Ac 4344 WES 73 City of Westminster REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1963 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 (MIDD X.) A ND HIGH WYCOMBE City of Westminster REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1963 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 p r i n t e r s, l o n d o n, h a y e s (m i d d x.) a n d h i g h w y c o m b e CONTENTS Page Aged and Infirm 36 Aged Persons in need of Care and Attention 36 Animal Boarding Establishments Act, 1963 84 Area of the City 15 Assessment of Housing priorities on medical grounds 45 Atmospheric Pollution 73 Bacteriological Examinations 29 Basement Bakehouses 52 Bathing facilities for old people 37 Births 15 Births, Infant Deaths and Mortality Rates 17 Bodies, transportation of abroad 85 Bread and Flour Regulations 1963 67 British Red Cross Society 33 Burial of Cremation of the Dead 85 Catering establishments 53 Census 1961 39 Certificates of Disrepair 44 Clean Air Act, 1956 79 ,, ,, ,, ,, —Grants towards adaptations or alterations 80 „ „ ,, „ —Westminster (Eaton) Smoke Control Order 1962 81 Cleansing of bed linen of elderly and infirm persons 37 Cleansing of Persons 85 Clearance Areas 45 Club Registration Certificates 64 Colouring Matter in Food Regulations 1957 64 Common Lodging Houses 47 Coroner's Court and Mortuary 86 Day Club for Handicapped old people 33 Deaths 15, 18 Disinfection and Disinfestation 85 Disposal of unsound food 63 Drainage 41 Dust Nuisances 70 Dwelling Houses 15, 40 Dysentery 25 Emergency Fuel Supply Service—old people 37 Export Certificates 66 Factories Act, 1961 52, 88 Factories, Workplaces, Shops and other Premises 50 Factories, Defects and Nuisances 50 Fluoridation of Water 83 (B5852) A 2 Page Food—Registration of Premises 61 „—Inspection and Supervision 55 —Legal Proceedings 64 „•—Poisoning 60 —Sampling 55 „—Shops and Premises 54 ,,—Unsound and Disposal of 63 Food and Drugs Act, 1955 52, 63, 64 Food Hygiene (General) Regulations 1960 64 Foodstuffs, Examination of 66 Furnaces, installation of 78 Handicapped old people, Day Club 33 Health Education 37 Holborn Borough Council, Mortuary accommodation for 87 House Purchase and Housing Act, 1959 44 Houses in multiple occupation 46 Houses, number of 15 Housing Act, 1961 44, 46 Housing (Financial Provisions) Act, 1958 44 Housing Statistics 42 Ice Cream (Heat Treatment) (Amendment) Regulations 1963 67 IceCream—Registration of premises 63 Ice Cream—Samples 63 Infant Mortality 16 Infectious Diseases 23 Infectious Diseases—compensation for stopping employment 28 Infectious Diseases—Notifications 25 International Certificates of Vaccination and Inoculation 27 Introduction 7 Invalid Meals Service 35 Justices' Licences 64 Land Charges Act, 1955 45 Legal Proceedings 64 Licensing Act, 1961 64 London Building (Constructional) Amending Byelaws 1960 81 London County Council Divisional Health Committee, Division No. 2 11 London County Council (Drainage) Byelaws 1934 68 London County Council (General Powers) Act, 1937 51 London County Council (General Powers) Act, 1960 70 Luncheon Clubs 34 Mass X-Ray Service 30 Maternal Mortality15 Measles 25 Meat Inspection Regulations 1963 67 Milk and Dairies (General) Regulations 1959 62 Milk (Special Designation) Regulations 1960 62 Milk (Special Designation) Regulations 1963 67 Milk Examinations 62 Milk Licences 62 Mobile Library Service for old people 37 Page Mobile Meals Service ("Meals on Wheels") 33 Mortuary Accommodation 87 National Assistance Act, 1948 (Amendment) Act, 1962 35 Neonatal Mortality 15 Noise Abatement Act, 1960 69 Notices 41, 51, 53, 54 „ Statutory 41 Notifications of Infectious Diseases 25 Nuisances 41, 51, 53 ,, Noise 46, 69 Offices, Shops and Railway Premises Act, 1963 47 Offices, Workplaces, Shops, etc. 50 Oil fired furnaces 77 Oil Heater Regulations, 1962 38 Outworkers 52 Overcrowding 44 Paratyphoid Fever 26 Perinatal Mortality 15 Pet Animals Act, 1951 84 Pharmaceutical Services in Westminster 39 Pharmacy and Poisons Act, 1933 84 Poliomyelitis 25 Pollution from oil fired furnaces 77 Pollution from vehicles 77 Population 15 Preserved food premises 63 Prevention of Damage by Pests Act, 1949 68 Private Deep wells 83 Public Health Committee 11 Public Health Department staff 12 Public Health Laboratory—Specimens submitted to 29 Public Health (London) Act, 1936 68 Public Swimming Baths 70 Puerperal Pyrexia 27 Radioactive Substances Act, 1960 71 Rag and Flock and other Filling Materials Act, 1951 69 Rateable Value 15 Rats and Mice Repression 68 Rent Act, 1957 44 Rodents destroyed 68 Samples, Food 55 Sanitary circumstances 40 Sequential Smoke Sampling 76 Sewerage and Sewage Disposal 68 Slaughter of Animals Act, 1933 84 Slaughterman's Licences 84 Slum Clearance 45 Smallpox 27 Smoke Abatement 79 Smoke Control Areas 82 Smoke Control Areas Map facing page 82 Smoke Control (Exempted Fireplaces) Order 1959 80 Page Smoking and Health 37 Southwark Borough Council—Mortuary accommodation for 87 Specimens submitted to Public Health Laboratory 29 Staff of the Public Health Department 12 Statistics and Social Conditions 15 Swimming Baths 70 Tuberculosis 29 Typhoid Fever 26 Unsound Food 63 Water 83 Welfare of Old Persons 32 Wells 83 Westminster (Dufours Place, Broadwick Street and Marshall Street) Compulsory Purchase Order, 1959 46 Westminster (Eaton) Smoke Control Order, 1962 81 Westminster Old People's Welfare Association 32 Workplaces, Shops, etc. 50 7 City of westminster Public Health Department, Telephone: Trafalgar 7070 Alhambra House, 31, Charing Cross Road, W.C.2. To the Right Worshipful The Mayor, Aldermen and Councillors of the City of Westminster. Mr. Mayor, Aldermen and Councillors, I have the honour to present for your consideration a Report on the health of the City of Westminster during the year 1963. It is with much regret that I record in this Report the death of Dr. Andrew Shinnie, O.B.E., on 10th May, 1963. Dr. Shinnie joined the Westminster City Council as Tuberculosis Officer and Assistant Medical Officer of Health in 1916, and was appointed Medical Officer of Health in 1925. He rendered service of great distinction to the City of Westminster until his retirement in 1953. Following his retirement, he maintained a close liaison with many statutory and voluntary bodies in Westminster and continued to lead a very active and full life for the succeeding ten years. His interest in the health and well-being of all sections of the community was neverceasing and gave him an outlet for his unbounded energy and enthusiasm. During his long service with the City Council, Dr. Shinnie witnessed many changes and effected many improvements in the health services, particularly those provided for mothers and children. Further great changes are now imminent; under the London Government Act, 1963, the Health Department of the new City of Westminster will shortly become responsible not only for the environmental health services provided by the boroughs of Paddington, St. Marylebone and the present City of Westminster, but also for the personal health services provided by the London County Council in this area. The closing of the present era of London Government opens up a future of challenge and opportunity. I am confident that all the staff of the new Health Department will respond magnificently to the heavy tasks which lie ahead; and will ensure that the existing high standards of service to the public are not only maintained but expanded and improved wherever possible. (B5852) A 3 8 The vital statistics for 1963 are summarised on page 15 of this Report and show minor changes compared with the previous year. The number of live births increased by 28, whereas deaths increased by 18; there were seven fewer illegitimate births. Fortunately, there were no maternal deaths. The death rate of infants under one year shows some improvement, but the numbers from which these rates are computed are so small that fluctuations will occur from time to time. Turning to the analysis of causes of death in the City during 1963 (pages 18-22) it is of interest to note that the largest single cause of death was Coronary Disease and Angina, which accounted for 214 deaths out of a total of 1,054 (20.3 per cent.). The second largest single cause of death was carcinoma of the lung and bronchus in males (50 deaths, 4.7 per cent.). A further matter of some concern is the number of suicides which occurred in Westminster during 1963—a total of 34, evenly divided between males and females. This is the highest number of suicides recorded in Westminster since 1934 when the total reached 37. I have again included in the Report the adjusted Birth and Death Rates. These adjusted rates can be compared directly with similarly adjusted rates for other districts, and with those for England and Wales as a whole. During 1963 there were no serious outbreaks of infectious diseases in Westminster. The outbreak of typhoid fever in Zermatt, Switzerland, caused some concern and created additional work for your officers in tracing direct contacts and taking the necessary preventive measures; fortunately, no secondary case of this disease occurred. At the beginning of 1963 the establishment of public health inspectors was up to full strength for the first time since 1956. Unfortunately, this happy state of affairs was shortlived and the customary turnover of inspectors was resumed later in the year. In April, 1963, the establishment of inspectors was increased by four posts, to assist in work connected with the Offices, Shops and Railway Premises Act, 1963, reference to which is made later in this introduction. During the period March 1963-July, 1964, no fewer than 12 public health inspectors left the Council's service, one on retirement, but the others to take up positions with other authorities nearer their homes, or with Councils who offered the added inducements of higher grades, housing or car allowances. Although thirteen inspectors were recruited during this period, the constant changes and consequent lack of continuity in the work are reflected in some of the statistics contained in this Report. There were also frequent changes in the clerical staff, resulting in senior members having to spend much time training newcomers in their duties. This difficulty is not confined to Westminster alone but is common throughout London at the present time. 9 The Council's training programme for student public health inspectors continues to operate satisfactorily and five students are under training at the present time— the maximum number which under the Regulations of the Public Health Inspectors Education Board can be accepted by the existing staff of qualified inspectors. The practical training of these students places an added burden on the senior inspectors in the Department, but the work is worthwhile and will assist materially in overcoming the nation-wide shortage of inspectors which exists at the present time. Since 1958, four students have been trained in the Department, have qualified and have been appointed to positions with the City Council. The survey of houses in multiple occupation continues steadily and good progress is being made. The work of inspecting all the houses in multiple occupation in Westminster is a task of some magnitude and will inevitably take some while to complete. The Offices, Shops and Railway Premises Act, 1963, comes into operation on 1st August, 1964. Registration of premises is being effected at the present time and many thousands of application forms are being received in the Department. A number of Statutory Instruments have now been issued by the Government setting out standards for amenities and facilities in such premises. Visits to those premises covered by the Act in which responsibility for inspection is placed upon the City Council, have now commenced and where necessary improvements in working conditions will be required. In April, 1963, as an initial step the establishment of the Health Department was increased by four posts of public health inspector to assist in carrying out this additional work. The Council's programme for the establishment of Smoke Control Areas has almost reached completion. The original programme provided for the whole of Westminster to be smokeless by 1965, but an endeavour was made to hasten the work with a view to its completion during 1964. Unfortunately, the final Smoke Control Order in respect of the Westminster (South) area was not confirmed by the Minister of Housing and Local Government in time for it to be operative during 1964, and it will now come into operation on 1st July, 1965. Opportunity has again been taken to include in this Report a map (facing page 82) showing those parts of the City where Smoke Control Orders are in force. The public health inspectors have continued to give attention to food shops and catering establishments, of which there are several thousand in Westminster. This is a difficult and time consuming task, but every effort is made to obtain the highest possible standards not only of premises and equipment but also in personal hygiene. In the majority of cases owners and caterers are co-operative and many improvements have been achieved, but, with constantly changing staffs, (B5852) a 4 10 many of whom know only a smattering of English, the inspectors have to pay frequent visits to many establishments in an endeavour to inculcate good personal hygiene among new employees. Much good work has been undertaken by the staff of the Health Department during the past year in the many and varied duties which are dealt with fully later in this Report. To all the members of the staff I express my sincere thanks for their unfailing support and loyalty; and to my colleagues in other Departments my appreciation of 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, support and help which I have received during the past year. J. H. Briscoe-Smith, Medical Officer of Health July, 1964 11 PUBLIC HEALTH COMMITTEE The Mayor (ex-officio): Councillor Leslie Farmiloe, M.C. The Deputy Mayor (ex-officio): Councillor P. A. Negretti Chairman : Lady Hulbert, M.B., J.P. Vice-Chairman: Councillor W. B. Clowes Members : Alderman Miss P. C. Paton Walsh. Councillor Dr. T. Anwyl-Davies, F.R.C.P. „ T. Stirling Boyd. „ Mrs. P. C. Butchers. „ The Countess of Dartmouth, L.C.C. „ W. F. Davis. „ Mrs. Paul Dean. „ R. L. Everest, F.R.I.C.S., F.I.Arb. „ 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 Mrs. Paul Dean. 12 STAFF OF THE PUBLIC HEALTH DEPARTMENT (as at 31st December, 1963) 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. P. A. Lloyd, O.B.E. F. E. Siddle. (Inspector with special duties relating to Rodent Control and Disinfestation). R. Scott. W. G. Stivey. 