Hc.4348 1Mmara d w JB 2 Lilsary II KEN 65 The Royal Borough of Kensington ANNUAL REPORT ON THE Health of the Borough FOR THE YEAR 1956 BY J. H. WEIR m.d., b.s., b.h.y., d.p.h MEDICAL OFFICER OF HEALTH CW THE ROYAL BOROUGH OP KENSINGTON Public Health Department, Hornton Street, Kensington, W.8. 1st June, 1957. 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 1956. The Minister of Health has again requested (Circular 19/56) 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 population of the borough as ascertained at the Census in 1951 was 168,160: but for the purpose of this report, the population for 1956 has been estimated by the Registrar-General to be 168,800. The estimated population figure for the previous year was 169,400. Birth Rate. The number of births per 1,000 population of the borough was 16.5 in 1956, which was 0.7 higher than the figure recorded for the previous year (15.8). Death Rate. The number of deaths per 1,000 population was 10.5 which was 0.2 higher than the death rate for the previous year (10.3). Area Comparability Factors for Birth and Death Rates. Comparisons of crude birth and death rates between local areas are not strictly valid since these rates take no account of the varying composition of the populations of the different areas by sex and age. In order to compare Kensington birth and death rates with England and Wales as a whole, the Registrar-General has, in the case of death rates since 1934 and in the case of birth rates since 1949, supplied area comparability factors (A.C.Fs) which are effectively indirect standardising factors. This is considered to be necessary as the proportion of old people to young, and of males to females, varies considerably in different districts. The local crude death rates are affected as the mortality at the extremes of life is much greater than in the middle period, and at practically all ages the mortality in females is rather less than in males of corresponding ages. Similarly, as far as the local birth rates are concerned, the child bearing component of the population varies in different districts. In a borough such as Kensington, which has a higher proportion of females amongst its inhabitants compared with most other districts, the crude birth and death rates cannot be compared satisfactorily with those of say an industrial district where the proportion of males is much higher. The factors are calculated from the final 1951 Census 2 populations, and the Registrar-General has supplied, for use in Kensington, the figures of 0.72 for births and 1.03 for deaths. The crude birth and death rates for the borough should be multiplied by the appropriate factor, and when so adjusted the results are comparable with the crude rates for England and Wales or with the corresponding adjusted rates for any other area. The following table gives the adjusted Kensington birth and death rates compared with the rates for London and for England and Wales for the year 1956 Kensington adjusted London England and Wales No. of births per 1,000 population 11.9 15.9 15.7 No. of deaths per 1,000 population 10.8 11.7 11.7 Infant Death Rate. This rate for 1956 was 21.1, which was a decrease from the rate for the previous year of 10.3. The rate for the County of London was 21.0 and for England and Wales was 23.8. The following table shows the rates for the last five years:- Year Kensington London England & Wales 1956 21.1 21.0 23.8 1955 31.4 23.3 24.9 1954 22.5 21.0 25.5 1953 19.7 23.9 26.8 1952 27.0 23.1 27.6 It will be seen that the rate for Kensington has reverted to a "normal figure" when compared with last year's infant death rate which had increased to 31.4 deaths per 1,000 live births. Maternal Death Rate. Five deaths of mothers due to childbirth were recorded in 1956, giving a maternal death rate per 1,000 live and still births of 1.76. (The maternal mortality rate for the County of London was 0.51 and for England and Wales the figure was O.56.) Infectious Diseases. There was no serious outbreak of infectious disease in the borough during 1956. The total number of notifications received was 1,331 in comparison with 2,322 in the previous year. The decrease was almost entirely due to the decline in the number of cases of measles notified - 358 in 1956 compared with 1,425 in 1955. One case of diphtheria was notified in 1956 which compares with two cases in the previous year. This case was of a boy admitted to hospital as suffering from whooping cough but on routine swabbing C. Diphtheriae (gravis type) was found. The patient was notified as a diphtheria carrier, more or less on technical grounds. No other cases were reported. The patient had in fact been immunised against diphtheria about three years prior to his admission to hospital. Tuberculosis. The death rate from all forms of tuberculosis per 100,000 population was 11.8, which is a little higher than last year's figure of 10.0. The 1956 Kensington death rate is slightly better than the rate (l2.l) for England and Wales. Lung Disease. Kensington's death rate from pulmonary tuberculosis per 100,000 population increased in 1956 compared with the previous year but the death rate for cancer of the lung remained more or less stationary. Comparative figures for England and Wales showed a decrease of the rate in respect of pulmonary tuberculosis but a continuing increase in the death rate for lung cancer. The comparative figures for England and Wales and Kensington are shown in the following 3 table and show the trend in these diseases since the end of the war. 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 1951 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 1956 4,851 10.9 18,185 40.7 19 11.2 73 43.2 (Death rates quoted above are per 100,000 population) It is of interest to note that whilst the death rate from lung cancer for the country as a whole has been increasing in recent years, the rate for Kensington has been fairly steady for the past seven years. Housing. The proposals for slum clearance which the Council, jointly with the London County Council, submitted to the Minister of Housing and Local Government in 1955 were approved by the Minister who fixed ten years as the period for securing the demolition of the unfit houses. Of the total of 630 premises scheduled, the London County Council took responsibility for 66 of these in the Fenelon Place/Warwick Road area, and made them the subject of a clearance area. Subsequently, the County Council acquired the properties. The clearance and redevelopment of the area is now under consideration. * The remaining 564 houses were left to be dealt with by the Borough Council and it was decided to undertake the task of dealing with the Kensal New Town Area as a priority. The provisional redevelopment of the area has been planned by Sir William Holford, F.R.I.B.A., M.T.P.I., and the first section, comprising 34 houses, was represented as a clearance area towards the end of the year. At the present time a Public Inquiry by the Minister of Housing and Local Government is pending, there having been objections lodged by a number of interested parties. It is probable that the Rent Bill, now being debated in Parliament, will materially affect the Council's task of securing reasonable standards of housing accommodation in the borough. As the Council are aware, the freezing of rents of controlled premises since 1939, and the tremendous increase in the cost of repairs and maintenance, has resulted in the cessation of the Council's work of securing the proper repair and maintenance of dwelling houses under Section 9 of the Housing Act, 1936. This section requires that the Council must be satisfied that any repairs 4 required can be executed at reasonable cost. With the low rent values of many of the unfit houses in the borough, this condition could not be complied with. If, however, the Rent Bill as proposed leads to an increase in the rents of these houses, the Council will be able to reassess the value of the houses compared with the cost of repairs and, once again, commence to enforce their powers to repair houses under Section 9» There is no doubt that the need to preserve housing accommodation in the borough is acute, especially in view of the comparatively high costs of building new accommodation on expensive sites. Food Hygiene. The Regulations in regard to the protection of food supplies made by the Minister of Agriculture, Fisheries and Food and the Minister of Health, acting jointly, under the Food and Drugs Act, 1955, came into operation fully (with one small exception) on the 1st July, 1956. There has been a concentration of effort in the last twelve months to secure strict compliance with the Regulations by all food manufacturers and traders in the borough. Generally speaking, there has been willing co-operation on all sides and the results of the efforts can be seen in the borough by the improved methods of food handling, storage and exposure for sale in the many food shops serving Kensington residents and others. The protection of open foods on display counters behind glass screens is becoming a common feature in the Kensington food shops, and there is no doubt that the standards are improving rapidly. General. The Sanitary Inspectors (Change of Designation) Act, 1956, received Royal Assent on the 2nd August, 1956, and provided that sanitary inspectors shall henceforth be designated "public health inspectors". For the past few years it has not been possible to recruit the required number of public health inspectors and this position is common throughout the Metropolitan area. This persistent shortage of inspectors could have an adverse effect on the work of the department, particularly having regard to the additional work resulting from new legislation dealing with food hygiene and smoke abatement, and also the Council's slum clearance programme. The Council have adopted a scheme for enrolling students for training as public health inspectors and authority was given to appoint two men, subject to certain conditions. One has already commenced training and it is hoped to start a second man in the near future. The Minister of Health in Circular 19/56 supports the view that the best training is obtained by those students who are engaged by a local authority specifically as pupils or student public health inspectors and he has no doubt that local authorities will bear this in mind and consider the advantages of adopting a system of paid pupillage or, where appropriate, of extending existing arrangements. Dr. W. C. Turner, the Council's Deputy Medical Officer of Health, resigned his post and left on the 2Jrd September, 1956, to take up an appointment as Medical Officer of Health for the Metropolitan Borough of Poplar. Dr. Turner was with the Council for nearly six years and rendered excellent service at all times. His place has been taken by Dr. Hastings E. A. Carson, who took up his appointment as Deputy Medical Officer of Health on the 15th October, 1956. It is with regret that I have to record the unusual occurrence of an officer dying in service. Mr. A. V. Boddington, the Superintendent at the Medicinal Baths, who had been in the Council's service for twentyseven years, unfortunately died on the 22nd May, 1956. He had at all times given loyal and efficient service to the Council. VITAL STATISTICS The table set out on the next two pages gives the important vital statistics for 1956, together with comparative figures for the previous seven years. 6 7 SUMMARY OP VITAL STATISTICS FOR KENSINGTON Description 1956 1955 1954 1953 1952 1951 1950 1949 POPULATION \ Population (estimated.) 168,800 169,400 170,600 171,500 172,800 171,300 177,400 174,220 Density of population per acre 74 74 74 74 75 74 77 76 LIVE BIRTHS Total births 2,792 2,674 2,707 2,642 2,810 2,656 2,745 2,681 Legitimate births 2,422 2,361 2,399 2,321 2,508 2,390 2,470 2,417 Illegitimate births 370 313 308 321 302 266 275 264 Birth rate per 1,000 population 16.5 15.8 15.9 15.4 16-3 15.5 15.5 15.4 STILL BIRTHS Total still births 51 40 48 53 48 60 54 39 Legitimate still births 43 31 40 47 37 55 51 39 Illegitimate still births 8 9 8 6 11 5 3 Nil Still birth rate per 1,000 total births 17.9 14.7 17.4 19.7 16.8 22.1 19.3 14.3 DEATHS Total deaths 1,772 1,744 1,643 1,708 1,936 1,920 1,848 1,819 1 A Death rate per 1,000 population 10.5 10.3 9.63 9.96 11.2 11.2 10.4 1U.4 DEATHS OF INFANTS UNDER 12 MONTHS OF AGE Total infant deaths 59 84 61 50 75 65 78 64 Legitimate deaths 50 66 54 42 67 55 69 52 llegitimate deaths 9 18 7 8 8 10 9 12 Infant death rate per 1,000 births 21.1 31.4 22.5 19.7 27 24 28 24 Death rate of legitimate infants per 1,000 legitimate births 20.6 27.9 22.5 18 27 23 28 22 Death rate of illegitimate infants per 1,000 illegitimate births 24.3 57.5 22.7 25 26 38 33 45 MATERNAL DEATHS Deaths of mothers as a result of pregnancy or childbirth 5 1 2 Nil 5 3 5 Ni1 Death rate of mothers per 1,000 live and still births 1.76 0.37 0.72 Nil 1.75 1.1 1.79 Nil TUBERCULOSIS Death rate from all forms per 100,000 population 11.8 10.0 14.0 19.2 18.5 21 33 34 Death rate from respiratory tuberculosis per 100,000 population 11.2 7.1 11.7 15.1 16.8 17.5 29 32 Death rate from non-respiratory tuberculosis per 100,000 population 0.6 2.9 2.3 4.1 1.7 3.5 4 2 8 CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE IN 1956 Cause of death All ages Under 1 year 1 year and under 5 5 years and under 45 45 years and over Respiratory tuberculosis 19 _ _ 4 15 Other forms of tuberculosis 1 _ _ _ 1 Syphilis 9 _- _ _ 9 Diphtheria _ _ _ _ Whooping Cough 1 1 _ _ _ Meningococcal infections _ _ _ _ _ Acute poliomyelitis _ _- _ _ _ Measles _ _- _ _ _ Other infective diseases, etc. 4 _ 1 _ 3 Cancer (all forms) 362 _ _ 22 340 Leukaemia, aleukaemia 3 _ _ _ 3 Diabetes 7 _ _ 1 6 Vascular lesions of nervous system 191 _ _ 7 184 Coronary disease, angina 281 _ _ 6 275 Hypertension with heart disease 36 _ _ _ 36 Other heart disease 199 _ _ 6 193 Other diseases of circulatory system 89 _ _ 3 86 Influenza 9 _ _ 1 8 Pneumonia 106 10 _ 1 95 Bronchitis 117 1 _ 1 115 Other respiratory diseases 18 _ _ _ 18 Ulcers of the stomach 32 1 _ 2 29 Gastritis, enteritis and diarrhoea 9 1 _ 2 6 Nephritis and nephrosis 17 _ _ 1 16 Hyperplasia of prostate 10 _ _ _ 10 Pregnancy, childbirth and abortion 5 _ _ 5 _ Congenital malformations 7 6 _ l _ All other diseases 144 39 2 13 90 Motor vehicle accidents 23 _ _ 7 16 All other accidents 28 _ 3 3 22 Suicide 40 _ _ 18 22 Homicide and operations of war 5 _ 1 3 1 TOTALS 1,772 59 7 107 1,599 - 9 - GENERAL PROVISION OF HEALTH SERVICES IN THE AREA Bacteriological and Analytical Work The following is a summary of the work performed during 1956:- Nature of specimen or sample Number examined Nose and throat swabs 136 Faeces and rectal swabs 1,042 Milk (bacteriological) 136 Water (drinking) 4 Water (swimming baths) 14 Ice cream 37 Miscellaneous 25 Water Supply The water supply in Kensington is almost entirely provided by the Metropolitan Water Board, but there are two 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 1956 is as follows:- Description Scabies Vermin Impetigo Other conditions Persons Cleans -ings Persons Cleans -ings Persons Cleans -ings Persons Cleans -ings Adults Kensington 52 99 95 102 1 2 _ _ Other boroughs 38 55 128 129 _ _ _ _ Schoolchildren Kensington 22 76 747 747 _ _- 2 6 Other boroughs 6 14 276 276 _ _- _ _ Children under 5 Kensington 10 21 45 45 _ _- _ _- Other boroughs _ _ 7 7 _ _ _ _ Compulsory cleansings _ _ 110 110 TOTALS 128 265 1408 1416 1 2 2 6 In addition to the cleansing of persons referred to above, articles of personal clothing disinfested at the Medicinal Baths during the year numbered 1,986. 