AC 4346 chld Ful 49 Metropolitan Borough of Fulham REPORT of the MEDICAL OFFICER OF HEALTH Including the Report of the Public Analyst for the year 1958 M. I. Adams, B.Sc., M.B., B.Ch., D.P.H. Medical Officer of Health CONTENTS Page Public Health Committee - Members 1 Public Health Department - Staff 2 Introduction 4 SECTION A General and Vital Statistics 6 SECTION B Prevalence and Control of Infectious and Other Diseases . 10 SECTION c. Personal Services 16 SECTION D Sanitary Circumstances of the Area 26 SECTION E Inspection and Supervision of Pood, including Report by Council's Public Analyst, T. McLochlan, Esq. 40 SECTION P Miscellaneous Services 60 A detailed index is given at the beginning of each Section. 1 METR0P0LITA1N BOROUGH OF FULHAM MEMBERS OF THE PUBLIC HEALTH COMMITTEE (as at December, 1958) Ex-Officio: Councillor Leonard George Penton, J. P. (Mayor) Chairman Councillor John William Perotti Vice Chairman Councillor Herbert George Rainger. Aldermen Abe James Bourne Desmore, M. A. Eric Leslie Hill Councillors Jack Herbert Clark Miss Ella Myrtle Mann Miss Phyllis May Cooper Mrs. Laura May Mills Mrs. Elizabeth Lydia Desborough Henry James Rickards Robert Halliday Gibbons Francis James Rumsey COUNCIL REPRESENTATIVES ON OUTSIDE COMMITTEES AND OTHER ORGANISATIONS CONNECTED WITH PUBLIC HEALTH WORK Accident Prevention Committee Councillors Sidney Toms, Frank Desborough, Mrs. Elizabeth Lydia Desborough, Brian John Francis Gal pin, Robert Halliday Gibbons, Alfred John Samuel Laver, and Henry James Rickards. Fulham Old People' s Welfare Committee Councillors Frank Desborough, Mrs. Rosemary Longstaff, Mrs. Laura May Mills, and Henry James Rickards. L C C Divisional Health Committee (Division 1) Alderman Mrs. Helen Maude Fournier, Councillors Miss Phyllis May Cooper and Miss Ella Myrtle Mann. London and Home Counties Clean Air Advisory Council Chairman of the Public Health Committee and The Medical Officer of Health. National Society for Clean Air: Councillors John William Perotti, Francis James Rumsey, and Mr. Frederick C. Payne, Inspector for Factories and Staoke Abatement. 2 STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December, 1958 Medical Officer of Health - Dr. Mary I. Adams. B. Sc., M. B. , B. Ch., D. P. H. Deputy Medical Officer of Health - Dr. Caroline A. Meade, M.B. , B.S. (Lond. ). D.P.H. Public Analyst - Thomas McLachlan, A.C. G.F.C.. P. R. I. C. , M.I. Biol. Administrative and Clerical Section: Chief Clerk J E. Burton, D.P1I, Second Clerk J. W. Chance. A. I. Hsg. Dip. R. I.P.H.H. Administrative Clerk B. C. Bolton Secretary to Medical Officer of Health Miss R. P. Begg, Dip. Soc. S. Clerks R A Green Miss R Reed J. R. McWhinnie Mrs, R. E. Edwards & J- Sweeney Shorthand Typists Mrs. C M Phillips Miss B. J. Clark Mrs. V J Warrier (Part-time) Assistant (Housing Acts) (Vacancy) Public Health Inspectors" Section Chief Public Health Inspector G. W Herrick. DP A (1) (2) Deputy to above and Officer-in-Charge Rodent Repression Service F E Walsh (1) (2) Senior Public Health Inspector (Special Duties) AW Gammack (1) (2) Senior Public Health Inspector (Pood and Drugs) and Sampling Officer A Clegg (1) (2) Factories and Smoke Abatement Officer PC. Payne (1) (2) (3) (4) Lady Public Health Inspector Miss E. H. Sexton. S. RN. , S. C M , H V (1) District Public Health Inspectors H. Hutchinson (1) (2) A. H. Newport (1) (2) (4) D Brisk (1) (2) R F Griffiths (1) A Grimston (1) A Bell (1) D Corfield (1) J Clayden (1) H. Batson (1) (1 Vacancy) Student Public Health Insp ectors J. Deards (2 Vacancies) Clean Air Officer B.C.Jago (1) Certificate of Royal Society of Health and Public Health Inspectors' Examination Joint Board. (2) Meat and Other Foods Certificate, Royal Society of Health. (3) Diploma of the Royal Institute of Public Health and Hygiene. (4) Smoke Certificate, Royal Society of Health. 3 DISINFECTING STAFF Superintendent R. J. Osmond One Disinfector/ Three Disinfectors One Motor Driver Motor Driver J. W. Smith L. Howes W. H. Parsons A. R. Wilson R. Crowe (Temporary) RODENT CONTROL One Foreman Operative Two Operatives: K. Sawyer G. H. Leaver V. Greenway (Temporary) PUBLIC CONVENIENCE ATTENDANTS Fifteen Male Attendants Fifteen Female Attendants G. H. Connor Mrs. M. Brewer F. W. Davis Mrs. L. Cannon A. E. Hawkins Mrs. E. R. B. Chick F. W. Hawkins Mrs. D. E. Collis R. C. Hewitt (Temporary) Mrs. K. Cook W. A. Howard Mrs. E. Crowle A. A. Hulbert Mrs. M. Cude S. W. McKenzie Mrs. E. Edwards H. C. Maggs Miss B. M. Evans S. G. Marshall Mrs. A. Larking R. J. Myles Miss V. M. Lewington J. Pollard Mrs. B. Llewellyn E. J. Tarry Miss E. 0 Hara F. J. Taylor Mrs. M. A. Richards (1 Vacancy) Mrs. A. N. Wade MORTUARY KEEPER HOME BATHING ATTENDANTS G. Churchill Mrs. M. D. Coxall Mrs. L. M. Lankester Mrs. M. M. Baines (All part-time). 4 METROPOLITAN BOROUGH OF FULHAM PUBLIC HEALTH DEPARTMENT, TOWN HALL, FULHAM, S. W. 6. May, 1959. To: The Mayor, Aldermen and Councillors of the Metropolitan Borough of Fulham Mr. Mayor, Ladles and Gentlemen, I have the honour to present to you the annual report on the health and sanitary circumstances in the Borough for the year 1958, together with the report of your Public Analyst. T. McLachlan, Esq., A.C.G.F.C., F.R.I.C., M. I. Biol. Statistics The Registrar General's estimate gives the mid-year population of the Borough as 114,700, a decrease of 1,500. This is the largest decrease of the past 10 years. In 1949, the estimated population was 124,040 - an increase of 740 over the figure for 1948. The birth rate is 15.39 - exactly the same as in 1957 and compares with a rate of 18.3 per 1,000 in 1949 ten years ago. The infant mortality rate has dropped steeply - 18. 13 in 1958 from 26.29 in 1957. This is the lowest infant mortality rate on record for the Borough and compares favourably with England and Wales (22.5). The death rate is 11.16, the figure for 1957 being 11.04. The death rate in Fulham from tubercular disease of 14.8 per 100,000 shows a fall compared with the figure of 19.8 for 1957. These figures show the steady decline which has taken place in the incidence and mortality of this disease. The same decline continues in the notification rate, which was 90.7 in 1958 and 106.7 in 1957. This shows the great improvement on ten years ago, when the figures for 1949 were: T. B. Death rate per 100.000 population, 48.4 and notification rate, per 100.000, 192.7. I regret to report one maternal death during the year. These statistics confirm that the state of good health was maintained in Fulham. From the classification of causes of death, it will be seen that all diseases of the heart account for the largest number of deaths. The second largest number is due to all forms of cancer, which show a slight rise for both males and females in lung and bronchus cancer. Bronchitis and the pneumonias account for the third largest number of deaths. Infectious Diseases The incidence of infectious diseases was low and there was no serious epidemic during the year. There were 1,030 notifications received, which was less than half the 1957 figure. This is accounted for by the fact that in 1957, the expected epidemic of measles occurred, 1,531 notifications of the disease being received. Seven confirmed cases of poliomyelitis occurred, with one death (a Scottish adult male visitor, 26 years old). There was a rise in the number of dysentery cases notified. Such a rise was experienced generally. The disease was mild in nature, with a rapid recovery. As a result of immunization and anti-biotic drugs, the clinical character 5 and course of whooping cough have been greatly modified and the incidence of the disease reduced. Housing and Slum Clearance The Rent Act has had the effect of encouraging owners to maintain their property in an improved condition and much has been done regarding the remedying of defects. The effect of this has been that properties which otherwise have been ripening for clearance and development have been improved in many instances. There are few properties of the pre-war slum standard left in Fulham and it is pleasing to report that the joint 1951/60 slum clearance programme, agreed between the London County Council and Fulham Borough Council has been completed with one exception. The future position will be carefully reviewed at the time of the joint discussions with the London County Council to formulate the 1961/65 programme. Clean Air The Council continued its policy of implementation of the Clean Air Act, especially with regard to Smoke Control Areas, in their determination to make the air of Fulham clean as quickly as possible. This subject is dealt with fully in the main report. In this connection, I would like to record the good co operation by the public in the matter of clean air - as in other public health matters - and this co-operation is facilitating the creation of smoke control areas. Food Hygiene One big food hygiene problem in the Borough is the large number of small cafes and restaurants, which have considerably increased the number of their customers. In many cases, where the accommodation was cramped or inadequate, it has required practical and thoughtful planning to get improved kitchen storage and other accommodation to meet this increase in the number of customers. Standards are improving. Proprietors, by persuasion or otherwise, are encouraged to make improvements to install up-to date equipment and to modernise their establishments. Food hygiene education is quietly and steadily continuing and is beginning to bear fruit. Much has been done but much remains to be done. Persuasion and good relationships pay. Emphasis is now on the personal hygiene of the food handler and his reactions and co-operation in carrying out the Food Hygiene Regulations. In this report I would like to record my thanks for the co-operation, kindness and help always extended to me in the service of the Borough by general practitioners, by medical colleagues in hospitals, by the London County Council Divisional Office and by all the Voluntary Associations who are doing such good work in the Borough. I should also like to extend my thanks to all members of the Council, particularly the Chairmen of the Committees with which I have served, and to the Town Clerk and other Chief Officers and colleagues for their unfailing assistance and co operation. Finally, I would like to record my thanks and appreciation to my Deputy, the Chief Public Health Inspector, the Chief Clerk, my Secretary, and to all members of the Public Health "team" for their loyalty, efficiency and consideration, which has made possible the work of the department. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, 6 Section A General and Vital Statistics Page Physical Features of Borough 7 Population and Area 7 Rateable Value and Product of Id. Rate 7 Marriages 7 Births and Stillbirths No. and Rate per 1,000 population 7 Deaths No. and Rate per 1,000 population 7 Death Rate of Infants under 1 year of age 7 Deaths, classification of causes of 8 / Deaths, Infant Table of causes of 8 Maternal Mortality 8 Deaths, Cancer Table of last 6 years 8 Birth and Death rates Graph 9 7 PHYSICAL FEATURES OF BOROUGH AND EXTRACTS FROM VITAL STATISTICS FOR THE YEAR 19 58 The Borough of Fulham lies in a loop of the River Thames which forms the whole of its southern boundary and gives Fulham a very long riverside frontage. Its other boundaries are formed by the Boroughs of Hammersmith in the west, Chelsea in the east, and the Royal Borough of Kensington in the north. It is very flat and low lying being only 12-13 ft. above sea level. The subsoil is of flood plain gravel overlying London clay 20 to 40 ft. below. Subsoil water is rarely met within 15 ft. of the ground surface. Pulham is principally a dormitory Borough with a fringe of heavy industrial undertakings on the riverside, and is well served with open spaces and parks which have been added to by post-war development. The slum clearance and redevelopment programmes are also having the dual effect of improving the standard of housing and the appearance of the Borough. Population (estimated mid 1958) 114 700 Area of Borough 1,706 acres Separate Dwellings (estimated at April 1958) 30.579 Rateable Value £1.728.382. Rate levied 17s. Od. in the £ Estimated yield £1,438.200. A Penny Rate produces approximately £7,050 per annum. No. of assessments 33,711. 830 Marriages were registered during the year. Total Males Females Rate per 1,000 Populat ion LIVE BIRTHS 1957 19 56 Legitimate Illegitimate Totals 1,620 168 1,788 800 85 885 820 83 903 13 94 1 45 15 39 13 89 1 50 15 39 STILLBIRTHS Legitimate Illegitimate Totals DEATHS 32 5 37 1, 283 18 2 20 684 14 3 17 599 0 27 0 04 0 31 11 04 0 25 0 04 0 29 11 61 DEATH RATE of Infants under one year of age All infants per 1 000 live births 26 29 18 13 Legitimate infants per 1.000 legitimate births 25 31 18 20 Illegitimate infants per 1,000 illegitimate births 35 71 17 44 8 1,332 Deaths as follows - CLASSIFICATION OF CAUSES OF DEATH Under 1 Age Groups Over 65 Total 1-5 5-15 15- 45 4 5-65 Tuberculosis Respiratory - - - 3 4 8 15 Tuberculosis, other - - - - 2 - 2 Syphilitic Disease - - - - 1 3 4 Diphtheria - - - - - - - - - Whooping Cough - - - - - - - Meningococcal Infections - - - - - - - - Acute Poliomyelitis - - - 1 - - - - - 1 Measles - - - - - - 1 Other infective and parasitic diseases - - - - - - - Cancer - - - 18 106 155 279 Diabetes - - - - - - 3 7 10 Vascular lesions of nervous system - - - 5 24 123 152 Coronary disease, angina - - - 6 73 145 224 Hypertension with heart disease - - - - - 16 16 Other heart disease - - - 5 19 123 147 Other circulatory disease - - - - 10 52 62 Influenza - - - - - - 1 1 Pneumonia - 7 - - - 10 47 65 Bronchitis 1 - - 3 28 91 124 Other diseases of respiratory system - - - - 3 10 13 Ulcer of stomach and duodenum - - - - 1 6 14 21 Gastritis, enteritis, diarrhoea - - - 1 - 3 4 Nephritis and nephrosis - - 1 3 7 12 Hyperplasia of prostate - - - - - - 9 9 Pregnancy, childbirth, abortion - - - - 1 - - 1 Congenital malformations 4 - 2 3 1 10 Other defined and ill-defined diseases 19 - - 3 24 55 102 Motor vehicle accidents - - - - 4 2 5 11 All other accidents 1 - 1 3 18 23 Suicide - - - - 9 8 4 21 Homicide and operations of war - - - - 2 - 2 Totals 32 2 3 64 334 897 1, 332 Infant Deaths CAUSES OF DEATH IN CHILDREN UNDER ONE YEAR Under 24 hrs. 1 day1 week 1-2 wk s. 2-3 wks. 3-4 wk s. TOTAL Under 4 wks. 1-3 nths. 3-6 nths. 6-9 nths. 9-12 nths. TOTAL Accidental (Fall at home) - - - - 1 1 - - - - 1 Asphyxia 1 - - - - 1 - - - - - 1 Atelectasis - 2 - - - - 2 - - - - - 2 Bronchitis - - - - - - - - 1 - - 1 Congenital Malformations - 1 - - - 2 - 2 - - 4 Haemolytic Disease 1 - - - - 1 - - - - 1 Haemorrhage _ 2 - - - - 2 - - - - 2 Pneumococcal Meningitis - - - - - - 1 - - - 1 Pneumonia - 1 - - - 1 1 3 - - 5 Prematurity 5 6 1 - 1 13 - - - - 13 Rhesus Incompatability 1 - - - - 1 - - - - 1 8 12 2 2 24 2 6 - - 32 The large number of deaths in the first month are due to prematurity. The Infant death rate was 18 13 per 1,000 live births (26 29 in 1957) There was one death in pregnancy (abortion) during the year, giving a rate of 55 per 1,000 births (live and still). DETAILS OF DEATHS FROM CANCER DURING THE LAST SIX YEARS SHOWING SITES 1953 1954 19 55 1956 1957 1958 LUNGS AND BRONCHUS - Male 