4347 ack 9 HAM 50 Metropolitan Borough of Hammersmith ANNUAL REPORT of the Medical Officer of Health with STATISTICAL SUPPLEMENT for the year 1958 by F. M. DAY, M.R.C.S., L.R.C.P., D.T.M., D.P.H. HAMMERSMITH TOWN HALL ackd by p.c 29.9.59 MBJ No.l Smoke Control Area (see p. 26) METROPOLITAN BOROUGH OF HAMMERSMITH Health Committee At 31st December, 1958 Councillor E. O'K. Finn (Mrs.), M.B.E. (Chairman) „ E. W. Flynn (Vice-Chairman) „ S. M. Atkins „ A. Belsham „ J. Farndale „ D. M. Heaks (Mrs.) „ E. R. Hunt „ F.W.Ing „ R. W. Oak „ E. M. Tebay, F.I.A.C. „ W. J. Trinder „ E. C. Woods (Miss) 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 Washhouses. Establishment Committee. Dealing with medical examination of Staff, etc. Housing and Town Planning Committee Powers and duties of the Council under the Housing Acts (other than those delegated to the Health Committee). Works Committee. Construction, maintenance and improvement of sewers and public sanitary conveniences. Collection, removal and disposal of house and trade refuse. Cleansing of public highways. Management and control of the Council's cemeteries. Maintenance and control of parks, gardens and open spaces provided by the Council. CONTENTS Page Introduction 1 Staff 2 SECTION A—Social Conditions and Statistics:- Births 4 Deaths 4 Infant Mortality 4 Marriages 4 Maternal Mortality4 Population 3 Social Conditions 3 SECTION B—Prevalence of and Control over Infectious Diseases:- Contacts and Carriers—Sickness Benefit 5 Dysentery 6 Food Poisoning 6 Health Laundry9 Medicinal Baths 6 Notifications 5 Poliomyelitis 6 Tuberculosis 5 SECTION C—Housing:- Overcrowding (Licences) 13 Permanent Estates 13 Re-housing 12 SECTION D—Inspection and Supervision of Food:- Designated Milk Licences 19 Food and Drugs Act, 1955 14 Ice Cream 17 Ice Cream and Preserved Food Premises 18 Markets 16 Milk Supplies 19 Public Health (Condensed Milk) Regulations, 1923-48 19 Sampling 15 Wormwood Scrubs Fair 17 SECTION E—Sanitary Administration:- Coroner's Court and Public Mortuary 20 Exhumation and Re-interment of Bodies 20 Housing Repairs and Rent Act, 1954 20 L.C.C. (General Powers) Act, 1952—Rag and Bone Dealers 21 L.C.C. (General Powers) Act, 1954 Hairdressers and Barbers 22 Pet Animals Act, 1951 21 Pharmacy and Poisons Act, 1933, and Pharmacy and Medicines Act, 1941 22 Public Baths and Washhouses 21 Rag Flock and Other Filling Materials Act, 1951 21 Rent Act, 1957 20 Staff—Inspectorial 20 SECTION F—Sanitary Circumstances:- Atmospheric Pollution 24 Clean Air Act, 1956 26 Drainage 23 Dustbins 23 Factories 24 Inter-Boroughs Smoke Liaison Committee 26 Public Cleansing 23 Rodent Control 24 Sanitary Inspection 23 Water Supply 23 SECTION G—General Provision of Health Services:- Page Ambulance Facilities 27 Burial or Cremation of the Dead 31 Conferences 33 Diseased or Infirm Persons 31 Financial Contributions to Voluntary Organisations 33 Hammersmith Chest Clinic 27 Health Information Bureau 33 Hospitals 27 International Certificates of Vaccination and Inoculation 30 Laboratory Facilities 27 Old People's Welfare 31 Personal Health Services 28 Clinics and Welfare Centres 29 Creches 29 Day Nurseries 30 Domestic Help Service 30 Staff Medical Examinations 32 STATISTICAL SUPPLEMENT—TABLES Causes of Death in Age Groups 43 Deaths from Carcinoma of Lungs in Age Groups 39 Disinfection 57 Extract from Vital Statistics 37 Factory Defects 50 Factory Inspections 50 General Statistics 37 Incidence of Cancer during the past 10 years 38 Incidence of Pulmonary Tuberculosis and Neoplasms of the Lungs 40 Infant Deaths under 1 year in age groups 46 Infant Mortality 45 Infant Mortality Rates—England and Wales and various other Countries 48 Infectious Diseases—Notifications in Age Groups 54 Maternal Mortality 48 Medicinal Baths—Cleansing of Verminous Persons 57 Mortuary and Coroner's Court 53 Natural Increase or Decrease of the Population during the past 20 years 38 Outworkers 51 Sanitary Inspection—Notices served and complied with 49 Summonses—Proceedings instituted 49 Tuperculosis—Notifications and deaths for the past 20 years 55 Tuberculosis—Notifications in sex and age groups 55 Unsound Food condemned 52 Vital Statistics of Whole District 41 CHARTS Birth and Death Rates for the past 20 years 42 Number of Infant Deaths under 1 year of age during the past 20 years 47 Number of new cases of Tuberculosis notified during the past 20 years 56 Proportion of Deaths from Principal Causes 44 1 Town Hall, Hammersmith, W.6. Telephone: Riverside 3020. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Hammersmith. Mr. Mayor, Ladies and Gentlemen, I beg to present my Annual Report upon the health and circumstances of the Borough for the year 1958. Once again, I regret that it was not possible to publish it earlier as the Registrar General's figures required to calculate various statistics were not available. The year was not characterised by any increased prevalence in infectious disease. Measles was less numerous and only two cases of Poliomyelitis occurred. It is pleasing also to report that for the first time for five years the cases of lung cancer were reduced in number. The Health Committee pressed on with Clean Air arrange- ments, and as a result Hammersmith was well to the fore in planning and can bear comparison with any of the pioneer Local Authorities who have put the Clean Air Act into force. The Committee of representatives of the adjacent Middlesex, Surrey and London Boroughs, comprising Acton, Brentford and Chiswick, Barnes, Fulham, Willesden and ourselves, met at regular intervals in order that each constituent member authority knew fully how the others were planning their programmes and also in order that full exchange of information took place to their mutual advantage. Much of the work of the Department was of a routine nature and repetitive in character and little unusual is available for report. At the Medicinal Baths, however, for the first time in my own memory and that of my Staff, two adult males have presented themselves for treatment for head lice. Up to the present time we have treated women and children only. The details are referred to later in the report and I think are interesting in that they show how human health and fitness are bound up with the whims of fashion. In conclusion, 1 wish to express my appreciation of the kindness and consideration shown to me by the Chairman, ViceChairman and Members of the Health Committee, and to record my thanks to the staff of the Department for the efficient manner in which they have carried out their duties at all times during the year. I am. Your Worship, Ladies and Gentlemen, Your obedient Servant, F. M. DAY, Medical Officer of Health. 2 STAFF OF THE PUBLIC HEALTH DEPARTMENT at 31st December, 1958 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. Pottier (Part-Time) Clerical: J. C. Turner (lst Assistant) W. M. Robinson T. J. Hares Mrs. F. Lawford Mrs. D. Kelley F. E. Martin Mrs. L. G. Stimpson E. G. Baines (Temporary) Miss I. E. Waller Miss D. M. Ridyard (Temporary) (M.O.H.'s Secretary) Senior Public Health Inspector: ¶†*P. T. Bayes Public Health Inspectors: o†§J. C. Hopkins °†§S. C. Metcalf §E. W. Pike x†§G. G. Gardiner †§H. R- Fry §J. M. Read ||†/§Miss E. M. Cross °†§C. H. Wright Food and Drugs Inspector: $†*W. J. Godden Enquiry Officers (Clean Air Act): A. Mackay (Temporary) P. E. C. Pendock (Temporary) Mortuary Keeper: W. Gauntlett Medicinal Baths Superintendent: ||F. G. Baldwin Public Analyst: D. F. H. Button, A.R.C.S., F.R.I.C. * Cert. Sanitary Inspectors' Examination Board. † Cert. Royal Sanitary Institute (Meat and other foods). ¶ Smoke Abatement Cert., L.C.C. School of Engineering. § Cert. Royal Sanitary Institute and Sanitary Inspectors' Examination loint Board. ° Cert. Royal Sanitary Institute (Smoke). $ Cert. Royal Sanitary Institute (Inspector). / Cert. Royal Sanitary Institute (Health Visitor). o Cert. Royal Sanitary Institute (General Science and Sanitation). x Cert. Royal Sanitary Institute (Sanitary Science as applied to Buildings and Public Works). ‡ State Certified Midwife. || State Registered Nurse. 3 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, and became part of the County of London in 1885. It 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 and Kent House and others in the Malls also date back to the 17th century. Kelmscott House, the home of William Morris, and houses in Hammersmith Terrace, were built in the 17th and 18th centuries. The sub-soil in the northern part of the Borough, i.e., north of Uxbridge Road, mainly consists of clay, whilst in the south there is a layer of some 20 feet of gravel above blue clay, particularly in the east, much of which was excavated for brick-making purposes. There are approximately 287 acres of parks and open spaces, 262 acres of which are controlled by the London County Council and the remaining 25 acres by the Borough Council. The total length of roads 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 past the Town Hall. Vital Statistics. (a) Population. In this report the rates are calculated on the estimated population adopted by the Registrar General, namely, 110,200, which compared with 111,700 for 1957, shows a reduction of 1,500. For the last six years the Registrar General has reported a steady reduction in the population figures of the Borough. It should be emphasised that his calculations are based on estimates, and that his figures are not factual and may well be somewhat removed from the truth. There has been no epidemic causing mortality during the year and the excess of births over deaths has been maintained. 