4348 BHTD ACK. KEN 68 The Royal Borough of Kensington ANNUAL REPORT ON THE Health of the Borough FOR THE YEAR 1959 BY J. H. WEIR m.d.. b.s.. b.hy.. d.p.h MEDICAL OFFICER OF HEALTH THE ROYAL BOROUGH OF KENSINGTON Telephones: WEStern 3173. Public Health Department, Hornton Street, Kensington, W.8. 1st June, 1960. 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 1959• The Minister of Health has again requested (Circular l/6o) that the Report should be generally in the same form as has been the case for some years past. The public health in Kensington during the year under review was maintained at a satisfactory standard. Population. The population of the borough as ascertained at the Census in 1951 was 168,160: but for the purpose of this report, the population for 1959 has been estimated by the Registrar-General to be 166,500. The estimated population figure for the previous year was 165,700. Birth Rate. The number of births per 1,000 population of the borough was 18.1 in 1959, which compares with the figure of 18.0 for the previous year. Death Rate. The number of deaths per 1,000 population in 1959 was 9.93, slightly lower than the death rate for the previous year (lO.l). 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 Registrar-General has supplied, for use in Kensington in 1959, the figures 0.72 for births and 1.01 for deaths. The crude birth and death rates for the borough should be multiplied by the 2 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 1959:- Kensington adjusted London England and Wales No. of births per 1,000 population 13.0 17.3 16.5 No. of deaths per 1,000 population 10.0 11.9 11.6 Infant Death Rate. This rate for 1959 was 24.8, an increase above the rate for the previous year of 2.1. The rate for the County of London was 22.3 and for England and Wales was 22.0. The following table shows the rates for the last five years:- Year Kensington London England & Wales 1959 24.8 22.3 22.0 1958 22.7 22.6 22.5 1957 28.2 22.0 23.1 1956 21.1 21.0 23.8 1955 31.4 23.3 24.9 It will be seen that the infant death rate for Kensington showed a slight increase compared with last year's rate. 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 Year Age in days at death Total Total deaths due to prematurity 1 or under 2 5 4 5 6 1955 41 5 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 1959 34 3 5 4 3 3 52 38 Maternal Death Rate. One death of a mother due to childbirth was recorded in 1959, giving a maternal death rate per 1,000 live and still births of 0.32. (The maternal mortality rate for the County of London was 0.52 and for England and Wales the figure was 0.38). Infectious Diseases. There was no serious outbreak of infectious disease in the borough during 1959. The total number of notifications received was 1,489 in comparison with 1,400 in the previous year. No case of diphtheria was notified in 1959. This is the third consecutive year giving a nil return; one case being notified in 1956. Only six cases of diphtheria have been notified in Kensington in the last ten years, in five of which there was a 'nil' return. Tuberculosis. The death rate from all forms of tuberculosis per 100,000 population was 6.0 which is the lowest ever recorded in the borough. The 1959 Kensington death rate compares with the rate (provisional) of 8.5 for England and Wales. Lung Disease. Kensington's death rate from pulmonary tuberculosis per 100,000 population decreased in 1959 compared with the previous year and the death rate for cancer of the lung also showed a decrease. Comparative 2 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 following table shows the trend in these diseases since the end of the war:- England and Wales Kensington Year Pulmonary Tuberculosis Cancer of the lung Pulmonary Tuberculosis Cancer of the lung Deaths Rate Deaths Rate Deaths Rate Deaths Rate 1947 19,753 47.3 9,204 22.0 71 43.0 58 34.9 1948 18,798 44.0 10,162 23.8 76 45.0 45 26.6 1949 17,471 40.5 10,975 25.5 56 32.0 50 28.7 1950 14,079 32.1 12,241 28.0 52 29.0 70 39.4 1951 12,031 27.5 13,247 30.2 36 17.5 70 40.9 1952 9,335 21.2 14,218 32.3 29 16.8 71 41.1 1953 7,913 17.9 15,132 34.3 26 15.1 65 37.9 1954 7,069 16.0 16,331 36.9 20 11.7 72 42.2 1955 5,838 13.1 17,271 38.9 12 7.1 73 43.1 1956 4,851 10.9 18,185 40.7 19 11.2 73 43.2 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 1959 3,475 7.7 21,063 46.4 9 5.4 75 45.0 (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. Housing. During the year under review, progress was made in carrying out the slum clearance programme for 1955/60 which the Council adopted in collaboration with the London County Council, and which was approved by the Minister of Housing and Local Government. The progress made over the past few years made it desirable for the Council to re-state their slum clearance programme, and the following table gives the current programme as approved by the Council on 8th November, 1959:- Railway Mews 10 premises Kensington Park Mews 13 " Stanley Gardens Mews 4 " Lecky Street 5 " Portland Road 16 " Penelon Place, Ashley Cottages and Warwick Road 66 " Kensal New Town 516 " Portobello Road, Telford Road 18 " Of these slum areas the County Council assumed responsibility for the clearance of 66 premises in the Penelon Place/Warwick Road area, and have dealt with the demolition. The future development of the area will be carried out jointly by the County Council and the Borough Council. 4 The other areas are being dealt with by the Borough Council and, in accordance with the priority need determined, the emphasis at the present time is on clearing and re-developing the Kensal New Town area. Work in this area has been divided into phases, the first of which covers an area consisting of 6½ acres out of a total of 21 acres. The Council have obtained the confirmation by the Minister of Housing and Local Government of five compulsory purchase orders in this phase, subject to minor modifications. Demolition of the slum houses has taken place and work is proceeding on the erection of two 14-storey blocks (each containing 78 flats), and two 4-storey blocks (containing maisonettes and flats), plus 24 garages. It is expected that the two "tower" blocks of flats will be ready for occupation by August, 1960, and the remaining part of the development should be completed early in 1961. In this connection it is my pleasure to record that on 10th June, 1959 the Rt. Hon. Henry Brooke, Minister of Housing and Local Government, was accompanied on a tour of inspection of the work in progress by His Worship the Mayor of Kensington (Councillor A. N. McHaffie) together with Members of the Council and Chief Officers. In a letter dated 15th June, 1959, addressed to His Worship the Mayor, the Minister expressed his appreciation of the opportunity of seeing the way in which the Council are tackling their housing problem in North Kensington. Progress in dealing with Phase I of the Kensal New Town clearance area has been satisfactory, but the project of dealing with the total area of 21 acres is, at the present time, complicated by the London County Council's desire to bring into the development an area, immediately north of the 21 acres, situated in the borough of Paddington. The complications arise because of Town Planning considerations, involving possible construction of new roads and open spaces in the combined area. Negotiations between the two authorities concerned are still in progress and it is hoped that an agreed plan will be made in the near future. Because of the threat of demolition in the next year or two, a few owners have allowed their property to deteriorate, through lack of maintenance and repairs, to the extent that the question of dealing with the unfitness of these houses has become an urgent problem. As a temporary expedient the Council have decided to deal with these isolated properties (to secure their demolition or closure) in advance of the clearance area procedure under Part III of the Housing Act, 1957. One other area, consisting of the 16 unfit properties in Portland Road, has also been dealt with, and the Council have approved plans for the construction of 22 new dwellings suitable for occupation by old people. Clean Air Act. In connection with the duties of Local Authorities to declare their areas, or parts thereof, to be Smoke Control Areas (in which the emission of smoke from any chimney is prohibited), the Minister of Housing and Local Government requested Authorities (Circular 5/59 dated 26th January, 1959) to make faster progress in this work, especially in "black areas" where pollution is worst. The whole of London is a black area, and Councils were asked to prepare a programme indicating the order of priority in making Smoke Control Orders to cover the whole district. The Minister also asked to be informed of the specific details of the work proposed for the first five years. The Council decided in principle to extend this work over 15 years to cover the whole borough, and the details of the first five years, as submitted to the Minister, will be found on page 20 of this Report. Although the work involved in making Smoke Control Areas involves a considerable amount of detail in making surveys and keeping records, good progress has been made. Three Smoke Control Orders have been made by the Council covering the whole of the Holland Ward in the central part of the borough, and a survey is progressing with the object of making a further Order in respect of the southern half of the Pembridge Ward in North Kensington. 5 Two of the Orders in regard to Holland Ward were confirmed by the Minister with no opposition from residents, but in the case of the Order covering the western portion of the Holland Ward, objections were lodged by a few householders. The Minister, in accordance with the provisions of the Clean Air Act, held a public Local Inquiry at the Town Hall on 7th March, 1960, and, at the time of writing, the result of the Inquiry is awaited. It is gratifying to record this so far almost negligible opposition to the Council's action and policy, which appears to indicate that the public generally are prepared to co-operate in eliminating the pollution of the atmosphere by the smoke from household fires and furnaces. Food Hygiene. The work of enforcing the requirements of the Food Hygiene Regulations was continued throughout the year. Food traders and the public are generally striving to maintain a high hygienic standard in connection with the storage, preparation and sale of food. The 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 (46 in 1959) by the public health inspectors for various contraventions of the Hygiene Regulations and the greater need to take 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 Orders, 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 reqquired number of public health inspectors for Kensington 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. 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, and have also increased the staff by the appointment of unqualified assistants to help the inspectors. The Council's scheme for training students as public health inspectors was augmented by the appointment of a third student during the year. These men are giving increasingly valuable assistance to the inspectorial staff, whilst undergoing training. In fact, owing to pressure of work, one student, in his final year, was detailed to work on a district, under the supervision of one of the senior public health inspectors. VITAL STATISTICS The table set out on the next two pages gives the important vital statistics for 1959, together with comparative figures for the previous seven years. - 9 - - 7 - SUMMARY OP VITAL STATISTICS FOR KENSINGTON Description 1959 1958 1957 1956 1955 1954 1953 1952 POPULATION Population (estimated) 166,500 165,700 167,900 168,800 169,400 170,600 171,500 172,800 Density of population per acre 73 72 73 74 74 74 74 75 LIVE BIRTHS Total births 3,026 2,990 2,765 2,792 2,674 2,707 2,642 2,810 Legitimate births 2,546 2,549 2,404 2,422 2,361 2,399 2,321 2,508 Illegitimate births 480 441 361 370 313 308 321 302 Birth rate per 1,000 population 18.1 18.0 16.5 16.5 15.8 15.9 15.4 16.3 STILL BIRTHS Total still births 55 49 50 51 40 48 53 48 Legitimate still 'births 44 37 42 43 31 40 47 37 Illegitimate still births 11 12 8 8 9 8 6 11 Still birth rate per 1,000 total births 17.8 16.1 17.8 17.9 14.7 17.4 19.7 16.8 DEATHS Total deaths 1,654 1,659 1,750 1,772 1,744 1,643 1,708 1,936 Death rate per 1,000 population 9.93 10.01 10.4 10.5 10.3 9.63 9.96 11.2 DEATHS OF INFANTS UNDER 12 MONTHS OF AGE Total infant deaths 75 68 78 59 84 61 50 75 Legitimate deaths 63 58 58 50 66 54 42 67 Illegitimate deaths 12 10 20 9 18 7 8 8 Infant death rate per 1,000 births Death rate of legitimate infants 24.8 22.7 28.2 21.1 31.4 22.5 19.7 27 per 1,000 legitimate births 24.7 22.8 24.1 20.6 27.9 22.5 18 27 Death rate of illegitimate infants per 1,000 illegitimate births 15.0 22.7 55.4 24.3 57.5 22.7 25 26 MATERNAL DEATHS Deaths of mothers as a result of pregnancy or childbirth 1 1 1 5 1 2 Nil 5 Death rate tsf mothers per 1,000 live and still births 0.32 0.33 O.36 1.76 0.37 O.72 Nil 1.75 TUBERCULOSIS Death rate from all forms per 100,000 population 6.0 6.6 10.1 11.8 10.0 14.O 19.2 18.5 Death rate from respiratory tuberculosis per 100,000 population 5.0004 6.0 7.7 11.2 7.1 11.7 15.1 16.8 Death rate from non-respiratory tuberculosis per 100,000 population 0.6 0.6 2.4 0.6 2.9 2.3 4.1 1.7 KENSINGTON INFANTILE DEATH RATES (Death of children under 1 year per 1000 birth) 9 CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE IN I959 Cause of death All ages Under 1 year 1 year and under 5 5 years and under 45 45 years and over Respiratory tuberculosis 9 — - 3 6 Other forms of tuberculosis 1 - - 1 - Syphilis 9 - - - 9 Diphtheria - - - - - Whooping Cough 1 1 - - - Meningococcal infections - - - - - Acute poliomyelitis - - - - - Measles 1 - 1 - - Other infective diseases, eto., 3 . - - 3 Cancer (all forms) 347 1 - 20 326 Leukaemia, aleukaemia 6 - 2 1 3 Diabetes 5 - - - 5 Vascular lesions of nervous system 192 - - 6 186 Coronary disease, angina 275 - - 11 264 Hypertension with heart disease 22 - - - 22 Other heart disease 118 1 - 4 113 Other diseases of oirculatory system 110 - - 4 106 Influenza 32 - - 3 29 Pneumonia 108 6 1 2 99 Bronohitis 95 3 - 1 91 Other respiratory diseases 20 . - 1 19 Ulcers of the stomach 20 - - - 20 Gastritis, enteritis and diarrhoea 9 1 - - 8 Nephritis and nephrosis 6 - - 2 4 Hyperplasia of prostate 12 - - - 12 Pregnancy, childbirth and abortion 1 _ . 1 _ Congenital malformations 10 12 2 2 2 All other diseases 134 40 - 8 78 Motor vehicle accidents 17 - - 8 9 All other accidents 51 2 2 8 39 Suicide 31 - _ 13 18 Homicide and operations of war 1 - - 1 - TOTALS 1,654 75 8 100 1,471 10 GENERAL PROVISION OP HEALTH SERVICES IN THE AREA Bacteriological and Analytical Work The following is a summary of the work performed during 1959:- Nature of specimen or sample Number examined Nose and throat swabs 134 Faeces and rectal swabs 1,320 Milk (bacteriological) 57 Water (drinking) 6 Water (swimming baths) 16 Ice Cream 12 Miscellaneous 38 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 1959 is as follows:- Description Scabies Vermin Impetigo Other conditions Persons Clean3 -ings Persons Cleans -ings Persons Cleans -ings Persons Cleans -ings Adults Kensington Other 67 119 68 71 - - - - boroughs 5 9 35 35 - - - - Schoolchildren Kensington 40 123 664 664 - - 3 21 Other boroughs 15 71 234 234 - - - - Children under 5 Kensington 38 73 36 36 - - - - Other boroughs 2 3 12 12 - - - - Compulsory cleansirwrs - - 69 69 - - - - TOTALS 167 398 1,118 1,121 - - 3 21 In addition to the cleansing of persons referred to above, articles of personal clothing disinfested at the Medicinal Baths during the year numbered 446. 