FuL 42. METROPOLITAN borough of fulham AC 4346 REPORT of the MEDICAL OFFICER OF HEALTH for the year 1951 M. I. ADAMS B.Sc., MB., B.Ch., D.P.H. Medical Officer of Health FULHAM BOROUGH COUNCIL Public He 1 Public He 2 Introduct TowN HALU .5 Vital Sta 9 Classifie 11 Infantile & Maternal Deaths 12 Infectious Disease 14 Hospitals in the Borough 19 Bacteriological Examinations 19 Public Conveniences 20 Public Mortuary 21 National Assistance Act, 1948 21 Old Peoples' Welfare 22 National Assistance (Amendment) Act, 1948 23 Rehousing of Families 24 Public Health Propaganda 24 Health Week 26 L.C.C. Health Services 27 Extracts from Annual Report of Dr. H.C. Price, Chest Physician 30 Sanitary Circumstances of the area 33 Disinfection,, Disinfestation & Laundry Services 36 Drainage 37 Rodent Control 37 Factories 38 Rag Flock 42 Pharmacy & Poisons 43 Food Inspection 45 Food & Drugs Act 1938 - 1950 47 Sale of Milk Regulations 58 Food Establishments 61 (1) MEMBERS OF THE PUBLIC HEALTH COMMITTEE (as at December, 1951) Ex-officio: Councillor Percy fliward Fenne, J.P. (Mayor) Chairman: Councillor Christopher Lancaster, J*P. Vice-Chairman: Councillor John William Perotti, J .P. Alderman: Mrs. Helen Maude Fournier. Alderman: Mr. Walter Rankin. / Councillors Vivian Arthur Baron. Alexander Montgomery Greaves Beattie. Arthur Andrew Clark. Thomas Michael Cox, J.P. Albert James Frost. Mrs. Laura May Mills. Herbert Henry Poulter. Thomas Alfred Winstanley. (2) STAFF OF THE PUBLIC HEALTH DEPARTMENT (December 1951) Medical Officer of Health - Mary I. Adams, B.Sc., M.B., B.Ch., D.P.H. Deputy Medical Officer of Health - Caroline A. Meade, M.B., (Part-time) B.S.(Lond.), D.P.H. Public Analyst (Paid by fees) - Thomas McLachlan, A.C.G.F.G., F.I.C. Administrative and Clerical Section. Chief Clerk - J.E. Burton, D.F.M. Second Clerk -J.W. Chance, A.I.Hsg., Dip. R.I.P.H.H. Administrative Clerk - B.C. Bolton. Clerk -S.T. Ansell. Clerk -R.G. Larcher, A.B.I. Clerk -S. Wright, Dip.R.I.P.H.H. Clerk -Vacant. Secretary to M.O.H.m -Mrs. H.A. Stapp. Shorthand-Typist.-Mrs . C .M. Phillips. Clerk-Typist. - Vacant. Clerk-Typist. - Miss R. Reed. (3) Sanitary Inspectors' Section. Chief Sanitary Inspector - G.W. Herrick, D.P.A. (1) (2) Deputy to Chief Sanitary Inspector and Officer -in-charge Rodent - F.E. Walsh, (1) (2.) Repression Service Factories and Smoke Abatement Officer - F.C. Payne, (1) (2) (3) (4-) Lady Sanitary Inspector - Miss E.H. Sexton, S.R.N.y S.C.M., H.V. (1) District Sanitary Inspector - H. Hutchinson (1) (2) do. - C.Jo Price (1) (2) do. -I. Jones (1) do.- R.D. Richards (l) do.- C.W. Owens (1) do.- G. Bailey (l) (2) do.- Vacant do.- B.J. Parsons (l) Food & Drugs Section. Senior Sanitary Inspector - A.W. Gammack (l) (2) Sanitary Inspector - W.G. Thurgood (1) (3) do.- A.H. Newport (l) (2) do.- A.G. Patterson (1) (2) (1) Certificate Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. (2) Meat & Other Foods Certificate, Royal Sanitary Institute. (3) Diploma of the Royal Institute of Public Health & Hygiene. (4) Smoke Certificate, Royal Sanitary Institute. (4) DISINFECTING STATION. Superintendent: J.H. Hughes. Three Disinfectors. One Motor Driver. One Disinfector - Motor Driver. RODENT CONTROL. One Foreman Operative. Three Operatives. PUBLIC CONVENIENCES. Fifteen Male Attendants. Fifteen Female Attendants. MORTUARY KEEPER. G. Churchill. (5) METROPOLITAN BOROUGH OF FULHAM. Public Health Department, Town Hall, FULHAM, S.W.6. To the Mayor, Aldermen and Councillors of the METROPOLITAN BOROUGH OF FULHAM. Your Worship, Ladies and Gentlemen, I have the honour to present the Annual Report on the health of the Borough for the year 1951. On the 31st March, 1951, Mr. T.H. Robey, Chief Sanitary Inspector, retired after 42 years conscientious and capable service with this Council. Mr. Robey who had a detailed knowledge of housing and sanitation, was a "character" in the life of the Borough. His friendly manner made him acceptable to citizens, contractors, builders, and the staff alike. Many tributes to his unobtrusive kindness and consideration are still being received. It is a pleasure to record the appointment of Mr.G.W.Herrick,D.P.A., Ollett Gold Medallist, to fill the vacancy. Mr. Herrick was a Sanitary Inspector in the Borough from 1927 to 1929; and since then has had wide and varied experience in the West London area. Dr. Caroline A. Meade Was appointed Deputy Medical Officer of Health on the 1st October in a part-time capacity. Dr. Meade has had extensive experience in public health, more especially epidemiological work, in this country and abroad. During the year special medical examinations and reports called for by Employing Committees have continued to be done by myself. Since the 1st November all the medical examinations of the Council's newly appointed staff and employees have been carried out by your Medical Officers. Previously these examinations were carried out by Dr. O.Watts-Tobin, and I would like to record my appreciation of his co-operation in arranging appointments and furnishing speedy and efficient reports on the persons examined. The yearly statistics show that the health of the Borough continues to be maintained at a very satisfactory standard which compares favourably with London and the country as a whole, In 1951, as in 1950, no case of diphtheria occurred. (6) There was a decrease in the notification of all forms of tuberculosis but an increase in the number of deaths from pulmonary tuberculosis during the year. A large number of infective tubercular patients have still to share a bed, and an even greater number a room. Whilst a considerable number of children and young adults are living in overcrowded conditions, owing to housing difficulties, they run a high risk of being infected. It is hoped that B.C.G. vaccination, which is now being carried out on those most susceptible to tubercular infection and where there is an existing tubercular patient in the home, may prove highly effective in raising the immunity in these cases, thus lessening the risk of infection. Extracts from the Annual Report of Dr. H.C. Price,Chest Physician, Fulham Clinic, have been included on pp. 30 to 32, which outline the tuberculosis position in Fulham. As in the country generally, poliomyelitis in the Borough declined. There were six cases; four of these were the paralytic type but considerable recovery of function followed rehabilitation work in these cases. There were no fatalities. Again, in company with many other areas in the country,cases of paratyphoid B. occurred between June and August. It was found on investigation that in the seven cases notified during this period, there were five different "types" of the microbe concerned. Each year different "types" are making their appearance in this country, for example, the type "Kentish" first appeared on the south coast from the continent and has gradually "travelled" to London, taking about two years to make the journey. From the table on page 14 the infectious group of diseases will be seen to be more or less the same as in 1950, with three notable exceptions, viz: dysentery, measles and acute pneumonia, which show a steep rise in this year's records. Firstly, dysentery (Bacillus Dysenteriae Sonne) showed a marked increase. It has been found that this microbe inhabits the alimentary tract of the common cockroach and may infect food and utensils. Personal hygiene is therefore of the utmost importance in the home and food factory.This outbreak was practically confined to Sands End district. Extensive investigations were made in each case and every precaution taken. There is no doubt these precautions, along with the course of preventive treatment carried out on request by medical practitioners concerned, were responsible for bringing the outbreak under control as quickly as possible. The disease does not usually prove fatal and no deaths occurred. (7) Measles also increased,there being 1948 notifications including one death,that of an infant under one year. In the previous measles epidemic in 1949 there were 1099 notifications and one death. Records dating from the beginning of the century show that in 1926 Fulham experienced its worst epidemic, there being 3700 cases with 47 deaths. During the five years 1944/1948 no deaths from measles occurred. The incidence of acute pneumonia also increased by 38 cases over the 1950 figures. These occurred during an epidemic of influenza which took an unusually heavy toll of the elderly. In the previous years the death rate due to pneumonia decreased with the single exception of 1947, when there was a rise, again in conjunction with influenza; not unexpectedly the older age groups were most affected. The number of old people requiring investigation by the Public Health Department and the number of visits paid to them has increased markedly. It is notable that 110 old people voluntarily entered hospital for treatment or were admitted to Homes for the Aged. This is a tribute to the persuasive methods used and the tact and skill of the Lady Sanitary Inspector. Thanks are due for the excellent co - operation given by the following Societies and people; Bishop Creighton House Voluntary Workers, British Red Cross Society, District Nursing Association, Family Welfare Association, General Practitioners in the district, the Women's Voluntary Services, the many kindly neighbours and relatives of the old people and especially to Dr, Wyman and the staff of Fulham Hospital and the Welfare Officer at King's Mead Institution, wit ho ut whose help such splendid results could not have been achieved. The year has seen continuous and increasing efforts to interest people in public health. Two types of propaganda used are worthy of special mention - (l) the number of Film Shows at the Central Library was increased and given a wider scope to include talks on topical health subjects. These have been well received by attendances almost to the capacity of the hall. (2) As part of the Festival of Britain celebrations an open-air "Health Week",which was declared open by the Rt .Hon. Hilary Marquand, M„P. at the time Minister of Health,was held in June at Lillie Road Recreation Ground. The weather was good and the items included a marquee exhibition, demonstrations and displays. This novel form of exhibition was most successful, the evening open-air displays proving especially popular and drawing large attendances. As in London generally the inspection of tenement houses forms a major part of the work of the District Sanitary Inspectors. Quoting from (8) the Housing Survey carried out in the Borough in 1947 "Fulham was largely built around 1890, a time when speculative building was rampant, and 62 years of life completed with a poor initial joh and a rising demand for an improved standard of amenities have resulted in many areas in the Borough falling well below standard". This deterioration continues, as does the difficulty to maintain satisfactory standards. This is reflected in the number of defects requiring to be dealt with through statutory action. As in 1950 there was again a marked increase in the occurrence of the more serious defects such