C4344 ??? WES 69 City of Westminster REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1959 J. A. STRUTHERS, M.D., M.R.C.P., D.P.H. Medical Officer of Health LONDON: made ix great britain by harrison and sons limited by appointment to her majesty the queen, printers, london, hayes (middx.) and high wycombe 68684 City of Westminster REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1959 J. A. STRUTHERS, M.D., M.R.C.P., D.P.H. Medical Officer of Health LONDON: made in great britain by harrison and sons limited by appointment to her majesty the queen, printers, london, hayes (middx.) and high wycombe CONTENTS Page Aged and Infirm—Care of 23 Area of the City 10 Atmospheric Pollution 44 Bacteriological Examinations 19 Basement Bakehouses 33 Bathing facilities for old people 24 Births 10 Births, Infant Deaths and Death Rates 12 British Red Cross Society 22 Burial or Cremation of the Dead 52 Catering Establishments 34 Certificates of Disrepair 29 Clean Air Act, 1956 46 Cleansing of bed linen of elderly and infirm 24 Cleansing of Persons 51 Clearance Areas 29 Common Lodging Houses 30 Compulsory Purchase Order 29 Coroner's Court and Mortuary 52 Deaths 10, 13 Disinfection and Disinfestation 51 Disposal of Unsound Food 40 Drainage 42 Dwelling Houses 25 Factories, Workplaces, Shops and other Premises 31 Factories, Defects and Nuisances 32, 55 Food Hygiene, Codes of Practice 40 Food Hygiene Regulations, 1955 33 Food, Inspection and Supervision 35 „ Legal Proceedings 49 „ Poisoning 39 „ Sampling 36 „ Shops and Premises 35 „ Unsound 40 Food & Drugs Act, 1955 38 Housing Act, 1957 26 Housing Statistics 26 Houses, number of 10 Ice Cream 38, 39 Infant Mortality 11 Infectious Diseases 15, 16, 17 Infectious diseases, compensation for stopping employment 20 International Certificates of Vaccination and Inoculation 20 Introduction 9 Land Charges Act, 1925 29 Legal Proceedings 49 London County Council Divisional Health Committee, Division No. 2 5 Luncheon Clubs 23 Page Mass X-Ray Service 20 Maternal mortality 11 Milk 41 Mobile Library Service for old people 24 Mobile Meals Service (" Meals on Wheels ") 22 Mortuary Accommodation 53 Neonatal Mortality 10 Nuisances 26, 32, 34, 35 „ Noise 43 Notices 25, 32, 34, 35 „ Statutory 25 \ Outworkers 35, 56 Paratyphoid Fever 18 Perinatal Mortality 11 Pet Animals Act, 1951 42 Pharmacy and Poisons Act, 1933 41 Poliomyelitis 17 . Population 10 Preserved Food Premises 38 Prevention of Damage by Pests Act, 1949 43 Private Deep Wells 50 Public Health Committee 5 „ Sub-Committee on Smoke Control Areas 5 Public Health Department Staff 6 Public Swimming Baths 50 Puerperal pyrexia 18 Rag Flock and other Filling Materials Act, 1951 43 Rateable Value 10 Rats and Mice Repression 43 Rent Act, 1957 29 Rodents Destroyed 43 Samples, Food 36 Sanitary Circumstances 25 Sanitary conveniences, provision at Inns, etc. 42 Slaughterman's Licences 42 Slum Clearance 29 Smallpox 17 Smoke Abatement 46 Smoke Control Areas 47 „ „ „ Public Health Sub-Committee 5 Staff of the Public Health Department 6 Statistics and Social Conditions 10 Swimming Baths 50 Tuberculosis 19 Typhoid Fever 18 Unsound Food 40 Water 50 Welfare of Old Persons 21 Wells 50 Westminster Old People's Welfare Association 21 Workplaces, Shops, etc. 31 5 PUBLIC HEALTH COMMITTEE. The Mayor [ex-officio]: Councillor Group Captain Gordon H. Pirie, C.B.E., J.P. The Deputy Mayor (ex-officio): Councillor David Cobbold. Chairman: Councillor Lady Hulbert, M.B., J.P. Vice-Chairman: Councillor Dr. Brian Warren. Members : Alderman Miss P. C. Paton Walsh. ,, C. P. Russell (ex-officio). Councillor Dr. T. Anwyl-Davies, F.R.C.P. G. M. Boyd. ,, T. Stirling Boyd. ,, L. E. Johnson. ,, Viscountess Lewisham. ,, Miss E. A. Marsh. ,, A. Sciver, B.Sc.(Lond.), F.R.I.C. ,, Peter Sebastian, J.P. „ Mrs. A. Silverstone. „ W. R. Hornby-Steer, D.L., M.A., LL.B. B. J. Tibbies. Public Health Sub-Committee on Smoke Control Areas. The Mayor and Deputy Mayor (ex-officio). Alderman Miss P. C. Paton Walsh. Councillor G. M. Boyd. „ Lady Hulbert, M.B., J.P. (ex-officio). ,, A. Sciver, B.Sc.(Lond.), F.R.I.C. (Chairman). W. R. Hornby-Steer, D.L., M.A., LL.B. „ Dr. Brian Warren (ex-officio). Members of the Council were appointed to The London County Council Divisional Health Committee, Division No. 2. Alderman Miss P. C. Paton Walsh and Councillors Lady Hulbert and Peter Sebastian. (5348) a 2 6 STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health: (Jointly for Westminster and Holborn) J. A. Struthers, M.D., M.R.C.P., D.P.H. Deputy Medical Officer of Health: (Jointly for Westminster and Holborn) G. W. Piper, M.B., D.P.H. Public Analysts: (Part time) F. W. Edwards, F.R.I.C. T. McLachlan, A.C.G.F.C., F.R.I.C. Chief Public Health Inspector: W. G. J. Sutton, F.A.P.H.I. Chief Clerk: W. D. Sambrook, D.S.M. (to 1.3.59). J. H. Gillett (from 2.3.59). Deputy Chief Public Health Inspector: (and with special duties relating to Theatres, Cinemas and other placet- of entertainment), C. F. Brockett Public Health Inspectors: District: S. G. Bennett. J. H. Brownlee. W. Cornelius (to 31.12.59). J. E. Drake. S. Firsht. F. A. Freeman. A. A. Sleet (to 30.9.59). F. E. Siddle (Inspector with special duties relating to Rodent Control and Disinfection). 7 Housing: J. M. Burbridge (Housing Inspector) J. W. Baxter. G. McFall (to 30.9.59). Food: J. J. Coveney. P. A. Lloyd. Catering Establishments: R. F. Stubbs. W. H. Dunstan. Atmospheric Pollution: W. J. Davies. Technical Assistants: (Smoke Control Areas). N. H. Billing (from 20.7.59). W. A. Huckin (from 20.7.59). Student Public Health Inspector W. G. Stivey. Clerical Staff: Miss S. A. Barker (from 28.11.59). W. F. C. King. R. L. Booker. Miss K. Lee. S. J. Chamberlain. D. Levitton. Miss B. Cleasby. L. J. Nunn. A. H. Cole. J. M. Shotbolt. P. Cox (temporary). B. Shrensky. Mrs. P. M. Crump (to 31.1.59). W. E. F. Simmons. R. W. Easton. W. H. Smith (Senior Clerk). Miss R. M. Fitzgerald. E. A. Taylor. Miss H. Woodford. (5348) a 3 8 Coroner's Court and Mortuary. Superintendent: A. W. Nicholls. 1st Mortician: G. Warren (to 12.4.59). W. H. Wilshire (from 13.4.59). Mortuary Assistants: C. C. Evans (from 19.5.59). H. J. Yeats. Cleaner: Mrs. E. Williamson. Rodent Control. Rodent Officer: J. W. Brown. Foreman: H. J. Felstead. Rodent Operatives: T. Izzard. E. Jacobs. G. Murray. W. Weems. General Assistants to Public Health Inspectors A. Jones. A. Murkin. 9 City of Westminister Public Health Department, Telephone: Trafalgar 7070 Alhambra House, 31, Charing Cross Road, W.C.2. To the Right Worshipful The Mayor, Aldermen and Councillors of the City of Westminster. Mr. Mayor, Aldermen and Councillors, Herewith I beg to present a report upon the health and sanitary conditions of the City for the year 1959. I have the honour to be Your obedient Servant, J. A. Struthers, Medical Officer of Health June, 1960. 10 STATISTICS AND SOCIAL CONDITIONS Area (acres) 2,502.7 Population (Registrar General's Estimate, mid-year, 1959) 94,640 Number of inhabited houses (Census, 1951) 27,349 Rateable Value (at 1st April, 1959) £20,529,639 Births Live Births (registered)— Total. Males. Females. Legitimate 854 453 401 Illegitimate 102 54 48 956 507 449 Birth rate per 1,000 of the estimated resident population (Rate for England and Wales, 16.5) 10.10 Number of stillbirths (males, 10; females, 9) 19 Rate of stillbirths per 1,000 (live and still) births 19.48 Total live and still births 975 Illegitimate live births per cent, of total live births 10.66 Deaths Net deaths (males, 552; females, 460) 1,012 Death-rate per 1,000 of the estimated resident population 10.69 (Rate for England and Wales, 11.6) Deaths from causes associated with child bearing 1 Rate per 1,000 total (live and still) births 1 Deaths of infants under 1 year (males, 13; females, 6) 19 Death-rate of infants under 1 year— All infants per 1,000 live births 19.87 Legitimate infants per 1,000 legitimate live births 21.07 Illegitimate infants per 1,000 illegitimate live births 9.80 Neonatal mortality 13.59 Deaths (all ages) from measles Nil „ „ whooping cough Nil „ ,, gastritis, diarrhoea and enteritis 7 ,, „ cancer 227 11 Maternal Mortality The maternal death recorded was the result of an unusual complication of pregnancy. Perinatal Mortality Perinatal Mortality (still-births plus deaths in first week of life per 1,000 total births) 31.79 The majority of infant deaths now occur in the first week of life and most of these deaths are due to factors operating during pregnancy and birth. These are also the factors which tend to cause still-birth. The Perinatal Mortality, which is the number of still-births plus the number of deaths in the first week of life per 1,000 total births, is therefore an index of the total mortality due to factors arising before and during birth. Infant Mortality Cause of Death Total Legitimate Illegitimate Pneumonia 4 4 — Congenital malformations ... 3 3 — *Other defined and ill-defined diseases 10 9 1 All other accidents 2 2 — 19 18 1 * 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. 