Ac, 43 46 FULL 54 Libra. Metropolitan Borough of Fulham II REPORT of the MEDICAL OFFICER OF HEALTH for the year 1963 H. L. Settle, M.Sc., M.D., D.P.H., F.R.S.H., A.R.P.S. Medical Officer of Health CONTENTS Public Health Committee - Members 2 Public Health Department - Staff 3 Introduction 5 SECTION A. General and Vital Statistics 9 SECTION B. Prevalence and Control of Infectious and Other Diseases 13 SECTION C. Personal Services 21 SECTION D. Sanitary Circumstances of the Area 32 SECTION E. Inspection and Supervision of Food, including Report by Council's Public Analyst, T. McLachlan, Esq 49 SECTION F. Miscellaneous Services 64 An index is given at the beginning of each Section, with a detailed index at the end of the Report. METROPOLITAN BOROUGH OF FULHAM MEMBERS OF THE PUBLIC HEALTH COMMITTEE (as at December, 1963) Ex-Officio: Chairman: Vice-Chairman: The Worshipful the Mayor (Councillor A. H. Little, J.P.) Councillor Mrs. Florence Charlotte Pusey Councillor Sidney Albert Matthews Alderman David Shopland, B.A. Councillors John Murrie Browning John Douglas Frederick Martyn, B.Sc. (Sociology) Miss Phyllis May Cooper Reginald Walter Mitchell Mrs. Elizabeth Lydia Desborough George Henry Shell Mrs. Gladys Irene Dimmick, B.Sc., A.R.I.C. John Arthur Tagg Mrs. E. Harries, B.A. COUNCIL REPRESENTATIVES ON OUTSIDE COMMITTEES AND OTHER ORGANISATIONS CONNECTED WITH PUBLIC HEALTH WORK Accident Prevention Committee Councillor Jack James Ireland (Chairman), Councillor C. W. Howard (Vice-Chairman) (exofficio), Councillor Mrs. Elizabeth Lydia Desborough, Councillor Mrs. Florence Charlotte Pusey, Councillors George Henry Shell and John Arthur Tagg. Fulham Old People's Welfare Committee Councillors John Murrie Browning, Jack Herbert Clark, Mrs. Elizabeth Lydia Desborough, Laurence Giovene, B.A. (Cantab.), James Thomas Horton, M.B.E., J.P., and John Arthur Tagg. L.C.C. Divisional Health Committee (Division I) Councillors Miss Phyllis May Cooper, Mrs. G.I. Dimmick, B.Sc., A.R.I.C. and John Arthur Tagg. London and Home Counties Clean Air Advisory Council The Chairman of the Public Health Committee and the Medical Officer of Health National Society for Clean Air Councillors Mrs. Florence Charlotte Pusey, M.R.S.H., Sidney Albert Matthews and Mr. Frederick C. Payne, Inspector for Factories and Smoke Abatement. 3 STAFF OF THE PUBLIC HEALTH DEPARTMENT (at 31st December, 1963) Medical Officer of Health Herbert Leslie Settle, M.Sc., M.D.,Ch.B., D.P.H., F.R.S.H., A.R.P.S. Deputy Medical Officer of Health Caroline A. Meade, M.B., B.S. (Lond.) D.P.H. Public Analyst Thomas McLachlan, D.C.M., A.C.G.F.C., F.R.I.C., M.I.Biol. Administrative and Clerical Section: Chief Clerk J.E. Burton, D.F.M. Second Clerk J.W. Chance, A.l.Hsg. Dip. R.I.P.H.H Administrative Clerk B. C. Bolton Secretary to Medical Officer of Health Mrs. C. M. Phillips Clerks R.A. Green Miss. P. Bowden J.R. McWhinnie Mrs. R.E. Edwards Mrs. M. Ashby Mrs. L. Birdseye T. Cordery Shorthand Typists Miss. F. Cullum Miss. R. Dawkins Mrs. D. Townsend Assistant (Housing Acts) (Vacancy) Public Health Inspectors Section Chief Public Health Inspector G.W. Herrick, D.P.A. (1) (2) Senior Public Health Inspector F.E.Walsh (1) (2) Senior Public Health Inspector (Food and Drugs) and Sampling Officer A.Clegg (1) (2) Public Health Inspector for Factories and Smoke Abatement F. C. Payne (1) (2) (3) (4) District Public Health Inspectors AH. Newport (1) (2) (4) D. Corfield (1) (2) W.Dicks (1) (2) G. McFall (1) (2) J. Lund (1) D. Wells (1) (2) M. Cander (1) (2) D. Franklin (1) R. Hayes (1) J. Looman (1) (2) Student Public Health Inspectors D. Roach T. Gerard Clean Air Officer B. C Jago Administrative Assistant - Old People's Welfare W. W. Birdseye Lady Visitor - Old People Miss J. Sands, S.R.N., S.C.M., H.V. Cert. Assistant Mrs. B. Barton, S.E.A.N Enquiry Officers Smoke Control Area Surveys H. Edwards Mrs. B. Vane (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. 4 DISINFECTING STAFF Superintendent: J. W. Smith Operatives: W. H. Parsons A. E. Leach T. W. Rains A. J. Alderman A. F. Robins Mrs. M. Celino - (Part-time) RODENT CONTROL Foreman Operative: Operatives: K. Sawyer G. H. Leaver V. Greenway PUBLIC CONVENIENCE ATTENDANTS Male Attendants: Female Attendants: W. J. Allsop Mrs. N. W. Andrews J. L. Andrews Miss L. M. Bates Mrs. M.Brewer A. J. Bullock R. W. Cambridge Mrs. W. M. Clarke J. P. Chandler Mrs. D. E. Collis S. G. Clements Mrs. M. Cude G. H. Connor Mrs. D. Darcy F. H. Davis Mrs. E. Edwards F. W. Davis Miss B. M. Evans W. J. Duffield Mrs. A. Larking W. H. Gray Miss V. M. Lewington F. W. Hawkins Mrs. R. A. Molloy R. C. Hewitt (Temporary) Miss D. E. E. Reynolds A. A. Hulbert Mrs. A. N. Wade F. J. Murray J. Pollard F. J. Taylor HOME BATHING ATTENDANTS (all Part-time) Mrs. J. Burke Mrs. L. M. Lankester Mrs. M. D. Coxall Mrs. E. M. Moore Mrs. I. Day 5 METROPOLITAN BOROUGH OF FULHAM 2-6 FULHAM BROADWAY, FULHAM, S.W.6. TELEPHONE: FULHAM 7871 (ENTRANCE IN EFFIE ROAD) H. L. SETTLE M.Sc., M D.. D.P.H., F.R.S.H. Medical Officer of Health All communications to be addressed to the Medical Officer of Health. To: The Mayor, Aldermen and Councillors, of the Metropolitan Borough of Fulham. Mr Mayor, Ladies 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 1963. The report of the Public Analyst, T. McLachlan, Esq ,D CM, A.C.G.F.C., F.R.L.C., is included. 1963 was uneventful from the infectious diseases point of view and the health of the inhabitants of the Borough has again been satisfactory. The number of notified cases of infectious disease rose by approximately 900 compared with 1962, this increase being accounted for by cases of measles. Staff changes have again occurred. Miss R.P. Begg , Secretary to the Medical Officer of Health, resigned her appointment in October on taking up a post with Holborn Metropolitan Borough Council as Social Welfare Officer. Miss Begg had been with the Department for ten years Two Public Health Inspectors left the staff, Mr. A.W. Gammack retired after 41 years' service in the department, which he joined in 1922. In the course of his long service he had been for many years the Senior Inspector for Food and Drugs, but later in his career and at his own request he returned to general district duties. Mr J.W. Deards who joined the staff as a pupil Public Health Inspector in 1958 and after qualifying as a Public Health Inspector became a District Inspector, resigned on obtaining a similar post at Cambridge, his home town. Miss R. Reed, a clerical officer, resigned on being appointed Senior Clerk to the Banstead Urban District Council Health Department She had worked in the Fulham Health Department for 15 years. All the above officers had served the department well and loyally and their departure is a loss to the Council and the public. The year has been an arduous one as a result of the reorganisation of London Local Government which involves the combination of Fulham with Hammersmith to form the new London Borough of Hammersmith The Health Department of the new Borough will take over all the functions of the two Metropolitan Boroughs and also the services carried out by the London County Council in both Boroughs. There will also be a transfer of staff on a large scale. All this has meant much extra work in the preparation of reports and attendance at meetings. For the greater part of the year your Medical Officer of Health also acted as Medical Officer of Health to the Borough of Hammersmith on account of the illness of Dr. F.M. Day, Medical Officer of Health, Hammersmith, and the vacant post of Deputy Medical Officer of Health, which was not being filled due to the forthcoming merger. CLEAN AIR The Council's Clean Air programme has continued according to plan and No. 8 Smoke Control Order has been made by the Council and confirmed by the Ministry of Housing and Local Government. The usual public meeting was held to give residents an early opportunity to ask questions and air grievances, if any. The meeting was under the Chairmanship of Councillor Mrs. F.C. Pusey, M.R.S.H., Chairman of the Health Committee, and the panel of experts present to answer questions consisted of representatives from the Fulham Power Station, The London Electricity Board, the North Thames Gas Board and the Solid Smokeless Fuels Federation. TRAINING OF PUBLIC HEALTH INSPECTORS This authority has, since 1954, operated a scheme for the "in service' training of Public Health Inspectors, During the nine years the scheme has operated a total of 16 pupils have been accepted and 10 duly qualified. Of these 10, none unfortunately has remained permanently with the department after qualification. This problem of drift away from those authorities providing training is a common one and a cause sometimes of resentment on the part of authorities which incurexpenditure on training inspectors only to lose them to employers who do not. In the light of recent events it is of interest to look closer into the arrangements for the training of Public Health Inspectors. Prior to 1961, a Public Health Inspector's training for the official certificate occupied two years. In 1961 a Diploma was introduced for which four years" study is required. Under the old regulations most of the entrants to the Public Health Inspectorate came from clerical staff in local government health or surveyor's departments, or from the building trade. Under the new arrangements, provided they hold the requisite pass in certain subjects in G.C.E., pupils may be enrolled straight from school. In Fulham, out of 11 students studying under the old regulations, 7 were successful in their final examination at their first attempt, 3 at the second and one at the third. The results, however, have been very different under the Diploma Regulations where of 3 students, one has failed the Intermediate examination, one has been referred in part and one resigned before sitting the examination. It would appear that there is something radically wrong somewhere with the present day arrangements. Either the type of applicant we are now getting, who is younger than previously, is unable to benefit from the training he receives, or the training programme is not suited to his needs and ability. As regards the former, students are at present selected by the Medical Officer of of Health and the Chief Public Health Inspector and appointed on the staff of the Health Department in the General Division. It is very questionable whether Medical Officers of Health and Chief Public Health Inspectors are the persons best fitted to ascertain whether an applicant is academically and temperamentally suitable for undertaking and benefiting from a 4-year course of training. There is no doubt that at present entry to the training scheme, due to a national shortage of public health inspectors, is often easy and offers little or no competition. Any applicant with the requisite minimum G.C.E. passes is almost assured of acceptance but the possession of the requisite minimum G.C.E. subjects is, however, little guide to a person's academic capacity, as applicants often obtain their G.C.E. passes one subject at a time. Depending on age and G.C.E examination passes, the student can enter his training with a salary of £490 per annum or even more, with increments assured each year. His fees and expenses are also paid, in part at least For much of the four years he spends only one day per week at a technical college, the rest of the time being spent either studying in the Health Department, or accompanying public health inspectors on their daily work. This method of selection and training is not, in my opinion, efficient, nor fair to the pupil, nor to the local authority which is footing the bill. I am critical of arrangements whereby a pupil is given only one day per week of formal instruction with qualified teachers and the rest of his time 7 picking up what crumbs he can from the rest of the Health Department staff who, although in most cases desirous of beinghelpful, are not, and make no claim to be, teachers. From the student's point of view, it is most unsatisfactory to be expected to train for important examinations under such conditions Under the present arrangements a student enjoys relative freedom and financial independence and these, together with the opportunities available for and the encouragement given to the pursuit of other interests must interfere with serious studying and it is small wonder that failures now occur so frequently. I suggest the training scheme should be taken away completely from local authorities, as health departments are not equipped, staffed, nor competent to undertake this work. A student public health inspector should not be on the staff of a health department, but should be treated like any other technical trainee and obtain his entry to an approved course through his appropriate Education Authority, which would also make appropriate financial grants to candidates who were considered educationally and temperamentally suited to the training course. The normal conditions attached to such education grants would be an incentive to students to work seriously during their training If the training course was made a full-time course of study, it could be completed in a far less period than the four years at present involved, say, 18 months to two years at the most As regards the aspects of practical training which would require to be taken in a health department, a number of local authorities should be carefully selected to which pupils undergoing training would be attached for a limited period of full-time field experience This period need not be too long and could be given towards the end of the theoretical training period, when they would have a considerable background knowledge on which to base their practical training The authorities selected for practical training should be those where the Medical Officer of Health and Chief Public Health Inspector and other appropriate staff have expressed an interest and willingness to undertake practical tuition and where facilities exist for adequate practical experience The above briefly outlines what I consider to be a better scheme of training for public health inspectors than the existing one It would encourage recruitment and enhance the status of the public health inspectorate, which the present training arrangements are in danger of undermining NORTH END ROAD MARKET For many years the North End Road Market has been a problem to the Health Department. More recently, the demand for higher standards of hygiene in food-handling, especially since the Food Hygiene Regulations were introduced, has thrown the problem into even sharper perspective Unfortunately, it is not possible to reconcile standards of food hygiene which can and must, be rightly demanded for the public these days, with a street market, The only solution, as far as the Health Department is concerned, is a properly construction covered market with hygienic fixtures, modern amenities and adequate supervision. It is appreciated that interests and problems other than those of food hygiene are involved but I consider no time should be lost in commencing a comprehensive study of the problem with a view to its earliest solution. REHOUSING ON MEDICAL GROUNDS During the year a points scheme for re-housing was introduced by the Council and your Medical Officer of Health was asked to undertake the allocation of points for medical priorities This has proved to be a formidable and difficult task occupying much time of the Medical Officer of Health and Deputy Medical Officer of Health. Up to the time this preface was written, over 300 cases have been investigated and about 90 given maximum points. Unfortunately, none of these cases has yet been rehoused, due to lack of suitable housing accommodation - many require ground floor accommodation or access to a lift. 8 Investigation of these cases has involved obtaining detailed information from private medical practitioners and hospital medical staff and the amount of professional time and effort involved in this has been very considerable. It is unfortunate that so little has so far been achieved. Among the difficulties encountered is that of trying to compare different medical