PAD 49 Metropolitan Borough of Paddington REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1949 A. B. STEWART, M.D., D.P.H. VAIL & Co., Ltd., Printers to the Council, 170, Farringdon Road, E.C.I 2 CONTENTS. page Aged and Infirm Persons 12 Bacteriological Examinations:— Infectious Disease 9 Milk and Foods 18 Bakehouses 15 Births 5,7 Bombed Sites 15 Burials 12 Canal Boats 15 Certificates of Disrepair 15 Common Lodging Houses 15 Compulsory Repairs 22 Deaths Numbers and Rates 6 Classification 7, 8 Infantile 6, 9 Maternal 6, 9 Tuberculosis 6 Disinfection.13 Drainage Reconstruction Plans 15 Factories Act, 1937 13 Food and Drugs (Whalemeat) Regulations, 1949 21 Food Poisoning Food Premises, etc. 19 Food Supervision 16.21 Fumigation 13 Holiday Home for Elderly People 21 Houses Unfit for Human Habitation 22 Housing 22.23 IceCream 18 Infantile Mortality 6. 9 Infectious Disease 9 Legal Proceedings 15 Marriages 7 PAGE Maternal Mortality 6, 9 Medicinal Baths 13 Milk and Dairies Regulations, 1949 .20 Milk (Special Designations) Regulations 20 Mineral Oil in Food Order, 1949.21 Miniature Mass Radiography 12 Mortuary 12 National Assistance Act, 1948 12 Outworkers 14 Overcrowding 22 Penny Rate 6 Pharmacy and Poisons Act, 1933 15 Population 5 Rateable Value 6 Rodent Control 16 Rent and Mortgage Interest (Restrictions) Acts 15 Sampling of Foo4 16.18 Sanitary Inspectors, Work of 14, 15 Scabies, Treatment of 13 Smallpox 9 Smoke Nuisance 13 Shops Acts 16 Static Water Tanks 15 Staff 5 Stillbirths 6 Tuberculosis 10, 12 Unsound Food 18 Vacant Sites 16 Venereal Diseases 12 Verminous Rooms 13 Vital Statistics, Summary 5, 6 Water Supply 12, 13 Work of District Inspectors 14, 15 Work of Lady Sanitary Inspectors 9, 10 3 His Worship the Mayor, Aldeimen and Councillors of the Metropolitan Borough of Paddington. Mr. Mayor, Ladies and Gentlemen, I have the honour to present the Annual Report of the Medical Officer of Health for the year 1949. In this, the first full year following the introduction of the National Health Service, it has been possible to assess the place of the Health Department in the scheme of things, and to direct our efforts where there appeared to be the greatest scope for development. The work of the department has been directed towards problems of environmental hygiene, the supervision of food and food premises, and the control of infectious disease. Reference to the statistical summary on pages 5 and 6 gives the present position, the birth rate showinga further fall, but it is still well above the immediate pre.war figure. There has been a slight increase in the death rate, but the considerable fall in the infant mortality rate is the outstanding feature in the vital statistics this year. In 1901 this figure was 135 and this year, the fourth successive year in which the figure is the lowest recorded, it is 26. Having regard to our present knowledge, we are close to what is generally regarded as the irreducible figure for infant deaths. The tuberculosis figures show little variation and our disappointment at our failure to progress is tempered by the relief that, in spite of hospital staffing difficulties, the position has not deteriorated. In the field of environmental hygiene it is gratifying to report that the number of cases requiring legal proceedings was less than half the number of cases taken in the preceding year. It is disquieting to note, however, that there is an increasing number of landlords, many of them pensioners relying on property to supplement their incomes to some extent, who find it very difficult or even impossible to meet the cost of repairs to property. It is evident that the current high cost of repairs and the small return from rents are factors which are operating to the detriment of many properties in the Borough. We are faced with the continued deterioration of many properties with the ultimate prospect of loss of housing accommodation at a time when it is essential to keep property in a habitable condition if this is possible. The existing Housing Acts give some powers to local authorities, but our experience suggests that they are inadequate to deal with many of the problems which are met. It is reasonable to suggest that if local authorities were relieved of some of the financial risk they might be in a position to undertake further work. In theory expenses may be recovered in certain cases by the collection of rents, but with controlled rents and present building repair prices it is doubtful in some cases whether this can be done in a reasonable time with properties requiring extensive repair. Another aspect of this problem which requires attention is the worn out property with a small return in rent which cannot be repaired at a reasonable cost. This same property taken over as a derelict building may be almost completely rebuilt for sale within the Government ceiling figure and give the builder a reasonable profit. So long as such a state of affairs exists, and this building emergency period may last twenty years, there seems to be a case for some temporary measure to enable local authorities to deal with such problems themselves. The alternative to increasing the powers of the local authorities is the unpopular one of increasing the rents. As far as the property owner with limited means is concerned, one or other of these remedies must be applied and applied soon enough to prevent the creation of slums faster than we can build new homes. An unusual occurrence was the notification of two cases of smallpox in the borough. Both cases were infected on board S.S. Mooltan and one of the cases was fatal. There were no secondary cases. Every possible assistance was rendered by the epidemiological Medical Officers of the Ministry of Health and the County Council Officers made vaccination freely available immediately. Details of the outbreak are included in the appropriate section of the report. It is a pleasure to record that the Holiday Home for the Aged was opened at Bexhill during the year and that our hopes for its success have been justified. A description of the home will be found in the report. 4 During a particularly busy year I am grateful for the valuable support of the members of the Council, and to my colleagues both in other departments and in the Public Health Department I am indebted for valuable continued assistance. I have the honour to be— Mr. Mayor, Ladies and Gentlemen, Your obedient servant, Medical Officer of Health. Public Health Department, 15, Park Place Villas, Paddington Green, W.2. May 31st, 1950. 5 PUBLIC HEALTH OFFICERS (on December 31st, 1949).— W.T.—Whole-time appointments. P.T.