AC 4347 cam HAM 47 Metropolitan Borough of Hammersmith ANNUAL REPORT of the Medical Officer of Health with STATISTICAL SUPPLEMENT for the year 1955 by F. M. DAY, M.R.C.S., L.R.C.P., D.T.M., D.P.H. ack d 21st aug. 1956 MBJ. METROPOLITAN BOROUGH OF HAMMERSMITH Health committee At 3lst December, 1955. Councillor E. O'K. Finn (Mrs.), M. B.E. (Chairman) " E. R. GOSllng (Vice — Chairman) Alderman R. J. Buckingham councillor A. Belsham " J. Farndale " E. W. Flynn " E. D. Freeman (Mrs.) " V. E. Grant (Miss) " D. M. Heaks (Mrs.) " L. C. Newton " B. wildman (Miss) " E. C. Woods (Miss) Ex officio: The worshipful the Mayor (Councillor t.A. Keating, J.P.) OTHER COMMITTEES OF THE COUNCIL CONCERNED WITH VARIOUS ASPECTS OF THE HEALTH SERVICES Baths committee. Management and supervision of the council's Public Baths and Washhouses. Establishment committee. Dealing with medical examination of staff, etc. Housing and Town Planning committee. Powers and duties of the council under the Housing Acts (other than those delegated to the Health Committee). Works Committee. Construction, maintenance and Improvement of sewers and public sanitary conveniences. Collection, removal and disposal of house and trade refuse. Cleansing of public highways. Management and control of the Council's cemeteries. Maintenance and control of parks, gardens and open spaces provided by the council. CONTENTS Page Introduction 1-3 Staff 4 SECTION A - Social conditions and Statistics:- Births 8 Deaths 8 Infant Mortality 9 Marriages 8 Maternal Mortality 9 Population 8 Social Conditions 5 SECTION B - Prevalence of and control over Infectious Diseases:- Contacts and Carriers - Sickness Benefit 10 Food Poisoning 12 Health Laundry 14 Medicinal Baths 12 Notifications 10 Poliomyelitis 11 Tuberculosis 10 SECTION C - Housing:- Overcrowding (Section 61) 21 Permanent Estates 20 Re-housing 19 SECTION D - inspection and supervision of Food:- Clean Food Campaign - Hammersmith Clean Food 32 Traders Guild Designated Milk - Licenses 31 Food & Drugs Act, 1938 22 Ice Cream 30 Markets 28 Meat and other Foods 23 Milk Supplies 30 Olympia Exhibition Halls 29 Pharmacy & Poisons Act, 1933 29 Public Health (Condensed Milk) Regulation,1923/48 32 Sampling 24 Wormwood Scrubs Fair 28 SECTION E - Sanitary Administration:- Coroner's Court and Public Mortuary 37 Exhumation and Re-interment of bodies 35 Heating Appliances (Fire Guards) Act, 1952 38 Housing Repairs and Rent Act, 1954 35 L.C.C. (General Powers) Act, 1952 Rag and Bone Dealers 38 L.C.C. (General Powers) Act, 1954 - Hairdressers and Barbers 38 Pet Animals Act, 1951 37 Public Baths and Washhouses 38 Rag Flock and Other Filling Materials Act, 1951 37 Staff - Inspectorial 35 SECTION F - Sanitary Circumstances: - Page Atmospheric Pollution 44 Drainage 41 Dustbins 42 Factories 42 Public Cleansing 41 Rodent Control 42 Sanitary Inspection 42 Water Supply 41 SECTION G - General provision of Health services:- Ambulance Facilities 46 Burial or Cremation of the Dead 51 Conferences 54 Diseased or Infirm Persons 51 Financial Contributions to Voluntary Organisations 53 Hammersmith Chest Clinic 46 Health Information Bureau 54 Hospitals 46 International Certificates of Vaccination and Inoculation 50 Laboratory Facilities 46 Old People's Welfare 51 Personal Health Services 47 Clinics and Welfare Centres 47 Creches 49 Day Nurseries 50 Domestic Help Service 50 Staff Medical Examinations 53 STATISTICAL SUPPLEMENT - TABLES Causes of Death in Age Groups 62 Deaths from Carcinoma of Lungs in Age Groups from year 1941 58 Disinfection 76 Extract from Vital Statistics 56 Factory Defects 69 Factory Inspections 69 General Statistics 56 Incidence of Cancer during the past 10 years 57 Incidence of Pulmonary Tuberculosis and Neoplasms of the Lungs 59 Infant Deaths under 1 year in age groups 65 Infant Mortality 64 Infant Mortality Rates - England and Wales and various other Countries from year 1950 67 Infectious Diseases - Notifications in Age Groups 73 Maternal Mortality 67 Medicinal Baths - Cleansing of Verminous Persons 76 Mortuary and Coroner's Court 72 Natural Increase or Decrease of the Population during the past 20 years 57 Outworkers 70 Sanitary Inspection, Notices served and complied with 68 Summonses - Proceedings instituted 68 Tuberculosis - Notifications and deaths for the past 20 years 74 Tuberculosis - Notifications in sex and age groups 74 Unsound Food Condemned 71 Vital Statistics of Whole District from year 1925 60 CHARTS Birth and Death Rates for the past 20 years 61 Number of Infant Deaths under 1 year of age during the past 20 years 66 Number of new cases of Tuberculosis notified during the past 20 years 75 Proportion of Deaths from Principal Causes 63 Town Hall, Hammersmith, w. 6. To the Mayor, Aldermen and Councilors of the Metropolitan Borough of Hammer smith. Mr. Mayor, Ladles and Gentlemen, I Have the honour to present to you my Annual Report on the health and sanitary circumstances of the Borough for the year 1955. Once again, I regret that it was not possible to publish it in the earlier months of the year, as the Registrar General's figures required to calculate the various statistics were not available sooner. As in 1954 we have again had a good year and infectious disease has not been a serious problem. Poliomyelitis increased but no deaths resulted. The proportion of cases with residual paralysis was somewhat high, but out of a total of 35 cases only 12 had crippling after effects in varying degrees. We had a large Measles epidemic during February, March and April but here also no deaths occurred. It is always fascinating to compare the ups and downs of good and bad years so I have made up the following credit and debit account. It illustrates how we have in some directions improved our records whilst in others there has been a deterioration. CREDIT: 1. Fewer new cases of Tuberculosis, a record low number. 2. Lowest number of deaths from Tuberculosis on record. 3. No cases of, or deaths from, Diphtheria. 4. continued increase of Births over Deaths. 5. Decrease in the number of food samples found to be unfit. 6. More people have benefitted from the Health Laundry. 7. Lowest number of cases of verminous condition ever treated. 8. First creche in Hammersmith opened in Glenthorne Road. 9. Decrease in the number of cases of Scabies. DEBIT: 1. Increase in the number of cases of Poliomyelitis, and of serious cases. 2. Increase in the number of cases of Measles. 3. Increase in the total number of deaths. 4. Increase in the Infant Mortality rate. 5. Increase in the number of deaths from cancer (all causes). 6. Increase nn the death rate from Bronchitis from 66 to 99 per 100,000 of the population. 1 Hie Borough is now strategically covered by five air pollution stations. First impressions of an analysis of results Indicate that the Ravenscourt Park area is the clearest, followed by the westcott Lodge area, Hythe Road, white city Estate and westvllle Road in that order, comparison with other nearby Boroughs shows that, if anything, we can boast that we are ahead in the race to get clean air. This is no small point at a time when we believe that lung cancer is in some way associated with atmospheric pollution. Figures show that deaths from cancer of the lung have increased 300% here in the last 14 years, we do not know that air pollution has increased here. The reverse seems to be more likely. Why then has lung cancer increased? It is difficult in our present state of knowledge to answer this question. If, however, the cigarette theory is close to the truth the explanation might be that never before have there been so many heavy smokers who have smoked cigarettes for many years. There is also the question of the increase in Bronchitis. The effects of long continued atmospheric pollution are also serious from this aspect. Mortality from bronchitis in England and Wales is 20 to 50 times greater than in Scandinavian countries where little coal is burnt. In industrial areas mortality is two to four times as great as in the countryside (with peak rates in the conurbations of Manchester, Liverpool and Sheffield). In 1954, for example, the death rate from bronchitis (per 100,000) was 139 in Oldham, 120 in Dewsbury, 119 in sal ford, 114 in Blackburn and 66 in Hammersmith, compared with 29 in Brighton, 34 in Oxford, 37 in Reading and 33 in Southampton. In 1955 the death rate from bronchitis rose to 99 in Hammersmith. The rate of invaliding from the postal service in London because of bronchitis is considerably higher among workers in the central area and north-east quadrant than among workers in other London districts, and this fits in with the fact that the prevailing south-westerly winds cause a build up of air pollution in these areas. The abolition of atmospheric pollution may prove to be the most important single factor in bringing about a reduction of chronic bronchitis. Finally, I wish to express my appreciation of the kindness and consideration shown to me by the Chairman and Members of the Health Committee and to record my thanks to the staff of the Department for the efficient manner in which they have carried out their duties at all times during the year. The sanitary Inspectors have carried out their work with 37% staff shortage and the district inspectors 2 have been understaffed for some years. It was recently decided to appoint two student inspectors, and I am hopeful that this move will soon ameliorate the shortage of fully trained men. I am, Your worship, Ladles and Gentlemen, Yours obedient servant, F. M. DAY, Medical Officer of Health. 3 STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December, 1955 Medical Officer of Health: F.M. Day, M.R.C.S., L.R.C.P., D.T.M., D.P.H. Deputy Medical Officer of Health (Part-Time): A.J. Shinnie, O.B.E., M.D., D.P.H. Administrative Officer: (¢* P.W. Pottler (Part-Time): Clerical: J.c. Turner (1st Assistant) w. Robinson T.J. Hares Mrs. f. Lawford Mrs. D- Kelley E. Brines (Temporary) Mrs. L.G. Stlmpson Miss J.New (Temporary) Miss I.E. waller (M.O.H 's Secretary) Senior Sanitary Inspector: φ¢* w. Rlgby Sanitary Inspectors: φ¢* P. T. Bayes (Deputy Senior) ¢#H.R. Fry e¢# J.C-Hopklns # E.W. Pike x¢# G. G. Gardiner ¢# A.H. Chappell ║†"# Miss e.M.Cross Food and Drugs Inspectors: ¢# J. Collier $¢* W.J. Godden Mortuary Keeper: D.A.Mackay Medicinal Baths Superintendent: || F. G. Baldwin Public Analyst: D. F.H. Button, A.R.C.S., F. R. I. C. * Cert. Sanitary Inspectors' Examination Board. ¢ Cert. Royal Sanitary Institute (Meat and other foods). φ Smoke Abatement Cert.,L.C.C. School of Engineering. # Cert. Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. $ Cert. Royal Sanitary Institute (Inspector). " Cert. Royal Sanitary Institute (Health Visitor). e Cert. Royal Sanitary Institute (General Science and Sanitation). X Cert. Royal Sanitary Institute (Sanitary Science as applied to Buildings and Public Works). † State Certified Midwife. ║ State Registered Nurse. 4 SECTION A SOCIAL CONDITIONS OF THE BOROUGH AND STATISTICS Hammersmith is the most westerly Borough in the county of London, covering an area of 2,282.5 acres. It is bounded on the north by the Borough of Willesden, on the south by the River Thames, on the east by the Royal Borough of Kensington and the Metropolitan Borough of Fulham, and on the west by the Boroughs of Acton, and Brentford and chlswick. The sub-soil in the northern half of the Borough, i.e. north of Uxbridge Road, mainly consists of clay, whilst in the south it consists of a layer of some 20 ft. of gravel above blue clay, particularly in the east of the Borough, much of which was excavated for brick making purposes before building development took place. On 16th September 1955 the Chairman of the London county Council opened "Hammersmith park", which has been laid out in part of the old White City Exhibition grounds and adds a further 7.23 acres of gardens and open spaces to that already controlled by the London County council, making a total of 262 acres under their Jurisdiction and 23 acres under the control of the Borough Council. There are also 4½ acres of the Grand Junction canal and 128 acres covered by the River. The Borough, once a quiet rural area in the county of Middlesex and relatively untouched by the spread of London, became part of the County of London in 1885, and is now a highly developed industrial and residential area and little remains of the old world. However, the Latymer Foundation school was founded in 1624 and Kent House and others in the Malls date back to the 17th century. The old home of William Morris, Kelmscott House, and also the houses in Hammersmith Terrace were built in the 17th and 18th centuries. Apart from its residential and industrial population, the Borough attracts a large number of visitors by reason of various centres which are found within its boundaries. St. Paul's Boys' and Girls' schools, West London and Royal Masonic Hospitals, Queen charlotte's Maternity Hospital, Hammersmith Hospital and British Postgraduate Medical school, white city Stadium, Olympia, the Television Studios at Lime Grove and the Television centre In Wood Lane, and, of course, wormwood scrubs, all attract their quota of people from outside our boundaries. The Boat Race also brings many people to our attractive riverside for a few hours every spring, whatever the weather may be. The total length of the roads in the Borough is approximately 67 miles, and traffic on the main roads is very heavy particularly over Hammersmith Bridge leading to the south, and to the main roads to Oxford, the west and London Airport. During the year a start was 5 made on the Hammersmith section of the New Cromwell Road Extension and considerable progress was made. The road will consist of a dual carriageway with roundabouts and subways and will link up the existing road with the Great west Road and provide a direct route to London Airport, Oxford and the west, thus easing the traffic leading to these areas. As a result of commencement of work on the Cromwell Road Extension it was necessary to remove a block of Almhouses near the river front. This possibility was envisaged as long ago as 1936 by the Trustees of the Hammersmith United Charities who were responsible for the property, and as a result sycamore House, Sycamore Gardens, was designed and built as a replacement by the Trustees and was opened by the Duchess of Gloucester on 9th June 1955. This provided new Almshouses consisting of 40 flats, selfcontained and with all modem amenities, and the occupiers provide their own furniture and equipment. There is a common room with a fireplace at each end and a large kitchen from which refreshments can be served. The residents live rent free and are also supplied with fuel and ligit. 