10 Disinfection and. Disinfestation A summary of the routine work of the disinfecting staff is shown in the following table:- Houses disinfected after infectious disease 290 ( 456 rooms) Houses disinfested after vermin 392 ( 895 rooms) Loads of furniture treated with hydrogen cyanide 25 Total weight of furniture, bedding, etc. dealt with:- 46 tons 18 cwt. 2 qtr. 12 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 706 parcels of clothing were disinfected and the income amounted to £88. 5s. Od. The following table indicates the destination of these parcels :- No. of parcels Czechoslovakia 145 Russia 151 Hungary 1 Poland 3 Peru 2 Bulgaria 2 Ecuador 1 + Unknown 401 + 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, one such certificate was 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 public health 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 Gammexane smoke preparations. (d) The inspector re-visits the flat after a period of six months, and takes appropriate action if the flat is found to have become infested. 11 During 1956, sixty-eight new flats, which became ready for occupation, were treated with Gammexane smoke generators before being occupied. The furniture, etc. of the sixty-eight families selected to move into these flats was inspected. With one exception, every case was found to be free from vermin and the tenants were allowed to move directly into their new homes. In the one infested case, the furniture was taken to the Council's disinfecting station and treated with H.C.N, before being moved into the new accommodation. In addition to the above case, the furniture of ten other families, selected to move into vacated Council flats (or conversions) was found to be infested and was treated with H.C.N, at the disinfecting station. 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, 1957, and the following table gives the details for this period:- 12 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 37,585 8,232 45,853 II. Number of properties inspected by the Local Authority during twelve months ended 31/3/57 as a result (a) (a) of notification (b) survey (b) or (c) otherwise (c) 10 974 92 1,076 2 100 13 115 — 151 — 151 III. Total inspections carried out, including re-inspections 41 6,926 650 7,617 IV. Number of properties (under II) found to be infested Major by rats Minor — 2 1 3 7 318 39 364 V. Number of properties (under II) found to be infested Major by mice Minor — — — — 5 644 44 693 VI. Number of infested properties (under IV and V) treated by the Local Authority 12 964 84 1,060 VII. Total treatments carried out 9 1,171 93 1,273 VIII. Number of notices served under Section 4:- (l) Treatment — — — — (2) Structural Works (i.e.Proofing) —- 15 — 15 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 — — — — 13 On two occasions during the year all the sewers in the borough were treated with poison bait, and it was estimated that in the first treatment 4,764 rats were destroyed; and in the second 4,138 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. This work 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 1952 5,982 4,133 1953 5,458 4,312 1954 4,142 4,667 1955 4,515 3,430 1956 4,764 4,138 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:-0 Complaints investigated 1,300 Premises inspected following complaints 1,373 Premises where rats were found 338 Premises where mice were found 699 Premises where other vermin were found 172 Premises where no infestation existed 164 Number of visits made 7,327 Number of notices served 17 Premises successfully treated 1,208 Cases in which advice only was given 48 Borough Council properties dealt with 83 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 and other public places. This arrangement did not prove satisfactory during 1956, and, in view of the number of complaints received, further consideration was given to the steps to be taken to remedy the nuisance. It was decided to provide special cage traps, so constructed to allow the pigeons to enter but not to leave. Pood and water can be provided in the cages to attract the birds, and members of the staff of the public health department visit the traps either early in the morning or late evening, to destroy those caught. These special measures were put into operation early in 1957. Pharmacy and Poisons Act, 1935 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 twenty-nine. Of this number, three were new registrations during the year. Three samples of poisons were taken during the year and were found to comply with legal standards. 14 Rag Flock and other Filling Materials Act, 1951 This Act regulates the use of clean filling materials in upholstered articles and other articles which are stuffed or lined. Subject to certain exceptions, the Act makes it unlawful to use prescribed filling materials except on premises registered by a local authority. The exceptions are in the remaking and reconditioning of any article or upholstering in connection with the making of railway carriages, road vehicles, ships or aircraft. The local authority are required, on the application of the occupier of premises, to register the premises on payment of a registration fee of one pound. At the end of the year, there were nineteen registered premises in the borough. Sixteen 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 licences 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 (second-hand articles are excepted.) Thirteen samples of rag flock and other fillings were taken during the year for analysis and the results were satisfactory, except in the case of one sample of cotton felt. This was found to contain a "true trash" content of 8.4% - the permitted maximum being 7.5%. Appropriate warnings were given in this case. Description No. of samples taken Hair 2 Coir fibre 3 Woollen Felt 3 Cotton Felt 3 Sisal Pads 1 Algerian Fibre 1 Pet Animals Act, 1951 This Act requires that no person shall keep a pet shop except under the authority of a licence issued by the Council and in compliance with any conditions specified in the licence. During the year, seven premises were licensed under the Act. The general conditions for pet shops approved by the Council are those recommended for their constituent councils by the Metropolitan Boroughs' Standing Joint Committee. Health Education Health education is being increasingly recognised as a vital part of the public health service. 15 In September, 1956, the Public Health Committee approved a publicity campaign being undertaken aimed at reducing smoke in the atmosphere. The campaign was carried out during the week commencing 29th October and considerable interest was aroused. Display stands at the Town Hall and the public health department were provided and the co-operation of the local Gas and Electricity Boards' offices was enlisted. Ten thousand bookmarks were distributed through the several public library buildings, and posters and leaflets were distributed to local institutions, clubs and voluntary organisations. Special articles were printed in the local newspapers, who gave prominence in their columns to appropriate letters sent by the Chairman of the Committee, Councillor Ernest D„ Wallis, V.R„D., FoR.I.C.S., and also by the Chairman of the National Smoke Abatement Society. The number of enquiries from local residents received as a result of the campaign was evidence of its success in drawing the public's attention to the urgent need to reduce smoke production. In the past few years, the public health department has organised a Health Exhibition, a Food Hygiene Exhibition, and several smaller campaigns, mainly in connection with flies, nuisances from dogs and home safety. 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. 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. Mass Radiography Mass radiography is undertaken by the Regional Hospital Boards. Kensington is included in the area covered by the Mass X-ray Unit No. 5A operated by the North-West Metropolitan Regional Hospital Board. The purpose of mass radiography is twofold (i) to find abnormalities of the chest, and in particular tuberculosis and cancer of the lungs, and (ii) to give those whose x-ray is within "normal limit" a certain degree of security. During 1956, the Mass X-ray Unit No. 5A undertook a large scale mass x-ray operation in Kensington covering approximately two months. Twenty-five different sites in the borough were chosen where the Unit set up, either in a closed or public session, to offer x-ray facilities to Kensington residents and people working in the borough. The sites included schools, colleges, hotels, departmental stores, Council housing estates, etc. Publicity to the campaign was given by means of posters and leaflets and, in addition, an appeal was made by Councillor Ernest D. Wallis, V.R.D., F.R.I.C.S.., Chairman of the Public Health Committee through the local newspapers. A total of 12,086 persons was examined in the campaign; 16 5,920 men and 6,166 women. The positive cases revealed as a result of this large scale operation were as follows Active Pulmonary Tuberculosis Lung Cancer Men 15 2 Women 15 — 30 2 Atmospheric Pollution The Council maintain two atmospheric pollution measuring stations; 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 have established two smoke measuring stations, one at the public health department, Hornton Street, W.8., and the other at the public library, Ladbroke Grove, W.ll. 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 calender 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 the results obtained from other sites throughout the country. The following tables set out details of the results obtained in Kensington during 1956:- - 17 - A. Deposit Gauge Month 1956 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 30 3.41 9.40 ll.21 20.61 .313 .374 .687 February 29 0.13 5.17 8.49 13.66 .179 .292 .471 March 33 0.87 9.60 16.98 26.58 .290 .515 .805 April 28 0.95 7.45 10.97 18.42 .266 .392 .658 May 30 0.14 3.83 8.32 12.15 .128 .277 .405 June 32 1.89 6.54 9.60 16.14 .204 .300 .504 July 30 5.28 8.76 9.53 18.29 .292 .317 .609 August 33 4.29 8.46 8.25 16.71 .256 .250 .506 September 28 1.67 6.07 6.78 12.85 .217 .242 .459 October 31 2.01 7.18 8,69 15.87 .232 .280 .512 November 32 0.33 6.51 12.01 18.52 .204 .375 .579 December 29 2.46 9.30 8.72 18.02 .321 .301 .622 TOTALS 365 23.43 88.27 119.55 207.82 South Kensington January 30 3.25 11.28 10.27 21.55 .376 .342 .718 February 29 0.15 5.10 7.05 12.15 .176 .243 .419 March 33 0.82 9.50 14.40 23.90 .288 .436 .724 April 28 0.93 7.21 10.07 17.28 .257 .360 .617 May 30 0.08 3.86 7.75 11.61 .129 .258 .387 June 32 1.71 4.70 7.78 12.48 .147 .243 .390 July 30 4.86 9.80 8.19 17.99 .327 .273 .600 August 33 3.89 8.05 8.29 16.34 .244 .251 .495 September 28 1.78 5.27 7.38 12.65 .188 .263 .451 October 31 1.64 6.14 6.54 12.68 .198 .211 .409 November 32 0.36 5.80 10.24 16.04 .181 .320 .501 December 29 2.26 8.19 8.89 17.08 .282 .306 .588 TOTALS 365 21.73 84.90 106.85 191.75 B. Estimation of atmospheric sulphur Milligrams of sulphur trioxide per day Month 1956 Days expos ed North Kensington South Kensington January 30 3.88 4.35 February 29 4.33 4.45 March 33 3.87 4.17 April 28 3.13 3.03 May 30 1.21 1.55 June 32 0.97 1.19 July 30 0.94 1.13 August 33 1.03 1.37 September 28 1.89 2.05 October 31 2.57 2.87 November 32 3.62 4.19 December 29 3.42 3.47 Average for year: 2.56 2.81 - 18 - 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 1956 North Kensington South Kensington Country District Indus trial District A B A B A B A B January .687 3.88 .718 4.35 .394 1.1 .813 5.7 February .471 4.33 .419 4.45 .168 1.2 .445 4.6 March .805 3.87 .724 4.17 .246 1.1 .474 3.8 April .658 3.13 .617 3.03 .314 0.7 .707 3.2 May .405 1.21 .387 1.55 .227 0.6 .509 2.5 June .504 0.97 .390 1.19 .213 0.5 .710 2.2 July .609 0.94 .600 1.13 .284 0.25 .698 1.9 August .506 1.03 .495 1.37 .233 0.34 .813 2.3 September .459 1.89 .451 2.05 .155 0.45 .577 2.9 October .512 2.57 .409 2.87 .168 0.6 .597 3.8 November .579 3.62 .501 4.19 .222 1.3 .560 4.5 December .622 3.42 .588 3.47 .269 1.4 .948 5.2 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 207.82 2.56 South Kensington 191.75 2.81 Country 86.40 0.79 District Industrial area 240.20 3.54 Readings from the two monthly stations in Kensington have now extended over three years, and it is possible to compare the results. 