AC4348 1 5B 2 Library KEN 64 The Royal Borough of Rensington ANNUAL REPORT ON THE Health of the Borough FOR THE YEAR 1955 BY J. H. WEIR M.D.. B.S.. B.HY.. D.P.H. MEDICAL OFFICER OF HEALTH THE ROYAL BOROUGH OF KENSINGT0N Public Health Department, Hornton Street, Kensington, W. 8, 1st June, 1956. To the Mayor, Aldermen and Councillors of the Royal Borough of Kensington. My Lords, Ladies and Gentlemen, I have much pleasure in presenting the Annual Report on the state of the public health in Kensington for 1955. The Minister of Health has again requested (Circular 17/55) 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 (169,400) of the population of the borough for 1955 shows a decrease compared with the figure for the previous year (170,600). (The actual population figure for Kensington obtained as a result of the 1951 Census was 168,160.) Birth rate. The number of births per 1,000 population of the borough was 15.8 in 1955, which was 0.1 lower than the figure recorded for the previous year. The Kensington birth rate was lower than that for the County of London (17.4) but higher than that for the whole of England and Wales (15.0). (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 11.2.) Death rate. The number of deaths per 1,000 population was 10.3. This figure is higher than the death rate for the County of London (9.6) but lower than that for England and Wales (11.7). (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 1955 was 31.4,. which was an increase over the rate for the previous year of 8.9. The rate for the County of London was 23.3 and for England and Wales was 24.9. The following table shows the rates for the last five years:- Year Kensington London England & Wales 1955 31.4 23.3 24.9 1954 22.5 21.0 25.5 1953 19.7 24.8 26.8 1952 27.0 23.8 27.6 1951 24.0 26.4 29.6 2 It will be seen that whilst the infant death rate for England and Wales has consistently decreased, the rates for London and for Kensington have fluctuated. The number of infant deaths in the borough, compared with the country as a whole, is very small and a few deaths more or less in any one year will make a marked difference in the rate compared with previous years. One significant factor which could account for part of the increase in Kensington's rate is the higher number of deaths of infants from prematurity. In 1955, out of a total of eighty-four infant deaths, thirty-eight (45.26) were due to prematurity; in 1954 it was twenty-four (39%) out of sixty-one; and in 1953 it was sixteen (32%) out of fifty. These deaths practically all take place in hospital and within a few hours or days of birth. Many of the infants are very tiny, only weighing 1-2 lb. This factor apparently affects inversely the position regarding stillbirths, because in 1955 there were only forty-one stillbirths, compared with forty-eight in 1954 and fifty-three in 1953. There is no doubt that in the maternity hospitals every effort is made to save these tiny premature babies, but some of them are so small that they are hardly capable of life and die within minutes. It is possible that in past years some of these cases would have been classified as miscarriages. However, it is certain that the increase in Kensington's infant death rate for last year will be carefully investigated by the London County Council's Divisional Health Committee. Maternal death rate. One death of a mother due to childbirth was recorded in 1955» giving a maternal death rate per 1,000 live and still births of 0.37. (The maternal mortality rate for the County of London was 0.77 and for England and Wales the figure was 0. 64). Infectious diseases. Apart from the expected high number of measles cases notified, there was no serious outbreak of infectious disease in the borough during 1955. The total number of notifications received was two thousand three hundred and twenty-two in comparison with eight hundred and ninety-six in the previous year. The increase in notifications was mainly due to the one thousand four hundred and twenty-five cases of measles notified compared with ninety-four in the previous year. Two cases of diphtheria were notified in 1955 compared with no case in the previous year. Neither case had been immunised. Tuberculosis. The death rate from all forms of tuberculosis per 100,000 population was 10.0, which is much lower than last year's figure of 14.0. The 1955 death rate is the lowest ever recorded in Kensington, and compares favourably with the rate (14.6) for England and Wales. Lung Disease. In the past few weeks, public attention has been drawn to the increasing death rate due to lung cancer. The subject has a popular interest because of the discussions which have taken place regarding the possibility of cigarette smoking having an effect on the mortality rate. On the 7th May, 1956, the Minister of Health made a statement in the House of Commons as follows :- "Since my predecessor made a statement in February, 1954, investigations into the possible connection of smoking and cancer of the lung have been proceeding in this and other countries. Two known cancer producing agents have been identified in tobacco smoke, but whether they have a direct role in producing lung cancer, and if so what, has not been proved. The extent of the problem should be neither minimised 3 nor exaggerated. The number of deaths from cancer of the lung has risen from 2,286 in 1931 to 17,271 last year. To place figures in perspective - in 1954, out of every thousand deaths of men aged between 45 and 74, 77 were from bronchitis, 112 were from strokes and apoplexies and 234 were from cancer, of which 85 were cancer of the lung. Deaths of women from cancer of the lung are still not very significant and represent a small fraction of the total. The Chairman of the Committee of the Medical Research Council, which has been investigating the subject, considers that the fact that a casual agent has not yet been recognised should not be allowed to obscure the fact that there is, statistically, an incontrovertible association between cigarette smoking and the incidence of lung cancer. The statistical evidence from this and other countries to which he refers tends to show that mortality from cancer of the lung is twenty times greater amongst heavy smokers than amongst non-smokers. The Government will take such steps as are necessary to ensure that the public are kept informed of all the relevant information as and when it becomes available." Whilst the outcome of the investigations will be awaited ith interest by all, especially smokers, it is perhaps desirable o draw attention to the position as far as Kensington is concerned. The main disease of the lungs, of which the public are best bare, is pulmonary tuberculosis, and in the following table the death rates from this disease, since the end of the war, are compared with the death rates for lung cancer, both for Kensington and for England and Wales. Year England and Wales Kensington Pulmonary Tuberculosis Cancer of the Lung Pulmonary Tuberculosis Cancer of the Lung Deaths Rate Deaths Rate Deaths Rate Deaths Rate 1947 19,753 47.3 9,204 22.0 71 43.0 58 34.9 1948 18,798 44.0 10,162 23.8 76 45.0 45 26.6 1949 17,471 40.5 10,975 25.5 56 32.0 50 28.7 1950 14,079 32.1 12,241 28.0 52 29.0 70 39.4 951 12,031 27.5 13,247 30.2 36 17.5 70 40.9 1952 9,335 21.2 14,218 32.3 29 16.8 71 41.1 1953 7,913 17.9 15,132 34.3 26 15.1 65 37.9 1954 7,069 16.0 16,331 36.9 20 11.7 72 42.2 1955 5,838 13.1 17,271 38.9 12 7.1 73 43.1 (Death rates quoted above are per 100,000 population) 5 It will be seen that in 1947 the death rates from pulmonary tuberculosis for both England and Wales and Kensington were much higher than those for lung cancer, but by 1955 the position has been very much reversed. In Kensington, the death rate from lung cancer in 1955 was over six times that for pulmonary tuberculosis, whilst in England and Wales the rate was approximately three times greater. The graphs on the opposite page show the death rates for Kensington and England and Wales, and it will be seen that about five or six years ago, the death rates from lung cancer overtook the rates for pulmonary tuberculosis. The fact is that since the war, taking the country as a whole, the number of deaths from lung cancer have increased by roughly 1,000 each year, but in Kensington the rate has been more or less steady over the past six years; approximately forty persons per 100,000 population died in each of those years from lung cancer. Whereas in the last half-century, tuberculosis was a disease which had to be fought with all the resources of preventive public health, we now find that it is no longer the "scourge of the white man." Improved methods of diagnosis, resulting in the earlier discovery of the disease, have enabled modern medical science to reduce enormously the mortality from tuberculosis. On the other hand, lung cancer is a much more difficult problem to tackle because (unlike tuberculosis, the cause of which is well known) its cause is not known, although a great amount of information has already been discovered. It remains for the experts to discover the way to deal with lung cancer and its prevention. One of the things which can be done in the meantime is to secure a cleaner and purer atmosphere. At the moment of writing, Parliament is in the process of framing a Clean Air Bill, which it is hoped will go a long way towards dealing with atmospheric pollution. Later on in this report are given analyses relating to atmospheric pollution in Kensington from which it can be seen that the problem provides no mean task. If the impurities in the air could be removed, the health of Kensington residents would be materially improved and it would no doubt help in reducing the incidence of lung cancer. Housing. The year under review brought the completion of the first stage in the new campaign to deal with houses unfit for human habitation. All local authorities were required by Section 1 of the Housing Repairs and Rents Act, 1954, to submit to the Minister of Housing and Local Governments, by the end of August, 1955, proposals for dealing with unfit houses in their districts. Metropolitan boroughs were required to consult with the London County Council in this matter and to submit their proposals jointly with that authority. Kensington's proposals have been submitted as required, and include the proposal to deal with the Kensal New Town area, comprising five hundred and sixteen premises, as a clearance area. The redevelopment of this area was still under consideration at the end of the year; the Council having appointed Sir William Holford, F.R.I.B.A., M.T.P.I., to act in this matter. Early in 1956, Sir William submitted a draft redevelopment scheme, which at the present time is the subject of negotiation between the Council and the London County Council. The important feature of the redevelopment of this large area is that it will involve the eventual displacement (overspill) of some of the persons living in the area. It is hoped partially to meet this problem by reserving the one hundred and thirty-three flats and maisonettes to be erected on the Treverton Street area for rehousing families to be displaced from the Kensal New Town area. The whole project will need careful synchronization, and it is expected that the first steps will be taken in 1956 to declare formally a suitable part of the area for clearance under Part III of the Housing Act, 1936. 6 The proposal to redevelop the Kensal New Town area marks the culmination of many years' work by the Council to deal with the unsatisfactory housing conditions in that part of the borough. It will be recalled that as long ago as 1933, this area was declared by the Council to be an improvement area under the Housing Act, 1930, and special byelaws were made to enable housing improvements to be carried out. Although a considerable amount of work was done, the conditions deteriorated very rapidly during the war years, when practically all housing repair work ceased. This process of deterioration also took place in two other improvement areas declared under the Housing Act, 1930, namely, the Becher Street area and the Treverton Street area. The properties in these areas have been cleared and have been, or are being, replaced by new housing estates. The Kensal New Town area is the last of the three improvement areas which the Council tackled under the 1930 Act and, as with the other two areas, the only reasonable course of action left is to demolish and rebuild. Generally speaking, the poorer three or four storey type of tenement house in North Kensington has reached the end of its useful life, and when the pressure on the. Council's housing resources becomes easier, there will be other areas in the borough which will have to be considered for clearance in the next decade or so. Food Hygiene. During 1955, the Food and Drugs (Amendment) Act, 1954, was not put into operation as expected, and the work of dealing with hygiene standards in food shops continued to be based on the London County Council's byelaws for the protection of food. Much good work was done under these byelaws, and publicity was given to the problem at the Health Exhibition held in Kensington High Street (Empress Rooms) in October, 1955- The new Food and Drugs Act, 1955, and the Food Hygiene Regulations made thereunder, came into force on 1st January, 1956, and should prove a marked advancement on the London County Council's byelaws. At the present time, strenuous efforts are being made to bring the new standards into force throughout all the food shops in the borough. The task is a heavy one and is hampered by the fact that the establishment of sanitary inspectors is under-strength. Attempts to recruit the required number of staff have been unsuccessful and it seems that the general shortage of sanitary