AC 4348 KEN 61 THE ROYAL BOROUGH OP KENSINGTON ANNUAL REPORT on the HEALTH OP THE BOROUGH for the year 1952 by J. H. WEIR, M.D., B.S., B.Hy., D.P.H. Medical Officer of Health 29th June, 1953. Public Health Department, The Red House, Hornton Street, Kensington, W.8. - 1 - THE ROYAL BOROUGH OF KENSINGTON Public Health Department, Hornton Street, Kensington, W.8. 29th. June, 1953. To the Mayor, Aldermen and Councillors of the Royal Borough of Kensington. My Lord, Ladies and Gentlemen, I have much pleasure in presenting the Annual Report on the state of the public health in Kensington for 1952. The Minister of Health has again requested (Circular 2/53) that the report should be in the same abbreviated form as has been the case for some years past. The public health in Kensington during the year under review was maintained at a satisfactory standard. Population. The Registrar-General's estimate (172,800) of the population of the Borough for 1952 shows an increase over the figure for the previous year (171,300). The actual population figure for Kensington obtained as a result of the 1951 Census was 168,054. Birth rate. The number of births per 1,000 population of the Borough was 16.3 in 1952, which was 0.8 higher than the figure recorded for the previous year. The Kensington birth rate was lower than that for the County of London (17.6) but higher than that for the whole of England and Wales (15.3). (In order to compare the Kensington birth rate with the rates for other areas, the Registrar-General has supplied an area comparability factor (0.76) which reduces the actual birth rate for Kensington for comparison purposes to 12.4). Death rate. The number of deaths per 1,000 population was 11.2 which was the same rate recorded in the previous year. This figure is lower than the death rate for the County of London (12.6) and that for England and Wales (11.3). (The Registrar-General's area comparability factor for the Kensington death rate is 1.02 and this increases the Kensington death rate for comparison purposes to 11.4). Infant death rate. There was a slight increase in the number of deaths of infants under one year per 1,000 live births in 1952. The infant death rate for the year was 27, in comparison with the lowest rate (24) ever recorded in Kensington for 1951. The infant death rate for the County of London in 1952 was 23.8 and for England and Wales 27.6. Maternal death rate. Five deaths of mothers due to childbirth were recorded in 1952 compared with three in the -2- previous year. The maternal mortality rate was 1.75 in comparison with 0.72 for England and Wales. (The figure for London is not yet available.) Atmospheric pollution. On page 11 reference is made to the sudden increase in deaths from broncho-pneumonia and heart disease associated with the smoke-fog which occurred in the early part of December, 1952. Infectious diseases. There was no serious outbreak of infectious disease in the Borough during 1952. The total number of notifications received was 1,731 in comparison with the total number received during the previous year of 2,479. The difference in the figures in these years was mainly due to the reduction in the number of notifications of measles and whooping cough. One of the welcome features of the incidence of infectious diseases during 1952 was that no case of diphtheria occurred. This was the first year on record that Kensington has been entirely free from diphtheria. Reference has been made in previous annual reports to the rapid reduction since the 1930's in the annual number of cases of diphtheria notified. This is to a large extent due to the intensive preventive work carried out in regard to the immunisation of children against this disease since 1934. Tuberculosis. The death rate from all forms of tuberculosis per 100,000 population was 18.5 for 1952, which was the lowest figure ever recorded in Kensington. The number of new cases of tuberculosis notified, however, during the year was 251 which compares with a figure of 238 for the previous year. Furthermore, the number of cases registered in the Borough increased during the year from 1,342 to 1,414. The work carried out by the Public Health Department in connection with the environmental aspects of tuberculosis was maintained at a high level, and every newly notified case, or known case transferred into Kensington, has been carefully investigated with the object of removing conditions etc., conducive to the spread of infection. A more detailed reference to this aspect of the work is made later in the Report. It will be seen from the foregoing remarks that statistically the state of the health of the residents of Kensington is satisfactory, but it will be remembered that attention was drawn in my Report for last year to the many residents whose environmental conditions could not be regarded with equanimity. Repair of houses. The problem of maintaining existing dwelling houses in a reasonable state of habitation is becoming more urgent as time goes on. The position of some owners of rent-controlled properties in maintaining habitable conditions is becoming increasingly difficult. The difficulties which have confronted the Council in exercising their powers under Section 9 of the Housing Act, 1936, (which deals with the repair of unfit houses) have, at last, brought the work to a standstill. No house in the borough was dealt with under this Section during 1952. On the 23rd June, 1952, the Public Health Committee held a special meeting to consider the position. A report was submitted to the Council on the 15th July, 1952, and the conclusions set out below illustrate the seriousness of the present position- "We are driven inevitably to the conclusion that there is no satisfactory way out of the present difficulties with regard to the disrepair of houses other than by increasing the rents of houses subject to the Rent Restrictions Acts. This cannot be done without an amendment of the law, and it is a matter of - 3 - national policy on which the Government would have to decide. It is felt that in addition to any legislative change designed to meet the existing difficulties, there should be some method introduced to control furnished and unfurnished sub-tenancies, so that they become proportional in yield to the gross standard rent. At present, in many instances, the tenant receives aggregate amounts from sub-letting greatly in excess of the rent paid to the landlord, who is unable to afford the high cost of repairing the rapid deterioration which results from multiple sub-tenancies-often by undesirables." In view of the urgency of the situation the Council decided to make representations to the Ministry of Housing and Local Government. A reply was received from the Ministry stating that the problem is under consideration but the Minister is unable to give any Indication as to when he will be able to introduce the necessary legislation. Slum clearance. No new slum clearance area was formally represented during 1952. The rate of clearing areas is necessarily governed by the amount of rehousing accommodation available to the Council. Furthermore, the legal formalities with regard to the nine areas already being dealt with by the Council have involved a considerable amount of work. However, during the year, the Council did review their future programme for slum clearance, and reference to this programme, and to the progress in dealing with the outstanding slum areas, is made later in the Report. Old People. The welfare work in relation to old people was continued substantially on the same lines as the previous year. It is unquestionable that this feature of the Council's health work is proving to be one of the important post-war developments. Experience has shown the urgent need for this service. There are many old people living in Kensington whose lives have been brightened by the services of both the Council and those voluntary organisations interested in the welfare of old people. Some of the conditions under which old people were found to be living (and which have been remedied) were reminiscent of the dark ages. Old people have been found living in indescribable conditions of neglect and squalor, and the value of the work which has been carried out by all parties to alleviate these conditions is inestimable. Staff. The Council are reminded that great difficulty has been experienced in maintaining an adequate staff of sanitary inspectors. At the time of writing this Report, there are three vacancies which have been unfilled for many months. It is a matter of praise that the sanitary inspectors on the staff have been able to carry on efficiently, and deal with the more serious problems which have arisen during the year. The shortage of staff, however, is reflected in the amount of routine work which can be carried out, and unless special efforts are made to bring the number of sanitary inspectors up to establishment, it is inevitable that certain features of their work cannot be carried out to the high standards which the Council expect. VITAL STATISTICS The table set out on the next two pages gives the important vital statistics for 1952, together with comparative figures for the previous seven years. - 4 - - 5 - SUMMARY OP VITAL STATISTICS FOR KENSINGTON Description 1952 1951 1950 1949 1948 1947 1946 1945 POPULATION Population (estimated) 172,800 171,300 177,400 174,200 168,800 166,170 147,870 117,170 Density of population per acre 75 74 77 76 74 72 64 51 LIVE BIRTHS Total births 2,810 2,656 2,745 2,681 2,908 3,012 2,695 1,890 Legitimate births 2,508 2,390 2,470 2,417 2,608 2,696 2,378 1,579 Illegitimate births 302 266 275 264 300 316 317 311 Birth rate per 1,000 population 16.3 15.5 15.5 15.4 17.2 18.1 18.2 16.1 STILL BIRTHS Total still births 48 60 54 39 56 65 68 49 Legitimate still births 37 55 51 39 47 58 60 40 Illegitimate still births 11 5 3 Nil 9 7 8 9 Still birth rate per 1,000 total births 16.8 22.1 19.3 14.3 18.9 21.1 24.6 25.3 DEATHS Total deaths 1,936 1,920 1,848 1,819 1,685 1,866 1,821 1,586 Death rate per 1,000 population 11.2 11.2 10.4 10.4 10 11.2 12.3 13.5 DEATHS OP INFANTS UNDER 12 MONTHS OP AGE Total infant deaths 75 65 78 64 111 124 132 92 Legitimate deaths 67 55 69 52 103 105 117 73 Illegitimate deaths 8 10 9 12 8 19 15 19 Infant death rate per 1,000 births 27 24 28 24 38 41 49 49 Death rate of legitimate infants per 1,000 legitimate births 27 23 28 22 39 39 49 46 Death rate of illegitimate infants per 1,000 illegitimate births 26 38 33 45 27 60 47 61 MATERNAL DEATHS Deaths of mothers as a result of pregnancy or childbirth 5 3 5 Nil 5 4 3 4 Death rate of mothers per 1,000 live and still births 1.75 1.1 1.79 Nil 1.68 1.3 1.08 2.06 TUBERCULOSIS DEATHS Death rate from all forms per 100,000 population 18.5 21 33 34 51 47.5 55 84 Death rate from respiratory tuberculosis per 100,000 population 16.8 17.5 29 32 45 43 47 70 Death rate from nonrespiratory tuberculosis per 100,000 population 1.7 3.5 4 2 6 4.5 8 14 -6- CAUSES OP DEATH AT DIFFERENT PERIODS OF LIFE IN 1952 Cause of death All ages Under 1 year 1 year and under 5 5 years and under 45 45 years and over Respiratory tuberculosis 29 - - 5 24 Other forms of tuberculosis 3 - - 3 - Syphilis 11 - - - 11 Diphtheria - - - - - Whooping cough - - - - - Meningococcal - infections 3 2 1 - - Acute poliomyelitis 2 - - 2 - Measles 1 - 1 - - Other infective diseases, etc. 4 - - 1 3 Cancer (all forms) 374 1 - 25 348 Leukaemia, aleukaemia 7 — 1 1 5 Diabetes 9 — - - 9 Vascular lesions of nervous system 229 - - 5 224 Coronary disease, angina 260 - - 5 255 Hypertension with heart disease 22 - - - 22 Other heart disease 283 - - 10 273 Other diseases of circulatory system 86 - - 2 84 Influenza 14 1 - 1 12 Pneumonia 98 11 2 3 82 Bronchitis 105 4 - 1 100 Other respiratory diseases 24 - - 5 19 Ulcers of the stomach 24 - - 3 21 Gastritis, enteritis and diarrhoea 16 5 1 2 8 Nephritis and nephrosis 25 - - 6 19 Hyperplasia of prostate 25 - - - 25 Pregnancy, childbirth and abortion 5 - - 5 - Congenital malformations 20 13 1 4 2 All other diseases 171 37 2 19 113 Motor vehicle accidents 14 - 1 8 5 All other accidents 45 1 3 8 33 Suicides 26 — - 15 11 Homicide and operations of war 1 - - 1 - TOTALS 1,936 75 13 140 1,708 KENSINGTON INFANTILE DEATH RATES (Deaths of children under 1 year per 1000 births) - 8- GENERAL PROVISION OP HEALTH SERVICES IN THE AREA Bacteriological and Analytical Work Pathological and bacteriological work during 1952 was carried out at the Central Public Health Laboratory, Colindale Avenue, Hendon, free of charge to the Council who, however, bear the cost of transporting the specimens and samples. The following is a summary of the work performed during the year:- Nature of specimen or sample Number examined Nose and throat swabs 257 Sputum 66 Faeces, rectal swabs and other specimens 197 Milk (bacteriological) 115 water (drinking) 6 Water (swimming baths) 12 Ice cream 41 Miscellaneous 127 Note. Arrangements have now been made for all pathological and bacteriological specimens to be sent to the Public Health Laboratory (6th Floor) County Hall, Westminster Bridge, S.E.1. Medicinal Baths (Personal Cleansing Station) The record of work done during 1952 is as follows:- Description Scabies Vermin Impetigo Other conditions Persons Clean -singe Persons Clean -sings Persons Clean -sings Persons Clean -sings Adults Kensington 47 94 96 110 - - 12 14 Other boroughs 28 55 73 83 - - 3 4 Schoolchildren Kensington 21 78 1062 1062 1 1 3 11 Other boroughs 9 29 277 278 - - - - Children under 5 Kensington 7 14 42 42 - - - - Other boroughs 11 21 15 17 - - - - Compulsory Cleansings - - 142 142 - - - - TOTALS 123 291 1707 1734 1 1 18 29 - 9- In addition to the cleansing of persons referred to above, articles of personal clothing disinfested at the Medicinal Baths during the year numbered 1,390. Disinfection and Disinfestation A summary of the routine work of the disinfecting staff is shown in the following table:- Houses disinfected after infectious disease 453 ( 609 rooms Houses disinfested after vermin 807 (1640 rooms Loads of furniture treated with hydrogen cyanide 255 Total weight of furniture, bedding, etc. dealt with :- 261 tons 3 cwt. 3 quarters 19 lb. During the year 228 new Council flats became ready for occupation, and the furniture of the ingoing tenants was treated with H.C.N. Prevention of Damage by Pests Although the Prevention of Damage by Pests Act, 1909, imposes a duty on occupiers of premises to notify the Council of rodent infestation, the Council must ensure that as far as practicable the borough is kept free from rats and mice. Section 4 of the Act enables the Council to serve notices requiring rat destruction treatment and precautionary works and the Medical Officer of Health, the Deputy Medical Officer of Health, all sanitary inspectors and the rodent officers have been authorised to take necessary action. The Council have decided to deal with rat and mice infestation in dwelling houses without cost to occupiers. The Council's work under the Prevention of Damage by Pests Act, 1949, during the year, continued to attract the grant of 50% of the approved net expenditure from the Ministry of Agriculture and Fisheries. No grant aid is given in respect of expenditure on the treatment of infestations at commercial or industrial premises, the intention of the Ministry being that such expenditure shall be fully recovered from the occupiers and should not fall on public funds. The Minister is empowered from time to time to require reports and, in particular, an Annual Report must be submitted to him on (i) the extent of infestation, (ii) special circumstances to which any undue presence of rats and mice might be attributed and (iii) the nature and extent of co-operative working with contiguous local authorities. The following is the Report submitted to the Ministry of Agriculture and Fisheries for the year ended 31st December, 1952 -10- Prevalence of Rats and Mice Type of Property Local Authority Dwelling Houses All other (including Business & Industrial) Total I. Total number of properties in Local Authority's District 33 35,938 8,028 43,999 II. Number of properties inspected by the Local Authority during (a) 1952 as a result (a) of notification or (b) otherwise (b) 10 960 81 1,051 3 96 8 107 III. Number of properties (under II) Major — — — — found to be infested by rats Minor 10 324 27 361 IV. Number of properties (under II) found to be seriously infested by mice 3 599 55 657 V. Number of infested properties (under III and IV) treated by the Local Authority 10 1,147 111 1,268 VI. Number of notices served under Section 4: - (1) Treatment — — — — (2) Structural Works (i.e. Proofing) — 14 1 15 Total — 14 1 15 VII. Number of cases in which default action was taken by Local Authority following issue of notice under Section 4 — — — — VIII. Legal Proceedings — — — — IX. Number of "block" control schemes carried out 1 — — — -11- On two occasions all the sewers in the Borough were dealt with by poison bait, and it was estimated that in the first treatment 5,982 rats were destroyed; and in the second 4,133 rats were killed. Sewer baiting was carried out in co-operation with contiguous Local Authorities. The rodent staff deal with infestations from pests other than rats and mice, and the following is a summary of all action taken during the year:- Complaints investigated 1,332 Premises inspected following complaints 1,386 Premises where rats were found 361 Premises where mice were found 657 Premises where other vermin were found 163 Premises where no infestation existed 205 Number of visits made 8,211 Number of notices served 36 Premises successfully treated 1,135 Cases in which advice only was given 107 Borough Council properties dealt with 81 Public Mortuary The number of bodies taken to the mortuary during the year was 495. Inquests were held in 80 cases. Destruction of Pigeons In order to deal with the nuisance and damage occasioned by the activities of wild pigeons, the Council have for many years authorised a pigeon-catcher to catch pigeons on the highway. He is provided, when necessary, with suitable pigeon food for bait. Nine complaints of nuisance caused by pigeons were passed to him for investigation during the year. Atmospheric Pollution The dense smoke-fog which occurred in London between the 5th and 8th December, 1952, gave a striking illustration of the loss of life which results from gross atmospheric pollution. The following table shows the deaths from (a) bronchitis and pneumonia and (b) heart disease registered in the County of London for November and December, with the Kensington figures in brackets:- Week-ended (a) (b) Totals Deaths from bronchitis & pneumonia Deaths from heart disease November 1. 67 (4) 223 (3) 290 (7) 8. 74 (6) 226 (5) 300 (11) 15. 74 (8) 247 (6) 321 (14) 22. 77 (8) 264 (2) 341 (10) 29. 101 (7) 312 (2) 413 (9) December 6. 121 (14) 318 (2) 439 L (16) 13. 872 (30) 801 (11) 1,673 (41) 20. 521 (24) 457 (8) 978 (32) 27. 275 (15) 325 (5) 600 (20) In 1953, following a recommendation by the Metropolitan Boroughs' Standing Joint Committee, the Council agreed to - 12 - assist in the work of measuring atmospheric pollution in London by setting up in the Borough two recording stations. Steps are now being taken to set up these stations. Welfare of Old People The Council have accepted the responsibility, within their powers for co-ordinating, and assisting in the extension of, activities for aged persons and to alleviate unsatisfactory conditions under which many old people are living. Co-operation with voluntary bodies interested in the welfare of old people is effected wherever possible. In order that action taken shall be uniform, the Kensington Old people's Welfare Voluntary Committee act as an intermediary between the Council and the voluntary bodies,, Pour members of the Public Health Committee are nominated to serve on the Kensington Old People's Welfare Voluntary Committee which acts as a co-ordinating non-executive Committee through which voluntary bodies claim assistance from the Council and through which the Council pass requests for executive action. Advice Leaflets The Kensington Old People's Welfare Voluntary Committee considered the problem of bringing to the notice of old people the services which are available for their welfare. Acting on their suggestion, the Council arranged for the printing of 5,000 copies of a pamphlet giving all the necessary information for distribution to old people individually or through their clubs. Grants to Club, etc. Financial aid which the Council grant is given direct to the voluntary organisation concerned. In this connection the Council decided to exercise the powers of Section 31 of the National Assistance Act, 1948, to make contributions to voluntary bodies in respect of the provision of recreation or meals for old people. During the year grants were made as follows:- (a) Latymer Road Mission Old People's Luncheon Club were granted £50 towards their general expenses in providing meals, including replacement of equipment, (b) The Earls Court Group were granted £l3,17s,6d. for certain welfare activities carried out for old people, (c) The Women's Voluntary Services were granted £15 as a contribution towards the cost of providing floor covering, cutlery and other equipment for the new Home from Home Club established at the Royal Palace Hotel, Kensington High Street, W,8. Holidays The Council continued to operate the scheme for providing holidays for old people, in co-operation with the Family Welfare Association. Applications are made direct to the Medical Officer of Health, who arranges for the investigation of the applicant's circumstances. An assessment is made, - 13 - in accordance with an approved scale, of the contribution towards the holiday expenses, which the old person is asked to make. Each case recommended is submitted to the Chairman of the Public Health Committee for approval. It is then referred to the Family Welfare Association who arrange for the holiday, as far as possible meeting the applicant's wishes and needs, The Council make themselves responsible for the expenses, subject to collection of the old person's contribution by the Family Welfare Association. During the year seventy-six old persons were sent away for holidays of one or two weeks. The total cost to the Council amounted to £282.10s.10d. Altogether ninety cases were accepted under the scheme, but in fourteen of the cases the old people concerned cancelled the arrangements after the booking had been made. Domiciliary Cleansing Arrangements have been made whereby old people's living accommodation and household articles are cleansed and, if necessary, disinfested. The Regional Hospital Boards, the London County Council and the Kensington Council of Social Service co-operate by providing temporary accommodation, where necessary, while old people's belongings are being dealt with at the disinfecting station. Twenty-five old people were dealt with in 1952. Cleansing of Old People The powers of the Council to cleanse persons are limited to verminous or suspected verminous persons (apart from special provisions for common lodging houses). These powers are contained in Sections l24 and 125 of the Public Health (London) Act, 1936. The Council also have powers under Section 122 of the same Act to cleanse articles. These powers are wider and enable the Council to deal not only with verminous articles but with articles which are in such a filthy, dirty or unwholesome condition that health is affected or endangered. Records are being compiled of old people living alone who may be in need of care and attention, and this work has revealed that there are many old people who are suffering from personal uncleanliness. They are not sick but merely feeble or senile, and occasionally they are found to be verminous. Some of them are dirty through lack of selfinterest, but others are acutely conscious of their inability to maintain a reasonable standard