 11 and they cover the wide field of Food and Drugs administration, including the supervision of catering establishments, the conditions of dwelling houses and details of administrative action taken under the Housing and Public Health Acts, progress in measures to safeguard the atmosphere from pollution, and a variety of other activities. Since the transfer of the maternity and child welfare and other personal services to the London County Council by the Health Service Act in 1948, it is true that a number of matters of much local interest find no place in this report, but the City Council's representatives on the London County Council Divisional Committee are able to maintain some measure of contact with the services for which the City Council was formerly responsible. One is sometimes asked what effects on the health services have been observed since 4th July, 1948. From a somewhat limited observation post it is difficult to discern any real advantages during the past four years. In such essentially local affairs as the birth and care of children, the home care of the consumptive, the home help service which safeguards the welfare of old citizens whose energies and faculties are failing, centrally administered control must always be at some disadvantage. The London County Council in this division has striven to preserve the customs and traditions of the services formerly under the control of the City Council and no higher compliment could have been paid. Relations with the officers of the London County Council have been uniformly happy. As officers of a very large administrative machine they have shown themselves very understanding in adapting the pre-existing local methods into the complex structure of the County administration. As an obiter dictum one is led to reflect on the traditional common sense of the British people. What chaos might have resulted in a less experienced democracy or one without the advantage of a stable and well-trained Civil and Local Government Service in view of the rapid succession of revolutionary changes which Parliament has brought about since 1945. It is almost entirely due to the ability and great experience of the officers of all ranks already engaged in those services that the vast new machines of publicly-owned undertakings cuch as the National Health Service have rumbled onwards so smoothly. There will appear sooner or later some curtailment in the activities of the department. This is due to the extreme difficulty in obtaining sanitary inspectors of suitable ability and experience to fill vacancies. These difficulties are not exclusive to Westminster but are being experienced throughout most of the London Boroughs. I would again wish to thank the Chairman, Councillor C. R. Purnell, for his active interest in all matters relating to the staff and work of the department. The Vice-Chairman, Lt.-Col. Norman Edwards, and all members of the Public Health Committee have shown great appreciation and consideration of the staff who have carried out their duties with their accustomed loyalty and high sense of duty. I have the honour to be Your obedient servant, Andrew J. Shinnie, July, 1952. Medical Officer of Health. (6916) a. 4 12 STATISTICS AND SOCIAL CONDITIONS. Area (acres) 2,502.7 Population (Registrar General's Estimate, mid-year, 1951) 100,000 Number of inhabited houses (Census, 1931) 22,536 Rateable Value £11,016,000 Births. Live Births (registered)— Total. Males. Females. Legitimate 1,110 573 537 Illegitimate 125 71 54 1,235 644 591 Births Notified—1,217. Birth rate per 1,000 of the estimated resident population 12.35 (Rate for London, 17.8; for England and Wales, 15.5) Number of stillbirths (males, 9; females, 11) 20 Rate of stillbirths per 1,000 (live and still) births 15.93 Deaths. Net deaths (males, 624 ; females, 563) 1,187 Death-rate per 1,000 of the estimated resident population (Rate for London, 13.1; for England and Wales, 12.5 11.87 Deaths from puerperal causes Nil (Rate per 1,000 total (live and still) births) — Deaths of infants under 1 year (males, 21; females, 21) 42 Death-rate of infants under 1 year— All infants per 1,000 live births 34.00 Legitimate infants per 1,000 legitimate live births 31.53 Illegitimate infants per 1,000 illegitimate live births 56.00 Rate for London for infants under 1 year 26.4 Deaths (all ages) from measles Nil ,, ,, whooping cough 1 „ ,, gastritis, diarrhoea and enteritis 7 ,, ,, cancer 232 13 Infantile Mortality. Causes of Death. Total. Legitimate. Illegitimate. Whooping Cough 1 1 — Meningococcal infections 1 1 — Other infective and parasitic diseases 1 1 — Influenza 1 1 — Bronchitis 1 1 — Pneumonia 5 5 — Congenital Malformations 2 2 — *Other defined and ill-defined diseases 26 22 4 All other Accidents (other than motor vehicles) 3 1 2 Homicide 1 — 1 42 35 7 *This is the Registrar-General s classification; but such conditions as prematurity, birth injuries and other fatal conditions relating to the process of birth are included under this heading. Infectious Disease. Disease. Original Notifications. Removed to Hospital. Rediagnosed. Corrected Notifications. Dysentery 210 88 24 186 Enteric Fever 1 1 1 — Erysipelas 11 7 2 9 Food Poisoning 59 4 — 59 Malaria (origin unknown 1 — — 1 Measles 1,022 73 4 1,018 Meningococcal Infection 2 2 1 1 Paratyphoid 1 1 — 1 Pneumonia— Acute Primary 6 — — 6 Influenzal 76 — — 76 Poliomyelitis— ' Paralytic 3 3 2 1 Non-Paralytic 1 1 1 — Puerperal Pyrexia 12 10 — 12 Scabies 35 — — 35 Scarlet Fever 62 21 2 60 Typhoid Fever 2 2 — 2 Whooping Cough 380 40 8 372 No cases of the following diseases were notified during the year: Anthrax; Cholera; Continued Fever; Diphtheria; Encephalitis; Glanders; Hydrophobia; Membranous Croup; Ophthalmia Neonatorum; Plague; Relapsing Fever; Smallpox; Typhus Fever. (6916) a 5 14 Smallpox. On eight separate occasions during the year, the Medical Officer of Health was called to see suspected cases of smallpox. Fortunately in every case, the disease was excluded. On two occasions, information was received that passengers who were coming to Westminster, had been in contact with a case of smallpox whilst travelling by sea to this country. These contacts, in one instance numbering 96, were visited or telephoned by officers of the department until the period of danger was past. At the beginning of the year, smallpox at Brighton considerably increased the work of the department. The original case, while suffering from the disease, had travelled through Westminster and as large numbers travelled daily from Brighton to Victoria, the department was immediately concerned. Many hundreds of requests for advice were received from these and other persons. Arrangements for vaccination facilities were made with Charing Cross and St. George's Hospitals and with the London County Council and plans were made to supplement these if necessary. Officers of the department who might come into contact with cases were offered, and in almost all cases, accepted vaccination. Fortunately, however, no cases occurred. Medical Research Council. Research on Poliomyelitis. The City Council readily agreed to their Medical Officer of Health collaborating with the Medical Research Council in the latter's virological and epidemiological research into this disease in 1951. Accordingly the required particulars of the four notified cases of the disease in the City were furnished to the Medical Research Council. Three of these cases were, however, subsequently re-diagnosed as not suffering from poliomyelitis and left one confirmed case of the paralytic type. Ministry of Health Circular 115/48—Contacts and Carriers of Infectious Disease—Sickness Benefit. This circular empowers the Medical Officer of Health to issue certificates to persons who have been in contact with or are carriers of infectious disease, thus enabling them to claim sickness benefit under the National Insurance Acts during the period of exclusion from their work. Certificates were issued by the Medical Officer of Health during the year to two persons engaged in the food trade who had been in contact with cases of dysentery. Both were allowed to return to work as soon as they were found to be clear of infection. 