4348 KEN 67 Royal Borough of Kensington ANNUAL REPORT ON THE Health of the Borough FOR THE YEAR 1958 BY J. H. WEIR M.D.. B.S.. B.Hy., D.P.H. MEDICAL OFFICER OF HEALTH THE ROYAL BOROUGH OF KENSINGTON Telephone: Western 3175 Public Health Department, Hornton Street, Kensington, W.8. 1st June, 1959. 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 1958. The Minister of Health has again requested (Circular 22/58) 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 168,160s but for the purpose of this report, the population for 1958 has been estimated by the Registrar-General to be 165,700. The estimated population figure for the previous year was 167,900. Birth Rate. The number of births per 1,000 population of the borough was 18.0 in 1958, which compares with the figure of 16.5 for the previous year. Death Rate. The number of deaths per 1,000 population was 10.1, 0.5 lower than the death rate for the previous year (l0.4). 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). 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, so 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 populations and the Registrar-General has supplied, for use in Kensington for 1958, the figures of 0.72 for births and 1.01 for deaths. The crude - 2 - 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 1958 s- Kensington adjusted London England and Wales No. of births per l,000 population 13.0 16.7 16.4 No. of deaths per l,000 population 10.1 11.8 11.7 Infant Death Rate. This rate for 1958 was 22.7, a decrease from the rate for the previous year of 5.5. The rate for the County of London was 22.6 and for England and Wales was 22.5. The following table shows the rates for the last five years:- Year Kensington London England & Wales 1958 22.7 22.6 22.5 1957 28.2 22.0 23.0 1956 21.l 21.0 23.8 1955 31.4 23.3 24.9 1954 22.5 21.0 25.5 It will be seen that the infant death rate for Kensington showed a marked decrease compared with last year's rate. A similar decrease occurred in 1956. Variations in the infant mortality rate are often caused by perinatal mortality, i.e. deaths in the first week of life, prematurity (see table below) and the statistical difficulties arising from the small numbers involved. Just over two deaths suffice to increase the rate by one. Number of deaths of babies under one week of age Age in days at death Year 1 or under 2 3 4 5 6 Total Total deaths due to prematurity 1955 41 3 3 1 2 1 51 32 1956 24 4 4 2 4 - 38 21 1957 37 5 7 2 1 - 52 35 1958 37 5 3 2 2 1 50 29 Maternal Death Rate. One death of a mother due to childbirth was recorded in 1958, giving a maternal death rate per 1,000 live and still births of 0.33. The maternal mortality rate for the County of London was 0.60 and for England and Wales the figure was 0.43.) Infectioue Diseases. There was no serious outbreak of infectious disease in the borough during 1958° The total number of notifications received was 1,400 in comparison with 1,781 in the previous year. The decrease was almost entirely due to the fewer number of cases of measles notified -654 in 1958 compared with 982 in 1957. No case of diphtheria was notified in 1958. This is the second consecutive year giving a nil returns; one case being notified in 1956. Only ten cases of diphtheria have been notified in Kensington in the last ten years, in four of which there was a "nil" return. In the previous ten years (1939-48), 494 cases of diphtheria were notified, the highest number in one year being 102. Tuberculosis. The death rate from all forms of tuberculosis per 100,000 population was 606 which is the lowest ever recorded in the - 3 - borough. The 1958 Kensington death rate compares with the rate (provisional) of 10.0 for England and Wales. Lung Disease. Kensington's death rate from pulmonary tuberculosis per 100,000 population decreased in 1958 compared with the previous year and the death rate for cancer of the lung also showed an appreciable decrease. 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 in the following table, show the trend in these diseases since the end of the war. England and Wales Kensington Year Pulmonary Tuberculos is 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 1957 4,250 9.5 19,118 42.6 13 7.7 90 53.6 1958 4,000 8.9 19,809 43.9 10 6.0 79 47.7 (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 a number of years, with the exception of 1957, when a marked increase was recorded, and 1958, when the rate dropped nearly six per 100,000 population. Housing. The emphasis in regard to housing during the year was concentrated on the execution of the slum clearance programme, which the Council, jointly with the London County Council, had prepared in 1955/56. This programme scheduled the clearance of 630 premises and the Minister of Housing and Local Government had fixed ten years as the period for securing the demolition of the houses- Of the total of 630 premises, the County Council assumed responsibility for the clearance of 66 of these in the Fenelon Place/Warwick Road area. They have acquired the premises and discussions are taking place with this Council in regard to the future redevelopment of the area. Action in regard to the other 564 houses is being taken by the Borough Council. The majority are situated in the Kensal New Town area, which consists of 516 premises. A redevelopment plan was made in respect of this area, dividing it into three phases for the purposes of demolition and rebuilding. - 4 - The work in dealing with Phase 1, which consists of acres, proceeded satisfactorily during 1958. Five Compulsory Purchase Orders under the Housing Act, 1957, made by the Council, have been confirmed by the Minister of Housing and Local Government, subject to minor modifications. Demolition of a number of the houses has already taken place and rebuilding of the first stage, which consists of two 14-storey blocks (each containing 78 flats) and two 4-storey blocks (containing maisonettes and flats) has been put in hand. The new accommodation which is now under development in this first Phase consists of:- 20 four-room maisonettes 4 four-room flats 68 three-room flats 52 two-room flats 52 bed-sitting room flats In addition to the work in the Kensal New Town area, the Council, during 1958, declared 15 premises in Portland Road to be a Clearance Area. A Compulsory Purchase Order was made in respect of 5 premises (the remaining 10 premises were already in the Council's ownership). The Order has been confirmed and plans are being prepared for the demolition of the properties and the erection of garages on the site. Clean Air Act. This Act came into operation fully on 1st June, 1958. Perhaps its most important provision is that which enables local authorities to declare the whole or any part of their district to be a Smoke Control Area, in which the emission of smoke from any building (not otherwise exempted) is an offence. The Council lost no time in beginning to implement these new provisions and a survey was made of the Holland Ward of the Borough with the object of making a Smoke Control Area. Careful consideration was given to the information obtained from the survey and as a first step the Council decided to make a Smoke Control Area of the central portion of the Holland Ward consisting of 1,400 premises. The Order was made and subsequently confirmed by the Minister of Housing and Local Government. No objections from any householder or other interested parties were received and it is anticipated that there will be little difficulty in enforcing the Order, when it comes into operation on 1st October, 1959° Proposals to make the remaining portions of the Holland Ward Smoke Control Areas were submitted to the Minister of Housing and Local Government who has given his preliminary approval. At the present time, a detailed survey to estimate the full requirements and financial costs is being made. It is hoped that by 1960 the whole of the Holland Ward will be a Smoke Control Area. A programme to make the whole of Kensington a Smoke Control Area within the next fifteen years is under consideration. Food Hygiene. The work of enforcing the requirements of the Food Hygiene Regulations was continued throughout the year. There is no doubt that both the food traders and the general public are becoming more and more conscious of the need of maintaining a higher hygienic standard in connection with the storage, preparation and sale of food. The general willingness of most people to co-operate in the task of ensuring clean food becomes more evident as time goes on. Unfortunately, the need for periodical inspections is still an urgent one, as is indicated by the number of informal notices served by the Public Health Inspectors (32 in 1958) for various contraventions of the Hygiene Regulations and the occasional Court proceedings against wilful offenders. General. The work of dealing with slum clearance, the repair of houses, food hygiene in shops, Clean Air Act and Smoke Control Areas, is placing a heavy burden on the staff of the Department, especially the 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 health departments. - 5 - To overcome this, the Council have agreed to permit the existing inspectors to use their own cars on official work on a "casual-user" basis. The Council have a scheme for training students as public health inspectors, and two men work in the department. They are giving increasingly valuable assistance to the inspectorial staff, whilst undergoing training. The Minister of Health has stated that the best training is obtained by those students who are engaged by local authorities 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. Women's Voluntary Services. It is appropriate that in this, the year in which the Service comes of age, a special tribute should be paid to the work in connection with old people's welfare so ably carried out by the local branch, under their indefatigable Centre Organiser, Mrs. Bertha Hastings, O.B.E. Possibly their greatest service to the old people is in connection with the distribution of meals on wheels. During the year 1958/59, they undertook the delivery of 51,002 meals and, in addition to this, they undertook the service of meals at five luncheon clubs. Their activities also include the operation of the only old people's club in daily session in Kensington. They also undertake the distribution of library books, visiting old people, acting as escorts, and operating a much appreciated clothing store. In the words of an appreciation appearing in "The Times", "Help - in every walk of life-is the key word of the organisation One of the most remarkable voluntary forces in all history." This is a magnificent Service whose "organisers promise a million women for a National emergency although they declare that they have not the slightest idea of their current membership as they do not keep any register of members nor do they ask for subscriptions. Workers, however, have to hold a permit in order to be able to wear the famous green uniform for which they themselves pay." I am indeed happy to have this opportunity of joining the National praise of this "organised, hard working, motherliness on the grand scale" and in particular to pay a personal tribute to the local work so efficiently organised by Mrs. Hastings over the past seventeen years. VITAL STATISTICS The table set out on the next two pages gives the important vital statistics for 1958, together with comparative figures for the previous seven years. - 6 - - 7 - SUMMARY OF VITAL STATISTICS FOR KENSINGTON Description 1958 1957 1956 1955 1954 1953 1952 1951 POPULATION Population (estimated) 165,700 167,900 168,800 169,400 170,600 171,500 172,800 171,300 Density of population per acre 72 73 74 74 74 74 75 74 LIVE BIRTHS Total births 2,990 2,765 2,792 2,674 2,707 2,642 2,810 2,656 Legitimate births 2,549 2,404 2,422 2,361 2,399 2,321 2,508 2,390 Illegitimate births 441 361 370 313 308 321 302 266 Birth rate per 1,000 population 18.0 16.5 16.5 15.8 15.9 15.4 16.3 15.5 STILL BIRTHS Total still births 49 50 51 40 48 53 48 60 Legitimate still births 37 42 43 31 40 47 37 55 Illegitimate still births 12 8 8 9 8 6 11 5 Still birth rate per 1,000 total births 16.1 17.8 17.9 14.7 17.4 19.7 16.8 22.1 DEATHS Total deaths 1,659 1,750 1,772 1,744 1,643 1,708 1,936 1,920 Death rate per 1,000 population 10.01 10.4 10.5 10.3 9.63 9.96 11.2 11.2 DEATHS OF INFANTS UNDER 12 MONTHS OF AGE Total infant deaths 68 78 59 84 61 50 75 65 Legitimate deaths 58 58 50 66 54 42 67 55 Illegitimate deaths 10 20 9 18 7 8 8 10 Infant death rate per 1,000 births 22.7 28.2 21.1 31.4 22.5 19.7 27 24 Death rate of legitimate infants per 1,000 legitimate births 22.8 24.1 20.6 27.9 22.5 18 27 23 Death rate of illegitimate infants per 1,000 illegitimate births 22.7 55.4 24.3 57.5 22.7 25 26 38 MATERNAL DEATHS Deaths of mothers as a result of pregnancy or childbirth 1 1 5 1 2 Nil 5 3 Death rate of mothers per 1,000 live and still births 0.33 0.36 1.76 0.37 0.72 Nil 1.75 1.1 TUBERCULOSIS Death rate from all forms per 100,000 population 6.6 10.1 11.8 10.0 14.0 19.2 18.5 21 Death rate from respiratory tuberculosis per 100,000 population 6.0 7.7 11.2 7.1 11.7 15.1 16.8 17.5 Death rate from non-respiratory tuberculosis per 100,000 population 0.6 2.4 0.6 2.9 2.3 4.1 1.7 3.5 - 9 - CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE IN 1958 Cause of death All ages Under 1 Year 1 year and under 5 5 years and under 45 45 years and over Respiratory tuberculosis 10 - - 2 8 Other forms of tuberculosis 1 - - 1 - Syphilis 5 - - - 5 Diphtheria 1 - - 1 - Whooping Cough - - - - - Meningococcal infections - - - - - Acute poliomyelitis - - - - - Measles - - - - - Other infective diseases, etc., 4 - - 1 3 Cancer (all forms) 332 - - 25 307 Leukaemia, aleukaemia 5 - - 1 4 Diabetes 14 - - 1 13 Vascular lesions of nervous system 190 - - 2 188 Coronary disease, angina 259 - - 10 249 Hypertension with heart disease 30 - - 2 28 Other heart disease 169 - - 6 163 Other diseases of circulatory system 118 - - 2 116 Influenza 10 - - - 10 Pneumonia 84 10 - 3 71 Bronchitis 97 - 1 2 94 Other respiratory diseases 18 1 - 2 15 Ulcers of the stomach 25 - - 2 23 Gastritis, enteritis and diarrhoea 10 - - - 10 Nephritis and nephrosis 11 2 9 Hyperplasia of prostate 6 - - - 6 Pregnancy, childbirth and abortion 1 - - 1 - Congenital malformations 14 10 - 1 3 All other diseases 136 47 - 9 80 Motor vehicle accidents 23 - - 10 13 All other accidents 53 - 4 20 29 Suicide 31 - - 16 15 Homicide and operations of war 2 - - 1 1 TOTALS 1,659 68 5 123 1,463 - 10 - GENERAL PROVISION OF HEALTH SERVICES IN THE AREA Bacteriological and Analytical Work The following is a summary of the work performed during 1958:- Nature of specimen or sample Number examined Nose and throat swabs 247 Faeces and rectal swabs 884 Milk (bacteriological) 117 Water (drinking) 11 Water (swimming baths) 17 Ice Cream 11 Miscellaneous 14 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 1958 is as follows:- Description Scabies Vermin Impetigo Other conditions Persons Cleans -ings Persons Cleans -ings Persons Cleans -ings Persons Cleans -ings Adults Kensington 84 160 80 82 - - 1 1 Other boroughs 3 5 39 39 - - - - Schoolchildren Kensington 28 94 651 651 - - 16 57 Other boroughs 4 13 230 230 - - - - Children under 5 Kensington 25 43 29 29 - - - - Other boroughs - - 2 2 - - - - Compulsory cleansings - - 60 60 - - - - TOTALS 144 315 1,091 1,093 - - 17 58 In addition to the cleansing of persons referred to above, articles of personal clothing disinfested at the Medicinal Baths during the year numbered 888. - 11 - Disinfection and Disinfestation A summary of the routine work of the disinfecting staff is shown in the following table Houses disinfected after infectious disease 200 ( 293 rooms) Houses disinfested after vermin 547 (1484 rooms) Loads of furniture treated with hydrogen cyanide 16 Total weight of furniture, bedding, etc. dealt with s- 24 tons 13 cwt. 2 qtr. 3 lb. It is the practice of certain foreign countries to prohibit the import of parcels of clothing, unless accompanied with a certificate that the articles have been disinfected. The Council afford facilities to persons desirous of sending clothing abroad, but make a charge of 2/6d. for each certificate provided. During the year, 135 parcels of clothing were disinfected and the income amounted to £16. 