PH/C 4347 HAM 52 Metropolitan Borough of Hammersmith Report on the Health of the Borough 1960 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, 1960 Councillor E. O'K. Finn (Mrs.), M.B.E. (Chairman) ,, E.D. Freeman (Mrs.) (Vice-Chairman) Alderman H. G. Reynolds Councillor B. Evans (Mrs.) ,, D. M. Heaks (Mrs.) ,, F.W. Ing ,, L. S. Jones, A.R.Ae.S. ,, D. R. P. Murray, M.A., Ph.D. ,, 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 (Alphabetical Index—page 68) Page Introduction 1 Staff 2 SECTION A—Social Conditions and Statistics :— Births 4 Deaths 4 Infant Mortality 5 Marriages 4 Maternal Mortality 5 Population 4 Social Conditions 3 SECTION B—-Prevalence of and Control over Infectious Diseases :— Contacts and Carriers—Sickness Benefit 6 Dysentery 8 Food Poisoning 8 Health Laundry 11 Measles 6 Medicinal Baths 9 Notifications 6 Poliomyelitis 7 Smallpox 7 Tuberculosis 7 SECTION C—Housing Permanent Estates 16 Re-housing 15 SECTION D—Inspection and Supervision of Food :— Bacteriological Examination of Food 20 Designated Milk Licences 22 Food and Drugs Act, 1955, and Food Hygiene Regs., 1955 & 1960 17 Ice Cream 21 Ice Cream and Preserved Food Premises 22 Markets 24 Milk Supplies 22 Public Health (Condensed Milk) Regulations, 1923-48 24 Sampling 18 SECTION E—Environmental Hygiene—Administration :— Coroner's Court and Public Mortuary 27 Exhumation and Re-interment of Bodies 26 Housing Repairs and Rents Act, 1954 27 L.C.C. (General Powers) Act, 1952—Rag and Bone Dealers 27 L.C.C. (General Powers) Act, 1954—Hairdressers and Barbers 28 Pet Animals Act, 1951 27 Pharmacy and Poisons Act, 1933, and Pharmacy and Medicines Act, 1941 28 Public Baths and Washhouses 27 Rag Flock and Other Filling Materials Act, 1951 27 Rent Act, 1957 27 Staff—Inspectorial 26 SECTION F—Sanitary Circumstances : Atmospheric Pollution 32 Clean Air Act, 1956 32 Maps—Smoke Control Areas 34-37 Drainage 30 Dustbins 30 Factories 30 Inter-Borough Smoke Liaison Committee 33 Page Public Cleansing 30 Rodent Control 30 Sanitary Inspection 30 Sewerage 31 Water Supply 29 SECTION G—General Provision of Health Services :— Ambulance Facilities 38 Burial or Cremation of the Dead 42 Conferences 44 Financial Contributions to Voluntary Organisations 44 Hammersmith Chest Clinic 38 Health Information Bureau 44 Hospitals 38 International Certificates of Vaccination and Inoculation 41 Laboratory Facilities 38 National Assistance Acts 1948/51—Removal of Aged Persons 42 Old People's Welfare 42 Personal Health Services 39 Ante-natal Clinics 40 Chiropody 40 Creche 41 Day Nurseries 41 Domestic Help Service 41 Immunisation 40 Speech Therapy 40 Welfare Centres 40 Staff Medical Examinations 43 STATISTICAL SUPPLEMENT—TABLES Causes of Death in Age Groups 53 Deaths from Carcinoma of Lungs in Age Groups 49 Disinfection 67 Extracts from Vital Statistics 47 Factory Defects 60 Factory Inspections 60 General Statistics 47 Incidence of Cancer during the past 10 years 48 Incidence of Pulmonary Tuberculosis and Neoplasms of the Lungs 50 Infant Deaths under 1 year in age groups 56 Infant Mortality 55 Infant Mortality Rates—England and Wales and various other Countries 58 Infectious Diseases—Notifications in Age Groups 64 Maternal Mortality 58 Medicinal Baths—Cleansing of Verminous Persons 67 Mortuary and Coroner's Court 63 Natural Increase or Decrease of the Population during the past 20 years 48 Outworkers 61 Sanitary Inspection—Notices served and complied with 59 Summonses—Proceedings instituted 59 Tuberculosis—Notifications and deaths for the past 20 years 65 Tuberculosis—Notifications in sex and age groups 65 Unsound Food condemned 62 Vital Statistics of Whole District 51 CHARTS Birth and Death Rates for the past 20 years 52 Number of Infant Deaths under 1 year of age during the past 20 years 57 Number of new cases of Tuberculosis notified during the past 20 years 66 Proportion of Deaths from Principal Causes 54 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 have much pleasure in presenting my Annual Report on the state of the Public Health in Hammersmith for the year 1960, the Report being on the lines requested by the Minister of Health. Once again, I regret that it was not possible to publish it sooner, as it is necessary to include in the Report vital statistics which cannot be calculated until the necessary figures are received from the Registrar General. The year was notable particularly with regard to the Public Health Department's added responsibilities with regard to the various services for old people. We have always worked closely with the Town Clerk and his officers but in June the Secretary of the Hammersmith Old People's Welfare Association and that Association asked us to play a greater part in their activities and requested that I should become their Hon. Medical Director. The Public Health Department and I welcomed this opportunity to give more of our time to old people and the arrangement continues to work very well indeed. I should emphasise, however, that the affairs of the Hammersmith Old People's Welfare Association could not flourish without the very generous assistance of the Hammersmith Borough Council. The Council, and the Mayor himself, have repeatedly come to our rescue and enabled us to introduce new services of which we are very proud. For instance in June, the delivered lunches were first served from a new type of container which maintains the meal at the appropriate temperature—a hundred of these being then served from two vehicles particularly designed for this service. Serious infectious disease was happily scarce during 1960 but in April two carriers of a food poisoning organism (Salmonella St. Paul) were found in a large food factory and were isolated at home until free from infection. It is of interest to record that financial compensation was paid to both men by the Hammersmith Borough Council under their powers contained in the London County Council (General Powers) Act, 1959. There are a number of other unusual problems which came to our notice and will be found later in the substance of the report. In conclusion, I wish to thank the Members of the Council and, in particular, the Chairman and Members of the Health Committee and the Establishment Committee, for the support and encouragement which I have at all times received, and to express my sincere thanks to all the Staff of the Public Health Department for their loyal support and excellent work done throughout 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, 1960 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. Assistant Administrative Officer: S. G. Bennett (b, d.) Clerical: J. C. Turner (Ist Assistant) F. E. Martin A. E. Blake W. M. Robinson Mrs. J. P. Brodie Mrs. L. G. Stimpson T. J. Hares Miss I. E. Waller Mrs. D. Kelley (M.O.H.'s Secretary) Mrs. F. Lawford Senior Public Health Inspector: P. T. Bayes (a, b, c.) Deputy Senior Public Health Inspector : E. W. Pike (b, d.) Public Health Inspectors: W. R. Bland (d) W. H. Tyrrell (Assistant) G. G. Gardiner (b, d, h.) R. J. Darrington (Assistant) J. C. Hopkins (b, d, g.) (National Service 5.10.60) S. E. Thelner (d) Food and Drugs Inspector: W. J. Godden (a, b, e.) Clean Air Act: Enquiry Officers: Technical Officer : P. E. C. Pendock (Temporary) E. Bonnar (Unestablished) E. R. James (Temporay) Old People's Welfare: Miss E. M. Cross (d, f, i, j.) Mrs. E. Coats (Public Health Welfare Officer)Mrs. C. Willison Miss M. A. Tyreman (j) (Part Time) (Nursing Visitor) Mortuary Keeper: W. Gauntlett Medicinal Baths Superintendent : F. G. Baldwin (j) Public Analyst: D. F. H. Button, A.R.C.S., F.R.I.C. (a) Cert. Sanitary Inspectors' Examination Board. (b) Cert. Royal Sanitary Institute (Meat and other foods). (c) Smoke Abatement Cert. L.C.C. School of Engineering. (d) Cert. Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. (e) Cert. Royal Sanitary Institute (Inspector). (f) Cert. Royal Sanitary Institute (Health Visitor). (g) Cert. Royal Sanitary Institute (General Science and Sanitation). (h) Cert. Royal Sanitary Institute (Sanitary Science as applied to Buildings and Public Works). (i) State Certified Midwife. (j) State Registered Nurse. 3 SECTION A SOCIAL CONDITIONS OF THE BOROUGH AND STATISTICS Hammersmith, the most westerly of the Metropolitan Boroughs, although largely industrial in character can still boast of quiet spots by the riverside; the waterfront between Chiswick Mall and Hammersmith Bridge is an attraction at any time of the year. There are the period places such as Kent House and Kelmscott House that contrast strongly with the twentieth century dwellings. It is a very far cry from the old coaching road to the Great West Road as we know it today; with the Fly-over constructed by the most upto-date methods now nearing completion. There are still hold-ups on the Great West Road, but they are no longer the work of highwaymen, but, of course, traffic congestion. All those activities that are a part of modern urban life can be found in Hammersmith, from the processing of raw materials in factories to the retailing of the finished article in the very fine shops in the Borough. There is a variation of approximately 120 ft. in the elevation of the Borough from the southern 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, Cornwall), 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 has an estimated population for 1960 of 108,290 and an area of 2,282.5 acres, of which 286 acres are given over to parks and open spaces. There are approximately 70 miles of roads, most of which carry the very heavy traffic that is such a feature of life today. Apart from the residents, many people come to Hammersmith for relaxation. The Boat Race was run for the 106th time in 1960 (Oxford won); athletics are to be found at the White City Stadium; exhibitions of all kinds are held at Olympia. Excellent transport services facilitate these events. The new B.B.C. Television Centre in Wood Lane provides entertainment for millions. 