—Part-time appointments. Medical Officer of Health, P. T. A. B. Stewart, M.D., D.P.H. Public Analyst, P.T. C. H. Wordsworth, B.Sc., F.R.I.C. Clerical Staff—W. T. S. W. Ruffey (Chief Clerk) A. J. O. Sheppard R. I. Fisher H. J. Parker. S. W. Wordingham. A. G. L. E. Houghton. E. J. Cleaver. D. J. Myers. J. T. G. Warby. L. Allchin. A. H. Lawrence B. W. Godden E. Craddock T. New. Miss D. Smeaton. Mrs. L. Walters. Miss P. Goldenberg. Mrs. M. J. P. Miller. Miss E. Low. Sanitary Inspectors—W. T. C. G. Heron (Senior Sanitary Inspector). V. L. Ronchetti. E. B. Wilde. F. J. Pallet (Food and Sampling). E. Marshall. A. C. Harrison (Food). G. Duncan. W. H. G. Atkins. J. Mains. G. A. Fraser. V. A. Vickers. C. Chesterman. D. B. Hooper. F. H. Free. B. W. James. T. W. Harry. R. Fowler. N. E. Broom. B. J. Jones. Lady Sanitary Inspectors—W.T. Miss D. M. Newhall. Mortuary Superintendent—W. T. C. C. Lewis. Miss E. Z. Amor. Mortuary Assistant—W.T. S. King. Rodent Officer—W.T. W. A. Dunkley. and 16 Disinfecting, Fumigation, Rodent Control and Porter Staff. Bexhill Holiday Home. Manageress—Mrs. G. Hoskings—W.T. and 4 Domestic Staff—3 W.T. 1 P.T. Except where otherwise indicated, the figures in brackets throughout this Report are the figures for 1948, and are shown for comparison. SUMMARY OF VITAL STATISTICS—1949. Area of Borough : 1,356.1 acres, including waterways 20.0 acres. Population: Registrar-General's estimate of Civilian Population at middle of year: 130,640 (128,100). Inhabited Houses fend of vearl according to Rate Books—22.663 (22.041). Live Births: Males Females Totals Legitimate 1,027 (1,050) 924 (997) 1,951(2,047) Illegitimate 170 (167) 122 (139) 292 (306) Totals 1,197 (1,217) 1,046 (1,136) 2,243 (2,353) Birth Rate per 1,000 estimated civilian population 17.17 (18.37) 6 Stillbirths: Males Females Totals Legitimate 21 (18) 21 (21) 42 (39) Illegitimate 4 (5) 1 (6) 5 (11) Totals 25 (23) 22 (27) 47 (50 Stillbirth Rate per 1,000 (live and still) births 20'52 (20-81) Males Females Totals Deaths (all ages) 754 (704) 735 (677) 1,489(1,381) Death Rate per 1,000 estimated civilian population 11.39 (10.78) Deaths from Pueperal Causes: Puerperal Sepsis 2 (2) Rate per 1,000 (live and still) births 0.87 (0-83) Other Puerperal Causes - (1) Rate per 1,000 (live and still) births 0.00 (0-42) Total 2 (3) Rate per 1,000 (live and still) births 0.87 (1-24) Deaths of Infants Under One Year of Age : Males Females Totals Legitimate 29 (41) 13 (29) 42 (70) Illegitimate 7 (12) 9 (3) 16 (15) Totals 36 (53) 22 (32) 58 (85) Death Rates of Infants Under One Year of Age:— All infants per 1,000 live births 26 (36) Legitimate infants per 1,000 legitimate live births 21 (34) Illegitimate infants per 1,000 illegitimate live births 55 (49) Deaths from Tubebculosis: Pulmonary (all ages) 79 (69) Other forms (all ages) 6 (12) Death Rate from Pulmonary Tuberculosis per 1,000 estimated civilian population 0.60 (0.54) Death Rate from all forms of Tuberculosis per 1,000 estimated civilian population0.65 (0.63) Rateable Value £1,760,851 (£1,750,252) Product of a Penny Rate £6,967 (£6,762) General Summary of Vital Statistics. Year. Reg. General's Estimate of Population. Live Births Deaths Deaths under One Year Maternal Deaths Tuberculosis Deaths (All forms) Number. * Rate. Number. * Rate. Number. * Rate. Number. * Rate. Number * Rate. 1901 143,976 3359 23.29 2163 15.00 455 135 9 2.1 223 1.53 1911 142,541 2977 20.88 1885 13.22 388 129 10 3.3 212 1.48 1921 145,600 2859 19.63 1758 12.06 265 92 13 4.54 125 0.86 1931 140,300 2075 14.79 1831 13.05 182 87 10 4.63 138 0.98 1938 137,400 1888 13.74 1557 11.33 125 66 3 1.53 81 0.59 1939 135,300 1812 13.39 1608 12.74 106 60 8 4.38 95 0.75 1940 97,860 1556 15.90 1766 18.04 88 59 4 2.61 86 0.88 1941 77,640 1217 15.67 1418 18.26 64 60 4 3.62 97 1.25 1942 83,640 1397 16.70 1268 15.16 78 56 4 2.77 87 1.04 1943 90,580 1569 17.32 1390 15.32 107 68 2 1.86 79 0.87 1944 93,030 1639 17.62 1388 14.92 100 61 2 1.18 84 0.90 1945 99,790 1712 17.16 1367 13.69 104 61 7 3.97 68 0.68 1948 117,670 2386 20.28 1525 12.96 113 47 4 1.63 100 0.85 1947 127,450 2520 19.77 1567 12.29 109 43 1 0.39 83 0.65 1948 128,100 2353 18.37 1381 10.78 85 36 3 1.24 81 0.63 1949 130,640 2243 17.17 1489 11.39 58 26 2 0.87 85 0.65 * Corrected figures after allowing for inward and outward transfers. 7 BIRTHS.—The Borough Birth.rate for 1949 is 17.17, which represents a fall of 1.20 per 1,000 of the population compared with the rate for 1948. This rate is, however, a little higher than that for England and Wales (16.7), but slightly lower than that for the County of London (18.5). MARRIAGES.—The number of marriages solemnised in the Borough was 1,581, representing a rate of 24.20 per 1,000 of the population. The number for 1948 was 1,805 (rate 28.2), and for 1947 1,948 (rate 30.6). Of the 1,581 marriages solemnised in 1949, 1,142 took place at the office of the Registrar of Marriages, 314 were Church of England marriages, and 125 took place in Non.Conformist Churches. The decline in the number of marriages is general throughout the country, and is no doubt intimately connected with the housing shortage. DEATHS.—There were 108 more deaths in 1949 than in 1948, representing an increase in the rate per 1,000 of the population of 0.51 to 11.39. The causes of death accounting for this increase were cancer, heart disease and respiratory diseases. The local rate was, nevertheless, slightly lower than the rates for London and England & Wales, which were 12.2 and 11.7 respectively. In the Table on the next page the deaths are classified according to the Abridged List of the International Manual of Causes of Death, and the sex.age distribution is also shown. 8 Deaths, 1949.—Abridged List of Causes of Death, and Sex.Age Distribution. Cause of Death. All Ages Deaths at Ages 0— 1— 5— 15— 45— 65— M. F. Total M. F. M. F. M. F. M. F. M. F. M. F. Typhoid and paratyphoid fevers -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) Cerebro.spinal fever -(1) -(-) -(1) -(-) -(-) -(-) -(-) -(-) -(-) -(1) -(-) -(-) -(-) -(-) -(-) Scarlet fever -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) Whooping cough 1(-) -(2) 1(2) 1(-) -(2) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) Diphtheria -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) Pulmonary tuberculosis 46(38) 33(31) 79(69) -(-) -(-) -(-) -(-) -(-) -(-) 13(14) 18(22) 24(22) 13(7) 9(2) 2(2) Other tuberculous diseases 2(8) 4(4) 6(12) -(-) - (1) 1(-) -(1) -(2) 1(-) -(6) 1(1) 1(-) 2(1) -(-) -(-) Syphilitic diseases 14(7) 4(7) 18(14) -(-) -(-) -(-) -(-) -(-) -(-) 1(-) -(2) 7(3) 2(2) 6(4) 2(3) Influenza 7(2) 5(1) 12(3) -(-) -(-) -(-) -(-) -(-) -(-) 2(1) 1(-) -(-) -(-) 5(1) 4(1) Measles 1(2) 1(-) 2(2) -(-) -(-) 1(2) 1(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) Acute polio.myelitis and polioencephalitis -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) Acute infectious encephalitis -(-) -(1) -(1) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(1) -(-) -(-) -(-) -(-) Cancer of buccal cavity and oesophagus (males) 10(10) -(-) 10(10) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) 4(4) -(-) 6(6) -(-) Cancer of uterus -(-) 19(16) 19(16) -(-) -(-) -(-) -(-) -(-) -(-) -(-) 4(-) -(-) 10(11) -(-) 5(5) Cancer of stomach and duodenum 26(12) 17(18) 43(30) -(-) -(-) -(-) -(-) -(-) -(-) 2(1) -(1) 13(4) 3(1) 11(7) 14(16) Cancer of breast -(-) 26(25) 26(25) -(-) -(-) -(-) -(-) -(-) -(-) -(-) 4(3) -(-) 10(12) -(-) 12(10) Cancer of all other sites 99(94) 71(66) 170(160) -(-) -(-) 1(1) -(-) 1(-) -(-) 6(8) 5(6) 40(42) 32(24) 51(43) 34(36) Diabetes 4(4) 4(3) 8(7) -(-) -(-) -(-) -(-) -(-) -(-) -(2) -(-) 1(1) 1(1) 3(1) 3(2) Intra.cranial