as leaking roofs and other damp conditions.There is, however, a more encouraging side to the housing question, for to quote from information kindly supplied by the Director of Housing and Public Buildings, 190 family units were newly constructed by the Council during 1951 , and a further two units by a private owner. In addition, 256 dwellings were under construction at the end of the year, schemes were in preparation for imminent development in connection with 96 fa m ily units and plans were in active consideration regarding a further 477 units. A number of other schemes were either being discussed at officer level with the Ministry of Housing and Local Government or the London County Council as at 31st December, 1951. The relationship between the officers of the Divisional London County Council Health Service and the Department has continued on a cordial and co-operative footing. I am indebted to all the members of the Fulham Borough Council for their help and co-operation and especially to the Chairmen, Vice-Chairmen and Members of the Public Health and Staff Committees of the Council for their sympathetic consideration of the medical problems of the Council's staff and employees. I would like to record my appreciation to all the Chief Officers and the members of their Departments for their unfailing assistance and take this opportunity of conveying to every member of my Department my thanks for the loyalty and efficiency with which everyone has carried out his or her duties. I have the honour to be, Your Worship, Ladies and Gentlemen, Your obedient Servant, (9) EXTRACTS FROM VITAL STATISTICS FOR THE YEAR 1951. POPULATION (estimated) 122,400 SEPARATE DWELLINGS (estimated at 1.10„51) 32,048 A Penny rate produces approx: £4,870 p.a. LIVE BIRTHS: Rate Per 1.000 Population. Total Males Females 1951 1950 Legitimate 1,590 787 803 12.99 13.3 Illegitimate 129 58 71 1 °05 1.05 Totals 1,719 845 874 14.04 14.35 STILLBIRTHS: Legitimate 37 14 23 0.3 0.23 Illegitimate 5 4 1 0.04 0.02 Totals 42 18 24 0.34 0.27 DEATHS: 1,579 773 806 12 .9 11.5 Death Rate of Infants under one year of age: All infants per 1,000 live births . 1951 26.5 1950 25.0 Legitimate Infants per 1,000 legitimate births 25 .7 23.8 Illegitimate Infants per 1,000 illegitimate births 38.7 46.0 Deaths from: Cancer (all ages) 1951 1950 269 280 Measles (all ages) 1 Nil Whooping Cough (all ages) 2 1 (10) GRAPH SHOWING COMPARISON BETWEEN BIRTH AND DEATH RATES FOR LAST TEET YEARS. (11) ClASSTFICATION OF CAUSES OF DEATH 1579 Deaths as follows:- under 1 Age Groups Over 45 Total 1-5 5-45 Tuberculosis Respiratory - - 13 31 44 Tuberculosis other - - 3 2 5 Syphilitic Disease - - 1 9 10 Diphtheria - - - - - Whooping Cough - 2 - - 2 Meningococcal Infections - - - - - Acute Poliomyelitis - - - - - Measles 1 - - - 1 Other infective & paralytic diseases - - 3 - 3 Cancer - 1 24 244 269 Diabetes — - 3 9 12 Vascular lesions of nervous system — - 3 150 153 Coronary disease - - 4 150 154 Hypertension with heart disease - - 1 63 64 Other heart disease - - 6 239 245 Other circulatory diseases - - 1 62 63 Influenza 1 2 27 30 Pneumonia 3 2 5 76 86 Bronchitis - - 5 139 144 Other diseased of respiratory system - 1 - 9 10 Ulcer of stomach & duodenum - - - 19 22 Gastritisf enteritis, diarrhoea 2 - - 6 8 Nephritis & nephrosis 1 - 1 12 14 Hyperplasia of prostat 9 - - - 13 13 Pregnancy, childbirth, abortion - - - 1 1 Congenital malformations 7 - 2 5 14 Other ill-=defined and defined diseases 32 3 15 105 155 Motor vehicle accidents - 1 - 7 8 All other accidents - - 1 27 28 Suicide - - - 20 20 Homicide and operations of war - - - 1 1 46 11 96 1426 1579 INFANTILE DEATHS: There were 46 deaths of infants under the age of one year. A large number of deaths in the first month being, as is usual, due to prematurity, immaturity and congenital malformation. Cause of Death 1951 1950 Measles 1 - Whooping Cough - 1 Pneumonia 8 5 Gastritis, enteritis and diarrhoea 1 A Prematurity 16 12 Asphyxia 2 1 Atelectasis 2 5 Congenital Malformations 4 10 Meningitis - 1 Pulmonary Tuberculosis - - Non-Pulmonary Tuberculosis - 1 Want of attention at birth - 1 All other causes 12 4 46 45 The Infant Mortality rate was 26.7 per thousand live births (25 in 1950). There was 1 maternal death in 1951 giving a rate of .58 per thousand births (live and still) (1.7 in 1950). "p vo The figures given in the columns are the number of Live Births in that year. (H) NOTIFIABLE INFECTIOUS DISEASES The following table shows the number of cases of infectious disease notified during 1951 (corrected figures) with the comparative figures for the last five years. Infectious Disease 1947 1948 1949 1950 1951 Diphtheria 17 10 6 - - Scarlet Fever 93 100 327 126 77 Measles 631 889 1099 527 1948 Whooping Cough 236 368 192 428 450 Acute Poliomyelitis Paralytic 27 2 32 6 4 Non-Paralytic 8 - 4 5 2 Acute Encephalitis - - - - 1 Acute Pneumonia 75 28 32 32 70 Dysentery 1 13 10 10 7.1 Typhoid Fever - 1 10 - 1 Paratyphoid Fever - 2 - - 8 Meningococcal Infection 6 1 4 3 7 Erysipelas 23 25 20 12 17 Puerperal Pyrexia 11 14 14 10 9 Ophthalmia Neonatorum 8 2 6 4 1 Epidemic Diarrhoea 41 40 45 12 12 Scabies 160 67 28 20 17 Malaria - - - - - Food Poisoning 7 7 11 6 2 Pulmonary Tuberculosis 226 203 245 209 172 Non-Pulmonary Tuberculosis 33 23 23 19 24 1603 1795 2108 1429 2893 (15) The following are some of the infectious disease rates for Fulham as compared with London and England & Wales: Rates per 1„000 population Notifications Fulham London England & Wales Scarlet Fever 0.63 1.10 1.11 Diphtheria - 0.01 0.02 Meningococcal Infection 0.05 0.03 0.03 Whooping Cough 3.67 3.11 3.87 Measles 15.91 14.64 U.07 Pneumonia 0.57 0.72 0.99 Acute Poliomyelitis: Paralytic 0.03 0.02 0.03 N on-Paralytic 0.01 0.02 0.02 Food Poisoning 0.01 0.23 0.13 Erysipelas 0.13 0.15 0.14 Paratyphoid Fever 0.06 0.01 0.02 PREVALENCE OF AMD CONTROL OVER INFECTIOUS AND OTHER DISEASES Smallpox: During the year 28 contacts of cases of smallpox were kept under daily observation until the expiration of the quarantine period. No cases occurred in the Borough. Typhoid: There was one case of Typhoid notified during the year.This case, a child of 7'k years, together with her parents and two sistersy stayed for three months in Cyprus with relatives and then returned via steamer to Naples and then over land. The day after they arrived home on 26th August the patient became unwell. A doctor was called in to attend the child and on 7th September she was admitted to hospital as a case of-dysentery. Teste were made aiii the case was re-diagnosed and confirmed as typhoid „ As the father was a cafe proprietor the whole family were investigated for possible carriers as a precautionary measure, but were found to be free from infection. Paratyphoid: During the period 9th July to 20th August seven cases were confirmed as suffering from Paratyphoid B. The Ministry of Health co-operated in the investigation. Food supplies and any common factor discovered was immediately fully examined. (16) The seven cases were not confined to one area of the Borough and the phase typing of each case did not help in any way as, out of the seven cases, there were five different types, i.e. 'Taunton', 'Dundee', 'Group One', 'Group Two' and 'Kentish'. No paratyphoid organisms were found in any of the samples taken for bacteriological examination and, as no further cases occurred, the investigation was closed. There were no deaths. Sonne 71 cases of Sonne Dysentery were notified during the year.Of Dysentery: these, 52 notifications occurred in the fourth quarter, when Sonne showed increased prevalence in London and elsewhere. Of these 52 notifications, U7 were in respect of the Sand s End area, the age distribution being:- Under 5 years 17 5 to 14 years 18 15 to 44 years 16 65 years† 1 28 families were affected. Visits were made at the homes of notified cases which were fully investigated and specimens from all members of the household (contacts) were examined where co-operation could be gained. \ This resulted in the discovery of a number of minor cases, and symptomless carriers who had not consulted their private practitioner, and accounts for the relatively high proportion of adult notifications. Doctors were informed and willingly co-operated by prescribing routine treatment. By these means, and by exclusion from school and day nursery etc., the control of the epidemic was secured. Polio- 19 suspect cases of poliomyelitis were admitted to hospital myelitis: during the year. Of these, U cases were confirmed as suffering from paralytic poliomyelitis and 2 cases confirmed as suffering from non-paralytic poliomyelitis. (17) Of the total number of cases, 3 occurred in children uaier 5 years, 2 occurred in children of school age, and the remaining case was a person over school age. Food There were no outbreaks but two cases were notified. One Poisoning: death occurred, Salmonella typhi murium being isolated in an elderly patient who died. 24 hours after admission to hospital. This person lived alone and did his own cooking. There is no doubt that a considerable amount of food poisoning exists which is not notified as those suffering from it do not consult their doctor unless seriously ill. It is then too late ard usually impossible to obtain and investigate samples of suspected articles of food. Scabies and Treatment was arranged for 13 adults and .11 children at the Allied con- Kensington Medicinal Baths. ditions: EXCLUSION FROM WORK OF CONTACTS OF INFECTIOUS DISEASE. Under the National Insurance Act of 1946, a certificate can be issued in any case where the Medical Officer of Health considers it advisable that a person should be excluded from work. This is usually done where a person is suspected of being a "carrier" of a disease, or has been in contact with a disease, and where the person, because of t h e nature of his/her occupation, is liab]e to transmit the diseases (e.g. a food handler). The granting of 3uch a certificate enables the person affected to claim sickness benefit. No certificates were issued during the year. (18) TUBERCULOSIS. (19) HOSPITALS IN THE BOROUGH OF FULHAM Details supplied by courtesy of the Fulham & Kensington Hospital Management Committee. 1. Fulham Hospital: St. Dunstan's Road, W.6. An acute general hospital for medical and surgical cases; mental observation unit; chronic sick wards; out-patient department. Number of staffed beds - 384. 2. Fulham Maternity Hospital; 5-7, Parsons Green, SoW.6. • Number of staffed beds - 30. 3. Western Hospital: Seagrave Road, S.W.6. A hospital for the treatment of infectious diseases of all kinds; poliomyelitis unit; pulmonary tuberculosis wards. Number of staffed beds - 172. 