13 Housing: J. W. Baxter (Senior Public Health Inspector—Housing). J. E. Drake. L. Lewis. R. J. W. Plummer. G. Marsland (from 13.7.1963). J. A. Croydon (from 2.9.1963). M. Crisp (from 4.11.1963). Food and Catering Establishments: R. F. Stubbs (Senior Public Health Inspector—Food). W. H. Dunstan. S. Firsht. S. Shave. Atmospheric Pollution: W. J. Davies (Senior Public Health Inspector—Smoke). J. J. Coveney. Technical Assistants: (Smoke Control Areas). R. H. Major. P. Syrett. Public Health Inspector Students: P. E. Beeching (from 2.9.1963). J. C. Bray. A. Miller. T. C. Moore. R. Pendreigh. General Assistants to Public Health Inspectors: A. Jones. A. Murkin. 14 Clerical Staff. W. H. Smith (Senior Clerk). Miss P. Allen. Miss L. E. Minors. R. Bastable. L. J. Nunn. R. L. Booker. B. Sheridan. Miss B. Cleasby. J. M. Shotbolt. R. W. Easton. W. E. F. Simmons. W. F. C. King. Miss D. V. Stothard. Miss J. Lee. E. A. Taylor. Miss K. Lee. Miss J. K. Velden. D. Levitton. Coroner's Court and Mortuary. Superintendent: A. W. Nicholls. 1st Mortician: W. H. Wilshire. Mortuary Assistants: H. Barker. (1 vacancy). Cleaner: Mrs. W. Wells. Rodent Control. Rodent Officer: J. W. Brown. Foreman: W. Weems. Rodent Operatives: T. Izzard. G. Murray. C. Ralph. R. West. 15 STATISTICS AND SOCIAL CONDITIONS Area (acres) 2,503.9 Population (Registrar General's Estimate, mid-year, 1963) 86,550 Population, Census, 1961 85,735 Number of private dwellings (Census, 1961) 30,801 Rateable Value (at 1st April, 1963) £68,850,000 Births Live Births (registered)— Total. Males. Females. Legitimate 929 443 486 Illegitimate 160 85 75 1,089 528 561 Birth rate per 1,000 of the estimated resident population 12.58 Area Comparability Factor—Births: 0.83 Birth rate (adjusted) 10.44 (Rate for England and Wales, 18.2) Number of stillbirths (males, 7; females, 9) 16 Rate of stillbirths per 1,000 (live and still) births 14.48 Total live and stillbirths 1,105 Illegitimate live births per cent. of total live births 14.69 Deaths Net deaths (males 565; females, 489) 1,054 Death-rate per 1,000 of the estimated resident population 12.18 Area Comparability Factor—Deaths: 1.0 Death rate (adjusted) 12.18 (Rate for England and Wales, 12.2) Deaths arising from pregnancy, childbirth, abortion Nil Rate per 1,000 total (live and still) births — Deaths of infants under 1 year (males, 14; females, 11) 25 Death-rate of infants under 1 year— All infants per 1,000 live births 22.95 Legitimate infants per 1,000 legitimate live births 22.60 Illegitimate infants per 1,000 illegitimate live births 25.00 Neo-natal mortality rate (deaths under 4 weeks per 1,000 total live births) 17.44 Early neo-natal mortality rate (deaths under 1 week per 1,000 total live births) 16.53 Perinatal mortality rate (stillbirths plus deaths under 1 week per 1,000 total live and stillbirths) 30.77 (B5852) a 5 16 Infant Mortality Analysis of Infant Deaths, 1963 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 Acute tracheo bronchitis - - 1 - 1 1 - - - 2 Anencephaly — — — — — 1 - - - 1 Broncho-pneumonia - - - - - 1 - - - 1 Congenital heart disease 1 - - - 1 1 — - - 2 Cerebral haemorrhage 1 — — — 1 - - - - 1 Intracranial haemorrhage 1 — — — 1 - - — — 1 Intrapartum haemorrhage 1 — — — 1 - - - - 1 Subdural haemorrhage — — — — — 1 - — - 1 Pneumonia 1 — — - 1 - - - - 1 Prematurity 7 - - - 7 - - - - 7 Respiratory failure 2 - — — 2 - - - - 2 Vagal inhibition (misadventure) — - — — — — - 1 — 1 Illegitimate Pemphigus 1 - - - 1 - - - - 1 Prematurity 2 - — — 2 - - - - 2 Respiratory failure 1 - — — 1 — — — — 1 Totals 18 - 1 — 19 5 — 1 — 25 17 Births, Infant Deaths and Mortality Rates Year. All Infants. Legitimate. Illegitimate. Total Births. Deaths. Mortality Rate. Births. Deaths. Mortality Rate. Births. Deaths. Mortality Rate. 1963 1,089 25 22.95 929 21 22.60 160 4 25.00 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 (B5852) A 6 18 Deaths 1963 Causes of Deaths in the City at different periods of life No. Cause of Death Sex Total All Ages Under 4 weeks 4 weeks and under 1 year Age in Years 1- 5- 15- 25- 35- 45- 55- 65- 75 and over 1 Tuberculosis, Respiratory M. 4 - - - - - - - - 3 1 — F. - - - - - - - - - - - - 2 Tuberculosis, Other M. 1 - - - - - - - 1 - - - F. - - - - - - - - - - - - 3 Syphilitic Disease M. 2 - - - - - - - - 1 — 1 F. 1 - - - - - - - - - 1 — 4 Diphtheria M. - - - - - - - - - - - - F. - - - - - - - - - - - - 5 Whooping Cough M. - - - - - - - - - - - - F. - - - - - - - - - - - - 6 Meningococcal Infections M. - - - - - - - - - - - - F. - - - - - - - - - - - - 7 Acute Poliomyelitis M. - - - - - - - - - - - - F. - - - - - - - - - - - - 19 8 Measles M. - - - - - - - - - - - - F. - - - - - - - - - - - - 9 Other Infective and Parasitic Diseases M. - - - - - - - - - - - — F. - - - - - - - - - - - - 10 Malignant Neoplasm, Stomach M. 12 - - - - - - - - 7 4 1 F. 10 - - - - - - - - 2 4 4 11 Malignant Neoplasm, Lung, Bronchus M. 50 — — — — 1 — — 6 17 17 9 F. 12 - - - - - - 1 2 3 1 5 12 Malignant Neoplasm, Breast M. - - - - - - - - - - - - F. 15 - - - - - - - 4 2 7 2 13 Malignant Neoplasm, Uterus F. 8 - - - - - - - 3 - 3 2 14 Other Malignant and Lymphatic Neoplasms M. 67 — — — 1 4 2 3 10 17 23 7 F. 56 — — — 1 — — 2 10 14 11 18 15 Leukaemia, Aleukemia M. 6 — — — — — 2 1 — — 3 — F. 5 - - - - - - - - 1 4 — 16 Diabetes M. 1 - - - - - - - - - - 1 F. 6 - - - - - - - - - 2 4 17 Vascular Lesions of Nervous System M. 49 - - - - - 1 — 3 8 15 22 F. 64 - - - - - - 1 1 8 15 39 20 No. Cause of Death Sex Total All Ages Under 4 weeks 4 weeks and under 1 year Age in Years 1- 5- 15- 25- 35- 45- 55- 65- 75 and over 18 Coronary Disease, Angina M. 132 - - - - - 1 3 14 50 37 27 F. 82 - - - - - - 1 1 13 31 36 19 Hypertension, with Heart Disease M. 5 - - - - - - - 2 1 — 2 F. 7 - - - - - - - - - 2 5 20 Other Heart Disease M. 25 — — — — — 1 — — 1 8 15 F. 34 - - - - - - - 2 1 3 28 21 Other Circulatory Disease M. 29 - - - - - - - 2 6 8 13 F. 41 - - - - - - - - 3 9 29 22 Influenza M. 1 - - - - - - - - - - 1 F. - - - - - - - - - - - - 23 Pneumonia M. 39 — — 1 — — — — 1 5 15 17 F. 29 1 - - - - - - 1 2 5 20 24 Bronchitis M. 35 1 1 - - - - - 2 8 14 9 F. 13 - - - - - - - 1 1 1 10 25 Other Diseases of the Respiratory System M. 3 - - 1 - - - - - - 2 F. 2 - - - - - - - 1 - - 1 21 26 Ulcer of Stomach and Duodenum M. 7 — — — — — 1 - - 2 2 2 F. 1 - - - - - - - 1 - - - 27 Gastritis, Enteritis and Diarrhoea M. 2 - - - - - - - - - - 2 F. 5 - - - - - - - 1 1 2 1 28 Nephritis and Nephrosis M. 5 - - - - - - - 2 1 1 1 F. 3 — — — — — 1 — 1 — — 1 29 Hyperplasia of Prostate M. 1 - - - - - - - - - - 1 30 Pregnancy, Childbirth, Abortion F. - - - - - - - - - - - - 31 Congenital Malformations M. 6 2 1 — 1 — — — — 1 1 — F. 6 1 2 — — — 2 — — — — 1 32 Other Defined and Ill-Defined Diseases M. 30 8 — — — — 4 2 4 6 4 2 F. 52 6 1 — — — 1 3 7 8 10 16 33 Motor Vehicle Accidents M. 2 - - - - 1 - - - - - 1 F. 6 — — — — 1 — — - 2 1 2 34 All other Accidents M. 34 — 1 — 1 3 5 5 7 5 2 5 F. 13 - - - - - 2 1 — 4 1 5 35 Suicide M. 17 - - - - - 3 1 5 8 — — F. 17 — — — — 2 3 1 5 3 2 1 22 No. Cause of Death Sex Total All Ages Under 4 weeks 4 weeks and under 1 year Age in Years 1- 5- 15- 25- 35- 45- 55- 65- 75 and over 36 Homicide and Operations of War M. - - - - - - - - - - - - F. 1 - - - - - - 1 - - - - Total All Causes M. 565 11 3 2 3 9 20 15 59 147 155 141 F. 489 8 3 — 1 3 9 11 41 68 115 230 Grand Totals 1,054 19 6 2 4 12 29 26 100 215 270 371 23 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, 1955— Section 26. Leprosy* Public Health (Leprosy) Regulations, 1951. Malaria Public Health (Infectious Diseases) Regulations, 1953. Measles County of London (Measles and Whooping Cough) Regulations, 1938 to 1948. Membranous Croup Public Health (London) Act, 1936— Sections 192 and 304. Meningococcal Infection L.C.C. Order dated 27.2.1912 and Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949. Ophthalmia Neonatorum† L.C.C. Order dated 2.11.1910 and Public Health (Ophthalmia Neonatorum) Regulations, 1926 to 1937. Plague Local Government Board Order, 1900. Pneumonia (Primary and Influenzal) Public Health (Infectious Diseases) Regulations, 1953. Poliomyelitis, Acute L.C.C. Order dated 27.2.1912 and Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949. * Notifiable to the Chief Medical Officer, Ministry of Health. † Notifiable to the County Medical Officer of Health for London. (B5852) a 7 24 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 (includ- Public Health (London) Act, 1936—Sections ing Paratyphoid) 192 and 304. Typhus Fever Do. Whooping Cough County of London (Measles and Whooping Cough) Regulations, 1938 to 1948. For each of the above a fee of 2s. 6d. is payable by the Local Authority to the medical practitioner if the case occurs in his private practice, or Is. if the case occurs in his practice as medical officer of a public body or institution. 25 Notifications of Infectious Disease Disease Notifications Removed to Hospital Diagnosis not Confirmed Diagnosis Established Diphtheria — — — — Dysentery 75 14 1 74 Erysipelas 3 3 - 3 Food Poisoning 22 14 1 21 Malaria (contracted abroad) 2 — 2 Measles 472 11 — 472 Pneumonia— Acute Primary 9 3 — 9 Influenzal — —• — — Paratyphoid Fever 1 1 — 1 Poliomyelitis— Paralytic __ — - Non-Paralytic - — — - Puerperal Pyrexia 2 2 — 2 Scabies 3 — — 3 Scarlet Fever 13 1 1 12 Typhoid Fever 1 1 — 1 Whooping Cough 28 3 — 28 Measles Measles follows a well-established pattern, reaching epidemic proportions every other year. It is of interest to note that 472 notifications of measles were received in 1963, compared with 90 in 1962 and 795 in 1961. Only 11 patients were removed to hospital in 1963, and there were, fortunately, no deaths from this disease. Dysentery Seventy-five notifications of dysentery were received during 1963, compared with 22 in the previous year. Whilst the majority were single unconnected cases, ten notifications related to a minor outbreak of the disease which occurred in young children living in one block of dwellings in Westminster. Poliomyelitis For the third 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. Immunisation against poliomyelitis began in 1956:— 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 21 16 29 13 1 10 9 4 15 7 5 1 1 l l— — — (B5852) a 8 26 The Medical Officer of Health for the County of London has reported that in London in 1963 there were only three notifications of poliomyelitis, of which one was a paralytic case and two were non-paralytic. After final diagnosis only the one paralytic case was confirmed, that of a man aged 34 years who had not been vaccinated. Comparable confirmed figures for 1962 were sixteen paralytic cases and three non-paralytic cases. By the end of the year 77 per cent. of the child population of London aged six months to 14 years had received three injections or doses of poliomyelitis vaccine. Following the widespread use of Sabin vaccine a substantial reduction in the incidence of poliomyelitis in both the vaccinated and the unvaccinated was to be expected. While this situation is most gratifying, it would be unwise to assume that it will be permanent. Should the community be exposed to a virulent strain of the virus, the proportion (23 per cent.) of unvaccinated children would provide fertile ground for an epidemic. Paratyphoid Fever One notification of paratyphoid fever was received in 1963. The patient was a young man of 25 years, a resident of Westminster, who contracted the infection in March whilst on a visit to the Continent. He was admitted to a London hospital in June, 1963, where the diagnosis of paratyphoid B. fever was confirmed. Typhoid Fever One case of typhoid fever was notified in Westminster in 1963. The patient was a young male of 21 years on a visit to this country from the Middle East. He was admitted to a London hospital on 1st August, 1963, suffering from pyrexia of unknown origin; subsequently a diagnosis of typhoid fever was made. He made an uneventful recovery and was discharged from hospital on 14th September, 1963. Typhoid Fever in Switzerland As a result of an outbreak of typhoid fever in Zermatt, Switzerland, in 1963, 68 persons in this country contracted the disease. Fortunately, none of these cases was in Westminster but there were 36 persons resident in or visiting Westminster who had been in contact with known cases. These were visited by the Council's Public Health Inspectors and the necessary checks made which proved to be negative in character. The Public Health Inspectors also visited food premises in Westminster and reminded managements of the risks of infection in regard to any staff who had recently returned from Zermatt. A letter was also sent by the Medical Officer of Health to all medical practitioners and hospitals in Westminster, emphasising the need for bacteriological examination of anyone who had been to Zermatt since the middle of February and, in particular, anyone employed in catering or other food premises, dairy 27 or water undertaking. Numerous enquiries were received in the Public Health Department from workplaces and private households with regard to persons either going to or recently returned from Zermatt, seeking advice on precautions to be taken against risk of infection. No secondary cases of typhoid fever occurred in Westminster. Puerperal Pyrexia Only two notifications of puerperal pyrexia were received in 1963, compared with 14 in the previous year. Both cases occurred in local hospitals, the cause of the pyrexia being unknown. 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, and early in 1962, when cases of smallpox were imported into this country from Pakistan, where an epidemic of this disease existed, and I make no apology for repeating the warning this year. With modern means of transport, it is now possible for a person unknowingly to be in contact with an infectious disease in one country and within a few hours to have travelled half across the world. Constant vigilance is required to prevent the spread of disease, and vaccination against smallpox is clearly still necessary until such time as this disease has been eradicated. Fortunately, no case of smallpox occurred in Westminster during 1963, although on several occasions information was received in the Public Health Department concerning persons who had been in contact with the disease 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 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. Three thousand and eighty-three such certificates were authenticated in 1963, compared with 16,206 in 1962 and 4,617 in 1961. 28 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. Thirty-six of these certificates were issued during 1963, compared with 20 in the previous year. 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 1963. 