4347 31 OCT 1930 HAM 51 Metropolitan Borough of Hammersmith Report on the Health of the Borough 19 59 F. M. DAY, M.R.C.S., L.R.C.P., D.T.M., D.P.H., MEDICAL OFFICER OF HEALTH. METROPOLITAN BOROUGH OF HAMMERSMITH Health Committee At 31st December. 1959 Councillor E. O'K. Finn (Mrs.), M.B.E. (Chairman) J. Farndale (Vice-Chairman) S. M. Atkins R. G. Field E. D. Freeman (Mrs.) D. M. Heaks (Mrs.) F.W. Ing M. Kemp R. W. Oak D. A. Reynolds D. W. Thorpe, T.D., M.I.E.E. E. C. Woods (Miss), (Deputy Mayor) Ex-Officio: The Worshipful the Mayor (Councillor J. F. Hayes, M.M., 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 3 Maternal Mortality 4 Population 3 Social Conditions 3 SECTION B—Prevalence of and Control over Infectious Diseases :— Contacts and Carriers—Sickness Benefit 5 Dysentery 7 Food Poisoning 5 Health Laundry 9 Medicinal Baths 7 Notifications 5 Poliomyelitis 5 Tuberculosis 5 SECTION C—Housing :— Permanent Estates 13 Re-housing 12 SECTION D—Inspection and Supervision of Food:— Bacteriological Examination of Food 17 Basement Bakehouses 21 Designated Milk Licences 20 Food and Drugs Act, 1955, and Food Hygiene Regs., 1955 14 Ice Cream 18 Ice Cream and Preserved Food Premises 19 Markets 21 Milk Supplies 20 Public Health (Condensed Milk) Regulations, 1923-48 21 Sampling 15 SECTION E—Sanitary Administration:— Coroner's Court and Public Mortuary 23 Exhumation and Re-interment of Bodies 22 Housing Repairs and Rents Act, 1954 22 L.C.C. (General Powers) Act, 1952—Rag and Bone Dealers 24 L.C.C. (General Powers) Act, 1954—Hairdressers and Barbers 24 Pet Animals Act, 1951 23 Pharmacy and Poisons Act, 1933, and Pharmacy and Medicines Act, 1941 24 Public Baths and Washhouses 24 Rag Flock and Other Filling Materials Act, 1951 23 Rent Act, 1957 22 Staff—Inspectorial 22 SECTION F—Sanitary Circumstances : Atmospheric Pollution 26 Clean Air Act, 1956 27 Drainage 25 Dustbins 25 Factories 26 Inter-Borough Smoke Liaison Committee 27 Public Cleansing 25 Page Rodent Control 26 Sanitary Inspection 25 Water Supply 25 SECTION G—General Provision of Health Services:— Ambulance Facilities 28 Burial or Cremation of the Dead 32 Conferences 33 Diseased or Infirm Persons 32 Financial Contributions to Voluntary Organisations 33 Hammersmith Chest Clinic 28 Health Information Bureau 33 Hospitals 28 International Certificates of Vaccination and Inoculation 31 Laboratory Facilities 28 Old People's Welfare 32 Personal Health Services 29 Clinics and Welfare Centres 29 Creches 31 Day Nurseries 31 Domestic Help Service 31 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 Extracts 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 Tuberculosis—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 1959. 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, and a short illness of my own further delayed matters. Infectious disease has again decreased and poliomyelitis remained scarce. A large outbreak of food poisoning caused by one of the Salmonella group of organisms took up much time of the Health Department, but eventually after three months it was cotrolled and no new cases occurred. In June the Health Department were asked to assist the Old People's Welfare Department in much of their work and since then we have played a constantly increasing part in their affairs. Much attention has been given to the meals service for which the demand appears to be insatiable and we have found this work particularly rewarding. The year was a somewhat mournful one for all his friends because at Christmas time Mr. Percy W. Pottier retired and went to live by the sea at Lancing. He had served the Department for 40 years, the last 19 of which had been as Administrative Officer. A brilliant man, and a glutton for work, he had been of incalculable help to Medical Officer of Health Dr. Howell, Medical Officer of Health Dr. Brodie, and since my appointment in July, 1946, to myself. Lung cancer is much in the public and medical eye at the moment. Fulhams' Medical Officer of Health, Dr. Settle, has referred to the death rate in Fulham. Fulham exceeds Hammersmith in population in the proportion of 113,300 to 108,900. Lung cancer killed 96 Fulham people in the year under review, whilst in Hammersmith only 63 died. The percentage involved may have some significance, but I have difficulty in identifying it. Since Dr. Settle's figures were published I have been in touch with him and we propose to work together on the problem. In conclusion I wish to express my gratitude to the Chairman, Vice-Chairman and Members of the Health Committee, and also to the staff who have all assisted me very helpfully during the period under review and who, I am sure, will do so also in the future. 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, 1959 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: (Vacant) 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 Miss D. M. Ridyard Miss I. E. Waller Mrs. J. P. Brodie (M.O.H.'s Secretary) Senior Public Health Inspector: ¶†*P. T. Bayes Public Health Inspectors: o†§J. C. Hopkins †§E. W. Pike x†§G. G. Gardiner §W. R. Bland ║‡/ §Miss E. M. Cross Food and Drugs Inspector: $†*W. J. Godden Clean Air Act Enquiry Officers: Technical Officer: P. E. C. Pendock (Temporary) E. Bonnar (Unestablished) E. R. James (Temporay) 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 Joint Board. $ Cert. Royal Sanitary Institute (Inspector). 7 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 thriving and prosperous community, part industrial and part residential, situated at the north west corner of the county of London. There is a variation of approximately 120 ft. in the elevation of the borough from the south boundary at the River Thames to the northern boundary. The highest point is at the junction of Scrubs Lane and Harrow Road (133 ft. above Mean Sea Level at Newlyn) and the lowest at points in the Lower and Upper Malls (13 ft. above Mean Sea Level at Newlyn). The sub-soil of 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 ft. of gravel above blue clay, particularly in the east, much of which was excavated for brick-making purposes in the distant past. The Borough covers an area of 2,282.5 acres. 287 acres or approximately one-eighth of the total area consists of parks and open spaces, and most of this is controlled by the London County Council and the remainder by the Hammersmith Borough Council. Hammersmith has become largely an industrial and business district with an estimated population of 108,900 in 1959. The Registrar General reports that there has been a steady reduction in the population figures of the Borough for the last seven years. As we are placed between Central London and the attractive residential south west, many fine houses are to be found here, and the water front from Chiswick to Hammersmith Bridge still retains much of its original character and charm. Vital Statistics. (a) Population A detailed analysis of population figures is shown in the statistical supplement. The Registrar-General's figures of estimated population show that there has been a reduction in population from 110,200 in 1958 to 108,900 in 1959. As there has been no national census during this period his figures are pure estimates and are in no way factual. (b) Marriages The number of marriages was 1,267. a decrease of 17 compared with the previous year. 4 Particulars are set out hereunder:— The Registrar Office 494 Buildings registered for marriages (Roman Catholic Churches and Chapels at which a Registrar attends) 417 Churches of the Church of England 305 Authorised Persons (Chapels at which a Registrar does not attend) 39 Jewish Synagogues 12 1,267 (c) Births The corrected number of births for the year was 2,004 as against 2,027 in 1958. On an estimated population of 108,900 this represents an annual rate of 18.4 births per thousand persons living. In 1958 the birth rate per thousand of the population was 18.3. There was an increase in illegitimate births from 220 in 1958 to 256 in 1959. (d) Deaths The number of deaths registered last year was 1,442. The Registrar-General has transferred 504 deaths of residents of the Borough who died elsewhere and has deducted 668 deaths which occurred here among the non-residents and 41 transferable deaths. Therefore the corrected figure of deaths is 1,237 (645 males and 592 females). Using the estimated population figure of 108,900, the number of deaths per thousand of the population would be 11.3 as against 11.2 in 1958. The principal causes of death during 1959 were again diseases of the heart and cancer. (e) Infant Mortality There were 55 deaths of infants under one year of age during the year under review. The mortality rate per thousand live births was 27 against 24 in 1958. (f) Maternal Mortality One death from maternal causes occurred during the year. The death rate from such causes was 0.8 per thousand live and still births. 