AC 4843 ??? pc.A.b.c. KEN 63 The Royal Borough of Kensington ANNUAL REPORT ON THE Health of the Borough FOR THE YEAR 1954 BY J. H. WEIR m.d.. b.s.. b.hy.. d.p.h. MEDICAL OFFICER OF HEALTH THE ROYAL BOROUGH OF KENSINGTON Public Health Department, Hornton Street, Kensington, W. 8. 1st June, 1955. 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 1954. The Minister of Health has again requested (Circular 28/54) 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 (170,600) of the population of the borough for 1954 shows a decrease compared with the figure for the previous year (171.500). The actual population figure for Kensington obtained as a result of the 195.1 Census was 168,160. Birth rate. The number of births per 1,000 population of the borough was 15.9 in 1954, which was 0.5 higher than the figure recorded for the previous year. The Kensington birth rate was higher than that for the County of London (15.24) and higher than that for the whole of England and Wales (15.2). (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 11.3.) Death rate. The number of deaths per 1,000 population was 9.63, which is the lowest ever recorded for Kensington. This figure is lower than the death rate for the County of London (10.68) and that for England and Wales (11.3). (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 1954 was 22.5 showing an increase of 2.8 over the figure for 1953 (19.7) which was the lowest ever recorded in Kensington. (The infant death rate for 1954 in the County of London was 21.0 and England and Wales 25.5.) Maternal death rate. Two deaths nf mothers due to childbirth were recorded in 1954, giving a maternal death rate of mothers per 1,000 live and still births of 0.72. (The maternal mortality rate for England and Wales in 1954 was 0.69 and the figure for the County of London was 0. 66. ) 2 Infectious diseases. There was no serious outbreak of infectious disease in the borough during 1954. The total number of notifications received was 896 in comparison with 1,846 in the previous year. The reduction in notifications was mainly due to only 136 cases of whooping cough having been notified in 1954 compared with 485 cases notified in 1953, and only 94 cases of measles compared with 740. No case of diphtheria was notified in 1954; there were two cases in the previous year. This is the second year on record when no case of diphtheria was notified in the borough; the first occasion being in 1952. Tuberculosis. The death rate from all forms of tuberculosis per 100,000 population was 14.0, which is much lower than last year's figure (19.2). The 1954 rate is the lowest figure ever recorded in Kensington, and compares very favourably with the rate (17.9) for England and Wales. Housing. The passing of the Housing Repairs and Rents Act on the 30th August, 1954, brought fresh hope to the problem of dealing with unfit housing accommodation in the borough. Under Section 1 of the Act, the Council were required to prepare proposals for dealing with unfit property. The Minister of Housing and Local Government requested all local authorities to submit to him their proposals not later than the 30th August, 1955. In London, proposals must be submitted jointly by the London County Council, and the Council of each Metropolitan Borough. The inspectorial staff of the public health department were busily engaged during the year in making surveys of those areas of the borough, where it was known that unfit houses existed. As a result of these surveys, the proposals adopted by the Council and forwarded to the London County Council for approval, are set out later in this Report. At the time of writing, these proposals are under consideration in common with those submitted by the other London boroughs, and it is hoped that the Council will be enabled to proceed on the lines they have suggested. That part of the Housing Repairs and Rents Act, 1954, dealing with permitted increases in rents has not been used to any great extent in Kensington. The number of cases where an increase of rent has been demanded by the landlord and where the tenant has applied for a certificate of disrepair has been comparatively negligible; only 50 such applications were received from tenants during the year. It would appear at this early stage that the effect of the Housing Repairs and Rents Act, 1954, in Kensington has not been of much practical benefit. There are two obvious reasons. Firstly, that notwithstanding the right to increase rents, landlords are still finding the cost of repairing their houses uneconomical, and secondly, that in many cases the maximum rent permitted under the 1954 Act, namely twice the gross rateable value, had already been reached or practically so. It may be that with the introduction of new valuation lists as from 1st April, 1956, the position will be materially altered and landlords may be further encouraged, by new legislation, to repair their property by relating the maximum permitted rent to gross rateable values on 1st April, 1956, instead of 30th August, 1954. The Council's work of enforcing the repair of houses under Part II of the Housing Act, 1936, is still at a standstill. The introduction of a new standard of fitness under the 1954 Act has not improved the position. The main difficulty, namely that the cost of repairs must be reasonable, still 3 exists and until the rents are sufficiently increased to enable landlords to secure a reasonable return on their outlay, the future of housing repairs in the borough seems rather dark. There is, however, one ray of light insofar as the number of applications for improvement grants under the Housing Act, 1949, is increasing, and it is hoped that much benefit will accrue thereby. Houses newly converted into flats after the introduction of the 1954 Act are removed from the restriction of the Rents Acts. That is to say, if an owner converts a house into two or more self-contained flats, he can charge, (subject to the approval of the Council where an improvement grant is made) such rents as will give him a reasonable return on his expenditure. The Housing Repairs and Rents Act, 1954, is still in its early stages of operation and it is hoped that as the experience of this Council and other authorities accumulates, the solution of the problem of dealing with dilapidated houses will become clearer. Food Hygiene. The work of improving the hygiene standards in food shops received a strong impetus when the London County Council made byelaws for the Protection of Food, which are enforced by the Metropolitan Borough Councils. A great deal of work was carried out under these byelaws in 1953 and the inspection of food shops was continued during the year under review. It was hoped, however, that the new Food and Drugs (Amendment) Act would have been put into operation in 1954, but, as is commonly known, difficulties arose regarding the Government's proposals to make various regulations governing food hygiene and practice. The 1954 Act, whilst on the Statute Book, is in fact inoperative (apart from Section 28, which deals with slaughterhouses). It is understood that the Government's intention is to introduce a consolidated Food and Drugs Bill, the passing of which will be made to coincide with new food hygiene regulations. Until these new legislative operations are completed, the Council must rely upon the byelaws for the protection of food, which do not go so far as the regulations originally proposed. However, where measures could be taken to improve food hygiene, they have been carried out. For example, in the quinquennial inspection of underground bakehouses, under the Factories Act, 1937, the Council have secured the closure of thirteen more unsatisfactory underground bakehouses. At the present time, only fourteen underground premises are certified as suitable for baking purposes, which compares with a figure of fifty-nine when the Factories Act, 1937, first came into operation. 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. One of the problems is the need for more intensive visiting of old people in their own homes. Experience over the past years has shown that old people, living alone and unvisited, often neglect themselves. The rate of deterioration in their living standard increases very rapidly and in some cases annoyance is caused to other tenants in the houses. In 1952, the Council increased the staff dealing with old people by the appointment of an assistant woman health officer. In that year 3,388 cases of old people were known to the public health department. At the end of 1954 the number had increased to 5,100. The following table gives a summary of the visiting and interviewing work for the last three years :- 5 1952 1953 1954 No. of old people on register at beginning of year 3,388 4,949 5,017 No. of cases lost 250 355 604 No. of initial visits 1,844 2,027 2,292 No. of re-visits 1,536 2,387 2,598 No. of interviews 1,739 1,005 2,054 Taking the figures as a basis it would appear that each case has received an initial visit, and re-visits would appear to have been made at the rate of one in three years. This is false deduction, because some old people need to be re-visited on many occasions; for example, the number of special cases, including chronic sick cases discharged from hospital, is increasing and these need closer attention than many other old people. In 1952 the number of visits paid to chronic sick cases was 196 and in 1954 the number of such visits increased to 500. The visiting of old persons is an essential feature of the welfare work in connection with their care, and it is inevitable that the Council will sooner or later have to review the question of increasing the staff employed for this purpose. VITAL STATISTICS The table set out on the next two pages (following the graphs opposite), gives the important vital statistics for 1954, together with comparative figures for the previous seven years. - 6 - - 7 - SUMMARY OF VITAL STATISTICS FOR KENSINGTON Description 1954 1953 1952 1951 1950 1949 1948 1947 POPULATION Population (estimated) 170,600 171,500 172,800 171,300 177,400 174, 220 168,800 166,170 Density of population per acre 74 74 75 74 77 76 74 72 LIVE BIRTHS Total births 2,707 2,642 2,810 2,656 2,745 2,681 2,908 3,012 Legitimate births 2,399 2,321 2,508 2,390 2,470 2,417 2,608 2,696 Illegitimate births 308 321 302 266 275 264 300 316 Birth rate per 1,000 population 15•9 15•4 16•3 15•5 15•5 15•4 17•2 18•1 STILL BIRTHS Total still births 48 53 48 60 54 39 56 65 Legitimate still births 40 47 37 55 51 39 47 58 Illegitimate still births Still birth rate per 8 6 11 5 3 Nil 9 7 1,000 total births 17•4 19•7 16•8 22•1 19•3 14•3 18•9 21•1 DEATHS Total deaths 1,643 1,708 1,936 1,920 1,848 1,819 1,685 1,866 Death rate per 1,000 population 9•63 9•96 11•2 11•2 10•4 10•4 10 11•2 DEATHS OP INFANTS UNDER 12 MONTHS OF AGE Total infant deaths 61 50 75 65 78 61+ 111 124 Legitimate deaths 54 42 67 55 69 52 103 105 Illegitimate deaths 1 8 8 10 9 12 8 19 Infant death rate per 1,000 births 22•5 19•7 27 24 28 24 38 41 Death rate of legitimate infants per 1,000 legitimate births 22•5 18 27 23 28 22 39 39 Death rate of illegitimate infants per 1,000 illegitimate births 22•7 25 26 38 33 45 27 60 MATERNAL DEATHS Deaths of mothers as a result of pregnancy or childbirth 2 Nil 5 3 5 Nil 5 4 Death rate of mothers per 1,000 live and still births 0•72 Nil 1•75 1•1 1•79 Nil 1•68 1•3 TUBERCULOSIS DEATHS Death rate from all forms per 100,000 populat ion 14•0 19•2 18•5 21 33 34 51 47•5 Death rate from respiratory tuberculosis per 100,000 population 11•7 15•1 16•8 17•5 29 32 45 43 Death rate from nonrespiratory tuberculosis per 100,000 population 2•3 4•1 1•7 3•5 4 2 6 4.5 8 YEAR 1954 Ages Cause of Death 0 - 1 1 - 4 5-14 15-24 25 - 64 65+ Total Respiratory Tuberculosis _ _ _ 1 9 10 20 Tuberculosis (other forms) 1 - - 1 1 1 4 Syphilitic disease _ __ _ _ 1 4 5 Diphtheria - — - - — — — Whooping Cough 1 - - - - - 1 Measles - - - - - - - Malignant neoplasms: Stomach - - - - 16 35 51 - do - Lungs & bronchus - - - - 42 30 72 - do - Breast - - - - 11 21 32 - do - Uterus - - - - 8 7 15 Other malignant and lymphatic neoplasms - 2 1 1 67 106 177 Vascular lesions of nervous system _ _ _ _ 53 150 203 Coronary disease, angina - - - - 75 187 262 Hypertension with heart disease - - - - 7 35 42 Other heart diseases — - - - 36 156 192 Other circulatory diseases - - - - 21 67 88 Influenza - - - - 3 2 5 Pneumonia 8 - - - 15 52 75 Bronchitis 1 - - - 11 45 57 Other respiratory diseases - - - - 3 6 9 Ulcers of stomach and duodenum - - - - 6 18 24 Gastritis, enteritis & diarrhoea - - - - 3 7 10 Nephritis and nephrosis — - - 1 7 5 13 Hyperplasia of prostate - - - — 2 8 10 Pregnancy, childbirth & abortion - - - 2 - - 2 Congenital malformations 11 1 - 1 6 2 21 Motor vehicle accidents - 1 1 2 6 5 15 All other accidents 1 - 1 3 24 20 49 Suicide - - - 3 32 4 39 Homicide and war operations - - - - 1 - 1 Smallpox - - - - - - - Scarlet fever — - - - - - - Enteric fever - - - - - - - Erysipelas - - - - - - - Meningoccocal infections - - - - - 1 1 Other infectious and parasitic diseases - _ 1 _ 1 1 3 Leukaemia - - - - 2 3 5 Diabetes - - - - 1 4 5 Other defined and ill-defined diseases 38 3 - - 36 58 135 TOTALS: 61 7 4 15 506 1050 1643 9 YEAR 1904 Ages Cause of Death 0 - 1 1 - 4 5-14 15-24 25 - 64 65+ Total Respiratory Tuberculosis 1 7 8 30 167 13 226 Tuberculosis (other forms) 32 39 10 6 28 1 116 Venereal disease 6 - - 2 2 - 10 Diphtheria 1 11 5 - - - 17 Whooping Cough 7 12 - - - - 19 Measles 11 52 3 - 1 — 67 Cancer: Malignant disease - 1 1 1 106 65 174 Heart disease 1 - 2 5 107 97 212 Influenza 4 — — 1 17 28 50 Pneumonia 42 52 3 5 59 36 197 Bronchitis 36 23 1 1 72 123 256 Other respiratory diseases 3 1 - - 30 28 62 Diarrhoea and enteritis 120 17 - 1 5 14 157 Diseases and accidents of parturition, Puerperal fever - - - 2 10 - 12 Accidents 22 7 5 1 24 16 75 Suicide — — - 1 19 1 21 Homicide 2 — - - - - 2 Smallpox — — - - 1 — 1 Scarlet fever 1 2 2 — — — 5 Enteric fever — — 1 2 4 — 7 Erysipelas 1 — — 1 - 1 3 Croup 1 - - - - - 1 Other septic diseases 2 1 — - 5 3 11 Alcoholism — — — - 10 1 11 Cirrhosis of liver — — — — 24 7 31 Premature birth 71 - - - - - 71 All other causes 139 28 16 22 247 274 726 TOTALS: 503 253 57 81 938 708 2540 10 CAUSES OF DEATH IN KENSINGTON (IN AGE GROUPS) IN 1954 COMPARED WITH 1904 On the preceding pages is a combined table showing the deaths occurring in Kensington residents in the years 1954 and 1904 analysed by cause and age. The following are other relevant statistics for the two years:- 1954 1904 Population 170,600 178,500 Total deaths 1,643 2,540 Males 737 1,190 Females 906 1,350 Crude death rate 9.63 14.2 For a number of reasons a direct comparison between the two years is difficult. The classification of causes of death has altered radically. In 1904, for example, there is an all inclusive cause "Malignant Disease: Cancer", whereas in 1954 malignant diseases were analysed. Again, in 1904 a generic term "Heart disease" was used in place of a number of differentiated causes used now. In addition to changes in terminology and classification, account must be taken of advances in medical knowledge and practice. In 1904, 728 deaths were recorded under the heading "All other causes"; a significantly smaller figure of 135 is shown for this heading in 1954. Alcoholism, which accounted for 11 deaths in 1904, is now no longer regarded as a precise cause of death. Even where direct comparisons can be made, as in the diseases of whooping cough, measles and scarlet fever, there is the possibility to be considered that organisms causing the diseases have changed, and the comparison may not be between like things. However, there are a few observations which can be made. The age of death has materially altered. This is graphically illustrated in the chart on Page 13 from which it is clear that the heavy death rate in the early years of life, which was manifest at the beginning of the century, has been substantially reduced; the death rate in the age period 25/64 has been almost halved and there is a resultant increase in the 65+ age group. These facts have to be considered with the age distribution of the population which is shown on the same page. It will be seen that in 1951 there were roughly twice as many people living over the age of 65 as in 1901. In the 25/65 age group this proportion approaches unity and through the 15/24 and the 5/14 groups progressively diminishes to approximately one half. Deaths are occurring at later ages from different diseases. Tuberculosis There is a marked difference between the deaths in these two years. Apart from the disparity in numbers, in 1954 there were no deaths from respiratory tuberculosis under the age of 15 years compared with 16 in 1904. For non-respiratory tuberculosis, there was one death compared with 81 in the same age-group. In respiratory tuberculosis, the peak group in 1904 was 25/62+ whilst in 1954, with a smaller number of deaths, the peak occurred in the highest age group. 