29 Specimens Submitted to the Public Health Laboratory Nature of Specimen Number Examined Positive Findings Nasal and Throat Swabs 123 Haemolytic streptococci 25 Staphylococcus aureus 2 Monilia and B. coli 1 Monilia 1 Faeces 593 Shigella sonnei 44 Shigella flexneri 2a 4 Shigella flexneri 2 1 Salmonella typhimurium 6 Ova of Ascaris lumbricoides and Trichuris trichiura 1 Bact. coli 026 2 Bact. coli 0128 1 Pathogenic Bact. coli 0111 1 Salmonella brandenburg 1 Cl. Welchi 11 Urine 40 Monilia 1 Swab from gums 2 Oral swab 3 Monilia 1 Swab of mouth ulcer 1 Rectal swab 4 Shigella sonnei 1 Sputum 1 Organisms of coliform group 1 Tuberculosis Age Periods New Cases Deaths Pulmonary NonPulmonary Pubnonary NonPulmonary M. F. M. F. M. F. M. F. Under 5 years - - - - - - - - 5 to 15 years 1 1 - - - - - - 15 to 25 years 4 9 - - - - - - 25 to 45 years 19 10 1 3 — — — — 45 to 65 years 27 5 — 1 3 — 1 — 65 to 75 years 2 2 — — 1 — — — 75 and over 2 - - - - - - - Age not known 1 - - - - - - - 56 27 1 4 4 — 1 — 30 New cases Source of Information Pulmonary Non-Pulmonary M. F. M. F. Primary notifications 37 19 1 4 Transfers from other areas 18 8 - - Non-notified deaths - - - - Posthumous notifications 1 - - - Mass X-Ray Service (This report was kindly supplied by the Organising Secretary of the South West London Mass X-Ray Service.) In 1963, Units of the South West London Mass X-Ray Service made a total of 92 visits in the City of Westminster, during which 33,658 people were examined, of whom 61 were referred to Chest Clinics for further investigation. Fifty-six visits were made to firms and organisations, which included five large hotels. Two University Colleges and one Training College were visited in connection with the London County Council B.C.G. Inoculation Scheme, to X-ray students and positive reactors to the tuberculin skin tests. A Mass X-Ray Unit was installed on the premises of a large organisation in the Strand, where 2,550 people were X-rayed from their staff, and the staff of adjacent shops and offices. Three cases were sent to Chest Clinics for further investigation. At the end of the year a Unit moved into the Board of Trade Offices at Horse Guards Avenue, where 6,120 Civil Servants from the Ministries were X-rayed, of whom seven were referred for further investigation. The regular monthly visits to Bruce House, the London County Council Lodging House in Kemble Street, W.C.2, which were begun in 1958, were continued throughout 1963. During the year, personal letters were sent to all newcomers inviting them to be X-rayed and, in all, 438 were examined, of whom 10 were referred to Chest Clinics. Visits were also made to Rowton House, Vauxhall, The Little Sisters of the Poor, St. Peter's Home, the Salvation Army Hostel and the Church Army Hostel in Great Peter Street. Altogether, 402 residents at these Hostels have been examined, of whom 11 were referred to Chest Clinics. The six-monthly service for men over 45, which was inaugurated in South London in December, 1958, in an attempt to provide some protection against the hazards of lung cancer, is still in operation, and some 18,000 men are regularly attending the South West London Mass X-Ray Service Units. Nearly 100 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. Many visits to Westminster have been made to provide this special 31 service, including visits to Gatliff Road and Monck Street Public Cleansing Depots to X-ray members of the City Council's staff. During the years 1959 to 1962 a total of 229,908 examinations of men over 45 were made under this scheme in South London. Ninety-five cases of lung cancer were discovered as a result of the 63,524 initial examinations carried out, i.e., a rate of 1.5 per thousand, and the 166,384 repeat examinations revealed 115 cases, i.e., 0.69 per thousand. In connection with this service, periodic visits were made throughout the year to sites at Burlington Gardens, W.l, Horse Guards Avenue and Victoria, S.W.I, and Strand, W.C.2. During these visits, members of the public, and staff working in adjacent premises, were also X-rayed. In all, 26 visits were made and these, together with frequent visits of Mobile Units to firms, etc., ensured that during most weeks of the year at least one Unit of the South West London Mass X-Ray Service was operating within the boundaries of the City of Westminster. It is felt that special mention should be made here of the assistance which is received from the Metropolitan Police Force and the Traffic Wardens' Offices, without whose co-operation over the parking of the vehicles it would not be possible to provide X-ray facilities at such easily accessible sites in the central area of London. One of the notable events of the year was the acquisition of a new Mobile Unit for South West London, which was first brought into service in May, 1963, when a visit was made to the Houses of Parliament, where the vehicle was parked in Black Rod's Garden. On the 20th May, Mr. S. Ripley, Chairman of the South West Metropolitan Regional Hospital Board welcomed the then Minister of Health, The Rt. Hon. J. Enoch Powell, M.P., who came to inspect the Unit. During the course of this visit, which was made primarily to X-ray the staff, a great many Peers and Members of the House of Commons took the opportunity of looking at one of the most up-to-date Mobile Mass X-ray Units, and of being X-rayed in it. During the year under review, the three Units of the South West London Mass X-Ray Service carried out 102,208 chest X-ray examinations. Two hundred and sixty-nine cases were referred with radiological abnormalities suggestive of clinically significant pulmonary tuberculosis. One hundred and sixty were referred with radiological abnormalities suggestive of neoplasm requiring further study. In addition, 277 cases of non-tuberculous miscellaneous conditions requiring further study were referred, making a total of 706 referrals to Chest Clinics. Residents of Westminster are again invited to make full use of the Mass X-Ray Service whenever a Mobile Unit is within convenient reach of them. An appeal is also made to firms and organisations to co-operate in the effort being made to eliminate tuberculosis from shops, offices, factories and catering establishments. This they can do by notifying the Headquarters of the South West London Mass X-Ray Service, at the Western Hospital, Seagrave Road, Fulham, S.W.6, telephone (B5852) a 9 32 FUJLham 9311, whenever it is known that a case of tuberculosis has occurred on their premises. Arrangements will then be made for the prompt attendance of a Mass X-Ray Unit to X-ray the "works contacts " there. Welfare of Old Persons Westminster Old People's Welfare Association This voluntary Association, whose members include representatives of various bodies interested in the welfare of old people, continued its activities in the City during the year. These activities include the organisation in various parts of the City of 14 Darby and Joan Clubs, where light refreshments and recreation are provided; arranging holidays at seaside resorts, summer outings, Christmas parties, and other entertainments. Special outings and parties were organised during the year for handicapped old people, many of whom by reason of their infirmities, had not been outside their homes for long periods. The distribution of gift parcels at Christmas time was arranged; and also friendly visiting by voluntary helpers. The City Council, under powers conferred by the National Assistance Act, 1948 (Amendment) Act, 1962, makes an annual contribution to the funds of the Association. 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 3s. 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. This side of the Association's work continues to increase 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, and a third edition is now in preparation. 33 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. 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 some cases old neighbours, not seen for many years, have re-met, and old friendships have been renewed. 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 1963, 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 Is. 10(2. to 2s. per meal. The price charged to the old people remained unchanged at 8d. per meal; the London County Council contributed Is. Id. per meal and the City Council bore the balance of 3d. per meal. As from 1st April, 1963, the London County Council subvention was discontinued and the City Council assumed responsibility for the whole of the balance, amounting to Is. 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 (B5852) a 10 34 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. 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 21,910 meals were delivered during 1963, an increase of 2,284 on the previous year. This is the highest number of meals ever delivered in Westminster. During June, 1963, a bunch of roses was delivered by the Society to every old person having meals from the Westminster Meals on Wheels Service—a kindness welcomed by the old people. 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 Is. Id., and the City Council bore the balance of 3d. per meal. Here again, the London County Council subvention was discontinued in April, 1963, when the City Council became responsible for the whole of the balance, amounting to Is. 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 1963, a total of 2,604 meals were served at this Club. As mentioned previously, mid-day meals are also supplied on five days per week by the Westminster Old People's Welfare Association at the Day Club at Sherborne House. During 1963, a total of 5,414 meals were supplied. 35 The total number of meals supplied by all these sources to elderly people in Westminster during 1963 was therefore as follows:—- Delivered by the Mobile Meals Service 21,910 Westminster Old People's Welfare Association Day Club (five days per week) 5,414 British Red Cross Society Luncheon Club (two days per week) 2,604 Total 29,928 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. 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) replaced Section 31 of the National 36 Assistance Act, 1948, by a new Section giving 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 on 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 1963 but fortunately it was not found necessary to resort to these compulsory powers. Aged and Infirm Persons Much of the visiting of the aged and infirm is done by the Westminster Old People's Welfare Association social worker. There are many occasions, however, when a visit by a Medical Officer or a Public Health Inspector is required, because of their specialist knowledge or statutory powers. Three hundred and forty-five such visits were made during the year. 37 Mobile Library (Personal Delivery Service) Anyone unable through age or infirmity to get to one of the City Council's Libraries can apply to the Librarian at any branch of the Westminster Public Libraries to be placed on the list for the Personal Delivery Service. Each person using this Service receives a fortnightly home-visit from a qualified member of the Libraries Department. Books are also available at the Darby and Joan Clubs. Bathing Facilities The City Council has made available to old age pensioners facilities whereby they can have hot baths at the Council's public baths at reduced charges. Cleansing of Bed Linen of Elderly and Infirm, Persons Facilities have also been made available by the Council for the cleansing of bed linen of elderly and infirm people when it has become fouled and unwholesome. 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. A stock of fuel was obtained in the autumn of 1963 and stored for possible use during the winter 1963-64. Health Education Some success in health education has 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 dealt with by the Health Department during 1963 related to Smoking and Health. Publicity material was obtained free of charge from the Ministry of Health and the London 38 County Council, and also purchased from the Central Council for Health Education, and was distributed as widely as possible throughout Westminster. The amount available for health education in Westminster is small when compared to the many thousands of pounds spent by cigarette manufacturers in the West End advertising their products. It is hoped, however, that the Department's activities brought home to some of the young people in Westminster 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. During the winter of 1963, 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 Westminster Meals on Wheels Service. 