conditions affecting different individuals living in different environments. It is impossible to decide whether a person with, say, a serious heart condition who has to climb stairs, is more deserving of priority than a young mother with a serious disability requiring her to have frequent hot baths and a young family also requiring frequent baths, and who has no bathroom and no convenient water supply. Both cases, in my opinion, are equally deserving of priority. The best that can be done is to pick out those cases which obviously would be helped by immediate rehousing and to give themmaximum points. This is what has been done and beyond that there appears to be no method which permits of further differentiation of priority. The position is further complicated because the condition of cases given less than the maximum points when first considered may deteriorate, in some instances suddenly and unexpecredly, and as a result at a later date deserve more priority than they were originally granted. Also new cases of equal severity to some already allotted the maximum points and still awaiting rehousing, are continually being brought to our notice. The question is how these two categories are to be fitted into the waiting list. The problem of medical priority can only be solved by the provision of suitable accommodation in adequate amount. It should be borne in mind that merely allotting priority and points does not help the patient in the slightest - they can only be benefited by early rehousing - and unless this can be done rapidly once the need has been ascertained, the lives of some people will be shortened and others will deteriorate until when eventually they are rehoused, perhaps after a long delay, they cannot enjoy full, or even any, benefit from their new accommodation. Finally, it is a great pleasure to tender my sincere thanks to the Council and Chairman and and members of the Health Committee for their support and interest in the work of the department. As always we have readily received every assistance from the other departments of the Council and I thank my Chief Officer colleagues and their staffs for their willing co-operation. I also wish to thank my medical colleagues in hospitals, general practice and the L.C.C. Divisional Office, and also the voluntary organisations who so often play a large part in resolving the human problems we so frequently encounter. In conclusion I gratefully acknowledge the loyal assistance given by all members of the staff of the Health Department at all times. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient Servant, H.L.Seule Medical Officer of Health. August, 1964. 9 SECTION A General and Vital Statistics Page Physical Features of Borough 10 Population and Area 10 Rateable Value and Product of 1d. Rate 10 Marriages 10 Births and Stillbirths, number and rate per 1,000 population 10 Deaths, number and rate per 1,000 population 11 Death Rate of Infants under 1 year of age 11 Maternal Mortality 11 Deaths, Classification of causes of 11 Deaths, Infant Table of causes of 12 Deaths, Cancer Table of last 10 years 12 10 PHYSICAL FEATURES OF BOROUGH AND EXTRACTS FROM VITAL STATISTICS FOR THE YEAR 1963 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 sub-soil 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. Fulham 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. Area of Borough 1,706 acres Population (estimated mid-1963) 109,700 Separately Rated Dwellings 30,269 Rateable Value £5,747,996 Rate levied - 8/-d in the £ - Estimated Yield £2,246,400 A Penny Rate produces approximately £23,400 Number of assessments 34,442 The Registrar General's estimate gives the mid-year population of the Borough as 109,700 a decrease compared with 1962 of 870. Ten years ago, in 1953, the estimated population was 122,500. The birth rate is 17.06 compared with 17.14 in 1962. Ten years ago the birth rate was 13.6. The figure for England and Wales in 1963 is 18.2. The infant mortality rate has decreased to 22.3 compared with 26.12 in 1962. The figure for England and Wales in 1963 is 21.1. The death rate in 1963 shows a slight increase compared with 1962 - being 12.75 as compared with 11.93. Heart disease continues to be the main 'killer', with cancer the next most important. The figure for England and Wales for 1963 is 12.2. LIVE BIRTHS STILL BIRTHS Sex Total Legitimate Illegitimate Total Legitimate Illegitimate 135 130 15 8 14 5 1 3 1,077 1,026 Males Females 942 896 Totals 265 19 4 2,103 1838 23 Number of Marriages Registered during year 926 Birth Rate (crude) per 1,000 population 19.17 Birth Rate (adjusted) per 1,000 population 17.06 Stillbirth Rate per 1,000 live and still births 10.82 Illegitimate Live Births per cent of total Live Births 12.6 11 Total Males Females DEATHS (All Ages) 1,372 720 652 Death Rate (crude) per 1,000 population 12.5 Death Rate (adjusted) per 1,000 population .. 12.75 Death Rate (adjusted) per 1,000 population (England and Wales) 12.2 Total Females INFANT DEATHS (Under 1 year) Males 47 28 19 Infant Mortality Rate:- All Infants per 1,000 Live Births 22.3 Legitimate Infants per 1,000 Legitimate Live Births 22.3 Illegitimate Infants per 1,000 Illegitimate Live Births 22.64 Neonatal (first 4 weeks) Mortality Rate per 1,000 Live Births 18.54 MATERNAL DEATHS There were no maternal deaths during the year. CLASSIFICATION OF CAUSES OF DEATH 1,372 Deaths as follows Under 1 Age Groups Over 65 Total 1-5 5-15 15-45 45-65 - - 1 - - - - - - - - 5 - - - - - - 8 32 - 1 - - - - - - - - - - - - - 1 1 - - - - - - - - - - - - - 6 6 Tuberculosis, Respiratory 12 Syphilitic Disease 3 3 - - 6 Other infective and parasitic diseases - - 1 1 3 Cancer 1 19 99 149 268 1 Diabetes 5 6 - - - 142 Vascular lesions of nervous system 1 19 122 - Coronary disease, angina 5 76 179 260 - - - Hypertension with heart disease 13 13 Other heart disease - 3 11 120 134 Other circulatory disease - 2 15 84 101 Influenza - 1 - 5 6 110 Pneumonia - 2 14 88 25 Bronchitis - 2 83 111 Other diseases of respiratory system - - 3 7 10 Ulcer of stomach and duodenum 1 1 7 9 - Gastritis, enteritis, diarrhoea - 1 1 5 7 Nephritis and nephrosis 1 2 2 5 - Hyperplasia of prostate - - - 2 2 Congenital malformations - - 1 - 9 Other defined and ill-defined diseases - 7 18 57 114 Motor vehicle accidents - 3 - 2 5 5 23 All other accidents - 7 10 Suicide - 4 5 5 14 Homicide and operations of war - 2 2 - - 20 19 - - - 39 5 1 TOTALS DETAILS OF DEATHS FROM CANCER DURING THE LAST TEN YEARS SHOWING SITES 1954 1955 1956 1957 1959 1960 1958 LUNGS AND BRONCHUS Male 61 59 68 61 70 80 72 Female 17 16 9 7 14 16 23 STOMACH Male 22 22 13 17 6 15 14 Female 12 13 13 13 18 17 15 BREAST -Male - 1 - 1 - - 1 23 -Female 18 21 21 13 25 19 UTERUS -Female 7 13 8 13 9 16 13 OTHER SITES -Male 59 65 65 72 58 78 61 Female 47 65 59 61 63 62 53 243 275 269 236 279 300 271 TOTALS 13 SECTION B Prevalence and control of Infectious and other Diseases Page Infectious Disease 14 Diseases notifiable 14 Puerperal Pyrexia 14 Infectious Disease notifications 15 Tuberculosis 15 Fulham Chest Clinic - Report 16 South West London Mass X-Ray Service - Report 18 Food Poisoning 19 Scabies and Allied Conditions 19 Vaccination and Inoculation Certificates, Authentication of 19 Bacteriological Examinations 20 14 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'. The following infectious diseases are at present notifiable in Fulham:- Acute Encephalitis Measles Acute Influenzal Pneumonia Membranous Croup Acute Primary Pneumonia Meningococcal Infection Acute Poliomyelitis Ophthalmia Neonatorum Anthrax Plague Cholera Puerperal Pyrexia Diphtheria Relapsing Fever Dysentery Scabies Epidemic Diarrhoea (Under 5 years of age) Scarlatina or Scarlet Fever Smallpox Erysipelas Tuberculosis Food Poisoning Typhoid and Paratyphoid Fevers Leprosy Typhus Fever Malaria Whooping Cough PUERPERAL PYREXIA (Puerperal Pyrexia Regulations, 1951) Fulham residents .. .. .. 5 Non-Fulham residents .. .. .. 2 Total cases notified in Fulham 7 Fulham residents notified to other Authorities 15 Total number of Fulham cases 20 15 NOTIFICATIONS OF INFECTIOUS DISEASE, 1963 (in age groups) -1 1-2 5-9 15- 24 25- 44 45- 64 65 10- 14 3-4 Total Scarlet Fever - 1 7 11 1 1 - - - 21 Whooping Cough 15 29 34 36 6 4 1 - - 125 Acute Poliomyelitis: Paralytic - - - - - - - - - - Non-Paralytic: - - - - - - - - - - 311 265 381 19 3 3 - - 1020 Measles 38 Diphtheria - - - - - - - - - - Acute Pneumonia - - - - - 1 - 9 4 14 Dysentery 9 20 18 24 10 21 29 17 8 156 Smallpox - - - - - - - - - - Acute Encephalitis Infective - - - - - - - - - - Acute Encephalitis Post Infectious - 1 - - - - - - - 1 Typhoid Fever - - - - - - 1 - - 1 Paratyphoid Fever - - - - - - - - - - Erysipelas - I ,1 - 1 - - 2 2 3 8 Meningococcal Infection - 1 - - - - - 1 - 2 Food Poisoning 4 - - - 1 4 5 1 1 16 Puerperal Pyrexia - - - - - 3 4 - - 7 Ophthalmia Neonatorum - - - - - - - - - - Malaria - - - - - - - - - - Scabies - 2 - - 1 4 2 - - - Tuberculosis, Pulmonary - - - 1 1 7 19 18 12 58 Tuberculosis, Non-Pulmonary - - - 1 - 3 7 2 - 13 66 365 324 455 39 51 73 50 28 1451 TOTALS There were 1,451 notifications - an increase of 938 compared with the figure (513) for 1962 TUBERCULOSIS The tuberculosis death rate of 10.93 has risen compared with last year when it was 5.42. In 1953, the tuberculosis death rate per 100,000 population was 19.59. The notification rate for tuberculosis in 1963 was 64.6 compared with 75.1 in 1962. 16 FULHAM CHEST CLINIC - ANNUAL REPORT FOR 1963 (SUPPLIED BY COURTESY OF DR. H.C. PRICE - CHEST PHYSICIAN) NEW NOTIFICATIONS IN AGE GROUPS ' Males Females Under 1 Year Nil Nil 1-5 years 1 - 6-15 years 1 1 16-25 years 5 9 26 -35 years 6 3 36-45 years 6 4 46-55 years 10 2 56-65 years 11 1 Over 65 years 8 2 48 22 COMPARATIVE SUMMARY OF STATISTICS FOR ANNUAL REPORT, 1963. Number of NEW PATIENTS Attending:- 1963 1962 Non-Tuberculous Chest Cases 221 (220) New Contacts of Notified Cases 168 (146) New Notifications transferred in 45 (61) Number of CLINIC ATTENDANCES:- Notified Cases of Tuberculosis 1630 (1765) Contacts of Cases of Tuberculosis 2746 (2617) Other Chest Diseases 2160 (2340) Number of NEW NOTIFICATIONS OF TUBERCULOSIS IN FULHAM Pulmonary 58 (75) Non-Pulmonary 12 (8) Number of DEATHS IN FULHAM (Taken off Clinic Register) Pulmonary Tuberculosis 21 (26) Non-Pulmonary Tuberculosis Nil (Nil) Bronchitis 111 (114) Cancer of the Lung 78 (77) Number Taken off the Tuberculosis Register as CURED Pulmonary 36 (24) Non-Pulmonary 6 (4) Number of Visits by the Chest Physician 70 (70) Number of Visits by the Health Visitors 2272 (2025) 17 1963 1962 Number of Patients X-Rayed 3834 (3844) Number of Patients undergoing treatment at home 1 (Nil) Number of B.C.G. Vaccinations 199 (233) Number of Notified Cases of Tuberculosis on Register at 31.12.63 1203 (1235) Figures in brackets are the comparative figures for 1962. 1. Number of cases of tuberculosis (notified or not) under treatment or supervision at 31st December. NON-RESPIRATORY RESPIRATORY Men Children Total Women Children Total Women Men 601 459 12 1072 57 60 14 131 Less patients on Ward at 31.12.63 9 3 - 12 - 1 - 1 592 456 12 1060 57 59 14 130 Plus TB. Obs. 25 23 5 53 479 1113 59 14 130 617 17 57 2. Number of cases of respiratory tuberculosis (whether notified or not) included in 1. new to clinic (excluding transfers from other clinics) during year ended 31.12.63. BACTERIOLOGIC ALLY CONFIRMED NOT BACTERIOLOGICALLY CONFIRMED Men Women Children Total Men Women Children Total 8 Group 1 12 7 2 21 7 Group 2 3 2 - 5 10 4 - 14 1 2 - 3 6 1 - Group 3 7 Totals 16 11 2 29 23 6 - 29 3. Number of cases of non-respiratory tuberculosis (notified or not) included in 1. new to clinic (but excluding transfers from other clinics) during year ended 31st December. Men 7 Women 4 Children 1 Total 12 4. Number of cases included in 1 whose broncho-pulmonary secretion was positive during the year - 51. - 1 18 REPORT FROM THE SOUTH WEST LONDON MASS X-RAY SERVICE (SUPPLIED BY COURTESY OF DR. F.A. NASH - MEDICAL DIRECTOR) The South West London Mass X-Ray Service, which operates three Mobile Chest X-Ray Units is located in Fulham at the Western Hospital, Seagrave Road, where a regular one day a week service is provided continuously throughout the year. This Centre is open to everyone over the age of 15, irrespective of where they work or live, and people from all parts of London attend it, including a considerable number of those who are resident in the Borough of Fulham. The Centre is open on Wednesdays from 2 p.m. to 4 p.m. and from 5 p.m. to 7 p.m. and no appointments are necessary for attendance there. In addition to all those who come as private individuals, many patients are referred there by General Practitioners. Employees of local firms and organisations also attend in organised parties, by arrangement with the Managements concerned. Ante-Natal patients, and children between the ages of 6 and 7 are also x-rayed, provided they have been sent by a Clinic or their Doctor, and that a previous appointment has been made for them. Children aged 8-14 can be brought to the Public Sessions if referred by a General Practitioner. In 1963, over 16,000 people were x-rayed at the Fulham Centre, of whom 5,987 Were sent from their own Doctors. Figures relating to cases discovered are not kept separately for this Centre, or for those attending from the Borough of Fulham, but it may be of interest to know that in the year under review, 102,208 x-ray examinations were carried out by Mass X-Ray Units in South West London. As a result of these examinations, 269 cases were referred to Chest Clinics with radiological abnormalities suggestive of clinically significant pulmonary tuberculosis, and 160 cases were referred which were suggestive of neoplasm requiring further investigation. In addition, 277 other examinees were found to have non-tuberculous miscellaneous conditions requiring further study. In all, 706 cases were referred to Chest Clinics or Hospitals. The Ante-Natal Clinics in the Borough continue to make regular use of the special large film service provided for their patients at the Western Hospital Mass X-Ray Centre. Parties of school children are also brought there for an x-ray examination, by arrangement with the Divisional Medical Officer, if they are positive reactors to the tuberculin skin tests given in connection with the London County Council B.C.G. inoculation scheme. The Mobile Units made 30 visits to firms and organisations in Fulham, including two food factories, the Lord Roberts Workshops, the Fulham Gas Works and the Power Station, and the premises of the London Electricity Board in Effie Road, where staff working at the Fulham Town Hall were also x-rayed. In all, 4,654 people were x-rayed during these visits, of whom 8 were referred for further investigation . Twelve Fulham firms and organisations have been co-operating since 1958 in the South London six-monthly chest x-ray service, by allowing their male employees who are over 45 yews of age to attend an x-ray unit twice a year. This service provides regular six-monthly chest x-tay examinations for this section of the population, in an effort to detect more cases of lung cancer in the earlier stages of the disease. Over 30,000 men in South London are now being x-rayed sixmonthly, and many men in this older age group, who live in Fulham, attend regularly at the Western Hospital Centre. During 1963, a total of 33,964 examinations were made under this Service in South West London. 