M PAD 35 AC 4349 Metropolitan Borough of Paddington. REPORT ON THE Public Health AND Vital Statistics OF THE BOROUGH OF PADDINGTON. FOR THE YEAR 1935. BY GEOFFREY EUGENE OATES, M.D., B.S. (London). M.R.C.P. (London); D.P.H. (Cambridge); Barrister-at-Law, Medical Officer of Health. Metropolitan Borough of Paddington. REPORT ON THE Public Health AND Vital Statistics OF THE BOROUGH OF PADDINGTON. FOR THE YEAR 1935. BY GEOFFREY EUGENE OATES, M.D., BS. (London), M.R.C.P. (London); D.P.H. (Cambridge); Barrister-at-Law, Medical Officer of Health. CRUSHA & SON, Ltd., Printers, 825-7, High Road, Tottenham, N.17. CONTENTS. page Acute Encephalitis Lethargica 21 Acute Influenzal Pneumonia 21 Acute Polio-encephalitis 20 Acute Polio-myelitis 20 Acute Primary Pneumonia 21 Acute Rheumatism 21 Administrative Work 38 Agricultural Produce (Grading and Marking) Act, 1928 55 Annual Cleansing 46 Ante-natal Consultation Centres 5, 29, 30, 31 Anthrax 21 Artificial Cream Act, 1929 55 Artificial Sunlight Treatment 26, 30 Baby Hospital 33 Bacteriological Work 38 Bakehouses 49 Beauchamp Lodge Emergency Home 33 Births 7 ,, Illegitimate 8 ,, in Institutions 9 ,, Notification 9 ,, Stillbirths 8 Birth-rates 8 Canals, Canal Boats 40 Cancer 22 Cerebro-spinal Fever 21 Chicken-pox 19 Cholera 22 Clearance Areas 42 Clinics, Treatment Centres, etc. 5 Common Lodging Houses 46 Compulsory Repairs 41 Compulsory removal of certain persons 56 Condensed Milk Regulations 53 Continued Fever 19 Contraceptive Advice 33 Convalescent Homes 31, 37 "Conversions," Housing 41 Dairies and Milkshops 52 Day Nurseries 5, 34 Deaths, Causes of 9, 10 in Institutions 11 Death-rates 11 Dental Treatment 25, 31 Diarrhoea 23 Diphtheria 16 ,, Carrier Clinic 17 ,, Immunisation 4, 17 Disinfection 38 District Inspectors' Work 60 Drainage, Combined 39 ,, House39 ,, Reconstruction Plans 9 Dried Milk Regulations 3 Dysentery l Erysipelas 0 Factories and Workshops 8 Food Adulteration2 ,, Chemical and Bacteriological Examination 3 PAGE Food Destroyed 52 ,, Poisoning 22 ,, Purveyors 51 ,, Samples Analysed 54 ,, Supervision 51 ,, Unsound 51 Fouling of Footways by Dogs 40 German Measles 20 Glanders 22 Health Visiting 29 Homework (Outworkers) 49 Houses Unfit for Habitation 43 Housing 41-48 ,, Artesian Road Clearance Area 42 ,, Brindley Street Flats 44 ,, Mews Areas and Individual Mews Dwellings 42 ,, North Wharf Road Area 42 ,, Paddington Houses Association 44 ,, on L.C.C. Estates 41 Hydrophobia 22 Ice Cream 52 Improvement Areas 43 Infant Consultation Centres 5, 29-31 Infant Life Protection 37 Infantile Mortality 12 Infantile Mortality in Special Areas 13 Infectious Diseases, Notification of 15 ,, ,, Prevention of 38 Infective Enteritis 23 Inquests 14 Invalid Children's Aid Association 37 Legal Proceedings 57 Malaria 21 Manure, Removal of 40 Marriages 7 Massage Treatment 30 Maternal Consultations 33 ,, Mortality 14 ,, Mortality Investigations 37 Maternity and Child Welfare 29 ,, Nursing 2 ,, Outfits 33 ,, Wards 5, 32 Measles 19 Meat Regulations 51 Merchandise Marks Act, 1926 55 Midwifery Service 33 Milk Grants 34 Milk and Dairies Order 52 Milk (Special Designations) Order 52 Mortuary 40 Notifiable Diseases 15 Nursing of cases of Infectious Illness 38 Nutritional and Physio-therapeutic Clinic 5, 31 Office Work 59 Ophthalmia Neonatorum 20 Outworkers (Homework) 49 Overcrowding 46 Overcrowding Survey 41 Pharmacy and Poisons Act 55 CONTENTS—Continued, page Pigeons, Nuisance from 56 Plague 22 Population 7 Poultry Slaughtering 51 Pneumonia 21 Preservatives, etc., in Food Regulations 53 Puerperal Fever 20 ,, Pyrexia 20 Rag and Bone Dealers 40 Rag Flock Acts 49 Rats and Mice Destruction 56 Relapsing Fever 22 Rent and Mortgage Interest (Restrictions) Acts 46 Rent Books 46 Scarlet Fever 16 Schools and Infectious Disease 38 Sewer Emanations 40 ,, Connections 39 Shops Act, 1934 50 Slaughter of Animals Act 51 Slaughterhouses 51 Smallpox 18 Smoke Control 40 Staff 4, 38 Supply of Medicine and Medical Assistance 56 Tenement Houses 45 page Trade Nuisances 40 Tuberculosis Artificial Pneumothorax Treatment 25 ,, Artificial Sunlight Treatment 25 ,, Deaths from 24 ,, Dental Treatment25 ,, Dispensary Treatment 5,26 ,, Home Visiting24 ,, Notification 23, 24 ,, Regulations, 1930 and 1925 24, 25 ,, Shelters 25 ,, Supply of Beds and Bedding 25 ,, Ultra-Violet Light Treatment 25 Tuberculosis Care Committee 28 Typhoid Fever 19 Typhus Fever 22 Underground Rooms 44 Unmarried Mothers ad their Children 33 Vaccination 18 Venereal Diseases Clinic 5 Verminous Conditions 56 Vital Statistics 6, 7, 14 Water Supply 39 Whooping Cough 22 Workshop Supervision 48 3 TO HIS WORSHIP THE MAYOR, THE ALDERMEN AND COUNCILLORS OF THE METROPOLITAN BOROUGH OF PADDINGTON. Mr. Mayor, Ladies and Gentlemen, I have the honour to present to you my Annual Report for the year 1935 as required by the Statutes and Orders applicable to my office. During the year the health of the Borough continued to be good, and it is satisfactory to note a substantial improvement in infantile mortality, both absolutely and relatively to other London Boroughs. Since infantile mortality varies in a remarkable way from year to year it would be premature to attach too much importance to this reduction. The year was one of steady progress in strengthening the various services for securing the health of the community, and particularly of mothers and young children. A large and convenient site in Harrow Road was acquired for the purpose of erecting a Maternity and Child Welfare Centre, and the lease of a commodious building in Westbourne Ward was secured for the purposes of a Day Nursery. During the year a number of unhealthy areas and individual unfit premises were surveyed and considerable progress was made in the closing of the worst basements. A survey of overcrowding in the Borough was in progress at the end of the year. By the decease in June, 1935, of Mr. E. E. Gower, Chief Clerk in the Public Health Department, the Council lost a loyal and capable officer. I have again to express my appreciation of the loyal help of the staff of the Public Health Department of the Council and to thank the members of the Public Health, Maternity and Child Welfare, and Special Housing Committees for the support and kind consideration which they have extended to me during the past year. I have the honour to be, Mr. Mayor, Ladies and Gentlemen, Your obedient servant, G.E. Oates. M.D., M.R.C.P., D.P.H., Medical Officer of Health. Town Hall, Paddington Green, W.2. 20th June, 1936. 4 PUBLIC HEALTH OFFICERS (on December 31st, 1935). ( W.T.= Whole-time appointments. P.T. = Part-time appointments. See subjoined notes for explanation of figures in parentheses.) Medical Officer of Health, Administrative Tuberculosis Officer, W.T. G. E. Oates, M.D., B.S., M.R.C.P., D.P.H., Barrister-at-Law. Assistant Medical Officers of Health, P.T. (For purposes of the Public Health (Tuberculosis) Regulations). R. S. Walker, M.R.C.P., L.R.C.S.Ed., L.R.F.P.S.Glas., D.P.H., Tuberculosis Officer, Paddingtot Tuberculosis Dispensary. A. B. Porteous, M.D., D.P.H., Tuberculosis Officer, St. Mary's Hospital Tuberculosis Dispensary. Medical Officers of Welfare Centres, P.T. S. Denovan Adam, M.R.C.S., L.R.C.I'. R. Cove-Smith, M.A., M.B., B.Ch., M.R.C.P. E. Dorothy Fenwick, M.R.C.S., L.R.C.P. A. S. Hall, M.R.C.S., M.R.C.P. H. Hodge, M.B., B.Ch. Public Analyst, P.T. Alan W. Stewart, D.Sc., A.I.C. J. McKail, M.A., M.B., B.Ch. Evelyn T. D. Maclagan, M.B., B.S., M.R.C.S., L.R.C.P. C. T. Potter, M.D., M.R.C.P. Joyce R. Simpson, M.A., B.Ch.,M.B., D.P.H. J. Thoresby-Jones, M.D., L.R.C.P., M.R.C.S. Public Vaccinators, P.T. P. Denovan Adam, M.R.C.S., L.R.C.P. (For Borough, excluding Paddington Hospital). W. J. Gill, M.D., M.B., Ch.B., F.R.C.S.(Ed.) (For Paddington Hospital.) Deputy Public Vaccinator. P.T. F. A. Bryning, M.B., B.S.(Lond.), M.R.C.S., L.R.C.P. (For Paddington Hospital.) Vaccination Officer, P.T. T. E. Rainger. Sanitary Inspectors, W. T. J. S. Aekerman (2), (4). H. D. Bailey (2), (3), (4). F. L. Barker (2), (3). A. J. Fisher (2). A. C. Harrison (2), (3). C. G. Heron (2), (3). (Senior.) E. Marshall (2), (3), (4), (5). F. J. Pallet (2), (3). (Meat and Food.) V. L. Ronchetti (2), (3), (4), (5). (Also Canal Boats and Infant Protection.) E. B. Wilde (2), (3), (4), (5), (10). (Also Bakehouses, Common Lodging Houses and Infant Protection.) Five Temporary inspectors. Women Sanitary Inspectors, W.T. E. Z. Amor (2), (6), (7), (8), (9). D. M. Newhall (1), (2), (7), (8), (9). Health Visitors, W.T. H. S. Beattie (7), (9). P. E. Blake (7), (8), (9). E. A. S. Davies (7), (8). (Superintendent.) N. M. Hill (7), (8), (9). (Also Maternity Wards Almoner.) E. C. Jackson (7), (8), (9). M. A. MacLean (7), (8), (9). (Also Infant Protection Visitor.) D. K. Newington (7), (8), (9). E. M. Sells (9). F. E. Stammers (8), (9). G. E. Stephens (6), (7), (8), (9). H. Waite (7), (8), (9). (1) Sanitary Inspector's Certificate, Royal Sanitary Institute. (2) ,, ,, ,, Sanitary Inspectors'Examination Board, or Royal Sanitary institute and Sanitary Inspectors' Examination Joint Board. (3) Meat and other Foods Certificate, Royal Sanitary Institute, or Sanitary Inspectors' Examination Joint Board. (4) Building Construction Certificates. (5) Plumbing Certificates. (6) Tuberculosis Certificate. (7) State Certified Midwife. (8) Nursing Training Certificates. (9) Health Visitor's Certificate. (10) Smoke Inspector's Certificate, Royal Sanitary Institute. Clerical Staff. T. F. Dunning (Chief Clerk). H. Ewings (Class 1). A. J. 0. Sheppard (ClaBs 1). R. I. Fisher (Class 1). C. T. Wyatt (Class 3). R. H. Davis (Class 4). C. H. F. Drake (Class 4). H. J. Parker (Class 4). S. W. Wordingham (Class 4). One Vacancy. Two Temporary Clerks. T. E. Rainger (Class 1, P.T., and Vaccination Officer, P.T.). I. C. Webb (Miss), (Clerical Assistant, Welfare Centre) Mortuary Keeper. J. T. Lawson. Assistant Mortuary Keeper. L. W. J. Spears. Disinfectors. G. Cox. F. Webber. 5 CLINICS, TREATMENT CENTRES, ETC. Maternity and Child Welfare. Adress. By whom provided. Ante-natal Consultation Centres.. 232, Harrow Road Paddington School for Mothers. St. Simon's Hall, Macroom Road ,, ,, ,, St. Mary's Hospital, Cambridge Place St. Mary's Hospital. Infant Consultation Centres .. *232, Harrow Road Paddington School for Mothers. *St. David's Church Hall, St. Mary's Terrace „ „ *Congregational Institute, Third Avenue ,, ,, ,, *St. Simon's Hall, Macroom Road ,, ,, ,, Christ Church Parochial Church House, Queensborough Passage ,, ,, ,, Nutritional and Physiotherapeutic Centre *232, Harrow Road ,, ,, ,, * Two sessions weekly. Day Nurseries 21, Howley Place Paddington Day Nursery. 66, LancefieId Street Queen's Park, Paddington, Day Nursery. Maternity Wards St. Mary's Hospital, Cambridge Place St. Mary's Hospital. diphtheria Immunisation. Clinic 232, Harrow Road Paddington School for Mothers. One session weekly. Tubbbculosis. Dispensaries 20, Talbot Road Paddington Tuberculosis Dispensary. St. Mary's Hospital, Cambridge Place.. St. Mary's Hospital. Venereal Diseases. Clinic St. Mary's Hospital, Cambridge Place (Male and Female) .. London County Council.+ 6 SUMMARY OF VITAL STATISTICS. 1935. Area of Borough 1,356.1 acres, including waterways 20.0 acres. Population: Census, 1931 144,923 Registrar-General's estimate of resident population for year 1935 138,600 Density of population per acre 102 Number of inhabited houses (end of 1935) according to Rate Books 21,092 Marriages 1,875 Total. M. F Live Legitimate 1,711 852 859) Births Illegitimate 253 125 128) Stillbirths 60 30 30 Deaths 1,675 775 900 Birth-rate 14.17* Stillbirth-rate 29† Death-rate 12.08* Percentage of total deaths occurring in public institutions 56.9 Number of women dying in, or in consequence of childbirth from sepsis 3 other causes 5 Maternal mortality 3.95† Deaths of Infants under 1 year of age 140 Infantile Mortality 717† Legitimate, 85†; Illegitimate, 110†. Deaths from Measles (all ages) 1 ,, Whooping Cough (all ages) 5 ,, Diarrhoea (under 2 years of age) 31 ,, Pulmonary Tuberculosis 75 ,, All forms of Tuberculosis 88 Death-rate from Pulmonary Tuberculosis 0.54* Tuberculosis death-rate 0.63* Rateable Value £1,824,505 Product of a Penny Rate £7,048 * per 1,000 persons. † per 1,000 lire births. ‡ per 1,000 total births. 7 VITAL STATISTICS. The Metropolitan Borough of Paddington as constituted under the London Government Act, 1899, covers an area of 1,356.1 acres, including 20.0 acres of waterways. It is co-extensive with the Civil Parish and Registration District of the same name. The Borough is divided into nine wards. General Summary of Vital Statistics. Year. Estimated Population.* Births. Deaths at All Ages. Deaths under One Year. Registered Locally. Transfers. Nett. Registered Locally. Gross Mortality. Transfers. Nett. Registered Locally. Nett. Out. In. Totals. Rates. Out. In. Totals. Mortality. Number. Mortality Totals. ity. 1925 147,100 2,206 312 443 2,337 15.88 2,011 13.67 570 339 1,780 12.10 196 88 170 72 1926 146,700 2,131 345 462 2,248 15.32 2,067 14.09 554 344 1,857 12.65 210 98 194 86 1927 142,700 2.064 322 474 2,216 15.53 2,006 14.05 489 419 1,936 13.56 188 91 176 79 1928 145,200 2,074 376 479 2,177 14.99 1,954 13.45 507 446 1,893 13.03 186 89 186 85 1929 142,800 2,058 447 518 2,129 14.90 2,344 16.41 550 417 2,211 15.48 230 111 215 101 1930 142,800 2,216 524 469 2,161 15.13 1,890 13.23 482 397 1,805 12.64 174 78 169 78 1931 140,300 2,073 462 464 2,075 14.79 2,000 14.25 589 420 1,831 13.05 228 110 182 87 1932 143,600 1,765 401 613 1,977 13.76 1,817 12.65 601 688 1,904 13.26 220 121 212 107 1933 141,900 1,855 460 508 1,903 13.41 1,864 13.13 567 599 1,896 13.36 171 92 163 85 1934 139,790 2,104 589 394 1,909 13.70 1,756 12.56 580 567 1,743 12.47 185 88 183 95 1935 138,600 2,038 547 473 1,964 14.17 1,623 11.71 543 595 1,675 12.08 154 75 140 71 * Registrar-General's estimates of resident population. POPULATION. Estimated Population.—The resident population of the Borough at the middle of 1935 was estimated by the Registrar-General to be 138,600 persons, 1,190 fewer than the number for the previous year. The following table shows the population distributed among the Wards in the proportions recorded at the Census of 1931. All rates for 1935 quoted in this report are based on these figures. The Borough 138,600 Wards— Queen's Park 13,027 Harrow Road 24,3621 Maida Vale 22,261 Town 6,893' Westbourne 24,150' Church 16,572 Lancaster Gate, West 9,465 Lancaster Gate, East 9,488 Hyde Park 12,382. North Paddington 66,543 South Paddington 72,057 MARRIAGES. According to provisional figures supplied by the Registrar-General 1,875 marriages were solemnized in the Borough during 1935, being a rate of 27.0 persons per 1,000 of the population. BIRTHS. The number of births registered in the Borough during 1935 was 2,038. From this total it is necessary to deduct 547 births which occurred to residents of other localities and to add 473 births which occurred to Paddington residents outside the Borough. The corrected total of 1,964 births thus obtained is equal to a rate of 14.17 per 1,000 of the population. Of the 1,964 births, 977 were those of males and 987 those of females, and of these 125 males and 128 females were illegitimate, 8 The following table shows the birth-rate during each of the last six years in England and Wales, in London, in Paddington and in each of the wards of the Borough:— 1935 Birth-rates. No. of Births. Birthrates. 1934 1933 1932 1931 1930 England and Wales 599,167 14.7 14.8 14.4 15.3 15.8 16.3 London 63,145 13.3 13.2 13.2 14.3 15.0 15.7 Paddington 1,964 141.7 13.70 13.41 13.76 14.79 15.12 Wards— Queen's Park 135 10.36 11.94 10.94 10.67 9.46 10.32 Harrow Road 457 18.76 17.01 17.44 14.89 15.32 17.58 Maida Vale 294 13.20 12.91 12.15 12.87 14.79 13.57 Town 131 19.00 17.98 17.28 18.20 18.19 13.40 Westbourne 440 18.22 16.09 15.73 16.70 17.58 19.78 Church 289 17.44 16.57 18.39 21.55 23.81 22.12 Lancaster Gate, West 54 5.70 6.91 5.67 6.32 5.93 5.40 Lancaster Gate, East 42 4.43 5.12 4.94 4.17 8.31 7.18 Hyde Park 122 9.85 10.81 9.38 10.83 11.17 13.30 The following table shows the course of the birth-rate in the Borough in the past:— BIRTH-RATES. Paddington. 1881-1885 26.66 1886-1890 24.89 1891-1895 24.44 1896-1900 23.9 1901-1905 22.9 1906-1910 21.4 1911-1915 20.8 1916-1920 17.3 1921-1925 17.6 1926-1930 15.7 1931 14.9 1932 13.6 1933 13.1 1934 13.0 1935 14.7 Illegitimate Births.—These were 253 in number, or 12.88 per cent.of the total number of births. The proportion of illegitimate births varies remarkably in the different wards as is shown in the table below:— RATE OF ILLEGITIMATE BIRTHS PER 100 TOTAL LIVE BIRTHS Ward. Bate. Queen's Park 9.63 Harrow Road 6.78 Maida Vale 14.62 Town 16.79 Westbourne 12.73 Church 11.76 Lancaster Gate, West 24.08 Lancaster Gate, East 23.81 Hyde Park 17.21 Stillbirths.—During 1935, 67 stillbirths were registered in the Borough in accordance with the provisions of the Births and Deaths Registration Act, 1926. Of these, 26 occurred to residents of other localities; on the other hand 19 stillbirths occurred outside the Borough to Paddington residents. The nett number for the Borough was therefore 60, a figure equivalent to 2.9 per cent, of the total births recorded. Of the 60 stillbirths, males numbered 30 and females 30, 4 of the malesand 11 of the females being illegitimate. 9 Births in Institutions. Local— Legitimate. Illegitimate. Total. Residents. Non-residents. Residents. Non-residents. Residents. Non-residents. Paddington Hospital 326 36 Ill 24 437 50 St. Mary's Hospital 273 280 10 5 283 285 Lock Hospital 2 15 2 40 4 55 Outlying (Paddington residents) — Legitimate. Illegitimate. Total. Queen Charlotte's Hospital 157 17 174 Other Hospitals and Maternity Homes 120 12 132 Public Assistance Committees' Institutions 57 31 88 Notification of Births Acts, 1907 and 1915.—These Acts require the father of a child, if actually residing in the house where a birth takes place at the time of its occurrence, and any person in attendance upon the mother at the time of, or within six hours after, the birth, to give notice in writing of the birth to the Medical Officer of Health of the district in which the child is born, in the manner provided. Notification applies in the case where a child has issued forth from its mother after the expiration of the twenty-eighth week of pregnancy, whether alive or dead. In practice, it is almost always the doctor or midwife who notifies a birth, and not the father of the child. During the year, 2,052 live births were notified to the Medical Officer of Health. There were also 61 stillbirths notified. Of the 2,113 living and stillbirths notified, 63.1 per cent. were notified by medical practitioners, 28.0 per cent. by midwives, 0.4 per cent. by parents, and 8.5 per cent. by medical students or other persons. A comparison of the Notification Register with the returns supplied by the local Registrars of Births shows that 98.9 per cent. of the live births and 94.0 per cent. of the stillbirths occurring within the Borough were duly notified. It will be seen that only a small proportion of births are not notified and so escape being brought to the notice of the Medical Officer of Health until they come to be registered within the statutory period of six weeks. In nearly every case of default a cautionary letter was sent to the person responsible. In no instance did the Maternity and Child Welfare Committee consider it necessary to institute legal proceedings. DEATHS. The number of deaths registered during the year as having taken place in the Borough was 1,623. Of these, 543 were of persons whose residence was not in Paddington, 486 dying in Paddington Institutions and 57 in other places in the Borough. There were also reported to the Registrar-General 595 deaths of Paddington persons whose deaths occurred outside the Borough. This correction gives the nett number of deaths for Paddington as 1,675, making an annual deathrate of 12.08. The Registrar-General has calculated a comparability factor for each district, by the use of which differences in mortality rates due to variations in the sex and age constitution of the populations of districts selected for comparison may to a great extent be eliminated. The factor for Paddington is .99, which applied to the crude death rate of 12.08 per 1,000 persons for the year 1935, gives an adjusted death rate of 11.95 per 1,000 persons. 1935. Selected Causes of Death Arranged in Four-Weekly Periods. Period ended. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Phthisis. Cancer. Influenza. Bronchitis. Pneumonia. Diarrhoea & Enteritis January 26th — 1 3 21 — 2 9 6 February 23rd — — — 1 9 24 2 4 7 6 March 23rd — — — 4 11 22 6 4 18 3 April 20th — — — 2 5 16 4 10 15 4 May 18th — — — — 4 13 5 2 7 2 June 15th — — 6 16 — 7 2 — July 13th — —. — 1 4 22 1 1 4 2 August 10th — — 4 — 4 10 — — 1 1 September 7th — — — 2 6 23 — 2 4 2 October 5th — — 1 — 2 23 — 3 5 2 November 2nd — — — — 4 18 1 3 6 5 November 30th — — 1 7 14 1 4 6 1 December 31st 1 — \— 1 9 13 — 9 16 4 Totals 1 — 5 13 74 235 20 51 100 36 The foregoing table gives the numbers of deaths from the various causes as classified locally. Some of the totals difier slightly from those supplied by the Registrar-General in the table appearing on the next page. 10 Deaths of Residents of the Borough, 1935. Sex-Age Distribution for Whole Borough. All Ages. Deaths at Ages. 0— 1— 2— 5— 15— 25— 35— 45— 55— 65— 75— M. F. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. All Causes 776 900 1675 85 55 9 2 5 6 8 18 18 18 32 31 34 39 84 84 159 138 179 196 162 313 Typhoid and Paratyphoid Fevers — — — — — — — — — — — — — — — — — — — — — — — — — Measles — — — — — — — 1 — — — — — — — — — — — — — — — — — Scarlet Fever — — — — — — — — — — — — — — — — — — — — — — — — — Whooping Cough 2 3 5 1 3 1 — — — — — — — — — — — — — — — — — — — Diphtboria 4 9 13 — — — — 3 2 — 7 — — — — — — — — 1 — — — — — Influenza 7 13 20 — — — — — — — — — — — — — 1 — — 2, 1, 4 3 1 7 Encephalitis Lethargica — — — — — — — — — — — — — — — —— — — — — — — — — — Cerebro-spinal Fever 3 2 5 2 — — — — — — — — — — — — — — — — — — — — — Tuberculosis of Respiratory System 42 33 75 — — — — — — 1 — 5 10 4 7 7 4 12 5 9 6 4 — — 1 Other Tuberculous Diseases 5 8 13 1 — — 1 — — — 1 1 — 1 1 1 1 l 1 1 — ?, — — Syphilis 3 1 4 — 1 — — — — — — — — — — 1 1 1 — — — — — General Paralysis of the Insane, Tabes Dprsalis 6 2 8 — — — — — — — — — — 1 — — 1 3 1 — — 2 — — — Cancer, Malignant Disease 94 141 235 — — — — — — — 1 — — 6 1 1 9 9 25 29 37 33 38 16 30 Diabetes 3 9 12 — — — — — — — — — — — — — — — 2 — 2 3 4 1 Cerebral Haemorrhage, etc. 31 35 66 — — — — — — — — — — — — — 1 2 4 8 6 10 7 11 17 Heart Disease 192 244 436 — — — — — — — 3 3 2 2 6 1 3 19 13 53 23 50 68 64 127 Generall Paralysis of the Insane, Tabes Dorsalis 7 8 15 — — — — — — — — — — — — 1 1 — 4 3 3 2 1 Other Circulatory Diseases 26 67 93 — — — — — — — — — — — — 1 1 2 2 8 15 9 19 6 30 Bronchitis 26 28 54 8 4 — — — — — — — — — — 1 — — — 2 2 7 4 8 18 Pneumonia (all forms) 54 49 103 9 7 3 1 — 2 — 1 1 — 3 — 7 1 6 3 9 10 9 8 7 16 Other Respiratory Diseases 8 12 20 — — — — — — — — — — 1 — 1 — 2 2 — 1 4 2 — 7 Peptic Ulcer 18 8 26 — — — — — — — — — 1 2 1 — — 8 3 2 2 4 — 2 1 Diarrhoea, etc. 20 16 36 18 13 1 — — — — — — — — — — — — 1 — — 1 1 — 1 Appendicitis 6 7 13 — — — — — — — 2 — — 1 2 0 — 1 — 2 2 — 1 — — Cirrhosis of Liver 2 4 6 — — — — — — — — — — — — — — 2 4 — — — — — — Other Diseases of Liver, etc 1 5 6 — — — — — — — — — — — 1 — — — — 2 — 3 — — Other Digestive Diseases 21 17 38 3 1 2 — — 1 1 — — 1 1 1 1 — 2 1 3 6 6 3 2 3 Acute and Chronic Nephritis 20 21 41 — 1 — — — — — — — — 1 — 1 2 3 2 5 3 6 7 4 6 Puerperal Sepsis — 3 3 — — — — — — — — — — — 3 — — — — — — — — — — Other Puerperal Causes — 5 5 — — — — — — — — — 1 — 3 1 — — — — — — — — Congenital debility, Premature Birth, Malformations, etc. 34 23 57 34 23 — — — — — — — — — — — — — — — — — — — — Senility 6 25 31 — — — — — — — — — — — — — — — — — — — 2 6 23 Suicide 18 9 27 — — — — — — — — — 1 4 2 2 2 4 3 5 1 1 — 2 — Other Violence 46 37 83 5 1 1 — 1 — 4 — 7 1 4 3 3 3 2 2 4 5 5 6 10 16 Other defined diseases 69 56 125 4 1 1 — — 1 2 3 1 1 1 2 2 7 5 6 12 11 18 16 23 8 Causes ill-defined or unknown — — — — — — — — — — — — — — — — — — — — — — — — 11 The following table shows the death-rate during each of the last six years in England and Wales, in London, in Paddington, and in each of the wards of the Borough:— 1935. Death-rates. No. of Deaths. Deathrates. 