AC4347 ach 16/9 HAM 44 Metropolitan Borough of Hammersmith ANNUAL REPORT of the Medical Officer of Health with STATISTICAL SUPPLEMENT for the Year 1952 by F. M. DAY, M.R.C.S.,L.R.C.P., D.T.M., D.P.H. 4 METROPOLITAN BOROUGH OF HAMMERSMITH Health Committee At 31st December, 1952 Councillor E. O'K. Finn (Mrs.), M.B.E. (Chairman) „ A. R. Mingaye (Vice-Chairman) Alderman R. J. Buckingham „ W. H. Church, J.P. Councillor A. Belsham „ J. M. Chambon (Mrs.), M.A. „ E. H. Freeman „ G. R. M. Hale „ J. F. Heaks „ L. A. Lall „ A. Martin „ E. C. Woods (Miss) Ex officio: The Worshipful the Mayor (Councillor W. H. Brind, J.P.). CONTENTS Page Introduction ... ... ... ... ... ... 1-2 Staff of the Public Health Department 3 Section A.—Social Conditions of the Borough and Statistics ... ... ... 4-10 Section B.—Prevalence of and Control over Infectious Diseases ... ... ... 11-16 Section C.—Housing ... ... ... ... ... 17-19 Section D.—Inspection and Supervision of Food ... 20-27 Section E.—Sanitary Administration ... ... 28-34 Section F.—Sanitary Circumstances of the Borough 35-37 Section G.—General Provision of Health Services in the Borough 38-45 Statistical Supplement—List of Tables ... ... 47-69 1 Town Hall, Hammersmith, W.6. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Hammersmith. Mr. Mayor, Ladies and Gentlemen, I have very much pleasure in presenting to you my Annual Report for 1952. I regret that it is not possible to publish it in the earlier months of the year. As is explained in Ministry of Health Circular 2/53 and Article 14 (3) of the Sanitary Officers' Order, 1926, it is necessary to wait for the Registrar General to furnish vital statistics which must not be omitted from the Annual Report of any Medical Officer of Health. The general health of our citizens continued to be very satisfactory. As the result of an increase of births over deaths, and other factors, the number of old people further increased. The great fog of December 5th to 9th was responsible for the deaths of 28 of our elderly persons. Poliomyelitis did not return in its 1949 strength and 11 cases were notified between May and November. One death occurred amongst this number. I think the Borough is fortunate in having available for the treatment of poliomyelitis the Western Fever Hospital which rightly has a very high reputation for this highly specialised technique. Other infectious diseases also did not occur in serious proportions except measles, which, as in 1951, exceeded 1,500 cases during the year. No case of diphtheria occurred and I have very much pleasure in reporting that no adult or child has died from this disease since April, 1944. The infant mortality rate was 21 and the number of maternal deaths numbered two. It perhaps does not need emphasis that it is still more hazardous for an illegitimate child to survive as compared with one born in wedlock. The death rate for illegitimate children during the year was almost double that of legitimate infants. This difference is a worsening of the position compared with the previous three years. The incidence of new cases of tuberculosis continued at approximately the same level as the average for the last five years but the deaths from this condition tended to become less. The deaths from cancer again show an increase and these have now taken second place in the killing diseases from lung conditions, the first on the list being diseases affecting the heart and important blood vessels. I commented in my 1951 Report upon the extraordinary increase of cancer of the lung in the Borough, I now have to 2 record that a further increase has taken place and the adult total has gone up from 56 to 64 deaths. An event of outstanding interest occurred in December when, as a result of the activity of the Health Committee, a health laundry service was started in the Department's Medicinal Baths. An electric washing machine, ironing equipment and drying cupboard were provided and are operated by the existing staff. At the time of writing there has been a pronounced tendency to increase the use of the service. During the year both the Ealing and Southall Borough Councils decided to entrust to us the treatment of persons in their area suffering from verminous conditions. Thus the scope of the Department's Medicinal Baths further expanded. It is of interest to record that on the 27th May the first High Temperature Short Time Plant commenced operations at Cadby Hall for the pasteurisation of ice cream. I understand that this is the first of its type to be used anywhere. I can also report that tests have shown this improved method to produce ice cream bacteriologically sound. Once again I have pleasure in reporting on the happy and friendly co-operation which exists between the Divisional Staff of the London County Council and ourselves. Similarly an excellent liaison exists with the Hammersmith Chest Clinic. The Borough of Hammersmith continued to be a designated area for the purpose of instruction of medical practitioners studying for the Diploma in Public Health of the London University. In conclusion, Mr. Mayor, Ladies and Gentlemen, I wish to acknowledge the help and courtesy I have received from the Chairmen ana Members of the Health Committee and Establishment Committee throughout the year and to extend my sincere thanks to all members of the Health Department who have carried out their duties with their accustomed loyalty and high sense of duty. I am, Your Worship, Ladies and Gentlemen, Your obedient Servant, F. M. DAY, Medical Officer of Health. 3 STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December, 1952 Medical Officer of Health: F. M. Day, M.R.C.S., L.R.C.P., D.T.M., D.P.H. Assistant Medical Officer of Health (Part-Time): W. K. Calwell, M.D., D.P.H. Administrative Officer: P. W. Pottier Clerical: J. C. Turner (1st Assistant) W. Robinson T. J. Hares Mrs. F. Lawford Mrs. D. Kelley D. Haynes (Temporary) Mrs. L. G. Stimpson (Temporary) E. Baines (Temporary) Miss I. E. Waller Miss J. Wood (Temporary) (M.O.H.'s Secretary) Senior Sanitary Inspector: W. Rigby Sanitary Inspectors: P. T. Bayes (Deputy Senior) J. E. Davies J. C. Hopkins E. W. Pike E. J. Nether S. Kelly G. G. Gardiner B. E. Martin Miss E. M. Cross Food and Drugs Inspectors: T- Collier W. J. Godden Mortuary Keeper : D. A. Mackay Medicinal Baths Superintendent: F. G. Baldwin, S.R.N. Public Analyst: D. F. H. Button, A.R.C.S., F.R.I.C, 4 SECTION A SOCIAL CONDITIONS OF THE BOROUGH AND STATISTICS Hammersmith is the most westerly Borough in the County of London. It has an area of 2,282.5 acres and is bounded on the north by the Borough of Willesden, on the south by the River Thames, on the east by the Boroughs of Kensington and Fulham and on the west by the Boroughs of Acton and Chiswick. The sub-soil in the northern half of the Borough (north of Uxbridge Road) mainly consists of clay, whilst in the south it consists of a layer of some 20ft. of gravel above blue clay. Years ago there was a layer of several feet thick of brown clay, particularly in the east of the Borough, much of which was excavated for brick-making purposes before building development took place. Under the control of the Council and within the Borough are 22/2 acres of public gardens and open spaces. The London County Council similarly controls 278 acres of public open spaces. In addition to the five pre-war housing estates many Eost-war dwellings consisting of 1, 2, 3 and 4 bedroomed flats ave been erected by the Borough Council on various sites in the Borough. Under the control of the London County Council are also six housing estates. The total length of roads in the Borough is approximately 67 miles. There are many industries most of which are situated in our northern extremity. Year 1951 saw the triumph of the Festival of Britain and the opening of Furnivall Gardens and Hammersmith Pier, where a large number of visitors to London embarked on the water buses to complete their journey to the Festival site and Pleasure Gardens. The year under review has been one of steady progress in . Hammersmith. Furnivall Gardens for most of the spring and summer was a mass of flowers, and with the Town Hall and a new block of flats in the background, edged with the remaining Queen Anne and early Georgian houses in Upper Mall, was a very popular rendezvous for local people. The Council have pressed forward with their various development plans. Odd blitzed sites have been developed into pleasant gardens amid the built-up areas. The tenancies of all war time allotments in the Borough have been terminated and the land is being restored to its former uses or re-developed. The Town and Country Planning (Control of Development) 5 Act has been applied vigorously enabling many unsightly hoardings to be removed. Public buildings and private residences have been repainted, shop fronts renewed and roads re-made, and this, coupled with the rapidly developing community spirit fostered by the Council, stimulates a new outlook in the Borough. Vital Statistics. (a) Population In this report the rates are calculated on the estimated population adopted by the Registrar General, i.e., 118,800. This compares with 118,300 for the year 1951. No epidemic resulting in high mortality occurred during the year and the natural increase in population resulting from an excess of births over deaths has been maintained. (b) Marriages. The number of marriages registered during the year was I,262, this being an increase of 42 as compared with the previous year. (c) Births. The corrected number of births for the year, supplied by the Registrar-General, was 1,777. On the estimated population, i.e., 118,800, this represents an annual rate of 14.9 births per thousand persons living as compared with 15.8 the previous year. (d) Deaths. During the year 1,509 deaths were registered. Adding 383 deaths of residents of this Borough transferred by the RegistrarGeneral as having occurred in various parts of England, and deducting 519 deaths of non-residents and 16 transferable deaths which occurred, the corrected number of deaths of residents was 1,357 (719 males, 638 females). On the estimated population, i.e., 118,800, the corrected number of deaths of residents was equal to an annual rate of II.4 deaths per 1,000 persons living, as compared with the previous years rate of 12.6. In the month of December, London and many parts of the Country experienced a very bad fog lasting continuously over several days, and at the instance of the Ministry of Health investigations were made into all deaths occurring in the Borough between the 5th and 16th December with a view to ascertaining how many of them were due to the fog or associated with it in such a way that death resulted. 6 Out of a total of 85 deaths I concluded that 28 were directly associated with the fog. In the Statistical Supplement will be found a chart showing the proportion of deaths from the principal causes, from which will be seen that diseases affecting the heart and important blood vessels are most numerous, cancer second, and lung conditions occupy third place. (e) Infant Mortality. The number of deaths of infants under one year of age during the year was 37, giving an annual mortality rate per 1,000 live births of 21. (f) Maternal Mortality. Two maternal deaths occurred during the year as against one for the previous year, resulting in a death rate of 1.10 per 1,000 live and still-births. Census of Great Britain, 1951. An innovation of considerable interest and importance in the trend of census development in Great Britain has been the introduction by the Registrar-General of a Report entitled " Census 1951, Great Britain, One Per Cent. Sample Tables." This Report marks a further and novel stage in the work of census analysis and the decision of the Registrars-General of England and Wales and of Scotland to isolate and analyse a small sample of the total records collected throughout the respective countries at the enumeration of the 8th April, 1951, has resulted in a joint publication well in advance of the time by which their own separate reports dealing with the full census returns would normally be available. The Volume implementing this decision and embodying extensive analyses of the various census characteristics of a representative sample of one per cent, of the 1951 population of Great Britain is being published in two sections, of which the present publication constitutes the first portion. Part II, the concluding part of the Sample Report, will be published at a later date. The Report contains sections giving the distribution of the population by age and marital condition, occupations, industries and the housing of private households. 