A04348 1 Mrs Boyne Div 5B 2 Mrs Lnoules bhes Itse 3 Library KEN 62 The Royal Borough of Kensington ANNUAL REPORT ON THE Health of the Borough FOR THE YEAR 1953 » BY J. H. WEIR m.d.. b.s.. b.h.y.. d p.h MEDICAL OFFICER OF HEALTH THE ROYAL BOROUGH OF KENSINGTON Public Health Department, Hornton Street, Kensington, W. 8. 1st June, 1954. 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 1953. The Minister of Health has again requested (Circular 1/54) that the report should be in the same 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 (171,500) of the population of the borough for 1953 shows a decrease compared with the figure for the previous year (171,800). The actual population figure for Kensington obtained as a result of the 1951 Census was 168,160. Birth rate. The number of births per 1,000 population of the borough was 15•4 in 1953, which was 0.9 lower than the figure recorded for the previous year. The Kensington birth rate was lower than that for the County of London (17.5) and lower than that for the whole of England and Wales (15.5). (In order to compare the Kensington birth rate with the rates for other areas, the Registrar-General has supplied an area comparability factor (0.71) which reduces the actual birth rate for Kensington for comparison purposes to 10.9) Death rate. The number of deaths per 1,000 population was 9.96, which is the lowest ever recorded for Kensington. This figure is lower than the death rate for the County of London (12.5) and that for England and Wales (11.4). (The Registrar-General's area comparability factor for the Kensington death rate is 1.00 and thus there is no adjustment this year for comparison purposes with other authorities.) Infant death rate. This rate for 1953 was 19.7, which is the lowest ever recorded in Kensington. The infant death rate for the County of London was 24.8 and for England and Wales 26.8. This record must be especially gratifying, when it is recalled that the average annual infant death rate in Kensington for the five years 1934 - 1938 was 81.2. - 1 - 2 Maternal death rate. No deaths of mothers due to childbirth were recorded in 1953. This is the second year that such a satisfactory position has materialised, the previous occasion being in 1949. (The maternal mortality rate for England and Wales in 1953 was 0.76; the figure for the County of London is not yet available.) Infectious diseases. There was no serious outbreak of infectious disease in the borough during 1953. The total number of notifications received was 1,846 in comparison with 1,731 in the previous year. The slight increase in notifications was mainly due to the 485 notified cases of whooping cough in 1953 compared with 228 cases notified in 1952. It is unfortunate that two cases of diphtheria were notified in 1953 compared with no case in the previous year. Neither of these cases strictly "belonged" to Kensington as the infections were contracted overseas. It is on such occasions that emphasis is given to the need to maintain a high standard of diphtheria immunisation, in order that Kensington residents, especially children, should be protected against the introduction of diphtheria from outside sources. The danger of diphtheria still exists, and efforts must be maintained, and indeed increased, to ensure that every infant and schoolchild in the borough is immunised against this disease. Tuberculosis, The death rate from all forms of tuberculosis per 100,000 population was 19.2 which is slightly higher than last year's figure (18.5), which was the lowest figure ever recorded in Kensington. Repair of houses. In last year's report attention was drawn to the urgent problem of maintaining dwelling houses in a reasonable state of habitation, and the conclusions of the Borough Council, after careful consideration, were enunciated in the following paragraphs:- "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 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." The Government have introduced the Housing Repairs and Rents Bill, and it is hoped that, when this Bill becomes law, 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) will be considerably reduced. 3 Although no new slum clearance area was formally represented during 1953, the Council did decide to deal with the Treverton Street area (which had been earmarked for clearance), by acquiring the houses under Part V of the Housing Act, 1936. This proposal has been approved by the Minister of Housing and Local Government and when the rebuilding scheme is completed, it will effect a worthwhile improvement in the St. Charles Ward of the borough. The development of Kensington was in the main accomplished in the middle of the nineteenth century and, although new buildings have been erected since that time, it is true to say that a large proportion of the housing in the borough is approaching the end of its useful life. Between 1840 and 1870, the population of Kensington increased from 26,834 to 120,299, and the rateable value increased from approximately £140,000 to £900,000. Whilst most of the houses built in this period were of much better construction and design than the old and small cottage-type property which one generally associates with slums, it is a fact that modern amenities are lacking. Reference to the extracts from the 1951 Census appearing on pages 19-23 reveals that there are many households in Kensington which do not possess normal amenities such as separate baths, water closets, kitchen sinks, etc. Moreover, because of economic circumstances, during the war and since, works of repair and improvements to these houses have been kept at a minimum. Therefore, any improvement in procedure for dealing with these houses, which the new Housing Repairs and Rents Bill will effect will be most welcome and it is hoped that a new impetus will be given to the Council's work of securing and maintaining proper and fit standards of habitation in the borough. The Housing Repairs and Rents Bill will require all local authorities to prepare their proposals regarding the action to be taken in respect of unfit houses, and at the present time preliminary work is being undertaken in anticipation of the Bill being passed in its present form. Old People's Welfare. The welfare work in relation to old people is developing satisfactorily and is proving to be one of the more important post-war developments in public health work. The need for the service is emphasised by the increasing longevity of people. The age distribution of the population of Kensington, as revealed in the 1951 Census, is illuminating when compared with the corresponding figures for fifty years ago. To-day 11% of the population of Kensington are aged 65 years or over, compared with 4.9% of the population in 1901; in other words there are approximately 10,000 more people in Kensington aged 65 years or over than there were in 1901. The age distribution is indicated below:- Census of Proportion of population aged Actual Population 0-4 5 - 14 15-44 45 - 64 65 & over 1951 6.4% 8.3% 49.7% 24.6% 11.0% 168,160 1901 8.1% 14.65% 55.5% 16.85% 4.9% 176,628 4 The characteristics of the scope of public health and social work have, over the last half century, been changing in emphasis from the younger population (child welfare services) to the older population (old people's welfare). It is estimated that this change will be accentuated and various calculations have been made which indicate that the proportion of the population attaining the age of 65 years or more will greatly increase in the next decade or so. The hard work carried out in the first half of the twentieth century in the child welfare and school medical services has been rewarded in many directions by the generally improved health of the child population. It is only to be expected that much labour will be similarly expended in the second half of the century under the heading of Old People's Welfare. VITAL STATISTICS The table set out on the next two pages (following the graphs opposite), gives the important vital statistics for 1953, together with comparative figures for the previous seven years. KENSINGTON INFANTILE DEATH RATES Deaths of children under 1 year per 1000 births) 9 7 SUMMARY OF VITAL STATISTICS FOR KENSINGTON Description 1953 1952 1951 1950 1949 1948 1947 1946 POPULATION Population (estimated) 171,500 172,800 171,300 177,400 174, 220 168,800 166,170 147,870 Density of population per acre 74 75 74 77 76 74 72 64 LIVE BIRTHS Total births 2,642 2,810 2,656 2,745 2,681 2,908 3,012 2,695 Legitimate births 2,321 2,508 2,390 2,470 2,417 2,608 2,696 2,378 Illegitimate births 321 302 266 275 264 300 316 317 Birth rate per 1,000 population 15.4 16.3 15.5 15.5 15.4 17.2 18.1 18.2 STILL BIRTHS Total still births 53 48 60 54 39 56 65 68 Legitimate still births 47 37 55 51 39 47 58 60 Illegitimate still births 6 11 5 3 Nil 9 7 8 Still birth rate per 1,000 total births 19.7 16.8 22.1 19.3 14. 3 18.9 21.1 24. 6 DEATHS Total deaths 1,708 1,936 1,920 1,848 1,819 1,685 1,866 1,821 Death rate per 1,000 population 9.96 11.2 11.2 10.4 10.4 10 11.2 12.3 DEATHS OF INFANTS UNDER 12 MONTHS OF AGE Total infant deaths 50 75 65 78 64 111 124 132 Legitimate deaths 42 67 55 69 52 103 105 117 Illegitimate deaths 8 8 10 9 12 8 19 15 Infant death rate per 1,000 births 19.7 27 24 28 24 38 41 49 Death rate of legitimate infants per 1,000 legitimate births 18 27 23 28 22 39 39 49 Death rate of illegitimate infants per 1,000 illegitimate births 25 26 38 33 45 27 60 47 MATERNAL DEATHS Deaths of mothers as a result of pregnancy or childbirth Nil 5 3 5 Nil 5 4 3 Death rate of mothers per 1,000 live and still births Nil 1.75 1.1 1.79 Nil 1.68 1.3 1.08 TUBERCULOSIS DEATHS Death rate from all forms per 100,000 population 19.2 18.5 21 33 34 51 47.5 55 Death rate from respiratory tuberculosis per 100,000 population 15.1 16.8 17.5 29 32 45 43 47 Death rate from nonrespiratory tuberculosis per 100,000 population 4.1 1.7 3.5 4 2 6 4.5 8 8 CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE IN 1953 Cause of death All ages Under 1 year 1 year and under 5 5 years and under 45 45 years and over Respiratory tuberculosis 26 - - 8 18 Other forms of tuberculosis 7 _ 2 2 3 Syphilis 6 - - - 6 Diphtheria - - - - - Whooping cough - - - - - Meningococcal infections - - - - - Acute poliomyelitis 1 - - 1 - Measles - - - - - Other infective diseases, etc. 4 - - 1 3 Cancer (all forms) 339 — — 27 312 Leukaemia, aleukaemia 4 — 1 - 3 Diabetes 4 - - - 4 Vascular lesions of nervous system 174 - - 7 167 Coronary disease, angina 223 - - 5 218 Hypertension with heart disease 30 - - - 30 Other heart disease 212 - - 6 206 Other diseases of circulatory system 94 - - 3 91 Influenza 33 - - 1 32 Pneumonia 96 11 1 - 84 Bronchitis 115 1 - 2 112 Other respiratory diseases 19 - - 1 18 Ulcers of the stomach 24 - - - 24 Gastritis, enteritis and diarrhoea 13 4 2 1 6 Nephritis and nephrosis 10 - - 2 8 Hyperplasia of prostate 13 - - — 13 Pregnancy, childbirth and abortion - - - - - Congenital malformations 15 8 - 4 3 All other diseases 152 24 3 12 113 Motor vehicle accidents 14 - - 5 9 All other accidents 45 2 1 21 21 Suicides 32 - - 12 20 Homicide and operations of war 3 - - 2 1 TOTALS 1,708 50 10 123 1,525 9 GENERAL PROVISION OF HEALTH SERVICES IN THE AREA Bacteriological and Analytical Work Pathological and bacteriological work is carried out at the Public Health Laboratory (6th floor), County Hall, Westminster Bridge, S. E. 1., 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 1953:- Nature of specimen or sample Number examined Nose and throat swabs 270 Sputum 68 Faeces, rectal swabs and other specimens 631 Milk (bacteriological) 106 Water (drinking) 7 Water (swimming baths) 8 Ice cream 13 Miscellaneous 116 Medicinal Baths (Personal Cleansing Station) The record of work done during 1953 is as follows :- Description Scabies Vermin Impetigo Other conditions Persons Cleans -ings Persons Cleans -ings Persons Cleans -ings Persons Cleans -ings Adults Kensington 62 111 77 89 — — 18 35 Other boroughs 41 70 42 44 - - 1 1 Schoolchildren Kensington 14 51 875 875 3 4 12 28 Other boroughs 25 39 269 269 - - 5 6 Children under 5 Kensington 9 15 28 29 1 1 1 1 Other boroughs 10 19 4 4 - - - - Compulsory Cleansings - - 140 140 - - - - TOTALS 161 305 1,435 1,450 4 5 37 71 In addition to the cleansing of persons referred to above, articles of personal clothing disinfested at the Medicinal Baths during the year numbered 1,447. 10 Disinfection and Disinfestation A summary of the routine work of the disinfecting staff is shown in the following table Houses disinfected after infectious disease 386 ( 573 rooms) Houses disinfested after vermin 679 (1271 rooms) Loads of furniture treated with hydrogen cyanide 251 Total weight of furniture, bedding, etc. dealt with:- 266 tons 0 cwt. 0 qtrs. 13 lb. During the year, 165 new Council flats became ready for occupation, and the furniture of the ingoing tenants was treated with H.C.N. It is the practice of certain foreign countries to prohibit the import of parcels of clothing, unless accompanied with a certificate that the articles have been disinfected. The Council afford facilities to persons desirous of sending clothing abroad, but make a charge of 2/6d. for each certificate provided. During the year, 423 parcels of clothing were disinfected and the income amounted to £52. 17s. 6d. The following table indicates the destination of these parcels:- No. of parcels Hungary 279 Czechoslovakia 47 Russia 6 Argentine 4 Esthonia 1 Jugoslavia 1 + Unknown 85 + All these parcels were dealt with by one Kensington firm of exporters. Prevention of Damage by Pests The Prevention of Damage by Pests Act, 1949, imposes a duty on occupiers of premises to notify the Council of rodent infestation, and the Council are required to ensure that the borough is, as far as practicable, kept free from rats and mice. The Ministry of Agriculture and Fisheries continue to pay a grant of 50% of the approved net expenditure incurred. The Council have agreed to deal with rat and mice infestation in dwelling houses without cost to the occupiers, but expenditure incurred in treating infestations on commercial and industrial premises is recovered. The Council are required to submit reports on (1) 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. So far, such reports have dealt with work carried out in each calender year, but the Minister has requested that the report for 1953, should be extended to cover the fifteen months period ended 31st March, 1954. The following is the report submitted for this period:- 11 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 36,244 7,995 44,272 II. Number of properties inspected by the Local Authority during 15 months ended 31/3/1954 as a result (a) (a) of notification 10 1,165 105 1,280 (b) survey (b) or (c) otherwise 7 122 22 151 (c) - - 95 95 III. Number of properties (under II) + Major found to be infested by rats Minor 1 - - 1 8 375 50 433 IV. Number of properties (under II) found to be seriously infested by mice 3 774 50 827 V. Number of infested properties (under III and IV) treated by the Local Authority 13 959 72 1,044 VI. Number of notices served under Section 4 - (1) Treatment - - - - (2) Structural Works (i.e.Proofing) - 11 - 11 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 - - - - + This major infestation occurred in the garden of premises, owing to the defective condition of a sewer. The sewer was repaired and a course of treatment undertaken, following which the infestation was remedied. 