Ac. 434 Gd 9 HAM 49 Metropolitan Borough of Hammersmith ANNUAL REPORT of the Medical Officer of Health with STATISTICAL SUPPLEMENT for the year 1957 by F. M. DAY, M.R.C.S., L.R.C.P., D.T.M., D.P.H. 73027 HAMMERSMITH TOWN HALL METROPOLITAN BOROUGH OF HAMMERSMITH Health Committee At 31st December, 1957. 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 J.F. Heaks, 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 Wash houses. Establishment Committee Dealing with medical examination of Staff, etc. Housing and Town Planning Committee Powers and duties of the Council under the Housing Acts (other than those delegated to the Health Committee). Works Committee. Construction maintenance and improvement of sewers and public sanitary conveniences. Collection, removal and disposal of house and trade refuse. Cleansing of public highways. Management and control of the Council's cemeteries. Maintenance and control of parks gardens and open spaces provided by the Council. CONTENTS Page Introduction 1 Staff 2 SECTION A -SOCIAL CONDITIONS AND STATISTICS: - Births 5 Deaths 5 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 10 Malaria 7 Medicinal Baths 8 Notifications 6 Poliomyelitis 7 Tuberculosis 6 SECTION C - HOUSING Overcrowding (Licences) 15 Permanent Estates 15 Re-housing 14 SECTION D - INSPECTION AND SUPERVISION OF FOOD:- Designated Milk Licences 23 Food & Drugs Act 1955 16 Ice Cream 21 Ice Cream and Preserved Food Premises 22 Markets 20 Milk Supplies 22 Pasteurisation of Frozen Mixed Whole Egg 19 Public Health (Condensed Milk) Regulations 1923/48 24 Sampling 17 Swimming Baths 20 Wormwood Scrubs Fair 21 SECTION E - SANITARY ADMINISTRATION:- Coroners Court and Public Mortuary 26 Exhumation and Re-interment of bodies 25 Housing Repairs and Rent Act, 1954 25 L C C (General Powers) Act, 1952 Rag and Bone Dealers 27 L C. C (General Powers) Act, 1954 Hairdressers and Barbers 27 Pet Animals Act 195 1 26 Pharmacy & Poisons Act 1933 and Pharmacy & Medicines Act, 1941 28 Public Baths and Wash houses 27 Rag Flock & Other Filling Materials Act, 1951 26 Rent Act 1957 25 Staff Inspectorial 25 SECTION F - SANITARY CIRCUMSTANCES:- Atmospheric Pollution 31 Clean Air Act 1956 33 Drainage 29 Dustbins 29 Factories 30 Public Cleansing 29 Rodent control 30 Sanitary Inspection 30 Water Supply 29 SECTION G - GENERAL PROVISION OF HEALTH SERVICES:- Page Ambulance Facilities 34 Burial or Cremation of the Dead 39 Conferences 41 Diseased or Infirm Persons 38 Financial Contributions to Voluntary Organisations 40 Hammersmith Chest Clinic 34 Health Information Bureau 41 Hospitals 34 International Certificates of Vaccination and inoculation 38 Laboratory Facilities 34 Old People's Welfare 39 Personal Health Services 35 Clinics and Welfare Centres 36 Creches 37 Day Nurseries 38 Domestic Help service 38 Staff Medical Examinations 40 STATISTICAL SUPPLEMENT-TABLES Causes of Death in Age Groups 49 Deaths from Carcinoma of Lungs in Age Groups 45 Disinfection 63 Extract from Vital statistics 43 Factory Defects 56 Factory Inspections 56 General statistics 43 Incidence of Cancer during the past 10 years 44 Incidence of Pulmonary Tuberculosis and Neoplasms of the Lungs 46 Infant Deaths under I year in age groups 52 Infant Mortality 51 Infant Mortality Rates-England and wales and various other Countries 54 Infectious Diseases Notifications in Age Groups 60 Maternal Mortality 54 Medicinal Baths Cleansing of Verminous Persons 63 Mortuary and Coroner's court 59 Natural Increase or Decrease of the Population during the past 20 years 44 Outworkers 57 Sanitary Inspection Notices served and complied with 55 Summonses - Proceedings instituted 55 Tuberculosis Notifications and deaths for the past 20 years 61 Tuberculosis Notifications in sex and age groups 61 Unsound pood Condemned 58 Vital Statistics of whole District 47 CHARTS Birth and Death Rates for the past 20 years 48 Number of infant Deaths under 1 year of age during the past 20 years 53 Number of new cases of Tuberculosis notified during the past 20 years 6 2 Proportion of Deaths from Principal Causes 50 Town Hall Hammersmith, W. 6. To the Mayor Aldermen and Councillors of the Metropolitan Borough of Hammersmith Mr. Mayor, Ladles and Gentlemen, Herewith I beg to present to you my Annual Report upon the health circumstances of the Borough for the year 1957 Once again, I regret that it is not possible to publish it sooner as it is necessary to include in the report vital statistics which cannot be calculated until the necessary figures are received from the Registrar General Fortunately I have nothing serious on which to comment so far as epidemics are concerned Poliomyelitis occurred only in minimum incidence and the serious infectious diseases were equally scarce On the other hand milder conditions were prevalent from time to time Sonne Dysentery gave some trouble, particularly at the Uxbridge Road Day Nursery, and measles totalled 1,267 cases mostly in the schools The position of lung cancer continues to stimulate apprehension A further increase occurred and the almost meteoric rise in the death rate shows no sign of slackening The closing months of the year were notable because of preparations necessary to implement the coming Clean Air Act The council wisely decided to try and form a condominium of neighbouring authorities The Councils of Acton Barnes Brentford & Chiswick, Fulham and Willesden were approached so that orderly planning of smoke control areas was achieved rather than the higgledy-piggledy and scattered setting up of smoke control areas which is evident elsewhere At the time of writing, Barnes, Brentford & Chiswick, Fulham and Willesden all have in mind the advantages of fusion of areas, and planning proceeds in that direction Finally Mr Mayor Ladies and Gentlemen it is my pleasure to express my appreciation of the kindness and consideration shown to me by the Chairman Vice-Chairman and Members of the Health Committee and to record my thanks to all the Staff of the Department for their loyal co-operation and support 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, 1957 Medical Officer of Health: F. M. Day, M.R.C.S.; L.R.C.P., D.T.M., D.P.H. Deputy Medical Officer of Health (Part-Time): A.J.Shinnie, O.B.E., M.D., D.P.H. Administrative Officer: ¢* P. W. Pottler (Part-Time): Clerical: J,C.Turner(1st Assistant) W. 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 ô¢* P.T. Bayes (Deputy Senior) ¢#H.R.Fry é¢# J.C.Hopkins # E.W.Pike X¢# G.G.Gardiner # J. M. Re ad /# Miss E.M Cross o¢# C.H. Wright o¢# S. C. Metcalf Food and Drugs Inspector: $¢* W. J. Godden Mortuary Keeper: D. A. Mackay Medicinal Baths Superintendent: OF. G. Baldwin Public Analyst D. F. H. Button, A.R.C.S., F.R.I.C. * Cert. Sanitary Inspectors Examination Board. ¢ Cert. Royal Sanitary Institute (Meat. and other foods) & 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 Visiter). ¢ Cert. Royal Sanitary Institute (General Science and Sanitation) X Cert. Royal Sanitary Institute (Sanitary Science as applied to Buildings and Public Works). % State Certified Midwife θC 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 Boroughs, on the south by the Thames and on the east by the Royal Borough of Kensington and the Metropolitan Borough of Fulham. In 879 South Hammersmith was overrun by a party of marauding Danes sailing up the Thames past London who landed on a small island which they knew as the Isle of Hame and which we now know as Chiswick Eyot. From there they plundered in Hammersmith and Fulham. The community was centred around a navigable creek fishing was good and a village grew up which was part of the lands of the Manor of Fulham held by the Bishops of London from the Saxon Kings It is referred to in the Domesday Book and some ancient deeds as Hermodersworth but there seems to be no sure explanation of their derivation of the name Most likely is that it comes from Ham (Saxon for dwelling or town) and Hythe (a creek or harbour) and as the creek was the most important feature this is quite possible, The creek was in existence until recent times only being covered when the new Town Hall was built. Medieval wars and quarrels left Hammersmith prosperous, it became the home of nobility, being within reasonable distance of London and with pleasant surroundings King Edward III owned a manor here and its lands are now known as Ravenscourt Park. It was in the reign of James I that the great west road from London was continued through the village with a turnpike across at which is now known as Blythe Road in Hammersmith and North End Road in Fulham Hammersmith Broadway was really like a village green. In 1827 the first suspension bridge was built and the neighbourhood was beginning to become more important commercially For some time the area had been a flourishing market garden and various small industries such as brickfields bleaching mills, crucible manufacturers, wax and varnish makers, brewing boat building and sawmills were scattered around the village Although it might not be easy to find one today a species of autumn sown lettuce known as "Hammersmith Hardy" was England's most popular lettuce in early summer before spring sown salad plants were available Not many London boroughs can boast of plants or trees being named after them but it so happens that our neighbour Borough Fulham has two, the Fulham Oak and the Fulham Yew. Fishing was still good but even in those days the increased river traffic and growth of industry were blamed for the deterioration in the fishermen's livelihood. In the early part of the nineteenth century only 3 18 of the 2,300 acres which comprised Hammersmith were occupied by houses and little did the Chronicler of those days foresee what would happen in a mere 100 years 3 after the advent of the railway which he praised in glowing and patriotic terms, how the market gardens would be built over and commerce and trunk roads would take precedence Hammersmith became part of the County of London in 1885 and is now a highly developed industrial and residential area, but still a little remains of the old scene, The Latymer Foundation School was founded in 1624, Kent House and others in the Malls also date back to the seventeenth century. Kelmscott House the home of William Morris and also houses in Hammersmith Terrace were built in the 17th and 18th centuries. The sub soil in the nothern part of the Borough i.e. north of Ux- bridge Road mainly consists of clay whilst in the south it consists of a layer of some 20 feet of gravel above blue clay particularly over in the east much