17s. 6d. The following table indicates the destination of these parcels s- No. of parcels Czechoslovakia 88 Spain 23 Bulgaria 6 Hungary 6 Rumania 5 Russia 5 Argentine 1 Italy 1 TOTAL 135 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, thirteen such certificates were issued, H.C.N. (hydrogen cyanide) Disinfestation In 1933, the Council adopted a policy of disinfesting with H.C.N. the furniture and household effects of all tenants moving into new Council property, as a method of preventing bed bugs being taken from old houses into the new dwellings. With the manufacture and sale for general use of effective insecticides, such as D.D.T., there has been a considerable reduction in the number of infested houses in the borough and, therefore, in 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. A scheme was substituted under which the Council's Chief Housing Officer notifies the Medical Officer of Health, in advance, of the names and addresses of prospective tenants, and inspections of the furniture and effects at the old homes are made by a public health inspector. If infestation is found, the contents of the home are collected by the Council's staff, disinfested at Wood Lane with H.C.N., and then taken to the new house or flat. If no infestation is found, the prospective tenant is allowed to move in directly to the new flat or house. In all cases, the walls and ducts of the new flats or houses are treated with Gammexane smoke generators (B.H.C.) as a preventive measure. During 1958, one hundred and seventy new flats, which became ready for occupation, were treated with Gammexane smoke generators before being occupied. The furniture, etc. of the families selected to move into these flats were inspected. With nine exceptions every case was found to be free from vermin and the tenants were allowed to move directly into their new homes. In the nine infested cases, the furniture was - 12 - 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 cases, the furniture of three 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, 1959, and the following table gives the details for this period:- - 13 - 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 31 39,021 11,040 50,092 II. Number of properties inspected by the Local Authority during twelve months ended 31/3/59 as a result (a) of notification (b) survey or (c) otherwise (a) 7 844 88 939 (b) 1 114 14 129 (c) - - - - III. Total inspections carried out, including re-inspections 47 6,862 690 7,599 IV, Number of properties (under II) found to be infested Major - - - - by rats Minor 6 315 47 368 V. Number of properties (under II) found to be infested Major - - - - by mice Minor 2 500 41 543 VI. Number of infested properties (under IV and V) treated by the Local Authority 8 815 88 911 VII. Total treatments carried out 11 1,033 109 1,153 VIII. Number of notices served under Section 4:(l) Treatment - - - - (2) Structural Works (i.e.Proofing) - 2 - 2 IX. Number of cases in which default action was taken by Local Authority following issue of notice under Section 4 1- - - - - X. Legal Proceedings - - - - XI. Number of "block" control schemes carried out - - - - - 14 - For a number of years, all the sewers in the borough have been treated with poison bait, to destroy rats, twice yearly. This work had, up to 1957, been carried out in January and June each year, coinciding with similar treatments carried out in neighbouring boroughs. The Ministry of Agriculture, Fisheries and Food recommended in 1957 that a new system of treatment should be introduced, which involved changing the times of baiting to April and September each year, allowing a longer period of time during which baits were left in the sewers, and mixing a mould inhibitor (paranitrophenol) with the baiting material to act as a preservative. The following table shows the results obtained during the year, compared with the results obtained in the previous six years:- Year Estimated number of rats killed First treatment Second treatment 1952 5,982 4,155 1955 5,458 4,512 1954 4,142 4,667 1955 4,515 5,450 1956 4,764 4,158 1957 4,476 (January) 7,751 (April) 7,044 (September) 1958 4,945 6,617 The rodent staff deal with infestations from pests other than rats and mice, and the following is a summary of all action taken during the year:- Complaints investigated 1,160 Premises inspected following complaints 1,199 Premises where rats were found 351 Premises where mice were found 515 Premises where other vermin were found 129 Premises where no infestation existed 204 Number of visits made 7,173 Number of notices served 20 Premises successfully treated 1,019 Cases in which advice only was given 39 Borough Council properties dealt with 33 Pharmacy and Poisons Act, 1933 At the end of the year the number of sellers of Part II Poisons (other than registered pharmacists) on the list maintained by the Council was one hundred and twenty-seven. Of this number, fifteen were new registrations during the year. Rag Flock and Other Filling Materials Act, 1951 This Act regulates the use of clean filling materials in upholstered articles and other articles which are stuffed or lined. 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. 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 - 15 - 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). Inspections of the registered premises were made during the year and ten samples of rag flock and other fillings were taken for analysis. The results were satisfactory, with the exception of a sample of woollen mixture felt. This was found to contain 47 parts of chlorine per 100,000, whereas the permitted maximum is 30. Appropriate warnings were given in this case. Description No. of samples taken Algerian fibre 1 Coir fibre 1 Cotton felt 3 Hair 2 Sisal pad 1 Woollen mixture felt 2 Pet Animals Act, 1951 This Act requires that no person shall keep a pet shop except under the authority of a licence issued by the Council and in compliance with any conditions specified in the licence. During the year, nine premises were licensed under the Act. The general conditions for pet shops approved by the Council are those recommended for their constituent councils by the Metropolitan Boroughs' Standing Joint Committee. Health Education Health education is an important activity of both Central and Local Authorities and forms an integral part of the National Health Service. For many years the Council have made an annual grant of fifteen guineas to the Central Council for Health Education, which is the body recognised by the Minister 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. The Council continued to purchase copies of "Better Health" (the monthly journal of the Central Council for Health Education) for free distribution to members of the public. Posters, booklets and leaflets, dealing with health matters, were sent to all youth clubs, old people's clubs, voluntary organisations, large business houses, etc., in the borough during the year, for the information of their members or staffs. In this way a wide section of the general public can be reached easily and quickly. Bookmarks are a most valuable form of health propaganda; once having been taken from the library counter and placed in a book, the marker is constantly before the reader on each occasion the volume is - 16 - opened. Once again the Borough Librarian and his staff readily co-operated with the Public Health Department, and many thousands of bookmarks were distributed to members of the public using the Council's libraries. Posters dealing with a variety of health topics were displayed at regular intervals during the year on the ex-Empire Marketing Board poster frames in the borough. There now remain only nine of these frames in Kensington; they were presented to the Council over thirty years ago. Having regard to their age and condition, the Public Health Committee have decided to replace them with smaller poster boards of modern design, capable of displaying four double-crown posters (20" x 30"). This work is to commence in 1959 and the boards will be replaced at the rate of three per year. Home Safety The London County Council (General Powers) Act, 1957, enables a Metropolitan Borough Council to make arrangements for the dissemination of information and advice for the purpose of promoting safety in the home. Good use was made of this new power during the year 1958 and an intensive home safety propaganda campaign was introduced in an endeavour to make the public aware of the dangers which exist in every home. Early in 1958, Circular No. 6/50 was received from the Minister of Health, expressing concern at the number of casualties arising from accidents in the home, and stating that the Government proposed to initiate a National Campaign aimed at reducing the number of home accidents caused by clothing coming in contact with unguarded fires. This Campaign commenced on 3rd November, 1958, when the Home Secretary, the Rt. Hon. R.A. Butler, C.H. , M.P., opened an exhibition arranged by the London County Council at County Hall in support of the Campaign, National newspapers and periodicals, the television companies and large firms, notably insurance companies, co-operated in many ways. The Public Health Committee decided to augment the National Campaign by a local campaign in Kensington during December, 1958. Posters and leaflets were distributed to approximately one hundred organisations in the borough-youth clubs, old people's clubs, large business houses, industrial concerns, voluntary organisations, hospitals, etc. Poster displays were arranged at Council offices and other buildings. Leaflets were available to members of the public visiting the Council's offices, and bookmarks were issued through the Borough libraries. The local newspapers, Electricity Board and Gas Board, readily co-operated with the Council, and special displays of posters were arranged at the Boards' showrooms. Arrangements were made with the local cinemas to show special film trailers and slides dealing with home safety during the campaign periodo There are many leaflets available dealing with accident prevention, but it was felt that no composite leaflet had been produced by any organisation outlining the action which should be taken in the event of an accident occurring. A special leaflet was devised by the Public Health Department, entitled "The Household Code". Five thousand copies were widely distributed as part of the local home safety campaign. The leaflets aroused a great deal of interest and comments appeared in several national newspapers, and local newspapers throughout the country, and in several women's magazines and other periodicals. This publicity created considerable demand and the initial printing was soon exhausted. A further five thousand copies were produced and distributed early in 1959. Leaflets were obtained from the Ministry of Health and the - 17 - Central Office of Information, without charge. The London County Council also provided posters, leaflets and bookmarks free of charge, for distribution throughout Kensington. The following table shows the large amount of publicity material which was obtained from various sources and distributed in Kensington Posters (20" x 30") 168 Leaflets 11,500 Bookmarks 23,000 Special window labels 200 Correspondence labels (used by Borough Council Departments) 9,000 Mass Radiography Mass radiography is undertaken on behalf of the Minister of Health by the Regional Hospital Boards. Kensington is included in the area covered by the Mass X-ray Unit No. 5A operated by the Northwest 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 a period of approximately two months. A total of 12,086 persons (5,920 men and 6,166 women) was examined. Consequently, during 1958, the Mass X-ray Unit No. 5A was engaged mainly in other districts; nevertheless, three small surveys were carried out, in which 886 persons (612 men and 274 women) were mass x-rayed in Kensington. No active case of tuberculosis was found. Atmospheric Pollution Clean Air Act. 1956. Certain provisions of the Clean Air Act, 1956, which received Royal Assent on 5th July, 1956, came into force on 31st December, 1956, and the remaining provisions came into operation on 1st June, 1958. Sections 11 to 15 relate to the declaration by the Council of smoke control areas, in which the emission of smoke from the chimney of any building would be an offence. In order to obtain the information needed to assess the full implications of these sections, a preliminary survey was made of the Holland Ward of the borough. The survey, which was carried out by one of the Council's public health inspectors, assisted by two student inspectors, was commenced in July, 1957, and completed in February, 1958. After consideration of the information obtained, the Council decided to submit preliminary proposals to the Minister of Housing and Local Government in respect of a specified area of the Holland Ward, asking for his approval to proceed with making an official declaration. The Minister has given his preliminary approval, and subsequently at their meeting on 10th November, 1958, the Council made a Smoke Control Order in respect of an area in the central part of the Holland Ward of the borough; bounded by Kensington High Street in the south, Campden Hill Road in the east, Holland Park Avenue in the north, and Abbotsbury Road in the west. The area, which comprises 162 acres, includes Holland Park, together with 1,302 dwellings, 75 commercial and industrial premises, - 18 - and 23 other premises, which include religious and educational establishments and embassies. KENSINGTON HOLLAND WARD (No.1) SMOKE CONTROL AREA The Area is bounded on the north by the centres of Holland Park Avenue and Notting Hill Gate, on the east by the centre of Campden Hill Road, on the south by the centre of Kensington High Street, and on the west by the centres of Abbotsbury Road and the eastern end of Melbury Road. The conversion or adaptation of a little over 400 grates will be necessary, at an estimated cost of about £7,500. Of this