12 Births, Infant Deaths and Death Rates Year. All Infants. Legitimate. Illegitimate. Total Births. Deaths. Death Rate. Births Deaths. Death Rate. Births. Deaths. Death Rate. 1959 956 19 19.87 854 18 21.07 102 1 9.80 1958 1,032 19 18.41 919 17 18.49 113 2 17.69 1957 1,056 23 21.78 949 16 16.85 107 7 65.42 1956 1,135 26 22.90 1,024 19 18.55 111 7 63.06 1955 1,083 29 26.70 959 24 25.02 124 5 40.30 1954 1,136 31 27.20 1,016 22 21.60 120 9 75.00 1953 1,223 32 26.16 1,080 24 22.22 143 8 55.94 1952 1,243 31 24.93 1,107 23 20.77 136 8 58.82 1951 1,235 42 34.00 1,110 35 31.53 125 7 56.00 1950 1,251 44 35.17 1,117 37 33.12 134 7 52.20 1949 1,246 42 33.70 1,110 38 33.30 136 4 36.80 1948 1,390 53 38.10 1,227 42 34.20 163 11 67.50 1947 1,594 53 33.20 1,427 42 29.40 167 11 65.90 1946 1,361 55 40.40 1,143 35 30.60 218 20 91.70 1945 936 67 71.50 728 41 60.40 208 26 110.60 13 Causes of Death in the City at Different Periods of Life Causes of Death Years of Age. Sex. All Ages. 0- 1- 5- 15- 25- 45- 65- 75+ All Causes M. 552 13 3 1 13 36 196 149 141 F. 460 6 2 2 1 14 107 121 207 Grand Totals 1,012 19 5 3 14 50 303 270 348 Tuberculosis, Respiratory M. 11 - - - - 1 7 2 1 F. 2 - - - - 1 1 - - Tuberculosis, Other M. 1 - - - - - 1 - - F. 1 - - - - - - - 1 Syphilitic Disease M. 2 - - - - - 1 1 - F. 1 - - - - - - 1 - Diphtheria M. - - - - - - - - - F. - - - - - - - - - Whooping Cough M. - - - - - - - - - F. - - - - - - - - - Meningococcal Infections M. - - - - - - - - - F. - - - - - - - - - Acute Poliomyelitis M. - - - - - - - - - F. - - - - - - - - - Measles M. - - - - - - - - - F. - - - - - - - - - Other Infective and Parasitic M. 2 - -- - 1 - - - 1 Diseases F. - - - - - - - - - Malignant Neoplasm, M. 14 - - - - 2 5 6 1 Stomach F. 8 - - - - - 4 4 Malignant Neoplasm, M. 50 - - - - 2 29 13 6 Lung, Bronchus F. 10 - - - - 1 5 1 3 Malignant Neoplasm, M. - - - - - - - - - Breast F. 25 - - + - 4 8 7 6 Malignant Neoplasm, - - - - - - - - - Uterus F. 8 - - - - - 6 1 1 Other Malignant and M. 50 - - - 3 5 16 13 13 Lymphatic Neoplasms F. 56 - - - - - 19 22 15 Leukaemia, Aleukaemia M. 2 - - - 1 - 1 - - F. 4 - 1 1 - - - 1 1 Diabetes M. - - - - - - - - - F. 7 - - - - - 1 3 3 Vascular Lesions of Nervous M. 28 - - - - - 11 11 6 System F. 67 - - - - - 10 20 37 Coronary Disease, Angina . M. 122 - - - - 3 53 35 31 F 73 - - - - - 17 26 30 (6348) A 4 14 Deaths, 1959—continued Causes of Death in the City at Different Periods of Life—continued Causes of Death Years of Age Sex All Ages 0- 1- 5- 15- 25- 45- 65- 75+ Hypertension, with Heart M. 11 - - - - - 4 2 5 Disease F. 11 - - - - - 1 3 7 Other Heart Disease M. 35 - - - - 3 10 7 15 F. 33 - - 1 - 1 6 1 24 Other Circulatory Disease M. 27 - - - - 1 5 10 11 F. 31 - - - - 1 6 6 18 Influenza M. 9 - - - - 2 4 1 2 F. 5 - - - - - 2 1 2 Pneumonia M. 34 4 - - - 2 8 7 13 F. 22 - - - - - 2 4 16 Bronchitis M. 59 - 1 - - 1 15 22 20 F. 24 - - - - - 4 7 13 Other Diseases of Respiratory System M. 5 - - - - - 3 1 1 F. 2 - - - - - 1 - 1 Ulcer of Stomach and Duodenum M. 7 - - - - - 4 1 2 F. 3 - - - - - - - 3 Gastritis, Enteritis and Diarrhoea M. 1 - - - - - - 1 - F. 6 - - - - - - 3 3 Nephritis and Nephrosis M. 6 - - - 1 1 3 1 - F. 5 - - - - - 3 2 - Hyperplasia of Prostate M. 3 - - - - - - - 3 Pregnancy, Childbirth, Abortion F. 1 - - - - 1 - - - Congenital Malformations M. 4 2 1 - - - 1 - - F. 3 1 - - - 1 - - 1 Other Defined and IllDefined Diseases M. 29 6 - - - 1 8 8 6 F. 28 4 - - - 1 5 6 12 Motor Vehicle Accidents M. 8 - - - 3 3 1 1 - F. 2 - - - - - 1 - 1 All other Accidents M. 23 1 1 1 3 4 6 3 4 F. 13 1 1 - - 1 4 2 4 Suicide M. 8 - - - 1 4 - 3 - F. 9 - - - 1 2 5 - 1 Homicide and Operations of War M. 1 - - - - 1 - - - F. - - - - - - - - - 15 Infectious Diseases The undermentioned conditions are compulsorily notifiable in Westminster:— Disease Authority for Notification Anthrax L.C.C. Order dated 23.3.1909 and Public Health (London) Act, 193G–Section 305. Cholera Public Health (London) Act, 1936-Sections 192 and 304. Diphtheria Do. Dysentery Public Health (Infectious Diseases) Regulations, 1953. Encephalitis, Acute Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949. Enteric Fever (including Paratyphoid) Public Health (London) Act, 1936—Sections 192 and 304. Erysipelas Do. Food Poisoning Food and Drugs Act, 1955—Section 26. Glanders L.C.C. Order dated 23.3.1909 and Public Health (London) Act, 1936—Section 305. Hydrophobia Do. Leprosy Public Health (Leprosy) Regulations, 1951. Malaria Public Health (Infectious Diseases) Regulations, 1953. Measles County of London (Measles and Whooping Cough) Regulations, 1938 to 1948. Membranous Croup Public Health (London) Act, 1936—Sections 192 and 304. Meningococcal Infection L.C.C. Order dated 27.2.1912 and Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949. Ophthalmia Neonatorum† L.C.C. Order dated 2.11.1910 and Public Health (Ophthalmia Neonatorum) Regulations, 1926 to 1937. Plague Local Government Board Order, 1900. Pneumonia (Primary and Influenzal) Public Health (Infectious Diseases) Regulations, 1953. * Notifiable to the Chief Medical Officer, Ministry of Health † Notifiable to the County Medical Officer of Health for London. (5348) a5 16 Disease Authority for Notification Poliomyelitis, Acute L.C.C. Order dated 27.2.1912 and Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949. Puerperal Pyrexia ... Puerperal Pyrexia Regulations, 1951. Relapsing Fever ... Public Health (London) Act, 1936—Sections 192 and 304. Scabies County of London (Scabies) Regulations, 1943. Scarlet Fever Public Health (London) Act, 1936—Sections 192 and 304. Smallpox Do. Tuberculosis Public Health (Tuberculosis) Regulations, 1952. Typhoid Fever (including Public Health (London) Act, 1936-—Sections Paratyphoid) 192 and 304. Typhus Fever Do. Whooping Cough County of London (Measles and Whooping Cough) Regulations, 1938 to 1948. For each of the above a fee of 2s. (yd. is payable by the Local Authority to the medical practitioner if the case occurs in his private practice, or 1s. if the case occurs in his practice as medical officer of a public body or institution. 17 Notifications of Infectious Disease Disease Notifications Removed, to Hospital Diagnosis not Confirmed Diagnosis Established Dysentery 21 13 — 21 Encephalitis 1 — — 1 Erysipelas 2 — — 2 Food Poisoning 15 5 1 14 Measles 442 16 — 442 Meningococcal Infection 1 1 1 — Ophthalmia Neonatorum 2 2 — 2 Paratyphoid Fever 2 2 — 2 Pneumonia— Acute Primary 9 3 — 9 Influenzal 10 2 — 10 Poliomyelitis— Paralytic 1 1 — 1 Non-Paralytic — — — — Puerperal Pyrexia 26 24 — 26 Scabies 9 — — 9 Scarlet Fever 30 5 1 29 Typhoid Fever 3 3 — 3 Whooping Cough 14 1 — 14 Smallpox No case of smallpox occurred in the City during 1959. There were as usual numerous cases of persons who had been in contact with smallpox— in most cases outside this country. The necessary preventive measures were taken. Poliomyelitis Only one notification of Acute Poliomyelitis (Paralytic) was received during the year, a non-immunised girl of fourteen months. Immunisation against poliomyelitis was begun in 1956. The number of corrected notifications of poliomyelitis, including polio-encephalitis, for each year since 1947 are given below. It will be seen that the numbers vary greatly and it is not yet possible to attribute the paucity of cases during the past few years to the effects of immunisation:— 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 21 16 29 13 1 10 9 4 15 7 5 | 1 1 18 Paratyphoid Fever Two cases of paratyphoid fever were notified. Each was a solitary case in which the source of infection could not be ascertained. Puerperal Pyrexia Twenty-six cases of puerperal pyrexia were notified but one merits notice. This was the case of a young woman, a resident of another borough, who was delivered in one of the hospitals in Westminster. She developed a fever with signs of pneumonia and was accordingly notified as a case of puerperal pyrexia due to pneumonia. Subsequently S. typhi was isolated from her blood and it was considered that she suffered from typhoid fever with a typhoid pneumonitis. Typhoid Fever Three cases of typhoid fever were notified during the year. One was a young lady who in company with some 30 other people from various parts of the British Isles went on a tour of holy places in France and Spain. Eight members of the party contracted typhoid fever. The other two cases were a mother and daughter. The daughter aged 17 years became ill first and was admitted to a general hospital. Three days later she was found to have typhoid fever and was transferred to an isolation hospital. Her mother was subsequently found to be infected and was admitted to hospital thirteen days after her daughter. The daughter's infection responded readily to treatment but that of the mother defied antibiotics and cholecystectomy and she was discharged from hospital a chronic carrier. 19 Bacteriological Examinations Nature of Specimen Number Examined Number of specimens in which organisms were found to be present Nasal and Throat Swabs 67 Haemolytic streptococci 8 Pneumococci 2 Coliforms 1 Vincent's organisms 1 Yeasts 1 Faeces 252 Rectal Swabs 7 Shigella sonnei 23 Salmonella typhimurium 11 Pathogenic Bact. coli 3 Clostridium Welchii and Staphylococcus aureus 1 Giardia lamblia 1 Vaginal Swab 1 Other 5 Trichomonas 1 Staphylococcus aureus 1 Haemolytic streptococci 1 Tuberculosis Age Periods New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary M. F. M. F. M. F. M. F. Under 5 years - - - - - - - - 5 to 15 years 1 - - - - - - - 15 to 25 years 10 10 2 1 — — — — 25 to 45 years 32 21 — 4 1 1 — — 45 to 65 years 35 2 1 1 7 1 1 — 65 to 75 years 5 1 — — 2 — — — 75 and over — — — — 1 — — 1 83 34 3 6 11 2 1 1 New cases Source of Information Pulmonary Non-Pulmonary M. F. M. F. Primary notifications 58 23 3 6 Transfers from other areas 18 10 — — Non-notified deaths 6 1 — — Posthumous notification 1 — — — 20 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 required 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. 