1934 1933 1932 1931 1930 England and Wales 477,371 11.7 11.8 12.3 12.0 12.3 11.4 London 46,708 11.4 11.9 12.5 12.3 12.4 11.4 Paddington 1,675 12.08 12.47 13.36 13.26 13.05 12.64 Wards— Queen's Park 155 11.89 12.40 13.34 13.93 10.64 11.54 Harrow Road.. 316 12.97 13.10 14.11 13.82 11.99 11.85 Maida Vale 263 11.81 12.24 12.50 13.22 13.12 13.12 Town 94 13.63 12.65 16.01 14.28 15.57 12.59 Westbourne 320 13.25 13.14 13.99 13.90 15.31 13.99 Church 195 11.76 14.06 14.44 16.65 15.69 14.43 Lancaster Gate, West 103 10.88 10.06 13.52 10.40 11.54 10.59 Lancaster Gate, East 96 10.12 9.61 10.70 9.86 9.57 12.00 Hyde Park 133 10.74 12.17 11.28 9.90 12.10 11.72 The following table shows the course of the death-rate in the Borough in the past DEATH-RATES. Paddington. 1881-1885 16.23 1886-1890 16.19 1891-1895 17.17 1896-1900 15.51 1901-1905 15.33 1906-1910 14.52 1911-1915 14.06 1916-1920 14.62 1921-1925 12.41 1926-1930 13.47 1931 13.05 1932 13.29 1933 13.36 1934 12.47 1935 12.08 Deaths in Institutions, 1935. Local. Total. Nonresidents. Paddington Hospital 488 104 St. Mary's Hospital 245 190 Paddington Green Children's Hospital 33 26 Hospital for Women and Children (Lock Hospital) 4 4 St. Luke's Hospital 172 162 942 486 486 456 Outlying Paddington Residents. Isolation Hospitals of London County Council 24 Municipal General Hospitals and Public Assistance Committees' Institutions 288 Mental Hospitals 58 Voluntary Hospitals (General) Hospitals (Special, including Sanatoria) 28 497 Total Deaths of Paddington residents in institutions 953 12 INFANTILE MORTALITY. During the year 1935 there were 1,964 births, and 140 deaths of children under the age of twelve months in the Borough. These figures give an infantile mortality rate (deaths of infants under twelve months to each 1,000 births) of 71. The following table gives the births and the infantile deaths and death-rates for the year 1935 in England and Wales, in London, in the Borough and in the various wards of the Borough. The infantile mortality rates for 1930 to 1934 are given for comparison. 1935 Infantile Mortality Rates. No. of Births. No. of Deaths of Children under 1 year. Infantile Mortality Rates. 1934 1933 1932 1931 1930 England and Wales 599,167 34,089 57 59 64 64 66 60 London 63,145 3,229 58 67 60 66 65 59 Paddington 1,964 140 71 95 85 107 87 78 Wards— Queen's Park 135 5 37 31 96 125 55 43 Harrow Road 457 34 74 79 48 80 78 39 Maida Vale 294 21 71 93 94 84 81 97 Town 131 14 107 72 123 161 106 50 Westbourne 440 32 73 109 87 107 80 86 Church 289 24 83 169 112 138 116 122 Lancaster Gate, West 54 1 18 91 127 113 109 98 Lancaster Gate, East 42 2 48 — 62 97 60 103 Hyde Park 122 7 57 96 67 79 90 62 Infantile Mortality Rates, 1896-1935. England and Wales. London. Paddington 1896-1900 156 162 161 1901-1905 138 139 128 1906-1910 117 114 104 1911-1915 109 110 108 1916-1920 91 92 103 1921-1925 76 70 76 1926-1930 68 64 86 1931 66 65 87 1932 64 66 107 1933 64 60 85 1934 59 67 95 1935 67 68 71 Infantile Mortality in Paddington—1935. Causes of Death. Under 1 week. 1 to 2 weeks. 2 to 3 weeks. 3 to 4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total Deaths under 1 year. Rate per 1,000 Births. All Causes 46 3 1 1 51 22 33 26 8 140 71.28 Common Infectious Diseases (6-10, — — — — — — — — — — — 44) — — — — — — 1 2 1 4 2.04 Tuberculous Diseases (23-32) — — — — — — — 1 1 0.51 Diarrhoea and Enteritis (119) — 1 — — 1 12 8 9 1 31 16.78 Developmental and Wasting Diseases (157, 158, 159, 161a) 38 2 1 1 42 6 4 2 1 55 28.00 Miscellaneous Diseases (Remainder) 8 — — — 8 4 20 12 5 49 24.96 Measles (7) — — — — — — — — — — — Whooping cough (9) — — — — — — 1 2 1 4 2.04 Diphtheria (10) — — — — — — — — — — — Influenza(11) — — — — — — — — — — — Tuberculosis of nervous system (24) — — — — — — — 1 — 1 0.51 Tuberculosis of intestines and peri- — — — — — — — — — — — Other tuberculous diseases (23, 2632) — — — — — — — — — — — Syphilis (34) — — — — — — 1 — — 1 0.51 Meningitis (79) — — — — — — — — — — Convulsions (86) — — — — — — 1 1 0.61 Bronchitis (106) — — — — — — 7 2 2 11 5.61 Pneumonia (107-109) — — — — — 3 5 4 2 14 7.13 Other respiratory diseases (105, 110114) — — — — — — — — — —— — Inflammation of the stomach (118) — — — — — — — — — 1 0.51 Diarrhoea and Enteritis (119) — 1 — — 1 12 8 9 1 31 15.78 Hernia, intestinal obstruction (122) — — — — — — 2 1 3 1.63 Congenital malformations (157) 6 — — — 6 1 1 1 9 4.58 Congenital debility and sclerema (158) — — 1 — 1 3 3 1 — 8 4 07 Icterus (1616) 1 1 — — 2 — — — — 2 1.02 Premature birth (159) 24 1 — 1 26 2 — 1 — 29 14.76 Injury at birth (160) 3 — — — 3 — — 3 1.53 Disease of umbilicus (161c :1) — — — — — — — — — — — Atelectasis (161a) 3 — — — 3 — — — — 3 1.53 Suffocation—in bed or not stated how (182 pt.) 1 — — — 1 — 1 — — 2 1.02 Other causes 8 — — — 8 — 3 5 1 17 8.65 Nett Births in the Year Legitimate 1,711. Illegitimate 253. Nett Deaths in the Year Legitimate Infants 112. Illegitimate Infants 28. Note.—The numbers given in brackets after certain causes of death indicate the numbers of the corresponding headings in the Detailed International List of Causes of Death, 1929. It has been customary in previous annual reports to make a note of infantile mortality in special localities. The following is a summary of the results:— Infantile Mortality in Special Areas. Areas. 1935 Infantile Mortality Rates. Births. Deaths. 1935 1934 1933 1932 1931 1930 Church Ward— North Wharf 35 2 57 77 135 105 53 77 Clarendon Street 110 9 82 177 121 142 116 153 Rest of Ward 144 13 90 181 98 140 129 106 Westbourne Ward— Alfred Road 97 7 72 114 69 123 116 84 Rest of Ward 343 25 73 108 92 104 69 87 Maida Vale Ward— Amberley Road 37 1 27 151 166 190 48 206 Rest of Ward 257 20 78 85 81 67 87 83 Totals for 4 Areas 279 19 68 145 114 140 102 129 Rest of Borough 1685 121 72 88 80 100 85 69 14 MATERNAL MORTALITY. During the year 8 deaths, attributable to childbirth, occurred among the women residents of the Borough. Of these, 3 were due to puerperal sepsis and 5 to other puerperal causes. All of the deaths occurred in institutions. The 8 deaths were equivalent to a mortality rate of 3.95 per 1,000 total (live and still) births. In the following table this rate is compared with the rates for London and England and Wales. Corresponding rates for the four previous years are also given. England and Wales. London. Paddington. 1935 3.93 2.50 3.95 1934 4.41 2.70 4.57 1933 4.32 3.55 5.00 1932 4.04 2.89 2.94 1931 3.94 3.68 4.62 VITAL STATISTICS. Metropolitan Boroughs. The subjoined information, comparing the vital statistics for the metropolitan boroughs, has been supplied by Dr. W. Allan Young, Medical Officer of Health of Poplar:— 1935. Cities and Boroughs. Estimated Resident Population. Live Births (Rate). Death Rate. Infantile Mortality per 1,000 Births. Crude. Adjusted. West Districts. Paddington 138,600 14.17 12.08 11.95 71 Kensington 178,300 12.4 12.1 11.3 79 Hammersmith 128,100 14.7 11.9 12.3 70 Fulham 143,600 13.8 11.6 11.7 51 Chelsea 57,320 10.2 12.6 10.7 59.6 Westminster 124,400 8.3 11.5 11.8 72 North Districts. St. Marylebone 92,200 9.72 11.8 11.7 56 Hampstead 90,600 11.02 11.2 10.5 49 St. Pancras 185,300 13.3 11.97 12.2 62.8 Islington 308,170 14.85 — 10.99 52 Stoke Newington 50,210 13.9 11.1 10.6 51 Hackney 210,600 14.0 10.6 11.1 47.6 Central Districts. Holborn 35,400 7.65 11.9 12.7 89 Finsbury 63,100 14.7 12.6 13.7 59 City of London 9,360 7.6 11.0 12.2 113 East Districts. Shoreditch 88,400 14.6 11.3 12.4 52 Bethnal Green 99,910 14.4 10.3 11.6 51 Stepney 211,500 14.3 11.3 12.8 63 Poplar 143,700 15.4 11.0 12.3 46 South Districts. Southwark 156,100 14.8 — 12.4 66 Bermondsey .. 102,700 14.5 11.7 13.3 69 Lambeth 279,900 13.65 12.15 12.02 59 Battersea 148,200 14.2 12.0 11.9 65.11 Wandsworth 343,300 11.03 11.00 10.23 55 Camberwell 234,400 13.4 11.8 11.8 60 Deptford ,. 99,500 14.4 11.1 11.5 52 Greenwich 96,600 13.87 10.83 11.04 59 Lewisham 223,000 12.5 9.9 10.0 43 Woolwich 146,400 14.0 10.2 10.8 44 INQUESTS. During 1935, 131 inquests were held on residents of the Borough, and 90 deaths were registered after the issue of certificates by the Coroner under powers conferred by the Coroners (Amendment) Act, 1926. 15 THE PREVALENCE OF DISEASE. The following diseases are compulsorily notifiable under certain conditions in Paddington:— Acute Encephalitis Lethargica. Acute Influenzal Pneumonia. Acute Polio-encephalitis. Acute Polio-myelitis. Acute Primary Pneumonia. Acute Rheumatism. Anthrax. Cerebro-spinal Fever. Chicken-pox. Cholera. Continued Fever. Diphtheria or Membranous Croup. Dysentery. Erysipelas. Food Poisoning or Suspected Food Poisoning. Glanders. Hydrophobia. Infective Enteritis or Summer Diarrhoea. Malaria. Ophthalmia Neonatorum. Plague. Puerperal Fever. Puerperal Pyrexia. Relapsing Fever. Scarlatina or Scarlet Fever. Smallpox. Tuberculosis. Typhoid or Enteric Fever. Typhus Fever. The following table summarises the eases of notifiable diseases notified in the years 1925 to 1935:— Analysis of Notification Certificates. (Uncorrected for Errors in Diagnosis.) 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 Acute Encephalitis Lethargica 7 4 4 1 5 1 — — — — — ,, Influenzal Pneumonia 88 76 107 59 135 40 97 66 102 35 33 ,, Primary Pneumonia 265 184 183 202 247 168 243 184 157 155 99 ,, Polio-encephalitis 3 3 1 1 1 — 1 1 — —_ — ,, Polio-myelitis 3 4 3 1 1 2 2 3 6 2 ,, Rheumatism — — (a)34 76 52 43 37 21 37 41 18 Anthrax — 1 1 — — — 1 — — — — Cerebro-spinal Fever 5 5 3 4 6 3 5 9 6 3 7 Chicken-pox 459 599 461 567 382 515 555 291 364 333 365 Continued Fever — — 2 10 3 2 4 1 1 1 Diphtheria 336 462 367 302 311 366 254 194 277 245 203 Dysentery — — — — — — 2 5 1 1 11 Erysipelas 64 76 9.0 90 69 74 67 60 66 66 50 Food Poisoning or Suspected Food Poisoning — — — — — — — (a)ll 17 45 63 German Measles 375 124 78 109 1163 86 58 77 (6)11 — — Infective Enteritis or Summer Diarrhoea — — (a) 6 20 63 30 40 103 67 70 81 Malaria 1 1 2 3 — 1 — 1 1 1 3 Measles 879 1738 154 2862 210 1790 541 1414 (b)103 — — Membranous Croup 1 1 2 4 6 7 6 6 1 2 Ophthalmia Neonatorum 23 16 15 24 9 15 18 22 21 19 11 Puerperal Fever 15 14 7 5 4 5 8 7 12 12 14 ,, Pyrexia — (a)17 34 32 42 37 32 31 53 36 27 Scarlet Fever 264 199 320 519 323 356 379 286 396 437 267 Smallpox — — — 5 3 3 — 2 1 — — Tuberculosis—Total 400 356 381 321 335 284 311 289 270 284 242 Pulmonary 231 218 212 196 242 196 218 213 203 199 186 Other Forms 169 138 169 125 93 88 93 76 67 85 56 Typhoid or Enteric Fever 18 12 16 25 19 10 9 4 6 9 7 (а) First Year of Notification. (b) Not notifiable after 19th March, 1933. The following table furnishes an analysis of some of the notifiable diseases according to age, sex and ward of the Borough:— 1935. NOTIFICATIONS. A.—Ward Distribution. Queen's Park. Harrow Road. Maida Vale. Town. Church. Westbourne. Lancaster Gate. Hyde Park. West. East. Diphtheria and Memb. Croup M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 4 6 12 11 17 24 6 10 19 23 21 32 2 1 1 3 7 6 (???) and Continued Fever — — 1 — — 1 — 1 — — 2 1 — 1 — 1 (???) 3 3 4 7 — 3 — — — 9 9 5 2 1 — 1 — 2 (???)lmia Neonatorum — — 2 — — 2 — 1 2 — 2 — — — — 2 — (???)nia—Acute Influenzal 1 1 5 3 5 2 3 1 2 2 2 1 — — 3 — 2 — (???) Acute Primary 8 4 8 6 7 8 1 — 13 14 13 14 2 — — 1 — — (???)peral Fever — 3 — 3 — 1 — 1 — 4 — 1 — — — 1 — — „ Pyrexia — 1 — 10 — 6 — — — 2 — 6 — — — 1 — 1 Screlet Fever 8 12 35 28 17 23 10 16 17 17 26 29 4 3 3 4 5 10 16 B.—Sex-Age Distribution. Borough. 0— 1— 2— 3— 4— 5— 10— 15— 20— 35— 45— 65-[/$$$] M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. P. M F. Diphtheria and Memb. Croup 4 1 2 4 8 4 14 10 11 13 36 49 5 6 2 7 5 17 1 1 1 3 — 1 Typhoid and Continued Fever — — — — — — — — — — 1 — — — — — 1 2 1 — — 3 — — Erysipelas — 2 — — — — — — — — — 1 — — 1 2 7 2 5 11 10 3 6 Pneumonia—A. Influenzal — — — — — — — — 1 — 1 1 1 — — — 4 3 1 2 5 5 7 2 ,, A. Primary 8 3 5 3 4 6 5 6 — 1 3 6 1 — 3 1 6 5 5 4 12 7 — 5 Scarlet Fever — 1 9 3 10 11 10 8 10 10 53 46 11 24 4 11 11 21 5 5 3 1 — — SCARLET FEVER. During 1935 there were 267 cases of scarlet fever notified. Of the cases notified, 1 was under the age of 1 year, 71 were between the ages of 1 and 5 years, 134 between the ages of 5 and 15 years, 47 between the ages of 15 and 35 years, and 14 over the age of 35 years. Of the 267 cases, 241 were removed to Isolation Hospitals. The remaining cases were treated at home, proper facilities being available for isolation and treatment. No death from this disease occurred during the year. The clinical picture of scarlet fever nowadays is totally different from what it was 50 years ago. It was then a dangerous disease with a high case-mortality. It is now a disease of minor importance as compared with measles, diphtheria and whooping cough. 1935. Notifications of Scarlet Fever. Four-Weekly Periods. Period No. 1. Period No. 2. Period No. 8. Period No. 4. Period No. 6. Period No. 6. Period No. 7. Period No. 8. Period No. 9. Period No. 10. Period No. 11. Period No. 12. Period No. 13. Totals. London 1078 962 895 870 761 771 642 709 627 821 1062 1008 856 11062 Paddington 26 23 28 16 18 16 15 22 5 26 20 31 22 267 Wards— — — — — — — — — — — — — — — Queen's Park 3 2 — 3 — 2 2 1 1 1 3 1 1 20 Harrow Road 3 5 8 1 5 3 5 3 — 14 5 9 2 63 Maida Vale 3 2 2 4 1 3 2 1 1 4 2 7 8 40 Town — 2 2 — 1 2 — 7 — — 2 5 5 26 Church 4 3 3 1 2 3 3 4 1 3 4 1 2 34 Westbourne 10 3 6 5 6 2 2 6 2 3 3 6 2 65 Lancaster Gate, West 1 2 1 1 — — — — — 1 — 1 7 Lancaster Gate, East.. — 1 3 — 1 — 1 — — 1 — — — 7 Hyde Park 1 3 3 1 3 1 — — — — — 2 1 16 DIPHTHERIA. (Including Membranous Croup.) During 1935 there were 203 cases of diphtheria notified, and 2 of membranous croup. Of the 205 cases, 5 were under the age of 1 year, 66 between the ages of 1 and 5 years, 96 between the ages of 5 and 15 years, 31 between the ages of 15 and 35 years, and 7 aged 35 years and upwards. Two hundred patients were removed to Isolation Hospitals. The remaining cases were treated at home, proper facilities being available for isolation and treatment. Thirteen deaths from this disease occurred during 1935, 5 of the deaths being those of children under the age of 5 years. Comparison with previous years is as follows:— 1921 22 deaths. 1922 26 „ 1923 14 „ 1924 14 „ 1925 11 „ 1926 21 „ 1927 11 „ 1928 7 „ 1929 9 „ 1930 12 „ 193 1 8 „ 1932 13 ,, 1933 19 ,, 1934 13 ,, 1935 13 „ 17 Seasonal Prevalence.—The following table shows the number of cases notified in each four-weekly period during 1935:— Notifications of Diphtheria and Membranous Croup. Four-Weekly Periods. Period No. 1. Period No. t. Period No. 3. Period No. 4. Period No. 6. Period No. 0. Period No. 7. Period No. 8. Period No. 0. Period No. 10. Period No. 11. Period No. 18. Period No. 15. Totals. London 1148 1008 829 763 669 540 605 541 474 703 775 811 640 9409 Paddington 30 22 20 12 15 8 14 9 6 12 14 27 16 205 Wards— — — — — — — — — — — — — — — Queen's Park 3 1 — — 1 — 1 — — 1 2 — — 9 Harrow Road 5 1 6 1 2 — 2 2 — — — 3 2 24 Maida Vale 1 6 3 1 1 3 4 3 — 1 3 12 3 41 Town 2 2 5 2 — — — 1 1 1 2 — — 16 Church 8 3 — — 4 1 4 3 2 5 2 6 4 42 Westbourne 8 7 6 8 5 — 3 — 2 1 2 5 6 63 Lancaster Gate, West 1 — — — — 1 — — — 1 — — — 3 Lancaster Gate, East — — — — 1 2 — — — 1 — — 4 Hyde Park 2 2 — — 1 1 — — 1 2 2 1 1 13 Diphtheria Carriers.—There is a clinic for diphtheria carriers held at St. Mary's Hospital, to which 25 cases were referred by the Public Health Department during the past year. Anti-Diphtheritic Serum.—This is stocked at the Town Hall and supplied to medical practitioners on request for the use of patients who are too poor to obtain such serum privately. During the year 33 phials of 4,000 units and 19 phials of 500 units were distributed. Diphtheria Immunisation.—In June, 1933, a clinic for the immunisation of children against diphtheria was inaugurated at the Welfare Centre, 232, Harrow Road, Dr. R. Cove-Smith being appointed Medical Officer. At first one session weekly was held, but the increasing numbers of children presenting themselves for treatment, following the distribution of leaflets at the various schools in the Borough, necessitated the provision of additional facilities, and a second session weekly was accordingly started in December of that year. Early in 1934 a third session was opened, this being continued until nearly the end of the year. Two sessions weekly were continued until the week ended 16th February, 1935, when an additional session was found to be necessary. In the week ended 3rd August, two sessions were reverted to, and in the week ended 9th November one session only was found to be sufficient. Towards the end of 1934 the Council, after consultation with local representatives of the medical profession, decided to introduce a scheme for enlisting the services of private medical practitioners in the work of diphtheria immunisation. The scheme provides for the payment to the practitioner of a fee of 10s. for immunising treatment given to any child between the ages of one year and twelve years, whose parent or guardian cannot reasonably be expected to afford a private fee for such treatment. All Schick testing for the purpose of ascertaining whether the child is susceptible to diphtheria is to be done by the Medical Officer of the Council's diphtheria immunisation clinic at the Welfare Centre, No. 232, Harrow Road. In the case of a child sent to the clinic for a pre-immunisation test, the result of which is negative, a fee of 2s. 6d. only is payable to the practitioner. The practitioner is required to bear the cost of an immunising agent specified by the Medical Officer of Health, and he is also responsible for any subsequent medical attention that may be necessary. Dr. Cove-Smith resigned his appointment as Medical Officer, and the duties were taken over on the 6th November by Dr. C. T. Potter. The following report has been received from Dr. B. Cove-Smith and Dr. C. T. Potter on the work carried out at the Clinic during the year. "During the year 1935, 285 cases have attended the Diphtheria Immunisation Clinic for preliminary testing. Of this number 51 were sent by local practitioners. One hundred and eightyseven were found to be liable to infection. One hundred and thirty cases have been fully immunised at the clinic, and a further 71 cases had not completed the course of injections when this report was made. In accordance with the scheme adopted towards the end of 1934, to enlist the services of local practitioners for Diphtheria Immunisation, 276 cases have been fully immunised by them, and Schicktested afterwards at the clinic; and a further 115 cases were in the process of immunisation at the end of the year. This makes a total of 592 who have taken adv antage of the facilities for immunisation under the Borough scheme. 18 Nine cases during the year were found after re-testing to require further injections. This seems to emphasise the importance of re-testing all cases so that none of those presenting themselves should be merely partially immunised. Of all those who have been fully immunised during the year we have not heard of a single case which has developed Diphtheria. It will be seen from the figures presented that there has been an increase over last year of 181 in the total number of cases fully immunised in the Borough under the scheme The largest percentage increase has been in the 2 to 5 year age-group, and as most cases of Diphtheria occur in this age-period this fact is encouraging. Some of the parents of the children have asked to be tested and immunised themselves, and we have encouraged them to take advantage of the protection afforded." 1935. Number of Schick Tests. Pos. Neg. Ps. Pos. Ps. Neg. Unknown result. Total. Fully Inoculated. Partly Inoculated. No. of Inocs. given. Ordinary Clinic 164 67 — 1 2 234 130 71 441 Private Practitioners 23 28 — — — 51 276 115 1227 Totals 187 95 — 1 2 285 406 186 1668 Number op Schick Re-tests. Positive. Negative. Ps. Positive. Ps. Negative. Unknown Result. Total. After First Re-test. After Further Re-test. After First Re-test. After Further Re-test. After First Re-test. After Further Re-test. After First Re-test. After Further Re-test. Ordinary Clinic 3 — 110 16 — 2 2 2 135 Private Practitioners e 1 255 10. — — 1 — 13 286 Totals 9 1 365 26 — — 3 2 15 421 Tho number "Fully Inoculated" come under the following age groups:— Ordinary Clinic. Private Practitioners. 6 to 12 months 1 130 nil 276 1 year to 5 years 65 95 5 years to 10 years 47 134 10 years to 15 years 17 47 15 years and upwards nil nil SMALLPOX. No case of this disease was notified during the year, but a number of persons who had been exposed to risk of infection from cases occurring outside the Borough were kept under observation until all danger of their developing the disease was over. During the year all vaccinations of smallpox contacts were performed by the Public Vaccinator, none being performed by the Medical Officer of Health under the Public Health (Smallpox Prevention) Regulations, 1917. VACCINATION. There are two vaccination districts in the Borough, one consisting of the Paddington Hospital, for which the Medical Superintendent, Dr. W. J. Gill, acts as Public Vaccinator and Dr. F. A. Bryning as Deputy Public Vaccinator, and the other of the rest of the Borough, the Public Vaccinator being Dr. S. Denovan Adam. The Vaccination Officer is Mr. T. E. Rainger, who was appointed to that position in 1931. The appointment is a part-time one, Mr. Rainger also holding a position on the clerical staff of the Public Health Department. The latest return available as to the state of vaccination in the Borough is for the year 1934. This shows that 57.0 per cent, of the children whose births were registered during that year were successfully vaccinated, and that 18.4 per cent, were exempted on production of statutory declarations of conscientious objection. Insusceptibility, removals, deaths, postponement by medical certificate and not traced, account for the remaining 24.6 per cent. 19 During the year 1935, 2 primary vaccinations were performed in the Paddington Hospital. In the rest of the Borough 712 infants under one year of age, and 38 persons over that age were successfully vaccinated by Dr. Denovan Adam, by whom also 31 persons were re-vaccinated who had been successfully vaccinated at some previous time. Of children born in the Borough and those transferred from other districts the total number vaccinated by Public Vaccinators and other Medical Practitioners was 1,357; and the total number of statutory declarations of conscientious objection received from Paddington and other districts was 381. No legal proceedings were taken during the year 1935 for non-compliance with the provisions of the Vaccination Acts. CHICKEN-POX. Chicken-pox has been notifiable in Paddington since November 28th, 1922, but the sections of the Public Health (London) Act, 1891, dealing with disinfection, exposure to infection, etc., are not in force as regards this disease. During 1935, 365 certificates were received from medical practitioners. In addition 256 cases were reported from other sources, making a total of 621 for the year. Chicken-pox is not usually nursed in an institution, but 39 cases received institutional treatment for various reasons. TYPHOID FEVER AND CONTINUED FEVER. Seven cases of typhoid fever and one case of continued fever were notified in 1935. In cases where the diagnosis of typhoid fever cannot be made with certainty but there is a strong likelihood of the disease being present, local doctors are encouraged to obtain early hospital treatment for the patients by notifying them as having continued fever. Six cases of typhoid fever and the case of continued fever received hospital treatment. No death from typhoid fever occurred during the year. MEASLES. This disease is no longer notifiable in the Borough, but the Order made by the London Countv Council on 1st April, 1903, applying to measles, Sections 60-65, 68-70 and 72 of the Public Health (London) Act, 1891, still remains in force. The Order enables local authorities to disinfect after measles and to safeguard the public in several ways against spread of infection. During the year 85 cases were brought to the knowledge of the Department through reports from schools, parents, etc. In the following table these cases are distributed among the various Wards of the Borough in four-weekly periods. 