7 The first section, giving population distribution by ages and marital condition, will come into use for many administrative purposes and I append figures extracted from the Report relating to this Borough : — Age Group Males Females Total 0— 4 4,600 4,500 9,100 5—14 6,600 6,300 12,900 15—24 7,500 7,800 15,300 25—34 10,800 10,000 20,800 35—44 9,900 10,100 20,000 45—54 9,200 9,200 18,400 55—64 4,900 5,300 10,200 65 and over 4,500 8,100 12,600 58,000 61,300 119,300 It will be seen that over the age of 65 women are almost twice as numerous as men. Marital Condition Males Females Total Single 25,500 25,600 51,100 Married 30,700 29,400 60,100 Widowed or Divorced 1,800 6,300 8,100 58,000 61,300 119,300 Sections two and three cover occupations and industries. The number of males, 15 years or over, in the Borough is approximately 45,400. Classified according to occupation or profession these fall into the Social Classes as under: — Social Class I 3.30% „ II 9.92% „ III 57.27% „ IV 10.13% .. V 19.38% Examples of occupations or professions classified within the various groups are as under: — Social Class I Clergymen Solicitors Doctors Architects Company Directors Commissioned Officers in the Defence Forces, etc., etc. 8 Social Class II Farmers Nurses Pharmacists Teachers Proprietors and Managers of Retail Businesses Local Government Administrative etc., etc. Social Class III Foremen and Skilled Workers Bricklayers Engine Drivers Signalmen Clerks & Typists Salesmen & Shop Assistants Policemen Firemen 'Bus & Tram Drivers Actors and Musicians Other ranks in the Defence Forces, etc., etc. Social Class IV Domestic Servants Barmen & Barmaids Hospital Orderlies 'Bus Conductors Loco. Firemen Semi-skilled Workers, etc., etc. Social Class V Labourers. Navvies Porters Messengers Lift Attendants, etc., etc. The fourth section dealing with the housing of private households is of especial interest to the Health Department and I append some particulars relating to the population of the Borough based upon a \% sample of the forms returned during the Census: — The number of separate households residing in the Borough is approximately 38,300. The average number of persons per household is approximately 2.87. (In 1931 it was 3.43.) 58% of the households occupy shared dwellings, i.e., dwellings which do not have a separate entrance from the street or from a common passage or stairway. 9 The number of rooms (including sleeping rooms, living rooms, kitchens, etc., but excluding sculleries) occupied by the 38,300 households is approximately 126,600. The average number of persons per room is 0.87. (In 1931 it was 1.01). The percentage of households living more than 3 persons per room is Nil. The percentage of households living more than 2 but less than 3 persons per room is 1.04. The percentage of households living more than 1*2 but less than 2 persons per room is 6.27. The percentage of households living more than 1 but less than 1/2 persons per room is 13.84. The percentage of households living 1 or less persons per room is 78.85. The percentage of persons living more than 2 persons per room is 2.19. (In 1931 it was 10.16.) These figures reveal a notable change. Since 1931 the percentage of persons living more than 2 persons per room has decreased from 10.16 to 2.19. Another interesting factor is that, measured in terms of occupants per room, housing has improved since 1931 from 1.01 persons per room to .87 persons per room in 1951. A new question at the 1951 census sought to ascertain the availability to each household of the following household arrangements: — Piped water within the dwelling (not a tap in the yard or a public stand pipe). Cooking stove with an oven. Kitchen sink with drainpipe leading outside (not a wash basin). Water closet (not an earth or chemical closet). Fixed bath with waste pipe leading outside. From the following summary it wouid appear that the amenity in greatest need is that of a Fixed Bath— 39% of the households living in the Borough are without the exclusive use of a W.C. 62% of the households living in the Borough are without the exclusive use of a fixed bath. 10 14% of the households living in the Borough are without the exclusive use of both stove and sink. The above facts are illuminating and clearly indicate that the housing problem involves considerations not only of quantity but also of quality of the accommodation provided. In other words, even when the acute shortage of houses has been remedied, there will still be large numbers of sub-standard houses requiring up-to-date fittings and amenities. 11 SECTION B PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASES Infectious Disease. There were, omitting tuberculosis, 2,339 cases of infectious disease notified in the Borough during the year. 261 cases were removed to isolation hospitals. Of this number, however, 84 were subsequently returned home as they were found not to be suffering from the disease suspected. Thus the corrected number of cases of infectious disease for the year was 2,255. Although this total shows a reduction of 284 as compared with the previous year, the measles epidemic again accounted for an unusually large proportion of the cases, i.e., 1,502. Twenty-four cases of diphtheria were notified but not one case was confirmed, and I have very much pleasure in recording that no death from this disease has occurred in the Borough during the past eight years. This is a record for the present century, if not for any previous similar period during which diphtheria has been recognised as a separate disease. During recent years great strides have been made in protecting children against diphtheria, and this service, free of charge, is carried out by the Local Health Authority at clinics which are held regularly at the infant welfare centres. It is now possible by vaccination and inoculation to safeguard an individual against various infectious diseases, and the number of these continue to increase with the inevitable progress of preventive medicine. To assist correct diagnosis the Council has made arrangements for the examination of specimens from patients sent in by doctors in doubtful or suspicious cases of diphtheria, typhoid fever, tuberculosis, etc. This service is carried out at the West London Hospital and is referred to later in the report. Contacts and Carriers of Infectious Disease—Sickness Benefit Ministry of Health circular 115/48 empowers the Medical Officer of Health, where justified, to issue certificates to persons who have been in contact with or who are carriers of an infectious disease, thus enabling them to claim sickness benefit under the National Insurance Acts during the period of exclusion from their work. Certificates were issued by the Medical Officer of Health during the year to two persons engaged in the food trade who had been in contact with cases of scarlet fever, 12 Tuberculosis. The Public Health (Tuberculosis) Regulations, 1952, which revoked the Public Health (Tuberculosis) Regulations, 1930, came into operation on the 1st May. These Regulations provide that tuberculosis becomes a notifiable infectious disease under section 144 of the Public Health Act, 1936. It is no longer necessary for a Medical Officer of Health to keep a register of tuberculosis notifications, although it is urged that he should do so in the same way that he keeps a record, for his own purposes, of notifications of other infectious diseases. The Register of Notifications kept by the Hammersmith Chest Clinic becomes the official register. Close co-operation exists between the Chest Clinic and the Public Health Department in connection with all matters concerning the well-being of Dr. Stradling's patients. The number of new cases notified during the year was 194 as against 208 for the previous year. There was a decrease of thirteen in the number of pulmonary cases notified and one less in the number of non-pulmonary cases. In my Annual Report for 1948, when the number of cases notified for that year was 187, I reported that it was reasonable to suppose that the expected post war drop in the incidence of this disease had begun. It is regretted, however, that although in 1950 there was no increase, the fall has not materialised. The total notifications for this year is only seven above that of 1948, but the fact is that there has been no substantial fall in the post war incidence of the disease. In the statistical supplement will be found a chart shewing the number of new cases of tuberculosis notified during the past 20 years. Tuberculosis still remains a serious menace to public health and affects largely those age groups which are of the greatest value to the productive capacity of the nation and has a serious influence on the industrial life of the people. Although high priority is given by the housing authorities in re-housing tuberculous persons, the acute housing shortage results in inevitable difficulty in obtaining satisfactory homes at the right rent for the tuberculous and their families. The number of deaths from tuberculosis was 43 as compared with 44 for the previous year. Mass Radiography. The campaign for the early detection of tuberculosis was continued during the year by the establishment of a Mass X-Ray Unit of the North West Metropolitan Regional Hospital Board at Olympia from the 29th July to 13th August. 13 The scheme enables large groups of persons to have their chests X-rayed, the object being, of course, to detect anything abnormal and, in particular, to discover cases of early tuberculosis. A large number of firms in the Borough were invited to allow their employees to undergo examination by the Unit and the managements proved very co-operative. Facilities were also afforded for examination of the general public. The scheme was advertised to the public in the local press, by means of posters and handbills and slides were shown at four of the largest cinemas in the Borough. 3,673 persons availed themselves of the opportunity of being X-rayed and I append particulars giving the results of the examinations. Males Females Total Number examined 1960 1713 3673 Recalled for large films 67 50 117 Disposal of large film cases: — (a) No further action 68 (b) To return to Unit for further X-ray 11 (c) Further investigation required (this does not necessarily indicate tuberculosis) 29 (d) Known cases had or having treatment 3 (e) Failed to return for large films 6 Following the termination of the examinations at Olympia, the Unit visited two large industrial undertakings in the Borough, and, at the request of the London County Council, carried out a survey at one of their schools, the results of which are appended. 8th October to 10th October. General Post Office, Savings Division, Blythe Road, W.14. Males Females Total Number examined 413 543 956 Recalled for large films 10 10 20 Disposal of large film cases: — (a) No further action 15 (b) To return to Unit for further X-ray — (c) Further investigation required (this does not necessarily indicate tuberculosis) 5 (d) Known cases had or having treatment — (e) Failed to return for large films — 14 13th October to 20th October. Messrs. J. Lyons 6- Co., Ltd., Cadby Hall, W.14. Males Females Total Number examined 733 1086 1819 Recalled for large films 44 13 57 Disposal of large film cases: — (a) No further action 44 (b) To return to Unit for further X-ray 1 (c) Further investigation required (this does not necessarily indicate tuberculosis) 11 (d) Known cases had or having treatment 1 (e) Failed to return for large films - 27th October. Hammersmith School of Building, Arts and Crafts, Lime Grove, W.12. Males Females Total Number examined 305 52 357 Recalled for large films 9 9 Disposal of large film cases: — (a) No further action 8 (b) To return to Unit for further X-ray - (c) Further investigation required (this does not necessarily indicate tuberculosis) 1 (d) Known cases had or having treatment — (e) Failed to return for large films — Food Poisoning. Thirty-nine cases occurred, seven more than last year. This total includes two outbreaks—(three in one family and four in another). There were no deaths. In four cases Salmonella Typhi Murium were identified as the responsible organisms. Responsible organisms were not isolated in the remaining cases. Foods alleged to have been involved included sausages, meat pie, sardines, luncheon meat, winkles and cockles, mincemeat, duck eggs, pork, fish and chips and tinned meat. 15 Medicinal Baths. The Medicinal Baths in Scotts Road, Shepherds Bush, provide for the cleansing of verminous persons, etc., and for the treatment of