4 (b) Marriages. The number of marriages was 1,284, an increase of 18 compared with the previous year. Particulars are set out hereunder:— The Register Office 500 Buildings registered for marriages (Roman Catholic Churches and Chapels at which a Registrar attends) 405 Churches of the Church of England 326 Authorised Persons (Chapels at which a Registrar does not attend) 42 Jewish Synagogues 11 1,284 (c) Births. The corrected number of births for the year as supplied by the Registrar General was 2,027. On the estimated population of 110,200 this represents an annual rate of 18.3 births per thousand persons living, which is 1.5 higher than the previous year. (d) Deaths. During the year 1,416 deaths were registered. Add to this figure 480 deaths of residents of the Borough who died in various parts of England and transferred by the Registrar General, and deduct 627 deaths of non-residents and 28 transferable deaths which occurred in the Borough, the correct figure shows a total of 1,241 deaths of residents (667 males and 574 females) which is an increase of 12 compared with 1957. On the estimated population of 110,200 the corrected number of deaths per 1,000 persons living was 11.2 compared with 11.0 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 (bronchitis, pneumonia, etc.) third, which is similar to the last three years. (e) Infant Mortality. The number of deaths of infants under one year of age during the year was 49, giving a mortality rate per 1,000 live births of 24 compared with 25 last year. (f) Maternal Mortality. There were two maternal deaths during the year, resulting in a death rate of 0.96 per 1,000 live and still births. 5 SECTION B PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASES Infectious Diseases. 1,117 cases of infectious diseases were notified during the year, 140 cases were removed to hospital, and of this number 29 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 1,088. These figures show a decrease on the previous year of 1,083 cases. This is due to the fact that there were very few cases of Measles until the latter part of the year and a decrease in the number of cases of Whooping Cough and Puerperal Pyrexia. There were only three cases of suspected Diphtheria brought to the notice of the Department during the year, and I am pleased to be able to report that none of them was confirmed. Contacts and Carriers of Infectious Disease—Sickness Benefit One certificate was issued during the year in the following circumstances:— A pupil midwife at a Maternity Hospital who was a carrier of a streptococcal infection. Tuberculosis. During the year there was, once again, a decrease in the incidence of this disease. The number of new cases notified was 128, compared with 142 in the previous year. These figures show a decrease of 3 in pulmonary cases and 11 in non-pulmonary cases. At no time, since records have been kept, has such a low figure as this been recorded. In the Statistical Supplement will be found a chart showing the numbers of new cases notified during the past 20 years. Despite the low number of new notifications. Tuberculosis remains a serious menace to public health and chiefly affects the age groups which are vital to the productive output 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. The London County Council proceeded with the campaign for B.C.G. inoculations among schoolchildren and a total of 2,545 received these inoculations during the year. The number of deaths from tuberculosis was 15, compared with 9 in the previous year. 6 Poliomyelitis. There was a considerable decrease in the incidence of this disease during the year, only 2 cases were notified compared with 11 in 1957. There was one case of the paralytic type and one non-paralytic. During the year 24,458 vaccinations against the disease were carried out in Division 1, either at clinics or by family doctors. Food Poisoning. There were 36 cases of Food Poisoning during the year, compared with 49 in 1957. Salmonella typhi-murium was identified in 12 cases, salmonella Thompson in 1 case, and salmonella Newport in another, but in the remaining cases no causa organism was recovered. Towards the end of the year a report was received regarding an outbreak of suspected food poisoning in a factory in the Borough. The canteen at this factory was run by a firm of independent caterers, and samples of the meal eaten by the affected persons were sent to the Public Health Laboratory. The samples consisted of chicken, ham and sausage, and heat resistant C1. Welchii was isolated in all three items. Stool specimens were obtained from the members of the canteen staff and similar organisms were found in two members, namely, a vegetable cook and a washer-up. Both reported to their own doctors and received treatment, which was still continuing at the end of the year. Apart from this there were no serious outbreaks, but foods alleged to have been responsible for the patients' condition included meat pie, swiss roll, lamb chop, sausages, tinned meat, cream cake, frozen fish fingers, fish frying fat, and ham. Dysentery. There were 122 cases of Dysentery notified compared with 137 in 1957. During the year there were two outbreaks in London County Council Day Nurseries, namely, Dalling Road and Brook Green. Once again the clinical exclusion method of control failed to stop new cases appearing and bacteriological control was used and again proved to be successful. The outbreaks lasted for three weeks and five weeks respectively. Medicinal Baths. New features in infection of the community with insect paransites are of obvious importance. During 1958, for the first time in our experience, two men have had to be treated for head lice. This insect only makes its home in the scalp, and in scalps which are untroubled by the comb. 7 A certain section of the adult male population now wear hair fashions that cost a pound or more to produce and are designed to remain unaltered in appearance for one or more weeks. Much combing is contraindicated as the set becomes disarranged, and a minimum is performed after the night's rest only when necessary. If, therefore, the owner of such a creation becomes infected by the head louse he can be sure of a rapid multiplication of the parasite, resulting in a heavy infestation. As stated previously, this has now happened in two men in 1958 in Hammersmith. It is obvious that the demolition of some of the old buildings is ridding the Borough of sources of bed bug spread. The higher standard of living accommodation is valued by the fortunate and jealously coveted by others. Many more of the requests for disinfestation are received from persons occupying only one or two rooms, than from all other tenants. The time saved by lessening work in the above matters over the past two years has been overspent on the fast growing laundry service. One might say, therefore, that the work of the Cleansing Station is passing from the eradication of existing evil to help in the prevention of or alleviation of suffering. There was an increase of 7 in the number of treatments of verminous persons compared with 1957, this despite the fact that there was a decrease of 55 in the number of head treatments for schoolgirls. During the year only 23 mothers of infested schoolchildren consented to have treatment. This number is far too low when related to the number of families needing attention. The schoolchildren treated were members of 140 different families. At the request of mcdical departments of industrial establishments, 28 verminous heads were treated: some of these had been previously treated with their children, but had now found employment. Sixty-two children under five years of age were shampooed, which although not a large total, covers many more families than last year. Some of these children are brought by brothers and sisters only a few years older. While there has been considerable reduction in numbers amongst schoolchildren, the numbers of adult and pre-school age attenders seems to remain fairly constant. Five families were responsible for 137 head cleansings of schoolchildren, i.e., 27% and two of the families requested 12 cleansings for under fives. One girl of eight years visited on no less than 15 occasions. A blind person of no fixed abode requested a bath. He said