1935. Measles. Reported Cases. Four-Weekly Periods. Period No. 1. Period No. 2. Period No. 8. Period No. 4. Period No. 6. Period No. 6. Period No. 7. Period No. 8. Period No. 9. Period No. 10. Period No. 11. Period No. 12. Period No. 18. Totals Borough 3 7 3 6 1 6 5 1 4 2 7 16 24 85 Wards— Queen's Park — — — — — — — — 1 — — — 3 4 Harrow Road — 3 3 2 3 1 2 1 3 18 Maida Vale 1 2 1 2 1 1 1 9 Town — 1 — — — — — — 1 2 Church 3 3 — — — — — 1 1 — 1 10 13 32 Westbourne — 2 — — — — — — 1 — — 3 1 7 Lancaster Gate, West — — — 1 — — — — — — — — — 1 Lanoaster Gate, East 1 1 1 1 2 6 Hyde Park — 1 — — — — — — — — 4 1 — 6 One death from measles occurred during the year in a boy of 3 years. The Women Sanitary Inspectors visit cases of measles with few exceptions and arrange, where necessary, for the attendance of the District Nurses. The cases requiring nursing assistance during the year numbered 4 under 5 years of age and 1 over 5 years of age. The number of visits paid by the nurses was 52 and 4 to each group respectively. Thirty-nine cases received treatment in hospital. 20 GERMAN MEASLES. As is the case with measles this disease is no longer notifiable in Paddington. In the course of the year 56 cases came to the knowledge of the Department through various sources of information. Ten patients received treatment in hospital. OPHTHALMIA NEONATORUM. This disease is notifiable in London under Section 55 of the Public Health (London) Act, 1891, the London County Council having by resolution in 1911 made this section applicable to the disease. Eleven notifications relating to cases of purulent eye-discharge of the new-born were received during 1935. All of the patients recovered without any impairment of vision. As soon as a case of this disease is notified, intensive efforts are made by the Council's Staff to ensure that proper treatment is carried out. Daily visits are paid and private or charitable medical treatment is invariably enforced. Where necessary the infant and its mother are removed to a hospital, provision of this accommodation being ample. All necessary nursing attention is given by home visiting on the part of the Paddington and St. Marylebone District Nursing Association. In addition to true purulent discharge, 2 cases of slight discharge from the eyes of infants reported by midwives to the London County Council were referred to this Department and received attention, no doubt preventing the onset of the more severe form of the disease. During 1935, 2 cases were referred to the District Nursing Association, 70 visits being paid. Nine cases of ophthalmia of the new-born were treated in hospitals as in-patients. PUERPERAL FEVER. There were 14 cases of puerperal fever notified during 1935, all of which were removed to or nursed in a hospital. There is no difficulty in obtaining institutional treatment for women suffering from this disease. Cases of puerperal fever referred to the London County Council are usually sent to the North-Western Hospital, Hampstead, where a special ward is set aside for these cases and special medical and nursing staffs are provided. Excellent accommodation is also available at Queen Charlotte's Isolation Hospital, Hammersmith. Three deaths from the disease were recorded during the year. PUERPERAL PYREXIA. This condition is defined as:— "Any febrile condition (other than a condition which is required to be notified as puerperal fever) occurring in a woman within 21 days after childbirth or miscarriage in which a temperature of 100.4 degrees Fahrenheit, or more, has been sustained during a period of 24 hours or has recurred during that period." The febrile condition referred to in the above definition may be due to any cause, and it may be to some cause quite independent of the puerperal condition. It may, however, be the precursor of the more serious condition known as puerperal fever, and it is with this in view that the numerous conditions comprised under the term puerperal pyrexia are made notifiable. During the year 27 cases of puerperal pyrexia were notified, 26 of which occurred within or were removed to institutions. During the year the Council retained the services of Mr. Aleck W. Bourne, F.R.C.S. (England), Obstetric Surgeon to Out-patients, St. Mary's Hospital, to act in a consultative capacity, for cases of puerperal fever and puerperal pyrexia. No request for his assistance was made to the Council during the year. ERYSIPELAS. Fifty cases were notified, 31 of which occurred within or were removed to hospitals. ACUTE POLIO-MYELITIS. Two cases of this disease, otherwise known as Infantile Paralysis, were notified, one of which received treatment in hospital. Owing to the serious after-effects, such as deformities, which result from this disease, much care is taken to keep in touch with all cases previously notified. Recent experience tends to show that most of the cases notified by doctors receive all the necessary remedial treatment. It is evident that the possibility of preventing the onset of serious deformities is now realised by parents and doctors more than formerly. ACUTE POLIO-ENCEPHALITIS. No case of this disease, somewhat similar in its nature to the last-mentioned, was notified. 21 ACUTE ENCEPHALITIS LETHARGICA. No case of this disease was notified. CEREBRO-SPINAL FEVER. Seven cases of this disease were notified in 1935, and were treated in hospital. Five of the cases proved fatal. MALARIA. Three cases of this disease were notified, all being treated in hospital. ACUTE PRIMARY PNEUMONIA, ACUTE INFLUENZAL PNEUMONIA. Ninety-nine (99) cases of acute primary pneumonia were notified in 1935, as compared with 155 in 1934. Of the 99 cases, 58 were nursed in institutions. Thirty-three (33) cases of acute influenzal pneumonia were notified, as compared with 35 in 1934. Of the 33 cases, 16 were nursed in institutions. Fifty-two (52) cases of pneumonia of all kinds received nursing attention at home under the auspices of the Council's scheme for district nursing, 937 visits being paid. ANTHRAX. No case of this disease was notified during the year. ACUTE RHEUMATISM. This widely prevalent disease was made notifiable as from the 1st March, 1927, by virtue of the Paddington (Acute Rheumatism) Regulations, 1927. Paddington was the first area in Great Britain to make acute rheumatism notifiable. The above Regulations remained in force for a year and were extended to 31st March, 1930, from which date the disease, under further Regulations, became permanently notifiable in the Borough. During 1935, 18 oases of acute rheumatism were notified. This figure compares with 41 cases in 1934, 37 cases in 1933, 21 cases in 1932, 37 cases in 1931, 43 cases in 1930, 52 cases in 1929, 76 cases in 1928, and 34 oases for the ten months of the year 1927 during which the disease was notifiable. Acute rheumatism is defined in the Regulations as being the following conditions, occurring separately or together in a child under the age of 16 years:— (1) Rheumatic pains or arthritis, if accompanied by a rise of temperature; (2) Rheumatic chorea; (3) Rheumatic carditis. The Regulations enjoin the medical officer of health to make such enquiries and take such steps as are necessary or desirable for investigating the source of disease, for removing conditions harmful to the patient and arranging for the treatment of the patient. All these enquiries and any necessary action have been delegated to the "Rheumatism Supervisory Centre" which was opened at Paddington Green Children's Hospital on October 9th, 1926. During the year 1935, a grant of £100 was made by the Council towards the cost of the maintenance of the centre. The objects of this voluntary centre are:— (1) To meet the need shown by rheumatic cases for careful supervision during periods of apparent quiescence to prevent the development of heart disease. (2) To supervise rheumatic children, when apparently well, by periodical examinations, and to instruct the parents to consult their usual doctor or hospital should fresh symptoms of rheumatism develop. Treatment at the Centre itself is only given in urgent cases. (3) To instruct parents in the care of rheumatic children and to make investigations in Paddington into the causation of rheumatism. The Centre is under the personal supervision of one of the Honorary Physicians to the Hospital and there is also a salaried medical officer who devotes her whole time to visiting cases of the disease and making such enquiries as may elucidate the causes thereof. The work of the Centre lies with children who are suffering from rheumatism in any of its forms, whether slight or "acute'' as defined in the Regulations. 22 Paddington Green Children's Hospital Rheumatism Supervisory Centre. Report fob the Year 1935 by Reginald Miller, M.D., F.R.C.P., Physioian-in-Charge. Although since the beginning of 1936 there has been an increase in the amount of acute rheumatism seen amongst the children of Paddington, during the whole of 1935 the disease kept very mild, with consequent benefit to the children of the Borough. The Centre held 44 sessions during the year, meeting always on Saturday mornings. The total numbers of attendances by Paddington children amounted to 161. During the year 9 new cases attended, 5 of which were referred by the School Medical Service. 18 cases were notified during the year but none of these has yet attended the Centre. During the year 22 cases were discharged; 15 on account of being over age, 4 by reason of removal of their homes, two as being judged after prolonged observation as no longer needing advice, and one case died. These figures tend to show how much the Centre is appreciated by those who use it, as the number of children who lapse merely from parental slackness, remains, as it always has been, remarkably low. At the end of 1935 there were on the live register of the Centre 90 Paddington children attending regularly. The number of relapses amongst them during the year was satisfactorily small, and were all amenable to out-patient treatment. The women Sanitary Inspectors have paid 417 visits in connection with the work of the Centre, inspecting the home conditions of the new cases and keeping in touch with the old. All instances of damp in the homes have been reported to, and remedied by, the Medical Officer of Health. I acknowledge most gratefully the valuable work undertaken so promptly and punctually by the women inspectors; and should wish to call attention once more to the very successful regime provided for children with rheumatic heart disease in the special schools for the physically defective. I am also indebted to Dr. Mary Davies for her assistance throughout the year. CHOLERA, DYSENTERY, GLANDERS, HYDROPHOBIA, PLAGUE, RELAPSING FEVER, TYPHUS FEVER. Eleven cases of dysentery were notified during 1935, but there were no cases of the other diseases included in the heading. WHOOPING-COUGH. This disease is notifiable in only three London Boroughs and not in Paddington. Since both the cause of the disease and effective means for treating it are unknown it would not appear that notification could assist very much in checking it. Whooping-cough is very infectious in the catarrhal stage, before the characteristic whoop develops, and this adds to the difficulty in dealing with the disease. In 1935, 5 persons died of whooping-cough, all being children under the age of 5 years. The number of deaths in 1934 and 1933 were 11 and 5 respectively. FOOD POISONING. Section 7 of the London County Council (General Powers) Act, 1932, requires medical practitioners to notify cases of food poisoning or suspected food poisoning. During 1935 63 cases of illness, suspected to have been caused by food poisoning, were notified in the Borough. In no case was action considered necessary as regards the source of the food supply. In most of the cases there was no doubt that the illness was not "food-poisoning," but was due to personal idiosyncracy or to the results of some dietetic indiscretion. CANCER. Cancer is now one of the commonest causes of death. 235 deaths occurred among Paddington residents during the year. The numbers of deaths for previous years are shown in the list following:— Numbers of Deaths in Paddington. 1935 235 1934 222 1933 231 1932 254 1931 226 1930 278 1929 284 1928 260 1927 247 1926 239 1925 230 1924 234 1923 206 1922 191 1921 226 1920 194 1919 170 1918 164 1917 201 1916 205 1906 164 23 The following table furnishes an analysis of the sites affected in the fatal cases of cancer during the year. 1935. Cancer. Site of Disease. Ages. All Ages. 0— 15— 25— 35— 45— 55— 65— 75— M. F. M. F. M. F. M. F. M. F. M. F. m. f. M. F. M. F. Buccal cavity and pharynx — — — — — — — 1 — — 2 — 2 — — — 4 1 Digestive organs and peritoneum _ 1 _ _ 2 1 1 4 5 6 12 17 21 23 9 20 50 72 Respiratory organs — — — — 1 — — — 2 — 8 5 4 1 1 2 16 8 Uterus — — — — — — — 3 — 3 — 5 — 1 — — — 12 Other female genital organs — — — — — — — — — 1 — 4 — 4 — 1 — 10 Breast — — — — — — — 2 — 11 — 5 — 4 — 6 — 28 Male genito-urinary organs — — — — — — — — — — 5 — 5 — 6 — 16 — Skin — — — — — — — — — 1 1 — — — 1 — 2 1 Other or unspecified organs — — — — 1 — — — 2 3 2 1 1 — — 5 5 8 — 1 — — 4 1 1 10 9 25 30 37 33 33 17 34 94 141 INFECTIVE ENTERITIS. This disease is notifiable in some eight other metropolitan boroughs. On May 2nd, 1927, the Council made the disease known as "Infective Enteritis" or "Summer Diarrhoea," notifiable for a period of two years. This Order was made by virtue of the Public Health (London) Act, 1891. and is only applicable to children under the age of five years. It was extended in 1929 for a further period of three years. In 1932 the disease was made permanently notifiable. Eighty-one (81) cases of the disease were notified during the year. The number of deaths under the age of 5 years was 22, as compared with 44 in 1934, 33 in 1933, 103 in 1932, 29 in 1931, 29 in 1930, 37 in 1929, 23 in 1928, and 16 in 1927. Fifty (50) patients received treatment in various hospitals. TUBERCULOSIS. Tuberculosis of all kinds is notifiable, and particulars of the number of notification certificates received during the year 1935 are set out in the tables appended hereto. Owing to the fact that a case of tuberculosis may be notified in several boroughs or districts, the number of notification certificates received is only a very imperfect guide to the amount of tuberculosis in the Borough. There is also the consideration that notification is more strictly enforced in some districts than in others. However, recent alterations in procedure tend to make the number of cases on the tuberculosis register serve as a guide to the real prevalence of the disease. One can also take the annual number of deaths as being a measure of prevalence. This is probably the most exact method which can be used at the present time. From pulmonary tuberculosis there were 75 deaths in 1935, and from other tuberculous diseases there were 13 deaths. The number of deaths from tuberculosis of all kinds was 104 in 1933, 97 in 1934, and 88 in 1935, the latter figure creating a new low record. In recent years the numbers of deaths were as follows:— 1919 133 1920 146 1921 125 1922 143 1923 127 1924 149 1925 119 1926 125 1927 118 1928 116 1929 128 1930 114 1931 138 1932 122 1933 104 1934 97 1935 88 24 Public Health (Tuberculosis) Regulations, 1930. Summary of Notifications on Form A received during the year 1935. Tuberculosis of the Lungs. Other Tuberculosis. Male. Female. Total. Male. Female. Total. Primary Notifications— 0—1 year — — — 1 1 2 1—5 years — — — 8 3 11 5—10 ,, — 2 2 12 2 14 10—15 ,, 2 2 4 5 - 5 15—20 ,, 3 9 12 2 2 20—25 ,, 17 20 37 4 2 6 25—35 ,, 27 28 55 6 6 35—45 ,, 19 14 33 1 3 4 45—55 ,, 16 9 25 2 2 4 55—65 ,, 9 6 15 1 1 2 65 years and over 2 1 3 — — — Total 95 91 186 34 22 56 Cases re-notified 69 62 131 10 8 18 Total Notifications on Form A 164 153 317 44 30 74 Cases removed from Register:— 1935. By reason of— Death 79 Removal 290 Recovery of patient or variation of diagnosis 65 Total 434 Of the patients who removed from the Borough during 1935, the new addresses were obtainable in 116 instances, and particulars of the cases were transmitted to the medical officers of health of the respective districts. In 1935, 9 cases of patients who had removed into the Borough from other districts were added to the register. The number of cases remaining on the Tuberculosis Register at the close of 1935 was 1,033 as compared with 1,200 at the close of the year 1934. Visits Paid to Homes of Tuberculous Patients. By Council's Women Inspectors 1,104 By Tuberculosis Officers 453 By Dispensary Nurses— 20, Talbot Road 3,385 St. Mary's Hospital 2,076 7,018 Tuberculosis. New Cases and Mortality During 1935. Age Periods. New Cases. Deaths. Pulmonary. Non-Pulmonary. Pulmonary. Non-Pulmonarv. M. F. M. f. M. f. m. f. 0— — — 1 1 — — 1 — 1— 8 3 1 5— 2 12 2 1 — — 1 10— 2 2 5 — 15— 3 9 3 5 10 1 — 20— 17 21 4 2 25— 27 28 6 4 7 1 1 35— 19 16 1 3 7 4 1 45— 16 9 2 2 12 5 1 1 55— 9 6 1 1 9 6 1 1 65 years and upwards 2 1 — — 4 1 — 2 Totals 95 94 34 23 42 33 5 8 25 Twenty-six persons dying from tuberculosis during the year were not formally notified, this number being equal to 29.5 per cent. of the total tuberculosis deaths recorded. In all cases where it appeared necessary, inquiries were made as to the reason for the absence of notification. Public Health (Prevention of Tuberculosis) Regulations, 1925. By virtue of these regulations persons who are aware that they are suffering from tuberculosis of the respiratory tract may not enter upon any employment or occupation in connection with a dairy which would involve the milking of cows, the treatment of milk or the handling of vessels used for containing milk. Furthermore, if a local authority are satisfied that a person residing in their district who is engaged in any such occupation mentioned above is suffering from tuberculosis of the respiratory tract and is in an infectious state, they may by notice in writing require such person to discontinue his employment or occupation. No use has so far been made of these regulations. Supply of Beds and Bedding.—In certain instances, so that the separate sleeping of tuberculous patients may be arranged, beds and bedding are supplied on loan by the Council. Seven sets were so supplied during 1935 and three sets were returned following the removal of the patients. Shelters.—The Council possesses four shelters, which, on the recommendation of the Tuberculosis Officers, are lent to patients who are able to make use of them. No shelters were lent during the year, but one, lent in a previous year was still in use at the end of 1935. Artificial Pneumothorax Treatment.—By arrangement with various Hospitals patients recommended for this treatment are given refills at a cost to the Council of 10s. 6d. per refill. During 1935. 21 patients received 173 refills, the total cost amounting to £90 16s. 6d. Dental Treatment.—Dental treatment for tuberculous persons attending either of the Tuberculosis Dispensaries is provided at 20, Talbot Road, by the Committee of the Paddington Tuberculosis Dispensary, in return for a payment by the Council of the sum of £90 per annum. A Dental Surgeon is in attendance one half-day weekly. Arrangements have also been made for the supply of dentures by the Dispensary Committee. In connection therewith 4 patients were provided with full dentures, 5 with partial dentures, and in 4 cases repairs to dentures were carried out. The total cost was £40 10s. 6d. Grants amounting to £17 6s. Od. were made by the Council, the balance being contributed by the patients, approved societies, or other agencies. When patients are able to contribute towards the cost of their dentures, arrangements are usually made for payment to be accepted by instalments. Ultra Violet Light Treatment.—No applications were received during the year for the Counoil to bear financial responsibility for this form of treatment. Particulars of the dental work done during the year are shown in the subjoined table. Summary of Dental Treatment for the Year 1935. Particulars of Patients. Number of Fillings. Number of Scalings. Extraction Cases. Dentures. Number of Dressings. Number for Advice. Denture Visits. Number of New Patients. Number of Attendances. Simple. Root. Without Anaesthetic. Local Administration. Gas Administration. Number of teeth extracted. Upper. Lower. Re-models. Repairs. Women 152 11 — 15 1 2 26 90 11 10 — 5 — 33 61 24 Children 115 28 1 — — 6 32 90 — — — — 4 48 — 24 Men 38 — — 2 1 — 12 56 2 2 — 1 — 9 13 10 Total 305 39 1 17 2 8 70 236 13 12 6 4 90 74 58 Number of Sessions held = 45. 26 DISPENSARY TREATMENT OF TUBERCULOSIS. For administrative purposes the Borough is divided into two dispensary areas, the line of division passing down Inverness Terrace, Porchester Road, Ranelagh Road, Formosa Street to its junction with Shirland Road, and Shirland Road to its junction with Kilburn Park Road. The portion of the Borough to the east of this line is served by the St. Mary's Hospital Dispensary, and the portion to the west of the line by the Paddington Tuberculosis Dispensary. Paddington Tuberculosis Dispensary, 20, Talbot Road. This is a voluntary agency supported by voluntary subscriptions, and a grant from the Paddington Borough Council which last year amounted to £1,600. A full account of the Dispensary and its activities will be found in the annual reports for 1924 and 1925. During the year 162 X-ray examinations were made. Experience continues to confirm that an X-ray apparatus on the Dispensary premises is a necessity rather than a luxury, giving invaluable assistance in connection with the diagnosis of early cases, which is such an important factor in preventive work. Throughout the winter months certain delicate children have received artificial sunlight treatment with encouraging results. During 1935, 20 patients received this form of treatment, 322 exposures being given. Artificial sunlight treatment is not recognised as part of the approved scheme by the Ministry of Health and the London County Council. Parties of students from the London School of Hygiene attended the Dispensary on two occasions, when lectures were given by Dr. Harley Williams, Medical Commissioner of the National Association for the Prevention of Tuberculosis, and Dr. R. S. Walker, Tuberculosis Officer. By arrangements made between the Executive Committee of the Dispensary and the College of Nursing and the Battersea Polytechnic, Public Health students attend the Dispensary for short courses of practical experience of tuberculosis work. International Public Health students from Bedford College also attend for similar courses. The class which was established in 1931 for the manufacture of hand-made gloves by tuberculous women continues successfully. It is interesting to note that two patients have attended almost continuously since the class commenced. The Central Fund for the Industrial Welfare of Tuberculous Persons, under whose auspices this scheme was established, have no difficulty in disposing of the finished gloves as the work is of such good standard. Return Showing the Work of the Dispensary During the Year 1935. Diagnosis. Pulmonary. Non-Pulmonary. Total. Grand Total. Adults. Children. Adults. Children. Adults. Children. M. F. m. F. M. F. M. f. m. F. M. F. A.