of cleanliness. There are some who live in the older tenement houses which are not provided with baths and bathrooms, and they are unable to go to the public baths because of incapacity. After consideration the Council came to the conclusion that it would be desirable for the powers of the Council under Sections 124 and 125 of the Public Health (London) Act, 1936, to be extended to provide for the cleansing not only of verminous persons but also of persons in such a filthy, dirty or unwholesome condition that their health is affected or endangered. Representations were made to the Metropolitan Boroughs' Standing Joint Committee who agreed that it was desirable for extended powers to be given to metropolitan borough councils providing the consent of the person was obtained. Whilst these deliberations were in progress, the Council authorised the Medical Officer of Health to arrange for the cleansing, including bathing in their own homes, of old people - 14 - who were, or were believed to be, verminous,, During 1952 six cases were dealt with. Three of these were limited to the cleansing of verminous heads but in the other cases it was necessary to undertake complete cleansings, including bathing. The absence of bathing apparatus and other household amenities in the homes presented difficulties. It was decided, therefore, that" where possible old people should be conveyed in a suitable vehicle to the personal cleansing station where all facilities are available and, if necessary, their clothing could be disinfested while they were being bathed. During the year arrangements were made for twelve old persons in a dirty or verminous condition to be cleansed at the Council's personal cleansing station, Blechynden Mews, W. 11. Institutional Care, etc. Facilities for institutional care, hospital treatment, medical care, nursing care,ophthalmic, dental and pharmaceutical services, sick room equipment, convalescent holidays, financial aid and pensions are dealt with by the responsible official organisations. These and the various services provided by the Council are in many instances made available to old persons through the intervention of the Women Health Officers who act as liaison officers in this respect. During the year it was possible to arrange for eighteen old people to be admitted to hospital for institutional treatment and, in addition, twenty-seven cases were admitted to homes for the aged. Laundry At present no direct authority exists for the Council to provide a laundry service, as such, for old people. Section 122 of the Public Health (London) Act, 1936, enables the Council to cause any article in a house in the Borough to be cleansed, disinfected or destroyed if it is in such a filthy, dangerous or unwholesome condition that health is affected or endangered thereby. The cleansing of grossly fouled bedding in cases of incontinence may be dealt with under this Section. To comply with the legal requirements, the Council have given a general authority to the Medical Officer of Health to take whatever action appears to be requisite under the terms of Section 122 of the Public Health (London) Act, 1936. In one hundred and nineteen cases action was taken on an experimental basis. The bedding was marked, laundered at the Council's disinfecting station and returned to the old people. The scheme works smoothly and appears to fill a much felt want. From stocks of bedding held, the Council are able to supply linen and bedding on loan to old people while their own is being laundered, and where possible voluntary organisations are asked to undertake replacements of much worn articles. During the year, three hundred and ninety-nine separate collections of laundry were made under this scheme, and the number of articles cleansed totalled three thousand, one hundred and four. Library Facilities The Libraries Committee co-operate in providing books for old people confined to their homes. The circulation of the books is effected by t he Women's Voluntary Services mobile library. -15- Chiropody During the year, the Council made a grant of £55 to the Kensington Council of Social Service for the purpose of a chiropody service for house-bound old people. The treatment of old people was increased from twenty to thirty per month during the year, each treatment costing the Council 4/-. All patients are referred by the Medical Officer of Health to the Council of Social Service which administers the financial aspect of the scheme. The British Red Cross Society arrange the treatments., including providing the chiropodists and making the appointments. The total number of persons treated under the home chiropody scheme was seventy-two and the number of treatments given was two hundred and eight. Meals Service The arrangements for meals either delivered to old people in their homes or in canteens were continued with great success by the Women's Voluntary Services in conjunction with Kensington Communal Kitchens. The Women's Voluntary Services undertake the work of verifying the bona fides of applicants, arrange delivery of meals at the homes of old people and collect the money (8d. per meal). The Kensington Communal Services Committee supply the meals and the vehicles for delivery. The following statement shows the progress of the service and the financial effect since it was taken over by the Kensington Communal Services Committee Period Number of meals Gross Cost Receipts from old people Grant from LCC. Net Cost October 1948- £ £ £ £ 31st March,1949 3,535 352 149 - 203 Year 1949/50 10,461 1,016 432 27 557 Year 1950/51 13,758 1,250 477 115 558 Year 1951/52 18,370 1,634 625 445 564 Year 1952/53 28,426 2,103 954 948 201 It will be observed that the number of meals served is growing and that the net cost is substantial. The deficiencies have been met by the Kensington Communal Services Committee. Under Section 31 of the National Assistance Act, 1948, the Council have power to make grants to voluntary bodies undertaking the supply of meals to old people, but up to the present they have not been requested to do so. Visiting The Council's Women Health Officers visit old people brought to their notice. A comprehensive record system is kept of old people in the Borough including personal particulars, environmental conditions and special needs. The local voluntary organisations supply records of old people whom they help and every endeavour is made to keep this information up to date. The following is a summary of the work carried out by the —16— Council's Women Health Officers in connection with the care of old people during the year 1952:- Cases on register at the beginning of year 3,388 New cases added to register 1,811 Cases removed to hospitals 18 Cases removed to homes (voluntarily) 23 Cases removed to homes (compulsorily) 4 Cases removed from district 17 Number of deaths 188 Total number of cases remaining on register at end of year 4,949 Number of old people sent away for holiday 76 Number of old people provided with Council's laundry service 119 Number of old people provided with "Meals on Wheels" 349 Cases referred to National Assistance Board 118 Cases referred for assistance from Home Help Department 132 Cases referred for assistance from Voluntary Organisations 139 Cases referred to Recreational Clubs 113 Cases assisted with provision of medical and nursing care 89 Cases where disinfestation was carried out 25 Number of initial home visits made 1,648 Number of re-visits 1,536 Number of other visits made in connection with old people, including visits to clubs 196 Number of interviews, enquiries, etc. on behalf of old people 1,739 Removal of old and infirm persons to institutions etc. Under Section 47 of the National Assistance Act, 1948, the Council may apply to a Court for an order to remove to a suitable institution any person who- (a) is suffering from grave chronic disease, or being aged, infirm or physically incapacitated, is living in insanitary conditions, and (b) is unable to devote to himself, or is not receiving from other persons, proper care and attention. The National Assistance (Amendment) Act, 1951, which came into operation on 1st September, 1951, amended Section 47 of the National Assistance Act, 1948. Previously, it was necessary for the Medical Officer of Health to certify in writing that a person should be removed, and the Council had to apply to the Court for a Removal Order. Seven clear days' notice had to be given to the person concerned and to the Superintendent of the hospital or institution to which it was proposed to remove such person. Under the Act of 1951, application for removal of urgent cases may be made by the local authority or by the Medical Officer of Health, if authorised by the Council to do so, without giving the seven days' notice. Such applications may be made either to a Court of Summary Jurisdiction or to a single Justice, on a certificate by the Medical Officer of Health and another registered medical practitioner. Further, where the hospital or Institution agree to receive the case, it is no longer necessary to give seven days' notice to the -17- manager thereof. Detention Orders made in respect of these urgent cases are limited to three weeks, and if it is necessary to extend this time, compliance must be made with the original requirements of Section 47. The Medical Officer of Health was authorised by the Council to make applications, where necessary, for the urgent removal of persons to hospital, etc., as provided by the National Assistance (Amendment) Act, 1951. Although many cases were investigated during the year, four only resulted in formal action being taken to secure compulsory removal. Details of these cases are as follows:- (a) An old woman of 78 years living in a basement flat in the Pembridge Ward. She was suffering from senile deterioration and incontinence and evinced symptoms of mental disorder. The rooms she occupied were extremely dirty and littered with old furniture, old clothes and rubbish. On application to the Justice of the Peace, an Order was granted for her compulsory removal to Kingsmead Institution, and this was enforced. Subsequently, the woman was certified as insane and removed to a mental hospital. (b) An old woman of 86 years living in one room in a house in the St. Charles Ward. She was extremely thin, and dirty in her person, clothing and habits. The room she occupied was in a filthy state and smelled offensively. An Order for her compulsory removal to Kingsmead Institution was executed and after the statutory period of three weeks expired, the woman voluntarily decided to stay on as an inmate. (c) An old woman of over 90 years living in one room in the Pembridge Ward. She was bedridden, suffering from senility and was incontinent. A relative was prepared to arrange for the woman's removal to a nursing home, but she refused to go. Accordingly, application was made to a Justice who granted an Order for the woman's compulsory removal to the Arundel Lodge Invalid's Home in Surrey. The Order was enforced and the woman subsequently decided voluntarily to stay on as an inmate of the nursing home. (d) An old woman, aged 82 years, who occupied one room in a house in the Golborne Ward. She was bedridden and, although in receipt of various forms of assistance from neighbours, the Home Help Service and "Meals on Wheels" for the past year or two, her condition had gradually deteriorated. She persistently refused to go into hospital and eventually application had to be made to a Justice, who granted an Order for the woman's compulsory removal to StcCharles Hospital„ This was effected and the woman subsequently agreed to stay on as a voluntary patient. Burial of the Dead Section 50 of the National Assistance Act, 1948, imposes on the Council the duty to arrange for the burial or cremation of any person who dies, or is found dead, within the Borough, where no suitable private arrangements are made for the disposal of the remains. The Council have authorised the Medical Officer of Health to make arrangements for the burial of any person to whom it applies. In the twelve months ended 31st December, 1952, the Council became responsible for the burial of twenty-nine persons -18- dying in the Borough. The following is a summary of the action taken:- (a) Cases where the Council's funeral expenses have been fully recovered 10 (b) Cases where part only of the expenses has been recovered 13 (i) Number of these where balance of expenses will be recovered 4 (amounting to £26.11s.0d.) (ii) Number of these where there is no estate or "liable" relative 9 (c) Cases where full cost has been borne by the Council 6 (i) Number of these where there is no estate or "liable" relative 1 (ii) Number of these where "liable" relatives are unable to contribute 5 Amount recovered by end of year £158. 