inspectors throughout the country will have the effect of slowing down the work in regard to food hygiene. Old People's Welfare. The work carried out by the Council's two women health officers in regard to the care of the aged is an important branch of public health. The services provided for the aged, such as meals-on-wheels, holidays, home chiropody, recreational clubs, etc., are no doubt instrumental in relieving much of the misery and discomfort which ear befall old people living alone without the care and attention of members of their own families. The importance of home-visiting by the Council's health officers (and by voluntary workers) cannot be too highly emphasised, because it is mainly by this means that the health needs of old people are brought to light. In the past four years, over 7,000 old people have come under the supervision in one way or another of the public health department and the number of "initial" home visits paid in this period was over 6,900. The following table gives a summary of the visiting and interviewing work for this period 7 1952 1953 1954 1955 No. of old people on register at beginning of year 3,388 4,949 5,017 5,100 No. of cases lost 250 355 604 691 No. of initial visits 1,844 2,027 2,292 740 No. of re-visits 1,536 2,387 2,598 3,320 No. of interviews 1,739 1,005 2,054 1,859 No. of visits to chronic sick 196 356 500 560 One feature of the work is the increased demand made in respect of the home supervision of chronic sick old people awaiting admission, or discharged from, hospital (or not suitable for hospital treatment). Pour years ago, the number of visits paid to chronic sick was one hundred and ninety-six, and in 1955, the figure had increased to five hundred and sixty. These visits, generally speaking, take up a large amount of time, and as a consequence the work of visiting old people, believed to be in reasonably good health, has to be curtailed. VITAL STATISTICS The table set out on the next two pages gives the important vital statistics for 1955, together with comparative figures for the previous seven years. 8 9 SUMMARY OF VITAL STATISTICS FOR KENSINGTON Description 1955 1954 1953 1952 1951 1950 1949 1948 POPULATION Population (estimated) 169,400 170,600 171,500 172,800 171,300 177,400 174,220 168,800 Density of population per acre 74 74 74 75 74 77 76 74 LIVE BIRTHS Total births 2,674 2,707 2,642 2,810 2,656 2,745 2,681 2,908 Legitimate births 2,361 2,399 2,321 2,508 2,390 2,470 2,417 2,608 Illegitimate births 313 308 321 302 266 275 264 300 Birth rate per 1,000 population 15.8 15.9 15.4 16.3 15.5 15.5 15.4 17.2 STILL BIRTHS Total still births 40 48 53 48 60 54 39 56 Legitimate still births 31 40 47 37 55 51 39 47 Illegitimate still births 9 8 6 11 5 3 Nil 9 Still birth rate per 1,000 total births 14.7 17.4 19.7 16.8 22.1 19.3 14.3 18.9 DEATHS Total deaths 1,744 1,643 1,708 1,936 1,920 1,848 1,819 1,685 Death rate per 1,000 population 10.3 9.63 9.96 11.2 11.2 10.4 10.4 10 DEATHS OF INFANTS UNDER 12 MONTHS OF AGE Total infant deaths 84 61 50 75 65 78 64 111 Legitimate deaths 66 54 42 67 55 69 52 103 Illegitimate deaths 18 7 8 8 10 9 12 8 Infantdeath rate per 1,000 births 31.4 22.5 19.7 27 24 28 24 38 Death rate of legitimate infants per 1,000 legitimate births 27.9 22.5 18 27 23 28 22 39 Death rate of illegitimate infants per 1,000 illegitimate births 57.5 22.7 25 26 38 33 45 27 MATERNAL DEATHS Deaths of mothers as a result of pregnancy or childbirth 1 2 Nil 5 3 5 Nil 5 Death rate of mothers per 1,000 live and still births 0.37 0.72 Nil 1.75 1.1 1.79 Nil 1.68 TUBERCULOSIS Death rate from all forms per 100,000 population 10.0 14.0 19.2 18.5 21 33 34 51 Death rate from respiratory tuberculosis per 100,000 population 7.1 11.7 15.1 16.8 17.5 29 32 45 Death rate from non- respiratory tuberculosis per 100,000 population 2.9 2.3 4.1 1.7 3.5 4 2 6 KENSINGTON INFANTILE DEATH RATES (Deaths of children under 1 year per 1000 births) 11 CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE IN 1955 Cause of death All ages Under 1 year 1 year and under 5 5 years and under 45 45 years and over Respiratory tuberculosis 12 – 2 10 Other forms of tuberculosis 5 – 1 1 3 Syphilis 9 — - 1 8 Diphtheria — — — — — Whooping Cough — — — — — Meningococcal infections 1 1 – – — Acute poliomyelitis - - - - — Measles 1 1 — — — Other infective diseases, etc. 1 – – – 1 Cancer (all forms) 312 - 1 16 295 Leukaemia, aleukaemia 6 - 1 1 4 Diabetes 11 - - 1 10 Vascular lesions of nervous system 216 mm 4 212 Coronary disease, angina 284 _ — 4 280 Hypertension with heart disease 33 _ 1 32 Other heart disease 199 - - 3 196 Other diseases of circulatory system 79 — 2 77 /•» Influenza 6 - - — 6 Pneumonia 102 9 1 2 90 Bronchitis 114 5 1 — 108 Other respiratory diseases 13 1 — — 12 Ulcers of the stomach 27 - - 1 26 Gastritis, enteritis and diarrhoea 7 3 — — 4 Nephritis and nephrosis 7 — — 4 3 Hyperplasia of prostate 16 — — — 16 Pregnancy, childbirth and abortion 1 1 — Congenital malformations 16 11 1 2 2 All other diseases 163 51 2 10 100 Motor vehicle accidents 23 1 8 14 All other accidents 38 2 1 11 24 Suicide 40 - - 23 17 Homicide and operations of war 2 - 1 1 - TOTALS 1,744 84 11 99 1,550 12 GENERAL PROVISION OP HEALTH SERVICES IN THE AREA Bacteriological and Analytical Work The following is a summary of the work performed during 1955:- Nature of specimen or sample Number examined Nose and throat swabs 241 Sputum 10 Faeces, rectal swabs and other specimens 905 Milk (bacteriological) 106 Water (drinking) 6 Water (swimming baths) 20 Ice Cream 20 Miscellaneous 47 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. Medicinal Baths (Personal Cleansing Station) The record of work done during 1955 is as follows:- Description Scabies Vermin Impetigo Other conditions Persons Cleans -ings Persons Cleans -ings Persons Cleans -ings Persons Cleans -ings Adults Kensington 79 131 102 110 1 1 6 7 Other boroughs 49 77 43 46 - - - - Schoolchildren Kensington 63 266 748 748 3 3 4 10 Other boroughs 14 41 287 287 - - - - Children under 5 Kensington 23 47 34 34 2 2 2 6 Other boroughs 6 9 2 2 - - - - Compulsory Cleansings - - 116 116 - - - - TOTALS 234 571 1,332 1,343 6 6 12 23 In addition to the cleansing of persons referred to above, articles of personal clothing disinfested at the Medicinal Baths during the year numbered 2,083. 13 Disinfection and Diainfestation A summary of the routine work of the disinfecting staff is shown in the following table :- Houses disinfected after infectious disease 369 ( 552 rooms) Houses disinfested after vermin 556 (1528 rooms) Loads of furniture treated with hydrogen cyanide 23 Total weight of furniture, bedding, etc. dealt with 42 tons 11 cwt. 0 qtr. 22 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 1+63 parcels of clothing were disinfected and the income amounted to £57. 17s. 6d. The following table indicates the destination of these parcels No. of parcels Czechoslovakia 160 Russia 19 Hungary 14 Ireland 1 Esthonia 1 Unknown 268 + 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, sixteen such certificates were issued. H.C.N. Disinfestation For many years, the Council 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. 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, and, from the beginning of 1954, the Council decided to discontinue 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 examines the furniture and home of each prospective tenant; (b) If bug infestation is present, the furniture is dealt with by H.C.N, at the Disinfecting Station. (c) If no infestation is apparent, no action is taken in regard to the furniture, but the walls and ducts of new flats are treated with D.D.T. or Gammaxane smoke preparations. 14 (d) The sanitary inspector re-visits the flat after a period of six months, and takes appropriate action if the flat is found to have become infested. During 1955, 148 Council flats became ready for occupation, and in 134 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 14 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, Fisheries and Food pay a grant of 50% of the approved net expenditure incurred. The Council 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 from the owners. 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, 1956, and the following table gives the details for this period:- 15 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 36 37,156 8,129 45,321 II. Number of properties inspected by the Local Authority during 12 months ended 31/3/1956 as a result (a) 7 905 56 968 (a) of notification (b) survey (b) 1 86 7 94 or (c) otherwise (c) - 233 ~ 233 III. Total inspections carried out, including re-inspections 46 6,654 518 7,218 IV. Number of properties (under II) found to be Major infested by rats Minor mm 2 — 2 5 263 23 291 V. Number of properties (under II) found to be Major infested by mice Minor – – – – 2 613 36 651 VI. Number of infested properties (under IV and V) treated by the Local Authority 7 878 59 944 VII. Total treatments carried out 7 1,106 62 1,175 VIII. Number of notices served under Section 4:- (1) Treatment – – – – (2) Structural Works (i.e.Proofing) – 12 – 12 IX. Number of cases in which default action was taken by Local Authority following issue of notice under Section 4 – - - - X. Legal Proceedings – - - - XI. Number of "block" control schemes carried out - - - - 16 On two occasions during the year all the sewers in the borough were dealt with poison bait, and it was estimated that in the first treatment 4,515 rats were destroyed; and in the second 3,430 rats were killed. Sewer-baiting is usually carried out in January and June each year, and steps are taken to ensure that this work coincides with similar treatments carried out by neighbouring boroughs. Public Mortuary The number of bodies taken to the mortuary during the year was 512. The number of postmortem examinations was 429 and inquests were held in 76 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, and complaints of nuisance caused by pigeons are passed to him for investigation. 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-two. Of this number, two were new registrations during the year. 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. This sewer-baiting has been going on for some years and the figures of the estimated destruction of rats for the past five years are as follows Year Estimated number of rats killed First treatment Second treatment 1951 7,572 4,637 1952 5,982 4,133 1953 5,458 4,312 1954 4,142 4,667 1955 4,515 3,430 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 1,186 Premises inspected following complaints 1,243 Premises where rats were found 300 Premises where mice were found 617 Premises where other vermin were found 148 Premises where no infestation existed 178 Number of visits made 7,884 Number of notices served 25 Premises successfully treated 1,109 Cases in which advice only was given 81 Borough Council properties dealt with 90 17 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. Twenty-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 of one pound. No licenses have been issued in Kensington. If on registered premises there are unclean filling materials, the occupier shall be guilty of an offence; and it is also an offence to sell or offer for sale any article which is upholstered with unclean filling materials (secondhand articles are excepted.) Seventeen samples of rag flock and other fillings were taken during the year for analysis and the result in each case was satisfactory. Description No. of samples taken Hair 3 Rag flock 3 Cotton flock 1 Coir fibre 4 Woollen Pelt 3 Cotton Pelt 1 Sisal Pads 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 complianae with any conditions specified in the licence. During the year, nine premises were licensed under the Act. The general conditions for pet shops approved by the Council are those recommended for their constituent councils by the Metropolitan Boroughs' Standing Joint Committee. Hairdressers' and Barbers' Shops Section 18 of the London County Council (General Powers) Act, 1954, provides that from "an appointed day" hairdressers and barbers must be registered by the Council. The "appointed 18 day" is such day as may be fixed by resolution of the Council, at least one month after notice has been given in the local press of the passing of the resolution and of the general effect of Section 18. The Act gives power to the Council to make byelaws and provides that the person registered shall display on his premises a copy of the byelaws and of his certificate of registration. These powers are permissive, and in view of the generally satisfactory standard of hairdressers' and barbers' establishments in the borough, the Council are satisfied that at the present time there is no public health need to implement this legislation; especially as to do so would place an extra burden on the sanitary inspectors who are short-staffed. Health Propaganda Exhibition A Health and Civil Defence Exhibition was held in the Empress Rooms, Royal Palace Hotel, Kensington High Street, from 10th-15th October, 1955. The Exhibition was open to members of the public from 10 a.m.- 8 p.m. daily (Saturday 10 a.m.