scabies, impetigo, psoriasis, and other forms of dermatitis. The figures showing the numbers dealt with during the year will be found on reference to the table in the Statistical Supplement. Although there has been a slight decrease in the total number of verminous cleansings, there was an increase in the numbers of adults attending for treatment. It is very pleasing to report, however, that the incidence of scabies has decreased from the record number of 5,731 in year 1942 to 238 cases, the same level as year 1935. The County Council continue to use this centre for the treatment of school children, and special attention has been given to head infestations at the Welfare Centres and at the Day Nurseries. Infested school children, together with their contacts of pre-school age, have been followed up in the home, and facilities (for all ages) have been made available at the Medicinal Baths. Advice is always given as to the best methods of eradication and of preventing recurrence. During the year requests were received from Ealing and Southall Borough Councils for the use of the Disinfecting Station and Medicinal Baths, and arrangements were made for this Council to undertake the cleansing of verminous persons from these two boroughs. Assistance was also afforded to four other Councils during the year. On 64 occasions the West London Hospital used the services at the Medicinal Baths. The mobile team which is available for dealing with homes that require spraying and other treatment was again actively engaged, and during the year 335 premises were sprayed for vermin (713 rooms) and 67 premises for infectious disease (104 rooms). As compared with the previous year, this was an increase of 56 in the number of verminous premises dealt with but a decrease of 79 for infectious disease. Following notification of vermin infestation or infectious disease, bedding and articles of clothing, etc., were collected from 243 premises and removed to the Disinfecting Station for sterilisation, and particulars are summarised in a table in the Statistical Supplement. 16 Health Laundry. During the year, arrangements were completed which enable the Health Department to undertake, in certain cases, the cleansing of foul and unwholesome articles of bed-linen, clothing, etc., under Section 122 of the Public Health (London) Act, 1936. The scheme is intended to meet the needs of those who are unable to devote to themselves proper care and attention and have no one who can give them that care. It does not provide a general laundry service, but affords a means of preventing a deterioration in health of people who are ill and more or less confined to their beds. It is felt that the service will be particularly useful in the cases of old persons and those who are awaiting hospital treatment. When an application for the service is received, a visit is made by the Superintendent of the Disinfecting and Cleansing Station (who is a State Registered Nurse) and, if his report indicates that the case is one that can be dealt with under the scheme, a certificate is issued by the Medical Officer of Health. The articles are collected by the staff of the Council's Disinfecting Station, washed, ironed (where necessary), and returned to the owner. No charge is made for any part of the service. 17 SECTION C HOUSING Rehousing. Applications for rehousing by the Borough Council are made to the Housing Department, 218, Goldhawk Road, Shepherds Bush, W.12. Requests are received from the Housing Estates Manager asking for inspections to be made with a view to ascertaining whether a family is living in overcrowded conditions. Enquiries are then made by the Sanitary Inspectors and, if a family is found to be living in such conditions, overcrowding is duly certified. In many cases the request is accompanied by medical certificates supporting the family's application on medical grounds, and careful consideration is given that recommendations are made only for the most urgent cases, having regard to the nature of the illness, the condition of the premises and the amenities available. Applications for rehousing by the London County Council are made to that body, and requests are received from them via the Housing Estates Manager, for similar enquiries to be made. In cases where there is medical evidence the Medical Officer of Health to the London County Council is responsible for allocating priorities on health grounds. Reports are also asked for and supplied in regard to existing overcrowding and sanitary condition of premises. 387 enquiries regarding rehousing were received in the Department during the year. 187 families were found upon investigation to be living in overcrowded conditions, and particulars of this were passed to the Housing Department for transmission to the London County Council. 27 cases were recommended for rehousing on ground of health, tuberculosis, inadequate hygienic facilities for the proper care of babies and young children and many other health risks. In addition to the above, a recommendation for rehousing of a special character was made to the Borough Council's Housing Department in cases where the applicant represented a recently married family who were expecting a baby, or where there were young children already living in unhygienic surroundings which I considered inadequate to maintain the high level of health which is so vital in the family unit in its early stages. These applications are most important. In spite of their many difficult responsibilities, the Housing Department accept these recommendations and do the best they can in each case. During 18 the year five such recommendations were made to the Housing Estates Manager. The remainder of the cases were found to be living in circumstances which were not sufficiently necessitous to recommend. The construction of new homes by the Borough Council and the London County Council still continues. During the year the under-mentioned flats were completed by the Borough Council: Black Lion Lane 6 Blythe Road— Block 2 24 Block 3 24 Ashchurch Park Villas 6 Tunis Road (Arlington House)— Block A 6 Block B 16 Eyot Gardens 6 TOTAL 88 Although no dwellings were actually completed by the London County Council, their present programme of building includes six new blocks on the White City Estate which will have a minimum of 30 flats and a maximum of 40 flats per block, accommodating approximately 1,000 more people when finished. The present population lives in just under 2,000 flats and the average number of people living in each flat is between four and five. In December, 1949, there were 1,400 less people living on the Estate than at present. During the year the Borough Council's Housing list was the subject of revision and I understand from the Housing Manager that the number of families on the waiting list at the end of the year was 4,905. The revised list, however, is not yet complete. The following table illustrates the progress that is being made: — 1. Number of families rehoused by the Borough Council in new flats since the war 629 2. Number of families rehoused by the Borough Council in rebuilt houses since the war 30 3. Number of families rehoused by the Borough Council in prefabricated dwellings since the war 77 4. Number of Borough Council licensees living in requisitioned properties at the end of the year 1677 19 Overcrowding (Section 61). No licences were granted during the year under Section 61 of the Housing Act, 1936, which provides that a local authority may, on the application of the occupier or intending occupier of a dwelling house in their district, grant him a licence authorising him to permit such number of persons in excess of the permitted number as may be specified in the licence to sleep in the house. Slum Clearance. A compulsory purchase order respecting Nos. 1-10, Latimer Mews, which were represented for clearance in 1951 was confirmed by the Minister in May, 1952. Building Licences. The arrangements existing for dealing with applications for building licences have continued in operation throughout the year. The Sanitary Inspectors have continued to investigate and report upon all applications. Applications received 494 Licences issued 449 Referred to Ministry of Works 8 Not recommended 1 Cancelled 31 The amount of work which can be carried out without licence was increased to £200 per dwelling for the six months ending 31st December, 1952. With the increase in the free limit, many applications for works which do not now require to be licensed are not being proceeded with. Landlord and Tenant (War Damage) (Amendment) Act, 1941. Applications for certificates of fitness for housing purposes are normally dealt with by the Senior Sanitary Inspector. No application was received during the year. 20 SECTION D INSPECTION AND SUPERVISION OF FOOD Food and Drugs Act, 1938. Meat and, Other Foods. Throughout the year routine inspection of premises, shops, stalls and vehicles was carried out where food is prepared, stored or sold. During 1952, 5,160 visits were made, and at 110 of these, unsatisfactory conditions constituting contraventions under Section 13 of the Food and Drugs Act, 1938, were present. In two, conditions required the institution of legal proceedings, and convictions with fines and costs amounting to £8 4s. 0d. were made. In the remaining cases the unsatisfactory conditions were remedied following the issue of warning letters by the Food and Drugs Inspectors. Under Section 10 of the Act four seizures of fancy pastries were made. In two cases chocolate cream buns showed dark stains in the cream portions and on parts of the pastry. Upon analysis it was found that the chocolate colour used was a composite one, being a harmless food colour normally used by the trade, and differential absorption had taken place giving rise to a chromatographic effect. The remaining two cases were chocolate eclairs affected by mould. Sampling During the year 1,600 samples of food and drugs were submitted to the Public Analyst for chemical analysis. Of this number 10 or 0.625 per cent. samples were reported to be nongenuine; this represents a small increase on last year. Four of the unsatisfactory samples were samples of pork sausages which failed to comply with the standard laid down by the Meat Products No. 2 Order, 1952, and reports on these were forwarded to the Ministry of Food. A total of 161 samples of synthetic and butter cream used in bakers' confectionery were taken for bacteriological examination. Extensive sampling in all stages of production was carried out in the case of a manufacturer of bakers' confectionery in which synthetic and butter cream was used, following identification of human excretal pollution. The manufacturer welcomed our assistance and gave full co-operation throughout the investigation, as a result of which a satisfactory standard of purity was reached. 21 The results obtained throughout the year are as follows:— Total number of samples of synthetic and butter cream 161 Free from Bacillus Coli 97 Bacillus Coli (non faecal) present 55 Bacillus Coli (faecal) present 9 A number of samples of shell-fish sold from stalls and barrows in the Borough taken for bacteriological examination were found to be satisfactory. During the year samples of fruit were submitted for identification and examination for the presence of harmful chemical contamination. A number of samples of tea were taken. Only one showed a minor abnormality and the remainder were sound. Markets The Food and Drugs Inspectors made 390 visits to the three markets at Bradmore Lane, Railway Approach and Norland Road. A large amount of food is sold in these markets (because of competitive prices) and calls for careful and vigilant supervision. The vacant site of the Silver Cinema adjoining Railway Approach has been resurfaced and developed as an addition to the main market. It will be recalled that the stall-holders in Bradmore Lane and Norland Road markets are licensed by the Council, whereas those in Railway Approach and adjoining sites are privately controlled. A number of vacant sites in the Borough, particularly in the area of King Street, are frequently used by stall-holders for the sale of foodstuffs and other commodities and these are kept under careful observation. Wormwood Scrubs Fair. A Fair is held on Wormwood Scrubs during the three spring and summer Bank Holiday periods. On these occasions a number of stall-holders licensed by the London County Council cater for the popular requirements of holiday crowds with the inevitable cockles, whelks, soft drinks, ice cream, as well as fried fish and chips. At each of these Fairs, samples of ice cream, soft drinks and shell-fish have been taken both for chemical and bacteriological examination. 