4344 mit Library WES 72 Cltv of Westminster REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1962 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 high wycombe Cits of Westminster REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1962 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 (m i d d x.) a n d highwyoombe CONTENTS Page Aged and Infirm—Care of 33 Area of the City 15 Assessment of Housing priorities on medical grounds 43 Atmospheric Pollution 69 Bacteriological Examinations 26 Basement Bakehouses 49 Bathing facilities for old people 35 Births 15 Births, Infant Deaths and Mortality Rates 17 Bodies, transportation of Abroad 82 British Red Cross Society 30 Burial or Cremation of the Dead 82 Catering establishments 50 Certificates of Disrepair 42 Clean Air Act 1956 74 Cleansing of bed linen of elderly and infirm persons 35 Cleansing of Persons 82 Clearance Areas 44 Club Registration Certificates 61 Common Lodging Houses 43 Coroner's Court and Mortuary 83 Day Club for Handicapped old people 29 Deaths 18 Disinfection and Disinfestation 82 Disposal of unsound food 58 Drainage 66 Dust nuisances 68 Dwelling Houses 38 Emergency Fuel Supply Service—old People 35 Export Certificates 63 Factories Act 1937 49 Factories, Workplaces, Shops and other Premises 47 Factories, Defects and Nuisances 48 Flooding, Building liable to 65 Fluoridation of Water 78 Food, Frozen and pre-packed 57 „ Inspection and Supervision 49 „ Legal Proceedings 78 „ Poisoning 56 „ Sampling 52 „ Shops and Premises 51 „ Unsound 58 Food and Drugs Act 1955 49,58 Frozen and Pre-packed foods 57 Furnaces, installation of 74 Page Handicapped old people, Day Club 29 Health Education 35 Holbom Borough Council, Mortuary Accommodation for 84 House Purchase and Housing Act, 1959 42 Houses in multiple occupation 44 Houses, number of 15 Housing Act, 1961 42,44 Housing (Financial Provisions) Act, 1958 42 Housing Statistics 39 Ice Cream 58, 59 Ice Lollies 60 Infant Mortality 16 Infectious Diseases 20 Infectious Diseases—compensation for stopping employment 25 Infectious Diseases—Notifications 22 International Certificates of Vaccination and Inoculation 24 Introduction 7 Invalid Meals Service 32 Justices' Licences 61 Land Charges Act 1955 42 Legal Proceedings 78 London Building (Constructional) Amending Byelaws 1960 66 London County Council Divisional Health Committee. Division No. 2 11 London County Council Drainage Byelaws 66 London County Council (General Powers) Act 1955 46 London County Council (General Powers) Act 1960 68 London County Council (General Powers) Act 1962 64 Luncheon Clubs 31 Mass X-Ray Service 27 Maternal Mortality 15 Means of escape in case of fire 46 Measles 22 Milk and Dairies (General) Regulations 1959 57 Milk and Dairies (Preservatives) Regulations 1962 63 Milk (Special Designation) Regulations 1960 57 Milk Examinations 58 Milk Licences 57 Mobile Library Service for old people 34 Mobile Meals Service ("Meals on Wheels") 30 Mortuary Accommodation 84 National Assistance Act 1948 (Amendment) Act 1962 80 Neonatal Mortality 15 Noise Abatement Act 1960 67 Notices 38, 48, 50, 51 „ Statutory 38 Notifications of Infectious Diseases 22 Nuisances 39, 48, 50, 67 „ Noise 67 Offices, Workplaces, Shops, etc 47 Oil fired furnaces 73 Oil Heaters 37 Outworkers 49 Overcrowding 42 Page Paratyphoid fever 23 Perinatal Mortality 15 Pet Animals Act, 1951 81 Pharmacy and Poisons Act 1933 81 Poliomyelitis 22 Pollution from oil fired furnaces 73 Pollution from vehicles 73 Population 15 Preservatives in Food Regulations 1962 62 Preserved Food Premises 58 Prevention of Damage by Pests Act 1949 66 Private Deep Wells 78 Public Health Committee 11 Public Health Department Staff 12 Public Health Laboratory—Specimens submitted to 26 Public Health (London) Act 1936 46, 66 Public Swimming Baths 80 Puerperal Pyrexia 23 Rag Flock and other Filling Materials Act 1951 67 Rateable Value 15 Rats and Mice Repression 66 Rent Act 1957 42 Rodents Destroyed 66 Samples, Food 52 Sanitary Circumstances 38 Sanitary conveniences, provision at Inns, etc. 63 Sequential Smoke Sampling 72 Sewers, Discharge into of trade effluents 64 Sewerage and Sewage Disposal 66 Slaughterman's Licences 81 Slum Clearance 43 Smallpox 24 Smoke Abatement 72, 74 Smoke Control Areas 77 Smoke Control Areas Map Facing page 77 Smoke Control (Exempted Fireplaces) Order 1959 75 Smoking and Health 36 Southwark Borough Council—Mortuary Accommodation for 84 Specimens submitted to Public Health Laboratory 26 Staff of the Public Health Department 12 Statistics and Social Conditions 15 Swimming Baths 80 Trade effluents—discharge into sewers 64 Tuberculosis 26 Typhoid Fever 23 Unsound Food 58 Water 78 Weights and Measures Bill 59 Welfare of Old Persons 28 Wells 78 Westminster Old People's Welfare Association 28 Workplaces, Shops, etc. 47 (14489) a2 7 City of Westminister Public Health Department, Telephone: Trafalgar 7070 Alhambra House, 31, Charing Cross Road, W.C.2. To The Bight 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 1962. An examination of the vital statistics set out on page 15 reveals several changes compared with last year. All the Rates are higher, with the exception of that relating to deaths of illegitimate infants. Reference to the analysis of Births, Infant Deaths and Mortality Rates, set out on page 17 shows that the mortality rates for 1962 in respect of All Infants, and Legitimate Infants, are the highest for seven years. Why this should be so is not easy to understand but it must be remembered that the numbers from which the rates are computed are relatively small, so that fluctuations are bound to occur from year to year, and the increases which have occurred in the last two years may not represent a continuing trend. I have again included in the Report 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. Fortunately, there was no maternal death during 1962, nor were there any serious outbreaks of infectious disease in Westminster. In my Annual Report for 1961 I drew attention to the continued need for vaccination against smallpox as a preventive measure in these days of high-speed travel between countries. This point was brought vividly to the fore at the end of 1961 and the early months of 1962, when a case of smallpox, imported from Pakistan where an epidemic existed, occurred (14489) a3 8 in St. Pancras, and subsequently others in Woolwich and elsewhere in the country. Direct contacts of these cases resided, worked or visited addresses in Westminster, and all had to be kept under close surveillance for the required period. Fortunately, no secondary cases occurred, although there were some anxious moments. The number of illegitimate births in 1962 again shows a disquieting increase. Expressed as a percentage of the total number of live births, this amounted to 15.74, compared with 12.16 in the previous year. Seven years ago, in 1956, illegitimate births in Westminster amounted to 9.78 per cent, of the total live births. Various factors have contributed to the continued rise during the past seven years. As the County Medical Officer of Health has already said, the vastness of London provides a welcoming cloak of anonymity for women and young girls, many of whom are already pregnant on arrival in London. Good antenatal care and help from moral welfare organisations are readily forthcoming; this is to be commended and is possibly reflected in the lower illegitimate infant death rate recorded this year. A further disturbing factor, linked with the current decline in moral standards, is the increasing number of cases of venereal diseases. Up to the time of the second world war, the incidence of venereal disease in this country had steadily declined. During the war, as is usual in such times, the number of cases rose considerably, but subsequently diminished until about 1955. Since then there has been a continued yearly increase in new cases. Venereal diseases are not notifiable and the only statistical information relating to London is that provided in the Annual Report of the Medical Officer of Health of the London County Council. From this it has been ascertained that the number of new cases of venereal disease treated at out-patient clinics in the London area rose from 8,481 in 1955 to 18,156 in 1961. Of 105 countries which made returns to the World Health Organisation last year, 76 recorded a significant increase in the incidence of venereal disease. The problem is not, therefore confined to this country alone. This is a major, growing and serious problem, and it is to be hoped that new suggestions for bringing the disease under control will result from the study now being undertaken by the British Medical Association. The welfare of old people has again received much attention and support from the Health Department. The Day Club for Handicapped Old People, opened by the Westminster Old People's Welfare Association in 1961, has continued to flourish, and has brought much happiness to some handicapped old people who would otherwise be confined to their own homes. As a result of the wind of change blowing in Africa it has been possible to recruit to the staff several public health inspectors returning to this 9 country. This, added to the improved salary scales approved by the City Council in April, 1962, made it possible during the year not only to fill vacancies which had existed for several years but also to fill two posts which were added to the establishment in connection with the survey of houses in multiple occupation. Although some posts remained vacant for the majority of the year, by December, 1962, the public health inspectorate was at full strength for the first time since 1956. This improved state of affairs has naturally resulted in an increase in the number of inspections undertaken during the year and these are recorded throughout the Report. These new inspectors are all widely experienced officers and now that they have come to work in London it is to be hoped that they will settle down happily in the service of the City Council. In April, 1960, in an endeavour to overcome the shortage of public health inspectors which existed at that time, the City Council authorised the employment of three assistants in the Department, who held appropriate qualifications in building, plumbing, food or allied trades, to help with certain aspects of the routine work of the inspectors. This proved very successful, and the officers appointed gave good service to the Council. In 1962, however, as a result of the improved recruiting position mentioned above, these three posts were deleted from the establishment. All the occupants of these posts held the necessary preliminary qualifications and wished to become public health inspectors; they were accordingly placed in vacancies which existed for student public health inspectors. The Council's training programme for student public health inspectors continues to operate satisfactorily. During 1962, two students qualified and were appointed to posts in the Department. At the present time, four students are under training; this number will increase to five in September, 1963 the maximum number of students which, under the regulations of the Public Health Inspectors Education Board, can be accepted by the existing staff of qualified inspectors. It is only by this long-term policy of training, adopted by this Council and other authorities, that the present nation-wide shortage of inspectors will be overcome. In 1962 a total of 4,507 inspections were made of catering premises in Westminster. The City Council has a special responsibility to ensure that good standards are maintained in restaurants and other catering establishments in Westminster, where thousands of meals are served each day, mainly to non-residents, including the many visitors and tourists, who come for business, shopping and amusement. It is important that the food consumed should be wholesome, the premises satisfactory, and hygiene and sanitation of the highest order. Westminster is also the place of work of many thousands of persons living in and around London. The proposed Offices, Shops, etc., Bill, at present before Parliament, will place an additional burden on the 10 staff of the Health Department in carrying out the inspections which will be required to bring about, where necessary, improvements in working conditions. In April, 1963, the establishment of the Health Department was further increased by four posts of public health inspector, who will be necessary to undertake this additional work. Good progress is being made in connection with the Council's programme for smoke control orders. This programme provides for the whole of Westminster to be smokeless by the autumn of 1965, but an endeavour is being made to hasten the work with a view to its completion by 1964. Opportunity has again been taken this year to include in this Report a map (facing page 77) showing parts of the City where Smoke Control Orders are in force and the proposals for the future. The number of complaints of noise received again increased in 1962, totalling 86, compared with 80 in 1961. A substantial amount of this annoyance results from thoughtlessness on the part of persons arriving at, and leaving, clubs and other places of entertainment late at night, who do not appear to appreciate the hardship which their noisy behaviour can cause to neighbouring residents. The noise resulting from large-scale demolition and building works also caused much annoyance to those living and working nearby. While some of this noise is unavoidable, much can be prevented and especially that caused by building workers who often handle materials carelessly without realising the nuisance they are creating. Each complaint was carefully investigated and fortunately in the majority of cases it was possible to secure co-operation in reducing the noise without resort to statutory action. During 1962, two long-service members of the staff of the Health Department retired: Mr. J. M. Burbridge, Senior Housing Inspector, retired in July, 1962, after 28 years' service with the City Council, and Mr. P. Cox, clerk (Drainage) retired in September, 1962, after 23 years' service. Both these officers have given long and good service to the City Council and we wish them well in their retirement. To all the other members of the staff of the Health Department I express my sincere thanks 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 1962, and for the support and help which has been forthcoming at all times. J. H. Briscoe-Smith, Medical Officer of Health July, 1963 11 PUBLIC HEALTH COMMITTEE The Mayor (ex-officio): Councillor P. A. Negretti, J.P. The Deputy Mayor (ex-officio): Councillor J. L. C. Dribbell Chairman: Councillor Dr. Brian Warren, L.C.C. Vice-Chairman: Councillor Dr. T. Anwyl-Davies, F.R.C.P. Members : Alderman C. J. Citron. ,, Miss P. C. Paton Walsh. Councillor T. Stirling Boyd. ,, Mrs. P. C. Butchers. ,, W. B. Clowes. ,, The Countess of Dartmouth, L.C.C. ,, R. L. Everest, F.R.I.C.S., F.I.Arb. „ Lady Hulbert, M.B., J.P. ,, L. E. Johnson. „ R. V. Mares. ,, Miss E. A. Marsh. ,, A. Sciver, B.Sc.