AC 4346 Cut PC. Fck 26 10 55 Cmc FUL 45 METROPOLITAN BOROUGH OF FULHAM REPORT of the MEDICAL OFFICER OF HEALTH including the Report of the Public Analyst for the year ADAMS FUL 45 CONTENTS Subject Page No; Public Health Committee and Staff of Department 1-3 Introduction 4 - 6 Vital Statistics and Infectious Disease 7-20 Extracts from Annual Report of Chest Clinic 21 - 24. Hospitals in the Borough 25 L.C.C. Personal Health Services 26 - 28 Old People's Welfare 29 - 32 Mortuary and Public Conveniences 33 - 34 Health Education 35 - 36 New Legislation 37 Sanitary Circumstances of tho Area 38 - 42 Housing Repairs and Rents Act, 1954 43 - 46 Dwellings completed by Council in 1954 47 Rodent Control 48 - 49 Pharmacy & Poisons Act, 1933 50 Pet Animals Act, 1951 51 Atmospheric Pollution 52 - 53 Factories Act, 1937 54 - 58 Food Inspection 59 - 76 Report of Public Analyst 77 - 85 Detailed Index at end of Report. (1) METROPOLITAN BOROUGH OF FULHAM MEMBERS OF THE PUBLIC HEALTH COMMITTEE (as at December. 1954.) Ex-officio: Councillor Walter Rankin, J.P., (Mayor). Chairman: Councillor John William Perotti. Vice-Chairman: Councillor Percy Edward Fenne . Alderman: George Henry Ellis. Councillors. Miss Phyllis May Cooper. Mrs, Elizabeth Lydia Desborough. Mrs . Marjorie Annie Gale Mrs. Rosemary Longstaff. Mrs . Laura May Mills . Royden George Morgan. Herbert Henry Poulter. Henry James Riekards. Francis James Rumsey. (2) STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December. 1954. 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., B.S. (Lond.), D.P.H. Public Analyst. Thomas McLachlan, A.C.G.F.C., F.R.I.C. Administrative & Clerical Section. Chief Clerk. J.E. Burton, D.F.M. Second Clerk. J.W. Chance, A.I.Hsgo, Dip.R.I.P.H.H. Administrative Clerk. B.C. Bolton. Secretary to M.O.H. Miss R.P. Begg, Dip. Soc. Science. Clerks. S.T. Ange11. R.A. Green. Miss P. Dopson. J.R. McWhinnie. Clerk-Typist. Miss R. Reed. Shorthand-Typistso Mrs. C.M. Phillips. [Vacancy.] Sanitary Inspectors' Section. Chief Sanitary Inspector. G.W. Herrick, D.P.A. (1) (2). Deputy to above and Officer-inCharge, Rodent Repreisiom Service. F.E. Walsh. (1) (2). Senior Sanitary Inspector and Sampling Officer. A.W., Gammack. (1) (2). Factories and Smoke Abatement Officer. F.C. Payne, (l) (2) (3) (4). Lady Sanitary Inspector. Miss E„H. Sexton, S.R.N., S.C.M., H.V.(l). District Sanitary Inspectors. H. Hutchinson. (1) (2). W.G. Thurgood. (1) (2) (3). A.H. Newport, (l) (2). G. Bailey. (1) (2). D. Brisk, (l). R.F. Griffiths (l). T.H. Robey (Temp.) (1) (2). F. Williams. (1) (2). [3 Vacancies] Student Sanitary Inspectors. B.A. Cantwell. M.R.San.I. S.F. Everitt. (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) Staoke Certificate, Royal Sanitary Institute. (3) DISINFECTING STATION Superintendents: J.H. Hughes. Three Disinfectors: One Motor Driver: One Disinfector/ Motor Driver. W„H. Parsons. R.J. Osmond. L. Howes. A. Wright. A. Lamb. RODENT CONTROL One Foreman Operative: Three Operatives: G.H. Leaver. K. Sawyer. J. Pace. V. Greenway (Temp.). PUBLIC CONVENIENCES Fifteen Male Attendants: Fifteen Female Attendants: S. Brazil. Mrs. D.E. Collis. R.W. Chapman. Mrs. K. Cook. W. Covey. Mrs. A. Brophy. F.W. Davis. Mrs. E. Crowle. F.W. Hawkins. Mrs. M. Cude. W.A. Howard. Mrs. E. Edwards. A.R. Light. Mrs. F. Francis S.G. Marshall. Mrs. N. Johnson. H.B. Mills. Mrs. A. Larking. A.J. Munday. Miss V.M. Lewington. J.J.M. Ross. Miss E. O'Hara. K.G. Tamblyn. Mrs. F.E.A. Spencer. F.J. Taylor. Mrs. A.S. Thomas. J.W. Smith. Mrs. E.A. Schabbon. One vacancy. One vacancy. MORTUARY KEEPER G. Churchill. (4) 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, Mr. Mayor, Ladies and Gentlemen, I have the honour to present my Annual Report for the year 1954, together with the report of your Public Analyst, Mr. T. McLachlan, A.C.G.F.C., F.R.I.C., for the year. The report continues to appear in the form required by the Minister of Health. The estimated mid-year population of the Borough was 120,700 compared with the mid-year estimate of 122,500 in 1953. Statistical returns for the year indicate that the health of the citizens of Fulham was maintained at a good standard. The Birth Rate, 14.06 per 1,000 population., is higher than the 1953 rate (13.65) and the Infant Mortality Rate of 19.4 per 1,000 live births (27.5 in 1953) is the lowest on record for the Borough of Fulham and compares satisfactorily with London 22.1 (24.8 in 1953). The Death Rate was 10.2 per 1,000 population, a lower rate than that of 11.5 in 1953. This is the lowest recorded Death Rate in Fulham. The total number of deaths in Fulham from tuberculosis was 29 two of which were non-pulmonary. It is gratifying to record that no Fulham mother died in childbirth during the year. Infectious Diseases on the whole showed a very marked decrease and I am pleased to record especially that the number of notifications of Measles were down by 849 and Whooping Cough by 415 on those of 1953, and there was no death recorded either disease. The number of notified cases of tuberculosis was 139, of which 13 were non-pulmonary. The number of notifications has teen steadily declining and this latest figure is the lowest for the last ten years. (5) There was a minor oat break of Typhoid Fever involving nine persons all of whom completely recovered. Concurrently and making the position a little involved there was an extensive outbreak of foodborne Sonne Dysentery. This is dealt with by Dr. C.A. Meade, Deputy Medical Officer of Health, in another part of the report. Immediate action was taken; otherwise there was a likelihood of the persistence of Sonne Dysentery for months. One case of Paralytic Poliomyelitis was confirmed during the year in an infant of 10 weeks. It is good to report that the infant completely recovered and no paralysis remained. Again no one in Fulham has suffered from Diphtheria since 1949. I regret to report that there is still a shortage of Sanitary Inspectors throughout the country and Local Authorities are finding it more and more difficult to fill vacancies. This shortage is having a serious effect on the work as at present only the most important items of the Sanitary Inspectors work can be carried out. In order to ease this situation this Council was amongst the first in the Metropolitan Area to initiate during the year, a scheme to admit candidates for practical training as Sanitary Inspectors in the Public Health Department. Two such Students are now in the process of completing their course of training. The number of nuisance complaints has consistently dropped since 1952 and a measure of house to house inspection was resumed during the year, but it was subsequently found impossible to continue these inspections owing to shortage of staff. The Housing Repairs and Rents Act, 1954, became operative on the 30th August, It requires, amongst other things, that the Local Authority should issue certificates of disrepair if premises are found to be not in a state of good repair where notices of increased rent have been issued. It also deals with Hostels, Lodging Houses and other Houses let in Multiple Occupation, cancels existing bye-laws for such premises and introduces new standards. A considerable amount of property in Fulham comes into this category. It also requires Local Authorities to present to the Minister of Housing and Local Government before August, 1955, a Slum Clearance etc. programme. In the case of the Metropolitan Boroughs this programme is an agreed one by each Borough Council with the London County Council. I must report that many properties still continue in occupation which are not worth continual patching up. (6) Relations between the Public Health Department and the London County Council Divisional Office continue to be cordial and happy since the operation of the National Health Act, 1946. Every kindly assistance and the fullest co-operation has been given by Dr. Russell and her staff. The findings of the Beaver Report on Atmospheric Pollution have been published and it is welcome information that legislation is envisaged in the near future to implement the main recommendations to reduce atmospheric pollution. In the Councils' Housing Estates built since the war, grates have been installed capable of using smokeless fuel. There are still the questions of supply and storage of these fuels. The Welfare of the Elderly continues to expand and extend in scope and more facilities and amenities are being made available by the Old Peoples' Welfare Committee who co-ordinate the fine work of Voluntary Associations and Societies and the Statutory Bodies in Fulham. I am again indebted to the members of the Council for their willing help and consideration in Public Health problems as they arise and to each of them I express thanks, especially to the Chairmen of the Public Health and Staff Committees. To all fellow Chief Officers and their staffs for consistent help and friendliness I express my thanks and also to the staff of the Public Health Department for their loyal service and efficiency which has made the work go smoothly and this report again possible. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, (7) EXTRACTS FROM VITAL STATISTICS FOR THE YEAR 1954. POPULATION (estimated) 120,700 AREA of Borough 1,706 acres, SEPARATE DWELLINGS (estimated at 31.12.54) 31,337 A PENNY RATE produces approximately £4,830 per annum. 919 MARRIAGES were registered during the year. LIVE BIRTHS: Total Males Females Rate per 1,000 Population. 1953 1954 Legitimate 1,561 786 775 12•78 12•93 Illegitimate 137 76 61 0•87 1•13 Totals 1,698 862 836 13•65 14•06 STILLBIRTHS: Legitimate 29 17 12 0•19 0•24 Illegitimate 4 3 1 0•03 0•03 Totals 33 20 13 0•22 0•27 DEATHS: 1,233 658 575 11•5 10•2 DEATH RATE of infants under one year of age: 1953 1954 All infants per l,000 live births 27•5 19•4 Legitimate infants per l,000 legitimate births 26•2 19•2 Illegitimate infants per l,000 illegitimate births 46•7 21•9 (8) CLASSIFICATION OF CAUSES OF DEATH 1,233 Deaths as follows:- Under 1. Age Groups Over 45 Total 1-5. 5-15. 15-45 Tuberculosis Respiratory - - - 2 25 27 Tuberculosis, other - - — 1 1 2 Syphilitic Disease - - - - 6 6 Diphtheria - - - - - - Whooping Cough - - - - - - Meningococcal Infections 1 - - - - 1 Acute Poliomyelitis - - - - - - Measles — — — - - - Other infective and parasitic diseases — 1 — 1 — 2 Cancer — — — 16 234 250 Diabetes — — — 1 11 12 Vascular lesions of nervous system — — — 1 124 125 Coronary disease, angina - - - 4 182 186 Hypertension with heart disease - — - 2 24 26 Other heart disease — — — 4 135 139 Other circulatory disease - — - 2 53 55 Influenza — — - — 3 3 Pneumonia 3 2 — 1 79 85 Bronchitis — — — — 69 69 Other diseases of respiratory system — 1 — - 13 14 Ulcer of stomach and duodenum — — — — 20 20 Gastritis, enteritis, diarrhoea — - — — 6 6 Nephritis and nephrosis - — - 2 12 14 Hyperplasia of prostate - - - — 16 16 Pregnancy, childbirth, abortion - - — - — — Congenital malformations 4 - — - 1 5 Other defined and ill-defined diseases 25 — 1 9 82 117 Motor vehicle accidents — 1 1 2 5 9 All other accidents — 1 — 4 22 27 Suicide — — — 5 11 16 Homicide and operations of war - - - - 1 1 Totals 33 6 2 59 1,135 1,233 (9) INFANT DfiATHS. There were 33 deaths of infants under the age of one year (a considerable decrease.) A large number of deaths in the first month being, as is usual, due to prematurity, congenital malformation and complications of labour. Cause of Death. 1953 1954 Whooping Cough. 2 _ Pneumonia. 4 3 Gastritis, enteritis and diarrhoea. - - Prematurity. 13 15 Asphyxia. 4 1 Atelectasis. 5 2 Congenital malformations. 5 4 Bronchitis. 1 — Influenza. 1 - Malnutrition. 1 — All other causes. 10 8 The Infant Mortality rate was 19.4 per 1,000 live births (27.5 in 1953,) the lowest ever recorded. It is gratifying to record that there were no maternal deaths during the year. DEATHS FROM LUNG CANCER. Males. Females. Total. 1950 50 8 58 1951 45 7 52 1952 47 12 59 1953 43 8 51 1954 61 17 78 Total for the 5 years. 246 52 298 (10) (11) INFECTIOUS DISEASE PUBLIC HEALTH (LONDON) ACT. 1936. Section 192 of the above Act requires the head of the household and the medical practitioner attending to notify the District Medical Officer of Health when a case of notifiable infectious disease occurs. The following table gives the infectious diseases at present notifiable in Fulham. Disease. Authority for Notification. Acute Encephalitis. Public Health Act, 1936. (See. 143). Regulation (No.2259) made by the Minister of Health, 1949. (1.1.50.) Acute Influenzal Pneumonia. Public Health Act, 1936. (Sec. 143). Regulation (No.229) made by the Minister of Health, 1953. (1.4.53). Acute Primary Pnemonia. do. do. do. Acute Poliomyelitis. Public Health Act, 1936. (Sec.143). Regulation (No.2259) made by the Minister of Health, 1949. (1.1.50.) Anthrax. L.C.C. Order, 1909, Public Health (London) Act, 1936. (Sees.192 and 305.) Cholera. Public Health (London) Act, 1936. (Secs.192 and 304.) Continued Fever. do. do. do. Diphtheria. do. do. do. Dysentery. Public Health Act, 1936. (See.143.) Regulation (No.229) made by the Minister of Health, 1953. (1.4.53.) Epidemic Diarrhoea (under 5 years of age). Fulham Borough Council Order, 1919. Public Health (London) Act, 1936. (Secs.192 and 305.) Erysipelas. Public Health (London) Act, 1936. (Sees.192 and 304). Food Poisoning. Food and Drugs Act, 1938. (Sec.17.) Glanders. L.C.C. Order, 1909. Public Health (London) Act, 1936. (Secs.192 and 305.) (12) Disease. Authority for Notification. Hydrophobia in Man. L.C.C. Order, 1909. Public Health (London) Act, 1936 (Secs.192 and 305.) Leprosy, Public Health Act, 1936. (Sec.143.) Regulation (No.1036) made by the Minister of Health, 1951. (22.6.51.) (Notification direct to Ministry of Health. Malaria. Public Health Act, 1936. (Sec.143.) Regulation (No.229) made by the Minister of Health, 1953. (1.4.53.) Measles. Public Health Act, 1936. (Sec. 14.3.) Regulations made by the Minister of Health, 1938 to 1948. Membranous Croup. Public Health (London) Act, 1936. (Secs,192 and 304.) Meningococcal Infection. Public Health Act, 1936. (Sec. 143.) Regulation (No.2259) made by the Minister of Health, 1949. (1.1.50.) Ophthalmia Neonatorum. L.C.C. Order, 1910. Public Health (London) Act, 1936. (Secs.l92 and 305.) Regulations made by the Minister of Health 1926 to 1937. Plague. Public Health Act, 1936. (Sec. 143.) Regulations of Local Government Board, 1900. Puerperal Pyrexia. Public Health Act, 1936. (Sec.143.) Regulations made by the Minister of Health, 1951 and 1954. Relapsing Fever. Public Health (London) Act, 1936. (Secs.l92 and 304.) Scabies. Public Health Act, 1936. (Sec.143.) County of London (Scabies) Regulations, 1943. Scarlatina or Scarlet Fever. Public Health (London) Act, 1936. (Secs.192 and 304.) Small-pox. Public Health (London) Act, 1936. (Secs.l92 and 304.) Tuberculosis. Public Health Act, 1936. (Sec.143.) Regulation (No.704) mada by the Minister of Health, 1952. (l.5.52.) (13) Disease. Authority for Notification. Typhoid and Paratyphoid Fevers. Public Health Act, 1936. (Sec.143) Regulation (No.229) made by the Minister of Health, 1953. (1.4.53.) Typhus Fever. Public Health (London) Act, 1936. (Secs.192 and 304.) Whooping Cough. Public Health Act, 1936. (Sec.143.) Regulations made by the Minister of Health, 1938 to 1948. Exclusion from work of Contacts of Infectious Disease. Both by regulations made under the National Insurance Act, 1946, and the Public Health (Infectious Disease) Regulations, 1953, persons may be excluded from work and entitled to National Health sickness benefit if, in the opinion of the Medical Officer of Health, such persons are contacts or carriers of disease and it is necessary to exclude them from work in order to prevent the spread of infection. These regulations apply particularly to food handlers in foodshops; also cooks and kitchen hands employed in cafes, canteens and restaurants. During the year 35 such Certificates were issued. (14) TUBERCULOSIS NOTIFICATIONS RATE PER 1.000 POPULATION DEATHS (15) NOTIFIABLE INFECTIONS DISEASES. The following table shows the number of infections diseases notified during 1954 (corrected figures) with the comparative figures for last five years. Infectious Disease 1950 1951 1952 1953 1954 Diphtheria. — — — — — Scarlet Fever. 