22 Merchandise Marks Act, 1926. Regular inspections were carried out under this Act. In some cases warnings were given by the Food and Drugs Inspectors in connection with the labelling requirements for fruit, particularly tomatoes. In no case, however, was it necessary to take legal proceedings. Ice Cream. Thirty-two premises were registered for the sale of ice cream during the year and at the end of 1952 the total number of registrations in compliance with Section 14 of the Act was 236. The Food and Drugs Inspectors made 749 visits to premises where ice cream is sold, stored or manufactured. During the year 68 samples of ice cream were taken for bacteriological examination. The results of the methylene blue test are as follows:— 37 samples were within Grade 1 standard 20 „ „ „ „ 2 „ 4 „ „ „ „ 3 „ 7 „ „ „ „ 4 „ Samples graded in I and II are considered satisfactory, but samples graded in III and IV doubtful. It is of interest to note that no samples coming within grades III or IV were wrapped. In addition 105 samples of ice cream were taken for chemical analysis, all of which complied with the standard laid down by the Food Standards (Ice Cream) Orders, 1951/2. Under the Food Standards (Ice Cream) (Amendment) Order, 1952, the legal minimum fat and sugar content of ice cream was reduced. The Order, which came into force in July, 1952, provides that ice cream must contain not less than 4 per cent. fat, 10 per cent. sugar and 5 per cent. milk solids other than fat. Ice cream containing fruit, fruit pulp, etc., shall either conform to this standard or, alternatively, the total content of fat, sugar and milk solids other than fat shall be not less than 21 per cent. of the ice cream including the fruit, fruit pulp, etc., as the case may be, and such total content of fat, sugar and milk solids other than fat shall include not less than 6 per cent. fat, 10 per cent. sugar and 2 per cent. milk solids other than fat. "Parev" (Kosher) ice cream must now contain not less than 8 per cent. fat and not less than 14 per cent.sugar. 23 Another change in the legislation affecting the manufacture of ice cream was introduced by the Ice Cream (Heat Treatment etc.) Amendment Regulations, 1952, and came into operation in May, 1952. Under these Regulations, it is now permitted to pasteurise ice cream by the high temperature short time (H.T.S.T.) method which has for some years been used in the pasteurisation of milk. The Regulations require that the ice cream mixture shall be raised to and kept at a temperature of not less than 175° Fahrenheit for 15 seconds. This is a third alternative method which may be used for the heat treatment of ice cream. After an experimental period of 2½ years, the first Plant for the H.T.S.T. pasteurisation of ice cream to be used in this Country under these Regulations was installed in a large Hammersmith food factory. This Country leads the world in introducing legislation permitting H.T.S.T. pasteurisation of ice cream. The United states have permitted some establishments to employ this process in an experimental nature only, but there is no doubt that our local plant is the first one, not only in this Food Inspector Godden beginning his examination of Ice Cream H.T.S.T. Plant, just installed. 24 A further stage in the inspection. Country but in the world to use the H.T.S.T. process in the manufacture of ice cream in full conformity with national legislation. The outfit is thermostatically controlled and is fitted with a positive displacement pump which maintains the flow of the mixture during its retention at the prescribed temperature at an even rate and also with a device which automatically diverts the flow of any mixture which has not been raised to the prescribed temperature. Before the commercial use of this Plant was permitted, exhaustive tests were carried out by the Food and Drugs Inspectors in the presence of representatives of the Ministry of Health, the National Institute of Research in Dairying and the manufacturers of the Plant, to ensure that the requirements of the Regulations were met particularly with regard to operating temperatures, rate of flow, holding time and efficiency of flow diversion. Since the viscosity of ice cream mix may vary considerably, it is necessary to ensure that whatever effect this variation may have on the rate of flow, the holding time could not possibly be reduced below the minimum (15 seconds) required by the Regulations. In order to do this, calculations were made under operating conditions to ascertain what is known as the "holding efficiency" of the Plant. From this it is 25 possible to calculate the shortest holding time that can be obtained under any circumstances. The photographs show a holding time test in progress on the H.T.S.T. Ice Cream Plant. Milk Supplies. As we approach October, 1954, the date after which all pasteurised milk must be bottled at the premises at which it is pasteurised, a noticeable reduction is taking place in the number of small retailers bottling milk at their premises. The effect the Food and Drugs (Milk Dairies and Artificial Cream) Act, 1950, is having on the changing scene in the milk trade is more apparent when we consider that the number of small retail bottlers in the borough has been reduced since the Act came into force from 22 to 4. One result of this change is an increased demand for bottled milk from the large bottling companies of which there are two in the borough. At these bottling depots all pasteurised milk is processed by the modern method of pasteurisation, namely the high temperature short-time method. In addition to pasteurised milk, other types, including sterilised milk, are also produced. At one milk depot a fermented milkmarketed as "Yoghourt," is manufactured, the demand for which has increased considerably in recent years. During the year 105 samples of Special Designated milk were submitted for the phosphatase, methylene blue and turbidity tests, the results of which are set out below:— Class of Milk No. Tested Phosphatase Test Meth. Blue Test Turbidity Test Passed Failed Passed Failed Passed Failed Pasteurised 68 68 — 68 — — — T.T. Pasteurised 16 16 — 16 — — — Tuberculin Tested 10 — — 9 1 — — Sterilized 11 — - — — 11 — Total 105 84 — 93 1 11 — One sample of tuberculin tested milk which failed to pass the methylene blue test was reported to the Ministry of Food and further samples from the same source proved to be satisfactory, including a sample submitted for biological examination. In addition 108 formal samples of milk were submitted to the Public Analyst for chemical analysis, who reported 104 samples to be genuine. Legal proceedings were taken in two cases, resulting in a total of £16 8s. 0d. in fines and costs. 26 Designated Milk. Under the Milk (Special Designation) (Pasteurised and Sterilised Milk) Regulations, 1949, and the Milk (Special Designation) (Raw Milk) Regulations, 1949, the following licences were issued during the year:— Dealer's (Pasteuriser's) Licence 3 Dealer's (Steriliser's) Licence 1 Dealer's (Bottling) Licence 1 Dealer's Licences Tuberculin Tested 59 Pasteurised 63 Sterilised 79 Dealer's Supplementary Licences Tuberculin Tested 13 Pasteurised 15 Sterilised17 Public Health (Condensed Milk) Regulations, 1923/1948. These Regulations provide standards for milk fat and milk solids of condensed milk and control the labelling of tins or other receptacles. During the year 22 samples were submitted for examination to the Public Analyst and were reported genuine. Sale of Horseflesh for Human Consumption. During recent years the sale of horseflesh for human consumption in this country has considerably increased for very obvious reasons. In pre-war days there were a number of establishments generally in the large cities where horses were slaughtered for the continental trade, and while this trade still carries on, the present traffic in horseflesh has increased the number of animals passing through these slaughterhouses. During the war years rigid control was exercised over the movement and sale of horseflesh, but as this control was gradually removed, Parliament became perturbed by some reports particularly over the conditions in which horses are transported to the various slaughterhouses and the treatment of the animals prior to slaughter and even with regard to their humane slaughter. A committee of enquiry has been appointed to enquire into the slaughter of horses in England, Wales and Scotland and in the meantime the Public Health Meat Regulations, 1924/35, have been amended so as to make the notification 27 of slaughter of horses compulsory. In this Borough no slaughtering of horses is carried on, but there are three establishments dealing with the sale of horseflesh for human consumption, two shops and one mobile stall, each of which is frequently inspected. The horseflesh sold at these premises comes from slaughtering establishments elsewhere, apart from frozen horseflesh from New Zealand. Hammersmith Clean Food Traders' Guild. The Clean Food Traders' Guild, formed in 1948, continued to function during the year under the Chairmanship of the ViceChairman of the Health Committee. The Advisory Committee responsible for the working of the Guild is composed of representatives of the Health Committee, nominees of the various Food Trades Associations and the local Chamber of Trade and Commerce and representatives of the employees' Trade Unions. Whilst a small number of traders allowed their membership to lapse, additional members were enrolled and at the end of the year the total membership was 120. In accordance with the conditions of membership an annual report upon each trader member's premises was submitted to the Advisory Committee by the Public Health Department. These reports indicated that, in general, the standard of hygiene required by the Codes of Practice approved by the Guild was well maintained. A number of talks on "Food Hygiene," illustrated by film strips, were given during the year to employees, school children and women's organisations. As a means of obtaining publicity to the work of the Guild and to call attention to the Council's campaign for Cleaner Food, a number of "shopping list" pads were prepared and distributed to housewives through trader members, the cost being shared between the trader members and the Council. 28 SECTION E SANITARY ADMINISTRATION Staff. The establishment of Sanitary Inspectors consists of one Senior Sanitary Inspector, a Deputy Senior Sanitary Inspector and 10 other district Inspectors, two Food and Drugs Inspectors and one woman Inspector. There have been a number of resignations during the year and replacement has been exceedingly difficult. At the end of the year, three of the district Inspectors' positions were vacant. Exhumation and Re-interment of Bodies. During the year three licences were granted by the Secretary of State for the exhumation and removal of bodies from graves in St. Mary's Catholic Cemetery, Harrow Road. Each of these was attended by the Sanitary Inspector for this area and in each case it was possible to certify that the removal was carried out in a proper manner. Increase of Rent and Mortgage Restrictions Act, 1920/1939. Three applications were received during the year for certificates under the above Act and in all cases certificates were granted. One application was from an occupier requesting the granting of a certificate that the premises were not in a reasonable state of repair and two were from owners requesting the cancellation of such certificates, upon completion of works considered necessary. Coroner's Court and Public Mortuary. The number of bodies admitted to the Public Mortuary shows an increase of 42 as compared with last year. This increase is accounted for by larger numbers from other boroughs. There was also an increase of 64 over last year in the number of post mortem examinations conducted. The Mortuary and Court were also used by the Boroughs of Fulham, Chelsea and Kensington. The Mortuary is equipped with a large refrigeration plant and this ensures a completely satisfactory standard of hygiene. Full particulars relating to the work carried out will be found in a table in the Statistical Supplement. 