11 Malignant diseases and Heart disease In 1954, there were 347 deaths from malignant neoplasms compared with 174 certified from similar causes in 1904. Similarly, there were 787 deaths in 1954 which might be compared to the cause "Heart disease" in 1904 which accounted for only 212 deaths. Although these groups of diseases may, in fact, be accounting for more deaths in 1954 than in 1904, it cannot be taken for granted, particularly in view of the large number of "Other causes" shown for 1904. Respiratory diseases Deaths from these diseases (including pneumonia and bronchitis) show a drop from 515 in 1904 to 141 in 1954. Apart from possible differences in classification (for example, the 1904 figures may have included some cases which would have been diagnosed as lung carcinoma in 1954), much of this improvement may be due to the use of modern drugs. This view is supported by the fact that there were only 9 deaths from these diseases under the age of 25 in 1954 compared with 167 in 1904. Influenza may be mentioned here, although conclusions are difficult to draw in view of the loose use of the term. In 1904 there were 50 deaths compared with 5 in 1954; the majority of deaths occurring over the age of 25 in both years. Diarrhoea and enteritis In 1954, there were 10 deaths all occurring in people over the age of 25. In 1904, there were 157 deaths, but 137 of these occurred in children under the age of 5 years. The problem of gastro-enteritis in young children was recognised specifically by the Kensington Council in 1924, when this disease in children up to the age of 5 years was made notifiable. Childbirth There were only two deaths from this cause in 1954 compared with 12 in 1904 Infectious diseases The following is a summary of the deaths from several diseases in the two years concerned 1904 1954 Diphtheria 17 _ Whooping Cough 19 1 Measles 67 _ Smallpox 1 _ Scarlet fever 5 _ Enteric fever 7_ Erysipelas 3_ In respect of some of these diseases, a true comparison cannot be reached in the absence of an analysis of the borough's child population. Violence The figures for homicide are very small (1904 - 2 1954 - 1 ), but one interesting feature is that in the earlier year both victims were under the age of 1 year (1 murder and 1 manslaughter) and in 1954 the victim was an adult. There were only 21 suicides in 1904 compared with 39 in 1954. 12 As far as accidents are concerned, a little more direct comparison can be made as the causes of accidents were roughly analysed for 1904. Of course, the 15 deaths from motor vehicle accidents in 1954 have no counterpart in 1904, although the figures for other accidents show a drop from 75 in the earlier year to 49 in 1954. From the rough analysis given, the 1904 accidents were what are now called home accidents, and although the number has dropped in 1954, it still represents 49 preventable deaths. This figure of 49 has some significance to the public health department in view of the decline, say, in the deaths from infectious diseases noted earlier. Both sets of causes are preventable to some extent, and the decline in one set enables our resources to be deployed against the other. The figures seem to confirm the present policy of vigilance regarding the infections and positive measures to prevent accidents. From the tables on pages 8 and 9 it is clear that no easy answer can be given to the question "What are Kensington residents dying of now compared with fifty years ago?". For example, there are no deaths recorded in 1904 for such causes as acute poliomyelitis, meningococcal infections, diabetes, leukaemia, ulcers of the stomach, nephritis and nephrosis. The table does give some general pointers which are, however, difficult to formulate definitely without combining a review of sociological factors with the facts of medicine over the last fifty years. 11 GENERAL PROVISION OP 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 1954:- Nature of specimen or sample Number examined Nose and throat swabs 224 Sputum 13 Faeces, rectal swabs and other specimens 688 Milk (bacteriological) 111 Water (drinking) 6 Water (swimming baths) 4 Ice Cream 23 Miscellaneous 38 Medicinal Baths (Personal Cleansing Station) The record of work done during 1954 is as follows:- Description Scabies Vermin Impetigo Other conditions Persons Cleansings Persons Cleansings Persons Cleansings Persons Cleansings Adults Kensington 57 98 97 110 - - 12 13 Other boroughs 50 84 49 57 - - - - Schoolchildren Kensington 30 152 885 885 — - 8 26 Other boroughs 10 23 310 312 - - - - Children under 5 Kensington 15 23 23 23 — — — - Other boroughs 2 3 5 6 - - - - Compulsory Cleansings - - 128 128 - - - - TOTALS 146 383 1,497 1,521 - - 20 39 In addition to the cleansing of persons referred to above, articles of personal clothing disinfested at the Medicinal Baths during the year numbered 1,548. 15 Disinfection and Disinfestation A summary of the routine work of the disinfecting staff is shown in the following table :- Houses disinfected after infectious disease 234 ( 333 rooms) Houses disinfested after vermin 550 (1412 rooms) Loads of furniture treated with hydrogen cyanide 33 Total weight of furniture, bedding, etc. dealt with:- 54 tons 7 cwt. 1 qtr. 13 lb. 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, 60k parcels of clothing were disinfected and the income amounted to £75. 10s. 0d. The following table indicates the destination of these parcels :- No, of parcels Hungary 228 Czechoslovakia 196 Russia 13 Turkey 1 Esthonia 2 + Unknown 164 + All these parcels were dealt with by one Kensington firm of exporters. Some countries allow the import of clothing if accompanied by a certificate stating that no case of infectious disease has occurred at the sender's address within twenty-one days prior to mailing. During the year, twenty-two such certificates were issued. H.C.N. Disinfestation For many years past, the Council have adopted the policy of disinfesting with H.C.N. the furniture and household effects of all tenants moving to new Council property, as a method of preventing bed bugs being taken from old houses into the new dwellings. In recent years, there has been considerable reduction in the number of bug infested houses in the borough, no doubt due to the introduction of new and effective insecticides such as D.D.T. This disinfestation of furniture service was proving costly, both in its operation and in the fact that the occupation of new flats was unavoidably held up owing to the disinfestation plant being able only to treat two loads per day. The problem was considered by the Public Health Committee and it was eventually agreed to abandon the policy of treating the furniture of all incoming tenants, irrespective of whether there was evidence of infestation or not, and substitute the following scheme :- (a) A sanitary inspector will examine the furniture and present home of each prospective tenant; (b) If bug infestation is present, the furniture will be dealt with by H.C.N, in the normal way; 16 (c) If no infestation is apparent, no action will be taken in regard to the furniture, but the walls and ducts of new flats will be treated by spraying with D.D.T. or with certain new smoke preparations. (d) The sanitary inspector will re-visit the flat after a period of six months; if necessary, appropriate action will be taken if the flat is found to have become infested. The Housing and Town Planning Committee agreed to the new proposals, subject to the carrying out of preliminary experiments. This was done and it was revealed that whilst the walls of old property were unaffected by liquid spray, the walls of the new flats appeared to be incapable of absorbing the insecticide, which tended to collect and stain the walls. It was, therefore, agreed to modify the proposals and to arrange for all rooms and ducts of new flats to be treated with D.D.T. or Gammexane in the form of smoke. This new scheme was put into operation at the beginning of 1954. During the year, 166 Council flats became ready for occupation, and in 161 cases the furniture of the ingoing families was found to be free from vermin and the tenants were allowed to move in directly. In the remaining 5 cases, the furniture was taken to the Council's Disinfecting Station and treated with H.C.N, before being moved into the new flats. 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 (i) the extent of infestation, (ii) special circumstances to which any undue presence of rats and mice might be attributed and (iii) the nature and extent of co-operative working with contiguous local authorities. The Minister has requested a report for the year ended 31st March, 1955, and the following table gives the details submitted for this period 17 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 36,731 8,019 44,783 II. Number of properties inspected by the Local Authority during 12 months ended 31/3/1955 as a result (a) (a) of notification 6 904 72 982 (b) survey (b) 7 72 12 91 or (c) otherwise (c) - - 226 226 III. Total inspections carried out, including re-inspections 87 7,236 555 7,878 IV. Number of properties (under II) found to be Major - - - - infested by rats Minor 9 319 35 363 V. Number of properties (under II) found to be Major - - - - infested by mice Minor 1 566 31 598 VI. Number of infested properties (under IV and V) treated by the Local Authority 10 860 59 929 VIIo Total treatments carried out 10 1,056 78 1,144 VIII. Number of notices served under Section 4:- (1) Treatment - - - - (2) Structural Works (i.e„Proofing) - 1 - 1 IX. Number of cases in which default action was taken by Local Authority 'ollowing issue of notice inder Section 4 - - - - X. Legal Proceedings - - - - XI. Number of "block" control schemes carried out - - - - - 18 - On two occasions all the sewers in the borough were dealt with by poison bait, and it was estimated that in the first treatment l+,1l+2 rats were destroyed; and in the second I|.,667 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 1,122 Premises inspected following complaints 1,236 Premises where rats were found 370 Premises where mice were found 625 Premises where other vermin were found 127 Premises where no infestation existed 111+ Number of visits made 8,111+ Number of notices served 1+0 Premises successfully treated 1,099 Cases in which advice only was given 71+ Borough Council properties dealt with' 81 Public Mortuary The number of bodies taken to the mortuary during the year was 1+97- The number of post-mortem examinations was 1+21+ and inquests were held in 80 cases. Destruction of Pigeons In order to deal with the nuisance and damage occasioned by the activities of wild pigeons, the Council have for many years authorised a pigeon-catcher to catch pigeons on the highway. He is provided, when necessary, with suitable pigeon food for bait. Pour complaints of nuisance caused by pigeons were passed to him for investigation during the year. Approximately 700 pigeons were destroyed. Atmospheric Pollution The Council have established 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 has been 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 carried out in 1951+ by the Council's Public Analyst, show the following results - 19 - Deposit Gauges North Kensington Month 1954 Days exposed Rainfall (ins.) Total deposits for period in tons per square mile Deposits per day in tons per square mile (average) Soluble Insol -uble Total Soluble Insol -uble Total January 31 0.95 5.81 7.82 13.63 .188 .252 .440 February 28 2.15 9.73 16.58 26.31 .347 .592 .939 March 31 2.10 7.45 6.38 13.83 .240 .206 .446 April 29 0.22 3.82 8.09 11.91 .132 .279 .411 May 31 2.07 7.89 13.32 21.21 .255 .429 .684 June 31 3.98 9.16 9.56 18.72 .296 .308 .604 July 33 2.80 7.11 8.59 15.70 .216 .260 .476 August 29 3.48 8.29 8.56 16.85 .286 .295 .581 September 29 1.46 4.93 7.42 12.35 .170 .256 .426 October 32 2.08 7.11 8.02 15.13 .222 .251 .473 November 30 3.62 12.15 9.16 21.31 .405 .305 .710 December 30 1.79 9.90 8.26 18.16 .330 .275 .605 TOTALS 364 26.70 93.35 111.76 205.11 South Kensington January 31 0.70 5.44 5.20 10.64 .176 .168 .344 February 28 1.96 8.66 13.87 22.53 .309 .495 .804 March 31 1.79 8.32 10.50 18.82 .268 .339 .607 April 29 0.23 3.62 5.54 9.16 .125 .191 .316 May 31 3.14 10.97 14.23 25.20 .354 .459 .813 June 31 3.22 6.34 6.24 12.58 .205 .201 .406 July 33 2.18 4.96 5.57 10.53 .150 .169 .319 August 29 3.32 8.59 6.98 15.57 .296 .241 .537 September 29 1.33 4.50 6.17 10.67 .153 .213 .366 October 32 2.02 5.87 5.67 11.54 .183 .178 .361 November 30 2.84 10.67 9.33 20.00 .356 .311 .667 December 30 1.48 8.76 5.47 14.23 .292 .182 .474 TOTALS 364 24.21 86.70 94.77 181.47 - 20 - Estimation of atmospheric sulphur Estimation of sulphur in milligrams of sulphur trioxide per day Month 1954 Days exposed North Kensington South Kensington January 31 3.75 4.07 February 28 3.73 3.82 March 31 3.15 3.55 April 29 2.36 2.65 May 31 1.64 2.14 June 31 0.90 1.23 July 33 0.75 1.15 August 29 0.87 1.32 September 29 1.12 1.44 October 32 1.72 2.03 November 30 3.22 3.61 December 30 3.12 3.77 Comparison of results The following table compares the Kensington results 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 1954 North Kensington South Kensington Country Kensington Industrial District A. B. A. B. A. B. A. B. January .440 3.75 .344 4.07 .179 1.17 .316 5.00 February .939 3.73 .804 3.82 .478 1.73 .811 5.04 March .446 3.15 .607 3.55 .267 1.25 .539 4.07 April .411 2.36 .316 2.65 .154 0.68 .403 2.85 May .684 1.64 .813 2.14 .265 0.66 .888 2.63 June .604 0.90 .406 1.23 .271 0.40 .509 2.36 July .476 0.75 .319 1.15 .177 0.33 .675 2.52 August .581 0.87 .537 1.32 .177 0.07 .689 2.16 September .426 1.12 .368 1.44 .178 0.91 .686 3.28 October .473 1.72 .361 2.03 .228 0.93 .763 4.79 November .710 3.22 .667 3.61 .426 1.44 .826 4.95 December .605 3.12 .474 3.77 .278 0.89 .844 4.55 Column 'A' - Deposits per day in tons per square mile. Column ®B' - Estimation of sulphur in milligrams of sulphur trioxide per day. These comparative figures may be summarised as follows:- Total weight o deposit for the year in tons per square mile Daily average of sulphur for year in milligrams of sulphur trioxide North Kensington 205.11 2.15 South Kensington 181.47 2.57 "Country district" 92.66 0.87 "Industrial district" 252.36 3.57 - 21 - Observations on the foregoing tables (a) General observations Readings at the two stations in Kensington were commenced in September, 1953, and it is now possible to compare the figures for the last three months of 1954 with those for the corresponding period of 1953, as follows:- Deposit gauge Month Days exposed North Kensington South Kensington Nth. & Sth. Kensington Total deposits in tons per sq. mile Total deposits in tons per sq. mile 1953 1954 1953 1954 1953 1954 October 32 32 20.53 15.13 21.24 11.54 November 29 30 13.89 21.31 10.87 20.00 December 31 30 16.51 18.16 16.47 14.23 The deposit gauge readings show considerable fluctuations although, in general, the deposit in the summer months was less than in the winter months. The amount of rainfall appears to have a bearing on the deposited matter, due mainly to an increase in soluble deposit. The effect of wind direction and velocity is a matter receiving attention, and from preliminary observations it appears that a period ofnortherly winds produces an increase in deposited matter. Atmospheric Sulphur Sulphur in milligrams of sulphur trioxide daily Month North Kensington South Kensington 1953 1954 1953 1954 October 2.56 1.72 3.14 2.03 November 