126 77 134 70 47 Measles. 527 1,948 720 908 63 Whooping Cough. 428 450 50 531 116 Acute Poliomyelitis. Paralytic. 6 4 12 7 1 Non-Paralytic. 5 2 2 2 — Acute Encephalitis. — 1 — 2 — Acute Pneumonia. 32 70 26 45 27 Dysentery. 10 71 32 48 215 Typhoid Fever. — 1 1 — 10 Paratyphoid Fever. — 8 1 — 3 Meningococcal Infection. 3 7 2 3 3 Erysipelas. 12 17 7 9 10 Puerperal Pyrexia. 10 9 40 23 41 Ophthalmia Neonatorum. 4 1 1 18 1 Epidemic Diarrhœa. 12 12 12 17 12 Scabies. 20 17 7 15 7 Malaria. — — 1 3 2 Food Poisoning. 6 2 8 26 26 Pulmonary Tuberculosis. 209 172 191 161 126 Non-Pulmonary Tuberculosis. 19 24 30 11 23 1,429 2,893 1,277 1,899 723 (16) PREVALENCE AND CONTROL OVER INFECTIOUS AMD OTHER DISEASES Smallpox; There were three persons from smallpox areas abroad requiring observation during the year. Food Poisoning: Twenty-six isolated cases were notified. Routine investigations were carried out and in nine cases salmonella typhi-murium was isolated from faecal specimens submitted by the patients for bacteriological examination. 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 they are seriously ill. It is then usually too late to obtain and investigate suspected articles of food. Scabies and allied conditions: Treatment was arranged for 69 adults and 8 children at the Kensington Medicinal Baths. Typhoid Fevers There was a minor outbreak of typhoid fever in the Borough in June involving nine persons, all of whom completely recovered. Full investigations were carried out, with the co-operation of the Ministry of Health, in field work. The sufferers all sickened at about the same time, and it is gratifying to report that there were no secondary cases amongst relatives in contact with the patients. Phage typing was carried out in the Public Health Laboratory at Colindale, which revealed that two distinct varieties of the organism were responsible. For this reason a carrier was less likely to have been the cause of the outbreak, and therefore the possibility of contamination from drainage cannot be excluded. It will be remembered that on the 12th May, there was flooding with some overflow from drains in Fulham, following a freak storm in the district. During the investigations 30 food samples and 100 food handlers and contacts were examined. With the co-operation of the Borough Surveyor, Moore's swabs were placed in manholes at points nearest to the houses of patients. Extensive investigation by means of these swabs was without result. Indeed, all methods of investigation failed to disclose the original source or sources of the infection and the investigation was concluded. (17) FOQDBORNE OUTBREAK OF SONNE DYSENTERY An explosive outbreak of Sonne Dysentery involving 4 schools simultaneously and leading to 313 proven cases occurred in June, 1954. Investigations indicated that the outbreak was food-borne and that the vector was almost certainly salad which had formed part of a meal taken by the initially affected individuals on 16th June. The degree of the problem may be indicated by the fact that on the 25th June, 1954, of a total of 1,205 children on the combined rolls of the A schools concerned, the head teachers reported 437 absentees, of whom 340 were believed to be dysentery cases. All general practitioners in the Borough were informed by circular letter on the 22nd June, and their co-operation sought in the exclusion of all cases and suspects from school pending satisfactory "clearance" being assured, by means of a series of 3 negative stool specimens. Strict application of this exclusion measure by general practitioners and school authorities naturally resulted in large numbers of requests for such examinations Pressure on all staff concerned and also on the West London Laboratory was consequently very great, even though many practitioners did not refer patients for tests until after clinical recovery. Over a hundred specimens were submitted daily for at least two weeks. Other measures taken included the closing of the Swimming Baths to children from the affected schools and, at the suggestion of the Medical Officer of Health, the London County Council temporarily instituted chlorination of paddling pools in the area, and Day Nurseries were screened for contacts. Fortunately secondary cases did not reach uncontrollable numbers as had been feared. Apart from kitchen and dining staffs at the schools concerned, some 29 relatives who were either cases or strong suspects, were found to be food handlers. Certificates under the Public Health Regulations, 1953, were issued where appropriate. By the end of July a large proportion of all cases were already cleared. The numbers of outstanding cases diminished steadily throughout August and by mid-October the situation was once more considered normal. The final figures for the outbreak may be given as follows:- (18) Proved positive cases 313 531 Clinical cases not referred until after recovery and suspects at risk 218 ) Clearance Certificates issued (after 3 negative specimens) for parents to take to their doctors 480 ) Hospital cases 33 ) 531 Known cases dealt with outside the Borough 18 ) Laboratory investigations on specimens sent through the Council's Public Health Department during the 12 weeks from 21st June to 11th September, 1954 2,468 . The above figures give an illustration of the very great amount of work which was carried out by the West London Pathological Laboratory, the general practitioners and the members of the Public Health Staff concerned. Without their ready co-operation, it would have been impossible to bring such a large epidemic to a close within such a relatively brief time. (19) BACTERIOLOGICAL EXAMINATIONS. The following bacteriological examinations were carried out for the Council on specimens submitted by general practitioners and the Public Health Department during the year. Nose and Throat Swabs 63 Faeces 3,160 Urines 328 Miscellaneous 32 MEDICAL EXAMINATIONS. Medical examinations of both new entrants to the staff and persons referred for special examination or superannuation purposes were carried out during the year, 150 persons in all being examined. (20) AUTHENTICATION OF VACCINATION AND INOCULATION CERTIFICATES. In several parts of the world certificates of vaccination and/or inoculation are not accepted unless they are endorsed by a Medical Officer in the Government or Municipal Service of the country of issue. The form of authentication which appears to be most readily accepted by Health Authorities abroad is that given by Public Health Authorities and identified by a rubber stamp impression placed by them on the certificate. The Minister of Health therefore has asked Local Authorities to make arrangements under which any person who desires to have a certificate of vaccination or inoculation for the purpose of travel abroad may have it stamped accordingly at the office of the Health Department. 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 practitionero Authenticators are not required to certify that the vaccination or inoculation has been properly carried out or, indeed, that it has been carried out at all; the responsibility for issuing the certificate remains with the Doctor signing it. This does not imply any suggestion that a certificate of vaccination or inoculation issued by a registered Medical Practitioner requires any official supervision or control in order to be of adequate medical value. Authentication is not a requirement of Her Majesty's Government but the proposal is designed as a remedy for difficulties whieh have in practice been met by persons from this country travelling abroad. During the year a total of 459 certificates of vaccination and/ inoculation were authenticated by the Medical Officer of Health. (21) EXTRACTS FROM THE ANNUAL REPORT OF DR, H.C, PRICE. CHEST PHYSICIAN, FULHAM CHEST CLINIC. 1954. Trends in Tuberculosis. Notifications. There has been an increased fall this year in the number of notified cases referred to the Clinic, - 120 compared with 172 in 1953, - when there had been a smaller drop compared with the previous year. This comparison is not a fair one, since in 1953 a mass x-ray unit visited the Borough, but did not do so during 1954. However these figures do emphasise the important role played by mass miniature radiography in diagnosing Pulmonary Tuberculosis. Deaths. The number of deaths rose from 24 in 1953 to 33 in the current year; this was due mainly to the number of deaths occurring in old chronic cases whose lives had been prolonged by the extensive use of chemotherapy. Looking for Tuberculosis. The usual stream of contacts and observation cases referred by local doctors has continued, although the tempo has been a little less at times owing to the absence from the Borough of the main seeker-out of Tuberculosis - the mass miniature radiography unit. The yield that ensues from the periodic activities of such a unit in reducing the still large reservoir of undiscovered active cases of Tuberculosis in the population, is the answer to those who now say that Tuberculosis has been largely wiped out. It is hoped that the siting of a mass x-ray unit in the Clinic grounds in the very near future will ease this serious situation. During the year the laboratory has been closed down except for the Thursday evening Clinic. This is a retrograde step, - the result of the general policy of economy in the Health Service. Treatment. For the first time in many years the number of attendances at the artificial pneumothorax refill sessions has fallen. The number of patients being treated in their homes has declined rapidly during the year; this is due to the greater number of general hospital beds now available, and the more rapid turnover of patients under modern methods of chemotherapyo The continued reduction in the waiting period for hospital and sanatorium beds has greatly assisted the work of the Clinic in so far as patients can now, in the main, be admitted at once when their clinical state demands it. However the waiting period for major surgery is still far too long. (22) Prevention. Contact work has continued as usual, and the increasing number of children coming forward for B.C.G. vaccination is a good augury for the future extension of this form of protection of the whole population. In June 1954 the L.C.G. commenced their scheme for the vaccination of school leavers with B.C.G. After-care and Rehabilitation. A scheme for domiciliary diversional therapy as an adjunct to domiciliary rest and chemotherapy was commenced by the Voluntary AfterCare Committee of the Clinic in May 1954, when we had an offer of the services of a fully trained artist and occupational therapist. This provides a useful recruiting ground for the Meekly Handicraft class. Future Trends in Chest Clinic Work, The increasing success of our clinical attacks on Pulmonary Tuberculosis and the gradual disappearance of the untreatable case, is causing Chest Physicians to pause and consider the future of the service. Ever since their inception, chest clinics have unearthed, investigated and treated a very large number of cases of lung diseases other than that caused by Tuberculosis. The returns of the Ministry of National Insurance for 1950 showed that 16,500,000 working days were lost in that year due to Chronic Bronchitis alone. Impaired function due to Pulmonary Fibrosis as a sequaele to Pulmonary Tuberculosis, and following extensive chemotherapy, is another problem that has to be faced in the near future by chest clinics. The increase in deaths from cancer of the lung from 5,000 in 1939 to 16,656 in 1954 is a very urgent problem that chest clinics up and down the country can play a very useful part in helping to solve Finally the industrial hazards of dust in the lung is a problem that has only just begun to be appreciated; we know something about the hazards of dust in mines, foundries, mills and in china clay and cement works, but very little about the other 90% in industry, where the symptoms are less dramatis, and the onset of disability much slower; nevertheless the loss of function by the time 60 years of age is reached may be considerable. As the increasing tempo of modern scientific medicine engulfs and sweeps away one section of social diseases after another, it is necessary for the organisation of the medical services to become more elastie, always ready to adapt itself to deal with the fresh problems exposed more clearly by the removal of the old ones." (23) COMPARATIVE SUMMARY OF STATISTICS FOR ANNUAL REPORT - 1954. 1954 No. of New Patients attending. 417 No. of Attendances: 1. Notified Cases. 2,537 2. Contacts. 972 3. Observations. 461 4. Refills. 2,878 6,848 Attendances at Laboratory: (a) For investigation. 2,367 (b) For medicines. 179 No. of Clinic Notifications. 112 Pul. 8 Non. 120 No. of Deaths. 33 Pul.* - Non. 33 No. of home visits by Chest Physician. 154 do. do. do. Health Visiters. 3,301 do. x-rays taken. 4,046 do. Patients undergoing treatment at home. 65 do. B.C.G. Vaccinations. 193 do. Notified cases on register at 31.12.54. 1,344 * ..... This includes patients on the Clinic Register who did not die primarily from Tuberculosis. (24) Clinic Times. Monday 9.30 a.m. to 11.30 a.m. Female Clinic. 2 p.m. to 4 p.m. Children's Clinic. Tuesday 9.30 a.m. to 11.30 a.m. Male Clinic. 2 p.m. to 4 p.m. New Male Patients by appointment. Wednesday 9.30 a.m. to 11 a.m. Female Refill Clinic. Afternoon Domiciliary Visits. Thursday 9.30 a.m. to 11 a.m. Male Refill Clinic. 2 p.m. to 4 p.m. Special Car Clinic, Male and Female. Thursday 5 p.m. to 7.30 p.m. Male & Female Workers Clinic. Evening. 5 p.m. to 6 p.m. Male & Female Workers Refill Clinic. (25) 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; 87 beds for Chronic Sick; out-patient department. Number of staffed beds 384. (2) Fulham Maternity Hospital. 5-7 Parsons Green, S.W.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, 58 beds. Number of staffed beds 192. (4) Fulham Chest Clinic. 114 New King's Road, S.W.6. Various types of clinic sessions held for the out-patient treatment of tuberculosis. There are 2 Registered Homes in the Boroughs The Glazbury Nursing Home, 20 Glazbury Road, W.14, and 94 Sedlescombe Road, S.W.6, which is an L.C.C. home to recommended disabled (blind) men and women. (26) LONDON COUNTY COUNCIL - PERSONAL 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 Officer. Dr. Violet I. Russell, the Divisional Medical Officer, has kindly supplied the following information regarding these services for the years 1953 and 1954. Ante-Natal Clinic: 1952. 