15 Deaths, 1951. Causes of Death at Different Periods of Life in the City. Causes of Deaths. Years of Age. Sex. All Ages. 0-1 1-5 5-15 15- 25 2545 4565 6575 75+ All Causes M. 624 21 3 3 12 49 204 185 147 F. 563 21 3 1 1 26 137 144 230 Grand Totals 1,187 42 6 4 13 75 341 329 377 Tuberculosis, Respiratory M. 30 — — — — 3 18 8 1 F. 5 — — — — 2 2 1 — Tuberculosis, Other M. 2 — — 2 — — — F. — — — — — — — — — Syphilitic Disease M. 5 — — — — — 4 1 — F. — — — — — — — — — Diphtheria M. — — — — — — — — — F. — — — — — — — — — Whooping Cough M. — — — — — — — — — F. 1 1 — — — — — — — Meningococcal Infections M. 2 1 — — — — 1 — — F. 1 — — — — 1 — — — Acute Poliomyelitis M. — — — — — — — — — F. — — — — — — — — — Measles M. — — — — — — — — — F. — — — — — — — — — Other Infective and Parasitic Diseases M. 3 — — — — 1 — 2 — F. 4 1 — — — — 3 — — Malignant Neoplasm, Stomach M. 10 — — — — 1 6 2 1 F. 15 — — — — - 5 7 3 Malignant Neoplasm, Lung, Bronchus M. 37 — — — 1 1 20 13 2 F. 5 — — — — — 2 3 — Malignant Neoplasm, Breast M. — — — — — — — — — F. 32 — — — — 5 13 9 5 Malignant Neoplasm, Uterus M. — — — — — — — — — F. 11 — — — — 1 6 1 3 Other Malignant and Lymphatic Neoplasms M. 69 — — 1 3 14 20 18 13 F. 53 — — — — 6 21 15 11 Leukaemia, Aleukaemia M. 6 — — — 1 1 — 2 2 F. 4 — — — — — 2 1 1 Diabetes M. — — — — — — — — — F. 6 — — — — 1 3 1 1 Vascular Lesions of Nervous System M. 43 — — — — 1 12 20 10 F. 60 — — — — — 15 14 31 Coronary Disease, Angina M. 111 — — — — 5 34 44 28 F. 59 — — — — — 14 16 29 (6916) A 6 16 Deaths, 1951 —continued. Causes of Death at Different Periods of Life in the City—continued. Causes of Deaths. Years of Age. Sex. All Ages. 0-1 1-5 5-15 1525 2545 4565 6575 75+ Hypertension, with Heart Disease M. 20 — — — — — 8 6 6 F. 16 — — — — — 1 7 8 Other Heart Disease M. 59 — — — 2 — 10 19 28 F. 80 — — — — 1 7 22 50 Other Circulatory Disease M. 14 — — — — — 4 1 9 F. 22 — — — — — 3 5 14 Influenza M. 12 — — — — — 4 3 5 F. 12 1 — — — 1 2 3 5 Pneumonia M. 35 4 — — — 1 9 8 13 F. 31 1 — — — — 5 7 18 Bronchitis M. 44 1 — — — 1 12 20 10 F. 28 — — — — 1 6 4 17 Other Diseases of Respiratory System M. 5 — — — — 1 3 1 — F. 7 — — — — — — 4 3 Ulcer of Stomach and Duodenum M. 15 — — — — 1 5 5 4 F. 6 — — — — — 1 2 3 Gastritis, Enteritis and Diarrhoea M. 4 — — — — — 3 — 1 F. 3 — — — — 1 1 — 1 Nephritis and Nephrosis M. 4 — — — 1 — 1 — 2 F. 13 — 1 1 — 1 5 3 2 Hyperplasia of Prostate M. 8 — — — — — 1 4 3 F. — — — — — — — — — Pregnancy, Childbirth, Abortion M. — — — — — — — — — F. — — — — — — — — — Congenital Malformations M. 7 — 1 1 — 2 3 — — F. 5 2 1 — — — 1 1 — Other Defined and IllDefined Diseases M. 41 14 — — — 5 11 7 4 F. 66 12 1 — 1 4 15 15 18 Motor Vehicle Accidents M. 5 — 1 — 2 1 1 — — F. 2 — — — — — — — 2 All other Accidents M. 17 1 1 1 '2 3 6 — 3 F. 11 2 — — — 1 2 1 5 Suicide M. 16 — — — — 5 8 1 2 F. 4 — — — — — 2 2 — Homicide and Operations of War M. — — — — — — — — — F. 1 1 — — — — — — — 17 Bacteriological Examinations. Negative. Positive. Nasal and Throat Swabs 171 Nil Faeces 230 66 Urine 4 Nil Skin Swabs 64 33 Tuberculosis .244 81 Tuberculosis. Age Periods. New Cases. Deaths. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. M. F. M. F. M. F. M. F. Under 1 year 1 1 — — — — — — 1 to 5 years 4 5 1 — — — — — 5 to 15 years 5 1 1 2 — — — — 15 to 25 years 15 21 — 4 — — — — 25 to 45 years 52 58 2 4 3 2 2 — 45 to 65 years 65 7 — — 18 2 — — 65 to 75 years 6 2 — — 8 1 — — 75 and over 4 — — — 1 — — — 152 95 4 10 30 5 2 — New Cases. Pulmonary—247 new cases, including 51 transfers and 18 non-notified deaths. Non-Pulmonary—14 new cases, including 2 transfers. (1950—Pulmonary, 242 new cases; Non-Pulmonary, 17 new cases.) Deaths from Tuberculosis. Pulmonary—35 (30 males, 5 females). Non-Pulmonary—2 (2 males). Welfare of Old People. Aged Persons in need of care and attention. Under the provisions of the National Assistance Acts, a Medical Officer of Health is empowered to apply to the Courts for an order for the compulsory removal to a hospital or other suitable place, of persons who are suffering from grave chronic disease or, being aged, infirm or physically incapacitated, are living in insanitary conditions and unable to devote to themselves, and are not receiving from others, proper care and attention. Fortunately it has not been found necessary to invoke these powers during the year because aged persons are often quite willing to enter 18 hospitals or homes where they could receive treatment. Difficulties are still being experienced however, in obtaining admission of urgent cases into hospitals or homes and all too frequently all that can be done is to enter their names on a waiting list. Pending admission, the resources of the family doctor, District Nurses, the Home Help Service and the Old People's Welfare Association are brought to bear and the Meals on Wheels Service employed to ease the lot of these old people. In those cases where conditions are aggravated by neglect and the home is found to be dirty and verminous, cleansing is carried out by the Council's disinfecting staff. Also fouled and unwholesome bed linen is cleansed and disinfected by the Council's staff to render it acceptable by commercial laundries. Close co-operation has always been maintained between the officers of this department and those of the Welfare Department of the London County Council and hospitals in trying to alleviate the hardships of the aged. An indication of the increasing problem of these cases may be gauged from the fact that some 785 visits by the Sanitary Inspectors to 214 aged persons were necessary during the year as compared with 23 in 1938. Medical Attention. Following receipt of a report by the Metropolitan Boroughs Standing Joint Committee that in some London Boroughs some old people had not registered under the National Health Service Acts, 1946-49 and were without the services of a doctor, the Medical Officer of Health inquired into the position in Westminster and found that it was not a serious problem in the City although it sometimes happens at common lodging houses that only when an inmate becomes ill it is found that he is not registered with a doctor. In such emergencies, the patient is referred to the out-patients' department of the nearest hospital, or if seriously ill, is removed by ambulance to hospital. British Red Cross Society—Mobile Meals Service. The Westminster Division of the British Bed Cross Society have continued the service which they established in the City in 1945 for the delivery to their homes of hot mid-day meals to aged people who are themselves unable to prepare meals of this sort. The service is operated with three vans, two provided by the Society and one by the City Council. The City Council also provides the equipment for the vans and makes a grant to the Society of 75 per cent. of the running cost of the vans. The meals are purchased by the Society from a London County Council Civic Restaurant and consist of meat or fish and two vegetables and a sweet. The cost of the meal is Is. 2d. but the old people are charged 8d., the London County Council bearing the difference of 6d. per meal. The meals are obtained in bulk from the Civic Restaurant and placed in thermostatic containers on the vans and served at the homes of recipients. 