(Lond.), F.R.I.C. ,, L. F. Squires. ,, K. J. Taylor. 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 Mrs. P. C. Butchers and Dr. Brian Warren. 12 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. 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 (Senior Public Health Inspector -District). B. J. Dawson. H. J. Felstead. F. A. Freeman. I). Landeg (to 28.2.62). P. A. Lloyd, O.B.E. F. E. Siddle (Inspector with special duties relating to Rodent Control and Disinfestation). R. Scott (from 2.4.62). W. G. Stivey. 13 Housing: J. M. Burbridge (Senior Public Health Inspector—Housing) (Retired 6.7.62). •T. W. Baxter (Senior Public Health Inspector—Housing), (from 7.7.62). J. E. Drake (from 20.12.62). G. E. Clayton-Turner (from 19.7.62). B. Emmerson (from 12.3.62 to 4.11.62). L. Lewis (from 17.12.62). R. J. W. Plummer (from 19.7.62). A. J. Shields (from 20.8.62 to 13.12.62). Food and Catering Establishments: R. E. Stubbs (Senior Public Health Inspector—Eood). W. H. Dunstan. S. Firsht. S. Shave. Atmospheric, Pollution: W. .T. Davies (Senior Public Health Inspector—Smoke). J. J. Coveney. Factories: Miss A. M. P. Telford (from 17.9.62). Technical Assistants: (Smoke Control Areas). N. H. Billing (to 11.2.62). R. H. Major. P. Syrett (from 16.4.62). Public Health Inspector Students: G. E. Clayton-Turner (to 18.7.62) II. J. W. Plummer (to 18.7.62) J. C. Bray A. Miller T. C. Moore (from 5.11.62) R. Pendreigh General Assistants to Public Health Inspectors: A. Jones A. Murkin. (14489) a4 14 Clerical Staff W. H. Smith (Senior Clerk) Miss S. Atkins (from 6.2.62 to 4.11.62). W. F. C. King. R. L. Booker. Miss K. Lee. Miss B. Cleasby. D. Levitton. A. H. Cole. L. J. Nunn. P. Cox (Retired 30.9.62). Miss I. Oliver. Miss S. A. Critchlow (from 3.12.62). J. M. Shotbolt. B. Davies. B. Sheridan. R. W. Easton. W. E. F. Simmons. Miss C. Gannon (to 3.6.62). E. A. Taylor. R. W. F. Jenkins (from 16.7.62). Coroner's Court and Mortuary. Superintendent: A. W. Nicholls. lst Mortician: W. H. Wilshire. Mortuary Assistants: A. Munro (to 30.9.62). H. Banford (from 16.4.62). H. Barker (from 22.10.62). Cleaner: Mrs. E. Williamson. Rodent Control. Rodent Officer: J. W. Brown. Foreman: W. Weems. Rodent Operatives: T. Izzard. G. E. Killgallon (from 19.2.62). G. Murray. C. Ralph. R. West (from 22.10.62). 15 STATISTICS AND SOCIAL CONDITIONS Area (acres) 2,503.9 Population (Registrar General's Estimate, mid-year, 1962) 86,110 Population, Census, 1961 85,735 Number of private dwellings (Census, 1961) 30,801 Rateable Value (at 1st April, 1962) £22,247,725 Birth rate per 1,000 of the estimated resident population 12.32 Area Comparability Factor Births: 0.84 Birth rate (adjusted) 10.35 (Rate for England and Wales, 18.0) Number of stillbirths (males, 9; females, 13) 22 Rate of stillbirths per 1,000 (live and still) births 20.31 Total live and stillbirths 1,083 Illegitimate live births per cent. of total live births 15.74 Deaths Net deaths (males 551; females, 485) 1,036 Death-rate per 1,000 of the estimated resident population 12.03 Area Comparability Factor—Deaths: 0.98 Death rate (adjusted) 11.78 (Rate for England and Wales, 11.9) Deaths arising from pregnancy, childbirth, abortion Nil Rate per 1,000 total (live and still) births - Deaths of infants under 1 year (males, 17; females, 9) 26 Death-rate of infants under 1 year- All infants per 1,000 live births 24.50 Legitimate infants per 1,000 legitimate live births 22.37 Illegitimate infants per 1,000 illegitimate live births 35.93 Neo-natal mortality rate (deaths under 4 weeks per 1,000 total live births) 17.90 Early neo-natal mortality rate (deaths under 1 week per 1,000 total live births) 16.02 Perinatal mortality rate (stillbirths plus deaths under 1 week per 1,000 total live and stillbirths) 36.01 (14489) a5 Births Live Births (registered)- Total. Males. Females.[.###] Legitimate 894 486 408 Illegitimate 167 86 81 1,061 572 489 Infant Mortality Analysis of Infant Deaths, 1962 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 3 — — — 3 — — — — 3 Acute Pneumonia — — — — — 1 — — — 1 Broncho-pneumonia — — — — — — 1 — — 1 Congenital Malformations 1 2 — — 3 2 — — — 5 Intracranial Haemorrhage 1 — — — 1 — — — — 1 Prematurity. 6 — — — 6 — — — — 6 Rhesus Incompatibility 1 — — — 1 — — — — 1 Illegitimate Accidental 1 — — — 1 — — — — 1 Atelectasis 1 — — — 1 — — — — 1 Prematurity. 3 — — — 3 1 — — — 4 Totals 17 2 — — 19 4 2 1 — 26 16 Births, Infant Deaths and Mortality Kates Year. All Infants. Legitimate. Illegitimate. Total Births. Deaths. Mortality Rate. Births. Deaths. Mortality Kate. Births. Deaths. Mortality Rate. 1962 1,061 26 24.50 894 20 22.37 167 6 35.93 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 18 Deaths, 1962 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. 551 17 2 3 6 33 173 153 164 F. 485 9 - 2 2 17 103 136 216 Grand. Totals 1,036 26 2 5 8 50 276 289 380 Tuberculosis, Respiratory M. 9 — — — —. —. 4 1 4 F. 5 - - - - - 2 1 2 Tuberculosis, Other M. 1 - - - - - - - 1 F. - - - - - - - - - Syphilitic Disease M. 1 - - - - - 1 — - F. 3 - - - - - - 1 2 Diphtheria M. - - - - - - - - - F. - - - - - - - - - Whooping Cough M. - - - - - - - - - F. - - - - - - - - - Meningococcal Infections M. - - - - - - - - - F. - - - - - - - - - Acute Poliomyelitis M. .— — — — — — — — - F. - - - - - - - - — Measles M. 1 — — 1 — — — — - F. - - - - - - - - — Other Infective and Parasitic Diseases M. 2 — — — — 1 1 — - F. — - - - - - - - - Malignant Neoplasm, Stomach M. 11 - - - - - 7 3 1 F. 11 — .— — — — 3 5 3 Malignant Neoplasm, Lung, Bronchus M. 49 - - - - - 23 19 7 F. 18 - - - - - 9 4 5 Malignant Neoplasm, Breast M. 1 — — — — — 1 — - F. 31 — — — — 2 16 6 - Malignant Neoplasm, Uterus F. 3 - - - - - 1 2 - Other Malignant and Lymphatic Neoplasms M. 59 — 2 — 2 9 15 16 15 F. 50 — — 1 — 2 14 20 13 Leukaemia, Aleukaemia M. - - - - - - - - - F. 4 — — — — — 1 3 - Diabetes M. 4 — — — — 1 1 — 2 F. 3 — — — — — —. 2 1 Vascular Lesions of Nervous System M. 36 - - - - - 9 9 18 F. 53 - - - - - 9 14 30 Coronary Disease, Angina M. 129 — — — — 3 54 42 30 F 75 — — — — 2 9 23 41 10 Deaths, 1962—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- 75+ Hypertension, with Heart Disease M. 9 - - - - - 2 4 3 F. 6 - - - - - 1 2 3 Other Heart Disease M. 29 — — — — 1 4 11 13 F. 52 — — — — 1 2 14 35 Other Circulatory Disease M. 34 — — — — 1 6 9 18 F. 32 — — — — 1 5 5 21 Influenza M. - - - - - - - - - F. 5 — — — — 1 1 — 3 Pneumonia M. 25 2 — — — 1 4 9 9 F. 27 - - - - - 3 7 17 Bronchitis M. 37 — — — — 1 11 8 17 F. 13 - - - - - 2 6 5 Other Diseases of Respiratory System M. 8 - - - - - 2 4 2 F. 4 - - - - - 1 — 3 Ulcer of Stomach and Duodenum M. 3 — — — — 1 — 2 — F. 3 - - - - - 1 — 2 Gastritis, Enteritis and Diarrhoea M. 1 — — — — — 1 — — F. 1 — — — — — — — 1 Nephritis and Nephrosis M. 3 - - - - - 1 1 1 F. — — — — — — — — — Hyperplasia of Prostate M. 8 - - - - - — 1 7 Pregnancy, Childbirth, Abortion F. - - - - - - - - - Congenital Malformations M. 5 4 — — — — — 1 — F. 2 1 — — — — 1 — - Other Defined and Ill Defined Diseases M. 45 11 — 1 1 4 10 9 9 F. 46 5 — — — — 11 14 16 Motor Vehicle Accidents M. 8 — — — 1 2 3 — 2 F. 5 — — — 1 1 — 1 2 All other Accidents M. 18 — — — 1 4 7 2 4 F. 19 3 — 1 .— 2 4 6 3 Suicide M. 14 — — 1 — 4 6 2 1 F. 13 — — — 1 4 7 — 1 Homicide and Operations of War M. 1 — — — 1 — — — — F. 1 - - - - 1 - - - 20 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 Paratyphoid) Public Health (London) Act, 1936—Sections 192 and 304. Erysipelas Do. Food Poisoning Food and Drugs Act, 3955—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 Infec- L.C.C. Order dated 27.2.1912 and Public tion Health (Acute Poliomyelitis, Acute phalitis and Meningococcal Infection) Regulations, 1949. Ophthalmia Neona- L.C.C. Order dated 2.11.1910 and Public torumf Health (Ophthalmia Neonatorum) tions, 1926 to 1937. Plague Local Government Board Order, 1900. Pneumonia (Primaryand Influenza) 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. I Notifiable to the County Medical Officer of Health for London. 21 (14489) 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 (including Paratyphoid) 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. 22 Notifications of Infectious Disease Disease Notifications Removed to Hospital Diagnosis not Confirmed Diagnosis Established Diphtheria — — — — Dysentery 22 9 2 20 Encephalitis infectious) 1 1 - 1 Erysipelas 2 2 — 2 Food Poisoning 16 4 — 16 Malaria (contracted abroad) 2 2 — 2 Measles 90 9 1 89 Meningococcal Infection 2 2 — 2 Ophthalmia Neonatorum 1 1 — 1 Pneumonia— Acute Primary 3 1 — 3 Influenzal 1 — — 1 Paratyphoid Fever 3 3 — 3 Poliomyelitis— Paralytic — — — — Non-Paralytic — — — — Puerperal Pyrexia 14 13 — 14 Scabies 7 — - 7 Scarlet Fever 6 1 1 5 Typhoid Fever 2 1 — 2 Whooping Cough 6 1 — 6 Measles Measles follows a well-established pattern, reaching epidemic proportions every other year, and it is of interest to note that only ninety notifications of measles were received in 1962, compared with seven hundred and ninety-five in the previous year. Nine patients were removed to hospital, one of whom died, a boy of 6 years. Poliomyelitis For the second consecutive year, no case of poliomyelitis occurred in Westminster. The number of corrected notifications of poliomyelitis, including polio-encephalitis, for each year since 1947 is given below. 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 195S 1959 1960 1961 1962 21 16 29 13 1 10 9 4 15 7 5 1 1 1 — — 23 Immunisation against poliomyelitis began in 1956, and the number of cases of this disease in England and Wales was lower in 1962 than it had been for nearly half a century. Whilst this reflects great credit on all concerned, there is no reason for complacency. It would be dangerous now to relax the efforts that have been made to secure a high degree of protection; and every endeavour should be made to raise the number of persons, and especially of children, who are vaccinated against poliomyelitis. Paratyphoid Fever Three notifications of paratyphoid fever were received in 1962. The first related to a young woman of 24 years, who contracted the infection while touring in the Mediterranean area. She was admitted to hospital in August, 1962, on her return to London. An elderly Egyptian visiting this country in August, 1962, was investigated by his doctor because of a persistently raised temperature— paratyphoid fever was not suspected. Blood tests, however, revealed the condition and the patient was admitted to hospital for treatment. He returned to Cairo on discharge from hospital in September. The third notification was in respect of a young girl of 12 years of foreign origin who was admitted to hospital in September, 1962. It was not possible to ascertain where she had contracted the infection, but as she had only recently arrived in this country it was assumed that this had occurred during her travels in Europe. No other members of her family were affected. All three patients made a satisfactory recovery. Typhoid Fever During 1962, two cases of typhoid fever were notified. One, a man of 62 years, returned to this country in October, 1962, after travelling extensively in Europe, where it must be assumed he contracted the infection. The second notification was in respect of a young Indian woman of 31 years, travelling from Delhi, where her husband had been stationed, via Bombay to England by sea. Her illness was diagnosed on board ship as pneumonia, but by the time the family had reached London in October, typhoid fever was confirmed. No other members of the family contracted the infection. Both patients made a satisfactory recovery. Puerperal Pyrexia Fourteen notifications of puerperal pyrexia were received during 1962. All the cases but one occurred in hospitals. Of these only eight were normally resident in Westminster. (14484) a7 24 Puerperal pyrexia is defined as any febrile 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 fourteen cases notified in 1962: Cause Number of cases Urinary infection 3 Uterine infection 1 Chest infection 3 Suspected food poisoning 1 Wound infection 1 Unknown 5 In addition to the above cases, information was received concerning five 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, despite a number of cases elsewhere in the country, no case of smallpox occurred in Westminster during 1962, although on several occasions information was received in the Public Health Department concerning persons who had been in contact with 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. 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 25 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. Owing to the presence of cases of smallpox in this country early in 1962, various European countries imposed a new requirement that passengers proceeding from the United Kingdom should possess current International Certificates of Vaccination. During the months of January, February and March, 1962, 10,672 such certificates were submitted to the Westminster Health Department for authentication, throwing an additional burden on the clerical staff. Fortunately, the requirement was relaxed before the summer, and the number of certificates for authentication returned to the normal average of about 400 per month. Altogether, 16,206 certificates were authenticated during 1962, compared with 4,617 in the previous 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. Twenty of these certificates were issued during 1962, compared with 51 in the previous year. This drop in the number of certificates issued arose from the presence of cases of smallpox in this country early in 1962, when the United States immigration authorities refused to accept such certificates. 