5 SECTION B PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASES Infectious Diseases. 1,909 cases of infectious diseases were notified during the year. 252 cases were removed to hospital and of this number, 45 were notified on discharge as not having suffered from the condition originally notified. As a result the corrected number of cases of notifiable infectious diseases for the year was 1,864. These figures show an increase on the previous year of 776 cases. This is due to the fact that there was an epidemic of Measles in the early part of the year, and there was also an increase in the number of cases of Scarlet Fever, Dysentery and Food Poisoning. Four cases of suspected Diphtheria were notified, only one of which was confirmed. Contacts and Carriers of Infectious Disease—Sickness Benefit. One certificate was issued during the year in the following circumstances :— Female kitchenhand in a Canteen who was a carrier of a Food Poisoning organism. Tuberculosis. I have to report a slight increase in the incidence of this disease. The number of new cases notified during the year was 143 as against 128 in the previous year. These figures show an increase of 12 in pulmonary cases and 3 in non-pulmonary cases. The number of deaths, however, was only 8 as against 15 in 1958. In the Statistical Supplement will be found a chart showing the number of new cases notified during the past 20 years. The London County Council continued with the campaign for B.C.G. inoculations among school-children and a total of 1,264 received these inoculations during the year. Poliomyelitis. Once again only two cases of this disease were notified during the year, both being of the paralytic type. The Ministry of Health reports that by the end of March, 1960, nearly 13,200,000 people in Great Britain had received at least two vaccinations against poliomyelitis; over 9,400,000 of them had had the course of three injections. The estimated acceptance-rate for children (1943-59 group) was 75.5% and for young adults (1933-42) 48%. Food Poisoning. In 1958 there were 36 cases of Food Poisoning. This year the number of cases increased to 318. 83 cases were treated in hospital but fortunately there were no deaths. 6 The following agents were identified Salmonella Typhi-murium 271 Salmonella Muenchen 10 Salmonella Potsdam 1 Salmonella Thomson 2 Salmonella St. Paul 2 Salmonella Newport 6 Staphylococci (including toxic) 2 In all other cases no specific organisms were isolated. The reason for the large increase in the number of cases is mainly due to the fact that early in the year outbreaks were reported from two hospitals in the Borough. The first two cases of the main outbreak occurred at the end of March. They were both mothers in a Maternity Ward. After consultation between the Medical Superintendent, the Medical Staff and myself the following action was taken : 1. All the patients and staff submitted faecal specimens and if Salmonella was identified they were excluded from contact with the Hospital. 2. The Public Health Department staff supplied and collected all containers and specimens and notified the Medical Superintendent of the results. (The hospital laboratory service also collaborated with this work.) 3. The Public Health Department disinfected Wards as required by the Medical Superintendent. 4. Admission to the Hospital was restricted as little as possible in order not to interfere with essential treatment. This was suggested in view of the extremely mild symptomatology of the clinical cases resulting from infection with this strain of Salmonella Typhi-murium. 5. The Public Health Department investigated foods arriving at the Hospital which might be responsible (the Hospital laboratory also collaborated in this work). The facts of the outbreak were reported to the Ministry of Health with an undertaking to report any new information which might be forthcoming, and subsequently two of the doctors from the Ministry of Health met the Medical Superintendent and myself at the hospital to study the situation. During this period a small outbreak of food poisoning occurred at the other Hospital, but the infection did not spread and it was not necessary to take any special measures. Examinations of all persons at risk in both hospitals were carried out and a large number of positive results were obtained, the majority being symptomless excreters (carriers). The organism responsible for the great majority of the cases was identified as Salmonella Typhi-murium Phage Type 27. The food and drink supply of both hospitals was the same until 1st April, 1959. 7 The Public Health Inspectors visited the kitchens of both Hospitals and were satisfactory. Food handlers dealing with food in Contractors' premises were found not to be carriers. Dysentery. 148 cases of Dysentery occurred in the year but there were no deaths. Medicinal Baths. The Medicinal Baths in Scott's Road, Shepherds Bush, provide for the treatment of scabies, impetigo and certain verminous conditions, and occasionally psoriasis. The London County Council continue to use this centre for the treatment of school children and special attention has been given to head infestations at the Welfare Centres and at the Day Nurseries. Infected children, together with their contacts of pre-school age, have been followed up in the home and treatment (for all ages) has been made available at the Medicinal Baths. Advice is always given as to the best methods of home treatment and for preventing recurrence. During the year cases from Acton, Barnes, Brentford and Chiswick, Ealing, Fulham, Heston and Isleworth, Southall and Staines received treatment, and Barnes, Brentford and Chiswick, Ealing, Heston and Isleworth Councils, and the London County Council used our centre for steam sterilisation of bedding. On 89 occasions the West London Hospital used the services of the Medicinal Baths for sterilisation purposes. The year 1959 will be recorded and long remembered for a glorious summer, both hot and dry for many weeks. One result of this was that bed bugs were very much in evidence and more premises and rooms were disinfested than in any other year. The number of rooms sprayed for verminous conditions increased for the third year in succession, and the highest figure ever for disinfestation was recorded. Infestations during this summer were heavier in some homes than the slight traces which have become to be expected as evidence of vermin existence. Not one case, however, was as bad as the many infestations seen in the year immediately following the last War. There has, however, been a continuous rise in infestations during the last three years, but this may possibly be due to more complaints being made. 86% of spraying took place between June and October with August claiming 31% of the yearly total. There were more complaints than in previous years regarding the suspected purchase of bug infested second-hand furniture. 