12 On two occasions all the sewers in the borough were dealt with by poison bait, and it was estimated that in the first treatment 5,458 rats were destroyed; and in the second 4,312 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 1,140 Premises inspected following complaints 1,397 Premises where rats were found 360 Premises where mice were found 641 Premises where other vermin were found 126 Premises where no infestation existed 270 Number of visits made 8,121 Number of notices served 55 Premises successfully treated 1,087 Cases in which advice only was given 57 Borough Council properties dealt with 80 Public Mortuary The number of bodies taken to the mortuary during the year was 486. Inquests were held in 79 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. Four complaints of nuisance caused by pigeons were passed to him for investigation during the year. Atmospheric Pollution During 1953, the Council approved the establishment of two atmospheric pollution measuring stations, one at St. Joseph's Convent, Portobello Road, and the other on the roof of Messrs. John Barker & Co. Furniture Depository in Pembroke Road. The apparatus at each station consists of a standard deposit gauge for collecting soluble and insoluble deposits, and a lead peroxide apparatus by means of which the sulphur content in the air can be estimated. Similar action is being taken in other Metropolitan Boroughs and, indeed, throughout the country, and the results obtained form part of an investigation into the problem of atmospheric pollution, now being undertaken by the Department of Scientific and Industrial Research. The examinations have been carried out by the Council's Public Analyst, with the following results:- 13 A. Deposit gauges North Kensington Month 1953 Days exposed Rainfall (ins. ) Total deposits for period in tons per square mile Deposits per day in tons per square mile Soluble Insoluble Total Soluble Insoluble Total September 27 1.5 6.61 9.80 16.41 .245 .363 . 608 October 32 3.57 9.90 10.63 20.53 . 309 .333 .642 November 29 0.44 5.14 8.75 13.89 .177 .302 .479 December 31 0.65 6.11 10.40 16.51 . 198 .335 .533 South Kensington September 27 1.5 6.51 8.36 14.87 .242 .309 .551 October 32 3.2 8.69 12.55 21.24 .272 .392 . 664 November 29 0.27 4.03 6.84 10.87 .139 .236 .375 December 31 0.46 3.99 12.48 16.47 .129 .402 .531 B. Estimation of atmospheric sulphur Estimation of sulphur in grams of sulphur trioxide per day Month 1953 North Kensington South Kensington September 1.28 1.76 October 2.56 3.14 N ovembe r 3.23 3.36 December 3.41 4.39 The Department of Scientific and Industrial Research publish monthly the results obtained from all areas where tests are made, and in the following table the Kensington results are compared with those of a country district, which is mainly rural and with those obtaining in a large industrial town in the north of England. Month 1953 North Kensington South Kensington Country District Industrial District A. B. A. B. A. B. A. B. September .608 1.28 .551 1.76 .236 0.44 .564 2.95 October .642 2.56 .664. 3.14 .214 0.66 .598 4.10 November .479 3.23 .375 3.36 .207 1.53 .587 5.40 December .533 3.41 .531 4.39 .302 1.33 .586 4.86 Column 'A' - Deposits per day in tons per square mile. Column 'B' - Estimation of sulphur in milligrams of sulphur trioxide per day. 14 Whilst it would be premature to draw any conclusions from the Kensington results, one or two general inferences are of interest. For example, there appears to be a relationship between the amount of rainfall and the amount of pollution deposited. The heaviest rainfall occurred in the month of October, in which month the deposit was also greatest; similarly, the least rainfall was in November, when the deposit was lowest. It is also of interest to note that there was more sulphur in the atmosphere above South Kensington than in North Kensington, an explanation for which may well be the geographical position of the two parts of the borough in relation to the Pulham Lots Road and Battersea Power Stations. The figures obtained in Kensington are similar to those in London generally, apart from a few areas where the measuring stations are sited close to power stations and gas works, etc. Survey of fuel-burning plants in the borough Opportunity has been taken during the past few months to make a survey of the larger fuel-burning plants in the borough. Eighty such plants have been inspected and placed into categories according to the type of fuel consumed. The following tables provide a summary of the information obtained, which includes the quantity and type of fuel consumed in an average week during the month of December. Classification of Plants Purpose of plant Fuel Oil Coal Coke Other fuels Total Industrial steam raising 3 12 8 4 27 Industrial other purposes 2 - - - 2 Hospitals and institutions 2 4 - - 6 Space heating, domestic blocks 3 8 18 2 31 Space heating other than above 6 - 7 1 14 Total 16 24 33 7 80 15 Quantities of fuel consumed in an average December week Purpose of plant Fuel Oil Galls. Coal Tons Coke Tons Creosote - pitch Tons Wood Cwts. Industrial steam raising 17,700 184. 15 70 1 Industrial other purposes 1,900 — — - - Hospitals and institutions 2,750 165 — — — Space heating, domestic blocks 1,750 129 166 — _ Space heating, other than above 5,000 - 30 - - Totals 29,100 478 211 70 1 Note: This table does not include particulars of the fuel consumed in one large size plant, three moderate size plants, and one small plant, all of which use gas or electricity, and do not have a direct bearing on the problem of atmospheric pollution. Domestic fires The 1951 Census gives the number of structurally separate dwellings in the borough as 41,390. Some of these are supplied with space heating from central sources, and others may rely on gas or electricity. It is not unreasonable to assume that in 30,000 dwellings coal is burned, and if only 1 cwt. is burned in each dwelling per week, the total consumed in these domestic fires amounts to 1,500 tons per week. This compares with just under 500 tons of coal consumed in industrial buildings. In a recent paper, an expert of the Department of Scientific and Industrial Research stated that only 18% of the total coal consumed in this country is used directly for domestic purposes, most of the remainder being used in industrial and other large-scale installations. But whereas the efficiency of combustion in industrial plants has steadily improved, the domestic use of coal has not improved to anything like the same extent. Consequently, each ton of coal burned in a domestic fire produces on an average two or three times as much smoke as each ton burned in industrial furnaces. It is estimated that over the country as a whole, the proportion of smoke contributed annually by domestic fires represents at least 40% of the whole; in winter the proportion rises to about 60% or possibly more in some areas, including London. It seems clear, therefore, that in any consideration of the atmospheric pollution problem in the borough, the part played by the domestic consumer cannot be overlooked. 16 Action taken in regard to smoke nuisances During the year 1953, there were 14 complaints of smoke nuisance, as a result of which 71 observations were made. The premises concerned comprised 3 separate large blocks of flats (two privately owned and one municipally owned), two departmental stores, one hospital, and one restaurant. Remedial measures were secured in all cases by informal action, with the exception of one case where it was necessary to serve a formal notice. 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. Since the 5th July, 1948, the Council have arranged the burial of 248 persons under Section 50 of the National Assistance Act, 1948, which empowers the Council to recover the funeral expenses from a liable relative or the estate. The work involves visiting and examining rooms (not necessarily in Kensington, and sometimes while the body is still there); making inventories; searching for Wills or traces of next-of-kin, taking possession of money, valuables, insurance policies, etc; interviewing relatives and others; interviewing hospital authorities, registrars and police, and dealing with correspondence, etc. Most of these cases are destitute and friendless, and the rooms are often indescribably filthy and infested. For example, H.M. Coroner asked the Public Health Department to bury an old man who had been found dead by the police in a room in North Kensington. On examining the room-which measured about 10' x 8' - it was found to be full of junk such as tins, bottles, newspapers, rags, old iron, etc. and on the floor was a "carpet" of filth several inches deep. On turning over some rags, the officers of the department, accompanied by the owner of the premises, noticed some tobacco tins fastened (by wire and rope) inside an old mackintosh. These tins were found to contain treasury notes. This discovery meant that every inch of the room, and every article therein, had to be examined. The filth was shovelled up into baskets by Council workmen, under supervision, and the contents of each basket were carefully sifted before being loaded into a dustcart. More money and a large number of National Savings Certificates were found, but there was nothing else of value in the room. The estate in this case amounted to £666, which was, of course, passed to the Treasury Solicitor after deducting funeral expenses. Each case has its own peculiarities; some are disposed of easily and quickly but others take months to settle. In the twelve months ended 31st December, 1953, the Council became responsible for the burial of twenty-five persons dying in the borough. The following is a summary of the action taken:- 17 (a) Cases where the Council's funeral expenses have been fully recovered 14 (b) Cases where -part only of the expenses has been recovered 7 (i) Number of these where balance of expenses will be recovered 2 (amounting to £15. 4s. 8d.) (ii) Number of these where there is no estate or "liable" relative 4 (iii) Number of these where "liable" relatives are unable to contribute 1 (c) Cases where full cost has been borne by the Council 4 (i) Number of these where there is no estate or "liable" relative 4 Amount recovered by end of year £177. 18. 10d. Additional amount expected to be recovered 15. 4. 8d. £193. 3. 6d. Irrecoverable 81. 6. 6d. Total cost £274. 10. Od. It is of interest to note that of the twenty-five cases dealt with, only six were eligible for a Death Grant from the Ministry of National Insurance. The total amount recovered from this source amounted to £36. 6s. Od. (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 1953, there were two hundred and twelve Kensington cremations, in comparison with one hundred and ninety-eight in 1952 and 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 thirty one examinations were made. Dog Nuisance Campaign Apart from being an objectionable social offence, fouling 18 of footways by dogs is a public health nuisance for which an adequate remedy is hard to find. While it has been shown that dogs can carry and excrete germs capable of producing illness in man, it is seldom that cases of human disease can positively be related to infections originating from this source. Nevertheless, such instances do occur and the potential risk cannot be ignored. Certainly dog filth is an attraction to flies and blowflies, with consequent possibilities of conveyance of infection. The main objection, however, to the fouling of pavements and grass verges by dog excreta is the nauseating revulsion, embarrassment and distress caused by chance pollution of shoes, clothing, mats and carpets, necessitating disgusting and timeconsuming cleansing operations. Many complaints from residents were received at the Public Health Department and several letters on the subject had appeared in the local press. Detailing sanitary inspectors to watch for offenders proved unrewarding in view of the expenditure of the time of officers who could be ill-spared from more urgent duties, and the relatively few offenders who could be caught as accessories before, during or after the act. Even a survey of "dirty spots" and concentration of observation thereon failed to secure the detection of offenders, the main reason being that so many dog attendants take their charges out under the cover of darkness, in the evening and early morning. The more disinterested merely turn them out to evacuate unaccompanied. In these circumstances, it was decided to repeat an anti-dog nuisance educational campaign which had been successful some four years before. Attempts were made to focus attention on the project by means of posters, displayed on hoardings, Council vehicles and other suitable sites, by cryptic advertisements in the Personal columns of the local newspapers, and by handbills which were widely distributed. The Press were most helpful and co-operative, giving full accounts of the project and reinforcing the campaign by most encouraging articles. The campaign was further publicised by book-marks distributed with each volume borrowed from the four public libraries. The shop window displays were arranged in seventeen pet shops by courtesy of the proprietors. They consisted of the exhibition of posters, handbills and booklets on dog training and prizes consisting of dog foods and dog requisites, which were to be won by successful competitors in a Competition. This Competition was a simple one, involving the placing of twelve different breeds of dogs in order of popularity. Entry cards were distributed from Council offices, pet shops and at demonstrations. Prizes were supplied by the makers of proprietary dog foods on a most generous scale, which permitted of worth-while awards to thirty-four entrants. These firms also kindly supplied exhibition material and gave most valuable advice and co-operation in planning the campaign. The local byelaw to deal with this nuisance provides that:- "No person being in charge of a dog shall allow the animal to foul the footway of any street or public place by depositing its excrement thereon. For the purpose of this byelaw the owner of the dog shall be deemed to be in charge thereof, unless the Court is satisfied that at the time when the dog fouled the footway it had been placed in or taken into the charge of some other person." 19 During the year seven summonses were issued under this byelaw. In all cases convictions were obtained and fines totalling £3. 5s. Od. were imposed. In one of these cases the defendant was ordered to pay the Council 5s. Od. costs. Health Handbook During the year, the Council, on the recommendation of the Public Health Committee and the General Purposes Committee, decided to issue a "Health and Social Services" handbook for the use of official and voluntary bodies and members of the general public in Kensington. The work of preparing the handbook was undertaken jointly by the Town Clerk's and Public Health Departments. The booklet, which comprises seventy-two pages, was published at the end of the year; 10,000 copies were printed at a cost of £330. Copies were distributed to all Members of the Council, local Members of Parliament and London County Council Representatives, Justices of the Peace, Government Departments, hospitals, general practitioners, dentists, chemists, voluntary bodies, schools, infant welfare centres, day nurseries, old people's clubs, etc. and to ratepayers calling at the Town Hall (Information Office), Public Health Department, Citizens' Advice Bureau and Public Libraries. Publications During the year the following articles emanated from the Public Health Department and were published as indicated:- "Dirty Dogs" by J. H. Weir and W. C. Turner "The Medical Officer", 29th August, 1953. "Housing Priorities" by J. H. Weir "Public Health", October, 1953. "An outbreak of Pood Poisoning due to C1. Welchii" by A. Beck, A. W. H. Foxell and W. C. Turner "British Medical Journal", 20th March, 1954. Census 1951 The Registrar-General has published a Census report on the County of London in respect of the living population enumerated as at midnight 8th-9th April, 1951. The report contains details of all the metropolitan boroughs and it will be of interest to the Council to deal with the features revealed by the Census peculiar to Kensington. The Registrar-General gives the population for the borough and the various wards as set out in the following table:- 20  1931 1951 Total Persons Total Persons Males Females Acreage Densit (Person per act Whole Borough 180,667 168,160 72,112 96,048 2,290 73.4 Wards:- St. Charles 28,991 25,835 12,123 13,712 400 64.6 Golborne 23,682 14,493 7,036 7,457 113 128. Norland 21,620 16,672 7,755 8,917 195 85.5 Pembridge 20,425 18,947 8,047 10,900 193 98.2 North Kensington 94,718 75,947 34,961 40,986 901 84.3 Holland 18,981 20,537 7,950 12,587 485 42.3 Queens Gate 14,486 14,173 5,541 8,632 173 81.9 Earls Court 18,405 20,603 8,409 12,194 244 84.4 Redcliffe 21,527 23,815 9,578 14,237 271 87.9 Brompton 12,560 13,085 5,673 7,412 216 60.6 South Kensington 85,959 92,213 37,151 55,062 1,389 66.4 London 4,397,003 3,347,982 1,565,888 1,782,094 74,850 44.7 It will be seen that in the inter-censal period between 1931 and 1951, the population of North Kensington decreased from 94,718 to 75,947; whilst the population for South Kensington increased from 85,959 to 92,213. The ward populations in the southern half of the borough all show an increase with the exception of the Queens Gate Ward which showed an inter-censal diminution of 313 persons. All the wards in the northern half of the borough showed a decrease in population particularly the Golborne Ward. Notwithstanding this marked reduction, the Golborne Ward has the highest percentage of population in the whole of London living at a density of more than two persons per room (12.750 and, furthermore, has the highest average number of persons per room, viz. 1.13. The following table shows the number of persons per acre in the various wards and the density of occupation:- Area Persons per acre Density of occupation Persons per room Percentage of persons at more than 2 per room London 44.7 0.83 2.5 Kensington 73.4 0.82 4.6 St. Charles 64. 