vascular lesions 43(46) 72(79) 115(125) -(-) -(-) -(-) -(-) -(-) -(-) 1(-) 1(1) 10(10) 18(11) 32(36) 53(67) Heart disease 184(165) 186(167) 370(332) -(-) -(-) -(-) -(-) -(-) -(-) 14(9) 4(4) 53(46) 24(15) 117(110) 158(148) Other circulatory diseases 50(42) 49(47) 99(89) -(-) -(-) -(-) -(-) -(-) -(-) 1(1) -(1) 8(12) 8(7) 41(29) 41(39) Bronchitis 63 (53) 43 (34) 106 (87] 3 (4) - (1) - (1) - (1) - (-) - (-) 1(3) 1(-) 17(5) 7(5) 42(40) 35(27) Pneumonia 43(39) 53(42) 96(81) 4(4) 5(7) 2(1) 1(1) -(-) -(-) 3 (1) 3 (3) 4 (5) 5 (4) 30 (28) 39(27) Other respiratory diseases 9(9) 8(8) 17(17) -(-) -(1) -(-) -(-) -(-) -(-) -(3) 1(1) 6(-) 2(3) 3(6) 5(3) Ulcer of stomach or duodenum 14(14) 6(8) 20(22) -(-) -(-) -(-) -(-) -(-) -(-) 1(1) 1(1) 7(10) 3(2) 6(3) 2(5) Diarrhoea (under 2 years) 1(6) 1(2) 2(8) -(5) 1(2) 1(1) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) Appendicitis 1(1) 1(3) 2(4) -(-) -(-) -(-) 1(-) -(-) -(-) -(-) -(-) 1(-) -(3) -(1) -(-) Other digestive diseases 18(15) 10(15) 28(30) -(-) -(-) 1(—) -(1) -(-) -(-) 3(-) 1(-) 6(7) 3(7) 8(8) 6 (7) Nephritis 10(13) 18(11) 28(24) -(-) -(-) -(-) -(-) -(1) -(-) 4(2) 5(1) 2(1) 4(1) 4(9) 9(9) Puerperal sepsis -(-) 2(2) 2(2) -(-) -(-) -(-) -(-) -(-) -(-) -(-) 2(2) -(-) -(-) -(-) -(-) Other maternal causes -(-) -(1) -(1) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(1) -(-) -(-) -(-) -(-) Premature birth 5(11) 7(7) 12(18) 5(11) 7(7) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) -(-) Congenital malformation, birth injury, infantile disease 18(23) 11(8) 29(31) 17(22) 8(7) 1(-) -(-) -(-) -(-) -(-) -(-) -(1) 2(-1) -(-) 1(1) Suicide 21(14) 7(15) 28(29) -(-) -(-) -(-) -(-) -(-) -(-) 7(9) 4(4) 11(3) 3(8) 3(2) -(3) Road traffic accidents 10(5) 3(3) 13(8) -(-) -(-) 1(-) -(-) 1(1) -(-) 5(1) 2(-) -(2) 1(3) 3(1) -(-) Other violent causes 23(25) 27(20) 50(45) 6(4) 1(4) -(-) -(-) 1(-) 1(1) 3(5) 3(4) 4(4) 4(2) 9(12) 18(9) All other causes 31(45) 47(31) 78(76) -(3) -(-) -(1) 1(-) 1(1) -(-) 3(6) 6(7) 9(4) 9(7) 18(30) 31(17) All Causes (Totals) 754(704) 735(677) 1,489(1,381) 36(53) 22(32) 9(7) 4(4) 4(5) 2(1) 70(74) 67(66) 228(186) 166(137) 407(379) 474 (437) 9 INFANTILE MORTALITY.—.Although the infantile death.rate for the Borough has steadily declined for several years, it has always been higher than the rates for London and the country as a whole. This year, however, our rate of 26 deaths per 1,000 live births is lower than the London rate (29) and the rate for England and Wales (32). MATERNAL MORTALITY.—Two deaths from puerperal sepsis occurred, there being no death from other maternal causes. This gives a rate of 0.87 per 1,000 live and still births. INFECTIOUS DISEASE.— Notifications.—Following is a table showing the numbers of cases of infectious disease notified in each year from 1940 to 1949. Commencing from 1948, the actual number of cases after allowing for correction of diagnosis, is shown in brackets. Disease 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 Acute encephalitis lethargica 1 1 - - - - - - - (-) - (-) „ influenzal pneumonia 22 8 11 29 11 9 20 18 8 (8) 25 (24) „ primary pneumonia 80 68 96 53 47 88 100 67 59 (59) 62 (62) „ polioencephalitis - - - - - - - 4 - (-) 1 (1) „ poliomyelitis 1 3 1 1 2 1 2 21 6 (5) 35 (32) „ rheumatism 9 6 2 5 6 - 9 6 4 (4) 2 (2) Cerebro.spinal fever 24 19 11 9 7 9 4 6 4 (2) 2 (1) Continued fever 3 1 - - - - - - - (-) - (-) Diphtheria 42 58 38 54 50 51 37 20 10 (3) 13 (7) Dysentery 3 12 35 94 38 86 34 8 13 (11) 14 (10) Erysipelas 43 29 28 29 33 31 23 27 29 (27) 13 (12) Food poisoning or suspected food poisoning 6 4 6 10 3 4 11 17 16 (16) 24 (23) Infective enteritis or summer diarrhoea 24 13 27 84 107 154 143 128 68 (57) 64 (58) Malaria 4 - 3 - 5 2 9 2 3 (3) 2 (2) Measles 253 301 707 592 174 1,046 690 960 1,027 (1,023) 568 (567) Membranous croup - - - - 1 - - - - (-) - (-) Ophthalmia neonatorum 20 6 6 8 13 11 5 4 9 (9) 8 (8) Puerperal fever* 23 6 5 3 8 25 10 3 1 (1) - (-) Puerperal pyrexia 17 25 38 23 24 37 24 16 20 (20) 18 (18) Scabiest - - - 246 644 804 726 344 196 (196) 84 (83) Scarlet fever 56 61 110 312 137 126 228 129 147 (134) 127 (123) Smallpox - - - - 1 - - - - (-) 2 (2) Typhoid or enteric fever 5 9 1 3 - 9 - 3 2 (2) 4 (1) Whooping cough 24 170 235 142 156 54 155 227 254 (250) 131 (130) * Ceased to be notifiable on 30.7.48. † Notifiable from 1.8.43. Bacteriological Examinations.—The number of examinations made in connection with infectious disease was 242, including 55 examinations of sputa for tuberculosis. Smallpox.—A passenger on S.S. Mooltan contracted smallpox at an Indian port whilst on a journey to this country from Australia. The disease was not diagnosed until the ship reached Tilbury. All the passengers were vaccinated, but it became evident later that several people on board had become infected and that the vaccination, was in several cases, carried out at too late a stage to give adequate protection against the disease. A considerable number of the passengers took up residence in the Bayswater area and it became the routine task of the district Sanitary Inspectors to visit all contacts until such time as the danger of developing the disease had passed. Two of the district inspectors reported illness in two of the contacts. Both contacts developed smallpox and had very severe attacks. They were removed to hospital and one a man aged about 60 died; the other made a good recovery after a period of anxiety. Every assistance was received from the County Council in arranging for the vaccination of contacts. In particular, Dr. Fenwick went to great trouble to ensure that as many contacts as possible were vaccinated. The whole story of the surveillance of contacts is too long to tell but it meant constant visiting and tracing of contacts, no easy matter when these contacts are frequently sight-seeing holiday makers who may at any time decide to change hotels or visit relatives at some distant town. The Sanitary Inspectors spent a very busy and worrying two weeks which included the Easter period and acquitted themselves well. Visiting.—The Lady Sanitary Inspectors visit cases of infectious disease, with the exceptions given below, and following is a summary of their work in this connection. 10 Disease. No. of Visits. Acute Poliomyelitis 125(169) Acute Rheumatism 9(13) Cerebro-spinal Fever 8(8) Chickenpox 109(297) Diphtheria 27(40) Dysentery 22(29) Erysipelas 12(35) Lice 441(516) Malaria 2(3) Measles 875(1,449) Pneumonia 89(69) Scabies 334(833) Scarlet Fever 20(234) Typhoid and Paratyphoid Fever 24(13) Whooping Cough 234(380) Visits to Schools 67(68) Miscellaneous 1,410(1,168) Typhus and smallpox cases are visited by the male Sanitary Inspectors, food poisoning or suspected food poisoning by the Food Inspectors, puerperal pyrexia, ophthalmia neonatorum and infective enteritis by the London County Council's Health Visitors, and tuberculosis by the Nurses at the Chest Clinic. 356 visits to cases of infectious disease were paid by the male Sanitary Inspectors, nearly all of which were to contacts of the 2 cases of smallpox notified, and of other contacts referred to us by Port Authorities or under the Aircraft Regulations. TUBERCULOSIS. Notification Register.