6 ALMH0USES - sycamore House, sycamore Gardens. There are approximately 300 industrial undertakings here,the majority of which are situated in the North, although some of the largest single employers are to be found in the south. VITAL STATISTICS. (a) Population. In this report the rates are calculated on the estimated population adopted by the Registrar General, namely 114,700 which compared with 116,500 for 1954 shows a reduction in population of 1,800. This is the third year the Registrar General has reported a reduction. In view of the new building of 10 storey flats and others almost as large, it is difficult to believe strongly in the accuracy of the Registar General's figures especially as no census has taken place since 1951. Furthermore, no epidemic causing any mortality occurred during the year and the excess of births over deaths has been maintained. (b) Marriages. The number of marriages solemnised during the year was 1375, this being an increase of 105 as compared with the previous year. Particulars are set out hereunder;- The Register Office 595 Buildings registered for marriages (Roman catholic Churches and Chapels) at which a Registrar attends 345 Churches of the Church of England 386 Authorised Persons (Chapels at which a Registrar does not attend) 33 Jewish synagogues 16 1,375 (c) Births. The corrected number of births for the year as supplied by the Registrar General was 1,707. On the estimated population of 114,700 this represents an annual rate of 14.8 births per thousand persons living, which is a slightly lower rate than for the previous year. (d) Deaths. During the year 1,495 deaths were registered. Add to this figure 393 deaths of residents of the Borough who died in various parts of England and transferred by the Registrar General, and deduct 616 deaths of non-residents and 27 transferable deaths which occurred, the corrected figures show a total of 1,245 deaths of residents (683 males, 562 females) which shows an increase of 174 as compared with 1954. 8 On the estimated population of 114,700 the corrected number of deaths per 1,000 persons living was 10.8 as compared with 9.1 last year. In the statistical supplement will be found a chart showing the proportion of deaths from the principal causes, from which which will be seen that diseases affecting the heart and important blood vessels come first, with cancer second and lung conditions now occupying third place. (e) Infant Mortality. The number of deaths of infants under one year of age during the year was 51, giving an annual mortality rate per 1,000 live births of 30. (f) Maternal Mortality. There were two maternal deaths during the year, resulting in a death rate of 1.14 per 1,000 live and still births. 9 SECTION B PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASES Infectious Disease 2695 cases of infectious diseases were notified during the year. 335 cases were removed to Hospital and of this number 76 were notified on discharge as not having suffered from the disease originally notified, as a result the corrected number of cases of notifiable infectious disease for the year was 2619. These figures show an increase on the previous year of 1,540 cases. This is entirely due to the fact that in the early part of the year there was an epidemic of Measles, and there was also an increase in the number of cases of Whooping cough and Poliomyelitis. Five cases of suspected Diphtheria were notified, but once again I am pleased to report that not one of them was confirmed. It is also pleasing to be able to report for the eleventh year in succession, that there have been no deaths from this disease. Contacts and carriers of Infectious Disease - Sickness Benefit. Four certificates were issued during the year in the following circumstances:- (a) Male nurse who was a direct contact of a case of poliomyelitis. (b) Male employee in a bakehouse of a food factory Who was a contact of a case of Sonne Dysentery. He was later found to be suffering from this disease, and was undoubtedly infected by the first case. (c) Female assistant in the cake department of a food factory who was a contact of a case of Sonne Dysentery. (d) Woman counter -hand in a Grocery & Provision Merchants' store who was a contact of a case of Scarlet Fever. Tuberculosis It is with much pleasure that I am again able to report a considerable decrease in the incidence of this disease. The number of new cases notified during the year was only 150 as against 180 in the previous year. These figures show a decrease of 32 in pulmonary cases but an increase of 2 in nonpulmonary cases. 10 This is the lowest number of cases ever notified in one year in the Borough. In the statistical supplement will be found a chart showing the number of new cases notified during the past 20 years. Although the figures for this year show such an improvement it must be borne in mind that tuberculosis still remains a serious menace to public health and is affecting the age groups which are of the utmost value to the productive ability of the nation, and despite the fact that high priority is given by the housing authorities in re-housing tuberculous persons, the housing shortage still 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 16 as compared with 21 in the previous year. As in the case of notifications this is the lowest figure every recorded in the Borough. Modern treatment is reducing the disease almost to controllable proportions and further reductions in incidence and fatalities seem probable. Poliomyelitis I regret to have to report a considerable increase in the number of cases of this disease over the previous year. There were 35 confirmed cases and of these 17 were of the paralytic type and the remainder non-paralytic. I am, however, pleased to state that none of the cases proved fatal. Most of the cases were treated in the first instance at the western Hospital, seagrave Road, s.W. 6., and I should like to express my appreciation to the hospital staff for their co-operation with the Health Department in local control. Of the 17 paralytic cases, 7 were transferred to Queen Mary's Hospital, carshalton, and 2 to the Royal National Orthopaedic Hospital, Stanmore, for further treatment. It is interesting to note that there was never more than one case either in a family or a house, although in two cases it transpired that a relative of the patient, either a brother or sister, had had the disease five or six years ago. Cases were fairly widespread in the area north of King street and south of Wormwood scrubs, but no cases were reported either to the south or north of these boundaries. The ages covered a range from 5 months to 31 years, with the majority of paralytic cases in the early school age groups between 4 and 10 years, and the majority of non-paralytic cases between 4 and 15 years. 11 Food poisoning Twenty three cases of food poisoning occurred during the year as compared with 19 in the previous year. In six cases Salmonella Typhi-Murlum were identified as the responsible organisms, in one case staphylococcal toxin was identified, and in another Cl.Welchii was identified, but in the remaining cases no specific organisms were isolated. Foods alleged to have been responsible for the patients' condition included meat pie, whelks, home bottled tomatoes, rabbit, Russian tinned salmon, fish paste, dripping, boiling fowl and mussels. In December an outbreak of food poisoning was reported from one of the larger schools in the Borough where all the cooking was carried out by a firm of caterers, and the food under suspicion was either boiled lamb or curry. Faecal specimens were obtained from the catering staff and together with samples of the boiled lamb and curry were forwarded to the Medical Research council's Laboratory at county Hall. The Manageress and the cook were found to be carriers of heat resistant Cl.Welchii and this organism was also recovered from the boiled lamb. All other specimens were negative. Upon making enquiries it transpired that the lamb was delivered on Friday and immediately boiled. It was then left to cool in a larder until Monday, when it was again boiled and served to about 45 people, 14 of whom complained of diarrhoea and vomiting during the same night or early the next morning, but in all cases the illness was only of short duration. The Bacteriologist on being informed of these facts gave it as his opinion that the second boiling was the cause of the trouble and that the Cl.Welchli was already in the meat when it was delivered, and not introduced by the cook. She was given advice as to the care of her hands when handling food, but not put off work. Medicinal Baths The Medicinal Baths in scotts Road, Shepherds Bush, provide for the treatment of scabies, impetigo, and certain verminous conditions, and occasionally psoriasis. The figures showing the numbers dealt with during the year will be found on reference to the table in the Statistical supplement. It is pleasing to report once more a decrease in verminous conditions and also in scabies infection. The total of verminous treatments at 904 was the lowest ever recorded, and with the exception of persons of no fixed address, no heavy infestation was noted. The scabies figure of 224 was 33% lower than in the previous year though 42 families were Involved in treatment. 12 13 The county council continue to use this centre for the treatment of schoolchildren and special attention has been given to head Infestations at the welfare centres and at the Day Nurseries. infected schoolchildren, together with their contacts of pre-school age, have been followed up in the home and treatment (for all ages) has been made available at the Medicinal Baths. Advice is always given as to the best methods of home treatment and of preventing recurrence. There was little difference in the number of school children treated for head lice, but the number of mothers attending with their children was depresslngly low, the difficulty appears to be that more of the mothers are now at work. Almost 50% of the females treated were referred by business welfare and medical departments. As in other years a few large families are responsible for a high percentage of treatments for head lice in school children. During the year cases from Barnes, Brentford and chlswlck, Ealing, Feltham, Fulham, Heston & Isleworth, Richmond, southall, Staines and sunbury, received treatment, and Barnes, Ealing, Heston & Isleworth Borough Councils and the London county council used our centre for steam sterllsatlon of bedding. On 46 occasions the west London Hospital used the services of the Medicinal Baths for sterilisation purposes and 23 requests were received from the Hospital for formaldehyde disinfection. Following the precedent of successful treatments in the past, the Town Hall carpets and soft furnishings were sprayed as a protection against damage by moths. In this connection Gammexane Emulsion (I.C.I) was used. The mobile team which is available for dealing with homes requiring dlslnfestatlon was again actively engaged, and during the year 249 premises were sprayed for bed bugs and fleas (495 rooms) and 48 premises for infectious disease (78 rooms). In this connection a most interesting point was the number of fleas reported by tenants. During the period from April to October no less than 105 rooms were treated. The hot weather in the late summer was responsible for increased flea breeding. If we get another hot summer in 1956 fleas are expected to provide an even greater problem than 1955. Following the notification of vermin infestation or infectious disease, bedding and articles of clothing etc., were collected from 57 premises and removed to the disinfecting station for sterllsatlon, particulars of these are summarised in a table in the statistical supplement. This is the lowest number ever recorded. 