8 During the year 845 rooms were sprayed for bed bugs and fleas. People are still sending articles of clothing, etc., to relatives living abroad, but as frontier restrictions lessen fewer countries are requiring Certificates of Disinfection. Only five European countries now require these Certificates. They are Russia, Poland, Bulgaria, Czechoslovakia and East Germany. During the year 17 Certificates were granted in respect of 351 articles and a nominal charge of 2/6 made in respect of each Certificate. Once again mattresses lent by the proprietors of Olympia to persons sleeping on the premises, particularly in connection with the Dairy Show, were cleaned after the show. This year there was a total of 307 mattresses. There was an increase of 16% over the previous year's figure in respect of the treatment for head and body lice. This was largely due to head louse infestation of school children, but there was a lower number of body lice treatment of persons of no fixed abode. There were 37 verminous cleansings at the request of business concerns and some of the younger ladies wished for a "check up" before going for a permanent wave. It is probable that they had previously been sent for treatment by their hairdresser. In two cases use was made of Section 43 of the L.C.C. (General Powers) Act, 1953, to enable two women to receive baths prior to admission to a Home. In both instances the British Red Cross supplied escorts. Neither of the ladies was in a verminous condition, although one was extremely dirty with hair so matted that it had to be cut and styled to suit its new length. There was an increase in the number of treatments of 50% over 1958. Compared with 48 definitely confirmed cases last year there were 87 in 1959. Various cleansings were carried out at the Baths during the year in addition to those already referred to. These included two Council employees who had become polluted by sewer sludge; a vagrant who was arrested by the police, soaked to the skin after having been out in a storm all night. (His clothes were dried whilst he had a warm bath); a family who were referred by their doctor after having spent a camping holiday, minute insects were seen in the husband's underclothing but were not identified. One case of Impetigo was dealt with, a young lady of 24 years who had just found a room in Hammersmith after hitch-hiking from Manchester. She was in a filthy state with many large impetiginous sores in a very verminous head. She was treated once and never seen again. There was also 34 treatments given for Psoriasis at the request of Hammersmith Hospital. Health Laundry. Whilst enquiries regarding this service come from numerous sources, they are also proving the worth of another Hammersmith 9 Public Health venture. The enquiry often starts with "according to your Health Services Guide" There can be no doubt that this public service is gaining recognition by doctors and nurses. This is obvious from the fact that the Public Health Department are receiving notifications of illness of younger persons to whom suitable help can be extended, in one case a young man of 21 years, in another a family of four very young children. Although the object of the service must necessarily mostly benefit the elderly, six persons under 60 received help and at the other end of the scale 10 persons of 90 plus were enrolled. One of the persons now being helped was first served in 1953, two started in 1957 and four in 1958. Many others have received help for more than six months. As the number of cases continues to grow so does the number of visits, reaching a total of 151 in 1959. The oldest person receiving help has almost completed her 103rd year. In one case service was given to a family after the mother had left her husband and four children in a most dirty home. The mattresses were wet with urine and the bedding fouled, the bath was filled with stained clothing and sheets and the whole house most unpleasant. At the request of the Home Help Organiser, help was given to bring the home back to tenable conditions. Certificates granted during 1959 Sex and Age Collections up to 31.12.59 Primary Cause of Ill-health Sequel F 87 156 Fractured Femur Service still in operation F 32 202 Disseminated Sclerosis Service still in operation F 75 169 Mental Deficiency Service still in operation F 102 108 Senility Service still in operation F 81 120 Arthritis Service still in operation F 85 81 Senility Service still in operation F 87 86 Cerebral Haemorrhage Service still in operation F 90 11 Senility Patient removed to other care F 80 2 Senility Admitted to hospital F 83 38 Chronic Bronchitis Deceased 10 Sex and Age Collections up to 31.12.59 Primary Cause of Ill-health Sequel M 21 21 Congenital Cerebral Atrophy Deceased M 41 4 Arthritis Service no longer required M 82 29 Hemiplegia Patient removed to other care F 72 2 Cardiac Failure Deceased M 67 5 Hypertension Admitted to hospital F 90 18 Arthritis Admitted to hospital F 92 24 Chronic Bronchitis Patient removed to other care F 83 4 Accident Deceased F 94 3 Arthritis Deceased Family 4 Enuresis Service no longer required M 90 1 Dirty home conditions Deceased F 83 22 Senility Service no longer required M 56 24 Hypertension Service no longer required M 82 1 Dirty home conditions Service no longer required M 75 4 Arthritis Patient removed to other care F 82 38 Senility Service no longer required M 82 35 Incontinence Admitted to hospital M 78 1 Carcinoma of Rectum Deceased F 88 8 Colostomy Admitted to hospital M 80 21 Diabetes Melitus Service still in operation M 83 1 Pneumonia Deceased F 75 24 Apoplexy Service still in operation F 84 22 Senility Service still in operation F 58 3 Carcinoma of Colon Deceased F 72 20 Disseminated Sclerosis Service still in operation F 83 19 Incontinence Service still in operation 11 Sex and Age Collections up to 31.12.59 Primary Cause of Ill-health Sequel F 98 3 Apoplexy Admitted to hospital F 96 3 Incontinence Admitted to hospital F 75 16 Paraplegia Service still in operation M 73 3 Carcinoma of Bladder Deceased F 78 14 Incontinence Service still in operation M 58 8 Carcinoma of Bladder Deceased F 82 7 Senility Service still in operation F 94 7 Senility Service still in operation F 93 1 Incontinence Admitted to hospital Summary of Articles Cleansed: Articles 1952 1953 1954 1955 1956 1957 1958 1959 Blankets — 33 19 40 67 72 186 203 Sheets 19 183 514 2006 2057 2550 2531 2710 Quilts — 11 — — -- 33 24 31 Pillow Slips — — 163 459 440 645 852 777 Towels — 141 377 401 505 731 797 Pyjama Jackets — — 9 — — 83 162 208 „ Trousers — — — — — — 75 62 Nightdresses — — 131 208 252 363 497 548 Clothing — 72 Sundries — 180 197 813 920 1329 5379 6068 Total 19 479 1201 3903 4137 5580 10437 11504 12 SECTION C HOUSING Rehousing. The Housing Estates Manager continues to co-operate with the Health Department on applicants with overcrowding or medical problems. Requests are received asking for inspections to be made with a view to ascertaining whether a family is living in overcrowded conditions. Enquiries are then made by the Public Heatlh Inspectors, and, if a family is found to be living in such conditions, overcrowding is duly certified. In instances where the request is accompanied by medical certificates supporting the family's application on medical grounds, very careful consideration is given that the recommendations are made only for the most urgent cases, having regard to the nature of the illness, the condition of the premises and the amenities available. Applications for rehousing by the London County Council are made to that authority direct, and requests for various enquiries to be made are received from that Council 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. 