METROPOLITAN BOROUGH OF FULHAM REPORT of the MEDICAL OFFICER OF HEALTH Including the Report of the Public Analyst for the year 1964 H. L. Settle, M.Sc., M.D., D.P.H., F.R.S.H., A.R.P.S. Medical Officer of Health CONTENTS Page Public Health Committee - Members 2 Public Health Department - Staff 3 Introduction 5 Public Health in Fulham 1900 - 1964 11 SECTION A General and Vital Statistics 16 SECTION B Prevalence and Control of Infectious and Other Diseases 21 SECTION C Personal Services 29 SECTION D Sanitary Circumstances of the Area .. 35 SECTION E Inspection and Supervision of Food including Report by Council's Public Analyst, T.McLachlan Esq. 47 SECTION F Miscellaneous Services 63 An index is given at the beginning of each Section. 2 METROPOLITAN BOROUGH OF FULHAM MEMBERS OF THE PUBLIC HEALTH COMMITTEE Ex-Officio: The Worshipful the Mayor (Councillor R.G. Morgan, J.P., F.B.0.A., M.R.S.H.). Chairman: Councillor Mrs. Florence Charlotte Pusey, M.R.S.H. Vice-Chairman: 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. STAFF OF THE PUBLIC HEALTH DEPARTMENT (at 31st December, 1964) Medical Officer of Health Herbert Leslie Settle, M.Sc., M.D., Ch.B., D.P.H., R.R.S.H., A.R.P.S. Deputy Medical Officer of Health (to sth August).. Caroline A. Meade, M.B., 8.S.(Lond.)., D.P.H. (from 24th August) Donald Marcus Osborne Lowry, M.A., M.R.C.S., L.R.C.P., D.P.H., D.I.H., D.T.M. & 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.HH. Administrative Clerk B.C. Bolton Secretary to the Medical Officer of Health Mrs. C.M. Phillips Clerks R.A. Green Mrs. R,E. Edwards Mrs. M.M. Ashby Mrs. L.I. B irdseye W.G. Myers Shorthand Typists Mrs. F. Smith Mrs. D. Townsend Miss R.F. Dawkins Public Health Inspectors Section: Chief Public Health Inspector G.W. Herrick, D.P.A. (1) (2) Sen ior Public Health Inspector F.E.Walsh (1) (2) Sen ior Public Health Inspector (Food and Drugs) and A. Clegg (1) (2) Sampling Officer Public Health Inspector for Factories and F.C. Payne (1) (2) (3) (4) Smoke Abatement District Public Health Inspectors A.H. Newport (1) (2) (4) W.G.Dicks (1) (2) G. McFall (1) (2) J.R. Lund (1) K.W. Davies (1) R.A. Hayes (1) Technical Assistant A.W. Knee Administration Assistant - Old People's Welfare w.w. Birdseye Lady Visitor - Old People Miss J. Sands, S.R.N., S.C.M., H.V. Assistant Mrs. B. Barton, S.E.A.N. (1) Certificate of Royal Society of Health and Public Health Inspector's Examination Joint Board. (2) Meat and Other Foods Certificate, Royal Society of Health. (3) Diploma of the Royal Institute of Rpublic Health and Hygiene. (4) Smoke Certificate, Royal Society of Health. Disinfecting Staff Superintendent J.W. Smith Operatives W.H. Parsons, A.E. Leach T.W. Rains, A.J. Alderman Mrs. M. Celino (part-time) Rodent Control Foreman Operative K. Swayer Operatives V. Greenway R. Parker ** Appointed Medical Officer of Health; Principal School Medical Officer and Chief Welfare Officer to the London Borough of Bexley. METROPOLITAN BOROUGH OF FULHAM 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 oircumstances in the Borough tor the year 1964 Included is the report of the Public Analyst, T. MoLachlan, Esq., D.C.M., A.C.G.F.C., F.R.I.C. There has been no serious outbreak of infectious disease and the health of the inhabitants of the Borough has again been satisfactory. Notifications of infectious disease decreased by 1104 compared with 1963, the reduction being due to a decrease in the cases of measles. Staff changes include the retirement of Dr. C.A. Meade, Deputy Medical Officer of Health, who had served the' Council and the in habitants conscientiously and loyally for more than ten years. Dr. Meade combined a wide experience of clinical medicine gained in many parts of the world with an enthusiasm for and interest in preventive medicine a rare combination these days - and her retirement was a'serious loss to the department.. Dr. D.M.O. Lowry was seconded part time by the London County Council to succeed Dr. Meade. Dr. Lowry also, has had overseas experience in Public Health. Three Public Health lnspectors left for other posts, in two cases to authorities near their homes. They were Messrs. M. Cander, D. Corfield and J. Looman. The latter two Inspectors had both trained in the department. The Clean-Air Officer, Mr. B. Jago, who had been with the Department from the start of the Clean-Air programme in 1957, left to join the staff of Lambeth Borough Council. Mr. Jago had played an important part in the smooth running of the Council's clean air scheme being concerned with advising and assisting the public and also the builders concerned with the technical aspects of the Scheme. Two other officers, Mr. H. Edwards and Mrs. B. Vane, part-time Clean Air Enquiry Officers, completed their survey of the ninth and last Smoke Control Area and left the Council's service with the satisfaction of seeing their task completed. It is with regret that I have to report the death in April, after an operation, of Mr. G.H. Leaver, a Rodent Operative, who had served the Council I loyally for 16 years. He was succeeded by Mr. R. Parker, who commenced duty in August. This will be the last Annual Report to be repared by a Medical Officer of Health of the Metropolitan Borough of Fulham. On April Ist, 1965, the Metropolitan Boroughs of Fulham and Hammersmith combine to form the London Borough of Hammersmith, the Health Department of which will have virtually all the responsibilities of a County Borough. In view of this important event I have included a brief historical review of the activities of the department over the past sixty years whilst Fulham has been a Metropolitan Borough. The forthcoming amalgamation inevitably placed additional work on the senior staff in preparing plans for the merging of the two health departments and the taking over of staff and services at present provided by the London County Council. In April, 1964, the Health Department vacated its accommodation in the Town Hall and moved into a large suite of offices nearby at 2/6, Fulham Broadway which had been acquired by the Council mainly on the advice that they would provide adequate accommodation for the future Health, Welfare and Departments of the Hammersmith London Borough. Despite these difficulties the department continued to Carry out its existing functions without interruption and was even able to develop some services, thanks to the willing co-operation of the staff. OLD PERSONS WELFARE This work has continued to expand. Close collaboration is maintained with the various organisations providing appropriate services, with the London County Council Welfare Department and with the geriatric departments of hospitals. The Meals on Wheels Service and the "Luncheon Club" meal service has been further developed towards the goal of a hot meal on at least five days per week for all old persons who desire it. The demand for the Meals on Wheels service has increased and an additional Vehichle was purchased during the year. An electrically heated form of hot chamber was fitted to the new vehicle in accordance with the policy decided for the new Hammersmith Borough but it did not prove entirely satisfactory as difficulty was encountered in cleaning the equipment properly. Modifications made to the equipment have partially overcome the problem but it is felt that the older and well proved type of charcoal heated container is the most suitable for this type of service. The W.V.S. in co-operation with the directors of Stamford Bridge Greyhound Racing Association opened an old people's luncheon club at the Stamford Bridge Football Ground staff canteen. The meals are cooked on the premises - the ideal arrangement - and the old people enjoy excellent meals in interesting surroundings as the dining room overlooks the race track and football pitch where various training activities often take place. As a result of the opening of this Luncheon Club, we closed our nearby Shamrock Luncheon Club which had never been adequately supported. CLEAN AIR It is very gratifying to be able to state that at the time of writing this Report the approval of the Ministry of Housing and Local Government has been received to the proposals for the ninth and last Smoke Control Area to be established by the Council. This means that by October Ist, 1965, when the 9th order becomes operative, the whole of Fulham will be one large Smoke Control Area covering 1,700 acres and benefitting over 100,000 persons. Although not the first London local authority to complete its Smoke Control programme, it is fair to say Fulham is the first major residential area to do this, and its achievement in only eight years is one of which Fulham can feel justly proud: This success is in my opinion largely due to three factors. Firstly, the determination of the Council to play its full part in the national battle against that most important public health menace and economic waster, atmospheric pollution, by eliminating from within the borough as quickly as possible the production of avoidable atmospheric pollution. Secondly, to the willing support given to the Council to achieve this objective by the ratepayers. It i s important to recall that throughout thr whole Clean Air programme not a single public enquiry into the Council's proposals had to be held by the Ministry of Housing and Local Government, tes^ than half a dozen objections were made to the Minister and all were withdrawn, after officers of the Health Department had interviewed the objectors and solved their problems. Thirdly, to the attitude adopted by the staffs of the various departments of the authority directly concerned, e.g., Town Clerk's, Borough Treasurer's and Health who apporached the many new problems with a determination to overcomeall difficulties and see that the task was satisfactorily completed. It has been notifiable that in many other authorities the approach by the Council public and officers to the problems of atmospheric pollution has been a negative one, and they have looked for grounds on which to delay, or avoid, taking action. In Fulham the reverse has applied and the emphasis has always been a positive one aimed at cleansing the air as quickly and completely as possible. In my experience the attitude of a Council and its officers largely sets the pattern for the public's response and therein lies the key to the future success or failure of the national Clean Air campaign. FOOD HYGIENE The progress made in the field of hygiene in food premises has been disappointing. This is a national problem and as I have previously pointed out, little progress can be expected until the public conscience is aroused and everyone demands clean handling of food at all stages. It is not sufficient for a food shop to display its pre-packed ware in a chrome-plated, glassfronted, refrigerated showcase, if conditions in the other parts of the premises where the foodstuffs are handled or prepared are unhygienic. Unfortunately, these back rooms are never seen by the public and all too often conditions there are most unhygienic. Similarly with restaurants and cafes. The part the public sees may be attractive and superficially clean but the handling and storage of food which is outside the view of the public may be appallingly bad. The only solution to this problem is the opening up to public view of these inner fastnesses. Why should the public not see at all stages the conditions under which their food is being handled? There is no reason why this cannot be done - in fact some of the newer restaurants and cafes now display their preparation and cooking arrangements openly. This practice should be encouraged especially in butchers' shops, fishmongers' premises, cafes and restaurants, and the pre-packing sections of general food shops. During the year the Ministry of Health issued an excellent series of food hygiene posters for use in kitchens and canteens. Each poster consisted of a drawning depicting some undesirable food hygiene practice with an appropriate warning in the caption. Having previously been asked to speak on food hygiene to the kitchen staff of a large canteen and finding only one of the audience of approximately 30 persons who understood English, it occurred to me that there was an urgent need to have the Mini stry of Health posters available in various languages for distribution to the