A C4347 HAM 148 Metropolitan Borough of Hammersmith ANNUAL REPORT of the Medical Officer of Health with M.R.C.S . L.R.C.P., D.T.M., D.P.H. Bacd by 23.8.57.7 METROPOLITAN BOROUGH OF HAMMERSMITH Health Committee At 31st December, 1956. Councillor E. O.K. Finn (Mrs.) M.B.E. (Chairman) " E.W. Flynn (Vice-Chairman) " S.M. Atkins " A. Belsham " J.A. Blanckensee " J. Farndale " E.D. Freeman (Mrs.) " D.M. Heaks (Mrs.) " F. W. Ing " E.M. Tebay, F. I. A. C. " E.C. Woods (Miss) " E.A. Worne 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 Commlttee. 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 Staff 2 SECTION A - SOCIAL CONDITIONS AND STATISTICS:- Births 4 Deaths 4 Infant Mortality 5 Marriages 4 Maternal Mortality 5 Population 4 Social Conditions 3 SECTION B - PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASES:- Contacts and Carriers - Sickness Benefit 6 Dysentery 7 Food Poisoning 7 Health Laundry 11 Medicinal Baths 8 Notifications 6 Poliomyelitis 7 Tuberculosis 6 SECTION C - HOUSING:- Overcrowding (Section 61) 16 Permanent Estates 15 Re-housing 15 SECTION D - INSPECTION AND SUPERVISION OF FOOD:- Designated Milk - Licenses 24 Food & Drugs Act, 1955 17 Ice Cream 21 Ice Cream (Heat Treatment etc.) Fiegulations 1947- 1952 21 Ice Cream and Preserved Food Premises 22 Markets 20 Meat and other Foods 18 Milk Supplies 23 Olympia Exhibition Halls 20 Public Health (Condensed Milk) Regulations. 1923/48 25 Sampling 19 Wormwood Scrubs Fair 20 SECTION E - SANITARY ADMINISTRATION:- Coroner's Court and Public Mortuary 27 Exhumation and Re-interment of bodies 26 Housing Repairs and Rent Act, 1954 26 L.C.C. (General Powers) Act, 1952 - Rag and Bone Dealers 27 L.C.C. (General Powers) Act. 1954 - Hairdressers and Barbers 28 Pet Animals Act, 1951 27 Pharmacy & Poisons Act, 1933 and Pharmacy & Medicines Act,1941 28 Public Baths and Washhouses 28 Lag Flock and Other Filling Materials Act, 1951 27 Staff - Inspectorial 26 SECTION F - SANITARY CIRCUMSTANCES:- Atmospheric Pollution 32 Drainage 30 Dustbins 30 Factories 31 Public Cleansing 30 Rodent Control 31 Sanitary Inspection 31 Water Supply 30 SECTION G - GENERAL PROVISION OF HEALTH SERVICES:- Page Ambulance Facilities 34 Burial or Cremation of the Dead 39 Conferences 42 Diseased or Infirm Persons 39 Financial Contributions to Voluntary Organisations 41 Hammersmith Chest Clinic 35 Health Information Bureau 42 Hospitals 34 International Certificates of Vaccination and Inoculation 38 Laboratory Facilities 34 Old People's Welfare 40 Personal Health Services 35 Clinics and Welfare Centres 36 Creches 37 Day Nurseries 38 Domestic Help Service 38 Staff Medical Examinations 41 STATISTICAL SUPPLEMENT - TABLES Causes of Death in Age Groups 51 Deaths from Carcinoma of Lungs in Age Groups 47 Disinfection 65 Extract from Vital Statistics 45 Factory Defects 58 Factory Inspections 58 General Statistics 45 Incidence of Cancer during the past 10 years 46 Incidence of Pulmonary Tuberculosis and Neoplasms of the Lungs 48 Infant Deaths under 1 year in age groups 54 Infant Mortality 53 Infant Mortality Rates - England and Wales and various other Countries 56 Infectious Diseases - Notifications in Age Groups 62 Maternal Mortality 56 Medicinal Baths - Cleansing of Verminous Persons 65 Mortuary and Coroner's Court 61 Natural Increase or Decrease of the Population during the past 20 years 46 Outworkers 59 Sanitary Inspection, Notices served and complied with 57 Summonses - Proceedings instituted 57 Tuberculosis - Notifications and deaths for the past 20 years 63 Tuberculosis - Notifications in sex and age groups 63 Unsound Food Condemned 60 Vital Statistics of Whole District 49 CHARTS Birth and Death Bates for the past 20 years 50 Number of Infant Deaths under 1 year of age during the past 20 years 55 Number of new cases of Tuberculosis notified during the past 20 years 64 Proportion of Deaths from Principal Causes 52 Town Hall, Hammersmith, W. 6. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Hammersmith Mr. Mayor, Ladles and Gentlemen, I have very much pleasure In presenting to you my Annual Report on the health circumstances of the Borough for the year 1956. Once again, I regret that It was not possible to publish It earlier, as the Registrar General's figures required to calculate the various rates are not available sooner. We have been fortunate In having no dangerous Infectious disease for many years now. Last year's epidemic of paralytic poliomyelitis has not been repeated and one hopes that with vaccination gaining momentum we shall be better protected In future. Fatal and paralytic cases so often occur in adult life, and age groups at present vaccinated are much too restricted to reduce epidemics to any marked extent. It is felt, now that the public have accepted poliomyelitis vaccination, a more ambitious programme should be attempted and more age groups should be protected. Our control over Infant and maternal mortality, and tuberculosis, continues to result in saving countless numbers of lives, but on the debit side, cancer of the lung and disease of the heart continue to Increase. There has not been a death from diphtheria for 12 years, and this "scourge of the twenties and thirties", like scarlet fever, has vanished, possibly temporarily, as a menace to public health. In conclusion, I wish to express my Indebtedness for the encouragement shown and support given me at all times by the Chairman, VlceChairman and Members of the Health committee and to record my thanks to the Staff of the Department for their loyal co-operation In maintaining a high standard of efficiency throughout the year. I am, your Worship, Ladies and Gentlemen, Your obedient Servant, F.M. DAY, Medical Officer of Health, 1 STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December, 1956 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- Shlnnle, O.B E., M.D, D.P.H. Administrative Officer: c* P.W Pottler (Part-Time): Clerical: J.C.Turner (1st Assistant) W, M. Robinson T.J.Hares Mrs. F.Lawford Mrs. D. Kelley E-G.Baines (Temporary) Mrs. L.G.StImpson Miss J.New Miss I. E-Waller (M.O.H.'s Secretary) Senior Public Health Inspector: o¢* W. Rigby Public Health Inspectors: ®<£* P. T. Bayes (Deputy Senior) ¢# H. R. Fry iu J. c.Hopkins # E-W-Plke Ht G.G.Gardiner # J,M,Read II † "# Miss E.M.Cross o ¢# C.H.Wright o$# S.C-Metcalf Food and Drugs Inspector' $* W.J.Godden Student Public Health Inspectors: A.O.Guy G.Bethell (Recalled to H M Forces 8.8.56) Mortuary Keeper: D, A, Mackay Medicinal Baths Superintendent: II F.G. Baldwin Public Analyst: D. F.H, Button, A. RcCcS., F R-I.C. * Cert. Sanitary Inspectors' Examination Board. Cert. Royal Sanitary Institute (Meat and other foods). 6 Smoke Abatement Cert., L„C,C. School of Engineering. * Cert. Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. o Cert. Royal Sanitary Institute (Smoke) $ Cert. Royal Sanitary Institute (Inspector). * Cert. Royal Sanitary Institute (Health Visitor). 4 Cert. Royal Sanitary Institute (General Science and Sanitation.) X Cert. Rcyal Sanitary Institute (Sanitary Science as applied to Buildings and Public Works). / State Certified Midwife | State Registered Nurse 2 SECTION A SOCIAL CONDITIONS OF THE BOROUGH AND STATISTICS Hammersmith Is a westerly Borough In the County of London, covering an area of 2,282.5 acres. It Is bounded on the north and west by Middlesex Borougis, on the south by the Thames, and on the east by the Royal Borough of Kensington and the Metropolitan Borough of FUlham. The sub-soli In the northern half of the Borough, I.e. north of Uxbrldge Road, mainly consists of clay, whilst in the south it consists of a layer of seme 20 feet of gravel above blue clay,particularly over in the east, much of which was excavated for brick, making purposes before building development occurred. We have approximately 287 acres of parks and open spaces, of which 262 acres are controlled by the London County Council, and the remaining 25 acres by the Council. Hammersmith, once a quiet rural area in the County of Middlesex and untouched by the spread of London, became part of the County in 1885, and is now a highly developed industrial and residential area, and almost nothing remains of old times. The Latymer Foundation School was founded in 1624 and Kent House and others in the Malls date back to the seventeenth century. Kelmscott House, the home of William Morris, and also houses In Hamnersmlth Terrace were built In the 17th and 18th centuries. Apart frcm Its residential and industrial population a large number of visitors are attracted by various centres which perhaps are world famous. St. Paul's Boys and Girls' Schools, West London and Royal Masonic Hospitals, Queen Charlotte' s Maternity Hospital, Hanmersmlth Hospital and British Postgraduate Medical School, the White City Stadium, Olympla and the Television Studios at Lime Grove and woodLana Wormwood Scrubs also attracts its quota of people from outside our boundaries. The Boat Race too brings many visitors 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 68 miles and traffic Is very heavy particularly over Hanmersmlth Bridge leading to the south, and on the main roads to Oxford, the Wtest and London Airport. Towards the end of the year the portion of the new Cromwell Road Extension, now known as the Great West Road, from Hanmersmlth Bridge Road to Chiswlck Lane in the Borough of Brentford and Chlswick was opened for vehicular traffic by the Chairman of the London County Council, Mrs. Helen c. Brentwlch, J.P., and work on a further section eastwards towards Barons Court is in progress, and as a result the Thames side area had been opened up and much improved. The new road consists of a dual carriageway with roundabouts and subways, and It is proposed to Join the old section of the Great West 3 Road at Chiswlck by means of a "flyover". 