WES71 AC-4541 Cftg of Mestminster Achs 13/7/62 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1961 J. H. BRISCOE-SMITH, M.B., Ch.B.D.fP.H. Medical Officer of Helth LONDON: made in great britain by harrison and sons limited by appointment to her majesty the queen, printers, london, hayes (middx.) an d high wycombe Cits of Westminster REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1961 J. H. BRISCOE SMITH, M.B., Ch.B., 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 0igb wycombe ' CONTENTS Page Aged and Infirm—Care of 32 Area of the City 14 Assessment of Housing priorities on medical grounds 45 Atmospheric Pollution 65 Bacteriological Examinations 24 Basement Bakehouses 48 Bathing facilities for old people 32 Battersea Power Stationirths 14 Births, Infant Deaths and Mortality Rates 16 British Red Cross Society 30 Burial or Cremation of the Dead 73 Catering establishments 49 Certificates of Disrepair 45 Clean Air Act 1956 68 Cleansing of bed linen of elderly and infirm persons 32 Cleansing of Persons 73 Clearance Areas 41 Codes of Practice—Poultry 55 Common Lodging Houses 45 Compulsory Purchase Order 42 Coroner's Court and Mortuary 74 Day Club for Handicapped old people 29 Deaths 14, 17 Disinfection and Disinfestation 73 Disposal of unsound food 57 Drainage 61 Dust nuisances 62 Dwelling Houses 14, 37 Factories Act 1937 48, 75 Factories, Workplaces, Shops and other Premises 46 Factories, Defects and Nuisances 47 Fires from Oil Heaters 35 Food Hygiene, Codes of Practice 55 Food, Inspection and Supervision 51 „ Legal Proceedings 71 „ Poisoning 55 „ Sampling 51 „ Shops and Premises 50 ,, Unsound 57 Food and Drugs Act 1955 48 Grit and Dust from Power Stations 63 " Guard that Fire " Campaign 34 Handicapped old people, Day Club 29 Health Education 34 Housing Act 1961 43 Housing Statistics 38 Houses, number of 14 (11247) a2 Page. Ice Cream 56, 58 Ice Lollies 56 Infant Mortality 15 Infectious Diseases 19 Infectious Diseases—compensation for stopping employment 23 Infectious Diseases—Notifications 21 International Certificates of Vaccination and Inoculation 23 Introduction 7 Invalid Meals Service 31 Land Charges Act, 1925 45 Legal Proceedings 71 Licensing Act 1961 58 London County Council Divisional Health Committee, Division No. 2 10 Luncheon Clubs 30 Mass X-Ray Service 25 Maternal Mortality 14 Measles 21 Milk and Dairies (General) Regulations 1949 56 Milk (Special Designations) Regulations 1960 57 Milk Examinations 57 Milk Licences 57 Mobile Library Service for old people 32 Mobile Meals Service (" Meals on Wheels ") 30 Mortuary Accommodation 74 Neonatal Mortality 14 Noise Abatement Act 1960 60 Notices 37, 47, 49, 50 „ Statutory 37 Notifications of Infectious Diseases 21 Nuisances 38, 47, 49, 50, 62 „ Noise 61 Offices, Workplaces, Shops, etc 46 Oil fired furnaces 70 Oil Heaters, Incidence of fires from 35 Outworkers 48 Overcrowding 41 Perinatal Mortality 14 Pet Animals Act, 1951 59 Pharmacy and Poisons Act 1933 59 Poliomyelitis 21 Pollution from oil fired furnaces 70 Population 14 Poultry—Codes of Practice 55 Power Stations 64 Preserved Food Premises 58 Prevention of Damage by Pests Act 1949 Private Deep Wells 72 Public Health Committee 10 „ „ Sub-Committee on Smoke Control Areas 10 Public Health Department Staff 11 Public Health Laboratory—Specimens submitted to 24 Public Swimming Baths 72 Puerperal Pyrexia 22 Page Rag Flock and other Filling Materials Act 1951 61 Rateable Value 14 Rats and Mice Repression 61 Rent Act 1957 45 Rodents Destroyed 61 St. Luke's Hospital—Proposed closure 33 Samples, Food 51 Sanitary Circumstances 37 Sanitary conveniences, provision at Inns, etc. 59 Sewers, Discharge into of trade effluents. 60 Sewerage and Sewage Disposal 60 Slaughterman's Licences 59 Slum Clearance 41 Smallpox 22 Smoke Abatement 68 Smoke Control Areas 70 „ „ „ ,Public Health Sub-Committee 10 Smoke Control Areas Map Facing page 70 So ho, Incidence of Tuberculosis in 26 Specimens submitted to Public Health Laboratory 24 Staff of the Public Health Department 11 Statistics and Social Conditions 14 Swimming Baths 72 Trade effluents—discharge into sewers 60 Tuberculosis 24 Typhoid Fever 23 Underground Room Regulations 42 Unsound Food 57 Water 71 Welfare of Old Persons 28 Wells 71 Westminster Old People's Welfare Association 28 Workplaces, Shops, etc 46 • • 7 Citp of westminster Public Health. Department, Telephone: Trafalgar 7070 Alhmbra 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, I have the honour to present for your consideration a report on the health of the City of Westminster during the year 1961. An examination of the vital statistics on page 14 reveals little change from last year. The estimated mid-year population figure provided by the Registrar General very closely approximates that obtained by the Census of Population undertaken in 1961. The birth rate is slightly higher; but it is unfortunate to have to record increases in the Infant Death Rates, both for Legitimate and Illegitimate infants. It must be borne in mind, however, that the numbers from which the rates are computed are so small that fluctuations are bound to occur from time to time, as a result of chance alone. The increases this year cannot, therefore, be regarded as reversing the steady downward trend which is apparent when the figures for the past 17 years are examined. These will be found in the table on page 16. I have included in the Report again this year the adjusted Birth and Death Rates. These are arrived at by applying Area Comparability Factors, supplied by the Registrar General, which compensate for variations in the age and sex composition of the population from district to district. The adjusted rates can, therefore, be compared directly with similarly adjusted rates for other districts, and with those for England and Wales as a whole. Regular readers of the Report will have noted an increase of 1 - 2 acres in the size of Westminster. This does not arise from alteration of the boundaries. The Director General of Ordnance Survey advises me that the difference is due to the survey of the City of Westminster having been completed to the 1/2500 scale National Grid, thus providing an up-todate figure of the actual area of the City. 8 There were no serious outbreaks of infectious disease in the City during 1961. No case of poliomyelitis occurred and there were no deaths from any notified case of infectious disease. Measles notifications showed a sharp increase; this was expected since the disease assumes epidemic proportions approximately every two years. Fortunately the infection was generally mild in character. No maternal death occurred in 1961. The Day Club for Handicapped Old People, opened by the Westminster Old People's Welfare Association in premises at Sherborne House, has been an unqualified success, and is bringing much happiness to handicapped old people who would otherwise be confined to their homes. Providing a club of this nature produced the associated problem of transporting the old people to it. The London County Council Welfare Department supplies a specially adapted coach, with a power-operated lift for wheelchairs at the rear, but it became clear at an early stage that this would have to be supplemented by the provision of additional transport if the club were to flourish. With this in mind the City Council in July, 1961, agreed to purchase for Public Health Department use a 14-seater " Minibus ", which is hired to the Old People's Welfare Association as occasion demands for transporting the old people to and from their club. This short outing around Westminster also has beneficial effects, and is much appreciated by the old people. When not in use by the Association, the vehicle is used for general purposes by the Health Department. Unfortunately, owing to an industrial dispute at the manufacturers' works delivery of the vehicle was not obtained until March, 1962. The shortage of public health inspectors was somewhat alleviated during the year, when it was possible to fill four vacancies. Of the four public health inspectors appointed, one was returning to local government service from private business, whilst two had just returned to this country from appointments in East Africa. One of these left within a short time to take up a position with an authority in Berkshire, which offered housing accommodation, car allowance and London scales. The difficulties of Central Metropolitan Boroughs in maintaining a full establishment under these conditions are well appreciated by all concerned. It is, however, pleasing to report that the staffing position was better than for over seven years, and this is reflected throughout the report by increases in the number of inspections undertaken. The Council's training programme for student public health inspectors continues to operate satisfactorily, and at the present time five persons are under training—the maximum number which can be accepted by the existing staff of qualified inspectors. Two of these students take their qualifying examination in July, 1962. One of the students qualified in 1961 and was appointed to a position in the department; subsequently in May, 1962, he obtained the Diploma 9 of the Royal Society of Health for Inspectors of Meat and other foods. This officer was rather older than the usual student when he joined the staff of the Health Department. As he had not previously obtained the necessary preliminary qualifications, it meant that although he has always been successful at examination he had to study continuously in his spare time for almost eight years before being accepted two years ago under the Council's training scheme. His tenacity of purpose is much to be commended and has set an excellent example to the other students in the department. The long-term policy of training students adopted by this Council and other authorities is making a most valuable contribution toward overcoming the shortage of inspectors which exists throughout the country. Opportunity has been taken again this year to include in the report the map (facing page 70) showing parts of the City where Smoke Control Orders are already in force, and the Council's proposals for the future. The programme approved by the City Council provides for the whole of Westminster to be smokeless by the autumn of 1965, and good progress is being made. For many years complaints of noise nuisance averaged about forty a year; in 1961 the number increased sharply to eighty. The passing of the Noise Abatement Act, 1960, and the activities of the Noise Abatement Society have quite rightly made the public more " noise conscious ", and this apart from any actual increase in noise has accounted for a number of the additional complaints. There are a number of manufacturing, demolition, and building processes which could and should be undertaken more quietly. In many cases this can be done without detracting from efficiency, and there is no possible excuse for allowing excessive noise to continue. In some other cases, it must be admitted that a substantial reduction of noise does entail some loss of efficiency, but this is a price which must be paid if the working and resident population of Westminster is to be protected. Fortunately officers of the Public Health Department usually secure the willing cooperation of contractors and others carrying out works in the City and formal action is seldom necessary. My thanks are due to the staff of the Public Health Department for their unfailing support during the year, and to my colleagues in other departments for their co-operation and help. Finally, Mr. Mayor, I would thank you, the Chairman and Members of the Public Health Committee, and all Members of the Council, for the many kindnesses you have shown to me during 1961. J. H. Briscoe-Smith, Medical Officer of Health. June, 1962. (11247) A3 10 PUBLIC HEALTH COMMITTEE The Mayor (ex-ojficio) : Councillor J. L. C. Dribbell, J.P. The Deputy Mayor (ex-officio): Councillor R. L. Everest, F.R.I.C.S., F.I.Arb. Chairman : Councillor Dr. Brian Warren Vice-Chairman: Councillor Miss E. A. Marsh Members: Alderman C. J. Citron „ Miss P C. Paton Walsh. „ C. P. Russell, C.V.O., J.P. (ex-officio) (died 9th August 1961) Councillor Dr. T. Anwyl-Davies, F.R.C.P. „ G. M. Boyd „ T. Stirling Boyd „ W. B. Clowes „ Lady Hulbert, M.B., J.P. „ L. E. Johnson „ Viscountess Lewisham, L.C.C. „ 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-ojficio). Alderman Miss P. C. Paton Walsh. „ C. P. Russell, C.V.O., J.P. (ex-officio) (died 9th August 1961) Councillor Dr. T. Anwyl-Davies, F.R.C.P. „ G. M. Boyd. „ Miss E. A. Marsh (ex-officio). „ A. Sciver, B.Sc. (Lond.), F.R.I.C. (Chairman) „ Mrs. A. Silverstone. „ 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 Peter Sebastian and Mrs. A. Silverstone. 