1954 Number of women who attended during the year 1,111 872 Maternal Deaths: 1 Nil. Infant Welfare Centres: Total number of children who attended centres during the year 3,367 3,122 Health Visiters: Number of infants under one year of age visited for the first time 1,401 1,555 Total visits to infants under one year 7,075 7,527 Total visits to children - 1 to 5 years 12,634 12,626 Number of expectant mothers visited for the first time 892 768 Total visits to expectant mothers 1,718 1,542 Infant Life Protection: Number of Foster mothers at 31st December 50 43 Number of Foster children do. do. 63 70 Child Minders (Daily Guardians): Number of daily guardians minding children (voluntary) 57 74 Number of children minded 65 83 (27) 1953 1254 Care of Premature Infants: Number of Premature births during the year 97 135 Number of deaths under one month 12 16 Dental Clinic: Number of expectant and nursing mothers treated 230 207 Number of cases in which general anaesthetic was administered 78 58 Number of teeth extracted 364 300 Number of children under five years treated 229 242 Number of cases in which general anaesthetic was administered 28 63 Number of teeth extracted 45 105 Immunisation and Vaccination: Number of children immunised in London County Council clinics during the year 862 1,068 Further number of children immunised at schools and by private doctors 723 571 Number of children receiving boosting injections 536 2,124 The percentage of child population immunised against Diphtheria at the end of 1954 was 84%, an increase of 1% over 1953, which is very satisfactory. Number of children vaccinated in London County Council clinics during the year 826 817 (28) SERVICES. Ante-Natal. Mornings. Afternoons. 5/7 Parsons Green. - Tuesday. Thursday. 170 Wandsworth Bridge Road. Wednesday. - 90/92 Greyhound Rd. Friday. Thursday. 62/63 Burnt 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 Rd. Tuesday. Tuesday. 90/92 Greyhound Road. - Monday. Wednesday. Friday. 62/63 Burne Jones House. Thursday. Monday. Thursday. Toddler's 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. Mulgrave, Mulgrave Road. Eridge House, Fulham Park Rd. Grove House, Bagley's Lane. Home Help Service. Office where application may be madee: 129 Fulham Palace Road, W.6.) Number of cases attended during the year:- 1953. 1954. Maternity 27 17 Tuberculosis 66 61 Chronic sick (including aged and infirm persons) 832 762 Others 237 (29) OLD PEOPLE'S WELFARE. The extent of tha problem. According to the 1951 census there were in Fulham. 11,800 people aged 55-64. 14,000 do. do. 65 and over. It is estimated that by 1977 one person in 5 of the population will be over 65 years of age. The welfare of the elderly is therefore an increasing and extending social service. Facilities available. There are many voluntary societies and bodies, as well as private individuals, actively working for the care of the aged. The Fulham Old People's Welfare Committee co-ordinates all their splendid efforts and has representatives from the Borough Council and other official bodies. In 1954 the Borough Council made a grant of £1,650 towards the Fulham Old People's Welfare Committee. Of the many facilities available through the Old People's Welfare Committee, only a few are mentioned, e.g. W.V.S. Meals on Wheels. Formerly provided through the London County Council and now provided by a private contractor, the high standard of the meals supplied under this Service has been maintained. The average number of meals per week is 326.9. Invalid Kitchen of London Meals Service. The number of meals provided to the housebound under this service totalled 9,619 for the 26 weeks period September 1954 to February 1955« Those able to visit the kitchen can have a meal on the premises. Chiropody o A Clinic is held on alternate weeks at the British Red Cross Office and at Bishop Creighton House. These facilities are greatly in demand and there is a waiting list. Holidays, A holiday scheme has been in exist4iee in Fulham for several years. whereby old age pensioners save up to enjoy a holiday by the sea of one or two weeks in May or September. Coach travel is arranged to the destination. In September last 92 elderly folk went on holiday, and (30) in May of this year, 113 participated. Darby and Joan Clubs, ete. The Women's Voluntary Services are now running nine Darby and Joan Clubs, comprising 4 afternoon, 3 evening and 2 luncheon clubs and a Working Party. Luncheon Clubs. The three existing luncheon clubs, organised by the W.V.S. and the Red Cross Society, continued to provide a first-class meals service, obtaining their meals from the same source as the W.V.S. "Meals on Wheels* service. Home for Old People. Fulham is fortunate in having its own Home for elderly people who find themselves solitary or for whom the difficulty of housekeeping or running their own home has become too heavy a burden. Like other similar homes, Royston is run rather like residential clubs where household responsibilities or cares are removed but personal freedom remains. Residents go out and visit friends and relatives whenever they like and restrictions are reduced to a minimum. There are 35 residents. Christmas Dinner. His Worship the Mayor gave over £100 from his Charity Fund, which is supported by local contributions, to meet the cost of arranging a Christmas Party for 200 old people which was organised on similar lines as previous parties, invitations being allocated to the various local organisations. The party was again an outstanding success, to which thanks are mainly due to the Mayor, the local voluntary organisations, the Boys' Brigade, the North Thames Gas Board (for the loan and installation of a large gas cooker), Methodist Church Hall, Fulham Road, SoW.6, and to the local business people and residents who most generously gave donations both in cash and goods. Visiting of the sick and housebound. The visiting by local voluntary organisations is greatly appreciated and is undertaken by members of such bodies as the Family Welfare Association, the British Red Cross Society, the St. John's Ambulance Brigade, Bishop Creighton House, W.V.S. etc., and is of real value to, and very much appreciated by, the elderly. (3D NATIONAL ASSISTANCE ACT. 1948. SECTION 47. NATIONAL ASSISTANCE (AMENDMENTTACT. 1951. Statutory visiting of old people who come under the above Act is carried out by the Public Health Department. There was no compulsory removal under the National Assistance Act, 1948, but one lady was removed under the National Assistance (Amendment) Act, 1951, and brief details of this case are as follows:- An old couple, husband aged 92 and wife, aged 87, were reported to be living in very unsatisfactory, unhygienic and neglected conditions and were not receiving care and attention from anyone. A visit confirmed that this wag correct, and although a Home Help, meals and laundry services were immediately provided, it soon became obvious that they needed nursing care and attention. Although the old man was willing to go to Hospital, his wife, who was senile, refused to go, and it was therefore necessary to obtain a Compulsory Removal Order under the National Assistance (Amendment) Act for her to be detained in Hospital for three weeks, the maximum period prescribed by the Act. At the same time arrangements were also made for accommodation to be provided in Hospital for the husband. He died from cerebral thrombosis a few days after admittance and the old lady died a few months later. The details of old persons as they become known are recorded in the Department and the number, although fluctuating, is on the increase. Number of cases recorded in 1954. 184 do. do. deaths recorded in 1954. 39 do. admitted to Hospital and Institutions during 1954. 62 do. admitted to Homes during 1954. 33 Re-visits to known eases. 1,004 Total number of recorded cases. 582 Number of cases referred to other Authorities and Organisations, or miscellaneous. 32 CHRONIC SICK. The aged and chronic sick are often solitary without dependants or relatives, and it is important that they should be visited periodically. It is regretted that there is still all over the Country an acute shortage of beds for the chronic sick. In Fulham, in order to ensure that available beds are allocated to the most urgent cases, the Medical (32) Superintendent of Fulham Hospital (Dr. Wyman) sends weekly to the Medical Officer of Health the waiting list of Chronic sick for assessment of social and home conditions. These are visited by the Council's Lady Sanitary Inspector, and reported to the Medical Superintendent. Recently it has been arranged for this officer also to call to give verbal reports or to discuss a visit and report in cases of emergency. The Medical Superintendent has also agreed to arrange for surgical chiropody at Fulham Hospital for some bedridden old people. HOME BATHING SERVICE. This service was commenced in April, 1954, for women only. It has proved immensely popular and not unduly costly. Provision has been mad© for the extension of the service. It is hoped to commence a similar service for men as soon as a suitable male attendant becomes available. Number of baths given during 1954. 647 do. persons receiving baths. 47 do. persons on waiting list at end of 1954. 17 S.O.S. CARD SCHEME. The S.O.S. Card Scheme was started in August, 1953, with the object of getting help quickly to elderly people in emergency. Total cards issued since scheme started. 69 do. during 1954. 17 OLD PEOPLE'S LAUNDRY. Service for Incontinent Persons. (Section 122 of the Public Health (London) Act, 1936.) A scheme under the provisions of this Section to cleanse the linen and bedding of aged and incontinent persons was commenced in March, 1952, and is proving of real benefit to sufferers. The work is carried out at the Disinfecting Station, and the replacement in November, 1953, of the obsolete laundry machinery by modern equipment, is enabling the staff to deal more quickly and efficiently with the increased volume of work. The following 7,619 articles were cleansed during the years:- Sheets 2,461 Mattress Covers 52 Towels 1,390 "Pieces". 900 Pillow Cases 885 Blankets. 124 Underwear. 1,807 (33) NATIONAL ASSISTANCE ACT. 1948. Section 50. Burial or Cremation of the Dead. Nine funerals were arranged under the provisions of this Section of the Act. Details of the cost of the burials are as follows:- * 9 Funerals as per contract £97. 5. 0. Less amount recovered from estate of deceased, or by gifts, or responsible relatives traced £46.15.9. Balance being cost to Council. * The cost of the funerals varies slightly, the average cost of an adult being approximately £12.0.0. MORTUARY. It had been evident for some time that the refrigeration accommodation at the Mortuary was insufficient to cope with any sudden emergency such as occurred following the severe fog of December, 1952, including many post-mortem cases. It was decided that the most practical way of increasing the accommodation was a reconstruction of the refrigeration chamber by altering the depth of the compartments, thus providing 3-tier compartments instead of 2-tier, and increasing the accommodation by one-third. The following cases were dealt with during the years:- No. of post mortems carried out by order of the Coroner 242 No. of convenience cases 149 Total. 391 (34) There are 7 Public Conveniences in all which have been constructed at various times between 1900 and 1939. Replacement. West Kensington. Negotiations for a site to build a Public Convenience in the West Kensington area are still proceeding. This modern convenience will replace the old underground convenience at Gibbs Green which is small, worn out and very expensive to maintain. New Site. Wandsworth Bridge Rd. The Council have been trying for same considerable time to obtain a site for a Public Convenience in the Wandsworth Bridge area, and after several disappointments it seems as though one has now been found near Wandsworth Bridge, and negotiations are proceeding satisfactorily. Washing Facilities. The 'Free Wash' facilities provided by the Council at Conveniences to encourage personal hygiene continue to be used and appreciated by members of the public. There is also a steady demand for the '3d. Wash and Brush Up' available in addition to the 'Free Wash'. Proposed Increase in Free Lavatory Accommodation. A proposal to increase the number of Free W.Cs. in the Public Conveniences is being considered. It is felt, however, that some members of the public prefer to pay when using a toilet in a Public Convenience, and for that reason a complete conversion of the paid toilets to free use is not envisaged. Inspections of Public Conveniences. Regular inspections of the Conveniences are carried out by Officers of the Department. (35) HEALTH ESPGAT10N. With the enthusiastic co-operation of all concerned, the activities of the Department are steadily widening, and it is hoped will continue. There is almost boundless scope in this field of work. Every Autumn it is the practice of the Department to circularise all the organisations in the Borough with details of the planned programme, at the same time inviting them to submit requests and ideas they may have. All the film shows and the majority of the talks are given during the autumn and winter months from September to March. The film shows at the Central Library are now a regular feature, and continue to be well attended. This year the experiment of taking similar shows to Church Halls was tried, and met with success. Requests for Discussion Groups and Talks are also increasing, and one very satisfactory feature is that once an initial visit has been made to an Organisations, there are invariably further requests. The only difficulty has been in obtaining the hire of a suitable film projector for shows at Church Halls, and with the continued expansion of activities this may prove an increasing problem. The attendance figures for the various activities are as followsDiscussion Groups. These were given with the aid of a sound film strip produced by the Central Council for Health Education on a variety of present-day problems, e.g. 'Should Married Women with Young Children go out to Work?' 7 Discussion groups were held - total attendances 131, average attendance 19. Talks. Talks were given by several members of the Department to various Borough organisations usually on some particular aspect of Public Health work, e.g. Rodent Control. 12 Talks were given, total attendance 262, average attendance 22. Film Shows. These were given at the Central Library and Church Halls, a minimum audience of 100 being required. A commercial feature film was shown on each occasion, with Health films and/or talks on Health subjects. 15 Shows were given, total attendance 1,875 persons, average attendance 125. (36) Special Film Shows for Adults. 2 of these were given - one on the "Stockton Test" at the Central Library, 56 persons attending, and the other to the Sir John Lillie School Parent-Teachers' Association, where two Health films and a talk on Child Guidance were given. 