large number of cafes, restaurants, kitchens and canteens, etc. which nowadays so often employ foreign nationals. A check in Fulham revealed that persons from a large number of different nationalities are nowadays employed in the food industry. To obtain translations of the captions into all the commoner languages involved proved a far more difficult and protracted task than had at first been anticipated. I would like to express my thanks to the various embassies and other persons who kindly co-operated and supplied information. Finally much greater attention is required in the selection and training of food handlers. The personal habits of some food handlers are disgusting - I have seen assistants in eating houses finger their teeth or scratch their heads or pimples and then, without first washing their hands, handle unwrapped food. Such behaviour makes it farcical and pointless to insist on the relatively harmless dog being excluded from food shops whilst allowing the menace of the unhygienic pathogenic human food-handler to go unchecked. HOUSING - SLUM CLEARANCE Fulham is an ageing borough, the majority of residential properties having been built at or before the end of the last century. Thanks to vigorous slum clearance programmes in the past,there are few houses remaining which are likely to become legally unfit for habitation within the next few years. There are, however, many properties which,although old, are still substantially sound and capable of further useful life. They do, however, in many instances lack modern amenities such as bathrooms, inside W.Cs., adequate food and fuel stores etc. This view was confirmed by the London County Council Town Planning Committee in its report of the 25th May, 1964, on the Taylor Woodrow "Urban Renewal - Fulham Study" which stated that: The larger part of the residential areas of Fulham consists of small houses, mostly in singlefamily occupation and many owner-occupied although in the ma in fairly old, they are in reasonable condition and can provide satisfactory living conditions for many years to come, particularly with assistance from improvement grants The opportunities for large scale slum clearance projects are likely to be less frequent over the next few decades because the general trend nowadays is for owner-occupiers and landlords to spend considerably more on repairs and maintenance, which will have the effect of preventing many old houses from becoming unfit. It is indeed noticeable how many streets have improved in appearance over recent years when the houses are owner-occupied. Also, in the case of the larger properties, the 1961 Housing Act has enabled improvements, repairs and property maintenance to be insisted upon and here again, as a result, the life of these properties will be considerably lengthened There is, however, understandable wish on the part of some members of the Council to get rid of those properties lacking amenities and to redevelop the sites made available with modern houses. Unfortunately, there has been current in some quarters an idea that this can easily be done and all that is required is for the Medical Officer of Health to declare the houses to be unfit for habitation to enable the Council to acquire them at low cost. I feel it is most important to point out the true position. A Medical Officer of Health can only represent houses as unfit to live in if the condition of the house complies with the requirements of Section 4 of the Housing Act, 1957, which states: "In determining for any of the purposes of this Act whether a house is unfit for human habitation, regard shall be had to its condition in respect of the following matters, that is to says- (a) repair; (d) natural lighting; (b) stability; (e) ventilation; (c) freedom from damp; (f) water supply; (g) drainage and santiary conveniences. (h) facilities for storage, preparation and cooking of food and for the disposal of waster water". The question of lack of amenities does not ariseandeven the absence of artificial lighting, a piped hot water supply or a bathroom does not render a house legally unfit to live in. It will be appreciated that where a local authority has ambitious schemes for redevelopment the position of the Medical Officer of Health can become one of potential difficulty. It is easily overlooked that he is a statutory technical officer charged with implementing the law and that he is appointed to serve the public and not solely to further the interests of the Council which employs him. Indeed, were the position otherwise it requires little imagination to realise that under different Circumstances a Medical Officer of Health could be put in an equally embarrassing position by a Council which wished him to withhold taking necessary slum clearance action to suit its purposes. Where his technical advice is at variance with the desires of the Council he.can find himself in a difficult position..This possibility is, of course, well recognisedand to protect him in the conscientious performance of his duties his tenure of office, under normal conditions, carries safeguards. Some of those who want to improve housing conditions in Fulham by getting rid of old properties lacking amenities have naturally been disappointed to find that such houses cannot be brought within the scope of unfit houses and cleared as slums. To try and help to resolve this impasse I suggested to the Health Committee that the present legal powers, which only recognise fit and unfit houses, are too restrictive What is required is either a new set of standards for assessing unfitness, which would take into account the absence of amenities which are today regarded as essential in newly built homes, or the introduction of a legally recognised third category of property - substandard which would cover properties lacking essential amenities such as a bathroom, food store, fuel store, piped hot water supply, indoor W.C., etc., and which it was considered could better be dealt with by demolition and redevelopment of the area than by individual improvement grants Whereas slum property can be acquired cheaply - compensation often being only a few pounds - substandard properties which the local authority wished to acquire would have to camycompensation at a much higher rate but still less than market value. The above idea was accepted in principle by the Health and Housing Committees and it has been very gratifying to find that this latter suggestion was being active I y pursued at a national level by the Council. If legislation ultimately appears covering this type of problem, it should prove of benefit in many of the older densely populated areas of the country as well as in London. There is no doubt that the housing problem in London is a difficult one, due to more people wanting houses than there are houses available. Unfortunately, redevelopment schemes at the best only rehouse the number originally on the site and quite freque ntly end up by rehousing fewer than the number originally living on the site This comes about due to the application of rigid standards of maximum permitted population per acre which have been laid down in planning schemes. It is, therefore, obvious that if more people are to be rehoused in London without interfering with open spaces then the permitted density per acre must be increased It would be most useful if the present density standards were to be carefully examined to see if the assumptions on which they are basedare really valid. From the health point of view it is completely overlooked that in London ar least, whilst we i nsist on a maximum density of not more than 200 persons per acre as regards our homes, we spend a great proportion of our lives at far higher densities We are packed like sardines in trains and buses and at sports meetings. At theatres dances, cinemas and other entertainments, on the beaches and on the roads, we pay scant attention to density and apply no comparable standards. Yet no-one has so far suggested that these types of overcrowding should be controlled on health grounds Obviously, from the health angle the housing density in many parts of London could be in- 10 creased and thus go a long way towards accommodating many of those who at present have to endure unsatisfactory housing conditions. As state above, I consider an early scientific investigation into the need to retain or change the present housing density standards could be most useful. In conclusion may I pay tribute to the Council and especially the Health Committee. It has been a great privilege to serve the Fulham Borough Council and my five and a half years on its staff have been very happy ones. It has been a pleasure always to receive such excellent support and encouragement from the Council in respect of the various activities of the Health Department. To the Chairman and Members of the Health Committee I am especially grateful for the support they havealways extended to the department and for the keen interest they have taken in health atters and the encouragement they have always given to the staff. No Health Department can function efficiently without the help of the other departments of the Authority and I record with gratitude the ready co-operation I and the Health Department staff have always received from my Chief Officer colleagues and their staffs. I am also indebted to my medical colleagues in general practice and hospitals for their full and willing co-operation without which many of my tasks would have been indeed difficult. There has always been a close link with the L.C.C. Divisional Medical Officer and her staff and the various voluntary organisations in the borough and toall these I am indebted for their prompt and unfailing co-operation. Finally, as regard the staff of the Health Department it would be invidious to single out individuals for special mention. All members have contributed to the efficient functioning of the various services provided for the public and to one and all I place on record my sincere thanks for their loyalty, interest and support and wish them well in their new spheres. I have the honour to be. Mr. Mayor, Ladles and Gentlemen, Your obedient Servant, H.L. SETTLE, Medical Officer of Health. Ist March, 1965. 11 PUBLIC HEALTH IN FULHAM 1900 - 1964 It is generally accepted that Vital Statistics are a valuable index of the health of a community. The table on page 15 shows certain statistics at ten-year intervals for the period 1904-1964. The falls in the death-rate and infant mortality-rate have been dramatic, but the still-birth rate has not shown a comparable improvement over the years. Under "Causes of Death" it is important to notice that in the first half of the period, measles, whooping cough, scarlet fever and diphtheria were serious killer diseases especially among young children. Death from these diseases has now become a rarity. Deaths from typhoid fever have also been reduced significantly and the risk of death from this disease is now small. Deaths from tuberculosis also show a dramatic fall - today they are less than one tenth of the number in 1904. In contrast, cancer and heart disease deaths both show a marked upward trend particularly the latter. Notifications of infectious diseases have fallen dramatically in the case of diphtheria,scarlet fever, typhoid fever, whoopihg cough and tuberculosis, but have shown no significant change as regards puerperal fever. These reductions in incidence and mortality are attributable to improvements in the environment, preventive inoculation and improved methods of treatment. The following extracts, taken from the Annual Reports of my predecessors at ten yearly intervals from 1904 onwards show how some of the services provided by the Council have evolved and also some of the problems encountered in the past. 1904 Dr. J. Charles Jackson was M.O.H. A proposal to establish a Municipal Milk Depot is reported. This was an attempt to reduce infantile mortality especially from diarrhoea. It was not pursued because of the cost (£6OO-£7OO per annum). The appointment of lady inspectors was urged (as had already been done at Preston) to visit homes and advise mothers - the precursors of Health Visitorsl 491 cases of smallpox occurred in the County of London with 25 deaths. No cases occurred in Fulham. For exposing for sale unsound haddock a Fulham trader was fined £25. Under the heading "Removal of Manure" we find complaints were received respecting a nuisance arising during the removal of manure from the stables of the Star Omnibus Company in Filmer Road and Grimston Road. "Clean Air" was being actively pursued and 19 notices were served in respect of "chimneys not being chimneys of private dwelling houses sending forth black smoke in such quantities as to be a nuisance." 