HAY 30 ANNUAL REPORT on the HEALTH of the Urban District of HAYES & HARLINGTON Middlesex V. SHAW, M.B., Ch.B., D.(Obst.)R.C.O.G., D.P.H. Medical Officer of Health THE URBAN DISTRICT OF HAYES AND HARLINGTON Members of the Council, 1955 : Chairman : Councillor R. M. Smith, J.P. Vice-Chairman : Councillor S. G. Chilton. Councillors : I. Anthony, Mrs. R. E. Beard, A. J. C. Beck, J.P., P. J. Burke, R. J. Came, F. W. Coleman, B. E. Cooper, J. H. Dawson, Mrs. B. F. Frost, O. Garvin, S. Gelberg, H. R. Hann, E. K. Harding, F. H. W. Johnson, M.B.K.S., W. C. Mongor, E. C. Perkins, Miss E. Pink, F. W. D. Rosser, N. L. Shakespeare, A. Smith, A. H. Smith, M. C. Wheeler. Public Health Committee, 1955 : Chairman : Councillor F. W. D. Rosser. Vice-Chairman : Councillor Mrs. B. F. Frost. Councillors : S. G. Chilton, F. W. Coleman, B. E. Cooper, W. C. Mongor. Staff of the Public Health Department : Medical Officer of Health : V. Shaw, M.B., Ch.B., D.(Obst.)R.C.O.G., D.P.H. Chief Sanitary Inspector, Inspector under the Shops Act, and Petroleum Inspector : John S. Hodgins, A.M.I.P.H.E., M.R.S.H. Deputy Chief Sanitary Inspector : Sydney Greenhead. Additional Sanitary Inspectors : E. J. Marsden, C. R. Southgate (left 2/1/55), J. Smith (left 25/5/55), W. G. Thurston (left 18/10/55), J. T. Healy (commenced 29/8/55), K. Popham (commenced 23/6/55). Clerks : B. S. Bedborough, Mrs. C. F. Pickett, Mrs. A. Barltrop (left 5/8/55), Miss S. Hill (commenced 22/8/55). Trainee-Assistant : L. Osborne (commenced 21/11/55). 1 MEDICAL OFFICER'S ANNUAL REPORT. Public Health Department, Town Hall, Hayes, Middlesex. June, 1956 To The Chairman and Members of the Council, Mr. Chairman, Ladies and Gentlemen, The year opened with a visit from the Mass Radiography Unit in January. Sessions were held at the Queen's Hall and over 5,000 people attended ; from these four active cases of chest disease were ascertained. This may seem a small proportion, but when one reflects that these cases were previously unknown and constituted a potential source of danger to others, the whole visit becomes worthwhile. Detailed results of the survey will be found elsewhere in this report. During the spring and early summer there was a sharp epidemic of measles, 1,154 cases being notified, the majority of moderate severity. This follows the now well-known cycle for this disease, as the last epidemic was in 1953. There was no other major incidence of disease during the year and the vital statistics follow the pattern of previous years, but with a slight increase above the last 2 years. The Registrar General gives a special factor in respect of the birth and death rates, and the use of this enables the rates for the district to be compared accurately with those for the country as a whole. Both the rates for this district are lower than those for England and Wales. There was one maternal death during the year. 1955 will long be remembered for its extraordinarily fine summer, but even this had its drawbacks in the form of the increased number of cases of Poliomyelitis which occurred between August and October. The average person is so frightened by this disease that he tends to shun the relations of patients, and by this thoughtless action causes much additional suffering. Paralysis, when it occurs, is so dramatic that its appearance tends to throw facts out of their true perspective. By far the greater number of cases of poliomyelitis which occur are of the non-paralytic variety. The figures in Hayes this year were 14 paralytic and 8 non-paralytic cases. The picture, however, is not altogether a true one, as many nonparalytic cases are so mild that doubt exists in the doctor's mind regarding the diagnosis. These are not notified and so do not figure in the statistics. It should also be remembered that other 2 people are so mildly affected that they do not even think of consulting their doctor. Herein lies the danger of spread of the disease, and it would be well if more people realised that it is now known that the virus is carried in the bowel and excreted in the faeces, whence it may return to the mouth by contamination. One is almost tired of the voice crying in the wilderness "Wash your Hands" yet here again is another excellent reason why it should be heard in the cities as well. In the U.S.A. earlier in the year, announcement of a vaccine to prevent Poliomyelitis raised many hopes, but these were dashed by the tragic events which followed so soon. British research, however, has been progressing on similar lines and it is hoped that a more suitable vaccine will be available for trial in this country during the next year. The chances of any one person contracting paralytic poliomyelitis are small and are negligible compared with the risks of fatal or disfiguring injury even in the home. I wonder how many of the people who worry about poliomyelitis have adequate fireguards in the homes, keep saucepan handles and hot teapots out of reach of childish hands, and have no loose mats to trip the unwary, to mention only a few possible hazards. Christmas mail in the Public Health Department included the