6,864 were x-rays of men examined for the first time under the service, and 27,100 were repeat examinations made at six-monthly intervals. The 6,864 initial examinations revealed 13 cases of lung cancer, i.e. 1.88 per thousand men examined. The 27,100 repeat (six-monthly) examinations revealed 21 (radiologically new) cases of primary lung cancer, i.e. 0.77 per thousand examinations. Any men over 45 who wish to be included in this service can obtain a leaflet and all particulars by attending the Mass X-Ray Centre on any Wednesday during the stated times. During the past year, a close liaison has been maintained with the Fulham Chest Clinic, whose records of notified cases provide valuable information on which to base the visits of Mobile Units. Under the 'Works Contracts' Scheme immediately it is known that a case of tuberculosis has occurred on the premises of any firm or organisation, steps are taken at once to send a Mass X-Ray Unit to x-ray all the other employees there. In the same way, a careful watch is kept on the number of new cases occurring in any particular part of the Borough, so that a Mobile Unit can be sent to provide x-ray facilities for all the residents in the district concerned, where the circumstances appear to call for action of this kind. 19 However, the information obtained from the Fulham Chest Clinic about cases in local factories, can only be related to employees who both live and work in Fulham, and does not include employees who work in Fulham and live elsewhere. All employers and managements are therefore asked to co-operate in the elimination of tuberculosis by notifying the Headquarters of the South West London Mass X-Ray Service whenever a case of tuberculosis occurs amongst those whom they employ. The South West London Mass X-Ray Units take the opportunity again this year of inviting all citizens in the Borough of Fulham to make full use of this Service, and thereby safeguard their own health, as well as that of their families, and those with whom they work. FOOD POISONING During the year sixteen cases were notified. The causative agent was identified in eleven of the cases, as follows:- Agent Identified No. of Cases Salmonella Typhi-murium 8 Salmonella Oslo 1 Salmonella Brandenberg 1 Salmonella Seftenberg 1 SCABIES AND ALLIED CONDITIONS (Treatment Centre - Disinfecting Station, Townmead Road The Centre which was established 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 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 95 Children (under 5 years) 17 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 inoculations 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 20 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 572 certificates of vaccination and/or inoculation were autasnticated. 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:- Faeces 1,094 Urine 30 Nose and Throat Swabs 19 Vaginal Swabs 7 Miscellaneous 3 21 SECTION C Personal Services Page Hospitals and other Centres in the Borough 22 L.C.C. Personal Health Services 23 Home Nursing - Fulham District Nursing Association 25 Old People's Welfare in Fulham 26 Services for the Elderly Questionnaire 26 Meals Service 26 Bathing facilities for the Elderly 27 S.O.S. Card Scheme 27 Old People's Laundry 28 National Assistance Acts - compulsory removals 28 Departmental Records of Old People 28 Fulham Old People's Welfare Committee 29 Chiropody 29 Christmas Parcels Scheme 29 Friendly Visiting 30 Fuel 30 Holiday Scheme 30 Home Decoration Scheme 31 Old People's Outings 31 Social Clubs 31 22 HOSPITALS AND OTHER CENTRES IN THE BOROUGH OF FULHAM (1) FULHAM HOSPITAL (under the Charing Cross Group of Hospitals) St. Dunstan's Road, W. 6. A general hospital dealing with Acute Medical, Surgical and Orthopaedic cases 274 beds Mental Observation Unit 19 beds Geriatrics 87 beds Total number of staffed beds 380 plus Outpatient Departments' (2) FULHAM MATERNITY HOSPITAL (under the Charing Cross Group of Hospitals) 5-7, Parsons Green, S.W.6. Number of staffed beds 30 (3) WESTERN HOSPITAL Seagrave Road, S.W.6. An infectious disease hospital Isolation 98 beds Respiratory 20 plus 20 reserved beds Chest 63 beds Rehabilitation Unit (female) 17 beds Total number of staffed beds 218 In addition the Royal Marsden Hospital has 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 are held for the diagnosis and out-patient treatment of tuberculosis and other chest conditions. (5) Mass Miniature Radiography Unit Seagrave Road, S.W.6. (6) Hurlingham Lodge Hurlingham Road, S.W.6. A London County Council Hostel for homeless infective tuberculous men. 28 beds (7) There is a private home for men and women (4 residents), registered by the London County Council in the Borough at 94, Sedlescombe Road, S.W.6. There has been a reduction of two in the number of places at this home during the year. (8) There is an old people's dwelling at 234. Munster Road, S.W.6, supervised by Abbeyfield (Chelsea & Fulham) Society. (5 bed-sitting rooms). 23 LONDON COUNTY COUNCIL - PERSONAL HEALTH SERVICES The following information on the Clinic Services of the London County Council and the statistical data have been kindly supplied by Dr. B.E.A. Sharpe, L.C.C. Divisional Medical Officer. CLINIC SERVICES 5-7 Parsons Green 6 2 - 6 3 Burne Jones House Type of Clinic 170 Wandsworth Bridge Road 90-92 Greyhound Road Ante-Natal and Post-Natal Wednesday a.m. - Friday a.m. Wednesday p.m. Monday a.m. (4th in month) Wednesday p.m. Relaxation and Moth ercraft Tuesday a.m. - Thursday p.m. - Tuesday a.m. Tuesday p.m. Infant Welfare Friday a.m. Monday p.m. Wednesday p.m. Tuesday p.m. Monday a.m. Wednesday a.m. Monday p.m. Friday p.m. Monday p.m. Thursday p.m. Thursday a.m. (altemate) Toddlers Wednesday a.m. Thursday a.m. (altemate) Tuesday p.m. Dental Mon. a.m. & p.m. Wed. a.m. & p.m. Thurs. a.m. & p.m. Fri. a.m. & p.m. Family Planning Thursday a.m. - Tuesday p.m. - Thursday p.m. Vaccination & Immunisations Monday p.m. Wednesday p.m. Tuesday a.m. Tuesday p.m. STATISTICS FOR FULHAM AREA, 1963 CHILD WELFARE AND TODDLERS SESSIONS First attendances this year of children - Born in 1963 1,812 Born in 1962 2,434 CHILD WELFARE SESSIONS Total attendances 23,157 TODDLER'S SESSIONS Total attendances 976 24 ANTE-NATAL AND POST-NATAL SESSIONS First attendances this year (1963) (a) Ante-natal cases 669 (b) Post-natal cases 44 Total attendances 2,020 FAMILY PLANNING SESSIONS Total attendances 1,021 MOTHERCRAFT AND RELAXATION SESSIONS Total attendances 991 SMALLPOX VACCINATIONS 188 Inspections 152 Diphtheria injections 6,072 Poliomyelitis injections 5,479 Number of Premature infants born during 1963 161 Number of Premature infants deaths under one month 17 Maternal deaths Nil CHILD MINDERS - VOLUNTARILY REGISTERED Number minding children at end of the year 44 Number of children minded at end of the year 67 CHILD MINDERS - STATUTORILY REGISTERED Number minding children at end of the year 6 Number of children minded at end of the year 21 PRIVATE REGISTERED DAY NURSERIES Number minding children at end of the year 2 Number of children minded at end of the year 29 L.C.C. DAY NURSERIES Attendances during the year 29,462 CHILD PROTECTION Number of Foster Mothers at end of the year 31 Number of foster children maintained at end of the year 43 HOME HELP SERVICE Number of cases receiving service at end of the year:- Maternity 1 Tuberculosis 12 Chronic Sick 57 Others 655 Creche attendances during the year 421 Total attendances at Foot Clinics during the year 11,577 HOME NURSING In Fulham, Home Nursing is provided by the Fulham District Nursing Association, a voluntary body, which receives the major part of its financial resources from the London County Council, the Statutory body responsible for the provision of this service under the National Health Service Act, 1946. The Department receives every co-operation from the Superintendent, Miss A. Whyte and Mr Vernon Phillips, Secretary/Accountant of the Association, who has kindly supplied the following details of the nurses work. FULHAM DISTRICT NURSING ASSOCIATION Staff Employed Resident Non-Resident 1 Superintendent (Queen's) 11 District Sisters (Queen's) 1 Male S.R.N. (Queen's) 5 District Sisters S.R.N. 1 Assistant Superintendent (Queen's) 2 District Sisters (Queen's) 2 Enrolled Assistant Nurses Domestic Staff - 1 Full-time and 2 Part-time Nurses' Work 1962 1963 Cases nursed 1,770 1,839 Visits to patients 55,934 53,896 Visits to patients over 65 years 44,189 43,502 New Cases Sent by Doctors 1,168 1,276 Sent by Hospitals 520 456 Sent by T.B. Clinic 12 12 Sent by L.C.C. 3 12 Sent by Public Health Department 22 41 Sent by Rabbi 1 1 Direct Approach 44 41 1,770 1,839 Results Convalescent 818 846 Sent to Hospital 378 382 Died 151 144 Transferred to other areas 7 49 Remaining on books 416 418 1,770 1,839 Cases Nursed 1962 1963 Cases Visits Cases Visits Medical 1,337 41,844 1,457 40,394 Surgical 311 12,055 278 11,752 Infectious Diseases 1 4 11 37 T.B. Medical and Surgical 23 1,297 7 1,092 Maternity Complications 34 257 46 306 Under 5 years 57 443 40 315 Others 7 34 - - - 1,770 55,934 1,839 53,896 26 OLD PEOPLE'S WELFARE IN FULHAM SERVICES FOR ELDERLY PEOPLE - QUESTIONNAIRE The Health Department has been handicapped in planning the services for the old people by a lack of accurate information on the needs of the elderly. In order to overcome this handicap, a questionnaire, in the form of a returnable postcard, was delivered to every house (38,000) in Fulham in July, 1963. These asked on which of the following services persons would like further information:- Chiropody Home Bathing Holidays ' Friendly visits' Home Helps Meals Luncheon Clubs 327 replies were received. The following table summarises the information received:- Service Requests for Information Chiropody 219 Home Bathing 23 Holidays 65 'Friendly' Visits 54 Home Helps 71 Meals 28 Luncheon Clubs 23 TOTAL 483 MEALS SERVICE For many years the W.V.S operated a Meals on Wheels and Luncheon Club Service Due to staffing difficulties the W.V.S. found itself unable to continue the Meals Service (except at the Coronation Luncheon Club) and the Council took over the Service through the Health Department, with effect from the 1st April, 1963. Close co-operation was maintained between the W.V.S and the Health Department and this enabled a smooth transfer to be made without disorganizing the Service, or causing hardship for the recipients of the meals. The Council has been able to employ paid staff and also to provide an additional delivery vehicle and, as a result, the Service has expanded as the following table shows:- 27 MEALS SERVICES Luncheon Clubs Meals on Wheels 1963 Total Brunswick Coronation Lytton Shamrock 162 136 1,325 January 718 206 103 February 616 166 96 137 108 1,123 555 204 116 166 118 1,159 March 448 180 105 230 153 1,116 April 110 195 1,502 May 610 352 235 June 515 375 73 144 144 1,251 July 588 417 74 155 198 1,432 August 600 435 82 200 148 1,465 September 694 424 82 169 196 1,565 801 111 1,905 October 562 198 233 November 996 450 92 172 78 1,788 112 136 1,845 December 1,174 364 59 8,315 4,135 1,103 2,080 1,843 17,476 Totals 1,299 6,891 1,976 1,549 14,322 1962 2,607 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 Manager, Mr. R.C. Gerred, M.N.A.B.S., M.I.Mar.E., that 140/150 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. The service was expanded during the year as seen from the 1962 figures shown in brackets. Number of baths given during 1963 3,939 (2,988) Number of persons receiving baths at end of year 231 (139) Number of persons on waiting list at end of year 5 (2) At the end of the year there were five part-time female attendants engaged on this work paid on a sessional basis. It is not easy to recruit suitable ladies for this work. They need to be physically strong, patient, kind and gentle and imbued with a desire to be of service to old people. Authority exists to increase the number employed as there is an increasing demand for the service 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. 140 cards have been issued since the scheme started. One card was issued in 1963. 28 OLD PEOPLE'S LAUNDRY (Section 122 of the Public Health (London) Act, 1936) SERVICE FOR INCONTINENT PERSONS This scheme which provides for the cleansing of linen and bedding of aged, infirm and incontinent persons has now been in operation for over ten years. It is of very great benefit, both to the persons themselves and to the relatives or other persons who are looking after them. The work is carried out at the Disinfecting Station where modern equipment enables the staff to deal quickly and efficiently with the work. By arrangement with Chelsea Borough Council the laundry of Chelsea old people is dealt with at the Station. During the year 6,170 lbs (dry weight) of laundry was cleansed. The following 29,770 articles of Fulham residents were cleansed during the year:- Sheets 10,552 Pillow Cases 1,982 Towels 4,123 Underwear 9,045 Mattress Covers 351 'Pieces' 2,957 Blankets 760 NATIONAL ASSISTANCE ACT, 1948, and NATIONAL ASSISTANCE (AMENDMENT) ACT, 1951 Visiting of old people whose circumstances require assessment under the above Acts is carried out by the Public Health Department. No compulsory removals were found necessary under either Act. DEPARTMENTAL RECORDS OF OLD PEOPLE It is estimated that there must be about 11,000 persons over 65 years of age in Fulham. Fortunately, the majority are able to look after themselves, or have friends or relatives to look after them. The details of old persons as they become known are recorded in the Department and the number, although fluctuating is generally on the increase:- Number of new cases investigated in 1963 665 Number of above recorded for supervision 596 Number of deaths recorded in 1963 82 Number of old people admitted to Hospitals, Homes and Institutions permanently 42 Number left District 4 Hospital liaison visits 47 Re-visits 1,241 Total number of cases under supervision at end of year 721 Total number of cases recorded in Department 2,613 29 FULHAM OLD PEOPLE'S WELFARE COMMITTEE The Fulham Old People's Welfare Committee is a co-ordinating and advisory body set up for the furtherance of old people's welfare in the Borough of Fulham. It is a voluntary organisation which has as its members, representatives of authorities and organisations concerned with the welfare of the aged. The following information on some of the Committee's activities has been supplied by Mr. C.F. Thatcher, LL.B., Honorary Secretary. Close liaison is maintained with the Health Department, through Mr. J. Burton, Chief Clerk of the Health Department who is Assistant Secretary to the Committee. CHIROPODY Clinics The demand for this service continues to grow and replies to a questionnaire on Services for the Elderly distributed to all households in the Borough in July 1963, revealed that this was the service most in demand. The London County Council run Chiropody Clinics at:- 133, Fulham Palace Road, W. 6. 706, Fulham Road, S.W.6. 18/20, Bagley's Lane, S.W.6. To supplement these, the Old People's Welfare Committee have clinics at:- Bishop Creighton House, 378, Lillie Road, S.W.6. British Red Cross H.Q., 52, New Kings Road, S.W.6. The London County Council pays most of the cost of these two clinics. In November, two extra half-day sessions were started at both these premises and the number of treatments provided from the 1st January, 1963 to 31st December, 1963, was as follows:- British Red Cross 1,024 (685 in 1962) Bishop Creighton House 819 (680 in 1962) DOMICILIARY This service is arranged for those who are housebound, the cost being shared between the London County Council and the Old People's Welfare Committee. The number of visits increased from 654 in 1962, to 711 in 1963. CLOTHING AND BEDDING Requests for clothing from needy Old Age Pensioners are referred to the W.V.S. who supplied five persons with suitable garments during the year. At Christmas, the Licensee of 'The Glen' public house, collected £30 and kindly gave it to be spent on the Elderly. It was used to purchase blankets for 18 elderly persons in need. CHRISTMAS PARCELS SCHEME A generous donation by His Worship the Mayor, Councillor A.H. Little, J.P., of £300, and a further donation from the Old People's Welfare Committee, of £100, again made it possible last Christmas to distribute parcels to elderly Fulham residents living alone. 30 A collection was also made by the cinema management from the patrons of the Regal Cinema (£23.5s.9 d.). A Fulham businessman gave 700 lbs. of sugar, and the New Zealand Government gave 56 lbs. of butter. All these gifts were used to provide parcels. 