4 Vital Statistics. (a) Population A detailed analysis of population figures is shown in the statistical supplement. The Registrar-General's estimated population for Hammersmith for 1960 is 108,290 which shows a reduction of 610 compared with 1959. This is a reduction in population for the eighth year in succession. The last national census was in 1951 and there will be a further one in 1961: figures issued by the Registrar-General for the years between are estimates and are in no way factual. Despite the drop in total estimated population, the number of children under 15 years of age is 22,300 for 1960 as against 22,000 for 1959 : this shows an increase of 300. (b) Marriages The number of marriages was 1,308, an increase of 41 compared with the previous year. Particulars are set out hereunder :— The Register Office 497 Buildings registered for marriages (Roman Catholic Churches and Chapels at which a Registrar attends) 442 Churches of the Church of England 322 Authorised Persons (Chapels at which a Registrar does not attend) 31 Jewish Synagogues 16 1,308 (c) Births The corrected number of births for the year was 2,212 as against 2,004 in 1959. On the estimated population of 108,290 this represents an annual rate of 20.4 births per thousand persons living. In 1959 the birth rate per thousand of the population was 18.4. There was an increase in illegitimate births from 256 in 1959 to 261 in 1960. (d) Deaths The number of deaths registered last year was 1,429. From this figure must be deducted 688 in respect of non-resident and transferable deaths, and added to it 464 deaths of residents of the Borough who died in various parts of England. This gives the corrected figure of deaths as 1,205 (615 males and 590 females). Using the estimated population figure of 108,290, the number of deaths per thousand of the population is 11.1 as compared with 11.3 in 1959. 5 Once more the principal causes of death during 1960 were diseases of the heart and cancer. In the Statistical Supplement will be found a detailed analysis of deaths from carcinoma of the lungs during recent years. (e) Infant Mortality The number of deaths of infants under one year of age during the year was 50 giving a mortality rate per 1,000 live births of 23 as compared with 27 last year. (f) Maternal Mortality There was 1 maternal death during the year, resulting in a death rate of 0.44 per 1,000 live and still-births. 6 SECTION B PREVALENCE OF AND CONTROL OVER INFECTIOUS DISEASES Infectious Diseases. 1,031 cases of infectious diseases were notified during the year. 124 cases were removed to hospital and of this number, 11 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 1,020. These figures show a decrease on the previous year of 844 cases. This is largely due to the fact that there were very few cases of Measles until the end of the year; and to a substantial decrease in the number of cases of Food Poisoning. Scarlet Fever, Pneumonia and Dysentery also showed a decrease; although the figure for Whooping Cough was higher. It is interesting to note how regular in its habits the Measles cycle is, and this is clearly seen in the chart below showing figures of notifications received during the last ten years. If past experience is anything to judge by, then we should reach a further Measles peak during the early months of 1961. I am pleased to be able to report that no cases of Diphtheria were brought to the attention of this Department during 1960. Contacts and Carriers of Infectious Disease—Sickness Benefit. No certificates were issued during the year. 7 Tuberculosis. During the year there was a decrease in the incidence of this disease. The number of new cases notified was 111 as against 143 in the previous year. These figures show a decrease of 37 in pulmonary cases and an increase of 5 in non-pulmonary cases. This total of 111 cases notified for 1960 is a new record low figure, beating the previous best (in 1958) by no less than 17 cases. In the statistical supplement will be found a chart showing the number of new cases notified during the past 20 years. The number of deaths was 7 as against 8 in 1959. This, over the years, I regard as a quite remarkable improvement. As in previous years, the London County Council continued with the campaign for B.C.G. inoculations among school-children and a total of 2,045 received these inoculations during the year. Poliomyelitis. There was only one confirmed case of this disease in the Borough in 1960: it was found to be of the paralytic type. There were two confirmed cases ir. 1959. 48,255 vaccinations against this disease were carried out in Division 1 of the London County Council. Smallpox In October a Dutch businessman arrived in London from Singapore and was subsequently found to be suffering from Smallpox. Public Health Services all over London were alerted, and it was discovered that the patient had visited Wormwood Scrubs Prison in Hammersmith whilst he was in an infectious state, and had been in contact with members of the prison staff and with prisoners. As one of the precautionary measures, I arranged with the Chief Medical Officer of the prison that everyone there should be offered vaccination without delay. The Public Health Department treated this as an emergency and immediately obtained sufficient vaccine and delivered it to the prison, thus making vaccination possible the same day. A supply of vaccine was kept in hand at the Public Health Department, and vaccination was made available to the public. All general practitioners practising locally were informed of arrangements made and of the facilities available. I made daily visits to the prison, and as prisoners were discharged to their homes outside the Borough the appropriate local authority was notified in order that full precautions might be taken. No further cases of Smallpox did occur, but the fullest preparations were made should this have happened. 8 Food Poisoning. This year there were 35 cases of Food Poisoning. This compares very favourably with the 318 cases in 1959; however, it must be remembered that in 1959 there were large outbreaks at two hospitals in the Borough, whereas in 1960 the total of 35 was made up largely of single cases. The following agents were identified :— Salmonella Typhimurium 8 Salmonella Reading 1 Salmonella Stanley 1 Total 10 In 25 other cases no specific organism was isolated. During December, 1959, three cases of Salmonella St. Paul were discovered in different London Hospitals. It was then found that all three individuals concerned were employed at the same place—a food factory in Hammersmith. Great importance must be placed on any outbreak of food poisoning discovered in a food factory, and the Health Department immediately commenced extensive investigations. Swabs were taken at various points in the drainage system of this factory, and it was found that certain toilets were receiving the Salmonella St. Paul organism. This narrowed the search to some extent, but it was necessary to investigate still further, and, working with the full co-operation of the management of the factory, it was then found necessary to test individual members of the staff. The tests revealed that two employees were in fact carriers. They were requested to stay away from the factory and to consult their own doctors. Both of these employees claimed and received compensation from the Council in accordance with Section 26 of the London County Council (General Powers) Act, 1959, which provides that where, in a case of this nature, the Medical Officer of Health requests in writing a person to discontinue his employment, the Borough Council may, if they think fit, compensate such person for any loss occasioned by compliance with this request. After further tests both were found to have eliminated the organism and resumed their employment once more. Whilst it was impossible to pinpoint the original source of the infection, at least the action taken did ensure that the outbreak was limited. Dysentery. 100 cases of Dysentery occurred during 1960 which is 48 less than last year. There were no deaths, nor were there any outbreaks. 9 Medicinal Baths. In Scotts Road, Shepherds Bush, the Health Department's treatment baths and laundry carry on their multiple responsibilities. Treatment is provided for scabies, impetigo, verminous conditions and for psoriasis. During the year, the London County Council discontinued the use of this centre for school-children. However, cases from Brentford and Chiswick, Ealing, Fulham, Hendon, Heston and Isleworth, Kensington, Richmond, Southall and Uxbridge received treatment. Barnes and Brentford and Chiswick Councils, and the London and Middlesex County Councils used our centre for the steam sterilisation of bedding. On 148 occasions the West London Hospital used the services of the Medicinal Baths for sterilisation—a total of 905 articles. In my report for last year I wrote that "The year 1959 will be recorded and long remembered"; I was, of course, referring to the weather. The same can be said of 1960, but, alas, whereas 1959 was hot and dry for long periods, 1960 was cold and wet. The level of bed bug activity is known to fluctuate with temperature variation, and, as the last two years were so different in character a comparison of treatments given is worthwhile. 1959 I960 Treatments Average Mean Temperature Degrees Fall. Treatments Average Mean Temperature Degrees Fah. January — 39 9 43 February 2 43 22 43 March 5 48 29 45 April 25 53 47 51 May 48 57 92 57 June 91 63 94 63 July 117 67 90 62 August 245 67 51 63 September 170 63 39 59 October 76 57 19 54 November 26 49 24 49 December 8 46 17 43 Totals 813 533 The figure of 813 for 1959 was a record and it is likely that there was a residue which may be the reason for so much bug activity so early in the year 1960. A constant temperature of above 65 deg. F. produces ideal conditions for bed bugs to complete a quick life cycle. Below 55 deg. F., they are more lethargic and feed less and therefore give less trouble. The temperature fluctuation of a normal English summer will to some extent retard infestation. Calls for spraying are rare when the average temperature is below 50 deg. F., except where redecorations are in progress. 