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 1962. 26 Specimens Submitted to the Public Health Laboratory Nature of Specimen Number Examined Positive Findings Nasal and Throat Swabs 125 Haemolytic streptococci 33 Monilia 2 Staphylococcus aureus 1 Pneumococci 1 Faeces 324 Shigella sonnei 23 Shigella flexneri 2a 1 Shigella flexneri type 6 2 Salmonella typhimurium 6 Salmonella brandenburg 1 Salmonella mission 1 Salmonella Liverpool 1 Salmonella bovis morbificians 1 Salmonella bredeney 19 Ova of Schistosoma mansoni 1 Ova of Trichuris trichiura 112 Ova of Hookworm 2 Bact. coli 026 2 Occult Blood 3 Urine 17 Haemolytic streptococci 1 Mouth Swab 1 Sputum 1 Tuberculosis Age Periods New Cases Deaths Pulmonary NonPulmonary Pulmonary NonPulmonary M. F. M. F. M. F. M. F. Under 5 years — — — 1 — - — — 5 to 15 years — 4 - - - - - - 15 to 25 years 6 10 — 2 — — — — 25 to 45 years 27 9 2 2 - - — — 45 to 65 years 35 6 — — 4 2 — — 65 to 75 years 6 3 — — 1 1 — — 75 and over 2 2 — — 4 2 1 — 76 34 2 5 9 5 1 — 27 New cases Source of Information Pulmonary N on-Pulmonary M. F. M. F. Primary notifications 60 25 - 4 Transfers from other areas 16 9 2 1 Non-notified deaths - - - - Posthumous notifications - - - - Mass X-Ray Service (This report was kindly supplied by the Organising Secretary of the South-West London Mass X-Ray Service). In 1962, Mobile Units of the South West London Mass X-Ray Service made 66 visits to firms and organisations in the City of Westminster, during which 26,650 persons were examined, of whom 89 were referred to Chest Clinics for further investigation. Two Colleges were visited in connection with the London County Council B.C.G. Inoculation Scheme to X-ray students who were positive reactors to the tuberculin skin tests. During July and part of August a Mass X-Ray Centre was opened at the Abbey Community Centre, Marsham Street, S.W.I, which was attended by nearly 2,000 employees from offices and organisations in the district, and also by over 2,000 members of the public. As a result of the 4,000 examinations made, seven persons were referred for further investigation. A Mass X-Ray Unit was installed for a period on the premises of three large organisations in the Victoria, Strand and Embankment districts, where 3,254 were X-rayed from their staff. Thirteen cases were sent to Chest Clinics for further examination. The same Unit later made a visit of four weeks to the Board of Trade and X-rayed 3,473 civil servants from Ministries in Whitehall, of whom four 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 1962. During the year, letters of invitation were sent to all newcomers there, and in all 513 residents were X-rayed, of whom 17 were referred to Chest Clinics and five to Chest Hospitals. Visits were also made to the Salvation Army Hostel and The Church Army Hostel in Great Peter Street. Altogether 810 hostel residents have been examined of whom 27 were referred to Chest Clinics. Final returns on all cases are not yet available, but it is known that seven infectious cases were found, and six cases were in need of out-patient treatment. 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 28 provide some protection against the hazards of lung cancer, is still in operation and some 18,000 men are attending the South West London Mass X-Ray Units. Over 50 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. Sixty visits to Westminster have been made to provide this special service, which includes those made to the Gatliff Road and Monck Street Public Cleansing Depots, to X-ray members of the the City Council's staff. Following the very successful survey of workers employed in catering establishments in Soho, which was undertaken in January to June, 1960, a further survey was carried out jointly by the Westminster Hospital Chest Clinic and the South West London Mass X-Ray Service in 1962. During a series of 15 visits made by the Mass X-Ray Unit, over 3,000 catering trade employees were X-rayed; a report on the results of this survey is being prepared for publication. During the year under review, the three Mass X-Ray Units of this service carried out 210 visits in South West London (including Westminster), and made 98,902 examinations. Three hundred and seventeen cases were referred with radiological abnormalities suggestive of clinically significant tuberculosis, and 111 were referred with radiological abnormalities suggestive of neoplasm, requiring further study. The last figures published by the Ministry of Health show that the number of new cases of tuberculosis notified, which was 49,000 in 1950, fell to 23,605 in 1960, and in the same period deaths from pulmonary tuberculosis decreased from 10,000 to 3,105. Nevertheless, while the figures for new cases and deaths remain as high as they are, it is important that the subject of tuberculosis should not be overshadowed in the public mind by spectacular diseases of greater " news value " which occur quite infrequently, and in comparison cause a regretable, but very small number of deaths. The South West London Mass X-Ray Service takes the opportunity again this year, of inviting all residents of Westminster to make full use of the facilities offered to them when a Mobile Unit is in their district. All firms and organisations are also invited to co-operate with the Mass X-Ray Service in the efforts being made to eliminate tuberculosis from shops, offices, factories and catering establishments, by the immediate notification of any known cases occurring on their premises, so that arrangements can be made for the prompt attendance of a Mass X-Ray Unit to X-ray all "Contacts at Work". 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 29 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 five clinics in Westminster or in the homes of housebound old people. The charge is 3.s. per treatment but the County Council's scheme usually enables pensioners to obtain treatment free of charge. 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 1961 the basement of one of the City Council's blocks of flats-Sherborne House, Abbots Manor—was adapted at a cost of some £4,600 for use as a Day Club and Luncheon Club for old people, operated by the Westminster Old People's Welfare Association. The Club started on 6th July, 1961, and is used as a Day Club for about 25 handicapped old people on three days per week (including the service of lunches which are cooked on the premises), and as a Luncheon Club for up to 40 persons on two days per week. (14489) a8 30 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 enables a number of disabled old persons, who were formerly confined largely to their own homes, to participate in the happy atmosphere which prevails at the Club. The admission of some of the handicapped elderly people to the Club has undoubtedly given them a new lease of life. In several instances they were brought to the Club just at a time when they were resigned to giving up their own accommodation and seeking admission in a Welfare Home because they felt they could no longer manage on their own. During the first few weeks at the Club they were quiet, and in some cases morose, but they soon began to take an active interest in their new surroundings and to participate in the Club's activities. In some cases old neighbours, not seen for many years, were re-met, and old friendships renewed. Thoughts of entering a Home were put aside. The Club has proved to be a most worthwhile venture, and it need hardly be said that a waiting list exists, both for the Day Club and the Luncheon Club. British Red Cross Society—Mobile Meals Service During 1962, 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 July, 1962, in order to take account of rising food costs, the price paid to the caterers was increased from 1s. 10d. to 2s. per meal. The price charged to the old people remained unchanged at 8d. per meal; the London County Council contributed 1s. 1d. per meal and the City Council bore the balance of 3d. per meal. As from 1st April, 1963, the London County Council subvention is being discontinued and the City Council will then assume responsibility for the whole of the balance, amounting to 1s.4d. per meal. The service is operated with three 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. 31 The provision of a third van, in July, 1960, enabled the meals service to be extended to certain areas of the City not adequately covered at that time, and in which there was a need for meals. It is pleasing to note that the provision of this third van has enabled the service to be brought to many more old people in Westminster. A total of 19,626 meals were delivered during 1962, a slight decrease on the number delivered during the previous year. This was expected, as some of the disabled old people who now take their mid-day meal at the Day Club at Sherborne House (referred to in the preceding section) were previously in receipt of meals through the Mobile Meals Service. This service is dependent on the help of a small band of willing volunteers who turn out regularly, whatever the weather, to assist in delivering meals to the old people in their homes. The invaluable service rendered by the Society and the voluntary helpers is much appreciated by all concerned. Luncheon Clubs The British Red Cross Society operate a luncheon club for the elderly, in accommodation provided by the City Council in Monck Street. The club operates on two days per week, and provides a convenient centre where elderly 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 club, where they are served by voluntary workers. As in the case of the "Meals on Wheels" service, the price paid to the caterers was increased in July, 1962, to 2s. per meal; the old people pay 8d. per meal, the London County Council paid 1s. 1d., and the City Council bore the balance of 3d. per meal. Here again, the London County Council subvention is being discontinued in April, 1963, when the City Council will become responsible for the whole of the balance, amounting to 1s. 4d. per meal. The City Council also makes a grant to the British Red Cross Society of 75 per cent. of the costs of running the Club, as well as bearing the cost of equipment. During 1962, a total of 2,520 meals were served at this Club. As mentioned previously, mid-day meals are also supplied by the Westminster Old People's Welfare Association at the Day Club at Sherborne House. During 1962, meals were provided on four days per week during the period January June, and on five days per week from July December; a total of 5,458 meals were supplied during the year. (14489) a9 32 The total number of meals supplied by all these sources to elderly people in Westminster during 1962 was therefore as follows:- Delivered by the Mobile Meals Service 19,626 Westminster Old People's Welfare Association Day Club (four/five days per week) 5,458 British Red Cross Society Luncheon Club (two days per week) 2,520 Total 27,604 Invalid Meals Service 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. The long-term solution to this problem would be the establishment of a comprehensive domiciliary meals service, which would be available, for long or short periods as need arose, to those requiring special diets, and to young invalids and convalescents, as well as to the frail elderly. Until such a comprehensive service can be provided, arrangements have been made for the existing " Meals on Wheels " service to be extended to include young persons who are sick in their own homes. National Assistance Act, 1948 (Amendment) Act, 1962 Section 31 of the National Assistance Act, 1948, empowers local authorities (including the City Council) to make contributions to the funds of any voluntary organisation whose activities consist in or include the provision of recreation or meals for old people. The National Assistance Act, 1948 (Amendment) Act, 1962 (which originated as a private Member's Bill) replaces Section 31 of the National 33 Assistance Act, 1948, by a new Section which gives local authorities wider powers, enabling them— (i) to make arrangements for providing meals and recreation for old people in their homes or elsewhere, including the employment of voluntary organisations (whose activities consist in or include the provision of such meals or recreation) as their agents for the purpose; (ii) to impose charges for any service provided under the Section, either generally or in particular cases; (iii) to assist voluntary organisations to provide meals or recreation for old people by (1) contributing to their funds; (2) permitting them to use premises belonging to the local authority on such terms as may be agreed; (3) making available furniture, vehicles or equipment (whether by way of gift, loan or otherwise) and the services of any staff who are employed by the local authority in connection with the. premises or other things which they permit the organisation to use. The Act came into force on 24th May, 1962. The Council's powers under the original provision of the 1948 Act, with regard to the making of arrangements for meals and recreation for old people, were referred to the Public Health Committee, and the City Council, at its meeting oil 26th July, 1962, agreed that these new wider powers should also be referred to that Committee. 