14 The sale of second-hand furniture infected with bed bugs is only too frequent and many new flats are originally infested in this way. Tenants newly-housed might well be warned of the dangers of the indiscriminate purchase of old furniture which has hot been dlslnfested before sale. Nowadays many people send articles of clothing etc., to relatives living abroad, and in this connection some Eastern European countries require that the articles shall be disinfected before being despatched, and a certificate to that effect produced. During the year 50 such certificates relating to 508 articles were issued and a nominal charge of 2/6 was made for each certificate. An unusual request was received from a from of shipping Importers. a cargo of coir matting had been delivered to a London county Council store in the Borough and was found to be infested with Domestes Frichii, (carpet Beetle). Dlslnfestatlon of the whole of the consignment was carried out. Where it is necessary, mattresses are supplied by the proprietors of Olympla for people who have to sleep on the premises during certain exhibitions, particularly those with cattle at the Dairy Show, and in this connection 230 were dealt with after this particular show. The steam steriliser was also used to dry mattresses etc. of families who were unfortunate enough to suffer damage from water as a result of burst water storage tanks and defective roofs. At the beginning of the year there was a steady increase of cases of body lice from inmates of Rowton House, a visit was made to the premises with the District sanitary inspector and it was found that it was not possible to improve on the cleanliness of the premises, and the hlgh number of individuals sent for treatment only emphasises the vigilance of the staff in their attempt to keep up the standard of cleanliness The superintendent of Rowton House also visited the cleansing station to see for himself how the work is carried out. The incidence of body lice In the Borough is very low and there have been no re-infectlions since 1951 of local people who have received treatment for pediculosis pubis, (crab lice), at the baths. One case of Impetigo was seen at the cleansing station. This was the first since 1953 and was a secondary infection of pediculosis capitis. It quickly cleared when treated with mercury ointment. In the immediate pre-war period the average number of cases was about 300 per year. Health Laundry Three years have now elapsed since the introduction of the Health Laundry Scheme. 15 The increasing demand for the service from all in touch with the aged proves its place in the alleviation of distress and suffering of those ill, and of preventing additional illness because of their immobility. Requests are received from doctors, nurses, welfare associations, relatives and others and are assessed largely on the health position of the applicant. There can be no doubt of the worth of the Laundry service and the fact that no deterioration is the rule after our visits emphasises its value with the frail and aged. It must be emphasised that this is an essential service which covers only those cases falling within the terms of section 122 of the Public Health (London) Act 1936. During the year 34 new cases were added to the list of patients and 350 certificates were slgned authorising the laundering of bed linen etc. This is an increase of 215% over last year. The patients were revisited at intervals of two or three months and the old people are not slow in showing their appreciation. Often by discussing their problems it is possible to bring other means of help to them and invalid meals and home helps are thus brought in. Despite incontinence no patient developed bed sores after the start of the service, although the average age of all cases was 76.4 years. Only 4 patients were under 70 years of age. One male patient of 92 years, after six months in bed, recovered sufficiently to attend to his own toilet. Another female patient aged 83 years with very little movement in her fixed flexed legs after over five years in bed still has a healthy skin. In 12 other cases the service enabled patients to be admitted to hospital in a much better condition for further treatment that would otherwise not have been possible. The service still continues in operation in eight cases, one of these having started in December 1953. The following are details of the service to individuals Sex and Age Collections up to 31. 12.5 Primary Cause of ill health Sequel F 83 107 Arthritis Service still in ope ration. F 75 48 Cardiac failure Admitted to hospital F 70 66 Spondylitis Service still in operation 16 Sex and Age Collections up to 31.12.55 Primary cause of ill-health Sequel F 70 16 Cerebral haemorrhage Admitted to hospital M 66 6 Apoplexy Died M 92 37 Found collapsed Service no longer necessary F 80 8 Apoplexy Removed for care e1sewhere F 79 4 Senile debility Died F 70 9 Apoplexy Died M 72 6 Apoplexy Service no longer necessary F 90 2 Cardiac failure Admitted to hospital M 77 2 Acute retention Died M 89 5 Cerebral haemorrhage Died M 74 1 Post-operative incontinence Service' no longer necessary M 83 2 Carcinoma of Pancreas Died M 73 2 Apoplexy Admitted to hospital M 71 1 Apoplexy Service no longer necessary F 77 1 Apoplexy Died M 70 11 Cerebral haemorrhage Died F 82 3 Apoplexy Died F 80 3 Senile dementia Admitted to hospital F 82 2 Diarrhoea ?cause Admitted to hospital F 79 2 Carcinoma of Rectum Died 17 Sex and Age Collections up to 31.12.55. Primary cause of ill-health Sequel F 74 15 Senility Service still in operation M 76 15 Carcinoma of Recturn Service still in operation F 56 8 Carcinoma of Uterus and Bladder Removed for care e1sewhere M 63 10 Cerebral tumour Removed for care elsewhere. F 91 7 Senility Admitted to hospital F 82 10 Enuresis Removed for care e1sewhere F 75 2 Senility Admitted to hospital F 72 1 Debility and varicose ulcers Died F 79 1 Cardiac failure Admitted to hospital M 79 5 Apoplexy Admitted to hospital F 52 2 Carcinoma of Col on Admitted to hospital F 89 5 Prolapsed Uterus Admitted to hospital F 73 2 Senility Died F 85 5 Arthritis Service still in operation F 71 6 Apoplexy ditto M 80 3 Enuresis ditto F 78 3 Senility ditto Cleansings carried out during the year included:- Sheets ... ... 2,006 Blankets ... ... 40 Pillow slips ... ... 459 Towels ... ... 377 Nightdresses ... ... 208 Sundries ... ... 813 Total 3,903 19 SECTION C HOUSING Rehousing The Housing Estates Manager continues to co-operate with the Health Department for advice on applicants with overcrowding or medical problems. If overcrowding is found to exist by the District sanitary inspector, legal overcrowding is reported to the Housing Manager of the London county council. Applications for rehousing by the London County Council are made to that Authority direct, and requests are received from them through 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 conditions of premises. Enquiries of this nature totalled 290 and of these 129 families were found to be living in overcrowded conditions. Twenty-eight cases were recommended for rehousing on grounds of health. In addition to the above, a recommendatian for rehousing 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 are inadequate to maintain the high level of health which is so vital to the family unit in its early stages. in spite of the many claims made upon them, the Housing Department do the best they can in each case. During the year six such recommendations were made to the Housing Estates Manager. I append a table showing the number of cases recommended for rehousing under the three headings mentioned above and those actually rehoused from 1949:- Year HEALTH GROUNDS OVERCROWDING GROUNDS SPECIAL CASES Recom- mended Rehoused Recommended Rehoused Recommended Rehoused 1949 61 25 358 132 34 4 1950 35 10 439 203 8 9 1951 37 10 243 88 9 4 1952 27 10 187 79 7 7 1953 30 6 178 65 17 5 1954 34 2 145 86 14 4 1955 28 3 129 55 6 5 To make the above figures realistic it should be pointed out that the figures for those rehoused are extremely unlikely to be from recommendations of the same year. 20 PERMANENT ESTATES During the year both the Borough council and the London County council have been still actively engaged in providing accomodation for those in the greatest need, and further schemes are still in progress. Ninety four flats in Queen Caroline street were completed by the London County Council and the undermentioned were completed by the Borough council. 25/29, Cromwell Grove 6 144/172, Askew Road 15 8/22, Chancellors Road 8 7/9, Ashchurch Terrace 6 1/12, Ashchurch court, Ashchurch Grove 12 88/98, Godolphin Road 6 161/185, Flora Gardens Walpole court, Spring vale Estate, 25 Blythe Road 24 65/67, St. Stephens Avenue 8 1/20, Benbow court, sycamore Gardens 20 Total 130 The council acts as landlords for 3,865 principal tenants. The properties managed include houses, flats, prefabs and requisitioned accommodation. At the end of the year there were 6,033 applicants for accommodation on the Borough council's list awaiting rehousing. No points scheme is used to assess these applicants. Their need, according to bedroom deficiency, ill-health, insanitary conditions, overcrowding and separation of families is measured and used as a guide in allocating accomodation. The following table illustrates the progress that is being made:- 1. Number of families rehoused by the Borough Council in new flats and houses since the war 966 2. Number of families rehouses 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 80 (Still living in prefabricated dwellings at end of year, 48). 4. Number of Borough council licensees living in requisitioned properties at the end of the year 1,429 21 Overcrowding (section 61) No licences were granted under this section of the Houseing Act, 1936, during the year. 22 SECTION D INSPECTION AND SUPERVISION OF FOOD Food and Drugs Act 1938 The end of 1955 brings us to yet another milestone in the history of food and drugs administration. The principal instrument by which food, food premises and drugs were controlled by local authorities, namely the Food and Drugs Act 1938, continued until the end of the year. it has now been superseded by the pood and Drugs Act, 1955 which came into operation on 1st January, 1956. One feature of the 1938 Act was that for the first time an attempt was made to group legislation relating to the control of food under one statute. Previously legislation governing the control of the sale and preparation of food, unsound food, the registration of food premises etc., were found scattered in several Acts dealing with other diverse subjects, and the necessity for separating legllslatlon dealing with food and matters concerning it from other subjects, e.g., sewers, drains, nuisances, etc., was recognised. The principal Acts involved were the Factories Act 1937 and the public Health Acts of 1875, 1890, 1907, 1908, 1925, 1936. Many other Acts were also consolidated, some dating back, to the 16th century, such as an Act of Henry VIII "Concning Phisicans" and one of queen Mary I "An Act touching Thincorporations of the pilsitions in London". It is already becoming difficult today to visualise the situation that existed until the 1938 Act was passed, nevertheless the advances of science and food technology together with the changed outlook of the public had demanded even more comprehensive legislation resulting in the introduction of the Food & Drugs Act 1955. It is, of course, too early to assess the value of this new legislation but I am glad to see that the proposed codes of practice suggested in the short-lived Food and Drugs Amendment Act 1954 have been Jettisoned. One item of interest in the new Act is the inclusion of chewing gum in the definition of 'food'. until now this commodity has been a problem owing to a decision in the High court establishing that it was not food and the resulting lack of control of hygienic conditions where chewing gum was wrapped and packed in the private homesof outworkers, its inclusion in the definition of food also raised another problem since its composition would contravene the Mineral Oil in Flood Order 1949. This has been overcome by the introduction of an amending Regulation which provides that the prohibition of that Order relating to mineral oil in food shall not apply in relation to chewing compounds which contain not more than 12.5 parts by weight of microcrystalline wax per 100 parts by weight of chewing compound and otherwise contain no mineral oil. 23 Among other new legislation concerning food introduced during the year is the Bread (Amendment) Order 1955 which permits bakers to produce and sell a loaf containing not less than a prescribed proportion of skimmed milk powder, an ingredient not hitherto permitted, and to be known as National Milk Bread. A loaf sold under this name must contain not less than six parts by weight of skimmed milk powder to one hundred parts by weight of national flour or national brown flour. This order has been severely criticized and I am not entirely happy about it myself. I do not like the use of the description 'milk bread' for bread which contains a small proportion of skinned milk powder. The purchasing public might well think that milk bread contains at least some proportion of each of the more valuable constituents of milk. Another matter relating to bread which has caused some concern in the past was the use of agene as an improver in flour. Following extensive experiments the Minister of Agriculture and pood announced that effect should now be given to the decision taken in 1950 to discontinue the use of agene. In view of that decision the National Association of British and Irish millers agreed to recommend their members to discontinue the use of agene and to give an undertaking that the equipment for treating flour in that way would be removed from their mills by the end of 1955. The National Association of Flour Importers has similarly agreed to recommend their members to ensure that no flour treated with agene will be imported by them. The Transfer of Functions (Food & Drugs) Order 1955 provides for the transfer of certain food hygiene functions from the Minister of Agriculture, Fisheries and pood to the Minister of Health. under this Order the Ministry of Health became the central department responsible In England and wales for general food hygiene work. The Ministry of Agriculture, Fisheries and Food, however, remains the central department responsible for the hygiene of milk production and distribution and of meat and meat products while in a slaughterhouse or in the course of importation, as well as for the composition and labelling of food. The Ministry of Health is still the central department responsible for medical advice on all food matters and for measures for the control of milk—borne disease. Meat and other Foods. Throughout the year routine inspection of premises, shops, stalls and vehicles was carried out where food is prepared or sold. During 1955, 2,844 visits were made and at 39 of these, unsatisfactory conditions constituting contraventions under section 13, Food and Drugs Act 1938 were found. In every case the unsatisfactory conditions were remedied following the issue of warning letters by the pood and Drugs inspectors. 