10 cases were recommended for rehousing on grounds of health and 57 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 1959 10 6 57 25 — 1 Totals 316 94 1,992 766 100 40 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. Permanent Estates. During the year both the Borough Council and the London County Council were engaged in providing accommodation for those in the greatest need, and whilst no new dwellings were actually erected by the London County Council the under-mentioned flats were completed by the Borough Council:— 1-12 Brangwyn Court, Brangwyn Estate 12 Becklow Gardens Extension (Block G) 40 Aldine Court, Aldine Street 48 Askham Court, Askham Road 56 49-68 Sulgrave Gardens (Block B) 20 62 Lakeside Road 3 81, 83 and 85 Lakeside Road 6 Conversions 88, 90, 92 Lakeside Road 6 39 Frithville Gardens 6 Total 197 The Council acts as landlord for 3,321 principal tenants. The properties managed include houses, flats, pre-fabs 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 1,323 2. Number of families rehoused by the Borough Council in rebuilt houses since the war 30 3. Number of families rehoused in pre-fabricated dwellings since the war (Still living in pre-fabricated 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 185 5. Number of families on the Waiting List at the end of the year 1,511 14 SECTION D INSPECTION AND SUPERVISION OF FOOD Food and Drugs Act, 1955. Food Hygiene Regulations, 1955. Shops, stalls, vehicles and premises where food intended for human consumption is prepared, stored, etc., were subjected to routine inspection throughout the year. Visits have been made in connection with the Food Hygiene Regulations 1955 and occupiers of food premises and stalls were on the whole co-operative to suggestions made for necessary improvements in connection with these Regulations. During 1959, 3,510 visits were made at food premises, stalls and markets and at 42 of these, conditions constituting contraventions under the Food Hygiene Regulations 1955 were found. Legal proceedings were taken in one case, a penalty of £2 with £2 2s. 0d. costs being imposed. 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 33 Beer Bottlers 1 Biscuit Manufacturers 1 Butchers 67 Cafes and Restaurants 160 Canteens and Clubs 91 Chemists 38 Confectioners (sweetshops) 152 Fishmongers (wet and fried) 27 Fruit and Greengrocers 82 Grocers and Provisions 216 Honey (packing) 1 Ice Cream Manufacturers 3 Jellied Eels and Pies (manufacture and sale) 5 Milk Processing Depots 2 Milk Distributors 123 Off Licences 41 Public Houses 95 Sweet and Chocolate Manufacturers 3 15 Under Section 9, Food and Drugs Act 1955, two seizures of unsound food were made. Legal proceedings were taken in one case, resulting in a penalty of £20 with £5 5s. 0d. costs. As distinct from the above, a large quantity of foods which although unsound, did not call for action under Section 9, were voluntarily surrendered. A list of the commodities and the amount involved is shown in the statistical supplement. Sampling. Throughout the year 875 samples of food and drugs taken by the Food and Drugs Inspector were submitted to the Public Analyst for chemical analysis. Adverse reports received in respect of 22 samples are shown in the following summary:— Sample Infringement Remarks Nerve Food Misleading label Informal Sample Instructions given for Minister to be consulted Ice Cream Lolly Incorrectly labelled No action Bean Soup Powder Incorrectly labelled Informal sample Bean Soup Powder Incorrectly labelled Warning letter Pearl Barley Contained 320 parts per million sulphur dioxide Informal sample Nerve Food Misleading label Penalty £5 and £21 costs Mushrooms in Butter Incorrectly labelled Warning letter Skimmed Milk Powder Deteriorated. 25% insoluble Brought to notice of vendor Pearl Barley Contained 320 parts per million sulphur dioxide Warning letter French Coffee Incorrectly labelled and contained 3.3 parts per million lead Informal sample Ammoniated Tincture of Quinine 23% deficient in ammonia Informal sample Ammoniated Tincture of Quinine 12% deficient in ammonia Informal sample French Coffee Incorrectly labelled and contained 2.5 parts per million lead Informal sample French Coffee Incorrectly labelled and contained 3 parts per million lead Penalty £2 and £2 2s. costs 16 Sample Infringement Remarks Ammoniated Tincture of Quinine 25% deficient in ammonia Penalty £3 and £10 10s. costs Ammoniated Tincture of Quinine 9% deficient in ammonia Summons dismissed with £10 10s. costs awarded to the defendant Cooking Butter Contained 3.5% free fatty acids Informal sample Health Drink Description on label did not indicate the true nature of the ingredients Taken up with the manufacturer who changed labels Seidlitz Powder Contained 6.5 grams of sodium potassium tartrate instead of 7.5 grams Informal sample Cooking Butter Contained 4.1% free fatty acids; also added colouring matters which were not permitted colouring matters as defined by the Colouring Matters in Food Regulations 1957 Legal proceedings contemplated. Matter referred to Ministry of Agriculture, Food and Fisheries Shredded Beef Suet 8% deficient in fat Informal sample Yogurt Incorrectly labelled Warning letter During the year 18 complaints were received from members of the public in connection with food. The following summary shows the action taken after a full investigation was made in each case Nature of Complaint Bread Roll containing bristle Bread containing pieces of wire Bread containing insect Swiss Rolls, rancid Bread containing charred starch, carbon and oil globules Meat Pie in mouldy condition Bread in mouldy condition Meat Pie in sour condition Bread containing rusty nail Bread containing piece of metal Action Taken Absolute discharge; £3 3s. costs Penalty £1 10s.; £3 3s. costs Penalty £1; £3 3s. costs Penalty £1; £5 5s. costs Warning letter Warning letter Warning letter Warning letter Penalty £2; £5 5s. costs Penalty £10; £3 3s. costs 17 Nature of Complaint Biscuit containing piece of glass Ice Cream containing cigarette Sausage Rolls in mouldy condition Fried chips with beetle Bread roll containing iron rust Milk containing earwig Milk containing glass splinters Dirty Milk Bottle Action Taken No action Penalty £1; £5 5s. costs Warning letter No action Warning letter Warning letter Warning letter Penalty £5; £5 5s. costs Bacteriological Examination of Food. The following samples were submitted to the Public Health Laboratory Service for bacteriological examination Broiler chickens 10 Frozen Egg 18 Cream (Dairy) 1 „ (Clotted) 1 „ (Imitation) 30 „ (Butter) 1 „ (Fondant) 2 Chicken Cutlet 1 Scotch Egg 1 Hamburger 1 Mock Salmon Cutlet 1 Lolly with ice-cream centre 1 Ice Cream and Ice Cream Mix 49 Milk 98 Chocolate Flavoured Drink 1 I felt it desirable that a check should be made on the efficiency of cooking chickens by the "spit" method which has become popular of late in some London retail shops, and for that purpose 10 samples of broiler chickens were taken for bacteriological examination to determine whether this process of cooking was sufficiently adequate to ensure freedom of pathogenic organisms, particularly those of the Salmonella group. These samples were obtained from three different sources and the examinations were made from both uncooked and cooked birds. In no case were pathogenic organisms 18 isolated; the results of the examinations are shown below:— Sample No. Sample Plate Count No. of Colonies Bact. Coli No. of Colonies Broiler Chicken 62 Cooked More than 560,000 More than 560,000 63 Uncooked More than 140,000 Less than 5,000 64 Cooked More than 28,000 Less than 5,000 65 Cooked More than 140,000 Less than 5,000 66 Uncooked More than 98,000 Less than 5,000 67 Cooked Less than 5,000 Less than 5,000 68 Cooked Less than 5,000 Less than 5,000 69 Uncooked More than 400,000 Less than 100,000 77 Uncooked More than 6,000,000 Less than 6,000 76 Cooked Less than 5,000 Less than 5,000 Ice Cream. Regular inspection of premises used for the sale, storage and manufacture of ice-cream has been made and particular attention was given by the Food and Drugs Inspector where manufacture takes place. There are three such premises registered in the borough where ice-cream is manufactured, two of which are wholesalers. During the year 46 samples of ice-cream were taken and submitted to the Public Health Laboratory Service and the Royal Institute of Public Health and Hygiene for bacteriological examination and 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 46 samples taken were placed in the following grades:— 37 samples were within Grade 1 standard 7 samples were within Grade 2 standard 2 samples were within Grade 4 standard 19 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 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 1959 46 37 7 - 2 In addition, 27 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) Regulations 1959. These Regulations which replace the Food Standards (Ice Cream) Order 1953 prescribe amended standards for ice-cream and introduce separate standards for dairy ice-cream (or dairy cream ice or cream ice) and for milk ice. The standards for dairy ice cream and for milk ice provide that they shall contain no fat other