—New Cases examined during the year (excluding contacts):— 684 (a) Definitely tuberculous 41 35 — 1 4 11 14 3 45 46 14 4 (6) Diagnosis not completed — — — — — — — — — — 4 6 (e) Non-tuberculous — — — — — — — — 78 195 133 159 B.—Contacts examined during the year:— 191 (a) Definitely tuborculous 1 1 — — — 1 3 — 1 2 3 — (b) Diagnosis not completed — — — — — — — — — — — — (c) Non-tuberculous — — — — — — — — 40 56 39 50 C.—Cases written off the Dispensary Register as 764 (a) Recovered 2 5 — 1 — 2 2 2 2 7 2 3 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) — — — — — — — — 118 251 172 209 D.—Number of Persons on Dispensary Register on December 31st:— 648 (a) Definitely tuberculous 176 129 3 2 39 62 84 143 215 191 87 145 (b) Diagnosis not completed — — — — — — — — — — 4 6 27 1. Number of eases on Dispensary Register on January 1st 719 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 18 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of".. 171 4. Cases written off during the year as Dead (all causes) 29 6. Number of attendances at the Dispensary (including Contacts) 4,717 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 140 7. Number of consultations with medical practitioners:— (а) Personal (б) Other 62 200 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) .. .. .. .. .. 272 9. Numbor of visits by Nurses or Health Visitors to Homes for Dispensary purposes 3,385 10. Number of (а) Specimens of sputum, etc., examined (б) X-ray examinations made in connection with Dispensary work 260 162 11. Number of "Recovered" cases restored to Dispensary Register and included in A (a) and A (6) abovo 12. Number of "T.B. plus" cases on Dispensary Register on December 31st .. 170 St. Mary's Hospital Tuberculosis Dispensary. This dispensary is voluntary and was subsidised by a grant of £1,095 from the Paddington Borough Council during the year 1935. A full account of this Dispensary and its activities will be found in the annual reports for 1924 and 1925, the only subsequent change being the transference of the Dispensary in April, 1933, from the old building to the newly-erected extension of the Hospital. During 1935, 124 refills were done in Artificial Pneumothorax cases, as against 98 in the previous year. Return Showing the Work of the Dispensary During the Year 1935. Diagnosis. Pulmonary. Non-Pulmonary. Total. Grand Total. Adults. Children. Adults. Children. Adults. Children. M. F. M. F. M. F. M. F. M. F. M. F. A.—New Cases examined during the year (excluding contacts):— | 108 (o) Definitely tuberculous .. 20 18 2 2 — 5 5 1 20 23 7 3 (ft) Diagnosis not completed — — — — 1 2 — 1 13 24 6 8 B.—Contacts examined during the year:— | 50 (a) Definitely tuberculous — 2 — — — — 1 — — o 1 — (ft) Diagnosis not completed 4 17 16 10 C.—Cases written off the Dispensary Register as | 105 (o) Recovered — — — — 1 4 2 — 1 4 2 (ft) Non-tnberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) 17 41 22 18 D.—Nombeb of Persons on Dispensary Register on December 31st:— } 237 (a) Definitely tuberculous 66 60 » 6 17 33 19 23 83 93 28 29 (ft) Diagnosis not completed — — 1 2 — 1 28 1. Number of cases on Dispensary Registor on January 1st 253 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of" 67 5. Number of attendances at the Dispensary (including Contacts) 2,298 7. Number of consultations with medical practitionors:— (a) Personal 10 (b) Other — 9. Number of visits by Nurses or Health Visitors to Homes for Dispensary purposes 2,076 11. Number of "Recovered" cases restored to Dispensary Register and included in A (a) and A (6) above — 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 11 4. Cases written off during the year as Dead (all causes) 13 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 11 8. Number of visits by Tuberculosis Officers to homes (including personal consultations) 181 10. Number of (а) Specimens of sputum, etc., examined 102 (b) X-ray examinations made in connection with-Dispensary work 105 12. Number of "T.B. plus" cases on Dispensary Register on December 31st 79 The decrease in the number of cases on the Register of each Dispensary continues. Many patients and their families have taken advantage of the increasing opportunities to obtain better housing accommodation out of the district, and a large number of patients remove's to houses or flats on the London 'County Council Housing Estates. The Borough Tuberculosis Care Committee. The constitution of the Tuberculosis Care Committee for the year 1935 was as follows:— Representing. Paddington Borough Council „ „ „ „ „ „ „ „ „ „ British Red Cross Society Charity Organisation Society „ „ Insurance Committee Invalid Children's Aid Association London County Council „ „ Paddington Tuberculosis Dispensary „ „ „ „ „ „ „ „ „ Paddington and St. Marylebone War Pensions Committee Kensal House School Care Committee „ „ „ „ „ „ Paddington and St. Marylebone District Nursing Association Public Assistance Committee Area VI Panel Committee St. Mary's Hospital „ „ „ Red Cross Emergency Fund Local Social Worker „ „ „ Paddington and St. Marylebone Employment Committee .. Councillor E. G. Lee. Councillor T. Turner. Councillor Mrs. J. E. Wright. Dr. G. E. Oates, Medical Officer of Health. Miss D. Newhall, Sanitary Inspector. Miss E. Z. Amor, Sanitary Inspector. Miss A. V. Edden. Mrs. G. S. Warren. Miss Hugh Smith. Miss L. Sherman. Miss L. C. Streatfeild. Dr. R. H. Simpson (Divisional Medical Officer). Miss H. Bell (District Organiser of School Care Committees). Dr. R. S. Walker (Tuberculosis Officer). Nurse C. Griffin. Nurse A. B. Munro. Miss C. Milner. Mr. S. G. Last, J.P. (Chairman). Mrs. R. M. Drury, J. P. Miss E. M. Kerr. Miss A. M. Bennett. Councillor Mrs. K. Mahoney. Dr. S. Crown. Dr. A. B. Porteous (Tuberculosis Officer). Sister E. M. Phillips. Miss M. M. Barthorp. Mr. J. E. Bennison. Miss H. C. Davidson. Mr. A. E. Goss. Miss P. Simey was appointed in April (vice Miss Hugh Smith, resigned), and Mrs. C. Taylor in October (vice Councillor Mrs. K. Mahoney, resigned). The Medical Officer of Health continued to act as Honorary Secretary to the Committee. The social work of the Tuberculosis Care Committee is ancillary to the work of the Public Health Committees of the Borough Council and London County Council in tho sphere of the prevention and treatment of tuberculosis. The Committee met on 20 occasions during the year, and the attendance of members was well maintained. Two hundred and seventy-eight individual cases were considered. Residential treatment was granted by the London County Council to 201 patients, 44 of whom were children under the age of 16 years. In several instances help was sought from voluntary agencies for the patient or dependents. No funds are available in the hands of the Committee for the assistance of patients. 29 MATERNITY AND CHILD WELFARE. The staff engaged in maternity and child welfare work consists of a Superintendent Health Visitor, 10 whole-time Health Visitors, one of whom also acts as Infant Protection Visitor and one as Almoner for the Borough Council's Maternity Wards, 10 part-time Medical Officers, 3 parttime Masseuses, and I Clerical Assistant. Health Visitors. The duties of these officers are:— (1) To visit the homes of children from birth up to the age of 5 years where considered necessary. (2) To make enquiries concerning stillbirths and deaths of infants and young children. (3) To visit and give advice to parents in cases of ophthalmia of the new-born, infective enteritis and other important diseases. (4) To investigate all cases of puerperal fever and puerperal pyrexia. (5) To attend the maternity and infant consultations at the Centres provided by the Paddington School for Mothers. The home visiting work performed by the Health Visitors during the year is summarised in the appended table:— Health Visiting. First Visits to children under 1 year of age 1,714 Revisits ,, ,, ,, 6,532 8,246 Visits to children between the ages of 1 and 5 years 8,018 First visits to expectant mothers 1,099 Revisits ,, ,, 468 1,567 Other Visits— Sickness (including Puerperal Fever, Puerperal Pyrexia, Ophthalmia Neonatorum and Infantile Diarrhoea) 363 Miscellaneous (including 4,071 ineffective calls) 11,614 11,977 The total number of children on the Health Visitors lists at the close of the year was 4,977. Maternity and Child Welfare Centres. For many years the need of a more suitable headquarters for the carrying out of the maternity and child welfare work of the Borough has been apparent, emphasis on the necessity being referred to by the Minister of Health as a result of his investigations into the services during 1934. The present premises, 232, Harrow Road, have proved unsuitable and insufficient to cope with the growth of the staff and work, having been in use since 1910, when the then Paddington Health Society was divided into two distinct bodies, one to deal with tuberculosis and the other infant welfare. The latter was the Paddingdon School for Mothers. In June, 1934, the Council decided to proceed with a scheme for the provision of a well equipped Centre of modern type, but owing to the difficulty experienced in finding a suitable site, and to the prolonged negotiations in securing the Parsonage site near Lock Bridge (which was the one eventually decided upon), full proposals were not ready for submission to the Council by the end of the year. It is hoped that the Centre will be in use early in 1937. The existing Centres are provided by the Paddington School for Mothers, which is a voluntary society financed by voluntary contributions and by grants from the Paddington Borough Council. An annual contribution of £500 is made by the Council to the Paddington School for Mothers. This is provided for in the Scheme made by the Minister of Health under Section 101 (6) of the Local Government Act, 1929. The following is a brief account of the activities of the Paddington School for Mothers:— Centres (as in December, 1935). 232, Harrow Road, W.2.—Nine good rooms and Health Visitors' rest room, warmed by gas fires. Bath room. 30 Two Infant Consultations weekly.—Tuesday, 2.15 p.m. Medical Officer, Dr. Joyce R. Simpson. Thursday, 2.15 p.m. Medical Officer, Dr. J. Thoresby Jones. Area served:—Parts of Church, Harrow Road, Westbourne and Maida Vale Wards. One Maternity (Ante-and Post-Natal) Consultation weekly.—Monday, 10 a.m. Medical Officer, Dr. E. Dorothy Fenwick. Area served:—South Paddington. Consultative and Physical Treatment Consultation weekly. Tuesday and Thursday, 10 a.m. Medical Officer, Dr. R. Cove-Smith. Schick Testing and Diphtheria Immunisation Treatment weekly—Wednesday, 2 p.m. Medical Officers, Dr. R. Cove-Smith until 5th November, 1935, Dr. C. T. Potter thereafter. Artificial Sunlight Treatment and Massage are given twice weekly, Tuesday and Thursday, 10 a.m., by Miss Denny, C.S.M.M.G., Miss P. Smiddy, C.S.M.M.G., and Miss Suffiing, C.S.M.M.G., in conjunction with the Consultative and Physical Treatment Consultation under Dr. R. Cove-Smith "Toddlers" Clinic, twice monthly.—First and third Friday, 10 a.m. Medical Officer, Dr. C. T. Potter. Instruction in Maternal Hygiene (Ante- and Post-Natal), and in cutting out and making babies' clothes, together with a stall for the sale of babies' garments and woollies, Monday, 10 a.m. Area served:—All Paddington. St. David's Welsh Church Hall, St. Mary's Terrace, W.2.—Large hall, electrically heated, and doctor's room, guarded coal fire. Two Infant Consultations weekly.—Wednesday, 2 p.m. Medical Officer, Dr. Alexander S. Hall. Friday, 2 p.m. Medical Officer, Dr. Evelyn Maclagan. Special arrangements for toddlers once in three months. Friday, 2 p.m. Area served:—Church, Town and Hyde Park Wards. Christ Church Parish Rooms, Queensborough Passage, Porchester Terrace, W.2.—Two large rooms, doctor's room and sales room warmed by electricity and coal fires. One Infant Consultation weekly.—Monday, 2 p.m. Medical Officer, Dr. E. Dorothy Fenwick. Special arrangements for toddlers once in three months. Monday, 2 p.m. Instruction in Invalid Cookery, Knitting, etc., is given by a qualified Voluntary Worker. Monday, 2 p.m. Area served:—Lancaster Gate East and West Wards and part of Westbourne Ward. Congregational Institute, Third Avenue, Harrow Road, W.10.—Large room, doctor's room and sales room warmed by gas radiators and hot pipes. Large outer room for perambulators, etc. Two Infant Consultations weekly.—Tuesday, 2 p.m. Medical Officer, Dr. E. Dorothy Fenwick. Friday, 2 p.m. Medical Officer, Dr. S. Denovan Adam. Special arrangements for toddlers once in three months. Tuesday, 2 p.m. Area served:—Queen's Park Ward and part of Harrow Road and Westbourne Wards. St. Simon's Parish Hall, Macroom Road, Saltram Crescent, W.9.—Large hall, doctor's room and weighing room warmed by gas radiators and gas fires. Two Infant Consultations weekly.—Wednesday, 2 p.m. Medical Officer, Dr. J. McKail. Thursday, 2 p.m. Medical Officer, Dr. Hubert Hodge. Area served:—Maida Vale Ward and part of Harrow Road Ward. One Maternity (Ante- and Post-natal) Consultation weekly.—Thursday, 10 a.m. Medical Officer, Dr. E. Dorothy Fenwick. Instruction in Maternal Hygiene (Ante- and Post-Natal), and in cutting out and making babies clothes, together with a stall for the sale of babies garments and woollies.— Thursday, 10 a.m. Area served:—North Paddington. In March, a special "Toddlers" Clinic was inaugurated, being held twice each month at 232, Harrow Road. Dr. C. T. Potter was appointed Visiting Medical Officer. At each Infant Consultation Centre there is a stall for the sale of babies' woollies, etc. 31 Dental Arrangements.—Mr. F. H. Brinkley Tofts, L.D.S., R.C.S., 281, Harrow Road, treats mothers and children who attend Centres, on special terms. Financial assistance from private funds of the School for Mothers is given in many cases. Dental Treatment can also be obtained for mothers and children from Paddington Centres, at the local Hospitals, and at the Eastman Dental Clinic, Royal Free Hospital, Gray's Inn Road. Lectures on Health Topics are provided weekly at each Centre by the Health Visitors. Co-operation with Personal Service League.—Grants of clothes for cases recommended by Health Visitors are received at No. 232, Harrow Road, W.2, for distribution. Convalescent and, Holiday Homes.—Mothers and children are sent to Convalescent and Holiday Homes on the recommendation of Medical Officers at Centres. Financial assistance is given in many cases by the Borough Council for nursing mothers and their babies. In some other cases assistance is obtained from private sources. The Vest Fund is maintained by a small Association of Ladies connected with the School, who knit garments and woollies which are sold at low cost to mothers at the Centres. The stock of clothing and the financial balance are augmented by gifts from friends, and the money realised is spent on dentures, convalescence, etc., already referred to. Consultation Centres. Summary of Work for the Year 1935. Harrow Road. Third Avenue. Macroom Road. St. Mary's Terrace. Queens- boro' Passage. Totals. Tues. Thurs. Tues. Fri. Wed. Thurs. Wed. Fri. Mon. Number of Sessions 51 50 49 49 51 49 51 51 48 449 Number of Attendances 2458 1552 3356 2566 2659 2220 2312 3033 3853 24009 Average Attendance 48.2 31.0 68.5 52.3 52.1 45.3 45.3 59.4 80.2 53.4 Seen by Doctor 1169 689 1449 959 831 790 886 1211 1605 9589 Average number seen by Doctor at each Session 22.9 13.7 29.5 19.5 16.2 16.1 17.3 23.7 33.4 21.3 The total number of children attending the consultations was 2,469, 1,120 being under 1 year of age and 1,349 between the ages of 1 and 5 years. Ante-Natal and Post-Natal Clinics. Harrow Road. Macroom Road. Number of Sessions 48 SO Number of Attendances 681 460 Number of Expectant or Recently Confined Mothers who Attended 327 187 Average Attendance per Session 14.1 9.2 Number of Cases Referred by Midwives in Private Practice 20 25 Consultative and Physical Treatment Centre. Number of Attendances 2,981 Number of Cases 211 (of which 162 were new) Classification of Cases— Artificial Sunlight only 51 Artificial Sunlight and Massage 66 Massage only 68 Dietetic only 26 Treatments given— Artificial Sunlight 1,352 Massage 2,106 The following report has been received from Dr. R. Cove-Smith on the work carried out at the Centre:— The Consultative and Physio-Therapeutic Centre held at 232, Harrow Road, on Tuesday and Thursday mornings has carried out a very satisfactory year's work during 1935. The number of attendances almost reached the 3,000 mark, spread over 211 cases. One hundred and sixty-two new cases were seen during the year and the types of treatment given fall into the following categories:— 32 Dietetic only 26 Massage only 68 Dietetic, U.V.L. and Massage 66 Dietetic and U.V.L. 51 211 More than two thousand (2,106) massage treatments were given and 1,352 Artificial Sunlight exposures carried out, which bears adequate testimony to the organisation and efficiency of the workers concerned. Cases of frank rickets have been fewer in number, which may be due in part to the fact that public education in the use of anti-rachitic measures is beginning to bear fruit and also to the fact that the milder cases can be satisfactorily dealt with at the Welfare Centres. The number of children with deformities requiring treatment has definitely increased and particularly is this so in the case of Tortcollis or wry-neck. I do not consider this to be due to any actual increase in the oases but rather to a more rapid appreciation by those in charge of children of the benefits to be obtained from physio-therapeutic measures. It is certainly encouraging to find the scope of the centre increasing as a result of the active co-operation of all health workers in the Borough. Queen Charlotte's Maternity Hospital.—During the year 1935, 106 infants of mothers resident in Paddington attended the Infant Consultation Centre. The average number of attendances per infant was 10. During 1935 there were received into the Hospital for confinement 172 women from Paddihgton, and 272 Paddington women were delivered in their own homes by midwives from the Hospital. The average attendance of these patients at the Ante-natal Clinic was approximately 8. St. Mary's Hospital.—There is no Infant Consultation Centre at this Hospital but in addition to the ordinary ante-natal consultations one is specially held each week for women who have booked beds in the Borough Council's Maternity Wards at the Hospital. The number of attendances at than Clinic during the year was 1,290 by 239 women. No definite figures are available as to the number of Paddington women who attended the ordinary ante-natal consultations but the number of confinements attended by the Hospital extern staf in the Borough was 97 and presumably all of these received examination and advice there. Maternity Nursing.—The arrangement whereby the Paddington and St. Marylebone District Nursing Association provides the services of trained maternity nurses in connection with lying-in cases attended by the students and the Medical Officer of the Extern Midwifery Department of St. Mary's Hospital, continued in operation throughout the year. The results of this arrangement are excellent although it is not possible to adduce any figures in support of this statement. During the year 1935, 97 confinements were attended by the nursing staff, the number of visits being 2,024. These figures compare with similar ones of 109 and 1,863 in the year 1934. The annual grant in aid of this work is now £175. Maternity Wards.—Under an agreement made with the Board of Management of St. Mary's Hospital, a suite of wards containing 14 beds became available in the Hospital on the 1st April, 1933, for patients accepted for admission by the Borough Council. The agreement is for a period of five years and provides for payment to be made to the Board at the rate of 9s. per day for each bed, whether occupied or not, the annual amount being approximately £2,300. The following scale has been adopted by the Council for the assessment of cases for admission to the maternity wards, subject to such variation as the Maternity and Child Welfare Committee deem necessary or desirable, having regard to the financial position of the family. The charges specified are based on the assumption that the applicant will receive one maternity benefit only, and that the family consists of not more than one child:— Where the amount of family income (after deducting rent and insurance) is under £2 Os. Od. the charge to be fixed by the Committee. ,, ,, is between £2 0s. Od. and £2 10s. Od. the minimum charge per case to be £3 Os. Od. ,, ,, ,, £2 10s. Od. and £3 0s. Od. ,, ,, ,, £4 0s.0d. ,, ,, ,, £3 0s. Od. and £3 10s. Od. ,, ,, ,, £5 Os. Od ,, ,, ,, £3 10s. Od. and £4 0s. Od. „ ,, ,, £6 0s.0d. Where there are two maternity benefits and the father is in regular employment, an endeavour will be made to recover a maximum fee of £8 8s. Od. per case. A booking fee of 10s. will be charged in each case which will be taken in part payment of the scale fee. 33 In consideration of a further payment at the rate of £100 per annum, the Hospital Authorities agreed to provide the part-time services of an almoner for duties in connection with the assessment and collection of charges for the use of the maternity wards. This arrangement ceased on the 31st March, 1935, and since that date the duties of the Maternity Wards Almoner have been allocated to Miss Hill, one of the Council's Health Visiting Staff. During the year, 274 women were delivered in the wards. Two cases of puerperal fever and 7 of puerperal pyrexia were notified. There were 6 stillbirths, and 5 deaths within 10 days of birth. The payments made by patients admitted, or accepted for admission, to the wards amounted to £647 0s. 0d. for the year. Midwifery Service.—In March, 1932, the Council authorised the Maternity and Child Welfare Committee to make arrangements for the provision of a qualified midwife to attend emergency maternity cases at an estimated cost of £10 per annum. This service is undertaken by the Paddington and St. Marylebone District Nursing Association at a fee of 30s. per case. One patient was attended, the charge being met by the Council. Under a further arrangement the midwifery staff of the Nursing Association attend, on behalf of the Council, certain women in their own homes who, for various reasons, are unable to go to an institution for their confinements. Payment is made at the rate of £3 3s. 0d. per case, the whole or part of the cost being recovered from the patients. During 1935, 36 cases were attended, the patients' contributions collected to the end of the year amounting to £43 0s. 6d. Maternity Consultations.—On 2 occasions the services of an obstetric consultant were requisitioned on account of complications associated with cases of parturition. Maternity Outfits.—Supplies of Maternity Outfits have been made available for confinement at home of necessitous women. In some instances the total cost (5s. 11d.) has been repaid by the recipient, but grants have been made in most cases by the appropriate Committee towards the cost. The total amount recovered from patients during the year has been £6 4s. 1d. Contraceptive Advice.—In June, 1934, the Council decided that arrangements be made with the North Kensington Women's Welfare Centre for the giving of contraceptive advice to expectant and nursing mothers who are married and who are already in attendance at a maternity and child welfare centre of the Council, such advice to be given only in cases where another pregnancy would be detrimental to health. The recommendations of the medical officers of the Centres are submitted to the appropriate Sub-Committee and where considered necessary, grants towards the cost of the advice (10s.) are made. During the year 39 necessitous women were referred to the Centre for advice, the cost in each case being borne by the Council. X-Ray Examinations.