10 It is likely that even better results could be obtained from insecticides if they were used at the time of bug hibernation; this applies to old property in particular. The old saying that a dog is allowed his first bite would appear to apply to bugs also, as rarely are steps taken by the afflicted until the bugs are really active. If only those concerned would consult the Public Health Department as soon as they are aware that they have bugs, it would enable treatments to be spread over much of the year instead of the summer months, as they are at the moment. This year there were 39 treatments for cockroaches and 34 treatments for fleas; both figures very slightly up on 1959. In January a staphylococcal infection was persistent in one ward of a local hospital, and it was decided to close the ward while disinfection was carried out. All mattresses, pillows and blankets were steam sterilised at the disinfecting station; other articles were laundered by the hospital. There were 11 requests for formaldehyde disinfection from this hospital at other times. Following requests made to the Health Department, disinfection was carried out in 12 instances following a death. Also, 9 rooms were sprayed subsequent to tuberculosis. Articles of clothing continue to be sent abroad to relatives by persons living in the Borough. During the year 22 Certificates of Disinfection were issued in respect of 486 items of clothing. 260 mattresses were sterilised which had been used by persons sleeping on premises during show business. For the third year in succession the number of sterilisations of verminous bedding for private residents has increased; this year's figure of 872 articles was 484 higher than last year. As usual, the Town Hall carpets had their annual anti-moth treatment. There was a substantial decrease in the number of treatments made for head and body lice. There were 135 treatments for head lice as against 827 in 1959. This decrease is almost entirely due to the fact that the London County Council has now made other arrangements for the treatment of school-children. The number of treatments for scabies was also less:— 1959 1960 Treatments 313 173 Confirmed cases 87 65 This is also partly due to the fact that school-children are now treated elsewhere. 11 On three occasions section 43 of the London County Council (General Powers) Act, 1953, was utilised. A man of 80 was bathed and afterwards was taken to Luxborough Lodge under the care of the London County Council. Another man of 89 and a lady of 57 were both in a very dirty condition and on waiting lists for hospital beds; they were bathed and their clothing steam sterilised before they returned to their homes. Below follows a review of some of the persons visiting the cleansing station during 1960:— Said to have caused considerable annoyance on undeveloped sites in the Ealing area, a vagrant was brought to the baths for cleansing. Most of his chest, the left side of his abdomen and his left upper arm were without skin. A gangrenous area surrounded his abdomen. Pus discharged from numerous small foci. His body was dirty in the extreme, and his underclothing coated with an adherent matter. He presented a most unpleasant sight and smell indeed. He was cleansed where this could be performed without too much pain and the infected area covered with clean dressings. He was then taken to hospital. A man aged 89 was bathed at the request of the almoner of a hospital. He had reported for treatment and was too dirty to be properly examined. An urgent telephone call was received from a court probation officer. Could help be given to a man who had had an accident in his trousers whilst he was in the dock? The man was discharged by the magistrate and the fullest possible help was given. Health Laundry. Everv year the story of the Health Laundry Service is that of expansion. The figures speak for themselves. 1953 1954 1955 1956 1957 1958 1959 1960 Persons served during the year 16 12 40 39 39 45 45 71 Number of article; washed & ironed 479 1,201 3,903 4,137 5,580 10,437 11,504 14,977 Average weekly collections 2 3 9 9 14 22 27 32 Highest number of collections in one week 6 10 15 14 19 25 38 52 In fact, the laundry is now working for all practical purposes at its maximum capacity. There is no doubt that the facilities provided are becoming very well known and expansion is likely to 12 continue. As each year passes, the older age groups form a larger proportion of the population as a whole, and it is they who make the major demand on this service. In view of this, measures are being considered at the time of writing that will make expansion possible, and enable future demands to be met. As would be expected, the chronic cases outnumber the acute cases by between two and three to one. Many of those still being served during 1960 have received help for over twelve months, whilst one case dates back to 1953. Requests for help come from many sources: District Nurses, Home Helps, Doctors, Hospitals, Health Visitors, Welfare Departments, Voluntary Bodies, and friends or relations of the person concerned. There were also requests from victims of flooding. Below are details of a selection of the certificates issued during the year:— Sex and Age Collections up to 31.12.60 Primary Cause of III-health Sequel F 88 203 Fractured femur Service still in operation at the end of the year F 86 88 Cardiac failure Deceased F 33 286 Disseminated sclerosis Service still in operation at the end of the year F 76 204 Mental deficiency Deceased F 103 129 Senility Patient removed to other care F 82 128 Arthritis Admitted to hospital F 86 125 Senility Service still in operation at the end of the year F 88 114 Cerebral haemorrhage Service no longer required F 93 49 Chronic bronchitis Admitted to hospital F 57 25 Hypertension Admitted to hospital F 83 81 Senility Service still in operation at the end of the year M 81 64 Diabetes melitus Service still in operation at the end of the year F 76 74 Apoplexy Deceased F 85 75 Senility Service still in operation at the end of the year 13 Sex and Age Collections up to 31.12.60 Primary Cause of Ill-health Sequel F 73 75 Disseminated sclerosis Service still in operation at the end of the year F 84 59 Incontinence Patient removed to other care F 79 72 Incontinence Service still in operation at the end of the year F 84 65 Senility Service still in operation at the end of the year F 95 62 Senility Service still in operation at the end of the year F 82 21 Senility Patient removed to other care M 87 57 Incontinence Admitted to hospital M 84 52 Paraplegia Service still in operation at the end of the year F 96 59 Senility Admitted to hospital F 80 53 Incontinence Service still in operation at the end of the year F 80 47 Colostomy Service still in operation at the end of the year F 93 49 Senility Patient removed to other care F 77 32 Mental deficiency Admitted to hospital F 78 61 Arthritis Admitted to hospital M 78 52 Hemiplegia Service still in operation at the end of the year M 84 51 Accident Service still in operation at the end of the year 14 Summary of Articles Cleansed: Articles 1953 1954 1955 1956 1957 1958 1959 1960 Blankets 33 19 40 67 72 186 203 312 Sheets 183 514 2006 2057 2550 2531 2710 4278 Quilts 11 — — — 33 24 31 51 Pillow Slips — 163 459 440 645 852 777 928 Towels — 141 377 401 505 731 797 1364 Pyjama Jackets — 9 — — 83 162 208 194 „ Trousers - - - - - 75 62 55 Nightdresses — 131 208 252 363 497 548 623 Clothing 72 - - - - - - - Sundries 180 197 813 920 1329 5379 6068 7172 Total 479 1201 3903 4137 5580 10437 11504 14977 15 SECTION C HOUSING Rehousing. The Housing 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 Health 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 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 80 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 1960 10 2 80 9 — — Totals 326 96 2,072 775 100 40 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. 16 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:— 37-38, Ashchurch Park Villas 8 33-34, Ashchurch Park Villas 8 218, Goldhawk Road 16 Riverside Gardens 28 Clifton House, 127-129, Uxbridge Road 12} 45, Lakeside Road} 49a-53, Lakeside Road} 66-68, Lakeside Road 27} Conversions 70-74, Lakeside Road} 76-78, Lakeside Road} 84, Lakeside Road} Total 99 The Council acts as landlord for 3,408 principal tenants. The properties managed include houses, flats, pre-fabs, acquired and converted 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 war1,401 2. Number of families rehoused by the Borough Council in rebuilt houses since the war30 3. Number of families rehoused in pre-fabricated dwellings since the war 80 (Still living in pre-fabricated dwellings at the end of the year=38) 4. Number of families on the Waiting List at the end of the year 1,614 All properties which had been requisitioned by the Council were de-requisitioned by the 31st March, 1960, under a statutory obligation. 17 SECTION D INSPECTION AND SUPERVISION OF FOOD Food and Drugs Act, 1955. Food Hygiene Regulations, 1955 and 1960. The close of 1960 saw some new legislation of importance concerning food. A new set of Food Hygiene Regulations, the Food Hygiene (General) Regulations, 1960, and the Food Hygiene (Docks, Carriers etc.) Regulations, 1960, came into operation with certain exceptions, in October of that year. The 1955 Regulations dealt with the hygienic handling of food and the construction and maintenance of premises etc., where food is handled. Certain premises such as docks and warehouses and carriers were excluded. Briefly some of the changes are as follows :— The new Food Hygiene (Docks, Carriers, etc.) Regulations 1960, for the first time prescribe rules for preventing risk of contamination of food in premises previously excluded. The personal cleanliness of dock workers and other food handlers engaged in handling food which is not packed, is now insisted upon, and there are special requirements relating to the handling of meat and the notification of certain infections in food handlers. Premises so used are also required to be properly constructed and maintained, although there is no provision for exempting premises where it is not practicable to provide water supply and washing facilities. The Food Hygiene (General) Regulations, 1960, take the principal Regulations a further step forward by including homegoing ships and moored vessels. The expression "food premises" now applies to ships, passenger ferries, etc., from which a catering or retail food business is carried on. The definition "meat" has been extended to include rabbits, game and poultry. The scope of the expression "handling of food" has been widened so that the obligations of food handlers will in future extend to persons who wash-up or clean food equipment. Also as far as food handlers are concerned, the provision relating to the prohibition of the use of tobacco (including snuff) is extended to any other smoking mixture. The list of foods exempted from the provisions relating to the temperature at which food is to be kept has been extended to include others in which the danger of rapid multiplication of bacteria is small, e.g. chocolate or sugar confectionery, canned and bottled food, butter, margarine and other fats. The inspection and supervision of food supplies has always been one of the most important duties for which a Public Health Authority is responsible, and the shortage of inspectorial staff in the department has placed a heavy burden on the Inspectors who have had tc undertake the additional work in order to supervise the food supplies of the borough. 