29 Rag Flock and Other Filling Materials Act, 1951. The above Act, which came into operation on the 1st November, 1951, makes it compulsory for premises where certain prescribed filling materials are used in any form of upholstery, including the stuffing or lining of bedding, toys, baby carriages, etc., to be registered with the local authority. It is also necessary for premises where rag flock is manufactured or stored to be licensed. The fee for registration is £1 0s. 0d. The regulations also provide that the occupiers of registered premises must keep records of all filling materials consigned to the premises to which the Act applies and of all second-hand articles containing such filling materials. The occupier of premises licensed for the manufacture of or storage of rag flock must keep records of all rag flock consigned from those premises. All records must be properly kept, and must include appropriate details of the trade being carried on. During the year only one certificate of registration of premises was granted, making a total of nine since the Act came into force. Pharmacy and Poisons Act, 1933, and Pharmacy and Medicines Act, 1941. The names and addresses of 116 retailers were entered on the Council's list of persons entitled to sell poisons under Part 2 of the Pharmacy and Poisons Act, 1933, and Pharmacy and Medicines Act, 1941. No action was necessary in respect of any offence under the Act. All have been inspected as to their suitability, method of storage and labelling, as required under the Act, and have been found satisfactory. Shops Act, 1950. Section 38, sub-section (2) of the Shops Act, 1950, provides that in every shop, not being a shop exempt from the provisions of this sub-section, there shall be provided and maintained suitable and sufficient sanitary conveniences available for the use of persons employed in or about the shop. It is provided by sub-section (6) that a shop may be exempted from the provisions of sub-section (2) if there is in force a certificate exempting the shop therefrom granted by the Borough Council, whose duty it is to enforce the necessary provisions. 30 A certificate may be granted by the Borough Council if they are satisfied that by reason of restricted accommodation or other such circumstances it is not practicable to provide such accommodation on the premises, and that alternative arrangements are conveniently available. During the year one such certificate was issued. The Borough Council is also responsible for securing compliance with the provisions regarding heating and ventilation. It was found possible to obtain satisfactory heating and ventilation during the year without recourse to legal proceedings but some difficulty was experienced in the case of a block of shop premises with basement water closets mechanically ventilated. The control switches for the water closets and lobbies are in certain basements only and occupiers had to be circularised to ensure the proper operation of the electric switches and to ensure that the lobby doors which had been fitted with a spring to make them self-closing, were not wedged open, thereby nullifying the purpose for which they were provided. Pet Animals Act, 1951. The above Act, which came into operation on the 1st April, 1952, makes it unlawful for any person to keep a pet shop except under the authority of a licence granted by the local authority in accordance with the provisions of the Act. The fee for a licence is 10/- and a licence issued under the Act will remain in force until the end of the year in which it was issued and subsequently must be renewed annually. An advertisement has been issued in the local Press calling attention to the provisions of the Act. The Act provides that the local authority may, on application being made to them for that purpose, grant a licence to keep a pet shop subject to compliance with such conditions as may be specified in the licence. The following conditions were approved by the Council to be inserted on the licence:- 1. No animal shall be displayed in a cage, hutch, box or other receptacle in such position as to expose it to interference or annoyance by persons or animals. 2. Animals shall at all times be kept in accommodation suitable as respects size, temperature, lighting, ventilation and cleanliness. 3. Animals shall be adequately supplied with suitable food and drink and (so far as necessary) visited at suitable intervals. 31 4. Animals and stock shall not be placed or kept in or outside the shop so as to render ingress or egress difficult in case of fire or other emergency. 5. The licensee shall ensure that a responsible person shall at all times be in or within a reasonable distance from the premises for the purpose of giving warning and taking other necessary steps in the event of fire or other emergency. In the case of premises which are lock-up, outside business hours, the licensee shall appoint a responsible person residing within a reasonable distance to the premises to have custody of the key. The name and address of such person shall be displayed in legible characters on the front door, or windows, of the premises. A supply of water and sand and/or an efficient fire extinguisher must always be available on the premises. 6. No animal which is suffering from or could reasonably be suspected of having come into contact with any other animals suffering from any infectious disease shall be brought or kept on the premises unless it is properly isolated from the other animals therein. 7. Animals shall not be handed to customers in unsuitable containers. 8. No mammal shall be sold unweaned, or if weaned, at an age at which it should not have been weaned. 9. Where animals are kept in cages, hutches, boxes or other receptacles placed on top of other cages, hutches, boxes or other receptacles, effective means shall be provided for preventing water, food or other droppings falling on to or contaminating the animals or other surroundings which are underneath. Up to the end of the year 11 licences to keep a pet shop were issued. Note.—The Act makes it clear that the word "animal" covers all creatures which are sold as pets. London County Council (Ceneral Powers) Act, 1952. The above Act received the Royal Assent on the 26th June, 1952. Only one section of the Act affects this Council, i.e., section 26, which deals with restrictions on sales, etc., by dealers in rags, old clothes and similar articles. 32 Sub-section (1) is in the following terms:— No person being a rag and bone dealer or a person who collects or deals in old clothes or similar articles and no person assisting or acting on behalf of any such person as aforesaid shall— (a) in or from any shop or premises used for or in connection with the business of a rag and bone dealer or the business of a dealer in old clothes or similar articles: or (b) while engaged in collecting any articles in the course of any such business as aforesaid: sell or deliver, whether gratuitously or not, any article of food or drink to any person or any article whatsoever to a person under the age of fifteen years. Sub-section (2) imposes a fine of not exceeding £5 on summary conviction. The section is to be read and construed as one with the Public Health (London) Act, 1936. No reports of any contravention of this Section were received during the year. Annual Returns to Medical Practices Committee. The London Executive Council established under the National Health Service Act, 1946, has published its Report of the Council for the year 1st April, 1951, to 31st March, 1952. Included in the report under the heading of General Medical Services are tables, which are appended, showing the distribution of the population as between practitioners in the various Metropolitan Boroughs. The figures represent the information supplied to the Medical Practices Committee for 31st December, 1950, and 31st December, 1951, and relate only to the practitioners' London patients. This must be borne in mind in particular where London Boroughs, e.g., Hampstead, adjoin areas of other Executive Councils. To assist the Medical Practices Committee, the survey for 1951 was compiled in a different manner and the figures for 1951 are not, therefore, comparable with those for 1950. These figures should not be regarded as indicating the position with any exactitude. London, though divided administratively into the City and the Metropolitan Boroughs is, in fact, one large County with very few well defined barriers other than the River Thames. On the other hand, a railway line or canal may form an artificial barrier which will induce patients to 33 choose a doctor residing in an adjoining Borough. Again, it sometimes happens that there is a relative shortage of doctors in one district and a comparative surplus in the rest. The Council reviews the position from time to time in consultation with the Medical Practices and the Local Medical Committees. Assistant medical practitioners are not included in this table, but for the purpose of ascertaining the number of fully active principals such a practitioner is regarded as equal to one-half of a principal practitioner. The value of full-time assistants on this basis has been added to the number of fully active principals and used as the divisor in determining the average number of patients on the list in each Borough. Principal practitioners with "limited lists" are not regarded as "fully active." 1950 City or Borough No. of Principals Fully Active Principals No. on Lists of Fully Active Principals Average No. of Patients on List Battersea 37 36 108,019 2,806 Bermondsey 19 19 57,965 2,696 Bethnal Green 19 19 59,127 2,816 Camberwell 72 70 187,723 2,520 Chelsea 31 28 44,463 1,533 City of London and Shoreditch 23 20 42,118 2,055 Deptford 34 33 102,093 2,917 Finsbury 17 17 41,471 2,304 Fulham 56 54 129,410 2,231 Greenwich 25 24 74,244 2,802 Hackney 84 84 177,501 2,040 Hammersmith 120 118 120,730 977 Hampstead 201 196 92,471 467 Holborn 15 13 19,035 1,464 Islington 133 131 246,708 1,869 Kensington 145 133 143,495 1,059 Lambeth 102 100 219,928 2,075 Lewisham 117 114 213,949 1,805 Paddington 89 87 104,563 1,168 Poplar 38 38 74,043 1,899 St. Marylebone 75 65 70,144 1,062 St. Pancras 61 59 133,498 2,188 Southwark 37 37 108,465 2,746 Stepney 51 51 107,735 2,052 Stoke Newington 52 52 56,190 1,041 Wandsworth 243 238 319,056 1,308 Westminster 59 50 78,825 1,546 Woolwich 87 87 145,918 1,577 Total 2,042 1,973 3,278,887 1,599 34 1951 City or Borough No. of Principals Fully Active Principals No. on Lists of Fully Active Principals Average No. of Patients on List Battersea 42 36 111,124 2,886 Bermondsey 24 23 64,962 2,498 Bethnal Green 25 21 54,879 2,439 Camberwell 72 66 185,144 2,626 Chelsea 37 28 47,254 1,629 City of London and Shoreditch 27 21 46,413 2,063 Deptford 34 33 90,490 2,701 Finsbury 18 16 41,202 2,354 Fulham 37 53 128,883 2,261 Greenwich 29 25 76,382 2,727 Hackney 85 79 169,735 2,057 Hammersmith 130 123 122,624 969 Hampstead 215 203 100,145 490 Holborn 13 13 23,030 1,706 Islington 140 130 242,908 1,766 Kensington 141 130 150,052 1,137 Lambeth 107 99 226,838 2,160 Lewisham 129 122 218,023 1,737 Paddington 94 88 104,745 1,157 Poplar 42 41 72,332 1,746 St. Marylebone 79 61 71,142 1,138 St. Pancras 67 61 127,063 2,017 Southwark 40 37 108,774 2,754 Stepney 59 53 111,696 1,995 Stoke Newington 55 55 63,060 1,126 Wandsworth 253 237 314,175 1,290 Westminster 64 50 80,169 1,557 Woolwich 92 89 147,569 1,587 Total 2,170 1,993 3,301,813 1,595 35 SECTION F SANITARY CIRCUMSTANCES OF THE BOROUGH Water Supply. The Metropolitan Water Board is responsible for the water supply of the Borough and no complaints with regard to the condition of the water were received during the year. 91 certificates were granted under Section 95 (2) of the Public Health (London) Act, 1936, with regard to newly erected houses and flats having a proper and sufficient water supply. Public Cleansing. The Borough Engineer and Surveyor, who is responsible for supervising the collection, removal and disposal of refuse, has kindly furnished the following information with regard to this service. Tons Amount of house refuse collected—House Refuse 24,797 during the year 1952 (includ—Salvage 391 ing salvage and kitchen waste)—Kitchen Waste 3,444 28,632 Method of disposal By barge from Hammersmith to Mucking (River Thames). Controlled tipping at Mucking on reclaimed land. By Contractor. Frequency of collection House refuse collected weekly. (Trade refuse by arrangement, as required). Drainage. The bye-laws made by the London County Council under the Metropolis Management Acts with regard to drainage, and also those under the Public Health (London) Act relating to water closets, etc., are enforced by the Council. During the year 120 drainage plans (12 combined drainage) were submitted and approved, and a total of 2,409 inspections were made in connection with supervision of drainage works. In one case drainage work was carried out under Section 40 of the Public Health (London) Act, 1936, by the Borough Engineer and Surveyor's Department, in default of the owner. 