provisions of the Food and Drugs Act, 1955, some of which were to come into force on 1st January, 1956, and the rest on 1st July, 1956. Although not as stringent as some people would wish, they foreshadow a large increase in work for Public Health personnel, and should result in a rise in the standards of hygiene among food handlers. There has been much movement of staff in the department during the year, and for some time a reduction in numbers of Sanitary Inspectors, which has thrown an extra burden on those remaining. I should like to record my appreciation of the manner in which they have undertaken this and of the continued and loyal support of all the staff. My thanks are due to members of the Council, and in particular the Public Health Committee, for the way in which they have borne with and supported me during the year. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient Servant, V. SHAW, Medical Officer of Health. 3 STATISTICS AND SOCIAL CONDITIONS OF THE AREA Area (acres) 5,159 Population (Census) 65,608 Population (mid-year 1955—Registrar General's estimate of civilian population) 65,400 Number of inhabited houses at 31st December, 1955 18,500 Rateable value (estimated) as at 31st December, 1955 £481,843 Product of a penny rate £1,970 EXTRACTS FROM VITAL STATISTICS OF THE YEAR Live Births : M. F. Total Birth - rate per 1,000 of the Legitimate 474 412 886 estimated Illegitimate 26 19 45 lation 14.24 Comparability Factor is 0.94, giving a corrected birth rate of 13.39 Birth rate for England and Wales 15.02 Stillbirths : M. F. Total ' Rate per 1,000 total (live and Legitimate 6 15 21 Illegitimate 1 1 still) births 23.09 M. F. Total Deaths 259 222 481 Death rate 7.35 Comparability Factor is 1.50, giving a corrected death-rate of 11.03 Death rate for England and Wales 11.7 Deaths from puerperal causes Nil Death rate of infants under one year of age: (a) All infants per 1,000 live births 20.41 (b) Legitimate infants per 1,000 legitimate live births 21.44 (c) Illegitimate infants per 1,000 illegitimate live births Nil 4 BIRTH AND DEATH RATES, ETC. Year Live Births Rate* Still Births Rate‡ Infant Death Rate‡ Maternal Mortality‡ Deaths Rate* 1950 1,033 15.72 21 19.93 18.39 1.88 445 6.77 1951 938 14.37 19 19.85 14.93 0.00 500 7.66 1952 996 15.27 23 22.57 18.07 0.00 459 7.03 1953 959 14.73 18 18.42 25.03 1.02 465 7.14 1954 936 14.41 17 19.23 21.37 0.00 458 7.14 1955 976 14.92 22 22.07 20.49 1.05 481 7.36 *Rate per 1,000 population. †Rate per 1,000 Live Births. ‡Rate per 1,000 total births (live and still). INCIDENCE OF INFECTIOUS DISEASES. Disease 1950 1951 1952 1953 1954 1955 Scarlet Fever 79 101 144 84 52 117 Pneumonia 41 95 79 101 42 60 Diphtheria 0 0 0 0 0 0 Meningococcal Infections 1 1 4 2 0 1 Puerperal Pyrexia 3 20 16 12 6 6 Erysipelas 5 4 2 7 8 6 Ophthalmia Neonatorum 2 1 3 0 0 0 Measles 1,233 634 680 938 75 1,154 Whooping Cough 293 331 143 257 73 59 Dysentery Group 1 25 25 1 12 0 Poliomyelitis and Encephalitis 15 10 14 7 1 22 Food Poisoning 1 0 4 0 1 8 TUBERCULOSIS. 1950 1951 1952 1953 1954 1955 New Cases 133 109 101 88 73 59 Deaths 21 24 12 8 11 12 5 CAUSES OF DEATH DURING 1955. Cause of Death Male Female All causes 259 222 1. Tuberculosis, respiratory 5 6 2. Tuberculosis, other 1 — 3. Syphilitic diseases — — 4. Diphtheria — — 5. Whooping Cough — — 6. Meningococcal infections — — 7. Acute Poliomyelitis 1 1 8. Measles —. — 9. Other infective and parasitic diseases — — 10. Malignant neoplasm, stomach 9 8 11. Malignant neoplasm, lung, bronchus 19 5 12. Malignant neoplasm, breast — 12 13. Malignant neoplasm, uterus — 5 14. Other malignant and lymphatic neoplasms 21 17 15. Leukaemia, aleukaemia — — 16. Diabetes 1 2 17. Vascular lesions of nervous systems 16 35 18. Coronary disease, angina 56 20 19. Hypertension with heart disease 2 11 20. Other heart disease 25 33 21. Other circulatory disease 13 7 22. Influenza — — 23. Pneumonia 13 10 24. Bronchitis 29 11 25. Other diseases of respiratory system 1 — 26. Ulcer of stomach and duodenum 7 6 27. Gastritis, enteritis and diarrhoea 2 1 28. Nephritis and nephrosis 3 2 29. Hyperplasia of prostrate 2 — 30. Pregnancy, childbirth, abortion — 1 31. Congenital malformations 4 3 32. Other defined and ill-defined diseases 14 19 33. Motor Vehicle accidents 6 — 34. All other accidents 7 2 35. Suicide 2 5 36. Homicide and operations of war — — Deaths of Infants : Legitimate 11 8 Illegitimate — — Total 11 8 Live Births : Legitimate 474 412 Illegitimate 26 19 Total 500 431 Stillbirths : Legitimate 6 15 Illegitimate 1 Total 7 15 Home-population (mid-year), 65,400 6 HEALTH SERVICES IN THE AREA, INCLUDING CONTROL OF INFECTIOUS DISEASES. Hospitals. Hayes Cottage Hospital, Grange Road, Hayes. Harlington Cottage Hospital, Sipson Lane, Harlington, for maternity cases. Hillingdon Hospital, near Uxbridge. St. John's Hospital, Uxbridge, for infectious diseases. Joyce Green Hospital, Dartford, for cases of smallpox. Ambulance Service. This is provided by the Middlesex County Council for the conveyance of all cases to hospital and one ambulance is based in Hayes; other ambulances operate from Hillingdon