5,123 certificates were authenticated during the year. The Medical Officer of Health also issues, on request and in appropriate circumstances, certificates to the effect that no cases of smallpox have occurred in the district during the preceding two weeks. These certificates are sought by persons proceeding to the United States of America who do not wish to submit to vaccination. It is understood that the United States immigration authorities reserve the right to place such persons under surveillance notwithstanding the production of such a certificate. Infectious Diseases—Compensation for Stopping Employment Section 26 of the London County Council (General Powers) Act, 1959, provides that if a Medical Officer of Health requests a person to discontinue his employment with a view to preventing the spread of an infectious disease, a Borough Council may, if they think fit, compensate such person for any loss occasioned by complying with the request. Insured persons who are excluded from work by reason of having been in contact with an infectious disease, can obtain benefit under the National Insurance Act, 1946. This benefit in most cases is less than the normal earnings of the person excluded from work, so that some hardship has been occasioned in the past. Section 26 of the London County Council (General Powers) Act, 1959, will now enable a Borough Council to pay adequate compensation to persons excluded from work to prevent the spread of an infectious disease. It was not necessary for any action to be taken in this connection during 1959. Mass X-Ray Service (This report was kindly supplied by the Organising Secretary of the South-West London Mass X-Ray Service). During 1959 mobile Units of the South-West London Mass X-Ray Service made forty-seven visits in the City of Westminster to provide chest x-ray facilities for the staffs of firms, Government Departments, and the staff and students of three University Colleges and three training 21 colleges. The total numbers x-rayed were 25,506, as a result of which eighty-two people were referred to Chest Clinics with a radiologically significant lesion requiring further investigation. A Mass X-Ray Unit was also installed at the Board of Trade, Horse Guards Avenue, S.W.I, for three weeks, when 6,063 X-ray examinations were carried out, as a result of which nine people were referred to Chest Clinics. In view of the high incidence rate which was found during the two visits made to Bruce House, Kemble Street, in 1958, it was decided, in consultation with the London County Council, to make regular monthly visits to this Lodging House; these were carried out on the first Tuesday of each month from May to December. During these visits 548 persons were X-rayed, of whom forty-four were referred to the Westminster Chest Clinic for further investigation. Twenty-seven firms and organisations in Westminster are co-operating in the attempt, being made by the Mass X-Ray Services in South London, to afford some protection against the hazards of lung cancer, which is causing an increasing number of deaths, particularly in men in the older age groups, by making it possible for their male employees to use the special six-monthly chest X-ray service for men over 45. Forty visits, at six-monthly intervals, have been made in connection with this special service, including one to each of the Westminster City Council Public Cleansing Depots at Gatliff Road and Monck Street. Welfare of Old Persons Westminster Old People's Welfare Association This voluntary Association, whose members include representatives of various bodies interested in the welfare of old people, continued its activities in the City during the year. These activities include the organisation in various parts of the City of 14 Darby and Joan Clubs, where light refreshments and recreation are provided; arranging holidays at seaside resorts, summer outings, Christmas parties, and other entertainments. Special outings and parties were organised during the year for handicapped old people, many of whom by reason of their infirmities, had not been outside their homes for long periods. The distribution of gift parcels at Christmas time was arranged; and also friendly visiting by voluntary helpers. The Association also provides a chiropody service for the elderly. Treatment can be obtained at two clinics in the City, or at home. The charge is 2s. 6d. per treatment; the balance of cost, which varies from 3s. 6d. to 6s. per treatment, is borne by the Association. The City Council, under powers conferred by the National Assistance Act, 1948, makes an annual contribution to the funds of the Association. In 1957 the Association agreed to a proposal by the City Council to recruit on their staff a welfare worker with the appropriate qualifications, whose duties would include case-work with individual old people (5348) a 6 22 and the co-ordination of services provided by the various statutory authorities for the welfare of old people; duties which were formerly carried out by a Public Health Inspector on the City Council's staff. The welfare worker commenced duty in February, 1958, and the Council reimburses the Association annually the salary and expenses of the appointment, with the consent of the Minister of Housing and Local Government, under Section 136 of the Local Government Act, 1948. During 1959, the Association published a handbook setting out details of the services available in the City for old people, and other information likely to be of interest to pensioners. British Red Cross Society—Mobile Meals Service Notwithstanding the difficulties which beset the meals service in January, 1959, the Westminster Division of the British Red Cross Society continued the service which it established in the City in 1946, for the delivery of hot mid-day meals to aged people who are themselves unable to prepare meals at home. On Friday, 2nd January, 1959, the two vans which are provided by the City Council and loaned to the Society for delivering the meals, were parked outside St. Thomas's Hospital Medical School waiting to be loaded when a large lorry collided with both vans, damaging them beyond repair. Even more unfortunately, one of the British Red Cross Society drivers was standing at the rear of one of the vans and sustained serious injuries, necessitating hospital treatment for many months. To avoid any breakdown in the service, the City Council's Director of Public Cleansing immediately despatched two vans to take over the delivery of the meals; and it is a tribute to all concerned that not a single meal remained undelivered on that day, although a few were a little delayed in arriving at their destinations. So far as the injured driver is concerned, she is making a steady recovery; and at the time of preparing this Report (15 months after the accident) is walking with the aid of two sticks and a caliper on the right leg. In order that the meals service should not be dislocated for a longer period than necessary, the City Council authorised the immediate purchase of two new vans at a net cost of £1,056 after credit had been allowed for an amount received from the insurers in respect of the damaged vans. The new vans were specially adapted and painted and are loaned to the Society on condition that they will be transferred to the Council should they cease to be used for the service. The City Council also makes a grant to the Society of 75 per cent. of the running costs of the vans. In June, 1959, in an endeavour to provide more balanced and nourishing meals for the old people, the British Red Cross Society asked to be allowed to increase the price paid to the caterers from 1s. 6d. to 1s. 10d. per meal. It was decided that the price to the old person should remain 23 unchanged at 8d. per meal; with the contribution of 10d. per meal from the London County Council, the balance of id. per meal was borne by the City Council. The menus improved considerably and many of the old people expressed to the Society their appreciation of the better meals which were being provided. The number of meals delivered by the Society continued to increase and in 1959 reached a total of 15,324, the highest total since the meals service was commenced in Westminster in 1946. The Mobile Meals Service is dependent upon the help of a small band of willing volunteers who turn out regularly, whatever the weather, to assist in delivering meals to the old people in their homes; the invaluable service rendered by the Society and these voluntary helpers is much appreciated by all concerned. Luncheon Clubs The British Red Cross Society, in March, 1957, opened a luncheon club for the elderly in accommodation on one of the Council's Housing Estates, a second luncheon club being opened in October, 1958, in City Council premises in Monck Street. Both clubs operate on two days each week, and have proved convenient centres where aged persons who are not housebound can have a hot meal at a modest price, and enjoy the company of others. The meals are purchased by the Society from the caterers who supply the meals for the mobile service, and are conveyed in insulated containers to the clubs, where they are served out by voluntary workers. As in the case of the "Meals on Wheels" Service, the price of the meals was increased in June, 1959, from 1s. 6d. to 1s. l0d. per meal; the old people pay 8d., the London County Council pays 1 Of/., and the City Council bears the balance of 4d. per meal. The City Council also makes a grant to the Society of 75 per cent. of the costs of running the Clubs, as well as bearing the cost of equipment. During 1959, 4,877 meals were served at the two Luncheon Clubs. 