6 0.98 5.8 Golborne 128.3 1.13 12.7 Norland 85.5 0.95 5.6 Pembridge 98.2 0.87 4.4 Holland 42.3 0.68 1.7 Queens Gate 81.9 0.67 1.3 Earls Court 84.4 0.75 1.9 Redcliffe 87.9 0.77 2.9 Brompton 60.6 0.68 5.5 21 The following table shows the birthplaces and nationalities of the population of Kensington as revealed by the Census. It is interesting to note that of the Kensington residents in April, 1951, only 64,590 (or 38%) were returned as having been born in London. The number of "true" foreigners in the borough on Census night was 18,283 (or 11%). Birthplaces and Nationalities of population of Kensington Males Females Total England 49,334 65,223 114, 557 Wales 1,889 2,907 4,796 Scotland 2,159 3,557 5,716 Northern Ireland 579 846 1,425 Irish Republic 3,510 5,672 9,182 Isle of Man and Channel Islands 111 200 311 Commonwealth Countries 2,657 4,387 7,044 Colonies, etc. 1,403 1,035 2,438 Foreign Countries 8,641 9,642 18,283 Born at sea 11 26 37 Not stated 658 893 1,551 Total 70,952 94,388 165,340 Visitors 1,160 1,660 2,820 Grand Total 72,112 96,048 168,160 The following table shows the population distribution in regard to marital condition, age and sex ratio, (i.e. the number of females per 1,000 males) compared with the County of London:- Population Distribution by Marital Condition, Age and Sex Ratio Area Percentage Distribution of Population Sex Ratio (Females per 1,000 Males By marital conditions By age Single Married Widowed and Divorced 0-4 5-14 15-44 45-64 65 and over London 42.4 49.0 8.6 8.1 11.5 45.3 24.0 11.1 1,138 Kensington 47.7 42.3 10.0 6.4 8.3 49.7 24. 6 11.0 1,332 The County of London Census Report gives interesting details regarding private households. These are defined as comprising single persons living alone or groups of individuals voluntarily living together under the same menage in the sense of sharing the same living room or eating at the same table. The number of private households in Kensington revealed by the Census was 60,718. The following table shows these households in relation to marital conditions, age and sex of the head of the household compared with the County of London:- 22 Private Households by Marital Condition, Age and Sex of Head Area Total Households Percentage of households with heads as follows - Married Non-married under 40 years either sex Non-married males aged- Non-married females aged- 40-59 60 & over 40-59 over London 1,120,710 68.5 5.0 2.9 3.3 7.6 12.7 Kensington 60,718 54.5 14.0 3.9 2.6 11.3 13.7 The following table gives the private households, showing the number of persons in the number of rooms occupied per household Private households related to persons and rooms occupied Number of persons in household Number of households occupying the following number of rooms 1 2 3 4 5 6 Over 6 1 11,595 4,126 2,364 843 322 167 195 2 3,076 5,375 5,090 2,467 1,011 614 584 3 524 2,440 3,226 2,166 971 572 701 4 132 1,111 1,708 1,549 727 472 631 5 28 333 635 806 442 309 544 6 3 122 228 437 221 168 348 7 - 24 72 227 114 89 187 8 1 11 27 75 69 35 101 9 - 6 8 43 32 24 52 Over 9 - 4 9 28 35 12 50 TOTALS 15,359 13,552 13,367 8,641 3,944 2,462 3,393 Below is shown the room density of private households. Persons per room Households Persons Number Percentage Number Percentage Over 3 218 0.4 1,143 0.8 3 and over 2 1,174 1.9 5,649 3.8 2 and over 1½ 5,487 9.0 18,520 12.4 1½ and over 1 5,930 9.8 24,570 16.7 1 or less 47,909 78.9 98,493 66.3 TOTALS 60,718 100% 148,375 100% 23 The following table shows the housing of private households in Kensington compared with London indicating the structurally separate dwellings, the number of households and the density of occupation of rooms Housing of Private Households Structurally separate dwellings:- London Kensington (i) Number 820,918 44,043 (ii) Percentage increase since 1931 census 9.6% 41.6% (iii) Percentage vacant and unfurnished 1.0% 2.1% (iv) Rooms per dwelling - a. 1951 census 4.76 4.37 b. 1931 census 5.75 6.80 (v) Percentage with 1 or 2 rooms only 13. 2% 27.4% Households (i) Number 1,120,710 60,718 (ii) Percentage increase or decrease since 1931 5.8% decrease 27.2% increase (iii) Percentage sharing a dwelling 47-8% 43.7% (iv) Rooms per household 3.39 2.98 (v) Percentage occupying 1 or 2 rooms only 28.6% 47.6% (vi) Persons per household 2.82 2.44 (vii) Percentage of 1 person households 19.7% 32.3% Density of Occupation (i) Persons per room 0.83 0.82 (ii) Percentage of population at density- a. over 2 per room 2.5% 4.6% b. over 1½ per room 12.2% 17.1% (iii) Percentage of households at density- a. over 2 per room 1.4% 2.3% b. over 1½ per room 7.6% 11.3% Included in the general Census enquiry was a request for information regarding water supply, cooking arrangements, the existence of kitchen sinks, water closets and fixed baths in each household. The following table gives figures for Kensington compared with those for London as a whole:- 24 Household Domestic Arrangements Kensington Lond on Piped water Households sharing 21,224 35% 332,939 31% without 210 9,157 Cooking stove Households sharing 4,061 19% 57,854 6% without 7,706 35,947 Kitchen sinks Households sharing 6,576 25% 117,461 16% without 8,301 67,311 Water closets Households sharing 24,478 41% 388,473 35% without 188 2,774 Fixed baths Households sharing 18,071 52% 205,575 62% without 13,422 488,206 Households with exclusive use of all five arrangements 23,005 or 38% 375,248 or 33% Generally In looking at the above tables, the essentially residential character of Kensington should be borne in mind when making any comparison with the figures in respect of any other borough. 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. Four 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 revised pamphlet giving all the necessary information for distribution to old people individually or through their clubs. S.O.S cards During the year window display cards were provided bearing 25 the letters "S.O.S" in red on one side and, on the reverse side, directions how the use the card and particulars of nextof-kin, nearest relatives and local social services. These cards were distributed to appropriate old people with instructions how to use them. Any person seeing one of the cards in a window would be able to summon help from one of the sources given on the back of the card. The local press generously assisted in making this service known. Grants to Clubs, 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 £100 towards their general expenses in providing meals, including replacement of equipment. (b) The Quest Old People's Club were granted £3° 0s„ Od. for the purchase of gramophone records. (c) The Kensington Communal Kitchens Service were granted £200 as a contribution towards the cost of operating a Meals-on-Wheels service in co-operation with the Kensington Women's Voluntary Services. Holidays In April, 1951, the Council approved a scheme under which the Family Welfare Association co-operate in arranging holidays for old people. An application for a holiday is made to the Medical Officer of Health, who investigates the applicant's circumstances, and an assessment is made in accordance with an approved scale of the contribution towards the expenses which the old person is required to make. When the application is approved it is referred to the Family Welfare Association, who make all the arrangements for a holiday. The Association apply to the Council for reimbursement of expenses after deducting the contribution from the old person. The Family Welfare Association were unable to continue this work because of various difficulties which have arisen. These include the non-reimbursable expense involved; numerous visits to old people caused by their not replying to correspondence, failing to collect travelling tickets or cancelling applications; difficulty in finding escorts (escorts are necessary for about half the applicants); difficulty in booking ground or first floor rooms at holiday homes during the holiday period; difficulty in booking travelling reservations during the holiday period; and the reluctance of old people to go on holiday except in warm weather. The Council found it necessary to review the holiday scheme and approved the following revised arrangements. Block bookings of ground and first floor rooms for June 26 were made at two holiday homes, Lennox House, Southsea, and St. Mary's Home, Dover. Private coaches were hired to take the old people to and from these homes, and convenient assembly points in the borough arranged. The Family Welfare Association undertook the work, including the bookings at the holiday homes and the hire of coaches, and the Council paid towards their administrative expenses the sum of five shillings for each person for whom a holiday was arranged. Where the arrangements were for a family of two or more persons only one payment of five shillings was made. Applications for holidays continued to be investigated by the Medical Officer of Health, assessed in accordance with the approved scale, and passed to the Family Welfare Association to make all arrangements. The following is a summary of work carried out in 1953:- Total applications received 112 Unsuitable on medical grounds 11 Consideration deferred 19 30 Number approved 82 Cancellations after approval 16 Number sent on holiday 66 Number sent to Lennox House 41 Number sent to St. Mary's Home 25 Contributions by applicants £ 57. 12s. Od. Cost of holidays to the Council 4 26. 15s. 8d. Booking fees paid to Family Welfare Association 14. 15s. Od. 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 the old people's belongings are being dealt with at the disinfecting station. Forty-one old people were dealt with in 1953. Cleansing of Old People One of the problems arising in the work of caring for old people is the number of old people found to be living alone and 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. The powers of the Council to cleanse persons were limited to verminous or suspected verminous persons (apart from special provision for common lodging houses). These powers were not so wide as those for dealing with the cleansing of articles. Representations were made to the Metropolitan Boroughs' 27 Standing Joint Committee who agreed that it was desirable for extended powers to be given to metropolitan borough councils to provide for the cleansing of persons in such a filthy, dirty or unwholesome condition that their health is affected or endangered, subject to the person's consent being obtained. The London County Council were approached and agreed to promote legislation to this effect. On 31st July, 1953, Royal Assent was given to the London County Council (General Powers) Act, 1953, Section 43 of which provides that - 1. Where it appears to a sanitary authority upon a report from the medical officer of health or a sanitary inspector for their district that any aged person within their district - (a) is verminous or is for any other reason in need of cleansing in order to prevent injury or the danger of injury to health; and (b) is so enfeebled that he is unable to avail himself of any facilities for cleansing himself provided by the authority under any enactment or to cleanse himself properly; the authority may on the application or with the consent of that person (but not otherwise) cause him to be cleansed free of charge at the place where he resides or at any other suitable place. 2. A sanitary authority may make all such arrangements and provide all such apparatus and things as may be necessary for the convenient exercise of the powers conferred by the foregoing sub-section. 3. This section shall be read and construed as one with Part III of the Public Health (London) Act, 1936. The Council authorised the Medical Officer of Health to arrange for the cleansing, including bathing in their own homes, of old people. In cases where the absence of bathing apparatus and other household amenities present difficulties, a specially adapted vehicle is used to convey the old people to the Council's personal cleansing station, where in addition to bathing, the clothing can be disinfested where necessary. During the year twenty-eight old people were cleansed. 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 people through the intervention of the Women Health Officers, who act as liaison officers in these respects. During the year it was possible to arrange for sixty old people to be admitted to hospitals for institutional treatment and, in addition, twenty-six cases were admitted to homes for the aged. Laundry At present no direct authority exists for the Council to 28 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 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 him to be necessary under the terms of Section 122 of the Public Health (London) Act, 1936. In sixty-four cases action was taken under the Section. 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 five hundred and sixty-two separate collections of laundry were made under this scheme, and the number of articles cleansed totalled five thousand, five hundred and two. 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 the Women's Voluntary Services mobile library. Chiropody During the year, the Council made a grant of £96 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 thirty to forty 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 one hundred and sixty-seven and the number of treatments given was four hundred and twenty. 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 financial effect since it was taken over by the 29 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 Year 1953/54 39,196 - Not yet available - It will be observed that the number of meals served is growing and that the net cost is substantial. Until this year the deficiencies had 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, and a grant of £200 was made to the Kensington Communal Services for 1953/54. 