18 During the year 3,041 visits were made at food premises, stalls and markets and at 8 of these, conditions constituting contraventions under the Food Hygiene Regulations 1955-1960 were found. Legal proceedings were taken in one case, fines totalling £30 with £5 5s. Od. 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 35 Beer Bottlers 1 Biscuit Manufacturers 1 Butchers 66 Cafes and Restaurants 160 Canteens and Clubs 91 Chemists 38 Confectioners (sweetshops) 152 Fishmongers (wet and fried) 25 Fruit and Greengrocers 82 Grocers and Provisions 222 Honey (packing) 1 Ice Cream Manufacturers 3 Jellied Eels and Pies (manufacture and sale) 5 Milk Processing Depots 2 Milk Distributors 128 Off Licences 43 Public Houses 94 Sweet and Chocolate Manufacturers 3 Under Section 9, Food and Drugs Act, 1955, three seizures of unsound food were made. Legal proceedings were taken in one case resulting in a penalty of £2 with £4 4s. Od. 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 12 samples are shown in the following summary :— Sample Infringement Remarks Cooking Butter Rancid Referred to Ministry of Agriculture Food & Fisheries for report. 19 Sample Infringement Remarks Coloured Desiccated Coconut Incorrectly labelled Informal sample Coloured Desiccated Coconut Incorrectly labelled Informal sample Coloured Desiccated Coconut Incorrectly labelled Warning letter Coloured Desiccated Coconut Incorrectly labelled Warning letter Cooking Butter Contained non-permitted colouring matter Informal sample Cooking Butter Contained non-permitted colouring matter and was slightly rancid Informal sample Cooking Butter Contained non-permitted colouring matter and was rancid Legal proceedings taken resulting in an absolute discharge on payment of £7 7s. Od. costs plus the payment of the Government's chemist fee Sulphur and Lime Tablets 15% deficient in sulphur Informal sample Sulphur Tablets 15% deficient in sulphur Warning letter Raspberry Flavoured Syrup Contained 2,600 parts per million benzoic acid Informal sample Raspberry Flavoured Syrup Contained 2,400 parts per million benzoic acid Legal proceedings taken resulting in a penalty of £20 with £3 3s. Od. costs. The following summary shows the action taken after a full investigation was made in each case of 26 complaints received from members of the public in connection with food. Nature of Complaint Action Taken Chocolate Rolls mouldy and insect infested Summons withdrawn Cake containing fly Bread containing carbon and oil globules Penalty £5; £3 3s. Od. costs Warning letter Chocolate Biscuits, chocolate covering deteriorated No action Bread containing insect Warning letter 20 Nature of Complaint Action Taken Sausage containing metal Penalty £5; £3 3s. 0d. costs Dirty milk bottle Penalty £1; £3 3s. 0d. costs Sausage in sour condition Warning letter Sausage Roll in mouldy condition Warning letter Ham in stale condition No action Bread containing carbon particles and Warning letter oily matter Cornish Pastry in mouldy condition Warning letter Bread in mouldy condition Warning letter Bottle of milk containing human hair Summons dismissed Bottle of Orange Drink containing No action metal bottle cap Ants in Fruit Pie carton Warning letter Bread in mouldy condition Warning letter Apples falsely described Summons dismissed. £3 3s. 0d. costs against the Council Stout in a flat and stale condition No action Steak and Kidney Pie in mouldy Penalty £5; £5 5s. 0d. costs condition Meat Pies in a mouldy condition Company granted absolute discharge on payment of £2 2s. 0d. costs Sultanas in a maggoty condition Warning letter Canadian Cheese with strong smell Warning letter Apple Tart containing screw Warning letter Loaf with beetle Warning letter Dirty milk bottle Penalty £10; £2 2s. 0d. costs Bacteriological Examination of Food. The following samples were submitted for bacteriological examination. These examinations were made by the Public Health Laboratory Service and in some instances by the Royal Institute of Public Health and Hygiene, Queen's Square, London. Ice Cream 19 Ice Lollies 2 Milk 89 Milk (Chocolate flavoured) 1 Cream 2 Imitation Cream 14 Frozen Prawns 1 Potted Shrimps 1 Fish Pie 1 Canned Pork 1 21 Ice Cream. Most of the ice-cream sold in the borough is pre-packed. A regular inspection of premises used for the sale, storage and manufacture of ice-cream has been carried out, particular attention being given by the Food and Drugs Inspector where the manufacture of ice-cream takes place. There are three such premises in the borough registered under section 16 of the Food and Drugs Act 1955, where ice-cream is manufactured, two of which are wholesalers. The production of ice-cream is controlled by the Ice-Cream (Heat Treatment) Regulations, 1959, which allow the use of two methods of manufacture. These are (1) the Cold Mix, where icecream powder which has been submitted to heat treatment and sent out by the manufacturers in air-tight containers, is mixed with cold water and frozen. (2) The Hot Mix or Pasteurised Mix in which the mixed ingredients are subjected to specified temperatures for certain periods. It is an offence to sell or offer for sale ice-cream which has not been made under these conditions or which has been allowed to reach a temperature of 28 deg F. without again being treated. Water ices and certain ice lollies having a sufficient acid content to make pasteurisation or sterilization unnecessary, are excluded. During the year 19 samples of ice-cream were taken and submitted to the Public Health Laboratory service 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 decolourise methylene blue being recorded and the samples 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 19 samples were placed in the following grades:— 9 samples were within Grade 1 Standard 9 samples were within Grade 2 Standard 1 sample was within Grade 4 Standard Samples falling within Grades 1 and 2 are regarded as satisfactory. Grades 3 and 4 indicate carelessness in hygiene at some stage in the manufacture, handling and storage of the ice-cream. It is the practice to investigate fully when samples fall within the latter grades and it is of interest to note that the one sample classified grade 4 was not manufactured in the borough. 22 In addition, 34 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, i.e. not less than 5 per cent, fat and not less than 7½ per cent. milk solids other than fat. The fat content of the samples taken ranged from 5.2 per cent. to 16.8 per cent. Ice Cream and Preserved Food Premises. The following summary, which includes new registrations affected during the year, shows details of the number and type of premises registered under Section 16 of the Food and Drugs Act, 1955. Ice Cream Manufacturers 3 Ice Cream sales only 18 Confectioners (sweet-shops) selling ice-cream 153 Restaurants (selling ice-cream for consumption off the premises 41 Grocers selling ice-cream 108 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 418 Milk Supplies. The Milk (Special Designation) Regulations, 1960. New legislation concerning milk was brought out in October, 1960, when the Milk (Special Designation) Regulations, 1960, came into operation. These Regulations consolidate and re-enact with amendments the Milk (Special Designation) (Raw Milk) Regulations, 1949 to 1954 and the Milk (Special Designation) (Pasteurised and Sterilized Milk) Regulations 1949 to 1953. Some of the changes are:— Licences—Dealers' licences will permit sales outside as well as inside the area of the licensing authority and supplementary licences are discontinued. The period for which a dealer's licence is granted is extended from one year to five years. A dealer only selling milk in the same sealed containers as he receives them is issued with a new form of licence which permits him to sell any or all three kinds of specially designated milk– "Pasteurised" "Sterilized" and "Tuberculin Tested". This simplifies licencing procedure. Sampling—In the main, provision as to sampling are similar with the following additions:— (1) When the milk is in containers exceeding one quart in capacity, the sample shall consist of not less than two fluid ounces of the milk. (2) Where the officer taking the samples breaks the seal on a container he shall after taking the sample, re-seal the container and attach to it a label certifying that it has been opened and re-sealed by him. (3) Under the old Regulations a licence holder must permit the licencing authority to take samples of milk "free of charge". These words are omitted in the new Regulations. Prescribed Tests—The conditions of the methylene blue test for tuberculin tested (raw) milk and pasteurised milk are modified. In the case of samples taken from a dealer, the present 4½ hour test for tuberculin tested (raw) milk is replaced by the ½ hour test. Also a new and quicker phosphatase test for pasteurised milk is prescribed. The turbidity test for sterilized milk remains unchanged. Additional legislation relating to milk made in 1960, and coming into operation on 19th September, 1961, are the Skimmed Milk with Non-Milk Fat Regulations, 1960. By controlling labelling and advertising, these Regulations enable consumers to distinguish skimmed milk containing added non-milk fat and the same product in condensed or dried form, from whole milk. Milk is processed in the borough at the two large milk depots in Wood Lane and Scrubs Lane. There are nine high temperature short-time milk pasteurising plants and a number of sterilizing milk plants. In addition, the bottling of cream, the production of specially fermented milk and chocolate flavoured milk is carried out. At one milk depot a fermented milk marketed as "Yoghourt" is manufactured, the demand for which has increased considerably in recent years. At regular intervals the Food and Drugs Inspector checks the efficiency and working temperature of the milk plants and takes samples to ensure that they comply with the requirements of the Milk (Special Designation) Regulations, 1960. All samples taken from these milk plants were reported to be satisfactory. 