1914 Dr. J.C. Jackson was still M.O.H. He reported that the Tuberculosis Dispensary was transferred to 114 New King's Rd., the premises being leased by the Borough Council. The Council also paid a grant of £300 towards the running costs. It was also reported that "Differential diagnosis had been greatly assisted by increased facilities for X-Ray, laryngoscopic and laboratory work, especially bacteriological examinations of sputum." 12 Home visiting of tubercular patients was now well established, 2,385 visits being made by doctors and 2,747 by nurses. All new cases were being visited by both a doctor and a nurse. Infectious cases received special attention and more frequent visiting. The 1914-18 war affected the work of the department as the following shows:- "Medical Officers of Health in London were appointed to the Staff of the D.A.D.H. London to supervise sanitary conditions in camps and billets." All the Sanitary Inspectors joined the forces. A dairy was fined £50 for selling milk adulterated with 10% added water. 1924 The M.O.H. Dr. A.M. Hewat, referring to cancer stated it was his "unpleasant duty to record the fact that more deaths took place from this disease in Fulham during 1924 than have ever taken place since records have been kept." He devoted nearly 8 pages of his report to the problem of cancer, its causes, early diagnosis and treatment. A plea was also made for more mothers to attend ante-natal clinics or attend their own doctor for ante-natal supervision, so that the number of infant deaths could be reduced The Council made a grant of £300 per annum to Fulham Day Nursery, then run by a Voluntary Committee. Concern was also expressed regarding a serious increase in the number of cases (21) of encephalitis lethargica (sleepy sickness) and of pneumonia. Dr. Hewat reports his findings of a follow-up of six encaphalitis cases and found that after recovery from the acute illness all showed serious permanent nervous or personality changes. Under Health Education eleven public lectures and film shows were given on Venereal Diseases. Mr. F.E. Walsh who is now a Senior Public Health Inspector and Mr. A.W. Gammack (Public Health Inspector), who only recently retired, are listed as members of the Clerical staff of the department, Even in 1924 Dr. Hewat on housing states "It is obvious that there is little room in Fulham for new buildings." The eviction by the Council of 40 persons occupying seven unfit cottages in Jerdan place and Vanston Place was reported. The Council had to purchase two empty houses to accommodate five of the families consisting of 23 persons. In 1924 the Housing Committee which had previously ceased to function, was reconstituted. Under Food & Drugs, the prohibition was being urged of all preservatives except S0 2 and Benzoic Acid in all articles of food and drink offered or exposed for sale. Constant watchfulness was required in order to deal with the unsatisfactory places where costers had been found to keep food, especially fruit, prior to its sale on their barrows or stalls. There were 43 Underground bakehouses in the Borough and 2 licensed slaughtermen. The absence of a requirement to register food-preparing premises was deplored. 13 1934 The M.O.H. Dr. J. Sullivan was sick and Dr.P.L.T. Bennett was Acting M.O.H.It is interesting to note among the staff the names of two Public Health Inspectors who are still active members of the department, Messrs. F.E. Walsh and F.C. Payne. Infectious Diseases 473 cases of diphtheria were notified, and 30 deaths all under 13 years of age occurred from this serious disease. This year was noteworthy for the start of the Borough's Diphtheria Immunisation Clinic under that pioneer of diphtheria precaution Dr. Guy Bousfield. Scarlet fever was also prevalent, no less than 691 cases occurring, fortunately with only one death. There were 2,967 cases of measles with 31 deaths. Food & Food Premises The low standard of hygiene in food shops was criticised. The report states "The public can assist materially by encouraging clean food shops and discouraging any that are not obviously clean and hygienic." 1944 Dr. P.L.T. Bennett the M.O.H., had just succeeded Dr. J.A. Scott who was later to become M.O.H. to the London County Council. The report is brief and reports the staff of the department to be heavily committed to Civil Defence activities and records that the Babies" Hospital in Broomhouse Lane was hit by a flying-bomb and put out of action. Fortunately there were no casualties. This year also saw the introduction by the L.C.C. of mass miniature radiography at St. Luke's Hospital, Chelsea, for the early detection of pulmonary tuberculosis by means of which nine cases of tuberculosis in Fulham residents were diagnosed. Six day-nurseries were in operation with accommodation for a total of 315 children. This report also mentions 79 visits paid by the lady Public Health Inspector to aged and infirm and physically incapacitated persons. 925 persons were treated for scabies and 158 persons for head lice infestation. 1954 The M.O.H. was Dr. Mary I. Adams. There was an outbreak of typhoid fever involving 9 persons who fortunately all recovered. Control was complicated by a concurrent and extensive outbreak of Sonne dysentery affecting more than 300 school children. The probable cause of the typhoid was contamination by flooding from overflowing drains following a freak storm. The Beaver Report on Atmospheric Pollution was warmly welcomed. The services to the elderly were being expanded and extended in scope. Attention was drawn to the shortage of hospital beds for the chronic sick and the aged, and a scheme for cooperation with Fulham Hospital, the health department assessing priority for these cases, was introduced. The first suggestion that all W.Cs. in the public conveniences should be free is reported, but it was felt public opinion was not ready for this and only an increased proportion of W.Cs. was made "free? 14 Health Education had now assumed an important role and regular film shows on health topics were being given at the Central Library during the winter months. Underground bakehouses had now been reduced to ten. As will be seen from the above extracts, although outstanding progress has been made in some fields, there are still public health problems which are as pressing to-day as they were in previous decades. 15 1904 1914 1924 1934 1944 1954 1964 Population 152,482 153,284 163,100 145,400 95,090 120,700 110,000 Birth Rate 32.2 26.4 18.2 13.7 18.5 14.06 16.83 Still-Birth Rate 0.38 0.31 - 0.28 0.44 0.27 0.30 Death Rate 15.4 13.6 11.10 12.7 16.6 10.2 11.32 Infant Mortality Rate 113 72 59 43 19.4 18.85 Causes of Death Smallpox nil nil nil - nil nil nil Measles 64 31 29 31 nil nil nil Scarlet Fever 4 21 5 1 nil nil nil Whooping Cough 58 43 14 7 5 nil nil Diphtheria 24 23 11 30 nil nil nil Typhoid 6 9 1 1 nil nil nil Tuberculosis 295 252 162 132 79 29 6 Cancer 128 167 221 270 210 250 306 Bronchitis 188 153 156 69 86 69 82 Pneumonia 189 219 189 139 79 85 78 Heart Disease 134 1 85 221 498 381 451 349 Premature Births 110 1 47 80 19 36 5 11 Notifications of I.D. Diphtheria 299 272 259 473 19 nil nil Scarlet Fever 294 1,042 360 691 253 47 17 Typhoid 39 40 7 4 1 10 0 Whooping Cough 209 116 40 Puerperal Fever 8 33 26 41 7 41 0 Polio nil 7 2 1 1 Measles 1,692 2,967 213 63 1 94 Tuberculosis, Respiratory 270 258 182 126 Tuberculosis, other 165 715 126 33 32 13 51 Dysentery nil 37 531 25 16 SECTION A General and Vital Statistics Page Physical Features of the Borough 17 Population and Area 17 Rateable Value and Product of Id. Rate 17 Marriages 18 Births, Stillbirths, number and rate per 1,000 population 17 Deaths, number and rate per 1.000 population 18 Death rate of infants under 1 year of age 18 Maternal Mortality 18 Deaths, Classification of causes of 19 Deaths, Infant Table of causes of 20 Deaths, Cancer Table of last 10 years 20 17 PHYSICAL FEATURES OF BOROUGH AND EXTRACTS FROM VITAL STATISTICS FOR THE YEAR 1964 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 postwar 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-1964) 109,410 Separately Rated Dwellings 30,138 Rateable Value £6,009,914 A Penny Rate produces approximately £24,000 Number of assessments 34,323 The Registrar General's estimate gives the mid-year population of the Borough as 109,410 a decrease compared with 1963 of 290. Ten years ago, in 1954, the estimated population was 120,700. The birth rate is 16.83 compared with 17.06 in 1963. Ten years ago the birth rate was 14.06. The figure for England and Wales in 1964 is 18.4. The infant mortality rate has decreased to 18.85 compared with 22.3 in 1963. The figure for England and Walesin 1964 is 20.0. The death rate in 1964 shows a decrease compared with 1963 - being 11.32 as compared with 12.75. Heart disease continues to be the main 'killer', with cancer the next most important. The figure for England and Wales for 1964 is 11.3. LIVE BIRTHS STILL BIRTHS Sex Total Legitimate Legitimate Illegitimate Illegitimate Total 13 Males 12 1 1070 155 915 16 4 Females 999 869 130 20 2069 28 5 1784 285 33 Totals 18 Number of Marriages Registered during year 941 Birth Rate (crude) per 1,000 population 18.91 Birth Rate (adjusted) per 1,000 population 16.83 Stillbirth Rate per 1,000 live and still births 15.70 Illegitimate Live Births per cent of total Live Births 13.77 DEATHS (All Ages) Total Males Females 1,215 637 578 Death Rate (crude) per 1,000 population 11.10 Death Rate (adjusted) per 1,000 population 11.32 Death Rate (adjusted) per 1,000 population (England and Wales 11.30 Infant Deaths (Under 1 year) Total Males Females 39 28 11 Infant Mortality Rate:- All infants per 1,000 Live Births 18.85 Legitimate infants per 1,000 Legitimate Live Births 20.17 Illegitimate infants per 1,000 Illegitimate Live Births 10.53 Neonatal (first 4 weeks) Mortality Rate per 1,000 Live Births 14.02 MATERNAL DEATHS There were no maternal deaths during the year. CLASSIFICATION OF CAUSES OF DEATH 1,215 Deaths as follows Under 1 Age Groups 1-5 45-65 5-15 15-45 Tuberculosis, Respiratory 1 1 - - - Syphilitic Disease 1 - - - - Acute Poliomyelitis 1 - - - - Other infective and parasitic diseases 2 - - - - 1 11 Cancer - 113 - Diabetes 1 3 - - - Vascular lesions of nervous system 1 6 29 - - Coronary disease, angina 7 81 - - - Hypertension with heart disease 1 3 - - - Other heart disease - 4 11 - - Other circulatory disease 1 13 - - - Influenza 1 1 - - - 7 7 Pneumonia - - - Bronchitis 18 - - - - Other diseases of respiratory system - - - - 4 Ulcer of stomach and duodenum 2 5 - - - Gastritis, enteritis, diarrhoea 1 1 2 - - Nephritis and nephrosis - - - - 2 Hyperplasia of prostate - - - - - Congenital malformations 8 1 2 - - Other defined and ill-defined diseases 22 2 2 10 13 Motor vehicle accidents 5 3 - - - 1 1 All other accidents - 2 3 Suicide - 3 10 - - Infant Deaths CAUSES OF DEATH IN CHILDREN UNDER ONE YEAR Under 34 hours 1 day-1 week 2-3 weeks TOTAL Under 4 weeks 1-3 months 3-6 months 6-9 months 9-12 months 1-2 weeks 3-4 weeks TOTAL 2 2 2 Anoxia - - - - - - - - Asphyxia 1 1 1 - 2 - - - - - - 2 1 3 Atelectasis - - - - - - - 3 2 3 1 6 1 1 8 Congenital Malformations - - - - Gastro-enteritis 1 - 1 - - - - - - - - 1 1 Heart failure - - - - - - - - - Meconium Ileus 1 1 - 1 - - - - - - - 1 1 2 1 Pneumonia - - - - 3 1 7 7 5 12 12 Prematurity - - - - - - - Respiratory Failure 2 2 - 2 - - - - - - - TOTALS 17 9 2 1 - 2 2 4 2 39 29 DETAILS OF DEATHS FROM CANCER DURING THE LAST TEN YEAR SHOWING SITES 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 75 61 LUNGS AND BRONCHUS Male 59 68 70 80 72 69 65 60 16 14 16 23 12 Female 9 7 26 18 22 STOMACH Male 22 13 6 15 14 17 18 25 19 24 Female 13 13 13 18 17 15 11 9 13 8 BREAST Male 1 1 - 1 - - - - - - Female 21 21 13 25 23 19 24 21 21 37 13 8 13 9 16 13 15 UTERUS Female 7 6 5 OTHER SITES Male 65 78 61 65 72 58 73 71 68 70 