13. 5d. Additional amount expected to be recovered 26. 11. 0d. £185. 4. 5d. Irrecoverable 152.16.10d. Total cost £338. 1. 3d. It is of interest to note that of the twenty-nine cases dealt with, only ten were eligible for a Death Grant from the Ministry of National Insurance. The total amount recovered from this source amounted to £83.14s.0d. (included in the above figures.) Borough Cremation Service The General Cemetery Company, who own the Kensal Green Crematorium situated at the north-west corner of the Borough, agreed with the Council to make a reduced standard charge of four guineas for cremation of Kensington residents, subject to certain financial conditions. The agreement came into force on the 1st January, 1951. In 1952, there were one hundred and ninety-eight Kensington cremations, in comparison with one hundred and seventy-four in 1951 and sixty in 1948; the latter year was taken as the basis on which the financial provisions of the Agreement were framed. Medical Examinations of Staff The Medical Officer of Health undertakes all medical examinations of staff for the purposes of the Borough Council's Superannuation Scheme. During the year one hundred and fifty one examinations were made. SANITARY INSPECTION The following table shows a summary of the inspections -19- etc., carried out by the sanitary inspectors during the year Public Health (London) Act. 1936 Houses inspected on complaint 4,526 Houses inspected after infectious disease 2,820 Re-inspections 14,141 Smoke observations 16 Other inspections 4,754 Housing Act. 1936 Initial inspections (including preparation or revision of house-to-house cards) 347 Re-inspections 552 Inspections in regard to overcrowding 1,185 Underground Living Rooms Primary inspections 174 Re-inspections 807 Drainage Applications 456 Plans submitted 155 House drains tested and inspected 4,290 The following table shows the number of notices issued in respect of nuisances, defects, etc., found during the year Public Health (London) Act, 1936 Intimation notices 2,249 Statutory notices 1,061 Final notices 446 Various Notice of intention to enter premises for 85 Rent Restrictions Act certificates 4 Report of waste water to the Metropolitan 80 Report of dangerous structures to the London County Council 111 59 The following is a summary of works completed under the supervision of the sanitary inspectors during the year:- - 20 - House drains, reconstructed or repaired 226 House drains cleansed 142 Water closets, reconstructed or repaired 140 Water closets, new provided 246 Soil pipes, vent pipes, repaired etc. 49 Soil pipes, vent pipes, new provided 122 Baths, new provided 153 Sinks, new provided 132 Lavatory basins, new provided 389 Waste pipes, new provided 212 Cisterns, cleansed 11 Cisterns, covered 8 Taps fixed on rising main 12 Yards and areas paved, drained etc. 22 Dustbins provided 94 Accumulations of filth, etc. removed 120 Roofs repaired 558 Houses provided with water above basement level 14 Dampness in dwellings remedied 875 Infectious disease cases removed 337 Houses disinfected after infectious disease (including bedding, etc.) 453 Rooms in such houses, disinfected after infectious disease 609 Houses cleansed under Houses let in Lodgings Byelaws 10 Cleansing of houses not on register 62 Verminous houses cleansed (including bedding, clothing, etc.) 807 Verminous rooms in such houses, cleansed 1,640 Dirty bedding, cleansed 84 Dirty bedding, destroyed 22 Other sanitary works executed 2,689 HOUSING Inspection of dwelling houses during the year (i) (a) Dwelling houses inspected for housing defects (under Public Health or Housing Act) 9,052 (b) Inspections made for the purpose 29,306 (ii) (a) Dwelling houses (including those under sub-head (i) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 347 (b) Inspections made for the purpose 899 (iii) Dwelling houses found not to be in all respects reasonably fit for human habitation 2,249 Action under statutory powers during the year (a) Action under Sections 9 and 10 of the Housing Act, 1936 (i) Dwelling houses in respect of which notices under Section 9 were served requiring repairs - (ii) Dwelling houses which were rendered fit by owners under Section 9 27 (iii) Dwelling houses rendered fit by the Council in default of owners under Section 10 2 -21- (b) Action under Sections 11 and 13 of the Housing Act, 1936:- (i) Dwelling houses in respect of which demolition orders were made 2 One of these was quashed on appeal by owner to County Court. (ii) Dwelling houses demolished in pursuance of demolition orders 2 (iii) Dwelling houses in respect of which undertakings were accepted from owner to render premises fit for habitation 1 (iv) Dwelling houses rendered fit for habitation by owners in accordance with undertakings to do so 1 (c) Action under Section 12 of the Housing Act, 1936:- (i) Separate tenements or underground rooms in respect of which closing orders were made ( 34 premises rooms ( 59 (ii) Separate tenements or underground rooms in respect of which closing orders were determined, the tenements or rooms having been rendered fit ( 22 premises rooms ( 44 (iii) Separate tenements or underground rooms in respect of which closing orders operate, but where the Council consented during the year to the use of the rooms for purposes other than sleeping ( 29 premises rooms ( 45 (iv) Separate tenements or underground rooms in respect of which the Council accepted undertakings from owners to render fit within specified time ( - premises rooms ( - (v) Number of undertakings by owners to render separate tenements or underground rooms fit, which were cancelled, the necessary works having been completed ( 1 premises rooms ( 2 (d) Action under Section 25 of the Housing Act, 1936:- Number of areas represented to Council for clearance Nil (e) Action under the Public Health (London) Act, 1936:- (i) Number of Intimation Notices served requiring defects to be remedied 2,249 (ii) Number of Statutory Notices served 1,061 (iii) Number of Summonses issued 161 London County Council (General Powers) Act, 1951 During the year there were two cases of unfit premises which had been dealt with under the Public Health (London) Act, 1936. In each case the owner of the house could not be found, and various sanitary defects were causing nuisances to the occupiers. Legal proceedings were taken against the "Owner, c/o the Occupier", and abatement orders were obtained. Where a Court Order has not been complied with, the Council may themselves carry out the work, and the London County Council (General Powers) Act, 1951, empowers them to recover the cost in a manner similar to that laid down in the Housing Act, 1936. The Council decided to do the necessary work themselves, and in - 22 - one case the cost amounted to £99,3s,6d. and in the second case £55. Steps are now being taken to recover these expenses. Rent and Mortgage Interest (Restrictions) Acts Six applications by occupiers were made to the Council during the year for certificates of unfitness for habitation under these Acts, four were granted and in the remaining cases the applicants subsequently withdrew their requests. In one case, an owner applied for the revocation of an "unfitness certificate" granted to his tenant on the grounds that the necessary works had been carried out, The application was granted. The provision of new housing accommodation The post-war new housing schemes completed or being erected by the Council are summarised as follows:- Dwellings Henry Dickens Court 328 Rackham Street 120 Portobello Court 158 Kelfield Court 18 St. Columbs House, Blagrove Road 16 St. Marks Place 12 Corbett House, Catheart Road 15 Elgin Crescent/Ladbroke Grove 16 Walmer Road/Clarendon Road 72 Lansdowne Road 8 Old Brompton Road 15 Denbigh Road/Walmer Road 102 Finborough Road (part) 6 Holland Street 32 Trebovir Road 8 Wornington Road 9 Other schemes for building are in various stages of preparation. Slum Clearance In 1950, the Council re-commenced their slum clearance work under the Housing Act, 1936, which had necessarily been interrupted during the war and post-war years. The following is a summary of the action taken up to the end of 1952 Elgin Mews (28 premise) This area was made the subject of a Compulsory Purchase Order on the 3rd October, 1950, which was confirmed without modification by the Minister of Housing and Local Government on the 28th March, 1951. By the end of the year, the Council were completing purchase of the properties and the vacation of the premises, Lionel Mews (13 premises) A Compulsory Purchase Order made on the 27th Februarys 1951? by the Council was confirmed without modification by the Minister of Housing and Local Government on the 13th September, 1951. By the end of the year, the Council were completing purchase of the properties and the vacation of the premises. - 23 - Lonsdale Mews (19 premises) A Compulsory Purchase Order made on the 1st May, 1951, by the Council was confirmed without modification by the Minister of Housing and Local Government on the 14th September, 1951. The rehousing of the occupants had been completed by the end of the year, and the purchase of the properties was being effected. Munro Mews (24 premises) This area was made the subject of a Compulsory Purchase Order on the 1st May, 1951, which was confirmed without modification by the Minister of Housing and Local Government on the 18th January, 1952. By the end of the year, the Council were completing purchase of the properties and the vacation of the premises. South End Row and Gardens (10 premises) The Council made a Clearance Order on the 17th July, 1951, in respect of this area. Subsequently the owners demolished all the properties except one small house. It was therefore unnecessary for the Minister of Housing and Local Government to take any action. Appropriate action was taken under the Public Health (London) Act, 1936, to secure improvements to the remaining house, which is at ill occupied by one family. East Mews Road (14 premises) This area was made the subject of a Compulsory Purchase Order on the 17th July, 1951, which was still awaiting confirmation by the Minister of Housing and Local Government at the end of the year. Powis Mews (13 premises) A Clearance Order was made by the Council on the 11th March, 1952. Following a public enquiry, the Minister of Housing and Local Government confirmed the Order on the 22nd September, 1952, but directed the Council to make payments for well-maintained houses in regard to three of the properties under Section 42 of the Housing Act, 1936. By the end of the year, steps were being taken to secure the vacation of the premises. St. Luke's Mews (20 premises) This area was made the subject of a Clearance Order on the 11th March, 1952. Following a public enquiry, the Minister of Housing and Local Government modified the Order on the 13th December, 1952, to exclude seven properties and directed that payments for well-maintained houses should be made by the Council in regard to two other premises under Section 42 of the Housing Act, 1936. - 24 - Portobello Road 14 premises) A Clearance Order made by the Council on the 11th March, 1952, was