- 2 p.m.); the stands were staffed by members of the public health department, Civil Defence service, W.V.S., etc. The opening ceremony was performed by the Rt. Hon. Sir Hugh Lucas-Tooth, Bt., M.P., Parliamentary Under-Secretary of State, Home Office, who was introduced by The Worshipful The Mayor, Councillor Lady Petrie, J.P., L.C.C. One thousand, six hundred and twelve persons attended during the week, including several parties of senior school children, all of whom showed great interest in the various exhibits. Twenty-two stands (each 10' x 5'6") were provided by the Ministry of Agriculture, Fisheries and Food, and the allocation was made as follows :- Stand 1 - Information Bureau available to all exhibitors Stands 2-14 - Civil Defence service, W.V. S., and display National Fire Service, St. John panels at Ambulance Brigade, British Red end of hall Cross Society, Civil Nursing Reserve, etc.) Stands 15-22 - Public health department The centre of the Exhibition was devoted to some aspects of the work of the public health department, and included a large exhibit of the Ministry of Agriculture, Fisheries and Food, dealing with rodent control work. The Exhibition showed, inter alia, the work undertaken by the Council in determining the extent of the pollution of the air of Kensington; home safety models and exhibits; the use of germicides and disinfectants in the home, hospitals and catering industry; the rodent control work undertaken by the Council; models and other exhibits depicting the care taken in milk production, processing and handling; a photographic sequence showing the increasing use of hygienic methods in food handling; a photographic sequence dealing with the action taken in an outbreak of food poisoning. Films were shown to members of the public and to specially CLEAN MILK-SAFE MILK 20 invited audiences, in a lecture room on the floor above the Empress Rooms (seating capacity sixty persons). Programmes consisted of films on Civil Defence matters, public health, home safety, food hygiene, atmospheric pollution, etc. A talk on "Infestation Control in Business Premises" was given to food traders in the borough in the lecture room above the Empress Rooms. The speaker was a senior officer of the Ministry of Agriculture, Fisheries and Food (Infestation Control Division) and invitations were sent to all food traders in the borough. Advance publicity took the form of advertisements in the local newspapers, posters, handbills, bookmarks in the public libraries, etc. The Kensington Chamber of Commerce "Shopping Week" was held during the same week as the Exhibition, and the Chamber of Commerce advertised the Exhibition in a special booklet which was produced by them. One or more members of the staff were present at all times to answer questions from members of the public or to explain the exhibits, and the opportunity was taken to distribute suitable leaflets and propaganda material. General Health education is being increasingly recognised as a vital part of the public health service and in his report for the year 1953, the Chief Medical Officer of the Ministry of Health comments as follows "On the occasion of the establishment of the Ministry of Health, in 1919, special attention was directed to the need for regarding public health education as an essential part of any national health policy. The passing of time has seen a growing interest in the instruction in the principles and practice of hygiene throughout the whole field of preventive medicine. Progress, which at first was slow and uneven, has now so far developed that there must be few public health departments in the country where health education receives indifferent attention. Prom the early beginnings of "Health Weeks" and the occasional publication of leaflets and pamphlets, followed later by regular issues of popular health journals, health education has come to mean something more than a subsidiary function and responsibility; it is now regarded as a primary activity of local authorities." In addition to the above-mentioned Exhibition, the public health department has organised in the past two or three years, a food hygiene exhibition and several smaller campaigns, mainly in connection with flies, nuisances from dogs and home safety. The department also participated in a London County Council Divisional Health Exhibition at Hammersmith in 1954. Whilst these periodic campaigns are an extremely valuable form of health propaganda, they are soon forgotten, and there is need for a more continuous form of health education. This has been accomplished by the distribution each month of copies of "Better Health" (the monthly journal of the Central Council for Health Education) to clubs, hospitals and various other organisations in the borough; by the display of suitable posters on the ex-Empire Marketing Board poster frames and other sites in Kensington; and by the distribution of booklets, bookmarks, leaflets, posters, etc., dealing with such matters as food hygiene, food poisoning, infectious diseases, home safety, etc. 21 The Council make an annual grant of fifteen guineas to the Central Council for Health Education, a body recognised by the Ministry of Health as the medium through which health education material is distributed throughout England and Wales. Good use is made of the services available and posters, leaflets and other material are frequently obtained from the Central Council for use in Kensington. During the year, the Council accepted the offer of a publishing firm to print, free of cost to the Council, 3,500 copies of a booklet containing information on Civil Defence and Home Safety. The Public Health Committee co-operated with the Civil Defence Committee in this matter, so far as the section dealing with accidents in the home was concerned. Atmospheric Pollution The Council continued to maintain the two atmospheric pollution measuring stations during the year. One is in North Kensington (St. Joseph's Convent, Portobello Road, W.10) and the other in South Kensington (Messrs, John Barker's Furniture Depository, Pembroke Road, W.8). 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 of the air can be estimated each month. In addition to the above mentioned stations, the Council established during the year two smoke measuring stations, one at the public health department, Hornton Street, W.8., and the other at the public library, Ladbroke Grove, W.11. (It is hoped to establish a third smoke measuring station in the southern part of the borough.) The equipment at the public health department consists of a smoke filter and a hydrogen peroxide bubbling apparatus. The smoke filter measures the daily concentration of smoke suspended in the atmosphere, and the hydrogen peroxide bubbler extracts the sulphur dioxide content of the atmosphere. Readings are taken each day, and results are averaged to produce figures for each calendar month. The equipment at the public library consists of a smoke filter only. Measurements are taken three times a week, and daily and monthly averages are calculated from the results. All information obtained is forwarded each month to the Director of Observations at the Fuel Research Station of the Department of Scientific and Industrial Research, for correlation with results obtained from other sites throughout the country. The following tables set out details of the results obtained in Kensington during 1955:- 22 A. Deposit Gauge Month 1955 Days exposed Rain fall (ins.) Total deposits for period in tons per square mile Deposits per day in tons per square mile (average) Soluble Insoluble Total Soluble Insoluble Total North Kensington January 32 2.39 14.13 17.22 31.35 .442 .538 .980 February 28 1.40 9.20 13.22 22.42 .328 .472 .800 March 31 1.08 9.13 16.44 25.57 .295 .530 .825 April 31 0.74 6.28 10.97 17.25 .202 .354 .556 May 30 4.02 10.84 11.58 22.42 .361 .386 .747 June 30 1.95 6.07 10.10 16.17 .202 .337 .539 July 32 0.06 4.36 8.59 12.95 .136 .269 .405 August 28 0.88 3.99 8.49 12.48 .143 .303 .446 September 34 2.08 5.40 11.08 16.48 .158 .326 .484 October 29 2.49 7.99 7.95 15.94 .275 .275 .550 November 30 0.71 6.61 10.54 17.15 .221 .351 .572 December 32 1.93 8.49 9.06 17.55 .265 .283 .548 TOTALS 367 19.53 92.49 135.24 227.73 South Kensington January 32 1.75 9.97 12.48 22.45 .312 .390 .702 February 28 1.12 7.82 9.53 17.35 .280 .340 .620 March 31 0.81 6.11 9.67 15.78 .198 .311 .509 April 31 0.63 3.66 6.95 10.61 .118 .224 .342 May 30 3.75 9.70 10.37 20.07 .323 .346 .669 June 30 2.18 6.88 9.50 16.38 .229 .317 .546 July 32 0.44 4.26 7.79 12.05 .133 .244 .377 August 28 0.72 3.72 7.35 11.07 .133 .262 .395 September 34 1.53 4.84 8.99 13.83 .142 .265 .407 October 29 2.40 8.96 6.88 15.84 .309 .237 .546 November 30 0.54 7.25 11.74 18.99 .241 .392 .633 December 32 1.83 8.02 9.26 17.28 .251 .289 .540 TOTALS 367 18.70 81.19 110.51 191.70 B. Estimation of atmospheric sulphur Milligrams of sulphur trioxide per day Month 1955 Days exposed North Kensington South Kensington January 32 4.39 4.65 February 28 3.72 4.58 March 31 3.17 3.88 April 31 1.66 1.97 May 30 1.42 1.97 June 30 1.41 1.85 July 32 1.03 1.31 August 28 1.08 1.64 September 34 0.80 1.54 October 29 2.51 3.01 November 30 3.62 3.61 December 32 3.19 3.38 23 C. Comparison of results The following table compares the Kensington results with those of a country district, and with those of a large industrial area in the north of England:- Month 1955 North Kensington South Kensington Country District Industrial District A. B. A. B. A. B, A, B. January .980 4.39 .702 4.65 .343 1.74 .663 4.67 February .800 3.72 .620 4.58 .248 1.27 .405 4.19 March .825 3.17 .509 3.88 .283 1.00 .563 3.70 April .556 1.66 .342 1.97 .223 0.90 .564 3.50 May .747 1.42 .669 1.97 .320 0.45 .442 2.70 June .539 1.41 .546 1.85 .230 0.40 .581 2.00 July .405 1.03 .377 1.31 .131 0.25 .197 1.70 August .446 1.08 .395 1. 64 .250 0.40 .707 1.70 September .484 0.80 .407 1.54 .197 0.50 .530 2.90 October .550 2.51 .546 3.01 .142 0.90 .587 3.70 November .572 3.62 .633 3.61 .140 1.30 .487 5.80 December .548 3.19 .540 3.38 .203 1.30 .748 4.90 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 summarized as follows:- Total weight of deposit for year in tons per sq. mile Daily average of sulphur over the year in milligrams of sulphur trioxide North Kensington 227.73 2.32 South Kensington 191.70 2.77 Country District 81.00 0.87 Industrial area 196.53 3.45 Observations Readings from the two monthly stations have now extended over two whole years, and it is possible to compare the results of the two years. Year No. of days exposed Total weight of deposited matter in tons per square mile. Daily average of sulphur in milligrams of sulphur trioxide. North Kensington South Kensington North Kensington South Kensington 1954 364 205.11 181.47 2.15 2.57 1955 367 227.73 191.70 2.32 2.77 24 Although these results show an increase in measured atmospheric pollution in 1955 as compared with 1954, the increase might not be entirely due to an increase in the emission of pollutants, but might quite easily reflect different atmospheric conditions causing pollution to be deposited, e.g. different wind conditions. It should be borne in mind that some of the pollution being measured in Kensington must have its origin outside the borough boundary. In general, the figures reflect the trend noted in my previous report, with readings lower in summer than in winter, and, further, deposited matter continued to be heavier in North Kensington than in South Kensington, whereas sulphur readings continued higher in South Kensington than in North. Measurement of smoke and sulphur by the volumetric method (i) Public health department. (Readings at this station commenced on 1st June, 1955.) Volumetric smoke Concentration of smoke in milligrams per cubic metre Month 1955 Highest value Lowest value Average value June .289 .041 .155 July .447 .086 .207 August .379 .072 .199 September .379 .063 .166 October .462 .072 .296 November 1.214 .144 .451 December 1.228 .064 .414 Volumetric sulphur Concentration of sulphur in parts per million volumes of air Month 1955 Highest value Lowest value Average value June .234 .021 .094 July .180 .022 .073 August .181 .012 .069 September .127 .011 .054 October .221 .028 .103 November .474 .028 .149 December .459 .016 .165 (ii) Public library. (Readings for smoke content only commenced at this station on 1st September, 1955.) 25 Volumetric smoke Concentration of smoke-millgrams per cubic metre Month 1955 Highest value Lowest value Average value September .332 .107 .222 October .564 .303 .387 November .658 .248 .496 December .846 .219 .399 Action taken in regard to smoke nuisances During the year, there were fifteen complaints of smoke nuisance, as a result of which seventy-seven observations were made. Remedial measures were secured in all cases by informal action. Burial of the Dead Section 50 of the National Assistance Act, 1948, imposes on the Council the duty to arrange for the burial or cremation of any person who dies, or is found dead, within the borough, where no suitable private arrangements are made for the disposal of the remains. The Council have authorised the Medical Officer of Health to make arrangements for the burial of any person to whom it applies. Since the 5th July, 1948, the Council have arranged the burial of 317 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, 1955, the Council became responsible for the burial of thirty-three persons dying in the borough. The following is a summary of the action taken:- 26 (a) Cases where the funeral expenses have been fully recovered 13 (b) Cases where part only of the expenses has been recovered 11 (i) Number of these where balance of expenses will be recovered 2 (amounting to £15. 13s. 1d.) (ii) Number of these where there is no estate or "liable" relative 6 (iii) Number of these where "liable" relatives are unable to contribute 3 (c) Cases where full cost has been borne by the Council 9 (i) Number of these where there is no estate or "liable" relative 6 (ii) Number of these where "liable" relatives are unable to contribute 3 Amount recovered by end of year £238. 19s. 4d. Additional amount expected to be recovered 15. 13s. 1d. £254. 12s. 5d. Irrecoverable 134. 17s. 4d. Total cost £389. 9s. 9d. It is of interest to note that of the thirty-three cases dealt with, ten were eligible for Death Grant from the Ministry of National Insurance. The total amount recovered from this source amounted to £87. 