11 Disinfection and Disinfestation A summary of the routine work carried out in 1959 by the disinfecting staff is shown in the following table Houses disinfected after infectious disease 220 (344 rooms) 510 (892 rooms) Loads of furniture treated with hydrogen cyanide 5 Total weight of furniture, bedding, etc. dealt with:15 tons 18 cwt. 1 qtr. 6 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, 181 parcels of clothing were disinfected and the income amounted to £22. 12s. 6d. The following table indicates the destination of these parcels:- No. of parcels Czechoslovakia 102 Spain 15 Bulgaria 2 Rumania 61 Italy 1 TOTAL 181 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, thirty-one such certificates were issued. H.C.N, (hydrogen cyanide) Disinfestation 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. The Council have, therefore, discontinued their policy of treating with H.C.N, the furniture of all incoming tenants of new flats irrespective of whether there was evidence of infestation or not. The present scheme provides for the Council's Chief Housing Officer to notify 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 flat. If no infestation is found, the prospective tenant is allowed to move in directly to the new flat. In all cases, the walls and ducts of the new flats are treated with Gammexane smoke generators (B.H.C.) as a preventive measure. During 1959, no new flats became ready for occupation, but in four cases the furniture of 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, 12 kept free from rats and mice. 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 of Agriculture, Fisheries and Food has in the past requested reports for each twelve months ended 31st March, but in order to conform to the "calendar year" in future, the Minister has asked (Circular PDP/1959/l) that this year the report should be limited to the nine months ended 31st December, 1959. 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 nine months ended 3l/l2/59 as a result (a) (a) of notification 8 674 52 734 (b) survey (b) 1 42 6 49 or (c) otherwise (c) - - - - III. Total inspections carried out, including re-inspections 44 4,977 416 5,437 IV. Number of properties (under II) found to be infested Major by rats 1 1 - 2 Minor 7 235 24 266 V. Number of properties (under II) found to be infested Major by mice - - • — Minor 1 427 21 449 VI. Number of infested properties (under IV and V) treated by the Local Authority 9 663 45 717 VII. Total treatments carried out 10 819 53 882 VIII. Number of notices served under Section 4:(l) Treatment - - - - (2) Structural Works (i.e.Proofing) - 1 - 1 IX. Number of cases in which default action was taken by Local Authority following issue of notice under Section 4:- - - - - X. Legal Proceedings - - - - XI. Number of "block" control schemes carried out - - - - 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 1953 5,458 4,312 1954 4,142 4,667 1955 4,515 3,430 1956 4,764 4,138 1957 4,476 (January) 7,751 ( April) 7,044 (September) 1958 4,945 6,617 1959 6,211 8,082 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 1,045 Premises inspected following complaints 1,077 Premises where rats were found 354 Premises where mice were found 554 Premises where other vermin were found 141 Premises where no infestation existed 28 Number of visits made 7,640 Number of notices served 5 Premises successfully treated 1,147 Cases in which advice only was given 53 Borough Council properties dealt with 62 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-eight. Of this number, three 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 axe excepted). Inspections of the registered premises were made during the year and five samples of rag flock and other fillings were taken for analysis. The results were satisfactory. Description No. of samples taken Algerian fibre 1 Coir fibre 2 Cotton felt 1 Woollen mixture felt 1 Pet Animals Act. 1951 This Act requires that no person shall keep a pet shop except under the authority of a licence issued by the Council and in compliance with any conditions specified in the licence. During the year, eight premises were licensed under the Act. The general conditions for pet shops approved by the Council are those recommended for their constituent councils by the Metropolitan Boroughs' Standing Joint Committee. Two applications for licenses were refused as the conditions of sale were unsatisfactory. 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 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. During 1959, a Working Party, set up by the Local Authorities' Associations, suggested a formula, based on population statistics, for minimum contributions to the Central Council by local authorities. (The formula approved by the Local Authorities' Associations, provided that no request for increased contribution rates be made by the Central Council within five years.) On the new basis, the Council increased their annual grant to the Central Council from fifteen guineas to £23. Os. Od. for the year I959/196O. Good use was made of the services available, and posters, leaflets, and other material were 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. Bookmarks are a most valuable form of health propaganda, and the Borough Librarian and his staff readily co-operated with the public health department during the year in distributing bookmarks to members of the public 16 using the Council's libraries. Nine ex-Empire Marketing Board poster frames, which had been presented to the Council over thirty years ago, remained in use during the year. Having regard to their age and condition, the Public Health Committee decided to replace them with smaller poster boards of modern design, capable of displaying four double-crown posters (30" × 20"). This work commenced during 1959, when three old boards were removed and new boards supported by metal frames of modern design were erected. The remaining boards will be replaced during 1960 and 1961. In addition, a single poster space has been made available by London Transport to the public health department in the subway at Notting Hill Gate Underground station. During the year, posters dealing with a variety of health topics were displayed at regular intervals on the poster frames in the borough. 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 power during 1959 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. The Royal Society for the Prevention of Accidents organised a National "Check that Fall" Campaign during the year, and a special "Home Safety Week" was held at the beginning of November, 1959. This was augmented by the Public Health Committee by a local campaign in Kensington during November, 1959. 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 made available to members of the public visiting the Council's offices, and bookmarks were issued through the libraries. In addition, the Public Health Committee approved the printing of a further ten thousand copies of "The Household Code" (devised by the public health department) and which deals with simple first-aid action to be taken following accidents in the home. These were distributed mainly through the libraries. Leaflets were obtained from the Ministry of Health and the Central Office of Information, without charge, and the London County Council provided posters, leaflets and bookmarks, also free of charge. Some posters were purchased from the Central Council for Health Education and Royal Society for Prevention of Accidents to supplement those obtained from other sources. The following table shows the amount of publicity material which was obtained and distributed in Kensington:- "The Household Code" 10,000 Leaflets 5,200 Bookmarks 10,000 Special window labels 350 Posters 30" x 20" 240 17 Heating Appliances (Fireguards) Act, 1952 This Act makes it an offence to sell any gas or electric fire, or oil heater, suitable for use in residential premises, unless it is fitted with an adequate guard. Generally speaking, traders do not commit offences under this Act, but it has been found necessary to keep a careful watch on the sale of second-hand appliances from stalls in public markets. On a number of occasions during the year offences by street traders were reported to the Public Health Committee and warnings in every case were issued. 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 North-West Metropolitan Regional Hospital Board. The purpose of mass radiography is twofold:- (i) to find abnormalities of the chest, and in particular tuberculosis and cancer of the lungs, and (ii) to give those whose X-ray is within "normal limit" a certain degree of security. Details of persons X-rayed by the Unit during surveys held in Kensington in 1959, are as follows:- I. Organised Groups No. X-rayed Wates Building Site 0 114 Geological Museum, etc. 911 Warwick Road Council Depot 402 G.P.O. Charles House 1,470 Barkers 792 C & A High Street, etc. 387 Harrods, Knightsbridge 2,345 College of Estate Management, etc 316 Baileys Hotel, etc. 256 B.E.A. West London Air Terminal, etc. 484 Rootes, Brlby Road 338 Merchant Adventurers, Portland Road, etc. 105 7,920 II. General Public Barkers 915 GRAND TOTAL: 8,835 A provisional analysis of the surveys revealed fifteen cases of active tuberculosis and five cases where it is necessary to keep the patients under observation. No case of lung cancer was discovered. 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. Smoke Control Areas. Sections 11 to 15 of the Act relate to 18 the functions of the Council to declare smoke control areas, in which the emission of smoke from the chimney of any building would be an offence. The procedure for establishing a smoke control area is laid down by the Minister of Housing and Local Government and comprises four main phases, as follows:- (a) Having decided in principle on the location, size, area and types of property to be included in the area, the Council must give provisional notice of their proposals to the Minister. (b) Upon receipt of the Minister's approval to the provisional plan, a detailed survey of the area must be made. (c) When the survey has been completed, the Council may make the Order and submit it to the Minister for confirmation. (d) After the Minister's confirmation, enforcement action to bring the Order into operation. This stage includes the conversion of firegrates, the payment of grants, and the necessary action to secure Exchequer contributions. The first area in Kensington to be specified was the central part of the Holland Ward, bounded by Kensington High Street in the south, Campden Hill Road in the north and Abbotsbury Road in the west. The preliminary proposals were submitted to the Minister in 1958, who gave his approval. As a result of the preliminary survey, a reliable estimate was obtained of those premises in the area which were already smokeless and those which were not. Two circular letters were sent out from the public health department, one for occupiers of houses believed to be using bituminous coal and one for occupiers of smokeless houses. In addition to giving prior notification of a visit to be made by one of the Council's officers, the letters included a map of the proposed area, details of the grant available, and a statement of the duties of occupiers in a smoke control area. With the letters were sent leaflets and brochures designed and produced by various organisations concerned with smokeless fuels and authorised appliances. These contained much information relating to the Clean Air Act, 1956, and were supplied free of charge by the following organisations:- Coal Utilisation Council Gas Council London Electricity Board North Thames Gas Board Radiation Ltd. Solid Smokeless Fuels Federation The detailed survey was completed and on 11th November, 1958, the Council made an Order declaring the area to be a Smoke Control Area. No objections were made in this case and the Minister confirmed the Order which came into operation on 1st October, 1959• On 11th November, 1958, the Council decided to proceed with the remainder of the Holland Ward in two areas, viz. Holland Ward (No.2) Area and Holland Ward (No.3) Area. The Minister approved the proposal in each case and the detailed surveys were completed during the year. On 13th October, 1959, the Council declared both these areas to be Smoke Control Areas and submitted the Ordeisto the Minister for confirmation. The following table gives a summary of the details of the three Holland Ward areas:- On 13th October, 1959, the Council declared both these areas to be Smoke Control Areas and submitted the Orders to the Minister for confirmation. The following table gives a summary of the details of the three Holland Ward areas:- 19 Smoke Control Area Date Declared by Council Acreage Total No. of (1) Dwellings (2) All buildings Estimated No. of fireplaces needing conversion Total estimated cost of conversions Date from which Order operates Holland Ward (No.l) 11.11.58 162 (1) 1,302 (2) 1,400 403 £7,559 1.10.59 Holland Ward (No.2) 13.10.59 139 (l) 2,020 (2) 2,104 714 £12,453 1.10.60 Holland Ward (No.3) 13.10.59 184 (l) 2,681 (2) 3,032 87.8 £16,050 1.10.60 In addition to the above three areas the Council have preliminarily approved a proposal to specify the next area, which is the southern half of the Pembridge Ward, extending from Notting Hill Gate to Westbourne Grove. The detailed survey of this fourth area is at present being undertaken. On 26th January, 1959* the Minister of Housing and Local Government issued Circular 5/59, in which he stated that an encouraging response to the Clean Air Act had been made by local authorities, but the Minister hoped that it will be possible to make faster progress, especially in removing the smoke pall from the Tjlack areas" where pollution is worst. These black areas were indicated in the Interim Report of the Committee on Air Pollution published in December, 1953> and they include the London area. The Minister asked councils in the black areas to consider their domestic smoke problem as a whole and decide on the smoke control orders which are needed, in what order of priority they should be made, and how many years it is likely to take to finish the operation. The councils were asked to prepare a phased programme for establishing smoke control areas over the next five years and to inform the Minister by 30th June, 1959, of their conclusions. The Pinal Report of the Committee on Atmospheric Pollution suggested that the complete programme would take from ten to fifteen years, and the Council formed the opinion that endeavours should be made to produce smoke control orders covering the whole of the borough within a period of fifteen years. The following programme was adopted for the first five years and submitted to the Minister as requested 20 Smoke Control Area Boundaries PreliminarySurvey Detailed Survey and Order made Order operative Holland Ward (No.l) Holland Ward (No.2) Holland Ward (No.3) Pembridge Ward (No.l) Pembridge Ward (No.2) Norland Ward (No.l) Norland Ward (No.2) N. Holland Park Avenue S. Kensington High Street E. Campden Hill Road W. Abbotsbury Road N. Holland Park Avenue S. Kensington High Street E. Abbotsbury Road W. Borough Boundary N. Notting Hill Gate S. Kensington High Street E. Borough Boundary W„ Campden Hill Road N. Westbourne Grove S. Notting Hill Gate E. Borough Boundary W. Ladbroke Grove N. Lancaster Road S. Westbourne Grove E. Borough Boundary W. Ladbroke Grove N. Lancaster Road S. Holland Park Avenue E. Ladbroke Grove W. Walmer Road and Princedale Road N. Lancaster Road S. Holland Park Avenue E. Walmer Road and Princedale Road W. Borough Boundary 1957 1957 1957 1959 1959 1961 1962 1958 1959 1959 1960 1961 1962 1963 1959 (1st October) 1960 (1st October) 1960 (1st October) 1961 1962 1963 1964 New furnaces 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 1959 eleven notifications were received, and three applications for approval of plans etc., were approved. Smoke emissions. The Sections of the Clean Air Act, 1956, which relate to industrial smoke come 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. 