744 applications for parcels were received and 468 of these were met direct. The remainder were referred to other organisations known to be operating Christmas schemes and 163 pensioners received a parcel or monetary gift from one of these sources. Care is taken by the exchange of names and addresses to ensure as far as possible that a recipient only receives one Christmas parcel from the various sources available. FRIENDLY VISITING The visiting services are co-ordinated through Miss D. Wilson, Warden of Bishop Ceighton House. The need for fresh volunteers to visit a lonely old person each week or fortnight, is as great as ever. Voluntary visiting is greatly appreciated not only by the lonely or handicapped people who receive them, but by all those who have a concern for them - especially relatives living far away and unable to visit, voluntary organisations and the department of the various Authorities who are constantly trying to enlist helpers. Voluntary helpers and the staff of Bishop Creighton House also visit Fulham Hospital on Monday afternoons to talk to patients in the chronic wards and to play cards or dominoes with those who wish. FUEL Following the severe winter of 1962/63, 100 bags of prepacked solid smokeless fuel were bought and held in reserve to supply to elderly people in emergencies. In addition, all the local coal merchants were circularised and asked to give priority to elderly people should there be any prolonged cold weather. Fortunately, the winter was mild and only two bags of fuel were issued. HOLIDAY SCHEME This scheme enables any resident of Fulham who is over the age of sixty years and in reasonable health, to enjoy a holiday at a good-class boarding house at Broadstairs at very reasonable terms during the early and late summer periods During the 1963 season, 239 pensioners participated as compared with 284 in the previous year. The charges and periods chosen were as follows:- 17th May to 31st May 14th September to 28th September 1st week only 10 Ist week only 40 2nd 60 2nd 32 Two weeks 54 Two weeks 43 Total 124 Total 115 The cost per head was £4.10s.0d. (full-board) plus 15/- coach fare. The Mayor and Mayoress (Councillor and Mrs. A.H. Little, J.P.) visited the party at Broadstairs on the 17th September and were received by the Chairman of the Broadstairs Urban District Council. 31 HOME DECORATION SCHEME Two visits to Fulham were made during the year by working parties from the International Voluntary Service. This organisation arranges for parties of volunteers to brighten the homes of deserving old people by re-decorating their rooms in cases where the old person concerned has no other means of having the work done. The work was carried out at week-ends when the working parties were accommodated at the Lytton Estate Club Room. No charge is made to the pensioners and the International Voluntary Service receive no payment for the labour. The Committee, assisted by the National Assistance Board in appropriate cases, has however, reimbursed the International Voluntary Service with the cost of the materials used. 46 rooms were re-decorated - 22 in April/May and 24 in October/November. OLD PEOPLE'S OUTINGS Outing or Show Date Number in Party River trip from Windsor 12.6.63 186 Outing to Maldon, Essex 11.7.63 297 Black and White Minstrel Show 20.12.63 137 Tour of Surrey Beauty Spots 2.4.64 194 SOCIAL CLUBS The fourteen social clubs in the Borough, all of which are run by voluntary organisations, have been well supported during the year. They offer companionship to those who are lonely and the atmosphere of their weekly meetings is always convivial. They arrange their own entertainments, annual outings, and Christmas activities, towards the cost of which, the Old People's Welfare Committee, in appropriate cases, makes a grant. 32 SECTION D Sanitary Circumstances of the Area Page Visits to Dwellings by Public Health Inspectors 33 Statutory Action 33 Summary of Works carried out under supervision of Public Health Inspectors 33 Legal Proceedings 34 Works in Default 34 Water Sampling 34 Land Charges 35 Hairdressers and Barbers 35 Noise Nuisances 35 Disinfection, Disinfestation and Laundry Services 36 Arrangements for Sewerage and Sewage Disposal 37 Housing Act. 1957 - Demolition and Closing Orders 37 Improvement Grants - Housing Acts, 1949-1957 38 Slum Clearance Programmes 38 Housing Act, 1961 39 Common Lodging Houses 40 Dwellings Completed by Council 40 Drainage of New Buildings and Reconstruction of Drainage 41 Rent Act, 1957 41 Habitation Certificates 41 Re-housing of Fulham Residents 42 Rodent Control 42 Clean Air Act, 1956 42 Industrial Premises 42 Smoke Nuisances 43 Smoke Control Areas 43 Measurement of Air Pollution 45 Notices of Intention to Install Furnaces 46 Factories Acts 47 33 SANITARY CIRCUMSTANCES OF THE AREA With an overall improvement in the staffing position in the public health inspectors section during 1963 it proved possible not only to give more attention to important routine matters, but also to make a substantial resumption in house-to-house inspections, area surveys and individual inspections of houses in multiple occupation. The comment was made in my last report that the number of complaints received had increased for the first time for several years. This trend was even more marked in 1963, the number requiring investigation increasing sharply from 1,403 to 2,294. VISITS TO DWELLINGS BY PUBLIC HEALTH INSPECTORS After complaint 2,294 After infectious disease 154 Re-inspections (excluding house-to-house) 4,611 Drains tested 1,089 Drains inspected 1,581 Voluntary drainage works supervised 1,478 Housing enquiries 64 Owners/builders, etc. 847 Miscellaneous visits 426 Ineffectual visits 2,452 Vermin (rehousing cases) 478 Houses in Multiple occupation 660 House to house (initial inspections) 1,287 House to house (reinspections) 1,085 * Rodent control 152 (*Additional to visits by rodent operatives separately reported). STATUTORY ACTION Public Health (London) Act, 1936 and London County Council (General Powers) Acts. Intimation notices served 903 Intimation notices complied with 543 Statutory Notices served 703 Statutory Notices complied with 445 Summary of Works carried out under supervision of Public Health Inspectors Fresh Air Inlets repaired or renewed 21 Soil and Vent Pipes repaired or renewed 65 Drains cleared 80 Drains repaired 95 Drains relaid 29 Rainwater gutters and pipes repaired or renewed 191 Traps cleansed, repaired, etc. 10 Pans renewed 75 Seats repaired or renewed 32 Flushing cisterns repaired or renewed 100 Fastenings provided to doors, and doors repaired 7 Sinks provided, repaired or renewed 20 Sink and bath wastes repaired or renewed 61 Baths cleansed 1 Water cisterns repaired, cleansed, etc. 69 34 Water supply pipes and fitting repaired 37 Internal house repairs 817 Fireplaces repaired (nuisances from smoke etc.) 36 Kitchen ranges repaired or renewed (for cooking purposes) 3 Dampness remedied 721 Rooms provided with adequate light and ventilation 15 Staircases provided with light and ventilation and repaired 40 Ventilation provided under floors and repairs 127 Roofs repaired 420 Other external repairs 195 Accumulations of refuse removed 40 Dustbins replaced 232 Yards, forecourts paved and drained 31 LEGAL PROCEEDINGS During the year 44 summonses were heard at the Park Petty Sessional Division in respect of outstanding nuisances under the Public Health (London) Act, 1936. The cases covering dampness and other sanitary and structural defects were dealt with as follows:- No. of cases where dally penalties were awarded No. of cases withdrawn or adjourned sine die No. of Orders made 9 Nil 35 In four of these cases costs of £1. 1s. 0d. were awarded, and in two cases costs of £2. 2s. 0d. WORKS IN DEFAULT PUBLIC HEALTH (LONDON) ACT, 1936 During 1963 the Council's contractors carried out works in default at 11 premises, the owners having failed to comply with Statutory Notices served under the Public Health (London) Act, 1936. The costs of the work varied in individual cases from £1. 10s. 0d. to £70. 5s. od., the total sum involved being £219. 0s. 9d. WATER SAMPLING The regular monthly sampling for bacteriological examination of domestic supplies in different parts of the borough continued. During the year 93 samples were taken, all except 6 being found satisfactory. Suitable steps were taken and subsequent samples proved satisfactory. The following information has been kindly supplied by Dr. E. Windle Taylor, M.A., M.D., D.P.H., M.R.C.S., L.R.C.P., Director of Water Examination to the Metropolitan Water Board. Number of Samples AFTER TREATMENT Agar plate count per ml. Coliform count E. Coli count Source of Supply Per cent. samples negative in 100 ml. Per cent. samples negative in 100 ml. 3 days at 22°C. 20-24 hours 37° C. Surbiton 524 16.9 - 98.09 98.28 The results of the chemical examination of the samples taken were also satisfactory. 35 Results of Swimming Bath Water Samples During the year 29 samples of swimming bath water were takfrom public and private baths, all samples except one being reported free from B. coli. Bacterial counts were all satisfactory except in one case where more than 300 per m.l. were found. Visits were paid and follow-up samples taken which proved satisfactory. LAND CHARGES ACT, 1925 Enquiries as to any outstanding sanitary or other notices and orders of charges were dealt with in respect of 3,256 premises. In 97 cases notices were outstanding at the time of search, and these were declared accordingly. HAIRDRESSERS AND BARBERS The number of registered hairdressers and barbers increased during the year to 108. 78 inspections were made and no statutory action was found necessary. NOISE NUISANCES The following table sets out the various noise nuisances alleged and action taken following investigations:- _J Nature of complaint Action taken (if any) Number of pets considerably reduced on request. Reduction in noise achieved as result. 1 Nocturnal noise nuisance from cats within curtilage of factory. Trouble due to 'beating' between two motor driven fans and resonance in large bore metal ducting. Cure effected by synchronization of fan motors and treatment of ducting to reduce resonance. 2 Noise following introduction of new fans and machinery. Large undertaking. 3 Noisy handling of deliveries at engineering factory. Management informed. Appreciable reduction of noise effected. Management acceded to request to provide effective sound insulation. 4 Intermittent noise from boiler and other machinery in launderette. 5 Machines re-sited on request and some processes transferred to daylight working. Thumping from plastic machines during night shifts. 6 Night noises from dropping of metal trays when loaded on vans at large food factory. Noise from bell on detector plants. Noise immediately reduced on request and detector bell encased so that it is heard only within factory. 36 Nature of complaint Action taken (if any) 7 Continuous playing of noisy radio set in engineering works. Management co-operative. Volume reduced, and set not used late evening or on Sundays. 8 Noise from demolition work on ex-factory site. Use of demolition machine (heavy ball swinging apparatus) restricted to reasonable hours. 9 Noise from refrigerating motor in butcher's shop. New motor fixed on request. Sound reduced. 10 Noise from machinery at Engineers Works. Metal doors kept closed on request. Sound reduced. DISINFECTION, DISINFESTATION AND LAUNDRY SERVICES Number of rooms disinfested 322 Number of rooms disinfected after Infectious Disease 29 Number of wards and rooms disinfected in Maternity Hospital 16 Number of articles stoved 3,108 Laundry carried out for the Refuse Destructor Staff:- Bath towels 453 Roller towels 58 Dust Coats 26 Boiler Suits 3 The disinfecting staff have also dealt with infestation from cockroaches, beetles, ants, silver fish, moths, wasps, etc. List of verminous and/or stained articles destroyed during 1963:- Bedsteads and Bedsprings 11 Mattresses 30 Bolsters 3 Pillows 12 Blankets 15 Sheets 13 Clothing 71 Miscellaneous furniture 22 37 ARRANGEMENTS FOR SEWERAGE AND SEWAGE DISPOSAL (Information supplied by the courtesy of the Borough Engineer and Surveyor, Mr. E.R. Knight, M.Eng., M.I.C.E., M.I.Mech.E., M.I.Struct.E., M.I Mun.E., M.A.P.L.E., F.S.S.) All local sewers discharge to L.C.C. trunk sewers to which the properties on the routes of the latter are also directly connected. The district is generally effectively drained but there are certain areas where minor flooding is known to occur at infrequent intervals (of the average order of two years) on premises at levels approaching those of the adjacent sewers, which are generally deep. These occasions appear to be associated with rainfalls of the order of 0.25 inches in one-quarter of an hour and with heavy surcharge in the trunk sewers, causing surcharge and reduction of flow capacity in the local severs connected thereto. It is anticipated that improvements, mainly outside the Borough, to trunk sewers in accordance with the programme at present in hand by the L.C.C. will reduce the risk and extent of surcharge in the trunk sewers passing through the Borough, with consequent improvement in the flow of storm water in the local sewers and elimination or reduction of surcharge therein during storms. HOUSING ACT, 1957 DEMOLITION AND CLOSING ORDERS One demolition order was made during the year, as follows:- Premises Date of Order 10, Halford Road 21.1.1963 Two closing orders were made in respect of whole houses, as follows:- Premises Date of Order 86/86A, Townmead Road 11.9.1963 82, Townmead Road 11.9.1963 Two closing orders were made in respect of parts of buildings, as follows:- Premises Part Closed Date of Order 7, Salisbury Mews First Floor 24.4.1963 7, Salisbury Pavement Basement 25.9.1963 The following closing orders were determined during the year, approved works having been carried out on behalf of the owners to render the premises fit for human habitation:- Premises Part Closed Date of Order 42, Vereker Road Basement 25.8.1960 28, North End Road Basement 24.9.1958 The annual survey of 155 premises subject to closing orders was carried out during the year, and the results are as follows :- 38 6 premises and 143 parts of premises were still either not used or used strictly in accordance with the 'permitted use' granted by the Council either at the time of making the closing order or subsequently. Orders were determined in two cases where the premises had been made fit. Premises found to have been demolished since the previous year's survey. In the remaining three cases works were in progress in one and re-housing was awaited in the other two. IMPROVEMENT GRANTS (HOUSING ACTS, 1949-1957) I am indebted to the Borough Architect and Director of Housing, Mr. E.A.H. MacDonald, A.R.I.B.A., F.I. Hsg., for the following particulars applicable to 1963. Applications Received No. of Dwellings Refused/ Withdrawn Approved Standard Discretionary 136 142 117 84 33 25 In each case the Public Health Department is given an opportunity to check whether proposals comply with statutory requirements. HOUSING ACT, 1957 ACQUISITION OF LAND (AUTHORISATION PROCEDURE) ACT, 1946 SLUM CLEARANCE PROGRAMMES: The following Orders were made during 1963, and were awaiting confirmation by the Minister of Housing and Local Government at the end of the year:- The London County Council (Hartopp Avenue, Fulham) Compulsory Purchase Order, 1963. Premises declared to be a clearance area:- Premises to be acquired to provide a suitable site for redevelopment:- 2-48 (even) Hartopp Avenue 1-25 (odd) Hartopp Avenue 2-26 (even) Werley Avenue 1-35 (odd) Werley Avenue 16-28 (even) Pellant Road 2-28b (even) Hannell Road 1-9 (odd) Hannell Road together with adjacent car park at the corner of Hannall Road and Dawes Road. 216-230 (even) Dawes Road. The London County Council (Farm Lane, Fulham) Compulsory Purchase Order, 1963. Premises declared to be a clearance area:- Premises to be acquired to provide a suitable site for redevelopment:- 11, 13, 17-29 (odd), 35, 47-61 (odd), Farm Lane. 15, 29A, 31, 31A, 33, 37, 39, 41, 43, 45, 63 and 65, Farm Lane. 50-52 (even), Farm Lane. Workshop and stores between 61 and 63. 54-60 (even), Farm Lane. 62-72 (even), Farm Lane. 39 The Fulham Borough Council (Field Road (No.4) Compulsory Purchase Order, 1963. Premises declared to be a clearance area Premises to be acquired to provide a suitable site for redevelopment:- 1, 3, 8, 11, 13, 15, 17 and 19 Dewport Street. 3, 9, Field Road. 5, 7, Dewport Street. 