amount, the Council will contribute three-tenths, and the Government four-tenths. The Order has been confirmed by the Minister of Housing and Local Government, and will come into operation on 1st October, 1959. The Council have also agreed in principle to establish two more smoke control areas in the Holland Ward which would result in the whole of the ward being covered by the smoke control area provisions of the Act. Preliminary approvals have been received from the Minister of Housing and Local Government and the detailed survey of both areas is in progress at the present time. Section 3 requires that new furnaces, not used mainly for domestic purposes and exceeding a specified capacity, shall be so far as is practicable smokeless. Any person installing such a furnace must give prior notice to the Council and may submit detailed plans and specifications for approval before the work of installation takes place. During 1958 ten notifications were received, but there - 19 - were no applications for approval. Smoke emissions. The Sections of the Clean Air Act, 1956, which relate to industrial smoke came into force on 1st June, 1958. Up to that date emissions of industrial smoke were dealt with under the provisions of the Public Health (London) Act, 1936. The provisions mainly affecting the Council are contained in Section 1, which prohibits the emission of dark smoke (except for certain periods laid down by regulation) and Section 16 which deals with smoke nuisances. One offence was observed under the provisions of Section 1 of the Clean Air Act, 1956. Informal notice was given to the offenders, and immediate steps to rectify the offence were taken. Observations in this case are still being carried out. During the year twenty complaints of smoke nuisance were received, and forty-eight formal smoke observations were carried out. Remedial measures by informal action were secured in all cases. Routine measurement of atmospheric pollution The Council maintain two atmospheric pollution measuring stations as follows (1) North Kensington (St. Joseph's Convent, Portobello Road) (2) South Kensington (Messrs. John Barker's Furniture Depository Pembroke Road) The apparatus at each station consists of a standard deposit gauge for collecting soluble and insoluble deposits and a lead peroxide apparatus for measuring the sulphur content of the air. Readings are taken at each station at the end of each month. In addition to the above mentioned stations, the Council have established three smoke measuring stations as follows:- (1) Public Health Department, Hornton Street, W.8. (2) Public Library, Lad broke Grove, W.10. (3) L.C.C. Welfare Centre, Redcliffe Street, S.W.10. 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 and the welfare centre consists of smoke filters 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 1958:- - 20 - A. Deposit Gauge Month 1958 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 (Pertobello Road) January 29 2.02 7.68 9.33 17.01 .264 .321 .585 February 28 2.16 9.13 11.54 20.67 .326 .412 .738 March 33 1.19 7.99 13.93 21.92 .244 .422 .666 April 30 1.56 6.48 10.27 16.75 .216 .342 .558 May 32 2.71 7.01 9.83 16.84 .219 .307 .526 June 29 4.50 8.16 8.39 16.55 .281 .289 .570 July 30 1.76 5.13 7.48 12.61 .171 .249 .420 August 32 3.29 6.75 6.88 13.63 .211 .215 .426 September 30 3.99 7.22 8.79 16.01 .241 .293 .534 October 29 2.15 5.50 3.96 9.46 .190 .137 .327 November 32 2.17 7.32 8.79 16.11 .229 .275 .504 December 31 2.99 8.29 11.24 19.53 .261 .363 .624 TOTALS 365 30.49 86.66 110.43 197.09 South Kensington (Pembroke Road) January 29 1.73 7.89 9.06 16.95 .272 .312 .584 February 28 2.12 9.06 10.64 19.70 .324 .380 .704 March 33 1.22 8.66 13.32 21.98 .263 .403 .666 April 30 1.33 6.07 7.22 13.29 .202 .241 .443 May 32 2.60 6.11 7.85 13.96 .191 .245 .436 June 29 4.28 7.75 7.42 15.17 .267 .255 .522 July 30 1.32 4.36 6.38 10.74 .145 .213 .358 August 32 3.61 6.71 6.01 12.72 .209 .188 .397 September 30 3.62 7.01 8.59 15.60 .224 .286 .520 October 29 1.84 5.10 3.66 8.76 .176 .126 .302 November 32 2.03 6.44 6.34 12.78 .201 .198 .399 December 31 2.73 7.85 11.34 19.19 .253 .365 .618 TOTALS 365 28.43 83.01 97-83 180.84 B. Estimation of atmospheric sulphur Milligrams of sulphur trioxide per day Month 1958 Days exposed North Kensington South Kensington January 29 3.44 4.38 February 28 3.24 3.74 March 33 3.65 3.83 April 30 2.31 2.50 May 32 1.19 1.34 June 29 1.36 1.57 July 30 1.09 1.34 August 32 0.89 1.24 September 30 1.80 2.03 October 29 2.21 2.48 November 32 3.61 3.90 December 31 3.50 3.95 Average for years 2.36 2.69 - 21 - C. Readings from the two monthly stations in Kensington have now extended over five 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 1957 365 200.11 172.99 2.25 2.42 1958 365 197.09 18O.84 2.36 2.69 D. Measurement of smoke and sulphur by the volumetric method 1958 Volumetric smoke Concentration of smoke in milligrams per cubic metre Average daily values at :- Volumetric sulphur Concentration of sulphur in parts per million volumes of air Average daily values at:- Public Health Department No Kensington Public Library South Kensington Welfare Centre Public Health Department January .196 .343 .252 13.3 February .133 .258 .194 10.8 March .108 .232 .204 12.3 April .091 .202 .l34 7.7 May .O65 .181 .l29 4.5 June .059 .172 .122 5.5 July .051 .146 - 4.4 August .062 - .094 3.7 September .091 - .097 6.1 October .102 - .142 7.3 November .195 - .258 17.4 December .185 - .335 14.6 Note: July, South Kensington Welfare Centre - break down of electric motor. August-December, Public Library interruption due to rebuilding operations. General observations The figures obtained in 1958 indicated that the atmospheric pollution recorded throughout the year was very similar to the results of preceding years. A slight increase is shown in the sulphur readings but this is probably due to no more than a variation in atmospheric conditions. Deposited matter continued to be greater in North Kensington than in South Kensington. The South Kensington sulphur content of the air has continued higher than the sulphur content in North Kensington. The Public Health Department have continued to co-operate with the Department of Scientific and Industrial Research throughout the year and special action was taken in respect of periods when persistent fog was announced. The results obtained from the daily apparatus during these periods were immediately forwarded to the Fuel Research Station for correlation with other results obtained elsewhere in the London area. - 22 - Burial of the Dead Section 50 of the National Assistance Act, 1948, imposes on the Council the duty to arrange for the burial or cremation of any person who dies, or is found dead, within the borough, where no suitable private arrangements are made for the disposed 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, 1958, the Council became responsible for the burial of thirty persons dying in the borough. The following is a summary of the action taken:- (a) Cases where the funeral expenses have been fully recovered 11 (b) Cases where part only of the expenses has been recovered 11 (i) Number of these where balance of expenses will be recovered 4 (amounting to £21.14s.6d) (ii) Number of these where there was no further estate or "liable" relative 6 (iii) Number of these where "liable" relatives were unable to contribute 1 (c) Cases where full cost has been borne by the Council 8 (i) Number of these where balance of expenses will be recovered 1 (amounting to £13. l5s. 0d.) (ii) Number of these where there was no estate or "liable" relative 2 (iii) Number of these where "liable" relatives were unable to contribute 5 Amount recovered by the end of the year £171. 7s. 9d. Additional amount expected to be recovered 35. 9s. 6d. £206. 17s. 3d. Irrecoverable 122. 7s. 9d. Total COSt £329. 5s. 0d. Of the thirty cases dealt with, eleven were eligible for Death Grant from the Ministry of Pensions and National Insurance. The total amount recovered from this source amounted to £122. 15s. 0d. (included in the above figures.) Since the National Assistance Act came into force on the 5th July, 1949, the Council have arranged for the burial of four hundred and three persons under Section 50. Public Mortuary For many years, the Council have maintained a public mortuary at No. 1A, Hornton Place, W.8. From 15th April, 1958, the Coroner decided that all bodies of persons dying within Kensington coming under his jurisdiction should be taken to the Hammersmith Mortuary, which - 23 - adjoins the West London Coroner's Court. Consequently, the Council decided to close their premises and made an arrangement with the Hammersmith Borough Council that all Kensington cases should be accommodated in the Hammersmith Mortuary. The agreement provides that an annual payment of £500 shall be made for this service. Prom the beginning of the year until 15th April, one hundred and thirty-seven bodies were admitted to the Kensington Mortuary; postmortem examinations were made in ninety-eight cases, and in twenty-two of these the Coroner held inquests. Borough Cremation Service The Council have an arrangement with the General Cemetery Company who own the Kensal Green Crematorium at the north-west corner of the borough, whereby a reduced charge of five guineas is made for the cremation of Kensington residents, subject to certain financial conditions. In 1958, there were two hundred and sixty-three Kensington cremations, in comparison with two hundred and eighty-three in 1957 and two hundred and fifty-five in 1956. These figures compare with only sixty Kensington cremations in 1948, (prior to the arrangement coming into effect.) Medical Examinations of Staff The Medical Officer of Health undertakes all medical examinations of staff for the purposes of the Borough Council's Superannuation Scheme. During the year one hundred and fifty-four 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 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 four summonses were issued under this byelaw. Convictions were obtained and fines totalling £2. 0s. Od. with £1. 16s. 6d. costs were imposed. - 24 - 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-erdinating non-executive Committee through which voluntary bodies claim assistance from the Council and through which the Council pass requests for executive action. Advice Leaflets The Council arrange for the distribution of copies 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.OoS" 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 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) The St. Luke's Darby and Joan Club were granted £7 for the purchase of equipment. (c) The Kensington Council of Social Service were granted £120 for chiropody treatment of old persons confined to their homes. (d) The Home from Home Club, Royal Palace Hotel, were .granted £42. 14s. 6d. towards their general running expenses. Holidays The Council have a scheme of arranging holidays for old people under which the Family Welfare Association co-operate. An elderly person must apply for a holiday to the Medical Officer of Health, who investigates the applicant's circumstances. If the application is approved, it is referred to the Family Welfare Association, who make all the arrangements for the holiday, the net cost being borne by the Council. Bookings were made at two holiday resorts, Southsea and - 25 - Ramsgate. Private coaches were hired, to take the old people to and from these towns, 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 1958:- Total applications received 121 Unsuitable on medical grounds 6 Consideration deferred 32 Referred to other organisations 3 Subsequently withdrawn 6 47 Number approved 74 Cancellations after approval 7 Number sent on holiday 61 Number sent to Lennox House, Southsea 42 Number sent to Ramsgate 25 Cost of holidays: Board and lodging fees and fares £650. 14s. 9d. Booking fees paid to Family Welfare Association 14. 15s. 0d. £645. 9s. 9d. Less contributions by applicants 81. 15s. 0d. Actual cost to the Council £563. 16s. 9d. In each case the holiday was for a period of two weeks and many letters of appreciation have been received from the old people concerned5 all those participating expressed their utmost satisfaction when seen by the Woman Health Officer on their return. Domiciliary Cleansing Arrangements have been made whereby old people's living accommodation and household articles are cleansed and, if necessary, disinfested. Nine old people were dealt with in 1958. Institutional and Domiciliary Care of the Aged Sick 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 by the Minister of Health. The borough is situated in the area of two Metropolitan Regional Hospital Boards. One Hospital Management Committee in the northern portion of 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". Cases on the chronic sick waiting lists of St. Mary Abbots Hospital in the borough are referred to the public health department. They are visited and assessed by the Women Health Officers. 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. 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 - 26 - 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 by the Women Health Officers during the year totalled four hundred and twenty. During the year it was possible to arrange for one hundred and forty-seven old people to be admitted to hospitals for institutional treatment and, in addition, sixty-two cases were admitted to homes for the aged. Laundry At present no direct authority exists for the Council to provide a laundry services 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 seventy-eight cases action was taken under the Section. The bedding was marked, laundered at the Council's disinfecting station and returned to the old people. The scheme works smoothly and appears to fill a much felt want. Prom stocks of bedding held, the Council are able to supply linen and bedding on loan to old people while their own is being laundered, and where possible voluntary organisations are asked to undertake replacements of much worn articles. During the year one thousand separate collections of laundry were made under this scheme, and the number of articles cleansed totalled nine thousand, four hundred and three. Library Facilities The Libraries Committee co-operate in providing books for old people confined to their homes. The circulation of the books is effected by the Women's Voluntary Services mobile library. Chiropody During the year, the Council made a grant of £120 to the Kensington Council of Social Service for the purpose of enabling the provision of a chiropody service for house-bound old people. All patients are referred by the Medical Officer of Health to the Council of Social Service which administers the financial aspect of the scheme. The British Red Cross Society arrange the treatments, including providing the chiropodists and making the appointments. The total number of persons treated under the home chiropody scheme was two hundred and thirty-four and the number of treatments given was five hundred and ten. 