—Three hundred and five new cases of pulmonary tuberculosis and 28 of non-pulmonary tuberculosis were notified, being a decrease of 1 pulmonary case and an increase of 5 non-pulmonary cases compared with the previous year. The numbers of cases notified in previous years are shown in the following table:— Year Population Pulmonary Non.Pulmonary Total Cases Incidence Rate (all forms) per 1,000 C. Pop. 1911 142,541 397 No record 397 pul. 2.8 1921 145,600 244 91 335 2.3 1931 140,300 213 87 300 2.1 1939 135,300 189 32 221 1.6 1940 97,860 168 37 205 2.1 1941 77,640 184 26 210 2.7 1942 83,640 195 40 235 2.8 1943 90,580 229 28 257 2.8 1944 93,030 233 26 259 2.8 1945 99,790 224 21 245 2.5 1946 117,670 261 24 285 2.4 1947 127,450 273 22 295 2.3 1948 128,100 300 23 329 2.6 1949 130,640 305 28 333 2.5 The ward distribution of the cases notified during 1949 is as follows:— Ward Pulmonary Non-Pulmonary Total Males Females Males Females Queens Park 10(11) 3(9) -(-) -(1) 13(21) Harrow Road 16(27) 24(22) 1(2) 2(3) 43(54) Maida Vale 42(28) 32(29) 2(-) 3(2) 79(59) Westbourne 26(28) 33(30) 2(2) 5(6) 66(66) Church 21(18) 14(12) 2(-) 2(1) 39(31) Town 6(5) 3(3) -(-) -(-) 9(8) Lancaster Gate, W. 15(15) 10(12) -(-) -(1) 25(28) Lancaster Gate, E. 19(13) 7(8) 1(-) 1(2) 28(23) Hyde Park 13(24) 11(12) 2(1) 5(2) 31(39) Borough 168(169) 137(137) 10(5) 18(18) 333(329) 11 Forty cases of tuberculosis came to the knowledge of the Department during the year otherwise than by formal notification. These are classified as follows:— Source of information Pulmonary Non.Pulmonary Males Females Males Females Death Returns from Local Registrars 8(8) 2(2) -(3) 1(2) Death Returns from Registrar.General 3(3) 1(2) 2(1) -(2) Posthumous notifications 3(1) 1H 1(-) -B Transfers from other areas (excluding transferable deaths) 9(6) 7(3) -(1) 2(-) Totals 23(18) 11(7) 3(5) 3(4) The following table shows the age distribution of the 333 cases:— 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- Total All ages Pulmonary-Male -(-) 2(2) 7(4) - (1) 7(4) 15(23) 44(55) 35(37) 34(25) 15(14) 9(4) 168(169) Pulmonary-Female 1(-) 2(-) 1(8) 7(-) 10(15) 29(32) 47(45) 17(25) 18(3) 5(7) -(2) 137(137) Non-Pulmonary-Male -(-) 1(2) 2(-) 1(-) 1(-) 3(-) 1(2) -(1) 1(-) -(-) -(-) 10(5) Non-Pulmonary-Female 2(-) 2(2) 3(-) 1(4) 1(2) 5(-) 3(5) -(3) -(-) 1(2) -(-) 18(18) Total 3(-) 7(6) 13(12) 9(5) 19(21) 52(55) 95(107) 52(66) 53(28) 21(23) 9(6) 333(329) The number of cases on the Notification Register at the end of the year was 1,180, against 1,075 at the end of 1948. Deaths.—The numbers of deaths from tuberculosis, and the death rates for each year from 1939 are set out in the following table:— Year No. of Deaths From Total Deaths Death-Rate Per 1,000 Pop. Pulmonary Tuberculosis Non-Pulmonary Tuberculosis Pulmonary Tuberculosis All Forms of Tuberculosis 1939 83 12 95 0.66 0.75 1940 72 14 86 0.73 0.88 1941 85 12 97 1.09 1.25 1942 70 17 87 0.83 1.04 1943 74 5 79 0.82 0.87 1944 76 8 84 0.82 0.90 1945 59 9 68 0.59 0.68 1946 95 5 100 0.80 0.85 1947 71 12 83 0.56 0.65 1948 69 12 81 0.54 0.63 1949 79 6 85 0.60 0.65 12 Work Carried out at the Chest Clinic.—The following particulars relating to Paddington patients have been supplied by the Chest Clinic:— No. of patients examined for first time (excluding contacts) 1,453 (1,360) No. of above found tuberculous 266 (247) No. of contacts examined 367 (270) No. of contacts found tuberculous 19 (2) No. of attendances at Chest Clinic 7,704 (7,477) No. of visits by Chest Physicians 199 (131) No. of visits by Nurses 1,670 (1,685) MINIATURE MASS RADIOGRAPHY.—The North-West Metropolitan Regional Hospital Board installed an X-Ray Unit at Paddington Hospital Extension from 7th March until 26th April, during which period 5,491 persons presented themselves for examination. It has not been possible to obtain an estimation as to how many of this number were Paddington residents or workers, but of the Borough Council's staff and employees 374 availed themselves of the facilities. The following analyses of the work undertaken at the session have been supplied by the Regional Board:— Males Females Total Miniature X-Rays taken 3,159 2,332 5,491 Recalled for large films 87 55 142 Recall percentage 2.75 2.35 2.76 ANALYSIS OF LARGE FILMS. Males Females Total No further action 52 27 79 Referred to Chest Clinics 14 20 34 To return to Unit for recheck at later date 17 6 23 Failed to attend for large film 4 2 6 VENEREAL DISEASES.—The Borough Council is not concerned with the treatment of venereal diseases, but we call attention to the dangers of the disease by the display of posters and distribution of leaflets. The Council also make a contribution to the funds of The National Society for the Prevention of Venereal Disease. NATIONAL ASSISTANCE ACT, 1948.— Section 47—Removal to suitable premises of persons in need of care and attention.—No Court Orders were applied for. In one case where such action was contemplated, the person concerned finally went voluntarily into hospital. All cases brought to our notice are kept under regular surveillance, and during the course of the year 723 visits were paid by the Lady Sanitary Inspectors. Section 50—Burial or cremation of the dead.—81 burials were arranged. MORTUARY.—376 bodies were taken to the Mortuary, a decrease of 6 compared with 1948. Inquests were held in 123 cases, and Coroner's Certificates were issued in 239. The remaining 14 bodies were taken to the Mortuary to await burial. WATER SUPPLY.—Two complaints were received as to the quality of water supplied for domestic purposes, but investigation by the Metropolitan Water Board proved that in both cases the water was chemically and bacteriologically pure and of good quality, as were all the routine samples which the Board took regularly throughout the year. 13 19 cases were notified of water supply being cut off on account of wastage or non-payment of rates, in accordance with the provisions of Section 98 of the Public Health (London) Act, 1936. Appropriate action was taken by the Department for the reinstatement of supplies. FUMIGATION SERVICE AND CLEANSING OF VERMINOUS ROOMS.—395 rooms were fumigated and 1,250 sprayed for vermin by the Council at the request of owners or occupiers, the comparable figures for 1948 being 740 and 729 respectively. It was found necessary to serve only three notices under Section 123 of the Public Health (London) Act, and these were complied with without further action by the Council. DISINFECTING STATION AND MEDICINAL BATHS.—Approximately 13 tons of bedding passed through the steam disinfector, and 369 rooms were sprayed with formalin after the occurrence of infectious disease. 294 library books were also disinfected. Scabies is still notifiable, but treatment is no longer compulsory. The incidence of this unpleasant complaint can, however, be guaged from the numbers of persons who attend the Baths for treatment. The numbers continue to fall off, only 217 persons attending in 1949, of whom 35 were children under the age of 5 years. The 1948 figures were 307 (including 72 children). There was, however, an increase in the number of cases treated for vermin—291 as against 137 for 1948. SMOKE NUISANCE.