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 e stlmated population adopted by the Registrar General namely, 113,300 which compared with 114,700 for 1955 shows a reduction of 1,400. This Is the fifth year the Registrar General has reported a reduction. There has been no epidemic causing any mortality during the year and the excess of births over deaths has been maintained. (b) Marriages. The number of marriages solemnised during the year was 1,288 being a decrease of 87 as compared with the previous year. Particulars are set out hereunder:- The Register Office 500 Buildings registered for marriages (Roman Catholic Churches and Chapels) at which a Registrar attends 374 Churches of the Church of England 362 Authorised Persons (Chapels at which a Registrar does not attend) 29 Jewish Synagogues 23 1,288 (c) Births. The corrected number of births for the year as supplied by the Registrar was 1,810. On the estimated population of 113,300 this represents an annual rate of 15.9 births per thousand persons living, viilch Is 1.1 higher than the previous year. (d) Deaths. During the year 1,414 deaths were registered. Add to this figure 449 deaths of residents of the Borough who died In various parts of England and transferred by the Registrar General, and deduct 563 deaths of non-residents and 19 transferable deaths which occurred the correct 4 figures show a total of 1,281 deaths of residents (671 males and 610 females which shows an Increase of 36 as compared with 1955. On the estimated population of 113,300 the corrected number of deaths per 1,000 persons living was 11.3 as compared with 10.8 last year. In the Statistical Supplement will be found a chart showing the proportion of deaths from the principal causes, from which will be seen that diseases affecting the heart and Important blood vessels come first with cancer second and lung conditions third, which Is the same order as last year. (e) Infant Mortality. The number of deaths of Infants under one year of age during the year was 39, giving an annual mortality rate for 1,000 live births of 21, as compared with 30 last year. ( f) Maternal Mortality. There were no maternal deaths during the year. This Is the first time I have been able to report a nil return since 1940. 5 SECTION B PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASES Infectious Diseases 1,237 cases of Infectious diseases were notified during the year, 211 cases were removed to hospital, and of this number 36 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 1,201. These figures show a decrease on the previous year of 1,418 cases. This is because there was no measles epidemic and there was a decrease In the number of cases of Poliomyelitis, Scarlet Pever and Pneumonia, although there was a slight Increase in the number of cases of Whooping Cough and Dysentery. Two cases of suspected Diphtheria were notified, but once again I am pleased to report that neither of them was confirmed. It is also pleasing to be able to report for the twelfth year in succession, that there have been no deaths from this disease. Contacts and Carriers of Infectious Disease - Sickness Benefit. One certificate was Issued during the year in the following circumstances: - Male employee in a cake department of a food factor Who was a direct family contact of a case of Paralytic Poliomyelitis. Tuberculosis. During the year there was a slight Increase in the Incidence of this disease. The number of new cases notified during the year was 165 as compared with 150 in the previous year. These figures show an increase of 21 In pulmonary cases but a decrease of 6 in non-pulmonary cases In the Statistical Supplement will be found a chart showing the numbers of new cases notified during the past 20 years. Tuberculosis still remains a serious menace to public health, and is affecting the age groups which are vital to the productive abllity of the nation, and despite the fact that high priority is given by the housing authorities in rehousing tuberculous persons, the housing shortage still results in serious delay In obtaining satisfactory hones at the right rent for the tuberculous and their families. 6 The number of deaths from tuberculosis was 17 as compared with 16 In the previous year. Poliomyelitis I am very pleased to report a considerable decrease In the number of cases of this disease compared with the previous year. There were only three confirmed cases, all of the paralytic type, but none proved fatal. Two of the cases were In the same family which consisted of mother and father and the two patients living In overcrowded conditions In two small rooms In a basement, the whole of the family sleeping in one room. One of the children was discharged from hospital with no resultant paralysls, but it was feared that the other would be slightly paralysed in his legs for some time. The third case was a boy of l¼ years, one of three children, whose brother aged 4± years suffered from non-paralytic poliomyelitis in 1955. The patient was discharged from hospital with no apparent 111 effects. The family appears to be of a poor type, and despite the attack, in 1955, and the fact that letters regarding vaccination against poliomyelitis had been sent out by the London County Council to parents of children In particular age groups, no request was made for vaccination prior to the attack, nor has any request been made since in respect of the other child. Food Poisoning 28 cases of Food Poisoning occurred during the year compared with 23 cases in 1955. In one case only was salmonella typhi-murium identified, the remaining cases having no obvious causa organism recovered. There were no serious outbreaks during the year but foods alleged to have been responsible for the patients' condition Included comed beef fritters, steak and kidney pie, continental sausage, roast duck, ice cream, cockles, chicken essence, canned meat, canned fruit, minced meat, "hot pot", and oysters. It Is usual to condemn any recent unusual articles of dlet,but in none of the above "delicacies' were we able to confirm the patients' suspicions. Dysentery There were 138 cases Of Dysentery notified during the year compared 7 with 80 in 1955- This Increase was due mainly to the fact that there were two outbreaks in the London County Council's Day Nursery In Uxbridge Road. The first outbreak occurred in January and February and the second in November and December. The method of control in the first outbreak was to exclude all cases where bacteriological examination showed the presence of Shigella Sonnei, and in this connection faecal specimens were obtained from everyone in the Nursery, Including the Staff. No patient was allowed to return until two negative results had been obtained. The result was that all affected persons were free from infection and back In the Nursery by the middle of March. In all 32 children and 5 of the Staff were affected. During this outbreak a very detailed examination of the Nursery and its contents was carried out to ascertain how the infection was passing from person to person, but we were not able to do this. Whilst this outbreak was in progress no new admissions were allowed to take place until fourteen days after the last case reported. It was suggested during the second outbreak that the method of control should be the clinical exclusion method, In wiilch sufferers were to be excluded and no bacteriological examinations were to be carried out. This method was adopted but failed and the method of control used in the first outbreak was again put Into force but with the exception that only seven days had to elapse after the last case before fresh admissions were permitted. Again the mode of infection could not be traced. The outbreak was controlled by 19th January 1957. Medicinal Baths The Medicinal Baths in Scotts Road, Shepherds Bush, provide for the treatment of scabies, impetigo, and various verminous conditions. The work at the Baths was running quite smoothly until the middle of March when a breakdown In the supply of steam from Lime Grove Baths put all cleansing services out of action, and only a supply of cold water was available, and a few days later even this supply was cut and the Extension to the Medicinal Baths had to be closed. When the steam supply failed, emergency steps were taken and all treatment of children was arranged by the Divisional Medical Officer of the London County Council and carried out by arrangement with Dr. Weir, Medical Officer of Health of Kensington at Blechynden Mews. 8 At the beginning of April water was restored and electric immersion heaters were fitted, thus enabling treatment of head conditions to be resumed, and children and adults were again treated for Ped. Capitis and Scabies. It was, however, still not possible to carry out dlslnfestatlon of clothing and bedding, and this, as well as other verminous conditions was dealt with by Kensington. The total stoppage of treatments lasted five weeks, and the London County Council arranged for school children to attend the cleansing Centres either at FUlham or Kensington according to their convenience. As time went on it became obvious that the restoration of steam and hot water would not take place by the date estimated, and even by the end of the year the work had not been completed. The Health committee, however, provided every assistance possible to keep the service in action, and the staffs of the fulham and Kensington Borough Councils also enabled our cases to have whatever treatment was necessary. 