19 The City Council in collaboration with the Society were in consultation with the London County Council Catering and Restaurant Department as to the possibility of introducing a system of delivery of meals in individual containers, which has the merit of securing a greater variety of meals more suited to individual requirements. This system will be introduced in 1952. Some 7,325 meals were delivered by this service during the year. It cannot be sufficiently emphasized that providing attractive hot meals at home to these aged and needy people may be the means of fortifying them and with the attention of the family doctor, keeping them at home while obviating or postponing admission to hospital or other institution. Having regard to the present-day cost of in-patient treatment this is a sound and beneficial economy. The Westminster Old People's Welfare Association. This Association, formed in 1948, continued its activities for the welfare of aged persons in the City. Assisted by a number of active voluntary assistants the Association's sphere of activities includes the conduct of eight Darby and Joan Clubs throughout the City where recreation and light refreshments are provided. Regular home visiting of the aged by members of the Association has also brought comfort to the lonely. Holidays at seaside resorts have been arranged as well as Christmas parties and summer outings. A foot clinic is held weekly under the auspices of the Association and treatment at home provided for those who are home bound, a small charge being made for this treatment. Increasing use has been made of the mobile library service, which brings books to their homes and to the clubs. This has been organized and conducted by the City Council's Librarian, in collaboration with the Association. The City Council make an annual grant to the Association and office accommodation is provided for them in the Public Health Department. International Certificates of Vaccination and Inoculation. Arrangements continued during the year for the authentication by the Medical Officer of Health of International Certificates of Vaccination and Inoculation completed by medical practitioners in Westminster. These certificates are requiied by passengers proceeding abroad from this country, and the purpose of the authentication is to provide proof to those health authorities abroad who desire it that the signature of the person issuing the certificate is that of a registered medical practitioner. Some 1,733 certificates were authenticated during the year. Medical Inspection of Aliens. The City Council on behalf of the Minister of Health continued during the year arrangements for the medical inspection of aliens arriving daily at Victoria Station by the through sleeping car service from Paris. 20 The inspection is carried out by the Assistant Medical Officer of Health and by the medical staff from Westminster Hospital. The Government reimburse the Council the cost of this service. During the year 10,807 aliens were inspected and 41 medically examined. Slaughter of Animals Act, 1933—Slaughterman's Licences. The Council during the year granted Slaughterman's licences to ten men who had been accepted by the Royal Society for the Prevention of Cruelty to Animals to act as their inspectors in different parts of the country. These licences are required to be held by the pupils while undergoing training in humane slaughtering as inspectors of the R.S.P.C.A. 21 SANITARY CIRCUMSTANCES. Duties Performed by the Sanitary Inspectors. The following statistics show the work of the Sanitary Inspectors during the year. These figures are divided under the headings: Housing, Factories and Workplaces, Catering and Food. Summary of Inspections of all Types of Premises. Re- Primary. inspection. Dwellings ... ... ... ... ... 6,025 8,258 Factories, workplaces and shops (other than food), &c 3,396 4,768 Catering establishments and food premises ... 2,236 3,412 11,657 16,438 Number of Sampling of food ... Inspection of food Smoke Noise Rat and mice repression Visits. 452 1,884 1,501 123 4,232 8,192 22 Summary of Notices Served. Dwell- Factories, Food, Catering. Totals. places, &c. Public Health (London) Act, 1936 388 66 5 72 531 Food & Drugs Act, 1938... — — 12 139 151 Factories Act, 1937 ... — 71 — — 71 London County Council (Drainage) By-laws, 1934 3 6 1 1 11 London County Council (Watercloset) By-laws, 1930 1 5 1 3 10 Shops Act, 1950 — 1 — — 1 London County Council (Houses let in Lodgings) By-laws ... 3 — — — 3 Prevention of Damage by Pests Act, 1949 45 234 23 43 345 440 383 42 258 1,123 Dwelling Houses. Analysis of Inspections— Primary. Re-inspection. Complaint 1,525 876 House to house by Housing Inspectors 642 376 Routine 375 276 Infectious disease ... ... ... ... 356 102 Underground rooms 348 863 Other parts 6 17 Housing applications 451 298 Building licences and permits 91 165 Drainage—voluntary 915 1,620 Drainage under notice — 18 Sanitary defects under notice — 1,682 Aged and infirm ... 139 646 Common Lodging Houses 3 61 Rodent control 658 329 Other reasons 506 929 6,015 8,258 Included in the above totals— Requisitioned properties ... ... 283 133 Houses let in lodgings 1,017 2,334 Council properties 115 16 23 Notices served. Public Health (London) Act, 1936 388 London County Council (Drainage) Bylaws, 1934 ... 3 London County Council (Watercloset) Bylaws, 1930 ... 1 London County Council (Houses let in Lodgings) Bylaws, 1938 ... ... ... ... ... ... 3 Prevention of Damage by Pests Act, 1949 45 440 Statutory notices 34 Nuisances and Defective Conditions found. Defective, dirty internally ... ... ... ... 224 Damp ... ... ... ... ... ... ... 274 Inadequate underfloor ventilation 8 Defective drainage 192 ,, roofs ... ... ... ... ... ... 156 „ area paving, &c. 27 „ exteriors 29 Waterclosets—insufficient ventilation and light ... 21 „ defective 65 ,, insufficient 3 Water supply insufficient 5 „ absence of in upper floors 1 „ cisterns dirty, uncovered 4 Absence of food storage accommodation ... ... 13 Staircase lighting, tenements ... ... ... ... 3 Ventilation ... ... ... ... ... ... 15 Smells ... ... ... ... ... ... ... 62 Rubbish 47 Other nuisances ... ... ... ... ... ... 1 Vermin ... ... ... ... ... ... ... 10 Water supply in tenement houses. Under the powers of the Public Health (London) Act, 1936, six additional water supplies were provided to working class tenement houses during the year. Drainage. Drainage plans submitted, 517. Combined Drainage Orders made, 64. The examination of drainage plans submitted to the Council and the subsequent inspection of the works set out in these plans form part of the duties of the Sanitary Inspectors. Drainage works included in these plans may have to be reconciled with the provisions of the Public Health Acts, Housing Acts, the Food and Drugs Act, the Factories Act and the Shops Act, according to the type of premises. Many provisions of these statutes fall to be administered by the Public Health Department 24 and there are also the detailed requirements of the London County Council Drainage and Water Closet Byelaws which must be observed and the inspector, in examining plans, necessarily takes cognizance of the intended user of the building. For instance, in a canteen, methods of ventilation, siting of apparatus, etc., must have relationship to the drainage layout. During 1951, 517 plans were submitted for approval by the Council requiring some 4,200 visits by the Inspectors. These visits do not include the numerous consultations with architects, surveyors, and property owners at the office in regard to proposed or actual building, rebuilding, alteration, conversion or repair of premises of all types. The plans submitted cover works ranging from the installation of a single lavatory basin to the complete drainage and sanitation of large modern office buildings, complete with canteen facilities and rest rooms, mechanically ventilated sanitary accommodation and basement rooms, often with a garage included. In consequence of two wars with an economic disturbance in the interval, changes have taken place in the character of the City of Westminster, more particularly noticeable in the Mayfair, Belgravia and Knightsbridge districts. Enemy bombs destroyed indiscriminately and after the destruction both living and business accommodation was needed by those whose homes and businesses had been destroyed. The empty town houses and mansions of Mayfair and Knightsbridge have, subject to the sanctions of the Town Planning Authority, fairly adequately filled the needs of those in search of office accommodation. These houses, with their numerous large rooms, are capable of housing large office staffs, and the elegant Victorian and Edwardian ballrooms are now converted into board rooms for which purpose they are most eminently suitable. Sic transit gloria mundi. The original sanitary accommodation of these mansions falls far short of the needs of the increased number of occupants and in the conversion from house to office the decorated toilet and sanitary ware, adorned with its glazed blue flowers and substantial mahogany surrounds, have departed to make way for the more functionally designed modern appliances. The plumbing that went with the old, rather elaborate appliances, the pride of the craftsman who installed it, has been supplanted by more streamlined and modern fittings. The scarcity of materials, in particular lead, has brought changes in plumbing practice. There has been a greater use of screw.jointed iron piping, a more intractable material than lead, and therefore not so appreciated by the real craftsman. The use of copper piping is increasing. A different technique to that needed for lead and iron is required and when skilfully handled, copper provides a strong, durable and unobtrusive plumbing system with almost the flexibility in installation of lead plumbing. Restriction in the supply of some building materials and the high cost of others have inevitably led manufacturers to produce substitutes. For example, various types of plastic impervious material are used in place of tiles for wall surfaces, reconstituted wood waste and composite 25 material of metal and wood are prefabricated in sections and erected for partition walls in place of timber or breeze partitions. Although such materials were not conceived when the byelaws were drafted, many of them have proved quite suitable in regard to strength, durability, ease of cleaning and of sound insulation. Housing Acts, 1936 to 1949. A.