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 the 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 - 27 - 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/ £ £ £ £ £ March, 1949 3,535 352 149 mm - 203 1949/50 10,461 1,016 432 27 - 557 1950/51 13,758 1,250 477 115 - 558 1951/52 18,370 1,634 625 445 - 564 1952/53 28,426 2,103 954 948 - 201 1953/54 39,196 3,459 1,317 1,306 200 636 1954/55 45,116 3,853 1,611 1,512 300 430 1955/56 45,933 4,204 1,926 1,531 300 447 1956/57 45,995 4,211 1,933 1,758 500 20 1957/58 49,334 5,054 2,064 2,056 500 434 1958/59 51,002 Not yet available It will be observed that the number of meals served continues to increase and for the year 1958/59 has reached a record total of 51,002. The net deficiencies of the scheme (after crediting subsidies from the London County Council and grants from the Kensington Council) have been met to date 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 was made to the Kensington Communal Services Committee for 1958/59. 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 1958:- - 28 - Cases on register at the beginning of year 5,008 New cases added to register 720 Cases removed to hospital 147 Cases removed to homes (voluntarily) 61 Cases removed to homes (compulsorily) 1 Cases removed from district 171 Number of deaths 289 Total number of cases remaining on register at end of year 5,059 Number of old people sent away for holiday 67 Number of old people provided with Council's laundry service 78 Number of old people provided with "Meals on Wheels" 248 Cases referred to National Assistance Board 224 Cases referred for assistance from Home Help Department 171 Cases referred for assistance from Voluntary Organisations 74 Cases referred to Recreational Clubs 230 Number of visits to chronic sick cases 420 Cases assisted with provision of medical and nursing care 151 Cases referred to home chiropody service 234 Cases where disinfestation was carried out 9 Number of initial home visits made 615 Number of re-visits 3,448 Number of other visits made in connection with old people, including visits to clubs 83 Number of interviews, enquiries, etc. on behalf of old people 1,999 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. Details of this case were as follows An old man, aged 83 years, without friends or relatives, was living alone in North Kensington in - 29 - extremely insanitary conditions. He was gravely ill and in need of medical and nursing care. Every effort was made to persuade him to enter hospital, but he refused. Application was made to a Justice of the Peace who granted an Order for the man's compulsory removal to hospital. The Order was enforced but unfortunately the man died on admission. Emergency admissions to Hospitals On 11th February, 1958, the Public Health Committee reported to the Council on the difficulties experienced in securing admission to hospitals of sick and aged persons compulsorily removed under the provisions of Section 47 of the National Assistance Act, 194S, as amended by the National Assistance (Amendment) Act, 1951. The Council decided to ask the Metropolitan Boroughs' Standing Joint Committee to make representations to the Ministry of Health for the establishment of a standardised and efficient procedure whereby these people could be admitted to hospital without difficulty or delay. The Standing Joint Committee had discussions with the North-West Metropolitan Regional Hospital Board and, as a result, the following arrangements have been made, which it is hoped will solve the problem (i) In every instance, a Medical Officer of Health contemplating action under the National Assistance (Amendment) Act, 1951, should first make contact with the geriatrician or his representative at the hospital serving his area and endeavour to secure his agreement to admit the case. (ii) In the event of the above proving unsuccessful, contact should be made with the Emergency Bed Service, at which the Medical Officer on duty would accept such a case as one to be admitted under the medical referee procedure. (iii) The above arrangements will continue until September, 1959, and then be subject to review. SANITAHY INSPECTION The following table shows a summary of the inspections, etc. carried out by the public health inspectors during the year s- - 30 - Public Health (London) Act, 1936 Houses inspected on complaint 2,347 Houses inspected after infectious disease 1,565 Re-inspections 8,777 Smoke observations 48 Other inspections 967 Housing Act, 1957 Initial inspections (including preparation or revision of house-to-house cards) 1,494 Re-inspections 1,208 Initial inspections for overcrowding 277 Re-inspections 381 Underground Living Rooms Initial inspections 307 Re-inspections 1,618 Drainage Applications 552 Plans submitted 292 House drains inspected 4,747 House drains tested 529 Clean Air Act, 1956 Premises inspected (Smokeless zone) 3,053 Factories Act, 1937 Premises inspected 480 Outworkers' premises inspected 60 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 1,418 Statutory notices 617 Final notices 152 Various Factories Acts 22 Report of waste water to the Metropolitan Water Board 19 Report of dangerous structures to the London County Council 56 Other notices 108 - 31 - The following is a summary of works completed under the supervision of the public health inspectors during the year:- House drains, reconstructed or repaired 364 House drains cleansed 112 Water closets, reconstructed or repaired 154 Water closets, new provided 305 Soil pipes, vent pipes, repaired etc 74 Soil pipes, vent pipes, new provided 160 Baths, new provided 292 Sinks, new provided 249 Lavatory basins, new provided 570 Bidets, new provided 10 Waste pipes, new provided 325 Cisterns, cleansed 8 Cisterns, covered 14 Taps fixed on rising main 8 Yards and areas paved, drained etc 12 Dustbins provided 156 Accumulations of filth, etc. removed 92 Roofs repaired 409 Houses provided with water above basement level 13 Dampness in dwellings remedied 553 Houses disinfected after infectious disease (including bedding, etc.) 200 Rooms in such houses, disinfected after infectious disease 293 Houses cleansed 13 Rooms in such houses 62 Verminous houses cleansed (including bedding, clothing, etc.) 547 Verminous rooms in such houses, cleansed 1,484 Other sanitary works executed 1,321 HOUSING Inspection of dwelling houses during the year (i) (a) Dwelling houses inspected for housing defects (under Public Health or Housing Act) 5,990 (b) Inspections made for the purpose 18,541 (ii) (a) Dwelling houses (including those under sub-head (i) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 1,494 (b) Inspections made for the purpose 2,702 (iii) Dwelling houses found not to be in all respects reasonably fit for human habitation 1,418 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 833 - 32 - Action under statutory powers during the year (a) Premises repaired after service of formal notice under the Public Health (London) Act:- (i) By owners 613 (ii) By local authority in default 4 (b) Action under Sections 9, 10 and 12 of the Housing Act, 1957 (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 1 (iii) Dwelling houses rendered fit by the Council in default of owners - (c) Action under Sections 16, 17 and 23 of the Housing Act, 1957:- (i) Dwelling houses in respect of which demolition orders were made 6 (ii) Dwelling houses demolished in pursuance of demolition orders 1 (iii) Dwelling houses in respect of which closing orders in lieu of demolition orders, were made 2 (iv) Dwelling houses in respect of which undertakings were accepted from owner to render premises fit for habitation (v) Dwelling houses rendered fit for habitation by owners and closing order determined 2 (d) Action under Section 18 of the Housing Act, 1957:- (i) Separate tenements or underground rooms in respect of which closing orders were made (31 premises (64 rooms (ii) Separate tenements or underground rooms in respect of which closing orders were determined, the tenements or rooms having been rendered fit (43 premises (80 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 (14 premises (20 rooms (iv) Separate tenements or underground rooms in respect of which the Council accepted undertakings from owners to render fit within specified time (4 premises (v) (9 rooms Undertakings cancelled (1 premises (4 rooms (e) Action under Section 42 of the Housing Act, 1957 Number of areas represented to Council for clearance 1 (l6 premises) - 33 - (f) Housing Act, 1957, Part IV - Overcrowding (i) Number of dwellings overcrowded at end of year No reliable estimate (ii) Number of new cases of overcrowding reported during the year 136 (554 units) (iii) Number of cases of overcrowding relieved during the year 239 (918½ 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. Certificates of Disrepair in relation to Dwelling Houses The Council's duty to issue certificates of disrepair in respect of dwelling houses, not reasonably suitable for occupation, subject to the Rent and Mortgage Interest Restrictions Acts, was governed by the Housing Repairs and Rents Act, 1954, until the 6th July, 19571 when the Rent Act, 1957, came into operation and laid down a new procedure. The following is a short summary of the new procedure:- The provisions allowing for the increase, within limits of the rents of houses remaining in control are coupled with machinery dealing with repairs (First Schedule). The standard of repair is to be such as will secure the remedying of defects which ought reasonably to be remedied having due regard to the age, character and locality of the dwelling. The first stage is the tenant must serve a notice on his landlord specifying the defects which he thinks should be remedied. The landlord has six weeks in which to do the work or give an undertaking that the work will be done. If he does neither of these things, the tenant may apply to the Council for a certificate of disrepair in relation to the defects specified in his notice to the landlord. When the Council have decided whether any, or all of these items justifies the issue of a certificate of disrepair they must notify the landlord and allow him three weeks to reconsider the giving of an undertaking. The Council have a discretion to refuse to accept such an undertaking (and to issue a certificate of disrepair) in certain circumstances. If no undertaking is given, and a certificate of disrepair is issued, the landlord may apply to the Council for cancellation of the certificate if he subsequently does the work. The Council must then ask the tenant if he objects to the cancellation. If he does not object within three weeks, the certificate must be cancelled. If he does object, it is for the Council to decide whether or not to cancel the certificate. For the tenant, the effect of the granting of a certificate, or of failure to carry out an undertaking within six months of the giving of it, is an abatement of the rent. There is provision for recovery of excess - 34 - rent by the tenant back to the date of application for the certificate, or the date of the undertaking if there has been no such application. A landlord can appeal to the county court against the decision of the Council to issue a certificate, and a tenant can appeal against their refusal to issue one. Similarly, if a landlord has applied to the Council for cancellation, on the ground that he has remedied the defects, he can appeal to the county court against their refusal to cancel; conversely, if the Council decide to cancel, in spite of the tenant's objection, the tenant can appeal to the county court. The following is a summary of the action taken under the Rent Act, 1957, during 1958:- PART I - Applications for Certificates of Disrepair Number of applications for certificates 125 Number of decisions not to issue certificates 3 Number of decisions to issue certificates - (a) in respect of some but not all defects 94 (b) in respect of all defects 28 Number of undertakings given by landlords 82 Number of undertakings refused by Council 2 Number of certificates issued 61 PART II - Applications for Cancellation of Certificates Applications by landlords to Council for cancellation of certificates 35 Objections by tenants to cancellation of certificates upheld 9 Certificates cancelled 26 Houses in Multiple Occupation, (including hostels) Under Sections 36 and 90 of the Housing Act, 1957, which apply to any house or part of a house "which is let in lodgings or occupied by members of more than one family", power is given to the Council to require adequate provision of the following services and amenities Natural lighting; Ventilation; Water supply; Drainage and sanitary conveniences; Facilities for storage, preparation and cooking of food, and for the disposal of waste watep; Sleeping room accommodation. Section 36 enables the Council to take action if in their opinion the premises are so defective in the matters set out above as not to be reasonably suitable for the number of persons or households in occupation. In such cases they may serve a notice on the person in control: (a) specifying the works required to render the premises reasonably suitable for occupation by those persons or households; (b) requiring the person in control, in default of executing these works within the prescribed period, to take such steps as are reasonably open to him (including, if necessary, the taking of legal proceedings) for securing a reduction in the number of persons accommodated or the number of households, or both, as specified in the notice. Thus, where a notice is served, a choice is given, either to carry out the specified works, or, alternatively, to reduce the intensity of occupation of the house, in which case possession of the house or parts of the house can be obtained by an owner notwithstanding the Rents Acts. - 55 - Under Section 90, 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. 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 Bousing Acts was recommenced, up to the end of the year:- Name of Area Date of Decl0aration No. of houses No. of persons displaced Elgin Mews 25. 4. 1950 28 86 Lionel Mews (Nos. 1 and 2.) 3.10. 1950 13 38 Lonsdale Mews (Nos. 1 and 2.) 2. 1. 1951 19 14 Munro Mews 2. 1. 1951 24 55 South End 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.ll. 1951 20 41 Portobello Road 13.ll. 1951 4 3 Kensal New Town (No. l) Area 11.12. 1956 34 309 Kensal New Town (No. 2) Area 14. 1. 1958 62 441 Kensal New Town (No. 5) Area 14. 1. 1958 15 146 Portland Road (No. l) Arda 11. 3. 1958 5 31 Portland Road (No. 2) Area 11. 3. 