than milk fat except such as may be introduced by the use of any egg, any flavouring substances or any emulsifying or stabilising agent. The requirement in the 1953 Order that ice-cream should contain not less than 10 per cent. of sugar is replaced by a provision that no type of ice-cream shall contain any artificial sweetener. The minimum standard for fat content (5 per cent) and milk solids other than fat (7½ per cent) remain. The fat content of the samples taken ranged from 8.8 per cent to 13.2 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 of 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 new registrations affected 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 11 Confectioners (sweet-shops) selling ice-cream 149 20 Restaurants (selling ice-cream for consumption off the premises) 24 Grocers selling ice-cream 92 Bakers and Confectioners selling ice-cream 5 Fruiterers and Greengrocers selling ice-cream 16 Butchers preserving meat and/or manufacturing sausages 51 Grocers and Provision Dealers preserving meat 17 Grocers and Provision Dealers preserving fish 1 Fishmongers curing fish 2 Food Factories manufacturing sausages and preserved food 3 TOTAL 374 Milk Supplies. One hundred and seventy-four inspections of premises used in connection with the processing and distribution of milk were made. Generally the premises were found to be satisfactory. The wholesale milk pasteurising and bottling depot at Scrubs Lane, and the wholesale milk pasteurising and milk sterilising and bottling depot at Wood Lane have continued in operation. There are altogether nine milk pasteurising plants in which milk is processed by the high temperature short time method. The milk is retained at a temperature of not less than 161°F. for at least 15 seconds and immediately cooled to a temperature of not more than 50°F. In addition to these processes, the bottling of cream and the production of specially fermented milks and chocolate milk is carried out. At regular intervals the Food and Drugs Inspector checks the efficiency and working temperature of these plants and periodically takes samples to ensure that they comply with the requirements of the Milk (Special Designation) (Pasteurised and Sterilized Milk) Regulations 1949/53. All samples taken from these milk plants were reported to be satisfactory. One hundred and twenty-three persons were registered as distributors of milk and two premises were registered as Dairies at the close of the year. The Milk (Special Designation) (Pasteurised & Sterilized Milk) Regulations 1949/1953 and the Milk (Special Designation) (Raw Milk) Regulations 1949/1953. The following licences were issued by the Council under these Regulations during 1959:— Dealer's Licences Pasteurisers Licences 2 Sterilisers Licences 1 Tuberculin Tested Licences 73 Pasteurised Licences 98 Sterilised Licences 93 21 Dealers Supplementary Licences Tuberculin Tested 17 Pasteurised 19 Sterilised 21 Ninety-six samples of Special Designated Milk were taken under the Regulations from milk processing plants, milk distributors and hospitals. 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 48 48 — 48 — — — T.T. Pasteurised 14 14 — 14 — — — Tuberculin Tested 16 — — 14 2 — — (Raw) Sterilised 18 — — — — 18 — 96 62 — 76 2 18 — The results of the examinations are sent to the Milk Division of the Ministry of Agriculture, Fisheries and Food and they were informed at once of the above adverse reports. 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 16 samples were submitted for examination by the Public Analyst and were reported genuine. Markets. Considerable attention was given to street-trading in food at the four markets in the borough situate in Bradmore Lane, Railway Approach, Cinema Extension and Norland Road, the stalls and storage accommodation receiving frequent inspection by the Food and Drugs Inspector. During the year 776 visits were made to these markets. Basement Bakehouses. In accordance with the provisions of Section 4 Factory Act 1937, inspections were made of the four basement bakehouses in respect of which certificates of suitability were issued at the time of the last quinquennial review. In two cases, the certificates were not renewed as the bakehouse concerned had not been used for baking over the required period. The Factory Act 1937 provides that if a Basement bakehouse is not used for a period exceeding twelve months, it shall not be so used again. On completion of certain works to the remaining two basement bakehouses it was considered justified for the certificate of suitability to be continued. 22 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 and Drugs Inspectors and one Woman Inspector. During the year a further four Inspectors resigned, and for some time the Inspectorial staff consisted of the Senior and Deputy Senior Public Health Inspectors, three District Inspectors, one Food and Drugs Inspector and one Woman Inspector. An additional Inspector commenced duties on the 30th November, 1959. One of the District Inspectors also acts as Inspector in Charge of Rodent Control Operations. It is a matter of grave concern to me that, through the prolonged shortage of Public Health Inspectors, I am not able properly to ensure that the statutory duties laid on the Health Department are being carried out. Many types of routine inspections are not able to be done and the additional duties imposed on the Department by the introduction of Smoke Control areas under the Clean Air Act, 1956, made the position even more acute in 1959. Exhumation and Re-Interment 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. 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, 1920/1931. 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 48 Number granted 22 For Revocation of Certificates Number received 33 Number granted 33 Undertakings Given by Landlord Number accepted 25 23 Coroner's Court and Public Mortuary. The number of bodies admitted to the Public Mortuary during the year was 1,139, an increase of 15 compared with 1958. There were 1,128 post-mortem examinations. This also is an increase of 43 compared with last year. The Mortuary and Court were also used by the Boroughs of Fulham, Chelsea and Kensington. During the year extensive alterations were carried out to the Mortuary and Coroner's Court at a cost of approximately £12,000, with the result that there is now accommodation for more bodies, a much larger and more hygienic post-mortem room, a new waiting room, jury room, viewing lobby and an office for the use of the pathologist and any of his staff. During this time, the Mortuary was closed and the Fulham Borough Council kindly arranged to accept our bodies at their mortuary. A view of the post-mortem room is shown in the photograph below:— 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 remained in force and ten applications for renewal of licences were received and granted during the year. 24 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. The larger of the two indoor baths is closed during the winter season and converted into a public hall which may be hired for meetings, concerts, dances, etc. In addition, certain periods are set aside for Badminton and Indoor Bowls. 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. Nine 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. London County Council (General Powers) Act, 1954. Hairdressers and Barbers. During the year five new applications were received and registered, making a total of 101 hairdressers and barbers registered in the Borough. All the premises were kept under observation during the year and several warning letters were sent regarding conditions. Pharmacy and Poisons Act, 1933. Pharmacy and Medicines Act, 1941. The names and addresses of 100 retailers were entered on the Council's list of persons entitled to sell poisons under Part II of the Pharmacy and Poisons Act, 1933, and the Pharmacy and 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. 25 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 water. It is indeed a happy circumstance that the Chairman of the Metropolitan Water Board was, for the greater part of the year, Hammersmith's Alderman R. J. Buckingham. 