he asked for no help from anyone and wished to live as he did. Seven of the persons of no fixed abode had attended at the Baths before. On two occasions it was necessary to convey persons to and from the Baths for treatment. In the first instance it was a very dirty old man of 80, not verminous. He was bathed and supplied 8 with clean second-hand clothing and was most thankful. The other was a female of 55. She had head and body lice ++. Before leaving her home she was very indignant and refused to allow her bedding to be removed for stoving. The bedding was sprayed with the rest of the contents of the room. At the Baths she allowed her hair to be cut as it was too matted to be combed. The comfort of the bath gradually changed her attitude from aggressive to passive. After treatment she spent about half an hour combing her hair to the required position, then departed quite happy. The total number of Scabies treatments for the year was 518; this is a higher figure than for the past two years, but out of the 110 first treatments given, only 48 were confirmed as suffering. Sixty-two persons were treated as contacts or questionable cases. Sixty-seven families were involved in the 110 first treatments. There were also 12 reinfections. Despite the above figures, it is pleasing to note that the number of confirmed cases is lower than it has ever been. Many more doctors are sending patients to the Baths as? Scabies, and this is perhaps due to the fact that more people are taking their spots and pimples to the doctors for treatment. During the year cases were treated from 10 other Councils, including the London County Council, and since 1955, 15 Boroughs or Urban District Councils within London, Middlesex and Surrey have been assisted, namely, Acton, Barnes, Brentford and Chiswick, Ealing, Feltham, Fulham, Hayes and Harlington, Heston and Isleworth, Kensington, Richmond, Southall, Staines, Sunbury, Wandsworth and West Drayton and Yiewsley. There were very few calls from other Authorities for steam sterilisation during the year, assistance only being required by London County Council, Barnes, Heston and Isleworth and Richmond. The assistance given to Barnes included the drying of bedding, etc., after flooding in the early part of the year. On 94 occasions the West London Hospital made use of the service for sterilisation purposes for a total of 604 articles. Articles of clothing and materials are still being sent abroad to relatives by persons living in the Borough and although more countries are now allowing freedom of import, it is still necessary to grant Certificates in certain instances. Twenty-six certificates were issued in connection with the following countries: Poland 13, Russia 8. Bulgaria 3 and Czechoslovakia 2. Two hundred and fifty-three mattresses were sterilised for Olympia Ltd. after use during the Dairy Show and other exhibitions. Another service carried out was drying bedding and linen after damage by burst pipes or flooding. A male and female, aged about 50, were brought to the Baths by the police; they were charged with stealing and were both in need of cleansing. On examination both were found to be filthy and verminous. They had been wandering in company for many months. The female's feet were exuding pus at the base of 9 both big toes, but she was unaware that anything was amiss. She complained of no pain and apart from the fact that her feet had ached at times there was nothing wrong with them last time she had seen them. The right foot was definitely gangrenous and the other foot was in an earlier stage of the same condition. She was in need of food. The feet were cleansed and covered. The police were advised that hospital attention was essential. Permission was obtained for her to be taken to Hospital instead of Court. Another, an inhabitant of Barnes, an old man aged 84, living with his son aged 49, was brought to the Baths suffering from body lice. The old man said he had not had a bath since his wife died about 50 years ago, and the son said he was sure this statement was true. The story was not belied by witness. After the bath the old man's feet were so sore he found it painful to walk. Health Laundry. The Health Laundry can no longer be considered the junior partner at the Disinfection Station. Rather can it be likened to a hub around which the other work revolves because this work must keep to a planned time-table, although this time-table must allow flexibility to cope with cleansings and other outside work. Unless collections and deliveries are made within stipulated times the co-operation needed at the homes is not forthcoming. The new machines, which were installed in 1956, are still giving excellent results and the number of articles passing through them increases every year as is shown by the figures below. It is not the length of time which the service runs for any particular individual that really matters, but that a need can be met at a time when it is essential, and having given a promise to do the work, to faithfully carry it through. At times the work can be unpleasant in character and the staff are thankful that the Council has done all in its power to make the working conditions as favourable as possible. Forty-two initial visits were made upon request for the service, and 90 subsequent visits were made to the homes to ascertain progress. A lady of 85 living with her almost blind daughter, first brought to our notice in 1953, is one of the worthy cases still on the list and receiving help. Another, a female of 31 with advanced disseminated sclerosis, has been receiving help for the past 18 months, and in January of this year the service was started for an old lady aged 101. Her enjoyment of life is a tribute to her daughter who, although born with a partial right sided paralysis 68 years ago, anticipates all her mother's requirements. Requests for the service come mainly from Home Helps, District Nurses, Hospitals, Doctors and Welfare Associations, and 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. 10 Certificates granted during 1958: Sex and Age Collections up to 31.12.58 Primary Cause of Ill-health Sequel F 86 90 Fractured Femur Service still in operation F 85 24 Senility Admitted to hospital F 70 54 Senility Deceased M 74 95 Incontinence Deceased F 63 82 Incontinence Admitted to hospital F 34 17 Disseminated Sclerosis Service no longer required F 61 33 Apoplexy Deceased F 68 39 Intestinal Obstruction Admitted to hospital F 31 132 Disseminated Sclerosis Service still in operation M 77 37 Hemiplegia Admitted to hospital F 52 19 Tuberculous Spine Service no longer required M 75 28 Carcinoma of Rectum Service no longer required F 69 5 Apoplexy Service no F 81 21 Carcinoma of Breast longer required Deceased F 64 97 Mental Deficiency Service still in operation M 65 5 Carcinoma of Bladder Service no longer required M 81 18 Ascites Service no longer required F 101 55 Senility Service still in operation F 70 40 Mental Deficiency Admitted to hospital M 73 2 Cardiac Failure Admitted to hospital F 77 3 Senility Admitted to hospital F 75 1 Mental Deficiency Admitted to hospital M 84 25 Incontinence Deceased M 78 6 Cardiac Failure Deceased F 77 32 Chronic Bronchitis Deceased F 45 26 Colostomy Admitted to hospital F 87 2 Senility Deceased 11 Sex and Age Collections up to 31.12.58 Primary Cause of Ill-health Sequel F 80 65 Arthritis Service still in operation F 90 1 Senility Admitted to hospital F 85 14 Incontinence Admitted to hospital F 77 7 Carcinoma of Stomach Deceased F 84 2 Senility Admitted to hospital F 84 1 Carcinoma of Colon Service no longer required F 84 27 Senility Service still in operation F 82 17 Senility Deceased F 84 3 Cardiac Failure Deceased F ? 1 Pulmonary Tuberculosis Service no longer required F 88 2 Cardiac Failure Admitted to hospital F 86 20 Cerebral Haemorrhage Service still in operation F 80 2 Cardiac Failure Service no longer required F 52 3 Carcinoma of Uterus Admitted to hospital M 80 2 Dirty Conditions Service no longer required M 73 5 Apoplexy Admitted to hospital F 89 3 Senility Service still in operation Summary of Articles Cleansed: Articles 1953 1954 1955 1956 1957 1958 Blankets 33 19 40 67 72 186 Sheets 183 514 2006 2057 2550 2531 Quilts 11 — — — 33 24 Pillow Slips — 163 459 440 645 852 Towels — 141 377 401 505 731 Nightdresses — 131 208 252 363 497 Pyjama Jackets — 9 — — 83 162 „ Trousers - - - - - 75 Clothing 72 — — — — — Sundries 180 197 813 920 1329 5379 Total 479 1201 3903 4137 5580 10437 12 SECTION C HOUSING. Rehousing. The Housing Estates Manager has remained in close touch with the Health Department regarding applicants who are living in overcrowded conditions 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 Council. 