24 The inspection of food exposed for sale, in storage and in course of preparation and manufacture was under constant supervision. section 10, Food and Drugs Act 1938 empowered an authorised officer of a local authority to examine any food intended for human consumption which had been sold, or was offered or exposed for sale, or was in the possession of or had been deposited with or consisted to any person for the purpose of sale, or of preparation for sale, and if it appeared to be unfit for human consumption he could seize it and remove it in order to have it dealt with by a Justice of the Peace, section 9 of this Act provided that any person who sold or offered or exposed for sale, or had in his possession for the purpose of sale, or of preparation for sale, or deposited or consigned to any person for the purpose of sale, or of preparation for sale, any food intended for but unfit for human consumption would be guilty of an offence. These sections are, of course, re-enacted in the Food and Drugs Act 1955. In two instances seizures of unsound food were made under section 10 of the Act. In one case sausage rolls were found to be unfit for human consumption and in the other, toffees and sweets had been contaminated by mice and insects. In the latter, legal proceedings were taken and a penalty of £5 with £3 3.0. costs were imposed. As distinct from the above, a quantity of unsound foods which did not call for action under section 10 of the Food and Drugs Act 1938 was voluntarily surrendered. A list showing the foodstuffs and the amount involved is given in the statistical supplement. Sampling 1,255 samples of food and drugs were submitted to the Public Analyst during the year for chemical analysis. Of this number 14 were reported not to be genuine. This represents only one per cent and is an improvement on last year. The following are details of defective samples:- Sample Result of Analysis Remarks Dessicated Coconut Contained 7 parts per million lead Informal sample (Formal sample genuine) Margarine Contained 16.2 per cent water Informal sample Cod Liver Oil Deficient in Vitamin A ditto (Formal sample genuine) Minced Beef Contained 55 parts per millions S.0.2 Informal sample (Formal sample genuine) 25 Sample ResuLt of Analysis Remarks Raisins Insect infested Remainder of stock destroyed Cod Liver Oil Deficient in Vitamin A Informal sample (Formal sample genuine) Non-brewed Condiment 10 per cent deficient in acetic acid Informal sample ditto 12.5 per cent deficient in acetic acid Absolute discharge £l.1. 0 costs. Whisky 39.5 degrees under proof. Penalty £3., with £3.3.0. costs. Butter Contained 16.2 per cent water. Informal sample (Formal Sample genuine) Pork sausages 20 per cent deficient in meat ditto Margarine Contained 17 per cent Water ditto Cyder Vinegar 12.5 per cent deficient in acetic acid Informal sample (Formal sample unobtainable ) Tomato Puree Contained copper 175 part per million Informal sample (Formal sample genuine) Attention has been f6cussed on the growing practice of mothers of young children purchasing proprietary brands of orange juice drink some of which are diluted ready for consumption, and giving these to their children instead of concentrated orange juice which is available from Local Authorities' Clinics. So much has been done by Local Health Authorities to make concentrated orange Juice available for young children and expectant mothers, that it is disappointing to know how many of the public fail to realise the difference between the concentrated juice and orange-flavoured drinks sold in the shops and by milk roundsmen. It is, of course, much easier to buy soft drinks along with other shopping, or when the vendor calls at the door, but clearly, from the experience of a number of Health Authorities more will have to be done to demonstrate to the public that while these soft drinks may be admirable thirst quenchers, they are not a proper substitute for the concentrated orange juice available at Local Authorities' Clinics. in fact it has for so long been made available that the public may be taking it for granted and overlooking its real value. 26 With the object of ascertaining the amount of fruit Juice etc., contained in fruit drinks now on the market, a number of these were sampled and submitted for analysis. The results are very interesting and are shewn hereunder in comparison with the concentrated Orange Juice referred to above, which is shown at the top of the table:- SAMPLE Sulphur Di-oxide P.P. M. Added Sugar pe r cent Vitamin C mg/fl. oz. App.Equiv. No. of whole fruit per bottle Capacity of bottle fl. oz. Price Concentrated Orange Juice 350 Not stated 60 2.5 6 5d Orange Squash 250 35 4.3 2.6 26 3/- ditto 220 32 5.7 2.8 26 3/- Children's Orange Squash 250 38 8.0 1.32 13 1/11d Orange Squash 280 10 3.0 2.6 26 2/- ditto 320 35 3.4 2.6 26 3/- Orange Drink Nil 28 4. 0 1.2 26 3/- Lemon Drink Nil 30 4.3 2.4 26 3/- Lemon Squash 320 32 7.7 2.6 26 3/- ditto 230 18 5.0 2.8 26 3/- Orange Squash 290 35 6.6 3.4 26 2/9d. ditto 250 32 8.0 1.32 13 l/8d. Fresh Orange Drink 30 8.5 A trace 0.08 5½ 3d Orange Drink 60 10 3.1 0.72 26 6½d Fresh Orange Drink 20 8.5 A trace 0.08 5½ 3d All samples complied with the requirements of the Food Standards (Soft Drinks) Order 1954. f>7 The Public .analyst's comments are of Interest - "The size of an orange and the amount of Juice In It varies, of course, greatly, but an average orange probably contains about two to three fluid ounces of Juice. The composition of the Juice also varies widely. The above figures for fruit Juice are calculated on average phosphorus content, but there may be a variation of as much as 50 per cent In this, so large a variation Is doubtless unlikely In bulked Juice from vMch these squashes are presumably made, but the figures for fruit Juice must be regarded as very rough approximations only." The matter was referred to the Metropolitan Boroughs standing Joint committee vAio stated that the Ministry on being approached regarding the standards at present laid dowi In the pood Standards (soft Drinks) Order 1954 were of the opinion that there was no evidence that mothers have been mislead Into giving orange drink to their children in place of orange Juice. The following articles of food were submitted for bacteriological examination;- ARTICLE OF FOOD NO OF SAMPLES CONTAINING THE FOLLOWING ORGANISMS Faecal Coli Non>Faecal Coli Other Pathogens 30 samples of Synthetic Cre am 5 - 2 Staph Aureus 5 samples of Pork Sausage s - 2 it She 11f i sh 1 _ 9 ti Egg Albumen " ( 1 Salmone11a ( Thompson (1 Salmone11a ( Muenchen 1 n Egg Powder - 1 it Frozen Egg 2 n Chocolate Milk Drink 1 12 n Iced Lollies - FX)r some time past It has been the practice In the baking and confectionery trade to make use of dried egg albumen in place of fresh eggs for reasons of economy and convenience. This substance which is In powdered or crystalline form Is derived from the white of eggs and Is Imported on a large scale, mostly from China. During the year reports were received that seme consignments of Chinese egg albumen were found to contain food poisoning organisms of the salmonella group, despite the fact, we understand, that some consignments have been accompanied by certificates stating 28 that they are In a satisfactory bacteriological condition and free from Intestinal pathogens. In view of these reports samples were taken from all bakers In the borough found to be using this commodity. Although these were reported to be satisfactory, samples taken of a later consignment at a large bakery were found to contain salmonella thompson and salmonella meunchen, These were from an unused consignment of 400 lbs. which was returned to the wholesaler by arrangement with the Medical Officer of Health of the area concerned, following consultations with representatives of the Ministry of Health. Samples of Chinese egg albumen are being taken at ports of entry and any consignment vtfilch are found to be unsatisfactory are being detained and not released except for non-edible purposes. in the meantime Interested parties In the trade formed a coirmittee, In which they and the Public Health Laboratory service were represented, with the object of finding a solution to this problem, I understand that a suitable method of sterilising this albumen has been devised, and the Ministry of Health Is awaiting the final results of further tests before dealing with the accumulated stocks of detained albumen. Markets There are four markets in the borough, two of which are privately owned, the Uxbrldge Road market on the site of the silver Cinema and the market In Railway Approach. At the other two markets street traders operate frcm approved pitches licensed by the Borough council under sec.21, London County council (General powers) Act 1947. street trading licences are renewed annually upon application frcm the holders and where such application Is for the renewal of the licence on Its original terns, the renewal Is automatic unless grounds are known to exist which call for a review of the conditions prescribed In the Licence, I.e., permission to trade In different articles of coraaodlties from those originally licensed, or if the storage accommodation Is not satisfactory, particularly in the case of foodstuffs. The council may refuse to renew a licence or may vary such licence upon renewal only where the applicant Is, on account of misconduct or for any other sufficient reason, In their opinion unsuitable to hold such licence on its original terms. Considerable attention is paid to street trading in food, and the stalls and storage accommodation are visited frequently. During the year 603 visits were made by the rood and Drugs Inspectors to these markets. Wormwood scrubs Fair A fair Is held on the 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 29 requirements of holidays crowds with the Inevitable cockles, whelks, soft drinks and Ice-cream,. At each of these fairs the food stalls were Inspected and samples taken with satisfactory results. Olympia Exhibition Halls These halls are used for staging exhibitions of world wide Interest attracting both exhibitors and visitors from many countries. Many of these Shows are basically concerned with the production, preparation and sale of food and drink and on these occasions the Food and Drugs Inspectors visit to ensure that legal and hygienic requirements are compiled with satisfactorily. A high standard of hygiene is obtained although restricted conditions may make things not too easy at times. Pharmacy & poisons Act 1933- The local authority Is responsible for the supervision of the sale of scheduled poisons In Part II of the Poisons List In shops other than chemists and pharmacists, section 18 of the Act requires that except In the case of an authorised seller of poisons selling from premises duly registered under part I of the Act (qualified pharmacists) no person shall sell any poison Included In part II of the Poisons List unless his name Is entered in a local authority s list of sellers of such poisons. The requirements applicable are laid down In this section and in the Poisons Rules and are briefly as follows-- The sale must be effected on the premises specified In the local authority5s list. The container of the poison must be labelled with the various particulars and in the prescribed manner. No poison may be sold except In containers which comply with the requirements of the Rules. Certain specified poisons must not be sold by any person other than the listed shopkeeper himself, or a responsible deputy nominated by him to the local authority. The sale of certain specified poisons may be made only to persons satisfying the prescribed qualifications and must be entered in a poisons book to be kept by the listed seller and to be available for Inspection by the local authority. Arrangements for storage must be satisfactory and in compliance with the prescribed methods. 