3.23 3.22 3.36 3.61 December 3.41 3.12 4.39 3.77 Daily average 3.06 2.69 3.63 3.13 These results show that there has been a slight overall improvement during the last three months of 1954, as compared with the corresponding period of 1953» despite an increase in the amount of deposited matter at the North Kensington site. The results, however, must be treated with caution as variations in wind direction, rainfall and atmospheric conditions appear to have an effect on the figures. The estimation of atmospheric sulphur results show a more regular trend. It will be observed that in both North and South Kensington the sulphur readings fell from a maximum in January to a minimum in July, rising again to a high figure in December. The variation would seem to be due to the worsening of atmospheric conditions in winter, which inhibits the escape of the products of combustion into the upper atmosphere, and also to the increase in fuel burned for space heating in the colder weather. - 22 - It will be observed that the sulphur readings in South Kensington continued higher than those for North Kensington throughout the period, thus supporting the view that South Kensington is adversely affected by the power stations south of the borough boundary. Smoke Measuring Stations At their meeting on 22nd September, 195U» the Committee authorised the establishment of three smoke measuring stations. Unfortunately? there was a delay in obtaining the necessary equipment, and three essential components were not delivered until May, 1955. Arrangements have been made for these stations to be set up at the Public Library, Ladbroke Grove; the Public Health Department, Hornton Street, and at the London County Council Welfare Centre, Redcliffe Street, and it is expected that readings will commence in June, 1955« Action taken in regard to smoke nuisances • During the year, there were twelve complaints of smoke nuisance, as a result of which forty-one observations were made. Remedial measures were secured in all cases by informal action,, Burial of the Dead Section 50 of the National Assistance Act, 19U8, 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, 19U8, the Council have arranged the burial of 2&U persons under Section 50, which also 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, tracing 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. In the twelve months ended 31st December, 195U, the Council became responsible for the burial of thirty-six persons dying in the borough. The following is a summary of the action taken :- - 23 - (a) Cases where the funeral expenses have been fully recovered 13 (b) Cases where part only of the expenses has been recovered 13 (i) Number of these where balance of expenses will be recovered 3 (amounting to £18. 15s. 0d. ) (ii) Number of these where there is no estate or "liable" relative 6 (iii) Number of these where "liable" relatives are unable to contribute 4 (c) Cases where full cost has been borne by the Council 10 (i) Number of these where there is no estate or "liable" relative 3 (ii) Number of these where "liable" relatives are unable to contribute 7 Amount recovered by end of year £210. 5s. 8d. Additional amount expected to be recovered 18. 15. 0d.£229. 0s. 8d. Irrecoverable 177. 17. 10d. Total cost £406.18. 6d. It is of interest to note that of the thirty-six cases dealt with, only three were eligible for a Death Grant from the Ministry of National Insurance. The total amount recovered from this source amounted to £24. 0s. 0d. (included in the above figures.) Borough Cremation Service The General Cemetery Company, who own the Kensal Green Crematorium situated at the north-west corner of the borough, agreed with the Council to make a reduced standard charge of four guineas for cremation of Kensington residents, subject to certain financial conditions. The agreement came into force on the 1st January, 1951. In 1954, there were one hundred and ninety-six Kensington cremations, in comparison with two hundred and twelve in 1953 and one hundred and ninety-eight in 1952 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 seventy-six examinations were made. - 22 - Dog Nuisances Apart from being an objectionable social offence, fouling 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. The Council's byelaw dealing 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 soma other person." During the year ten summonses were issued under this byelaw. Two were subsequently withdrawn and in the other eight cases convictions were obtained and fines totalling £3. 15s. 0d. were imposed and costs amounting to £5. 10s. 0d. were awarded to the Council. 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 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 Council arranged for the printing of 2,000 copies of a revised pamphlet giving all the necessary information for distribution to old people individually or through their clubs. S.O.S Cards Window display cards are provided bearing the letters "S.O.S" in red on one side and, on the reverse side, directions - 25 - how to use the card and particulars of next-of-kin, nearest relatives and local social services. These cards are distributed to appropriate old people. Any person seeing one of the cards in a window is able to summon help from one of the sources given on the back of the card. The local press have generously assisted in making this service known. Grants to Clubs, etc. The Council have 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 North Kensington Old Age Pensioners' Club were granted £3. 0s. 0d. for the purchase of crockery. (c) The Kensington Communal Kitchens Service were granted £300 as a contribution towards the cost of operating a Meals-on-Wheels service in co-operation with the Kensington Women's Voluntary Services. Holidays The Council have 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. Block bookings of ground and first floor rooms for June 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. The following is a summary of work carried out in 1954:- Total applications received 115 Unsuitable on medical grounds 10 Consideration deferred 20 Referred to other organisations 10 40 Number approved 75 Cancellations after approval 13 Number sent on holiday 62 Number sent to Lennox House 43 Number sent to St. Mary's Home 19 Contributions by applicants £ 47. 16s. 0d. Cost of holidays to the Council 437. 14s. 0d. Booking fees paid to Family Welfare Association 13. 0s. 0d. - 26 - 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-five old people were dealt with in 1954. 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 ' 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 - 27 - 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-three old people were cleansed. National Health Service - Institutional Care, etc. Facilities for institutional care, home nursing, sick room equipment and home helps are provided by the London County Council. Hospital treatment, medical care, ophthalmic, dental and pharmaceutical services are provided under statute. The borough is situated in the area of two Metropolitan Regional Hospital Boards. One Hospital Management Committee in the borough utilizes the part-time service of a local medical practitioner as a clinical assessor to decide the priority need for admission of all patients submitted to that Hospital Group as being in need of hospital treatment and classed as "chronic sick". This ensures the early or immediate admission of patients where the need is urgent on medico/social grounds. There is usually no difficulty in the admission to hospital for the treatment of acute conditions. During the year it was possible to arrange for one hundred and thirty-five old people to be admitted to hospitals for institutional treatment and, in addition, fifty-three cases were admitted to homes for the aged. Domiciliary care of "chronic sick" All the cases on the chronic sick waiting lists of the hospitals in the borough are referred to the public health department. They are visited and assessed by the Women Health Officers. Where necessary, medical care, home nursing, home helps, convalescent holidays, financial aid and pensions are arranged with the appropriate statutory bodies. These, together with various services operated by the Council augmented by voluntary bodies are provided to such good effect that, in many cases, the need for hospital admission is postponed indefinitely. Laundry At present no direct authority exists for the Council to provide a laundry service, as such, for old people. Section 122 of the Public Health (London) Act, 1936, enables the Council to cause any article in a house 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 incon tinence 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 ninety 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. Prom 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 one thousand and three separate collections - 28 - of laundry were made under this scheme, and the number of articles cleansed totalled twelve thousand and thirty-three. 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 enabling the provision of a chiropody service for house-bound old people. 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 two hundred and thirty-five and the number of treatments given was five hundred and seventeen. 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 Kensington Communal Services Committee:- The following statement shows the progress of the service and financial effect since it was taken over by the Kensington Communal Services Committee:- Period Number of meals Gross Cost Receipts from old people Subsidy from L.C.C Grant from R.B.K Net Cost October 1948- £ £ £ £ £ 31st March, 1949 3,535 352 149 - - 203 1949/50 10,461 1,016 432 27 - 557 1950/51 13,758 1,250 477 115 - 558 1951/52 18,370 1,634 625 445 - 564 1952/53 28,426 2,103 954 948 - 201 1953/54 39,196 3,459 1,317 1,306 200 636 1954/55 45,116 -Not yet available- It will be observed that the number of meals served is growing and that the net cost is substantial. Up to 1952/53 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 grants of £200 for 1953/54 and £300 for 1954/55 were made to the Kensington Communal Services. - 29 - 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 1954:- Cases on register at the beginning of year 5,017 New cases added to register 687 Cases removed to hospitals 135 Cases removed to homes (voluntarily) 53 Cases removed to homes (compulsorily) 2 Cases removed from district 125 Number of deaths 289 Total number of cases remaining on register at end of year 5,100 Number of old people sent away for holiday 62 Number of old people provided with Council's laundry service 90 Number of old people provided with "Meals on Wheels" 367 Cases referred to National Assistance Board 187 Cases referred for assistance from Home Help Department 186 Cases referred for assistance from Voluntary Organisations 112 Cases referred to Recreational Clubs 179 Cases assisted with provision of medical and nursing care 118 Cases referred to home chiropody service 235 Cases cleansed at Medicinal Baths 23 Cases where disinfestation was carried out 45 Number of initial home visits made 2,292 Number of re-visits 2,598 Number of other visits made in connection with old people, including visits to clubs 155 Number of interviews, enquiries, etc. on behalf of old people 1,852 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, and provided that 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 seven days' notice as previously required. 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 - 30 - and another registered medical practitioner. Further, where the hospital or institution agree to receive the case, it is not 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. Although many cases were investigated during the year, in only two cases was formal action taken to secure compulsory removal. The first case was that of an old lady, aged 85, living alone and unable to devote to herself proper care and attention. She was living in insanitary conditions and refused all domiciliary services, such as home helps. Application was made to a Justice of the Peace for an Order to remove her compulsorily to an Old People's Home maintained by the London County Council. The Order was granted and executed and subsequently the old lady decided to remain in the Home permanently. The second case was also an old lady, aged 83, living alone in one room. She had had a stroke resulting in partial paralysis. Efforts to persuade her to enter hospital failed and the domiciliary services were insufficient to meet the needs of the case. Accordingly application was made to a Justice of the Peace to remove her compulsorily to hospital. The Order was granted and executed. Eventually the old lady settled down in hospital and agreed to remain there until considered fit to be discharged. SANITARY INSPECTION The following table shows a summary of the inspections, etc., carried out by the sanitary inspectors during the year:- Public Health (London) Act, 1936 Houses inspected on complaint 4,309 Houses inspected after infectious disease 1,798 Re-inspections 10,312 Smoke observations 41 Other inspections 1,830 Housing Act, 1936 Initial inspections (including preparation or revision of house-to-house cards) 7,213 Re—1nspections 1,728 Inspections in regard to overcrowding 1,467 Underground Living Rooms Primary inspections 166 Re-inspections 1,148 Drainage Applications 578 Plans submitted 236 House drains tested and inspected 6,002 Shops Act, 1934 Premises inspected 157 - 31 - 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 1,721 Statutory notices 680 Final notices 239 Various Shops Act, 1934 16 Notice of intention to enter premises for inspection 583 Rent Restrictions Act certificates 4 Certificates of disrepair 60 Report of waste water to the Metropolitan Water Board 64 Report of dangerous structures to the London County Council 84 Other notices 103 The following is a summary of works completed under the supervision of the sanitary inspectors during the year:- House drains, reconstructed or repaired 270 House drains, cleansed 180 Water closets, reconstructed or repaired 212 Water closets, new provided 265 Soil pipes, vent pipes, repaired etc 106 Soil pipes, vent pipes, new provided 99 Baths, new provided 240 Sinks, new provided 178 Lavatory basins, new provided 761 Waste pipes, new provided 347 Cisterns, cleansed 3 Cisterns, covered 7 Taps fixed on rising main 14 Yards and areas paved, drained etc. 9 Dustbins provided 128 Accumulations of filth, etc. removed 85 Roofs repaired 433 Houses provided with water above basement level 7 Dampness in dwellings remedied 681 Houses disinfected after infectious disease (including bedding, etc.) 234 Rooms in such houses, disinfected after infectious disease 333 Houses cleansed under Houses let in Lodgings Byelaws 32 Cleansing of houses not on register 20 Verminous houses cleansed (including bedding, clothing, etc.) 550 Verminous rooms in such houses, cleansed 1,412 Dirty bedding, cleansed 38 Dirty bedding, destroyed 10 Other sanitary works executed ,1,684 - 32 - HOUSING Inspection of dwelling houses during the year (i) (a) Dwelling houses inspected for housing defects (under Public Health or Housing Act) 14,953 (b) Inspections made for the purpose 29,971 (ii) (a) Dwelling houses (including those under sub-head (i) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 7,213 (b) Inspections made for the purpose 8,941 (iii) Dwelling houses found not to be in all respects reasonably fit for human habitation 1,721 Remedy of defects without service of formal notices Number of defective dwelling-houses rendered fit in consequence of informal action 1,041 Action under statutory powers during the year (a) Action under Sections 9, 10 and 16 of the Housing Act, 1936 :- (i) Dwelling houses in respect of which notices under Section 9 were served requiring repairs 1 (ii) Dwelling houses which were rendered fit by owners under Section 9 - (iii) Dwelling houses rendered fit by the Council in default of owners - (b) Action under Sections 11 and 13 of the Housing Act, 1936:- (i) Dwelling houses in respect of which demolition orders were made 2 (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 2 (iv) Dwelling houses in respect of which undertakings were accepted from owner to render premises fit for habitation - (v) 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 ( 38 premises made ( 87 rooms (ii) Separate tenements or underground rooms in respect of which closing orders were determined, the tenements or rooms 45 premises having been rendered fit (72 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 24 premises for purposes other than sleeping (43 rooms - 33 - (iv) Separate tenements or underground rooms in respect of which the Council accepted undertakings from owners to render fit ( 6 premises within specified time ( 17 rooms (v) Number of undertakings by owners to render separate tenements or underground rooms fit, which were cancelled, the ( 2 premises necessary works having been completed ( 9 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 1,721 (ii) Number of Statutory Notices served 680 (iii) Number of Summonses issued 121 (f) Housing Act, 1936, Part IV - Overcrowding :- (i) Number of dwellings overcrowded at end No reliable of year estimate (ii) Number of new cases of overcrowding reported during the year 207 (802 units) (iii) Number of cases of overcrowding relieved during the year 159 (570 units) (iv) Number of cases in which dwelling houses have again become overcrowded after the local authority have taken steps for the abatement of overcrowding Nil NOTE: Units means the number of equivalent persons in the families obtained by regarding children between 1 and 10 years of age as "half-persons" and disregarding infants under the age of 12 months. Housing Repairs and Rents Act, 1954 Certificates of Disrepair The Housing Repairs and Rents Act, 1954, which came into operation on 30th August, 1954, altered the legislation relating to the Council's duty to issue certificates of disrepair in respect of dwelling houses, not fit for habitation, subject to the Rent and Mortgage Interest Restrictions Acts. Under Part II of the Act, the Council are required to deal with application from a tenant for a certificate of disrepair where the landlord has claimed a repairs increase in rent, and the tenant feels that the house is not in sufficiently good condition to justify it. Further, the new provisions replace those (under the Rents Acts, 1920-39), relating to the 40 per cent, increase of rent permitted under the Increase of Rent and Mortgage Interest (Restrictions) Act, 1920. Thus in particular, if a tenant, not subject to a repairs increase under the 1954 Act, applies to the Council for a certificate of disrepair under the 1920 Act, they must adopt the same criteria regarding the condition of the house as they must under the 1954 Act. A certificate of disrepair must be in the form prescribed by the Minister of Housing and Local Government and must specify the defects in respect of which it is issued. This is to make - 34 - it easier for the landlord to determine what work of repair must be carried out to the house in order to secure the revocation of the certificate. The Council have decided that each application for a certificate, or for the revocation of a certificate, must be accompanied by a fee of one shilling. The following table gives a summary of the action taken under the 1954 Act up to the end of the year:- Category Applications for certificates of disrepair Applications for certificates to be revoked No. granted No. refused No. granted No. refused (a) Dwelling houses which have been the subject of a notice of repairs increase of rent under Part II of the 1954 Act 48 2 - 3 (b) Dwelling houses which have NOT been the subject of a notice of repairs increase of rent under the 1954 Act, but in respect of which permitted increases of rent are recoverable under Section 2(1)(c) and (d) of the Increase of Rent and Mortgage Interest (Restrictions) Act, 1920 12 1 - - In addition to the cases mentioned above, four applications were made to the Council prior to the 30th August. 1954, (when the Housing Repairs and Rents Act came into force) for certificates of unfitness for habitation under the Rent and Mortgage Interest (Restrictions) Act, 1920-1939. In these four cases, the conditions found justified the issue of certificates of unfitness, the operation of which is not affected by the new 1954 Act. In two cases, the owners applied for the revocation of unfitness certificates granted to their tenants, on the grounds that the necessary repairs had been carried out. Both applications were granted. Houses in Multiple Occupation, (including hostels) The provisions of the Housing Act, 1936, (Sections 6-8) and the Public Health (London)Act, 1936, (Section 155), enabling local authorities in London to make and enforce byelaws relating to houses let in lodgings and hostels respectively, have been superseded by provisions contained in Sections 11 and 12 of the Housing Repairs and Rents Act, 1954, which apply to any house or part of a house "which is let in lodgings or occupied by members of more than one family." The new provisions replace the power to make byelaws by a general power given to the Council to require in houses which are in multi-occupation an adequate provision of the following services and amenities :- - 35 - Natural lighting; Ventilation; Water supply; Drainage and sanitary conveniences Facilities for storage, preparation and cooking of food, and for the disposal of waste water; Overcrowding of sleeping rooms. Section 11 enables the Council to take action if in their opinion the premises are so defective in the matters set out above as not to be reasonably suitable for the number of persons or households in occupation. In such cases they may serve a notice on the person in control: (a) specifying the works required to render the premises reasonably suitable for occupation by those persons or households; (b) requiring the person in controls, in default of executing these works within the prescribed period, to take such steps as are reasonably open to him (including, if necessary, the taking of legal proceedings) for securing a reduction in the number of persons accommodated or the number of households, or both, as specified in the notice. Thus, where a notice is served, a choice is given, either to carry out the specified works, or, alternatively, to reduce the intensity of occupation of the house, in which case possession of the house or parts of the house can be obtained by an owner notwithstanding the Rents Acts. Under Section 12, the Council may serve a notice on the occupier, or the person having the control and management of a house or part of a house, where excessive numbers of persons are accommodated, specifying in relation to any room on the premises the maximum number of persons by whom it is suitable to be occupied for sleeping purposes at any one time, or, if appropriate, that the room is unsuitable to be occupied for sleeping purposes. It will be an offence after the notice has become operative to cause or allow any rooms to be occupied otherwise than in accordance with the notice, or to cause or permit the accommodation to be so occupied that it is not possible to avoid persons of opposite sexes over the age of 12 years (excluding persons living together as husband and wife) occupying sleeping accommodation in the same room. In view of the large number of multi-occupied houses in Kensington, Sections 11 and 12 are of considerable importance, applying not only to tenement houses and hostels, both of which were formerly subject to byelaw control, but to boarding houses, boarding schools, guest houses, and houses divided into one room flatlets, which were not formerly subject to such control. Even hotels might also be brought within the scope of these sections, and whilst it might be inappropriate to apply them generally to such premises, the two sections may be of value in dealing with staff quarters where these are unsatisfactory. The premises affected vary considerably and render impracticable the provision of a single rigid code of requirements applicable to all cases; indeed, such a code would appear to be contrary to the wishes of the Minister, who has expressed the view that the provision of the prescribed services and amenities should be decided on the merits of each case. During the year, the Public Health Committee gave careful consideration to the question of applying Sections 11 and 12, and, for general guidance, decided to recommend the Council to adopt the following as standards of the essential services and amenities which will be considered as satisfactory in appropriate cases:- A house or part of house which is let in lodgings or - 36 - occupied by members of more than one family shall not, in the absence of special circumstances justifying a modification thereof, be regarded as reasonably suitable for such occupation unless the following general standards obtain:- A. Natural Lighting: (i) The provision and maintenance in every habitable room, of a window or windows (capable of being opened at the top), opening directly to the external air, and having, where practicable, a glass area equal to at least 1/10th of the floor area. (ii) The provision and maintenance, wherever practicable, of adequate means of natural light to a common staircase. B. Ventilation: The provision and maintenance of adequate means of ventilation for every passage, room, water closet apartment and staircase. C. Water Supply: (i) The provision of one tap per floor with a water supply, preferably from the rising main, a sink of suitable size and pattern and efficient means for carrying off any waste water from the tap. (ii) The provision in future conversions into multioccupation of one tap per floor and, if more than one letting, one tap per letting. In each case the provision of a sink of suitable size and -pattern and efficient means for carrying off any waste water from the tap. (iii) The provision in every hostel, boarding house, guest house, and boarding school, of a water supply reasonably accessible to the occupants of each sleeping room. D. Sanitary Conveniences: (i) If practicable, the provision and maintenance of one water closet for every four habitable rooms, or one water closet for every ten persons irrespective of age; existing accommodation is to be deemed insufficient if it fails to conform to both of these requirements, or if it is not reasonably accessible to the persons for whom it is intended; except in the case of (ii) hostels, boarding houses and similar establishments where one water closet for every ten persons, sited so as to be conveniently accessible in relation to sleeping rooms, shall be deemed sufficient; and (iii) Boarding schools, where a standard of one water closet for every five pupils, as laid down in the Standards for School Premises Regulations, 1954, should be borne in mind; and (iv) Future conversion to single room lettings, where one water closet for every four lettings and not more than one floor distant shall be required; and - 37 - (v) Existing single room lettings, where, if practicable, there must be a provision of one water closet for every four lettings or for every ten persons irrespective of age, the accommodation to be deemed insufficient if it fails to conform to both of these requirements. E. Facilities for storage, preparation and cooking of food: The provision inside each separate dwelling (as distinct from a staircase or landing in common use), of facilities for cooking foods, and a food cupboard ventilated to the external air and of dimensions not less than :- A one room letting 3 cu.ft. A two room letting 4 cu.ft. A three room letting 6 cu.ft. A dwelling comprising more than three rooms 8 cu.ft. (These requirements relate to separate dwellings in family occupation. In the case of bed-sitting rooms in use as bachelor apartments, facilities for storing, preparing and cooking food, are normally not necessary and in such circumstances these provisions will not be required. ) P. Overcrowding of sleeping rooms: The provision in hostels and boarding schools of a minimum floor space of 60 sq.ft. for each person, and the prohibition of the use of any underground room less than 7 ft. in height, or any room which does not comply with the requirements of the Council's Underground Room Regulations. The above recommendations were adopted by the Council on 5th April, 1955. Slum Clearance The following table gives details of the clearance areas declared by the Council since 1950, when slum clearance work under the Housing Act, 1936, was recommenced:- Name of Area Date of Declaration No. of houses No. of persons displaced Elgin Mews 25.4.1950 28 86 Lionel Mews (Nos. 1 and 2.) 3.10.1950 13 38 Lonsdale Mews (Nos. 1 and 2.) 2.1.1951 19 14 Munro Mews 2.1.1951 24 55 South End Road and Gardens 3.4.1951 10 4 East Mews Road 3.4.1951 14 40 Powis Mews 13.11.1951 13 30 St. Lukes Mews 13.11.1951 20 41 Portobello Road 13.11.1951 4 3 The Minister of Housing and Local Government has confirmed that all the above-mentioned areas may be dealt with as - 38 - clearance areas with the exceptions that (a) in the case of St. Lukes Mews seven properties were excluded from the confirming order and, (b) in the case of South End Road and Gardens, the owners carried out the necessary demolition works prior to the Minister's decision. On the 22nd March, 1954, Circular 30/54 was issued by the Ministry of Housing and Local Government. The circular states that the Minister has received a number of enquiries from local authorities about slum clearance. In particular, local authorities have asked whether the advice in paragraph 3 of circular 61/47 of 27th March, 1947, still stands. That circular referred to the report of the Standards of Fitness Sub-Committee of the Central Housing Advisory Committee, and paragraph 3 said :- "The Minister is in general agreement with the recommendations made by the Committee and desires to make such standards effective at the earliest moment practicable. Because, however, of the need to concentrate on the erection of new houses for families without a separate home of their own as much as possible of the labour and materials available for housing purposes, it will not be practicable to require the execution of works to existing houses which would make substantial calls on these resources or, save in exceptional circumstances, to set in motion procedure for the demolition of unfit houses which would involve the provision of new houses for persons who would be displaced from those houses." The Ministry state that that advice is now withdrawn. The circular adds that local authorities should forthwith resume the full exercise of their powers under Part II (unfit houses) and Part III (clearance areas) of the Housing Act, 1936, and continue to do so until the proposals they will have to submit under section 1 of the new Housing Repairs and Rents Act, 1954s have been approved. A preliminary survey was made during the year of a number of areas where it appears that action under Part III of the Housing Act, 1936, is desirable, and a provisional five-year programme has been prepared. It may be necessary to modify this programme when a more detailed survey is undertaken. The Council decided that the following areas are suitable for clearance during the period ending 1960:- Stanley Gardens Mews 4 premises Kensington Park Mews 13 " Addison Place 12 " Railway Mews 10 " Penelon Place (including Shaftesbury Cottages) Ashley Cottages )66 " Warwick Road ) Portland Road 16 " Denbigh Close } Portobello Road )37 " Denbigh Terrace ) Lecky Street 5 " The foregoing areas are being inspected in detail with a view to formal representation for slum clearance procedure under Part III of the Housing Act, 1936. The above programme is supplementary to the areas which the Council decided on the 14th October, 1952, to schedule for clearance as a long-term programme. These areas are as follows :- - 39 - Addison Place Area 48 premises 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 ninetyone premises :- Treverton Street Nos. 14 - 60 even 1 - 63 odd Ladbroke Grove Nos.329 - 339 odd Raymede Street Nos. 1-17 consecutive Hewer Street Nos 1 -12 " Exmoor Street No. 5 Following a public enquiry, the Minister of Housing and