Hospital. Tuberculosis. Provision for treatment is made at South Mimms Hospital, Harefield Hospital and other places, while the chest clinic is situated at the Local County Offices, High Street, Uxbridge. The following table shows the details of the visit of the Mass Radiography Unit in January Sessional Men Women Total Queen's Hall, Hayes 2,069 2,091 4,160 Visits to Industrial Concerns Harrison & Sons Ltd 277 59 336 British Electric Transformer Co. Ltd. 308 81 389 Weston Chibnalls (Chibnall's Bakeries) Ltd 147 61 208 2,801 2,292 5,093 Organised Groups 1,889 645 2,534 Visitors 675 1,344 2,019 Ex-School Leavers 237 303 540 2,801 2,292 5,093 Large Film Recalls. Number recalled 26 26 52 No further action 42 Further investigation required 10 of these, four active cases (2 men from organised groups 1 woman from organised groups 1 woman visitor). 7 Child Welfare Clinics, etc. There are numerous Maternity and Child Welfare Clinics in the district; these are administered by the Middlesex County Council and the services provided are available free of charge. Sessions are held regularly in clinic buildings and certain church halls ; the mobile clinic now visits three districts in the area which are a long way from established clinics. Immunisation. Vaccination against smallpox and immunisation against diphtheria and whooping cough are available free of charge at all the County Council Clinics in the district, and protection against Tetanus is also available on request. Owing to the increased number of poliomyelitis notifications this year, immunisation was suspended for about two months, and this resulted in an even lower rate of protection than before. This apathy on the part of parents is causing serious concern among Public Health workers, and it is feared that a serious outbreak of diphtheria may arise and bring unpleasant sequelae. Many fathers refuse vaccination to their children on account of their own experiences in Her Majesty's Forces. They probably do not know that the younger a child is when vaccinated for the first time, the less liable it is to complications, and thus by their action they are inviting trouble instead of preventing it. I give below details of protection carried out in this district during 1955; these figures were kindly supplied by the Area Medical Officer, Area No. 8. Number of children who completed a full course of primary immunisation Number of children who received a secondary (reinforcing) injection Persons vaccinated or or re-vaccinated Age Diphtheria only Combined Diphtheria and Whooping Cough Whooping Cough only Diphtheria only Combined Diphtheria and Whooping Cough Whooping Cough only Vaccination ReVaccina tion Under 1 19 428 2 — — — 445 — 1 10 162 — — — — 20 — 2—4 22 50 4 26 51 5 26 3 5—14 40 10 15 508 247 — 24 8 15 & over — — 2 — — 58 96 Totals 1955 91 650 21 536 298 5 573 107 1954 176 777 34 848 187 8 584 279 Water Supply. The greater part of the district is supplied with water by the Rickmansworth & Uxbridge Valley Water Co., but a small area in the South is supplied by the South West Suburban Water Co., only seven houses in the district are now supplied from stand pipes. During the year 14 samples have been taken and all have proved of a satisfactory standard. 8 Medical Examinations of Council Staff. The total number of examinations carried out during 1955 was 201. Of these 97 were for Superannuation purposes alone, 21 for admission to the Council's Sick Pay Scheme, 49 for Sick Pay and Superannuation and 34 for various special purposes. NOTIFIABLE DISEASES (OTHER THAN TUBERCULOSIS) DURING THE YEAR, 1955. Disease Confirmed, cases notified Deaths Scarlet Fever 117 — Pneumonia 60 23 Puerperal Pyrexia 6 — Erysipelas 6 — Measles 1,154 — Whooping Cough 59 — Dysentery — — Acute Poliomyelitis and Encephalitis 22 2 Pood Poisoning 8 — Meningococcal Infections 1 — TUBERCULOSIS New cases and Mortality during the year, 1955. New Cases Mortality Age Periods Respiratory NonRespiratory Respiratory NonRespiratory M. F. M. F. M. F. M. F. Under 1 year 1 1 — — — — — 1—4 1 1 — — — — — — 5—14 — — — — — — 15—24 7 7 — — — — — — 25—34 8 3 — 1 — 2 — — 35—44 3 4 — 2 — — — — 45—54 6 1 — — 2 — — — 55—64 4 1 — — _ — 2 — — 65 and over 5 2 — — 2 1 — — Age Unknown — 1 — — 1 1 1 — Totals 35 21 — 3 5 6 1 — 9 10 ANALYSIS OF TOTAL CASES AT AGES Disease Under 1 year 1—2 3—4 5—9 10—14 15—24 25 and over Age unknown Totals Scarlet Fever __ 5 25 78 6 3 117 Whooping Cough 7 15 14 23 — — — — 59 Acute Poliomyelitis — 3 5 8 3 1 1 1 22 Measles 40 203 297 583 5 4 3 19 1154 Disease AT AGES Under 5 years 5—14 15—44 45—64 65 and over Age unknown Totals Acute Pneumonia 7 8 20 16 6 3 60 Dysentery — — — — — — — Erysipelas — — 3 2 1 — 6 Meningococcal Infections 1 — — — — — 1 Food Poisoning 3 1 1 2 — 1 8 Puerperal Pyrexia — — 6 — — — 6 REPORT OF THE CHIEF SANITARY INSPECTOR I have the honour of presenting my sixth annual report on the sanitary circumstances of the district. Staffing difficulties, to which I referred in my last report, continued for the major part of the year. Careful consideration was given to a proposal that unqualified staff