AC 4348 II KEN 72 The Royal Borough of Kensington ANNUAL REPORT ON THE Health of the Borough FOR THE YEAR 1963 BY J. H. WEIR M.D.. B.S., B.HY., D.P.H. f MEDICAL OFFICER OF HEALTH THE ROYAL BOROUGH OP KENSINGTON Telephone: WEStern 3173 Public Health Department, Hornton Street, Kensington, W.8. 1st June, 1964 To the Mayor, Aldermen and Councillors of the Royal Borough of Kensington. My Lord, Ladies and Gentlemen, I have much pleasure in presenting the Annual Report on the state of the public health in Kensington for 1963. The Minister of Health has again requested (Circular l/64) 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 finally ascertained by the Census in 1961 was 171,272. For the purpose of this report, the population for 1963 has been estimated by the Registrar-General to be 172,170. The estimated population figure for the previous year was 172,020. Birth Rate. The number of live births per 1,000 population of the borough was 19.1 in 19&3 which compares with the figure of 19•7 for the previous year. Death Rate. The number of deaths per 1,000 population in 1963 was 10.20, slightly lower than the death rate for the previous year (10.21). 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 area, where the proportion of males is much higher. The Registrar-General has supplied, for use in Kensington in 1963, the figures 0.58 for births and 1.18 for deaths. The crude birth and death rates for the borough should be multiplied by the appropriate factor, and when so adjusted the results are comparable with the crude rates for England and Wales or with the corresponding adjusted rates for any other area. - 2 - The following table gives the adjusted Kensington birth and death rates compared with the provisional rates for London and for England and Wales for the year 1963:- Kensington adjusted London England and Wales No. of births per 1,000 population 11.08 20.0 18.2 No. of deaths per 1,000 population 12.04 12.5 12.2 Infant Death Rate. This rate for 1963 was 25.2, an increase compared with the rate for the previous year of 22.4. The provisional rate for the County of London was 21.8 and for England and Wales was 20.9. The following table shows the rates for the last five years Year Kensington London England and Wales 1963 25.2 21.8 20.9 1962 22.4 21.1 21.6 1961 20.9 21.5 21.6 1960 20.8 21.6 21.9 1959 24.8 22.3 22.2 Variations in the infant mortality rate are contributed to partly by perinatal mortality, i.e. stillbirths and 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 No. of deaths due to prematurity 1 or under 2 3 4 5 6 1959 34 3 5 4 3 3 52 38 1960 27 4 - 4 - 2 37 22 1961 30 6 - 3 - 1 40 21 1962 36 4 1 - l 4 46 19 1963 36 4 1 - — 1 42 20 1963 1962 Neo-natal mortality rate (i.e. deaths of infants under 4 weeks per 1,000 total live births) 16.11 15.32 Early neo-natal mortality rate (i.e. deaths of infants under 1 week per 1,000 total live births) 13.07 13.55 Perinatal mortality rate (i.e. stillbirths and deaths of infants under 1 week per 1,000 total live and still births) 26.39 30.96 - 3 - Maternal Death Rate. Three deaths of mothers due to child-birth were recorded in 1963, giving a maternal death rate per 1,000 live and still births of 0.90. (The provisional maternal mortality rate for the County of London was 0.43 and for England and Wales the figure was 0.28.) Infectious Diseases. There was no serious outbreak of infectious disease in the borough during 1963. The total number of notifications received was 1,394 in comparison with 714 in 1962. The difference is almost entirely due to the increase in the number of cases of measles notified in 1963 compared with the previous year. Tuberculosis. The death rate from all forms of tuberculosis per 100,000 population was 7.0, which was the same as last year's figure. The 1963 Kensington death rate compares with the rate (provisional) of 6.3 for England and Wales. Lung Disease. Kensington's death rate from pulmonary tuberculosis per 100,000 population in 1963 showed no change compared with the previous year, but the death rate for cancer of the lung showed an increase. Comparative figures for England and Wales showed a decrease in the rate in respect of pulmonaiy tuberculosis, but a continuing increase in the death rate for lung cancer. The following table shows the trend in these diseases for the past ten years Year 1 England and Wales Kensington Pulmonary Tuberculosis Cancer of the Lung Pulmonaiy Tuberculosis Cancer of the Lung Deaths Rate Deaths Rate Deaths Rate Deaths Rate 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 1960 3,094 6.8 21,992 48.1 11 6.6 94 56.0 1961 3,002 6.5 22,810 49.4 16 9.45 71 42.0 1962 2,774 5.9 23,779 51.0 11 6.4 75 43.6 1963 2,613 5.6 24,422 51.9 11 6.4 84 48.8 (Death rates quoted above are per 100,000 population.) The indictment of cigarettes as the cause of lung cancer in the Royal College of Physicians 1962 Report on Smoking and Health has been more than fully substantiated and endorsed by the recently published report of the Advisory Committee to the Surgeon-General of the American Public Health Service. This states unequivocally that "Cigarette smoking is causally related to lung cancer in man; the magnitude of the effect of cigarette smoking far outweighs all other factors..... In comparison with non-smokers, the average male smokers of cigarettes have approximately a 9 to 10-fold risk of developing lung cancer and heavy smokers at least a 20-fold risk The data for women though less extensive point in the same direction." Even more recently the original exponents of this subject, Sir Austin Bradford Hill and Dr. Richard Doll, writing in the British Medical Journal, have shown that the death rate of cigarette smokers from cancer of the lung has been thirteen times the rate of nonsmokers, and the death rate of heavy cigarette smokers has been more than 30 times the rate of non-smokers. Probably one of their most dramatic and convincing pieces of evidence is a table relating to doctors, among 41,000 of whom they have conducted and are conducting a prospective survey. This table, which relates the death from lung -4- cancer to age and the number of cigarettes smoked, shows that between the ages of 45 and 74 no death occurred among non-smokers, whereas 133 deaths occurred among cigarette smokers: 22 among those smoking 1-14 cigarettes daily, 54 among those smoking l5-24 cigarettes daily, and 57 among those smoking 25 or more cigarettes daily. Among those who had given up smoking the death rate per thousand was reduced to about a half in those who had given up smoking for less than 5 years, to approximately three-eighths for those who had given up smoking for 5-9 years, and to one-sixth in those who had ceased smoking for 10 to 19 years. Housing. The work of dealing with public health in the borough comprises many branches which must receive attention. From time to time, certain sections of the work need special attention and energetic measures. Housing conditions in the borough have for many years received special attention by the Council, but with the introduction of the Housing Act, 1961, this work became more concentrated in North Kensington. Part II of the Housing Act, 1961, introduced measures for dealing with unsatisfactory conditions in tenement houses. The object was to improve normal household facilities and amenities for individual families, many of whom, in the tenement houses in North Kensington, are not provided with adequate sanitary accommodation, personal washing facilities (such as baths and washhand basins), hot and cold water, means of cooking and storing of food, etc. On 12th March, 1963, following deliberations by a Joint Committee comprising representatives of both the Public Health and Housing and Town Planning Committees, the Council adopted proposals to improve the amenities of houses in North Kensington. In order to assess the situation, a rapid estimate was made of the property situation; current or future proposals; the population; living conditions and the household facilities available. The property situation was summed up under four headings:- (1) Those properties in slum clearance or redevelopment areas, which have been agreed or are in prospect. (2) Areas of properties up to 100 years old where the houses are either unsuitable or not worth converting. (3) Areas of property of younger and/or more substantially built houses with a prospective life of at least another 20 or 30 years. (k) The remaining areas in North Kensington which, except in isolated cases, do not fall generally into the foregoing categories. Whilst demolition and redevelopment in the case of properties mentioned in category (2) above would be the best long-term project, existing slum clearance commitments will undoubtedly prevent the Council undertaking this for many years, Having regard to the age, location and type of properties, the owners, occupants, multiple occupation, and the Council's long experience, it was felt that a better short term policy for these areas would be the application of the provisions of the Housing Act, 1961, in relation to houses in multiple occupation as soon as possible. The implementation of this short term policy required the provision of additional staff and accommodation, and the Finance Committee were requested to deal with this. - 5 - The Council decided:- (a) That action be taken under the provisions of the Housing Act, 1961, relating to houses in multiple occupation in respect of specified areas. (The systematic application of this had already commenced in houses in St. Ervan's Road, and in selected individual houses elsewhere.) (b) That representations be made to the Minister of Housing and Local Government that, in view of the peculiar problem attaching to tenement property in Kensington, power should be given to the Council to waive, in appropriate cases, the requirements of section 4 of the House Purchase and Housing Act, 1959, that standard grants are payable only where standard amenities are provided for the exclusive use of the occupants of a given dwelling which must on completion have all five amenities. (c) That representations also be made to the Minister of Housing and Local Government that the administrative and legal procedures associated with action under the Housing Act, 1961, regarding houses in multiple occupation be simplified. (d) That the Town Clerk and the Medical Officer of Health be authorised to seek an interview with the officials of the Ministry of Housing and Local Government to support the Council's representations. In order to press on with this work the Council decided to increase the staff in the Town Clerk's department by 2 officers to deal with service of notices, etc. and the staff of the Public Health department by 4 inspectors and 3 clerical officers. Owing to the shortage of office accommodation in the Public Health department it was necessary for the Council to convert an old coach-house and stables into office accommodation at a cost of approximately £3,500. The conversion of the office accommodation was not completed until about October, 1963, and to this extent there was some delay in progress in implementing the provisions of the Housing Act, 1961. Further, the enforcement procedure laid down in the Act, allowing owners of properties sufficient time to carry out the necessary works, is time consuming. The Council have specified amenity standards for houses in multiple occupation. By the end of the year 300 houses had been inspected, notices had been prepared and served, and improvement works had been completed or commenced in over 120 cases. Since then the operation has gained momentum and the figures to date (May, 1964) are:- Total number of houses inspected 478 Number where work has been completed 69 Number where work is well in hand 158 In addition to this specialised work which commenced in 1963, progress was made in dealing with the clearance of slum houses. During the year four new clearance areas were declared, comprising 135 houses with an eventual displacement of 979 persons. Three of these areas were in Kensal New Town which the Council, together with the London County Council, have planned to redevelop, and the fourth area was in Princedale Road, which the Council have agreed should be redeveloped by the Rowe Housing Trust, Ltd. - 6 - Clean Air Act. Steady progress was made in the Council's programme of dealing with Smoke Control Areas, which provides for the borough to be completely dealt with by 1970. The Council's programme is being dealt with in accordance with the scheduled times. Apart from the five isolated objections received in respect of the Holland Ward (No.2) area, which resulted in a twelve months' delay, the residents of Kensington, both owners and occupiers, appear to be welcoming the Council's efforts to reduce atmospheric pollution. The work is of a detailed nature and necessitates numerous inspections to ensure that contraventions of the Clean Air Act will not occur, but, generally speaking, the initial difficulties in operating this legislation have been overcome and there is no reason why the work should not proceed quickly and smoothly to its finality. During the year, the Norland Ward (Nod) area was completed and the remainder of the Ward was made the subject of a new order, fixing the date of operation as 1st October, 1964. Food Hygiene. The work of maintaining satisfactory hygienic standards in food shops was continued unabated. The number of inspections of food shops made during the year was 1,452. It is somewhat disappointing that, although the Pood Hygiene Regulations have been in force since 1955, it is still found necessary to take legal proceedings for contraventions of the Regulations in what appears to be an increasing number of cases each year. The following table shows the number of summonses issued for contraventions of the Regulations in the last three years:- Year No. of summonses issued 1961 50 1962 149 1963 196 Whilst the great majority of food traders in the borough observe the Regulations in a satisfactory manner, the need for keeping a careful watch for unsatisfactory traders does not appear to diminish. Adequate standards in some cases can only be maintained apparently by frequent inspections, in order to maintain satisfactory standards throughout the borough, Staff. With the extra work falling on the Public Health department, by reason of new legislation, the need for increasing the number of public health inspectors became more acute than before. The Council decided, following unsuccessful attempts to recruit non-qualified staff, that an effort should be made to recruit older and more experienced inspectors by offering a higher grade of salary than recommended by the London District Council. As a result the establishment of the public health inspectors has been increased from 15 to 20 in the past few months. Mr. H.W. Walters, the Council's Chief Public Health Inspector, decided to retire on superannuation in October, 1963 • He had been employed by the Council for nearly 40 years, and his loyal, enthusiastic and efficient service had been a valuable contribution towards fostering the public health in the borough. Owing to the impending amalgamation of the two boroughs of Kensington and Chelsea it was decided to fill the vacancy temporarily by the appointment of Mr. D.C. Draper as Acting Chief Public Health Inspector until 1st April, 1965. VITAL STATISTICS The table set out on pages 8 and 9 gives the important vital statistics for 1963, together with comparative figures for the previous seven years. - 8 - - 9 - SUMMARY OP VITAL STATISTICS FOR KENSINGTON DESCRIPTION 1963 1962 1961 1960 1959 1958 1957 1956 POPULATION Population (estimated) 172,170 172,020 169,080 167,240 166,500 165,700 167,900 168,800 Density of population per acre 75 75 74 73 73 72 73 74 LIVE BIRTHS Total births 3,290 3,395 3,295 3,077 3,026 2,990 2,765 2,792 Legitimate births 2,650 2,721 2,697 2,560 2,546 2,549 2,404 2,422 Illegitimate births 640 674 598 517 480 441 361 370 Birth rate per 1,000 population 19.1 19.7 19.5 18.4 18.1 18.0 16.5 16.5 STILL BIRTHS Total still births 45 61 55 44 55 49 50 51 Legitimate still births 27 42 40 31 44 37 42 43 Illegitimate still births 18 19 15 13 11 12 8 8 Still birth rate per 1,000 total births 13.5 17.7 16.4 14.1 17.8 16.1 17.8 17.9 DEATHS Total deaths 1,757 1,756 1,731 1,657 1,654 1,659 1,750 1,772 Death rate per 1,000 population 10.20 10.21 10.24 9.91 9.93 10.01 10.4 10.5 DEATHS OF INFANTS UNDER 12 MONTHS OF AGE Total infant deaths 83 76 69 64 75 68 78 59 Legitimate deaths 69 60 56 51 63 58 58 50 Illegitimate deaths 14 16 13 13 12 10 20 9 Infant death rate per 1,000 births 25.2 22.4 20.9 20.8 24.8 22.7 28.2 21.1 Death rate of legitimate infants per 1,000 legitimate births 26.0 22.0 20.8 19.9 24.7 22.8 24.1 20.6 Death rate of illegitimate infants per 1,000 illegitimate births 21.9 23.7 21.7 25.1 25.0 22.7 55.4 24.3 MATERNAL DEATHS Deaths of mothers as a result of pregnancy or childbirth 3 1 2 4 1 1 1 5 Death rate of mothers per 1,000 live and still births 0.90 0.29 0.60 1.28 0.32 0.33 0.36 1.76 TUBERCULOSIS Death rate from all forms per 100,000 population 7.0 7.0 10.05 8.4 6.0 6.6 10.1 11.8 Death rate from respiratory tuberculosis per 100,000 population 6.4 6.4 9.45 6.6 5.4 6.0 7.7 11.2 Death rate from non-respiratory tuberculosis per 100,000 population 0.6 0.6 0.6 1.8 0.6 0.6 2.4 0.6 - 10 - CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE IN 1963 Cause of death All Ages Under 1 yr 1 yr and under 5 5 yrs and under ^5 45 yrs and under 65 65 yrs and over Respiratory tuberculosis 11 _ - 1 3 7 Other forms of tuberculosis 1 - - - - 1 Syphilis 2 - - - - 2 Diphtheria - - - - - - Whooping Cough - - - - - - Meningococcal infections 1 - 1 - - - Acute poliomyelitis - - - - - - Measles - - - - - - Other infective diseases, etc. 4 - _ 2 2 - Cancer (all forms) 351 - - 12 120 219 Leukaemia, aleukaemia 13 1 1 2 2 7 Diabetes 8 - - 2 1 5 Vascular lesions of nervous system 175 - - 4 25 146 Coronary disease, angina 321 - - 9 84 228 Hypertension with heart disease 21 - - - 1 20 Other heart disease 133 - - 6 14 113 Other diseases of circulatory system 115 4 16 95 Influenza 9 1 - - - 8 Pneumonia 105 18 - - 14 73 Bronchitis 126 1 1 1 30 93 Other respiratory diseases 13 - 1 - 3 9 Ulcers of the stomach 8 - - - 1 7 Gastritis, enteritis and diarrhoea 7 2 1 1 3 Nephritis and nephrosis 7 - - - - 7 Hyperplasia of prostate 2 - - - - 2 Pregnancy, childbirth and abortion 3 3 Congenital malformations 19 15 4 - - - All other diseases 169 43 1 15 30 80 Motor vehicle accidents 18 - 1 9 1 7 All other accidents 58 2 3 16 24 13 Suicide 54 - - 29 20 5 Homicide and operations of war 3 - - 1 2 - TOTALS 1,757 83 13 117 394 1,150 - 11 - GENERAL PROVISION OF HEALTH SERVICES IN THE AREA The Royal Borough of Kensington as constituted under the London Government Act, 1899, covers an area of 2,291 acres, and is conterminous with the civil parish and. registration district of the same name. The line of demarcation formed by Holland Park Avenue, Notting Hill Gate and the Bayswater Road, divides the borough into approximately equal halves known as North and South Kensington respectively. The borough is further sub-divided into nine wards. North Kensington includes the wards of St. Charles, Golborne, Norland and Pembridge, whilst South Kensington is made up of the five wards Holland, Earl's Court, Queen's Gate, Redcliffe and Brompton. The population of the borough as ascertained at the census in 1961 was 171,272 persons. For the purpose of this report the population for 1963 has been estimated by the Registrar-General to be 172,170. Population: Census 1901 176,628 ,, 1911 172,317 " 1921 175,686 " 1931 180,677 ,, 1931 168,160 " 1961 171,272 ,, 1963 estimated 172,170 The following table gives the number of population in the nine wards of the borough as ascertained in the 1961 Census:- Ward Population St. Charles 25,543 Golborne 14,522 Norland 16,893 Pembridge 20,153 Holland 20,930 Earl's Court 21,289 Queen's Gate 14,903 Redcliffe 23,806 Brompton 13.233 Total 171,272 Area (statute acres) 2,291.1 Roads: Mileage maintained by Council 94.37 Assessments: Number of assessments at 1st April, 1964 52,889 Rateable Value: 1st April, 1964 £18,470,368 Product of Id. rate (net): 1st April, 1964 £72,500 - 12 - THE GENERAL DRAINAGE AND SEWER SYSTEM The drainage system in the Metropolitan Boroughs is a combined one whereby surface water and foul water both enter the same sewers. In most cases houses are connected direct to borough council sewers, and these in turn discharge into the London County Council main sewers. In a few cases, where local sewers do not exist, house connections are taken direct into the main sewers. Flooding On Friday evening, 7th June, 1963, a storm broke over Kensington and continued for nearly two hours. The rainfall was very heavy and the London County Council rain gauge at Campden Hill recorded .40 inches in five minutes and 1.8 inches in forty-five minutes. The rain gauge at Wormwood Scrubs indicated that the fall there was lighter, i.e. 1 inch in forty minutes and 1.10 inches in ninety minutes. The intensity of .40 inches in five minutes was probably too short in duration to cause surcharging of the main sewers, but could have caused overloading of the normal house drains, giving rise to flooding. This is shown by the pattern of the flooding reports which