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. Several cases of this kind were investigated by the medical officers during 1962, but in only two instances was it found necessary to resort to legal action. The first case related to an old lady of 80 years, living in extremely insanitary conditions in a flat near Covent Garden. She had been known to the Depaitment for some months, during whicli time her condition deteriorated, both mentally and physically; she became very vague and forgetful, and neglectful of her personal hygiene. She had also acquired a cat, which she refused to allow out in case it got lost, thus adding to the insanitary condition of her flat. 34 After much persuasion by the Deputy Medical Officer of Health, the old lady grudgingly agreed to accept the various services which were obtained for her. Eventually, a vacancy was obtained for her in a Welfare Home, to which she was admitted; within a few hours, however, she left and returned home. In her lucid moments she appreciated that she could no longer manage on her own, but she would not consent voluntarily to enter an old people's home, mainly on account of her cat. There was no alternative but to apply to the Court for an Order for her removal for a period of three months to a Welfare Home, which was granted. Arrangements were made for the cat to be cared for by the People's Dispensary for Sick Animals. The old lady, however, refused to give up the tenancy of her fiat; at the expiration of the three months period conditions were unchanged (except that her home had been cleaned up) and it was necessary for a further application to be made for an extension of the original Order; this was granted. After this the old lady settled down happily in the Home. In the second case, legal action was instituted, but the old lady concerned voluntarily removed herself to an old people's home in another part of the country on the day on which the case was to be heard by the Court. Fortunately, it is only occasionally necessary to invoke these legal powers which have been provided for the purpose of protecting frail old people from causing themselves unnecessary harm and suffering. 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. Two-hundred and ninety-seven such visits were made during the year. Motile 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 Wcstmin.ster 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, 35 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. Emergency Fuel Supply Service During the severe winter of 1962-63, which started with the heavy snow-fall on Boxing Day, 1962, several old people in Westminster found themselves without solid fuel supplies. An emergency scheme was, therefore, put into operation whereby 28-lb. bags of solid fuel were obtained from a coal yard in a neighbouring borough, and were delivered to the homes of old people in need. The scheme continued until the severe weather abated, and a total of 187 28-lb. bags of fuel were supplied to 73 old people. The majority of old persons paid the full basic cost of the fuel, but in some necessitous cases the cost was met from various philanthropic sources. Thanks are due to those members of the staff of the Health Department, and of the Westminster Old People's Welfare Association, who undertook this heavy work in very trying conditions. 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 which is undertaken 36 in the West End. Some success in health education has, however, been achieved during the past few years by the distribution of 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. The health education topic chosen for 1962 was that of Smoking and Health. In Circular No. 6/62, dated 12th March, 1962, the Minister of Health had drawn the attention of local authorities to the Report of the Royal College of Physicians entitled " Smoking and Health One of the recommendations contained in the Report was that there should be more education of the public, especially of school children, on the hazards of smoking in relation to health. The Minister accordingly asked local authorities to use all possible means to make the contents of the Report widely known and to bring home to the public the dangers to health of smoking, particularly cigarette smoking. Publicity material on the hazards of smoking was obtained free of charge from the Ministry of Health, and was also purchased from the Central Council for Health Education, and was distributed as widely as possible throughout Westminster. With the co-operation of other Committees of the Council, posters were displayed wherever possible at Council establishments—public conveniences, baths and wash-houses, housing estates, depots, and offices, and at the Citizens' Advice Bureaux. Posters were also sent to the Secretaries of the three Tenants' Associations, and the seven Street Associations in Westminster, with a request that they should consider bringing the matter to the attention of their members. Twentythousand bookmarks were purchased from the Central Council for Health Education and were distributed through the Council's Libraries. Supplies of leaflets were also purchased from the Chest and Heart Association, and were distributed through the Public Health Department and the Citizens' Advice Bureaux. Large advertisements, bearing the same wording as shown on the bookmarks used in the campaign, were inserted in two local newspapers for a period of two consecutive weeks. The co-operation of the Regional Hospital Boards and the Teaching Hospitals Association was sought. By arrangement, the Medical Officer of Health of the London County Council and the Education Officer of that authority undertook various measures to publicise this subject in schools and youth clubs. In addition, in order to set a good example, the members of the Public Health Committee present at its meeting on 6th June, 1962, 37 unanimously decided that they would refrain from smoking during future meetings of the Committee. It is hoped that all these activites helped to bring home to residents of Westminster, and particularly to the children, the dangers to health of smoking, particularly of cigarettes. Oil Heaters Regulations, 1962 On 10th May, 1962, the Home Office issued Circular No. 76/62 calling attention to these Regulations, made under Section 1 of the Consumer Protection Act, 1961. The Regulations, which came into force on 1st June, 1962, provide that, subject to certain exceptions, no person may sell or let on hire or hire purchase an oil heater or a component part of an oil heater not complying with certain requirements designed to prevent or reduce risk of death or personal injury, in relation to domestic space heaters which burn paraffin oil and are not designed for use with a flue. The British Standards Institute has also issued a Standard Specification (No. 3300) 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 the Regulations or the above 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 these requirements 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. In 1961, in connection with a Home Safety Campaign held in Westminster that year, opportunity was taken of including a reference to the dangers which exist from oil heater fires; an advertisement was inserted in the Westminster and Pimlico News and the West London Press dealing 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. It is proposed to repeat the distribution of these leaflets from time to time during coming winters. (A14489) a10 38 Sanitary Circumstances Duties performed by the Public Health Inspectors The following statistics relate to the work of the public health inspectors during 1962:— Dwelling Houses Reasons for initial inspections:— Inspections Complaints 621 House-to-house (by Housing Inspectors) 504 Routine 968 Infectious disease 158 Underground rooms 79 Other parts unfit for habitation 16 Housing circumstances 122 Applications for loans and grants 167 Drainage 371 Rodent control 1,011 Miscellaneous 92 4,109 Included in the above totals are:— Houses in multiple occupation 121 Council properties 297 *Aged and infirm persons 95 Common Lodging Houses 6 *A further 202 visits were made by the medical officers. 6,809 re-inspections were made following the above inspections. Notices Served Public Health (London) Act, 1936 128 London County Council (Drainage) Byelaws 2 Westminster City Council Byelaws as to Artificial Lighting of Common Staircases in Tenement Houses and Flats 1 Noise Abatement Act, 1960 1 132 Statutory Notices 4 39 Nuisances, defective and unsatisfactory conditions found:— Defective and dirty internally 25 Damp 57 Defective drainage 44 Defective roofs 27 Water Closets:— Defective or dirty 24 Insufficient 2 Water Supply:— Insufficient 1 Smells 45 Rubbish 37 Animals 12 Other Nuisances 24 Staircase lighting, tenements 2 Verminous 25 Cockroaches 9 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) 3,605 (b) Number of reinspections 6,360 (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 504 (b) Number of reinspections 443 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 11 (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 131 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 107 (A14489) all 40 3. Action under Statutory Powers during the year. A.—Proceedings under Sections 9, 10 and 12 of the Housing Act, 1957 (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil (2) Number of dwelling-houses which were rendered fit after service of formal notices— (a) By owners Nil (b) By Local Authority in default of owners Nil B.—Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 131 (2) Number of dwelling-houses in which defects were remedied after service of formal notices— (a) By owners 131 (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 Nil (2) Number of dwelling-houses in respect of which Demolition Orders were made (represented in 1961) 1 (3) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (4) Number of dwelling-houses in respect of which Closing Orders were made Nil D.—Proceedings under 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 7 (20 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 7 (16 rooms) 41 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 10 (31 rooms) (b) Number of Closing Orders made in respect of underground rooms 7 (19 rooms) (c) Number of undertakings accepted in lieu of Closing Orders in respect of underground rooms Nil (2) (a) Number of other parts of buildings represented for closure 1 (1 room) (b) Number of Closing Orders made in respect of other parts of buildings 1 (1 room) (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 10 (4) (a) Number of Closing Orders determined in respect of underground rooms 6 (14 rooms) (6) Number of Closing Orders determined in respect of other parts of buildings 1 (2 rooms) (5) (a) Number of applications made for modification of Closing Orders to permit approved use 9 (17 rooms) (b) Number of applications approved 8 (16 rooms) (6) Number of cancellations of Closing Orders (premises demolished) 2 42 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 Regulat ions made thereunder— (a) in respect of underground rooms 12 (b) in respect of other parts of buildings 92 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 4 (2) Number of cases of overcrowding relieved during the year 7 Housing (Financial Provisions) Act, 1958 House Purchase and Housing Act, 1959 Housing Act, 1961 During 1962, a total of 61 applications for loans or grants under the above Acts were received by the Council, relating to the improvement of 167 dwellings. Altogether, 528 visits were made by the public health inspectors in connection with these applications. Rent Act, 1957—Certificates of Disrepair One application for a Certificate of Disrepair was received during 1962. On receipt of the notice of the Council's intention to issue a Certificate, the owner gave an undertaking to carry out the necessary works. Subsequently, after some of the works had been completed, the owner sold the premises, which were then improved and modernised. Land Charges Act, 1925 The number of enquiries dealt with and reported upon during 1962 was 2,937, relating to 7,793 properties. The number of properties to which these enquiries related was 2,557 more than in 1961. 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. 43 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, 122 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. Six visits were made by the Public Health Inspectors to the lodging houses during the year. 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. 