—Individual Houses Unfit for Human Habitation. Number of houses represented for demolition Nil Number of Demolition Orders made Nil B.—Parts of Buildings Unfit for Human Habitation. (a) Number of basements represented for closure 34 (90 rooms) Number of Closing Orders made in respect of underground rooms 34 (94 rooms) (b) Number of other parts of buildings represented for closure 1 (2 rooms) Number of Closing Orders made in respect of other parts of buildings 1 (2 rooms) (c) Number of specifications submitted and approved 19 (d) Number of Closing Orders determined in respect of underground rooms 11 (28 rooms) Number of Closing Orders determined in respect of other parts of buildings 1 (1 room) (e) Number of applications made for modification of Closing Orders to permit approved use 26 (46 rooms) Number of applications approved 26 (46 rooms) C.—Informal Action in Respect of Parts of Buildings Unfit for Human Habitation. Number of instances of informal action taken to secure requirements of the Housing Acts and Regulations made thereunder:— (a) in respect of underground rooms 79 (b) in respect of other parts of buildings 7 Number of instances of informal action taken included in (a) and (b) above:— (a) as a result of applications for Building Licences 24 (b) on the initiative of the owner 25 (c) at the suggestion of the Medical Officer of Health 37 26 D.—Contraventions of Closing Orders. Number of contraventions of Closing Orders reported 4 Number of legal proceedings instituted 2 Overcrowding (Housing Act, 1936, Section IV). Cases coming to the notice of the Public Health Department during the year 106 Cases in which overcrowded families have been rehoused during 1951. Westminster City Council 17 45 London County Council 28 • — A Note on Housing and a Record of Action Taken in Relation to Individual Unfit Buildings and Parts of Buildings—1930 to 1951. If any proof were needed of the importance of housing in national affairs it lies in the fourteen statutes which Parliament has passed in the past sixty or seventy years relating to this ever.expanding problem with its protean features. Successive governments came to realise that the provision of new dwellings, the standard of fitness of existing houses and the clearance of those where defects were irremediable were responsibilities too massive for private ownership to discharge and could only be adequately borne by the whole community. Moreover, the population of the country (England and Wales) had increased from 32,527,843 in 1901 to 43,744,924 in 1951. But full credit at the same time must be given to many private owners, housing corporations and charitable bodies for their notable contributions in dealing with housing problems from the days of the monastic Orders, the Elizabethan almshouses and many benefactors till the time of George Peabody and others who made charitable trusts in Victorian times. The City Council under the powers of the Housing of the Working Classes Act of 1890 made its first contribution in new housing in 1903 by the erection of three blocks in Regency Street. Prior to the last war under the powers granted by successive Housing Acts some 1,557 flats had been erected in the City and when Churchill Gardens programme is completed the Council will have provided for 3,252 families exclusive of the projected scheme at Warwick Way where 280 flats are proposed. The difficulty of providing alternative accommodation for the persons displaced by closure or demolition was a serious handicap in the early years of the period under review and during 1930 and 1931 only three Closing Orders were made. In 1932, however, the City Council considered that, as the housing situation had become easier, the provisions of the statutes in relation to underground dwellings and sleeping rooms should be more rigorously enforced. In that year, although only one formal Closing Order was made, owners and other persons having control of underground rooms were communicated with warning them against reletting contrary to 27 the Act and Regulations and, as a result, written undertakings not to relet or use as sleeping places were given in respect of 91 houses. In the next few years many more such undertakings were given and the number of formal Closing Orders gradually increased. In each of the subsequent years an increasing number of Closing Orders was made until in 1937 and 1938 they totalled 203 and 232 respectively. During this period, and increasingly in the years immediately preceding the war, many owners were prepared to recondition basement rooms to secure conformity with the City Council's Regulations and between 1936 and 1938 some 250 Closing Orders were determined and something like 600 rooms were rendered fit for human habitation and brought back into use as dwellings. At that time the average cost of the works necessary to make three basement rooms fit was £150, a figure which many owners considered justified and not unreasonable in the hope of future recoupment. During the War reprobated basements recovered their attraction and, Closing Order or no Closing Order, they were much in demand during periods of air raids. In the immediate post.war period there was inevitably little activity towards the closure or reconditioning of properties and it was not until 1948 that Closing Order procedure was restarted because people who had been thankful to live in basements in time of danger, when danger had passed became clamant for rehousing. In that year 65 Closing Orders were made in an effort to deal with the worst of the basements. The cost of building works in the post.war years has increased enormously and so few owners have felt disposed or able to undertake the reconditioning of basement or other rooms that have fallen under condemnation. The average cost of bringing three rooms up to the standard of the statute and regulations is now £450, but, nevertheless, since 1948, works have been carried out in some 80 instances and an equivalent number of Closing Orders have been determined. With building costs still advancing it is not possible to forecast to what extent or for how long such reconditioning works will continue to be carried out, because the length of interest in a property will always remain a determining factor, and this doubtless influenced leaseholders in the years of activity before the War. Few leaseholders in Pimlico—. which is still the principal residential area—have long unexpired terms. A Statistical Summary of 20 years Activity. (a) In the 20 years since 1931, 1,532 unfit dwellings as parts of buildings—primarily basements—have been dealt with by formal and informal methods as follows:— By means of Closing Orders 951 By means of Informal Action 526 By Undertakings given in lieu of Closing Orders 55 1,532 28 (b) Of this total, reconditioning works to secure conformity have been carried out in 862 cases:— Formally after Closing Orders 314 (Closing Orders determined). Formally after Undertakings 22 (Undertakings cancelled). Voluntarily following informal Action 526 862 (c) In 216 cases, Closing Orders have been modified to permit approved uses other than human habitation, e.g., washhouses, stores, workshops, offices, etc. (d) Some 