39 Pharmaceutical Services in Westminster In October, 1962, the Council's attention was called to difficulties experienced by residents of the Pimlico area in finding a chemist who kept open late in the evening for dispensing prescriptions. Enquiries revealed that, while there was no official rota for chemists in the Pimlico area to keep open later than normal shop hours, certain of them voluntarily did so for one hour or more after 6 p.m. on weekdays—and a few chemists also opened for a short time on early closing days, Sundays and public holidays. The City Council felt that the arrangements ought to be improved and made suggestions to that end to the London Executive Council of the National Health Service, which was at that time reviewing the pharmaceutical services throughout the County of London. These suggestions included:— (a) the Pharmaceutical List, or extracts from it, should be circulated to all general medical practitioners and Police Stations in Westminster—in addition to Post Offices; and (b) list should be displayed in chemists' shop windows giving details of other chemists' shops in the neighbourhood which were open after normal shop hours. The London Executive Council decided to adopt the first of these suggestions. With regard to the second, the Executive Council stated that this was already in operation, but that consideration was being given to a better form of notice. The Council is also arranging for more detailed information about the pharmaceutical services to be inserted in future editions of the City Council's Information Handbook. (B5852) a 11 Census, 1961 The following figures, extracted from the Report of the Census of the County of London for 1961, are of interest, and illustrate the changes in housing conditions in Westminster during the ten years 1951-61:— Population 1951 1961 99,048 85,735 Density of persons per acre. 39.6 34.2 Number of persons per room 0.76 0.69 Total number of private households 32,449 32,869 Number of households occupying separate dwellings 21,732 28,317 Number of households sharing dwellings 10,717 4,552 Number of households sharing dwellings without exclusive use of stove and sink 3,300 1,983 Number of households without a fixed bath 10,405 5,740 Number of households sharing a watercloset 11,411 8,026 Number of households having exclusive use of piped hot and cold water, fixed bath and watercloset 12,449 16,899 40 The vast majority of households sharing amenities consist of one or two-person households in one, two or three-room accommodation. There are two matters included in the Report to which attention should be called. In the 1951 Census it was stated that there were then 85 households in Westminster without watercloset accommodation while, according to the 1961 census, there were then 115 such households. The accuracy of both these figures is doubted for during the twelve years since 1951 none of these cases has come to the notice of the Medical Officer of Health. It is possible that some confusion might have arisen from the wording of the 1961 census form, as the person completing it was required to indicate whether the household had access to a watercloset " in the building or attached to it This might easily have been taken to exclude waterclosets in, say, the yard, of which there are a number in Westminster. Further, in recording the degree of accessibility intercloset) the symbol "E" was used to indicate "Exclusive" and "E" was again used for" Exclusive" but "N" was used to indicate "Not Exclusive". The explanation may, therefore, be that in the 115 households recorded as having no access to a watercloset, there was, in fact, access on either an exclusive or shared basis to a watercloset which is not necessarily approached from within the building or physically attached to it. Similar remarks apply with equal force in the case of 58 households recorded in the Report as being without a piped cold water supply. The Medical Officer of Health knows of no dwelling in Westminster to which there is not a piped cold water supply available within the building of which it forms part. Sanitary Circumstances Duties performed by the Public Health Inspectors. The following statistics relate to the work of the public health inspectors during 1963:— Dwelling Houses Reasons for initial inspections:— Inspections Complaints 645 House-to-House (by Housing Inspectors) 584 Routine 935 Smoke Control Areas 1,377 Infectious Disease 124 Underground rooms 75 Other parts unfit for habitation 51 Housing circumstances 140 41 Applications for Loans and Grants 146 Drainage 323 Rodent Control 695 Miscellaneous 99 5,194 Included in the above totals are:— Houses in multiple occupation 300 Council properties 232 *Aged and infirm persons 105 Common Lodging House 5 * A further 240 visits were made by the medical officers. 6,358 reinspections were made following the above inspections. Notices served Public Health (London) Act, 1936 106 Noise Abatement Act, 1960 1 107 Statutory Notices 2 Nuisances, defective and unsatisfactory conditions found:— Defective, dirty internally 22 Damp 83 Defecive drainage 26 Defective roofs 25 Water Closets:— Defective or dirty 17 Water Supply:— *Insufficient 20 *Absence of in upper floors 5 Smells 39 Rubbish 35 Animals 13 Other Nuisances 24 Verminous 21 Cockroaches 10 * These abnormally high figures were due to the exceptionally cold winter of 1963. (B5852) A 12 42 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) 4,610 (6) Number of reinspections 6,117 (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 584 (b) Number of reinspections 241 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 45 (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 106 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 89 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 106 (2) Number of dwelling-houses in which defects were remedied after service of formal notices— (a) By owners 106 (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 Nil (3) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil (4) Number of dwelling-houses in respect of which Closing Orders were made Nil 43 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 41 (132 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 5 (14 rooms) 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 23 (67 rooms) (b) Number of Closing Orders made in respect of ground rooms 24 (69 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 22 (88 rooms) (6) Number of Closing Orders made in respect of other parts of buildings 17 (63 rooms) (c) Number of undertakings accepted in lieu of Closing Orders in respect of other parts of buildings 1 (11 rooms) (3) (a) Number of specifications submitted in respect of proposed works to parts of buildings subject to Closing Orders 16 (b) Number of specifications approved 16 (4) (a) Number of Closing Orders determined in respect of underground rooms 4 (11 rooms) (b) Number of Closing Orders determined in respect of other parts of buildings 1 (3 rooms) (5) (a) Number of applications made for modification of Closing Orders to permit approved use 7 (15 rooms) (b) Number of applications approved 7 (15 rooms) 44 (6) (a) Number of cancellations of Closing Orders (premises demolished) 9 (b) Number of cancellations of undertakings (premises demolished) 1 B.—Informal action in respect of parts of buildings unfit for human habitation (1) Number of instances of informal action initiated to secure requirements of the Housing Acts and Regulations made thereunder— (a) in respect of underground rooms 9 (b) in respect of other parts of buildings 88 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 11 (2) Number of cases of overcrowding relieved during the year 5 Housing (Financial Provisions) Act, 1958 House Purchase and Housing Act, 1959 Housing Act, 1961 During 1963, a total of 61 applications for loans or grants under the above Acts were received by the Council, relating to the improvement of 146 dwellings. Altogether, 223 visits were made by the public health inspectors in connection with these applications. Rent Act, 1957—Certificates of Disrepair Three applications for Certificates of Disrepair were received during 1963. In the case of the first application, the necessary works were carried out before the service of notice of the Council's intention to issue a Certificate. The premises which were the subject of the second application were not controlled premises, and therefore the provisions of the Rent Act, 1957, relating to the issue of Certificates of Disrepair, did not apply. The applicant was informed accordingly. Subsequently, it was learnt that the owners had voluntarily remedied the defects. On receipt of the Council's notice of intention to issue a Certificate in respect of the third application, the owner gave an Undertaking on the 20th December, 1963, that he would remedy the defects within six months. 45 Land Charges Act, 1925 The number of enquiries dealt with and reported upon during 1963 was 3,181, relating to 10,720 properties. The number of properties to which these enquiries related was 2,927 more than in 1962. The enquiries concerned outstanding statutory or informal notices, combined drainage orders, smoke control orders, applications for decontrol under the Rent Restrictions Acts, and certificates of disrepair. Additional questions appeared on many of the search forms, mainly in regard to any proposals for dealings 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. In addition, special enquiries were dealt with in relation to 2,500 premises which form part of one of the principal estates in the City of Westminster. Assessment of Housing Priorities on Medical Grounds During the year, 140 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. Slum Clearance Clearance Areas In pursuance of the City Council's slum clearance programme 1961-65> I made representations during 1963 for dealing with a further 10 unfit houses (including 27 flats) in the Green's Court/Peter Street area of Soho. At its meeting in November 1963, the Public Health Committee decided to adjourn consideration of these representations to enable me to discuss with the freeholders of the various premises whether they would be prepared jointly to imdertake a comprehensive rebuilding scheme, including the provision of a substantial number of new units of housing accommodation. At the end of the year these discussions were still in progress, but as a result thereof, the freeholder of three of the premises had expressed his willingness to sell his interest to the Council. 46 Westminster (Dufour's Place, Broadwick Street and Marshall Street) Compulsory Purchase Order, 1959 Demolition of the buildings included in the above Compulsory Purchase Order, which includes the lands comprised in the Westminster (Dufour's Place, Broadwick Street and Marshall Street) Clearance Area, 1958, and the Westminster (Marshall Street) Clearance Area, 1958, was completed during 1963. The site has been let for use as a temporary car park pending redevelopment by the City Council for housing purposes. Housing Act, 1961—Houses in Multiple Occupation Progress By the end of 1963, the public health inspectors had completed a routine house-to-house survey of 230 houses located mainly in the Pimlico area of the City. Of these 230 premises 180 were found to be in multiple occupation. Schedules of works required, which covered items of dilapidations, fire precautions (as agreed with the London County Council), the provision of additional facilities and, where applicable, works to basement, were sent to the owners of 16 premises. Standard Form of Tenancy Agreement where Controlled Tenants are rehoused The Housing and Public Health Committees at their meetings in October, 1963, considered how the service of notice under Section 15, requiring the provision of additional basic facilities and services, will affect living conditions in the premises. In cases where the execution of the necessary works will result in the temporary or permanent displacement of any tenant, the Public Health Committee wished me to do all that I can to ensure that the landlord adopts a reasonable attitude towards that tenant, and, where practicable, that the landlord either takes the tenant back in the case of temporary displacement, or provides alternative accommodation in the event of a permanent displacement. On the instructions of the Housing and Public Health Committees, the Town Clerk arranged for Conveyancing Counsel to settle a model form of tenancy agreement which could be recommended to landlords for adoption. Complaint of Noise—Intimidation of Tenants On the 1st August, 1963, the City Council, on the joint recommendation of the Housing and Public Health Committees, expressed its intention to consider exercising to the fullest extent its statutory powers, including where necessary compulsory purchase, to deal with any case which might 47 come to its notice where a landlord of house property in Westminster acted with conscious and flagrant disregard for the rights of his tenants to the quiet and peaceful enjoyment of their lettings. I had reported to the July meetings of the Housing and Public Health Committees the instance of a tenant of a furnished letting on the second floor of a house in multiple occupation. This tenant had recently taken up residence in the house, and frequently held noisy all-night parties which not only disturbed four other tenants in the house (at least three of whom were statutory tenants), but also caused annoyance to families living in the neighbourhood. In spite of complaints from the tenants and nearby residents, and a letter from the Town Clerk to the landlord, disturbance by the all-night parties continued. The statutory tenant of the third floor of the premises consulted the local Citizens' Advice Bureau about the annoyance and inconvenience she was suffering. As a result, this lady, showing considerable public spirit and courage, instituted County Court proceedings against the offending tenant, although she was not entitled to legal aid and despite the fact that she only had limited means. The case was heard at the Bloomsbury County Court on the 31st July, 1963, when the Judge granted the plaintiff an interim injunction restraining the tenant complained of from committing any further acts of nuisance at the premises. The defendant immediately vacated the premises and, as it had not been possible to trace his whereabouts, the proceedings in the County Court which were set down for final hearing on the 7th October, 1963, were withdrawn. Because the defendant had disappeared, the plaintiff had not been able to recover any of her costs in the proceedings which amounted to £91 10s. 6d. At its meeting on the 12th December, 1963, the City Council adopted a recommendation of the General Purposes Committee that the sum of £91 10s. 6d. be paid to the plaintiff in reimbursement of her legal costs. In view of the publicity given to these proceedings, and the interest which the Council openly displayed in their result, landlords, as well as tenants, were left in no doubt what the Council's attitude would be if there were any further cases in Westminster of the intimidation of statutory tenants. 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. Five visits were made by the Public Health Inspectors to the lodging houses during the year. 48 The Offices, Shops and Railway Premises Act, 1963 This Act received the Royal Assent on 31st July, 1963. Provisions relating to registration of premises come into operation on 1st May, 1964, but the majority of the provisions operate from 1st August, 1964. In certain instances statutory regulations to be made by the Government will come into force during 1965. The Act contains provisions for securing the health, safety and welfare of persons employed in offices, shops and railway premises. The duty of enforcing the Act has been placed on local authorities in regard to the majority of the provisions, on fire authorities (in London the London County Council) in relation to fire precautions and upon H.M. Inspector of Factories in respect of the remaining provisions. In certain types of premises, such as Crown Properties, Fire and Police, Education, and premises occupied by local authorities, the provisions will be dealt with by the Factory Inspector. The Council's duties under the Act have been referred to the Public Health Committee and in January, 1963 the establishment of the Public Health Department was increased by four posts of public health inspector to help undertake inspections necessitated by this Act. It was possible to recruit some of these additional inspectors during 1963 and, pending the coming into operation of the Act, they were engaged on house-tohouse inspections under the housing survey already in operation. Subsequently, in December, 1963, the establishment of the Department was further increased by one post of shorthand-typist to assist the inspectors with their work. The Act contains the following general requirements for dealing with conditions in offices, shops and railway premises:— Cleanliness Overcrowding Temperature Ventilation Lighting Sanitary conveniences Washing facilities Drinking water Accommodation for clothing Seating arrangements Seats for sedentary workers Eating facilities Floors, passages and stairs 49 Fencing of exposed parts of machineryCleaning of machinery Training and supervision of persons working at dangerous machines Prohibition of heavy work First aid Penalisation of dangerous acts and interference with equipment Dangerous conditions and practices Information for employees During 1963, pilot surveys of certain blocks of offices in Westminster were carried out by the Council's officers in order to gain experience in this type of work and to ascertain the conditions existing. Because of the large number of offices and shops in Westminster and to deal fully with all the above matters, it will inevitably take a period of some years before inspections of all premises can be carried out and the required conditions achieved. 