21 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. During the year eighteen complaints of smoke nuisance were received, and thirty-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, Ladbroke 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. The following tables set out details of the results obtained in Kensington during 1959:- - 22 - A. Deposit Gauges Month 1959 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 (Portobello Road) January 32 2.23 8.05 7.92 15.97 .251 .247 .498 February 28 0.04 5.57 10.17 15.74 .198 .363 .561 March 30 1.46 6.98 9.40 16.38 .232 .313 . 545 April 30 2.23 6.31 8.46 14.77 .210 .282 .492 May 32 0.93 3.99 7.28 11.27 .124 .227 .351 June 29 0.57 3.76 6.88 10.64 .129 .237 .366 July 30 0.89 2.32 3.22 5.54 .077 .107 .184 August 32 2.13 4.26 4.73 8.99 .133 .147 .280 September 30 0.00 1.88 4.30 6.18 .062 .143 .205 October 32 1.76 6.38 9.43 15.81 .199 .294 .493 November 29 2.49 0.39 8.39 16.78 .289 .289 .578 December 31 3.11 7.32 5.94 13.26 .236 .191 .427 TOTALS 365 17.84 65.21 86.12 151.33 South Kensington (Pembroke Road) January 32 2.21 8.59 7.22 15.81 .268 .225 • 493 February 28 0.04 4.80 7.25 12.05 .171 .258 .429 March 30 1.56 6.91 8.16 15.07 .230 .272 .502 April 30 1.57 5.81 4.56 10.37 .193 .152 .345 May 32 Collecting bowl found displaced. Deposit incomplete. June 29 0.43 4.20 3.19 7.39 .144 .110 .254 July 30 0.95 3.15 6.21 9.36 .105 .207 .312 August 32 0.98 3.09 3.22 6.31 .096 .100 .196 September 30 0.04 3.93 6.75 10.68 .131 .225 .356 October 32 1.65 7.25 8.79 16.04 .232 .274 .506 November 29 2.25 8.73 6.41 15.14 .301 .221 .522 December 31 2.45 7.92 5.84 13.76 .255 .188 .443 TOTALS 365 14.13 64.38 67.60 131.98 B. Estimation of atmospheric sulphur Milligrams of sulphur trioxide per day Month 1959 Days exposed North Kensington South Kensington January 32 5.15 5.77 February 28 4.65 4.84 March 30 2.75 3.10 April 30 2.20 2.65 May 32 1.56 2.00 June 29 1.18 1.61 July 30 1.04 1.31 August 32 1.21 1.85 September 30 1.73 2.41 October 32 2.70 3.61 November 29 3.29 3.99 December 31 2.34 2.87 Average for year 2.48 3.00 - 23 - c. Readings from the two monthly stations in Kensington have been taken for six years and the following table compares the annual 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 365 197.09 180.84 2.36 2.69 1959 365 151.34 131.98 2.48 3.00 D. Measurement of smoke and sulphur by the volumetric method 1959 Volumetric smoke Concentration of smoke in milligrams per 100 cubic metres 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 28.8 54.2 27.8 15.8 February 19.0 53.0 34.0 17.0 March 13.0 33.0 31.0 10.9 April 12.0 26.0 20.0 9.4 May 10.0 21.0 14.0 6.4 June 8.5 11.0 16.0 6.0 July 4.6 12.0 14.0 6.0 August 8.0 16.0 14.0 6.1 September 7.0 11.0 8.0 5.3 October 9.0 16.0 18.0 6.2 November 13.0 23.0 23.0 10.6 December 11.0 23.0 10.0 6.2 General observations The figures obtained in 1959 showed a marked decrease in the total weight of deposited matter in both North and South Kensington, but the daily average of sulphur content showed a slight increase in both cases. It would be unwise to draw any firm conclusions from the results because, as will be remembered, the summer of 1959 was, from the general public's point of view, a dry and sunny one compared with previous years. Further, it is unwise to express opinions on figures obtained locally in comparatively small areas. The work of the public health department is a small part of that being undertaken throughout the country, and all results obtained in Kensington are forwarded to the Fuel Research Station of the Department of Scientific and Industrial Research for correlation with results obtained in all other districts. - 24 - Public Baths The Minister of Health (Circular l/6o) has requested that reference should be made to any public swimming baths in the borough. The Council have provided indoor swimming pools at the Public Baths situated in North Kensington at the junction of Lancaster Road and Silchester Road. The original building was constructed about seventy years ago and no major structural alterations have since taken place. However, the facilities available for the public are maintained in as modern a standard as possible. The swimming pools are described as follows:- 1. 1st Class Swimming Pool (Used for mixed bathing). 2. Men's 2nd Class Swimming Pool. 3. Ladies' 1st Class Swimming Pool. 4. Ladies' 2nd Class Swimming Pool. The large mixed bathing pool has an area of approximately 4,500 sq.ft. and the other three have each an area of about 1,500 sq.ft. All the pools are available for swimming in the summer months (mid-April to mid-October), but during the winter months only one of the smaller pools is open to the public for swimming. The water used for swimming is taken from the Metropolitan Water Board's supply at the commencement of the bathing season, and throughout the season it is treated by a continuous filtration system. Low pressure sand filters were installed in 1927 and a continuous chlorination equipment added several years later. This plant is now worn out and new equipment embodying the latest improvements is being substituted. The work of replacing the filtration plant for the large swimming pool and ladies' first class pool was carried out during the winter of 1959/60 and completed on 2nd May, 1960, the date scheduled for the beginning of the summer season. It is proposed to replace the plant for the two second class pools during the next two years. The filtration process consists of drawing water from the deep end of the pool through a suitable strainer and, after the addition of coagulants to flocculate organic matter and to obtain efficient filtration, the water is pumped to the top of four Vertical Air-Scoured Pressure Filters. The water, before filtration, is sterilized; this is done by introducing chlorinated water into the circulating flow from "Wallace & Tiernan" Automatic Residual Chlorine Control equipment, with hydraulic solution feeder for automatic pH Control. This gives an accurate method of controlling the dosage. The chlorinator automatically injects water chlorinated to the correct strength and at the same time adjusts the doses to suit varying bathing loads. The amount of chlorination provided operates on the principle of "breakpoint chlorination" and is recorded on a chart from which the degree of sterilization of the water is known at any time during the swimming season. The filter units consist of vertical closed cylinders containing graded Non-Friable Leighton Buzzard Sand supported on a bed of graded granite chippings, through which the water passes at a rate of 230-gallons per square foot of filter area per hour. The sand has to be washed regularly - this is done by steam and air agitation and reversing the flow of water, which runs to waste and carries impurities with it. Water taken from the pools is used for the washing process. - 25 - The filtered water is then aerated, thereby assisting in the maintenance of bacterial purity. It is then heated by calorifiers to about 75°F. It re-enters the swimming pools through suitable inlets at the shallow ends. Scum troughs are being provided on the sides of the pools which draw off any pollution which may accumulate near the surface, together with any dust which settles thereon. The new equipment has been designed to give a turnover period up to hours, which is about twice that obtained from the old plant. By this means, quicker purification of water is obtained and is particularly beneficial during peak periods. The whole of the new equipment has been designed to comply with the latest recommendations of the Ministry of Health for indoor swimming pools. Samples of the water in the pools are taken from time to time, and during 1959 the results obtained were well within the bacteriological standards recommended by the Ministry of Health. The residual chlorine similarly was maintained within the concentration advocated. Public Mortuary For many years, the Council maintained a public mortuary at No.lA, 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 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. Details regarding the number of Kensington cases admitted to the Hammersmith Public Mortuary since the agreement commenced are as follows:- 15th April, 1958-31st December, 1958 By Order of Coroner 251 On application of Undertaker 5 Total bodies admitted 256 1st January-31st December, 1959 By Order of Coroner 372 By Order of Police 4 On application of Undertaker 7 Total bodies admitted 383 Burial of the Dead Section 50 of the National Assistance Act, 1948, imposes on the Council the duty to arrange for the burial or cremation of any person who dies, or is found dead, within the borough, where no suitable private arrangements are made for the disposal of the remains. The Council have authorised the Medical Officer of Health to make arrangements for the burial of any person to whom the Section applies. In the twelve months ended 31st December, 1959, the Council became responsible for the burial of thirty-one persons dying in the borough. The following is a summary of the action taken:- - 26 - (a) Cases where the funeral expenses have been fully recovered 17 (b) Cases where part only of the expenses has been recovered 7 (i) Number of these where balance of expenses will be recovered 1 (amounting to lOS.Od.) (ii) Number of these where there was no further estate or "liable" relative 5 (iii) Number of these where "liable" relatives were unable to contribute 1 (c) Cases where full cost has been borne by the Council 7 (i) Number of these where there was no estate or "liable" relative 2 (ii) Number of these where "liable" relatives were unable to contribute 5 Amount recovered by the end of the year £240. 19s. 6d. Additional amount expected to be recovered 10s. Od. £241. 9s. 6d. Irrecoverable 163. 17s. 6d, Total cost £405. 7s. Od. Of the thirty-one cases dealt with, ten were eligible for Death Grant from the Ministry of Pensions and National Insurance. The total amount recovered from this source amounted to £114. os. 0d. (included in the above figures.) Since the National Assistance Act came into force on the 5th July, 1948, the Council have arranged for the burial of four hundred and thirty-four persons under Section 50. 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 1959, there were two hundred and seventy-three Kensington cremations, in comparison with two hundred and sixty-three in 1958 and two hundred and eighty-three in 1957. 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 seventy-two examinations were made. - 27 - Dog Nuisances Apart from being an objectionable social offence, fouling of footways by dogs is a public health nuisance for which an adequate remedy is hard to find. While it has been shown that dogs can carry and excrete germs capable of producing illness in man, it is seldom that cases of human disease can positively be related to infections originating from this source. Nevertheless, such instances do occur and the potential risk cannot be ignored. Certainly dog filth is an attraction to flies and blowflies, with consequent possibilities of conveyance of infection. The main objection, however, to the fouling of pavements and grass verges by dog excreta is the nauseating revulsion, embarrassment and distress caused by chance pollution of shoes, clothing, mats and carpets, necessitating disgusting and 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 purposes 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 no prosecution was taken under this byelaw. WELFARE OF OLD PEOPLE The Council have accepted the responsibility, within their powers, for co-ordinating and assisting in the extension of activities for aged persons and to alleviate unsatisfactory conditions under which many old people are living. Co-operation with voluntary bodies interested in the welfare of old people is effected wherever possible. In order that action taken shall be uniform, the Kensington Old People's Welfare Voluntary Committee act as an intermediary between the Council and the voluntary bodies. four members of the Public Health Committee serve on the Old People's Welfare Voluntary Committee which acts as a co-ordinating 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.O.S" in red on one side and, on the reverse side, directions how the 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 - 28 - 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 whose activities include the provision of recreation or meals for old people. During the year grants were made as follows:- (a) The Kensington Communal Kitchen 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 Kensington Council of Social Service were granted £165 for chiropody treatment of old persons confined to their homes. (c) The Home from Home Club, Royal Palace Hotel, were granted £46. 8s. 6d. towards their general running expenses. (d) The Merrymakers' Club for old people were granted £5 towards the cost of purchasing new crockery. (e) The Evergreen Club were granted £5 for the purchase of games, gramophone records, etc. (f) The Hammersmith Old Age Pensioners' Angling Competition Committee were granted £5 towards the cost of their annual competition. (g) The Old Age Pensioners' Social and Angling Club (North Kensington Community Centre) were granted £15 towards the cost of crockery and other equipment. Holidays In April, 1951, the Council approved a scheme for arranging holidays for old people through a voluntary organisation; this scheme was amended in 1953 and in 1957. The procedure prior to 1959 provided for block bookings being made at Lennox House, Southsea, and through the Ramsgate & District Hotel and Boarding Association. Applicants for a holiday were visited by the woman health officer, and were assessed for payment in accordance with the approved scale, which was based on the income of the applicant, (In 1958, the amount paid by an old person for a fortnight's holiday varied from 10s. to £2). In 1958, sixty-seven old people were sent on holiday; the total cost to the Council, after deducting contributions, was £563.l6s.9d. - 29 - Other boroughs operate similar holiday schemes and the contributions made by old people in those boroughs are mostly higher than in Kensingtonin some cases the full cost of the holiday is charged to the old people. The Council formed the opinion that old people in Kensington should be asked to make contributions more in line with those in neighbouring boroughs. If the contributions were increased, more people could be sent on holiday each year at the same net cost to the Council, which would enable the waiting list to be reduced to a minimum. There is little variation in the incomes of old people who apply for a holiday (especially old age pensioners with supplementary allowances), and it was believed that if contributions were fixed at a definite amount instead of being based on income, more people equally in need of a holiday would apply, particularly those who, through a feeling of pride, will not now apply for what they regard as a "charitable holiday From experience gained during the seven years the scheme has been in force, it was thought that old people could be expected to pay a reasonable contribution towards an annual holiday. A charge of £2 per week was fixed by the Council and, as a result, it was estimated that one hundred and eight old people, instead of sixty-seven, could be sent away at the same net cost to the Council. 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. During 1959, bookings were made at two holiday resorts, Southsea and 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 5s. for each person (or man or wife) for whom a holiday was arranged. The following is a summary of work carried out in 1959:- Total applications received 128 Unsuitable on medical grounds 4 Referred to other organisations 3 Subsequently withdrawn 16 23 Number sent to Lennox House, Southsea 41 Number sent to Ramsgate 64 Cost of holidays? Board and lodging fees and fares £981. 18s. 4d. Booking fees paid to Family Welfare Association 22. 15s. od. £1,004. 13s. 4d. Less contributions by applicants 416. 