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, the number of treatments at 730 was even lower than last year and Is the lowest ever recorded in the Borough. The figure of 193 cases treated for Scabies is, apart from 192 in 1930, the lowest recorded since the Baths opened In 1923, and is 14% lower than last year, althougi 44 families were involved In treatment. A pleasing feature Is the fact that in only three cases was re-infection noted, although in quite a number of Instances all the family did not report to the Baths. Thirteen husbands or wives of persons requiring treatment and not attending with the affected spouse were asked to attend. Ten did so, and eigjit were found to be Infected. Three families alone accounted for 63 attendances as under:- family "A" - Four in the family, two children extensively Infected total treatments 16. Family "B" Nine of the family treated, but not the husband, all severe cases, the origin said to be from a daughter on holiday from her home in Ireland - total treatments 24. Family "C" Six of the family treated, but not the husband. Two boys previously suffered In 1951 - total treatments of 23. The remaining 41 families accounted for 124 baths, and Is quite a good record. A large proportion of persons requiring delouslng have no fixed 9 abode, but owing to the Cleansing Station being closed for the best part of the year only six persons were dealt with as compared to 156 last year. The County Council retain their use of the centre for 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 preschool age have been followed up In the home and treatment (for all ages) Is available at the Medicinal Baths. Advice Is always given as to the best methods of home treatment and of preventing recurrence. There was, I am glad to report, a considerable decrease In the number of schoolchildren treated for vennlnous heads. Treatment Boom for Young Children During the year cases from Barnes, Brentford and Chlswlck, Ealing, Hayes and Harllngton, Southall and West Drayton and Ylewsley received treatment, and Barnes, Ealing, Heston and Isleworth and Richmond Borough Councils and the London County Council used our centre for steam sterilisation of bedding. On 54 occasions the West London Hospital used the service for sterilisation purposes and 13 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 Gammexane Emulsion (I.C.I) was used. 10 The mobile team Which is available for dealing with homes requiring dislnfestation was again actively engaged, and during the year 109 premises were sprayed for bed bugs and fleas (259) roans and 11 premises for infectious disease (26 rooms). A most Interesting point was the decrease In the number of fleas reported by tenants, only four rooms being treated. Fleas are heatloving insects and the cold summer may be responsible for their comparative absence. 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 only too often have to regret the purchase of old furniture Which has not been bug-proofed before sale. Nowadays many people send articles of clothing and materials to relatives living abroad, and in this connection some Eastern European countries require that the article shall be disinfected before being despatched and a Certificate to that effect produced. During the year 46 such Certificates relating to 518 articles were Issued and a nominal charge of 2.6d was made for each certificate. Where it is necessary, mattresses are supplied by the proprietors of Olympla for people who have to sleep on the premises during certain exhibitions, particular those with cattle at the DairyShow and in this connection 226 were dealt with after this particular show. The steam steriliser was also used to dry mattresses etc. of families vtfio were unfortunate enough to suffer damage from rain as a result of defective roofs in the early part of the year. Five cases of Impetigo were encountered during the year, In one case, a female of 24, it was most severe. All cases were secondary infections following ped. capitis. In the immediate pre-war period the average number of cases was about 300 a year. Health Laundry Four yeaishave now elapsed since the introduction of the Health Laundry Scheme. The continuing 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. 11 There can be no doubt of the Worth of the Laundry Service, and the fact that deterioration rarely occurs after our visits emphasises Its value with the frail and aged. It should 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. Cleansing of Soiled Linen During the year 31 new cases were added to the list of patients and 352 certificates were signed authorising the laundering of bed linen etc. 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 Heme Helps are thus brought In. The average age of all cases was 79, and only four patients were under 70 years of age. In 16 cases the service enabled patients to be admitted to hospital In a much better condition for treatment than would otherwise not have been possible. Certificates granted during 1956. Sex and Age Collections up to 31 12 56 Primary Cause of ill health Sequel F 84 158 Arthritis Service still in operation F 71 113 Spondy1i ti s Service still in operation F 76 46 Senility Service still in operation 12 Sex and Age Collection up to 31.12.56 Primary Cause of ill health Seque1[/$$$] M 76 15 Cerebral haemorrhage Admitted to Hospital F. 85 12 Arthritis Admitted to Hospital F 71 10 Apoplexy Admitted to Hospital M 80 4 Enuresis No longer necessary F 78 12 Se n i 1 i t y Deceased F 77 6 Apolexy Dece ased F 69 12 Apop1exy Admitted to Hospi t al F 84 2 Senility Admitted to nospit al F 79 2 Senility Admitted to Hospital F 84 2 Chronic Bronchiti s Admitted to Hospital F 86 32 Multiple Ventral Hernae Admitted to Hospital F 74 4 Se n i 1 i t y Deceased F 79 9 Apoplexy De c e a s e d F 87 6 Senility Admitted to Hospi t al F 89 41 Senili ty Service still in operation F 83 2 Cardiac Failure Deceased F 84 3 Senili ty No longer necessary F 80 5 Arthritis No longer nece ssary M 68 3 Enuresis Admitted to Hospital F 86 2 Senility Admitted to Hospi t al F 79 6 Carcinoma of Stomach Admitted to Hospital F 72 24 Seni1i ty Service still in operation F 84 10 Apoplexy Admitted to Hospital F 84 2 Senility Deceased 13 Sex and Age Collection up to 31.12.56 Primary Cause of ill health Seque 1[/$$$] F 82 1 Cardiac Failure No longer nec essary F 80 1 Appplexy De c e a s e d F 67 4 Cerebral Haemorrhage De c e a s e d F 89 2 Ar thri ti s Admitted to hospi tal M 70' 1 Disseminated Sclerosis No longer necessary F 69 12 Seni1i ty Service still in operation M 86 1 Se n i 1 i t y De c e a s e d F 81 1 Cardiac Failure Admitted to hos pi tal F 81 2 Paraplegi a No longer necessary F 77 1 Seni1i ty Removed to care e1sewhe re F 83 2 Intestinal Carcinoma Service still in operation M 73 1 Apoplexy Service still in operation Cleanslngs carried out during the year Included; - Sheets 2,057 Blankets 67 Pillow Slips 440 Towels 401 Nightdresses 252 Sundries 920 Total 4,137 14 SECTION C HOUSING Rehousing Hie Housing Estates Manager Is In close touch with the Health Department regarding applicants who are overcrowded or have medical troubles. If overcrowding Is found to exist by the District Public Health 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 various 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 but has recently made It known that rehousing on medical grounds must be substantially reduced during the next few years. Sixteen cases were recommended for rehousing on grounds of health, and ninety-seven on grounds of overcrowding. In addition recommendartlons were made to the Borough Council's Housing Department In cases vvhere the families were 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. Five such cases were recommended to the Housing Estates Manager during the year. I append a table showing the number of cases recommended for rehousing under the three headings mentioned above and those actually rehoused frcm 1949: - Year HEALTH GROUNDS OVERCROWDING GROUNDS SPECIAL CASES Re commended Rehoused Recommended Rehoused Re commended 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 17 8 65 17 5 1954 34 2 145 86 14 4 1955 28 3 129 55 6 5 1956 16 4 97 4 5 -• To make the above figures realistic It should be pointed out that the figures for those rehoused are extremely unlikely to be frcm recommendations of the same year. Parmanent Estates During the year both the Borough Council and the London County 15 Council have been still engaged In providing accommodation for those In the greatest need, and further schemes are In progress. Seventy-eight flats In Queen Caroline Street were completed by the London County Council and the undermentioned were completed by the Borough Council. 25/30, Linden Court 6 11/15. Lakeside Road 8 22/24, Paddenswlck Road 9 76/80, Netherwood Road 8 Flora Gardens Extension 12 Total 43 The Council acts as landlord for 3,481 principal tenants. The properties managed Include houses, flats, prefebas and requisitioned accommodation. At the end of the year there were 2,482 applicants for accommodatlon 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 separatlon of families Is measured and used as a guide In allocating accommodation. The following tables Illustrates the progress that Is being made: - 1. Number of families rehoused by the Borough Council In new flats and houses since the war 1,057 2. Number of families rehoused by the Borough Council In rebuilt houses since the war 30 3. Number of families rehoused by the Borough Council In prefabricated dwellings since the war 80 (Still living In prefabricated dwellings at the end of year. 48) 4. Number of Borough Council licensees living In requisitioned properties at the end of the year 908 OVERCROWDING (Section 61) Three licences were granted under this Section of the Housing Act, 1936, during the year. 16 SECTION D INSPECTION AND SUPERVISION OF FOOD Food & Drugs Act 1955 The chief statutory changes this Act brought about When It came Into operation on 1st January. 