185 inspections of premises used in connection with the processing and distribution of milk were made. Generally the premises were found to be satisfactory. 128 persons were registered as distributors of milk and two premises were registered as Dairies at the close of the year. 24 The following licences were issued by the Council under the Milk (Special Designation) Regulations:— Dealer's Licences Pasteurisers 2 Sterilisers 1 Tuberculin Tested 78 Pasteurised 102 Sterilised 93 Dealer's Supplementary Licences Tuberculin Tested 18 Pasteurised 20 Sterilized 22 90 samples of Special Designated Milk were taken under the Regulations from milk processing plants, milk distributors and milk vending machines. 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 42 42 - 42 - - T.T.Pasteurised 15 15 - 15 - - - Tuberculin Tested 16 - - 15 1 - (Raw) Sterilised 17 - - - - 17 - 90 57 - 72 1 17 The results of the examinations are sent monthly to the Milk Division of the Ministry of Agriculture, Fisheries and Food and they were informed at once of the above adverse report on the sample of farm bottled tuberculin tested milk. Further follow-up samples taken were reported to be satisfactory. Public Health (Condensed Milk) Regulations 1923/1948. These Regulations provide standards for milk fat and milk solids of condensed milk and control the labelling of tins and other receptacles. During the year 11 samples were submitted for examination by the Public Analyst and were reported genuine. Markets. There are four markets in the borough, two of which are privately owned, the Uxbridge Road Market on the site of the Silver Cinema and the market in Railway Approach. At the other two markets in Bradmore Lane and Norland Road street traders 25 operate from approved pitches licenced by the Borough Council under Section 21, London County Council (General Powers) Act, 1947. Street traders licences are renewed annually upon application from the holders and where such application is for the renewal of the licences on its original terms, the renewal is granted unless grounds are known to exist which call for a review of the conditions prescribed in the licences, i.e. permission to trade in different articles or commodities from those originally licenced, or if the storage accommodation is not satisfactory, particularly in the case of foodstuffs. The Council may refuse to renew a licence or may vary such licence upon renewal only where the applicant is, on account of misconduct or for any other sufficient reason, in their opinion unsuitable to hold such licence on its original terms. Close attention is paid to street trading in food and street traders storage accommodation. The Food and Drugs Inspector made 751 visits to street markets and food storage premises associated with same during 1960. 26 SECTION E ENVIRONMENTAL HYGIENE—ADMINISTRATION Staff—Inspectorial. The revised establishment of Public Health Inspectors consists of a Senior Public Health Inspector, Deputy Senior Public Health Inspector, eight District Inspectors, one Food and Drugs Inspector and one Woman Inspector. An additional Inspector commenced duties on 1st January, but despite further advertisements four vacancies remained unfilled. The Council appointed two Assistants in May to help the Public Health Inspectors and they have been given training facilities, as both of them intend to become Public Health Inspectors. One Assistant was called up for National Service in October. The shortage of qualified Inspectors has resulted in a serious decline in the number of routine visits to food premises, factories, shops, etc., and I am unable to ensure that the various Acts and Regulations are being observed. The position has been slightly ameliorated by the Public Health Inspector who covers the area north of Uxbridge Road using his motor car; the falling off in the number of applications for certificates under the Rent Act, and a slight reduction in the number of complaints received. On the other hand, the smoke control programme has brought increased work, and it has not been possible to consider other routine work, such as house-to-house inspections. In October, Miss Cross, the Woman Public Health Inspector, was appointed Public Health Welfare Officer in connection with the old people of the Borough, and in consequence of these additional duties less of her time was spent on matters of environmental hygiene. Exhumation and Re-Interment of Bodies. During the year four licences were granted by the Secretary of State for the exhumation and removal of four 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. 27 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 12 Number granted 4 For Revocation of Certificates Number received 7 Number granted 5 Undertakings Given by Landlord Number acccepted 8 Coroner's Court and Public Mortuary. The number of bodies admitted to the Public Mortuary during the year was 1,204, an increase of 65 compared with 1959. There were 1,194 post-mortem examinations. This also is an increase of 66 compared with last year. Details can be found in a table (page 63) in the Statistical Supplement. The Mortuary and Court were also used by the Boroughs of Fulham, Chelsea and Kensington and the amount of their annual contribution towards this Council's expenditure on the premises was as follows:— Fulham £350 Chelsea 10 guineas Kensington £500 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 two. Pet Animals Act, 1951. This Act remained in force and ten applications for 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. Lime Grove: The public baths and wash-houses in Lime Grove, Shepherds Bush, provide facilities for bathing, swimming and laundry work. For bathing there are private hot baths or shower cubicles; and towels, soap, bath cubes and shampoos are 28 supplied at a small cost. There are concession rates for children and for old age pensioners free baths on certain days. In the public wash-houses, fully automatic machinery is provided for washing, spin drying and tumbler drying. There are also hand irons. There are two swimming baths at Lime Grove: the smaller of which (100 ft. by 30 ft.) is open all the year round. The larger one ( 105 ft. by 34 ft.) is open during summer months only, as during the winter season it is converted into a public hall which may be hired for meetings, concerts, wrestling, dances, etc. In addition, certain periods are set aside for Badminton and Indoor Bowls. Bloemfontein Road: There is an Open Air Pool (150 ft. by 75 ft.) at Bloemfontein Road, Shepherds Bush, which, during summer months provides for swimming and sunbathing. This Pool is open daily, including Sundays, from the middle of May to the end of August, or later according to weather conditions. The Metropolitan Water Board supply water for both Bloemfontein Road and Lime Grove Baths, and all pools are subjected to chlorination and alkali treatment and filtration with continuous circulation of the water. Eight samples of water were taken for chemical analysis by the Public Health Department from the Public Baths and the Open Air Bath, all of which were reported to be satisfactory. In addition, frequent checks are made during each day by the staff of the baths. London County Council (General Powers) Act, 1954. Hairdressers and Barbers. During the year eight new applications were received and registered, making a total of 109 hairdressers and barbers registered in the Borough. All the premises were kept under observation during the year. Pharmacy and Poisons Act, 1933. Pharmacy and Medicines Act, 1941. The names and addresses of 91 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 were inspected for their suitability, methods of storage and labelling as required under the Acts and have been found satisfactory. 29 SECTION F SANITARY CIRCUMSTANCES OF THE BOROUGH Water Supply. The water supplied to the Borough by the Metropolitan Water Board during 1960 has been satisfactory both in quantity and quality. It is derived from the River Thames, stored in the Littleton and Staines reservoirs and filtered and chlorinated at Ashford Common and Barn Elms Works. The average results of chemical and bacteriological analyses of water supplied are set out below:— Chemical Examinations: No. of samples 207 Ammonia Nitrogen 0.024 Milligrammes per litre. Albuminoid Nitrogen 0.082 „ „ „ Oxidised Nitrogen—Nitrate 4.0 „ „ „ Chlorides as C1. 28 „ „ „ Oxygen abs. from Permanganate 4 hrs at 27° C. 1.22 „ „ „ Turbidity 0.4 Units Hardness (Total) 264 Milligrammes per litre Hardness (non-carbonate) 66 „ „ „ pH Value 7.9 „ „ „ Phosphate as PO4 0.95 „ „ „ Silicate as SiO2 9 „ „ „ Sulphate as SO4 58 ,, „ „ Fluoride as F 0.25 „ „ „ Magnesium as Mg 4 „ „ „ Surface Active Material as Manoxd. 0.12 „ „ „ Bacteriological Examinations: No. of samples 1,778 Agar plate count per ml.: 20-24 hours at 37° C. 14.4 Coliform count: Per cent samples negative in 100 ml. 98.71 E. coli/count: Per cent samples negative in 100 ml. 100.00 No new important extensions of trunk mains, nor changes in the general scheme of supply have been made during the past year but 1,303 yards of new mains have been laid. All new as well as repaired mains are disinfected with chlorine before being brought into or restored to service. 92 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. All of the houses in the Borough, numbering some 25,000, are supplied with water direct from the mains. 30 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 30,279 tons Amount of trade refuse collected during the year 4,231 tons 34,510 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 92 plans (13 of which related to combined drainage) were submitted to the Health Department and a total of 1,961 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. 