should be employed to carry out some of the Sanitary Inspectors extraneous duties such as Shops Act (hours of closing, etc.) and Petroleum Acts Administration, but it was found that there was not sufficient work of this nature to warrant a full-time appointment and it would, in any case have entailed a certain amount of overlapping of duties and dual visits to a large number of premises. No action therefore was taken on the proposal. A more effective step to remedy the present shortage of Sanitary Inspectors in industrial areas was the appointment, towards the end of the year, of a Trainee Assistant. Although there are no immediate benefits from such an appointment the common acceptance of such a post as an essential part of the establishment of all public health departments could make a vital contribution to the problem. Whether or not a sufficient number of youths could be persuaded to undertake a four-year training for a job which is in part distasteful, in part dangerous and as a whole of increasing complexity and which offers little material reward, is another matter. The clearance of unfit houses continued, and a programme for future action which will remove the remaining unfit houses in the district by 1959, was approved. Owing to the difficulties mentioned in the previous paragraph it was not possible to recommence the routine inspection of dwelling houses under the Housing Act. A busy time for Sanitary Inspectors was foreshadowed by the introduction into Parliament of the Clean Air Bill and the publication, in the closing days of the year, of the Food Hygiene Regulations. Although the Clean Air Bill does not contain all the recommendations of the Beaver Committee it has enough "teeth" to become a really useful piece of public health legislation and brighten the prospect of an early improvement in the purity of the atmosphere. The long awaited Food Hygiene Regulations are another step forward in the fight against food poisoning and food infections and by calling for better washing facilities for staff and equipment, more satisfactory methods of storing those foods most likely to be dangerous and a higher standard of personal hygiene on the part of the persons engaged in handling food, cannot fail to have a beneficial effect. The following report on the work of the Sanitary Inspectors is set out under four headings : (1) Sanitary Administration—including inspection of the district, complaints, notices served, legal proceedings, offensive trades, atmospheric pollution, drainage, keeping of animals, rodent control. 11 (2) Food—including milk supply, ice cream, inspection of meat and other foods, food hygiene, hawkers of food, sampling of foods and drugs, food poisoning, inspection of food premises. (3) Housing—including overcrowding, Improvement Grants, Certificates of Disrepair, moveable dwellings. (4) Factories and Shops—including outworkers. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient Servant, JOHN S. HODGINS, Chief Sanitary Inspector. PART 1. SANITARY ADMINISTRATION. Inspection of the District. Visits to dwelling houses re disrepair, nuisances, etc. 2,351 Visits to dwelling houses re overcrowding and rehousing enquiries 538 Visits re Improvement Grants 73 Visits re Certificates of Disrepair 101 Visits re defective dustbins 781 Visits re defective drainage 1,120 Visits re disinfestation and disinfection 65 Visits re accumulation of refuse and refuse tips 118 Observations re smoke, noise and smell nuisances 411 Inspections of public conveniences . 16 Inspections of piggeries and stables 134 Inspections of moveable dwellings and caravan sites 193 Visits re infectious diseases 370 Visits re Shops Acts (during office hours) 1,232 Visits re Shops Acts (outside office hours) 1,420 Visits re inspection of food 605 Inspections of dairies and milk shops 44 Inspections of ice cream manufacturers' premises 35 Inspections of ice cream dealers' premises and vehicles 348 Inspections of food shops, cafes, etc 2,354 Inspections of licensed premises 79 Inspections of hawkers' vehicles and store places, mobile canteens, etc. 128 Inspections of factories, workplaces and outworkers' premises 530 Inspections re rodent control 1,283 Inspections re music and dancing licences 33 Visits re milk, water and ice cream sampling, etc. 142 Interviews with builders, owners, etc. 430 Inspections of petroleum stores 268 Inspections of slaughterhouses 30 Inspections of ditches, watercourses, etc. 39 Inspections of schools 26 Miscellaneous visits 1,106 " No Access " visits 1,254 Total 17,657 12 Complaints. During the year 1,465 complaints were received with respect to the following matters: Choked and defective drains 319 Insanitary or dilapidated conditions of houses or premises 233 Offensive accumulations or deposits ... 19 Defective dustbins 376 Vermin or insects 54 Gypsies 11 Rat and mouse infestations 315 Unsound food 27 Nuisances from animals 11 Overcrowding 28 Dust, smoke and noise nuisances 17 Other nuisances 55 Total 1,465 Notices Served. Informal Notices served 851 Statutory Notices served : Public Health Act, 1936 Section 39 20 do. Section 45 5 do. Section 75 10 do. Section 93 80 do. Section 47 10 do. Section 56 1 do. Section 103 ... 