84 persons attended. Visit of Schoolboys. A party of schoolboys from one of the local schools visited the Town Hall and were given a talk, with visual aids, on the work of the Department. The usual leaflet and poster propaganda continued to be carried out. (37) ACTS OF PARLIAMENT. STATUTORY INSTRUMENTS AND CIRCULARS ISSUED BY GOVERNMENT DEPARTMENTS RELATING TO THE PUBLIC HEALTH SERVICES DURING 1954. Acts of Parliament. Housing Repairs and Rents Act, 1954 - operative date 30th August, 1954. Food & Drugs (Amendment) Act, 1954 - operative date still to be announced by Minister. Statutory Instruments. The Puerperal Pyrexia (Amendment) Regulations, 1954. The Milk and Dairies (Amendment) Regulations, 1954. The Milk (Special Designation) (Raw Milk) (Amendment) Regulations, 1954. The Mineral Oil in food (Amendment) Order, 1954. The Food Standards (Soft Drinks) (Amendment) Order, 1954. The Housing Repairs (Increase of Rent) Regulations, 1954. The Rent Restrictions Regulations, 1954. Ministry of Health Circulars. Annual Reports of Medical Officer of Health for 1953 and 1954. Memorandum on "Prevention of Tuberculosis". Memorandum on Poliomyelitis. Notification of Puerperal Pyrexia. Housing Repairs and Rents Act, 1954° Slum Clearance Procedure. Ministry of Food Circulars. Approved Oxidising and Preservative Agents - Milk and Dairies Regulations, 1949 and 1953. The Public Health (Preservatives, etc. in Food) Regulations, 1925 to 1948. Thiourea. Cream Soups. Public Health (Meat) Regulations 1924-1952 - Slaughtering and Meat Inspection. Meat Content and Price of Sausages. Standards for Soft Drinks. The Milk and Dairies (Amendment) Regulations, 1954. The Milk (Special Designation) (Raw Milk) (Amendment) Regulations, 1954. The Milk (Special Designation) (Raw Milk) Regulations 1949 and 1950. The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949 to 1953. Slaughter of Animals (Amendment) Act, 1954. Myxomatosis in Rabbits and Hares. Interim Report of Interdepartmental Committee on Slaughterhouses. Food Standards Committee Report on Colouring Matters. Food Standards Committee Report on lead content of foods. (38) SANITARY CIRCUMSTANCES OF THE AREA. Though it was still necessary to issue summonses in far too many eases, with consequent long delays before the nuisances concerned were abated, on the whole statutory requests received fairly ready attention. The policy adopted by some owners of regularly delaying carrying out works until a summons is received, and then abating the nuisances between that date and the day of the Court hearing, must be strongly deprecated. Such actions, besides causing unnecessary prolonging of hardship to their tenants, is also short-sighted from the owner's point of view. It is a common occurrence for defects to get progressively worse, causing further damage to the fabric and necessitating the service of additional sanitary notices. Inspections after complaint 2,667 Re-inspections 8,157 Inspections after Infectious Disease 131 Re-inspections after Infectious Disease 71 Drains tested 246 Drains inspected 1,144 Intimation notices served 1,775 Statutory Notices served 684 Intimation Notices complied with 1,826 Statutory Notices complied with 600 House to Houses:- Inspections 70 Re-inspections 323 Intimation notices served 43 Intimation notices complied with 61 Housing enquiries 367 Underground rooms 55 Owners, builders, etc. 335 Voluntary work 246 Heating Appliances (Fireguards Act) 25 Certificates of Disrepair 203 Miscellaneous Visits 104 (39) SUMMARY OF WORKS CARRIED OUT UNDER SUPERVISION OF SANITARY INSPECTORS Fresh Air Inlets 22 Soil and Vent pipes repaired or renewed 47 Drains cleared 136 Drains repaired 83 Drains relaid 40 Rainwater gutters and pipes repaired or renewed 216 Traps cleansed, repaired etc 39 Pans renewed 102 Seats repaired or renewed 49 Flushing cisterns repaired or renewed 163 Fastenings provided to doors, and doors repaired 14 Sinks provided, repaired or renewed 59 Sink and bath wastes repaired or renewed 122 New baths fitted 9 New lavatory basins fitted 12 Baths cleansed 2 Drinking water cisterns cleansed etc. 19 Water supply pipes and fittings repaired 130 Rooms cleansed 519 Internal house repairs 1,943 Fireplaces repaired (nuisances from smoke etc) 228 Kitchen ranges repaired or renewed (for cooking purposes) 96 Washing coppers repaired or renewed 7 Dampness remedied 1,410 Rooms provided with adequate light and ventilation 22 Staircases provided with light and ventilation and repaired 38 Ventilated food cupboards provided 1 Ventilation provided under floors and repairs 227 Roofs repaired 755 Other external repairs 284 Accumulations of refuse removed 29 Dustbins 127 Yards, forecourts paved and drained 66 Other nuisances 2 Additional W.C. accommodation 2 Rat runs traced 5 Total 7,025 (40) The fallowing details relate to the services provided by the Disinfecting Superintendent and his staff during 1954:- No. of rooms disinfected after Infectious Disease 107 No. of articles stored 5,218 No. of rooms disinfested 495 No. of inspections made of prospective Council tenants 302 laundry carried out for the Dust Destructor staffS:- Roller TowelS 7 Hand TowelS 66 Boiler suits 31 Bath Towels 1,511 Dust coats 24 Duffle coats 4 The Disinfecting Superintendent has also dealt with many kinds of infestation such as cockroaches, beetles, ants, silver fish, moths etc. List of verminous and stained articles destroyed during 1954:- Bedsprings 6 Bedsteads 4 Mattresses 59 Beds 3 Divans 3 Pillows 39 Sheets 8 Bolsters 8 Quilts 3 Clothing 148 furniture 15 Miscellaneous pieces. 239 535 (41) Public Health Nuisance Summonses. During the year ended 1954, summonses were down for hearing at the Kensington Divisional Petty Sessions with regard to cases where owners had failed to comply with Statutory Notices served under the Public Health (London) Act, 1936. The cases were dealt with as follows:- No. of Orders made. No. of eases where daily penalties were awarded. No. of cases withdrawn or adjourned sine die. 16 3 75 2 summonses were dismissed on points of law, no costs being awarded against the Council. One owner appealed to the London Sessions against the order made at the Kensington Petty Sessions. His appeal was dismissed and the Council awarded five guineas costs. He again appealed against the subsequent daily penalty imposed. This second appeal was also dismissed, the Council being awarded fifteen guineas costs. The necessary works to comply with the Order were eventually carried out by the Owner. WORKS IN DEFAULT. Public Health (London) Act. 1936. During 1934 the Council's contractors carried out works in default at 11 premises, the owners having failed to comply with Statutory Notices served under the Public Health (London) Act, 1936. The costs of the work varied in individual cases from £4.0s.0d. to £389.14s.6d., the total sum involved being £l,156,5a.2d. Housing Act. 1936 - Section 9. The owner of one premises failed to comply with the Section 9 notice served under the above Act, and work in default was carried out at a cost of £234.5a.6d. (42) HOUSING ACT. 1936 - Sections 11 & 12 DEMOLITION AND CLOSING ORDERS. Daring May, 1954, as a preliminary step to the Housing Survey necessitated by the advent of the Housing Repairs and Rents Act, 1954, inspections were made of the 222 premises, parts of which had been the subject of Closing Orders made by the Council on various dates from 1913 onwards. It was known that particularly during the war and in post-war years many changes of ownership and occupiers had taken place; in some premises there were changes, and in other cases the premises had been demolished. In 181 of the 222 premises concerned, it was found that they were still either not used, or were being used strictly in accordance with the 'permitted use' granted at the time of closing or subsequently fey the Council. The remaining 41 cases were made up as follows:- (i) It was found in 20 oases that the part of the premises subject to a closing order were being used in connection with business or industrial concerns. The Council granted 'permitted use' on the lines of the existing use. (ii) In 16 cases it was discovered that the premises no longer existed, having been demolished, and the records were amended accordingly. (iii) The necessary works had been carried out in 3 premises to render the closed portions fit for human habitation, and the Council approved that the Closing Orders be determined. (iv) The remaining 2 premises were being used in contravention of the Closing Orders made. In one instance it was decided to take no action, the premises now being occupied by the Owner, and in the other case the premises were vacated on request. New Orders made in 1954. Housing Act. 1936 - Section 11. Premises. Date made. Demolition Order. 31 Caroline Walk. 4th May, 1954. Housing Act. 1936 - Section 12. Closing Orders in respect of 33 Ongar Road. (Basement Rooms) 8th January, 1954. parts of buildings?- 1 Richmond Cottages.(Ground Floor). Ditto. 6 Fairholme Road (Basement Rooms.) 27th October 1954. (43) HOUSING REPAIRS AND RBNTS ACT, 1954. This Act, which came into operation on the 30th August, 1954, amends and amplifies the Housing Act of 1936. Its aims are to make further provision for the clearance and redevelopment of areas of unfit housing accommodation, and for securing or promoting the reconditioning and maintenance of houses; and otherwise to amend the enactments relating to housing, the exercise of certain powers relating to land, and rent control. The underlying policy of the Act was set out in Command Paper 8996: "Houses - The next Step", as follows%- "The need for slum clearance is urgent from the human point of view. It is equally urgent in the interests of the national economy. We cannot 1st the centres of our cities decay while they are expanding continually outside their present boundaries. The core is too valuable, actually and potentially, to be allowed to rot away; nor can we afford to take for housing - and out of food production - more than the absolute minimum of good agricultural land". Report to Minister - Survey of Unfit Properties. Each local authority is requested, by 1st August, 1955, to submit proposals to the Minister of Housing and Local Government for dealing with houses within their district which appear to be unfit for human habitation, and with any other houses which are, or in the opinion of the authority ought to be, included in clearance areas. It has been agreed between the Metropolitan Boroughs' Standing Joint Committee and the London County Council that the individual Metropolitan Boroughs shall make these reports jointly to the Minister, thus carrying on the liaison between the County Council and the Metropolitan Boroughs in the matter of slum clearance which had existed prior to the Act coming into operation. During the year under review, therefore, all likely areas in the Borough were surveyed, and sample inspections were made in each area to the extent found to be warranted. The evidence found during this survey will form a basis for the Borough Council initially to formulate plans which can, in turn, be the subject of discussions with the London County Council, and from these negotiations no doubt the report required by the Minister will emerge. (44) Slum Clearance. During the year further steps were taken to implement the 1951/55 Slum Clearance Programme already agreed between the Borough Council and the County Council as follows:- London County Council (Caroline Walk, Fulham) Clearance Order. 1953. The London County Council declared 16 premises in Caroline Walk to be a clearance area, and following a Public Inquiry when objections were heard, the action of the County Council was confirmed by the Minister of Housing and Local Government. The Fulham Borough Council (Sands End Lane) (No.l) Clearance Order. 1954. Under the above Order, the Fulham Borough Council declared 8 premises in Sands End Lane to be a clearance area. The Fulham Borough Council (Sands End Lane) (No.2) Clearance Order, 1954. Under the above Order, the Fulham Borough Council declared 3 premises in Sands End Lane to be a clearance area. The Fulham Borough Council (Harwood Terrace) (No.l) Clearance Order, 1954. Under the above Order, the Fulham Borough Council declared 5 premises in Harwood Terrace to be a clearance area. A Public Inquiry was held when objections were heard in respect of each of the foregoing areas, and the Minister of Housing and Local Government has confirmed the Orders in every case. Houses in Multiple Occupation. The Act contains new provisions which replace the power to make bye-laws for houses let in lodgings and hostels by a general power to require in any houses which are in multi-occupation an adequate provision for the following services and amenities:- Natural lighting. Ventilation. Water supply. Drainage and Sanitary Conveniences. Facilities for storage, preparation and cooking of food, and for the disposal of waste water. (45) Where, in the opinion of the Council, premises are found to be so defective in the above-mentioned matters as not to be reasonably suitable for the number of persons or households in occupation, they may serve a notice on the person in control specifying the works required. The Act, however, goes on to give a person in receipt of such a notice an alternative of taking steps reasonably open to him (including, if necessary, the taking of legal proceedings) for securing a reduction of the number of persons accommodated or the number of households, or both, as specified in the notice. A similar alternative is given if the Council serves a notice regarding this type of house requesting abatement of overcrowding. It is too soon to comment on these changes in legislation, but first impressions are that the indiscriminate implementation of these provisions would cause grave rehousing difficulties and hardship. Certificates of Disrepair. Where a tenant is in receipt of a valid notice of rent increase from his landlord, he may apply to the local authority for a certificate that either or both of the conditions justifying an increase of rent are not fulfilled. These conditions are:- ■ (1) that the dwelling house is in good repair; and (2) that it is reasonably suitable for occupation, in the matter of stability, freedom from damp, natural lighting, ventilation, water supply, drainage and sanitary conveniences, and facilities for storage preparation and cooking of food, and for the disposal of waste water. When satisfied that either or both of the conditions are not fulfilled, the local authority must certify accordingly. Similarly when a landlord has executed works which fulfil both the conditions, the local authority must, on application from the landlord, revoke the certificate. The following table sets out the action taken between the date of the coming into operation of the Act and the end of the year under review:- Applications for Certificates of Disrepair 159 Certificates of Disrepair issued 137 Applications refused 22 Applications for Reyocation Certificates 11 Revocation Certificates issued 11 Improvement Grants. The proposals in the Act regarding improvement grants which extend and amend those in previous legislation, come within the province of the Borough Architect and Director of Housing. However the co-ordination and co-operation whereby he obtains comments on the public health aspects of any applications continues. The necessity for this close liaison is obvious, (46) and it works very well. Perhaps it would be appropriate for me to comment, however, that in my view the proposals regarding improvement grants provide potentially great opportunities for installing in many homes some of the essentials of decent living. It is hoped particularly that more and more homes will be provided with baths, and supplies of constant hot water. RENT AND MORTGAGE INTEREST RESTRICTIONS ACTS, 1920 TO 1939. Applications for Certificates of Disrepair 11 Certificates of Disrepair issued 10 Applications refused 1 Applications for Revocation Certificates 1 Revocation Certificates issued 1 HABITATION CERTIFICATES UNDER SECTION 95(2) OF THE PUBLIC HEALTH(LONDON) ACT, 1936. During the year 62 certificates were issued in respect of newly erected and rebuilt premises in the Borough compared with 204 in 1953. REHOUSING OF FULHAM RESIDENTS ON L.C.C HOUSING ESTATES During the year 353 families were visited by the Sanitary Inspectors at the request of the London County Council and the Borough Architect and Director of Housing, Fulham Borough Council, in connection with applications for alternative accommodation. Of this number 122 cases applied on the grounds of overcrowding and the remaining 231 on medical grounds and the insanitary condition of their living accommodation. 