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. It is with satisfaction that I report that the number of rat infestations, both ordinary and major, have again decreased. The big increase in the number of mice infestations is to be deplored. This, in my opinion, is due to the increasing number of dwellings 31 being used by a greater number of families per dwelling. Hence more rooms per house have scraps of food left lying around, and this not only helps the mice to breed, but is making successful treatment more and more difficult. The Public Health Inspectors are trying to guide the public on this aspect of biological control. The sewers were baited twice during the year. Approximately £171 was received for treatment at business premises as against approximately £130 in 1959. The following is a summary for the year with comparable figures for 1959 in brackets:— Premises inspected : Dwellings 580 (560) Business 1,166(1.030) Total 1,746(1,590) Complaints : Rats 379(401) Mice 214(124) Total 593 (525) "Discovered" other than by complaint: Dwellings 23 (34) Business 2(1) Total 25 (35) Premises infested by rats : Dwellings 254 (281) Business 41(39) Total 295 (320) Premises infested by mice : Dwellings 188(113) Business 31 (30) Total 219(143) Premises treated by Council staff 518 (468) Major infestations 23 (38) Notices served relating to Rodent Control 66 (65) Re-inspections by Public Health Inspectors on infested premises 1588 (1216) Sewerage. The main sewers and the sewage disposal in London are the responsibility of the London County Council. Rainwater and soil sewage is carried in the same sewers, and the arrangements for Hammersmith are not yet adequate inasmuch that some basements in the Borough are liable to flooding from time to time when heavy storms cause the sewers to become surcharged. The area mostly affected is in the vicinity of the northern end of Askew Road. In 1960 flooding occurred on two occasions. The first was on the 7th August and was more wide spread than previously. Many complaints were received from various parts of the Borough and the staff of the Health Department, in co-operation with the Borough Engineer and Surveyor's Department, were organised to give immediate help in cases of most need. Some 327 premises were visited by the Public Health Inspectors and assistance was given in drying bedding, cushions and carpets; the Council's laundries were made available free of charge, and disinfectant was supplied where necessary. The removal of silt and water from under floors, and drain clearance was referred to the Borough Engineer and Surveyor. 32 The second flooding, which fortunately was not so severe as the first, occurred on the 1st September. 189 premises were visited by the Public Health Inspectors and similar assistance was given where required. The London County Council are to undertake works that, when completed, will reduce the risk of flooding in the Borough. Atmospheric Pollution. The stations set up in 1954 for measuring and recording the extent of atmospheric pollution continued to function during the year. Clean Air Act, 1956. Smoke Control Areas. The Hammersmith (No. 1) Smoke Control Order, 1959, came into operation on 1st November, 1959. This is our first area and covers that part of the Borough shown in Map 1 (page 34). As I stated in my Report for 1959, applications for approval for adaptations and replacement of firegrates were very slow in coming in and it was necessary to serve a number of notices under the Act requiring the execution of work after the Order was in force, and in 7 instances the Council carried out the work in default. Of the 2,025 private dwellings in the Area, adaptations or replacement of firegrates were carried out in 665 cases. The occupiers of many of the remainder use oil convector heaters or burn the more expensive solid fuels on their existing firegrates. Others have carried out alterations and have not applied to the Council for grant. In 40 cases the Council assisted old age pensioners by repaying the whole of the cost incurred in carrying out necessary work. In May, 1960, the Minister of Housing and Local Government confirmed the Hammersmith (No. 2) Smoke Control Order, 1960. This Order comes into operation on the 1st July next year. The Area covers approximately 170 acres and is shown on Map No. 2 on page 35 and on the instructions of the Health Committee publicity measures were adopted which included a small exhibition at the Town Hall in the late autumn to which the local Electricity and Gas Boards contributed stands as well as the Solid Smokeless Fuels Federation. At the same time the Solid Smokeless Fuels Federation's Mobile Unit toured the area for a period of two weeks displaying various approved fuels and appliances and giving general advice to the public. 33 All the occupiers of private dwellings, property agents, local builders, coal merchants, commercial and industrial undertakings, churches and buildings used by charities, were notified of the Order, and other publicity measures included a talk at a local school, display of posters and the issue of Notice of the Order to the local press. Despite this publicity the number of applications received was less than expected and appropriate reminder letters were sent out. There will inevitably be a number of cases in which Notices will have to be served before adaptations are carried out. As in Area No. 1, in many instances the Council approved the payment of the whole of the cost of adaptations for deserving cases. In December 1960, the Council made an Order in respect of the No. 3 Area, and this is now awaiting confirmation by the Minister of Housing and Local Government. The suggested operative date is 1st May, 1962. This area covers approximately 128 acres and relates to that part of the Borough shown in Map 3 on page 36. The survey in respect of the Council's proposed No. 4 area (Map No. 4 on page 37) was commenced in December, 1960. Inter-Borough Smoke Liaison Committee. During the year the Borough of Richmond was welcomed to membership of this committee and joined the Boroughs of Acton, Barnes, Brentford and Chiswick, Fulham, Hammersmith, and Willesden who continued as members. Representatives of the committee met on five occasions, and maintained a full exchange of information; in this way each constituent member is aware of progress being made by others. Among items discussed during the year were smoke control areas, atmospheric pollution by vehicles, electric fire lighters and grants. All the Councils concerned made good progress in the establishment of Smoke Control Areas during the year. 34 THE HAMMERSMITH (No. 1) SMOKE CONTROL AREA, 1959. 35 THE HAMMERSMITH (No. 2) SMOKE CONTROL AREA, 1960. 36 THE HAMMERSMITH (No. 3) SMOKE CONTROL AREA (PROPOSED) 37 38 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. 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 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 chest diseases on the staff of the Post-Graduate Medical School. 39 The Clinic, its associated independent radiography department and 27 beds are housed in the same building and are run as an integral Unit. A consultant diagnostic service for all chest diseases 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 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. 40 The following is a list of Clinics:— Ante-Natal Clinics 1/3 Milson Road Monday 1.30 p.m. Friday 9.30 a.m 48 Glenthorne Road Monday 6.00 p.m. Tuesday 1.30 p.m. Friday 1.30 p.m. Becklow Gardens Tuesday 9.30 a.m. Wednesday 6.00 p.m. Thursday 1.30 p.m. The Curve, Westway Wednesday 1.30 p.m. Friday 9.30 a.m. Infant Welfare Centres 1/3 Milson Road Tuesday 1.30 p.m. Wednesday 9.30 a.m. (toddlers by appointment) Thursday 9.30 a.m., 1.30 p.m. 48 Glenthorne Road Monday 1.30 p.m. Tuesday 9.30 a.m. (toddlers by appointment) Thursday 1.30 p.m. Becklow Gardens Tuesday 1.30 p.m. Wednesday 9.30 a.m. (toddlers by appointment) Wednesday 1.30 p.m. Friday 9.30 a.m., 1.30 p.m The Curve, Westway Monday 1.30 p.m. Thursday 9.30 a.m., 1.30 p.m. Friday 1.30 p.m. (toddlers by appointment—first 3 Fridays in month) Queen Charlotte's Maternity Hospital Tuesday 1.45 p.m. Immunisation (Diphtheria, Poliomyelitis, Smallpox, Tetanus and Whooping Cough). 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 to Friday at 2 p.m. Thursday and Friday at 10 a.m. 207 Westway Monday, Wednesday and Thursday 1.30 p.m. Speech Therapy 48 Glenthorne Road Monday and Thursday 1.30 p.m. 103 Shepherds Bush Road Tuesday p.m., Wednesday all day, Friday a.m., Saturday a.m. 41 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—7.30 a.m. to 6 p.m. Dalling Road Day Nursery—8.00 a.m. to 6 p.m. Latimer Road Day Nursery—8.00 a.m. to 6 p.m. Uxbridge Road Day Nursery—7.30 a.m. to 6 p.m. 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 7 full-time and 118 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 37 Tuberculosis 8 Other 1202 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 639 certificates were authenticated. 42 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, application may be made to a Court of summary jurisdiction for an Order for the compulsory removal to hospital of persons in need of proper care and attention. Of the cases referred to the Department for examination during the year, only in the following two instances was it necessary to take action under the above Acts. Miss S. first came to the attention of the Department in 1951, then aged 69. An extremely independent old lady, she had had an operation for cataract, and suffered from pernicious anaemia. The maximum help was made available: home-helps, meals service, National Assistance. However, as result of her old age, medical condition and blindness, by 1960 there was a marked deterioration. She was found to be living amidst dirt and rubbish, sleeping on a bare mattress, not eating dinners provided, and confused in mind. She had refused to go into a home. An Order for removal to a London County Council home was obtained for a period of three weeks, but it has since been found necessary to apply for three extensions, each of three months. Mrs. B. first came to the attention of the Department in 1954, then aged 87 years, and was found to be weak and suffering from a substantial degree of senility. She was opposed to any medical assistance and had no doctor. The Old People's Welfare Visitor called daily, and the services of the District Nurses, the Home Help (twice daily) and Mobile Meals were made available. However, by 1960 and at the age of 94 her condition had deteriorated until she was completely bedridden. An Order for removal to Hospital for a period of three weeks was obtained, but it was necessary to apply for a three months extension. Before this expired, it was learned that the lady had died. In all other cases it was found possible to find a solution in other ways: either by co-operation with the family doctor or by making use of available services. National Assistance Act, 1948. Burial or Cremation of the Dead. During the year thirteen burials were carried out by the Council under Section 50 of the above Act. Hammersmith Old People's Welfare Association. This Association was formed in 1950, with the object of promoting the general welfare of all old people in the Borough. Its work is financed almost entirely by grant from the Borough Council under the National Assistance Act, 1948. 