2 Legal Proceedings. (a) Public Health Act, 1936. Twenty summonses were taken out for failure to comply with Abatement Notices. In 17 instances the requirements of the Notice were carried out before the hearing took place and the summonses were withdrawn on payment of costs. The other three summonses related to infringements of the byelaws relating to piggeries. One summons was dismissed, and fines of £2. and £1. respectively imposed in the other cases. The use of the piggery was subsequently discontinued. Notices served on a property owner to supply dustbins to four houses resulted in his appealing to the Magistrates against the Notices. In each case the appeal was allowed. [b) Food and Drugs Act. 1938, A summons under Section 13 was taken out for failure to provide an adequate supply of hot water in a confectioners' shop. A suitable geyser was installed before the hearing took place and the summons was withdrawn on payment of costs. Offensive Trades. There is no establishment in the district carrying on an offensive trade. 13 Atmospheric Pollution. A great deal of attention has again been paid to this subject and highly satisfactory results have been achieved in a few specific cases. In the absence of proper recording instruments it is difficult to assess whether or not there has been a general reduction in the pollution of the atmosphere but this omission will be remedied in the near future. Arrangements have been made to set up three stations for the measurement of smoke and sulphur by the daily volumetric method. Contraventions of the Byelaws were noted on two occasions as a result of observations on factory chimneys, and statutory notices were served. In one instance the nuisance was remedied by conversion of the boiler to oil firing, whilst in the other case a larger boiler was installed. Oil firing is not, in itself, a guarantee against smoke emission but in the case in question the improvement has been spectacular. There were, however, many occasions when the emission of smoke was in excess of the amount which need be caused by a well run plant. On such occasions discussions took place with the management of the factories concerned, often leading to improved operation of the plant. The mobile exhibition of the Solid Smokeless Fuels Federation created a great deal of interest when shown in the Town Hall Park on the occasion of the Town Fete in June. Drainage. At the end of the year there were sixty-six cesspools and fortythree pail closets in the district. These numbers are respectively three and fourteen less than at the beginning of the year, the reduction having been achieved mainly by the demolition of unfit houses. In an effort to expedite the abolition of cesspools the Council have agreed to make a contribution towards the cost of connecting drains from these premises to the sewer and negotiations with the owners concerned are now in progress. Pail closets and cesspools are emptied regularly by the Engineer & Surveyor's Department. The practice of clearing stopped drains free of charge has now been in operation for six years and has reduced to a minimum nuisances from this cause. Keeping of Animals. Byelaws under Section 81 of the Public Health Act to control the keeping of pigs, horses and cattle are in force. The byelaws deal with the structural condition and cleanliness of premises in which these animals are kept, the storage of manure, boiling of swill, drainage etc., and have proved of considerable assistance to the Sanitary Inspectors in their efforts to minimise nuisances from this source. In view of the suspicion which has fallen on flies in the spread of poliomyelitis these additional powers of control over premises which are particularly liable to infestation are useful and necessary. Proceedings were taken in one instance on account of failure to comply with the Byelaws. 14 Rodent Control. Rodent control forms part of the duties of the Public Health Department's general assistant. Treatment is carried out in accordance with the methods suggested by the Ministry of Agriculture and Fisheries. A charge to cover labour and cost of materials is made for work done in business premises but all treatment at dwelling houses is free. During the year 599 treatments were carried out at dwelling houses and 186 at business premises, and also many ditches, undeveloped sites etc., were treated. The use of Warfarin " as a poison has been continued on an increased scale and its value as an alternative to the older poisons fully confirmed. PART II. FOOD. Milk Supply. A register of Dairies and Milk Distributors (other than dairy farms and farmers) is maintained and the numbers shown on the Register are : Milk Distributors 22 Dairies 8 The following licences have been issued: Designation Dealers' Licences Supplementary Licences Tuberculin Tested 10 10 Pasteurised 10 10 Sterilised 15 12 An order made under Section 23 of the Food and Drugs (Milk, Dairies and Artificial Cream) Act, 1950, specifying this district as one within