—No complaints were received, but 21 observations were made. FACTORIES.—Following is a table showing the work carried out during the year under the Factories Act, 1937. Premises Number on Register Number of Inspections Written notices Occupiers prosecuted (i) Factories in which Sections 1, 2, 3, 4 and 6 are to be enforced by Local Authorities 103(121) 29(31) -(3) -(-) (ii) Factories not included in (i) in which Section 7 is enforced by the Local Authority 508(556) 34(293) 17(17) -(-) (iii) Other Premises in which Section 7 is enforced by the Local Authority (excluding out-workers' premises) 11(2) -(-) -(-) -(-) TOTAL 622(679) 353(324) 17(20) -(-) Particulars of Defects Number of cases in which defects were found Found Remedied Referred To H.M. Inspector By H.M. Inspector Number of cases in which prosecutions were instituted Want of cleanliness (S.l) 19 (30) 16 (28) -(—) 2(1) -(—) Overcrowding (S.2) 2(2) 2(—) -(2) -(—) -(—) Unreasonable temperature (S.3) -(—) -(—) -(—) -(—) -(—) Inadequate ventilation (S.4) 4(5) 3(5) -(—) 1(—) -(—) Ineffective drainage of floors (S.6) 1(1) 1(1) -(—) -(—) -(—) Sanitary Conveniences (S.7) (a) Insufficient 1(4) 1(3) -(—) -(3) -(—) (b) Unsuitable or defective 28(51) 25(49) -(—) 3(5) -(—) (c) Not separate for sexes 4(2) 4(2) -(—) 2(2) -(—) Other offences against the Act (not including offences relating to Outwork) 6(—) 5(—) -(—) -(—) -(—) TOTAL 65(95) 57(88) -(2) 8(11) -(—) 14 OUTWORKERS.— Section 110 Section 111 No. of out-workers in August list required by Sect. 110 (1) (c) No. of cases of default in sending lists to the Council No. of prosecutions for failure to supply lists No. of instances of work in unwholesome premises Notices served Prosecutions 179(77) -(-) -(-) -(-) -(-) -(-) The 179 Outworkers visited were engaged in the following occupations:— Wearing apparel (making, altering or repairing) 114 Wearing apparel (cleaning and washing) 3 Household linen 3 Furniture and upholstery 1 Artificial flowers 9 Paper bags 26 Buttons, carding of 2 Toys, stuffed 7 Lampshades 14 179 No cases of infectious disease were reported from outworkers premises, and the visits (219) paid by the Lady Sanitary Inspector engaged on this work showed that the premises were suitable for homework, although advice was necessary in a few cases as regards cleanliness and ventilation. WORK OF THE DISTRICT INSPECTORS.— Summary. Complaints received 5,680 (5,166) Inspections and reinspections of dwelling houses 38,319 (36,951) Inspections of basements 457 (147) Inspections for purposes of Housing Act 307 (57) Visits in connection with re-housing applications 2,055 (404) Visits in connection with infectious disease 356 (70) Smoke observations 21 (6) Written Intimation Notices 3,342 (3,570) Statutory Notices 1,157 (1,520) Bye-law Notices 603 (977) Work carried out:— New dustbins provided 908 (545) Roofs repaired 1,251 (1,509) Gutters and rain-water pipes renewed or repaired 447 (416) Dampness remedied 1,776 (2,409) Rooms cleansed 2,525 (5,120) Rooms treated for vermin 119 (250) Yard paving repaired 58 (148) Water-closets repaired or renewed 395 (834) Wall and ceiling plaster renewed 2,383 (3,710) Flooring repaired 548 (746) Accumulations of rubbish removed 184 (244) Sundry repairs 4,137 (4,332) Staircase lighting provided 46 (18) Drainage:— Entire re-drainage 18 (14) Partial re-drainage 175 (129) 15 Drains tested or examined 532 (615) Drains repaired 217 (220) Drains cleared 289 (278) Drainage conversions 73 (20) Soil and waste pipes repaired or renewed 181 (546) New sinks provided 192 New baths or lavatory basins provided 299 (297) Water Supply :— New supplies provided 46 (32) Supplies reinstated 55 (108) Cisterns cleansed 19 (44) Cisterns renewed 14 (9) Legal Proceedings :— No. of cases referred for legal action 196 (522) No. of summonses heard 135 (264) Fines £121 5s. Od. (£358 18s. Od.) Costs £89 17s. Od. (£427 7s. Od.) Abatement/Prohibition Orders 27 (78) Dismissed under Probation of Offenders Act 4 (45) Adjourned sine die 8 (30) No. of summonses withdrawn on payment of costs 59 Amount of costs received £93 9s. Od. RENT AND MORTGAGE INTEREST (RESTRICTIONS) ACTS.—Applications for disrepair certificates numbered 21, 17 of which were granted. Four clearance certificates were also applied for and issued to owners. DRAINAGE RECONSTRUCTION PLANS.—During the year 236 plans were submitted for drainage work to be executed in existing buildings. In five cases work was found to have been done without the deposit of plans. In two of these cases the plans were eventually received, but legal proceedings were instituted in the remaining three. These proceedings resulted in a fine of £1 with one guinea costs in each of two cases, while the remaining case was dismissed under the Probation of Offenders Act on payment of £5 5s. 0d. costs. VACANT SITES.—Complaints continued to be received about the condition of bombed sites and static water tanks. Improvements were effected in many cases, mainly by the removal of offensive refuse by the Council's Cleansing Department. On the whole, the position cannot yet be regarded as satisfactory, but it is hoped that the Bye.laws as to the Deposit of Rubbish which have been framed by the Council and await final approval of the Home Office, in conjunction with the War Damaged Sites Act, will result in the problem of these areas being finally solved. CANAL BOATS.—The Canal Boats Inspector visited the Paddington Basin on 105 occasions, and inspected 73 boats. No serious defects or infringements were discovered, the minor matters requiring attention being disposed of without recourse to the service of notices. Six girls and five boys of school age were found to be living on the boats coming into the Basin. There were no cases of infectious disease among the canal boat population, but one death was registered. Several complaints of nuisance from mosquito bites were received, one of the complainants being St. Mary's Hospital. It was thought that a direct attack on possible breeding grounds would possibly prevent a re.occurrence of this trouble in the summer months. Acting along these lines the Inland Waterways Executive were approached as to whether they would empty the canal, as was the custom prior to the last war. My request was readily granted and for the first time since 1939, the Canal Basin was emptied of water as far as Bishop's Bridge Road for the purpose of repair work and dredging. This took place during the Easter Holidays 29th April to 2nd May, when a considerable amount of repair work was done to the brickwork, and 1,665 tons of mud were removed by dredger and manual labour. The weight of mud removed in 1939 was 1,228 tons. I would like to record my appreciation of the co.operation afforded by the Inland Waterways Executive. PHARMACY AND POISONS ACT, 1933, etc.—At the end of the year the Register contained the names of 107 persons entitled to sell the poisons scheduled in Part II of the Poisons List. BAKEHOUSES.