Local Government confirmed the Order without modification. Active steps are now being taken by the Council to acquire the Treverton Street properties and to rehouse the tenants. Plans are in the course of production for re-developing the area. Proposals under Section 1 of the Housing Repairs and Rents Act, 1954 Every metropolitan borough, jointly with the London County Council, is required to submit to the Minister of Housing and Local Government by 29th August, 1955, proposals for dealing with houses which are unfit within the meaning of section 9 of the Housing Repairs and Rents Act, 1954, and which are suitable for action under section 11 (demolition) or section 25 (Clearance Area procedure) of the Housing Act, 1936. Survey Six inspectors, later reduced to four, were taken off their normal duties in order to undertake a rapid survey of the houses where conditions were known to be below standard. The information obtained was restricted to those matters affecting the fitness of the houses for habitation, and where the house was unfit, the cost of carrying out repairs with a view to determining whether the house was repairable at reasonable cost. Valuations made from time to time by the Council's Valuer, and by private valuers employed by the Council, were borne in mind when estimating the value of the house. It was clearly impossible and indeed unnecessary to examine all houses in the borough, but efforts were made to inspect all houses of the tenement type where from information already in the possession of the public health department the conditions were suspected to be unsatisfactory. It was not possible to — 40 — gain access to all these houses owing to their occupants being out throughout the day; and in these cases the condition of that part of the house inspected was presumed to be typical of the remainder. In all, 6,166 houses of the tenement were inspected, whilst a further 1,250 houses where conditions were known to be somewhat better were assessed on a token inspection of one—fifth of their number, The remaining 30,981 houses in the borough were not examined, and apart from possible isolated houses here and there, these may be regarded as fit for habitation. Results of Survey The 3,293 houses deemed to be unfit and not repairable at reasonable cost fall into two categories — those which are included in areas regarded as suitable for Clearance Area procedure, and those which would best be dealt with as individual unfit houses with a view to unit redevelopment. Eight areas have already been included in a slum clearance programme approved by the Council as follows Area No„ of houses Railway Mews 10 Kensington Park Mews 13 Addison Place 12 Portland Road 16 Penelon Place, Ashley Cottages and Warwick Road 66 Stanley Gardens Mews 4 Denbigh Terrace, Denbigh Close and Portobello Road 37 Lecky Street 5 At the time that these areas were being programmed for slum clearance, the Kensal New Town (east) area was included in the County Council's Town Planning Development Plan as a future area of industrial development, and because of this it was not considered appropriate to include the area in the Council's slum clearance programme. Recently the Minister of Housing and Local Government amended the redevelopment plan in regard to this area and it is zoned as a Residential Area. The area comprises a site of 20¼ acres, and includes premises in the following streets Kensal Road Southam Street Edenham Street Kensal Place Golborne Road Appleford Road Golborne Gardens Hazlewood Crescent Adair Road Bosworth Road Practically all these houses are between eighty and one— hundred years old, and have been subjected to heavy usage as tenement houses throughout a period, with the result that they are now worn out, unfit, and seriously devoid of amenities to such an extent that the only practical solution is to demolish all the houses within the area. A detailed survey of these houses has now reached an advanced stage and it confirms that, with few exceptions, the houses are unfit for habitation and are not repairable at reasonable cost. The Council decided to submit to the London County Council slum clearance proposals comprising the eight areas already approved and the eastern part of the Kensal New Town Area. The prescribed form of Kensington proposals under Section 1 41 of the 1954 Act, as submitted to the London County Council, is as follows:- Total number of permanent dwellings in the borough 38,397 Part 1. The total problem: (i) Estimated number of houses unfit for human habitation within the meaning of Section 9 of the Housing Repairs and Rents Act, 1954, and suitable for action under Section 11 or Section 25 of the Housing Act, 1936 3,293 (ii) Period in years which the Council think necessary for securing the demolition of all the houses in (i) Not less than 20 years Part 2. Orders already made, etc.: By L.C.C. By M.B.C. (iii) Number of houses in (i) in clearance areas and already covered by operative clearance or compulsory purchase orders or owned by the local authority 104 (iv) Number of houses which are already in clearance areas and for which clearance or compulsory purchase orders have been submitted to the Minister but have not yet become operative 0 Part 3. Action in the first five years: (v) Number of houses which are already in clearance areas and for which clearance or compulsory purchase orders are to be made or which are to be purchased by agreement within the five years 0 (vi) Number of houses which are to be included in clearance areas still to be declared and which within the five years will be owned by the local authority or will have been included in a clearance order or a compulsory purchase order submitted to the Minister 679 (vii) Number of houses under (iii), (iv), (v) and (vi) to be patched (if necessary) and retained within the five years under section 2 of the Housing Repairs and Rents Act, 1954, for temporary accommodation: + A maximum figure of 516 (viii) Number of houses under (iii), (iv), (v) and (vi) to be demolished in the five years: + A minimum figure of 267 (ix) Number of houses (including those already comprised in operative demolition orders) to be demolished in the five years as a result of action under Section 11 of the Housing Act, 1936 + 50 — 42 — NOTE. + As this will be governed by progress of Clearance Area programme, the rehousing and derequisitioning programme, it is impossible to predict accurately., A token figure of 50 is suggested for item (ix) These proposals are still subject to negotiation between the Council and the London County Council. Housing Act, 1949 — Improvement Grants Circular 36/54 dated 20th April, 1954, issued by the Ministry of Housing and Local Government, stated that the Government desired to give every possible encouragement to local authorities and private owners who wish to modernise and make better use of existing houses by improvements and conversions,, The following points were made by the Circular (a) Works of improvement or conversion need no longer be reckoned as part of the local authority's approved programme of new house building. (b) Local authorities may themselves approve applications for grant submitted by private owners, instead of having to refer to the Minister. In special cases, e.g. where it may be desired to invoke the Minister's power to waive specified requirements, local authorities can still approach the Minister. Improvement or conversion schemes undertaken by a local authority will continue to require the Minister's approval. (c) The requirements which the Minister has now specified for a dwelling in respect of which an improvement grant is to be made are as follows The dwelling must, after improvement or conversion 1. be in a good state of repair and substantially free from damp; 2. have each room properly lighted and ventilated; 3. have an adequate supply of wholesome water laid on inside the dwelling; 4. be provided with efficient and adequate means of supplying hot water for domestic purposes; 5. have an internal or otherwise readily accessible water closet; 6. have a fixed bath (or shower) preferably in a separate room? 7. be provided with a sink or sinks and with suitable arrangements for the disposal of waste water; 8. have a proper drainage system; 9. be provided in each room with adequate points for gas or electric lighting (where reasonably available); 10. be provided with adequate facilities for heating; 11. have satisfactory facilities for storing, preparing and cooking food; 12. have proper provision for the storage of fuel (where required). (d) Houses which lack modern services and amenities are well on the way to permanent unfitness and the owners have less and less incentive to maintain them properly as they fall behind modern standards. In considering a scheme of improvement or conversion submitted for grant, only one — 43 — question may properly be asked, namely, whether it will produce a satisfactory modernised dwelling complying with the statutory conditions and the specified requirements. (e) Reasonable expenditure on professional fees of architects, surveyors and engineers may now be included in the estimated cost of improvement works ranking for granto (f) Arrangements have been made with the professional associations for sending each local authority lists of architects and surveyors who would be prepared to advise on improvement work. The Housing Repairs and Rents Act, 1954, amended the Housing Act, 1949, in relation to improvement grants, and in particular Section 16 made certain amendments in the statutory conditions attached to the payment of improvement grants under Part II of the Housing Act, 1949, and (together with Section 37 of the new Act) altered the arrangements for fixing the maximum rent of dwellings on which grant is paid. Under the Act of 1949, a dwelling had to be considered to provide satisfactory accommodation for at least thirty years in order to attract the granto Under the new Act that period is reduced to "more than fifteen years" with the added condition that the Minister or the local authority — as the case may be — should be satisfied "that it is expedient in all the circumstances that the proposals or application should be approved," Section 16removes altogether the requirement that schemes of improvement or conversion must not cost more than £800 per dwellingj and provides instead a maximum grant of half the cost of the work per dwelling or £400, whichever is the less. The power is, however, reserved to local authorities, with the Minister's concurrence, to pay a higher grant in any case in which they consider the circumstances justify it. Section 37 extends the duty of local authorities to fix maximum rents for grant—aided dwellings within the rateable value limits of the Rent Acts. They are now required to fix a maximum rent for all such dwellings, whether let or not, with the exception of one class, namely, those which have been let for the first time since 1st September, 1939, and for which a reasonable rent has been fixed by a rent tribunal under the Landlord and Tenant (Rent Control) Act, 1949. A rent fixed by a rent tribunal under that Act for a dwelling improved with the aid of grant may be increased by 8 per cento of that portion of the cost of the improvement which is borne by the owner. A maximum rent fixed by a local authority will become the standard rent to the exclusion of any existing standard rent. In fixing the maximum rent the local authority are required by the section to have regard to "the age of the dwelling, to the character and condition of the dwelling after the carrying out of the proposed improvement works and to the cost of those works." Applications for improvement grants received and dealt with during 1954 are summarised as follows Applications received 20 Applications granted 13 (comprising 19 separate "dwellings") Applications refused 7 Total amount of grants approved £5, 066. 0s. 3d. 44 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 310 Balfour of Burleigh Estate 120 Portobello Court 158 Denbigh Road/West bourne Grove 102 Ingelow House, Holland street 33 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, Lansdowrne Road 8 Hunter House, Old Brompton Road 15 Pinborough 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 96 and 98, Blenheim Crescent 10 Colville Gardens and Square 20 19 - 27, Acklam Road 8 10 - 14 Blagrove Road 6 Raddington Road 18 10 - 14 Cambridge Gardens 8 Other schemes for building new housing accommodation are in various stages of preparation,, 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 1+. As in Category 3s but without special medical circumstances. — 45 — 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. Ninety—three new cases were dealt with in 1954 by the Special Sub—Committee as follows :— (a) Recommended for alternative accommodation by the Council 50 (b) Proceedings ordered to be taken without prior offer of alternative accommodation 7 (c) Action postponed 36 The total number of cases of overcrowding abated during the year was eighty—one and, in addition, seventy—eight Category 4 cases were also abated during the year. Since the war, the Special Sub—Committee have dealt with one thousand, one hundred and twenty—one cases of overcrowding under Categories 1, 2 and 3, and no fewer than eight hundred and eighty of these have been abated. Assessment of Housing Priorities on Medical Grounds During the year two hundred and seventy—five 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 forty—five cases, recommendations for re—housing on medical grounds were also made to the London County Council, and to other local authorities in four cases. Accommodation for Costermongers The general condition of mews dwellings in the borough has received much attention from the public health viewpoint in recent years. In connection with the Council's policy of clearing unsatisfactory mews dwellings, it was appreciated that street traders must have storage accommodation for their horses, vehicles, barrows and goods. At the Council's request, the London County Council promoted legislation to enable them to provide and maintain storage and stabling accommodation for use by street traders and other like persons displaced by reason of the exercise of powers under the Housing Acts, 1936/49, or by the acquisition of lands under any other enactment. During the year, the erection of costermongers' stabling and storage accommodation in Gadsden Mews (which had been cleared under Housing Act procedure) was completed and - 46 - the following places have been provided Large stores 8 Stnall stores 3 Stables 6 17 units In addition, a refuse container shed, manure store and sanitary convenience have been provided for the traders. Further plans are being made to erect on the site of Elgin Mews and Lonsdale Mews, (other clearance areas), the following accommodation, with manure stores, conveniences, etc. Elgin Mews Lonsdale Mews Large stores 14 6 Small stores 11 5 Stables 17 5 42 units 16 units 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 1954 Inspections Premises Number on Register Number of of Inspections Number Writtes Notices Factories in which Sections 1, 2, 3, 4 and 6 are enforced by the Council 225 201 5 Factories in which Section 7 is enforced by the Council (not included above) 568 817 19 TOTALS 793 1,018 24 47 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 1 1 — _ Overcrowding — — — — Unreasonable temperature — — — — Inadequate ventilation — — — — Ineffective drainage of floors - — _ _ Sanitary conveniences:— (a) insufficient 2 1 — — (b) unsuitable or defective 22 16 - 4 (c) not separate for sexes 1 — — — Other offences (not including offences relating to Homework) — — — — TOTALS 26 18 — 4 During 1954, 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 fifty-one home workers on the register of outworkers during 1954:- Nature of work Number Wearing apparel - making, etc. 102 Artificial flowers 11 Paper bags, etc. 3 Carding etc. of buttons, etc. 5 Stuffed toys 13 Cosaques, crackers, stockings, etc. 8 Furniture and upholstery 4 Lampshades 5 151 During the year, one hundred and twenty—nine 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. Basement Bakehouses The Factories Act, 1937, (Section 54), requires the Council to carry out (in every fifth year) an examination of all basement bakehouses in the borough, for which certificates of suitability have been issued and are still in force. The quinquennial inspections for the year 1953/54 were made of twenty—seven underground bakehouses in respect of which certificates still operated. In thirteen cases the Council decided to give notice that — 48 — the certificates shall continue to operate. In the remaining fourteen cases, some of which were no longer used as bakehouses, the occupiers were notified that their certificates of suitability could not be renewed. In two cases, the occupiers appealed to a Court of Summary Jurisdiction against the Council's decision. In one case the magistrate decided that the bakehouse was suitable within the terms of Section 54 of the Factories Act, 1937. He allowed the appeal and awarded the appellant ten guineas costs against the Council. In the second case, the magistrate dismissed the appeal arid awarded the Council ten guineas costs. As a result of the quinquennial inspection and the successful appeal mentioned above, the occupiers of the following basement bakehouses may continue to carry on their businesses for the next five years:- 93—95, Old Brompton Road 259, " " " 139, Portland Road 46, Walton Street 151, Earls Court Road 310, " " " 62, Fulham Road 178, " " 290, " " 51, Golborne Road 65, " " 79, " " 196, Lancaster Road 216, Portobello Road Rag Flock and other Filling Materials Act, 1951 This Act 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 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 twenty registered premises in the borough. Forty-eight inspections of these premises were made during the year. 