confirmed by the Minister of Housing and Local Government, without modification, on the 4th July, 1952. By the end of the year, the premises had been vacated and steps were being taken to secure demolition. Future programme On the 14th October, 1952, the Council approved a further programme of slum clearance to include the following areas:- Addison Place Area 60 premises Child's Passage Area 6 „ Blechynden Street Area 107 „ Wornington Road Area 370 „ Talbot Grove Area 72 „ Thorpe Mews Area 26 „ Treverton Street Area 120 „ Progress will be governed by national and local policy, by economic and financial consideration and by the Council's capacity to re-house the persons to be displaced. Although it is hoped to deal with these areas within the next twenty years, no definite indication can be given as to commencing dates in any instance. Overcrowding Since the end of the war, it has been felt that the rigid enforcement of the overcrowding standards in the Housing Act, 1936, is impracticable and, therefore, the Public Health Committee approved a scheme for dealing with the worst cases in the first place. The Committee adopted a Modified Standard which involved increasing the "permitted numbers" for a dwelling house by a specific amount according to the number of rooms. This Standard has been applied throughout although minor amendments have been made as a result of experience gained. All cases of overcrowding coming to notice have been classified under four headings as follows Category 1. Overcrowding under the legal standard where alternative accommodation has been offered and refusedo Category 2. Overcrowding in excess of the Modified Standard. Category 3. Overcrowding above the legal standard but within the Modified Standard, where there are special medical reasons involved. Category 1+. As in Category 3» but without special medical circumstances. Cases within Categories 1,2 and 3 have been considered by a special Sub-Committee of the Public Health Committee which was established for that purpose. Cases within Category k have not been reported but records have been made and the families are kept under observation by the - 25 - sanitary inspectors who try and secure abatement by persuasion. Eighty-five new cases were dealt with in 1952 by the Special Sub-Committee as follows ;- (a) Recommended for alternative accommodation by the Council 52 (b) Proceedings ordered to be taken without prior offer of alternative accommodation 7 (c) Action postponed 26 The total number of cases of overcrowding abated during the year was sixty-eight and, in additions, sixty-three Category 4 cases were also abated during the year. Since the war, the Special Sub-Committee have dealt with nine hundred and twenty-seven cases of overcrowding under Categories 1,2 and 3, and no few than six hundred and ninety-five of these have been abated. Assessment of Housing Priorities on Medical Grounds During the year two hundred and thirteen applications for re-housing on medical grounds were examined, and recommendations for the award of additional points were made to the Chief Housing Officer. In each case the precise medical condition and resultant disability were determined (frequently necessitating communication with the family doctor or with the hospital attended,, ) The premises were inspected in detail to ascertain the extent and nature of the existing accommodation ; the adequacy of day and sleeping space; the risk of infection; the existence of remediable or irremediable sanitary or structural defects, and the existence of inconveniences, such as stairs which might be prejudicial to the patient. On this information and that supplied by the Chief Housing Officer, an assessment of points to be awarded on medical grounds was made. In a large number of cases, recommendations for re-housing on medical grounds were also made to the London County Council. Hostels In the past two or three years, consideration has been given to the question of the increasing number of hostels provided in the Borough for students or persons without homes of their own or whose places of employment are far removed from their usual place of residence. Whilst the accommodation provided differs widely, these hostels are generally satisfactory, but in a few privately owned hostels the conditions left much to be desired. Accordingly, with the consent of the Minister of Housing and Local Government, the Council have made special byelaws under the Public Health (London) Act, 1936, to enable them to control and supervise hostel accommodation. These deal with such matters as:- - 26 - Registration Inspection Space per head Prohibition of underground rooms for sleeping purposes Separation of sexes Cleanliness of premises and furnishings Ventilation Infectious disease precautions Provision of washing facilities and sanitary accommodation By the end of the year, thirty-nine hostels had been registered under the byelaws. Notices were served requiring the remedy of certain defects and deficiencies and the following is a summary of the works required:- Description Cases involved Insufficient water closet accommodation 2 Insufficient baths 9 Insufficient lavatory basins 3 Inadequate ventilation 7 Absence of hot water supply 2 Insufficient dustbins 1 Dirty walls and ceilings, etc 3 Minor items of disrepair 2 FACTORIES Section 128 of the Factories Act, 1937, requires the Medical Officer of Health to make an annual report in regard to the Council's functions under the Act. The following tables contain a summary of the inspections made and the defects found and remedied within the Borough during 1952:- Inspections Premises Number on Register Number of Inspections Number of Written Notices Factories in which Sections 1,2, 3, 4 & 6 are enforced by the Council 263 172 7 Factories in which Section 7 is enforced by the Council (not included above) 522 572 48 TOTALS 785 744 55 - 27 - Defects found Particulars No. of defects found No. of defects remedied No. of defects referred To H. M. Inspectors By H. M. Inspectors Want of cleanliness — — — — Overcrowding — — — — Unreasonable temperature — — — — Inadequate ventilation — — — — Ineffective drainage of floors — — — — Sanitary conveniences:- (a) insufficient 1 — — — (b) unsuitable or defective 53 43 — 3 (c) not separate for sexes 2 2 — — Other offences (not including offences relating to Homework) — — — — TOTALS 56 45 — 3 During 1952, no prosecutions were instituted under the Factories Act, 1937. Outworkers The following table shows the nature of the work carried out by the two hundred and nine home workers on the register of outworkers during 1952 Nature of work Number Wearing apparel - making, etc. 158 Fur pulling 2 Curtains„ etc 1 Artificial flowers 19 Paper bags, etc 15 Umbrellas 1 Feather sorting 1 Carding etc. of buttons, etc 4 Stuffed toys 4 Cosaques, crackers, stockings, etc. 1 Furniture and upholstery 1 Lampshades 1 Textile weaving 1 209 During the year, two hundred and forty-eight inspections of outworkers' premises were made, but in no case was action necessary to prevent work being carried on in unwholesome premises. No instance of infectious disease occurring in premises, where home work is carried on, was reported during the year. Rag Flock and other Filling Materials Act. 1951 This Act came into operation on 1st November, 1951, and regulates the use of clean filling materials in upholstered articles and other articles which are stuffed or lined. - 28 - Subject to certain exceptions, the Act makes it unlawful in the course of a business to use filling materials to which the Act applies except on premises registered by a local authority. The exceptions are the remaking or reconditioning of any article and upholstering in connection with the making of railway carriages, road vehicles, ships or aircraft. The local authority are required, on the application of the occupier of premises, to register the premises on payment of a registration fee of one pound. If on registered premises there are unclean filling materials the occupier shall be guilty of an offence, but there are safeguarding provisions for secondhand articles brought on the premises for remaking. The Act provides that no rag flock shall be delivered to registered premises except from premises licensed for manufacturing rag flock or premises licensed under the Act as a rag flock store, A local authority on receiving from the occupier of premises an application for the grant or renewal of a licence authorising him to manufacture rag flock on those premises, or for the licensing of the premises as a rag flock store, may grant or renew a licence on payment of a fee of one pound. Licences are to be renewed annually. No new licence is to be granted until the premises have been inspected and reported upon. A person aggrieved by a refusal of a licence has a right of appeal to the Minister of Housing and Local Government. The Act makes it an offence to sell or offer for sale any article to which the Act applies which is upholstered with unclean filling materials; secondhand articles are excepted. At the end of the year, eighteen premises had been registered under the Act. Eight samples of rag flock and other fillings were taken during 1952 and submitted to the prescribed Analyst for examination. Seven of the samples were satisfactory, but in the remaining case the Analyst reported that the chlorine content was 71 parts per 100,000 instead of the maximum allowed of 30 parts per 100,000. The manufacturers of this sample were notified and upon receipt of their explanation and in view of the fact that the sample was otherwise clean and of good quality, the Public Health Committee decided to take no further action. Pet Animals Act. 1951 This Act came into operation on the 1st April, 1952, and requires that no person shall keep a pet shop except under the authority of a licence issued by the Borough Council and in compliance with any conditions specified in the licence. During the year, nine premises were licensed under the Act. The general conditions for pet shops approved by the Council are those recommended for their constituent councils by the Metropolitan Boroughs' Standing Joint Committee. INSPECTION AND SUPERVISION OP POOD General There are no abattoirs or slaughter-houses in the Borough, and no killing of animals for human consumption is carried out. Premises, where food is prepared, stored or exposed for sale for human consumption, are frequently inspected. The - 29 - following is a record of the inspections made by the sanitary inspectors engaged on this work for 1952 :- Food factories 17 Bake houses - underground 29 - others 34 Ice-cream premises 120 Preserved food premises 30 Butchers 230 Grocers 392 Dairies and milk shops 393 Public houses 110 Greengrocers 91 Fishmongers 82 Restaurants and cafes 259 Hotels 33 Sweetshops 69 General stores 213 Street traders' premises 54 Other inspections: stalls, etc 222 Clean Food Campaign In 1951, a Clean Food Advisory Committee was formed comprising members of the Council's Public Health Committee and representatives from the various food trades and the local Chamber of Commerce. Pending the introduction of the new Byelaws for the Protection of Food, which were at that time under consideration, the Council had arranged for the distribution to all food premises in the Borough of a booklet setting out basic codes of practice in regard to food hygiene, for the use of employees in the food trades. It had been suggested that, in addition to the routine follow-up inspections by the sanitary inspectors, consideration should be given to the question of appointing food hygiene liaison officers in the larger firms and giving instruction by means of lectures and films where desirable. Despite an appeal to the representatives of the different food trades, it was not possible to arrange for any lectures or films to be given during the year. On the 3rd November, 1952, the London County Council's Byelaws for the Protection of Food were confirmed