—Arrangements were made during the year with the Paddington Tuberculosis Dispensary for the use of their facilities for X-ray examinations of expectant mothers and of children attending the Ante-natal and Welfare Centres. 14 examinations were made during the year, 7 being of expectant mothers and 7 of children, the fee for the former cases being 15s. and for the latter 7s. 6d. per patient. Unmarried Mothers and Their Children.—With a view to securing closer supervision of unmarried mothers in the early days of motherhood and where desirable affording facilities for breast feeding of their infante, the co-operation of the Paddington and St. Marylebone Ladies Association for Rescue and Preventive Work has been enlisted and the Council make grants to the Association towards the cost of detaining in their Homes for varying periods such unmarried mothers and their babies. Three cases were assisted during the year by grants amounting to £12 18s. 0d. Baby Hospital, Ladbroke Square.—The Council, on the 21st March, 1933, decided to make provision of four beds at the Baby Hospital, Ladbroke Square, for the reception of ailing infants recommended for treatment there by the Medical Officers of the Council's Welfare Centres, at a cost of £400 per annum. The beds became available on the 1st May in that year. On the 1st April the number of beds was reduced to 2, and the grant therefor to £200 per annum. Ten (10) children were admitted during the year, and one re-admitted, the periods of treatment ranging from 24 weeks to 2 weeks. One (1) death occurred amongst these patients. Special attention is paid by the Medical Officers of Centres, and the Health Visitors, etc., to children after their discharge. Every case admitted is reported to the Grants Sub-Committee and where considered necessary the parents are assessed to pay a small weekly sum towards the cost of maintenance, etc., in Hospital. The total sum recovered during the 12 months amounted to £2 16s. 6d. Beauchamp Lodge Emergency Home for Children.—Arrangements can be made for the admission of children to this home whilst the mothers are in hospital. The charge therefor is 12s. 6d. per week per child. In no case during the year was it necessary to take advantage of the facilities. 34 DAY NURSERIES. At the end of the year 1935, there were two Day Nurseries in Paddington, situated at No. 66 Laucefield Street, Queen's Park, W.10, and No. 21, Howley Place, W.2. Statistical Summary . Queen's Park. Howley Place. Full days. Saturdays. Full days. Saturdays. Days open 252 50 254 50 Attendances 4,925 1,271 8,855 1,292 Average attendance 19 25 34 25 New Children 30 32 Cases of Infectious Disease. Scarlet Fever 2 Measles - 1 Impetigo - — Whooping Cough 2 4 Mumps 1 — Chickenpox 2 — There were no Closures during the Year on Account of Infectious Disease. The premises of the Queen's Park Day Nursery at No. 66, Lancefield Street, are owned by the Council. The Scheme made by the Minister of Health under Section 101 (6) of the Local Government Act, 1929, provides for the annual payment of contributions from the Council, to the Paddington Day Nursery, £377, and to the Queen's Park Day Nursery, £252. A supplemental contribution of £50 was made by the Council to the Queen's Park Day Nursery in respect of the year 1935. The need for additional Day Nursery accommodation in the Borough has been realised for many years and with a view to making further provision the Council has obtained from the London Young Women's Christian Association a lease of a large portion of the building known as St. John's House, Great Western Road. Somewhat extensive alterations and decorations were in hand at the end of the year and the opening of the Westbourne Day Nursery is expected to take place in April, 1936. Accommodation up to 75 children can be provided. PROVISION OF MILK FOR NECESSITOUS MOTHERS AND CHILDREN. Scheme Adopted by the Borough Council. (1) The supply of milk at less than cost price to be limited to necessitous cases of (a) Nursing mothers, actually feeding their children; (b) Expectant mothers after the fifth month of pregnancy; and (c) Children under the age of three years. Provided that where specially certified by the Medical Officer of Health to be necessary on grounds of health, such supply may be granted in respect of a child between the ages of three and five years. (2) The amount of milk to be supplied to any mother or child not to exceed one pint per day, but if specially certified by the Medical Officer of Health to be necessary for the child's health the amount supplied to a child aged from three to eighteen months may be increased to one and a half pints per day. (3) All applications for a supply of milk at less than cost price to be made on the prescribed Form known as "M.C.W.3," such Form to be signed by both parents whenever practicable. (4) Any application for the supply of milk at less than cost price which is not supported by a medical certificate in the prescribed form signed by a Medical Officer of one of the Consultation Centres maintained by the Paddington School for Mothers on behalf of the Borough Council, to be approved by the Medical Officer of Health. (5) On the receipt of an application for the supply of milk at less than cost price. a visit to be made to the home of the applicant. A report of the home conditions, health of children, etc., will be entered on Form "M.C.W.3." 35 (6) Where deemed necessary the income of the applicant's family as stated in Form "M.C.W.3" to be verified in the usual manner by the Investigation Ofiicer. (7) The "Grants" Committee is a Sub-Committee of the Maternity and Child Welfare Committee. All applications for supply of milk at less than cost price to be reserved for consideration by the "Grants" Committee and, except as hereafter provided, no supply to be granted until the application has been considered by the " Grants " Committee. (8) In considering an application for a supply of milk at less than cost price the "Grants" Committee to adhere to the scale of incomes set out in the Schedule appended to this Scheme. Provided that where the "Grants" Committee are of opinion that a strict adherence to the Schedule would deprive any mother or child of a supply of milk really necessary on grounds of health, the Committee may take into consideration any other facts of the case, and make their decision accordingly. No grant to be made for a period exceeding four (4) weeks. (9) Where the Medical Officer of Health certifies that an immediate supply of milk at less than cost price is necessary on grounds of health to any mother or child, he may issue an Emergency Order for such supply for a period sufficient to include the interval which will elapse before the next meeting of the "Grants" Committee. (10) Orders for the supply of milk at less than cost price to be in the prescribed form and no payment for any such supply to be made except upon production of the receipt of supply signed by the applicant. (11) Orders for the supply of milk at less than cost price to be issued only to such dairymen or milk purveyors as maintain their premises in accordance with the Milk and Dairies Order, 1926. The names of all purveyors of milk who are warned or prosecuted by order of the Public Health Committee for breaches of the Milk and Dairies Order, 1926, or for offences against the law as regards adulteration, etc., shall be reported to the Maternity and Child Welfare Committee, who will decide whether orders shall be placed with such purveyors of milk. (Samples will be taken periodically of the milk supplied under any order issued under this Scheme.) (12) Stock books showing orders for the disposal of all forms of dried milk and of other preparations of milk to be kept by the Public Health Department, and stock to be taken monthly at each Consultation Centre maintained by the Paddington School for Mothers which acts as the distributing agent for the Borough Council. (13) No grants of milk or milk substitutes at less than cost price to be made to families in receipt of Poor Law Belief. (14) "Pasteurised" milk to be supplied to recipients of milk grants, provided that the medical officers engaged at the several infant welfare centres of the Paddington School for Mothers shall be authorised, in special cases, to recommend the supply of "Grade A (Tuberculin Tested)" milk, such supplies of "Pasteurised" and "Grade A (Tuberculin Tested)" miik to be in accordance with the terms and conditions prescribed in the Milk (Special Designations) Order, 1923. (15) Grants of oil and malt, etc., to be supplied to necessitous mothers or children who may be in receipt of milk grants from the Council, or who, in the opinion of the Superintendent of a Centre, are unable to pay for an emergency issue deemed necessary by the Medical Officer. Schedule . Scale of Income for Grants. Basis.—Total income of family, less rent, divided by number of persons living on said income. In determining the number living on income include dependants living at home in addition to man, wife and their children. Number of family. Free. Half-Price. Total Income less Rent. Average Per Head. Total Income less Rent. Average Per Head. s. d. s. d. s. d. s. d. 1 16 0 15 0 18 0 18 0 2 20 0 10 0 24 0 12 0 3 25 6 8 6 27 0 9 0 4 30 0 7 6 34 0 8 6 5 32 6 6 6 37 6 7 6 6 36 0 6 0 42 0 7 0 Families of more than six persons to be dealt with according to their circumstances. (Paragraph 8 of Scheme.) 36 The arrangements for administering the Scheme are as follows:— Applications for Grants.—Applicants for grants are referred to the Town Hall by, amongst others, medical practitioners, the staffs of the welfare centres, the health visitors, relieving officers, maternity and general hospitals and various public and charitable institutions. Procedure.—Before any case is considered the Medical Officer of Health must be satisfied that the supply is necessary on grounds of health. In the case of an expectant mother the existence and duration of pregnancy must be verified by the signature of a doctor or midwife. The quantity of milk authorised varies with the need of the mother or infant concerned. Usually, one pint per day is granted to an expectant mother and to a nursing mother, unless she be nursing twins, when up to one quart is allowed. The bottle-fed baby, also, normally has the same quantity up to about the sixth month of its age, but thereafter this is increased to l½ or 2 pints per day when the necessity is certified by the medical officer of a Welfare Centre. The "Grants" Sub-Committee now make a practice of insisting on the attendance periodically of the infants on grant at one or other of the welfare centres and the issue of at least one medical certificate of necessity every three months. Applications are made at the Public Health Department, when particulars of the circumstances of the family are obtained. Whenever considered necessary, wages, etc., are verified from the employer, and other enquiries instituted by the investigation officer. Close touch is also maintained with all other sources of assistance. All new cases are considered by the "Grants" Sub-Committee, and in addition expiring grants are brought forward for re-consideration, together with a report by the health visitor on the condition of the mother or child in receipt of the grant and a note by the investigation officer dealing with financial or other circumstances at that juncture. Generally, renewals are made for four weeks, discretion being given to the investigation officer to issue orders up to that period for one, two or three weeks as he may consider advisable. Pending a sitting of the "Grants" Sub-Committee the Medical Officer of Health may authorise emergency grants. Grants take one or other of the following forms:— (a) Fresh Milk—to expectant or nursing mother or a child under 5 years of age (see first paragraph) on an order issued on the dairyman usually supplying the family; (b) Dried Milk—supplied at the Welfare Centre attended by the infant; (c) Dinners (cut from joint, two vegetables and milk pudding)—to expectant or nursing mother partaken at approved restaurant; (d) Accessory Foods—Oil and malt, etc. The necessary orders are despatched direct to the tradesman and a copy sent or handed to the grantee. On the grantee's copy the following conditions are printed:— Milk supplied under this order is to be used only for the mother or child to whom the milk has been granted. It is not to be given to other members of the family. The Medical Officer of Health should be informed at once if there be:— (1) Any change whatever in workplace or income of any member of the family; (2) Any change of address; (3) Any assistance received from the Relieving Officer. Particulars of Milk Grants During 1935. (1934 figures in brackets.) The total number of cases considered by the "Grants" Sub-Committee during the year was 2,813, of which 767 represented new applications. These latter were divided up as follows:— Number of New Applications. Fresh Milk 673 (744) Dried Milk 87 (118) Dinners 7 ( 5) 767 (867) Granted. 582 (579) 87 (118) 7 (5) 676 (702) Refused, withdrawn or referred to Public Assistance Committee. 91 (165) - (-) -(-) 91 (165) 37 Details relating to expenditure incurred are given below:— £ s. d. £ s. d. Cost of Milk at Full Price 828 6 2 (737 15 0) Cost of Milk at Half Price 15 4 11 (6 3 10) Cost of Dried Milk at Full Price 154 3 9 (150 12 3) Coat of Dried Milk at Half Price 18 8 (3 14 8) Cost of Dinners 27 18 9 (7 11 3) £1026 12 3 (£905 17 0) Supply of DRied Milk, Etc., at Consultation Centres. £ s. d. Purchases of Dried Milks, Drugs, etc. 1,380 12 8 Sales 1,123 12 3 Grants from Borough Council 273 15 6 The reception into the Borough of a large number of migratory necessitous families, referred to in previous Reports, would appear to persist. Four hundred and seventy-five (475) families hitherto unknown to the Department applied for grants during the year. INVALID CHILDREN'S AID ASSOCIATION. A grant of £10 in aid of the funds of the local branch of the Invalid Children's Aid Association was made. CONVALESCENCE. Eleven cases of nursing mothers with babies were referred for convalescence at a cost to the Council, after deducting contributions by patients, and from other sources, of £20 19s. 0d. In 28 instances the Council made grants towards the cost of children convalesced by the Invalid Children's Aid Association. The amount paid by the Council to the Association during the year for the convalescing of children was £95 10s. 3d MATERNAL MORTALITY. During the year six maternal deaths were enquired into by Dr. E. Dorothy Fenwick, the Council's medical investigator, and reports thereon forwarded to the Ministry of Health. INFANT LIFE PROTECTION. In pursuance of the Transfer of Powers (London) Order, 1933, the duties of the London County Council in connection with infant life protection were transferred to the Borough Council as from the 1st April, 1933. These duties are laid down in Part I of the Children Act, 1908, as amended by Part V of the Children and Young Persons Act, 1932, and relate to:— (a) Reception of notices given by persons who undertake for reward the nursing and maintenance in a dwelling of infants; (b) Inspection of premises by Infant Protection Visitors, or other persons appointed by the Council for that purpose; (c) Fixing the number of infants to be kept in a dwelling in which any infant is received for reward. (d) Application to a Court or Justice for an Order directing the removal of an infant to a place of safety. Miss M. E. Lockington acted as Infant Protection Visitor until her retirement in June. In July Miss M. A. MacLean was appointed to the dual office of Health Visitor and Infant Protection Visitor, her duties in the latter respect occupying three-fourths of her time. In addition other Health Visitors act as occasion requires and the Medical Officer of Health and two of the Sanitary Inspectors are also authorised to exercise the powers and duties of Infant Protection Visitors for special purposes. During the year 1935, 1,762 visits and inspections were made, 41 new registrations of fostermothers were recorded, 77 new infants were received, and 59 infants were removed—14 to hospital and 45 elsewhere. No deaths were reported. At the close of the year, the Register contained the names of 103 persons who were receiving children for reward. These persons had charge of 128 children. Section 11 of the Children Act, 1908, exempts from the provisions of the Act certain approved hospitals or institutions undertaking the nursing or maintenance of children under 9 years of age. During the year certificates of exemption were issued in conformity therewith to the following:— The Paddington Green Children's Hospital, W.2; The London Lock Hospital and Home, 283, Harrow Road, W.9; The Spanish and Portuguese Jews' Orphanage, 2, Ashworth Road, W.9; The Convent of the Sisters of the Church and Orphanage of Mercy, Randolph Gardens, N.W.6; The Victoria Orphanage Church Extension Association, 111, Shirland Road, W.9; and the Beauchamp Lodge Emergency Home for Children, Beauchamp Lodge, 2, Warwick Crescent, W.2. 38 ADMINISTRATION. Staff of the Department.—A complete list of the Staff of the Department appears on page 4. The following changes occurred during the year. Inspectorial. Mr. L. G. Brooks resigned on the 24th February and Mr. F. L. Barker was appointed in his stead on the 30th April. The appointment of Mr. J. S. Ackerman as a Sanitary Inspector on the 28th May brought the number of permanent Inspectors to 10. At the end of 1934 three temporary Sanitary Inspectors were engaged on special Housing work, but during the year 1935 this number was increased to six, two being allocated to special inspections in Westbourne Ward, and one to inspections under the Shops Act. The holder of this latter appointment, however, resigned in October, and thereafter his duties were carried out by the District Inspectors. There were thus five temporary Sanitary Inspectors on duty at the end of 1935. Health Visiting. Miss E. Elsley, part-time Health Visitor, resigned on the 14th May, and Miss M. E. Lookington, Infant Protection Visitor and Health Visitor, resigned on reaching the age limit on The 27th June. Miss C. Mc.N. Keachie resigned her position as Health Visitor on the 31st August. Miss M. A. MacLean was appointed Infant Protection Visitor and Health Visitor on the 30th July; and Miss H. S. Beattie and Miss D. K. Newington were appointed Health Visitors on the 30th July and 29th October respectively. Miss N. M. Hill, Health Visitor, was appointed in a part-time capacity to act as Almoner for the Borough Maternity Wards, vice Miss Meers, of the St. Mary's Hospital Staff, who resigned in March. Visiting Medical Officer. Dr. C. T. Potter was appointed Visiting Medical Officer of the newly-instituted "Toddlers" Centre at 232, Harrow Road, in March, and of the Diphtheria Immunisation Clinic, vice Dr. R. Cove-Smith, resigned, in October. Clerical. Mr. E. E. Gower, Chief Clerk of the Department since 1902, died on the 24th June. Mr. T. F. Dunning, who has been in the service of the Council since 1902, was appointed Chief Clerk. Prevention of Infectious Disease.—Visits of enquiry after notification of infectious disease numbered 1,899. This figure excludes visits in connection with tuberculosis, puerperal fever and pyrexia, ophthalmia neonatorum and infective enteritis, which are recorded elsewhere in this report. The removals to hospitals and other institutions for various diseases other than tuberculosis numbered 682. In connection with the arrangement between the Council and the Paddington and St. Marylebone District Nursing Association, 61 patients (comprising 5 cases of measles, 52 of pneumonia, 2 of ophthalmia neonatorum and 2 of whooping cough) were visited in their homes by the nurses of the Association. The visits paid to such patients numbered 1081. Disinfection.—The rooms disinfected after infectious disease numbered 960. The weight of bedding, etc., removed for disinfection at the Wood Lane Disinfecting Station, under the agreement with the Kensington Borough Council, amounted to approximately 17½ tons. Two hundred and forty-six library books were disinfected. Schools.—A total of 1,223 notices relating to cases of infectious disease was despatched to the Head Teachers of the various schools attended by patients or their "contacts," 683 of such notices referring to cases of measles and chicken-pox, and the remainder to cases of diphtheria, scarlet fever and other notifiable diseases. In addition, 245 reports were sent to the medical officers of health of other boroughs in connection with cases attending outlying schools. Bacteriological Work.—The Council have an arrangement with the Royal Institute of Public Health, 23, Queen Square, W.C.I, for the bacteriological examination, at the expense of the Council, of specimens sent by medical practitioners from Paddington patients suspected to be suffering from diphtheria or typhoid fever. 39 All specimens are collected at the Town Hall and transmitted to the Institute by special messenger. The results are generally available the next morning, and are telephoned to the medical practitioner concerned. Examinations of sputa from patients suspected to be suffering from tuberculosis of the lungs are undertaken by the Paddington Tuberculosis Dispensary, 20, Talbot Road. The examinations made during 1935 were as follows:— Disease suspected. Number of Examinations. Number of Positive Results Diphtheria 1,006 108 Tuberculosis 253 36 Typhoid Fever 6 — Food Poisoning 1 — House Drainage.—During the year 13 existing drains were tested and found water-tight, and 153 defective drains were wholly or partly reconstructed. Reconstruction Plans.—Four hundred and sixty-two (462) plans were submitted for drainage works in existing buildings. In connection therewith 1,126 letters were despatched. Seven summonses were issued for failure to supply plans. Combined Drainage.—Orders were made under Section 74 of the Metropolis Management Act, 1855, with respect to new drainage systems to which the following groups of houses were to be connected:— Edgware Road, Nos. 291 and 293. Cleveland Square, Nos. 28 and 29. Gloucester Terrace, Nos. 42 and 44. Harrow Road, Nos. 304 and 306 and Woodchester Street, Nos. 1 and 3. Harrow Road, Nos. 357 to 369 (odd) and Fermoy Road, Nos. 14, 16 and 18. New block of residential flats or building situate on the west side of Lancaster Gate Terrace, and on the sites now numbered and known as Nos. 1 and 2, Lancaster Gate Terrace. New Indoor Bowls Pavilion, Winter Garden and Squash Court situate on the west side of Castellian Road, and on the site at the rear of Nos. 2 to 50, Castellian Mansions and Nos. 1 to 24, Delaware Mansions. New licensed premises or building situate on the west side of Bouverie Street, and on the site now numbered and known as Nos. 14, 15, and 16, Bouverie Street. Bark Place, Nos. 2 and 3, and Caroline Place, No. 26. Leinster Square, Nos. 38, 39 and 40, and Nos. 17 and 18. Porchester Terrace, No. 38, and Shakespeare Garage, Queensborough Passage. Stanhope Place, No. 6, and Frederick Close, No. la. Westbourne Terrace, Nos. 158 and 159, and Nos. 29 and 31. Sussex Gardens, Nos. 17 and 19, Nos. 21 and 23, Nos. 43, 45 and 47, and Nos. 67 and 69. Gloucester Terrace, Nos. 75 and 77. Sutherland Avenue, Nos. 92 and 94. Westbourne Street, Nos. 21 and 22, and Sussex Mews West, Nos. 10 and 11. Richmond Road, Nos. 23, 25 and 27. Amberley Wharves, Nos. 5 and 6. Caroline Place Mews, Nos. 7 and 8. Desborough Street, Nos. 6 and 7. Harrow Road, Nos. 494 and 496. Kilburn Lane, Nos. 312 and 314. Queens Road, Nos. 14 and 16. No combined systems were reconstructed by the Council during the year. Sewer Connections.