1, 3, 6, 7 and 10, Lundy Street. 2, 4, 5, 8, 11, 12 and 13, Lundy Street. 2, Margravine Road and land adjoining 147, 149, 151, 153, 155, 157, 159, 161, 163, 169, Greyhound Road. 11, 11a, 13, 15, 17 and 19 Field Road. St. Albans Works. The Fulham Borough Council (Estcourt Road No. 2) Compulsory Purchase Order, 1962. During the year the Minister of Housing and Local Government confirmed without modification the above Compulsory Purchase Order. The Fulham Borough Council (Fulham Road No. 1) Compulsory Purchase Order, 1 962. During the year the Minister of Housing and Local Government confirmed without modification the above Compulsory Purchase Order. The Fulham Borough Council (Townmead Road No.1) Clearance Order, 1962. The Minister of Housing and Local Government confirmed the above Order with modification, this being the exclusion of No. 88/88a, Townmead Road on which house a Closing Order was subsequently made. HOUSING ACT, 1961 Four cases of individual houses in multiple occupation in which conditions were found calling for action under Part 11 of this Act. In each case single-room Settings predominated and the facilities provided fell far short of the standards adopted by the Council when applying these statutory provisions. During the year two of these cases were brought to a satisfactory conclusion and work commenced in the remainder. Consideration was given to exploring the line of action outlined in the Ministry of Housing and Local Government's Circular No. 42/62, with a view to getting a big increase in the number of premises improved. The Minister suggested a systematic approach and this involved taking a street or area considered worth improving and then indicating to all the owners and tenants concerned What improvements would be necessary to bring their premises up to a satisfactory standard, stating the help the Council could give them towards bringing about the desired results Close co-operation was necessary and maintained between the Health and Housing Committees and the corresponding departments. To give effect to the Minister's suggestion, the Council selected two areas, differing in character, for survey by the public health inspectors. The first area comprised 160 three-storeyed houses in two adjoining streets Multiple occupation (mainly sub-letting) was present in 117. The structures were sound and any sanitary defects found were dealt with as a separate issue by exercising powers under the Public Health (London) Act, 1936. Owners and 'persons in control' were then informed of the Council's desire to bring about improvements of the area They were given details of what was involved in each particular case and of the improvement grants which could be made available in appropri ate cases Both 40 owners and tenants were invited to a meeting held at a School in the area and a large attendance resulted The Council's plans were expounded and a plea made for maximum co-operation. Numerous questions were raised, most of which had been anticipated in Circular 42/62. Would loans be available in addition to grants? What happens when there is no room for a bathroom? What rent increases would be involved? Supposing elderly tenants did not wish to be disturbed? There followed a prolonged period of consideration of individual cases. Council's officers conducted a vast correspondence and separately interviewed the owners, and/or their professional advisers, of 94 of the premises. Many site meetings took place. The Minister had warned that such projects can be very hard work and that resistances would be met. In the event this proved to be the case Nevertheless, gradually and painstakingly this particular area plan has reached a stage where some success can reasonably be anticipated. Already some of the larger owning interests have either instructed architects or surveyors to prepare improvement schemes or have discussed the sale of their premises to the Council. Some owners of individual premises have come to terms with their tenants and provided additional sanitary facilities. With the preliminaries over, next year should see further worthwhile practical results. The second area surveyed comprised 360 two-storeyed premises, almost all owned by one company. After the few sanitary defects found had been dealt with, the responsibility for further exploring the possibility of effecting improvements was taken over by the Housing Committee which is being advised by the Borough Architect. COMMON LODGING HOUSES There are no common lodging houses in the Borough. DWELLINGS COMPLETED BY THE COUNCIL BETWEEN Ist JANUARY AND 31st DECEMBER, 1963 Information supplied by the courtesy of the Borough Architect and Director of Housing Mr. E. A. H. MacDonald, A.R.I.B.A., F.I.Hsg:- Estate Date Completed No. of Dwellings Rooms Total Rooms 1 2 3 4 Ethel Rankin Court 30.3.63 9 3 - 3 3 24 Cobbs Hall 20.4.63 30 15 5 10 55 - 11.5.63 36 4 - 100 The Grange 32 - 14.12.63 6 - 24½26, Matheson Road - 6 - 18 197 5 81 22 51 3 Under the Housing Act, 1957, the Council is continuing to acquire property for general housing needs. Some 41 properties were acquired in 1963 which at the time of purchase provide accommodation for 50 family units. After improvements these dwellings will provide 56 family units. 41 DRAINAGE OF NEW BUILDINGS and RECONSTRUCTION OF DRAINAGE A Senior Public Health Inspector specialises in the inspection, supervision and testing of drainage works and is available for advising contractors and others on any project. During the year the following drainage schemes were approved by the Public Health Committee:- Additions to existing buildings or additional sanitary accommodation 130 Reconstruction of drainage system 2 Conversion of premises into flats 39 New buildings 13 Total 184 RENT ACT, 1957 The administration regarding questions of certificates of disrepair under this Act continued to work smoothly. The examination of documents and giving of advice was undertaken in the Town Clerk's Department, whilst inspections, preparations of forms and correspondence 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 to secure abatement of nuisances, whether or not so included. During the year no certificate of disrepair issued by the Council was challenged by any owner or occupier in the County Court. There are still 89 certificates issued under the Housing Repairs and Rents Act, 1954, uncancelled, 1 being cancelled during 1963. 96 Certificates under the 1957 Act were outstanding at the end of the year. Details of action taken between 1st January and 31st December, 1963, are as follows:- Applications for certificates 10 Decisions not to issue certificates 1 Decisions to issue certificates 9 (a) in respect of some but not all defects 4 (b) in respect of all defects 5 Undertakings given by landlords 4 Undertakings refused by Council Nil Certificates issued 4 Applications by landlords to Council for cancellation of certificates 10 Objections by tenants to cancellation of certificates 1 Council decisions to cancel in spite of tenants' objections 1 Certificates cancelled 10 HABITATION CERTIFICATES UNDER SECTION 95(2) OF THE PUBLIC HEALTH (LONDON) ACT, 1936 During the year three certificates were issued in respect of 75 newly erected dwellings in the Borough. 42 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. Number of families rehoused by London County Council 137 Number of families rehoused by Fulham Borough Council 201 Total 338 RODENT CONTROL During the year four baiting treatments of the sewers were carried out. On each occasion 315 inspection chambers were poison baited by a service company using sodium fluoracetate in 4 oz baits. The toxic qualities of this poison are well-known and the main reason for engaging this particular company was that their operators are thoroughly trained in the use of this substance. After each treatment there was a reduction in the number of surface infestations, both reported' and 'discovered' by inspection. Practically all of the reported cases of surface infestations were traceable to rats coming off either a defective or disused house connection to the sewer. Type of Property Business & Industrial Premises Total Local Authority Dwelling Houses 1. No. of complaints received 526 73 599 2. No. of properties inspected - 693 131 824 3. No. of properties found to be infested by rats: Major Minor - - - - 278 - 239 39 4. No. of properties found to be infested by mice 321 - 287 34 5. No. of properties treated: (a) Rats - 239 39 278 (b) Mice 267 25 292 - 6. No. of notices served under Section 4: - - - - (a) Treatment (b) Structural works, i.e. Proofing - - - - No. of Notices served under the Public Health (London) Act, 1936 - - - - 7. No. of visits made by Rodent Operatives - 5,617 678 6,295 CLEAN AIR ACT, 1956 INDUSTRIAL PREMISES It is pleasing to report that emissions of smoke from factory chimneys constituting offences under the Act or contraventions of The Dark Smoke (Permitted Periods) Regulations, 1958 were few Often the cause was mechanical breakdown, which the firms concerned reported immediately to the department. In every case managements took the necessary steps without delay and no case called for legal proceedings. 43 SMOKE NUISANCES Six complaints of smoke nuisances due to burning refuse of various kinds in the open were received. In each case the matter received immediate attention on request and no recurrences were reported. SMOKE CONTROL AREAS A map showing the progress of Smoke Control Areas is shown as the Frontispiece. The procedure has continued its now familiar pattern, the most important steps in date order during the year were as follows:- January Confirmation of Smoke Control Order No.7 received from the Ministry of Housing and Local Government on 30th. Householders and interested parties informed by letter of the confirmation and invited to attend a Clean Air Exhibition. The letter also set out the action required to obtain grant aid towards the cost of conversions or adaptations to fireplaces. February Clean Air Exhibition held 14th-16th February at St.Etheldreda's Church Hall, Fulham Palace Road. 1919 persons visiting the exhibition. A competition was held in which competitors were invited to place ten benefits arising from the creation of Smoke. Control Areas in what they considered to be their order of importance. 94 entries were received and valuable prizes for the competition were kindly donated by the exhibitors June Reminder notices were distributed to all householders in No. 7 Smoke Control Area in the week ending 25th June They achieved their desired effect and were followed by a spate of enquiries to the Department for grants. July The survey of No. 8 Smoke Control Area was completed and the survey of No. 9 Area commenced. The estimated number of premises in No. 9 area is 7,249 October RESIDENT MEETING - NO. 9 SMOKE CONTROL AREA No. 9 Smoke Control Area includes some large industrial undertakings and adjoins the main heavy industrial zone of the borough. In anticipation of possible opposition to the proposed order, it was decided to hold a public meeting in the area as early as possible after the preliminary survey had commenced so that the public could be fully informed on what was involved and to enable them to ask questions. The Chairman of the Health Committee, Councillor Mrs F.C. Pusey, presided over a panel consisting of the Medical Officer of Health and representatives from the Central Electricity Generating Board, the London Electricity Board, the North Thames Gas Board and the Solid Smokeless Fuels Association who answered questions Only 35 residents attended but a lively meeting ensued, many questions on the position of industry in relation to the Clean Air Act being asked and satisfactorily answered. The meeting was well reported in the local press. November VISIT OF SOLID SMOKELESS FUELS FEDERATION VAN This unit toured the No 7 Smoke Control Area during the week ending 9th November but was poorly attended. It would seem therefore that the Fulham public do not need these ancillary exhibitions. SMOKE CONTROL AREA NO. 8. An Order to cover this area was made and brief details are as follows:- Size of Area 335 acres 44 Number of industrial premises 142 Number of commercial premises 291 Number of dwellings 6,022 Number of other premises 27 Total estimated costs of works based on the survey 67,340 Of this sum:- Exchequer contribution: 26,936 Council's contribution 20,871 Present annual tonnage of bituminous coal and other smoky fuels to be replaced (excluding oil) 1,981 Suggestive operative date of Order 1.10.64. December Ministry of Housing and Local Government Circular 69/63. This circular was issued following a comprehensive reassessment of the probable availability of the different smokeless fuels in Great Britain during the coming decade or so and the probable demand in the same period. In the light of this reassessment the Minister of Housing decided that current arrangements under the Clean Air Act needed some reshaping in order to ensure the continued smooth establishment of smoke control areas. The range of fuels likely to be available in Fulham was ascertained and the Public Health Committee decided to follow the recommendations made in the circular and allow full grants on: (1) free standing or inset openable stoves (2) underfloor draught fires (3) electric thermal storage space heaters. POSITION REACHED BY THE COUNCIL AT 31.12.63 No. of Applications Estimated No. of conversions No. of Premises Operative Date Area Acres 1 100 3,927 1.10.58 1.10.59 1.10.60 1.10.61 1 10.62 1.10.62 1.10.63 1.10.64 1,494 2,241 2 160 5,827 1,177 1,765 3 85 2,423 603 904 4 174 5,801 2,091 3,136 5 147 5,466 1,456 2,184 6 47 14 1 2 7 290 6,283 6,798 2,267 3,401 8 335 Confirmation received 21.11.63 Proposed date 9 368 6,872 1.10.65 * Based on an average of 1½ per application. Clean Air Exhibition. St. Elheldreda's Church Hall - February Left to Right Mayor, Councillor Miss Phyllis Cooper J.P., Dr. H. L. Settle Medical Officer of Health, The Mayoress, Councillor Miss F. C. Pusey M.R.S.H. Mr. Nicholls - Solid Smokeless Fuels Federation. Friends of Fulham Hospital Carnival Departmental Float “Smoking and Health” July 1963. 