of which was excavated for brick making purposes There are 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 Borough Council. The total length of the roads in the Borough is approximately 68 miles and traffic is very heavy particularly over Hammersmith Bridge to the south and the main roads to Oxford, the West and London Airport especially on that part of the Great West Road running through the Borough work on which is still in progress VITAL STATISTICS (a) Population In this report the rates are calculated on the estimated population adopted by the Registrar General namely 111, 700 which compared with 113,300 for 1956 shows a reduction of 1,600. This is the sixth 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 was 1,266 a decrease of 22 as compared with the previous year. Particulars are set out hereunder The Register Office 487 Buildings registered for marriages (Roman Catholic Churches and Chapels at which a Registrar attends) 391 Churches of the Church of England 322 Authorised Persons (Chapels at which a Registrar does not attend) 46 Jewish Synagogues 20 1,266 4 (c) Births. The corrected number of births for the year as supplied by the Registrar General was 1,886. On the estimated population of 111,700 this represents an annual rate of 16.8 births per thousand persons living which is 0.9 higher than the previous year (d) Deaths. During the year 1,412 deaths were registered Add to this figure 420 deaths of residents of the Borough who died in various parts of England and transferred by the Registrar General and deduct 582 deaths of nonresidents and 21 transferable deaths which occurred the correct figure showsa total of l,299 deaths of residents (639 males and 590 females), which shows a decrease of 52 compared with 1956. On the estimated population of 111,700 the corrected number of deaths per 1,000 persons living was 11.0 as compared with 11.3 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 are most numerous, with cancer second and lung conditions third which is the same order as the last two years. (e) Infant Mortality. The number of deaths of infants under one year of age during the year was 48, giving a mortality rate per 1,000 live births of 25 compared with 21 last year. (f) Maternal Mortality. There were two maternal deaths during the year resulting in a death rate of 1.04 per 1,000 live and still births. 5 SECTION B PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASES Infectious Diseases 2,224 cases of infectious diseases were notified during the year 217 cases were removed to hospital and of this number 53 were notified on discharge as not having suffered from the disease originally notified As a result the corrected number of cases of notifiable infectious diseases for the year was 2,171. These figures show an increase on the previous year of 937 cases. This is due to the Measles epidemic early in the year and a slight increase in the number of cases of Pneumonia and Food Poisoning although there was a decrease in the number of cases of Whooping Cough and Puerperal Pyrexia. Ten cases of suspected diptheria were notified and I regret to report that one case was confirmed and the patient died in hospital. This is the first time in thirteen years that I have had to report a death 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 food factory who was a direct contact of a case of Paralytic Poliomyelitis Tuberculosis. During the year there was a considerable decrease in the incidence of this disease. The number of new cases notified was 142 as compared with 165 in the previous year These figures show a decrease of 30 in pulmonary cases but an increase of 7 in non-pulmonary cases. This is the lowest figure ever recorded in the Borough. 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 ability of the nation, and despite the fact that high priority is given by the housing authorities in rehousing tuberculous persons the housing shortage still precludes many from obtaining satisfactory homes 6 It is hoped that the campaign which the London County Council is conducting among school children and others for B C. G inoculations will, in due course, result in a considerable decrease in the incidence of this disease, and at a later date relegate the disease to the same level as scarlet fever and diptheria The number of deaths from tuberculosis was 9 as compared with 17 in the previous year. This is also the lowest figure ever recorded. Poliomyelitis. I regret to report an increase in the number of cases of this disease compared with the previous year. There were eleven confirmed cases all of the paralytic type but none proved fatal. During the year 10,438 children were vaccinated in Division 1, either at Clinics or by the family doctors. Food Poisoning. 49 cases of food poisoning occurred during the year compared with 28 cases in 1956. Salmonella typhi murium was identified in six cases, salmonella anatum in two cases, but in the remaining cases no causa organism was recovered. There were no serious outbreaks during the year but foods alleged to have been responsible for the patients' condition included corned beef, cooked ham tinned fish, fishcakes, liver, cockles, Jellied veal, pork luncheon meat, pork & veal sausage, fish, chicken roll, cornish pastie, beef and tinned peas Dysentery. There were 137 cases of Dysentery notified compared with 138 in 1956. There was another outbreak in the London County Council's Day Nursery at Uxbridge Road. The clinical exclusion method of control failed to stop new cases appearing Bacteriological control was therefore used and was successful The outbreak lasted five weeks Malaria. There were four cases notified during the year and in each Instance it was found that these were recurrences of cases which had been contracted abroad. 7 It is not often that I have the opportunity to write of Malaria so I quote from a letter received by a local newspaper 100 years ago "I wish to enlist your assistance in drawing the attention of the parishioners to the necessity of agitating the all important question of adopting means for the removal of the several existing sources of malaria and its concomitant evils prior to the mid summer heats con verting them into verulent fever stills I feel assured unless you arouse the too lukewarm inhabitants and awaken the all-but slumbering Board we will have the return of some ravaging epidemic. Many offensive postiferous ditches and stagnant pools in the closely built over and densely populated districts should be cleaned and covered." Medicinal Baths. The Medicinal Baths in Scotts Road Shepherds Bush provide for the treatment of scabies impetigo and various verminous conditions The reconstruction work at Lime Grove Baths which had interrupted steam and hot water supplies for the greater part of i956 was still in progress in the early part of 1957 and the emergency measures referred to in my last Report were still kept in operation. Steam was first restored on 20th February but it was soon realised that the pipes running via an underground duct were faulty and it was decided to renew all pipework immediately. The old pipes when dug up were found to be rusted through. The pipes bringing both hot and cold water were ready by 4th March and the steam circuit by 15th March on which date the Extension to the Medicinal Baths was reopened having been closed for twelve months. In July all the staff of the Disinfecting Station were vaccinated as a precaution against Smallpox. It is perhaps unfair to compare the number of verminous cleansings for 1957 with those of the previous year As the station was closed for most of 1956 many school children who visit regularly in normal times did not bother to go the extra distance to the Kensington Cleansing Station. Since 1951 efforts have encouraged more mothers to have cleansings at the same time as their children This was hoped to keep reinfestations to a minimum. However since 1954 an increasing number of mothers are at work and do not as a result, accompany the children for treatment In 1950 for every female adult shampooed 26,79 children received the same treatment, By 1954 this ratio was reduced to 7 67 This gap increased to 11 to 1 in 1957 with reinfestation increased by just over one third in school children. 568 cleansings took place during this year and seven families were responsible for 22% of these with one family alone responsible for over 25% of the cleansings of children under five. 8 168 families were represented by school children. Considering the pre-war yearly figure for head cleansings was over 2,000 the present day figure would appear to be quite good but having regard to the change in social conditions over the past 20 years the present day position leaves much to be desired. The county Council retain their use of the Centre for treatment of school children and special attention has been given to head infestations at the Welfare Centres and Day Nurseries. Infected school children together with contacts of pre-school 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. The fact that the cleansing station is open again does not seem to be general knowledge in the ranks of the homeless, only about half of the usual number called during the year seeking a bath. Of the 15 male callers, two were employed eight appeared fit for work of some kind, five were in need of medical attention, and of these it appeared that three would have benefitted from institutional care One man who was undergoing a medical examination was noted by his doctor to have bed bugs in his clothing and was referred to the station for cleansing The figure of 164 cases treated for Scabies during the year is considerably lower than any ever recorded since the Baths opened in 1923 47 families were treated accounting for 51 confirmed cases. 