11 STAFF OF THE PUBLIC HEALTH DEPARTMENT Medical Officer of Health J. H. Briscoe-Smith, M.B., Ch.B., D.P.H. Deputy Medical Officer of Health Marjory A. Dawson, M.B., Ch.B., D.P.H. (from 1st July, 1961) 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 J. H. Gillett Deputy Chief Public Health Inspector (and with special duties relating to Theatres, Cinemas and other places of entertainment), C. F. Brockett Public Health Inspectors District: J. H. Brownlee B. J. Dawson (from 2.1.1961) D. N. Faulkner (from 9.1.1961 to 25.6.1961) H. J. Felstead (from 13.7.1961) S. Firsht F. A. Freeman D. Landeg S. Shave (from 20.2.1961) F. E. Siddle (Inspector with special duties relating to Rodent Control and Disinfestation) (11247) A4 12 Housing: J. M. Burbridge (Housing Inspector) J. W. Baxter W. G. Stivey Food: J. J. Coveney P. A. Lloyd, O.B.E. Catering Establishments : R. F.Stubbs W. H. Dunstan Atmospheric Pollution: W. J. Davi es Technical Assistants: (Smoke Control Areas) N. H. Billing W. A. Huckin (to 14.5.1961) R. H. Major (from 29.5.1961) Public Health Inspector Students: H. J. Felstead (to 12.7.1961) G. E. Clayton-Turner R. J. W. Plummer Qualified Assistants to Public Health Inspectors: J. C. Bray A. Miller R. Pendreigh General Assistants to Public Health Inspectors: A. Jones A. Murkin 13 Clerical Staff W. H. Smith (Senior Clerk) R. L. Booker Miss K. Lee S. J. Chamberlain (to 5.11.1961) D. Levitton Miss B. Cleasby L. J. Nunn A. H. Cole Miss I. Oliver P. Cox (Temporary) J. M. Shotbolt B. Davies (from 6.11.1961) B. Sheridan R. W. Easton W. E. F. Simmons Mrs. S. A. Fox (to 5.11.1961) E. A. Taylor Miss C. Gannon (from 1.5.1961) Miss H. Woodford (to 27.2.1961) W. F. C. King Coroner's Court and Mortuary Superintendent: A. W. Nicholls 1st Mortician: W. H. Wilshire Mortuary Assistants: A. Munro G. Wirdnam (to 25.2.1961) Cleaner: Mrs. E. Williamson Rodent Control Rodent Officer: J. W. Brown Foreman: W. W eems Rodent Operatives: T. Izzard E. Jacobs G. Murray C. Ralph 14 STATISTICS AND SOCIAL CONDITIONS Area (acres) 2,503-9 Population (Registrar General's Estimate, mid-year, 1961) 86,680 Population, Census, 1961 85,223 Number of private dwellings (Census, 1961) 30,214 Rateable Value (at 1st April, 1961) £22,120,415 Births Live Births (registered)— Total. Males. Females. Legitimate 888 458 430 Illegitimate 123 71 52 1,011 529 482 Birth rate per 1,000 of the estimated resident population 11-66 Area Comparability Factor—Births: 0-84 Birth rate (adjusted) 9-79 (Rate for England and Wales, 17-4) Number of stillbirths (males, 9; females, 8) 17 Rate of stillbirths per 1,000 (live and still) births 16-53 Total live and still births 1,028 Illegitimate live births per cent, of total live births 12-16 Deaths Net deaths (males 508; females, 463) 971 Death-rate per 1,000 of the estimated resident population 11-20 Area Comparability Factor—Deaths: 0-99 Death rate (adjusted) 11.08 (Rate for England and Wales, 12-0) Deaths arising from pregnancy, childbirth, abortion Nil Rate per 1,000 total (live and still) births Deaths of infants under 1 year (males, 14; females, 9) 23 Death-rate of infants under 1 year— All infants per 1,000 live births 22-74 Legitimate infants per 1,000 legitimate live births 19-14 Illegitimate infants per 1,000 illegitimate live births 48-78 Neo-natal mortality rate (deaths under 4 weeks per 1,000 total live births) 15-82 Early neo-natal mortality rate (deaths under 1 week per 1,000 total live births) 14-83 Perinatal mortality rate (stillbirths plus deaths under 1 week per 1,000 total live and stillbirths) 31-12 15 Infant Mortality Analysis of Infant Deaths, 1961 Cause of Death 1st week 2nd week 3rd week 4th week Total under 4 weeks 1-3 months 4-6 months 7-9 months 10-12 months Total under 1 year Legitimate Accidental — — — — — 1 1 — — 2 Atelectasis 2 — — — 2 — — — — 2 Anencephaly 1 — — — 1 — — — — 1 Bronchitis — — — — — — 1 — — 1 Broncho-pneumonia — — — — — 1 — — — 1 Congenital Malformations 2 1 — — 3 — — — — 3 Cerebral Trauma 1 — — — 1 — — — — 1 Intracranial Haemorrhage 2 — — — 2 — — — — 2 Prematurity 4 — — — 4 — — — — 4 Illegitimate Atelectasis 2 — — — 2 — — — — 2 Broncho-pneumonia — — — — — 1 — — — 1 Congenital Malformations — — — — — 1 — — 1 2 Prematurity 1 — — — 1 — — — — 1 Totals 15 1 — — 16 4 2 — 1 23 16 Births, Infant Deaths and Mortality Rates All Infants. Legitimate. Illegitimate. Year. Total Births. Deaths. Mortality Rate. Births. Deaths. Mortality Rate. Births. Deaths. Mortality Rate. 1961 1,011 23 22.74 888 17 19.14 123 6 48-78 1960 1,007 16 15.88 892 13 14.57 115 3 26-08 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 17 Deaths, 1961 Causes of Death in the City at Different Periods of Life Years of Age Causes of Death Sex All Ages 0- 1- 5- 15- 25- 45- 65- 75+ All Causes m. 508 14 1 - 6 26 186 133 142 f. 463 9 3 1 1 24 95 113 217 Grand Totals 971 23 4 1 7 50 281 246 359 Tuberculosis, Respiratory m 5 - - - - - - 4 1 f. 2 - - - - - 1 — 1 Tuberculosis, Other m. - - - - - - - - - f. - - - - - - - - - Syphilitic Disease m. 2 - - - - - 1 1 — f. 5 - - - - - 1 2 2 Diphtheria m. - - - - - - - - - f. - - - - - - - - Whooping Cough m. - - - - - - - - - f. - - - - - - - - - Meningococcal Infections m. - - - - - - - - - f. - - - - - - - - - Acute Poliomyelitis m. - - - - - - - - - f. — — — — — - - — - Measles m. — — — — - — - — f. - - - - - - - - - Other Infective and Parasitic Diseases M. 1 — - - - — 1 - — f. - Malignant Neoplasm, Stomach m. 11 — — — — 1 5 3 2 f. 8 — — — — — 2 3 3 Malignant Neoplasm, Lung, Bronchus m. 37 — — — — 1 22 13 1 f. 13 —. — — — 1 4 4 4 Malignant Neoplasm, Breast m. — — — — ... — — — — f. 27 — — — — 4 9 8 6 Malignant Neoplasm, Uterus f. 8 — — — — 2 4 2 — Other Malignant and Lymphatic Neoplasms m. 62 — —' — 1 3 26 15 17 f. 53 — 1 — 1 4 21 12 14 Leukaemia, Aleukaemia m. 4 — 1 - — 1 — — 2 f. 1 - - - - - - 1 — Diabetes m. 1 - - - - - - - 1 f. 6 — — — — — 2 2 2 Vascular Lesions of Nervous System m. 30 — — — — 2 7 7 14 f. 48 — — — — — 6 11 31 Coronary Disease, Angina m. 127 — — — — 4 62 30 31 f 72 — — — — — 17 24 31 (11247) a5 Deaths, 1961—continued Causes of Death in the City at Different Periods of Life—continued Years of Age Causes of Death Sex All Ages 0- 1- 5- 15- 25- 45- 65- 754 Hypertension, with Heart Disease M. 3 - - - - - 2 1 — F. 6 - - - - - 1 — 5 Other Heart Disease M. 37 — — — — 3 8 9 17 F. 52 — — — — 1 4 8 39 Other Circulatory Disease M. 25 - - - - - 7 9 9 F. 41 — — — — — 7 9 25 Influenza M. 3 — — — — — 2 1 — F. 2 — — — — — — 1 1 Pneumonia M. 24 1 — — — — 3 6 14 F. 29 1 — — — — 1 6 21 Bronchitis M. 40 1 — — — — 12 15 12 F. 14 — — — — — 2 3 9 Other Diseases of Respiratory System M. 7 — — — — — 1 1 5 F. 2 — — — — — 1 — 1 Ulcer of Stomach and Duodenum M. 5 — — — — — 2 3 — F. 4 — — — — — — 1 3 Gastritis, Enteritis and Diarrhoea M. 2 — — — — — 1 — 1 F. 5 — — — — — — 2 3 Nephritis and Nephrosis M. 2 — — — — — 2 — — F. 1 — — — — 1 — — Hyperplasia of Prostate Pregnancy, Childbirth, Abortion M. 5 — — — — — — 1 4 F. — — — — — — — — — Congenital Malformations M. 5 2 — — — 1 1 1 — F. 5 4 — — — — 1 Other Defined and IllDefined Diseases M. 35 8 — — 2 2 9 7 7 F. 32 4 1 1 — 4 3 11 8 Motor Vehicle Accidents M. 2 — — — — — — 2 — F. 1 — 1 — — — — — — All other Accidents M. 19 2 — — 2 3 5 3 4 F. 14 — — — — 1 4 2 7 Suicide M. 13 — — — 1 4 7 1 — F. 12 — — — — 6 4 1 1 Homicide and Operations of War M. 1 — — — — 1 — — — F. — — — — — — — — — 18 19 Infectious Diseases The undermentioned conditions are compulsorily notifiable in Westminster:— Disease Authority for Notification Anthrax Public Health (Infectious Diseases) Amendment Regulations, 1960. 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 Public Health (London) Act, 1936—Sections Paratyphoid) 192 and 304. Erysipelas Do. Food Poisoning Food and Drugs Act, 1955—Section 26. 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 Neonatorumf † 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. Poliomyelitis, Acute L.C.C. Order dated 27.2.1912 and Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949. * Notifiable to the Chief Medical Officer, Ministry of Health, † Notifiable to the County Medical Officer of Health for London. (11247) A6 20 Disease Authority for Notification 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 (includingParatyphoid) Public Health (London) Act, 1936-—Sections 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. 6d. 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. 21 Notifications of Infectious Disease Disease Notifications Removed to Hospital Diagnosis not Confirmed Diagnosis Established Diphtheria 3 - 3 — Dysentery 27 2 — 27 Erysipelas 3 3 — 3 Food Poisoning 21 6 1 20 Malaria (contracted abroad) 2 2 — 2 Measles 797 33 2 795 Meningococcal Infection 1 1 — 1 Pneumonia: Acute Primary 4 — — 4 Influenzal — — — — Poliomyelitis: Paralytic — — — — Non-Paralytic — — — — Puerperal Pyrexia 11 11 — 11 Scabies 3 — — 3 Scarlet Fever 12 — — 12 Typhoid Fever 1 1 — 1 Whooping Cough 5 1 — 5 Measles It is of interest to note that seven hundred and ninety-seven notifications of measles were received in 1961, compared with forty-seven in 1960; thirty-three patients were removed to hospital. This is the highest number of cases notified since 1955, when nine hundred and twenty-one notifications were received. Poliomyelitis For the first year since 1944, no case of poliomyelitis occurred in Westminster. Immunisation against poliomyelitis began in 1956. The number of corrected notifications of poliomyelitis, including polio-encephalitis, for each year since 1947 is given below. Whilst the numbers vary greatly, it is to be hoped that the decrease in the number of cases during the past few years is attributable to the effects of immunisation:— 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 21 16 29 13 1 10 9 4 15 7 5 1 1 1 - 22 Puerperal Pyrexia Eleven notifications of puerperal pyrexia were received during 1961. All the cases occurred in hospitals. Of these only four were normally resident in Westminster. Puerperal pyrexia is defined as any lebnle condition occurring in a woman in whom a temperature of 100.4°F. or more has occurred within fourteen days after childbirth or miscarriage. The following table is an analysis of the causes of pyrexia of the eleven cases notified in 1961:— Cause Number of cases Urinary infection 4 Breast engorgement 1 Vaginal infection 1 Transfusion reaction 1 Partly retained membrane 1 Post-operative condition 1 Septic abortion 1 Unknown 1 In addition to the above cases, information was received concerning six patients normally resident in Westminster, who were notified as suffering from puerperal pyrexia in other London districts. Smallpox In my Annual Report for 1960, in connection with the smallpox case which had occurred in Westminster in October of that year, I drew attention to the continued need for vaccination as a protective measure, particularly in these days of high speed travel between Far Eastern countries and the United Kingdom. This need was brought even more to the fore in 1961 when towards the end of December, cases of smallpox were imported into this country from Pakistan, where an epidemic of this disease existed. With modern means of transport, it is now possible for a person unknowingly to be in contact with an infectious disease in one country and within a few hours to have travelled half across the world. Constant vigilance is required to prevent the spread of disease, and vaccination against smallpox is clearly still necessary until such time as this disease has been eradicated. Fortunately, no case of smallpox occurred in Westminster during 1961, although on several occasions information was received in the Public Health Department concerning persons who had been in contact with 23 the disease either in this country or abroad. In each case the necessary preventive measures were taken and the contacts kept under daily surveillance for the required period. Typhoid Fever One case of typhoid fever was notified during the year. The patient was on a visit to this country from Karachi, and it was established that the infection had been contracted abroad. 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. 4,617 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. Fifty-one of these certificates were issued during 1961. Infectious Diseases—Compensation for Stopping Employment 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, 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. It was not necessary to take action under this section during 1961. 24 Specimens Submitted to the Public Health Laboratory Nature of Specimen Number Examined Positive Findings Nasal and Throat Swabs 200 Haemolytic streptococci 36 Monilia 3 Staphylococcus aureus 1 Vincents organisms 1 Faeces 296 Shigella sonnei 15 Salmonella typhimurium 25 Bact. coli 0111 1 Bact. coli 026 1 Occult blood: Benzidine test Positive 1 Clostridium Welchii 2 Ova of hookworm, Trichuris trichiura & Ascars lumbricoides 1 Vomit 1 Swab from gums 1 Aural swabs 2 Diphtheroids & micrococci 1 Skin swabs 3 Tuberculosis Age Periods New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary M. F. M. F. M. F. M. F. Under 5 years 1 1 — — — — — — 5 to 15 years — 2 1 — — — — — 15 to 25 years 7 9 — — — — — — 25 to 45 years 30 16 — — — — — — 45 to 65 years 26 5 — — — 1 — — 65 to 75 years 7 — — — 4 — — — 75 and over 3 — — — 1 1 — — 74 33 1 — 5 2 — — New cases Source of Information Pulmonary Non-Pulmonary M. F. M. F. Primary notifications ... ... 50 23 1 — Transfers from other areas ... ... 22 9 — — Non-notified deaths ... ... 