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. It was not found necessary to use these powers during the year. Aged and Infirm Persons Most of the visiting of the aged and infirm is done by the Westminster Old People's Welfare Association social worker. There are occasions, (5348) a7 24 however, when a visit by the Public Health Inspector is required, either because he has specialist knowledge or because of his statutory powers. Thirteen such visits were made during the year. Mobile Library (Personal Delivery Service) Anyone unable through age or infirmity to get to one of the City Council's Libraries can apply to the Librarian at any branch of the Westminster Public Libraries to be placed on the list for the Personal Delivery Service. Each person using this Service receives a fortnightly home-visit from a qualified member of the Libraries Department. Books are also available at the Darby and Joan Clubs. Bathing Facilities The City Council has made available to old age pensioners facilities whereby they can have hot baths at the Council's public baths at reduced charges. Cleansing of Bed Linen of Elderly and Infirm Facilities have also been made available by the Council for the cleansing of bed linen of elderly and infirm people when it has become fouled and unwholesome. 25 Sanitary Circumstances Duties performed by the Public Health Inspectors The following statistics show the work of the Public Health Inspectors during the year:— Dwelling Houses Analysis of Inspections:— Complaints 834 House to House (by Housing Inspectors) 100 Routine 886 Infectious Disease 141 Underground Rooms 231 Other parts unfit for habitation 25 Housing circumstances 81 Applications for Loans and Grants 25 Drainage 889 Rodent Control 692 Miscellaneous 235 4,139 Included in the above totals are:— Requisitioned properties 11 Houses let in lodgings 174 Council properties 204 Aged and Infirm Persons 13 Common Lodging Houses 12 6,443 re-inspections were made following the above inspections. Notices Served Public Health (London) Act, 1936 230 London County Council (Drainage) Bye-laws, 1934 5 235 Statutory Notices 8 26 Nuisances, defective and unsatisfactory conditions found:— Defective and dirty internally 43 Damp 36 Defective drainage 14 Defective roofs 28 Water Closets:— Insufficient 3 Insufficient ventilation, light 1 Defective or dirty 9 Unsuitable 2 Water Supply:— Insufficient 1 Absence of, in upper floors 1 Cistern, dirty 1 Cistern, uncovered 1 Smells 59 Rubbish 47 Animals 5 Other Nuisances 3 Staircase lighting, tenements 1 Want of ventilation 6 Verminous 50 Cockroaches 12 Overcrowding 5 Housing Statistics 1. Inspection of Dwelling-houses during the year (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 4,139 (6) Number of inspections made for the purpose 10,582 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 100 (6) Number of inspections made for the purpose 146 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 7 27 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 235 2. Remedy of defects during the year without service of formed Notices Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 152 3. Action under Statutory Powers during the year. A.—Proceedings under Sections 9, 10 and 12 of the Housing Act, 1957. (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By owners Nil (b) By Local Authority in default of owners Nil B.—Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 235 (2) Number of dwelling-houses in which defects were remedied after service of formal notices:— (as) By owners 234 (b) By Local Authority in default of owners 1 C.—Proceedings under Sections 16, 17 and 23 of the Housing Act, 1957. (1) Number of dwelling-houses represented for demolition Nil (2) Number of dwelling-houses in respect of which Demolition Orders were made Nil (3) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (4) Number of dwelling-houses in respect of which Closing Orders were made Nil D.—Proceedings under Section 18 of the Housing Act, 1957. (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 3 (9 rooms) (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 12 (30 rooms) 28 4. Parts of buildings unfit for human habitation A.—Formal action in respect of parts of buildings unfit for human habitation. (1) (a) Number of basements represented for closure 6 (16 rooms) (6) Number of Closing Orders made in respect of underground rooms 3 (9 rooms) (c) Number of Undertakings accepted in lieu of Closing Orders in respect of underground rooms Nil (2) (a) Number of other parts of buildings represented for closure 1 (2 rooms) (b) Number of Closing Orders made in respect of other parts of buildings Nil (3) Number of specifications submitted and approved 9 (4) (a) Number of Closing Orders determined in respect of underground rooms 12 (30 rooms) (b) Number of Closing Orders determined in respect of other parts of buildings Nil (5) (a) Number of applications made for modification of Closing Orders to permit approved use 40 (83 rooms) (6) Number of applications approved 38 (78 rooms) (6) Number of cancellations of Closing Orders (premises demolished) 2 B.—Informal action in respect of parts of buildings unfit for human habitation. (1) Number of instances of informal action initiated to secure requirements of the Housing Acts and Regulations made thereunder:— (a) in respect of underground rooms 73 (b) in respect of other parts of buildings 4 In 21 instances the informal action procedure was adopted at the suggestion of the Medical Officer of Health, and in 56 cases on the initiative of owners. C.—Contravention of Closing Orders. (1) Number of contraventions of Closing Orders reported Nil (2) Number of legal proceedings instituted Nil 5. Housing Act, 1957—Part IV—Overcrowding (1) Number of new cases of overcrowding reported during the year 5 (2) Number of cases of overcrowding relieved during the year 4 29 Slum Clearance Official representations were made in 1958 for dealing with 17 unfit houses within a site bounded by Dufour's Place, Broadwick Street and Marshall Street, in pursuance of the City Council's slum clearance programme, 1956-60. The houses were contained in two areas which were declared to be clearance areas; and on 13th March, 1959, the City Council made a Compulsory Purchase Order for the acquisition of the properties Nos. 1-6 (consecutive and inclusive) Dufour's Place, 60-74 (even), Broadwick Street, and 7-13 (consecutive and inclusive), Marshall Street (including factory premises at the rear of 9-13, Marshall Street). The Order was cited as the Westminster (Dufour's Place, Broadwick Street and Marshall Street) Compulsory Purchase Order, 1959, and was submitted to the Minister of Housing and Local Government for confirmation. On the 13th September, 1959, the City Council received a report that three objections had been received by the Minister to the confirmation by him of the above Compulsory Purchase Order, and that a public local Inquiry into these objections would be held by the Ministry's Inspector at the City Hall on the 5th October, 1959, at 10.30 a.m. It was further reported that the London County Council raised no objection under Section 30 of the Town and Country Planning Act, 1947, to the demolition of No. 74, Broadwick Street, the birthplace of William Blake, painter, poet and mystic. The County Council requested, however, that the City Council should examine the possibility of preserving some of the features of architectural interest such as original doors, staircases and panelling in other properties included in the clearance area. The public local Inquiry was duly held at City Hall on the 5th October, 1959, and the Minister's confirmation of the Order, with or without modification, is awaited. Rent Act, 1957—Certificates of Disrepair One application for a certificate of disrepair was received during the year. A certificate was duly issued and was still in force at 31st December, 1959. Land Charges Act, 1957 The number of enquiries dealt with and reported upon was 3,010, relating to 5,234 properties. These figures are an increase of 621 on the number of enquiries dealt with in 1958. These enquiries followed their usual form of questions relating to outstanding statutory or informal notices, combined drainage orders, smoke control area orders, applications for decontrol under the Rent Restrictions Acts, and certificates of disrepair. 