32 persons were also treated as contacts. There were ten re- infections and one family was responsible for seven of them. A pleasing feature is the continued drop in the attendance of school children. During the year cases from Acton Brentford and Chiswick Ealing Feltham, Heston and Isleworth Richmond and southall received treatment, and Barnes Ealing and Heston and Isleworth Borough Councils and the London County Council used our centre for steam sterilisation of bedding. On 60 occasions the West London Hospital used the service for sterilisation purposes for a total of 349 articles, and five requests were received from the hospital for formaldehyde disinfection. As in previous years the Town Hall carpets and soft furnishings were sprayed as a protection against moths and once again Gammexane Emulsion (I. C I. ) was used. The mobile team which is available for dealing with homes requiring disinfestation was very actively engaged during the year The total number of rooms sprayed amounted to 549 compared with 285 in 1956. Many people are still sending articles of clothing and materials to relatives living abroad, and some Eastern European countries require that the articles shall be disinfected before being despatched and a Certificate 9 to that effect produced. During the year 22 Certificates relating to 382 articles were issued and a nominal charge of 2/6d was made for each Certificate. Once again the proprietors of Olympia supplied mattresses for people who had to sleep on the premises during various shows particularly the Dairy show and 240 such mattresses were dealt with after this Show. On three occasions help was given to families suffering water damage to bedding by using the steam steriliser for drying purposes. Use was made of Section 43 of the London county council (General Powers) Act 1953 to treat a lad;' of 84 years with head and body lice impetigo of the head and face and with a mild Scabies infection She was conveyed to and from the Baths. Impetigo responding to treatment was encountered four times during the year Each case was a secondary infection of ped capitis and treated with Uhydrargyri. This was a commonplace infection in pre war days aver age about 300 per year but is rarely seen nowadays Health Laundry. The Health Laundry service has now completed its fifth full year of good work as a service second to none in the Metropolitan area. The new building and equipment can cope with all requests expected for some years to come. The arrangements are up to expectations and the average time taken for washing linen of an incontinent person from start to finish including ironing is about one and a half hours As the work through the machine once started is continuous (washer hydro extractor and tumbler dryer) a clean bundle of bedding is ironed ready for delivery about every half hour. These new machines went into action in March 1957 and it is now possible to offer all patients a much needed twice weekly collection and de livery This more frequent cleaning also offers additional aid to other services such as District Nurses and Home Helps The time has now arrived in Hammersmith when the Laundry Service takes a place with the other domiciliary services as an accepted relief to many of the chronic sick. The reliability on the Department for quickly returned clean bedding is appreciated and well known. Requests come mainly from Home Helps District Nurses Hospitals Doctors and Welfare Associations. It should be appreciated that this is an essential service which covers only those cases falling within the terms of Section 122 of the Public Health (London) Act, 1936. During the year 32 new cases were added to the list of patients and 511 certificates were signed authorising the laundering of bed linen etc 10 Persons to whom certificates have been issued fall into one or more of the following categories and typical examples are given. 1. A person whose health would deteriorate if assistance was not give (Those bedridden). 2. In order that the patient may receive fuller help from the District Nurse's treatment (Those incontinent). 3. To enable a patient to obtain a Home Help when conditions would be otherwise than favourable to such employment (Senile patients of unclean habits). 4. To try and hold the present health of a patient until hospital or other accommodation is available, 5 To help over an acute or chronic phase of illness. 6 To give temporary assistance during a post-operative period (following transurethral prostatectomy for instance.) 7. To enable a person to be nursed at home instead of being caredfor elsewhere (those refusing hospital treatment), 8. When a private laundry refuses service (Cases of discharging bedsores) . 9. Temporary service during a domestic emergency (failure of hot water supply and no heating facilities). Certificates granted during 1957 Sex and Age Collections up to 31.12.57. Primary Cause of ill-health Sequel F 85 201 Arthritis Deceased. F 71 139 Spondylitis Admitted to Hospital. F 77 71 Senility Deceased F 89 63 Senility Admitted to Hospital F 80 9 Arthritis Admitted to Hospital F 72 33 Senility Admitted to Hospital F 70 46 Senility Service still in operation F 83 27 Carcinoma of Colon Deceased M 73 2 Apoplexy Admitted to Hospital. 11 Sex and Age Collections up to 31.12.57 Primary Cause of ill health Sequel F 88 7 Arthritis Admitted to Hospital F 78 1 Prolapsed rectum Deceased F 86 3 Arthritis Removed to care elsewhere F 86 23 General debility Admitted to Hospital M 73 66 Incontinence Service still in operation F 80 4 Carcinoma of rectum Deceased F 89 5 Cardiac failure Deceased F 83 9 Senility Admitted to Hospital F 63 30 Incontinence Service still in operation F 70 4 Cardiac failure Deceased F 33 13 Disseminated Sclerosis Admitted to Hospital F 60 4 Apoplexy Service still in operation F 68 30 Intestinal obstruction Service still in operation F 80 2 Accident Admitted to Hospital M 64 3 Carcinoma of bladder Deceased F 74 16 Senility Admitted to Hospital F 79 5 Hypertension Admitted to Hospital F 30 34 Disseminated Sclerosis Service still in operation M 76 7 Hemiplegia Service still in operation M 65 4 Ca. involving liver Deceased F 94 8 Senility Deceased F 84 6 Diabetes mellitus Admitted to Hospital F 52 13 Tuberculous spine Service still in operation 12 Sex and Age Collections up 31.12.57. Primary Cause of ill. health Sequel F 78 4 Apoplexy Removed to care elsewhere M 75 11 Carcinoma of rectum Service still in operation F 69 4 Apoplexy Service still in operation F 81 7 Carcinoma of breast Service still in operation F 72 5 Apoplexy Deceased F 90 2 Senility Deceased F 73 2 Mental deficiency Service still in operation Summary of articles cleansed Sheets 2,550 Blankets 72 Quilts 33 Pillow Slips 645 Towels 505 Nightdresses 363 Pyjamas 83 Sundries 1,329 Total 5,580 13 SECTION C HOUSING Rehousing The Housing Estates Manager has remained 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 statutory certification is made to the Housing Manager of the London county Counc il. Applications for rehousing by the London county Council are made to that Authority direct, and requests for various enquiries to be made are received from them through the Housing Estates Manager. 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 rehousing on such grounds has become substantially reduced. Eighteen cases were recommended for rehousing on grounds of health and ninety on grounds of overcrowding. I append a table showing the number of cases recommended for rehousing under the headings mentioned above and those actually rehoused from 1949. Year HEALTH GROUNDS OVERCROWDING GROUNDS SPECIAL CASES Recommended Rehoused Recommended Rehoused Recommended Rehoused 1949 61 25 358 132 34 4 1950 35 10 439 203 8 9 1951 37 10 243 88 9 4 1952 27 10 187 79 7 7 1953 30 6 178 65 17 5 1954 34 2 145 86 14 4 1955 28 3 129 55 6 5 1956 16 4 97 4 5 - 1957 18 5 90 13 - - Totals 286 75 1,866 725 100 38 To make the above figures realistic it should be pointed out that the figures for those rehoused are extremely unlikely to be from recommendations of the same year Nevertheless the seriousness of the housing position can be measured by the facts as shown by the figures. Of 1866 statutory certifications in ten years only 725 were rehoused It is a fair deduction that most if not all of the remaining 1141 families remain in their overcrowded conditions. 14 Permanent Estates. During the year both the Borough Council and the London County Council have still been engaged in providing accommodation for those in the greatest need, and whilst no new flats were erected in the Borough by the county Council, the Borough Council erected 16 new flats at Boswell Court on the Springvale Estate Blythe Road and 1 at 15 Batson Street. The Council acts as landlord for 3 344 principal tenants. The properties managed include houses flats prefabs and requisitioned accommodation. During the year a scheme for the annual renewal of applications was instituted by the Borough council As a large number of applicants failed to renew their applications the waiting list was considerably reduced but at the end of the year there were still 1,299 applicants still awaiting accommodation There is no points scheme used to assess these applicants Their need according to bedroom deficiency, ill health insanitary condit ions, overcrowding and separation of families is measured and used as a guide in allocating accommodation. The following table illustrates the progress that is being made:- 1. Number of families rehoused by the Borough Council in new flats and houses since the war 1,074 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 (Still living in prefabricated dwellings at the end of the year-38) 80 4. Number of Borough Council licensees living in requisitioned properties at the end of the year 723 Overcrowding. Two licences were granted under Section 61 of the Housing Act, 1936 and one under Section 80 of the Housing Act, 1957. 15 SECTION D INSPECTION & SUPERVISION OF FOOD Food & Drugs Act 1955 Without doubt, the supervision and control of the conditions under which food is handled is one of the particularly important factors coming within the jurisdiction of the Food and Drugs Authority. The maintenance of frequent inspection of all kinds of food premises is the key to a successful service. The inspection of these premises during the year under the Food Hygiene Regulations 1955, has called for a considerable amount of work from the Inspectorial staff. During 1957, 4,186 visits were made at food premises and stalls and at 149 of these, conditions constituting contraventions under the Food Hygiene Regulations 1955 were found. In each case remedies resulted following the issue of verbal notices and warning letters. It has been found that the persons responsible are co-operative in adopting suggestions and recommendations made to them. In no instance has it been necessary to institute legal proceedings. Three exemption certificates were granted by the Council in connection with the Regulations during the year. 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 66 CAFES & RESTAURANTS 154 CANTEENS AND CLUBS 79 CHEMISTS 32 CONFECTIONERS (sweetshops) 148 FISH (wet and fried) 25 FRUIT & GREENGROCERS 91 GROCERS & PROVISIONS 203 HONEY (packing) 1 ICE CREAM MANUFACTURERS 5 JELLIED EELS & PIES (manufacture & sale) 5 MILK PROCESSING DEPOTS 2 MILK DISTRIBUTION DEPOTS 32 OFF LICENCES 48 PUBLIC HOUSES 96 SWEET & CHOCOLATE MANUFACTURE 3 No seizures of unsound food were made under section 9 of the Food and Drugs Act 1955. 