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 on 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.) 49 Ten samples of rag flock and other fillings were taken during the year with the following results:- Description No. of samples taken Satisfactory Unsatisfactory Hair 2 2 — Rag flock 1 1 — Cotton flock 1 1 — Coir fibre 3 3 — Kapok mixture 1 1 — Algerian fibre 2 2 — Pet Animals Act, 1951 This Act requires that no person shall keep a pet shop except under the authority of a licence issued by the Council and in compliance with any conditions specified in the licence. During the year, eight 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 OF FOOD 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 a licence to slaughter animals for human consumption outside Kensington. The applicant was a head butcher employed by a national firm of butchers, grocers and provision merchants. The application was granted in accordance with the Slaughter of Animals Act, 1933. Inspection of Food Premises 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 1954:- 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 icecream, or the storage of ice—cream intended for sale 332 71 + (b) for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale 154 238 (2) Milk and Dairies Regulations, 1949 — (a) as dairies 87 381 (b) where the occupier is registered for the sale of milk in sealed containers only 97 329 — 50 — + Additional inspections of the premises (not primarily in connection with the sale of ice—cream) are recorded under different headings in the following table. Pood premises (all categories) No. of premises No. of inspections Bakehouses — underground 14 55 " — others 16 31 Bread and cake shops 45 60 Butchers 80 242 Dairies 87 381 Fishmongers 47 69 Pood factories 6 63 General stores 10 148 Greengrocers 115 62 Grocers 239 510 Ice—cream 332 71 Preserved food 28 54 Public houses and off— licences 161 60 Restaurants and cafes 265 463 Sweet shops 167 46 Street markets, stalls and storage premises 88 (licensed traders. ) 140 Glean Food Campaign The London County Council's Byelaws for the protection of food came into force on the 3rd November, 1952. A list of practical suggestions has been sent 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. During the year sixty—two intimation 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. The next steps towards the goal of clean food will be the operation of the new Pood and Drugs (Amendment) Act, and the new regulations to be 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:- — 51 — Principal Supplementary Dealers licensed to bottle and sell Tuberculin Tested Milk; 1 — Dealers licensed to sell Tuberculin Tested Milk; 91 21 Forty—seven samples of Tuberculin Tested milk were submitted for examination during the year. Five 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) 38 33 5 Tuberculin Tested 9 9 _ Six samples of Tuberculin Tested milk were examined for tuberculosis (guinea pig inocculation tests) and all results were negative. Milk (Special Designations) (Pasteurized and Sterilized Milk) Regulations. 1949 Details of licences granted during 1954 are as follows Principal Supplementary Dealers' licences to sell Pasteurized Milks 108 21 Dealers' licences to sell Sterilized Milk; 120 24 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) +29 28 - 29 — — — Pasteurized ++27 24 1 27 — — — 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. ++ Two samples were not submitted to the methylene blue test for the same reason as stated above. — 52 — Milk and Dairies Regulations, 1949 (a) Registrations A summary of the alterations made in the register of dairymen and dairies during 1954, 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 4 — 1 Additions to register 5 5 3 Removals from register — — — Dairymen with premises outside the borough added to register — — — On register 31st December, 1954 105 87 97 (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 use. In the case of bottled milk, the time "immediately befor 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 £2. 0so 0d» Composition of milk During the year three hundred and forty=three samples of milk were submitted to the Public Analyst and, with the exception of thirteen, were found "to be of genuine composition. ' In the case of the thirteen samples not complying with the presumptive standards established by the Sale of Milk Regulations, 1939, the following action was taken Ministry of Agriculture & Fisheries notified 1 Warning letters to producer or vendor 3 No further action 9 The following table shows percentages of milk fats and non-fat solids of the genuine samples taken during each month 53 Month No. of samples taken Average percentages Milk fats Non-fat solids January 45 3.69 8.63 February 21 3.57 8.61 March 36 3.65 8.64 April 24 3.44 8.56 May 29 3.59 8.78 June 38 3.42 8.77 July 29 3.53 8.75 August 10 3.66 8.75 September 23 3.72 8.81 October 34 3.81 8.81 November 24 3.83 8.78 December 17 3.74 8. 67 Average for whole year 3.63 8.71 Legal minimum standards 3.00 8.50 Quality of Milk Supplies In my Report for last year, there appeared a report on the apparent deterioration of milk supplies, which, in conjunction with the Council's Public Analyst, Dr. H. Amphlett Williams, I submitted to the Council in July of that year. In October, 1954, the subject of unsatisfactory milk supplies was again considered by the Public Health Committee who submitted the following report to the Council :- "In July, 1953, a detailed report was submitted dealing with the deterioration of the quality of milk supplies. Particular attention was drawn to the increasing number of instances where samples of milk, although below the presumptive standard of the Sale of Milk Regulations, 1939, were shown to be as produced by the cow, in which circumstances there was no offence for which legal proceedings could be instituted. Figures quoted in an article by the Chief Analyst of one of the largest milk distributors, and collated over a period of fifty years, revealed that in the period 1900-1950, the average content of milk had declined as follows:- Fat Solids-not-fat 3.78%-3. 62% 9. 05%-8. 74% For the period 1926-1950, omitting the war years, the figures for samples taken in Kensington showed a similar tendency ;- Fat Solids-not-fat 3. 66%-3. 52% 8. 78%-8. 8% The Working Party on quality milk production in 1950, whilst agreeing that deterioration in the composition of milk had occurred over the past thirty years, considered that the decline had been more marked in the solids-not-fat content than in the fat content, and that much of this decline - 54 - was due to war-time difficulties. Remedial proposals either by fixing a minimum legal standard or making a higher presumptive standard, and a further suggestion for a scheme of payment on the basis of compositional quality, were rejected by the Working Party. When considering the proposal for introducing absolute standards, the Working Party took the view that this would certainly improve the average quality, but that it would also reduce the amount of milk available for consumption and that both producers and distributors would resent a departure from the traditional view that milk, as it comes from the cow, is "genuine". It was considered that the interests of the consumer could be safeguarded by less drastic means. It was recommended that the best way to bring about improvement was by means of closer co-operation between producers, distributors, advisory services and research institutes. This long-term proposal does nothing to assist those whose primary interest is in the supervision and control from the angle of consumption. Any scheme which still allows a standard other than a fixed legal standard will still handicap local authorities in their endeavours to ensure that milk of a reasonable standard is being supplied to the consumer. A further effort to improve the quality standard was taken in the early part of this year during the Committee stage in the House of Lords of the Pood and Drugs Amendment Bill. An amendment was proposed to require a minimum butter-fat content of 3 per cent. Opinions expressed by local authorities' associations and the Milk Marketing Board were quoted in support of the amendment. The amendment was, however, withdrawn after an assurance had been given on behalf of the Government that every endeavour would be made to raise the level of milk production so that the fat content would be above 3 per cent. In Kensington during the twelve months ended 30th June, 1954, three hundred and seventy-two samples of milk were analysed; three samples were deficient in butter-fat and twenty-six were deficient in solidsnot-fat. The deficiencies in the case of the butterfat varied between 2 per cent, and 7 per cent., and in the case of the solids-not-fat, between 1 per cent, and 2 per cent. The majority of the deficiencies were from bulked supplies and occurred during the late winter and spring of this year. During this period it is well known that the quality of milk is at its lowest. In each case where the milk was below the presumptive standards the suppliers were asked for an explanation. In the main the replies were to the same effect - that every effort was made to balance the supplies before release to the public but, owing to individual and seasonal variations in fat and non-fat solid content, this was not always possible. Nevertheless the milk was as supplied by the cow. As the matter now rests it appears that in the absence of legal standards the Council can take no action in cases where milk as produced by the cow falls below the presumptive standards. " 55 Adulteration of Food During the year five hundred and thirty-three formal samples of food and drugs were purchased, of which twenty-eight (52.%) were either adulterated or otherwise unsatisfactory. Four hundred and sixty-eight informal samples were also purchased, of which thirty-seven (7.9%) were either adulterated or otherwise unsatisfactory. The following table summarizes the action taken in respect of the defective samples:- Unsatisfactory sample No. of Prosecutions No, of warnings to Producers, Manufacturers or Vendors No. of Notifications to Ministries of Agriculture or Food No further action Total Milk — 3 1 9 13 Cake Mixture - 1 — 1 2 Cake Flour Mixture _ 1 - 1 2 Cheese Spread - - - 2 2 Meringues - - 5 — 5 Lung Syrup - - 1 1 Chest and Lung Mixture - _ - 1 1 Cream (canned) — — - 1 1 Meat and Gravy (canned) _ - 1 - 1 Potted Meat — — 1 — 1 Meringue Powder - - — 1 1 Beef Sausages - 1 - — 1 Pork Sausages - 3 — — 3 Dappled Sugar (Coffee sugar) - - _ 2 2 Cider - — - 1 1 Butta Mints — - - 1 1 Custard Powder — — — 1 1 Tonic Water - 1 — _ 1 Ground Nutmeg - — - 3 3 Non-Brewed Condiment - 2 - - 2 Creamed Cheese — — — 1 1 Cream Cheese — — 5 - 5 Coffee — — - 1 1 Sweets - — - 1 1 Single Cream — — - 1 1 Egg Powder — 1 - — 1 Orange Juice - 1 - — 1 Pate de Foie (canned) _ - 1 - 1 Pull Cream Conden sed Milk - - - 1 1 Tomato Soup (canned) - - - 3 3 Dundee Cake Mixture - - - 1 1 Raspberry Fruit Syrup - - - 1 1 Table Jelly — 1 _ - 1 Pork Sausage Meat - 1 - - 1 TOTALS:- - 16 14 35 + 65 + In all cases the results of these unsatisfactory samples were brought to the notice of the producers, manufacturers or vendors as the case may be. - 56 - Cream Cheese During the year investigations were undertaken regarding the composition of cream cheese. Eleven samples were submitted to the Public Analyst and, in his opinion, three were of genuine cream cheese, three were of soft cheese with added cream, and five were soft cheese made from milk but not from cream. There is no legal standard for cream cheese although it was a recognized practice before the last war that this product should be made from sour cream. The dictionary defines cream cheese as cheese of a soft rich kind, made from skimmed milk and cream. Before the war the National Mark Scheme, under the Agricultural Produce (Grading and Marking) Acts, required a fat content of not less than 60 per cent, in cream cheese. The average fat content of forty-nine samples of cream cheese, taken in the years 1933-1939, was found by the Government Chemist to be 71.6 per cent. Taking the result of one of the samples considered to be soft cheese made from milk but not from cream, the comparative food values are as follows:- Description Cream Cheese (average for 1933-1939) Cheddar Cheese (average) Specimen sample of soft cheese taken in 1954 fat 71.6% 31.8% 12.7% Non-fatty solids 3.9% 31.5% 14.9% Water 24.5% 36.7% 72.4% Calories per 100 grams. 