includes many isolated houses. The fall of 1.8 inches in forty-five minutes would be enough to cause surcharging of some of the main sewers. So far as was ascertained, 154 properties were flooded, 86 in the area served by the London County Council Counters Creek sewer, and 68 in the remainder of the borough. Of the 68 properties in South Kensington, few were affected in 1960. The isolated nature of the flooding in this area suggests that it was more likely to have been caused by the .40 inches in five minutes intensity overloading the house drains. Some flooding may have been due to surface water flowing over the ground into basement areas. The improvement made by the County Council's new pumping station in Holland Gardens resulted in no reports being received of flooding of houses draining into sewers served by this station. Extra drivers and workmen worked throughout the week-end to give assistance where required. The gully machines dealt with 36 premises. Some 349 articles of soft furnishings and carpets were collected from 111 premises, dried at the public baths and returned to their owners. In addition items damaged beyond repair were collected from 72 premises and taken to Chelsea Wharf for disposal. Disinfectant was also delivered to numerous premises. The laundry at the public baths was used to receive soaked carpets, and on Saturday, 8th June, staff off duty were called in and carpets were hose-cleaned, disinfected and dried. The staff worked throughout the week-end and shifts of stokers were required during the nights to raise steam for the drying rails. Normal service at the public laundry was restored on Thursday, 13th June, 1963. The sewer gang of four men and twelve contractor's men worked throughout the week-end clearing outlet drains in private premises, road gullies and attending to other drainage problems. The records from 1928 show that, under certain heavy storm conditions, about 1,100 basements have been at different times subject to flooding in Kensington. It is to eliminate this surcharge in North Kensington that relief sewers are now being provided by both this Council and the London County Council. No relief sewer of this nature has so far been proposed for South Kensington, and the London County Council have been asked to give consideration to this question. -13- 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. Fluoridation of Water Supplies During the year the attention of the Metropolitan Boroughs' Standing Joint Committee was drawn to the published results of a fiveyear study of the effect of artificial fluoridation of water supplies on the incidence of dental caries among children, conducted on behalf of the Ministry of Health, which confirmed the findings of similar surveys in other countries. The Minister of Health announced in the House of Commons that he would approve local authority schemes to add fluoride to the water supplies. The Council decided on 12th February, 1963, that they were in favour of the Metropolitan Water Board being asked to introduce fluoridation of water at an early date. All other constituent Councils of the Standing Joint Committee indicated their support, and the Metropolitan Water Board were informed accordingly. So far no action has been taken by the Water Board to introduce the fluoridation of water in London. BACTERIOLOGICAL AND ANALYTICAL WORK The following is a summary of the work performed during 1963:- Nature of specimen or sample Number examined Nose and throat swabs 90 Faeces and rectal swabs 788 Milk (bacteriological) 63 Water (drinking) 6 Water (swimming baths) 20 Ice Cream 25 Miscellaneous 212 COMBINED DISINFECTING STATION AND MEDICINAL BATHS The Council approved a scheme to combine the disinfecting station and the medicinal baths on the site of the latter, which adjoins the public baths in Lancaster Road. A single-storey building with vehicular access from Blechynden Mews, and pedestrian access both for the staff and the public on the Silchester Road frontage, has been provided at a cost of approximately £37,000. The new building came into use on 6th May, 1963. A contract existed between this Council and the London County Council under which personal cleansing facilities for school children were afforded at the medicinal baths, for which the County Council paid £500 per annum. This contract terminated with the demolition of the old medicinal baths. Discussions took place with the County Council, and it was provisionally agreed that the contract be renewed for one year to enable school children to be cleansed at the new medicinal baths. The County Council agreed to pay the Council £500 per annum and the renewed contract operated with effect from 6th May, 1963. Medicinal Baths (Personal Cleansing Station) The following table shows the work carried out during 1963 at both the Kensington and the Hammersmith Medicinal Baths:- - 14 - Description Scabies Vermin Impetigo Persons Cleansings Persons Cleansings Persons Cleansings Adults Kensington 58 103 65 70 - - Other boroughs 1 2 3 3 - - School-children Kensington 30 60 86 86 - - Other boroughs 3 6 66 66 - - Children under 5 Kensington 23 41 12 12 — _ Other boroughs - - - - - TOTALS 115 212 232 237 - - In addition to the cleansing of persons referred to above, articles of personal clothing disinfested at the Medicinal Baths during the year numbered 433. Disinfection and Disinfestation A summary of the routine work carried out in 1963 by the disinfecting staff is shown in the following table:- Houses disinfected after infectious disease 127 (203 rooms) Houses disinfested after vermin 258 (551 rooms) Total weight of bedding, etc. dealt with:- Tons cwt. qtr. lb. 6 3 2 26 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, 142 parcels of clothing were disinfected and the income amounted to £17.15s.0d. The following table indicates the destination of these parcels:- No. of parcels Czechoslovakia 32 Spain 66 Rumania 7 East Germany 31 Bulgaria 4 Albania 2 TOTAL 142 Some other 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 23 such certificates were issued. 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 - 15 - practicable, 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 Pood requested a report for the twelve months ended 31st December, 1963, in the following form:- Prevalence of Rats and Mice Type of Property Total Local Authority Dwelling Houses All other (including Business & Industrial) I. Number of properties in Local Authority's district 31 +1,207 11,067 52,305 II. Total number of properties inspected as a result of notification 12 768 62 842 Number of such properties found to be infested by:- Common rat Major - 1 - 1 Minor 9 136 74 169 Ship rat Maj or _ - _ Minor — - - - House Mouse Major - 1 1 2 Minor 3 499 28 530 III. Total number of properties inspected in the course of survey under the Act - 126 18 144 Number of such properties found to be infested by:- Common rat Major - - - - Minor - 13 2 15 Ship rat Maj or - - - - Minor - - - - House Mouse Major — _ — - Minor - 28 2 30 IV. Total number of properties otherwise inspected (e.g. when visited primarily for some other purpose) - - - - Number of such properties found to be infested by:- Common rat Major - - - - Minor — - - - Ship rat Major - _ _ Minor - - - - House Mouse Major - - - - Minor - - - — V. Total inspections carried out including re-inspections: 57 3,147 429 3,633 VI. Number of infested properties (in Sections II, III & IV) treated by the Local Authority 12 678 57 747 VII. Total treatments carried out including re-treatments 16 755 66 837 - 16 - Destruction of rats in Council's sewers For many years, destruction of rats in severs has been carried out on a systematic basis twice a year (April and September). In 1963, this method was discontinued and the Council adopted a system of continuous baiting of the sewers using a new acute poison, fluoracetamide. A new Morris 12 cwt. van was purchased and adapted for use, and the Borough Engineer arranged for a sewerman to be seconded more or less permanently to this work. The new system of treatment of the sewers throughout the borough commenced in May, 1963, and by the end of the year four treatments had been carried out. Baits are laid at access points throughout the sewers, of which there are ninety-three miles in the borough. These points comprise side entrances connected by galleries to the sewers and ventilating shafts immediately over the sewers. There are over 1,600 of these baiting points, but it is never possible to bait all the points at one treatment owing to road repairs and the presence of parked vehicles. The last treatment included the laying of non-poison test bait. Observations were made to ascertain the number of points where there was still evidence of a rat infestation, however small. The results which have been obtained show a remarkable decrease in the rat population of the sewers. In addition, the Council's sewermen and contractors' staff engaged on the repair of sewers have commented on the decrease in the number of rats seen in the sewers. There has also been a marked decrease in the number of complaints of rats received in the department from householders. The following table shows the result of the test baiting of access shafts and side entrances since 1960 and the number of complaints of rat infestation received in the department in each of the six-monthly periods:- Year Period No. of points test-baited No. of points infested Percentage infestation No. of complaints received 1960 Jan - June 1,273 1,170 91.9% 192 July- Dec. 1,189 1,066 89.6% 195 1961 Jan - June 1,335 1,030 77.0% 125 July-Dec. 1,407 933 66.3% 106 1962 Jan - June 1,430 780 54.5% 114 July- Dec. 1,413 902 63.1% 140 Jan - June - - - 123 July- Dec. 1,558 177 11.3% 64 The results which have been obtained are highly encouraging and the Council have decided to continue with this method of treating the sewers. 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:- - 17 - Premises inspected following complaints 842 Premises where rats were found 185 Premises where mice were found 562 Premises where other vermin were found 121 Number of visits made 3,813 Number of successful treatments 909 Cases in which advice only was given 49 Borough Council properties (excluding dwelling houses) dealt with 12 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 121. Of this number 8 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 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 19 registered premises in the borough. If on registered premises there are unclean filling materials, the occupier shall be guilty of an offence. It is also an offence to sell or offer for sale any article which is upholstered with unclean filling materials (second-hand articles are excepted). Inspections of the registered premises were made during the year, and 4 samples of rag flock and other fillings were taken for analysis. The results were:- Description No. of Samples Satisfactory Unsatisfactory Algerian Fibre 1 1 - Cotton Felt 2 1 1 Hair 1 1 — The unsatisfactory sample of cotton felt failed to meet the requirements of the Regulations in respect of the Dust Index which was found to be 2.0% the permitted maximum being 1.8%. A warning was given to the suppliers. The Act further provides that no rag flock shall be delivered to registered premises except from premises licensed for manufacturing rag flock or used as a store for rag flock. A local authority on receiving from the occupier of premises an application for the grant or renewal of an annual licence authorising him to manufacture rag flock or to use his premises as a rag flock store, may grant or renew the licence on payment of a fee of One Pound. No licences have been issued in Kensington. 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. - 18 - During the year, 8 premises were licensed tinder 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. ANIMAL BOARDING ESTABLISHMENTS ACT. 1963 This Act, which came into operation on 1st January, 1964, regulates the keeping of boarding establishments for animals - defined as any dog or cat. Section 1 provides that no person shall keep a boarding establishment for animals except under the authority of a licence granted by the Council. Sub-section (2) of this section empowers the Council on payment of such fee not exceeding ten shillings (as may be determined) to grant a licence to keep a boarding establishment for animals at such premises as may be specified in the application and subject to compliance with such conditions as may be specified in the licence. The Council may refuse such a licence to any person who has been disqualified - (a) under the Act, from keeping a boarding establishment for animals; (b) under the Pet Animals Act, 1951 from keeping a pet shop; (c) under the Protection of Animals (Cruelty to Dogs) Act, 1933, from keeping a dog; (d) under the Protection of Animals (Amendment) Act, 1954, from having the custody of animals. In determining whether to grant a licence, the Council shall in particular (but without prejudice to their discretion to withhold a licence on other grounds) have regard to the need for securing - (a) that animals will at all times be kept in accommodation suitable as respects construction, size of quarters; number of occupants, exercising facilities, temperature, lighting, ventilation and cleanliness; (b) that animals will be adequately supplied with suitable food, drink and bedding material, adequately exercised, and (so far as necessary) visited at suitable intervals; (c) that all reasonable precautions will be taken to prevent and control the spread among animals of infectious or contagious diseases, including the provision of adequate isolation facilities; (d) that appropriate steps will be taken for the protection of the animals in case of fire or other emergency; (e) that a register be kept containing a description of any animals received into the establishment, date of arrival and departure, and the name and address of the owner, such register to be available for inspection at all times by an officer of the local authority, veterinary surgeon or veterinary practitioner authorised under section 2(l) of this Act; and shall specify such conditions in the licence, if granted by them, as appear necessary or expedient in the particular case for securing all the objects specified in paragraphs (a) to (e) of this sub-section. There are no animal boarding establishments in the borough at the present time. - 19 - HEALTH EDUCATION Health education is an important activity 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. For the year 1963/64 the Council made a grant of £23. 0s. 0d. Posters, leaflets and other material dealing with a variety of health topics for display and distribution were obtained from the Central Council. The Council approved the publication of a "Health and Social Services" Handbook for the use of official and voluntary bodies and members of the general public in Kensington. When the handbooks were distributed, an advisory leaflet giving information of the services to old people and a list of addresses of government departments, voluntary organisations, etc. in the borough, were included with each book. Copies of the handbook were sent to all members of the Council, to local Members of Parliament and the London County Council, hospitals, general practitioners, dentists, chemists, clergy, child welfare centres, day nurseries, old people's clubs, etc. Ratepayers applying at the Town Hall (information Office), the Public Health Department or the Citizens' Advice Bureau were also supplied with a free copy. Smoking and Health For some years before the publication in 1962 of the Royal College of Physicians Report on "Smoking and Health," posters and leaflets relating to lung cancer and cigarette smoking had been distributed in the borough. Following receipt of Ministry of Health Circular 6/62, the Council decided that further steps should be taken to give publicity to the relationship between smoking and chest diseases. A local publicity campaign was undertaken in 1963, coinciding with action taken in the schools and youth clubs by the London County Council, who are the local health and education authority. The following action was taken by this Council:- (a) Posters were displayed at various sites throughout the borough and in the Council's branch libraries, where leaflets were also distributed; (b) display stands with posters and stocked with leaflets, were placed in the Town Hall, the Central Library (main entrance and Children's Library entrance) and in the Public Health Department; (c) printed notices (size 10" x 8") requesting customers not to smoke were sent to appropriate food premises for display; (d) posters and leaflets were sent to all the various clubs, voluntary organisations and general practitioners, and (e) ten thousand bookmarks were placed in the libraries. - 20 - After this campaign, posters, leaflets and bookmarks continued to be distributed during the remainder of the year as part of normal health education work. HOME SAFETY The majority of home accidents, when investigated, show clearly that human ignorance and carelessness were basic causes. The prevention of home accidents depends on individuals having the necessary knowledge to ensure their personal and domestic safety. The Home Safety Act, 1961, empowers the Council to arrange for the dissemination of information and advice relating to the prevention of accidents in the home, and activities under this heading are combined with the work of health education. Accidents in the home are not required to be notified in the same way as accidents in factories, and therefore information regarding home accidents is incomplete. However, figures are compiled by the Registrar-General and indicate the continual increase in deaths from home accidents. 1952 1956 1960 1961 1962 Number of deaths in England and Wales 4,686 5,916 6,008 5,881 6,504 Number of deaths (included in the figures above) from: Accidents caused by fire and explosion of combustible material* 574 579 564 552 690 (*A detailed analysis of these causes is not available.) The London County Council, as the ambulance authority, have been keeping records of home accident cases (both fatal and non-fatal) removed to hospital by them. The Medical Officer for the County Council has kindly supplied me with the following figures for 1963. It has not been possible to give details of cases by cause in age and sex groups. The figures relate to Health Division 1, which comprises Kensington, Chelsea, Fulham and Hammersmith. Cause of Accident Division 1 London County Falls On stairs 137 961 From ladder 12 102 From chair 14 132 Outside 44 233 In garden 10 174 In bath 2 23 From one level to another 52 400 On same level 105 866 Unspecified 535 4,009 Hit by object 22 189 Cooking stove 15 140 Teapots 9 52 Other boiling water 23 194 Electric shock 4 43 Poisoning 45 393 Gassing 39 294 Knife-like wounds 38 319 Fires 44 267 Windows 4 36 Suffocation 4 45 Not specified 41 436 Totals: 1,199 9,308 - 21 - The distribution of the cases in Division 1 is shown in the following table:- Borough Population (1963) Number of Accidents Rate per 10,000 Kensington 172,170 424 24.6 Fulham 109,700 335 30.5 Chelsea 48,050 92 19.1 Hammersmith 107,660 348 32.3 Division 1 ^37,580 1,199 27.4 County of London 3,178,870 9,308 29.2 CONSUMER PROTECTION ACT. 1961 This Act empowers the Secretary of State to make Regulations imposing, in respect of any prescribed class of goods, requirements which are expedient to prevent or reduce risk of death or personal injury. Fireguards The Heating Appliances (Fireguards) Regulations, 1953, continue to operate and make 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 these Regulations, but it is necessary to keep a careful watch on the sale of second-hand fires from stalls in public markets. Oil Heaters The Oil Heaters Regulations, 1962, prescribe certain standards of construction, design and performance with which all unflued domestic oil heaters manufactured after 1st June, 1962, must comply, and make it an offence for any person to sell, or let on hire, or hire purchase, or have in his possession for sale, any such oil heater or component part of an oil heater not complying with the Regulations. As the Oil Heater Regulations, 1962, apply only to heaters manufactured since 1st June, 1962, the Council have asked the Metropolitan Boroughs' Standing Joint Committee to consider making representations to amend the Regulations so that they apply to all oil heaters irrespective of the date of manufacture. The Director of Fire Research, Department of Scientific and Industrial Research and Fire Offices, Committee Joint Fire Research Organisation has supplied the following information:- 22 Fires caused by space heating appliances using various fuels in dwellings in the United Kingdom Type of Fuel Numbers of fires (estimated) 1958 1959 1960 1961 1962 Oil 2,148 2,340 2,220 2,356 2,690 Electricity 940 856 912 1,030 1,246 Town Gas 84 76 68 100 144 Solid Fuel: Fire in grate 5,012 4,580 4,160 4,022 4,644 Slow combustion stove 248 248 308 230 294 Concern has been expressed over the growing practice, particularly in the northern part of the borough, of heating rooms in tenement houses by oil heaters, and the increased danger from fire which results from this practice. The oil heater has rapidly gained in popularity over the past few years and is in considerable use by the large coloured population in North Kensington. It provides a rapid means of intensive heat at a price lower than either gas or electricity; there is no work or expense involved in installation; comparable heating from an efficient oil heater is obtained at approximately half the cost of an electric fire. Secondhand heaters can be bought very cheaply and the fuel which is used, namely paraffin, is readily available and is usually delivered direct to the home by the distributors. The fuel is available in small quantities and, if necessary, a supply can easily be purchased each day; thus for the cost of one gallon of fuel at 2/3d., a room can be heated effectively for say 16 hours per day. There is a further point that no difficulties in connection with gas and electricity meters are encountered. There are grave risks of fire from oil heaters, particularly those manufactured before June, 1962. The fuel itself is highly inflammable and can be stored in circumstances giving rise to danger. The filling, if undertaken whilst the heater is alight, can also cause accidents. Even the modified heaters which have been manufactured since 1st June, 1962, can be knocked over and can also cause a fire if moved whilst alight. Since 1954, the Council have arranged, or participated in, a number of campaigns emphasising the need for home safety precautions, particularly when dealing with oil heaters. Various types of posters relating to oil heater safety have been obtained and have been displayed on posterboards about the borough; and leaflets have been made available to the public at the public libraries and to those calling at the Public Health Department. During 1963, a display panel, featuring the points of safety to be followed when using oil heaters, was obtained on loan from the Oil Appliance Manufacturers' Association. The display panel was exhibited at the North Kensington Branch Library and the Notting Hill Gate Branch Library. Eight thousand copies of a leaflet entitled "Simple Oil Heater Instructions.and produced by the Association were also obtained. Copies of the leaflet were placed with the panel, and were sent to the North Kensington Citizens Advice Bureau for distribution. 