452 Closing Orders remain fully operative and outstanding, some of the rooms, because of the difficulty of rehousing, remain occupied. (e) In two instances where properties were completely demolished the Closing Orders in each of them cancelled themselves. (/) In addition, during the same period 19 individual unfit properties were dealt with:— By means of demolition 8 By means of Undertakings given in lieu of Demolition Orders 11 19 of this total six premises have been demolished. Informal and Voluntary Action. Throughout the whole of the 20 years under review excluding the war years, voluntary reconditioning of unfit parts of buildings has gone on side by side with the work of reinstatement which has followed formal closure. Up to 1939, such voluntary works totalled rather more than one half of those carried out to determine Closing Orders. By the end of 1951, informal or voluntary works had been carried out in 526 instances against 327 instances of formal reconditioning, The requirement to obtain licences for building operations, including the restoration of war damage, has stimulated the process of reconditioning of dwellings and owners have seen the advantage of including basement rooms which formerly did not comply with the law in their scheme of rehabilitation so that the properties may be fully occupied. 29 Public Health (London) Act, 1936. A.—Illegal Separate Occupation of Underground Rooms. Number of instances of formal action taken to secure compliance with Section 132 Nil Number of instances of informal action taken to secure compliance with Section 132 17 House to House Inspection. (by Housing Inspectors). During the year 240 properties, involving 642 individual dwellings were inspected. Of these 240 properties, 173 were wholly residential in character, 19 part residential, 17 business premises and 31 bombed, derelict, etc., buildings. Inspections. Primary inspections (dwellings) 642 Reinspections 1,544 Notices served. Public Health (London) Act, 1936 88 Nuisances and defective conditions found. Defective roofs 28 Dampness 40 Dirty, defective, dilapidated internally 64 Defective drainage 8 Insufficient water supply 4 Absence of food storage accommodation 1 Insufficient water closet accommodation 1 The above statistics are included in the totals shown on page 22. Factories, Workplaces, Shops and Other Premises (other than Food Premises). Summary of Inspections. Primary, Re.inspections. Factories—Power 695 719 Factories—Non.Power 465 647 Workplaces, &c 1,790 2,890 Shops (other than food) 446 512 3,396 4,768 30 Primary. Re.inspections. Analysis of Inspection. Complaint 423 330 Routine 911 714 Infectious disease 193 19 Building Licences and permits 2 2 Drainage—Voluntary 794 1,719 Drainage—Under Notice — 10 Sanitary defects under Notice — 436 „ „ Voluntary 4 7 Outworkers 226 53 Rodent Control 765 1,374 Other Reasons 78 104 3,396 4,768 Types of premises inspected. Places of Public Entertainment 209 Carpentry, joinery, &c. 94 Wearing apparel 1,576 Furriers 132 Garages, motor tyres and rubber works 74 Boots and shoes and other leather goods 125 Jewellers, precious and other metal workers 125 Cigar and cigarette manufacturers 2 Hairdressers 99 Laundries and dry cleaners 38 Printers and publishers 172 Warehouses and packers 69 Shops (other than food) 958 Upholstery and carpets 56 Photographers, film renters 156 Opticians 3 Florists 25 Offices 2,443 Stables and mews 27 Surgical goods 13 Various 1,415 Outworkers. Inspections 279 Number of outworkers (includes workers living in areas outside the City) 3,699 N otices—Summary. Factories—Power 76 Factories—Non.power 78 Workplaces, shops (other than food) 229 383 31 Abstracts. Reports were made to the Factory Inspector of 67 instances for failure to display the appropriate abstracts of the Factories Act, 1937. N otices—Analysis. Factories, Power. Factories, Non.power Workplaces, Shops, &c. Public Health (London) Act, 1936 12 14 40 Factories Act, 1937 31 39 1 London County Council (Drainage) Bylaws, 1934 1 5 London County Council (Water. closet) Bylaws, 1930 1 3 1 Shops Act, 1950 — — 1 Prevention of Damage by Pests Act, 1949 31 22 181 76 78 229 Total 383 Nuisances and defective etc., conditions found. Factories, Power. Factories, Non.power Workplaces, . Shops, &c. Dirty, defective internally 12 23 25 Dampness 8 3 24 Drainage defective 6 5 47 Roofs defective 1 4 — Sanitary accommodation— Insufficient 1 1 5 Insufficient ventilation and light 13 9 5 Defective 20 23 14 Direct approach 6 2 4 Not separate for sexes 8 — 4 Unsuitable 2 — — No indicating notices on doors of waterclosets 16 15 2 Overcrowding — 8 — Smells 4 1 65 Rubbish 4 3 96 Ventilation, want of — 7 4 Failure to fix abstracts 45 22 — Water supply insufficient 2 — — Absence of washing accommodation — 2 — Temperature — 4 — 32 Common Lodging Houses. There are three common lodging houses in the City, two for men and one for women. Sixty.four visits were made during the year for infectious disease, chronic illness and other reasons. Clean Food Campaign. Report of Manufactured Meat Products Working Party. The Report of this Working Party was published during che year, and contained recommendations for securing that conditions in the meat manufacturing trades are clean and sanitary and that the products and materials used are wholesome in all respects. The City Council expressed general agreement with the tenor of the Report. Catering Establishments and Other Food Premises. Hygiene in Catering Establishments. In view of the importance of the catering industry in Westminster, the City Council gave consideration to the Report of the Catering Trade Working Party which was published on the 31st January, 1951. The City Council welcomed the Report and considered that it would make a substantial contribution to focussing public attention on the essential need for high standards of hygiene in kitchens and in the serving of food. It considered that the Report would be of the utmost value to the Council's Sanitary Inspectors in securing compliance with the requirements of the Food and Drugs Act, 1938, and in controlling standards of hygiene in places where food is prepared and sold to the public as meals. Summary of Inspections. Primary. Re.inspections. Caering establishments 1,523 2,909 Food shops and other food premises 713 503 2,236 3,412 Analysis of Inspections. Primary. Re.inspections. Complaint 399 173 Routine 853 224 Infectious disease 57 8 Building Licences and permits 29 9 Drainage—Voluntary 323 469 Drainage—Under Notice 1 43 Sanitary defects—Voluntary 6 11 Sanitary defects—Under Notice 1 1,223 Food Licences 13 1 Catering Licences 210 467 Rodent Control 337 769 Other Reasons 7 15 2,236 3,412 33 Summary of Notices served. Food Shops and other food premises. Catering establishments. Food and Drugs Act, 1938 12 139 Public Health (London) Act, 1936 5 72 London County Council (Drainage) Bylaws, 1934 1 1 London County Council (Watercloset) Bylaws, 1930 1 3 Prevention of Damage by Pests Act, 1949 23 43 42 258 Statutory Notices served 1 (smoke) Food Shops and Other Food Premises (other than Catering Establishments). Primary. Reinspections. Bakehouses (underground included) 29 38 Dairies and milkshops 133 36 Ice cream premises 84 39 Meat shops 79 30 Other meat shops (preserved food, &c.) 15 3 Stalls 20 17 Confectioners 37 18 Fruit and greengrocery 89 146 Provision shops 103 78 Fish and poultry 27 31 *Other food premises 97 67 713 503 Included in the above totals are 16 visits in connection with the sale of horseflesh, and 81 inquiries in relation to food poisoning outbreaks were made. *Other Food Premises. Under this heading are included:— (1) Off.Licences. (2) Food factories. (3) Bonded warehouses. (4) Chemists' shops. (5) Visits made in connection with applications for entry on the List of Persons entitled to sell Poisons included in Part II of the Poisons List. (6) Visits to various offices in connection with inquiries regarding adulterated samples. 