8s. 0d. Actual cost to the Council £588. 5s. 4d. In each case the holiday was for a period of two weeks and many letters of appreciation have been received from the old people concerned; 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. Eleven old people were dealt with in 1959. - 30 - 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 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 seven. During the year it was possible to arrange for one hundred and sixty old people to be admitted to hospitals for institutional treatment and, in addition, eighty cases were admitted to homes for the aged. Laundry At present no direct authority exists for the Council to provide a laundry service, as such, for old people. Section 122 of the Public Health (London) Act, 1936, enables the Council to cause any article in the house to be cleansed, disinfected or destroyed, if it is in such a filthy, dangerous or unwholesome condition that health is affected or endangered thereby. The cleansing of grossly fouled bedding in cases of incontinence may be dealt with under this Section. To comply with the legal requirements, the Council have given a general authority to the Medical Officer of Health to take whatever action appears to him to be necessary under the terms of Section 122 of the Public Health (London) Act, 1936. In seventy cases action was taken under the Section. The bedding was marked, laundered at the Council's disinfecting station and returned to the old people. The scheme works smoothly and appears to fill a much felt want. From stocks of bedding held, the Council are able to supply linen and bedding on loan to old people while their own is being laundered, and where possible voluntary organisations are asked to undertake replacements of much worn articles. During the year one thousand two hundred and sixty-eight separate collections of laundry were made under this scheme, and the number of articles cleansed totalled thirteen thousand, one hundred and thirty-seven. 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 £165 to the - 31 - 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 aspects 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 forty-seven and the number of treatments given was six hundred. 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 (lOd. per meal). The Kensington Communal Services Committee supply the meals and the vehicles for delivery. During the year the two organisations involved gave a considerable amount of thought to the difficulties encountered in this Service. Among the difficulties were the problems of keeping the meals hot; serving them (sometimes in the van); keeping the van interior clean; avoiding waste or spillage; and washing up. Added to these troubles were the weight and the unwieldiness of the containers. Various methods of keeping the meals warm had been tried - water jackets, insulated containers, charcoal blocks or preheated cabinets, but none was wholly satisfactory. A solution of these problems was forthcoming, when the idea was devised of developing electric containers which could be used on mains voltage to preheat the food and then, using another circuit, operate off the vehicle batteries to maintain the temperature of the food during its journey. An approach was made to the Rootes Group who, in co-operation with the General Electric Company, investigated the problem. As a result of this, it was decided to make container units capable of carrying 20 main meals in expendable foilpak dishes each having a 12-ounce capacity. These dishes which "nest" in quantity are extremely light and have a modest salvage value. Pour container units can be plugged into one vehicle. The General Electric Company container is a neat cabinet 12½in. wide, 8¾ in. deep and 22 in. high. It is constructed of polished aluminium with an inner and outer case lagged by an insulating material. Unloaded it weighs approximately 35-lb. and loaded about 55-lb. It is preheated by a 250 Watt element operating at mains voltage and the maintaining heat is supplied by a 40 watt element operating on a 12 volt vehicle battery. For easy servicing all the electrical components are situated in a removable tray in the bottom of the unit. To avoid the danger of plugging the elements into the incorrect supply voltage, the two elements are connected to dissimilar plugs. The containers have top and bottom doors so that food can be removed from the top section first and the maximum heat retained in the bottom section. The foilpak dishes are placed five to each of four removable wire cages, each dish being completely separated from its neighbour. Extremely light, the units are easily carried by one or two people using the handles mounted on the sides. This is important as the containers have to be placed in the vehicle with as little delay as possible, plugged in and switched on. A. pilot light in the vehicle glows to indicate that they are in fact, on circuit. The containers are fitted into metal holding trays on the floor of the vans and strapped down to prevent them rocking during transit and spilling food. At. the delivery point, two foilpak dishes containing a complete meal are taken out on a metal dish covered with a close fitting dish - 32 - cover and carried to the recipient. The holding trays and vehicle electrics have been made by the Rootes Group. Heat within the containers keeps the food in good condition even after a period of 2½/3 hours, or longer if they are used purely for storage. The fear that a traffic jam or vehicle breakdown will result in a pensioner getting a cold midday meal is at an end. Vehicle batteries only need charging every fourth day or so. The system, the first of its kind in this country, possesses the following advantages (i) space and weight saving; (ii) portability and lightness in handling; (iii) maintenance of temperature; (iv) abolition of washing up, with consequent saving in staff wages; (v) abolition of the necessity for serving meals in the van; (vi) cleanliness and ease of service; (vii) increased speed and efficiency of service; (viii) added convenience and comfort for staff and beneficiaries; (ix) more appetising meals. In operation, it has proved most popular with the old people and the staff. 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 _ — 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 5,210 2,134 2,125 500 451 1959/60 51,532 - Not yet available - It will be observed that the number of meals served continues to increase and for the year 1959/60 has reached a record total of 51,532. 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 1959/60. 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 - 33 - 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 1959:- Cases on register at the beginning of year 5,059 New cases added to register 776 Cases removed to hospital 160 Cases removed to homes (voluntarily) 80 Cases removed to homes (compulsorily - Cases removed from district 151 Number of deaths 321 Total number of cases remaining on register at end of year 5,123 Number of old people sent away for holiday 105 Number of old people provided with Council's laundry service 70 Number of old people provided with "Meals on Wheels" 246 Cases referred to National Assistance Board Cases referred for assistance from Home Help 214 Department 179 Cases referred for assistance from Voluntary organisations 149 Cases referred to Recreational clubs 162 Number of visits to chronic sick cases 407 Cases assisted with provision of medical and nursing care 144 Cases referred to home chiropody service 160 Cases where disinfestation was carried out 11 Number of initial home visits made 635 Number of re-visits 3,467 Number of other visits made in connection with old people, including visits to clubs 90 Number of interviews, enquiries, etc. on behalf of old people 1,728 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, 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 no case was formal action taken to secure compulsory removal. - 34 - SANITARY INSPECTION The following table shows a summary of the inspections, etc. carried out by the public health inspectors during the year s- Public Health (London) Act, 1936 Houses inspected on complaint 2,494 Houses inspected after infectious disease 1,947 Re-inspections 7,101 Smoke observations 38 Other inspected 1,113 Housing Act, 1957 Initial inspections (including preparation or revision of house-to-house cards) 506 Re-inspections 129 Initial inspections for overcrowding 348 Re-inspections 701 Underground Living Rooms Initial inspections 265 Re-inspections 2,214 Drainage Applications 606 Plans submitted 311 House drains inspected 5,888 House drains tested 578 Clean Air Act, 1956 Premises inspected (Smokeless zone) 7,367 Factories Act, 1957 Premises inspected 287 Outworkers' premises inspected 168 The following table shows the number of notices issued in respect of nuisances, defects, etc., found during the year :- Public Health (London) Act, 1956 Intimation notices 1,022 Statutory notices 405 Final notices 155 Various Factories Acts 24 Report of waste water to the Metropolitan Water Board 32 Report of dangerous structures to the London County Council 34 Other notices 54 - 35 - The following is a summary of works completed under the supervision of the public health inspectors during the year:- House drains, reconstructed or repaired 273 House drains cleansed 125 Water closets, reconstructed or repaired 155 Water cloests, new provided 416 Soil pipes, vent pipes, repaired etc 71 Soil pipes, vent pipes, new provided 151 Baths, new provided 312 Sinks, new provided 255 Lavatory basins, new provided 767 Bidets, new provided 17 Water pipes, new provided 370 Cisterns, cleansed 3 Taps fixed on rising main 1 Yards and areas paved, drained etc 5 Dustbins provided 101 Accumulations of filth, etc. removed 144 Roofs repaired 247 Houses provided with water above basement level 7 Dampness in dwelling remedied 323 Artificial lighting to staircases provided 4 Houses disinfected after infectious disease (including bedding, etc.) 220 Rooms in such houses, disinfected after infectious disease 344 Houses cleansed 15 Verminous houses cleansed (including bedding, clothing,etc.) 510 Verminous rooms in such houses, cleansed 892 Other sanitary works executed 720 HOUSING Inspection of dwelling houses during the year (i) (a) Dwelling houses inspected for housing defects (under Public Health or Housing Act) 5,560 (b) Inspections made for the purpose 16,818 (ii) (a) Dwelling houses (including those under sub-head (i) above) which were inspected and recorded under the Housing Consolid- ated Regulations, 1925 506 (b) Inspections made for the purpose 635 (iii) Dwelling houses found not to be in all respects reasonably fit for human habitation 1,071 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 657 - 36 - Action under statutory powers during the year (a) Premises repaired after service of formal notice under the Public Health (London) Act:- (1) By owners 401 (11) By local authority in default 8 (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 - (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 2 (ii) Dwelling houses demolished in pursuance of demolition orders 7 (iii) Dwelling houses in respect of which closing orders in lieu of demolition orders, were made 3 (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 (43 premises (72 rooms (ii) Separate tenements or underground rooms in respect of which closing orders were determined, the tenements or rooms having been rendered fit (37 premises (63 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 (15 premises (22 rooms (iv) Separate tenements or underground rooms in respect of which the Council accepted undertakings from owners to render fit within specified time ( 6 premises (14 rooms (v)Undertakings cancelled (3 premises (7 rooms (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 262 (1,035½ units) - 37 - (iii) Number of cases of overcrowding relieved during the year 673 (2,559½ 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 2 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, 1957, when the Rent Act, 1957, came into operation and laid down a new procedure. The following is a short summary of the new procedure s- 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 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 - 38 - 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 1959:- PART I - Applications for Certificates of Disrepair Number of applications for certificates 25 Number of decisions not to issue certificates 1 Number of decisions to issue certificates - (a) in respect of some but not all defects 17 (b) in respect of all defects 7 Number of undertakings given by landlords 13 Number of undertakings refused by Council - Number of certificates issued 13 PART II - Applications for Cancellation of Certificates Applications by landlords to Council for cancellation of certificates 16 Objections by tenants to cancellation of certificates upheld 5 Certificates cancelled 11 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 water; 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. 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 - 39 - 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. The work of enforcing the Council's standards falls into two categories :- (a) where large houses are properly converted for multiple occupation it is found that in practice that owners and contractors co-operate willingly in providing the necessary amenities? (b) in the case of houses which are let for multiple occupation without proper conversion (especially furnished lettings) a certain amount of difficulty has been experienced in enforcing the standards. Usually these houses are of the poorer class property and the occupants are somewhat nomadic in character. In these houses it is difficult to obtain the exact details of occupation, and when pressure is brought to bear upon the landlord he generally has no hesitation in serving notices to quit. In one or two cases the Council have had to resort to formal notices under Section 36 of the Housing Act, 1957> in order to obtain the desired improvements. Slum Clearance Action already taken The following table gives details of the clearance areas declared by the Council since 1950, when slum clearance work under the Housing Acts was recommenced, up to the end of the year:- - 40 - Name of Area Date of Declaration No. of houses No. of persons displaced Elgin Mews 25. 4. 1950 28 86 Lionel Mews (Nos.l 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.ll. 1951 13 30 St. Lukes Mews 13.11. 1951 20 41 Portobelldø 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.3) Area 14. 1. 1958 15 146 Portland Road (No.l) Area 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 Row and Gardens, the owners carried out the necessary demolition works prior to the Minister's decision. 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:- Estimated population Premises 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 Penelon 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. - 41 - 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. Action under Part III and Part V of the Housing Act, 1957, has been taken by the Council in respect of the major portion of 6½ acres. Many of the slum properties have been demolished and building operations are in progress. Two tower blocks, each comprising 78 dwellings, are expected to be completed in 1960, and the further development consisting of flats and maisonettes of 4-storey blocks is expected to be completed early in 1961. The task of dealing with the whole of the twenty odd acres of the Kensal New Town Area is complicated by town planning considerations. Negotiations between the London County Council, the Kensington Borough Council and the Paddington Borough Council, are at present in progress, and it is expected that agreement will be reached in the near future. The Portland Road clearance area consisting of 16 premises, has been dealt with by the Council under Part III of the Housing Act, 1957, and following a public Local Inquiry the Minister confirmed the Compulsory Purchase Order. The Council have approved plans for erectiag a block of single room lettings on the cleared site. The four remaining areas, which are comparatively small, are expected to be dealt with in the near future. 