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 very substantially reduced. Twenty cases were recommended for rehousing on grounds of health and 69 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 — — 1958 20 13 69 16 — 1 Totals 306 88 1,935 741 100 39 13 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 1,935 certifications of overcrowding in ten years only 741 were rehoused. It is a fair deduction that most, if not all, of the remaining 1,194 families remain in their overcrowded conditions. Permanent Estates. During the year both the Borough Council and the London County Council were still engaged in providing accommodation for those in the greatest need, and whilst no new dwellings were erected by the London County Council, the Borough Council erected 33 dwellings for Old People in Sycamore Gardens. 4 fiats in Clematis Street, 48 flats in Sulgrave Gardens and 6 in DuCane Road. The Council acts as landlord for 3,336 principal tenants. The properties managed include houses, flats, prefabs and requisitioned 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 1,165 2. Number of families rehoused by the Borough Council in rebuilt houses since the war 30 3. Number of families rehoused 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 598 5. Number of families on the Waiting List at the end of the year 1,480 Overcrowding. One licence was granted under Section 80 of the Housing Act, 1957. 14 SECTION D INSPECTION AND SUPERVISION OF FOOD Food and Drugs Act, 1955. Food Hygiene Regulations, 1955. The supervision of the food supplies of the Borough is one of the most important duties which devolves upon the Health Committee. The careless handling of food or storage under unsuitable conditions can be dangerous, since food in good condition may easily become contaminated unless suitable and proper precautions are taken. Hygienic conditions vary according to the type of person or employee engaged, the nature of the trade carried on, working conditions and structural arrangements, and it is found that only by frequent inspection of food premises and food stalls, that a satisfactory standard is maintained. There are certain types of food traders whose hygienic standards or quality of products would rapidly fall if the Inspector were not a frequent visitor. During 1958, 4,366 visits were made at food premises, stalls and markets, and at 173 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. No 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) 2 Bakers' Retail Shops 34 Beer Bottlers 1 Biscuit Manufacturers 1 Butchers 67 Cafes and Restaurants 155 Canteens and Clubs 95 Chemists 38 Confectioners (sweetshops) 150 Fishmongers (wet and fried) 28 Fruit and Greengrocers 96 Grocers and Provisions 215 Honey (packing) 1 Ice Cream Manufacturers 3 Jellied Eels and Pies (manufacture and sale) 5 Milk Processing Depots 2 Milk Distributors 120 Off Licences 39 Public Houses 96 Sweet and Chocolate Manufacturers 3 15 Under Section 9, Food and Drugs Act, 1955, three seizures of unsound food were made. These were in connection with sugared peanuts found to be moth infested. Legal proceedings were taken; a penalty and costs amounting to £10 10s. 0d. were imposed. The Council's Inspectors accepted the voluntary surrender of foodstuffs which upon examination were found to be unfit for human consumption. A list of the commodities and the amount involved is shown in the statistical supplement. Among new legislation concerning food introduced during the year is the Antioxidant in Food Regulations, 1958. An antioxidant is defined as any substance which delays, retards or prevents the development in food of rancidity or other flavour deterioration due to oxidation, but does not include lecithin, ascorbic acid, tocopherols, citric acid, tartaric acid, phosphoric acid, or any permitted preservative. Only foods specified in the Regulations may contain antioxidant and then only of a nature and proportion laid down. Sampling. During 1958, 875 samples of food and drugs were submitted to the Public Analyst for chemical analysis. Adverse reports were received in respect of 18 samples as shown in the following summary:— Sample Result of Analysis Remarks Preserved Beef Sausages Contained 650 parts per million sulphur dioxide Penalty £5 £2 2s. 0d. costs Minced Beef Contained artificial colour Absolute discharge £3 3s. 0d. costs Minced Beef Contained artificial colour Informal sample Caviar Contained Hexamine 285 parts per million Absolute discharge £4 4s. 0d. costs Minced Beef Contained sulphur dioxide 3100 parts per million Penalty £10 £2 2s. 0d. costs Caviar Contained Hexamine 510 parts per million Informal sample Minced Beef Contained sulphur dioxide 1500 parts per million Informal sample Hydrogen Peroxide Acidity 2.5 times B.P. limit Warning letter 16 Sample Result of Analysis Remarks Sulphur Tablets 26% deficient in Informal sample sulphur Sulphur Tablets 26% deficient in Warning letter sulphur Sulphur Tablets 26% deficient in Warning letter sulphur Minced Beef Contained sulphur Conditional discharge dioxide 550 parts £3 3s. 0d. costs per million Bread Roll Contaminated with Warning letter iron rust Minced Beef Contained sulphur Informal sample dioxide 680 parts per million Meat Sauce Cube Not labelled with Warning letter ingredients Vitamin Food 88% deficient in Informal sample Vitamin C Vitamin Food 77% deficient in Legal proceedings Vitamin C pending Cream Cheese 85% deficient in fat Informal sample In addition to samples taken for analysis, 101 various samples of food were taken for bacteriological examination. In order to maintain a check on the hygiene in the preparation of artificial cream and butter cream, the sampling of cakes and pastries was continued throughout the year. The results obtained are shown below:— No. of Samples taken Article of Food Organisms found Other Organisms Faecal Coli Non-faecal Coli 42 Frozen Whole Egg 1 — 3 Butter Cream — — — 52 Imitation Cream 5 12 — 1 Pressed Beef — — — 3 Mussels 2 — — Markets. There are four markets in the borough, two of which, the Uxbridge Road Market and the market in Railway Approach, are privately owned. At the other two markets in Bradmore Lane and Norland Road, street traders operate from approved pitches licensed by the Borough Council under Sec. 21, London County Council (General Powers) Act, 1947. Street trading licences are renewed annually upon application from the holders, and where 17 such application is for the renewal of the licence in its original terms, the renewal is automatic unless grounds are known to exist which call for a review of the conditions prescribed in the licence, i.e. permission to trade in different articles or commodities from those originally licensed, or if the storage accommodation is unsatisfactory, particularly in the case of the storage of food. The Council may refuse to renew a licence or may vary such licence upon renewal where the applicant is, on account of misconduct or for any other sufficient reason, in their opinion unsuitable to hold such licence. Considerable attention is paid to street trading in food; the stalls and storage accommodation receiving frequent inspection. During the year 629 visits were made by the Food & Drugs Inspector to these markets. Wormwood Scrubs Fair. Officially recognised in 1896 when the London County Council first licensed plots for the erection of stalls and stands, this traditional fair, which is believed to have been in existence some years before that date, was at that time used more for the sale of commodities, including sweets, pies, hot potatoes, shellfish and general merchandise. The fair which is now held during the spring and summer Bank Holiday periods, includes a number of stalls retailing soft drinks, ice cream, shellfish, etc. These were inspected on each occasion by the Borough Council's Inspectors. Ice Cream. During the year 52 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 de-colourise methylene blue being recorded and the sample graded as follows:— Provisional Grade Time taken to Decolourise Methylene Blue 1 4½ hours or more 2 2½ to 4 hours. 3 ½ to 2 hours. 4 Less than ½ hour. The 52 samples taken were placed in the following grades:— 44 samples were within Grade 1 standard. 6 samples were within Grade 2 standard. 1 sample was within Grade 3 standard. 