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 Council's Women Health Officers in connection with the care of old people during the year 1953:- Cases on register at the beginning of year 4,949 New cases added to register 423 Cases removed to hospitals 60 Cases removed to homes (voluntarily) 26 Cases removed to homes (compulsorily) — Cases removed from district 35 Number of deaths 234 Total number of cases remaining on register at end of year 5,017 Number of old people sent away for holiday 66 Number of old people provided with Council's laundry service 64 Number of old people provided with "Meals on Wheels" 339 Cases referred to National Assistance Board 97 Cases referred for assistance from Home Help Department 122 Cases referred for assistance from Voluntary Organisations 41 Cases referred to Recreational Clubs 183 Cases assisted with provision of medical and nursing care 104 Cases referred to home chiropody service 167 Cases cleansed at Medicinal Baths 28 Cases where disinfestation was carried out 41 Number of initial home visits made 1,795 Number of re-visits 2,387 Number of other visits made in connection with old people, including visits to clubs 232 Number of interviews, enquiries, etc. on behalf of old people 1,005 30 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 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 hospitals, etc., as provided by the National Assistance (Amendment) Act, 1951. Although many cases were investigated during the year, in no case was formal action taken to secure compulsory removal. SANITARY INSPECTION The following table shows a summary of the inspections etc., carried out by the sanitary inspectors during the year 31 Public Health (London) Act. 1936 Houses inspected on complaint 4,051 Houses inspected after infectious disease 3,221 Re-inspections 14,210 Smoke observations 71 Other inspections 2,748 Housing Act, 1936 Initial inspections (including preparation or revision of house-to-house cards) 395 Re-inspections 143 Inspections in regard to overcrowding 1,361 Underground Living Rooms Primary inspections 181 Re-inspections 856 Drainage Applications 590 Plans submitted 223 House drains tested and inspected 5,622 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 2,044 Statutory notices 1,042 Pinal notices 455 Various Notice of intention to enter premises for inspection 67 Rent Restrictions Act certificates 9 Report of waste water to the Metropolitan Water Board 107 Report of dangerous structures to the London County Council 91 Other notices 119 The following is a summary of works completed under the supervision of the sanitary inspectors during the year 32 House drains, reconstructed or repaired 250 House drains cleansed 179 Water closets, reconstructed or repaired 179 Water closets, new provided 299 Soil pipes, vent pipes, repaired etc. 60 Soil pipes, vent pipes, new provided 122 Baths, new provided 245 Sinks, new provided 197 Lavatory basins, new provided 635 Waste pipes, new provided 319 Cisterns, cleansed 7 Cisterns, covered 4 Taps fixed on rising main 7 Yards and areas paved, drained etc 30 Dustbins provided 76 Accumulations of filth, etc. removed 123 Roofs repaired 664 Houses provided with water above basement level 14 Dampness in dwellings remedied' 957 Houses disinfected after infectious disease (including bedding, etc.) 386 Rooms in such houses, disinfected after infectious disease 573 Houses cleansed under Houses let in Lodgings Byelaws 7 Cleansing of houses not on register 40 Verminous houses cleansed (including bedding, clothing, etc.) 679 Verminous rooms in such houses, cleansed 1,272 Dirty bedding, cleansed 60 Dirty bedding, destroyed 11 Other sanitary works executed 2,840 HOUSING Inspection of dwelling houses during the year (i) (a) Dwelling houses inspected for housing defects (under Public Health or Housing Act) 9,209 (b) Inspections made for the purpose 27,166 (ii) (a) Dwelling houses (including those under sub-head (i) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 395 (b) Inspections made for the purpose 538 (iii) Dwelling houses found not to be in all respects reasonably fit for human habitation 2,044 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 (iii) Dwelling houses rendered fit by the Council in default of owners under Section 10 - 33 (b) Action under Sections 11 and 13 of the Housing Act, 1936:- (i) Dwelling houses in respect of which demolition orders were made 1 (ii) Dwelling houses demolished in pursuance of demolition orders 2 (iii) Dwelling houses in respect of which closing orders in lieu of demolition orders, were made 6 (iv) Dwelling houses in respect of which demolition orders were cancelled and closing orders substituted 5 (v) Dwelling houses in respect of which undertakings were accepted from owner to render premises fit for habitation 2 (vi) 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 (41 premises (82 rooms (ii) Separate tenements or underground rooms in respect of which closing orders were determined, the tenements or rooms having been rendered fit (41 premises (70 rooms (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 (21 premises (37 rooms (iv) Separate tenements or underground rooms in respect of which the Council accepted undertakings from owners to render fit within specified time (3 premises (5 rooms (v) Number of undertakings by owners to render separate tenements or underground rooms fit, which were cancelled, the necessary works having been completed (3 premises (4 rooms (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 2,044 (ii) Number of Statutory Notices served 1,042 (iii) Number of Summonses issued 198 Rent and Mortgage Interest (Restrictions) Acts Eleven applications were made to the Council during the year for certificates of unfitness for habitation under these Acts; nine were granted, but in the other two, the conditions found did not justify the issue of certificates. 34 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. This application was granted. The provision of new housing accommodation The post-war new housing schemes completed or being erected in Kensington by the Council are summarised as follows:- Dwellings Henry Dickens Court 328 Balfour of Burleigh Estate 120 Portobello Court 158 Denbigh Road/Westbourne Grove 102 Holland Street 32 Kelfield Court 18 St. Columbs House, Blagrove Road 16 Allom House, Walmer Road 40 Barlow House, Walmer Road 32 Hudson House, St. Marks Place 12 Corbett House, Cathcart Road 15 Galsworthy House, Elgin Crescent 16 Liddiard House, Lansdowne Road 8 Hunter House, Old Brompton Road 15 Finborough Road (two schemes) 22 Orpen House, Trebovir Road 8 Wornington Road 9 11 and 29, Chepstow Crescent 16 319, Ladbroke Grove 9 Salter House, Silchester Road 15 Cornwall Crescent, Blenheim Crescent 10 Other schemes for building new housing accommodation 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 1953:- Elgin Mews (28 premises) 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 February, 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. 35 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 occupants have been rehoused and the purchase of the properties has been completed. Demolition will be undertaken in due course. Munro Mews (24 premises) This area was made the subject of a Compulsory Purchase Order on the 1st May, 1951. The Order 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. Before the Minister of Housing and Local Government could decide whether to confirm the Order or not, the owners demolished all the properties except one small house. No further action is necessary. East Mews Road (14 premises) This area was made the subject of a Compulsory Purchase Order on the 17th July, 1951, and the Minister of Housing and Local Government confirmed the Order, subject to the modification that certain land and a warehouse, at the rear of one of the dwellings, were excluded from the clearance area. The Minister authorised the Council to purchase the excluded land and building under Section 27 of the Housing Act, 1936. By the end of the year, the Council were completing purchase of the properties and the vacation of the dwellings. 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 and to settle the amounts to be paid under Section 42. St. Lukes 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 36 modified the Order, on the 13th December, 1952, to exclude seven properties. In addition he directed that payments under Section 42 of the Housing Act, 1936, should be made by the Council in respect of two other premises in the area. Steps are being taken to secure the vacation of the premises confirmed for clearance purposes, and to settle the amounts to be paid under Section 42. Portobello Road (4 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. The premises were vacated during the year and, in default of the owners, the Council carried out the demolition of the properties. 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. During 1953, the Council gave further consideration to the question of dealing with the Treverton Street Area, and eventually decided to proceed with the acquisition of part of the area under Part V of the Housing Act, 1936, instead of waiting to deal with the area as a clearance area under Part III of the Act. On the 13th October, 1953, the Council made a formal Compulsory Purchase Order in respect of the following ninety-one premises:- Treverton Street Nos. 14-60 even 1- 63 odd Ladbroke Grove Nos. 329-339 odd Rayraede Street Nos. 1-17 consecutive Hewer Street Nos. 1-12 consecutive Exmoor Street No. 5 Following a public enquiry, the Minister of Housing and Local Government confirmed the Order without modification. Restriction of Redevelopment of Clearance Areas Section 26(5) of the Housing Act, 1936, provides that when a Clearance Order has become operative, no land to 37 which the Order applies shall be used for building purposes, or otherwise developed, except subject to such restrictions and conditions, if any, the Borough Council may think fit to impose. Aggrieved owners have a right of appeal to the Minister of Housing and Local Government. Clearance Orders became operative in respect of the following three areas:- Portobello Road Nos. 423-429 odd Powis Mews Nos. 1-13 consecutive St. Lukes Mews Nos. 30-42 even 41-51 odd It was felt that the erection of accommodation for dwelling purposes should not be permitted in these three areas, but that possibly the land might be used for private garages, warehouses, community halls and club houses. Alternatively, certain types of factories might be permitted provided there was no nuisance from noise, vibration or any such cause, and that no building should be permitted to have more than two storeys and, preferably, not more than one. Although the County Council are able generally to control development under the Town and Country Planning Act, 1947, the Borough Council decided to impose the following restrictions on the use of the land included in the above three clearance areas:- The land shall not be developed by the erection thereon of- (i) accommodation for dwelling purposes; (ii) factories from which a nuisance by noise, vibration, or any similar cause might arise; or (iii) buildings of more than two storeys in height. 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 refused. 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 4. As in Category 3, but without special medical circumstances. 38 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 4 have not been reported but records have been made and the families are kept under observation by the sanitary inspectors who try and secure abatement by persuasion. One hundred and one new cases were dealt with in 1953 by the Special Sub-Committee as follows:- (a) Recommended for alternative accommodation by the Council 64 (b) Proceedings ordered to be taken without prior offer of alternative accommodation 5 (c) Action postponed 32 The total number of cases of overcrowding abated during the year was one hundred and four and, in addition, seventyeight Category 4 cases were also abated during the year. Since the war, the Special Sub-Committee have dealt with one thousand and twenty-eight cases of overcrowding under Categories 1, 2 and 3, and no fewer than seven hundred and ninety-nine of these have been abated. Assessment of Housing Priorities on Medical Grounds During the year three hundred and thirty-six 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 fifty-one cases, recommendations for re-housing on medical grounds were also made to the London County Council, and to other local authorities in five cases. Hostels In recent 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. With the consent of the Minister of Housing and Local Government, the Council 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:- 39 Registration and inspection Space per head and separation of the sexes Prohibition of underground rooms for sleeping purposes Cleanliness of premises and furnishings Ventilation, washing facilities and sanitary accommodation Infectious disease precautions By the end of the year, fifty-three hostels had been registered under the byelaws. Six notices were served requiring the remedy of certain defects and deficiencies. Accommodation for Costermongers The general condition of mews dwellings in the borough has received much attention from the public health viewpoint for many years. In certain of the mewsways occupied by persons of the street trading class, the stable accommodation is used for storage, etc., and difficulties constantly arise owing to the nature of the businesses carried on. In connection with the policy of clearing unsatisfactory mews dwellings, the Council appreciated that street traders must have storage accommodation for their horses, vehicles, barrows and goods. Accordingly, the London County Council were requested to promote legislation to enable the Borough Council to provide accommodation for costermongers, who might be displaced from unfit mewsways. Since 28th July, 1950, special legislation has enabled the Kensington Council to provide and maintain storage and stabling accommodation for use by street traders and other like persons displaced by reason of the exercise by the Council of their powers under the Housing Acts, 1936/49, or by the acquisition of lands under any other enactment. Plans for erecting costermongers' stabling and storage accommodation in Gadsden Mews have been prepared by the Borough Engineer and the building operations are now proceeding. 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 1953:- Inspections Premises Number on Register Number of Inspections Number of Written Notices Factories in which Sections 1, 2, 3, 4 and 6 are enforced by the Council 228 274 14 Factories in which Section 7 is enforced by the Council (not included above) 561 931 39 TOTALS 789 1,205 53 40 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 5 3 - _ Overcrowding - - - - Unreasonable temperature - - - - Inadequate ventilation - - - - Ineffective drainage of floors - - - - Sanitary conveniences:(a) insufficient 6 3 _ - (b) unsuitable or defective 42 30 _ 4 (c) not separate for sexes 3 2 - - Other offences (not including offences relating to Homework) - - - - TOTALS 56 38 - 4 During 1953, no prosecutions were instituted under the Factories Act, 1937. Outworkers The following table shows the nature of the work carried out by the one hundred and thirty-seven home workers on the register of outworkers during 1953:- Nature of work Number Wearing apparel-making, etc 99 Artificial flowers 12 Paper bags, etc. 5 Carding etc. of buttons, etc 2 Stuffed toys 10 Cosaques, crackers, stockings, etc. 4 Furniture and upholstery 3 Lampshades 1 Brass articles 1 137 During the year, three hundred and thirty-seven 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. Subject to certain exceptions, the Act makes it unlawful 41 to use prescribed filling materials except on premises registered by a local authority. The exceptions are in the remaking and reconditioning of any article or 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. At the end of the year, there were nineteen registered premises in the borough. The Act further provides that no rag flock shall be delivered to registered premises except from premises licensed for manufacturing rag flock or used as a store for rag flock. A local authority on receiving from the occupier of premises an application for the grant or renewal of an annual licence authorising him to manufacture rag flock or to use his premises as a rag flock store, may grant or renew the licence on payment of a fee of one pound. No licenses have been issued in Kensington. If on registered premises there are unclean filling materials, the occupier shall be guilty of an offence; and it is also an offence to sell or offer for sale any article which is upholstered with unclean filling materials (secondhand articles are excepted.) Fifteen samples of rag flock and other fillings were taken during the year with the following results:- Description No. of samples taken Satisfactory Unsatisfactory Remarks Feathers and down 1 - 1 Impurities exceeded maximum permitted. Occupier warned. Hair 1 1 - Fibre 1 1 - Rag flock 5 4 1 Impurities exceeded maximum permitted. Premises not registrable under Act. Cotton felt 1 1 - Coir fibre 3 3 - Woollen mixture felt 2 2 — Algerian fibre 1 - 1 Contained insects mites and larvae. Disinfested by Council. Premises not registrable under Act. 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. 