66 families were found to be living in overcrowded conditions, and reports were sent to the Director of Housing, London County Council, recommending them for alternative accommodation on the L.C.C. Housing Estates. 448 families were known to have been rehoused during the year, compared with 236 in 1953. There is close co-operation between the Housing and Public Health Departments on all matters relating to housing. (47) SWELLINGS COMPLETED By THE COUNCIL BETWEEN 1st JANUARY AND 31ST DECEMBER, 1954. Information supplied by the courtesy of The Borough Architect and Director of Housing. Estates No. of Flats (1) (2) (3) (4) (5) Total Rooms. 141/143 Munster Rd. 3 - - - 3 - 12 26/28 Cole Hill Lane. 3 - - 1 2 - 11 Sulivan Court. 72 24 - 48 - - 168 Lancaster Court. 40 5 5 15 10 5 125 William Banfleld House Extension. 10 5 5 - - - 15 2/20 Basuto Road (Alex Gossip House). 15 - - 15 - - 45 Totals 143 34 10 79 15 5 376 DRAINAGE Of NEW BUILDINGS and RECONSTRUCTION OF DRAINAGE. Additions to existing buildings or additional sanitary accommodation 53 Reconstruction of drainage systems enemy action 5 New buildings 26 Total applications for approval of plans (48) PREVENTION OF DAMAGE BY PESTS ACT, 1949. The following is a summary of the work carried out by the Rodent Operatives during the year:- TYPE OF PROPERTY. Local Authority. Dwelling Houses. Business and Industrial Premises. Total. l. No. of complaints received. 685 98 783 2. No. of properties inspected. 843 483 1,326 3. No. of properties found to be infested with rats. Major. Minor. 365 36 401 4. No, of properties found to fee infested with mice. 319 59 378 5. No. of properties treated. (a) Rate. 365 36 401 (b) Mice. 319 59 378 6. No. of Notices served under section 4. (a) Treatment. (b) Structural works. i.e. proofing. No. of Notices served under the Public Health London Act, 1936. 9 1 10 7. No. of visits made by Rodent Operatives. 5,848 953 6,801 (49) In July the Rodent Operative Staff had become so depleted by resignations and the retirement of the Foreman Rodent Operative that the work Was being seriously affected In September the staff was brought up to a strength of four, a foreman and three operatives, and with this staff it was possible to embark upon a policy of inspection and investigation of industrial and business premises in the Borough in addition to those from whom complaints had been received. This work has continued, and so far reveals that the amount and degree of infestation found is not excessive for a Borough with a long riparian boundary. In co-operation with the Borough Surveyor, the usual two Sewer Treatments were carried out in accordance with the requirements of the Ministry of Agriculture, Food & Fisheries. The results show a remarkable consistency with those of the past two years which again seems to indicate that the rat population in the sewers is being held in check. (50) PHARMACY AND POISONS ACT. 1933 - THE POISON RULES The retail sale of poisonous substances by shopkeepers who are not registered pharmacists is controlled by the Acts and rules made thereunder. The Poisons List, which has been prepared by the Poisons Board and confirmed by the Home Secretary, prescribes two Lists of Poisons Part I and Part II. The sale of poisons included in Part I is restricted to registered pharmacists whilst those included in Part II may be sold to the general public not only by registered pharmacists, but also (subject to certain conditions) by ordinary traders whose names are entered on a List of Persons entitled to sell such poisons, kept by the local authority. The Acts and Rules lay down certain requirements regarding type of container, labelling, storage, transport and sale of poisons, penalties being prescribed for non-compliance. Fees are payable to the local authority by persons whose names are entered on the List- At the end of 1954 there were 165 names on the Council's List and the following changes took place in the Register daring the year:- NO. of listed sellers on Council's register at 1.1.54. 166 No. added during the year 11 177 No. who transferred their business or discontinued the sale of poisons 12 NO. on register at 31.12.54 165 393 visits of inspection were made during the year under review and 9 samples of Part II Poisons were submitted for analysis all of which were reported to be satisfactory. (51) PET ANIMALS ACT, 1951. This Act, which came into operation on 1st April, 1952, regulates the sale of pet animals and empowers a local authority (in London a Metropolitan Borough) to grant licences to keep a pet shop on payment of a fee not exceeding ten shillings. During 1954, 10 licences were renewed and three new licences issued, appropriate conditions being applied to each. No contraventions of the Act were found during routine inspection or re-inspection. SWIMMING BATH WATER SAMPLES 1954. Samples of swimming bath water, details of the analysis of which follow, were uniformly good:- Date. Bath. Time. Bacteria per c.c. B Coli Free Chlorine parts per million. 31.3.54. Mixed. Morning Nil. Negative 0.12. ,, ,, Afternoon ,, ,, 0.70. 1.9.54. Gents. Morning. ,, ,, 0.30. ,, ,, Afternoon. 5 ,, 0.20. (52) ATMOSPHERIC POLLUTION. Publication of the findings of the Government Committee on Air Pollution (Beaver Report) in November, 1954, emphasised that the problem of atmospheric pollution generally is both vast and complicated; there are no easy solutions. Legislation to deal with the matter is at present before Parliament in the form of a Clean Air Bill including smokeless zones, and a review of the problem in Fulham would perhaps be of interest. This Borough is situated in a loop of the River Thames which causes movements of air in the form of eddies and currents. This was clearly illustrated in the severe fog of December 1952, when the density of the fog in Fulham was less than the surrounding Boroughs. Another factor is that for nine months in the year the prevailing wind is from the south-west, which means that all the sulphur dioxide and some of the lighter solids are carried by the wind into the neighbouring Borough. The grit problem in Fulham is therefore at its worst from January to March when the winds are in a reciprocal direction from the north-east, with the eddying effects becoming most apparent, or when there is comparatively little or no wind. The Fulham Power Station (opened on the 26th September, 1936), and now the British Electricity Authority Power Station, was originally fitted with a gas washing plant which was regarded as an efficient process to eliminate the emission of grit. In 1940 it was decided to put the gas washing plant out of action to help put up a smoke screen to hide the course of the river Thames from enemy aircraft. At the end of the war many complaints were received regarding grit emissions from the Power Station, and it was found that the gas washing plant had deteriorated to such an extent that it could not be reinstated. After repeated representations from the Council and receiving a delegation appointed by a Towns Meeting, the then Chancellor, Sir Stafford Cripps, agreed to release sufficient steel necessary to manufacture and install grit arresting machinery, instead of gas washing plant, which was cheaper and reputed to be just as satisfactory. Initially the grit arresters, installed in 1950, were extremely efficient but by 1953 the position had deteriorated and complaints were received of large amounts of grit falling in the area. (53) To deal with the problem, the Council decided to set up two Atmospheric Pollution Measurement Stations instead of one in collaboration with London and the country generally, and these were installed in August 1953, - one at Shell Wharf, and the other at Messrs. Rickett & Colman, Demorgan Road. Monthly analyses are made, the solids in the deposit gauge are measured, and also the amount of sulphur dioxide in the atmosphere. In December 1954, in conjunction with other London Boroughs apparatus was installed to give a daily reading of the atmosphere and provide an over-all picture. The apparatus is installed in the Town Hall, and on an upper floor of Messrs. Rickett & Colman, Demorgan Road, who have kindly co-operated. These daily readings are reported to the Public Health Committee and the Department of Scientific Industrial Research. The monthly analyses and daily recordings are still being taken, and will reflect any unusual increase or decrease in the area in which they are sited. Following very heavy readings from the Shell Wharf Deposit Gauge and discussions with London County Council officials, a joint representation was made to the Ministry of Fuel and Power to investigate the cause of the heavy deposits. The Ministry appointed the Chief Inspector of Alkalis, Mr. Damon, to make an independent check over several months on the Power Station. The results of his investigations were still awaited at the end of the year. SMOKE ABATEMENT. Complaints received 18 Total number of observations made (external) 1,114 Total number of inspections made (internal) 149 WINDBORNE DEPOSITS OF GRIT, ASH & SOOT. No. of complaints received 11 No. of re-inspections made 489 (54) FACTORIES ACT. 1937. Regular inspections of factories, both mechanical and nonmechanical have been carried out, and special attention has been paid to new factories. Much has been done to improve the sanitary conditions in factories by the provision of additional sanitary conveniences and lavatory (hand) basins with hot and cold water, and experience has shown that these additional amenities are appreciated and used. Factory canteens have been enlarged and improved, morning "breaks" and mid-day meals can be taken in a more congenial atmosphere in many places. Many factories are close to residential property, and when nuisances have arisen, managements have co-operated with the Council in reducing noise and vibration, especially at night. Although the standard of the larger factories is high, there are still a number of small factories where little can be done to improve working conditions due to lack of space and congestion. Although the standard of the larger factories is high, there are still a number of small factories where little can be done to improve working conditions due to lack of space and congestion. Premises: Inspections: Factories without mechanical power ( Initial VISltS ) 105 Factories with mechanical power (initial visits} 107 Other premises under the Act (building operations and works of engineering construction - Number of re-inspections of all factories 850 Total 1,062 (55) No. of cases in which defects were found:- Particulas. Found. Remedied. Want of cleanliness. 29 27 Inadequate ventilation. 1 1 Ineffective drainage of floors. 8 8 Sanitary Conveniences: (a) Insufficient. 19 17 (b) Unsuitable or defective. 28 28 (c) Not separate for the sexes. 2 2 Other offences against the Act (not including those relating to outwork). - - 87 83 No prosecutions were instituted under the Factories Act, 1937, during 1954. FACTORY DRAINAGE. No. of drains inspected 180 No. of existing drains tested 108 No. of new drains water tested 159 No. of drains cleared 18 No. of sinks renewed 76 NOISE. No of Complaints received 12 No o of complaints remedied 11 No. of re-inspections made 164 These inspections often involve very early morning or late visits. (56) PART VIII OF THE FACTORIES ACT. OUTWORKo Nature of Work No. of Outworkers on list. Boot making 7 Wearing Apparel 94 Box making 2 2 Upholstery 5 Toy saking 39 Lampshades 4 Fancy goods 18 Sweet wrapping 8 weet Wrapping 8 Paper Bags gs 2 Total. 179 185 visits were made to Outworkers during the year. Under this Act it is unlawful in the course of business to use filling materials to which the Act applies in any form of upholstery, 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). Six sets of premises are registered in Fulham. During 1954 the following samples of filling materials were purchased by the Sampling Officer and submitted to the Prescribed Analyst for the purpose of tke Act:- Horse Hair 1 Rag flock 6 Coir fibre 6 Kapok 1 Hair and fibre mixture 1 17 All samples of filling materials submitted fox examination were reported to be satisfactory in quality. (57) FACTORIES ACT, 1937. SECTION 54 - BASEMENT BAKEHOUSES. Section 54 of the Factories Act, 1937, imposes certain duties upon the Borough Council with regard to the closure or certification for fitness for use of basement bakehouses. "Underground" bakehouses, as they were then known, were first the subject of special legislation in 1901, when Sections 97 to 102 of the Factories & Workshops Act, 1901, were devoted to their improvement. This Act prohibited the establishment anew of underground bakehouses, laid down standards of cleanliness etc., for existing bakehouses and required certification as to fitness by the local authority. The 1901 Act envisaged the alteration of underground bakehouses in order that they might be brought into line with the requirements of the day as regards "construction, light, ventilation and all other respects". The Factories Act, 1937, deals with "basement" bakehouses (as they are now termed) in Section 54. This Section defines a basement bakehouse as a "a bakehouse any baking room of which is so situated that the surface of the floor is more than three feet below the surface of the footway of the adjoining street or of the ground adjoining or nearest to the room" and requires that:- (1) No basement bakehouse shall be established anew; (2) No basement bakehouse may be used as such unless certified by the local authority under the 1901 Act; (3) If the use of the basement bakehouse is discontinued for a period exceeding twelve months, it must not be used again. (4) Every local authority shall examine all basement bakehouses between 1st July, 1938, and 30th June, 1939, and in every fifth succeeding year. (58) After the first examination, the local authority shall either (a) Certify the bakehouse as suitable for continued use without prejudice to the local authority's power to revoke the certificate as a result of further quinquennial examinations or; (b) Give at least one month's notice of closure of the bakehouse. Power of appeal to a Court of Summary Jurisdiction against the notice that the Certificate of Suitability of a basement bakehouse is to cease to have effect is given to the occupier, exercisable within twenty-one days. Following the examination carried out between 1st July, 1948, and 30th June, 1949, there were in the Borough ten basement bakehouses which were still in use and which had been certified as suitable for use as such until 1954. The statutory quinquennial survey of these ten bakehouses was made in 1954 and the renewal for a further period of five years of the Certificates of Suitability which were issued in 1949 and which expired in 1954, was recommended by the Public Health Committee in nine cases. In the tenth instance no action was recommended as baking ceased at these premises on 7th December, 1953, and has not been resumed. Retail Bakers' Shops. There are in the Borough eleven bakers' shops without bakehouses attached. •" During 1954 59 inspections were made of bakehouses and bakers' shops. (59) INSPECTIONS OF FOOD PBBMISES. Type of Business. No. on Register. No. of Inspections. Contraventions foundo Premises made fit. Bakehouses (Non-basement) . 