36 Dustbins. By Section 105 of the Public Health (London) Act, 1936, if any house is without a sufficient ashpit (dustbin) the Council may serve a notice on the owner or occupier requiring him to make such provision, and the notice may include direction as to the number, material, size and construction of the dustbins to be provided. Eighty three such notices were served during the year. As from the 1st August, 1951, an appeal against the service of a notice could be made to a Court of Summary Jurisdiction. Three appeals were lodged against notices served. In one case the appeal was subsequently withdrawn. In the remaining two cases the action of the Borough Council was upheld by the Magistrate, with the award of £5 5s. 0d. costs in one. Sanitary Inspection. The sanitary conditions of the Borough were subject to routine inspection and investigations were made into all complaints received. Particulars of visits made by the Sanitary Inspectors during the year, the numbers of preliminary and statutory notices served and complied with, and proceedings instituted, will be found on reference to the table in the Statistical Supplement. Owing to the frequent changes in the inspectorial staff and to the difficulty in filling vacancies, it was not always possible to take action to investigate complaints and secure the abatement of nuisances as expeditiously as desired. Factories. During the year 15 notices were served relating to insanitary conditions found to exist during the inspection of factories in the Borough and 35 notices were complied with. In the Statistical Supplement will be found a table which has been prepared in accordance with the form prescribed by the Minister of Labour and National Service on the administration of the Factories Act, 1937, dealing with factories (mechanical and non-mechanical) and outwork. Rodent Control. Prevention of Damage by Pests Act, 1949. The practice of the sanitary inspectors making an enquiry or inspection at all premises visited, having particular regard to food premises, to ascertain whether rodents are present, appears to be having a good effect, as the number of premises infested fell from 550 to 427. 37 This may be by reason of incipient infestations being prevented from spreading, or that occupiers of premises are becoming rodent conscious as a result of our drive. Complaints of infestations dropped from 440 to 410 (280 rat, 130 mice) and some of these were without foundation. Infestations discovered by inspection, other than by complaint, rose from 116 to 125 (60 rat, 65 mice). This is still a large proportion of the total number of premises infested and shews the importance of the drive being continued. Total rat infestations have decreased from 324 to 230. Total mice infestations have decreased from 226 to 197. The " Ship " (black) rat has not been seen in the Borough. As required by the Ministry of Agriculture and Fisheries, the sewer manholes have been poison baited twice during the year, by the Borough Engineer's Department. Approximately £130 has been received for treatment by rodent operatives at 78 business premises. Ten notices to effect repairs or rat proofing were served under the above Act and in one case the Council did the work in default and charged the owner. Seventy-one Notices to repair drains, etc., causing rat infestation were served under the Public Health (London) Act. The new rodenticide "Warfarin" has been used, in conjunction with the other rodenticides with good results. The main figures required for the detailed record sent to the Ministry of Agriculture and Fisheries are shown in the following summary: — Summary Totals Premises inspected: Dwellings 911, Business 829 1,740 Complaints of rats and mice: 410 410 Premises infested by rats:— Dwellings 191, Business 39 230 Premises infested by mice:— Dwellings 158, Business 39 197 New infestations treated 427 Statutory Notices served 10 Prosecutions Nil Inspections and re-inspections by Sanitary Inspectors re Rodent Control 3,799 Barbers' and Hairdressers' Establishment's—Registration and Control. The Council seek to obtain powers with regard to the supervision of all health matters likely to be met, and are in agreement with the Metropolitan Boroughs Standing Joint Committee on necessary measures of control. 38 SECTION G GENERAL PROVISION OF HEALTH SERVICES IN THE BOROUGH Laboratory Facilities. During the year, Mr. F. W. Edwards, F.R.I.C., F.C.S., retired from his position as Public Analyst after an association of some 48 years with this Council, first as assistant and then for the last 18 years as Public Analyst. Mr. Edwards attended a meeting of the Council in December and was presented by The Worshipful the Mayor with a Certificate of Thanks in respect of his long service. On 1st October, Mr. D. F. H. Button, A.R.C.S., F.R.I.C., Public Analyst to the Southwark Borough Council, was appointed in his stead and the chemical analysis of food is now carried out at the Council's Laboratory situated at The Health Centre, Walworth Road, S.E. The food and drugs part of the Council's bacteriological examinations are dealt with at the Public Health Laboratory, Colindale, and the Borough Council have arranged for the convenience of local doctors and their patients that various bacteriological investigations are made at the West London Hospital. Our work at this laboratory includes the examination of throat swabs and intestinal specimens, etc., and the service is of much benefit in view of its immediate accessibility. Throat swabs and faeces outfits are supplied free on application to the Public Health Department to all medical practitioners practising in the Borough. Ambulance Facilities. The London County Council is responsible, under the National Health Service Act, 1946, for the provision of ambulance facilities within the administrative County of London. Hospitals. The following hospitals are situated in Hammersmith:— Hammersmith Hospital, Ducane Road, W.12. Queen Charlotte's Maternity Hospital, Goldhawk Road, W.6. Royal Masonic Hospital, Ravenscourt Park, W.6. West London Hospital, Hammersmith Road, W.6. Hammersmith Hospital and West London Hospital are designated as teaching Hospitals, and together with St. Mark's 39 Hospital, Chelsea, are under the control of a joint board of governors. The Royal Masonic Hospital is a private hospital and Queen Charlotte's is a maternity hospital with its own board of governors. It is one of the largest of its kind in the country. The Hammersmith Chest Clinic, established at Hammersmith Hospital, continued to function during the year, and sessions are held regularly at the following times:— Monday mornings „ afternoons „ evenings 10 a.m. 1.30 p.m. (routine chest X-ray) 5.0 p.m. (contacts and refill) Tuesday mornings „ afternoons Wednesday mornings 10 a.m. 2 p.m. (refill) 9.15 a.m. (refill review) Thursday mornings afternoons 10 a.m. 2 p.m. (refill) Friday mornings 10 a.m. „ afternoons 2 p.m. (children and B.C.G. Vaccination) All new patients should bring a letter of introduction from their family doctor. Personal Health Services. These services, which became the responsibility of the London County Council on the 5th July, 1948, include maternity and child welfare, diphtheria immunisation, vaccination, day nurseries, foster mothers and child minders, midwifery, home helps, home nursing, etc. Division 1 of the London County Council, the offices of which are at 129, Fulham Palace Road, W.6, consists of the metropolitan boroughs of Chelsea, Fulham, Hammersmith and Kensington. Dr. Violet I. Russell, the Divisional Medical Officer, is responsible for the administration of the services, but she is assisted in the day-to-day administration by the Medical Officers of Health of the respective boroughs. The liaison between the staffs of the county council and the borough council continue on a very happy and cordial footing. 40 The following is a list of the various clinics:— Ante-natal Clinics. 1/3, Milson Road Monday 1.30 p.m. Tuesday 9.30 a.m. Friday 9.30 a.m. 48, Glenthorne Road Monday 6 p.m. Tuesday 1.30 p.m. Thursday 9.30 a.m. Friday 1.30 p.m. Becklow Gardens Monday 1.30 p.m. Tuesday 9.30 a.m. Thursday 9.30 a.m., 1.30 p.m. 6 p.m. The Curve, Westway Monday 9.30 a.m. Wednesday 9.30 a.m., 1.30 p.m. The Library, College Park . Tuesday 1.30 p.m. Infant Welfare Centres. 1/3, Milson Road Tuesday 1.30 p.m. Wednesday 9.30 a.m. Thursday 9.30 a.m., 1.30 p.m. 48, Glenthorne Road Monday 1.30 p.m. Wednesday 1.30 p.m. Thursday 1.30 p.m. Friday 9.30 a.m. Becklow Gardens Tuesday 1.30 p.m. Wednesday 9.30 a.m., 1.30 p.m. Friday 9.30 a.m., 1.30 p.m. The Curve, Westway Monday 1.30 p.m. Thursday 9.30 a.m., 1.30 p.m. Friday 1.30 p.m. The Library, College Park. Friday 9.30 a.m. Physiotherapy (Massage and Light). 48, Glenthorne Road Monday 1.30 p.m. Tuesday 1.30 p.m. Wednesday 1.30 p.m. Thursday 1.30 p.m. Friday 1.30 p.m. 41 Diphtheria Immunisation. 1/3, Milson Road Friday 1.30 p.m. 48, Glenthorne Road Wednesday 9.30 a.m. Becklow Gardens Thursday 9.30 a.m. The Curve, Westway Tuesday 9.30 a.m. The Library, College Park Friday 9.30 a.m. Vaccination. 1/3, Milson Road Friday 1.30 p.m. 48, Glenthorne Road Wednesday9.30 a.m. The Curve, Westway Tuesday 9.30 a.m. Chiropody. 48, Glenthorne Road Monday 2 p.m. Wednesday 2 p.m. Thursday 2 p.m. Friday 10 a.m. During the year dried milk and other nutrients have been issued from the Maternity and Child Welfare Centres. In addition, the Ministry of Food has been responsible for National Dried Milk, Concentrated Orange Juice and Cod Liver Oil in accordance with their recognised scale of charges. The County Council also maintain the following four Day Nurseries, which are available for children up to five years of age:— Brook Green Day Nursery Dalling Road Day Nursery Latimer Road Day Nursery Uxbridge Road Day Nursery Each is open on Mondays to Fridays from 7.30 a.m. to 5.30 p.m., and the charge for children received into them is 4.0d. per day. Domestic Help Service. This service, also administered by the County Council, employs 15 full-time and 70 part-time helpers and maintained its good and valuable work during the year. Its local headquarters are in the Public Health Department in the Town Hall. Number of cases in which help was provided:— Maternity 42 Tuberculosis 76 Other 700 1,455 effective visits were made to various homes by the organiser. 42 International Certificates of Vaccination and Inoculation. Arrangements continued during the year for the authentication by the Medical Officer of Health of certificates of vaccination and inoculation in the international form. These certificates are required by passengers proceeding abroad from this country and the purpose of the authentication is to provide proof to health authorities abroad that the signature of the person issuing the certificate is that of a registered medical practitioner. National Assistance Act, 1948. Removal to Suitable Premises of Persons in Need of Care and Attention. Section 47 of the above Act provides that the Council shall be responsible for the removal to suitable premises of persons who are suffering from a grave chronic disease or being aged, infirm or physically incapacitated, who are living in insanitary conditions and who are unable to devote to themselves and are not receiving from other persons proper care and attention. The National Assistance (Amendment) Act, 1951, which became operative on the 1st September, 1951, filled an urgent need by providing expeditious arrangements for the compulsory removal of persons to hospitals or institutions as laid down by section 47 of the National Assistance Act, 1948. The amending Act obviates the need for giving seven days' notice to the person and to the hospital board or welfare authority. Application may also be made to a single Justice of the Peace instead of to a Court of Summary Jurisdiction. An application for an order must be certified by a general practitioner as well as the Medical Officer of Health and the period of removal is for three weeks. During the year one case was dealt with under this new procedure. Sixty five other cases, mostly persons of advancing years alleged to be living in insanitary conditions, were brought to the notice of the Public Health Department during the year. In none of these, however, was there justification for certifying that application for an order for removal be made. It was possible, however, to arrange the voluntary admission of seven cases to hospital, one case was referred to the duly authorised officer of the London County Council and two cases were referred to the social welfare officer of the London County Council with a view to admission to an institution. Four cases died before admission to Hospital could be arranged. 