30 The names and addresses of 110 retailers were entered cti the Council's list of persons entitled to sell poisons under part II of the Pharmacy & Poisons Act 1933 and Phannacy & Medicines Act 1941° By far the greater majority of these are food retailers. In seme Instances the poisons sold are only household disinfectants, but careful watch Is kept of commodities sold under proprietary names containing other poisons Included In the llst„ No action was necessary In respect of any offence under the Act. All the premises have been Injected as to their suitability, method of storage and labelling as required under the Act and have been found satisfactory. ice Cream 10 premises were registered by the council for the sale of Ice cream and at the end of 1955 the total number of registrations In compliance with sec.14 of the pood & Drugs Act 1938 was 309. The FOod & Drugs Inspectors made 458 visits to premises where Ice cream Is sold, stored or manufactured. During the year 94 samples of Ice cream were taken for bacteriological examination. Most of these were from Ice cream factorles situated In the Borough. The results of the methylene blue test were as follows: - 60 samples were within Grade I standard ii n it n g n 12 « « » » 3 » g II n n k 4 n 9 n n ungraded samples graded I and 2 are considered satisfactory, but samples graded In 3 and 4 are doubtful. This again shows an Improvement on previous years, and It Is gratifying to note that the only two samples falling within grade 4 were from Ice cream manufactured outside the Borough. The samples shown as ungraded were taken during a special Investigation carried out to trace the source of contamination by faecal coll In Ice cream at a production factory situated In the Borougi. as a result of this Investigation changes of staff and management were made, and later samples have maintained a satisfactory standard. Milk supplies. 98 persons were registered as Distributors of milk at the close of the year. One direct effect of the pood and Drugs (Milk Dairies and Artificial cream) Act 1950 has been the disappearance of the small retail bottler In London. When the Act came Into force there were 22 small shops In the Borough where milk, was bottled on the premises. This small-scale bottling is no longer being done, all milk is obtained by the retail shop keeper in bottles or cartons filled at the premises where the milk is pasteurised. There are two large milk bottling depots situated in the Borough each with Its own private Railway siding enabling them to receive milk by rail and road from all parts of the country. Rail tanks, each holding 3,000 gallons of milk, are received daily and a large quantity of milk is also delivered to these depots by road tankers each holding the same quantity. The total quantity of milk handled by these two depots is some 180,000 gallons daily. A proportion of this milk is pasteurised and distributed in chums, some 12,000 gallons are sterilised in bottles and the remainder is pasteurised and bottled. This involves the washing and filling of about eight million bottles a week. The milk from one of these depots is distributed in the North West London area to 29 retail distributing depots Which in turn supply the company's shops and milk roundsmen. Milk from the other bottling depot is distributed to the smaller dairymen who have no facilities themselves for pasteurising and bottling milk, and to hospitals, hotels and restaurants etc., covering the greater London area and beyond, reaching as far as camberley and Gerrards cross. Designated Milk. During the year 145 samples of designated milk were taken fr milk distributors, milk processing depots, hospitals and schools, and submitted for the phosphatase, methylene blue and turbidity tests, the results of which are set out below;- Class of Milk No. Tested Phosphatase Meth-Blue Test Turbidity Test Passed Failed Passed Failed Passed Failed Pasteurised 90 90 - 90 - - - T. T- Pasteurised 29 29 - 29 - - - Tuberculin Tested 8 - - 7 1 - - Sterilised 18 - - - - 18 - TOTAL 145 119 - 126 1 18 - 31 The sample of tuberculin tested milk, which failed to pass the methylene blue test was reported to the Ministry of Agriculture and Fisheries, and further samples from the same source proved to be satisfactory. A further 70 samples of milk were submitted to the Public Analyst for chemical analysis, all of which were reported genuine. under the Milk (Special Deslgnations) (pasteurised and sterilised Milk) Regulations 1949 and the Milk (Special Designation) (Raw Milk) Regulations 1949, the following licences were issued during the year- Dealers (Pasteurised) Licence 2 Dealers (sterilisers) " 1 Dealer's Licences Tuberculin Tested 66 Pasteurised 72 Sterilised 83 Dealer's Supplementary Licences Tuberculin Tested 14 Pasteurised 16 Sterilised 8 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 and other receptacles. During the year 13 samples were submitted for examination to the Public Analyst and were reported genuine. Hammersmith Clean Food Traders Guild. On June 21st the Advisory committee considered the future functions and activities of the guild having regard to the rood and Drugs Amendment Act 1954, and it was decided that owing to this new legislation and the meagre support given to the Guild by the majority of rood Traders in the Borough, no useful purpose would be served by continuing Its existence. Much good work was achieved by the Guild since its inception in 1949, and at the time of its dissolvement, 185 applications had been received for Trader Membership. Arrangements were made for talks on "rood Hygiene" to be given to employees in the foods trades. The talks were Illustrated by films strips shown by a portable diascope and screen at the Traders' own premises. A number of talks along similar lines were also given to school children, women's Institutes, Church Guilds and other similar organisations. 32 Early in 1951 a "Brains Trust" was held at the Town Hall to which the general public were invited., The team of experts which included the Chairman of the Guild, the Chairman of the Health Committee, a representative from the Ministry of rood and the Medical Officer of Health, answered questions put to them by the audience ranging over a wide field and covering most aspects of food-hygiene. In May of the same year a clean rood Exhibition was held at the Town Hall. Exhibits provided by the Ministry of rood, the Ministry of Agriculture and Fisheries, the central Council for Health Education, the Public Health Department, and the Guild, illustrated the necessity for care in the handling of food, the dangers which might arise as the result of improper practices, and the best methods to be adopted in the preparation, storage and exposure for sale, rood care in the home was also covered by exhibits. It is estimated that between 2,500 and 3,000 members of the general public visited the Exhibition during the week, that it was open. Each day visiting parties of children from the senior schools in the Borough Joined in specially designed demonstrations. 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 and bookmarks were prepared. The shopping list pads were distributed to housewives through Trader Members, the cost being shared between the Trader Members and the Council, and the bookmarks were distributed through the public Libraries. In 1953, the Guild, in conjunction with the Health committee, published a handbook on "rood Hygiene", and copies were distributed to various Organisations throughout the Borough and to members of the public. The booklet, which dealt, amongst other things, with the causes of food poisoning, and gave Information about how it can be prevented, proved very popular, and requests for copies were received from many local Authorities all over the country and from as far afield as Ireland, New Zealand and Australia. During the week commencing 8th February, 1954, a Health Exhibition was held at the Town Hall under the auspices of the London county Council at which were shown the services provided by the London County Council, the Metropolitan Borough Councils and a number of voluntary agencies for the Inhabitants of Chelsea, FUlham, Kensington and Hammersmith. A comprehensive exhibit on behalf of the Borough council's Health Services showed how the Sanitary Inspectors and other officers protect the public by checking food premises, sampling food and drugs, etc., and also included the work and activities of the Guild, copies of the "Food Hygiene" booklet and leaflets were distributed to schoolchildren and members of the public who attended the Exhibition. In the same year, on the occasion of the Mayor's Reception at the Town Hall, an Exhibition featuring the work of the Guild and the council's Clean rood campalgn was staged in one of the committee rooms. 33 The Exhibition was visited by a number of persons representing most of the Organisations conducting activities in the Borough who attended the Reception. Although the Guild ceased to function as such, an appeal was finally made to all fonner Members to continue to do all they could to further the objects for which it was formed, i.e., to secure an improvement in the conditions under which foodstuffs are prepared, stored and sold in the future. 34 SECTION E SANITARY ADMINISTRATION Staff The establishment of sanitary Inspectors consists of the senior sanitary Inspector, a Deputy senior sanitary Inspector and 10 other district Inspectors, two Food and Drugs Inspectors and one woman Inspector. One district Inspector also acts as Inspector in charge of rodent control operations. There were three resignations during the year, but none of these could be replaced owing to the shortage. At the end of the year only 7 district Inspectors remained and there seems little chance of getting back to our full establishment. There could be no better moment than now, however, to mention my appreciation of the work of Mr. Rigby, the senior Inspector, and those of his colleagues who remain have done to provide a service that has been more than a credit to the public Health Department. Exhumation and Re-interment of Bodies During the year ten licences were granted by the secretary of State for the exhumation and removal of ten bodies from graves in St. Mary's catholic cemetery, Harrow Road. Each of these was attended by the local district Inspector 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 Acts. 1920/1939. The Housing Repairs and Rents Act. 1954. The Housing Repairs and Rents Act, 1954, came into operation on 30th August 1954. The Act is described as "An Act to make further provisions for the clearance, and redevelopment of areas of unfit housing accommodation, and for securing and promoting the reconditioning and maintenance of houses and otherwise to amend the enactmentsrelatlng to housing, the exercise of certain powers relating to land, and rent control". Part I contains further provisions as to Clearance and Redevelopment, Reconditioning of Unfit Houses, and other Amendments of Housing Acts. The local authority is required to submit proposals for the exercise of its functions as to clearance areas etc., to the Minister within one year from the commencement of the Act subject to the Minister's power to extend the time in exceptional circumstances. 35 Powers are given to local authorities for the following purposes: - (a) to retain for temporary accommodation certain houses in clearance areas. (b) to purchase houses for temporary accommodation in lieu of making demolition orders. (c) to postpone demolition under clearance order in the case of houses let to local authority. (d) to permit reconstruction of condemned houses. (e) to licence for temporary occupation houses subject to existing demolition or clearance orders. Provision is made for Exchequer contributions towards expenses of local authorities in buying houses for temporary occupation. A new standard of fitness of houses for human habitation is set out. Provisions are made regarding houses let-in-lodgings for securing fitness for occupation by number of families accommodated and for the prevention of overcrowding. Part II deals with Repairs Increase in respect of controlled Dwelling-houses and other Amendments of the Rent Acts, etc. Before the increase of rent permitted by the Act is operative in the case of a controlled Dwelling House, certain conditions must be fulfilled. In addition to the landlord producing to the tenant satisfactory evidence that work, of the required specified value has been carried out, the dwell In ghouse must be in good repair and be reasonably suitable for occupation having regard to certain specified matters. The expression "good repair" is defined in the Act for this purpose. A tenant served with notice of increase, if not satisfied that the house is in good repair and reasonably suitable for occupation can apply to the local authority for a certificate of disrepair. The landlord can apply for the revocation of the certificate and the local authority must revoke the certificate if satisfied that the landlord has executed such work as requires to be executed. During the year, applications were received as follows: - APPLICATIONS TOR CERTIFICATES Number received 66 Number granted 69* * Applications for a number of these certificates were received at the end of 1954- 36 APPLICATIONS FDR REVOCATION OF CERTIFICATES Number received 59 Number granted 53 Coroner's court and Public Mortuary The number of bodies admitted to the Public Mortuary during the year was 666, an increase of 37 over last year. There were 630 post mortem examinations, this is an increase of 38 over last year. The Mortuary and Court were also used by the Boroughs of Fulham, Chelsea and Kensington who pay to the Hammersmith council, as owner, appropriate charges. 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 the statistical supplement. Rag Flock and Other Filling Materials Act, 1951. The above Act, which makes it compulsory for manufacturers, retailers and other users of rag flock and other prescribed filling materials to be registered or licensed by the local authority still remained in force. Registered premises are those where certain filling materials are used in upholstery, including the stuffing or lining of bedding, toys, baby carriages &c. Licensed premises are those where rag flock is (a) manufactured, or (b) stored for distribution to registered premises. No fresh certificates were issued during the year. The total number of premises registered under the Act still remains at 10. Pet Animals Act, 1951. Local Authorities remained responsible under the above Act for issuing licences to persons for keeping pet shops, and for the inspection of premises so licensed to check that the requirements are complied with. The Act includes requirements as to the suitability of the accommodation, adequate supply of suitable food and drink for animals, that mammals are not to be sold at too early an age, and for reasonable precautions against fire and spread of infec tious diseases amongst animals. 