34 Visits for the Purpose of Obtaining Samples and Inspecting Foodstuffs. Sampling. Inspection of Food. Bakehouses — 2 Dairies and milkshops 149 52 Ice cream premises 37 26 Meat shops and stalls 2 222 Confectioners 10 7 Fruit and greengrocery 6 220 Provision shops 130 679 Other food premises 26 132 Staff canteens 1 100 Hotels, restaurants, clubs 14 224 Cafes, teashops, &c. 6 80 Public Houses 71 80 Fish and poultry — 60 452 1,884 Notices served. Food and Drugs Act, 1938 12 Public Health (London) Act, 1936 5 London County Council (Drainage), Bylaws, 1934 1 London County Council (Watercloset), Bylaws, 1930 1 Prevention of Damage by Pests Act, 1949 23 42 Nuisances and defective conditions found. Dirty and dilapidated internally 4 Defective internally 1 „ externally — „ drainage 3 „ floors 1 Preparation tables and equipment worn and insanitary 2 Ventilation insufficient 1 Washing facilities for staff, insufficient, unsuitable 1 Waterclosets:— Insufficient — Insufficient ventilation and light 1 Defective 1 Rats/Mice 7 35 Catering Establishments. Analysis of Inspections. Primary. Re.inspections. Hotels, restaurants, clubs 915 1,795 Cafes, teashops, &c. 316 588 Staff canteens 114 160 Public Houses 178 366 1,523 2,909 Notices served. Public Health (London) Act, 1936 72 Food and Drugs Act, 1938 139 London County Council (Drainage), By.laws, 1934 1 London County Council (Watercloset), Bylaws, 1930 3 Prevention of Damage by Pests Act, 1949 43 258 Nuisances and defective conditions found. Dirty and dilapidated internally 87 Defective internally 60 „ externally 11 „ drainage 56 „ floors 38 Preparation tables and equipment, worn and insanitarty 28 Food storage, inadequate, unsuitable 26 Vegetable preparation and washing up facilities— Worn and insanitary 38 Insufficient 33 Ventilation insufficient 51 Staff washing facilities, insufficient, unsuitable 16 Staff changing rooms, insufficient, unsuitable 11 Fuel, rubbish and other extraneous materials in food preparation rooms 22 Accommodation unsuitable (re.designing and re.siting of equipment necessary), &c. 17 Vermin— Cockroaches 19 Rats/Mice 52 Fuel storage accommodation insufficient 3 Waterclosets— Insufficient 11 Insufficient ventilation and light 10 Defective 23 Dirty and dilapidated 29 Direct approach 3 Not separate for the sexes 6 Unsuitable 2 Dampness 8 Water supply inadequate 8 Lighting 1 36 Samples Purchased under the Food and Drugs Act, 1938, Showing Results of Analysis for the Year 1951. Articles of Food. Number of Samples Purchased. Adulterated. Genuine. Bread 1 1 — Bacon 5 — 5 Baking powder 9 2 7 Biscuits 1 1 — Butter 18 — 18 Cakes, cake and pudding mixture, custard powders 126 3 123 Cereals 7 — 7 Cheese 13 1 12 Cocoa 11 — 11 Coffee preparations and essences 37 — 37 Condiments and spices 68 — 68 Confectionery 60 — 60 Cooking fat 9 — 9 Cream and synthetic cream 5 — 5 Culinary flavours 53 — 53 Dried fruits 11 1 10 Drugs 50 5 45 Fish canned and fish preparations 46 3 43 Flour 4 — 4 Flour—self.raising 4 — 4 Fruit, canned bottled and preserved etc 28 9 19 Fruit 9 7 2 Gelatine 10 2 8 Ice cream 58 — 58 Jam and preserves 71 — 71 Jelly 43 — 43 Macaroni product 3 — 3 Margarine 11 — 11 Milk 569 1 568 Milk condensed and evaporated 13 4 9 Milk beverages 5 — 5 37 Articles of Food. Number of Samples Purchased. Adulterated. Genuine. Pickles and sauces 55 1 54 Meat, canned meat and meat preparations 55 12 43 Poultry, and poultry canned, chopped and sliced 8 1 7 Salad oils and dressings 21 — 21 Sandwich spread 5 — 5 Sausage and sausage rolls 3 1 2 Soft drinks cordials etc 59 — 59 Soup 23 3 20 Spaghetti in tomato sauce and beans in tomato sauce 3 — 3 Spirits 142 2 140 Suet 1 — 1 Sugar 12 — 12 Tea 19 — 19 Vegetables, canned vegetables and vegetable spreads 14 — 14 Vinegar 20 — 20 Wines 1 1 — Rabbit and chicken canned 1 — 1 Totals 1,800 61 1,739 Registration of Premises used in Connection with the Manufacture, Sale or Storage of Ice Cream. On the 1st January, 1951, 173 premises were registered for the sale and storage of ice cream. During the course of the year applications were received in respect of 19 further premises, and these were duly registered, making a total of 192 registered premises. By reason of 4 removals during the year, the total number now registered is 188. At the commencement of the year 12 premises were on the Register for the manufacture of ice cream. During the year three firms discontinued to manufacture, leaving 9 premises now used for this purpose. 38 Ice Cream (Heat Treatment) Regulations, 1947. During the year 79 samples of ice cream were submitted for examination by the methylene blue test. The samples were classified in provisional grades, as follows:— Grade 1 39 Grade 2 14 Grade 3 19 Grade 4 7 The above grading is based upon the method of examination recommended by the Ministry of Health. In this test the grading is consequent upon the time taken for a measured volume of the ice cream to reduce the colour of a measured volume of methylene blue dye. Grade 1 Over 4½ hours. Grade 2 Between 2 and 4½ hours. Grade 3 Between ½ and 2 hours. Grade 4 Under ½ hour. Milk and Dairies Regulations, 1949. At the 31st December, 1951, the following were entered in the City Council's Register of Dairies and Distributors of Milk:— Distributors of milk with premises registered as Dairies 49 Distributors of milk with premises not registered as dairies 71 Distributors of milk with premises situate outside Westminster 46 Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, and Milk (Special Designation) (Raw Milk) Regulations, 1949. The following are particulars of licences granted during 1951 to dealers in respect of the sale of milk under prescribed or special designations:— Principal Licence. Supplementary Licence. Tuberculin tested 29 17 Pasteurised 103 22 Sterilised 84 21 The Milk (Special Designations) (Specified Areas) Order, 1951. This Order made under the Milk and Dairies Act, 1950, specified among other places the whole of the County of London as a specified area as from the 1st October, 1951. The effect of the Order is that no milk can be sold in the specified area other than designated milk, i.e., pasteurised, sterilised, tuberculin tested and, in some instances, accredited milk. All distributors of this designated milk have to be licensed with the Local Authority. 39 Pharmacy and Poisons Act, 1933. At the end of the year the number entered on the List of Persons entitled to sell poisons included in Part II of the Poisons List was 170. During the year 4 persons had been removed from the list because they were no longer in business or had moved out of the City, and 7 new applicants had been duly entered on the list. Unsound Food. The following table shows the amount, and method o' disposal, of food condemned by the inspectors as unfit for human consumption during the year 1951:— Articles. Amount Destroyed. Amount Salvaged. Total. Tons Cwt Lb. Tons Cwt Lb. Tons Cwt Lb. Canned food 30 13 62 6 7 50 37 1 0 Meat 1 0 106 — 2 107 1 3 101 Fats — — 6 — 1 88 — 1 94 Fruit and vegetables 149 13 21 2 0 149 15 21 Fish 1 3 79 — — — 1 3 79 Cereals — 2 41 — 8 75 — 11 4 Confectionery — 1 48 — 2 0 — 3 48 Miscellaneous — 7 82 1 12 105 2 0 75 Total 183 2 109 8 17 89 192 0 86 Food Poisoning. A total of 19 outbreaks of food poisoning occurred in the City during the year. Of this number, 10 concerned single cases, and despite the most complete investigations, in only two cases was it possible to identify the causative agent. Of the other 9 outbreaks concerning groups of individuals, the causative agent was traced in 5 instances. Details of these 9 are as follows:— (1) An outbreak involving some 42 men occurred in a Police Section House. The onset was characterised by abdominal pain and bloodstained loose motions. They were suffering from Sonne Dysentery and in 10 cases the organism was recovered. Similar specimens were collected from members of the kitchen staff, comprising 13 in number, but proved negative, nor could any dysentery organism be recovered from samples of suspected food. (2) Two families in Pimlico were affected by the consumption of ham and jellied veal purchased on the same day at a branch shop of a large chain of grocery and provision merchants. The total number of persons affected was 8 and 2 of these were sufficiently affected to require removal to hospital. Specimens of vomit and faeces, and the 40 unconsumed portion of the suspected food were submitted to the bacteriologist, together with swabs taken from the 4 members of the staff of the store concerned. The reports received indicated that the jellied veal and ham