and came into operation. The Food Advisory Committee met to consider the best method of applying these Byelaws in Kensington, and it was decided that the best course of action was to promote discussion with the various groups of traders and the Council's officers. A number of these meetings have been held at which the salient features of the Byelaws were emphasized. At the end of the year arrangements were being made to supply the managers of all food premises in the Borough with copies of the Byelaws and certain other pamphlets and leaflets recommended for distribution by the Food Advisory Committee. Milk (Special Designations) (Raw Milk) Regulations, 1949 During the year licences under these Regulations were granted as follows:- Principal Supplementary Dealers licences to bottle and sell Tuberculin Tested Milk; 1 - Dealers licences to sell Tuberculin Tested Milk; 86 18 - 30 - Forty-five samples of Tuberculin Tested milk were submitted for examination during the year. Nine failed to pass the prescribed test and warning letters were sent to the vendors of these unsatisfactory samples. Milk (Special Designations) (Pasteurized and Sterilized Milk) Regulations, 1949 Details of licences granted during 1952 are as follows :- Principal Supplementary Dealers licences to sell Pasteurized Milk; 103 18 Dealers licences to sell Sterilized Milk ; 111 20 The following table shows the number of samples of processed milk taken during the year, together with results of examinations:- Designation No. of samples Methylene blue test Phosphatase test Turbidity test Passed Failed Passed Failed Passed Failed Tuberculin tested (Pasteurized) 25 + 20 - - - - - Pasteurized 43 ++ 26 - 42 1 - - Sterilized 2 - - - - 2 - + Five samples not submitted to Methylene Blue test - Atmospheric shade temperature exceeded 65° F. as laid down in the Regulations. ++ Seventeen samples not submitted to Methylene Blue test Atmospheric shade temperature exceeded 65° F. the maximum temperature specified in the Regulations. Milk During the year three hundred and ninety-four samples of milk were submitted to the Public Analyst and, with the exception of ten, were found to be of genuine composition. In the case of the ten adulterated samples the following action was taken:- Summonses issued 5 samples Warning letters to Farmers 3 samples Warning letters to Wholesalers 2 samples The following table shows percentages of milk fats and non-fat solids of the genuine samples taken during each month:- - 31 - Month No.of samples taken Average percentages Milk fats Non-fat solids January 46 30.48 8.73 February 40 3.44 8.67 March 24 3.41 8.58 April 18 3.37 8.58 May 54 3.47 8.71 June 37 3.85 8.72 July 21 3.63 8.67 August 28 3.64 8.63 September 25 3.70 8.87 October 37 3.73 8.86 November 33 3.80 8.82 December 21 3.91 8.72 Average for whole year: 3.59% 8.71% Legal minimum standards: 3.00% 8.50% Milk and Dairies Regulations, 1949 A summary of the alterations made in the register of dairymen and dairies during 1952, and the number of persons and dairies registered at the end of the year is shown in the following table Dairymen Dairies Purveyors of milk in sealed containers Transfers 10 10 3 Additions to register - - 7 Removals from register - - 1 Dairymen with premises outside borough added to register 1 - - On register 31st December, 1952 98 82 92 Under Article 20 of the Milk and Dairies Regulations, 1949, the Medical Officer of Health is empowered to prevent the sale of milk in his area from any registered premises where he is satisfied that any person is suffering from disease caused by consumption of the milk, or that the milk is infected with disease communicable to man. There was no occasion during the year where the exercise of these powers was necessary. Adulteration of Food During the year five hundred and forty-two formal samples of food and drugs were taken of which twenty (3.6%) were adulterated. Pour hundred and fifty-eight informal samples were taken of which nine (1.9%)were adulterated. - 32 - Details of the adulterated samples are as follows :- Sample Nature of Adulteration Remarks Non-brewed condiment 25% deficient in acetic acid No further action. Milk 10% deficient in fat and 1.04% deficient in nonfat solids Warning to farmer. Milk 2.6% deficient in fat and 4.8% deficient in non-fat solids Summons issued - dismissed. No costs awarded. Milk 1.6% deficient in fat and 3.6% deficient in non-fat solids Ditto Milk 3.6% deficient in fat Ditto Milk 9% deficient in fat Ditto Milk 2.7% deficient in nonfat solids Ditto Milk 1% deficient in fat Warning letter to farmer. Olive Oil Genuine Olive Oil contaminated by use of dirty bottle Informal sample. No further action. Pork Sausages Contained sulphur dioxide 140 parts per million. (No declaration of preservative) Technical offence- attention of retailer drawn to matter and warning against repetition given. Shredded Beef Suet Contained Suet fat 77.5%: Flour 22.5% Informal sample. Formal sample taken and found to be genuine. Tea Saving Tablets Contained caffeine 7% or 1/6 grain per tablet Informal sample. Further sample taken in local authority area of manufacture and found to be genuine. "Cydelux" Contained benzoic acid 530 parts per million Particulars sent to Ministry of Food. Observations of Public Analyst and Ministry sent to bottlers of this product. "Cydelux" Contained benzoic acid 600 parts per million Ditto Rainbow Icing The fat contained in the sample was rancid and the taste was objectionable. Remainder of stock surrendered and destroyed. Milk . Contained fat 2.90% and solids non-fat 8.80% corresponding to the abstraction of 3% of the fat. Warning sent to wholesaler. - 33 - Sample Nature of Adulteration Remarks Milk Contained fat 2.85% and solids non-fat 8.96% corresponding to the abstraction of 5% of the fat Warning sent to farmer. Milk Contained fat 4.37% and solids non-fat 8.18% corresponding to the presence of 3% of added water Warning sent to wholesaler. Christmas Pudding Contained carcases of mites and insect fragments, approximately 20 per ounce No further action. Christmas Pudding Contained carcases of mites and insect fragments, approximately 25 per ounce Ditto Christmas Pudding Contained carcases of mites and insect fragments, approximately 24 per ounce Ditto Pork Sausages Contained sulphur dioxide 310 parts per million Warning sent to retailer. Beef Sausage Meat Contained sulphur dioxide 85 parts per million Warning sent to retailer. Pork Sausages Meat content 58% Details sent to Ministry of Food. Pork Sausages Meat content 62% Ditto Sage and Onion Stuffing Contained no appreciable proportion of suet Informal sample. Formal sample taken and found to be genuine. Tomato Paste Canned Contained: Tin 2.6 grains per pound; Copper 51 parts per million, equal to 160 parts per million calculated on the dried total solids Remaining stock destroyed. Whiskey Contained excessive water 4% Summons. Absolute discharge on payment of 2½ guineas costs. Whiskey Contained excessive water 2% Ditto - 34 - Unsound food Seizure Under Sections 9 and 10 of the Pood and Drugs Act, 1938, it is an offence to sell, offer, or expose for sale, food intended for human consumption, which is in an unfit condition. Such food can be seized and taken before a Justice, who can condemn it, and order it to be destroyed or disposed of for purposes other than human consumption. In one case during the year, a quantity of unsound ham was found in a hotel kitchen exposed for the purpose of sale. The sanitary inspector seized the food and took it to a Justice of the Peace who condemned it. The Public Health Committee considered the question of proceedings, but on the advice of the Town Clerk no further action was taken. Surrender Any person having in his possession, food which is diseased, unsound, or unfit for human consumption can, under Section 180(8) of the Public Health (London) Act, 1936, surrender it to the Council for destruction or other suitable method of disposal. During the year the following amounts of food were surrendered and condemned as unfit for human consumption:- Food Tons Cwts. Qrs. Lb. Meat (Raw) 4 9 2 16 Meat (Tinned) — 8 1 22 Bacon — — 3 23 Ham 1 8 3 19 Sausages — 12 — 7 Luncheon Meat — 12 — 11 Poultry and Rabbits — 1 2 16 Pish (Wet and Dry) — 5 2 11 Pish (Tinned) — — 3 8 Pish (Shell) — — 1 14 Dried Milk Powder — — — 26 Potato Crisps — — 1 4 Sago — — — 9 Pearl Barley — — 1 — Prunes — 3 — 4 Sweetened Fat 1 1 — 12 Cheddar Cheese — — 1 8 Butter — — — 1 Flour — — 1 22 Peppercorns — — 20 Rice — — 2 — Rolled Oats — — — 20 Bulk Dates — — 1 22 Assorted Chocolates — — — 12 Dried Egg Powder — — — 2 Toffee — — — 11 TOTAL: 9 7 3 12 Tins, jars, packets or cartons of fruit, vegetables and miscellaneous foodstuffs10,998 Cow's milk 6½ gallons Pish Cakes 216 Cabbages 5 bags Pork Pies 30 Honey Cakes 28 - 35 - Pharmacy and Poisons Act. 1933 At the end of the year the number of sellers of Part II Poisons (other than registered Pharmacists) on the list maintained by the Council was one hundred and thirty-five. Of this number three were new registrations during the year. Water Supply Although the water supply in Kensington is almost entirely provided by the Metropolitan Water Board, there are three premises which obtain water from artesian and deep wells. Samples of water were taken both by the Council and the owners for bacteriological and chemical examination. Results showed that the waters were suitable for drinking and other domestic purposes. Ice Cream The Pood Standards (Ice Cream) Order, 1951, made under the Pood Standards (General Provisions) Order, 1944, and which came into operation on the 1st March, 1951, provided a minimum standard for ice cream of 5% fat, 10% sugar and 7½% milk solids other than fat. Owing to the shortage of the supply of milk powder and fats, the allocation of these materials to ice cream manufacturers could not be maintained at the same rate as in 1951. In order to avoid a reduction in the supply of ice cream it became necessary to modify the standard introduced in March, 1951. The Food Standards (Ice Cream) (Amendment) Order, 1952, which came into operation on the 7th July, 1952, reduced the minimum fat content of ice cream to and the minimum nonfat milk solids content to 5%. The sugar content remained at 10% as previously. The following table shows the number of samples taken during the year for chemical analysis compared with 1951. - 1952 1951 No. of samples 34 55 Variation of fat content % 4.4 to 12.4 2.0 to 14.7 Variation of non-fat solids content % 18.1 to 26.8 14.6 to 33.0 Average fat content % 8.28 7.94 Average non-fat solids content % 23.13 24.47 There is still no legal bacteriological standard for ice cream. As in previous years, samples were taken and submitted for examination under the provisional Methylene Blue Reduction test which is aimed to give a simple and practical means for the routine examination of ice cream. The test is not of sufficient precision to justify its use as a statutory test. The grading is determined by the length of time ice cream takes to decolourize the Methylene Blue and it is suggested that if samples consistently fail to reach grades 1 and 2, it would be reasonable to regard this as an indication of defects in manufacture or has handing which warrant further investigation. - 36 - During 1952, forty-one samples of ice cream were taken and submitted to the Methylene Blue test and the results are as follows Grade No. of samples 1 13 2 11 3 7 4 10 Premises in the Borough where ice cream is manufactured, stored or sold were frequently inspected during the year and found to be in a satisfactory condition. Cream The sale of cream continued to be prohibited during 1952. FOOD POISONING Under Section 17 of the Food and Drugs Act, 1938, any medical practitioner, on becoming aware that a person is suffering, or is suspected to be suffering, from food poisoning, must notify the Medical Officer of Health. The following table shows particulars of notifications received in 