Female 65 59 61 63 62 53 63 76 57 70 268 TOTALS 275 269 236 279 300 271 299 285 306 21 SECTION B Prevalence and control in Infectious and other Diseases Page Infectious Disease 22 Diseases notifiable 22 Puerperal Pyrexia 22 Infectious Disease notifications 23 Tuberculosis 23 Fulham Chest Clinic - Report 24 Vaccination and Inoculation Certificates, authentication of 28 Bacteriological Examinations 28 22 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 Typhoid and Paratyphoid Fevers Food Poisoning Leprosy Typhus Fever Malaria Whooping Cough PUERPERAL PYREXIA (Puerperal Pyrexia Regulations, 1951) Fulham residents notified to other Authorities 15 Total number of Fulham cases 15 NOTIFICATIONS OF INFECTIOUS DISEASE 1964 (in age groups) 10-14 15-24 25-44 45-64 1 1-2 3-4 5-9 65 + Total Scarlet Fever 1 - - 1 3 11 1 17 - - 7 11 9 7 3 1 1 1 40 Whooping Cough - Acute Poliomyelitis: Paralytic 1 1 - - - - - - - - Non-Paralytic: - - - - - - - - - - Measles 10 59 50 67 5 3 194 - - - Diphtheria - - - - - - - - - - Acute Pneumonia - - - - - - - 2 3 5 Dysentery 2 4 5 5 1 4 1 2 1 25 Smallpox - - - - - - - - - - Acute Encephalitis Infective - - - - - - - - - - Acute Encephalitis Post Infectious - - - - - - - - - - Typhoid Fever - - - - - - - - - - Paratyphoid Fever - - - - - - - - - - Erysipelas 1 1 3 5 - - - - - - Meningococcal Infection - - - - - - - - - - Food Poisoning 1 2 3 - - - - - - - Puerperal Pyrexia - - - - - - - - - - Ophthalmia Neonatorum 1 1 - - - - - - - - Malaria 2 2 - - - - - - - - Scabies 1 2 3 - - - - - - - Tuberculosis, Pulmonary 1 2 3 11 20 8 45 - - - - 1 Tuberculosis, Non-Pulmonary - 1 3 1 6 - - - TOTALS 67 93 16 21 27 347 20 76 12 15 There were 347 notifications - a decrease of 1,104 compared with the figure 1,451 for 1963 TUBERCULOSIS The tuberculosis death rate of 5.48 is roughly half that of last year when it was 10.93. In 1954, the tuberculosis death rate per 100,000 population was 24.03. The notification rate for tuberculosis in 1964 was 47,53 compared with 64.60 in 1963. 24 FULHAM CHEST CLINIC - ANNUAL REPORT FOR 1964 (SUPPLIED BY COURTESY OF DR. H.C. PRICE - CHEST PHYSICIAN) The present epidemological position of pulmonary tuberculosis in the Metropolitan Borough of Fulham is comparatively stable. This is seen by reference to Table 1 which is concerned with the clinic statistics. The fall in morbidity continues and Table 2 shows that the main age incidence is in the males over 45. The same picture is presented by the mortality figures in Table 3, except that there has been a slight increase in the deaths of males over the age of 65. The fall in the number of visits made by the Health Visitors is due to the fact that during the current year there has been a reduction in the staff available. The fall in the morbidity and morality rates and the gradual lessening of the incidence of tuberculosis, makes it increasingly difficult to trace and examine contacts. However, new patients, and especially those with a positive sputum, are discussed at weekly clinic meetings of the health visitors and the Organiser of the Mass X-ray Unit. After Care. There is much that can be done to help a family when one of its members are ill, and to assist in the financial, domestic and emotional crisis that it may cause. The Samaritan Fund of the Fulham Chest Clinic Care Committee is able to help patients and their relatives with the payment of rent, fares to visit patientsin hospital, with holidays and with loans. It can give extra comforts to the elderly, each year at Christmas forty 10-shilling notes and a Christmas card are sent to the old and sick. Recuperative holidays are arranged through the health department for those in need of a rest and change; for tuberculous patients on a low income extra nourishment is provided in the form of eggs, butter and milk. The Disablement Resettlement Officer visits the clinic regularly for meetings with the doctor and almoner about finding suitable work for patients. The Pottery Unit in the New Kings Road still continues to produce work of a high standard. An exhibition of the patients' work was held in November, and there has been an increase in the amount of pottery sold over the year. The Diversional Therapist helps patients in their own homes to make rugs, basket work, trays, embroidery and toys. She holds a class each week at Hurlingham Lodge. Both Pottery and Diversional Therapy can increase the morale of the patient, and give him a new interest and restored confidence. Many problems still remain, those of patients who are forced to live in damp cold and over- crowded conditions, those of patients who are fit enough to work but are unable to find employment, and old people living on small and inadequate pensions. Non-Tuberculous Chest Diseases. Unfortunately, owing to the early date of this report, the figures for deaths from all respirat- ory diseases in this borough are not available. However, the relatively mild winter of 1963/4 was kind to the bronchitic and the pressure on outpatient and inpatient services was not excessive. 25 Smokers' Advisory Clinic. This venture continued during the year without much success. The Group evening session was transferred to the Public Health Department with the co-operation of the Medical Officer of Health as this was considered to be a more convenient venue for prospective patients. However, this was not successful and has not been functioning since July. Patients still use the Wednesday evening session at the clinic, but the attendances are very poor, from one to four patients in an evening. 26 COMPARATIVE SUMMARY OF STATISTICS FOR ANNUAL REPORT, 1964 1964 1963 No. of NEW PATIENTS Attending:- « . * Non-Tuberculous Chest Cases 228 (221) New Contacts of Notified Cases 119 (168) New Notifications transferred in 55 (45) No. of CLINIC ATTENDANCES:- Notified Cases of Tuberculosis 1627 (1630) Contacts of Cases of Tuberculosis 2088 (2746) Other Chest Diseases 2381 (2160) No. of NEW NOTIFICATIONS OF TUBERCULOSIS IN FULHAM Pulmonary 42 (58) NON-Pulmonary 8 (12) No. of DEATHS IN FULHAM Pulmonary Tuberculosis 22 (21) Non-Pulmonary Tuberculosis 1 (Nil.) Bronchitis (111) Cancer of the Lung (78) No. Taken off Tuberculosis Register as CURED Pulmonary 27 (36) Non-Pulmonary 1 (6) No. of Visits by the Chest Physician 46 (70) No. of Visits by the Health Visitors 1719 (2272) No. of Patients X-rayed (3834) No. of Patients undergoing treatment at home (1) No. of B.C.G. vaccinations 214 (199) No. of Notified cases of Tuberculosis on Register at 31.12.64 1197 (1203) Figures in brackets are the comparative figures for 1963 27 Table 2. NEW NOTIFICATIONS IN AGE GROUPS MALES FEMALES - Under 1 year 1 1 - 5 years 1 - 6-15 years 2 1 16-25 years 2 5 26 - 35 years 4 4 36 - 45 years 3 3 46 - 55 years 4 7 - 56 - 65 years 7 Over 65 years 3 3 29 21 Table 3. DEATHS IN AGE GROUPS YEARS MALES FEMALES 36 -45 years 1 - 46 - 55 years 2 - 56 - 65 years 8 2 Over 65 years 7 3 17 6 28 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 super- vision 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 62 Children 4 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. 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 775 certificates of vaccination and/or inoculation were authenticated. BACTERIOLOGICAL EXAMINATIONS The following bacteriological examinations were carried out for the Council on specimens submitted by general practitioners and the Public Health Department during the year:- Faeces 293 Urine 23 Throat Swabs 13 Miscellaneous 3 29 SECTION C Personal Services Page Hospitals and other Centres in the Borough 30 L.C.C. Personal Health Services 31 Old People's Welfare in Fulham 33 Meals Service 33 Bathing facilities for the Elderly 34 S.O.S. Card Scheme 34 Old People's Laundry 34 30 HOSPITALS AND OTHER CENTRES IN THE BOROUGH OF FULHAM (1) FULHAM HOSPITAL St. Dunstan's Road, W. 6. (under the Charing Cross Group of Hospitals) 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- 5-7, Parsons Green, S.W.6. (under the Charing Cross Group of Hospitals) Number of staffed beds 30 (3) WESTERN HOSPITAL Seagrave Road, S.W.6. An infectious disease hospital solation 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. (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). 31 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. M. Cran L.C.C. Divisional Medical Officer. Ante-Natal Clinics Number of women who attended during the year 1,743 Care of Premature Infants Number of premature infants born during the year 149 Number of deaths under one month 17 Infant Welfare Centres Total attendances 24,278 Total medicals 8,541 Children aged 2-5 yrs. Total attendances 1,191 Total medicals 1,171 Prophylaxis at L.C.C. Welfare Centres Vaccination against smallpox Number of vaccinations 510 Number of inspections 485 Immunization Number of diphtheria injections 6,052 Number protected against poliomyelitis 5,644 Family Planning Sessions Total attendances 964 Creche's Total attendances 357 Child Minders - Voluntarily Registered Number minding children at end of the year 42 Number of children minded at the end of the year 58 Child Minders - Statutorily Registered Number minding children at end of the year 6 Number of children minded at end of the year 25 Private Registered Day Nurseries Number minding children at end of the year 3 Number of children minded at end of the year 59 Child Protection Number of foster mothers at end of the year 37 Number of foster children maintained at end of the year 40 32 Home Help Service Number of cases receiving service at end of the year:- Maternity 2 Tuberculosis 17 Chronic Sick 61 Others 9 The Child Protection Service was transferred to the Children's Department in December, 1964. 33 OLD PEOPLE'S WELFARE IN FULHAM MEALS SERVICE Following the trend of the previous year, the Meals Service hascontinued to expand rapidly. The demand for meals to be delivered to elderly housebound persons grew to such proportions at the beginning of the year that it was found necessary to purchase an additional vehicle which was put into operation on 1st April, with the result that the number of such meals delivered exceeded by over three times the figure for 1963. A new Luncheon Club at Stamford Bridge Stadium organised by the W.V.S. was opened on 1st June serving meals freshly cooked on the premises for up to 30 elderly persons on Mondays, Wednesdays and Fridays. Consequent upon this development the small Shamrock Luncheon Club was closed, the members transferring to the new Club. The Lytton Luncheon Club moved to fresh premises at The Grange, a new block of flats owned By the Fulham Borough Council during June. The Clubroom at The Grange is very pleasantly situated at ground floor level as opposed to the stair climbing involved at the Lytton Estate, which is no doubt a factor contributing to the increase in membership of the Club during the latter half of the year. The Coronation Luncheon Club also moved to fresh premises at the end of May, from a very large room at St. Augustine's Church Hall to a more homely atmosphere at Mohican House, the Headquarters of the 20th Fulham Scout Group, in Li I lie Road. The following table indicates the growth of the service during the year:- Luncheon Clubs Meals on Wheels Total 1964 Brunswick Shamrock Coronation Lytton Grange Stamford Bridge January 1753 442 100 175 183 - 2,653 February 1727 411 170 133 2,553 112 - March 1765 408 96 163 154 2,586 - April 2053 451 116 180 153 2,953 - 1815 384 98 159 128 2,584 May - 2034 388 147 June - 147 216 2,932 July 2289 399 - 197 174 381 3,440 August 2227 346 155 149 263 3,140 - September 2582 396 168 216 397 3,759 - October 2620 471 155 237 340 3,823 - November 2457 449 149 190 347 3,592 - December 2623 457 114 207 275 3,676 - Totals 25,945 5,002 522 1,932 2,219 37,691 2,071 1,103 1,843 1963 8,315 - 2,080 4,135 14,322 34 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., thet 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. Number of baths given during 1964 3981 Number of persons receiving baths at end of year 239 Number of persons on waiting list at end of year 4 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 ladiesfor 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. 142 cards have been issued since the scheme started. Two cards was issued in 1964. 