contained staph, pyogenes organisms, certain strains of which are known to cause food poisoning, and were probably the cause of the illness, although the specimens from the patients proved negative and those from the staff proved inconclusive. The firm was subsequently communicated with and informed that the storage of this type of food, being exposed to possible contamination by customers or staff, left much to be desired. The firm was quick to adopt suggested improvements such as the provision of enclosed glass screens to protect the food exhibited for sale. The firm also gave an assurance that every opportunity would be taken to impress on the staff the necessity for personal cleanliness. (3) A large firm of printers reported that 31 of their staff had been subjected to attacks of abdominal pain and diarrhoea after lunch, one being sufficiently ill to be removed to hospital, where he was subsequently diagnosed to be suffering from "clinical dysentery," while two received treatment at home by their own medical practitioners. Two specimens of the food served during the lunch in question were obtained and submitted for examination, as also were some faecal and vomit specimens, but the examinations failed to produce any positive result. The catering arrangements in this instance called for some improvement, while evidence of a fairly heavy rat infestation did not brighten the picture. The premises were subsequently treated and cleared of rats by the Council's Rodent Staff. (4) An outbreak occurred during the year at the nurses' home of a large hospital where some 83 persons were affected—all members of the hospital staff. The duration of the illness was generally from 3 to 5 days and was accompanied by headache, malaise, muscle pains, fever, diarrhœa and vomiting. The causative organism was found to be salmonella typhimurium, a well.known cause of food poisoning, but as none of the food was available from the suspected meal, it was not possible to determine the exact vehicle of the infection. It was found, however, that the chef, who did not partake of the meal and had not previously complained of any symptoms, was a carrier of salmonella typhimurium. It appears highly probable the infection was transmitted by him to the food consumed. (5) Recurrence at intervals of isolated cases of food poisoning at the same hotel has entailed prolonged investigation. The food.handling staff employed on the premises, methods of preparation and of the food storage, and any other likely source of contamination of foodstuffs in the hotel have come under careful review. The outbreaks have affected usually single individuals and have on each occasion been due to a prepared sauce. It was confidently believed that one of the chefs, presumed to be the cause of the infections, had become free as he had undergone thorough treatment. In December, however, a single case occurred in which a sauce had been specially prepared by this chef 41 for a customer, and it was disappointing to find that he was again a carrier, the same organism being recovered from his hands. Further safeguards were made which it is hoped will prevent any further cases. (6) This outbreak occurred in a Government canteen wherein 13 people of a total number of 50 were affected. Five were taken to hospital. The suspected article in this case was chicken sandwich prepared from sliced galantine purchased from a source outside the City of Westminster. Bacteriological examination of the sandwich revealed the presence of staph, pyogenes, but the swabbing of the two sandwich handlers in the canteen kitchen and the proprietor of the shop from whence the chicken was purchased failed to reveal any of them as carriers of the organism. During the course of the investigation certain shortcomings in the food.handling process were discovered and advice was subsequently offered to the Government Department responsible for the elimination of these practices. (7) Four people dined in a well.known restaurant and were subsequently taken ill with severe abdominal pain, vomiting and diarrhoea. The duration of the illness was only for one day and the attack was of a moderate nature. The food eaten by each of the persons affected consisted of steak, sauce Bernaise and chips. No food samples were available for bacteriological examination. Three of the staff employed in preparing food were swabbed and two were found to be infected with staph, pyogenes, one belonging to a type capable of causing intestinal illness. Suitable safeguards were adopted. No further cases occurred. (8) At a canteen run by a large publishing firm 22 persons were mildly affected with abdominal pain and diarrhoea, the duration of the illness being only 2 to 3 hours. The food causing this illness was thought to be boiled beef, although no absolute conclusion could be reached. The meat in question was delivered to the canteen on Friday afternoon and boiled that same afternoon for 3 hours. It was left to cool in its juice in the pan over the week.end until Monday, and the meat was then sliced and heated on trays before serving for lunch. After complaints of illness had been made, the manageress wisely withdrew the meat from the menu and placed it in the canteen refrigerator until the inspector called. The Bacteriologist reported that it was just possible that the boiled beef from which Clostridium Welchii was recovered, may have been responsible for the outbreak. The presence of this organism is not so far known to be capable of being conveyed by persons and therefore does not imply any reflection on the preparation of the food. 42 Rat and Mice Repression. Complaints received 1,306 Treatments carried out 1,072 Inspections by Rodent Officer 3,863 Inspections by the Sanitary Inspectors 369 Notices served. Prevention of Damage by Pests Act, 1949 345 Rodents destroyed. Black rats 5,676 Brown rats 1,417 Mice 8,229 15,322 Pigeons. Under the provisions of Section 121 of the Public Health (London) Act, 1936, the City Council, as a Sanitary Authority, is empowered for the purpose of abating or mitigating any nuisance, annoyance or damage caused by the congregation of pigeons in the City, having no owner, or for preventing or minimising any such nuisance, annoyance or damage, to reduce the number of such pigeons. The following action was taken during the year in this connection:— Premises visited 5 Visits made 120 Pigeons destroyed 278 Starlings. In view of complaints received of nuisance and damage caused by starlings roosting on buildings in the City, the Medical Officer of Health has been exploring ways and means of preventing the birds from roosting on buildings. As many Cities in America are similarly troubled with starling roosts, the Medical Officer of Health has been in communication with the civic authorities there on the subject. The Ministry of Agriculture and Fisheries has been consulted, also the London Natural History Society who have made a special study of the problem. No ready and effective means of preventing starlings from roosting has come to light. A limited experiment was carried out on one building where a selected cornice was wired with low.power electric wiring operated by batteries similar to the methods used to prevent cattle from straying. This experiment showed that starlings avoided the portion of the building so wired. It must be pointed out, however, that this method is only capable of application to easily accessible ledges on buildings, otherwise the erection of scaffolding for comprehensive 43 installations would make the cost prohibitive. However adequately a building might be protected, this in no wise prevents starlings seeking other roosting places in other buildings not so protected. Noise Nuisance. Complaints 52 Investigations made 123 Most of the complaints arose from apparatus used in road works or demolition of buildings, nuisances temporary in character. In no case was a statutory abatement necessary. Atmospheric Pollution. Investigation of atmospheric pollution in the City was continued throughout the year at the Pimlico and Mayfair Stations, and an additional deposit gauge was installed in the Charing Cross district at Alhambra House. The following tables give the results of the monthly analysis ot the impurities collected in the deposit gauges. Deposit Gauges. Month. Monthly Deposits of Impurities—Tons per square mile. Mayfair. Pimlico. Charing Cross. Total Solids. Dissolved. Undissolved. Total Solids. Dissolved. Undissolved. Total Solids. Dissolved. Undissolved. January 25.44 7.81 17.63 27.51 8.55 18.96 32.29 12.58 19.71 February 33.00 11.76 21.24 44.82 17.79 27.03 59.38 24.53 34.85 March 32.74 10.95 21.79 38.12 10.10 28.02 41.49 13.28 28.21 April 29.15 11.. 