4. Fulham Chest Clinic: 114, New King's Road, S.W.6. Various types of clinic sessions hold for the out-patient treatment of tuberculosis. BACTERIOLOGICAL EXAMINATIONS The following bacteriological and other examinations were carried out during the year 1950 at the West London Hospital for the Council: Nose & Throat swabs 198 Urines 67 Faeces 504 Miscellaneous 7 (20) PUBLIC CONVENIENCES WAR DAMAGE REPAIRS. At the beginning of the year there were two War Damage claims outstanding on the Public Conveniences; the one on Effie Road Convenience was agreed and the necessary work was commenced by the Director o f Housing in June. Owing to various unforeseen factors, including a delay in delivery of materials, the work was not finally completed until February, 1952. However, the Convenience was kept open as much as possible whilst the work was in progress and the public were not greatly inconvenienced. The remaining claim on Lillie Road Convenience has not yet been "agreed", but it is anticipated that this will be settled and the work carried out in 1952. THEFT OF LEAD. Another matter which arose during the year was the stealing of lead from the public conveniences. At four men's conveniences thefts occurred: several other unsuccessful attempts were also made to remove lead fittings. In all cases the police were immediately notified, but both they and the attendants have been unable to apprehend anyone. FREE WASH FACILITIES. The free washing facilities, which have now been in operation for two years, continue to be used and appreciated by the public, although of course, some still prefer the "3d. wash and brush up" which remains in operation. The cost of the free wash service, in paper towels and soap, for the year was £85., an increase of 18% over last year's cost. This is offset, however, by an increase in free washes of 18.6% - 39,913 washes being provided during the year as against 33,650 washes in 1950. I consider the number of washes compared to the cost involved very satisfactory. (21) PUBLIC MORTUARY The following number of bodies were admitted to the Mortuary during the year:- By order of the Coroner 271 Convenience Cases (i.e. admitted at the request of Undertakers) 176 Total 447 Number of Post-Mortem Examinations conducted 271 NATIONAL ASSISTANCE ACT. 1913. Section 50: Burial or Cremation of the Dead. Eleven funerals were arranged under the provisions of this Section. The funerals were carried out by Mr. J. Goulborn of 62.,Greynound Road, the Council's official Contractor. Details of the cost of the Burials are as follows:- *11 Funerals as per contract »£88. 8s. 6d Less amount recovered from estate of deceased, or by gifts, or responsible relatives traced. £23. 6s . 9d . Balance being cost to Council .£65.l8. 9d. *The cost of the funerals varies slightly, the average cost of an adult being approximately £10. Section 47: Removal to suitable premises of persons in need of care and attention. No removals were made under the provisions of this Section. (22) OLD PEOPLES WELFARE. Figures available show that people live to an advanced age in Fulham and as the provisions for them become better known, so increasing numbers of old people are brought to the notice of the Public Health Department. This year the number of visits made was much in excess of last year, increasing from 379 in 1950 to 816 in 1951. The initial ascertainment visits may be difficult and protracted.Old people are often suspicious of visitors, slow to react and stubbornly independent. A sensitive and gentle approach is essential to acquire the necessary particulars regarding their relatives, friends and private resources. These visits often reveal the most appalling squalor and self-negLect and although old people may be very independent by nature, they are often found to be living in insanitary conditions, sometimes so gravely ill or infirm that they are not able to devote proper care and attention to themselves or, receiving no help from others, become a source of injury to health or trouble to their neighbours. Removal to a Home or Hospital is then necessary. In such circumstances they are sympathetically advised to enter a home or hospital for their own good. Persuasion, if sometimes difficult, is well repaid when they voluntarily agree to make a change and settle down happily in their new surroundings. The numbers persuaded to enter homes and hospitals testify to the success of these methods; twenty -five cases being voluntarily removed to Homes and eighty-five to Hospitals in the year under review. When persuasion fails it may be necessary to resort to statutory action under Section 47 of the National Assistance Act, 1948, hy applying for a Magistrate's Order for compulsory removal. If at all possible or desirable, a further trial at home is given to the old people. The necessary domiciliary and social services co-operate in the effort. Home Helps are arranged, Meals on Wheels, Home Nursing and also the help of supplementary grants of money to enable the purchase of clothing, bedding etc. Friendly visits to the old folk by voluntary visitors of various associations are a real help in combating loneliness. (23) A brief note on the conditions of two of the old people vis ite d during the year may be of interest:- Case A. 70 odd; completely deaf, frail and unsteady in gait; Living in two rooms, but occupying only one.his landlady reported that he kept falling down six or seven times a day and was unable to cook, clean or care for himself. He left the water tap running, having flooded the room below on several occasions. When visited he was found in a very neglected and unwashed condition, wearing only a thin cotton shirt on a bitterly cold day.The room occupied was in a dirty and disorderly state and literally packed and stocked with books, many of which were first editions. There was also an abundance of pictures of horses and football teams all stacked to some feet high. A broken wire mattress spring propped up on books served as a bed, while one tattered blanket and an old overall was his only bedding. He was persuaded to enter a home for old people and after a stay of some months returned to occupy one room on the ground floor of the same house, having disposed of some of his collection of books and pictures. Case B. 72 years old; had a three-roomed flat but used only one room. The sub-tenant complained that she made noises, prowling around this room at night, keeping the other members of the household awake. She did not feed herself properly, would not buy matches, bread etc. She received the Old Age Pension but no Supplement. The sub-tenant cooked meals for her and provided her with other necessaries, small sums of money etc. but was tired of so doing and appealed to the Town Hall. A visit was made and the old lady found to be in an unwashed and unkempt condition, Her room was dusty and unclean. She seldom changed her garments and slept in a chair in the room. It was necessary to report her to the Duly Authorised Officer with a view to certification, and she was removed to hospital, where it was discovered that her handbag contained £4,000. (24) NATIONAL ASSISTANCE (AMENDMENT) ACT. 1951. In September of this year the National Assistance (Amendment) Act, 1951, came into force. This provides an emergency method of applying to Court for compulsory removal of aged and infirm persons to a hospital or other suitable place for a maximum period of three weeks, by dispensing with the seven clear days' notice to the person concerned or in charge of him, as required in Section 47 of the National Assistance Act. The Amendment Act is designed to cover cases where a delay of even a few hours might prove decisive. It was agreed by the Public Health Committee that the Medical Officer of Health be authorised to make any applications necessary under this Act. REHOUSING OF FULHAM RESIDENTS ON L.C.C. HOUSING ESTATES. During the year 420 families were visited by the Sanitary In spectors at the request of the London County Council in connection with applications for alternative accommodation. Of this number 162 cases applied on the grounds of overcrowding and the remaining 258 on medical grounds and the insanitary condition of their living accommodation. 102 families were found to be living in overcrowded conditions,and reports were sent to the Director of Housing and Valuer, London County Council, recommending them for alternative accommodation on the L.C.C. Housing Estates. 49 families were known to have been rehoused during the year. The scheme inaugurated the previous year of linking applicants on the Fulham Borough Council Housing List with the London County Council system of awarding a priority for overcrowding has been continued, the Sanitary Inspectors visiting premises and interviewing applicants as indicated by the Housing Department; and where necessary forms certifying the overcrowding being forwarded to the London County Council. There is close co-operation between the Housing and Public Health Departments on all matters relating to housing. (25) PUBLIC HEALTH PROPAGANDA FILM SHOWS. During the Metropolitan Boroughs' Golden Jubilee Exhibition held at the Public Baths the film "Another Cass of Food Poisoning" was shown,and members of the public were invited to spot the i'ood handling faults in the film. This competition was a success and it was decided to give film shows to the public as a means of conveying some of the "do's and dont's" of health and hygiene. Although not intended purely for juveniles the first show, held at the Central Library, was organised on behalf of a local Youth Club and was very poorly attended. A second show given to a Social Club on their premises produced a larger audience, 61 persons being present. Whilst still determined to run these shows it was realised that some form of attraction would have to be employed to obtain better attendances, and it was decided to use commercial feature films for this purpose. Arrangements were therefore made with a Film Company to ply feature films, and since they have been exhibited the shows have been extremely successful. The average attendance at the four shows, one a month from September to December inclusive, was 138, and as the seating capacity of the hall is only 150 and a certain wastage is inevitable, these figures are considered very satisfactory. Educational films on health subjects are shown before the feature films, which themselves are from a specially selected group with an educational flavour, e.g. "Madame Curie"„ Alternatively, a speaker addresses the audience on a particular subject, usually followed or preceded by a short film on the subject, e.g. Speaker on the Mass X-Ray Service - film on Tuberculosis.