which the use of special designations in relation to milk sold by retail is in force. During the year twelve samples of milk were taken for bacteriological examination; all passed the Statutory Tests, i.e. the Methylene Blue and Phosphatase tests in the case of pasteurised milk and Turbidity test in the case of sterilised milk. It has not been necessary to take any action under Article 20 of the Milk and Dairies Regulations, 1949 to prohibit the sale of milk. Ice Cream. One hundred and five persons are registered for the sale of ice cream in the district, including fifteen who are registered for its manufacture. All the latter use methods of heat treatment laid down in the Ice Cream (Heat Treatment) Regulations. Twelve samples of water ices and ice lollies were taken, all of which were reported to be satisfactory. Bacteriological reports on samples of ice cream manufactured in Hayes were excellent, i.e. Grade I 13 or 92.9% Grade II l or 7.1% 15 The results from samples of ice cream brought in from other districts were however, much less satisfactory. The grading of all samples taken was as follows: Grade I 22 64.7% Grade II 2 5.9% Grade III 8 23.5% Grade IV 2 5.9% 34 100.0% The Inspection of Meat and Other Foods. The three licensed slaughterhouses in use are proving more than adequate for the needs of the district. Details of the animals slaughtered and diseases found are set out below : Carcases and Offal inspected and condemned in whole or in part. Cattle— excluding Cows Cows Calves Sheep and Lambs Pigs Number killed 98 125 41 47 3,242 Number inspected 98 125 41 47 3,242 All Diseases except Tuberculosis and Cysticerci Whole carcases condemned 1 1 — — 1 Carcases of which some part or organ was condemned 11 38 — 6 82 Percentage of the number inspected affected with disease other than tuberculosis and cysticerci 12.24% 31.2% — 12.40% 2.56% Tuberculosis only : Whole carcases condemned — — — — 1 Carcases of which some part or organ was condemned 3 18 — — 39 Percentage of the number inspected affected with tuberculosis 3.06% 14.4% — — 1.23% Cysticercosis: Carcases of which some part or organ was condemned 2 Carcases submitted to treatment by refrigeration 2 — — — — Generalised and totally condemned — — — — — 16 The inspection of meat in slaughterhouses, which is carried out to the standards laid down in Memo. 3/Foods, resulted in the condemnation of 1,319 pounds of carcase meat and 2,105 pounds of offal, whilst in retail shops 1,347 pounds of raw meat and 4,354 pounds of tinned meat were condemned. The following foods (other than meat) were also condemned during the year : Cheese 3 38½cwts. Bacon 57 lbs. Eggs 4 doz. Cake 60 lbs. Fish 130 lbs. Milk and cream (tinned) 216 lbs. Fish (tinned) 28 lbs. Tomato Puree, etc. (tinned) 1¼ tons Frozen foods 140 lbs. Vegetables (tinned) 9 cwts. Sandwich Spread 201 lbs. Miscellaneous tinned or Fruit (dried) 6 cwts. bottled food 270 lbs. Fruit (tinned) 14¼wts. Other miscellaneous food 93 lbs. Condemned foods are disposed of, whenever possible, to a manufacturer of animal feeding stuffs and, fertilisers or in accordance with the Salvaged Goods (Revocation) Order, 1953. Small quantities of condemned foods are buried on the Council's refuse tip. Food Hygiene. There has been no slackening in efforts to improve the conditions under which food is prepared, handled and stored. All food premises were visited, on average, six times each during the year by the Sanitary Inspectors. These visits are valuable not only from the inspection point of view but for the opportunity they offer for discussions on all aspects of food hygiene on the spot with the people engaged in handling food. This method of education has been found superior to lectures, meetings, film shows, etc. which invariably fail to attract those most in need of instruction. The Council's notice boards in all parts of the district have again been used for the display of food hygiene propaganda posters and during the summer sets of posters issued by the Ministry of Health were shown in all the schools in the district. Byelaws made under Section 15 of the Food and Drugs Act, 1938, have been in force since July, 1950, and have helped to bring about the considerable improvement in food hygiene standards which has taken place since that time. The Food Hygiene Guild has continued to serve a useful purpose by displaying, through its 115 members in all parts ot the district, the membership certificate and window plaque and so keeping food hygiene constantly in the minds of the shopping public. Ihe Food Hygiene Regulations, 1955, by laying down standards for food premises which are higher than those specified in the Guild's Codes of Practice has made the Guild, in its present form, redundant. Consideration will soon have to be given to the acceptance of redrafted and improved Codes of Practice. With a continuation of the goodwill which has been a salient feature of the Guild ever since its inception it should be possible to devise suitable Codes of Practice 17 requiring little if any additional financial outlay but placing greater emphasis on the personal