30 Supplementary information has been requested on many of the search forms. These additional questions mainly concern any proposals for dealing with properties by means of clearance or re-development under the Housing Acts, restrictions on the use of underground rooms, and the suitability of premises for specific purposes such as catering establishments and workrooms. Assessment of Housing Priorities on Medical Grounds During the year 46 applications for re-housing on medical grounds were examined, and recommendations were made for the guidance of the Housing Committee. In each case the precise medical condition and resultant disability were determined (frequently necessitating communication with the family doctor or with the hospital attended). Investigations concerning the present housing circumstances of the applicants were made by the Public Health Inspectors. Their detailed reports included a reference to the extent and nature of existing premises, and its adequacy for the number of persons accommodated; the sanitary and structural conditions; the risk of infection, and the existence of inconveniences, such as stairs, which might be prejudicial to the patient. On this information, an assessment was made of the degree of priority merited on medical grounds. Common Lodging Houses There are two common lodging houses for men in the City, licensed by the City Council under the Public Health (London) Act, 1936. These common lodging houses have accommodation for 716 and 565 men lodgers respectively. Twelve visits were made by the Public Health Inspectors to the lodging houses during the year. 31 Inspection of Factories, Workplaces, Shops, Offices and Other Premises (other than Food Premises) Total Number of Visits Factories—Power 128 Factories—Non-power 27 Workplaces, etc. 3,119 Offices 5,071 Shops (Other than Food) 526 8,871 Analysis of Inspections:— Complaints 509 Routine 907 Infectious Disease 9 Drainage 1,326 Rodent Control 432 Sanitary Defects 2 Other Reasons 47 3,232 5,639 re-inspections were made following the above inspections. Types of premises inspected:— Places of public entertainment 116 Carpentry, joinery, etc. 1 Wearing apparel 123 Furriers 13 Garages, motor tyres and rubberworks 67 Boots and shoes and other leather goods 15 Jewellers, precious and other metalworkers 12 Hairdressers 56 Laundries and dry cleaners 14 Printers and publishers 36 Warehouses and packers 84 Chocolate Manufacturers 1 Shops (other than Food) 1,142 Upholstery and carpets 1 Photographers, film renters 9 Opticians 2 Florists 12 Offices 5,071 Various (schools, hospitals, halls, etc.) 2,096 8,871 32 Notices Served Factories Power Factories, Nonpower Workplaces, Offices, Shops, etc. Total Public Health (London) Act, 1936 - - 21 21 Clean Air Act, 1956 — — 1 1 Factories Act, 1937 21 18 — 39 London County Council (General Powers) Act, 1955 - - 1 1 London County Council (Drainage) Byelaws, 1934 - - 1 1 London County Council (Water Closet) Byelaws 1930 - - 1 1 Shops Act, 1950 — — 9 9 21 18 34 73 Nuisances, Defective and Unsatisfactory Conditions Found Factories Power Factories Nonpower Workplaces, Offices, Shops, etc.[/##] Defective, dirty internally 4 5 7 Damp — — 11 Inadequate underfloor ventilation — — 1 Defective drainage 1 — 11 Defective roofs 1 — 3 Sanitary accommodation:— Unsuitable — — 1 Insufficient 5 — 1 Insufficient ventilation, light 2 2 10 Defective or dirty 35 15 30 Not separate for sexes 5 1 2 Smells 2 1 101 Rubbish — — 75 Animals 1 — 4 Other Nuisances — — 5 Temperature 1 — — Want of ventilation 1 — 17 Cockroaches — — 5 Overcrowding — — 2 No indicating notices on doors of water closets 12 5 4 (See Appendix I to this Report.) 33 Factories Act, 1937 Section 54—Basement Bakehouses Certificates of Suitability in respect of six basement bakehouses were renewed during the year. This was on the occasion of the quinquennial review. All were inspected and found to be suitable for use as regards construction, height, light, ventilation, and other hygienic aspects. Two other premises which had previously been used as basement bakehouses, were formally removed from the Register. One had been demolished, and the other vacated and baking discontinued. Section 110—Outworkers Number of outworkers (includes 1,601 workers living in areas outside the City) 2,660 (See Appendix II to this Report.) Food and Drugs Act, 1955 Inspections of all types of Food Premises Analysis of Inspections:— Complaints 341 Routine 1,909 Infectious Disease 17 Drainage 106 Rodent Control 271 New Catering Businesses 166 Miscellaneous 2 2,812 3,621 re-inspections were made following the above inspections. 34 Catering Establishments At the end of the year, particulars of 3,146 catering establishments were in the register. Summary of inspections:— Hotels, restaurants, clubs 3,497 Cafes, teashops, etc. 693 Staff Canteens 125 Public Houses 305 4,620 Notices served Public Health (London) Act, 1936 4 Food and Drugs Act, 1955 40 Food Hygiene Regulations, 1955 69 London County Council (Water Closet) Byelaws, 1930 2 115 Nuisances, defective and unsatisfactory conditions found:— Dirty, dilapidated internally 48 Defective internally 25 Defective drainage 6 Defective floors 56 Preparation tables and equipment worn and insanitary 31 Food storage accommodation inadequate and suitable 16 Vegetable preparation and washing up facilities worn and insanitary 32 Ventilation insufficient 17 Lighting inadequate 4 Staff washing facilities insufficient and unsuitable 26 Staff changing rooms insufficient and unsuitable 7 Fuel, rubbish and other extraneous materials in food preparation rooms 3 Cockroaches 3 Water Closets:— Insufficient ventilation and light 7 Defective 16 Dirty and dilapidated 10 Unsuitable 3 35 Food Shops and Food Premises (Other than Catering Establishments) Types of business and summary of inspections:— Inspections Bakehouses (underground included) 63 Dairies and milkshops 160 Ice cream premises 90 Meat shops 165 Other meat shops (preserved food, etc.) 19 Stalls 209 Confectioners 79 Fruit and greengrocery 151 Provision shops 476 Fish and poultry 133 Fried fish shops 2 *Other food premises 266 1,813 Included in the above totals are 47 visits of enquiry in relation to food poisoning outbreaks. *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 of enquiry regarding adulterated samples. Notices Served Food Hygiene Regulations, 1955 7 Nuisances and defective conditions found:— Dirty and dilapidated internally 3 Defective internally 3 Defective floors 1 Staff washing facilities insufficient and unsuitable 1 Water Closets:— Insufficient ventilation and light 1 Defective 1 Dirty and dilapidated 1 Unsuitable 1 Absence of suitable notices 2 36 Visits for the Purposes of Obtaining Samples and Inspecting Foodstuffs Sampling Inspection of Food Confectioners 29 77 Dairies and milkshops 94 133 Fish and poultry 18 137 Fried fish shops — 1 Fruit and greengrocery 21 372 Ice cream premises 46 85 Meat shops and stalls 32 372 Other food premises ... 105 192 Provision shops ... 117 448 Cafes, teashops, etc. 31 66 Hotels, restaurants, clubs, etc. 37 107 Staff canteens 6 25 Public Houses 31 20 567 2,035 Food Sampling During the year the following 1,540 samples were submitted to the City Council's Public Analysts for chemical analysis. Of this number 74 were reported upon adversely, representing a percentage of 4-8:— Ale, beer and stout ... 4 Baby foods 19 Baking powder 5 Biscuits 10 Bread 16 Butter and peanut butter 10 Cake, puddings and pudding mixture 57 Cereals 11 Cheese 19 Cocoa 3 Coffee, extracts and essences 39 Condiments and spices 34 Confectionery 85 Cooking fats and oils 19 Cream 13 Custard powders, blancmange and jellies 27 37 Drags 38 Fish and fish products 69 Flavourings and colourings 21 Flour 16 Fruit, canned, etc. 22 Herbs and stuffing 10 Ice cream 52 Jams, marmalades and preserves 56 Malt and chocolate drinks 8 Margarine 18 Meat and meat products 71 Milk 400 Milk—condensed and evaporated 18 Nuts 7 Pickles and sauces 40 Pies and pie filling 13 Poultry 2 Salad cream and mayonnaise 14 Soft drinks, cider, perry, fruit juices, etc 70 Soup and soup powders 42 Spirits 76 Spreads, various 6 Suet 4 Sugar 7 Syrup 4 Tea and tea extracts 28 Vegetables, tinned, etc 26 Vinegar 10 Yoghurt 12 Miscellaneous 9 The following are a few of the samples upon which the Public Analyst reported adversely:— Imported canned smoked saithe which, on analysis, was found to contain a preservative, contrary to the Public Health (Preservatives, etc., in Food) Regulations, 1925-58. After a prolonged investigation it was ascertained that the importers had taken reasonable steps to ensure compliance on the part of the foreign manufacturers with the provisions of the Regulations. A cautionary letter was sent to each importer. 