1956, were the consolidation of the Food & Drugs Act 1938, the Food & Drugs ( Milk Dairies and Artifcial Cream) Act 1950, Part I of the Slaughterhouse Act 1954 and the Food & Drugs Amendment Act 1954. One Important change Introduced by the new Act was the Incorporation of the Flood Hygiene Regulations 1955 Which replaced Section 13 of the Flood & Drugs Act 1938 and sections 19, 20 and 21 of the Public Health (Meat) Regulations 1984. These Regulations add a number of new provisions In respect of the hygienic handling of food and the construction and maintenance of premises, stalls, vehicles, etc., Where food is handled. The Regulations lay down requirements in respect of:- (1) the cleanliness of food premises, stalls, etc., and of apparatus and equipment. (11) the hygienic handling of food. (Ill) the cleanliness of persons engaged In the handling of food and of their clothing and the action to be taken where they suffer from, or are carriers of certain infections. (lv) the construction, repair and maintenance of food premises, stalls, vehicles, etc., and the facilities to be provided. (v) the temperature at which certain foods that are particularly liable to transmit disease are to be kept in food premises. Under the new Act a caterer convicted of offences under the Food Hygiene Regulations 1955 may be disqualified from using particular catering premises for a period not exceeding 2 years. Letters containing a summary of the principal requirements of the Food Hygiene Regulations 1955 together with a guide to the Regulations Issued by the Central Council for Health Education were sent to all occupiers or owners of food businesses in the borough. Among other new legislation concerning food Is the Flour (Composition) Regulations 1956. These Regulations provide that all flour Intended for human consumption, Aether home produced or imported, shall contain not less than 1.65 milligrams of iron, 0.24 milligrams of Vitamin B.I and 1.60 milligrams of nicotinic acid or nicotinamide per 100 grams and, except in the case of flour containing the Whole of the products derived from the milling of wheat, between 235 and 390 milligrams of crete praeparata (chalk) per 100 grams. 17 Meat and other Foods Throughout the year the routine inspection of premises, shops, stalls and vehicles where food is prepared, stored or sold was carried out. During 1956,3,461 visits were made and at 83 of these, unsatisfactory conditions constituting contraventions under the wood Hygiene Regulations 1955 were found. In each case the unsatisfactory conditions were remedied following the issue of verbal notices and warning letters by the Inspectors. The inspection of food exposed for sale, In storage and in course of preparation and manufacture was under constant supervision. No food was formally seized under Section 9 of the Act. Quantities of unsound food not coming within this section were voluntarily surrendered to the Inspectors. A list showing the amount involved is shown in the statistical supplement. The disposal of condemned or unsound food was strictly supervised by the Inspectors. Tins of unsound food were pierced and taken to the Council's wharf at Chancellors Road for transport to a controlled tip. Quantities of unsound fish and meat were disposed of in the same way., unsound meat being stained with naphthalene green dye before disposal. Diseased meat is destroyed in co-operation with the Royal Borough of Kensington at their destructor situated In the borough in Wood Lane. A list showing the number and type of premises in the borough where food is sold, stored and prepared Is given below.- BAKEHOUSES (level) 13 BAKEHOUSES (basement) 3 BAKERS RETAIL SHOPS 32 BEER BOTTLERS 1 BISCUIT MANUFACTURERS 1 BUTCHERS 72 CAFES & RESTAURANTS 180 CANTEENS AND CLUBS 67 CHEMISTS 32 CONFECTIONERS (sweet shops) 179 FISH (wet) 15 FISH (fried) 12 FISH (wet and fried) 6 FRUIT & GREENGROCERS 78 GROCERS & PROVISIONS 214 HONEY (packing) 1 ICE CREAM MANUFACTURERS 5 JELLIED EELS & PIES (manufacture & sale) 6 MILK PROCESSING DEPOTS 2 MILK DISTRIBUTION DEPOTS 32 OFF LICENCES 48 PUBLIC HOUSES 91 SWEET & CHOCOLATE MANUFACTURE 3 18 Sampling During the year 682 samples of food and drugs were submitted to the Public Analyst for chemical analysis. Of this number five were adversely reported upon. One of these was a sample of tablets reported by the Public Analyst to be 88 per cent. deficient of the Vitamin B. 1 stated to be present. The retailers who were summoned by the Council availed themselves of the provisions of Sections 113 and 115 of the Food & Drugs Act 1955, and gave notice that they Intended to prove that the contravention was due to the act or default of their suppliers, and, further, or alternatively, that they relied upon a warranty given to them by the suppliers in respect of the tablets. Both the retailers and the suppliers pleaded "not guilty". The Magistrate found that the retailers could not rely upon the warranty and that they had not proved that the contravention was due to the act or default of the suppliers; also that the contravention arose as a result of a chemical reaction In the tablets betwsen the time of manufacture and the time of sale. The summons by the retailers against the suppliers was dismissed, the retailers were granted an absolute discharge and the Council awarded £10.10.0. costs. As shown below. 314 articles of food (excluding milk and ice cream), were taken for bacteriological examination. ARTICLE OF FOOD No. of Sample s Taken — No. of samples containing the following organisms Faecal Coli Non-faecal coli Other Pa thogens Cream 6 - • . Skimmed Milk (Heated) 1 - - - Yoghourt 1 - - - Chocolate Milk Drink 2 - - - Imitation Cream 23 2 10 - Butter Cream 6 - - - Pork Sausage Meat 4 - - 2 Salmonella typhi-murium Pork Sausages 183 - - 3 Salmonella typhi -murium 1 Salmone11a braenderup 3 Salmonella an a turn 1 Salmonella bredeney Beef Sausages Beef Sausage 59 - - 2 Salmonella typhi-murium 1 Salmonella an atum Meat 5 - - - 19 ARTICLE OF FOOD No. of Sample s Taken No. of s ample s containing the following organisms Faecal Coli Non-faecal coli Other Pathogens[/$$$] Beef Minced 13 - - Shellfish 8 5- - Fish Paste 1 - - Chicken Paste 1 - - Iced Lolly 1 - - Markets The markets situate in the borough at Bradmore Lane, Railway Approach, the south side of Uxbrldge Road, and at Norland Road, have been visited on 580 occasions by the Inspectors. The large amount of food sold In these markets (because of competitive prices) calls for careful and vigilant supervision. It will be recalled that the stall holders In Bradmore Lane and Norland Road markets are licenced by the Council, whereas those In Railway Approach and the South side of Uxbrldge Road are privately controlled. Refuse Is removed dally from the private markets by a contractor. In the case of the two street markets controlled by the Council, the Borough Engineer Is responsible for the cleansing of the thoroughfares. Waste materials and refuse from the stalls Is removed several times a day. The number of vacant sites In the borough used by the stallholders for the sale of foodstuffs Is decreasing. Wormwood Scrubs Fair A Flair Is held on Wornwood Scrubs during the spring and summer Bank Holiday periods. On these occasions a number of stall-holders licenced by the London county Council cater for the popular requirements of holiday crowds with the sale of soft drinks, Ice cream, shellfish etc. Samples of these commodities were taken for chemical analysis and bacteriological examination. Olympia Exhibition Halls Exhibitions of world wide Interest are held each year at these Halls attracting both exhibitors and visitors from many countries. Many of these exhibitions are basically concerned with the sale etc. of food and drink. 20 In addition to the routine visits made to the regular catering establishments permanently connected with these Halls, the Inspection of all exhibition stands concerned with the production, preparation and sale of food and drink were made, with particular regard to the requirements of the Food Hygiene Regulations 1955. Despite the restricted space and conditions Inevitably associated with exhibition stands, a satisfactory standard of hygiene was obtained. Ice Cream Under Section 16 Food and Drugs Act 1955 the Public Health Committee approved the registration of 9 new applications for the sale of Ice cream, and at the end of the year the premises of 275 retailers and 6 manufacturers were on the Council's register. The Council's Inspectors made 306 visits to premises where Ice cream Is sold, stored or manufactured. Ice Cream (Heat Treatment etc.) Regulations 1947-1952. In the manufacture of Ice cream for sale for human consumption these Regulations require:- (1) Where a complete cold mix Is used which Is reconstituted wit water and to which nothing Is added other than colouring, flavouring, fruit, nuts, chocolate, etc., the product must be converted Into Ice cream within one hour of reconstltutlc (2) In any other case, the Ingredients after mixing shall not be kept for more than one hour at any temperature which exceeds 450F before being subjected to heat treatment by one of the following methods. Method 1. The mixture shall be raised to and kept at a temperature of not less than 150° F for 30 minutes. Method 2. The mixture shall be raised to and kept at a temperature of not less than 160°F for 10 minutes. Method 3. The mixture shall be raised to and kept at a temperature of not less than 175°F for 15 seconds. After heat treatment by one of these methods, the mixture must within 1½ hours be reduced to a temperature of not more than 45°F and so kept until the freezing process is begun. Ice cream must not be sold unless It has been kept at a temperature not exceeding 28°F since being frozen, and It must be protected from dirt, dust or otner contamination at all times during Its manuture, storage and distribution. 21 During the year 91 samples of ice cream were taken and submitted to the Public Health Laboratory Service for bacteriological examination by the methylene blue test. This test is recommended by the Ministry of Health as a guide for ascertaining the bacteriological cleanliness of ice cream, the time taken to decolourise methylene blue being recorded and the sample graded as follows:- PROVISIONAL GRADE TIME TAKEN TO DECOLOURISE METHYLENE BLUE 1. 