16 The Council's inspectors accepted the voluntary surrender of foodstuffs which upon examination was found to be unfit for human consumption. A list of the commodities and the amount involved is shown in the statistical supplement. Since the Meat Products Order 1952 which controlled the meat content of sausages was revoked in 1953 there has been no legal standard for that commodity, and although the matter has been raised in Parliament and representations made by local authorities the position remains unchanged. This absence of a national standard is responsible for the lack of uniformity existing throughout the country and makes difficulties to both consumer and trade alike. I include the trade, as I believe there are many manufacturers who would welcome a standard fixed by statute. The sausage in this country has become something that is sacrosanct and the aora of mystery which surrounds its composition is boasted as a national asset. In the event of legal proceedings being taken a Court may only be reminded of a legal standard that was in force about four years ago; it can therefore only arrive at a decision after hearing the evidence of trade practices and price comparison, both of which can be misleading Prices especially are no criterion as to quality and no one pretends that the consumer can rely on the price to indicate the nature or quality of the constituents. However, some new legislation of considerable importance concerning other foods was introduced during the year. Following a report of the Food Standards Committee of the Ministry of Agriculture Fisheries and Food on colouring matters the Colouring Matter in Food Regulations were brought into operation on 30th June, 1957 These regulations prohibit the sale or importation of food containing any added colouring matter other than that specified in a permitted list, and furthermore all colouring matter sold for use in food is now subject to special labelling requirements. Sampling During 1957, 882 samples of food and drugs were submitted to the Public Analyst for chemical analysis Adverse reports were received in respect of 16 samples as shown in the following summary:- Sample Result of Analysis Remarks Liqueur Chocolates The filling contained 4.5% proof spirit Vendor warned that the article should be described as "Imitation Liqueur Chocolates." Essence of Peppermint Contained no glycerine Informal sample - no further supplies available Cream of Mushroom Soup Deficient in fat Informal sample Cream of Mushroom Soup 22% total fat deficiency Formal sample to aboveWarning letter sent Sale and manufacture discontinued 17 Sample Result of Analysis Remarks Slimming Tablets Misleading Label Informal sample Slimming Tablets ditto Formal sample to above Warning letter sent Manufacturer agreed to change label. Ground Mustard Deficient in allyl isothiocyanate Informal sample Ground Mustard 48% deficient in allyl isothiocyanate Formal sample to above Warning letter sent Manufacturer agreed to change label Ground Mustard Seed 70% deficient in allyl isothiocyanate No standard in existence Beef sausages Contained 750 parts per million of sulphur dioxide Informal sample Legal proceedings taken in 1958 on formal sample. Hot Milk 10% added water Warning letter Grape Juice Minimum quantities of vitamins and minerals not stated Informal sample Grape Juice ditto Formal sample to above no action Vitamin Food Supplement Contained no vitamin A Informal sample Formal sample genuine Milk Contained dark mould deposits Penalty £3. £3.3.0 costs Milk Dirty Milk Penalty £5. £5.5.0 costs In addition to samples taken for analysis 270 samples of food were taken for bacteriological examination The results obtained are shown below. No of Samples Taken ARTICLE OF FOOD Organisms found OTHER ORGANISMS Faecal Coli Non-faecal Coli 209 Frozen Whole Egg 2 2 1 Salmonella thompson 4 Cream - - - 47 Imitation Cream (used in bakers confectionery) 2 10 2 Staph, aureus 1 Coagulase positive staphylococci 1 Custard - _ - 2 Sponge Cakes - - - 1 Mortadella - - - 1 Liver Sausage - - - 18 No. of Samples Taken ARTICLE OF FOOD Organisms found OTHER ORGANISMS Faecal Coli Non-faecal Coli 4 Brawn - - - 1 Meat Extract - - - Pasteurisation of Frozen Mixed Whole Egg Most of the egg used in the baking industry is supplied in the frozen condition in tins containing from 14 lbs to 44 lbs. Such egg is hygienically prepared by mixing freshly shelled egg, subjecting it to rapid freezing and then maintaining the product in this solid frozen state until it is required for use. Great care is necessarily taken in the process of preparing such frozen egg because obviously even the admixture of one egg of unsuitable freshness or quality could affect the flavour and quality of other egg in the bulk. In the process of baking the temperature reached in the goods (cakes and the like) and the time necessary for baking result in a practically sterile product For reasons of public health it has recently become the rule for the local authorities concerned to make bacteriological examinations of samples of all shipments of whole egg arriving in their port area and when deemed necessary - to cover other possible circumstances than the actual baking to require that certain shipments should only be used for food if a satisfactory pasteurising process is applied prior to the actual use of the egg in baking with the proviso that the Medical Officer of Health of the area where such egg is used shall satisfy himself (as he does for ice cream etc.) that the pasteurisation applied is properly carried out and is efficient This pasteurisation treatment is of the same nature and significance as pasteurisation of milk and ice cream The procedure in the pasteurisation of egg is much more exacting and delicate than for milk and ice cream because the temperature and time effects required for adequate pasteurisation verge on the borderline where egg may coagulate thereby damaging the baking quality of the egg and also seriously impeding the pasteurising process With my co-operation and agreement this matter has been adequately and satisfactorily dealt with in this area by a firm of food manufacturers who have full facilities for such work and who in their laboratories employ a scientific staff well experienced in matters of food hygiene Investigations on the pasteurising of egg were made by that firm and as a result they developed a process which they found to be fully satisfactory and which was then brought to my attention More than 1,000 tons of egg have passed through this specially designed plant and the following saimonellae have been identified in the material fore pasteurisation but not afterwards 19 Newport Dublin Typhi-murium Infantis Anatum Bredeney Cholera suis Thompson Meleagridis Braenderup Hessarek Virchow Cambridge Aberdeen Give Dahlem Chester Meunchen Orion In the case of al1 the egg the Medical Officer of Health holding the consignment has approached me to know whether I would agree to the materia being released and coming to Hammersmith for the particular treatment. After noting the type of salmonallae present I have agreed to despatch. We have received batches from London, Liverpool, Bristol, Cardiff and Glasgow. The firm's own scientific staff also supervised the process and applied their own bacteriological control. The experiment has proceeded according to plan and has been a success. Swimming Baths During the year a total of 45 samples of water were taken for chemical analysis and bacteriological examination from the Council's swimming baths at Lime Grove and the Open Air Swimming Pool, Bloemfontein Road. It has been established that the action of sunlight is an important factor as regards the loss of free chlorine in water. Following reports that samples taken at the Open Air Swimming Pool were low in chlorine content during the hot sunny spell in June, I decided to increase the frequency of sampling especially whilst this kind of weather persisted With the co- operation of the Baths Superintendent a satisfactory chlorine content was reached and maintained. Markets Two of the four markets in the borough are privately owned the Uxbridge Road Market on the site of the Silver cinema and the market in Railway Approach At the other two markets Bradmore Lane and Norland Road street traders operate from approved pitches licenced by the Borough Council under Section 21 of the London County Council (General Powers) Act, 1947. Licences are renewed annually upon application from the holders Providing the conditions prescribed in the Licence have been fulfilled (and in the case of food satisfactory storage accommodation etc ) the Licence is renewed. The majority of Licences issued are in connection with foodstuffs The present stallholders have held Licences and occupied the same pitches in the markets for many years and in almost every case the business is a family concern. 20 Considerable attention is paid to street trading food, the stalls and storage accommodation receiving frequent inspection During the year 672 visits were made by the Food & Drugs Inspector to these markets. Wormwood Scrubs Fair The Fair held on wormwood Scrubs during the spring and summer Bank Holiday periods includes a number of stalls retailing soft drinks ice cream, shellfish etc. These stalls which are licenced by the London County Council were inspected on each occasion by the Borough council's Inspectors, Ice Cream During the year 83 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 4½ hours or more 2 214½ to 4 hours 3 ½ to 2 hours 4 Less than ½t hour The 83 samples were placed in the following grades:- 59 samples were within Grade 1 standard 15 ,, ,, ,, ,, 2 ,, 6 ,, ,, ,, ,, 3 ,, 3 ,, ,, ,, ,, 4 ,, Figures showing 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 UNGRADED 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 - - 1957 83 59 15 6 3 - 21 In addition 18 samples of ice cream were taken for chemical analysis by the Public Analyst all of which complied with the standard laid down by the Pood Standards (Ice Cream) order 1953 which requires that ice cream shall contain not less than 5 per cent fat, 10 per cent sugar, and 7½ per cent milk solids other than fat. The fat content of the samples taken ranged from 7,9 per cent to 12.3 per cent. Ice Cream and Preserved Food Premises Under section 16 of the Food and Drugs Act, 1955 no premises (with certain exceptions) may be used for:- (a) the sale or the manufacture for the purpose of sale, of ice cream or the storage of ice cream intended for sale or (^) 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 4 Ice cream sales only 10 Confectioners (sweet shops) selling ice cream 150 Restaurants (selling ice cream for consumption off the premises) 28 Grocers selling ice cream 79 Bakers and confectioners selling ice cream 4 Fruiterers and greengrocers selling ice cream 8 Butchers preserving meat and/or manufacturing sausages 52 Grocers and Provision Dealers preserving meat 19 Grocers and Provision Dealers preserving fish 1 Fishmongers curing fish 3 Food Factories manufacturing sausages and preserved food 3 Total 361 The above includes 7 new registrations effected during the year. 495 inspections of registered food premises were made. Milk-Supplies 256 inspections of premises used in connection with the processing and distribution of milk were made by the Inspector Generally the premises were found to be satisfactory. In 10 cases it was found necessary to send warning letters in respect of unsatisfactory conditions. 