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 1956 365 207.82 191.75 2.56 2.81 - 19 - Although the results show an increase in measured atmospheric pollution 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. Measurement of smoke and sulphur by the volumetric method Volumetric smoke Concentration of smoke in milligrams per cubic metre Readings at Public Health Department Readings at Public Library Month 1956 Highest value Lowest value Average value Highest value Lowest value Average value January 1.627 .154 .408 1.032 .259 .427 February .678 .165 .245 .592 .246 .373 March .330 .083 .092 .448 .219 .321 April .290 .048 .137 .409 .165 .286 May .192 .024 .069 .165 .041 .081 June .096 .024 .045 .115 .058 .083 July .124 .021 .059 .154 .077 .093 August .145 .048 .069 .175 .082 .118 September .145 .024 .077 .164 .082 .120 October .253 .048 .119 .434 .082 .191 November .246 .048 .112 .467 .127 .234 December 1.168 .072 .279 .434 .083 .260 Volumetric sulphur Concentration of sulphur in parts per million volumes of air Readings at Public Health Department only Month 1956 Highest value Lowest value Average value January .848 .063 .204 February .362 .054 .153 March .308 .072 .155 April .295 .058 .125 May .108 .020 .056 June .068 .021 .038 July .068 .023 .042 August .074 .021 .036 September .137 .026 .061 October .250 .037 .097 November .263 .044 .133 December .562 .041 .158 Notes (a) On the 7th January and the 19th December, 1956, warnings of persistent fog were issued. Special readings for smoke and sulphur were made at two-hourly intervals throughout each day at the Public Health Department station, and the results obtained were supplied to the Fuel Research Station for correlation with other results obtained elsewhere in the London area. - 20 - (b) During the year, agreement was reached with the London County Council to enable the Borough Council to set up a third smoke measuring station in the Welfare Centre, Redcliffe Street, South Kensington. Readings commenced at this new station on the 1st January, 1957. General observations The results obtained during 1956 have continued to reflect trends noticed in previous years. Pollution has continued higher during winter months, falling to a minimum during the months of June and July. Deposited matter is found to be heavier in North Kensington than in South Kensington, whereas the sulphur readings were higher in the South than the North of the Borough. It is now possible to compare results obtained during three consecutive years. Although the general inference from these results is that atmospheric conditions in the borough have gradually worsened over the period in question, it should be noted that the relative differences are small, particularly in the case of deposited matter. The variations may be accounted for by differences in climatic conditions in each of the three years, and it will be necessary for results to be obtained over a longer period before any firm conclusions can be arrived at. Action taken in regard to smoke nuisances During the year there were twelve complaints of smoke nuisance as a result of which seventy observations were made. Remedial measure by informal action were secured in all cases except one. In this case the Public Health Committee decided to give a warning that legal proceedings would be instituted if further nuisance occurred. 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 suitabl 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 the Section applies. In the twelve months ended 31st December, 1956, the Council became responsible for the burial of twenty-seven persons dying in the borough. The following is a summary of the action taken (a) Cases where the funeral expenses have been fully recovered 14 (b) Cases where part only of the expenses has been recovered 8 (i) Number of these where balance of expenses will be recovered 1 (amounting to £6. 18s. 1d.) (ii) Number of these where there was no further estate or "liable" relative 5 (iii) Number of these where "liable" relatives were unable to contribute 2 - 21 - (c) Cases where full cost has been borne by the Council 5 (i) Number of these where there was no estate or "liable" relative 3 (ii) Number of these where "liable" relatives were unable to contribute 2 Amount recovered by the end of the year £235. 17s. 6d. Additional amount expected to be recovered 6. 18s. 1d. £242. 15s. 7d. Irrecoverable 111. 2s. 8d. Total cost £353. 18s. 3d. Of the twenty-seven cases dealt with, twelve were eligible for Death Grant from the Ministry of Pensions and National Insurance. The total amount recovered from this source amounted to £120. 0s. 0d. (included in the above figures.) Since the National Assistance Act came into force on the 5th July, 1948, the Council have arranged for the burial of three hundred and forty-four persons under Section 50. Public Mortuary The number of bodies taken to the Public Mortuary, maintained by the Council at No. 1A, Hornton Place, W.8., during the year was four hundred and twenty-seven. Post-mortem examinations were made of three hundred and fifty-seven cases, and in seventy instances the Coroner "held inquests. 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 1956, there were two hundred and fifty-five Kensington cremations, in comparison with two hundred and fifty-six in 1955 and one hundred and ninety-six in 1954 and sixty in 1948; the latter year was taken as the basis on which the financial provisions of the agreement were framed. Medical Examinations of Staff The Medical Officer of Health undertakes all medical examinations of staff for the purposes of the Borough Council's Superannuation Scheme. During the year one hundred and seventy-three examinations were made. 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 - 22 - 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 time-consuming 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 two summonses were issued under this byelaw. Convictions were obtained and fines totalling £1. 0s. 0d. were imposed and costs amounting to £1. 1s. 0d. were awarded to the Council. In a third case, the Public Health Committee decided to send a warning letter. 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, 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 - 23 - 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 £500 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 £50 towards their general expenses in providing meals, including replacement of equipment. 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 1956:- Total applications received 122 Unsuitable on medical grounds 8 Consideration deferred 15 Referred to other organisations 34 Number approved 88 Cancellations after approval 12 Number sent on holiday 76 Number sent to Lennox House, Southsea 60 Number sent to St. Mary's Home, Dover 16 Contributions by applicants £74. 17s. 6d. Net cost of holidays to the Council £590. 12s. 6d. Booking fees paid by Council to Family Welfare Association £15. 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. Sixteen old people were dealt with in 1956. - 24 - National Health Service - Institutional Care, etc. Facilities for institutional care, home nursing, sick room equipment and home helps are provided by the London County Council. Hospital treatment, medical care, ophthalmic, dental and pharmaceutical services are provided under statute. The borough is situated in the area of two Metropolitan Regional Hospital Boards. One Hospital Management Committee in the borough utilizes the part-time service of a local medical practitioner as a clinical assessor to decide the priority need for admission of all patients submitted to that Hospital Group as being in need of hospital treatment and classed as "chronic sick". This ensures the early or immediate admission of patients where the need is urgent on medico/social grounds. There is usually no difficulty in the admission to hospital for the treatment of acute conditions. During the year it was possible to arrange for one hundred and eighty old people to be admitted to hospitals for institutional treatment and, in addition, seventy-one 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-three. 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 the house to be cleansed, disinfected or destroyed, if it is in such a filthy, dangerous or unwholesome condition that health is affected or endangered thereby. The cleansing of grossly fouled bedding in cases of incontinence may be dealt with under this Section. To comply with the legal requirements, the Council have given a general authority to the Medical Officer of Health to take whatever action appears to him to be necessary under the terms of Section 122 of the Public Health (London) Act, 1936. In sixty-one cases action was taken under the Section. The bedding was marked, laundered at the Council's disinfecting station and returned to the old people. The scheme works smoothly and appears to fill a much felt want. From stocks of bedding held, the Council are able to supply linen and bedding on loan to old people while their own is being laundered, and where possible voluntary organisations are asked to undertake replacements of much worn articles. During the year seven hundred and ten separate collections of laundry were made under this scheme, and the number of articles cleansed totalled nine thousand, nine hundred and twenty-two. Library Facilities The Libraries Committee co-operate in providing books for old people confined to their homes. The circulation of the books is effected by the Women's Voluntary Services mobile library. Chiropody During the year, the Council made a grant of £96 to the - 25 - Kensington Council of Social Service for the purpose of enabling the provision of a chiropody service for house-bound old people. All patients are referred by the Medical Officer of Health to the Council of Social Service which administers the financial aspect of the scheme. The British Red Cross Society arrange the treatments, including providing the chiropodists and making the appointments. The total number of persons treated under the home chiropody scheme was one hundred and ninety-eight and the number of treatments given was four hundred and eighty. 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 Services Committee. 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 (l0d. 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 the inception of the scheme. 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 5,459 1,317 1,306 200 636 1954/55 45,116 3,853 1,611 1,512 300 430 1955/56 45,933 4,204 1,926 1,531 300 447 1956/57 45,995 - Not yet available _ It will be observed that the number of meals served and the net cost are 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 £500 for 1956/57 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 1956:- - 26 - Cases on register at the beginning of year 5,176 New cases added to register 640 Cases removed to hospitals 180 Cases removed to homes (voluntarily) 71 Cases removed to homes (compulsorily) 1 Cases removed from district 54 Number of deaths 534 Total number of cases remaining on register at end of year 5,176 Number of old people sent away for holiday 76 Number of old people provided with Council's laundry service 61 Number of old people provided with "Meals on Wheels" 340 Cases referred to National Assistance Board 221 Cases referred for assistance from Home Help Department 188 Cases referred for assistance from Voluntary Organisations 48 Cases referred to Recreational Clubs 185 Number of visits to chronic sick cases 565 Cases assisted with provision of medical and nursing care 222 Cases referred to home chiropody service 198 Cases cleansed at Medicinal Baths 2 Cases where disinfestation was carried out 16 Number of initial home visits made 616 Number of re-visits 5,428 Number of other visits made in connection with old people, including visits to clubs 106 Number of interviews, enquiries, etc. on behalf of old people 1,845 Removal of old and infirm persons to institutions, etc. Under Section 47 of the National Assistance Act, 1948, the Council may apply to a Court for an order to remove to a suitable institution any person who - (a) is suffering from grave chronic disease, or being aged, infirm or physically incapacitated, is living in insanitary conditions, and (b) is unable to devote to himself, or is not receiving from other persons, proper care and attention. The National Assistance (Amendment) Act, 1951, 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 one case was formal action taken to secure compulsory removal. The patient was a man aged 65 years, suffering from a grave chronic disease, who was living alone in a flat situated in a block of offices in South Kensington. He was unable to devote to himself proper care and attention, and the domiciliary services were - 27 - considered insufficient for his needs, as continuous nursing attention was necessary. Every endeavour was made to persuade him to enter a hospital voluntarily, but he refused to go. In these circumstances, application was made to a Justice of the Peace for an Order for compulsory removal. The Order was granted and the man was removed to St. Mary Abbots Hospital, where he died during the detention period. SANITARY INSPECTION The following table shows a summary of the inspections, etc. carried out by the public health inspectors during the year Public Health (London) Act, 1936 Houses inspected on complaint 5,166 Houses inspected after infectious disease 2,485 Re-inspections 8,475 Smoke observations 70 Other Inspections 1,356 Housing Act, 1936 Initial inspections (including preparation or revision of house-to-house cards) 205 Re-inspections 531 Initial inspections for overcrowding 425 Re-inspections 318 Underground Living Rooms Initial inspections 216 Re-inspections 1,845 Drainage Applications 468 Plans submitted 345 House drains inspected 5,156 House drains tested 658 Factories Act, 1957 Premises inspected 728 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 1,609 Statutory notices 614 Final notices 220 - 28 - Various Factories Acts 20 Notice of intention to enter premises for Inspection 42 Report of waste water to the Metropolitan Water Board 26 Report of dangerous structures to the London Country Council 44 Other notices 118 The following is a summary of works completed under the supervision of the public health inspectors during the year House drains, reconstructed or repaired 251 House drains cleansed 108 Water closets, reconstructed or repaired 162 Water closets, new provided 314 Soil pipes, vent pipes, repaired etc. 100 Soil pipes, vent pipes, new provided 130 Baths, new provided 270 Sinks, new provided 275 Lavatory basins, new provided 548 Bidets, new provided 20 Waste pipes, new provided 393 Cisterns, cleansed 2 Cisterns, covered 2 Taps fixed on rising main 4 Yards and areas paved, drained etc. 17 Dustbins provided 157 Accumulations of filth, etc. removed 82 Roofs repaired 366 Houses provided with water above basement level 4 Dampness in dwellings remedied 452 Houses disinfected after infectious disease (including bedding, etc.) 290 Rooms in such houses, disinfected after infectious disease 456 Houses cleansed 32 Rooms in such houses 102 Verminous houses cleansed (including bedding, 392 Verminous rooms in such houses, cleansed 895 Other sanitary works executed 1,031 HOUSING Inspection of dwelling houses during the year (i) (a) Dwelling houses inspected for housing defects (under Public Health or Housing Hr.