38 A member of the public purchased a glass of milk in a restaurant. He was of opinion that it was not up to standard; this was later confirmed by the Public Analyst, who certified that the milk was 30 per cent. deficient in fat. An investigation revealed that the deficiency was due to the counter assistant's failure to shake the bottle to distribute the cream before the milk was first poured from the bottle. A cautionary letter was sent to the management. Imported oranges on analysis were found to contain thiourea, a prohibited preservative. The importers were warned that the importation of oranges containing this preservative rendered them liable to prosecution. The Ministry of Health, the Ministry of Agriculture, Fisheries and Food, and Port Health Authority, at port of entry, were informed. Samples taken subsequently were found to be satisfactory. Several specimens of bread were the subject of complaints during the year:— One, a sliced wholemeal loaf, through some inadvertence at the baker's bench, contained streaks of white bread. This was quite harmless, but presented an unusual appearance. A loaf containing "foreign matter," which on analysis proved to be a portion of a raisin or sultana, was also the subject of a complaint. A loaf contaminated with dirt and mould resulted in legal proceedings. The case was subsequently heard in March, 1960, when the defendants were fined £50 with £26 5s. costs. A complaint was received alleging the presence of particles of glass in a cream doughnut, but it was not possible to ascertain where they had gained access. The complainant did not wish any action to be taken other than an informal enquiry. Two hundred gallons of ice cream were contaminated and rendered unpalatable by the presence of excess chlorine in the water supply. No further action was required following the initial analysis. In addition to the above, other complaints were investigated which did not necessitate the submission of specimens to the Public Analyst; where necessary, appropriate action was taken. Food and Drugs Act, 1955—Section 16 Registration of Premises used in connection with the Manufacture, Sale or Storage of Ice Cream Two hundred and seventy-two premises are registered for the manufacture and/or sale and/or storage of ice cream. Registration of Premises used for the Preparation or Manufacture of Preserved Foods Seventy-six premises are registered for the preparation or manufacture of preserved foods. 39 Ice Cream (Heat Treatment, Etc.), Regulations, 1959. The above Regulations came into operation on 27th April, 1959, and consolidated and amended the Regulations of 1947-52. Regulation 3 allows that water ices and ice lollies of more than a certain acidity (whether or not they contain milk solids) need not be pasteurised or sterilised before freezing. This is because it is most unlikely that harmful germs will multiply in such acid mixtures. This Regulation removes many difficulties which have arisen as a result of the many varieties of ice lollies which are now manufactured. Regulation 5' describes a method of sterilising ice-cream mix which may be used instead of the methods of pasteurisation previously prescribed. If a mix so sterilised is placed immediately and kept in a sterile airtight container, it need not be kept (as must pasteurised mixes) at a temperature below 45° F. In a Circular which accompanied the Regulations, the Minister of Health reaffirmed the recommended provisional grading for the examination of ice cream, based on the methylene blue reduction test, but re-states his decision that the standard should not be made statutory. . During the year, seventy-five samples of ice cream were submitted for examination by the methylene blue test, and were classified in the following provisional grades:— Grade No. of Samples 1 40, 2 18 3 6 4 11 Food and Drugs Act, 1955—Section 26 Fourteen cases of food poisoning were notified during the year; four of these related to one outbreak. Of the remainder the type of organism responsible was indicated in five cases at the time of notification; and in two of these cases other members of the respective families were found to be involved. The four persons notified who were concerned in one outbreak were resident staff at a club. The illness was of short duration. Heat resistant CI. welchii and Shig. sonnei were isolated from the patients but not from samples of the suspected foods. The origin of this outbreak thus remained undiscovered. Two other outbreaks were investigated. In one no conclusion could be reached, and in the other although the organism responsible was isolated, it was not possible to be certain where it came from. Three other single cases of salmonella typhimurium infection, not formally notified, were investigated. 40 Prompt notification of an outbreak of food poisoning is essential if the cause is to be found. Delay may result in failure to obtain important pathological specimens and food remnants. These might contain the causative organisms which can be found by bacteriological examination. In this respect, the Food and Drugs Act, 1955, imposes a duty on all ' registered medical practitioners to inform the local medical officer of health of any cases of food poisoning of which they may be aware. The Food Hygiene Regulations 1955, say that if any person engaged in handling food is aware that he is suffering from, or is a carrier of, typhoid fever, paratyphoid fever or any other salmonella infection, or dysentery, or any staphylococcal infection likely to cause food poisoning, he must inform the occupier or owner of the food business who must then notify the medical officer of health of the district in which the premises are situated. If the occupier is the person affected, he shall himself give similar notification. Food Hygiene Codes of Practice—Meat Two Food Hygiene Codes of Practice were published during the year and were issued jointly by the Minister of Health and the Minister of Agriculture, Fisheries and Food. The Codes were entitled "Hygiene in the retail meat trade" and "The hygienic transport and handling of meat" Copies were sent by the City Council to every butcher's shop in Westminster, with a request that the contents of the publications be brought to the attention of those concerned. Food and Drugs Act, 1955, Section 8 The following table shows the amount of food condemned as unfit for human consumption during the year:— Amount destroyed. Tons Cwts. Lbs. Canned food 17 18 60 Meat 1 11 93 Fruit and vegetables 165 12 9 Cereals — 2 21 Fats — — 90 Fish 5 0 84 Confectionery — 8 48 Miscellaneous — 14 79 Total 191 9 36 41 Method of disposal of condemned food Food condemned or voluntarily surrendered to the Public Health Inspectors is disposed of by depositing in the Council's refuse barges at the Central Depot at Gatliff Road, S.W.I. Foodstuffs disposed of at this depot are removed by barge for land reclamation by controlled tipping at Pitsea. No recovery or diversion of any goods whatsoever takes place at the central tipping site. Milk (Special Designation) Regulations The following licences authorising the sale of designated milks were issued during 1959:— Dealers' Licences Dealers' Supplementary Licences Pasteurised 125 47 Sterilised 100 46 Tuberculin Tested 90 46 Milk and Dairies (General) Regulations, 1959 Under these regulations, which came into force on 8th March, 1959, distributors are now required to be registered only with the local authority in whose area the premises from which the milk is distributed are situated. At the 31st December, 1959, the following were entered in the City Council's Register of Dairies and Distributors of Milk:— Distributors of milk with premises registered as dairies 31 Distributors of milk with premises not registered as dairies 85 Bacteriological Examination of Milk During the year 30 samples of milk were submitted for methylene blue and phosphatase test. The results received showed that the milk had been efficiently pasteurised. Pharmacy and Poisons Act, 1933 Persons entitled to sell poisons included in Part II of the Poisons List numbered 139 at 31st December, 1959. 42 Pet Animals Act, 1951 Five licences were issued by the Council during the year in relation to premises subject to the provisions of this Act. Slaughter of Animals Act, 1933—Slaughterman's Licences The Council during the year granted Slaughterman's licences to 17 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 part of the course for appointment as inspectors of the R.S.P.C.A. Sanitary Conveniences—Provision at Inns, Refreshment Houses, Etc. Under Section 25 of the London County Council (General Powers) Act, 1959, a Borough Council may require the owner or occupier of any Inn, Refreshment House or place of public entertainment (not coming within certain exempted classes of premises listed below), to provide and maintain in a suitable position a reasonable number of sanitary conveniences for use of persons frequenting the premises. If necessary the Borough Council may, by agreement, execute at the expense of the owner or occupier, such works as are necessary and recover the costs, in the manner laid down in the London County Council (General Powers) Act, 1951. The classes of premises which are exempted are as follows:— (a) those in respect of which a licence is in force under the Disorderly Houses Act, 1751, or the Cinematograph Acts, 1909 and 1952; (b) premises licensed for the consumption of intoxicating liquor on the premises; (c) premises licensed for the public performance of stage plays; (d) premises forming part of railway stations. It was not necessary for any notices to be served