110 persons were registered as distributors of milk and 2 premises 22 were registered as Dairies at the close of the year. The Milk (Special Designation) (Pasteurised & Sterilised Milk) Regulations 1989 and The Milk (Special Designation) (Raw Milk) Regulations 1949 Three designations are prescribed under the above Regulations: Tuberculin tested, Pasteurised and sterilised. Tuberculin Tested milk is derived from herds which have been submitted to the tuberculin test and from which cows that have reacted to the test have been excluded No animal may be added to the herd unless it has passed the test, In addition, every animal of the herd must be examined by a veterinary surgeon and the milk must have been produced under good hygienic conditions. Tuberculin tested milk must be supplied in a properly closed container. If the container is a bottle, the cap must bear the address of the premises at which the bottle was filled and the words tuberculin Tested Milk" Any other type of container must be closed with a tight fitting cover and suitably sealed and labelled Pasteurised Milk The term 'pasteurised' which is used freely today is derived from the name of the French scientist Louis Pasteur who found that the abnormal souring and fermentation of wines could be prevented by exposing them to certain temperatures It was later discovered that heat treatment applied to milk under satisfactory conditions not only destroyed most of the souring organisms but also the various pathogenic or diseaseproducing organisms Milk sold under this designation must be subjected to one of two methods of heat treatment specified in the Regulations In both methods the temperature is well below boiling point, It must be delivered in containers closed at the dairy where they are filled, with a cap or cover over-Iapping the lip of the container and labelled 'Pasteurised Milk' Sterilised Milk is m Ik wh h has been, heated to a temperature of 212°F or more. All persons who pasteurise or sterilise, or deal in a special designated milk, are required to hold licences, which, except in the case of producers of raw milk, are Issued by Food & Drugs Authorities Under the milk (Special Designations} Specified Areas Orders, all milk sold by retail in the areas specified, must be one coming within one of the above designations The County of London is one of the specified areas. The following table shows the number of Licences issued by the council during 5.957:- Dealers- (Pasteurisers) Licences 2 Dealers (Sterilisers) Licences 1 DEALERS LICENCES Tuberculin Tested 66 Pasteurised 80 Sterilised 89 23 DEALERS SUPPLEMENTARY LICENCES Tuberculin Tested 16 Pasteurised 18 Sterilised 18 In addition to the numbers of samples shown under "sampling" 105 samples of Special Designated milk were taken under the 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 Tested Phosphatase Test Methylene Blue Test Turbidity Test Passed Fai1ed Passed Failed Passed Failed Pasteurised 60 60 - 60 - - - - T. T. Pasteurised 16 16 - 16 - - Tuberculin Tested 12 - - 12- - - Sterilised 17- - - - 17 - Total 105 76 - 88 - 17 - Three samples of Tuberculin Tested "raw" milk were submitted for biological testing for the presence of tubercle bacilli The test is made by injecting a preparation of the milk to be tested into a guinea pig. In each case a negative report was received. At the two large milk processing depots in the borough checks are made on the cleanliness and bacteriological condition of milk bottles and milk churns which pass through the washing plants before filling Eight samples submitted to the Council's bacteriologist for examination were reported satisfactory. Public Health (Condensed Milk) Regulations 1923/1948. These Regulations provide standards for milk fat and milk solids of condensed milk and control the labelling of tins and other receptacles During the year 13 samples were submitted for examination by the Public analyst and were reported genuine. 24 SECTION E SANITARY ADMINISTRATION Staff - inspectorial The establishment of Public Health Inspectors consists of the Senior Public Health Inspector, a Deputy Senior Public Health Inspector, ten district Inspectors, two Food & Drugs Inspectors and one woman Inspector, but the Borough is at present covered by eight district Inspectors, one Food and Drugs Inspector aad one woman Inspector. One of the district Inspectors also acts as Inspector in charge of rodent control operations. Exhumations aid Re-Intemnent of Bodies During the year three licences were granted by the secretary of State for the exhumation and removal of three bodies from graves in St Mary's Catholic Cemetery, Harrow Road In one instance it was necessary for two other bodies to be exhumed temporarily and then re-buried, to enable one of the above removals to be carried out Each of these cases was attended by the local district Inspector and it was possible to certify that each removal had been carried out in a proper manner. Increase of Rent and Mortgage Restrictions Acts 1920/ 1939 Housing Repairs and Rents Act , 1954 Rent Act, 1957 The Rent Act, 1957 came into force on 6th July, 1957 and is an Act to amend the Rent and Mortgage Interest Restrictions Acts 1920 to 1939, the Furnished Houses (Rent Control) Act, 1946 and certain other enactments relating to the control of rents and the right to retain possession of houses. The Act limits the rent of a controlled house. If upon receipt of a Notice of proposed increase of rent the tenant of a controlled house considers that his house is in disrepair he may serve on the landlord a notice in the prescribed form stating that the dwelling or any part thereof is in disrepair by reason of defects specified in the notice and that those defects ought reasonably to be remedied having regard to the age, character and locality of the dwelling and requesting the landlord to remedy them If after six weeks the defects have not been remedied or the landlord has not given, in the prescribed form, an undertaking to do the work, the tenant may apply to the local authority for a certificate of disrepair Such application must be accompanied by the statutory fee of 2/6d. If the local authority is satisfied that the dwelling or part is in 25 disrepair by reason of defects specified in the notice they will issue a certificate of disrepair after the expiration of three weeks from the service by them on the landlord of notice of intention to do so unless they receive an undertaking from the landlord in the meantime. This certificate entitles the tenant to pay a reduced rent as provided in the Act until such time as the certificate is cancelled. During the year applications under the above Acts were received as follows:- FOR CERTIFICATES OF DISREPAIR Number received 164 Number granted 56 FOR REVOCATION OF CERTIFICATES Number received 13 Number granted 11 UNDERTAKINGS GIVEN BY LANDLORD Number received 61 Coroner's Court and Public Mortuary The number of bodies admitted to the Public Mortuary during the year was 765 an increase of 131 compared with 1956. There were 734 post-mortem examinations. This is also an increase of 115 compared with last year. The Mortuary and Court were also used by the Boroughs of Fulham,Chelsea and Kensington. The Mortuary is equipped with a large refrigeration plant and this ensures 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 one fresh certificate was issued six registrations were cancelled as the holders of the certificates were no longer carrying on business, and the number of premises registered under the Act at the end of the year was four. Pet Animals Act, 1951. Local Authorities remain responsible under the above Act for issuing licences to persons for keeping pet shops, and for the Inspection of premises 26 so licensed to check that the requirements are complied with. During the year no new licences were granted. Ten applications for renewal of licences were received and granted. 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. Public Baths and Wash houses The public baths and wash-houses in Lime Grove, Shepherds Bush,provide facilities for bathing, swimming and laundry work For bathing the facilities include private hot baths or shower cubicles and towels, soap, bath cubes and shampoos are supplied for a small cost. The water in the swimming baths is controlled by filtration and chlorination to secure a high degree of purity In the public wash-houses fully automatic machinery for washing, wringing, full drying and ironing are provided at a small cost. Owing to considerable reconstruction work which was carried out at the Baths, certain of the facilities referred to above were not available for the whole year. The Open Air Bath 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 purifications treatment. London County Council (General Powers) Act, 1954 Hairdressers & Barbers During 3955 the Council obtained the necessary approval to Bye-laws relating to the registration of Hairdressers and Barbers. The Bye-laws came into force on 1st October, 1955 and during 1957, one further application was received and registered, making a total of 94 Hairdressers and Barbers registered in the Borough up to the end of the year. Eight applications were received and registered on change of ownership during the year. All the premises were inspected and kept under observation and as a 27 result it was necessary to serve nine notices and send several warning letters regarding conditions. Pharmacy & Poisons Act, 1933 Pharmacy & Medicines Act, 1941 The names and addresses of 106 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 on commodities sold under proprietary names containing other poisons included in the list. No action was necessary in respect of any offence under the Acts. 