—The number of bakehouses on the Register at the end of the year was 34 ("level") and 18" basement"), to which 253 visits were paid for the purposes of the Factories Act, 1937. In the early part of the year the quinquennial inspection of basement bakehouses was made as required by Section 54 of the Act, the purpose being to decide whether the Certificates of Suitability should be allowed to continue in operation. In no case was the Certificate actually withdrawn, but certain proprietors were warned that improvements would have to be made before the next inspection took place. COMMON LODGING HOUSES.—45 visits were made by a Lady Sanitary Inspector to Cecil House, 179 Harrow Road. Periodical visits were also paid by a Male Sanitary Inspector to examine the boilers and fire escape arrangements. 16 RODENT CONTROL.—The same procedure was followed as outlined in my Report for 1948. Two sewer treatments were undertaken, as were also a number of minor "block" schemes. In addition 347 individual complaints were received and dealt with. SHOPS ACTS.—1,394 visits were paid by the two Shops Acts Inspectors. No notices were served, all contraventions of the Acts being dealt with informally. FOOD SUPERVISION. Sampling.—600 samples were submitted to the Public Analyst, 50 being formal samples (all milk) and 550 informal. All the samples were reported upon as genuine. The following table shows the complete list of samples taken:- Number Examined Number Adulterated Formal Informal Formal Informal Aspirin - 4 - - Bacon - 10 - - Baking powder - 6 - - Bicarbonate of soda - 1 - - Biscuits - 1 - - Black pudding - 3 - - Brawn, canned - 1 - - Bread - 5 - - Butter - 11 - - Cake mixture - 1 - - Cakes - 12 - - Camphorated oil - 4 - - Capers - 1 - - Cheese - 11 - - Chocolate spread - 1 - - Cocoa - 2 - - Coffee - 8 - - Coffee and chicory essence - 5 - - Cooking fats - 9 - - Cooking fats, sweetened - 7 - - Cooking oil - 1 - - Cough mixture - 6 - - Cream salad - 3 - - Curry powder - 3 - - Custard powder - 8 - - Dessert powder - 1 - - Digestive mints - 1 - - Epsom salts - 3 - - Faggots - 1 - - Fish canned - 21 - - Fish cakes - 1 - - Fish cakes, canned - 3 - - Fish paste - 11 - - Fish pickled - 2 - - Flavouring essence - 8 - - Flavourings - 1 - - Flour - 3 - - Food tonic - 1 - - Fruit, canned - 1 - - Fruit juice, canned - 4 - - Fruit pie - 2 - - Fruit puree canned - 3 - - Gelatine — 2 - - Glycerine - 1 - - Ground ginger - 2 - - Halibut liver oil - 1 - - 17  Number Examined Number Adulterated Formal Informal Formal mal Health salts - 1 - - Honey - 3 - - Hors d'oeuvre - 2 - - Horseradish - 2 - - Indigestion tablets - 4 - - Insecticide - 1 - - Iodine - 2 - - Ice Cream - 5 - - Jam - 4 - - Junkets - 1 - - Ketchup - 6 - - Lemon curd - 2 - - Liver sausage - 11 - - Macaroni - 3 - - Malt loaf - 1 - - Margarine - 11 - - Meat, canned - 3 - - Meat extract - 1 - - Meat paste - 4 - - Meat pie - 13 - - Meat roll - 1 - - Milk 50 148 - - Milk condensed full cream sweetened - 4 - - Milk condensed skimmed sweetened - 4 - - Mince pies - 1 - - Mincemeat - 1 - - Mustard - 2 - - Nutmeg - 1 - - Ointment, healing - 1 - - Ointment, sulphur - 3 - - Ointment, zinc - 3 - - Olive oil - 4 - - Orangeade crystals - 1 - - Pastry mixture - 1 - - Peas, canned - 4 - - Peel, cut - 3 - - Pepper - 3 - - Pickles - 8 - - Poppy balsam - 1 - - Porridge oats - 1 - - Prunes, canned - 2 - - Pudding, canned - 1 - - Pudding powder - 1 - - Quinine - 1 - - Rhubarb, canned - 1 - - Rice - 1 - - Sago - 1 - - Saccharine tablets - 2 - - Sandwich spread - 1 - - Sauce powder - 1 - - Sausage rolls - 1 - - Seidlitz powder - 1 - - Semolina - 3 - - Senna pods - 2 - - Soda water - 1 - - Soft drinks - 1 - - Soup, canned - 6 - - Spaghetti - 4 - - Spice - 2 - - 18  Number Examined Number Adulterated Formal Informal Formal mal Sulphur tablets - 1 - - Sugar - 10 - - Sunny Spread - 1 - - Sweets - 5 - - Syrup of figs - 1 - - Tea - 11 - - Tomato parmeno - 1 - - Tomato juice, canned - 3 - - Tomato puree, canned - 4 - - Tomato spread - 1 - - Veal and beef loaf - 2 - - Vegetables, canned - 4 - - Vinegar - 1 - - 50 550 - - 600 Unsound Food.—Approximately 22\ tons of diseased or unsound food were surrendered for destruction, 9.1 tons more than in 1948. Three cases were reported to the Public Health Committee of food being offered or exposed for sale which was unfit for human consumption. These consisted of :— (a) a piece of chocolate in which a shilling was embedded. (b) a scone containing a nail. (c) a part of a loaf containing a nail. In each case the observations of the firm or person responsible were requested, and after very careful consideration the Committee decided not to institute legal proceedings, but to issue a severe warning that any further offence would result in a summons being taken out immediately. Food Poisoning.—24 cases of Food Poisoning or Suspected Food Poisoning were notified and investigated. One instance occurred in which several persons attending a function afterwards complained of food poisoning symptoms. A thorough investigation was made, without, however, revealing any tangible cause. In the majority of cases transient symptoms have been reported to the Department several days after their occurrence. Investigation in such cases is difficult and almost invariably fruitless. Bacteriological Examination of Milk and Food.— Milk.—53 samples of "Pasteurised" and 2 of " Sterilised " milk were submitted for bacteriological examination, and, with two exceptions, complied with the tests prescribed in the Milk (Special Designations) Regulations. The attention of the wholesaler was drawn to these two cases, and a satisfactory explanation was received. Ice Cream.—24 samples were examined for bacterial content in the manner prescribed in the Ice Cream (Heat Treatment) Regulations, with the following results :— Grade 1 .. .. .. 1 Grade 2 .. .. 5 Grade 3 .. .. 4 Grade 4 .. .. 14 Meat and Other Foods.—3 samples of pork, 1 sample of luncheon meat, 1 of cooked pie, 1 of dutch brawn, and 1 of salad cream were examined, the reports upon which were as follows :— Pork (all 3 samples) .. .. Many B. Coli and Enterococci grown. Diphtheroids also present. No definite pathogenic organisms found. Luncheon Meat .. .. .. Heavy growth staphylococcus, enterococci and B. Coli. 19 Cooked Pie Heavy growth Gram positive spore-b0earing bacilli. Practically no other organisms present. Dutch Brawn Heavy growth of B. Paracolon; streptococci viridans also present in moderate numbers. Salad Cream A diphtheroid with haemolytic reaction grown, probably not pathogenic. No other pathogenic organisms grown. Food Premises and Undertakings.—There were in existence in the Borough at the end of the year 1,218 food premises and undertakings, the complete list of which is as follows :— Food "Shops" Bakers 34 Cake shops 14 Butchers 60 Horsemeat shops (human consumption) 3 Confectioners 109 Chemists 48 Dairies 13 Fishmongers 24 Fried Fish 20 Grocers 43 Grocers and Provisions 97 Domestic Stores 16 Corn Chandlers 2 Greengrocers 79 General shops 48 Public Houses 98 Cider Houses 2 Off Licences 54 Cafes, restaurants, dining rooms and snack bars 141 905 Note.