2 1 — — Posthumous notifications ... ... — — — — — 25 Mass X-Ray Service (This report was kindly supplied by the Organising Secretary of the South West London Mass X-Ray Service.) In 1961 the Mobile Units of the South-West London Mass X-Ray Service made 60 visits to firms and organisations in the City of Westminster, during which 19,494 parsons were examined; 58 were referred to Chest Clinics. Three Colleges were also visited in connection with the London County Council's B.C.G. Inoculation Scheme, to X-Ray students who were positive reactors to the tuberculin skin tests. During April, May and June, a Mass X-Ray Centre was open at the New Gallery, 123 Regent Street, W.I., which was attended by over eleven thousand employees from firms, shops and offices in the W.l. district. In addition to the usual programme where attendance is by appointment, special lunchtime and early evening sessions were held this year, which were well attended by staff working in small shops and offices, catering and hairdressing establishments etc., for whom the fixed appointment system is not practical. Twenty-one people X-Rayed here were referred for further investigation. A Mass X-Ray Unit was installed for three weeks on the premises of a large organisation in the Strand, where 4,403 were X-Rayed from their staff, and from staff of other business-houses in the vicinity: seven cases were sent to Chest Clinics. The same Unit later spent a week at The Admiralty, and three weeks at The Board of Trade, and X-Rayed 6,000 civil servants from Ministries in Whitehall, of whom eight were referred for further investigation. The regular monthly visits to Bruce House, the L.C.C. Lodging House in Kemble Street, W.C.2, which were begun in 1958, were continued throughout 1961. During the year, letters of invitation were sent to all newcomers there, and, in all 529 residents were X-Rayed, of whom seventeen were tuberculous, and three others were referred to Chest Hospitals. Visits were also made to The Salvation Army Hostel and The Church Army Hostel in Great Peter Street. The six-monthly service for men over forty-five years of age, which was inaugurated in South London in December 1958, in an attempt to provide some protection against the hazards of lung cancer, is still in operation, and some eighteen thousand men are attending the SouthWest London Mass X-Ray Units. Over fifty firms in Westminster are co-operating, by making it possible for their male employees in this age group to attend twice a year, either at their place of work or at a convenient centre. Fifty-eight visits to Westminster have been made to provide this special service, including those made to the Gatliff Road and Monck Street Public Cleansing Depots, to X-Ray members of the City Council's Staff. 26 Soho Survey During the months of January-June, 1960, a survey of workers employed in catering establishments in Soho was cartied out jointly by the Westminster Hospital Chest Clinic and The South-West London Mass X-Ray Service. 2,611 catering trade employees were X-Rayed during a series of thirteen visits made by the Mass X-Ray Unit. A report on the results of this survey was published in July, 1961, and is referred to in the following section. In view of the findings and recommendations, plans were made to repeat this survey in Soho during the period January-April 1962, and to X-Ray as many as possible of those employed in hotels and catering establishments elsewhere in the City of Westminster. Incidence of Tuberculosis in Soho A survey undertaken in 1958 by the staff of the Westminster Hospital Chest Clinic, suggested that workers in the catering trade in Soho had a particularly high incidence of pulmonary tuberculosis. A further survey was therefore arranged by the Chest Clinic to ascertain the present position and was carried out during the months of January to June, 1960. The results of the current survey were published in an article by the Chest Physician and Almoner of the Westminster Hospital Chest Clinic and a member of the South-West London Mass X-Ray Service and appeared in the British Medical Journal of 15th July, 1961. The Soho area had been chosen for the survey because of the large number of catering establishments centred there. Details of some 400 catering establishments in the area were supplied from Public Health Department records to the Chest Clinic and the proprietors or licensees of 240 establishments were asked to co-operate (47 public houses and 193 restaurants, cafes, and coffee bars). 238 agreed to do so and out of 4,733 workers in these establishments, 2,611 were interviewed and X-Rayed. As a result it was found that 86 workers showed radiological evidence of past or present tuberculosis. These 86 cases were divided into three groups:— " Active "—all new cases requiring treatment: Sputum t.b. positive 6 Sputum t.b. negative 15 " Observed "—requiring observation only (including 2 already attending other Chest Clinics) 32 " Discharged "—with evidence of old healed pulmonary tuberculosis, but not thought to be requiring clinical observation 33 It will be observed that out of 21 active cases, only 6 were sputum positive at that time; the nationalities of these 6 persons were as follows:- 27 English 1 Italian 1 Pakistani 1 Chinese 3 In their article the authors stated that they realised that the results of their survey were based on a 55 per cent, sample, but they suggested that there was no reason to suppose that the remaining 45 per cent, who did not co-operate were any less likely to have tuberculosis. In fact there may have been many who knew that they had tuberculosis or who were already attending clinics and who deliberately avoided the survey for fear of losing their work as food handlers. The following is a summary of the conclusions reached by the authors of the article as a result of their investigation:— (i) Tuberculosis is more than four times as common in the catering trade in the Soho ar a than in the general population and almost certainly more common in Soho than in the catering trade elsewhere in the United Kingdom. The disease is most common among alcohol servers, food preparers and other kitchen staff. (ii) There is evidence that rather more than half the tuberculous workers have the disease before joining the catering trade and a majority of these have come from countries where there is a high national incidence of tuberculosis, e.g., China and Italy. (iii) It is considered that all new entrants to the catering trade in Soho should be X-rayed and tuberculin tested and, where necessary, B.C.G., vaccinated, whether they come from abroad or were born in the United Kingdom. For the Chinese, these precautions are especially necessary. In view of the information contained in the survey, I held discussions with the Chest Physician of the Westminiter Hospital Chest Clinic, the President of the Association of Chinese Restaurateurs, and with officials of the Far Eastern Department of the Colonial Office who deal with matters relating to Hong Kong. As a result the following action was initiated:— (1) As a routine measure, all Public Health Inspectors visiting catering premises in Westminster now enquire when the restaurant or catering staff were x-rayed and advise as to how x-ray examination can be obtained if necessary; further, whether arrangements have been made for staff to be medically examined and x-rayed before engagement. (2) The Association of Chinese Restaurateurs asked all its members to arrange for every member of their staff to be x-rayed immediately and recommended c rtain steps designed to improve the health of their respective staffs. Announcements in English and Chinese were inserted in Hong Kong papers calling attention to the concern which was felt in England regarding the incidence of tuberculosis amongst Chinese workers 28 in the catering trade and urging that all staff seeking employment in the United Kingdom should be x-rayed. (3) The Association compiled a register of all Chinese employed by Members with particular regard to their medical circumstances and this will be available for inspection by officers of the Public Health Department when required. (4) The help of the Colonial Office was sought to improve arrangements in Hong Kong for the x-ray examination of prospective employees in the catering trade in the United Kingdom. Some difficulties had previously existed in regard to this matter, as no certificates relating to x-ray or medical examination were being issued. The control and medical examination of immigrants came particularly to the fore during the winter of 1961-1962 in connection with the passage of the Immigrants Bill through Parliament. So far as Westimnster is concerned, it is to be hoped that the action which was taken and which is set out above will ensure that in future most, if not all, recruits from Hong Kong to the catering industry will be medically examined and x-rayed before coming to this country. 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 City Council, under powers conferred by the National Assistance Act, 1948, makes an annual contribution to the funds of the Association, to be used for work which comes within the scope of " Meals and Recreation." A chiropody service for old people has been in existence in Westminster for several years. During 1960, the service was considerably extended and is now grant-aided by the London County Council. Treatment is available at four clinics in Westminster or in the homes of housebound old people. The charge is 3s. per treatment but the County Council's scheme usually enables pensioners to obtain treatment free of charge. 29 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 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 the year under review this side of the Association's work increased steadily. In 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. This handbook has proved to be of great assistance to all concerned; a second edition was published during 1961. Day Club for Handicapped Old People In December, 1960 the Council agreed that the basement of Sherborne House, Abbots Manor, should be adapted for use as a Day Club and Luncheon Club for old people at an estimated cost of £4,000, and that a grant of £600 should be made to the Westminster Old People's Welfare Association for the provision of essential furniture and equipment for the Club, on condition that this should be returned to the Council if it ceased to be used for this purpose. The Club started on July 6th, 1961, and the official opening was performed on November 16th, 1961 by The Worshipful The Mayor of Westminster. It is used as a Day Club for about 25 handicapped old people on two days per week (including the service of lunches which are cooked on the premises) and as a Luncheon Club for 40 persons on two days per week. This latter arrangement necessitated the transfer to the Westminster Old People's Welfare Association of responsibility for the Luncheon Club formerly run at Tintern House by the British Red Cross Society. The accommodation includes a club room, a warden's office, kitchen, bathroom, hairdressing and chiropody cubicles, together with lavatory accommodation. The disabled old people are transported to and from the Club in special vehicles provided by the City Council and the London County Council Welfare Department. The success of this club is due in no small measure to the Warden and her staff. It caters for the recreational needs of a section of Westminster's elderly population for whom no provision had previously been made, and 30 enables a number of disabled old persons, who were formerly confined 1 argely to their own homes, to participate in the happy atmosphere which prevails at the Club. British Red Cross Society—Mobile Meals Service During 1961, the Westminster Division of the British Red Cross Society continued the service which it established in the City in December, 1946, for the delivery of hot mid-day meals to the homes of old people who are themselves unable to prepare meals at home. In June, 1959, in an endeavour to provide more balanced and nourishing meals for old people, the price paid to the caterers was increased from Is. 6rI. to Is. 10d. per meal and as a result the menus improved considerably. The price charged to the old people remained unchanged at 8d. per meal; in February, 1960, the London County Council's contribution was increased to 11d. per meal and the balance of 3d. per meal is borne by the CityCouncil. The service had previously been operated with two vans provided by the City Council and loaned to the Society on the understanding that they will be returned to the Council if they cease to be used for the service. The City Council also makes an annual grant to the Society of 75 per cent, of the running costs of the vans. In July, 1960, at the Society's request, the City Council agreed that a third van should be purchased and loaned to the Society on the same conditions. The provision of the third van has enabled meals to be delivered more frequently, particularly in the Soho area, and also extended the service to certain areas of the City not adequately covered and in which there was a need for meals. It is pleasing to note that the provision of the third van has enabled this service to be brought to many more old people in Westminster. The number of meals delivered during the year reached a total of 20,500, the highest total since the meals service 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 the meals to old people in their homes. The invaluable service rendered by the Society and the voluntary helpers is much appreciated by all concerned. Luncheon Clubs Up to July, 1961, the British Red Cross Society operated luncheon clubs for the elderly in accommodation on one of the Council's Housing Estates, and in City Council premises in Monck Street. Both clubs 31 operated on two days each week, and provided 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 mentioned in the preceeding section, the Luncheon Club at Tintern House was closed down in July, 1961, when the Westminster Old People's Welfare Association Day Club at Sherborne House opened. As in the case of the " Meals on Wheels " Service, the price of the meals was increased in June, 1959, from Is. 6d. to Is. 10d. per meal; the old people pay 8d., the London County Council pays 11d., and the City Council bears the balance of 3d. 