50 Inspection of Factories, Workplaces, Shops, Offices and Other Premises (other than food premises) Total Number of Visits Factories—Power 464 Factories—Non-power 120 Workplaces, etc 3,384 Offices 4,391 Shops (other than food) 717 9,076 Reasons for initial inspections:— Complaints 533 Routine 1,349 Infectious Disease 33 Drainage 512 Rodent Control 403 Smoke Control 477 Outworkers 37 3,344 Re-inspections 5,732 Types of premises inspected:— Places of public entertainment 54 Carpentry, joinery, etc 13 Wearing apparel 640 Furriers 60 Garages, motor tyres and rubberworks 72 Boots and shoes and other leather goods 24 Jewellers, precious and other metal-workers 39 Hairdressers 93 Laundries and dry cleaners 24 Printers and publishers 133 Warehouses and packers 14 Shops (other than food) 717 Photographers, film renters 57 Opticians 2 Florists 6 Offices 4,391 Various (schools, hospitals, halls, building sites, etc.) 2,738 9,076 51 Notices Served Factories Power Factories, Nonpower Workplaces, Offices, Shops, etc. Total Public Health (London) Act, 1936 - - 21 21 Factories Act, 1961 58 8 — 66 Noise Abatement Act, 1960 — — 7 7 L.C.C. (General Powers) Act, 1937 - - 2 2 Shops Act, 1950 — - 1 1 58 8 31 97 Nuisances, Defective and Unsatisfactory Conditions Found Factories Power Factories Non-power Work places, Offices, Shops, etc. Damp — — 9 Inadequate underfloor ventilation — — 1 Defective drainage 1 — 23 Sanitary accommodation:— Insufficient — 2 — Insufficient ventilation and light 19 1 1 Defective or dirty 44 5 15 Direct approach 1 1 — Not separate for sexes 4 1 — Unsuitable — — 1 No indicating notices on doors of water-closets 21 4 — Water supply:— Insufficient — — 2 Absence of in upper floors — — 1 Smells — — 92 Rubbish — — 33 Animals — — 2 Other nuisances — — 19 Temperature — — 1 Want of ventilation — — 4 Cockroaches — — 3 Overcrowding — — 1 Failure to display Abstracts from Factories Acts 60 19 — 52 Factories Act, 1961 Section 70—Basement Bakehouses There are five basement bakehouses in Westminster in respect of which Certificates of Suitability are in force. Section 133-—Outworkers Number of outworkers (includes 2,322 workers living in areas outside the city) 3,328 (See Appendix II to this Report.) Food and Drugs Act, 1955 Inspections of all types of food premises Reasons for initial inspections:— Complaints 376 Routine 4,672 Infectious Disease 43 Drainage 94 Rodent Control 139 New catering proposals 171 Miscellaneous 4 5,499 2,407 reinspections were made following the above inspections. 53 Catering Establishments At the end of the year, particulars of 3,012 catering establishments were in the register. Summary of inspections:— Hotels, restaurants, clubs 3,399 Cafes, teashops, etc. 388 Staff Canteens 20 Public Houses 230 4,037 Notices served Public Health (London) Act, 1936 3 Food Hygiene (General) Regulations, 1960 46 Noise Abatement Act, 1960 3 52 Nuisances, defective and unsatisfactory conditions found:— Dirty, dilapidated internally 29 Defective internally 47 Defective externally 1 Defective area paving, etc. 1 Defective floors 20 Preparation tables and equipment worn and insanitary 15 Food storage accommodation inadequate and unsuitable 15 Vegetable preparation and washing up facilities worn and insanitary 22 Ventilation insufficient 11 Staff washing facilities insufficient and unsuitable 4 Staff changing rooms insufficient and unsuitable 4 Fuel, rubbish and other extraneous materials in food preparation rooms 4 Fuel storage accommodation insufficient 1 Water Closets:— Insufficient 1 Insufficient ventilation and light 14 Defective 8 Dirty and dilapidated 6 Direct approach from food room 1 Not separate for sexes 1 Smoking in catering premises 1 Cockroaches 1 54 Food Shops and Food Premises (Other than Catering Establishments) Types of businesses and summary of inspections:— Inspections Bakehouses (underground included) 30 Dairies and milkshops 126 Ice cream premises 147 Meat shops 435 Other meat shops (preserved food, etc.) 2 Stalls 248 Confectioners 336 Fruit and greengrocery 556 Provision shops 1,195 Fish and poultry 277 Fried fish shops 50 *Other Food Premises 467 3,869 Included in the above totals are 13 visits of enquiry in relation to food poisoning outbreaks. *0ther 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 II of the Poisons List. (6) Visits of enquiry regarding adulterated samples. Notices Served Food Hygiene (General) Regulations, 1960 8 Nuisances and defective conditions found:— Dirty and dilapidated internally 8 Defective internally 5 Defective floors 3 Preparation tables and equipment worn and insanitary 2 Fuel, rubbish and other extraneous materials in food preparation rooms 1 55 Water Closets:— Insufficient ventilation and light 1 Dirty and dilapidated 4 Direct approach from food room 1 No indicating notices 1 Ventilation insufficient 1 Smoking in Food Premises 2 Visits for the Purpose op Obtaining Samples and Inspecting Foodstuffs Sampling Inspection of food Bakehouses — 1 Confectioners 26 330 Dairies and milkshops 100 149 Fish and poultry 5 307 Fried fish shops 1 2 Fruit and greengrocery 17 615 Ice cream premises 57 143 Meat shops and stalls 2 633 Other food premises 94 454 Provision shops 91 1,253 Cafes, teashops, etc 9 94 Hotels, restaurants, clubs, etc. 29 96 Staff canteens 2 9 Public Houses 21 7 454 4,093 Food Sampling During the year the following 1,540 samples were submitted to the City Council's Public Analysts for chemical analysis. Of this number 52 were reported upon adversely, representing a percentage of 3-4. Ales, beer and stouts 56 Baby foods 24 Baking powder, pastry, cake, cake and pudding mix and fillings 49 Bread, biscuits and rusks 12 Butter 23 Cereals 37 Cheese 35 Coconut, dessicated 2 56 Coffee and coffee extracts 18 Condiments and spices 30 Cooking fats and oils 13 Confectionery 69 Cream 7 Custard powder, blancmange and jellies 20 Drugs 42 Fish and fish products 35 Flavourings, colourings and essences 29 Flour 17 Fruit, canned, bottled and dried 51 Herbs 2 Icecream 115 Ice and ice cream lollies 26 Jams, marmalade and preserves 28 Malted beverage and tablets 3 Margarine 10 Meat and meat products 51 Milk 400 Milk, evaporated 3 Pickles and sauces 29 Pies and sandwiches 4 Sausages 3 Soft drinks, syrups, fruit juices, etc. 110 Soups and soup powders 19 Spirits and wines, etc. 79 Tea 32 Vegetables, tinned, etc 32 Vinegar 10 Yeast and yeast extract 3 Miscellaneous 12 57 Samples submitted for chemical analysis, on which the Public Analyst reported adversely, included the following:— A complainant alleged that a bottle of Champagne which was bottled 20 years ago, and which he had purchased, caused him to be sick. The price paid for the Champagne was about half the normal cost. The remainder of the Champagne received from the complainant and a formal sample were submitted to the Public Analyst who stated that the quality had deteriorated, probably as the result of bottling under war-time or immediate post-war conditions. The Champagne tasted and smelt vinegary. The retailer was informed of the analysis, and of his responsibility under the Food and Drugs Act, 1955, to ensure that food (which includes drink) sold by him was in all respects fit for human consumption. One half-pound pack of wrapped butter purchased from a shop in Westminster was found, on analysis, to contain small pieces of transparent material of the cellulose acetate type, with layers of general dirt and a small amount of mould. The butter formed part of 1?, lbs. purchased by the complainant. Enquiry revealed that the butter had been packed and manufactured by different companies. Representatives of all concerned were interviewed, but investigations failed to reveal the source of contamination. Tinned goods, including preserved mixed fruit, salted cucumbers, preserved vegetables and lychees, were the subject of a report from the Public Analyst. Two of the samples were found to have a dangerous contamination of nickel and tin, and others contravened the provisions of the Labelling of Food Order. All the goods were imported from a British Colony. On the receipt of the Analyst's report immediate surrender was accepted of the remaining stock of goods held by the retailer which were affected by metallic contamination. General information was given to the retailer, who was also the importer, of his responsibilities to ensure that foodstuffs offered for sale complied in all respects with relevant Statutes and Regulations. The appropriate Government Department of the Colony and the local authority concerned were informed of the matter. A portion of minced meat purchased was found to contain small pieces of bone. Investigation revealed that in all probability a small piece of bone had been picked up with the trimmings, and passed unnoticed through the mincer. The butcher's shop concerned was very clean and well maintained. The complainant accepted a refund of the cost of the meat. Samples of dried shrimp imported from abroad were stated on the label of the tin, to contain ' starch, shrimp paste and salt' in that order. The starch accounted for 79 per cent of the commodity in one sample, and 78.3 per cent in the second sample. It was considered that the sample should more correctly be described as ' Dried shrimp flavoured slice Representations were made to the packers by the local authority regarding the unsatisfactory labelling. 58 A sample of Bakewell tart mixture containing instructions for making 'Real Home Made Bakewell Tarts" was adversely reported upon. In the opinion of the Analyst, bakewell tarts must be made essentially from ground almonds, whereas this ingredient was absent from the sample. The manufacturers were informed of the Analyst's contention, but they maintained that research had established that some people used ground almonds in bakewell tarts, and some did not. Various recipe reference books were consulted, and these mostly agreed with the Analyst's opinion. However, one universally accepted cookery book did give an alternative recipe, which excluded the use of ground almonds. The manufacturers were reminded of the differing views expressed in relation to their product. Several tinned meat products were reported as having, in the opinion of the Public Analyst, an insufficient total meat content. There is no statutory standard for the meat content of canned meat products, but minimum limits have been recommended in the Report of the Food Standards Committee of the Ministry of Agriculture, Fisheries and Food, published in 1962. These recommendations as yet have no statutory force, and the manufacturers and the Ministry concerned were informed of the analyses. Tinned spaghetti sauce imported from the Continent, had the word 'vegetables' on the label as a description of an ingredient. The Labelling of Food Order requires that the statement on a label shall specify in the case of a food made of two or more ingredients, the common or usual name of the food, and the appropriate designation of each ingredient, and where it contains an ingredient which is made from two or more constituents, the appropriate designation of these constituents shall be specified. The product was in fact not a spaghetti sauce, but a tomato sauce. Following representations an amended label was submitted to this Department which incorporated suitable amendments. Gear oil was found to be present in a loaf which had been baked at premises outside Westminster. The complaint arose from the too liberal application of oil, to the bread-making machinery. Enquiry revealed that the oil used was of the edible variety. The Company on being informed of the matter apologised for the incident, and undertook in future to keep the use of oil to a minimum. The local authority in whose area the bakery was situated reported the premises to be clean, well supervised and generally satisfactory. A bottle of milk was found to contain a lump of material approx. | in. cube adherent to the inside of the bottle. It was considered that the material consisted very likely of cement dust, together with decomposed milk. Proceedings were instituted against the Company concerned, and a fine of £20 was imposed by the Justices. 