45 Window aid Foyer Displays The window display was used in conjunction with No. 7 Smoke Control Order at Messrs. Metroglaze premises, Munster Road. The display showed a map of No. 7 Area and the streets affected and the action to take to obtain grants. A comprehensive display unit was borrowed from the Solid Smokeless Fuels Federation for exhibition in the Department's foyer. It consists of two units, one showing the types of solid smokeless fuels available and the other the advantages from using solid fuel. Exhaust Fumes from Motor Vehicles The practice of drawing the attention of vehicle owners to emissions of heavy exhaust from their vehicles was continued. During 1963, eight diesel-engined vehicles were observed in the Borough to be emitting dark smoke of a sufficient density to warrant the attention of the owners being drawn to the fact. All the firms concerned were most co-operative in immediately having the vehicles withdrawn from service and examined. West London Inter-Boroughs' Smoke Control Liaison Committee Three meetings of this Committee were held during the year for the purpose of exchanging views on common problems arising from the creation of Smoke Control Areas. The following Local Authorities are members of this Committee:- Acton Borough Council Fulham Metropolitan Borough Council Barnes Borough Council Hammersmith Metropolitan Borough Council Brentford and Chiswick Borough Council Willesden Borough Council Richmond Borough Council MEASUREMENT OF AIR POLLUTION The Department co-operates in the National Atmospheric Pollution Survey of the Department of Scientific and Industrial Research by measuring smoke and sulphur dioxide pollution at three sites in the Borough, viz. Chelsea Secondary School, Clem Attlee Court and Fulham Town Hall. The department has also collaborated with the D.S.I.R. and the College of General Practitioners and certain other Metropolitan Boroughs in a special investigation to find the connection, if any, between atmospheric pollution and chest complaints. Special equipment is brought into use at the Town Hall when fogs are forecast to measure the smoke and SO2 continuously for hourly periods, this apparatus functioning automatically. Figures issued by the D.S.I R. show there has been a definite reduction in the smoke concentration in London over recent years and this can be attributed directly to the introduction of smoke control areas. SECTION 3. Notices of Intention to Install Furnaces The following notices were received during the year:- Type of Appliance(s) and fuel to be used Type of Premises Furnace Rating Purpose Dwelling House 1 Janitor gas fired boiler 60,000 B.T.U's per hour Hot water supply Dwelling House 1 Janitor gas fired boiler 60,000 B.T.U's per hour Hot water supply Dwelling House 1 Potterton gas fired boiler 67,000 B.T.U's per hour Hot water supply Dwelling House 1 Kin gas fired boiler 70,000 B.T.U's per hour Hot water supply Dwelling House 1 Janitor oil fired boiler 125,000 B.T.U's per hour Central heating 2 Potterton oil fired boilers Launderette 270,000 B.T.U's per hour each Hot water supply Launderette 2 Potterton oil fired boilers 270,000 B.T.U's per hour each Hot water supply 47 FACTORIES ACTS The position at the end of 1963 was as follows:- Factories with mechanical power 283 Factories without mechanical power 279 The following is a summary of industries and trades registered as factories in the Borough:- Antique dealers 18 Boot repairers 34 Cement Works and Road Surfacing Materials 7 Clothing (including tailors, dressmakers, shirtmakers and bathing costume manufacturers) 27 Coal Wharf 1 Dyers and Cleaners' 4 Dyers and Cleaners' Receiving Depots 33 Electricity Generating Station 1 Engineers: Electrical 22 General 39 Precision 17 Sheet Metal 11 89 Exhibition Stand and Display specialists 7 Food (in all its branches - pie manufacturers, butchers, etc.) 26 Garages (services and repairs) 48 Gas Works 1 Laboratories 5 Launderettes 16 Laundries 9 Laundry Receiving Depots 18 Metal frame spraying 8 Oil Depots 5 Paint Manufacturer 1 Paper Bag and Cardboard Box Manufacturers 4 Photographic Processing 1 Potteries 3 Printers: General 25 Silk Screen 3 28 Scrap Metal merchants 11 Timber Merchants and Joiners 38 Warehouses, Wharfingers and Bonded Stores 36 Miscellaneous 83 562 48 The following is a record of inspections made and action taken:- Section 8 No. of Notices served - - - - Inspections Premises Factories without mechanical power (initial visits) 29 Factories with mechanical power (initial visits) 24 Other premises under the Act (building operations and works of engineering construction) 3 Number of re-inspections of all factories 1,554 - 1,610 - Number of cases in which defects were found:- Particulars Found Remedied Want of cleanliness 36 36 11 Inadequate ventilation 11 Inadequate lighting 8 8 18 Ineffective drainage of floors 18 Sanitary Conveniences:- (a) Insufficient 16 15 16 56 (b) Unsuitable or defective 3 3 (c) Not separate for the sexes 148 147 No prosecutions were instituted under the Factories Acts during 1963. Section 110 - Outwork Nature of Work Artificial flowers Artificial jewellery Boot making Box making Button carding Fancy goods Lampshades Leatherwork Millinery Paper and plastic bags Toymaking Upholstery Wearing apparel 143 visits were made to outworkers during the year. No. of Outworkers on list 27 3 2 1 3 2 5 1 4 3 30 5 31 117 SECTION E Inspection and Supervision of Food Page Food, Examination 50 Food, Voluntary surrender 50 Milk 50 Ice Cream (Heat Treatment etc.) Regulations 51 Food Standards (Ice Cream) Regulations 52 Sampling, Foods and Drugs 52 Adulterated or Irregular Samples and Food subject of Complaint 53 Bacteriological Examination of Foodstuffs 56 Food Establishments, Inspection 56 Food Hygiene Regulations 57 Report of the Council's Public Analyst Thomas A. McLachlann 58 50 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 can be seized with subsequent condemnation by a Justice of the Peace and destruction. Voluntary Surrender of Food In practice, shopkeepers rarely attempt knowingly to sell to the public any food-stuff 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, if satisfied after examination that the food is unfit, issues a certificate to that effect and arranges for its removal to, and destruction at the Council's Refuse Destructor. The surrender of food-stuffs from various depots and food premises during the year involved the examination and destruction of the following articles and the issue of 547 certificates:- Tinned and packeted goods 5,201 Beef Kidneys 20 lbs Chicken 25½ lbs Fresh Cream Cakes 7 lbs Fish 48 lbs Meat 1,066½ lbs Pickled Cabbage 5 lbs Pigs Liver 15 lbs Milk Chocolate Toffees 1 lbs Potatoes 3 tons 17 cwts. Bacon 130 lbs 6 oz. SALE OF MILK REGULATIONS, 1939 The above Regulations state that where a sample of milk contains less than 3% of milk fat or 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 percentage of fat and non-fatty solids present:- No. of Average % Month Samples Fat Non-fatty solids January 6 3.79 8.75 February 8 3.68 8.74 March 4 3.64 8.60 April 2 3.50 8.51 May 5 3.48 8.52 June 3 3.57 8.59 July 3 3.58 8.54 August 2 3.68 8.50 September 2 3.58 8.69 October 3 3.80 8.65 November 1 3.80 8.62 December 2 3.63 8.64 3.64 8.61 51 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', 'Jersey', 'Guernsey', or 'South Devon', if it contains less than 4% milk fat. The following table shows the details of samples taken:- Average % No. of samples Fat Non-fatty solids 22 4.44 8.92 In no case did a sample fall below the minimum of 4.0% milk fat. Milk (Special Designation) Regulations, 1960 The following table gives details of samples taken under these Regulations:- Phosphatase test No. of Samples tested Methylene blue test Turbidity test Grade of Milk Passed Failed Passed Failed Void Passed Failed Pasteurised 5 5 - 5 - - - - Sterilised 3 - - - - - 3 - Tuberculin tested (Pasteurised) 74 74 - 69 5 7 - - The following are details of licences issued during the year. The expiry date of all current licences is December 31st 1965. Issued in 1963 Total on Register To retail Tuberculin Tested Milk 3 80 To retail Pasteurised Milk 12 130 To retail Sterilised Milk 11 119 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 130 premises so engaged. Number of Inspections of milk dealers premises 158 Ice Cream (Heat Treatment, etc.) Regulations, 1959 Ingredients used in the manufacture of ice cream are required to be pasteurised or sterilised and thereafter kept at low temperature until the freezing process is begun. Ice cream which has been allowed to reach a temperature exceeding 280F must be heat treated again before sale. Exempted from the heat treatment requirements are water ices and ice lollies that are mixed before freezing and have a pH value of 4.5 or less. 52 Routine sampling has been carried out, and it is pleasing to report that nearly every sample has reached the highest grade of cleanliness prescribed under the Regulations. Details of samples taken are as follows:- Total Wrapped 'Loose' Ice Cream 23 1 24 2 - 2 Lollies 26* * Grade 1-23; Grade 2-1; Grade 3-1; Grade 4-1. The Food Standards (Ice Cream) Regulations, 1959 The Regulations prescribe standards for ice cream and for 'Tarev' (kosher) ice and separate standards for dairy ice cream and for milk ice. No type of ice cream shall contain any artificial sweetener. The standard of composition briefly stated is as follows:- Ice Cream. Shall contain not less than 5% fat and 7½% milk solids other than fat. (Where ice cream contains any fruit, fruit pulp, etc. the total fat and milk solids other than fat shall be not less than 12½% of the whole). Dairy Ice Cream. Shall contain not less than 5% milk fat and no other fat, and not less than 7½% milk solids other than fat. (Where dairy ice cream contains any fruit, fruit pulp, etc. the total content of milk fat and milk solids other than fat, shall be not less than 12½% of the whole). Milk Ice (or milk ice containing any fruit, fruit pulp, etc.) shall contain not less than 2½% of milk fat and no other fat and not less than 7% milk solids other than fat. 'Parev' or kosher ice shall contain not less than 10% fat and no milk fat or other derivative of milk. During the year a total of 35 samples of ice cream were obtained with the following average results:- Average % Fat Non-fatty solids Total solids Ice Cream 25.98 34.72 8.74 Dairy Ice Cream 8.11 25.23 33.34 In two cases samples fell below minimum requirements. FOOD AND DRUGS SAMPLING Nine complaints were received from members of the public regarding food, and these were fully investigated. 53 ADULTERATED OR IRREGULAR SAMPLES AND FOOD SUBJECT OF COMPLAINT Formal (F) or Informal (I) or Complaint (C) Adulteration, Irregularity or nature of complaint and Analysts' comments Action taken Article Black Pudding (No. 5607) I Contained total meat 55%. Public Analyst of opinion meat content should be not less than 70% Further sample obtained. Letter to and discussion with producer/retailer. Bun Loaf (No. 5646) I Two loaves contained respectively 21.85% and 9.64% fruit. Inadequate distribution of fruit. Loaf of Bread C When cut found to contain portions of wire. Letter to producers. Olives stuffed (No. 5758) I Contained numerous budding yeast cells and would probably not keep very long Retailer notified and stock position checked. Ice Cream (No. 5839) I Contained 4.54% fat. Food Standards (Ice Cream) Regulations, 1959, require ice cream to contain not less than 5% fat. Sample is therefore 9% deficient in fat. Producer/retailer informed and further informal sample obtained. Beef Sausages (No. 5860) C Found to contain black material probably caused by mineral oil. Warning letter to producers. Meat Pie C Complaint was received that a meat pie had been found to contain a large number of live ants. Visit to premises failed to reveal presences of ants - bakehouse in very clean condition. Difficulty in proving ants were in pie at time of purchase so no action taken. Fruit Pie C Complaint of ants found in fruit pie when opened. No trace of ants at complainants house or retail shop. No action taken. Cream Cheese (No.5879) I Contained fat on dry matter only 46.4%. Further sample being obtained. Mint Concentrate (No. 5888) I Contained hazel leaf though probably less than 5%. Letter to producers. Corned Beef (No. 5893) Contents of tin attacked by black stains. Slice of meat contained 91 p.p.m. tin. Adulterated. Further samples obtained from stock and all sales stopped pending further results. I 54 Formal (F) or Informal (I) or Complaint (C) Adulteration, Irregularity or nature of complaint and Analysts' comments Action taken Article Ice Cream (No. 5906) I Contained 4.54% fat only. Inferior. Informal follow-up of sample No. 5839. Formal sample now taken. Top of the Milk (No. 5941) I The Food & Drugs Act defines cream as that part of the milk rich in fat which has been separated by skimming or otherwise and the Food Standards Order requires sterilised cream to contain not less than 23% milk fat. This product contains 18.8% fat and 7% solids-not-fat. It is therefore 18% deficient in fat. No action. Prepared Apricots, Lemons and Oranges (Nos. 5885, 5886 and 5887) I Label implies contents are uncut, whereas they are cut. Letter to producers. Ice Pops (No. 5983) I Product satisfactory, but label should declare 'sodium alginate' instead of 'alginate' and 'saccharin' instead of 'saccharine'. Letter to producers. Corn Puffs (No. 6008) I Contain an American certified red colour not permitted in this country. Letter to importers. Currants (No. 6050) I Currants satisfactory but contained considerable quantity of extraneous dirt. Inferior. Retailer informed and appropriate action requested. Double Cream (No. 6059) F Contained fat 41.92%. Should be 48%. Letter to producers. Sugar Confectionery (Lemon Drops) (No. 6067) I Contain citric acid 0.68%, vitamin C 13.2 mg. per oz. colouring and flavour, sugar to 100%. Labelling of Food Order requires quantity of vitamins present to be stated. Use of flavouring should also be disclosed. Letter to person having control of stock from which sample taken. 55 Formal (F) or Informal (I) or Complaint (C) Adulteration, Irregularity or nature of complaint and Analysts' comments Action taken Article Shelled Walnuts C Contained evidence of infestation by Mediterranean Mill Moth. Warning letter to retailer. Steak and Kidney Pie C Found to be in a mouldy condition. Warning letter to retailer. Scone C Found to contain an insect i.e. a wasp. No further action. Tomato Paste (No. 6069) Further samples obtained. Howard Mould Count 80% - excessive. Sample of dark colour and possesses caramelised taste. I Steak and Kidney C Complainant said steak and kidney was composed of heart and kidney. Assistant thought complainant wanted it for her dog. Warning letter to retailer. Haslet (No. 6119) I Contained lean meat 39%, fat 22%, total meat 61%. Haslet should contain about 70% meat (lean fore-end pork). Inferior. Letter to vendors. Tomato Paste (Nos. 6136, 6137, 6138) I Howard Mould Counts respectively 100%, 90%, 80%. Should not be greater than 60%. Wholesaler informed. also local authority for district concerned. Tomato Puree (No. 6140) Letter to retailer and wholesaler; two further samples taken. I Howard Mould Count 80%. Should not be greater than 60%. Wholesaler interviewed. Tomato Paste (No. 6142) I Howard Mould Count 70%. Should not be greater than 60%. Vodka (No. 6157) I Contained 64.1% proof spirit although label declares 65.5% proof. Inferior. Further brands of vodka to be sampled. Sweetener (No. 6167) I Contains 99% sugar and 1% soluble saccharin, which is satisfactory. Claim that it should be used for sweetening puddings is not justified. No further action deemed necessary. Ingredients not disclosed in correct order. Soup Mix (No. 6178) I Further sample obtained. 56 Article Minced Beef (canned) (No. 6235) Soup Mix (No. 6272) Black Pudding (No. 6309) Figs, pasteurised (No. 6361) Vodka 800 proof (No. 6364) Potatoes (boiled, mashed) (No. 6380) Formal (F) or Informal (I) or Complaint (C) I I I I I C Adulteration, Irregularity or nature of complaint and Analysts' comments Action taken Inferior. Contained 45% total meat. Ingredients not disclosed in correct order. Total meat content 51%, very low. Inferior, as broken cellophane cover defeats purpose of pasteurisation. Inferior. Contained 78.9% proof. Spirit therefore 1.4% deficient. Had unappetising rancid smell. Contained high bacterial count. Reickert test showed fat to be margarine. Letter to producers. Commodity now withdrawn from production. Second sample in similar condition. Letter to packers. Letter to retailers. No action. No action at present. Investigations proceeding. BACTERIOLOGICAL EXAMINATION OF FOODSTUFFS Cream filled confectionery is an excellent medium for the growth of bacteria and thus the transmission of illness and because of this, routine sampling takes place of the filling at the bakeries and of the completed confectionery as exposed for sale in the shops. 59 samples were examined for the presence of faecal coliform bacilli and staphylococcus aureus. The results obtained were generally satisfactory. FOOD ESTABLISHMENTS The following inspections were carried out during the year. Type of Business No. of premis es No. of Inspections Bakehouses (non-basement) 27 ) 50 Bakehouses (basement) 2) Bread and Cake shops 12 73 Butchers' shops 68 284 Confectionery 74 64 Cooked Meat Shops 16 103 57 Type of Business No. of premises No. of Inspections Milk distributors 130 170 Eel and Pie shops 3 13 Food Factories 7 137 Fishmongers' shops 25 73 Fried Fish shops 23 37 General Food shops 230 701 Greengrocers and Fruiterers 109 140 Ice Cream (Manufacturers and Dealers) 232 155 Licensed Premises 106 114 Restaurants and Dining rooms 144 682 Stalls 109 376 Stallholders' Storage premises 70 42 Other Food premises 10 174 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. FOOD HYGIENE (GENERAL) REGULATIONS, 1960 The ever-increasing tendency to the sale of prepacked food-stuffs is excellent from the food hygiene standpoint. It means that if conditions of production are satisfactory, a hygienically sound article reaches the home of the consumer - a feat which is the goal of all regulations concerned with food handling. Again, the constantly reducing number and increasing size of food production units usually - but initially not always - results in more modern and more hygienic methods of food production and handling. However, whether in food factory, cafe kitchen or foodshop, cleanly personal habits need to be pursued at all times. It is this personal element that can so often be the cause of needless trouble. It was found necessary to lodge five charges of contraventions against one firm. The Court imposed penalties of £10 on each charge and awarded the Council two guineas costs. 