44 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) six unfit houses in the Soho area, and (6) two unfit houses in the Covent Garden area:— (a) Nos. 20, 21, 22 and 23, Peter Street, W.l, and 6 and 7, Green's Court, W.l (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, and that a Compulsory Purchase Order should be made for the acquisition of the properties, in accordance with the provisions of the Housing Act, 1957. On the 2nd July, 1962, the Minister of Housing and Local Government confirmed the Compulsory Purchase Order, without modification. The Minister directed the Council to make a "well-maintained" payment under powers conferred upon him by Section 60 of the Housing Act, 1957, in respect of 21, Peter Street, W.l. On the 12th October, 1961, the Council authorised the acquisition by agreement of the freehold interests in all the premises concerned and they were acquired on the 13th April, 1962, subject to a number of short leases. It only remained, therefore, for the Council to exercise its powers of compulsory purchase in respect of the leasehold interests. (b) Nos. 20 and 22, Mercer Street, W.C.2. The City Council on the 27th July, 1961, declared the above two houses to be a clearance area under Part III of the Housing Act, 1957, and, at the same time, decided to make the Westminster (Mercer Street) Clearance Order, 1961, for securing the demolition of the houses. This Order was made by the Council on the 25th September, 1961, and was confirmed on the 26th January, 1962, by the Minister of Housing and Local Government. On the 25th October, 1962, it was reported to the City Council that both houses had been demolished by the owners in compliance with the Order. Housing Act, 1961 Houses in multiple occupation This Act came into force in November, 1961, and gave 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. Part II of the Act is of particular importance to Public Health Departments as 45 it conferred upon local authorities (and concurrently upon the London County Council) new and greatly strengthened powers to deal with squalid living conditions in houses in multiple occupation, viz.:— (i) an entirely new power to apply a Code of Management to individual houses in which proper standards of management have not been observed; (ii) stronger powers to require the provision of additional facilities and amenities essential to decent living conditions, and the provision of adequate means of escape from fire; (iii) power for the local authority to carry out works itself in default, and to recover the cost incurred; and (iv) power to make a directive limiting the number of persons who may live in a house in multiple occupation. Full enforcement of these new provisions may well result in a reduction in the number of families living in a particular house, with the result that families displaced will doubtless approach the Council for rehousing. To carry out its duties under the Act, the Council decided that a comprehensive survey should be undertaken of all houses in Westminster iu multiple occupation; this necessitated strengthening the inspectorate of the Public Health Department and subsequently the establishment of the Department was increased by two posts of public health inspector. In May, 1962, the Housing (Management of Houses in Multiple Occupation) Regulations, 1962, came into operation, providing a code of management for houses in multiple occupation. The Regulations require the person managing a house to arrange for the proper 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. At its meeting on 21st June, 1962, the City Council adopted a Code of Practice (a) for securing the fitness of the premises for occupation by the number of families accommodated; and (b) for the prevention of overcrowding. This Code was produced as a result of a review of the code adopted in April, 1956, having regard to the wider powers conferred upon local authorities for securing an improvement in services and facilities in houses in multiple occupation. The City Council resolved that, unless special circumstances may justify a modification, a house or part of a house which is let in lodgings or occupied by members of more than one family, and to which Part II of the Housing Act, 1961, and Section 90 of the Housing Act, 1957, apply, shall not be regarded as reasonably suitable for occupation unless the standards set out in the Code obtain. 46 Means of escape in cave of fire The Housing Act, 1961 (section 16), contains provisions for the regulation of means of escape in case of fire in houses in multiple occupation, and requires a borough council to consult the London County Council as fire authority before issuing any notices specifying the execution of works to provide means of escape. In December, 1962, the Metropolitan Boroughs' Standing Joint Committee advised that arrangements for the administration of section 16 of the Act should be made individually by constituent councils with the County Council, on the understanding that the County Council would approve a code for use in connection with means of escape procedure, together with a simple drill for consultation by constituent councils. This procedure has been adopted in Westminster and is working satisfactorily. Progress By the end of 1962, the public health inspectors had completed a routine house-to-house survey of 115 premises in the Pimlico area of the City. Of these 115 premises, 40 were found to be in single-family occupation and a further 6 were vacant. The remaining 69 premises (comprising 289 dwellings) were in multiple occupation. Schedules of the works required were sent to the owners of 31 premises that had been fully inspected; schedules in respect of the remaining premises were held up pending the finalising of the means of escape from fire procedure mentioned above. The formidable task of surveying all houses let in lodgings, or occupied by members of more than one family, is not likely to be completed quickly; speedy results cannot be achieved as much time is having to be spent on gaining access to all httings, in order to complete the detailed inspections involved. Public Health (London) Act, 1936 London County Council (General Powers) Act, 1955 No. 6, Stanley Place, S. W.I Owing to the failure of the owner to comply with a statutory notice which had been served, requiring works to be carried out immediately to remedy certain defective conditions at these premises, the works were executed by the City Council at a cost of £331 12s. 3d. The expenditure was recovered from the owner. 47 Inspection of Factories, Workplaces, Shops, Offices and Other Premises (other than food premises) Total Number of Visits Factories—Power 225 Factories—Non-power 70 Workplaces, etc. 4,091 Offices 5,060 Shops (other than food) 848 10,294 Reasons for initial inspections:- Complaints 530 Routine 1,192 Infectious Disease 09 Drainage 526 Rodent Control 509 Sanitary Defects 1 Other Reasons 30 2,857 Re-inspections 7,437 Types of premises inspected Places of public entertainment 242 Carpentry, joinery, etc. 6 Wearing apparel 225 Furriers 22 Garages, motor tyres and rubberworks 131 Boots and shoes and other leather goods 22 Jewellers, precious and other metal-workers 27 Hairdressers 57 Laundries and dry cleaners 27 Printers and publishers 80 Warehouses and packers 41 Shops (other than food) 848 Photographers, film renters 25 Opticians 2 Florists 7 Offices 5,060 Various (schools, hospitals, halls, building sites, etc.) 3,472 10,294 48 Notices served Factories Power Factories, Nonpower Workplaces, Offices, Shops, etc. Total Public Health (London) Act, 1936 - - 28 28 Factories Act, 1961 18 10 1 29 Noise Abatement Act, 1960 — — 4 4 Shops Act, 1950 — — 1 1 18 10 34 62 Nuisances, Defective and Unsatisfactory Conditions Found Factories Power Factories Nonpower Workplaces, Offices, Shops, etc. Defective, dirty internally 4 2 1 Damp — — 8 Defective drainage — — 22 Defective roofs — — 3 Sanitary accommodation:- Insufficient — — 2 Insufficient ventilation and light 10 13 2 Defective or dirty 3 2 13 Not separate for sexes 2 2 3 Water supply:— Insufficient — — 1 Smells 1 — 54 Rubbish 1 — 19 Animals - - 2 No indicating notices on doors of water closets 3 3 1 Other nuisances — — 8 Temperature — — 1 Want of ventilation 1 2 — Cockroaches - - 9 Failure to display Abstracts from Factories Acts 5 - - 49 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 2,380 workers living in areas outside the city) 3,469 (See Appendix II to this Report.) Food and Drugs Act, 1955 Inspections of all types of food premises Reasons for initial inspections:— Complaints 336 Routine 3,227 Infectious disease 151 Drainage 112 Rodent control 145 New catering businesses 143 Miscellaneous 10 4,124 3,066 re-inspections were made following the above inspections. 50 Catering Establishments At the end of the year, particulars of 3,213 catering establishments were in the register. Summary of inspections:— Hotels, restaurants, clubs 3,750 Cafes, teashops, etc. 407 Staff Canteens 59 Public Houses 291 4,507 Notices Served Public Health (London) Act, 1936 3 Food Hygiene (General) Regulations, 1960 31 Noise Abatement Act, 1960 2 36 Nuisances, defective and unsatisfactory conditions found:— Dirty, dilapidated internally 12 Defective internally 13 Defective floors 11 Preparation tables and equipment worn and insanitary 13 Food storage accommodation inadequate and unsuitable 3 Vegetable preparation and washing-up facilities worn and insanitary 11 Ventilation insufficient 5 Staff washing facilities insufficient and unsuitable 3 Staff changing rooms insufficient and unsuitable 3 Fuel, rubbish and other extraneous materials in food preparation rooms 3 Water Closets:— Insufficient ventilation and light 1 Defective 3 Dirty and dilapidated 4 Not separate for sexes 1 Smoking in food room 1 51 Food Shops and Food Premises (Other than Catering Establishments) Types of businesses and summary of inspections:— Inspections Bakehouses (underground included) 19 Dairies and milkshops 132 Ice cream premises 162 Meat shops 345 Other meat shops (preserved food, etc.) 20 Stalls 142 Confectioners 163 Fruit and greengrocery ... 356 Provision shops 721 Fish and poultry ... 131 Fried fish shops 3 *Other Food premises 489 2,683 Included in the above totals are 113 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) Chemist's shops. (5) Visits made in connection with applications for entry on the List of Persons entitled to sell poisons included in Part IT of the Poisons List. (6) Visits of enquiry regarding adulterated samples. Notices Served Food Hygiene (General) Regulations, 1960 ... ... 11 Nuisances and defective conditions found: Dirty and dilapidated internally ... ... ... 8 Defective internally ... ... ... ... ... 5 Defective floors ... ... ... ... ... 4 Food storage accommodation inadequate and unsuitable ... ... ... ... ... ... ... 3 Water Closets:— Defective 3 Dirty and dilapidated ... ... ... ... 4 Smoking in food premises 3 52 Visits for the Purpose of Obtaining Samples and Inspecting Foodstuffs Sampling Inspection of food Confectioners 14 143 Dairies and milkshops 93 127 Fish and poultry 7 121 Fruit and greengrocery 5 476 Ice cream premises 68 192 Meat shops and stalls 1 484 Other food premises 87 285 Provision shops 116 798 Cafes, teashops, etc. 19 53 Hotels, restaurants, clubs etc. 39 148 Staff Canteens — 7 Public Houses 14 29 463 2,863 Food Sampling During the year the following 1,540 samples were submitted to the City Council's Public Analyst for chemical analysis. Of this number 73 were reported upon adversely, representing a percentage of 4.07. Ale and beer 31 Baby foods 29 Baking powder, cake, cake and pudding mix 57 Bread and biscuits 8 Butter 16 Cereals 30 Cheese 23 Chocolate and milk beverages 3 Coffee and coffee essences 17 Condiments and spices 44 Cooking fats and oils 9 Confectionery 86 Cream 18 5a Custard powder, blancmange and jellies 27 Drugs 41 Fish and fish products 40 Flavourings and colourings 13 Flour 15 Fruit canned 9 Herbs 8 Ice cream 142 Ice and ice cream lollies 44 Jams, marmalades and preserves 27 Margarine 17 Meat and meat products 21 Milk 400 Olives 4 Pickles and sauces 38 Pies 8 Pulses 4 Sausages 12 Soft drinks, syrups, fruit juices, etc. 122 Soups 11 Spaghetti, in tomato sauce 3 Spirits 59 Spreads 14 Tea 42 Vegetables tinned, etc. 26 Vinegar 4 Yoghourt 6 Miscellaneous 12 1,540 54 Samples submitted for chemical analysis, on which the Public Analyst reported adversely, included the following:— Chili sauce imported from a British Colony was found to contain 406 parts per million of benzoic acid contrary to the Preservatives, &c., in Food Regulations, 1925. The Regulations permit the presence of 250 parts per million of this preservative in this type of sauce. The importer was informed of the contravention, and arrangements were made for the immediate re-export of the commodity to the country of origin. Information was received concerning the analysis of l½lb. tin of melons in syrup. This was found to contain 505 parts per million of tin; the recommended limit is 250 parts per million. The importing Company, who have premises in Westminster, obtained three tins from a further consignment, and an analyses of these shewed a tin content of 749, 476 and 273 parts per million of tin respectively. The Port Health Authority at the port of entry placed a 'stop' order on the consignment. Tinned stewed steak imported from East Africa was, on opening by the purchaser, found to contain a beetle. The canning was on behalf of an English Company with very wide interests, and of high repute. After careful consideration of the circumstances of the case, it was decided not to institute legal proceedings. The Company assured the Council that everything possible was being done, and would continue to be done, to prevent the Company's products from falling below their normal high standard. A small piece of foreign matter which had the characteristics of black india rubber was found in a bottle of milk. The Dairy Company was prosecuted, and a conditional discharge, with £5 5s. costs to the Council, resulted. The proprietor of a restaurant stated that he had received complaints concerning imported bottled wine. Patrons had alleged the wine was bitter, unpalatable and had a general roughness. The Public Analyst expressed the opinion that the wine had been filled into a new chestnut wood barrel, and the flavour of the wine was due to tannins extracted from the chestnut. It was, however, fit for human consumption. A quantity of minced meat sold for human consumption, but fed by the complainant to his domestic pet, resulted in the animal being sick. On closer examination, the purchaser noted a pinkish tinge in the vomit, and was of opinion a dye had been added to the meat. On analysis, his suspicion proved to be well founded, for the meat had been artificially dyed with colouring matter. Under the Colouring Matter in Food Regulations, 1957, the addition of certain colourings to foodstuffs is permitted, but these foodstuffs do not include meat in a raw and unprocessed state, which is intended for human consumption. Legal proceedings were instituted and resulted in a fine of £7 being imposed, with four guineas costs. (The case was heard in 1963, and for this reason 55 is not shown in the analysis of legal proceedings which is included later in this Report.) As the result of a complaint received, bread and butter was formally sampled at a restaurant. Following purchase, chemical analysis showed the bread to have been spread with margarine. One of the joint proprietors admitted the use of margarine instead of butter when the Public Health Inspector made his statutory declaration at the time of the formal purchase. Legal proceedings resulted in a fine of £5, with £3 3s. costs against the proprietors. During the year, a number of complaints were received from members of the public alleging 