4½ours or more 2. 2½to 4 hours 3. ½to 2 hours 4. Less than ½hour Reports on the 91 samples of ice cream taken during the year show an improvement on previous years. it is satisfactory to note than no samples came within the lowest grade, particularly as the majority of the ice cream sampled was manufactured in ice cream factories situate in the borough. The samples were graded as follows:- 62 samples were within Grade 1 standard 25 „ „ „ „ 2 „ 4 „ „ „ "3 „ Figures shownng the results of samples taken in the borough since the methylene blue test has been used for the grading of ice cream are shown below- Year No. of Samples taken Grade 1 Grade 2 Grade 3 Grade 4 Ungr aded 1951 49 29 12 3 5 - 1952 68 37 20 4 7 - 1953 105 62 22 15 4 2 1954 89 64 16 5 4 . 1955 94 60 11 12 2 9 1956 91 62 25 4 - - in addition, 14 samples of ice cream were taken for chemical analysis by the Public Analyst, all of which complied with the standard laid down by the Flood Standards (ice Cream) Order 1953 which requires that ice cream shall contain not less than 5 percent fat, 10 per cent sugar and 7½ per cent milk solids other than fat. The fat content in the samples taken ranged from 9 per cent to 12.1 per cent. ice Cream and Preserved Food Premises Under Section 16 FOOd & Drugs Act 1955 no premises (with certain exceptions) may be used for:- 22 (a) the sale, or the manufacture for the purpose of sale, of ice cream, or the storage of ice cream intended for sale, or (b) the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale, Unless they are registered under this section for that purpose by the local authority. The following summary gives details of the number and type of premises registered under this section:- ice cream manufacturers 6 " " sales only 10 Confectioners (sweet shops) selling ice cream 147 Restaurants (selling ice cream for consumption off the premises) 28 Grocers selling ice cream 78 Bakers & Confectioners selling ice cream 4 Fruit & Greengrocers selling ice cream 8 Butchers preserving meat and/or manufacturing sausages 52 Grocers preserving meat 17 Fishmongers curing fish 3 Flood Factories manufacturing sausages and preserved foods 3 The above total includes 10 new registrations effected during the year. 496 inspections of registered food premises were made during the year. Milk Supplies The Milk and Dairies Regulations 1949 to 1954 control the stration of premises and provide for the protection of milk against contamination throughout its stages of production and sale. Again it was found that the most frequent contravention under these Regulations related to the use of bottles from which all foreign matter had not been removed. it is an unfortunate fact that milk bottles are at times used for purposes other than those for which they are designed, e. g. the holding of paint, paraffin etc. Also bottles left on building sites containing cement sometimes find their way back to the milk depots. The dairy companies in the borough have issued strict instructions to their staff to destroy any such bottles. There has been in existence for some years in London and other parts of the country, a company operating a bottle recovery service who collect 'stray' milk bottles, subject them to special treatment and sell them back to their original owners. Despite these methods taken for dealing with this problem, some contaminated bottles do get filled again with milk and find their way back to the consumer. 23 During the year 489 inspections of premises used in connection with the processing and distribution of milk had been made by the inspectors. Generally, the premises were found to be satisfactory. in 13 cases it was found necessary to send warning letters in respect of unsatisfactory conditions. 101 persons were registered as distributors of milk and 8 premises were registered as dairies at the close of the year. The Milk (Special Designation) (Pasteurised & Sterilised Milk) Regulations 1949 and the Milk (Special Designation) (Raw Milk) Regulations 1949. in addition to the numbers of samples shown under "Sampling", 133 samples of Special Designated milk were taken under the above Regulations from milk distributors, milk processing depots, hospitals, schools and day nurseries. These samples were submitted for the phosphatase, methylene blue and turbidity tests, the results of which are set out below Class of Milk No. Te sted Phosphatase Te s t Meth.Blue Test Turbidity Testl Passed Failed Passed j Fai1ed Passed j Failed j Pasteurised 83 83 - 83 - - - T.T.Pasteurised 22 22 - 22 - - - Tuberculin Tested 12 - - 12 - - - Sterilised 16 - - - 16 - TOTAL 133 105 - 117 - 16 - Two samples of Tuberculin Tested "raw" milk were submitted for biological testing for the presence of tubercle bacili. in each case a negative report was received. The test is made by injecting a preparation of the milk to be tested, into the thigh of a guinea pig. At the end of six weeks the animal is killed and an autopsy is carried out to ascertain whether tuberculosis is present. The following table shews the number of licences issusd under the above Regulations during 1956 Dealers (Pasteurisers) Licences 2 Dealers (Sterilisers) " 1 DEALERS LiceNCES Tuberculin Tested 65 Pasteurised 75 Sterilised 84 34 DEALERS SUPPLEMENTARY LICENCES Tuberculin Tested 16 Pasteurised 18 Sterilised 18 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 7 samples were submitted for examination to the Public Analyst and were reported genuine. 25 SECTIONE SANitARY ADMINISTRATION On 2nd August 1956 an Act of Parliament known as The Sanitary inspectors (Change of Designation) Act, 1956 received Royal Assent and from that date the title of Sanitary inspector ceased to exist and that of Public Health inspector came into being. Staff The establishment of Public Health inspectors consists of the Senior Public Health inspector, a Deputy Senior Public Health inspector, ten other district inspectors, two Food and Drugs inspectors and one woman inspector. One of the district inspectors also acts as inspector in charge of rodent control operations. There was one resignation and one death during the year, and at one time the operational staff consisted of six inspectors including the Senior and Deputy Senior inspectors, one Pood and Drugs inspector and the woman inspector. During the year three of the vacancies were filled and the Borough is now covered by eight District inspectors one pood and Drugs inspector and one woman inspector. Exhumation and Re-interment of Bodies. During the year five licences were granted by the Secretary of State for the exhumation and removal of five 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 Housing Repairs and Rents Act, 1954. During the year applications under these Acts were received as follows:- FOR CERTifICATES OF DISREPAIR: Number received 21 Number granted 24* 26 FDR REVOCATION OF CERTifICATES Number received 27 Number granted 31* * Application for a number of these Certificates was received during 1955. Coroner s Court and Public Mortuary The number of bodies admitted to the Public Mortuary during the year was 634, a decrease of 32 compared with 1955. There were 619 post mortem examinations, this is also a decrease of 11 compared with last year. The Mortuary and Court were also used by the Boroughs of Fttlham, Chelsea and Kensington. The Mortuary is equipped with a large refrigeration plant and this ensures an entirely satisfactory standard of hygiene. Full particulars of the work carried out will be found in the Statistical Supplement. Rag Flock and other Filling Materials Act, 1951 The above Act remained in force during the year and whilst no fresh certificates of registration were issued, one registration was cancelled by request and the number of premises registered under the Act at the end of the year was nine. Pet Animals Act, 1951. Local Authorities still 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 compiled with. During the year three applications were received for new licences, two of which were approved. Eleven applications for renewal of ences were received and granted during the year, and one licence previously granted was not renewed. London County Council (General Powers) Act, 1952. During the year there were no contraventions of Section 26 of this Act, which deals with the restrictions on sales etc., by dealers in rags, old clothes and similar articles. 27 Public Baths and Wash-houses The public baths and wash-houses in Lime Grove, Shepherds Bush, provide facilities and bathing (slipper baths), swimming and laundrywork. The water in the swimming bath is controlled by filtration and chlorinatlon to secure a high degree of purity. in the public wash-houses modem facilities are provided for washing, drying and ironing at a small cost. Owing to considerable reconstruction work being carried out at the Baths all the facilities referred to above were not available for a great portion of the year. The Open Air Baths at Bloemfontein Road, Shepherds Bush, provides during the summer months, facilities for swimming and sunbathing and is open daily, including Sundays, from the middle of May to the end of August, or later according to weather conditions. The water in this bath also undergoes the required purification treatment. London County Council (General Powers) Act, 1954 Hairdressers & Barbers During 1955 the Council obtained the necessary approval to Byelaws relating to the registration of Hairdressers and Barbers. The Bye-laws came into force on 1st October 1955, and during 1956 8 further applications were received and registered, making a total of 93 Hairdressers and Barbers registered in the Borough up to the end of the year. All the premises were inspected, and as a result it was necary to serve 6 notices and send several warning letters regarding conditions. Pharmacy & Poisons Act, 1933 Pharmacy & Medicines Act, 1941 The names and address of 109 retailers were entered on the Council's list of persons entitled to sell poisons under Part II of the Pharmacy & Poisons Act, 1933 and the Pharmacy & Medicines Act, 1941. By far the greater majority of these are food retailers. in some 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 list. No action was necessary in respect of any offence under the Acts. 28 All the premises have been inspected as to their suitability, methods of storage and labelling as required under the Acts, and have been found satisfactory. 