1958 10 71 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 Sow and Gardens, the owners carried out the necessary demolition works prior to the Minister's decision. - 36 - Programme for Slum Clearance A survey, made in Kensington in 1955 of 7,416 houses where conditions were known to be below standard, revealed that 3,293 houses were unfit for habitation. After consultation with the London County Council, proposals were submitted to the Minister of Housing and Local Government comprising the following areas thought to be suitable for clearance area procedure in the period 1956/60:- 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, 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 are being dealt with by the Borough Council, who decided that the most urgent was the Kensal New Town Area. The problem of overspill of population necessitates the decanting of persons at present living in the area while development on cleared sites proceeds. The redevelopment plan, as approved by the Council, proposes action in three phases. The London County Council approved in outline the first stage of the lay-out of the Kensal New Town Area and granted permission for the redevelopment for housing purposes of the area bounded by Hazlewood Crescent, Golborne Road, Southam Street, Adair Road, Appleford Road and Bosworth Road comprising in total approximately 6½ acres. On 11th December, 1956, the Council declared the first section of this area, comprising the following thirty-four houses, to be a clearance area:- Nos. 10 - 18 (even) and 18a, Adair Road Nos. 26 - 56 (even) Appleford Road No. 17, Bosworth Road Nos. 35 - 57 (odd) Golborne Gardens On 12th February, 1957, the Council made a Compulsory Purchase Order in respect of this area, excluding those premises which were in the Council's ownership but including the vacant site of No. 59, Golborne Gardens. The Minister confirmed the Order, but modified it by excluding two properties (No. 37, Golborne Gardens and No. 56, Appleford Road) from - 37 - the clearance area and including them as land which the Council are authorised to purchase compulsorily outside the clearance area. The Minister also directed that the Council should make payments in respect of No. 44, Appleford Road and the basement of No. 54, Appleford Road, on the ground that these properties had been well-maintained. The Order became operative on 23rd November, 1957. All the properties have been acquired and demolished by the Council. Compulsory Purchase Orders were made in respect of two additional sites within the Kensal New Town 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 two sites were submitted to the Minister, who confirmed them without modification. On 14th January, 1958, the Council declared the following sections of the Kensal New Town Area to be clearance areas Kensal New Town (No. 2) Area Nos. 9-15 (odd) and 17a, Adair Road Nos. 1-21 (odd) Appleford Road Nos. 2-24 (even) Appleford Road Nos. 1-33 (odd) Golborne Gardens Nos. 12-18 (even) and 22 - 34 (even) Golborne Road Nos. 74 - 84 (even) Southam Street Kensal New Town (No. 5) Area Nos. 20a and 20- 28 (even) Adair Road Nos. 22 - 38 (even) Golborne Gardens On 15th April, 1958, the Council made Compulsory Purchase Orders in respect of these areas; Nos. 10 and 20, Golborne Road were included in No. 2 Area as "grey" land, and 20a, Adair Road was excluded from No. 3 Area as it was already in the Council's ownership. Objections were received from certain owners and the Minister of Housing and Local Government held a Public Local Inquiry on 23rd September, 1958. The Minister confirmed the Orders, but made the following modifications in regard to the No. 2 Area:- Nos. 15 and 17a, Adair Road; 33, Golborne Gardens; 16 and 24, Appleford Road, and 22, Golborne Road, were excluded from the clearance area, but approved for compulsory purchase as lands outside the area. Further the Council were directed by the Minister to make well-maintained payments under Section 60 of the Housing Act, 1957, in respect of Nos. 5 and 14, Appleford Road; Nos. 1, 3, 17, 23 and 31, Golborne Gardens 5 and Nos. 24 and 30, Golborne Road. In addition to the above mentioned work in the Kensal New Town Area, the Council, on 11th March, 1958, declared two small adjacent areas in Portland Road as clearance areas. The total premises - 38 - involved was fifteen, but ten of these were already in the Council's ownership- On 15th April, 1958, a Compulsory Purchase Order was made in respect of the five non-Council properties and the sites of three adjoining premises were added as "grey" land. A Public Local Inquiry was held on 23rd September, 1958, following which the Minister confirmed the Order, with no modifications, but directed the Council to make wellmaintained payments under Section 60 of the Housing Act, 1957, in respect of Nos. 150 and 152, Portland Road. Future Slum Clearance Programme At the request of the London County Council, consideration was given to the question of scheduling unfit houses for inclusion in a third five-year programme, i.e. 1961/65. The demands which will be made on the Council's resources by the commitments already entered into, especially that of Kensal New Town, will be such that it will not be possible to make any substantial addition to them during the period 1961/65. There are, however, certain premises which the Council considered. should be included in the programme for that period. They are Nos. 375-401 (odd) Portobello Road, and Nos. 5-11 (odd) Telford Road, and they form part of an area, known as the Wornington Road Area which, in the opinion of the Council, should be dealt with as a clearance area in the future. The Council have already expressed the view that a period of 10 - 20 years would be required to deal with the Wornington Road Area, but inspections have shown that the premises mentioned above are seriously dilapidated, and it was considered that they should be dealt with as soon as possible. Accordingly Nos. 375 - 401 (odd) Portobello Road and Noso 5-11 (odd) Telford Road, were submitted to the London County Council for inclusion in the slum clearance programme for 1961/65. Artificial lighting of common staircases in tenement houses and flats Council Byelaws relating to artificial lighting of common staircases in tenement houses and flats came into operation on 11th March, 1958. The principal Byelaw reads as follows The occupier of every tenement house to which these Byelaws apply and the owner of every block of flats shall provide adequate artificial lighting for all common staircases:- (a) from half an hour before sunset until 12 o'clock midnight:- (b) for one hour before sunrise during the months of October, November, December, January, February and Marsh: and (c) at other times as and when necessary if adequate means of natural lighting are not provided. Housing (Financial Provisions) Act. 1958 - Improvement Grants Owners who wish to modernise and make better use of existing houses by improvement and conversion, may apply to the Council for a grant towards the cost of the works of improvement or conversion. Houses which lack modern services and amenities are well on the way to permanent unfitness and the owners have hitherto had little incentive to maintain them properly as they fall behind modern standards. - 39 - 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 dwellings 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.) Applications for improvement grants received and dealt with during 1958 are summarised as follows:- Applications received 8 Applications granted 7 (comprising 9 separate "dwellings") Applications refused 1 Total amount of grants approved £3,099. 0s. 0d. Overcrowding At the end of the war, it was felt that the rigid enforcement of the overcrowding standards in the Housing Act was impracticable. The Public Health Committee, therefore, 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 since 1945, although minor amendments have been made as a result of experience gained. All cases of overcrowding coming to notice have been classified under four headings as follows Category 1. Overcrowding under the legal standard where alternative accommodation has been offered and refused. Category 2. Overcrowding in excess of the Modified Standard. 40 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. In November, 1958, the Public Health Committee decided that it was opportune to abandon the use of the "Modified Standard" and to deal with all cases of overcrowding on the strict interpretation of the Housing Act, 1957> standard; distinguishing between "penal" and "non penal" cases. Eighty-five new cases of overcrowding came before the Sub-Committee during 1958. The number of cases of overcrowding abated during the year was two hundred and thirty-nine (including one hundred and sixty-four "Category 4" cases). In the last fifteen years, the Special Sub-Committee have dealt with 1,411 cases of overcrowding and a total of 1,152 cases have been abated. Assessment of Housing Priorities on Medical Grounds During the yeax one hundred and seventy-seven applications for re-housing on medical grounds were examined, and recommendations for the award of additional points were made to the Chief Housing Officer. In each case the precise medical condition and resultant disability were determined (frequently necessitating communication with the family doctor or with the hospital attended.) The premises were inspected in detail to ascertain the extent and nature of the existing accommodation| the adequacy of day and sleeping space? the risk of infection; the existence of remediable or irremediable sanitary or structural defects, and the existence of inconveniences, such as stairs which might be prejudicial to the patient. On this information and that supplied by the Chief Housing Officer, an assessment of points to be awarded on medical grounds was made. In one case, a recommendation for re-housing on medical grounds was also made to the London County Council. (At the end of 1956, the London County Council notified the 165,000 applicants on their waiting lists (Categories A, B and C) that only 2,000 could expect to receive an offer of accommodation within the next three years. No further names would be added to the waiting lists, although new applicants could, if they wished, place their names on a "deferred" list. A little over a hundred houses a year would be reserved for cases of very serious medical condition, aggravated by housing circumstances, confirmed by the County Medical Officer of Health. Applications for these must be made by the family medical practitioner concerned (or by the Chest Physician) direct to the County Medical Officer. In these circumstances, the number of cases notified to the London County Council as possessing medical claims for re-housing has been reduced.) The provision of new housing accommodation The post-war housing schemes completed in Kensington by the 41 Council have provided 1,414 flats. The total number of properties under Council management at the end of 1958 is summarized in the following table s- Housing Properties 1890 Act 26 Cottage Estates 220 1919 Conversion 90 Pre-war Flats 344 Sundry Properties 75 755 Temporary Bungalows 68 Compulsory Purchase Area 15 1949 Act Conversion 58 Post-war Flats 1,414 1,555 Noso 27/29» Hazlewood Crescent 10 onslow Garden 26 Other Properties Henry Dickens Court Garages 10 Ingelow House Garages 12 25, Basing Street Garages 2 Gadsden Mews Stores and Stables 17 Lonsdale Mews Stores and Stables 17 Treverton Street Garages 12 70 Requisitioned Properties (in Family Units) 565 2,981 Other schemes for building new housing accommodation are in various stages of preparation. 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, or by the acquisition of lands under any other enactment. The erection of costermongers' stabling and storage accommodation in Gadsden Mews and Lonsdale Mews (which had been cleared under Housing Act procedure) has been completed and the following places have been provided Gadsden Mews Lonsdale Mews Large stores 8 5 Small stores 5 4 6 8 17 units 17 units In addition, a refuse container shed, manure stores and sanitary conveniences have been provided for the traders. FACTORIES Section 128 of the Factories Act, 1937, requires the Medical 42 Officer of Health to make an annual report in regard to the Council's functions under the Act. The following tables contain a summary of the inspections made and the defects found and remedied within the borough during 1958 s- 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 177 113 5 Factories in which Section 7 is enforced by the Council (not included above) 555 367 17 TOTALS 732 480 22 Defects found Particulars No. of defects found No. of defects remedied No.of defects referred To H. M. Inspectors By H. M. Inspectors Want of cleanliness 1 1 _ _ Overcrowding _ _ _ _ Unreasonable temperature _ _ _ _ Inadequate ventilation _ _ _ _ Ineffective drainage of floors _ _ _ _ Sanitary conveniences (a) insufficient 2 _ _ _ (b) unsuitable or defective 18 12 _ 1 (c) not separate for sexes 1 _ _ _ Other offences (not including offences relating to Homework) 1 1 _ _ TOTALS 23 14 _ 1 During 1958 no prosecutions were instituted under the Factories Acts, 1937 and 1948. 43 Outworkers The following table shows the nature of the work carried out by the two hundred and thirty-three home workers on the register of outworkers during 1958 s- Nature of Work Number 6 Wearing apparel - making, etc. 138 Artificial flowers and jewellery 8 Carding etc. of buttons, etc. 6 Stuffed toys 43 Lampshades 1 Curtains, etc. 2 Miscellanmeous 29 233 During the year, sixty inspections of outworkers' premises were made, but in no case was action necessary to prevent work being carried on in unwholesome premises. No instance of infectious disease occurring in premises, where home work is carried on, was reported during the year. Basement bakehouses The Factories Act, 1937, (Section 54), requires the Council to inspect in every fifth year all basement bakehouses in the borough for which certificates of suitability have been issued. The certificates continue to operate if the Council are satisfied that the bakehouses are still suitable. When the last quinquennial review was made in 1953, there were twenty-eight certificates of suitability in force. Thirteen of these were withdrawn* and another nine bakehouses have voluntarily closed since then, so that the present time there are six basement bakehouses in use in the borough. They are as follows:- 151, Earl8 Court Road 178, Fulham Road 65, Golborne Road 79, Golborne Road 139, Portland Road 46, Walton Street These six bakehouses were inspected in 1958, in accordance with the quinquennial review, and were found to be satisfactory in all respects. The occupiers were informed that the certificates of suitability will continue to operate until the next review. Register of Factories Section 8 of the Factories Act, 1937, requires the Council to keep a list of all factories within the borough with respect to which the duty of enforcing the provisions of the Factories Acts is imposed upon them. The following table gives a summary of the factories on the Council's register at the end of the year, indicating the types of business carried on, whether or not mechanical power is used, and where situated, i»e» North or South Kensington s- 44 Factory - business North Kensington South Kensington Mech. N-M. Mech. N-M. Bakers and Confectioners 7 4 9 3 Belt Manufacturers 2 1 - - Builders and Decorators 5 6 9 18 Carton making and Salvage - 2 - 1 Coffee Grinding and Roasting 1 - 5 - Cosmetics & Toilet Preparations 2 - - 2 Dental Mechanics 1 - 2 1 Disinfectants 1 - - - Display Works and Signwriting 4 3 1 3 Doll and Toy Manufacturers 7 4 4 - Dressmaking 10 - 31 14 Dyers and Cleaners 7 1 11 1 Electro=Platers 2 - - - Engineering (Elec.) 10 - 6 3 Engineering (Mecho) 