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. The following 33,216 articles of Fulham residents were cleansed during the year;- Sheets 11,912 Pillow Cases 1,703 Towels 4,043 Underwear 11,244 Mattress Covers 292 'Pieces' 3,218 Blankets 804 35 SECTION D Sanitary Circumstances of the Area Page Visits to Dwellings by Public Health Inspectors 36 Statutory Action 36 Summary of Works carried out under supervision of Public Health Inspectors 36 Legal Proceedings 37 Works in Default 37 Water Sampling 37 Land Charges 38 Hairdressers and Barbers 38 Noise Nuisances 38 Disinfection, Disinfestation and Laundry Services 39 Arrangements for Sewage and Sewage Disposal 40 Housing Act, 1957 - Demolition and Closing Orders 40 Common Lodging Houses 41 Dwellings Completed by Council 41 Improvement Grants - Housing Acts, 1949 - 1957 41 Re -housing of Fulham Residents 42 Housing Act, 1961 42 Offices, Shops and Railway Premises Act, 1963 42 Rent Act. 1957 42 Rodent Control 43 Clean Air Act, 1956 44 Industrial Premises 44 Smoke Nuisances 44 Smoke Control Areas 44 Notices of Intention to Install Furnaces 44 Measurement of Air Pollution 45 Factories Act 45 36 sanitary circumstances of the area VISITS TO DWELLINGS BY PUBLIC HEALTH INSPECTORS After complaint 2,076 After infectious disease 86 Re-inspections (excluding house-to-house) 4,876 Drains tested 1,237 Drains inspected 1,665 Voluntary drainage works supervised 1,119 Housing enquiries 112 Owners /builders, etc 683 Miscellaneous visits 238 Ineffectual visits 2,745 Vermin (rehousing cases) 390 Houses in Multiple occupation 525 House to House (initial inspections) 938 House to House (reinspections) 1,121 Rodent control 98 (* 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 987 Intimation notices complied with 624 Statutory Notices served 674 Statutory Notices complied with 539 Summary of Works carried out under supervision of Public Health Inspectors. Fresh Air Inlets repaired or renewed 38 Soil and Vent Pipes repaired or renewed 96 Drains cleared 126 Drains repaired 239 Drains relaid 47 Rainwater gutters and pipes repairedor renewed 125 Traps cleansed, repaired, etc 9 Pans renewed 52 Seats repaired or renewed 87 Flushing cisterns repaired or renewed 38 Fastenings provided to doors, and doors repaired 16 Sinks provided, repaired or renewed 37 Sink and bath wastes repaired or renewed 48 Baths cleansed 4 Water cisterns repaired, cleansed, etc. 36 Water supply pipes and fitting repaired 88 Internal house repairs 1,038 Fireplaces repaired (nuisances from smoke etc.) 97 Kitchen ranges repaired or renewed (for cooking purposes) 5 Dampness remedied 627 Rooms provided with adequate light and ventilation 11 37 Staircases provided with light and ventilation and repaired 25 Ventilation provided under floors and repairs 236 Roofs repaired 268 Other external repairs 173 Accumulations of refuse removed 64 Dustbins replaced 167 Yards, forecourts paved and drained 29 LEGAL PROCEEDINGS During the year 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 Orders made 11 No. of cases where daily penalties were awarded. Nil No. of cases withdrawn or adjourned sine die 28 WORKS IN DEFAULT PUBLIC HEALTH (LONDON) ACT, 1936 During 1964 the Council's contractors carried out works in default at 9 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 £1.10. 0. to £104. 0. 0. the total sum involved being £137.16. 0. WATER SAMPLING The regular monthly sampling for bacteriological examination of domestic supplies in different parts of the borough continued. During the year 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. Source of supply Number of Samples AFTER TREATMENT Agar plate count per ml. Coliform count. E. Coli count Per cent samples negative in 100 ml. 20-24 hours 37° c. 3 days at 22° C. Per cent samples negative in 100 ml. Surbiton 516 3,5 100.0 100.0 The results of the chemical examination of the samples taken were also satisfactory. 38 Results of Swimming Bath Water Samples During the year 27 samples of swimming bath water were taken from 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.1. 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 2,978 premises. In 75 cases notices were outstanding at the time of search, and there were declared accordingly HAIRDRESSERS-AND BARBERS The number of registered hairdressers and barbers increased during the year to 110. 65 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:- Nature of Complaint Action Taken (if any) 1 Noise and vibration from machinery in basement following extension to business. Action taken by London County Council under planning powers. Case not yet resolved. 2 Noise nuisance from deployment of taxis in street. Police consulted and management informed of complaints. Appreciable reduction of noise effected as result. 3 Noise from movement of oil drums on concrete unloading bays. Management co-operated with provision of rope mats. 4 Night noise of machinery from nearby established launderette Noise reduced by sound insulating measures. 5 Noise from pumps used on public sewerage scheme. Contractors co-operated as far as possible and works expedited. 6 General noises from first floor of large engineering works. Management informed and appreciable reduction of general noises effected. 7 Noise and vibration of pile driving near houses due for demolition. Temporary and short-lived nuisance abated the day after complaint received. 39 Action taken (if any) Nature of Complaint 8 Noisy handling of delivery at engineering works on a Sunday morning. 9 Night boises from paint spraying. 10. Night noises from refrigerator in foodshop; bedroom of complainant immediately above shop. 11. General noises from large engineering works. 12 Noisy refrigerator vans in yard of food premises. 13 Noisy fan in restaurant. 14 Noisy fan in restaurant. Sunday delivery exceptional. Not since repeated. Management acceded to request to provide sound insulation to noisy compressor. Management acceded to request to provide better sound insulation. Appreciable reduction of noise following approach to management. Correspondence with management resulted in resiting more remote from nearest residences. New system installed on request resulting in complete abatement of nuisance. Management on request called in consultants. Nuisance not yet abated. DISINFECTION, DISINFESTATION AND LAUNDRY SERVICES 281 Number of rooms disinfested Number of rooms disinfected after Infectious Disease 26 Number of wards and rooms disinfected in Maternity Hospital 25 Number of articles stoved 3,127 Laundry carried out for the Refuse Destructor Staff:- Bath towels 440 Roller towels 72 34 Dust Coats Boiler Suits 6 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 1964:- Bedsteads and Bedsprings 24 Mattresses 36 10 Bolsters Pillows 15 Blankets 12 Sheets 10 Clothing 54 Miscellaneous furniture 14 40 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 sewers connected therto. 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 No demolition orders were made during the year. Two closing orders were made in respect of parts of premises as follows:- Premises Part closed Date of Order 209 Munster Road Basement 23.9.1964. 47 Harwood Road Basement 17.6.1964 The annual survey of 158 premises subject to closing orders was carried out during the year and the results are as follows:- 5 premises and 149 parts of premises were still either not used or used in accordance with the 'permitted use' granted by the Council either at the time of making the closing order or subsequently. In the following cases action by the Council was required as indicated:- 31 and 32, St. Thomas's Way. (Whole Houses) Premises had been demolished and the closing orders made on 4th March, 1954 were determined. 7, Fulham Broadway (Basement). The Council had previously granted 'permitted use' as a carpenter's workshop. The basement had been taken over by a restaurant for use as a store-room and changing room in connection with the business and this alteration in 'permitted use' was granted.. 41 12, Lanfrey Place (Whole House) The owners had carried out works to render the premises fit for human habitation and the closing order made on 9th March, 1960 was determined. COMMON LODGING HOUSES There are no common lodging houses in the Borough. DWELLINGS COMPLETED BY THE COUNCIL BETWEEN 1st JANUARY AND 31st DECEMBER, 1964 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:- New Building Dwellings Rooms Completed B.S.R. and 4 2 & 4 May Street 4 2 2 17th July, 1964. In addition, 468 dwellings are under construction as follows:- Dwellings Favart Road/Parthenia Road 30 Bluebell Works Area 176 Clem Attlee/St. Thomas's Way 159 Field Road Area 103 Housing Act, 1957 - Purchase for General Housing Needs Properties Accommodation in Improvements after Dwellings at Purchase Conversion Proposed Dwellings 83 161 179 This does not include properties acquired in the Maxwell Estate Area/ Moore Park Road Area. Improvement Grants:- Privately Owned Property Dwellings Applications Received 158 No. of Dwellings concerned 170 Dwellings Approved Standard Grants 66 Discretionary Grants 38 104 Further information required from Applicant before submitting Proposals to Committee 39 Withdrawn or refused (dwellings) 27 Dwellings 170 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 179 Number of families rehoused by Fulham Borough Council 230 Total 409 HOUSING ACT, 1961 Eight cases of individual houses in multiple occupation were found calling for action under Part II of this Act. The facilities provided fell short of the standards adopted by the Council. During the year four of these cases were brought to a satisfactory conclusion, and work put in hand in the remainder. OFFICES, SHOPS AND RAILWAY PREMISES ACT, 1963 The above-mentioned Act required employers between Ist May and 31st July, 1964 to register with the appropriate authority all premises coming within the scope of the Act. So far as this Borough is concerned it is estimated that there are probacly some 2,000 premises to which the Act applies, but at 31st July only 519 applications for registration had been received. This was typical of the somewhat poor response which had been received throughout London notwithstanding Government publicity. Letters were sent to employers reminding them of their obligations under the Act. Inspection of premises was commenced on the Ist October. RENT ACT, 1957 Details of action taken between 1st January and the 31st December, 1964 are as follows:- No. of applications for certificates 7 No. of decisions not to issue certificates Nil No. of decisions to issue certificates:- (a) in respect of some but not all defects 4 (b) in respect of all defects 3 No. of undertakings given by landlords under para. 5 of the First Schedule 5 No. of undertakings refused by Council Nil No. of certificates issued 5 Applications by landlords for cancellation of certificates 10 Objections by tenants to cancellation of certificates 4 Council's decisions to cancel in spite of objections 1 Certificates cancelled 7 At the end of the year 96 certificates under the 1957 Act and 89 certificates under the Housing Repairs and Rents Act, 1954 were still outstanding. 43 For the first time, during the year two decisions of the Council were challenged in the County Court;- Case No. 560 The landlord appealed against the Council's decision to issue a certificate of disrepair The Court ruled that the certificate should not have been issued, the tenant having given incorrect information to the department regarding the terms of his tenancy. Case No. 550 The tenant objected to the Council's decision to cancel the long outstanding certificate of disrepair on the grounds that the work had not been satisfactorily carried out. The County Court Judge, after personally visiting the premises, ruled that cancellation should be withheld for a period of one month in order to allow the landlord to carry out further work. At the subsequent hearing the Court ruled that the certificate should be cancelled. 