(The shows last for approximately two and a half hours and are given from 7 p.m. to 9.30 p.m.). The shows, which are to mixed audiences,are introduced by a member of the Public Health Committee and suggestions, comments and criticisms from the audience are invited. They are all held at the Central Library and I would like to record my appreciation of the co-operation of the Libraries Committee, the Librarian and his staff. In view of their success, the Committee plan to increase the number of shows given next season (September to March) from seven to twelve. They will be organised on the same lines as those of last season. (26) HEALTH WEEK. (June 18th - 23rd inclusive). LILLIE ROAD RECREATION GROUND. This outdoor Health Week staged during the afternoons and evenings as part of the Council's Festival of Britain activities proved a great attraction. It was opened by the Minister of Health, the Right Honourable Hilary Marquand, M«P. on the 18th June. The Mayor presided and the two members of Parliament for the Borough, Dr, Edith Summerskill and Mr. Michael Stewart, were present. The opportunity was taken to demonstrate the work of both local and National Health Services. Evening Instit utes and the majority of the voluntary societies and organisations operating within the Borough took part. The Health Week was divided into two sections. (1) Marquee Exhibition. This housed a Clean Food pictorial exhibit from the Ministry of Health and exhibits from the British Red Cross Society;Blood Transfusion Service; the Fulham and Kensington Hospital Service; Mass X-Ray Service; St. John Ambulance Brigade and the London County Council Day Nursery Service. Another feature of the Exhibition was a display of paintings, leatherwork and other articles made by patients,both in hospitals and at home, and this wonderful rehabilitation work proved a popular attraction. (2) Open Air Displays. A demonstration square was marked out in the Recreation Ground and P.T. displays were given by members of the R.A.F, (School of Physical Training, Cosford); Langford Road Recreation Institute; King Edward VII Nautical School; Monster Women's Institute; Church Lads' Brigade and the Boys' Brigade. The British Red Cross and St.John Ambulance Brigade gave demonstrations throughout the week of their work in dealing with casualties and the finer points of First Aid. Other attractions included hibitions of badminton and basket-ball matches and Highland dancing; while 'Old Tyme' dancing was first demonstrated, and then the public invited to join in the dancing. Music was provided in the evenings by the Fulham Borough Silver Band; A.T.C. Massed Bugle Band; the Sea Cadet Corps Band, and the bands of the local groups of the Church Lads' Brigade and the Boys1 Brigade. The public showed great interest in the exhibitions and demonstrations arranged. It was estimated that 15,000 people attended the demonstrations and that 6,000 people saw the Exhibition. The week was undoubtedly a great success. (27) LONDON COUNTY COUNCIL - HEALTH SERVICES The Maternity and Child Welfare Services since July 1948 are the responsibility of the London County Council. Division I of the London County Council consists of the Metropolitan Boroughs of Chelsea, Fulham, Hammersmith and Kensington. The Divisional Medical Officer is assisted in each of the four Boroughs in the day to day administration of the Maternity and Child Welfare Services by the respective Borough Medical Officers. Dr. Violet I. Russell, the Divisional Medical Officer, has kindly supplied the following information regarding these services for the year 1951s- Ante-Natal and Post-Natal Clinics. Number of women who attended during the year: Ante-Natal clinics 1,107 *Post-Natal clinics 113 *Special Post-Natal Clinic discontinued during the year. Maternal Deaths. There was 1 maternal death during the year. Infant Welfare Centres. Total number of children who attended centres during the year 3,787 Health Visitors. Number of infants under one year of age visited for first time 1,446 Total visits to infants under one year 6,607 Total visits to children 1-5 years 10,895 Number of expectant mothersvisited for first time 688 Total visits to expectant mothers 1,155 Infant Life Protection. Number of Foster mothers at 31st December 1951 40 Number of Foster children " " 55 (28) Child Minders (Dally Guardians). Number of daily guardians (voluntary) 67 Number of children minded 52 Care of Premature Infants. Number of premature births during the year 110 Number of deaths under one month 16 Dental Clinic. Number of expectant and nursing mothers treated 193 Number of cases in which general anaesthetic was administered 68 Number of teeth extracted 271 Number of children under five years treated 381 Number of cases in which general anaesthetic was administered 102 Number of teeth extracted 190 Immunisation and Vaccination. 922 children were immunised in London County Council clinics during the year, a further 431 being immunised at schools and by private doctors. 10,45 received boosting injections. The percentage of the child population immunised against diphtheria at the end of the year was 73% 898 children were vaccinated in London County Council clinics during the year. Diphtheria Immunisation, The percentage of the child population (l - 15 years) immunised in this Borough is 73% compared with 70% for 1950; whilst for children under 5 years who have completed a course of immunisation it is only 52.8%, compared with 53.7% for the County of London as a whole. Note: These figures speak for themselves „ A generation has arisen which has not seen a case of diphtheria, not to mention an outbreak of the disease, and every effort should be made to encourage vaccination of all children in infancy followed up with a booster dose before five years of age. (29) SERVICES Ante-Natal Mornings Afternoons 5/7 Parsons Green - Tuesday,Thursday 170 Wandsworth Bridge Road Wednesday - 90/92 Greyhound Road Friday Thursday 62/63 Burne Jones House Friday Wednesday Family Planning 90/92 Greyhound Road - Tuesday 5/7 Parsons Green Thursday - Infant Consultation 5/7 Parsons Green Wednesday, Friday Monday,Wednesday. 170 Wandsworth Bridge Road Tuesday Tuesday 90/92 Greyhound Road - Monday,Wednesday and Friday 62/63 Burne Jones House Thursday Monday, Thursday Toddlers' Clinic 62/63 Burne Jones House - Tuesday 90/92 Greyhound Road Thursday - 170 Wandsworth Bridge Road Tuesday - Vaccination 90/92 Greyhound Road Wednesday - 170 Wandsworth Bridge Road Thursday - Immunisation 90/92 Greyhound Road Tuesday - 170 Wandsworth Bridge Road - Thursday Day Nurseries Eridge House, Fulham Park Road. Grove House, Bagley's Lane. St. James, Maxwell Road. Mulgrave, Mulgrave Road. 23, Broomhouse Road. Home Help Service. (Office where application may be made - 129, Fulham Palace Road). Number of cases attended during the year:- Maternity 30 Tuberculosis 52 Others (including aged and infirm persons) 777 (30) EXTRACTS FROM THE ANNUAL REPORT OF Dr. H.C PRICE. Chest Physician. FULHAM CHEST CLINIC. 114. New King's Road. Fulham. S.W.6. INTRODUCTION. All of us are, naturally, very pleased to hear from official sources that the number of people who die from Tuberculosis has fallen in the last year. In the main, this good news is due to the widespread use of the two drugs, Streptomycin and P.A.S. But the fall in the death rate does not mean that the problem of Tuberculosis has been solved. Far from it. It does mean, however, that as many of us have been saying, Tuberculosis can be wiped out in this generation. What has to be done to do this? First and foremost, by tackling the root cause of this disease, not just treating the people who already have it. Tuberculosis is an infeotious disease that can affect anyone, but we know from experience that it is the working population who are attacked most Young people, in particular,are very prone to attack by Tuberculosis. From childhood to adolescence they need extra food to cope with their growth, and good living conditions. All of which are lacking in many cases today. TUBERCULOSIS IN FULHAM. Reference to the statistical table will show the total number of notifications have fallen from 228 in 1950 to 197 in 1951, but the total number of deaths has risen from 42 in 1950 to 49 in 1951.The considerable fall in the number of deaths which were registered during 1950, and which many attributed to the effects of the extensive use of streptomycin which tended to prolong the life of otherwise hopeless cases, did not continue durine 1951. THE WORK OF THE FULHAM CHEST CLINIC. GENERAL. Further reference to the table will show that the flow of work of the clinic has increased steadily since 1949. The fact that the attendance of new cases has practically doubled, has been due to the increased vigilance on the part of the clinic staff,and local general practitioners and also to the much greater use that has been made in the last two years of Mass Radiography. (31) CONTACT EXAMINATION. There has been a considerable improvement in the work of examination and follow-up of contacts, leading to a number of child contacts being vaccinated with B.C.G. The vaccination is available to all mantoux negative student nurses commencing their training at the Fulham, Western and St. Mary Abbot's Hospitals, and the majority avail themselves of this form of protection. A number of investigations amongst school children have been undertaken in conjunction with the Divisional School Medical Officer of the London County Council In line with similar investigations elsewhere, it has been found that the school staffs and school leavers are most probably the sections that are most exposed to risk and those which need to be closely investigated as a regular routine. TREATMENT OF NEW CASES AT HOME. IN HOSPITALS AND SANATORIA. The clinic treatment sessions and especially the A.P.sessions and the home visiting, have expanded tremendously, and there is every indication that they will continue to do so until the Tuberculosis problem in Fulham is under control. The better use of the eight treatment beds in the Western Hospital has been instrumental in the last three years in reducing the numbers of patients admitted to Sanatoria. A very good liaison has been created between this clinic and King George V, Sanatorium, Godaiming. It is now a modern surgical unit, resulting in the more rapid intake of early treatable cases which are suitable for sanatorium or surgical treatment. This has accordingly reduced the waiting list for this type of patient to within the region of two or three months. Unfortunately,it is not true that similar liaison with Sanatoria dealing with female patients has been established, with a result that the waiting period for this sex is often up to six months. CONVALESCENCE. The need for a number of good Convalescent Homes in this area of London is still very great. Many patients who have successfully completed their home treatment are capable of returning to work after a varying period of convalescence without resort to sanatorium treatment. Again many patients not requiring domiciliary chemo-therapy, but whose homes are unsuitable, could return to work after a period of convalescence without occupying a sanatorium bed. Much greater priority needs to be given to this side of the problem in the future. CHRONIC SICK. The problem of the chronic tuberculous patient still remains to be adequately tackled. Many beds that were available to chronic cases are now only accepting patients in early stages of the disease, and there is increasing failure to realise that many so-called chronic cases are (32) able to modern methods of treatment and can often be returned home after they are sputum negative. We require many more beds for such chronic cases and these beds should be situated in the same Hospital unit as those dealing with the earlier and more acute cases. Reference cannot be made to the problem of the chronic sick without mention of the great need for hostels for these patients. In this area of London we require hostel accommodation, firstly for those patients who are ambulant and fit for some types of work, and secondly for those who are semi-ambulant and unfit for any type of work. RETURN TO WORK. Little, if nothing, has been done in this sphere in the last year.In spite of the 1944 Rehabilitation Act, the Ministry of Labour are still unable to find work for sputum positive cases,and are not very successful even with the sputum negative. The increasing difficulties now arising in the labour market following the end of full employment are aggravating these problems and it appears that this particular difficulty will increase in the near future. We still require a sheltered workshop and re-training centre in this area of London, in order to begin to tackle this problem. CONCLUSION. The problem of tuberculosis is now recognised as capable of solution. In order to achieve this we must first of all step up our measures to prevent the disease. This means not only providing Mass Radiography examinations, but also by raising the standard of living and rehousing the population. Secondly we must find and treat every infectious patient in the community STATISTICAL REPORT. 