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— A complainant was under the impression that buns she had purchased had been nibbled by mice. On investigation it was found that the process of tearing one bun from its 'neighbour' had given the appearance of ' nibbling '. Confectionery purchased was alleged to contain a fly. Subsequent investigation revealed the 'fly' to be a piece of burnt toffee. A bar of chocolate which subsequent investigation showed to have been manufactured nearly two years previously, was found to contain larvae of the spicier beetle. It appeared conclusive that infestation took place after leaving the distribution centre. The retailer was instructed regarding the rotation of her stock. Imported cheese from the Commonwealth was found to contain a fly. The matter was taken up with the Dairy Board of the country of origin. Resulting from this, additional precautions were introduced at the factories abroad, and in one case complete fly-proofing was immediately undertaken. Information was received that millions of pounds of cheese had been imported into this country from this particular source, all of which had been quite satisfactory. A knuckle of ham purchased from premises in Westminster was immersed by the complainant in water for cooking the same evening. Immediately, maggots rose to the surface of the water. The retail shop was visited and other hams on sale inspected. All were free from contamination, and the general standard of hygiene was satisfactory. The complainant was unwilling to participate in any further action which might have been taken by the Council, and the matter was therefore dealt with by sending a written warning to the proprietor of the shop. A further case of ham purchased from other premises and found to contain maggots when cooked the same evening was reported to the 56 Public Health Department. This case resulted in legal proceedings, and the offending company was fined £10, with five guineas costs. Legal proceedings were also taken against a firm who baked bread in which a piece of wire was discovered. A fine of £5 was imposed, with five guineas costs. Part of a meat pie, sold unwrapped, was brought to the Department with the complaint that it had a bitter taste. No conclusion could be reached as to how this had occurred, but it may have resulted from the use of a chlorine antiseptic at the retail premises, or by some similar solution at the complainant's place of employment. Food Poisoning During the year, sixteen notifications were received of persons residing in Westminster who suffered from food poisoning. Nine of these were single cases. The remaining seven were associated with three small outbreaks involving two families, and a single person who was taken ill following a meal at an hotel; in this latter case, no notifications were received in respect of the patient's three companions who also suffered minor symptoms. Apart from these formal notifications, a number of other outbreaks came to the notice of the Public Health Department and were investigated. Two outbreaks closely followed one another at the same restaurant, where the causative organism was found to be Salmonella bredeney. The significant discovery during this enquiry was that fourteen members of the staff of the restaurant concerned were unknowingly carriers of the organism. Treatment to rid the carriers of the organism extended over several months during which time the employees were excluded from work. Further outbreaks, in which this organism was discovered, occurred in London at the same time, and the vchicle of infection was found to be ham from a distribution centre (not in Westminster). Firms who received ham from this source wore all visited, and appropriate action taken. Two further small outbreaks which occurred at premises in Westminster were investigated, without conclusive results. Information was also received concerning four individuals who were excreting organisms associated with food poisoning; two were understood to have recently returned from abroad. The cases were not notified. Symptoms of food poisoning were suffered by diners following a function at a Westminster hotel. Three hundred and forty people attended the dinner, and of these it is known that fifty-two were affected. On the day following the meal, on receipt of information concerning the outbreak, an immediate investigation was undertaken at the hotel 57 by the public health inspectors. The standard of hygiene and food storage was satisfactory, and there was an absence of infectious conditions amongst the staff. Unfortunately, no food remained from the meals for examination. The illness, although fairly severe in some cases, was of short duration. Questionnaires supplied by the Public Health Department were completed by 75 of the diners; an analysis was made of the replies received but it was not possible to establish any significant differences between the dishes consumed by those who were ill and those who were not. Frozen and Prk-packed Foods It has become increasingly popular for shopkeepers to instal frozen food conservators from which frozen pre-packed foods are dispensed. In practice, foodstuffs sold in this manner receive the minimum of handling, and the customer is presented, after defrosting, with a ready-touse commodity which usually needs very little further preparation. It is, however, necessary for the retailer to give careful attention to the rotation of his stock and to the regular maintenance of the refrigeration units in use. Attention is also necessary to the stacking of the frozen food cabinet. Some tend to be overfilled with the result that the food at the top of the cabinet receives insufficient refrigeration, and in consequence can suffer early deterioration. This problem would, of course, be solved if some indicator could be incorporated in each package to show whether it had been maintained continually in a frozen condition from the time of production. No such indicator is at present available in this country but research is proceeding here and abroad and it is hoped that this will be successful. Milk and Dairies (General) Regulations, 1959 At the 31st December, 1962, the following were entered in the Council's Register of Dairies and Distributors of Milk: Distributors of milk with premises registered as dairies 6 Distributors of milk with premises not registered as dairies 130 Milk (Special Designation) Regulations, 1960 During the year fourteen applications were received from newly registered Distributors of Milk for Dealer's (Pre-packed Milk) Licences for the use of one or more of the designations, "Pasteurised," "Sterilised" or "Tuberculin Tested". The licence permits the sale of milk both inside as well as outside the area of the licensing authority. 58 Examination of Milk During the year 67 samples of milk were submitted for methylene blue and phosphatase tests. The results showed that the milk had been efficiently pasteurised in every case. Nine of these samples were obtained from vending machines situated outside premises in the City. The remainder were obtained from establishments under the control of the London County Council. Food and Drugs Act, 1955—Section 8 The following table shows the amount of food surrendered as unfit for human consumption during the year:— Amount surrendered Tons Cwts. Lbs. Canned food 8 13 43 Meat - 13 28 Fruit and vegetables 168 17 59 Fats - 3 90 Fish 1 12 17 Cereals — 5 25 Confectionery - 5 91 Miscellaneous 2 16 67 183 7 84 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 Gatliif 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. Food and Drugs Act, 1955—Section 16 Registration of Premises in connection with the manufacture, sale or storage of ice cream. Two hundred and sixty-three 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-two premises are registered for the preparation or manufacture of preserved foods. 59 Weights and Measures Bill During 1962, the Public Health Committee considered the provisions of a new Weights and Measures Bill, which considerably alters and extends the scope of existing legislation on this subject. The Public Health Committee is responsible for the enforcement of the Council's powers under the Food and Drugs Act, and the public health inspectors purchase samples of spirit at licensed premises in Westminster in order to detect cases of adulteration. As a result of experience gained in this connection, the Committee called attention to the provisions contained in Schedule 4, Part VI, para. 3, of the Bill, regarding the measurements (viz., one-fourth, onefifth, or one-sixth of a gill) to be used in connection with the retail sale of gin, rum, vodka, and whiskey, for consumption on the premises, and suggested the following amendments:- (a) the requirement should be extended to include brandy and other spirits and liqueurs; (b) opportunity should be taken to limit to one specified quantity the minimum amount to be sold; and (c) the statement to be displayed on the licensed premises, indicating the quantities in which the spirits and other liqueurs are offered for sale, should be easily readable, and in a conspicuous position, with possibly a prescribed minimum size of lettering. Ice Cream (Heat Treatment) Regulations, 1959 During the year, 114 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 80 2 22 3 1 4 11 It will be noted that twelve samples failed to reach a satisfactory grading, and of these eleven were placed in the lowest grade. Of the Grade 4 samples, three were taken from a manufacturer who has premises in Westminster. Altogether, ten samples were taken from this manufacturer during the year; four failed to reach a satisfactory grading, but samples taken later in the year were placed in Grade 1. 60 The Public Health Inspector kept the premises concerned under close surveillance during the year, and further samples will he taken when manufacturing recommences in 1963. In all, the products of 17 manufacturers were sampled during 1962. Results of bacteriological examination of samples of ice cream are notified to manufacturers, and where applicable, to retailers also. In addition, 142 samples of ice cream were submitted to the Public Analyst for examination, with satisfactory results. Ice Lollies During the year, 15 samples of ice lollies were submitted for bacteriological examination. All were reported to be of satisfactory standard. Forty-four samples of ice lolly or ice cream lolly were submitted for chemical analysis during 1962; all were reported to be satisfactory. Licensing Act, 1961 I referred in my last Annual Report to the impending legislation which would come into effect on the 1st March, 1962, relating to powers for regulating the conduct of clubs where intoxicating liquor was supplied to members and their guests. Briefly, a club wishing to obtain a registration certificate must apply to a Magistrates Court, and notification must also be made to the Police and to the local authority. The first registration is for 12 months, and the first renewal is also for 12 months, but on a second and subsequent occasion, a renewal may be for a period not exceeding 10 years. Certain transitional arrangements were provided for clubs already registered on the 1st March, and for clubs of long-standing the renewal could be for a period not exceeding 10 years. The Act set forth statutory grounds on which objection to an application may be lodged by the Police and by a local authority; objections lodged with the Court by the City Council were confined to the unsuitability of the premises, the applicant being informed accordingly. A club unable or unwilling to adjust its affairs so as to qualify for registration, could alternatively apply for a Justices Licence. In dome cases, clubs which applied to the Court for a certificate of registration subsequently withdrew their applications or applied for a Justices On-licence if their application to the Magistrate had been dismissed, or if they considered their application would not be granted. In those cases where objections to registration had been raised by the City Council, these were again raised with the Licensing Justices. 61 The objections made in respect of applications for Justices On-licences were, with one exception, in respect of premises where objections were initially raised to the grant of a Club Registration Certificate. The exception was in regard to a club premises, where a Justices On-licence was provisionally granted. The above-mentioned Act, with effect from the 1st November, 1961, also applied the procedure for obtaining Justices On-licences in respect of restaurants, private hotels and guest houses, etc., where intoxicating liquor is to be sold, and provided that one of the grounds for the refusal of a Justices Licence should be that the premises are not suitable and convenient for the proposed use having regard to their character and condition. Details of notifications received up to the end of the year, are as follows: Club Registration Certificates: 346 Number of objections lodged with the Court 28 Result of applications to which the Council lodged objection: Dismissed or Refused 13 Withdrawn 10 Adjourned (to 1963) 5 28 Costs awarded to the City Council in respect of cases heard amounted to £152 5s. Notices of Appeal were received in respect of two applications (to which objection had been lodged) on the Magistrate's refusal to grant registration. Justices licences 223 Number of objections lodged 11 Result of applications to which the Council lodged objection: Granted 1 Withdrawn 1 Adjourned (to 1963) 1 Not heard (in 1962) 2 *Provisionally granted 6 11 *Subject to completion of works to the satisfaction of the Council. 