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 1961, 4,169 meals were served at the Luncheon Clubs. Invalid Meals Service For many years Invalid Kitchens of London provided an invalid meals service covering a number of areas within the County of London. Early in 1961, because of certain financial difficulties, this service was taken over by the London County Council, who stated that, while they were willing to continue and expand the service themselves, they would be equally willing to promote legislation so that the Metropolitan Boroughs could, if they wished, operate the service instead. At the request of the Metropolitan Boroughs' Standing Joint Committee these powers were obtained and Section 69 of the London County Council (General Powers) Act, 1961, enables Metropolitan Borough Councils to operate an invalid meals service, or to employ any voluntary organisation providing invalid meals as an agent for the purpose, and to make charges (if any) to persons availing themselves of the service. Councils may combine in providing such a service. The City Council's powers under this section were delegated to the Public Health Committee. An Invalid Meals Service has never operated in Westminster and the precise extent of the need which may exist is not known. From experience in other London Boroughs, however, it would appear that the majority of meals being supplied are, in fact, ordinary meals comparable with those being distributed to old people by the Meals on Wheels service, but which are delivered to younger persons who are sick in their own homes. It would also appear that the number of persons requiring special diets, for which the services of a qualified dietician would be required, is very small. 32 The long-term solution to this problem is the establishment of a comprehensive domiciliary meals service which would be available, for long or short periods as the need arose, to those requiring special diets and to young invalids and convalescents, as well as to the frail elderly. So far as the present is concerned, discussions are taking place with interested organisations with a view to extending the existing Meals on Wheels service to include young persons who are sick in their own homes. 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. Although several cases were investigated during 1961, it was not found necessary to use these compulsory powers. Aged and Infirm Persons Much of the visiting of the aged and infirm is done by the Westminster Old People's Welfare Association social worker. There are many occasions, however, when a visit by a Medical Officer or a Public Health Inspector is required, because of their specialist knowledge or statutory powers. One hundred and seventy-four 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 Persons 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. 33 Proposed Closure of St. Luke's Hospital, Chelsea In June, 1961, it was learned that agreement had been reached between the Ministry of Health and the South-West Metropolitan Regional Hospital Board concerning the provision of a new post-graduate Medical School in Central London. The scheme will involve the re-organisation and possible re-building of a number of hospitals in the Brompton Road area and the concentration of post-graduate work from 16 centres in the metropolis. Among the changes which would be brought about is the closure of St. Luke's Hospital, Chelsea, which has accommodation for 264 chronic sick patients; also affected would be the Royal Marsden Hospital, the Brompton Hospital, the Chelsea Hospital for Women, and various other hospitals in central London. It was understood that the Ministry had given a categorical assurance that, in order that hospital facilities for the seriously ill and chronically sick would not be diminished in West London, the hospital board's proposals for further development would be sympathetically considered. Opposition to the plans was expressed by the Chelsea and Kensington Hospital Management Committee, the Group Medical Advisory Committee representing the doctors, and the various borough councils concerned. They were particularly disturbed by the proposal to empty St. Luke's Hospital, (the only one for chronic sick in the area) and felt that no patients should be transferred from St. Luke's Hospital until a proper alternative had been provided. St. Luke's Hospital accepts chronic sick patients from the postal areas S.W.I., S.W.3., S.W.5., S.W.7. and S.W.10., which comprise parts of the boroughs of Chelsea, Fulham, Kensington and Westminster. In addition, the hospital receives all the chronic sick cases from St. Mary Abbots Hospital, Princess Beatrice Hospital and St. Stephen's Hospital, irrespective of where they live; so that, in fact, St. Luke's accommodates chronic sick patients from a very wide area of West London. I am pleased to record that the closest possible co-operation exists between the geriatricians at St. Luke's Hospital and the Westminster Public Health Department. This has often made it possible, at very short notice, to secure the admission of a chronic sick patient living in the southern portion of the City, while the admission of chronic sick patients from other portions of Westminster to hospitals in another Hospital Management Committee area, is usually much more difficult. This facility will be lost if St. Luke's Hospital is closed without alternative accommodation first being made available for the reception of such cases from Westminster. The City Council therefore decided to ask the Minister of Health to provide details of his plans for the future reception of chronic sick patients from Westminster. 34 On 27th June, 1961, the Minister of Health made a statement in the House of Commons giving information relating to the future of the London post-graduate teaching hospitals. After outlining his proposals for various hospitals in the central London area, the statement concluded— "The proposals involve redevelopment of the sites now occupied by the Chelsea Hospital for Women and St. Luke's Hospital. The Chelsea Hospital for Women will be rebuilt adjacent to Queen Charlotte's. St. Luke's Hospital urgently needs to be replaced, and I am satisfied that satisfactory alternative geriatric provision can be made for the area; specific proposals will emerge from consideration of the 10-year plan for the South-West Metropolitan Region." At the time of preparing this report in May, 1962, no further information has been forthcoming from the Ministry concerning these proposals. Health Education Section 298 of the Public Health (London) Act, 1936, provides that "... a sanitary authority may arrange for the publication of information on questions relating to health or disease, and for the delivery of lectures, and the display of pictures (including cinematography displays) in which such questions are dealt with." In his Report for the year 1953, the Chief Medical Officer of the Ministry of Health stated: "Progress (in health education) has now so far developed that there must be few public health departments in the country where health education receives indifferent attention . . . Health education has come to mean something more than a subsidiary function and responsibility; it is now regarded as a primary activity of local authorities, which demands sound understanding and wise planning if it is to attain any reasonable measure of achievement. . ". It is impossible for a local authority department with a modest budget to compete with the high power advertising campaigns which are undertaken in the West End. It was, however, felt that some success in health education could be achieved by distributing posters and leaflets to all old people's clubs, youth clubs, Boy Scout and Girl Guide troops, and to various voluntary organisations in Westminster, for exhibition at their meeting places. Accordingly, in June 1961, the City Council agreed that a Home Safety Campaign should be held in Westminster during November and December, to supplement the National Fire Prevention Week which commenced on 30th October, 1961. Supplies of posters and leaflets, with an appropriate covering letter, were sent to the above-mentioned organisations, to the secretaries of the four Council Tenants' Associations, the local Chamber of Commerce, and the seven Street Associations. Several large departmental stores 35 in Westminster also co-operated by arranging special window displays of fireproof night wear and children's clothing, fire-guards and other safety devices. A special Home Safety Display with the topic " Guard that Fire," was arranged in the window of the Citizens' Advice Bureau at Alhambra House, and attracted considerable attention. With the kind co-operation of other committees, posters were displayed wherever possible at the Council's establishments—public conveniences, baths, housing estates and offices. Twenty thousand bookmarks were distributed through the Council's Public Libraries, and correspondence stickers (small reproductions of Home Safety posters) were affixed to the envelopes of letters dispatched by the Council's various departments throughout the period of the campaign. So far as direct advertising was concerned, small advertisements were inserted in eight consecutive weekly issues of the West London Press, and the Westminster and Pimlico News. Altogether, 150 double-crown posters (20 in. by 30 in.), 50 small fluorescent posters, 2,000 leaflets, 20,000 bookmarks, and 8,000 correspondence stickers, were purchased for use in this campaign. It is hoped that all these measures helped to bring home to the residents of Westminster, and to the many thousands of shoppers and office workers who visit Westminster each day, the fact that the majority of home accidents are caused by carelessness, and can be avoided with a little thought. Incidence of Fires Originating from Oil Heaters On 14th November, 1961, a report was submitted to the London County Council by the Fire Brigade Committee and the Health Committee dealing with the incidence of fires originating from oil heaters. The report showed that the problem of fires from oil heaters is almost entirely a post-war one, the number of fires in England and Wales from this cause having risen from 63 in 1946 to 2,204 in 1959. An examination of the statistics set out in the report indicated that oil heater fires are essentially a localised problem, the highest incidence being in certain parts of Paddington, Lambeth, Islington and Kensington. The Oil Burners (Standards) Act, 1960, became effective on 1st January, 1961. It empowered the Home Secretary to make regulations as to the standards of safety of oil heaters and their parts, to reduce or prevent risk of fire, and for the affixing of instructions on their working and use. This Act was subsequently repealed by the Consumer Protection Act, 1961; the Oil Heaters Regulations, 1962, were issued in May, 1962, 36 and came into operation from 1st June, 1962. The British Standards Institute has also issued a Standard Specification (No. 3,300), to which all new oil heaters offered for sale should conform. As a routine measure, all Public Health Inspectors going round their districts in Westminster look out for any oil heaters which are offered for sale and which do not comply with this standard. Particular attention is paid to secondhand shops and stalls where old oil heaters may be found. So far, no oil heater which does not comply with the standard has been found offered for sale. In any doubtful case the Council is empowered to purchase a sample heater for testing, but the necessary tests can only be satisfactorily carried out by the British Standards Institute. The fee for such an examination may amount to as much as £35 to which must be added the cost of purchasing the heater or its component parts (say, £15). Although it is understood that the heater may sometimes be useable after testing, and may therefore have some secondhand value, an expenditure of up to £50 would, therefore, be incurred in respect of each oil heater submitted to the Institute for examination. The London County Council report concluded by suggesting that action was needed to warn the public of their danger from oil heater fires, and that Metropolitan Borough Councils with their detailed local knowledge would be the appropriate authorities to organise suitable campaigns. Accordingly, opportunity was taken to include in the Home Safety Campaign (mentioned in the preceding section of this Report) a reference to the dangers which exist from oil heater fires; one of the advertisements inserted in the Westminster and Pimlico News and the West London Press dealt specifically with this problem. As a further measure 250 copies of a special leaflet "How Safe is your Oil Heater?" were obtained from the London County Council and distributed by the local division of the British Red Cross Society to all old people receiving meals under the Meals on Wheels service. 37 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 853 House-to-House (by Housing Inspectors) 607 Routine 616 Infectious Disease 130 Underground Rooms 122 Other Parts unfit for habitation 28 Housing circumstances 88 Applications for Loans and Grants 176 Drainage 609 Rodent Control 996 Miscellaneous 89 4,314 Included in the above totals are:— Houses let in lodgings 201 Council properties 273 *Aged and Infirm Persons 94 Common Lodging Houses 9 *A further 80 visits were made by the medical officers. 