59 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 complaint was received of a loaf which was thought to contain mouse droppings. On examination the "droppings" were found to consist of poppy seeds. A packet of sweet peppers purchased at a multiple store was found to be affected with mould. The Public Health Inspector inspected the remainder of the stock displayed, and found two further packs similarly affected. A representative of the manufacturing Company arranged immediate replacement of the stocks at the shop, and the matter was taken up with the suppliers overseas. The complainant was recompensed. A doughnut which contained mould growth was brought to the Department. The bakers investigated the complaint which arose through human error. Cakes were normally baked in sufficient numbers for the daily needs only of the branch shops, any surplus being returned. It was beleived that in this instance an unsold cake intended for return to the bakery had inadvertently become mixed with cakes intended for sale in the shop. A beetle was found in a loaf, the insect being identified as tenebroides mauritanicus. The matter was discussed with the management with the result that certain works were undertaken at the bakery, and regular disinfestation arranged. Subsequent to this complaint, a further case arose concerning the same firm—a loaf purchased by a customer was found to contain a fly. Legal proceedings resulted, and a fine of £5 with £5 5s. 0d. costs was imposed. Apple strudel was found to be affected by mould growth. The Inspector called at the retail premises and found that pies on receipt were kept in an unventilated cupboard at the shop until all were sold. The proprietor was informed that it was unwise to keep pies of this nature for longer than 48 hours, following delivery, and that storage should in any case be in a properly ventilated food cupboard. A complaint was received that minced meat purchased from a local store was unfit prior to use the following day. The retail premises were a large multiple store where there was a continuous demand and prepared stocks were soon exhausted. The management were of opinion that the meat in question was unlikely to have been in the shop longer than a few hours before being sold to the customer. It is possible that the deterioration of the meat took place after purchase. The use of a polythene bag or similar container by the complainant to carry the meat home could have provided a suitable environment for this deterioration. The shop concerned refunded the cost of the meat. 60 Eggs purchased at a retail grocery were found to be bad. Enquiry at the shop revealed an inefficient system of rotation of stock, and the management were instructed to ensure that close attention be given to this in future. A tin of raspberries was found to contain an insect. The product was canned on the Continent, and the trade representative of the Embassy in the United Kingdom of the country concerned instituted an investigation at the factory. He reported that the construction of the factory precluded insects having free access to fruits intended for processing, and furthermore, the cleaning process appeared to be adequate. He stated that the matter was viewed with some seriousness, and emphasised that every effort would be made to safeguard the interest of the consumer. It was arranged that the complainant should be recompensed. A cake purchased from a multiple store was found to contain a piece of adhesive bandage. The cake was made at a factory outside the United Kingdom. It transpired that adhesive bandages used at the factory contained a thin metal strip for the very purpose of avoiding the type of complaint received. The purpose of this strip was to ensure that should a bandage inadvertently gain access to the mix, the metaldetector device on the production line would immediately indicate its presence, and the necessary action could be taken. In this instance, however, the operative responsible had not adhered to the Company's regulations, and had used a bandage not of their design and without the metal strip. The complainant after first indicating her willingness to participate in legal proceedings had such action been taken, decided that she did not wish to be further involved. As the complaint originated through the failure of an employee to adhere to the Company's standing instructions in relation to the use of special first aid facilities, there was some degree of mitigation. However, the Company were reminded of the inherent danger in an incident of this nature. The purchaser of a small almond tart found on cutting the cake that it contained an open safty pin. Legal proceedings were instituted against the bakers concerned who also owned the retail premises; the Magistrate granted an absolute discharge with £10 10s. Od. costs. Food Poisoning During the year 21 notifications were received of persons suffering from food poisoning. Eleven of these were single cases; nine others were in-patients at a teaching hospital who were notified as suffering from an infection due to salmonella Brandenburg. The remaining notification concerned one person, who was concerned with five others who were not 61 notified, but were all found to be excreting salmonella typhimurium organism; this was later phage typed as l2a. In the hospital incident, the matter was dealt with by the hospital authorities, and as far as is known no source of infection was discovered. In the other case in which six persons were affected, the investigation was conducted in company with an official of the Ministry of Health. No positive conclusion was reached. A mild outbreak affecting 24 workers and canteen staff at a building site was investigated by the Public Health Inspector and C1. welchii was isolated from specimens obtained. CI. welchii is an organism which, if present in food may, under suitable conditions of temperature and humidity, multiply and form toxins. Food poisoning from this cause is especially associated with pre-cooked meat which has been re-heated, since even boiling does not destroy the toxins once they have formed; symptoms include stomach pains and diarrhoea of short duration occurring several hours after consumption of the meal. In this incident the meat available for examination was found to be free from pathogenic organisms. Other cases of illness which was suspected to have been food borne in origin were reported to the Department and all were investigated. In one case a coach party from the country came to the West End for a prearranged meal and a visit to the theatre. On the return journey home eight persons were taken ill and received treatment. Samples of food consumed at the restaurant and specimens from those examined were all reported negative. No likely source of initial contamination or infection of the food concerned was discovered at the restaurant. Food Premises—Registration A proposal put forward by a Metropolitan Borough during 1963 suggested the introduction of legislation requiring that all premises, and the proprietors thereof, where the handling of food takes place, should be registered with the local authority for the area where the premises are situated. At present, only those premises where the manufacture or sale of ice cream, or manufacture of preserved foods, takes place are required to be registered with the local authority, and then only if catering is not a major part of the activity carried on. It is considered that in the interests of securing the best possible standards of hygiene in the handling of food, such registration should be effected with the local authority. Whilst this may not be of prime importance in the case of established businesses, it is of importance at the 62 commencement of a new business for a new proprietor to be aware of the Regulations which exist to ensure maximum food hygiene, and his responsibility thereunder. The proposal has been referred to the Ministry concerned but legislation to secure the compulsory registration of all food premises and food traders has not yet been effected. Provisions exist for intending street traders to make application to a local authority for licensing or registration before they are entitled to trade, but difficulty lies with those traders who are neither registered nor licenced, but who flagrantly defy the law and carry on their trade, usually in articles of food for immediate human consumption. The standard of hygiene employed by these latter traders is often of a low order or non-existent, and is a potential danger to public health. They are often employed on a casual basis and have little knowledge of even the elements of food hygiene. Milk and Dairies (General) Regulations, 1959 At the 31st December, 1963, 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 133 Milk (Special Designation) Regulations, 1960 During the year twelve 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. Examination of Milk During the year 43 samples of milk were submitted for methylene blue and phosphatase tests. The phosphatase tests of all samples was satisfactory, but in seven cases the methylene blue test was declared void. The prescribed test for Tuberculin tested and Pasteurised milk under the Milk (Special Designation) Regulations, 1960 provides that if during the period of storage the atmospheric shade temperature exceeds 70°F, the test shall not be applied. In the case of these seven samples, the atmospheric shade temperature in the laboratory exceeded 70°F during the period of storage and the test was, therefore, rendered void. 63 Food and Drugs Act, 1955—Section 16 Registration of premises in connection with the manufacture, sale or storage of ice cream. Two hundred and seventy-five 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. Sixty-nine premises are registered for the preparation or manufacture of preserved foods. Ice Cream (Heat Treatment) Regulations, 1959 During the year, 94 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 63 2 22 3 5 4 4 It will be noted that nine samples failed to reach a satisfactory grading, and of these only four were placed in the lowest grade. Two of these latter samples were from manufacturers who have premises in Westminster, but subsequent samples taken showed a satisfactory grading. 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 meat and fish 1 18 94 Canned vegetables and fruit 7 10 47 Bottled and packeted foods 2 0 28 Frozen foodstuffs 2 18 44 Meat 2 18 75 Fish 1 1 8 Fruit and vegetables 305 4 87 Confectionery 1 4 31 Fats — 2 109 Cereals — 4 33 325 3 108 64 Method of disposal of condemned food Food condemned or voluntarily surrendered to the Public Health Inspectors is disposed of by depositing in the Council's refuse barges at the Central Depot at Gatliff Road, S.W.1. 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. Analysis of Legal Proceedings, 1963 Fines Costs £ s. d. £ s. d. Food and Drugs Act, 1955, Section 2 Selling to the prejudice of the purchaser food not of the nature or substance demanded— 1 conviction 500 550 Food Hygiene (General) Regulations, 1960 Failing to take such steps as were reasonably necessary to protect food from risks of contamination— 2 convictions 45 0 0 10 10 0 Insanitary premises and equipment— 5 convictions 80 0 0 15 15 0 Other contraventions— 3 convictions 1 10 0 — Colouring Matter in Food Regulations, 1957 Selling minced meat intended for human consumption, in a raw and unprocessed state, containing added colouring matter— 1 conviction 7 00 440 £138 10 0 £35 14 0 Licensing Act, 1961 The above Act contains provisions for regulating the conduct of Clubs, where intoxicating liquor is supplied to members and their guests. 65 A Club wishing to obtain a registration certificate which is for an initial period of 12 months with renewal thereafter must apply to a Magistrates' Court and notification must also be made to the Police and the local authority. Statutory grounds are laid down on which objection to an application may be lodged by the Police or the local authority. Similar legislation is contained in the Act in relation to objections to applications made to the Licensing Justices for On-licences, in respect of the supply of intoxicating liquor to Clubs, restaurants, private hotels, and guest houses, etc. My last Annual Report gave details of applications for Club Registration Certificates and Justices' Licences respectively which had been made to the Magistrates' Courts and the Licensing Justices in 1962 and which stood adjourned, or had not then been heard at the end of the year. Five applications for Club Registration Certificates to which the Council had lodged objections were outstanding at the end of 1962. At the hearing of these applications, two were refused, one was withdrawn, one was adjourned sine die. In the remaining case a Certificate of Registration was granted for the period of one year following the completion of works. Total costs awarded to the Council were £51 10s. 0d. Three applications to the Licensing Justices for Justices On-licences were similarly outstanding at the end of 1962. These were ultimately resolved—two being granted, subject to the completion of certain works, the remaining application being withdrawn. Two appeals against the Magistrates' refusal to grant Certificates of Regist ration in respect of premises to which the City Council had previously lodged an objection, were pending at the end of 1962. In one case the appeal was abandoned, and in the other case it was dismissed. During 1963 only one objection was lodged in respect of an application for a Club Registration Certificate. This was on the grounds that the first-floor room it was proposed to use as club premises was unoccupied and was not adapted for the purposes of a club. Information was subsequently received that the owner of the property had, on further consideration, decided not to agree to lease the accommodation for club premises and the application was withdrawn by the applicant. Three objections were raised to applications made to the Licensing Justices for On-licences. All were in respect of club premises. In two of these the applications were granted, subject to the completion of certain works to satisfy the Council's requirements, and in the remaining case the application was withdrawn. In this latter case, following completion of work to satisfy the Council's objection, a successful application Was made by the Club concerned for a Club Registration Certificate. 66 During the year the following applications were received:— Club Registration Certificates: New applications 14 Variations 1 Renewals 121 Justices' Licences: Applications (including re-grants) 112 During the year the Public Health Inspectors concerned with catering premises again attended all the meetings of the Licensing Justices in order to give evidence in connection with works proposed or in progress at the licensed premises where such alterations concerned the food preparation area or sanitary accommodation. Export Certificates Applications for Certificates of Export continued to be received in the Health Department, in respect of foodstuffs which consignors wished to despatch to places outside the United Kingdom and for which the authorities in the recipient country required a Certificate stating that the goods mentioned therein had been examined by the Public Health Inspector and found to be fit for human consumption. During 1963, 48 such certificates were issued in respect of foodstuffs, which included Scotch salmon, tinned caviar, Spanish tomatoes, frozen trout, peeled prawns, rock lobster, Stilton cheese, turbot, crab meat and cartons of langoustes' tails. Examination of Foodstuffs Three thousand, four hundred and forty-four cartons, each containing 6x5 kilo tins of canned pears were on a barge which sank in the River Thames and remained submerged before being refloated and repaired. The incident occurred late in January, 1963, during the bitterly cold weather, and the goods on recovery were found to be frozen solid. On the day following recovery of the barge, the cans were inspected by one of the Council's Public Health Inspectors, who found them to be in a remarkably good condition. As, however, they had been immersed in river water, it was considered that the cans should be cleansed externally and disinfected before use. An undertaking to this effect was obtained from the consignee Company and the goods were eventually transported by road to the Company's factory, for storage and processing. The Medical Officer of Health for the district concerned was informed to ensure that sterilisation of the cans was carried out in accordance with the undertaking given. 