1949/50 1950/51 1951/52 No. of new patients 738 639 791 No. of new attendances 5,690 7,058 10,610 No. of patients who have attended,old and new 1,686 1,532 2,006 No. of clinic notifications 268 228 197 No. of notified cases on Records 31st Mar.1952. 1,096 1,131 1,233 No. of deaths 60 42 49 No. of contacts examined 361 397 516 No. of home visits bv medical staff 110 327 375 No. of home visits by nursing staff 2,420 2,935 2,606 No. of letters written 11,127 11,519 10,524 No. of X-rays 2,546 2,666 3,048 No. of Tomograms 91 116 130 No. of natients sent to Sanatoria 278 215 62 No. of B.C.G. vaccination - - 62 No. of patients undergoing chemo-therapy daring current year - 45 163 (33) SANITARY CIRCUMSTANCES OF THE AREA. The tendencies commented upon in previous Annual Reports persisted during 1951. There was again a slight falling off in the number of complaints received regarding insanitary conditions,but a sharp rise in the number of sanitary defects found calling for statutory action. This rise was again particularly noticeable in the case of the more serious nuisances, e.g. defective drains, roofs and gutters and damp walls. It must still be appreciated that the continued housing shortage makes it necessary to maintain premises which from the public health point of view would be better demolished. One circumstance which is becoming more and more apparent is worthy of note. Many properties in the borough are now held on very short leases. As reversion dates get near many owners seize the opportunity to be rid of their approaching obligations by giving away or selling at nominal rates their leasehold interests to individuals who have no sense of responsibility either to the public or their tenants. When these persons take over it soon becomes apparent that their sole aim is the collection of rent. Attention to repairs, no matter how urgent, plays no part in their scheme of operation until the utmost pressure is brought upon them. Sanitary Notices are ignored and even Court Orders often receive no attention in the first instance. The activities of these individuals, by no means confined to Fulham, cause serious hardship and misery to large numbers of families, and present a challenge to the department which has been firmly taken up. Every step within the law is actively pursued in the minimum possible time. It does seem, however, that the ultimate remedy lies with the Magistrates, who have power to make this anti-social behaviour financially unattractive. Inspections after complaint 4,646 Re-inspections 16,819 Inspections after Infectious Disease 375 Re-inspections after Infectious Disease 237 Drains tested 548 Drains inspected 1,498 Inspections of Outworkers' Premises 202 Inspections of Food Premises 5,016 Other Visits 1,241 Intimations served 3,667 Statutory Notices served 2,021 Intimations complied with 2,224 Statutory Notices complied with 1,658 (34) SUMMARY OF WORKS CARRIED OUT UNDER SUPERVISION OF SANITARY INSPECTORS. Fresh Air Inlets 42 Soil ani Vent pipes repaired or renewed 135 Drains cleared 383 Drains repaired 172 Drains relaid 92 Rainwater gutters and pipes repaired or renewed 875 Drains sealed off 3 Disused drains excavated 4 Traps cleansed, repaired etc.84 Pans renewed 304 Seats repaired or renewed 102 Flushing cisterns repaired or renewed 210 Additional W.C. accommodation provided 3 Fastenings provided to doors, and doors repaired 178 W.C. apartments ventilated 2 Sinks provided, repaired or renewed 236 Sink and bath wastes repaired or renewed 327 New baths fitted 7 New lavatory basins fitted 18 Baths cleansed 12 Drinking water cisterns cleansed etc. 48 Water supply pipes and fittings repaired 212 Water supply provided to separate floors 14 Rooms cleansed 4,836 Decorations and internal house repairs 8,587 Fireplaces repaired (nuisances from smoke etc.) 935 Kitchen ranges repaired or renewed (for cooking purposes) 318 Washing coppers repaired or renewed 13 Dampness remedled 3,980 Rooms provided with adequate light and ventilation 23 Staircases provided with light and ventilation and repaired 189 Ventilated food cupboards provided 2 Ventilation provided under fl oors and repairs 825 Roofs repaired 2,318 Other external repairs 750 Accumulations of refuse removed 35 Dustbins 217 Yards, forecourts paved and drained 81 Animals in state of nuisance 2 Rat runs traced 11 Bombed sites 8 Other nuisances 121 Total 26,719 (35) LEGAL PROCEED DIGS PUBLIC HEALTH NUISANCE SUMMONSES During the year ended 1951, 461 Summonses were down for hearing at the West London Magistrates Court and the Kensington Divisional Petty Sessions with regard to cases where Owners had failed to comply with Statutory Notices served under the Public Health (Lorxlon) Act, 1936. The cases were dealt with as follows:- No. of Summonses served No. of Orders made No„ of cases withdrawn or adjourned sine die 461 62 399 WORKS IN DEFAULT During 1951 works in default of owners of 40 premises failing to comply with the requirements of the Public Health (London) Act 1936,were carried out by contractors to the Council. The costs of work varied in individual cases from 13s .6d. to £136. 15s. Od., the total sum involved being £970. 4s. 6d. In addition works were carried out by the Council's contractor when an owner failed to comply with a notice served under Section 9 of the Housing Act, 1936. The costs in this case were £146. 18s.Od. RENT RESTRICTIONS ACTS During the year 21 applications for a Certificate of Disrepair were received. In 14 cases the premises were found not to be in a reasonable state of repair, and certificates were issued. In 5 cases the property was outside the scope of the Acts,and in the remaining 2 cases the state of the premises did not warrant the issue of a certificate of disrepair. 2 Revocation Certificates were issued to owners during the same period on satisfactory completion of the necessary repairs. HABITATION CERTIFICATES UNDER SECTION 95 (2) OF THE PUBLIC HEALTH (LONDON) ACT. 1936. During the year 217 certificates were issued in respect of newly erected and rebuilt premises in the Borough. (36) PUBLIC HEALTH (LONDON) ACT. 1936 - SECTION 122. 2 Certificates under the above-named Act and Section were issued requiring the cleansing or destruction of filthy and / or verminous articles. DISINFECTION. PISINFESTATION & LAUNDRY SERVICES. The following details relate to the services provided by the Disinfecting Superintendent and his staff during 1951:- Number of rooms disinfected after Infectious Disease 191 Number of articles stoved 4,097 Number of rooms disinfested 646 Number of inspections made of prospective Council tenants 392 Laundry carried out for the Dust Destructor staffs- Roller towels 14 Dust Coats 53 Bath towels 1,879 Boiler Suits 8 Hand towels 88 Overalls 4 The Disinfecting Superintendent has also dealt with many kinds of infestation such as cockroaches, beetles, ants, silver fish, moths etc. LIST OF VERMINOUS & STAINED ARTICLES DESTROYED DURING 1951. Bolsters 8 Mattresses 59 Overlays 6 Beds 37 Divans 4 Pillows 49 Sheets 16 Blankets 21 Quilts 8 Cushions 6 Clothing 381 Furniture 41 Trunks 7 Miscellaneous Pieces 84 Total 727 (37) DRAINAGE OF NEW BUILDINGS & RECONSTRUCTION OF DRAINAGE. During the year 107 applications for approval of drainage works were received and approved. Of these 42 were in connection with additions to existing buildings or the provision of additional sanitary accommodation; 20 were for the reconstruction of existing drainage systems and 11 others were in connection with the rebuilding of premises demolished as a result of enemy action. 32 applications were for the erection of new buildings, the majority of which will occupy gap sites in the Borough and developed by the Housing Department, but also included the first stage of the Avenues Redevelopment Area comprising 65 flats in three blocks, and the erection by the Borough Council of 33 flats designed for the occupation of elderiy persons. Two further approved applications were of some interest as they were in connection with the development by the London County Council of two new parks. One, which will be known as Normand Park, situated north of Lillie Road utilising a badly bombed area and providing a much needed "lung" in an otherwise heavily built up area, and another, to be known as Hurlingham Park, which is that portion of the Hurlingham Club Grounds acquired by the London County Council which will be laid out as a public park and sports arena. RODENT CONTROL. The Council's Rodent Repression Service continued its campaign against rats and mice during the year. This year was the first full year of operation of the Prevention of Damage by Pests Act, 1949. A total of 802 complaints,or notifications of the existence of rats or mice, were received by the Department, which represents a slight increase over those of last year. Investigation of these complaints, including routine inspections of riverside premises necessitated 7,767 visits by the staff. The number of infestations by mice were again in excess of those by rats. In the case of dwelling houses a total of 746 were treated, 445 for mice and 301 for rats. A total of 56 business premises were treated for either rats or mice, which is lower than last year. (38) In accordance with the requirements of the Ministry of Agriculture and Fisheries and with the co-operation of the Borough Engineer and Surveyor's Department, two treatments of the public sewers were carried out during the year. Assessed results of these treatments and comparison with those of the last two years indicate that the rat population of the sewers is not increasing but is being held In chock, and this fact coupled with the continued discovery and repair of defective outlet drains has resulted in a reduction of surface infestations. FACTORIES ACT, 1937. Most of the larger factories are grouped along the extensive river frontage of the Borough and usually have residential premises only the width of the roadway from their external