1952 Food poisoning notifications (corrected) Received in first quarter 2 Received in second quarter 4 Received in third quarter 10 Received in fourth quarter 4 TOTAL: 20 Outbreaks due to identified agents 1 Total cases 2 Outbreaks of undiscovered cause - Nil Single cases - Unknown cause 10 Agent identified 8 Total cases 18 Outbreak due to identified agent A child aged 16 months was admitted to a children's hospital suffering from severe pain, diarrhoea and vomiting. After laboratory tests, the child was notified to the Public Health Department as suffering from paratyphoid fever. Examination of faeces specimens from the other three members of the family was made, and it was discovered that a second child, aged 8 years, (who had suffered from slight diarrhoea) was a case of food poisoning„ This information was given to the hospital, who checked on the laboratory investigation made in respect of the first child. It was then ascertained that the first child was suffering from food poisoning and not paratyphoid fever. The agent identified in both cases was salmonella typhi-murium. - 37 - The outbreak was limited to the two children and investigations failed to reveal the source of infection. Single cases In addition to the two cases referred to above, there were eighteen single cases of food poisoning notified. In ten of these no agent was identified, but the remaining eight oases were found to be caused by salmonella typhi-murium. INFECTIOUS DISEASE Smallpox No case of smallpox was notified in the Borough during the year 1952. Many persons came to Kensington from places abroad who were reported to have been in contact with smallpox. All contacts were kept under surveillance until the possibility of developing the disease had disappeared. In the Ministry of Health's Memorandum on Vaccination against smallpox, it is recommended that public health officers, likely to have to deal with cases of smallpox at short notice, should be regularly re-vaccinated at not more than yearly intervals. During the year thirty-one members of the staff of the Public Health Department were vaccinated or re-vaccinated by the Medical Officer of Health. Scarlet fever The number of cases notified in 1952 was 108 and, of this total, 33 were treated in hospital. There was no fatal case during the year, in fact there has been no death from scarlet fever in Kensington since 1940. Diphtheria No case of diphtheria was reported in Kensington during 1952. This is the first year on record when there has been complete absence of this disease in the Borough. Diphtheria immunisation work, commenced by the Council in 1934, was continued by the London County Council during the year. A summary of the work carried out in Kensington is as follows Number of pre-school children immunised 1,199 " " school " " 640 " " re-inforcing injections given 1,341 " " children attending for pre-Schick tests 375 " which gave a positive reaction 301 " of children attending for post- Schick tests 1,050 " proving negative 803 " proving positive 24 " who failed to attend for reading 223 Enteric fever One case of typhoid fever and one case of paratyphoid B. fever were notified during year. Both cases recovered after treatment in hospital. Investigations made revealed that the infections had been contracted abroad. - 38 - Puerperal pyrexia Under the Puerperal Pyrexia Regulations, 1951, all cases of the disease occurring within the Borough, whether the patients are Kensington residents or not, have to be accepted. During 1952, eighty-three cases were notified as having occurred in Kensington, and of these thirty-eight were patients normally resident outside the Borough, Seventy-nine of the cases were treated in hospital and no death occurred. Information was received in the Public Health Department concerning seventeen patients normally resident in Kensington who were notified under the Regulations in other London areas. Pneumonia There are various forms of pneumonia, but the only kinds notifiable are acute primary and acute influenzal. Seventy-one notifications were received during the year, fifty-seven being acute primary pneumonia and fourteen being acute influenzal pneumonia. Of the total, thirty-eight cases were treated in hospital. During the year, the number of deaths from pneumonia (all forms) was ninety-eight and fourteen deaths were certified as due to influenza. Dysentery Thirty-one cases of dysentery were notified in 1952, all of which were bacillary in origin, the majority being due to Sonne bacillus. Generally speaking the cases were of a mild type and there were no deaths. Erysipelas Of the eleven cases notified, five were admitted to hospital. There were no deaths. Meningococcal infection Pour cases of this disease were notified during the year and all the patients were removed to hospital. Three deaths were recorded during 1952. Malaria Only one case of malaria was reported during the year and it was found that the patient had a previous history of the disease during the last war. Poliomyelitis There were twenty-one cases of acute poliomyelitis notified and confirmed during the year; seventeen of the cases showed symptoms of paralysis. Two of the cases died. The figures for the past five years are as follows Confirmed cases Deaths 1951 12 Nil 1950 13 3 1949 47 4 1948 9 Nil 1947 27 2 - 39 - As in previous years, contacts of cases were kept under supervision for twenty-one days from the last date of contact. Eight hundred and ninety-six visits by sanitary inspectors and two hundred and thirty-four other enquiries were made for this purpose,, During the year, the attention of the Public Health Committee was called to an unsatisfactory feature concerning the isolation and treatment of patients. Of the twenty-one cases notified, one (a child) was nursed at home and four others were retained in general hospitals. Indeed, three of these four were nursed in children's hospitals. Endeavours were made to secure the removal of these cases to an infectious diseases hospital without success. The facts were reported to the Ministry of Health with the object of securing the Ministry's co-operation in requiring the removal of acute poliomyelitis patients from general hospitals to isolation hospitals, as it would appear that the provisions of the Public Health (London) Act, 1936, relating to dangerous infectious diseases do not apply to this disease,. During the year, the Public Health Department continued to co-operate with the Medical Research Council on two separate poliomyelitis investigations. One of these projects is concerned with the possible association between inoculations and operations and the contraction of the disease, and the other is a wider investigation involving a comparison between the histories of child sufferers and those for selected healthy children of the same age group9 etc. Acute encephalitis Three cases of acute encephalitis were notified during 1952. One was of the post-infectious type following an attack of shingles, whilst the other two cases were of the infective type. All the patients recovered after hospital treatment. Measles Of the eight hundred and thirty-one cases notified during 1952, there was only one death from measles. The number of the cases admitted to hospital for treatment was ninety-three. Ophthalmia neonatorum Two cases of this disease were notified, both of which were treated at home and recovered without any injury to sight. Gastro-enteritis This disease is notifiable in children up to the age of five years. Thirty cases were reported during the year, nineteen of which were removed to hospital for treatment. There were six deaths of children under five years from gastritis, enteritis or diarrhoea. Scabies The number of notifications of this disease during 1952 was only twenty-six, which compares with thirty-four in the previous year and four hundred and sixty-three in the peak year of 1946. - 40 - Tuberculosis During the year two hundred and fifty-one new cases of tuberculosis were notified, of which two hundred and twentyseven were respiratory and twenty-four non-respiratory cases. The following table shows the number of cases added to and the number removed from, the notification register during the year Description Respiratory Non Respiratory Total M F M F On register of notifications on 1st January, 1952 613 572 69 88 1,342 Notified for the first time during the year 130 97 7 17 251 Brought to notice other than by notification 81 60 2 2 145 Removed from register on account of having - (a) recovered from the disease 13 12 2 3 30 (b) removed from district lost sight of, etc. 124 114 7 17 262 (c) died 24 5 3 — 32 Remaining on register on 31st December, 1952 663 598 66 87 1,414 The system of investigation into the environmental conditions of tuberculous patients continued during the year. All newly notified cases and those cases transferring into Kensington or changing their address in the Borough, have been visited by the sanitary inspectors with the objects of tracing the source of infection, preventing the spread of infection and removing conditions favourable to infection. Particular attention was given to the home conditions in addition to the dissemination of advice to prevent the transmission of infection to contacts. During the year, four hundred and fourteen visits were paid to the homes of tuberculous patients. In two hundred and sixty-five of these, the environmental conditions were such as to require no further action on the part of the Public Health Department; in a further twenty-nine cases it was found that the patients had moved away, and in sixteen other cases the investigation was postponed as the patients were away in hospitals. The action taken in the remaining one hundred and four cases is summarised below s- Action taken Cases Investigation or supervision undertaken in respect of :- (a) re-arrangement of existing accommodation 16 (b) occupation of patients 14 (c) tracing of contacts 18 (d) preventing spread of infection 23 Recommended for priority re-housing 33 Action taken under Public Health and Housing Acts in respect of insanitary or unhealthy conditions 18 - 41 - Incidence of tuberculosis amongst Kensington residents who originated from areas outside England, Scotland and Wales In the Annual Report for 1951, attention was drawn to what appeared to be a disturbing trend in the incidence of tuberculosis amongst immigrants. During 1952, a more detailed investigation of this problem has taken place and the following table sets out the result. Country of origin Period (in years) between entry to United Kingdom and notification of disease Possibles (Period not known) Total 1 2 3 4 5 6 7 8 9 Argentine — — — — — — — — — 1 1 Canada 1 1 1 — — — — — — — 3 Ceylon — 1 — — — — — — — 2 3 Cyprus — 1 — — — — — — — — 1 Palestine — — 1 — — — — — — — 1 Esthonia — — — — — — — — — 1 1 Gold Coast — 1 — — — — — — — — 1 India 1 1 — — 1 — — — — 1 4 Ireland 4 1 1 1 — 2 2 1 — 4 16 Italy 1 — — — — 1 — — — — 2 Jamaica — — — — — — — 1 — — 1 Jordan — — — — — — — — — 1 1 Lithuania — — 1 — — — — — — — 1 Malaya 1 — — — — — — — — 1 2 Malta — — 2 — — — — — — — 2 Nigeria -— — — — — — — — — 1 1 Palestine — — 1 — — — — — — — 1 Poland 1 1 — 2 1 2 — — 2 4 13 Roumania — — — — — — — — — 1 1 Spain — — 1 — — — — — — 1 Ukraine — — — 1 — — — — — — 1 United States 1 — — — — — — — — — 1 Not known — 1 — — — — — — — 1 TOTAL: 60 Patients who had resided in London all their lives or for at least 10 years 134 Patients who tiad resided in other parts of the country all their lives prior to coming to Kensington 40 Patients from whom information concerning origin was not obtained but where it is believed to be this country 42 Patients from Ireland who resided here at least 10 years prior to notification 9 Patients notified in Ireland before coming to this country 3 Patients from Poland who resided here at least 10 years prior to notification 2 Patients (Malta - 1 and Armenia - 1) who resided here at least 10 years prior to notification 2 Patients