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. Towards the end of the year the Council, who had from time to time scheduled certain areas as possible clearance areas, reviewed the situation and decided to limit their official programme to the areas submitted to the Ministry of Housing and Local Government in 1955, plus the Portobello Road/Telford Road area. There was, however, one other area, Blechynden Street area, which had been the subject of negotiations between the Council and the London County Council, and during the year the following allocation, as far as redevelopment is concerned, was agreed by both sides:- - 42 - To be developed by the London County Council Blechynden Street area north west of railway Gross area in acres 8.30 To be developed by the Borough Council Blechynden Street area south east of railway:Gross area in acres 11.40 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 prinoipal 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 March; and (c) at other times as and when necessary if adequate means of natural lighting are not provided. During 1959, informal notices were served in twelve cases, requiring compliance with these Byelaws. Improvement or Conversion of existing houses There are two methods by which owners of private dwellings may apply to the Council for assistance towards carrying out works of improvement or conversion. The first method is to apply for an improvement grant - known as a discretionary grant - under the Housing (Financial Provisions) Act, 1958. The maximum grant payable is one half of the approved expenditure (which must not be less than £100) subject to a maximum allowance of £400. 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 pf Housing and Local Government has specified for a dwelling in respect of which an improvement grant may be made are as follows The dwelling must, after improvement or conversion- 1. be in a good state of repair and substantially free from damp; 2. have each room properly lighted and ventilated; 3. have an adequate supply of wholesome water laid on inside the dwelling; 4. be provided with efficient and adequate means of supplying hot water for domestic purposes; 5. have an internal or otherwise readily accessible water closet; - 43 - 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 watery 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 (discretionary) grants received and dealt with during 1959 are summarised as follows § - Applications received 22 Applications granted 20 Applications withdrawn after approval 1 Applications refused 2 Total amount of grants approved £6,918. Os. Od. The second method is to apply for standard grants, which were introduced by the House Purchase & Housing Act, 1959, which came into operation on 14th June, 1959. The Act sets up a new system of standard grants to supplement the present system of improvement grants paid at the discretion of the local authority. The distinctive features of the new system are that these grants are payable only in respect of the provision of specified standard amenities and on the expenditure actually incurred for this purposes and that provided certain conditions are satisfied the owner of the property can claim the grant as of right. The new system has been designed to produce as simple a procedure as possible and enable owners generally to form a reasonably accurate idea of the assistance they can hope to receive before any expense is incurred. It is designed to deal in the main with relatively straightforward cases in which the improvements involve little or no structural alteration, leaving the present system of discretionary grants to deal with the more elaborate proposals. There are five standard amenities (listed in Section 4 (l) as shown below) eligible for standard grant, which is one half of the cost shown to have been incurred in executing the works involved, subject to a maximum payment of £155° The maximum payment is reduced by the amount shown in parentheses in cases where the particular provision is omitted, as having been already provided:- (a) A fixed bath or shower in a bathroom (£25) (b) A wash-hand basin (£5) (c) A hot water supply (£75) (d) A water closet in or contiguous to the dwelling (£40) (e) Satisfactory facilities for storing food (£10) These ameaities must be for the exclusive use of the occupants of the particular dwelling,, The dwelling must after improvement be equipped with all five standard amenities; conversely, grant is not payable towards the cost of providing a second water-closet or other amenity if there is already one in the house. If a hot water supply is provided it must be - 44 - connected to a sink as well as to the bath or shower and. wash-hand basin (Section 4(5)). The works which may qualify for grant are such works for the improvement of a dwelling as are required to provide it with such of the standard amenities as it lacks and "improvement" bears the meaning given to it by Section 42(2) of the Housing (Financial Provisions) Act, 1958. Thus to the direct cost of installing, say, a bath or wash-hand basin there may be added the cost of any necessary structural alterations and consequent redecoration; while in some cases it may be impracticable to do the work without removing and replacing elsewhere an existing facility such as a sink or foodstore. The test to be applied in considering whether expenditure on any particular work is eligible for grant is whether it would in all the circumstances have been reasonably practicable to equip the dwelling with the amenities it lacked without carrying out that work. No application for a standard grant can be entertained if the dwelling concerned was provided after the end of 1944, with one exception. If the dwelling was produced by conversion and the original building was erected before the end of 1944 then provided the conversion was completed not later than the end of 1958, the dwelling will be eligible for standard grant purposes (Section 4(6)). As under the existing discretionary grant scheme, for grant to be payable the approval of the authority must be obtained before work is begun and the work must be done to their satisfaction (Section 4(l)). Prom the time the Act came into force until the end of the year, only two applications for standard grants were received. In each case the statutory conditions were not complied with and the application was refused. Overcrowding In view of the shortage of housing accommodation, created by the war, the Council had up to last year operated the overcrowding provisions of the Housing Acts under a special scheme. In November, 1958, however, it was decided to deal with all cases of overcrowding on the strict interpretation of the standards laid down in the Housing Act, 1957s distinguishing between "penal" and "non penal" cases. A review of all the known cases of overcrowding which the Public Health Committee had, under their previous scheme, regarded as less serious was undertaken during the year and it was found that in 573 cases the overcrowding had been abated. The number of new cases of overcrowding reported to the Committee during 1959 was 262, giving an equivalent number of persons of 1,035½. Of these overcrowding was abated in 100 cases. Thus the total number of overcrowding cases which were recorded during the year as having been abated was 673, comprising a total of 2,559½ units. Assessment of Housing Priorities on Medical Grounds During the year 143 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, - 45 - an assessment of points to be awarded on medical grounds was made in 140 cases. Provision of new housing accommodation The post-war housing schemes completed in Kensington by the Council have provided 1,414 flats. The total number of properties under Council management at the end of 1959 is summarized in the following table Housing Properties 1890 Act 18 Cottage Estates 220 1919 Conversions 95 Pre-war Flats 325 Sundry Properties 75 733 Temporary Bungalows 62 Compulsory Purchase Areas 15 1949 Act Conversions 85 Post-war Flats 1,414 1,576 Nos. 27/29, Hazlewood Crescent 10 Requisitioned Properties-purchased 229 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 Familv Units) 285 2,903 Other schemes for building new housing accommodation are in various stages of preparation. FACTORIES Section 128 of the Factories Act, 1937, requires the Medical Officer of Health to make an annual report in regard to the Council's functions under the Act. The following tables give the prescribed particulars in the form requested by the Ministry of Health in circular No. l/60 dated 8th January, 1960. - 46 - Part 1 of the Act 1 - INSPECTIONS for purposes of provisions as to health (including inspections made by Public Health Inspectors) Premises Number of No. on Register (2) Inspections (3) Written notices (4) Occupiers prosecuted (5) (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 150 45 7 - (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 578 242 17 3 (iii) Other premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) - - - - TOTAL 728 287 24 3 2 - Cases in which DEFECTS were found (If defects are discovered at the premises on two, three or more separate occasions they should be reckoned as two, three or more "cases") Particulars Number of cases in which defects were No. of cases in which prosecutions were instituted Found Remedied Referred To H. M. Inspector By H. M. Inspector (1) (2) (3) (4) (5) (6) Want of cleanliness (S.l) 2 l 1 - Overcrowding (S.2) - - - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) - - - — - Ineffective drainage of floors (S.6) - - - - - Sanitary conveniences (S.7) (a) insufficient - - - - - (b) unsuitable or defective 16 10 - - 2 (c) not separate for sexes 7 6 - 1 1 Other offences against the Act (not including offences relating to Outwork.) - - - - - TOTAL 25 17 - 2 3 - 47 - During 1959, three prosecutions were instituted under the Factories Acts, 1937 and 1948. Two were in respect of the defective ventilation to sanitary conveniences, but the work was carried out before the Court hearings and the summonses were withdrawn. The third was in respect of the absence of separate W.C. accommodation for the sexes; and as the work was in progress at the time the Court hearing was due, the summons was adjourned sine die. Part VIII of the Act Outwork (Sections 110 and 111) Nature of Work Section 110 Section 111 No. of outworkers in August list required by Section 110(l)(c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions (1) (2) (3) (4) (5) (6) (7) Wearing )Making apparel)etc. 83 - - - - - )Cleaning ) and )Washing 1 - - - - - Household linen 1 - - - - - Curtains and furniture 3 - - - - - hangings larding, etc. if buttons, etc. 5 - - - - - Stuffed toys 60 - - - - - Lampshades 2 - - - - - During the year, 168 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. The last quinquennial review was made in 1958, and at the present time there are six basement bakehouses in use in the borough. They are as follows :- 151, Earls Court Road 178, Fulham Road 65, Golborne Road 79, Golborne Road 139, Portland Road 46, Walton Street 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 Act 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 - 48 - Factory - business North Kensington South Kensington Mech. N-M. Mech. N-M. Bakers and Confectioners 6 2 11 2 Belt and Button Manufacturers 4 — — 1 Builders and Decorators 9 3 11 12 Carton Making and Salvage 1 2 - — Coffee Grinding and Roasting 1 - 5 - Cosmetics and Toilet Preparations 1 - - 1 Dental Mechanics 1 — 2 Disinfectants 1 — _ — Display Works and Signwriting 3 3 1 2 Doll and Toy Manufacturers 8 4 3 - Dressmaking 11 - 31 13 Drug Manufacturers - 1 - - Dyers and Cleaners 8 - 12 - Electro-Platers 1 _ — — Engineering (Elec.) 8 - 3 3 Engineering (Mech.) 29 - 10 - Electrical Generating Stations 2 - 2 - Film Editing and Slide Making - - - - Furriers 2 1 10 2 Gas Works 1 _ — Glass Cutting and Polishing 3 - 4 - Handbags and Shopping Bags 2 - - - Ice Cream Manufacture 1 - - - Jewellers and Watchmakers 5 2 3 3 Lamp Shade Manufacturers 1 3 1 1 Laundries 18 6 — Leather Goods 2 — 1 3 Metal Merchants 5 3 3 2 Milliners - 1 1 8 Motor Car Accessories 4 2 _ - M.V.R. And Garages 34 - 79 6 Musical Instruments - - 1 • Needle Grinding 2 - 1 - Novelty Goods 1 - - - Office Equipment 1 - - - Oil Blenders and Packers 2 — _ 1 Paint Makers and Storers 2 1 _ — Photographers 2 2 4 3 Picture Frame Makers 1 1 5 4 Plastics 3 2 1 - Printers and Bookbinders 14 1 6 Radio and Television Repairs 4 - 7 1 Records 1 — - - Rubber Goods Manufacturers 1 - — — Rag Merchant - 1 • — Sausage Makers 13 - 6 - Scientific & Hospital Instruments 3 - 3 - Shoe Makers and Repairers 10 — 10 1 Silk Screen Printing and Spraying 3 - 1 - Starch and Soda Manufacturers 2 1 - - Soft Furnishings and Upholstery 11 3 17 12 Stone Masons 2 - 1 - Sweet Making and Packing - 1 - - Spray Painting 1 - - - Tailoring 7 3 17 14 Undertakers 1 - - 1 Wax Workers 1 _ • «. Weaving - - 1 - Woodworkers (Joiners, etc.) 14 1 11 1 Wheelwrights 1 - - - Miscellaneous Factories 6 1 6 8 TOTALS 281 45 297 105 - 49 - Sanitary accommodation, etc. in shops Certificates of Exemption Under 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 1959, two exemption certificates under the Shops Act were 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 1959s two exemption certificates were issued under the Food Hygiene Regulations in respect of water supply and sinks in food shops. The London County Council (General Powers) Act, 1958, transferred to metropolitan borough councils, from 1st January, 1959, the responsibility for enforcing provisions of the Shops Act, 1950, relating to adequate lighting, suitable and sufficient washing facilities and, where employees take any meals in the shop premises, suitable and sufficient facilities for taking those meals. The Council may grant an exemption certificate in respect of washing facilities if they are satisfied that it is reasonable to do so because of restricted accommodation or other circumstances. The London County Council sent particulars of shops where exemption certificates had been granted by them; in nine cases these have been replaced by certificates issued by the Council, and in five cases the exemption certificates were cancelled. The London County Council are empowered to retain the above functions in relation to any shop at a place of public entertainment, and they gave formal notice that the transfer of functions will not apply to the following premises in Kensington :- Twentieth Century Theatre 291, Westbourne Grove, W.ll. Imperial Playhouse 191, Portobello Road, W.11. Royalty Cinema 105-109, Lancaster Road, W.11. Classic Cinema 87, Notting Hill Gate, W.ll. The Gaumont Notting Hill Gate, W.ll. Odeon Theatre 263, Kensington High Street, W.8. Chanticleer Theatre Clareville Street, S.W.7. Paris Pullman Cinema Drayton Gardens, S.W.10. Forum Theatre 142-150, Fulham Road, S.W.10. - 50 - SUPERVISION OF FOOD SUPPLIES Food and Drugs Act. 1955 This Act, 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 s- 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; (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, windows, ceiling, woodwork, doors 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. - 51 - Requirements relating to food stalls Every stall - (a) must bear the name and address of the person carrying on the business; (b) must be kept clean and in good repair; (c) when used for meat and fish, must be covered over and screened at the sides and back, and a covered metal refuse bin must be provided for all waste trimmings; (d) when used for open food, for immediate consumption, must be provided with suitable and sufficient sinks for washing food and equipment, together with a supply of hot and cold water, soap, nailbrush, clean towels and drying cloths. Generally Suitable and sufficient bandages, dressings and antiseptic must be provided and maintained in food premises. Sufficient and suitable cupboard or locker accommodation for clothing and footwear must be provided for persons engaged in or about food premises. In premises where the business consists wholly or partly of the supply of food for immediate consumption, food consisting of meat, fish, gravy or imitation cream, or prepared from or containing these substances, or any egg or milk, must be kept in accordance with the specified temperatures. 