28 36 5 5 Bakehouses (Basement). 9 31 2 3 Bread & Cake shop®. 11 24 5 5 Butchers' shops. 75 130 8 9 Confectionery = 68 35 - - Co®ked Meat shops. 15 15 ~ ~ Milk Pasteurising ) Establishments. 2) 223 - - Bottled Milk Depots. 2) Purveyors of Bottled Milk* 129) Eel and Pie shops „ 4 11 - - Food Factories. 6 33 1 4 Fishmongers' Shops. 28 67 6 3 Fried Fish Shops. 34 32 10 3 General Food Shops0 226 332 6 8 Greengrocers and Fruiterers« 120 56 13 11 Horseflesh butchers. 3 3 1 - Ice Cream (Manufacturers and Dealers). 235 80 11 9 Licensed Premises. 105 51 4 4 Restaurants and Working Class Dining rooms. 143 227 29 24 Stalls. 81 19 2 5 Stallholders' Storage premises 40 74 3 2 Other Foed premises. 15 102 1 2 Totals. 1*379 1,581 107 97 (60) INSPECTION AND SUPERVISION OF FOOD. SLAUGHTERMEN'S LICENCES. Slaughter of Animals Act, 1933. During the year 1954, one such licence was issued to a slaughterman resident in Fulham. There are no slaughterhouses in the Borough. FOOD AND DRUGS ACT. 1938. SECTION 10. Examination of Food and Seizure of Unsound Food. Certain articles of food which are liable to be adulterated are controlled by sampling and chemical analysis by the Public Analysts, but foods which deteriorate in quality and become unfit for human consumption are supervised by inspection and seizure with subsequent condemnation by a Justice of the Peace and destruction. Section 10 of the Act empowers any authorised officer of the local authority to examine food for human consumption which is deposited for sal®, and if it appears"to him to be unfit he may seize it and remove it in order to have it dealt with by a Justice of the Peace. If it appears to the Justice of the Peace that any food brought before him is unfit for human consumption he shall condemn it and order it to be destroyed or to be so dealt with as to prevent it being used for human food. No action was necessary under this section during 1954. Voluntary Surrender of Food. In practice, shopkeepers make very little attempt to sell to the public any foodstuff which is unfit for human'consumption and it is customary for retailers who find food they have purchased f^om wholesalers to be unsound at the time they receive it or to have become unfit after storage on their premises to notify the local authority, and request an inspection by the district sanitary inspector who will, if satisfied after examination that the food is unfit, issue a certificate to that effect and arrange for its removal to, and destruction at, the Council's Refuse Destructor. Diseased or unsound meat and all other unsound food dealt with by the Sanitary Inspector becomes the property of the local authority, whose duty it is to destroy it or otherwise dispose of it in such a way that it cannot be exposed for sale or issue for human consumption. (61) After removal from his premises a certificate is issued to the shopkeeper giving details of the foodstuffs dealt with which may enable him to obtain credit or compensation from his wholesale suppliers. During 1954 801 Certificates of Condemnation were issued by the sanitary inspectors relating to the under-mentioned voluntarily surrendered food:- Tinned Packeted and Fish Meat Chickens and Bottled Food. Rabbits. 18,736 items, 51 Stone. 4,147 lbs. 144 lbs. Dried Fruit 268 lbs. Biscuits 215 215 lbs. Cooking Fat 104 lbs. Chocolate 1,368 bars Rice 406 lbs. Sage 100 lbs. Sugar 202 lbs. Cheese 209 lbs. Oatmeal 38 lbs. Margarine 568 lbs. Butter 486 lbs. Other foodstuffs l,388 lbs. Orange Juice 3,200 gallons. (62) COMPLAINTS. During the year under review, nine complaints were received from members of the public regarding foreign objects etc. in food. Each complaint is fully investigated and reported to the Public Health Committee, and the following are details. No. Nature of Complaint. Action Taken on recommendation of Public Health Committee. 1 Cement in milk bottle. Dairy Company warned by letter. 2 Wire in meat pie. Explanation of manufacturers accepted by Committee. 3 Foreign matter in milk bottle. Certified by Public Analyst to be burnt milk. No action. 4 Disc in milk bottle. Dairy Company warned by letter. 5 Foreign matter in bread which on analysis proved to be edible oil used for lubricating machinery. Bakers warned by letter. 6 -do- -do- 7 Cement in milk bottle. Referred to Borough Council In whose area the bottle was washed and filled. 8 Foreign matter in bread, which on analysis proved to be charred whole meal. No action. 9 Winged insect on biscuit. No action. Legal proceedings instituted by the Borough Council concerned, and a fine of £1 together with two guineas costs imposed on dairy Company. (63) FOOD ESTABLISHMENTS. Regular inspections were carried out during the year 1954 resulting in 44 requests to the persons responsible requiring the execution of essential work. In no case was it necessary to institute legal proceedings. Details of the more important improvements which have been effected in food premises during the year are given below:- Water heaters 8 New sinks provided 7 New W.Cs. provided 2 W.Cs. repaired and cleansed. 13 Kitchens, preparation rooms etc. redecorated 36 Floors renewed or repaired. 7 Shops fronts repaired or redecorated 15 New dustbins 16 Counter cases for the protection of food 5 New windows 2 Improvements to ventilation 6 Counter refrigerators. 2 Gas stoves repaired or renewed 1 New refrigerators 5 New counters 6 Premises re-designed 4 Yards cleaned and repaired 25 Refuse removed 7 Under the provisions of Section 14 of the Food and Drugs Act, 1938, premises used for the preparation of certain specified articles of food must be registered with the local authority. It the end of 1954, there were 65 premises on the Register concerned in the preparation of preserved foods and 235 premises on the Register relating to the manufacture or sale and storage of ice cream, as follows- Premises registered for the manufacture, storage and sale of ice cream 3 Premises registered for storage and sale of ice cream 232 (64) BACTERIOLOGICAL EXAMINATION OF "CREAM" FILLED CQNFBCTIONKHJ. During 1954, 144 samples of synthetic and "butter" cream used as a filling in eclairs, doughnuts etC., were purchased for bacteriological examination. In addition 21 samples of liquid egg and 5 of ingredients used in the preparation of "cream" confectionery were taken. The importance of scrupulous cleanliness and care by persons handling this type of confectionery cannot be over-emphasized when one remembers that the cream-filling is an excellent medium for the growth of bacteria, and is not subject to any form of heat-treatment before consumption. The following is a summary of the examination of the 144 samples:- Free from bacillus coliform 47 Bacillus Goliform (non-faecal) present in 89 Bacillus Goliform (faecal) present in 7 Staphylococcus Aureus present in 1 Three of the seven samples contaminated with faecal coli and that with staphylococcus aureus, although sold in Fulham shops or cafes, were actually prepared in bakehouses outside the Borough and for this reason it is difficult to say definitely where the contamination occurred. In such cases, in addition to visiting the local shop and giving advice to the staff on food hygiene, the facts are communicated to the Medical Officer of Health for the district in which the bakery is situated for his information and appropriate action. Four samples contamined with faecal coli were the product of local bakeries and every assistance was given to the baker concerned in an effort to trace the source of infection. In every instance, subsequent samples examined have been satisfactory. SALE OF MILK REGULATIONS 1939. During 1954, 172 samples of milk were procured by the Sampling Officer and submitted to the Council's Public Analyst for chemical analysis. Of these 66 were purchased from milk roundsmen in the streets of the Borough during the early delivery, 15 were purchased on Sundays and 16 were taken at the early morning delivery to the Western and Fulham Hospitals. One sample of milk was reported to contain 1.5 per cent extraneous water and on the recommendation of the Public Health Committee a letter of warning was sent to the purveyor. (65) SALE OF MILK REGULATIONS 1939. The following table gives the monthly average composition of all samples of milk examined in Fulham, and it will be seen that the quality of the milk distributed in the Borough is well maintained and compares very favourably with the legal standards laid down in the above Sale of Milk Regulations. Month. No. of Samples. Fat% Solids not Fat% January. 11 3.54 8.70 February. 15 3.61 8.69 March. 18 3.49 8.63 April. 14 3.33 8.63 May. 15 3.23 8.69 June. 13 3.39 8o76 July. 13 3.45 8.75 August. 13 3.57 8.72 September. 19 3.51 8.77 October. 14 3.61 8. 77 November. 14 3.74 8.76 December. 13 3.63 8.72 172 3.51 8.71 Legal Standards. 3.00 8.50 Average composition of normal cow's milk. 3.76 8.84 (66) QUALITY OF Milk The time of year is one of the chief circumstances on which the variations in the composition of cows' milk depend, and the year may be divided into four periods according to the character of the milk yielded. Thus, during period one, 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 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 then that Fulham's milk supply appears to follow the normal rise and fall. 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 1954, and the following were taken for chemical analysis, the results being on the table included in Page 68. Institution. No. of samples Fulham Hospital 9 Hestern Fever Hospital LoC.Cc Schoolso 51 Meals Kitchens etc 4 Fulham Maternity Home 2 Day Nurseries 3 Total. 21 REGISTRATION OF PURVEYORS OF Milk. The Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, provide that as from 1st October 1954 all pasteurised milk shall be put into bottles or other containers in which it is to be delivered by retail at the premises at which it is pasteurised as soon as possible after pasteurisation. In the past, the majority of registered purveyors purchased their supplies of milk in chums from reputable wholesalers by whom it had been (67) pasteurised in accordance with the legal requirements and either sold it in small quantities from a shop counter-pan or bottled it in their own dairies for distribution to their customers. As the Regulation which came into force on 1st October 1954 makes this practice illegal, purveyors in the Borough have made arrangements for their wholesalers to supply milk in bottles which have been washed, filled and sealed at the premises at which it has been pasteurised. This regulation is a welcome step in the right direction. There are in the Borough two dairies in which milk is pasteurised. In one, the plant is of the "Holder" type, i.e. the milk is retained at a temperature of not less than 1450F. and not more than 150°F. for at least thirty minutes, and immediately cooled to a temperature of not more than 50°F. In the other9 in which the High Temperature - Short Time (H.T. - S.T.) process is employed, the milk is retained at a temperature of not more than 161°F. for at least fifteen seconds,and is immediately cooled to a temperature of not more than 50°F. Both methods comply with the requirements of the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949, and it is satisfactory to record that during 1954, sixteen samples of milk were taken from each of these plants, all of which satisfied the prescribed tests viz., the Phosphatase Test for efficient heat-treatment and the Methylene Blue Test for keeping quality. In addition, there are in Fulham two large bottled milk distributing depots,and the occupiers of 129 retail shops (mostly grocers) are registered to sell milk in the properly closed and sealed receptacles in which it is delivered to their premises. Of these 31 made daily deliveries to their customers' houses, whilst the remainder merely sell bottled milk in their shops. (68) Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949-1953. Milk (Special Designtion) (Raw Milk) Regulations. 1949 - 1954. To comply with the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, Tuberculin Tested (Pasteurised) and Pasteurised Milk must not give a reading of more than 2.3 Lovibond blue units in the phosphatase tests and must not decolourise methylene blue in thirty minutes in the laboratory at atmospheric shade temperature not exceeding 65°F. until between 9 a.m. and 10 a.m. on the day following that on which the sample was collected. To comply with the Milk (Special Designation) (Raw Milk) Regulations, 1949, Tuberculin Tested and Accredited Milk must not decolourise methylene blue within 4½ hours if the sample is taken between 1st May and 31st October9 or within 5½ hours if taken between 1st November and 30th April. Tuberculin Tested (Sterilised) and Sterilised Milk when submitted to the turbidity tests must show no sign of turbidity. 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). 17 17 - 17 - _ Pasteurised. 71 71 — 71 - Sterilised. 21 21 (69) 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 on the 1st January, principal licences being granted to retailers occupying premises within the Borough, whilst supplementary licences are issued to purveyors who distribute milk in Fulham from premises situated outside. The following axe details of licences granted for the year 1954:- No. of licences to retail Tuberculin Tested milk 83 No. of supplementary licences to retail Tuberculin Tested milk 10 No. of licences to pasteurise milk 2 No. of licences to retail pasteurised milk l30 No. of supplementary licences to retail pasteurised milk 11 No. of licences to retail sterilsed milk 129 No. of supplementary licences to retail sterilised milk ll (70) ICE CREAM (HEAT TREATMENT) REGULATIONS, 1947-1952. The singulations control the preparation and subsequent treatment of ice cream. Ice Cream must be kept at a temperature of not more than 28°F. and should the temperature rise above 28°F. the ice cream must be subject to further heat treatment and again kept at a temperature not exceeding 28°F. The Methylene blue test is recommended as a guide for ascertaining the bacteriological cleanliness of ice creasy the time taken to decolourise Methylene blue being recorded and the samples graded as follows:- Provisional Grads. Time taken to reduce Methylene blue. 1 4½ hours or more. 2 2½ to 4 hours. 