130 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 29,391 tons Amount of trade refuse collected during the year 3,954 tons 33,345 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 1855 with regard to drainage, and also those under the Public Health (London) Act 1891 relating to waterclosets, etc., are enforced by the Council. During the year 108 plans (21 of which related to combined drainage) were submitted to the Health Department and a total of 1,921 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 1936 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 the number of proceedings instituted, will be found in the Statistical Supplement. 26 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 on the administration of the Factories Act, 1937, dealing with factories (mechanical and nonmechanical) and outwork. Rodent Control. The figures given below once again show the static position of the "Rodent" problem in the Borough, complaints, and premises affected, varying little from previous years. Again, Spring and Autumn were the busiest times of the year 94 (78 in 1958) infestations by rats were directly traced to defective drainage. Tracing these drainage faults is a most difficult problem and great credit is due to the Public Health Inspectors for their work in this field. The sewers were baited twice during the year at the same time as those of the neighbouring Boroughs, thus covering as large an area as possible. The week ending 29th July was quite a welcome landmark as, for the first time for at least 10 years, no complaints were received of rats or mice. During the year approximately £130 was received for treatment at business premises, as against approximately £141 in 1958. The following is a summary of the work for the year with comparable figures for 1958 in brackets:— Premises inspected: Dwellings 560 (584) Business 1030 (1210) 1590 (1794) Complaints: Rats 401 (424) Mice 124 (122) 525 (546) "Discovered" other than by complaint Dwellings 34 (26) Business 1 (8) 35 (34) Premises infested by rats: Dwellings 281 (287) Business 39 (52) 320 (339) Premises infested by mice: Dwellings 113 (107) Business 30 (22) 143 (129) Premises treated by Council staff 468 (468) Major infestations 38 (53) Notices served relating to Rodent Control 65 (78) Re-inspections by Public Health Inspectors on infested premises 1216 Atmospheric Pollution. The stations set up in 1954 for measuring and recording the extent of atmospheric pollution continued to function during the year. 27 Clean Air Act, 1956. Proposed Smoke Control Areas. During the year the Minister of Housing and Local Government confirmed the Hammersmith (No. 1) Smoke Control Order with an operative date of 1st November, 1959. The area is approximately 169 acres and includes 11 industrial premises, 296 commercial premises, 2,025 private dwellings, seven Churches and other religious institutions, five Schools, three Crown properties and 12 other properties, and is shown in red on the map at the commencement of the report. In the early days after the Order had been confirmed applications for adaptations, etc., were very slow in coming in, but gradually members of the public became aware of the position, and by the end of the year 70 applications were dealt with, not allowing for alterations to property owned by the Council and also two large estates of artisans' dwellings in the borough. During the year it was decided to begin No. 2 area and a survey of the area was undertaken. As this is a larger area than No. 1 it is not proposed that it should come into operation until 1st July, 1961. This area is also shown on the map at the commencement of the report and coloured blue. 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 and Chiswick, and Willesden in the County of Middlesex, met at regular intervals during the year in order that each constituent member knew fully how the others were planning their programmes, and also in order that full exchange of information took place to their mutual advantage. All the Councils concerned have now established Smoke Control Areas, and wherever practicable, are arranging the Areas to join those of other member Boroughs. 28 SECTION G GENERAL PROVISION OF HEALTH SERVICES IN THE BOROUGH Laboratory Facilities. Our Public Analyst works at the Southwark Borough Councils' 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.1, 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. 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. Queen Charlotte's is a maternity hospital with its own Board of Governors, and is the largest independent maternity hospital in the British Isles. It 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 adminstration 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 29 integral Unit. A consultant diagnostic service for all chest diseases is 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 tuberculosis 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 tuberculosis 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 tuberculosis 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. Much of the day to day administration of the service was provided by the Medical Officers of Health for the Boroughs of Chelsea, Fulham, Hammersmith and Kensington. The liaison between the staffs of the County Council and the Borough Council continues on a very happy and cordial footing. The following is a list of Clinics:— Ante-Natal Clinics 1/3 Milson Road Monday 1.30 p.m. Friday 9.30 a.m. 30 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. Wednesday 6.00 p.m. Thursday 1.30 p.m. The Curve, Westway Monday 9.30 a.m. Tuesday 1.30 p.m. Infant Welfare Centres 1/3 Milson Road Monday 1.30 p.m. 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. The Library, College Park Friday 9.30 a.m. Physiotherapy (Massage and Light) 48 Glenthorne Road Monday 9.30 a.m. Wednesday 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 a.m. 207 Westway Monday and Wednesday 1.30 p.m. Speech Therapy 48 Glenthorne Road Monday and Thursday 1.30 p.m. 31 Creche 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 1s. 9d. 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 12 full-time and 107 part-time helpers and maintained its good and valuable work during the year. Its local headquarters are in the Public Health Department at 48 Glenthorne Road. The number of cases in which help was provided is as follows: Maternity 17 Tuberculosis 7 Other 1,153 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 645 certificates were authenticated. 32 National Assistance Act, 1948. National Assistance (Amendment) Act, 1951. Removal to Hospital of Persons in Need of Care and Attention. Under the provisions of the above Acts a Medical Officer of Health may apply to a Court of summary jurisdiction for an Order for the compulsory removal to hospital of persons in need of care and attention. It was possible to find a solution either by co-operation by the family doctor or by making use of other available services for all cases referred to the department for examination, and it was not found necessary during the year to take action under the above Acts in any case. National Assistance Act, 1948. Burial or Cremation of the Dead. During the year twenty burials were carried out by the Council under Section 50 of the above Act. Hammersmith Old People's Welfare Association. This Association was formed to promote and assist the general good of old people resident in the Borough. Its work is financed almost entirely by grants given by the Borough Council and amongst the Association's activities may be mentioned the provision of daily lunches, at a nominal cost. The lunches are prepared at the Town Hall and are despatched either to the houses of the old persons or to the luncheon clubs which have been set up in the Borough. Some 200 meals are served each day. Arrangements were also made for sending old persons on holidays at the seaside. The work of the many voluntary associations connected with the welfare of old people is co-ordinated by the association so that various facilities are made available which do much to brighten the lives of the elderly. There is very close co-operation between the Association and the Health Department to the mutual benefit of both. 