walls. Regular inspections of both mechanical and non-mechanical factories have been carried out, during the course of which emissions from factory shafts, airborne deposited impurities, and noises and smells which may cause a nuisance to people living in the vicinity have received attention. Where smoke emissions are concerned, consideration is given to the density and colour of the smoke and the length of time of the emanations . VThere it is considered that a nuisance is taking place an mediate inspection of the factory is made and the attention of the management is drawn both to the danger to health and to the waste of fuel. Visits are paid to the boiler rooms aixi the methods of stoking are checked. To control nuisances from *airborne deposited impuritiesn (otherwise "grit") very careful observations are regularly made,petrie dishes being placed at strategic points in the Borough to collect any deposits. These actions make it possible both to track down the likely source of any particular nuisance and also to draw comparisons as between one part of the Borough and another. Deposits are heavier in the isst Division, particularly in Sands End (North, East and South), where most of the industries involving extensive use of coal and coke and other dusty materials are situated. In the West Division the deposits are heaviest in Margravine West Ward, conditions improving as one passes through Munster Ward to Town Ward. It can be said, however, that whilst appreciating that the presence of dust and other airborne de - posits to same extent is almost inevitable in any industrial area, the regular and close watch which is being kept in Fulham is resulting in markad improvements. (39) Much of the time of the Inspector for Factories and Smoke Abatement has been taken up in investigating complaints of noise. Some of these complaints are from individuals, but sometimes they take the form of petitions from a number of residents. It is not surprising that with the drive for increased production and exports, creating a good deal of night work in some of our factories, that complaints have been received regarding such things as noisy ventilating fans, heavy presses, electric saws and squeaky bearings. In some cases noise is caused by newly installed additional machinery still subject to final adjustments by the contractora. All these complaints are fully investigated,observations being made by day or night as required. Where complaints are considered to be justified a visit is paid to the mannagement concerned to seek remedies. It can be recorded that as regards both these types and the other types of nuisance from factories to which I have referred, ready co-operation has always boen forthcoming. Defects are quickly remedied, experiments are put in hand to minimise nuisance as far as possible and often the re-arrangement either of the work or of the siting of offending pieces of machinery is undertaken. An example may be of interest, which concerns a machine being used at night for the first time on urgent work after several years of day use without complaint. The complaint that loss of sleep was being caused was found to be justified. A late evening meeting was arranged between the director of the firm and the Council's Inspector which resulted in the party wall between the factory and the residence concerned being officiently sound-proofed. The following gives details of inspections made and action taken throughout the year under review:- Premises Inspections Number of written Notices Factories without mechanical power. 125) ) 14 Factories with mechanical power 79) Other premises under the Act (building operations and works of engineering construction. 11 - Number of re-inspections of all factories. 1,489 - Total 1,704 14 (4O) Number of cases in which defects were found. Particulars Found Remedied Complaints referred To H.M. Inspector By H.M. Inspector Want of cleanliness 30 27 - 1 Inadequate ventilation 8 7 - - Ineffective drainage of floors 19 17 - - Sanitary Conveniences: (a) Insufficient 3 2 - - (b) Unsuitable or defective 18 11 - - (c) Not separate for sexes — — — — Other offences against the Act (not including those relating to Outwork) - - - - Total 78 64 — 1 No prosecutions were instituted under the Factories Act 1937 during 1951. FACTORY DRAINAGE No. of drains inspected 646 No. of drains tested 297 No, of drains water tested 71 No, of drains cleared 16 No. of sinks renewed 47 SMOKE ABATEMENT Total No, of Observations and Inspections made 1,016 Complaints received 27 Observations (external) 665 Inspections (internal) 351 (41) WINDBORNE DEPOSITS OF GRIT. ASH & SOOT. No. of complaints received 11 No. of re-inspections 272 NOISE. No. of complaints received 13 No. of complaints remedied 5 No. of re-inspections made 161 PART VIII. of the FACTORIES ACT. OUTWORK Nature of Work No. of Outworkers on list Boot making 8 Wearing Apparel 72 Paper Bags 3 Upholstery 3 Toy making 101 Lampshades 3 Fancy goods 22 Miscellaneous 9 Total 221 202 Visits were made to Outworkers during the year. (42) RAG FLOCK AND OTHER FILLING MATERIALS. The Rag Flock and Other Filling Materials Act, 1951, and the Rag Flock and Other Filling Materials Regulations, 1951, came into operation on 1st November, 1951, and repeal the Rag Flock Acts, 1911 and 1928, and Section 136 of the Public Health (London) Act, 1936. Under the new Act, it is unlawful in the course of a business to use filling materials to which the Act applies in any form of upholstering, the stuffing or lining of toys, baby carriages or of articles of such other kinds as may be prescribed, except on premises registered by a local authority (in London a Metropolitan Borough Council). The remaking or reconditioning of any article or any upholstering in connection with railway carriages, road vehicles, ships or aircraft are specially exempt. The fee for registration is £1 ard once registered the premises do not have to be re-registered although any change of occupier must be notified to the local authority. The occupier of registered premises may only obtain supplies from premises licensed by a local authority to manufacture or store rag flock for distribution to registered premises. A fee of £1 is payable for a licence to manufacture or store rag flock and a licence once granted remains in force for a maximum period of one year onlyoThe local authority may refuse to grant or renew a licence if on inspection the premises do not comply with prescribed standards. Any person aggrieved by the decision of the local authority has the right of appeal to the Ministry of Local Government and Planning. The occupier of registered premises must keep accurate records of all filling materials consigned to his premises and of all second-hand articles containing filling materials conveyed to or from the premises. The occupier of premises licensed to manufacture rag flock must keep records of all rag flock consigned from the premises and the occupier of premises licensed to store rag flock must keep records of all rag flock consigned to or from the premises. It is an offence to possess for sale, offer or expose for sale or sell any article other than second-hand articles which:- (43) (1) is upholstered or otherwise lined or stuffed with filling materials to which the Act applies which are not clean, and (2) is of a kind which ought to be upholstered or stuffed or lined on premises registered under the Act. It is the duty of the local authority to enforce the Act and provision is made for a duly authorised officer to take samples of any terials appearing to him to be filling materials to which the Act applies. The Regulations set out the tests which are to be applied to samples of the various filling materials, the fees payable for the examination of samples and the nomes and addresses of prescribed Analysts to whom samples are to be submitted. As there are no premises in the Borough of Fulham where Rag Flock is manufactured or stored preparatory to distribution to upholsterers, no applications for licences were received. All premises in the borough which might be liable to registration under the Act were visited but in five instances only was the manufacture of new articles of upholstery etc, undertaken,the remainder merely remaking or reconditioning secondhand furniture etc., and were there fore exempt from the provisions of the Act regarding registration. During 1951, four samples of Rag Flock which were examined by the Council's Public Analyst were reported to be satisfactory. PHARMACY & POISONS ACT. 1933. THE POISONS RULES PHARMACY & HEDICII3ES ACT. 1941. A resume of the above was included in my Annual Report for 1950 and at the end of 1951,there were 174 names on the Council's List of Persons entitled to sell Part II Poisons. 243 visits of inspection were made during the year under review and 14 samples of Part II Poisons were submitted for analysis none of which calls for special comment. (44) SWIMMING BATH WATER SAMPLES, 1951. Samples of swimming bath water, details of the analyses of which follow, were uniformly good. Date Bath Time Bacteria per c.c. B. Coli. Free Chlorine parts per million April 24th Ladies Morning 2,800 No Coli 0.25 " Ladies Afternoon Nil " 0.7 June 21st Gents. Morning Nil " 0.64 " Gents. Afternoon Nil " 0.74 " Ladies Morning Nil " 0.70 " Ladies Afternoon Nil " 0.80 " Mixed Morning Nil " 0.48 " Mixed Afternoon Nil " 0.62 October 3rd Ladies (inlet) Morning Nil " 0.25 " Ladies (outlet) Morning 370 " 0.23 " Ladies (inlet) Afternoon Nil " 0.38 " Ladies (outlet) Afternoon Nil " 0.28 (45) INSPECTION & SUPERVISION OF FOOD. SLAUGHTERMEN'S LICENCES. The Slaughter of Animals Act, 1933,provides that no animal shall be slaughtered in a slaughterhouse or knacker's yard by any person who is not a holder of a licence granted by a local authority. A licence may only be granted to a person aged 18 years or upwards who is, in the opinion of the local authority, a fit and proper person to hold a licence. A licence remains in force for a period up to three years and may be renewed from time to time at the discretion of the local authority. During 1951, two such licences were issued to slaughtermen resident in the Borough of Fulham. There are no slaughterhouses in the Borough and no animals are killed for human consumption. UNSOUND FOOD. During 1951, 1,395 Certificates of Condemnation were issued by the Food Inspectors relating to the under-mentioned voluntarily surrender ed foods- Meat 4,234 lbs. Ham 1,801 lbs. Sausages 46½ lbs. Fish 69 stone. Tinned Goods 16,929 tins . Other Goods 13,084¾ lbs. The large amount of tinned ham which the Council's Food Inspectors were called upon to deal with during the year gave rise to some concern among the members of the Public Health Committee to whom details of all foodstuffs condemned as unfit for human consumption are. regularly given. On the instructions of the Committee the matter was brought to the notice of the appropriate department of the Ministry of Food who pointed out that the Ministry was not responsible for the purchase,importation or distribution of tinned hams, these being brought in by private traders on open general licence. The Ministry was, however, concerned with the "official certificate" which is recognised for the purposes of the Public Health (Imported Food) Regulations 1937 and 1948 and which is a guarantee that in the country of origin every precaution has been taken in the preparation of the canned ham so as to prevent any possible danger to public health. (46) The Ministry stated that the matter had already been taken up with the governments of the countries concerned and in order to assist them in tracing the manufacturers, particulars of the brand and country of origin of all tins dealt with in Fulham were forwarded to the Ministry. COMPLAINTS. During 1951, twenty-two complaints were received from members of the public regarding foreign matter etc. in food, each of which was fully investigated and reported to the Public Health Committee. The following are details:- No. Nature of Complaint Action taken on recommendation of Public Health Committee. 