37 Certain conditions approved by the council are applied to all licences issued. During the year 3 applications were received for new licences and all were approved. Nine applications for renewal of licences were received and granted during the year. Heating Appliances (Fire Guards) Act, 1952. This Act prohibits the sale or letting of unguarded domestic electric fires, gas fires or oil heaters, empowers authorised officers of local authorities to inspect and list appliances kept on any premises for sale or letting, and imposes penalties for contraventions. No reports of any contravention have been received since the Act came into force. London county council (General powers) Act. 1952. During the year there was one contravention of Section 26 of this Act, which deals with the restrictions on sales etc., by dealers in rags, old clothes and similar articles. The offender was prosecuted, found guilty and fined 20/- Public Baths and wash-houses. The public baths and wash-houses in Lime Grove, Shepherds Bush, continued to provide facilities for bathing (slipper baths) swimming and for laundry work. The water in the swimming bath is filtered and chlorinated to secure a high degree of purity. In the public wash-houses, modern facilities are provided for washing, drying, ironing and mangling at a small cost. The Open Air Bath at Bloemfontein Road, Shepherds Bush, provides facilities for swimming and sun-bathing during the summer months, and the water in this bath also undergoes the required purification treatment. London county council (General Powers) Act. 1954. Sec. 18 Hairdressers & Barbers. During the year the council obtained the necessary approval to Bye-laws relating to the registration of Hairdressers and Barbers in the Borough. 38 The Eye-laws require:- For the purpose of securing the cleanliness of the premises, a hairdresser or barber shall comply with the following provisions:- (a) all internal walls, partitions and ceilings shall be painted, distempered, whitewashed, papered, decorated, furnished or otherwise treated and shall be capable of being kept clean, kept in good repair and cleansed as necessary. (b) the floor and any coverings shall be kept in good repair, and shall be cleansed at least once a day and swept as necessary to prevent the accumulation of hair clippings, neck wool or other litter; (c) all such sweepings and all other litter shall be placed in suitable covered receptacles, which shall be emptied as necessary and at least once a day, and kept clean; (d) every chair or seat shall be cleansed as necessary; (e) every shelf, table, cabinet, washbasin and other fitting shall be kept clean. For the purpose of securing the cleanliness of any Instruments, towels, materials and equipment used in the premises, a hairdresser or barber shall comply with the following provisions:- (a) before use in connection with any customer - (i) any gown, wrap, overall or other protective clothing shall be clean; (ii) any paper or other covering placed on the back of a chair and any towel, cloth, haimet, neck wool or other article which is applied to the face, head or neck shall be clean, and shall not previously have been used in connection with any other customer unless it consists of a material (other than paper or wool) which can be, and has been, adequately cleansed; (iii) any metal instrument shall have been sterilised or otherwise adequately cleansed. (iv) any hairbrush, comb or similar instrument shall be clean, and shall have been sterilised, or otherwise adequately washed or cleansed, at least once a day; (v) Any soap in solid form shall have been adequately rinsed; (b) a fresh supply of water shall be used for purposes of shaving, shampooing or washing each customer, and all articles used for purposes of shaving (including any styptic in solid form) shall be adequately cleansed immediately after use; 39 (c) there shall be provided washing facilities which are adequate for the purposes of any cleansing carried out in pursuance of this byelaw. For the purpose of securing cleanliness of persons employed in the premises, in regard to both themselves and their clothing, a hairdresser or barber shall - (a) cause every such person to keep his hands and clothes in a clean condition; (b) provide and maintain suitable and sufficient washing facilities for the use of such persons; (c) cause any overalls worn to be clean; (d) cause every such person who has an open boll or sore on an exposed part of the body to keep such open boil or sore effectively covered by an impermeable dressing While attending any customer. These Bye-laws came into force on 1st October, 1955, and between that date and the end of the year 85 Hairdressers and Barbers where registered, and 95 inspections to ascertain that the premises comply with the requirements of the Bye-laws have been carried out. 40 SECTION F SANITARY CIRCUMSTANCES OF THE BOROUGH Water Supply The Metropolitan water Board is responsible for the supply of water to the Borough and no complaints with regard to the condition of the water were received during the year. 189 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 the collection, removal and disposal of refuse, has kindly furnished the following information with regard to this service. Amount of house refuse collected during the year = 29,989 tons Amount of trade refuse collected during the year 3,135 " 33,124 " Method of Disposal By road to tip at Harefleld Frequence of collection (a) House refuse - weekly (b) Trade refuse - as required. During the year the council received sanction to bring into force Bye-laws relating to the deposit of litter to the detriment of public amenities. The Bye-laws provide, inter alia, that no unauthorised person shall deposit or leave any rubbish, waste or discarded matter of any description so as to create or tend to create a litter on any highway, roadside, waste or unfenced ground abutting on any highway, common, park, recreation ground or any open space to which the public have access for the time being, or any water, watercourse or ditch in or adjoining any place aforementioned. 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. 41 During the year 112 drainage plans (7 of which related to combined drainage) were submitted and approved and a total of 2,384 inspections were made in connection with supervision of drainage works. Dustbins Two appeals were lodged in respect of Notices served under Section 107 of the Public Health (London) Act, 1936, requiring the provision of proper ashpit (dustbin) accomodation. Both appeals were dismissed on payment of £1.1.0. costs. Sanitary inspection The sanitary conditions of the Borough were subject to routine inspection and investigations were made into all complaints received. Particulars of the visits made by the sanitary Inspectors during the year, the number of preliminary and statutory notices served and compiled with, and proceedings instituted, will be found in the table in the statistical Supplement. Owing to the difficulty in filling vacancies in the inspectorial staff, it has still not been possible to investigate complaints and secure abatement of nuisances as quickly as we would have liked. Factories During the year 17 notices were served relating to insanitary conditions found to exist during the inpection of factories inthe Borough. 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 The year was again a busy one, and although the number of complaints decreased sllgitly, many of the Infestations proved stubborn and were not easily dealt with. Complaints dropped slightly from 617 to 597 (442 rats and 155 mice), and upon investigation 491 of the complaints were found to be Justified. This proportion of false alarms has been fairly consistent over the last few years. 42 Infestations discovered, other than by complaint, continue to show a steady decrease, falling from 101 last year to 66 this year. I attribute this to the fact that members of the public are becoming more "Rodent conscious", particularly in the matter of leaving food about as an attraction to rodents, due to the propaganda of recent years. Three "Block, control" areas were inspected, treated and cleared of infestation. The sewers were treated with poisen baits twice during the year and good results were obtained. Defective drains were again the largest individual cause of rat problems, 115 drains were found to be defective and repaired. Sane of these drains were responsible for widespread infestations. Approximately £92 was received during the year for treatment at business premises. The following is a summary of the work for the year, with comparable figures for 1954 in parenthesis. Premises inspected:- Dwellings 750(725); Business 1,231(1,251) 1,981 (1976) Complaints: - Rats 442(404); Mice 155(213) 597 (617) "Discovered" other than by complaint: - Dwellings 45(68); Business 21(33) 66 (101) Premises infested by rats:- Dwellings 321(284); Business 61(47) 382 (331) Premises infested by mice:- Dwellings 156 (180); Business 20 (24) 176 (204) Premises treated for infestation by Council staff 553 (535) Major infestations 27 (19) Notices served relating to Rodent control 92 (91) Inspections and re-inspections by sanitary Inspectors re Rodent control 2,941 (3,333) 43 Atmospheric pollution. The two stations set up in 1954 at westville Road and Livingstone schools for measuring and recording the extent of atmospheric pollution continued to function together with the lead peroxide instrument in Ravenscourt Park: maintained by the London county council. Comparison between the two areas served by the lead peroxide Instruments is shown by the following table:- LEAD PEROXIDE APPARATUS Louvred boxes sited at Ravenscourt Park and Livingstone school. Month Mg. of S.O.3 per day per 100 sq.cc. Ravenscourt Park Livingstone School January 3.20 4.01 February 3.14 4.38 March 2.7 3.6 April 1.3 1.2 May 1.2 1.2 June 1.2 1.4 July 0.7 1.2 August 0.9 1.5 September 0.7 1.2 October 1.5 2.9 November 0.5 4.0 December 2.5 3.6 Two other stations for measuring the concentration of smoke and Sulphur Di-oxide daily were set up during the year, one at the council's Depot in Hythe Road in the extreme north of the Borough in a factory area, and the other at westcott Lodge in the south of the Borough on the river front in a residential area. The stations commenced operations in May and July respectively. 44 The following diagrams show "A" the approximate sites of the various stations referred to, and "B" the approximate appraisal of air pollution with the worst areas shown in darker shading and the better areas left clear. SECTION G GENERAL PROVISION OF HEALTH SERVICES IN THE BOROUGH Laboratory Facilities. Our Public Analyst works at the Southwark Borough Council's Laboratory situated at The Health centre, Walworth Road, s.E. Bacteriological examination of food is carried out by the Public Health Laboratory service, county Hall, and this Laboratory is also, together with the Laboratory at the west London Hospital, at the disposal of all medical practitioners practising in the Borough for bacteriological examinations, including throat swabs and intestinal specimens etc., and the necessary swabs and outfits for both Laboratories can be obtained on application to the Public Health Department. The West London Hospital is of much benefit in view of its immediate accessibility. 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 deslgnated as teaching hospitals, and together with St. Mark's 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, perhaps, the best known of its kind in the country. Hammersmith chest clinic. The Hammersmith chest clinic continued to function during the year. 46 The clinic, with its associated independent radiography department and 27 tuberculosis beds, is based in Hammersmith Hospital and is run as an integral unit. A consultant diagnostic service for chest diseases is provided for local practitioners, who may send patients for full consultation, provided a letter of introduction is produced, or for X-ray examination only; this is arranged by a special fonn of reference. This latter service provides a rapid means of obtaining a chest X-ray without the formality of being examined by a consultant or other hospital physician. In addition to the diagnostic services provided, out-patient Clinics are held for new and follow-up cases, for refills, ambulance cases, contacts, and for anti-tuberculosis vaccinations, Attendances at all clinics (with the exception of the x-ray only service, which is held on Monday afternoon) are strictly by appointment only. During the treatment, rehabilitation and re-settlement of tuberculous patients, many social and financial problems arise, to provide adequate help and advice in these circumstances a fully equipped social welfare department fonns an integral part of the Chest clinic service. This department is in the hands of a certified Almoner, who is in contact with many statutory and voluntary agencies through which advice and assistance can be provided. In view of the relative shortage of sanatorium beds, a comprehensive domiciliary management scheme for tuberculous patients is in operation in Hammersmith. Patients are treated with modern methods in their own hones and visited there by the staff of the Chest Clinic. visits to the clinic are arranged as necessary by ambulance and patients are also admitted to the chest Clinic beds for chemotherapy and for major and minor thoracic surgery, sanatorium treatment, when this is necessary, is undertaken in sanatoria under the auspices of the North-west Metropolitan Regional Hospital Board. Personal Health services The county council remained responsible for the personal health services under the charge of or, V-I.Russell, and her deputy, Dr. R.H. Simpson. The day to day administration of these services is provided by the Medical Officers of Health for the Boroughs of Chelsea, Fulham, Hammersmith and Kensington, The liason between the staffs of the county council and the borough council continue on a very happy and cordial footing. The following is a list of the various clinics:- Ante-natal Clinics 1/3, Milson Road Monday 1.30 p.m. Friday 9.30 a.m. 47 Ante-natal Clinics (cont'd). 