3 1½ to 2 hours. 4 Less than ½ hour. During 1954, 63 samples of ice cream were examined and graded as follows?— Grade. Wrapped. Taken from Bulk, Total. 1 32 18 50 2 3 2 5 3 4 4 8 4 — - — Total 32 - 63 In addition to the above, 21 iced lollies were examined, all of which satisfied Grade I. 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 fully when samples fall within the latter grades. It is satisfactory to note that no samples fell below Grade 3. (71) THE FOOD STANDARDS (ICE CREAM) ORDER, 1953. This Order lays down the following standards for Ice Creams- Fat 5% Sugar 10% Milk Solids other than fat 7.5% During 1954, 24 samples of ice cream were purchased for chemical analysis by the Public Analyst all of which were reported to be genuine, a summary of the results being:- Percentage of fat. No: of samples. Less than 5% 5% - 7½% 7 7½%- 10% 8 Over 10% 9 The average fat content of all samples was 8.95 per cent. FOOD AND DRUGS ACT, 1938-1950. During the year under review, 800 samples of food and drugs purchased by the Sampling Officer were submitted to the Council's Public Analyst for chemical analysis. The samples were taken under the various Acts, Orders and Regulations relating to foodstuffs. The Public Analyst reported adversely on 35 of the samples examined, one of which was milk and is referred to on pages 72 - 76 inc. In no case were legal proceedings instituted. (72) Action taken on recommendation of the Public Health Committee in connection with the other articles of food which were reported to be not in accordance with accepted standards is as follows:- Sample No. Article. Result of Analysis. Action taken. 18 Non-Brewed Condiment. Contained 3.72% w/v acetic acid. 7% deficient. Must contain not less than 4% acetic acid. Warning letter to vendor. 35 Dripping. Contained 2% free fatty acids calculated as oleic acid. Must not contain more than 1.5% free fatty acids calculated as oleic acid. Warning letter to vendor. 39 Shredded suet. Contained 82.2% fat. 1% deficient. Must contain &3% fat. No action. 48 Fresh Orange drink. Contained 1.2-2.5 lbs. fresh Orange per 10 galls, drink. 1 Mg. vitamin C per fl. os. soft drink. At least 50% deficient in Orange and insufficient vitamin C to warrant description "Fresh Orange Drink". See report on No.85. 73 Meat Pie. Rancid fat. Matter taken up with manufactureres. 85 Fresh Orange drink. Contained 1.5-3.1 lbs. fresh Orange per 10 galls. drink. 0.7 mgs. vitamin C per fl. os. soft drink. At least 57% deficient in Orange and insufficient Vitamin C to warrant description "Fresh Orange Drink". Matter taken up with manufacturers. (73) Sample No. Article. Result of Analysis. Action taken. 127 Cherry Sundae. Consisted of soft nougat, but labelled "Sundae". Incorrectly labelled. Term "Sundae" restricted almost entirely to iced confection. Manufacturer has agreed to amend description to read "Cherry Dessert". 128 Dripping. Rancid. Warning letter to manufacturer. 181 Tea. Contained a nail 1" long. Attention of packers drawn to matter. 192 Majoram. Contained 10% foreign leaf, probably derived from a species of cistus. Warning letter to vendors suppliers. 196 Vinegar. Coloured dilute acetic acid, not vinegar. Contained acetic acid 4.3% and yielded acid oxidation value 7.1. Must not be described as vinegar which is a product of double fermentation. Warning letter to vendor. 254 White pepper. Acid-insoluble ash 1.1% Contaminated with excess outer husk and mineral matter. Acidinsoluble ash must not be more than 0.3%. Warning letter to vendor. 267 Dripping. Free fatty acids 4%. Must not contain more than l.5% free fatty acids. Warning letter,to vendor. (74) Sample No. Article. Result of Analysis. Action taken. 286 Fiz- Whizzers. Contained no available carbon dioxide. Must not be described as "Fizzers". Result of Analysis communicated to manufacturers. 300 Butter Mints. Prepared with margarine. Warning letter to vendor. 308 Lard. Inferior, Mutton or beef dripping flavour due to over refining. No action. 380 Dried Fruit salad. Inferior quality. Very poor quality dried prunes and apricots present. Remainder of stock examined and appeared to be satisfactory. 389 Jelly Crystals. Incorrectly labelled. Not called "Jelly Crystals" and ingredients labelled in wrong order. Inaccuracies in description communicated to manufacturers. 451 Flaked Tapioca. Uneven in size. Should be called tapioca, not Flaked tapioca. No action. 472 Flaked Tapioca. Ditto. Analyst's opinion communicated to manufacturers. 526 Flaked Tapioca. Ditto. Ditto. 430 Natural Orange Juice. Contained yeasts. ) Did not possess a ) normal odour of ) Orange Juice. ) Fermenting. ) 3,250 gallons voluntarily surrendered and destroyed 431 Natural Orange Juice. Ditto. ) 3,250 gallons voluntarily surroundered and destroyed 433 Pineapple Squash. Fermenting. Remainder of stock (one bottle) withdrawn from sale. (75) Sample No. Article. Result of Analysis. Action taken. 572 Cream Cheese., Contained 43.3% of fat calculated on dry matter. 33% deficient in milk fat. Vendor advised not to describe as "cream1*1 cheese. 650 Dried Fruit Salad. Not of the quality expected. Fruit shrivelled and discoloured. Remainder of stock destroyed. 661 Milk. Contained 8.41% solids not fat. l.5% added water. Sale of Milk Regulations, 1939. Purveyor warned. 663 685 Lard. ) Lard. ) These two samples contained large quantities of triglycerides insoluble in ether and the melting point of the insoluble glycerides was abnormal. The determination of the iso-oleic acid when carried out by the method given in a standard text book indicated that the samples contained hydrogenated lard and not ordinary lard. A full investigation has, however, shown that the abnormality was not due to the presence of hydrogenated lard, but to the abnormality of the pig, fat. Matter taken up with the vendors. (76) Sample No. Article. Result of Analysis. Action taken. 730 Saltanas. Contained 23.5% water. Mouldy. Had probably been washed and not properly dried. Sultanas normally contain 18.5% water. Remainder of stock returned to wholesalers. 745 Cut peel. Contained only 56.8% sugar . Must contain not less than 60% sugar. Result of analysis to be communicated to packers. 750 N.A. Ginger Wins. Incorrectly labelled. Non-Alcoholic win® a contradiction of terms. No action. 770 Soft cheese. Contained water 70.9% and fat 13.0%. Incorrectly labelled. Not a soft cheese but a curd cheese. Soft cheese must contain not snore than 60% water nor less than 20% milk fat. Shop Keeper advised. 776 Mincemeat. Contained only 62.5% soluble solids 4% deficient. Food Standards Preserves Order 1953 requires mincemeat to contain not less than 65% soluble solids. Result of analysis communicated to packers. 792 Currants. Dry and good flavour, but did not consist of currants. Derived from small seed containing grapes. Currants are derived from seedless or stoneless graphs. Matter taken up with the wholesalers and the Ministry of Food. (77) REPORT OF THE COUNCIL'S PUBLIC ANALYST Thomas McLachlan. A.C.G.F.C., F.R.I.C. During the year 1954, 800 samples of foods and drugs were examined. Of these 788 were taken formally and 12 informally. The number adulterated was 35, or 4.4 per cent. The incidence of adulteration may be classified as follows:- Article. No. of Samples examined. No. of samples adulterated. Milk 172 1 Other foods 625 34 Drugs 3 - A sample of milk contained only 8.41 per cent of milk solids not fat and therefore contained at least 1.5 per cent of added water. Some Cream Cheese contained only 43.3 per cent of fat calculated on the dry matter, and should not therefore be sold as a Cream cheese. Although there are no standards in this country Canadian and United States law stipulates that cream cheese must contain not more than 55 per cent of moisture and not less than 65 per cent of milk fat calculated on the dry basis. A sample of Soft cheese contained 70.9 per cent of water and 44.7 per cent of fat calculated on the dry matter. A Soft cheese must contain not more than 60 per cent of water nor less than 20 per cent of milk fat, and in your analyst's opinion this sample was a Curd cheese which is a wetter product. Two samples of Dripping contained excessive free fatty acids calculated as Oleic acid. One sample contained 4.0 per cent and the other 2.0 per cent. Dripping must not contain more than 1.5 per cent of free fatty acids calculated as Oleic acid. Another sample of dripping gave a positive reaction for rancidity by the Kreis reaction. A sample of lard was reported as inferior as it appeared to be genuine pork fat with a definite mutton or beef flavour. Two other samples examined contained large quantities of triglycerides insoluble in ether and the melting point of these insoluble glycerides was abnormal. The determination of the iso-oleic acid when carried out by the method given in a standard teSt book indicated that the samples contained hydrogenated lard and net ordinary lard. A full investigation showed however, that the abnormality was not due to the presence of hydrogenated lard, but to the abnormality of the pig fat. (78) A sample of shredded suet contained 82.2 per cent fat instead of 83 per cent and was therefore 1 per cent deficient in fat. The fat of a meat pie was rancid. It appeared to be the fat used in the preparation of the crust rather than the fat belonging to the meat filling which was rancid. Two samples of Fresh Orange Drink were found to contain from 1.2 2.5 lbs. and 1.3 - 3.1 lbs. respectively of comminuted fr esh orange per 10 gallons of drink, so that in the opinion of your analyst they contained less than the minimum quantity of comminuted fresh oranges required to be present. They also contained only 1 mg. and 0.7 mg. respectively of vitamin C per fl. 03. of soft drink. Since the rejected portion of the oranges is often used for the manufacture of marmalade which also has to comply with a standard under the Food Standards (Preserves) Order, it is difficult to see how one batch of oranges can supply essential fruit for two different products to comply with different standards Orders. It is, however, understood that the Food Standards (Soft Drinks) Order, may be amended. Two samples of Orange Juice contained a large number of yeasts, and were slightly fermented. Some Pineapple Squash was fermenting »lightly, although it contained 42 per cent of sugar which is quite good for a Squash. A sample of Non-Alcoholic Ginger Wine was considered to be incorrectly labelled, as in view of the High Court action concerning Non-Brewed Vinegar the term "Non-Alcoholic Wine" is a contradiction of terms. Some mincemeat contained only 62.5 Per cent of soluble solids, whereas the Food Standards Preserves Order, 1953, required Mincemeat to contain not less than 65 per cent. The sample was therefore 4 per cent deficient in soluble solids. A sample of cut peel contained only 56.8 per cent of total sugar. The Food Manufacturers Federation agreed that their members would make cut peel to contain 60 per cent of sugar but they are not keeping to this agreement. At the present time salted peel is being used with the result that less sugar is required. This particular sample contained 1.23% of salt which is not as high as in some samples examined recently. Some Sultanas which smelt mouldy on receipt contained 23 of water. Sultanas normally contain 18.5 per cent of water, and it is probable that these sultanas had been washed in order to clean them, and then not properly dried. A sample of currants examined contained stones. Currants are derived from a seedless or stoneless grape known as Vitis Vinifera var. Corinthiaca. It was eventually found that these currants were by the Ministry as the lowest grade and would normally be expected to be used only for making wins, sauces, etc. This sample however (79) had been sold as ordinary currants for making cakes. Two samples of Dried Fruit Salad examined were considered to be poor quality. A sample labelled "Crystal Table Jelly" complied with the Table Jelly Order but was incorrectly labelled. The correct name should be "Table Jelly Crystals". The order of disclosure of composition was also incorrect, although there is no necessity t© declare the composition of Jelly Crystals. Three samples of Flaked Tapioca were reported as inferior as they were all uneven in size. A sample labelled Vinegar consisted of 4.3% acetic acid, total solid matter 0.27 per cent, and water, and showed an acid oxidation value of 7.1. Coloured dilute acetic acid must not be described as vinegar which is a product of double fermentation. Some Non-Brewed Condiment contained 3.72% w/v acetic acid. NonBrewed Condiment must contain not less than 4 per cent of acetic acid and this sample was therefore 7 per cent deficient in acetic acid. A sample of tea examined contained a nail 1" long. The acid-insol. ash on a sample of white pepper was 1.1 per cent whereas it must not be more than 0.3 per cent. It was considered that the sample was contaminated with an excess of outer husk and mineral matter. Some Majoram contained 10 per cent of foreign leaf, probably derived from a species of cistus. A sample labelled "Fiz Wizzers" contained no available carbon dioxide. Th* description "Fiz Wizzer" gives the impression that it effervesces in the mouth and the constituents must be arranged so that some slight effervescence occurs on sucking. Some Butter Mints examined were prepared with margarine, Confectionery labelled as Butter Mints must be prepared with butter and not with margarine. A sample labelled Cherry Sundae consisted of a soft nougat. your Analyst considers that the term "Sundae" should be restricted to ice cream preparations of a certain type, and this product should properly be called nougat. Legislation during 1954. The most important piece of food and drug legislation passed during the year was undoubtedly the Food and Drugs (Amendment) Act, 1954, which will not, however, come into force as such, but will be consolidated with the Food and Drugs Act, 1938, the Food and Drugs (Milk and Dairies) Act, 1944, and the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950. When the Food and Drugs Act, 1938, (80) was introduced it was intended merely to be a consolidating Act with a view to bringing th* whole of Food and Drugs Administration up to date, but th* war prevented this, and much piecemeal legislation has been passed under the description of Emergency Orders,, Many writers have referred to the Amendment Act as a "Hygiene" Act, but it was more than this. It is doubtful whether any Government is sufficiently strong at the present time to faring in the wholesale legislation necessary to safeguard health, if it is realised that the British have passed from being a nation which eats fleshly cooked food in the home or in small restaurants to one which consumes food cooked days or months before it is eaten and not always even kept in refrigerators or under sterile conditions for much of the intervening periods. One of the main objects of