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 46 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. It was, however, found necessary to take legal proceedings for contraventions of the Regulations, as follows :- - 52 - DETAILS OF LEGAL PROCEEDINGS TAKEN UNDER FOOD HYGIENE REGULATIONS IN 1959 As requested by Ministry of Health Circular 22/58 Date of hearing Offence Regulation Result Fined Costs awarded to Council 21. 4.59 Failure to protect food (unwrapped sweets placed less than 18" from ground in forecourt). 8 £2. 0s. 0d. £2. 2s. 0d. 21. 4.59 Failure to keep clean walls and ceiling of kitchen (restaurant) 23(1) £2. 0s. 0d.} 21. 4.59 Food business carried on in insanitary premises 5 Withdrawn} 21. 4.59 Absence of hot water supply for persons engaged in food handling 16(2) £2. 0s. 0d.} £2. 2s. 0d. 21. 4.59 Absence of soap, nail brushes and clean towels for persons engaged in food handling 16(3) £2. 0s. 0d.} 21. 4.59 No notice on or near sanitary convenience requesting food handlers to wash hands 14(5) £2. 0s. 0d .} 30. 6.59 Dirty floor of bread store room 23(1) £5. 0s. 0d.} £2. 2s. 0d. 30. 6.59 No suitable and sufficient wash basin 16(1) £5. 0s. 0d.} 30. 6.59 Accumulation of refuse in food room 24 £5. 0s. 0d.} 28. 7.59 Dirty floor of food premises 23(l) £3. 0s. 0d.} 28. 7.59 Dirty articles and equipment in food room 6(1)(C) £3. 0s. 0d.} £3. 0s. 0d. 28. 7.59 Dirty sink in food room 19(1)(C) Not dealt with separat ely 13.10.59 Use of tobacco whilst handling open food (fruit) 9(e) £1. 0s. 0d.} £1. 1s. 0d. 13.10.59 Dirty and defective floor of kitchen 23 £5. 0s. 0d} 13.10.59 Refuse accumulated in kitchen 24 £5. 0s. 0d.} 13.10.59 Insufficient washhand basins for persons employed in handling food 16 £5. 0s. 0d.} £4. 4s. 0d. 13.10.59 Inadequate supplies of nail brushes and clean towels 16(3) £1. 0s. 0d.} 13.10.59 Failure to keep clean clothing (overalls) worn by food handlers 9 £5. 0s. 0d. - 53 - 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 1959 Premises registered under - No. of premises No. of inspections (1) Section 16, Food and Drugs Act, 1955 - (a) for the sale, or the manufacture for the purpose of sale, of ice-cream, or the storage of ice-cream intended for sale 330 60 + (b) for the preparation or manufacture of sausages or potted, pressed, pickled or preserved food intended for sale 113 172 (2) Milk & Dairies (General) Regulations, 1959 as dairies or where the occupier is registered for the sale of milk in sealed containers only 220 764 + 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 12 " - others 10 7 Bread and cake shops 45 33 Butchers 71 125 Dairies and premises where milk is sold 220 215 Fishmongers 31 46 Food factories 5 39 General stores 11 152 Greengrocers 109 52 Grocers 222 371 Ice-cream 330 60 Preserved food 21 47 Public houses and off-licences 151 72 Restaurants and cafes 254 397 Sweet shops 168 93 Street markets, stalls and storage premises 95 (lic311 ensed traders.) 95 (Miscellaneous ). Milk (Special Designations)(Raw Milk) Regulations, 1949/54 During the year licences under these Regulations were granted as follows :- - 54 - Principal Supplementary Dealers licensed, to sell Tuberculin Tested Milk; 145 25 Thirty-five 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) 55 26 9 Milk (Special Designations)(Pasteurized and Sterilized Milk) Regulations. 1949/55 Milk in relation to which the special designation "Pasteurized" is used shall be pasteurized, i.e. (a) retained at a temperature of not less than 145°F. and not more than 150°F. for at least 30 minutes (the "Holder" system); or (b) retained at a temperature of not less than l6l°F. for at least 15 seconds (the "High Temperature, Short Time" system). Milk treated by either system must be immediately cooled to a temperature not exceeding 50°F. Pasteurized Milk samples are subjected to the phosphatase and methylene blue tests. The former is to test the efficiency of the treatment as to whether or not the milk has been properly pasteurized or whether any raw milk has become mixed after treatment. The methylene blue test shows the keeping quality of the treated milk. Sterilized Milk must be filtered or clarified, homogenised and heated to and maintained at such a temperature, not less than 212°F. for a period as to ensure its compliance with the prescribed turbidity test. Details of licences granted during 1959 are as follows :- Principal Supplementary Dealers' licences to sell Pasteurized milks 159 25 Dealers' licences to sell Sterilized milk: 148 28 The following table shows the number of samples of processed milk taken during the year-, together with results of examinations :- Methylene blue test Phosphatase test Turbidity test Designation No. of samples Passed Failed Passed Failed Passed Failed Tuberculin tested (Pasteurized) 5 5 - 5 - - - Pasteurized 17 17 - 17 - - - Sterilized - - - - - - "" - 55 - Milk and. Dairies (General) Regulations, 1959 (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 220. (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 two contraventions were reported to the public health department. In both cases investigations failed to reveal sufficient evidence to justify legal action. In one case the Public Health Committee authorised that a warning be given to the bottlers, and in the other case it was decided to take no action. Composition of Milk During the year, three hundred and nineteen samples of milk (all grades.) were submitted to the Public Analyst. Eight 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. In three of these cases legal proceedings were instituted, warnings were given in two cases, and in the remaining three cases it was decided to take no further action. 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 sixty-six samples certified by the Analyst to be genuine, although the percentage of solids-not-fat was slightly below the presumptive standard of 8.5%. Month No. of samples taken Average percentages Milk fats Non-fat solids January 29 3.70 8.49 February 29 3.55 8.42 March 14 3.46 8.43 April 21 3.40 8.53 May 15 3.28 8.65 June 8 3.30 8.65 July 13 3.46 8.60 August 1 3.95 8.60 September 15 3.47 8.62 October 18 3.68 8.65 November 24 3.81 8.70 December 21 3.75 8.66 Average for the whole year 3.57 8.58 Legal minimum standards 3.00 8.5O Milk and Dairies (Channel Islands and South Devon Milk) Regulations, 1956 These Regulations require that all milk for human consumption - 56 - 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, one hundred and eight samples of these milks have been taken and five of these have been found to be below the legal standard laid down. The action taken; legal proceedings in three cases and warnings in two cases, has already been mentioned previously in this report. The following table shows the average percentages of milk fat and non-fat solids of the genuine samples of these milks taken during each month Month No. of samples taken Average percentages Milk fats Non-fat solids January 6 4.6l 8.99 February 11 4.44 8.77 March 3 4.28 8.80 April 8 4.33 8.97 May 10 4.13 9.04 June 6 4.36 8.98 July 8 4.18 8.91 August 2 4.45 8.85 September 12 4.35 8.88 October 15 4.38 8.92 November 16 4.44 9.00 December 6 4.47 9.02 Average for the whole year 4.37 8.93 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 1959 there was one occasion when it was found necessary to enforce this procedure. This concerned the offering for sale of chocolate biscuits which were found to be mouldy. 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 legal proceedings be taken in this case. - 57 - Surrender Any person having in his possession food which is diseased, unsound, or unfit for human consumption can, under Section 180(8) of the Public Health (London) Act, 1936, surrender it to the Council for destruction or other suitable method of disposal. During the year the following amounts of food were surrendered and condemned as unfit for human consumption :- Food Tons Cwt. Qrs, Lb. Meat (raw) - 7 1 17 Meat (tinned) - 5 - 2 Ham 1 12 2 20 Fish (Wet and dry) - 9 - 7 Sausage - 10 - 10 Fruit - - 2 15 Sugar - 2 2 - Cheese - - 2 25 Dried fruit — 2 1 3 Sauerkraut — - 3 16 Cooking fats and butter - - 2 22 Polish Pork paste - 7 2 - Rabbits - - - 18 Spaghetti - 1 - - TOTAL 4 - 2 15 Tins, jars, packets or cartons of fruit, vegetables and miscellaneous foodstuffs 9,907 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. Anthrax On 5th November, 1959, an announcement was broadcast that meat infected with anthrax had been delivered to a shop in North Kensington, The shop in question was used only for the sale of pet foods, A notice under the Anthrax Order, 1938, was served by the London County Council declaring the premises to be an infected place and requiring it to remain closed until satisfactory measures had been taken. The remains of the infected meat, with other meat in the shop, were removed and burnt, A report was received that the proprietor of a food shop had purchased meat from the infected shop for his cats, and had placed it in a refrigerator containing fats intended for sale to the public. The contents of the refrigerator were surrendered and destroyed and the refrigerator was disinfected. Complaints by purchasers of unfit food During the year, fourteen 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, a chicken, bread and cakes, and the unsatisfactory condition of beer, tinned tomatoes and porage oats. In all cases it was decided to take no legal action and the - 58 - complaints were dealt with informally, either owing to lack of proper evidence, or to the complaint not being substantiated. Adulteration of Food During the year, five hundred and sixty-four formal samples of food and drugs were purchased, of which twenty seven (4.8%) Were either adulterated or otherwise unsatisfactory. Four hundred and thirtv-six informal samples were also purchased, of which thirty-seven (8.5%) were either adulterated or otherwise unsatisfactory. The following table summarizes the action taken in respect of the defective samples :- Unsatisfactory sample No. of prosecutions No. of warnings to Producers, Manufacturers or Vendors No further action Total Milk 3 2 3 8 Milk Shake Syrup - - 1 1 Sterilized cream - - 1 1 Double cream cheese - 1 - 1 Cheese spread with shrimp - - 1 1 Cream of asparagus soup - 1 - 1 Spinach puree - - 1 1 Condensed tomato puree - - 11 - Tomato paste - 1 - 1 Tomato juice - 2 - 2 Blackcurrant juice - 1 - 1 Grape and blackcurrant juice - - 1 1 Fresh fruit squash - - 1 1 Orange squash - - 1 1 Cochineal - - 3 3 Chopped glace fruit - 1 - 1 Dried nectarines 1 - - 1 Dried apricots - 1 1 2 Apricots - - 1 1 Dried mixed fruit - - 1 1 Sultanas - 1 - 1 Seed pearl tapioca - 1 - 1 Semolina pudding - - 1 1 Pearl barley 4 1 2 7 Yellow corn meal - 1 - 1 Popping corn - 1 - 1 Pork sausages - 3 2 5 Beef sausages - 1 - 1 Liver sausage - - 1 1 Yorkshire relish - - 1 1 Sauce - - 2 2 Curry powder - - 1 1 Ground nutmegs - 1 - 1 + Nutmeg flavoured compound - 1 - 1 Chocolate sauce powder - 1 - 1 Instant coffee - - 3 3 Dressed crab - - 2 2 Minced chicken in jelly - - 1 1 Cough medicine - - 1 1 TOTALS 8 22 34 ++ 64 + 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. - 59 - Date Marking of Pies On 10th February, 1959, the Council decided to ask the Metropolitan Boroughs' Standing Joint Committee to make representations to require manufacturers to mark pies with the date of manufacture, or the date of issue, in a prescribed uncoded manner. The Standing Joint Committee agreed with this proposal and made representations to the Minister of Agriculture, Fisheries and Food. The Ministry replied that the suggestion could be applied only to wrapped pies, and the effect of a statutory requirement might be to discourage the use of wrappers. The Ministry consider that the date-marking of wrapping would not be a useful indication of the condition of the pie when it was sold, because so much depended upon the storage and other conditions on the sellers' premises, and the quality and the freshness of the product when it was processed. The Ministry were of the opinion that the provisions of the Food and Drugs Act, 1955, which make it an offence to sell unfit food, and provide for the seizure of unfit food, give effective protection to the consumer. Ice Cream The Food Standards (ice Cream) Regulations, 1959, and the Labelling of Food (Amendment) Regulations, 1959, have been made jointly by the Minister of Health and the Minister of Agriculture, Fisheries and Food. They came into operation on 27th April, 1959, and repealed the previous Order of 1953- The ice cream regulations prescribe amended standards for ice cream and introduce separate standards for "dairy ice cream" (or "dairy cream ice" or "cream ice"), and for "milk ice". The legal Standards of Composition for ice cream are as follows :- (a) Ice cream shall contain not less than 5 per cent. fat and 7½ per cent. milk solids other than fat so, however, that where ice cream contains any fruit, fruit pulp or fruit puree it shall either conform to the above standard or, alternatively, the total content of fat and milk solids other than fat shall be not less than 12½ per cent. of the whole including the fruit, fruit pulp or fruit puree, as the case may be, and such total content of fat and milk solids other than fat shall include not less than 7½ per cent. fat and 2 per cent. milk solids other than fats Provided that as respects any ice cream sold, or offered or exposed for sale under any of the descriptions hereinafter specified, or under any such other description as is calculated to lead an intending purchaser to believe that he is purchasing ice cream of any such description as is so specified, the standard of composition shall be as follows :- (i) Dairy Ice Cream, Dairy Cream Ice or Cream Ice shall in each case contain not less than 5 per cent. milk fat and no other fat (save as may be introduced by the use as an ingredient of any egg, any flavouring substance or any emulsifying or stabilising agent) and not less than 7½ per cent. milk solids other than fat, so, however, that where any Dairy Ice Cream, Dairy Cream Ice or Cream Ice contains any fruit, fruit pulp or fruit puree it shall either conform to the standard of composition for that ice cream, or alternatively, the total content of milk fat and milk solids other than fat shall be not less than 12½ per cent. of the whole including the fruit, fruit pulp or fruit puree, as the case may be, and such total content of milk fat and - 60 - milk solids other than fat shall include not less than 7½ per cent. milk fat and no other fat (save as may be introduced by the use as an ingredient of any egg, any flavouring substance or any emulsifying or stabilising agent) and not less than 2 per cent, milk solids other than fat. (ii) Milk Ice, or Milk Ice containing any fruit, fruit pulp or fruit puree, shall contain not less than 2½ per cento milk fat and no other fat (save as may be introduced by the use as an ingredient of any egg, any flavouring substance or any emulsifying or stabilising agent) and not less than 7 per cent. milk solids other than fat. (iii) "Parev" (kosher) ice shall contain not less than 10 per cent. fat and no milk fat or other derivative of milk. (b) No ice cream of any description shall contain any artificial sweetener. The previous requirement that ice cream shall contain not less than 10 per cent. of sugar has been revoked. The Labelling Regulations prohibit the labelling, marking or advertising of ice cream in a manner suggestive of butter, cream, milk, or anything connected with the dairy interest unless the ice cream contains no fat other than milk fat (except such as may be introduced by the use as an ingredient of any egg, flavouring substance, or emulsifying or stabilising agent), but permit the presence of skimmed milk solids to be declared. These regulations also provide that, after 30th November, 1959, it will be an offence to sell under the description "ice cream", any pre-packed ice cream which contains fat other than milk fat unless it bears on the wrapper or container a declaration "Contains non-milk fat", or, if appropriate, "Contains vegetable fat", in type of a prescribed minimum size. The following table shows the number of samples (l2 ice cream and 7 dairy ice cream) taken during 1959 for chemical analysis compared with those taken in the previous year :- 1959 1958 Number of samples 19 15 Variation of fat content per cent 8.1 to 13.3 7.1 to 12.8 Variation of non-fat content per cent 22.6 to 32.1 22.7 to 32.3 Average fat content per cent 11.25 11.40 Average non-fat solids content per cent 26.44 25.95 The Ice Cream (Heat Treatment etc.,) Regulations, 1959, came into operation on 27th April, 1959, and revoked the Regulations of 1947 to 1952. They require that ingredients used in the manufacture of ice cream are to be pasteurized by one or other of three specified methods, viz. Method I The mixture shall be raised to and kept at a temperature of not less than 150°F. for at least 30 minutes. - 61 - Method II The mixture shall be raised to and kept at a temperature of not less than 160°F. for at least 10 minutes. Method III The mixture shall be raised to and kept at a temperature of not less than 170°F. for at least 15 seconds. An alternative method is by sterilisation by raising the mixture to a temperature of not less than 300°F. for at least 2 seconds. After pasteurization or sterilisation the mixture has to be reduced to a temperature of not more than 45°F. within 1½ hours and kept at this temperature until frozen, after which it must be kept at a temperature not exceeding 28°F. up to the time of being sold. 