1 Wood in Toffee No Action - Complainant refused to supply name and address of vendor 2 Mouse (?) foot in sausage No Action - Certified by Analyst to be piece of gristle 3 Horseflesh sold as Grilled Steak Legal Proceedings. Summons dismissed. 4 Beetle in Fruit Tart Warning Letter. 5 Mites in Loaf. do. 6 Cement in Milk Bottle do. 7 Nail in Loaf Legal Proceedings. Baker fined £3. and £3. 3.0. costs. 8 Cigarette end in Loaf No action - Complainant unwilling to appear in Court. 9 Mouse excreta in Loaf Warning Letter. 10 Glass in jar of jam do. 11 Disc in Milk Bottle do. 12 Dirty Loaf of Bread do. 13 Nail in Cake No action - anonymous complaint. 14 do. Warning Letter. 15 Cigarette end in Loaf do. 16 Grease in Loaf do. 17 Mouse excreta in Loaf do. 18 Mouldy Meat Pie do. 19 Button in Loaf do. 20 Cement in Milk Bottle do. 21 ? Horseflesh sold as Beef Steak No action - Certified as beef by Public Analyst. 22 Rope in Loaf Warning Letter. (47) FOOD & DRUGS ACTS. 1938 - 1950. During the year under review one thousand samples of food and drugs purchased by the Sampling Officer were submitted to the Council's Public Analyst for chemical analysis. The samples, which are taken under the various Acts,Orders and Regulations relating to foodstuffs, are divided into two classes, viz:- (a) formal samples, or those in the purchase of which the legal procedure laid down in the Food & Drugs Act 1938, relating to declaration of identity,division into three parts,sealing etc. of the sample is carried out.In these cases legal proceedings can be instituted when the samples are certified to be adulterated; (b) informal samples, which are samples purchased without carrying out the legal formalities and merely serve to indicate the conditions obtaining without disclosing to the vendor the object of the purchase. Adverse reports were received from the Public Analyst on forty-two or 4.2% of the samples examined and in only one instance were legal proceedings instituted, viz:- Sample No. Article Result of Analysis Result of Proceedings 59 Grilled Steak (Private sample) Certified to be horseflesh. Summons dismissed. The following are details of the forty-one articles which were reported to be not in accordance with accepted standards and the action taken:- Sample No. Article Result of Analysis Result of Proceedings 3 Artificial Cream powder Not artificial cream Referred to Ministry of Food 17 Fizzade Dabs Did not effervesce. Strongly alkaline.Yellow colouring present but not declared on label. Taken up with manufacturers. (48) Sample No. Article Result of Analysis Action taken 29 Canned Rhubarb Can badly lacquered Reported to Canners 32 Effervescing Soft Drink powder Incorrectly declared composition Taken up with manufacturers 64. Soft Drink Tablets Contained talc but not declared on label do. 79 do. do. do. 88 Christmas Pudding Slight mould growth Arranged for sale at cheaper rate 102 Dry Mince Meat Notdry Mince Meat as defined by Dried Fruits Order, 1951. Referred to Ministry of Food. 110 Cut Dried Peel Deficient in sugar do. 131 Dry Fruit Mince Should be called Dry Fruit Mix do. 145 Non-Brewed Vinegar Should be described as non-brewed condiment Remainder of labels amended. 167 Beef Sausage Meat 10.8% deficient in meat Referred to Ministry of Food 179 Compound Syrup of Figs Not compound Syrup of Figs of the B.P.C. Matter taken up with packers. 184. Pepper compound Incorrectly labelled do. 220 Semolina Too fine Matter already receiving consideration of Ministry of Food. 222 do. do. do. 281 Sherbet Suckers Contained maize starch Matter taken up with manufacturers (49) Sample No. Article Result of Analysis Action taken 286 Ground Almonds Rancid Remainder of stock returned to wholesalers 267 Semolina Too fine No action. 268 do. do. do. 312 Tapioca dessert Misleading description do. 322 Sherbet Sucker Excess starch and alkali Taken up with manufacturers 338 Dessert Gelatine Contained no sugar No action 386 Chocolate Cream Biscuit Not sufficient chocolate to warrant description Taken up with manufacturers 442 Sherbet Sucker Excess starch and alkali Taken up with manufacturers 446 Cream Deficient in fat No action 447 do. do. do. 453 Orange Squash Deficient in sugar Referred to Ministry of Food 455 Ice Cream Improper emulsification and should contain a stabiliser Manufacturer advised 460 Chocolate Cream Biscuit Not sufficient chocolate to warrant description Taken up with manufacturer 520 Semolina Too fine No action (50) Sample No. Article Result of Analysis Action taken 537 Madeira Cake Rancid Remainder of stock withdrawn 547 Lemonade Powder Composition not declared No action 617 Ice Cream Lolly Deficient in fat Vendor warned not to describe as "Ice Cream" Lollies 646 do. do. do. 703 Non—Brewed Vinegar Misdescription Labels amended 712 N.B. Condiment Deficient in acetic acid Two further formal samples taken and both genuine 768 Semolina Too fine No action 773 Mince Meat Deficient in sugar Taken up with manufacturers 775 Semolina Too fine No action 963 Fondants (off points) Contained sucrose and glucose No action DETAILS OF SAMPLES OF FOOD & DRUGS EXAMINED BY THE COUNCIL'S PUBLIC ANALYST Articles Formal Adulterated Informal Adulterated Total Percentage Adulterated Samples Adulterated Milk 278 - 7 __ 285 — — Almonds Ground 9 1 — — 9 1 11.1 Baking Powder 1 — — — 1 — — Batter Mixture 1 — — — 1 — — Biscuits (chocolate) 1 1 1 1 2 2 100.0 Breadcrumbs 2 — 2 — 4 — — Butter 49 — — — 49 — — Black Pudding 1 — — — 1 — — Blanc Mange 1 — 1 — 2 — — Cachous 1 — — — 1 — — Cake Mixture 2 — 4 — 6 — — Cake Decorations 1 — — — 1 — — Cheese 6 — — — 6 — — Chicory 1 — — — 1 — — Coconut (Desiccated) 3 — — — 3 — — Colouring Cochineal — — 1 — 1 — — Coffee & Chicory Essence 12 — — — 12 — — Confectionery 24 6 10 — 34 6 17.6 Cooking Fat 11 — — — 11 — — " " (Kosher) 3 — — — 3 — _ Cornflour 1 — 1 — 2 — — Cream — — 2 2 2 2 100.0 Artificial Cream Powder 1 1 — — 1 1 100.0 Custard Powder 1 — 1 — 2 — — Dessert Powder 1 — — — 1 — — Dripping 1 — — — 1 — — Faggots 1 — — — 1 — — Flour 7 — 1 — 8 — — Carried Forward 420 9 31 3 451 12 — (51) Articles Formal Adulterated Informal Adulterated Total Percentage Adulterated Samples Adulterated Brought forward 420 9 31 3 451 12 — Fishcakes 1 — — _ 1 — — Fruit (Dried) 7 — — — 7 — — Fruit (Glace Cherries) 3 — — — 3 — — Galantine 2 — — — 2 — — Gelatine Dessert — — 1 1 1 1 100.0 Gravy Powder — — 1 — 1 — — Ginger 2 — — — 2 — — Ice Cream 21 2 27 1 48 3 6.2 Jam 4 — — — 4 — Jelly 3 — 2 — 5 — Lard 12 — — — 12 — Lentils 1 — — — 1 — Malt Extract Tablets 1 — — — 1 — Macaroni 7 — — — 7 — Madeira Cake 1 1 — — 1 1 100.0 Margarine 8 — — — 8 — — Marmalade 2 — — — 2 — — Meat Pie 9 — 1 — 10 — — Meat (Canned) 5 1 2 — 7 1 14.2 Mint — — 1 — 1 — — Mincemeat 19 1 — — 19 1 5.2 Mince Dry 8 2 — — 8 2 25.0 N.B .Condiment 14 — 1 1 15 1 5.2 N.B. Vinegar 1 1 1 — 2 1 50.0 Nutmeg — — 1 — 1 — — Oatmeal 6 — — — 6 — — Oats 1 — — — 1 — — Paprika — — 2 — 2 — — Carried forward 558 17 71 6 629 23 — (52) Articles Formal Multerate d Informal Adulterated Total Percentage Adulterated Samples Adulterated Brought forward 558 17 71 6 629 23 — Pastry Puff 1 — — — 1 — — Peas 1 — — — 1 — — Peel (Cut) 7 1 — — 7 1 14.2 Pepper Cayenne — — 2 — 2 — — " Compound — — 9 1 9 1 11.1 Pickles — — 1 — 1 — — Pulses 1 — — — 1 — — Pudding Mixture 2 — — _ 2 — — " (Christmas) — — 1 — 1 — — Rhubarb (Canned) 1 1 — — 1 1 100.0 Rice 14 — — — 14 — — Saccharin 12 — — — 12 — — Sauce — — 1 — 1 — — Sage 1 — — — 1 — — Sago 3 — — — 3 — — Sausages 106 — — — 106 — — Sausage Roll 5 — — — 5 — — Sausage Meat 1 1 — — 1 1 100.0 Syrup 2 — — — 2 — — Semolina 7 7 — — 7 7 100.0 Soup Powder — — 2 — 2 — — Spice — — 2 — 2 — — Suet 5 — — — 5 — — Tapioca 20 — — — 20 — — Tapioca Dessert — - 2 1 2 1 50.0 Tea 9 — — — 9 — — Vegetables (Dried) — — 1 — 1 — — Vinegar (Malt) 21 — — — 21 — — Ammon. Quinine 1 — — — 1 — — Carried forward 778 27 92 8 870 35 — (53) Articles Formal Adulterated Informal Adulterated Tota1 Percentage Adulterated Samples Adulterated Brought forward 778 27 92 8 870 35 — Aspirin — — 2 — 2 — — Boric Ointment 1 — 4 — 5 — — Calomine Ointment — — 5 — 5 — — Cough Lozenges 1 — 1 — 2 — — Seidlitz Powder 1 — — — 1 _ — Sulphur Ointment 1 — 5 — 6 — — Syrup of Figs — _ 4 1 4 1 25.0 Vaseline — — 1 — 1 — — Lemon Barley Water 6 — — — 6 — — Blackcurrant Cordial 1 — — — 1 — — Cherry Wine 1 — — — 1 — — Cider 3 — — — 3 — — Grapefruit Squash 1 — — — 1 — — Ginger Wine (N.A.) 9 — — — 9 — — Lime Juice Cordial 4 — — — 4 — — Lemon Squash 3 — — — 3 — — Orange Squash 9 1 — — 9 1 11.l Pineapple Squash 1 — — — 1 — — Raisin Wine 2 — — — 2 — — Strawberry Cordial 1 — — — 1 — — Soft Drink Tablets 1 1 3 1 4 2 50.0 Soft Drink Powder 2 2 1 — 3 2 66.6 Ale 29 — — — 29 — — Brandy 3 — — — 3 — — Rum 5 — — — 5 — — Gin 3 — — — 3 _ — Sherry 3 — — — 3 — — Whisky 12 — — — 12 — — Grilled Steak — — 1 1 1 1 — Totals 881 31 119 11 1,000 42 4.2 (54) (55) ICE CREAM (HEAT TREATMENT. etc.) REGULATIONS. 1947 — 1951. These Regulations control the preparation and subsequent treatment of ice cream. Ice Cream must be kept at a temperature of not more than 28°F., and if the temperature has risen above 28° F. the ice cream must be subject to further heat treatment and again kept at a temperature not exceeding 28°F. A modified Methylene Blue teoL is recommended as a provisional test of bacterial cleanliness and four grades have been defined. During 1951, the following samples of ice cream were examined:- Grade Wrapped Taken from Bulk Total 1 28 17 45 2 7 6 13 3 1 6 7 4 4 2 6 Totals 4O 31 71 in addition to the above, nineteen ice lollies were examined,eighteen of which satisfied Grade I and one of which was placed in Grade 2. Samples falling within Grade I and 2 are regarded as satisfactory whilst Grades 3 and 4 indicate carelessness in hygiene at some stage in the manufacture, handling or storage of the ice cream.It is the practice in Fulham to investigate when samples—fall within the latter grades. THE FOOD STANDARDS (ICE CREAM) ORDER. 