682 426 179 It will, therefore, be seen that cream cheese, as at present being sold is a soft watery cheese containing only one-fifth of the proper amount of fat, and the prices charged varied from 2s.6d. to 10s. 6d. per lb. Careful consideration was given to this matter to see whether proceedings could be taken under either the Pood and Drugs Act, 1938, or the Defence (Sale of Pood) Regulations, 1943. Having regard to the impending operation of the new Pood and Drugs Amendment Act, 1954, which will require the word "Cream" to mean real cream when used in combined descriptions, it is felt that the present practice will cease. In the absence of a legal standard for this article of food and in the light of present-day practices and opinion based on a standard which obtained in pre-war years, the view was held that proceedings could not be taken with any reasonable hope of success. Having regard to all the circumstances, it was ultimately decided that particulars be forwarded to the Ministry of food. Meringues With reference to this confection, the traditional ingredients are white of egg and sugar. Due to war-time and immediate post-war restrictions and shortages of eggs, synthetic materials have been used for the manufacture of meringues, in the nature of cellulose ether and methyl cellulose, During the year fourteen samples were submitted for analysis Wine of these were reported as genuine and to contain white of egg or albumen. The remaining five, however, were reported as imitation meringues containing no white of egg or albumen. - 57 - Despite the indications of the analytical results that many manufacturers continue to sell genuine articles of some nutritional value, I am concerned with the trend to supply the public with comestibles which, although harmless, are of little or no nutritional value. Should this trend continue it seems likely that manufacturers will forsake genuine ingredients in favour of cheaper and valueless substitutes. It may be argued, that in the light of modern practice, the purchaser is not prejudiced by being supplied with a confection constituted with ingredients of a synthetic nature, but it is not the practice to label such confections when exposed for sale as "artificial" or "imitation". This matter was carefully considered and correspondence took place with the appropriate trade organisation and the Ministry of Food. The matter was also considered in the early part of 1955 by the Metropolitan Boroughs' Standing Joint Committee who were of the opinion that it is desirable that the composition of meringues should be prescribed by law, and they proposed to make appropriate representations to the Ministry of Pood. In view of this, no further action was taken by the Councilo Cream - Bacteriological Examination Fourteen samples of cream were submitted for bacteriological examination during the year.Nine samples showed the presence of coliform bacilli (non-faecal), whilst one sample contained faecal coli. The other samples were found to be satisfactory. In twelve of the fourteen samples the plate count was abnormally high. Further investigations were made but these had not been concluded at the end of the year. In the early part of the year a warning was given over the radio and in the Press regarding the discovery of typhoid germs in imported canned cream. All shops in the borough where cream is sold were visited, but only six were found to have stocks of the cream in question. Nine samples were taken and submitted for examination and all were found free from typhoid infection. All retailers' stocks of this cream were subsequently recalled by the importing agents, through the wholesalers. Complaints by purchasers of unfit food During the year twenty-one complaints were received from members of the public who found food they had purchased to be in an -unsatisfactory condition. All these cases were carefully investigated and, in two, the Public Health Committee authorised proceedings to be taken. One of these related to the sale of bread containing string, in respect of which proceedings were taken under the Food and Drugs Act, 1938, and resulted in the vendors being fined £10. 0s. Od. with £5° 5s. Od. cost. In the other case, which concerned the sale of cheese contaminated by mice, the vendors pleaded guilty and were fined £5. 0s. Od. with £2. 2s.Od. costs. Of the remaining nineteen cases, warnings were sent to the vendors or producers in seven cases, and in two other cases the complaints were referred to adjoining local authorities. It was not possible to take further action in respect of ten cases owing to the lack of sufficient detailed evidence. Unsound food Seizure Under Sections 9 and 10 of the Food and Drugs Act, 1938, — 58 — it is an offence to sell;, offer, or expose for sale, or to be in possession for the purpose of sale or preparation 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 two cases during the year quantities of dried fruit weighing approximately one ton were found in a food factory in a mouldy and fermented condition. The food was seized and taken before a Justice of the Peace, who condemned it and ordered it to be destroyed. 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) 2 8 1 11 Meat (Tinned) — 9 1 3 Ham — 5 3 19 Sausages — 8 — 6 Poultry and Rabbits — 2 2 21 Pish (Wet and Dry) 1 2 2 15 Fish (Shell) — 2 3 11 Scotch Oats — — — 2 Mortadella — 5 3 25 Beef Suet — — — 8½ Self Raising Flour — — — 15 Cheese — — 3 6½ Fishcakes — — 1 1 Tomatoes — 5 3 6 Bananas — 2 — 6 Dried Fruit 1 4 2 22 TOTAL: 6 19 2 10 Tins, jars, packets or cartons of fruit, vegetables and miscellaneous foodstuffs 7,947 Chocolate teacakes 62 Dates 12 boxes Yam flour 1 bag Fondant Creams 110 cases 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. 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—three. Of this number, four were new registrations during the year. During the year a sample of ammonia was obtained from a - 59 - branch establishment of a multiple firm of grocers (not on the register), which on analysis, was found to contain a percentage of ammonia consistent with that of a poison included in Part II of the Poisons' List. In addition, the labelling of the sample did not meet with the requirements of the Pharmacy and Poisons Act, 1933. A communication was addressed to the firm in question drawing their attention to the requirements of the Act and also to the fact that their name was not included in the Local Authority list of sellers of poisons included in Part II of the Poisons' List„ The firm subsequently made application to have their name entered on such list and agreed to amend the labels in question to conform 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. The following table shows the number of samples taken during 1954 for chemical analysis compared with the previous year :- 1954 1953 Number of samples 24 23 Variation of fat content per cent 5.1 to 11.7 3.9 to 12.6 Variation of non-fat content per cent 22.2 to 26.9 20.3 to 27.4 Average fat content per cent 8.65 8.82 Average non-fat solids content per cent 24.40 22.28 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 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 taken to decolourize the methylene blue and it is suggested that if samples consistently fail to reach grade 1 and 2 it would be reasonable to regard this as an indication of defects in manufacture or handling which warrant further investigation. During the year twenty-one samples of ice cream were taken and submitted to the methylene blue test. The results are as follows :- 60 Grade No. of samples 1 12 2 2 3 2 4 5 Two samples of ingredients used in the manufacture of ice cream were also submitted to bacteriological examination and in each case the result was satisfactory. Premises in the borough where ice cream is manufactured, stored or sold were frequently inspected during the year and generally were found to be in a satisfactory condition, having regard to the Ice Cream (Heat Treatment, etc.) Regulations, 19U7/52. FOOD POISONING Under Section 17 of the Pood 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 1954:- Pood poisoning notifications (corrected) Received in first quarter 11 Received in second quarter 29 Received in third quarter 9 Received in fourth quarter 9 TOTAL: 58 Outbreaks due to identified agents Nil Outbreaks of undiscovered cause 3 Total cases 24 Single cases - Unknown cause 22 Agent identified 12 Total cases 34 Outbreaks of undiscovered cause (3 outbreaks) (a) The first outbreak occurred when four out of five members of a Kensington family fell ill with diarrhoea and vomiting. The fifth member of the family had partaken food in common with the four sufferers, but had exhibited no symptoms. Although investigations, including bacteriological examination of specimens from patients and contact, revealed no causative agent, it was suspected that the environment had contributed to the outbreak. The family were living in overcrowded conditions and the rooms showed evidence of recent bug infestation. The food storage accommodation was unventilated and was in a fair condition only; the cooking utensils were dirty. (b) The second outbreak involved 17 out of 140 inmates of an old people's home in Kensington. The symptoms of diarrhoea and vomiting were not severe, nor did they persist - 61 - long. Specimens from the patients and staff revealed no causative agent, but a sample of pig's trotters (which formed part of the suspected meal) showed a heavy growth of normally harmless bacteria. This meat had been cooked on the day prior to consumption and then reheated just before the meal, and it is possible that the process had incubated the bacteria and resulted in gross contamination leading to symptoms of food poisoning amongst some of the old people. The kitchens, food storage accommodation, equipment, and the standard of food handling at this institution were found to be very good, but the opportunity was taken to warn those in charge of the dangers of reheating meat. (c) The third outbreak affected three children in a Kensington family comprising eight persons. The difficulty in this outbreak was to pinpoint the possible source of infection, particularly as none of the food likely to give rise to suspicion remained for examination. Specimens obtained from the patients and contacts revealed no causative agent. The symptoms of pain, diarrhoea and vomiting quickly cleared up with treatment. Single cases In addition to the outbreaks referred to above, there were thirty-four single cases of food poisoning notified. In twenty-two of these no causative agent was identified but of the remaining twelve cases, eleven were found to be caused by salmonella typhi-murium and one by salmonella oranienbergo INFECTIOUS DISEASE Smallpox No case of smallpox was notified in the borough during the year 1954. Many persons came to Kensington from places abroad and 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 twenty-four 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 1954 was fifty-two and, of this total, twelve were treated in hospital. There was no fatal case during the year, in fact there has been no death from scarlet fever in Kensington since 1940. Diphtheria No case of diphtheria was notified during 1954. This is the second time on record when the borough remained free from this dangerous disease for a whole year. The first occasion was during the year 1952. 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:- 62 Number of pre-school children immunised 1,746 " " school " M 335 ,, ,, re-inforcing injections given 1,822 " " children attending for pre-Schick tests 461 " which gave a positive reaction 357 " " " " negative " 96 " of children attending for post- Schick tests 1,075 " proving negative 1,066 " proving positive 5 " who failed to attend for reading 12 Enteric Fever Two cases of typhoid fever and three cases of paratyphoid B. fever were notified during 1954. Investigations revealed that the infections had been contracted abroad with the exception of one case of typhoid fever. In this case, a little girl aged sixteen months contracted the disease and was removed to hospital where a full recovery was effected,, Enquiries showed that the child was often in the care of her grandmother who had had typhoid fever in Poland in 1934. Bacteriological investigations revealed that the grandmother was a typhoid fever carrier and at the end of the year she was still undergoing treatment in her own home for the condition. In the meantime she was advised of the precautions she had to take in order to prevent spread of the infection. Puerperal pyrexia During 1954, the number of cases of this disease notified was ninety-six, of whom fifty-three were persons normally resident outside the borough. Ninety-four of the cases were treated in hospital. Information was received in the public health department concerning fifty-three 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, fifty-four notifications were received, forty-five being acute primary pneumonia and nine being acute influenzal pneumonia. Of the total, twenty-eight cases were removed to hospital for treatment. The number of deaths from pneumonia (all forms) was seventy-five and the number of deaths from influenza was five during 1954. Dysentery Sixty-eight cases of dysentery were notified in 1954, all of which were bacillary in origin, the majority being due to Sonne bacillus. Generally speaking the cases were of a mild type and there were no deaths. Erysipelas Of the fourteen cases notified, six were admitted to hospital. There were no deaths. Meningococcal infection Only one case of this disease was notified during the year 63 and the patient was removed to hospital. The attack was a mild one and the patient made a complete recovery. Malaria Pour cases of malaria were reported during the year. Investigations showed that two of the patients were natives of countries where malaria is endemic and who had recently arrived in this country. The remaining two patients were persons who had recently returned from abroad. Poliomyelitis There were five cases of acute poliomyelitis notified and confirmed during the year; all the cases showed symptoms of paralysis. There was no death from this disease during the year. The figures for the past five years are as follows:- Year Confirmed Cases Deaths 1953 14 2 1952 21 2 1951 12 Nil 1950 13 3 1949 47 4 As in previous years, contacts of cases were kept under supervision for twenty-one days from the last date of contact. In the Annual Reports for 1952 and 1953, attention was drawn to the unsatisfactory feature of treatment for poliomyelitis patients in general hospitals. During 1954, three of the five notified cases were nursed in such hospitals, although the public health department continues to press for the removal of all sufferers to infectious disease hospitals. The investigation concerning the possible association between inoculations and the contraction of the disease, is still continuing in co-operation with the Medical Research Council. Acute encephalitis One case of this disease was notified in the borough during 1954. The patient, a boy aged 11 years, died a few hours after admission to hospital. Measles Of the ninety-four cases notified during 1954, nine were admitted to hospital for treatment. No death occurred from this disease. Ophthalmia neonatorum Two cases of this disease were notified. Both were treated in hospital and 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. Eleven were removed to hospital for treatment. No death of a child under five years of age was recorded as due to gastritis, enteritis or diarrhoea. Typhus Fever One case of typhus fever was notified during the year. 64 The patient, a visitor to a London exhibition, fell ill shortly after his arrival from the continent. He was removed to an isolation hospital for treatment and eventually recovered. Effective measures were taken immediately to control the spread of infection and no further cases occurred. Scabies The number of notifications of this disease during 1954 was forty-two, which is the same as in the previous year and compares with four hundred and sixty-three in the peak year of 1946. Tube rculosis During the year two hundred and forty-three new cases of tuberculosis were notified, of which two hundred and eighteen were respiratory and twenty-five non-respiratory cases. The following table shows the number of cases added to and the number removed from, the notification register during the year:- Description Respiratory Non Respiratory Total M F M F On register of notifications on 1st January, 1954 735 636 68 89 1,528 Notified for the first time during the year 113 105 10 15 243 Brought to notice other than by notification 87 64 2 7 160 Removed from register on account of having - (a) recovered from the disease 15 21 1 3 40 (b) removed from district lost sight of, etc. 112 100 6 12 230 (c) died 15 7 1 2 25 Remaining on register on 31st December, 1954 793 677 72 94 1,636 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, three hundred and eighty-eight visits were paid to the homes of tuberculous patients. In two hundred and thirty-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 forty-one cases it was found that the patients had moved away, and in forty-six other cases the investigation was postponed as the patients were away in hospital or had not been contacted by the end of the year. The action taken in the remaining sixty-seven cases is summarised as follows:- - 65 - Action taken Cases Investigation or supervision undertaken in respect of (a) re-arrangement of existing accommodation 2 (b) occupation of patients 4 (c) tracing of contacts5 (d) preventing spread of infection 9 Recommended for priority rehousing 47 Action was taken under the Public Health and Housing Acts in respect of insanitary or unhealthy conditions in nine cases. Incidence of tuberculosis amongst Kensington residents who originated from areas outside England. Scotland and Wales In the Annual Report for 1951, attention was drawn to what appeared to be a disturbing trend in the incidence of tuberculosis amongst immigrants. Since 1952, a more detailed investigation of this problem has taken place and the following table sets out the information found in 1954. Country of origin Period (in years) between entry to United Kingdom and notification of disease Total 1 2 3 4 5 6 7 8 9 Australia 1 — _ — 1 _ — _ — 2 Austria — - — — 1 — — — — 1 British Guiana 2 - - - - - - - - 2 Burma - - - - - - 1 — - 1 Canada 1 - - - - - - - - 1 Ceylon - 1 - - - - - - - 1 Egypt - - - 1 - - - - - 1 Prance — 2 1 - - - - - - 3 India — 1 - 1 — — — — - 2 Ireland 6 1 2 2 — 1 2 2 _ 16 Israel - 1 - - - - — — - 1 Italy - 2 - - - - - - - 2 Jamaica — — — - 1 - — - - 1 Latvia - — — — — 1 — — — 1 Lithuania — — - - — 1 — — — 1 New Zealand 1 - - - - - - - - 1 Pakistan — 2 — - — - — — - 2 Poland - 1 2 1 - 4+ _ 2 1 11 Siam 1 — — 1 — — — — — 2 Spain 2 - - - - - - - - 2 TOTAL: 54 Patients who had resided in London all their lives or for at least 10 years 100 Patients who had resided in other parts of the country all their lives prior to coming to Kensington 72 Patients from whom information concerning origin was not obtained but where it is believed to be this country 16 Patients from Ireland who resided here at least 10 years prior to notification 4 Patients notified abroad before coming to this country (Ireland 2, Japan 1) 3 Patients from Poland who resided here at least 10 years prior to notification 1 Patients who resided here at least 10 years prior to notification: (Australia 1, Esthonia 1, Hungary 1, India 1, Iraq 1, Russia 1, Spain 1.) 