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 twelve samples of ice cream were also taken and submitted to the methylene blue test. The results axe as follows Grade No. of samples 1 2 3 4 2 2 3 5 Premises in the borough where ice cream is manufactured, stored or sold were frequently inspected during the year and generally were found to be in a satisfactory condition, having regard to the Ice Cream (Heat Treatment etc.,) Regulations, 1959. Condensed Milk The Condensed Milk Regulations, 1959, made jointly by the Minister of Agriculture, Fisheries and Food, and the Minister of Health, came into operation on 26th June, 1959. They substantially re-enact in a consolidated and revised form the Public Health (Condensed Milk) Regulations, 1923/1953. Certain new provisions have been introduced, the principal ones being (a) to provide for the sale of condensed partly skimmed (half cream) milk labelled "should not be used for babies except under medical advice." (b) to define half cream milk as meaning milk which contains not less than 10.8% of milk solids including not less than 1.8% of milk fat (c) to prescribe minimum percentages of milk fat and milk solids including fat for condensed partly skimmed (half cream) milk. During the year ten samples of condensed milk were submitted for analysis and found to comply with the requirements. - 62 - General There are no abattoirs or slaughterhouses in the borough and. no killing of animals for human consumption is carried out. FOOD POISONING The Pood and Drugs Act, 1955, requires any medical practitioner, on becoming aware that a person is suffering, or is suspected to be suffering from food poisoning, to notify the Medical Officer of Health. The following table shows particulars of notifications received during 1959 :- Food poisoning notifications (corrected) First quarter 10 Second quarter 15 Third quarter 24 Fourth quarter 16 TOTAL 65 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 - 1 3 _ 3 Agent unidentified 5 - 12 - 12 Single cases No. of cases Notified Otherwise ascertained Total cases Agent identified 27 - 27 Agent unidentified l 23 - 23 Salmonella infections, not food-borne No incidents under this heading occurred in Kensington in 1959• The cases of food poisoning summarized in the above table are reported in greater detail below Outbreaks due to identified agents (l outbreak) Three Kensington patients were associated with an outbreak which occurred in a large general hospital in a neighbouring borough. The patient (2 males under 1 year and a female aged 34) were unconnected as far as family or residence were concerned. The two babies had been born in the hospital and the infection remained undiscovered until after discharge; both these children were admitted to hospital for treatment. The adult patient) who was treated at home, was a member of the hospital's ancillary staff. Outbreaks of undiscovered cause (5 outbreaks) The figures relating to these five family outbreaks have remained - 63 - uncorrected, largely in order not to discourage notification, even though the evidence adduced during investigations strongly suggested that none of the twelve associated patients should be strictly classified as food poisoning sufferers. Bacteriological examinations of faecal specimens from patients and contacts, and of suspected food where available, were negative in respect of all the incidents. In each outbreak, there were others at risk, either in the same home or from the sources where suspected articles of food were obtained, but none of these was affected. Each of the outbreaks is briefly described below :- (a) Two adults (Male 30: Female 30) suffered an abdominal upset after eating continental sausage. (b) Two adults (Male 26: Female 25) were ill after eating a meal of hamburgers. (c) Two adults (Females 57 and 88) were ill after giving a party at home. Seven other people at risk remained well. The younger patient had recently had a breast removed and was still undergoing x-ray therapy, and the other patient was under treatment for a gall bladder condition. (d) Three people (Males 34 and 3: Female 29) out of a family of four had an abdominal upset over a short period. This was possibly due to a gross contamination of some article of food by organisms harmless in lesser numbers (although conditions of food storage and preparation were good); or, more probably, to a virus infection. (e) Three people (Male 9: Females 40 and 16) out of a family of seven were ill, but the illness did not spread even though the mother was affected. Single cases In addition to the outbreaks referred to above, there were fifty single cases of food poisoning notified. In twenty-three of these, no causative agent was identified, but in the remaining twenty-seven cases, the identified agents were as follows :- Agent Cases Salmonella typhi-murium 25 Salmonella newport 1 Salmonella dublin 1 None of the cases due to unidentified agents was admitted to hospital, but twenty-one of the twenty-seven cases where a causative agent was found were treated in hospital. The problem of corrected figures also arises in the single cases where no agent was identified. Many of these cases in 1959 appeared to be doubtful on investigation. Two examples taken from this year illustrate the problem. In one case, it was found that an ulcer patient occasionally rebelled against the strict diet; in fact, the patient had been notified in a previous year for a similar indiscretion. In a second instance, the history was strongly suggestive of sub-acute appendicitis to which the attention of the medical practitioner was drawn. INFECTIOUS DISEASE Smallpox No case of smallpox was notified in the borough during 1959. - 64 - In the Ministry of Health's Memorandum on Vaccination against Smallpox, it is recommended that public health officers, likely to have to deal with cases of smallpox at short notice, should be regularly re-vaccinated at not more than yearly intervals. During the year twenty- four members of the staff of the public health department were vaccinated or re-vaccinated by the Medical Officer of Health. Scarlet fever The number of cases notified in 1959 was fifty-four and, of this total, four 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. 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 1,996 " " school " " 344 " " re-inforcing injections given 1,497 " " children attending for pre-Schick tests 387 " which gave a positive reaction 270 " " " " negative reaction 103 " of children attending for post-Schick tests 772 " proving negative 679 " proving positive 12 " who failed to attend for reading 81 Enteric fever During the year, there were four cases of typhoid fever and two of paratyphoid fever. The first two cases of typhoid fever reported in 1959 were two Cypriot women, aged 59 and 22 years respectively, associated with a previous case reported on in my Annual Report for 1958. The older woman had contracted the disease whilst nursing the original patient and had transmittei the infection to the younger woman who lived in the same house. All the contacts were kept under surveillance after submitting negative specimens and no further cases occurred. The older woman became a "carrier" and after hospital treatment returned to Cyprus; the Ministry of Health were informed. The younger woman recovered in hospital. The third case involved a woman aged 19 years who was admitted to hospital suffering from a pyrexia of unknown origin. She had not been abroad and neither had she departed from her normal routine prior to the onset of the disease. All contacts remained well and submitted negative specimens. The patient recovered in hospital, but the source of infection remained undiscovered. The fourth case of typhoid fever occurred in a little girl aged 3 years who had recently returned from a three months' stay with relatives in Italy. She had, in fact, suffered the first symptoms of the disease just before the return journey. She was still undergoing treatment in hospital at the end of the year. All the contacts remained well and, with the exception of the child's mother who was found to be a carrier of Plexner dysentery, all submitted negative specimens. The first patient reported with paratyphoid fever in 1959 was a woman aged 45 years. Investigations showed that a younger colleague of the patient, at her place of work in another borough, had contracted the disease earlier, and it is thought that infection may have occurred during - 65 - the preparation of refreshments there. The earlier case was involved in an outbreak of the disease in South London where the source of infection was believed to be confectionery. The Kensington case recovered in hospital and her home contacts remained well and submitted negative specimens. The second case of paratyphoid fever occurred in a woman aged 46 years who fell ill on the return journey from a month's holiday in Jugo-Slavia. Immediately on her arrival in Kensington she was admitted to hospital where she recovered. All the contacts submitted negative specimens and remained well. Puerperal Pyrexia During 1959, the number of cases of this disease notified was one hundred and twelve, of whom eighty-three were persons normally resident outside the borough. All of these cases occurred in hospital. In order to show some perspective in reviewing the incidence of this disease (defined as any febrile condition occurring in a woman in whom a temperature of 100.4°F. or more has occurred within fourteen days after childbirth or miscarriage), the following table sets out an analysis of the causes of pyrexia in the cases notified in 1959 :- Cause Number of cases Flushed breast, breast abscess, mastitis 14 Respiratory infections Chest infection 4 Influenza 6 Coryza 2 12 Urinary infection 32 Pyrexia associated with abnormal delivery:- Retained placenta 1 Forceps delivery 1 Transfusion reaction 2 Caesarian section 4 Subinvolution 1 9 Uterine infection 22 Causes unknown after investigation 23 In addition to the above one hundred and twelve cases, information was received 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 sixty notifications were received, fifteen being acute primary pneumonia and forty-five being acute influenzal pneumonia. Of the total, thirteen cases were removed to hospital for treatment. The number of deaths from pneumonia (all forms) was one hundred and eight, and the number of deaths from influenza was thirty-two during 1959. Dysentery One hundred and ten cases of dysentery were notified during 1959, 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. Thirty-six of these patients were treated in hospital. 66 Erysipelas Six cases were notified during the year; four were treated at home, and two were admitted to hospital. There were no deaths. Meningococcal infection Two cases of this disease were notified during the year and were removed to hospital. No deaths were reported. Malaria One case of malaria was reported during the year, but investigation showed that the patient had recently returned from abroad, and presumably contracted the infection overseas. Poliomyelitis There were eight cases of acute poliomyelitis notified and confirmed during the year; seven of the cases showed symptoms of paralysis. There were no deaths from this disease during the year. The figures in the last five years are as follows Year Confirmed cases Deaths 1955 50 Nil 1956 21 Nil 1957 15 1 1958 4 Nil 1959 8 Nil There were seventeen suspected cases removed to hospital, where the diagnosis was not confirmed. Contacts of all cases were kept under surveillance for twenty-one days, (or until the diagnosis was changed in unconfirmed cases.) In each instance an advisory pamphlet was issued setting out the elementary precautions to be taken. Kensington residents, who were contacts of cases occurring outside the borough, were also kept under observation. It is still too early to assess whether or not the programme of vaccination against poliomyelitis has permanently affected the incidence of this disease. During the year, the Medical Research Council continued its investigation of the possible association between poliomyelitis and inoculation against disease, including 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 the post-infectious type (measles) of this disease was notified in the borough during 1959; the patient recovered after treatment in hospital. Measles Of the seven hundred and thirty-seven cases notified during 1959j twenty-four were admitted to hospital for treatment. One death of a child occurred in hospital and the cause was registered as "extensive broncho-pneumonia and measles." 