—In 1935, 30 were reconstructed, either partially or wholly, 4 after Orders under Section 85 of the Metropolis Management Act, 1855, and 22 on the application of the owners of the properties concerned. Water Supply.—Six certificates under Section 48 of the Public Health (London) Act, 1891, were issued. The Metropolitan Water Board reported 10 cases of discontinuance of water supply for non-payment of rates. Three of the premises were unoccupied. In the remaining cases the water supply was restored after various intervals, ranging from one day to four weeks. 40 Mortuary.—Six hundred and eight (608) bodies were deposited at the Mortuary, inquests being held on 443 of that number. Bodies deposited pending burial (all non-infectious) numbered 21. Three hundred and seventy-two (372) post-mortom examinations were made. Trade Nuisances.—Twelve (12) complaints were received during the year, those relating to manure numbering 3. Removal of Manure.—Section 36 (2) of the Public Health (London) Act, 1891, empowers the local authority to give notice requiring the periodical removal of manure from stables, etc. With a view to the prevention of an increase in flies as well as other nuisances arising from accumulation of manure, it has been the practice of the Council for some years past to require stable refuse to be removed twice weekly during the months of May to September, public notice of such requirement being given by means of posters displayed in the various Mews in the Borough. Very little difficulty is experienced in securing compliance with the notice. Rag and Bone Dealers.—In December, 1935, there were 14 rag and bone dealers in the Borough. Smoke Control.—During 1935, 9 trade premises were kept under observation for the detection of smoke emitted so as to be a nuisance. These premises were watched on 26 occasions, occupying 15 hours. Smoke of all descriptions was noted during 5½ hours, the duration of "black" smoke being only 13 minutes. Eight complaints relating to the emission of smoke were received during the year. Sewer Emanations.—Complaints of nuisance caused by emanations of sewer gas from road gratings, more particularly in the northern parts of the Borough, received the attention of the Public Health Committee and the Works Committee, and, on their representations, the London County Council made experiments with a view to minimising the nuisance. FOULING OF PUBLIC FOOTWAYS BY DOGS. The following bye-law was made by the Council on the 29th July, 1924, for the good rule and government of the Borough:— No person being in charge of a dog in any street or public place and having the dog on a lead shall allow or permit such dog to deposit its excrement upon the public footway. Any person offending against this bye-law shall be liable to a penalty not exceeding 40 shillings. This bye-law shall cease to be in force after the 1st day of August, 1926, unless a bye-law confirming and continuing its provisions has been duly made and come into force before that date. In July, 1926, the bye-law was adopted permanently by the Council. This bye-law is enforced by the Medical Officer of Health and his staff. Active assistance is given by the police, the Home Secretary having intimated in June, 1928, as a result of representations from the Council, that the police had been instructed to report to the Council such offences against the bye-law as come to their notice in the course of their ordinary duties. During 1935 ten prosecutions were instituted, fines ranging from 7s. 6d. to 10s. being imposed. The publicity which has been given to the bye-law has had good effect in causing many dogowners to be more careful. One minor difficulty in enforcing the bye-law is that an offender cannot be compelled to divulge his identity, and cannot be given in charge as the police do not enforce the bye-law. Notices concerning the bye-law were frequently posted on shingle-bins throughout the Borough. CANAL BOATS ACTS, 1877 and 1884. By virtue of the Local Government Board Regulations of 17th May, 1878, the Paddington Borough Council is one of the Registration Authorities for the Regents and Grand Junction Canals, now the Grand Union Canal. The Medical Officer of Health is the Examining Officer for the purposes of the Regulations. Mr. V. L. Ronchetti acted as Canal Boats Inspector during the year. The following report for the year 1935 was made to the Council by the Medical Officer of Health, and was adopted by the Council as their statutory report to the Minister of Health as required by the Canal Boats Act, 1884. Ninety-three (93) canal boats were inspected during the year, the following infringements of the Acts and Regulations being discovered:— 41 Boats leaky 1 Cabins leaky 1 Woodwork of cabins defective 2 Absence of water storage vessel 1 Stoves defective 2 Boats without certificates 5 Painting of cabins required 1 Bulkheads required 3 Boats overcrowded 1 Nine formal notices were served. The three inhabited boats which were found to be conveying offensive cargo have, since the service of notices requiring the provision of double bulkheads, been used for other cargoes. On no occasion was admission to a boat refused, and no legal proceedings were necessary in respect of any of the infringements discovered. One case of scarlet fever was reported. No deaths were recorded as occurring among canal boat dwellers. Thirty-one (31) children of school age were found to be living on the canal boats inspected. The total number of boats on the Register at the end of the year was 249. It is practically certain that a number of boats, registered many years ago, have changed ownership, been registered with another authority or been broken up. It is under the circumstances impossible to trace a number of registered boats or to know the exact number of "live" certificates of registration. One of the requisites for an inhabited canal boat is that if ordinarily used for the conveyance of any foul or offensive cargo, it shall contain between the space occupied by such cargo and the interior of any cabin used as a dwelling, two bulkheads of substantial construction, separated by a space not less in any part than four inches, open throughout to the external air. Such space must be furnished with a pump for the removal of any liquid and the bulkhead next to the cargo is to be watertight. Until recent years it had not been considered in this Borough that house refuse came within the scope of the term "foul or offensive" cargo. Steps are now being taken, however, to ensure that double bulkheads shall be fitted to all inhabited canal boats conveying house refuse, and the owners of such boats are taking all necessary action to comply with this interpretation of the Regulations. The annual cleansing at Paddington Basin was carried out during the week-end 26th-28th April. About 790 tons of mud were removed from the bed of the Basin, in addition to 526 tons which were dredged previously, a total of 1,316 tons, being some 11 tons less than that removed in 1934. HOUSING. Overcrowding Survey.—As required by the Act of 1935, the survey of the Borough to ascertain the extent of overcrowding in it and the places where it exists, was commenced on the 30th October. The survey applied only to "premises used as a separate dwelling by members of the working classes or of a type suitable for such use" and involved some 12,100 premises. The work was not completed by the end of the year. Conversions.—Section 102 of the Housing Act, 1925, and Section 84 of the Law of Property Act, 1925, empower a County Court to vary the terms of a lease or other instrument so as to enable a house to be converted into tenements, notwithstanding any restrictive covenant there may be to the contrary. Three applications under these Sections were made during the year, the premises to which they related being No. 76, Queensborough Terrace, No. 8, Hyde Park Place, and No. 2, Palace Court. Plans continue to be submitted to the Council under the drainage bye-laws, relative to the conversion of premises into tenements. It is probable that a number of other conversions were carried out in which no interference with existing drainage was involved. Such conversions would not come within the purview of the department. Compulsory Repairs.—The number of notices served from the 1st January to the 31st December, 1935, under Section 17 of the Housing Act, 1930, was four. In the case of No. 18, Clarendon Street the notice was complied with, but the repairs in respect of Nos. 26, 39 and 45, Clarendon Street had not been executed at the end of the year. Three hundred and forty-nine communications were sent to owners drawing attention to defects liable to be dealt with under this Section. These communications in most instances resulted in the defects being remedied. 42 North Wharf Road Clearance Area.—The London County Council passed a resolution on the 18th December, 1934, declaring the area to be a clearance area. On the 26th June, 1934, the Council concurred in the suggestion of the London County Council that they should purchase the site under Section 1 of the Housing Act, 1930, for the purpose of rehousing, and the Council undertook to purchase the cleared site from the County Council on the basis of an approximate cost of £12,000. Subsequently, the County Council stated no figure of the actual cost could be agreed for the time being, and that the question of estimating the price must be left until the Compulsory Purchase Order had been confirmed, and the classification of the properties for the purpose of compensation definitely ascertained. Early in 1935 the County Council made an Order for the compulsory purchase of the land comprised in the area and the demolition of the houses thereon. A map of the area was subsequently exhibited in the Council Chamber. A Ministry of Health inquiry was held on the 7th May, 1935, and the Minister of Health duly confirmed the Order without modification. On the 6th November, 1935, the County Council stated that Section 62 (2) of the Housing Act, 1935, had altered the basis of compensation payable in respect of lands in a Clearance Area proposed to be re-developed for housing purposes; that the reduction factor no longer operated; and that, on the revised basis, the estimated cost of acquisition and clearance of the North Wharf Road Area would be £19,000; The Council were of opinion that the revised estimate of £19,000 was an appropriate figure and agreed to accept the transfer of the site on the terms indicated. The area to be purchased is approximately 36,500 square feet. At the figure of £19,000 the oost of the cleared site will be at the rate of £23,000 per acre. The land available for re-development, if the absorption of the highway of Dudley Street be sanctioned, will be about 41,500 square feet. The London County Council's requirements under their standard of accommodation, issued in March, 1935, do not appear to encourage intensive development. A lay-out to attain the maximum accommodation, and to preserve air space, would, so far as at present can be ascertained, allow at the most for the erection of 65 flats, housing approximately 325 persons. There are at present fifty-five properties on the site, a few of which are empty. The question of the development of the site is still proceeding. Artesian Road Clearance Area.—On the 24th July, 1934, the Council made a Clearance Order in respeot of the Artesian Road Area, comprising Nos. 69, 69a, 71 and 71a, Artesian Road. Notices of objection having been received on behalf of the owners and lessees of the dwelling-houses within the area, a Public Inquiry was held at the Town Hall on the 15th January, 1935, when the notices of objection were withdrawn. The Minister of Health subsequently confirmed the Order. The Council have since acquired the freehold and leasehold interests in the site for £700. The tenants have vacated the premises and steps will be taken in due course for the clearance of the area. The Council propose to erect on the site a small block of eight self-contained flats suitable for the occupation of the better paid members of the working-classes. Each of the flats is to consist of an entrance hall, living room, two bedrooms, kitchenette, bathroom and water-closet combined, with external facilities for coal storage and dust removal. Three of the flats will be capable of providing three bedrooms by reducing the size of the living room. The flats will provide accommodation for approximately fifty people. Mews Areas and Individual Mews Dwellings.—On the 30th May, 1935, the Council informed the London County Council that they were of opinion that the initiative in dealing with mews areas and individual mews dwellings should rest with the Borough Council, who would be prepared to undertake to survey such areas and dwellings within a reasonable time and to formulate the necessary proceedings under the Housing Acts. Fifteen areas have since been surveyed. In twelve cases it was recommended that the most satisfactory method of dealing with the conditions in the areas would be by declaring them clearance areas and that the best means of dealing with the unhealthy conditions in the three other areas would be by closing order procedure and notice to repair. Formal notice of the Council's intentions has been given to the London County Council. The Council have adopted the following standard of minimum requirements for dealing with individual mews dwellings:— (i) That the height throughout a habitable room shall be 7 ft. 6ins. (ii) That every habitable room over a stable shall be separated therefrom by a floor every part of which shall have between the floor joists or girders solid material 3 ins. in thickness and ceiled on the underside with lath and plaster or other approved material. Any staircase or structure leading to any such room and adjoining a stable shall be separated from it by a brick wall 4½ ins. in thickness or 3 ins. breeze slabs, cement rendered. (iii) Where a mews dwelling is over a garage where petrol is stored, the underside of the ceiling thereof and the staircase approach thereof shall be lined with 3/16ins. compressed asbestos sheeting. 43 (iv) That the standard embodied in the London Building Act be adopted as regards windows in habitable rooms with such modification as may be necessary as regards the height of the top of the window in rooms having an external wall and in which a height of 7 ft. 6 ins. will not be exceeded. (v) That every habitable room shall have means of permanent ventilation with an unobstructed sectional area of 30 square inches. (vi) That staircases shall be required to be safe as regards inclination and structure and be provided with a handrail; and that a window or skylight opening shall be provided, opening directly into the external air. (vii) All partition walls of badly arranged rooms shall be reconstructed where practicable in order to provide properly lighted and ventilated passageways. (viii) That the following shall also be required:— (а) Provision of a copper and means of heating. (б) A food cupboard ventilated to the external air and fly-proof. (c) A sink with a gas cooker or kitchen range for the preparation and cooking of food. (d) A water supply in the dwelling-house and over the sink. (e) That the requirements of the bye-laws applicable to newly constructed water- closets shall be enforced so far as is practicable. At the close of the year the survey of the Mews Areas was still proceeding. Improvement Areas.—In 1933 the London County Council declared fifty houses in Clarendon Street to be an improvement area. Following the closure of basement rooms and the abatement of overcrowding in the area, notices were served requiring the owners of the houses to carry out reconditioning work. A summary of the works executed during 1935 is given below:— Rooms cleansed and redecorated 150 Staircases and passages redecorated 39 Verminous rooms fumigated and redecorated 58 Floors repaired 68 Walls repaired (internal) 48 Walls repaired (external) 65 Windows repaired 290 Firegrates repaired 40 Ranges repaired 46 Staircases repaired 35 Hearths repaired 61 Doors and locks repaired (to rooms) 124 Vault doors repaired 37 Cupboards repaired and cleansed 132 Steps repaired 18 Ceilings repaired 21 Roofs repaired 30 Coppers repaired 30 Yards and areas cleansed 65 Rainwater pipes and gutters repaired 12 Chimney pieces repaired 66 Windows made to open 8 Drain fresh-air-inlets repaired 20 Water-closets provided 42 Water-closets repaired 43 Water-closets ventilated 12 Sinks and taps provided 113 Sinks repaired 20 New soil pipes 34 New waste pipes and stacks 140 With the exception of certain items of repair, etc. at Nos. 26, 39 and 45, Clarendon Street, the whole of the re-conditioning works in the area has now been completed, and the houses, as re-conditioned, should provide for a considerable number of years fairly satisfactory accommodation for the number of families allowed to occupy them. Houses Unfit for Human Habitation.—The following figures show the extent of the Council's operations during 1935:— Number of basement rooms closed for human habitation 46 Number of basement rooms closed for sleeping purposes only 158 Number of dwelling-houses or parts of dwelling-houses closed for human habitation (other than basement rooms) 12 Number of persons displaced or who will be displaced as a result of the Council s operations 542 Number of displaced persons rehoused on London County Council Housing Estates 291 A number of displaced persons have found accommodation through their own efforts, while others are awaiting suitable vacancies on London County Council Estates. 44 In lieu of making closing orders the Council, in 63 instances, after consultation with owners, accepted undertakings from them as empowered by Section 19 (2) of the Housing Act, 1930. Suoh undertakings possess the advantage of expediting prooedure, whilst securing the closure of the parts of the premises to which they refer as effectively as though olosing orders had been made. Subsequently, three of the owners submitted proposals for making the premises fit for human habitation. In each instance the proposals were approved, the work carried out to the satisfaction of the Council, and the undertakings cancelled. No action under the Housing Acts could be taken in respect of over 137 other basements, and altogether during the year nearly 2,000 inspections and re-inspections of basement premises were made. The premises are brought to notice:— (1) by the occupants applying for new housing accommodation; (2) by the rooms being advertised to let; (3) by the house as a whole being for sale or lease, and (4) by a house-to-house survey. Underground Rooms.—The use of this term in this paragraph is restricted to rooms dealt with under Section 96 of the Public Health (London) Aot, 1891. Particulars of basement rooms in regard to which action was taken under the Housing Act, 1930, will be found in the preceding paragraphs. During the year special attention was given to the inspection of underground rooms which did not appear to possess the requisites specified in the above-mentioned section and therefore could not lawfully be oocupied separately as dwellings. As a result of the inspections made, 105 underground rooms were discovered which did not fulfil the conditions essential for separate occupation. Not only were occupied rooms inspected for this purpose, but also any empty rooms which appeared to have been recently occupied as separate tenements. In every case a communication was addressed to the owner either calling upon him to terminate the unlawful ocoupation, or, where empty rooms were concerned, warning him not to re-let them except in conjunction with a room or rooms on another floor of the same house. In this way the illegal occupation of the majority of the rooms above referred to was either terminated or prevented. Further action will, if necessary, be taken during the current year with regard to any room which is found on reinspection to be separately occupied. Purchasing and Re-conditioning. of Houses.—In August, 1930, the consent of the Minister of Health was obtained to the Counoil's subscribing an amount not exceeding £5,000 in respect of debentures, bearing interest at per cent, per annum, secured by a Trust Deed and issued by a public utility society known as The Paddington Houses Association, Ltd. The money subscribed will be utilised in purchasing, re-conditioning and improving working-class houses in the Borough, which will be let in tenements. In May, 1932, the Minister of Health sanctioned the provision of a further sum of £1,500 for this purpose. No money was subscribed during 1935, the total remaining at £5,500 as at the end of 1933. Brindley Street Flats.—These flats were erected by the Council in 1933. They contain four tenements each with living room, kitchen and two bedrooms, and four tenements each with living room, kitchen and one bedroom, the rents being 8s. 6d. and 6s. Od. respectively for each class of tenement. Accommodation is provided for 33 persons. During the year one flat became vacant and was re-let to a family which had been displaced from basement rooms. Housing! on the London County Council Estates. During the year 354 applications were accepted for housing accommodation on London County Council Estates. Of this number 222 were sent forward to the County Council with a request that the applications be given preferential consideration in the allocation of accommodation on grounds of overcrowding, unhealthy conditions, urgency and special hardship. The remainder of the applications, in view of the fact that the financial circumstances and place and hours of work of the applicants did not justify their removal to estates situated outside the London area, were placed on the liat of applicants waiting to be nominated for suitable vacancies on local estates, such as the Wormholt Estate, Hammersmith, and the Old Oak Estate, East Acton. The number of Paddington families accommodated on London County Council Estates on applications submitted by the Borough Council was 93, whilst 51 other Paddington families were offered and accepted improved accommodation on applications submitted direct to the County Council. 