42 During the year, seven 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. SUPERVISION OP POOD SUPPLIES General There are no abattoirs or slaughterhouses in the borough and no killing of animals for human consumption is carried out. An application was received during the year for the renewal of a licence to slaughter animals for human consumption outside Kensington. This application was from a man who had previously been licensed by a Rural District Council and who had taken up residence in Kensington. His application was granted in accordance with the Slaughter of Animals Act, 1933. Inspection of Food Premises In Circular 1/54, dated 12th January, 1954, the Ministry of Health have asked for details of food premises in the borough and the number of inspections made during the year. Premises, where food is prepared, stored or exposed for sale for human consumption, are frequently inspected. The following is a record of the inspections made by the sanitary inspectors engaged on this work for 1953:- Premises registered under - No. of premises No. of Inspections (1) Section 14, Food and Drugs Act, 1948- (a) for the sale, or the manufacture for the purpose of sale, of ice-cream, or the storage of ice-cream intended for sale 316 121+ (b) for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale 154 218 (2) Milk and Dairies Regulations, 1949- (a) as dairies 82 319 (b) where the occupier is registered for the sale of milk in sealed containers only 94 321 + Additional inspections of the premises (not primarily in connection with the sale of ice-cream) are recorded under different headings in the following table. 43 Food premises (all categories) No. of premises No. of inspections Bakehouses - underground 15 114 " - others 16 57 Bread and cake shops 45 103 Butchers 78 382 Dairies 82 319 Fishmongers 47 98 Food factories 6 29 General stores 10 192 Greengrocers 115 94 Grocers 239 451 Ice-cream 316 121 Preserved food 26 37 Public houses and off- licences 161 135 Restaurants and cafes 263 666 Sweet shops 164 80 Street stalls and storage premises 88 (licensed traders.) 134 Clean Food Campaign The London County Council's Byelaws for the protection of food came into force on the 3rd November, 1952, and with a view to securing the maximum co-operation of food traders in the borough, the Medical Officer of Health and the Chief Sanitary Inspector met representatives of various groups of traders to discuss the implications of the Byelaws on their particular trades. An exchange of views resulted in agreement on a number of points which were ultimately incorporated in a list of practical suggestions sent, together with copies of the Byelaws and explanatory notes on specific matters, to all food traders in the borough. The explanatory notes dealt with food handling and disease and the protection of food at all stages from contamination. The Council's Sanitary Inspectors undertook special inspections with the object of discussing individual problems with the traders and offering suggestions for securing compliance with the Byelaws. In view of the educational and co-operative character of the work, the service of notices was avoided but as an alternative, informal letters incorporating the suggestions of the inspector were sent where appropriate. One thousand, nine hundred and ninety-nine inspections were made for this specific purpose and two hundred and eightythree letters of the type referred to were sent. In a large number of cases, however, the immediate response of the traders to the suggestions offered, rendered unnecessary any further action. Particular attention was given to the protection of food from contamination by the public and the provision of glass screens to counters was encouraged. In one multiple chain store, foods displayed in the cafeteria were entirely enclosed 44 with perspex, whilst three other similar trading concerns first imitated and then improved on these fitments in their own establishments. The food stores reorganised their methods of display and sale so as to ensure that all food stuffs are displayed and sold in protected coverings, whilst another group of shops provided total covering to 75% of their commodities. Several shops introduced refrigerated show cases and in every case the traders concerned claimed to have increased their food turn-over, thus demonstrating the response of the public. Much remains still to be done. In the case of a large multiple store, it was possible to arrange, through the co-operation of the St. John Ambulance Brigade, for the Medical Officer of Health, the Deputy Medical Officer of Health and the Chief Sanitary Inspector to give lectures to those members of the store engaged in food handling. At the end of the series, an examination was held by the St. John Ambulance Brigade and certificates were presented to those food handlers who were successful in satisfying the examiners of their ability to practice food hygiene in their work. It is gratifying to record that forty-nine persons sat for this examination and all passed. The next step towards the goal of clean food will be the advent of the new Pood and Drugs (Amendment) Act, and the new regulations made thereunder and now in course of preparation. Milk (Special Designations) (Raw Milk) Regulations, 1949 During the year licences under these Regulations were granted as follows:- Principal Supplementary Dealers licensed to bottle and sell Tuberculin Tested Milk; 1 - Dealers licensed to sell Tuberculin Tested Milk; 94 19 Forty-nine samples of Tuberculin Tested milk were submitted for examination during the year. Fourteen failed to pass the prescribed tests and in each case particulars were forwarded to the Ministry of Food. The following table summarises the details of the samples taken:- Designation No. of samples Methylene blue test Passed Failed Tuberculin Tested (Farm bottled) 41 29 12 Tuberculin Tested 8 6 2 Five samples of Tuberculin Tested milk were examined for tuberculosis (guinea pig inocculation tests) and all results were negative. 45 Milk (Special Designations) (Pasteurized and Sterilized Milk) Regulations, 1949 Details of licences granted during 1953 are as follows:- Principal Supplementary Dealers' licences to sell Pasteurized Milk; 109 19 Dealers' licences to sell Sterilized Milk; 119 22 The following table shows the number of samples of processed milk taken during the year, together with results of the examinations:- Designation No. of samples Methylene blue test Phosphatase test Turbidity test Passed Failed Passed Failed Passed Failed Tuberculin tested (Pasteurized) +20 19 - 20 - - - Pasteurized 33 32 1 33 — — — Sterilized 2 — — - - 2 - + One sample was not submitted to the methylene blue test as the atmosphere shade temperature exceeded 65°F, which is the limit specified in the Regulations. Milk and Dairies Regulations, 1949 (a) Registrations A summary of the alterations made in the register of dairymen and dairies during 1953, 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 6 6 5 Additions to register — - 4 Removals from register — — 2 Dairymen with premises outside the borough added to register 2 - - On register 31st December, 1953 100 82 94 (b) Unclean milk containers It is an offence under these Regulations for any dairy farmer or distributor to use for holding milk any vessel that is not in a state of thorough cleanliness immediately before 46 use. In the case of bottled milk, the time "immediately before use" is considered to mean at the time the bottle is first filled and, therefore, any offence would be committed at the time and place of bottling. There are no processing or bottling plants in the borough and particulars of any offence for using a dirty bottle are referred to the local authority in whose area the bottling plant is situated. During the year only one contravention had to be referred to a neighbouring authority, who took action against the firm. The firm pleaded guilty and were fined £3. 0s. 0d. In addition, a complaint was made that a bottle of milk containing a dead mouse had been delivered to a resident by a roundsman engaged by one of the larger milk distributing firms. The matter was investigated, and a pathological examination of the mouse revealed that it had died of poisoning and was in fact dead before being put into the milk. It could not be shown conclusively however, at what stage or by whom the mouse was put into the bottle. Accordingly, no proceedings were instituted. Composition of milk During the year three hundred and fifty-nine samples of milk were submitted to the Public Analyst and, with the exception of fifteen, were found to be of genuine composition. In the case of the fifteen samples not complying with the presumptive standards established by the Sale of Milk Regulations, 1939, the following action was taken:- Summons issued 1 Warning letters to producers 9 Warning letters to vendors 4 No further action 1 The following table shows percentages of milk fats and non-fat solids of the genuine samples taken during each month:- Month No. of samples taken Average percentages Milk fats Non-fat solids January 30 3.58 8.66 February 34 3.40 8.57 March 35 3.40 8.62 April 30 3.39 8.75 May 28 3.49 8.73 June 21 3.50 8.79 July 36 3.87 8.72 August 19 3.65 8.72 September 24 3.73 8.84 October 29 3.79 8.83 November 30 3.79 8.78 December 28 3.72 8.68 Average for whole year 3.62 8.73 Legal minimum standards 3.00 8.50 47 Quality of Milk Supplies Arising out of the Council's work in connection with the sampling of food and drink under the Pood and Drugs Act, 1938, and the various Regulations made thereunder, it began to appear that the quality of milk supplies was deteriorating. After careful consideration, and in conjunction with the Council's Public Analyst, Dr. H. Amphlett Williams, I submitted the following report to the Public Health Committee on the 15th July, 1953:- "For some time, concern has been felt regarding the number of milk samples which have failed to comply with the presumptive standards established in the Sale of Milk Regulations, 1939. The Regulations provide that a sample of milk which contains less than 3% of milk fat or less than 8.5% of milk solids other than milk fat shall, until the contrary is proved, be presumed to be not genuine by reason of the abstraction therefrom of milk fat or milk solids other than milk fats or the addition thereto of water. In any proceedings taken under the Pood and Drugs Act, 1938, in respect of milk failing to comply with these standards, a producer may secure an acquittal if he satisfies the Court that the milk was as it came from the cow. In this regard he is empowered to require the sampling authority to obtain samples from the cows, provided he does so within 60 hours of the original sample being taken. Most of the milk supplied to Kensington retailers is bulked and pasteurized by wholesalers and cannot be identified with any particular producer, thus application for "Appeal to Cow" samples in this borough are infrequent. An exception to this general rule is Tuberculin Tested Milk which is supplied to Kensington residents in the same sealed containers as it was despatched from the farm. During 1952 forty samples of farm bottled milk were taken and no fewer than nine of these or 22½% were reported adulterated. In the first three months of the current year, twenty-eight similar samples were taken and four of these or 14% were adulterated. Some of the remaining samples, though conforming to the presumptive standard laid down in the Regulations were, nevertheless, below the average usually found. Of the thirteen samples of farm bottled milk found to be adulterated in 1952/53, eight were deficient in butter fat in amounts ranging from 1-9%, three were deficient in both butter fat and solids not fat, whilst the remaining two were deficient in non-fatty solids only. Where farm bottled milk has been adulterated, it has been the practice to notify the Regional Officer of the Milk Marketing Board in the hope that by local action an improvement in the quality of milk could be found. Recently four samples taken from a 400-gallon consignment of milk showed the following results, all of which are below the presumptive standards. Sample No. 1. 2. 3. 4. Milk fat 2o.66% 2.76% 2.78% 2.75% Milk solids other than milk fat 8.56% 8.53% 8.5% 8.68% Water 88.78% 88.71% 88.72% 88. 57% 48 In the quarterly report received from the Public Analyst, eight samples are shown to be deficient in fat during the past quarter. In the majority of instances "Appeal to the Cow" sampling has shown either that the milk was of the same quality as delivered, or if of a better quality, an explanation could be offered which would be likely to be accepted by a Court. The effect is that the public are receiving milk which, though genuine, is nevertheless of a poor quality. This position is borne out by figures quoted in an article by the Chief Analyst to one of the largest distributors, who quotes figures for milk analyses during the past fifty years, showing a deterioration in quality illustrated by the following figures:- Period Adjusted weighted averages Fat S.N.F 1900-05 3.78 9.05 1906-10 3.70 9.13 1911-15 3.74 9.10 1916-20 3.80 9.20 1921-25 3.76 9.18 1926-30 3.81 9.09 1931-35 3.74 8.98 1936-40 3.72 8.96 1941-45 3.67 8.85 1946-50 3.62 8.74 Figures for samples taken in Kensington by the Council's Sampling Officer show the same general tendency. This is shown in the following table, which covers a period of twenty-five years, omitting the war years. Fat S.N.F 1926-30 3.66 8.78 1931-35 3.65 8.88 1936-40 3.59 8.81 1946-50 3.52 8.8 It is well recognised that the quality of milk is influenced by such factors as the breed of cattle, the feeding, the milking times and the time of year, and modern tendencies are in the direction of using herds which produce a large quantity of milk which in many instances is of a low fat and/or low solids-not-fat content. The position has been examined by a Working Party on Quality Milk Production, among whose members consumers as such do not appear to have had any noticeable representation. In a recently published Report they state that there has been some deterioration in the composition in milk in England and Wales over the past thirty years and that the decline in solids-not-fat has been more marked than that in fat. The Working Party considered that there was evidence to suggest that the decline had been arrested at least in some areas. Nevertheless, milk of poor compositional quality is still being produced throughout the year by too many producers. In the early spring and occasionally at other seasons, substantial quantities of milk in many parts of England and Wales fall below the presumptive minimum standards. There is, 49 therefore, no cause to be satisfied with the present level of milk quality in England and Wales, and every reason for taking steps to improve it. The Working Party find that "much of the decline took place during the war and was due to the feeding difficulties then experienced. Neither a change in the breed distribution of the national herd nor any deliberate policy of breeding for quantity regardless of quality have been the main causes of the decline. In seeking for a remedy, the Working Party reject the suggestion of a fixed minimum legal standard and of a higher presumptive standard. They also feel unable to recommend the introduction of a scheme for payment of milk on the basis of compositional quality. They suggest that the best way to improve quality is through the close co-operation of all parties concerned - the producers, the distributors, the advisory services and the Research Institutes, and they recommend that the Joint Milk Quality Control Committee should implement a scheme involving the buyer's farm inspector (if any), the National Agricultural Advisory Service, the Milk Marketing Board and the Research Institutes to deal with producers who consistently send milk at or near the presumptive minimum standard." Notwithstanding the findings of the Working Party and their long term proposals for securing an improvement of milk quality, the position is that, although the price of milk has risen by 100% and even more in the case of farm bottled milk, the public are receiving milk which, in an increasing number of instances, is below the presumptive standards for fat and solids-not-fat, yet can be shown to be as produced by the cow. In these circumstances, no legal action is possible. It is obviously desirable that action should be taken to ensure an improvement in the quality of milk, to foster a continued improvement in the future, and for this purpose it seems desirable either to make it unprofitable for the farmer to produce milk at poor quality by means of a simple quality payment system, or to establish an absolute standard under the Pood Standards Order, thus making a definite procedure available to Pood and Drugs Authorities in cases where milk fails to comply with these standards. In these circumstances, WE RECOMMEND that the attention of the Metropolitan Boroughs' Standing Joint Committee should be drawn to this position and that they should be asked to consider the desirability of urging legislation designed to improve the quality of the Nation's milk supply." The Public Health Committee submitted the report to the Council, who adopted the recommendation and took the necessary action as indicated. The question of the quality of milk is still under consideration. 