43 61 59 68 61 70 Female 8 17 16 9 7 14 STOMACH - Ma 1e 25 22 22 13 6 15 F ema1e 11 12 13 13 13 18 BREAST - - - Male - - 1 - 1 - Female 22 18 21 21 13 25 UTERUS Female 10 7 13 8 13 9 OTHER SITES - - Male 84 59 65 78 61 65 Fema le 46 47 65 59 61 63 Totals 249 243 275 269 236 279 9 10 Section B Prevalence and control of Infectious and other Diseases Page Notifiable Diseases, List of 11 Puerperal Pyrexia 11 Acute Poliomyelitis 11 Pood Poisoning 11 Dysentery 12 Infectious Disease, Table of notifications 12 Tuberculosis 13 Scabies and Allied Conditions 15 Vaccination and Inoculation Certificates, Authentication of 15 Bacteriological Examinations 15 11 INFECTIOUS DISEASE The following infectious diseases are at present notifiable in Fulham Acute Encephalitis Malaria Acute Influenzal Pneumonia Measles Acute Primary Pneumonia Membranous Croup Acute Poliomyelitis Meningococcal Infection Anthrax Ophthalmia Neonatorum Cholera Plague Continued Fever Puerperal Pyrexia Diphtheria Relapsing Fever Dysentery Scabies Epidemic Diarrhoea (Under Scarlatina or Scarlet Fever 5 years of age) Smallpox Erysipelas Tuberculosis Food Poisoning Typhoid and Paratyphoid Fevers Glanders Typhus Fever Hydrophobia in Man Whooping Cough Leprosy NOTIFICATION OF INFECTIOUS DISEASE Public Health Act. 1936 - Section 144(1) "When an inmate of any building used for human habitation is suffering from every medical practitioner attending on, or called in to visit, that inmate (in this section referred to as "the patient") shall, as soon as he becomes aware that the patient is so suffering, send to the medical officer of health of the district in which the building is situate a certificate in the form set out in the second schedule to these regulations" PUERPERAL PYREXIA (Puerperal Pyrexia Regulations, 1951) Fulham residents 22 Non-Fulham residents 3 Total cases notified in Fulham 25 Fulham residents notified to other Authorities 16 Total number of Fulham cases 38 ACUTE POLIOMYELITIS (The Public Health (Acute Poliomyelitis, Acute Encephalitis and Meningococcal Infection) Regulations, 1949) Fulham residents Paralytic 5 Non paralytic 2 7 FOOD POISONING In January of this year the revised Memorandum of Food Poisoning was received and in consequence the local medical practitioners were circularised seeking their co-operation in informing the Public Health Department immediately a case of food poisoning was suspected 12 During the year eighteen single cases were notified and in ten of these the causative agent was identified as follows:- Agent Identified: No. of Cases: Salmonella Typhi-murium 7 " Newport 2 " St. Paul 1 There was no outbreak of Pood Poisoning. DYSENTERY During the year 83.4% of the total number of cases (223) were notified in the first three months. This represents an increase on the 1957 figures. The highest incidence occurred in the under 5 age groups, affecting some nursery classes in infant schools and also day nurseries. Sensitivity tests were carried out by the Pathological Laboratory and in the majority of cases the organism was found to be resistant to sulphonamides. This information was transmitted to the private practitioners and greatly aided them in prescribing treatment for their patients. The character of the illness was mild and responded quickly to treatment, the majority of cases being clear after one course of treatment. NOTIFICATIONS OF INFECTIOUS DISEASE, 1958 (In age groups) -1 1-2 3- 4 5-9 10-14 15- 24 25-44 45-64 65- Total Scarlet Fever - 2 9 29 8 3 - - - 51 Whooping Cough 9 18 4 18 1 - 1 - - 51 Acute Poliomyelitis Paralytic - 2 1 - - 1 1 - - 5 Non-Paralytic - - - 1 1 - - - - 2 Measles 10 80 133 228 4 2 5 - - 462 Diphtheria - - - - - - - - - - Acute Pneumonia - 2 3 3 4 - 9 19 18 58 Dysentery 9 43 40 58 23 10 33 7 - 223 Smallpox - - - - - - - - - - Acute Encephalitis Infective 1 - - - - 1 - - - 2 Acute Encephalitis Post Infectious - - - - - - - - - - Typhoid Fever - - - - - - - - - - Paratyphoid Fever - - - - - - - - - - Erysipelas - - - - - - 2 4 1 7 Meningococcal Infection - - - - - 1 1 - - 2 Pood Poisoning 2 3 - 2 1 5 2 2 1 18 Puerperal Pyrexia - - - - - 11 14 - - 25 Ophthalmia Neonatorum - - - - - - - - - - Epidemic Diarrhoea 6 2 1 - - - - - - 9 Scabies - 2 1 1 1 2 4 1 - 12 Tuberculosis Pulmonary 2 - 1 1 4 19 23 30 12 92 Tuberculosis Non-Pulmonary - - 1 1 - 2 3 2 2 11 39 154 194 342 47 57 98 65 34 1,030 13 TUBERCULOSIS Return for Year Ending 31st December, 1958 PULMONARY NON-PULMONARY Men Women Children* Total Men Women Children* Total Notified cases on Register at 1st January, 1958 677 507 44 1, 228 55 62 19 136 Add:- Notifications 51 35 9 95 3 6 - 9 Transfers from other areas 44 31 3 78 l 4 - 5 Children transferred to adults 8 2 - 10 l 2 - 3 Deduct:- Deaths (all causes) 22 8 - 30 - - - - Left the Borough 80 39 7 126 2 5 1 8 Recovered 10 25 5 40 2 10 2 14 Children transferred to adults - - 8 8 - - 3 3 Other reasons 5 13 1 19 3 1 - 4 Notified cases on Register at 31st December, 1958 663 490 35 1, 188 53 58 13 124 * For the purpose of this Return, children are recognised as adults upon attaining the age of 15 years. T.B. Death Rate 14 8 per 100,000 Population compared with 19.8 in 1957. The Notification Rate has decreased from 106.7 in 1957 to 90.7 in 1958. 14 15 SCABIES AND ALLIED CONDITIONS (Treatment Centre Disinfecting Station. Townmead Road) The Centre which commenced in January 1957. is open on Tuesdays and Thursdays from 1.30 to 4.30 p. m. During the time of bathing the clothing is heat treated and is ready to wear afterwards. The work of bathing the men is undertaken by the existing staff under the supervision of the Superintendent, and the bathing of women and children by a part time female bathing attendant Medical practitioners are notified after treatment has been carried out. Number of treatments carried out during the year Adults 59 Children (under 5 years) 9 Children of school age are referred to local L.C. C. School Treatment Centres. 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, whereby practitioners signatures are verified by the Medical Officer of Health, 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 practitioner. 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 which have in practice been met by persons from this country travelling abroad During the year a total of 560 certificates of vaccination and/or inoculation were authenticated 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 20 Faeces 1,742 Urines 3 Miscellaneous 5 16 Section C Personal Services Page Hospitals and Other Centres in the Borough 17 Report from the South West London Mass X-Ray Service 17 Fulham Chest Clinic - Comparative Summary of Statistics 18 L. C. C. Personal Health Services 19 Fulham District Nursing Association - Statistics 20 Fulham Old Peoples' Welfare Committee - Extracts from Annual Report 21 Bathing facilities for the Elderly 24 S. 0. S. Card Scheme 24 Old People's Laundry 24 National Assistance Acts 25 Old People, Department Records of 25 17 HOSPITALS AND OTHER CENTRES IN THE BOROUGH OF FULHAM DETAILS SUPPLIED BY COURTESY OP THE FULHAM AND KENSINGTON HOSPITAL MANAGEMENT COMMITTEE (1) Fulham Hospital St. Dunstan's Road, W. 6. A general hospital dealing with (a) Acute Medical and Surgical cases 274 beds (b) Mental Observation Unit 19 " (c) Chronic Sick 87 " Total number of staffed beds 380 plus Outpatient Department. (2) Fulham Maternity Hospital 5-7, Parsons Green, S. W. 6. Number of staffed beds - 30. (3) Western Hospital Seagrave Road, S. W. 6. An infectious disease hospital. General infectious disease 94 beds Poliomyelitis unit 40 " T.B. 58 " Rehabilitation unit (female) 17 " Total number of staffed beds 209 In addition the Royal Marsden Hospital have a unit based at this hospital consisting of 44 beds. (4) Fulham Chest Clinic Western Hospital, Seagrave Road, S. W. 6. Various types of clinic sessions held for the out patient treatment of tuberculosis and other chest conditions. (5) Hurlingham Lodge Hurlingham Road, S. W. 6. London County Council Hostel for homeless infective tuberculous men. 28 beds. (6) There is one Home registered by the London County Council in the Borough - 94, Sedlescombe Road, S. W. 6. which is a private home for blind men and women (6 residents). REPORT FROM THE SOUTH WEST LONDON MASS X-RAY SERVICE SUPPLIED BY COURTESY OP DR. F. A. NASH, MEDICAL DIRECTOR The South West London Mass X Ray Service continued throughout 1958 to hold regular sessions at The Central Mass X-Ray Centre, Western Hospital, Seagrave Road, Fulham. Public sessions are held weekly on Wednesday afternoons and evenings, and these are open without appointment to members of the public, patients referred by general practitioners, contacts, and employees of local firms and organisations. The total number x-rayed at this Centre in 1958 was 12,476, and of the total examined 5,451 were doctors patients. 18 In addition to the x-ray examinations carried out at The Western Hospital, the mobile unit visited four firms as a result of which a further 1,290 x-ray examinations were made. All firms in Fulham have been asked to encourage their male employees to use the six-monthly chest x-ray service for men over 45. This was started in South London in December, in an attempt to afford some protection against the hazards of lung cancer which is causing an increasing number of deaths, particularly in that age group. FULHAM CHEST CLINIC - COMPARATIVE SUMMARY OF STATISTICS SUPPLIED BY COURTESY OF DR. H. C. PRICE - CHEST PHYSICIAN Number of new patients attending 1958 1957 * Non Tuberculous Cases 175 (231) Contacts 177 (221) Transfer-In Notifications 83 ( 52) Others (Notified) by other units in area 14 ( 11) 449 (515) Number of New Notifications by Fulham Chest Clinic (Of this figure, 8 were referred by the M.R.U.) 38 ( 54) Number of Clinic Attendances Notified Cases 2,207 (2,624) Contacts 2,842 (2,424) * Non Tuberculous 1,187 (1,660) ø Refills - ( 263) 6,236 (6,971) Attendances at Laboratory for Investigation (These returns are now made through the hospital) - ( 912) Total number of Notifications in Fulham Borough Pulmonary 95 ( 116) Non-Pulmonary 9 ( 8) Number of Deaths Pulmonary 30 ( 36) Non-Pulmonary - ( 2) Number taken off Register as Cured, 1958 Pulmonary 40 ( 41) Non-Pulmonary 14 ( 9) Number of visits by Chest Physician 113 ( 105) Number of visits by Health Visitors 3,537 (6,330) Number of X-rays taken 5,788 (5,477) Number of Patients undergoing treatment at home 8 ( 8) Number of B.C. G Vaccinations 136 ( 192) Number of Notified Cases on Register at 31.12.58 1,312 (1,364) * Patients attending Bronchitis Trials are included in these figures, ø Refill Sessions have now ceased. 19 NEW NOTIFICATIONS FOR 1958 IN AGE GROUPS Males Females Under 1 _ 2 1 — 5 _ 2 6 — 15 3 3 16 — 25 10 13 26 — 35 10 5 36 — 45 5 7 46 — 55 12 8 56—65 7 3 Over 65 9 5 56 48 TOTAL - 104 LONDON COUNTY COUNCIL - PERSONAL HEALTH SERVICES INFORMATION SUPPLIED BY COURTESY OP DR. B. E. A. SHARPE, L.C.C. DIVISIONAL M. O. Ante- nat al clinics Number of women who attended during the year 866 Maternal Deaths Number 1 Infant Welfare Centres Children aged 0-1 year 1st attendances 1,601 subsequent attendances 16,735 Total attendances 18,336 " " 1-2 years "" 2,822 " " 2-5 " " " 1.135 Special Toddlers Sessions " " 1,001 Health Visitors Number of infants under 1 year of age visited for the first time 1,795 Total visits to infants under 1 year 9,507 Total visits to children 1-5 years of age 13,313 Number of expectant mothers visited for the first time 1,049 Total visits to expectant mothers 2,060 Infant Life Protection Number of foster mothers at 3rd January, 1959 55 Number of foster children at 3rd January. 1959 71 Child Minders (Daily Guardians) Number of daily guardians minding children (voluntary) 53 Number of children minded 63 Care of Premature Infants Number of Premature births during the year 126 Number of deaths under 1 month 22 Immunisation and Vaccination Number of children immunised in L. C C. clinics during the year 3,600 Number of children immunised by general practitioners 212 Number of children receiving boosting injections 1,269 Number of children vaccinated in L. C, C clinics during the year 2,072 20 Home Help Service Number of cases attended during the year Maternity (MAT) 11 Tuberculous (TB) 34 Chronic sick (including aged and infirm) (CSAI) 936 Others 169 Day Nurseries Eridge House, Fulham Park Rd. Mulgrave, Mulgrave Rd. Grove House, Bagley's Lane. CLINIC SERVICES Type of Clinic 5/7 Parsons Green 170 Wandsworth Bridge Road 90/92 Greyhound Road 62/63 Burne Jones House Ante-Natal and PostNatal Wed. a.m. Fri. a.m. Wed. p.m. Mon. Thurs. p.m. Wed. p.m. Artificial Sunlight, simple massage and Exercises Mon. Tues. Wed. Thurs. & Fri. a.m. Thurs. p.m. Child Welfare Fri, a.m. Tues. a. m. Wed. a, m. Thur. a. m. Mon. & Wed. p.m. Tues, p. m. Mon, p. m. Mon. p.m. Fri. p.m. Thur. p.m. Dental Wed. & Fri. a.m. Mon. Wed. & Fri. p.m. Family Planning Thurs. a. m. Tues. p. m. Mothercraft Tues. p.m. Toddlers Thur. a. m. (Alternate) Tues. p.m. Vaccination Thur. a.m. Wed. a. m. Immunisation Thur. p.m. Tues. a. m. FULHAM DISTRICT NURSING ASSOCIATION Nurses' Work 1957 1958 Cases nursed 2,230 2, 189 Visits to patients 57, 449 56,714 Visits to patients over 65 years 41,206 42,816 New Cases 1957 1958 Sent by Doctor 1,596 1,516 Sent by Hospital 556 592 Sent by T.B. Clinic 52 32 Sent by L. C. C. 1 3 Sent by B. R. C. 1 2 Sent by Public Health Department 4 12 Direct approach 20 30 Sent by Rabbi - 2 2,230 2,189 21 Results 1957 1958 Cured 1,241 1,204 Died 129 143 Sent to Hospital 422 409 Transferred to other areas 6 21 Remaining on Books 432 412 2,230 2, 189 Diseases Nursed 1957 1958 Cases Visits Cases Visits Medical 1,735 41,081 1,698 41,059 Surgical 267 11,849 298 11,815 Infectious Diseases 4 13 8 39 T. B. Medical and Surgical 82 3,720 58 3,049 Maternal complications 18 152 23 190 Under 5 years 108 642 84 527 Various 16 42 20 35 2,230 57,499 2,189 56,714 The following figures show the steady increase in the number of visits paid to old people over 65 years of age:- 1954 .. 33,919 1955 .. 35,898 1956 .. 39,223 1957 .. 41,206 1958 .. 