45 The following Table gives some idea of the amount of housing already achieved for Paddington, showing as it does the total number of applications received since April, 1920, and how they were dealt with. Estate. Number of Applications Received. Number Housed. Waiting. Withdrawn. Refused by L.C.C. Offered, not accepted. Becontree 479 140 3 237 66 33 Castelnau 30 13 1 16 Downham 223 103 4 72 12 32 Old Oak Common 117 53 20 21 15 8 Roehampton 65 28 5 20 2 St. Helier 511 98 24 326 33 30 Tottenham 38 14 2 13 5 4 Watling 719 150 108 424 22 15 Wormholt 748 301 52 351 23 21 Central Dwellings 25 7 8 9 1 ,, Estates 440 — 370 70 — — 3385 907 597 1559 178 144 The following agreements have been entered into by the Paddington Borough Council for the provision of rehousing accommodation on London County Council Estates for Paddington families:— In November, 1927, and July, 1928, agreements were completed between the London County Council and the Paddington Borough Council whereby provision was made for the housing of 150 families on the Wormholt Estate, Hammersmith, the Borough Council to pay to the London County Counoil the sum of £7 per annum for a period of 20 years for each house occupied. Since the 150 families went into occupation, 46 vacancies have occurred and the cottages or flats have been re-let to deserving families selected from the waiting list. The annual cost to the Council in respect of the 150 dwellings is £1,050. On the 30th October, 1934, the Council entered into an agreement with the London County Council in respect of the provision of re-housing accommodation for families displaced as a result of the Council's operations under the Housing Act, 1930, in connection with clearance or improvement areas, or the demolition of insanitary houses or the closing of parts of buildings, by which the Borough Council shall pay the sum of £1 17s. 6d. per dwelling a year for a period of 40 years. In the event of a dwelling occupied by a re-housed tenant becoming vacant, the Borough Council is empowered to nominate further tenants for such dwelling for the whole of the 40 years, but not one that has been displaced by the operations of the Council under the Housing Act, 1930. At the end of December, 1935, the number of houses and flats provided under tihis agreement was 89, and since the first tenants went into occupation 8 vacancies have occurred. Fresh tenants for these vacancies were admitted at once from the waiting list. The annual cost to the Council in respect of the 89 dwellings is £166 17s. 6d. The agreements entered into by the Council have resulted in 293 Paddington families obtaining improved housing conditions, and this number should be considerably increased in the near future as a result of the re-housing of displaced persons in connection with the Council's slum clearance programme. The Council continue to co-operate with the London County Council in improving the home conditions of oertain families, who, at first view, do not appear to come up to the standard it is desired to maintain on London County Council Estates. If at the end of a period of, say, three months the families have improved their standard of living to such an extent that they would appear to prove satisfactory tenants, an opportunity is given them of making further application for accommodation. Tenement Houses.—The number of houses on the register at the close of the year was 1,376. Inspections totalled 5,474, and legal proceedings were instituted with respect to nuisances or contraventions of the Bye-laws in 17 instances. Particulars of the defects, etc., discovered and remedied will be found on page 47. 46 Bye-law 17 of the Bye-laws made by the London County Council with respect to lodg-ing-houses (i.e., houses intended or used for occupation by tho working-classes and let in lodgings or occupied by members of more than one family), requires every owner of a lodging-house to provide and maintain for the use of each family by whom any part of the house is occupied, and so far as is practicable on the storey or one of the storeys in which are situate the rooms or lodgings in the separate occupation of the family— (а) Water-closet accommodation; (б) Accommodation for the washing of clothes; (c) Accommodation for the storage of food in a reasonably cool position with proper ventilation from the external air wherever practicable, and with protection from dust and flies; (d) Accommodation for the preparation and cooking of food; and, where reasonably necessary, and so far as practicable, the owner shall provide separate accommodation as specified in (a), (6), (c) and (d) for each such family. For the present, however, this Bye-law is applicable only to a house which is decontrolled throughout. During the year steps continued to be taken to enforce the Bye-law in the case of every decontrolled tenement house which came under the notice of the sanitary inspectors in the ordinary course of their duties, and special attention was devoted to certain areas. Notices were served with respect to 135 premises, the notices being complied with in 120 instances either by the provision of the necessary accommodation or by re-arrangement of the tenancies, and 14 cases were outstanding at the end of the year. In addition to the action thus taken, wherever there appeared to be any likelihood of an empty house being re-let in separate tenements to persons of the working classes, a letter was sent to the owner calling attention to the Bye-law. Overcrowding.—During the year 4 cases of overcrowding were discovered. In one instanoe the overcrowding was abated by the removal of the family, and in another instance by the re-arrangement of the occupants of the rooms. The remaining 2 cases will be dealt with during 1936. Annual Cleansing.—Six hundred and forty-four (644) registered tenement houses were inspected during the year, and notices were served for the oleansing and other work found to be necessary. Common Lodging Houses.—There are 2 common lodging houses in Kilburn Lane and 1 (Cecil House) in Harrow Road. The number of beds for which each is licensed is as follows:— 268 and 270, Kilburn Lane, 60 beds for men. 272, 274 and 276, Kilburn Lane, 105 beds for men. Cecil House, 179, Harrow Road, 69 beds for women and ohildren. During the year 53 inspection (including 18 night inspections) were made by the two Sanitary Inspectors responsible for the supervision of these houses. Two cases of notifiable illness and three deaths occurred among the occupants. Housing Act: Rent Books.—One report was received as to a rent book not containing the required particulars. A cautionary letter was sent to the owner. Rent and Mortgage Interest (Restrictions) Acts, 1920-1933. Seven applications for certificates were made, all of which were granted. In one case a certificate was subsequently issued to the owner of the premises, under Section 5 (2) of the 1923 Act, on the completion of the necessary repairs. 47 Defects, Nuisances and Contraventions of Bye-laws (other than items of Dilapidation) Discovered and Remedied in Registered Tenement Houses. 1935. Drain defective 3 ,, choked 5 ,, not properly ventilated or ventilating pipe defective 13 Manhole cover defective 1 Gully choked .. 3 Soil pipe defective 2 Water-closet defective 10 ,, choked 7 ,, without sufficient flush — ,, flushing apparatus defective 25 ,, foul 11 ,, improperly constructed 1 ,, accommodation insufficient 2 ,, without door, door defective, or without proper fastenings 16 Rain-water pipe defective 19 ,, choked — ,, untrapped 10 Wasto pipe defective 11 ,, choked — ,, untrapped 1 ,, not provided or missing 12 Sink defective or not provided 26 Other drainage defects 2 Cistern defective 12 dirty 1 ,, without proper cover or cover defeotive — Dustbin defective 58 ,, not provided — ,, insufficient 6 „ disused and not abolished — Paving of yard or area defective 43 ,, washhouse defective 22 Premises damp 46 Rooms, etc., dirty (including staircases, washhouses, water-closots, yards, areas, etc.) 2125 ,, verminous 200 ,, contents, bedding, etc., dirty 8 ,, not provided with a window opening directly to the external air — Chimney smoky 12 Food cupboards not provided 28 Windows defective including cords and fastenings out of repair 208 Roof defective 164 Common staircases out of repair 41 Staircases without sufficient handrail 6 Animals improperly kept — Accumulation of refuse (not offensive) 16 Premises withour water, or supply insufficient 71 Any other defects, etc. 8 Notices Issued. Written Intimations 683 Statutory Notices 264 Bye-law 1062 Notices under L.C.C. (G.P.) Acts— Verminous rooms 199 Additional taps 71 Items or Dilapidation for which Letters weresent to the Owners (Section 17 of the HousinoAct, 1930). Wall-plaster broken, bulging, or defective 62 Matchboarding defective 1 Wall-paper loose 1 Skirting defective — Doors defective or missing 21 Locks defective 60 Ceiling plaster defective 21 Ceiling paper loose 2 Floors broken or badly worn 33 Stoves defective (including fire tiles burnt away, bars broken or mining, oven plates burnt through, oven doors defective or missing, plates broken or missing) 101 Stovo settings defective 5 Flues defective 12 Hearths defective 10 Chimney-pieces loose or defective (including jambs, frieze, or mantel broken, loose, or missing) .. 11 Cupboard doors defective or missing and shelves missing 5 Window-sashes defective (including sash or sash-bars broken, rotten or defective, beads missing or defective, putties defective) 110 Window-frames loose or defective (including oak sills worn or rotten) 52 Window-glass broken 82 Copper brickwork defective, furnace pan leaky, furnace door missing or defective, setting defective, flue smoky or defective 66 Steps ot front entrance or area defective 8 Railing to area or area steps defective 1 Guard rails to addition roofs defective, broken or rotten 2 Rubbish or refuse in yard, washhouse, vault, area, under- basement, etc. — Vault doors missing or defective 1 48 HOUSING. (Ministry of Health Table.) 1.—Inspection of Dwelling-houses during the Year (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health and Housing Acts) 2,983 (6) Number of inspections made for the purpose 23,971 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 – (6) Number of inspections made for the purpose – (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation – (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects fit for human habitation 2 —Remedy of Defects during the Year without Service of formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers No record. 3.—Action under Statutory Powers during the Year. A. Proceedings under Sections 17, 18 and 23 of the Housing Act, 1930— (1) Number of dwelling-houses in respect of which notices were served requiring repairs *349 (2) Number of dwelling-houses which were rendered fit after service of formal notice:— (o) by owners 266 (6) by Local Authority in default of owners — B. Proceedings under Public Health Acts— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 1,738 (2) Number of dwelling-houses in which defects were remedied after service of formal notices— (a) by owners (b) by Local Authority in default of owners 1,725 C. Proceedings under Sections 19 and 21 of the Housing Act, 1930— (1) Number of dwelling-houses in respect of which Demolition Orders were made — (2) Number of dwelling-houses demolished in pursuance of Demolition Orders — D. Proceedings under Section 20 of the Housing Act, 1930— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were made 216 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 3 * Informal notices. FACTORIES AND WORKSHOPS. 1935. Inspection of Factories, Workshops and Workplaces. Premises. Number of Inspections. Written Notices. Occupiers prosecuted. Factories (including factory laundries) 421 4 — Workshops (including workshop laundries) 324 5 — Workplaces (other than outworkers’ premises) 17 1 — Total 762 10 — 49 Defects Found in Factories, Workshops and Workplaces. Particulars. Number of Defects. Number of offences in respect to which Prosecutions were instituted. Found. Remedied. Referred to h.m. Inspector. Nuisances under the Public Health Acts:*— Want of cleanliness 88 88 Want of ventilation 4 2 Overcrowding – Want of drainage of floors — – Other nuisances 3 3 Sanitary accommodation insufficient 3 unsuitable or defective 4 8 – not separate for sexes 6 3 – Offences under the Factory and Workshop Acts:— Illegal occupation of underground bakehouse (s. 101) — — – — Other offences 1 1 (Excluding offences relating to outwork and offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921.) Total 105 114 1 — * Including those specified in Sections 2,3,7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. At the end of 1934 there were 1,001 premises on the Register. During 1935, 52 premises were removed from the Register and 47 added, making the total at the end of the year 996. The Department reported to the Home Office 14 cases in which the prescribed abstract of the Factory and Workshop Act, 1901, was not displayed, and received from that Office notice of 18 workshops, 7 of which were already known to the Department. Homework (Outworkers).—Local employers of outworkers sent in 15 lists in February and 15 in August. These lists contained 200 names and addresses of which 162 were forwarded to other districts. From other districts 282 addresses within the Borough were received. No instances were discovered during the year of outwork being carried on in unwholesome premises (Section 108). Supervision.—There were during the year 762 inspections, comprising 421 of factories, 324 of workshops and 17 of workplaces. There were 105 nuisances or defects found upon registered premises, all of which were remedied during the year, the majority being remedied on verbal request. The defects found are shown in the above Table. The Home Office forwarded 15 complaints, which comprised:— Sanitary conveniences not separate for sexes 4 Other offences 9 Bakehouses.—During the year 2 level bakehouses were opened and 1 closed, the total number on the Register at the end of the year being 67, of which 49 were factory bakehouses. The number of level bakehouses was 29 (14 being factories), and of underground 38 (35 being factories). The bakehouses were inspected on 324 occasions during the year. RAG FLOCK ACTS, 1911 and 1928. Little, if any, rag flock is used in the Borough, and no samples were taken during the year. 50 SHOPS ACT, 1934. Under date the 27th August, the following Report was submitted to the Public Health Committee:— “ The Shops Act, 1934, enacte that in every part of a shop in which persons are employed about the business of the shop:— (а) Suitable and sufficient means of ventilation shall be provided and suitable and sufficient ventilation shall be maintained; (b) suitable and sufficient means shall be provided to maintain a reasonable temperature and a reasonable temperature shall be maintained. Generally speaking the standards to be adopted as regards these two matters will give rise to little difficulty with one exception, that is as regards the use of heating apparatus which discharges the products of combustion directly into the air of the shop, such as a flueless gas heater or an oil stove. “In a factory or workshop the heating apparatus must not interfere with the purity of the air in any room in which any person is employed. Since electric energy is available in almost every part of the borough and affords a hygenic means of heating where a flue is not available it would appear that the same standard should be applied generally in a shop as in a factory or workshop. “The Act also enacts that:— ‘In every shop, not being a shop which is exempted, there shall be provided and maintained suitable and sufficient sanitary conveniences available for the use of persons employed in or about the shop. “A shop is exempted if there is in force a certificate exempting the shop, granted by the Council, and any such certificate remains in force until it is withdrawn by the authority. No such certificate may be granted unless the Council is satisfied that by reason of restricted accommodation or other special circumstances affecting the shop it is reasonable that such a certificate should be in force, and that suitable and sufficient sanitary conveniences are otherwise conveniently available. “A certificate must be withdrawn if the Council is at any time not satisfied that it should remain in force. “There is no right of appeal against the refusal of the Council to issue a certificate, but there is a right of appeal to the county court against a deoision to withdraw a certificate. “The question of what is ‘suitable and sufficient’ as regards sanitary conveniences in a shop, and what is the meaning of ‘ restricted accommodation or other special circumstances affecting a shop ’ is one of difficulty. “In factories and workshops there is a statutory requirement that a separate convenience must be provided for the person or persons of each sex employed or in attendance. This requirement is rigidly enforced in Paddington and there are also requirements as regards screening of conveniences and separate approaches. In my opinion any endeavour to enforce this standard in shops would, for the present, cause great inconvenience to shopkeepers and it is doubtful if the courts would support such a standard. The following standard has been adopted in Kensington and is submitted for your consideration:— ‘In shops where members of both sexes are employed, separate sanitary conveniences for each sex are to be provided if the number of assistants exceeds four, but if the number is four or less, one sanitary convenience is to be regarded as suitable and sufficient, provided that the door of such convenience is fitted with a proper lock or fastener on the internal side and an automatic indicator showing on the external side of the door whether the apartment is engaged or vacant. “The other point of difficulty is to decide how far from a shop an outside convenience may be, in cases where a certificate has been applied for. In other boroughs the distances which are considered to be the limit vary from 50 to 100 yards. In this connection the possibility of an assistant being taken suddenly unwell must be considered. “I would suggest that no certificate of exemption be granted unless the sanitary convenience provided for a male shop assistant is less than 100 yards from the shop, and that it may be a public or private convenience. As regards a female shop assistant I would suggest that the maximum distance be 25 yards and that the convenience be a private one. "Such standards as you may see fit to adopt would of course only be provisional and be a guide in dealing with applications for exemption and otherwise. 51 The inspection of the shop premises in the Borough (approximately 2,000) was commenced by the District Inspectors, but in May the Council, with a view to expediting the enquiry, authorised the appointment of a special temporary Sanitary Inspector for the work. This official resigned in November and thereafter the District Inspectors resumed the inspections. Applications for 59 Certificates of Exemption from the provisions relative to the provision of “suitable and sufficient sanitary conveniences available for the use of persons employed in or about the shop” were received. Five such Certificates were issued, the remainder being under review at the end of the year pending the decision of the Council as to the standards to be adopted. FOOD SUPERVISION. Slaughterhouses.–There were, at the end of the year 1935, two slaughterhouses within the Borough:— 275, Edgware Road; 249, Maida Vale. There were 300 inspections made during the year. The number of animals slaughtered, so far as is known, was 2,782, comprising 208 bullocks and 2,474 sheep, an increase of 8 bullocks and a decrease of 1,287 sheep as compared with 1934. The following Table shows the number of organs destroyed, and the disease with which they were affected:— Bullocks. Sheep. Heads. Tongues. Lungs. Livers. Mesenteries. Stomachs. Lungs. Livers. Hearts. Tuberculosis 1 1 1 1 1 ___ ___ Actinomycosis 1 1 — 1 — — — — — Abscess — 3 7 4 — — 8 8 8 Distomum Hepaticum — — — 59 — — — — — Parasitic Invasion — — — — — — 337 44 28 Pentastomum Deuticulatum — — 1 — 1 — — — — Injury 1 1 — — 1 1 — — — Pleurisy — — 5 — — — — — — Cystercercus Tenui-collis — — — — — — 2 2 2 Cavernous Angioma — — — 4 — — — — — 3 6 14 68 3 2 347 54 38 Total weight, 1,888 lbs. Pieces of meat, weighing in all 50 lbs. were also destroyed for various reasons. In addition to the animals slaughtered in the licensed slaughterhouses, a number of pig carcases arrive in the Borough which have not been previously inspected. During 1935 the number of carcases was 80. On examination it was found necessary to destroy 5 heads and offal weighing 104 lbs. all affected with tuberculosis. Slaughter of Animals Act, 1933.—The purpose of this Act is to provide for the humane and painless slaughter of animals and for the licensing of slaughtermen. Licences were granted to the three slaughtermen who follow that occupation in the Borough. Public Health (Meat) Regulations, 1924.—It was not found necessary to take any legal proceedings under these Regulations during the year. Occasional defaults were dealt with by means of a caution. Poultry Slaughtering.—This business is dealt with by special bye-laws. The only poultry slaughterhouse in the Borough is situated at No. 51, Shirland Road. During the year 50 inspections were made and approximately 4,844 head of poultry were slaughtered. Unsound Food.—No proceedings were necessary in regard to food unfit for human consumption. Food Purveyors.—At the end of the year there were some 830 purveyors of food in the Borough, classified as follows:—Butchers 74, Fishmongers 26, General 67, Grocers 106, Fried Fish 31, Refreshments 122, Confectioners 112, Greengrocers 101, Milk 130, Provision 61. 52 In addition to the above, there were at the end of 1935 74 licensed Street Traders selling food within the borough, namely:—Fruit and Vegetables 50, Ice Cream 10, Light Refreshments 10, Rabbits and Poultry 2, Fish 1, Sweets 1. These, with the storage premises of 25 Street Traders licensed by other boroughs, are under constant supervision. There were 8 premises on which fish curing was performed, this business, as well as fish frying, being regulated by special bye-laws. The number of visits of inspection paid to premises occupied by food purveyors was 2,299. Section 5 of the London County Council (General Powers) Act, 1932, provides that any premises (other than premises used as a club, hotel or restaurant) used or proposed to be used for the preparation or manufacture of sausages, potted, pressed, pickled or preserved meat, fish or other food intended for sale shall be registered by the owner or occupier, or intending occupier, thereof with the sanitary authority. At the close of the year the Register contained the addresses of 137 premises. lce Cream.—There were 183 shops at which ice cream was known to be sold, comprising the following kinds Qf businesses:—Bakers 9, General 26, Milk 12, Confectioners 82, Refreshment 48, Wholesale 2, Newagents 2, Greengrocer 1, Fancy Goods 1. One hundred and thirty (130) inspections of premises were made. Ice cream was gold from 25 barrows stored within the Borough and from some 35 barrows stored outside the Borough. The above-quoted section of the London County Council (General Powers) Act, 1932, also makes it necessary for the owner or occupier to register with the sanitary authority any premises used or proposed to be used for the sale or the manufacture for the purpose of sale of ice cream or other similar commodity or the storage of ice cream or other similar commodity intended for sale. At the end of 1935 there were 153 entries in the Register. Food Destroyed.—The total weight of food surrendered by tradesmen and dealers for destruction by the Council was 1 ton 12 cwts. 3 qrs. 21 lbs., comprising the following varieties:—Meat and Offal, 2,307 lbs.; Fish, 337 lbs.; Poultry, 261 lb6.; Fruit, 672 lbs.; Mussels and winkles, 112 lbs. Dairies and Milkshops.—At the end of the year 1934 there were 128 names on the Register. During the year 1935 6 names were added and 4 removed, making a total of 130. Eight of these businesses were transferred to new proprietors. There were 256 inspections made. In addition to the above-mentioned, there are 31 persons registered as purveyors of milk whose premises are situated in other districts but who come into the Borough to trade. Sterilised milk in bottles was found to be on sale at 105 premises. Milk (Special Designations) Order, 1923. The licences issued by the Council during the year in pursuance of this Order numbered 110, but of these 4 were issued consequent upon changes of ownership of businesses. The number of licences in force at the end of the year was 106, comprising 11 for “Certified” milk, 29 for “Grade A (Tuberculin Tested)” milk, 2 for “Grade A (Pasteurised)” milk, and 64 for “Pasteurised” milk. The licences in respect of “ Grade A (Tuberculin Tested)” milk included one for a bottling establishment and those in respect of “ Pasteurised” milk, 1 for a pasteurising establishment. The samples taken by the Council’s Inspector numbered 19, comprising 2 of “Certified” milk, 16 of “Pasteurised” milk and 1 of “Grade A (Tuberculin Tested)” milk. The samples included 3 of “Pasteurised” milk taken at Paddington Hospital, and 5 of “ Pasteurised” milk taken at Schools. All the samples were reported to comply with the appropriate bacteriological standards. Milk and Dairies Order, 1926. No contraventions of the provisions of this Order were reported during the year. Food and Drugs (Adulteration) Act, 1928. Of the 600 samples taken during the year, 16 (2.6 per cent.) were found to be “not of the nature, or not of the substance, or not of the quality demanded by the purchaser.” This compares with 2.5 per cent. in 1934 and 3.1 per cent, in 1933. Fifty-one of the samples were taken on Sundays and Bank Holidays. All were reported to De genuine. Fifty-one samples of milk were taken at Paddington Station on delivery by rail, three of which were reported to be not genuine. No samples of milk were obtained at Paddington Station at the request of other Boroughs. 