conduct and more important still, knowledge and training in food hygiene matters, possessed by persons engaged in handling food. Hawkers of Food. The registration of hawkers of certain classes of food has been compulsory in this district since 1939 and immediately after the Middlesex County Council Act, 1950, came into force the Council adopted Section 11 of the Act to extend the registration of hawkers to cover all classes of foodstuffs. The vehicles and storage premises used by these traders are regularly inspected by the Sanitary Inspectors. In one instance the unauthorised use of unsatisfactory storage premises was discovered. The hawker in question unsuccessfully appealed against the Council's refusal to grant registration. The use of premises continued and proceedings were taken with the result that a fine was imposed and the hawker gave an undertaking to vacate the premises. Sampling of Food and Drugs. (a) The sampling of food and drugs for chemical analysis is carried out by the Middlesex County Council and the following information regarding samples obtained during the year has been kindly supplied by the Senior Public Control Officer : 260 samples were taken, including 118 of milk; 14 11 of which were milk) were found to be unsatisfactory. All cases except one, were dealt with by cautions. In this case successful proceedings were taken. (b) Miscellaneous foods, such as shell-fish, cream cakes, watercress and meat products are regularly sampled by the Sanitary Inspectors for bacteriological examination and the results are of considerable assistance to them in their contacts with food-handlers, illustrating, as they often do, that the greatest care is necessary in the storage and handling of this class of food. The bacteriological examination of samples of milk, ice cream, water and miscellaneous foods is carried out at the Public Health Laboratory, Ealing, and I am indebted to the Director and Staff of the Laboratory for their ready assistance at all times. Details of the samples submitted will be found elsewhere in this report under their respective headings. Food Poisoning. Eight cases of food poisoning were notified during the year, seven due to undiscovered causes and one due to Salmonella typhimurium. 18 Inspection of Food Premises. (a) Inspections. Total number in Inspections Premises District Made Restaurants and Cafes 40 487 Ice cream dealers and manufacturers 105 383 Licensed premises 33 79 Dairies and milk distributors' premises 28 44 Preserved food premises 58 315 Bakehouses 10 104 Butchers' shops 33 335 Grocers' shops 72 478 Fish shops 16 107 Greengrocers' shops 31 270 Food hawkers' premises 8 23 Mobile canteens 3 10 (b) Defects remedied. Total Cleanliness improved 42 Structural repairs 14 Lighting improved 1 Ventilation improved 3 Eqipment improved 7 Hot water supplies improved 3 Clean towels provided 1 Food storage accommodation improved 9 Rodent infestation abated 2 Sanitary accommodation provided or improved 4 Sinks provided or renewed 2 Other improvements 6 PART III. HOUSING. A survey of all the old houses in the district, i.e., those constructed before 1919, was carried out during 1953 and 1954. The information disclosed by the survey showed that approximately 120 houses were incapable of being rendered fit and should be demolished or closed. Early in 1954 I reported to the Council on this matter and it was agreed that an immediate start should be made on the clearance of these dwellings and that the remainder should be dealt with within the next five years. During 1954, 27 of these dwellings were dealt with and a further 21 during the current year. Inspection of Houses during the year. 1. (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 461 (b) Number of inspections made for the purpose 1,890 2. (a) Number of dwelling houses which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 14 (b) Number of inspections made for the purpose 44 19 20 3. Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 1 4. Number of dwelling houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 240 Remedy of Defects, etc., during the year without the service of Formal Notices. (a) Number of dwelling houses rendered fit in consequence of informal action by the Local Authority or their Officers 186 (b) Number of dwellings in respect of which voluntary undertakings not to re-let on termination of present tenancy were given (c) Number of unfit dwellings closed in pursuance of voluntary undertakings 1 (d) Number of unfit dwellings demolished voluntarily 2 Action under Statutory Powers during the year. 1. Proceedings under Sections 9, 10 and 16 of the Housing Act, 1936 : (a) Number of dwelling houses in respect of which notices were served requiring repairs — (b) Number of dwelling houses which were rendered fit after service of formal notices : (i) by owners — (ii) by Local Authority in default of owners — 2. Proceedings under Public Health Act, 1936: (a) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 102 (b) Number of dwelling houses in which defects were remedied after service of formal notices: (i) by owners 