29 SECTION F SANitARY CIRCUMSTANCES OF THE BOROUGH Water Supply The Metropolitan Water Board is responsible for our supply of water and no complaints with regard to the purity of the water were made. 150 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 = 30,631 tons Amount of trade refuse collected during the year = 3,198 „ 33,829 „ Method of Disposal By road to tip at Hare field Frequence of collection (a) House refuse - weekly (b) Trade refuse - as required Drainage The Bye-laws made by the London county Council under the Metropolis Management Acts with regard to drainage, and also those under the Public Health (London) Act, relating to water closets etc., are enforced by the Council. During the year 99 drainage plans (9 of which related to combined drainage) were submitted and approved and a total of 2,124 inspections were made in connection with supervision of drainage works. Dustbins No appeals were lodged in respect of Notices served under Section 107 of the Public Health (London) Act, 1936, requiring the provision 30 of proper ashpit (dustbin) accomodation. 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 Public Health inspectors during the year, the number of preliminary and statutory notices served and complied with, and proceedings instituted, will be found in the table in the Statistical Supplement. Factories During the year 3 notices were served relating to insanitary conditions found to exist during the inspection of factories in the 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 number of complaints of rats and mice showed a decrease compared with the previous year, but as 447 premises were found to be infested it is obvious that there is still a hard core of infestations to be dealt with. During the last five years there has been an average of 100 false alarms per year, but this year the number dropped considerably, for no apparent reason, to 28. The number of infestations discovered, other than by complaint, also shows a sllgit decrease. Three "Block. Control" areas were inspected, treated and cleared of infestations. The sewers have been treated with poison bait twice during the year. The sewer infestation appears to be rather static, and during 1957 a new method is to be tried which, it is hoped, will make for an improvement. Defective drains continue to be the main factor of rat infestations, ninety four having been found to be defective and requiring repair. 31 Unfortunately one defective drain can be the cause of three or four infestations. Approximately £104 was received for treatments at Business premises during the year. The following is a summary of the work for the year with comparable figures for 195.5 in parenthesis. Premises inspected: Dwellings 525(750); Business 1,108(1,231) 1,633(1981) Complaints: Rats 364(442); Mice 121(155) 485(597) "Discovered" other than by complaint: Dwellings 40(45); Business 18(21) 58(66) Premises infested by rats; Dwellings 277(321); Business 55(61) 332(382) Premises infested by mice; Dwellings 85(146); Business 30(2) 115(176) Premises treated for infestations by Council staff 447(553) Major infestations 23(27) Notices served relating to Rodent Control 75(92) inspections and re-inspections by Public Health inspectors re Rodent Control 2,444(2941) Atmospheric Pollution The two stations set up in 1954 at Westvllle 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:- 32 LEAD PEROXIDE APPARATUS Louvred boxes sited at Ravenscourt Park and Livingstone School. Month Mg. of S.O.3 per day per 100 sq. c.c. Ravenscourt Park Livingstone School[/##] January 3.3 February 3.1 4.2 March 3.6 3.5 Apri1 2.4 3.2 May 0.9 1.5 June 0.6 1.1 July 0.6 1.4 August 0.8 September 1.2 1.9 October 1.7 2.9 November 3.0 4.2 December 2.7 4.5 * No figures available. The two other stations for measuring the concentration of smoke and Sulphur Dioxide dally at the Council's Depot in Hythe Road and at Wstcott Lodge in the South of the Borough on the river front in a residential area continued to function throughout the year. 33 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 desigiated 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. Mention of the West London Hospital reminds us that the Hospital celebrated its Centenary during the year. it was opened on 2nd July 1856, and was then known as the Fulham and Hammersmith General Dispensary, and the site of the original building is believed to be where the entrance to the London Transport Station in Queen Caroline Street is situated. During the first nine months of its life 1,270 patients were seen. 34 the total number of attendances was 9,223 and 855 people were visited in their homes. The growth of the Hospital is shown by present day figures. The Hospital has 238 beds and treats nearly 20,000 casualties who make 48,000 attendances. The Out-patients Department deal with about 19,000 new patients who mate nearly 100,000 attendances in the course of a year. Figures show that about 70% of all in-patients come from the West London area. hammersmith Chest Clinic 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 which is arranged by a special form of reference. This latter service provides a rapid means of obtaining chest X-ray without the formality of being examined by a 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 forms an integral part of the Chest Clinic service. This department is in the hands of a certificated Almoner, who is in contact with many statutory and voluntary agencies through which advice and assistance can be provided. A comprehensive management scheme for tuberculous patients is in operation in Hammersmith. Patients are treated with modem methods as out-patients or in their own homes where they are visited by the staff of the Cihest 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. During the year both Dr. V.I.Russell and her deputy, 35 Dr. R.H. Simpson, retired and Dr. B. E. A. Sharpe was appointed as Divisional Medical Officer with Dr. E.M.Cran as her deputy. The day to day administration of the services is provided by the Medical Officers of Health for the Boroughs of Chelsea, Fulham, Hammersmith and Kensington. The liaison between the staffs of the county council and the borougi 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. 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 Curve, westway Monday 9.30 a.m. Wednesday 9.30 a.m., 1.30 p.m. The Library, College Park. Wednesday 1.30 p.m. infant Welfare Centres 1/3, Milson Road Tuesday 1.30 p.m. Wednesday 9.30 a.m. Thursday 9.30 a.m., 1.30 p.m. 48, Glenthorne Road Monday 1.30 p.m. Tuesday 9.30 a.m. Wednesday 1.30 p.m. Thursday 1.30 p 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 9.30 a.m., 1.30 p.m. The Library, College Park Friday 9 30 a.m. Physiotherapy (Massage and Light) 48, Glenthorne Road Monday 1.30 p.m. Wednesday 1.30 p.m. Friday 1.30 p.m. 36 Diphther i a Immunisation 1/3, Milson Road Friday 1.30 p.m. 48, Glenthorne Road Wednesday 9.30 a.m. 3ecklow Gardens Thursday 9.30 a.in. The Curve, Westway Tuesday 9.30 a.m. The Library, College Park Friday 9.30 a.m. Vaccination 1/3, Milson Road Friday 1.30 p.m. 48, Glenthorne Road Wednesday 9.30 a.m. Becklow Gardens ... Thursday 9.30 a.m. The Curve, westway Tuesday 9.30 a.m. Chiropody 48, Glenthorne Road Monday 2 p.m. Tuesday 2 p.m. Wednesday 2 p.m. Thursday 2 p.m. Friday 10 a.m. Speech Therapy 48, Glenthorne Road Monday 1.30 p.m. Thursday 1.30 p.m. Creches 48, Glenthorne 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, laundry, visits to dentists and hospital and other duties. These Creches are also useful as play centres for the only child who needs companionship. 37 There were no such Creches in Hammersnlth and during 1955 it was decided to open one at 48 Glenthorne Road in the same building as the infant Welfare Centre. The Creche is open 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 of dentist for treatment or otherwise. 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 1/9 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 people. 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 Uxbrldge Road Day Nursery Each is open on Monday to Fridays from 7.30 a.m. to 6 p.m. and the charge for children received into than is based on the parents' income and is reduced if the circumstances warrant it. Domestic Kelp Service This service,, also administered by the County Council employs 20 full-time and 66 part-time helpers and maintained its good and valuable work during the year. its local headquarters are in the Public ffealth Department at the Town Hall. Number of cases in which help was provided:- Maternity 20 Tuberculous 26 Other 990 1,355 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 signature of Doctors on certificates of vaccination and inoculation required by travellers from this 38 country going abroad. This authentication is required to prove that the signature on the certificate of the person Who carried out the vaccination or inoculation is that of a registered medical practitioner. During the year 583 certificates were authenticated. National Assistance Act. 1948 National Assistance (Amendment) Act, 1951 Removal To Suitable Premises of Persons in Need of Care and Attention Under the provision 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 tions and are unable to devote to themselves and are not receiving from others proper care and attention. During the year 19 cases were referred to the Department as being in need of care and attention but only in one instance was it necessary to take action under the above Acts. This was in respect oft- Mrs. S. age 86, suffering from senility and confined to her bed, her room was in a filthy condition and no help was available in the house. She refused to see a Doctor or to have any help. An Order for removal under an Emergency Order was obtained and she was removed to Hospital. This Order was later extended for a further two months. Her condition gradually improved in Hospital and she was discharged home four months after removal. In 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, our 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 and one cremation were carried out at a cost of £147.17.0. of which amount £73. 