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 23 West Metropolitan Regional Hospital Board from 285 Harrow Road, W.9. The purpose of mass radiography is two-fold:- (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. The number of persons X-rayed by the Unit during a survey held in Kensington during the year was 268, and a provisional analysis of the results revealed no abnormalities. ATMOSPHERIC POLLUTION Smoke Control Areas. Sections 11 to 15 of the Clean Air Act, 1956, relate to the functions of the Council to declare smoke control areas, in which the emission of smoke from the chimney of any building (not exempted under the Order) would be an offence. The procedure for establishing a smoke control area has been prescribed by the Minister of Housing and Local Government, who has stated that now considerable experience has been gained, there is no longer a need for provisional proposals to be submitted. Circular 69/63 dated 17th December, 1963, was issued by the Ministry of Housing and Local Government, with a White Paper on "Domestic Fuel Supplies and the Clean Air Policy". The White Paper was the result of a review of current arrangements for fuel supplies in future Smoke Control Areas in order to ensure that progress with Smoke Control will not be impeded. It pointed out that adequate supplies of solid smokeless fuel for open grates will continue to be available to meet the needs of existing Smoke Control Areas, including those confirmed but not yet in operation. Supplies, particularly of the reactive fuels such as Coalite, Rexco, Warmco, Cleanglow, etc. are, however, likely to fall increasingly short of requirements for new areas. It is recommended that there should be an increased use of closed appliances and underfloor-draught open grates, as there is, and will continue to be adequate supplies of suitable fuels for use in them. It also suggests that gas, oil and electricity provide acceptable alternatives to solid fuels for many householders in Smoke Control Areas, and it is felt that these industries should have little difficulty in expanding supplies to the extent necessary to fill the gap in the supply of solid smokeless fuels, although in the case of electricity it is desirable that space heating should be done by storage, and not by direct-acting appliances. Circular 69/63 confirmed the Government's intention to encourage and facilitate vigorous action against air pollution, but draws attention to the fact that current arrangements under the Clean Air Act will need some reshaping in order to ensure the continued smooth establishment of Smoke Control Areas. In future, in order to take full account of the local supply situation in preparing future Smoke Control Orders, the Council must consult representatives of the producers and distributors to determine the availability of the various fuels. The results of these consultations must be reported to the Minister when the Order is submitted for confirmation. A. Where such consultations with the fuel producers and distributors show that supplies of open grate fuel will not be available for a proposed Smoke Control Area, it is proposed to:- 24 (i) refuse payment of grant for the installation of an improved open grate; (ii) extend grant to cover the replacement of an existing approved grate by other appliances; (iii) treat the provision of "other appliances".such as openable stoves, under-floor-draught open fires and fixed gas, electric storage and oil heaters as "reasonably necessary" works so that the full expenditure on these installations (if comparable with the cost of appliances of the same type installed in local authority dwellings) can rank for grant. 13. Where the Council is advised that supplies will be available:- (i) grant will continue to be paid as usual for the installation of improved open grates; (ii) encouragement should, however, be given to householders to choose some other- form of space heating as in A(iii) above, which would attract higher grant. These directives will modify the principles previously observed in determining which works are "reasonably necessary" and rank for grant. The Circular suggested, where it is not possible to ascertain the 'Notional Cost' of providing these more expensive 'other appliances', that the 'Notional Cost' be taken as £25 for each room in which appliances in regular use would have required works of adaptation. The Circular drew attention to the amendments of the Clean Air Act proposed in the Housing Bill, as follows:- (i) that grant be payable towards the conversion of open grates in dwellings constructed or produced by conversion between 1956 and 1964 which previously had been excluded from grant» Most of these had been fitted with open grates capable of burning smokeless fuel; (ii) it is proposed to give local authorities and the Exchequer a wider discretion as to the expenditure to be taken into account for grant purposes and will also provide that grant may be withheld for appliances which would strain available fuel resources; (iii) grant will be allowed on the provision of ignition even if no other works are involved; (iv) local authorities will be empowered to pay grant retrospectively where expenditure is incurred without their approval, between the date of confirmation and date of operation of the Order. The main effect of this new policy will be to increase the cost and difficulty of creating Smoke Control Areas. The installation of appliances which are now to be regarded as "reasonably necessary ", i.e. openable stoves, under-floor-draught open fires, fixed gas fires, electric storage heaters and fixed oil heaters, will have the effect of substantially increasing the cost of any future areas. This is based on the assumption that many of the existing coal users may wish to continue to use solid fuel in openable stoves. So far as electric block storage heaters (whose use is advocated) are concerned, the cost of installation of two of these is £54 to provide the same heat as an open grate.burning gas coke,costing £7. The following is the programme of Smoke Control Areas adopted by the Council with the object of securing that the whole of Kensington is controlled by 1970. The map of the borough following page 23 indicates the various areas. 25 Smoke Control Area Boundaries Detailed Survey & Order Made Order operative Holland Ward (No.l) N. Holland Park Avenue 1958 1959 (1st October) S. Kensington High Street E. Campden Hill Road W. Abbotsbury Road Holland Ward (No.2) N. Holland Park Avenue 1959 1960 fist October) (Revised by Minister to 1st Oct.1961) S. Kensington High Street E. Abbotsbury Road W. Borough boundary Holland Ward (No.3) N. Notting Hill Gate 1959 1960 (1st October) S. Kensington High Street E. Borough Boundary W. Campden Hill Road Pembridge Ward (No.l) N. Westbourne Grove 1960 1961 (1st October) S. Notting Hill Gate E. Borough Boundary W. Ladbroke Grove Pembridge Ward (No.2) N. Lancaster Road 1961 1962 (1st October) S. Westbourne Grove E. Borough Boundary W. Ladbroke Grove Norland Ward (No.l) N. Lancaster Road 1962 1963 (1st October) S. Holland Park Avenue E. Ladbroke Grove W. Walmer Road and Princedale Road Norland Ward (No.2) N. Lancaster Road 1963 1964 S. Holland Park Avenue E. Walmer Road and Princedale Road W. Borough Boundary Earls Ct. & Queens Gate Wards N. Kensington High St. 1964 1965 S. West Cromwell Road E. Palace Gate and Gloucester Road W. Borough Boundary Earls Ct. Redcliffe & Brompton Wards N. West Cromwell Road 1965 1966 S. Old Brompton Road E. Queens Gate W. Borough Boundary Redcliffe & Brompton Wards N. Old Brompton Road 1966 1967 S. Fulham Road E. Onslow Gardens and Neville Terrace W. Borough Boundary 26 Smoke Control Area Boundaries Detailed Survey & Order Made Order operative Brompton & Queens Gt. Wards N. Borough Boundary 1967 1968 S. Borough Boundary E. Borough Boundary W. Palace Gate, Gloucester Road, Brompton Road, Queens Gate, Onslow Gardens & Neville Terrace St. Charles Ward (No.l) st. Quintin Avenue & Chesterton Road 1968 1969 S. Lancaster Road E. Portobello Road W. Borough Boundary St.Charles & Golborne Wards N. Harrow Road 1969 1970 S. St. Quintin Avenue, Chesterton Road, Portobello Road and Lancaster Road E. Borough Boundary W. Borough Boundary By the beginning of 1963 the following areas had been declared:- Smoke Control Area Date Declared by Council Acreage Total No. of: 1. Dwellings 2. All ings 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 1. 2,020 2. 2,104 714 £12,453 1.10.61 Holland Ward (No.3) 13.10.59 184 1. 2,681 2. 3,032 878 £16,050 1.10.60 Pembridge Ward (No.l) 26. 7.60 110 1. 2,517 2. 2,859 535 £ 9,272 1.10.61 Pembridge Ward (No.2) 27. 6.61 83 1. 2,629 2. 2,932 797 £13,491 1.10.62 Norland Ward (No.l) 31. 7.62 100 1. 2,747 2. 2,909 1,212 £21,992 1.10.63 27 On 30th July, 1963, the Council made a Smoke Control Order in respect of the Norland Ward (No.2) Area. It has an area of about 95 acres and contains 2,479 buildings. From the detailed survey it was estimated that the total cost of adaptations would be about £22,932. In this new area there was a small block of property scheduled for redevelopment by the London County Council in respect of which it was thought necessary to grant exemption. The Council accordingly resolved that the fireplaces in the premises as specified in the following table should be exempt from the operation of Section 11 of the Clean Air Act. Description Conditions Fireplaces in buildings, or parts Only authorised fuels, as of buildings, separately occu- declared by Regulations pied, without gas supply. under the Clean Air Act, 1956, and kindling sticks and paper shall be used in the fireplaces. Nos. 186-204 (even) Holland Park ) Avenue ) ) Nos.4-12 (even) Norland Road ) Nil ) ) NO.33 Royal Crescent Mews ) (part only) ) The Norland Ward (No.2) Smoke Control Order has been confirmed by the Minister without modification, and will operate from 1st October, 1964. The Council also decided to deal with the (No.8) Earl's Court-Queen's Gate area, which is bounded on the north by the centre of Kensington High Street and Kensington Road, on the west by the borough boundary, on the south by the centre of West Cromwell Road and on the east by the centre of Gloucester Road and Palace Gate. It has an area of about 236 acres. Final costs in respect of completed Smoke Control Areas The following table shows the final figures in respect of the conversion of fireplaces (except in Council property) in dwelling houses and other buildings in Smoke Control Areas completed by the end of the year:- 28 Area No.of dwellings where fireplace conversions were carried out Total amount of grants paid to applicants Total amount of Exchequer contribution Total cost of statutory grants made by Council in respect of private dwellings Total amount of discretionary grants paid by Council under Section 15 Holland Ward (No.l) 135 £1564. 1. 9 £ 893.14. 0. £ 670. 7. 9. £100. 3. 6. Holland Ward (No.2) 191 £2550. 3.11 £1457.5. 1. £1092.18.10. £ 34.14. 6. Holland Ward (No.3) 327 £3439.13. 4 £1965.10. 6. £1474. 2.11. £ 64.13.11. Pembridge Ward (No.1) 209 £2577.15. 5 £1473.0.3. £1104.15. 2. £183.10.11. Pembridge Ward (No.2) 281 £4797.15.11 £2731.11.11. £2066. 4. 0. £623. 5. 6. 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 1963, 17 notifications were received, and two applications for approval of plans, etc. were approved. Smoke emissions. The Sections of the Clean Air Act, 1956, which relate to industrial smoke came into force on 1st June, 1958. Up to that date emissions of industrial smoke were dealt with under the provisions of the Public Health (London) Act, 1936. The provisions mainly affecting the Council are contained in Section 1, which prohibits the emission of dark smoke (except for certain periods laid down by regulation) and Section 16 which deals with smoke nuisances. During the year 51 complaints of smoke nuisance were received and 28 formal smoke observations were carried out. Remedial measures in all cases except one were secured without further proceedings. Two summonses were issued in respect of the emission of smoke from premises in a Smoke Control Area; convictions were obtained and fines totalling £6. 0. 0. were imposed and £2. 2s. Od. costs awarded to the Council. Routine measurement of atmospheric pollution. The two stations used by the Council for measuring atmospheric pollution by means of deposit gauges were discontinued as from 1st January, 1963. The three smoke measuring stations set up at the following premises have, however, continued to operate:- (1) Public Health Department, Hornton Street, W.8. (2) Public Library, Ladbroke Grove, W.10. (3) L.C.C. Child Welfare Centre, Redcliffe Street, S.W.lO. 29 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 sire taken each day. The equipment at the Public Library and the Welfare Centre consists of smoke filters only. Measurements are taken three times a week. With the use of a Reflectometer,daily and monthly averages are calculated from the results. The work undertaken in Kensington is a small part of that taking place throughout the country, and all results are forwarded to the Fuel Research Station of the Department of Scientific and Industrial Research for correlation with results obtained in all other districts. The following table gives the results of the measurements taken by the apparatus at the Public Health Department for the twelve months ended November, 1963 (which is the latest information from the Department of Scientific and Industrial Research). Month Average daily concentration of Smoke in microgrammes per cubic metre of air Average daily concentration of Sulphur Dioxide in microgrammes per cubic metre of air. 1962 December 159 745 1963 January 193 463 February 178 431 March 60 235 April 66 257 May 44 177 June 35 111 July 33 132 August 43 171 September 59 247 October 84 257 November 85 259 Emission of smoke in the London area has decreased by about 60 per cent in the last ten years, according to estimates by Warren Spring Laboratory, DSIR.* This is considered to be due mainly to the decrease in domestic smoke pollution. On the other hand, increasing use of fuel oil by industry and of coal and fuel oil by power stations has brought an estimated increase of 32 per cent in sulphur dioxide emissions. Estimates for the whole country are 35 per cent less smoke emission and 23 per cent more sulphur dioxide in the last ten years. NOISE ABATEMENT ACT. 1960 This Act came into operation on 27th November, 1960. Under Section 1 any noise or vibration which would amount, to a nuisance at common law is deemed to be a statutory nuisance which can be dealt with according to the procedure provided in Part III of the Public Health Act, 1936. *Warren Spring Laboratory Annual Report 1963. 30 In London, Section 66 of the London County Council (General Powers) Act, 1937 has for many years given Metropolitan Borough Councils power to deal with noise as a nuisance under the Public Health (London) Act, 1936, where a person made or caused to be made or continued an excessive or unreasonable or unnecessary noise which was injurious or dangerous to health. The Noise Abatement Act, 1960 amended this Section to conform with the new meaning of noise nuisance. Local authorities are now able to require the abatement of a noise or vibration nuisance (not necessarily injurious or dangerous to health) by the service of an abatement notice on the person causing the nuisance, and, if the Notice is not complied with, it can be enforced by proceedings in a Magistrate's Court. Apart from action by a local authority, any three or more occupiers of land or premises who are aggrieved by a noise or vibration nuisance may make complaint direct to a Magistrate. Complaints are received in the department from time to time regarding noise nuisances, mainly arising as a result of industrial work. Remedies are generally secured without recourse to legal action, but in one case legal proceedings were instituted against the occupier of a factory causing a noise nuisance in operating their works. It should be noted that, in the case of noise or vibration caused in the course of a trade or business, it is a defence in any proceedings to show that the best practicable means have been used for preventing it and counteracting its effect. Section 2 of the Act deals with the use of loudspeakers in streets. It prohibits their use for any purpose between 9 p.m. and 8 a.m. except in the special circumstances defined in sub-section 2 of the section, and at any other time for advertising any trade, business or entertainment, with the exception that between noon and 7 p.m. a loudspeaker fixed to a vehicle used for the sale of perishable foodstuffs may be operated to announce that the commodities are on sale: the loudspeaker is, however, not to be so operated as to give reasonable cause for annoyance to persons in the vicinity. 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. There were four swimming pools, two of which have now been discontinued. The swimming pools now available are as follows:- (1) The large mixed swimming pool. (2) The small mixed swimming pool. The large pool has an area of approximately 4,500 square feet and the smaller one is one-third of this area.s. Both pools are available for swimming in the summer months, mid-April to mid-October, but during the winter months only the large pool will be available to the public. 31 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. 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 sterilised; 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 sterilisation of the water is known at any time during the swimming season. The filter units consist of vertical closed cylinders containing special 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. The filtered water is then aerated, thereby assisting in the maintenance of bacteriological purity. It is then heated by calorifiers to about 75°F. It re-enters the swimming pools through suitable inlets at the shallow ends, and scum troughs are 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 equipment has been designed to give a turnover period up to 3½ hours. By this means, quick purification of water is obtained and is particularly beneficial during peak periods. The whole of the equipment is designed to comply with the latest recommendations of the Ministry of Health for indoor swimming pools. Samples of water in the pools are taken from time to time, and during 1963 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. In 1958 the Council closed their premises and made an arrangement with the Hammersmith Borough Council that all Kensington cases should be accommodated in the Hammersmith mortuary, at 77, Fulham Palace Road, W.6. The agreement provides that an annual payment of £500 shall be made for this service. Details regarding the number of Kensington cases admitted during 1963 to the Hammersmith mortuary in accordance with the agreement are as follows By Order of Coroner 458 (125 inquests) On application of Undertaker 2 Total 467 32 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, 1963, the Council became responsible for the burial of 38 persons dying in the borough. The following is a summary of the action taken:- (a) Cases where the funeral expenses have been fully recovered 18 (b) Cases where part only of the expenses has been recovered 8 (i) Number of these where balance of expenses will be recovered 3 (amounting to £l4.l0s.0d.) (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 (c) Cases where full cost has been borne by the Council 12 (i ) Number of these where expenses will be recovered (ii) Number of these where there was no estate or "liable" relative 5 (iii) Number of these where "liable" relatives were unable to contribute 7 Amount recovered by the end of the year £05. 