—103 grocers and general shops are registered as purveyors of milk. 90 public houses hold catering licences from the Ministry of Food. Catering Establishments other than Food Shops, holding catering licences from the ministry of Food. Private hotels 142 Industrial canteens 20 Staff canteens 56 Institutions 17 235 Note.—There are an unknown number of residential establishments (probably several hundreds) which provide meals to residents on their books, but which do not hold catering licences. Food Factories 11 (3 ice-cream factories are included in this total.) 20 Street Traders. Coffee stalls 11 Greengrocers stalls 33 Greengrocers rounds 18 Ice cream stalls 2 64 Animal Food Dealers Cat meat shops 2 Cat meat stall 1 3 Milk (Special Designations) Regulations.—The Milk (Special Designation) Regulations, 1936—1948 were superseded on the 1st October, 1949 by two distinct sets of Regulations:— (a) Milk (Special Designation) (Raw Milk) Regulations, 1949. The designations authorised by these Regulations are "Tuberculin Tested" and "Accredited." The use of the designation "Accredited" is to cease after 1st October, 1954, and after 1st October, 1957, the use of the designation "Tuberculin Tested" is to be restricted to milk obtained from attested herds. licences are to be granted by the Ministry of Agriculture and Fisheries, and Dealers licences by local authorities. (b) Milk (Special Designation) (Pasteurised and, Sterilised Milk) Regulations, 1949. These Regulations authorise the use of the designations "Pasteurised" and "Sterilised," and where "Tuberculin Tested" milk is subjected to either the pasteurising or sterilising process, the milk so treated may be sold as "Tuberculin Tested Milk (Pasteurised) "or " Tuberculin Tested Milk (Sterilised)." From 1st October, 1950, pasteurised milk is to be sold only in bottles or containers which have been filled on the premises of persons holding licences under the Regulations, and from 1st October, 1954, the bottles are to be filled only at pasteurising establishments. Where milk is pasteurised or sterilised on the premises of the applicant, the licence is to be granted by the Food and Drugs Authority, and all other licences by the local authority. The Council is, of course, the Food and Drugs Authority for the Borough, but at present there are no premises used for the pasteurising or sterilising process. The Milk (Special Designations) Act, 1949, under which the above Regulations are made, also provides that the Ministry of Food may, in any area where he is satisfied that there is an adequate supply of designated milk, restrict the sale of milk in that area to designated milk, It is probable, therefore, that in the near future it will be possible to purchase in the Borough, no milk except specially designated milk, and which is sold under the conditions laid down in the Regulations. Licences in force at the end of the year were as follows:— Dealers' Principal Licences To sell—"Pasteurised " milk 58 "Sterilised" milk 97 "Tuberculin Tested" milk 51 "Accredited" milk — Dealers' Supplementary Licences. (These licences enable applicants to sell milk in the Borough from premises outside the Borough on condition that they hold principal licences from the authorities concerned.) To sell—"Pasteurised" milk 16 "Sterilised" milk 17 "Tuberculin Tested" milk 16 "Accredited" milk 1 Milk and Dairies Regulations, 1949.—These Regulations, which came into operation on the 1st October, 1949, re-enact, with amendments, the Milk and Dairies Regulations, 1926-1943. The Minister of Agriculture and Fisheries becomes responsible for the registration of dairy farms and of persons carrying on the trade of dairy farmer. The execution and enforcement of the Regulations so far as dairy farms are concerned is the responsibility of the Minister except for those which relate to diseases communicable to man, this matter being still the concern of the local authority. The local authority is responsible for administering the provisions which relate to milk distributors who are not dairy farmers, and for the registration of dairies which are not dairy farms. 21 A medical officer of health may stop the sale of milk, or require it to be diverted for heat treatment, if there is evidence that it is infected with a disease communicable to man, and he may require milk to be heat treated if he has reasonable grounds for suspecting it to be so infected. The Regulations as to buildings, cleansing of vessels and utensils, distribution and prevention from contamination of milk have been revised and brought into line with modern thought and practice. Mineral Oil in Food Order, 1949.—The increasing use of medicinal paraffin in the preparation and composition of articles of food for sale to the public resulted in this Order being made. It came into operation on the 9th April, 1949, and prohibits the use of mineral oil in the composition or preparation of any article of food intended for human consumption. The presence of mineral oil not exceeding 0.2 parts by weight of the article of food is not deemed to be an offence where its presence is due, not to inclusion as an ingredient, but to its use as a lubricant or greasing agent on a surface with which the article of food necessarily comes into contact during preparation. In only one instance did analysis reveal the presence of soft paraffin in an article of food, but it did not constitute an offence against the Order, being less than 0.2 parts by weight and used only as a lubricating agent. Food and Drugs (Whalemeat) Regulations, 1949.—These Regulations came into force on the 20th March, and are designed, amongst other things, to secure observance of hygienic conditions in connection with the sale, transport and handling of whale meat. The importation of whale meat into England and Wales for human consumption is prohibited unless accompanied by a veterinary certificate, and the Regulations prescribe the manner in which uncertificated whale meat shall be dealt with. HOLIDAY HOME FOR ELDERLY PEOPLE.— As foreshadowed in my report for 1948, the Council completed arrangements for the establishment of a holiday home for elderly people on the 18th March, 1949, at "Kincardine," Brassey Road, Bexhill-on-Sea. The acquisition of this desirable property was eventually completed by agreement with the owner at a price of £7,450 and a figure of £1,200 was agreed for the purchase of the existing furniture, fittings, etc. Additional furniture, etc., required was purchased for £850 and after certain repair works costing approximately £223 were completed, the Holiday Home was ready for its first visitors on the 25th April, an achievement which was only made possible by the co-operation of all concerned. Full particulars of accommodation etc., were given in my report of 1948, but for purposes of record as well as information these are repeated hereunder:— Accommodation available for 16 visitors as follows:— Two double bedrooms for married couples; Five rooms each containing two single beds; Two single bedrooms. Situation— Faces east, within 100 yards of the sea front, and within easy reach of the Town's shopping centre and the railway station. Conditions of acceptance— Applicants must be residents of Paddington, and of pensionable age (i.e. men 65 years, women 60 years). Admission Fees— 21/- per week inclusive. (This fee is reduced to 15/- per week if the applicant is in receipt of a supplementary pension.) All fees must be fully paid by three weeks prior to the date of visit and can, if desired, be paid in instalments. Transport arrangements— These arrangements are the responsibility of the Old People's Welfare Committee, who have entered into a contract with the Maidstone and District Motor Services Limited, which provide for a motor coach to transport homecoming visitors from Bexhill to Paddington every Monday at 9.30 a.m., arriving at the Town Hall about 12.30 p.m. and returning at 1.30 p.m. with a fresh batch of visitors. Staff— The staff comprises Manageress (resident), Cook, Chambermaid/Waitress—all full time: domestic help and gardener/handyman—part.time. To cover any medical attendance that may be required from time to time, the services of Dr. R. P. Mills have been retained at a fee of £11 per annum. 