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 of medical examinations carried out in connection with admission to the Councils' Superannuation and/or Sick Pay Scheme during the year was 296, and of this number 61 were found to be unfit for the following reasons:— Chronic Otorrhoea 3 Albuminuria 1 Hypertension 17 Diabetes 1 Gastric Ulcer History 9 Partial Gastrectomy 2 Pulmonary T.B. 1 Hernia 3 Rheumatism 1 Duodenal Ulcer 1 Depressive illness 1 Otitis Media 4 Heart Condition 1 Bronchitis 2 33 Dermatitis 1 Colostomy 1 Growth of eye 1 Neurasthenia 1 Abdominal operation 1 Hydrocele 2 Cerebral Vascular Disease 1 Arteriosclerosis 1 Congenital Eventration 1 Petit Mal 1 Subacute Bacterial Endocarditis 1 Anaemia 1 Chest Condition 1 At the beginning of 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 60 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 year as follows:— Organisation National Society for Clean Air Amount Statutory Authority 21 0 0 Public Health (London) Act, 1936, Section 298. Local Government Act, 1948, Section 136. Central Council for Health Education 12 14 0 Public Health (London) Act 1936, Section 298. Conferences. The Council was officially represented at the under-mentioned Conferences:— Conference Delegates "The Elderly in the Community" (Central Council for Health Education), London. 22nd January, 1960. Councillor Miss E. C. Woods. The Royal Society of Health (Health Congress), Harrogate. 27th April—1st May, 1960. Councillor Mrs. E. O'K. Finn, M.B.E. The Association of Public Health Inspectors, Margate. 15th—18th September, 1960. Mr. P. T. Bayes, Senior Public Health Inspector. Health Information Bureau. The Health Information Bureau continued its works successfully throughout the year and once again the opportunity was taken to fuse into the Bureau the various lines of enquiry on numerous health matters which normally come to the Department. A revised copy of the Health Services Guide was printed and approximately 2,500 copies were distributed to all interested persons and to many places all over the world. The Guide has proved to be a most valuable adjunct to the work of the Health Department. STATISTICAL SUPPLEMENT TO ANNUAL REPORT FOR YEAR 1959 37 GENERAL STATISTICS—1959 Area 2,282.5 acres Population (1959) (estimated) 108,900 „ (1958) (estimated) 110,200 „ Census (1951) 119,367 Natural increase, i.e., excess of births over deaths 767 Marriages registered 1,267 Rateable Value (April, 1959) £2,233,243 Sum represented by a penny rate (April, 1959) £9,100 EXTRACT FROM VITAL STATISTICS—1959 Live Births Legitimate Total M. F. Birth Rate per 1,000 estimated resident population = 18.4 1,748 918 830 Illegitimate 256 124 132 Stillbirths 50 23 27 Rate per 1,000 total (live and still) births = 24.3 Deaths 1,237 645 592 Death Rate per 1,000 estimated average population=11.3 Deaths from maternal causes— Pregnancy, childbirth, abortion Deaths Rate per 1,000 total (live and still) births 0.48 1 Death Rate of Infants under one year of age:— All infants per 1,000 live births 27 Legitimate infants per 1,000 legitimate live births 25.74 Illegitimate infants per 1,000 illegitimate live births 39.06 Deaths from Cancer (all ages) 252 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 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 — 1959 108,900 767 — INCIDENCE OF CANCER DURING THE PAST 10 YEARS Year Population Deaths Rate per 1,000 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 1959 108,900 252 2.3 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 1959 M 2 27 20 7 56 F — — 2 3 2 7 Total — 2 29 23 9 63 40 INCIDENCE OF PULMONARY TUBERCULOSIS AND NEOPLASMS OF THE LUNGS Age Groups Pulmonary Tuberculosis Neoplasms of the Lung or Bronchus 1958 1959 1958 1959 MALES 0— — - - — 1— — - — — 5— — — — — 15— — — - — 25— 2 1 1 2 45— 5 2 29 27 65— 1 — 23 20 75— 2 3 6 7 Total Males 10 6 59 56 FEMALES 0— — — — - 1— — - — — 5— - - — — 15— — - — — 25— 1 1 — — 45— 1 1 1 2 65— - — 3 3 75— 1 — 1 2 Total Females 3 2 5 7 41 VITAL STATISTICS OF WHOLE DISTRICT 1959 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 14.9 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 114,700 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 1959 108,900 2,004 18.4 1,442 13.2 709 504 55 27 1,237 11.3 * B=Birth-rate Population Figure. D=Death-rate Population Figure. 42 CHART SHOWING BIRTH AND DEATH RATES PER 1,000 POPULATION FOR THE PAST 2.0 YEARS . BIRTH RATE DEATH RATE 43 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1959 Cause of Death Sex 0— 1— 5— 15— 25— 45— 65— 75— Total all Ages 1. Tuberculosis, respiratory M F - - — - — - — - 1 1 2 1 - - 3 - 6 2 2. Tuberculosis, other M F - - - - - - - - - - - - - - - - - - 3. Syphilitic disease M F - - - - - - - - - - — 1 1 - - - - - 4. Diphtheria M F - - - - - - - - - - - - - - - - - - 5. Whooping Cough M F - - - - - - - - - - - - - - - - - - 6. Meningo-coccal infections M F - - - - -1 - - - - - - - - - - - - 7. Acute poliomyelitis M F - - - - - - - - - - - - - - - - - - 8. Measles M F - - - - - - - - - - - - - - - - - - 9. Other infective and parasitic diseases M - - - - - - - - - - - - - - - - - - 10. Malignant neoplasm, stomach M F - - - - - - - - - 1 11 3 8 7 5 5 24 16 11. Malignant neoplasm, lung bronchus M F — - — - — - — - 2 - 27 2 20 3 7 2 56 7 12. Malignant neoplasm, breast M F — - — - — - — - 3 8 7 4 22 13. Malignant neoplasm, uterus M F — - — - — - — - — - - 4 — 1 - 1 14. Other malignant and lymphatic M F — - — - — - - - 5 4 16 16 24 12 20 24 65 56 15. Leukaemia, aleukaemia M F — - 1 - 1 - 1 - — - 3 1 1 - 1 1 8 2 16. Diabetes M - - - - - - - - 1 - — - 3 2 4 2 17. Vascular lesions of nervous system M F — - — - — - 1 - 2 1 15 11 19 16 17 56 54 84 18. Coronary disease, angina M F — - — - — - — - 3 - 41 12 39 ?8 31 37 114 77 19. Hypertension with heart disease M F - - - - - - - - - - 2 1 2 3 4 7 8 11 20. Other heart disease M F — - - - - - — - 3 1 6 6 14 15 20 50 43 73 21. Other circulatory disease M F — - - - - - 1 1 — - 8 1 11 13 9 16 29 31 22. Influenza M F - - - - - - - - -1 5 1 2 1 2 2 9 5 23. Pneumonia M F 2 3 — - — - 1 - - 2 6 3 18 5 11 17 38 30 24. Bronchitis M F - - — - — - — - 1 1 24 4 19 14 27 22 71 41 25. Other disease of respiratory system M F - - - - - - - - - 1 2 - 2 1 2 - 6 2 26. Ulcer of stomach and duodenum M F — - — - — - — - 1 - 3 - 1 - - 2 5 2 27. Gastritis, enteritis and diarrhoea M F — - — - — - — - 1 - 2 1 — - -2 3 3 28. Nephritis and nephrosis M F - - - - - - - - - - 2 - — - 2 2 29. Hyperplasia of prostate M F - - - - - - - - - - 1 - 2 - 9 - 12 - 30. Pregnancy, childbirth, abortion M F - - - - - - - - -1 - - - - - - - - 31. Congenital malformations M F 5 7 -2 -2 — - — - -2 - - -1 7 15 32. Other defined and ill-defined illnesses M F 16 20 - - —- 1 1 12 10 10 7 8 35 47 73 33. Motor vehicle accidents M F — - — - — - — - 3 1 1 2 2 1 2 2 8 6 34. All other accidents M F 1 - — 1 2 - 3 1 — - 5 1 3 3 2 2 16 8 35. Suicide M F — - - - — - — - 3 4 5 4 1 1 - - 10 10 36. Homicide and operations of war M F - - - - - - - - - - - - - - - - - - M F 24 31 1 4 4 3 7 2 26 23 198 95 201 143 184 291 645 592 Total of all causes 55 5 7 9 49 293 344 475 1237 44 1959. PROPORTION OF DEATHS FROM PRINCIPAL CAUSES. TOTAL DEATHS, 1237. 45 INFANT MORTALITY—1959 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 1959 2,004 55 27 * Rate calculated on a birth figure supplied by the RegistrarGeneral of 1,781. * Rate calculated on a birth figure supplied by the Registrar- General of 1,501. * Rate calculated on a birth figure supplied by the RegistrarGeneral of 1,253. 46 Net deaths of infants at various ages under one year of age Under 1 week ... ... ... ... ... ... 33 1—2 weeks ... ... ... ... ... ... 3 2—3 weeks ... ... ... ... ... ... 3 3—4 weeks ... ... ... ... ... ... 3 4 weeks and under 3 months ... ... ... ... ... ... 7 3 months and under 6 months ... ... ... ... ... ... 4 6 months and under 9 months ... ... ... ... ... ... 2 9 months and under 1 year ... ... ... ... ... ... - Total deaths under 1 year 55 Net Births in the Year: Legitimate 1,748, Illegitimate 256. Net Deaths in the Year: Legitimate Infants 45, Illegitimate Infants 10. 