9. 8d. Additional amount expected to be recovered £ l4.lO. Od. £419.19. 8d. Irrecoverable £188.15. 4d. Total cost £608. 5. Od. Of the thirty-eight cases dealt with, twenty-two were eligible for Death Grant from the Ministry of Pensions and National Insurance. The total amount recovered from this source amounted to £320. 5s • Od. (included in the above figures). Since the National Assistance Act came into force on 5th July, 1948, the Council have arranged for the burial of 594 persons. 33 BOROUGH CREMATION SERVICE The Council have an agreement with the General Cemetery Company for a borough cremation service with the object of popularising this form of disposal of the dead and so conserving the land available at Gunnersbury Cemetery for earth burial. The agreement with the General Cemetery Company has been in force since 1951 and under it the Company makes a reduced charge for cremation to residents of Kensington. The agreement provides for a basic charge which is below that made to the general public and any increase in the basic charge is based on a formula incorporated in the agreement. The current fee paid by Kensington residents, which is fixed by the Council but paid direct to the Company by those using the service, is £5. 5s. Od., and this is known as the "borough charge." The Council pay to the Company the difference between the "borough charge" and the scale mentioned above. During the year the Council considered an application by the General Cemetery Company for an increase in the basic charge and, after careful consideration, it was decided that, as from 1st June, 1963, the basic charge should be increased from £5.5s.Od. to £6.l6s. 6d. for each Kensington cremation. The following table shows the number of cremations and cost to the Council since 1956/1957:- Year No. of Cremations Cost to Council 1956/57 253 £252. 0s. Od. 1957/58 277 £260.18s. 6d. 1958/59 304 £275.12s. 6d. 1959/60 24l £242. 0s. 6d. 1960/61 327 £278. 0s. Od. 1961/62 314 £276. 3s. Od. 1962/63 313 £273.10s. Od. These figures compare with only 60 Kensington cremations in 19^8 (prior to the arrangement coming into effect). MEDICAL EXAMINATIONS OF STAFF The Medical Officer of Health arranges all medical examinations of staff for the purpose of the Council's superannuation scheme. During the year, 195 examinations were made. 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. Four members of the Public Health Committee serve on the Kensington 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. 34 Grants to Clubs, etc. Under Section 31 of the National Assistance Act, 1948, the Council have power to make grants towards the expenses of voluntary organisations whose activities include the provision of meals or recreational facilities for old people. During the year the following grants were made:- (a) The Kensington Communal Kitchen Service were granted approximately £4,000 towards the cost of operating a meals-on-wheels service for old people, in co-operation with the Kensington Womens' Voluntary Services. (b) The West London Angling Competitions Committee were granted £5 towards the cost of their annual competition and outing. (c) The Merrymakers Old People's Club were granted £10 towards the cost of providing additional equipment. (d) The Kensington Old People's Welfare Voluntary Committee were granted £35 to assist in meeting their general expenditure. Kensington Day Centre The Kensington Council of Social Service adopted a proposal to establish a Day Centre for old people in Convent Gardens, North Kensington, W.ll. During the year building operations commenced and it was planned to open the new Day Centre in May, 1964. The Council decided, in principle, to make an annual grant of £3,250 payable halfyearly in advance, subject to having substantial representation on the Management Committee of the Centre. This was agreed to by the Committee of the Kensington Council of Social Service and six members of the Council were appointed to serve on the Management Committee. Holidays Since April, 1951, the Council, in co-operation with the Family Welfare Association, have operated a scheme for providing holidays for old people. During 1963, advance bookings were made with the Ramsgate and District Hotel and Boarding House Association for two weeks' reservations in each of the months of May and September, at a charge of £5.5s.Od. per week. The old people selected for holidays under this scheme are required to pay £2 per week towards the cost. Private coaches were hired to take them to and from the holiday establishments. The Hotel and Boarding House Association provided entertainments, coach outings and other concessions during the holidays. As in other years, applications for holidays were investigated by the Woman Health Officer, approved by the Chairman, and then passed to the Family Welfare Association for the holidays to be arranged. A sum of Five Shillings per booking was paid to the Family Welfare Association towards their administration expenses. 35 The following is a summary of the action taken:- Total number of old people who applied 157 Number considered unsuitable on medical grounds 11 Number referred to London County Council for recuperative holidays 2 13 Number of applications approved by the Chairman 144 Cancellations after approval 26 Number sent on holiday 118 In the main, the reason for cancellation after approval by the Chairman was ill health. Cost of holidays £ s. d. £ s. d. Board and lodging fees and fares Booking fees paid to the Family Welfare Association 1,344 1.10. 1,369.11.10. 25.10. 0. Less contribution by applicants 474.10. 0. Actual cost to Council 895. 1.10. In each case the holiday was for a period of two weeks. Letters of appreciation have been received from many of the old people concerned. Advice Leaflets The Council arrange for the publication of a pamphlet giving information on the services available in the borough for old people individually or through a club. The pamphlet was revised during the year and a new edition printed. The Ministry of Pensions and National Insurance send to every person in London reaching retirement pension age, a leaflet giving general information on welfare services for old people. S.O.S. Cards Window display cards are provided by the Council, bearing the letters "S.O.S." in red on one side, and on the reverse side directions how to use the card, with space for particulars of next-ofkin or nearest relative. These cards are distributed to appropriate old people. Any person seeing one of the cards in a window is able to summon help from one of the sources given on the back of the card. The local press have generously assisted in making this service known. Institutional and Domiciliary Care of the Aged Sick 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. 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 36 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 southern part of the borough are visited and assessed by the Council's 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 55. It was necessary to arrange for 23 old people to be admitted to hospitals for institutional treatment and, in addition, 16 cases were admitted to homes for the aged. 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 1963. 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 37 cases action was taken under the section. The bedding was marked, laundered at the Council's disinfecting station and returned to the old people. The scheme works smoothly and appears to fill a much felt want. Prom stocks of bedding held, the Council are able to supply linen and bedding on loan to old people while their own is being laundered, and where possible voluntary organisations are asked to undertake replacements of much worn articles. During the year 1,338 separate collections of laundry were made under this scheme, and the number of articles cleansed totalled 14,801. Library Facilities The Libraries Committee authorise the provision of books for old people confined to their homes. The circulation of the books is effected by the Women's Voluntary Services mobile library. Chiropody The London County Council, with the approval of the Minister of Health, extended their functions under Section 28 of the National Health Service Act, 1946, to include a chiropody service, giving 37 priority to the needs of old people, the physically handicapped and expectant mothers. They make a grant to the Kensington Old People's Welfare Committee for the purpose of enabling the provision of a chiropody service for housebound old people. The Kensington Branch of the British Red Cross Society have accepted responsibility for the complete administration of the service in the borough, and all the patients are referred to them through the Public Health Department. During the year the total number of persons on the Register for treatment under the home chiropody scheme was 336, and the number of treatments given was 910. 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. 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 £ £ £ £ £ 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 5,482 2,138 2,219 500 625 1960/61 52,317 5,623 2,170 2,616 510 327 1961/62 56,528 6,021 2,343 2,827 500 351 1962/63 55,298 6,337 2,292 3,113 850 82 1963/64 60,672 - figures not available - 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. As from 1st April, 1963, the Council assumed responsibility for the subsidies hitherto paid by the London County Council. Under Section 31 of the National Assistance Act, 1948, the Council have power to make grants to voluntary bodies undertaking the supply of meals to old people and grants of approximately £4,000 were made to the Kensington Communal Services Committee for 1963/64. 38 Visiting The Council's women health officers visit old people brought to their notice. A comprehensive record system is kept of old people in the borough including personal particulars, environmental conditions and special needs. The local voluntary organisations supply records of old people whom they help and every endeavour is made to keep this information up-to-date. The following is a summary of the work carried out by the Council's women health officers in connection with the care of old people during the year 1963:- Cases on register at the beginning of year 5,173 New cases added to register 613 Cases removed to hospital 23 Cases removed to homes (voluntarily) 16 Cases removed to homes (compulsorily) Nil Cases removed from district 75 Number of deaths 381 Total number of cases remaining on register at end of year 5,291 Number of old people sent away for holiday 118 Number of old people provided with Council's laundry service 37 Number of old people provided with "Meals on Wheels" 258 Cases referred to National Assistance Board 80 Cases referred for assistance from Home Help Dept. 175 Cases referred for assistance from voluntary organisations 91 Cases referred to recreational clubs 119 Number of visits to chronic sick cases 455 Cases assisted with provision of medical and nursing care 64 Cases where disinfestation was carried out 11 Cases referred to home chiropody service 165 Number of initial home visits made 569 Number of re—visits 3,282 Number of other visits made in connection with old people, including visits to clubs 84 Number of interviews, enquiries, etc. on behalf of old people 3,007 Removal of old and infirm persons to institutions, etc. Under Section 47 of the National Assistance Act, 1948, the Council may apply to a Court for an order to remove to a suitable institution any person who - (a) is suffering from grave chronic disease, or, being aged, infirm or physically incapacitated, is living in insanitary conditions, and (b) is unable to devote to himself, or is not receiving from other persons, proper care and attention. The National Assistance (Amendment) Act, 1951, amended Section 47 of the National Assistance Act, 1948, and provided that application for removal of urgent cases may be made by the local authority or by the Medical Officer of Health, if authorised by the Council to do so, without giving seven days' notice as previously required. Such applications may be made either to a Court of Summary Jurisdiction or to a single Justice, on a certificate by the Medical Officer of Health and another registered medical practitioner. Further, where the hospital or institution agree to receive the case, 39 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 of old people were investigated during the year, in no case was formal action taken to secure compulsory removal to an institute. SANITARY INSPECTION The following table shows a summary of the inspections, etc. carried out by the public health inspectors and their assistants during the year:- Public Health (London) Act. 1936 Houses inspected on complaint 2,824 Houses inspected after infectious disease 1,496 Re-inspections 6,112 Smoke observations 28 Other inspections 1,422 Housing Acts, 1957/1961 Initial inspection of dwelling houses 646 Re-inspections 2,936 Initial inspections for overcrowding 277 Re-inspections 719 Underground Living Rooms Initial inspections 473 Re—inspections 1,779 Drainage Applications 315 Plans submitted 359 House drains inspected 6,110 House drains tested 765 Factories Act, 1961 Premisees inspected 162 Outworkers' premises inspected 223 Clean Air Act. 1956 Total inspections 4,684 The following table shows the number of notices issued in respect of nuisances, defects, etc. found during the year:- Public Health (London) Act, 1936 Intimation notices 1,010 Statutory notices 327 Final notices 116 40 Various Factories Act 5 Report of waste water to the Metropolitan Water Board 51 Report of dangerous structures to the London County Council 55 Other notices (including notice of entry) 947 The following is a summary of the principal works completed under the supervision of the public health inspectors during the year:- House drains, reconstructed or repaired 339 House drains cleansed 125 Water closets, reconstructed or repaired 122 Water closets, new provided 397 Soil pipes, vent pipes, repaired, etc 87 Soil pipes, vent pipes, new provided 142 Baths, new provided 318 Sinks, new provided 262 Lavatory basins, new provided 590 Bidets, new provided 24 Waste pipes, new provided 522 Cisternss cleansed 18 Dustbins provided 72 Accumulations of filth, etc. removed 140 Roofs repaired 95 Dampness in dwellings remedied 109 Artificial lighting to staircases provided 2 Houses disinfected after infectious disease (including bedding, etc.) 127 Rooms in such houses, disinfected after infectious disease 203 Verminous houses cleansed (including bedding, clothing, etc•) 258 Verminous rooms in such houses, cleansed 551 Other sanitary works executed 355 HOUSING Inspection of dwelling houses during the year (i) (a) Dwelling houses inspected for housing defects (under Public Health or Housing Act) 6,362 (b) Inspections made for the purpose 23,762 (ii) (a) Dwelling houses (including those under sub-head (i) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 1,396 (b) Inspections made for the purpose 6,830 (iii) Dwelling houses found not to be in all respects reasonably fit for human habitation 1,086 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 759 41 Action under statutory powers during the year (a) Premises repaired after service of formal notice under the Public Health (London) Act:- (i) By owners 321 (ii) By local authority in default 6 (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 105 (ii) Dwelling houses which were rendered fit by owners Tinder Section 9 Nil (iii) Dwelling houses rendered fit by the Council in default of owners Nil (c) Action under Sections 16, 17 and 23 of the Housing Act, 1957: — (i) Dwelling houses in respect of which demolition orders were made Nil (ii) Dwelling houses demolished in pursuance of demolition orders Nil (iii) Dwelling houses in respect of which closing orders, in lieu of demolition orders, were made 1 (iv) Dwelling houses in respect of which undertakings were accepted from owner to render premises fit for habitation Nil (v) Dwelling houses rendered fit for habitation by owners and closing order determined 2 (b) Action under Section 18 of the Housing Act 1957:- (i) Separate tenements or underground rooms in respect of which closing orders were made 20 (54 rooms) (ii) Separate tenements or underground rooms in respect of which closing orders were determined, the tenements or rooms having been rendered fit 71 (131 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 11 (18 rooms) (iv) Separate tenements or underground rooms in respect of which the Council accepted undertakings from owners to render fit within specified time 4 (ll rooms) (v) Undertakings cancelled 5 (ll rooms) (e) Housing Act, 1957, Part IV - Overcrowding:- (i) Number of dwellings overcrowded at end No reliable of year estimate. (ii) Number of new cases of overcrowding reported during the year 174 (646½ units) (iii) Number of cases of overcrowding relieved during the year 150 (575 units) (iv) Number of cases in which dwelling houses have again become overcrowded after the local authority have taken steps for the abatement of overcrowding Nil Note: Units mean 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. 42 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. Name of Area Date of Declaration No. bf 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.l and 2) 2.1.1951 19 14 Munro Mews 2. 1.1951 24 55 South End Row and Gardens 3. 4.1951 10 4 East Mews Road 3. 4.1951 14 40 Powis Mews 13.11.1951 13 30 St. Luke's Mews 13.11.1951 20 41 Portobello Road Kensal New Town 13.11.1951 4 3 (No.l) Area Kensal New Town 11.12.1956 34 309 (No.2) Area Kensal New Town 14. 1.1958 62 441 (No.3) Area Portland Road 14. 1.1958 15 146 (No.l) Area Portland Road 11. 3.1958 5 31 (No.2) Area Kensal New Town 11. 3.1958 10 71 (No.4) Area Kensal New Town 8. 3.1960 7 41 (No.5) Area Kensal New Town 8. 3.1960 20 187 (No.6) Area 8. 3.1960 6 62 Railway Mews Area Portobello Road/ 10. 5.1960 10 7 Telford Road Area Kensal New Town 17.10.1961 18 127 (No.7) Area 12. 3.1963 49 350 Princedale Road Area Kensal New Town 25. 6.1963 7 30 (No.8) Area Kensal New Town 23. 