+.S 6. 00 Inspections made for the purpose 19,061 (ii) (a) Dwelling houses (including those under sub-head (i) above) which were inspected and recorded under the Housing Consolid- 203 00 Inspections made for the purpose 734 (iii) Dwelling houses found not to be in all respects reasonably fit for human habitation 1,609 - 29 - 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 1,031 Action under statutory powers during the year (a) Premises repaired after service of formal notice under the Public Health (London) Acts:- (i) By owners 614 (ii) By local authority in default 4 (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 - (ii) Dwelling houses demolished in pursuance of demolition orders 7 (iii) Dwelling houses in respect of which closing orders in lieu of demolition 5 (iv) Dwelling houses in respect of which undertakings were accepted from owner to render premises fit for habitation 1 (v) Dwelling houses rendered fit for habitation by owners and closing order 1 (d) Action under Section 12 of the Housing Act, 1936:- (i) Separate tenements or underground rooms in respect of which closing orders were made (45 premises (91 rooms (ii) Separate tenements or underground rooms in respect of which closing orders were determined, the tenements or rooms having been rendered fit (28 premises (53 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 (22 premises (37 rooms (iv) Separate tenements or underground rooms in respect of which the Council accepted undertakings from owners to render fit within specified time ( 7 premises (13 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 ( 5 rooms - 30 - (e) Action under Section 25 of the Housing Act, 1936:- Number of areas represented to Council 1 (35 premises) (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 153 (556 units) (iii) Number of cases of overcrowding 73 (273 units) (iv) Number of cases in which dwelling houses have again become overcrowded after the local authority have taken steps for the abatement of overcrowding Nil NOTE: Units means the number of equivalent persons in the families obtained, by regarding children between 1 and 10 years of age as "half-persons" and disregarding infants under the age of 12 months. Appeals against Closing Orders During the year, three owners appealed to the County Court against Closing Orders made by the Council in respect of the following premises:- 53, Ledbury Road - First and Second floors 14, Hogarth Place - Front underground room 44, Ifield Road - Front and Back underground rooms In the first case the appellant withdrew before the Court hearing. The second case was heard at the West London County Court on the 3rd July, 1956, but as the appellant did not appear, the Judge dismissed the appeal and awarded £1. 10s. 0d. costs to the Council. The third case was adjourned sine die on condition that the rooms were not occupied or relet until the appeals had been settled. Surveyors acting for the owner subsequently submitted a schedule of works which suggested some variations of the Council's specification to make the rooms comply with the Underground Room Regulations. Certain variations were accepted, but the owner's surveyors were informed that, although there was no evidence of rising dampness in the walls of either rooms at that time, freedom from dampness would not be permanent unless proper damp-courses were provided. The owner applied for reinstatement of the appeals, which were heard at the West London County Court on 14th November, 1956. The Judge allowed both appeals and quashed the Closing Orders, but made no order for costs. 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 - 31 - Interest Restrictions Acts. Under Part II of the Act, the Council axe 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 tinder Part II of the 1954 Act 20 4 12 4 (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 (l)(c) and (d) of the Increase of Rent and Mortgage Interest (Restrictions) Act, 1920 4 - - 2 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 multioccupation, an adequate provision of the following services and amenities:- Natural lighting; Ventilation; Water supply; Drainage and sanitary conveniences - 32 - 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 controls (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. The Council have adopted certain standards of the essential services and amenities which will be considered as satisfactory in appropriate cases. These standards were enumerated at length in my Report for last year. In exercising the powers under Section 11 and 12 of the Housing Repairs and Rents Act, 1954, two deficiencies came to light as a result of the repeal of the Tenement House Byelaws. (a) Artificial lighting of common staircases The byelaws 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. Sections 11 and 12 do not cover this point and the Council made representations to the Metropolitan Boroughs' Standing Joint Committee, who decided to ask the London County Council to promote appropriate legislation. This was done and Section 63 of the London County Council (General Powers) Act, 1956, enables the Borough Council to make byelaws - 33 - with respect to tenement houses and flats for the adequate artificial lighting of any common staircase in such premises. (b) Periodical cleansing and redecoration Representations were made to the Metropolitan Boroughs' Standing Joint Committee asking them to consider the effect of the repeal of Byelaw 22 of the Tenement House Byelaws, which had enabled Borough Councils to require the periodical cleansing of rooms, etc. in certain tenement dwellings. The loss of this power appears to prevent the maintenance of a satisfactory standard of cleanliness and decoration in buildings of this kind, and, whilst recognising that satisfactory provision for maintaining the condition of buildings as such is available under the Housing Repairs and Rents Act, 1954, supplemental powers, similar to those formerly available under Byelaw 22, would be of considerable assistance in dealing with those tenement buildings where low standards of cleanliness may persist. On consideration, it was felt that the main difficulty which arises in London at the present time is in obtaining the cleansing of common staircases and those other parts of buildings (commonly lavatories) which are used in common. After obtaining the views of their constituent Councils, the Standing Joint Committee decided to consult with the London County Council with a view to securing amending legislation on these lines. 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:- 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.l0.1950 13 38 Lonsdale Mews (Nos. 1 and 2.) 2.1.1951 19 14 Munro Mews 2.1.1951 24 55 South End Row 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 Row 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:- - 34 - 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 re-house the tenants and building operations are now in progress to erect the following housing accommodation on the cleared site 4 one-roomed flats 46 two-roomed flats 78 three-roomed flats 5 four-roomed maisonettes 12 garages 3 shops Future programme for Slum Clearance Section 1 of the Housing Repairs and Rents Act, 1954, required Metropolitan boroughs, jointly with the London County Council, to submit to the Minister of Housing and Local Government proposals for dealing with unfit houses by way of demolition or clearance area procedure. As a result of this legislation, a survey was made in Kensington of the houses where conditions were known to be below standard, and a total of 7,416 premises were inspected. The survey revealed that 3,293 houses were deemed to be unfit for habitation. After consultation with the London County Council, proposals were submitted to the Minister comprising the following areas thought to be suitable for clearance area procedure:- Premises Estimated population Families Persons Railway Mews 10 4 9 Kensington Park Mews 13 9 26 Stanley Gardens Mews 4 2 5 Lecky Street 5 2 4 Portland Road 16 39 110 Fenelon Place, Ashley Cottages & Warwick Road 66 57 176 Kensal New Town 516 1,106 3,550 630 1,219 3,880 The Minister approved these proposals and fixed ten years as the period for securing the demolition of unfit houses. By agreement, the London County Council accepted responsibility for dealing with the Fenelon Place Area, which was declared by the County Council to be a clearance area within the meaning of Section 25 of the Housing Act, 1936, and was acquired by them. The detailed redevelopment of this site is the subject of discussions between the County Council and the Borough Council. The remaining areas listed above will be dealt with by the Borough Council, who decided that the most urgent was the Kensal New - 35 - Town Area. In this connection, Sir William Holford, F.R.I.B.A., M.T.P.I., was retained by the Council to prepare and submit, in association with Mr. R. T. Kennedy, A.R.I.B.A., M.T.P.I., an architectural lay-out for the redevelopment of the area. During the year, Sir William Holford submitted his redevelopment plan and in doing so assumed that:-_ (i) Redevelopment will be almost entirely public authority housing subsidised by the Housing Acts. (ii) There are likely to be many delays and difficulties in the removal of industrial and commercial concerns at present scattered through the area which have received full or temporary planning permissions; and (iii) Reconstruction of the area is bound to be carried out in stages over a number of years unless, as seems unlikely, large numbers of the present inhabitants can be resettled elsewhere quickly by decentralisation. The proposals aim to change completely the present layout of buildings and to put into the area open spaces that are of amenity and recreational value for the groups of dwellings and the neighbourhood as a whole, while retaining in general the present layout of streets so as to obviate heavy capital expenditure in relaying or re-aligning existing services of gas, electricity, water, telephone and sewers. Certain streets will be closed to vehicles and converted into pedestrian ways. The objects of these proposals axe (i) reduction in the number and frequency of road junctions and intersections; (ii) reduction of drivers' opportunity to short-cut through the housing area; (iii) increase of paved space for pedestrians free of traffic hazards; (iv) quieter conditions for the new housing; (v) reduction of street maintenance costs. Provision is further made for a generous allocation of land for garages and hardstandings so as to avoid street parking in the area. Within the confines of the blocks of property separated from each other by existing streets, Sir William proposes a complete change of the existing pattern of buildings for a pattern which he believes to be not only more architecturally stimulating but one that recognises the value of letting in more daylight, sunlight and air to the dwellings. Sir William Holford draws attention to proposals in the County of London Development Plan for the extension of the Horniman Pleasance and the recently added playgrounds as public open space. This adjacent public open space is likely to be more used by Kensal New Town inhabitants than by those of any other area and, therefore, he makes no special provision for additional public open space but within the scheme he proposes that the recreational needs of different age groups should be catered for as well as the provision of trees, shrubs and grass in selected places. The spaces between the blocks might be laid out as communal gardens with provision for toddlers' play spaces, and an area of open space proposed on the site of the existing Edenham Mews as an equipped playground for 6-11 year olds. As regards the type of development suggested, the plan envisages four tall point blocks of flats, 10 or 11 storeys in height, which is a form of development involving less extensive clearance of existing - 36 - properties prior to the erection of the new accommodation than any other, and one therefore particularly suited to the Kensal housing problem. The bulk of the new housing, however, will be in four-storey maisonettes. Provision is also made for a certain number of terrace houses and if the problems of overspill and cost permit, it is suggested that even more of such houses might be provided within the framework of the plan. Realising that the problems of overspill necessitate the decanting of persons at present living in the area while development on cleared sites proceeds, the plan proposes redevelopment in three phases. The first phase suggested is in Golborne Gardens and would consist of the construction of two blocks on sites which are at present cleared, comprising an 11-storey, 42 flat block and a four-storey, 10 maisonettes block followed by the erection of a second 11-storey block of flats and a second four-storey block of maisonettes. At a later stage the area bounded by Golborne Gardens, Golborne Road, Southam Street and Adair Road would be redeveloped and finally the area adjacent to Kensal Road where the majority of the industry in the area is at present located would be dealt with under the plan. Subsequently, the London County Council approved in outline the first stage of the layout of the Kensal New Town Area and permission was granted relating to the redevelopment for housing purposes at a residential density of 136 persons per acre of the area bounded by Hazlewood Crescent, Golborne Road, Southam Street, Adair Road, Appleford Road and Bosworth Road comprising in total approximately acres. In view of this, on the 11th December, 1956, the Council declared the first section of the Kensal New Town Area, comprising thirty-four houses, to be a clearance area. A Compulsory Purchase Order, made in respect of this area, has been submitted to the Minister for confirmation. In addition, the Council decided to make Compulsory Purchase Orders in respect of two additional sites within the area as follows:- No.1. Situated on the north-east corner of the junction of Bosworth "Road and Golborne Gardens and formerly occupied by No. 40, Golborne Gardens and Nos. 9, 11, 13 and 15, Bosworth Road. (The site formerly occupied by No. 42, Golborne Gardens is also within this area, but has been excluded from the Order as it is in the Council's ownership.) No.2. Situated on the junction of Golborne Gardens and Hazlewood Crescent and partially occupied by engineering works in the former St. Andrews and St. Philips Church Hall. The vacant portion of the site formerly occupied by No, 2, Golborne Gardens and St. Andrews and St. Philips Church. The Orders in respect of these sites have been submitted to the Minister for confirmation. 