1951. Under this Order ice cream (but not water ices or ice lollies) must contain not less than 5% fat; 10% sugar, and milk solids (other than fat) 7½%. These standards do no apply to ice cream which contains a high proportion of fruit, fruit pulp or fruit puree or to "Kosher" ices. During the year under review forty—eight samples of ice cream were purchased for chemical analysis by the Public Analyst and a summary o f results is given below:— Percentage of Fat. Less than 5% 5% — 7½% 7½% — 10% Over 10% No. of Samples. 3 9 26 10 (56) FOOD & DRUGS ACTS. 1938 — 1950. MILK (SPECIAL DESIGNATION) (PASTEURISED & STERILISED MILK) REGULATIONS. 1949/1950. MILK (SPECIAL DESIGNATION)(RAM MILK) REGULATIONS 1949/1950. BACTERIOLOGICAL EXAMINATION OF MILK. The tests prescribed for Pasteurised Milk are:— (a) The Phosphatase test for efficient heat—treatment which is satisfied by milk which gives a reading 2.3 Lovibond Blue units or less, and (b) The Methylene Blue test for keeping quality which is satisfied by milk which fails to decolourise Methylene Blue in thirty minutes. The Turbidity test is prescribed for Sterilised Milk, the presence of any signs of turbidity indicating that the milk has not been heated to sterilisation temperature. During 1951, one hundred and twenty—five samples of milk were purchased by the Sampling Officer and submitted for the appropriate tests. Of these, forty—two were taken at the early morning delivery to the hospitals in the Borough and twenty—one were taken at schools under the control of the London County Council. The following table gives details of these samples:— Grade of Milk No. of Samples tested Phosphatase Test Methylene Test Turbidity Test Passed Failed Passed Failed Passed Tuberculin Tested (Pasteurised) 12 12 — 12 — — Pasteurised 106 105 1 106 — — Sterilised 7 - — — — 7 (57) It will be seen that only one sample of pasteurised milk failed to satisfy the phosphatase test for efficient heat-treatment. This case was reported to the Milk Division of the Ministry of Food to whom a monthly return is submitted of the samples taken in the Borough together with the results of the appropriate examinations. The milk now retailed in Fulham is either the product of "tuberculin tested" herds or has been "pasteurised" or "sterilised" in accordance with the provisions of the above Regulations. The use of these special designations is only permissible by persons duly licensed by the local authority. Licences issued under these Regulations are renewable annually o n the 1st January, principal licences being granted to retailers occupying premises within the Borough, whilst supplementary licences are issued to purveyors who distribute milk within the Borough of Fulham from premises situate outside. The following are details of licences granted for the year 1951:- No. of Licences to retail Tuberculin Tested milk 49 No. of Supplementary Licences to retail Tuberculin Tested milk 11 No. of Licences to retail Pasteurised milk 80 No. of Supplementary Licences to retail Pasteurised milk 11 No. of Licences to retail Sterilised milk 89 No. of Supplementary Licences to retail Sterilised milk 11 (58) THE MILK (SPECIAL DESIGNATIONS) (SPECIFIED) ARMS ORDER.1951. The above-mentioned Order made by the Minister of Food, under Section 23 of the Food & Drugs (Milk, Dairies & Artificial Cream) Act, 1950, specifies areas within which milk sold by retail must conform to the requirements of the Milk (Special Designation) (Pasteurised & Sterilised Milk) Regulations, 194-9 1950, and the Milk (Special Designation) (Raw Milk) Regulations, 1949 and 1950. The Order, which became operative on 1st October, 1951, specifie s two areas - the "London" area and the "Portsmouth" area.From that date all milk sold in these areas must be special designated milk, i.e. tuberculin tested milk, pasteurised milk, sterilised milk or accredited milk from a single herd. No accredited milk is retailed in Fulham, all tuberculin tested milk and sterilised milk being supplied to local dairymen in sealed bottles. A large proportion of the pasteurised milk distributed in the Borough is also delivered to retailers in bottles. Some dairymen, however, purchase milk in bulk from wholesalers by whom it has been pasteurised in accordance with the requirements of the Regulations. This is bottled in local registered dairies and prior to the coming into force of this Order such milk was not retailed under the special designation "Pasteurised". On and after 1st October, 1951, however, this designation has been included on the disc or other device used for sealing bottles. SALE OF MILK REGULATIONS. 1939. During 1951, two hundred and eighty-five samples of milk w er e purchased by the Sampling Officer and submitted to the Council's Public Analyst for chemical analysis. Of these, one hundred and eighty two were purchased from milk vendors in the streets of the Borough during the early delivery, forty-five were purchased on Sundays and forty-two, were taken at the early morning delivery to the hospitals in the Borough. It is satisfactory to record that no adulterations were reported . The following table gives the monthly average composition of all samples of milk and it will be seen that the quality of the milk retailed in Fulham is well maintained aid compares very favourably with the legal standards laid down in the Sale of Milk Regulations, 1939:- (59) Month No .of Samples Fat % Solids not Fat % January 35 3.56 8.68 February 25 3.39 8.65 March 24 3.37 8.67 April 24 3.43 8.60 May 25 3.23 8.61 June 20 3.23 8.74 July 21 3.40 8.71 August 6 3.38 8.72 September 35 3.53 8.75 October 19 3.58 8.80 November 26 3.74 8.83 December 25 3.69 8.78 285 3.47 8.71 Legal Standards 3.00 8.50 Average Composition of normal cows ' milk 3.76 8.84 The time of the year is one of the chief circumstances on which the variations in the composition of cows' milk depends and the year may be divided into four periods according to the character of the milk yielded. Thus during period I, i.e. November, December and January, milk is rich in fat and solids-not-fat. During the second period, February, March and April, the fat figure falls whilst the solids-not-fat content remains practically the same. At the beginning of the third period, May to August, the fat content is less but tends to rise towards the end of the period; and September and October,the fourth period,sees an increase in both fat and solids-not-fat. It will be seen that Fulham's milk suoply appears to follow t he normal rise and fall. (60) The arrangement whereby samples of milk are taken either at, or in course of delivery to the hospitals, institutions, schools, etc., in the Borough was continued during 1951 and the following were taken for chemical analysis:- Institution No. of Samples Fulham Hospital 18 Western Fever Hospital 24 L.C.C. Schools 48 Meal Kitchens, etc. 9 Fulham Maternity Home 1 Total 100 REGISTRATION OF PURVEYORS OF MILK. The following are details of changes which occurred during the year:- No. of dairymen on Register at 31st December 1951 47 No. of registrations granted during 1951 1 48 No. who transferred their business or tinued selling milk during 1951 3 Total on Register at 31st December 1951 45 In addition there were seventy-four shop-keepers at the end of 1951 registered to sell milk which is not supplied otherwise than in the properly closed and unopened receptacles in which it is delivered to their premises as compared with fifty-nine at the commencement of the year. During the year 1951, two hundred and sixty-one visits of inspection were made to these dairies and milkshops, in addition to visits for the purpose of talcing samples. (61) FOOD ESTABLISHMENTS. Regular inspections were carried out during the year 1951 resulting in the service of 116 written Notices, and 217 verbal intimations to the persons responsible requiring the execution of essential work.In no case was it necessary to institute legal proceedings,a tribute to the success of the Council's Food Inspectors in obtaining the co—operation of the traders. My last report drew attention to the fact that the majority of the eating—houses in the Borough are of the smaller type owned and conducted by a single individual. The business in many has outgrown the facilities available, and the kitchens and food—preparing rooms are inadequate, resulting in a great deal of congestion. This is re—stated owing to the relevance of such conditions to standards of food hygiene. Details of the more important improvements which have been effected in food premises during the year are given below:- Water heaters installed 21 New sinlcs provided 19 New W.C.'s provided 8 W.C.'s repaired or cleansed 12 Kitchens, preparation rooms, etc. redecorated 101 Floors renewed or repaired 12 Shop fronts repaired, or redecorated 33 Shop fronts rebuilt 7 New dustbins provided 26 Counter cases for protection of food provided 4 (62) INSPECTIONS OF FOOD PREMISES. Type of Business No. on Regist er No. of Inspections NOTICES complied with Written Verbal Bakehouses (NonBasement) 26 151 8 4 5 Bakehouses (Basement) 10 55 1 2 3 Bread and Cake Shops 11 114 10 3 5 Butchers' Shops 72 650 6 24 19 Cooked Meat Shops 7 65 2 — 2 Dairies Purveyors of Bottled Milk 45) ) 74) 243 - 1 1 Eel and Pie Shops 5 36 1 - — Food Factories 3 59 2 — 2 Fishmongers Shops 21 197 7 15 5 Fried Fish Shops 33 237 4 4 8 General Food Shops 289 862 25 24 35 Greengrocers and Fruiterers 94 375 13 46 22 Horseflesh Butchers 2 15 2 — 2 Ice Cream (Manufacturers and Dealers) 195 205 3 6 4 Licensed Premises 85 171 7 9 7 Restaurants and Working Class 137 1,124 19 73 40 Dining Rooms Stallholders' Storage Premises 35 227 1 3 1 Other Food Premises 25 230 5 3 4 Totals 1,169 5,016 116 217 165 (63) PREMISES USED FOR THE PREPARATION OF FOOD. Under the provisions of Section 14. of the Food & Drugs Act, 1938, premises used for the preparation of certain specified articles of food must be registered with the local authority. At the end of 1951 there were fifty—eight premises on the Register concerned in the preparation of preserved foods and one hundred and ninety—five premises on the Register relating to the manufacture or sale and storage of Ice Cream, as follows:— Premises registered for manufacture, storage and sale of Ice Cream 2 Premises registered for storage and sale of Ice Cream 193 "CREAM" CONFECTIONERY. During the year under review, seventy—nine samples of "cream"—filled cakes, doughnuts, eclairs etc. were purchased for bacteriological examination . The fact that the "cream" filling used in this type of confectionery is not subject to any form of cooking before consumption makes it most important that scrupulous cleanliness be observed by persons handling the cakes. Proper sterilisation of the utensils etc. used for containing the "cream" is also desirable. Satisfactory reports were received from the laboratory regarding seventy—seven of the samples, whilst two showed the presence of faecal coli. In both instances the matter was taken up with the bakers concerned, advice on food hygiene given, and subsequent samples proved satisfactory. INSPECTION OF BAKEHOUSES AND BAKERS SHOPS„ At the end of 1951, there were thirty—six bakehouses in the Borough, ten of which are "basement* bakehouses. In addition, there were eleven retail bakers' shops without bakehouses attached. During the year under review two hundred and six inspections were made.