9. 10d. was recovered. 39 Hammersmith Old People's Welfare Association The Hammersmith Old People's Welfare Association which discovert; and meets the needs of necessitous old persons, continued to make further progress during the year. The activities of the Association include:- Clubs arranged by the British Red Cross Society,Women's Voluntary Services, Old Age Pensioners' Associations, Missions and Churches. Each open one or two afternoons a week- Much of the entertainment of 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. in 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 Ped 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 Organ lser of the Association is available to give talks to any interested organisations in the Borcugh. There are three luncheon clubs in Church or Mission Halls providing mid-day meals at 10d. each, and two mobile meals services deliver lng 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 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, 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 1/6 per treatment, the Association paying the chiropodist on a sessional basis. There is also a chiropody service for Home 3ound patients operated by the British Fed Cross Society in conjunction with the Association. Special facilities have also teen arranged for evening classes for men and women in boot repairing, woodwork, leatherwork and home tailoring. 40 A monthly legal advice service is available, free to pensioners within certain income limits. 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 321 and of this number 79 were found to be unfit for the following reasons:- Hypertension 27 Glycosuria 2 Chronic Otitis Media 1 Gastric Ulcer 1 Otorrhoea 3 Albuminuria 1 Prostatectomy 1 T. B. Spine 1 Epilepsy 1 Low I. Q. 3 Varicose veins 1 Arthritis 2 Chest condition 3 Osteomyelitis 1 Pulmonary tuberculosis 6 injury to R,elbow 1 Duodenal ulcer 4 Dermitis 2 Asthma 1 Disc lesion 2 Psychiatric History 4 War wound 1 Defective heart 4 Totally unfit 2 Hernia 4 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 71 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 41 recommendation of the Health Canmittee, made by the Council during 1956, as follows:- Org an is at i on Amoun t Statutory Authority £ s d Central Council for Health Education 11 0 0 Public Health (London) Act. 1936, Section 298 National Smoke Abatement Society 12 12 0 Public Health (London) Act, 1936, Section 298. Local Government Act, 1948. Section 136. Conferences The Council were officially represented at the undermentioned Conferences dealing with matters within the purview of the Public Health Department:- Conference De legates Health Congress of the Royal Society for the Promotion of Health. Blackpool 24th/27th April, 1956. Councillor Mrs. E, O'K.Finn M.B.E. Dr. F.M.Day Medical Officer of Health, Sanitary inspectors Association. Bournemouth 18th/21st September. 1956. Mr. W.Rigby, Senior Public Health inspector. Food Hygiene Conference of the Royal Society for the Promotion of Health. London. 7th March 1956. Messrs. J,Collier and W.J, Godden Food and Drugs inspectors. National Smoke Abatement Society Southport. 3rd/5th October,1956 Councillor E.W.Flynn Dr. A.vLShinnie Deputy Medical Officer of Health. Health information Bureau The Health information Bureau continued its works successfully and once again the opportunity was taken to fuse into the Bureau all enquiries on numerous health matters which normally came to the Departments and 6,011 of these came into the Bureau up to the end of the year. They varied from meals for a sick child at home whilst parents worked, to arrangements for assistance in laying out a dead person, and in looking up the answers we again taught ourselves a lot we didn!t know before. A revised copy of the Health Services Guide was printed and approximately 2,500 copies were distributed, and once again many of 42 these 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 1957. 43 STATISTICAL SUPPLEMENT TO ANNUAL REPORT FOR YEAR 1956 GENERAL STATISTICS - 1956 Area 2,282.5 acres Population (1956) (estimated)113,300 „ (1955) (estimated) 114.700 " Census ( 1951) 119 367 Natural increase, i.e., excess of births over deaths 529 Marriages registered 1,288 Rateable Value (April, 1956) £2,218,926 Sum represented by a penny rate (April. 1956) £8.900 EXTRACT FROM VITAL STATISTICS 1956 Total M. F. Live Births Legitimate 1,637 / 817 820 Birth Rate per 1,000 estimated resident population s 15.9 Illegitimate 173 94 79 Stillbirths 44 27 17 Rate per 1,000 total (live & still) births .23.7 Deaths 1,281 671 610 Death Rate per ls 000 estimated average population s 11.3 Deaths from maternal causes Nil Death Bate of Infants under one year of age:- All Infants per 1,000 live births 21 Legitimate infants per 1,000 legitimate live births 21.99 Illegitimate infants per 1,000 illegitimate live births 17.34 Deaths from Cancer (all ages) 229 „ „ Measles (all ages) - „ „ Whooping Cough (all ages) - 45 NATURAL INCREASE OR DECREASE OF THE POPULATION DURING THE PAST 20 YEARS Year Population Excess of Births over Deaths Excess of Deaths over Births 1937 126,500 320 _ 1938 125,100 521 - 1939 B122,800 D116,200 438 - 1940 98,320 - 156 1941 84,880 77 - 1942 89,370 337 . 1943 92,050 468 - 1944 89,190 370 - 1945 96,100 434 ■ 1946 111,860 974 - 1947 117,280 1,190 . 1948 115,800 847 - 1949 118,440 662 - 1950 119,200 691 . 1951 118,300 377 . 1952 118,800 420 . 1953 117,600 543 - 1954 116,500 705 - 1955 114,700 462 . 1956 113,300 5 29 . B-Birth Rate Population Figure. D-Death Rate Population Figure INCIDENCE OF CANCER DURING THE PAST 10 YEARS Year Population Deaths Rate per 1,000 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 1956 113,300 229 2.0 46 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 1947 M - 3 25 7 2 37 F - - 1 1 1 3 Tot al - 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 Tot al - 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 Tot al - 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 1956 M - 5 27 24 8 64 F - - 3 3 3 9 Total - 5 30 27 11 73 47 INCIDENCE OF PULMONARY TUBERCULOSIS AND NEOPLASMS OF THE LUNGS Age Groups Pulmonary Tuberculosis Neoplasms of the Lung or Bronchus 1955 1956 1955 1956 MALES 0- - - - - 1- - - - - 5- - - - - 15- - - 1 - 25- 1 3 4 5 45- 7 5 31 27 65- 3 2 19 24 75- 2 3 3 8 Total Males 13 13 58 64 FEMALES 0- - - - - 1- - - - - 5- - - - - 15- - - - - 25- 1 1 1 - 45- 2 2 3 3 65- - 1 - 3 75- - - 2 3 Total Females 3 4 6 9 48 VITAL STATISTICS OF WHOLE DISTRICT 1956 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 Rale of Non-residents re gistered 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 1,581 119 230 377 126 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 •I939} B122,800 Dl16,200 1,829 14.9 1,311 11.2 362 442 77 43 1,391 12.0 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 J 5.8 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 14.9 1,409 12.0 498 196 35 20 1,207 10.3 1954 11 ft,500 1,776 15.2 1.382 11.8 606 295 38 21 1,071 9.1 1955 114,7004 1707 14.8 1,495 13.0 643 393 51 30 1,245 10.8 1956 113.300 1810 15.9 1414 12.4 582 449 39 21 1281 11.3 • B —Birth-rate Population Figure. D Death-rate Population Figure. 49 50 CHART SHOWING BIRTH AND DEATH RATES PER. 1,000 POPULATION FOR THE PAST 20 YEARS . CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1956 Cause of Death Sex 0- 1- 5- 15- 25- 45- 65- 75- Total all Ages 1.Tuberculosis,respiratory M - _ _ _ 3 5 2 3 13 F - - - - 1 2 1 - 4 2.Tuberculosis, other M - - - - - - - - - F - • • - . . . _ _ 3.Syphilitic disease M - - - - . - - . - F - - - - - - 3 1 4 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 - - - - - - - - - 10.Malignant neoplasm, stomach M - - - - - 6 7 3 16 F - - - - - 5 3 3 11 11-Malignant neoplasm, lung bronchus M - - - - 5 27 24 8 64 F - - - - - 3 3 3 9 12.Malignant neoplasm, breast M - - - - - - - - - F - - - - 2 5 4 1 12 13.Malignant neoplasm, uterus M - - - - - - - - - F - - - - 1 4 - 2 7 14.Other malignant and lymphatic neoplasms M - - 2 - 3 13 18 16 52 F - - - - 4 17 21 16 58 15. Leukaemia, aleukaemia M - - 1 - 1 - 1 - 3 F - - - 1 1 1 1 2 6 16.Diabetes M - - - - - 1 3 - 4 F - - - - - 2 1 1 4 17.Vascular lesions of nervous system M - - - - 1 15 22 22 60 F - - - - 1 22 24 53 100 18.Coronary disease, angina M - - - - 8 42 36 26 112 F - - - 1 - 8 21 28 58 19. Hypertension with heart disease M - - - - - 4 5 7 16 F - - - - - 4 12 13 29 20.Other heart disease M - - - 1 1 9 15 29 55 F - - - - 5 8 22 62 97 21.Other circulatory disease M - - - - 2 5 9 12 28 F - - - - 2 5 11 22 40 22. Influenza M - - - - - - 1 1 F - - - - - - 2 2 23. Pneumonia M 1 1 - - 1 7 6 13 29 F 1 - - - - 4 8 30 43 24.Bronchitis M 1 - - - - 21 32 21 75 F 1 1 - - - 4 7 27 40 25.Other disease of respiratory system M - - - - - 3 3 2 8 F - - - - - - - - 26.Ulcer of stomach and duodenum M - - - - - 1 4 1 6 F - - - - - 1 1 - 2 27. Gastritis,enteritis and diarrhœa M - - - - - - - 1 1 F - - - - 2 - 1 1 4 28.Nephritis and nephrosis M 1 1 - - 3 2 - 2 9 F - - - 1 1 2 3 - 7 29. Hyperplasia of prostate M - - -- - - 2 2 6 10 F - - - - - - - - - 30.Pregnancy, childbirth, abortion M - - - - - - - - - F - - - - - - - - - 31-Congenital malformations M 6 - - 1 3 - - - 10 F 3 - - - - - - - 3 32.Other defined and illdefined illnesses M 16 - - 2 5 7 11 10 51 F 7 - - 1 2 6 7 26 49 33.Motor vehicle accidents M - - 3 2 3 3 1 1 13 F - - - - 1 2 - 4 7 34.All other accidents M 1 - 1 2 4 6 6 4 24 F - - - 1 - 4 2 5 12 35.Suicide M - - - 1 2 4 2 1 10 F - - - - - 1 - - 1 36.Homicide and operations of war M - - - - 1 - - - 1 F - - - - - - - " - M 26 2 7 9 46 183 209 189 671 F 13 1 - 5 23 110 156 302 610 Total of all Causes 39 3 7 14 69 293 365 491 1281 51 1956. PROPORTION OF DEATHS FROM PRINCIPAL CAUSES. 