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 - 37 - 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 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. The 1954 Act reduced that period 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 removed 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. Local authorities may, with the Minister's concurrence, 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 Rents Acts. They are now required to fix a maximum rent for all such dwellings, whether let or not, with the exception of one class, namely, those which have been let for the first time since 1st September, 1939, and for which a reasonable rent has been fixed by a rent tribunal under the Landlord and Tenant (Rent Control) Act, 1949. A rent fixed by a rent tribunal under that Act for a dwelling improved with the aid - 38 - 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." Applications for improvement grants received and dealt with during 1956 are summarised as follows Applications received 22 Applications granted 18 (comprising 37 separate "dwellings") Applications refused 4 Total amount of grants approved £13,829. 0s. 0d. Applications withdrawn after approval 1 (amounting to £400. 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 Longlands Court/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 16 Galsworthy House, Elgin Crescent 16 Liddiard House, Lansdowne Road 8 Hunter House, Old Brompton Road 15 Pinborough Road (four schemes) 42 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 Colvilie Gardens and Square 20 19-27, Acklam Road 8 10, Blagrove Road 6 Raddington Road 18 12-14, Cambridge Gardens 8 82-84, Redcliffe Square 11 32,St. Charles Square 8 19, Acklam Road 8 18 and 25, Basing Street 8 55, Faraday Road 6 275 and 297, Ladbroke Grove 9 3, Talbot Grove 20 42, Tavistock Crescent 3 Other schemes for building new housing accommodation are in various stages of preparation. - 39 - 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 followss:- Category 1. Overcrowding under the legal standard where alternative accommodation has been offered and refused. Category 2. Overcrowding in excess of the Modified Standard. Category 3. Overcrowding above the legal standard but within the Modified Standard, where there are special medical reasons involved. Category 4. As in Category 3, but without special medical circumstances. 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 public health inspectors who try and secure abatement by persuasion. Seventy-eight new cases were dealt with in 1956 by the Special Sub-Committee as follows:- (a) Recommended for alternative accommodation by the Council 44 (b) Proceedings ordered to be taken without prior offer of alternative accommodation 1 (c) Action postponed 24 (d) Warnings sent to abate overcrowding within specified period 9 The total number of cases of overcrowding abated during the year was forty-seven and, in addition, twenty-six Category 4 cases were also abated. Since the war, the Special Sub-Committee have dealt with one thousand, two hundred and seventy-seven cases of overcrowding under Categories 1, 2 and 3, and no fewer than one thousand and fourteen of these have been abated. Assessment of Housing Priorities on Medical Grounds During the year two hundred and twenty-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 - 40 - disability were determined (frequently necessitating communication with the family doctor or with the hospital attended.) The premises were inspected in detail to ascertain the extent and nature of the existing accommodation; the adequacy of day and sleeping space; the risk of infection; the existence of remediable or irremediable sanitary or structural defects, and the existence of inconveniences, such as stairs which might be prejudicial to the patient. On this information and that supplied by the Chief Housing Officer, an assessment of points to be awarded on medical grounds was made. In forty-one cases, recommendations for re-housing on medical grounds were also made to the London County Council, and to other local authorities in two cases. Accommodation for Costermongers The general condition of mews dwellings in the borough has received much attention from the public health viewpoint in recent years. In connection with the Council's policy of clearing unsatisfactory mews dwellings, it was appreciated that street traders must have storage accommodation for their horses, vehicles, barrows and goods. At the Council's request, the London County Council promoted legislation to enable them to provide and maintain storage and stabling accommodation for use by street traders and other like persons displaced by reason of the exercise of powers under the Housing Acts, 1936/49, or by the acquisition of lands under any other enactment. 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 6 17 units In addition, a refuse container shed, manure store and sanitary convenience have been provided for the traders. Further plans are being made to erect on the site of Elgin Mews and Lonsdale Mews, (other clearance areas), the following accommodation, with manure stores, conveniences, etc. Elgin Mews Lonsdale Mews Large stores 14 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 - 41 - with the borough during 1956:- Inspections Premises Number on Register Number of Inspections Number of Written Notices Factories in which Sections 1, 2, 3, 4 and 6 are enforced by the Council 182 170 1 Factories in which Section 7 is enforced by the Council (not included above) 544 558 19 TOTALS 726 728 20 Defects found Particulars No. of defects found No. of defects remedied No. of defects referred To H. M. Inspectors By H. M. Inspectors Want of cleanliness Overcrowding 1 1 1 - Unreasonable temperature - - — — Inadequate ventilation - - - - Ineffective drainage of floors - - - - Sanitary conveniences (a) insufficient 2 1 - - (b) unsuitable or defective 17 10 2 - (c) not separate for sexes 2 2 - - Other offences (not including offences relating to Homework) - - 8 - TOTALS 22 14 11 - During 1956, no prosecutions were instituted under the Factories Act, 1937. Outworkers The following table shows the nature of the work carried out by the hundred and nine home workers on the register of outworkers during 1956:- Nature of Work Number Wearing apparel - making, etc. 71 Artificial flowers 14 Carding etc. of buttons, etc. 4 Stuffed toys 13 Lampshades 1 Chocolates and sweetmeats 6 109 During the year, one hundred and fifty-four inspections of - 42 - outworkers' premises were made, but in no case was action necessary to prevent work being carried on in unwholesome premises. No instance of infectious disease occurring in premises, where home work is carried on, was reported during the year. Basement Bakehouses The Factories Act, 1937, (Section 54), requires the Council to carry out (in every fifth year) an examination of all basement bakehouses in the borough, for which certificates of suitability have been issued and are still in force. The quinquennial inspections for the year 1953/54 were made of twenty-seven underground bakehouses in respect of which certificates still operated. As a result, the occupiers of fourteen basement bakehouses were permitted to carry on their businesses. Since that time, however, some of these basement bakehouses have ceased to be used as such for a period exceeding twelve months, and, in accordance with Section 54 of the Factories Act, 1937, shall not be so used again. At the end of the year, the following eight premises in the borough were the only basement bakehouses remaining where baking can legally be carried on:- 93-95, Old Brompton Road 139, Portland Road 46, Walton Street 151, Earls Court Road 178, Fulham Road 65, Golborne Road 79, Golborne Road 196, Lancaster Road 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 public health inspectors engaged on this work for 1956:- - 43 - No. of No. of Premises registered under - premises inspections (1) Section 16, Food and Drugs Act, 1955 - (a) for the sale, or the manufacture for the purpose of sale, of ice-cream, or the storage of ice-cream intended for sale 374 155 + (b) for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale 152 231 (2) Milk and Dairies Regulations, 1949 - (a) as dairies 87 204 (b) where the occupier is registered for the sale of milk in sealed containers only 111 531 + Additional inspections of the premises (not primarily in connection with the sale of ice-cream) are recorded under different headings in the following table. Food premises (all categories) No. of premises No. of inspections Bakehouses - underground 8 13 " - others 16 19 Bread and cake shops 45 99 Butchers 78 158 Dairies 87 284 Fishmongers 44 51 Food factories 6 25 General stores 8 110 Greengrocers 110 69 Grocers 235 421 Ice-cream 343 155 Preserved food 28 73 Public houses and off-licences 160 69 Restaurants and cafes 265 577 Sweet shops 170 132 Street markets, stalls and storage premises 90 (licensed traders. ) 75 Food and Drugs Act, 1955 The Food and Drugs Act, 1955» which came into operation on 1st January, 1956, is now the principal Act for controlling the composition, labelling, fitness and hygienic handling of food; and the Food Hygiene Regulations, 1955, the principal instrument for enforcing good food hygiene practice. The new Act repealed the Act of 1938, and made changes affecting the work of the Council as follows:- (a) The power given to an authorised officer to examine food, is extended to include the power to examine and detain containers and vehicles transporting food other than those belonging to certain transport undertakings. (b) A Magistrate's Court may disqualify a caterer from - 44 - carrying on business if he is convicted of a serious offence against the Food Hygiene Regulations. (c) Requirements relating to the registration of certain types of food premises (ice-cream, or manufacture of sausages and potted, pressed, pickled or preserved food) were re-enacted in a different form. Applications for registration must now specify the particular part or parts of the premises it is desired to use for the purpose of the registered trade, and new registrations will not in future include any part of the premises not specified in the application. (d) Cream substitutes are divided into two categories "imitation cream" and "reconstituted cream". It is an offence to sell any substance which resembles cream in appearance, but is not cream, under a description which includes the word "cream". It is also an offence to sell any article of food containing such a substance unless it is not intended for use as cream or as a substitute for cream. Ice-cream, however, is not affected by these new provisions. (e) Changes in sampling procedure were effected, but these are mainly of a minor character. Food Hygiene Regulations, 1955 The title of these Regulations emphasises the changing trend whereby a national policy is slowly developing along the lines of clean food handling to safe food. The Regulations replace the former Section 13 of the Food and Drugs Act, 1938, and whilst they may be thought capable of varying interpretation, they constitute a considerable improvement. A brief summary of the main requirements is as follows:- Requirements affecting food handlers Persons handling food must - (a) keep their hands and clothing clean; (b) cover open cuts and abrasions with a water-proof dressing; (c) refrain from spitting; (d) refrain from smoking or taking snuff when handling food or when in any room where there is open food; (e) not place food so as to involve risk of contamination; (f) not allow unclean or printed wrapping material to come into contact with food; (g) notify the occupier (and owner) if suffering from, or becoming a carrier of, certain infectious conditions. Requirements relating to food premises (a) No room which communicates with a sanitary convenience may be used for the handling of food or the cleaning of equipment; (b) notices requesting users to wash their hands must be displayed in every sanitary convenience; (c) a constant, clean and wholesome water supply must be provided; - 45 - (d) suitable and. sufficient washbasins must be provided, together with a supply of hot and cold water, soap, nailbrush and clean towels; (e) in premises where open food is handled, suitable and sufficient sinks, together