the Act is to enable temporary legislation to be made permanent. This accounted for much of the delay in the passing of the Amendment Act and has retarded the introduction of the Consolidation Act. The power of the Minister to make fresh orders had been greatly extended. From the public analyst's point of view legislation has become necessary in order to obtain efficient control ever the large number of chemicals, now being used as fertilisers, weed destroyers, insecticides, and fungicides, not to mention the use of anti-oxidants for the prevention of the oxidation of fats and vitamins, and even anti-biotics, which are now included as regular ingredients of animal foods. In the 1938 Act the definition of food included "any substance intended for use in the preparation of food", 'but this does not appear to have been appreciated by most Local Authorities. The point is made much clearest in the new Act fey enabling a sampling officer to take a sample of any food "or of any substance capable of being used in the preparation of food, which appears to him to be intended for sale This provision enables articles such as enamelled jugs pails etc*,, to be sampled, if it is thought that they might be used for the preparation of food and one has to remember that "the use of enamelled pails for the preparation of lemonade caused severe poisoning from antimony some years ago and that the Minister of Health published a special report about such enamels. Whilst the definition of food itself has been widened there is now an extended provision that if the public analyst certifies a food to be a food to which amy particular regulations apply, that food may be seised and condemned on the order of a magistrate. Similarly the Minister may now require manufacturers to produce evidence concerning the composition and chemical formulae of substances which it is proposed to add to foods. It will in future be unnecessary to prove that a label or advertisement is "otherwise" calculated to mislead. The Amendment Act permits the Minister to make regulations prohibiting the sale of milks of higher quality unless they conform to certain minimum standard® - this will bring Channel Island and Devon milks under the control of the Food and Drugs Act, though it has not, so far, been made illegal to sell milk containing less than 3.0 per cent of fat or less than 8.5 per cent of solids-not-fat. The definition of cream has been completely revised. In future three substances appearing to be cream be sold:- genuine cream, reconstituted cross, and imitation cream and, from the wording of the Act, it would appear that a cream bus must (81) contain genuine cream,, Provision is made for the sampling officer to inform the manufacturer or packer of a food that it has been sampled, thus ensuring that the latter cannot be ignorant of the fact until, perhaps, proceedings may be commenced against them. Similarly with certain articles sealed in containers it is now unnecessary for the sampling officer to open them to divide the contents; it will be sufficient for him to buy three or multiples of three of the article and to separate the containers or articles. This provision would apply to such goods as whole fruit jam, medicaments containing volatile constituents, condensed milk, etc. Action may now be taken against proprietary medicaments, which have previously been protected from attack if they were supplied in response to a demand for the article. Various other fresh points have been introduced. A part-time Public Analyst has been placed in the same category as any other officer of his Local Authority, when acting in his capacity as a Public Analyst, Similarly a Public Analyst may now pass to another Public Analyst a sample, which he is unable to analyse personally. With the increase in cost of apparatus and the specialised knowledge required to be able to operate some of this apparatus this provision has become essential. From the point of view of the Public Analyst and of the Local Authority a most unfortunate insertion was made in the Act on the third Reading in the House of Commons and it has been impossible to have this removed. This is the clause relating to what has been christened as the "Bob-a-nob" certificate or the provision that the Local Authority must supply any vendor of a sample who demands it with a copy of the Public Analyst's certificate on payment of a fee of one shilling,, A public analyst can only report on a sample to the best of his ability and knowledge. It is sometimes impossible to detect the presence of some deleterious substance or the destruction of some essential constituent in a food without inside information or very specialised knowledge in a particular field. He may therefore occasionally report an adulterated product as satisfactory. During the late War it was a common practice for certain disreputable manufacturers to ask Local Authorities whether samples had been reported as genuine by Public Analysts and to use such reports when any adverse comments were made. There appears, moreover, to be nothing to prevent copies of these certificates being used for advertisement purposes. Care will have to be exercised in bringing into permanent legislation much of the temporary legislation now in force. Thus the new Act specifies that "chewing gum" is a Food but the Mineral Oil in Food Order prohibits the presence of more than 0.2 per cent of mineral hydrocarbons in foods, other than dried fruit, which may contain 0.5 Per cent, and citrus fruit which may only contain 0.1 per cent. Chewing gu* generally contains up to A per cent of one or other of the various paraffin wax hydrocarbon products. (82) The Food Standards (Margarine) Order, 1954, made it compulsory to add vitamin A and vitamin D to margarine and prescribed the method for the determination of vitamin A. The Food Standards (Soft Drinks) (Amendment) Order, 1954, permitted soft drinks to be made from fruit juice with or without added sugar and in concentrated or frozen form, During the year all ordinary control Orders relating to the rationing of manufacture or consumption of foods have been revoked leaving their manufacture and sale more flexible. These revocations, unless controls are introduced under the new Food and Drugs Consolidation Act, may entail greater care before manufacturers are prosecuted or warned. A Report was issued by the Food Standards Committee on Antioxidants in foods and recommended that propyl, octyl, or dodecyl gallates or mixtures of these should be permitted up to 0.0l per cent in edible oils and fats and 0.1 per cent in essential (that is volatile flavouring) oils. Alternatively butylated hydroxyanisole should be permitted in quantities up to 0.02 and 0.1 per cent respectively. A fresh Report on lead was issued by the Food Standards Committee proposing that a general limit of 0.2 parts per million should be imposed on ready-to-drink beverages and 2.0 parts per million in other foods. Various exceptions to these general limits are suggested and in certain cases, such as food colours and solid pectin, the quantities rise to 20 and 50 parts per million respectively. The Food Standards Committee issued a Report suggesting that readyto-drink beverages should not contain more than 5 parts per million of zinc and that other foods should not contain more than 50 parts per million, but that these limits should be exercised with discretion if it could be proved that the presence of the zinc is a natural occurrence. Although the Minister of Food has stated more than once in Parliament that he does not wish to fix a standard for the meat content of sausages, the Ministry issued a Circular showing the average meat content 6f pork sausages is greater than 65 per cent and of beef sausages greater than 50 per cent. The Ministry issued a Circular drawing the attention of Local Authorities to the use by certain exporters in other countries of thiourea as a fungicide to prevent deterioration in citrus fruits and that this was a contravention of the Public Health (Preservatives etc. in Food) Regulations. The Ministry issued a Circular which stated that cream soups should contain either not less than per cent of butter fat, or not less than per cent of butter fat and not less than 3 per cent of total edible fat, or not less than 3½ per cent of edible fat. (83) Article. No. of Samples Examined. No.of Samples Adulterated, etc. Formal Informal Private Total Formal Informal Private Total Ale. 13 13 Almonds,Ground. 10 10 Barley,pearl. 2 2 Batter Flour. 5 5 Biscuit. 1 1 Breadcrumbs. 1 1 Butter. 43 43 Cake Mixture. 1 1 Cheese. 5 5 2 2 Cider. 1 1 Coffee and Chicory Essence 5 1 5 Confectionery. 14 14 3 3 Cooking Fat. 15 15 Cooking Fat, Kosher. 2 2 Curd, Lemon. 4 4 Curd, Orange. 1 1 Custard Powder 1 1 Dripping. 20 20 3 3 Fat. 2 2 Fish, canned. 1 1 Flavour Orange. 1 1 Flour. 10 10 Flour S.R. 12 12 Flour, Soya. 2 2 Fruit, canned. 2 1 3 Fruit, dried. 36 36 4 4 Fruit, Glace. 2 2 Carried Foward 209 2 2 213 12 12 (84) Article No. of Samples Examined. No. of Samples Adulterated, etc. Formal Informal Private Total Formal Informal Private Total Bgt. Forward. 209 2 2 213 12 12 Fruit, Juice . 2 2 2 2 Gelatine. 2 2 Herbs. 4 4 1 1 Ice Cream. 24 24 Ice Cream Mix. 1 1 Ice Lolly. 2 2 Jam. 22 22 Jelly, apple. 1 1 Jelly crystals. 1 1 1 1 Lard. 21 21 3 3 Macaroni. 6 6 Margarine. 42 42 Margarine Kosher. 1 1 Marmalade. 4 4 Marzipan„ 2 2 Meat. 1 1 Meat Extract 1 1 Meat Pie 4 4 1 1 Milk 172 172 1 1 Milk evaporated 1 1 Mincemeat. 7 7 1 1 Non-brewed Condiment. 8 8 1 1 Oatmeal. 4 4 Pastry. 1 1 Peel, cut. 7 7 1 1 Pepper, white. 1 1 1 1 Carried Fwd. 549 4 2 555 23 2 25 (85) Article. No. of Samples Examined. No. of Samples Adulterated, etc. Formal Informal Private Total. Formal Informal Private Total. Bt. Forward. 549 4 2 555 23 2 25 Pickles. 7 7 Pickled cabbage. 1 1 Pulses. 10 10 Rice. 22 22 Saccharin Tablets. 1 1 Sago. 5 5 Sauce. 1 1 Sausages. 68 4 72 Sausage Luncheon. 1 1 Sausage Black Pudding. 1 1 Semolina. 12 4 12 Soft Drinks. 22 3 25 3 1 4 Soup. 2 2 Spirits. 24 24 Suet. 9 9 1 1 Tapioca. 17 17 3 3 Tapioca Substitute 1 1 Tea. 16 16 1 1 Vinegar. 15 15 1 1 Drugs: Ammoniated Tincture of Quinine. 1 1 Seidlitz Powder. 1 1 Sulphur Ointment. 1 1 Total. 786 12 2 800 32 3 35 (i) I N D E X Page Abatement, smoke 53 Acts of Parliament 37 Analyst, Report of 77 Area of Borough 7 Assistance Act, National 31 Assistance (Amendment) Act, National 31 Atmospheric Pollution 50 Authentication of Vaccination and Inoculation Certificates 20 Bacteriological examinations 19 Bacteriological examinations, Cream filled confectionery 64 Bath water samples 31 Basement Bakehouses 57 Bathing Service, Home 32 Birth Rate 7 Birth and Death Rate (Graph) 10 Borough Population 7 Buildings, drainage of new 47 Burials? National Assistance Act 33 Certificates of Disrepair 45 Certificates re Contacts of Infectious Disease 13 Certificates of Habitation 46 Chest Clinic, Extracts from Report of 21 Chiropody 29 Christmas Dinner - Old People's 30 Chronic Sick 31 Circulars from Ministries 37 Classification of Causes of Death 8 Clearance, Slum 44 Closing Orders 42 Clubs, Darby and Joan 30 Clubs, Luncheon 30 Committee, Public Health 1 Complaints, Food 62 Condemnation of Unsound Food 60 Conveniences, Public 34 Council Dwellings completed 47 Cream filled confectionery, Examination of 64 (ii) Page Darby Joan Clubs 30 Deaths, Classification of causes 8 Deaths, Infant 9 Deaths from Lung Cancer 9 Deaths, Maternal 9 Death Rate 7 Demolition Orders 42 Deposits, Windborne 51 Destruction of Articles 40 Discussion Groups 35 Diseases, Notifiable Infectious 11 Disinfection 40 Disinfestation 40 Disrepair Certificates 45 Drainage of Factories 55 Drainage of New Buildings 47 Drainage, Reconstruction of 47 Dwellings completed by Council 47 Dysentery, Sonne 17 Educations, Health 35 Examinations, Bacteriological 19 Examination of Cream filled Confectionery 64 Examination of Food 60 Exclusion from Work of Contacts of Infectious Disease 13 Factory Drainage 55 Factories Act, 1937 54 Fever, Typhoid 16 Film Shows 35 Food Complaints 62 Food and Drugs Act 60, 68, 71 Food and Drugs, Samples 71, 76 Food Establishments 63 Food Poisoning 16 Food Premises Inspections 59 Food Standards (Ice Cream)Order 71 Food Surrender 60 Food, Seizure of Unsound 60 Fulham Chest Clinic, Extracts from Report of 21 (iii) Page Graph, Birth and Death Rate 10 Graph, Tuberculosis Notifications and Deaths 14 Grants, Improvement 45 Groups, Discussion 35 Habitation Certificates 46 Health Education 35 Heat Treatment Regulations, Ice Cream 70 Holidays, Old Peoples' 29 Hospitals in the Borough 25 Home Bathing Service 32 Houses in Multiple Occupation 44 Housing Act, 1936 41 Housing Repairs and Rents Act, 1954 43 Ice Cream (Heat Treatment) Regulations 70 Improvement Grants 45 Infant Deaths 9 Infectious Diseases, Notifiable 11 Inoculation Certificates 20 Invalid Kitchens, Meals Service 29 Laundry, Old Peoples' 32 Laundry Service 40 Legal Proceedings 41 Legislation, New 37 Licences, Milk 69 L.C.C. Personal Health Services 26 Luncheon Clubs 30 Lung Cancer, Deaths from 9 Marriages in the Borough 7 Maternal Deaths 9 Meals on Wheels, W.V.S 29 Medical Examinations 19 Members of the Public Health Committee 1 Milk Licences 69 Milk Purveyors 66 (iv) Page Milk Regulations 68 Milk Regulations, Sale of 64 Milk Quality 66 Ministries, Circulars 37 Mortuary 33 Multiple Occupation, Houses in 44 National Assistance Act, Section 47 31 National Assistance Act, Section 50 33 National Assistance (Amendment) Act 31 New Buildings, Drainage of 47 New Legislation 37 Noise Nuisances 55 Notifiable Infectious Diseases 11 Nuisance Summonses 41 Old People's Christmas Dinner 30 Old Peoples' Holidays 29 Old Peoples' Laundry 32 Old Peoples' Welfare 29 Orders, Closing 42 Orders, Demolition 42 Outwork 56 Penny Rate, Produce of 7 Personal Health Services, L.C.C. 26 Pet Animals Act 51 Pharmacy and Poisons Act 55 Poisoning, Food 16 Pollutions Atmospheric 50 Population of the Borough 7 Public Analyst, Report of 77 Public Conveniences 34 Public Health Committee, Members of 1 Public Health Department, Staff 2 Public Health (London) Act, 1936 41 Publie Health Nuisance Summonses 41 Purveyors of Milk 66 Prevention of Damage by Pests Act 48 Properties, Survey of Unfit 43 (v) Page Quality of Milk 66 Hag Flock 56 Rate, Birth 7 Rate, Death 7 Rate, Produce of a Penny 7 Reconstruction of Drainage 47 Registered Homes 25 Registration of Purveyors of Milk 66 Regulations, Milk 68 Rehousing of Fulham Residents 46 Rent and Mortgage Interest Restrictions Act 46 Report of Chest Clinic, extracts from 21 Report of Public Analyst 77 Rodent Control 48 Sale of Milk Regulations 64 Samples of Food and Drugs 71,76 Sanitary Circumstances 38 Scabies and Allied Conditions 16 Seizure of Unsound Food 60 Sick, Chronic 31 Slaughtermen's Licences 60 Slum Clearance 44 Smallpox 16 Smoke Abatement 53 Sonne Dysentery 17 (vi) Page S.O.S. Card Scheme 32 Staff of Public Health Department 2 Statistics, Vital 7 Stillbirths 7 Summary of Works 39 Survey of Unfit Properties 43 Swimming Bath Water Samples 51 Talks 35 Typhoid Fever 16 Unsound Food, Seizure of 60 Unfit Properties, Survey of 43 Vaccination and Inoculation Certificates 20 Vital Statistics 7 W.V.S. Meals on Wheels 29 Welfare, Old People's 29 Windborne Deposits 51 Works in Default 41 Works carried out by Sanitary Inspectors 39