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 four hundred and ninety-seven formal samples of food and drugs were taken, of which twenty-four (4.82%) were adulterated. Five hundred and six informal samples were taken, of which fifteen (2.96%) were adulterated. - 50 - Details of action taken in respect of the adulterated samples are as follows Sample Nature of Adulteration Remarks Butter Unsound - rancid and inedible. No further action. Soda Water Contained sodium bicarbonate not more than 1 grain per pint. Particulars sent to Ministry of Food. Milk Contained fat 3.73%, solids-not-fat 8.411% corresponding to the presence of 1% of added water.. Warning sent to vendors. Milk Contained fat 3.41%, solids-not-fat 8.41% corresponding to the presence of of added water. Warning sent to vendors. Milk Contained fat 2.92%, solids-not-fat 8*95% corresponding to the abstraction of 2% of the fat. Particulars sent to Ministry of Agriculture and Fisheries. Milk Contained fat 3.24%, solids-not-fat 8.17% corresponding to the presence of 3% of added water. Summons. Vendors fined £2. 2s. 0d. with £2. 2s. 0d. costs. Milk Contained fat 2.90%, solids-not-fat 8.64% corresponding to the abstraction of 3% of the fat. Particulars sent to Ministry of Agriculture and Fisheries. Chop Sauce Contained carcases of mites and insect fragments - approximately 80 per ounce. Retailer's premises visited but no further stocks of this commodity held. Ground nutmeg Contained insect fragments derived from small beetles and their larvae and pupae, approximately 900 per ounce. Particulars sent to manufacturers. Retailer's stocks withdrawn. Ground nutmeg Contained insect fragments exceeding one-fifth of a millimetre in length, derived from small beetles and their larvae and pupae approximately 1000 per ounce. Particulars sent to manufacturers. Retailer's stocks withdrawn. Ground nutmeg Contained insect fragments exceeding one-fifth of a millimetre in length, derived from small beetles and their larvae and pupae approximately 2000 per ounce. Particulars sent to manufacturers. - 51 - Sample Nature of Adulteration Remarks Ground nutmeg Contained insect fragments exceeding one-fifth of a millimetre in length, derived from small beetles and their larvae and pupae approximately 800 per ounce. Particulars sent to manufacturers. Double cream Contained milk fat 46.4%. (Double cream should contain not less than 48% of milk fat.). Warning sent to vendor. Double cream Contained milk fat 46.7%. Warning sent to retailer. Canned Cherries Contained Iron 250 parts per million, tin 0.8 grain per pound. (The can was "blown" due to chemical action on the tinplate and the cherries had an unpleasant metallic taste.) Remainder of stock surrendered and destroyed. Sage, dried Consisted of Sage, 75% Foreign leaf (of a form consistent with that of a species of cistus) 25%. Particulars sent to manufacturers who returned stocks to suppliers. Ice Cream Contained fat 4.0%. (Ice Cream should contain not less than 5% of fat.) Warning given to vendor. Lard Consisted of edible fat, of a different character from that of lard. No further action. Milk Contained fat 2.92%, solids-not-fat 8.65%, corresponding to the abstraction of 2% of the fat. Warning sent to producer and particulars sent to County Milk Production Officer. Milk Contained fat 2.76%, solids-not-fat 8.58%, corresponding to the abstraction of 8% of the fat. Ditto Milk Contained fat 2.58%, solids-not-fat 8.51%, corresponding to the abstraction of 14% of the fat. Warning sent to producer and retailer. Particulars sent to Ministry of Agriculture and Fisheries. Milk Contained fat 2.66%, solids-not-fat 8.56%, corresponding to the abstraction of 11% of the fat. Warning sent to producer and particulars sent to Ministry of Agriculture and Fisheries. - 52 - Sample Nature of Adulteration Remarks Milk Contained fat 2.76%, solids-not-fat 8.53%, corresponding to the abstraction of 8% of the fat. Warning sent to producer and particulars sent to Ministry of Agriculture and Fisheries. Milk Contained fat 2.75%, solids-not-fat 8.50%, corresponding to the abstraction of 7% of the fat. Ditto Milk Contained fat 2.75%, solids-not-fat 8.65%, corresponding to the abstraction of 8% of the fat. Ditto Milk Contained fat 2.50%, solids-not-fat 8.65%, corresponding to the abstraction of 16% of the fat. Warning sent to producer and retailer. Soda Water Deficient in sodium bicarbonate. Manufacturers' attention drawn to deficiency. Ice Lolly Contained excessive lead. No further action as production at producer's premises had terminated. Table Jelly Infested by mites and unfit for consumption. No further stocks held by retailer. Information sent to Head Office of retail firm and to Medical Officer for the area. Milk Contained fat 2.79%, solids-not-fat 8.52%, corresponding to the abstraction of 7% of the fat. Warning sent to producer and particulars sent to Ministry of Agriculture and Fisheries. Milk Contained fat 2.94%, solids-not-fat 8.45%, corresponding to the abstraction of 2% of the fat. No further action as retailer had terminated supply from farmer. "Pickapeppa" Sauce Contained dead mites. No further action. Pork Sausages Contained sulphur dioxide, 50 parts per million presence of preservative not disclosed. Warning sent to vendor. Ground nutmeg Contained insect fragments. No further action. - 53 - Sample Nature of Adulteration Remarks Canned Tomato Puree Contained excessive tin. Remainder of stock surrendered and destroyed. Double Cream Contained milk-fat 46.3%. Warning sent to vendor. Glauber's Salt Consisted of effloresced Glauber's Salt and did not comply with the standard of the British Pharmacopoeia. The sample lost 48% of its weight when dried instead of not less than 51.5%. No further action. Table Jelly Infested by mites and unsuitable for human consumption. Warning sent to vendor. Remainder of stock surrendered and destroyed. Shredded Beef Suet Contained suet fat 70%, flour 30%. Suet should contain not less than 83% of beef fat. No further action. Cream - Bacteriological Examination Thirteen samples of cream were submitted to bacteriological examination. Eight samples were satisfactory, four showed the presence of Coliform bacilli (non-faecal) and one contained Staph. Aureus in small numbers but a repeat sample proved satisfactory. Five samples were submitted to guinea pig inoculation (tuberculosis) tests: four of these proved negative, while in the other case the guinea pig died before a diagnosis could be made. Labelling of Food Order, 1953 Where food is pre-packed for sale it is a requirement of the Labelling of Food Order, 1953, with certain exceptions, that a list of ingredients of the food must be stated on the label of the packet or container. During the year four minor infringements of this Order were found. The manufacturers concerned were notified and the necessary amendments to the labels have been made. Unsound food Seizure Under Sections 9 and 10 of the Food 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 of the Peace, 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 preserved fruit was found in a bakehouse, in a fermented and decayed condition. The sanitary inspector seized the food and took it to a Justice - 54 - of the Peace who condemned it. A summons was issued and the defendant was later fined £35. 0s. 0d. plus £5. 5s. 0d. costs. 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) 3 12 3 9 Meat (Tinned) 1 9 3 8 Bacon — — 3 5 Ham - 9 1 20 Sausages — 7 1 16 Luncheon Meat — 1 — 14 Poultry and Rabbits — 1 — 10 Pish (Wet and Dry) — 15 2 11 Pish (Tinned) - - 2 6 Pish (Shell) — — 2 14 Soya Flour - — 1 2 Figs — 1 1 19 Stilton Cheese — — — 6 Beef Suet — — — 8 Rice — 1 — — Sauerkraut — — 1 14 Biscuits — — — 11 Almonds — — — 2 Lentils — — 1 — Butter — — - 7 Prunes - - - 15 Tea - — 1 8 Margarine - - - 2 Flour - - - 9 TOTAL: 7 3 1 10 Tins, jars, packets or cartons of fruit, vegetables and miscellaneous foodstuffs 8,613 Peaches 57 boxes Fish Cakes 36 Apricots, dried 1 box Buns 128 Bread 8 loaves All food condemned as unfit for human consumption, is collected by the Council, taken to their refuse destructor in Wood Lane and destroyed. In no instance, were large quantities of food involved, necessitating special examination of stocks of food. - 55 - 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-one. Of this number five were new registrations during the year. It was found necessary to procure two samples, one of ammonia and the other of household disinfectant; both samples complied with the requirements of the Act. 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. During 1952, owing to the shortage in supplies of milk powder and fats, this standard was temporarily reduced by the Ministry. The original standard, however, was reinstated during the year under the Pood Standards (Ice Cream) Order, 1953. It was also possible for manufacturers to include milk as an ingredient which, for many years past, had been prohibited. The following table shows the number of samples taken during 1953 for chemical analysis compared with the previous year. Number of samples 1953 1952[/####] 23 34 Variation of fat content per cent 3.9 to 12.6 4.4 to 12.4 Variation of non-fat solids content per cent 20.3 to 27.4 18.1 to 26.8 Average fat content per cent 8.82 8.28 Average non-fat solids content per cent 24.28 23.13 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 - 56 - 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 handling which warrant further investigation. During 1953 thirteen samples of ice cream were taken and submitted to the Methylene Blue test and the results are as follows Grade No. of samples 1 7 2 - 3 1 4 5 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, having regard to the Ice Cream (Heat Treatment, etc.) Regulations, 1947/52. Ice Lollies There is no standard, either bacteriological or chemical, laid down for ice lollies, for these are specifically exempted from the Pood Standards(Ice Cream) Order, 1953. It would appear that sales of ice lollies are increasing and, during the year seven samples were submitted for bacteriological examination and chemical analysis. In one case, the result of the bacteriological examination was unsatisfactory. The manufacturer ceased to manufacture this particular kind of ice lolly. One sample submitted for chemical analysis was found to contain an excessive amount of lead. Representations were made to the manufacturer, who decided to cease production. Some manufacturers of ice lollies prefer to use the metal moulds rather than the plastic type. It is understood that this preference is due to metal providing quicker and more efficient freezing, but unless they are kept in a good state of repair, there exists a risk of metallic contamination. 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 1953:- - 57 - [####]Food poisoning notifications (corrected) Received in first quarter 3 Received in second quarter 10 Received in third quarter 55 Received in fourth quarter 11 TOTAL: 79 Outbreaks due to identified agents 2 Total cases 48 Outbreaks of undiscovered cause 4 Total cases 10 Single cases - Unknown cause 7 Agent identified 14 Total cases 21 Outbreaks due to identified agents (two outbreaks) The first outbreak concerned a family comprising four persons. They fell ill within five hours of eating some home-cooked boiled bacon, which had been kept in storage during a spell of hot weather. All patients suffered severe symptoms and were admitted to hospital, where they eventually recovered. Staphylococcal food poisoning was suggested and a sample of the bacon on examination revealed a heavy growth of staphylococcus aureus. The second outbreak involved thirty-nine in-patients and five members of the staff of a hospital in the borough. All sufferers experienced sharp attacks of diarrhoea and abdominal pain after eating a meal including pork. Specimens of the pork from the same consignment upon examination were found to be infected by C1. welchii; organisms of the same type were found in faeces specimens taken from the patients. The main factor in the outbreak was the reheating of cold cooked meat and its retention for some time before serving in hot gravy, which served as an admirable culture medium for the redevelopment of the organisms and toxin. It is worthy of comment that the co-operation between the public health department, the hospital authorities and the Public Health Laboratories was all that could be desired. Outbreaks of undiscovered cause (four outbreaks) Each of three of the outbreaks affected two patients in the same family. Investigations, which included the bacteriological examination of food samples and specimens from the patients, failed to establish a source of infection or any causative agents. In the fourth outbreak, four Kensington residents were notified and on investigation it was found that they were involved in a larger outbreak affecting approximately sixty persons employed at a large food factory in a neighbouring borough. The enquiries into the main outbreak revealed no source of infection or causative agent. Specimens taken from the four Kensington patients proved negative and no secondary cases occurred. Single cases In addition to the outbreaks referred to above, there - 58 - were twenty-one single cases of food poisoning notified. In seven of these no causative agent was identified, but the remaining fourteen cases were found to be caused by salmonella typhi-murium. INFECTIOUS DISEASE Smallpox No case of smallpox was notified in the borough during the year 1953. 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 fifteen 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 1953 was seventy-eight and, of this total, twenty 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 During the year, there were two confirmed cases of diphtheria. The first occurred in a female aged 55 years who had just returned from a visit to the United States of America. Prior to arrival in Kensington, the patient had spent a week in Leicestershire where the first symptoms developed. The appropriate Medical Officer of Health in Leicestershire was informed and all London contacts were swabbed after the patient's admission to hospital. No further cases developed. The second case involved the son, aged 4 years, of a member of the Indian High Commissioner's staff. The little boy fell ill during the voyage from India and was admitted to hospital three days after disembarkation in this country. Contacts were kept under surveillance, but no further oases occurred. In neither of these cases had the patient been immunised. Both patients recovered. 