30 1 10 - Electrical Generating Stations 2 - 2 - Film Editing and Slide Making 1 - 1 - Furriers 1 1 9 3 Gas Works 1 - - - Glass Cutting and Polishing 5 - 3 - Handbags and Shopping Bags 2 - - 1 Jewellers and Watchmakers 7 2 3 3 Lamp Shade Manufacturers 2 3 1 1 Laundries 17 - 5 - Leather Goods 1 1 1 2 Metal Merchants 3 2 - 2 Milliners - 1 l 7 Motor Car Accessories 1 1 1 1 MoVoRo and Garages 41 4 72 5 Needle Grinding 2 - 1 - Novelty Goods - 1 - - Office Equipment 1 - 2 1 Oil Blenders and Packers 2 _ - - Paint Makers and Storers 2 1 - Photographers - 1 4 3 Picture Frame Makers 1 1 5 3 Plastics 3 2 1 _ Printers and Bookbinders 15 - 5 - Radio and Television Repairs 3 1 8 1 Records 1 - - — Rubber Goods Manufacturers 1 - — — Sausage Makers 7 6 6 - Scientific & Hospital Instruments 1 - 2 - Shoe Makers and Repairers 11 1 9 2 Silk Screen Printing & Spraying 2 1 1 - Starch and Soda Manufacturers 2 1 - - Soft Furnishings and Upholstery 7 5 16 11 Stone Masons 2 - - 1 Sweet Making and Packing - l - - Spray Painting 1 - - - Tailoring 9 2 22 10 Undertakers 1 - — 1 Weaving 1 - 1 - Woodworkers (Joiners, etc.) 12 3 15 5 Miscellaneous Factories 6 2 4 2 TOTALS 266 66 289 111 45 Sanitary accommodation!, etc-o in shops Certificates of Exemption tinder Section 38 of the Shops Act, 1950, the Council may grant a certificate exempting a shop from the provision of suitable and sufficient water closet accommodation if they are satisfied that by reason of restricted accommodation or other special circumstances affecting the shop it is reasonable that such a certificate should be in force, and that suitable and sufficient sanitary accommodation is otherwise conveniently available„ The Council have decided that in those shops where members of both sexes are employed, separate sanitary conveniences for each sex should be required if the number of employees exceeds four, but if the number is less than four, one sanitary convenience should be regarded as suitable and sufficient, provided that the door of the convenience is fitted with a proper lock or fastener on the internal side, and an automatic indicator shows on the external side of the door whether the apartment is engaged or vacant. During the year 1958, no exemption certificate under the Shops Act was granted in respect of the provision of sanitary accommodation. Similarly, under the Food Hygiene Regulations, 1955> exemption may now be granted in food shops in respect of the provision of constant water supply, washhand basins with hot and cold water, cupboard or locker accommodation for outdoor clothing and facilities for washing food and equipment, if such provision cannot reasonably be required. During 1958, two exemption certificates were issued under the Food Hygiene Regulations in respect of washing facilities in food shops. SUPERVISION OF FOOD SUPPLIES Food and Drugs Act, 1955. This Acts which came into operation on 1st January, 1956, is now the principal Act for controlling the composition, labelling, fitness and hygienic handling of food. Food Hygiene Regulations, 1955 to 1957. These Regulations are the principal instruments for enforcing good food hygiene practice in foodshops. Their title emphasises the changing trend whereby a national policy is 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 :- Reauirements 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? 46 (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; (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 hot1 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 temperatures0 47 Pood 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. During the year, the public health inspectors have been engaged on surveying food premises in the borough and a total of 2,280 inspections was made. In 32 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 contraventions of the Regulations, as follows s- DETAILS OF LEGAL PROCEEDINGS TAKEN UNDER FOOD HYGIENE REGULATIONS IN 1958 As requested by Ministry of Health Circular 22/58 Date of hearing Offence Regulation Result 18. 2.58 Failure to take reasonable steps to protect food (bread) from risk of contamination 8 Conditional discharge £4. 4s. 0d. Costs. 18. 2.58 Placing bread so as to involve risk of contamination 8(a) Conditional discharge £2. 2s. 0d. Costs. 18. 2.58 Placing bread outside premises involving risk of contamination 8(a) Fined £4. 0s. 0d. with 10s. 6d. Costs. 18. 2.58 Placing bread on forecourt lower than 18" from ground 8(b) Fined £1. 0s. 0d. with 10s. 6d. Costs. 6. 5.58 Placing oranges on pavement involving risk of contamination 8(a) Fined £1. 0s. 0d. 6. 5.58 Failure to refrain from use of tobacco whilst handling open food (tomatoes) 9(e) Conditional discharge £1. Is. 0d. Costs• 6. 5.58 - Ditto (tomatoes and apples) 9(e) Conditional discharge. 18.11.58 Failure to supply hot water to washbasin in food premises 16(2) Fined £5. 0s. 0d. with £2. 2s. 0d. Costs. 48 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 1958 - Premises registered under - No. of premises No. of inspections (l) Section l6a Food and Drugs Acta 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 312 85 + (b) for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale 112 228 (2) Milk and Dairies Regulations, imhA. as dairies or where the occupier is registered for the sale of milk in sealed containers only 225 832 + 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 6 11 " - others 11 13 Bread and cake shops 45 20 Butchers 71 171 Dairies and premises where milk is sold 225 246 Fishmongers 30 54 Food factories 5 11 General stores 11 160 Greengrocers 109 83 Grocers 222 426 Ice-cream 312 85 Preserved food 21 57 Public houses and off-licences 152 133 Restaurants and cafes 254 416 Sweet shops 168 100 Street markets, stalls and storage premises 79 (licensed traders. ) 176 118 (Miscellaneous .) Milk (Special Designations)(Raw Milk) Regulations, 1949/54 During the year licences under these Regulations were granted as follows s~ 49 Principal Supplement ary Dealers licensed to sell Tuberculin Tested Milk; 142 25 Forty-eight samples of Tuberculin Tested Milk (Farm bottled) were submitted for examination during the year. Nine 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 Designation No. of samples Methylene blue test Passed Failed Tuberculin Tested (Farm bottled) 48 39 9 Milk (Special Designations)(Pasteurized and Sterilized Milk) Regulations, 1949/53 Details of licences granted during 1958 are as follows Principal Supplementary Dealers' licences to sell Pasteurized Milks 157 25 Dealers' licences to sell Sterilized Milks 152 27 The following table shows the number of samples of processed milk taken during the year, together with results of the examinations Designation Methylene blue test Phosphatase test Turbidity test No. of samples Passed Failed Passed Failed Passed Failed Tuberculin tested (Pasteurized) 14 14 _ 14 _ _ _ Pasteurized 54 54 _ 54 _ _ _ Sterilized 1 _ _ _ _ _ _ Milk and Dairies Regulations, 1949/54 (a) Registrations The number of persons registered under these Regulations at the end of the year, to sell milk from premises in the borough (including the sale of milk and cream in sealed containers) was 225. (b) Unclean milk containers It is an offence under the 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. During the year six contraventions were reported to the Public Health Department. In five cases investigations failed to reveal 50 sufficient evidence to justify legal action. In the remaining case the Public Health Committee authorised legal proceedings, and on pleading guilty the suppliers were fined £2. 0s. Od. with £2. 2s. Od. costs. Composition of Milk During the year, three hundred and fourteen samples of milk (all grades) were submitted to the Public Analyst. Two were found to be below the legal and presumptive standards laid down, and the results of these were sent to the Ministry of Agriculture, Fisheries and Food. A warning was given to the retailer in one of these cases, but in the remaining case it was decided to take no action. In addition to the above, thirteen samples of hot milk were taken from catering establishments in the borough and submitted to the Public Analyst. Six were found to be below the standard for non-fat-solids, by reason of added water. Warnings were given to the retailers in all six cases. The following table shows the percentages of milk-fat and non-fat solids of the genuine samples of milk, other than Channel Islands and South Devon Milk, taken during each month. It should be mentioned that, included in these, are nineteen samples certified by the Analyst to be genuine, although the percentage of solids-not-fat was slightly below the presumptive standard of 8t>9i°° Month No. of samples taken Average percentages Milk fats Non-fat solids January 31 3.80 8.60 February 24 3.60 8.55 March 7 3.45 8.78 April 27 3.55 8.55 May 10 3.56 8.74 June 10 3.42 8.80 July 22 3.54 8.65 August 21 3.56 8.56 September 14 3.66 8.66 October 19 3.91 8.73 November 17 3.66 8.68 December 11 4.76 8.54 Average for the whole year 3.62 8.65 Legal minimum standards 3.00 8.50 Milk and Dairies (Channel Islands and South Devon Milk) Regulations, 1956 These Regulations require that all milk for human consumption sold under the specific 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° During the year, ninety-nine samples of these milks have been taken and were all found to be satisfactory. 51 The following table shows the average percentages of milk fat and non-fat solids of the genuine samples of these milks taken during each months- Month No. of samples taken Average percentages Milk fats Non-fat solids January 11 4.55 9.06 February 7 4.24 8.90 March 6 4.63 9.07 April 10 4.41 8.91 May 8 4.40 9-10 June 9 4.38 9.01 July 14 4.36 8.94 August 5 4.56 8.89 September 11 4.50 9-01 October 8 4.64 9.01 November 8 4-51 9.04 December 2 4.55 8.85 Average for whole year 4.46 8.98 Legal minimum standards 4-00 8.50 Unsound food Seizure Under Part 1 of the Food and Drugs Act, 1955> it is an offence to sell, offer, or expose for sale, or to be in possession for the purpose of sale or preparation for sale, food intended for human consumption which is in an unfit condition. Such food can be seized and taken before a Justice of the Peace who can condemn it, and order it to be destroyed or disposed of for purposes other than human consumption. During 1958 there was one occasion when it was found necessary to enforce this procedure. This concerned the offering for sale of bananas which were unsound. They were seized and taken before a Justice of the Peace who condemned them as being unfit for human consumption. The Public Health Committee directed that a warning should be sent in this case. 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 52 Food Tons Cwt. Qrs. Lb. Meat(raw) - 19 3 6 Meat(tinned) - 5 - 9 Ham 1 13 1 11 Sausage - 14 3 - Fish (wet and dry) - 13 1 21 Dried fruit 1 - - 10 Fruit - 10 1 22 Potatoes - 1 1 22 Rice and sago - - 3 23 Ground cashew nuts - - 3 - Sauerkraut - 2 1 - Cucumbers in brine - 3 - 14 TOTAL 6 5 1 26 Tins, jars, packets or cartons of fruit, vegetables and miscellaneous foodstuffs 6,275 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-eight complaints were received from members of the public, alleging the unsatisfactory condition of food purchased by them in the borough. The complaints generally related to the presence of foreign matter in foods, mouldy condition of meat pies, bread and cakes, and the unsatisfactory condition of chicken, pearl barley, sweets, meat, baked beans and fishpaste. In one case the Public Health Committee authorised legal proceedings being taken against the manufacturers of a loaf of bread, the external surface of which was dirty. At the Court hearing (February, 1959)» the firm pleaded guilty and were fined £2. Os. Od. and £2. 2s. Od. costs were awarded to the Council. In a further fourteen cases, the Public Health Committee decided to send warnings to the vendors. The remaining thirteen cases were dealt with by informal action, either owing to lack of proper evidence, or to the complaint not being substantiated. Adulteration of Food During the year, six hundred and twenty-four formal samples of food and drugs were purchased, of which twenty-seven (4.3%) were either adulterated or otherwise unsatisfactory. Three hundred and seventy-six informal samples were also purchased, of which twenty-seven (7.2%) were either adulterated or otherwise unsatisfactory. The following table summarizes the action taken in respect of the defective samples:- 53 Unsatisfactory sample No. of prosecutions No. of warnings to Producers, Manufacturers or Vendors No further action Total Milk - 2 - 2 Hot milk - 6 - 6 Butter - 2 - 2 Cream cheese - 1 - 1 Lard (American pure) - - 1 1 + Beef sausages - 1 - 1 Cooking oil - - 1 1 Tomato juice - 2 - 2 Tomato paste - 1 1 2 Tomato puree - - 1 1 Currants - 6 - 6 Sul tanas - 1 - 1 Dried Apricots - 2 - 2 Crystallized apricots - 1 - 1 Glace apricots 1 - - 1 Processed apricots - 1 - 1 Apples - - 2 2 Pickle - - 1 1 Pickled onions - 1 - 1 Mango chutney - 1 - 1 Malt vinegar - 1 - 1 Ground pepper - 1 - 1 Meringue powder - - 1 1 Lemonade powder - 1 - 1 Orange squash - - 1 1 Table jelly - 1 1 2 Dressed crab - 2 1 3 Yeast protein - 2 - 2 Chocolate covered brazils - - 1 1 Chest and lung mixture - 1 - 1 Nut cheese - 1 - 1 Veal cutlets in cream sauce - 1 - 1 Crude black molasses fudge - 1 - 1 Baby food - - 1 1 TOTALS 1 40 13 ++ 54 + This result was notified to the Ministry of Agriculture, Fisheries and Food. ++ 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. Ice Cream The Food Standards (ice Cream) Order, 1953, specifies a minimum standard for ice cream of 5% fat, 10% sugar and milk solids other than fat. The following table shows the number of samples taken during 1958 for chemical analysis compared with the previous year 54 1958 1957 Number of samples 15 30 Variation of fat content per cent 7.1 to 12.8 7.8 to 13.0 Variation of non-fat content per cent 22.7 to 32.3 21.0 to 34.4 Average fat content 11.40 10.32 Average non-fat solids content per cent 25.95 25.87 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 grades 1 and 2 it would be reasonable to regard this as an indication of defects in manufacture or handling which warrant further investigation. During the year eleven samples of ice-cream were also taken and submitted to the methylene blue test. The results are as follows Grade No. of samples 1 2 3 4 3 1 3 4 Premises in the borougfr 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. General There are no abattoirs or slaughterhouses in the borough and no killing of animals for human consumption is carried out. POOD POISONING The Pood and Drugs Act, 1955, requires any medical practitioner, on becoming aware that a person is suffering, or is suspected to be suffering from food poisoning, to notify the Medical Officer of Health. The following table shows particulars of notifications received during 1958:- 55 Food poisoning notifications (corrected) Firs t quarter 9 Second quarter 13 Third quarter 15 Fourth quarter 10 TOTAL 47 Cases otherwise ascertained Nil Fatal cases Nil Particulars of outbreaks No. of outbreaks No. of cases Family outbreaks Other