7.1963 24 182 (No.9) Area 15.10.1963 54 417 The London County Council have been engaged in slum clearance operations, using Parts III and V of the Housing Act, 1957, and the following areas have been, or are being, dealt with:- (a) Fenelon Place/Ashley Cottages/Warwick Road Area - containing 66 premises. This site has been cleared. (b) Nos.12/46 (even) Bosworth Road. This clearance area and adjoining land will be used for an extension of the Enslie Horniman Pleasance. - 43 - (c) Nos.325/335 Kensal Road. This clearance area is in that part of Kensal New Town development area zoned for industrial purposes. (d) Nos.68/76 (even) Southern Row. These properties are in an area of about one acre which the Minister of Housing and Local Government proposes to re-zone from light industry to residential (1962/1967). Programme for Slum Clearance Blechynden Street/Lancaster Road (West) Area. Negotiations have taken place between the Council and the London County Council in regard to the proposal to redevelop an area known as the "Blecyhnden Street area", The allocation of responsibility between the two authorities has been agreed as follows:- To be developed by the London County Council: Blechynden Street area north-west of railway - Gross area 8.30 acres To be developed by the Council: Blechynden Street area south-east of railway - Gross area 16.23 acres It will be appreciated that by no means all the properties in this area sire suitable for action under "slum clearance", and the extent to which action under Part III of the Housing Act, 1957, can be taken will depend on the results of a survey of individual properties. In connection with that part of the Blechynden Street area allocated to the County Council, Compulsory Purchase Orders were made during 1962 by that Council in respect of the following premises:- 1-3 (cons.) Bramley Mews 43-49 (odd) and 53-59 (odd) Bramley Road 33-67 (odd), 73-81 (odd) and 56-78 (even) Blechynden Street 1-17 (odd), 8, 10 and 16 East Mews Road 1-25 (odd) Lockton Street 1-15 (odd), 2-14 (even) Martin Street 36-44 (cons.) Mersey Street 33-41 (odd) Oldham Road. 35-43 (odd) Silchester Road 21-33 (odd) and 2-30 (even) Silchester Terrace During 1963 the London County Council decided to make further compulsory purchase orders under Parts III and IV of the Housing Act, 1957, in respect of the following properties in the Blechynden Street area:- 2/3, 5, 9 and garage adjoining Nos.2/3 Blechynden Mews 23-31 (odd) and 50/54 (even) Blechynden Street 82, 82a and 84-94 (even) Bramley Road 15-21 (odd), 33 and passageway and land adjoining No.15 Silchester Road 1-17 (odd) Silchester Terrace Kensal New Town Area. This area, consisting of over 20 acres, is scheduled for clearance. The first portion of 6½ acres has been dealt with by the Borough Council, and the redevelopment of the site by the erection of new flats and maisonnettes is well in progress. - 44 - The remaining portion of the Kensal New Town Area, which is zoned for residential development, will be dealt with by the Council and the London County Council on the following basis:- (i) The Council will undertake the redevelopment of 3.1 acres to the north and 1.62 acres to the south of the 6½ acres upon which they are at present engaged. This area, including the present 6½ acres, is bounded by Kensal Road, Golborne Road, Bosworth Road and the railway. (ii) The London County Council will undertake the re-development of 7.2 acres to the east of the Borough Council's present 6½ acres. This area is bounded by Golborne Road, Kensal Road and the railway. The London County Council will also be responsible for the redevelopment of a small area of 0.41 acres between Kensal Road and the canal, to the west of an area in Paddington, of 3.6 acres, which the County Council now propose to zone as open space in place of the open space of 3.6 acres originally proposed at the eastern end of the area. The London County Council will be responsible for school extensions and the provision of additional open space north of Kensal Road. On 25th June, 1963, the Council were informed that the London County Council had passed resolutions for the acquisition of a number of properties in the Kensal New Town comprehensive development area under Parts III and V of the Housing Act, 1957, and for the purposes of the Open Spaces Act, 1906. So far as Kensington is concerned, the properties involved form the whole of that part of the comprehensive development area east of Golborne Road to the borough boundary. The resolutions of the County Council also apply to land in Paddington between Kensal Road and the Grand Union Canal where about 4 acres of land will be made available for open space purposes. The compulsory purchase orders will be submitted by the County Council to the Minister of Housing and Local Government in due course for confirmation. The western area of Kensal New Town, which is scheduled for non-residential purposes, will be dealt with by the London County Council as and when convenient. IMPROVEMENT OR CONVERSION OF EXISTING HOUSES Owners of private dwellings may apply to the Council for assistance towards carrying out works of improvement or conversion. One aim is to encourage owners to provide services and amenities in houses which are sound but which were built to a lower standard than is generally acceptable nowadays. The other is to encourage the provision of additional satisfactory dwellings, either by converting the large outmoded house from one dwelling into a number of flats, or by converting an old building into one or more dwellings. Grants are not intended to help owners meet the cost of ordinary repairs and renewals, nor are they intended to adapt a perfectly adequate dwelling to the needs of a particular family. They are not normally payable for the provision of extra living rooms or bedrooms, or for increasing the size of existing rooms. They are not payable for the improvement of premises used primarily or partly for business purposes. - 45 - Two methods of application are available. The first is to apply for an improvement grant-known as a discretionary grantunder 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 of Housing and Local Government has specified for a dwelling, in respect of which an improvement grant may be made, are as follows:- The dwelling must, after improvement or conversion- 1. Be in a good state of repair and substantially free from damp; 2. have each room properly lighted and ventilated; 3. have an adequate supply of wholesome water laid on inside the dwelling; 4. be provided with efficient and adequate means of supplying hot water for domestic purposes; 5. have an internal or otherwise readily accessible water closet; 6. have a fixed bath (or shower) preferably in a separate room; 7. be provided with a sink or sinks and with suitable arrangements for the disposal of waste water; 8. have a proper drainage system; 9. be provided in each room with adequate points for gas or electric lighting (where reasonably available ); 10. be provided with adequate facilities for heating; 11. have satisfactory facilities for storing, preparing and cooking food; 12. have proper provision for the storage of fuel (where required). Applications for improvement (discretionary) grants received and dealt with during 1963 are summarised as follows:- Applications received 38 Applications granted 31 Applications refused 7 Total amount of grants approved £11,355.15s. 0d. The second method is to apply for standard grants, which were introduced by the House Purchase & Housing Act, 1959. The Act sets up a new system of standard grants to supplement the present - 46 - system of improvement grants paid at the discretion of the local authority. These standard grants are payable only in respect of the provision of specified standard amenities and on the expenditure actually incurred for this purpose. Provided certain conditions are satisfied, the owner of the property can claim the grant as of right. 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 parenthesis 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 for the dwelling (£40) (e) Satisfactory facilities for storing food (£10). These amenities 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. During 1963, four applications for standard grants were received in respect of individual premises. Of the two applications approved, one was for the provision of all the standard amenities, and the other was in respect of the provision of a wash-hand basin, hot water supply and a water closet. The remaining two applications were refused as the statutory conditions were not complied with. Houses in Multiple Occupation In the last few years the Council have given very serious consideration to the question of improving tenement houses. Many attempts have been made to obtain improvements by exercising the Council's powers under the Public Health (London) Act, 1936. These attempts, however, have been frequently frustrated, partly because of the difficulty of ascertaining exactly who was the legal owner at any particular time. A further difficulty was the reluctance of some tenants to attend court. One of the factors mainly accounting for the squalid appearance of these houses was the condition of the entrance halls, the communal staircases and kitchens. The artificial lighting of the halls and staircases was adequate, but the decorations were old and drab. These parts of the houses were seldom swept, with the result that there was an accumulation of litter. Many of the communal kitchens presented an even worse appearance, food refuse having been left about, and little attempt seened to have been made to clean stoves, sinks or floors. It was doubtful whether the bathrooms were much used, probably owing to lack of hot water, and the condition of many of the water closets indicated lack of normal cleansing. The method of letting produced a great volume of refuse, and the number of bins needed could not be housed in the small front areas and cellars. As a result, some were kept in the flats and, on collection day, all were brought down and stacked on the front entrance steps. Some refuse was thrown out of rear windows into the areas, where it choked the drains. - 47 – On 24th November, 1961, a new Housing Act came into operation providing new powers for dealing with bad living conditions in houses let in lodgings or occupied by members of more than one family. (It also makes a number of changes in the law affecting condemned houses, improvement grants, town development and housing subsidies.) The 1961 Act provides, amongst other powers:- (i) A new power to apply a code of management to individual houses in which proper standards of management have not been observed. The requirements of this code are prescribed in the Housing (Management of Houses in Multiple Occupation) Regulations, 1962, which came into operation on 22nd May, 1962. (ii) Stronger powers to require the provision of additional facilities and amenities essential to decent living conditions, and the provision of adequate means of escape from fire. (iii) A power for local authorities to carry out works themselves in default and recover the cost. (iv) A new power to make a direction limiting the number of persons who may live in a house, or part of a house, which is in multiple occupation. The new powers are designed to deal primarily with the worst type of multi-occupied house. Part I of the Regulations mentioned in (i) above deals with their application and interpretation; Part II prescribes the duties of management to be discharged by the manager of the house; and Part III deals with ancillary requirements including the provision of information. It also places certain obligations on occupants for the purpose of ensuring that the manager can effectively carry out his duties. Responsibility for management will rest on an owner or lessee who receives the rents or other payments from tenants or lodgers, including any agent or trustee through whom the rents are received. The main substance of the code of management is contained in Part II of the Regulations which deals with the manager's responsibilities for repair and maintenance. Broadly, these responsibilities amount to ensuring the repair (including reasonable decorative repair), cleanliness and good order of the parts of the house in common use; the proper maintenance throughout the house of installations for basic services, such as water supply, drainage, gas and electricity; the repair and good order of all means of ventilation and means of escape from fire. The manager is also required to ensure an adequate provision of refuse bins and to take reasonable precautions to protect tenants from injury as a result of structural conditions in the house. Where rooms are let to tenants or lodgers as their living accommodation, the manager must ensure that the rooms are clean and in a reasonable state of structural repair at the commencement of the letting and that defects are remedied in the rooms which are already let, when the Regulations are applied to a house. There is a continuing obligation for the repair and proper working order of installations in the rooms, for the supply of water, gas and electricity as well as baths, sinks, basins and sanitary conveniences. - 48 - In Part III of the Regulations a general obligation is placed on occupants to take reasonable care not to hinder the manager in carrying out his duties. Regulation 14 requires the manager to display in a suitable position in the house a notice containing his name and address and that of any other manager with an indication of his interest (i.e. agent or trustee), a copy of the Management Order, a copy of the Regulations and, if the local authority require, a notice which the authority may provide for indicating briefly the main provisions of the Regulations. The Regulations do not stand in isolation, and they must be taken together with existing powers under the Housing Act, 1957, and the new powers contained in the 1961 Act relating to the provision of additional services and facilities and the prevention or reduction of overcrowding. It is likely that there will be houses where Orders applying a code of management, prescribed in the Regulations, will be all that are necessary to bring about an improvement in conditions. In others, the reason for the unsatisfactory state of affairs will be not so much bad management as lack of essential facilities. To put this right, a local authority can require the necessary work to be done and, where need be, link the notice of works with a direction limiting the number of occupants in a house. In the very worst type of houses conditions may be so bad that, to effect any real improvement, it will be necessary to take action at one and the same time to secure better management, additional facilities, and a limitation on the number of occupants. The premises affected vary considerably, and render impracticable the provision of a single rigid code of requirements applicable to all cases. However, the Council on 29th May, 1962, adopted certain minimum requirements as standards of essential services and amenities. These were given in detail in my reports for 1962 and have been recommended for adoption throughout London by the Metropolitan Boroughs' Standing Joint Committee. Plan of Action In January, 1963, the Medical Officer of Health reported to the Public Health Committee on the improvement of houses and, inter alia, referred to areas of properties which are up to 100 years old where the property is either unsuitable or not worth converting. These areas are shown on a map coloured pink and include a total of 1,436 properties. The best long term solution for these properties is demolition and redevelopment, but the existing slum clearance commitments of the Council will prevent them from undertaking this for many years. The properties consist predominantly of houses in multiple occupation. The joint meeting of the Public Health Committee and Housing and Town Planning Committee therefore recommended that as a short term policy the provisions of Part II of the Housing Act, 1961, relating to houses in multiple occupation should be applied to these areas as soon as possible, and that additional staff should be engaged and additional office accommodation provided. The aim was to deal with the 1,436 houses within three years, and to do this it was decided to engage four additional technical assistants working under the direction of two qualified public health inspectors. In view of the substantial increase in administrative and clerical work it was decided to engage one senior clerk and two shorthand typists. - 49 - The accommodation at the Public Health Department was already strained to the limit and, in order to house this new housing section, it was decided to convert the coach house and stable at the rear of the Red House, Hornton Street, for the accommodation of the additional staff. The work on this office conversion was completed in October, 1963. Difficulty was encountered in securing qualified staff as technical assistants. In view of the nation wide shortage of public health inspectors, and the even greater shortage in the London area, it was decided to attempt to recruit assistants with sufficient experience to undertake routine inspections, but, despite several advertisements, the type of applicant was generally quite unsuitable with regard to experience and qualification to undertake the work involved. As a result, a further effort was made to secure public health inspectors and by the end of 1963 it was possible to assign four inspectors to this work, together with the clerical staff referred to above. The full establishment of six public health inspectors was reached early in 1964. Two public health inspectors had been engaged on the preliminary work for some time prior to the completion of the office accommodation and inspections had commenced. A system was devised to deal with the house-to-house inspection, report, preparation and service of all necessary notices, for when it was eventually possible to commence the operation on a full scale. The procedure involved under the Act of 1961 is complicated and calls for very close liaison between the officers of the Town Clerk's and Medical Officer of Health's Departments. It was decided that the purpose of the inspections should be threefold:- (i) to secure, under section 12 of the Housing Act, 1961, the satisfactory management of all premises in multiple occupation; (ii) to obtain the installation of satisfactory sanitary facilities and amenities under section 15 of the Housing Act, 1961, to comply with the standards made by the Council; and (iii) to secure the repair of houses under section 9 of the Housing Act, 1957. Action taken Inspections were commenced in the Golborne Ward area adjoining Kensal New Town where the Council's slum clearance programme is in progress. The first road to be dealt with was St. Ervan's Road, followed by Wornington Road (south-east of Golborne Road), Swinbrook Road and Bevington Road, and, by the end of the year, 296 houses had been inspected. The following table summarises the action taken by December 31st, 1963:- Houses inspected 296 No action required 27 Management orders made 27 Notices served: Section 9-Housing Act, 1957 105 Section 15-Housing Act, 1961 117 Section 16-Housing Act, 1961 2 Negotiations in progress 6 Work in progress 96 Work completed 27 Work in default authorised 4 - 50 - In the part of the area dealt with to date, the houses mainly consist of a basement and three storeys, with a back addition, usually to the basement and ground floors. In some cases the basement rooms are subject to closing orders. In the past, these houses have been occupied by a family on each floor, but due largely to the settling of immigrants in this area, many have been found to be in oneroom lettings. The majority of the houses in the area have no bathroom and, generally, there is one internal water closet situated on the ground floor or first half landing, with an external water closet in the rear yard, the latter normally used only by the basement tenant. The requirements generally have, therefore, been for the provision of at least one bath in every house, and in some cases an additional internal water closet, together with a hot water supply and exclusive facilities for the cooking, preparation and storage of food in each separate letting. Where there are one-room lettings it has been found mainly that kitchens are shared or cooking facilities are provided on landings. In these cases the provision of hot and cold water supplies, sinks, food storage and cooking facilities have also been required within each letting. In a number of cases, the baths have been installed in the ground floor back addition rooms, and, where additional water closet accommodation has been necessary, it has been possible to provide it in the new bathroom, in those cases where there is a separate water closet also available. Where the back addition rooms are occupied, the bathrooms have been provided by building up the back addition by an additional storey. This is an expensive improvement but in view of the present high market value of these properties and the added value such an improvement secures, the expenditure is not considered to be excessive or disproportionate. In many cases the owners have considered such improvements to be worth while and have carried out the work without any undue pressure being brought to bear. Some owners are converting premises into self-contained units which involves building up the back addition to the full height of the building, and they have sought improvement grants from the Council to assist them in doing this. In a number of cases where premises are free from mortgage, the Council are considering the advance of loans to owner/occupiers to assist them to improve their properties. Problems encountered In the administration of new legislation of this nature it is inevitable that difficulties should be encountered. The largest single problem which has been met in this work is the element of delay. This has been experienced at all stages of the procedure, of which the following are examples:- (a) At the outset when the Town Clerk is endeavouring to obtain details of persons interested in the premises, undue delay has been caused by owners in the time taken to reply to the enquiry. This information is essential before any notices can be served. (b) A lack of co-operation by owners and tenants has been met in gaining access to some premises. (c) Delay brought about by the administrative procedure necessary in making a management order. - 51 - (d) Various methods adopted by recalcitrant landlords to avoid or delay executing the necessary works. (e) Changes of ownership. (f) Changes of occupier and the method of letting a house. (g) Slow progress by builders in executing work. This has been brought about mainly by the insufficiency of builders willing and able to undertake this type of work. (h) Delay by landlords proceeding with works at a very slow pace and by this action preventing the Council from executing the work in default. (i) Poor standard of work found in many cases which necessitates a larger number of re-inspections and causes delay in the resultant alterations necessary to amend the work. (j) Genuine cases of hardship, particularly in the case of some old owner/occupiers or old principal tenants who have sub-let and become liable to carry out certain works as they are responsible for the multiple occupation. Representations have been made to the Minister of Housing and Local Government by this Council and other local authorities, and, as a result, it is hoped that effective new measures will be introduced when the Housing Bill at present before Parliament becomes law. It is