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 1955, there were two hundred and fifty-four Kensington cremations, in comparison with one hundred and ninety-six in 1954 and two hundred and twelve in 1953 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 sixtyfour examinations were made. 27 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 some other person." During the year seven summonses were issued under this byelaw. Two were subsequently withdrawn and in the other five cases convictions were obtained and fines totalling £2. 10s. 0d. were imposed and costs amounting to £3. 3s. 0d. wore 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 serve on the Old People's Welfare Voluntary Committee which acts as a co-ordinating nonexecutive Committee through which voluntary bodies claim assistance from the Council and through which the Council pass requests for executive action. Advice Leaflets The Council arrange for the distribution of a pamphlet giving information of the services available to old people individually or through a club. S.O.S. Cards Window display cards are provided by the Council, bearing the letters "S.O.S" in red on one side and, on the reverse side, - 28 - directions how to use the card, with space for particulars of next-of-kin or nearest relative. 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. Under Section 31 of the National Assistance Act, 1948, the Council can 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) 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. (b) Latymer Road Mission Old People's Luncheon Club were granted £100 towards their general expenses in providing meals, including replacement of equipment. (c) The Dale Old Folks' Club were granted £15. Os. Od. for the purchase of crockery. (d) The Merry Makers' Club were granted £10. Os. Od. for the purchase of crockery. (e) The First Feathers Club were granted £11+. Os. Od. towards the cost of repairing chairs. Holidays The Council have 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 the coaches, and the Council paid towards their administrative expenses the sum of five shillings for each person (or man and wife) for whom a holiday was arranged. The following is a summary of work carried out in 1955:- 29 Total applications received 126 Unsuitable on medical grounds 10 Consideration deferred 30 Referred to other organisations 49 Number approved 77 Cancellations after approval 16 Number sent on holiday 61 Number sent to Lennox House, Southsea 46 Number sent to St. Mary's Home, Dover 15 Contributions by applicants £50. 14s. 6d. Cost of holidays to the Council 445. 1s. 0d. Booking fees paid to Family Welfare Association 12. 15s. 0d. 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 1955. 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 extended by 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. 30 3. This section shall be read and construed as one with Part III of the Public Health (London) Act, 1936. The Council have authorised the Medical Officer of Health to arrange for the cleansing, including bathing in their own homes, of old people. In cases where the absence of bathing apparatus and other household amenities present difficulties, a specially adapted vehicle is used to convey the old people to the Council's personal cleansing station, where in addition to bathing, the clothing can be disinfested where necessary. During the year twenty-five 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 two hundred old people to be admitted to hospitals for institutional treatment and, in addition, seventy 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. The number of "chronic sick" visits during the year totalled five hundred and sixty. 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 incontinence may be dealt with under this Section. To comply with the legal requirements, the Council have given a general authority to the Medical Officer of Health to take whatever action appears to him to be necessary under the terms of Section 122 of the Public Health (London) Act, 1936. In seventy-two 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 31 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 six hundred and forty separate collections of laundry were made under this scheme, and the number of articles cleansed totalled six thousand, nine hundred and thirteen. 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 tne home chiropody scheme was one hundred and forty-five and the number of treatments given was four hundred and fifty-seven. 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 (10d. 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:- 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 3,853 1,611 1,512 300 430 1955/56 45,933 -Not yet available- 32 It will be observed that the number of meals served is growing and that the net cost is substantial. The deficiencies have been met by the Kensington Communal Services Committee. Under Section 31 of the National Assistance Act, 1948, the Council have power to make grants to voluntary bodies undertaking the supply of meals to old people, and a grant of £300 for 1955/56 was made to the Kensington Communal Services. 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 1955:- Cases on register at the beginning of year 5,100 New cases added to register 767 Cases removed to hospitals 200 Cases removed to homes (voluntarily) 70 Cases removed to homes (compulsorily) 2 Cases removed from district 79 Number of deaths 340 Total number of cases remaining on register at end of year 5,176 Number of old people sent away for holiday 61 Number of old people provided with Council's laundry service 72 Number of old people provided with "Meals on Wheels" 264 Cases referred to National Assistance Board 214 Cases referred for assistance from Home Help Department 224 Cases referred for assistance from Voluntary Organisations 99 Cases referred to Recreational Clubs 167 Number of visits to chronic sick cases 560 Cases assisted with provision of medical and nursing care 223 Cases referred to home chiropody service 145 Cases cleansed at Medicinal Baths 25 Cases where disinfestation was carried out 45 Number of initial home visits made 740 Number of re-visits 3,320 Number of other visits made in connection with old people, including visits to clubs 189 Number of interviews, enquiries, etc. on behalf of old people 1,859 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. - 33 - 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 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 an old lady, aged 83 years, living alone in one room in North Kensington. She was unable to devote to herself proper care and attention, and was living in insanitary conditions, refusing all domiciliary service. Every endeavour was made to persuade her to enter a hospital voluntarily, but she refused to go. A Justice's Order was obtained, and she was removed to St. Charles Hospital, where she has settled down well. The second case was also an old lady, aged 76 years, who normally lived with her sister in a house in South Kensington. At the beginning of November the sister was admitted to hospital for an operation, and the old lady was unable to devote to herself proper care and attention. Every endeavour was made to persuade her to enter a home voluntarily, but she refused to go. A Justice's Order was obtained and she was removed to the Kings Mead Home, Chelsea. Subsequently, she was certified under the Mental Deficiency Acts, and was removed to Banstead Hospital. SANITARY INSPECTION The following table shows a summary of the inspections, etc., carried out by the sanitary inspectors during the year:- 34 Public Health (London) Act, 1936 Houses inspected on complaint 3,237 Houses inspected after infectious disease 3,608 Re-inspections 9,221 Smoke observations 77 Other inspections 1,564 Housing Act, 1936 Initial inspections (including preparation or revision of house-to-house cards) 644 Re-inspections 1,951 Initial inspections for overcrowding 509 Re-inspections 458 Underground Living Rooms Initial inspections 166 Re-inspections 972 Drainage Applications 544 Plans submitted 367 House drains inspected 5,084 House drains tested 702 Factories Act, 1937 Premises inspected 865 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 1,212 Statutory notices 479 Final notices 159 Various Factories Acts 30 Notice of intention to enter premises for inspection 1,122 Certificates of disrepair 67 Report of waste water to the Metropolitan Water Board 56 Report of dangerous structures to the London County Council 41 Other notices 49 The following is a summary of works completed under the supervision of the sanitary inspectors during the year:- 35 House drains, reconstructed or repaired 255 House drains, cleansed 141 Water closets, reconstructed or repaired 137 Water closets, new provided 378 Soil pipes, vent pipes, repaired etc. 132 Soil pipes, vent pipes, new provided 145 Baths, new provided 281 Sinks, new provided 183 Lavatory basins, new provided 719 Bidets, new provided 18 Waste pipes, new provided 366 Cisterns, cleansed 10 Cisterns, covered 7 Taps fixed on rising main 5 Yards and areas paved, drained etc. 14 Dustbins provided 184 Accumulations of filth, etc. removed 97 Roofs repaired 367 Houses provided with water above basement level 1 Dampness in dwellings remedied 444 Houses disinfected after infectious disease (including bedding, etc.) 369 Rooms in such houses, disinfected after infectious disease 552 Houses cleansed 18 Rooms in such houses 90 Verminous houses cleansed (including bedding, clothing, etc.) 556 Verminous rooms in such houses, cleansed 1,528 Other sanitary works executed 883 HOUSING Inspection of dwelling houses during the year (i) (a) Dwelling houses inspected for housing defects (under Public Health or Housing Act ) 8,622 (b) Inspections made for the purpose 22,410 (ii) (a) Dwelling houses (including those under sub-head (i) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 644 (b) Inspections made for the purpose 2,595 (iii) Dwelling houses found not to be in all respects reasonably fit for human habitation 1,212 Remedy of defects without service of formal notices Number of defective dwelling-houses rendered fit in consequence of informal action under the Housing or Public Health Acts 773 Action under statutory powers during the year (a) Premises repaired after service of formal notice under the Public Health (London) Act:- (i) By owners 479 (ii) By local authority in default 2 36 (b) 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 — (ii) Dwelling houses which were rendered fit by owners under Section 9 — (iii) Dwelling houses rendered fit by the Council in default of owners — (c) Action under Sections 11 and 13 of the Housing Act, 1936:- (i) Dwelling houses in respect of which demolition orders were made 7 (ii) Dwelling houses demolished in pursuance of demolition orders — (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 — (d) Action under Section 12 of the Housing Act, 1936:- (i) Separate tenements or underground rooms in respect of which closing orders were made (40 premises (80 rooms (ii) Separate tenements or underground rooms in respect of which closing orders were determined, the tenements or rooms having been rendered fit (35 premises (59 rooms (iii) Separate tenements or underground rooms in respect of which closing orders operate, but where the Council consented during the year to the use of the rooms for purposes other than sleeping (21 premises (33 rooms (iv) Separate tenements or underground rooms in respect of which the Council accepted undertakings from owners to render fit within specified time (2 premises (6 rooms (v) Number of undertakings by owners to render separate tenements or underground rooms fit, which were cancelled, the necessary works having been completed (2 premises (3 rooms (e) Action under Section 25 of the Housing Act, 1936:- Number of areas represented to Council for clearance Nil (f) Housing Act, 1936, Part IV-Overcrowding (i) Number of dwellings overcrowded at end of year No reliable estimate (ii) Number of new cases of overcrowding reported during the year 182 (699 units) (iii) Number of cases of overcrowding relieved during the year 147 (551 units) 37 (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 any 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 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 during 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 57 12 41 7 (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 Mortgate Interest (Restrictions) Act, 1920 10 1 1 — 38 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, were 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." A general power is given to the Council to require in houses, which are in multi-occupation, an adequate provision of the following services and amenities 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 control, 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. 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. On 5th April, 1955, the Council adopted 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 39 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 - 40 - (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 food, 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. ) F. 