outbreaks Notified Otherwise ascertained Total cases Agent identified 2 a- 5 - 5 Agent unidentified 5 - 11 - 11 Single cases No. of cases Notified Otherwise ascertained Total cases Agent identified 11 - 11 Agent unidentified 20 - 20 Salmonella infections, not food-borne One incident of cross-infection in a hospital involving two patients. The cases of food poisoning summarized in the above table are reported in greater detail below:- Outbreaks due to identified agents (2 outbreaks) (a) The first outbreak involved three out of four members of one family; the mother, aged 33 years, a girl aged 2 years and a boy aged 1 year. All the sufferers had fairly severe symptoms of pain and diarrhoea at about the same time. Faecal specimens from the sufferers showed the presence of salmonella typhi-murium. A similar specimen from the father, who remained well throughout, was reported negative. The coincidence of onsets suggested a common source of infection, and the father's absence of symptoms and negative specimen pointed to a food eaten whilst he was not at home. Nevertheless, a firm source of infection was not established. The children were treated in hospital and mother was nursed at home. All the patients recovered quickly. (b) The second outbreak involved a man aged 38 years and his wife aged 36 years. Symptoms of diarrhoea, vomiting and fever were quite severe and the couple were removed to hospital. Unfortunately, food poisoning was not immediately suspected and some time elapsed before bacteriological examination revealed the presence of salmonella typhi-murium in the patients' faeces. By the time the Public Health Department was first notified of the cases, it was too late to obtain valid evidence of a source of infection. Outbreaks of undiscovered cause (5 outbreaks) (a) The first outbreak occurred when a family consisting of 56 husband, aged 29 years, wife aged 24 years and a daughter aged two years, fell ill one after the other at approximately 24-hour intervals; the child fell ill first, followed by the mother and then the father. In each case the main symptoms were diarrhoea and vomiting, with varying degrees of pain and prostration. Investigations revealed that the infection may have occurred during a visit by the mother and daughter to a relative whose child was suffering from gastro-intestinal symptoms. Faecal specimens submitted for bacteriologies examination by the sufferers were all reported negative. (b) In this incident two members of a family of three were affected with symptoms of mild vomiting and fever. Those affected were a woman aged 61 years and her daughter aged 26 years; the husband remained unaffected. The only suspicious item of food not eaten in common with the husband was a portion of continental sausage. An unconsumed remnant of this sausage was sent for bacteriological examination, together with faecal specimens from all members of the family, but the results were negative. (c) In this instance, a man aged 51 years and his wife aged 38 years, were affected with pain, headache, fever, drowsiness and prostration whilst their son, aged 2 years, remained well. Of the food not eaten in common with the child, the likeliest article seemed to be a pork pie, the remains of which were sent for bacteriological examination. However, these and the faecal specimens submitted by the three members of the family were reported negative. (d) In the fourth outbreak, two students, a man aged 29 years and a woman aged 23 years, staying with a Kensington family, were notified as cases of food poisoning, after they suffered symptoms of pain, vomiting, headache, thirst and fever. Very little significance could be attached to any of the food eaten by the two patients in the period just prior to onset, except that they had both attended a party 48-hours before the onset in a neighbouring borough. Unfortunately, both patients moved away, leaving no forwarding address, before investigations could be completed. (e) The last outbreak concerned two West Indian seamen, aged 20 years and 21 years respectively, who were spending their shore leave at a Kensington address when they suffered symptoms of pain and vomiting. From investigations, it appeared that the very short illness was probably due to a dietary indiscretion during the course of celebrations held on their arrival. Faecal specimens were reported negative. Single cases In addition to the outbreaks referred to above, there were thirty-one single cases of food poisoning notified. In twenty of these, no causative agent was identified, but in the remaining eleven cases, the identified agents were as follows s- Agent Cases Salmonella typhi-murium 7 Salmonella newport 3 Salmonella anaturn 1 Seven of these eleven cases were admitted to hospital for treatment and recovered. Salmonellosis - Cross infection in hospitals Occasionally outbreaks of infection occur in hospitals due to 57 salmonella organisms. Such outbreaks arise sometimes where a symptomless carrier has been admitted for treatment or where such a carrier is employed in hospital. Although the causative agent is one normally associated with food poisoning, such outbreaks are not generally food-bome. The point has been dealt with in a Ministry of Health Memorandum on Food Poisoning and provision has been made for an annual return of such cases as distinct from food-borne infections. During 1958, only a single incident occurred in a Kensington hospital when two little boys, aged 6 weeks and 4 months respectively, suddenly developed symptoms of diarrhoea and vomiting and were found to be excreting salmonella typhi-murium. Both sufferers were removed to an isolation hospital for treatment and investigations were instituted to trace the source of infection. Faecal specimens from all medical, nursing and domestic staff concerned with the ward in question were examined without finding a symptomless carrier. Admissions were stopped while this was going on. No source of infection was found and no further cases have occurred since. INFECTIOUS DISEASE Smallpox No case of smallpox was notified in the borough during the year 1958. In the Ministry of Health's Memorandum on Vaccination against Smallpox, it is recommended that public health officers, likely to have to deal with cases of smallpox at short notice, should be regularly re-vaccinated at not more than yearly intervals. During the year twenty-three 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 1958 was twenty-seven and, of this total, eight were treated in hospital. There was no fatal case during the year; in fact, there has been no death from scarlet fever in Kensington since 1940. Diphtheria No case of diphtheria was notified during the year. However, a young lady of 26 years died during the year after an illness lasting only two or three days. The general practitioner concerned was unwilling to notify the case as one of diphtheria, and, although bacteriological investigations on post-mortem specimens were negative for diphtheria, the death was returned to the Registrar General as one of diphtheria. All contacts were swabbed and found to be negative and no secondary cases occurred. Diphtheria immunisation work, commenced by the Council in 1934» was continued by the London County Council during the year. A summary of the work carried out in Kensington is as follows Number of pre-school children immunised 1,607 " " school " " 342 " " re-inforcing injections given 1,704 " " children attending for pre-Schick tests 395 H which gave a positive reaction 313 " " " " negative reaction 384 " of children attending for poat-Schick tests 559 " proving negative 545 " proving positive 9 " who failed to attend for reading 16 58 Enteric fever During the year, there were five cases of typhoid fever and none of paratyphoid fever. The first case of typhoid fever was in a young man of 18 years in whom the disease was confirmed after admission to hospital. At the time, the patient was unemployed and had not been outside this country. Many of his meals were taken in restaurants outside Kensington, and as he had no set habits, it was impossible to establish a source of infection. The only contact in Kensington submitted specimens for bacteriological examination which were reported negative. The second case involved a Uruguayan lady aged 29 years who was admitted to hospital a few days after arriving in Kensington, having spent some months in France and Spain. She had, in fact, exhibited clear signs of her illness before leaving the continent where she obviously contracted the disease. The patient's mother and sister, who were staying in Kensihgton too, submitted negative specimens. The third case was a man aged- 29 years who had not been out of the country for many years; the only departure from his normal routine had been a swim in the River Thames close to a drainage outlet. Having spent just over two months in hospital he was discharged home, but although he had given a series of negative faecal and urine specimens, his blood picture was such as to suggest that he might be developing a carrier status. At the end of the year, therefore, this patient was still being kept under surveillance and further examinations were being arranged to ensure that the possibility of carrier development was not overlooked. The only contact of this case submitted negative specimens. The fourth case occurred in a man aged 57 years who had recently returned from a holiday in Italy. However, bacteriological investigation revealed that the strain of organism was an unusual one having no connection with Italy but being associated with English oysters from a particular locality. It transpired that there were other cases in the country at the time associated with oysters from the same locality. It was confirmed later that the patient had, in fact, at a London restaurant eaten oysters obtained from the suspected beds. The patient was nursed at home. Towards the end of the year, the fifth case occurred in a Cypriot woman aged 28 years who had been admitted to hospital after having been nursed at home for two weeks. Exhaustive enquiries were made, particularly into a party attended by the patient in a neighbouring borough, but without revealing a source of infection. Early in 1959, two further cases occurred associated with this one; the first was a woman of 59 years who had nursed the original patient before her admission to hospital and the second was a woman relative living in the same house. These two cases will be shown for statistical purposes in my next Annual Report. All other contacts remained well and submitted negative specimens. Puerperal Pyrexia During 1958, the number of cases of this disease notified was one hundred and sixteen, of whom seventy-two were persons normally resident outside the borough. Three of the cases occurred after home confinements; 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 100o4°P or more has occurred within fourteen days after childbirth or miscarriage), the following table sets out an analysis of the cause of pyrexia of the cases notified in 1958:- 59 Cause Number of cases Flushed breast, breast abscess,mastitis 5 Respiratory infections Chest infection 4 Influenza 4 Coryza 1 9 Skin ulceration 1 Urinary infection 10 Thrombo-phlebitis 2 Offensive lochia 1 Pyrexia associated with abnormal deliverysBirth on way to hospital 1 Forceps delivery 3 Transfusion reaction 1 Caesarian section 10 15 Uterine infection 3 Causes unknown after investigation 65 Not stated 5 In addition to the above one hundred and sixteen cases, information was ireceived concerning forty-five 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 pneumonia. During the year seventy notifications were received, forty-six being acute primary pneumonia and twenty-four being acute influenzal pneumonia. Of the total, twelve cases were removed to hospital for treatment. The number of deaths from pneumonia (all forms) was eighty-four, and the number of deaths from influenza was ten during 1958. Dysentery One hundred and seventeen cases of dysentery were notified during 1958, all of which were bacillary in origin, the majority being due to the Sonne bacillus. Generally speaking the cases were of a mild type and there were no deaths. Erysipelas Eleven cases were notified during the year; nine 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 four cases of acute poliomyelitis notified and confirmed during the year; two of the cases showed symptoms of paralysis. There were no deaths from this disease during the year. - 60 - The figures in the last five years are as follows Year Confirmed cases Deaths 1954 5 Nil 1955 30 Nil 1956 21 Nil 1957 15 1 1958 4 - Contacts of all cases notified were kept under surveillance for twenty-one days, (or until the diagnosis was changed in unconfirmed cases.) There were twenty-six suspected cases removed to hospital, where the diagnosis was not confirmed. In each instance an advisory pamphlet was issued setting out the elementary precautions to be taken. Kensington residents, who were contacts of cases occurring outside the borough, were also kept under observation. The age incidence of the Kensington cases this year illustrates the inadequacy of the term "infantile paralysis" formerly used to describe this disease. Three out of the four cases were adults aged 45i 31 and 26 years respectively; the remaining patient was 2 years of age. In two of the cases, the disease was clearly contracted abroad. Although the number of cases in 1958 was the lowest since 1946, it is too early to assess whether or not this was entirely due to the programme of vaccination against poliomyelitis. During the year, the Medical Research Council restarted its investigation of the possible association between poliomyelitis and inoculation against other diseases and incorporated with it, enquiries relating to poliomyelitis vaccination. The Public Health Department continued to supply information to the Medical Research Council on these aspects of Kensington cases, and to keep the London County Council informed on the incidence of the disease in Kensington. None of the cases occurring this year had been vaccinated against the disease. Acute encephalitis One case of this disease was notified in the borough during 1958; the patient recovered after treatment in hospital. Measles Of the six hundred and fifty-four cases notified during 1958, eighteen were admitted to hospital for treatment. No death occurred during the year. Ophthalmia neonatorum Five cases of this disease were notified, two of which were treated in hospital. All recovered without injury to sight. Gastro-enteritis This disease is notifiable in children up to the age of five years. The number of cases reported during the year was thirteen. Pour were removed to hospital for treatment. Ten deaths of children under five years of age were recorded as due to gastritis, enteritis or diarrhoea. Scabies The number of cases of scabies notified during 1958 was fifty-two, which compares with four hundred and sixty-three notified in the peak year of 1946. Tuberculosis During the year one hundred and seventy-nine new cases of tuberculosis - 61 - were notified, of which one hundred and sixty-one were respiratory and eighteen non-respiratory. 