47 CHART SHOWING THE NUMBER OF DEATHS OF INFANTS UNDER 1 YEAR OF AGE DURING THE PAST 20 YEARS. 48 INFANT MORTALITY RATES—ENGLAND AND WALES AND VARIOUS OTHER COUNTRIES Deaths under 1 year per 1,000 live births Country 1954 1955 1956 1957 1958 England and Wales 25 25 24 23 23 Scotland 31 30 29 29 28 Northern Ireland 33 32 29 29 28 Australia 22 22 22 21 20 Canada 32 31 32 31 30 Chile 124 121 113 117 127 Denmark 27 25 25 23 22 France 41 39 36 34 32 Irish Republic 38 37 36 33 35 Italy 53 49 48 50 48 Netherlands 21 20 19 17 17 New Zealand 22 22 19 20 19 Sweden United States 19 17 17 17 16 of America 27 27 26 26 26 MATERNAL MORTALITY—1959 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 1959 1 2,004 0.48 † 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 74 Bakehouses 84 - — Complaints 2,816 585 231 Drainage 1,921 4 17 Factories (Mechanical) 272 2 3 Factories (non-Mechanical) 77 2 3 Food (other than Restaurants and Eating Houses) 1,830 1 Hairdressers and Barbers 203 2 1 Housing Act 610 4 3 Housing Applications 160 1 House to House 1 - Housing Repairs and Rents Act 242 12 6 Ice Cream Vendors 226 - Infectious Diseases 510 1 - Markets 776 - ] Milk Vendors 174 - Old People's Welfare 485 - Outworkers 420 - - Pet Shops Act 14 - - Pharmacy & Poisons Act 95 - - Public Urinals 7 - - Rag Flock Act — Rats and Mice 1,804 39 26 Restaurants and Eating Houses 420 7 4 Scabies — - Shops Act 198 1 - Slaughterhouses 4 - Smoke Observations 219 2 1 Miscellaneous 1,034 19 6 Re-visits 4,996 219 562 No answer 725 — - No. of Ineffective Visits 20,397 725 901 - 864 - Total 19,672 901 864 During the year 324 Statutory Notices were served and 423 complied with. (B) SUMMONSES—Proceedings instituted during the year Public Health (London) Act, 1936 ... ... ... 37 Food and Drugs Act, 1955 ... ... ... 13 L.C.C. Byelaws ... ... ... 2 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 119 77 2 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 298 270 2 - (iii) Other Premises in which Section 7 is enforced by the Local Authority, (excluding outworkers' premises) - - - - Total 417 347 4 — 2.—CASES IN WHICH DEFECTS WERE FOUND Particulars Number of Cases in which Defects were Found Number of Cases in which Prosecutions were Instituted Referred Found Remedied To H.M. Inspector By H.M. Inspector Want of Cleanliness (S.l) 3 5 - - - Overcrowding (S.2) — — — — Unreasonable temperature (S.3) _ _ - _ - Inadequate Ventilation (S.4) - - - - - Ineffective Drainage of Floors (S.6) - - - - - Sanitary Conveniences (S.7) (a) Insufficient (b) Unsuitable or Defective - - - - - 1 — - (c) Not separate for sexes Other offences against the Act (not including offences relating to Outwork) — — — — — — 1 - — - Total 4 6 — — — 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 inUnwhole ;ome Premises Notices Served Prosecutions Wearing ApparelMaking, etc. 156 - _ - - Lampshades 6 — - — — - Curtains and Furniture Hangings 3 — - Jewellery 8 — - — — — Paper bags 28 — - — — - Carding, &c., of Buttons, &c 99 — - Stuffed Toys 20 — - — — - Cracker Bon-bon, Christmas Crackers, Christmas Stockings, &c. 28 — - — - - Total 348 — — — - - 52 (D) UNSOUND FOOD CONDEMNED—1959 Bacon 124 lbs. Baked beans 16 tins Beetroot 36 lbs. Brussell Sprouts 448 lbs. Cabbage (Dutch) 112 lbs. Cauliflowers 36 Chicken 12 lbs. Chicken 4 tins Chicory 24 lbs. Chocolate teacakes 36 Cream 8 tins Fish 390 lbs. Fish 38 tins Frozen Pack. Chicken Pie 8 Steak 1 Lemon Mousse 3 Potato Puffs 2 Fruit 352 tins Fruit juice 30 tins Ham 86 tins Meat 116 lbs. Meat 231 tins Milk 51 tins Mushrooms 12 lbs. Mustard and Cress 12 boxes Nescafe 3 tins Onions 112 lbs. Oranges 105 lbs. Peas 48 tins Peas pudding 16 tins Pickles 41 jars Potatoes 392 lbs. Rice, Creamed 9 tins Savoys 224 lbs. Scotch Kale 30 lbs. Soup 34 tins Tomatoes 36 lbs. Tomatoes 24 tins Turnips 24 lbs. Vegetables 34 tins Vinegar 52 bottles Watercress 36 lbs. Walnuts, shelled 55 lbs. 53 PUBLIC MORTUARY—Bodies Admitted, &c. Bodies admitted from the Borough :— By order of Coroner 321 By order of Police 3 On application of undertakers 3 327 Bodies admitted from other Boroughs :— Fulham (218 by order of Coroner, 2 by order of Police and 1 on application of undertakers) 221 Chelsea (206 by order of Coroner and 2 by order of Police) 208 Kensington (372 by order of Coroner, 4 by order of Police and 7 on application of undertakers) 383 812 Total bodies admitted 1,139 No. of P.M. examinations conducted :— Hammersmith cases 324 Fulham cases 220 Chelsea cases 208 Kensington cases 376 Total P.M.'s 1,128 No. of Inquests held :— Hammersmith cases 86 Fulham cases 35 Chelsea cases 32 Kensington cases 91 Total Inquests held 244 54 INFECTIOUS DISEASES Diseases Notifications Total cases notified Cases 0—1 year 1—2 years 2—5 years 5—15 years 15—25 years 25—45 years 45—65 years 65 + years Age not known removed to Hospital Deaths Correctec Figures Scarlet Fever 2 3 19 75 - 2 1 _ 102 14 99 Whooping Cough 12 9 20 18 - - - - - 59 18 — 59 Acute Poliomyelitis (Par.) 1 3 3 4 1 1 13 13 — 2 „ " (Non.-Par.) — — — — — — — Measles 43 117 352 301 8 3 1 — — 825 22 — 823 Diphtheria — — — 1 3 — — — — 4 4 — 1 Pneumonia 4 7 17 11 4 9 23 17 - 92 19 68 92 Dysentery 11 17 24 64 4 24 8 7 — 159 30 - 148 A. Encephalitis (Inf.) — — — 1 — — 1 — — 2 1 — 1 Enteric or Typhoid Fever - - - - - - - - - - - - - Paratyphoid Fever — — — 1 — 1 — — — 2 1 — 1 Erysipelas — 1 — — — 1 3 2 7 3 — 6 Meningococcal Infection 4 2 1 2 1 1 1 — 12 12 1 2 Food Poisoning 42 8 12 13 82 64 55 31 12 319 88 — 318 Puerperal Pyrexia — — — — 53 69 — — - 122* — — 122* Ophthalmia Neonatorum 4 - - - - - - - - 4 † — — 4 † Malaria - — — 1 1 — 2 1 1 Scabies 1 — 1 7 15 15 — 3 42 — 42 Tuberculosis (Pulmonary) — 1 2 1 24 51 42 14 — 135 21 8 135 „ (Non-Pulmonary) — — — 1 4 3 - — — 8 5 - 8 Totals 123 166 451 499 203 245 136 74 12 1,909 252 77 1,864 * Of this total only 45 cases related to patients residing in the Borough. † Of this total only 2 cases related to patients residing in the Borough. 55 TUBERCULOSIS Summary of Notifications during the period from the 1st January, 1959, to the 31st December, 1959 Age Periods Formal Notifications Number of Primary Notifications of new cases of tuberculosis 0— 1— 2— 5— 10— 15— 20— 25— 35— 45— 55— 65— 75— Total (all ages) Respiratory, Males - 1 1 — — 1 9 15 14 16 14 6 5 82 Respiratory, Females - — 1 1 — 3 11 13 9 7 5 - 3 53 Non-Respiratory, Males — — — 1 — 1 — 1 — — — — - 3 Non-Respiratory, Females - - - - - 1 2 1 1 - — - — 5 CASES NOTIFIED AND DEATHS—1959 and Previous Years Year No. of Cases notified No. of Deaths No. of Cases on Register of Notifications Pulmonary NonPulmonary Total 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 1959 135 8 143 8 1,581 Average number of cases notified for the 10 years (inclusive)—203. 1940/1949 Average number of cases notified for the 10 years (inclusive)—171. 1950/1959 Average number of deaths for the 10 years (inclusive)—88. 1940/1949 Average number of deaths for the 10 years (inclusive)—24. 1950/1959 56 CHART SHOWING THE NUMBER OF NEW CASES OF TUBERCULOSIS NOTIFIED DURING THE PAST 20 YEARS.. PULMONARY TUBERCULOSIS : NOM-PULMONARY TUBERCULOSIS : 57 MEDICINAL BATHS Cleansing of Verminous Persons School Children—Hammersmith Scabies ... ... ... 88 Verminous ... ... ... 661 Other Conditions ... ... ... 7 School Children—Non-Hammersmith Scabies ... ... ... 18 Verminous ... ... ... 9 Children under Five Years—Hammersmith Scabies ... ... ... 30 Verminous ... ... ... 76 Children under Five Years—Non-Hammersmith Scabies ... ... ... 7 Verminous ... ... ... 2 Adults—Hammersmith Scabies ... ... ... 195 Verminous ... ... ... 132 Other Conditions ... ... ... 53 Adults—Non-Hammersmith Scabies ... ... ... 47 Verminous ... ... ... 17 Other Conditions ... ... ... 3 Lodging-Houses—Hammersmith Scabies ... ... ... 14 Verminous ... ... ... 56 Other Conditions ... ... ... 4 DISINFECTION Hammersmith Non-Hammersmith Cases Cases Mattresses ... 508 149 Pillows ... 618 97 Blankets ... 391 99 Sheets ... 237 91 Quilts ... 129 29 Clothing ... *1,267 120 Sundries ... *404 101 Total 3,140 * 17 Custom's Certificates issued in respect of 351 articles (309 Clothing, 42 Sundries) Rooms (including 1,047 verminous Rooms), 1,058