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. Artificial lighting of Common Staircases In exercising the powers under Sections 11 and 12 of the Housing Repairs and Rents Act,, 1954, one deficiency in the legislation came to light as a result of the repeal of the Tenement Houses Bye laws. These bye laws had required owners of houses suitable for occupation by persons of the working classes and let in lodgings, or occupied by members of more than one family, to provide adequate means for the artificial lighting of common staircases. Occupiers were required to keep the staircases adequately lighted with all the means- provided by the owner from one hour after sunset to 11 p.m. and, at such other times as were necessary, to keep adequately lighted any common staircase for which natural lighting could not be provided. The Council made representations to the Metropolitan Boroughs' Standing Joint Committee, who decided to ask the London County Council to insert an appropriate clause in their next General Powers Bill to replace the powers formerly contained in the byelaws. Slum Clearance Action already taken 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:- - 41 - 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 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. In addition to the above areas, a further area, the Treverton Street area, had been earmarked as a clearance area, but the Council eventually decided to proceed with the acquisition of the major 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. A Compulsory Purchase Order was made in respect of the following ninety-one premises :- Treverton Street Nos. 14-60 even 1-63 odd Ladbroke Grove Nos.329-339 odd Raymede Street Nos. 1-17 consec. Hewer Street Nos. 1-12 consec. Exmoor Street No. 5 Following a public enquiry, the Minister of Housing and Local Government confirmed the Order without modification. Steps have been taken to acquire the properties and rehouse the tenants and building operations are now in progress to erect the following housing accommodation on the cleared site:- 4 one-roomed flats 5 four-roomed maisonettes 46 two-roomed flats 12 garages 78 three-roomed flats 3 shops Future programme of slum clearance Every metropolitan borough, jointly with the London County Council, was required by Section 1 of the Housing Repairs and Rents Act, 1954, 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 Act, and which are suitable for action under Section 11 (demolition) or Section 25 (clearance area procedure) of the Housing Act, 1936. Although it was clearly impossible and indeed unnecessary to examine all houses in the borough, a survey was made of houses where conditions were known to be below standard or suspected to be unsatisfactory. In all, 6,166 houses of the - 42 - tenement type were inspected, whilst a further 1,250 other houses were inspected or assessed. 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. As a result of this survey, 3,293 houses were deemed to be unfit for habitation. Included in these, were the following areas which were thought to be suitable for slum clearance:- Premises Estimated population Families Persons Railway Mews 10 4 9 Kensington Park Mews 13 9 26 Addison Place 12 11 32 Stanley Gardens Mews 4 2 5 Lecky Street 5 2 4 Portland Road 16 39 110 Penelon Place, Ashley Cottages and Warwick Road 66 57 176 Denbigh Terrace, Denbigh Close and Portobello Road 37 54 144 Kensal New Town 516 1,106 3,550 679 1,284 4,056 The Council decided to submit the above proposals to the London County Council in the form prescribed by the Minister of Housing and Local Government as follows:- - 43 - 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 - 44 - 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). Discussions and correspondence took place on these proposals so far as they affected the areas suggested for slum clearance. In the case of Addison Place, it was agreed to accept a proposal for redevelopment by private enterprise to which there were no objections on public health grounds. It was further agreed that Denbigh Terrace, Denbigh Close and Portobello Road was a borderline case and, in view of the heavy commitments in respect of the other areas, the area was omitted from the present proposals, the position to be reviewed in the next five years. The two Councils agreed to allocate work of slum clearance as follows:- Borough Council:- Railway Mews 10 premises Kensington Park Mews 13 ,, Stanley Gardens Mews 4 ,, Lecky Street 5 ,, Portland Road 16 ,, 48 London County Council:- Penelon Place 66 premises Ashley Cottages Warwick Road The allocation of Kensal New Town (516 premises) was left undecided, but the Council resolved that a master plan should be prepared for the redevelopment of the whole area. In December, 1955, Sir William Holford, F.R.I.B.A., M.T.P.I., was retained for the preparation and submission of an architectural lay-out of the Kensal New Town Area. The question of the redevelopment is still under consideration. Housing Act. 1949 - Improvement Grants Owners who wish to modernise and make better use of existing houses by improvement and conversion, may apply to the Council for a grant towards the cost of the works of improvement or conversion. 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 question may properly be asked, namely, whether it will produce a satisfactory modernised dwelling complying with the statutory conditions and the specified requirements. The requirements which the Minister of Housing and Local Government has specified for a dwelling in respect of which an improvement grant may be made are as follows The dwelling must, after improvement or conversion - 45 - 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). Section 16 of the Housing Repairs and Rents Act, 1954, 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 grant. Under the 1954 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 16 removes altogether the requirement that schemes of improvement or conversion must not cost more than £800 per dwelling; 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 tinder 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 cent. 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." - 46 - Applications for improvement grants received and dealt with during 1955 are summarised as follows:- Applications received 38 Applications granted 24 (comprising 59 separate "dwellings") Applications refused 14 Total amount of grants approved £21,282. 0s. 0d. Applications withdrawn after approval 2 (amounting to £605. 0s. 0d. ) The provision of new housing accommodation The post-war new housing schemes completed or being erected in Kensington by the Council are summarised as follows:- Dwellings Henry Dickens Court 328 Balfour of Burleigh Estate 120 Portobello Court 158 Denbigh Road/Westbourne Grove 102 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, Lansdowne Road 8 Hunter House, Old Brompton Road 15 Pinborough Road (three schemes) 34 Orpen House, Trebovir Road 8 Wornington Road (Whyte House and Blackmore House) 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 Redcliffe Square 11 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. - 47 - Category 2. Overcrowding in excess of the Modified Standard. Category 3. Overcrowding above the legal standard but within the Modified Standard, where there are special medical reasons involved. Category 4. As in Category but without special medical circumstances. Cases within Categories 1,2 and 3 have been considered by a special Sub-Committee of the Public Health Committee which was established for that purpose. Cases within Category 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. Seventy-eight new cases were dealt with in 1955 by the Special Sub-Committee as follows:- (a) Recommended for alternative accommodation by the Council 36 (b) Proceedings ordered to be taken without prior offer of alternative accommodation 3 (c) Action postponed 31 (d) Warnings sent to abate overcrowding within specified period 8 The total number of cases of overcrowding abated during the year was eighty-nine and, in addition, fifty-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 ninety-nine cases of overcrowding under Categories 1, 2 and 3, and no fewer than nine hundred and sixty-seven of these nave been abated. Assessment of Housing Priorities on Medical Grounds .During the year two hundred and eighty-six applications for re-housing on medical grounds were examined, and recommendations for the award of additional points were made to the Chief Housing Officer. In each case the precise medical condition and resultant disability were determined (frequently necessitating communication with the family doctor or with the hospital attended.) The premises were inspected in detail to ascertain the extent and nature of the existing accommodation; the adequacy of day and sleeping space; the risk of infection; the existence of remediable or irremediable sanitary or structural defects, and the existence of inconveniences, such as stairs which might be prejudicial to the patient. On this information and that supplied by the Chief Housing Officer, an assessment of points to be awarded on medical grounds was made. In thirty-six 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 - 48 - 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. The erection of costermongers' stabling and storage accommodation in Gadsden Mews (which had been cleared under Housing Act procedure) has been completed and the following places have been provided Large stores 8 Small 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 accommodations, with manure stores, conveniences, etc. Elgin Mews Lonsdale Mews Large stores 14 5 Small stores 11 4 Stables 17 8 42 units 17 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 1955 Inspections Premises Number on Register Number of of Inspections Number of Written Notices Factories in which Sections 1, 2, 3, 4 and 6 are enforced by the Council 209 163 3 Factories in which Section 7 is enforced by the Council (not included above) 552 702 27 TOTALS 761 865 30 - 49 - Defects found Particulars No. of defects found No. of defects remedied No. of defects referred To H. M. Inspectors By H. M. Inspectors Want of cleanliness — — 5 2 Overcrowding — — — — Unreasonable temperature — — — — Inadequate ventilation — — — — Ineffective drainage of floors — — — — Sanitary conveniences (a) insufficient 3 3 — — (b) unsuitable or defective 26 19 — 2 (c) not separate for sexes 2 1 — — Other offences (not including offences relating to Homework) — — — — TOTALS 31 23 5 4 During 1955, no prosecutions were instituted under the Factories Act, 1937, although the Council issued a formal warning to the owner of a factory who had not complied with certain requirements of the Act. Outworkers The following table shows the nature of the work carried out by the one hundred and ninety home workers on the register of outworkers during 1955:- Nature of work Number Wearing apparel - making, etc. 119 Artificial flowers 5 Paper bags, etc. 10 Carding etc. of buttons, etc. 3 Stuffed toys 28 Furniture and upholstery 2 Lampshades 2 Textile weaving 12 Chocolates and sweetmeats 7 Curtains 2 190 During the year, three hundred and thirteen 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 carred 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 - 50 - made of twenty-seven underground bakehouses in respect of which certificates still operated. As a result, the occupiers of the following basement bakehouses were permitted to carry on their businesses. 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 During the year, No. 259, Old Brompton Road was found not to have been used as a basement bakehouse for over twelve months and in accordance with Section 54 of the Factories Act, 1937, it cannot legally be used as a basement bakehouse in the future. 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. 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 1955:- Premises registered under - No. of premises No. of Inspections (1) Section 14. Food and Drugs Act, 1938- (a) for the sale, or the manufacture for the purpose of sale, of icecream, or the storage of ice-cream intended for sale 343 103 + (b) for the preparation or manufacture of sausages or potted, pressed) pickled or preserved food intended for sale 159 168 (2) Milk and Dairies Regulations, 1949 - (a) as dairies 87 284 (b) where the occupier is registered for the sale of milk in sealed containers only 102 287 + Additional inspections of the premises (not primarily in connection with the sale of ice-cream) are recorded under different headings in the following table. - 51 - Pood premises (all categories) No. of premises No. of inspections Bakehouses - underground 13 24 " - others 16 14 Bread and cake shops 45 19 Butchers 81 140 Dairies 87 284 Fishmongers 47 32 Food factories 6 5 General stores 10 109 Greengrocers 115 15 Grocers 240 178 Ice-cream 343 103 Preserved food 28 28 Public houses and off- licences 161 42 Restaurants and cafes 263 179 Sweet shops 168 12 Street markets, stalls and storage premises 82 (lic161 ensed traders. ) Clean Food Campaign Copies of the London County Council's Byelaws for the protection of food, together with a list of practical suggestions and explanatory notes on specific matters were sent 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 ofnoticeswas avoided but as an alternative, informal letters incorporating the suggestions of the inspector were sent where appropriate. In most cases, the immediate response of the traders to th6 suggestions offered, rendered unnecessary any further action. The next step towards the goal of clean food will be the enforcement of the new Food and Drugs Act, and Food Hygiene Regulations made thereunder, which came into operation on 1st Januaryy 1956. Milk (Special Designations) (Raw Milk) Regulations, 1949 During the year licences under these Regulations were granted as follows:- Principal Supplementary Dealers licensed to sell Tuberculin Tested Milk; 102 20 Forty samples of Tuberculin Tested milk were submitted for examination during the year. Seven failed to pass the prescribed tests and in each case particulars were forwarded to the Ministry of Agriculture, Fisheries and Food. The following table summarises the details of the samples taken:- - 52 - Designation No, of samples Methylene blue test Passed I Failed Tuberculin Tested (Farm bottled) 36 29 7 Tuberculin Tested 4 14 - Four samples of Tuberculin Tested (Farm Bottled) 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 1955 are as follows:- Principal Supplementary Dealers' licences to sell Pasteurized Milk; 108 20 Dealers' licences to sell Sterilized Milk; 125 23 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) +37 36 - 37 - - - Pasteurized ++23 19 - 23 - - - 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. ++ Four samples were not submitted to the methylene blue test for the same reason as stated above. Milk and Dairies Regulations, 1949 (a) Registrat ions A summary of the alterations made in the register of - 53 - dairymen and dairies during 1955, and the numbers of persons and dairies registered at the end of the year are shown in the following table Dairymen Dairies Purveyors of milk in sealed containers Transfers 8 - - Additions to register - - 5 Removals from register - - - Dairymen with premises outside the borough added to register - - - On register 31st December, 1955 105 87 102 (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 before use" is considered to mean at the time the bottle is first filled and, therefore, any offence would be committed at the time and place of bottling. There are no processing or bottling plants in the borough and particulars of any offence for using a dirty bottle are referred to the local authority in whose area the bottling plant is situated. During the year, five contraventions were reported, four of which were referred to neighbouring authorities. In two of these the authorities took action against the firms. In one case the firm pleaded guilty and were fined £2. Os. Od., whilst the other case was dismissed, the magistrate finding that the case was not proved. In the other two cases, the local authority concerned decided not to take any action. In the remaining case, which was not a serious contravention, a warning letter was sent. Composition of milk During the year three hundred and forty-five samples of milk were submitted to the Public Analyst and, with the exception of twelve, were found to be of genuine composition. In the case of the twelve samples not complying with the presumptive standards established by the Sale of Milk Regulations, 1939, the following action was taken Ministry of Agriculture, Fisheries and Pood notified and warning letters to producer or vendor6 Legal proceedings taken 6 The following table shows percentages of milk fats and - 54 - non-fat solids of the genuine samples taken during each month:- Month No. of samples taken Average percentages Milk fats Non-fat solids January 48 3.68 8.59 February 23 3.84 8.67 March 27 3.56 8.57 April 18 3.35 8.57 May 32 3.38 8.74 June 30 3.43 8.77 July 27 3.52 8.72 August 26 3.67 8.68 September 13 3.71 8.75 October 29 3.73 8.79 November 41 3.72 8.74 December 17 3.92 8.85 Average for whole year 3.62 8.70 Legal minimum standards 3.00 8.50 Unsound food Seizure Under Sections 9 and 10 of the Food and Drugs Act, 1938, it is an offence to sell, offer, or expose for sale, 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 one case, portions of ham, in cellophane wrappers, said to be vacuum-packed, were seized and taken before a Justice of the Peace who condemned them and ordered them to be destroyed. The ham had been imported from the continent in prepacked form and full particulars were reported to the Ministry of Agriculture, Fisheries and Food. 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:- - 55 - Food Tons Cwts. Qrs. Lb. Meat (Raw) 1 — — 9½ Meat (Tinned) — 7 3 12 Ham — 15 1 27 Sausages — 1 1 1½ Poultry and Rabbits — — 1 9 Fish (Wet and Dry) — 14 2 — Fish (Shell) — 4 2 22 Puppodums (biscuits) — 10 — — Sauerkraut — 2 — 6 Rice — 1 2 — Ground almonds — — _ 23 Cheese — 7 2 17 Meat pies, etc. — — — 10 Tomatoes — — — 8 Butter — — — 13½ Dried fruit — — 2 8 Suet — — — 13½ TOTAL: 4 6 2 12 Tins, jars, packets or cartons of fruit, vegetables and miscellaneous foodstuffs 4,857 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. Damaged foodstuffs In October, 1955, a water main burst in a roadway in South Kensington. Two foodshops were badly flooded and a large amount of food was rendered unsalable or unfit for human consumption and had to be destroyed. A summary of the damaged food is as follows:- Food Cwts. Qrs. Lb. Jams and fruit sauce — 2 15 Marzipan and Ground Almonds 1 1 — Fondant, sugar and syrup 26 3 — Flour, milk powder, etc — 3 15 Salt 2 — — Cheese, butter, margarine and cooking fat 3 1 8 Cherries, sultanas, etc. 2 2 — Biscuits and cake 5 1 15 Nuts, various 1 1 22 Tea, coffee and cocoa 2 1 11 Chicken — — 3 Vegetables — 1 4 TOTAL: 46 3 9 Miscellaneous cakes, tarts, etc. 9,554 Potato Crisps 9 tins Olives 2 gallons (approx.) Rollmop herrings 1 gallon - 56 - Complaints by purchasers of unfit food During the year twenty-six complaints were received from members of the public that food they had purchased was in an unsatisfactory condition The complaints related to the presence of foreign matter in food, mouldy conditions of meat pies, unsatisfactory condition of canned food, rum, beer and quick-frozen peas. All these cases were carefully investigated. In two cases proceedings were authorised. The first related to the sale of bread containing a large piece of muslin and resulted in the vendors being fined £10. 0s. 0d. with £3. 3s. 0d. costs. The second concerned the sale of bread containing a maggot, and in this case the bakers were conditionally discharged (January, 1956), and the Council granted £5. 5s. 0d. costs. In five cases warnings were given to manufacturers and retailers. It was not possible to take further action in thirteen of the remaining cases owing to either the lack of detailed evidepce or to the results of chemical or bacteriological examinations failing to confirm the alleged complaints. The remaining six cases concerned food prepared outside Kensington and particulars were sent to the appropriate local authorities. One complaint deserves special comment. Some quick-frozen peas, after being cooked in margarine, became luminous. This condition was confirmed both by visual examination in the dark and by laboratory examination. The packers were anxious to co-operate with the department and carried out a series of experiments over a period of several months in an effort to reproduce this condition. Samples of peas were prepared in a similar fashion to that adopted by the complainant, whilst others were inoculated with luminous bacteria obtained from the Department of Scientific and Industrial Research. The peas were kept at varying temperatures in a cupboard and examined at various periods up to seven days. All experiments were unsuccessful in producing "luminous peas" and the investigations were abandoned. Adulteration of Food During the year five hundred and sixty-three formal samples of food and drugs were purchased, of which twenty-nine (5.1%) were either adulterated or otherwise unsatisfactory. Pour hundred and forty informal samples were also purchased, of which twelve (2.7%) were either adulterated or otherwise unsatisfactory. The following table summarises the action taken in respect of the defective samples:- - 57 - Unsatisfactory sample No. of prosecutions No, of warnings to Producers, Manufacturers or Vendors No„ of notifications to Ministry of Agriculture, Fisheries and Food No further action Total Soft Drink - - - 1 1 Golden Raising Powder -- - 1 1 Milk 6 - 6 - 1 2 Tomato Ketchup - 1 - - 1 Pork Sausages -9 - - 9 Beef Sausages - 3 - - 3 Ground Nutmeg - - - 3 3 Pure Cream Toffees - - - 11 Brisling Fillets in wine sauce - - - 11 Smoked Sea Salmon - - 1 - 1 Smoked Salmon (canned) - - - 1+1 Lung Syrup - - - 11 Soup Seasoning - - 11 Treble Cream Cheese 1 - - - 1 Double Cream Cheese - 1 - - 1 Single Cream Cheese - 1 - - 1 Spirit of Sal Volatile - - - 1 1 Tomato Soup (canned) - - - 1+ 1 TOTALS; 7 15 7 12++ 41 + In these cases the food was surrendered by the retailers and destroyed. ++ 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. Chinese Egg Albumen During the year, information was received from the Ministry of Health that certain samples of Chinese Egg Albumen (dried egg white), used in the bakery trade in connection with the manufacture of meringues and in the icing of cakes? had been found to contain Salmonella organisms, which are largely responsible for food poisoning. An appropriate statement was sent to bakers in the borough informing them that this commodity could only be used in the manufacture of products which were subjected to a sterilizing temperature of 212°F. for ten minutes. Samples were taken from the stocks of egg albumen and similar substances held by Kensington bakers, but no organism of the Salmonella group were isolated in any of the samples. Sausages There is at present no meat-content standard for sausages, - 58 - although during the years of rationing and price-control, under the provisions of the Meat Products Orders, pork sausages had to contain 65% of meat and beef sausages 50% of meat. These standards had been adopted as a basis for prosecutions in the lower courts, but in an Appeal case during the year the Lord Chief Justice declined to accept the standard of 65% meat for pork sausages. Representations have been made to the Ministry of Agriculture, Fisheries and Pood to prescribe standards, but it was stated by the Minister in the House of Commons that the introduction of compulsory standards of meat-content would not be justified at the time, but that the position would be kept under review. Fifty-six samples of sausages were obtained during the year, and of this number twelve (21.4%) were reported to have a meatcontent lower than 65% pork and 50% beef as the case may be. In November, the Council decided to ask the Metropolitan Boroughs' Standing Joint Committee again to urge the Ministry of Agriculture, Fisheries and Food to reintroduce legal standards for the meat-content of sausages. The Standing Joint Committee submitted to the Food Standards Committee of the Ministry the following observations 1. some form of control over the composition of sausages is desirable; 2. there should be a statutory minimum standard and a requirement to notify by labelling or other device the nature and percentage of meat-content; 3. there should be separate standards for beef and pork sausages, and that the standard for beef sausages should be 50% beef meat and the standard for pork sausages should be 65% pork meat; there should not be a lower standard than that stated above for sausages; 5. sausages sold under a description referring to a particular type of meat should consist wholly of that type of meat; 6. while the Committee are not in a position to say whether it is practicable, it is desirable to lay down a definition of meat which would have regard to quality, for example, by excluding gristle; 7. specific requirements relating to the nature and percentage of fat-content in sausages should be made, and the percentage of fat calculated as meat should be limited to a small percentage. Ice Cream The Food Standards (Ice Cream) Order, 1953, specifies 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 1955 for chemical analysis compared with the previous year:- 1954 1955 Number of samples 24 45 Variation of fat content per cent 5.1 to 11.7 5.4 to 14.4 Variation of non-fat content per cent 22.2 to 26.9 20. 5 to 31.8 Average fat content per cent 8.65 9.23 Average non-fat solids content per cent 24.40 25.16 - 59 - 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 samples of ice cream were taken and submitted to the methylene blue test. The results are as follows:- Grade No. of samples 1 3 2 1 3 4 4 12 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, 1947/52. FOOD POISONING The Pood and Drugs Act, 1955, requires any medical practitioner, on becoming aware that a person is suffering, or is suspected to be suffering from food poisoning, to notify the Medical Officer of Health,, The following table shows particulars of notifications received in 1955 Pood poisoning notifications (corrected) First quarter 10 Second quarter 16 Third auarter 13 Fourth auarter 14 TOTAL: 53 Outbreaks due to identified agents 5 (11 cases) Outbreaks of undiscovered cause 4 (10 cases) Single cases Unknown cause 21 Agent identified 11 Total cases 32 Outbreaks due to Identified agents (5 outbreaks) (a) The first outbreak occurred when a mother fell ill with diarrhoea, and, later on, a daughter aged three years had the same symptoms. The remaining two members of the family suffered no symptoms and bacteriological examinations of their faeces were negative. The patients' faeces were positive for salmonella 60 oranienberg. Investigations narrowed the possible source of infection to a cream doughnut, although the daughter had not eaten this confection nor did the examination of similar articles from the same baker reveal any further evidence. The storage accommodation and general standard of hygiene at the home were good, and it is possible that the mother contracted a chance infection which was passed on to her daughter. (b) The second outbreak involved the father and two children in a family of four; the mother was unaffected. The symptoms were suggestive of staphylococcal food poisoning and enquiries were quickly concentrated on caerphilly cheese as this was the likeliest vehicle of such an infection. The fact that the mother disliked cheese and had eaten none was an additional pointer. Specimens of faeces from the sufferers were negative, but a remnant of the suspected cheese was found to be infected with a particular strain of staphylococcus. Enquiries were made to trace the origin of the cheese sold by the family's grocer, and it was found that three farms in Somerset supplied the wholesaler concerned. The appropriate Medical Officers of Health were