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 infectations, both 'reported' and 'discovered' by inspection. Practically all of the reported cases of surface infectations were traceable to rats coming off either a defective or disused house connection to the sewer. Dwelling Houses Business Premises Total 1. No. of complaints received 581 93 674 2, No. of properties inspected 756 113 869 3. No. of properties found to be infested by rats - Major - - - Minor 247 30 277 4. No. of properties found to infested by mice 335 33 368 5. No. of properties treated - (a) Rats 247 30 277 (b) Mice 335 32 367 6. No. of notices served under Section 4 - (a) Treatment - - - (b) Structural works, i.e. proofing - - - No. of notices served under Public Health (London) Act, 1936 - - - 577 5,412 7. No. of visits made by Rodent Operatives 4,835 44 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. SMOKE NUISANCES Ten complaintsof 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 Smoke Control Order No.8 To publicise the effect of Smoke Control Order No.8 which came into operation on 1st October 1964, letters were sent to 5,371 householders in the area, to estate agents, coal merchants, builders, electrical contractors and to other business premises. It is the Council's usual practice following the confirmation of a smoke control order by the Minister to hold an exhibition in the area affected, but having regard to the large size of area No.8 two very successful Clean Air Exhibitions were held at the following places and times:- Christ Church Hall 13th - 15th February 1964 Holman Hunt School 18th - 20th February 1964 Smoke Control Order No. 9 This area which is the only remaining one not so far dealt with under the Council's clean air programme has been surveyed. The survey shows that the area, which comprises 368 acres, contains 6,752 dwellings and 497 other premises. The estimated cost of adapting and replacing fireplaces to the agreed standard is £64,721 towards which the Council will make grants estimated at £48,405; of this amount £25,888 will be contributed by the Exchequer leaving £22,517 to be found by the Borough Council. The Council recommended that the order should become operative as from 1st October, 1965. Section 3. Notices of Intention to Install Furnaces During the year two notices were received in respect of oil-fired boilers. 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 1964, twelve diesel-engine vehicles were 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. 45 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. FACTORIES ACTS The position at the end of 1964 was as follows:- Factories with mechanical power 287 Factories without mechanical power 281 The following is a summary of industries and trades registered as factories in the Borough:- Antique dealers 19 Boot repariers 34 Cement Works and Road Surfacing Materials 7 Clothing (including tailors, dressmakers, shirtmakersand bathing costume manufacturers) 30 Coal Wharf 2 Dyers and Cleaners 4 Dyers and Cleaners' Receiving Depots 32 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) 49 Gas Works 1 Laboratories 5 Launderettes 17 Laundries 9 Laundry Receiving Depots 17 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 46 Timber Merchants and Joiners 38 Scrap Metal Merchants 11 Warehouses, Wharfingers and Bonded Stores 36 Miscellaneous 83 The following is a record of inspections made and action taken:- Section 8 Premises Inspections No. of notices served Factories without mechanical power (initial visits) 37 - Factories with mechanical power (initial visits) 48 - Other premises under the Act (building operations and works of engineering construction) 2 - Number of re-inspections of all factories 1668 - Number of cases in which defects were found:- Particulars Found Remedied Want of cleanliness 28 28 Inadequate ventilation 10 10 Inadequate lighting 11 11 Ineffective drainage of floors 8 8 Sanitary Conveniences (a) Insufficient 14 14 (b) Unsuitable or defective 31 31 (c) Not separate for the sexes 2 2 No prosecutions were instituted under the Factories Acts during 1964. Section 110 - Outwork Nature of Work No. of Outworkers on list Artificial flowers 27 Artificial jewellery 3 Boot making 2 Box making 1 Button carding 3 Fancy goods 2 Lampshades 5 Leatherwork 1 Millinery 4 Paper and plastic bags 3 Toymaking 32 Upholstery 5 Wearing apparel 29 117 128 visits were made to outworkers during the year. 47 SECTION E Inspection and Supervision of Food Food, Examination 48 Food, Voluntary surrender 48 Milk 48 Ice Cream (Heat Treatment etc.) Regulations 50 Food Standards (Ice Cream) Regulations 50 Sampling, Foods and Drugs 50 Adulterated or Irregular Samples and Food subject of Complaint 51 Bacteriological Examination of Foodstuffs 54 Food Establishments, Inspection 54 Food Hygiene Regulations 54 Report of the Council's Public Analyst Thomas A. McLachlan .. .. 55 48 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 seel 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 premi ses during the year involved the examination and destruction of the following articles and the issue of 637 certificates:- Tinned and packeted goods 5,876 Poultry 108 lbs. Fish 127 lbs. Meat 4,295 lbs. Butter 22 lbs. Offal 69 lbs. Sausages 60 lbs. Potatoes 47 cwts. Pears 9 cwts. 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:- Month No. of Samples Fat. Average % Non-fatty solids January 4 3.85 8.53 February 6 3.53 8.53 March - - - 11 8.59 April 3.58 May 4 3.50 8.67 June - - - 6 3.53 July 8.54 August 4 * 3.16 8.61 September 3 3.70 8.59 October 2 3 90 8.73 November 4 3.68 8.69 December 7 3.94 8.67 * Incl. one adulterated 3.64 8.62 49 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', '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 6 4.38 8.85 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 Me thylene blue test Turbidity test Grade of Milk Passed Failed Passed Failed Void Passed Failed - - Pasteurised 28 28 - 26 2 - 4 4 Sterilised - - - - - - 32 Tuberculin tested (Pasteurised) 38 38 6 - - - - The following are details of licences issued during the year. The expiry date of all current licences is December 31st 1965. Issued in 1964 Total on Register To retail. Tuberculin Tested Milk 4 72 To retail Pasteurised Milk 9 130 To retail Sterilised Milk 7 118 Untreated 4 5 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 136 premises so engaged. Number of Inspections of milk dealers premises 167 50 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 28ºF 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. Routine sampling has been carried out, and it is pleasing to report that most samples reach the highest grade of cleanliness prescribed under the Regulations. 23 samples of ice cream were taken, with results as under:- Grade 1 -9; Grade 2- 4; Grade 3-6; Grade 4- 4; The Food Standards (Ice Cream) Regulations, 1959 The Regulations prescribe standards for ice cream and for 'Parev' (kosher) ice and separate standards for dairy ice cream and for milk ice. No type of ice cream shall contain any artificial sweeten er. 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 iceshall contain not less than 10% fat and no milk fat or other derivative of milk. During the year a total of 23 samples of icecream were obtained with the following average results. (One inferior sample not included - insufficient details given). Average % Ice Cream Dairy Ice Cream Non fatty solids Total Solids Fat 25.78 33.91 8.13 8.71 26.93 35.64 FOOD AND DRUGS SAMPLING 26 complaints were received from members of the public regarding food, and these were fully investigated. 51 ADULTERATED OR IRREGULAR SAMPLES AND FOOD SUBJECT OF COMPLAINT Whether Formal Informal or Private Serial Number Nature of adulteration or irregularity Action taken Article 6457 Salmon Spread with Butter. Informal Contained only 7% butter fat Letter to producers. 6458 Chicken Spread with Butter Informal Contained only 7% butter fat Inferior.Should contain not less than 8%. Syrup contained only 16.6% soluble solid as sugar,and only 54% drained weight peaches. Syrup not "heavy" as labelled and quantity of peaches low. 6461 Canned Sliced Peaches in heavy syrup Informal No action at present. 6474 Black Pudding Informal Contained total meat only 46%. Deficient in meat. Should contain at least 65% meat. No action. 6507 Vitaminized Apple Juice. Informal Stated to contain 35 mgms. Vitamin C per 100 cc but contained only 21 mgs. Inferior. Perhaps old stock. Letter to producers. Contained only 6.2% butter fat. 6539 Potted Beef with Butter Informal Letter to producers Contained only 6.4% butter fat. Inferior. Should contain not less than 8%. 6542 Dressed Crab with Butter. Informal 6653 Ice Cream Informal Contained 4.4% fat. 12% deficient in fat. Food Standards Ice cream Order requires not less than 5% fat. Formal follow-up sample satisfactory. Legal proceedings, Defendant fined £5. 1 gn. costs to Council. 6672 Roll & Butter Formal Spread with margarine 6689 Bread & Butter Formal Spread with margarine. do 6693 Roll & Butter Formal Spread with mixture of butter and margarine do No further action. 6713 Salmon Informal Complaint of glass.These were crystals of struvite. continued 52 Whether Formal Informal or Private Serial Number Article Nature of adulteration or irregularity Action taken 6730 Lemon Crush Informal Contained only 20% Lemon Juice. Soft Drink Order requires not less than 25% Lemon Juice Producers notified 6778 Bread Roll Informal Contaminated with dirt probably from improperly cleaned baking trays. Due to carelessness in bakery Letter to firm concerned. 6779 Bread Loaf Informal Contaminated with oil and particles of metel and dirt from shafting. Due to carelessness in bakery. do 6786 Ground Almonds Informal Complaint of unpleasant flavour. Probably due to the use of bitter almonds which had been de-bittered. Inferior. No action 6814 Prunes Informal Contained 107 parts per million sorbic acid. Dis- Enquiries showed natural sorbic acid content. 6888 Milk Informal Contained 1.85% fat only. 38% deficient in fat. Milk must have been mixed at bottling Depot. Sample from vending machine. Dairy company unable to account for deficiency. No further action. Sauce (for Spaghetti) 6939 Informal Contained 1.66% salt, and when opened ferments slowly. More salt required to prevent fermentation. Inferior. Letter to distributors. 6960 Butter canned Informal Cans blown and fat smells of butyric acid. Free Fatty Acids 12.8% and 10.5% respectively. Satisfactorily labelled. No further action. 6973 Butter canned (Follow up to 6960) Informal Fit for cooking purposes only. Inferior. I 6970 Prunes Informal Mouldy. Packed and stored under unsatisfactory conditions. Retail packing and storing investigated. 6964 Table Jelly Informal When made up in accordance with directions jelly would not set. Food Standards (Table Jellies) Order 1949-1962. Further sample obtained. 6981 Bread Informal Mouldy. Had been cut and packed warm. Representative of producer interviewed. continued 53 Article Whether Formal Informa1 or Private Nature of adulteration or irregularity Action taken Tuna Informal 6 out of 12 cans contained Informal Tuna sporing bacterium No further action Informal Tuna Cottage Cheese Formal Deficient in fat Referred to Metropolitan Boroughs Standing Joint committee Cottage Cheese Informal Deficient in fat Referred to Metropolitan Boroughs Standing Joint Committee. Starch reduced biscuits Informal Incorrectly labelled Label altered to comply. Starch reduced rolls Informal Incorrectly labelled Label altered to comply. 54 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. 77 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 premises No. of inspections Bakehouses 28 78 Bread and Cake shops 12 67 Butchers' shops 69 77 Confectionery 74 52 Cooked Meat shops 16 91 138 Milk distributors 129 Eel and Pie shops 3 10 7 Food Factories 152 25 86 Fishmongers' shops Fried Fish shops 23 30 General Food shops 228 922 Greengrocers and Fruiterers 109 160 Ice Cream (Mfrs. and Dealers) 232 238 Licensed Premises 106 101 Restaurants and Dining rooms 142 756 Stalls 109 308 Stallholders storage premises 70 64 Other Food premises 12 216 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. 