43 In the remaining cases, amenities were provided in numerous instances and included provision of nursing by the District Nursing Association, home help, visits by the Welfare Organiser of the Hammersmith Old People's Welfare Association and the provision of invalid meals. Although much is being done in many ways in assisting elderly persons, the problem of the ageing population and people compelled to live alone in very unsatisfactory conditions continues. Many of the cases reported are not sufficiently ill to warrant admission to hospital, and yet are too infirm for admission to an institution, and it is at this time that they most require help and assistance. There is a tendency, also, for elderly persons who have no relatives to help them, to dig their toes in and insist on remaining where they are. Burial or Cremation of the Dead. It is provided that the local authority shall arrange burial or cremation in the case of any person who has died or been found dead in the Borough, in any case where it appears to the authority that no suitable funeral arrangements have been or are being made. The Council may recover from the estate of the deceased person or from any person who, for the purpose of this Act, was liable to maintain the deceased person immediately before his death, expenses incurred for the burial or cremation. During the year seventeen burials have been carried out in Hammersmith at a total cost of £218 13s. 0d. Of this amount £146 has been recovered. Hammersmith Old People's Welfare Association. The Hammersmith Old People's Welfare Association which discovers and meets the needs of necessitous old persons continued to make great progress during the year. Up to the end of the year approximately 950 cases were on the records of the Association, nearly double that of last year, and new cases continue to be brought to the notice of the Association daily. For the financial year 1952/53, a grant of £3,000 was made by the Council to the Association, and at the time of writing provision has been made for this amount to be increased to £4,500 for the year 1953/4. The Association's sphere of activity embraces party holidays at the seaside, three luncheon clubs, domiciliary meals to the needy, a chiropody service, free legal advice and social visitation on a very large scale. Very much good work is being done and the expansion which has taken place during the year will undoubtedly continue. 44 Medical Examination of Council's Staff. During the year I have continued to carry out the duties of medical advisor to the Council. Every new entrant to the service is required to undergo a medical examination, which includes a chest X-ray in order to ascertain whether he or she is fit to be admitted to the Council's Superannuation and/or Sick Pay Schemes. In addition to this, medical examinations are conducted in all cases where the prescribed "sick leave with pay" has been exceeded. The Council in many such instances makes up sick pay for further periods to bring their employee back to good health. The total number of first examinations carried out during 1952 was 293, and of this number 52 were found to be unfit for the following reasons:— Totally unfit 3 (over 65 years) Bronchitis 6 Defective heart 3 Diabetes 1 Otitis media 5 Duodenal ulcer 2 Spinal injury 1 Hyperpiesia 5 Psychoneurosis 1 Inguinal hernia 3 Pulmonary Tuberculosis 2 Injury, right elbow 1 Nystagmus 1 Right nephrectomy 1 Stomach disorders 2 Chest condition 2 Gastric ulcer 3 Teeth 2 Dermatitis 3 Post concussional psychosis 1 Awaiting operation for excision of scar 1 Vertigo 1 Throat condition 1 Arthritis of left knee 1 At the beginning of the year the Council decided to put into operation a scheme for streamlining sick leave arrangements, and in this connection I was called in to advise on the continued control of their scheme. This works sympathetically and efficiently and I have no doubt will become a permanent feature of the Council's services. In all, 67 examinations were conducted by the Department's medical staff. 45 Financial Contributions to Voluntary Organisations. Payments to the funds of voluntary bodies were, on the recommendation of the Health Committee, made by the Council during 1952, as indicated below:— Organisation Amount Statutory Authority £ s. d. Central Council for Health Education 10 10 0 Public Health (London) Act, 1936, Section 298. National Smoke Abatement Society 12 12 0 Public Health (London) Act, 1936, Section 298. Local Government Act, 1948, Section 136. Conferences. The Council were officially represented at the undermentioned Conferences dealing with matters within the purview of the Public Health Department: — Conference Delegates Royal Sanitary Institute, Margate — 22nd/25th April, 1952. Councillor Mrs. E. O'K. Finn, M.B.E. Dr. F. M. Day, Medical Officer of Health. Sanitary Inspectors' Association, Brighton — 9th/12th September, 1952. Councillor Mrs. E. O'K. Finn, M.B.E. Mr. W. Rigby, Senior Sanitary Inspector. National Smoke Abatement Society, Portsmouth—24th/ 26th September, 1952. Alderman R. J. Buckingham. Mr. P. W. Pottier, Administrative Officer. The Public Works and Municipal Services Congress and Exhibition, Olympia—3rd/ 8th November, 1952. Dr. F. M. Day, Medical Officer of Health. STATISTICAL SUPPLEMENT TO ANNUAL REPORT FOR YEAR 1952 47 GENERAL STATISTICS—1952 Area 2,282.5 acres Population (1951) (estimated) 118,300 „ (1952) (estimated) 118,800 „ Census (1951) 119,317 Natural increase, i.e., excess of births over deaths 420 Marriages registered 1,262 Rateable value (April, 1952) £1,238,858 Sum represented by a penny rate (April, 1952) £5,050 EXTRACT FROM VITAL STATISTICS—1952 Live Births Legitimate Total M. F. 1,625 823 802 Birth Rate per 1,000 estimated resident population = 14.9 Illegitimate 152 81 71 Stillbirths 34 14 20 Rate per 1,000 total (live and still) births = 18.7 Deaths 1,357 719 638 Death Rate per 1,000 estimated average population = 11.4 Deaths from maternal causes— Pregnancy, childbirth, abortion Deaths 2 Rate per 1,000 total (live and still) births 1.10 Total 2 1.10 Death Rate of Infants under one year of age:— All Infants per 1,000 live births 21 Legitimate Infants per 1,000 legitimate live births 19.69 Illegitimate Infants per 1,000 illegitimate live births 32.89 Deaths from Cancer (all ages) 290 „ „ Measles (all ages) — „ „ Whooping Cough (all ages) — 48 NATURAL INCREASE OR DECREASE OF THE POPULATION DURING THE PAST 20 YEARS Year Population Excess of Births over Deaths Excess of Deaths over Births 1933 131,400 137 — 1934 129,170 115 — 1935 128,100 353 — 1936 127,700 325 — 1937 126,500 320 — 1938 125,100 521 — 1939 b122,800 d116,200 438 — 1940 98,320 — 156 1941 84,880 77 — 1942 89,370 337 — 1943 92,050 468 — 1944 89,190 370 — 1945 96,100 434 — 1946 111,860 974 — 1947 117,280 1,190 — 1948 115,800 847 — 1949 118,440 662 — 1950 119,200 691 — 1951 118,300 377 — 1952 118,800 420 — b = Birth Rate Population Figure. d = Death Rate Population Figure INCIDENCE OF CANCER DURING THE PAST 10 YEARS Year Population Deaths Rate per 1,000 1943 92,050 206 2.2 1944 89,190 200 2.2 1945 96,100 207 2.1 1946 111,860 226 2.0 1947 117,280 253 2.1 1948 115,800 254 2.1 1949 118,440 238 2.0 1950 119,200 258 2.1 1951 118,300 254 2.1 1952 118,800 290 2.4 49 DEATHS FROM CARCINOMA OF LUNGS Year 0—25 —45 —65 —75 +75 Total 1941 M 10 1 11 F — — 2 3 — 5 Total — — 12 4 — 16 1946 M 6 30 5 1 42 F — — 2 2 — 4 Total — 6 32 7 1 46 1947 M 3 25 7 2 37 F — — 1 1 1 3 Total — 3 26 8 3 40 1948 M — 1 19 8 4 32 F — 1 8 3 1 13 Total — 2 27 11 5 45 1949 M 7 25 13 4 49 F — — 3 1 1 5 Total — '7 28 14 5 54 1950 M 4 28 10 3 45 F 1 3 2 2 8 Total — 5 31 12 5 53 1951 M 1 33 11 3 48 F — 1 3 3 1 8 Total — 2 36 14 4 56 1952 M 3 31 14 5 53 F — — 5 4 2 11 Total — 3 36 18 7 64 50 INCIDENCE OF PULMONARY TUBERCULOSIS AND NEOPLASMS OF THE LUNG Age Groups Pulmonarv Tuberculosis Neoplasms of the Lung or Bronchus 1951 1952 1951 1952 MALES 0— — — — — 1— — — — — 5— - — — — 15— 1 — — — 25— 4 4 1 3 45— 15 14 33 31 65— 11 11 11 14 75— 1 2 3 5 Total Males 32 31 48 53 FEMALES 0— — — — — 1— — — — — 5— 1 — — — 15— 1 1 — — 25— 4 3 1 — 45— I 4 3 5 65— 1 — 3 4 75— 1 — 1 2 Total Females 9 8 8 11 51 VITAL STATISTICS OF WHOLE DISTRICT 1952 and Previous Years Year Population estimated to middle of each year Births Total Deaths Registered in the District Transferable Deaths Net Deaths belonging to the District Number Rate Number Rate of Non-residents registered in the District of Residents not registered in the District Under 1 Year of Age At all Ages Number Rate per 1,000 Net Births Number Rate 1 2 3 4 5 6 7 8 9 10 11 12 1925 134,500 2,351 17.5 1,034 7.7 186 756 153 65 1,604 11.9 1926 134,400 2,188 16.3 1,174 8.7 195 556 144 66 1,535 11.4 1927 132,800 2,076 15.6 1,581 11.9 230 377 126 61 1,728 13.0 1928 136,300 2,258 16.6 1,449 10.6 222 326 156 69 1,553 11.4 1929 136,900 2,162 15.8 1,757 12.8 222 340 133 62 1,875 13.7 1930 136,900 2,173 15.9 1,387 10.1 219 436 140 64 1,604 11.7 1931 135,100 2,073 15.3 1,567 11.6 288 373 140 68 1,652 12.2 1932 133,700 1,940 14.5 1,465 10.9 294 543 129 66 1,714 12.8 1933 131,400 1,827 13.9 1,500 11.4 340 530 119 65 1,690 12.9 1934 129,170 1,783 13.8 1,359 10.5 346 655 137 77 1,668 12.9 1935 128,100 1,877 14.7 1,347 10.5 406 583 131 70 1,524 11.9 1936 127,700 1,922 15.1 1,399 10.9 441 639 116 60 1,597 12.5 1937 126,500 1,913 15.1 1,333 10.5 402 662 130 68 1,593 12.6 1938 125,100 1,874 15.0 1,340 10.7 450 522 117 62 1,412 11.3 *1939} B122.800 1,829 14.9 1,311 11.2 362 442 77 43 1,391 12.0 D 116,200 1940 98,320 1,600 16.3 1,725 17.5 370 401 76 51 1,756 17.9 1941 84,880 1,405 16.5 1,315 15.4 351 364 52 41 1,328 15.6 1942 89,370 1,589 17.8 1,270 14.2 356 338 94 59 1,252 14.0 1943 92,050 1,768 19.2 1,278 13.9 365 387 102 58 1,300 14.1 1944 89,190 1,788 20.0 1,447 16.2 418 389 95 53 1,418 15.9 1945 96,100 1,742 18.1 1,464 15.2 423 267 78 45 1,308 13.6 1946 111,860 2,310 20.6 1,522 13.6 463 277 103 45 1,336 11.9 1947 117,280 2,559 21.8 1,570 13.3 472 271 97 38 1,369 11.6 1948 115,800 2,149 18.5 1,608 13.8 547 241 75 35 1,302 11.2 1949 118,440 1,971 16.6 1,532 12.9 545 322 55 28 1,309 11.0 1950 119,200 1,988 16.6 1,433 12.0 482 346 34 17 1.297 10.8 1951 118,300 1,874 15.8 1,605 14.4 509 401 41 22 1,497 12.6 1952 118.800 1,777 14.9 1,509 12.7 535 383 37 21 1.357 11.4 * B = Birth-rate Population Figure. D =Death-rate Population Figure. 52 CHART SHOWING BIRTH AND DEATH RATES PER 1.OOO POPULATION FOR THE PAST 20 YEARS. 53 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1952 Cause of Death Sex 0— 1— 5— 15— 25— 45— 65 75— Total all Ages 1. Tuberculosis, respiratory M - - - - 4 14 11 2 31 F - - - 1 3 4 - - 8 2. Tuberculosis, other M - - - 1 - - - - 1 F - - - - 1 1 - 1 3 3. Syphilitic disease M - - - - - 2 2 - 4 F - - - - 2 1 - - 3 4. Diphtheria M - - - - - - - - - F - - - - - - - - - 5. Whooping cough M - - - - - - - - - F - - - - - - - - - 6. Meningo-coccal infections M 1 - - - - 1 - - 2 F 1 - - - - - - - 1 7. Acute poliomyelitis M - - - - 1 - - - 1 F - - - - - - - - - 8. Measles M - - - - - - - - - F - - - - - - - - - 9. Other infective and parasitic diseases M — - - - - - - - - F 1 - - - - 2 - - 3 10. Malignant neoplasm, stomach M - - - - 1 5 11 9 26 F - - - - 1 7 6 8 22 11. Malignant neoplasm, lung bronchus M - - - - 3 31 14 5 53 F - - - - - 5 4 2 11 12. Malignant neoplasm, breast M - - - - - - - - - F - - - - 4 11 3 6 24 13. Malignant neoplasm, uterus M - - - - - - - - - F 3 3 1 7 14. Other malignant and lymphatic neoplasms M 1 - 1 4 22 28 19 75 F - 1 - - 7 27 14 23 72 15. Leukaemia, aleukaemia M - - 2 1 - 1 4 F - 1 - 1 1 - 2 5 16. Diabetes M - - 1 - 2 3 F - - - - - - 1 2 3 17. Vascular lesions of nervous system M - - - 1 4 17 17 20 59 F - - 1 - 20 30 50 101 18. Coronary disease, angina M - - - 4 39 49 20 112 F 1 16 27 29 73 19. Hypertension with heart disease M - - - - - 4 9 6 19 F - - - - - 1 6 7 14 20. Other heart disease M - j 3 18 19 44 85 F - j 1 6 16 75 99 21. Other circulatory disease M - 1 2 10 11 24 F - - - - - 5 7 20 32 22. Influenza M — - - - - 1 - 1 2 F - - - - - - 2 - 2 23. Pneumonia M 6 1 1 - 1 7 14 9 39 F 2 - - - - 5 6 14 27 24. Bronchitis M 1 - - 22 30 23 76 F - - - - - 3 12 26 41 25. Other diseases of respiratory system M - - - - 1 4 2 1 8 F - - - - 2 1 1 4 26. Ulcer of stomach and duo denum M - - - - 7 2 1 10 F - - - 1 2 3 6 27. Gastritis, enteritis and diarrhoea M - - - - - - - 1 1 F - - - - - 1 1 28. Nephritis and nephrosis M - - - - - 4 2 - 6 F - - - - 1 2 1 1 5 29. Hyperplasia of prostate M - - - - 1 1 7 9 F - - - - - - - - - 30. Pregnancy, childbirth, abortion M - - - - - - - - - F - 1 1 - - - 2 31. Congenital malformations M 2 — — - 1 — - - 3 F 2 - - - - 1 - - 3 32. Other defined and illdefined diseases M 15 - 1 1 3 10 7 9 46 F 6 - - 2 1 13 15 17 55 33. Motor vehicle accidents M - 1 3 2 - - - 6 F - - 1 - - 1 - 2 34. All other accidents M - - 2 - 2 1 5 F - 1 - j - - 1 2 5 35. Suicide M - - - 1 2 4 - 1 8 F - - 1 1 1 1 - 4 36. Homicide and operations of war M - - 1 - - - - 1 F — — - — — — — — - M 25 3 2 10 39 217 230 193 719 F 12 2 2 9 25 138 159 291 638 Total of all causes 37 5 4 19 64 355 389 484 1357 54 PROPORTION OF DEATHS FROM PRINCIPAL CAUSES 1952 55 INFANT MORTALITY—1952 and Previous Years Year Births Deaths of Infants Deaths of Infants per 1,000 births Average 1906-1913 3,000 359 117 ,, 1914-1923 2,639 230 88 ,, 1924-1933 2,145 141 66 1934 1,783 137 77 1935 1,877 131 70 1936 1,922 116 60 1937 1,913 130 68 1938 1,874 117 62 1939 1,829 77 43 * 1940 1,600 76 51† 1941 1,405 52 41‡ 1942 1,589 94 59 1943 1,768 102 58 1944 1,788 95 53 1945 1,742 78 45 1946 2,310 103 45 1947 2,559 97 38 1948 2,149 75 35 1949 1,971 55 28 1950 1,988 34 17 1951 1,874 41 22 1952 1,777 37 21 * Rate calculated on a birth figure supplied by the Registrar-General of 1,781. † Rate calculated on a birth figure supplied by the Registrar-General of 1,501. ‡ Rate calculated on a birth figure supplied by the Registrar-General of 1,253. 