6,912 re-inspections were made following the above inspections. Notices Served Public Health (London) Act, 1936 194 London County Council (Water Closet) Byelaws, 1930 1 Westminster City Council Byelaws as to Artificial Lighting of Common Staircases in Tenement Houses and Flats 1 196 Statutory Notices 6 38 Nuisances, defective and unsatisfactory conditions found:— Defective and dirty internally 27 Damp 80 Defective drainage 13 Defective roofs 34 Water Closets:— Defective or dirty 20 Water Supply:— Absence of in upper floors 1 Insufficient 1 Cisterns uncovered 1 Smells 33 Rubbish 54 Animals 7 Other Nuisances 23 Staircase lighting, tenements 4 Verminous 33 Cockroaches 15 Housing Statistics 1. Inspection of Dwelling-houses during the year (1) (a) Number of initial inspections of dwelling-houses for housing defects (under Public Health or Housing Acts)... 3,707 (b) Number of reinspections 6,538 (2) (a) Number of dwelling-houses which were examined in the course of " house-to-house" inspection and recorded under the Housing Consolidated Regulations, 1925 607 (6) Number of reinspections 374 (3) Number of dwelling-houses found to be in a state to dangerous or injurious to health as to be unfit for human habitation 12 (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 195 2. Remedy of defects during the year without service of formal Notices Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 74 39 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— (а) By owners Nil (б) By Local Authority in default of owners Nil B.—Proceedings under Public Health Acts. (1) Number of dwelling-houses in respcct of which notices were served requiring defects to be remedied 195 (2) Number of dwelling-houses in which defects were remedied after service of formal notices— (a) By owners 195 (b) By Local Authority in default of owners Nil C.—Proceedings under Sections 16, 17 and 23 of the Housing Act, 1957. (1) Number of dwelling-houses represented for demolition 1 (2) Number of dwelling-houses in respect of which Demolition Orders were made 1 (3) Number of dwelling-houses demolished in pursuance of Demolition Orders (includes 1 dwelling-house demolished under an order made in 1960) 2 (4) Number of dwelling-houses in respect of which Closing Orders were made Nil D.—Proceedings under Sections 18 and 27 of the Housing Act, 1957. (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 5 (15 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 11 (33 rooms) 40 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 9 (27 rooms) (b) Number of Closing Orders made in respect of ground rooms 4 (12 rooms) (c) Number of undertakings accepted in lieu of Closing Orders in respect of underground rooms N il (2) (a) Number of other parts of buildings represented for closure 2 (8 rooms) (b) Number of Closing Orders made in respect of other parts of buildings 1 (3 rooms) (3) (a) Number of specifications submitted in respect of proposed works to parts of buildings subject to Closing Orders 10 (b) Number of specifications approved 8 (4) (a) Number of Closing Orders determined in respect of underground rooms 10 (25 rooms) (b) Number of Closing Orders determined in respect of other parts of buildings 1 (8 rooms) (5) (a) Number of applications made for modification of Closing Orders to permit approved use 8 (16 rooms) (b) Number of applications approved 8 (16 rooms) (6) Number of cancellations of Closing Orders (premises demolished) 9 41 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 41 (b) in respect of other parts of buildings 16 In five instances the informal action procedure was adopted at the suggestion of the Medical Officer of Health, and in 52 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 7 (2) Number of cases of overcrowding relieved during the year 12 Slum Clearance Programme for 1961-65. On the 23rd June, 1960, the City Council approved proposals (which were also subsequently approved by the London County Council) for action to be taken by the City Council under Part II (Demolition of individual unfit houses) or Part III (Clearance area procedure) of the Housing Act, 1957, to secure the demolition during the five-year-period, 1961-65, of 87 houses and flats in Westminster which are considered to be unfit for human habitation. These proposals were submitted jointly by the County Council and the City Council to the Minister of Housing and Local Government for approval. In June, 1961, the Minister approved the proposals but pointed out that his approval did not imply that he will necessarily confirm the specific compulsory purchase orders or clearance orders submitted to him by the City Council to implement the programme. Clearance Areas. In pursuance of the slum clearance programme referred to above, I made representations during 1961 for dealing with (a) 6 unfit houses in the Soho area, and (b) 2 unfit houses in the Covent Garden area:— (a) Nos. 20, 21, 22 and 23 Peter Street, W. 1. and 6 and 7, Green's Court, W. 1. (0.132 acre). The City Council at its meeting on the 25th May, 1961, resolved that an Order should be made declaring this area to be a clearance area, in accordance with the provisions of the Housing Act, 1957. 42 Compulsory Purchase Order. This area forms part of a much larger site of about 1.2 acres, bounded by Peter Street, Wardour Street, Brewer Street and the eastern boundary of Lex Garage. This larger site, which is crossed by two pedestrian courtways from north to south, viz: Walker's Court and Green's Court, is mainly covered by old buildings, the basement, ground and some of the upper parts of which are in commercial use. It is also one of the most congested areas in Soho. In view of the congestion of this larger site, the City Council formed the opinion that clearance order procedure, i.e. requiring the owners to demolish and redevelop the cleared site, was unsuitable for dealing with the proposed small clearance area, because in their opinion this area should be redeveloped at the appropriate time in conjunction with as large an area of the premises adjoining as it may be found practicable to incorporate. Ownership of the small site would, therefore, undoubtedly assist in the promotion of the suggested scheme of overall development, and it was considered that the appropriate procedure would be for the Council to acquire the premises by means of a Compulsory Purchase Order. The Council would then be in a position at the appropriate time to exercise its influence to secure a much needed improvement of this part of Soho. It its meeting on the 25th May, 1961, therefore, the City Council resolved that a Compulsory Purchase Order should be made for the acquisition of the properties Nos. 20, 21, 22 and 23 Peter Street, W.l, and 6 and 7, Green's Court, W.l, and that the Order should be submitted to the Minister of Housing and Local Government for confirmation. (b) Nos. 20 and 22, Mercer Street, W.C.2. On the 27th July, 1961, the City Council resolved to make a Clearance Order in respect of the area comprising Nos. 20 and 22, Mercer Street, W.C.2, and to require that each building should be vacated within a period of forty-two days immediately following the date on which the Order became operative. A letter dated 26th January, 1962, was received from the Minister of Housing and Local Government confirming the Clearance Order, without modification. Housing Act, 1957—Underground Rooms- Regulations. At their meeting on the 14th June, 1961, the Public Health Committee considered a letter dated 5th May, 1961, from the Metropolitan Boroughs' Standing Joint Committee, referring to Circular No. 38/59 from the Ministry of Housing and Local Government, asking that local authorities should review their existing Regulations relating to underground rooms in the light of revised Model Regulations issued by the Ministry, and submit revised Regulations to the Ministry for approval. The Standing Joint Committee felt that the revised Model Regulations fell short of 43 the previous ones upon which the existing Regulations of most metropolitan boroughs were based and, on the recommendation of the Advisory Body of Medical Officers of Health, representations were made to the Minister suggesting certain amendments, particularly the deletion of Regulation 7 relating to ventilating and lighting of rooms not used as living rooms. Subsequently, a letter was received from the Standing Joint Committee stating that the Minister would be prepared to consent to Regulations from which Regulation 7 of the Model Regulations had been omitted, and had also accepted some of the other suggestions made by that Committee. The Standing Joint Committee recommended constituent Councils to submit for approval revised Regulations in the form of the Ministry's model, as amended. The new Model Regulations did not differ materially from the old Regulations but were drafted so as to give greater flexibility in their administration without impairing the standards prescribed in the old Regulations. On the 27th July, 1961, the City Council prescribed new Regulations for the control of underground rooms in the model form, as amended, and sought the consent of the Ministry of Housing and Local Government thereto. The Minister's consent was given on the 13th November, 1961. Housing Act, 1961 This Act, which came into force on the 24th November, 1961, introduces a new system of housing subsidies and gives to local authorities extensive new powers for dealing with bad living conditions in houses let in lodgings or occupied by members of more than one family. It also makes a number of. changes in the law affecting condemned houses, improvement grants to private owners, repairing obligations and town development. The policy embodied in the Act and the main reasons for it are set out in the White Paper "Housing in England and Wales" (Cmnd. 1290) which was presented to Parliament in February, 1961. The Sections of the Act are arranged in three Parts. Part I deals with financial assistance for housing accommodation provided by local authorities and other public bodies. Part II of the Act is of particular importance to Public Health Departments. The Sections in this part of the Act confer upon the Council (and concurrently upon the London County Council) stronger powers of control for securing proper standards of management of houses let in lodgings or occupied by members of more than one family. Regulations to be made by the Minister by statutory instrument will provide a code of management for houses in multiple occupation and will require the person managing the house to arrange for the proper 44 repair, maintenance, cleansing and good order of the water supply, drainage, communal kitchens, bathrooms and water closets, staircases, corridors, outbuildings and gardens, and to make adequate provision for the disposal of refuse. When these regulations are in force the Council may apply them by order to any house in multiple occupation which is in an unsatisfactory state due to failure to maintain proper standards of management, and the regulations will then apply to that house so long as the order is in force. There is a right of appeal to the Magistrates' Court against the making of the order. Similarly, the owner of a house to which an order has been applied, may ask the Council to revoke it and if the Council refuses to do so, he may appeal to the Court. The penalty for failure to comply with the regulations while an order is in force is not exceeding £20 for a first offence and not exceeding £100 or up to three months imprisonment (or both) for a subsequent offence. There is also provision for the Council to serve a notice requiring the manager of the house to carry out such works as are necessary in its opinion to bring the house up to the standards set by the regulations. There is a right of appeal to the Court against the notice and there are default powers whereby the Council may itself do the work and recover the cost. The Council is also given powers to require the person having control of a house let in multiple occupation to execute such works as it may think necessary to provide satisfactory lighting, ventilation, water supply, personal washing facilities, drainage and sanitary conveniences, food storage and cooking facilities, and space heating. It may withdraw the notice requiring these works if the number of persons occupying the house is reduced so as to render the works unnecessary. It may also, after consultation with the fire authority, serve notice requiring the provision of adequate means of escape in case of fire. Further, there is a right of appeal to the County Court and default powers for the Council to do the work itself and recover the cost. The Council is also given a supplementary power of limiting (by direction) the number of individuals who should be accommodated in a house let in multiple occupation having regard to its condition and, if such a direction is in force, it is the duty of the occupier not to permit any person to take up residence so as to increase the number of residents above the limit so fixed. The direction may be revoked or varied if the condition of the house warrants it. The Council may serve on the occupiers of houses to which the direction applies notices requiring them to furnish full particulars of all persons residing in a house let in multiple occupation. At any time after November, 1964, the Council may make and submit to the Minister for confirmation a scheme authorising it to compile and maintain a register of all dwellings in multiple occupation in Westminster. 