42,816 EXTRACTS FROM THE ANNUAL REPORT OF THE FULHAM OLD PEOPLE' S WELFARE COMMITTEE KINDLY SUPPLIED BY C. F. THATCHER, ESQ., LLB. , HONORARY SECRETARY OP THE COMMITTEE Meals on Wheels and Luncheon Clubs The number of hot mid-day meals supplied by this service for the period January to December, 1958 was as follows: - Meals on Wheels 8,188 Luncheon Clubs - "Brunswick" (Red Cross) 5,153 "Coronation" (W. V. S.) 2,932 "Shamrock" (W. V. S.) 2,705 Total 18,978 The delivery of the meals to both housebound old people and luncheon clubs was undertaken by the W.V.S. and the lunches were supplied by the South London Catering Company for 1s. 9d. each, the old people paying 10d. and the London County Council 10d. 22 The remaining 1d. per meal plus the cost of transport were borne by the Committee out of the borough council's grant. So far as the Meals on Wheels service is concerned, there is regular contact with hospitals, doctors and local organisations, statutory and voluntary, in an endeavour to satisfy the needs of old people who, through infirmity or illness, find difficulty in providing themselves with a hot meal at a price they can afford. Difficulty has again been experienced by the W.V.S. in recruiting voluntary help for the delivery service. There is an obvious need to increase the number of dinners supplied under the Meals on Wheels service and it is a great pity that in spite of appeals made from time to time more volunteers do not come forward to lend a hand in this vital service. Invalid Meals The Invalid Meals for London continues its delivery of meals to pensioners needing special diets. The service operates on five days a week and whilst not exclusively for elderly persons pensioners form a large proportion of the recipients. The meals are prepared at the Munster Road Kitchen and are delivered only to those who qualify for them by reason of their physical condition which has to be supported by a medical certificate. The charge made varies according to circumstances, the minimum charge for each meal being 1s. 4d. Chiropody For some years the Committee has financed a scheme to provide chiropody treatment for elderly persons and at the present time clinics are held on the premises of the British Red Cross Society and Bishop Creighton House, as follows - British Red Cross Society, 52 New King's Road, S.W.6. Day Time Chiropodist Tuesdays 9 a.m. - 1 p.m. Miss Hardman " 2 p.m. - 4 p.m. Mrs. Taylor Bishop Creighton House 378, Lillie Road, S.W.6. Day Time Chiropodist Tuesdays 10.30 a. m. - 12.30 p.m. Mrs. Taylor 1.30 p. m. - 5.30 p. m. Miss Hardman The number of treatments for the period 1st January, 1958 to 31st December, 1958, were as under: - British Red Cross Society 530 Bishop Creighton House 473 At the time of issue of this report, the Minister of Health has authorised that he is now prepared to approve proposals by local health authorities to provide or extend chiropody services under Section 28(1) of the National Health Service Act, 1946. This announcement is widely welcomed by old people's organisations throughout the country who have for some time brought pressure to bear on the Ministry to sanction expenditure by local health authorities themselves on this important service. The effect of this measure will be that as far as London is concerned the London County Council will in future be responsible for the provision of chiropody and the Minister's approval will be no longer required to contributions by health authorities to the funds of voluntary organisations providing this service. No doubt the London County Council will survey the position in London and make 23 proposals for the whole of their area. Whilst existing services run by voluntary organisations will become the responsibility of the County Council, the Minister has suggested that health authorities may decide that a continuation of the voluntary clinics with appropriate financial assistance might be the most acceptable way of meeting the needs of old people for some time to come. Social Clubs Old People's Clubs in the Borough now number 11, 6 of which are run by the W. V.S., 2 by Bishop Creighton House and the remainder by other local voluntary organisations. All the clubs receive some measure of financial assistance from the Council towards their expenses in providing recreation. Their weekly meetings continue to be well attended and apart from the companionship which the meetings in themselves offer, there are always interesting activities for the members to look forward to in the way of outings, parties and Christmas celebrations. One W. V. S. Club which started a Choir last year gained first place in a choir competition organised as part of the Bethnal Green Festival of Art, and were proud to receive a silver cup as prize. Throughout the year nearly all the clubs were visited by the Mayor and Mayoress (Alderman and Mrs. L. G. Fenton) who took a keen interest in their activities. Holiday Scheme Now in its tenth year this scheme is as popular as ever in offering a good cheap holiday to those over 60 years of age. The number of pensioners who participated in the early and late summer schemes and the charges therefor are shown below:- Charge for Return Number who Accommodation per week Fare Participated September, 1958 £3 13s. 6d. 15s. 79 May/June, 1959 £3 17s. 6d. 15s. 114 The holiday party, despite the holiday period chosen, which incidentally enables them to enjoy much reduced charges, are rarely disappointed with the weather and the September period was no exception. The Committee co-operates closely with the Broadstairs Urban District Council in the allocation of suitable holiday accommodation at boarding houses and the party enjoys several concessions such as free use of deck chairs, reduced rates of admission to entertainments, etc. One great advantage of this scheme is that the pensioners are taken direct to and from their holiday addresses by coach and receive assistance if required by voluntary escorts. Christmas Activities The ninth successive Christmas Dinner and Party was provided for 150 lonely pensioners who were guests of the Mayor and Mayoress (Alderman and Mrs. L. G. Penton) on Boxing Day. The expenses of the party, which amounted to approximately £80 were borne by the Mayor out of his Charity Fund. The names of the guests were selected from those submitted by 16 local organisations. With the aid of a grant from the Mayor, the Committee this year was able to extend its scheme for issuing parcels to housebound old people in the Borough and a total of 170 was delivered a few days before Christmas by a local scout group. Here again the names of those who received parcels were selected from those recommended by local organisations including churches. The Committee's thanks were expressed to the many helpers who gave up some of their Christmas holiday to enable these activities to be carried out successfully. 24 BATHING FACILITIES FOR THE ELDERLY Public Baths Old people may obtain without charge, a hot bath at the Fulham Baths on Tuesdays and Wednesdays between 10 a. m. and 12 noon, and 2 p. m. and 4 p. m. I am informed by the Baths' Superintendent, Mr. R. C. Gerred, M.N.A.B.S. , M.I. Mar. E. that 30-40 persons a week take advantage of these facilities. Home Bathing This service was commenced in April, 1954. It has proved immensely popular and not unduly costly. 1958 Number of baths given 2, 165 Number of persons receiving baths at end of year 90 Number of persons on waiting list at end of year 10 At the moment there are 3 female attendants engaged on this work paid on a sessional basis. It is hoped to increase the number of baths given as soon as additional suitable staff to carry out the duties can be found. 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 108 Total cards issued during 1958 7 OLD PEOPLE'S LAUNDRY (Section 122 of the Public Health (London) Act, 1936) Service for Incontinent Persons A scheme under the provisions of this Section to cleanse the linen and bedding of aged, infirm and incontinent persons was commenced in March 1952, and is proving of real benefit. The work is carried out at the Disinfecting Station where modern equipment is enabling the staff to deal quickly and efficiently with the work. By arrangement with Chelsea Borough Council the laundry of their old people is dealt with at the Station. The following 16,804 articles of Fulham residents were cleansed during the year:- Sheets 4,472 Pillow Cases 1,867 Towels 2,433 Underwear 5,449 Mattress Covers 341 "Pieces" 1,966 Blankets 276 25 NATIONAL ASSISTANCE ACT, 19 48, SECTION 47 NATIONAL ASSISTANCE (AMENDMENT) ACT, 19 51 Visiting of old people whose circumstances require assessment under the above Acts is carried out by the Public Health Department. There was one compulsory removal to a hospital under the Amendment Act during 1958. The Order was made for three weeks, the maximum permissible time under this Act. Brief details of this case, which is very typical, are as follows:- Mrs A.B. aged 90 The circumstances were referred by the patient's panel doctor. The husband, aged 82, had suffered two cerebral seizures and was unable to give the necessary care and attention. The patient was suffering from haemorrhages and refused to go to hospital when the ambulance, arranged by her doctor, arrived. She was therefore removed under the Amendment Act on the 28th March and died on the 12th April. She was an accomplished musician, a member of a gifted musical family and had given musical tuition in her earlier days to members of the Royal Family. A long and interesting tribute to her appeared in the obituary column of "The Times" Department Records of Old People 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 primary visits for investigation in 1958 256 New cases recorded for supervision in 1958 136 Number of deaths recorded in 1958 60 Number of old people admitted to Hospitals, Homes and Institutions permanently 66 Re-visits 911 Total number of cases under supervision at end of year 443 Total number of cases recorded in Department 1.260 Number of cases referred to other Authorities and Organisations, or miscellaneous 25 Number left District 8 Hospital Liaison Visits 110 26 Section D Sanitary Circumstances of the Area Page Public Health Inspectors, Visits by 27 Summary of Works carried out under Supervision of Public Health Inspectors 27 Hairdressers and Barbers - Registration 28 Disinfection, Disinfestation and Laundry Services 28 Legal Proceedings 29 Land Charges 29 Works in Default 29 Housing Act, 1957 - Demolition and Closing Orders 30 Improvement Grants - Housing Act, 1949 30 Slum Clearance Programmes 1951-60 30 Rent Act, 1957 31 Habitation Certificates 32 Rehousing of Fulham Residents 32 Dwellings completed by Council 32 Drainage of new buildings and reconstruction of drainage 32 Rodent Control 33 The measurement of Air Pollution 34 Clean Air Act, 1956 35 Inter Boroughs Smoke Control Liaison Committee 38 Factories Act, 1937 39 27 SANITARY CIRCUMSTANCES OF THE AREA There were four vacancies in the establishment for public health inspectors at the start of the year. During 1958 two inspectors left the service of the Council but, fortunately, during the later months five were appointed, including three who qualified under the Council's own pupil training scheme - a good performance. At the end of the year, therefore, house-to-house inspections were resumed. Visits by Public Health Inspectors Inspections after complaint 1,962 Re-inspections 6,983 Inspections after Infectious Disease 75 Re-inspections after Infectious Disease 13 Drains tested 121 Drains inspected 965 Intimation notices served 1,278 Statutory notices served 563 Intimation notices complied with 1,040 Statutory notices complied with 568 House-to House Inspections 74 Re-inspections 175 Intimation notices served 23 Intimation notices complied with 46 Housing enquiries 99 Underground rooms 255 Owners, builders, etc. 768 Voluntary work 645 Certificates of Disrepair 675 Lighting of Common Staircases 112 Miscellaneous Visits 81 Ineffectual Visits 2,911 Clearance Areas 19 Hairdressing Establishments 44 Vermin (Re-housing Cases) 217 SUMMARY OF WORKS CARRIED OUT UNDER SUPERVISION OF PUBLIC HEALTH INSPECTORS Fresh Air Inlets 48 Soil and Vent Pipes repaired or renewed 28 Drains cleared 124 Drains repaired 67 Drains relaid 49 Rainwater gutters and pipes repaired or renewed 131 Traps cleansed, repaired etc. 6 Pans renewed 65 Seats repaired or renewed 20 Flushing cisterns repaired or renewed 66 Fastenings provided to doors, and doors repaired 14 Sinks provided, repaired or renewed 42 Sink and bath wastes repaired or renewed 60 New baths fitted 10 Drinking water cisterns cleansed etc. 12 Water supply pipes and fittings repaired 43 C/f. 785 28 B/f. 785 Internal house repairs 1,342 Fireplaces repaired (nuisances from smoke etc.) 76 Kitchen ranges repaired or renewed (for cooking purposes) 13 Washing coppers repaired or renewed 4 Dampness remedied 697 Rooms provided with adequate light and ventilation 5 Staircases provided with light and ventilation and repaired 23 Ventilation provided under floors and repairs 98 Roofs repaired 469 Other external repairs 249 Accumulations of refuse removed 34 Dustbins 142 Yards, forecourts paved and drained 31 3,968 HAIRDRESSERS AND BARBERS LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1954 - SECTION 18 Operating from January 1st, 1957, hairdressers and barbers, and the premises in which they carry out their business, have required registration by the Council, Byelaws made by the Council to secure the cleanliness of premises, persons engaged and the instruments, towels, materials and equipment used, came into force on March 1st, 1957. Contraventions of the Act and Byelaws can attract substantial penalties, and the Court, in lieu of or in addition to imposing a fine, can order the suspension or the cancellation of the registration. There are 89 registered hairdressing establishments in the borough. Co operation in effecting improvements where found necessary was forthcoming and no recourse to the Court was necessary DISINFECTION, DISINFESTATION AND LAUNDRY SERVICES PUBLIC HEALTH (LONDON) ACT, 1936 The following details relate to the services provided by the Disinfecting Superintendent and his staff during 1958- Number of rooms disinfected after Infectious Disease 111 Number of articles stoved 8,828 Number of rooms disinfested 480 Number of wards and rooms disinfected in Maternity Hospital 109 Laundry carried out for the Dust Destructor staff :- Roller Towels 60 Dust Coats 52 Bath Towels 1,241 Boiler suits 10 Hand Towels 4 The disinfecting staff have also dealt with many kinds of infestation such as cockroaches, beetles, ants, silver fish, moths etc. 29 List of verminous and stained articles destroyed during 1958:- Bedsteads and Bedsprings 10 Mattresses 35 Beds 6 Bolsters 4 Pillows 22 Sheets 16 Blankets 14 Eiderdowns 2 Furniture 23 Cushions 7 Clothing 29 Rags and Pieces 8 176 LEGAL PROCEEDINGS During the year 53 summonses were heard at the Park Petty Sessional Division in respect of outstanding nuisances under the Public Health (London) Act, 1936. The cases were dealt with as follows:- No. of Orders made No. of cases where daily penalties were awarded No. of cases withdrawn or adjourned sine die Public Health (London) Act, 1936 (9 cases) 2 42 In six of these cases costs of £2 2s. 0d. and in one case costs of £1 1s. 0d. were awarded. LAND CHARGES ACT, 1925 Enquiries as to any outstanding sanitary or other notices, and orders of charges were dealt with in respect of 3,727 premises. In 42 cases notices were outstanding at the time of search, and these were declared accordingly. WORKS IN DEFAULT Public Health (London) Act, 1936 During 1958 the Council's contractors carried out works in default at 24 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 £1 5s 0d to £57 0s. 0d., the total sum involved being £286 5s 10d. 30 HOUSING ACT, 19 57 DEMOLITION AND CLOSING ORDERS No demolition orders were made during the year. Eleven closing orders were made in respect of parts of buildings as follows - Premises Part closed Date of Order 12B, Castletown Road Basement Back Room 30. 4. 1958 16, North End Road Front & Back Basement Rooms 18. 6. 1958 12, North End Road Two Basement Rooms 24. 9. 1958 14. North Bid Road Two Basement Rooms 24. 9.1958 20, North Bid Road Two Basement Rooms 24. 9.1958 22, North End Road Two Basement Rooms 24. 9. 1958 24, North End Road Two Basement Rooms 24. 