anticipated that it will introduce heavy penalties for failure to execute works required under the Housing Act, 1961. This will be in addition to the Council's power to execute the works in default, and will undoubtedly assist in expediting the completion of works. Powers of access will also be introduced where entry may be by force if necessary. At the present time obstruction is only punishable by a fine. Under the existing powers the Council may require the installation of sanitary facilities and amenities under section 15 of the Housing Act, 1961, and they may also make a direction under section 19 of the Act controlling the occupancy of houses in multiple occupation. The latter section has not proved as valuable as at first thought. It cannot be used concurrently with section 15 so that the Council can reduce the number of persons occupying a house to a reasonable number and, at the same time, require such additional facilities as are necessary to meet the needs of the new fixed number. In the new Act it is anticipated that it will be possible to operate sections 15 and 19 simultaneously. Although this Council have resolved that where works required under the Act of 1961 are not carried out they will execute them in default, some doubts have been expressed by other authorities concerning the recovery of the costs. The present Act provides that the costs may be recovered from the person on whom the notice was served. In earlier housing legislation costs have been recoverable as a charge against the premises. Now the new Bill provides that the cost of works will also be recoverable in this way. At the end of the year satisfactory progress was being made in the inspection of premises and, with the full complement of public health inspectors anticipated early in 1964, great headway will be made during the next year in tackling this important problem. - 52 - ARTIFICIAL LIGHTING OF COMMON STAIRCASES IN TENEMENT HOUSES AND FLATS Council Byelaws relating to artificial lighting of common staircases in tenement houses and flats came into operation on 11th March, 1958. The principal Byelaw reads as follows:- "The occupier of every tenement house to which these Byelaws apply and the owner of every block of flats shall provide adequate artificial lighting for all common staircases:- (a) from half an hour before sunset until 12 o'clock midnight; (b) for one hour before sunrise during the months of October, November, December, January, February and March; and (c) at other times as and when necessary if adequate means of natural lighting are not provided." During 1963 formal notices were served in 2 cases, requiring compliance with these Byelaws. CERTIFICATES OF DISREPAIR IN RELATION TO DWELLING HOUSES The Council's duty to issue certificates of disrepair in respect of "rent controlled" dwelling houses, not reasonably suitable for occupation, is governed by the Rent Act, 1957. The following is a summary of the action taken during 1963:- Part I - Applications for Certificates of Disrepair Number of applications for certificates 2 Number of decisions not to issue certificates Nil Number of decisions to issue certificates - (a) in respect of some but not all defects 1 (b) in respect of all defects 1 Number of undertakings given by landlords 2 Number of undertakings refused by Council Nil Number of certificates issued Nil Part II - Applications for cancellation of Certificates Applications by landlords to Council for cancellation of certificates 8 Objections by tenants to cancellation of certificates 1 Decision by Council to cancel in spite of tenant's objection 1 Certificates cancelled 8 OVERCROWDING All cases of overcrowding are dealt with on the strict interpretation of the standards laid down in the Housing Act, 1957: distinguishing between "penal" and "non-penal" cases. The number of new cases of overcrowding reported to the Committee during 196 3 was 174, giving an equivalent number of persons of 646½. The total number of overcrowding cases which were recorded during the year as having been abated was 150, comprising a total of 575 units. - 53 - During the year there was some adverse comment in the press on the Council's overcrowding policy, which is to operate the provisions of Part IV of the Housing Act, 1957, dealing with overcrowding, especially in the Golborne Ward. These provisions impose a statutory duty on local authorities to abate overcrowding, and are a re-enactment of provision. originally contained in the Housing Act, 1935. The Golborne Ward contains a very large immigrant population, both white and coloured. The 1961 census indicated that 46.5 per cent of the population of this Ward were born outside the United Kingdom, compared with 14.4 per cent for the Administrative County of London, and 29.3 per cent for Kensington as a whole. The census also indicated that the Golborne Ward had the highest number of persons per room in London (1.17); the highest percentage of persons at more than 1½ per room in London (40.5 per cent); and the fourth highest number of persons per acre (128.5). In the circumstances the Council considered as a public health authority that they have no alternative but to carry out their statutory duty to abate overcrowding. If they failed to do so, conditions in this part of the borough would soon become such as to render the Council liable to severe and justified criticism. ASSESSMENT OF HOUSING PRIORITIES ON MEDICAL GROUNDS During the year, 162 applications for rehousing on medical grounds were examined, and recommendations for the award of additional points were made to the Chief Housing Officer. In each case the precise medical condition and resultant disability were determined (frequently necessitating communication with the family doctor or with the hospital attended). The premises were inspected in detail to ascertain the extent and nature of the existing accommodation; the adequacy of day and sleeping space; the risk of infection; the existence of remediable or irremediable sanitary or structural defects, and the existence of inconveniences, such as stairs, which might be prejudicial to the patient. On this information and that supplied by the Chief Housing Officer, an assessment of points to be awarded on medical grounds was made in 159 cases. PROVISION OF NEW HOUSING ACCOMMODATION The post-war housing schemes completed in Kensington by the Council have provided 1,754 flats. The total number of properties under Council management is summarised in the following table:- Housing Properties 1890 Act 18 Cottage Estates 217 1919 conversions 96 Pre-war flats 285 Sundry properties 63 679 Temporary Bungalows 48 Compulsory Purchase Area/Properties 9 1949 Act conversions 107 Post-war flats 1,754 1,918 Properties formerly requisitioned (in family units) 402 c/f 2,999 - 54 - b/f 2,999 Other properties Henry Dickens Court Garages 10 Ingelow House Garages 12 25, Basing Street Garages 2 Balfour of Burleigh Estate Garages 3 Lonsdale Mews Stores and Stables 17 Treverton Street Garages and Shops 14 Kensal New Town Garages, etc 29 Hard Standings (for cars) 204 291 3,290 Other schemes for building new housing accommodation are in various stages of preparation. UNDERGROUND ROOM REGULATIONS During the year the Council gave consideration to the revision of their Underground Room Regulations to bring them into conformity with new model regulations issued by the Minister of Housing and Local Government. The Metropolitan Boroughs' Standing Joint Committee also considered this matter and suggested amendments to the model regulations, some of which were accepted by the Minister. Following the acceptance of the amendments, the Standing Joint Committee recommended their constituent councils to submit for approval revised regulations in the form of the amended model issued by the Minister. The main alteration is that the amended Regulations will allow greater flexibility in dealing with dampness. Where dampness is slight, comparatively minor works may be adequate but, on the other hand, where dampness is serious, it will still be possible to insist on the provision of a horizontal or vertical damp-proof course and a concrete oversite. The revised Regulations were made by the Council on 12th February, 1963, and were confirmed by the Minister of Housing and Local Government. They came into force on 29th April, 1963. FACTORIES Section 153(l) of the Factories Act, 1961, 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.1/64, dated 13th January, 1964. - 55 - Part I of the Act 1 - INSPECTIONS for the purposes of provisions as to health (including inspections made by public health inspectors) Premises (1) No. on Register (2) Number of Inspections (3) Written Notices (4) Occupiers prosecuted (5) i) Factories in which Secs.l, 2, 3, 4 and 6 are to be enforced by local authorities 113 9 - - ii) Factories not included in i) in which Sec.7 is enforced by the local authority 561 106 5 - iii) Other premises in which Sec.7 is enforced by the local authority (excluding outworkers' premises) 68 47 - - TOTAL 742 162 5 - 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.") Number of cases in which defects were No. of cases in which prosecutions were instituted (6) Particulars (1) Found (2) Remedied (3) referred To H.M. Inspector (4) By H.M. Inspector (5) Want of cleanliness (S.1) 2 4 - - _ Overcrowding (S.2 ) - - - - - Unreasonable temperature (S.3) - - - - - Inadequate ventilation (S.4) - - - 1 - Ineffective drainage of floors (S.6) - - - - - Sanitary conveniences (S.7): (a) insufficient - - - - - (b) Unsuitable or defective 2 1 - 1 - (c) not separate for sexes 2 2 - 1 - Other offences against the Act (not including offences relating to outwork) 1 1 _ - _ TOTAL 7 8 - 3 - - 56 - Part VIII of the Act Outwork (Sections 133 and 134) Section 133 Section 134 (l) Nature of Work No.of Outworkers in August lists (2) required by Sec. 133 (1) (c) (3)No. of cases of default in sending lists to the Council No. of prosecutions (4) for failure to supply lists No. of instances (5) of work in unwholesome premises (6) Notices served (7) Prosecutions Wearing apparel: Making, etc. 142 . - - - - Cleaning and washing 3 - - - - - Household linen 1 - - - - - Curtains and furniture hangings 4 - - - . - Furniture & Upholstery 4 - - - - - Boxmaking 19 - - - - - Feather sorting - - - - - - Artificial flowers 36 - - - - - Carding, etc. of buttons, etc. 2 - - - - - Stuffed toys 55 - - - - - Cosaques, Christmas Stockings 1 - - - - - Lampshades 2 - - - - - Paper Bags 3 — - - - - TOTAL 272 Nil Nil Nil Nil Nil During the year, 223 inspections of outworkers' premises were made, but in no case was action necessary to prevent work being carried out 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, 1961 (Section 70), 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 1963, and at the present time there are 6 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 - 57 - SANITARY ACCOMMODATION, ETC. IN SHOPS The Shops Act, 1950 empowers the Council to enforce in all shops- (a) suitable and sufficient means of ventilation; (b) suitable and sufficient means of maintaining a reasonable temperature; (c) suitable and sufficient water closet accommodation. As from 1st January, 1959 the London County Council transferred to Metropolitan Borough Councils 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. 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 or washing facilities 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 accommodation or facilities are 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 1963, no exemption certificate under the Shops Act was granted. Similarly, under the Food Hygiene Regulations, exemption may now be granted in food shops in respect of the provision of constant water supply, wash-hand 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 1963 no exemption certificate was issued under the Food Hygiene Regulations. REGISTER OF FACTORIES The Factories Act, 1961 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 Kensingtons:- - 58 - Factory-Business North Kensington South Kensington Mech. N-M. Mech. N-M. Bakers and confectioners 8 2 9 2 Belt & Button Manufacturers 2 - - 1 Builders & Decorators 7 4 8 9 Building Construction 6 - 62 - Carton Making & Salvage 3 1 - - Coffee Grinding & Roasting 1 - 3 - Cosmetics & Toilet Preparations 1 1 - 1 Dental Mechanics 2 - 3 - Disinfectants 1 - - - Display Works & Signwriting 4 1 2 - Doll & Toy Manufacturers 7 3 3 - Dressmaking 12 - 29 12 Drug Manufacturers - 1 - - Dyers & Cleaners 8 1 10 - Electro Platers 2 - - - Engineering (Electro) 8 - 7 2 Engineering (Mech.) 24 - 10 - Electrical Generating Stations 2 - 1 - Film Editing & Slide Making 2 - - - Furriers 1 1 11 2 Gas Works 1 - - - Glass Cutting & Polishing 3 - 2 - Handbags & Shopping Bags - - - 1 Ice Cube & Cream Manufacturers 2 - - - Jewellers & Watchmakers 2 1 3 2 Lamp Shade Manufacturers 1 1 1 1 Laundries 10 - 6 - Leather Goods 1 - 1 3 Metal Merchants 7 1 3 1 Milliners 1 - 1 5 Motor Car Accessories 1 - - 1 M.V.R. & Garages 48 1 68 3 Musical Instruments 2 - 2 - Needle Grinding 2 - - - Novelty Goods 2 - - - Office Equipment - - 1 - Oil Blenders & Packers 1 - - 1 Paint Makers & Storers 3 - - - Photographers 2 - 5 3 Picture Frame Makers 1 - 3 1 Plastics 6 2 1 - Printers & Bookbinders 12 - 6 1 Radio & Television 7 1 5 1 Rubber Goods Manufacturers 1 - - - Rag Merchants - 1 - - Sausage Makers 12 - 5 - Scientific & Hospital Instruments 3 - 2 - Shoe Makers & Repairers 6 - 11 - Silk Screen Printing & Spraying 3 - - - Starch & Soda Manufacturers 2 - - - Soft Furnishings & Upholstery 15 4 15 8 Stone Masons 1 - 1 - Sweet Making & Packing 1 1 - - Tailoring 8 1 13 10 Tool Making 6 - 1 - Undertakers 1 - - 1 Wax Workers 1 - - - Weaving - - 2 - Woodworkers (joiners etc.) 7 1 11 1 Wheelwrights 3 1 1 - Miscellaneous 10 2 5 7 TOTAL 296 33 333 80 - 59 - SUPERVISION OF FOOD SUPPLIES FOOD AND DRUGS ACT, 1955 This is the principal Act for controlling the composition, labelling, fitness and hygienic handling of food. FOOD HYGIENE (GENERAL) REGULATIONS, 1960 These Regulations are the principal instruments for enforcing good food hygiene practice in foodshops. Their main requirements were given in my previous reports, 1956-1962. During the year, the public health inspectors have been engaged on surveying food premises in the borough and a total of 1,452 inspections was made. In 17 cases it was necessary to send informal notices 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:- DETAILS OF LEGAL PROCEEDINGS TAKEN UNDER FOOD HYGIENE REGULATIONS IN 1963 As requested by Ministry of Health Circular 22/58 Date of Hearing Offence Regulations Result Fine Costs awarded to Council 1.1.63 (Restaurant) Insanitary premises 5 £10. 0. 0. £ 2. 2. 0. Walls of kitchen dirty 23(1) 6. 0. 0. - Equipment in kitchen dirty 6(1) 2. 0. 0. - Food sinks dirty 19(1) 2. 0. 0. - Absence of first aid equipment 17 2. 0. 0. - Walls of basement food room dirty 23(1) 5. 0. 0. _ Equipment in basement kitchen dirty 6(1) 2. 0. 0. - 9 Summonses regarding dirty conditions, etc. 23(1) Not separately dealt with. 1.1.63 (Restaurant) Insanitary premises 5 10. 0. 0. 2. 2. 0. Walls of vegetable room dirty 23(1) 12. 0. 0. — Sink in vegetable room unsatisfactory 6(1) 3. 0. 0. — Walls of main kitchen dirty 23(1) 9. 0. 0. - Walls of service lift dirty 23(1) 5. 0. 0. - Walls of basement kitchen unsatisfactory 23(1) 12. 0. 0. — Equipment in kitchen dirty 6(1) 10. 0. 0. - Walls of basement passage dirty 23(1) 15. 0. 0. — Walls of dry goods store dirty 23(1) 15.0. 0. — Floor of still room unsatisfactory 23(1) 3. 0. 0. - Absence of first aid equipment 17 3. 0. 0. - Food room communicating directly with W.C. 14(4) 5. 0. 0. - 17 Summonses regarding dirty conditions etc. 23(1) Not separately dealt with. - 60 - DETAILS OP LEGAL PROCEEDINGS TAKEN UNDER FOOD HYGIENE REGULATIONS IN 1963 (Cont'd) Date of Hearing Offence Regulations Result Fine Costs awarded to Council 25.1.63 (Shop) Failure to provide hot water to wash basin 16(2) £ 5. 0. 0. £ 2. 2. 0. 1.3.63 (Restaurant ) Walls of kitchen dirty 23(1) 10. 0. 0. 3. 3. 0. Equipment in kitchen dirty 23(1) 10. 0. 0. - Failure to provide hot water in kitchen 19(1) 2. 0. 0. - Walls of still room unsatisfactory 23(1) 2. 0. 0. - Walls of store room unsatisfactory 23(1) 5. 0. 0. - Absence of soap, towels,etc. 16(3) 2. 0. 0. - Shelves in food room dirty 23 2. 0. 0. - Walls of spice room dirty 23(1) 5. 0. 0. - Shelves in spice room dirty 23(1) 2. 0. 0. - W.C. apartment dirty 14(2) 2. 0. 0. - Sanitary conveniences dirty 14(1) 2. 0. 0. - Defective fittings to W.C. 14 (l) 2. 0. 0. - Absence of notice regarding washing hands 14(5) 2. 0. 0. _ Absence of first aid equipment 17 2. 0. 0. - 9 Summonses regarding dirty conditions, etc. 23 Not separately dealt with. 3 " " " " 23 Withdrawn 12.3.63 (cafe) Walls of food room not in good order 23(1) 3. 0. 0. 3. 3. 0. Refuse accumulated in food room 24 2. 0. 0. - Walls of food room not in good repair 23(1) 3. 0. 0. _ Walls of passage not in good repair 23(1) 3. 0. 0. _ Extractor fan dirty 23(1) 2. 0. 0. - Gas stove in food room dirty 6 2. 0. 0. - Absence of wash-hand basin 16(1) 2. 0. 0. - Absence of first aid dressings 17(1) 2. 0. 0. - Walls of dining room on ground floor dirty 23(1) 3. 0. 0. - Walls of dining room in basement dirty 23(1) 3. 0. 0. — Insufficient ventilation to food room 21 3. 0. 0. _ Insufficient lighting to food room 20 3. 0. 0. _ W.C. apartment dirty 14(2) 3. 0. 0. - W.C. apartment insufficiently ventilate 24(2) 2. 0. 0. — Absence of notice re washing hands 14(5) 2. 0. 0. — Risk of contamination of food 8(a) 2. 0. 0. • 14 Summonses regarding dirty conditions 23 Not separately dealt with. - 61 - DETAILS OF LEGAL PROCEEDINGS TAKEN UNDER FOOD HYGIENE REGULATIONS IN 1963 (Cont'd) Date of Hearing Offence Regulations Result Fine Costs awarded to Council 2.4.63 (Restaurant) Walls of food room dirty 23 £ 15. 0. 0. £ 3. 3. 0 Equipment in food room dirty 6(1) 5. 0. 0. - Refuse accumulated in food room 24 5. 0. 0. - Walls of food room (basement) dirty 23 15. 0. 0. - Insufficient lighting to food rooms (3) 20 15. 0. 0. - Insufficient ventilation to food rooms (3) 21 15. 0. 0. - Walls of back food room dirty 23 15. 0. 0. _ Walls of middle food room dirty 23 15. 0. 0. 4 Summonses regarding dirty conditions 23 Not separately dealt with 4 Summonses regarding unsatisfactory conditions 23 Withdrawn (not part of food premises) 2.4.63 (Grocer's Shop) Premises dirty and containing refuse 5 5. 0. 0. _ Dirty dustbin used to store bread 6 5. 0. 0. - Walls of lean-to food store not in good order 23(1) 5. 0. 0. - 33 Summonses regarding dirty conditions 23 Not separately dealt with. 11.6.63 (Restaurant) Walls of kitchen dirty 23 20. 0. 0. 3. 3. 0. Sink in kitchen dirty 23 7. 0. 0. - Shelves " " 23 2. 0. 0. - Surround to sink not in good order 23(1) 3. 0. 0. - Food equipment not in good order 6(1) 5. 0. 0. - Food equipment dirty 6(1) 2. 0. 0. - Wash-hand basin dirty 16(4) 7. 0. 0. - Absence of clean towels etc. 16(3) 7. 0. 0. - 3 Summonses regarding dirty conditions 23 Not separately dealt with. 29.10.63 (Bakehouse ) Insanitary food premises 5 15. 0. 0. 3. 3. 0. Food equipment dirty 6 2. 0. 0. - Risk of contamination to food 8 2. 0. 0. - Employees overalls dirty 9 2. 0. 0. - Absence of clean towels etc. 16(3) 5. 0. 0. - Wash-hand basin dirty 16(4) 2. 0. 0. - (2)Walls and ceiling of bakehouse dirty 23(1) 10. 0. 0. - Shelves in cupboards dirty 6 2. 0. 0. - Windows not in good order 23(1) 5. 0. 0. - Refuse allowed to accumulate 24 2. 0. 0. - Absence of waste pipe to basin 16(4) 5. 0. 0. - - 62 - Date of Hearing Offence Regulations Fine Costs award to Council. 29.10.63 (Bakery) 10 Summonses regarding dirty conditions, refuse and absence of equipment Withdrawn by Council's Solicitor as necessary work carried out. 6.12.63 (Restaurant) Walls of kitchen dirty 23(1) £ 2. 0. 0. £ 3. 3. 0 Insufficient ventilation to kitchen 21 1. 0. 0. - Absence of wash basin 16(1) 1. 0. 0. - 2 Summonses regarding dirty conditions 23 Not separately dealt with. 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 1963:- 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 374 72* the storage of ice cream intended for sale (b) for the preparation or manufacture of sausages or potted, pressed, pickled 126 147 or preserved food intended for sale (2) Milk & Dairies (General) Regulations 1959 as dairies or where the occupier is registered for the sale of milk in 201 132 sealed containers only * 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 10 Bakehouses-others 9 5 Bread and cake shops 43 19 Butchers 73 121 Dairies and premises where milk is sold 201 132 Fishmongers 23 21 Food Factories 19 23 General Stores 45 94 Greengrocers 83 13 Grocers 200 235 Ice Cream 374 72 Preserved Food 26 26 Public houses and off-licences 170 17 Restaurants and cagfes 366 277 Sweet shops 146 10 Street markets, stalls and storage premises 95 213 (licensed traders) (164 miscellaneous visits) - 63 - Milk (Special Designation) Regulations, 1960 These Regulations, which came into operation on 1st October, 1960, consolidated and re-enacted with amendments the Milk (Special Designation)(Raw Milk) Regulations, 1949-1954, and the Milk (Special Designation)(Pasteurised and Sterilised Milk) Regulations, 1949-1953. Changes in licensing dealers in milk provided that:- 1. All dealers' licences, other than those issued by the Minister, will be issued by the food and drugs authority for the area in which are situated the premises at or from which the milk is sold. A dealer's licence no longer restricts sales to the area of the licensing authority and supplementary licences are therefore discontinued . 