53 Sampling of Milk Supplies to Public Institutions.—There are 11 institutions and 18 Schools from whioh samples of milk are taken periodically. Twenty eamples were taken during 1935, all of which were returned as genuine. Sampling of Milk from Automatic Machines.—Automatic machines for supplying milk are in use at eight premises in the Borough. From these, during 1935, 22 samples were taken for chemical analysis, all of which were reported to be genuine. Public Health (Preservatives, etc., in Food) Regulations, 1925 to 1927. With few exceptions all samples taken under the Food and Drugs (Adulteration) Act were examined for the presence of preservatives. There were no contraventions of the Regulations. Public Health (Condensed Milk) Regulations, 1923 and 1927. During the year 2 samples of full cream sweetened, and 6 samples of skimmed sweetened condensed milk were taken. All were found to comply with the Regulations. Public Health (Dried Milk) Regulations, 1923 and 1927. One sample of dried milk was taken during 1935 which complied with the Regulations. Chemical and Bacteriological Examination of Food. Analyses for the purposes of the Food and Drugs (Adulteration) Act, 1928, and the various Food Regulations were made by the Public Analyst, Dr. Alan Stewart. The work is performed at the Royal Institute of Public Health, 23, Queen Square, W.C.I, where also bacteriological examinations are made of food suspected of being deleterious, and of samples of milk procured under the provisions of the Milk (Special Designations) Order, 1923. During 1935, samples of ice cream, prawns, cheese, tinned apricots, and black currant jam were submitted for special examination, no unusual features being detected. The results of other samples analysed or bacteriologically examined are recorded elsewhere in this Report under the appropriate headings. Summaries of the results of analyses made by the Public Analyst during the year are given below. No legal proceedings were taken during the year. In connection with the analysis of milk samples, the Public Analyst furnishes the result of his analysis and the following table is of interest. It may be noted that the Ministry of Agriculture standards for presuming milk to be adulterated are 3 per cent, for fat and 8.5 per cent, for non-fatty solids. These standards are generally considered to be rather unfair to the consumer and the deduction to be made from the table is that the milk sold in Paddington is, generally speaking, of average natural strength. Genuine Milk Samples, 1935. Average Monthly Figure for Percentage. Fat Content and Non-Fatty Solids. January — — February 3.55 8.62 March 3.56 8.68 April 3.49 8.66 May 3.52 8.80 June 3.59 8.71 July 3.35 8.65 August 3.50 8.67 September 3.88 8.64 October 3.75 8.66 November 3.91 8.72 December 3.83 8.69 Average for Year. Samples taken at Paddington Station 3.53 8.93 ” ” elsewhere 3.46 8.56 54 Samples Submitted to Public Analyst—1935. Number examined. Number adulterated. Percentage adulterated. Formal. Informal. Formal. Informal. Formal. Informal. Ale 2 — — — — Ammoniated Tincture of Quinine – 2 — — — — Arrowroot – 2 — — — — Baking Powder – 6 — — — — Boracic Ointment – 2 — — — — Brawn – 6 — — — — Bread 1 — — — — — Bread and Butter (cut) – 3 — — — — Butter 2 8 — — — — Cake — 4 — — — — Caraway Seeds — 1 — — — — Cheese — 4 — — — — Chicken and Ham Galantine — 1 — — — — Chicken, Ham and Tongue Roll — 1 — — — — Chocolates — 2 — — — — Coco cola — 1 — — — — Cocoa — 3 — — — — Coffee — 6 — — — — Compressed Liquorice Powder — 1 — — — — Cooked Milk — 2 — — — — Cough Medicine — 1 — — — — Cream — 8 — — — — Cream Soda — 1 — — — — Crystalized Ginger — 2 — — — — Custard Powder — 2 — — — — Dried Fruit — 11 — — — — Dried Peas — 2 — — — — Dripping — 1 — — — — Elixir of Senna Pods — 1 — — — — Essence of Coffee and Chicory — 1 — — — — Fish Paste — 4 — — — — Flour — 8 — — — — Full Cream Condensed Milk, Sweetened — 2 — — — — Game Pâté — 1 — — — — Gin — 5 — — — — Gregory's Powder — 1 — — — — Ground Almonds — 2 — — — — Ground Ginger — 2 — — — — Ham — 2 — — — — Ham Roll — 1 — — — — Honey — 3 — — — — Ice Cream 1 8 — — — — Jam 1 12 — — — — Jelly Cream — 3 — — — — Lard — 1 — — — — Lemonade — 1 — — — — Lemonade Powder — 2 — — — — Liver Pâté — 1 — — — — Margarine — 9 — — — — Meat — 1 — — — — Milk 299 2 14 — 4.68 — Milk Food — 1 — — — — Minced Beef 2 2 — — — — Mincemeat — 5 — — — — Mustard — 5 — — — — Olive Oil — 2 — — — — Pearl Barley — 4 — — — — Peel — 4 — — — – Pepper — 3 — — — — Pickles — 4 — — — – Prawns 1 1 — — — — Prescription — 5 — — — – Preserved Ginger — 1 — — – Rhubarb Powder — 1 — — — — Bice — 2 — — — — Rolls and Butter — 5 — — — – Rum — 5 — 1 — 20.00 Sago — 2 — — — – Salmon Luncheon Roll — 1 — — – – Sausages 12 — — — — – Seidlitz Powder — 1 — – – – Semolina — 2 — — — – Shredded Suet — 3 — — — – Skimmed Condensed Milk, Sweetened — 6 — — — – Sponge Cakes — 4 — — — – Steak and Kidney Pie — 1 — — – – Stout — 2 — — – – Sugar — 3 — – – — 55 Samples submitted to Public Analyst—1936—continued. Number examined. Number adulterated. Percentage adulterated. Formal. Informal. Formal. Informal. Formal. Informal. Sulphur Ointment 2 — Tapioca — 2 — – — — Tea — 3 — Tincture of Iodine 2 Tinned Fish — 4 _ Tinned Fruit — 7 Tinned Hot Snack 3 Tinned Soup — 1 Tinned Tomatoes — 3 Tinned Vegetables — 4 — – — — Tripe — 4 — – — Veal and Ham Pie — 1 Vinegar — 6 — – — — Vitacream — 1 — – — Whisky — 4 — 1 25.00 Zinc Ointment — 2 — — — — 319 281 14 2 4.38 0.71 600 16 2.66 Agricultural Produce (Grading and Marking) Act, 1928. The Council is responsible for enforcing the provisions of this Act and the Medical Officer of Health and the male Sanitary Inspectors have been authorised to act as officers for this purpose. No premises used by way of trade or for purposes of gain for the cold storage or chemical storage of eggs were registered during the year. Ten samples of canned fruit and vegetables were procured during the year comprising Strawberries 1, Blackcurrants 1, Peas 2, Plums 4, Loganberries 1, Raspberries 1. All were found to comply with the regulations applicable. Merchandise Marks Act, 1926. The Council is responsible for executing the provisious of this Act, so far as relates to any goods lieing foodstuffs to which an Order in Council under the Act applies, and excepting any provisions relating to the importation of goods. The Medical Officer of Health and the Sampling Officer have been authorised to act as officers in this respect. The following purchases were made with a view to ascertaining whether the requirements of the Orders had been complied with, viz.:—Honey 6, Butter 10, Apples 6, Tomatoes 6, Sultanas 8, Currants 8, Raisins 8, Oat products 4, Salmon 1. Artificial Cream Act, 1929. This Act, which came into force on May 10th, 1929, is intended to regulate the manufacture and sale of what is commonly known as reconstituted cream, usually prepared by emulsifying butter with dried skimmed milk and water. This substance gives the same analytical results as natural cream and cannot therefore be dealt with under the Food and Drugs (Adulteration) Act, 1928. One establishment- in the Borough has been registered under the Act for the manufacture or sale of Artificial Cream. Pharmacy and Poisons Act, 1933. This Act received Royal Assent on the 28th June, 1933, but will not come into operation until 1st May, 1936. It places upon the local authority the duty of keeping a list of persons who, not being entitled to sell poisons referred to in Part I of the Poisons List, will, under the Act, be entitled to sell certain other poisons, i.e., those included in Part II of the Poisons List. Powers of inspection and of enforcing the provisions are also conferred on the local authority, who may remove a name from or refuse to enter a name on the list. The Medical Officer of Health and the Sanitary Inspectors are authorised by the Council to act as Inspectors for the purposes of this Act. 56 LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1927, SEC. 52. Nuisance Caused, by Pigeons.—The number of complaints received arising from the above cause was six. On investigation no action on the part of the Council appeared to be necessary. It is estimated that there are some 2,000 pigeons at large in the Borough. RATS AND MICE (DESTRUCTION) ACT, 1919. Complaints concerning 74 premises were received. In a number of cases the Borough Engineer and Surveyor was asked to cause examinations to be made of the sewer connections of the infested house and the two premises immediately adjacent. In several instances this procedure resulted in the discovery of defects which received the requisite attention of either the owner or, where only a minor trouble, the Borough Engineer and Surveyor. One notice was served under the Act in respect of rat-infested premises. Rat Week.—This was held from 4th to 9th November inclusive. The usual circular letter was sent out to principal wharfingers, railway companies, tradesmen, etc. VERMINOUS CONDITIONS. Cleansing of Verminous Persons.—Forty-three (43) cases were referred by the department to the Kensington Medicinal Baths for treatment under the scheme arranged with the Kensington Borough Council. Cleansing of Verminous Rooms.—Notices under Section 10 of the London County Council (General Powers) Act, 1922, were served with respect to 312 premises, the verminous room6 numbering 546. The owners of 91 premises accepted the Council's offer with regard to the spraying of infested rooms with a special insecticidal solution, 156 rooms being so treated at a charge to the owners of 7s. 6d. per room. Verminous Household Goods.—-Arrangements were made during the year with the Council of the Royal Borough of Kensington for the disinfestation at their Station of verminous furniture, bedding, etc. Hy3ro-cyanide gas is used for furniture and steam treatment for bedding, the charge per load being £3 for the former and 2s. 6d. the latter. Section 26 of the London County Council (General Powers) Act, 1928, authorises the cleansing of verminous persons by the exercise of powers granted by a petty sessional court in oases where the verminous person does not consent to being removed to a cleansing station. No use was made of this Section during the year. COMPULSORY REMOVAL OF AGED, INFIRM OR DISEASED PERSONS. By virtue of Section 28 of the London County Council (General Powers) Act, 1928, it is possible in London to remove to a hospital o r infirmary, by compulsion and under certain circumstances, aged, infirm, sick or physically incapacitated persons. The circumstances which may enable an order for removal to be obtained are somewhat involved. Unless the person concerned is Buffering from disease it is necessary for the premises to be insanitary. It is in all cases necessary as well to prove that the person is not receiving proper attention and that removal is necessary in the interests of the affected person and of other persons. In no case was it necessary to obtain an order of the Court for removal, all cases which came to notice being dealt with by means of persuasion. SUPPLY OF MEDICINE AND MEDICAL ASSISTANCE. Section 77 qf the Public Health (London) Act, 1891, empowers a sanitary authority, with the sanction of the Minister of Health, to provide a "temporary supply of medicine and medical assistance for the poor inhabitants of their district." Arising out of an application from University College Hospital for the Council to bear the cost of insulin needed by a poor resident of the Borough attending the Diabetic Clinic, the sanction of the Minister of Health was sought and obtained, and during the year 7,300 units of insulin were supplied at a cost of £1 13s. 6d. 57 LEGAL PROCEEDINGS, 1935. Premises. Offence. Fine. Costs. Public Health (London) Act, 1891. Section 4. £ s. d. 33, Amberley Road Back addition roof defective Work done. Summons withdrawn — 21, Andover Place Main roof defective Work done. Summons withdrawn 1 1 0 181, Ashmore Road Walls of first and second floor kitchens damp; walls and ceiling of first floor water-closet Work done 1 1 0 234, Ashmore Road damp and dirty Back addition roof defective; walls and ceiling Work done 1 1 0 18, Campbell Street of top floor kitchen dirty Drain defective Work done. Summons withdrawn 1 1 0 5, Chippenham Mews Skylights and main roof defective Work done. Summons withdrawn 0 10 6 18, Clarendon Street Main roof defective Work done. Summons withdrawn — 15, Delamere Crescent Roof defective Work done. Summons withdrawn 0 10 6 18, Delamere Terrace Waste stack at rear choked and defective Work done. Summons withdrawn 4, Fernhead Road Top floor back room, first floor back room, general staircase, landings and passage dirty; Work done. Summons withdrawn — 84, Fernhead Road walls of first floor front and back rooms dirty Roof defective Order made 1 1 0 56, Formosa Street Roof defective; premises without a proper and sufficient water supply Work done. Summons withdrawn — 272, Gloucester Terrace Premises without a water supply Order made. (Premises vacated) — 94, Harrow Road Walls and ceilings of basement passage and water-closet dirty and walls defective; walls and ceilings of basement rooms dirty Work done 1 1 0 " " Premises without a proper and sufficient water supply Drain defective Work done 1 1 0 16, Howell Street Order made 1 1 0 25, Kennet Road Main roof defective Work done 1 1 0 93, Kilburn Park Road Walls and ceilings of ground floor slip room, Work done 0 10 6 general passage, staircase • and landings, ground floor front room, first floor slip room, first floor water-closet, second floor back room and back yard water-closet dirty; ceiling of top floor landing defective; basement front room and passage damp; sink on first floor half-landing defective Main and back addition roofs defective; ground Work done 0 10 6 floor front room damp Premises without a proper and sufficient water Work done 0 10 6 3, Modena Street supply Premises without water-closet accommodation Closing Order made .. 13, Northumberland Walls and ceiling of water-closet on first half- Work done. Summons — Place landing dirty withdrawn by tion of Magistrate 79, Sutherland Avenue Walls of basement front room damp; wall of Adjourned sine die .. — basement back room damp and walls and ceiling dirty; walls and ceiling of basement scullery, front entrance and yard water-closet dirty; waste-pipe of sink in basement scullery defective 5, Sutherland Place ,, ,, ,, ,, ,, Order made 1 1 0 Walls and ceilings of staircase and ground floor Summonses not served. — passage dirty Whereabouts of fendant not known 15, Upper Westbourne Rain-water pipe at rear choked Work done 1 10 6 Terrace Walls and ceilings of staircase, landings and Work done. — attic front and back rooms dirty; flooring of monses marked "not third floor front and back slip rooms served'' owing to tive; waste-pipe and trap of sink in ground change in floor slip room defective; premises without a tion of defendant proper and sufficient water supply company 19, Warlock Road Waste-pipe of first floor kitchen sink choked Order made 1 1 0 and defective 3, Westbury Road Wall damp, ceiling defective and walls and Work done l 1 0 ceiling dirty in first floor front room; wall damp and walls and ceiling dirty in second floor front room; walls and ceiling of ground floor water-closet dirty 58 LEGAL PROCEEDINGS, 1935.—continued. Premises. Offence. Fine. Costs. 54-58, Princes Square .. Section 37. £ s. d. Insufficient dustbin accommodation Adjourned sine die to enable a sufficient number of dustbins to be provided Bye-laws pursuant to above and other Acts. 234, Ashmore Road Sashcords in top floor front and back rooms defective £1 1 1 0 ,, ,, Flushing cistern to top floor water-closet defective £4 1 1 0 11, Bristol Mews Dustbin defective New bin provided 0 10 6 13, Clarendon Street Paving of front and back areas defective Work done. Summons withdrawn 0 10 6 1 1 0 15, Clarendon Street Paving of yard defective Work done. Summons withdrawn 1 1 0 47, Clarendon Street Paving of yard defective Work done. Summons withdrawn 18, Clarendon Street Failing to deposit completed notices and plans with respect to additional sanitary fittings £1 — 34, Clifton Gardens Failing to submit plans of drainage work executed Plans submitted 0 10 6 18, Delamere Terrace Paving of back yard defective Work done. Summons withdrawn — ,, ,, Dustbin defective New bin supplied. Summons withdrawn — la, Devonshire Terrace Failing to submit plans of drainage work executed 10s. 2 2 0 4, Elcom Street Sink waste-pipe constructed in a manner contrary to Bye-laws Work satisfactorily completed. Summons withdrawn 0 10 6 4, Fernhead Road Failing to provide accommodation for the washing of clothes and proper accommodation for the storage of food for each family £2 1 1 0 94, Harrow Road Treads of basement staircase defective Work done 1 1 0 422, Harrow Road Failing to provide sufficient water-closet accommodation Additional accommodation provided. Summons dismissed under Probation of Offenders Act 1 1 0 16, Howell Street Paving of yard defective 5s. 1 1 0 13, Howley Place Failing to carry out annual cleansing Work done. Summons withdrawn 0 10 6 ,, ,, Sashweights defective Work done. Summons withdrawn 0 10 6 43, Lancefield Street Failing to provide water-closet accommodation and proper accommodation for the storage of food for the separate use of each family Work done 1 1 0 142, Lancefield Street Failing to provide water-closet accommodation and proper accommodation for the storage of food for the separate use of each family Summons dismissed .. 80, Ledbury Road Fixing a sink waste-pipe in a manner contrary to the Bye-laws 10s. 1 0 0 13, Northumberland Place Absence of means for carrying off waste water from tap on second half-landing Order made 1 1 0 18, Park Place Villas.. Failing to submit plans of drainage work executed Plans submitted. Summons withdrawn 1 1 0 ,, ,, Fixing a soil pipe in a manner contrary to the Bye-laws Contravention remedied 0 10 6 42, Queen's Gardens Failing to deposit plans in connection with reconstruction of bath waste-pipe 10s. 0 10 6 ,, ,, Constructing a water-closet which was not adequately lighted and ventilated 10s. — ,, ,, Constructing a bath waste-pipe of materials which were not in conformity with the Bye- 5s. 189, Queen's Road laws Failing to submit plans of drainage work executed £2 £2 ,, ,, Fixing improper traps to waste-pipes 47, Ranelagh Road Dustbins defective 10s. Notice complied with 1 0 0 9, Statham Street Failing to carry out annual cleansing 10s. Work done 0 10 0 79, Sutherland Avenue Paving of back yard defective Adjourned sine die .. — 15, Upper Westbourne Terrace Paving of back yard defective Work done 1 1 0 Sashcords of first floor back room broken Work done. Summons marked ' 'not served'' owing to change in constitution of defendant company 59 LEGAL PROCEEDINGS, 1935.—continued. Premises. Offence. Fine. Costs. £ s. d. 87, Westbourne Park Villas Fixing to a water-closet a trap contravening the Bye-laws Work properly completed. Summons withdrawn by direction of Magistrate 3, Westbury Road Defective condition of flushing cistern and door 5s. Work done 1 1 0 23, Westmoreland Road of ground floor water-closet Failing to provide water-closet accommodation, Work done 1 1 0 46, Westmoreland Road accommodation for the washing of clothes, and proper accommodation for the storage of food for the separate use of each family Failing to deposit notices and plans in respect £1 21, Woodchester Street of drainage works executed Absence of efficient means for carrying off waste Work done 1 1 0 water from tap on flat roof Conveying offensive refuse in a manner contrary £2 to the Bye-law Removing offensive refuse in a manner contrary to the Bye-law London County Council (General Powers) Act, 1902. Section 51. 7s. 6d. 117, Edgware Road Receiving lodgers into a Common Lodging House without being licensed Summons marked "not served"—Defendant — 131, Edgware Road Receiving lodgers into a Common Lodging House without being licensed London County Council (General Powers) Act, 1908. Section 8. "gone away." Premises vacated Summons withdrawn — 153, Church Street Shop used as a sleeping place London County Council (General Powers) Act, 1922. Section 10. £1 13, Clarendon Street Second floor back room verminous Work done. Summons 0 10 6 17, Clarendon Street Second floor back room verminous withdrawn Work done. Summons 1 1 0 47, Clarendon Street Ground floor front room and first and second withdrawn Work done. Summons 0 10 6 4, Fernhead Road floor back rooms verminous Top floor rooms verminous withdrawn £2 1 1 0 78, Fernhead Road Ground floor front room verminous £2 1 1 0 93, Kilburn Park Road Basement front room, ground floor back room and top floor front and back rooms verminous Work done 0 10 6 5, Sutherland Place Top floor front room verminous Summons not served. Whereabouts of defendant not known 21, Woodchestcr Street Ground floor front room, first floor back room and second floor front and back rooms verminous Metropolis Management Act, 1855. Section 85. Work done 1 1 0 13, Northumberland Place Drain between premises and sewer defective Order made 1 1 0 OFFICE (CLERICAL) WORK. 1935. Letters received 5,987 ,, despatched 9,234 Kntrics in Postage Book 14,353 Certificates dealt with relating to Notifiable Diseases 2,029 Notices sent re above 3,796 Entries in Birth Register 2,154 Complaints received 2,145 Plans dealt with 483 New openings in Journals 726 Disinfection Orders 809 Notices to abate nuisances, etc 1,562 60 Report of the Work of the District Inspectors. Inspection of Dwelling Houses. Sanitary Works completed in Dwelling Houses. To Regulate Keeping of Animals. Drainage, etc. Water Supply. Dust Receptacles Miscellaneous. YEARS. Number of Complaints received. "House-to-House." On Complaint or after Illness. Re-Inspection of all kinds. Entire Reconstruction. Drains Relaid, Trapped or Ventilated. Drains Repaired and made Sound. Wastfa Pipes Disconnected. New Waste Pipes Provided. Rain-water Pipes Disconnected. W.C.'s, New Provided, Repaired, etc. Soil Pipes, New Provided. Soil Pipes Repaired. Soil Pipes Ventilated. Services Separated. Supplies Reinstated. Cisterns, New Provided. Cisterns, Cleansed, Repaired, etc. New Provided. Repaired, etc. Drains, Cleared, Flushed, etc. Houses or Rooms Cleansed, Whitewashed, etc. Cases of Overcrowding Abated. Yards and Areas Paved and Drained. Roofs Repaired. Manure Receptacles Reconstructed, etc. Accumulations Removed. Improperly kept, Removed. 1930 .. 1,076 — 2,084 13,753 22 106 36 38 1551 2 638 104 46 23 1 3 — 55 142 2 62 517 — 22 252 — 25 1 1931 .. 970 — 1,607 13,386 15 84 55 11 1179 12 436 92 61 39 3 6 9 27 168 4 97 516 2 18 183 5 29 2 1932 .. 1,191 91 1,474 13,377 1 66 60 11 1470 6 308 38 22 42 6 24 4 19 299 7 69 636 3 11 231 6 41 — 1933 .. 1,253 25 1,195 12,911 3 82 79 22 2383 10 443 83 22 24 3 14 2 18 359 3 98 908 4 30 303 3 59 1 1934 .. 1,521 27 1,735 14,028 4 164 61 68 3487 9 741 139 54 23 — 16 9 25 642 7 76 983 8 19 226 2 23 1 1935 .. 1,621 18 1,871 15,086 3 193 45 12 3415 7 945 65 16 168 4 7 12 16 546 10 58 1007 5 27 200 — 8 —