67 This incident necessitated the attendance of the Public Health Inspector and assistants for considerable periods at the wharf in Westminster. New Legislation The following brief summary of legislation relating to food which was promulgated during the year, is noted for information. The administration of these Regulations, where appropriate, will be the responsibility of officers of the Public Health Department. Meat Inspection Regulations, 1963 These regulations, which apply to England and Wales only, came into operation on the 1st October, 1963, and replace, with amendments, the Public Health (Meat) Regulations, 1924 to 1952. They relate to the inspection of carcases of animals at slaughter houses and the marking thereof. There are no slaughter houses in Westminster. Bread and Flour Regulations, 1963 The Bread and Flour Regulations re-enact the Flour (Composition) Regulations, 1956, and come into operation on the 1st September, 1964. The regulations lay down requirements as to the composition of wheat meal and wholemeal, milk bread, skimmed milk bread, butter bread, protein bread and gluten bread; and list permitted ingredients for wheat bread, brown bread, wheatmeal bread, wheat germ bread, wholemeal bread and soda bread. The regulations also permit the use in flour, other than wholemeal, of certain bleaching and improving agents. Prohibitions and regulations are laid down in relation to advertising and labelling. Provision is made for seizure of bread or flour not complying with the regulations. Ice Cream (Heat Treatment, etc.) (Amendment) Regulations, 1963 These regulations came into operation on 18th June, 1963, and amended the Ice Cream (Heat Treatment, etc.) Regulations, 1959, by allowing the addition of sugar to sterilised or pasteurised mixtures used in the manufacture of ice cream. Milk (Special Designation) Regulations, 1963 These regulations re-enact with amendments the Milk (Special Designation) Regulations, 1960. The principal changes are that on and after the 1st October, 1964:— (a) "Untreated" replaces "Tuberculin Tested" as the special designation for raw milk. (b) The test for milk to which a producer's licence relates has been replaced. 68 (c) The granting of a general licence for a restricted amount of milk in any one year to certain producers who sell milk produced from herds owned or controlled by them in the course of catering sales at or from premises where the herds are maintained. (d) The introduction of a producer's licence, valid for one month. 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 1963 there were no occasions on which heavy storms caused the sewers in the City to become surcharged and cause flooding. Public Health (London) Act, 1936 London County Council (Drainage) Byelaws, 1934 Drainage Drainage plans submitted 504 Combined drainage orders made 49 Prevention of Damage by Pests Act, 1949 Rats and Mice Repression Complaints received 434 Treatments undertaken 599 Inspections by Public Health Inspectors and Rodent Officer 2,020 Notices served — Rodents destroyed Black Rats 336 Brown Rats 3,411 Mice 3,900 69 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 licenoe was issued for the use of premises for storage purposes. Noise Nuisance Complaints received 75 Investigations made 120 Notices served 11 During 1963, complaints were received of noise caused by the following:— Compressors, pneumatic drills, machinery, building and demolition operations; cement mixer, crane, dismantling scaffolding; ventilating machinery, boiler, factory; radio, music and singing, and other noises, including those from cars arriving at and leaving clubs and dance halls; customers arriving at and leaving public houses; the yapping of dogs; taxis; chiming of bells; and banging by other 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. It was necessary for statutory action to be started during 1963 in regard to some such cases and there were also several occasions on which strong warnings were 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. Eleven notices under the Noise Abatement Act, I960, were served during 1963 in respect of the following matters:— Four in connection with compressors used on building sites. One in connection with works of demolition. 70 One in connection with building operations. One regarding a ventilating fan in an office. Two in connection with noises from clubs—dance bands, juke box, staff putting out dustbins, and noise created by members. One in connection with a gramophone in a public house. One regarding a noisy radio in a private dwelling. 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. 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 Boad and Marshall Street (each having two swimming pools) and at Great Smith Street, where there is one pool. The water for each of these 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. 71 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. Up to 31st August, 1963, an independent firm of analytical chemists took samples (without notice) of water from the swimming pools each fortnight. From 1st September, 1963, this work was undertaken by the public health inspectors in the course of their routine duties. 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, 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. Up to the end of August, 1963, an independent firm of analytical chemists took samples every week (without notice), but since 1st September, 1963, this work has been undertaken by the public health inspectors in the course of their normal duties. The results show that the water is maintained to a high bacterial and chemical standard. There is also the Lido in Hyde Park, which is under the control of H.M. Minister of Works. During 1963, a total of 213 samples of swimming bath water were examined; 71 were taken by the analytical chemists and 142 by the public health inspectors. Radioactive Substances Act, 1960 The Radioactive Substances Act, 1960, came into operation on the 1st December, 1963. The Act— (а) introduced a system of registration by the Minister of Housing and Local Government of premises at which radioactive substances and apparatus are kept or used, and required the Minister to send copies of registration certificates to local authorities in whose areas the premises are situate; (b) prohibited the accumulation or disposal of radioactive waste except with the authority of the Minister. The Minister is required to consult with appropriate local authorities and public bodies before granting any authorisation which is likely to result in a need for special precautions to be taken by them. Copies of all authorisation certificates must be sent to the local authorities whose areas will be affected by any authorisations. The Minister is 72 empowered to provide adequate facilities, where these are not available, for the safe disposal or accumulation of radioactive waste, and is required to consult with any local authority in whose area he proposes to provide such facilities. Where a local authority takes any special precautions in connection with the disposal of radioactive waste in accordance with an authorisation, or with the prior consent of the Minister, it may recover the cost of taking such precautions from the person to whom the authorisation was granted. The Act precludes local authorities from taking action under general public health legislation as specified in the first schedule of the Act, and any local enactment which contains powers for the control of nuisances, on account of the radio-activity of any substance or article or of any part of any premises. There are two aspects of the Act which concern the Council:— (i) it may be consulted by the Minister on applications for the registration of premises in Westminster on which radioactive substances may be kept or used, and (ii) it may also be consulted with regard to the disposal of radioactive waste. The Council decided that its functions under the Radioactive Substances Act, 1960, as regards disposal of radioactive waste in refuse tips should be delegated to the Public Cleansing and Baths Committee but that other functions under the Act should be referred to the Public Health Committee. So far, 14 notifications of registration of premises and nine authorisations for the disposal of radioactive waste have been received from the Minister of Housing and Local Government in respect of premises in Westminster at which radioactive substances are used. 73 Atmospheric Pollution Investigation into the atmospheric pollution in the City was continued during the year at three sites, Mayfair, Pimlico and Charing Cross, where deposit gauges, which measure the deposited pollution, and lead peroxide cylinders, which measure the sulphur activity, are sited. The following table gives the results of the monthly analyses, and shows separately the amounts of insoluble and soluble constituents. Monthly deposits of impurities—tons per square mile. Month Mayfair. Pimlico. Charing Cross. 1963 Insol. Sol. Total. Insol. Sol. Total. Insol. Sol. Total. January 10.64 12.28 22.92 13.08 13.76 26.84 30.93 24.49 55.42 February 10.84 10.13 20.97 14.49 13.52 28.01 12.81 11.68 24.49 March 17.08 23.02 40.10 16.81 23.56 40.37 20.47 19.05 39.52 April 19.84 16.13 35.97 17.11 15.40 32.51 21.90 18.22 40.12 May 10.23 12.79 23.02 11.17 12.89 24.06 14.20 14.54 28.74 June 8.79 13.50 22.29 10.47 12.68 23.15 11.15 13.44 24.59 July * * * 7.25 6.51 13.76 6.07 5.64 11.71 August 5.52 7.67 13.19 9.16 13.29 22.45 8.83 10.45 19.28 September 7.67 6.96 14.63 11.27 8.86 20.13 11.61 7.97 19.58 October 6.03 8.46 14.49 9.56 10.07 19.63 10.22 11.88 22.10 November 8.38 11.73 20.11 12.24 14.60 26.84 13.70 14.27 27.97 December 9.61 11.05 20.66 14.96 13.42 28.38 12.64 11.55 24.19 * No readings available; apparatus damaged by gale.force wind. 74 Estimation of sulphur activity by the lead peroxide method The cylinders for the estimation of sulphur activity are situated at Mount Street Gardens, Bessborough Street Clinic, and Alhambra House. The following table gives the degree of sulphation expressed in empirical units, viz., milligrams of sulphur trioxide per day per 100 square centimetres of standard lead peroxide exposed in the standard apparatus. Month. S03 in milligrams per 100 sq. cms. per day. Mayfair. Pimlico. Charing Cross. January 5.00 5.19 6.89 February 3.83 3.97 5.57 March 3.09 4.40 4.33 April 3.96 4.35 5.32 May 2.98 3.17 3.37 June 2.13 2.53 2.59 July 1.84 1.29 1.58 August 1.75 3.35 2.26 September 2.35 3.30 3.39 October 1.49 2.96 3.16 November 1.81 3.41 3.61 December 1.74 3.81 2.97 Estimate of sulphur content by the volumetric method In 1929, the City Council was apprehensive of the possible danger to public health by the pollution of atmosphere likely to arise from the emission of flue gases from the large power stations which were to be erected in close proximity to the south western boundaries of the City— namely Battersea and Fulham. Accordingly, in 1930, an atmospheric pollution measuring apparatus was installed in Westminster, and the results obtained have been regularly reported to the Public Health Committee since that date. In 1960 the City Council felt that it would be useful if additional information were obtained concerning the pollution of the atmosphere, particularly in the Pimlico area. A further atmospheric pollution measuring apparatus was, therefore, purchased and installed in April, 1960, on the top of a block of flats in Churchill Gardens. 75 The results obtained from the two sites are as follows:— Month S02 micrograms per cubic metre Monck Street Churchill Gardens January 691 533 February 614 465 March 360 262 April 317 268 May 193 165 June 162 189 July 166 204 August 143 163 September 226 234 October 251 220 November 317 314 December 477 524 76 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 Month Monck Street Churchill Gardens January 260.1 262.2 February 215.2 210.5 March 108.7 107.4 April 84.1 94.1 May 43.9 41.8 June 32.8 31.2 July 31.0 365 August 31.7 38.6 September 60.5 70.9 October 71.7 80.9 November 97.5 112.4 December 150.4 221.6 Sequential Smoke Sampling Apparatus As previously reported, the City Council is co-operating in the investigation 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 at regular intervals the solid pollution in a measured quantity of air. The machine was put into use during much of January and February, 1963, during fog or weather showing a fog tendency. Further readings were also taken during November and December, 1963. Where requested by the Department of Scientific and Industrial Research, the calculated results from these sample readings were supplied to them. 77 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 tine 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 1963. Air pollution from vehicles Another aspect of atmospheric pollution which received attention during 1963 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 April, 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. Several such instances were observed during 1963, 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. 