72 (ii) by Local Authority in default of owners — 3. Proceedings under Sections 11 and 13 of the Housing Act, 1936 : (a) Number of dwelling houses in respect of which Demolition Orders were made or Undertakings given — (b) Number of dwelling houses demolished in pursuance of Demolition Orders 10 4. Proceedings under Section 12 of the Housing Act, 1936: (a) Number of separate tenements or underground rooms in respect of which Closing Orders were made (b) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 5. Proceedings under Section 25 of the Housing Act, 1936: (a) Number of Clearance Areas declared 3 (b) Number of unfit dwellings included in Clearance Areas 19 (c) Number of unfit dwellings in Clearance Areas demolished — 6. Proceedings under Local Government (Miscellaneous Provisions) Act, 1953 : (a) Closing Orders made under Section 10(1) 2 (b) Number of dwellings closed 1 Overcrowding. Twenty cases of overcrowding were abated during the year and twenty-two new cases were discovered, making a net increase of two in the number of cases still to be dealt with. It is interesting to note that the average number of occupants for each house in the district is now 3.53, the lowest since 1939 when the figure was 3.44. The highest figure recorded was 4.02 in 1947, since when there has been a slight fall every year. Improvement Grants. As a result of the increased publicity given to the provisions of the Housing Act, 1949, dealing with the improvement or conversion of dwellings with grant assistance, several enquiries were received. Some intending applicants did not appreciate that luxury improvements were outside the scope of the scheme and others ran into difficulties with their Building Societies. The number of formal applications received therefore was only eight, two of which were refused, two given grants of 331/3% of the approved expenditure and three 50%, the remaining application being withdrawn. Certificates of Disrepair. It appears that few property owners in this district have been able to comply with the conditions laid down in the Housing Repairs and Rents Act, 1954, for increasing the rents of their houses. Consequently only 30 applications were received for certificates of disrepair under the Act; all were granted. Fifteen certificates, some of which were issued in 1954, were revoked upon application by the owners. Moveable Dwellings. There has been little change in the number of caravans in the District, which still stands at approximately 120, almost all on 21 unauthorised sites of varying degrees of unfitness, and including some of the most undesirable features, from the sanitary and public health point of view, to be found in the whole district. The Council's scheme for a municipal caravan site continues on its faltering career, but still exists only on paper. A modified scheme has been agreed and tenders obtained but at the end of the year a reply was awaited from the Ministry to the Council's application for loan sanction. New Houses. During the year 1955 the following dwellings were completed by the Council and private developers : Council Houses 78 Old Person's dwellings 4 Flats 113 Maisonettes 10 Private Development: Dwellings. 199 PART IV. FACTORIES AND SHOPS. Factories Act, 1937. There are one hundred and fifty nine factories with mechanical power and four factories without mechanical power on the Register, with a range of products including: Aircraft, building materials, caravans, carbon products, cheese, chocolate, cocoa, coffee extracts, electrical transformers, furniture, lubricating oil, optical lenses, potato crisps, pianos, radio, radar, television, gramophone records and gramophones, rubber, tarmacadam, and wood block floors. Inspection of Factories. Number on Register Number of Premises Inspections Written Notices Occupiers Prosecuted Factories with mechanical power 159 340 11 — Factories without mechanical power 4 11 — — Other premises under the Act (including work of building and engineering construction, but not including outworkers' premises). 7 28 — — Total 170 379 11 — 22 Defects Found. Particulars Number of Defects Found Remedied* Sanitary accommodation (Section 7): Insufficient 1 1 Unsuitable or defective 16 11 Not separate for sexes Other offences 1 1 Total 18 13 •Including defects found, but not remedied, in 1954. Outworkers. Part VIII of the Factories Act requires the occupier of a factory who employs persons to carry out certain classes of work in their own homes to supply a list of such persons to the District Council every six months. Sixty-three notifications have been received and seventy-five inspections made ; in every instance the work was found to be carried out under suitable conditions. Shops Act. All parts of the Shops Act are administered, including hours of closing, assistants' half-holiday, Sunday trading, comfort and welfare of assistants, etc. The Sanitary Inspectors made 2,652 visits for this purpose during the year, including 1,420 which were made outside normal office hours, i.e. in the evenings and on Sundays. 23 Perry & Routleff, ltd. Printers, Uxbridge and Ealing