under this Section during 1959. Public Health (London) Act, 1936 London County Council (Drainage) Byelaws, 1934 Drainage Drainage plans submitted 568 Combined drainage orders made 62 43 Prevention of Damage by Pests Act, 1949 Rats and Mice Repression Complaints received 965 Treatments undertaken 913 Inspections by Public Health Inspectors and Rodent Officer 2,298 Notices served — Rodents destroyed Black Rats 671 Brown rats 2,953 Mice 6,655 10,279 Rag Flock and other Filling Materials Act, 1951 Under the provisions of this Act, various types of premises concerned with the upholstery trade or with the provision of materials for that trade must be registered or licensed with the local authority. At the end of the year, seven premises were on the register and two premises licensed for storage purposes. Noise Nuisance Complaints received 41 Investigations made 72 The noises of which complaints were made were caused by power machines, compressors, pile drivers, pneumatic drills, excavators, machinery used for building and demolition work, an asphalting machine, radios, juke boxes, bands and record players, a cockerel, and noise from loading and unloading bays. 44 Atmospheric Pollution Investigation into the atmospheric pollution in the City was continued during the year at three sites, Mayfair, Pimlico and Charing Cross, where deposit gauges, which measure the deposited pollution, and lead peroxide cylinders, which measure the sulphur activity, are sited. The following table gives the results of the monthly analyses, and shows separately the amounts of insoluble and soluble constituents. Monthly deposits of impurities—tons per square mile. Month. Mayfair. Pimlico. Charing Cross. Insol. Sol. Total. Insol. Sol. Total. Insol. Sol. Total. January 14.42 21.48 35.90 19.80 22.05 41.85 36.01 19.41 55.42 February 15.24 1.19 16.43 17.61 1.85 19.46 25.06 2.65 27.71 March 15.34 8.39 23.73 20.23 8.36 28.59 21.57 8.96 30.53 April 12.68 8.12 20.80 17.58 9.40 26.98 21.96 10.52 32.48 May 10.43 4.53 14.96 11.74 4.36 16.10 13.01 6.11 19.12 June 11.25 10.26 21.51 13.59 8.79 22.38 13.11 8.30 21.41 July 10.84 7.91 18.75 9.86 6.78 16.64 12.71 7.77 20.48 August 9.55 10.23 19.78 10.53 10.14 20.67 10.62 8.20 18.82 September 10.33 5.12 15.45 10.27 5.30 15.57 10.62 5.24 15.86 October 13.81 10.26 24.07 16.81 12.45 29.26 21.31 13.47 34.78 November 13.09 10.98 24.07 14.56 13.12 27.68 20.38 13.44 33.82 December 11.46 24.75 36.21 13.15 25.07 38.22 19.98 19.98 39.96 Estimation of sulphur activity by the lead peroxide method The cylinders for the estimation of sulphur activity are situated at Alhambra House, Farm Street Depot and Bessborough Street Clinic. 45 The following table gives the degree of sulphation expressed in empirical units, viz., milligrams of sulphur trioxide per day per 100 square centimetres of standard lead peroxide exposed in the standard apparatus. Month. S03 in milligrams per 100 sq. cms. per day. Mayfair. Pimlico. Charing Cross. January 7.00 7.00 8.21 February 6.31 6.48 6.92 March 4.01 4.28 4.20 April 3.48 3.77 3.64 May 2.12 3.06 2.49 June 1.96 2.02 2.48 July 1.40 1.77 1.79 August 1.88 2.60 2.29 September 2.10 2.91 2.61 October 3.21 4.17 5.55 November 3.97 3.90 5.36 December 3.83 3.85 5.77 Estimate of sulphur content by volumetric method Daily estimations were continued at the Monck Street station and the results are given below:— Month SO2 p.p.m. Daily average. January .266 February .228 March .109 April .108 May .086 June .070 July .054 August .064 September .084 October •116 November •148 December •105 46 Smoke. Average readings from apparatus sited at Monck Street, S.W.l. By means of this apparatus a measured volume of air is drawn through a filter paper which removes solid matter from it. The stain thereby produced is compared with a standard, from which the amount of pollution is calculated. Parts per 100 c.m. Average value January 41 February 34 March 17 April 12 May 7 June 4 July 4 August 5 September 8 October 15 November 29 December 19 Smoke Abatement—Results op Observations and Action Taken 1955 1956 1957 1958 1959 Complaints received 121 87 41 67 58 Observations taken 2,413 2,634 1,603 625 497 Notices issued— Preliminary 7 23 6 — 1 Statutory — — — — 1 Clean Air Act, 1956 In the Report of the Government Committee on Air Pollution, issued in 1953, the City of Westminster and adjoining Boroughs were included in the list of "black areas," that is, areas where pollution is particularly bad. In January, 1959, the Minister of Housing and Local Government issued a Circular drawing attention to the fact that about half the smoke in the atmosphere comes from domestic fireplaces burning coal. The Minister expressed the hope that, although an encouraging start had been made by local authorities in using their powers to make smoke control 47 orders, faster progress would now be made, especially in "black areas." The Minister requested that Councils in "black areas" should consider their domestic smoke problem as a whole; decide on the smoke control orders that would be required, and the order in which they should be made; and assess how many years it would take to complete the work. Local authorities were also asked to prepare a phased programme for establishing smoke control areas over the ensuing five years. The City Council, at its meeting on 30th April, 1959, approved the following programme which provides for the whole of Westminster to be covered by operative smoke control orders by 1st October, 1965:— Programme for Declaration of Smoke Control Areas. (The acreage of each Ward is shown in brackets after the name of the Ward.) Order in operation from lst October. 1960 Covent Garden Area (100 acres) (this Area is not minous with the boundaries of the ward of that name). 1961 Soho (94 acres) (part not included in the Covent Garden Area mentioned above). St. James's (315) (part not included in the present Adelphi/Whitehall Area). 1962 Regent (110). Berkeley (116). Knightsbridge (355). Grosvenor (325). 1963 Abbey (94) (part not included in the present Adelphi/ Whitehall Area). Victoria (200). Wilton (94). Eaton (72). 1964 Millbank (84). Cathedral (90). Warwick (48). Tachbrook (60). 1965 Alderney (43). Ebury (64). Dolphin (38). Churchill (48). In order to implement this programme, the City Council approved the appointment of two Technical Assistants in the Public Health Department. It was pointed out that the success of the programme would depend on the ability of local builders to undertake in a relatively 48 short time the necessary conversions of fireplaces and ancillary works. Attention was also drawn to the necessity for adequate supplies of suitable smokeless fuels. An assurance has been given on behalf of the Government, that all possible steps will be taken to increase the output of smokeless fuels to meet the increased demands for them. The Temple Bar Smoke Control Order has been in operation since 1st October, 1958. The Adelphi/Whitehall Order was confirmed on 26th March, 1959, and came into operation on 1st October, 1959. Thus, at present, some 250 acres of the City are included in a Smoke Control Zone. On the 15th October, 1959, the Council resolved to make the Covent Garden Smoke Control Order which it is hoped to bring into operation on 1st October, 1960. Grants towards adaptations or alterations Owners or occupiers of domestic premises in a Smoke Control Area may apply for a grant towards the cost of any necessary alterations or adaptations to their existing equipment, to enable them to use an authorised fuel. The work must have the approval of the City Council and the expense must be incurred after the confirmation of the order but before it comes into operation. The amount of grant which can be claimed is 70 per cent. of the total cost incurred; forty per cent. of this total is subsequently recoverable by the local authority from the Central Government. Smoke Control (Exempted Fireplaces) Order, 1959 This Order came into operation in July, 1959, and exempts from the provisions of Section 11 of the Clean Air Act (the Section which provides for the designation of Smoke Control Areas) those furnaces installed after 31st December, 1956, which are equipped with mechanical stoking apparatus but do not burn pulverised fuel, as long as they are operated and maintained so as to minimise the emission of smoke and burn the fuel for which they were designed. Two proprietary types of appliances are granted similar exemption under the Order, namely the solid fuel "Ductair" unit, and the "Fulgora" slow combustion stove (used for burning wood shavings, etc.). It was recommended that mechanically stoked furnaces capable of working as smokelcssly as those exempted by the Order but which were installed before 31st December, 1956, should be exempted individually on similar conditions. Accordingly on 15th October, 1959, the Council made Orders varying the Temple Bar and Adelphi/Whitehall Smoke Control Orders, so as to exempt three mechanically stoked furnaces. Two such furnaces were exempted from the Covent Garden Order. 