1 sample was within Grade 4 standard. Figures showing the results of samples taken in the borough since the methylene blue test has been used for the grading of ice 18 cream are shown below. It will be noticed that the results for 1958 are better than for any previous year — In addition, 21 samples of ice cream were taken for chemical analysis by the Public Analyst, all of which complied with the standard laid down by the Food 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 per cent to 13.1 per cent. Ice Cream and Preserved Food Premises Under Section 16 of the Food & Drugs Act 1955, no premises, with certain exceptions, may be used for:— (a) the sale or the manufacture for sale of ice cream or the storage of ice cream intended for sale, or (b) the preparation or manufacture of sausages, or potted, pressed, pickled or preserved food intended for sale unless they are registered under this Section for that purpose by the local authority. The following summary, which includes 16 new registrations effected during the year, gives details of the number and type of premises registered under this Section of the Act— Ice Cream Manufacturers 3 Ice Cream sales only 10 Confectioners (sweet shops) selling ice cream 156 Restaurants (selling ice cream for consumption off the premises) 28 Grocers selling ice cream 87 Bakers & Confectioners selling ice cream 5 Fruiterers and greengrocers selling ice cream 9 Butchers preserving meat and/or manufacturing sausages 52 Grocers and Provision Dealers preserving meat 18 Grocers and Provision Dealers preserving fish 1 Fishmongers curing fish 5 Food Factories manufacturing sausages and preserved food 3 TOTAL 377 Year No. of samples taken Grade 1 Grade 2 Grade 3 Grade 4 1951 49 29 12 3 5 1952 68 37 20 4 7 1953 105 62 22 15 4 1954 89 64 16 5 4 1955 94 60 11 12 2 1956 91 62 25 4 1957 83 59 15 6 3 1958 52 44 6 1 1 19 During the year 514 inspections of registered food premises were made by the Council's Inspectors. Milk Supplies. One hundred and fifty-two inspections of premises used in connection with the processing and distribution of milk were made by the Inspectors. Generally the premises were found to be satisfactory. In 16 cases it was found necessary to send warning letters in respect of unsatisfactory conditions but in no instance has it been necessary to institute legal proceedings. 120 persons were registered as distributors of milk and 2 premises were registered as Dairies at the close of the year. The Milk (Special Designation) (Pasteurised & Sterilised Milk) Regulations 1949 and The Milk (Special Designation) (Raw Milk) Regulations 1949. The following licences were issued by the Council under these Regulations during 1958. Dealer's Licences Pasteurisers Licences 2 Sterilisers Licence i Tuberculin Tested Licences 66 Pasteurised Licences 84 Sterilised Licences 92 Dealers Supplementary Licences Tuberculin Tested 17 Pasteurised 19 Sterilised 20 In addition to the numbers of samples shown under "Sampling" 81 samples of Special Designated milk were taken under the Regulations from milk processing plants, milk distributors, 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 Failed Passed Failed Passed Failed Pasteurised 59 59 — 59 — — — T.T.Pasteurised 6 6 — 6 — — — Tuberculin Tested 8 — — 8 — — — Sterilised 8 — — — — 8 81 65 73 — 8 — Public Health (Condensed Milk) Regulations 1923/1948. These Regulations provide standards for milk fat and milk solids of condensed milk and control the labelling of tins and other receptacles. During the year 22 samples were submitted for examination by the Public Analyst and were reported genuine. Public Health (Preservatives, etc. in Food) Regulations 1925/1958 Four samples of oranges, lemons and grape fruit were taken for examination by the Public Analyst who reported finding no evidence of the presence of diphenyl in any of the samples. 20 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 & Drug Inspectors and one woman Inspector, but the Borough has been covered by eight District Inspectors, one Food and Drugs Inspector and one woman Inspector. At the end of the year, Mr. W. Rigby retired from the service having been with the Borough for 39 years, 17 of which were in the capacity of Senior Public Health Inspector. One of the district Inspectors also acts as Inspector in charge of rodent control operations. Exhumation and Re-Interment of Bodies. During the year five licences were granted by the Secretary of State for the exhumation and removal of five bodies from graves in St. Mary's Catholic Cemetery, Harrow Road. Each of these 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 During the year applications under the above Acts were received as follows:— For Certificates of Disrepair Number received 167 Number granted 78 For Revocation of Certificates Number received 36 Number granted 35 Undertakings Given by Landlord Number accepted 117 Coroner's Court and Public Mortuary The number of bodies admitted to the Public Mortuary during the year was 1,124, an increase of 319 compared with 1957. There were 1,085 post-mortem examinations. This also is an increase of 251 compared with last year. 21 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. During the year the Council approved plans for alterations to the Mortuary which will provide more accommodation and better facilities, and it was anticipated that the work would be commenced early in 1959. Rag Flock and other Filling Materials Act, 1951. The above Act remained in force during the year and the number of premises on the register at the end of the year was four. Pet Animals Act, 1951. This Act remains in force and ten applications for renewal of licences were received and granted during the year. 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. Considerable reconstruction work was still being carried out at the Baths during the year and as a consequence certain of the facilities referred to above were not available. The Open Air Baths in Bloemfontein Road, Shepherds Bush, provides during the summer months, facilities for swimming and sunbathing and is open daily, including Sundays, from the middle of May to the end of August, or later according to weather conditions. The water in this Bath also undergoes the required purification treatment. Seven samples of water were taken for chemical analysis from the Public Baths and the Open Air Bath, all of which were reported to be satisfactory. 22 London County Council (General Powers) Act, 1954. Hairdressers and Barbers. During the year two new applications were received and registered, making a total of 96 hairdressers and barbers registered in the Borough. Three applications were received and registered for change of ownership during the year. All the premises were kept under observation during the year and several warning letters were sent regarding conditions. Pharmacy & Poisons Act, 1933. Pharmacy & Medicines Act, 1941. The names and addresses of 103 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. The majority of these persons are food retailers and in some instances the poisons sold are only household disinfectants, but a 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 premises are inspected for their suitability, methods of storage and labelling as required under the Acts and have been found satisfactory. 23 SECTION F SANITARY CIRCUMSTANCES OF THE BOROUGH Water Supply. The Metropolitan Water Board is responsible for the supply of water to the Borough and it maintained its high degree of consumer service and also that of its supplied water. It is indeed a happy circumstance that the Chairman of the Metropolitan Water Board is, in fact, Hammersmith's Alderman R. J. Buckingham. 96 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 supply of water. Public Cleansing. The Borough Engineer and Surveyor, who is responsible for the collection, removal and disposal of refuse, has kindly furnished the following information with regard to this service. Amount of house refuse collected during the year 30,539 tons Amount of trade refuse collected during the year 3,551 tons 34,090 tons 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 waterclosets, etc., are enforced by the Council. During the year 116 plans (20 of which related to combined drainage) were submitted and a total of 2,333 inspections were made in connection with supervision of drainage works. Dustbins. Once again there were no appeals lodged in respect of Notices served under Section 107 of the Public Health (London) Act requiring the provision of proper ashpit (dustbin) accommodation. 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, together with the number of preliminary and statutory notices served and complied with, and proceedings instituted, will be found in the Statistical Supplement. 