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. 28 SECTION F SANITARY CIRCUMSTANCES OF THE BOROUGH water Supply The Metropolitan Water Board is responsible for the supply of water to the Borough and no complaints with regard to the purity thereof were made 23 certificates were granted under Section 95(2) of the Public Health (London) Act, 1936, with regard to newly erected houses and flats having a proper and sufficient water supply Public Cleansing The Borough Engineer and Surveyor, who is responsible for the collection, removal and disposal of refuse, has kindly furnished the following information with regard to this service Amount of house refuse collected during the year 29,751 tons Amount of trade refuse collected during the year 3,422 " 33,173 " Method of disposal By road to tip at Harefield Frequency 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 Act 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 115 plans 25 of which related to combined drainage) were submitted and a total of 2,381 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 of proper ashpit (Dustbin) accommodation 29 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 the proceedings instituted will be found in the table in the Statistical Supplement, Factories During the year it was not found necessary to serve any notices relating to insanitary conditions in 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 Although the number of complaints of rats was about the same as last year (373) the number found to be infested (284) showed a decrease of about 25% This is the lowest figure for five years and may be significant. Unfortunately the mice infestations (180) have increased by about a third so that the total number of premises treated for rats and mice (459) are almost the same as in 1956 and as mice are more difficult to clear the work has not lessened. An interesting point is that we rarely receive a complaint of mice that is not justified whereas during this year about 100 complaints relating to rats were found to be apprehension rather than fact. This is indicative of the fear of rats, and I regret to say, partial toleration of mice. In many cases the mice infestation is severe before a complaint is made. Five small areas were treated for rats by "Block control Method". The sewers were baited three times during the year instead of the usual twice Good results followed the additional treatment with which we are wel1 satisfied. Defective drainage has once again been the main single cause of rat infestation. Approximately £182 was received for rat and mice baiting at business premises, 30 The following is a summary of the work for the year with comparable figures for 1956 in brackets. Premises inspected: Dwellings 471 (525): Business 975 (1,108) 1,446 ( 1,633) Complaints: Rats 373 (364); Mice 155 (121) 528 (485) "Discovered* other than by complaint: Dwellings 30 (41); Business 7 (18) 37 (58) Premises infested by rats: Dwellings 219 (277); Business 65 (55) 284 (332) Premises infested by mice: Dwellings 137 ( 85); Business 43 ( 30) 180 (115) Premises treated for infestations by Councill staff 459 (447) Major infestations 25 ( 23) Notices served relating to Rodent Control 56 (75) Inspections and re-inspections by Public Health Inspectors re Rodent Control 2,752 (2,444) Atmospheric Pollution The two stations set up in 1954 at Westville Road and Livingstone Schools for measuring and recording the extent of atmospheric pollution continued to function together with the lead peroxide instrument in Ravenscourt Park maintained by the London County Council. A comparison of total solids in tons per square mile deposited in Hammersmith which is partly industrial and mostly residential, and the average amount deposited in Harlow, a new town, Warrington an industrial town in Lancashire, and Stepney an industrial and residential area in the 31 east end of London is shown in the following chart. Average amount of TOTAL SOLIDS deposited in tons per sq. mile HAMMERSMITH STEPNEY WARRINGTON HARLOW 32 Clean Air Act 1956 On the advice of the Health Committee the Council approached surrounding Boroughs to see whether a liaison could be established to promote linked plans to work the Act in this region of London, Middlesex and surrey. As a result, Acton, Barnes, Brentford & Chiswick, Fulham and Willesden joined Hammersmith, and in my Annual Report for 1958 I propose to list the achievements of the first year's association of these Authorities. 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 available to doctors for bacteriological examinations, throat swabs, intestinal specimens etc.. The necessary swabs and outfits for both Laboratories can be obtained on application to the Public Health Department. The West London Hospital is particularly useful in view of its central position. Ambulance' Facilities The London County Council is responsible under the National Health Service Act, 1946, for the provision of ambulance facilities throughout the County. 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 is the Headquarters of the Post-Graduate Medical School of London and also includes the Medical Research Council's Linear Accelerator and Cyclotron building in connection with cancer Research and treatment. The Royal Masonic Hospital is one of the few remaining private hospitals and Queen Charlotte's is a maternity hospital with its own Board of Governors and is the largest independent maternity hospital in the British Isles and has an average annual birth rate of between 2,400 and 3 000 babies of all nationalities Hammersmitth Chest Clinic All aspects of the tuberculosis problem are dealt with at this Clinic which is housed at Hammersmith Hospital The administration of the Clinic is by a sub-Committee of the Board of Governors of the Hammersmith, West London and St. Mark's Hospitals The Clinic is closely linked With the Post Graduate Medical School of London and takes pact in the teaching of post 34 graduate students. Management of the clinic is under the direct supervision ofaConsultant Chest Physician, who is also a lecturer in tuberculosis on the staff of the Post Graduate Medical School. The Clinic, its associated independent radiography department and 27 beds are housed in the same building and are run as an integral Unit. A consultant diagnostic service for all chest diseases are provided for local practitioners who may send patients for a 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 a chest X-ray without the formality of being examined by a consultant or other hospital physician. In addition to the diagnostic services provided out-patient clinics are held for new and follow-up cases, for refills, for ambulance cases, for contacts and for anti-tuberculosis vaccinations. A special clinic is also held for patients suffering from Chronic Bronchitis. Attendances at all clinics apart from the X-ray only service, are strictly by appointment only. During the treatment rehabilitation and re- settlement of tuberculous and other 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 the Borough. Suitable patients are treated with modern methods in their own homes and visited there by the staff of the Chest clinic. Visits to the Clinic are arranged as necessary by ambulance and patients are also admitted to the Chest clinic beds for chemotherapy and for major and minor thoracic surgery. Sanatorium treatment, when this is necessary, is undertaken in sanatoria under the auspices of the North-West Metropolitan Regional Hospital Board Such admissions can only be arranged through the Chest Clinic, as is also the case with tuberculous patients to be admitted to Hammersmith Hospital. Personal Health Services The County Council remained responsible for the personal health services, with Dr. B.E.A. Sharpe and Dr E M. Cran as Division Medical Officer and Deputy respectively. The day to day administration of the services is provided by the Medical Officers of Health for the Borough of Chelsea, Fulham, Hammersmith and Kensington. The liaison between the staffs of the County council and the Borough 35 Council continues on a very happy and cordial footing. The following is a list of our Clinics. ANTE-NATAL CLINICS 1/3 Milson Road Monday 1.30 p.m. Wednesday 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 Monday 9.30 a.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, Wednesday and Friday at 1.30 p.m. 36 DIPTHERIA IMMUNISATION 1/3 Milson Road Friday 1.30 p.m. 48 Glenthorne Road Wednesday 9.30 a.m. Becklow Gardens Thursday 9.30 a.m. The Curve, Westway Tuesday 9.30 a.m. The Library, College Park Friday 9.30 a.m. VACCINATION 1/3 Milson Road Friday 1.30 p.m. 48, Glenthorne Road 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 Tuesday Wednesday and Thursday at 2 p.m. Friday at 10 a.m. SPEECH THERAPY 48, Glenthorne Road Monday and Thursday 1.30 p.m. CRECHES 48, Glenthorne Road Tuesday and Friday 9.30 a.m. to 12 noon. A Creche is a public nursery in which children are taken care of whilst their parents are otherwise engaged. At Glenthorne Road there is sufficient accommodation for 10 children if required. Application for admission is made to the Superintendent of the Welfare Centre or the Health Visitor in charge. In all instances priority is given to children whose mothers have to attend a clinic, hospital, doctor or dentist for treatment or otherwise. 