from whom information concerning origin could not be obtained 81 TOTAL 313 - 42 - The investigation covered only patients newly notified or transferring into the Borough from other areas. The total of three hundred and seventy-three cases surveyed differs from the total of tuberculous patients visited in the year in that forty-one of these were old cases changing residence within the Borough,, As a guide, it will be seen that the cases have been analysed to show immigrants who have become notified cases within ten years of arrival in this country. Thus, it seems that 16% of the tuberculous patients visited in Kensington for the first time in 1952 were immigrants who had possibly contracted the disease within the first ten years of residence in this country. These statistics cannot be taken as evidence of a conclusive nature because of the interaction of unknown variable factors such as the specific dates of onset. Again the table showing the countries of origin must be treated with care as the total number of aliens resident in Kensington is not known. Conclusions derived from the basis of racial immunity are difficult to evaluate, particularly as precise information as to opportunity for infection or acquisition of immunity in the country of origin is lacking. It is known, for example, that North Kensington has been for many years a transit area for Irish immigrants and that since the war, a portion of the Holland and Earls Court Wards has provided homes for a Polish colony. The preponderance of these nationalities in the table appear to support this knowledge. However, the question of relative immunity still remains, for it is also known that since the war many Negroes (mostly West Africans, it is believed) have settled in North Kensington, and there is evidence of a widespread sprinkling of Hungarians in the Borough. However, the table shows the notification of no Hungarians during the year and only two natives of West Africa, There is, of course, the question of immigrants who arrive already carrying the infection, although a discussion of this aspect cannot be made without accurate data on dates of onset. However, there is unquestionably a great deal more evidence available this year to support the contention that there is a public health problem which must be faced. It is clear, also, that this problem has two important aspects. Firstly, there is the duty of protecting the existing population and secondly, there is the task of securing an acquired immunity for immigrants. Mass Radiography Under the National Health Service Act, mass radiography is undertaken by the Regional Hospital Boards. On one occasion in 1952, the North-West Metropolitan Regional Hospital Board provided facilities for mass radiography at premises in Kensington. The number of persons examined totalled one thousand and thirty-two. The following table gives a summary of the results obtained s- - 43- Number examined Males 515 Females 517 1,032 Number recalled for large films 9 (0.87%) Disposal of large film cases - No further action 5 To return for further 3 examination (0.29%) Known case 1 Malignant disease of the lungs Attention was called in last year's Annual Report to the marked increase of deaths from cancer or other malignant disease of the lungs in recent years. This is shown in the sub-joined table, where the corresponding figures for pulmonary tuberculosis are given for comparison. The relation to the population and general mortality is also indicated. Deaths from Pulmonary Tuberculosis and Malignant Disease of the Lungs Kensington : 1930 - 1952 inclusive Year Population Total Deaths Malignant Disease of the Lungs Pulmonary Tuberculosis Male Female Total Male Female Total 1930 176,000 2,242 10 4 14 81 59 140 1931 174,800 2,455 6 6 12 73 54 127 1932 183,500 2,490 13 17 30 66 41 107 1933 181,100 2,336 12 7 19 66 58 124 1934 179,080 2,377 18 11 29 52 51 103 1935 178,300 2,154 20 11 31 47 31 78 1936 176,100 2,201 24 22 46 67 38 105 1937 175,600 2,345 26 19 45 58 56 114 1938 174,100 2,049 17 10 27 56 37 93 1947 166,170 1,866 44 14 58 37 34 71 1948 168,800 1,685 35 10 45 46 30 76 1949 174,220 1,819 33 17 50 36 20 56 1950 177,400 1,848 54 16 70 38 14 52 1951 171,300 1,920 57 13 70 21 15 36 1952 172,800 1,936 52 19 71 24 5 29 Whooping cough Two hundred and twenty-eight cases were notified during the year, thirty-nine of which were treated in hospital. No deaths occurred from this disease. Notifications The following tables show (1) the number of cases of infectious disease notified during the year 1952, with comparative figures for the previous seven years ; (2) the number of notifications divided into age groups; and (3) the number of cases notified in each ward of the Borough. -44- TABLE 1 Notifiable disease Number of cases notified 1952 1951 1950 1949 1948 1947 1946 1945 Scarlet fever 108 68 100 114 94 98 195 136 Diphtheria (including Membranous Croup) — 1 2 2 12 23 37 19 Enteric fever 2 7 12 7 4 4 6 3 Puerperal fever ø — — — — — 3 4 7 Puerperal Pyrexia 83 22 18 33 25 9 8 12 Acute primary pneumonia and acute influenzal pneumonia 71 149 69 121 142 103 111 81 Dysentery 31 81 18 33 145 21 49 142 Erysipelas 11 13 17 15 24 34 37 33 Meningococcal infection 4 8 5 8 4 7 10 3 Malaria 1 2 2 — 2 4 8 11 Acute poliomyelitis Paralytic 17 8 7 47 9 27 1 3 Non-paralytic 4 4 6 Acute encephalitis 3 1 — 1 — 2 — 1 Tuberculosis (all forms) 251 238 278 266 258 259 210 188 Measles 839 1314 696 740 868 852 264 868 Ophthalmia Neonatorum 2 2 12 5 7 4 4 8 Enteritis + 30 25 63 88 64 102 69 100 Pood poisoning 20 18 23 33 11 7 7 6 Scabies 26 34 72 106 141 239 463 460 Whooping cough 228 484 316 304 264 274 209 62 TOTALS: 1731 2479 1716 1923 2074 2072 1692 2143 ø Puerperal Pyrexia only notifiable in London since 1948. + Notifiable only in children under the age of 5. NOTE: Gases of mistaken diagnosis are excluded from above table. - 45 - TABLE 2 Notifiable disease Number of Gases Notified in 1952 Age Groups in Years Under 1 1 to 2 3 to 4 5 to 9 10 to 14 15 to 24 25 & over Scarlet fever — 10 30 59 4 4 1 Diphtheria (including Membranous Croup) — — — — — — — Enteric fever — — — — — 1 1 Puerperal Pyrexia — — — — — 43 40 Acute primary pneumonia and acute influenzal pneumonia 2 5 1 8 2 3 50 Dysentery 2 7 3 2 1 3 13 Erysipelas — — — — — — 11 Meningococcal infection 2 1 — — — — 1 Malaria — — — — — 1 — Acute poliomyelitis Paralytic 1 2 2 3 — 3 6 Non-paralytic 1 — 1 1 — 1 — Acute encephalitis — — — — — 1 2 Tuberculosis (all forms) 2 — 7 5 3 60 174 Measles 23 180 230 357 14 16 19 Ophthalmia neonatorum 2 — — — — — — Enteritis 20 4 6 — — — — Pood poisoning — 1 — 1 1 2 15 Scabies — — — 1 4 7 14 Whooping cough 23 80 65 52 4 2 2 TOTALS : 78 290 345 489 33 147 349 TABLE 3 Total Cases Notified in each Ward Notifiable disease St. Charles Golborne Norland Pembridge Holland Earls Court Queens Gate Redcliffe Brompton Scarlet fever 27 17 18 10 6 8 3 15 4 Diphtheria (including Membranous Croup) — — — — — — — — — Enteric fever — 1 — — 1 — — — — Puerpe ral Pyrexia 1 1 5 11 8 8 43 4 2 Acute primary pneumonia and acute influenzal pneumonia 11 14 5 11 11 5 4 10 — Dysentery 6 3 2 7 7 1 — 5 — Erysipelas 1 3 2 1 3 — — 1 — Meningococcal infection 1 — 1 — 2 — — — — Malaria — — — — — 1 — — — Acute poliomyelitis Paralytic 2 2 3 1 2 3 2 1 1 Non-paralytic 1 — 1 — — — — 2 — Acute encephalitis 1 — — 1 — 1 — — — Tuberculosis (all forms) 46 27 38 35 33 20 13 28 11 Measles 175 112 148 140 96 78 20 56 14 Ophthalmia neonatorum — 1 — 1 — — — — — Enteritis 7 7 2 2 7 2 — 3 — Pood poisoning 2 — 2 7 1 3 — 5 — Scabies 3 5 5 4 2 2 2 1 2 Whooping cough 47 31 34 53 18 7 9 25 4 — 46 — LEGAL PROCEEDINGS Public Health (London) Act. 1936 Nuisances During the year one hundred and fifty-five summonses were issued for various nuisances under the Public Health (London) Act, 1936. In forty-one cases abatement orders were secured; fines amounting to £2. 2s. 0d. were imposed and £57.15s. 0d. costs were awarded to the Council. In forty cases the summonses were withdrawn, the nuisances having been abated by the owners prior to the Court hearings. In seventy-four cases the summonses were adjourned as the necessary works were in progress of being carried out by the owners. Twenty-nine prosecutions were undertaken for failure to comply with Justices' Orders to abate statutory nuisances. In ten cases fines amounting to £63.17s. 6d. were imposed and costs amounting to £19.19s. 0d. were awarded to the Council. The remaining nineteen cases were withdrawn or adjourned as the necessary works had been, or were being, carried out. One defendant appealed against a conviction for failing to comply with a Justices' Order,, The appeal was heard at the County of London Sessions and was dismissed, the Council being awarded £10.10s. 0d. costs. Later this defendant was fined a further £2. 2s. 0d. for failing to pay the Council's costs and was ordered to pay within seven days. Drainage Byelawa Six summonses were issued in respect of offences under these Byelaws. Convictions were obtained in all cases and fines amounting to £64. were imposed and costs of £5. 5s. 0d. were awarded to the Council,, Council's Byelaws Dog Nuisances Five summonses were issued under this Byelaw. In all cases convictions were obtained and fines totalling £2. 5s. 0d. were imposed,, Housing Act, 1936 A writ was served on the Town Clerk by the owner of seven premises in respect of which the Council had carried out work in default under Section 9 of the Housing Act, 1936, and had claimed reimbursement of their expenses. The writ issued by the owner claimed a declaration in the High Court that the Council's charge was irregular and unlawful. The works in question had been carried out in 1948. The basis of the claim appeared to be that certain works costing between £250 and £300 were either not carried out or were negligently carried out by the Council's contractors. After certain legal negotiations, the owner compromised and agreed to pay the outstanding expenses over a period of ten years, subject to each party paying their own legal costs. The Council agreed to accept this offer and the application to the High Court was withdrawn. Contravention of Closing Orders Three summonses were issued in respect of illegal occupation of closed underground rooms. Conviction was obtained - 47 - in one case and a fine of £1. 0s. 0d. was imposed. In the other two cases the summonses were withdrawn as the illegal occupation had been abated. Food and Drugs Act, 1936 Five summonses were issued in respect of milk samples deficient in fat or non-fatty solids. The defendants successfully pleaded that the milk had been sold in the same condition as it had been given by the cows. The summonses were dismissed, but no costs were awarded against the Council. A summons was issued in respect of the sale of a bottle of milk containing glass fragments. The case was dismissed and the Council were ordered to pay £8. 8s. 0d. costs,, A further summons was issued in respect of the dirty condition of a bakehouse and store. The defendants were fined £19. 0s. 0d. and costs amounting to £5. 5s. 0d. were awarded to the Council. National Assistance Acts. 1948/51 In four cases, applications were made to Justices of the Peace for Detention Orders to secure the compulsory removal of aged and infirm persons to suitable institutions,, In each case the order was granted and the person removed to the institution for the statutory period of three weeks. CONCLUSION In presenting this Report, I should like to express my grateful appreciation of the kind co-operation which I have received from His Worship the Mayor, the Chairmen and Vice Chairmen of the various Committees and all members of the Council. My sincere thanks are also given to the staff of the Public Health Department for their loyal and efficient service during the year, and to the other Chief Officers and their staffs for their ready willingness to co-operate at all times. I have the honour to be Your obedient Servant, J. H. WEIR Medical Officer of Health.