43 The Association has been steadily expanding its services for old people along the lines of the provision of meals, both for the active and homebound; holidays and outings; chiropody; and social visiting, etc. This year, as a consequence of my appointment as the Hon. Medical Director of the Association, the Health Department has an even closer link with the maintenance of the Association's activities, with the day-to-day work being carried out in the old people's welfare office at the Town Hall. Miss Cross, Woman Public Health Inspector, has been appointed to the post of Public Health Welfare Officer, and is in charge of the old people's welfare office as well as undertaking certain public health duties. She is assisted by Miss Tyreman, S.R.N., Nursing Visitor, who also came to the staff this year. In June a new form of the Mobile Meals Service was inaugurated. The existing vans have been replaced by vehicles specially equipped to take heated containers. The meal is prepared in the Council's kitchens at the Town Hall and is placed in expendable foil dishes, which in turn are put into pre-heated containers, each of which holds 10 meals consisting of main dish and sweet dish. These containers are kept hot in the delivery vans by electric power so that the meals arrive at the right temperature. This method is a distinct improvement on the old system whereby meals had to be warmed up by the recipient before they could be eaten. This service, together with the meals supplied to the six Luncheon Clubs in the Borough, is now issuing an average of 250 meals a day. 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 356, and of this number 86 were found to be unfit for the following reasons:— Chronic Otitis Media 11 Neurosis 2 Prolapsed Disc 3 Dyspepsia 1 Vertigo 2 Partial Gastrectomy 1 Synovitis of knees 1 Mitral Stenosis 1 Hydrocele 2 History of Pulmonary T.B. 2 Hypertension 22 Rheumatic Condition 1 Gastric History 5 Inguinal Hernia 2 Chest Condition 4 Congenital eventration 1 Psychiatric History 4 History of Coronary Thrombosis 1 Diabetes 5 Prostetectomy 1 History of Duodenal Ulcer 1 Dermatitis 1 Femoral Hernia 1 Colostomy 1 Mental Certification 1 Bronchitis 2 Albuminuria 1 Liver Condition 1 Low I.Q. 1 Heart Condition 3 Varicose Veins 1 44 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 46 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 Amount Statutory Authority National Society for Clean Air 31 10 0 Public Health (London) Act. 1936, Section 298. Local Government Act, 1948, Section 136. Central Council for Health Education 14 19 9 Public Health (London) Act 1936, Section 298. Conferences. The Council was officially represented at the under-mentioned Conferences:— Conference Delegates The Royal Society of Health (Health Congress), Torquay. Councillor Mrs. E. O'K. Finn, M.B.E. 25th-29th April, 1960. Dr. F. M. Day, Medical Officer of Health. The Association of Public Health Inspectors, Scarborough. 20th-23rd September, 1960. Mr. P. T. Bayes, Senior Public Health Inspector. The National Society for Clean Air, Harrogate. 5th-7th October, 1960. Councillor Mrs. E. D. Freeman. Mr. E. W. Pike, Deputy Senior Public Health Inspector. Health Information Bureau. As in previous years, the Health Information Bureau continued its good work, and dealt with the great variety of enquiries that come daily into the Public Health Department. The public do make full use of this Bureau and are provided with on-the-spot help and information. 2,500 copies of the 1960 edition of the Health Services Guide were printed and distributed in the usual way. This booklet is now becoming very well known indeed, and as each year passes more and more people ask to be put on the mailing list. It would appear that not only does the guide have a very wide distribution, but, more important still, is also widely used. STATISTICAL SUPPLEMENT TO ANNUAL REPORT FOR YEAR 1960 47 GENERAL STATISTICS—1960 Area 2,282.5 acres Population (1960) (estimated) 108,290 „ (1959) (estimated) 108,900 „ Census (1951) 119,367 Natural increase, i.e., excess of births over deaths 1,007 Marriages registered 1,308 Rateable Value (April, 1960) £2,268,589 Sum represented by a penny rate (April, 1960) £9,200 EXTRACT FROM VITAL STATISTICS—1960 Total M. F. Live Births Legitimate 1,951 1,000 951 Birth Rate per 1,000 estimated resident population = 20.4 Illegitimate 261 139 122 Stillbirths 37 17 20 Rate per 1,000 total (live and still) births = 16.4 Deaths 1,205 615 590 Death Rate per 1,000 estimated average population= 11.1 Deaths from maternal causes—- Deaths Rate per 1,000 total Pregnancy, childbirth, abortion 1 (live and still) births 0.44 Death Rate of Infants under one year of age:— All infants per 1,000 live births 23 Legitimate infants per 1,000 legitimate live births 24.09 Illegitimate infants per 1,000 illegitimate live births 11.49 Deaths from Cancer (all ages) 291 Deaths from Measles (all ages) - Deaths from Whooping Cough (all ages) - 48 NATURAL INCREASE OR DECREASE OF THE POPULATION DURING THE PAST 20 YEARS Year Population Excess of Births over Deaths Excess of Deaths over Births 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 - 1960 108,290 1,007 — INCIDENCE OF CANCER DURING THE PAST 10 YEARS Year Population Deaths Rate per 1,000 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 1960 108,290 291 2.6 49 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 1960 M 2 39 18 10 69 F — 2 7 2 4 15 Total — 4 46 20 14 84 50 INCIDENCE OF PULMONARY TUBERCULOSIS AND NEOPLASMS OF THE LUNGS Age Groups Pulmonary Tuberculosis Neoplasms of the Lung or Bronchus 1959 1960 1959 1960 MALES 0— - - - - 1— — - - - 5— - - - - 15— - - - — 25— 1 - 2 2 45— 2 2 27 39 65— — 2 20 18 75— 3 1 7 10 Total Males 6 5 56 69 FEMALES 0- - - - - 1— - - - — 5— - - - — 15— — - - — 25— l — — 2 45— l 1 2 7 65— - - 3 2 75- - - 2 4 Total Females 2 1 7 15 51 VITAL STATISTICS OF WHOLE DISTRICT 1960 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 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 114,700 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 1960 108,290 2,212 20.4 1,429 13.1 688 464 50 23 1,205 11.1 * B= Birth-rate Population Figure. D=Death-rate Population Figure. 52 CHART SHOWING BIRTH AND DEATH RATES PER 1,000 POPULATION FOR THE PAST 20 YEARS . BIRTH RATE DEATH RATE 53 CAUSES OF, AND AGES AT, DEATH DURING THE YEAR 1960 AS SUPPLIED BY THE REGISTRAR GENERAL Cause of Death Sex 0— 1— 5— 15— 25— 45— 65— 75— Total all Ages 1. Tuberculosis, respiratory M - - - - - 2 2 1 5 F - - - - - 1 — — 1 2. Tuberculosis, other M 1 - - - - - - - 1 F - - - - - - - - - 3. Syphilitic disease M — — — — — 3 — — 3 F - - - - - - - - - 4. Diphtheria M - - - - - - - - - F - - - - - - - - - 5. Whooping Cough M - - - - - - - - - F - - - - - - - - - 6. Meningococcal infections M - - - - - - - - - F - - - - - - - - - 7. Acute poliomyelitis M - - - - - - - - - F - - - - - - - - - 8. Measles M - - - - - - - - - F - - - - - - - - - 9. Other infective and parasitic diseases M - - - - - - - - - F — — — — — 2 — — 2 10. Malignant neoplasm, stomach M — — — — — 6 5 3 14 F — — — — 1 2 1 2 6 11. Malignant neoplasm, lung bronchus M — — — — 2 39 18 10 69 F — — — — 2 7 2 4 15 12. Malignant neoplasm, breast M — — — — — — — — - F — — — — 3 22 5 1 31 13. Malignant neoplasm, uterus M — — — — — — — — - F — — — — 1 5 2 4 12 14. Other malignant and lymphatic neoplasms M — — 1 1 5 35 25 11 78 F 1 — 2 — 6 23 13 21 66 15. Leukaemia, aleukaemia M - - - - - 1 1 — 2 F - - - - - 2 — 1 3 16. Diabetes M - - - - - 3 — 1 4 17. Vascular lesions of nervous system F - - - - - 1 3 1 5 M — — — — I 6 9 19 35 18. Coronary disease, angina F - - - - - 13 24 57 94 M — — — — 3 52 46 27 128 19. Hypertension with heart disease F — — — — 1 16 28 44 89 M - - - - - 2 1 3 6 F - - - - - 2 3 2 7 20. Other heart disease M — — — — 3 6 15 15 39 F — — — — 1 14 11 38 64 21. Other circulatory disease M 9 9 14 32 F 1 — — — — 6 12 19 38 22. Influenza M - - - - - - - - - F - - - - - - - - - 23. Pneumonia M 3 1 — — — 4 5 11 24 F — — — 1 — 2 5 19 27 24. Bronchitis M 2 1 — — 1 20 11 16 51 F 1 1 — — — 4 5 15 26 25. Other disease of respiratory system M - - - - - 3 5 5 13 F - - - - - 2 — 2 4 26. Ulcer of stomach and duodenum M - - - - - 3 4 1 8 F — — — — 1 3 — 5 9 27. Gastritis, enteritis and diarrhoea M - - - - - - 2 1 3 F - - - - - 1 2 2 5 28. Nephritis and nephrosis M — — — — 1 1 1 - 3 F — 1 — — — 1 - 2 4 29. Hyperplasia of prostate M — — — — — — — 5 5 30. Pregnancy, childbirth, abortion F - - - - - - - - - M - - - - - - - - - 31. Congenital malformations F — — — 1 — — — — 1 M 9 1 2 1 2 — — — 15 32. Other defined and ill-defined illnesses F 6 1 1 1 — 1 1 — 11 M 17 — — 2 2 8 8 6 43 33. Motor vehicle accidents F 9 — — 1 2 9 11 19 51 M — — 1 1 3 2 2 1 10 34. All other accidents F — 1 — — — 1 1 3 6 M — 1 2 1 4 — 3 6 17 35. Suicide F - - - - - 1 3 6 10 M — — — 1 1 4 1 — 7 F — — — — 1 — 1 — 2 36. Homicide and operations of war M - - - - - - - - - F - - - - 1 — — — 1 M 32 4 6 7 28 209 173 156 615 F 18 4 3 4 20 141 133 267 590 Total of all causes 50 8 9 11 48 350 306 423 1205 54 I960 PROPORTION OF DEATHS FROM PRINCIPAL CAUSES. TOTAL DEATHS , 1205. 55 INFANT MORTALITY—1960 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 1960 2,212 50 23 * 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. 56 Net deaths of infants at various ages under one year of age Under 1 week 32 1—2 weeks — 2—3 weeks 1 3—4 weeks 3 4 weeks and under 3 months 8 3 months and under 6 months 4 6 months and under 9 months 1 9 months and under 1 year 1 Total deaths under 1 year 50 Net Births in the Year: Legitimate 1,951, Illegitimate 261. Net Deaths in the Year: Legitimate Infants 47, Illegitimate Infants 3. CHART SHOWING THE NUMBER OF DEATHS OF INFANTS UNDER 1 YEAR OF AGE DURING THE PAST 20 YEARS. 