45 The Sections in Part III of the Act deal with miscellaneous and general provisions relating to private improvements in housing, repairing obligations and town development. Rent Act, 1957—Certificates of Disrepair Two applications for certificates of disrepair were received during the year. In one instance a certificate was duly issued and was still in force at the 31st December, 1961. The other application was still under consideration at the end of the year. Land Charges Act, 1925 The number of enquiries dealt with and reported upon was 2,833 relating to 5,236 properties. Whilst these figures indicate a decrease of 316 on the number of enquiries dealt with in 1960, the number of properties to which these enquiries related was 646 more than in 1960. The enquiries concerned outstanding statutory or informal notices, combined drainage orders, smoke control orders, applications for decontrol under the Rent Restrictions Acts, and certificates of disrepair. Additional questions appeared on many of the search forms, mainly in regard to any proposals for dealing with properties by means of clearance or redevelopment 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, 124 applications for rehousing 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. Nine visits were made by the Public Health Inspectors to the lodging houses during the year. 46 Inspection of Factories, Workplaces, Shops, Offices and Other Premises (other than food premises) Total Number of Visits Factories—Power 254 Factories—Non-power 21 Workplaces, etc. 4,062 Offices 3,984 Shops (other than food) 1,049 9,370 Analysis of Inspections:— Complaints 576 Routine 1,599 Infectious Disease 5 Drainage 526 Rodent Control 432 Sanitary Defects 4 Other Reasons 34 3,176 6,194 re-inspections were made following the above inspections. Types of premises inspected:— Places of public entertainment 94 Carpentry, joinery etc. 2 Wearing apparel 238 Furriers 17 Garages, motor tyres and rubberworks 59 Boots and shoes and other leather goods 26 Jewellers, precious and other metal-workers 8 Hairdressers 65 Laundries and dry cleaners 19 Printers and publishers 37 Warehouses and packers 51 Shops (other than food) 1,049 Upholstery and carpets 1 Photographers, film renters 16 Opticians 2 Florists 5 Offices 3,984 Various (schools, hospitals, halls, building sites, etc.) 3,697 9,370 47 Notices Served Factories Power Factories Non-power Workplaces, Offices, Shops, etc. Total Public Health (London) Act, 1936 5 5 Factories Act, 1937 5 — 1 6 5 — 6 11 Nuisances, Defective and Unsatisfactory Conditions Found:— Factories Power Factories Non-power Workplaces, Offices, Shops etc. Defective, dirty internally 4 — 3 Damp — — 7 Defective drainage — — 23 Defective roofs — — 3 Sanitary accommodation:— Insufficient 3 — 3 Insufficient ventilation and light 1 — 3 Defective or dirty 15 — 18 Not separate for sexes — — 1 Unsuitable — — 1 Water Supply:— Insufficient 1 — 1 Absence of in upper floors — — 1 Cisterns dirty — — 1 Smells 1 — 61 Rubbish — — 30 No indicating notices on doors of Water Closets 3 — — Other Nuisances — — 15 Want of ventilation — — 7 Cockroaches 1 — 7 48 Factories Act, 1937 Section 54—Basement Bakehouses There are five basement bakehouses in Westminster in respect of which Certificates of Suitability are in force. Section 110—Outworkers Number of outworkers (includes 1,680 workers living in areas outside the city) 2,669 (See Appendix II to this Report.) Food and Drugs Act, 1955 Inspections of all types of Food Premises Analysis of Inspections:— Complaints 382 Routine 2,429 Infectious Disease 43 Drainage 151 Rodent Control 180 New Catering Businesses 116 Miscellaneous 9 3,310 3,094 re-inspections were made following the above inspections. 49 Catering Establishments At the end of the year, particulars of 3,158 catering establishments were in the register. Summary of inspections:— Hotels, restaurants, clubs 3,360 Cafes, teashops, etc. 490 Staff Canteens 66 Public Houses 285 4,201 Notices Served Public Health (London) Act, 1936 2 Food Hygiene Regulations, 1955 38 Noise Abatement Act, 1960 1 41 Nuisances, defective and unsatisfactory conditions found:— Dirty, dilapidated internally 26 Defective internally 21 Defective drainage — Defective floors 33 Preparation tables and equipment worn and insanitary 23 Food storage accommodation inadequate and unsuitable 6 Vegetable preparation and washing-up facilities worn and insanitary 22 Ventilation insufficient 8 Lighting inadequate 3 Staff washing facilities insufficient and unsuitable 5 Staff changing rooms insufficient and unsuitable 7 Fuel, rubbish and other extraneous materials in food preparation rooms 2 Water Closets:— Insufficient ventilation and light 4 Defective 3 Dirty and dilapidated 3 50 Food Shops and Food Premises (Other than Catering Establishments) Types of businesses and summary of inspections:— Inspections Bakehouses (underground included) 34 Dairies and milkshops 183 Ice Cream premises 111 Meat shops 247 Other meat shops (preserved food, etc.) 27 Stalls 259 Confectioners 66 Fruit and greengrocery 131 Provision shops 515 Fish and poultry 109 Fried fish shops 2 *Other food premises 519 2,203 Included in the above totals are 141 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 Public Health (London) Act, 1936 3 Food Hygiene (General) Regulations, 1960 8 11 Nuisances and defective conditions found:— Dirty, dilapidated internally 1 Preparation tables and equipment worn and insanitary 4 Washing-up facilities worn and insanitary 4 Staff washing facilities insufficient and unsuitable 3 Rubbish and other extraneous materials in food preparation rooms 1 Smoking in food premises 3 51 Visits for the Purpose of Obtaining Samples and Inspecting Foodstuffs Sampling Inspection of food Confectioners 38 63 Dairies and milkshops 96 151 Fish and poultry 11 94 Fruit and greengrocery 7 429 Ice Cream premises 76 104 Meat shops and stalls 25 473 Other food premises 76 326 Provision shops 92 510 Cafes, teashops, etc. 32 114 Hotels, restaurants, clubs etc. 30 138 Staff Canteens 1 16 Public Houses 45 22 529 2,440 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 65 were reported upon adversely, representing a percentage of 4.22:— Ale, lager and stout 4 Baby food 7 Bread, rolls, sandwiches and biscuits 18 Butter 21 Cakes, cake and pastry mixture, pudding and pudding mix 46 Cereals 38 Cheese 24 Cocoa and cocoa powder 5 Coffee, extracts and essences 24 Condiments and spices 30 Confectionery 52 Cooking fats and oils 22 52 Cream 10 Custard powders, blancmange and jellies 20 Drugs 52 Fish and fish products 46 Flavourings and colourings 29 Flour 11 Fruit, canned, etc. 39 Herbs and Stuffing 15 Ice cream 74 Ice and ice cream lollies 42 Jams, marmalades and preserves 43 Malt and chocolate drinks 8 Margarine 17 Meat and meat products 41 Milk 400 Milk, condensed and evaporated 4 Nuts 3 Pickles and sauces 49 Pies and pie filling 11 Poultry 3 Saccharin 4 Salad cream and mayonnaise 5 Soft drinks, cider, syrups, perry, fruit juices, etc. 115 Soup and soup powders 17 Spirits 103 Spreads, various 10 Suet 3 Sugar 8 Tea and tea extract 16 Vegetables, tinned, etc. 30 Vinegar 11 Yoghourt 7 Wine 3 53 Samples submitted for chemical analysis, on which the Public Analyst reported adversely, included the following: A complaint concerning cheese which had a strong and unpleasant odour. The Public Analyst was of opinion that this was probably due to the initial infection of the milk from which the cheese was made. The complainant thought it had been subjected to animal contamination. Blocks of frozen whitebait on thawing were found to be dark in colour. It was believed that decomposition had occurred before the fish were deep frozen, and also that it had been improperly washed. The matter was taken up with the suppliers. Cheese imported from Germany was moulding with fruiting penicillia growing on the surface. Some 233 packets were voluntarily surrendered and destroyed. The importers took the matter up with the manufacturers. A quantity of frozen prawns sh wed the presence of bacteria when defrosted. The prawns had a tinny taste and became powdery on defrosting. It was thought that this may in some measure have been caused by incorrect defrosting procedure. Buttered rolls requested at a public house were proved on analysis to be spread with margarine. Legal proceedings resulted in a fine of £10 being imposed with £2 2s. costs. A sample of ice lolly labelled with an ingredient shewn as "E.H.E.C." was not considered by the Public Analyst to be the 'appropriate designation' of the ingredient as defined by the Labelling of Food Order, 1953. He considered that the full name—Ethyl hydroxyethyl cellulose— should be printed on the label. The manufacturers of the product agreed that the label would be amended if the use of the ingredient were continued. Twelve articles of foodstuffs, consisting of mixes and sauces, were reported upon adversely in connection with labelling offences and misleading descriptions. Considerable correspondence followed with the manufacturers and satisfactory agreement was eventually reached in all cases. A diner at a restaurant was of opinion that smoked salmon on the menu was smoked saithe. Samples were taken which proved the salmon was correctly described, though the quality, due to poor processing, was not of the best. A consignment of 986 X 7 oz. tins of rollmops in aspic were rendered unfit due to acid mixture attacking the tin plate and releasing gas. Another consignment of 351 x 3½ oz. jars of Lumpfish roe were surrendered, due to discolouration of the roe by bacteria which reduced the colour of the dye. Both consignments were imported products, and were destroyed. 54 During the year a number of complaints were received from members of the public alleging that foodstuffs purchased by them were unfit for consumption for one reason or another. All these were investigated and appropriate action taken. The following provide a note of interest:— Bread containing dark material which the complainant thought to be mouse excreta, was brought to the department. Examination showed that the foreign matter was charred bread, derived from the baker's bench. Three out of four cartons of milk obtained from a vending machine were found to be unfit, the milk being curdled with complete separation of the milk from the solids. Here the offence arose through the human element; cartons of milk without code markings had not been withdrawn from the machine by an assistant, and in consequence the milk had turned sour. A warning was given to the company. A churn of milk delivered to premises in Westminster was found, on emptying, to contain a complete folded newspaper. Investigation did not reveal how this had occurred, but a cautionary letter was sent to the Dairy Company concerned. A packet of cake mix contained two moths and webbing. At the retail shop eight further packets were found to be similarly affected, and as one packet was opened by the Food Inspector, a moth flew out. The packets had been in the shop for a considerable time and the source of infestation was believed to be a quantity of dried fruit, which contained a large number of dead moths. Legal proceedings were taken against the shopkeeper and a fine of £40 was imposed with £10 10s. costs. A milk bottle containing what the complainant thought was a squashed beetle was the subject of a complaint to the department. The 'beetle' in fact was a blob of paint. The Dairy Company stated that no mechanical washer could remove this, though the processes through which the bottle had passed had made it sterile. Two and a half million bottles are washed and filled by the Company weekly. Locust beans purchased at a large store contained insects, and the upper layers of the sack containing the beans were found to be contaminated with the dried currant moth. The infestation was believed to have occurred prior to the arrival of the beans at the shop, but regular inspection of the stock would have revealed that infestation had occurred. A bath bun was found by the complainant to contain a folded paper towel. A similar type of towel was found to be in use at the bakehouse (not in Westminster). It was claimed that by misadventure one of the towels must have fallen into the mixing pan without being observed. Court proceedings ensued, and a fine of £10 was imposed with £5 5s. costs. 55 A cigarette-end found in a fruit pie was the subject of a further prosecution. The defendant Company entered a plea of 'Guilty' and the offence resulted in a fine of £10 and £5 5s. costs. Several complaints were received during the year concerning perishable foodstuffs affected by mould growth. Careless handling or storage, or retention beyond the time limit recommended by the manufacturers, sometimes leads to the presence of mould. In this respect, the recommendations of the Food Manufacturers Federation Incorporated, in relation to the care and handling of meat pies, has been promulgated in brochure form by at least one manufacturer, and copies are available for the Company's customers. This action it to be commended. Food Poisoning Only twenty notifications of food poisoning were received during 1961 in respect of Westminster residents; six of these persons were admitted to hospital for treatment. Five of the notifications related to members of four families, living in close proximity to one another, who met socially for meals in each other's homes. Investigations covering several weeks failed to determine the food responsible although salmonella typhimurium organisms were found in faecal specimens. The remaining notifications were in respect of individual cases. Enquiries were undertaken in each case but without conclusive results. Several other outbreaks came to the notice of the public health department during the year involving a number of persons who suffered mild food poisoning symptoms, and almost all of whom lived outside Westminster. In only three cases was the causative organism traced. Codes of Practice—Poultry A Food Hygiene Code of Practice was published during the year, issued jointly by the Minister of Health and the Minister of Agriculture, Fisheries and Food. The Code was entitled 'Poultry Dressing and Packing'. Copies were sent by the City Council to those engaged in the poultry trade in Westminster, with a request that the contents of the publication should be brought to the attention of those concerned in poultry dressing and packing. This follows the practice carried out in previous years when Codes of Practice concerning the butchery and fish trades were published. 