55 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 1964 800 samples of food were examined. Of these 114 were taken formally and 686 informally. The number adulterated or about which somecomment was made was 49. The incidence of these criticisms may beclassified as follows:- Number of samples Examined. Number of samples adulterated, etc. Milk 57 1 Other Foods 743 48 Some homogenised milk contai ned 1.85 per cent of fat, 8.62 per cent of solids not fat, and 89.53 per cent of water was was 38 per cent deficient in fat. The dairy was unable to offer any explanation as the bottle was one of a large number filled and heated at the same time. Two samples of canned butter, one received as a complaint and the other a follow up, were examined and although the complaint butter contained 13,000 bacteria the unopened tin contained fewer that 100 bacteria per gram growing at 37 ºC. The free fatty acids were 12.8% and 10.5% respectively. The butter was considered to be fit for cooking purposes but would be unacceptable as butter in this country. It was better than most ghee sold in India and tropical countries and was later stated to be intended only for cooking purposes on the lines of ghee. A sample of ice cream contained 4.4 per cent of fat, whereas the Food Standards (Ice Cream) Order requires ice cream to contain not less than 5 per cent of fat, and this sample was, therefore, 12 per cent deficient in fat. A product sold as ''Top of the Milk" was reported as satisfactory although it contained only 18 per cent of milk fat. 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 Food Standards Cream Order, 1951, but unfortunately the sellers have been given a contrary opinion by the Ministry of Agriculture, Fisheries and Food. A roll and butter consisted of a roll spread with margarine and some bread and butter consisted of pieces of bread spread with margarine. Another roll and butter was found to contain a mixture of 66 per cent butter and 34 per cent margarine. Rolls and butter or bread and butter must be spread with butter and not margarine. Some foreign matter stated to have been found in a bread roll appeared to be a piece of refractory material from the lining of an oven. Another roll was contaminated with dirt which was distributed fairly evenly throughout the interior of the roll, the dirt being derived from improperly cleaned baking trays. A loaf also contained dirt, consisting of gear oil with particles of metal and other dirt from shafting. Some slices of bread which were badly attacked by a yellowish red mould were submitted for the identification of the mould asa result of a complaint. The mould was identified as Monilia sitophila which is a mould that often gains access to bakeries and causes a lot of trouble There was also an aspergillus mould present which did not grow as rapidly as the Monilia. The Council believed 56 that the scale of this loaf was due to stale bread being sold from the shop, and brought an action against the seller. Unfortunately a well known barrister appeared for the defence and managed to cast doubt on the behaviour of the complainant. In your analyst's opinion had the Court listened to the witness carefully there was little doubt chat the defence story did not hold together properly. A table jelly, when made up according to the directions, would not set properly and was reported as adulterated. A sample of prunes contained 107 parts per million of sorbic acid, and of this two thirds was found on the skins and only one third in the pulp, from which it appeared that the sorbic acid had been added as a preservative to the prunes before drying. This contravenes the British Preservatives in Food Regulations, but the practice is legal in the United States. Another sample of prunes was badly infected with aspergillus mould and was unfit for sale. The whole of the exterior of a Christmas pudding was covered in mould growth, due to excessive water and was obviously inedible and some dates which were also very mouldy were contained in a box, the bottom of which was very wet indicating that it must have been left open in the rain at a shop or stall. A Lemon Crush contained not more that 20 per cent of lemon juice , whereas according to the Soft Drinks Order it should contain not less than 25 per cent of juice. It was suggested the matter should be drawn to the manufacturer's attention, although he would doubtless claim that the deficiency was due to the low mineral constituents of their particular lemon juice and not a deficiency in juice. Samples of salmon spread with butter, chicken spread with butter, potted beef with butter and dressed crab with butter were exami nedand found to contain 7%, 7%, 6.2% and 6.44% of butter fat respectively. The recognised quantity of butter fat in this type of product is 10 per cent, and the samples were all reported as inferior. Several cans of salmon and tuna were received due to a complaint in another borough and they had caused sickness. The cans of salmon appeared to be satisfactory, but microbiological examination of the tuna showed a slow growing gram-positive spore bearing rod bacterium. A complaint was received regarding crystals found in a tin of salmon. These were crystals of magnesium ammonium phosphate (Struvite), and are commonly found in canned salmon, canned lobster, and similar products. For the crystals in this particular product to have become so large it was probable that the salmon must have been canned for some considerable period. Another complaint was also received that a meat extract contained beads, but these were really beautiful crystals of salt, which hadformed with occlusions of meat extract in the centre of each facet. Some almonds possessed a peculiar flavour thought to be due to rancidity, but this was probably due to the fact that they werebitter almonds which had been de bittered. The sample was reported as inferior. It would be useful if legislation made it obligatory to label de-bittered almonds as such. Some melon and lemon jam contai ned only 62.3 per cent of soluble solids as compared with the minimum requirement of 65 per cent for hermetically sealed jams and was 4 per cent deficient in soluble solids. A black pudding contained an amount of blood, which calculated as 46 per cent of total meat only and was reported as adulterated. Your analyst is of the opinion that a black pudding should contain the equivalent of at least as much meat, and protein, calculated as meat, as pork sausages, but as the black puddings are partially dried, the final meat content should appear much higher. 57 The ingredients on several samples of fruit salad and fruit cocktail were not listed in accordance with the quanitites of fruit found to be present. A can of ' Sliced Peaches in Heavy Syrup contained only 54 per cent by weight of drained peaches and the syrup contained 16.6 per cent of soluble solids. They should not have been labelled as being in heavy syrup, but as being in syrup A follow up sample was lightly better with 54.8 per cent of drained weight of peaches, and 20.7 per cent of soluble solids in the syrup. Some canned apple juice was stated on the label to contain not less than 35 mgs. of vitamin C per 100 c.c.but only 21 mgs. was found. The sample was reported as inferior, but the label would have been better if amended to read "contains 35 mgs of vitamin C. per 100 c.c. when packed".- A product sold as "Pure Grape Juice" contained added colour Amaranth Fast Red E and Green S, although there was no disclosure of the presence of artificial colour. The label of a composite product sold as "Chicken Dinner" had the ingredients declared in the wrong order. Peas were listed before carrots, although the product contained 66 parts by weight of peas and only 34 of carrots. Three samples of soya sauce were incorrectly labelled. One did not declare its ingredients at all, and the other two declared among other things "extract of soya bean", which is unsatisfactory because extracts can be obtained as alcoholic or aqueous extracts, or, as was probably the case with this product it was really hydrolysed soya protein. One of these latter samples also listed the ingredients in incorrect order and the product also contained a large number of crystals of salt. A sauce for spaghetti contained 10.5 p.p.m. of copper, but as it contained a mixture of ingredients it was impossible to determine the amount of tomato solids present and it was therefore difficult to know what would be the quantity of copper permitted. When the product had been opened for some time it fermented slowly, and it was suggested that the presence of rather more salt would prevent this fermentation. Several samples of hot pepper pickle were examined and contained varying quantities of salt and acetic acid, indicating that more care was required in their manufacture. A tomato sauce was incorrectly labelled as it was stated to contain "solution of acetic acid", but this is not a recognised description since this is itself a mixture of ingredients. The correct description would be 'acetic acid' in its proper order of priority. Legislation issued or proposed during 1964 The year 1963 was a comparatively quite one as regards food legislation, but the year 1964 was busy, not because of the number of Statutory Instruments issued, but on account of fresh legislation, which is being initiated. The following items are of interest:- Food Additives and Contaminants Committee, The Minister of Agriculture, Fisheries and Food decided to make the above Committee a committee in its own right on account of the importance that this aspect of food has assumed. He asked the Committee among other things, to examine the leeching out of poisonous substances into foods from any wrapping materials that might be employed. Urgent attention, however, is 58 needed about the presence of lead and other toxic substances in children's toys and paints, which children are likely to suck or chew. It is believed that lead and mercury are causing more ill-health among children than was formerly recognised The Committee have also been asked to examine the whole subject of food preservatives. Colouring Matter in Food Regulations The Colouring Matter in Food Regulations 1957 were considered and the Food Standards Committee issued a report making recommendations for amendments to these regulations. The Ministry is now adopting the policy of keeping Statutory Instruments constantly under review and amending them, if necessary, fairly frequently. It is now suggested that six of the existing food colours should be withdrawn from the list, that titanium dioxide should be permitted only for the surface colouring of food, that the colouring of citrus fruit should be forbidden, and that specifications of purity should be introduced On the other hand it is suggested that another black colour should be provisionally added to the permitted list and that two named carotenoids should be permitted. It is noted that no organic blue colour will now be permitted in food if the recommendations are adoptedand it is a remarkable thing that no natural food appears to be coloured blue.. Probably the most important proposed piece of legislation is the suggestion that the control of foods should be separated from that of drugs and that the whole of drug legislation should be brought under one main umbrella. The present proposals would, however, retain many of the present anomalies of control and doubtless more consideration will be given to this in the near future. During the year The Food Standings Committee issued a Report on Food Labelling and, although the recommendations included some 72 provisions, there is little doubt that many of the proposals will have to be modified. The Meat (Treatment) Regulations. 