58 INFANT MORTALITY RATES—ENGLAND AND WALES AND VARIOUS OTHER COUNTRIES Deaths under 1 year per 1,000 live births Country 1955 1956 1957 1958 1959 England and Wales 25 24 23 23 22 Scotland 30 29 29 28 28 Northern Ireland 32 29 29 28 28 Australia 22 22 21 20 22 Canada 31 32 31 30 28 Chile 121 113 117 127 120 Denmark 25 25 23 22 22 France 39 36 34 32 30 Irish Republic 37 36 33 35 32 Italy 49 48 50 48 45 Netherlands 20 19 17 17 17 New Zealand 22 19 20 19 20 Sweden 17 17 17 16 16 United States of America 27 26 26 26 26 MATERNAL MORTALITY—1960 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 1960 1 2,212 0.44 † 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." 59 ENVIRONMENTAL HEALTH SERVICES (A) SANITARY INSPECTION Cause of Inspection No. of Inspections No. of Notices served No. of Notices complied with Atmospheric Pollution and Clean Air 63 - - Bakehouses 164 — — Complaints 2,574 780 235 Drainage 1,961 10 13 Factories (Mechanical) 98 1 — Factories (Non-Mechanical) 7 — — Food (other than Restaurants and Eating Houses) 1,536 3 1 Hairdressers and Barbers 86 — — Housing Act 380 4 1 Housing Applications 153 6 1 House to House 126 — — Housing Repairs and Rents Act 61 13 5 Ice Cream Vendors 170 — — Infectious Diseases 304 — — Markets 703 — — Milk Vendors 185 — — Old People's Welfare 596 — — Outworkers 105 — — Pet Shops Act 12 — — Pharmacy & Poisons Act 106 — — Public Urinals 9 — — Rag Flock Act 9 — — Rats & Mice 1,323 23 25 Restaurants & Eating Houses 283 5 1 Shops Act 87 2 — Smoke Observations 139 4 — Miscellaneous 817 21 6 Re-visits 8,134 186 686 No Answer 412 - - No. of Ineffective Visits 20,603 1,058 974 412 — — Total 20,191 1,058 974 During the year 410 Statutory Notices were served and 382 complied with. (B) SUMMONSES—Proceedings instituted during the year Public Health (London) Act, 1936 54 Food and Drugs Act, 1955 23 L.C.C. Byelaws 6 H.B.C. Byelaws 1 Housing Act, 1957 2 60 (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 108 7 - - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 294 98 1 - (iii) Other Premises in which Section 7 is enforced by the Local Authority, (excluding outworkers' premises) - - - - Total 402 105 1 — 2.-CASES IN WHICH DEFECTS WERE FOUND Particulars Number of Cases in which Defects were Found Number of Cases in which Prosecutions were Instituted Found Remedied Referred To H.M. Inspector By H.M. Inspector Want of Cleanliness (S.1) 1 - - - - 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 - - - - - (c) Not separate for sexes - - - - - Other offences against the Act (not including offences relating to Outwork) - - - - - Total 1 — — — — 61 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 in Unwhole some Premises Notices Served Prosecutions Wearing Apparel— Making, etc. 145 — — — — — Lampshades 5 — — — — — Curtains and Furniture Hangings 2 — — — — — Jewellery 7 — — — — — Paper bags 27 — — — — — Carding, &c., of Buttons, &c 43 — — — — — Stuffed Toys 19 — — — — — Cracker Bon-bon, Christmas Crackers, Christmas Stockings, &c. 27 — — — - — Total 275 — — — - — 62 (D) UNSOUND FOOD CONDEMNED—1960 Bacon 128 lbs. Baked beans 5 tins Biscuits 548 lbs. Blanchmange 36 packets Breakfast Cereal 118 packets Butter Beans (Dried) 37 lbs. Cakes (Fancy) 606 Cake Mixture 90 packets Chicken 28 lbs. Chicken 2 tins Coconut Desiccated 144 lbs. Cooking Fat 100 lbs. Cream 17 tins Custard Powder 18 packets Escallops 60 Fish 747 lbs. Fish 15 tins Fruit (Dried) 89 lbs. Fruit 335 tins Ham 122 tins Ice Cream Wafers & Cones 14 tins Jam 805 jars Jellies 1008 packets Meat 864 lbs. Meat 167 tins Milk 20 tins Nescafe 39 tins Nuts (Salted) 112 lbs. Peas 42 tins Peas (Dried) 46 lbs. Peas pudding 3 tins Pickles 3 jars Rabbits 30 lbs. Rice 3 tins Rice 125 lbs Salt 48 lbs. Sausage 82 tins Soup 29 tins Spaghetti 3 tins Sugar 140 lbs. Swiss Rolls 48 Toffees 56 lbs Tomatoes 187 tins Tomato Juice 4 tins Vegetables 21 tins Vegetables (Dried) 53 packets Yams (Nigerian) 6 tons 5 cwts 63 PUBLIC MORTUARY—Bodies Admitted, &c. Bodies admitted from the Borough:— By order of Coroner 351 By order of Police 2 On application of undertakers 5 358 Bodies admitted from other Boroughs:— Fulham (226 by order of Coroner and 1 on application of undertakers) 227 Chelsea (226 by order of Coroner and 2 on application of undertakers) 228 Kensington (387 by order of Coroner, 2 by order of Police and 2 on application of undertakers) 391 846 Total bodies admitted 1,204 No. of P.M. examinations conducted:— Hammersmith cases 353 Fulham cases 226 Chelsea cases 226 Kensington cases 389 Total P.M.s 1,194 No. of Inquests held:— Hammersmith cases 78 Fulham cases 41 Chelsea cases 44 Kensington cases 89 Total Inquests held 252 64 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 Age not known Scarlet Fever - 1 13 36 1 51 10 - 50 Whooping Cough 20 19 59 66 1 — — — — 165 13 — 165 Acute Poliomyelitis (Par.) — — 1 — — — — — — 1 1 — 1 » » (Non-Par.) — — — — — — — — — — — — — Measles 12 36 125 142 5 — — — — 320 14 — 318 Diphtheria — — — — — — — — — — — — — Pneumonia 9 3 9 8 3 9 18 11 — 70 15 51 69 Dysentery 11 17 24 23 9 14 4 3 — 105 21 — 100 A. Encephalitis (Inf.) — — — — — — — — — — — — — Enteric or Typhoid Fever — — 1 1 2 1 — — — 5 5 — 4 Paratyphoid Fever — — 1 1 — — — — — 2 2 — 2 Erysipelas — — — — — 1 3 4 — 8 2 — 8 Meningococcal Infection — — 1 — — — — — — 1 1 — 1 Food Poisoning 3 2 3 4 6 5 11 2 36 11 — 35 Puerperal Pyrexia — — — — 63 65 — — — 128* — — 128* Ophthalmia Neonatorum 2 - - - - - - - — 2† — — 2† Smallpox — — — — — — — — — — — — — Malaria — — — — — — — — — — — — — Scabies — 2 5 7 6 5 1 — - 26 1 — 26 Tuberculosis (Pulmonary) — — 3 2 17 39 27 10 — 98 26 6 98 „ (Non-Pulmonary) - —- - 1 3 4 3 2 — 13 2 1 13 Totals 57 80 245 291 116 143 67 32 - 1,031 124 58 1,020 * Of this total only 56 cases related to patients residing in the Borough. † Of this total only 1 case related to a patient residing in the Borough. 65 TUBERCULOSIS Summary of Notifications during the period from the 1st January, 1960, to the 31st December, 1960 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 — — 2 6 18 8 11 9 7 1 63 Respiratory, Females — - 2 — 2 2 7 9 4 4 3 - 2 35 Non-Respiratory, Male - — — 1 — — — — 1 1 — — 1 4 Non-Respiratory, Females — — — - — — 3 3 - 2 - - 1 9 CASES NOTIFIED AND DEATHS—1960 and Previous Years Year No. of Cases notified No. of Deaths No. of Cases on Register of Notifications Pulmonary NonPulmonary Total 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 1960 98 13 111 7 1,528 Average number of cases notified for the 10 years 1941/1950 (inclusive)—205. Average number of cases notified for the 10 years 1951/1960 (inclusive)—164. Average number of deaths for the 10 years 1941/1950 (inclusive)—81. Average number of deaths for the 10 years 1951/1960 (inclusive)—21. 66 CHART SHOWING THE NUMBER OF NEW CASES OF TUBERCULOSIS NOTIFIED DURING THE PAST 2.0 YEARS. PULMONARY TUBERCULOSIS NON-PULMONARY TUBERCULOSIS 67 MEDICINAL BATHS Cleansing of Verminous Persons School Children—Hammersmith Scabies 35 Verminous 90 School Children—Non-Hammersmith Scabies 1 Verminous 1 Children under Five Years—Hammersmith Scabies 20 Verminous 16 Other Conditions 2 Children under Five Years—Non-Hammersmith Scabies 2 Verminous 1 Adults—Hammersmith Scabies 118 Verminous 96 Other Conditions 70 Adults—Non-Hammersmith Scabies 23 Verminous 28 Other Conditions 1 Lodging-Houses—Hammersmith Scabies 4 Verminous 41 Other Conditions 2 DISINFECTION Hammersmith Cases Non-Hammersmith Cases Mattresses 538 75 Pillows 648 53 Blankets 295 277 Sheets 170 15 Quilts 31 4 Clothing *1,108 43 Sundries *819 20 Total 4,096 * 22 Custom's Certificates issued in respect of 486 articles (413 Clothing 73 Sundries) Rooms (including 725 verminous Rooms), 736 68 INDEX Page Ambulance facilities 38 Ante-Natal Clinics 40 Atmospheric Pollution 32 Barbers 28 Births 4, 52 Burials 42 Cancer, incidence of 48 Causes of Death in Age Groups 53 Chest Clinic 38 Chiropody Clinics 40 Clean Air 32 Condemnation of Food 62 Condensed Milk Regulations 24 Conferences 44 Contacts and Carriers of Infectious Diseases 6 Coroner's Court 27, 63 Creche 41 Day Nurseries 41 Deaths 4 Deaths—Principal Causes in Age Groups 53, 54 Deaths—Rates 52 Deaths—From Carcinoma of Lungs in Age Groups 49 Diphtheria Immunisation 40 Disinfection 67 Domestic Help Service 41 Drainage 30 Dustbins 30 Dysentery 8 Environmental Hygiene—Administration 26 Exhumation and Re-interment of Bodies 26 Factories 30 Factories—Defects 60 Factories—Inspections 60 Financial Contributions to Voluntary Organisations 44 Food—Bacteriological Examination 20 Food and Drugs Act, 1955 17 Food Hygiene Regulations, 1955 and 1960 17 Food—Inspection and Supervision 17, 62 Food Poisoning 8 Hairdressers and Barbers 28 Health Services 38 Health Information Bureau 44 Health Laundry 11 Hospitals 38 Housing 15 Housing Repairs and Rents Act, 1954 27 Ice Cream 21 Ice Cream and Preserved Food Premises 22 Immunisation 40 Infant Mortality 5, 55, 56, 57, 58 69 Page Infectious Diseases: Contacts and Carriers 6 Dysentery 8 Food Poisoning 8 Measles 6 Notifications 6, 64 Poliomyelitis 7 Smallpox 7 Tuberculosis 7, 65, 66 International Certificates of Vaccination and Inoculation 41 Inter-Borough Smoke Liaison Committee 33 Introduction 1 Laboratory facilities 38 Markets 24 Marriages 4 Maternal Mortality 5, 58 Measles 6 Medical Examination of Staff 43 Medicinal Baths 9, 67 Milk Licences 22 Milk Supplies 22 Mortuary 27, 63 National Assistance Acts 1948/51 42 Notifications of Infectious Diseases 6 Old People's Welfare 42 Outworkers 30, 61 Personal Health Services 39 Permanent Estates 16 Pet Animals Act, 1951 27 Pharmacy and Poisons Act, 1933 28 Pharmacy and Medicines Act, 1941 28 Poliomyelitis 7 Poliomyelitis Immunisation 40 Population 4, 48 Public Baths 27 Public Cleansing 30 Pulmonary Tuberculosis and Neoplasms of the Lungs 50 Rag and Bone Dealers 27 Rag Flock and Other Filling Materials Act, 1951 27 Rehousing 15 Removal of Aged Persons 42 Rent Act, 1957 27 Rodent Control 30 Sampling 18 Sanitary Circumstances 29 Sanitary Inspection 30 Sanitary Inspection—Notices served and complied with 59 70 Page Sewerage 31 Smallpox 7 Smallpox Immunisation 40 Smoke Control Areas 32 Social Conditions 3 Speech Therapy 40 Staff, at 31st December, 1960 2 Staff—Inspectorial 26 Summonses 59 Tetanus Immunisation 40 Tuberculosis 7, 65, 66 Unsound Food Condemned 62 Vital Statistics 4, 5, 47, 51 Washhouses 27 Water Supply 29 Welfare Centres 40 Whooping Cough Immunisation 40