with an adequate supply of hot and cold water, soap or suitable detergent, and of clean cloths must be provided, and in addition adequate and suitable cleaning and drying facilities; (f) lighting and ventilation of food rooms must be adequate and satisfactory; (g) walls, floors, doors, windows, ceiling, woodwork, and all other parts of structure of every food room, must be kept clean, and in such good order, repair and condition, as to enable them to be effectively cleaned and prevent risk of infestation by rats, mice, insects and birds. Requirements relating to food stalls Every stall - (a) must bear the name and address of the person carrying on the business; (b) must be kept clean and in good repair; (c) when used for meat and fish, must be covered over and screened at the sides and back, and a covered metal refuse bin must be provided for all waste trimmings; (d) when used for open food, for immediate consumption, must be provided with suitable and sufficient sinks for washing food and equipment, together with a supply of hot and cold water, soap, nailbrush, clean towels and drying cloths. Generally Suitable and sufficient bandages, dressings and antiseptic must be provided and maintained in food premises. Sufficient and suitable cupboard or locker accommodation for clothing and footwear must be provided for persons engaged in or about food premises. In premises where the business consists wholly or partly of the supply of food for immediate consumption, food consisting of meat, fish, gravy or imitation cream, or prepared from or containing these substances, or any egg or milk, must be kept in accordance with the specified temperatures. Food in or about any forecourt, yard, market or stall must not be placed lower than 18 inches from the ground. A person guilty of an offence against any of these regulations shall be liable to a fine not exceeding £100 or to imprisonment for a term not exceeding three months, or to both, and, in the case of a continuing offence, to a further fine not exceeding £5 for each day during which the offence continues after conviction. The Council, in considering these new Regulations, decided to send to every person, in charge of a food business in the borough, a copy of the Regulations with a summary of their main provisions. It was also decided to request the local newspapers to give publicity to the new Regulations. During the year, the public health inspectors have been engaged - 46 - on surveying food premises in the borough and a total of 2,330 inspections were made. In 350 cases it was necessary to send informal letters pointing out deficiencies under the Regulations and, generally speaking, the food traders are complying with the requirements in a co-operative manner. In a few cases it was found necessary to take legal proceedings for contravention of the Regulations in respect of - (i) smoking whilst engaged in handling food; (ii) exposing food to contamination; (iii) lack of cleanliness of equipment; and (iv) lack of cleanliness and repair of food rooms. Pines totalling £34. Os. Od. with £8. 16s. 6d. costs were imposed. 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; 97 25 Sixty-two samples of Tuberculin Tested Milk were submitted for examination during the year. Nineteen 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 s- Methylene blue test No. of Designation samples Passed Failed Tuberculin Tested (Farm bottled) 62 43 19 Tuberculin Tested - Milk (Special Designations)(Pasteurized and Sterilized Milk) Regulations, 1949 Details of licences granted during 1956 are as follows :- Principal Supplementary Dealers' licences to sell Pasteurized Milk; 114 25i Dealers' licences to sell Sterilized Milk; 118 23 The following table shows the number of samples of processed milk taken during the year, together with results of the examinations:- - 47 - Designation No. of samples Methylene blue test Phosphatase test Turbidity test Passed Failed Passed Failed Passed Failed Tuberculin test (Pasteurized) + 33 32 — 33 - - - Pasteurized 41 41 - 41 - - - Sterilized - - - - - - - + One sample was not submitted to the methylene blue test as the atmosphere shade temperature exceeded 65ºF, which is the limit specified in the Regulations. Milk and Dairies Regulations. 1949 (a) Registrations A summary of the alterations made in the register of dairymen and dairies during 1956, 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 9 - - Additions to register - - 10 Removals from register - — 1 Dairymen with premises outside the borough added to register 3 - - On register 31st December, 1956 108 87 111 (b) Unclean milk containers It is an offence under the Milk and Dairies 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, three of which were referred to neighbouring authorities, where the milk had been bottled. In one of these cases, the authority took legal proceedings against the bottling firm, who pleaded guilty and were fined £4. 0s. 0d. In the other two cases, the authorities decided not to take legal action. Of the two cases remaining, investigations proved that in one (which was not a serious contravention) the evidence available was not - 48 - sufficient to justify action, and in the second the alleged dirty condition of the bottle could not be substantiated. Composition of milk During the year, three hundred and sixty-five samples of milk were submitted to the Public Analyst, and only six were found to be below the presumptive standards laid down in the Sale of Milk Regulations, 1939. Warnings were given to the producer or vendor in four cases and, in addition, the results of three of these samples were sent to the Ministry of Agriculture, Fisheries and Food. In the remaining two cases of deficiency, it was decided to take no action. The following table shows the percentages of milk fats and nonfat solids of the genuine samples taken during each month :- Month No. of samples taken Average percentages Milk fats Non-fat solids January 37 3.72 8.63 February 39 3.56 8.53 March 28 3.58 8.55 April 23 3.73 8.73 May 39 3.57 8.79 June 30 3.57 8.77 July 29 3.89 8.79 August 25 4.00 9.12 September 22 3.97 8.83 October 53 4.03 8.88 November 27 4.17 8.88 December 7 4.16 8.74 Average for whole year 3.83 8.77 Legal minimum standards 3.00 8.50 Milk and Dairies (Channel Islands and South Devon Milk) Regulations, 1956 These Regulations came into operation on 1st July, 1956, and required that all milk for human consumption sold under a specified description of - Channel Islands milk, Jersey milk, Guernsey milk, or South Devon milk must contain not less than 4% by weight of milk fat. This compares with the presumptive milk fat standard of 3%, specified for ordinary milk, by the Sale of Milk Regulations, 1939. Since the 1st July, 1956, sixty samples of these milks have been taken and not one was found to be below the standard laid down. Unsound food Seizure Under Part I of the Food and Drugs Act, 1955, it is an offence - 49 - 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. There was no occasion during 1956 when it was found necessary to enforce this procedure. Surrender Any person having in his possession, food which is diseased, unsound, or unfit for human consumption can, under Section 180(8) of the Public Health (London) Act, 1936, surrender it to the Council for destruction or other suitable method of disposal. During the year the following amounts of food were surrendered and condemned as unfit for human consumption :- Food Tons Cwt. Qrs. Lb. Mear (raw) - 17 - 6 Meat (tinned) - 5 - 15 Ham - 9 - 13 Sausages - 1 1 16 Fish (wet and dry) 1 9 3 21 Dried fruit - 5 - 3 Macaroni - — 1 - Frozen peas - - 1 7 Cheese - 2 1 23 Marzipan - 1 - 3½ TOTAL 3 11 2 23½ Tins, jars, packets or cartons of fruit, vegetables and miscellaneous foodstuffs 4,912 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. Complaints by purchasers of unfit food During the year, twenty complaints were received from members of the public who alleged the unsatisfactory condition of food purchased by them. The complaints generally related to the presence of foreign matter in the foods, mouldy conditions of meat pies, bread, etc., and the unsatisfactory condition of canned foods, chicken, mushrooms, sherry and other articles. In three of these cases, it was alleged that the articles purchased had given rise to illness, such as sickness and diarrhoea, and special bacteriological and chemical examinations were made. In two of the cases, the foods complained of, viz. tinned cream and tinned crab paste respectively, were found to be sterile. The third case was in respect of flower-scented cachous, whioh were found to contain bismuth, inadvertently introduced during manufacture} but nevertheless the illness was not due to this and no action was taken except to notify the - 50 - manufacturers. In four other complaints it was decided to take legal proceedings. Two of these were in respect of the sale of mouldy pork pies and the proceedings resulted in the vendors being fined a total of £4. 0s. 0d. with £5. 5s. 0d. costs to the Council. The third case was in respect of mildew affected sliced bread and the vendor was fined £3. 0s. 0d. with £2. 2s. Od, costs. In the fourth case, which was also of mouldy wrapped sliced bread, the bakers were convicted and fined £2. Os. Od. and ordered to pay £5. 5s. Od. costs both to the Council and to the retailer, who was discharged. A further case concerned the presence of a metal screw in a loaf of bread; the Public Health Committee decided to send a warning to the manufacturers. The remaining twelve complaints were dealt with by informal action, owing to the lack of detailed evidence. Adulteration of Food During the year five hundred and forty-four formal samples of food and drugs were purchased, of which seventeen (3.1%) were either adulterated or otherwise unsatisfactory. Four hundred and sixty-two informal samples were also purchased, of which twenty-nine (6.2%) were either adulterated or otherwise unsatisfactory. The following table summarises the action taken in respect of the defective samples:- - 51 - 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 Milk - 4 - 2 6 Tomato Puree - - 2 2 Tomato Juice - - 3 3 Tomato Paste - - 11 Almond Cream - - 11 Cream Cheese - - 11 Cream - 3 - - 3 Cream Toffee - - 2 2 Ice Cream 1 - 1 Sterilized Cream 1 - 1 Crystallised Seeds Cake Decoration - - 11 Grape Juice - 1 1 Beef Sausages (Canned) - - 11 Sardines (Canned) - - - 11 Sild (Canned) - - 11 Smoked Saithe (Canned) - - 11 Brisling (Canned) - - 11 Brisling Paste 1 - 1 Strawberry Flavouring - - 11 Raspberry Fruit Drink 1 - 1 Cochineal 1 - 1 Tincture of Iodine B.P - - 11 Lung, Throat and Chest Mixture 1 - 1 Zinc and Castor Oil ~ Ointment 1 - 1 Sweet Pickles 1 - 1 Chicken Soup with Rice - - - 11 Cider Vinegar - - 1+1 Butter 1 - 1 Flower Scented Cachous - - - 11 Condensed Milk (Sweetened) 1 - 12 Green Herbs Mustard - - - 11 White Gelatine - - 2 2 Port Wine - - 11 TOTALS Nil 17 1 20 ++ 46 + Case notified to the Customs & Excise Officer. ++ 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. Sausages In November, 1955» the Council decided to make representation to the Metropolitan Boroughs' Standing Joint Committee to urge the Ministry of Agriculture, Fisheries and Food to introduce legal standards for the meat content of sausages. The Metropolitan Boroughs' Standing Joint Committee submitted a number of observations (reported in my Annual Report for 1955) to the Ministry. It is interesting to note that the Ministry's Food Standards Committee in their Report dated 30th May, 1956, recommended that - 52 - regulations should be made for the following :- (a) A minimum standard of meat content of 65 per cent. for sausages made wholly or mainly with pork and of 50 per cent. for all other meat sausages. (b) The meat content to be restricted to bacon, ham, beef, mutton, lamb, veal, pork, edible offals (other than prohibited offals), poultry, game, rabbit, hare and venison. (c) The proportion of fat not to exceed 50 per cent. of the total meat content. (d) The standards to apply to uncooked sausages, sausage meat, skinless sausages, chipolatas and slicing sausages. (e) The sale of sub-standard sausages to be prohibited. (f) The standard to apply to sausages, etc. intended for sale by catering establishments. (g) As regards the use of the description "pork sausage" and "beef sausage", the majority of the Committee consider that these descriptions should apply where at least four-fifths of the meat content consists of the named meat, but certain members of the Committee consider that they should only apply where the meat content consists wholly of the named meat and that suitable alternative descriptions should be found for sausages containing up to one-fifth of other meat. So far no standards have been made. 