1964, prohibit the addition of ascorbic acid, erythorbic acid, nicotinic acid, nicotinamide, and any of their salts or derivatives to raw and unprocessed meat intended for human consumption. Unfortunately the definition of the word "processed" does not clarify exactly whether products such as sausages and salamis would be considered as processed or not. Proposals were issued for canned meat products and also for meat pies. Doubtless many of these proposals are being contested behind the scenes, but it will be a great advantage if the drafts can come into force without too much amendment. The Dried Milk Regulations, 1964, come into operation on the 11th March, 1965.The chief modifications introduced are the maximum and minimum percentages of milk fat required for grades of milk powder other than full cream powder, and regulations for the labelling of such products. There is also a proposal to amend the present Skimmed Milk with Non-Fat Regulations, 1960. During the year the Ministry issued a provisional method for the testing of milk for the presence of antibiotics. It is very seldom, however, that the presence of antibiotics can be proved in bulk milk. Fresh Mineral Hydrocarbons in Food Regulations were issuedduring the year. Besides increasing the amount of paraffin hydrocarbons permitted in or on foods, they also lay down specifications for the quality of such hydrocarbons The difficulty of enforcing in Great Britain regulations regarding the quality of liquid paraffin employed for coating citrus or dried prunes, currants, sultanas or rasins in other countries will be appreciated. The Soft Drinks Regulations, 1963, which should have come into force in 1964, were revoked and replaced by the Soft Drinks Regulations, 1964, which will come into operation on the 2nd June, 59 1965. These Regulations will permit the use of cyclamates for sweetening soft drinks and presumably, therefore. Regulations will be introduced to permit the use of the se compounds in other foods, such as diabetic jams. These Regulations also require the disclosure of the presence of artificial sweeteners in soft drinks and prescribe standards for semi-sweet and low calorie soft drinks. Thomas McLachlan. 60 Article Number Examined Number Adulterated etc. Total Formal Informal Formal Informal Total Acetic Acid 1 1 2 2 Ale Almonds, ground 1 1 1 1 Baby Food 1 1 Baking Powder 2 2 Beans, baked, canned 5 5 Beverages, chocolate 3 3 Bicarbonate of Soda 5 5 Biscuits 1 1 Biscuit Mix 1 1 Blancmange Powder 2 2 10 8 18 3 3 6 Bread, bread and butter etc Bread, foreign matter 1 1 1 1 Butter 25 25 2 2 Cheese 12 12 Cider 1 1 Coconut, desiccated 4 4 Coffee, extract 1 1 Colouring 2 2 Confectionery 7 7 Cooking fat 5 5 Cornflour 4 4 Cornmeal 1 1 Cream 13 6 19 5 5 Cream of Tartar Custard Powder 3 3 Dripping 1 1 Fish Cakes 1 1 4 4 Fish, canned 19 19 Fish Paste 4 4 Fish Saithe 1 1 5 Flavouring 5 13 Flour 13 Fruit, canned 37 37 9 9 Fruit, dried 33 33 3 3 Fruit Juice 14 14 2 2 Herbs 9 9 Honey 2 2 Horseradish 2 2 1 1 Ice Cream 3 22 25 Ice Cream Mix 1 1 1 1 Ice, water Icing, chocolate coconut 1 1 Jam and Preserves 15 15 1 1 14 14 1 1 Jelly Lard 6 6 Lemon Curd 7 7 1 1 Liqueur, cherry 1 Macaroni Product 1 Margarine 12 12 26 331 357 3 C/forward 28 31 63 Number Adulterated etc. Article Number Examined Formal Informal Total Formal Informal Total Marmalade 18 18 Marzipan 1 1 3 Mayonnaise 3 Meat Products Black Pudding 1 1 1 1 Brawn 2 2 Breakfast Sausage 3 3 Chicken Roll 1 1 Chicken, canned 1 1 Chopped Pork 2 2 Liver Sausage 1 1 Meat Extract 1 1 5 Meat Paste 5 Ox Tongue 1 1 Pork 5 5 Sausages 13 13 Snack Meal 3 3 1 1 Tongue 1 1 Veal, jellied 4 4 Milk 1 28 29 57 1 Milk Beverage 1 1 Milk, condensed 3 3 4 4 Milk, evaporated Milk Shake Syrup 1 1 Milk, skimmed 1 1 Milk, top of the 1 1 Mincemeat 2 2 Mint Sauce 1 1 1 Mint in vinegar 1 Mushrooms, canned 1 1 Non-Brewed Condiment 1 1 3 Nuts 3 Oil, nut 2 2 1 Olives 1 Pancake Mixture 1 1 Pease Pudding 1 1 Peel, cut 1 1 1 Perry and Gin 1 Pickles 6 6 4 4 Pie Filling, Apple 1 1 4 Pudding, Milk, canned 4 Pudding, Christmas 2 2 1 1 Raising Powder 1 1 2 2 Rennet Essence Rice, ground 4 4 Salt 3 3 Sauce 17 17 4 4 3 Sauce Mix 3 Semolina 5 5 C/forward 468 522 40 43 54 3 62 Number Examined Number Adulterated etc. Article Formal Informal Total Formal Informal Total Shandy 4 4 1 1 Soft Drinks 56 56 1 1 Spice 21 21 Spirits 59 59 Soup, canned 7 7 Spaghetti, canned 1 1 Spread, savoury 11 11 4 4 Starch Reduced Food 1 1 Sugar 7 7 Syrup 7 7 Tea 22 22 Treacle 1 1 Vegetables, dried 2 2 Vegetables, canned 3 3 Vegetables, pickled 7 7 Vegetables, salad 1 1 Vinegar 11 11 Wine 1 10 11 Drugs Blackcurrant Pastilles 1 1 Catarrh Pastilles 1 1 Cough Lozenges 1 1 1 Cough Pastilles 1 Cough Syrup 1 1 Cough Tablets 1 1 Glycerine Lemon and Honey 1 1 Linctus Pastilles 1 1 Nerve Tonic 1 1 Oil of Peppermint Tablets 1 1 Throat Pastilles 2 2 Tonic 1 1 800 Total 114 686 3 46 49 63 SECTION F Miscellaneous Services Page Health Education 64 National Assistance Act - Burials 65 Public Conveniences 65 Medical Examinations 65 Pet Animals Act 65 Pharmacy and Poisons Act 66 Rag Flock and Other Filling Materials Act 66 Licensing Act, 1961 67 64 HEALTH EDUCATION A list of titles of talks etc., available on a wide variety of health matters with brief explanatory 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 Discussion Groups or Talks No. of persons attending Average Attendance 249 25 10 Film Shows 561 70 8 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. HOME SAFETY The civic news sheet, 'Town Topics', which is distributed to all the householders in the Borough, was used to bring to the attention of the public various aspects of Home Safety including (a) Maintenance of Oil Heaters and safe disposal of worn out ones, (b) Fire Safety precautions on Caravan Holidays, (c) Water Safety, (d) Danger of Fireworks. In October there was a campaign on the danger of fireworks and posters were distributed for display on a large number of sites. In addition a leaflet 'Hints on Handling Fireworks' w as produced and distributed to Newsagents and various organisations in the Borough and an advertisement was inserted in the local papers. Prior to Christmas a window display on non-inflammable decorations was again arranged to remind the public that the majority of Christmas decorations on sale were of non-inflammable materials and included in this display was an item on flare free materials for childrens' nightwear. DENTAL HEALTH In co-operation with Dental Health the campaign sponsored by the London County Council a window display 'Join the Apple Club' was arranged to commence in November and continue until February, 1965. 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. 65 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 cooperated in distributing leaflets on matters of special topical importance. Appropriate leaflets are handed out to audiences at lectures and discussion groups etc. NATIONAL ASSISTANCE ACT, 1948 Section 50 - Burial or Cremation of the Dead. 16 burials were arranged during the year under the provisions of this section of the Act. 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 often received from persons living outside the Borough congratulating the staff on the clean and hygienic condition of the conveniences. STAFF MEDICAL EXAMINATIONS During the year 204 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. 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. Nine licences were renewed during the year. No contraventions of the Act were found during inspections. 66 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 I and Part II. The sale of poisons included in Part I is restricted to registered pharmacists whilst those included in Part II may be sold to the general public not only by registered pharmacists, but also (subject to certain conditions) by ordinary traders whose names are entered on a List of Persons entitled to sell such poisons, kept by the Local Authority. The Acts and Rules lay down certain requirements regarding type of container, labelling, storage transport and sale of poisons, penalties being prescribed for non-compliance. Fees are payable to the local authority by persons whose names are entered on the List. At the end of 1964 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 1.1.64. 141 Number added during the year 9 150 23 Number who transferred their business or discontinued the sale of poisons 127 48 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. 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 23 samples of filling material were obtained and one was reported unsatisfactory. The following are the details:- Algerian fibre 1 Cotton wadding 3 Rag flock 4 Millpuff 2 Rag flock, layered 2 Reconditioned hair 1 Coir fibre 2 Hair and fibre mix 1 Feathers 3 Used wood wool 1 Feather & Down Mixture 2 Hair 1 23 67 LICENSING ACT, 1961 This Act places on local authorties responsibilities in relation to licensed restaurants and clubs and is largely concerned with amendments to the general Licensing Laws. Part III 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 powers given to the local authority are considered to be most helpful. No. of applications for registration and re-registration investigated 17 No. of cases where works required or objection recommended 4 INDEX Page Adulterations of Food 51 Atmospheric Pollution 45 Authentication of Vaccination Certificates 28 Bacteriological Examination of Specimens 28 Bacteriological Examinations of Foodstuffs 54 Bath Water Samples, results 38 Births and Stillbirths, numbers and rate per 1,000 population 17 Certificates of Disrepair 42 Certificates - Vaccination, Authentication of 28 Clean Air Act: Industrial Premises 44 Smoke Nuisances 44 Smoke Control Areas 44 Measurement of Air Pollution 45 Notices of Intention to Install Furnaces 44 Clinic Services - L.C.C. 31 Complaints from public regarding food 51 Council's Public Analyst - Report of 55 Deaths, Classification of causes of 19 Deaths, Cancer - Table of last 10 years 20 Deaths, Infant - Table of causes of 20 Deaths - Number and Rate per 1,000 population 18 Death Rate of Infants under 1 year 18 Demolition and Closing Orders 40 Discussion Groups - Health Education 64 Disrepair, Certificates of 42 Page Diseases, notifiable 22 Disinfecting Station, staff 4 Disinfection, Disinfestation Services 39 Dwellings completed by the Council 41 Exhaust Fumes from Diesel Vehicles 44 Factories Act 45 Film Shows, Health Education 64 Food, Bacteriological Examination of 54 Food and Drugs Sampling, Complai nts from public 51 Food Establishments, Inspection of 48 Food, Examination of 48 Food Hygiene Regulations 54 Food Standards (Ice Cream) Regulations 50 Food, Surrender of 48 Fulham Chest Clinic - Report of 24 Furnaces - Notices of intention to install 44 Hairdressers and Barbers 38 Health Education 64 Discussion Groups and Talks 64 Film Shows 64 Leaflets and Posters 65 Press Publicity 64 Town Topics 64 Smoking and Health 25 Heat Treatment Regulations (Ice Cream) 50 Home Bathing for the Elderly 34 Hospitals and Other Centres in the Borough 30 Houses in Multiple Occupation 42 Page Ice Cream: Heat Treatment Regulations 50 Food Standards Regulations 50 Improvement Grants 41 Infectious Diseases 23 Land Charges 38 Laundry, Old People's 34 Leaflets and Posters - Health Education 65 Legal Proceedings 37 Licensing Act, 1961 67 London County Council - Personal Health Services 31 Marriages 18 Maternal Mortality 18 Meals on Wheels and Luncheon Club Services 33 Measurement of Atmospheric Pollution 45 Medical Examinations 65 Milk: Sale Regulations 48 Channel Island and South Devon Regulation s 49 Special Designation Regulations 49 Registration of Purveyors 49 National Assistance Acts, Funerals 65 Noise Nuisances 38 Notifiable Diseases 22 Notifications of Infectious Disease 23 Offices, Shops and Railway Premises Act 42 Old People's Welfare Services Provided 34 Page Personal Health Services - L.C.C. 31 Pet Animals 65 Pharmacy and Poisons 66 Physical Features of the Borough 17 Population and Area 17 Public Conveniences 66 Public Health Committee - Members of 2 Public Health Department - Staff 3 Public Health in Fulham 1900-1964 11 Puerperal Pyrexia 22 Rag Flock 66 Rates Levied and yei Id 17 Rateable Value and Product of Id. Rate 17 Registration of Purveyors of Milk 49 Rehousing of Fulham Residents 42 Rent Act 42 Rodent Control 43 Rodent Control - Staff 4 Sale of Milk Regulations 48 Samples of Swimming Bath Water, results of 38 Sampling of Tap Water 37 Sanitary Circumstances of the Area 36 Scabies and Allied Conditions 28 Section A. General and Vital Statistics 16 Section B Prevalenance and Control of Infectious Diseases 21 Page Section C. Personal Services 29 Section D. Sanitary Circumstances 35 Section E. Inspection and Supervision of Food 47 Section F. Miscellaneous Services 63 Sewage Disposal 40 Smoke Control Areas - Clean Air Act 44 Smoking and Health 25 S.O.S. Card Scheme 34 Staff of Public Health Department 3 Staff, Disinfecting Station 4 Staff, Rodent Control 4 Statutory Action 36 Summary of Works carried out under Public Health Inspectors 36 Swimming Bath Water Samples, Results of 38 Tap Water Samples 37 Town Topics - Health Education 64 Tuberculosis 23 Vaccination and Inoculation Certificates (Authentication of) 28 Visits to Dwellings by Public Health Inspectors 36 Vital Statistics 17 Water Sampling 37 Works in Default 37