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 l/9d per session is made, but this may be 37 abated in certain circumstances. Since the Creche was opened in 1955 it has proved a great success and had been welcomed by many people. During the year welfare foods and other nutrients including National Dried Milk, concentrated Orange Juice and cod Liver Oil have continued to be provided at welfare centres. The County Council also maintains the following four Day Nurseries in the Borough which are available for children up to five years of age Brook Green Day Nursery Dalling Road Day Nursery Latimer Road Day Nursery Uxbridge Road Day Nursery Each is open on Monday to Friday from 7.30 a.m. to 6 p.m. and the charge for children received into them is based on the parents' income and is reduced if possible Domestic Help service This service, also administered by the London County Council employs 21 full-time and 69 part-time helpers and maintained its good and valuable work during the year. Its local headquarters are in the Public Health Department at the Town Hall. The number of cases in which help was provided is as follows:- Maternity 26 Tuberculous 13 Other 996 1,286 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 by travellers from this country going abroad, as required by the International Sanitary Regulations. During the year 885 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 above Acts, a Medical Officer of Health may 38 have to apply to the courts for an Order for the compulsory removal to a hospital in certain particularly difficult cases. During the year 18 cases were referred to the Department for examination but only in the following instance was it necessary to take action under the above Acts. Mrs. S. age 86 suffering from serious burns of both legs. Both she and her room were in a filthy condition and she refused to see a Doctor or have any help. An Order for removal under the Amendment Act was obtained and she was removed to Hospital This Order was later extended for a further two months Her condition improved and she was discharged to a Home in Dorset. In the other cases it was possible to find a solution either by co-operation with the family doctor or by making use of available services. 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 a person who had 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 sixteen burials were carried out. Hammersmith Old People s Welfare Association This Association discovers and meets the needs of necessitous old persons and continued to progress during the year It is a self contained unit with its office in the Town Hall and with the assistance of many outside voluntary associations sponsors various activities for the old people including:- Arrangements for free bathing facilities at the Council's Baths. Reduction in cost of boot and shoe repairs Chiropody service Clubs for Old People Reduced cost of hairdressing for female Old Age Pensioners A visiting service whereby a number of friendly people 'adopt' lated old people. Holiday schemes Luncheon clubs Loans of Wireless sets. The association also operates a Mobile Meals Service in the Borough. The Public Health Department works in co-operation with the Association and both have been able to assist each other during the year in various matters. 39 Medical Examination of Council's Staff During the year I have continued to carry out the duties of Staff 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 scheme. In the case of Officers this examination takes place on appointment and in the case of Servants after six months' service with the Council. 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 286. and of this number 61 were found to be unfit for the following reasons:- Hypertension 23 Mitral Stenosis 1 L.I. Hernia 2 Left Hydrocele 1 Bilaterial Hernia 2 Varicose Veins & Eczema 3 Petit Mai 2 Chronic Otorrhoea 2 Glycosuria 4 Deafness & Fixation of Left Elbow 1 Chest condition 5 Cardiac history 1 Obesity? Glandular 1 History of pulmonary tuberculosis 2 Bilateral Leucotomy 1 War Wound 1 Peptic Ulcer 1 Defective vision 3 Median Nerve Palsy 1 Epilepsy 1 Urethral Dilatation 1 History of Haematuria 1 Old tubercular Left Ankle 1 At the beginning of 1953 the Council decided to put into operation a scheme for streamlining sick leave arrangements The scheme worked smoothly and satisfactorily and during the year 98 examinations were carried out by the Department. Financial Contributions to Voluntary Organisations Subscriptions to the funds of voluntary bodies were, on the recommendation of the Health committee, made by the Council during the year as follows: - Organisation Amount Statutory Authority Central Council for Health Education £ll,11,0 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 40 Conferences The Council were officially represented at the under-mentioned Conferences. Conference Delegates Mechanical Engineers' Contribution to Clean Air. London 19/21 February, 1957. Mr, C.H.Wright Public Health Inspector Health Congress of the Royal Society for the Promotion of Health Folkestone 30th April - 3rd May 1957. Councillor Mrs. E. O' K. Finn M.B.E., Dr. F.M. Day, Medical Officer of Health Association of Public Health Inspectors, Eastbourne 17/20 September, 1957. Mr. W Rigby. Senior Public Health Inspector. National Smoke Abatement Society, Hastings, 2/4 October, 1957. Councillor E .W. Flynn, Dr. A.J. shinnie, O. B. E. Deputy Medical officer of Health. Health Information Bureau The Health Information Bureau continues successfully and as before all enquiries on health matters, which normally come to the Department, were handled and we had a total of 5,949 all told. A revised copy of the Health Services Guide was printed and approximately 2,500 copies were distributed to local doctors Councillors, a large number of interested persons and in fact to many places all over the world. 41 STATISTICAL SUPPLEMENT TO ANNUAL REPORT FOR YEAR 1957 GENERAL STATISTICS - 1957 Area 2,28 2. 5 acres Population ( 1957) (estimated) 111, 700 „ (1956) (estimated) 113,300 „ Census (1951) 119,367 Natural increase i.e., excess of births over deaths 657 Marriages registered 1,266 Rateable Value (April, 1957) £2,052,441 Sum represented by a penny rate (April, 1957) £8,150 EXTRACT FROM VITAL STATISTICS 1957 Total M. F. Live Births Legitimate 1,671 886 785 Birth Rate per 1,000 estimated Illegitimate 215 114 101 resident population =16.8 Stillbirths 35 20 15 Rate per 1,000 total (live & still) births = 18. 2 Deaths 1,229 639 590 Death Rate per 1,000 estimated average population = 11.0 Deaths from maternal causes - Deaths Rate per 1,000 total (Live and still births) Pregnancy, childbirth, abortion 2 1,04 Death Rate of Infants under one year of age: - All Infants per 1.000 live births 25 Legitimate infants per 1,000 legitimate live births 23.33 Illegitimate infants per 1,000 illegitimate live births 41.86 Deaths from Cancer (all ages) 284 „ „ Measles (all ages) .. „ „ Whooping Cough (all ages) .. 43 NATURAL INCREASE OR DECREASE OF THE POPULATION DURING THE PAST 20 YEARS Ye ar Population Excess of Births over Deaths Excess of Deaths over Births 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 70 5 .. 1955 114,700 462 .. 1956 113,300 529 .. 1957 111,700 657 .. 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 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 23 2 2.0 1955 114,700 269 2.3 1956 113,300 229 2.0 1957 111,700 284 2.5 44 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 1948 M - 1 19 8 4 32 F - 1 8 3 1 13 Total - 2 27 11 5 45 1949 M - 7 25 13 4 49 F - - 3 1 1 5 Total - 7 28 14 5 54 1950 M . 4 28 10 3 45 F - 1 3 2 2 8 Total - 5 31 12 5 53 1951 M - 1 33 11 3 48 F - 1 3 3 1 8 Total - 2 36 14 4 56 195 2 M - 3 31 14 5 53 F - - 5 4 2 11 Total - 3 36 18 7 64 1953 M - 2 18 25 2 47 F - - 1 3 1 5 Total - 2 19 28 3 52 1954 M - - 31 11 11 53 F - - 4 3 2 9 Total - - 35 14 13 62 1955 M 1 4 31 19 3 58 F - 1 3 - 2 6 Tot al 1 5 34 19 5 64 1956 M - 5 27 24 8 64 F - - 3 3 3 9 Total - 5 30 27 11 73 1957 M - 3 36 25 3 67 F - - 2 6 4 12 Total - 3 38 31 7 79 45 INCIDENCE OF PULMONARY TUBERCULOSIS AND NEOPLASMS OF THE LUNGS Age Groups Pulmonary Tuberculosis Neoplasms of the Lung or Bronchus 1956 1957 1956 1957 MALES 0- - - - - 1- - - - - 5- - - - 15- - - - - 25- 3 - 5 3 45- 5 3 27 36 65- 2 1 24 25 75- 3 1 8 3 Total Males 13 5 64 67 FEMALES 0- - - - - 1- - - - - 5- - - - - 15- - - - - 25- 1 1 - - 45- 2 2 3 2 65- 1 - 3 6 75- - - 3 4 Total Females 4 3 9 12 46 VITAL STATISTICS OF WHOLE DISTRICT 1957 and Previous Years Year Population estimated to middle of each year Births Total Deaths Registered in the District Transferable Deaths Net Deaths belonging to the District Number Rate Number Rate of Non-residents registered in the District of Residents not registered in the District Under 1 Year of Age At all Ages Number Rate per 1,000 Net Births Number Rate 1 2 3 4 5 6 7 8 9 10 11 12 1925 134,500 2,351 17.5 1,034 7.7 186 756 153 65 1,604 11.9 1926 134,400 2,188 16.3 1,174 8.7 195 556 144 66 1,535 11.4 1927 132,800 2,076 15.6 1,581 11.9 230 377 126 61 1,728 13.0 1928 136,300 2,258 16 6 1,449 10.6 222 326 156 69 1,553 11.4 1929 136,900 2,162 15.8 1,757 12.8 222 340 133 62 1,875 13.7 1930 136,900 2,173 15.9 1,387 10.1 219 436 140 64 1,604 11.7 1931 135,100 2,073 15.3 1,567 11.6 288 373 140 68 1,652 12.2 1932 133,700 1,940 14.5 1,465 10 .9 294 543 129 66 1,714 12.8 1933 131,400 1,827 13.9 1,500 11.4 340 530 119 65 1,690 12.9 1934 129,170 1,783 13.8 1,359 10.5 346 655 137 77 1,668 12.9 1935 128,100 1,877 14.7 1,347 10.5 406 583 131 70 1,524 11.9 1936 127,700 1,922 15.1 1,399 10 .9 441 639 116 60 1,597 12.5 1937 126,500 1,913 15.1 1,333 10.5 402 662 130 68 1,593 12.6 1938 125,100 1,874 15.0 1,340 10.7 450 522 117 62 1,412 11.3 1939 B 122,800 D 116,200 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 15.8 1,605 14.4 509 401 41 22 1,497 12.6 1952 118,800 1,777 14.9 1,509 12.7 535 383 37 21 1,357 11.4 1953 117,600 1,750 14.0 1,400 12.0 406 206 35 20 1,207 10.3 1954 116,500 1,776 15.2 1 ,382 11.8 606 295 38 21 1,071 9.1 1955 114,700 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 1957 111700 1886 16.8 1412 12.6 60 3 4 20 48 25 1229 11.0 * B — Birth-rate Population Figure. D= Death-rate Population Figure. 47 CHART SHOWING BIRTH AND DEATH RATES PER l,000 POPULATION FOR THE PAST 20 YEARS . BIRTH RATE DEATH RATE 48 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR Cause of Death Sex 0- 1- 5- 15- 25- 45- 65- 75- Total all Ages 1. Tuberculosis, respiratory M _ _ _ . - 3 1 1 5 F - - - - 1 2 - - 3 2.Tuberculosis, other M - - - - 1 - - - 1 F - - - - - - - - - 3.Syphilitic disease M - - - - - 1 2 - 3 F - - - - - 1 - - 1 4.Diptheria M - - - - - - - - - F - - - - - 1 - - 1 5.Whooping Cough M - - - - - - - - - F - - - - - - - - - 6.Meningo-coccal infections M - - - - - - - - - F - - - - - - - - • 7. Acute Poliomyelitis M - - - - - - - - - F - - - - - - - - - 8. Measles M _ _ _ _ . . . _ _ F _ _ . - _ _ _ _ . 