67 Ophthalmia neonatorum One patient, who was notified as suffering from this condition, fully recovered after treatment at home. Information was also received of two babies born to Kensington mothers in a hospital outside the borough, who contracted the disease before discharge. One of these children has recovered and the second was still undergoing treatment at the end of the year. Gastro-enteritis This disease is notifiable in children up to the age of five years. The number of cases reported during the year was seven. Three were removed to hospital for treatment. One death of a child under five years of age was recorded as due to gastritis, enteritis or diarrhoea in 1959. Scabies The number of cases of scabies notified during 1959 was forty-two, which compares with four hundred and sixty-three notified in the peak year of 1946. Tuberculosis During the year one hundred and ninety-four new cases of tuberculosis were notified, of which one hundred and seventy-two were respiratory and twenty-two 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, 1959 823 672 70 95 1,660 Notified for the first time during the year 93 79 10 12 194 Brought to notice other than by notification 95 62 3 4 164 Removed from register on account of having - (a) recovered from the disease 15 16 1 3 33 (b) removed from district lost sight of, etc. 137 93 8 10 248 (c) died 10 6 - - 16 Remaining on register on 31st December, 1959 851 698 74 98 1,721 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 fifty-five visits were paid 68 to the homes of tuberculous patients. In two hundred and forty-seven of these, the environmental conditions were such as to require no further action on the part of the public health department; in a further forty-nine cases, it was found that the patients had moved away, and in thirty-one 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 twenty-eight is summarised as follows:- Action taken Cases Investigation or supervision undertaken in respect of:- (a) re-arrangement of existing accommodation 11 (b) occupation of patients 2 (c) tracing of contacts 2 (d) prevention of spread of infection 4 Recommended for priority re-housing 6 Action taken under Public Health and Housing Acts in respect of insanitary or unhealthy conditions 7 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 1959:- 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 Austria - - - 1 _ 1 _ _ - 2 British West Indies 3 - - - - - - 1 - 4 Cyprus 1 - - - - - - - - 1 France - - - - - 1 - - - 1 Gibraltar - 1 - - - - - - - 1 Hungary - - 2 - - - - - 1 3 India 3 1 - - - - - - - 4 Ireland 7 4 2 2 2 1 2 - 1 21 Italy - 1 1 - - - - - - 2 Malaya 1 - - 1 - - - - - 2 Nepal - 1 - - - - - - - 1 Nigeria 1 1 - - - - - - - 2 Pakistan 1 2 - - - - - - - 3 Persia - 1 - - - - - - - 1 Poland 1 - - - - - - - - 1 Seychelles 1 - - - - - - - - 1 South Africa 1 - - - - - - - - 1 Spain 3 - 1 - - - - - - 4 Uganda 1 _ - - - - — - - 1 TOTALS 24 12 6 4 2 3 2 1 2 56 69 Patients who had resided in London all their lives or for at least 10 years 42 Patients who had resided in other parts of the country all their lives prior to coming to Kensington 53 Patients from whom information concerning origin was not obtained hut where it is believed to be this country 14 Patients notified abroad before coming to this country (Ireland 7) 7 Patients who resided here at least 10 years prior to notifications (Poland 2, Ireland 2, Phillipines 1, u.s.A.I, Sweden 1, South Africa l) 8 Patients from whom information concerning origin could not be obtained 105 TOTAL 229 The investigations only covered patients newly notified or transferring into the borough from other areas. The total of two hundred and eighty-three 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 per cent. of the tuberculous patients visited for the first time in that year were immigrants who contracted the disease within ten years of arrival in this country. A more accurate investigation in the following years indicated that, of the new cases reported in the borough, the proportions who were immigrants contracting the disease in the first ten years of arrival, were as follows:- Year Proportion per cent. 1952 16 1953 10 1954 16 1955 17 1956 15 1957 16 1958 23 1959 20 This year, 43% (1958 = 38%) of the immigrants contracted the disease within one year of arrival in this country; 75% (1958 = 80%) 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 Eighty-three cases were notified during the year, eight of which were treated in hospital. One child, under 12 months of age, died of "whooping cough and pneumonia" during 1959. 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, 70 yellow fever and. cholera. When completed by the medical practitioner, the certificate must be authenticated by the Medical Officer of Health. During the year, three thousand, two hundred and thirty-three of these certificates were authenticated in Kensington. In addition, twenty-four special exemption certificates were issued to travellers for use in the United States of America. Notifications The following tables show (1) the number of cases of infectious disease notified during the year 1959, 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 1959 1958 1957 1956 1955 1954 1953 1952 Scarlet fever 54 27 33 45 50 52 78 108 Diphtheria (including membranous croup) - - - 1 2 - 2 - Enteric fever 6 5 5 10 7 5 5 2 Puerperal pyrexia 112 116 123 117 125 96 65 83 Acute primary pneumonia and acute influenzal pneumonia 60 70 75 65 105 54 93 71 Dysentery 110 117 77 88 99 68 131 31 Erysipelas 6 11 7 5 9 14 11 11 Meningococcal infection 2 6 3 6 2 1 6 4 Malaria 1 1 5 1 6 4 5 1 Acute poliomyelitis Paralytic 7 2 13 14 10 5 9 17 Non-paralytic 1 2 2 7 20 - 5 4 Acute encephalitis 1 1 3 2 4 1 - 3 Tuberculosis (all forms) 194 179 208 258 218 243 256 251 Measles 737 654 982 358 1425 94 740 839 Ophthalmia neonatorum 1 5 1 1 4 2 7 2 Enteritis + 7 13 10 14 13 20 27 30 Pood poisoning 65 47 52 63 53 58 79 20 Scabies 42 52 52 40 54 42 42 26 Whooping Cough 83 92 130 236 116 136 485 228 Typhus fever - - - - - 1 - - TOTALS 1489 1400 1781 1331 2322 896 2046 1731 + Notifiable only in children under the age of 5. NOTE: Cases of mistaken diagnosis are excluded from above table. 71 TABLE 2 Notifiable disease Number of Cases Notified in 1959 Age Groups in Years Under 1 1 to 2 3 to 4 5 to 9 10 to 14 15 to 24 25 & over Scarlet fever 1 6 17 24 5 - 1 Diphtheria(including membranous croup) - - - - - - - Enteric fever - - 1 - - 2 3 Puerperal pyrexia - - - - - 58 54 Acute primary pneumonia and acute influenzal pneumonia 1 3 1 - 1 2 52 Dysentery 12 25 7 17 6 13 30 Erysipelas - - - - - - 6 Meningococcal infection 1 1 - - - - - Malaria - - - - - 1 - Acute poliomyelitis Paralytic - 3 3 - - - 1 Non-paralytic - - - - - - 1 Acute encephalitis - 1 - - - - - Tuberculosis (all forms) 1 3 1 3 - 46 140 Measles 28 149 188 311 24 22 15 Ophthalmia neonatorum 1 - - - - - - Enteritis 6 1 - - - - - Food poisoning 7 6 3 2 1 15 31 Scabies 1 1 5 1 3 18 13 Whooping cough 17 22 13 28 3 - - TOTALS 76 221 239 386 43 177 347 TABLE 3 Notifiable disease Total cases notified in each Ward St.Charles Golborne Norland Pembridge Holland Earls Court Queens Gate Redcliffe Brompton Scarlet fever 11 7 12 9 5 1 1 5 3 Diphtheria (including membranous croup) - - - - - - - - - Enteric fever 2 - - 1 1 1 1 - - Puerperal pyrexia 1 3 1 3 7 8 85 4 - Acute primary pneumonia and acute influenzal pneumonia 10 15 5 12 5 4 2 5 2 Dysentery 21 14 13 13 9 19 4 16 1 Erysipelas - - 1 1 - 4 - - - Meningococcal infection 1 1 - _ — - - - - Malaria - - - - - 1 - - — Acute poliomyelitis Paralytic 5 1 - - - 1 - - _ Non-paralytic - - - - - - 1 - - Acute encephalitis - - - - 1 - - - - Tuberculosis (all forms) 31 23 22 22 14 28 18 24 12 Measles 78 79 99 94 97 106 71 90 23 Ophthalmia neonatorum - - 1 _ - _ - — - Enteritis 1 5 _ 1 - _ — - - Food poisoning 12 8 6 11 8 10 3 4 3 Scabies 9 3 10 12 3 2 - 3 - Whooping cough 22 25 4 11 1 10 1 9 - 72 LEGAL PROCEEDINGS Public Health (London) Act, 1936 Nuisances During the year, 69 summonses were issued for various nuisances under the Public Health (London) Act, 1936. In 25 cases Abatement Orders were secured and costs amounting to £36. 15s. Od. were awarded to the Council. In 31 cases the summonses were withdrawn, the nuisances having been abated prior to the Court hearings, and two other cases were withdrawn owing to change of ownership in the premises concerned. In 11 cases the summonses were adjourned as the necessary works were being carried out by the defendants. Fourteen prosecutions were undertaken for failure to comply with Justices' Orders to abate statutory nuisances. In 9 cases fines amounting to £63. Os. Od. were imposed and costs amounting to £13. 2s. 6d. were awarded to the Council. The remaining five cases were withdrawn or adjourned sine die as the necessary works had been, or were being, carried out. London County Council (General Powers) Act, 1954. (Section 12) Three summonses were issued in respect of deficient or defective dustbin accommodation. In one case the owner was fined £3. Os. Od. with £1. 1s. Od. costs. The other two cases were withdrawn as the required dustbins had been provided before the Court hearings. Housing Act, 1957 Illegal occupation of closed underground rooms Five summonses were issued during 1959 against the landlords or tenants for occupying closed underground rooms. In two cases fines totalling £1. 10s. Od. and costs of £2. 2s. Od. were imposed. Two cases were withdrawn as the illegal occupation had ceased prior to the Court hearings. The remaining case was dismissed on a "legal technicality". Illegal occupation of closed part of house One summons was issued against a landlord for permitting the upper part of a dwelling, closed for human habitation, to be occupied. A fine of £5. 0s. 0d. was imposed and £3. 3s. 0d. costs were awarded to the Council. Overcrowding One summons was issued against the landlord of overcrowded premises. A fine of £2. 0s. 0d. was imposed and costs of £2. 2s. 0d. were awarded to the Council. Food and Drugs Act. 1955 Sale of unfit food The following proceedings were taken under Section 2 of the Act, for selling, to the prejudice of the purchaser, food not being of the nature, substance or quality demanded, with the results indicated:- (a) Sale of loaf of bread in dirty condition Fine £2. 0s. 0d. with £2. 2s. 0d. costs. 73 (b) Sale of mouldy sausage roll Fine £2. 0s. 0d. with £1. 1s. 0d. costs. (c) Sale of Milk (Channel Islands) deficient in milk fat Fine £2.10s. 0d. with £2. 2s. 0d. costs. (d) Sale of Milk (Channel Islands) deficient in milk fat Fine £2.10s. 0d. with £2. 2s. 0d. costs. (e) Sale of Milk (Channel Islands) deficient in milk fat Absolute discharge on payment of £2. 2s. 0d. costs. Preservatives in Food Regulations, 1925/58 Three summonses were issued in respect of the sale of food containing preservative in contravention of these Regulations. The vendors exercised their right under Section 115 of the Food and Drugs Act, 1955, to plead that they had in fact sold the food under a "Written Warranty", and consequently the summonses were withdrawn. Obstruction of Council's Officer In one case, a summons was issued under Section 105(l) against a person for obstructing the Chief Public Health Inspector from entering food premises. A fine of £3. 0s. 0d. with £3. 3s. 0d. costs were imposed. Food Hygiene Regulations, 1955 and 1957 Eighteen 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, failure to keep food premises in a clean condition, and lack of equipment (hot water supply, towels and nail brushes). In sixteen cases fines totalling £53. 0s. 0d. with £14. 11s. 0d. costs were imposed. One summons was withdrawn and the remaining case was "not dealt with separately." Factories Act. 1937 Three summonses were taken out in respect of the unsatisfactory sanitary accommodation provided in factories in the borough. In two cases, the summonses were withdrawn as the work had been completed, and in the third case, the hearing was adjourned sine die as the necessary work was in progress. 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. 74 PARTICULARS OP THE STAFF OF THE PUBLIC HEALTH DEPARTMENT AT THE END OF 1959 (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 So Wheeler, Chief Clerk 1924 Clement G. Legge, D.M.A. 1959 Miss Elizabeth Howarth 1951 George W. Churcher, B.Sc.(Econ.) 1935 Mrs. B. Hennessey 1954 Digby A. Smith 1939 Stanley C. Nottingham 1956 Miss Vera F. Osborne 1941 Miss Phyllis Schifreen 1957 Mrs. S. Scott 1943 Andrew Banfield 1958 Miss Doris Gibbs 1944 Roy H. Beard 1959 Victor W. Waymark 1946 Mrs. D. M. Haffenden 1959 Mrs. B. Beesley 1948 Public Health Inspectors 2.3. Henry W. Walters, F.R.S.H., Chief Inspector, 1925 2.3. Cecil R. Webb 1925 1.2. Arthur E. Standish 1947 1. Arthur L. Vague 1934 1. Arthur E. Sills 1949 1.2. Ronald D. Callis, B.Sc.(Econ.) 1.2. Kenneth Bell 1955 D.P.A. 1935 1.2.4. Leslie A. Palmer 1956 1. Dennis C. Draper 1938 1.2. David A. McLaren 1957 1. Harold Hind 1939 Student Public Health Inspectors Raymond J. Grinsted 1957 Brian H. Stone 1959 Roy S. Fierheller 1959 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 L. J. Barker, Drainage Assistant 1959 Kenneth Brown, Assistant to Public Health Inspectors 1959 1. Certificate of the Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. 2. Certificate for Inspectors of Meat and Other Poods. 3* Certificate of London Sanitary Inspectors' Examination Board. 4. Smoke Inspectors' Certificate. 75 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 Prevention of litter in streets 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 66 Adulteration of Food 58 Anthrax 57 Artificial lighting of staircases 42 Atmospheric Pollution 17-23 Bacteriological Work 10 Bakehouses 47 Birth Rate 1 Burial of the Dead 25 Cancer of the Lung 2 Certificates of Disrepair 37 Chiropody for Aged Persons 30 Clean Air Act, 1956 4, 17-23, 34 Clearance Areas 39 Cleansing of Aged Persons 29 Committees 75 Cremation Service 26 Deaths, Causes of 9 Death Rate 1 Diphtheria 64 Diphtheria Immunisation 64 Disinfection & Disinfestation 11 Dog Nuisances 27 Drainage 34 Dysentery 65 Enteric Fever 64 Erysipelas 66 Factories 45-48 Food - 5, 50 Adulteration 58 Condensed Milk 61 Hygiene Regulations 5, 50 Ice Cream 59 Inspections 51, 53 Legal Proceedings 52 Milk 53-56 Poisoning 62 Unsound 56, 57 Castro Enteritis 67 Health Education 15 Heating Appliances (Fireguards) Act, 1952 17 Holidays for Aged Persons 28 Home Safety 16 Houses in Multiple-occupation 38 Housing - 3, 34 Clearance Areas 39 Improvement Grants 42 Inspections 34 Medical Priorities 44 INDEX Page Housing - New Housing Accommodation 45 Overcrowding 36, 44 Slum Clearance 39-42 Underground Rooms 34, 36 Ice Cream 59 Improvement Grants 42 Infant Death Rate 2 Infectious Diseases 2, 63 Acute Encephalitis 66 Diphtheria 64 Dysentery 65 Enteric Fever 64 Erysipelas 66 Gastro Enteritis 67 Malaria 66 Measles 66 Meningococcal Infections 66 Notifications 70 Ophthalmia Neonatorum 67 Poliomyelitis 66 Pneumonia 65 Puerperal Pyrexia 65 Scabies 67 Scarlet Fever 64 Smallpox 63 Tuberculosis 67 Whooping Cough 69 Institutional Care of Aged Persons 30 International Certificates 69 Laundry Facilities for Aged Persons 30 Legal Proceedings - Defective dustbins 72 Factories Acts 73 Food and Drugs Acts 72 Food Hygiene Regulations, 1955 52 Nuisances 72 Obstruction of Council's officers 73 Overcrowding 72 Preservatives in food 73 Underground rooms 72 Library Facilities for Aged Persons 30 Lung Disease 2 Malaria 66 Mass Radiography 17 Maternal Death Rate 2 Meals for Aged Persons 31 Measles 66 Meat Pies - marking 59 Medical Examination of Staff 26 Medicinal Baths 10 Meningococcal Infections 66 Milk 53, 55 Milk - Channel Islands, etc 55 Milk & Dairies Regulations, 1949/54 53 Milk, Special Designations 54 Mortuary 25 INDEX Page National Assistance Acts, 1948/51 25, 33 New Housing Accommodation 45 Notification of Infectious disease 70 Nuisances 72 Old People's Welfare 27 Advice Leaflets 27 Chiropody 30 Cleansing 29 Grants 28 Holidays 28 Institutional Care 30 Laundry Facilities 30 Library Facilities 30 Meals Service 31 Removals 33 S.O.S. Cards 27 Visiting 32 Ophthalmia Neonatorum 67 Outworkers 46 Overcrowding 36, 44 Pests, Prevention of Damage by 11-14 Pet Animals Act, 1951 15 Pharmacy & Poisons Act, 1933 14 Poliomyelitis 66 Population 1 Pneumonia 65 Public Swimming Baths 24 Puerperal Pyrexia 65 Rag Flock & Other Filling Materials Act, 1951 14 Removal of Aged Persons 33 Rent Act - Certificates 37 Rodent Control 11-14 Sanitary Inspection 34 Drainage 34 Dwelling Houses 35 Inspections 34 Legal Proceedings 72 Sanitary Notices served 34 Supervision of Work 35 Scabies 67 Scarlet Fever 64 Sewer Baiting (rats) 14 Shops, Sanitary Accommodation 49 Slum Clearance 39-42 Smallpox 63 Smoke Control Areas 4, 17 - 20 Smoke Measuring Stations 21-23 S.O.S. Cards 27 Staff 5, 74 Standard Grants - houses 43 Student Public Health Inspectors 5 Swimming Baths 24 INDEX Page Tuberculosis 2 Underground Rooms 34 Unsound Food 56 Vaccination 63 Vital Statistics 5-7 Water Supply 10 Whooping Cough 69 Women's Voluntary Services 31