24 Factories. It was not found necessary to serve any notices relating to insanitary conditions in any factory during the year. In the Statistical Supplement will be found a table in 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. Once again statistics show that although plenty of hard work has been, and is being, done, the hard work must continue. In recent years new methods of baiting and new poisons have been brought into use, but the hard fact remains that we have a nucleus of about 460 premises that need treatment for either rats or mice every year. It appears that other Boroughs are experiencing a similar state of affairs, i.e., that whilst present efforts are just about keeping the rat and the mouse within check, no reduction in the general population of either species has yet been achieved in a large area such as ours. Defects in drains continue to be the major single cause of rat infestations, and in recent years this has been aggravated during the demolition of old properties when making way for new roads, etc. This, of course, should stabilise itself. During the year approximately £141 was received for rat and mice haitinp at business nremises The following is a summary of the work for the year with comparable figures for 1957 in brackets. Premises inspected: Dwellings 584 (471) Business 1210 (975) 1,794 (1,446) Complaints: Rats 424 (373) Mice 122 (155) 546 (528) "Discovered" other than by complaint: Dwellings 26 (30) Business 8 (7) 34 (37) Premises infested by rats: Dwellings 287 (219) Business 52 (65) 339 (284) Premises infested by mice: Dwellings 107 (137) Business 22 (43) 129 (180) Major infestations 53 (25) Premises treated by Council staff 468 (459) Notices served relating to Rodent Control 78 (56) Inspections and re-inspections by Public Health Inspectors 4872 (2752) Atmospheric Pollution. The stations set up in 1954 for measuring and recording the extent of atmospheric pollution continued to function during the year. 25 A comparison of total solids in tons per square mile deposited in Hammersmith, 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 east end of London is shown in the following chart. Average amount of TOTAL SOLIDS deposited, in tons per square mile. 26 Clean Air Act, 1956. Proposed Smoke Control Areas. During the year the Council decided to apply the "Smoke Control Area" provisions of the above Act to the whole of the Borough by progressive stages and to carry out a pilot survey of a small area in the South of the Borough. This Pilot Survey was carried out over an area roughly 46 acres in extent containing approximately 650 private dwellings and 80 commercial premises, but with no major industrial plants. It contained the Town Hall, a Telephone Exchange, one school, one cinema and several blocks of residential flats, including two blocks owned by the Council. As a result of this Pilot Survey the Council agreed to make an area to be known as the "No. 1 Smoke Control Area" bounded by the Town Hall to the West, the River Thames to the South, the south side of King Street and Hammersmith Road to the North and along the boundary between Hammersmith and Fulham to the East. The acreage of this area was approximately 169 acres and included 11 Industrial premises, 296 Commercial premises (including three cinemas), 2,025 private dwellings, 7 Churches and other religious institutions, 5 schools, 3 Crown properties and 12 other properties. The situation of this Area is shown in red on the map at the commencement of the report. The estimated cost of making the necessary alterations to approximately 1,157 firegrates, so far as residential properties were concerned, was £12,761 and the authorised fuel required was approximately 1,750 tons. Of the estimated cost referred to above, £2,400 would be in respect of Council-owned properties. It was hoped that the Minister would confirm the Order early in 1959 and that it would come into operation on 1st November, 1959. Inter-Boroughs Smoke Liaison Committee. This Committee consisting of representatives from the Boroughs of Fulham and Hammersmith in the County of London, Barnes in the County of Surrey, and Acton, Brentford & Chiswick, and Willesden in the County of Middlesex, held its inaugural meeting early in the year with the idea of exchanging views regarding problems that might arise in implementing the provisions of the Clean Air Act, 1956, and to co-ordinate the proposals of the different Councils for the establishment of Smoke Control Areas. All the Councils concerned have either made Areas or are in process of so doing and in certain cases, wherever practicable, are arranging the Areas to adjoin those of other member Boroughs. 27 SECTION G GENERAL PROVISION OF HEALTH SERVICES IN THE BOROUGH Laboratory Facilities. Our Public Analyst works at the Southwark Borough Council's laboratory situated in the Health Centre, Walworth Road, S.E. Bacteriological examination of food is carried out by the Public Health Laboratory Service, County Hall. S.E.I, and this Laboratory, together with the Laboratory at West London Hospital is also 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 PostGraduate 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 birth rate of between 2,400 and 3,000 babies of all nationalities. Hammersmith 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 part in the teaching of post-graduate students. Management of the Clinic is under the direct supervision of a Consultant 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 28 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 tuberculosus 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 tuberculosus 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 Region Hospital Board. Such admission can only be arranged through the Chest Clinic, as is also the case with tuberculosus 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 Divisional Medical Officer and Deputy respectively. The day to day administration of the service is provided by the Medical Officer of Health for the Boroughs of Chelsea, Fulham, Hammersmith and Kensington. The liaison between the staffs of the County Council and the Borough 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 p.m. 29 48 Glenthorne Road Monday 6.00 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., 6.00 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. Diphtheria Immunisation 1/3 Milson Road Friday 1.30 p.m. 48 Glenthorne Road Wednesday 9.30 a.m. Becklow Gardens Thursday 9.30 a.m. The Curve, Westway Tuesday 9.30 a.m. The Library, College Park Friday 9.30 a.m. Vaccination 1 /3 Milson Road Friday 1.30 p.m. 48 Glenthorne Road 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 10.00 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 30 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 1/9 per session is made, but this may be abated in certain circumstances. Since the Creche was opened in 1955 it has proved a great success and has 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 parents' income and is reduced if possible. Domestic Help Service. This service, also administered by the London County Council, employs 15 full-time and 91 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 10 Tuberculosus 9 Other 714 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 560 certificates were authenticated. 31 National Assistance Act, 1948. National Assistance (Amendment) Act, 1951. Removal to Suitable Premises of Persons in Need of Care and Attention. Under the provisions of the above Acts, a Medical Officer of Health may have to apply to the Courts for an Order for the compulsory removal to a hospital in certain particularly difficult cases. During the year 12 cases were referred to the Department for examination, but it was not found necessary to take action under the above Acts in any case. It was possible to find a solution either by co-operation for the family doctor or by making use of other available services. National Assistance Act, 1948. Burial or Cremation of the Dead. During the year eighteen burials were carried out by the Council under Section 50 of the above Act. Hammersmith Old People's Welfare Association. This Association discovers and meets the needs of necessitous old people, and is a self-contained Unit with its office at the Town Hall. It also sponsors various activities for the old people with the assistance of many outside voluntary associations. These activities include:— Arrangements for free bathing facilities at the Council's Baths. 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' isolated old people. Holiday schemes. Luncheon clubs. Loans of wireless sets. The Association also operates a Mobile Meals Service in the Borough. The lunches are prepared in the Town Hall kitchen and the number of persons served rose to approximately 100 per day, 5 days per week. 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. 32 Medical Examination of Council's Staff. During the year I have continued to carry out the duties of Staff Medical adviser to the Council. The total number or medical examinations carried out in connection with admission to the Council's Superannuation and/or Sick Pay Scheme during the year was 243, and of this number 63 were found to be unfit for the following reasons: — Hypertension 15 Otosclerosis 1 Glycosuria 3 Diabetic 1 L.I. Hernia 2 Ureteral Dilation 1 Mitral Stenosis 1 Emphysema 1 Recurrent Hernia 1 Duodenal Ulcer 1 Peptic Ulcer 1 Partial Gastrectomy 1 Gastric Ulcer 5 Left Hydrocele 1 33 Chronic Otitis Media 4 Nephritis 1 Anorexia & Weight Loss 1 Low I.Q. 2 Bronchitis 3 Injury to Head 1 Heart Condition 3 History of Neurasthenia 1 Chest Condition 5 Psychiatric condition 2 Varicose Veins 1 Deafness 2 Epilepsy 1 Anaemia 1 At the beginning or 1953 the Council decided to put into operation a scheme for streamlining sick leave arrangements. The scheme still works smoothly and satisfactorily and during the year 47 examinations were carried out in this connection. 