48, Glenthorne Road Monday 6 p.m. Tuesday 1.30 p.m. Friday 1.30 p.m. Becklow Gardens Monday 1.30 p.m. Tuesday 9.30 a.m. Thursday 1.30 p.m.,6 p.m. The crave, 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, Glenthome 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, Glenthome 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. Diphtheria Immunisation 1/3, Milson Road Friday 1.30 p.m. 48, Glenthome 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. 48 Vaccination 1/3, Milson Road Friday 1.30 p.m. 48, Glenthome Road Wednesday 9.30 a.m. Becklow Gardens Thursday 9.30 a.m. The curve, westway Tuesday 9.30 a.m. Chiropody 48, Glenthome Road Monday 2 p.m. Tuesday 2 p.m. Wednesday 2 p.m. Thursday 2 p.m. Friday 10 a.m. Speech Therapy 48, Glenthome Road Monday 1.30 p.m. Tuesday 1.30 p.m. Wednesday 1.30 p.m. Thursday 1.30 p.m. Creches 48, Glenthome Road Tuesday 9.30 a.m.-12 noon Friday 9.30 a.m.-12 noon During the year welfare foods and other nutrients Including National Dried Milk, concentrated Orange Juice and cod Liver Oil have continued to be obtainable at the welfare centres, for certain of these foods charges are made and the London county council is responsible for the collection thereof. In January 1955 the London County council approved in principle the provision of additional occasional creches where children between the ages of 2 and 5 may be left to give mothers free time for shopping, laundering, visits to dentists and hospital and other duties. These creches are also as useful play centres for the only child who needs companionship. There were no such Creches in Hammersmith, and in July it was decided to open one at 48, Glenthorne Road in the same building as the Infant welfare Centre. This Creche was opened on 30th August 1955 and is available every Tuesday and Friday from 9.30 a.m. to 12 noon and provides sufficient accommodation for 10 children if required. Application for admission is made to the superintendent of the welfare Centre or the Health Visitor in charge. In all instances priority is given to children whose mothers have to attend a clinic, hospital, doctor or dentist for treatment or otherwise. 49 No charge is made when the mother Is attending a clinic or class on the premises or if the mother or father is in receipt of National Assistance Benefit. Otherwise a charge of 1/3 per session is made, but this may be abated in certain circumstances. Since the creche was opened it has proved a great success and has been welcomed by many parents. The county Council also maintain the following four Day Nurseries in the Borough 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 6 p.m., and the charge for children received into them is based en the parent' s income and is reduced if the circumstances warrant it. Domestic Help Service This service, also administered by the county council employs 19 full-time and 68 part-time helpers and maintained its good and valuable work, during the year Its local headquarters are in the Public Health Department at the Torn Hall. Number of cases in which help was provided:- Maternity 27 Tuberculous 46 Other 982 1,359 effective visits were made to various homes by the organiser and her staff. International certificates of vaccination and inoculation Arrangements continued during the year for the authentication by the Medical Officer of Health of the signatures of Doctors on certificates of vaccination and inoculation required by travellers from this country going abroad. This authentication is required to prove that the Doctor named on the certificate as having carried out the vaccination or inoculation is a duly registered medical practitioner During the year 451 certificates were authenticated. 50 National Assistance Act, 1948 National Assistance Amendment Act 1951 Removal to Suitable premises of persons in Need of care and Attention Under the provisions of the National Assistance Acts, a Medical Officer of Health is empowered to apply to the courts for an Order for the compulsory removal to a hospital or other suitable place, of persons who are suffering from grave chronic disease, or, being aged, infirm or physically incapacitated, are living in insanitary conditions and unable to devote to themselves and are not receiving from others proper care and attention. During the year 17 cases were referred to the Department as being in need of care and attention but in only one instance was it necessary to take action under the above Acts, This was in respect of:- Mrs. A, age 69 found lying in entrance to rooms by Police and refused to go to Hospital, stated by own doctor to be suffering from Arthritis, and lack of nutrition, with consequent loss of power to legs, quite unable to look after herself. An Order for removal under an Emergency Order was obtained and she was removed to Hospital. This order was later extended. With regard to the other cases it was possible to find a solution either by reference to the family doctor or by applying other available services such as admission to Hospital, assistance by Home Helps, District Nurses, Old people's welfare Association, or by our Health Laundry, Burial or cremation of the Dead It is provided by section 50 of the National Assistance Act 1948, that a local authority shall arrange for burial or cremation in the case of any person who has died or been found dead in the Borough Where it, appears to the Authority that no suitable arrangements have been or are being made for a funeral. During the year twelve burials, including two stillborn children and one unknown child were carried out at a cost of £13.5.0., of which amount £88.9.2d., was 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 further progress during the year. 51 The activites of the Association include:- Clubs arranged by the British Red cross society, women's Voluntary services, Old Age Pensioners' Association, Missions and churches. Each open one or two afternoons a week. Much of the entertainment at these clubs is provided by the council and grants are made for expenses such as hire of halls etc. A friendly visiting service has been arranged for lonely old people through volunteers who provide such things as playing cards, magazines, Jig saw puzzles, handicraft materials, send birthday cards and generally "adopt" old people who are really lonely and isolated. An Old People's savings club which enables the old people to save for a holiday and other personal needs. Party holiday trips with reduced transport and accommodation charges for a week or fortnight's duration. Sick room equipment may also be hired through the British Red cross society. Arrangements have been made at one of the centres where old people or others interested in their welfare can be interviewed, and advised. Leaflets are prepared and published informing the old people and others of the services available and by whom provided, and the Organiser of the Association is available to give talks to any interested organisations in the Borough. There are three luncheon clubs in church or Mission Halls providing mid-day meals at 10d each, and two mobile meals services delivering meals at the same price (our own and that of the invalid Kitchens based at Acton). The Missions and Churches lend the premises, provide the helpers and organise day-to-day running of the clubs. Free baths open Monday to Friday at the public baths and a chiropody service at two foot clinics in the Borough, one of which is free to those on National Assistance or charging 2/6d per treatment for others. The other is operated by the British Red cross society in conjunction with the Association, and is open once a week at a charge of l/6d per treatment, the Association paying the chiropodist on a sessional basis. Special facilities have also been arranged for evening classes for men and women in boot repairing, woodwork, leatherwork and home tailoring. A monthly legal advice service has been inaugurated in conjunction with the Family welfare Association, free to pensioners with certain income limits. 52 Arrangements have been made for reduced prices at cinemas other than on Bank Holidays. Various outings and gatherings are also arranged by the Council's community Recreation Officer. Medical Examination of Council's staff During the year I have continued to carry out the duties of medical adviser to the council. Every new entrant to the service is required to undergo a medical examination, including a chest x-ray. In order to find 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 employees back to good health. The total number of first examinations carried out during the year was 315 and of this number 56 were found to be unfit for the following reasons:- Otorroea 5 Hypertension 16 Chest condition 4 Dermatitis 3 Duodenal ulcer 1 Old tuberculosis 2 Old osteomyelitis 1 Psycho-neurosis 2 Fractured spine 1 Enuresis 1 Varicose veins 1 Glycosuria 3 Epilepsy 3 Chronic Otitis media 3 Chronic deafness 2 Diabetes mellitus 1 Slipped disc history 1 Mitral stenosis 1 Pleural effusion 1 Bilateral hernia 1 Gastric condition 1 Bronchitis 1 Valvular disease of heart 1 At the beginning of 1953 the council decided to put into operation a scheme for streamlining sick leave arrangements. The scheme has continued to work smoothly and satisfactorily and during the year 30 examinations in this connection were conducted by the Department's medical staff. Financial contributions to Voluntary organisations Subscriptions to the funds of voluntary bodies were, on the 53 recommendation of the Health committee, made by the council during 1955, as follows: Organisation Central Council for Health Education National Smoke Abatement Society Amount £ s. d. 11.11. 0. 12.12. 0. Statutory Authority Public Health (London) Act, Act, 1936, Section 298. Public Health (London) Act, 1936. Section 298. Local Government Act 48, Section 136. Conferences. The Council were officially represented at the undermentioned Conferences dealing with matters within the purview of the Public Health Department:- Conference Sanitary Inspectors' Association, Scarborough - 13th 16th September, 1955 Royal Sanitary Institute, Bournemouth - 26th-29th April 1955 National Smoke Abatement Society, Bournemouth - 28th30th September, 1955 Fourth Commonwealth Health & Tuberculosis London 21st-24th June 1955, Delegates Mr, W. Rigby, Senior Sanitary Inspector. Councillor Mrs E.O.K. Finn, M.B.E., Dr. F.M. Day Medical Officer of Health Councillor E.R. Gosling, Dr. A.J. Shinnie. Deputy Medical Officer of Health. Councillor Mrs, E.O'K Finn, M.B.E., Dr. F.M Day, Medical Officer of Health. Health Information Bureau. The Health Information Bureau continued its work, successfully, and again the opportunity was taken to fuse into the Bureau all enquiries on numerous health matters which normally come to the Department, and 4,798 of these came into the Bureau up to the end of the year. They varied from passes for blind persons on buses to vacancies for students in Mental Hospitals, and in looking up the answers to such tongue twisters, we taught ourselves a lot that we didn't know in 1954. A revised copy of the Health Services Guide was printed and approximately 2,500 copies were distributed, and once again many copies were sent to various parts of the British commonwealth and many Authorities throughout the Country. Authority has again been received from the Health committee for a further revised Edition of the Guide to be issued for 1956. 