56 Ice Cream (Heat Treatment, etc.) Regulations 1959 During the year, 126 samples of ice cream were submitted for examination by the methylene blue test, and were classified in the following provisional grades as recommended by the Ministry of Health:— Grade No. of Samples 1 89 2 24 3 8 4 5 It will be noted that only thirteen of these samples failed to reach a satisfactory grading. In my report for 1960, I remarked that one firm's products over the year had shown, on examination, poor bacteriological results. During 1961, nine samples of this firm's ice cream were tested. Seven were placed in Grades 1 and 2, and two in Grade 3. This shews a marked improvement on those samples examined in the previous year. The manufacturing premises of this firm are outside Westminster. Several premises in Westminster now sell ice cream from dispensers which freeze and extrude soft ice cream into a container held by an assistant for immediate sale to the customer. The final process of manufacture is therefore performed at the premises where the machine is installed, and frequent inspection is necessary to ensure that the mix is properly stored and handled before being introduced into the machine. Of particular importance is the necessity for a high standard of personal hygiene being practised by the operators who attend these machines. Ice Lollies Forty-eight samples of ice lollies were taken during the year and submitted for bacteriological examination. All were reported to be of satisfactory standard. Ice lolly samples submitted for chemical analysis during the year were also reported to be satisfactory as regards quality. Milk and Dairies (General) Regulations, 1949 At the 31st December 1961, the following were entered in the Council's Registers of Dairies and Distributors of Milk:— Distributors of milk with premises registered as dairies 6 Distributors of milk with premises not registered as dairies 123 57 Milk (Special Designation) Regulations, 1960 As from the 1st January, 1961, a simplified licensing procedure came into effect which authorised in a single form of licence the sale of 'designated' milks obtained by dealers in the containers in which they are supplied to the consumer. The licence is for five years, expiring on the 31st December, 1965. During the year, 135 applications were received, comprising 333 licences for the use of one or more of the designations pasteurised, sterilised and tuberculin tested. The licence permits the sale of milk both inside as well as outside the area of a licensing authority. Examination of Milk During the year 27 samples of milk were submitted for methylene blue and phosphatase tests. The results showed that the milk had been efficiently pasteurised in every case. The samples were obtained from establishments under the control of the London County Council. Food and Drugs Act, 1955—Section 8 The following table shews the amount of food surrendered as unfit for human consumption during the year:— Amount surrendered Tons Cwts. Lbs. Canned food 46 19 45 Meat 1 6 36 Fruit and vegetables 113 8 2 Fish 1 9 108 Cereals 1 7 60 Confectionery 6 24 Fats 3 82 Miscellaneous 1 7 47 166 8 40 The total of canned food surrendered included two large consignments of canned peaches. 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 takes place at the central tipping site. 58 Food and Drugs Act, 1955—Section 16 Registration of Premises in connection with the manufacture, Sale or Storage of ice cream. Two hundred and forty-six 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. Licensing Act, 1961 This Act received the Royal Assent in August. From the 1st November 1961, it created new types of licences for restaurants, private hotels and guest houses, etc., and revised the procedure for the granting of Justices' licences. Of main concern to the City Council are the grounds on which an objection can be raised to the grant or renewal of a licence. This can be done where the premises are, on inspection, found to be not suitable or convenient for the proposed use having regard to their character and condition. The ground for objection to which the City Council will probably have most cause to resort is that concerning the provision of sufficient and suitable sanitary accommodation for the use of patrons of licensed premises. From the 1st March 1962, a more effective system of registration and control of clubs in which intoxicating liquor is sold comes into effect. Clubs will need to make application either to the Clerk to the Justices for a Justices' Licence or to the Magistrates' Court for a Certificate of Registration. Objection to these applications can be lodged by the City Council on similar lines to those mentioned above. This Act has imposed much additional work on the staff of the Public Health Department. 59 Pharmacy and Poisons Act, 1933 Persons entitled to sell poisons included in Part II of the Poisons List numbered 130 at 31st December, 1961. Pet Animals Act, 1951 Five licences wore 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 14 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 1961. Some doubt exists as to the interpretation of the words "Refreshment House" in this connection, although section 80 of the Public Health Act, 1961, (which section does not apply to London) now defines it as "any building in which food or drink is sold to and consumed by the public." During 1961, therefore, the Metropolitan Boroughs' Standing Joint Committee asked the London County Council to promote similar legislation for London. 60 Discharge of Trade Effluents into Sewers In November, 1961, a communication was received from the Metropolitan Boroughs' Standing Joint Committee stating that, following meetings of the Working Party on the Control of Trade Effluents, they had considered the form of legislation required in order to apply to London provisions for a more efficient control of these effluents similar to those now obtaining in the rest of the country under Part V of the Public Health Act, 1961, and had decided that they should be as follows:— (i) The occupiers of trade premises from which trade effluent is discharged into sewers to be required to pay to the London County Council a charge covering the use of the sewers and sewerage works and the treatment and disposal of the effluent. (ii) The County Council to apportion the amount received between itself and the sewer authorities concerned. (iii) Each local sewer authority and the County Council to keep registers of all premises from which trade effluent is discharged into a sewer and the local sewer authority to furnish the County Council with such information as it may require. (iv) All local authorities and the County Council to be enabled to direct that the discharge of trade effluents into sewers shall be subject to conditions relating to the provision of apparatus to record the volume and rate of discharge and the nature and composition of the effluent, and to impose other conditions where appropriate. The City Council in November, 1961, decided to support the proposals by the Standing Joint Committee that the County Council should include clauses on the foregoing lines in the next General Powers Bill. A Register of all premises in Westminster from which trade effluent is discharged into a sewer, is kept in the Public Health Department. Sewerage and Sewage Disposal The trunk sewers and sewage disposal in London are the responsibility of the London County Council; the local sewers, which discharge into the trunk sewers, are the responsibility of the City Council. All premises in Westminster are connected to the main drainage system, the sewage passing to disposal works maintained by the London County Council outside the City. The arrangements for Westminster would appear to be adequate; in 1961 there were no occasions on which heavy storms caused the sewers in the City to become surcharged and cause flooding. 61 Public Health (London) Act, 1936 London County Council (Drainage) Byelaws, 1934 Drainage Drainage plans submitted 489 Combined drainage orders made 36 Prevention of Damage by Pests Act, 1949 Rats and Mice Repression Complaints received 754 Treatments undertaken 838 Inspections by Public Health Inspectors and Rodent Officer 2,630 Notices served — Rodents destroyed Black Rats 766 Brown rats 3,329 Mice 5,293 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; one licence was issued for the use of premises for storage purposes. Noise Nuisance Complaints received 80 Investigations made 134 Notices served 1 During 1961 complaints were received of noise caused by the following: pneumatic drills and compressors, building and demolition works, power machines, printing works, refrigeration and air-conditioning plant, hammering, sawing and banging, cranes, trollies with metal wheels, traffic, milk carts and floats, dustmen, cleaners, radios, juke boxes, loudspeakers, fire alarm, boys playing football, and piano playing and singing in early hours of the morning. 62 Powers to deal with noise nuisance are contained in the Public Health (London) Act, 1936, the London County Council (General Powers) Act, 1937, the Noise Abatement Act, 1960, and byelaws relating to Good Rule and Government. Previously some of these powers had been delegated by the Council to the Public Health Committee and some to the General Purposes Committee. During 1961 it was agreed that, to facilitate investigation and enforcement of remedies, and to simplify administration, all the Council's powers relating to the abatement of noise should be delegated to the Public Health Committee. In a built-up area, large-scale demolition and building operations, such as those being undertaken at several sites in Westminster, must inevitably result in noise and annoyance being caused to residents of neighbouring dwellings, offices and shops. Although it was not necessary for statutory action to be taken during 1961 in regard to these matters, there were several occasions on which strong warnings had to be given to contractors, reminding them of their duty to carry out their operations with the minimum amount of noise and annoyance consistent with their activities. One notice was served during 1961 under the Noise Abatement Act, 1960, in respect of noise and vibration caused by machinery at a bakery in Soho. Dust Nuisances London County Council (General Powers) Act, 1960 Under Section 14 of the London County Council (General Powers) Act, 1960, the provisions of Section 82 of the Public Health (London) Act, 1936 (which prescribes nuisances which may be dealt with summarily) are extended to include "any dust or other airborne particles caused by any trade business process or manufacture and being a nuisance or injurious or dangerous to health." It is a defence in any proceedings that having regard to cost and to local conditions and circumstances, the best practicable means have been taken for preventing or for counteracting the effect of such dust or airborne particles. A sanitary authority may not institute proceedings under the above Act without the consent of the Minister of Housing and Local Government if proceedings could be taken under the Alkali, etc., Works Regulation Act, 1906. During the year it was not necessary for any notices to be served under Section 14 of the above Act. In Westminster, the London County Council Byelaw, No. 2671, relating to dust nuisance from the demolition of buildings, is administered by the City Engineer. During the year notifications concerning this type of nuisance were forwarded to him on several occasions and the necessary action was taken by his department. 63 Grit and Dust Arresting Plant at Power Stations In March, 1961, notification was received from the Metropolitan Boroughs' Standing Joint Committee that, at the suggestion of the St. Marylebone Borough Council, representations had been made to the Minister of Housing and Local Government that if old power stations were to be kept in operation they should be equipped with modern smoke and grit arresting plant. In reply, the Ministry referred to the recommendation of the Committee on Air Pollution that there should be a definite date, say 1964, after which no power station should be allowed to operate with obsolete and inadequate grit and dust arresting plant except in emergency conditions. The Ministry stated that it remains the objective of the Alkali Inspectorate to secure the implementation of this recommendation and added that it would be wasteful to instal grit and dust arresting plant at stations which are being used to a decreasing extent and are likely soon to be shut down completely, except in emergency. On consideration by the Metropolitan Boroughs' Standing Joint Committee, the view was expressed that the difficulties of the situation were appreciated, but the matter would be kept under review as the presence of old power stations is far from helpful in efforts which are being made to secure clean air for London. 