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 1956 for chemical analysis compared with the previous year:- 1955 1956 Number of samples 45 32 Variation of fat content per cent 5.4 to 14.4 4.6 to 13.6 Variation of non-fat content per cent 20.5 to 31.8 21.2 to 31.6 Average fat content 9.23 9.99 Average non-fat solids content per cent 25.16 24.90 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 - 53 - indication of defects in manufacture or handling which warrant further investigation. During the year thirty-seven samples of ice cream were taken and submitted to the methylene blue test. The results are as follows Grade No. of samples 1 15 2 8 3 2 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 Food 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 1956 Food poisoning notifications (corrected) First quarter 16 Second quarter 10 Third quarter 28 Fourth quarter 9 TOTAL: 63 Outbreaks due to identified agents 2(17 cases) Outbreaks of undiscovered causes 4(16 cases) Single cases - Unknown cause 18 Agent identified 12 Total cases 30 Outbreaks due to identified agents (2 outbreaks) (a) The first outbreak concerned two young children. It was discovered when a boy aged 4 years suffered moderately severe symptoms of headache, pain and diarrhoea. Bacteriological examination of his faeces showed the presence of salmonella miami. Specimens from the family contacts were examined, and whilst those for the parents were negative, the one submitted by the patient's sister, aged 14 months, also showed salmonella miami, although she had suffered no obvious symptoms. Investigations at the home revealed nothing significant, except that both children attended a private day nursery each morning. Enquiries at this establishment showed that the children had only milk and biscuits during their attendance. Moreover, no other children were absent with intestinal symptoms. The original patient quickly recovered and both he and his sister were treated for the eradication of the organism. No - 54 - source of infection was established. (b) The second outbreak affected fifteen persons staying at a residential club. At the time of the outbreak, there were eighty-four guests and a staff of nine staying at the premises. The sufferers exhibited symptoms of stomach pain, diarrhoea and vomiting which, although fairly severe, quickly moderated. Bacteriological examination of specimens showed the presence of Clostridium welchii. Although no food remained for examination, enquiries suggested that the practice of reheating meat was responsible for the outbreak. In other respects, the food handling techniques and the kitchen at the establishment were found to be of a good order. The patients were cared for from the onset of symptoms by a local medical practitioner and they soon recovered. Outbreaks of undiscovered cause (4 outbreaks) (a) The first outbreak affected seven persons (only one of whom lived in Kensington) who had eaten meals at a Kensington restaurant. All the sufferers had symptoms of vomiting or nausea, whilst others experienced, in addition, diarrhoea, thirst, prostration, drowsiness and headache. One patient was admitted to hospital for forty-eight hours. Although the outbreak seemed to be one of staphylococcal food poisoning (average interval between ingestion and onset = 3½ hours), the picture was confused in that the sufferers had different meals with perhaps only the condiments as a common item. Furthermore, laboratory investigation of food handlers revealed no supporting evidence. The meals at this restaurant were obtained from a food factory in another borough, whose Medical Officer of Health reported satisfaction as to methods and absence of complaints. In the restaurant itself, the food handling routine was good. The possibility of chemical poisoning was investigated and although no evidence was found, accidental poisoning by chemical means could not be ruled out. The origin of this outbreak was not established. (b) The second outbreak affected four persons (three adults and a child aged 4 years) who suffered fever, pain, headache, diarrhoea and thirst. Faeces specimens submitted by the patients were found to be negative. Investigations indicated that egg sandwiches eaten in a restaurant outside Kensington were the likeliest vehicle of infection. The Medical Officer of Health of the borough concerned reported that his enquiries revealed nothing of significance at the premises. Neither the source nor the agent of infection was definitely found. (c) Two adults, who suffered symptoms of giddiness, nausea, and vomiting, were concerned in this outbreak. Specimens of their faeces were reported negative. Enquiries elicited no definite evidence as to the food causing symptoms or any source of infection. (d) The last outbreak involved two adults and a child aged 4 years, who suffered symptoms of pain, diarrhoea and vomiting. Two other members of the same family remained well. Faeces specimens submitted by patients and contacts were reported negative. With treatment, the patients soon recovered, but investigations as to the source of infection prove unrewarding. - 55 - Single cases In addition to the outbreaks referred to above, there were thirty single cases of food poisoning notified. In eighteen of these, no causative agent was identified, but in the remaining twelve cases, the identified agents were as follows :- Agent Cases Salmonella typhi-murium 7 Salmonella newport 1 Salmonella enteriditis 1 Salmonella anatum 1 Salmonella mikawasima 1 Salmonella montevideo 1 INFECTIOUS DISEASE Smallpox No case of smallpox was notified in the borough during the year 1956. 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 revaccinated at not more than yearly intervals. During the year thirty 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 1956 was forty-five and, of this total, fifteen 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 One case of diphtheria was notified during the year. The patient, a boy aged 7 years, was admitted to hospital as a case of whooping cough. A routine throat swab taken there showed C. diphtheriae (gravis type). The case was notified as a "carrier" presumably because clinical support for a diagnosis as a diphtheria sufferer was inadequate. It is believed that the bacteriology in this case was atypical in that the strain may have been a non-starch fermenter. Recently other cases with similar bacteriology have been reported elsewhere and there is some doubt as to their validity as true diphtheria cases. As far as this child was concerned, the contacts remained well. It was ascertained that the boy had been immunised three years prior to his admission to hospital, and the attention of the London County Council was drawn to this, and the details were reported to the Ministry of Health. 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:- - 56 - Number of pre-school children immunised 1,383 " " school " " 302 " " re-inforcing injections given 1,657 " " children attending for pre-Schick tests 414 " which gave a positive reaction 352 " " " " negative reaction 75 " of children attending for post-Schick tests 873 " proving negative 749 " proving positive 49 " who failed to attend for reading 63 Enteric Fever During the year, there were five cases of typhoid fever and five of paratyphoid B. fever. Of the ten cases, nine were removed to hospital for treatment, and no deaths occurred. The first case of typhoid fever involved an Iraqui student, who had suffered intermittent symptoms throughout his stay in this country. In hospital, he was regarded as a long standing carrier of the disease. The second case occurred in a man who virtually never left his home owing to epilepsy; he had never been abroad. Investigations, including the examination of faeces specimens submitted by all contacts, revealed nothing to indicate the source of infection. Tht third case was a girl aged 14 years who fell ill following a long continental tour. Her mother and sister were investigated and found to be free from infection, and no further cases occurred. The source of infection was believed to be abroad. The fourth and fifth cases were a mother and her daughter aged 3 years. The husband and the second child remained well. The family had never been abroad and there was no contact with other cases in Kensington, either recent or remote. It was alleged, during the investigations, that the lavatory at the tenement house in which the family lived was often fouled. Accordingly, faeces specimens were obtained from every occupant in the house, but all were reported negative. The first case of paratyphoid B fever occurred in a man who had recently returned from Paris where he had spent ten days on business. No other members of his family were ill (they had remained in London) and the specimens they submitted were negative. The second case was a young lady who fell ill on arrival in Kensington after leaving a summer occupation on the South Coast. She was immediately admitted to hospital and the Medical Officer of Health of the area from whence she came was informed of her movements. However, nothing was found to indicate the source of infection. The third case came to light when contacts of a suspected case of typhoid fever (subsequently diagnosed as a non-infectious illness) submitted faeces specimens for bacteriological examination. The specimen submitted by a lady aged 62 years was reported positive for paratyphoid B fever. It was established in hospital that she was a carrier, probably as a result of an attack many years before when she lived abroad. The remaining two cases were children aged 1 and 3 years respectively in a West Indian family. A third, aged 5 years, was also involved, but as the diagnosis of this case occurred in 1957, it will be dealt with for statistical purposes in the next year's report. In spite of exhaustive enquiries made into this small outbreak, and the investigation of specimens submitted by contacts, the source of infection remained undisclosed. - 57 - Puerperal Pyrexia During 1956, the number of cases of this disease notified was one hundred and seventeen, of whom seventy-five were persons normally resident outside the borough. Three of the cases occurred after home confinements (one of these patients was subsequently moved to a hospital outside Kensington for treatment.,) One patient fell ill at home and had a miscarriage after admission to hospital. The remaining one hundred and thirteen cases occurred in hospital. In order to show some perspective in reviewing this disease (defined as 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), the following table sets out an analysis of the causes of pyrexia in 1956 :- Cause Number of cases Flushed breast, breast abcess, mastitis 13 Respiratory infections:- Influenza 3 Coryza 2 5 Urinary infection 15 Cystitis 1 Pyrexia associated with abnormal delivery:- Breech delivery 1 Haemorrhage 2 Forceps delivery 3 Retained chorion 1 Retained placenta 2 Caesarian section (including 2 associated with other causes as follows:- 1 Pulmonary Tuberculosis, 1 Urinary infection) 15 24 Uterine infection 14 Causes unknown after investigation 27 Not stated 18 In the case of the two patients nursed at home, it was found that both had been attended by the same midwife and assistant. Further, it was reported that the assistant had performed her duties although she had a "bound finger." The circumstances were reported to the County Medical Officer of Health. In addition to the above one hundred and seventeen cases, information was received concerning eighty-six 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, sixty-five notifications were received, fifty-two being acute primary pneumonia and thirteen being acute influenzal pneumonia. Of the total, thirty-two cases were removed to hospital for treatment. The number of deaths from pneumonia (all forms) was one hundred and six, and the number of deaths from influenza was nine during 1956. Dysentery Eighty-eight cases of dysentery were notified during 1956, 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 - 58 - were no deaths. Erysipelas Five cases were notified during the year; three were treated at home, and two were admitted to hospital. There were no deaths. Meningococcal infection Six cases of this disease were notified during the year and all were removed to hospital. No deaths were reported. Malaria One case of malaria was reported during the year, but investigations showed that the patient had recently returned from abroad, and presumably had contracted the infection overseas. Poliomyelitis There were twenty-one cases of acute poliomyelitis notified and confirmed during the year; fourteen 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 s- Year Confirmed cases Deaths 1955 30 Nil 1954 5 Nil 1953 14 1 1952 21 2 1951 12 Nil 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. During this year, there were two instances of multiple cases within a single family. In the first instance, two children were involved (one paralytic and one non-paralytic), and in the second, both parents (paralytic) and one (non-paralytic) Of their two children were affected. Investigation in the field concerning the possible association between inoculation against other diseases and the contraction of poliomyelitis was discontinued during the year by the Medical Research Council. However, with the advent of inoculations against poliomyelitis itself, the public health department has been working closely with the London County Council. One case of non-paralytic poliomyelitis, who fell ill in September, had been inoculated three months earlier. It was clear that the inoculation was not responsible for the disease. Acute encephalitis Two cases of this disease were notified in the borough during 1956. No deaths occurred. Measles Of the three hundred and fifty-eight cases notified during 1956, thirteen were admitted to hospital for treatment. No deaths occurred from this disease. - 59 - Ophthalmia neonatorum Only one case of this disease was notified. The patient was 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 fourteen. Five were removed to hospital for treatment. One death of a child under five years of age was recorded as due to gastritis, enteritis or diarrhoea. Scabies The number of cases of scabies notified during 1956 was forty, which compares with four hundred and sixty-three notified in the peak year of 1946. Tuberculosis During the year two hundred and fifty-eight new cases of tuberculosis were notified, of which two hundred and thirty-four were respiratory and twenty-four non-respiratory cases. The following table shows the number of cases added to and the number removed from the notification register during the year :- Description Respiratory Non Respiratory Total M F M F On register of notifications on 1st January, 1956 840 699 75 95 1,709 Notified for the first time during the year 130 104 10 14 258 Brought to notice other than by notification 96 80 1 6 183 Removed from register on account of having - (a) recovered from the disease 25 20 1 4 50 (b) removed from district lost sight of, etc. 192 162 14 14 382 (c) died Remaining on register on 23 13 - 2 38 31st December, 1956 826 688 71 95 1,680 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 public health 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 seventy-six visits were paid to the homes of tuberculous patients. In two hundred and ninety-seven of