22 The first party left for Bexhill on the 25th April, 1949 and from that date until 14th November, 442 visitors have been accommodated at the Home, an average of nearly 15 per week. At the invitation of His Worship the Mayor (Alderman J. E. MacColl, J.P.) the Mayor of Bexhill (Alderman W. H. Hughes, J.P.) kindly consented to preside at the official opening on the 25th April. Several distinguished guests were present including The Rt. Hon. George Buchanan—Chairman of the National Assistance Board. Members of the Bexhill and Paddington Borough Councils were present along with other persons interested in the welfare of the aged. From the 14th November to the 19th December, the Home was closed for cleaning and minor repairs, and was re-opened on the 19th December for a party of visitors to spend the Christmas period at the Home until 28th December. At this point, I must express my sincere thanks and appreciation to His Worshipful the Mayor, the Mayor of Bexhill the Bexhill Rotary Club, International Stores, Ltd., and an anonymous donor for contributions which enabled the old people to spend a very enjoyable Christmas at "Kincardine." That this venture has proved an unqualified success is amply confirmed by the constant flow of letters of appreciation. In addition, Paddington's lead in this field of social welfare for the aged has brought enquiries from other metropolitan and provincial councils desirous of considering the provision of a similar service. In view of the success which has attended the Council's first venture to assist the aged, and the fact that the accommodation at "Kincardine" is insufficient to cope with the increasing demand for this beneficial service, I trust that the hope expressed in my last Report to the Council that the establishment of this holiday home may prove to be a prelude to a considerable expansion of welfare work for the aged, will in time be realised. HOUSES UNFIT FOR HUMAN HABITATION.— No. of basement rooms dealt with by closing orders 207 No. of upper parts of mews premises closed for human habitation 2 No. of houses dealt with by demolition orders in respect of which undertakings were accepted 6 Sixty-seven persons were displaced as a result of the Council's operations, twenty.six being rehoused by the Paddington Borough Council and fourteen by the London County Council. Fourteen secured accommodation through their own efforts and thirteen are awaiting suitable Council vacancies. Closing orders were determined or undertakings cancelled on two basements and the upper parts of five mews premises made fit for human habitation during the year. Two houses were also wholly made fit following action under Section 11 of the appropriate Act. BASEMENT ROOM SURVEY.— In accordance with the Council's desire to prevent the reoccupation of unfit basement rooms, the District Sanitary Inspectors were requested to report to the Medical Officer of Health the existence of empty basement rooms on their districts. A number of basement rooms suitable for closure were brought to notice in this way many of which were subsequently closed for human habitation, whilst others were brought up to the required standard without recourse to formal proceedings. COMPULSORY REPAIRS.— Twenty Notices under Section 9 of the Housing Act, 1936, were served during the year. Seven Notices were complied with, and works were in progress at ten other premises. In one further case works are being undertaken by the Council in default, and at two other premises the works have not yet commenced. Four Notices served prior to 1949 have also been complied with during the year. HOUSING ACT, 1936—OVERCROWDING.— (a) (1) Number of dwellings overcrowded at the end of the year 527 (2) Number of families dwelling therein 597 (3) Number of persons dwelling therein 2192 (Units) (b) Number of new cases of overcrowding reported during the year 377 (c) (1) Number of cases of overcrowding relieved during the year 275 (2) Number of persons concerned in such cases 1137½ (Units) 23 (d) Particulars of any cases in which dwelling.houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil. (e) Any other particulars with respect to overcrowded conditions upon which the medical officer may consider it desirable to report Nil. The number of overcrowded dwellings on the Register of Overcrowding at the end of 1949 (527) shows an increase on the figure for 1948 (425). Some 133 of these were basement dwellings. Of the cases of overcrowding relieved during the year:— 26 were provided with accommodation by the Borough Council. 112 were rehoused by the London County Council. 95 secured accommodation privately, and 42 were relieved by a natural reduction in the size of the family or on obtaining additional accommodation. The practice of sending warning letters to owners and landlords against permitting the premises to become again overcrowded has been continued in all known cases where overcrowding of premises has been abated. HOUSING ACCOMMODATION : PREFERENTIAL TREATMENT.— Five families recommended for preferential consideration in the allocation of accommodation on medical grounds were rehoused by the Borough Council, seventeen by the London County Council, and five removed privately. FUMIGATION.— During the year Associated Fumigators, Limited, under an agreement with the Council, removed and treated the furniture etc., of four families with hydrogen cyanide gas. The cost of the work was £34 0s. 0d. Following a letter from the Associated Fumigators, Limited, stating that the amount of furniture per family is now greater than when they commenced this work, and that, as often occurs, removal into large blocks of flats makes it impossible to complete the work in an ordinary working day, thus necessitating overtime, the Council agreed to the fixed charge of £7 10s. 0d. a day, inclusive of van, three men and necessary materials, being increased to £8 10s. 0d. per day, as from the 1st January, 1949. NEW ACCOMMODATION.— Two small blocks of flats comprising 12 dwellings at Queen's Park Court (Peach Street Housing Scheme) were completed early in the New Year, and families selected from the Council's waiting list were rehoused therein.