9.1958 26, North End Road Two Basement Rooms 24 9.1958 28, North End Road Two Basement Rooms 24 9.1958 668, Fulham Road All Basement Rooms 24. 9 1958 22, Greyhound Road Front Basement Room 22. 10,1958 IMPROVEMENT GRANTS (HOUSING ACT, 1949 - Section 20 as amended by Section 16 of the Housing Repairs and Rents Act, 1954) I am indebted to the Borough Architect and Director of Housing, Mr J, Pritchard Lovell, F R, I B A, F. I. Arb , P P I. Hsg., for the following figures- 1957 1958 Number of applications received 7 25 Number referred to Public Health Department for comment 11 23 Number of Grants approved 10 21 The increase in the number of applications compared with last year would appear to be due to the publicity given to the conversions by the Council of properties in Cedarne Road This has had the effect of encouraging owners of property to take advantage of the facilities available under the Act. SLUM CLEARANCE PROGRAMMES 1951 60 During the year the London County Council took the following steps under the Housing Act, 1957 to implement the Slum Clearance Programmes already agreed with the Borough Council The L C C. (Michael Road, Fulham) Order, 1957 Under this Order, confirmed by the Minister of Housing and Local Government during 1958, 6 premises were placed in the clearance area category, one further premises being added in order that the site would be properly redeveloped. The L C C (King's Road, Fulham) Order, 1957 Under this Order, confirmed by the Minister of Housing and Local Government during 1958, 5 premises were placed in the clearance area category. 31 The L,C,C, (Dawes Road, Fulham) Order, 1958 Under this Order, confirmed by the Minister of Housing and Local Government, 6 premises were placed in the clearance area category. The L.C»C. (Cumberland Crescent, Fulham) Order, 1958 This Order, comprising 24 premises in Cumberland Crescent and Gorleston Street, mentioned in my last report, was submitted to the Minister of Housing and Local Government during this year and his decision was being awaited at the end of the year, The L C Co (Pearscroft Road, Fulham) Order, 1958 Under this Order, mentioned in my last report, 51 premises in Pearscroft Road and Sandilands Road were placed in the clearance area category, a further 46 premises being added in order that the site could be properly redeveloped. The Order was submitted to the Minister of Housing and Local Government during this year and his decision was being awaited at the end of the year RENT ACT, 1957 The administration regarding questions of certificates of disrepair under this Act continued to work smoothly. Hie examination of documents and giving of advice was undertaken in the Town Clerk' s department, whilst inspections, preparations of forms and correspondence made necessary were carried out by the Public Health department staff. When visiting premises it was often found that nuisances under the Public Health (London) Act existed, sometimes, but by no means always included in the tenant's notice (Form G). Independent statutory action was taken in these cases to secure abatement of the nuisances. During the year no certificate of disrepair issued by the Council was challenged by any owner or occupier in the County Court. Judging by the very few cases brought to the Council's attention, landlord's undertakings to carry out their tenants' requests were usually honoured For the record, there are still 103 certificates issued under the Housing Repairs and Rents Act, 1954 uncancelled. Details of action taken between 1st January and 31st December, 1958, are as follows- Applications for certificates 224 Decisions not to issue certificates 4 Decisions to issue certificates 220 (a) in respect of some but not all defects 150 (b) in respect of all defects 70 Undertakings given by landlords 127 Undertakings refused by Council 1 Certificates issued 96 Applications by landlords to Council for cancellation of certificates 89 Objections by tenants to cancellation of certificates 39 Council decisions to cancel in spite of tenants' objections 16 Certificates cancelled 66 32 HABITATION CERTIFICATES UNDER SECTION 95(2) OF THE PUBLIC HEALTH (LONDON) ACT, 1936 During the year 4 certificates were issued in respect of 85 newly erected dwellings in the Borough, REHOUSING OF FULHAM RESIDENTS The situation in relation to the rehousing of Fulham residents remains substantially the same as last year, with priority being given to families displaced from slum clearance and compulsory purchase areas. No of families rehoused tay London County Council 269 ,, ,, ,, ,, Fulham Borough Council 134 403 DWELLINGS COMPLETED BY THE COUNCIL, between 1st January and 31st December, 1958 Information supplied by the courtesy of the Borough Architect and Director of Housing, Estate and Block No. Date Completed Number of Duellings No. of rooms Total Rooms 1 2 3 4 5 6 Clem Attlee Court 'K' 20. 1. 58 9 2 - 7 . . _ 23 Clem Attlee Court 'K' 7. 2. 58 40 19 - 21 - - - 82 Robert Owen House Extension 16.8,58 12 6 6 - - - - 18 61 27 6 28 - - - 123 DRAINAGE OF NEW BUILDINGS and RECONSTRUCTION OF DRAINAGE Addition to existing buildings or additional sanitary accommodation 47 Reconstruction of drainage system 2 Conversion of premises into flats 12 New buildings 17 33 RODENT CONTROL 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 Total Local Authority Dwelling Houses Business & Industrial Premises 1. No. of complaints received - 615 88 703 2. No. of properties inspected - 786 185 971 3. No. of properties found to be infested by rats: Major - - - - Minor - 373 26 399 4, No. of properties found to be infested by mice - 242 56 298 5. No. of properties treated (a) rats - 373 26 399 (b) mice - 242 56 298 6. No. of notices served under Section 4 (a) Treatment - - - - (b) Structural works, i.e. Proofing - - 1 1 No. of notices served under Public Health (London) Act, 1936 - - - - 7. No. of visits made by Rodent Operatives - 6,149 659 6,808 The number of complaints received was 112 less than last year. A high percentage of rat infestations were found, upon investigation, to be due to either defects in house drainage or defective outlet drains between interceptor and sewers. 34 Two treatments of the sewers were carried out during the year on lines agreed with the Infestation Division of the Ministry of Agriculture, Fisheries and Food The results once again demonstrated that six-monthly treatments merely hold the rat population of the sewers in check and that to make any marked reduction, more frequent treatments are necessary (three, or possibly, four a year) using new poisons as they become available. In a closely built-up area such as Fulham, the source of practically all infestations by rats is from the resident population of the sewers, and any reduction in this source should result in a reduction in surface infestation. Mice infestations were found to be mostly of a minor character and in some cases are recurrent. MEASUREMENT OF AIR POLLUTION TABLE OF RESULTS OF RECORDINGS AND ANALYSES Month Site Rainfall (in inches) Insoluble Deposit Soluble Deposit Total Solids Mg. of SO3/Day collected by 100 sq. cm. of Batch "A" Lead Peroxide (Tons per Sq. Mile) January Shell Wharf 1.22 28.32 12.31 40.63 3. 74 Manbre & Garton 1. 81 191.6 12.77 204.4 - Queens Club 1.06 3.96 5. 17 9. 13 2.31 Fulham Baths - - - - 3.68 February Shell Wharf 1.94 41.31 18.60 59.91 3.54 Manbre & Garton 2. 09 139.89 11.89 151. 78 - Queens Club - - - - 2.30 Fulham Baths - - - - 3.37 March Shell Wharf 0.71 14.79 9. 18 23.97 3.20 Manbre & Garton 0.83 69.95 7.97 77.92 Queens Club 0. 99 3. 14 4. 40 7.54 1.48 Fulham Baths - - - - 3. 83 April Shell wharf 1.26 13.77 13 60 27. 37 2.66 Manbre & Garton 1. 50 3.92 8.35 12.27 . Queens Club 1.50 4.14 6.97 11.11 Fulham Baths - - - - 3.01 May Siell Wharf 2.29 38.90 19.04 57. 94 1.94 Manbre & Garton 2.21 63.86 5. 17 69.03 Qieens Club 2.56 8. 50 9. 17 17. 67 . Fulham Baths - - - - 2. 04 June Shell Wharf 4. 53 11.05 16.46 27. 51 1. 49 Manbre & Garton 4. 30 69.61 13.31 82. 92 - Queens club 3 51 16.01 7. 24 23 25 . Fulham Baths - - - - 1,85 35 Month Site Rainfall (in inches) Insoluble Depos i t Solubl e Deposit Total Solids Mg. of SO Day collected by 100 sq. cm. of Batch "4" Lead Peroxide (Tons per Sq. Mile) July Shell Wharf 1.62 18. 53 16.49 35.02 1.34 Manbre & Garton 1. 14 3.72 7.74 11.46 - *Queens Club 2.17 7.47 5.34 12.81 0.76 Fulham Baths - - - - 1.70 August Shell Wharf 2.60 26.01 18.02 44.03 1.50 Manbre & Garton 1.50 69.95 14.19 84.14 - *Fulham Cemetery 3.35 4.34 8.30 12.64 0.78 Fulham Baths - - - - 1.62 September Shell Wharf 2.32 17.34 13.16 30.50 1.91 Manbre & Garton 2.13 18.08 8.24 26.32 - Fulham Cemetery 3.39 5.74 5.27 11.01 - Fulham Baths - - - - 2.58 October Shell Wharf 3.66 19.55 17.14 36.69 2.50 Manbre & Garton 3.19 116.24 30.54 146.78 - Fulham Cemetery 3.43 3.60 7.30 10 90 1, 04 Fulham Baths - - - - 2. 04 November Shell Wharf 0.35 5.78 6.29 12.07 3.41 Manbre & Garton 0.32 3.51 3.85 7.37 - Fulham Cemetery 0.55 4.07 5.54 9.60 2.64 Fulham Baths - - - 3.20 December Shell Wharf 2.29 21.08 15.37 36.45 - Manbre & Garton 1.62 3.58 7.57 11.15 - Fulham Cemetery 2. 68 8.17 8.34 16.51 2.41 Fulham Baths - - - - 2. 22 ** Changed to oil heating. * A siting change was made on August 1st as there had been damage to the instruments by vandals at the Queens Club Grounds. CLEAN AIR ACT, 1956 In my last report the main purposes of this Act were outlined followed by a statement giving the steps taken to implement those provisions which came into effect on the 31st December, 1956 The Clean Air Act, 1956 (Appointed Day) Order, 1958, brought the remaining provisions of the Act into operation on 1st June„ 1958, on which date too, the Dark Smoke (Permitted Periods) Regulations, 1958 became effective These Regulations were the subject of a letter sent to all factory managements likely to be affected. This communication was supplemented by visits by the Council's Smoke Abatement Officer and a special meeting at the Town Hall under the Chairmanship of Councillor J. W. Perotti (Chairman, Public Health Committee) attended by directors, managers and engineers of firms having large boiler installations. A plea for full co operation in reducing industrial smoke emissions to a minimum was made by the Council's Officers, supported by representatives of the Ministry of Power, the National Industrial Fuel Efficiency Service and the National Coal Board. Advice was given on problems likely to arise, and the need and opportunities for training of boiler attendants was fully discussed 36 Generally, there has been a striking improvement on the industrial side since the appointed day, though spasmodic cases have occurred requiring investigations and verbal warnings. The troubles were usually found to be caused by dirty oil burners or unsatisfactory fuel supplies. In one case of the latter happening a site conference convened by the Smoke Abatement Officer of representatives of the firm concerned, the National Coal Board and the coal distributor, resulted in more suitable fuel being made available and subsequent cessation of offences. Regular observations on industrial chimney shafts are kept where necessary, using either micro Ringelmann charts or the new Department of Scientific and Industrial Research "telesmoke" instrument. Cases arising of nuisance from smoke from rubbish burning in the open in factory yards etc., have resulted in immediate remedial action on request. One serious case of nuisance from dust over the area surrounding an asphalt works resulted, after much negotiation, in improvements in plant and techniques being effected Another complaint from a number of residents referred to yellow staining of laundry, alleged to be due to nearby industrial emissions Numerous test sheets were put out for periods in the area, but analyses were not possible owing to the paucity of the deposits obtained There has been a change over from coal to oil in connection with several boiler installations providing central heating to blocks of flats and in consequence a considerable drop in smoke emissions from these sources. The ready co operation of Industrialists was received in all cases SMOKE CONTROL AREAS The year was one of much activity in pursuance of the Council's policy to make the whole of Fulham a Snoke Control Area in ten years. THE FULHAM BOROUGH COUNCIL (NO 1) SMOKE CONTROL ORDER Operative date 1st October, 1958 Confirmation of the Council' s first Smoke Control Order was received from the Ministry of Housing and Local Government on the 13th March and householders were immediately notified of the action to take to obtain grant aid towards the cost of conversion or adaptation of their fireplaces. Estate Agents, coal merchants and local builders were also advised and their attention drawn to particular aspects of the Order with which they were most concerned. Inevitably there were teething troubles and problems to be solved but a good working system has been evolved for fulfilling grant requirements, One of the greatest problems arising is to induce the public to submit their proposals at an early date and not to leave them until just before the Smoke Control Order becomes operative The following graph on page 37 shows the rate of applications for the first area:- 37 38 The best solution to this problem would appear to be to allow a longer period between the date of confirmation of the Order and its date of operation, This has been achieved in the second Smoke Control Area Late Applications: The Council decided to serve notices specifying the required adaptations on all householders whose applications were received after the 1st October to enable them to receive the normal grants and the Council to reclaim its proportion from the Ministry. Open-fire gas coke is the only fuel in ample supply and is quite satisfactory when used on a suitable type grate in the correct way. Excellent co operation has been received from the Chairman of the Society of Coal Merchants' Local Clean Air Committee. THE PULHAM BOROUGH COUNCIL (NO. 2) SMOKE CONTROL ORDER Operative date 1st October, 1959 The preliminary survey of this area (25 per cent) was finished in April and the final survey (96 per cent) in October, a Smoke Control Order being made at the Council meeting on the 22nd October The Order covers an area of approximately 160 acres and extends from the north edge of the first area to the Borough boundary covering the district known as West Kensington The principal details of the area are:- Industrial premises 51 Commercial premises 248 Dwellings .. 5,520 Other premises 7 No exemptions were sought and the Minister was asked to confirm the Order to become operative on the 1st October. 