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 1,405 " " school " " 121 " " re-inforcing injections given 846 " " children attending for pre-Schick tests 386 " which gave a positive reaction " of children attending for post- 312 Schick tests 1,119 " proving negative 1,000 " proving positive 17 " who failed to attend for reading 102 - 59 - Enteric Fever Two cases of typhoid fever and three cases of paratyphoid B. fever were notified during 1953. Investigations revealed that the infections had been contracted abroad with the exception of one case of paratyphoid fever. In this case, a youth of 16 years, it was stated that the patient had never been out of this country, and enquiries failed to reveal the source of infection. Puerperal pyrexia During 1953, the number of cases of this disease notified was sixty-five, of whom thirty were persons normally resident outside the borough. Fifty-nine of the cases were t reated in hospital. Information was received in the public health department concerning forty-one patients normally resident in Kensington, who were notified as suffering from puerperal pyrexia in other London districts. No deaths occurred under this heading. Pneumonia There are various forms of pneumonia, but the only types notifiable are (i) acute primary and (ii) acute influenzal pneumonias. During the year, ninety-three notifications were received, forty-five being acute primary pneumonia and fortyeight being acute influenzal pneumonia. Of the total, fortynine cases were removed to hospitals for treatment. The number of deaths from pneumonia (all forms) was ninety-six and the number of deaths from influenza was thirtythree during 1953. Dysentery One hundred and thirty-one cases of dysentery were notified in 1953, 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. During 1952, a small committee of public health officers from the London County Council, Metropolitan Boroughs and the Laboratory service was set up to consider the problem of Sonne Dysentery with particular reference to the effect of environment on the spread of infection. The Medical Officer of Health was invited to be a member of this committee. The Committee decided to investigate each case of dysentery occurring in the London area between 1st November, 1952 and 31st October, 1953. A survey was conducted by means of questionnaires which were analysed at the London County Council. During the period in question, one hundred and eleven questionnaire forms were submitted in respect of Kensington cases. The analysis was still continuing at the end of the year and the findings on this difficult problem are not yet available. Erysipelas Of the eleven cases notified, two were admitted to hospital. There was no deaths. - 60 - Meningococcal infection Six cases of this disease were notified during the year and all the patients were removed to hospital. No death was recorded during 1953. Malaria Five cases of malaria were reported during the year. Investigations showed that three of the patients were natives of countries where malaria is endemic and who had recently arrived in this country. The remaining two patients were exservicemen who had served abroad, one during the 1939-1943 war and the other more recently in Korea. Poliomyelitis There were fourteen cases of acute poliomyelitis notified and confirmed during the year; nine of the cases showed symptoms of paralysis and one of the cases died. The death occurred in the case of a little girl who contracted the disease in Nigeria and was flown to a Kensington hospital for treatment. In addition to the above, a further case of death from poliomyelitis was allocated to the borough by the RegistrarGeneral. This was an adult Kensington resident who contracted the disease whilst staying in Devon. The figures for the past five years are as follows :- Year Confirmed Cases Deaths 1952 21 2 1951 12 Nil 1950 13 3 1949 47 4 1948 9 Nil As in previous years, contacts of cases were kept under supervision for twenty-one days from the last date of contact. It will be recalled that in the Annual Report for 1952, attention was drawn to an unsatisfactory feature concerning isolation and treatment of poliomyelitis patients in that several had been retained in general or children's hospitals. After the matter had been considered by the Public Health Committee representations were made to the Ministry of Health. On 17th April, 1953, the Minister issued a Memorandum to hospital authorities dealing with communicable diseases. It did not deal specifically with the problem of poliomyelitis but urged hospital staffs to consult the appropriate Medical Officers of Health to obtain assistance and advice. The memorandum also stressed the need for the prompt notification of infectious diseases. Of the fourteen cases notified during 1953, eleven were removed to isolation hospitals. One patient was retained in a children's hospital outside the borough and the Medical Officer of Health for the district was informed. The child mentioned above who was flown from Nigeria and subsequently died was nursed in a Kensington children's hospital. The remaining case was a child aged 5 years who was nursed at home after being examined in the out-patients' department of a children's hospital. In this case, the notification was not made until twelve days after the onset of the disease. -61- It can be said that some improvement occurred during 1953 in this aspect of the treatment of poliomyelitis, but the Public Health Department continues to press for the removal of all sufferers to infectious disease hospitals. In 1953, the broad investigation conducted by the Medical Research Council, involving a comparison between the histories of child sufferers from poliomyelitis and those for selected healthy children of the same age group, was concluded, and the results are awaited. The second investigation, concerning the possible association between inoculations and operations and the contraction of the disease, is still continuing in co-operation with the Medical Research Council. Acute encephalitis No case of this disease was notified in the borough during 1953. Measles Of the seven hundred and forty cases notified during 1953, twenty-nine were admitted to hospital for treatment. No death occurred from this disease. Ophthalmia neonatorum Seven cases of this disease were notified and all except one were treated in hospital. All recovered without injury to sight. Gastro-enteritis This disease is notifiable in children up to the age of five years. The number of cases reported during the year was twenty-seven. Ten were removed to hospital for treatment. Six deaths of children under five years of age were recorded as due to gastritis, enteritis or diarrhoea. Scabies The number of notifications of this disease during 1953 was forty-two, which compares with twenty-six in the previous year and four hundred and sixty-three in the peak year of 1946. Tuberculosis During the year two hundred and fifty-six new cases of tuberculosis were notified, of which two hundred and thirty-three were respiratory and twenty-three non-respiratory cases. The following table shows the number of cases added to and the number removed from, the notification register during the year:- - 62 - ##]Description Respiratory Non Respiratory Total M F M F On register of notifications on 1st January, 1953 663 598 66 87 1,414 Notified for the first time during the year 129 104 10 13 256 Brought to notice after than by notification Removed from register on account of having - 99 74 4 4 181 (a) recovered from the disease 7 5 1 2 15 (b) removed from district lost sight of, etc. 123 124 8 12 267 (d) died Remaining on register on 26 11 3 1 41 636 68 31st December, 1953 735 89 1,528 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 eighty-three visits were paid to the homes of tuberculous patients. In three hundred and four of these, the environmental conditions were such as to require no further action on the part of the Public Health Department; in a further fifty-eight cases it was found that the patients had moved away, and in thirty other cases the investigation was postponed as the patients were away in hospital. The action taken in the remaining ninety-one cases is summarised below:- Action taken Cases Investigation or supervision undertaken in respect of 11 (a) re-arrangement of existing accommodation (b) occupation of patients 16 (c) tracing of contacts 7 (d) preventing spread of infection 12 Recommended for priority re-housing 53 Action taken under Public Health and Housing Acts in respect of insanitary or unhealthy conditions 37 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 - 63 - tuberculosis amongst immigrants. Since 1952, a more detailed investigation of this problem has taken place and the following table sets out the information found in 1953. Country of origin Period (in years) between entry to United Kingdom and notification of disease Total 1 2 3 k 5 6 7 8 9 Australia 1 - - - - - - - - 1 Canada - 1 - - - - - - - 1 Hong Kong — 1 - - - - - - - 1 India 1 — - - - - - - - 1 Ireland 9 3 7 2 2 - 2 - — 25 Italy - — - — - — 1 - - 1 Jamaica - 1 - - - - - - - 1 Jugoslavia 1 - - - - - - - - 1 Malaya - 1 - - - - - - - 1 Malta 1 - - - - - - - - 1 Mauritius — 1 - - - - - - - 1 Poland - 2 - 1 - - - - - 3 Spain 1 — - - - - - - - 1 Russia - - - - 1 - - - - 1 Ukraine - - - — 1 — - - - 1 West Africa - - - 1 - - - 1 - 2 TOTAL: 43 Patients who had resided in London all their lives or at least 10 years 152 Patients who had resided in other parts of the country all their lives prior to coming to kensington 77 Patients from whom information concerning origin was not obtained but where it is believed to be this country 26 Patients from Ireland who resided here at least 10 years prior to notification 11 Patients notified in Ireland before coming to this country 1 Patients from Poland who resided here at least 10 years prior to notification 9 Patients who resided here at least 10 years prior to notification: (Belgium 1, Canada 1, Germany 3, India 1, Spain 1, Russia 1.) 8 Patients from whom information concerning origin could not be obtained 75 TOTAL: 359 CHART 2A. CHART 2B. - 65 - The investigation only covered patients newly notified or transferring into the borough from other areas. The total of four hundred and two cases surveyed differs from the total of tuberculous patients visited in the year in so far as the difference consisted of old cases changing residence within the borough. In 1951, a full survey was not made, but it was estimated that 20% of the tuberculous patients visited for the first time in that year were immigrants who contracted the disease within ten years of arrival in this country. A more accurate investigation showed that the proportion for 1952 was 16%, whilst the comparable figure for 1953 was 10%. Persons born in the Republic of Ireland were regarded as immigrants for this purpose. The publication of the findings of the 1951 Census enables the problem of immigrants to be put into proper perspective. The Kensington Census figures show that out of a total population of 168,160, there were 29,353 residents (or just over 17%) who were born outside the United Kingdom and the Republic of Ireland. Tuberculosis - Notifications and Mortality Notifications and deaths from tuberculosis are increasingly occurring at a later age, particularly amongst males. This is illustrated in the following table which shows Kensington notifications and deaths for two five-year periods separated by a gap of twenty years. The table, which is shown graphically in Chart 1 on page 64, shows the figures of males and females in age groups. Age Group (Years) 1929 - 1933 1949 - 1953 Notifications. Deaths Notifications. Deaths M F M F M F M F 0 - 6 4 5 7 3 6 1 1 1 - 20 22 9 10 33 26 3 1 5 - 65 52 14 20 20 33 - 1 15 - 156 202 63 107 130 171 8 6 25 - 231 243 150 101 289 259 33 27 45 - 141 76 123 58 171 59 71 23 65 - 15 15 26 12 52 23 32 12 634 614 390 315 718 577 148 71 GRAND TOTALS: 1,248 705 1,295 219 - 66 - The national figures for tuberculosis mortality similarly show a striking fall in the mortality of all age groups, which is generally agreed as being due to improved environmental conditions. This fall is shown graphically in charts 2A and 2B on page 64. Apart from this general fall, the most interesting feature is the change in age distribution and the very distinct difference between the sexes. For females, the death rate is greatest in early adult life, whereas for males it is greatest towards the end of working life. These features are illustrated in the following table. Period Age groups of maximum mortality Males Females 1851-1860 20-25 25-35 1861-1870 35-45 25-35 1891-1910 45-55 35-45 1931-1935 45-55 20-25 1940-1945 55-65 20-25 1946-1949 55-65 20-25 This aspect has been reviewed by Dr. V. H. Springett in his Milroy lecture to the Royal College of Physicians in 1952, in which he pointed out that if the tuberculosis mortality among groups of people of similar birth date are studied (as opposed to age groups of people alive in a given calendar year or group of years), it is found that the graph curves are essentially similar throughout. The mortality is low in childhood, then there is a peak in adult life, never at a greater age than 35-44. There is no tendency for the peak to pass to an older age group. Indeed in the more recent groupings the peak tends to occur in younger age groups. He concludes that a large part of the tuberculosis mortality in males in later life is due to a final breakdown of disease originally acquired many years earlier. It is comparatively seldom the result of recently acquired disease. In fact this view recalls the opinion of Email von Behring, the centenary of whose birth occurred this year, that tuberculosis was a lifelong infection. He stated that "phthisis is but the end of a lullaby sung at the cradle of the prospective consumptive." Doubtless also involved are such other factors as improved facilities for diagnosis, increased examination of household contacts of tuberculous cases, the increase in longevity, the different nature of tuberculosis in males and females and the greater risk of infection at work run by the older male. Mass Radiography Since the 5th July, 1948, mass radiography has been undertaken by Regional Hospital Boards. On three occasions in 1953 the North-West Metropolitan Regional Hospital Board provided facilities for mass radiography of the general public at premises in Kensington. The number of persons examined totalled 5,957. The following table gives a summary of the results obtained:- - 67 - St.Charles Hospital 5th-7th August St. Mary Abbots School 18th-27th August Christopher Wren School 31st August9th Sept. TOTALS Number examined: 1,279 2,750 1,928 5,957 Males 596 1,182 1,061 2,839 Females 683 1,568 867 3,118 Number recalled for large films 32 45 34 111 Disposal of large film cases - (2.50%) (1.64%) (1.76%) (1.86%) No further action 22 29 18 69 To return for further X-ray - - - - Further examination required 9 (0.70%) 15 (0.55%) 15 (0. 