informed of the outbreak and bacteriological examination of the cheesemaking process on each farm was undertaken. The identical strain of staphylococcus was found in the investigations at one of the farms. (c) In the third outbreak, only two members (father and small son) were affected in a family of five persons. The sufferers exhibited symptoms of diarrhoea and vomiting, but quickly recovered. Faeces specimens were examined from all members of the family and those for the two patients were positive for salmonella typhi-murium. Enquiries in this outbreak were inconclusive, although a suggestion was made by the father and the medical practitioner concerned that the source was ice-cream procured from an itinerant vendor. Unfortunately, the vendor was not traced, (d) The fourth outbreak concerned two children, aged seven years and one year; the mother and father were unaffected. Faeces specimens were examined from all members of the family, and those from the two sufferers were positive for salmonella typhimurium. Investigations were hampered in this outbreak by language difficulties, and nothing conclusive emerged. (e) The last outbreak also affected two children, aged seven and four years, although the mother and another child suffered no symptoms. Bacteriological examination of faeces specimens revealed salmonella typhi-murium. It was difficult in this outbreak to obtain accurate details of food eaten. The home conditions were only fair, and there was some evidence of mice infestation. Outbreaks of undiscovered cause (4 outbreaks) (a) In this outbreak, the mother, father and one child in a family had symptoms of diarrhoea; a second child was unaffected. The symptoms were not severe. Bacteriological examination of faeces specimens were negative for the whole family. Beyond a few items, the adults were unable to give a coherent history of food eaten. (b) In a family of six persons, three suffered symptoms of vomiting, discomfort, and slight diarrhoea. Investigations pointed to a salami brought from Germany a week prior to onset as the source of infection, but unfortunately none of it remained for bacteriological examination. Faeces specimens submitted by all members of the family were reported negative. Whilst this outbreak may have been due to a true food poisoning, it is believed it could equally well have been an exhibition of allergy in that the salami was eaten by all members of the family. A 61 contributory cause of illness could have been the length of time the food was kept in fairly warm conditions. (c) The third outbreak under this heading involved two middle-aged ladies living together. They resented the enquiries and gave little information. They refused to submit faeces specimens and the investigations had to be abandoned. (d) The fourth outbreak involved two out of three young ladies sharing a flat. Bacteriological examinations were negative and there was little in the history of food eaten suggestive of true food poisoning. It was significant, however, that shortly before onset the two patients had made and eaten a stew of green peppers. In view of the properties of green peppers, it seems likely that the two sufferers had eaten too many, rather than suffered from true food poisoning. Single cases In addition to the outbreaks referred to above, there were thirty-two single cases of food poisoning notified. In twentyone of these, no causative agent was identified, but of the remaining eleven cases, eight were found to be caused by salmonella typhi-murium, one by salmonella Thompson, one by salmonella St. Paul, and one by Clostridium welchii. INFECTIOUS DISEASE Smallpox No case of smallpox was notified in the borough during the year 1955. 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 thirty-nine 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 1955 was fifty and, of this total, ten 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 There were two cases of diphtheria notified during 1955. The first patient was a female, aged twenty-five years, who was admitted to hospital with a history of sore throat and enlarged cervical glands three weeks previously. Four negative cultures were obtained from her throat in hospital, but it was believed that the bacteriology was affected by a course of penicillin given prior to admission. The patient suffered from palatal paralysis which cleared up gradually, and she was discharged after a month's stay in hospital. The patient lived alone and no close contacts were traced; she had never been immunised. No further cases were reported. 62 The second case was a young girl, aged seven years, who had never been immunised. She was admitted to hospital with a sore throat and abdominal pain. Her symptoms cleared up quickly with treatment and she was discharged free from infection in seven weeks. At the hospital, throat cultures showed a mitis strain of diphtheria which was proved virulent by guinea-pig inoculation. All family contacts were examined and found to be negative, and no further cases occurred in the family or at the patient's school. Diphtheria immunisation work, commenced by the Council in 1934, was continued by the London County Council during the year. A summary of the work carried out in Kensington is as follows:- Number of pre-school children immunised 1,504 " " school " " 217 " " re-inforcing injections given 854 " " children attending for pre-Schick tests 420 " which gave a positive reaction 305 " " " " negative " 73 " of children attending for post-Schick tests 840 " proving negative 807 " proving positive 8 " who failed to attend for reading 67 Enteric fever During the year, there were four cases of paratyphoid B fever and three of typhoid fever. All the patients concerned were admitted to hospital for treatment and no deaths occurred. The four cases of paratyphoid B fever comprised all the members of a Kensington family (father, mother and two daughters aged three years and eight months respectively). In spite of thorough investigations, including the bacteriological examination of specimens from known contacts, nothing was found to suggest the source of infection. Unfortunately, there was a delay on the part of the patients in seeking medical advice after the onset of symptoms so the task of accumulating evidence was made difficult. As none of the patients had been abroad, one possibility seemed to be that the mother had been a carrier who had infected the other members of the family. However, sufficient bacteriological work was not done to confirm this nor was the problem of the mother's original source of infection resolved. The first case of typhoid fever was a Jugo-Slavian boy aged fourteen years who was taken ill on his way from his own country to join his father in Rochdale. On arrival in London, he was already ill and he was taken to a Kensington address for a few hours before admission to hospital. The source of infection in this case was clearly abroad. The second case was a woman aged fifty years, and enquiries indicated that the source of infection was probably a party held some time prior to onset in another part of London. Subsequent investigations showed that a number of cases had occurred in various parts of London as a result of the same focus of infection. Specimens were examined from Kensington contacts, who were kept under surveillance, and no further cases occurred. The last case occurred in a woman aged seventy-seven years who was living in a hostel for old people. The absence of severe symptoms and a scrutiny of her past history suggested that she was, in fact, a carrier, and to some extent the bacteriological evidence supported this belief. At the end of the year, the patient was still in hospital undergoing treatment to eradicate the carrier state. The considerable number of 63 contacts at the hostel, both residents and staff, were examined and kept under observation. No further cases occurred. puerperal pyrexia During 1955, the number of cases of this disease notified was one hundred and twenty-five, of whom eighty-four were persons normally resident outside the borough. Four of the cases occurred after home-confinements (two of these patients were subsequently moved to hospitals outside the borough for treatment), one case occurred in a private nursing home and the remaining one hundred and twenty cases occurred in a Kensington hospital with a maternity department. The increase of notifications (see table for previous years on page 68) and the preponderance of these in a single hospital might give cause for some alarm, but the following table showing the analysis of the causes of these cases of puerperal pyrexia (i.e. any febrile condition occurring in a woman in-whom a temperature of 100.4°F. or more has occurred within fourteen days after childbirth or miscarriage) brings the problem into perspective. Cause No. of cases Flushed breast, breast abscess, mastitis 23 Respiratory infections:- Coryza 6 Bronchitis 1 Pneumonia 1 Upper respiratory infection 1 9 Urinary infection (4 of which were associated with other causes as follows:- 1 mumps, 1 anaemia, 1 forceps delivery, 1 head cold) 47 Pyelitis 1 Phlebitis 1 Dermatitis 1 Operations:- Post-operative 1 Caesarean section 4 (including 1 stitch abscess) Twisted ovarian tumour 1 6 Uterine infection (including 1 case associated with anaemia) 7 Cause unknown after investigation 17 Not stated 12 Information was received in the public health department concerning fifty-one patients normally resident in Kensington, who were notified as suffering from puerperal pyrexia in other London districts. No deaths occurred under this heading. Pneumonia There are various forms of pneumonia, but the only types notifiable are (i) acute primary and (ii) acute influenzal pneumonias. During the year, one hundred and five notifications were received, seventy-six being acute primary pneumonia and twenty-nine being acute influenzal pneumonia. Of the total, thirty-six cases were removed to hospital for treatment. The number of deaths from pneumonia (all forms) was one hundred and two and the number of deaths from influenza was six during 1955. 64 Dysentery Ninety-nine cases of dysentery were notified during 1955, 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 Each of the nine cases notified during the year was treated at home. There were no deaths. Meningococcal infection Only two cases of this disease were notified during the year and both were removed to hospital. There was one death of a child under one year reported. Malaria Six cases of malaria were reported during the year. Investigations showed that all the patients were persons who had recently returned from abroad. Poliomyelitis There were thirty cases of acute poliomyelitis notified and confirmed during the year; ten of 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 1954 5 Nil 1953 14 1 1952 21 2 1951 12 Nil 1950 13 3 Contacts of all cases notified were kept under surveillance for twenty-one days, (or until the diagnosis was changed in unconfirmed cases). In each instance an advisory pamphlet was issued setting out the elementary precautions to be taken. A number of Kensington residents, who were contacts of cases occurring outside the borough, were also kept under observation. In early August, all general medical practitioners in the borough were circularised drawing their attention to the then increasing incidence of the disease, so that they would be on the alert for possible cases. (At that time of the year there was an unusual preponderance of non-paralytic cases-seventeen compared with two paralytic cases.) 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 Pour cases of this disease were notified in the borough during 1955. No deaths occurred. Measles Of the fourteen hundred and twenty-five cases notified during 1955, sixty-three were admitted to hospital for treatment. One death occurred from this disease. 