1959 Publicity: Mobile exhibition units of the North Thames Gas Board, the Solid Smokeless Fuels" Federation and the London Electricity Board toured No 1 area and a loud speaker van was used to draw residents attention to the units. The Coal Utilisation Council had a demonstration hut in May Street which was open on Wednesday and Saturday afternoons. Foyer displays were used at the Public Baths, Town Hall and the two cinemas in the Borough, and one cinema also showed a slide The local press were given many articles and the confirmation of the Order was announced on the B B C. Television and Radio Regional News programmes A reminder notice was distributed to all householders in July, asking them to submit their proposals as soon as possible The Council and its officers were invited to take part in the creation of a film 'The Air We Breathe® being made for the Gas Council by the Realist Film Corporation Ltd Scenes were taken at a Council meeting showing Councillors making a Smoke Control Order, of office routine and of householders in their homes discussing their problems with an Enquiry Officer and the Clean Air Officer. Every effort will be made to continue to keep the public advised of the Council's plans and the reasons for the creation of Smoke Control Areas Unless the willing co operation of the public is obtained the Clean Air Act will fail in one of its major objects viz., to prohibit the use of bituminous coal in domestic premises WEST LONDON INTER BOROUGHS SMOKE CONTROL LIAISON COMMITTEE This Committee, which has both Councillors and Officers was formed to exchange information and keep Boroughs informed of action taken to enable Smoke Control Areas to be planned to the best advantage. Prior to the formation of the Committee Medical Officers of Health of the surrounding Boroughs of Hammersmith, Kensington, Chelsea and Wandsworth had been notified by letter of the progress made in creating Smoke Control Areas in Fulham 39 FACTORIES ACT, 19 37 - PART I SECTION 8 Premises Inspections Factories without mechanical power (initial visits) 79 Factories with mechanical power (initial visits) 69 Other premises under the Act (building operations and works of engineering construction) „ Number of re-inspections of all factories 1,132 Total 1,380 No. of cases in which defects were found: Particulars Found Remedied Want of cleanliness 25 25 Inadequate ventilation 11 11 Inadequate lighting 10 10 Ineffective drainage of floors 12 12 Sanitary Conveniences' (a) Insufficient 6 6 (b) Unsuitable or defective 41 41 (c) Not separate for the sexes - - Total 105 105 No prosecutions were instituted under the Factories Act, 1937, during 1958 Factory Drainage: Number of drains inspected 56 Number of existing drains tested 17 Number of new drains water tested 14 Number of drains cleared 16 Number of sinks renewed 38 FACTORIES ACT, 19 37 - PART VIII SECTION 110 OUTWORK Nature of Work No, of Outworkers on List Boot 1 Wearing Apparel 54 Leatherwork 2 Upholstery 3 Toy making 10 Lamp shades 15 Fancy Goods 12 Paper Bags 1 Button Carding 4 Mi 11inery 7 Artificial Jewellery 6 Total 115 190 visits were made to Outworkers during the year. Noise Nuisances: Number of complaints received 5 Number of complaints remedied 2 Number of re-inspections made 39 CLEAN AIR ACT, 1956. Publicity for Smoke Control Areas. Portable Foyer Display. CLEAN AIR ACT, 1956—Smoke Control Areas. Some typical fireplace conversions. Open fire with gas ignition fitted in place of stool bottom grate. Open fire with gas ignition and new 6-piece brick set fitted in cast iron register grate. Fire opening filled in and convector type gas fire fitted. "FRIENDS OF FULHAM HOSPITAL" CARNIVAL Prize winning FOOD HYGIENE Float Sides of float covered by enlargements of Ministry of Health Posters. Photographs on cab and vehicle show street market scenes. Actors, left to right : The prisoner Hands ; judge, prosecuting counsel and policeman. STREET TRADING When store yards are not used, it's handy to let vegetables stay on the ground. Constant traffic keeps dust and dirt on the move. 40 Section E Inspection and Supervision of Food Page Food, Examination 41 Food, Voluntary surrender 41 Food, Complaints from General Public 41 Milk 42 Ice Cream (Heat Treatment) Regulations 44 Food Standards (Ice Cream) Order 45 Sampling, Food and Drugs 45 Adulterations and Irregularities 46 Cream Confectionery, Bacteriological Examination .. 50 Food Establishments, Inspection 51 Food Hygiene Regulations 1955 52 Report of the Council's Public Analyst Thomas A. McLachlan 52 41 INSPECTION AND SUPERVISION OF FOOD There are no offensive trades, slaughterhouses or licensed slaughtermen in the Borough. 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 Analyst, 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. 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 from 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 public health 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. During 1958, 909 Certificates of Condemnation were issued by the public health inspectors relating to the undermentioned voluntarily surrendered foods - Tinned Packeted and Bottled Pood 8,848 items Cereals 1 cwt. Milk Powder 12 tons Sugar 11 lbs. Pish Paste 72 lbs. Potatoes 224 lbs. Sauerkraut 112 lbs. Chicken .. 134 lbs. Salt 10 lbs. Fruit 1 ton 3 cwts. Pish 50 stone Meat 817 lbs. Ox Kidneys 468 lbs. Offal 365 lbs. COMPLAINTS During the year under review, 17 complaints were received from members of the public regarding food. Each complaint was fully investigated and the following are details of the action taken. 42 No. Nature of Complaint Action taken 1 Foreign matter in bottle of milk. Letter to Producers. 2 Mouldy jam sandwich. Prosecution Park Petty Sessions 20.5 58 Absolute discharge. Two guineas costs. 3 Mouldy jam roll. Letter to Producer. 4 Drawing pin in lunch. Letter to Retailer. 5 Chocolate contained grub. Letter to Producer. 6 Insect in cereal. No action. Source of supply not proved. 7 Foreign matter (tooth or pebble) in loaf. No action. Stone from dried fruit. 8 Foreign matter (string) in bread. Letter to Producer. 9 Mouldy cake. Letter to Retailer and Producer. 10 Coffee sponge cake substance green. Cake not unfit. Circumstances investigated with Producer. 11 Peculiar flavour of pint of milk. Letter to Producer/Retailer. 12 Foreign matter (bandage) in bread loaf. Prosecution 17. 3, 59. Park Petty Sessions. Penalty £2 0s, 0d. and costs £2 2s 0d. 13 Lemon squash with funny taste. No action. Contents satisfactory. 14 Metal in pork pie. Letter to Producer. 15 Mineral water with paraffin taste. Letter to Producer. 16 Foreign matter (milk bottle top) in bottle of milk. Letter to Producer/Retailers. 17 Foreign matter (insect) in biscuits. Interviewed Retailer. Sale of Milk Regulations, 1939 The above Regulations state that where a sample of milk contains less than 3% of milk fat and less than 8.5% of solids not fat, until the contrary is proved the sample shall be deemed to be not genuine. The following table sets out the monthly statement of the number of samples taken, together with the fatty and non-fatty solids contents. 43 Month No, of Samples Fat Average % Non-fatty solids January 4 3.72 8. 72 February 15 3.54 8. 65 March 9 3.51 8.61 April 11 3.41 8. 53 May 15 3.47 8. 64 June 12 3.36 8. 65 July 18 3.61 8. 68 August 10 3.55 8.60 September 14 3.65 8. 68 October 11 3.72 8.67 November 16 3.85 8.74 December 8 3.79 8. 63 Monthly Average 3.60 8.65 In the early part of the year there was a deficiency in the amount of solids not - fat present in a high proportion of samples taken from a local producer retailer. Attendance at the point of production, coupled with process sampling during treatment, and greater care on the part of those concerned in the handling of the milk, resulted in a return to normal standards. Milk and Dairies (Channel Islands and South Devon Milk) Regulations 1956 These Regulations prohibit the sale for human consumption of milk described as "Channel Islands" or "Jersey" or "Guernsey" or "South Devon" if it contains less than 4% milk fat. The following table shows the details of samples taken. No. of samples Average % Pat Non fatty solids 16 4.43 8.38 In no case did a sample fall below the minimum of 4% milk fat. Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations 1949 1953 Milk (Special Designation) (Raw Milk) Regulations 1949 1954 The following table gives details of samples taken under these Regulations:- Grade of Milk No. of Samples tested Phosphatase test Methylene test Turbidity test Passed Failed Passed Failed Void Passed Failed Pasteurised 82 82 - 82 - - - - Tuberculin Tested (Pasteurised) 28 28 - 28 - - - - Sterilised 19 - - - - - 19 - 44 The following are details of licences granted for the year 1958:- Number of licences to retail Tuberculin Tested Milk 84 Number of supplementary licences to retail Tuberculin Tested Milk 11 Number of licences to Pasteurise milk 1 Number of licences to retail Pasteurised milk 121 Number of supplementary licences to retail Pasteurised milk 11 Number of licences to retail Sterilised milk 127 Number of supplementary licences to retail Sterilised milk 10 Registration of Purveyors of Milk The arrangement whereby milk was sold from retail shops continued and there were on the register at the end of the year 127 number of premises so engaged. Number of Inspections of milk shops 110 Number of Inspections of Dairies 97 Ice Cream (Heat Treatment) Regulations 1947 1952 These Regulations control the preparation and subsequent treatment of ice cream. Ice Cream must be kept at a temperature of not more than 28°F. and should the temperature rise above 28°F. the ice cream must be subject to further heat treatment and kept at a temperature not exceeding 28°F. The Methylene Blue Test is recommended as a guide for ascertaining the bacteriological cleanliness of ice-cream, the time taken to decolourise Methylene blue being recorded and the samples graded as follows:- Provisional Grade Time taken to reduce Methylene Blue 1 2 3 4 4½ hours or more 2½ to 4 hours ½ to 2 hours Less than & hour During 1958. 35 samples of ice cream were examined with the following results:- Grade Wrapped Bulk Supply Total 1 23 10 33 2 - 1 1 3 - 1 1 4 - - - 23 12 11 In addition to the above 25 ice lollies were examined all of which satisfied the requirements of Grade 1. A noticeable feature of the sale of ice cream today compared with only 5 or 6 years ago is the decreasing use of the gallon can for supply purposes, and the increasingly widespread sale of the pre-wrapped bar or block. Even cafes and restaurants are showing a growing tendency to substitute the sale of wrapped blocks for the supply from the hand server. From the view point of control of cleanliness this is an encouraging movement. The other item calling for comment is the wide acceptance of the ice lolly as a refreshment by all ages of the population. The sales and variety of choice increase each year. 45 The Food Standards (Ice Cream) Order, 1953 This Order lays down the following standards for Ice Cream:- Fat 5% Sugar 10% Milk solids other than fat 7.5% During 1958, 28 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% - 5½ - 7½ 9 7½% - 10% 11 Over 10% 8 The average fat content of all samples was 8.50%, Food and Drugs Sampling During the year 800 samples of food and drugs were purchased by the Sampling Officer and submitted to the Public Analyst for chemical analysis. The Public Analyst commented adversely on 75 or 9.3% of the samples examined. Legal proceedings were instituted in respect of one sample only. (1) Section 2 Bread loaf (Sample No. 1498) contaminated by vegetable oil. Absolute discharge. Defendant to pay 2 guineas costs. The following case was also taken (2) Section 2 - Sandwich cake contained mould. Absolute discharge. Defendant to pay 2 guineas costs. In last year's report reference was made to special sampling being undertaken of canned meat and sausage rolls. The details are set out below. Australian Canned Meats Commodity No. of samples Suggested standard for total meat No. reaching standard No. below standard Stewed Steak 8 95% 5 3 Stewed Steak in Gravy 3 75% - 3 Casserole Steak 8 75% 1 7 Beef Steak with Gravy 5 75% - 5 Total 24 6 18 The following table shows the same samples when compared with the Australian Export Regulations where applicable- Commodity No, of samples Australian Reg. Standard No. reaching standard No. below standard Stewed Steak in Gravy 3 65% 2 1 Beef Steak with Gravy 5 65% 1 4 Total 8 3 5 46 There are no Export Regulations in Australia in respect of stewed steak or casserole steak. 8 samples of canned meat from other sources were obtained with the following results:- Commodity No. of samples Suggested total meat standard No. reaching standard No. below standard English Other English Other English Other Stewed Steak 2 5 95% 1 2 1 3 Stewed Steak with Gravy 2 — 75% 1 — 1 — Casserole Steak 1 — 75% 1 — — — Total 5 5 3 2 2 3 Further consideration was being given to the position at the end of the year. Sausage Rolls: A statistical table of samples and costs follows: - Number of samples obtained 50 % 100 Number where filling less than ⅓rd weight of roll 12 24 Number where meat content of filling less than ½ 19 38 Number where meat in roll less than 20% (This figure comprised 1 below 10% and 24 between 10% and 20%) 25 50 Number where meat in roll more than 20% (This figure comprised 23 between 20% and 30% and 2 over 30%) 25 50 Number where meat in roll more than 15% but less than 20% 18 36 " " " " " " '' 20% " " '' 25% 16 32 Total '' '' '' '' '' '' 15% '' '' '' 25% 34 68 Costs Number of samples @ 3d. 7 ,, ,, ,, @ 3½d. 9 ,, ,, ,, @ 4d. 20 ,, ,, ,, @ 4½d. 10 ,, ,, ,, @ 5d. 2 ,, ,, ,, @ 5½d. 2 _50 ADULTERATIONS AND IRREGULARITIES Article Result of Analysis Action taken or recommended Christmas Puddings (Nos. 1540, 1552, 1564) No. 1540 contained 43.8% sugar as sucrose and 5.5% fat. No. 1552 contained 44.3% sugar as sucrose and 7.3% fat. No. 1564 contained 44.6% sugar as sucrose and 6.4% fat. Public Analyst of opinion fat content should not fall below 7.5% Letters to producers. 47 Article Result of Analysis Action taken or recommended Stewed Beef Steak (No. 1569) Contained 85% total meat. Public Analyst of opinion meat content should be not less than 95% Letter to producers. Marzipan (No. 1590) Contained ground almonds 12%, sucrose 78.5% other constituents 9.5% Public Analyst of opinion ground almond content should be 25% Letter to Manufacturer/ retailer. Sugar Confectionery (Cream Milk) (No, 1614) Boiled sweet containing 0.13% of fat. 0.122% protein and flavoured with imitatation butter milk flavouring. Public Analyst of opinion that title "Cream Milk" is misleading. Produce of Holland. Letter to producers. Pork Sausage (Nos, 1576, 1624) No, 1576 Total meat content 59% No. 1624 Total meat content 61% Public Analyst of opinion meat content should be not less than 65% Letter to producer/ retailer after result of No. 1576, was followed by a visit and discussion after result of No, 1624 Subsequent sample (No. 1670) reported by Public Analyst to contain 65% total meat. Beef Steak with Gravy (Nos. 1625 1667) No. 1625. Total meat 60% No, 1667 Total meat 70% Public Analyst of opinion this commodity should contain not less than 75% total meat. Australian products. For subsequent reference to Senior Trade Commissioner. Sausage Rolls (Nos. 1666 1668, 1669) No. 1666 Total meat 18.8% No. 1668 Total meat 16.9% No. 1669 Total meat 17.1% Public Analyst of opinion meat content should be not less than 20% Letters to three producers concerned. Apples (Nos. 1672, 1673, 1675, 1676, 1690, 1691, 1692, 1693, 1695, Contaminated by arsenic and lead in amounts varying between 0.3 and 7.0 p.p.m. arsenic, and between 2.0 and 14.0 p.p.m. lead. Food Standards Committee's Reports suggest maximum content of 1 p.p.m. arsenic and 2 p.p.m. lead. Product of Lebanon, Apples cleansed locally. Irish Stew (No. 1708) Inferior. Contained 16.3% loose fat in a solid block at top of can. Total meat content 36% No action. Total meat content satisfactory. Stewed Steak with Gravy (No. 1698) Casserole Beef Steak (No. 1733) No. 1698 69% total meat. No. 1733 65% total meat. Public Analyst of opinion each of these products should contain not less than 75% total meat. Australian produce for subsequent reference to Senior Trade Commissioner Milk (Nos. 1722 1748 1751) No 1722-Fat 3.48% Solids-not-fat 8.42% No 1748-Fat 3.30% Solids-not-fat 8.39% No 1751-Fat 3.40% Solids-not-fat 8.49% Sale of Milk Regulations require Fat 3.0% Solids not fat 8.50%. Small deficiencies. Letter to producer concerned. 