32 17.83 31.00 11.84 19.16 33.19 13.67 19.52 May 36.28 10.23 26.05 23.37 6.64 20.26 19.35 5.58 13.77 June 23.15 6.75 16.40 27.31 7.05 20.26 22.14 6.87 15.27 July 19.06 6.10 12.96 23.06 9.24 13.82 18.19 6.87 11.32 August 24.38 10.81 13.57 26.01 10.54 14.47 24.33 11.45 12.88 September 24.11 10.37 13.74 22.96 10.85 12.11 26.05 13.41 12. 64 October 30.89 11.45 19.44 25.93 7.90 18.03 29.47 11.28 18.19 November 28.92 12.69 16.23 28.20 8.76 19.44 31.83 11.09 20.74 December 26.15 7.74 18.41 36.51 14.27 22.24 35.61 10.29 25.32 Estimation of Sulphur Activity by the Lead Peroxide Method. The lead peroxide cylinders for the estimation of sulphur activity are sited at Farm Street Depot, Mayfair, Bessborough Street Clinic, Pimlico, and Alhambra House, Charing Cross Road. The following 44 tables indicate the daily absorption of sulphur due to active sulphurous gases in the atmosphere. Sulphur Trioxide in Milligrammes per 100 sq. cms. per day. Mayfair Pimlico. Charing Cross. 1951. January 4.77 4.74 4.91 February 3.59 4.48 3.59 March 2.78 4.11 3.38 April 2.20 2.59 3.06 May 2.02 3.58 2.69 June 1.49 2.23 1.86 July 1.05 1.22 1.46 August 1.10 1.38 1.24 September 1.46 2.13 1.81 October 2.57 4.25 3.48 November 2.72 3.37 3.93 December 3.48 4.04 4.18 Owens Automatic Air Filter. An hourly record of suspended impurities in the air was continued by the Owens Method at the laboratory, Monck Street. Estimation of Sulphur Dioxide by the Hydrogen Peroxide Method. An estimation of sulphur gases in the atmosphere was made on alternate days at the laboratory, Monck Street. Smoke Abatement. Observations were continued throughout the year, and the following table summarises the action taken in mitigation of smoke nuisances:— Complaints 130 Observations 1,371 Notices issued 15 Statutory Notices served 1 With a view to securing so far as was reasonably practicable that a clean and smokeless atmosphere should prevail in the area of the Festival of Britain Exhibition on the South Bank of the River Thames, the Medical Officer of Health, on the instructions of the Public Health Committee, communicated with all commercial and industrial undertakings using smoke producing fuels in the City, inviting their co.operation in this matter. Generally speaking, there was appreciably less smoke 45 haze in the region of the river as a result of this request and credit is due to the industries concerned and particularly to masters of river vessels for their efforts. Legal Proceedings. Prosecutions instituted 9 Convictions 7 Cases withdrawn on payment of costs 1 Cases dismissed 1 Analysis. Dwellings. Public Health (London) Act, 1936. Failure to abate a Nuisance. Fines. Costs. £ s. d. £ s. d. ment Order made — 3 3 0 Catering. Food and Drugs Act, 1938. Selling horseflesh for human consumption— (a) No notice displayed. (b) Not asked for. Two convictions 10 0 0 2 2 0 Selling ice cream from a container not showing name and address of dealer— Three convictions 6 0 0 — Food (Whisky). Defence (Sale of Food) Regulations. Dismissed on Appeal. Costs against the Council £210. Factories. Factories Act, 1937. Insufficient sanitary accommodation. Withdrawn on payment of costs London County Council Bylaws - 8 8 0 ing Conduct of the business of Rag and Bone Dealers. Distributing toys in exchange for rags 2 0 0 — £18 0 0 £13 13 0 46 Rag Flock and Other Filling Materials Act, 1951. This Act came into operation on the 1st November, 1951. Under its provisions various types of premises connected with the upholstery trade or with the provision of filling materials for that trade must now be registered or licensed with the local authority. Up to the end of the year five premises had been registered by the City Council and two premises licensed for storage purposes. Water. The resident population of 100,000 in 22,914 houses received water from the Metropolitan Water Board's mains or from deep wells. Eighty. nine deep wells were in use at 31st December, 1951. In all but 3 of these 89 deep wells the water is used for domestic purposes. In these 3, one supply is used for cooling purposes, one for supplying boilers and one is a stand-by in case of fire. Seventy bacteriological and 23 chemical reports of analyses were received. Reports in relation to 3 of the water supplies showed evidence of contamination. On investigation, it was found that the water being drawn from the wells themselves was of a satisfactory quality but the storage cisterns in 2 cases were improperly covered, and in the other case a basement storage tank was found to be defective, allowing ground water to gain access. Necessary remedial measures were to be put in hand at each of the premises affected. One installation was dismantled and the bore sealed over during the year as the supply was insufficient. Five complaints of contaminated drinking water were received during the year, one of which was substantiated upon investigation. In this instance a dirty storage cistern gave rise to the nuisance and a direct mains supply was to be provided. Disinfection and Disinfestation. Rooms. Articles. Articles Destroyed. Articles Washed. Vehicles. Books. Disinfection 459 18,588 1,845 1,901 23 1,193 Disinfestation 1,185 2,543 *16,683 — 6 — Laundry towels — — — 5,634 — — 1,644 21,131 18,528 7,535 29 1,193 * Articles include pieces of furniture, books, clothing, etc., found in badly infested rooms. 47 Treatments. Men. Women. Children (under school age). Children (School). Articles. Scabies 45 46 13 91 3,941 Head lice — 21 7 325 575 Body lice 380 11 — — 7,346 425 78 20 416 11,862 Fumigation of Vermin.Infested Furniture. The City Council have a contract with a firm of fumigators for the disinfestation by hydrocyanic acid gas of the furniture of incoming tenants to the Council's Housing Estates where any article of such furniture has been found to be verminous. The bedding and soft furnishings of such tenants are treated by steam disinfection at the Council's disinfecting station. 9 The process of disinfestation is carried out during transfer of the furniture from the old to the new accommodation and the furniture of some 3 families was dealt with during the year. Burial or Cremation of the Dead. Under the provisions of Section 50 of the National Assistance Act, 1948, it is the duty of the City Council as a Sanitary Authority to cause to be buried or cremated the body of any person who has died or is found dead in the area, where no other arrangements have been made for the disposal of the body. The Council is empowered to recover the cost of burial from the estate of the deceased, and as from the 5th July, 1949, is eligible to receive payments in respect of the cost of such burial from death grants payable under the provisions of the National Insurance Act, 1946. Where persons without known relatives die in the City, it is frequently necessary not only to arrange for their burial, but to dispose of the contents of their homes. This course is necessary to enable the proceeds to be applied towards the cost of burial and also to avoid rent accruing and to release the accommodation for housing purposes as early as possible. During the year 47 burials were undertaken by the City Council in its cemetery at Hanwell, the requests for such burials being received from the following sources :— H.M. Coroner's Officer 23 Relatives of the deceased 12 Friends of the deceased 3 Hospitals in the City 9 47 48 Coroner's Court and Mortuary. During 1951 344 bodies were received in the Mortuary on Coroner's Warrants, etc. Five bodies were admitted to await burial. Number of Cases. Inquest cases 120 Non-inquest cases 224 Post mortem examinations held 275 Causes of death in the foregoing were as under :— Accidental drowning 2 Found drowned 11 Suicide by drowning 3 „ by other means 29 Accidents— Street 15 Domestic 9 Others 15 Natural causes 235 Misadventure 10 Murder 1 Miscellaneous cases 14