65 Ophthalmia neonatorum Four cases of this disease were notified. All the cases were treated at home 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 thirteen. Four were removed to hospital for treatment. Three deaths of children under five years of age were recorded as due to gastritis, enteritis or diarrhoea. Scabies The number of notifications of this disease during 1955 was fifty-four, which compares with four hundred and sixty-three in the peak year of 1946. Tuberculosis During the year two hundred and eighteen new cases of tuberculosis were notified, of which one hundred and ninety-three 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, 1955 793 677 72 94 1,636 Notified for the first time during the year 101 92 11 14 218 Brought to notice other than by notification 102 78 2 6 188 Removed from register on account of having - (a) recovered from the disease 11 18 - 3 32 (b) removed from district lost sight of, etc. 134 121 10 15 280 (c) died 11 9 — 1 21 Remaining on register on 31st December, 1955 840 699 75 95 1,709 The system of investigation into the environmental conditions of tuberculous patients continued during the year. All newly notified cases and those cases transferring into Kensington or changing their address in the borough, have been visited by the sanitary inspectors with the objects of tracing the source of infection, preventing the spread of infection and removing conditions favourable to infection. Particular attention was given to the home conditions in addition to the dissemination of advice to prevent the transmission of infection to contacts. During the year, four hundred and forty-nine 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 eighty-two cases it was found that the patients had moved away, and in fifty-seven other cases the investigations were postponed as the patients were away in 66 hospital or had not been contacted by the end of the year. The action taken in the remaining seventy-six cases is summarized as follows Action taken Cases Investigation or supervision undertaken in respect of:(a) re-arrangement of existing accommodation 13 (b) occupation of patients 1 (c) tracing of contacts10 (d) preventing spread of infection 5 Recommended for priority rehousing 47 Action was taken under the Public Health and Housing Acts in respect of insanitary or unhealthy conditions in fourteen cases. Incidence of tuberculosis amongst Kensington residents who originated from areas outside England. Scotland and Wales In my 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 1955:- Country of origin Period (in years) between entry to United Kingdom and notification of disease 123456789 Total Australia - 1 - - - - - - - 1 Cyprus -1 - - - - - - - 1 Czechoslovakia 1 - - - - - - - - 1 Falkland Is. -------1- 1 France 2 1 1 - - - - - - 4 Germany - - - - 1 - - - - 1 Holland - - -1 - - - - - 1 Hong Kong 1 - - - - - - - 1 India and Pakistan 2 - 1 1- - - 1 - 5 Ireland 8 8 1 3 2 - 1 - 2 25 Italy - 1 1 2 - - - - - 4 Jamaica 1 - 1 - - - - - - 2 Jugo-Slavia 1 - - - - - - 1 Poland 1 - 1 - 1 1 2 3 - 9 South Africa 1 - - - - - - - 1 Spain 1 1 1 - - - - - 3 Ukraine - - 1 - - - - - 1 TOTALS: 19 13 8 7 4 1 3 5 2 62 67 Patients who had resided in London all their lives or for at least 10 years 105 Patients who had resided in other parts of the country all their lives prior to coming to Kensington 47 Patients from whom information concerning origin was not obtained but where it is believed to be this country 7 Patients from Ireland who resided here at least 10 years prior to notification 2 Patients notified abroad before coming to this country (Ireland 8, U.S.A. 1, Poland 1, Australia 1) 11 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, Spain 1, Jugo-Slavia 1) 3 Patients from whom information concerning origin could not be obtained 123 TOTAL 299 The investigation only covered patients newly notified or transferring into the borough from other areas. The total of three hundred and sixty-one cases surveyed differs from the total of tuberculous patients visited in the year. 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, 1954 and 1955 were 10%, 16% and 17% 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 Kensington 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. Whooping Cough One hundred and sixteen cases were notified during the year, fourteen of which were treated in hospital. No 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 medical practitioner, the certificate must be authenticated by the Medical Officer of Health. During the year, two thousand, six hundred and seventy-three of these certificates were authenticated in Kensington. In addition, twenty-nine special exemption certificates were issued to travellers for use in the United States of America. 68 Notifications The following tables show (1) the number of cases of infectious disease notified during the year 1955, 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 1955 1954 1953 1952 1951 1950 1949 19248 Scarlet fever 50 52 78 108 68 100 114 94 Diphtheria (including Membranous Croup) 2 - 2 — 1 2 2 12 Enteric fever 7 5 5 2 7 12 7 4 Puerperal pyrexia 125 96 65 83 22 18 33 25 Acute primary pneumonia and acute influenzal pneumonia 105 54 93 71 149 69 121 142 Dysentery 99 68 131 31 81 18 33 145 Erysipelas 9 14 11 11 13 17 15 24 Meningococcal infection 2 1 6 4 8 5 8 4 Malaria 6 4 5 1 2 2 — 2 Acute poliomyelitis Paralytic 10 5 9 17 8 7 47 9 Non-paralytic 20 - 5 4 4 6 Acute encephalitis 4 1 - 3 1 — 1 - Tuberculosis (all forms) 218 243 256 251 238 278 266 258 Measles 1425 94 740 839 1314 696 740 868 Ophthalmia Neonatorum 4 2 7 2 2 12 5 7 Enteritis 13 20 27 30 25 63 88 64 Food poisoning 53 58 79 20 18 23 33 11 Scabies 54 42 42 26 34 72 106 141 Whooping Cough 116 136 485 228 484 316 304 264 Typhus fever — 1 — — — — — - TOTALS: 2322 896 1846 1731 2479 1716 1923 2074 + Notifiable only in children under the age of 5. NOTE: Cases of mistaken diagnosis are excluded from above table. 69 TABLE 2 Notifiable disease Number of Cases Notified in 1955 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 - 5 5 32 4 3 1 Diphtheria (including - - - - Membranous Croup) — — — 1 — — 1 Enteric fever 1 — 1 — 1 — 4 Puerperal Pyrexia - — — — — 52 73 Acute primary pneumonia and acute influenzal 2 10 8 8 4 8 65 pneumonia Dysentery 3 16 13 31 4 7 25 Erysipelas — — — - - - 9 Meningococcal infection 2 - - — - - - Malaria — — — — — - 6 Acute poliomyelitis Paralytic — - 1 - — 3 6 Non-paralytic — - 4 5 1 6 4 Acute encephalitis — — — 2 — 1 1 Tuberculosis (all forms) 4 4 6 6 5 52 141 Measles 45 319 364 609 27 26 35 Ophthalmia neonatorum 4 - - - - - - Enteritis 7 5 1 — — - - Food poisoning 1 3 6 4 - 4 35 Scabies — 3 2 11 2 19 17 Whooping Cough 10 31 30 42 2 1 - TOTALS: 79 396 441 751 50 182 423 TABLE 3 Notifiable disease Total Cases Notified in each Ward St. Charles Golborne Norland Pembridge Holland Earls Court Queens Gate Redcliffe Brompton Scarlet fever 13 2 5 9 2 1 2 13 3 Diphtheria (including Membranous Croup) — - 1 — - - 1 — - Enteric fever _ - 4 - - - 1 - 2 Puerperal Pyrexia 2 2 1 4 4 12 91 9 - Acute primary pneumonia and acute influenzal pneumonia 15 19 22 12 8 5 8 11 5 Dysentery 33 29 8 7 7 3 - 11 1 Erysipelas 1 1 2 1 4 - - - - Meningococcal infection - - - 2 - - - - - Malaria — - — — 2 - 1 2 1 Acute poliomyelitis Paralytic 3 1 — — 2 1 1 2 — Non-paralytic 4 4 1 3 5 1 — 1 1 Acute encephalitis - - - 1 1 - 1 1 - Tuberculosis (all forms) 21 34 24 26 23 30 17 28 15 Measles 212 259 169 224 141 162 72 142 44 Ophthalmia neonatorum 1 - 2 1 - - - - - Enteritis 3 6 2 1 1 - - - - Pood poisoning 5 3 9 7 6 5 10 4 4 Scabies 9 15 6 8 5 4 1 4 2 Whooping cough 19 27 14 11 19 7 3 10 6 70 LEGAL PROCEEDINGS Public Health (London) Act. 1956 Nuisances During the year, one hundred and seven summonses were issued for various nuisances under the Public Health (London) Act, 1936. In twenty-six cases Abatement Orders were secured and costs amounting to £26. 5s. Od. were awarded to the Council. In twenty-one cases the summonses were withdrawn, the nuisances having been abated prior to the Court hearings. In fifty-eight cases the summonses were adjourned as the necessary works were being carried out by the defendants. Of the remaining two cases, one summons was withdrawn as the defendant died before the case was heard, and the other summons was dismissed. Seventeen prosecutions were undertaken for failure to comply with Justices' Orders to abate statutory nuisances. In seven cases fines amounting to £45. 17s.. Od. were imposed and costs amounting to £12. 12s. Od. were awarded to the Council. The remaining ten cases were withdrawn or adjourned as the necessary works had been, or were being, carried out. Council's Byelaws Dog Nuisances Seven summonses were issued under this byelaw. In five cases convictions were obtained and fines totalling £2. 10s. Od. were imposed and costs of £3. 3s. Od. were awarded to the Council. The remaining two summonses were withdrawn, as the witnesses were not available. Housing Act, 1936 Contraventions of Closing Orders Three summonses were issued in respect of the illegal occupation of closed underground rooms. In one case a conviction was obtained and a fine of £5. 0s. Od. was imposed with £1. 1s. Od. costs to the Council. The other two summonses were withdrawn as the owners had carried out the works necessary to make the rooms fit for habitation. In a further case a summons was issued in respect of the illegal occupation of a closed house. A conviction was obtained and a fine of £10. 0s. Od. was imposed with £3. 3s. Od. costs to the Council. Food and Drugs Act. 1938 Eight summonses were issued in respect of the sale of food not being of the nature, substance or quality demanded. In the first case, the defendant was fined £10. Os. Od. and ordered to pay £3. 3s. Od. costs; in the second case the Court imposed a fine of £1. Os. Od. with £3. 3s. Od. costs; and the other six cases were all in respect of the sale of hot milk drinks. All the defendants were convicted and fines amounting to £6. 6s. Od. with £13. 13s. Od. costs were imposed. Seven summonses were issued under Section 13 of the Act in respect of the unsatisfactory condition of food premises. Convictions were obtained and fines totalling £23. Os. Od. with £k* Us. Od. costs were imposed. 71 Defence (Sale of Food) Regulations, 1943 A sample of "Treble Cream Cheese" was found to contain 46.4%of fat, 12% & of solids-not-fat and 41 „ 6% water. The Council's public analyst stated that the composition of the sample corresponded to that of a cheese made from cream ("Single cream"), but not from "Double cream", as defined in the Pood Standards (Cream) Order, 1951. In the analyst's opinion the description "treble cream cheese" was calculated to mislead as to the quality of the article. The Ministry of Agriculture, Fisheries and Food were informed of this case, and gave authority for the Council to institute legal proceedings. At the hearing, the defendants pleaded guilty and were fined £5. Os. 0d. and were ordered to pay £1o 1s. Od. to the Council. CONCLUSION In presenting this Report, I should like to express ray 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 1955 (As requested by Ministry of Health Circulars 1/54 and 28/54) Year of Medical Officer of Health Appointment James H. Weir, M.D., B.S. , B.Hy., D.P.H. 1950 Deputy Medical Officer of Health W. C. Turner, M„D., M. R.C.S. , L.R.C.P., D.P.H., D.I.H. 1951 Public Analyst H. Amphlett Williams, Ph.D.(Lend)., A.C.G.F.C., F.R.I.C. 1952 Administrative and Clerical Staff 1.2. John S. Wheeler, Chief Clerk 1924 Francis W. Gascoyne 1919 John H. Gillett 1938 George W. Churcher 1935 Eric A. Bardin 1949 Miss Vera F. Osborne 1941 Mrs. B. Beesley 1948 Digby A. Smith 1939 Mrs. S. Scott 1943 Victor W. Waymark 1946 Miss Doris Gibbs 1944 Miss Marjorie Mackay 1950 Miss Elizabeth Howarth 1951 Alan Rogers 1953 Philip Hayllar 1952 Mrs. B. Hennessey 1954 Harry Gibbs 1955 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 1.2. Arthur F. Standish 1947 1. Harold Hind 1939 1.2. Frederick H. Canton 1950 1. Arthur E. Sills 1949 1. Reginald Ge Weedon 1952 1.2.4.Joseph G. Tompkins 1951 1.2. Herbert B. Cade 1952 1.2.4. Leslie E. Bowskill 1954 1. Brian M. Rom 1955 1.2. Kenneth Bell 1955 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 Albert V. Boddington, Superintendent, Medicinal Baths 1929 James W. Noble, Chief Disinfector 1935 William G. Gauntlett, Mortuary Keeper 1939 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 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 64 Adulteration of Food 56 Artificial lighting of Common Staircases 40 Atmospheric Pollution 21 Bacteriological Work 12 Bakehouses 49 Birth Rate 1 Burial of the Dead 25 Cancer of the Lung 2 Certificates of Disrepair 37 Chinese Egg Albumen 57 Chiropody for Aged Persons 31 Clean Pood Campaign 51 Clearance Areas 5,35 Cleansing of Aged Persons 29 Closing Orders-Contraventions 70 Committees 73 Costermongers' accommodation 47 Cremation Service 26 Deaths, Causes of 11 Death rate 1 Demolition Orders 36 Diphtheria 61 Diphtheria Immunisation 62 Disinfection & Disinfestation 13 Dog Nuisances 27,70 Drainage 35 Dysentery 64 Enteric Fever 62 Erysipelas 64 Exhibition 18 Factories 48 Food - 6,50 Adulteration 56 Byelaws 6 Clean Food Campaign 51 Chinese Egg Albumen 57 Ice Cream 58 Inspections 50 Milk 53 Poisoning 59 Sausages 57 Unsound 54,56 Gastro Enteritis 65 Hairdressers' Shops 17 Health Propaganda 18 Holidays for Aged Persons 28 Houses in multiple-occupation 38 Housing - 5,35 Clearance Areas 40 Closing Orders - Contraventions 70 Demolition Orders 36 Improvement grants 44 Inspections 35 Legal Proceedings 70 Medical Priorities 47 New Housing Accommodation 46 Overcrowding 36,46 Slum Clearance 40 Underground Rooms 36 Housing Repairs and Rents Act, 1954 37,38,41 INDEX Page Ice Cream 58 Improvement Grants 44 Infant Death Rate 1 Infectious Diseases 2,61 Acute Encephalitis 64 Diphtheria 61 Dysentery 64 Enteric Fever 62 Erysipelas 64 Gastro Enteritis 65 Malaria 64 Measles 64 Meningococcal Infections 64 Notifications 68 Ophthalmia Neonatorum 65 Poliomyelitis 64 Pneumonia 63 Puerperal Pyrexia 63 Scabies 12,65 Scarlet Fever 61 Smallpox 61 Tuberculosis 2,65 Whooping Cough 67 Institutional Care of Aged Persons 30 International Certificates 67 Laundry Facilities for Aged Persons 30 Legal Proceedings Closing Orders-Contraventions 70 Dog Nuisances 70 Food and Drugs Acts 70 Nuisances 70 Library Facilities for Aged Persons 31 Lung Disease 2 Malaria 64 Maternal Death Rate 2 Meals for Aged Persons 31 Measles 64 Medical Examination of Staff 26 Medicinal Baths 12 Meningococcal Infections 64 Milk 53 Milk & Dairies Regulations, 1949 52 Milk, Special Designations 51 Mortuary 16 National Assistance Acts 1948/51 25,32 New Housing Accommodation 46 Notifications of infectious disease 68 Nuisances 70 Old People's Welfare 6 Advice Leaflets 27 Chiropody 31 Cleansing 29 Grant 28 Holidays 28 Institutional Care 30 Laundry Facilities 30 Library Facilities 31 Meals Service 31 Removals 32 S.O.S. Cards 27 Visiting 32 Ophthalmia Neonatorum 65 Outworkers 49 Overcrowding 36,46 INDEX Page Pests, Prevention of Damage by 14 Pet Animals Act, 1951 17 Pharmacy & Poisons Act, 1933 16 Pigeons, Destruction of 16 Poliomyelitis 64 Population 1 Pneumonia 63 Puerperal Pyrexia 63 Rag Flock & Other Filling Materials Act, 1951 16 Removal of Aged Persons 32 Repair of Houses 34 Rodent Control 14 Sanitary Inspection- Drainage 34 Dwelling Houses 35 Inspections 34 Legal Proceedings 70 Sanitary Notices served 34 Supervision of Work 34 Scabies 12,65 Scarlet Fever 61 Slum Clearance 40 Smallpox 61 Smoke Measuring Stations 24 S.O.S. Cards 27 Staff 72 Treble Cream Cheese 71 Tuberculosis 2,65 Underground Rooms 36 Unsound Food 54 Vaccination 61 Vital Statistics 8-9 Water Supply 12 Whooping Cough 67