52 INFANT MORTALITY - 1956 and Previous Years Year Births Deaths of Infants Deaths of Infants per 1,000 births Average 1906- 1913 3,000 359 117 " 1914-1923 2,639 230 88 " 1924- 1933 2, 145 141 66 1934 1,783 137 77 1935 1,877 131 70 1936 1,922 116 60 1937 1,913 130 68 1938 1,874 117 62 1939 1, 829 77 43* 1940 1,600 76 51¢ 1941 1,405 52 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 1956 1, 810 39 21 * Rate calculated on a birth figure supplied by the Registrar-General of 1,781. ¢ Rate calculated on a birth figure supplied by the Registrar- General of 1,501 ff Rate calculated on a birth figure supplied by the RegistrarGeneral of 1,253. 53 Net deaths of infants at various ages under one year of age Under 1 week 25 1-2 weeks 1 2-3 weeks 3 3-4 weeks 2 4 weeks and under 3 months 2 3 months and under 6 months 3 6 months and under 9 months 1 9 months and under 1 year 2 Total deaths under 1 year 39 NET BIRTHS IN THE YEAR: Legitimate 1,637, Illegitimate, 173 NET DEATHS IN THE YEAR: Legitimate Infants, 36, Illegitimate Infants, 3 54 55 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 1951 1952 1953 1954 1955 England and Wales 30 28 27 25 25 Scotland 37 35 31 31 30 Northern Ireland 41 39 38 33 32 Australia 25 24 23 22 22 Canada 38 38 35 32 31 Chi1e 149 134 114 124 121 Denmark 29 29 27 27 25 France 51 46 42 41 39 Irish Republic 45 41 39 38 37 Italy 67 64 59 53 49 Netherlands 25 23 22 21 20 New Zea1and 23 22 20 22 22 Sweden 21 20 19 19 17 United States of America 29 29 28 27 27 MATERNAL MORTALITY 1956 and Previous Years YEAR Number of Deaths Number of live Births Maternal Death Rate Pregnancy,childbirth, abortion Average 1924-1933 8 2 145 3.5 1934 9 1,783 5.0 1935 2 1,877 1.1 1936 3 1,922 1.6 1937 4 1,913 2.1 1938 2 1,874 1.1 1939 2 1,829 1.0 1940 – 1,600 – 1941 2 1,405 1.5* 1942 3¢ 1,589 1.9 1943 3 1,768 1.6 1944 2 1,788 1.08 1945 1 1,742 0.56 1946 7 2,310 2.94 1947 1 2,559 0.38 1948 1 2,149 0.45 1949 2 1,971 0.99 1950 1 1,988 0.49 1951 1 1,874 0.52 1952 2 1,777 1.10 1953 3 1,750 1.67 1954 3 1,776 1.66 1955 2 1,707 1.14 1956 – 1.810 – * 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"* 56 ENVIRONMENTAL HEALTH SERVICES (A) SANITARY INSPECTION Cause of Inspection No. of Inspections No. of Notices se rved No. of Notices complied with Atmospheric Pollution 13 – – Bakehouses 67 – – Complaints 3,049 1,261 1,085 Drainage 2,124 2 3 Factories (Mechanical) 367 12 13 Factories (Non-Mechanical) 180 8 6 Food (other than Restaurants & Eating Houses) 1,916 1 1 Hairdressers & Barbers 122 6 1 Housing Act 285 1 – Housing Applications 337 13 18 House to House 14 – – Housing Repairs and Rents Act 121 1 1 Ice Cream Vendors 306 – – Infectious Diseases 313 1 – Markets 580 – – Milk Vendors 489 – – Outworkers 1,043 3 6 Pet Animals Act 42 – – Pharmacy and Poisons Act 114 – – Public Urinals 11 – – Rag Flock Act 35 - 1 Rats and Mice 2,444 75 61 Restaurants and Eating Houses 683 12 14 Shops Act 145 8 7 Slaughterhouses - – – Smoke Observations 88 2 – Miscellaneous 932 41 35 Re-visits 7, 476 418 657 No answer 1,457 – – 24,753 1,865 1,909 No. of Ineffective visits 1,457 – – Total 23,296 1,865 1,909 During the year 870 Statutory Notices were served and 707 compiled with. 57 (B) SUMMONSES - Proceedings instituted during the year Public Health (London) Act, 1936 79 Food and Drugs Act, 1938 13 L.C.C. Byelaws 9 Housing Act, 1936 1 (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 100 180 8 – (ii) Factories not included in (i ) in which Section 7 is enforced by the Local Authority 542 367 12 – (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding outworkers' premises) – – – – Total 642 547 20 – 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.I) 6 5 – – – 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 14 14 – – – (c) Not separate for sexes – – – – – Other offences against the Act (not including offences relating to Out-work) – – – – – Total 20 19 – – – 58 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 Sending Lists to the Counci1 No., of Prosecutions for Failure to Supply Lists No. of Instances of Work in Unwholesome Premises Notices Served Prosecu tions Chocolates and Sweetmeats 7 – – – – – Wearing Apparel Making, etc. 232 – – 1 1 – Brass and Brass Articles 2 – – – – – Lampshade s 7 – – – – – Curtains and Furniture Hangings 6 – – – – – Furniture and Upholstery 3 – – – – – Electro-Plate 6 – – – – – Artificial Flowers 2 – – – – – Paper Bags 51 – – – – – Feather Sorting 2 – – – – – Carding, &c, of Buttons, &c. 64 – – 2 2 – Stuffed Toys 95 – – – – – Cracker Bon-bon Christmas Crackers , Chri stmas Stockings, &c. 193 – – – – – Household Linen 2 – – – – – Total 672 – – 3 3 – (D) UNSOUND FOOD CONDEMNED . 1956 Baby Food 1 pkt. Bacon 24 lbs. Beans, Baked 90 tins Cereal 21 pkts. Cheese 2 lbs. Chicken 4 tins Chocolate teacakes 21 pkts. Eggs, Frozen 6,866 lbs. Fish 94 tins Fish 459 lbs, Fruit 291 tins Fruit, Dried 360 lbs. Fruit, Fresh 31 lbs. Ham 151 tins Herrings 16 barrels Icing 253 tubes Meat 504 lbs. Meat 291 tins Milk 95 tins Peas 98 tins Pickles 8 jars Pudding 3 tins Sauerkraut 2 tins Sausages 74 tins Soup 41 tins Spaghetti 3 tins Toffee, Nut 55 lbs. Tomatoes 124 tins Tomato Puree 14 tins Vegetables 13 tins 60 PUBLIC MORTUARY - Bodies Admitted. &c. Bodies admitted from the Borough:- By order of Coroner 257 By order of Police 7 On application of undertakers 11 275 Bodies admitted from other Boroughs:- Fulham, (One hundred and fifteen by order of Coroner, twelve by order of Police, and two on application of undertakers) 129 Chelsea (One hundred and ninety nine by order of Coroner, one by order of Police, and two on application of undertakers) 202 Kensington (twenty eight by order of coroner) 28 359 Total bodies admitted 634 No. of P.M. examinations conducted:- Hammersmith cases 264 Fulham cases 127 Chelsea cases 200 Kensington cases 28 Total P.M.'s 619 No. of Inquests held:- Hammersmith cases 68 Fulham cases 42 Chelsea cases 41 Kensington cases 105 Total Inquests held 256 61 INFECTIOUS DISEASES Diseases Notifications Total Cases Notified Case s Removed to Hospital Deaths Corrected Figures 0 -1 year 1 -2 year 2 -5 years 5 -15 years lf-25 years 25-45 years 45-65 years 6 51" years Scarlet Fever 1 3 17 30 3 1 1 _ 56 12 - 55 Whooping Cough 26 20 89 80 1 3 - - 219 30 - 219 A. Poliomye1itis (Par.) - 2 6 4 1 1 - _ 14 14 - 3 " " (N.Par). - . . 2 - - - - 2 2 - _ Measles 11 20 56 70 4 4 - . 165 13 - 165 Diphtheria - - - - - 2 - - 2 2 - _ Pneumonia 5 3 14 7 3 7 12 15 66 26 72 66 Dysentery 8 19 43 46 7 8 7 5 143 48 - 138 Acute Encephalitis (Inf.) - - 1 1 1 _ 1 - 4 4 _ 2 Enteric or Typhoid Fever - - - - - - - - - - - _ Paratyphois Fever - 1 1 1 1 - - 4 4 - 1 Erysipelas 1 - - 1 1 1 4 3 11 3 _ 11 Meningococcal Infection 4 5 1 2 2 - - - 14 14 1 9 Food Poisoning 1 1 1 7 6 6 8 3 33 6 - 28 Puerperal Pyrexia - - - - 140 152 - - 292* _ - 292 Ophthalmia Neonatorum 2 - - - - - - .. 2 - _ 2 Ma1aria - - - - 1 1 - _ 2 _ _ 2 Scabies 1 2 1 4 12 14 8 1 43 1 - 43 Tuberculosis (Pulmonary) - . 3 5 38 62 33 15 156 31 17 156 " (Non Pulmonary) - * 2 1 1 3 1 1 9 1 - 9 TOTALS 60 76 235 260 222 266 75 43 1237 211 90 1201 * Of this total only 79 cases related to persons residing in the Borough. 901 TUBERCULOSIS Summary of Notifications during the period from the 1st January, 1956. to the 31st December, 1956. 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 – – 2 1 1 11 9 18 11 13 12 10 3 91 Respiratory, Females – – 1 1 2 8 10 16 17 5 3 2 – 65 Non-Respiratory, Males – – 1 – – – 1 1 1 1 – – – 5 Non-Respiratory, Females – – 1 1 – – – 1 – – – 1 – 4 CASES NOTIFIED AND DEATHS - 1956 and Previous Years Year No. of Cases notified No. of Deaths No. of Cases on Register of Notifications Pulmonary Non Pulmonary Total 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 1956 156 9 165 17 1,536 Average number of cases notified for the 10 years 1937/1946 (inclusive) - 199. Average number of cases notified for the 10 years 1947/1956 (inclusive) - 190. Average number of deaths for the 10 years 1937/1946 (inclusive - 97. Average number of deaths for the 10 years 1947/1956 (inclusive) - 43. 64 CHART SHOWING THE NUMBER, OF NEW CASES OF TUBERCULOSIS NOTIFIED DURING THE PAST 20 YEARS. MEDICINAL BATHS Cleansing of Verminous Persons School Children - Hammersmith Scabies 73 Verminous 494 Impetigo 3 Other Conditions 6 School Children - Non-Hammersmith Scabies 5 Children under Five Years - Hammersmith Scabies 14 Verminous 36 Impetigo 2 Children under Five Years - Non-Hammersmith Scabies 6 Adults - Hammersmith Scabies 100 Verminous 92 Impetigo 2 Other Conditions 10 Adults - Non-Hammersmith Scabies 15 Verminous 6 Lodging-Houses Scabies 6 Verminous 108 DISINFECTION Hammersmith Non-Hammersmith Cases Cases Mattresses 365 124 Pillows 229 38 Blankets 273 39 Sheets 76 3 Quilts 16 9 Clothing 769* 50 Sundries 160* 42 Total 2, 193 * 46 Custom's Certificates issued in respect of 518 articles (497 Clothing, 21 Sundries) Booms (including 259 verminous Rooms), 285. 65 /«?