9.Other infective and parasitic diseases M - - - - - - - - - F - - - - - - - - - 10. Malign ant neoplasm, stomach M - - - 1 1 11 4 3 20 F - - - - - 5 6 7 18 11. Malignant neoplasm, lung bronchus M - - - - 3 36 25 3 67 F - - - - - 2 6 4 12 12.Malignant neoplasm, breast M - - - - - - - - - F - - - - 2 16 6 3 27 13.Malignant neoplasm, uterus M - - - - - - - - - F - - - - - 3 3 2 8 14.Other malignant and lymphatic neoplasms M - - - 2 4 24 16 18 64 F - - - 1 4 20 16 27 68 15.Leukaemia, aleukaemia M - 1 - - 3 3 1 1 9 F - 1 - - 1 - - 1 3 16. Diabetes M - - - - - 1 1 1 3 F - - - - - 1 1 1 3 17. Vascular lesions of nervous system M - - - - - 9 19 23 51 F - - - - 2 15 23 54 94 18. Coronary disease, angina M - - - - 4 47 36 27 114 F - - - - 1 18 25 24 68 19. Hypertension with heart dise ase M - - - - 1 1 8 3 13 F - - - - - 3 7 10 20 20.Other heart disease M - - - - 4 4 12 16 36 F - - - - 4 10 10 49 73 21.Other circulatory disease M - - - - - 5 10 6 21 F - - - - - 7 9 15 31 22. Influenza M - - - 1 - 4 2 2 9 F - - - - - 1 2 - 3 23.Pneumonia M 4 - - - 1 4 11 16 36 F 3 2 - - - 2 2 13 22 24. Bronchitis M - - - - - 22 24 23 69 F - - - - 1 5 9 24 39 25.Other disease of respiratory system M - - - - - - 4 1 5 F - - - - - 2 1 1 4 26. Ulcer of stomach and duodenum M - - - - 1 6 4 2 13 F - - - - - 2 3 4 9 27. Gastritis, enteritis and diarrhoea M 1 - - - - - - - 1 F - - - - - - - 1 1 28.Nephritis and nephrosis M - - - 1 - 1 1 3 6 F - - - - - - 1 1 2 29 Hyperplasia of prostate M - - - - - 1 3 6 10 F . . - - - - 30. Pregnancy .childbirth, abortion M - - - - - - - - - F - - - - 2 - - - 2 31. Congenital malformations M 2 - - - 1 1 - - 4 F 2 - - - 1 - 1 - 4 2.Other defined and illdefined illnesses M 17 - 2 2 3 6 8 7 45 F 17 1 - 2 3 8 10 17 58 33.Motor vehicle accidents M - - - 1 2 2 1 - 6 F - - - - 2 - 1 1 4 34.All other accidents . M 1 - 1 1 3 2 4 4 16 F 1 - - - - - 1 4 6 35. Suicide M - - - 1 6 4 - - 11 F - - - 1 1 4 - - 6 36. Homicide and operations of war M - 1 - - - - - - 1 F - - - - - - - - - M 25 2 3 10 38 198 197 166 639 F 23 4 - 4 25 128 143 263 590 Total of all causes 48 6 3 14 63 326 340 429 1229 49 1957. PROPORTION OF DEATHS FROM PRINCIPAL CAUSES. TOTAL DEATHS , 1229. 50 INFANT MORTALITY 1957 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 5l¢ 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 1957 1,886 48 25 * 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 Registrar General of 1,253 51 Net deaths of infants at various ages under one year of age Under 1 week 36 1-2 weeks 1 2-3 weeks 1 3-4 weeks 1 4 weeks and under 3 months 2 3 months and under 6 months 4 6 months and under 9 months 3 9 months and under 1 year - Total deaths under 1 year 48 NET BIRTHS IN THE YEAR Legitimate 1,671; Illegitimate 215 NET DEATHS IN THE YEAR Legitimate Infants 39: Illegitimate Infants 9 52 53 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 1952 1953 1954 1955 1956 Engl and and Wales 28 27 25 25 24 Scotland 35 31 31 30 29 Northern Ireland 39 38 33 32 29 Australia 24 23 22 22 22 Canada 38 35 32 31 32 Chile 134 114 124 121 113 Denmark 29 27 27 25 25 Prance 46 42 41 39 36 Irish Republic 41 39 38 37 36 Italy 64 59 53 49 48 Netherlands 23 22 21 20 19 New Zealand 22 20 22 22 19 Sweden 20 19 19 17 17 United states of America 29 28 27 27 26 MATERNAL MORTALITY 1957 and Previous Years Number of Deaths YEAR Pregnancy childbirth abortion Number of live Births Maternal Death Rate Average 1924-193 3 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 19 48 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 - 1957 2 1,886 1.04 * Rate calculated on a (live and still) birth figure supplied by the Registrar General of 1,289 ¢ 1 death from pueperal sepsis not counted as "Maternal death"- 54 ENVIRONMENTAL HEALTH SERVICES (A) SANITARY INSPECTIONS Cause of Inspection No. of Inspections No. of Notices served No. of Notices complied with Atmospheric Pollution 7 - - Bakehouses 49 - - Complaints 2896 824 68 7 Drainage 2381 25 7 Factories (Mechanical) 347 14 14 Factories (Non-Mechanical) 149 5 6 Food (other than Restaurants & Eating Houses) 2332 7 5 Hairdressers & Barbers 198 9 10 Housing Act 722 33 1 Housing Applications 289 14 1 House to House 15 - 1 Housing Repairs and Rents Act 553 17 5 Ice cream Vendors 295 1 - Infectious Diseases 332 - - Markets 672 - - Milk Vendors 256 - - Outworkers 100 3 - - Pet Animals Act 24 - - Pharmacy & Poisons Act 110 - - Public urinals 28 - - Rag Flock Act 3 - - Rats and Mice 3058 56 37 Restaurants and Eating Houses 582 9 4 Shops Act 259 9 6 Slaughter houses 3 - - Smoke Observations 138 - - Miscellaneous 14 11 32 26 Re-visits 7310 342 590 No answer 1180 - - No, of Ineffective visits 26602 1397 1400 1180 - - Total 25422 1397 1400 During the year 566 Statutory Notices were served and 414 complied with. (B) SUMMONSES Proceedings instituted during the year Public Health (London) Act, 1936 56 Food and Drugs Act 1955 6 L C. C. Byelaws 4 Housing Act, 1936 6 55 (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 120 149 5 - (ii) Factories not in eluded in (i) in which Section 7 is enforced by the Local Authority 476 3 47 14 - (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding outworkers" premises) - - - - Total 596 49 6 19 - 2. CASES IN WHICH DEFECTS WERE FOUND Particulars Number of Cases in which Defects were Found Number of Cases in which Prcsecutions were Instituted Found Remedied Referred To H M. Inspector By H M Inspector Want of cleanliness (SI.) 10 11 - - - Overcrowding (S, 2) - - - - - Unreasonable Tempera ture (S„ 3) - - - - 1 Inadequate Ventilation (S 4) - - - - - Ineffective Drainage of Floors (S 6) - - - - - Sanitary conveniences (S 7) (a) insufficient - - - - - (b) unsuitable or Defective 7 7 - - - (c) Not separate for sexes - - _ - - Other offences against the Act (not including offences relating to Out-work) 2 2 - - - Total 19 20 - - - 56 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 De fault in Sending Lists to the Council No. of Prosecutions for Failure to Supply Lists No. of Instances of Work in Unwholesome Premises Notices Served Prosecutions Wearing Apparel Making, etc. 218 - - - - - Lampshades 6 - - - - - Lace,Lace curtains and Nets 1 - - - - - Jewellery 9 - - - - - Paper Bags 47 - - - - - Feather sorting 1 - - - - - Carding, &c, of Buttons &c. 47 - - - - - Stuffed Toys 25 - - - - - Cracker Bon-bon Christmas Crack ers Christmas Stockings &c. 32 - - - - - Total 386 - - - - - 57 UNSOUND FOOD CONDEMNED 1951 Baby Pood 3 pkts Bacon 78 lbs. Beans Baked 154 tins Chicken 36 lbs. Chicken 89 tins Chocolate Teacakes 16 pkts. Cream 3 t ins Eggs, Frozen 1 tin Pish 1110 tins Fish 676 lbs. Fruit 1349 tins Fruit Dried 2 lbs Fruit Juice 54 tins Ham 111 tins Jam 29 tins Lard 44 lbs Meat 250 lbs Meat 482 tins Milk 284 tins Mincemeat 2 Jars Nescafe 38 tins Peas 226 tins Pease Pudding 3 tins Pickles 10 jars Rice Creamed 6 tins Sandwich Spread 7 jars Sauce 7 bottles Sauerkraut 4 tins Sausages 77 tins Soup 86 tins Tomatoes 111 tins Vegetables 48 tins 58 PUBLIC MORTUARY - Bodies Admitted, &c Bodies admitted from the Borough:- By order of coroner 296 By order of police 1 On application of undertakers 7 From the West London Hospital during alterations to the Hospital Mortuary 3 307 Bodies admitted from other Boroughs:- Fulham (219 by order of Coroner, 13 by order of Police 2 on application of undertakers) 234 Chelsea (195 by order of Coroner 3 by order of Police, 2 on application of undertakers) 200 Kensington (24 by order of Coroner) 24 458 Total bodies admitted ... 765 No. of P M. examinations conducted:- Hanmersmith cases 296 Fulham cases 219 Chelsea cases 195 Kensington cases 24 Total P. M.'s 734 No. of Inquests held:- Hammersmith cases 78 Fulham cases 42 Chelsea cases 43 Kensington cases 75 Total Inquests held 238 59 60 INFECTIOUS DISEASES Diseases Notifications Total Cases Notified Cases Removed to Hospital Deaths Corrected Figures 0-1 year 1-2 years 2 -5 years 5-15 years 15-25 years 25-45 years 45-65 years 65 + years Scarlet Fever - 1 10 29 1 - _ - 41 11 - 38 Whooping cough 18 15 50 50 - - - - 133 13 - 131 A. Poliomyelitis (Par) - 2 11 13 3 4 - - 33 33 11 " " " (N.Par.) - - - - - - - - - - - - Measles 45 116 50 2 594 6 3 1 - 1267 41 - 1267 Diptheria 2 2 3 - 2 1 - 10 10 1 1 Pneumonia 7 3 15 7 3 9 32 20 96 17 58 93 Dysentery 8 18 39 50 2 22 5 1 145 22 - 137 A Encephalitis (Inf) - - 1 2 - • - - 3 3 - 1 Enteric or Typhoid Fever - - - - - - - - - - - Paratyphoid Fever - - - - - - - - - - Erysipelas - - - - 1 3 8 5 17 9 - 16 Meningococcal Infection - - - - - - - - - - - Food Poisoning 8 2 2 5 6 11 14 3 51 18 - 49 Ophthalmia Neonatorum 4 - - - - - - - 4 - - 4 Malaria - - - 2 - 1 1 4 3 - 4 Scabies - - 5 9 12 14 6 4 50 - - 50 Puerperal Pyrexia - - - 89 139 - - 228 3 - 227* Tuberculosis (Pulmonary) 1 1 6 28 58 25 7 126 27 8 126 " " (Non Pulmonary) - - - 2 5 5 4 16 7 1 16 Totals 93 158 637 77 2 156 271 97 40 2224 217 68 2171 * Of this total only 87 cases related to persons residing in the Borough TUBERCULOSIS Summary of Notifications during the period from the 1st January 1957 to the 31st December 1957 Formal Notifications Number of Primary Notifications of new cases of tuberculosis Age Periods 0- 1- 2- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- Total (All ages) Respiratory, Males 1 1 - 3 1 5 6 21 12 7 10 3 - 70 Respiratory, Females - - _ 2 . 10 7 12 13 5 3 3 1 56 Non- Respiratory Males . - _ - 2 1 1 1 - _ - _ . 5 Non- Respiratory, Females - - - - - 1 2 1 3 3 1 - - 11 CASES NOTIFIED AND DEATHS 1957 and Previous Years Year No. of Cases notified No. of Deaths No of Cases on Register of Notications. Pulmonary Non-Pulmonary Total 1938 155 37 19 2 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 19 53 198 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 1957 126 16 14 2 9 1,517 Average number of cases notified for the 10 years 1938/1947 (inclusive) - 202 Average number of cases notified for the 10 years 1948/1957 (inclusive) - 183. Average number of deaths for the 10 years 1938/1947 (inclusive) - 95. Average number of deaths for the 10 years 1948/1957 (inclusive) - 35. 61 62 CHART SHOWING THE NUMBER, OF NEW CASES OF TUBERCULOSIS NOTIFIED DURING THE PAST 20 YEARS. PULMOMARY TUBERCULOSIS: NON-PULMONARY TUBERCULOSIS: MEDICINAL BATHS Cleansing of Verminous Persons School children- Hammersmith Scabies 46 Verminous 568 Inpetigo 5 School Children-Non Hammersmith Nil Children under Five Years-Hammersmith Scabies 23 Verminous 41 Impetigo 3 Children under Five Years Non Hammersmith Scabies 2 Adults - Hammersmith Scabies 91 Verminous 92 Impetigo 2 Adults - Non-Hammersmith Scabies 24 Verminous 11 Lodging-Houses Hammersmith Scabies 4 Verminous 103 Lodging Houses - Non -Hammersmith Verminous 1 DISINFECTION Hammersmith Cases Non Hammersmith Cases Mattresses 356 16 Pillows 290 20 Blankets 109 59 Sheets 29 4 Quilts 15 3 Clothing 465* - Sundries 183* 78 Total 1627 * 23 Custom's Certificates issued in respect of 382 articles (370 Clothing 12 Sundries) Rooms (including 504 verminous Rooms) 549 63