7 Patients from whom information concerning origin could not be obtained 85 TOTAL: 288 66 The investigation only covered patients newly notified or transferring into the borough from other areas. The total of three hundred and forty-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 figures for 1953 and 1954 were 10% and 16% respectively. Persons born in the Republic of Ireland were regarded as immigrants for this purpose. The 1951 Census figures showed 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, 1913-1954 Although tuberculosis has been notifiable in one form or another throughout this century, the present system was not established until 1912, and statistics comparable for one year with another are available from 1913. The graph on Page 67 shows notifications and deaths in Kensington for this disease since 1913 with a distinction between pulmonary and nonpulmonary tuberculosis. The trend of notifications for both types of the disease follows the same pattern. At the beginning of the period, the number of notifications fell rapidly to a certain level and then followed a fairly regular course. There were, however, two exceptional periods in which this pattern was disturbed. They occurred during and after the two World Wars when the number of notifications tended to rise. This tendency was less marked in non-pulmonary tuberculosis during and after the Second World War, but this was due to the relatively small numbers involved. So far as pulmonary tuberculosis is concerned, the disturbed pattern has not yet settled down to what might be assumed to be a long term downward movement. In part this is due to the war, but the comparatively high number of notifications might also be explained as a result of the intensive effort made in recent years to achieve early recognition of the disease by mass-radiograph The decline in mortality shows a contrast to that of notification. There was no abrupt fall at the beginning of the period, but on the other hand the decline has continued steadily. In general terms, it may be said that tuberculosis mortality has followed the general trend of mortality, probably for the same reasons. In addition, however, there are more specific factors to which credit should be given. As far as pulmonary tuberculosis is concerned, mention has already been made to early diagnosis. In both the curative and preventive aspects of the disease, early diagnosis plays an important role. It undoubtedly saves the lives of many who would otherwise have died following a diagnosis in the later stages of the disease. In addition, methods of treating the disease over the period have been much improved. In non-pulmonary tuberculosis, the treatment of tuberculous meningitis with streptomycin and its derivatives has contributed markedly to the diminution of deaths from this particular type of disease, especially in children. In short, the graph shows that people who, fifty years ago, would have died from tuberculosis are now dying from other diseases. Furthermore, as indicated by the statistics shown on Page 8 of the Report) the incidence of mortality has shifted to the older age groups. Whooping Cough One hundred and thirty-six cases were notified during the year, twelve of which were treated in hospital. One death occurred from this disease. International Certificates In order to prevent the spread of infectious diseases, certain countries require that visitors should be vaccinated or inoculated against specified diseases. International certificates have been prescribed for smallpox, yellow fever and cholera. When 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, two thousand four hundred and ninety-five of these certificates were authenticated in Kensington. In addition, thirty-nine special exemption certificates for use in the United States of America were issued to travellers. Notifications The following tables show (1) the number of cases of infectious disease notified during the year 1954, 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 1954 1953 1952 1951 1950 1949 1948 1947 Scarlet fever 52 78 108 68 100 114 94 98 Diphtheria (including Membranous Croup) — 2 — 1 2 2 12 23 Enteric fever 5 5 2 7 12 7 4 4 Puerperal fever ø — — — — — — — 3 Puerperal pyrexia 96 65 83 22 18 33 25 9 Acute primary pneumonia and acute influenzal pneumonia 54 93 71 149 69 121 142 103 Dysentery 68 131 31 81 18 33 145 21 Erysipelas 14 11 11 13 17 15 24 34 Meningococcal infection 1 6 4 8 5 8 4 7 Malaria Acute poliomyelitis 4 5 1 2 2 — 2 4 Paralytic 5 9 17 8 7 47 9 27 Non-paralytic — 5 4 4 6 Acute encephalitis 1 — 3 1 — 1 — 2 Tuberculosis (all forms) 243 256 251 238 278 266 258 259 Measles 94 740 839 1314 696 740 868 852 Ophthalmia Neonatorum 2 7 2 2 12 5 7 4 Enteritis + 20 27 30 25 63 88 64 102 Pood poisoning 58 79 20 18 23 33 11 7 Scabies 42 42 26 34 72 106 141 239 Whooping Cough 136 485 228 484 316 304 264 274 Typhus fever 1 — — — — — — — TOTALS: 896 1846 1731 2479 1716 1923 2074 2072 Puerperal Pyrexia only notifiable in London since 1948. + Notifiable only in children under the age of 5. NOTE: Gases of mistaken diagnosis are excluded from above table. 69 TABLE 2 Notifiable disease Number of Cases Notified in 1954 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 5 8 33 2 2 1 Diphtheria (including Membranous Croup) - - - - - - - Enteric fever — 2 — — — 1 2 Puerperal Pyrexia - — — — — 41 55 Acute primary pneumonia and acute influenzal pneumonia - 4 4 3 2 4 37 Dysentery 2 15 13 12 5 6 15 Erysipelas — - - 1 1 1 11 Meningococcal infection — — — 1 — — - Malaria — — — - — - 4 Acute poliomyelitis Paralytic 1 _ 1 - 1 2 - Non-paralytic - - — — — — - Acute encephalitis - — — - 1 — — Tuberculosis (all forms) 4 2 6 15 3 42 171 Measles 4 23 21 41 1 3 1 Ophthalmia neonatorum 2 — — — — - — Enteritis 11 6 3 — _ _ — Food poisoning 3 6 3 3 — 3 40 Scabies 1 1 2 7 2 14 15 Whooping cough 16 29 39 41 8 1 2 Typhus fever - - - - - - 1 TOTALS: 45 93 100 157 26 120 355 TABLE 3 Notifiable disease Total Cases Notified in each Ward St. Charles Golborne Norland Pembridge Holland Earls Court Queens Gate Redcliffe Brompton Scarlet fever 7 12 5 4 7 3 5 5 4 Diphtheria (including Membranous Croup) — — — — — — — — — Enteric fever — — 1 — 1 1 2 — - Puerperal Pyrexia 5 1 4 8 5 9 57 7 - Acute primary pneumonia and acute influenzal pneumonia 9 10 7 12 6 2 5 3 - Dysentery 11 10 9 7 4 7 3 15 2 Erysipelas 3 2 2 1 — 2 1 3 — Meningococcal infection 1 _ — — — — - — - Malaria — — 1 — — 2 — — 1 Acute poliomyelitis Paralytic — — — — — 1 1 — 3 Non-paralytic — — — — — — — — — Acute encephalitis — — — — 1 — — — — Tuberculosis (all forms) 39 36 35 29 22 26 15 25 16 Measles 25 4 12 3 12 13 5 14 6 Ophthalmia neonatorum 1 - - — — — — — 1 Enteritis 4 4 2 1 5 2 - 2 — Food poisoning 7 28 2 7 4 3 3 3 1 Scabies 6 5 8 5 3 6 3 4 2 Whooping cough 16 16 14 10 13 24 6 35 2 Typhus fever — — — — — — 1 — — 70 LEGAL PROCEEDINGS Public Health (London) Act, 1936 Nuisances During the year, one hundred and nine summonses were issued for various nuisances under the Public Health (London) Act, 1936. In twenty-four cases abatement orders were secured; fines amounting to £5 .0s. 0d. were imposed and £33. 12s, 0d. costs were awarded to the Council. In twentyseven cases the summonses were withdrawn, the nuisances having been abated prior to the Court hearings. In fifty-six cases the summonses were adjourned as the necessary works were in progress of being carried out by the owners. In the remaining two cases, one summons was withdrawn as the defendant died before the case was heard, and the other summons was dismissed. Twenty-two prosecutions were undertaken for failure to comply with Justices' Orders to abate statutory nuisances. In sixteen cases fines amounting to £92. 16s. 3d. were imposed and costs amounting to £18. 18s. 0d. were awarded to the Council. The remaining six cases were withdrawn or adjourned as the necessary works had been, or were being, carried out. Drainage Bye laws Twelve summonses were issued in respect of offences under these Byelaws. Convictions were obtained in all cases and fines amounting to £13. 0s. 0d. were imposed and the Council were awarded £2. 2s. 0d. costs. Byelaws in regard to removal of obnoxious matter Two summonses were issued for offences against 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. 2s. 0d. costs. Council's Byelaws Dog Nuisances Ten summonses were issued under this Byelaw. In eight cases convictions were obtained and fines totalling £3. 15s. 0d. were imposed and costs of £5. 10s. 0d. were awarded to the Council. The remaining two summonses were withdrawn. Housing Act. 1936 Contraventions of Closing Orders Six summonses were issued in respect of the illegal occupation of closed underground rooms,. Convictions were obtained and fines amounting to £19. 0s. 0d. were imposed and costs of £3. 3s. 0d. were awarded to the Council. Failure to supply required information Under Section 168 of the Housing Act, 1936, the Council may require a person receiving rent in respect of any premises to state in writing the nature of his interest therein and 71 the name and address of any other person having an interest in the property, whether as freeholder, mortgagee, lessee or otherwise. In one case, a person refused to comply with the Council's request for information. Proceedings were undertaken and the person was fined the maximum penalty of £5. 0s. 0d. and ordered to pay the Council £5. 5s. 0d. costs. Subsequently the same defendant again refused to comply with this Section and proceedings against him resulted in another conviction with a fine of £5. 0s. 0d. and costs to the Council of £5. 5s. 0d. Food and Drugs Act. 1938 Legal proceedings were taken in two instances in respect of the sale of unfit food. In the first case, the defendant was fined £10. 0s. 0d. and ordered to pay £5° 5s. 0d. costs to the Council; in the second case the Court imposed a fine of £5. 0s, 0d. with £2. 2s. 0d. costs. Milk and Dairies Regulations, 1949 One case occurred in which milk was delivered to a Kensington resident in a bottle not in a state of thorough cleanliness. The milk had been bottled in a neighbouring borough, the Council for which took proceedings and secured a conviction. A fine of £2. Os. Od. was imposed. CONCLUSION In presenting this Report, I should like to express my grateful appreciation of the kind co-operation which I have received from The Worshipful 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. 72 PARTICULARS OF THE STAFF OF THE PUBLIC HEALTH DEPARTMENT AT THE END OF 1954 (As requested by Ministry of Health Circulars 1/54 and 28/54) Year of Medical Officer of Health Appointnme James H. Weir, M.D., B.S., B.Hy. , D.P.H. 1950 Deputy Medical Officer of Health W. C. Turner, MoD., 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. Ctiurcher 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 Philip Hayllar 1952 Mrs. B. Hennessey 1954 Noel 0 Connor 1954 Sanitary Inspectors 2.3. Henry W. Walters, F.R.San,I. , Chief Sanitary Inspector 1925 2.3. Cecil R. Webb 1925 1. Arthur L. Vague 1934 1.2. Ronald D. Callis, D.P.A.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 Go Tompkins 1951 1. William R. Bland 1951 1.2. Herbert B. Cade 1952 1. Ernest Killby 1953 1.2. Leslie E. Bowskill 1954 1. Keith Popham 1954 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 Foods. 3. Certificate of London Sanitary Inspectors' Examination Board, 4. Smoke Inspectors' Certificate. 73 SUMMARY OF COMMITTEES CONTROLLING MATTERS OF PUBLIC HEALTH (As requested by Ministry of Health Circulars 1/54 and 28/54) 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 63 Adulteration of Pood 55 Atmospheric Pollution 18 Bacteriological Work 14 Bakehouses 47 Birth Rate 1 Burial of the Dead 22 Certificates of Disrepair 33 Chiropody for Aged Persons 28 Clean Pood Campaign 50 Clearance Areas 33,37 Cleansing of Aged Persons 26 Closing Orders - Contraventions 70 Committees 73 Costermongers 45 Cream 57 Cream Cheese 56 Cremation Service 23 Deaths, Causes of 8-13 Death Rate 1 Demolition Orders 32 Diphtheria 61 Diphtheria Immunisation 61 Disinfection & Disinfestation 15 Dog Nuisances 24,70 Drainage 30,70 Dysentery 62 Enteric Fever 62 Erysipelas 62 Factories 46 Food - 3 Adulteration 55 Byelaws 50 Clean Food Campaign 50 Cream 57 Cream Cheese 56 Ice Cream 59 Inspections 49 Meringues 56 Milk 50-54 Poisoning 60 Unsound 57-58 Gastro Enteritis 63 Holidays for Aged Persons 25 Houses in multiple-occupation 34 Housing - 2 Clearance Areas 33,37 Closing Orders - Contraventions 70 Demolition Orders 32 Hostels 34 Improvement grants 42 Inspections 30 Legal Proceedings 70 Medical Priorities 45 New Housing Accommodation 44 Overcrowding 33,44 Slum Clearance 37 Underground Rooms 32 Housing Repairs & Rents Act, 1954 2,33,34,39 INDEX Page Ice Cream 59 Improvement Grants 42 Infant Death Rate 1 Infectious Diseases 2 Acute Encephalitis 63 Diphtheria 61 Dysentery 62 Enteric Fever 62 Erysipelas 62 Gastro Enteritis 63 Malaria 63 Measles 63 Meningococcal Infections 62 Notifications 68 Ophthalmia Neonatorum 63 Poliomyelitis 63 Pneumonia 62 Puerperal Pyrexia 62 Scabies 64 Scarlet Fever 61 Smallpox 61 Tuberculosis 2,614, 67 Typhus Fever 63 Whooping Cough 68 Institutional Care of Aged Persons 27 International Certificates 68 Laboratory Facilities l4 Laundry Facilities for Aged Persons 27 Legal Proceedings Closing Orders - Contraventions 70 Dog Nuisances 70 Drainage Byelaws 70 Food and Drugs Acts 71 Nuisances 70 Removal of Obnoxious Matter 70 Library Facilities for Aged Persons 28 Malaria 63 Maternal Death Rate 1 Meals for Aged Persons 28 Measles 63 Medical Examination of Staff 23 Medicinal Baths 14 Meningococcal Infections 62 Milk 50-54 Milk & Dairies Regulations, 1949 52,71 Milk, Special Designations 50 Mortuary 18 National Assistance Acts 1948/51 29 New Housing Accommodation 44 Notifications of infectious disease 68 Nuisances 70 Old People's Welfare 3 Ophthalmia Neonatorum 63 Outworkers 47 Overcrowding 33,44 Pests, Prevention of Damage by 16 Pet Animals Act, 1951 49 Pharmacy & Poisons Act, 1933 58 INDEX Page Pigeons, Destruction of 18 Poliomyelitis 63 Population 1 Pneumonia 62 Puerperal Pyrexia 62 Rag Flock & Other Filling Materials Act, 1951 48 Removal of Aged Persons 29 Rent Restrictions Acts 31 Repair of Houses 33 Rodent Control 16 Sanitary Inspection - Drainage 30 Dwelling Houses 33 Inspections 30 Legal Proceedings 70 Rent Restrictions Acts 31 Sanitary Notices Served 31 Shops, Inspection of 30 Supervision of Work 30 Scabies 64 Scarlet Fever 61 Slum Clearance 37 Smallpox 61 Smoke Measuring Stations 21 S.O.S. Cards 24 Staff 72 Tuberculosis 2,64-67 Typhus Fever 63 Underground Rooms 32 Unsound Food 58 Vaccination 61 Vital Statistics 6-7 Water Supply 59 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 29 S.O.S. Cards 24 Visiting 29 Whooping Cough 68