56 Net deaths of infants at various ages under one year of age Under 1 week 18 1-2 weeks 2 2-3 weeks 2 3-4 weeks - 4 weeks and under 3 months 7 3 months and under 6 months 4 6 months and under 9 months 3 9 months and under 1 year 1 Total deaths under 1 year 37 Net Births in the Year: Legitimate,1,625; Illegitimate, 152. Net Deaths in the Year: Legitimate Infants, 32; Illegitimate Infants, 5 57 CHART SHOWING THE NUMBER OF DEATHS OF INFANTS UNDE.R 1 YEAR OF AGE DURING THE PAST 20 YEARS. 58 INFANT MORTALITY RATES — ENGLAND AND WALES AND VARIOUS OTHER COUNTRIES Deaths under 1 year per 1,000 live births Country 1948 1949 1950 1951 England and Wales 34 32 30 30 Scotland 45 41 39 37 Northern Ireland 46 45 40 41 Australia 28 25 24 25 Belgium 50 57 54 66 Canada 44 43 41 38 Chile 160 169 153 149 Denmark 35 34 31 29 France 51 61 52 51 Irish Republic 49 53 45 45 Italy 70 74 64 67 Netherlands 29 27 25 25 New Zealand 22 24 23 23 Sweden 23 23 20 21 United States of America 32 31 29 29 MATERNAL MORTALITY—1952 and Previous Years Year Number of Deaths Number of live Births Maternal Death Rate Pregnancy, childbirth, abortion Average 1924-1933 8 2,145 3.5 1934 9 1,783 5.0 1935 2 1,877 1.1 1936 3 1,922 1.6 1937 4 1,913 2.1 1938 2 1,874 1.1 1939 2 1,829 1.0 1940 - 1,600 — 1941 2 1,405 1.5* 1942 3† 1,589 1.9 1943 3 1,768 1.6 1944 2 1,788 1.08 1945 1 1,742 0.56 1946 7 2,310 2.94 1947 1 2,559 0.38 1948 1 2,149 0.45 1949 2 1,971 0.99 1950 1 1,988 0.49 1951 1 1,874 0.52 1952 2 1,777 1.10 * Rate calculated on a (live and still) birth figure supplied by the Registrar-General of 1,289. † 1 death from puerperal sepsis not counted as "Maternal death", 59 ENVIRONMENTAL HEALTH SERVICES (A) SANITARY INSPECTION Cause of Inspection No. of Inspections No. of Notices served No. of Notices complied with Bakehouses 82 - - Complaints 4,623 1,674 1,467 Drainage 2,409 8 9 Factories (Mechanical) 653 9 25 Factories (Non-mechanical) 223 6 10 Food (other than Restaurants and Eating Houses) 2,625 4 Housing Act 770 8 4 Housing Applications 834 28 33 House to House 7 4 35 Ice Cream Vendors 749 - — Infectious Diseases 420 2 — Licences (Building) 649 1 — Markets 390 - — Milk Vendors 597 — - Outworkers 1,314 3 10 Pet Animal Act 22 — - Pharmacy and Medicines Act 165 — — Public Urinals 14 — - Rag Flock Act 4 — — Rats and Mice 3,799 71 59 Restaurants and Eating Houses 817 15 18 Shops Act 428 6 4 Smoke Observations 58 3 6 Miscellaneous 1,631 36 40 Re-visits 11,325 467 866 No Answer 2,902 — — 37,510 2,345 2,586 No. of Ineffective Visits 2,902 - — Total 34,608 2,345 2,586 During the year, 1,079 Statutory Notices were served and 1,119 complied with. (B) SUMMONSES—Proceedings instituted during the year Public Health (London) Act, 1936 125 Food and Drugs Act, 1938 9 Milk and Dairies Regulations, 1949 1 H.B.C. Byelaws 2 L.C.C. Byelaws 5 Shops Act, 1950 1 60 (C) FACTORIES ACT, 1937 1.—INSPECTIONS Premises Number on Register Number of Inspections Written Notices Occupiers Prosecuted (i) Factories in which Sections 1, 2, 3,4 and 6 are to be enforced by Local Authorities 230 223 6 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 590 653 9 - (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) - - - - Total 820 876 15 — 2.—CASES IN WHICH DEFECTS WERE FOUND Particulars Number of Cases in which Defects were Found Number of Cases in which Prosecutions were Instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of Cleanliness (S.l) 9 10 - - - Overcrowding (S.2) — — — — — Unreasonable Temperature (S.3) 1 1 Inadequate Ventilation (S.4) 1 - Ineffective Drainage of Floors (S.6) - - - - SanitaryConveniences (S.7)— (a) Insufficient 1 1 - - - (b) Unsuitable or Defective 13 10 (c) Not separate for Sexes - — Other offences against the Act (not including offences relating to Out-work) - - 6 - - Total 25 22 6 - — 61 OUTWORK Nature of Work Section 110 Section 111 No. of Outworkers in August List required by Sect. 110 (1) (c) No. of Cases of Default in Sending Lists to the Council No. of Prosecutions for Failure to Supply Lists No. of Instances of Work in Unwholesome Premises Notices Served Prosecutions Chocolate and Sweetmeats 35 — Wearing Apparel- Making, &c. 179 — — — — — Basket Making 2 — — — — Curtains and Furniture Hangings 4 — — — - Electroplate 5 - — — - - Artificial Flowers 2 — — — — — Paper Bags 53 — — — — — Feather Sorting 2 — — — Carding, &c., of Buttons, &c 33 - 1 1 - Stuffed Toys 42 — — — — - Cracker Bon-bon, Christmas Crackers, Christmas Stockings, &c 151 - - - - - Lampshades 2 - — — — — Total 510 — — 1 1 — 62 (D) HOUSING 1. Total number of houses in the Borough, including flats, tenements, etc., separately assessed 25,830 (approx.) Public Health (London) Act, 1936 2. No. of houses inspected on account of complaints or illness 4,623 3. Number of statutory notices served 1,079 4. Number of prosecutions 125 5. Number of houses repaired or nuisances remedied 1,467 Housing Act, 1936 6. Number of houses inspected — house-to-house (Housing Consolidated Regs. 1925) Nil 7. (a) Number of houses included in representations by the Borough Medical Officer under Sec. 25 of H.A., 1936 Nil (b) Number of houses demolished following representations by Borough Medical Officer under Sec. 25 of H.A., 1936 Nil 8. Number of houses repaired under Sections 9 and 10 of H.A., 1936: — (a) By owners 1 (b) By L.A. in default of owners 3 9. Number of houses demolished: — (a) In pursuance of orders under Sec. 11 of the Housing Act, 1936 2 (b) Voluntarily Nil 10. Number of rooms on which Closing Orders were made (excluding underground rooms) 2 11. Number of Closing Orders determined (excluding underground rooms) 2 Overcrowding (Housing Act, 1936) 12. Number of families living in overcrowded conditions 187 Number of overcrowded families who have obtained alternative accommodation 79 13. Number of dwellings erected by the Borough Council during year 88 (Flats) Underground Rooms 14. Number occupied but unfit Unknown Number closed or modified occupation approved 29 Number of Closing Orders 27 Number of Closing Orders determined 24 Houses Let in Lodgings 15. Number in Borough 9,600 (approx.) "Number of inspections — Number of prosecutions Nil fNumber of complaints remedied under the Bye-laws (not included under any other heading) ° Included under item No. 2. f Included under item No. 5. 63 (E) UNSOUND FOOD CONDEMNED—1952 Baby Food 17 tins Bacon 6 lbs. Baked Beans 182 tins Biscuits 82 lbs. Cakes 37 Carrots 35 tins Cereal 27 pkts. Cheese 81 lbs. Chicken 29 tins Coffee 11 tins Eggs 85 Fish (Tinned) 316 tins Fish 715 lbs. Fruit (Dried) 682 lbs. Fruit (Frozen) 1,120 lbs. Fruit (Jars) 43 jars Fruit (Pulp) 1 barrel Fruit (Tinned) 1,255 tins Jaffa Juice 5 bottles Jam (Tinned) 56 tins Meat (Tinned) 1,895 tins Meat 7,216 lbs. Milk (Tinned) 193 tins Nuts (Salted) 74 pkts. Ovaltine 1 tin Peas 344 tins Pickles 76 jars Puddings (Christmas) 2 Rabbit 133 lbs. Sausages 417 lbs. Soup 82 tins Spaghetti 16 tins Spinach 7 tins Sweets 8 lbs. Tea 2 pkts. Tomatoes (Tinned) 244 tins Tomato Juice 5 tins Tomato Purée 1 barrel Tongue (Tinned) 12 tins Vegetables 10 tins 64 PUBLIC MORTUARY—Bodies Admitted, &c. Bodies admitted from the Borough:— By order of Coroner 259 By order of Police 2 On application of undertakers 14 275 Bodies admitted from other Boroughs:— Fulham (Sixty by order of Coroner and twenty-six by order of Police) 86 Chelsea (Two hundred and eighteen by order of Coroner, three by order of Police and two by application of undertakers) 223 Kensington (by order of Coroner) 20 329 Total bodies admitted 604 No. of P.M. examinations conducted:— Hammersmith cases 251 Fulham cases 86 Chelsea cases 221 Kensington cases 20 Total P.M.'s 578 No. of Inquests held:— Hammersmith cases 57 Fulham cases 50 Chelsea cases 34 Kensington cases 87 Total Inquests held 228 65 (A) INFECTIOUS DISEASES Diseases Notifications Total Cases Notified Cases Removed to Hospital Deaths Corrected Figures 0—1 year 1—2 years 2—5 years 5—15 years 15—25 years 25—45 years 45—65 years 65 + years Scarlet Fever - 14 44 151 6 2 - - 217 60 - 206 Whooping Cough 24 66 60 85 3 — - - 238 27 - 238 Acute Poliomyelitis (Par.) — — 6 9 3 1 - - 19 19 1 7 Acute Poliomyelitis (Non. Par.) — — — 4 — — - — 4 4 — 4 Measles 57 305 369 711 59 5 1 - 1,507 42 — 1,502 Diphtheria 1 — 5 3 5 8 2 — 24 24 — — Acute Pneumonia 4 9 11 9 6 11 25 8 83 8 66 83 Dysentery 4 3 13 10 11 13 7 3 64 31 - 49 Acute Encephalitis (Inf.) — — — — — — — - - - - — Enteric or Typhoid Fever - - - - - - - - - - - - Paratyphoid Fever - — 1 — 1 1 - — 3 3 — 1 Erysipelas — — 1 1 6 13 4 25 11 — 25 Meningococcal Infection 3 2 2 9 1 2 — - 19 19 3 6 Food Poisoning 2 1 4 6 6 13 8 1 41 9 — 39 Puerperal Pyrexia - — — — 14 24 — - 38 - - 38 Ophthalmia Neonatorum 4 — — — — — — - 4 2 - 4 Malaria - — — — — 3 — - 3 2 — 3 Scabies - — 6 8 13 17 6 — 50 — — 50 Totals 99 400 521 1,006 129 106 62 16 2,339 261 70 2,255 66 (B) BACTERIOLOGICAL EXAMINATIONS Specimen Positive Negative Total Swabs for suspected cases of Diphtheria 2 165 167 Haemolytic Streptococci 14 39 53 Faeces 15 77 92 Vincents Organisms 1 24 25 Sputum - 3 3 32 308 340 67 TUBERCULOSIS Summary of Notifications during the period from the 1st January, 1952, to the 31st December, 1952 Age Periods Formal Notifications Number of Primary Notifications of new cases of tuberculosis 0— 1— 2— 5— 10— 15— 20— 25— 35— 45— 55— 65— 75— Total (all ages) Respiratory, Males — 1 1 5 6 5 7 25 15 17 7 10 - 99 Respiratory, Females 1 - 2 3 5 6 13 35 9 3 2 2 — 81 Non-Respiratory, Males — — — 1 1 — 1 3 — — — 1 — 7 Non-Respiratory, Females — — — — 1 — 1 2 1 — 2 — 7 CASES NOTIFIED AND DEATHS—1952 and Previous Years Year No. of Cases notified No. of Deaths No. of Cases on Register of Notifications Pulmonary NonPulmonary Total 1933 185 31 216 150 1,056 1934 184 31 215 124 1,070 1935 170 31 201 119 1,059 1936 156 40 196 116 1,063 1937 141 33 174 106 1,068 1938 155 37 192 87 859 1939 165 33 198 107 889 1940 143 24 167 118 813 1941 160 39 199 103 828 1942 169 31 200 104 963 1943 177 24 201 72 1,097 1944 192 22 214 93 1,184 1945 207 23 230 93 1,282 1946 188 23 211 85 1,487 1947 189 21 210 90 1,517 1948 167 20 187 76 1,599 1949 193 14 207 51 1,674 1950 166 21 187 39 1,779 1951 193 15 208 44 1,852 1952 180 14 194 43 1,494 Average number of cases notified for the 10 years 1933-1942 (inclusive)—196. Average number of cases notified for the 10 years 1943-1952 (inclusive)—205. Average number of deaths for the 10 years 1933-1942 (inclusive)—113. Average number of deaths for the 10 years 1943-1952 (inclusive)—69. 68 CHART SHOWING THE NUMBER OF NEW CASES OF TUBERCULOSIS NOTIFIED DURING THE PAST 20 YEARS. 69 MEDICINAL BATHS Cleansing of Verminous Persons School Children—Hammersmith Scabies 93 Verminous 954 Impetigo 26 School Children—Non-Hammersmith Nil. Children under Five Years—Hammersmith Scabies 46 Verminous 67 Impetigo 3 Children under Five Years—Non-Hammersmith Scabies 4 Verminous 4 Adults—Hammersmith Scabies 99 Verminous 137 Other conditions 16 Adults—Non-Hammersmith Scabies 10 Verminous 17 Lodging-Houses Verminous 223 DISINFECTION Beds 52 Mattresses 441 Pillows 326 Bolsters 26 Blankets 302 Sheets 135 Quilts 49 Carpets 102 Articles of Clothing 371 Sundries 279 2,083 Rooms (including 713 verminous rooms) 817