58 REPORT OF THE COUNCIL ANALYST (THOMAS McLACHLAN, D.C.M., A.C.G.F.C., F.R.I.C., M.I.Biol.) During the year 1963, 800 samples of food were examined. Of these 87 were taken formally and 713 informally. The number adulterated or about which some comment was made was 47. The incidence of these criticisms may be classified as follows:- Number of samples examined Number of samples adulterated, etc. Milk 63 - Other foods 737 47 The winter at the beginning of the year was extremely cold and there was much snow on the ground causing trouble in the feeding of cattle. This was reflected in the poor quality milk obtained during the months of February, March and April. A milk bottle contained a whiteish deposit consisting of dried milk protein together with silica. This was probably due to a little milk residue at the bottom of the bottle not being removed by the detergent used and some of the silica from the detergent being absorbed by the dried milk protein. Some double cream contained only 41.92 per cent of fat and was 12 per cent deficient in milk fat. The solids-not-fat of a sample of cream and one of double cream were 8.45 per cent and 8.10 per cent, when calculated back to the original milk, indicating that the cream had been prepared from watered milk. The fat contents were 19.8 per cent and 51.91 per cent. Two further samples contained 21.16 per cent and 49.50 per cent of fat respectively, and solids-not-fat 8.2 per cent and 6.7 per cent when calculated to the original milk. Two samples of dairy ice cream were deficient in fat, containing only 4.54 per cent of fat in each case. The Food Standards Ice Cream Regulations 1959 require the presence of not less than 5 per cent of fat. A product sold as Top of the Milk contained only 18 per cent of milk fat and your analyst in agreement with most public analysts maintains that this is canned cream and must, therefore, contain not less than 23 per cent of milk fat as required by the Food Standards Cream Order, 1951. The Food and Drugs Act, 1955 describes cream as that part of milk rich in fat which has been separated by skimming or otherwise', but it is understood that the Ministry of Agriculture, Fisheries and Food, have sent a letter to the vendors stating that as the product is not described as cream it is their view that it may legally be sold at a lower standard than is required for canned cream. Your analyst's opinion is based not merely on his interpretation of the Food and Drugs Act, but also on the object for which the product is sold. He has, moreover, sent two of his staff to separate shops to purchase tins of cream and they have been supplied with Top of the Milk. In one case the assistant refused to take the product as it was not labelled cream and the floor manager, on being called, informed her that this was the only type of cream they were then selling Another public analyst similarly sent one of his staff to a third shop and this assistant was again treated in the same way. Your analyst is very perturbed about this matter since several Local Authorities were preparing to take legal action, but were discouraged from doing so by the Ministry's letter although officially the Ministry discontinued its food advisory service many years ago. It remains to be seen how this situation will develop. A cream cheese contained only 46.4 per cent of fat on the dry matter, whereas it should contain not less than 45 per cent of fat on the cheese as sold. 59 The label of a liquid ice lolly required amendment: 'sodium alginate' was described as 'alginate' and 'saccharin was speit with a terminal e Five samples of soup mix were both incorrectly labelled and the ingredients were declared in the wrong order. Samples sold as prepared lemons, prepared oranges, and prepared apricots, were considered to be incorrectly labelled as this description indicated that the apricots, lemons, and oranges were whole whereas they were cut into small pieces for jam or marmalade manufacture. They should have been described as 'Prepared Apricot', 'Prepared Lemon', and 'Prepared Orange', theabsence of the plural description would imply better what was in the can. Some lemon drops contained 0.68 per cent of acid as citric acid, 13.2 mg of Vitamin C per oz, colouring, flavouring and sugar. They were prepacked and as confectionery exempt from the requirements of bearing the name and address of the manufacturer, but they were not exempt from part 6 of the Labelling of Food Order which requires any food making a claim for the presence of Vitamins to state the quantity of vitamins present. A sample of 'Slimmers Sugar' consisted of sugar with 1 per cent of sodium saccharin and was recommended for making puddings and cakes This was considered by your analyst to be a misleading label as with puddings and cakes one eats to repletion or comfort One does not eat to calories unless one is on a regulated diet, and this label disclaimed any pretence to be a diabetic sweetener. By analogy with the Bread and Flour Regulations, 1963, mentioned later, this product should only be recommended for slimming, when the label mentions that it should only be used to form part of a diet of which the calorie intake is controlled. One sample of Vodka was labelled as 65.50° Proof but was found to be only 64.10° Proof spirit so that it was 2.1 per cent deficient in proof spirit, and another was labelled as 80° Proof contained only 78.9 per cent of proof spirit and was therefore 1.4 per cent deficient in alcohol. LEGISLATION ISSUED OR PROPOSED DURING 1963. The year has been a comparatively quiet one regarding the issue of food regulations, but the following are of interest:- THE bread AND FLOUR REGULATIONS, 1963. These Regulations largely reinforce the provisions of the Flour (Composition) Order, 1956, with improvements but with restrictions on the sale of bread for dietetic purposes. It is now permissible to add iron to flour either as reduced iron or as iron and ammonium citrate, a provision which has been found necessary because the reduced iron has also been removed and has caused trouble with the magnets, when flour is passed under a magnet for manufacturing purposes in order to removenails and other pieces of iron, which may have got into flour. It is no longer necessary to add chalk to self-raising flours prepared with a calcium containing baking powder. Milk bread and skimmed milk bread must contain not less than 6 per cent of milk powder or skimmed milk powder, as the case may be, calculated on the dry weight of the bread Protein enriched bread must contain not less than 20 per cent of protein, calculated on the dry weight, and starch-reduced bread, biscuits, rusks, and breakfast foods must not contain more than 50 per cent of starch similarly calculated No claims are permitted for slimming properties unless these are accompanied by a statement to the effect that the food forms part of a diet of which the calories intake is controlled. THE LIQUID EGG (PASTEURISATION) REGULATIONS, 1963, have been issued as a result of the number of food poisoning cases, which have been traced to the use of raw liquid or frozen egg. The test relies on the fact that an enzyme, amylase, present in fresh egg is destroyed by pasteurisation 60 The fruit in some bun loaves from the same delivery was very badly distributed, one loaf containing 21.9 per cent of fruit whilst another contained only 9.6 per cent, so they were reported as inferior on account of faulty manufacture. A loaf of bread contained foreign matter consisting of some general dirt which had fallen into the dough during mixing or from a dirty baking tin, due to carelessness in the bakery. Some beef sausages contained black matter consisting of mineral oil introduced from the swivel of lids which were used to cover the sausage filling machines. A liver sausage was also deficient in meat, containing only 44 per cent. A large number of black puddings were examined during the year, and several were considered to be deficient in meat content. Five were reported as adulterated, two containing 55% and, the others 44 per cent, 51 per cent and 57 per cent respectively. Another containing 67 per cent was reported as inferior. Your analyst is of the opinion that a black pudding should contain at least as much meat, and protein calculated as meat, as pork sausage, but as these are partially dried, the final meat content should appear much higher. A sample of haslet contained only 61 per cent of meat of which 36 per cent was fat. A haslet must contain approximately 70 per cent of lean meat and this sample was reported as inferior. The tinplate of a can of corned beef was badly attacked and the meat was stained. The meat itself contained 91 parts per million of tin and was reported as adulterated. A canned minced beef with onions and gravy was reported as inferior because it contained only 45 per cent of total meat. The Food Standards Committee in their Report on Canned Meat Products do not state what is meant by an appreciable quantity of vegetables' but onions act only as a flavour and do not make a calorific contribution to a food. Several samples of tomato paste showed high Howard mould counts, these being one at 100 per cent, one at 95 per cent, two at 90 per cent, three at 80 per cent and one at 70 per cent. The Port of London Medical Officer of Health accepted a 50 per cent Howard mould count for the 1962 crop. Another sample had a poor flavour and was very acid, and another was dark coloured and possessed a caramelised taste. A further sample was satisfactory as regards mould count, colour and flavour but it contained 63 parts per millon of copper which was rather high, although the maximum permitted is 100 p.p.m. The brine in which some olives were packed contained budding yeast cells and the product would not, therefore, have kept very long although it may have been edible when received. Some pasteurised figs were packed in a carton with a cellophane cover which was broken so that bacteria and other micro-organisms had entered. Figs, if properly prepared, should not require pasteurisation. Some currants contained considerable quantities of extraneous dirt, and were reported as inferior. Some boiled mashed potatoes were received on account of their odour and this was found to be due to rancid butter. One of the dangers with meals on wheels is that food is often kept at an incubation temperature. More care should be exercised to keep the food either really hot or to cool it rapidly after cooking and then to re-heat as required. A sample of mint concentrate contained hazel leaf, although probably less than 5 per cent of the total leaf matter. The manufacturers stated that this was old stock and that their present stock of mint had been obtained from a different source. An American product 'Corn Puffs' contravened the Colouring Matter in Food Regulations, 1962, because they contained a red colour permitted in America but not in this country. 61 THE ICE CREAM (HEAT TREATMENT, ETC.)( AMENDMENT) REGULATIONS, 1963, have been issued to permit the addition of sugar as well as water to an ice cream mix, which has been prepared according to the requirements of the main regulations. THE MILK (SPECIAL DESIGNATIONS) REGULATIONS, 1963, follow the main lines of previous regulations, but now introduce a test for the efficiency of the heating of so-called sterilised milk This test depends on the coagulation of a protein, lactalbumen, during the heating of the milk. THE SOFT DRINKS REGULATIONS, 1963, increase the quantity of fruit juice or comminuted fruit required to be present in fruit drinks and permit the sale of comminuted fruit drinks made from citrus fruits other than oranges. They increase the quantity of sugar required to be present in soft drinks and reduce the permitted amount of saccharin. If present it is now necessary to declare the presence of saccharin on the label of any soft drink. Unfortunately it is still permissible to use acetic acid or phosphoric acid in soft drinks so long as they are not described as fruit squashes, fruit crushes, or comminuted citrus drinks, but it is now illegal to use any pictorial device or any wording to suggest the presence of fruit which is not represented in the flavouring of the drink. THE WEIGHTS AND MEASURES ACT, 1963 AND THE WEIGHTS AND MEASURES REGULATIONS, 1963, mainly affect Weights and Measures Authorities, though attention will have to be paid to the net contents of pre-packed foods, when examining such articles. REPORT OF THE FOOD STANDARDS COMMITTEE ON MEAT PIES. This report was issued during the year and at the beginning of 1964 draft regulations have been issued based on the recommendations as modified in view of comments received by the Minister. Essentially the proposals are that meat pies should contain not less than 25 per cent of meat, though pies weighing between 4 and 5½ ounces need contain only 1 ounce of meat and those weighing up to 3 ounces need contain only 5/8 ounce of meat. It is further suggested that in the event of the quality of larger pies, i.e those over 8 ounces declining as a result of any regulations, it might be necessary to issue regulations for larger meat pies. Suggestions were included in the report regarding the absorption of fat from the meat of a meat pie into the surrounding pastry Recommendations have been made to allow for fat in the pastry in excess of certain figures, as having been derived from the meat. A Circular, FSH/Circular 12/63 was issued by the Ministry of Agriculture, Fisheries and Food advising Local Authorities that the Customs and Excise are no longer testing for arsenic, glucose or invert sugar used in brewing and that this duty now devolves on Local Authorities in which breweries are situate Speaking generally manufacturers of these products see that they comply with the regulations because of the great value of the trade, which they have with brewers (Signed) THOMAS McLACHLAN. 62 FULHAM ANNUAL REPORT, 1963 Article Number Examined Number Adulterated etc. Formal Informal Total Formal Informal Total Advocaat 2 2 Almonds, ground I 6 6 I I Barley, pearl 4 4 I Beverages 2 2 I I Biscuits 1 1 I I Blancmange Powder 1 1 I I Bread 1 1 1 1 1 1 Bun Loaves 11 11 I I 1 * Butter 19 19 1 Cake decoration 1 1 I Cake Mix 1 1 1 1 Cheese 26 26 1 1 Cider 1 1 I Coconut, dessicated 3 3 I Coffee and Chicory Essence 3 3 Colouring 11 11 I ! Confectionery 14 14 1 1 Cornflour 1 1 1 1 1 Corn Puffs, canned 1 1 I _ Cream 18 15 33 2 3 5 Dripping 2 2 I Essences and Flavours 1 16 16 I I Fat 1 3 4 I • I Fish Cakes 2 2 I I Fish, canned 5 5 Fish, frozen 2 2 I Fruit, bottled 5 5 I Fruit, canned 27 27 I 3 3 Fruit, dried 51 51 I 2 2 Fruit, fresh 6 6 I Fruit, glace 10 10 Fruit Juice 7 7 I ■ Gelatine 1 1 Gravy 3 3 I I Herbs I 11 11 ! ! Honey 9 9 I I I I e i 2 2 Ice Cream 11 24 35 Ice Cream Mix 2 2 I Ice Lolly 3 3 I 1 1 Ice Water 1 1 I I Icing Mix 1 1 I I Jam 11 11 I Jelly 16 16 I Lard 7 7 I Macaroni Product I 1 1 I I Margarine 8 8 I Marmalade 12 12 Marzipan 7 7 Mayonnaise 1 1 Mead 1 1 . Meat Products 59 59 11 11 C/fd. 30 438 468 2 27 29 63 Number Examined Number Adulterated etc. Article Formal Informal Total Total Formal Informal B/f. 30 438 468 2 27 29 Milk 56 7 63 Milk bottle 1 1 I 1 1 Milk, canned 7 , 1 I Milk, Top of 1 1 1 1 Mincemeat 4 4 1 Mint concentrate 1 1 1 1 1 Mustard 3 3 I Non-brewed condiment 3 3 Oats, Porridge 2 2 I Oil, Vegetable 1 1 I Okra, canned 1 1 I 1 Olives, stuffed 1 1 I 1 1 Peel, cut 5 5 I Perry 1 1 I Pickles 4 4 I I Pie filling 4 4 I Puddings, sweet 3 3 I I I Puddings, Christmas 13 13 I Pulses 4 4 I Rice 10 10 I Sago 1 1 I Salad 3 3 I I Salad Dressing 5 5 I Salt Seasoning 1 1 I Sauce 11 11 I I Semolina . 