2. A new form of licence, the dealer's (pre-packed milk) licence, is introduced which may authorise, in a single form of licence, the use of any or all of the appropriate special designations where the milk is obtained by the licensed dealer pre-packed, i.e. in the container in which it is to be delivered to the consumer, or is pasteurised or sterilised by the dealer in accordance with a dealer's (pasteuriser's) licence or a dealer's (steriliser's) licence. The dealer's (tuberculin tested) licence is being retained. 3. Dealers' licences issued on or after 1st January, 1961 will be valid for five years from that date, and will be renewable for subsequent quinquennial periods. These changes in licensing procedure are designed primarily to reduce the amount of routine work involved in the administration of the Regulations. There are no milk processing depots in the borough and all the licenses granted were in relation to milk obtained in pre-packed form for sale from premises in the borough. The licences granted during the year are shown in the following table together with the total numbers in force at the end of the year. Licences issued in 1963 Total number in force at end of year Tuberculin tested milk 8 171 Pasteurised milk 9 193 Sterilised milk 7 159 The following table shows the number of samples of Tuberculin Tested (Farm Bottled) milk and processed milks taken during the year, together with the results of examinations:- Designation No. of Samples Methylene blue test Phosphatase test Turbidity test Passed Failed Passed Failed Passed Failed Tuberculin Tested (Farm bottled) 18 *13 4+ - - - - Tuberculin Tested (Pasteurised) 20 19 1+ 20 - - - Pasteurised 25 24 1+ 25 - - - Sterilised - - - - - - - * One sample of tuberculin tested (farm bottled) milk was not submitted to the methylene blue test as the water bath temperature exceeded 67°F which is the limit specified in the Regulations. + Details regarding these samples were sent to the Ministry of Agriculture, Fisheries and Food. - 64 - 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 cream in sealed containers) was 201. (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. In the case of bottled milk, the time "immediately before use" is considered to mean at the time the bottle is first filled and, therefore, any offence would be committed at the time and place of bottling. During the year six instances of "dirty milk bottles" were reported. In one case legal proceedings were instituted which resulted in a fine of £10 being imposed; in three other cases warning letters were sent to the bottlers, and in the remaining two cases it was decided to take no further action. Composition of Milk During the year, 290 samples of milk (all grades) were submitted to the Public Analyst for examination, all of genuine composition. The following table shows the percentage of milk fat and nonfatty solids of the genuine samples of milk, other than Channel Islands and South Devon milks, taken during each month:- Month No. of samples taken Average Percentages Milk Fats Non-fat Solids January 27 3.75 8.65 February 16 3.70 8.59 March 18 3.54 8.51 April 4 3.49 8.61 May 20 3.38 8.66 June 8 2.99 8.82 July 12 3.57 7.96 August 5 3.77 8.70 September 7 3.67 8.69 October 13 3.83 8.75 November 29 3.88 8.38 December 13 3.82 8.60 Average for the whole year 3.69 8.57 Legal minimum standard 3.00 8.50 Milk and Dairies (Channel Islands & South Devon Milk) Regulations 1956 These Regulations require that all milk for human consumption sold under the specific description of- Channel Islands Milk Jersey Milk Guernsey Milk or South Devon Milk must contain not less than 4% by weight of milk fat. This compares with the presumptive milk fat standard of 3% specified for ordinary milk by the Sale of Milk Regulations, 1939. - 65 - The following table shows the average percentages of milk fat and non-fat solids of the genuine samples taken during each month:- Month No. of Samples taken Average Percentages Milk Fats Non-fat Solids January 15 4.62 9.06 February 15 4.44 8.95 March 10 4. 38 8.88 April 4 4.32 8.89 May 9 4.22 9.07 June 10 4.29 8.79 July 10 4.31 8.93 August 5 4.48 8.99 September 7 4.42 9.05 October 11 4.43 9.02 November 11 4.58 9.04 December 11 4.61 8.98 Average for the whole year 4.42 8.96 Legal minimum standard 4.00 8.50 Unsound Food Seizure Under Part I of the Pood 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 the year, it was found necessary to enforce this procedure on three occasions. One case concerned a self-service shop where six packets of dried mixed fruit were found to be unfit for human consumption due to an infestation of maggots. They were seized and taken before a Justice of the Peace who condemned them and ordered them to be destroyed. Legal proceedings were instituted and the defendant was fined £15 and £3. 3s• 0d. costs. A similar case occurred later in the year at the same shop when fifteen packets of dried fruit were found to be unfit for human consumption due to the presence of maggots. These were also seized and taken before a Justice of the Peace who condemned them and ordered them to be destroyed. Legal proceedings were instituted and the defendant was fined £25 and £3. 3s. 0d. costs. The third case concerned a grocery, delicatessen and fruiterer's shop where mice infestation of the storerooms was found on inspection, and considerable amounts of foodstuffs were found to be contaminated by the excrement of mice. The food was seized and taken before a Justice of the Peace who condemned them and ordered them to be destroyed. Legal proceedings were instituted and the defendant was fined £10. - 66 - Surrender Any person having in his possession food which is diseased, unsound, or unfit for human consumption can, under Section 180(8) of the Public Health (London) Act, 1936, surrender it to the Council for destruction or other suitable method of disposal. During the year the following amounts of food were surrendered and condemned as unfit for human consumption:- Food Tons Cwts Qtrs lbs Meat (raw) 9 4 Ham and Pork 2 11 2 11 Other meat 3 3 21 Sauerkraut 10 2 2 Cucumbers and Gherkins in Brine 3 10 2 11 Fish (wet and dry) 5 - 7 Sausage 2 2 - 23 Butter and Cheese 2 3 21 TOTAL: 9 15 3 26 Tins, jars, packets or cartons of fruit, vegetables and miscellaneous foodstuffs 15,748 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. Food and Drugs Act, 1955 - Additives to Meat A complaint was received from a resident that, upon consumption of minced beef obtained from a local butcher, he and his two children were affected by symptoms of flushing, tingling and burning of the face, ears and hands with a feeling of faintness which ceased after about 50 minutes. His wife did not partake of the mince beef and was not affected. Investigations revealed that it was the practice by the butcher to dust the mince with a proprietary powder (Evered) in order to preserve the fresh red colour of the meat. The powder was analysed and found to be composed of nicotinic acid and ascorbic acid diluted with dextrose. A test for added colouring matter gave negative results. Nicotinic acid and ascorbic acid are not preservatives within the meaning of the Preservatives in Food Regulations, 1962, and, therefore, the use of the powder did not conflict with the provisions of these Regulations; neither did its use infringe the provisions of the Anti-oxident in Food Regulations, 1958, or the Colouring Matter in Food Regulations, 1957. Moreover, as the meat was not sold prepacked, it was not necessary to declare the presence of the powder as an ingredient. Although nicotinic acid in small amounts is regarded as essential for human nutrition, in larger quantities it acts as a vasodilator. Used as a dusting powder, it might be unevenly distributed on the meat and heavily dusted portions could well give rise to vasodilatory action. - 67 - It was alleged that the powder was on a wide sale to the meat trade throughout the U.K., the Continent and in America, and that provided it was correctly used at the recommended rate of 2 ozs. to 30 lbs. of meat prior to mincing, there was no danger. It was stated by the firm of butchers in question that the powder was used in all their shops, which numbered 140, and that no complaint had been received previously. Nevertheless the manufacturers decided to adjust their formula and use a much lower concentration of nicotinic acid in order to give a greater margin of safety against misuse. Considerable publicity in the national press was given to this practice, from which it appeared that at least three brands of dusting powders were in use by the meat trade. The Council considered that the use of the powder was highly undesirable as - (1) it could cause a reaction which might be serious in a person suffering ill health; (2) it added something to meat not demanded by the customer; (3) it produces an illusion of freshness which might mask staleness or deterioration. Representations were made by the Council to the Metropolitan Boroughs' Standing Joint Committee and to the Ministry of Health and Ministry of Agriculture, Fisheries and Food, with a view to prohibiting the use of the powder. The Meat (Treatment) Regulations, 1964, were made and came into operation on the 23rd January, 1964. These regulations make it an offence to sell, consign or deliver any raw and unprocessed meat intended for sale for human consumption which contains any ascorbic acid, erythorbic acid, nicotinic acid, nicotinamide or any salt or derivative of any of these substances. Complaints by purchasers of food During the year 33 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, and the unsatisfactory condition of bread, meat pie, liver, cheese, sausages, confectionery and meat. Of these complaints 8 cases resulted in the Public Health Committee instructing the Town Clerk to institute legal proceedings and in each case a conviction was awarded. In 8 cases, the Public Health Committee decided to send warning letters to the vendors or manufacturers concerned. The remaining 17 cases were dealt with informally, either owing to the lack of sufficient evidence, or to the complaint not being substantiated. Adulteration of Food During the year, 479 formal samples were submitted for analysis by the Public Analyst, of which 19 (3.96%) were either adulterated or otherwise unsatisfactory. 521 informal samples were - 68 - also submitted to the Public Analyst for analysis, of which 11 (2.11%) were either adulterated or otherwise unsatisfactory. The following table summarises the action taken in respect of defective samples:- Unsatisfactory Sample No. of Prosecutions No. of warnings to Producers, Manufacturers or Vendors No further action Total Glace cherries - 1 - 1 Lard 1 3 5 9 Dried mixed fruit - 1 - 1 Dessicated coconut - 1** 3** 4 Dried apricots - 2 - 2 Minced steak 2 - 1 3 Pork sausages - - 2 2 Cheese -1 - 1 Shredded Beef suet - - 1 1 Honeycomb Mould - - 1 1 Pineapple - 1 - 1 Lemonade - - 1 1 Garden Peas - - 1 1 Tomato Puree - - 1 1 Hawaran Punch - - 1 1 TOTAL 3 10 17 + 30 + 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. ** Details regarding these unsatisfactory samples, (products of foreign manufacturers), were sent to the Ministry of Agriculture, Fisheries and Food. 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. The Ice Cream Regulations prescribe standards for ice cream and introduce separate standards for "dairy ice cream" (or "dairy cream ice" or "cream ice"), and for "milk ice.". 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 (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 it is 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 nonmilk fat", or, if appropriate, "Contains vegetable fat." in type of a prescribed minimum size. The following table shows the number of samples of ice cream taken during 1963 for chemical analysis compared with those taken in the previous year:- - 69 - 1962 1963 Number of samples 18 7 Variation of fat content per cent 8.9 to 14.0 8.4 to 12.2 Variation of non-fat content per cent 23.1 to 30.3 24.9 to 31.5 Average fat content per cent 10.72 10.2 Average non-fat solids content per cent 26.66 27.1 The Ice Cream (Heat Treatment etc.) Regulations, 1959, require that ingredients used in the manufacture of ice cream are to be pasteurised 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. 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 heating the mixture to a temperature of not less than 300°F. for at least two seconds. After pasteurisation 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°P. 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 25 samples of ice cream were also taken and submitted to the methylene blue test. The results are as follows:- Grade No. of samples 1 2 3 4 5 4 8 8 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 During the year 18 samples of condensed milk were submitted for analysis and found to comply with the requirements of the Condensed Milk Regulations, 1959• General There are no abattoirs or slaughterhouses in the borough, and no killing of animals for human consumption is carried out. - 70 - FOOD POISONING The Food and Drugs Act, 1955, requires any medical practitioner, on becoming aware that a person is suffering or is suspected to be suffering from food poisoning, to notify the Medical Officer of Health. The following table gives a summary of all cases (notified or not) brought to notice during 1963:- Food poisoning notifications (corrected) First quarter 4 Second quarter 6 Third quarter 14 Fourth 7 Total: 31 Cases otherwise ascertained Nil Fatal cases Nil Particulars of outbreaks No. of outbreaks No. of cases Total cases FamilyOutbreaks Other Outbreaks Notified Otherwise Ascertained Agent unidentified 3 - 10 - 10 Single cases:- No. of cases Total Notified Otherwise ascertained cases Agent identified 7 - 7 Agent unidentified 14 - 14 Outbreaks due to unidentified agent (3 outbreaks) In the first case a family of four persons were affected with the same symptoms - pain, diarrhoea, headache and vomiting. Onset varied over a period of 5½ hours following the evening meal which consisted of meat pie (re-heated) and frozen vegetables. Faeces specimens taken proved negative. In the second case, a family of three persons were affected, all of whom had shared a tin of salmon and suffered diarrhoea, headache, etc. The fourth member of the family did not eat any salmon and remained well. Two tins of salmon of the same brand were submitted for analysis, but the results were negative. In the third outbreak, a doctor and two young sons were ill after eating a meal of minced meat, potatoes and carrots; within one minute all experienced flushing, tingling and burning of face, ears and hands, with a feeling of faintness. This lasted about fifty minutes and then ceased. Samples of the minced meat were forwarded to the Public Analyst and were found to have been dusted with an additive powder (Evered). - 71 - Single cases Twenty-one isolated cases of food poisoning were notified. In fourteen of these, no causative agent was identified, but in the remaining seven cases the identified agents were - Salmonella brandenberg 1 Salmonella seftenberg 1 Salmonella typhimurium 5 INFECTIOUS DISEASE Smallpox Following a meeting of the Public Health Committee of the Council of Europe which dealt with the importations of smallpox to 'excepted areas', the Minister of Health accepted the recommendations of this committee and issued the Public Health (Aircraft) (Amendment) Regulations 1963, amending the Public Health (Aircraft) and (Ships) Regulations 1952 to 1961. These Regulations enable port health officers to require the production of international certificates of vaccination against smallpox. If a person has not a certificate he may be offered vaccination, or may be placed under surveillance or in isolation. Experience has shown that travellers coming to the borough, not holding valid certificates, refuse vaccination and prefer to be kept under surveillance for sixteen days. No case was notified in the borough during 1963. The Ministry of Health's Memorandum on Vaccination against Smallpox recommends that public health officers likely to have to deal with cases of smallpox at short notice should be regularly revaccinated at not more than yearly intervals. During the year 19 members of the staff of the public health department were vaccinated or revaccinated by the Medical Officer of Health. Scarlet Fever The number of cases notified in 1963 was 9. There was no fatal case during the year. Diphtheria No case of diphtheria was notified during the year. Enteric Fever During the year two cases of paratyphoid fever and five cases of typhoid fever were notified. The first case of paratyphoid fever was a 22-year old female who was admitted to a general hospital with abdominal pains. Tests were carried out and proved positive for paratyphoid fever. Specimens submitted by home contacts proved negative. The source of infection remained unsolved, although it was presumed that the patient could have been a carrier. The second case of paratyphoid fever was a 22-year old male who was admitted to hospital. Enquiries revealed that the patient had just returned from a holiday in Iran. - 72 - The first case of typhoid fever was a 40-year old doctor who was ill immediately after returning from a holiday in Sicily and was admitted to hospital. All contacts submitted specimens for bacteriological examination. All proved negative. The patient recovered in hospital but was discharged as a confirmed carrier. Specimens examined at monthly intervals remained positive until he left the borough some nine months later. A complete case history was forwarded to the Medical Officer of Health of his new district. The second case was an adult female nurse who came from New Zealand, who was ill for a week before being admitted to hospital on 17th June. The patient came to this country from Holland on l6th May and stayed in the borough for eleven days before proceeding to Taunton where she stayed until 2nd June, then returning to Kensington. Taking into account the normal period of incubation, onset could have been during the period at Taunton and the local Medical Officer of Health was notified. The patient shared a maisonnette with eleven other girls, all of whom submitted specimens at weekly intervals for three weeks - all remained well. The remaining cases were involved in the typhoid outbreak at Zermatt, Switzerland. Although four cases were traced in the borough, only three were officially notified as Kensington cases a child aged 4, a female aged 23, and a male aged 29• The fourth, a female nurse, was notified to a neighbouring borough. Following the publicity in the national press, 23 residents who had been at Zermatt contacted this department for advice, and were requested to submit specimens for bacteriological examination at weekly intervals for three weeks. At the request of the Chief Medical Officer of the Ministry of Health, selected catering establishments were asked to notify me if any employee engaged in food handling had been on holiday in Zermatt in order that bacteriological investigation could be arranged. There was no case reported. Daily observation was kept on contacts of two confirmed cases; and the number of specimens submitted for bacteriological examination was 253• Puerperal Pyrexia During 1963, the number of cases of this disease notified was 74, of whom 57 were persons normally resident outside Kensington. All cases occurred in hospital. In order to show some perspective in reviewing the incidence of puerperal pyrexia (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 gives an analysis of the causes of pyrexia in the notified cases:- Cause No. of cases Breast infections 9 Urinary infections 2 Measles 1 Genital tract infections 2 Post operative 7 Causes unknown after investigation 43 Total: 74 - 73 - In addition to the foregoing, information was received concerning 33 patients normally resident in Kensington, who were notified as suffering from puerperal pyrexia in other London districts. No death 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 13 notifications were received, 9 being acute primary pneumonia and 4 being acute influenzal pneumonia. The number of deaths from pneumonia (all forms) was 105, and the number of deaths from influenza was 9 during 1963 • Dysentery Thirty-six cases of dysentery were notified during 1963, 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. Eighteen of these patients were treated in hospital. Erysipelas Two cases were notified during the year. There were no deaths. Meningococcal infection Pour cases of this disease were notified during the year and were removed to hospital. The death of one child was reported. Malaria Three cases of malaria were reported during the year, but investigations showed that the patients had recently been abroad and presumably had contracted infection overseas. Poliomyelitis One case of acute poliomyelitis (paralytic) was notified and confirmed during the year; there was no death from this disease during the year. The figures for the last nine years