49 London Building Constructional Byelaws During the year, the City Council decided to raise no objection to a proposal put forward by the London County Council, to make a byelaw under the London Building Act (Amendment) Act, 1935, and the Clean Air Act, 1956, requiring that every new building should be provided with either such appliances for heating or cooking as are suitably designed for burning gas, electricity, coke, or anthracite, or appliances of a description exempted by an Order in force under the Clean Air Act. Pollution from oil-fired furnaces One aspect of the atmospheric pollution problem which is causing concern in Westminster and elsewhere is the emission from certain oil-fired furnaces of very fine soot and smuts which are produced when oil is burned in an atomised or mist form. Investigations are being made into this new form of pollution of the atmosphere. Analysis of Legal Proceedings, 1959 Fines Costs £ s. d. £ s. d. Food and Drugs Act, 1955. Selling food not of the quality demanded by the purchaser (section 2)—14 convictions (All these cases were granted an absolute discharge on payment of costs) 21 0 0 Selling food not of the nature demanded (section 2)—1 conviction 1 10 0 — Giving a false label or advertisement to food (section 6)—1 conviction 1 10 0 — Food Hygiene Regulations, 1955 Failing to comply with the Food Hygiene Regulations, 1955: Insanitary premises and equipment— 22 convictions 462 10 0 123 18 0 Smoking whilst handling open food (unwrapped tomatoes)—1 conviction 10 0 — Totals £466 0 0 £144 18 0 50 Water The resident population of 94,640 in some 27,700 dwellings receive water from the Metropolitan Water Board's mains or from deep wells. At 31st December, 1959, eighty-five deep wells were in use. In eighty-two of these wells, the water is used for domestic purposes. In the remainder, one supply is used for cooling purposes, one for stand-by in case of fire, and one for supplying boilers. During the period of the long, hot, dry summer, reports received in respect of one of the wells showed that the water was not of the usual high bacterial standard. Investigations in regard to five other wells within a quarter of a mile showed that the water in these was also not altogether satisfactory. Advice was given to the occupiers of the affected premises, and, during the ensuing three weeks, the quality of the water reverted to normal. Despite exhaustive investigations, the cause of the pollution was not discovered. During the year, samples of water from wells in the City were submitted for examination; satisfactory reports were received of ninety bacteriological examinations and forty-four chemical analyses. Public Swimming Baths (I am indebted to the Director of Public Cleansing for the following information) The City Council has three public baths establishments, at Buckingham Palace Road, and Marshall Street (each having two swimming pools), and at Great Smith Street, where there is one pool. The water for each of the swimming pools is supplied by the Metropolitan Water Board and is continuously filtered and chlorinated (with modern equipment) at a rate of 25,000—40,000 gallons per hour, the whole of the water of any one pool being filtered and chemically treated in four hours. Automatic chlorine residual controllers and recorders, which automatically adjust the chlorine content of the water to the requirements of the bathing load, have been installed at both the Buckingham Palace Road and Marshall Street Baths, and are the first of this kind to be used in any public baths in Great Britain. An independent firm of analytical chemists take samples (without notice) of water from the swimming pools each fortnight, and the bacteriological examinations show that the water is maintained in a high standard of bacterial purity and is in every respect suitable for swimming purposes. 51 A further swimming pool of 70,000 gallons, which is available to the public but owned by a private company, is sited under a large block of flats within the City. The water is drawn from deep wells; continuous filtration through sand and chlorination is maintained during the time that the bath is in use, with a turn-over of four hours. Ozone treatment plant is also available. An independent firm of analytical chemists and bacteriologists take samples every week (without notice) and a high bacterial and chemical standard is maintained. There is also the Lido in Hyde Park, which is under the control of H.M. Minister of Works. Disinfection, Disinfestation and Cleansing of Persons— Arrangements with the Holborn Borough Council The arrangement between the City Council and the Holborn Borough Council whereby the latter undertook to carry out, on agreed terms, the work of disinfection, disinfestation and cleansing of persons, and the provision of the necessary transport therefor, continued. The arrangement came into operation on the 3rd September, 1956, and is working satisfactorily with resulting economies to both Councils. The following is a summary of the work carried out for Westminster during the year:— Disinfection and Disinfestation Rooms Articles Articles Washed Books Disinfection 175 25,397 205 279 Disinfestation 642 2,369 — — Cleansing of Persons Scabies Head Lice Body Lice Treatments Treatments Treatments Men 63 — 227 Women 21 3 3 Children — 1 — 52 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 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 is done in consultation with the Treasury Solicitor. Such action 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 44 burials were undertaken by the City Council in its Cemetery at Hanwell. The requests for the burials were received from the following sources:— H.M. Coroner 20 Relatives of the deceased 10 Hospitals in the City 13 General Practitioner 1 44 Coroner's Court and Mortuary During 1959, 303 bodies were received in the Mortuary on Coroner's Warrants, etc. Seventeen bodies were admitted to await burial. Number of Cases Inquest cases 54 Non-inquest cases 249 Post-mortem examinations held 284 Causes of death in the foregoing were as under:— Found drowned 6 Suicide by drowning 3 „ by other means 15 Accidents— Street 1 Domestic 9 Others 7 Natural causes 249 Misadventure 3 Murder 1 Miscellaneous causes 9 53 Mortuary Accommodation—Arrangement with Holborn Borough Council The City Council and the Holborn Borough Council, with the approval of the London County Council, made arrangements whereby bodies from Holborn, which were not the concern of H.M. Coroner, were accommodated at the City Council's Mortuary in Horseferry Road whilst awaiting burial. The arrangement came into operation on the 3rd September, 1956; no bodies were received in the mortuary during 1959. 54 APPENDIX I FACTORIES ACTS, 1937 to 1959 Prescribed Particulars on the Administration of the Factories Act, 1937 Part I of the Act 1. Inspections for purposes of provisions as to health (including inspections made by Public Health Inspectors). Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (1) (2) (3) (4) (5) (i) Factories in which Sections 1,2,3,4 and 6 are to be enforced by Local Authorities 578 27 18 — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 1,768 128 21 — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 59 — — — Total 2,405 155 39 — 55 2. Cases in which Defects were found (If defects are discovered at the premises on two, three or more separate occasions they should be reckoned as two, three or more "cases ") Particulars Number of cases in which defects were found Number of cases in which prosecutions were instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector (i) (2) (3) (4) (5) (6) Want of cleanliness (S.l) 9 8 — 9 — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) 1 1 — 1 — Inadequate ventilation (S.4) 1 1 — 1 — Ineffective drainage of floors (S.6) 1 1 — — — Sanitary Conveniences (S.7) (a) Insufficient 5 4 — 5 — (b) Unsuitable or defective 54 43 — 40 — (c) Not separate for sexes 6 6 — 6 — Other offences against the Act (not including offences relating to Out-work) 17 17 — — — Total 94 81 — 62 — 56 APPENDIX II Part VIII of the Act Outwork (Sections 110 and 111) Nature of work Section 110 Section 111 No. of outworkers in August list required by Section 110(1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions (1) (2) (3) (4) (5) (6) (7) Wearing apparel— Making, etc., 2,617 — — — — — Cleaning and washing — — — — — — Household linen — — — — — — Lace, lace curtains and nets — — — — — — Curtains and furniture hangings 20 — — — — — Furniture and upholstery — — — — — — Electro-plate — — — — — — File making — — — — — — Brass and brass articles — — — — — — Fur pulling 9 — — — — — Iron and steel cables and chains — — — — — — Iron and steel anchors and grapnels — — — — — — Cart gear — — — — — — Locks, latches and keys — — — — — — Umbrellas, etc. — — — — — — Artificial flowers 14 — — — — — Nets, other than wire nets — — — — — — Tents — — — — — — Sacks — — — — — — Racquet and tennis balls — — — — — — Paper bags — — — — — — The making of boxes or other receptacles or parts thereof made wholly or partially of paper — — — — — — Brush making — — — — — — Pea picking — — — — — — Feather sorting — — — — — — Carding, etc., of buttons, etc. — — — — — — Staffed toys — — — — — — Basket making — — — — — — Chocolates and sweetmeats — — — — — — Cosaques, Christmas stockings, etc. — — — — — — Textile weaving — — — — — — Lampshades — — — — — — Total 2,660 — — — — —