64 Battersea Power Station In my Annual Report for 1960 I mentioned that representations had been made by the City Council, the London County Council and the Battersea, Chelsea and Kensington Borough Councils to the Minister of Power regarding the failure of the Central Electricity Generating Board to ensure strict compliance with the conditions which had been imposed by the Minister upon the operation of the Battersea Power Station, requiring the washing of the chimney gases emitted from the station. In his reply, the Minister suggested that it would be helpful if representatives of the City Council and of the other Councils concerned could see the power station in operation. It was also stated that the Generating Board had given an assurance that it would in future plan the periodic overhauls in such a way that the output of the station would be limited to the capacity of the remaining gas washing plants. The Board pointed out, however, that if the gas washing plant were to break down at a time of high demand on the grid system, or if there were an emergency which would jeopardise the grid or local supplies if generation were curtailed, it might be necessary temporarily to operate the station without using the gas washing plant. Accordingly, the visit to the station took place on 12th July, 1961, when representatives of the Councils concerned were conducted over the station, the operations being explained in detail, and a number of questions, of which prior notice had been given, were answered comprehensively and willingly. An assurance was given by the Station Superintendent that every facility would be given to the Council's Officers to inspect from time to time the operational records, including notes about gas washing, on the understanding that the information thus obtained would not be released for general publication; a similar undertaking was given with regard to information obtained from the City Council's recording apparatus, which might be disclosed to the Station Superintendent. Arrangements have been made for the two sets of records to be compared regularly but it is clear that ample time must elapse before any definite conclusions can be drawn about the sources of pollution of the atmosphere. 65 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 1961 Mayfair. Pimlico. Charing Cross. Insol. Sol. Total. Insol. Sol. Total. Insol. Sol. Total. January 12.68 1187 24.55 25.77 11.44 37.21 4056 13.71 54.27 February 12.62 1026 2288 1846 866 27.12 2589 12.61 3850 March 9.95 9.89 19.84 No figures due to negligible rainfall April 1340 6.24 1964 1953 8.36 27.89 20.74 1089 31.63 May 1398 12.72 26.70 14.93 12.42 27.35 13.44 979 2323 June 6.85 11.83 18.68 9.73 9.53 1926 9.53 8.72 18.25 July 8.69 18.69 27.38 11.58 11.14 22.72 11.11 15.50 26.61 August 6.64 5.08 11.72 9.73 7.25 16.98 10.22 5.71 15.93 September 8.08 8.59 16.67 10.57 9.97 20.54 12.11 10.49 22.60 October 11.35 15.17 26.52 10.97 15.40 2637 1859 18.72 3731 November 9.61 11.94 21.55 12.48 14.50 26.98 19.18 1424 33.42 December 12.38 18.00 30.38 16.91 24.93 41.84 20.18 25.09 45.27 66 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. 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 4.02 4.03 5.39 February 3.74 3.62 6.12 March 3.15 5.36 547 April 3.06 2.99 3.64 May 2.62 3.11 2.98 June 2.66 2.98 2.88 July 2.79 3.20 3.10 August 3.13 4. 32 3.61 September 3.41 5.46 3.90 October 3.70 5.69 416 November 5.00 8.06 5.48 December 4.45 6.92 5. 39 Estimate of sulphur content by the volumetric method In 1929, the City Council was apprehensive of the possible danger to public health by the pollution of atmosphere likely to arise from the emission of flue gases from the large power stations which were to be erected in close proximity to the south western boundaries of the City — namely Battersea and Fulham. Accordingly, in 1930, an atmospheric pollution measuring apparatus was installed in Westminster, and the results obtained have been regularly reported to the Public Health Committee since that date. In 1960 the City Council felt that it would be useful if additional information were obtained concerning the pollution of the atmosphere, particularly in the Pimlico area. A further atmospheric pollution measuring apparatus was, therefore, purchased and installed in April, 1960, on the top of a block of flats in Churchill Gardens. 67 The results obtained from the two sites are as follows:— Month S02 parts per million Daily Average Monck Street Churchill Gardens January •103 •100 February •078 •090 March •121 •116 April •086 •088 S02 micrograms per cub. metre May 143 143 June 114 114 July 114 143 August 90 117 September 188 248 October 216 253 November 368 373 December 511 544 Smoke Average readings from apparatus sited at Monck Street, and Churchill Gardens. 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 Monck Churchill Street Gardens January 14.2 15.2 February 10.0 10.3 March 13.0 15.1 micrograms per cub. metre April 39.0 75.8 May 17.0 45.0 June 17.0 47.0 July 19.0 37.0 August 23.0 34.0 September 53.0 610 October 87.0 73.0 November 138.0 162.6 December 188.3 353.0 68 Smoke Abatement—Results of Observations and Action Taken 1956 1957 1958 1959 1960 Complaints received 87 41 67 58 53 41 Observations made 2,634 1,603 625 497 897 572 Notices issued— Preliminary 23 6 — 1 3 — 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 orders, faster progress would 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. Accordingly, the City Council at its meeting on 30th April, 1959, approved a programme which provides for the whole of Westminster to be covered by operative smoke control orders by 1st October, 1965. Fire Smoke Control Orders are now in operation in Westminster, covering some 759 acres of the City; four further Orders covering 906 acres, have been made and confirmed by the Minister of Housing and Local Government, and will come into operation during 1962. Details of the approved programme, and a map of the proposed Areas are set out on page 70 of this report. In order to implement this programme, two Technical Assistants were appointed to the staff of the Public Health Department, to assist in the routine survey of premises. The success of the programme will depend on the ability of local builders to undertake in a relatively short time the necessary conversions of fireplaces and ancillary works; and subsequently on the availability of 69 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. 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. The Council is empowered, in certain cases, to pay the full cost of conversion. 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.). Mechanically stoked furnaces capable of working as smokelessly as those exempted by the Order, but which were installed before 31st December, 1956, can also be exempted individually on similar conditions. London Building (Constructional) Amending Byelaw, 1960 During 1960 the London County Council byelaw under the London Building Act (Amendment) Act, 1935, and the Clean Air Act, 1956, came into operation and requires that every new building shall 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. 70 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 oilfired 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. Smoke Control Areas The following information should be read in conjunction with the map on the opposite page. Green on map: Area Acres (approx.) Map reference Areas already in operation from:— 1st October, 1958 Temple Bar 60 1 1st October, 1959 Adelphi/Whitehall 190 2 1st October, 1960 Covent Garden 100 3 1st October, 1961 Soho 94 4 1st October, 1961 St. James' 315 5 Yellow on map: Areas to come into operation on— 1st October, 1962 Regent 110 6 do. Berkeley 116 7 do. Grosvenor 325 8 1st December, 1962 Knightsbridge 355 9 Pale Yellow on map: Areas under survey to come into operation on— 1st October, 1963 Abbey 94 10 do. Victoria 200 11 do. Wilton 94 12 do. Eaton 72 13 Grey on map: Future programme for smoke control areas, in operation from 1st October, 1964. Millbank 84 14 do. Cathedral 90 15 do. Warwick 48 16 do. Tachbrook 60 17 1st October, 1965 Alderney 43 18 do. Ebury 64 19 do. Dolphin 38 20 do. Churchill 48 21 STC ■TT-STT .^T &' U "&VA* , 71 Analysis of Legal Proceedings Fines Costs £ S. d. £ s. d. Food and Drugs Act, 1955. Selling to the prejudice of the purchaser food intended for but unfit for human consumption. 1 conviction 25 0 0 10 10 0 Selling food not of the substance demanded. 1 conviction 10 0 0 2 2 0 Selling food not of the quality demanded. 5 convictions 90 0 0 35 14 0 Food Hygiene (General) Regulations, 1960. Smoking whilst handling open food. 3 convictions 6 0 0 10 6 Insanitary premises and equipment. 26 convictions 191 0 0 47 5 0 Food not adequately protected from risk of contamination. 1 conviction 4 0 0 6 0 0 Totals £326 0 0 £102 1 6 Water The resident population of 85,223 in some 30,200 dwellings receive water from the Metropolitan Water Board's mains or from deep wells. At 31st December, 1961, eighty-four deep wells were in use. From eighty-one of these wells the water is used for domestic purposes. Of the remainder, one supply is used for cooling purposes, one for stand-by in case of fire and one for supplying boilers. During the year 169 samples of water from wells in the City were submitted for examination; satisfactory reports were received of 116 bacteriological examinations and 53 chemical analyses. 72 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 heated, filtered and chlorinated 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. Fully automatic chlorine residual controllers and recorders, which adjust the chlorine content of the water to the requirements of the bathing load, are in use at both the Buckingham Palace Road and Marshall Street Baths and were the first of their kind to be used in any public baths in Great Britain. An independent firm of analytical chemists takes samples (without notice) of water from the swimming pools each fortnight and the bacteriological examinations show that the water is maintained to a high standard of bacterial purity and is in every respect suitable for swimming purposes. 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 turnover of four hours. Ozone treatment plant is also available. An independent firm of analytical chemists and bacteriologists takes 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. 73 Disinfection, Disinfestation and Cleansing of PersonsArrangements 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 Disinftction 142 50,646 436 92 Disinfestation 530 4,290 — — Cleansing of Persons Treatments Scabies Head Lice Body Lice Men 23 — 525 Women — 1 8 Children 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. 74 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 37 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 17 Relatives or friends of the deceased 9 Hospitals in the City 11 Coroner's Court and Mortuary During 1961, 286 bodies were received in the Mortuary on Coroner's Warrants, etc. Two bodies were admitted to await burial. Number of Cases Inquest cases 64 Non-inquest cases 222 Post-mortem examinations held 277 Causes of death in the foregoing were as under:— Accidental drowning 1 Found drowned 3 Suicide by drowning 6 ,, by other means 14 Accidents- Street 2 Domestic 8 Others 12 Natural causes 223 Misadventure 2 Murder 1 Miscellaneous causes 14 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 1961. 75 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 572 21 — — (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 1,747 254 5 — (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 76 — — — Total 2,395 275 5 — 76 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 (1) (2) (3) (4) (5) (6) Want of cleanliness (S.I) 4 4 — 3 — Overcrowding (S.2) — — — — — Unreasonable temperature (s.3) — — — — — Inadequate ventilation (S.4) — — — — — Ineffective drainage of floors (s.6) — — — — — Sanitary Conveniences (S.7) (a) Insufficient 3 3 — — — (6) Unsuitable or defective 15 14 — 7 — . (c) Not separate for sexes — — — — — Other offences against the Act (not including offences relating to Out-work) 1 1 1 ___ Total 23 - 22 — 11 — 77 APPENDIX II Part VIII of the Act (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., 2,626 — — — — — Cleaning and washing — — — — — — Household linen 6 — — — — — Lace, lace curtains and nets — — — — — — Curtains and furniture hangings 8 — — — — — Furniture and upholstery — — — — — — Electro-plate — — — — — — File making — — — — — — Brass and brass articles — — — — — — Fur pulling 23 — — — — — Iron and steel cables and chains — — — — — — Iron and steel anchors and grapnels — — — — — — Cart gear — — — — — — Locks, latches and keys — — — — — — Umbrellas, etc — — — — — — Artificial flowers 6 — — — — — 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. Stuffed toys z z z z Basket making — — — — — — Chocolates and sweetmeats — — — — — Cosaques,Christmas stockings etc. — — — — — — Textile weaving — — — — — — Lampshades — — — — — — Total 2,669 — — — — —