54 STATISTICAL SUPPLEMENT TO ANNUAL REPORT FOR YEAR 1955. GENERAL STATISTICS-1955 Area 2,282.5 acres Population (1955) (estimated) 114,700 „ (1954) (estimated) 116,500 „ Census (1951) 119,367 Natural increase, i.e., excess of births over deaths 462 Marriages registered 1,375 Rateable value (April, 1955) £1,298,748 Sum represented by a penny rate (April, 1955) £5, 310 EXTRACT FROM VITAL STATISTICS-1955 Total M. F. Live Births (Legitimate ( 1,574 818 756) ) Birth Rate per 1,000 estimated (Illegitimate 133 67 66) resident population=14.8 Stillbirths 42 21 21 Rate per 1,000 total (live and still) births =24.0 Deaths 1,245 683 562 Death Rate per 1,000 estimated average population =10.8 Deaths from maternal causes- Deaths Rate per 1,000 total (Live and still) births. Pregnancy, childbirth, abortion 2 1.14 Total 2 1.14 Death Rate of Infants under one year of age:- All Infants per 1,000 live births 30 Legitimate infants per 1,000 legitimate live births 30.49 Illegitimate infants per 1,000 illegitimate live births 22,55 Deaths from Cancer (all ages) 269 „ „ Measles (all ages) - „ „ whooping Cough (all ages) - 56 NATURAL INCREASE OR DECREASE OF THE POPULATION DURING THE PAST 20 YEARS Year Population Excess of Births over Deaths Excess of Deaths over Births 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 66 2 - 1950 119, 200 691 - 1951 118,300 377 - 1952 118,800 420 - 1953 117, 600 543 - 1954 116,500 705 - 1955 114,700 462 - Birth Rate Population Figure. D-Death Rate Population Figure. INCIDENCE OF CANCER DURING THE PAST 10 YEARS Year Population Deaths Rate per 1,000 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 1953 117,600 222 1.9 1954 116,500 232 2.0 1955 114,700 269 2.3 57 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 1953 M - 2 18 25 2 47 F - - 1 3 1 5 Total - 2 19 28 3 52 1954 M - - 31 11 11 53 F - - 4 3 2 9 Total - - 35 14 13 62 1955 M 1 4 31 19 3 58 F - 1 3 - 2 6 Total 1 5 34 19 5 64 58 INCIDENCE OF PULMONARY TUBERCULOSIS AND NEOPLASMS OF THE LUNGS Age Groups Pulmonary Tuberculosis Neoplasms of the Lung or Bronchus 1954 1955 1954 1955 MALES 0- - - - - 1- - - - - 5- - - - - 15- 1 - - 1 25- 2 1 - 4 45- 4 7 31 31 65- 5 3 11 19 7 5- 1 2 11 3 Total Males 13 13 53 58 FEMALES 0- - - - - 1- - - - - 5- - - - - 15- - - - - 25- 2 1 - 1 45- 2 2 4 3 65- 1 - 3 - 75- - - 2 2 Total Females 5 3 9 6 59 VITAL STATISTICS OF WHOLE DISTRICT 1955 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 D116,200 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 1953 117,600 1,750 14.0 1,409 12.0 498 296 35 20 1,207 10.3 1054 116,500 1,776 15.2 1,382 11.8 606 205 38 21 1,071 9.1 1955 114,700 1 707 14.8 1,495 13.0 643 393 51 30 1,245 10.8 * B= Birth-rate Population Figure. D=Death-rate Population Figure. 60 61 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1935 Cause of Death Sex 0. 1- 5- 15- 25- 45- 65- 75- Total all Ages 1. Tuberculosis, respiratory M _ _ _ _ 1 7 3 2 13 F _ _ _ _ 1 2 _ _ 3 2.Tuberculosis, other M _ _ _ _ _ _ _ _ _ F _ _ _ _ _ _ _ _ _ 3. Syphilitic disease M _ _ _ _ _ 1 5 1 7 F _ _ _ _ _ _ _ 1 1 4. Diphtheria M _ _ _ _ _ _ _ _ _ F _ _ _ _ _ _ _ _ _ 5. Whooping cough M _ _ _ _ _ _ _ _ _ F _ _ _ _ _ _ _ _ _ 6. Meningo-coccal infections M _ _ _ _ _ _ _ _ _ F _ _ _ _ _ 1 _ _ 1 7. Acute Poliomyelitis M _ _ _ _ _ _ _ _ _ F _ _ _ _ _ _ _ _ _ 8. Measles M _ _ _ _ _ _ _ _ _ F _ _ _ _ _ _ _ _ _ 9. Other infective and parasitic diseases M _ _ _ _ _ _ _ _ _ F _ _ 1 _ _ _ _ _ 1 10. Malignant neoplasm, stomach M _ _ _ _ _ 11 7 2 20 F _ _ _ 1 _ 5 1 2 9 11.Malignant neoplasm, 1ung bronchus M _ _ _ 1 4 31 19 3 58 F _ _ _ _ 1 3 _ 2 6 12. Malignant neoplasm, breast M _ _ _ _ _ _ _ _ _ F _ _ _ _ 2 11 6 4 23 13. Malignant neoplasm, uterus M _ _ _ _ _ _ _ _ _ F _ _ _ _ 2 9 1 3 15 14. Other malignant and lymphatic neoplasms M _ _ _ 1 3 31 20 27 82 F 1 _ _ 1 6 18 16 14 56 15.Leukaemia, aleukaemia M _ _ 1 _ _ _ _ 1 2 F _ _ _ _ 2 1 1 _ 4 16. Diabetes M _ _ _ _ _ 1 _ 1 2 F _ _ _ _ _ 1 1 1 3 17.Vascular lesions of nervous system M _ _ _ _ 2 15 18 24 59 F _ _ _ _ 4 11 18 48 81 18. Coronary disease, angina M _ _ _ _ 4 48 30 27 109 F _ _ _ _ 2 12 17 23 54 19.Hypertension with heart disease M _ _ _ _ _ 5 6 11 22 F _ _ _ _ 1 3 2 6 12 20. Other heart disease M _ _ _ 2 2 13 20 20 57 F _ _ _ _ 2 1 15 49 67 21. Other circulatory disease M _ _ _ 1 1 6 7 8 23 F _ _ _ 1 _ 2 11 25 39 22. Influenza M _ _ _ _ 1 1 _ _ 2 F _ _ _ _ 1 _ 1 _ 2 23. Pneumonia M _ _ _ 1 _ 4 10 14 29 F 2 2 _ _ _ 4 8 20 36 24. Bronchitis M 1 _ _ _ 1 24 28 22 76 F 1 _ _ _ _ 10 9 18 38 25. Other diseases of respiratory system M _ _ _ _ _ 3 1 1 5 F _ _ _ _ 1 1 2 _ 4 26. Ulcer of stomach and duodenum M _ _ _ _ _ 6 6 2 14 F _ _ _ _ _ _ 2 1 3 27. Gastritis, enteritis and diarrhoea M 1 _ _ _ _ 1 _ _ 2 F 1 _ _ _ _ 2 3 _ 6 28. Nephritis and nephrosis M _ _ _ _ _ 1 2 _ 3 F _ _ _ 1 _ 1 2 _ 4 29.Hyperplasia of prostate M _ _ _ _ _ 2 2 5 9 F _ _ _ _ _ _ _ _ _ 30. Pregnancy, childbirth, abortion M _ _ _ _ _ _ _ _ _ F _ _ _ _ 2 _ _ _ 2 31. Congenital malformations M 2 1 _ _ _ 1 _ _ 4 F 6 1 1 _ 2 1 _ 1 12 32. Other defined and illdefined illnesses M 23 2 - _ 3 14 7 12 61 F 12 1 1 2 3 8 13 18 58 33. Motor vehicle accidents M _ _ _ _ 1 _ _ 1 3 F _ _ _ _ _ 1 1 1 3 34. All other accidents M _ _ _ _ 4 3 1 1 9 F 1 _ _ 1 1 1 5 6 15 35. Suicide M _ _ _ 1 3 9 _ _ 13 F _ _ _ 1 2 _ _ _ 3 36. Homicide and operations of war M _ _ _ _ _ _ _ _ _ F _ _ _ 1 _ _ _ _ 1 Total of all causes M 27 3 1 7 30 238 192 185 683 F 24 4 3 9 35 109 135 243 562 51 7 4 16 65 347 327 428 1245 62 63 INFANT MORTALITY-1955 and Previous Years Year Births Deaths of Infants Deaths of Infants per 1,000 births Average 1906-1613 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 60 193 7 1,913 130 68 1938 1,874 117 62 1939 1,829 77 43* 1940 1,600 76 51¢ 1941 1,405 52 41ff 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 1953 1,750 35 20 1954 1,776 38 21 1955 1,707 51 30 * Rate calculated on a birth figure supplied by the RegistrarGeneral of 1,78 1. ¢ Rate calculated on a birth figure supplied by the RegistrarGeneral of 1,501. ff Rate calculated on a birth figure supplied by the RegistrarGeneral of 1,253. 64 Net deaths of infants at various ages under one year of age Under 1 week 38 1-2 weeks 1 2-3 weeks 2 3-4 weeks 1 4 weeks and under 3 months 1 3 months and under 6 months 5 6 months and under 9 months 2 9 months and under 1 year 1 Total deaths under 1 year 51 NET BIRTHS IN THE YEAR: Legitimate 1,574, Illegitimate, 133 NET DEATHS IN THE YEAR: Legitimate Infants, 48, Illegitimate Infants, 3 65 99 CHART SHOWING THE NUMBER. OF DEATHS OF INFANTS UNDER 1 YEAR OF AGE DURING THE PAST 20 YEARS INFANT MORTALITY RATES - ENGLAND AND WALES AND VARIOUS OTHER COUNTRIES Deaths under 1 year per 1,000 live births Country 1950 1951 195 2 1953 1954 England and wales 30 30 28 27 25 Scotland 39 37 35 31 31 Northern Irel and 40 41 39 38 33 Australia 24 25 24 23 22 Canada 41 38 38 35 32 Chile 153 149 134 114 124 Denmark 31 29 29 27 27 France 52 51 46 42 41 Irish Republic 45 45 41 39 38 Italy 64 67 64 59 53 Netherlands 25 25 23 22 21 New Zealand 23 23 22 20 22 Sweden 20 21 20 19 19 United states of America 29 29 29 28 27 MATERNAL MORTALITY - 1955 and Previous Years Number of Deaths Year Pregnancy, childbirth, abortion Number of live Births Maternal Death Rate[/##] 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 19 40 - 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 1953 3 1,750 1.67 1954 3 1,776 1.66 1955 2 1,707 1.14 * 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". 67 ENVIRONMENTAL HEALTH SERVICES (A) SANITARY INSPECTION Cause of Inspection No. of Inspections No. of Notices served No. of. Notices complied with Atmospheric Pollution 11 - - Bakehouses 98 - - complaints 3,751 1,342 1, 181 Drainage 2,384 9 5 Factories (Mechanical) 427 15 13 Factories (Non-Mechanical) 119 2 4 Food (other than Restaurants and Eating Houses) 2.377 4 1 Hairdressers & Barbers 95 - • Housing Act 241 2 - Housing Applications 703 42 30 House to House 411 - - Housing Repairs and Rents Act 252 8 2 Ice cream vendors 469 - - Infectious Diseases 367 3 1 Markets 603 - - Milk vendors 660 - - Outworkers 1135 - 5 Pet Animals Act 9 - - Pharmacy and Poisons Act 130 - - Public Urinals 14 - - Rag Flock Act 3 - - Rats and Mice 2,999 87 76 Restaurants and Eating Houses 507 6 13 Shops Act 159 10 6 Slaughterhouses - - - smoke Observations 136 1 2 Miscellaneous 1,287 38 50 Re-visits 7,961 435 744 No answer 1,913 - • 29, 221 2,004 2,133 No. of Ineffective visits 1,913 - - Total 27,308 2,004 2, 133 During the year 928 statutory Notices were served and 637 complied with. (B) SUMMONSES - Proceedings instituted during the year Public Health (London) Act, 1936 102 Food and Drugs Act, 1938 3 L.C.C Byelaws 13 Housing Act, 1936 1 68 (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. 105 119 2 - (ii) Factories not included in (i) in which section 7 is enforced by the Local Authority 562 427 15 - (iii) Other Premises in which section 7 is enforced by the Local Authority (excluding out-workers' premises) - - - - Total 667 546 17 - 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. 1) 9 9 - - - Overcrowding (s. 2) - - - - - Unreasonable Temperature (s. 3) - - - _ . Inadequate ventilation (s. 4) . - - - - Ineffective Drainage of Floors (S- 6) . _ - - - Sanitary conveniences (s. 7)- (a) Insufficient - . - _ - (b) unsuitable or Defective 4 3 - - - (c) Not separate for sexes 2 2 _ - - Other offences against the Act (not including offences relating to Out-work) 4 - 4 - - Total 19 14 4 - - 69 OUTWORK Nature of work Section 110 Section 111 No. of Out- workers in August List required by Sect. 110 (l)(c) No. of Cases of Default in ing Lists to the Council No, of Prosecutions for Failure to supply Lists No. of Instances of Work in Unwholesome Premises Notices Served Prosecu t ions Chocolates and Sweetmeats 86 - - - _ . wearing ApparelMaking, &c 240 - - - - - Brass and Brass Articles 2 - - - - - Lampshades 6 - - - - - Curtains and Furniture Hangings 6 - - - . . Furniture and Upholstery 3 - - - - - Electro-Plate 6 - - - - - Artificial Flowers 1 - - - - - Paper bags 60 - - - - - Feather sorting 4 - - - - - Carding, &c, of Buttons, &c. 61 - - - - - Stuffed Toys 73 - - 2 2 - Umbrellas 1 - - - - - Cracker Bon-bon, Christmas crackers, Christmas Stockings, &c 168 - - - - - Household Linen 2 - - - - - Total 719 - - 2 2 - 70 (D) UNSOUND FOOD CONDEMNED - 1955 Baby pood 1 Packet Bacon 26 lbs. Beans , Baked 39 tins Biscuits 6 packets Cereal 17 packets Cheese 38 lbs. Chicken 2 tins Chocolate Teacakes 42 Packets Cream 38 tins Custard powder 37 packets Desiccated coconut 146 lbs. Eggs, frozen 558 tins Fish 474 tins Fish 425 lbs. Flour 1 lb. Fruit, Dried 120 lbs. Fruit, Juice 70 tins Fruit 395 tins Ham 170 tins Jam 13 tins Meat 1628 lbs. Meat 243 tins Milk 182 tins Mincemeat 1 Jar Nescafe 2 tins Nuts, shelled 340 lbs. Peas 88 tins Pease Pudding 5 tins Pickles 12 Jars Pudding 4 tins Sauce 3 bottles sauerkraut 32 tins Sausages 24 tins sausages 1 lb. Soup 53 tins SP aghetti 15 tins Tomatoes 61 lbs. Tomatoes 211 tins Tomato Puree 7 tins Vegetables 44 tins 71 PUBLIC MORTUARY - Bodies Admitted, &c. Bodies admitted from the Borough:- By order of coroner 270 By order of Police 3 On application of undertakers 20 293 Bodies admitted from other Boroughs:- Fulham, (seventy by order of Coroner, and seven by order of Police ) 77 Chelsea (two hundred and sixty-nine by order of Coroner, four by order of Police and two by application of undertakers). 275 Kensington (Twenty-one by order of Coroner) 21 373 Total bodies admitted 666 No. of P.M. examinations conducted:- Hammersmith cases 271 Fulham cases 70 Chelsea cases 268 Kensington cases 21 Total P.M.'s 630 No. of Inquests held:- Hammersmith cases 74 Fulham cases 37 Chelsea cases 59 Kensington cases 65 Total Inquests held 235 72 INFECTIOUS DISEASES Diseases Notifications Tot al 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 - 2 28 57 2 _ _ 89 20 _ 87 Whooping cough 24 24 66 82 - 1 1 - 198 21 - 194 A. Poliomyelitis (Par). 5 4 9 21 10 5 1 - 55 55 - 17 " " (N. Par). - - 6 9 2 2 - - 19 19 - 18 Measles 53 160 692 720 15 8 1 - 1,649 79 - 1,645 Diptheria - - - - 4 1 - - 5 5 - - Pneumonia 7 4 21 18 3 £6 24 21 114 23 65 113 Dysentery 2 8 15 35 6 12 9 1 88 29 - 80 Acute Encephalitis (Inf). - - 1 - - - - - 1 1 . - Enteric or Typhoid Fever - - - - - - _ _ - - . - Paratyphoid Fever 1 1 - - 1 1 . - 4 4 _ 4 Erysipelas - - - - - 1 8 1 10 - - 10 Meningococcal Infection - 2 2 5 1 1 - - 11 11 1 3 Food Poisoning 2 - 2 2 5 6 5 4 26 9 - 23 Puerperal Pyrexia - - - - 103 113 - - *216 _ - 216 Ophthalmia Neonatorum 3 • - - - - - - 3 - - 3 Malaria - - - - 2 2 - _ 4 4 - 3 Scabies 3 1 5 10 8 23 3 - 53 - _ 53 Tuberculosis (Pulmonary) - - - 9 28 52 37 9 135 43 16 135 " (Non-Pulmonary) - - - 1 6 7 1 — 15 12 - 15 Totals 100 206 847 969 196 251 90 36 2,695 335 82 2,619 * Of this total only 60 cases related to persons residing in the Borough . TUBERCULOSIS Summary of Notifications during the period from the 1st January, 1955, to the 31st December, 1955. 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 - - - 3 2 2 7 15 15 13 17 6 - 80 Respiratory, Females - - - 2 2 8 11 14 8 7 _ 3 _ 55 Non-Respiratory, Males - - - 1 - - 3 2 1 . 1 - _ 8 Non-Respiratory, Females - - - - - 2 1 2 2 - - - • 7 CASES NOTIFIED AND DEATHS - 1955 and Previous years Year No. of cases notified No. . of Deaths No of cases on Register of Notifications. Pulmonary NonPulmonary Total 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 1953 198 17 215 33 1,595 1954 167 13 180 21 1,495 1955 135 15 150 16 1,510 Average number of cases notified for the 10 years 1936/1945 (Inclusive) - 197. Average number of cases notified for the 10 years 1945-1955 (Inclusive) - 195. Average number of deaths for the 10 years 1936-1946 (Inclusive) - 100. Average number of deaths for the 10 years 1946-1955 (Inclusive) - 50. 74 75 CHART SHOWING THE NUMBER. OF NEW CASES OF TUBERCULOSIS NOTIFIED DURING THE PAST 20 YEARS. PULMONARY TUBERCULOSIS : NON-PULMONARY TUBERCULOSIS : MEDICINAL BATHS Cleansing of verminous persons School Children - Hammersmith scabies 98 Verminous 620 Impetigo 1 School children - Non -Hammersmith Scabies 14 Verminous 3 Children under Five years - Hammersmith Scabies 13 Verminous 31 Children under Five years - Non-Hammersmith Scabies 9 Verminous 1 Adults - Hammersmith Scabies 108 Verminous 98 Other conditions 38 Adults - Non-Hammersmith Scabies 37 Verminous 27 Lodging -Houses Scabies 5 Verminous 155 DISINFECTION Hammersmith Non-Hammersmith Cases Cases Mattresses 434 85 Pillows 258 113 Bolsters 16 14 Blankets 208 76 Sheets 94 33 Quilts 24 24 Clothing *824 153 Carpets 46 - Sundries *398 56 Total 2,856 * 50 custom's certificates issued in respect of 508 articles (489 Clothing, 19 sundries) Rooms (including 495 verminous Rooms), 573. 76