78 Twice during 1963 the Metropolitan Boroughs' Standing Joint Committee considered the matter of atmospheric pollution from motor vehicles. In January, 1963, it was learnt that the Holborn Borough Council had suggested that there should be technical investigation to define an acceptable quality of vehicle exhausts in inner urban areas. The Standing Joint Committee considered that research on the subject of petrol and diesel fumes and ways of limiting emissions from motor vehicles should be regarded as a matter of urgency and that, if a final report by the Ministry of Health (who have been investigating this matter for many years) was not likely to be available immediately, consideration should be given to the issue of an interim report. The Standing Joint Committee decided to make representations to the Minister accordingly. Subsequently, in October, 1963, the Council was informed by the Metropolitan Boroughs' Standing Joint Committee that they concurred with the views expressed by the Hampstead Borough Council that the present requirements for private motor cars of a certain age to be periodically examined and approved in accordance with Section 65 of the Road Traffic Act, 1960, should be extended to cover commercial or diesel-engined vehicles, with special regard to the emission of excessive exhaust fumes and Vapours, and they made representations to the Minister of Transport accordingly. Installation of new furnaces Under Section 3 of the Clean Air Act, 1956, the installation of all new furnaces except domestic furnaces of less than 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 1963, 80 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 1963, 37 applications were approved. Since the Clean Air Act, 1956, came into operation on 1st January, 1956, up to the end of 1963, a total of 508 notifications have been received concerning the installation of new furnaces, of which 119 applications were submitted for approval. 79 Smoke Abatement—Complaints Received and Observations made 1956 1957 1958 1959 1960 1961 1962 1963 Complaints received 87 41 67 58 53 41 54 63 Observations made 2,634 1,603 625 497 897 572 584 806 Notices issued— Preliminary 23 6 — 1 3 — — - Statutory - - - 1 - - - - Clean Air Act, 1956 In the Report of the Government Committee on Air Pollution, issued in 1953, the City of Westminster and adjoining Boroughs were included in the list of "black areas," that is, areas where pollution is particularly bad. In January, 1959, the Minister of Housing and Local Government issued a Circular drawing attention to the fact that about half the smoke in the atmosphere comes from domestic fireplaces burning coal. The Minister expressed the hope that, although an encouraging start had been made by local authorities in using their powers to make smoke control orders, faster progress would be made, especially in "black areas". The Minister requested that Councils in "black areas" should consider their domestic smoke problem as a whole; decide on the smoke control orders that would be required, and the order in which they should be made; and assess how many years it would take to complete the work. Local authorities were also asked to prepare a phased programme for establishing smoke control areas over the ensuing five years. Accordingly, the City Council at its meeting on 30th April, 1959, approved a programme which provided for the whole of Westminster to be covered by operative smoke control orders by 1st October, 1965. An endeavour was made to accelerate this programme with a view to its completion by 1st October, 1964. Unfortunately, the final Order, covering some 321 acres, in respect of the Westminster (South) Area was not confirmed by the Minister of Housing and Local Government in time for it to come into operation during 1964, the operative date being 1st July, 1965. Thirteen Smoke Control Orders are now in operation in Westminster, covering 2,034 acres of the City; two further Orders, covering 154 acres, have been made and confirmed by the Minister of Housing and Local Government and will come into operation on 1st October, 1964. Details of the approved programme, and a map of the proposed Areas, are set out on page 82 of this report. 80 As mentioned last year, the success of the programme of Smoke Control Orders depends to a large extent on the ability of public utilities and private contractors to cope with the necessary conversions of fireplaces within the prescribed period of time and also on the availability of smokeless fuels. Up to the present, Westminster has been fortunate on both these points and it is hoped that the remaining programme will not be jeopardised by any difficulties in these directions. In December, 1963, the City Council received a further Circular from the Ministry of Housing and Local Government, based on the Government's recently published White Paper on Domestic Fuel Supplies. This Circular indicated that the changing pattern of gas production in the country has affected the Government's estimates of the availability of solid smokeless fuel supplies over the next few years. In the Circular the Ministry of Housing and Local Government made various suggestions as to measures to be adopted in regard to future smoke control areas, and this advice is being followed by the City Council. 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 to, or the replacement of, their existing equipment, to enable them to use an authorised fuel. The work must have the approval of the City Council and the expense must be incurred after the confirmation of the Order but before it comes into operation. The amount of grant which can be claimed is 70 per cent, of the total cost incurred; forty per cent, of this total is subsequently recoverable by the local authority from the Central Government. The Council is empowered, in certain cases, to pay the full cost of conversion. Smoke Control (Exempted Fireplaces) Order, 1959 This Order came into operation in July, 1959, and exempts from the provisions of Section 11 of the Clean Air Act (the Section which provides for the designation of Smoke Control Areas) those furnaces installed after 31st December, 1956, which are equipped with mechanical stoking apparatus but do not burn pulverised fuel, as long as they are operated and maintained so as to minimise the emission of smoke and burn the fuel for which they were designed. Two proprietary types of appliances are granted similar exemption under the Order, namely the solid fuel "Ductair" unit, and the "Fulgora" slow combustion stove (used for burning wood shavings, etc.). Mechanically stoked furnaces capable of working as smokelessly as those exempted by the Order, but which were installed before 31st December, 1956, can also be exempted individually on similar conditions. 81 London Building (Constructional) Amending Byelaw, 1960 During 1960 the London County Council byelaw under the London Building Act (Amendment) Act, 1935, and the Clean Air Act, 1956, came into operation and requires that every new building shall be provided with either such appliances for heating or cooking as are suitably designed for burning gas, electricity, coke, or anthracite, or appliances of a description exempted by an Order in force under the Clean Air Act. Westminster (Eaton) Smoke Control Order, 1962 During 1963 the Council considered an application from the Marketing Department of the National Coal Board for exemption from the operation of Section 11 of the Clean Air Act, 1956, in respect of the standard overnight burning heating appliance installed into the chimney in room No. 547A on the top floor of the Board's premises at Hobart House, Grosvenor Place, S.W.1. The Board proposed to carry out trials on their various smokeless fuels and briquettes, etc., and whilst, in the main, only smokeless fuels would be burned on this fireplace, on occasion (not more than six times a year) ordinary bituminous fuel briquettes would be tried to give experience with the burning of these materials and to give a standard of comparison with the smokeless fuels. The Council felt it would be reasonable to exempt the use of this fireplace for such purposes from the operation of the Act, subject to the following conditions:— (i) That some means of smokeless ignition be provided to the fireplace. (ii) That use of the fireplace for such purposes be restricted to not more than six occasions each year and for periods not exceeding two hours on each occasion. (iii) That prior notification of the proposed use of the fireplace for burning bituminous fuels be given to the Council. 82 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, 1961St. 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 1st November, 1963 Abbey 64 10 1st November, 1963 Victoria 190 11 1st November, 1963 Wilton 91 12 1st November, 1963 Eaton 83 13 Yellow on Map Smoke control areas to come into operation on 1st October, 1964:— Millbank 73 14 Ebury 81 19 Pale Yellow on Map Smoke control area to come into operation on 1st July, 1965:— South 321 15 16 17 18 20 21 83 Water The resident population of 86,550 in some 30,800 dwellings receive water from the Metropolitan Water Board's mains or from deep wells. At 31st December, 1963, 76 deep wells were in use. From 69 of these wells the water is used for domestic purposes. Of the remainder, six are used for standby only and one in case of fire. During the year the use of two wells situated at 26-40 Victoria Street, S.W.I, was discontinued; these wells had previously served Yickers House and No. 8 Broadway, S.W.1. During 1963, 112 samples of water from wells in the City were submitted for examination; satisfactory reports were received of 80 bacteriological examinations and 32 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. 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 within the County of London had indicated their agreement on the introduction of fluoride into London's water supply. When this information was transmitted to the Metropolitan Water Board, the Board replied that as there had been no general request by local health authorities in the wider area covered by the Board, the Board did not consider that the time was opportune for it to decide policy on this important issue. Later, in June, 1964, the Metropolitan Boroughs' Standing Joint Committee decided to ask the London County Council, as local health authority, to approach the Metropolitan Water Board and, should the County Council think it appropriate, to seek a meeting with the Minister of Health with a view to securing the artificial fluoridation of water supplies by the Board at an early date. 84 Phakmacy and Poisons Act, 1933 Persons entitled to sell poisons included in Part II of the Poisons List numbered 122 at 31st December, 1963. 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. Animal Boarding Establishments Act, 1963 This Act, which originated as a Private Member's Bill, came into operation on the 1st January, 1964. It provides for a system of annual licensing by local authorities (in London, the metropolitan borough councils and the City Corporation) of any establishment at which a business of providing accommodation for cats and dogs is carried on, and for the inspection by authorised officers of such establishments. The powers given by the Act are akin to those which the Council exercises under the Pet Animals Act, 1951, in respect of premises at which pet animals are sold. As the Council had delegated these latter powers to the Public Health Committee, it was decided to delegate to that Committee the exercise of its powers under the Animal Boarding Establishments Act, 1963. 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. 85 Disinfection, Disinfestation and Cleansing of PersonsArrangements with the holborn borough council The arrangement between the City Council and the Holborn Borough Council whereby the latter undertook to carry out, on agreed terms, the work of disinfection, disinfestation and cleansing of persons, and the provision of the necessary transport therefor, continued. The arrangement came into operation on the 3rd September, 1956, and is working satisfactorily. The following is a summary of the work carried out for Westminster during the year:— Disinfection and Disinfestation Rooms Articles Articles Washed Books Disinfection 83 7,066 555 180 Disinfestation 219 3,389 — — Cleansing of Persons Treatments Scabies Head Lice Body Lice Men 40 - 416 Women 6 3 2 Children 3 — — 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 1963, eight 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 86 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 57 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 22 Relatives or friends of the deceased 12 Hospitals in the City 21 Consular official 1 Medical practitioner 1 Coroner's Court and Mortuary During 1963,1,068 bodies were received in the Mortuary on Coroner's Warrants, etc. Of this number, 290 bodies were received following death within the City of Westminster, and 778 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. Five bodies were admitted to await burial. Number of Cases Inquest cases 185 Non-inquest cases 883 Post-mortem examinations held 1,025 Causes of death in the foregoing were as under:— Accidental drowning 1 Found drowned 5 Suicide by drowning 9 Suicide by other means 55 Accidents— Street 21 Domestic 40 Others 26 Natural causes 883 Misadventure 1 Murder 3 Miscellaneous causes 24 87 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 1963. (b) Southwark Borough Council In July, 1962, 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 continued until 18th January, 1964. This extended period unfortunately coincided with the severe winter of January-March, 1963, when an unexpectedly high number of bodies was deposited at the Mortuary, placing a heavy burden on the staff and the available accommodation. In addition, the re-building of the Southwark mortuary was hampered by the severe weather. I am pleased to record that all the members of the staff at the Mortuary carried out their duties in an exemplaty manner, despite varied meal breaks, long hours and exceptional weather conditions. 88 APPENDIX I FACTORIES ACT, 1961 Prescribed Particulars on the Administration of the Factories Act, 1961 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 569 220 8 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 1,700 464 58 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 92 - - - Total 2,361 684 66 — 89 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) 36 25 - 11 — Overcrowding (S.2) — — - — - Unreasonable temperature (s.3) — — - - - Inadequate ventilation (s.4) 7 1 - - - Ineffective drainage of floors (S.6) — - — - - Sanitary Conveniences (s.7) (a) Insufficient 2 — — 2 — (b) Unsuitable or defective 25 17 — 5 - (c) Not separate for sexes 4 3 — 3 - Other offences against the Act (not including offences relating to Out-work) 79 79 - - - Total 153 125 — 21 - 90 APPENDIX II Pakt VIII of the Act Outwork (Sectionss 133 and 134) Nature of Work Section 133 Section 134 No. of outworkers in August list required by Section 133 (1) (c) No. of cases of 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., 3,306 — - — - - 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 6 — - — - - Iron and steel cables and chains - - - - - - Iron and steel anehors and grapnels - - - - - - Cart gear — — - — - - Locks, latches and keys — — - — - - Umbicillaa, etc. —— — - — - - Artificial flowers 2 — - — - - 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 — — - — - - Cosaques, Christmas stockings, etc. - - - - - - Textile weaving - - - - - - Lampshades — — - — - - Total 3,328 - - - - -