62 It will be appreciated that the above-mentioned applications, and those in respect of premises already licensed, have resulted in much additional work for the Council's staff. Apart from the inspections carried out by the Public Health Inspectors in respect of the applications received, inspections have also been necessary in connection with works which have been proposed to satisfy the Council's objections. Attendances were necessary on many occasions at the Magistrates' Court in respect of those applications for Club Registration to which the Council lodged objection, and also at subsequent adjournments. In addition, the Public Health Inspectors concerned with catering premises have attended all meetings of the Licensing Justices held during 1962 to give evidence in connection with works proposed, or in progress, at licensed premises, where such alterations or improvements concerned the food preparation area or sanitary accommodation. Evidence was often called for on conditions existing at other premises in respect of which applications were before the Justices for consideration. The Preservatives in Food Regulations, 1962 These Regulations came into force on the 26th July, 1962, and reenacted with amendments the Public Health (Preservatives, etc.) in Food Regulations, 1925 to 1958. The principal changes in the Regulations relate to:— (i) an extension of the list of permitted preservatives and of specified foods which may contain these preservatives; (ii) specified foods may contain a mixture of permitted preservatives within certain limits: (iii) certain foods may contain permitted preservatives in excess of the limits specified, if the food concerned is covered by a statement in the prescribed form; (iv) food may contain not more than five parts per million of formaldehyde derived solely from any resin used in the manufacture of wet strength papers or of plastic food containers or utensils; (v) the skin, but not the flesh of a banana, may contain nystatin,* and certain other foods may contain nisin,* and (vi) food certified by a Public Analyst as containing any preservative not permitted by the regulations, may, subject to certain requirements, be seized and destroyed. (* anti-fungal substances) 63 Milk and Dairies (Preservatives) Regulations, 1962 These Regulations, which came into force on the 26th July, 1962, and applied only to England and Wales, prohibit the addition of any preservative to milk and the sale of any milk to which such an addition has been made. Export Certificates From time to time requests are received in the Department for Certificates of Export in respect of foodstuffs which consignors wish to despatch to places outside the United Kingdom, and for which the authorities in the recipient country require a certificate stating that the goods mentioned therein have been examined by the Public Health Inspector and found to be fit for human consumption. During 1962, 33 such certificates were issued by the Public Health Inspectors in respect of foodstuffs which included Pate en Croute, smoked salmon, scampi, lobster, prawns, escallopes, haddock fillet, plaice, jars of honey, sirloins of beef, saddles of lamb and grouse. Provision at Inns, Refreshment Houses, etc., of Sanitary Conveniences and Washing Facilities In May, 1958, the City Council supported the promotion of a clause in a London County Council (General Powers) Bill, similar to Section 89 of the Public Health Act, 1936, to enable metropolitan borough councils to require owners or occupiers of any refreshment house to provide and maintain a reasonable number of sanitary conveniences for the use of persons frequenting such premises. Subsequently, at the request of several of the constituent councils, the Metropolitan Boroughs' Standing Joint Committee asked the London County Council to include washing facilities as well as sanitary conveniences. The London County Council agreed to do so, but during the passage of the Bill through Parliament the provision regarding washing facilities was deleted from the clause. The remainder of the clause dealing with the provision of sanitary conveniences was enacted in Section 25 of the London County Council (General Powers) Act, 1959. Under this section 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 64 the manner laid down in the London County Council (General Powers) Act, 1951. The classes of premises which are exempted are as follows: (а) those in respect of which a licence is in force under the Disorderly Houses, Act, 1751, or the Cinematograph Acts, 1909 and 1952; (б) 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 1962. The omission of the power to require the provision of washing facilities was considered by the Standing Joint Committee to be most unsatisfactory, and recently, with the concurrence of the constituent councils, the London County Council has been asked to make a further approach to Parliament. London County Council (General Powers) Act, 1962 (a) Discharge of Trade Effluent into Sewers Part II of the Act amends and extends Pant II of the London County Council (General Powers) Act, 1953, which enables the London County Council, the Metropolitan Borough Councils and the City Corporation to regulate the admission of trade effluents into sewers under their control from premises in the County. Section 5 enables the County Council to require occupiers of trade premises from which trade effluents are discharged into public sewers to pay charges for the use of sewers and sewerage works and treatment and disposal of trade effluent. Such charges may be apportioned between the County Council, the local sewer authorities (including the City Council) and external sewerage authorities. Section 6 requires the local sewer authorities and the County Council to keep separate registers of all trade premises from which any trade effluent is discharged directly into any sewer vested in them. The local sewer authorities are required to transmit information from their registers to the County Council every six months. A local sewer authority may authorise the County Council to act on its behalf for the purposes of this Section and the following Section 7. Section 7 empowers the County Council and the local sewer authorities to impose conditions on the discharge of trade effluents into their respective sewers. These conditions may include the employment of apparatus for measuring the quantity, rate of flow and composition of effluents, the 65 keeping of records of such measurements, and the making of returns to the authorities. Any person failing to comply with any such conditions or damaging or interfering with apparatus, or keeping false records, or making false returns, will be guilty of an offence and liable to a fine not exceeding £100 or to imprisonment for a term not exceeding three months, or to both. The appointed day for the purposes of the foregoing provisions is the 1st April, 1964. The City Council, at its meeting on 31st January, 1963, agreed that the Council's powers under Part II of the above Act should be referred to the Works Committee. (b) Powers with regard to buildings liable to flooding In Part III of the Act, Section 23 gives the Metropolitan Borough Councils and the City Corporation powers in respect of any building which is liable to flooding by virtue of the fact that it does not drain efficiently by gravitation into a sewer at all times and under all conditions of flow. The owner or occupier may be required either to carry out remedial works or to close the building or part thereof, or to limit its use to a purpose approved by the authority. There is a right of appeal to the Magistrates' Court against such a requirement. A maximum fine of £20, and a maximum daily fine of £5. may be imposed for use of the premises in contravention of the authority's requirement. A local authority may, with the agreement of the owner or occupier, carry out any necessary work at its own expense. Section 24 enables an owner or occupier who has been required to carry out work to claim reasonable expenses in respect of that work from the authority. Compensation may also be claimed in respect of consequential trade disturbance, depreciation in the value of a building or any removal expenses. A local authority meeting such claims will be entitled to obtain reimbursement of certain of the expenses from the County Council where a building drains directly into a sewer vested in the County Council. Part III of the Act came into force on the 1st August, 1962. The City Council, at its meeting on 31st January, 1963, agreed that the Council's powers under Part III of the above Act, with regard to the prevention of flooding of premises, should be referred to the Public Health Committee. 66 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 1962 there were no occasions on which heavy storms caused the sewers in the City to become surcharged and cause flooding. London County Council Drainage Byelaws On 1st May, 1962, revised Drainage Byelaws, made by the London County Council, -came into operation. The new Byelaws, whilst being specific in some matters, are much more general in others; they provide a Code of Practice rather than detailed requirements as was formerly the case. The new Byelaws give wider scope for the use of different materials, particularly where materials are covered by a British Standard and a Code of Practice concerning their use has been issued. Public Health (London) Act, 1936 London County Council (Drainage) Byelaws, 1934 Drainage Drainage plans submitted 471 Combined drainage orders made 52 Prevention of Damage by Pests Act, 1949 Rats and Mice Repression Complaints received 636 Treatments undertaken 673 Inspections by Public Health Inspectors and Rodent Officer 2,378 Notices served Rodents destroyed Black Rats 391 Brown Rats 3,211 Mice 4,341 67 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 86 Investigations made 145 Notices served 7 During 1962, complaints were received of noise caused by the following:— Compressors, pneumatic drills, steam hammers; a hoist and a cement mixer at a building site; road operations; delivery lorries; ventilating machinery and refrigeration plant; loud-speakers; music, singing and dancing in a dance hall; radios; fighting, screaming and shouting in a club; taxi-drivers, Covent Garden porters, workmen, and milkmen; howling dogs, and noisy tenants. Noise caused by cars arriving at and subsequently leaving a club gave rise to many complaints from neighbouring tenants. 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 1962 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. 68 Seven notices under the Noise Abatement Act, 1960, were served during 1962 in respect of the following matters:— Noise from parties held until the early hours of the morning in a flat. Noise from road operations (pneumatic drills)—two notices. Noise from a record-player loudspeaker over a shop entrance. Noise from a workshop in the basement of an office block. Noise caused by loading and unloading crates, and lorries delivering to a bakery. Noise caused by the vibration of a ventilating plant in a public house. Dust Nuisance 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, but several verbal warnings were given. 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. 69 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. Month 1962 Monthly deposits of impurities—tons per square mile. Mayfair. Pimlico. Charing Cross. Insol. j Sol. Total, Insol. j Sol. Total. Insol. i Sol. Total. January 9.00 15.89 24.89 14.60 21.64 36.24 24.76 24.13 48.89 February 11.46 7.12 18.58 10.87 6.71 17.58 23.89 12.08 35.97 March 10.23 j 7.98 18.21 12.38 8.79 21.17 12.61 11.65 24.26 April 10.50 15.55 26.05 11.27 16.21 27.48 13.60 20.01 33.61 May 12.37 14.12 26.49 12.48 5.13 17.61 11.61 16.43 28.04 June 5.21 14.35 19.56 6.20 5.30 11.50 7.07 7.63 14.70 July 8.49 12.10 20.59 9.87 18.72 28.59 9.36 13.27 22.63 August 6.65 15.96 22.61 6.74 19.93 26.67 8.83 17.92 26.75 September 9.71 14.12 23.83 8.25 18.12 26.37 9.56 15.66 25.22 October 6.95 11.66 18.61 9.13 13.62 22.75 12.11 11.95 24.06 November 10.43 11.25 21.68 11.17 15.10 26.27 17.22 12.55 29.77 December 12.68 14.73 27.41 5.53 6.04 11.57 30.63 17.79 48.42 70 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 sulpliation 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. SO3 in milligrams per 100 sq. cms. per day. Mayfair. Pimlico. Charing Cross. January 3.47 6.52 6.73 February 5.69 7.88 7.71 March 3.31 5.91 6.03 April 2.57 4.38 4.59 May 2.72 4.24 4.22 June 2.53 3.37 3.16 July 2.66 3.47 3.20 August 2.07 3.07 3.45 September 3.17 3.43 3.47 October 3.46 3.83 4.59 November 3.59 3.71 5.25 December 4.60 5.08 6.50 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 Citynamely 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, 71 The results obtained from the two sites are as follows:- Month SO2 micrograms per cubic metre Monek Street Churchill Gardens January 347 402 February 283 296 March 420 345 April 238 230 May 178 170 June 160 187 July 145 155 August 123 145 September 166 180 October 406 435 November 431 391 December 683 741 72 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. Micrograms per cubic metre Monck Street Churchill Gardens January 151.2 161.5 February 102.6 117.6 March 141.7 162.5 April 66.0 82.7 May 48.0 58.0 June 38.2 37.6 July 28.0 32.7 August 26.4 30.0 September 34.1 58.0 October 93.9 69.5 November 50.0 42.8 December 58.0 71.0 Sequential Smoke Sampling Apparatus The City Council is co-operating in an investigation which is being carried out by the Department of Scientific and Industrial Research into the relation between atmospheric pollution and respiratory diseases. During 1962, in order to provide the information required, it was necessary for the Council to purchase and install, at a cost of approximately £55, a sequential smoke sampling apparatus which examines and records a measured quantity of air at regular intervals. Whilst this machine was purchased particularly for use during the winter of 1962, it will be of benefit subsequently in providing additional data for the City Council's regular survey of atmospheric conditions, particularly during periods of fog. 73 Pollution from oil-fired furnaces One aspect of the atmospheric pollution problem which is causing concern in Westminster and elsewhere is the emission from oil-fired furnaces of very fine soot and smuts which are produced when oil is burned in an atomised or mist form. Investigations into this new form of pollution of the atmosphere continued during 1962. Air