48 Article Result of Analysis Action taken or recommended Sausage Rolls (No. 1752) Contained total meat percentage of 12.8Public Analyst of opinion meat percentage should reach 20. Letter to producer/ retailer. Earlier sample (No. 1551) had meat content of 15. 1%. Sunny Spread (No. 1756) Satisfactory. but Public Analyst of opinion wording on label liable to mislead. Letter to producers who agreed to amend. Sausage Rolls (Nos. 1764, 1765) No. 1764-18.6% total meat. No. 1765-17.7% total meat. Public Analyst of opinion meat content should be at least 20% Further sample of No. 1764 to be obtained. Letter to producer/ retailer of No. 1765. Stewed Steak (No, 1776) Contained 59% total meat. Public Analyst of opinion meat content should be not less than 75% Australian produce for subsequent reference to Senior Trade Commissioner. Mint Sauce (No. 1777) Sweetened with saccharin. Public Analyst of opinion mint sauce must be sweetened with sugar. No action. Glace Cherries (No. 1781) Contained 54 p. p.m. S.O2 undeclared. S.O2 content must be declared. Letter to producers. Buttered Cheese Spread (No. 1811) Contained 30.1% fat equivalent to 20.6% fat in original cheese a comparatively low figure. No action. Pickled Red Cabbage (No. 1814) Acidity not high but contents insipid soft and inferior. Letter to producers. Milk (Nos. 1844, 1845, 1858, 1869, 1870) No. 1844-Fat 3.49% Solids-not-fat 8.46% No. 1845-Fat 3.39% Solids-not-fat 8.44% No. 1858-Fat 3.34% Solids-not-fat 8.36% No. 1870 Fat 3.36% Solids-not-fat 8.36% Sale of Milk Regulations require Fat 3.0% Solids not-fat 8.50% With exception of Sample No. 1858 these are re curring slight deficien cies from one producer. Investigations taking place at plant. Letter to second producer concerned. Minced Beef (canned) (No. 1766) Labelled as "Minced Beef" without qualification. Contains total meat 89% "Minced Beef" without qualification means that it contains no added water and should there fore contain at least 95% meat. Letter to producers. Dried Apricots (No. 1877) Contained 2,600 p.p.m. sulphur dioxide. Limit under Preservatives etc. in Food Regulations is 2,000 p.p.m. Thorough aeration before sale should evaporate excess. Letter to retailer. Casserole Steak (No. 1883) Total meat 66% Public Analyst of opinion meat content should be not less than 75%. Australian produce. For subsequent reference to Senior Trade Commissioner. Sausage Rolls (No. 1884) Meat content 15.2% Public Analyst of opinion meat content should be not less than 20% Letter to producer/ retailer. 49 Article Result of Analysis Action taken or recommended Fish Paste (Nos. 1893, 1894) No, 1893 contained tin 89 p.p.m.-fairly Satisfactory. Inferior sample. No. 1894 contained tin 645 p.p.m.-very excessive. Adulterated sample. Result reported to retailer. Stock surrendered. Cheese (No. 1922) Minute crystals of tyrosine present. Harmless constituent of protein but should not be present in properly matured cheese. No action. Coffee (No. 1942) Supplied in bags labelled "TEA". Letter to retailers. Glucose Drink (No. 1943) Label describes as "Sweetened Mineral Water". Sample contains 596 p.p.m. benzoic acid. Mineral water may not contain more than 120 p.p. m. benzoic acid. Letter to producers. Sausage Rolls (No. 2035) Total meat 16.7% Public Analyst of opinion meat content should be not less than 20% Letter to producer/ retailer Stewed Steak (No, 2036) Total meat 88% Filler 1% Added Water 11%. Public Analyst of opinion Stewed Steak should contain 95% meat. No action at present. Condensed Sweetened Skimmed Milk (No. 2053) Contained lumps of discoloured matter and taste unpleasant Retailer withdrew remaining stock. Casserole Steak (Nos. 2071, 2094) Total meat No, 2071 65%. No. 2094 56% Public Analyst of opinion Casserole Steak should contain not less than 75% meat. Produce of Australia. For reference to Senior Trade Commissioner. Marzipan (No. 2072) Artificial dye not disclosed on label. Letter to producers. Glucose Tablets (No. 2121) Minor error in declaration of ingredients. Letter to manufacturers. Processed Peas (canned) (Nos. 2130, 2131, 2132) Lactobacillic fermentation. Consignment of peas surrendered. Irish Stew (No. 2145) Total meat content 24% Public Analyst of opinion this percentage is low. No action. Casserole Steak (Nos, 2167, 2190 2202) No. 2167 Total meat 68%. No. 2190 '' " 61% No. 2202 " " 57%. Public Analyst of opinion meat content should be not less than 75% Australian produce. For reference to Senior Trade Commissioner. Beef Steak and Gravy (No. 2205) Total meat 64% Public Analyst of opinion meat content should be not less than 75% Australian produce. For reference to Senior Trade Commissioner. Coffee Gateau (No 2171) Green discolouration of cake substance due to alkaline reaction on other constituents. Circumstances investigated in collaboration with baker and adjoining Local Authority. Canned Salmon (No. 2201) Rancid taste due to salmon not having been properly cleaned. Letter to producers. 50 Article Result of Analysis Action taken or recommended Bread Loaf (No. 2246) Contained pieces of bandage. Legal proceedings instituted. Producer fined £2 and £2 2s. 0d. costs. Mincemeat (No. 2252) Slightly inferior-contained 64% solids. Further sample pur chased. See No. 2342 Celery Salt (No. 2318) Contained 30% celery seed-normal con tent 3% Inferior. No action. Stewed Steak with Gravy (No. 2324) Contained total meat 71% Public Analyst of opinion meat content should be not less than 75% British produce. No action at present. Mincemeat (No. 2342) Slightly inferior. Contained 63% solids. Pood Standards (Preserves) Order, 1953 requires percentage of solids to be not less than 65% Follow up of sample No. 2252 which contained 64% solids. Letter to producers. Crab Spread (No. 2344) Contained added salt which should be de clared on label. Letter to producers. Roll and Butter (No. 2362) Roll was spread with margarine. Legal proceedings instituted. Defendant fined £1. Cream Soda (No 2376) The contents of the bottle possessed an odour-taste of petroleum. Letter to producers. Minced Steak (No. 2392) Contained 100 p.p.m. S.02. Preservatives are forbidden in this commodity (Public Health (Preservatives etc, in Food) Regulations, 1925) Letter to producer/ retailer. BACTERIOLOGICAL EXAMINATION OF CREAM CONFECTIONERY Because of the excellent medium for the transmission of illness which cream filled confectionery forms a constant check is kept on the cleanliness of the filler. Samples are taken at bakeries before the filler is placed into the confection, and also at retail bakers' premises. When faecal coliform bacilli or staph, aureus are found, an immediate return visit is made, circumstances checked and follow-up samples obtained. During the year 180 samples were taken, three being found to be clear of staph, aureus and B. Coli. Non-faecal coliforms were present in 177 of these samples but this year no sample was found to contain the faecal type. The following table shows the full results:- Free from B. Col i and Staph. 3 B. Coli (non faecal) present 177 B. Coli (faecal) present Nil Staph. aureus positive 10 Staph. aureus negative 170 51 FOOD ESTABLISHMENTS Regular inspections were carried out during the year. In no case was it found necessary to institute legal proceedings. Type of Business No. of premises No. of Inspections Bakehouses (non-basement) 28) Bakehouses (basement) 9) Bread and Cake shops 11 66 Butchers' shops 73 269 Confectionery 76 64 Cooked Meat shops 14 31 Milk Pasteurising Establishments 1) Bottled Milk Depots 2) 194 Milk shops 127) Eel and Pie shops 3 3 Pood Factories 6 32 Fishmongers shops 28 80 Fried Fish shops 31 76 General Food shops 228 613 Greengrocers and Fruiterers 118 140 Horseflesh butchers 3 7 Ice Cream (Manufacturers and Dealers) 193 248 Licensed Premises 105 71 Restaurants and Dining rooms 142 482 Stalls 100 953 Stallholders' Storage premises 44 25 . Other Pood Premises 12 258 1,354 3,665 Details of the more important improvements which have been effected in food premises during the year are given below:- Wash hand basxns 20 Water heaters 22 New sinks provided 21 New W. C.'s provided 6 W.C.'s repaired and cleansed 14 Kitchens, preparation rooms etc. redecorated 79 Floors renewed or repaired 13 Shops fronts repaired or redecorated 21 New dustbins 28 Counter cases for the protection of food 11 Improvements to ventilation 4 Counter refrigerators 8 Gas stoves repaired or renewed 7 New refrigerators 8 New counters 7 Yards cleaned and repaired 18 Refuse removed 13 First Aid Kits provided 17 Renewal of work benches 4 Clothes Stores provided 4 Under the provisions of Section 16 of the Food and Drugs Act, 1955, parts of premises used for the preparation of certain specified articles of food must be registered with the local authority. 52 Following the re-inspection and registration of premises under Section 16 of the Food and Drugs Act, 1955, the number on register at the end of the year were as follows:- Premises registered for preparation of preserved food 77 Premises registered for manufacture, storage and ice cream 3 Premises registered for storage and sale of ice cream 190 FOOD HYGIENE REGULATIONS 1955 "You can lead a horse to the water but you cannot make him drink". So runs the adage. And you can provide all the facilities for the maintenance of high standards of hygiene in foodshops, and they may still remain unappreciated by some members of the staff. More and more shops during the year were transformed from sometimes forbidding appearance to havens of bright lights, cleanly fixtures and attractive displays, many changing from the service-by-assistant to self service at the same time. The cleanliness and smartness of the staff can harmonise with the new surroundings, but it is distressing when they do not. Is anything more unfortunate that to enter such a shop and be assisted by someone whose apparel is out of tune with the cleanly shelves and bright displays, or whose hair hangs in a limp mass on to the shoulders, or whose hands and finger nails indicate that use is not being made of the hot water, soap and nail brushes provided? Once more, the proprietor, or the manager of food premises (and usually one or two senior members of the staff in the latter case) seem to be the ones who are willing to make the Regulations work and consciously take pride in the manner in which they handle foodstuffs. They are often assisted by others whose interest does not extend beyond the rate-for-the-job and the ensuing wage packet, and it is amongst this type of person where continuous education is most necessary and most difficult. The case was never stronger for the inclusion in the curriculum of those in their last year at school, for instruction in food handling, and how loss and waste can be avoided by care and cleanliness. The tendency noted last year for members of the public to voice their feelings where food was being unsatisfactorily handled, or cleanliness was of a low order continued, and this is greatly welcomed by public health department officers. During the year, the first prosecution in Fulham for smoking in a foodshop was taken when a local trader was charged in respect of two incidents. He was fined 5s. on each charge. REPORT OF THE COUNCIL ANALYST THOMAS McLACHLAN, A C.G F.C., F R. I.C., M. I. Biol. During the year 1958, 800 samples of food and drugs were examined. Of these 218 were taken formally and 582 informally. The number adulterated or about which some comment was made was 75. The incidence of complaint may be classified as follows'- 53  Number of samples examined Number of samples adulterated, etc. Milk 165 9 Other foods 620 65 Drugs 15 1 Seven samples of milk contained less than 8.5 per cent. of milk solids not fat. They contained 8.36, 8.36, 8.36, 8.39, 8.42, 8.44 and 8.46 per cent. respectively. These were reported as adulterated, and another sample containing 8.49 per cent. was reported as inferior. A further sample was found to be contaminated with detergent from the washing machine. Some sweetened condensed skimmed milk contained lumps of browny coloured matter, and the milk had an unpleasant taste. No mould or yeasts could be detected in the lumps. It was presumably old stock. A sample of boiled sweets labelled "Cream Milk" contained only 0.13 per cent. of fat and 0.122 per cent. of protein, and were flavoured with imitation buttermilk flavour. The description "Cream" milk was therefore misleading, A sliced white loaf contained pieces of an adhesive medicated bandage. A sample purchased as a roll and butter was found to be spread with margarine instead of butter. Some crystals found in a sample of cheese consisted of "tyrosine". Tyrosine crystals are frequently found in meat and fish products and are quite harmless, but their presence is seldom reported in cheese. A Buttered Cheese Spread contained 30.1% of fat, and assuming that it contained 15 per cent. of added butter, the original cheese spread could have contained only 20.6 per cent. of fat. The labelling of a sample of "Crab Spread with Butter" was interesting. The spread contained butter as stated, but also contained added salt. If it were sold simply as a crab paste or spread it would be exempt from a declaration of the constituents, but as it was called a Spread with butter your analyst feels that the ingredients should be declared. The Pood Manufacturers Federation are not in agreement with this view, although they agree that whilst corned beef would be exempt from a disclosure of ingredients, corned beef with cereal would not be so exempt. The product itself was entirely satisfactory. The label of a spread made with invert sugar was also considered to be misleading. The label stated "As with many choice honeys, "Spread" is subject to "Frosting" which affects appearance but it is a natural condition''. The average housewife would tend to read this as meaning "as with many other choice honeys". The Food and Drugs Act states that a label may be held to be misleading notwithstanding that it contains a true statement of fact. Several samples of apples contained excess lead or arsenic, but it was considered that if they were washed or wiped before sale they would be satisfactory. Eight samples of Sausage Rolls contained less than 20 per cent. meat which is the quantity public analysts believe should be present. They contained 12.8, 15.2, 16.7, 16.9, 17.1, 17.7, 18.6 and 18.8 per cent. of meat respectively. As a result of representations the meat content of sausage rolls sold in Fulham is being increased. Two samples of Mincemeat contained