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 vear as follows: Organisation National Society for Clean Air Central Council for Health Education Amount £ s. d. 12 12 0 12 14 0 statutory Authority Public Health (London) Act, 1936, Section 298. Local Government Act 1948, Section 136. Public Health (London) Act 1936, Section 298. Conferences The Council was officially represented at the under-mentioned Conferences:— Conference Royal Society of Health (Health Congress) Eastbourne. 28th April to 2nd May, 1958. Association of Public Health Inspectors, Blackpool. 16th 19th September, 1958. National Society for Clean Air (formerly National Smoke Abatement Society), Llandudno, 1st—3rd October 1958. Delegates Councillor Mrs. E. O'K. Finn, M.B.E. Mr. W. Rigby, Senior Public Health Inspector. Mr. W. Rigby, Senior Public Health Inspector. Councillor E. W. Flynn, Dr. A. J. Shinnie, O.B.E., Deputy Medical Officer of Health. Health Information Bureau. The Health Information Bureau continued successfully and as before all enquiries, which normally come to the Department were handled and we had a total of 6,686 all told. Once again a revised copy of the Health Services Guide was printed and approximately 2,500 copies distributed to councillors, local doctors, many interested persons and to many places all over the world. STATISTICAL SUPPLEMENT TO ANNUAL REPORT FOR YEAR 1958 37 GENERAL STATISTICS — 1958 Area 2,282.5 acres Population (1958) (estimated) 110,200 „ (1957) (estimated) 111,700 „ Census (1951) 119,367 Natural increase, i.e., excess of births over deaths 786 Marriages registered 1,284 Rateable Value (April, 1958) £2,029,573 Sum represented by a penny rate (April, 1958) £8,200 EXTRACT FROM VITAL STATISTICS — 1958 Total M. F. Live Births Legitimate 1,807 913 894 Birth Rate per 1,000 estimated resident population = 18.3. Illegitimate 220 106 114 Stillbirths 35 17 18 Rate per 1,000 total (live and still) births = 16.9. Deaths 1,241 667 574 Death Rate per 1,000 estimated average population = 11.2. Deaths from maternal causes Pregnancy, childbirth, abortion Deaths 2 Rate per 1,000 total (live and still) births 0.96 Death Rate of Infants under one year of age:— All infants per 1,000 live births 24 Legitimate infants per 1.000 legitimate live births 26.00 Illegitimate infants per 1,000 illegitimate live births 9.09 Deaths from Cancer (all ages) 249 Deaths from Measles (all ages) — Deaths from Whooping Cough (all ages) — 38 NATURAL INCREASE OR DECREASE OF THE POPULATION DURING THE PAST 20 YEARS Year Population Excess of Births over Deaths Excess of Deaths over Births 1939 B122,800 438 - Dl16,200 — 1940 98,320 — 156 1941 84,880 77 — 1942 89,370 337 — 1943 92,050 468 — 1944 89,190 370 — 1945 96,100 434 — 1946 111,860 974 — 1947 117,280 1,190 — 1948 115.800 847 — 1949 118,440 662 — 1950 119,200 691 — 1951 118,300 377 — 1952 118,800 420 — 1953 117,600 543 — 1954 116,500 705 — 1955 114,700 462 — 1956 113,300 529 — 1957 111,700 657 — 1958 110,200 786 — 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 1949 118,440 238 2.0 1950 119,200 258 2.1 1951 118,300 254 2.1 1952 118,800 290 2.4 1953 117,600 222 1.9 1954 116,500 232 2.0 1955 114,700 269 2.3 1956 113,300 229 2.0 1957 111,700 284 2.5 1958 110,200 249 2.2 39 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 1952 M — 3 31 14 5 53 F — — 5 4 2 11 Total — 3 36 18 7 64 1953 M - 2 18 25 2 47 F — — 1 3 1 5 Total — 2 19 28 3 52 1954 M - - 31 11 11 53 F — — 4 3 2 9 Total — — 35 14 13 62 1955 M 1 4 31 19 3 58 F — 1 3 — 2 6 Total 1 5 34 19 5 64 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 1958 M - 1 29 23 6 59 F — — 1 3 1 5 Total — 1 30 26 7 64 40 INCIDENCE OF PULMONARY TUBERCULOSIS AND NEOPLASMS OF THE LUNGS Age Groups Pulmonary Tuberculosis Neoplasms of the Lung or Bronchus 1957 1958 1957 1958 MALES 0— - - -— 1— — - - - 5— — - - - 15— — - - - 25— - 2 3 1 45— 3 5 36 29 65— 1 1 25 23 75- 1 2 3 6 Total Males 5 10 67 59 FEMALES - o- - - - - 1— — - — - 5— — - - — 15— - - - — 25— 1 1 - — 45— 2 1 2 1 65— - - 6 3 75- - 1 4 1 Total Females 3 3 12 5 41 VITAL STATISTICS OF WHOLE DISTRICT 1958 and Previous Years Year Population estimated to middle of each year Births Total Deaths Registered in the District Transferatle 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 1,829 14.9 1,311 11.2 362 442 77 43 1,391 12.0 D116,200 1940 98,320 1.600 16.3 1,725 17.5 370 401 76 51 1,756 17.9 1941 84,880 1.405 16.5 1,315 15.4 351 364 52 41 1,328 15.6 1942 89,370 1,589 17.8 1,270 14.2 356 338 94 59 1,252 14.0 1943 92,050 1,768 19.2 1,278 13.9 365 387 102 58 1,300 14.1 1944 89,190 1,788 20.0 1,447 16.2 418 389 95 53 1,418 15.9 1945 96,100 1,742 18.1 1.464 15.2 423 267 78 45 1,308 13.6 1946 111,860 2,310 20.6 1,522 13.6 463 277 103 45 1,336 11.9 1947 117,280 2,559 21.8 1,570 13.3 472 271 97 38 1,369 11.6 1948 115,800 2,149 18.5 1,608 13.8 547 241 75 35 1,302 11.2 1949 118,440 1,971 16.6 1,532 12.9 545 322 55 28 1,309 11.0 1950 119,200 1,988 16.6 1,433 12.0 482 346 34 17 1,297 10.8 1951 118,300 1,874 15.8 1,605 14.4 509 401 41 22 1,497 12.6 1952 118,800 1,777 14.9 1,509 12.7 535 383 37 21 1,357 11.4 1953 117,600 1,750 14.9 1,409 12.0 498 296 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 114,703 1,707 14.8 1,495 13.0 643 393 51 30 1,245 10.8 1956 113,300 1,810 15.9 1,414 12.4 582 449 39 21 1,281 11.3 1957 111,700 1,886 16.8 1,412 12.6 603 420 48 25 1,229 11.0 1958 110,200 2,027 18.3 1,416 12.8 655 480 49 24 1,241 11.2 * B= Birth-rate Population Figure. D Death-rate Population Figure. CHART SHOWING BIRTH AND DEATH RATES PER 1,000 POPULATION FOR THE PAST ZO YEAFLS . 42 43 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1958 Cause of Death Sex 0— 1— 5— 15— 25— 45— 65— 75— Total all Ages 1. Tuberculosis, respiratory M — — — 2 5 1 2 10 2. Tuberculosis, other F — — — — 1 1 — 1 3 M - - - - - - - - - F 1 — 1 2 3. Syphilitic disease M - - - - - 2 3 1 6 4. Diphtheria F — — — — — 1 — 1 M — — — - F 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 — — — — — 1 — 1 F 1 1 10. Malignant neoplasm, stomach M — — — — 2 13 7 4 26 F 3 4 4 11 11. Malignant neoplasm, lung bronchus M — — — — 1 29 23 6 59 F 1 3 1 5 12. Malignant neoplasm, breast M - - - - - - - - - F — — — — 3 3 10 6 22 13. Malignant neoplasm, uterus M — — — — — — — — — F — — — — 2 5 1 2 10 14. Other malignant and lymphatic neoplasms M — 2 2 — 4 23 20 12 63 F — — — — 3 21 10 19 53 15. Leukaemia, aleukaemia M — — — 1 — — — — 1 F - - - - - - - 1 1 16. Diabetes M - - - - - 1 — 1 2 F 2 — 2 17. Vascular lesions of nervous system M - - - - 10 16 16 42 F — — — — 2 15 27 49 93 18. Coronary disease, angina M — — — — 2 59 41 35 137 F - - - - - 14 23 28 65 19. Hypertension with heart disease M - - - - - 1 5 1 7 F - - - - - 1 5 6 20. Other heart disease M — — — — 1 5 16 19 41 F — — — — 4 7 13 42 66 21. Other circulatory disease M - - - - - 9 14 6 29 F 8 15 26 4() 22. Influenza M — — — — — 1 — — 1 F 1 1 23. Pneumonia M 6 — — — — 6 8 20 40 F 3 — — — — 3 6 21 33 24. Bronchitis M 1 1 — — 1 28 22 22 75 F 1 1 — — — 7 14 26 49 25. Other disease of respiratory system M — — 1 — — 7 1 2 11 F 3 — 1 4 26. Ulcer of stomach and duodenum M - - - - - 1 4 4 9 F — — — — — 2 1 1 4 27. Gastritis, enteritis and diarrhoea M 1 - - - - - - - 1 F - - - - - 1 — 1 2 28. Nephritis and nephrosis M — — — — 1 3 — 1 5 F 1 2 3 29. Hyperplasia of prostate M - - - - - 2 4 4 10 F 30. Pregnancy, childbirth, abortion M - - - - - - - - - F 1 1 2 31. Congenital malformations M 3 — 1 2 1 — — — 7 F 6 — — 2 — — 1 — 9 32. Other defined and ill-defined illnesses M 19 — — 1 5 12 7 12 56 F 9 — 1 — 3 II 11 17 52 33. Motor vehicle accidents M — — — 1 1 2 — — 4 F — 1 — 1 1 3 34. All other accidents M — 1 — 2 2 1 3 7 16 F — 1 — — — — 1 7 9 35. Suicide M — — 1 2 4 — 1 8 F — — — 1 4 6 — 2 13 36. Homicide and operations of war M - - - - - - - - - F - - - - - - - - - M 30 4 4 8 25 225 195 176 667 F 19 2 2 4 23 114 145 265 574 Total of all causes 49 6 6 12 48 339 340 441 1241 44 1958. PROPORTION OF DEATHS FROM PRINCIPAL CAUSES. 45 INFANT MORTALITY — 1958 and Previous Years Year Births Deaths of Infants Deaths of Infants per 1,000 births Average 1906-1913 3,000 359 117 1914-1923 2,639 230 88 1924-1933 2,145 141 66 1934 1,783 137 77 1935 1,877 131 70 1936 1,922 116 60 1937 1,913 130 68 1938 1,874 117 62 1939 1,829 77 43* 1940 1,600 76 51† 1941 1,405 52 41‡ 1942 1,589 94 59 1943 1,768 102 58 1944 1,788 95 53 1945 1,742 78 45 1946 2,310 103 45 1947 2,559 97 38 1948 2,149 75 35 1949 1,971 55 28 1950 1,988 34 17 1951 1,874 41 22 1952 1,777 37 21 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 1958 2,027 49 24 * Rate calculated on a birth figure supplied by the RegistrarGeneral of 1,781. † Rate calculated on a birth figure supplied by the RegistrarGeneral of 1,501. ‡ Rate calculated on a birth figure supplied by the RegistrarGeneral of 1,253. 