pollution from vehicles Another aspect of atmospheric pollution which received attention during 1962 was that relating to the emission of black and oily fumes from vehicles on the roads. In some London boroughs a considerable amount of heavy long-distance traffic passes along the streets, but in Westminster the traffic of this type is mostly that using Covent Garden, which is largely confined to the night and early morning hours. Whilst there is no demonstrated relationship between excessive diesel fumes and lung cancer (or, in fact, any other disease) it is recognised that fumes from such vehicles are just as undesirable as any other form of smoke. It must be remembered, however, that these fumes form only a small proportion of the total pollution in London. The emission of these fumes is likely to be considerably reduced as a result of the Motor Vehicles (Construction and Use) (Amendment) Regulations, 1961, which came into effect in January, 1962. These Regulations prohibit the placing of the excess fuel device on new vehicles within reach of the driver while the vehicle is in motion. In the past, it has been possible for a driver to mis-use this device, to gain extra power, but this resulted in large amounts of black exhaust and fumes being emitted. During 1962 a Private Members Bill—The Diesel Fumes Bill—was presented to Parliament, which would have provided for the making of Regulations with respect to the emission of smoke by diesel vehicles, with penalties where this was excessive. It would also have provided for the road-side testing of vehicles to ensure that they complied with the Regulations. The Bill was withdrawn, on 6th April, on the promise of action by the Government. In Apri 1,1962, the City Council's public health inspectors were requested to report to the Medical Officer of Health the registration number, and, if possible, the name and address of the owner, of any vehicle seen to be emitting an excessive amount of dark smoke. Four such instances were observed during 1962, and in each case a letter was sent to the owner, calling his attention to the occurrence, and asking for his co-operation in preventing a continuance of it. 74 Installation of new furnaces Under Section 3 of the Clean Air Act, 1956, the installation of all new furnaces of or exceeding 55,000 British Thermal Units per hour capacity must be notified to the local authority. The purpose of the section is to ensure that new furnaces installed shall be capable, so far as is practicable, of being operated without emitting smoke. During 1962, 75 such notifications were received. Provision is also made in this section of the Act for proposals relating to the installation of new furnaces to be submitted to the local authority for approval, and during 1962, fourteen applications were approved. Since the Clean Air Act, 1956, came into operation on 1st January, 1956, up to the end of 1962, a total of 428 notifications have been received concerning the installation of new furnaces, of which 84 applications were submitted for approval. With the type of modern development that is now taking place within the City, whole blocks of property covering several acres of ground, are being developed as one unit, with one central boiler house, and the means of heating and supplying hot water is, in effect, a District Heating scheme. These schemes require the provision of furnaces with heat ratings of several million British Thermal Units; and it is of interest to note that in three recent cases the furnaces installed had ratings of 75,000,000, 64,000,000 and 17,000,000 British Thermal Units respectivelv. Smoke Abatement—Results of Observations and Action Taken 1956 1957 1958 1959 1960 1961 1962 Complaints received 87 41 67 58 53 41 54 Observations made 2,634 1,603 625 497 897 572 584 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 75 in the atmosphere conies 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 provided for the whole of Westminster to be covered by operative smoke control orders by 1st October, 1965. An endeavour is, however, being made to accelerate this programme with a view to its completion by 1st October, 1964. Nine Smoke Control Orders are now in operation in Westminster, covering 1,606 acres of the City; four further Orders, covering 428 acres, have been made and confirmed by the Minister of Housing and Local Government, and will come into operation on 1st November, 1963. Details of the approved programme, and a map of the proposed Areas are set out on page 78 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 suitable smokeless fuels. 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 76 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 Bvelaw, 1960 During 1960 the London County Council bvelaw 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. 77 Smoke Control Areas The following information should be read in conjunction with the map opposite:— Area Acres (approx.) Map reference Green on Map Areas already in operation from:- 1st October, 1958 Temple Bar 55 1 1st October, 1959 Adelphi/Whitehall 150 2 1st October, 1960 Covent Garden 70 3 1st October, 1961 Soho 76 4 1st October, 1961 St. James's 275 5 1st October, 1962 Regent 107 6 1st October, 1962 Berkeley 120 7 1st October, 1962 Grosvenor 345 8 1st December, 1962 Knightsbridge 408 9 Yellow on Map Areas to come into operation on:— 1st November, 1963 Abbey 64 10 1st November, 1963 Victoria 190 11 1st November, 1963 Wilton 91 12 1st November, 1963 Eaton 83 13 Pale Yellow on Map Future programme for smoke control areas, to come into operation on:- 1st October, 1964 Millbank 73 14 1st October, 1964 Cathedral 85 15 1st October, 1964 Warwick 61 16 1st October, 1964 Tachbrook 56 17 1st October, 1964 Alderney 38 18 1st October, 1964 Ebury 81 19 1st October, 1964 Dolphin 31 20 1st October, 1964 Churchill 50 21 78 Analysis of Legal Proceedings, 1962 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—4 convictions 15 0 0 21 0 0 Selling food not of the substance demanded —1 conviction 4 0 0 3 3 0 Selling food not of the quality demanded— 2 convictions 45 0 0 15 15 0 Food Hygiene (General) Regulations, 1960 Insanitary premises and equipment— 34 convictions 597 0 0 98 10 0 £661 0 0 £138 8 0 Water The resident population of 85,735 in some 30,800 dwellings receive water from the Metropolitan Water Board's mains or from deep wells. At 31st December, 1962, 78 deep wells were in use. From 71 of these wells the water is used for domestic purposes. Of the remainder, six are used for stand-by only and one in case of fire. During the year 89 samples of water from wells in the City were submitted for examination; satisfactory reports were received of 63 bacteriological examinations and 26 chemical analyses. Fluoridation of Water In 1962, the St. Marylebone Borough Council drew the attention of the Metropolitan Boroughs' Standing Joint Committee to the results which had been published of a five-year study of the effect of artificial fluoridation of water supplies on the incidence of dental caries in children, which showed that the effectiveness, safety and practicability of fluoridation as a preventive measure against dental decay had been established. In view of a statement by the Minister of Health that he would approve local authority schemes to add fluoride to water supplies, the Metropolitan Boroughs' Standing Joint Committee asked constituent Councils to indicate whether or not they were in favour of the Metropolitan Water Board being asked to introduce fluoridation of their water supplies. 79 After full consideration of the matter, the City Council decided that the Standing Joint Committee should be informed that the Westminster City Council favoured the Metropolitan Water Board being asked to adjust the fluoride content of the water supplies of the area to the best concentration for the protection of children's teeth against dental decay. Subsequently, in June, 1963, it was learned from the Metropolitan Boroughs' Standing Joint Committee that all 29 constituent councils had indicated their agreement on the introduction of fluoride into London's water supply. 80 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. 81 Pharmacy and Poisons Act, 1933 Persons entitled to sell poisons included in Part II of the Poisons List numbered 126 at 31st December, 1962. Pet Animals Act, 1951 Five licences were issued by the Council during the year in relation to premises subject to the provisions of this Act. Slaughter of Animals Act, 1933—Slaughterman's Licences The Council during the year granted Slaughterman's licences to 19 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. 82 Disnfection, disinfestation and cleansing of persons— Arrangements with the Holborn Borough Council The arrangement between the City Council and the Holborn Borough Council whereby the latter undertook to carry out, on agreed terms, the work of disinfection, disinfestation and cleansing of persons, and the provision of the necessary transport therefor, continued. The arrangement came into operation on the 3rd September, 1956, and is working satisfactorily with resulting economies to both Councils. The following is a summary of the work carried out for Westminster during the year:— Disinfection and Disinfestation Rooms Articles Articles Washed Books Disinfection 180 33,767 464 141 Disinfestation 313 2,988 Cleansing of Persons Treatments Scabies Head Lice Body Lice Men 40 - 405 Women 22 - 3 Children 2 - - Transportation of Bodies Abroad On occasion, when it is proposed to transport a body overseas for burial, the Medical Officer of Health of the district in which death has taken place is asked to provide a certificate to the effect that the deceased did not die from any infectious or contagious disease, and that no recent epidemic of dangerous infectious disease had occurred in the district. During 1962, five such certificates were issued in respect of persons who had died in Westminster, and whose bodies were being transported abroad for burial. 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 83 to be buried or cremated the body of any person who has died or is found dead in the area, where no other arrangements have been made for the disposal of the body. The Council is empowered to recover the cost of burial from the estate of the deceased, and is eligible to receive payments in respect of the cost of such burial from death grants payable under the provisions of the National Insurance Act, 1946. Where persons without known relatives die in the City, it is frequently necessary not only to arrange for their burial, but to dispose of the contents of their homes. This is done in consultation with the Treasury Solicitor. Such action is necessary to enable the proceeds to be applied towards the cost of burial and also to avoid rent accruing and to release the accommodation for housing purposes as early as possible. During the year 44 burials were undertaken by the City Council in its Cemetery at Hanwell. The requests for the burials were received from the following sources: H.M. Coroner 19 Relatives or friends of the deceased 14 Hospitals in the City 11 Coroner's Court and Mortuary During 1962, 445 bodies were received in the Mortuary on Coroner's Warrants, etc. Of this number, 316 bodies were received following death within the City of Westminster, and 129 from the Boroughs of Camberwell and Bermondsey, under an arrangement made with the Southwark Borough Council referred to in the following section of this Report. Two bodies were admitted to await burial. Number of Cases Inquest cases 82 Non-inquest cases 363 Post-mortem examinations held 436 Causes of death in the foregoing were as under:— Accidental drowning 2 Found drowned 4 Suicide by drowning 5 „ by other means 25 Accidents— Street 12 Domestic 16 Others 7 Natural causes 363 Misadventure 1 Murder 1 Miscellaneous causes 9 84 Mortuary Accommodation Arrangements with Other Authorities (a) Holborn Borough Council An arrangement exists between the City Council and the Holborn Borough Council whereby bodies from Holborn, which are not the concern of H.M. Coroner, can be accommodated at the City Council's Mortuary in Horseferry Road whilst awaiting burial. The arrangement came into operation in September, 1956; no bodies were received in the mortuary from Holborn during 196*2. (b) Southward Borough Council In July, 1S62, an arrangement was entered into between the City Council and the Southwark Borough Council whereby bodies from the Boroughs of Bermondsey and Camberwell would be accommodated at the Westminster mortuary whilst the Southwark mortuary was being rebuilt. The arrangement came into operation on 3rd November, 1962, and will continue for approximately one year. During the period 3rd November 31st December, 1962, a total of 129 bodies were received from Camberwell and Bermondsey. 85 FACTORIES ACTS, 1937 to 1959 APPENDIX I 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 70 10 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 1,745 225 18 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 108 - - - Total 2,425 295 28 — 86 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.1) 6 6 — 1 — Overcrowding (S.2) — — — — — Unreasonable temperature (S.3) — — — - - Inadequate ventilation (S.4) 1 1 — 1 — Ineffective drainage of floors (s.6) - - - - - Sanitary Conveniences (S.7) - - - - - (a) Insufficient - - - - - (b) Unsuitable or defective 18 16 - 10 - (c) Not separate for sexes 4 4 — — — Other offences against the Act (not including offences relating to Out-work) 5 5 - - - Total 34 32 — 12 — 87 Part VIII of the Act APPENDIX II Outwork (Sections 110 and 111) Nature of work Section 110 Section 111 No. of outworkers in August list required by Section 110 (1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions (1) (2) (3) (4) (5) (6) (7) Wearing apparel— Making, etc., 3,426 - - - - - 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 - - - - - - Basket making - - - - - - Chocolates and sweetmeats - - - - - - Losaques, Christmas stockings, etc. - - - - - - Textile weaving - - - - - - Lampshades - - - - - - Totel 3,460 - - - - -