these, the environmental conditions were such as to require no further action on the part of the public health department; in a further one hundred cases, it was found that the patients had moved away, and in thirty other cases the investigations were postponed as the patients were away in hospital or had not been contacted by the end of the year. The - 60 - action taken in the remaining forty-nine cases is summarised as follows:- Action taken Cases Investigation or supervision undertaken in respect of:- (a) re-arrangement of existing 12 (b) occupation of patients 2 (c) tracing of contacts 4 (d) prevention of spread of infection 3 Recommended for priority rehousing 28 Action was taken under the Public Health and Housing Acts in respect of insanitary or unhealthy conditions in ten 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 1956:- Country of origin Period (in years) between entry to United Kingdom and notification of disease Total 123456 7 89 Australia 1 1 - - - - - - - 2 Belgium - 1 - - - - 1 - - 2 British West Indies 3 - - - 2 1 - - - 6 Burma 1 - - - - - - - - 1 Cyprus - - - - - - - - 2 2 Denmark - - - - - 1 - - - 1 Germany 1 1 1 - - 1 2 - - 6 Gibraltar 1 - - - - - - - - 1 Greece - 1 - - - - - - - 1 Hong Kong - 2 - - - - - - - 2 India & Pakistan 2 2 - - - - - - - 4 Ireland 4 5 3 2 4 5 2 1 4 28 Italy - - - - - 1 - - - 1 Kenya 1 - - - - - - - - 1 Persia 1 - - - - - - - - 1 Poland - - - - - - - - 1 1 Portugal - 1 - - - - - - - 1 South Africa - - - - 1 - - - - 1 Spain 1 - - - 1 - 1 - - 3 United States 1 - - - - - - - - 1 TOTALS 17 14 4 2 8 7 6 1 7 66 - 61 - Patients who had resided in London all their lives or for at least 10 years 96 Patients who had resided in other parts of the country all their lives prior to coming to Kensington 82 Patients from whom information concerning origin was not obtained but where it is believed to be this country 5 Patients from Ireland who resided here at least 10 years prior to notification 10 Patients notified abroad before coming to this country (Ireland 1, Italy l) 2 Patients from Poland who resided here at least 10 years prior to notification 6 Patients who resided here at least 10 years prior to notification: (Germany 1, Spain 1, Norway 1, Russia 1, East Africa 1, Turkey 1, West Indies 1, Belgium l) 8 Patients from whom information concerning origin could not be obtained 139 TOTAL 348 The investigation only covered patients newly notified or transferring into the borough from other areas. The total of four hundred and fourteen 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 1952, 1954» 1955 and 1956 were 10%, 16%, 17% and 15% 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 29,355 residents (or just over 17%) who were born outside the United Kingdom and the Republic of Ireland. Whooping Cough Two hundred and thirty-six cases were notified during the year, fourteen of which were treated in hospital. One death was reported 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, seven hundred and eighty-nine of these certificates were authenticated in Kensington. In addition, twenty-eight special exemption certificates were issued to travellers for use in the United States of America. - 62 - Notifications The following tables show (l) the number of cases of infectious disease notified during the year 1956, 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 1956 1955 1954 1953 1952 1951 1950 1949[/### Scarlet fever 45 50 52 78 108 68 100 114 Diphtheria (including membranous croup) 1 2 - 2 – 1 2 2 Enteric fever 10 7 5 5 2 7 12 7 Puerperal pyrexia 117 125 96 65 83 22 18 33 Acute primary pneumonia and acute influenzal pneumonia 65 105 54 93 71 149 69 121 Dysentery 88 99 68 131 31 81 18 33 Erysipelas 5 9 14 11 11 13 17 15 Meningococcal infection 6 2 1 6 4 8 5 8 Malaria Acute poliomyelitis 1 6 4 5 1 2 2 – Paralytic 14 10 5 9 17 8 7 47 Non-paralytic 7 20 – 5 4 4 6 Acute encephalitis 2 4 1 - 3 1 – 1 Tuberculosis (all forms) 258 218 243 256 251 238 278 266 Measles 358 1425 94 740 839 1314 696 740 Ophthalmia neonatorum 1 4 2 7 2 2 12 5 Enteritis + 14 13 20 27 30 25 63 88 Pood poisoning 63 53 58 79 20 18 23 33 Scabies 40 54 42 42 26 34 72 106 Whooping cough 236 116 136 485 228 484 316 304 Typhus fever — — 1 — — — — — TOTALS 1331 2322 896 2046 1731 2479 1716 1923 + Notifiable only in children under the age of 5. NOTE: Cases of mistaken diagnosis are excluded from above table. - 63 - TABLE 2 Notifiable disease Number of Cases Notified in 1956 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 – 3 16 19 4 2 1 Diphtheria (including membranous croup) – – – 1 – – – Enteric fever - 1 2 1 – 2 4 Puerperal pyrexia _ _ _ a. – 54 65 Acute primary pneumonia and acute influenzal pneumonia – 2 4 5 – 10 46 Dysentery 1 19 19 17 2 4 26 Erysipelas – – – – – – 5 Meningococcal infection 2 1 1 m– – 2 – Malaria - – - - — – 1 Acute poliomyelitis Paralytic 1 1 2 5 – 5 4 Non.-paralytic - - 2 4 - 1 – Acute encephalitis – – – 1 – 1 – Tuberculosis (all forms) 1 5 3 5 5 41 204 Measles 9 77 111 154 11 8 8 Ophthalmia neonatorum 1 – – – – – – Enteritis 8 5 1 – – – – Food poisoning - 3 4 2 1 20 55 Scabies - 2 2 5 2 15 18 Whooping Cough 24 54 57 98 1 – 2 TOTALS: 47 171 224 289 24 161 415 TABLE 5 Notifiable disease Total Cases Notified in each Ward St.Charles Golborne Norland Pembridge Holland Earls Court Queens Gate Redcliffe Brompton Scarlet fever 9 1 15 8 2 2 1 6 3 Diphtheria (including membranous croup) – – – – 1 – – – – Enteric fever 1 – 4 – 1 – 5 – 1 Puerperal pyrexia 2 5 5 7 6 12 78 3 1 Acute primary pneumonia and acute influenzal pneumonia 9 12 8 10 5 4 4 12 1 Dysentery 19 10 11 10 9 6 9 5 9 Erysipelas – 1 – 4 – – – – – Meningococcal infection 5 – 1 – – 1 — 1 – Malaria – – – – – – – 1 – Acute poliomyelitis Paralytic 1 1 2 5 2 – – 3 – Non-paralytic 1 – – 5 1 – 1 1 – Acute encephalitis l – – – 1 – – – – Tuberculosis (all forms) 35 24 28 44 21 40 16 41 11 Measles 75 90 40 45 10 41 7 42 12 Ophthalmia neonatorum 1 – – – – – – – – Enteritis 2 7 2 2 – – 1 – – Food poisoning 1 9 10 7 2 25 5 4 2 Scabies 7 5 6 5 4 5 5 3 2 Whooping Cough 55 47 56 42 9 19 6 19 5 - 64 - LEGAL PROCEEDINGS Public Health (London) Act, 1956 Nuisances During the year, one hundred and sixty summonses were issued for various nuisances under the Public Health (London) Act, 1936. In forty-eight cases Abatement Orders were secured and costs amounting to £42. Os. Od. were awarded to the Council. In fifty-five cases the summonses were withdrawn, the nuisances having been abated prior to the Court hearings. In fifty-six cases the summonses were adjourned as the necessary works were being carried out by the defendants. In the remaining case the summons was dismissed. Eleven prosecutions were undertaken for failure to comply with Justices' Orders to abate statutory nuisances. In seven cases fines amounting to £25. 1s. 6d. were imposed and costs amounting to £8. 18s. 6d. were awarded to the Council. The remaining four cases were withdrawn as the necessary works had been carried out. Council's Byelaws Dog Nuisances Two summonses were issued under this byelaw. In both cases convictions were obtained and fines totalling £1. Os. Od. were imposed and costs of £1. 0s. 0d. were awarded to the Council. Housing Act, 1936 Contraventions of Closing Orders Nine summonses were issued in respect of the illegal occupation of closed underground rooms. In four cases convictions were obtained and fines of £10. 0s. 0d. were imposed with £4, 4s, 0d. costs to the Council. Three summonses were withdrawn as the owners had carried out the works necessary to make the rooms fit for habitation. The other two summonses were adjourned. 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 £12. Os. Od. was imposed with £4. 4s. Od. costs to the Council. Food and Drugs Act, 1955 Four summonses were issued in respect of the sale of food not being of the nature, substance or quality demanded. Convictions were obtained in all cases. In three, the defendants were fined a total of £7. Os. Od. with £14. 14s. Od. costs, and in the fourth case the defendant was discharged conditionally on payment of £5. 5s. 0d. costs. Food Hygiene Regulations, 1955 Proceedings were taken at the West London Magistrates 'Court against various defendants for contraventions of these Regulations. The contraventions included smoking whilst engaged in handling food, exposing food to contamination, lack of cleanliness of equipment, and lack of cleanliness and repair of food rooms. Fines totalling £34. 0s. 0d. with £8. 16s. 6d. costs were imposed. - 65 - CONCLUSION In presenting this Report, I should like to express my grateful appreciation of the kind co-operation which I have received from The Worshipful the Mayor, the Chairmen and Vice-Chairmen of the various Committees and all members of the Council. My sincere thanks are also given to the staff of the Public Health Department for their loyal and efficient service during the year, and to the other Chief Officers and their staffs for their ready willingness to co-operate at all times. I have the honour to be Your obedient Servant, J. H. WEIR Medical Officer of Health. - 66 - PARTICULARS OP THE STAFF OF THE PUBLIC HEALTH DEPARTMENT AT THE END OF 1956 (As requested by Ministry of Health Circulars l/54 and 28/54) Medical Officer of Health Year of Appointment James H. Weir, M.D., B.S., B.Hy., D.P.H. 1950 Deputy Medical Officer of Health Hastings E.A. Carson, M.D., B.S., D.P.H., S.M. 1956 Public Analyst H. Amphlett Williams, Ph.D.(Lond)., A.C.G.F.C., F.R.I.C. 1952 Administrative and Clerical Staff 1.2. John S. Wheeler, Chief Clerk 1924 Francis W. Gascoyne 1919 Miss Marjorie Mackay 1950 George W. Churcher 1935 Miss Elizabeth Howarth 1951 John H. Gillett 1938 Alan Rogers 1953 Digby A. Smith 1939 Mrs. B. Hennessey 1954 Miss Vera F. Osborne 1941 Harry Gibbs 1955 Mrs. S. Scott 1943 Stanley C. Nottingham 1956 Miss D. Gibbs 1944 Victor W. Waymark 1946 Mrs. B. Beesley 1948 Public Health Inspectors 2.3. Henry W. Walters, F.R.S.H., Chief Inspector 1925 2.3. Cecil R. Webb 1925 l.2.4. Joseph G. Tompkins 1951 1. Arthur L. Vague 1934 1. Reginald G. Weedon 1952 1.2. Ronald D. Callis ,D.P.A -1935 1.2. Herbert B. Cade 1952 1. Dennis C. Draper 1938 1.2.4. Leslie E. Bowskill 1954 1. Harold Hind 1939 1.2. Kenneth Bell 1955 1.2. Arthur F. Standish 1947 1.2.4. Leslie A.Palmer 1956 1. Arthur E. Sills 1949 1.2. Frederick H. Canton 1950 Women Health Officers Miss Anne Barker, S.R.No, S.CoM., H.V. 1949 Mrs. E. I. Gudde, Dip.Soc.Science (Lond.)., 1952 Other Officers 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 Poods. 3. Certificate of London Sanitary Inspectors' Examination Board. 4. Smoke Inspectors' Certificate. - 67 - SUMMARY OF COMMITTEES CONTROLLING MATTERS OF PUBLIC HEALTH (As requested by Ministry of Health Circulars l/54 and 28/54) Public Health Committee Sanitary administration generally Overcrowding, repair, closure and demolition of houses Clearance 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 58 Adulteration of Food 50 Artificial lighting of Common Staircases 52 Atmospheric Pollution 16 Bacteriological Work 9 Bakehouses 42 Birth Rate 1 Burial of the Dead 20 Cancer of the Lung 2 Certificates of Disrepair 30 Chiropody for Aged Persons 24 Clearance Areas 33 Cleansing of Aged Persons 23 Closing Orders - Contraventions 29 Committees 67 Costermongers' Accommodation 40 Cremation Service 21 Deaths, Causes of 8 Death rate 1 Diphtheria 55 Diphtheria Immunisation 55 Disinfection & Disinfestation 10 Dog Nuisances 21 Drainage Dysentery 57 Enteric Fever 56 Erysipelas 58 Factories 40 Food 42 Adulteration 50 Hygiene Regulations 4,64 Ice Cream 52 Inspections 43 Milk 46 Poisoning 53 Sausages 51 Unsound 48 Gastro Enteritis 59 Health Education 14 Holidays for Aged Persons 23 Houses in multiple-occupation 31 Housing 3 Clearance Areas 33 Closing Orders - Appeals 30 Closing Orders - Contraventions 29 Improvement grants 36 Inspections 28 Legal Proceedings 64 Medical Priorities 59 New Housing Accommodation 38 Overcrowding 59 Slum Clearance 33,34 Underground Rooms 29 Housing Repairs and Rents Act, 1954 30 INDEX Page Ice Cream 52 Improvement Grants 36 Infant Death Rate 2 Infectious Diseases 2,55 Acute Encephalitis 58 Diphtheria 55 Dysentery 57 Enteric Fever 56 Erysipelas 58 Gastro Enteritis 59 Malaria 58 Measles 58 Meningococcal Infections 58 Notifications 62 Ophthalmia Neonatorum 59 Poliomyelitis 58 Pneumonia 57 Puerperal Pyrexia 57 Scabies 9 >59 Scarlet Fever 55 Smallpox 55 Tuberculosis 2,59 Whooping Cough 61 Institutional Care of Aged Persons 24 International Certificates 61 Kensal New Town 34 Laundry Facilities for Aged Persons 24 Legal Proceedings- Closing Orders - Contraventions 64 Dog Nuisances 64 Food and Drugs Acts 64 Food Hygiene Regulations, 1955 64 Nuisances 64 Library Facilities for Aged Persons 24 Lung Disease 2 Malaria 58 Mass Radiography 15 Maternal Death Rate 2 Meals for Aged Persons 25 Measles 58 Medical Examination of Staff 21 Medicinal Baths 9 Meningococcal Infections 58 Milk 46 Milk & Dairies Regulations, 1949 47 Milk, Special Designations 46,48 Mortuary 21 National Assistance Acts, 1948/51 20 New Housing Accommodation 38 Notifications of Infectious disease 62 Nuisances 64 Old People's Welfare 22 Advice Leaflets 22 Chiropody 24 Cleansing 23 Grants 22 Holidays 23 Institutional Care 24 INDEX Page Old People's Welfare (cont'd) Laundry Facilities 24 Library Facilities 24 Meals Service 25 Removals 26 S.O.S. Cards 22 Visiting 25 Ophthalmia Neonatorum 59 Outworkers 41 Overcrowding 39 Pests, Prevention of Damage by 11 Pet Animals Act, 1951 14 Pharmacy & Poisons Act, 1933 13 Pigeons, Destruction of 13 Poliomyelitis 58 Population 1 Pneumonia 57 Puerperal Pyrexia 57 Rag Flock & Other Filling Materials Act, 1951 14 Removal of Aged Persons 26 Rodent Control 11 Sanitary Inspection- Drainage 27 Dwelling Houses 28 Inspections 27 Legal Proceedings 64 Sanitary Notices served 27 Supervision of Work 28 Scabies 9,55 Scarlet Fever 55 Slum Clearance 33,34 Smallpox 55 Smoke Measuring Stations 19 S.O.S. Cards 22 Staff 66 Student Public Health Inspectors 4 Tuberculosis 2,59 Underground Rooms 29 Unsound Food 48 Vaccination 55 Vital Statistics 4-7 Water Supply 9 Whooping Cough 61