respectively 63 and 64 per cent. of soluble solids instead of the 65 per cent. required by the Food Standards Preserves Order. Seven samples of Casserole Steak contained less than 75 per cent. of meat, namely 56, 57, 61, 65, 66, and 68 per cent. Seven samples of Stewed Steak with Gravy similarly contained only 59, 60, 64, 64, 69, 70 and 71 per cent, of meat. Casserole Steak and Stewed Steak with Gravy must contain not less than 75 per cent. of meat. 54 A sample of Stewed Steak contained flour and other ingredients One would not expect to find flour in Stewed Steak, and the total meat content was 88 per cent. Stewed Steak should contain not less than 95 per cent of meat. An Irish Stew contained 24 per cent of total meat whereas a reasonable standard was considered to be 35 per cent Another sample contained 36 per cent of meat, but was reported as inferior because of the presence of 16.3 per cent of loose fat, which, of course has to be calculated as part of the meat content. A tin of Minced Beef contained 89 per cent of meat, and 10 per cent. added water. If labelled "Minced Beef" without qualification it must contain no added water and the meat content should be at least 95 per cent. Some fresh minced steak contained 120 parts per million of sulphur dioxide The Preservatives etc in Food Regulations prohibit the addition of any preservative in meat products, but recently your analyst has examined a large number of samples of minced beef containing sulphur dioxide It acts not only as a preservative against bacteria, it gives the meat a very fresh colour. A sample of Pork Sausages contained only 61 per cent. of meat and were therefore 6.5 per cent. deficient. A can of salmon consisted of small pieces of genuine salmon, but these possessed a rancid taste due probably to the fish not having been properly cleaned before it was canned The label carried an illustration of a prime cutlet of salmon. Two tins of Brisling Paste were examined on account of a complaint One of these contained 645 parts of tin per million of paste and was badly sprung, the other contained only 89 parts of tin and was fairly, but not entirely satisfactory, The whole of this stock was condemned. A sample of Advocaat contained only 26.5 per cent. of proof spirit instead of 30 per cent. A bottle of Cream Soda possessed an odour and taste of petroleum due to the bottle having been improperly used for petrol or paraffin, and, although it had been washed the rinsing had been insufficient to remove the last traces of petrol. A "still" Orange drink appeared to be slightly carbonated, and on pouring into a container there was a definite evolution of carbon dioxide. Many soft drinks manufacturers are at present putting up mildly carbonated drinks as "still" drinks, but this is not a correct description. A sample of Glucose Drink contained 596 parts per million of benzoic acid Since it would appear to be a sweetened mineral water rather than a Non alcoholic Wine, Cordial, or Fruit Juice it must not contain more than 120 parts per million of benzoic acid. Some Celery Salt consisted of 30 per cent. celery seed and was reported as inferior Celery salt normally contains about 3 per cent. of celery seed, but, of course, it will be appreciated that the cost of celery seed is much greater than that of salt. Some Coffee submitted for examination was contained in a packet labelled "tea". This is a contravention of the Labelling of Food Order The contents of four cans of processed peas were decomposed due to improper processing and the consequent growth of bacteria. • A sample of Marzipan was stated on the label to have been prepared from sugar, almonds glucose and flavouring whereas it had been artificially coloured by the addition of a dye. 55 Some Glace Cherries contained 54 parts per million of Sulphur dioxide which is permitted, but it was not declared on the label. According to the Labelling of Pood Order the presence of sulphur dioxide must be declared, but most manufacturers overlook this point. Some dried apricots contained 2,600 parts per million of sulphur dioxide, whereas the limit permitted by the Preservatives Regulations is 2,000. A sample of Pickled Red Cabbage was reported as inferior on account of the very acid, but insipid taste. The cabbage itself was soft, although the acidity was only 1. 91 per cent. as acetic acid. Some mint sauce possessed a satisfactory flavour, but had been prepared with saccharin instead of sugar. A coffee sponge cake was submitted for examination because it possessed a green colour. This was thought to be due to the use of an alkaline baking powderAlkaline baking powders frequently cause discolouration of coffee cakes. There was a minor error in the labelling of some Glucose Tablets inasmuch as fruit acid was disclosed as an ingredient. The name of the acid must be disclosed. New Legislation The year 1958 probably witnessed less fresh legislation for food and drug administration than any year since the outbreak of the 1939 war. It would appear that the Minister of Agriculture, Fisheries and Pood has more to think about than he can manage at the present time and since there is almost invariably a tremendous amount of controversy about any fresh legislation, the Minister probably feels that the safest policy is to do little. The Public Health (Preservatives etc. in Food) Regulations The most important changes affected the Preservatives Regulations The Public Health (Preservatives etc in Food) (Amendment) Regulations, 1958, and The Public Health (Preservatives etc. in Food) (Amendment No. 2) Regulations, 1958 permit the treatment of certain fruit with anti-mould agents Fruit has for long caused trouble owing to its perishable nature and consequent attack by moulds between collection and consumption With greater dependence on foreign imports and with the food laws of other countries permitting what are considered to be harmless quantities of preservatives on the skins of fruits this country has been more or less forced to come into line As a result the fruits named below may now contain the following added preservatives:- Citrus fruits, Diphenyl not more than 100 parts per million. or Orthopheny1phenol not more than 70 parts per million or proportionate quantities of the two together Orthopheny1phenol in Apples, Pears, and Pineapples, not more than 10 parts per million, Peaches, not more than 20 parts per million, Melons, not more than 125 parts per million, and foods made with any of these fruits may contain proportionate quantities of these permitted preservatives, except that foods containing melon may not contain more than 10 parts of orthopheny1phenol for every million parts of melon in the food. It is difficult to understand why melons are permitted to be treated with 125 parts per million of orthopheny1phenol. The skin of melons, like that of the related squash families, is hard, and therefore more resistant to attack than that of many other 56 fruits, but the melon is a very juicy fruit and many consumers of melon are apt to spoon up the juice from their plates, thereby consuming a large proportion of the preservative, It does not seem to have been realised, moreover, that the area of the skin of a fruit is proportional to the square of the radius, whereas the weight, or volume is more or less proportional to the cube of the radius, so that the larger the fruit the less should be the quantity of preservative in parts per million required to cover the area of the skin. The Antioxidant, in Food Regulations, 1958 These regulations provide for the sale and importation of certain foods, which contain propyl, octyl, and dodecyl gallates, butylated hydroxyanisole and butylated hydroxytoluene within certain limits. Essentially these regulations permit the addition of these compounds to anhydrous edible oils and fats, to vitamin oils and concentrates, to butter for manufacturing purposes, and to essential oils and their flavouring constituents Since ingredients are allowed to contain anti-oxidants provision is made for the resultant foods to do so With our present knowledge it is extremely difficult to determine the quantity of anti oxidants in oils and the difficulty of doing so in prepared foods is much greater. There has been a considerable amount of discussion as to whether legislation should or should not be enacted before it is capable of being fully implemented, but if one were always to adopt the practice that legal requirements must follow the development of scientific knowledge to enable their ready enforcement, food laws would lag even further behind than they do at the present time It is generally found that science manages to catch up with legislation and public analysts owe much to the willing help received from their colleagues in industrial laboratories for information on some of these delicate matters. Labelling of Food (Amendment) Regulations, 1958 This amendment revokes Article 8 (d) of the Labelling of Pood Order, so that alcoholic cocktails need no longer contain 40 per cent. of Proof Spirit, but they will need to be labelled with the quantity of spirit which is present. Copper in Foods The Ministers of Agriculture, Fisheries and Food and of Health duly considered the Report of the Pood Standards Committee and decided not to issue any fresh Regulation, but recommended limits, which they hope will be adopted In general it has been found that recommendations of this type are accepted for enforcement purposes and are not disputed by trade interests. Tea Examination Greater vigilance is necessary regarding the purity of tea following the issue of Circular FSH 16/58 informing Local Authorities that H. M. Customs and Excise have discontinued sampling tea on importation for adulteration and unfitness, but it is not anticipated that this will cause any inconvenience to normal sampling and analysis. The Therapeutic Substances (Supply of Substances for Analysis) Regulations, 1958 These regulations came into force as the result of an oversight in the drafting of the Therapeutic Substances Act, 1956, and enabled public analysts and others likely to be responsible for testing products containing antibiotics, to obtain samples for control and for test. THOMAS McLACHLAN, Public Analyst. 57 DETAILS OF SAMPLES ANALYSED Article Number examined Number adulterated, etc. Formal Informal Private Total Formal Informal Private Total Ale 4 4 Baking Powder 3 3 Bicarbonate of Soda 4 4 Bread 1 1 1 1 Bread Roll and Butter 2 2 1 1 Butter 1 17 18 Cake 1 1 1 1 Cake (sponge) 1 1 Celery Salt 1 1 1 1 Cheese 9 9 1 1 Cheese (cream) 1 1 Cheese (processed) 1 1 Cheese (spread) 4 4 1 1 Chicken (minced) 1 1 Chocolate (drinking) 2 2 Cocoa 4 4 Coffee 3 3 1 1 Coffee Essence 1 1 Confectionery 6 6 1 1 Conserve 2 2 Cooking fat 2 2 Cornflour 4 4 Cream 19 5 24 Cream Soured 1 1 Cream of Tartar 3 3 Custard Powder 7 7 Pish Cakes 2 2 Pish Canned 6 6 1 1 Pish (dressed crab) 2 2 Fish Paste 18 18 12 2 Pish Spread 1 1 1 1 Flour 1 12 13 Fruit (dried) 1 30 31 l 1 Fruit (fresh) 23 23 9 9 Fruit (glace) 3 3 1 1 Fruit (juice) 1 1 Fruit (syrup) 1 1 Gelatine 1 1 C/f. 28 184 212 1 22 23 58 Article Number examined Number adulterated, etc. Formal Informal Private Total Formal Informal Private Total B/f. 28 184 212 1 22 23 Herbs (dried) Garlic 1 1 Mint 2 2 Mixed 1 1 Parsley 2 2 Sage 2 2 Thyme 4 4 Honey 14 14 Ice cream 28 28 Ice cream Mix 3 3 Ice Lolly 8 8 Jam 29 29 Jelly 17 17 Lard 4 4 Lemon Cheese 1 1 Lemon Curd 3 3 Margarine 7 7 Marmalade 26 26 Marzipan 4 4 1 1 Meat (canned) 34 34 18 18 Meat (fresh) 1 4 5 1 Meat Paste 12 12 Meat Pie 2 2 MiIk 164 1 165 8 1 9 Milk (condensed) 3 3 1 1 Milk (evaporated) 2 2 Milk (skimmed) 1 1 Mincemeat 4 8 12 2 2 Mustard 2 2 Non-Brewed Condiment 3 3 Oatmeal 1 1 Olive Oil 1 1 Onions, flaked 1 1 Orange Curd 1 1 Parsley Sauce Powder 1 1 Peas (canned) 3 3 3 3 Peel-cut-mixed 5 5 Pickles 1 1 1 1 Pie Filling 1 1 Pudding (meat, canned) 1 1 C/f. 197 428 625 10 49 59 59 Article Number examined Number adulterated, etc. Formal Informal Private Total Formal Informal Private Total B/f. 197 428 625 10 49 59 Pudding, Christmas 10 10 Rice 4 4 Sauce, Horseradish 2 2 Sauce, Mint 2 2 1 1 Sauce, Onion 1 1 Sausages 3 3 1 1 Sausage Meat 1 1 Sausage Rolls 19 19 8 8 Soft Drinks 3 47 50 3 3 Spices Curry 4 4 Ginger 6 6 Mixed 1 1 Nutmeg 2 2 Pepper 1 8 9 Spirits Advocaat 1 1 1 1 Brandy 2 2 Cherry Brandy 1 1 Gin 2 2 Rum 3 3 Whisky 4 4 Spread Savoury 2 2 Spread Sweet 1 1 1 1 Stuffing 1 1 Sugar 3 3 Tapioca 1 2 3 Tea 2 13 15 Tripe in Sauce 1 1 Turkey Minced in Jelly 1 1 Vinegar 6 6 Drugs Aspirins 4 4 Boracic Acid 1 1 Borax and Honey 2 2 Epsom Salts 3 3 Glucose Tablets 1 1 1 1 Liquid Paraffin 3 3 Zinc and Caster Oil Cream 1 1 Total 217 583 800 11 64 75 60 Section F Miscellaneous Services Page Legislation during year 61 Health Education 62 Mortuary 63 National Assistance Act - Burials 63 Public Conveniences 63 Medical Examinations 63 Pharmacy and Poisons Act 64 Pet Animals Act 64 Rag Flock and Other Pilling Materials Act 65 61 ACTS OF PARLIAMENT, STATUTORY INSTRUMENTS and CIRCULARS ISSUED BY GOVERNMENT DEPARTMENTS RELATING TO THE PUBLIC HEALTH SERVICES during 1958 ACTS: Slaughterhouses Act, 1958. Slaughter of Animals Act, 1958. London County Council (General Powers) Act, 1958. STATUTORY INSTRUMENTS: The Public Health (Preservatives etc. in Food) (Amendment) Regulations, 1958. The Public Health (Preservatives etc. in Food) (Amendment No 2) Regulations, 1958. The Labelling of Food (Amendment) Regulations, 1958. The Slaughterhouses (Hygiene) Regulations, 1958. The Slaughter of Animals (Prevention of Cruelty) Regulations, 1958. The Poisons Rules, 1958. The Poisons (No 2) Rules, 1958. The Poisons List Order, 1958. The Poisons List (No 2) Order, 1958. The Clean Air Act, 1956 (Appointed Day) Order, 1958. The Alkali, etc. Works Order, 1958. The Dark Smoke (Permitted Periods) Regulations, 1958. CIRCULARS: (Ministry of Health) No. 5/58 Revised Memorandum-Investigation of Pood Poisoning. (Ministry of Agriculture, Fisheries and Food) Nos. FSH. 1/2/7/10/20/1958 Milk and Dairies Regulations 1949-1954-Approved Oxidising or Preservative Agents. No. FSH. 5/58 Labelling of Food (Amendment) Regulations, 1958. No FSH. 6/58 Chemical Compounds used in Agriculture and Food Storage. No FSH. 8/58 Meat Content and Price of Sausages. No. FSH. 12/58 The Public Health (Preservatives etc in Pood) (Amendment) Regulations, 1958. No. FSH. 13/58 Copper in Foods. No. FSH. 16/58 Tea Sampling on Importation. No. FSH. 18/58 The Slaughterhouses (Hygiene) Regulations, 1958-The Slaughter of Animals (Prevention of Cruelty) Regulations, 1958. No. FSH. 19/58 The Public Health (Preservatives etc, in Food) (Amendment No. 2) Regulations, 1958. (Ministry of Housing and Local Government) No. 24/58 Clean Air Act, 1956-Alkali, etc. Works Regulation Act, 1906. No. 6/58 Clean Air Act, 1956-Date of operation of remaining provisions; byelaws under Section 24; miners' concessionary coal; approval of new furnaces. 62 HEALTH EDUCATION The following activities were carried out during the year, the majority of them taking place during the winter months, A circular letter to all organisations in the Borough was sent out in September, telling them of the facilities available. Seventeen Talks were given on the following subjects to 463 persons. Average attendance: 27. 