2 2 I Soft Drinks 1 26 27 I Soup dried 3 3 I I 2 2 Spaghetti, canned 1 1 I Spices 4 4 I Spirits 7 7 I 2 2 Spread, savoury 14 14 I I Spread, sweet 1 1 I Stuffing 4 4 I Suet 5 5 I Sugar 5 5 I Sugar, Slimmers 1 1 I 1 1 Syrup 2 2 I Tapioca 3 3 I Tea 34 34 I I Tomatoes, canned 3 3 Tomato Juice 4 4 I Tomato Pastes and Purees 15 15 8 8 Treacle 1 1 I Vegetables, canned 11 I 11 Vegetables, pickled 14 14 Vegetables, potatoes 2 2 I 1 1 Vinegar 2 2 I Wheatmeal 1 1 I Wine 13 13 I 87 713 800 2 45 47 64 SECTION F Miscellaneous Services Page Health Education 65 Mortuary 66 National Assistance Act - Burials 67 Public Conveniences 67 Medical Examinations and Inoculations against Influenza 67 Pet Animals Act 68 Pharmacy and Poisons Act 68 Rag Flock and Other Filling Materials Act 68 Licensing Act, 1961 69 65 HEALTH EDUCATION A list of titles of talks etc., available on a wide variety of health matters with brief explat natory notes is circulated to all suitable organisations in the Borough in September each year, as the majority of talks are requested in the winter months. Subjects on which talks were given were:- Clean Air Food Infection Insect Pests Fire Prevention Work of the Health Department Six talks were given to Fulham Boy Scouts preparing for their Public Health badge and five talks and/or film shows were given to school girls studying for their G.C.E. '0' level examinations in Science and Biology. Details of talks given are as follows:- Discussion Groups or Talks No. of Persons Average attending Attendance 20 468 23 Film Shows 9 384 43 The Department is very fortunate in having a number of members on the staff, both technical and administrative, who are competent and willing to give talks or hold discussion groups on some particular aspect of health education, usually outside the normal working hours. SMOKING AND HEALTH The Department entered a tableau on this subject in the Friends of Fulham Hospital Carnival and Fete held in July. The float represented a boxing contest billed 'Smoking versus Health' and the boxers and their seconds were labelled Nosmo King and Lung Cancer respectively. That the exhibit was successful was proved by the comment it aroused in the spectators who lined the carnival route. One local paper selected the float for reproduction under the heading 'K.O. for the Menace'. A photograph of the entry is shown in this Report. A display on this theme was used by the Department in the Fulham Annual Show at Bishop's Park in September. Every opportunity is taken to bring this subject to the attention of young people in the Borough. HOME SAFETY The principal activities and matters dealt with during the year were:- July WATER SAFETY. A film on water safety was hired from Worthing Home Safety Committee and shown on Ist and 2nd July at two youth centres. 66 August/ September OIL HEATER MAINTENANCE To remind the public of the necessity for proper servicing and maintenance of oil heaters a campaign was organised. For this purpose a special poster was designed by a member of the Department and nearly 300 copies were distributed over the Borough to appropriate sites. In addition a portable window display was assembled, which drew attention to parts likely to become defective in both wick-feed and drip-feed heaters, and this was displayed at various sites. The Press co-operated and published articles and the campaign was followed up by an article in the civic news sheet, Town Topics', which was distributed to all the householders in the Borough, together with 35,000 leaflets from the Oil Appliance Manufacturers Association. The poster itself received considerable appreciation and three other local authorities made use of it in their own campaigns. October FIREWORKS Posters were displayed on Council sites and at churches as in the previous year, and in addition an item on the danger of fireworks was included in 'Town Topics' and a safety slogan was printed on all the Council's outgoing mail. December CHRISTMAS DECORATIONS A shop window display on non-inflammable decorations was arranged to remind the public that the majority of Christmas decorations on sale were of non-inflammable materials. 'TOWN TOPICS', THE CIVIC NEWSLETTER ISSUED TO FULHAM RESIDENTS. This leaflet is distributed to all householders with additional copies available at Council Offices. The Health Department has contributed many of the articles and facts in the newsletters, and there is no doubt that this has proved a most useful publicity medium. PRESS PUBLICITY The local press frequently gives publicity to the various activities of the Department. Their co-operation in publishing articles, photographs, etc. was of great value and is much appreciated. LEAFLETS AND POSTERS As usual these were widely used in connection with the various campaigns, the principal sources of supply being the Ministry of Health, Central Council of Health Education and Royal Society for the Prevention of Accidents. The majority of the leaflets were distributed by means of the large display fixture in the foyer of the Department, but on occasions other Departments co-operated in distributing leaflets on matters of special topical importance. Appropriate leaflets are handed out to audiences at lectures and discussion groups etc. MORTUARY ACCOMMODATION I am indebted to Dr. F.M. Day, Medical Officer of Health, Hammersmith, for the following details of the Fulham cases admitted to the Hammersmith Mortuary during 1963:- Number of cases admitted 283 Number of post-mortem examinations 274 Number of inquests held 41 67 NATIONAL ASSISTANCE ACT, 1948 SECTION 50 - BURIAL OR CREMATION OF THE DEAD 19 Funerals were arranged under the provisions of this section of the Act. Details of the cost of the burials are as follows:- £. d. s. 19 Funerals as per contract 362 10 3 Less amount recovered from estates of deceased, or by gifts, or responsible relatives 223 18 10 138 11 5 Balance, being cost to Council PUBLIC CONVENIENCES There are eight conveniences under the control of the Public Health Department, each has a Men's and Women's Section with attendants present. The conveniences have been constructed at various times between 1900 and 1961; the older ones having been modernised as far as reasonably practicable. All the toilet accommodation is free and there are free washing facilities available. These facilities are well used and appreciated and letters are frequently received from persons living outside the Borough congratulating all concerned on the clean and hygienic condition of the conveniences. MEDICAL EXAMINATIONS During the year 158 medical examinations were carried out. These included the examination of new entrants to the Council's service to determine their medical fitness for the post and their suitability for acceptance under the Superannuation Scheme. Other Examinations were of employees referred because of prolonged sick leave or accident. These often require examination by a consultant and this is done in collaboration with the patient's private doctor. The testing of eyesight was carried out on the Fleming Master Vision Screener with the following results:- Advised further Investigation Vision Normal STAFF: New entrants to Council employment as part of medical examination 60 8 EMPLOYEES: As part of the medical examination either as new entrant or for admission to the superannuation scheme 46 9 106 17 Total 123 68 INOCULATIONS AGAINST INFLUENZA Under the scheme for the voluntary inoculation of the staff and employees of the Council as a precaution against influenza, a total of 605 injections were given by Dr. Meade and myself. PET ANIMALS ACT, 1951 This Act 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. Eight licences were renewed during the year, the number remaining unchanged. No contraventions of the Act were found during inspections. PHARMACY AND POISONS ACT, 1933 The retail sale of poisonous substances by shopkeepers who are not registered pharmacists is controlled by the Act 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 1 and Part 11. The sale of poisons included in Part 1 is restricted to registered pharmacists whilst those included in Part II may be sold to the general public not only by registered pharmacists, but also (subject to certain conditions) by ordinary traders whose names are entered on a List of Persons entitled to sell such poisons, kept by the Local Authority. The Acts and Rules lay down certain requirements regarding type of container, labelling, storage, transport and sale of poisons, penalties being prescribed for non-compliance. Fees are payable to the local authority by persons whose names are entered on the List. At the end of 1963 there were 141 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 1.1.63 143 Number added during the year 4 147 Number who transferred their business or discontinued the sale of poisons 6 141 52 visits to listed premises were made during the year under review. RAG FLOCK AND OTHER FILLING MATERIALS ACT, 1951 Under this Act it is unlawful in the course of business to use filling materials to which the Act applies in any form of upholstery, the stuffing or lining of toys, baby carriages, etc., except on premises registered by a local authority (in London, a Metropolitan Borough). It is also an offence to sell or expose for sale on any premises any article containing filling material to which the Act applies, which is unclean. 69 The standards of cleanliness for the various types of filling material are laid down in the Rag Flock and Other Filling Materials Regulations, 1961. There are six premises registered in the Borough. During the year 20 samples of filling material were obtained and all were reported satisfactory. The following are the details:- Cotton wadding 3 Algerian fibre 2 Millpuff 1 Woollen Mixture felt 2 Reconditioned Hair 1 Rag flock 3 Hair and fibre mix 2 Coir fibre 1 Used wood wool 1 Feathers 4 LICENSING ACT, 1961 This Act places on local authorities responsibilities in relation to licensed restaurants and clubs and is largely concerned with amendments to the general Licensing Laws. Part 111 of the Act (operative from Ist March, 1962) deals with the sale and supply of intoxicating liquor in club premises, which must be registered with the clerk to the justices for the petty sessions area in which the premises are situated. Such registration shall be for a period of twelve months in the first case. Objection to any registration may be made by the Police or the local authority, and officials of the Public Health Department have visited all premises in respect of which registration has been sought. The premises have been inspected with three main points in mind - compliance with Food Hygiene Regulations of that part of the premises concerned with the storage and sale of food, adequacy of sanitary accommodation and adequacy and efficiency of ventilation arrangements. It has been possible to improve or require certain facilities at several premises and the new powers given to the local authority is considered to be most helpful. No. of applications for registration investigated 8 No. of cases where works required or objection recommended 2 INDEX Page Adulterations of Food 53 Atmospheric Pollution 45 Attendants - Home Bathing 44 Attendants - Public Conveniences 4 Authentication of Vaccination Certificates 19 Bacteriological Examination of Specimens 20 Bacteriological Examinations of Foodstuffs 56 Bath Water Samples, results 35 Births and Stillbirths, numbers and rate per 1,000 population 10 Certificates of Disrepair 41 Certificates, Habitation 41 Certificates - Vaccination, Authentication of 19 Chiropody 29 Christmas Parcels Scheme 29 Clean Air Act: Industrial Premises 42 Smoke Nuisances 43 Smoke Control Areas 43 Measurement of Air Pollution 45 Notices of Intention to Install Furnaces 46 Clinic Services - L.C.C. 23 Complaints from public regarding food 53 Council's Public Analyst - Report of 58 Council's Representatives on Outside Committees 2 Deaths, Classification of causes of 11 Deaths, Cancer - Table of last 10 years 12 Deaths, Infant - Table of causes of 12 Deaths - Number and Rate per 1,000 population 11 Death Rate of Infants under 1 year 11 Demolition and Closing Orders 37 Page Discussion Groups - Health Education 65 Disrepair, Certificates of 41 Diseases, notifiable 14 Disinfecting Station, staff 4 Disinfection, Disinfestation Services 36 District Nursing Association 25 Drainage of new buildings 41 Dwellings completed by the Council 40 Exhaust Fumes from Diesel Vehicles 45 Factories Acts 47 Film Shows, Health Education 65 Food, Bacteriological Examination of 56 Food and Drugs Sampling, Complaints from public 52 Food Establishments, Inspection of 56 Food, Examination of 50 Food Hygiene Regulations 57 Food Poisoning 19 Food Standards (Ice Cream) Regulations 52 Food, Surrender of 50 Friends of Fulham Hospital Carnival 65 Fuel, emergency for Old People 30 Fulham Chest Clinic - Report of 16 Furnaces - Notices of intention to install 46 Habitation Certificates 41 Hairdressers and Barbers 35 Health Education: 65 Discussion Groups and Talks 65 Films Shows 65 Friends of Fulham Hospital Carnival 65 Leaflets and Posters 66 Press Publicity 66 Town Topics 66 Smoking and Health 65 Heat Treatment Regulations (Ice Cream) 51 Holidays, Old People 30 Page Home Bathing Service - Attendants 4 Home Bathing for the Elderly 27 Home Decoration Scheme 31 Home Nursing 25 Home Safety 65 Hospitals and Other Centres in the Borough 22 Houses in Multiple Occupation 39 Ice Cream: Heat Treatment Regulations 51 Food Standards Regulations 52 Improvement Grants 38 Infectious Diseases 14 Inoculations, Influenza „ 68 Land Charges 35 Laundry, Old People's 28 Leaflets and Posters - Health Education 66 Legal Proceedings 34 Licensing Act, 1961 69 London County Council - Personal Health Services 23 Luncheon Clubs 27 Map of the Borough - Smoke Control Areas Frontispiece Marriages 10 Mass X-Ray Services (Report) 18 Maternal Mortality 11 Meals on Wheels and Luncheon Club Services 26 Measurement of Atmospheric Pollution 45 Medical Examination 67 Milk: Sale Regulations 50 Channel Island and South Devon Regulations 51 Special Designation Regulations 51 Registration of Purveyors 51 Mortuary 66 Page National Assistance Acts, Funerals 67 National Assistance Act, Old People 28 New Buildings, Drainage of 41 Noise Nuisances 35 Notifiable Diseases 14 Notifications of Infectious Disease 15 Oil Heaters 66 Old People's Welfare Services Provided 26 Outings, Old People's 31 Outside Committees, Council Representatives on 2 Personal Health Services - L.C.C 23 Pet Animals 68 Pharmacy and Poisons 68 Physical Features of the Borough 10 Population and Area 10 Public Conveniences 67 Public Conveniences - Attendants 4 Public Health Committee - Members of 2 Public Health Depar tment - Staff 3 Puerperal Pyrexia 14 Rag Flock 68 Rates Levied and yield 10 Rateable Value and Product of Id. Rate 10 Reconstruction of Drainage 41 Registration of Purveyors of Milk 51 Rehousing of Fulham Residents 42 Rent Act 41 Rodent Control 42 Rodent Control - Staff 4 Sale of Milk Regulations 50 Samples of Swimming Bath Water, results of 35 Page Sampling of Tap Water 34 Sanitary Circumstances of the Area 32 Scabies and Allied Conditions 19 Section A. General and Vital Statistics 9 Section B. Prevalence and Control of Infectious Diseases 13 Section C. Personal Services 21 Section D. Sanitary Circumstances 32 Section E. Inspection and Supervision of Food 49 Section F. Miscellaneous Services 64 Sewage Disposal 37 Slum Clearance Programmes 38 Smoke Control Areas - Clean Air Act 43 Smoking and Health 65 Social Clubs, Old People 31 S.O.S. Card Scheme 27 Staff of Public Health Department 3 Staff, Disinfecting Station 4 Staff, Public Conveniences 4 Staff, Rodent Control 4 Statutory Action 33 Summary of Works carried out under Public Health Inspectors 33 Swimming Bath Water Samples, Results of 35 Tap Water Samples 34 Town Topics - Health Education 66 Tuberculosis 15 Vaccination and Inoculation Certificates (Authentication of) 19 Visits to Dwellings by Public Health Inspectors 33 Vital Statistics 10 Water Sampling 34 West London Inter-Boroughs Smoke Control Liaison Committee 45 Works in Default 34