46 Net deaths of infants at various ages under one year of age Under 1 week 32 1—2 weeks 1 2—3 weeks — 3—4 weeks 1 4 weeks and under 3 months 5 3 months and under 6 months 8 6 months and under 9 months 1 9 months and under 1 year 1 Total deaths under 1 year 49 Net Births in the Year: Legitimate, 1,807; Illegitimate, 220. Net Deaths in the Year: Legitimate Infants, 47; Illegitimate Infants, 2. CHART SHOWING THE NUMBER. OF DEATHS OF INFANTS UNDER i YEAR OF AGE DURING THE PAST 2.0 YEARS 47 48 INFANT MORTALITY RATES — ENGLAND AND WALES AND VARIOUS OTHER COUNTRIES Deaths under 1 year per 1,000 live births Country 1953 1954 1955 1956 1957 England and Wales 27 25 25 24 23 Scotland 31 31 30 29 29 Northern Ireland 38 33 32 29 29 Australia 23 22 22 22 21 Canada 35 32 31 32 31 Chile 114 124 121 113 117 Denmark 27 27 25 25 23 France 42 41 39 36 34 Irish Republic 39 38 37 36 33 Italy 59 53 49 48 50 Netherlands 22 21 20 19 17 New Zealand 20 22 22 19 20 Sweden 19 19 17 17 17 United States of America 28 27 27 26 26 MATERNAL MORTALITY — 1958 and Previous Years Year Number of Deaths Number of live Births Maternal Death Rate Pregnancy, childbirth, abortion Average 1924-1933 8 2,145 3.5 1934 9 1,783 5.0 1935 2 1,877 1.1 1936 3 1,922 1.6 1937 4 1,913 2.1 1938 2 1.874 1.1 1939 2 1,829 1.0 1940 — 1,600 — 1941 2 1,405 1.5† 1942 3* 1,589 1.9 1943 3 1,768 1.6 1944 2 1,788 1.08 1945 1 1,742 0.56 1946 7 2,310 2.94 1947 1 2,559 0.38 1948 1 2,149 0.45 1949 2 1,971 0.99 1950 1 1,988 0.49 1951 1 1,874 0.52 1952 2 1,777 1.10 1953 3 1,750 1.67 1954 3 1,776 1.66 1955 2 1,707 1.14 1956 — 1,810 — 1957 2 1.886 1.04 1958 2 2,027 0.96 † Rate calculated on a (live and still) birth figure supplied by the Registrar General of 1,289. * 1 death from puerperal sepsis not counted as "Maternal death." 49 ENVIRONMENTAL HEALTH SERVICES (A) SANITARY INSPECTION Cause of Inspection No. of Inspections No. of Notices served No. of Notices complied with Atmospheric Pollution 107 - - Bakehouses 74 — 1 Complaints 3,467 825 403 Drainage 2,333 6 1 Factories (Mechanical) 315 5 8 Factories (non-Mechanical) 162 8 7 Food (other than Restaurants and Eating Houses) 1,832 7 5 Hairdressers and Barbers 146 Housing Act 501 5 3 Housing Applications 251 1 3 House to House 261 12 5 Housing Repairs and Rents Act 451 39 4 Ice Cream Vendors 225 — — Infectious Diseases 292 — 1 Markets 629 — — Milk Vendors 152 — — Outworkers 1.059 — — Pet Animals Act 16 1 _ Pharmacy & Poisons Act 96 - Public Urinals 3 — 1 Rag Flock Act — — — Rats and Mice 2,880 60 40 Restaurants and Eating Houses 727 7 7 Shops Act 146 2 2 Slaughterhouses — — — Smoke Observations 203 3 5 Miscellaneous 1.507 53 24 Re-visits 7,773 413 655 No answer 952 — — 26,560 1,447 1,175 No. of Ineffective Visits 952 — — Total 25,608 1.447 1,175 During the year 658 Statutory Notices were served and 304 complied with. (B) SUMMONSES—Proceedings instituted during the Year Public Health (London) Act, 1936 78 Food and Drugs Act, 1955 11 L.C.C. Byelaws 6 Housing Act, 1957 3 50 (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 90 162 8 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 295 315 5 - (iii) Other Premises in which Section 7 is enforced by the Local Authority, (excluding outworkers' premises) - - - - Total 385 477 13 — 2.—CASES IN WHICH DEFECTS WERE FOUND Particulars Number of Cases in which Defects were Found Number of Cases in which Prosecutions were Instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of Cleanliness (S.l) 9 11 - - - Overcrowding (S.2) — — — — Unreasonable temperature (S.3) _ _ - _ - Inadequate Ventilation (S.4) - - - Ineffective Drainage of Floors (S.6) - - - - - Sanitary Conveniences (S.7) - - - - - (a) Insufficient - — - — - (b) Unsuitable or Defective . 4 4 - — — (c) Not separate for sexes — — - — — Other offences against the Act (not including offences relating to Outwork) - - 1 - - Total 13 15 1 — — 51 OUTWORK Nature of Work Section 110 Section 111 No. of Outworkers in August List required by Sect. 110(1) (c) No. of Cases of Default in Sending Lists to the Council No. of Prosecutions for Failure to Supply Lists No. of Instances of Work inlJnwhole ;ome Premises Notices Served Prosecutions Wearing Apparel— Making, etc. 180 - - - - Lampshades 6 — — — — — Curtains and Furniture Hangings 1 — — — Jewellery 19 — — — — — Paper bags 38 — — — — — Feather Sorting 1 — — — — — Carding, &c., of Buttons, &c 67 — — — — Stuffed Toys 37 — — — — — Cracker Bon-bon, Christmas Crackers, Christmas Stockings, &c 39 — - 2 1 - Total 388 — — 2 1 — 52 (D) UNSOUND FOOD CONDEMNED—1958 Apple Pulp 2 barrels Bacon 20 lbs. Baked Beans 124 tins Cheese 21 lbs. Chicken 44 lbs. Chicken 15 tins Cream Cakes 15 cakes Cream 10 tins Fish 444 lbs. Fish 83 tins Fruit 854 tins Fruit, Dried 30 lbs. Fruit Juice 29 tins Ham 172 tins Jam 9 jars Liver 10 lbs. Meat 324 lbs. Meat 597 tins Meat Paste 11 tins Milk 247 tins Peas 212 tins Pickles 11 jars Rice, Creamed 23 tins Rolled Oats 2 pkts. Sauce 9 bottles Sauerkraut 7 tins Sausages 29 tins Soup 157 tins Spaghetti 27 tins Tomatoes 48 tins Tomato Juice 107 tins Vegetables 95 tins 53 PUBLIC MORTUARY—Bodies Admitted, &c. Bodies admitted from the Borough: — By order of Coroner 346 By order of Police 4 On application of undertakers 24 374 Bodies admitted from other Boroughs: — Fulham (245 by order of Coroner, 16 by order of Police and 7 on application of undertakers) 268 Chelsea (213 by order of Coroner, 5 by order of Police and 3 on application of undertakers) 221 Kensington (256 by order of Coroner. 5 on application of undertakers) 261 750 Total bodies admitted 1,124 No. of P.M. examinations conducted: — Hammersmith cases 350 Fulham cases 261 Chelsea cases 218 Kensington cases 256 Total P.M.'s 1,085 No. of Inquests held: — Hammersmith cases 75 Fulham cases 46 Chelsea cases 51 Kensington cases 89 Total Inquests held 261 54 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 2 — 15 32 2 1 — — 52 13 — 50 Whooping Cough 12 12 25 28 — — — 77 13 75 Acute Poliomyelitis (Par.) — 1 2 3 1 3 — 10 10 1 „ „ (Non.-Par.) — — — 2 — — 2 2 1 Measles 20 49 173 252 14 4 — — 512 11 510 Diphtheria — — — — 2 1 — — 3 3 — Pneumonia 5 2 19 14 2 14 32 15 103 16 73 103 A. Encephalitis (Inf.) — — — — 1 — — — 1 1 1 Enteric or Typhoid Fever — — — — — — — — — — — — Paratyphoid Fever — — — — — — — — — — — — Erysipelas — — 1 — — 6 1 8 3 8 Meningococcal Infection 1 3 2 5 2 1 — 14 14 5 Food Poisoning 4 1 2 6 7 9 6 1 36 15 — 35 Ophthalmia Neonatorum 3 — — — — — — 3 — 3* Malaria - — — — — — Scabies - — 6 13 17 23 5 — 64 1 — 64 Puerperal Pyrexia - — — 59 45 — 104 — 104† Tuberculosis (Pulmonary) - — 3 28 44 38 10 123 36 13 123 „ (Non-Pulmonary) 1 — — — — 2 2 — 5 2 2 5 Totals 48 68 248 383 151 141 61 17 1,117 140 88 1,088 * Of this total only 2 cases related to patients residing in the Borough, † Of this total only 45 cases related to patients residing in the Borough. 55 TUBERCULOSIS Summary of Notifications during the period from the 1st January, 1958 to the 31st December, 1958. Age Periods Formal Notifications Number of Primary Notifications of new cases of tuberculosis 0— 1 — 2— 5— 10— 15— 20— 25— 35— 45— 55— 65— 75— Total (all ages) Respiratory, Males — — — 1 — 4 7 9 12 18 17 7 1 76 Respiratory, Females — — — 2 — 8 9 12 11 — 3 1 1 47 Non-Respiratory, Males 1 — — — — — — — 1 — 1 — — 3 Non-Respiratory, Females — — — — — — — — 1 1 — — — 2 CASES NOTIFIED AND DEATHS — 1958 and Previous Years. Year No. of Cases notified No. of Deaths No. of Cases on Register of Notifications Pulmonary NonPulmonary Total 1939 165 33 198 107 889 1940 143 24 167 118 813 1941 160 39 199 103 828 1942 169 31 200 104 963 1943 177 24 201 72 1,097 1944 192 22 214 93 1,184 1945 207 23 230 93 1,282 1946 188 23 211 85 1,487 1947 189 21 210 90 1,517 1948 167 20 187 76 1,599 1949 193 14 207 51 1,674 1950 166 21 187 39 1,779 1951 193 15 208 44 1,852 1952 180 14 194 43 1,494 1953 198 17 215 33 1,595 1954 167 13 180 21 1,495 1955 135 15 150 16 1,510 1956 156 9 165 17 1,536 1957 126 16 142 9 1,517 1958 123 5 128 15 1,537 Average number of cases notified for the 10 years 1939/1948 (inclusive)—202. Average number of cases notified for the 10 years 1949/1958 (inclusive)—178. Average number of deaths for the 10 years 1939/1948 (inclusive)—94. Average number of deaths for the 10 years 1949/1958 (inclusive)—29. CHART SHOWING THE NUMBER. OF NEW CASES OF TUBERCULOSIS NOTIFIED DURING THE PAST 20 YEARS. 56 57 MEDICINAL BATHS Cleansing of Verminous Persons School Children—Hammersmith Scabies 72 Verminous 514 Impetigo 11 Other Conditions 3 School Children—Non-Hammersmith Scabies 16 Verminous 3 Children under Five Years—Hammersmith Scabies 12 Verminous 62 Impetigo 2 Children under Five Years—Non-Hammersmith Scabies 11 Verminous 4 Adults—Hammersmith Scabies 129 Verminous 108 Other Conditions 2 Adults—Non-Hammersmith Scabies 33 Verminous 12 Lodging-Houses—Hammersmith Scabies 8 Verminous 105 DISINFECTION Hammersmith Cases Non-Hammersmith Cases Mattresses 416 4 Pillows 380 17 Blankets 187 13 Sheets 67 28 Quilts 32 4 Clothing +931 63 Sundries +257 13 Total 2,412 + 26 Custom's Certificates issued in respect of 462 articles (421 Clothing, 41 Sundries) Rooms (including 763 verminous Rooms), 782