78%) 39 (0.65%) Known cases had or having treatment - - - - Failed to return for large films 1 1 1 3 Whooping Cough Four hundred and eighty-five cases were notified during the year, thirty-five of which were treated in hospital. No death occurred from this disease. A century ago there were four diseases; smallpox, scarlet fever, measles and whooping cough, whose spread and mortality were difficult to control. Since then smallpox has been controlled, whilst measles and scarlet fever have become milder infections and less hazardous. In the case of whooping cough, the position is also much better although the decline in mortality has been less steep compared with the other three diseases mentioned. The Kensington position regarding incidence and mortality is shown in the following table:- - 68 - Quinquennial notifications and deaths in Kensington 1856 - 1953 Whooping Cough Measles Scarlet fever Diphtheria Notifications Deaths Notifications Deaths Notifications Deaths Notifications Deaths 1856-1860 - 206 - 153 - 276 - - 1861-1865 - 206 - 325 — 371 — 98 1866-1870 — 302 — 258 — 518 — 80 1871-1875 - 345 — 289 — 249 — 85 1876-1880 - 531 - 370 — 323 — 95 1881-1835 - 427 — 326 — 153 - 96 1886-1890 - 387 — 442 - 135 - 305 1891-1895 — 312 — 297 2,910 152 1,362 306 1896-1900 - 262 - 448 3,044 105 1,514 249 1901-1905 - 252 — 325 1,771 76 903 108 1906-1910 — 180 — 254 2,099 39 947 104 1911-1915 - 136 — 327 2,433 39 867 63 1916-1920 — 86 — 158 1,469 19 1,068 69 1921-1925 — 110 — 166 2,051 19 1,413 98 1926-1930 — 101 — 126 1,774 10 1,647 72 1931-1935 — 85 — 104 2,333 9 1,630 91 1936-1940 361 + 30 273 + 42 959 5 647 31 1941-1945 1,036 21 2,325 5 625 — 266 7 1946-1950 1,367 13 3,420 10 601 — 76 2 1951-1953 1,197 - 3,093 2 254 - 3 - Scarlet fever and Diphtheria first notifiable 1891. + Measles and whooping Cough first notifiable 1st October, 1938. As pointed out in the Ministry of Health Bulletin for May, 1953, nationally the relative position of whooping cough has become more important. Since the end of the last war, deaths from whooping cough have exceeded those from smallpox, scarlet fever, measles and diphtheria added together. It is the third largest cause of infant death. In addition, children lose more time from school through this disease than from the other common infections, and apart from poliomyelitis, whooping cough is the disease carrying the greatest risk of permanent after-effects. The following table indicates through the death rates the relative rise in importance of whooping cough Death rates per million living at ages under 15 - England and Wales 1856-1860 1901-1905 1945-1949 Scarlet fever 1,919 Measles 955 Whooping Cgh. 81 Diphtheria 1,347 Whooping Cgh. 874 Measles 47 Whooping Cgh. 1,300 Diphtheria 653 Diphtheria 30 Measles 1,114 Scarlet fever 319 Scarlet fever 3 - 69 - A similar trend is shcwn in the Kensington figures for these diseases over the past hundred years. Prom the notification figures (so far as these are available), it will be seen that although the incidence of measles and whooping cough has not significantly diminished, the mortality rates have been substantially reduced. Whooping cough first became notifiable in England and Wales in 1939, and earlier statistics are based on mortality. With the relative increase in importance of this disease, much research work has been carried out in recent years. It has been discovered that the disease is much more infectious than was at one time believed, and that the risk of infection is directly proportional to the intimacy and frequency of exposure. Again, one attack of the disease does not necessarily give life-long immunity, although second attacks are due to a strain of organism different from the one provoking the first attack. However, second attacks are relatively rare. Statistics suggest that a higher proportion of children from better class districts contract the disease before 12 years of age than from poorer districts and it is thought that this may be due to the fact that some auto-immunisation may occur in more crowded conditions. A study of the statistics does not reveal any clear epidemic pattern for the country as a whole although further investigations are proceeding with a view to establishing whether or not there is any regular periodicity. It has been found, for instance, that the fatality rate tends to be higher in towns and cities than in less populous districts. No age is immune from whooping cough. It is reported that infants have been born with the disease, and others have developed it within ten days of birth. During the ten years from 1941 to 1950, whooping cough was certified as the cause of death in ten persons over the age of 75 years. A remarkable feature of whooping cough is the preponderance of female deaths, a fact which was noted in the earliest history of the disease. No satisfactory explanation has been given for this, except that it is probably due to a combination of two factors, (a) the greater incidence of the disease in females, and (b) for some reason the disease is more fatal amongst females. The disease does not have any marked seasonal trend, although the lowest weekly figures are recorded in May and October. By contrast, well above the average weekly figures have occurred in midsummer as well as midwinter. Research into immunisation was intensified in 1942 and has continued. In recent years this work has been complicated by the possible association between injections of whooping cough vaccines and paralysis in poliomyelitis. Field investigations into this aspect have been undertaken by the Medical Research Council and Kensington is one of the areas co-operating in this project. The treatment of the disease has been improved by the use of the antibiotics, chloramphenicol and aureomycin, but much still remains to be done. However, as a result of assuming great importance amongst contemporary infectious diseases, whooping cough is demanding and receiving more attention. International Certificates In order to prevent the spread of infectious diseases, - 70 - certain countries require that visitors should be vaccinated or inoculated against specified diseases. International certificates have been prescribed for smallpox, yellow fever and cholera. Wnen completed by the practitioner, the certificate must be authenticated by the Medical Officer of Health for the area in which the certifying doctor resides or practises. During the year over two thousand of these certificates were authenticated in Kensington, Notifications The following tables show (1) the number of cases of infectious disease notified during the year 1953, 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. TABLE 1 Notifiable disease Number of cases notified 1953 1952 1951 1950 1949 1948 1947 1946 Scarlet fever Diphtheria (including 78 108 68 100 114 94 98 195 Membranous Croup) 2 - 1 2 2 12 23 37 Enteric fever 5 2 7 12 7 4 4 6 Puerperal fever ø - - — - - - 3 4 Puerperal pyrexia Acute primary pneumonia and acute influenzal 65 83 22 18 33 25 9 8 pneumonia 93 71 149 69 121 142 103 111 Dysentery 131 31 81 18 33 145 21 49 Erysipelas 11 11 13 17 15 24 34 37 Meningococcal infection 6 4 8 5 8 4 7 10 Malaria 5 1 2 2 — 2 4 8 Acute poliomyelitis Paralytic 9 17 8 7 47 9 27 1 Non-paralytic 5 4 4 6 Acute encephalitis - 3 1 - 1 - 2 - Tuberculosis (all forms) 256 251 238 278 266 258 259 210 Measles 740 839 1314 696 740 868 852 264 Ophthalmia Neonatorum 7 2 2 12 5 7 4 4 Enteritis + 27 30 25 63 88 64 102 69 Food poisoning 79 20 18 23 33 11 7 7 Scabies 42 26 34 72 106 141 239 463 Whooping Cough 485 228 484 316 304 264 274 209 TOTALS: 1846 1731 2479 1716 1923 2074 2072 1692 ø Puerperal Pyrexia only notifiable in London since 1948. + Notifiable only in children under the age of 5. NOTE: Cases of mistaken diagnosis are excluded from above table. - 71 - TABLE 2 Notifiable disease Number of Cases Notified in 1953 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 1 8 17 42 5 3 2 Diphtheria (including Membranous Croup) - - 1 - - - 1 Enteric fever — - - - 1 1 3 Puerperal Pyrexia - - - - - 31 34 Acute primary pneumonia and acute influenzal pneumonia 3 2 2 2 6 7 71 Dysentery 8 34 23 28 5 7 26 Erysipelas - - - — - 1 10 Meningococcal infection - - 3 1 1 - 1 Malaria - - - - — 4 1 Acute poliomyeltis Paralytic - 1 1 2 - 2 3 Non-paralytic - - 1 3 - 1 - Acute encephalitis - - - - - - - Tuberculosis (all forms) 3 5 5 9 6 56 172 Measles 18 153 236 244 18 32 39 Ophthalmia neonatorum 7 - - - - - - Enteritis 17 5 5 - - - - food poisoning — 6 1 5 3 4 60 Scabies 2 1 1 6 - 14 18 Whooping cough 47 127 126 175 3 3 4 TOTALS: 106 342 422 517 48 166 445 TABLE 3 Notifiable disease Total Cases Notified in each Ward St.Charles Golborne Norland Pembridge Holland Earls Court Queens Gate Redcliffe Brompton Scarlet fever 18 11 4 13 5 10 7 7 3 Diphtheria (including Membranous Croup) - - - - - - - 1 1 Enteric fever 2 — — — — 1 1 1 - Puerperal Pyrexia 4 - 1 4 7 8 29 8 4 Acute primary pneumonia and acute influenzal pneumonia 17 18 11 20 9 3 3 8 4 Dysentery 29 26 9 14 15 11 3 16 8 Erysipelas 1 1 1 3 - 4 1 - - Meningococcal infection - 1 1 2 - 1 - - 1 Malaria - 1 1 - 1 2 - - - Acute poliomyelitis Paralytic 2 - 2 - 2 - - 1 2 Non-paralytic 2 - 1 1 - - 1 - - Acute encephalitis - - - - - - - - — Tuberculosis (all forms) 39 37 40 38 24 23 14 30 11 Measles 122 93 45 81 102 93 70 77 57 Ophthalmia neonatorum 2 1 4 - - — - - - Enteritis 3 10 3 2 8 — — 1 - Food poisoning 55 2 3 5 4 4 2 4 - Scabies 5 6 4 12 — 4 6 3 2 Whooping cough 106 108 90 57 35 19 5 55 10 - 72 - LEGAL PROCEEDINGS Public Health (London) Act. 1936 Nuisances During the year one hundred and ninety-seven summonses were issued for various nuisances under the Public Health (London) Act, 1936. In sixty-three cases abatement orders were secured; fines amounting to £2. 2s. 0d. were imposed and £81. 7s. 0d. costs were awarded to the Council. In one case a Closing Order was made by the Justices prohibiting the use of a dwelling house for human habitation. In forty-six cases the summonses were withdrawn, the nuisances having been abated by the owners prior to the Court hearings. In eighty-six cases the summonses were adjourned as the necessary works were in progress of being carried out by the owners. In the last case the summons was withdrawn as the defendant died before the case was heard. Thirty-three prosecutions were undertaken for failure to comply with Justices' Orders to abate statutory nuisances. In sixteen cases fines amounting to £84. 18s. Od. were imposed and costs amounting to £28. 7s. Od. were awarded to the Council. The remaining seventeen cases were withdrawn or adjourned as the necessary works had been, or were being, carried out. Drainage Byelaws One summons issued in respect of an offence under these Byelaws was adjourned "sine die". Byelaws in regard to removal of obnoxious matter four summonses were issued for offences under Byelaws made by the London County Council under Section 84 of the Public Health (London) Act, 1936, which prescribe times for the removal by road of any faecal or offensive or noxious matter or liquid through London. Convictions were obtained; fines amounting to £4. 0s. 0d. were imposed, and the Council were awarded £2. 0s. 0d. costs. Council's Byelaws Dog Nuisances Seven summonses were issued under this Byelaw. In all cases convictions were obtained and fines totalling £3. 5s. 0d. were imposed. In one of these cases the defendant was ordered to pay the Council 5s. 0d. costs. Housing Act. 1936 Contravention of Closing Orders One summons issued in respect of illegal occupation of a closed underground room was adjourned "sine die". Food and Drugs Act. 1938 Two summonses were issued in respect of the sale of whisky not of the quality demanded. The Court granted the defendant an absolute discharge, but awarded the Council £5. 5s. 0d. costs. Two summonses were issued in regard to the possession of - 73 - unfit food for sale or the preparation for sale. On one summons the defendant was fined £35. Os. Od. and ordered to pay £5. 5s. 0d. costs; the second summons was not proceeded with. A summons was issued in respect of a sample of milk deficient in non-fatty solids. The defendant was fined £2. 2s. Od. and costs of £2. 2s. 0d. were awarded to the Council. 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. - 74 - PARTICULARS OP THE STAFF OF THE PUBLIC HEALTH DEPARTMENT AT THE END OF 1953 (As requested by Ministry of Health Circular 1/51) Medical Officer of Health Year of Appointment James H. Weir, M.D., B.S., B.Hy., D.P.H. 1950 Deputy Medical Officer of Health W. C. Turner, M.D., M.R.C.S., L.R.C.P., D.P.H., D.I.H. 1951 Public Analyst H. Amphlett Williams, Ph.D.(Lond)., A.C.G.F.C., F.R.I.C. 1952 Administrative and Clerical Staff 1.2. John S. Wheeler, Chief Clerk 1924 Francis W. Gascoyne 1919 John H. Gillett 1938 George W. Churcher 1935 Eric A. Bardin 1949 Miss Vera F. Osborne 1941 Mrs. B. Beesley 1948 Digby A. Smith 1939 Mrs. S. Scott 1943 Victor W. Waymark 1946 Miss Doris Gibbs 1944 Miss Marjorie Mackay 1950 Miss Elizabeth Howarth 1951 Alan Rogers 1953 Mrs. N. Sanders 1950 Philip Hayllar 1952 Sanitary Inspectors 2.3.Henry W. Walters, Chief Sanitary Inspector 1925 2.3. Cecil R. Webb 1925 1. Arthur L. Vague 1934 1.2. Ronald D. Callis 1935 1. Denis C. Draper 1938 1. Reginald G. Weedon 1952 1. Harold Hind 1939 1.2. Arthur F. Standish 1947 1. Arthur E. Sills 1949 1.2. Frederick H. Canton 1950 1.2.4. Joseph G. Tompkins 1951 1. William R. Bland 1951 1.2. Leslie A. Palmer 1951 1.2. John W. Meston 1952 1. Herbert B. Cade 1952 1. Bernard H. Young 1953 1. Frank J. Orrigan 1953 1. Ernest Killby 1953 Women Health Officers Miss Anne Barker, S.R.N., S.C.M., H.V. 1949 Miss Emmeline I. Filmer, Dip. Soc. Science (Lond)., 1952 Other Officers Joseph A. Newman, Rodent Assistant 1945 Aubrey E. Sole, Rodent Assistant 1945 Edward Sellwood, Rodent Assistant 1946 George Connor, Rodent Assistant 1947 Frank Beak, Drainage Assistant 1953 Albert V. Boddington, Superintendent, Medicinal Baths 1929 James W. Noble, Chief Disinfector 1935 William G. Gauntlett, Mortuary Keeper 1939 1. Certificate of the Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. 2. Certificate for Inspectors of Meat and Other Poods. 3. Certificate of London Sanitary Inspectors' Examination Board. 1+. Smoke Inspectors' Certificate. - 75 - SUMMARY OF COMMITTEES CONTROLLING MATTERS OF PUBLIC HEALTH (As requested by Ministry of Health Circular 1/54) Public Health Committee Sanitary administration generally Overcrowding, repair, closure and demolition of houses Clearance areas Improvement areas Nuisances under Public Health (London) Act, 1936 House drainage Food and drugs and sampling of foods Factories and shops Baths and washhouses and public mortuary Open spaces Infectious diseases Prevention of damage by pests Care of old people Cemeteries and burial of the dead Works Committee Public cleansing Collection and disposal of house and trade refuse Sewerage (including street drainage) Streets and highways Public lavatories Housing and Town Planning Committee Provision of housing accommodation and control and management of Council's houses Acquisition of land for housing Provision of open spaces Acquisition, improvement and conversion of houses Finance Committee Improvement grants and mortgages under Housing Acts INDEX Page Acute Encephalitis 61 Adulteration of Food 49-53 Atmospheric Pollution 12 Bacteriological Work 9 Birth Rate 1 Burial of the Dead 16 Census 19 Chiropody for Aged Persons 28 Clean Food Campaign 43 Clearance Areas 34,36 Cleansing of Aged Persons 26 Closing Orders - Contraventions 72 Committees 75 Costermongers 39 Cream 53 Cremation Service 17 Deaths, Causes of 8 Death Rate 1 Demolition Orders 33 Diphtheria 58 Diphtheria Immunisation 58 Disinfection & Disinfestation 10 Dog Nuisances 17 Drainage 31 Dysentery 59 Enteric Fever 59 Erysipelas 59 Factories 39 Food - Adulteration 49-53 Byelaws 43 Clean Food Campaign 43 Cream 53 Ice Cream 55 Ice Lollies 56 Inspections 42 Labelling of Food 53 Milk 44-49 Poisoning 56 Unsound 53 Gastro Enteritis 61 Health Handbook 19 Holidays for Aged Persons 25 Hostel Byelaws 38 Housing - Clearance Areas 34,36 Closing Orders - Contraventions 33 Demolition Orders 33 Hostels 38 Inspections 32 Legal Proceedings 72 Medical Priorities 38 New Housing Accommodation 34 Overcrowding 37 Slum Clearance 36 Underground Rooms 33 INDEX Page Ice Cream 55 Ice Lollies 56 Infant Death Rate 1 Infectious Diseases 2,58 Acute Encephalitis 61 Diphtheria 58 Dysentery 59 Enteric Fever 59 Erysipelas 59 Gastro Enteritis 61 Malaria 60 Measles 61 Meningococcal Infections 60 Notifications 70,71 Ophthalmia Neonatorum 61 Poliomyelitis 60 Pneumonia 59 Puerperal Pyrexia 59 Scabies 61 Scarlet Fever 58 Smallpox 58 Tuberculosis 2,61-66 Whooping Cough 67-69 Institutional Care of Aged Persons 27 International Certificates 69 Labelling of Food 53 Laboratory Facilities 9 Laundry Facilities for Aged Persons 27 Legal Proceedings - Closing Orders - Contraventions 72 Dog Nuisances 72 Drainage Byelaws 72 Food and Drugs Acts 72 Nuisances 72 Removal of Obnoxious Matter 72 Library Facilities for Aged Persons 28 Malaria 60 Mass Radiogzraphy 66 Maternal Death Rate 2 Meals for Aged Persons 28 Measles 61 Medical Examinations of Staff 17 Medicinal Baths 9 Meningococcal Infections 60 Milk 44-49 Milk & Dairies Regulations, 1949 45 Milk, Special Designations 44-45 Mortuary 12 National Assistance Acts 1948/51 16,30 New Housing Accommodation 34 Notifications 70,71 Nuisances 72 Old People's Welfare 3,24 Ophthalmia Neonatorum 61 Outworkers 40 Overcrowding 37 Pests, Prevention of Damage by 10 Pet Animals Act, 1951 41 Pharmacy & Poisons Act, 1933 55 INDEX page Pigeons, Destruction of 12 Poliomyelitis 60 Population 20 Pneumonia 59 Publications 19 Puerperal Pyrexia 59 Rag Flock & Other Filling Materials, Act, 1951 40 Removal of Aged Persons 30 Rent Restrictions Acts 33 Repair of Houses 2 Rodent Control 10 Sanitary Inspection - Drainage 31 Dwelling Houses 32 Inspections 31 Legal Proceedings 72 Rent Restrictions Acts 33 Sanitary Notices Served 31 Supervision of Work 31 Scabies 61 Scarlet Fever 58 Slum Clearance 34 Smallpox 58 S.O.S. Cards 24 Staff 17,74 Tuberculosis 2,61-66 Underground Rooms 33 Unsound Food 53 Vaccination 58 Vital Statistics 6, 7 Water Supply 55 Welfare of Aged Persons Advice Leaflets 24 Chiropody 28 Cleansing 26 Grants 25 Holidays 25 Institutional Care 27 Laundry Facilities 27 Library Facilities 28 Meals Service 28 Removals 30 S.O.S. Cards 24 Visiting 29 Whooping Cough 67-69