'Hygiene in the Home' 'Clean Air Act' 'Food Sampling' 'Atmospheric Pollution' 'Water Supply' 'Rehabilitation of the Aged 'Insect Pests and Disinfestation' 'Anatomy' 'Infectious Disease and Disinfestation' 'Old People's Welfare' 'How Your Body Works' 'Infectious Disease' 'Work of a Public Health Inspector' 'Clean Air Act-Smoke Control Areas' 'Care of Old People' Five Discussion Groups were also held on the following subjects. 67 people attended. Average attendance: 13. 'Divided Loyalties' 'Mother, Can I Go Out Tonight' 'A Mother's Place....' Fog Is Officially Forecast' In addition three Health Films were supplied for a Film Show at the Fulham Palace Road Congregational Church. Leaflets and Posters Every opportunity was taken to distribute leaflets and posters relating to Health Education There is a display stand at the Public Health enquiry counter, and there are poster sites under this Department' s control. Friends of Fulham Hospital Carnival, June 1958 An invitation was received from the Committee responsible for organising the above, to take part in any of the activities for this occasion The Department decided to enter a float to form part of the carnival parade, the theme of the float being 'Clean Food' based on a series of Ministry of Health Posters. Enlargements of these posters screened the sides and back of the vehicle and the heading over the driver's cab was taken from one of the posters "Is Hands guilty of food poisoning?". The tableau on the float depicted a court room scene with a judge, the prisoner Hands, prosecuting counsel and police constable. Photographs of the North End Road street market, taken by the Ministry of Health were mounted on the radiator and doors of the vehicle. Clean Air Act, 1956 Details of the publicity undertaken in connection with the Council's programme to make the Borough a Smoke Control Area are given on page 38 in the section dealing with Atmospheric Pollution. 63 FULHAM MORTUARY The Mortuary was kept in use during the year to accommodate convenience cases, i. e. those put in by undertakers before interment. 100 Convenience cases were admitted during the year. NATIONAL ASSISTANCE ACT, 1948 Section 50-Burial or Cremation of the Dead 10 Funerals (9 Adults and 1 child) were arranged under the provisions of this Section of the Act The cost of the funerals varies slightly, the average cost of an adult being approximately £15 8s. 0d. PUBLIC CONVENIENCES There are seven Public Conveniences, each with a Mens and Womens Section, under the control of the Public Health Department, which have been constructed at various times between 1900 and 1939. All the conveniences have both a free and paid wash for the convenience of the public, the only exception being at wyfold Road, where there is a free wash only. These facilities are well used and appreciated. New Convenience-Corner of Ismailia and Townmead Roads, Wandsworth Bridge At the end of the year permission was received from the Ministry of Housing and Local Government to invite tenders for building this convenience. It is anticipated, therefore, that if no complications arise the convenience will be ready for use in 1959. Replacement of Gibb's Green Convenience It is proposed to replace the old underground convenience at Gibb's Green with a modern convenience as soon as possible, and a suitable site near the existing convenience has been found Negotiations with the Ministry of Housing and Local Government commenced at the end of the year and it is hoped that the building of this new convenience will commence in 1959. MEDICAL EXAMINATIONS During the year 129 medical examinations were carried out. These included the examination of new entrants to the Council's service, to determine their suitability for acceptance under the Superannuation Scheme, and of others referred because of sick leave or accident. The latter usually required specialist investigation and resulted in quite a considerable amount of correspondence with private doctors and hospitals. 64 PHARMACY AND POISONS ACT 1933-THE POISON RULES PHARMACY AND MEDICINES ACT 1941 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 Pees are payable to the local authority by persons whose names are entered on the List. At the end of 1958 there were 156 names on the Council's List and the following changes took place in the Register during the year:- Number of listed sellers on Council s register at 1.1. 58 155 Number added during the year 19 174 Number who transferred their business or discontinued the sale of Poisons 18 Number on register at 31.12.58 156 105 Visits of inspection were made during the year under review PET ANIMALS ACT, 19 51 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 1958, twelve licences were renewed. No contraventions of the Act were found during 42 routine inspections. 65 « RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 Under this Act is 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). Eight premises are registered in Fulham. During 1958 the following samples of filling materials were purchased by the Sampling Officer and submitted to the Prescribed Analyst for the purpose of the Act:- Feathers 1 Horse Hair 1 Rag Flock 6 Coir Fibre 2 Kapok 5 Cotton Millpuff 1 Hair and Fibre mixture 1 Algerian Fibre 2 Re cleansed Hair 1 "Lyx Hair" Fibre 1 Sized Wadding 1 22 All the samples of filling materials submitted for examination were reported to be satisfactory FULHAM CHEST CLINIC, Western Hospital, Seangrave Road, S.W.6. ANNUAL REPORT-1953. The year 1958 was yet another milestone in the history of the Fulham Chest Clinic for during April the Clinic moved from its old home at 114, New King's Road to reconstructed premises in the grounds of the Western Hospital, Seagrave Road, The process of moving and becoming established in the new quarters interfered considerably with the routine work during the June quarter. Considerable discussion had taken place since 1948 regarding a possible future site for the Clinic. The isolated site in the New King's Road was satisfactory when tuberculosis was the only disease treated at that Dispensary and the general attitude pre-war both medical and lay towards tuberculosis as an infectious disease decreed its separation from the rest of general medicine. Three factors influenced the final settlement to develop the Clinic at the Western Hospital. A radical change has taken place in the public attitude to this erstwhile killing disease due to the vastly improved prognosis resulting from the introduction and standardisation of chemotherapeutic methods of treatment which has also made it possible now to treat this disease much more rapidly and effectively in all its forms in general hospitals. This change of attitude especially amongst the younger age groups has done much to overcome their reluctance to come forward for x-ray and investigation at Mass X-Ray Units and Chest Clinics and to accept treatment. The Chest Clinic or Tuberculosis Dispensary came into being within the old poor law system of treatment for the heedy and developed as a part of the Local Authority Health Services with their emphasis on the prevention and epidemological aspects of the disease. The poor response by patients to any known therapy tended to accentuate the clinical isolation of the old tuberculosis from the main stream of medical science. The introduction of the National Health Service in 1948 with the integration of the tuberculosis service into the Hospital service coincided with the first use of streptomycin therapy sounded the knell of the old type of chest service. All these factors pointed to Fulham Hospital as the obvious choice for the final development of the Chest Clinic in the area, but this depended on the rebuilding of this Hospital and especially of its Out-Patient Department. When it became obvious that the original plans for Fulham Hospital were unlikely to materialise in the immediate future, to which was added the uncertainty as to whether the Hospital would remain in the Fulham and Kensington Hospital Management Committee area, finally the logical development that has taken place generally in the Chest Service with the widening of the clinical scope to include all diseases of the chest and heart it was, therefore, decided to develop the Chest Clinic in the grounds of the Western Hospital. -1- ■ . TUBERCULOSIS: The fall in the notifications of pulmonary tuberculosis (ll6 to 95) in Fulham continued with very little change during the year, whilst the r???mber of non-tuberculosis cases remained the same. A significant fall in the number of deaths from pulmonary tuberculosis (36 to 30) occurred during the year. This year there were no deaths in the non-pulmonary group. Total Clinic attendance figures are somewhat down mainly due to the moving of the Chest Clinic and to the discontinuance of the artificial pneumothorax refill clinics which occurred at the end of 1957. Greater use has been made of B.C.G. vaccine this year, especially in the new born, this will assist in the final abolition of T.B. meningitis particularly in the under 5 age group. NEW CLINIC ARRANGEMENTS The prevision for the first time in the 42 years history of the Clinic of a full size X-Ray Department as an integral part of the Clinic building will enable all patients to be x-rayed and the wet film to be examined together with the patient at the first attendance. This routine enables the Clinic to issue a provisional report to the General Practitioner on the day when the patient first attends. This improvement of the service is not yet complete for all Clinic session-showing to the pressure of work on the single-handed Hospital radiographer, The possible provision of an extra pair of hands in this Department in the near future would enable an x-ray to be taken for all new patients attending and re-attendances as well as for the special General Practitioner referral cases. There are many instances where a report cannot be given either to the patient or their medical adviser, but every effort should be made to do this where possible, particularly where a doubt arises as to the possibility of bronchial car??? virions?, and this will help to reduce the interval from the patient's first attendance to the time when the surgery could take place. Earlier reporting enables the General Practitioner to pursue ether diagnostic avenues and avoids the unnecessary situation where patients have to make several attendances before they can be told that nothing abnormal has been discovered. CONTACTS The number of new contacts attending has fallen along with the new number of notifications but the attendance figures of contacts have incressed with the greater use of B.C.G. vaccine. As the number of tuberculosis cases fall so the task of weeding out the remainder and closely following up their contacts will become more difficult. -2- AFTER CARE: After care facilities were used by over 700 tiberculosis and nontuberculosis patients and covered a vide field from financial help, provision of clothes etc. to boarding out of children, convalesence and holidays. The pottery workshop has maintained its ork throughout the year but because it has remained next door to the original Clinic in New ???ing's Road it is now cut off from the parent Clinic following the latters transfer to the Western Hospital. This separation enabled some gangs of local youths to break in on several occasions and destroy much of the interior including the finished and partly finished work. However, in spite of two energetic instructors and a core of 5 enthusiastic patients attendances have sometimes fallen to three or four per session. This is not surprising when it is remembered that during the winter months most of these respiratory cripples are unable to come cut of doors or may even be in Hospital. Weather conditions likewise prevent other bronchitics from taking their place, in order to maintain attendance figures. However, even in the winter period there may be long spells of relatively mild weather, especially just before Christmas when the class can continue as usual. These facts are not appreciated in certain quarters and the class has remained under a threat of extinction for the last year. NON-TUBERCULOSIS CHEST DISEASES: Chronic respiratory disease in the form of chronic bronchitis killed 124 people in Fulham in 1958 compared with ll7 people in 1957. To these must be added the 84 deaths from carcinoma of the bronchus. They were all partially due to atmospheric pollution and the smoking of tobacco. These deaths were all unnecessary. The bronchial cancer deaths during the last two years are as follows:- 1957 1958 Male Female Male Female 61 7 70 14 More bronchial cancers are being diagnosed at the Wednesday afternoon bronchoscopic clinic than used to be the case 10 years ago, but to date we have not discovered a single non-smoker with cancer of the bronchus BRONCHITIS: Deaths in the country have remained about 30,000 per year but the deaths from bronchial carcinoma have risen from 5,000 in 1939 to 20,000 in the current year. If the present rate is allowed to continue it will exceed that for bronchitis before the end of the next dicennium. -3- In the acute phase patients presenting with acute bronchiolitis require immediate chemotherapy in order to deal with the infecting organisms which in many cases is the factor which has triggered off the acute attack. The associated bronchospasm and excessive sputum can be dealt with most effectively by means of "tipping" and breathing exercises. This latter is one of the most effective forms of therapy we have in dealing with respiratory distress when the patient cannot be removed away from the poisonous city air, either to an air-conditioned ward or to the country. This physiotherapy is continued after discharge from Hospital in the breathing exercise classes held daily at the Chest Clinic. Patients are also referred to these classes at the request of the General Practitioner. Patients may attend for allergy sensitivity tests at the Allergy Clinic on Friday afternoons and for bronchograms on Thursday afternoons to discover any latent bronchiectasis. COMPARATIVE SUMMARY OF STATISTICS FOR ANNUAL REPORT 1958 Number of New Patients attending: Non-Tuberculosis Cases 175 (231) Contacts 177 (221) Transfer-In Notifications 83 (52) Others (Notified) by other units in area 14 ( 11) 449 (515) Number of New Notifications by F.C.C. Of this figure 8 (13) were referred by the M.R.U. 38 (54) Number of Clinic Attendances: Notified cases 2207 (2624) Contacts 2842 (2424) Non-Tuberculous 1187 (1660) Refills (Discontinued now) ---- ( 263) 5236 (6071) Attendances at Laboratory for Investigation These returns are now made through the Hospital ---- (912) Total Number of Notifications in Fulham Borough Pulmonary 95 (116) Non-Pulmonary 9 (8) -4- I Number of Deaths Pulmonary 30 (36) Non-Pulmonary - (2) Number taken off Register as Cured 1958 Pulmonary 40 (45) Non-Pulmonary 14 (9) Number of visits by Chest Physician 113 (105) Number of visits by Health Visitors 3537 (6330) Number of X-rays taken 5788 (5477) Number of patients undergoing treatment at home 8 (8) Number of B.C.G. Vaccinations 136 (192) Number of Notified Cases on Register at 31.12.1953 1312 (1364) (Figures in brackets are the comparable figures for 1957) -5-