are as follows:- Year Confirmed cases Deaths 1955 30 Nil 1956 21 Nil 1957 15 1 1958 4 Nil 1959 8 Nil 1960 3 Nil 1961 7 Nil 1962 3 Nil 1963 1 Nil In view of the wider use of oral ("Sabin") vaccine in poliomyelitis vaccination programmes, and in the light of a year's experience of the use of oral vaccine, both in this country and abroad, the Minister of Health, on the advice of a new Joint Committee of Vaccination and Immunisation, issued a circular stating that further measures are desirable. - 74 - The number of cases of poliomyelitis in England and Wales was lower in 1962 than it has been for nearly half a century, which reflects great credit to all concerned, but the Joint Committee strongly commends that a renewed effort should be made to increase the number of persons, and especially of children, who are vaccinated against poliomyelitis. A circular sets out in broad terms the following principle to be adopted when a case of poliomyelitis is confirmed, particularly in regard to children. It recommends that one dose of oral vaccine be given to the children who would be more likely to be exposed to the same source of infection, e.g. those in the school or department of the school and those in the street or streets in the neighbourhood of the case; by so doing this could be expected to give some degree of immunity to children not previously vaccinated and to boost the immunity of any whose previous vaccination had not been completely successful. Although concentration would be on the vaccination of children, it might be appropriate in the light of local circumstances to offer vaccination to adults also. Acute Encephalitis No case of acute encephalitis was notified during the year. Measles Of the 944 cases notified during 1963, 21 cases were admitted to hospital for treatment. No death occurred during the year. Ophthalmia Neonatorum Pour babies were notified during 1963, three were treated at home, and one was treated in hospital. Information was also received of two babies, born to Kensington mothers in hospital outside the borough, who contracted the disease. All the babies recovered without injury to sight. Gastro-enteritis This disease is notifiable in children up to the age of five years. The number of cases reported during the year was three. Two were removed to hospital for treatment. Scabies The number of scabies notified during 1963 was 33. Tuberculosis During the year, 151 new cases of tuberculosis were notified, of which 143 were respiratory and 8 non-respiratory. The following table shows the number of cases added to and the number removed from the notification register during the year:- - 75 - Respiratory NonRespiratory Total M F M F On register of notifications on 1st January, 1963 656 531 66 95 1,348 Notified for the first time during the year 100 43 3 5 151 Brought to notice other than by notification 53 40 - 4 97 Removed from register on account of having - (a) recovered 32 39 2 2 75 (b) removed from district, lost sight of, etc. 123 106 4 16 249 (c) died 14 4 - 1 19 Remaining on register on 31st December, 1963 640 465 63 85 1,253 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 object 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, 278 visits were paid to the homes of tuberculous patients. In 171 of these, the environmental conditions were such as to require no further action on the part of the Public Health Department; in a further 55 cases, it was found that the patients had moved away; and in 37 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 15 cases is summarised as follows Action or supervision Cases Investigation or supervision undertaken in respect of:- Prevention of spread of infection 4 Recommended for priority rehousing 2 Action taken under Public Health and Housing Acts in respect of insanitary or unhealthy conditions 9 Incidence of tuberculosis amongst Kensington residents who originated from areas outside England, Scotland and Vales 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 1963:- -76- Country of origin Period (in years) between entry to U.K. and notification of disease Total 1 2 3 4 5 6 7 8 9 10 Nigeria 2 - - - - - - - - - 2 Spain 2 1 2 1 - - - - - - 6 India 2 2 - - - - - - - - 4 Ireland 5 - 3 4 1 1 - 1 2 - 17 South Africa 2 - - 2 - - - - - - 4 West Africa - - 3 - - 1 - - - - 4 West Indies 1 4 2 2 2 3 1 - - - 15 Hongkong - - - 1 - 1 - - - - 2 Russia - 1 - - - - - - - - 1 China 1 - - 1 - - - - - - 2 Hungary - 1 - - - 1 - - - - 2 Thailand - 1 - - - - - - - - 1 Pakistan 1 - 1 - - - - - - - 2 Prance 1 - - - - - - - - - 1 Cyprus - 1 - - - - - - - - 1 Portugal - - 1 - - - - - - - 1 Germany - - - - - 1 - - - - 1 British Guiana 1 - - - - - - - - - 1 Italy - - 1 - - - - - - - 1 TOTAL 18 11 13 11 3 8 1 1 2 - 68 Residential particulars of other cases notified during the year:- Patients who had resided in London all their lives or for at least 10 years 30 Patients who had resided in other parts of the country all their lives prior to coming to Kensington 25 Patients from whom information concerning origin was not obtained but where it is believed to be this country 22 Patients notified abroad before coming to this country (Ireland) 1 Patients who resided here at least 10 years prior to notification 23 Patients from whom information concerning origin could not be obtained 32 TOTAL 133 The investigations only covered patients newly notified or transferring into the borough from other areas. The total of 201 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 and "inward transfers" reported in the borough, the proportions who were immigrants contracting the disease in the first ten years of arrival, were as follows:- - 77 - Year Proportion per cent 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 16 10 16 17 15 16 23 20 20 11 20 27 This year, 26 per cent (1962 - 44 per cent) of the infected immigrants contracted the disease within one year of arrival in this country; 62 per cent (1962 - 69 per cent) contracted it within three years of arrival. Persons born in the Republic of Ireland were regarded as immigrants for this purpose. Whooping Cough Seventy-nine cases were notified during the year - four being treated in hospital - as against twenty-two cases for 1962; a similar increase occurred throughout the country Whooping cough is a serious disease in young babies, and immunisation, if it is to have its greatest effect, must be given as early as possible, and every effort must be made to see that the measure of immunisation is increased. International Certificates In order to prevent the spread of infectious diseases, certain countries require that visitors should be vaccinated or inoculated against specified diseases. International certificates have been prescribed for smallpox, yellow fever and cholera. When completed by the medical practitioner, the certificates must be authenticated by the Medical Officer of Health. During the year, 4,406 of these certificates were authenticated in Kensington. In addition, 64 special exemption certificates were issued to travellers for use in North America. Notifications The following tables show (l) the number of cases of infectious disease notified during the year 1963, 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. - 78 - TABLE 1 Notifiable disease Number of cases notified 1963 1962 1961 1960 1959 1958 1957 1956 Scarlet fever 9 15 30 29 54 27 33 45 Diphtheria (including membranous croup) - - 1 - - - - 1 Enteric fever 7 2 3 8 6 5 5 10 Puerperal pyrexia 74 103 168 138 112 116 123 117 Acute primary pneumonia & acute influenzal pneumonia 13 20 28 16 60 70 75 65 Dysentery 36 57 97 71 110 117 77 88 Erysipelas 2 7 5 9 6 11 7 5 Meningococcal infection 4 - 2 4 2 6 3 6 Malaria 3 3 1 2 1 1 5 1 Acute poliomyelitis: Paralytic 1 2 6 3 7 2 13 14 Non-paralytic - 1 1 - 1 2 2 7 Acute encephalitis - 1 - - 1 1 3 2 Tuberculosis (all forms) 151 160 195 164 194 179 208 258 Measles 944 269 1497 457 737 654 982 358 Ophthalmia neonatorum 4 3 5 6 1 5 1 1 Enteritis* 3 13 14 9 7 13 10 14 Pood poisoning 31 18 42 40 65 47 52 63 Scabies 33 18 25 28 42 52 52 40 Whooping Cough 79 22 30 154 83 92 130 236 TOTALS: 1394 714 2150 1138 1489 1400 1781 1331 * Notifiable only in children under the age of 5' NOTE: Cases of mistaken diagnosis are excluded from the above table. TABLE 2 Notifiable Disease Number of Cases Notified in 1963 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 3 3 - 2 — Diphtheria (including membranous croup) - - - - - - - Enteric fever - _ 1 — 4 2 Puerperal pyrexia - - - - - 33 41 Acute primary pneumonia and acute influenzal pneumonia - 1 - 1 - 2 9 Dysentery 4 8 4 3 - 8 9 Erysipelas — — - - _ 2 Meningococcal infection 1 2 1 - - - - Malaria - - - - - - 3 Acute poliomyelitis: Paralytic - - - - - - 1 Tuberculosis (all forms) 1 1 7 8 3 25 106 Measles 50 267 225 317 20 28 37 Ophthalmia neonatorum 4 - - - - - - Enteritis 3 _ _ _ — — — Pood poisoning 3 5 1 1 1 2 18 Scabies - 1 2 3 3 11 13 Whooping Cough 8 16 19 28 5 1 2 TOTALS: 74 302 263 364 32 116 243 - 79 - TABLE 3 Notifiable Disease Total cases notified in each Ward in 1963 St. Charles Golborne Norland Pembridge Holland Earls Court Queens Gate Redcliffe Brompton Scarlet Fever 3 — 1 - 1 1 - 2 1 Diphtheria (including membranous croup) - - - - - - - - - Enteric Fever - - 1 - 1 - 2 3 - Puerperal Pyrexia 2 3 - 3 1 3 61 1 - Acute primary pneumonia and acute influenzal pneumonia 1 3 2 7 - - - - _ Dysentery 5 6 7 2 1 8 2 5 - Erysipelas - — - 2 — - _ - - Meningococcal infection 1 - - 2 1 - - - - Malaria - - - - 1 1 - - 1 Acute poliomyelitis, paralytic - - - - - - - - 1 Tuberculosis (all forms) 29 30 18 18 14 11 10 10 11 Measles 236 131 119 113 88 71 46 104 36 Ophthalmia neonatorum 2 - - 2 - - _ - - Enteritis _ 2 - 1 — — - - — Food poisoning 7 1 6 11 — 3 - 1 2 Scabies 8 2 6 7 1 2 1 5 1 Whooping Cough 19 14 10 16 7 4 2 5 2 LEGAL PROCEEDINGS PUBLIC HEALTH (LONDON) ACT. 1936 Nuisances During the year 60 summonses were issued for various nuisances under the Public Health (London) Act, 1936. In 15 cases Abatement Orders were secured and costs amounting to £21.lls. 6d. were awarded to the Council. In 20 cases the summonses were withdrawn, the nuisances having been abated prior to the Court hearings. In 25 cases the summonses were adjourned sine die, as the necessary works were being carried out by the defendants. Six prosecutions were undertaken for failure to comply with Justices' Orders to abate statutory nuisances. In 4 cases fines totalling £83 were imposed and costs amounting to £7. 7s. 0d. were awarded to the Council. In the remaining 2 cases proceedings were adjourned sine die as the work was in the process of being carried out. London County Council Drainage Byelaws Twenty-four summonses were issued in respect of contraventions of these Byelaws, which included failure to deposit plans; failure to give notice of intention to commence drainage work; failure to carry out or to maintain drainage work in good condition, etc. Convictions were obtained in 22 cases and fines totalling £89 were imposed, with £12.12s. 0d. costs. In one case the summons was withdrawn as the - 80 - defendant had complied with the Byelaws before the Court hearing, and in the remaining case the summons was dismissed. London County Council Water Closet Byelaws Six summonses were issued for offences tinder these Byelaws. Convictions were obtained in five cases and fines amounting to £22 were imposed. The remaining summons was dismissed. Prevention of Nuisance from Demolition Byelaws Sixteen summonses were issued against demolition contractors for failing to take steps as required by the Byelaws to prevent nuisance arising from the demolition of slum properties. The Magistrates imposed fines totalling £11 in respect of four summonses; the remaining twelve were withdrawn by consent. The Council were awarded £3. 3s• 0d. costs. NOISE ABATEMENT ACT. 1960 (London County Council (General Powers) Act. 1937) Legal proceedings were taken against the occupiers of a factory premises in North Kensington for causing a noise nuisance in the operation of their works. The hearing was adjourned for three months on condition that the defendants carried out certain works to the satisfaction of the Council. (Note: The works, involving considerable expenditure, were eventually carried out and the noise nuisance was thereby abated.) CLEAN AIR ACT. 1966 (Section 11(2)) Two summonses were issued in respect of the emission of smoke in a smoke control area. Convictions were obtained in both cases and fines totalling £6 were imposed and £2. 2s. 0d. costs were awarded to the Council. HOUSING ACT. 1957 Illegal occupation of closed unfit rooms Eight summonses were issued against landlords or tenants in respect of the illegal occupation of closed rooms. In all cases convictions were obtained and fines totalling £6l were imposed, and costs of £9. 9s. 0d. were awarded to the Council. Overcrowding One summons was issued in respect of a case of overcrowding in a dwelling house. A conviction was obtained and a fine of £5 was imposed. POOD AND DRUGS ACT. 1955 Milk & Dairies (General) Regulations. 1959 In three cases summonses were issued in respect of dirty milk bottles. In two cases convictions were obtained and fines amounting to £7 were imposed and the Council were awarded £3. 3s. 0d. costs. In the remaining case the summons was withdrawn. - 81 - The Preservatives in Food Regulations, 1962 One summons was issued during the year in respect of the sale of minced steak containing added preservatives. A conviction was obtained and a fine of £20 was imposed; £5. 5s. 0d. costs were awarded to the Council. Labelling of Food Order. 1953 One summons was issued in respect of the failure to state the ingredients of a sample of lard. The undisclosed ingredient was an anti-oxidant. A conviction was obtained and a fine of £5 was imposed and costs of £7. 7s. 0d. were awarded to the Council. Unfit Food - Section 8 Legal proceedings were taken in respect of the sale, or exposure for sale, of the following unfit foods. In all cases convictions were obtained and fines were imposed and costs awarded to the Council as indicated:- Unfit Food Fine Costs £. s. d. £. s. d. Unfit Pork Sausages 15. 0. 0. 4. 4. 0. " Chipolata " 15• 0. 0. - " Dried Fruit 15. 0. 0. 3. 3. 0. " Loaf of Bread 1. 0. 0. 4. 4. 0. " Apple Turnovers 5. 0. 0. - " Black Pudding 5. 0. 0. 4. 4. 0. Food Hygiene (General) Regulations, 1960 One hundred and ninety-six summonses were taken out against various defendants for contraventions of these Regulations. The contraventions included the exposing of food to contamination, failure to keep food premises and equipment in a clean condition, failure to provide an adequate supply of wash basins, soap, nail brushes and towels, depositing refuse unnecessarily in food rooms, and failure to provide first aid equipment. In 88 cases convictions were obtained and fines totalling £450 were imposed, and the Council were awarded £25. 4s. 0d. costs. In 91 cases the summonses were not separately dealt with, but the Magistrates took the offences into account in dealing with other contraventions by the same defendants. In 17 cases the summonses were withdrawn. DOG NUISANCE BYELAW One summons was issued in respect of a contravention of this Byelaw. A conviction was obtained; a fine of 10/- was imposed, and 10s. 6d. costs were awarded to the Council. - 82 - 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 - 83 - 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 tinder Housing Acts - 84 - PARTICULARS OP THE STAFF OF THE PUBLIC HEALTH DEPARTMENT AT THE END OF 1963 Year of Appointment (as requested by Ministry of Health Circulars l/54 and 28/54) Medical Officer of Health James H. Weir, M.D., B.S., B.Hy., D.P.H. 1950 Deputy Medical Officer of Health Derek J. Sheerboom, M.B., B.S., D.P.H. 1960 Public Analyst H. Amphlett Williams, Ph.D.(Lond.), A.C.G.F.C., F.R.I.C. 1952 Administrative and Clerical Staff 1.2. John S. Wheeler, Chief Clerk 1924 Clement G. Legge, D.M.A. 1959 Mrs. A.C. Lambert 1960 Digby A. Smith 1939 Mrs. W. Baar 1961 Mrs. S. Scott 1943 John D. Perou 1961 Miss Doris Gibbs 1944 Stuart J. Chamberlain 1961 Victor W. Waymark 1946 Miss Joyce M. Bell 1962 Miss Elizabeth Howarth 1951 Ronald Hallifax 1962 Mrs. B. Hennessey 1954 Miss Pauline Beswick 1963 Mrs. D.M. Haffenden 1959 Mrs. L. Walch 1963 John A. Spencer 1960 Brian E. Davies 1963 Public Health Inspectors 1. Dennis C. Draper, Acting Chief Inspector 1938 2.3. Cecil R. Webb 1925 2.4.5. Brian H. Stone 1961 1. Arthur L. Vague 1934 2.5. Leslie J. Barker 1962 1. Harold Hind 1939 2.5. Kenneth Brown 1962 1.2. Arthur F. Standish 1947 2.5. Gilbert J. Follett 1962 1.2. Arthur E. Sills 1949 2.5. Michael A. Tracy 1962 1.2. Kenneth M. Bell 1955 5. Edward J. Parnell 1963 1.2.4. Leslie A. Palmer 1956 5. A.E.J. Banfield 1963 Women Health Officers Miss Anne Barker, S.R.N., S.R.M., H.V 1949 Mrs. E.I. Gudde, Dip. Soc. Science (Lond.) 1952 Other Officers James W. Noble, Chief Disinfector 1935 George W. Farrell, Rodent Officer 1960 Joseph A. Newman, Rodent Assistant 1945 Aubrey E. Sole, Rodent Assistant 1945 George Connor, Rodent Assistant 1947 Alfred G. Meredith, Assistant Smoke Inspector 1963 David G. Audus, Drainage Assistant 1963 Technical Assistant 1. Warner C. Swinson, G.M 1963 1. Certificate of the Royal Sanitary Institute and Sanitary Inspectors' Examination Joint Board. 2. Certificate or Diploma for Inspectors of Meat and Other Foods. 3. Certificate of London Sanitary Inspectors' Examination Board. 4. Smoke Inspectors' Certificate. 5. Certificate of the Public Health Inspectors' Education Board. INDEX Page Accidents in the Home 20-22 Acute Encephalitis 74 Adulteration of Food 67 Artificial lighting of staircases 52 Atmospheric Pollution 23-29 Animal Boarding Establishments 18 Bacteriological Work 13 Bakehouses 56 Birth Hate 1,8 Burial of the Bead 32 Cancer of the Lung 3, 19 Certificates of Disrepair 52 Chiropody for Aged Persons 36 Clean Air Act , 1956 6,23—29 Clearance Areas 42 Cleansing of Aged Persons 36 Committees 83 Consumer Protection Act 21 Cremation Service 33 Day Centre for Old People 34 Deaths, Causes of 10 Death Hate 1,8 Diphtheria 71 Disinfection & Disinfestation 13, 14 New Station 13 Dog Nuisances 81 Drainage 12,79 Dysentery 73 Enteric Fever 71 Erysipelas 73 Factories 54,58 Flooding 12 Fluoridation of Water 13 Food 59-69 Adulteration 67 Condensed Milk 69 Hygiene Regulations 6, 59-62 Ice Cream 68 Inspections 62 Legal Proceedings 64,80 Milk 63—65 Milk (Special Designations) 63 Poisoning 70 Unsound 65 Use of Additives to Minced Meat 66 Castro Enteritis 74 Health Education 19 Holidays for Aged Persons 34 Home Safety 20-22 Houses in Multiple Occupation 4, 46-51 INDEX Page Housing 4, 40-53 Clearance Areas 42 Improvement Grants 44 Inspections 5, 40 Kensal New Town 43 Lancaster Road West Area 43 Medical Priorities 53 New Housing Accommodation 53 Overcrowding 41 Slum Clearance 42 Tenement Houses 4, 46-51 Underground Rooms 54, 80 Ice Cream 63 Improvement Grants 44 Infant Death Rate 2,9 Infectious Diseases 3, 71-79 Acute Encephalitis 74 Diphtheria 71 Dysentery 73 Enteric Fever 71 Erysipelas 73 Gastro Enteritis 74 Malaria 73 Measles 74 Meningococcal Infections 73 Notifications 77—79 Ophthalmia Neonatorum 74 Poliomyelitis 73 Pneumonia 73 Puerperal Pyrexia 72 Scabies 74 Scarlet Fever 71 Smallpox 71 Tuberculosis 3, 9, 74-77 Typhoid Fever 71 Whooping Cough 77 Institutional Care of Aged Persons 35 International Certificates 77 Kensal New Town 43 Kensington Day Centre 34 Lancaster Road West Area 43 Laundry Facilities for Aged Persons 36 Legal Proceedings 79-81 Demolition Bye-laws 80 Drainage Bye-laws 79 Food and Drugs Acts 80 Food Hygiene Regulations 64, 81 Nuisances 79 Overcrowding 80 Underground Rooms 80 Library Facilities for Aged Persons 36 Lung Disease 3, 19 Malaria 73 Mass Radiography 22 Maternal Death Rate 3,9 Meals for Aged Persons 37 Measles 74 Medical Examination of Staff 33 INDEX Page Medicinal Baths 13 Meningococcal Infections 73 Milk 63—65 Milk - Channel Islands, etc 64 Milk & Dairies Regulations 63 Milk, Special Designations 63 Mortuary 31 National Assistance Acts, 1948/51 32, 34 New Housing Accommodation 53 Noise Abatement Act, 1960 29, 80 Notification of Infectious Disease 77-79 Nuisances 79 Oil Heaters Regulations 21 Old People's Welfare 33 — 38 Advice Leaflets 35 Chiropody 36 Cleansing 36 Grants 34 Holidays 34 Institutional Care 35 Laundry Facilities 36 Library Facilities 36 Meals Service 37 Removals 38 S.O.S. Cards 35 Visiting 38 Ophthalmia Neonatorum 74 Outworkers 56 Overcrowding 41, 52 Pests, Prevention of Damage by 14 - 17 Pet Animals Act, 1951 17 Pharmacy & Poisons Act, 1933. 17 Poliomyelitis 73 Population 1,8,11 Pneumonia 73 Public Swimming Baths 30 Puerperal Pyrexia 72 Rag Flock & Other Filling Materials Act, 1951 17 Removal of Aged Persons 38 Rent Act - Certificates 52 Rodent Control 14 — 17 Sanitary Inspection Drainage 12, 39 Inspections 39 Legal Proceedings 79 Sanitary Notices served 39 Supervision of Work 40 Scabies 74 Scarlet Fever 71 Sewer Baiting (Rats) 14 — 17 Shops, Sanitary Accommodation 57 Slum Clearance 42 Smallpox 71 Smoke Control Areas 23-28 Smoke Measuring Stations 28 INDEX Page S.O.S. Cards 38 Staff 6, 84 Standard Grants - Houses 45 Swimming Baths 30 Tenement Houses 4, 46—51 Tuberculosis 3,9, 74—77 Typhoid Fever 71 Underground Rooms 54,80 Unsound Food 65 Vital Statistics 6-9 Water Supply 13 Whooping Cough 77 Women's Voluntary Services 37