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, 1958 806 698 70 87 1,661 Notified for the first time during the year 102 59 3 15 179 Brought to notice other than by notification 74 66 3 7 150 Removed from register on account of having - (a) recovered from the disease 16 18 1 3 38 (b) removed from district lost sight of, etc. 124 124 3 11 262 (c) died 19 9 2 - 30 Remaining on register on 31st December, 1958 823 672 70 95 1,660 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, three hundred and sixty-six visits were paid to the homes of tuberculous patients. In two hundred and seventeen of these, the environmental conditions were such as to require no further action on the part of the public health department; in a further thirty-five cases, it was found that the patients had moved away, and in eighty-four 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 action taken in the remaining thirty cases is summarized as follows :- Action taken Cases Investigation or supervision undertaken in respect of :- (a) re-arrangement of existing accommodation 9 (b) occupation of patients 1 (c) tracing of contacts 4 (d) prevention of spread of infection 2 Recommended for priority re-housing 9 Action taken under Public Health and Housing Acts in respect of insanitary or unhealthy conditions 8 - 62 - 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 1958:- Country of origin Period (in years) between entry to United Kingdom and notification of disease Total 1 2 3 4 5 6 7 8 9 Australia 1 — — — — — — — — 1 British West Indies 2 4 — — 1 1 — — — 8 China — 1 — — — — — — — 1 Cyprus 1 — 2 — — — — — — 3 Egypt - 1 — — — — — — — 1 France — — — — — 1 — — — 1 Germany 2 1 — — — — — — 1 4 Gibraltar — 1 1 — — — — — — 2 India 3 1 — 1 — — — — — 5 Ireland 12 6 4 2 3 — 2 1 1 31 Italy - - 1 — — — — — — 1 Pakistan 2 _ — — — — — — — 2 Persia 2 1 — — — — — — — 3 Poland 1 3 1 — — — — — — 5 South Africa — — 1 — — — — — — 1 Spain - _ 1 — — — — — — 1 U.S.A. 1 - - — — — — — — 1 TOTALS 27 19 11 3 4 2 2 1 2 71 Patients who had resided in London all their lives or for at least 10 years 65 Patients who had resided in other parts of the country all their lives prior to coming to Kensington 43 Patients from whom information concerning origin was not obtained but where it is believed to be this country 7 Patients from Ireland who resided here at least 10 years prior to notification 6 Patients notified abroad before coming to this country (Ireland 8, China 1, Poland l) 10 Patients who resided here at least 10 years prior to notifications (France l) 1 Patients from whom information concerning origin could not be obtained 108 TOTAL 240 The investigation only covered patients newly notified or transferring into the borough from other areas. The total of three hundred and eleven 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 - 63 - were immigrants who contracted the disease within ten years of arrival in this country. A more accurate investigation showed that the proportion for 1952 was 16% whilst the comparable figures for 1953, 1954, 1955, 1956, 1957 and 1958 were 10%,l6% 17%, 15%, 16% and 23% respectively. This year, 38% (1957=37%) of the immigrants contracted the disease within one year of arrival in this country; 80% (1957 =61%) contracted it within three years of arrival. Persons born in the Republic of Ireland were regarded as immigrants for this purpose. The 1951 Census figures showed that out of a total Kensington population of 168,160, there were 29,353 residents (or just over 17%) who were born outside the United Kingdom and the Republic of Ireland. Whooping Cough Ninety-two cases were notified during the year, nine of which were treated in hospital. No 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, nine hundred and twenty-three of these certificates were authenticated in Kensington. In addition, twenty-nine special exemption certificates were issued to travellers for use in the United States of America. Notifications The following tables show (l) the number of cases of infectious disease notified during the year 1958, 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 1958 1957 1956 1955 1954 1953 1952 1951 Scarlet fever 27 33 45 50 52 78 108 68 Diphtheria (including membranous croup) - - 1 2 - 2 - 1 Enteric fever 5 5 10 7 5 5 2 7 Puerperal pyrexia 116 123 117 125 96 65 83 22 Acute primary pneumonia and acute influenzal pneumonia 70 75 65 105 54 93 71 149 Dysentery 117 77 88 99 68 131 31 81 Erysipelas 11 7 5 9 14 11 11 13 Meningococcal infection 6 3 6 2 1 6 4 8 Malaria 1 5 1 6 4 5 1 2 Acute poliomyelitis Paralytic 2 13 14 10 5 9 17 8 Non-paralytic 2 2 7 20 - 5 4 4 Acute encephalitis 1 3 2 4 1 - 3 1 Tuberculosis (all forms) 179 208 258 218 243 256 251 238 Measles 654 982 358 1425 94 740 839 1314 Ophthalmia neonatorum 5 1 1 4 2 7 2 2 Enteritis + 13 10 14 13 20 27 30 25 Food poisoning 47 52 63 53 58 79 20 18 Scabies 52 52 40 54 42 42 26 34 Whooping cough 92 130 236 116 136 485 228 484 Typhus fever - - - - 1 - - - TOTALS 1400 1781 1331 2322 896 2046 1731 2479 + Notifiable only in children under the age of 5. NOTE; Cases of mistaken diagnosis are excluded from above table. - 64 - TABLE 2 Notifiable disease Number of Cases Notified in 1958 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 - 2 7 14 2 1 1 Diphtheria (including membranous croup) - - - - - - - Enteric fever - - - - - 1 4 Puerperal pyrexia - - - - - 55 61 Acute primary pneumonia and acute influenzal pneumonia 1 2 1 3 2 4 57 Dysentery 4 22 17 28 8 5 33 Erysipelas - - - - - - 11 Meningococcal infection 3 1 1 - - 1 - Malaria - - - - - - 1 Acute poliomyelitis Paralytic - 1 - - - - 1 Non-paralytic - - - - - - 2 Acute encephalitis - - - - - 1 - Tuberculosis (all forms) - 3 4 1 2 41 128 Measles 33 154 162 275 11 10 9 Ophthalmia neonatorum 5 - - - - - - Enteritis 8 5 - - - - - Food poisoning 2 5 3 1 - 8 28 Scabies 1 2 - 2 3 18 26 Whooping cough 17 24 21 27 1 2 - TOTALS 74 221 216 351 29 147 362 TABLE 3 Notifiable disease Total cases notified in each Ward St.Charles Golborne Norland Pembridge Holland Earls Court Queens Gate Redcliffe Brompton Scarlet fever 8 3 4 4 2 2 1 2 1 Diphtheria (including membranous croup) - - - - - - - - - Enteric fever 2 - - 1 - - 1 1 - Puerperal pyrexia 3 4 4 9 6 12 76 2 - Acute primary pneumonia and acute influenzal pneumonia 11 6 4 11 5 12 2 15 4 Dysentery 27 16 16 14 1 20 5 17 1 Erysipelas 3 - 1 4 - 2 - 1 - Meningococcal infection 3 2 1 - - - - - - Malaria - - - - - 1 - - - Acute poliomyelitis Paralytic 1 - - - 1 - - - - Non-paralytic 1 - - - - - - 1 - Acute encephalitis - - - - 1 - - - - Tuberculosis (all forms) 23 29 16 25 16 27 13 18 12 Measles 133 194 40 78 42 65 17 70 15 Ophthalmia neonatorum - 2 1 1 1 - - - - Enteritis 4 5 - 1 - 3 - - - Food poisoning 7 7 6 12 2 5 5 2 1 Scabies 9 9 4 13 3 l 1 11 1 Whooping cough 23 25 5 23 3 6 - 7 - - 65 - LEGAL PROCEEDINGS Public Health (London) Act, 1936 Nuisances During the year, 54 summonses were issued for various nuisances under the Public Health (London) Act, 1936. In 17 cases Abatement Orders were secured and costs amounting to £23. 12s. 6d. were awarded to the Council. In 12 cases the summonses were withdrawn, the nuisances having been abated prior to the Court hearings. In 25 cases the summonses were adjourned as the necessary works were being carried out by the defendants. Nine prosecutions were undertaken for failure to comply with Justices' Orders to abate statutory nuisances. In three cases fines amounting to £13. 12s. 0d. were imposed and costs amounting to £2. 2s. 0d. were awarded to the Council. The remaining six cases were withdrawn or adjourned sine die as the necessary works had been, or were being, carried out. Obstruction of Council's officers One summons under the Public Health (London) Act, 1936, was issued against an owner for unlawfully obstructing one of the Council's public health inspectors from entering premises, and a fine of £5. 0s. 0d. with £4. 4s.0d. costs was imposed. London County Council (General Powers) Act. 1951 A summons was issued under Section 6 of this Act in respect of deficient or defective dustbin accommodation, and the owner was fined ten shillings. Council's Byelaws Dog nuisances Four summonses were issued under this byelaw. Convictions were obtained in all cases and fines amounting to £2. 0s. 0d. with £1. 16s. 6d. costs were imposed. Housing Act, 1957 Illegal occupation of closed underground rooms Two summonses were issued during 1958 against the landlords for occupying closed underground rooms. The hearings were postponed until 17th March, 1959, when fines of £1. 10s. 0d. and costs of £2. 2s. 0d. were imposed. Overcrowding Two summonses were taken out against the landlords of overcrowded premises. One was subsequently withdrawn as the overcrowding was abated before the hearing; in the second case the landlord was fined £2. 0s. Od. and costs of £2. 2s. 0d. were awarded to the Council. Food and Drugs Act, 1955 One summons was issued in respect of the sale of Glace Apricots containing an excessive amount of preservatives. A conviction was obtained, and a fine of £10. 0s.0d. with costs of £5. 5s. 0d. were imposed. - 66 - Food. Hygiene Regulations, 1955 and 1957 Eight summonses were taken out against various defendants for contraventions of these Regulations. The contraventions included smoking whilst engaged in handling food, exposing food to contamination, and lack of equipment (hot water supply). In four cases fines totalling £11. 0s. 0d. with £3. 3s.0d. costs were imposed. The remaining four defendants were discharged conditionally on payment of £7. 7s. 0d. costs to the Council. Milk and Dairies Regulations, 1949/54. One summons was taken out in respect of the use of a dirty milk bottle and the defendants were fined £2. 0s. 0d. and £2. 2s. 0d. costs were awarded to the Council. CONCLUSION In presenting this Report, I should like to express my grateful appreciation of the kind co-operation which I have received from 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. - 67 - PARTICULARS OF THE STAFF OF THE PUBLIC HEALTH DEPARTMENT AT THE END OF 1958 (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 George W. Churcher, B.Sc.(Econ.) 1935 John H. Gillett 1938 Digby A. Smith 1939 Miss Vera F. Osborne 1941 Mrs. S. Scott 1943 Miss Doris Gibbs 1944 Victor W. Waymark 1946 Mrs. B. Beesley 1948 Miss Elizabeth Howarth 1951 Alan Rogers 1953 Mrs. B. Hennessey 1954 Stanley C. Nottingham 1956 Miss Phyllis Schifreen 1957 Andrew Banfield 1958 Public Health Inspectors 2.3. Henry W. Walters, F.R.S.H., Chief Inspector 1925 2.3. Cecil R. Webb 1925 1. Arthur L. Vague 1934 1.2. Ronald D.Callis,B.Sc.(Econ.) D.P.A. 1935 1. Dennis C. Draper 1938 1. Harold Hind 1939 l.2. Arthur F. Standish 1947 1. Arthur E. Sills 1949 l.2.4. Joseph G. Tompkins 1951 l. Reginald G. Weedon 1952 l.2.4. Leslie E. Bowskill 1954 l.2. Kenneth Bell 1955 l.2.4. Leslie A. Palmer 1956 1.2. David A. McLaren 1957 Student Public Health Inspectors Raymond J. Grinsted 1957 Derek H. Vincent 1957 Women Health Officers Miss Anne Barker, S.R.N., S.C.M., H.V. 1949 Mrs. E. I. Gudde, Dip.Soc.Science (Lond.)., 1952 Other Officers James W. Noble, Chief Disinfector 1935 Joseph A. Newman, Rodent Assistant 1945 Aubrey E. Sole, Rodent Assistant 1945 Edward Sellwood, Rodent Assistant 1946 George Connor, Rodent Assistant 1947 Frank Beak, Drainage Assistant 1953 1. Certificate of the Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. 2. Certificate for Inspectors of Meat and Other Foods. 3. Certificate of London Sanitary Inspectors' Examination Board. 4. Smoke Inspectors' Certificate. - 68 - 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 Open spaces Infectious diseases Prevention of damage by pests Care of old people Cemeteries and burial of the dead Health, and Home Safety, Education 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 60 Adulteration of Food 52 Artificial lighting of staircases 38 Atmospheric Pollution 17-21 Bacteriological Work 10 Bakehouses 43 Birth Rate 1 Burial of the Dead 22 Cancer of the Lung 3 Certificates of Disrepair 33 Chiropody for Aged Persons 26 Clean Air Act, 1956 4, 17 Clearance Areas 36 Cleansing of Aged Persons 25 Committees 68 Costermongers' Accommodation 41 Cremation Service 23 Deaths, Causes of 9 Death Rate 1 Diphtheria 57 Diphtheria Immunisation 57 Disinfection & Disinfestation 11 Dog Nuisances 23 Drainage 30 Dysentery 59 Enteric Fever 58 Erysipelas 59 Factories 41, 43 Food - 4, 45 Adulteration 52 Hygiene Regulations 4, 45-47 Ice Cream 53 Inspections 48 Legal Proceedings 47 Milk 48, 50 Poisoning 54 Unsound 51 Castro Enteritis 60 Health Education 15 Holidays for Aged Persons 24 Home Safety 16 Houses in multiple-occupation 34 Housing - 3, 31 Clearance Areas 36 Improvement grants 38 Inspections 31 Medical Priorities 40 New Housing Accommodation 40 Overcrowding 39 Slum Clearance 35 Underground Rooms 32 INDEX Page Ice Cream 53 Improvement Grants 38 Infant Death Rate 2 Infectious Diseases 2, 57 Acute Encephalitis 60 Diphtheria 57 Dysentery 59 Enteric Fever 58 Erysipelas 59 Gastro Enteritis 60 Malaria 59 Measles 60 Meningococcal Infections 59 Notifications 63 Ophthalmia Neonatorum 60 Poliomyelitis 59 Pneumonia 59 Puerperal Pyrexia 58 Scabies 10, 60 Scarlet Fever 57 Smallpox 57 Tuberculosis 2, 60 Whooping Cough 63 Institutional Care of Aged Persons 25 International Certificates 63 Kensal New Town 36, 37 Laundry Facilities for Aged Persons 26 Legal Proceedings - Defective dustbins 65 Dog Nuisances 65 Food and Drugs Acts 65 Food Hygiene Regulations, 1955 47, 66 Milk Regulations 66 Nuisances 65 Obstruction of Council's officers 65 Overcrowding 65 Underground Rooms 65 Library Facilities for Aged Persons 26 Lung Disease 3 Malaria 59 Mass Radiography 17 Maternal Death Rate 2 Meals for Aged Persons 26 Measles 60 Medical Examination of Staff 23 Medicinal Baths 10 Meningococcal Infections 59 Milk 48, 50 Milk - Channel Islands, etc 50 Milk 4 Dairies Regulations, 1949/54 48, 49 Milk, Special Designations 48 Mortuary 22 National Assistance Acts, 1948/51 22, 28 New Housing Accommodation 40 Notification of Infectious disease 63 Nuisances 65 INDEX Page Old People's Welfare 24 Advice Leaflets 24 Chiropody 26 Cleansing 25 Emergency admissions to hospital 29 Grants 24 Holidays 24 Institutional Care 25 Laundry Facilities 26 Library Facilities 26 Meals Service 26 Removals 28 S.O.S. Cards 24 Visiting 27 Ophthalmia Neonatorum 60 Outworkers 43 Overcrowding 39 Pests, Prevention of Damage by 12 Pet Animals Act, 1951 15 Pharmacy & Poisons Act, 1933 14 Poliomyelitis 59 Population 1 Pneumonia 59 Puerperal Pyrexia 58 Rag Flock & Other Filling Materials Act, 1951 14 Removal of Aged Persons 28 Rent Act - Certificates 33 Rodent Control 13 - 14 Sanitary Inspection - Drainage 30 Dwelling Houses 31 Inspections 30 Legal Proceedings 65 Sanitary Notices served 30 Supervision of Work 31 Scabies 10 Scarlet Fever 57 Shops, Sanitary Accommodation 45 Slum Clearance 36 Smallpox 57 Smoke Control Areas 17 Smoke Measuring Stations 19 S.O.S. Cards 24 Staff 67 Student Public Health Inspectors 5 Tuberculosis 2,60 Underground Rooms 32 Unsound Food 51 Vaccination 57 Vital Statistics 5-7 Water Supply 10 Whooping Cough 63 Women's Voluntary Services 5